Appendicitis: Higher risk in Mexican Americans?

Objectives. Mexican Americans (MAs), compared to white non‐Hispanics (WNHs), have higher rates of biliary disease, noninsulin dependent diabetes, and endstage renal disease but lower rates of lung cancer, hip fractures, and mortality from coronary heart disease. Relatively little research has been done to identify other ethnic differences in disease incidence. We used surgical procedure rates to confirm known ethnic differences and to explore our clinical suspicion that MAs have higher rates of appendectomy than WNHs.

Methods. We used a registry of surgical procedures at two teaching hospitals in South Texas to calculate proportional operation ratios (PORs) for MAs versus WNHs. These two hospitals are the primary source of acute hospital care for the indigent in the area. The POR is arithmetically identical to proportional incidence and mortality ratios.

Results. MAs underwent appendectomy proportionally more often than WNHs at both hospitals (POR = 1.41 and 1.75, p < 0.0001). Other significant PORs were consistent with known ethnic disease differences in biliary tract operations, vascular access for chronic hemodialysis, lung cancer, and coronary artery bypass.

Conclusions. These findings support the hypothesis that MAs may undergo appendectomy more often than WNHs and so may be at higher risk of appendicitis.     

Auditory evoked responses in gestational diabetics.

Electrophysiological correlates of sensory function in diabetic pregnancy have not been documented. Present study reports changes in Auditory evoked responses (AER) in gestational diabetics when compared with normal pregnant controls. Human AER are generally classified into early Auditory brainstem responses (AER), Mid latency responses (MLR) and late Slow vertex responses (SVR). These potentials were recorded in 20 women with diabetic pregnancy using Ag/AgCl electrodes from Cz-A1 and Cz-A2 position on MEB 5200 Neuropack II ... plus (Nihon Kohden, Japan) Evoked Potential Recorder. The evoked potentials in gestational diabetics were compared with 20 age matched normal pregnant women using Student's t-test. Absolute latencies of waves I to V, Inter peak latencies I-III and I-V of ABR were significantly increased whereas amplitude of wave V decreased in diabetic pregnant women. No significant change in latency of any component of MLR was observed between the two groups whereas significant prolongation of latencies of all components of SVR was observed in diabetic pregnant women as compared to normal control group. These findings indicate prolongation of both peripheral transmission time (PTT) and central transmission time (CTT) in diabetic pregnant females. Prolongation of latencies of SVR components in this study implicates cortex in the central diabetic neuropathy in women with gestational diabetes.     

Identification of High-Risk Groups among Node-Positive Patients with Stage IB and IIA Cervical Carcinoma

The purpose of the present study was to identify a subset of high-risk patients among surgically treated node-positive patients with stage IB and IIA cervical carcinoma. From 1982 through 1991, 334 patients underwent radical hysterectomy for FIGO stage IB and IIA cervical carcinoma. In 68 patients pathological analysis of the surgical specimen revealed positive pelvic nodes. In this group, a Cox proportional hazard analysis was performed to examine the prognostic significance of clinicopathological variables. Only for adenocarcinoma (P= 0.002) and parametrium infiltration (P= 0.003) was evidence of an association with prognosis found. Based on these two factors, patients with positive pelvic nodes were categorized into a low-risk group (squamous cell carcinoma without parametrium infiltration,N= 33) and a high-risk group (squamous cell carcinoma with parametrium infiltration or adenocarcinoma,N= 34). The 5-year disease-specific survival in the low-risk group was 94% compared with 60% in the high-risk group (P= 0.003). For patients in the high-risk group, there is an urgent need for alternative adjuvant treatment to improve outcome.     

Discovery of 2-(4-cyano-3-trifluoromethylphenyl amino)-4-(4-quinazolinyloxy)-6-piperazinyl(piperidinyl)-s-triazines as potential antibacterial agents

A series of 2-(4-cyano-3-trifluoromethylphenyl amino)-4-(4-quinazolinyloxy)-6-piperazinyl(piperidinyl)-s-triazines have been synthesized in this study by a simple and efficient synthetic protocol. The synthetic route to final piperazinyl s-triazines involved two nucleophilic substitution reactions of 4-amino-2-trifluoromethyl-benzonitrile and 4-hydroxyquinazoline with 2,4,6-trichloro-1,3,5-triazine resulting in 2,4-disubstituted-6-chloro-1,3,5-triazine derivative to introduce the piperazinyl or piperidinyl functionality. The structures of the compounds were elucidated with the aid of IR, ¹H NMR, ¹³C NMR, ¹⁹F NMR spectroscopy, and elemental analysis. The antimicrobial activity of the compounds was tested against eight bacteria (Staphylococcus aureus MTCC 96, Bacillus cereus MTCC 619, Escherichia coli MTCC 739, Pseudomonas aeruginosa MTCC 741, Klebsiella pneumoniae MTCC 109, Salmonella typhi MTCC 733, Proteus vulgaris MTCC 1771, Shigella Flexneria MTCC 1457) and four fungi (Aspergillus niger MTCC 282, Aspergillus fumigatus MTCC 343, Aspergillus clavatus MTCC 1323, and Candida albicans MTCC 183). The title compounds were also investigated for their antituberculosis activity against MTB H37 R_V strain using BACTEC MGIT and L. J. agar dilution method. The bioassay results showed that compounds 5d, 5n, 5p, 5s, and 5t demonstrated 99% inhibition at the MIC of 6.25?μg/ml, equivalent to standard drug pyrazinamide.     

Mesenteric panniculitis does not confer an increased risk for cancers: A systematic review and meta-analysis

Background:Mesenteric panniculitis (MP) is a non-specific, localized inflammation at the mesentery of small intestines which often gets detected on computed tomography. An association with malignant neoplasms remains unclear. We performed a systematic review and meta-analysis to examine the association of malignancy with MP.Methods:MEDLINE, EMBASE, Web of Science, and Cochrane databases were searched for articles published from inception to 2020 that evaluated the association of malignant neoplasms with MP in comparison with control groups. Using random-effects method, a summary odds ratio (OR) estimate with 95% confidence intervals for malignant neoplasms in MP was estimated.Results:Four case-control studies reporting data on 415 MP patients against 1132 matched-controls met inclusion criteria and were analyzed. The pooled OR for finding a malignant neoplasm in patients with MP was 0.907 (95% CI: 0.688–1.196; P = .489). The heterogeneity was mild and non-significant. Also, there was no heightened risk of any specific type of malignancy with MP. Three more case-series with unmatched-control groups (MP: 282, unmatched-controls: 17,691) were included in a separate analysis where the pooled OR of finding a malignant neoplasm was 2.963 (95% CI: 1.434–6.121; P = .003). There was substantial heterogeneity in this group.Conclusion:This meta-analysis of matched controlled studies proves absence of any significant association of malignant neoplasms with MP. Our study also demonstrates that the putative association of malignancy with MP is mainly driven by uncontrolled studies or case-series.     

Practical synthesis of lespedezol A1

A practical formal synthesis of lespedezol A 1 ( 1) was accomplished in 33% yield for four steps starting from formation of the substituted chalcone. Of particular note is a useful protocol for reduction of the 2-ene bond in the isoflavone intermediate. A significant improvement in the final ring closure when water was scavenged from the reaction is also noteworthy. The ready availability of lespedezol A 1 will provide material for further pharmacological evaluation and for exploration of the pterocarpene nucleus as a potential entry into various 6a-hydroxypterocarpans.     

Intrauterine contraceptive device-related actinomycosis infection presenting as an incarcerated inguinal hernia

We report an unusual case of an intrauterine contraceptive device (IUCD)-related pelvic actinomyces infection presenting as an incarcerated inguinal hernia. An emergency laparotomy showed the presence of pyometra with large abscesses, involving both fallopian tubes and the right ovary with pyometra tracking down the left psoas into the groin, giving a clinical and radiological appearance of an incarcerated hernia. Subsequent results obtained from investigations showed the presence of actinomyces-like organisms on the patient's smear related to an IUCD.     

Biochar Synthesis from Mineral- and Ash-Rich Waste Biomass,Part 1: Investigation of Thermal Decomposition Mechanism during Slow Pyrolysis

Synthesizing biochar from mineral- and ash-rich waste biomass (MWB), a by-product of human activities in urban areas, can result in renewable and versatile multi-functional materials, which can also cater to the need of solid waste management. Hybridizing biochar with minerals, silicates, and metals is widely investigated to improve parent functionalities. MWB intrinsically possesses such foreign materials. The pyrolysis of such MWB is kinetically complex and requires detailed investigation. Using TGA-FTIR, this study investigates and compares the kinetics and decomposition mechanism during pyrolysis of three types of MWB: (i) mineral-rich banana peduncle (BP), (ii) ash-rich sewage sludge (SS), and (iii) mineral and ash-rich anaerobic digestate (AD). The results show that the pyrolysis of BP, SS, and AD is exothermic, catalyzed by its mineral content, with heat of pyrolysis 5480, 4066, and 1286 kJ/kg, respectively. The pyrolysis favors char formation kinetics mainly releasing CO₂ and H₂O. The secondary tar reactions initiate from ≈318 °C (BP), 481 °C (SS), and 376 °C (AD). Moreover, negative apparent activation energies are intrinsic to their kinetics after 313 °C (BP), 448 °C (SS), and 339 °C (AD). The results can support in tailoring and controlling sustainable biochar synthesis from slow pyrolysis of MWB.