Sudden Infant Death due to Early-Onset Group B Streptococcal Sepsis Diagnosed by Post-mortem Microbiology Analysis - A Case Report

                           http://austinpublishinggroup.com/clinical-microbiology/online-first.php

Suddeninfants’ death is one of the most important matters in forensic medicine. The ability to pose a differential diagnosis between internal/infection and external/violent death is of paramount importance. Here, we report a case of a sudden death of an infant due to early-onset Group B Streptococcal (GBS) sepsis diagnosed by post-mortem microbiology analysis, since the mother was negative at vaginorectal GBS screening by culture. This case report highlights the importance of rapid and accurate nucleic acid amplification tests to detect GBS carriage status, especially in the delivery room.

Streptococcus agalactiae or Group B Streptococcus (GBS) is a beta-hemolytic, catalase negative aerobe/anaerobe-facultative organism a common commensal of the gastrointestinal and/or genitourinary tract in 10-30% of pregnant women. GBS is also capable of causing severe infections, such as neonatal bacteremia, pneumonia, and meningitis and severe invasive infections both in pregnant women and in non-pregnant adults associated with significant mortality. Neonatal GBS infections may present as either fulminating septicemia or with subtle and non-specific early signs that overlap with those of non-infectious diseases. If not promptly treated with targeted antibiotic therapy, GBS infection may lead to rapid clinical deterioration represented by septic shock, multi-organ failure and disseminated intravascular coagulopathy.

Thetransmission of Group B Streptococcus between mother and her newborn is considered an important risk factor that could significantly increase the probability of the development of GBS disease. Invasive neonatal GBS infections have been categorized in two different diseases, following the definition by CDC (http://www.cdc.gov/groupbstrep/about/newborns-pregnant.html), namely Early Onset Disease (EOD) and Late Onset Disease (LOD). EOD is usually related to vaginal colonization of the mother and consequent vertical transmission during the delivery; it generally appears within 24 hours and occurs within the first week of life.

Non-Compliance with Follow-up Visits: Analysis of the First Year of Patient’s Attendance to a Second Level Headache Centre in Italy

                                          http://austinpublishinggroup.com/clinical-neurology/

Themanagement of headache patients is a complex process where many factors may play a crucial role, as for example, the compliance with follow-up visits. In order to monitor the first 12 months of activity of our secondary headache outpatient clinic, we have analysed the dropout frequency after the first visit. We retrospectively analysed 101 consecutive case records and found a drop-out rate of 45% (12 males, 33 females, mean age 38 ± 13 years, 39% foreigners), mostly not attending the first follow-up visit (74%) and suffering from chronic headache (60%). Migraine without aura was diagnosed in 56% of the patients while neither trigeminal autonomic cephalalgias nor secondary headache was suspected. We conclude that, even though our drop-out rates are similar to those already reported in the licterature and probably due to headache severity and/or language barriers, still we ought to improve in order to deliver better standards of headache care.

The management of headache patients is a complex process that includes many variables such as patient-clinician relationship, complete history collection, general and neurological examination and last, but not least, timely schedule of follow-up visits Recently, a multidimensional definition of quality of headache care has been proposed, where the following criteria ought to be achieved: accurate diagnosis and individualised management, appropriate referral pathways, education of patients about their headache and their management, convenience and comfort, patient’s satisfaction, efficiency and equitability, outcome assessment and safety. Moreover, in order to make a correct headache diagnosis, all patients seen for the first time should be given a follow-up visit after a short period of time (normally no more than two months) in order to check headache diary and eventually be treated with preventive medications. Such interval should be even shorter in case the patients suffer from chronic headache with or without medication overuse.

Therefore,non-compliance with the first follow-up visit can be an important barrier to optimal management of headache patients and contribute to inappropriate multiple uses of other healthcare services. In order to study this possible caveat concerning correct management of our patients, we analysed the dropout frequency after the first visit, during the very first year of activity of our headache outpatient clinic.

CT Angiographic Diagnosis and Explanation of Unusual Four-Limb Blood Pressures

                                               http://austinpublishinggroup.com/clinical-medicine/

A40-year-old man came to our hospital for his mysterious hypertension and his blood pressure returned to normal level after exertional activity. Except for symptoms above, his past medical history is unremarkable. The four-limb blood pressure showed a 50 mmHg gradient between the right and left arm (160/80 vs. 110/70 mmHg, respectively) but insignificant gradient with the both leg (100/70 vs.110/70 mmHg). Aortic CT angiography revealed type B interruption with tortuous cervical collateral vessels to the left subclavian artery and descendent aorta. Dilated intercostal arteries were also seen. The patient declined to further sugery and was regularly followed up. Interrupted Aortic Arch (IAA) is classified into three types according to the site of aortic interruption: Type A: the arch is interrupted distal to the left subclavian artery at the level of the aortic isthmus, which comprises 15% of IAAs. Type B: the arch is interrupted between the left common carotid and left subclavian arteries, which is the most common presentation of IAA and comprises 80% of all IAAs. Type C: the arch is interrupted between the innominate and the left common carotid artery, which is the least common presentation of IAA and comprises 5% of all IAAs. Transthoracic echocardiography is often the initial imaging modality used to evaluate cardiovascular anomalies. 

CT angiography is a noninvasive technique that enables rapid and high-spatial-resolution evaluation of vascular anomalies, in addition to assessment of tracheal or esophageal compression in the same study. The discrepancy of the four-limb blood pressure depends on interrupted location and collateral circulation in those affected patients. Knowledge of aortic anatomy and identification of arch anomalies allows for accurate surgical and intervention planning.

Robotic Surgery for Mastitis Complicated With Tricuspid Valve Infective Endocarditis: Case Report

Tricuspid Valve Infective Endocarditis (TVIE) is less common than left-sided infective endocarditis. Nevertheless, mastitis may be complicated with TVIE. Valve repair should be considered in this situation due to high probability of Methicillin resistant Staphylococcus aureus vegetation. By robotic surgery, postoperative recovery is expected to be rapid owing to the small surgical wound.

Tricuspid Valve Infective Endocarditis (TVIE) accounted for 5% to 10% of infective endocarditis. The researches of TVIE are increasing due to intravenous drug abusers are more often seen in healthcare settings. However, TVIE caused by mastitis is extremely rare.

According to the definition by the World Health Organization (WHO), mastitis refers to as an inflammatory condition of the breast, possibly accompanied by infection and usually associated with lactation. Mastitis often occurs in postpartum women. Once abscesses form in mastitis, generally surgical incision and drainage are required.

In a joint study conducted by National Yang Ming University Hospital and Heping Fuyou Branch of Taipei City Hospital, it was found that 88% of mastitis in Taiwan was caused by Staphylococcus aureus. In which, more than half of them are Methicillin Resistant Staphylococcus Aureus (MRSA). According to a study, 77% of patients can be cured from ultrasound-guided drainage without surgery. It is important to conduct health education to prevent patients from mastitis-associated complications. Once mastitis is complicated with TVIE, profound bacteremia and cardiac valve damage will be frequently accompanied. Early surgical valve repair is necessary to be considered due to Methicillin resistant Staphylococcus aureus are often seen. By robotic surgery, rapid postoperative recovery is expected due to the small surgical wound.

Advanced Colorectal Carcinoma with Testicular Metastasis in an Adolescent: A Case Report

                                         http://austinpublishinggroup.com/clinical-case-reports/

Colorectalcarcinoma is the second most common alimentary tract carcinoma after liver tumors in children with an incidence of 1.3-2 cases per million population, mostly present in the second decade of life. It tends to be very aggressive and present late, due to which it has very poor prognosis. It may present itself with distant metastasis. But metastasis to the testes is very rare and signifies advanced stage of the disease. Surgery is the only effective modality to cure patients with localized colorectal carcinomas. We are presenting a case of advanced colorectal carcinoma in an adolescent with testicular metastasis.

A15 years old Indian male presented to Surgical emergency with complaints of difficulty in passing stool for one month, passage of blood and mucus per rectum for 15 days, abdominal distension for 1week and obstipation for 3 days. These symptoms were associated with significant appetite and weight loss but there was no history of fever, jaundice, malena, hemetemesis, hemoptysis, cough, chest pain shortness of breath. There was no history of similar illness in family, and any other malignancy.

Onexamination patient was conscious with thin built and pallor was present. Abdomen was distended with no local bulge. On digital rectal examination, a circumferential proliferative growth was felt 1cm above the anal verge, which was occluding the lumen near completely. On scrotal examination, a small nodule was felt in Right testis. Rest systemic examination was normal. An abdominal and chest X-ray was done as preliminary investigations which revealed signs of intestinal obstruction.

Progressive Exertional Dyspnea and Fatigue in an Oncology-Patient

                                        http://austinpublishinggroup.com/clinical-cardiology/

Wepresent a case of a suspected myocarditis and multiorganic toxicity due to immune checkpoint inhibitors used in cancer treatment. Some cases have been reported in the literature although the peculiarity of this one was the multiorganic and simultaneously affectation. We are attending the striking development of cancer treatment, which allows patients in the most astonishing cases to the complete resolution of the disease. However, to get the aim many trials and surveillance studies must been performance. The release of biological targeted medications has passed over the feared chemo resistance to conventional drugs. But we need to balance even though the prognosis is often very poor, a detailed assessment of the advantages and disadvantages taking into account the patient and family’s preferences.

Howeverwe could think that more specific treatment would lead us to less aggressive adverse events, but that’s not the case with immune checkpoint inhibition drugs. A 78-year-old male, ex-smoker, who had a history of ischemic heart disease 10 years ago, with preserved ejection fraction, was diagnosed in June, 2016 of a non-small cell lung cancer (squamous cell carcinoma disseminated to liver without any remarkable molecular profiling). He was proposed to take part in a clinical essay that evaluate the answer to nivolumab 3mg/kg every 2 weeks associated to ipilimumab 1 mg/kg every 6 weeks; beginning the above mentioned treatment five months later and receiving the first dose of nivolumab on November 24^th.

Fungus Gnats and Shore Flies

Fungus gnat larvae are white and legless, about 1/4 inch long when mature, and have a shiny black head. The adult is mosquito-like in body shape, about 1/8 inch long, with long legs, a clear pair of wings, and long antennae. Fungus gnats are weak fliers and are frequently observed resting on the media in the pot or running over the foliage or other surfaces.

The adult fungus gnat is sometimes confused with another small dark-bodied fly called the shore fly, Scatella stagnalis. Shore flies have more robust bodies than fungus gnats and their antennae are very short. Their most distinguishing characteristic is the presence of five light-colored spots on each of their dark wings. Shore flies are also stronger, faster fliers than fungus gnats. In the larval stage shore flies can be distinguished by the opaque, tannish-brown color of the body and the absence of a head capsule.

Fungus gnats and shore flies are attracted to damp locations where fungi are apt to flourish. Fungi are a major part of their diet. Studies have shown that fungus gnats develop more rapidly and have greater survival on fungal diets. In the absence of a fungal food source however, fungus gnats are capable of feeding on healthy plant tissue. Fungus gnats are general feeders and can injure a number of flower crops grown in the greenhouse. Adults are primarily a nuisance however, larvae feed on plant roots, fungi and decaying organic matter and tunnel into the crown and stems of plants. The feeding damage creates wounds that allow soil borne pathogens to enter and can kill plants. Fungus gnat larvae may also carry some soil-borne pathogens such as Pythium, Thielaviopsis and Fusarium. Fungus gnats are a common problem on greenhouse crops growing in media that contains a high percentage of peat moss or compost. Larvae present in infested plants or soil can lead to prolonged emergence of adults. Shore flies are not known to feed on healthy plant tissue. Adult and larval stages of shore flies feed primarily on algae or decaying organic matter and breed in moist environments.

A Comparison of Flat-Panel CT to Non-Contrast Enhanced CT in the Detection of Intracranial Hemorrhage

                         http://austinpublishinggroup.com/cerebrovascular-disease-stroke/

InAIS, time is critically important: with 1.9 million neurons lost per minute, clinical outcomes after reperfusion correlate with the time spent ischemic. However, the current algorithm of care for AIS patients is to first receive a NECT to identify possible contraindications for IV tPA such as intracranial hemorrhage or large completed brain infarction that would raise the risk for reperfusion hemorrhage in already dead brain tissue. If the patient is demonstrated by CT angiogram to have an intracranial large vessel occlusion, the patient is then transported to the angiography suite for endovascular mechanical embolectomy. Every minute counts in the treatment of AIS, with improved outcomes for less time between onset of the stroke and reperfusion. Each step in the treatment protocol adds time until reperfusion. Angiography suites equipped with FPCT may be able to eliminate the need for imaging studies prior to the transport to the angiography suite. Previous studies have suggested that imaging in the angiography suite (FPCT) could be reliable and comparable to other forms of imaging in assessment of hemorrhage and blood volume. If FPCT is determined to be as sensitive to ICH as standard NECT in this future prospective study, this would allow elimination of NECT imaging as a separate step in the AIS treatment protocol needed for IV tPA administration and embolectomy. If FPCT is comparable to NECT currently used in the early steps of triage of AIS, then it may be possible to decrease delay in treatment of patients and improve overall outcomes. In 2016, Leyhe, et al. performed a 102 patient retrospective study comparing FPCT to NECT and showed FPCT had comparable sensitivity and specificity.

to NECT in the detection of SAH, IVH, and IPH. Building on this study, our group is preparing an international multicenter prospective study collaboration with the Leyhe group, comparing standard stroke management with NECT to one stop management with FPCT in the endovascular suite. In preparation for this collaboration, a study ensuring comparability in a tertiary cerebrovascular referral center in North America is warranted. We aim to assess the detectability of brain hemorrhages using FPCT images specifically in our tertiary hospital’s population.

Cardioprotection by Bioactive Polyphenols: A Strategic View

                                           http://austinpublishinggroup.com/cardiovascular-diseases/

Cardiovasculardisease (CVD) remains one causing most mortality worldwide. Common CVD risks include oxidative stress, hyperlipidemia, endothelial dysfunction, thrombosis, hypertension, hyperhomocysteinemia, inflammation, diabetes, obesity, physical inactivity, and genetic factors. Among which, lifestyle changes including diets are modifiable CVD risks, becoming the first line of prevention prior to any medication. In the past decades, the USDA, the American Heart Association, the American Nutrition Association, the Academy of Nutrition and Dietetics, and many other health organizations have launched five colors daily with vegetable and fruit consumption for human health. 

Lipophilic polyphenols, phytochemicals rich in vegetables and fruits, show classical antioxidation (e.g., radical-scavenging, metal chelating, NOX inhibition, attenuation on mitochondrial respiration, inhibition on xanthine oxidase, and upregulations on endogenous antioxidant enzymes), multiple effects on cell signaling (e.g., AMPK activation, SirT1 activation, eNOS activation, FOXO activation, NFkB inactivation, PI3K/AkT inhibition, mTORC1 inhibition, ERK inhibition, JAK/STAT inhibition, IKK/JNK inhibition, PDE inhibition, α-catenin inactivation, downregulation on TLR expression, ACE inhibition, adiponectin elevation, attenuated ET-1 production, and K+ channel activation), and many other biological actions (e.g., inhibition on α-glucosidase, anticoagulation, upregulation on paraoxonase 1, PAI-1 downregulation, tPA upregulation, epigenetic modulation, and altered gut microbiota). Accordingly, polyphenols multiple-targeting CVD risks and progression (Graphic summary) could offer broad range of cardioprotection from atherosclerosis, hypertrophy, arrhythmia, angina, heart failure, etc.

Oral Supplements Modulation of Dietary Polyaromatic Hydrocarbon Levels in Prostate Cancer Patients in Ibadan, Nigeria

                                      http://austinpublishinggroup.com/cancer-clinical-research/

The levels of dietary poly aromatic hydrocarbon and Total anti-oxidant Status (TAS) in the serum of 30 prostate cancer patients compared with 30 apparently healthy controls were measured to study the contribution of this toxicant in the aetiology of prostate cancer. Prostate Specific Antigen (PSA), Benzo {a} pyrene (BaP) and Total antioxidant Status (TAS) were analysed using standard methods. Benzo {a} pyrene was analyzed using high performance liquid chromatographic technique (HPLC).

The results showed significantly higher mean levels of PSA (ng/ml) (144.6 ± 556.0) in participants with prostate cancer compared to the controls (5.2 ± 9.7) respectively (p<0.05). Conversely, there was a significant decrease in the mean levels of BaP (μg/ml) (0.4 ± 0.2 versus 0.7 ± 0.2 and TAS (mmol/L) (11.7 ± 1.6 versus 12.9 ± 1.0)in participants with prostate cancer compared to the controls. There was a positive correlation of BaP with the frequency of smoked fish intake in participants with prostate cancer compared with the controls (0.630, p < 0.000 versus 0.117, p <0.537). A significantly reduced level of BaP was observed in participants and controls on oral supplements compared with those otherwise. Logistic regression to correct for supplement intake showed an indirect relationship with BaP (-6.367, p <0.05). There was no significant variation in the mean levels of all the anthropometric measurements between the cases and the controls (p> 0.05).

Increased consumption of smoked foods, reduced TAS and resultant oxidative stress may contribute to the aetiology of prostate cancer while supplements ingestion may ameliorate benzo (a) pyrene level in some individual. Prostate cancer, whose risk increases with age remains the most frequently diagnosed malignancy and the second leading cause of cancer-related mortality among males. It is the most diagnosed cancer among Nigerian men. Since the incidence of cancer increases with age, the number of newly diagnosed cases and death continues to rise as the life expectancy of the general population increases.

Do Predictive Power of Fibonacci Retracements Help the Investor to Predict Future? A Study of Pakistan Stock Exchange

                  http://austinpublishinggroup.com/business-administration-and-management/

There are number of ways like Technical Analysis, Fundamental Analysis and The Efficient Market Hypothesis that helps to know the behaviour of investor which helps to predict future. In this study author used Fibonacci numbers/series analysis which consider for forecasting future stock prices trends. For the purpose of this study four listed companies are selected at random by convenience sampling from Cement Sector for the period of 1st quarter of 2017. Closing prices of open days of market are taken from Karachi Stocks and graphs are made. This study concluded that in four companies of cement sector, there were total 63 support levels out of which 17 (27%) and total 66 resistance level from which 24 (36%) were followed Fibonacci retracements. So the study findings accept the hypothesis that the trend reversals in Cement sector listed in PSX follow Fibonacci retracements to some extent. Analysis of this study showed that there is at least one strong support and one strong resistance in every company and some small resistant and support levels.

Everyinvestor wants to get more return on his investments and to get each and every opportunity by mean of which he can get more return on his stock. So while making investments in any stock, investors want to make some predictions regarding their investments by analyzing the trends of a particular stock that it would be profitable for them to making investment in a particular stock in future or not?. For this purpose there are many ways to analysis the behaviour of investors like Technical Analysis, Fundamental Analysis and The Efficient Market Hypothesis through which future predictions can be made while investing in any stock.

Technicalanalysis indicates the previous stock price values by using the charts, graphs which shows to different trends and investors behaviour about the price fluctuations of financial instruments. In the period of 1981-1995, the stock prices strong and weak return indications were analyzed by the mean of technical analysis generic. Programming to provide information regarding six exchange rates trends to investor for their future investments.

Green Synthesis of Silver Nanoparticles Using Cyclodextrin Glycosyltransferase Produced by Recombinant Lactococcus lactis

                                               http://austinpublishinggroup.com/biomolecules/\

Cyclodextringlycosyltransferase (CGTase) is an extracellular enzyme commonly produced by alkaliphilic bacilli. In this article, we report one-step synthesis of silver nanoparticles (Ag-NPs) through a green method using CGTase as both reducing and stabilizing agents. Structural, morphological and optical properties of the Ag-NPs were characterized using X-Ray Diffraction (XRD), Transmission Electron Microscopy (TEM) and UV-Vis spectroscopy. The formations of Ag-NPs were confirmed with an absorbance band centered at 450nm. A TEM image displayed that the nanoparticles are spherical in shape with size ranging from 10 to 25nm. The XRD pattern showed that the nanoparticles were well arranged in the right crystalline system. The bio-formed nanoparticles are expected to have prominent uses in pharmaceutical and biomedical areas.

Researchersin the field of nanotechnology are turning to ‘Nature’ to provide inspiration, for stimulating and innovative approaches of nano-production. Synthesizing new metallic nanoparticles based on the notion of green nanotechnology is obtaining momentum. Green nanotechnology mixes the principles of green engineering and green chemistry to produce safe and eco-friendly nanoparticles, which do not use toxic substances in their synthesis procedure. The synthesis of nanoparticles of noble metals, such as Ag-NPs, is of excessive interest because of their unique characteristics. Manipulation of their shape and size creates unique properties which have potential applications in biomedical uses such as antibacterial, anti-HIV activity, controlling plant pathogens and as a biosensor and catalyst.

Currentchemical and physical techniques for the production of Ag-NPs use hazardous substances for example hydrazine, Dimethyl formamide (DMF) and Sodium borohydride, as reducing agents, and may also need to use costly instruments. These approaches produce Ag-NP efficiently, nevertheless downstream processing to distinct nanoparticles from the toxic compounds is costly and time consuming. Existence of even a slight trace of toxic compounds makes these Ag-NPs incompatible for pharmaceutical and biomedical applications.   

Bioethics and Bioethical Education, Where to?

                                              http://austinpublishinggroup.com/biology/

To 12^th World Conference Bioethics, Medical Ethics & Health Law, March 21-23, 2017, from Limassol, Cyprus, the conference president, Prof. Amnon Carmi showed that for the first fifty years of bioethics was discussed the construction and development of its bioethic concept and that we are now facing a second stage, a new task, that seems to be even more important, complex and difficult, namely the delivering of our message to society, by planting the ethical values into the soul of the people and into their daily life and behavior.

In bioethics are very important two different tools: educational tool that consist of the use of novel methods and a legal tool by translated and adopted of theory and language of bioethics by the legislator and the judiciary, e.g. the Universal Declaration of Bioethics and Human Rights of United Nations Educational, Scientific and Cultural Organization (UNESCO).

In actual society are many bioethical controversial issues, including: stem cell research, “in vitro” fertilization, human cloning, euthanasia, genetically modified crops, bioethics in food security, production of GMO (Genetically Modified Organisms), beyond species barriers, and their commercialization.

Differential Impact of the Ubiquitin-Proteasome System on Clear Cell Carcinoma and High-Grade Serous Ovarian Cancer

                                               http://austinpublishinggroup.com/biochemistry/

Ovariancancer is particularly deadly and difficult to target because of its aggressive nature. With high mortality rates, current studies are focused on improving early detection and prevention methods as well as developing new treatments. To successfully develop these therapeutic options, researchers first need to understand how the cancer forms, spreads, and functions. Since ovarian cancer is composed of many heterogeneous subtypes, such as high-grade serous ovarian cancer and clear cell epithelial ovarian cancer, the nuances of each type need also be examined and understood in order to target each individually. It has been determined that each subtype has a unique relationship with the tumor suppressor, p53. Understanding how each subtype interacts with p53 can lead to specialized treatment mechanisms that target these interactions. MDM2 and ADRM1, over expressed in clear cell carcinoma and high grade serous ovarian cancer respectfully, are key components of these interactions within ovarian cancer. MDM2 is a negative regulator of p53, while ADRM1 aids in protein degradation. The overexpression of each molecule acts specifically to aid ovarian cancer in survival. In this review, recent advances in studying ovarian cancer subtypes will be covered, as well as how these subtypes relate to the ubiquitin-proteasome system and the key tumor suppressor in human cells, p53.

DUBs: Deubiquitinating Enzymes; HGSC: High-Grade Serous Ovarian Cancer; CCC: Clear Cell Carcinoma; MDM2: Murine Double Minute 2; UPS: Ubiquitin-Proteasome System; ROCA: Risk Of Ovarian Cancer Algorithm; CIC: Cancer Initiating Cell; BRCA: Breast Cancer Gene; ADRM1: Adhesion Regulating Molecule 1; CA-125: Serum Cancer Antigen-125.

Ovariancancer, one of the deadliest and most aggressive gynecological malignancies, is the fifth most common cause of cancer death in women. As recently as 2017, the annual ovarian cancer mortality was approximately 65% of the incidence rate due to low predictive value in screening procedures for women without increased risk factors. As a result, only 15% of patients are diagnosed with localized disease and many patients are diagnosed in stage III or IV. The four main histological subtypes within epithelial ovarian cancer are serous, clear cell, endometrioid, and mucinous adenocarcinomas. Each subtype has its own unique abnormalities, making diagnosis and treatment of ovarian cancer difficult. While all women are susceptible to ovarian cancer, increased risk factors include familial history, nulliparity, lack of breast feeding, and infertility. About 20% of ovarian cancers are familial, linked mostly to Breast Cancer Alleles 1 and 2, (BRCA1 or BRCA2), though other gene mutations have been implicated as well.

Serum Immunoglobulin Levels in Nigerian Patients with Sickle Cell Anaemia in Bone Pain Crisis and Steady State

                                       http://austinpublishinggroup.com/blood-disorders/

SickleCell Disease (SCD) is a group of haemoglobin disorder resulting from the inheritance of the sickle β-globin gene. The homozygous state (Hb SS or sickle cell anaemia) is the most common form of the disease, however the interaction of the abnormal haemoglobin S (HbS) with thalassemia and other haemoglobin variants also result in sickling.

SCDis a major public health problem and the most common genetic disease disorder that affect mankind. The disease has a global distribution, but certain regions of the world have high prevalence for the sickle cell gene including Equatorial Africa, Sicily in Southern Italy, Middle East and Central India.

In Nigeria, the magnitude of the problem is much more pronounced given that 25% of the population carry the sickle cell gene. The World Health Organization (WHO) estimates the prevalence of SCA to be 20 per 1000 live birth annually which translate to about 150,000 children born annually with SCA in Nigeria, thus making Nigeria the country with the highest disease burden globally.

The common and most distressing clinical manifestation of SCA is the episodic and unpredictable sickle cell vaso-occlusive crisis (VOC). The crisis occurs unpredictably over a life-time and account for most common cause of emergency room visits and hospitalization. The most common acute VOC is the Bone Pain Crisis (BPC). BPC is defined as painful episodes involving one or more sites of bones in the absence of preceding trauma or obvious infection. The most common sites are the long bones of the limbs, lumbar spine, and thoracic cage.

Malaria bacterial and viral infection, are the most common precipitating factors for VOC and leading cause of mortality in SCD. SCA patients are prone to infection because of a defect in the alternative pathway of complement activation and opsonisation reduced ability of neutrophils to kill pathogens and functional 

The Association between Vitamin D and Rejection in Adult Renal Transplant Recipients: A Meta-Analysis

                                               http://austinpublishinggroup.com/biometrics/

The problem has been discussed a lot, but the results remain controversial. Since no consensus had been reached yet for whether vitamin D insufficient is a major contributor for rejection in renal transplant patients, we performed a meta-analysis of the association between them. Pub Med, Medline, web of science, Ovid and Springer databases were searched for observational studies linked with vitamin D and rejection in adult renal transplant recipients. A meta-analysis was conducted by pooling data from relevant cohort and case control studies. The Q statistic and I2 were used to measure heterogeneity. Subgroup analysis and meta-regression were conducted to detect the source of heterogeneity. When significant heterogeneity was observed statistically, a random-effect model can be used to estimate the odds ratio. And sensitivity analysis was conducted to make sure whether the results were stable. The analysis consisted of seven studies including five cohort studies and two case control studies, with a total of 2731 participants. These studies contained different vitamin D doses with a varying degree of intervention duration. Pooled odds ratio was 1.07, 95% confidence interval: [0.50-2.28], with significant heterogeneity among these studies (I2=82%, P<0.01). Vitamin D has no association with rejection in adult renal transplant recipients. There is a necessity that future investigations are encouraged to reveal the underlying mechanisms and the risk factors for rejection.

Chronic Kidney Diseases (CKD) is highly prevalent in the general population, which have become a worldwide epidemic with an occurrence rate of approximately 5%-15%. When the CKD is developing to End-Stage Renal Disease (ESRD), kidney transplantation is a preferred treatment for the increasing number of patients. Renal transplant recipients usually have low vitamin D levels, especially in the early post-transplantation period. Vitamin D is an important hormone which closely correlated with many immune disorders. It not only maintains the basic metabolism of calcium and phosphorus, but also affects immune functions of the body. More and more people have realized that vitamin D is one of the largest modifiable risk factors for health.

Since the kidney is an active organ of vitamin D, it is also increasingly appreciated that there may be an association between vitamin D and allograft outcomes in renal transplant recipients. Some retrospective cohort studies stated that vitamin D can improve the prognosis of graft, reduce graft loss and prevent rejection by inhibiting allograft rejection.

Vertebral Artery Dissection Associated with Bathing: A Case Report

                                           http://austinpublishinggroup.com/biomarkers/

VertebralArtery Dissection (VAD) is often associated with trauma or occurs spontaneously, inevitably causing some neurological deficits. We herein report the case of a 49-year-old female patient presented with sudden onset of severe posterior neck pain with occipital headache, vertigo and vomiting when she was bathing. Dissection of the right vertebral artery at the level of V4 segment was confirmed by use of Magnetic Resonance Imaging (MRI) and CT Angiography (CTA), and Digital Subtraction Angiography (DSA). The patient was started with clopidogrel (75mg/d) and low molecular weight heparin calcium injection (Fraxiparine, 0.4ml: 4100AXaIU/bid, subcutaneous injection). Recovery of neurologic function was excellent, and she was discharged after 21 days. However, reexamine CTA showed an abnormal intracranial segment of the right vertebral artery. The patient still continued treatment with Clopidogrel (75mg/d). We suggest that patients with symptoms of neck pain or headache and even disturbances of posterior circulation after manipulation and stretching of the neck, VAD has to be taken into consideration.

Spontaneousdissection of the intracranial vertebral artery is an increasingly recognized cause of stroke. The annual incidence of spontaneous Vertebral Artery Dissection (VAD) is 1-1.5 per 100,000. Usually, a history of drug treatment, generalized convulsive seizure, minor blunt trauma or activity associated with rotation or hyperextension of the neck, such as tooth-brushing, aerobics, yoga, painting of the ceiling and spinal manipulations can cause VAD, and it is generally labeled as spontaneous dissection. The purpose of this case report is to describe a female patient who presented with posterior neck and occipital pain and was undergoing a vertebral artery dissection when she was standing in a shower and washing her hair. The VAD caused embolic complications: pontine and cerebellar infarctions.

A49-year-old female patient presented with sudden onset of severe posterior neck pain with occipital headache, vertigo and vomiting when she was bathing two hours ago. When she was admitted to our department, she appeared tired and distressed. She stated that she had burning, sharp pain worse than she had ever experienced before. She was healthy previously, and denied any head or neck trauma and chiropractic manipulation. She has no personal or family history of systemic illnesses, connective tissue diseases, myocardial infarctions or cerebrovascular insults. On physical examination, her temperature was 37.6⁰C, pulse 72 beats/min, and blood pressure 132/78 mmHg. No remarkable positive signs were detected by the lung, cardiac, and abdominal examinations.

Characterization and Utilization of Podoviridae Phages for Controlling Pathogenic Escherichia coli Serovar O168 from Ducklings in Egypt

                                               http://austinpublishinggroup.com/bacteriology/

This study was carried out to isolate and characterize lytic bacteriophages against the multidrug resistant and pathogenic Escherichia coli serotype O168 isolated from ducklings in Egypt; and also to study efficacy of single phage and cocktail phages on In vitro inactivation of E. coli O168. One hundred and fifteen samples from ducklings, including caecal contents, skin, minced breast, gizzard, swabs from mouth, cloacae and inner surface of liver, were collected, pre-enriched in peptone water and streaked MacConkey agar, and Eosin-Methylene Blue agar. The presumptive isolates of E. coli were subjected for biochemical and serological identifications. Antimicrobial susceptibility testing was performed by the disk diffusion method. Phages against E. coli serotype O168 were isolated from sewage samples using plaque assay test. An evaluation of phages efficacy was achieved separately and in cocktail to control the most multidrug resistant serotype E. coli O168. Three different single plaques with different plaque morphologies and diameters designated as ECa1, ECb1, and ECc1 were picked and chosen for further purification, amplification and characterization. The recovered phages were belonged to the family Podoviridae. The use ofcocktail phages (ECa1/ECb1/ECc1) was significantly effective (reductions of 7.4 log CFU/ml 12hrs post treatment) than the use single phage suspensions. This study confirmed the higher efficacy of phage cocktails in controlling the infection of ducklings with multidrug resistant E. coli O168. These phages will reduce mortality in ducklings, and also protect human health from adverse side effects of antibiotic residues.

Duckmeat is the most popular type of food in Egypt and various parts of the world. Ducks are excellent sources of animal-derived high quality proteins that contain essential and nonessential amino acids. Pathogenic Escherichia coli infecting poultry is the causative agent of colibacillosis, one of the most important causes of economic losses in industry of poultry worldwide. In Egypt, five serotypes of E. coli (O86, O127, O114, O26 and O78) were identified from gizzard, heart, spleen and muscles of ducks. Some bacterial diseases such as salmonellosis, colibacillosis, and pasteurelliosis infect a variety of organ systems with involving the alimentary tract. Escherichia coli is a food borne pathogen, and has a public health concern. Recently, there has been attention that some multidrug resistant E. coli have represented a worldwide multiple food borne disease disorders related to the contaminated food consumption. Also, the misuse of antimicrobial agents in poultry production for growth promotion and treatment purposes increases the major interest for the multidrug resistance that are frequently seen among serovars of E. coli and Salmonella. Antimicrobial-resistant food borne pathogens is recognized as an essential public health in the developing countries and this resistance reduces the therapeutic options for treatment of human salmonellosis.

Investigation of Bismuth Nanoparticles Antimicrobial Activity against High Pathogen Microorganisms

                         http://austinpublishinggroup.com/bioterrorism-biosecurity-biodefense/

Despite of the common efforts in biodefense around the world the problem of high dangerous pathogens distribution, especially under the threat of terrorist attacks, is still urgent. Among the biotoxins that could be used for dispersion, leading experts identify large number of high pathogen microorganisms of category A and B, such as well-known pathogens: Bacillus anthracis, Salmonella, Escherichia etc. The most important problem in the struggle against biohazard is high effective defense of civil population. Such effective defense can be provided using safe drugs, which are effective against wide range of biotoxins.

Modern antimicrobial preparations and vaccines don’t possess by wide range of activity against different classes of pathogens. So, the search and development of new high effective antimicrobial substances with high effectiveness against wide spectra of high pathogen microorganisms - causative agents of most dangerous human and animals’ diseases is topical problem today. Metal nanoparticles are possessed by high potential in this area.

The main goal of presented work was antimicrobial activity investigation of the synthesized bismuth nanoparticles against wide spectra of pathogen microorganisms - potential causative agents of high dangerous human and animals’ diseases. Spherical Bismuth Nanoparticles (BiNP) have been synthesized by the method of chemical condensation in water medium. The concentration of obtained BiNP was 77.5 mg/ml by metal. The shape and size of synthesized BiNP have been defined by the method of Transmission Electron Microscopy.

Hormones and Feed Intake Regulation: Ruminant and Rat Models

                                  http://austinpublishinggroup.com/biotechnology-bioengineering/

Theobjective of this mini review article was to illuminate hormones-mediated feed intake regulation in ruminant and rat models. This was to help formulate nutritional strategies to optimize metabolism and performance in food-producing animals and to improve human physiology and health. Nutrient partitioning is mediated by a variety of hormones. Hormones are involved in both short-term and long-term regulation of feed intake. The greatest fluctuations in body metabolism, nutrient partitioning, and feed intake usually occur around calving in large ruminants when levels of metabolic and reproductive hormones are highly variable in periparturient cows.

Estrogen depresses feed intake by acting primarily on the paraventricular nucleus of the hypothalamus. Insulin is another important hormone possessing both long-term and short-term effects on ruminant nutrient partitioning and feed intake. The long-term roles of insulin in feed intake control relate to pregnancy and lactation. This occurs mainly during mid- and late-lactation when the cow tends to gain weight. Insulin is involved in both up- and down-regulation of feed intake in mammals. When compared to prepartum levels, insulin secretion drops substantively shortly after parturition. Without the postpartum drop in insulin secretion rate, the cow would be unable to use body reserves and deal with insufficient Dry Matter Intake (DMI). The low postpartum insulin will additionally enable the cow to gradually increase DMI.

Theshort-term insulin effects on nutrient metabolism and partitioning, which are more relevant to the findings of dairy cattle studies, initiate upon or even shortly before feeding or nutrient ingestion. Seeing the fresh feed can cause a surge in insulin secretion in sheep and cattle. The higher postprandial insulin surge leads to greater glucose uptake by peripheral tissues.