Evaluation of the impact of a low back pain educational intervention on physicians' practice patterns and patients' outcomes

This study was designed to evaluate the effects of an educational intervention on physicians' management of low back pain patients. The study universe composed of 64 providers employed by a large occupational health group, with 4411 LBP cases pretraining and 4665 cases posttraining selected from the organization's database. The control group had 151 providers with 8478 pretraining and 8876 posttraining cases. Results showed that practices of physicians who participated in the intervention strategy underwent significant changes between the two intervals. Specifically, the intervention group reduced the percentage of restricted work cases, reduced the percentage of lost-time cases for male patients and female patients (less than 40 years old), and shortened restricted workday duration and total case duration for female patients. These results provide early indication for the effectiveness of this type of educational intervention strategy.     

Promoting self-help activities for people living with HIV / AIDS in Ho Chi Minh City,Vietnam

The rising epidemic of HIV/AIDS in Ho Chi Minh City presents new challenges for sexually transmitted disease/HIV prevention in Vietnam. Most HIV/AIDS cases are found south of the country and this puts a burden on the Ho Chi Minh City AIDS Committee. Building on experiences from other countries, the AIDS Committee successfully implemented measures such as needle-exchange programs, condom distribution, peer education, and outreach activities. It also established a meeting place, the Cafe Hy Vong, for female sex workers and intravenous drug users. From the beginning, the Committee regarded meeting the special needs of people living with HIV/AIDS (PHA) as important prevention activities, and encouraged PHA to discuss their concerns with the committee. The PHA formed the Friend-to-Friend group in October 1995, where the Ho Chi Minh AIDS Committee gave its full support. The group organizes meetings and social gatherings where they can share their feelings and experiences, as well as get information and counseling.     

Study of MICA alleles in 201 African Americans by multiplexed single nucleotide extension (MSNE) typing

We have developed a method for major histocompatibility complex class I chain-related gene A (MICA) genotyping using multiplexed single nucleotide extension (MSNE) and flow cytometric analysis of an array of fluorescent microspheres. This technique employs a polymerase chain reaction-derived target DNA containing all the polymorphic sites of MICA, synthetic complementary primers, biotinylated dideoxynucleotide triphosphate, fluorescent reporter molecules (streptavidin-phycoerythrin), and thermophilic DNA polymerase. Genomic DNA was amplified by MICA locus-specific primers and the MSNE reactions were carried out in the presence of 30 MSNE primers used to assay polymorphisms in exons 2, 3, and 4 of the MICA genes. Thirty-two previously typed cell lines were used as reference material. The MICA gene frequencies among 201 African-American unrelated donors were determined. Of 51 previously known alleles, 18 were observed in African-Americans, compared to 16 that were found in North American Caucasians and 9 in South American Indians, suggesting a more diversified allelic distribution in African-Americans. MICA*00201 and MICA*00801 were the two most frequent alleles in African-Americans. We observed a high degree of linkage disequilibrium between certain alleles of MICA and of human leukocyte antigen-B in the African-American population. The methodology described here offers a powerful new approach to DNA typing of the MICA alleles.     

Effective reduction of nitrophenols and colorimetric detection of Pb(ii) ions by Siraitia grosvenorii fruit extract capped gold nanoparticles

This study presents a simple and green approach for the synthesis of Siraitia grosvenorii fruit extract capped gold nanoparticles (SG-AuNPs). The SG-AuNPs samples prepared under the optimized conditions were characterized by various techniques (UV-Vis, XRD, FTIR, HR-TEM, EDX, DLS). The biosynthesized nanoparticles were then studied for the reduction of 2-nitrophenol (2-NP) and 3-nitrophenols (3-NP) and for colorimetric detection of Pb²⁺ ions. The characterization results revealed that the crystals of SG-AuNPs were spherical with an average size of 7.5 nm. The FTIR and DLS analyses proved the presence of the biomolecule layer around AuNPs, which played an important role in stabilizing the nanoparticles. The SG-AuNPs showed excellent catalytic activity in the reduction of 3-NP and 2-NP, achieving complete conversion within 14 min. The catalytic process was endothermic and followed pseudo-first-order kinetics. The activation energy was determined to be 10.64 and 26.53 kJ mol⁻¹ for 2-NP and 3-NP, respectively. SG-AuNPs maintained high catalytic performance after five recycles. The fabricated material was also found to be highly sensitive and selective to Pb²⁺ ions with the detection limit of 0.018 μM in a linear range of 0–1000 μM. The practicality of the material was validated through the analyses of Pb²⁺ in mimic pond water samples. The developed nanoparticles could find tremendous applications in environmental monitoring.

Siraitia grosvenorii fruit extract capped AuNPs exhibited excellent catalytic activity in the reduction of nitrophenols and high sensitivity and selectivity for detection of Pb(ii) ions.     

Bilateral lacrimal gland lymphoma: Case report and literature review

Ocular adnexal lymphoma accounts for approximately 1%-2% of non-Hodgkin lymphomas and 8% of extranodal lymphomas. Lacrimal gland lymphoma, especially bilateral lacrimal gland lymphoma, is rare, and imaging is often utilized to differentiate lacrimal lymphoma from other types of masses that involve the lacrimal gland and the fossa. We describe a 74-year-old male patient presenting with bilateral eye proptosis, lachrymose without pain, and no changes in eyesight. Brain-orbit magnetic resonance imaging revealed bilateral lacrimal fossa masses with regular contours, moderate enhancement, and restriction on diffusion imaging, consistent with a lymphoma diagnosis, which was confirmed by histopathological results. Positron emission tomography-computed tomography was used to determine lymphoma grading. MRI, especially diffusion imaging, can be useful for guiding clinicians in the diagnosis and differentiation of lacrimal gland lymphoma from other lesions.     

Multiple sclerosis masquerading as a mass lesion

Summary Six patients presenting with new neurological deficits underwent magnetic resonance imaging (MRI) that displayed mass lesions leading to diagnoses of tumor or abscess. Biopsy revealed demyelinating lesions.     

Abnormal vitamin B12 metabolism in human immunodeficiency virus infection. Association with neurological dysfunction.

An increased prevalence of vitamin B12 deficiency has been reported in patients infected by the human immunodeficiency virus (HIV). We report an unexpectedly high prevalence (20%) of such abnormal vitamin B12 metabolism in a population of HIV-infected patients referred for neurological evaluation. This abnormality was associated with both peripheral neuropathy and myelopathy. A majority of those treated with cyanocobalamin had a therapeutic response. Selected neuropathological results suggest a relationship between vitamin B12 deficiency and vacuolar myelopathy. Vitamin B12 deficiency may be a frequent and treatable cause of neurological dysfunction in patients with HIV infection.     

TGFβ1对BxPC-3胰腺癌细胞周期基因表达的影响

目的:通过基因芯片技术进一步研究TGFβ1调控BxPC-3胰腺癌细胞周期的机制.方法:采用含有24个细胞周期相关基因位点的cDNA微阵列基因芯片,观察2.0 μg/L的TGFβ1干预BxPC-3细胞72h后细胞周期相关基因的表达变化,以相同培养的未加干预的BxPC-3细胞为空白对照.结果:加A.2.0μg/L TGFβ1干预前后,BxPC-3胰腺癌细胞系细胞周期相关基因表达有明显差异.表达增高基因3条,表达降低基因17条,基本不变有3条.仅有1条基因位点因芯片上出现负点影响分析.TGF-β1干预后,有多个G,期向S期转换的基因的mRNA表达发生下调.如GSPT1、ASK、CDK4、SKP2和Cyclin C.同时有多个转录因子的表达下调,如E2F3和E2F5.另外,与丝氨酸、苏氨酸磷酸化有关的激酶也有下调,如TRAD.结论:组织芯片显示TGFβ1可诱导BxPC-3细胞多种细胞周期相关基因表达变化,提示TGFβ1介导的生长抑制效应中Smad4依赖与非Smad4依赖信号通路存在串话.     

The effects of splinting on outcomes for epicondylitis

OBJECTIVE: To evaluate the effects of splinting on outcomes for injured workers with epicondylitis. DESIGN: Retrospective cohort study using propensity score methodology to statistically control for all observed pretreatment differences between patients with and without splints. SETTING: Nationwide network of 253 occupational medicine clinics. PARTICIPANTS: All injured workers (N=4614) receiving primary care for lateral or medical epicondylitis (International Classification of Diseases, 9th Revision, codes 726.31 or 726.32). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Physician-prescribed rates of duty restrictions and lost time, treatment duration, specialist referrals, and medical and physical therapy (PT) visits and charges. RESULTS: Overall, patients with splints had higher rates of limited duty ( P <.001), more medical visits and charges ( P <.001), higher total charges (medical and PT, P <.001), and longer treatment durations ( P <.01) than patients without splints. Evaluating differences for patients who did and did not receive PT, significant differences remained for rates of limited duty ( P <.05), medical visits ( P <.01), and medical charges ( P <.01). CONCLUSIONS: Splinting patients with epicondylitis may not optimize outcomes, including rates of limited duty, treatment duration, and medical costs.     

Posttransplant interleukin-4 treatment converts rat liver allograft tolerance to rejection

BACKGROUND: Previous studies showed that liver transplant rejection in the Piebald Virol Glaxo (PVG)-to-Lewis combination was associated with more intragraft interleukin (IL)-4 mRNA expression than in spontaneously tolerant grafts in the PVG-to-Dark Agouti (DA) combination. There was also immunoglobulin (Ig) G1 antibody deposition, suggesting an IL-4-induced IgG class switch in rejection. The aim of this study was to investigate whether IL-4 treatment converts PVG-->DA liver transplant tolerance to rejection. METHODS: DA (RT1a) rats were recipients of orthotopic PVG (RT1c) liver transplants and DA liver transplants were syngeneic controls. Supernatant from IL-4-transfected Chinese hamster ovary cells (0.5 mL, 30,000 U) or from untransfected cells was injected intraperitoneally on days 3 through 7. Samples were taken for immunohistochemical staining of frozen tissue sections to analyze cellular infiltrate and antibody deposition. RESULTS: IL-4 treatment significantly reduced survival of liver allografts from greater than 100 days in untreated animals to 9 days (P=0.004). Pathologic analysis of IL-4-treated animals showed that death was caused by liver transplant rejection, with a heavy infiltrate of mononuclear cells, disruption of portal tract areas, and infarction. Immunohistochemistry revealed an extensive infiltrate of T cells, CD25-expressing cells, and B cells that was similar to the level in PVG--> Lewis liver allograft recipients that reject the liver. There was also a more extensive monocyte-macrophage infiltrate and more major histocompatibility complex class II expression in IL-4-treated animals compared with untreated animals. There was moderate increase of IgM, little IgG1, and no IgE or IgG2a antibody deposition. CONCLUSIONS: IL-4, a T-helper type 2 cytokine that has previously been shown to inhibit delayed-type hypersensitivity responses such as rejection, was found to promote rejection of liver allografts. There was only slight evidence of a graft-specific antibody response, showing that IL-4 induces liver allograft rejection in association with some, but not all, of the changes accompanying rejection in the PVG-->Lewis strain combination.