Systemic oxidative stress in children with cystic fibrosis with bacterial infection including Pseudomonas Aeruginosa

IntroductionOxidative stress (OS) occurs in cystic fibrosis (CF).ObjectiveThe objective of this work is to evaluate the influence of bacterial infection on biomarkers of OS (catalase [CAT], glutathione peroxidade [GPx], reduced glutathione [GSH]), markers of oxidative damage (protein carbonyls [PC], thiobarbituric acid reactive substances [TBARS]), together with the nutritional status and lung function in children with CF.MethodsCross‐sectional study including CF group (CFG, n = 55) and control group (CG, n = 31), median age: 3.89 and 4.62 years, respectively. CFG was distributed into CFG negative bacteriology (CFGB−, n = 27) or CFG positive bacteriology (CFGB+, n = 28), and CFG negative Pseudomonas aeruginosa (CFGPa−, n = 36) or CFG positive Pseudomonas aeruginosa (CFGPa+, n = 19).ResultsCompared with CG, CFG (P = .034) and CFGB+ (P = .042) had lower body mass index‐for‐age z‐score; forced expiratory volume in the first second was lower in CFGB+ and CFGPa+ (both P < .001). After adjusting for confounders and compared with CG: CFG showed higher TBARS (P ≤ .001) and PC (P = .048), and lower CAT (P = .004) and GPx (P = .003); the increase in PC levels was observed in CFGB+ (P = .011) and CFGPa+ (P = .001) but not in CFGB− (P = .510) and CFGPa− (P = .460).ConclusionsThese results indicate a systemic OS in children with CF. The presence of bacterial infection particularly Pseudomonas aeruginosa seems to be determinant to exacerbate the oxidative damage to proteins, in which PC may be a useful biomarker of OS in CF.     

Technetium 99m-DTPA microcapsules: a new preparation for gastric emptying studies

Technetium 99m-DTPA microcapsules have been developed to measure gastric emptying. Such capsules not only provide high labeling efficiency in vitro, but demonstrate limited dissociation in vivo, resulting in decreased error during measurement. In normal control subjects, the half-life ranged from 40 to 80 minutes under the aforementioned conditions.     

Bypass enteritis. A new complication of jejunoileal bypass for obesity.

Four patients who had jejunoileal bypass for morbid obesity had increased frequency of diarrhea, diffuse abdominal tenderness and distention, and fever to 104 degrees F. Roentgenographic studies disclosed multiple distended loops in the bypassed bowel with few air fluid levels. Two of these patients underwent operation for suspected peritonitis from abscess or obstruction. No abscess or mechanical obstruction was found. The bypassed bowel contained many subserosal gas-filled blebs. The remaining two patients were treated with antibiotics and showed prompt improvement. "Bypass enteritis" must be considered in the postoperative period in patients undergoing surgery for morbid obesity. It responds to antibiotics and appropriate electrolyte therapy. The presumed factor is overgrowth of enteric bacteria in the distal portion of the bypassed bowel. Accurate diagnosis will obviate the need for surgical exploration to exclude peritonitis.     

Simultaneous foveal and parafoveal electroretinograms in hereditary degeneration of the central retina

Simultaneous foveal and parafoveal electroretinograms (ERG) in response to two identical checks (6 degrees per side) alternating at constant mean luminance were recorded in 26 patients (52 eyes) affected by central hereditary chorioretinal diseases and in 14 age-matched normal subjects (14 eyes). Patients were divided into four groups according to clinical diagnoses: 1. Stargardt's disease; 2. cone dystrophy; 3. vitelliform degeneration; 4. pattern dystrophy. The amplitude and latency of the foveal ERG and the amplitude ratio between foveal and parafoveal ERG (FPF ratio) were measured. The mean foveal ERG amplitude was significantly lower than the control mean in all patient groups. The foveal ERG latency showed a trend to a increase in all pathological groups. However, this difference was not statistically significant. The mean value of FPF ratio was significantly reduced as compared with the control mean in Stargardt's disease and cone dystrophy only. In 46 of 52 affected eyes (88.5%) at least one of the electrophysiological parameters was abnormal. Our results suggest that the simultaneous foveal and parafoveal ERG recording may be a sensitive technique in hereditary degenerations of the central retina. This method may also contribute to a better understanding of cone degeneration pathophysiology.     

Emulsification preparation of chitosan–urethane microbeads in the presence of a water-soluble blocked diisocyanate,containing furanone homosyrine lactone bacterial inhibitors

Chitosan is an abundant naturally occurring biopolymer that is biocompatible, of low toxicity and is well suited as a carrier for a range of active agents. Restrictions imposed by this biopolymers unique solubility requirements make if difficult to process. One approach to an internal setting system is to employ the water-soluble blocked isocyanate hexamethylene-1,6-di(aminocarboxysulphonate) (HDACS) in order to cross-link the chitosan and form microspheres in situ utilizing simple emulsion systems. Chitothane microspheres are capable of delivering active agents at controlled release rates and offers a viable alternative to external set methodologies utilizing aldehydes or similar cross-linking agents.     

Outpatient seizure identification: results of 502 patients using computer-assisted ambulatory EEG.

Patients with epilepsy may not always be able to identify their seizures. Epilepsy management relies on patient reporting to validate whether seizures occur during treatment. The goal of this study was to assess the frequency of unreported seizures recorded during routine outpatient ambulatory EEG recording. The authors reviewed 552 records from 502 patients who underwent outpatient 16-channel computer-assisted ambulatory EEG monitoring (CAA-EEG). Seizure identification was evaluated by assessing push-button activation. Partial seizures were seen most commonly. A total of 47 of 552 records (8.5%) had partial seizures recorded on CAA-EEG, with 29 of 47 (61.7%) with electroclinical seizures identified by push-button activation. Seizures on EEG without push-button activation were analyzed separately and compared with a self-reported written diary to verify lack of recognition. A total of 18 of 47 records (38.3%) had some partial seizures that were unrecognized by the patient, and 11 of 47 records (23.4%) had seizures recognized only by the computer. The authors conclude that patients frequently have seizures outside of the hospital that go unrecognized. Underreporting of seizure frequency occurs in the outpatient setting and impacts optimal diagnosis and treatment for patients with epilepsy.     

Developing a new endograft for the treatment of juxtarenal aortic aneurysms: definition and experimentation

OBJECTIVES:To analyze angiotomographic parameters of juxtarenal aneurysms to assess the applicability of an endograft model to patients and to create in vitro and in vivo models to assess the new endograft.METHODS:A total of 49 patients with juxtarenal aneurysms were submitted to angiotomographic evaluation, and parameters such as the aortic diameter, the length of the neck, and the angulations of the celiac trunk, superior mesenteric artery and renal arteries; the distances between them; and anatomic variations were analyzed. Based on these parameters, an endograft model was developed and tested in a newly created in vitro model of juxtarenal aneurysm. An experimental model of juxtarenal aneurysm was then established in six pigs weighing 50–60 kg to assess the new endograft model.RESULTS:The angiotomographic parameters of juxtarenal aneurysm measured in this study were similar to those reported in the literature and allowed the development of an endograft based on the hourglass concept, which was applicable to 85.8% of the patients. The in vitro model of juxtarenal aneurysm evidenced good radiopacity and functionality and permitted adjustments in the new device and technical improvements in the procedures for treating these aneurysms. In addition, the porcine model of juxtarenal aneurysm was successfully created in all six animals using a bovine pericardial patch, and use of the new endograft in three pilot procedures evidenced its feasibility.CONCLUSIONS:The Hourglass endograft was rendered applicable to treatment of the majority of patients with juxtarenal aneurysms simply by changing its diameter. Moreover, the new in vitro and in vivo models were shown to be effective for assessing both the presented endograft and experiments assessing the endovascular treatment of juxtarenal aneurysms.     

Economic Cost and Burden of Dengue in the Philippines

Dengue, the world''s most important mosquito-borne viral disease, is endemic in the Philippines. During 2008–2012, the country''s Department of Health reported an annual average of 117,065 dengue cases, placing the country fourth in dengue burden in southeast Asia. This study estimates the country''s annual number of dengue episodes and their economic cost. Our comparison of cases between active and passive surveillance in Punta Princesa, Cebu City yielded an expansion factor of 7.2, close to the predicted value (7.0) based on the country''s health system. We estimated an annual average of 842,867 clinically diagnosed dengue cases, with direct medical costs (in 2012 US dollars) of $345 million ($3.26 per capita). This is 54% higher than an earlier estimate without Philippines-specific costs. Ambulatory settings treated 35% of cases (representing 10% of direct costs), whereas inpatient hospitals served 65% of cases (representing 90% of direct costs). The economic burden of dengue in the Philippines is substantial.