A case series of symptomatic intraluminal duodenal duplication cysts: presentation, endoscopic therapy, and long-term outcome (with video)

BACKGROUND: Duodenal duplication cysts are rare congenital anomalies. Symptomatic cases have classically been treated by surgical resection, which can be complex because of the close proximity of the cysts to the papilla. OBJECTIVE: To describe a series of 8 patients with symptomatic duodenal duplication cysts who were treated endoscopically, with a special focus on the long-term outcome. DESIGN: Retrospective case series. SETTING: Three tertiary-care European academic hospitals. PATIENTS: Eight patients, age 8 to 72 years, were treated endoscopically for symptomatic intraluminal duodenal duplication cysts between 1981 and 2006. Seven patients presented with acute pancreatitis, and one patient presented with jaundice. INTERVENTION: Endoscopic incision and marsupialization of the cysts was performed by using a variety of endoscopic tools (needle-knife and regular sphincterotomes, cystotomes, and polypectomy snares). MAIN OUTCOME MEASUREMENTS: Technical success of endoscopic intervention and long-term clinical recurrence of symptoms. RESULTS: No major complications occurred. All patients remained asymptomatic at a median follow-up of 7.3 years. LIMITATIONS: Retrospective study; the small number of patients. CONCLUSIONS: The endoscopic treatment of symptomatic intraluminal duodenal duplication cysts is a safe and effective technique, with excellent long-term results. It represents a minimally invasive alternative to surgical resection and might be considered the preferred therapeutic modality for these cases.     

Highly sensitive p-type 4H-SiC van der Pauw sensor

This paper presents for the first time a p-type 4H silicon carbide (4H-SiC) van der Pauw strain sensor by utilizing the strain induced effect in four-terminal devices. The sensor was fabricated from a 4H-SiC (0001) wafer, using a 1 μm thick p-type epilayer with a concentration of 10¹⁸ cm⁻³. Taking advantage of the four-terminal configuration, the sensor can eliminate the need for resistance-to-voltage conversion which is typically required for two-terminal devices. The van der Pauw sensor also exhibits an excellent repeatability and linearity with a significantly large output voltage in induced strain ranging from 0 to 334 ppm. Various sensors aligned in different orientations were measured and a high sensitivity of 26.3 ppm⁻¹ was obtained. Combining these performances with the excellent mechanical strength, electrical conductivity, thermal stability, and chemical inertness of 4H-SiC, the proposed sensor is promising for strain monitoring in harsh environments.

This paper presents for the first time a p-type 4H silicon carbide (4H-SiC) van der Pauw strain sensor by utilizing the strain induced effect in four-terminal devices.     

Blood-based immunoassay of tau proteins for early diagnosis of Alzheimer's disease using surface plasmon resonance fiber sensors

We present the immunoassay of tau proteins (total tau and phosphorylated tau) in human sera using surface plasmon resonance (SPR) fiber sensors. This assay aimed at harvesting the advantages of using both SPR fiber sensors and a blood-based assay to demonstrate label-free point-of-care-testing (POCT) patient-friendly assay in a compact format for the early diagnosis of Alzheimer''s disease (AD). For conducting the assay, we used human sera of 40 subjects divided into halves, which were grouped into AD patients and control groups according to a number of neuropsychological tests. We found that on an average, the concentrations of both total tau and phosphorylated tau proteins (all known to be higher in cerebrospinal fluid (CSF) and the brain) turned out to be higher in human sera of AD patients than in controls. The limits of detection of total tau and phosphorylated tau proteins were 2.4 pg mL⁻¹ and 1.6 pg mL⁻¹, respectively. In particular, it was found that the AD group exhibited average concentration of total tau proteins 6-fold higher than the control group, while concentration of phosphorylated tau proteins was 3-fold higher than that of the control. We can attribute this inhomogeneity between both types of tau proteins (in terms of increase of control-to-AD in average concentration) to un-phosphorylated tau proteins being more likely to be produced in blood than phosphorylated tau proteins, which possibly is one of the potential key elements playing an important role in AD progress.

Blood-based early diagnosis of Alzheimer''s disease using a plasmonic fiber sensor that detects immunoreaction of tau proteins.     

Turning Data Into Information: Opportunities to Advance Rehabilitation Quality,Research, and Policy

Attention to health care quality and safety has increased dramatically. The internal focus of an organization is not without influence from external policy and research findings. Compared with other specialties, efforts to align and advance rehabilitation research, practice, and policy using electronic health record data are in the early stages. This special communication defines quality, applies the dimensions of quality to rehabilitation, and illustrates the feasibility and utility of electronic health record data for research on rehabilitation care quality and outcomes. Using data generated at the point of care provides the greatest opportunity for improving the quality of health care, producing generalizable evidence to inform policy and practice, and ultimately benefiting the health of the populations served.     

Sampling Males Who Inject Drugs in Haiphong,Vietnam: Comparison of Time-Location and Respondent-Driven Sampling Methods

Accurate measurements of HIV prevalence and associated risk factors among hidden and high-risk groups are vital for program planning and implementation. However, only two sampling methods are purported to provide representative estimates for populations without sampling frames: time-location sampling (TLS) and respondent-driven sampling (RDS). Each method is subject to potential biases and questionable reliability. In this paper, we evaluate surveys designed to estimate HIV prevalence and associated risk factors among people who inject drugs (PWID) sampled through TLS versus RDS. In 2012, males aged ≥16 years who reported injecting drugs in the previous month and living in Haiphong, Vietnam, were sampled using TLS or RDS. Data from each survey were analyzed to compare HIV prevalence, related risk factors, socio-demographic characteristics, refusal estimates, and time and expenditures for field implementation. TLS (n = 432) and RDS (n = 415) produced similarly high estimates for HIV prevalence. Significantly lower proportions of PWID sampled through RDS received methadone treatment or met an outreach worker. Refusal estimates were lower for TLS than for RDS. Total expenditures per sample collected and number of person-days of staff effort were higher for TLS than for RDS. Both survey methods were successful in recruiting a diverse sample of PWID in Haiphong. In Vietnam, surveys of PWID are conducted throughout the country; although the refusal estimate was calculated to be much higher for RDS than TLS, RDS in Haiphong appeared to sample PWID with less exposure to services and required fewer financial and staff resources compared with TLS.     

Synthesis and antibacterial properties of a novel magnetic nanocomposite prepared from spent pickling liquors and polyguanidine

Magnetic nanoparticles have received much interest for their application in wastewater treatment because of their easy retrieval and reuse. However, the methods used to synthesise high saturation magnetization magnetic nanoparticles require expensive and pure precursors. In the current study, we explore the potential for using spent pickling liquor, a wastewater solution from steel factories, as the iron precursor for preparing iron oxide nanoparticles. Here, magnetic Fe₃O₄ nanoparticles were synthesized via the oxidation–precipitation of spent pickling liquors using a saturated solution of calcium hydroxide at room temperature. The Fe₃O₄ nanoparticles were then modified with antibacterial polyguanidine to form a nanocomposite. It was found that monodisperse magnetic Fe₃O₄ nanoparticles with a size in the range 20–30 nm and a high saturation magnetization value of 73.9 emu g⁻¹ were synthesised. The Fe₃O₄ nanoparticles were successfully encapsulated with polyguanidine to form an Fe₃O₄/polyguanidine nanocomposite. FT-IR and TGA analysis results indicated the presence of the polymer on the Fe₃O₄ surface and the polymer content in the nanocomposite was about 15% (w/w). The Fe₃O₄/polyguanidine nanocomposite exhibited strong antibacterial activity against Escherichia coli (E. coli), demonstrating its potential for use in disinfecting wastewater.

An Fe₃O₄/polyguanidine nanocomposite with strong antibacterial activity was prepared from Fe₃O₄ nanoparticles, using spent pickling liquors as the iron source, which were then encapsulated with polyguanidine.     

Effect of Brain CYP2B Inhibition on Brain Nicotine Levels and Nicotine Self-Administration

The CYP2B enzyme is expressed in human and rat brain, and metabolizes many CNS-acting drugs. The gene that encodes human CYP2B6 is highly polymorphic, where the variation in brain enzyme levels could result in altered brain drug levels. CYP2B can metabolize nicotine, the main psychoactive ingredient in cigarettes; if altered brain CYP2B activity can influence nicotine brain levels, it could influence nicotine-mediated behaviors. To investigate this, a mechanism-based inhibitor selective for CYP2B, C8-xanthate (20 μg), was administered intracerebroventricularly (ICV) into the brain of rats, and 22 h later, nicotine levels were measured by in vivo microdialysis following nicotine (150 μg/kg intravenous). Brain nicotine levels from 15 to 30 min and the AUC_0–45min were both twofold higher (p<0.05) with C8-xanthate vs vehicle pretreatment; there was no difference in peripheral nicotine levels. Rats were then given ICV pretreatment with C8-xanthate/ASCF and underwent intravenous nicotine self-administration with 3.75–30 μg/kg per infusion dose. C8-xanthate pretreatment increased responding in progressive ratio (15 μg/kg per infusion dose, p<0.05). In a separate cohort, C8-xanthate increased the percentage of rats that acquired self-administration (7.5 μg/kg per infusion dose, p<0.05) from 40% after vehicle pretreatment to 100%, with no difference in peripheral nicotine levels measured at the end of behavior. In a third cohort, C8-xanthate increased the number of sessions required to meet extinction criteria (p<0.05). Together these data demonstrate that the brain CYP2B activity can influence nicotine brain levels and subsequent behaviors independent of hepatic metabolism. This suggests that human smokers with variable CYP2B brain levels could have different nicotine levels and reinforcement, which might have a role in smoking behaviors and dependence.