A 14-Day Elemental Diet Is Highly Effective in Normalizing the Lactulose Breath Test

Treatment of small intestinal bacterial overgrowth is frustrated by the low efficacy of antibiotics. Elemental diets have been shown to reduce enteric flora. In this study, we evaluate the ability of an elemental diet to normalize the lactulose breath test (LBT) in IBS subjects with abnormal breath test findings. Consecutive subjects with IBS and abnormal LBT suggesting the presence of bacterial overgrowth underwent a 2-week exclusive elemental diet. The diet consisted of Vivonex Plus (Novartis Nutrition Corp., Minneapolis, MN) in a quantity based on individual caloric requirement. On day 15 (prior to solid food), subjects returned for a follow-up breath test and those with an abnormal LBT were continued on the diet for an additional 7 days. The ability of an elemental diet to normalize the LBT was determined for days 15 and 21. A chart review was then conducted to evaluate any clinical benefit 1 month later. Of the 93 subjects available for analysis, 74 (80%) had a normal LBT on day 15 of the elemental diet. When those who continued to day 21 were included, five additional patients normalized the breath test (85%). On chart review, subjects who successfully normalized their breath test had a 66.4 +/- 36.1% improvement in bowel symptoms, compared to 11.9 +/- 22.0% in those who failed to normalize (P < 0.001). An elemental diet is highly effective in normalizing an abnormal LBT in IBS subjects, with a concomitant improvement in clinical symptoms.     

Microanatomical study of testis in juvenile ostrich (Struthio camelus)

The majority of investigations on the testis, as the main organ of male reproductive system, have been performed in mammalian species, with few studies on bird species. Thus, the structure of the ostrich testis remains largely unknown. The aim of this study was to investigate the microanatomical characteristics of the testis in five juvenile ostriches. A stereological study was performed according to the Delesse principle. The mean volume fraction of the seminiferous tubules was 0.569, and the mean volume of the seminiferous tubules in an average testis was 1.04 cm³. The Paraffin-embedded sections were stained with hematoxylin and eosin, Masson’s trichrome, Alcian blue, and periodic acid–Schiff stains. Histological studies revealed that the spermatogonial stem cells and Sertoli cells were localized inside the seminiferous tubules, close to the basement membrane. Inside the tubules a few meiotic cells up to the spermatozoa stage were located in a centripetal manner. Outside the tubules, one to three layers of euchromatic peritubular myoid cells were present, surrounded by loose interstitial connective tissue. A thick tunica albuginea contained many myoid cells and some rete ducts, with the latter extending from the hilus to the free surface of the testis. Straight seminiferous tubules were distributed in the lateral surfaces and hilar portions of the capsule but were rare in the free surface. These capsular rete ducts may participate in testicular fluid transit from the distal tubules through the capsule.     

The Value of Predischarge ICD Tests in Patients with a Successful Peroperative Test

An internal cardioverter defibrillator (ICD) is normally extensively tested during implantation. The necessity of retesting prior to discharge of the patient is a matter of debate. In our material of 30 patients undergoing first-time implantation of a transvenous internal defibrillator system, we retrospectively compare the predischarge defibrillation test with the peroperative test. A successful peroperative defibrillation test with no failed shocks at 10 J below maximal energy level was followed by a successful predischarge test with the same safety margin in 18/19 patients, while one patient required a maximal energy ICD shock for conversion at the predischarge test. We conclude that the predischarge defibrillation test can be omitted if the peroperative test was successful, with no failed shocks at 10 J below maximal energy level and if the shock therapy is set to maximal energy level.     

Morphological development of testes in ostrich (Struthio camelus) embryo

Although the histological structure of ostrich testis has been studied, very little information is currently available on the embryonic development of this organ. The aim of this study was to determine the sequence of the histological changes in diverse components of the testis in ostrich embryo from embryonic day (E) 20 to E42. The main findings were categorized into four histological features, i.e., development of sex cords, interstitial tissue and rete ducts, and the appearance of defective septa. While the lumen of sex cords, tunica albuginea, capsular rete ducts and Leydig cell precursors appeared at E26, the filum-shaped defective septa were visible at E36. The emersion of the lumen in the primary sex cords and formation of capsular rete ducts in the ostrich embryo is considerably different from that in other birds. However, tunica albuginea and Leydig cell precursors appeared in a similar pattern to those of other birds. An interesting observation was that the primordial germ cell (PGC)-like cells were completely distinct, while the capsular rete ducts were formed by trapping of some Sertoli cell aggregations in the tunica albuginea. This suggests that similar to the primary sex cords, the capsular rete ducts may originate from the Sertoli cell aggregations which had corralled some PGCs. Stereological estimations in the ostrich embryo testis showed the major proportion of testis is occupied by the seminiferous tubules, which is unlike the fowl embryo testis.     

Optimization of Hormonal Combinations for In Vitro Regeneration of Lesser Periwinkle (Vinca minor L.) and Assessment of Genetic Homogeneity

Proceedings of the National Academy of Sciences, India Section B: Biological Sciences - Lesser Periwinkle (Vinca minor L.) is an important source of valuable secondary metabolites. To survey the...     

Effect of COVID-19 on the Number of CT-scans and MRI Services of Public Hospitals in Iran: An Interrupted Time Series Analysis

BackgroundIn February 2020, the Ministry of Health and Medical Education in Iran announced the first case of COVID-19. The aim of this study was to investigate the impact of COVID-19 on the number of CT-Scans and MRI services in public hospitals in western Iran.MethodsWe collected CT-scans and MRI services data from 18 public hospitals via Vice-Chancellor Office, Lorestan University of Medical Sciences from January 2017 to February 2021. Interrupted time series analysis (ITSA) was conducted to assess the impact of COVID-19 on CT-Scans and MRI services. More specifically, ITSA was conducted using ordinary least squares regression with the number of CT-Scans and MRI services per 1,000 registered persons per month as dependent variable.ResultsAt the beginning of the observation period, the monthly rate of CT-Scans was constant (p for trend = 0.267) at 291.9 (from 95%CI 240.5 to 343.4) per 1,000 registered patients. The first case of COVID-19 coincided with an abrupt increase by 211.8 (from 95%CI 102.9 to 320.7) per 1,000 patients. Thereafter, the trend of CT-Scans did not change (p=0.576) compared to the pre-pandemic period. The rate of MRI services was 363.5 per 1,000 per registered patients per month (P = <0.0001) with a slightly decreasing trend (coefficient=-5; 95%CI, -6.9 to -3.1).ConclusionThe findings of this study showed that crises such as COVID-19 can affect the service delivery process. Health policymakers and decision makers should work to prevent potential reductions in health care during events such as COVID-19.     

Follow-up standard agglutination and 2-mercaptoethanol tests in 175 clinically cured cases of human brucellosis

BackgroundThe standard agglutination (SAT) and 2-mercaptoethanol (2-ME) tests are usually used in the follow-up of treated cases of human brucellosis. The purpose of this study was to monitor the levels of these tests, two years after clinical cure in cases of brucellosis.MethodsFrom April 2003 to September 2008, 175 clinically cured cases of brucellosis (103 males, 72 females) were evaluated. Diagnosis of brucellosis was established with a SAT of ≥1:320 and a 2-ME of ≥1:80, with clinical symptoms and signs compatible with brucellosis. SAT and 2-ME were retested at the end of therapy and at 3-monthly intervals for two years. Serologic cure was considered in the event of a SAT titer decrease to ≤1:160 or a 2-ME decrease to < 1:80.ResultsThe mean age of study patients was 31 ± 13.5 years. At 6, 12, 18, and 24 months after treatment, SAT titers ≥1:320 were seen in 41 (23.4%), 22 (12.6%), 7 (4%), and 6 (3.4%) cases, respectively, whereas 2-ME titers ≥1:80 were seen in 51 (29.1%), 24 (13.7%), 12 (6.9%), and 8 (4.6%) cases, respectively. The probability of serologic cure for patients with SAT titers ≤1:640 was higher than for those >1:640 (95% confidence interval (CI) 2.5–3.47, p = 0.023). The probability of serologic cure for patients with 2-ME titers ≤1:320 was higher than for those >1:320 (95% CI 2.48–3.5, p = 0.04).ConclusionsSAT and 2-ME may be found in significant titers in less than 5% of clinically treated cases after two years. Serologic cure for both tests with lower titers were higher than with higher titers.     

Ⅱ期人工晶状体植入术后102例患者视力的分析

目的:评价分析无晶状体眼Ⅱ期植入前房型和后房型人工晶状体的效果。进行Ⅱ期人工晶状体植入的最常见原因是无晶状体眼眼镜矫正不满意或不耐受及不愿意佩戴隐形眼镜。方法:前瞻性,非随机对照实验研究,伊朗亚兹德Sadoughi医院眼科,1995/2005年。根据之前进行的白内障手术的类型,后房型人工晶状体植入62眼(60.78%),前房型人工晶状体植入40眼(39.21%)。根据随访期间的病历记录分析患者基本资料和临床资料。结果:患者102例,其中女42例(41.18%),男60例(58.82%),在1995/2005年期间进行了II期人工晶状体植入术。年龄在48 ～72(平均62.6)岁,平均随访时间20.2mo(6 ～72mo)。术中及术后并发症少,手术及拆线后3mo视力状况如下:视力20/20的有48例(47.05%),视力20/40以上的有51例(50%),视力下降(snellens视力表中3行)的有3例(2.95%)。结论:Ⅱ期人工晶状体植入术的短期并发症并不比I期白内障摘除并人工晶状体植入多,视力结果与术前最佳矫正视力相同,因此II期人工晶状体植入术可以安全有效的治疗无晶状体眼。