Reproductive disruption in lambari Astyanax fasciatus from a Southeastern Brazilian reservoir

The aim of this study was to assess the health indicators and reproductive endpoints in a wild population of lambari Astyanax fasciatus, a small characid fish widely distributed in South America. A range of biomarkers, from the molecular to population levels, was evaluated in adult fish sampled from five sites from the Furnas Reservoir, Grande River. At the sites that receive untreated agriculture and industrial residues, fish showed reduced body size and delayed gonadal maturation. Fish from the sites located immediately downstream from the municipal wastewater discharges exhibited feminisation, intersex and evidence of contamination by xenoestrogens. Elevated levels of zona radiata proteins were found by Western blot in the livers of male fish from three contaminated sites. Overall, this study provides the first evidence of endocrine disruption in a wild fish population inhabiting the Furnas Reservoir, and suggests water contamination by oestrogenic compounds and agricultural residues with a possible risk to human health and wildlife.     

芬太尼透皮贴剂从储池型更换为骨架型的临床观察

目的观察芬太尼透皮贴剂从储池型更换为骨架型,其止痛作用和副反应有无变化。方法2007年11月至2007年12月,观察了40例患者在更换芬太尼透皮贴剂剂型前后的变化,按每储池型2.5 mg更换为骨架型4.2 mg计算药物剂量,疼痛程度用11分数字量表（NRS）评估。结果使用储池型芬太尼透皮贴剂同更换为骨架型芬太尼透皮贴剂前后对比患者疼痛控制均良好,无明显不同,便秘、恶心、呕吐、呼吸抑制等发生率及严重程度无明显差别,但皮肤耐受性、黏合性、贴用舒适度骨架型要好于储池型。结论骨架型芬太尼透皮贴剂同储池型芬太尼透皮贴剂止痛效果相当,不良反应更易耐受。     

储液囊埋置结合传统引流术治疗重度脑室内出血的护理

脑室内出血（Intravent ricular Hemorrhage,IVH）是指非外伤因素导致颅内血管破裂,血液进入脑室系统引起的综合征,其发病急,症状、体征重。早期部分血肿可堵塞室间孔、导水管、四脑室出口而引起急性梗阻性脑积水。而多数在发病后1周左右由于广泛蛛网膜下腔粘连及蛛网膜颗粒堵塞,引起不同程度的交通性脑积水,甚至迁延成慢性脑积水。脑室引流是治疗重度脑室出血的传统有效方法,如长时间引流,发生脑室感染几率将明显增加。但若早期行脑室一腹腔分流术又易发生分流管堵塞。     

Techniques of Ectopic Reservoir Placement and Their Pitfalls

BackgroundEctopic placement of penile prosthesis reservoirs has become more common in patients whose space of Retzius has been compromised.AimTo describe techniques and instruments used to place penile prosthesis reservoirs ectopically.MethodsWe present our method of placing ectopic reservoirs and review the literature for other techniques. We also catalog the instruments used for this purpose.OutcomesSimilar to traditional reservoir placement, successful ectopic reservoir implantation requires good cosmetic and functional success and low complication rates.ResultsEctopic reservoir placement has been shown to be effective, to safely avoid bowel, bladder, and vascular injury, and to maintain excellent function and cosmesis. Multiple tools for ectopic placement have been described, but no data exist comparing their effectiveness and complications. Examples include dissection of the space anterior to the transversalis muscle using the surgeon's finger, a pediatric Yankauer suction tip, or a Foerster lung clamp. Instruments described to grasp and advance the reservoir include a sponge stick, a Foerster lung clamp, and the ectopic reservoir insertion tool (Sontec, Centennial, CO, USA). The effect of different instruments on the integrity of reservoir has not been extensively studied.Clinical ImplicationsAttention to technique and the instruments used to dissect the ectopic space and grasp the reservoir are crucial to successful ectopic reservoir placement.Strengths and LimitationsReports of vascular, bowel, or bladder injuries during ectopic placement are exceedingly rare, as are reports of injury to reservoirs caused by traumatic grasping. However, no methods or tools have been compared in head-to-head trials.ConclusionEctopic placement is safe and effective, but differences between methods and instruments have not been delineated.Thirumavalavan N, Gross MS, Munarriz R. Techniques of Ectopic Reservoir Placement and Their Pitfalls. J Sex Med 2017;14:1451–1454.     

CD4 T cell nadir independently predicts the magnitude of the HIV reservoir after prolonged suppressive antiretroviral therapy

Background

The level of HIV-1 integrated DNA in CD4 T cells was reported to predict the evolution of untreated HIV-1 infection independently of CD4 cell counts or plasma HIV-1 RNA levels. However, the relevance of reservoir level while on efficient antiretroviral therapy (ART) is still unknown.

Objectives

To evaluate factors that may contribute to the establishment and maintenance of HIV-1 reservoir size in ART-treated HIV-1-infected adults with complete suppression of viremia.

Study design

35 subjects receiving ART with plasma HIV-1 RNA below the limit of detection for an average duration of 3.2 years were studied. A highly sensitive PCR was used to assess HIV-1 integrated DNA levels in sorted CD4 T cells.

Results

The mean HIV-1 integrated DNA was 300 ± 7 copies/10⁶ CD4 cells (range 10-1408). In univariate analysis, the levels of HIV-1 proviral DNA appeared to be independent of duration of HIV-1-infection, duration on ART, time since HIV-1 viral load was undetectable, delay between HIV-1 infection and starting ART, or viral load before starting ART. Conversely, CD4 T cell nadir, CD4/CD8 ratio and, to lesser degree, CD4 T cell counts were inversely associated with HIV-1 proviral DNA levels. In multivariate analysis, only CD4 T cell nadir significantly predicted levels of HIV-1 proviral DNA (P = 0.025).

Conclusions

CD4 T cell nadir strongly predicted reservoir size independently of other factors in HIV-1-infected adults with complete suppression of viremia. Collectively, these results indicate that the extent of CD4 T cell depletion before ART drives the size of the viral reservoir after prolonged therapy.     

1997-2008年三峡库区蓄水前后湖北宜昌段居民死因分析

目的分析三峡库区居民的主要死因,为制定疾病防治策略提供科学依据。方法收集三峡库区监测点居民死因资料,对死亡原因进行统计分析。结果三峡库区蓄水前后主要死因顺位发生改变,死因排序中循环系统疾病仍居第1位,损伤中毒由第3位上升到第2位,肿瘤由第4位上升为第3位,呼吸系统疾病从第2位降至第4位。结论蓄水后库区的环境改变对库区居民带来了影响,应从病因入手监测、治理饮水及其他环境污染,大力开展健康教育,改变个人不良生活方式和行为,保护库区人民健康。     

<Emphasis Type="Italic">Brasergasilus bifurcatus</Emphasis> sp. nov. (Copepoda,Ergasilidae, Abergasilinae) from the gills and nasal fossae of serrasalmid fishes from the Três Marias Reservoir,Upper São Francisco River,Minas Gerais State,Brazil

Brasergasilus bifurcatus sp. nov. (Copepoda, Ergasilidae, Abergasilinae) is described. Specimens of the new species were collected from the gills and nasal fossae of the serrasalmid fishes, known as “piranhas”, Pygocentrus piraya (Cuvier, 1819) and “pirambebas”, Serrasalmus brandtii (Lütken, 1875). The fishes were netted in the Três Marias Reservoir (18°12′59″S, 45°17′34″W) of the upper São Francisco River, Minas Gerais State, Brazil. The new species differs from its congeners by the following characters: the specific setation on the antennule; the terminal barb of the antenna; the deeply bifurcate distal segment of the mandible; the chalice-shaped genital complex; a conspicuous external indentation of the second segment of the first endopod and a very short terminal segment of the first exopod.     

Atrial Cardiomyopathy with Impaired Functional Reserve in Patients with Paroxysmal Atrial Fibrillation

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