Scanning electron microscopic assessment of coating irregularities and their precursors in unexpanded durable polymer‐based drug‐eluting stents

Objectives : To assess and quantify coating irregularities on unexpanded and expanded durable polymer‐based drug‐eluting stents (DES) to gain insights into the origin of coating irregularities. Background: Previous scanning electron microscopy (SEM) studies in various expanded DES revealed differences in frequency and size of coating irregularities between DES types and specific distribution patterns, however, the origin of these irregularities is unclear. Methods: We assessed at bench side a total of 1,200 SEM images obtained in 30 DES samples (15 expanded and 15 unexpanded) of Cypher Select Plus, Taxus Liberté, Endeavor, Xience V, and resolute. Results: For most coating irregularities seen on expanded DES (72%; 23/32), a matching irregularity (n = 18/23) and/or its precursor (n = 11/23) was observed in unexpanded DES. Unexpanded Cypher select showed (small) crater lesions and cracks together with precursors of “peeling.” On unexpanded Taxus Liberté, thinning of polymer, small bare metal areas, wrinkles, and one precursor type were found. Unexpanded endeavor showed cracks, small bare metal areas, crater lesions, and precursors of the latter. Unexpanded Xience V and resolute mainly revealed crater lesions and their precursors. On unexpanded versus expanded DES, there was no difference in measured frequency of coating irregularities and precursors (P = ns) with the exception of more bare metal areas on expanded Taxus Liberte (P = 0.01). Conclusions : Most coating irregularities, or the potential to develop them, are inherent to the unexpanded DES. Important determinants of the formation of coating irregularities may be the stent geometry and the physical properties of the coating, while stent‐balloon interaction plays no major role. © 2011 Wiley Periodicals, Inc.     

A rare case of unicondylar medial Hoffa fracture associated with ipsilateral vertical patella fracture

An 18 year old male patient was hit by a car to his motorcycle causing a unicondylar Hoffa fracture and an ipsilateral patella fracture. Hoffa fracture is a rare lesion and this association of injury has not been reported before.     

Validation of an Arabic multi-informant psychiatric diagnostic interview for children and adolescents: Development and Well Being Assessment-Arabic (DAWBA-Arabic)

Background

Countries in the Arab region lack a valid Arabic psychiatric diagnostic interview for children and adolescents. We set out to establish the diagnostic validity of the Arabic version of the Development and Well Being Assessment (DAWBA-Arabic), a multi-informant structured interview for predicting DSM-IV-TR diagnoses.

Methods

The DAWBA was translated, updated, and administered to 45 participants (child and adolescent psychiatric outpatients and their parents) as part of a clinic registry. Two clinicians, blinded to their respective diagnoses, formulated the DAWBA diagnoses. Participants also underwent a clinical evaluation by a child and adolescent psychiatrist who generated clinical diagnoses according to the DSM-IV-TR.

Results

Inter-rater reliabilities were .93, .82, and .72 for disruptive disorders, mood disorders and anxiety disorders respectively. Agreement between DAWBA and clinical diagnoses was substantial for disruptive disorders (κ = .0.82) and mood disorders (κ = 0.74), and moderate for anxiety disorders (κ = 0.46).

Conclusion

The DAWBA-Arabic could serve as a valid and reliable clinical tool for assessing psychiatric disorders among children and adolescents in the Arab region.     

Inflammatory pseudotumor of the spleen: two case reports

Inflammatory pseudotumor (IPT) of the spleen is an uncommon entity with debated etiology, characterized by a mixture of inflammatory cells and a component of myofibroblastic spindle cells. This lesion needs to be distinguished from the follicular dendritic cell tumor and the inflammatory myofibroblastic tumor. We report two cases of splenic PTI in a 69-year old and a 62-year old women. The tumors measured respectively 80 and 30 mn in greatest dimension. An inflammatory pseudotumor was histopathologically diagnosed following a splenectomy.     

Impact of human immunodeficiency virus type 1 subtypes on virologic response and emergence of drug resistance among children in the Paediatric European Network for Treatment of AIDS (PENTA) 5 trial

The association between virologic response and human immunodeficiency virus type 1 (HIV-1) subtype was investigated in 113 HIV-1-infected children randomly assigned to receive zidovudine plus lamivudine, zidovudine plus abacavir, or lamivudine plus abacavir in the Paediatric European Network for Treatment of AIDS (PENTA) 5 trial. Symptomatic children (n=68) also received nelfinavir; asymptomatic children (n=45) were randomly assigned to receive nelfinavir or placebo. HIV-1 subtypes A, B, C, D, F, G, H, A/E, and A/G were found in 15%, 41%, 16%, 9%, 5%, 2%, 1%, 5%, and 7% of the children, respectively. Resistance assay failure rates were higher for non-B subtypes than for B subtypes (genotype, P=.01; phenotype, P=.02). HIV-1 subtype was not associated with virologic response at 24 and 48 weeks after initiation of treatment. No differences were observed in the frequency of development of resistance mutations L90M (P=1.00) and D30N (P=.61) in B and non-B viruses. In conclusion, no evidence that subtype determined virologic response to therapy was found.     

Phosphorylated cellulose paper as highly efficient adsorbent for cadmium heavy metal ion removal in aqueous solutions

In search for more effective and eco-friendly adsorbent materials, this study comprehensively investigated Cd²⁺ adsorption onto phosphorylated cellulose paper (PCP). For this, cellulose microfibers (CMF) was extracted from Alfa fibers and phosphorylated using the solid-state phosphorylation approach. Then, the prepared PCP samples were characterized by SEM, EDX, XRD, FTIR, TGA, conductometric titration and zeta potential measurement. The adsorption of cadmium ions, the effect of time, pH and Cd²⁺ initial concentration were systematically studied in batch experiments. Based on the results, the highest adsorption capacity achieved was 479 mg of Cd²⁺ per g of PCP, which was remarkable compared to other modified cellulose capacities cited in the literature. Furthermore, the Cd²⁺ removal mechanism was investigated based on characterization results before and after adsorption and also based on the kinetics results. It was concluded that cation exchange and electrostatic attraction between phosphorylated cellulose and the cadmium ion mainly dominated the adsorption process. These findings highlighted that the phosphorylated cellulose paper has a broad application prospect in removal of divalent metal from aquatic solution.

In search for more effective and eco-friendly adsorbent materials, this study comprehensively investigated Cd²⁺ adsorption onto phosphorylated cellulose paper (PCP).