Drug-induced liver injury in a Swedish University hospital out-patient hepatology clinic

BACKGROUND: Limited data exist on the proportion of drug-induced liver injury among out-patients seen in a hepatology clinic. AIM: To determine the proportion of drug-induced liver injury cases, and identify the most important agents and the nature of the liver injury. METHODS: A computerized diagnoses database in an out-patient hepatology clinic in a Swedish University hospital was analysed during the period 1995-2005. All suspected drug-induced liver injury cases were causality assessed with the International Consensus Criteria. RESULTS: A total of 1164 cases were seen for the first time during this period. Drug-induced liver injury with at least a possible causal relationship was found in 77 cases (6.6%), 38 (3.3%) of whom were referred for evaluation to the out-patient clinic whereas 3% had a follow-up after hospitalization of drug-induced liver injury. The median age was 58 years, 43 (56%) were females, a hepatocellular pattern was observed in 37 cases (48%), cholestatic in 31 (40%) and mixed in 12%. Antibiotics were the most common agents causing drug-induced liver injury followed by non-steroidal anti-inflammatory drugs, with diclofenac most often responsible for the drug-induced liver injury. CONCLUSIONS: Drug-induced liver injury cases constituted 6% of all out-patients and 3% of referrals and occurred more often in women. Antibiotics and diclofenac were the most common causes of drug-induced liver injury among out-patients.     

New potential antihistaminic compounds. Virtual combinatorial chemistry, computational screening, real synthesis, and pharmacological evaluation

To study the utility of the virtual combinatorial chemistry coupled with computational screening, a library of amine and urea derivatives was designed by virtual combinatorial synthesis and eventually computationally screened by a mathematical topological model as antihistaminic compounds. The results reveal that virtual combinatorial synthesis and virtual screening together with molecular topology are a powerful tool in the design of new drugs.     

Community diagnosis of common skin diseases in the Zay community of the Zeway Islands, Ethiopia

BACKGROUND: Skin diseases are common public health problems throughout the world. Studies on skin problems are rare in Ethiopia. Easy and cheap methods of identifying skin conditions in the community are poorly developed in the country. OBJECTIVES: (1) To assess whether the newly developed Dermatological Screening Questionnaire (DSQ) can be used to effectively screen for common skin diseases and (2) to estimate the prevalence of skin diseases in a rural community. METHODS: A cross-sectional survey was conducted in the rural community residing on the islands of Lake Zeway. A locally prepared nine-item questionnaire (the DSQ) was used by lay-interviewers to screen for common skin diseases. Any respondent giving one or more positive responses, and a further 104 people who had replied negatively, underwent confirmatory diagnosis by specialist dermatologists. RESULTS: A total of 4697 people were included in the survey. Of these, 992 (20.0%) respondents screened positive on the DSQ. Out of 62.5% (N = 620) examined by dermatologists, 98.6% (n = 611) were found to have one or more skin conditions. Amongst screen negatives, 10.6% had skin diseases. Sensitivity and specificity of the DSQ was found to be 98% and 91%, respectively. The weighted prevalence of clinically-confirmed skin disease was 22.5%. Scabies was the most common of all skin conditions, followed by fungal infections. CONCLUSION: Our survey revealed that easily preventable and treatable skin diseases are common in this rural community. Nearly all those who gave a positive response to the DSQ had one or more skin disease confirmed on clinical examination. This finding indicates that the DSQ is a useful instrument for identification of common skin diseases in the community.     

Most HIV type 1 non-B infections in the Spanish cohort of antiretroviral treatment-naïve HIV-infected patients (CoRIS) are due to recombinant viruses

HIV-1 group M is classified into 9 subtypes, as well as recombinants favored by coinfection and superinfection events with different variants. Although HIV-1 subtype B is predominant in Europe, intersubtype recombinants are increasing in prevalence and complexity. In this study, phylogenetic analyses of pol sequences were performed to detect the HIV-1 circulating and unique recombinant forms (CRFs and URFs, respectively) in a Spanish cohort of antiretroviral treatment-naïve HIV-infected patients included in the Research Network on HIV/AIDS (CoRIS). Bootscanning and other methods were used to define complex recombinants not assigned to any subtype or CRF. A total of 670 available HIV-1 pol sequences from different patients were collected, of which 588 (87.8%) were assigned to HIV-1 subtype B and 82 (12.2%) to HIV-1 non-B variants. Recombinants caused the majority (71.9%) of HIV-1 non-B infections and were found in 8.8% of CoRIS patients. Eleven URFs (accounting for 13.4% of HIV-1 non-B infections), presenting complex mosaic patterns, were detected. Among them, 10 harbored subtype B fragments. Four of the 11 URFs were found in Spanish natives. A cluster of three B/CRF02_AG recombinants was detected. We conclude that complex variants, including unique recombinant forms, are being introduced into Spain through both immigrants and natives. An increase in the frequency of mosaic viruses, reflecting the increasing heterogeneity of the HIV epidemic in our country, is expected.     

'Inverse' temporomandibular joint dislocation

Temporomandibular joint (TMJ) dislocation can be classified into four groups (anterior, posterior, lateral, and superior) depending on the direction of displacement and the location of the condylar head. All the groups are rare except for anterior dislocation. ‘Inverse’ TMJ dislocation is a bilateral anterior and superior dislocation with impaction of the mandible over the maxilla; to the authors’ knowledge only two cases have previously been reported in the literature. Inverse TMJ dislocation has unique clinical and radiographic findings, which are described for this case.     

Characterization and Properties of Poly[N‐(2‐cyanoethyl)pyrrole]

PNCPy was prepared by anodic polymerization and its properties in both doped and undoped state were characterized. The doping level of the oxidized material has been found to be larger than that of other conducting polymers; the more relevant electrochemical properties of the doped material were retained after undoping. SEM and AFM data are consistent with a lumpy surface and a multidirectional growing of the polymer chains. Finally, PNCPy has been combined with PEDOT to prepare three‐layer systems with enhanced electroactivity and electrostability. Results suggest that PNCPy is a potential candidate for the fabrication of electric circuit components that are able to block the current flow below a given potential.

     

Detection of Bacillus anthracis spore germination in vivo by bioluminescence imaging

We sought to visualize the site of Bacillus anthracis spore germination in vivo. For that purpose, we constructed a reporter plasmid with the lux operon under control of the spore small acid-soluble protein B (sspB) promoter. In B. subtilis, sspB-driven synthesis of luciferase during sporulation results in incorporation of the enzyme in spores. We observed that B. anthracis Sterne transformed with our sspBp::lux plasmid was only luminescent during germination. In contrast, Sterne transformed with a similarly constructed plasmid with lux expression under control of the protective antigen promoter displayed luminescence only during vegetative growth. We then infected A/J mice intranasally with spores that harbored the germination reporter. Mice were monitored for up to 14 days with the Xenogen In Vivo Imaging System. While luminescence only became evident in live animals at 18 h, dissection after sacrificing infected mice at earlier time points revealed luminescence in lung tissue at 30 min after intranasal infection. Microscopic histochemical and immunofluorescence studies on luminescent lung sections and imprints revealed that macrophages were the first cells in contact with the B. anthracis spores. By 6 h after infection, polymorphonuclear leukocytes with intracellular spores were evident in the alveolar spaces. After 24 h, few free spores were observed in the alveolar spaces; most of the spores detected by immunofluorescence were in the cytoplasm of interstitial macrophages. In contrast, mediastinal lymph nodes remained nonluminescent throughout the infection. We conclude that in this animal system, the primary site of B. anthracis spore germination is the lungs.