The cellulose synthase BcsA plays a role in interactions of Salmonella typhimurium with Acanthamoeba castellanii genotype T4

Parasitology Research - Pathogenic bacteria share their natural habitat with many other organisms such as animals, plants, insects, parasites and amoeba. Interactions between these organisms...     

Perinatal outcome of twin pregnancies according to chorionicity: an observational study from tertiary care hospital

Objective: To assess the perinatal outcome in twin pregnancies according to chorionicity.

Methods: This was a retrospective cohort study of twin pregnancies from January 2001 to December 2012. Maternal and perinatal outcomes of monochorionic (MC) and dichorionic (DC) twins were compared by using chi-square and t-test. Perinatal complications were compared by adjusted odds ratio using logistic regression at 5% level of significance.

Results: Among 391 twin pregnancies, 116 (29.6%) were MC and 275 (72.95%) were DC. In MC twins, the rate of miscarriage was three fold higher than DC (12.6% versus 4.4%; p-value?p value?p value?=?0.042] more likely to be delivered preterm. Likewise, neonatal intensive care admission for MC was 2.23 times [CI (1.08–4.06), p-value?=?0.03], congenital anomalies were 4.75 times [CI (1.22–18.4), p value?=?0.024]. Fetal growth restriction was 1.86 times more common in the MC twin pair [CI (1.07–3.21), p-value?=?0.026].

Conclusions: MC twins were more at risk for adverse outcomes than DC twins. Determining chorionicity at early pregnancy will help the Obstetricians to plan the care of these patients. This will help not only in managing twin pregnancies but also help in counseling according to the local perinatal outcome.     

Comparing computer-generated and pathologist-generated tumour segmentations for immunohistochemical scoring of breast tissue microarrays

Background:

Tissue microarrays (TMAs) have become a valuable resource for biomarker expression in translational research. Immunohistochemical (IHC) assessment of TMAs is the principal method for analysing large numbers of patient samples, but manual IHC assessment of TMAs remains a challenging and laborious task. With advances in image analysis, computer-generated analyses of TMAs have the potential to lessen the burden of expert pathologist review.

Methods:

In current commercial software computerised oestrogen receptor (ER) scoring relies on tumour localisation in the form of hand-drawn annotations. In this study, tumour localisation for ER scoring was evaluated comparing computer-generated segmentation masks with those of two specialist breast pathologists. Automatically and manually obtained segmentation masks were used to obtain IHC scores for thirty-two ER-stained invasive breast cancer TMA samples using FDA-approved IHC scoring software.

Results:

Although pixel-level comparisons showed lower agreement between automated and manual segmentation masks (κ=0.81) than between pathologists'' masks (κ=0.91), this had little impact on computed IHC scores (Allred; =0.91, Quickscore; =0.92).

Conclusions:

The proposed automated system provides consistent measurements thus ensuring standardisation, and shows promise for increasing IHC analysis of nuclear staining in TMAs from large clinical trials.     

Intraoperative hypercyanosis in a patient with pulmonary artery band: case report and review of the literature

A case of intraoperative cyanosis in a patient with a common atrioventricular canal palliated with a pulmonary artery (PA) band is presented. The patient's physiology was consistent with cyanosis due to inadequate pulmonary blood flow, and responded quickly to typical interventions used for a hypercyanotic episode in a patient with unrepaired Tetralogy of Fallot. Differences and similarities in the physiology of PA banding compared with Tetralogy of Fallot are presented, including a rationale for treatment options for hemodynamic decompensation occurring in the setting of anesthesia and surgery.     

Angiomyofibroblastoma of the vulva

A 30-year-old female presented with unilateral labial enlargement. The clinical impression was that of a benign cyst. The microscopic features were that of angiomyofibroblastoma showing hyper and hypocellular areas containing spindle and plump stromal cells admixed with blood vessels. This tumour is benign with extremely low rate of recurrence. Surgery is the only treatment as in this case.     

Impact of initiating carvedilol before angiotensin-converting enzyme inhibitor therapy on cardiac function in newly diagnosed heart failure

OBJECTIVES: The purpose of this research was to evaluate the therapeutic value of initiating a beta-blocker before an angiotensin-converting enzyme inhibitor (ACEI) in the treatment of heart failure. BACKGROUND: Although ACEI and carvedilol produce benefits in heart failure, whether the order of initiation of therapy determines the impact on left ventricular (LV) function and New York Heart Association functional class (NYHA FC) has not been determined. METHODS: A single-center, prospective, randomized, open-label study was performed. We evaluated whether initiation of therapy with carvedilol either before (n = 38) or after (n = 40) perindopril therapy in newly diagnosed patients in NYHA FC II to III heart failure with idiopathic dilated cardiomyopathy, with the addition of the alternative agent after six months, determined subsequent changes in NYHA FC and LV function (echocardiography and radionuclide ventriculography). Study drugs were titrated to maximum tolerable doses. RESULTS: There were no differences in baseline characteristics between the study groups. After 12 months 11 patients died (6 in the group where the ACEI was initiated). At 12 months the group receiving carvedilol as initial therapy achieved a higher tolerable dose of carvedilol (43 +/- 17 mg vs. 33 +/- 18 mg, p = 0.03); a lower dose of furosemide (p < 0.05); and better improvements in symptoms (NYHA FC, p < 0.002), LV ejection fraction (radionuclide: 15 +/- 16% vs. 6 +/- 13%, p < 0.05; echocardiographic, p < 0.01), and plasma N-terminal pro-brain natriuretic peptide concentrations (p < 0.02). CONCLUSIONS: As opposed to the conventional sequence of drug use in the treatment of heart failure, initiation of therapy with carvedilol before an ACEI results in higher tolerable doses of carvedilol and better improvements in FC and LV function.     

Prevalence of elevated total IgE and food allergies in a consecutive series of ENT pediatric patients.

OBJECTIVE: Food allergies in childhood have been found to vary in frequency from 6% to 8% in the general population. Previous studies indicate milk allergy affects approximately 2.5% of infants and egg allergy has been estimated at 1.6% to 2.6%. Numerous allergists believe that the prevalence of food allergies is rising, similar to the rise in other atopic conditions. Prior studies have demonstrated that food-specific IgE is a useful test for diagnosing symptomatic allergies to certain foods, including milk and eggs, and could decrease the need to perform cumbersome multiple double-blind, placebo-controlled food challenges in children based on history alone. The purpose of this study was to determine the prevalence of food allergies and elevated IgE in a consecutive series of pediatric otolaryngology patients. STUDY DESIGN AND SETTING: ImmunoCap studies were drawn in a 2-year series of children undergoing ENT procedures of bilateral myringotomy with tubes (BMT) with or without adenoidectomy or tonsillectomy or adenoidectomy alone between 2001 and 2003. Sera was analyzed for increased total IgE antibodies, as well as specific IgE antibodies to antigens, including milk, egg, beef, and environmental allergens. A positive patient history or family history of allergy were documented. RESULTS: A total of 242 patients were assessed. Of the study population, milk allergy was found in 10.7%; egg white allergy was found in 5.0%. The prevalence of elevated IgE among participants was 11.2%. The overall food allergy prevalence was 14.5%. CONCLUSIONS: Although we cannot imply causality, the study demonstrated an increased prevalence of food allergy in children undergoing ENT procedures, specifically milk and eggs, than in previous population studies. EBM rating: C-4.