Airway inflammatory events in diabetic-antigen sensitized guinea pigs

Experimental evidence indicates that the relative lack of insulin in an organism results in an overall reduction in inflammatory reactions. This study was planned to determine the inflammatory events in antigen sensitized diabetic guinea pigs. Twenty-five male guinea pigs were categorized into five groups of five each as follows: diabetic, antigen sensitized, antigen sensitized diabetic, insulin-treated antigen sensitized diabetic and control animals. Induction of experimental diabetes and antigen sensitization was performed by injection of streptozotocin and ovalbumin, respectively. Animals were killed by exsanguination and bronchoalveolar lavage was performed. Bronchoalveolar lavage fluid cellular and protein contents were determined. Airway responsiveness to acetylcholine was assessed using isolated tracheal triple-ring. Histopathological examinations were performed on the lungs. Decreases in the airway reactivity in diabetic and antigen sensitized diabetic animals were found compared with antigen sensitized animals. Experimental diabetes also decreased antigen-induced protein leakage into the airspace as well as the accumulation of inflammatory cells (eosinophils, neutrophils, lymphocytes and macrophages) in bronchoalveolar lavage fluid of antigen sensitized animals. Insulin treatment prevented these decreases in protein content and inflammatory cells infiltration in bronchoalveolar lavage fluid observed in the antigen sensitized guinea pigs with diabetes. Histopathological results showed that coinduction of experimental diabetes significantly reduces the number of eosinophils in the lungs of antigen sensitized animals. Again, treatment with insulin increased the number of eosinophils in the antigen sensitized diabetic animals. Experimental diabetes causes were found to decrease the airway reactivity and inflammatory responsiveness induced by antigen sensitization due to a reduction in the insulin levels.     

Trauma care system in Iran

Objective: The high burden of injuries in Iran necessitates the establishment of a comprehensive trauma care system. The purpose of this paper is to describe the current status of trauma system regarding the components and function. Methods: The current status of trauma system in all components of a trauma system was described through expert panels and semi-structured interviews with trauma specialists and policy makers.Results: Currently, various organizations are involved in prevention, management and rehabilitation of injuries,but an integrative system approach to trauma is rather deficient. There has been ongoing progress in areas of public education through media, traffic regulation reinforcement,hospital care and prehospital services. Meanwhile, there are gaps regarding financing, legislations and education of high risk groups. The issues on education and training standards of the front line medical team and continuing education and evaluation are yet to be addressed. Trauma registry has been piloted in some provinces, but as it needs the well-developed infrastructure (regarding staff, maintenance,financial resources), it is not yet established in our system of trauma care.Conclusions: It seems that one of the problems with trauma care in Iran is lack of coordination among trauma system organizations. Although the clinical management of trauma patients has improved in our country in the recent decade, decreasing the burden of injuries necessitates an organized approach to prevention and management of trauma in the context of a trauma system.     

Using electronic health record alerts to provide public health situational awareness to clinicians

Alerting providers to public health situations requires timeliness and context-relevance, both lacking in current systems. Incorporating decision support tools into electronic health records may provide a way to deploy public health alerts to clinicians at the point of care. A timely process for responding to Health Alert Network messages sent by the New York City Department of Health and Mental Hygiene was developed by a network of community health centers. Alerts with order sets and recommended actions were created to notify primary care providers of local disease outbreaks. The process, effect, and lessons learned from alerts for Legionella, toxogenic E coli, and measles outbreaks are described. Electronic alerts have the potential to improve management of diseases during an outbreak, including appropriate laboratory testing, management guidance, and diagnostic assistance as well as to enhance bi-directional data exchange between clinical and public health organizations.     

A pilot trial of the microtubule-interacting peptide (NAP) in mice overexpressing alpha-synuclein shows improvement in motor function and reduction of alpha-synuclein inclusions

Abnormal accumulation of α-synuclein is associated with several neurodegenerative disorders (synucleinopathies), including sporadic Parkinson's disease (PD). Genetic mutations and multiplication of α-synuclein cause familial forms of PD and polymorphisms in the α-synuclein gene are associated with PD risk. Overexpression of α-synuclein can impair essential functions within the cell such as microtubule-dependent transport, suggesting that compounds that act on the microtubule system may have therapeutic benefit for synucleinopathies. In this study, mice overexpressing human wildtype α-synuclein under the Thy1 promoter (Thy1-aSyn) and littermate wildtype control mice were administered daily the microtubule-interacting peptide NAPVSIPQ (NAP; also known as davunetide or AL-108) intranasally for 2 months starting at 1 month of age, in a regimen known to produce effective concentrations of the peptide in mouse brain. Motor performance, coordination, and activity were assessed at the end of treatment. Olfactory function, which is altered in PD, was measured 1 month later. Mice were sacrificed at 4.5 months of age, and their brains examined for proteinase K-resistant α-synuclein inclusions in the substantia nigra and olfactory bulb. NAP-treated Thy1-aSyn mice showed a 38% decrease in the number of errors per step in the challenging beam traversal test and a reduction in proteinase K-resistant α-synuclein inclusions in the substantia nigra compared to vehicle treated transgenics. The data indicate a significant behavioral benefit and a long lasting improvement of α-synuclein pathology following administration of a short term (2 months) NAP administration in a mouse model of synucleinopathy.     

Nerve conduction changes following arteriovenous fistula construction in hemodialysis patients

Background  

Peripheral neuropathy is a common complication of chronic renal failure (CRF). Superimposed neuropathies may complicate arteriovenous fistulas (AVF) construction. The aim of this study was to evaluate the effect of AVF construction on nerve conduction.     

Synthesis and evaluation of in vitro anti-tuberculosis activity of N-substituted glycolamides

On the basis of the structural similarity of N-substituted glycolamides with N-glycolyl muramic acid residues of the cell wall of Mycobacterium tuberculosis, a series of these compounds were designed and synthesized by the reaction of glycolic acid acetonide 1 (2,2-dimethyl-5-oxo-1,3-dioxolane) with the proper amines. The minimum inhibitory concentration (MIC) was determined against M. tuberculosis H(37)Rv in BACTEC 12B medium, using the Microplate Alamar Blue Assay (MABA). Among the synthesized compounds, all those with disubstituted amide structure accompanied by one or two heteroatom(s) with loan pair(s) of electrons atom(s) beta to the amide nitrogen demonstrated moderate anti-tuberculosis activity and all the monosubstituted amides showed no activity at all.     

Pharyngeal-cervical-brachial variant of Guillain-Barre syndrome in a patient with thalassemia intermedia

Here, we present the first instance of Guillain-Barre syndrome variant in a patient with beta thalassemia and iron overload who had a history of transfusion before the onset of symptoms. Our patient was a 50- year-old Persian woman with history of intermediate thalassemia who had been treated with pack cells because of low hemoglobin level. Ten days after transfusion, she developed numbness of arms, left sided ptosis, and afterwards dysarthria, dysphagia, and bilateral ptosis. Electrodiagnosis on day 12 revealed reduced repetition of f-waves in the upper limbs and reduced recruitment with 1+ fibrillation in facial muscles. Electromyography and nerve conduction velocities in the limbs were normal. After excluding other causes and according to electrodiagnosis, the pharyngeal-cervical-brachial variant of Guillain- Barre syndrome was considered and plasma exchange began. Following exchanges, significant clinical improvement was attained. Iron overload and possible transmission of infections from blood products might have contributed in the development of syndrome.