Polymerization of lactams, 88. Copolymers poly(ϵ-caprolactam)-block-polybutadiene prepared by anionic polymerization,part III. Model polymerizations initiated with potassium salt of ϵ-caprolactam and accelerated with isocyanates and their derivatives

Anionic polymerization of ?-caprolactam was initiated with the potassium salt of ?-caprolactam and accelerated with phenyl isocyanate, toluylene diisocyanate, 4,4′-diphenylmethane diisocyanate, some derivatives of these isocyanates (urethanes, ureas, and allophanates), or combinations of phenyl isocyanate with its derivatives at 150°C. The effect of individual structures on the polymerization kinetics and their contribution to the preparation of block copolymers of ?-caprolactam with hydroxy-terminated prepolymers, in-situ functionalized with diisocyanates, are discussed on the basis of a detailed analysis of time functions of polymer yield and degree of polymerization.     

EAU Guidelines on vesicoureteral reflux in children

Context

Primary vesicoureteral reflux (VUR) is a common congenital urinary tract abnormality in children. There is considerable controversy regarding its management. Preservation of kidney function is the main goal of treatment, which necessitates identification of patients requiring early intervention.

Objective

To present a management approach for VUR based on early risk assessment.

Evidence acquisition

A literature search was performed and the data reviewed. From selected papers, data were extracted and analyzed with a focus on risk stratification. The authors recognize that there are limited high-level data on which to base unequivocal recommendations, necessitating a revisiting of this topic in the years to come.

Evidence synthesis

There is no consensus on the optimal management of VUR or on its diagnostic procedures, treatment options, or most effective timing of treatment. By defining risk factors (family history, gender, laterality, age at presentation, presenting symptoms, VUR grade, duplication, and other voiding dysfunctions), early stratification should allow identification of patients at high potential risk of renal scarring and urinary tract infections (UTIs). Imaging is the basis for diagnosis and further management. Standard imaging tests comprise renal and bladder ultrasonography, voiding cystourethrography, and nuclear renal scanning. There is a well-documented link with lower urinary tract dysfunction (LUTD); patients with LUTD and febrile UTI are likely to present with VUR. Diagnosis can be confirmed through a video urodynamic study combined with a urodynamic investigation. Early screening of the siblings and offspring of reflux patients seems indicated.Conservative therapy includes watchful waiting, intermittent or continuous antibiotic prophylaxis, and bladder rehabilitation in patients with LUTD. The goal of the conservative approach is prevention of febrile UTI, since VUR will not damage the kidney when it is free of infection. Interventional therapies include injection of bulking agents and ureteral reimplantation. Reimplantation can be performed using a number of different surgical approaches, with a recent focus on minimally invasive techniques.

Conclusions

While it is important to avoid overtreatment, finding a balance between cases with clinically insignificant VUR and cases that require immediate intervention should be the guiding principle in the management of children presenting with VUR.     

Pulmonary arterial hypertension associated with systemic sclerosis in the Czech Republic

Background  

Systemic sclerosis (SSc) is an important cause of pulmonary arterial hypertension (PAH), with an estimated prevalence of 7.85–26.7%.     

Patterns of surface temperatures in two mole-rats (Bathyergidae) with different social systems as revealed by IR-thermography

Furred subterranean mammals face the problem of dissipating heat to the environment because high humidity and absence of air flow in sealed belowground tunnels constrain heat loss from body by convection and evaporation. In order to detect body areas responsible for heat loss, surface temperatures in two species of African mole-rats were measured at different ambient air temperatures by infrared thermography. Fur characteristics were also evaluated. Thinner pelage of the ventrum, its moderate temperature and large size suggest that ventral side of the body is the main thermal avenue for heat loss in both species. Interspecific differences could be explained by different fur characteristics connected with social thermoregulation. Compared to the social Fukomys mechowii, the solitary Heliophobius argenteocinereus has denser and longer fur on most of its body; its surface temperature was thus lower than in F. mechowii at lowered ambient temperatures. On the other hand, the denser and longer hair cover in H. argenteocinereus impedes heat dissipation at highest ambient temperatures (and probably also during digging activity) resulting in increase of core body temperature. H. argenteocinereus seems to be more sensitive to overheating than F. mechowii. At lower air temperatures, the social species may uses huddling to combat hypothermia.     

An overview of the <Emphasis Type="Italic">Gyrodactylus</Emphasis> (Monogenea: Gyrodactylidae) species parasitizing African catfishes,and their morphological and molecular diversity

An overview of Gyrodactylus infecting catfishes from the African continent is provided, including new data from Sudan, Senegal, Kenya and Mozambique. Haptoral sclerite morphometry and nuclear ribosomal DNA sequences revealed the presence of eight Gyrodactylus species. On Senegalese Synodontis nigrita, Gyrodactylus synodonti n. sp. and Gyrodactylus nigritae n. sp. are described. These are the first reports of gyrodactylid parasites from mochokid hosts. From the fins of North African catfish Clarias gariepinus collected in Mozambique, Gyrodactylus alekosi n. sp. and Gyrodactylus rysavyi were identified. G. rysavyi was also reported from Kenyan C. gariepinus and Senegalese Clarias anguillaris. From the fins of C. anguillaris studied in Senegal, two more species, Gyrodactylus transvaalensis and Gyrodactylus gelnari n. sp. were recognised. In addition, Gyrodactylus turkanaensis n. sp. from the gills of Kenyan C. gariepinus was described and an undescribed Gyrodactylus sp. was recorded from Sudanese representatives of the same host. Detailed morphometrical and molecular comparisons of the species are presented and discussed. The study highlights the hitherto understudied diversity of viviparous monogenean parasites throughout Africa.     

Effect of Intravascular Iodinated Contrast Media on Natural Course of End-Stage Renal Disease Progression in Hemodialysis Patients: A Prospective Study

We evaluated the impact of intravascular iodinated contrast medium on residual diuresis in hemodialyzed patients. Two groups of clinically stable hemodialyzed patients with residual diuresis minimally 500 ml of urine per day were studied. The patients from the first group were given iso-osmolal contrast agent iodixanol (Visipaque, GE Healthcare, United Kingdom) in concentration of iodine 320 mg/ml with osmolality 290 mOsm/kg of water during the endovascular procedure. The second control group was followed without contrast medium administered. Residual diuresis and residual renal excretory capacity expressed as 24-h calculated creatinine clearance were evaluated in the both groups after 6 months. The evaluated group included 42 patients who were given 99.3 ml of iodixanol in average (range, 60–180 ml). The control group included 45 patients. There was no statistically significant difference found between both groups in daily volume of urine (P = 0.855) and calculated clearance of creatinine (P = 0.573). We can conclude that residual diuresis is not significantly influenced by intravascular administration of iso-osmolal iodinated contrast agent (iodixanol) in range of volume from 60 to 180 ml in comparison to natural course of urinary output and residual renal function during end-stage renal disease. This result can help the nephrologist to decide which imaging method/contrast medium to use in dialyzed patients in current practice.     

Association of muscular strength with incidence of metabolic syndrome in men

PURPOSE: To examine the association between muscular strength and incidence of metabolic syndrome. METHODS: Participants were 3233 men (20-80 yr) initially free of metabolic syndrome who had two or more clinical examinations between 1980 and 2003, including baseline muscular strength and cardiorespiratory fitness assessment. Metabolic syndrome was defined according to NCEP-ATP III criteria. Muscular strength was quantified by combining body weight-adjusted one-repetition maximal measures for leg and bench presses. Cardiorespiratory fitness was assessed by maximal treadmill test. RESULTS: A total of 480 men developed metabolic syndrome during a mean follow-up period of 6.7 +/- 5.2 yr. In a Cox regression analysis adjusted for age, the hazard ratios (95% confidence intervals) of metabolic syndrome associated with the incremental categories of muscular strength were 1.00 (referent), 0.88 (0.69-1.12), 0.77 (0.60-0.98), and 0.54 (0.42-0.71), respectively (linear trend P < 0.0001). The inverse trend persisted after adjustment for smoking, alcohol intake, number of baseline metabolic syndrome risk factors, family history of diabetes, hypertension, and premature coronary disease (P = 0.004), but was attenuated (P = 0.06) when further adjusted for cardiorespiratory fitness. Compared with the lowest strength category, the highest strength category was associated with 44 and 39% lower risk (P < 0.05 each) of incident metabolic syndrome among normal weight body mass index (BMI < 25) and overweight or obese (BMI > or = 25) men, respectively. An inverse association of incident rates was also seen within stratum of age (20-39 yr, P < 0.001; 40-49 yr, P < 0.01; and 50+ yr, P < 0.05). CONCLUSIONS: Muscular strength was inversely associated with metabolic syndrome incidence, independent of age and body size. Potential benefits of greater muscular strength presumably through resistance exercise training should be considered in primary prevention of metabolic syndrome.