bluuebunny/crossref_metadata_2025 huggingface dataset:
The invisible child: Sibling experiences of growing up with a brother with severe haemophilia—An interpretative phenomenological analysis
Authors: Tregidgo Catherine , Elander James
Published: December 2018

Introduction

Haemophilia is an inherited chronic condition that causes bleeding in the joints and soft tissue. Healthy siblings growing up in the family of a person with haemophilia can be affected socially and psychologically.

Aim

To explore qualitatively the experiences of healthy siblings who grew up with a brother with severe haemophilia.

Methods

Eleven healthy siblings (10 female, one male) who grew up with a brother with severe haemophilia A were recruited via the Haemophilia Society UK. The verbatim transcripts of individual semi‐structured interviews were analysed using interpretative phenomenological analysis (IPA).

Results

Three themes were identified as follows: lack of parental attention, negative social emotions, and carrier status anxiety. Participants described having engaged in attention‐seeking behaviours because they felt they lacked parental attention. They also described the resentment, anger and frustration they felt about the effect their brothers’ haemophilia had on their lives. Female participants described the impact their carrier status or lack of it had on their lives.

Conclusion

These findings could be translated into better advocacy and support for siblings through haemophilia centres. More research is also needed on how healthy siblings are affected by haemophilia, including studies guided by family systems theory.
Pressure‐induced phase transitions in PZ‐xBMN binary solid solutions
Authors: Nie Hengchang , Su Rigu , Peng Ping , Cao Fei , Liu Yusheng , He Hongliang , Wang Genshui , Dong Xianlin
Published: December 2018

Solid solutions of (1−x)PbZrO3‐xBa(Mg1/3Nb2/3)O3 (PZ‐xBMN, x = 0.02, 0.03, 0.04, and 0.05) were prepared, and their microstructures, electrical properties, and phase transition behaviors under hydrostatic pressure were investigated. It was found that the incorporation of BMN into PZ can provide improved ferroelectric properties, leading to the formation of antiferroelectric/ferroelectric phase boundaries in PZ‐xBMN ceramics when the value of x is between 0.02 and 0.03. It was also demonstrated that the ferroelectric phases exhibit excellent temperature stability in the remanent polarization. Importantly, complete depolarization was observed in the PZ‐xBMN solid solution due to the hydrostatic pressure‐induced ferroelectric‐antiferroelectric phase transition. The resultant properties and phase transition behaviors of PZ‐xBMN ceramics under pressure will benefit their application in pulsed power supplies.
Combined aerobic and resistance training, and incidence of diabetes: A retrospective cohort study in Japanese older women
Authors: Sawada Susumu S , Gando Yuko , Kawakami Ryoko , Blair Steven N , Lee I‐Min , Tamura Yoshifumi , Tsuda Hitomi , Saito Hikaru , Miyachi Motohiko
Published: December 2018

Aims/Introduction

To investigate the relationship between combined aerobic and resistance training, and the incidence of type 2 diabetes mellitus.

Materials and Methods

The present study included 10,680 Japanese women. Participants enrolled between 2005 and 2010, and were followed up until 2014. The frequency of combined training was counted for the first 3 months, the 6th month and the 9th month. In 2014, women reported whether or not they had diabetes, as well as the year of developing diabetes. Hazard ratios and 95% confidence intervals (CI) for the incidence of type 2 diabetes were obtained using Cox proportional hazard models.

Results

The median duration of follow up was 5 years, with 166 women developing type 2 diabetes. Using the lowest frequency of training group (1st quartile) as the reference, the hazard ratios for the second through fourth quartiles was as follows: 0.95 (95% CI 0.64–1.41), 0.73 (95% CI 0.48–1.13) and 0.69 (95% CI 0.44–1.07), respectively (P for trend = 0.116). After adjustment for age, body mass index and thigh circumference, the hazard ratios were: 0.84 (95% CI 0.56–1.26), 0.69 (95% CI 0.45–1.06) and 0.61 (95% CI 0.39–0.95), respectively (P for trend = 0.040).

Conclusions

A higher frequency of combined aerobic and resistance training is associated with a lower risk of developing type 2 diabetes in Japanese women.
Nursery treatments with resistant inducers, soil amendments and biocontrol agents for the management of the Fusarium wilt of lettuce under glasshouse and field conditions
Authors: Gilardi Giovanna , Pugliese Massimo , Gullino Maria Lodovica , Garibaldi Angelo
Published: December 2018

Lettuce Fusarium wilt, caused by Fusarium oxysporum f. sp. lactucae, represents a major problem in most lettuce production areas worldwide. In the present study, a number of resistance inducers, organic amendments and biocontrol agents were applied in a preventative way, in experimental and commercial situations, to soils artificially or naturally infested with race 1 of the pathogen, and to moderately susceptible lettuce cultivars. Potassium phosphite, acibenzolar‐S‐methyl, green composts, and Bacillus subtilis Qst713, Trichoderma asperellum + Trichoderma gamsii, and Pseudomonas strains achieved the most consistent disease control under the experimental conditions. Moreover, potassium phosphite, green compost, B. subtilis Qst713 and T. asperellum + T. gamsii, also showed a positive effect on plant development. In general, the results of the different treatments in naturally infested soil were similar to those observed in glasshouse trials under artificial inoculation. Potassium phosphite provided a consistent disease reduction (48%–62% in artificially infested soil and 60%–75% in naturally infested soil). The effects of adding 10% compost to a peat growing medium in the nursery, followed by a soil mixing application when lettuce was transplanted, significantly reduced the severity of Fusarium wilt (50%–59% efficacy) and increased fresh biomass production. Compost enrichment with Trichoderma TW2 generally further increased its efficacy. When tested under field conditions, the commercially available Trichoderma spp. and B. subtilis, together with experimental strains of Pseudomonas and Trichoderma spp., applied at the nursery level, provided a disease reduction of 30%–78%. Early application of the different control measures under nursery conditions and at lettuce transplant is noteworthy because it was carried out at a more localized level, with reduced amounts of products. Their use in practice should be integrated with other control strategies.
Further Evidence for Swimming‐Based Pica in Rats
Authors: Nakajima Sadahiko
Published: December 2018

Aberrant pica behavior (i.e., kaolin clay ingestion) has been regarded as a behavioral marker of nausea in rats that cannot vomit because of anatomical and/or neural reasons. The previous study reported that a single swimming session of 40 min generated pica behavior, implying that swimming induces nausea in rats. However, the rats tested in that report were not experimentally naive. The present study successfully replicated swimming‐based pica with experimentally naive rats (Experiment 1). It also showed that pica was observed with pool confinement of 20 min but not with that of 10 min (Experiments 2A and 2B) and that roaming in shallow water did not generate pica (Experiment 3). These results taken together suggest that swimming for at least 20 min induces nausea in rats, implying that rats’ taste aversion learning based on swimming is mediated by gastrointestinal discomfort.
Efficacy of long‐term oral telmisartan treatment in cats with hypertension: Results of a prospective European clinical trial
Authors: Glaus Tony M. , Elliott Jonathan , Herberich Esther , Zimmering Tanja , Albrecht Balazs
Published: December 2018

Background

Efficacy of telmisartan in treating hypertension (HT) in cats has not been largely investigated.

Objective

Telmisartan oral solution effectively controls systolic arterial blood pressure (SABP) in hypertensive cats.

Animals

Two‐hundred eighty‐five client‐owned cats with systemic HT.

Methods

Prospective, multicenter, placebo‐controlled, randomized, double‐blinded study. Hypertensive cats diagnosed with SABP ≥160 mmHg and ≤200 mmHg without target‐organ‐damage were randomized (2 : 1 ratio) to receive 2 mg/kg telmisartan or placebo q24 PO. A 28‐day efficacy phase was followed by a 120‐day extended use phase. Efficacy was defined as significant difference in mean SABP reduction between telmisartan and placebo on Day 14 and group mean reduction in SABP of > 20 mmHg by telmisartan on Day 28 compared to baseline.

Results

Two‐hundred fifty‐two cats completed the efficacy and 144 cats the extended use phases. Mean SABP reduction at Day 14 differed significantly between groups (P< .001). Telmisartan reduced baseline SABP of 179 mmHg by 19.2 (95% confidence interval [CI]: 15.92‐22.52) and 24.6 (95% CI: 21.11‐28.14) mmHg at Days 14 and 28. The placebo group baseline SABP of 177 mmHg was reduced by 9.0 (95% CI: 5.30‐12.80) and 11.4 (95% CI: 7.94‐14.95) mmHg, respectively. Of note, 52% of telmisartan‐treated cats had SABP <150 mmHg at Day 28. Mean SABP reduction by telmisartan in severe (≥180 mmHg) and moderate HT (160‐179 mmHg) was comparable and persistent over time.

Conclusions and Clinical Importance

Telmisartan solution (PO) was effective in reducing SABP in hypertensive cats with SABP ≥160 mmHg and ≤200 mmHg.
Infant temperament, maternal feeding behaviours and the timing of solid food introduction
Authors: Rogers Samantha L. , Blissett Jackie
Published: December 2018

Despite guidance from the World Health Organization and the U.K. Department of Health, many mothers introduce solid food before their infant is 6 months old. The current study aimed to investigate relationships between maternal feeding behaviours (preintroduction and postintroduction to solids), infant temperament, and the timing of introduction to solid food. Eighty‐one women were recruited on low‐risk maternity units and were contacted at 1 week, 3, and 6 months postpartum. Mothers of infants (45 males, 36 females, mean birth weight 3.52 kg [SD 0.39]) completed the behaviours component of the Infant Feeding Style Questionnaire via telephone interview at 3 months. At 6 months, they were observed feeding their infant solid food at home and reported infant temperament using the Infant Behaviour Questionnaire‐Revised (short form). Partial correlations (covariates: birth weight, maternal age, breastfeeding duration, and postnatal depression) revealed negative associations between age of introduction to solid food and temperament (smiling and laughter) and laissez‐faire milk feeding behaviours; and positive associations between age of introduction to solid food and restrictive milk feeding behaviours and verbal involvement during an observed mealtime. Hierarchical multiple regression analysis revealed that an infant's birth weight and the degree to which their mothers perceive them to smile and laugh are key predictors of when they will be introduced to solid food, over and above other variables of interest (e.g., maternal milk feeding behaviours, breastfeeding duration, and postnatal depression).
Role of western blot assay for the diagnosis of histoplasmosis in AIDS patients from a National Institute of Infectious Diseases in Rio de Janeiro, Brazil
Authors: Almeida Marcos Abreu , Damasceno Lisandra Serra , Pizzini Cláudia Vera , Muniz Mauro de Medeiros , Almeida‐Paes Rodrigo , Zancopé‐Oliveira Rosely Maria
Published: December 2018

Background

Histoplasmosis is a frequent fungal infection in HIV/AIDS patients, with high morbimortality rates when diagnosis and treatment are delayed. Antibody detection, which is faster than the gold standard culture test, hastens the laboratory investigation.

Objectives

To evaluate the role of WB for antibody detection in the diagnosis of histoplasmosis among HIV/AIDS patients.

Patients and Methods

Fifty patients with proven or probable histoplasmosis were included. Clinical, epidemiological and laboratory data were described in the same population after a review of their medical records. WB was performed using deglycosylated histoplasmin.

Results

About 82% of patients were adult males and the mean age was 39.3 years. CD4+ T lymphocyte count less than 150 cells/mm3 was observed in 62% patients. Antibodies against Histoplasma capsulatum M antigen were detected in 62% of patients, and against both M and H antigens in 28% of individuals. Sera from 10% of patients were nonreactive. Histoplasmosis was the first opportunistic infection in 38% of the cases. Disseminated and pulmonary histoplasmosis occurred in 84% and 16% of patients, respectively. The overall mortality was 16%.

Conclusion

WB could be useful for the histoplasmosis diagnosis in HIV/AIDS patients because of its easefulness and good sensitivity in a population where antibody production is hampered.
Microbiological characterisation of the colonisation by Candida sp in patients with orthodontic fixed appliances and evaluation of host responses in saliva
Authors: Tapia Cecilia V. , Batarce Christian , Amaro José , Hermosilla German , Rodas Paula I. , Magne Fabien
Published: December 2018

Objectives

We investigated the colonisation by Candida spp in patients using orthodontic fixed appliances by characterising the isolated Candida strains and by evaluating the host oral mucosa response through the measure of human β‐defensins 3 (HBD‐3) expression and Interleukin‐1ß/IL‐10.

Methods

Ninety patients were enrolled after signing an informed consent. Prevalence, susceptibility to fluconazole, genotyping and oral fungal burden of Candida sp. isolated were determined. Host responses were evaluated by measuring HBD‐3 expression as well as IL‐1ß and IL‐10 in saliva.

Results

The colonisation rate reached 6.7% (6/90), and 5 patients were colonised with C. albicans strains and one with one with C. tropicalis. The fluconazole MIC90/susceptibility of C. albicans strains ranged 1/0.25‐1 μg/mL. However, isolated strains did not present different genotype (SAB>0.9), C. albicans colonisation seems to be influenced by the duration of treatment and by level expression of HBD3 that were higher in colonised patients (not statistically different). A negative correlation between the fungal burden and IL‐1ß levels was found in colonised patients but not for IL‐10.

Conclusions

Our study revealed that patients with orthodontic fixed appliances were mainly colonised by C. albicans, which was related to a decrease in HBD‐3 expression and IL‐1ß levels.
Effects of probiotic supplements on the progression of chronic kidney disease: A meta‐analysis
Authors: Tao Sibei , Tao Siying , Cheng Yiming , Liu Jing , Ma Liang , Fu Ping
Published: December 2018

Background

Chronic kidney disease (CKD) is a worldwide public health problem. Although accumulated data suggested that probiotic supplements played roles in CKD, the results remained controversial. Here, we performed a meta‐analysis to assess the effects of probiotic supplements on the CKD progression.

Methods

A systematic search was conducted through the PubMed, Embase and Cochrane databases until September 2018. Randomized controlled trials with control receiving placebo, evaluating the effects of probiotic supplements on CKD were included.

Results

A total of 10 randomized controlled trials in 8 countries were selected. In the meta‐analysis, urea level was significantly reduced in probiotics‐administrated non‐dialysis patients (mean differences (MD) = −30.01; 95% confidence interval (CI) = [−56.78, −3.25]; P = 0.03) while no significant change was found in the dialysis patients receiving probiotics (MD = 0.1; 95% CI = [−9.28, 9.48]; P = 0.98). Probiotic supplements also exhibited no effect on uric acid (MD = −0.43; 95% CI = [−1.19, 0.33]; P = 0.27), C‐reactive protein (MD = −0.48; 95% CI = [−1.29, 0.33]; P = 0.24), creatinine (MD = −0.18; 95% CI = [−0.82, 0.47]; P = 0.59), and estimated glomerular filtration rate (MD = 2.10; 95% CI = [−1.31, 5.52]; P = 0.23) of CKD patients.

Conclusion

Our results highlighted that probiotic supplements exerted a statistically significant effect on urea levels in non‐dialysis CKD population, while no evidence suggested that probiotics possessed meaningful impacts on the reduction of uric acid, C‐reactive protein, creatinine and estimated glomerular filtration rate preservation of CKD population.
Effect of External Locus‐of‐Hope on Acquired Capability for Suicide
Authors: Wagshul Yitzchok D.
Published: December 2018

Objective

Of the three factors posited by Joiner's interpersonal theory of suicide as necessary before suicide can occur, increased hope has been shown to reduce two (thwarted belongingness and perceived burdensomeness), but, counterintuitively, to increase the 3rd (acquired capability for suicide). A fuller understanding of this phenomenon may lie with Bernardo's locus‐of‐hope construct—pursuant to which hope may lie not only in one's own plans and capabilities (internal locus‐of‐hope) but in those of others (external locus‐of‐hope)—but to date no study has researched the relationship between external locus‐of‐hope and acquired capability for suicide.

Method

Data from a sample recruited online (N = 193; 88.6% aged 21–49; 59.1% men; 80.3% White) were analyzed using a 3‐step hierarchical regression procedure designed to isolate the effects of external locus‐of‐hope on acquired capability for suicide by holding constant the effects of depression, demographic variables, and internal locus‐of‐hope.

Results

Results confirmed that internal locus‐of‐hope positively predicts acquired capability for suicide and demonstrated that external locus‐of‐hope has the opposite effect: It is associated with lowered acquired capability for suicide.

Conclusion

It follows that interventions designed to raise one's level of externally located hope have the potential to deter suicidal individuals from actualizing their plans.
A time‐geographic approach to quantifying wildlife–road interactions
Authors: Loraamm Rebecca W. , Downs Joni A. , Lamb David
Published: December 2018

Recent advances in time geography offer new perspectives for studying animal movements and interactions in an environmental context. In particular, the ability to estimate an animal's spatial location probabilistically at temporal sampling intervals between known fix locations allows researchers to quantify how individuals interact with one another and their environment on finer temporal and spatial scales than previously explored. This article extends methods from time geography, specifically probabilistic space–time prisms, to quantify and summarize animal–road interactions toward understanding related diurnal movement behaviors, including road avoidance. The approach is demonstrated using tracking data for fishers (Martes pennanti) in New York State, where the total probability of interaction with roadways is calculated for individuals over the duration tracked. Additionally, a summarization method visualizing daily interaction probabilities at 60 s intervals is developed to assist in the examination of temporal patterns associated with fishers’ movement behavior with respect to roadways. The results identify spatial and temporal patterns of fisher–roadway interaction by time of day. Overall, the methodologies discussed offer an intuitive means to assess moving object location probabilities in the context of environmental factors. Implications for movement ecology and related conservation planning efforts are also discussed.
Physics of Deep Surge in an Automotive Turbocharger Centrifugal Compression System
Authors: Dehner Rick , Selamet Ahmet
Published: December 2018

Deep surge is a violent fluid instability that occurs within turbomachinery compression systems and limits the low-flow operating range. It is characterized by large amplitude pressure and flow rate fluctuations, where the cross-sectional averaged flow direction alternates between forward and reverse. The present study includes both measurements and predictions from a turbocharger centrifugal compressor installed on a gas stand. A three-dimensional (3D) computational fluid dynamics (CFD) model of the compression system was constructed to carry out unsteady surge predictions. The results included here capture the transition from mild to deep surge, as the flow rate at the outlet boundary (valve) is reduced. During this transition, the amplitude of pressure and flow rate fluctuations greatly increase until they reach a repeating cyclic structure characteristic of deep surge. During the deep surge portion of the prediction, pressure fluctuations are compared with measurements at the corresponding compressor inlet and outlet transducer locations, where the amplitudes and frequencies exhibit excellent agreement. The predicted flow field throughout the compression system is studied in detail during operation in deep surge, in order to characterize the unsteady and highly 3D structures present within the impeller, diffuser, and compressor inlet duct. Key observations include a core flow region near the axis of the inlet duct, where the flow remains in the forward direction throughout the deep surge cycle. The dominant noise generation occurs at the fundamental surge frequency, which is near the Helmholtz resonance of the compression system, along with harmonics at integer multiples of this fundamental frequency.
Capital Cost Assessment of Concentrated Solar Power Plants Based on Supercritical Carbon Dioxide Power Cycles
Authors: Crespi Francesco , Sánchez David , Sánchez Tomás , Martínez Gonzalo S.
Published: December 2018

Previous work by the authors has shown that broader analyses than those typically found in literature (in terms of operating pressures allowed) can yield interesting conclusions with respect to the best candidate cycles for certain applications. This has been tested for the thermodynamic performance (first and second laws) but it can also be applied from an economic standpoint. This second approach is introduced in this work where typical operating conditions for concentrated solar power (CSP) applications (current and future generations of solar tower plants) are considered (750 °C and 30 MPa). For these, the techno-economic performance of each cycle is assessed in order to identify the most cost-effective layout when it comes to the overnight capital cost (OCC). This analysis accounts for the different contributions to the total cost of the plant, including all the major equipment that is usually found in a CSP power plant such as the solar field and thermal energy storage (TES) system. The work is, thus, aimed at providing guidelines to professionals in the area of basic engineering and prefeasibility study of CSP plants who find themselves in the process of selecting a particular power cycle for a new project (set of specifications and boundary conditions).
Loss Reduction in a 1.5 Stage Axial Turbine by Computer-Driven Stator Hub Contouring
Authors: Obaida Hayder M. B. , Rona Aldo , Gostelow J. Paul
Published: December 2018

Improvements in stage isentropic efficiency and reductions in total pressure loss are sought in a 1.5 stage axial turbine. This is representative of power generation equipment used in thermal power cycles, which delivers about 80% of the 20 × 1012 kWh world-wide electricity. Component-level improvements are therefore timely and important toward achieving carbon dioxide global emission targets. Secondary flow loss reduction is sought by applying a nonaxisymmetric endwall design to the turbine stator hub. A guide groove directs the pressure side branch of the horseshoe vortex away from the airfoil suction side, using a parametric endwall hub surface, which is defined as to obtain first-order smooth boundary connections to the remainder of the passage geometry. This delays the onset of the passage vortex and reduces its associated loss. The Automatic Process and Optimization Workbench (apow) generates a Kriging surrogate model from a set of Reynolds-averaged Navier–Stokes simulations, which is used to optimize the hub surface. The three-dimensional steady Reynolds-averaged Navier–Stokes model with an axisymmetric hub is validated against reference experimental measurements from the Rheinisch-Westfälische Technische Hochschule (RWTH) Aachen. Comparative computational fluid dynamics (CFD) predictions with an optimized nonaxisymmetric hub show a decrease in the total pressure loss coefficient and an increase in the isentropic stage efficiency at and off design conditions.
Structure-Based Engineering of Amidase from
Pantoea
sp. for Efficient 2-Chloronicotinic Acid Biosynthesis
Authors: Tang Xiao-Ling , Jin Jian-Qiang , Wu Zhe-Ming , Jin Li-Qun , Zheng Ren-Chao , Zheng Yu-Guo
Published: December 2018

In recent years, the demand for 2-chloronicotinic acid has been greatly increased. To date, several chemical methods have been used for the synthesis of 2-chloronicotinic acid, but all include tedious steps and/or drastic reaction conditions, resulting in both economic and environmental issues. It is requisite to develop an efficient and green synthesis route. We recently screened
Pa
-Ami and demonstrated its potential for synthesis of 2-chloronicotinic acid from 2-chloronicotinamide. However, chlorine substitution on the pyridine ring of nicotinamide significantly affected the activity of
Pa
-Ami. Especially for 2-chloronicotinamide, the enzyme activity and catalytic efficiency were relatively low. In this study, based on structure-function analysis, we succeeded in engineering the amidase by structure-guided saturation mutagenesis. The engineered
Pa
-Ami exhibited quite high catalytic activity toward 2-chloronicotinamide and could serve as a promising biocatalyst for the biosynthesis of 2-chloronicotinic acid.
Extremely Thermoacidophilic
Metallosphaera
Species Mediate Mobilization and Oxidation of Vanadium and Molybdenum Oxides
Authors: Wheaton Garrett H. , Vitko Nicholas P. , Counts James A. , Dulkis Jessica A. , Podolsky Igor , Mukherjee Arpan , Kelly Robert M.
Published: December 2018

In order to effectively leverage extremely thermoacidophilic archaea for the microbially based solubilization of solid-phase metal substrates (e.g., sulfides and oxides), understanding the mechanisms by which these archaea solubilize metals is important. Physiological analysis of
Metallosphaera
species growth in the presence of molybdenum and vanadium oxides revealed an indirect mode of metal mobilization, catalyzed by iron cycling. However, since the mobilized metals exist in more than one oxidation state, they could potentially serve directly as energetic substrates. Transcriptomic response to molybdenum and vanadium oxides provided evidence for new biomolecules participating in direct metal biooxidation. The findings expand the knowledge on the physiological versatility of these extremely thermoacidophilic archaea.
The Obligate Intracellular Bacterium
Orientia tsutsugamushi
Targets NLRC5 To Modulate the Major Histocompatibility Complex Class I Pathway
Authors: Rodino Kyle G. , Adcox Haley E. , Martin Rebecca K. , Patel Vaidehi , Conrad Daniel H. , Carlyon Jason A.
Published: December 2018

Orientia tsutsugamushi
is an obligate intracellular bacterium that infects mononuclear and endothelial cells to cause the emerging global health threat scrub typhus. The ability of
O. tsutsugamushi
to survive in monocytes facilitates bacterial dissemination to endothelial cells, which can subsequently lead to several potentially fatal sequelae.
A Resazurin Reduction-Based Assay for Rapid Detection of Polymyxin Resistance in Acinetobacter baumannii and Pseudomonas aeruginosa
Authors: Lescat Mathilde , Poirel Laurent , Tinguely Camille , Nordmann Patrice
Published: December 2018

A rapid test was developed for identification of polymyxin resistance in nonfermenting bacteria. This test detects viable cells after growth in a medium containing a defined concentration of colistin.
Evaluation of a Novel Stool Antigen Rapid Test Kit for Detection of Helicobacter pylori Infection
Authors: Kakiuchi Toshihiko , Okuda Masumi , Hashiguchi Kazutoshi , Imamura Ichiro , Nakayama Aiko , Matsuo Muneo
Published: December 2018

The Quick ChaserH. pylori(QCP), which is a novel antigen detection kit forHelicobacter pylori, was developed recently. The previous examination kits targeted the catalase ofH. pylori; however, this new test kit, to the best of our knowledge, is the first kit to target the flagellar protein ofH. pylori.
Tetraspanins: Architects of Viral Entry and Exit Platforms
Authors: Hantak Michael P. , Qing Enya , Earnest James T. , Gallagher Tom
Published: December 2018

Host factors render cells susceptible to viral infection. One family of susceptibility factors, the tetraspanin proteins, facilitate enveloped virus entry by promoting virus-cell membrane fusion.
Conjugative Selectivity of Plasmids Is Affected by Coexisting Recipient Candidates
Authors: Sakuda Ayako , Suzuki-Minakuchi Chiho , Okada Kazunori , Nojiri Hideaki
Published: December 2018

Most previous studies on plasmid conjugal transfer employed experimental setups with two strains: one as a donor and the other as a recipient. However, the results obtained sometimes failed to agree with observations obtained under natural environmental conditions or in a model microcosm using natural soil and water samples. Therefore, we consider that there is a “gap” in our understanding of plasmid behavior in the context of bacterial consortia that exist under the actual environmental conditions. In this study, we clearly showed that the conjugation selectivity of a plasmid can be affected by the recipient candidates existing around the donor strain by the use of a simplified experimental setup with one strain as the donor and two strains as recipients. These phenomena could not be explained by factors known to affect plasmid transfer as suggested by previous studies. Therefore, we suggest the presence of novel elements regulating plasmid transfer within consortia.
Primary small cell neuroendocrine carcinoma of the anterior mediastinum presenting with trepopnea
Authors: Iliyas Mohamed , Dona Das , Devi Uma , Noorunnisa Naseem
Published: December 2018

We report the case of an elderly man who had visited many physicians with breathlessness and was treated in an outpatient care. The cause of breathlessness was not evaluated, which turned out to be a slow-growing tumour in the mediastinum. Later, we diagnosed it to be a case of neuroendocrine carcinoma arising from the anterior mediastinum. The patient had succumbed to death because of the delayed diagnosis. A simple chest X-ray could have helped to make an early diagnosis. This case is reported with the intention to bring into light the effect of delayed diagnosis of a rare disease presenting with a very common symptom.
Compartment syndrome secondary to an atraumatic gastrocnemius tear in a patient on NOACs: presentation and complications of treatment
Authors: Phillips Georgina Stefanie Anne , McDonnell Stephen Martin
Published: December 2018

Acute compartment syndrome is a limb-threatening condition often associated with high-energy injury. We present the case of a man who sustained compartment syndrome secondary to an atraumatic tear in the gastrocnemius muscle and the complications which arose in his treatment due to his being on rivaroxaban.
Case of ruptured Staphylococcus aureusaortitis: presentation and management
Authors: Wang Stephani C , Tageldin Mohamed , Hand Drinnon O
Published: December 2018

Infectious aortitis with the complication of aortic aneurysm carries a high mortality rate without appropriate interventions, mostly due to aortic rupture. For this reason, early and prompt diagnoses along with surgical and medical managements play critical roles. Aortic infection withStaphylococcus aureus(SA) is uncommon, but reported cases have been usually associated with fatal complication from rapid progression into rupture. We report a 65-year-old man who developed methicillin-sensitive SA aortitis and then aortic rupture. Patient was successfully treated with staged vascular repair and long-term antibiotic use.
Diffuse large B cell lymphoma with superimposed lung abscess: potential role for intracavitary fibrinolytic therapy through a percutaneous drain to facilitate lung abscess drainage
Authors: Chae June , Kern Ryan , Nelson Darlene , Mullon John
Published: December 2018

This is a case of primary pulmonary lymphoma presenting concurrently with superimposed lung abscess, managed with the assistance of intracavitary fibrinolytic therapy. A 28-year-old man presented with 2 months of persistent cough. He had a large lung abscess involving almost the entire right upper lobe. The mass continued to progress in spite of appropriate antibiotic administration. Given the extent of involvement, he was not a surgical candidate. A bronchoscopy with bronchoalveolar lavage and transbronchial biopsies demonstrated diffuse large B cell lymphoma. Initial cultures were positive for Group GStreptococci. A CT-guided percutaneous drain was placed with initial purulent drainage that grewPrevotellaandStreptococcus mitis; however, drainage quickly abated without adequate evacuation of the abscess cavity. To further optimise drainage in anticipation of chemotherapy administration, intracavitary fibrinolytic therapy including tissue plasminogen activator and deoxyribonuclease was attempted to better evacuate the infected space.
Unilateral retinal venous beading
Authors: Abdel-hay Ahmed Fouad , Raman Vasant
Published: December 2018

Inherited retinal venous beading is a rare retinal vascular disorder that is characterised by tortuosity and beading of the retinal veins. This can potentially lead to vision-threatening complications such as vitreous haemorrhage, macular hard exudation and ischaemia. We report a case of sporadic unilateral retinal venous beading in an 18-year-old white man who was referred by his optician following a routine eye examination. This malformation was unilateral and did not involve any other ocular structure. He had no associated ocular or systemic disorders. When last seen, he did not have any visual complications due to this vascular anomaly.
A dog’s dinner: an interesting case presenting as gastroenteritis
Authors: Elliott Caroline , Byars John-Patrick , Weinhardt Barbara , Khalsa Kamaljit
Published: December 2018

We report a case of a 60-year-old Caucasian man with a history of alcohol excess who presented to the emergency department with a 72-hour history of abdominal pain, profuse diarrhoea and vomiting. He was admitted to the intensive care unit (ICU) 12 hours later in extremis with severe sepsis and multiorgan failure. Collateral history from the patient on admission to ICU identified that he had been bitten by a dog 3 days prior to his symptom onset. Provisional microscopy and Gram staining from peripheral blood cultures taken on admission revealed the presence of long, thin Gram-negative bacilli in the anaerobic bottle only. This was later identified asCapnocytophaga canimorsus. The patient survived the septic episode and was discharged to level 2 care 9 days later under the care of the renal physicians for ongoing renal dialysis.
Delayed presentation of neck arteries dissection, caused by water slide activity
Authors: Alboudi Ayman Mahmoud , Sarathchandran Pournamy , Geblawi Samar Sameer
Published: December 2018

A 16-year-old Korean boy presented with acute onset vertigo, dysphagia and gait ataxia of 16 hours duration. He had history of headache and neck pain along with transient vertigo during a water slide ride 12 days before presentation. CT brain showed left cerebellar and left lateral medullary infarcts. CT angiography showed left vertebral dissection with occlusion of left posterior inferior cerebellar artery. A 52-year-old Indian man, presented with acute onset global aphasia and right hemiparesis within 3 hours of onset of symptoms. He received intravenous tissue plasminogen activator (tPA) with partial improvement in his symptoms. He had headache and neck pain since 2 weeks, ever since he had a water slide ride. CT brain was normal, while the CT angiogram showed left carotid dissection. Cervical artery dissection has been reported with roller coaster rides and rarely with delayed presentations. Delayed presentation of cervical artery dissection after water rides have not been reported.
Multifocal granular cell tumour of the biliary tree
Authors: Vilardell Felip , Pardina Marina , Olsina Jorge Juan , Matias-Guiu Xavier
Published: December 2018

Fewer than 90 cases of granular cell tumour (GCT) of the biliary tract have been reported, including only five cases of multiple GCTs. We present the unusual case of a 40-year-old woman with multifocal GCTs affecting the intrahepatic biliary tree, which were initially suspected to be hepatic multiple metastases from a malignancy of unknown origin. The surgical specimen consisted of a hepatic segment in which five whitish nodular lesions were observed. On microscopic examination, nodular lesions were found in the portal tracts; these were composed of large polygonal cells with abundant highly granular cytoplasm. The nuclei were small and centrally located. The tumour cells tested diffusely positive for CD68-PGM1, S100 protein and α-inhibin, so a diagnosis of multifocal GCT of the biliary tree was made. Three years later, the patient is still alive and a MRI has shown no changes.
Insertion of a Dumon Y-stent via a permanent tracheostoma without using a rigid bronchoscope
Authors: Hayashi Kazuki , Motoishi Makoto , Sawai Satoru , Hanaoka Jun
Published: December 2018

A 63-year-old man who had received a permanent tracheostoma after oesophageal cancer surgery developed fistulas in the left and right main bronchi and suffered repeated aspiration pneumonia. Placing an indwelling Dumon Y-stent using a rigid bronchoscope is an option to treat fistula and stenosis at the tracheal bifurcation, but in some cases, it may be difficult to use a rigid bronchoscope in patients with a permanent tracheostoma. In this study, we report placing a Dumon Y-stent in a patient with a permanent tracheostoma using a specially modified stent and forceps instead of a rigid bronchoscope.
Pleomorphic lipoma of the bulbar conjunctiva
Authors: Li Emily , Silbert Jonathan , Sinard John
Published: December 2018

A 55-year-old woman presented with a painless, pink mass of the right eye bulbar conjunctiva that had been gradually increasing in size for the past 10 years. Excisional biopsy with histopathological analysis revealed a rare diagnosis of pleomorphic lipoma. There was no recurrence at last follow-up evaluation 6 months postoperatively. To the best of our knowledge, this represents the third case of pleomorphic lipoma of the bulbar conjunctiva reported to date.
Eagle’s syndrome: a piercing matter
Authors: Zammit Matthew , Chircop Charmaine , Attard Veronica , D’Anastasi Melvin
Published: December 2018

We present an unusual case of Eagle’s syndrome with bilateral internal carotid artery dissection in a 45-year-old man. Initial symptomatology included ipsilateral headaches and facial sensory symptoms. A right horner’s syndrome was present on clinical examination. Radiological imaging revealed an old infarct, with bilateral carotid dissections and bilateral elongated styloid processes consistent with Eagle’s syndrome. Despite initiation of secondary prevention with antiplatelet therapy, he had two further ischaemic events. The case highlights the symptomatology and complications of Eagle’s syndrome, with its management discussed through a review of similar case reports.
Unusual case of cellulitis due to primary cutaneous histoplasmosis
Authors: Paul Vishesh , Kuhlenschmidt Michael S
Published: December 2018

A 63-year-old white man with a history of rheumatoid arthritis on adalimumab was admitted to the hospital for left arm swelling and erythema. On physical examination, the patient was afebrile and non-toxic appearing and there was tense oedema of the left forearm. Initial laboratory work was unremarkable except for elevated inflammatory markers. MRI of the arm showed non-specific findings of inflammation. The patient was started on empiric antibiotics but did not improve. Given the patient’s immunosuppression, early consideration was given to fungal or mycobacterial causes. Initial serum fungal studies were negative and the patient was taken for diagnostic local incision and biopsy of the left volar forearm. Grocott’s methenamine silver and periodic acid–Schiff staining revealed fungal organisms resemblingHistoplasmaand intraoperative fungal cultures grewHistoplasma capsulatumconfirming the diagnosis. The patient was treated with a 6-month course of itraconazole with improvement in his condition and eventual complete resolution.
Repair of displaced thyroid cartilage fracture using miniplate osteosynthesis
Authors: Hallak Bassel , Von Wihl Sonia , Boselie Franciscus , Bouayed Salim
Published: December 2018

Acute laryngeal trauma is estimated to occur in approximately one patient per 14 500 to 42 500 emergency room admissions. If the larynx is injured, its vital functions are affected and can be threatened in case of severe injury. Soft cartilage offers no protective advantage, which is the reason why young as well as older individuals are at risk of thyroid cartilage fracture. Experimentation on cadaver larynx has demonstrated that virtually all laryngeal fractures are longitudinally oriented. Furthermore, muscular pull can contribute to a misalignment of the fractures. As stated by Bent and Porubsky, a fracture is considered severely rather than moderately displaced, if it is freely mobile on physical examination, has more than two fracture lines or demonstrates a displacement greater than the width of the thyroid cartilage on CT imaging. We present two cases of severely displaced thyroid cartilage fracture treated in our department by open reduction and internal fixation using miniplates. Functional and radiological outcomes were excellent.
Pancoast’s syndrome caused by lymph node metastasis from breast cancer
Authors: Di Stefano Vincenzo , Valdesi Cristina , Zilli Marinella , Peri Marta
Published: December 2018

Pancoast’s syndrome may be the result of neoplastic, inflammatory or infectious disease. We report an unusual case of Pancoast’s syndrome in a patient with metastatic breast cancer. A 54-year-old woman, affected by metastatic breast cancer, presented for severe shoulder pain, paraesthesia and numbness in the right arm. Despite further multiple lines of systemic chemotherapy, she developed a progressive enlargement of retropectoral, supraclavicular and infraclavicular lymph node metastases, which involved brachial plexus, apex of lung and anterior mediastinum. Physical examination revealed severe weakness of proximal muscles of the right arm. Neuropathic pain was managed with pharmacological treatment. Lastly, the patient has been treated with intrathecal analgesia with morphine and ziconotide with a good control of pain. The patient died after 3 months.
Left main coronary artery atresia complicated by fistulae between the left anterior descending artery and the right ventricle
Authors: Watura Karen , Pollentine Adrian
Published: December 2018

This case describes a 60-year-old man with congenital atresia of the left main coronary artery (LMCA), with fistulae between the left anterior descending artery (LAD) and the right ventricle (RV). This was detected at coronary CT. To our knowledge, this is the first reported case of congenital atresia of the LMCA in conjunction with fistulae between the LAD and RV. The patient remains asymptomatic at a 2-year follow-up. No treatment has been recommended. Coronary artery anomalies are rare. Although usually asymptomatic, they can present with symptoms varying from angina to sudden death. Identification and accurate description of coronary artery anomalies are vital in assessing the risk of associated adverse events.
Case of steroid-resistant Crohn’s-associated bronchiolitis in the setting of quiescent gastrointestinal disease treated with infliximab
Authors: Chuah Cher Shiong , Noble Colin , Leitch Andrew
Published: December 2018

A fit, 36-year-old man with a history of Crohn’s disease previously treated with azathioprine, presented acutely with progressive shortness of breath on exertion and pleuritic chest pain. At the time of presentation, his Crohn’s disease was quiescent, supported by a normal faecal calprotectin. The initial chest CT suggested the presence of a diffuse inflammatory disorder and he was subsequently started on high dose oral steroids. Despite 4 months of steroid therapy, there was minimal improvement. Following discussion at the inflammatory bowel disease multidisciplinary team meeting, a decision was made to commence infliximab. Subsequently, he made a dramatic clinical and physiological recovery. His forced expiratory volume in 1 s improved from 2.22 L/min (50% predicted) to 3.65 L/min (93% predicted) and he returned to baseline levels of exercise.
‘Hearing hooves, finding zebras’: the differential diagnosis of cardiac arrest precipitated by chest pain in the postpartum woman
Authors: Squire Gareth , Eltayeb Mohammed , Hogrefe Kai
Published: December 2018

We describe the case of a 3-week postpartum 27-year-old woman who presented with chest pain to the emergency department shortly before developing cardiac arrest with refractory ventricular fibrillation. She was initially misdiagnosed and treated for presumed pulmonary embolism (PE) with thrombolysis. A total of 14 direct current cardioversion shocks were given and return of spontaneous circulation (ROSC) was achieved post thrombolysis. Subsequent CT pulmonary angiography excluded PE. A post-ROSC ECG demonstrated anterolateral ST elevation and she was transferred to the local cardiac unit for angiography. This revealed extensive dissection of the left anterior descending artery (LAD) with proximal occlusion. The diagnosis therefore was pregnancy-associated spontaneous artery dissection, a type of acute coronary syndrome. She received percutaneous intervention to her LAD with five drug-eluting stents. The patient survived and was discharged 5 days later. Her ventricular function is now grossly impaired, and had the correct diagnosis been arrived at sooner, this loss of function would have been less severe.
Metformin-associated lactic acidosis precipitated by liraglutide use: adverse effects of aggressive antihyperglycaemic therapy
Authors: Hooda Ananya , Mehta Anurag , Hannallah Franck
Published: December 2018

Older patients with type 2 diabetes are prone to developing adverse events with aggressive antihyperglycaemic therapy. Metformin-associated lactic acidosis (MALA) is one such rare, life-threatening adverse drug effect. We report the case of a 70-year-old man with a glycated haemoglobin of 7.9% who was on a stable, maximally tolerated dose of metformin for managing his type 2 diabetes. He was initiated on liraglutide injections with hopes to achieve better glycaemic control, but developed unrelenting nausea and vomiting during the third week of treatment. He presented to the hospital with these symptoms and was noted to have severe MALA. He sustained an in-hospital cardiac arrest requiring emergent resuscitation along with vasopressor and mechanical ventilator support. He underwent continuous venovenous haemodiafiltration to remove metformin and correct the acidosis, following which he stabilised and supportive therapy was weaned off. He was discharged from the hospital on insulin therapy with incomplete renal recovery.