ABSTRACT
Previous studies demonstrate racial disparities in child abuse evaluations even after controlling for health insurance coverage. We conducted a cross-sectional study using the Military Health System Data Repository (MDR) of Military Health System (MHS) beneficiaries born between fiscal years 2016 and 2018 to evaluate racial disparities and other factors in the suspicion of child abuse. We observed beneficiaries for 2.5 years after birth and assessed the incidence of head injury using diagnostic codes. Among children with head injury codes, we performed a multivariable logistic regression analysis to measure the association between race and the concurrent use of the diagnostic code for suspected child abuse (SCA) or for the performance of a skeletal survey. There were 195,893 infants included and 45,269 (23.1%) underwent evaluations for head injury. Less than one percent (n = 424) concurrently had the diagnostic code for SCA or a skeletal survey performed within 2 weeks of the head injury evaluation. When controlling for other factors, race was not associated with SCA. Higher military rank was independently associated with decreased odds of SCA. Racial disparities in SCA may be mitigated in the MHS, and further evaluation is needed. Military rank could be a factor in SCA disparities and warrants further study.
Subject(s)
Child Abuse , Craniocerebral Trauma , Military Personnel , Infant , Child , Humans , United States/epidemiology , Cross-Sectional Studies , Child Abuse/diagnosis , Craniocerebral Trauma/diagnosis , Craniocerebral Trauma/epidemiology , Healthcare DisparitiesABSTRACT
OBJECTIVE: Proteostasis is an important process occurring in all living cells and is highly indispensable for cell survival. The HslVU protease/chaperone complex's critical role in regulating proteostasis to maintain a healthy cellular proteome and its presence in pathogenic microbes made it an important drug target. This study aimed to identify small molecular inhibitors of the HslV protease. MATERIALS AND METHODS: Herein, a library of small molecules belonging to the triazine and chromone families has been evaluated for their inhibitory potential against the E. coli HslV protease using both in silico and in vitro techniques. RESULTS: Four compounds, i.e., SHS-II-123a, SHS-II-147a, US-IV-89, and US-IV-92, were identified as potential inhibitors of the HslV protease having IC50 values in the range of 0.1 to 0.32 µM. Additionally, these compounds' drug-likeness and ADMET profiles indicated their compatibility to be considered safer drug candidates. CONCLUSIONS: To the best of our knowledge, this is the first report on small molecules having inhibitory effects on the HslVU complex. These identified compounds can be efficiently subjected to further investigations to develop novel and safer antimicrobial agents.
Subject(s)
Chromones , Peptide Hydrolases , Humans , Chromones/pharmacology , Triazines/pharmacology , Thiazoles , Escherichia coli , Endopeptidases , Molecular ChaperonesABSTRACT
Correction to: European Review for Medical and Pharmacological Sciences 2022; 26 (22): 8567-8575. DOI: 10.26355/eurrev_202211_30392-PMID: 36459037-published online on November 30, 2022. After publication, the authors applied some corrections to the text: - Dr. U. Salar's affiliation has been corrected as follows: Dr. Panjwani Center for Molecular Medicine and Drug Research, International Center for Chemical and Biological Sciences, University of Karachi, Karachi, Pakistan. - The values in the row "Binding energy with HsIV (Kcal/mol)" Table I have been corrected as follows: from -8.4 into -9.0; from -8.6 into -9.2; from -8.0 into -8.5 from -8.3 into -8.7. There are amendments to this paper. The Publisher apologizes for any inconvenience this may cause. https://www.europeanreview.org/article/30392.
ABSTRACT
Post-streptococcal glomerulonephritis (PSGN) is an immune-complex mediated inflammation that used to be considered one of the commonest causes of acute nephritis amongst children. PSGN is characterized by the proliferation of cellular elements called nephritogenic M type as a result of an immunologic mechanism following an infection of the skin (impetigo) or throat (pharyngitis) caused by nephritogenic strains of group A beta-hemolytic streptococci, a gram-positive bacteria that enters the body across pores in the skin or mucus epithelia and is responsible for more than 500,000 deaths annually due to multiple subsequence diseases such as rheumatic heart disease, rheumatic fever, PSGN, and other invasive infections. After the infection, the formation of an immune complex of antigen-antibody and complement system will take place and will deposit in the glomeruli where the injury occurs and leads to inflammation. The manifestations of PSGN can be explained by nephritic syndrome manifestation. PSGN is diagnosed by laboratory tests like microscopy and urinalysis. The imaging studies in PSGN could be used to assess the possible complications of PSGN such as pulmonary congestion and chronic kidney disease. The management of PSGN is symptomatic. If PSGN is not treated, the patient may develop chronic kidney disease. The main way to prevent PSGN is to treat group A streptococcal (GAS) infections by giving good coverage of antibiotic therapy to a patient who has primary GAS infections to prevent the development of the complication.
ABSTRACT
Quantum-dot cellular automata (QCA) as nanotechnology is a pledging contestant that has incredible prospective to substitute complementary metal-oxide-semiconductor (CMOS) because of its superior structures such as intensely high device thickness, minimal power depletion with rapid operation momentum. In this study, the dataset of average output polarization (AOP) for fundamental reversible logic circuits is organized as presented in (Abdullah-Al-Shafi and Bahar, 2017; Bahar et al., 2016; Abdullah-Al-Shafi et al., 2015; Abdullah-Al-Shafi, 2016) [1-4]. QCADesigner version 2.0.3 has been utilized to survey the AOP of reversible circuits at separate temperature point in Kelvin (K) unit.
ABSTRACT
Clinical reports of symptomatic intraocular metastasis as the initial presentation of lung cancer are rare. We report the case of a 49-year-old female patient who presented with loss of vision due to choroidal metastases as the initial manifestation of her disseminated lung cancer. This particular patient was referred to us from ophthalmology department as a case of choroidal metastases from unknown primary. Detailed evaluation at our department helped detect the primary to be a nonsmall cell carcinoma of the right lung, which had multiple distant metastases.
Subject(s)
Adenocarcinoma/secondary , Choroid Neoplasms/pathology , Choroid Neoplasms/secondary , Lung Neoplasms/pathology , Lung/diagnostic imaging , Thorax/diagnostic imaging , Vision Disorders/diagnostic imaging , Vision, Low/diagnostic imaging , Adenocarcinoma/therapy , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Female , Fluorescein Angiography , Humans , Lung Neoplasms/therapy , Middle Aged , Neoplasm Metastasis , Tomography, X-Ray Computed , Ultrasonography , Vision Disorders/etiology , Vision, Low/etiologyABSTRACT
Abdominal and vaginal hysterectomies are the two main operative modalities for various uterine conditions; however the indications for selecting a particular procedure in any setting may not be optimally defined. The present study was done with the objective to study the comparative risks of complications of abdominal and vaginal hysterectomies during intra-operative and post-operative period thereby improve the proportion of hysterectomies done vaginally. This randomized comparative study was carried out in the Department of Gynaecology and Obstetrics, Bangabandhu Sheikh Mujib Medical University, during the period from January 2012 to December 2012. Sixty subjects were equally divided into vaginal hysterectomy (Group A) and abdominal hysterectomy (Group B), thirty in each group for non-prolapsed cases with good uterine mobility and uterine size less than 12 weeks. Intra-operative blood loss, mean operating time was more in Group A than in Group B (250 ml, 72.97 ± 9.27 min) and (200 ml, 55.27 ± 1.80 min) respectively. Postoperative fever (17% & 7%), bleeding requiring transfusion (72% & 28%) and abdominal wound infection (13%, 0%) was more common in Group A as compared to Group B. From the study results it can be concluded that patients requiring hysterectomy for benign non prolapsed cases be offered the option of vaginal route which is less invasive, minimal or no complications, more economical and effective. In our centre, it is likely to replace abdominal hysterectomy as the operation of choice.
Subject(s)
Hysterectomy/methods , Uterine Diseases/surgery , Uterine Prolapse , Adult , Bangladesh , Blood Loss, Surgical , Blood Transfusion , Female , Humans , Hysterectomy, Vaginal/methods , Middle Aged , Postoperative Complications , Treatment OutcomeABSTRACT
(99m)Tc-Methylene diphosphonate (MDP) triple phase bone scintigraphy (BS) has a role in early diagnosis of Kienbock's disease, especially when the X-ray is negative. Early diagnosis can result in prompt management of the patient since wrist pain in older individuals due to aging may go unnoticed or be due to other diagnoses with the production of greater damage and eventually a worse prognosis. Herein, we present a case report of a 29-year-old female with Kienbock's disease in whom the X-ray was negative and MRI incorrect. The (99m)Tc-MDP SPECT/CT BS helped the diagnosis of the disease in an early stage (stage 1) and had a clinical impact on the patient's management.
Subject(s)
Lunate Bone/diagnostic imaging , Osteonecrosis/diagnostic imaging , Single Photon Emission Computed Tomography Computed Tomography/methods , Adult , Early Diagnosis , Female , Humans , Osteonecrosis/therapy , Radiopharmaceuticals , Technetium Tc 99m MedronateABSTRACT
Primary peritoneal serous carcinoma (PPSC) is a rare primary malignancy that diffusely involves the peritoneum, indistinguishable clinically and histopathologically from primary serous ovarian carcinoma. The origin of PPSC has not been well characterized. Here we present a case of PPSC diagnosed in ultrasonography-guided fine needle aspiration cytology (FNAC) in a 76- old female presenting with ascites, abdominal pain, distension and constipation. PPSC is an unusual tumour but cytomorphology is distinctive enough to diagnose preoperatively. In the case report hereby described PPSC is an inoperable malignancy, hence chemotherapy and palliative care are the only offered treatment.
ABSTRACT
We report experimental evidence of a remarkable spontaneous time-reversal symmetry breaking in two-dimensional electron systems formed by atomically confined doping of phosphorus (P) atoms inside bulk crystalline silicon (Si) and germanium (Ge). Weak localization corrections to the conductivity and the universal conductance fluctuations were both found to decrease rapidly with decreasing doping in the Si:P and Ge:P delta layers, suggesting an effect driven by Coulomb interactions. In-plane magnetotransport measurements indicate the presence of intrinsic local spin fluctuations at low doping, providing a microscopic mechanism for spontaneous lifting of the time-reversal symmetry. Our experiments suggest the emergence of a new many-body quantum state when two-dimensional electrons are confined to narrow half-filled impurity bands.
Subject(s)
Electrons , Germanium/chemistry , Models, Chemical , Silicon/chemistry , Electric Conductivity , Phosphorus/chemistry , Quantum TheorySubject(s)
Fluorodeoxyglucose F18 , Heart Diseases/diagnosis , Heart Neoplasms/diagnosis , Lymphoma, Non-Hodgkin/diagnosis , Multimodal Imaging , Positron-Emission Tomography , Radiopharmaceuticals , Thrombosis/diagnosis , Tomography, X-Ray Computed , Adult , Heart Diseases/etiology , Heart Neoplasms/complications , Humans , Lymphoma, Non-Hodgkin/complications , Male , Neoplasm Staging , Thrombosis/etiologyABSTRACT
Many factors, including relatively young age of thyroid cancer diagnoses and improved survival, have led to increased concerns about the occurrence of second primary malignancies. This paper describes the pattern of occurrence of second primary malignancies in patients who were treated for malignant thyroid neoplasms in an Indian hospital. There were 21 affected patients of the approximately 4500 seen over 25 years. Most of the second primary cancers are solid tumors, and when nonthyroid cancers are the second tumors, ductal carcinoma of the female breast is the most common. Most of these tumors have very short detection intervals (including synchronous occurrences), suggesting that therapy with internal radiation was not contributory to the tumor development. When thyroid malignancies were the second primary cancers, they usually follow radiotherapy to the head and neck region for treatment of the first primary tumor and tend to be of aggressive histologic types than the common well differentiated thyroid carcinomas.
Subject(s)
Breast Neoplasms/epidemiology , Neoplasms, Second Primary/epidemiology , Thyroid Neoplasms/epidemiology , Adult , Aged , Female , Humans , India/epidemiology , Male , Middle Aged , Prevalence , Retrospective Studies , Risk FactorsSubject(s)
Epithelioid Cells/pathology , Gastrointestinal Stromal Tumors/pathology , Intestinal Neoplasms/pathology , Intussusception/diagnosis , Jejunum/pathology , Proto-Oncogene Proteins c-kit/metabolism , Aged , Epithelioid Cells/metabolism , Female , Gastrointestinal Stromal Tumors/metabolism , Humans , Intestinal Neoplasms/metabolism , Intussusception/metabolism , Jejunum/metabolism , PrognosisABSTRACT
Alphaherpesviruses are widespread in the human population, and include herpes simplex virus 1 (HSV-1) and 2, and varicella zoster virus (VZV). These viral pathogens cause epithelial lesions, and then infect the nervous system to cause lifelong latency, reactivation, and spread. A related veterinary herpesvirus, pseudorabies (PRV), causes similar disease in livestock that result in significant economic losses. Vaccines developed for VZV and PRV serve as useful models for the development of an HSV-1 vaccine. We present full genome sequence comparisons of the PRV vaccine strain Bartha, and two virulent PRV isolates, Kaplan and Becker. These genome sequences were determined by high-throughput sequencing and assembly, and present new insights into the attenuation of a mammalian alphaherpesvirus vaccine strain. We find many previously unknown coding differences between PRV Bartha and the virulent strains, including changes to the fusion proteins gH and gB, and over forty other viral proteins. Inter-strain variation in PRV protein sequences is much closer to levels previously observed for HSV-1 than for the highly stable VZV proteome. Almost 20% of the PRV genome contains tandem short sequence repeats (SSRs), a class of nucleic acids motifs whose length-variation has been associated with changes in DNA binding site efficiency, transcriptional regulation, and protein interactions. We find SSRs throughout the herpesvirus family, and provide the first global characterization of SSRs in viruses, both within and between strains. We find SSR length variation between different isolates of PRV and HSV-1, which may provide a new mechanism for phenotypic variation between strains. Finally, we detected a small number of polymorphic bases within each plaque-purified PRV strain, and we characterize the effect of passage and plaque-purification on these polymorphisms. These data add to growing evidence that even plaque-purified stocks of stable DNA viruses exhibit limited sequence heterogeneity, which likely seeds future strain evolution.
Subject(s)
Alphaherpesvirinae/genetics , Genetic Variation , Herpesvirus 1, Suid/genetics , Microsatellite Repeats , Pseudorabies Vaccines/genetics , Alphaherpesvirinae/metabolism , Alphaherpesvirinae/pathogenicity , Amino Acid Sequence , Animals , Base Sequence , Genome, Viral , Herpesvirus 1, Human/genetics , Herpesvirus 3, Human/genetics , Herpesvirus Vaccines/genetics , Herpesvirus Vaccines/immunology , Humans , Molecular Sequence Data , Polymorphism, Genetic , Sequence Alignment , Sequence Analysis, DNA , Viral Proteins/geneticsABSTRACT
Cervical cancer is one of the few highly preventable cancers. The early detection and removal of precancerous cervical lesions effectively abolish the development of invasive cervical cancer. The Pap test has been the standard screening test in the Western world for the last five decades. Visual inspection of cervix with acetic acid (VIA) is currently more popular method of cervical cancer of screening test in low resource countries. Cervical cancer incidence and mortality have been reduced dramatically as a result of successful screening in many countries. Cancer cervix can be prevented through both primary prevention using human papilloma virus (HPV) vaccine and early detection using screening techniques. Several screening modalities are now available for early detection of cervical cancer and its precursor lesions. They all differ with regard to their test characteristics, feasibility and economic considerations. This review has different aspects of these screening modalities and provides different options considering mass application. In developed countries, Pap smear cytology is used for cervical cancer screening. But in low-resource country, like Bangladesh, it is too expensive and is not feasible. VIA, a non-cytological test is a simple and inexpensive test which can be provided by trained paramedical personnel with a short training. So VIA can be done in low-resource countries for screening of cervical cancer as an alternative to Pap smear cytology.
Subject(s)
Acetic Acid , DNA, Viral/isolation & purification , Developing Countries , Early Detection of Cancer/methods , Papillomaviridae , Uterine Cervical Neoplasms/prevention & control , Uterine Cervical Neoplasms/virology , Colposcopy , Female , Humans , Uterine Cervical Neoplasms/epidemiology , Uterine Cervical Neoplasms/pathologyABSTRACT
During normal pregnancy there is an increase in the maternal blood volume leading to portal hypertension with some changes in liver functions. However, in an apparently healthy woman without known liver cirrhosis or other advanced liver disease, severe oesophageal varices with along with repeated variceal bleeding during pregnancy is rare. In this paper we described a case of severe oesophageal variceal bleeding in a young woman without having any pre-existing liver pathology. Due to repeated pregnancy with short intervel bleeding the patient developed severe anaemia. Packed cell transfusion was done repeatedly and oesophageal variceal ligation (EVL) was done three times. In spite of these measures variceal bleeding continued and patient's condition was deteriorating progressively; so caesarean section was at 33rd week of gestation and a preterm but healthy baby was delivered. The puerperium was uneventful with no haematemesis and there was gradual improvement of the condition. A brief review of the literature on pregnancy with oesophageal varices is also presented.
Subject(s)
Pregnancy Complications , Pregnancy Outcome , Esophageal and Gastric Varices/surgery , Female , Gastrointestinal Hemorrhage/surgery , Humans , Hypertension, Portal/etiology , Ligation , Pregnancy , Pregnancy Complications/surgery , Reoperation , Young AdultSubject(s)
Syphilis/epidemiology , Age Distribution , Female , Humans , Incidence , Male , Pakistan/epidemiology , Prevalence , Sex DistributionABSTRACT
Pregnancy induced hypertension (PIH) is a major complication of pregnancy and is associated with high maternal and perinatal morbidity and mortality. The aim of this study was to investigate the possible causal association of PIH with maternal serum PAPP-A and urinary protein-creatinine ratio (UPCr) as well as to evaluate the usefulness of these two variables as predictive markers of PIH. A total 200 women of 8-16 weeks of pregnancy were enrolled in this study. All the patients were followed up till delivery for the development of pregnancy induced hypertension. Thirty patients were lost in the follow up, 3(1.76%) developed preeclampsia (PE) and 14(8.23%) gestational hypertension (GH). By a nested case-control design the 17 pregnancy induced hypertension cases were compared with 48 Controls with normal pregnancy outcome. Maternal serum PAPP-A was significantly lower in the pregnancy induced hypertension group compared to Control [mIU/ml, median (range) 1.8(0.70-4.1) vs. 5.45(2.7-10), p<0.001]. UPCr was significantly higher in the pregnancy induced hypertension group compared to Control (mg/mmol, mean+/-SD, 6.86+/-1.56 vs. 4.75+/-0.96, p<0.001). When tested as a predictive marker of pregnancy induced hypertension the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of maternal serum PAPP-A in the lowest 25th percentile were 82%, 95%, 87% and 93%. At 75th percentile the sensitivity, specificity, PPV and NPV of UPCr were 52%, 85%, 56% and 83% respectively.
Subject(s)
Creatinine/urine , Pre-Eclampsia/blood , Pre-Eclampsia/urine , Pregnancy Proteins/urine , Pregnancy-Associated Plasma Protein-A/metabolism , Adult , Biomarkers/blood , Biomarkers/urine , Female , Humans , Lipids/blood , Pre-Eclampsia/epidemiology , Predictive Value of Tests , Pregnancy , Pregnancy Outcome , Prospective Studies , Sensitivity and Specificity , Statistics, NonparametricABSTRACT
OBJECTIVE: Succinic semialdehyde dehydrogenase (SSADH) deficiency is an autosomal recessive disorder of GABA metabolism characterized by elevated levels of GABA and gamma-hydroxybutyric acid. Clinical findings include intellectual impairment, hypotonia, hyporeflexia, hallucinations, autistic behaviors, and seizures. Autoradiographic labeling and slice electrophysiology studies in the murine model demonstrate use-dependent downregulation of GABA(A) receptors. We studied GABA(A) receptor activity in human SSADH deficiency utilizing [(11)C]-flumazenil (FMZ)-PET. METHODS: FMZ binding was measured in 7 patients, 10 unaffected parents, and 8 healthy controls. Data analysis was performed using a reference region compartmental model, with time-activity curve from pons as the input function. Relative parametric binding potential (BP(ND)) was derived, with MRI-based pixel by pixel partial volume correction, in regions of interest drawn on coregistered MRI. RESULTS: In amygdala, hippocampus, cerebellar vermis, frontal, parietal, and occipital cortex, patients with SSADH deficiency had significant reductions in FMZ BP(ND) compared to parents and controls. Mean cortical values were 6.96 +/- 0.79 (controls), 6.89 +/- 0.71 (parents), and 4.88 +/- 0.77 (patients) (F ratio 16.1; p < 0.001). There were no differences between controls and parents in any cortical region. CONCLUSIONS: Succinic semialdehyde dehydrogenase (SSADH) deficient patients show widespread reduction in BZPR binding on [(11)C]-flumazenil-PET. Our results suggest that high endogenous brain GABA levels in SSADH deficiency downregulate GABA(A)-BZPR binding site availability. This finding suggests a potential mechanism for neurologic dysfunction in a serious neurodevelopmental disorder, and suggests that PET may be useful to translate studies in animal models to human disease.