Cardiac isoform of alpha-2 macroglobulin as a novel diagnostic marker for cardiac diseases.

BACKGROUND: Earlier we showed cardiac isoform of alpha-2 macroglobulin (CA2M) to be an early marker of cardiac hypertrophy. DESIGN: In this study, we tried to explore the possibility of using this protein as a marker for diagnosis of cardiac diseases. METHODS: A total of 593 samples were analyzed for the presence of CA2M using sandwich enzyme-linked immunosorbent assay. RESULTS: Samples include various cardiac diseases (230), non-cardiac ailments (263) and controls (100). CONCLUSION: Levels of CA2M in cardiac diseases were significantly higher than other sample groups but moderately elevated in leprosy. This protein could be considered for diagnosis of cardiac diseases as a serum marker.     

Spectrofluorometric determination of the toxic constituents of Cleistanthus collinus

Spectrofluorometric quantitation of a lignan lactone, diphyllin, and its glycosides cleistanthin A and cleistanthin B, the active principles of the poisonous plant Cleistanthus collinus, is reported for the first time. Thin layer chromatographic resolution of the components precedes the fluorometric measurements. The method is highly reproducible and sensitive to 0.1 microgram/mL for diphyllin and to 1 microgram/mL for cleistanthins A and B in ethanol. The technique is employed for the assay of several biospecimens of forensic and clinical importance.     

Impact of an Incomplete Colonoscopy Referral Program on Recommendations After Incomplete Colonoscopy

Background

There are limited data on recommendations and adherence to complete colon evaluation (CCE) after incomplete colonoscopy (IC).

Aims

Our objectives were to (1) identify recommendations and adherence to recommendations after IC, (2) determine the diagnostic yield of CCE after IC, and (3) determine the effect of an IC referral program on recommendations for CCE.

Methods

We conducted a retrospective review of IC procedures at a teaching hospital over two time periods (January 1 to May 1 2004 and July 1 to November 1 2010). A referral process for repeat colonoscopy after IC was instituted in April 2009. Outcomes included (1) recommendations (2) adherence, and (3) yield of CCE after IC.

Results

A total of 222 patients underwent at least one IC (overall rate of 2.5 %). In 120 patients (54.1 %), CCE was recommended within 1 year; the rate did not change from 2004 to 2010. Patients with IC due to poor preparation were more likely to have specific CCE recommendations (85.5 vs. 72.2 %, P = 0.03) and recommendations of endoscopic follow-up (76.3 vs. 10.4 %, P < 0.0001) than those with IC due to difficult anatomy. When IC was due to difficult colonoscopy, there was increase in endoscopic follow-up recommended (16.3 vs. 2.8 %, P = 0.01) in 2010 compared to 2004. Adherence to recommendations was similar regardless of modality recommended, inpatient/outpatient status, polyps on initial exam, or extent of initial exam. Polyp detection rate was greater utilizing colonoscopy than barium enema (34.3 vs. 3.6 %, P < 0.0001).

Conclusions

There is a lack of consensus in management strategies for patients after IC. Implementation of a referral program has had minimal impact on provider recommendations.     

Eculizumab treatment modifies the immune profile of PNH patients

Paroxysmal Nocturnal Haemoglobinuria (PNH) is due to pathological expansion of a stem progenitor bearing a somatic mutation of PIG-A gene involved in the biosynthesis of the glycosyl-phosphatidyl-inositol (GPI) anchor. Numerous data suggest a role for immune-mediated mechanisms in the selection/expansion of GPI-defective clone. Haemolytic anaemia in PNH is dependent on the effect of complement against GPI-defective red cells. Eculizumab, an anti-C5 monoclonal antibody, is dramatically effective in controlling haemolysis and thrombosis, in reducing fatigue and in improving quality of life of patients. However, this therapy presents new challenges that need to be properly faced. Here, we report the decrease in B, Natural Killer (NK) and regulatory T cells (Treg), an altered cytokine profile of invariant-NKT cells (NKTi) and the increasing of C-X-C chemokine receptor type 4 (CXCR4) receptor in PNH patients before the Eculizumab therapy. Treatment significantly affects some of these alterations: after Eculizumab, the number of B lymphocytes, the cytokine secretion of NKTi and CXCR4 expression on CD8 T cells became similar to healthy donors. No effects were observed on NK and Treg. The amplitude of the GPI-defective compartment remained unchanged.     

Bacterial chemoprophylaxis knowledge and practice among New Zealand dentists

OBJECTIVE: To investigate general dental practitioners' current understanding and practice of oral antibiotic prophylaxis. DESIGN: Cross-sectional survey of a random sample of New Zealand general dental practitioners (GDPs). METHODS: A postal questionnaire was sent to 700 GDPs (response rate 64.5%). RESULTS: Most practitioners (91.3%) followed the guidelines of the National Heart Foundation of New Zealand (NHFNZ), rather than those of other organisations, and the majority accurately prescribed the standard oral amoxycillin dose. However, there was inconsistency when prescribing for penicillin-allergic patients, with three-quarters of respondents opting for inappropriate regimens, and almost half favouring an outdated erythromycin regimen. There was also inconsistency in prescribing for patients with a prosthetic joint. Most respondents considered their practice to be adequately equipped to handle an allergic reaction. CONCLUSIONS: In general, New Zealand GDPs adhere to the accepted guidelines for antibiotic prophylaxis, but some confusion remains, and a review of the NHFNZ guidelines may be warranted to ensure that they reflect current scientific opinion, and to make New Zealand guidelines consistent with those used in similar countries.     

Impact Strength of Preplaced Aggregate Concrete Comprising Glass Fibre Mesh and Steel Fibres: Experiments and Modeling

Concrete is the most widely used and most affordable construction material. The structural damage that concrete cracks and fractures may cause can be severe. These concerns have lately been alleviated by new developments in fibre concretes. Recent advancements in fibrous concrete and its evolution have been rapidly drawing researchers’ attentions worldwide, which motivates the development of a new type of composite with superior impact resistance. Preplaced aggregate fibrous concrete (PAFC) is a revolutionary composite comprising a higher dosage of fibres. It has outstanding impact resistance that surpasses those of traditional fibrous concrete. The impact behaviour of PAFC in addition to glass fibre mesh (GFM) has not been investigated thoroughly. To fill this research gap, this study investigates the impact performance of three-layered PAFC comprising steel fibres and GFM insertion. Eight different mixtures were prepared and can be divided into two groups. In the first group, specimens were made with 4% fibres and two single, double and triple layers of GFM insertion between the three-layered concrete. The second group of specimens was reinforced with 5, 2 and 5% steel fibres at the top, middle and bottom layers, respectively. However, the GFM insertion scheme for the second group was the same as the first. Rectangular specimens of size 500 × 100 × 100 mm were cast and tested against drop weight impact. The parameters studied were cracking impact numbers, failure impact number, ductility index and failure patterns. In addition, an analytical model was used to evaluate the impact failure energies. Results indicate that the combined action of steel fibre and GFM exhibited an excellent impact resistance. Increasing the number of GFM insertions between the specimen layer led to increased impact strength. The dose of the fibres utilized in the outer layer of the PAFC was increased, resulting in the material having a higher impact resistance. The cracking impact numbers improved from 28 to 40%, and failure impact numbers ranged from 58.8 to 92.2% when the GFM insertion numbers increased from one to three.     

The effect of ceruloplasmin on iron release from placental (BeWo) cells; evidence for an endogenous Cu oxidase

The mechanism of iron release from the placenta into the fetal circulation is not well understood. Ceruloplasmin, a plasma ferroxidase, has been implicated in iron efflux from a variety of cell types. The hypothesis is that circulating ceruloplasmin facilitates iron efflux by oxidizing the released Fe(II) to Fe(III) for incorporation into transferrin. We tested whether this mechanism mediates iron release from placental cells into the fetal circulation, using the BeWo cell line, a choriocarcinoma which can differentiate into a syncytium.(59)Fe release from undifferentiated or differentiated cells and from cells grown on porous filters was not stimulated by extracellular ceruloplasmin. Instead, we found that BeWo cells express an endogenous ferroxidase. The protein is membrane bound and cross-reacts with an anti-ceruloplasmin antibody, but has a different size; 100 and 140 kDa. Similar immunoreactivity was identified in first- and third-trimester human placentae. In BeWo cells, the protein has a perinuclear localization but does not entirely co-localize with markers for the endoplasmic reticulum or Golgi apparatus. We propose that this oxidase performs the same function as serum ceruloplasmin and is involved in iron release into the fetal circulation.