The usefulness of prostate specific antigen density as a screening method for prostatic carcinoma

Prostate specific antigen (PSA) has been used extensively for monitoring the progression of prostatic cancer since its discovery in 1979. Unfortunately the measurement of PSA in serum is not sufficiently specific for early detection of prostatic carcinoma (CaP) as it is secreted by normal as well as hyperplastic or cancerous prostatic tissue. As serum PSA is the reflection of the number of prostatic epithelial cells, a small cancerous prostate gland having increased number of cells per unit volume leaks more PSA in serum than a benign, large gland. Thus the concept of PSA density (PSAD) has been proposed (the quotient of serum PSA divided by the volume of prostate in cubic centimeter) as an indicator for prostatic malignancy. In the present study pre-operative PSAD values of 65 cases of prostatic diseases were calculated [54 cases of benign prostatic hyperplasia (BPH) and 11 cases of C3P]. Serum PSA was measured by enzyme linked immunosorbent assay (ELISA) method and the prostatic volume was measured by transrectal ultrasonography (TRUS). Although 8 cases of BPH (14.8%) had raised PSA level, abnormal PSAD (0.1 or above) was noted in only 3 cases. All cases having PSAD value above 0.2 had carcinoma. The PSAD value above 0.1 in cases of CaP was found to be significant (p<0.001). By using PSAD as screening test the sensitivity increased from 85.1% to 94.4% and positive predictive value increased from 55.5% to 75%, compared to the detection of carcinoma by measuring PSA alone. The present study concludes that PSAD is more useful for prediction of CaP and the need of prostatic biopsy for early detection.     

Candida colonization and candidemia in a pediatric intensive care unit.

OBJECTIVE: To evaluate role of Candida colonization in development of candidemia and to identify risk factors associated with Candida colonization and candidemia in children treated for severe sepsis or septic shock in a pediatric intensive care unit (PICU) for >5 days. DESIGN: Prospective observational. SETTING: PICU of a tertiary care teaching hospital. SUBJECTS: Of 186 children, aged 1 month to 14 yrs, consecutively admitted to PICU for severe sepsis or septic shock, 65 patients having a stay of >5 days. INTERVENTIONS: Clinical and demographic data at admission and variables likely to influence Candida colonization were recorded. Oropharyngeal, rectal, and skin (groin) swabs were taken on days 0, 2, 5, and 7 of admission. Blood for fungal culture (two samples 48 hrs apart) was obtained if a patient developed signs of sepsis. The yeast growth was identified by conventional methods. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated, and multivariate logistic regression analysis was conducted. MEASUREMENTS AND MAIN RESULTS: Colonization by Candida species occurred in 45 (69%) patients. Oropharyngeal (52%) and rectal (43%) colonization was more common than skin (34%) colonization. The colonizing species were C. tropicalis (34.2%), C. parapsilosis (28.8%), C. albicans (14.4%), and others. Use of central venous catheters was the only independent predictor of colonization on multivariate logistic regression (OR 4.1; 95% CI 1.01-17.1). Twenty (30.2%) patients developed candidemia; 18 (90%) of them were colonized, 15 (75%) with the same Candida species. Independent predictors of candidemia on multivariate stepwise logistic regression analysis were presence of colonization (OR 5.1; 95% CI 1.01-25.6, p = .048) and Pediatric Risk of Mortality score (OR 1.3; 95% CI 1.02-1.6, p = .034). CONCLUSIONS: Monitoring for colonization with Candida species in children undergoing treatment for severe sepsis or sepsis shock in PICU for >5 days may offer opportunity for early intervention for prevention of candidemia.     

Toxicity and bioaccumulation of nickel sulfate in Sprague-Dawley rats following 13 weeks of subchronic exposure.

Adult male Sprague-Dawley rats were given 0, 0.02, 0.05, and 0.1% nickel sulfate (NiSO4-6H2O) or 0, 44.7, 111.75, and 223.5 mg Ni/L, respectively, in their drinking water for 13 wk. Twenty-four hours following the end of such treatment, all animals survived and no apparent clinical signs of toxicity were noted. The final mean body weights of various nickel sulfate-treated rats were not significantly decreased except for the 0.1% nickel sulfate treated group when compared to those in the control. The absolute and relative organ weights were either increased or decreased or remained unchanged, depending on the organ and the dose of nickel sulfate. Total plasma proteins, plasma albumin and globulins, and plasma glutamic pyruvic transaminase activity were all significantly decreased in 0.1% nickel sulfate-treated rats. Lymphocyte subpopulations (T and B cells) were induced at lower dose levels, but suppressed at the highest (0.1%) dose group. A significant decrease in urine volume and an increase in BUN were observed at the highest dose group. Biochemical analysis of bronchoalveolar lavage fluid and lung tissue showed some lung damage, whereas no damage to the testis or DNA in liver and kidneys were found. No gross or microscopic changes were seen in any of the various tissues examined. The relative order of bioaccumulation of nickel in different organs of rats when treated at 0.1% nickel sulfate (223.5 mg Ni/L) was kidneys > testes > lung = brain > spleen > heart = liver. But with regard to order of toxicity, both immune and pulmonary systems were found to be very sensitive targets, followed by kidney.     

An observational study on neurobehavioural effects of acute oxydemeton-methyl (insecticide and acaricide) exposure in rats

Oxydemeton-methyl, an organophosphate insecticide and acaricide produced decrease in the exploratory behaviour and prolongation of barbitone sodium-induced hypnosis after intermittent aerosol spray inhalational exposure for 1 h in rats compared to the saline control group. Further, CD50 +/- S.E.M. value for pentylenetetrazole (PTZ) and CI50 +/- S.E.M. value for electroshock (i.e. the dose of PTZ and intensity of electroshock producing positive seizure response in 50% of rats) were significantly decreased by acute exposure to oxydemeton-methyl compared to that of saline control group. The study has established the central nervous system depressant effect and proconvulsant potential of oxydemeton-methyl which is widely used by the agricultural workers in the form of field spray.     

Accountability for the human right to health through treaty monitoring: Human rights treaty bodies and the influence of concluding observations

Employing novel coding methods to evaluate human rights monitoring, this article examines the influence of United Nations (UN) treaty bodies on national implementation of the human right to health. The advancement of the right to health in the UN human rights system has shifted over the past 20 years from the development of norms under international law to the implementation of those norms through national policy. Facilitating accountability for this rights-based policy implementation under the right to health, the UN Committee on Economic, Social and Cultural Rights (CESCR) monitors state implementation by reviewing periodic reports from state parties, engaging in formal sessions of ‘constructive dialogue’ with state representatives, and issuing concluding observations for state response. These concluding observations recognise the positive steps taken by states and highlight the principal areas of CESCR concern, providing recommendations for implementing human rights and detailing issues to be addressed in the next state report. Through analytic coding of the normative indicators of the right to health in both state reports and concluding observations, this article provides an empirical basis to understand the policy effects of the CESCR monitoring process on state implementation of the right to health.     

Reduced number of anionic sites is associated with glomerular basement membrane thickening in the diabetic BB-rat

Summary Glomerular basement membranes of diabetic and age- and sex-matched non-diabetic BB rats were studied morphometrically and ultrastructurally using a quantitative histochemical technique employing the cationic dye cuprolinic blue. Six months of diabetes resulted in a significant reduction in the density of anionic sites associated with increased thickness of the glomerular basement membrane. These findings suggest that loss of anionic sites may be an important mechanism in the genesis of glomerular basement membrane dysfunction in diabetes.     

Toxin production by atypical strains of Vibrio cholerae E1 Tor under different cultural conditions

It was observed that at 37 degrees C under in vitro conditions, aerobic culture filtrates of a few strains of Vibrio cholerae biotype El Tor isolated from diarrhoeal cases produced a minute amount of toxin which failed to elicit a positive ileal loop reaction like toxigenic strains. Thus, these strains showed an atypical behaviour in their toxin producing ability. At 25 degrees C and 30 degrees C under aerobic cultural conditions enhanced toxin production was noticed in toxigenic strains, but these temperatures did not affect the toxigenicity of the atypical strains. The atypical Vibrio cholerae El Tor strains exhibited enhanced toxin production only at 37 degrees C under anaerobic conditions and the amount of toxin produced was akin to those of the toxigenic strains. In comparison to aerobic conditions, growth was observed to be comparatively lower under anaerobiosis both in the toxigenic and atpyical V. cholerae strains. Moreover, in contrast to the toxigenic strains, the toxin did not remain membrane-bound in these atypical strains at 37 degrees C and aerobic cultural conditions.