Thyroid hyperplasia in a saker falcon (Falco cherrug)

An adult female saker falcon (Falco cherrug) presented to our falcon medical and research hospital with intermittent regurgitation, dyspnea, and squawking sound. Physical, radiographic, and endoscopic examination revealed a markedly enlarged thyroid gland. Hematological and blood biochemical results were within normal ranges apart from a slight increase in creatinine phosphokinase and aspartate aminotransferase. Cytological evaluation of fine-needle aspirate from the enlarged gland showed few RBCs and cellular debris. Neither inflammatory nor neoplastic cells were found. The condition was diagnosed clinically as unilateral thyroid hyperplasia, a condition which has not been previously reported in saker falcons.     

Metabolic Effects of Bariatric Surgery in Insulin-Sensitive Morbidly Obese Subjects

Background

The effects of bariatric surgery (BS) in metabolically healthy morbidly obese (MO) subjects are not well established. Against this background, we characterized the metabolic and inflammatory profiles of MO subjects with insulin sensitivity (IS) in the normal range, and evaluated the changes on these parameters following BS in this population.

Methods

We conducted a retrospective analysis of prospectively collected data in MO women undergoing BS between 2006 and 2010. Anthropometric, metabolic comorbidities, and inflammatory markers were compared at baseline and 12 months after BS, between 52 women (10.4 %) presenting with a HOMA-IR <2.94 (80th percentile reference population) (IS-MO group) and an age- and BMI-matched group of women (n?=?52) with HOMA-IR >2.94.

Results

The IS-MO women presented a more favorable metabolic and inflammatory profile as compared to the IR-MO group. However, an enlarged waist circumference (WC), a high-sensitivity C-reactive protein (hs-CRP) >3 mg/dL, and metabolic syndrome (MS) were present in 100 %, 90 %, and 51.9 % of the IS-MO group at baseline. At 12 months after surgery, all the MS components and hs-CRP improved in IS-MO subjects (p?<?0.01). The prevalence of the MS in the IS-MO group significantly decreased (11 %, p?<?0.05) despite WC and hs-CRP being abnormal respectively in 53.3 % and 20.0 % of women in this group.

Conclusions

In MO women, an IS in the normal range is associated with a limited protection from metabolic co-morbidities. Nonetheless, BS results in the amelioration of the altered metabolic and inflammatory profiles also in this group of subjects.     

Activity of shoulder girdle muscles during the perfect push-up and push-up bar exercises using different hand positions in young overhead athletes

Background

Push-up is considered as an excellent exercise for both assessment and training in athletes. However, the influence of its mode of application on activation of shoulder girdle musculature has been scantily studied by previous research in young overhead athletes.

Objectives

To investigate the activity of pectoralis major (PM) and triceps brachii (TB) muscle during push-up exercise performed on the push-up bar and perfect push-up using shoulder width (SW), narrow shoulder width (NSW) and wide shoulder width (WSW) hand positions in young overhead athletes.

Methods

24 young overhead athletes were recruited for the present study. Surface electromyography (EMG) was recorded for the PM and the TB muscles during the performance of push-up exercise on the push-up bar and perfect push-up using different hand positions (SW, NSW, and WSW). Root mean square (RMS) of the EMG signal was analyzed during each variation of push-up exercise for both muscles. Muscle activity was calculated as percentage maximum voluntary isometric contraction (% MVIC).

Results

EMG activity of PM muscle was significantly greater in WSW hand position as compared to SW (p?<?0.01) and NSW (p?<?0.01) hand position; whereas, the activity of TB was significantly greater in NSW hand position as compared to SW (p?<?0.01) and WSW (p?<?0.01) hand position. There were no significant differences in the EMG activity of PM (p?=?0.54) and TB (p?=?0.68) muscles between the push-up bar versus the perfect push-up.

Conclusion

WSW hand position may be used during a push-up when the goal is to strengthen PM; whereas, an NSW hand position may be utilized for the selective strengthening of TB muscle. Both perfect push-up and push-up bar may be utilized by overhead athletes for performing push-ups based on the availability of equipment.

     

Anthropometric measurements in children having transfusion-dependent beta thalassemia

Objectives: The aim of this study was to determine the anthropometric measurements in transfusion-dependent β-thalassemia children in Pakistan. The secondary aim was to correlate serum ferritin with the physical growth.

Methods: We enrolled 367 children (aged 5–17 years) with transfusion-dependent beta-thalassemia major in the study. Anthropometric measurements, serum ferritin levels, and pre-transfusion hemoglobin levels were measured. Serum ferritin was correlated with the height z-score for age.

Results: Laboratory evaluation showed that patients had significantly low mean pre-transfusion hemoglobin of 7.66?±?1.34?g/dl (range 2.5–10.5) and high median (Q3–Q1) serum ferritin of 5012?ng/ml (6829–3532). The median (Q3–Q1) height-for-age z-score of children was low at ?2.69 and (?1.46 to ?3.80) and 65.4% children had stunted growth (height for age z-score z-score and serum ferritin levels (p?Conclusions: The study showed that children with beta thalassemia major had delayed physical growth possibly secondary to iron overload. Effective and early iron chelation is needed for preventing growth failure in transfusion-dependent beta thalassemia.     

Impact of first contact on symptom onset–to-door time in patients presenting for primary percutaneous coronary intervention

Objectives

To determine effect of first medical contact type on symptom onset–to-door time (SODT).

Background

Shorter total ischemic time is associated with improved outcomes in ST-elevation myocardial infarction.

Methods

From 2005 to 2009, we reviewed records of all consecutive patients treated with primary percutaneous coronary intervention for ST-elevation myocardial infarction at our tertiary care teaching hospital (median follow-up 3.85 years). We compared SODT in patients whose first medical contact was a private physician (in person or via telephone) vs patients who presented to the emergency department (ED) directly (in person or via Emergency Medical Services).

Results

Of 366 patients, 84 (23%) contacted a physician (group A) while 282 (77.6%) did not (group B). Group A had higher median SODT (239.5 vs 130 minutes, P = .0043) and significantly higher mortality (log rank P = .0392, Cox Proportional Hazard Model risk factors: physician contact first [P < .013], age [P < .0001] and peripheral vascular disease [P < .035]). Two factors associated with prolonged SODT: (1) contacting a physician first P = .002 and (2) personal mode of transportation, P = .002. Patients presenting during “on-hours” (weekdays) were more likely to first contact a physician compared with those presenting during “off-hours” (weeknights and weekends) (66.67% in group A vs 45.04% in group B, P < .001).

Conclusions

Patients whose first medical contact was a physician had greater pre-hospital delays and worse survival compared to those who sought emergent medical care directly. This pattern occurred more often during “on-hours.” Educational efforts aimed at both patient and physician office practices are warranted.     

Electrical neuromodulation therapy for inflammatory bowel disease

Inflammatory bowel disease (IBD) is an inflammatory disease of the gastrointestinal (GI) tract. It has financial and quality of life impact on patients. Although there has been a significant advancement in treatments, a considerable number of patients do not respond to it or have severe side effects. Therapeutic approaches such as electrical neuromodulation are being investigated to provide alternate options. Although bioelectric neuromodulation technology has evolved significantly in the last decade, sacral nerve stimulation (SNS) for fecal incontinence remains the only neuromodulation protocol commonly utilized use for GI disease. For IBD treatment, several electrical neuromodulation techniques have been studied, such as vagus NS, SNS, and tibial NS. Several animal and clinical experiments were conducted to study the effectiveness, with encouraging results. The precise underlying mechanisms of action for electrical neuromodulation are unclear, but this modality appears to be promising. Randomized control trials are required to investigate the efficacy of intrinsic processes. In this review, we will discuss the electrical modulation therapy for the IBD and the data pertaining to it.     

T cell activation by a Trypanosoma brucei brucei-deriyed lymphocyte triggering factor is dependent on tyrosine protein kinases but not on protein kinase C and A

Trypanosoma brucei brucei releases a lymphocyte-triggering factor (TLTF) that activates CD8⁺ T cells. We here study second messenger mechanisms in this activation, i. e. the effects of protein kinase C (PKC), protein kinase A (PKA) and tyrosine kinases (TPK) inhibitors on TLTF-induced interferon-γ (IFN-γ) secretion and proliferation in lymphoid cell cultures. The effects were compared to those obtained by phytohemagglutinin (PHA) stimulation. Rat spleen mononuclear cells (MNC) and spleen MNC from a mutant mouse strain possessing CD8⁺ T cells but lacking CD4⁺ T cells were used as responder cells. Although both the PKC and the PKA inhibitors suppressed PHA-induced IFN-γ secretion and proliferation of rat MNC and mouse CD8⁺CD4^? MNC, they had no effect on the same TLTF-induced responses. The TPK inhibitor genistein, however, strongly suppressed TLTF-induced activation of both types of responder cells to IFN-γ secretion and the TLTF-induced proliferation of mouse CD8⁺CD4^? MNC. The suppressive effects of the drugs could be overcome by ionomycin and tetradecanoylphorbol acetate, which show that the effects were not due to drug nonspecific cellular toxicity of the drugs. We conclude that TLTF activates CD8⁺ T cells through pathways other than the PKC- or PKA-dependent signal transduction, and that TPK may be involved in the triggering.