The Role of C-Reactive Protein as a Risk Predictor of Coronary Atherosclerosis: Implications from the JUPITER Trial

Much controversy surrounds the use of high-sensitivity C-reactive protein (hs-CRP) as a marker of cardiovascular (CV) risk. Although data regarding the association of hs-CRP with CV disease is extensive and consistent, its role in clinical practice remains unclear. The American Heart Association (AHA) recently published a scientific statement regarding criteria for evaluation of novel markers of CV risk. This article provides a comprehensive review of data regarding hs-CRP as a risk marker for CV disease in the context of these AHA criteria. The impact of the JUPITER trial on the utility of hs-CRP as a risk marker is emphasized. The review concludes with an evidence-based statement regarding the current role of hs-CRP in CV risk prediction.     

ONTODerm--a domain ontology for dermatology

A specialty specific ontology for dermatology can be a very useful tool for conveying an accurate meaning to collaborative guideline applications and software systems. This paper describes the basics of ontology and the need for ontology in dermatology. We also propose the basic structure for one such ontology called ONTODerm. ONTODerm is grounded on DOLCE Lite foundational ontology and its purpose is to address the unique needs of dermatology as a medical specialty. It is represented in Web Ontology Language (OWL) using the Protégé OWL Plugin. ONTODerm is available for download and collaborative development under GPL license.     

Phytoremediation of 137cesium and 90strontium from solutions and low-level nuclear waste by Vetiveria zizanoides

Vetiver grass (Vetiveria zizanoides) L. Nash plantlets when tested for their potential to remove (90)Sr and (137)Cs (5 x 10(3) k Bq l(-1)) from solutions spiked with individual radionuclide showed that 94% of (90)Sr and 61% of (137)Cs could be removed from solutions after 168 h. When both (90)Sr and (137)Cs were supplemented together to the solution, 91% of (90)Sr and 59% of (137)Cs were removed at the end of 168 h. In case of (137)Cs, accumulation occurred more in roots than shoots, while (90)Sr accumulated more in shoots than roots. When experiments were performed to study the effect of analogous elements, K(+) ions reduced the uptake of (137)Cs, while (90)Sr accumulation was found to decrease in the presence of Ca(2+) ions. Plants of V. zizanoides could also effectively remove radioactive elements from low-level nuclear waste and the level of radioactivity was reduced below detection limit at the end of 15 days of exposure. The results of the present study indicate that V. zizanoides may be a potential candidate plant for phytoremediation of (90)Sr and (137)Cs.     

Skull base hydatid cyst with intracranial extension presenting as vocal cord palsy: a case report

Hydatid disease of the skull base is extremely rare, and intracranial extension of hydatid cysts through the skull base is even rarer. We report an interesting case of a 42-year-old man who presented with features of right vocal cord palsy. The diagnosis of hydatid cyst was made based on his history and on pre-operative MRI and was confirmed by surgery and histopathological examination.Hydatid disease is caused by infestation of the larval stage of tapeworm of the genus Echinococcus. Multiple echinococcal species produce hydatid disease, the most common causative species being Echinococcus granulosus. Echinococcus multilocularis is less commonly described but is more invasive, mimicking a malignancy [1–3]. Liver and lung involvement are most common, whereas bone and soft tissue involvement are rare [1–5]. Only a few cases of skull base involvement have been reported in the literature [4, 6, 7]. Our case is an unusual location of hydatidosis (i.e. hydatid disease of the skull base with intracranial extension). Usually, hydatid cyst of the head and neck region presents with local swelling and non-specific symptoms. Our patient presented with progressive hoarseness of voice. Compression of the vagus nerve by an intracranial or extracranial hydatid cyst is rare [4].     

Transjugular intrahepatic portocaval shunt placed through the strut of an inferior vena cava stent in a patient with Budd–Chiari syndrome: a technical modification

Transjugular intrahepatic portocaval shunt (TIPS) is performed in patients with symptomatic Budd–Chiari syndrome (BCS) who do not have repairable hepatic veins. We report the case of a patient who had an inferior vena cava (IVC) stent placed previously as part of the management for BCS, and who subsequently required TIPS. The TIPS tract was created through the strut of the previously placed IVC stent; the TIPS stent was placed after dilatation of the liver parenchyma as well as the strut of the IVC stent. This novel technique of “strutplasty” of a previously placed stent as part of TIPS has not been reported in the literature.The transjugular intrahepatic portocaval shunt (TIPS) procedure, as well as stent technology, is continually being improved [1–5]. Direct intrahepatic portocaval shunt (DIPS) – a modification of the TIPS procedure – is especially useful when there are occluded hepatic veins or an unfavourable angle between the inferior vena cava (IVC) and the hepatic vein resulting from hydrothorax and hypertrophy of the caudate lobe of the liver [1]. Herein, we report a technical modification of the TIPS procedure in Budd–Chiari syndrome (BCS).