Effect of noise pollution on testicular tissue and hormonal assessment in rat

Many studies have focused on the effect of noise stress on the health. So far, few studies have been conducted on the effect of noise on reproductive system. The aim of study was to investigate the effect of noise pollution on morphometric parameters of testicular tissue and hormonal assessment (ACTH, cortisol and testosterone). In this study, 40 male rats were exposed to control, 95, 105 and 115 dB noise intensity for sixty days. At the end of study, blood sampling was performed and ACTH, cortisol and testosterone concentrations were assessed. The results showed that noise stress decreased testosterone levels in the 115 dB‐treated group, while it increased the ACTH and cortisol levels. Histological sections of testis showed that the mean diameter of the seminiferous tubules and thickness of the germinal epithelium reduced compared to the control group. Also the ratio of the interstitial tissue area to the total testicular tissue area was increased significantly. Our study shows that noise stress may have negative influences on male fertility.     

Comparison of corneal thickness measurement with the Pentacam,the PARK1 and an ultrasonic pachymeter

Purpose: The aim was to determine the agreement between PARK1 pachymetric readings and measurements made with the Pentacam and ultrasonic pachymetry. Methods: In this prospective study, we enrolled refractive surgery patients free of other ocular conditions and performed Pentacam and PARK1 acquisitions followed by ultrasonic pachymetry. We recorded pachymetric readings on the centre, apex and thinnest point with the Pentacam, corneal thickness values of the apex and minimum readings from the PARK1, and the central corneal thickness with the ultrasonic system. Data were compared using t‐tests, and the Pearson correlations and 95% limits of agreement (LoA) of all pairs were determined. Results: The mean age of the 47 participants was 32 ± 10.4 years and data from their right eyes were used. Overall, ultrasonic measurements were significantly higher than all readings from the PARK1 and the Pentacam. The smallest difference was between the PARK‐apex and Pentacam‐apex readings (0.2 ± 11 µm); the 95% LoA of this pair gave a width of 43.7 µm (‐21.7 to 22.0 µm). The smallest width pertained to the Pentacam‐centre and ultrasound‐centre paired readings; the width was 32.5 µm (‐21.8 to 11.8 µm), while the mean difference was ‐5.54 ± 8 µm. Conclusion: The PARK1 measurements of the apical corneal thickness can be a substitute for central corneal pachymetry with an ultrasonic device, provided that the range of agreement is taken into consideration in the interpretation of the results. Similar studies on populations with different corneal conditions such as keratoconus are needed.     

Proton Pump Inhibitors Reduce Mycophenolate Exposure in Heart Transplant Recipients—A Prospective Case-Controlled Study

This prospective study investigates the impact of proton pump inhibitors (PPI) on mycophenolic acid (MPA) pharmacokinetics in heart transplant recipients receiving mycophenolate mofetil (MMF) and tacrolimus. MPA plasma concentrations at baseline (C_{0  h}), 30 min (C_{0.5  h}), 1(C_{1  h}) and 2 h (C_{2  h}) were obtained by high-performance liquid chromatography (HPLC) in 22 patients treated with pantoprazole 40 mg and MMF 2000 mg. Measurements were repeated 1 month after pantoprazole withdrawal. A four-point limited-sampling strategy was applied to calculate the MPA area under the curve (MPA-AUC). Predose MPA concentrations with PPI were 2.6 ± 1.6 mg/L versus 3.4 ± 2.7 mg/L without PPI (p = ns). Postdose MPA concentrations were lower with PPI at C_{0.5  h} (8.3 ± 5.7 mg/L vs. 18.3 ± 11.3 mg/L, p = 0.001) and C_{1  h} (10.0 ± 5.6 mg/L vs. 15.8 ± 8.4 mg/L, p = 0.004), without significant differences at C_{2  h} (8.3 ± 6.5 mg/L vs. 7.6 ± 3.9 mg/L). The MPA-AUC was significantly lower with PPI medication (51.2 ± 26.6 mg × h/L vs. 68.7 ± 30.3 mg × h/L; p = 0.003). The maximum concentration of MPA (MPA-C_max) was lower (12.2 ± 7.5 mg/L vs. 20.6 ± 9.3 mg/L; p = 0.001) and the time to reach MPA-C_max (t_max) was longer with PPI (60.0 ± 27.8 min vs. 46.4 ± 22.2 min; p = 0.05). This is the first study to document an important drug interaction between a widely used immunosuppressive agent and a class of drugs frequently used in transplant patients. This interaction results in a decreased MMF drug exposure which may lead to patients having a higher risk for acute rejection and transplant vasculopathy.     

Luminex‐based virtual crossmatching facilitates combined third‐time cardiac and de novo renal transplantation in a sensitized patient with sustained antibody‐mediated cardiac allograft rejection

Deutsch M‐André, Kauke T, Sadoni S, Kofler S, Schmauss D, Bigdeli AK, Weiss M, Reichart B, Kaczmarek I. Luminex‐based virtual crossmatching facilitates combined third‐time cardiac and de novo renal transplantation in a sensitized patient with sustained antibody‐mediated cardiac allograft rejection.
Pediatr Transplantation 2010: 14:E96–E100. © 2009 John Wiley & Sons A/S. Abstract: Allosensitization represents a major obstacle to successful re‐transplantation since circulating antibodies can elicit antibody‐mediated rejection episodes with subsequent graft failure. Since sensitization is primarily considered a contraindication to transplantation the duration for patients waiting for a suitable donor organ to become available is considerably prolonged. Herein, we report on the successful application of a Luminex‐based virtual crossmatch approach to facilitate combined third‐time cardiac and de novo renal transplantation in a sensitized patient with sustained antibody‐mediated cardiac allograft rejection.     

Combination antifungal therapy for invasive pulmonary aspergillosis in a heart transplant recipient

Invasive pulmonary aspergillosis is a severe complication after solid organ transplant, with a high mortality rate. We present a 45-year-old male heart transplant recipient who developed fever, progressive worsening of dyspnea, and productive cough without response to antibiotics. Diagnosis of invasive pulmonary aspergillosis was made based on clinical, laboratory, and radiographic findings. The patient was treated successfully with combined antifungal therapy (voriconazole and micafungin). This case report highlights the importance of a high degree of clinical suspicion to allow curative treatment of invasive aspergillosis and the efficiency of new antifungal drugs.     

Surgical strategy for biventricular assist device implantation after previous coronary artery bypass grafting

In an aging population, numerous patients who underwent previous coronary artery bypass grafting (CABG) are presenting with end-stage ischemic cardiomyopathy. Although redo CABG and cardiological interventions are possible treatment options, orthotopic heart transplantation remains an ultimate option for these patients. However, there is high morbidity and mortality on the waiting list, and mechanical circulatory support is a life-saving concept [Hetzer 2006; Taylor 2009].We developed a simplified and safe technique for implantation of a biventricular assist device as a redo in complex patients after previous CABG and end-stage heart failure.     

Composition of pluralistic health systems: how much can we learn from household surveys? An exploration in Cambodia

In spite of all efforts to build national health services, health systems of many low-income countries are today highly pluralistic. Households use a vast range of public and private health care providers, many of whom are not controlled by national health authorities. Experts have called on Ministries of Health to re-establish themselves as stewards of the entire health system. Modern stewardship will require national and decentralized health authorities to have an overall view of their pluralistic health system, especially of the components outside the public sector. Little guidance has been provided so far on how to develop such a view. In this paper, we explore whether household surveys could be a source of information. The study builds on secondary data analysis of a household survey carried out in three health districts in rural Cambodia and of two national surveys. Cambodia is indeed an interesting case, as massive efforts by donors in favour of the public sector go hand in hand with a dominant role of the private sector in the provision of health care services. The study confirms that the health care sector in Cambodia is now highly pluralistic, and that the great majority of health seeking behaviour takes place outside the public health system. Our analysis of the survey also shows that the disaffection of the population with public health facilities varies across places, socio-economic groups and health problems. We illustrate how such knowledge could allow stewards to better identify challenges for existing or future health policies. We argue that a whole research programme on the composition of pluralistic health systems still needs to be developed. We identify some challenges and opportunities.     

Report of Theileria annulata and Babesia canis infections in dogs

Piroplasmosis is a zoonotic protozoan disease transmitted by ticks. The full geographical range of canine piroplasms has been found in dogs in the Middle East, parts of Africa, North America, and Europe. Following our studies on molecular detection of piroplasmosis in the south of Iran, we found Theileria annulata in two herd dogs, as well as information on their 18S rRNA gene sequences. Piroplasmosis agents were detected by PCR of 280 blood samples collected from dogs in seven regions of the Shiraz suburbia in southern Iran, between November 2009 and June 2011. Two positive samples from Shiraz were infected with T. annulata, and one sample was infected with Babesia canis. PCR positive samples were further analyzed by sequence analysis. The results of this study reconfirmed that T. annulata are not always as host specific as accepted. This is the first report of T. annulata in herd dogs in southern Iran and the second report of T. annulata in dogs worldwide.