High Frequency of Acquired ADAMTS13 Deficiency After Hemolysis in Hemiscorpius Lepturus (Scorpion) Stung Children

Objective

To estimate the frequency of acquired ADAMTS13 deficiency in severe cases of Hemiscorpius lepturus stung patients and the frequency of acute kidney injury (AKI) in these patients.

Methods

Sixty scorpion stung children who were referred with severe hemolysis and hemoglobinuria were studied. None of them had received blood products and no one had a past medical history of renal failure.

Results

Plasma levels of ADAMTS13 and ADAMTS13 antibody (IgG) were measured using ELISA. ADAMTS13 was decreased in 91.7 % of patients and the anti-ADAMTS13 antibody (Ab) was increased in 98.3 %. ADAMTS13 decreased in all of the patients with acute kidney injury and none of those with normal levels of ADAMTS13 developed renal failure; all patients with AKI had also increased levels of ADAMTS13Ab. Acute kidney injury was found in 23.3 % and had significant association with severe anemia, thrombocytopenia, pyuria, hematuria and considerable proteinuria (p?<?0.001). Disseminated intravascular coagulation (DIC) and Hemolytic uremic syndrome (HUS) developed in 6.7 % and 10 % respectively.

Conclusions

The index findings demonstrate that Hemiscorpius lepturus sting is usually associated with ADAMTS13 deficiency, and increased ADAMTS13 autoantibody. These combined mechanisms may contribute to scorpion sting-induced coagulopathies and may predispose patients to develop DIC and HUS.     

Spatial and statistical analyses of the relations between vegetation cover and incidence of cutaneous leishmaniasis in an endemic province,northeast of Iran

Objective

To investigate the relations between the vegetation cover and occurrence of cutaneous leishmaniasis (CL) in Golestan province during 2010-2012.

Methods

Data of monthly CL incidence and remote sensing normalized difference vegetation index (NDVI) of moderate resolution imaging spectroradiometer sensor were used in the study. Pearson''s correlation analysis was conducted to examine the type and strength of relationships between the spatially averaged NDVI variables (i.e. minimum, maximum and mean NDVI values) and CL incidence in township level. Spearman rank correlation was carried out to explain associations between the monthly CL incidence and NDVI variables at 0, 1, 2, 3 and 4 months lagged periods. Locations of CL cases at village level were geocoded and compared with frequency of CL cases in each NDVI-derived vegetation categories.

Results

Pearson''s analysis revealed significant associations between the NDVI variables and CL incidence at the township level (P<0.05). Results of Spearman analysis indicated that the highest correlations between NDVI variables and monthly CL incidence were established when the NDVI time-series lagged the CL incidence series NDVI variables. Purely spatial analysis demonstrated that despite majority of cases occurred at partially-vegetated areas, the possibility of CL occurrence was higher in bare soil areas by taking into account area of each vegetation zones.

Conclusions

lack or low vegetation cover is a major determinant of CL frequencies in Golestan province. The decrease of the mean vegetation density in townships is accompanied by increase of CL occurrence and vice versa.     

Sleep and respiratory outcomes in neonates with Pierre Robin sequence: a concise review

There are no standardized management algorithms for neonates with Pierre Robin sequence. Currently available literature is variable in terms of outcomes assessed across studies. In this paper, we have aimed to summarize the currently available literature on longitudinal sleep and respiratory outcomes in Pierre Robin sequence neonates with a focus on identifying gaps in literature and areas for future research development.

     

Alpha‐synuclein in peripheral tissues and body fluids as a biomarker for Parkinson's disease – a systematic review

Parkinson's disease (PD) is neuropathologically characterized as an alpha‐synucleinopathy. Alpha‐synuclein‐containing inclusions are stained as Lewy bodies and Lewy neurites in the brain, which are the pathological hallmark of PD. However, alpha‐synuclein‐containing inclusions in PD are not restricted to the central nervous system, but are also found in peripheral tissues. Alpha‐synuclein levels can also be measured in body fluids. The aim of this study was to conduct a systematic review of available evidence to determine the utility of alpha‐synuclein as a peripheral biomarker of PD. We searched PubMed (1948 to 26 May 2013), Embase (1974 to 26 May 2013), the Cochrane Library (up to 26 May 2013), LILACS (up to 26 May 2013) and CINAHL (up to 26 May 2013) for the studies of alpha‐synuclein in peripheral tissues or body fluids in PD. A total of 49 studies fulfilled the search criteria. Peripheral tissues such as colonic mucosa showed a sensitivity of 42–90% and a specificity of 100%; submandibular salivary glands showed sensitivity and specificity of 100%; skin biopsy showed 19% sensitivity and 80% specificity in detecting alpha‐synuclein pathology. CSF alpha‐synuclein had 71–94% sensitivity and 25–53% specificity for distinguishing PD from controls. Plasma alpha‐synuclein had 48–53% sensitivity and 69–85% specificity. Neither plasma nor CSF alpha‐synuclein is presently a reliable marker of PD. This differs from alpha‐synuclein in solid tissue samples of the enteric and autonomic nervous system, which offer some potential as a surrogate marker of brain synucleinopathy.     

Helicobacter pylori Protection Against Reflux Esophagitis

Background and Aim

Negative association has been reported between presence of Helicobacter pylori and developing gastroesophageal reflux disease (GERD) and its complications. The aim of this study was to determine whether H. pylori (HP) can be protective against GERD in an African American (AA) population.

Methods

From 2004 to 2007, we studied 2,020 cases; esophagitis (58), gastritis (1,558), both esophagitis and gastritis (363) and a normal control group (41). We collected their pathology and endoscopy unit reports. HP status was determined based on staining of gastric biopsy.

Results

HP data was available for 79 % (1,611) of the cases. The frequency of HP positivity in gastritis patients was 40 % (506), in esophagitis patients 4 % and in normal controls 34 % (11), while HP was positive in 34 % of the patients with both esophagitis and gastritis. After adjusting for effects of age and sex, odds ratio of HP was 0.06 (95 % CI 0.01–0.59; P value = 0.01) for the esophagitis group versus the normal group.

Conclusions

Our results show H. pylori has a significant negative association with esophagitis in AAs which may point to a protective role of H. pylori in the pathogenesis of esophagitis. In addition, H. pylori may be the reason for the low GERD complications in AAs.     

The influence of resin infiltration system on enamel microhardness and surface roughness: An in vitro study

Objective

To investigate the effect of a resin infiltrant on the surface microhardness and roughness of healthy enamel and, as a subsidiary aim, to compare it with a fissure sealant.

Materials and methods

Twenty freshly extracted premolars were used. Sound enamel surfaces were treated with a resin infiltrant (Icon) or fissure sealant (Seal-Rite). The average roughness (R_a, μm) of the specimens was measured with a profilometer (Surtronic 10 Tylor Hobson). Surface hardness was determined by utilizing Vicker’s surface hardness (VHN) with a Micromet II Microhardness tester. Each specimen acted as its own control. Data were analyzed with 2-way analysis of variance (ANOVA), and mean values were compared with independent t-test. All analyses were performed with the SPSS program version 16 (USA). Differences with a P-value of ⩽0.05 were considered statistically significant.

Results

Comparison of enamel surfaces before and after application of resin infiltrant revealed no significant differences in surface hardness; however, enamel surfaces treated by infiltrant showed significantly higher VHN (244.0 ± 79.8) values than those treated with fissure sealant (37.5 ± 14.2). Surface roughness did not differ before and after application of either material to sound enamel. Enamel surfaces treated with fissure sealant (5.3 ± 1.4) were significantly smoother than those treated with infiltrant (6.9 ± 2.0).

Conclusion

Within the limitations of the study, the results showed that enamels treated with the resin infiltrant showed approximately the same microhardness and surface roughness as sound enamel, indicating that this material might be suitable for the treatment of enamel subsurface lesions.     

State-Dependent Effects of Prefrontal Repetitive Transcranial Magnetic Stimulation on Emotional Working Memory

BackgroundA growing body of findings illustrates the importance of state-dependency in studies using brain stimulation.ObjectiveWe aimed to investigate the effects of tDCS priming followed by rTMS applied over the right dorsolateral prefrontal cortex (DLPFC) on emotional working memory.MethodsIn a randomized single-blind within-subjects design, participants performed an emotional 3-back task at baseline and after tDCS priming (anodal, cathodal) and subsequent low-frequency rTMS (active, sham) of the right DLPFC. Stimuli consisted of words related to the distinct emotion categories fear and anger as well as neutral words.ResultsTask accuracy increased for fear-related words and decreased for neutral words across stimulation conditions. No general state-dependent effects of prefrontal rTMS on working memory were found. We further showed a detrimental effect of negative emotional content on working memory performance.ConclusionsOur findings support a hemispheric lateralization of emotion processing by demonstrating that the withdrawal-related emotion fear is associated with the right DLPFC and contribute to clarifying the interaction between working memory and emotion.     

Synthesis methods for nanosized hydroxyapatite with diverse structures

Hydroxyapatite (HAp) is the major mineral constituent of vertebrate bones and teeth. It has been well documented that HAp nanoparticles can significantly increase the biocompatibility and bioactivity of man-made biomaterials. Over the past decade, HAp nanoparticles have therefore increasingly been in demand, and extensive efforts have been devoted to develop many synthetic routes, involving both scientifically and economically new features. Several investigations have also been made to determine how critical properties of HAp can be effectively controlled by varying the processing parameters. With such a wide variety of methods for the preparation of HAp nanoparticles, choosing a specific procedure to synthesize a well-defined powder can be laborious; accordingly, in the present review, we have summarized all the available information on the preparation methodologies of HAp, and highlighted the inherent advantages and disadvantages involved in each method. This article is focused on nanosized HAp, although recent articles on microsized particles, especially those assembled from nanoparticles and/or nanocrystals, have also been reviewed for comparison. We have also provided several scientific figures and discussed a number of critical issues and challenges which require further research and development.