Spiramycin is comparable to oxytetracycline in eradicating H. pylori when given with ranitidine bismuth citrate and metronidazole

BACKGROUND: We have consistently achieved about 90% eradication of H. pylori with liquid bismuth, metronidazole and oxytetracycline. AIM: To test eradication and adverse events of ranitidine bismuth citrate (RBC) when given with metronidazole and either oxytetracycline or spiramycin. METHODS: One hundred and eighty-three patients were randomized to one of four 10-day regimens: RBC400OM: RBC 400 mg b.d., oxytetracycline 500 mg q.d.s.; RBC400SM: RBC 400 mg b.d., spiramycin 1 g q.d.s.; RBC200OM: RBC 200 mg q.d.s., oxytetracycline 500 mg q.d.s.; RBC200SM: RBC 200 mg q.d.s., spiramycin 1 g q.d.s. Additionally, all patients received metronidazole 400 mg q.d.s. A 14C-urea breath test was performed at 8 weeks. RESULTS: Intention-to-treat eradication rates were 94%, 91%, 94% and 89% with RBC400OM, RBC400SM, RBC200OM and RBC200SM, respectively (P = 0.81). Eradication was significantly higher in ulcer patients (97%) than in those with diagnoses other than ulcer (86%) (P = 0.009). There was a strong tendency to better eradication among those who had never smoked (100%) compared with ex-smokers (93%) and smokers (89%) (P = 0.06). Fifty-three per cent experienced at least one moderate or severe adverse event, and women had more adverse events than men (P = 0.0002). CONCLUSIONS: All four regimens had comparable efficacy and adverse events. Eradication was significantly better in ulcer patients but there was a trend to better eradication in those who smoked less, used less alcohol and exercised more. Adverse events were frequent, perhaps because of the large dose of metronidazole used, but few patients stopped treatment.     

Clamp and sew techniques in thoracoabdominal aortic surgery using naloxone and CSF drainage

Surgical repair of thoracoabdominal (TAA) and thoracic aneurysm is challenging, with the potentials for high morbidity and mortality. There is no standardized operative approach. Operative management of TAA consists of simple clamp-and-sew techniques with adjuncts, cerebrospinal fluid (CSF) drainage, naloxone administration, and intraoperative hypothermia, to protect the spinal cord. The use of CSF drainage and naloxone administration has reduced paraplegia to 3.4%, compared with 21% when none of these adjunctive spinal cord measures were used. The authors discuss their operative strategy, surgical technique, and results at the University of Wisconsin Hospital and Clinics.     

Selective synthesis of visible light active γ-bismuth molybdate nanoparticles for efficient photocatalytic degradation of methylene blue,reduction of 4-nitrophenol,and antimicrobial activity

In this study, we have reported selective synthesis of bismuth molybdate (γ-Bi₂M₂O₆) nanoparticles (NPs) under different pH conditions for photocatalytic degradation of methylene blue (MB), reduction of 4-nitrophenol (4-NP) to 4-aminophenol (4-AP) and antimicrobial activities. The synthesis of pure phase γ-Bi₂M₂O₆ at pH = 3 was confirmed by X-ray diffraction (XRD) and Raman analysis. A single hexagonal morphology was obtained at pH = 3 which shows the formation of the pure phase γ-Bi₂M₂O₆ NPs. The mixed morphologies (hexagonal and spherical) were observed at different pH values other than pH = 3. The bandgap energy of all the synthesized Bi₂M₂O₆ NPs is found in the visible region (2.48–2.59 eV). The photocatalytic activity of bismuth molybdate (BM) NPs was examined by the degradation of MB under visible light irradiation. Results show that 95.44% degradation efficiency was achieved by pure γ-Bi₂M₂O₆ NPs compared to mixed phases (γ-Bi₂M₂O₆, α-Bi₂M₂O₆ and β-Bi₂M₂O₆) synthesized at pH = 1.5 and 5. Moreover, the degradation efficiency of γ-Bi₂M₂O₆ was enhanced to 98.89% by the addition of H₂O₂. The effective catalytic activity of γ-Bi₂M₂O₆ was observed during the reduction of 4-NP to 4-AP by NaBH₄. Potential antibacterial and antifungal activity of γ-Bi₂M₂O₆ was observed, which gives a basis for further study in the development of antibiotics.

In this study, we have reported selective synthesis of γ-Bi₂M₂O₆ NPs under different pH conditions for photocatalytic degradation of methylene blue (MB), reduction of 4-nitrophenol (4-NP) to 4-aminophenol (4-AP) and antimicrobial activities.     

Hydrothermal green synthesis of MoS2 nanosheets for pollution abatement and antifungal applications

In this study, we report a green synthesis of MoS₂ nanosheets (NSs) using a facile hydrothermal technique in the presence of l-cysteine. l-Cysteine can serve as a greener source of sulfur as well as a capping agent to help the growth of MoS₂ nanosheets. The prepared materials were characterized by X-ray powder diffraction (XRD), scanning electron microscopy (SEM) with energy dispersive spectroscopy (EDS), electron transmission microscopy (TEM), X-ray photoelectron microscopy (XPS), and Brunauer, Emmett, and Teller (BET) analysis. The results showed that MoS₂ NSs are of high crystallinity with a lattice spacing of 0.61 nm. The optical bandgap of MoS₂ NSs nanosheets prepared using l-cysteine as a source of sulfur was found to be 1.79 eV. The photocatalytic degradation of MoS₂ NSs towards methylene orange (MO) and rhodamine blue (RB) dyes under sunlight was found to be promising for practical applications. The fast kinetics of degradation of MO and RhB was observed over a wide range of pH range. Moreover, MoS₂ NSs showed excellent antifungal activities against Trichophyton mentagrophytes and Penicillium chrysogenum fungus.

In this study, we report a green synthesis of MoS₂ nanosheets (NSs) using a facile hydrothermal technique in the presence of l-cysteine.     

Objective computerized versus subjective analysis of facial synkinesis

OBJECTIVES/HYPOTHESIS: To compare the sensitivity of an objective, computerized approach to measurement of facial synkinesis with that for a subjective approach and to examine the test-retest reliability of these approaches. STUDY DESIGN: Prospective, nonrandomized, and blinded. METHODS: Remote facial motion at the upper eyelids and oral commissures during a closed-lip smile and eyelid closure were measured using a commercially available computerized motion analysis system. Thirty healthy adults with normal facial nerve function were enrolled to establish normative data and a threshold value for synkinesis. Thirty consecutive patients were analyzed based on the synkinesis threshold value. Blinded subjective evaluations by two observers were also performed independently on the same patients. RESULTS: Facial synkinesis was detected significantly more frequently with objective than subjective analysis for eyelid closure; no significant differences between approaches were shown for the closed-lip smile. Interestingly, five (17%) patients developed early synkinesis within 3 months from the onset of the facial nerve injury. The test-retest reliability of all objective measures was excellent for both expressions. Close agreement in percent of patients with synkinesis between test and retest subjective evaluations was obtained for both observers for both expressions. CONCLUSIONS: The objective, computerized approach to detection of facial synkinesis has excellent reliability and is more sensitive than the subjective approach to assessment to the presence of facial synkinesis associated with eyelid closure. The finding of early synkinesis suggests that central nervous reorganization plays a role in regeneration of the facial nerve.     

Tuberculosis defaulters from the "dots" regimen in Jimma zone, southwest Ethiopia

A cross-sectional study was conducted among patients with tuberculosis on the DOTS regimen in the four teaching health centers of Jimma zone to determine rate of defaulting and factors associated with it. All tuberculosis patients registered and treated using DOTS regimen in the 4 teaching health centers (THC's) from the second half of 1999 to December 30, 2000 were included in the study. A sub-sample of one hundred and fourteen 114 (56.2%) defaulters were traced at their homes and interviewed to elicit their reasons for defaulting. The study showed that overall rate of defaulting was 6.7%. The default rate from the DOTS regimen was found to be quite low when compared to the rate of defaulting from the standard regimen in Jimma zone. Socio-economic factors including distance of patients' residence from the health institution, lack of money for paying transportation and poor awareness about the disease were the major reasons contributing to poor compliance and defaulting. Designing community based strategies for DOTS regimen in order to make the drug available within the vicinity of the grass root community and strong information education and communication activities need to be employed in order to reduce the defaulter rate and improve the quality of treatment of tuberculosis cases by the DOTS regimen.     

Synaptic and extrasynaptic neurotransmitter receptors in glial precursors' quest for identity

It is widely established that neurotransmitter receptors are expressed in non-neuronal cells, and particularly in neural progenitor cells in the postnatal central nervous system. The functional role of these receptors during development is unclear, but it needs to be revisited now that cells previously considered restricted to glial lineages have been shown to generate neurons. The present review integrates recent advances, to shed new light on how neurotransmitter receptors may, alternatively, serve as excitable mediators of neuron-glia and neuron-neuroblast interactions.     

The utility of pallor detecting anemia in under five years old children

The diagnosis and management of anemia, which affects a significant proportion of young children in developing countries, largely depends on the clinical assessment for pallor. This study was conducted with the aim of evaluating the utility of pallor in detecting anemia. Children aged 2 to 60 months who visited the pediatric outpatient department of Jimma Hospital over 3 months period were assessed for the presence and degree of pallor in 4 anatomic sites (conjunctivae, tongue and buccal mucosa, nailbeds, palm) by trained nurses. Hemoglobin was then determined using the HemoCue method. Individuals involved in clinical examination did not have access to the laboratory results before documenting their findings. The mean hemoglobin in the 574 children examined was 11.03 gm/dl, and about 46% had anemia. Children younger than 2 years were found to have a higher prevalence of anemia as compared to older children (p < 0.001). Palmar pallor, with a sensitivity of 58%, had the highest sensitivity to detect moderate anemia as compared to other anatomic sites. The presence of either palmar or conjunctival pallor increased the sensitivity to 73%. The inter-observer agreement was highest for conjunctival pallor (kappa value = 0.81). The findings of the study suggest that pallor of a single anatomic site does not have adequate sensitivity to detect moderate anemia. We recommend further studies to look at the performance of severe pallor in correctly identifying severe anemia. Furthermore, the magnitude and causes of anemia need to be studied in a community setting.     

Predictors of adherence to antiretroviral therapy among people living with HIV/AIDS in resource-limited setting of southwest ethiopia

Background  

Good adherence to antiretroviral therapy is necessary to achieve the best virological response, lower the risk that drug resistance will develop, and reduce morbidity and mortality. Little is known about the rate and predictors of adherence in Ethiopia. Therefore this study determines the magnitude and predictors of adherence to antiretroviral therapy among people living with HIV/AIDS in Southwest Ethiopia.     

GRAPE: a graphical pipeline environment for image analysis in adaptive magnetic resonance imaging

Purpose

We present a platform, GRAphical Pipeline Environment (GRAPE), to facilitate the development of patient-adaptive magnetic resonance imaging (MRI) protocols.

Methods

GRAPE is an open-source project implemented in the Qt C++ framework to enable graphical creation, execution, and debugging of real-time image analysis algorithms integrated with the MRI scanner. The platform provides the tools and infrastructure to design new algorithms, and build and execute an array of image analysis routines, and provides a mechanism to include existing analysis libraries, all within a graphical environment. The application of GRAPE is demonstrated in multiple MRI applications, and the software is described in detail for both the user and the developer.

Results

GRAPE was successfully used to implement and execute three applications in MRI of the brain, performed on a 3.0-T MRI scanner: (i) a multi-parametric pipeline for segmenting the brain tissue and detecting lesions in multiple sclerosis (MS), (ii) patient-specific optimization of the 3D fluid-attenuated inversion recovery MRI scan parameters to enhance the contrast of brain lesions in MS, and (iii) an algebraic image method for combining two MR images for improved lesion contrast.

Conclusions

GRAPE allows graphical development and execution of image analysis algorithms for inline, real-time, and adaptive MRI applications.