Medical gases

Understanding the complex process of production, storage and delivery of medical gases is vitally important to ensure safe and efficient practice by anaesthetists. This article discusses the medical gases commonly used in anaesthesia and intensive care and details the journey of the commonly used medical gases from production to patient delivery. It includes core knowledge for the FRCA.     

Impact of disease severity on work productivity and activity impairment in Japanese patients with atopic dermatitis

Atopic dermatitis (AD) is a common inflammatory skin disease that is characterized by chronic and persisting pruritic and eczematous lesions. There has been no study of work productivity and activity in AD patients in relation to disease severity. The purpose of this study was to examine the impact of disease severity on work productivity and activity impairment (WPAI) in adult AD patients using the Japanese version of the questionnaire. Data were collected from 112 AD patients who visited the Jikei University Hospital. Outcomes as measured by the questionnaire included employment status, total work productivity impairment (TWPI) and total activity impairment (TAI). We investigated the correlation between TWPI or TAI scores and severity scoring of AD (SCORAD) for disease severity and dermatology life quality index (DLQI) for quality of life impairment. Both TWPI and TAI scores were significantly correlated with the SCORAD and DLQI scores (P < 0.001), indicating disease severity is significantly associated with WPAI in Japanese adult AD patients. Further studies are necessary to evaluate the effects of treatments on WPAI for severe AD patients.     

Low cdc27 and high securin expression predict short survival for breast cancer patients

Cell cycle regulators cdc27 and securin participate in control of the mitotic checkpoint and survey the mitotic spindle to maintain chromosomal integrity. This is achieved by their functions in metaphase–anaphase transition, DNA damage repair, enhancement of mitotic arrest and apoptosis. We report on the roles of cdc27 and securin in aneuploidy and prognosis of breast cancer. The study comprises 429 breast cancer patients with up to 22 years of follow‐up. DNA content was determined by image cytometry, and immunopositivity for cdc27 and securin was based on tissue microarrays. An inverse association between cdc27 and securin expression was observed in both image cytometric and immunohistochemical analyses. Low cdc27 and high securin expression identified patients with significant difference in disease outcome. Cdc27 and securin immunoexpression identified patients at risk of early cancer death within five years from diagnosis. In multivariate analysis, the combination of cdc27 and securin immunohistochemistry was the strongest predictor of cancer death after lymph node status. We demonstrate, for the first time in human breast cancer, the prognostic value of cdc27 and securin immunohistochemistry. Cdc27 and securin appear promising biomarkers for applications in predicting disease progression, prognostication of individual patients and potential in anti‐mitotic drug development.     

Micronutrients

Micronutrients are essential dietary components and play a fundamental role in the prevention of disease. 30 are essential and cannot be synthesized by the body on a daily basis, making dietary sources critical. Micronutrients have an array of biochemical functions which are fundamental in the homoeostatic regulation of body function. It is at any point in a metabolic pathway that the chemical reaction may be unable to continue along its nature cascading pathway because the essential micronutrient is lacking. The normal metabolic regulation of the body will have been disturbed and ill health may occur due to the absence of a specific micronutrients. Several population groups with specific nutritional requirements, complex social, environmental and economic circumstances may be at risk of inadequate micronutrient intakes due to poor consumption or excessive losses, and hence maybe unable to meet their recommended requirements of micronutrients. This group may benefit from micronutrient supplements. Infants/children are a specific population group who are at risk of micronutrient deficiency states making adequate intakes essential to ensure normal growth and development. The paediatric group will be discussed here, with reference to current recommendations for their micronutrient and supplementation requirements based on current evidence available to advisory groups.     

早期牙菌斑控制在2型糖尿病患者牙周病防治中的意义

目的 探讨早期牙菌斑控制治疗在2型糖尿病患者牙周病防治中的重要意义.方法 与内分泌科联合,选取2型糖尿病患者94例,随机分为试验组及对照组.试验组给以早期牙菌斑控制,对照组未进行该治疗,1年后对两组患者牙列进行检查.结果 试验组牙周病明显轻于对照组（P〈0.05）,差异有统计学意义.结论 早期牙菌斑控制治疗有助于2型糖尿病患者牙周病的防治.     

Treatment of Acute Rejection

Abstract

Background: Cardiovascular disease (CVD) is the most important cause of morbidity and mortality in patients with end stage renal disease (ESRD). Apelin expressed in endothelial and other tissues including brain and kidney is an adipocytokine defined recently and is emerging an important mediator of cardiovascular homeostasis. The aim of this study was to test whether apelin levels might be associated with carotid artery atherosclerosis and left ventricular mass index (LVMI) in peritoneal dialysis patients. Patients and methods: Fifty peritoneal dialysis patients (25 female, mean age 41.4?±?11.9 years, mean dialysis vintage 65.0?±?35.4 months) and 18 healthy individuals (9 female, mean age 41.7?±?6.8 years) were included in this cross-sectional study. Serum apelin 12 levels, echocardiographic findings and carotid intima media thickness (CIMT) were recorded as well as clinical and laboratory data. Results: There were no differences between the patient and the control groups with regard to demographic characteristics. In patient group, LVMI, CIMT, CRP and apelin levels were elevated compared to control group. However there was no association between apelin, LVMI and CIMT. There was a positive correlation between apelin and CRP, which was not statistically significant. When patients were divided into two groups according to the mean serum apelin levels, LVMI, CIMT and CRP were higher in the high apelin group but this difference did not reach statistical significance. Conclusion: We observed an increased inflammation and CVD risk in peritoneal dialysis patients. However, serum apelin levels seem not to be associated with cardiovascular risk in this group of patients.