Inferior glenohumeral joint dislocation with greater tuberosity avulsion

Inferior glenohumeral dislocation is the least common type of glenohumeral dislocations. It may be associated with fractures of the adjacent bones and neurovascular compromise. It should be treated immediately by close reduction. The associated neuropraxia usually recovers with time. Traction-counter traction method is commonly used for reduction followed by immobilization of the shoulder for three weeks. Here, we report a case of inferior glenohumeral joint dislocation with greater tuberosity fracture with transient neurovascular compromise and present a brief review of the literature.     

Regression to the mean in home blood pressure: Analyses of the BP GUIDE study

The aim of our study was to estimate the size of regression to the mean with home blood pressure (BP) monitoring and compare with that for office BP. Office and home BP measures were obtained from the BP GUIDE (value of central Blood Pressure for GUIDing managEment for hypertension) study, in which 286 patients had BP measured every 3 months for 12 months. Patients were categorized by 10 mm Hg strata of baseline BP, and regression to the mean measures was calculated for home and office BP. High baseline home BP readings tended to be lower on long‐term follow‐up, and low baseline readings tended to be higher. For example, patients in the group with mean baseline home systolic BP ≥ 150 mm Hg had a mean baseline systolic BP of 156 mm Hg, which fell to 143 mm Hg at 12 months; and patients in the group with mean baseline home systolic BP < 120 mm Hg had a mean baseline systolic BP of 113 mm Hg which rose to 120 mm Hg at 12 months. Similar patterns were seen in intervention and control groups, and for diastolic BP. The regression dilution ratio for home systolic BP and diastolic BP was 0.52 and 0.64, respectively, compared to 0.40 and 0.55 for office systolic BP and diastolic BP, respectively. Home BP is subject to regression to the mean to a similar degree as office BP. These findings have implications for the diagnosis and management of hypertension using home BP.     

Lipoprotein status among urban populations in Bangladesh

ObjectiveSerum lipoprotein is the most important predictor for microvascular diseases, and may be influenced by rapid urbanization. Currently available data are limited, particularly regarding age-specific lipoprotein status in urban Bangladeshi populations.MethodsBlood lipoprotein levels of 51,353 male and female individuals primarily residing in urban Bangladesh were analyzed. De-identified data (collected between January 2005 and December 2011) were extracted from the Clinical Biochemistry Laboratory Data Archive of International Centre for Diarrheal Disease Research, Bangladesh (icddr,b). For analyses, six age categories were created: (i) <20 years, n = 481; (ii) 20–29 years, n = 1602; (iii) 30–39 years, n = 7272; (iv) 40–49 years, n = 13,582; (v) 50–59 years, n = 15,890; and (vi) 60 years and more, n = 12,526.ResultsMean serum levels of TC, LDL, TG, LDL:HDL and TC:HDL were significantly higher among adults 30–39 years old compared to other age groups, regardless of sex. The proportion of high TC and LDL from 2005 to 2011 among individuals aged 30–39 years old varied widely (p < 0.01 for trend and all pairwise tests).Conclusion30–39 years old individuals had higher concentration of lipoprotein, which increases microvascular disease risk. Further population-based studies are needed to validate our observations in rural areas of Bangladesh.     

Outcomes of transcutaneous nerve stimulation for migraine headaches: a systematic review and meta-analysis

Journal of Neurology - Implanted and transcutaneous nerve stimulators have shown promise as novel non-pharmacologic treatment for episodic and chronic migraines. The purpose of this study was to...     

Hypercapnia modulates cAMP signalling and cystic fibrosis transmembrane conductance regulator‐dependent anion and fluid secretion in airway epithelia

Key points

• Raised arterial blood CO₂ (hypercapnia) is a feature of many lung diseases.
• CO₂ has been shown to act as a cell signalling molecule in human cells, notably by influencing the levels of cell signalling second messengers: cAMP and Ca²⁺.
• Hypercapnia reduced cAMP‐stimulated cystic fibrosis transmembrane conductance regulator‐dependent anion and fluid transport in Calu‐3 cells and primary human airway epithelia but did not affect cAMP‐regulated HCO₃ ⁻ transport via pendrin or Na⁺/HCO₃ ⁻ cotransporters.
• These results further support the role of CO₂ as a cell signalling molecule and suggests CO₂‐induced reductions in airway anion and fluid transport may impair innate defence mechanisms of the lungs.

Abstract

Hypercapnia is clinically defined as an arterial blood partial pressure of CO₂ of above 40 mmHg and is a feature of chronic lung disease. In previous studies we have demonstrated that hypercapnia modulates agonist‐stimulated cAMP levels through effects on transmembrane adenylyl cyclase activity. In the airways, cAMP is known to regulate cystic fibrosis transmembrane conductance regulator (CFTR)‐mediated anion and fluid secretion, which contributes to airway surface liquid homeostasis. The aim of the current work was to investigate if hypercapnia could modulate cAMP‐regulated ion and fluid transport in human airway epithelial cells. We found that acute exposure to hypercapnia significantly reduced forskolin‐stimulated elevations in intracellular cAMP as well as both adenosine‐ and forskolin‐stimulated increases in CFTR‐dependent transepithelial short‐circuit current, in polarised cultures of Calu‐3 human airway cells. This CO₂‐induced reduction in anion secretion was not due to a decrease in HCO₃ ⁻ transport given that neither a change in CFTR‐dependent HCO₃ ⁻ efflux nor Na⁺/HCO₃ ⁻ cotransporter‐dependent HCO₃ ⁻ influx were CO₂‐sensitive. Hypercapnia also reduced the volume of forskolin‐stimulated fluid secretion over 24 h, yet had no effect on the HCO₃ ⁻ content of the secreted fluid. Our data reveal that hypercapnia reduces CFTR‐dependent, electrogenic Cl⁻ and fluid secretion, but not CFTR‐dependent HCO₃ ⁻ secretion, which highlights a differential sensitivity of Cl⁻ and HCO₃ ⁻ transporters to raised CO₂ in Calu‐3 cells. Hypercapnia also reduced forskolin‐stimulated CFTR‐dependent anion secretion in primary human airway epithelia. Based on current models of airways biology, a reduction in fluid secretion, associated with hypercapnia, would be predicted to have important consequences for airways hydration and the innate defence mechanisms of the lungs.     

Particulate black carbon and gaseous emission from brick kilns in Greater Dhaka region,Bangladesh

Eighteen brick kilns of three brick-making technologies (Fixed Chimney Kiln (FCK), Zigzag, and Hoffmann) were selected to measure the concentrations of particulate matter (PM_2.5) with Aerocet 531S (USA) sampler, black carbon (BC) with Magee Scientific, OT-21 Soot scan Transmissometer (USA), and gaseous pollutants (CO₂, CO, SO₂, NO_x, and volatile organic carbon (VOC)) with Aeroqual 500 gas sampler (New Zealand) to understand the emission scenario from brick sector in Greater Dhaka region, Bangladesh. Emission factor (EF) of each pollutant was computed from their respective concentration for three brick kiln technologies. Ambient PM_2.5 and PM₁₀ were measured in brick kiln premises and 1 km far from the respective kilns to see the effect on the surrounding areas. The PM_2.5 concentration was found on an average of 141?±?86, 128?±?72, and 110?±?53 mg/m³ in FCK, Zigzag, and Hoffmann kilns, respectively. The average BC concentration was found 16.6?±?7.1 (FCK), 11.8?±?4.2 (Zigzag), and 8.9?±?4.4 (Hoffmann) mg/m³. FCK has a greater emission of CO, whereas Zigzag has a higher CO₂ emission. A comparatively higher value of CO₂ and lower value of CO indicates effective combustion of coal, and this is found to be more efficient for Zigzag and Hoffmann compared to traditional FCK. SO₂ and VOC emissions were depending not only on the kiln types but also on the fuel qualities. From EF calculation, approximately 4526 t of PM_2.5, 340 t of BC, 209,776 t of CO₂, 8700 t of CO, 19,441 t of SO₂, and 835,450 t of VOC per year found to emit from 1000 brick kilns. The conversion of traditional FCK to improved one, i.e., Zigzag and/or Hoffman is not a straight forward solution, as CO₂ emission was higher in Zigzag whereas BC and PM_2.5 emissions were higher in FCK. Therefore, considering EF of various pollutants from these three types of kilns, conversion of FCK to Zigzag or Hoffmann could be a better choice.     

Enhancing a clenbuterol immunosensor based on poly(3,4-ethylenedioxythiophene)/multi-walled carbon nanotube performance using response surface methodology

Clenbuterol (CLB) is an illegal antibiotic for livestock, which is misused as a growth promoter drug. In this study, an immunosensor modified with poly(3,4-ethylenedioxythiophene) (PEDOT), multi-walled carbon nanotubes (MWCNT) and anti-clenbuterol antibody (Ab) was developed for the detection of CLB. A screen-printed carbon electrode (SPCE) was modified with PEDOT/MWCNT as a sensor platform before immobilizing Ab for specific CLB binding through a competitive-type immunoassay. Free CLB in the sample solution competed with clenbuterol-horseradish peroxide (CLB–HRP) to bind with Ab. A high current signal was obtained after optimization of the electrochemical immunoassay conditions (pH, incubation temperature, antigen (Ag) incubation time and % blocking) using the response surface methodology/central composite design (RSM/CCD). The developed immunosensor is highly reproducible and sensitive with good storage stability, which are necessary for practical application. In real sample application, this immunosensor produces comparable results with liquid chromatography-mass spectrometry; thus, it is useful for CLB screening and monitoring in real meat samples.

A clenbuterol immunosensor was developed with a poly(3,4-ethylenedioxythiophene)/multi-walled carbon nanotube-modified screen-printed carbon electrode and optimized using response surface methodology.