Water-related vector-borne diseases

Land planning and engineering before construction can do much to control the water-related, vector-borne diseases schistosomiasis, malaria and filariasis. An example of control through land planning is buffer strips between habitations and water sources. Engineering controls involve regulation of water drainage and flow. The best way to control schistosomiasis, which is transmitted by human feces and urine released into freshwater, is to provide sanitation. In addition, it is helpful to speed the flow rate of streams, and to clear aquatic vegetation from irrigation canals. Engineering to control malaria means draining or filling areas that tend to collect water, especially if wastewater collects there. This will aid the usual malaria control techniques such as spraying houses, using bed nets taking prophylactic medication, and clearing refuse that can retain standing water. Filariasis, also spread by mosquitos, can be controlled by eliminating standing or slow-moving streams of contaminated water, speeding its flow rate, and providing sanitation to keep water clean, and latrines that do not flood. The health implications of development must be addressed before construction, not by more expensive vector control afterward.     

Evaluation of treatment options for postoperative and spontaneous chylothorax in adults

Open in a separate window OBJECTIVESBoth postoperative and spontaneous chylothorax remain therapeutic challenges without recommendations for a standardized treatment approach. Regardless of its aetiology, patients with chylothorax experience prolonged hospitalization and suffer from the associated complications or the invasive therapy administered.METHODSWe conducted a retrospective, observational review of adult patients with chylothorax treated between January 2010 and September 2019. The primary end point was successful management with sustained cessation and/or controlled chylous output. Therapy duration, inpatient stay and the incidence of complications were evaluated as secondary end points.RESULTSOf the 36 patients included (22 men; median age 63 years), 24 patients (67%) suffered from a postoperative accumulation of chylous fluid in the pleural space; in the remaining 12 (33%) patients, chylothoraces occurred spontaneously. Initial conservative treatment was successful in 42% (n = 15); in the other 20 cases (56%) additional invasive therapeutic strategies were followed. A complicated course requiring more than 1 treatment was seen in 54% (n = 13) of the postoperative and in 58% (n = 7) of the spontaneous cases. The median length of hospitalization was significantly longer in the postoperative group (37.5 vs 15.5 days; P = 0.016). Serious complications were observed only in the postoperative group (P = 0.28). There were no in-hospital deaths.CONCLUSIONSBasic treatment of both postoperative and spontaneous chylothorax should include dietary measures in all patients. Additional sclerosing radiotherapy and interventional or surgical therapy are often necessary. The choice of therapeutic approach should be indicated, depending on the aetiology and development of the chylothorax. Early, multimodal treatment is recommended.     

Leptin serum levels are not correlated with disease activity in patients with rheumatoid arthritis.

Leptin, the ob gene product, has been proposed as a mediator of inflammatory cytokine-dependent decreased food intake and cachexia in rodents. In humans, leptin serum levels increase after administration of tumor necrosis factor-alpha (TNF-alpha) or interleukin-2 or during septicemia. However, the effect of human chronic inflammatory disease on serum leptin is unknown. We therefore determined the serum leptin level (radioimmunoassay), body mass index (BMI), percent body fat ([%BF] bioelectrical impedance analysis), and disease activity (Disease Activity Score [DAS]) in 58 patients with rheumatoid arthritis (RA) and 16 controls. The BMI, %BF, serum leptin, and ratio of leptin to %BF (leptin/%BF) did not differ significantly in 25 patients with moderate RA activity (DAS, 3.6 +/- 0.5), 33 patients with low RA activity (DAS, 1.8 +/- 0.5), and controls. A positive correlation for serum leptin and %BF was detected in all groups. Our data indicate that in RA, a human chronic cytokine-mediated inflammatory disease, the serum leptin level is directly related to %BF but not to disease activity.     

Flavones. 3. Synthesis, biological activities, and conformational analysis of isoflavone derivatives and related compounds.

A series of 2-alkylisoflavone derivatives 1 was prepared with the intent to study the importance of the phenyl group (at the 3-position) of the isoflavone in imparting antihypertensive activity and the substitution effects at the 2-position of isoflavone. With the exception of the 2-isopropyl analog, the antihypertensive activity of these compounds appears to have a slow onset and long duration. None of the analogs appears better than the corresponding flavone (3) and 3-phenylflavone (2) analogs. An unsuccessful attempt to correlate the relationship between antihypertensive activity and the calculated torsional angle of C2-C3-C1'-C2' is discussed. Antiinflammatory activities of these compounds along with 7-(oxypropylamine)flavones were also evaluated and found to be not very potent. The antiinflammatory activity appears to be sensitive to steric effects of the alkyl group on the nitrogen and of substituents at the 2-position of the isoflavones, while the hydroxyl group of the propanolamine side chain is not essential.     

Quantitative technics in ultrasonic diagnosis

This paper presents techniques for computer-aided analysis of medical ultrasonic images. Methods of image processing, feature extraction and a classification algorithm for tissue characterization are described. Based on these techniques a pattern recognition system for semi-automatic analysis of ultrasonic images has been developed and proved within three clinical studies, which aimed to improve the ultrasound diagnosis of the prostate, the thyroid and the female breast. The results show that computer analysis of ultrasonic images is capable of providing a quantitative diagnosis as well as of differentiating tumor lesions by sonography.