Surgery and out-patient data collection and reporting using Filemaker Pro.

OBJECTIVE: The application of an electronic database in clinical practice is used widespread in every field of medicine. The aim of the present study is to illustrate our experience to use a database software for documentation of two of our clinical activities, outpatient hysteroscopy and inpatient gynaecological surgery. PATIENTS AND METHODS: In 2004, we designed two databases, the first one to document surgical procedures in the operating theatre, the second to document outpatient hysteroscopy procedures using FileMaker v.8.5. The data entry interface contains free text fields for patient demographic data and the description of the surgical procedure, supplemented by drop-down lists for items such as clinical findings, procedures, instrumentation, technique, and complications. Copies were filed in the main hospital notes, sent to General Practitioners, and also given to our patients. RESULTS: Since August 2004, we have used our two databases to document 2766 gynaecological operations and 3777 outpatient hysteroscopies. All users particularly liked the dropdown lists as their use greatly reduced the time taken to enter each patient's data. The databases were regularly used to select patients for audit projects and research data collection for prospective studies. CONCLUSIONS: FileMaker is an user-friendly and easily configured software, extremely valuable in everyday clinical work.

A novel amperometric catechol biosensor based on α-Fe2O3 nanocrystals-modified carbon paste electrode.

In this work, we designed an amperometric catechol biosensor based on α-Fe2O3 nanocrystals (NCs) incorporated carbon-paste electrode. Laccase enzyme is then assembled onto the modified electrode surface to form a nanobiocomposite enhancing the electron transfer reactions at the enzyme's active metal centers for catechol oxidation. The biosensor gave good sensitivity with a linear detection response in the range of 8-800 µM with limit of detection 4.28 µM. We successfully employed the sensor for real water sample analysis. The results illustrate that the metal oxide NCs have enormous potential in the construction of biosensors for sensitive determination of phenol derivatives.

Finding needles in a haystack: application of network analysis and target enrichment studies for the identification of potential anti-diabetic phytochemicals.

Diabetes mellitus is a debilitating metabolic disorder and remains a significant threat to public health. Herbal medicines have been proven to be effective anti-diabetic agents compared to synthetic drugs in terms of side effects. However, the complexity in their chemical constituents and mechanism of action, hinder the effort to discover novel anti-diabetic drugs. Hence, understanding the biological and chemical basis of pharmacological action of phytochemicals is essential for the discovery of potential anti-diabetic drugs. Identifying important active compounds, their protein targets and the pathways involved in diabetes would serve this purpose. In this context, the present study was aimed at exploring the mechanism of action of anti-diabetic plants phytochemicals through network and chemical-based approaches. This study also involves a focused and constructive strategy for preparing new effective anti-diabetic formulations. Further, a protocol for target enrichment was proposed, to identify novel protein targets for important active compounds. Therefore, the successive use of network analysis combined with target enrichment studies would accelerate the discovery of potential anti-diabetic phytochemicals.

Synthesis, antimicrobial, DNA-binding and photonuclease studies of cobalt(III) and nickel(II) Schiff base complexes.

New metal complexes of the type [M(nih)(L)](PF(6))(n)·xH(2)O and [M(nih)(2)](PF(6))·xH(2)O (where M=Co(III) or Ni(II), L=1,10-phenanthroline (phen)/or 2,2' bipyridine (bpy), nih=2-hydroxy-1-naphthaldehyde isonicotinoyl hydrazone, n=2 or 1 and x=3 or 2) have been synthesized and characterized by elemental analysis, magnetic, IR and (1)H NMR spectral data. The electronic and magnetic moment 2.97-3.07 B.M. data infers octahedral geometry for all the complexes. The IR data reveals that Schiff base (nih) form coordination bond with the metal ion through azomethine-nitrogen, phenolic-oxygen and carbonyl-oxygen in a tridentate fashion. In addition, DNA-binding properties of these six metal complexes were investigated using absorption spectroscopy, viscosity measurements and thermal denaturation methods. The results indicated that the nickel(II) complex strongly bind with calf-thymus DNA with intrinsic DNA binding constant K(b) value of 4.9×10(4) M(-1) for (3), 4.2×10(4) M(-1) for (4), presumably via an intercalation mechanism compared to cobalt(III) complex with K(b) value of 4.6×10(4) M(-1) (1) and 4.1×10(4) M(-1) (2). The DNA Photoclevage experiment shows that, the complexes act as effective DNA cleavage agent.

Emergent transcatheter relief of bronchus compression by an ectatic ductus arteriosus in a premature neonate: a case report.

A premature infant with tetralogy of Fallot with pulmonary atresia and prenatal compression of the left main bronchus by a large and ectatic patent ductus arteriosus is presented. Survival to surgery was accomplished by transcatheter placement of a coronary stent into the left mainstem bronchus.

Mid-aortic syndrome in two preterm infants.

We report mid-aortic syndrome (MAC) in two preterm infants. Both infants developed malignant hypertension refractory to medical therapy and died early in infancy. Thus far, this account is of the two youngest patients with MAC.

Cu(II) and Mn(II) complexes containing macroacyclic ligand: synthesis, DNA binding, and cleavage studies.

The two new metal complexes of Cu(II) and Mn(II) containing macroacyclic ligand of the type [Cu(hpn)](PF(6))(2) (1) and [Mn(hpn)](PF(6))(2) (2) [where hpn = [1-{[2-{[2-hydroxynaphthalen-1-yl)methylidine]amino}phenyl)imino]methyl}naphthalene-2-ol]] have been synthesized and characterized by employing analytical and spectral methods. The DNA binding properties of the complexes with calf thymus-DNA were studied by using absorption spectra and viscosity measurements, as well as thermal denaturation experiments. The absorption spectra indicated that the complexes intercalate tightly between the base pairs of the DNA with intrinsic DNA binding constants of 1.8 × 10(4) M(-1) for (1) and 3.7 × 10(4) M(-1) for (2) in 5 mM Tris-HCl/50 mM NaCl buffer at pH 7.2, respectively. The enhancement in the relative viscosity of DNA on binding to the ligand supports the proposed DNA binding modes. The oxidative cleavage activity of complexes (1) and (2) were carried out on double-stranded pUC19 circular plasmid DNA using gel electrophoresis. The complexes show significant nuclease activity.

Comparison of methods for teaching developmental milestones to pediatric residents.

BACKGROUND: Interactive media are effective tools in teaching and allow for self-directed study, which develops skills for life-long learning among health professionals. With this type of study, the learner can review material at his/her own pace and target areas that require emphasis. Pediatric residents require an accurate understanding of developmental milestones in children of various ages and their normal variations. The best representation of developmental milestones requires video recordings of children demonstrating appropriate skills. However, such recordings are not always available, so printed materials are most often used. In this realm, a computer-based interactive learning tool using animated cartoons gives flexibility for presentation using drawings. We compared pediatric residents' knowledge of developmental milestones in neonates to 5-year-olds before and after study with either an interactive DVD or paper-based materials. METHODS: A team of physicians and educational specialists in Texas Tech University Health Sciences Center produced an interactive DVD containing animated cartoons and questions. Residents were divided into an intervention group that used the DVD and a control group that used traditional paper-based materials. Each group's improvement [or increase] in knowledge was measured. RESULTS: Compared with the 17 residents in the control group, the 37 in the intervention group tended to acquire more knowledge about developmental milestones. The mean scores at T1, T2, and T3 doubled from the initial scores in the intervention group, while no difference was observed in the control group. CONCLUSION: An interactive educational DVD can be an effective supplement to improve residents' knowledge of developmental milestones.

Synthesis, DNA binding, and oxidative cleavage studies of Fe(II) and Co(III) complexes containing bioactive ligands.

The two complexes containing bioactive ligands of the type and [Fe(L)] (PF(6))(2) (1) (where L = [1-{[2-{[2-hydroxynaphthalen-1-yl)methylidine]amino}phenyl)imino] methyl}naphthalene-2-ol]) and [Co(L(1)L(2))] (PF(6))(3) (2) (where L(1)L(2) = mixed ligand of 2-seleno-4-methylquinoline and 1,10-phenanthroline in the ratio 1:2, respectively) were synthesized and structurally characterized. The DNA binding property of the complexes with calf thymus DNA has been investigated using absorption spectra, viscosity measurements, and thermal denaturation experiments. Intrinsic binding constant K(b) has been estimated at room temperature. The absorption spectral studies indicate that the complexes intercalate between the base pairs of the CT-DNA tightly with intrinsic DNA binding constant of 2.8 × 10(5) M(-1) for (1) and 4.8 × 10(5) M(-1) for (2) in 5 mM Tris-HCl/50 mM NaCl buffer at pH 7.2, respectively. The oxidative cleavage activity of (1) and (2) were studied by using gel electrophoresis and the results show that complexes have potent nuclease activity.

TiO2- and BaTiO3-assisted photocatalytic degradation of selected chloroorganic compounds in aqueous medium: correlation of reactivity/orientation effects of substituent groups of the pollutant molecule on the degradation rate.

Investigation of the photocatalytic activity of BaTiO(3), a perovskite wideband gap semiconductor has been done in comparison with a widely used photocatalyst TiO(2) for the degradation of 4-chlorophenol (4-CP), 4-chloroaniline (4-CA), 3,4-dichloronitrobenzene (3,4-DCNB), and 2,4,5-trichlorophenol (2,4,5-TCP). BaTiO(3)/TiO(2) nanoparticles were prepared by gel-to-crystalline conversion method. BaTiO(3) has exhibited better catalytic efficiency and process efficiency compared with TiO(2) in most of the cases. The present research focuses mainly on two aspects: first the photocatalytic activity of BaTiO(3), as there are very few reports in the literature, and second the reactivity/orientation effects of substituent groups of the pollutant molecules on the degradation rate. The above chloroorganic compounds have at least one chlorine substituent in common, along with other functional groups such as -OH, -NH(2), and -NO(2). Furthermore, the effect of electron acceptors and pH on the rate of degradation is presented. The reactions follow first-order kinetics. The degradation reaction was followed by UV-vis, IR, and GC-MS spectroscopic techniques. On the basis of the identification of the intermediates, a probable degradation reaction mechanism has been proposed for each compound.

Neonatal cyanosis: diagnostic and management challenges.

Neonatal central cyanosis is always a sign of serious pathological processes and may involve diverse organs and impose a significant diagnostic and therapeutic challenge. Here, we report an unusual presentation of Ebstein's anomaly, a rare congenital heart malformation, as the cause of central cyanosis in a one-week-old full-term infant. Initiation of PEG(1) therapy in neonates with Ebstein's anomaly always needs a very careful consideration because of a high risk for the development of a "circular shunt" leading to severe deterioration of multiple organs perfusion.

Synthesis, characterization and antimicrobial studies of 2-(4-methoxy-phenyl)-5-methyl-4-(2-arylsulfanyl-ethyl)-2,4-dihydro-[1,2,4] triazolo-3-ones and their corresponding sulfones.

In the present investigation, a series of novel 2-(4-methoxy-phenyl)-5-methyl-4-(2-arylsulfanyl-ethyl)-2,4-dihydro-[1,2,4] triazolo-3-ones and their corresponding sulfones were prepared with the objective of developing better antimicrobial agents. The chemical structures of the newly synthesized compounds were characterized by spectral (IR, (1)H NMR, (13)C NMR and LCMS) methods. The newly synthesized compounds (4a-i) and (5a-e, 5h) were screened for their antimicrobial activity against Bacillus subtilis, Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli and Pseudomonas aeruginosa. The antifungal activity was tested against Rhizopus oryzae, Aspergillus niger, Aspergillus flavus, Candida albicans and Saccharomyces cerevisiae. Among all the compounds synthesized, compounds 4d and 5b exhibited significant antibacterial activity.

Evaluation of lyophilized platelets as an infusible hemostatic agent in experimental non-compressible hemorrhage in swine.

INTRODUCTION: Human lyophilized platelets hold promise as a novel hemostatic infusion agent for the control of traumatic hemorrhage. Rehydrated, lyophilized platelets (Stasix) were investigated as an infusible hemostatic agent in experimental non-compressible hemorrhage, using a porcine liver injury model. METHODS: Yorkshire swine underwent a grade III liver injury and uncontrolled bleeding. After 15 min, animals were infused with Stasix (n = 10) or normal saline vehicle (n = 10). At 2 h, the liver was repaired, and the animals were monitored for another4 h. Resuscitation, including blood transfusion, was administered during the hospital phase. Laboratory data, including arterial blood gas, complete blood count, thromboelastography (TEG), and coagulation parameters, were collected. All animals underwent necropsy with complete histopathologic examination. RESULTS: Overall survival in the Stasix group [8/10 (80%)] was significantly higher than in the control group [2/10 (20%)] (P = 0.023). Mean total blood loss index (g kg(-1)) was lower in Stasix-treated animals (22.2 +/- 3.5) than in control animals (34.7 +/- 3.4) (P = 0.019). Hemodynamic parameters were improved in the Stasix group, and a trend towards higher hemoglobin and lower lactate was observed. Coagulation and TEG parameters were not different between the groups. One surviving animal in the Stasix group had evidence of thrombi on necropsy. CONCLUSIONS: This is the first reported study to evaluate rehydrated, lyophilized platelets as an infusible hemostatic agent for non-compressible hemorrhage. Stasix improved survival and reduced blood loss in a liver injury porcine model. However, evidence of thrombotic complications warrants further investigation prior to human use in the setting of traumatic hemorrhage.

Respiratory distress and behavioral changes induced by sodium cyanide in the fresh water TELEOST, Cyprinus carpio (Linnaeus).

An acute toxicity (LC50) test using a static renewal bioassay method was conducted to determine the toxicity of sodium cyanide in freshwater exotic carp, Cyprinus carpio exposed for 96 h to different concentrations of sodium cyanide. The acute toxicity value was found to be 1 mg/L; one third of the LC50 (0.33 mg/L) was selected as the sublethal concentration for subacute studies. Behavioral patterns were observed in lethal (1, 2, 3, and 4 d) and sublethal concentrations (1, 5, 10, and 15 d). Cyprinus carpio in toxic media exhibited irregular, erratic, and darting swimming movements, hyperexcitability, loss of equilibrium, and sinking to the bottom, which might be due to inhibition of cytochrome c oxidase activity and decreased blood pH. The combination of cytotoxic hypoxia with lactate acidosis depresses the central nervous system and myocardium, the most sensitive critical sites for anoxia, resulting in respiratory arrest and death. A decrease in oxygen consumption (-28.36 to -78.28%; -14.22 to -47.25%) was observed at both lethal and sublethal concentrations of sodium cyanide respectively. Fish at the sublethal concentration were found under stress, but that was not fatal.

TiO(2)/BaTiO(3)-assisted photocatalytic mineralization of diclofop-methyl on UV-light irradiation in the presence of oxidizing agents.

Gas chromatograph-mass spectroscopic identification of intermediate products in the degradation of diclofop-methyl and the kinetics of the reaction has been investigated. Formation of 4-[(2,4-dichlorophenoxy) phenoxy] ethane and (2,4-dichlorophenoxy) phenol was investigated. The other intermediate products are 2,4-dichlorophenol, 2,4-dichlorobenzene, phenol and acetic acid have been ascertained. The decrease in the concentration of the parent/intermediate compounds is followed by UV-vis spectral study and the supportive information on the functional groups in the intermediates has been obtained from IR-spectroscopy. Degradation process proceeds with oxidation-reduction reaction by the attack of OH*, H*, O(2)*(-) free radicals, which are photogenerated on the UV-light illuminated TiO(2)/BaTiO(3) photocatalysts particles in aqueous medium. In this presentation another wide band gap semiconductor BaTiO(3) is shown to have comparable photocatalytic efficiency. The oxidizing agents are added to accelerate the rate of the reaction by enhancing the formation of free radicals. Based on the intermediates formed in the process of degradation, a suitable mechanism has been proposed.

Early and late fistula failure.

While an arteriovenous fistula is the best available form of hemodialysis access, a significant number of fistulae never mature to support dialysis (early failure) or fail after successful use (late failure). Venous stenosis and the presence of accessory veins are the two main causes of early failure. Recent data have demonstrated that a great majority of such AVFs can be successfully salvaged by percutaneous interventions and become available for dialysis. In addition to early failure, a great majority of thrombosed fistulae can also be successfully declotted using simple endovascular techniques. Fistula thrombosis has clear differences from graft clotting. First of all, cannulation of a clotted fistula is more challenging. Secondly, thrombus volume present in a clotted fistula can be quite variable. A fistula might thrombose with minimal or no thrombus. At other times, there is moderate-to-severe thrombus burden that accompanies fistula clotting. While percutaneous balloon angioplasty to correct the underlying stenosis might be all that is needed to declot a fistula with no thrombus, thromboaspiration is required to successfully declot a fistula with moderate thrombus. Salvage of early and late fistula failure is critical to minimize catheter use and is supported by the National Kidney Foundation Dialysis Outcomes Quality Initiative. Additionally, it is a powerful strategy to maximize AVF use in hemodialysis patients.

Low response to HBsAg vaccine in chronic renal failure patients is not due to intrinsic defect of B cells.

OBJECTIVE: The aim of this study was to investigate whether the inability of chronic renal failure patients to mount an adequate antibody response following hepatitis B vaccination was due to an inherent defect in the antibody producing capacity of their B cells. MATERIAL AND METHODS: Peripheral blood mononuclear cells of end stage renal disease (ESRD) patients, who were not on maintenance hemodialysis (CRF) and those undergoing long-term hemodialysis (HD) were stimulated in vitro with pokeweed mitogen, a B cell mitogen or hepatitis B surface antigen. The total immunoglobulin (IgG, IgM and IgA) levels and anti-HBs specific IgM and IgG were quantitiated by sandwich ELISA and levels between patients who had a good antibody response in vivo and those who failed to mount an antibody response were compared. RESULTS: Spontaneous IgG production was significantly higher than normals in CRF and HD group; PWM induced IgM, IgG and IgA production was comparable to normals in both groups of patients. The spontaneous IgG and PWM stimulated IgM and IgG production was significantly higher in HD patients as compared to CRF. The in vitro Ig levels in the vaccine responders and non-responders was comparable except for the spontaneous IgG which was highest in the responders. The in vitro anti-HBs production was comparable in HB vaccine responders and non-responders; the in vivo and in vitro anti-HBs titers showed a significant correlation coefficient thereby indicating that the in vitro assay reflects the in vivo functional status of B cells. CONCLUSION: Our results demonstrate that the B cells in ESRD patients are functionally normal and cannot be the cause of the compromised vaccine response in these patients.

Differentiation of pathogenic and saprophytic leptospires by polymerase chain reaction.

PURPOSE: To study the differences between pathogenic and saprophytic leptospires. METHOD: A total of 275 samples were collected from different sources out of which 107 were subjected to PCR and bacteriological culturing. Two sets of primers were used for detection of leptospiral DNA and differentiation of pathogenic and saprophytic leptospires. Differentiation was also carried out by conventional methods. RESULTS: Twenty seven samples were found positive by PCR ut of which 26 were pathogenic and one was saprophytic. Culturing in EMJH medium yielded four isolates, of which isolates from sera were found to be pathogenic and isolate from water was found to be saprophytic. CONCLUSION: From the present study, it was concluded that PCR is simple, specific and rapid method for detection as well as differentiation of leptospires when compared to conventional methods.

RFI-641 inhibits entry of respiratory syncytial virus via interactions with fusion protein.

BACKGROUND: RFI-641, a small dendrimer-like compound, is a potent and selective inhibitor of respiratory syncytial virus (RSV), which is currently a clinical candidate for the treatment of upper and lower respiratory tract infections caused by RSV. RFI-641 inhibits RSV growth with an IC(50) value of 50 nM and prevents syncytia formation in tissue culture. RSV contains of three surface glycoproteins, a small hydrophobic (SH) protein of unknown function, and attachment (G) and fusion (F) proteins that enable binding and fusion of virus, respectively, with target cells. Because of their role in attachment and fusion, the G and F surface proteins are prominent targets for therapeutic intervention. RFI-641 was previously shown to bind purified preparations of RSV fusion protein. Based on this observation, in conjunction with the biological results, it was speculated that the fusion event might be the target of these inhibitors. RESULTS: A fusion assay based upon the relief of self-quenching of octadecyl rhodamine R18 was used to determine effects of the inhibitors on binding and fusion of RSV. The results show that RFI-641 inhibits both RSV-cell binding and fusion events. The inhibition of RSV is mediated via binding to the fusion protein on the viral surface. A closely related analog, WAY-158830, which is much less active in the virus-infectivity assay does not inhibit binding and fusion of RSV with Vero cells. CONCLUSIONS: RFI-641, an in vivo active RSV inhibitor, is shown to inhibit both binding and fusion of RSV with cells, events that are early committed steps in RSV entry and pathogenicity. The results described here demonstrate that a non-peptidic, small molecule can inhibit binding and fusion of enveloped virus specifically via interaction with the viral fusion protein.