bluuebunny/crossref_metadata_2025 huggingface dataset:
Duodenal Ulcer and Helicobacter pylori Infection at High Altitude: Experience from Southern Saudi Arabia
Authors: Ahmed M El Bagir K , Al-Knawy BA , Al-Wabel AH , Foli AK
Published: March 2016

OBJECTIVE: To study the clinical presentation, endoscopic features and prevalence of Helicobacter pylori in duodenal ulcer (DU) patients in southern Saudi Arabia, located 3150 m above sea level, and to compare results with those from low altitude regions of the Kingdom.

METHODS: Prospective study of patients with proven DU referred for upper gastrointestinal endoscopy at Asir Central Hospital, Abha, southern Saudi Arabia over an 18‐month period.

RESULTS: Of 126 patients with proven DU, 72% were men and mean age was 40.4 years (range 18 to 68). Twenty‐eight per cent were smokers and only 5% used nonsteroidal anti‐inflammatory drugs. Thirty‐eight patients (30%) presented with hematemesis or melena, and the majority had a single ulcer. Nineteen per cent of patients with dyspepsia had DU and 96% had H pylori. These results are comparable with those reported from the low altitude, warmer regions of Saudi Arabia.

CONCLUSIONS: Age of patients and the male:female ratio were similar to those in developing countries. The frequency of smoking is lower than in western countries and no patient in this report consumed alcohol. High altitude did not affect the prevalence of DU or the frequency of H pylori because the results were comparable with those from the low altitude areas of the Kingdom of Saudi Arabia and other lowland developing countries. Although great socioeconomic changes have increased the incidence of heart disease, the patterns of DU and H pylori infection assume those in developing nations.
Bacterial Glycosulphatases and Sulphomucin Degradation
Authors: Roberton Anthony M , Wright Damian P
Published: March 2016

The presence of a high bacterial population in a region of the gastrointestinal tract is usually associated with the secretion of sulphomucins into the mucus gel covering that region. The term ′sulphomucin′ is a histochemical description of the staining properties of mucin. At present this term can only be qualitatively related to the percentage of sulphate in the mucin molecule, which makes the term difficult to use in a biochemical and functional sense. Sulphomucins are thought to carry out the normal functions attributed to mucins; in addition, heavy sulphation rate‐limits the degradation of mucins by bacterial mucin‐degrading glycosidases. A number of mucin‐specific glycosulphatases have been reported in bacteria, although only two such enzymes have been purified. These enzymes remove part of the sulphate content from sulphomucins and make them more susceptible to further enzymic degradation. The variety of chain locations and sugar attachment sites of sulphate esters on the mucin oligosaccharides, taken together with the data on the enzymes, suggest there will be a spectrum of bacterial glycosulphatases, with different properties, cellular locations and substrate specificities. Bacterial glycosulphatases have the potential to modify sulphated glycoconjugates at mucosal surfaces and should prove useful as biochemical tools for the study of sulphated glycoconjugates.
Physiological Effects of Bulimia Nervosa on the Gastrointestinal Tract
Authors: Anderson Lisa , Shaw Jill-Marie , McCargar Linda
Published: March 2016

Bulimia nervosa is an eating disorder characterized by frequent bouts of binge eating accompanied by compensatory behaviour for preventing weight gain (purging). It is estimated that 3% to 5% of young women are affected by bulimia nervosa, and its prevalence is increasing. Bulimia nervosa afflicts both sexes and all races. It can lead to serious medical complications. The expression of the disease in the gastrointestinal tract may have a critical role in the diagnosis of bulimia nervosa. Physiological effects of bulimia nervosa on the gastrointestinal tract include dental caries and enamel erosion; enlargement of the parotid gland; esophagitis; changes in gastric capacity and gastric emptying; gastric necrosis; and alterations of the intestinal mucosa. Identification of any of these factors may aid in establishing an early diagnosis, which has been shown to increase the likelihood of recovery.
Atypical Perinuclear Antineutrophil Cytoplastmic Antibodies after Colectomy in Inflammatory Bowel Disease
Authors: Freeman Hugh J , Roeck Brenda , Devine Dana V , Carter Cedric J
Published: March 2016

Atypical perinuclear antineutrophil cytoplasmic antibodies (p‐ANCA) have been detected in most patients with ulcerative colitis and primary sclerosing cholangitis. Persistent atypical p‐ANCA have been observed in ulcerative colitis patients with a prior proctocolectomy, especially with pouchitis, suggesting that this serological marker might be predictive of subsequent development of chronic or refractory pouchitis. This study prospectively evaluated this serological marker in 24 consecutive patients with inflammatory bowel disease and prior colectomies (12 with a clinical diagnosis of ulcerative colitis and 12 with a clinical diagnosis of Crohn′s disease involving the colon). Of these, 14 were positive, including 11 with extensive ulcerative colitis and three with Crohn′s disease. Although two of three ulcerative colitis patients with pouchitis were positive, eight of eight ulcerative colitis patients having a pelvic pouch with no pouchitis were also positive, as was a patient who elected to have an end‐ileostomy (Brooke′s ileostomy). Two patients had abnormal liver chemistry tests. Both had end‐stage primary sclerosing cholangitis treated with liver transplantation and were positive for this serological marker. Although atypical p‐ANCA may be a marker of persistent inflammation in pelvic pouch patients, a positive test result should not be used for prognosis or as a decision‐making parameter for pelvic pouch procedures.
Use of Oral Sodium Phosphate Colonic Lavage Solution by Canadian Colonoscopists: Pitfalls and Complications
Authors: Chan A , Depew W , Vanner S
Published: March 2016

Oral sodium phosphate (NaP) has become an attractive alternative to polyethylene glycol (PEG) for colonic cleansing before colonoscopy, but it potentially has greater complications. This study surveyed members of the Canadian Association of Gastroenterology (CAG) to determine how these colonic lavage agents are used and what complications have been encountered. The Dillman survey technique produced responses from 67% of the 400 members who perform colonoscopy. For the larger out‐patient group, respondents used NaP more frequently than PEG (46% versus 35%, respectively, P<0.015). Respondents used NaP and PEG with similar frequencies for the in‐patient group (44% versus 43%). Of respondents using NaP, 45% reported excluding its use in patients with renal failure, 30% with heart disease, 13% with incomplete bowel obstruction and 9% with extreme age. Symptoms suggestive of hypovolemia were reported in 9% of those using NaP compared with 3% using PEG (P<0.02). Three patients receiving NaP developed acute renal failure. A greater proportion of those using NaP had small unexplained aphthous ulcers (16%) and excessive luminal bubbling (24%) compared with PEG users (3%, P<0.00001 and 14%, P<0.03, respectively). These data demonstrate that members of CAG use NaP more frequently than PEG as the colonic lavage solution before colonoscopy. A greater number reported complications with NaP versus PEG, and a significant proportion of the respondents appeared to be unaware of the potential for these complications in specific clinical circumstances.
Perforated Duodenal Ulcer in a Pediatric Patient with Eosinophilic Gastroenteritis
Authors: Deslandres Colette , Russo Pierre , Gould Peter , Hardy Pierre
Published: March 2016

An 11‐year‐old boy with eosinophilic gastroenteritis treated by an elimination diet alone presented with a perforated gastroduodenal ulcer subsequent to blunt trauma to the abdomen. Peripheral eosinophilia, chronic iron deficiency, chronic hypoalbuminemia and severe failure to thrive had been present since age 2 years. Immunological work‐up revealed food allergies, documented by skin tests. A review of the literature since 1966 revealed only six other cases of perforation of the gastrointestinal tract, one of whom was also a child.
Influence of Food on the Bioavailability of an Enteric‐Coated Tablet Formulation of Omeprazole 20 mg Under Repeated Dose Conditions
Authors: Thomson ABR , Sinclair P , Matisko A , Rosen E , Andersson T , Olofsson B
Published: March 2016

The objective of this study was to investigate the influence of food on the bioavailability of omeprazole (20 mg) given as an enteric‐coated tablet under repeated dose conditions. This open randomized crossover study consisted of three seven‐day treatment periods, each separated by a drug‐free period. During each treatment period an enteric‐coated tablet of omeprazole was taken once daily either under fasting conditions, or immediately before or after a standardized breakfast. On the last day of each treatment period, blood samples for the determination of plasma omeprazole concentrations were collected at baseline and at predetermined intervals over the 24 h period following drug administration. Fifty‐seven male and female subjects, aged 18 to 52 years, completed the study according to the protocol. No statistically significant differences were found when comparing either the before breakfast or after breakfast treatment regimens with the fasting regimen for the estimated mean area under the plasma concentration‐time curve (AUC). The maximum plasma concentration was not found to differ significantly among any of the treatment regimens. However, the lower limit of the CI for the comparison of fasting/before breakfast was not contained within the limits of bioequivalence. The time to reach maximum plasma concentration was significantly different when fasting and after breakfast regimens were compared. Thus, under repeated dose conditions, food has no influence on the bioavailability (expressed as AUC) of omeprazole given as the enteric‐coated tablet formulation.
Osteomyelitis and Osteonecrosis in Inflammatory Bowel Disease
Authors: Freeman Hugh J
Published: March 2016

Osteomyelitis and osteonecrosis are skeletal disorders seen in patients with inflammatory bowel disease (IBD). Osteomyelitis usually occurs in the pelvic bones, especially in complicated Crohn's disease, presumably by direct extension from a pelvic inflammatory mass, abscess or fistulous tract. Diagnosis of osteomyelitis may be difficult and can lead to spinal extension of the septic process with a resultant neurological deficit, including paraplegia. Osteonecrosis or avascular necrosis has been reported in patients with either ulcerative colitis or Crohn's disease, often, but not exclusively, during or following steroid treatment. The disease is often multifocal, but its natural history is unknown, especially if diagnosed early with modern imaging methods, such as magnetic resonance. In IBD patients, the relationship between osteonecrosis and steroid use is unknown. An adverse steroid effect on bones, especially the femoral heads, may develop in some patients with IBD but, to date, this hypothesis remains unproven. Critical evaluation of published data reveals no consistent association between osteonecrosis and steroid treatment in IBD patients.
Novel Approaches to the Diagnosis of Pancreatic Disease in Childhood
Authors: Couper Richard TL
Published: March 2016

The diagnosis of pancreatic disease is difficult. Most tests of pancreatic function need to be interpreted in the context of the patient′s presenting history and clinical examination. In childhood, classical signs of hemorrhagic pancreatitis are seldom useful because they rarely occur. A careful history is particularly useful in conditions with an autosomal dominant inheritance such as hereditary pancreatitis. Pedigree construction should be undertaken in all cases of pancreatitis. Assessment of exocrine pancreatic function is made easier by a thorough appreciation of the constellation of signs, both pancreatic and extrapancreatic, of various pancreatic disease. The purpose of this review is to explore novel means of diagnosing pancreatic disease, including pancreatic function testing, organ imaging and, more recently, molecular biology techniques. Most of the potentially novel techniques surround organ imaging or molecular biology.
Inflammatory Bowel Disease with Cytoplasmic‐Staining Antineutrophil Cytoplasmic Antibody and Extensive Colitis
Authors: Freeman Hugh James
Published: March 2016

A cohort of 18 patients with inflammatory bowel disease who were characterized by the presence of cytoplasmic‐staining antineutrophil cytoplasmic antibody (cANCA) and extensive colitis is reported. Almost half were Indo‐Canadians, and atypical perinuclear‐staining antineutrophil cytoplasmic antibody was also detected in five (28%), similar to the detection rate for Crohn′s disease and other less commonly detected forms of colitis, such as lymphocytic or collagenous colitis. Careful pathological review of all endoscopic biopsies and surgically resected colonic tissues did not reveal evidence of vasculitis or so‐called ′palisading′ granulomas, which is a typical pathological change of Wegener′s granulomatosis, an entity that has been traditionally characterized by the detection of cANCA. This report describes 18 patients with extensive colitis and the seromarker cANCA but without clinical features or histological evidence of vasculitis.
Castleman′s Disease and Neutropenic Enterocolitis Presenting as Crohn’s Disease
Authors: Burak Kelly W , Bridges Ronald J , Blahey Walter B
Published: March 2016

A rare case of Castleman′s disease presenting as Crohn′s disease is described. This 21‐year‐old male with chronic neutropenia for one year presented with recurrent right lower quadrant pain of two years′ duration. Small bowel follow‐through suggested Crohn′s of the terminal ileum. Colonoscopy confirmed ulcerations in the terminal ileum and cecum, with biopsies showing necrosis and inflammation. Treatment was initiated with prednisone, 5‐aminosalicylate and granulocyte colony‐stimulating factor for neutropenia. Symptoms recurred one year later, and repeat colonoscopy showed a focal cecal ulceration. Two years after presentation a resection was planned. Laparotomy revealed a normal ileocecal region and a large retroperitoneal mass of lymphadenopathy. Biopsies confirmed reactive hyperplasia, consistent with the plasma cell variant of Castleman′s disease. Chemotherapy has resulted in improvement of symptoms and decrease in mass size, but cecal ulceration persisted. This case illustrates a variant presentation of Castleman′s disease with neutropenia and manifestations in the gastrointestinal tract.
Survey of Gastroenterologists on the Diagnosis and Treatment of Adult Patients with Celiac Disease in British Columbia
Authors: Freeman Hugh J
Published: March 2016

A recent survey of physician specialists from New York City suggested that few patients with celiac disease are seen and that management experience is limited. The present study, using a survey similar to that of the New York City investigation, evaluated the diagnostic and management experience of specialists for adult celiac disease patients in British Columbia. Four hundred and four patients were reported in the combined clinical practice experience of the responding physicians. Of these, 59, or 15%, were diagnosed in the prior year. Although each physician diagnosed an average of 2.4 new celiac disease patients per year in their entire practice experience, an average of over 4.0 new celiac disease patients were detected in the past year. Most patients presented with diarrhea, weight loss, anemia or nutrient deficiency, but about 14% were asymptomatic or diagnosed by an incidental small intestinal biopsy done at upper gastrointestinal endoscopy. Specialist physicians in British Columbia usually refer patients to their family physicians, dietitians and patient support groups for continued care and appear to rarely rely on serological assays, including antibody tests, for detection of celiac disease in adults. An associated or complicating lymphoma was detected in 16 of 404 patients (4%). Recognition of biopsy‐defined celiac disease appears to be increasing in British Columbia.
Cancer of the Esophagus ‐ Endoscopic Ultrasound: Selection for Cure
Authors: Caletti Giancarlo , Bocus Paolo , Fusaroli Pietro , Togliani Thomas , Marhefka Gregary , Roda Enrico
Published: March 2016

Several treatment options are available to treat esophageal cancer. Ideally, treatment should be individualized, based on the projected treatment outcome for that individual. Accurate staging of the extent of the disease at the time of diagnosis offers the most rational attempt at stratifying patients into categories that can be used to affect treatment choices. Endoscopic ultrasonography (EUS) is the most accurate nonoperative technique for determining the depth of tumour infiltration and thus is accurate in predicting which patients will be able to undergo complete resection. EUS is also being used for tumour staging in order to guide treatment decisions in patients with esophageal cancer.
Endoscopic Mucosal Resection for Esophageal and Gastric Mucosal Cancers
Authors: Inoue Haruhiro
Published: March 2016

Accumulated data from surgically resected specimens reveal that mucosal cancers of the esophagus and stomach pose low risk of lymph node metastasis. The author used endoscopic mucosal resection (EMR) as curative treatment in 142 cases of esophageal cancer and 102 cases of stomach cancer. In absolutely indicated cases there has been no local or distant metastasis during the longest period of follow‐up (nine years). One perforation and one post‐treatment severe stenosis, which was resistant to dilation therapy in the esophagus, were encountered. Deeper layer resection (including partial proper muscle) occurred in the stomach in three cases where the lesions were positioned to the lesser curvature of the upper part of the stomach. Two cases of gastric mucosal resection leaving residual cancer were successfully treated by laser ablation. No case has required further surgery. Resected specimens were contributed to histological evaluation in all cases. In conclusion, EMR can be considered as the first‐line treatment for selected cases of early stage esophageal and stomach cancer.
Patients’ Diets and Preferences in a Pediatric Population with Inflammatory Bowel Disease
Authors: Green Timothy J , Issenman Robert M , Jacobson Kevan
Published: March 2016

PURPOSE: To determine the dietary practices of the pediatric inflammatory bowel disease population at the Children's Hospital of the Hamilton Health Sciences Corporation and the reported effectiveness of those diets.

PATIENTS AND METHODS: A questionnaire mailed to 153 pediatric patients was returned by 125 patients (76 Crohn's disease [CD] and 49 ulcerative colitis [UC] patients) - an 82% response rate.

RESULTS: The median age of respondents was 13 years, and 62% were male. Ninety per cent and 71% of CD and UC patients, respectively, had changed their diets since diagnosis. Caloric supplements (eg, BOOST [Mead Johnson Nutritionals]), sole source nutrition, low fibre and lactose-free diets were used by more than 15% of CD patients, whereas lactose-free, nonspicy, low acid, additive-free, caloric supplement and low fibre diets were used by more than 15% of UC patients. A diet supplement was more commonly used in CD patients (P<0.05) and an additive-free diet in UC patients. Corn and corn products, nuts, milk and bran were avoided by more than 20% of CD and UC patients; however, more CD than UC patients avoided corn and corn products. In addition, UC patients (more than 20%) also avoided tomato, other dairy (nonfluid milk-based products and foods containing milk products), chocolate, cheese, wheat, tomato sauces and fruit juice. A benefit was reported for 103 of 141 reported diets, with the most commonly alleviated symptoms being abdominal pain, diarrhea and flatulence.

CONCLUSION: Many children with inflammatory bowel disease have altered their diets to manage their disease and have attributed symptomatic relief to these diets.
The Clinical Effectiveness of Intralesional Injection of 2% Zinc Sulfate Solution in the Treatment of Common Warts
Authors: Mohamed Essam-elden Mohamed , Tawfik Khaled Mohamed , Mahmoud Asmaa Moneir
Published: March 2016

Objective.To investigate the clinical efficacy and safety of intralesional injection of 2% zinc sulfate solution in the treatment of common warts.Patients and Methods.One hundred and twenty patients (78 females and 42 males) aged 5–55 years with 225 common warts participated in this prospective monocentric randomized study. All lesions were treated with intralesional injection of 2% zinc sulfate.Results.From 225 warts injected, 135 warts (60%) cured from the first session, 51 warts (22.67%) cured from the second session, and 12 warts (5.33%) cured from the third session. There is no significant relation between improvement and patient’s ages, duration, or number of warts (P<0.05). All patients complained from pain during injection, and all treated lesions showed redness, tenderness, and swelling in the first 3 days after injection. Late complications were postinflammatory hyperpigmentation in 90 patients (75%), scaring in 9 patients (7.5%), and ulceration in 3 patients (2.5%). Recurrence occurred in 3 lesions (1.33%).Conclusion.The clinical data indicate that intralesional injection of 2% zinc sulfate is an effective maneuver in the treatment of common warts; however, its associated complications limit its use.
The McGill University Health Centre Cancer Pain Clinic: A Retrospective Analysis of an Interdisciplinary Approach to Cancer Pain Management
Authors: Perez Jordi , Olivier Sara , Rampakakis Emmanouil , Borod Manuel , Shir Yoram
Published: March 2016

Context. The McGill University Health Center (MUHC) Cancer Pain Clinic offers an interdisciplinary approach to cancer pain management for patients. The core team includes a nurse clinician specialist in oncology and palliative care, a palliativist, an anaesthetist, and a radiation oncologist. This tailored approach includes pharmacological and nonpharmacological therapies offered concurrently in an interdisciplinary fashion.Objectives. Description of the interdisciplinary MUHC cancer pain approach and analysis of treatments and outcomes.Methods. A retrospective analysis of new outpatients completing two subsequent visits (baseline and follow-ups: FU1, FU2) was conducted. Variables included (a) symptom severity measured by the Edmonton Symptom Assessment Scale, (b) pain and disability measured with the Brief Pain Inventory, and (c) analgesic plan implementation including pharmacological and nonpharmacological therapies.Results. 71 charts were reviewed. Significant pain relief was achieved consistently at FU1and FU2. The average pain severity decreased by 2 points between initial assessment and FU2. More than half (53%) of patients responded with a pain reduction greater than 30%. Severity of other symptoms (i.e., fatigue, nausea, depression, and anxiety) and disability also decreased significantly at FU2. The total consumption of opioids remained stable; however, the consumption of short acting preparations decreased by 52% whereas the prescription of nonopioid agents increased. Beyond drug management, 60% of patients received other analgesic therapies, being the most common interventional pain procedures and psychosocial approaches.Conclusion. The MUHC interdisciplinary approach to cancer pain management provides meaningful relief of pain and other cancer-related symptoms and decreases patients’ disability.
In2O3- and SnO2-Based Thin Film Ozone Sensors: Fundamentals
Authors: Korotcenkov G. , Brinzari V. , Cho B. K.
Published: March 2016

The paper considers SnO2and In2O3thin films as materials for the design of solid-state conductometric ozone sensors in depth. In particular, the present review covers the analysis of the fundamentals of SnO2- and In2O3-based conductometric ozone sensor operation. The main focus is on the description of mechanisms of ozone interaction with metal oxides, the influence of air humidity on sensor response, and processes that control the kinetics of sensor response to ozone.
Study ofB¯d,s⁎0→Dd,s+M-Decays with QCD Factorization Approach
Authors: Chang Qin , Hu Xiaohui , Chang Zhe , Sun Junfeng , Yang Yueling
Published: March 2016

Motivated by theb-physics experiments at running LHC and upcoming SuperKEKB/Belle-II, the nonleptonicB¯q⁎0→Dq+M-(q=d,sandM=π,K,ρ,K⁎) weak decays are studied within QCD factorization framework. The observables of these decay modes are first predicted. It is found that the tree-dominated and CKM-favoredB¯q⁎0→Dq+ρ-decays have the largest branching fractions~O(10-8)and thus are hopefully to be measured. TheB¯q⁎0→Dq+V-decays are dominated by the longitudinal polarization states. In addition, associating with the relevantBmeson decays, some interesting phenomena and relations are discussed in detail; for example,RB≡B(B¯q→Dq⁎P)/B(B¯q⁎→DqP)≃3τB/τB⁎, andfL,∥(B¯q→Dq⁎V)≃fL,∥(B¯q⁎→DqV).
Geometric Simulation Approach for Grading and Assessing the Thermostability of CALBs
Authors: Senthilkumar B. , Meshachpaul D. , Rajasekaran R.
Published: March 2016

Candida antarcticalipase B (CALB) is a known stable and highly active enzyme used widely in biodiesel synthesis. In this work, the stability of native (4K6G) and mutant (4K5Q) CALB was studied through various structural parameters using conformational sampling approach. The contours of polar surface area and surface area of mutant CALB were 11357.67 Å2and 30007.4 Å2, respectively, showing an enhanced stability compared to native CALB with a statistically significantPvalue of < 0.0001. Moreover, simulated thermal denaturation of CALB, a process involving dilution of hydrogen bond, significantly shielded against different intervals of energy application in mutant CALB revealing its augmentation of structural rigidity against native CALB. Finally, computational docking analysis showed an increase in the binding affinity of CALB and its substrate (triglyceride) in mutant CALB with Atomic Contact Energy (ACE) of −91.23 kcal/mol compared to native CALB (ACE of −70.3 kcal/mol). The computational observations proposed that the use of mutant CALB (4K5Q) could serve as a best template for production of biodiesel in the future. Additionally, it can also be used as a template to identify efficient thermostable lipases through further mutations.
Development and Validation of Stability-Indicating Method for Estimation of Chlorthalidone in Bulk and Tablets with the Use of Experimental Design in Forced Degradation Experiments
Authors: Sonawane Sandeep , Jadhav Sneha , Rahade Priya , Chhajed Santosh , Kshirsagar Sanjay
Published: March 2016

Chlorthalidone was subjected to various forced degradation conditions. Substantial degradation of chlorthalidone was obtained in acid, alkali, and oxidative conditions. Further full factorial experimental design was applied for acid and alkali forced degradation conditions, in which strength of acid/alkali, temperature, and time of heating were considered as independent variables (factors) and % degradation was considered as dependent variable (response). Factors responsible for acid and alkali degradation were statistically evaluated using Yates analysis and Pareto chart. Furthermore, using surface response curve, optimized 10% degradation was obtained. All chromatographic separation was carried out on Phenomenex HyperClone C 18 column (250 × 4.6 mm, 5 μ), using mobile phase comprising methanol : acetonitrile : phosphate buffer (20 mM) (pH 3.0 adjusted witho-phosphoric acid): 30 : 10 : 60% v/v. The flow rate was kept constant at 1 mL/min and eluent was detected at 241 nm. In calibration curve experiments, linearity was found to be in the range of 2–12 μg/mL. Validation experiments proved good accuracy and precision of the method. Also there was no interference of excipients and degradation products at the retention time of chlorthalidone, indicating specificity of the method.
Comparison of Transcanalicular Multidiode Laser Dacryocystorhinostomy with and without Silicon Tube Intubation
Authors: Yildirim Yildiray , Kar Taner , Topal Tuncay , Cesmeci Enver , Kaya Abdullah , Colakoglu Kadir , Aksoy Yakup , Sonmez Murat
Published: March 2016

Aim. To compare the surgical outcomes of surgery with and without bicanalicular silicon tube intubation for the treatment of patients who have primary uncomplicated nasolacrimal duct obstruction.Methods. This retrospective study is comprised of 113 patients with uncomplicated primary nasolacrimal duct obstruction. There were 2 groups in the study: Group 1 (n=58) patients underwent transcanalicular diode laser dacryocystorhinostomy surgery with bicanalicular silicon tube intubation and Group 2 (n=55) patients underwent transcanalicular diode laser dacryocystorhinostomy surgery without bicanalicular silicon tube intubation. The follow-up period was18.42±2.8months for Group 1 and18.8±2.1months for Group 2.Results. Success was defined by irrigation of the lacrimal system without regurgitation and by the absence of epiphora. Success rates were 84.4% for Group 1 and 63.6% for Group 2 (P=0.011). Statistically a significant difference was found between the two groups.Conclusion. The results of the study showed that transcanalicular diode laser dacryocystorhinostomy surgery with bicanalicular silicon tube intubation was more successful than the other method of surgery. Consequently, the application of silicone tube intubation in transcanalicular diode laser dacryocystorhinostomy surgery is recommended.
International Air Travel to Ohio, USA, and the Impact on Malaria, Influenza, and Hepatitis A
Authors: Brannen Donald E. , Alhammad Ali , Branum Melissa , Schmitt Amy
Published: March 2016

The State of Ohio led the United States in measles in 2014, ostensibly related to international air travel (IAT), and ranked lower than 43 other states in infectious disease outbreak preparedness. We conducted a retrospective cohort study using surveillance data of the total Ohio population of 11 million from 2010 through 2014 with a nested case control of air travelers to determine the risk of malaria, seasonal influenza hospitalizations (IH), and hepatitis A (HA) disease related to international travel and to estimate the association with domestic enplanement. IAT appeared protective for HA and IH with a risk of 0.031 (.02–.04) but for malaria was 2.7 (2.07–3.62). Enplanement increased the risk for nonendemic M 3.5 (2.5–4.9) and for HA and IH 1.39 (1.34–1.44). IAT’s ratio of relative risk (RRR) of malaria to HA and IH was 87.1 (55.8–136) greater than 219 times versus domestic enplanement which was protective for malaria at 0.397 (0.282–0.559). Malaria is correlated with IAT with cases increasing by 6.9 for every 10,000 passports issued.
Spread of TEM, VIM, SHV, and CTX-Mβ-Lactamases in Imipenem-Resistant Gram-Negative Bacilli Isolated from Egyptian Hospitals
Authors: Hamdy Mohammed El sayed , Elsadek Fakhr Ahmed , Mohammed El sayed Hanan , Al Johery Said abd Elmohsen , Abdel Ghani Hassanein Wesam
Published: March 2016

Carbapenem-resistant Gram-negative bacilli resulting fromβ-lactamases have been reported to be an important cause of nosocomial infections and are a critical therapeutic problem worldwide. This study aimed to describe the prevalence of imipenem-resistant Gram-negative bacilli isolates and detection ofblaVIM,blaTEM,blaSHV,blaCTX-M-1, andblaCTX-M-9genes in these clinical isolates in Egyptian hospitals. The isolates were collected from various clinical samples, identified by conventional methods and confirmed by API 20E. Antibiotic susceptibility testing was determined by Kirby-Bauer technique and interpreted according to CLSI. Production ofblaVIM,blaTEM,blaSHV, andblaCTX-Mgenes was done by polymerase chain reaction (PCR). Direct sequencing from PCR products was subsequently carried out to identify and confirm theseβ-lactamases genes. Out of 65 isolates, (46.1%) Escherichia coli, (26.2%) Klebsiella pneumoniae, and (10.7%) Pseudomonas aeruginosa were identified as the commonest Gram-negative bacilli. 33(50.8%) were imipenem-resistant isolates. 22 isolates (66.7%) carriedblaVIM, 24(72.7%) hadblaTEM, and 5(15%) showedblaSHV, while 12(36%), 6(18.2%), and 0(0.00%) harboredblaCTX-M-1,blaCTX-M-9, andblaCTX-M-8/25, respectively. There is a high occurrence ofβ-lactamase genes in clinical isolates and sequence analysis of amplified genes showed differences between multiple SNPs (single nucleotide polymorphism) sites in the same gene among local isolates in relation to published sequences.
Management of Severe and Complex Hypopharyngeal and/or Laryngotracheal Stenoses by Various Open Surgical Procedures: A Retrospective Study of Seventeen Patients
Authors: Chen Wenxian , Gao Pengfei , Cui Pengcheng , Ruan Yanyan , Liu Zhi , Sun Yongzhu , Bian Ka
Published: March 2016

Objective: To systematically study various surgical approaches for treating complex hypopharyngeal and/or laryngotracheal stenoses at a variety of sites and levels. Patients and Methods: We retrospectively analyzed the treatment of 17 patients with severe and complex hypopharyngeal and/or laryngotracheal stenosis at various sites and levels of severity. All of the 17 patients initially had a tracheostomy. Thirteen had failed the previous laser lysis and/or dilation treatment. Given the high severity and complexity of stenosis, all of these patients were treated by open surgical reconstruction techniques using repairing grafts (flaps), followed by stenting. Results: Thirteen of 17 patients had successful decannulation 1-8 months post-operation and had stable airway and adequate vocal and swallow function. Two patients with complex hypopharyngeal and esophageal stenosis had unsuccessful decannulation. Follow-up was lost in 1 patient with complex hypopharyngeal and esophageal stenosis and 1 patient with original hypopharyngeal stenosis and recurrent thoracotracheal stenosis. Conclusion: Despite the failure by the regular treatments using laser lysis and/or dilation therapy, severe and complex hypopharyngeal and/or laryngotracheal stenosis may be successfully treated by variable open surgical reconstruction techniques using different grafts (flaps) depending on the site and severity of the stenosis.
Coevolution between the Human Microbiota and the Epithelial Immune System
Authors: Sigal Michael , Meyer Thomas F.
Published: March 2016

The composition and spatial distribution of our gut microbiota is tightly controlled by the host to prevent bacterial invasion and systemic infection. The gastrointestinal epithelium is predominantly made up of a cellular monolayer equipped with a number of sophisticated autonomous defense mechanisms, which are strikingly efficient in maintaining homeostasis between the luminal microbes and the host. This short review highlights aspects of this finetuned interplay. We also address how deficiencies in mucosal defense can promote disease. First, genetic defects of sensors or effectors of epithelial defense can result in the disruption of the mucosal barrier and lead to chronic inflammatory conditions. Second, chronic colonizers of the gastrointestinal tract can actively manipulate mucosal defense to escape immune surveillance. As shown for Helicobacter pylori in the stomach, sustained manipulation of the epithelium through specialized virulence determinants can increase the risk for genetic lesions and malignant transformation.
Clostridium difficile Infection: A Model for Disruption of the Gut Microbiota Equilibrium
Authors: Blanchi Julie , Goret Julien , Mégraud Francis
Published: March 2016

The gut microbiota is a complex ecosystem defined by the combination of microorganisms living in the gastrointestinal tract. Its equilibrium is intimately involved in several aspects of vital process for human physiology and nutrition. Its composition changes depending on both exogenous and endogenous factors. The disruption of the gut microbiota by antibiotics often leads to an opportunistic infection by Clostridium difficile. The unbalanced intestinal microbiota promotes spore germination, growth of vegetative forms and toxin production leading to C. difficile infection, which is characterized by diarrhea and possibly pseudomembranous colitis. This nosocomial infection is a good model to understand the role of the gut microbiota in preventing the development of pathogens.
Principles of DNA-Based Gut Microbiota Assessment and Therapeutic Efficacy of Fecal Microbiota Transplantation in Gastrointestinal Diseases
Authors: Cammarota Giovanni , Pecere Silvia , Ianiro Gianluca , Masucci Luca , Currò Diego
Published: March 2016

Fecal microbiota transplantation (FMT), a process by which the normal gastrointestinal microbiota is restored, has demonstrated extraordinary cure rates for Clostridium difficile infection and low recurrence. The community of microorganisms within the human gut (or microbiota) is critical to health status and functions; therefore, together with the rise of FMT, the gastrointestinal microbiota has emerged as a ‘virtual' organ with a level of complexity comparable to that of any other organ system and capable to compete with powerful known antibiotics for the treatment of several disorders. Although treatment protocols, donor selection, stool preparation and delivery methods varied widely, with a few reports following an identical protocol, FMT has diffused to other areas where the alterations of the gut microbiota ecology (or dysbiosis) have been theorized to play a causative role, including inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS), among several other extra-intestinal disorders (i.e. metabolic syndrome and obesity, multiple sclerosis, cardiovascular diseases). FMT can be relatively simple to perform, but a number of challenges need to be overcome before this procedure is widely accepted in clinical practice, and currently, there is no consensus between the various gastrointestinal organizations and societies regarding the FMT procedure. In this article, we describe the modern high-throughput sequencing techniques to characterize the composition of gut microbiota and the potential for therapeutics by manipulating microbiota with FMT in several gastrointestinal disorders (C. difficile-associated diarrhea, IBD and IBS), with a look on the potential future directions of FMT.
Weight Loss Associated with Platinum-Based Chemotherapy in Patients with Advanced Lung Cancer
Authors: Morio Kayoko , Minami Toshiyuki , Sozu Takashi , Niki Kazuyuki , Kijima Takashi , Uejima Etsuko , Morio Kayoko
Published: March 2016

Background: We examined whether the weight loss that occurs with platinum-based chemotherapy in lung cancer patients is associated with chemotherapy side effects, treatment completion rates and therapeutic effect. Methods: We retrospectively reviewed charts of advanced lung cancer patients treated with ≥2 cycles of platinum-based chemotherapy. Patients were divided into 2 groups based on ≥5 or <5% weight loss. Relationships between weight loss and other variables were investigated. Results: Among 114 patients, 18 (15.8%) experienced ≥5% weight loss. Significantly more patients with small-cell lung cancer (SCLC) than with non-SCLC were found to have ≥5% weight loss (30.8 vs. 11.4%, p = 0.023). Patients with ≥5% weight loss experienced higher incidences of grade 3-4 leukopenia (p = 0.008) and neutropenia (p = 0.005), and treatment completion rates were lower in this group (p = 0.035). Weight loss was not significantly associated with therapeutic effect. Conclusion: The weight loss in patients with advanced lung cancer receiving platinum-based chemotherapy is associated with SCLC, grade 3-4 leukopenia, neutropenia and a decrease in treatment completion rate.
Squamocellular Carcinoma of the Skin: Clinicopathological Features Predicting the Involvement of the Surgical Margins and Review of the Literature
Authors: Ribero Simone , Osella Abate Simona , Di Capua Chiara , Dika Emi , Balagna Elena , Senetta Rebecca , Picciotto Franco , Tomasini Carlo , Macripo Giuseppe , Quaglino Pietro
Published: March 2016

Background: The new AJCC classification has highlighted some particular risk factors for squamous cell carcinoma (SCC) relevant for prognosis. Incomplete excision is not infrequent in SCC. The aim of this study is to examine features that can predict an incomplete excision on the basis of the new AJCC classification and to review the literature on this topic. Materials and Methods: 81 SCC patients were included. All patients were submitted to excisional biopsy with a margin of at least 4 mm from the clinical edges as recommended. Histological characteristics of the lesions analysed were maximum diameter, grading, site, Breslow thickness, Clark level, deep tissue invasion (neural, bone, muscle), presence of ulceration and positivity of the margins. Results: The average Breslow thickness was 3.93 mm. Out of the 81 patients included, 14 showed involved margins. The 2 parameters that were implicated in predicting involvement of the margins in the multivariable model were Breslow thickness and location of the lesion on the ear or lip. Grading was not associated with involvement of margins. Conclusion: According to the new AJCC classification, this study could be useful to plan the most suitable surgical technique in order to avoid the risk of incomplete surgery.
Effects of Power Training on Mobility and Gait Biomechanics in Old Adults with Moderate Mobility Disability: Protocol and Design of the Potsdam Gait Study (POGS)
Authors: Beijersbergen Chantal M.I. , Hortobágyi Tibor , Beurskens Rainer , Lenzen-Grossimlinghaus Romana , Gäbler Martijn , Granacher Urs
Published: March 2016

Background: Walking speed decreases in old age. Even though old adults regularly participate in exercise interventions, we do not know how the intervention-induced changes in physical abilities produce faster walking. The Potsdam Gait Study (POGS) will examine the effects of 10 weeks of power training and detraining on leg muscle power and, for the first time, on complete gait biomechanics, including joint kinematics, kinetics, and muscle activation in old adults with moderate mobility disability. Methods/Design: POGS is a randomized controlled trial with two arms, each crossed over, without blinding. Arm 1 starts with a 10-week control period to assess the reliability of the tests and is then crossed over to complete 25-30 training sessions over 10 weeks. Arm 2 completes 25-30 exercise sessions over 10 weeks, followed by a 10-week follow-up (detraining) period. The exercise program is designed to improve lower extremity muscle power. Main outcome measures are: muscle power, gait speed, and gait biomechanics measured at baseline and after 10 weeks of training and 10 weeks of detraining. Discussion: It is expected that power training will increase leg muscle power measured by the weight lifted and by dynamometry, and these increased abilities become expressed in joint powers measured during gait. Such favorably modified powers will underlie the increase in step length, leading ultimately to a faster walking speed. POGS will increase our basic understanding of the biomechanical mechanisms of how power training improves gait speed in old adults with moderate levels of mobility disabilities.
Is It Acute Stroke or Not? - A Prospective Observational Study from a Multidisciplinary Emergency Department
Authors: Wolf Marc E. , Chatzikonstantinou Anastasios , Grüttner Joachim , Ebert Anne D. , Walter Thomas , Hennerici Michael G. , Fatar Marc
Published: March 2016

Background: Acute stroke is a medical emergency with various clinical presentations. Since the introduction of systemic thrombolytic treatment, stroke diagnosis has been made quickly and with great caution, and the trend of rapid presentation at hospitals has increased. Methods: In our multidisciplinary Emergency Department, we prospectively collected and analysed data of consecutive patients presenting with suspected acute stroke (SAS) or transient ischemic attack (TIA). Results: Four hundred ten patients (200 men, mean age 68 ± 16, range 17-93 years) with SAS were admitted of which 105 were prehospitally announced as within the time-window for thrombolytic treatment (TW). Diagnosis of acute stroke/TIA was retained in 147 (35.9%). The initially reported TW <4.5 h was wrong in 35.3%. Thrombolysis was performed in 27 patients (23.5% of ischemic stroke patients; 6.6% of all SAS). Diagnosis of another neurologic disease was made in 62 (15.1%). Major differential diagnoses came from the field of internal medicine, psychiatry or otorhinolaryngology. One hundred fifty patients (36.6%) were rapidly discharged. Conclusion: About half the number of our patients admitted for SAS did not suffer from an acute neurologic disease. Residual symptoms post-stroke might be partly responsible for initial misinterpretation. The crucial difference between symptom onset and symptom recognition needs to be emphasized to improve the prehospital assessment of the TW.
Three Dimensional Space Vector Modulation Theory: Practices without Proofs
Authors: Bhattacharya Bhaskar , Chakraborty Ajoy Kumar
Published: March 2016

In three dimensional (3D) space vector modulation (SVM) theory with α-β-γ frame there are some issues which are well known and are widely practiced being quite obvious but without any proof so far. In this paper necessary scientific foundations to those issues have been provided. The foremost of these issues has been with the frame of reference to be considered in 3D SVM applications for unbalanced three phase systems. Although for balanced three phase systems there has been no controversy with α-β frame as the frame of reference but in 3D it has not yet been established which one, α-β-γ frame or the a-b-c frame, is mathematically correct. Another significant issue addressed in this work has been to ascertain the exact reason when a three phase system has to be represented in 2D or 3D space to apply SVM. It has been presented for the first time in this work that the key factor that determines whether 3D or 2D SVM has to be applied depends on the presence of time independent symmetrical components in a three phase ac system. Also it has been proved that the third axis, the Y–axis, represents the time independent quantity and that it must be directed perpendicular to the α-β plane passing through the origin.
New Algorithm for Fast Processing RFID System in Container Terminal
Authors: Abdul Kadir Evizal , Shamsuddin Siti Mariyam , Karya Detri , Rosa Sri Listia
Published: March 2016

The growth of world economic and increasing of trading in most of countries has impact to the number of containers export and import between countries. Some of container terminal is very busy to handle high volume of container movement. Conventional operational procedures have difficulties to handle containers movement then make slow and some issues in terminal operation for container clearance. This paper discus on proposing new algorithm to the current container terminal management system used RFID technology for fast processing and clearance. Container Terminal Management System (CTMS) is a system for port management and interface to the RFID system that used to identify container e-seal, truck and driver identity. Lack of communication and interfacing protocol made slow response during request or reply of message to the gate operator. Proposed algorithm with new procedure of request to CTMS made faster response and avoid inaccuracy of detecting container e-seal. Results of implementation new algorithm have improved to the productivity and efficiency of container terminal. Testing and implementation of this proposed system conducted in a private container terminal in Malaysia.