Mycobiota and mycotoxins (aflatoxins and ochratoxin) associated with some Saudi date palm fruits

This study aimed to determine the mycological profile of the retail date fruits distributed in different markets at Taif, Saudi Arabia. The presence of aflatoxins and ochratoxin A was also measured. Twenty-two fungal species belonging to 12 genera were isolated from 50 different date samples. Aspergillus flavus, A. niger, Penicillium chrysogenum, and Rhizopus stolonifer were the most prevalent species among isolated fungi. Eighty isolates of A. flavus and 36 of A. niger were detected for their aflatoxins and ochratoxin production potentials using thin layer chromatography. Toxicity test using Artimia larvae indicated that seven out of 18 A. flavus isolates had aflatoxins potentials, while nine out of 36 isolates of A. niger were ochratoxigenic. The quadruplex polymerase chain reaction using specific primers demonstrated the presence of four genes: nor A, ver 1, omt A, and avf A in seven A. flavus toxigenic isolates. Nine A. niger toxigenic isolates showed positive results for the presence of the PKS gene. In conclusion, the present study highlighted the potential hazards of mycotoxins on human health from consuming raw dates. Rapid molecular detection methods described here might help the food authorities to assure the safety of raw dates distributed in local markets.     

Nutritional and socio-economic determinants of cognitive function and educational achievement of Aboriginal schoolchildren in rural Malaysia

A community-based cross-sectional study was carried out among Aboriginal schoolchildren aged 7-12 years living in remote areas in Pos Betau, Pahang, Malaysia to investigate the potential determinants influencing the cognitive function and educational achievement of these children. Cognitive function was measured by intelligence quotient (IQ), while examination scores of selected school subjects were used in assessing educational achievement. Blood samples were collected to assess serum Fe status. All children were screened for soil-transmitted helminthes. Demographic and socio-economic data were collected using pre-tested questionnaires. Almost two-thirds (67·6?%) of the subjects had poor IQ and most of them (72·6?%) had insufficient educational achievement. Output of the stepwise multiple regression model showed that poor IQ was significantly associated with low household income which contributed the most to the regression variance (r2 0·059; P?=?0·020). Low maternal education was also identified as a significant predictor of low IQ scores (r2 0·042; P?=?0·043). With educational achievement, Fe-deficiency anaemia (IDA) was the only variable to show significant association (r2 0·025; P?=?0·015). In conclusion, the cognitive function and educational achievement of Aboriginal schoolchildren are poor and influenced by household income, maternal education and IDA. Thus, effective and integrated measures to improve the nutritional and socio-economic status of rural children would have a pronounced positive effect on their education.     

多中心随机对照试验：再生复原技术治疗各种开放性创面的疗效评价

目的 评估再生疗法( MEBT/MEBO)治疗各种急慢性开放性创面的安全性和有效性.方法 将2007年1月至2012年1月期间因各种开放性创伤就诊于3家不同医院的276例患者(376处创面)随机分组,接受 MEBT/MEBO治疗(1组:患者141例,创面190处)或生理盐水湿敷治疗(2组:患者135例,创面186处).前瞻性收集人口统计学、诱发疾病、合并症和创面特征等数据;每隔2周计算和对比创面面积和愈合指数,持续12周;记录治疗后24周的二次截肢情况.结果 开放性创伤包括慢性褥疮(202处)、糖尿病足溃疡(119处)和各种其它创面(55处).受试患者中171例(63%)为男性,105例(37%)为女性;年龄介于5~102岁,平均年龄63岁±14.5岁.两组患者在人口统计学、临床特点、生化检查和创面特征方面接近. MEBT/MEBO治疗组在治疗2周时,其愈合指数显著升高、创面面积显著缩小;在12周时, MEBT/MEBO组中66.3%(126/190)的创面实现了完全愈合( HI=1),而生理盐水湿敷组仅22.6%(42/186)的创面完全愈合(χ2=71.4, P=0.000).治疗12周时, MEBT/MEBO组无1例患者的愈合指数<0.5;而生理盐水湿敷组38.7%(72/186)的患者愈合指数<0.5(χ2=165, P=0.000).两组患者均无不良反应或过敏反应发生.治疗后24周,与生理盐水湿敷组相比, MEBT/MEBO治疗组的二次截肢率明显降低(3.3%∶19.0%)(χ2=7.52, P=0.006).结论 MEBT/MEBO不仅操作简便、使用安全,还能显著促进开放性创面的愈合,治疗2周就可显著提高创面愈合指数,12周时几乎2/3的创面可完全愈合,24周时糖尿病足溃疡患者中发生二次截肢的患者明显减少.     

Prevalence and predictors of low serum retinol and hypoalbuminaemia among children in rural Peninsular Malaysia

Vitamin A deficiency and malnutrition are still considered public health problems in rural areas of developing countries, including Malaysia. A cross-sectional exploration study was carried out on 281 Orang Asli (Aborigine) children aged between 2 and 15 years in Selangor, Malaysia. The overall prevalence of low serum retinol (<70 micromol/l) and hypoalbuminaemia (<35 g/l) were 25.2 and 7.8%, respectively. Univariate analysis showed that severe ascariasis, significant stunting and giardiasis were significantly associated with low concentration of serum retinol. As well as intestinal parasitic infections, low socio-economic status was a significant predictor of hypoalbuminaemia. Logistic regression analysis identified severe ascariasis and significant stunting as predictors of low serum retinol, while mixed intestinal parasitic infection and low household income were predictors of hypoalbuminaemia. In conclusion, control measures for intestinal parasitic infections should be included as one of the strategies for the prevention and control of malnutrition and vitamin A deficiency in this population.     

Selective spectrophotometric determination of phenolic β-lactam antibiotics

Two simple and selective spectrophotometric methods were developed for the quantitative determination of cefoperazone sodium, cefadroxil monohydrate, cefprozil anhydrous and amoxicillin trihydrate in pure forms as well as in their pharmaceutical formulations. The methods are based on the selective oxidation of these drugs with either Ce (IV) or Fe (III) in acid medium to give an intense yellow coloured product (λ_max=397 nm). The reaction conditions were studied and optimized. Beer's plots were obeyed in a general concentration range of 5–30 μg ml⁻¹ with correlation coefficients not less than 0.9979 for the four drugs with the two reagents. The methods are successfully applied to the analysis of pharmaceutical formulations containing amoxicillin, either alone or in combination with potassium clavulanate, flucloxacillin or dicloxacillin. They were also applied to the analysis of the other three studied drugs in vials, capsules, tablets and suspensions with good recovery; percent ranged from 99.7 (±0.46) to 100.32 (±1.05) in the Ce (IV) method and 99.6 (±0.50) to 100.3 (±1.32) in the Fe (III) method. Interferences from other antibiotics and additives products were investigated.     

Study of factor VII, tissue factor pathway inhibitor and monocyte tissue factor in noninsulin-dependent diabetes mellitus.

Changes in plasma tissue factor (TF)-activated factor VII (FVIIa) and plasma tissue factor pathway inhibitor (TFPI) in type II diabetes mellitus are assessed, vascular complicated and noncomplicated patients compared, and whether these novel hemostatic activity markers predict vascular complications in diabetic patients, improving risk assessment, is determined. Fifty type II diabetic patients and 20 healthy controls (age, sex and body mass matched) underwent medical history and examination, fasting plasma glucose level, glycosylated hemoglobin (HbA1c), lipid profile, hemostatic parameters, plasma TF activity, and TFPI and TF expression on blood monocytes. Mean TF, TF activity, TFPI, and FVIIa significantly increased among hyperlipidemic compared with normolipidemic diabetic patients, and normolipidemic diabetic patients compared with controls. Mean percentage TF-positive monocytes with and without lipopolysaccharide, plasma TF activity, TFPI and FVIIa were significantly higher among complicated than noncomplicated diabetic patients. Mean percentage TF-positive monocytes without and with lipopolysaccharide, plasma TF activity, plasma TFPI and FVIIa were higher among diabetic patients with macrovascular compared with microvascular complications. High significant correlation occurred between HbA1c, triglycerides and percentage TF-positive monocytes with and without lipopolysaccharide stimulation, plasma TF activity and both FVIIa and TFPI. High activity levels of plasma TF and FVIIa with increased circulating TF-positive monocytes occurred in type II diabetic patients, especially with vascular complications. Results reflect high procoagulant activity possibly involved in diabetic vascular complications. Elevated TFPI levels were observed, but were not sufficient to balance high procoagulant activity. Correlation of procoagulant activity markers with HbA1c reinforces the importance of optimal glycemic control in type II diabetes.     

Patterns of hepatocellular carcinoma incidence in Egypt from a population-based cancer registry.

Aim: Hepatocellular carcinoma (HCC) is increasing worldwide, and is frequently attributed to rising rates of hepatitis C virus infection and interactions between viral and environmental risk factors. Because of Egypt's unique risk factor profile, we analyzed data from the Gharbiah Population-Based Cancer Registry for the period 1999-2003 to characterize demographic and geographic patterns of cases in this province. Methods: We calculated age- and sex-specific and age- and sex-standardized HCC incidence rates for the eight districts in Gharbiah. We also compared rates from Gharbiah with the USA (US Surveillance Epidemiology and End Results [SEER] database). Results: The analysis revealed a higher incidence in males than in females, significant geographic variations among districts, and a higher incidence in Gharbiah than that reported by SEER. Conclusion: The findings of this study document the heterogeneous distribution of HCC at regional and international levels. This population-based registry offers the opportunity for careful representative studies of various etiologies, particularly infectious and/or environmental factors that may contribute to risk.     

Presentation and management of symptomatic central bone cement embolization

Background context

With more cement augmentation procedures done, the occurrence of serious complications is also expected to rise. Symptomatic central cement embolization is a rare but very serious complication. Moreover, the pathophysiology and treatment of intrathoracic cement embolism remain controversial.

Purpose

In this case series, we are trying to identify various presentations and suggest our emergent management scheme for symptomatic central cement embolization.

Patient sample

Retrospective case series of nine patients with symptomatic central cement embolism identified after vertebroplasty with 24 months of follow-up. Level IV.

Outcome measures

The degree of dyspnea measured by the New York Heart Association (NYHA) score and/or death related to cement embolism induced cardio/respiratory failure at the final follow-up at 24 months.

Methods

The nine patients, eight females, and one male had a mean age of 70.25 years (range 65–78 years) and were operated between January 2004 and December 2014. They had percutaneous vertebroplasty for osteoporotic non-traumatic and malignant vertebral collapse of dorsal and lumbar vertebrae. Post-vertebroplasty dyspnea and stitching chest pain were striking in the nine patients. After exclusion of cardiac ischemia and medical pulmonary causes for dyspnea, we identified radiopaque lesions on the chest X-ray. Further echocardiography and high-resolution chest CT were performed for optimal localization. Emergent heart surgery was performed in two patients: interventional therapy was conducted in one patient, while the remaining six patients were conservatively treated by anticoagulation. The management decision was taken in the setting of an interdisciplinary meeting depending on localization, fragmentation, and clinical status.

Results

All patients of this series showed gradual improvement and an uneventful hospital stay. During our 24-month follow-up phase, eight patients showed no subsequent cardiological and/or respiratory symptoms (NYHA I). However, one mortality due to advanced malignancy occurred. Preoperative anemia was the only common intersecting preoperative parameter among these nine patients.

Conclusions

After cement augmentation, close clinical monitoring is mandatory. A chest CT is pivotal in determining the interdisciplinary management approach in view of the availability of necessary expertise, facilities and the location of the cement emboli whether accessible by cardiac or vascular surgical means. The clinical presentation and its timing may vary and the patient may be seen subsequently by other health care providers obligating a wide-spread awareness for this serious entity among health care providers for this age group as spine surgeons, family and emergency room doctors, and institutional or home-care nurses. Most symptomatic central cement emboli may be treated conservatively.