Treatment of experimentally induced atherosclerosis in swine iliac arteries: A comparison of self-expanding and balloon-expanded stents

Atherosclerosis was induced in 20 Hanford miniature swine. Subsequently, one iliac artery lesion in each of 16 pigs was stented with either a self-expanding (8 pigs) or a balloon-expanded (8 pigs) stent. Immediately after stent placement, 4 animals in each group were taken off the atherogenic diet and continued on normal chow for the remainder of the study. Four months after stents were placed, atherosclerosis and the mural changes associated with the stent were more clearly evident in the arteries of the pigs continued on the atherogenic diet. These pigs also exhibited significantly more neointimal proliferation. In addition, the arteries containing the balloon-expanded stents showed more extensive and complex intimal changes when compared with arteries with self-expanding stents. Although both stent designs were equally effective in maintaining vascular patency, the balloon-expanded stent was more traumatic to the vessel wall which resulted in a significantly greater neointimal thickness.     

Social disability in different mental disorders.

ObjectiveTo assess the social disability of people with different psychiatric disorders.MethodsCross-site survey in five psychiatric hospitals (Dresden, Wrocław, London, Michalovce and Prague). Working-aged patients diagnosed (ICD-10) with schizophrenia and related disorders (F2), affective disorders (F3), anxiety disorders (F4), eating disorders (F5) and personality disorders (F6), were assessed at admission (n = 969) and 3 months after discharge (n = 753) using the Brief Psychiatric Rating Scale and the Groningen Social Disability Schedule. The main outcome measure was Interviewer-rated social disability.ResultsDuring acute episodes patients with personality, eating and schizophrenic disorders functioned less effectively than those with affective or anxiety disorders. After controlling for age and severity of psychopathology, there was no significant effect of the diagnosis (during remission), sex, education and history of disorder on disability. Site, employment and partnership were significant factors for the level of social disability in both measure points.ConclusionSeverity of psychopathological symptoms, not the diagnosis of a mental disorder, was the most significant factor in determining the level of social functioning, particularly during the remission period. Site, employment and partnership appeared as significant factors influencing the level of social disability.     

The effect of simulator training on clinical skills acquisition, retention and transfer

Context  Prior research has demonstrated that residents have poor clinical skills in cardiology and respirology. It is not clear how these skills can be improved because the number of patients with suitable clinical findings whose cooperation might help residents to better develop these clinical skills is limited.
Objectives  Our objective was to evaluate the effect of training on a cardiorespiratory simulator (CRS) on skills acquisition, retention and transfer.
Methods  We randomly allocated 146 students to CRS training in either chest pain or dyspnoea and compared each student's performance on the clinical presentation in which he or she had received CRS training with performance on the control presentation.
Results  Immediately after training, students were more accurate in identifying abnormal clinical findings on the CRS (70.0% versus 52.2%; d = 7.6, P  < 0.0001) and showed improved diagnostic performance (72.1% versus 55.6%; d = 4.3, P  = 0.0007) on the training clinical presentation. At the end of the course they were still better at identifying abnormal findings (57.1% versus 51.7%; d = 2.5, P  = 0.004) and diagnosing correctly (50.0% versus 38.1%; d = 3.0, P  = 0.002) on problems included in the training clinical presentation. However, they showed no difference between training and control presentations in diagnostic performance when required to transfer their skills between problems (45.9% versus 43.8%; P  = 0.5) or in performance on multiple-choice questions (64.1% versus 63.6%; P  = 0.8).
Conclusions  Students can acquire and retain clinical skills with CRS training, but demonstrate limited ability to transfer these to other problems. Further studies are needed to explore ways of improving learning and transfer with CRS training.     

Validation of analytical parameters of a competitive direct ELISA for aflatoxin B1 in peanuts

Analytical validation of a competitive direct SUNQuik ELISA with a reference High Performance Liquid Chromatography (HPLC) method and other methods including a minicolumn method and the VICAM Aflatest® system for aflatoxin in peanuts was conducted. Both the ELISA and the VICAM Aflatest® system, using the same peanut extracts were analytically comparable with the HPLC method (R=0.998, p<0.000). The minicolumn method was also found to be acceptable as a low cost rapid semi-quantitative test. Despite the large variation in sampling, the correlation between the SUNQuik ELISA and HPLC using the different peanut sub-samples was considered acceptable over the range of 0–1200 µg kg^?1 (R=0.938). No false negatives were found using the SUNQuik ELISA and false positives were either nil or negligible in all the studies conducted. The repeatability of the SUNQuik ELISA run on the same day was good with only±10% deviation. The reproducibility of the SUNQuik ELISA between days was also acceptable, but with a higher deviation. Applying the SUNQuik ELISA for aflatoxin surveys of peanuts in Indonesia proved that the method can deliver high quality, cost- and time-effective analysis with very little establishment capital and maintenance.     

Feeding preferences and attitudes to breastfeeding and its promotion among teenagers in Northern Ireland.

Northern Ireland has one of the lowest breastfeeding initiation rates in the world. Given that attitudes toward infant feeding are formed at an early age and a high rate of teenage pregnancy, it has become necessary to survey attitudes to infant feeding and breastfeeding promotion preferences in teenagers in Northern Ireland. Questionnaires were distributed to teenagers aged 14 to 18 years (n = 419) based in 7 schools selected by type and location throughout Northern Ireland. Attitudes to breastfeeding in public reflected preferred infant-feeding method and were positively influenced by prior exposure to breastfeeding (P = .024). Females were more positive than males both in relation to breastfeeding in public (P = .002) and breastfeeding promotion (P = .003). Recommendations for breastfeeding promotion include specific targeting of young people (both male and female) and enabling contact between teenagers and nursing mothers as much as possible.     

Salivary gland malignancy with divergent differentiation: is it a teratocarcinosarcoma?

Four poorly differentiated malignant lesions occurred in a 60-year-old Chinese male in the nasal cavity, submandibular gland, a lymph node in the neck, and the mandible. These malignant lesions developed within an 8-year period and each showed distinctive histological features. Among these malignant lesions, the neoplasm in the submandibular gland presented variegated histological and immunohistochemical (IHC) features and posed a diagnostic challenge in interpretation. Based on microscopic and IHC findings, we believe the diagnosis of teratocarcinosarcoma is justified for the submandibular neoplasm and the metastasis in the lymph node. The pathological features and diagnoses of these malignant lesions are discussed.