Improved quality of life after lung volume reduction surgery.

Lung volume reduction surgery (LVRS) improves dyspnoea, pulmonary function, and physical performance in patients with severe pulmonary emphysema. This study investigated the impact of LVRS on health-related quality of life (HRQL) over a 2-yr period following surgery. Thirty-nine consecutive patients were prospectively assessed before LVRS, and followed over 24 months postoperatively. The assessments included pulmonary function, dyspnoea (Medical Research Council (MRC) dyspnoea score), 6-min walking distance (6MWD) and HRQL using the Short Form 36-item questionnaire (SF-36). Several domains of SF-36 improved considerably over 2 yrs after surgery: Physical Functioning: 39 +/- 4 (mean +/- SEM) versus 16 +/- 2 (p<0.01); Vitality: 51 +/- 3 versus 32 +/- 3 (p<0.01); Social Functioning: 72 +/- 4 versus 51 +/- 5 (p<0.01). Also, improvements in pulmonary function (forced expiratory volume in one second (FEV1): 27 +/- 1% predicted, residual volume (RV)/total lung capacity (TLC): 0.65 +/- 0.01), 6 MWD (274 +/- 16 m) and dyspnoea (MRC: 3.9 +/- 01) were sustained for up to 2 yrs after LVRS (FEV1 36 +/- 2% pred, RV/TLC: 0.58 +/- 0.02; 6 MWD: 342 +/- 19 m; MRC: 2.0 +/- 0.2; p<0.05). In patients with severe emphysema, lung volume reduction surgery had positive effects on health-related quality of life and pulmonary function over 2 yrs.     

Arthritis associated with Mycoplasma pneumoniae in a pediatric patient: A case report

Introduction:Mycoplasma pneumoniae (MP) infection in infants is usually overlooked and it might result in important complications if left untreated. MP-induced arthritis is probably the least common extrapulmonary manifestation and frequently leads to delays in the diagnosis.Patient concerns:We report the case of a 2-year-old female child admitted in our clinic for prolonged fever (onset 2 weeks before the admission), for which the general practitioner established the diagnosis of acute pharyngitis and recommended antibiotics. But the fever persisted and the patient was referred to a pediatrician.Diagnosis:The laboratory tests revealed leukocytosis with neutrophilia, elevated C-reactive protein and liver cytolysis. The blood and urine cultures, as well as the serological hepatitis B and C, toxoplasmosis, Epstein Barr virus, Rubella, Herpes virus, and cytomegalovirus were negative. The chest X-ray established the diagnosis of pneumonia. The fever persisted for approximately 2 weeks after admission. On the 2nd week of admission, the patient began to experience gait difficulties complaining of pain in the right hip and ankle. The cardiology and pneumology consults revealed no pathological findings. The evolution was favorable after the initiation of Levofloxacin and MP infection was detected as we suspected. Moreover, the ultrasound of the hip revealed a mild joint effusion, while the ankle joint appeared to be normal at ultrasound. Thus, we established the diagnosis of hip and ankle arthritis based on the clinical and ultrasound findings.Interventions:Levofloxacin by vein was continued for 5 days, replaced afterwards with clarithromycin orally for 2 weeks.Outcomes:The gait difficulties persisted for approximately 5 months from the initial diagnosis, and improved once the titer of immunoglobulin M anti-MP antibodies lowered considerably. After more than 8 months, the patient was completely asymptomatic and the immunoglobulin M anti-MP was close to the normal range.Conclusion:The awareness of MP-induced arthritis in children represents the cornerstone in preventing diagnostic delays and initiating the proper treatment.     

Activation profile of dorsal root ganglia Iba-1 (+) macrophages varies with the type of lesion in rats

The interactions between neurons, immune and immune-like glial cells can initiate the abnormal processes that underlie neuropathic pain. In the peripheral nervous system the resident macrophages may play an important role. In this study we investigated in experimental adult Sprague-Dawley rats how Iba-1 (ionized calcium binding adaptor molecule 1) (+) resident macrophages in the dorsal root ganglion (DRG) are activated after a spinal nerve ligation (SNL) or streptozotocin (STZ)-induced diabetes. The activation profile was defined by comparing the responses of resident macrophages against microglia in the spinal cord as they share a common origin. After SNL, the Iba-1 (+) macrophages in L5 DRG reached their activation peak 5 days later, clustered as satellite cells around large A-neurons, expressed the MHC-II marker, but did not show p-p38 and p-ERK1/2 activation and did not secrete IL-18. After STZ-induced diabetes, the Iba-1 (+) macrophages reached their activation peak 1 week later in L4 and L5 DRG, remained scattered between neurons, expressed the MHC-II marker only in L5 DRG, did not show p-p38 and p-ERK1/2 activation and did not secrete any of the investigated cytokines/chemokines. These responses suggest that depending on the type of lesion DRG Iba-1 (+) resident macrophages have different activation mechanisms, which are dissimilar to those in microglia.     

The kinase-deficient Src acts as a suppressor of the Abl kinase for Cbl phosphorylation

The kinase activity of Abl is known to be regulated by a putative trans-acting inhibitor molecule interacting with the Src homology (SH) 3 domain of Abl. Here we report that the kinase-deficient Src (SrcKD) directly inhibits the tyrosine phosphorylation of Cbl and other cellular proteins by Abl. We found that both the SH2 and SH3 domains of SrcKD are necessary for the suppressor activity toward the Abl kinase phosphorylating Cbl. To suppress the Cbl phosphorylation by Abl, the interaction between the SH3 domain of SrcKD and Cbl is required. This interaction between SrcKD and Cbl is regulated by a closed structure of Cbl. The binding of Abl to the extreme carboxyl-terminal region of Cbl unmasks the binding site of SrcKD to Cbl. This results in a ternary complex that inhibits the Abl-mediated phosphorylation of Cbl by steric hindrance. These results illustrate a mechanism by which the enzymatically inactive Src can exert a biological function in vivo.     

An unusual case of congenital scoliosis associated with rib agenesis in the upper part of the concavity treated by VEPTR vertebra to vertebra

Background contextRib agenesis in congenital scoliosis is rarely encountered, and its disposal in the application area of the proximal vertical expandable prosthetic titanium rib (VEPTR) module is a challenge to the orthopedic surgeon.PurposeTo present a case in which known treatment methods in early-onset scoliosis were not possible to apply.Study designCase report.MethodsA patient aged 1 year and 10 months, presenting a congenital scoliosis with the following characteristics: left T3 hemisegmented hemivertebra, T5–T6–T7 hemivertebral segment, T9, T10 trapezoidal vertebrae, right side I–IV rib agenesis with T1–T2–T4 hemivertebral hypoplasia (T3 agenesis) and bilateral XIIth rib agenesis, and V–VI and VII–VIII–IX fused ribs on the right side. We applied a standard VEPTR in a new construct, vertebra to vertebra.ResultsThe VEPTR vertebra to vertebra proved to be an efficient and stabile construct after 1.5 years of follow-up and three device distractions in a row. The curve corrected from 100 to 58 Cobb degrees.ConclusionsWe believe that the vertebra-to-vertebra construct with eventual modifications may be a solution in the treatment of early-onset scoliosis needing surgery, which associate rib agenesis in the area where the proximal module has to be applied.     

Brief Report: Specificity of Interpersonal Synchrony Deficits to Autism Spectrum Disorder and Its Potential for Digitally Assisted Diagnostics

Journal of Autism and Developmental Disorders - Reliably diagnosing autism spectrum disorders (ASD) in adulthood poses a challenge to clinicians due to the absence of specific diagnostic markers....     

Tribology of Polymer Blends PBT + PTFE

This paper presents results on tribological characteristics for polymer blends made of polybutylene terephthalate (PBT) and polytetrafluoroethylene (PTFE). This blend is relatively new in research as PBT has restricted processability because of its processing temperature near the degradation one. Tests were done block-on-ring tribotester, in dry regime, the variables being the PTFE concentration (0%, 5%, 10% and 15% wt) and the sliding regime parameters (load: 1, 2.5 and 5 N, the sliding speed: 0.25, 0.5 and 0.75 m/s, and the sliding distance: 2500, 5000 and 7500 m). Results are encouraging as PBT as neat polymer has very good tribological characteristics in terms of friction coefficient and wear rate. SEM investigation reveals a quite uniform dispersion of PTFE drops in the PBT matrix. Either considered a composite or a blend, the mixture PBT + 15% PTFE exhibits a very good tribological behavior, the resulting material gathering both stable and low friction coefficient and a linear wear rate lower than each component when tested under the same conditions.     

Epidemiological researches on diabetes mellitus in Roumanian urban and rural population

Summary This paper presents the methodology and the results of screening forDiabetes mellitus in large population groups. The investigation consisted of two phases : the detection of glycosuria and blood sugar level 2 h after on oral glucose load; and afterwards, the performance of GTT on people with blood sugar levels above the limits defined as normal for each age group. — The screening of 1314 subjects from a rural population and 7113 from an urban population, between 25 and 65 years of age indicated a prevalence ofDiabetes mellitus of 1.44% and 3.7% respectively. This estimate includes diabetics already known to a special medical centre. –74.5% of the urban population and 88.7%, of the rural population were included in the screening. -Obesity was found in 51% and 69% of the newly found urban and rural diabetics, respectively. In 2.15% of the group, glycosuria was found with normal blood sugar levels during GTT, suggesting that this group should be specially recorded and subjected to periodical survey. — Screening forDiabetes mellitus solely by glycosuria testing is both inadequate and erroneous.

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Epidemiologische Studien über den Diabetes mellitus in der rumänischen Stadt- und Landbevölkerung

Zusammenfassung Es werden die Methoden und Resultate bei der Aufdeckung von Diabetikern in großen Bevölkerungsgruppen dargelegt. Die Untersuchungen erfolgten in zwei Teilen. Zunächst wurden der Harn- und Blutzucker zwei Stunden nach einer Glucosebelastung ermittelt. Später wurden bei den Personen mit im Vergleich zu den Normalwerten ihrer Altersgruppe erhöhten Blutzuckerwerten detailliertere Glucosetoleranzteste durchgeführt. -In einer Gruppe von 1314 Personen einer Landbevölkerung und in einer Gruppe von 7113 Personen einer Stadtbevölkerung zwischen 25 und 65 Jahren war die Häufigkeit des Diabetes 1.44% bzw. 3.7%. In der Endrechnung wurden schon bekannte Diabetiker, die in Diabeteszentren behandelt wurden, mit eingerechnet. An 74.5% der Stadtbevölkerung und 88.7% der Landbevölkerung wurden weitere Untersuchungen angeschlossen. Die Häufigkeit der Übergewichtigkeit unter den neu entdeckten Diabetikern lag bei 51% in der Stadtund bei 69% in der Landbevölkerung. Neben den Diabetikern ergaben die Massenuntersuchungen in 2.15% der Fälle eine Glykosurie bei normalen Blutzuckerwerten während des Glucosetoleranztestes. Diese Gruppe von Patienten benötigte eine ständige Überwachung. -Gleichzeitig wurde festgestellt, daß die Aufdeckung von Diabetikern allein mit dem Harnzuckernachweis unzureichend und fehlerhaft ist.

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Recherches êpidêmiologiques concernant le diabète sucré dans la population urbaine et rurale de la Roumanie

Résumé Les auteurs exposent la méthodologie et les résultats obtenus dans le dépistage du diabète sucré parmi de larges groupes de population. — L'exploration a été effectuée en deux phases : la glycosurie et la glycémie prise deux heures après la charge en glucose et après l'exploration parle test du GTT chez des sujets ayant des taux de glycémie dépassant les limites définies comme normales pour chaque groupe d'âge. — Chez un groupe de 1314 personnes parmi la population rurale et 7113 parmi la population urbaine, âgées de 25 à 65 ans, l'incidence du diabète sucré a été respectivement de 1.44% etde3.7%.Dansle calcul final on a considéré aussi les diabétiques déjà en traitement dans un centre médical spécial. Des investigations plus approfondies ont été faites sur 74.5% des malades du milieu urbain dépistés et sur 88.7% des malades provenant du milieu rural. -L'incidence de l'obésité parmi les diabétiques dépistés a été de 51% dans la population urbaine et de 69% dans la population rurale. — A part les cas de diabète sucré, les recherches en masse ont montré une proportion de 2.15% de glycosurie pour une glycémie normale lors du GTT, ce qui suggère que cette catégorie de malades devrait être recensée dans un centre médical et soumise à un controle périodique. -En même temps on a démontré que la méthode de dépistage du diabète sucré seulement d'après la glycosurie est insuffisante et erronée.