Use of mature hoop pine plantation by the vulnerable Black-breasted Button-quail (Turnix melanogaster)

Seventeen Black-breasted Button-quail were caught within a 24 ha corridor of vine forest within a mature (i.e. 50 years old) hoop pine plantation—vine forest matrix, near Yarraman, south-east Queensland. Six of these birds were fitted with a radio-transmitter and tracked prior to clear felling of a section of hoop pine. Four Black-breasted Button-quail were tracked after timber harvesting operations had ceased. Prior to harvesting. Black-breasted Button-quail were found to occur up to 120 m into the hoop pine plantation from the vine forest edge. Hoop pine with a closed canopy and well-developed understorey was used by the species. The activity area of the females ranged from 3.0 to 4.4 ha in the pre-harvest period and 5.2 to 17.9 ha post-harvest. Observations during the breeding season indicated that males caring for offspring had a smaller activity area than non-breeding males (1.9 ha compared to 6.2 ha). Circumstantial evidence suggests there was a turnover in the population following clearfelling of the mature hoop pine compartment.     

Differences in genomic architecture between two distinct geographical strains of the blood fluke Schistosoma japonicum reveal potential phenotype basis

The Chinese (SjC) and Philippine (SjP) strains of the blood fluke Schistosoma japonicum have been shown to present clearly different phenotypes in fecundity, pathology, drug sensitivity and immunology. We used microarray based comparative genomic hybridisation (aCGH) to investigate structural differences in the genomes of the two strains and identified seven distinct regions of the S. japonicum genome that present differential aCGH representing either deletion or duplication regions in SjP. Within these regions, genes predicted to be associated with the recognised phenotypic differences were identified and that may provide new insights into the biology and evolution of the two strains, with implications for the epidemiology and control of schistosomiasis japonica in China and the Philippines.     

P2X(7) receptors are expressed during mouse nephrogenesis and in collecting duct cysts of the cpk/cpk mouse.

BACKGROUND: Purinergic receptors are cell-surface molecules that bind extracellular nucleotides, notably ATP. The P2X family includes seven nonselective ion channels with one member, P2X(7), implicated in cytolytic pore formation and cell death. MATERIALS AND METHODS: We sought P2X(7) expression in mouse nephrogenesis and cpk/cpk renal cyst growth, conditions in which both proliferation and apoptosis are prominent. RESULTS: P2X(7) immunolocalized to condensed metanephric mesenchyme: both proliferation and apoptosis were detected in this compartment, assessed by proliferating cell nuclear antigen expression and propidium iodide-stained pyknotic nuclei respectively. Later in nephrogenesis, P2X(7) was detected in collecting ducts, a pattern persisting to maturity. A mesenchymal to epithelial shift of P2X(7) expression was also documented in ureter development. In cpk/cpk kidneys, P2X(7)-expressing collecting duct cysts dominated histology from two weeks until four weeks after birth, when animals die from uremia. In polycystic kidneys pyknotic nuclei were rarely identified in P2X(7)-expressing epithelia, but were detected between cysts, consistent with a non-apoptotic role for P2X(7) in cyst enlargement. CONCLUSION: P2X(7) is expressed during normal nephrogenesis and in a model of congenital polycystic kidney disease. Further experiments are necessary to define possible functions of P2X(7) in these settings.     

Severe Acute Local Reactions to a Hyaluronic Acid-derived Dermal Filler

Injectable fillers are normally well tolerated by patients with little or no adverse effects. The most common side effects include swelling, redness, bruising, and pain at the injection site. This report describes three cases in which patients injected with a hyaluronic acid-derived injectable filler that is premixed with lidocaine developed adverse reactions including persistent swelling, pain, and nodule formation. Two of the three patients'' abscesses were cultured for aerobic and anaerobic bacteria and mycobacterium. All three cultures were negative. Abscess persistence in all cases necessitated physical removal and/or enzymatic degradation with hyaluronidase. The effects subsided only after the product had been removed. Two of these patients were subsequently treated with other hyaluronic acid-derived dermal fillers without adverse events.Injectable fillers are commonly used for soft tissue augmentation in areas of collagen loss. Adverse events with these materials are rare.¹ Hyaluronic acid (HA)-based injectables as well as polylactic acid (PLA)-based fillers, when injected into the glabella, are reported to have a lower incidence of complications compared to permanent fillers.² The most serious reactions can be reduced through a greater understanding of the anatomy of the area being treated as well as proper technique employed to avoid blood vessels.³ The reports of adverse reactions in the use of PLA-based injectables has declined in recent years due to an increase in physician education and standardized practice.⁴ Although rare, hypersensitivity and inflammatory reactions likely due to contamination of byproducts with bacterial fermentation are the most common adverse reactions associated with HA-based fillers.⁵ As new products enter the market, however, adverse reactions may become more common.Elevess (Anika Therapeutics, Inc., Bedford, Massachusetts), an HA-based injectable filler, was approved by the United States Food and Drug Administration (FDA) in 2006 for cosmetic use. It is a cross-linked hyaluronan gel suspended in a buffer solution with 0.3% lidocaine hydrochloride. It is indicated for injection for the correction of moderate-to-severe facial wrinkles.⁶In the authors'' experience, anecdotal evidence is surfacing that details adverse events with injectable Elevess including edema, pain, nodules, redness, purpura, and formation of granulomas and purulent exudate. This report describes three such cases.     

Review article: Renal support in critical illness

Purpose

This review provides a focused and comprehensive update on established and emerging evidence in acute renal replacement therapy (RRT) for critically ill patients with acute kidney injury (AKI).

Principal findings

There have been considerable technological innovations in the methods and techniques for provision of extracorporeal RRT in critical illness. These have greatly expanded our capability to provide both renal and non-renal life-sustaining organ support for critically ill patients. Recent data suggest earlier initiation of RRT in AKI may confer an advantage for survival and renal recovery. Two large trials have recently shown no added benefit to augmented RRT dose delivery in AKI. Observational data have also suggested that fluid accumulation in critically ill patients with AKI is associated with worse clinical outcome. However, several fundamental clinical questions remain to be answered, including issues regarding the time to ideally initiate/discontinue RRT, the role of high-volume hemofiltration or other blood purification techniques in sepsis, and extracorporeal support for combined liver-kidney failure. Extracorporeal support with RRT in sepsis, rhabdomyolysis, and liver failure are discussed, along with strategies for drug dosing and management of RRT in sodium disorders.

Conclusions

We anticipate that this field will continue to expand to promote research and innovation, hopefully for the benefit of sick critically ill patients.     

Male infertility

PURPOSE: We assessed male infertility and its treatment in the United States by identifying trends in the use of health care resources and estimating the economic impact of such care. MATERIALS AND METHODS: The analytical methods used to generate these results were previously described. RESULTS: Inpatient hospitalizations for male infertility were relatively few with an overall rate of 0.9/100,000 population. Of these stays 55% were associated with inpatient management of varicocele and 749 of 797 occurred in a rural setting. Between 1994 and 1996 there were 55,411 ambulatory surgery visits with men 25 to 34 years old having the highest use rate of 61/100,000. Men living in the West had the lowest rate of ambulatory surgical visits, which was significantly lower than that for men living in the Northeast and Midwest (29/100,000 vs 104/100,000 and 72/100,000, respectively). The Veterans Affairs health system showed no geographic trend in infertility diagnosis and Hispanic men had the highest frequency of treatment for male infertility, followed by black and then white men. The National Survey for Ambulatory Surgery estimated that 67% of patients undergoing ambulatory surgery for male infertility had a diagnosis of varicocele. In 2000 total expenditures for treating primary male infertility were approximately $17 million. However, adding the cost for assisted reproduction technology cycles placed total cost at about $18 billion. CONCLUSIONS: Infertile males generally seek infertility care outside of traditional reimbursement patterns. For this reason obtaining accurate data regarding the costs associated with male fertility care has proved to be challenging. Given the expense of in vitro fertilization and its attendant technologies, emphasis should be placed on addressing the underlying causes of male infertility. Further systematic examination of the demographics and management of male reproductive dysfunction is warranted.     

Prevalence of the metabolic syndrome among patients receiving clozapine

OBJECTIVE: This study compared the prevalence of the metabolic syndrome among outpatients with schizophrenia and schizoaffective disorder receiving clozapine with a matched comparison group from the National Health and Nutrition Examination Survey. METHOD: Ninety-three outpatients and a matched group of 2,701 comparison subjects were compared according to National Cholesterol Education Program criteria. Outpatient data were obtained through physical assessments, laboratory testing, and reviews of medical records. RESULTS: The prevalence of the metabolic syndrome was significantly higher among clozapine patients (53.8%) than among the comparison group (20.7%). For clozapine patients, logistic regression analysis revealed significant associations with age, body mass index, and duration of clozapine treatment. Only age and body mass index were associated with the prevalence of metabolic syndrome in both groups. CONCLUSIONS: Patients receiving clozapine are at significantly increased risk for developing the metabolic syndrome. Psychiatrists and other providers should consider performing regular physical health monitoring to prevent long-term adverse health consequences.     

Akt‐mediated mechanotransduction in murine fibroblasts during hypertrophic scar formation

Although numerous factors are implicated in skin fibrosis, the exact pathophysiology of hypertrophic scarring remains unknown. We recently demonstrated that mechanical force initiates hypertrophic scar formation in a murine model, potentially enhancing cellular survival through Akt. Here, we specifically examined Akt‐mediated mechanotransduction in fibroblasts using both strain culture systems and our murine scar model. In vitro, static strain increased fibroblast motility, an effect blocked by wortmannin (a phosphoinositide‐3‐kinase/Akt inhibitor). We also demonstrated that high‐frequency cyclic strain was more effective at inducing Akt phosphorylation than low frequency or static strain. In vivo, Akt phosphorylation was induced by mechanical loading of dermal fibroblasts in both unwounded and wounded murine skin. Mechanically loaded scars also exhibited strong expression of α‐smooth muscle actin, a putative marker of pathologic scar formation. In vivo inhibition of Akt increased apoptosis but did not significantly abrogate hypertrophic scar development. These data suggest that although Akt signaling is activated in fibroblasts during mechanical loading of skin, this is not the critical pathway in hypertrophic scar formation. Future studies are needed to fully elucidate the critical mechanotransduction components and pathways which activate skin fibrosis.