Bartonella henselae prosthetic valve endocarditis in an adult patient with congenital heart disease: favorable outcome after combined medical and surgical management

Bartonella spp. are a known cause of culture-negative endocarditis. We report a 42-year-old male with underlying surgically corrected congenital heart disease who was diagnosed with Bartonella henselae endocarditis involving the right-ventricle-to-pulmonary-artery conduit.     

Cadmium adsorption using novel MnFe2O4-TiO2-UIO-66 magnetic nanoparticles and condition optimization using a response surface methodology

In this study, magnetic nanocomposites (UIO-66-MnFe₂O₄-TiO₂) were synthesized based on the metal–organic framework. To investigate the synthesized adsorbent structure, XRD, SEM, FT-IR, BET, and VSM techniques were used, and also an EDX test was applied after adsorption of Cd(ii). The synthesized nanocomposite was used for Cd(ii) adsorption. The effects of four parameters such as the amount of adsorbent (0.05 to 0.25 g), pH (1 to 9), adsorption time (24 to 120 minutes), initial amount of metal ion (100 to 900 mg), at five levels (−2 to +2) were evaluated during the experiment based on the Response Surface Methodology (RSM) using Central Composite Design (CCD) and then, the optimal levels were determined. The F-value and P-value of the fitted second order model were obtained as 6039.62 and 0.0001, respectively. Optimization of the values was also performed for variables and, initial concentration of metal, pH, adsorption time and amount of adsorbent were obtained as 5.2 mg l⁻¹, 5, 63 minutes, and 0.18 g, respectively as optimum conditions. For optimal conditions, the maximum adsorbance was equal to 98%. Investigation of kinetic and isotherm adsorption showed that a second-order kinetic model and a Langmuir isotherm cover the Cd(ii) adsorption data well. It was also revealed that the adsorbent was removed from the environment by an external magnetic field.

In this study, magnetic nanocomposites (UIO-66-MnFe₂O₄-TiO₂) were synthesized based on the metal–organic framework.     

Possible mechanisms of late-life-onset allergic diseases and asthma in the senior citizen.

The clinical spectrum of allergic diseases and asthma changes over the life span of the individual and is influenced by a wide variety of anatomic, physiologic, and immunologic factors. Nowhere do these changes play a more important role than in the elderly patient with allergic disease or asthma where the culmination of these events contribute to disease expression, which at times can result in irreversible endstage disease. It is estimated that between 2010 and 2030 the elderly population will increase by 75% and will represent a significant proportion of consumers of total health care resources. This presentation will examine possible mechanism(s) that contribute to the development of late-onset allergic diseases and asthma in the elderly as a possible basis for identification of antecedents of endstage disease and interventive strategies for the prevention of the irreversible consequences in this population.     

Reconstruction of cervical esophagus,hypopharynx and oral cavity using free jejunal transfer

Experience with 22 cases of reconstruction of the cervical esophagus, hypopharynx and oral cavity using free jejunal transfer is presented. The method requires an experienced team with high technical competence, but the benefits related to rapid single-stage completion and low morbidity certainly justify its use.     

Molecular characterization of glucose-6-phosphate dehydrogenase deficiency in the Eastern Province of Saudi Arabia.

The level of activity of the enzyme glucose-6-phosphate dehydrogenase (G6PD) was determined in 154 unrelated Saudi males and females with G6PD deficiency who were residing in the Eastern Province of Saudi Arabia. DNA was extracted from blood samples and analyzed for known G6PD mutations by polymerase chain reaction (PCR) and restriction fragment length polymorphism techniques. Two different polymorphic mutations were identified which accounted for 90% of the samples analyzed. Of 114 G6PD-deficient males, 96 had G6PD Mediterranean, nine had African deficient variant G6PD A- and in nine the mutation has not been identified. Of the 40 G6PD-deficient females, 34 were homozygous for the G6PD Mediterranean mutation and six were genetic compound, G6PD Mediterranean/G6PD A-. The data indicate that the G6PD Mediterranean mutation is the most common (84%) in the Eastern Province, followed by G6PD A- (5.8%). Seventy one subjects who suffered from favism were found to carry the Mediterranean mutation.     

Gonadal steroids and affective symptoms during in vitro fertilization: implication for reproductive mood disorders

Gonadal steroids (GSs) have been associated with the onset of a number of reproductive-related mood disorders in women, in which fluctuating or unstable hormonal levels are postulated to act as the trigger for the destabilization of mood. There is, however, rather limited direct clinical evidence that can link rapidly changing GS levels with the induction of mood symptoms. We aimed to study the effect of controlled and rapid GS fluctuations on mood in an in vivo model. Women undergoing in vitro fertilization (n=108) were assessed for depression and anxiety levels on 3 time points: during a low estradiol and progesterone baseline, during a gonadotropin stimulated estradiol-dominant phase, and after embryo transfer, during a progesterone-dominant low estrogen phase. Plasma levels for estrogen and progesterone were drawn on these time points. Symptoms of depression and anxiety significantly increased from baseline to the high estradiol levels but were not correlated with estrogen. The sharp drop from high estradiol levels at the estradiol-dominant phase to low levels at the progesterone-dominant phase was significantly correlated with rising depression scores. The rise in progesterone levels from low levels at the estradiol-dominant phase to high levels at the progesterone-dominant phase was significantly and inversely correlated with depression scores. This study suggests that the mechanism underlying the role of estrogen in reproductive-related mood disorders involves an abrupt and precipitous drop in its plasma level that can precipitate negative mood states. This finding has implications on the treatment of GS-related mood disorders.     

Virtual azoospermia and cryptozoospermia--fresh/frozen testicular or ejaculate sperm for better IVF outcome?

Men diagnosed as having azoospermia occasionally have a few mature sperm cells in other ejaculates. Other men may have constant, yet very low quality and quantity of sperm cells in their ejaculates, resulting in poor intracytoplasmic sperm injection (ICSI) outcome. It has not been conclusively established which source of sperm cells is preferable for ICSI when both ejaculate and testicular (fresh or frozen) sperm cells are available. It is also unclear whether there is any advantage of fresh over frozen sperm if testicular sperm is to be used. We used ejaculate, testicular (fresh or frozen) sperm cells, or both for ICSI in 13 couples. Five of these couples initially underwent ICSI by testicular sperm extraction, because the males had total azoospermia, and in later cycles with ejaculate sperm cells. Ejaculate sperm cells were initially used for ICSI in the other 8 patients, and later with testicular sperm cells. The fertilization rate was significantly higher when fresh or frozen-thawed testicular sperm cells were used than when ejaculated sperm cells were used. Likewise, the quality of the embryos from testicular (fresh and frozen) sperm was higher than from ejaculated sperm (65.3% vs 53.2%, respectively, P < .05). The use of fresh testicular sperm yielded better implantation rates than both frozen testicular sperm and ejaculate. Therefore, fresh testicular sperm should be considered first for ICSI in patients with virtual azoospermia or cryptozoospermia because of their superior fertility.