Abnormal Intraepidermal Nerve Fiber Density in Disease: A Scoping Review.

Background: Intraepidermal nerve fiber density (IENFD) has become an important biomarker for neuropathy diagnosis and research. The consequences of reduced IENFD can include sensory dysfunction, pain, and a significant decrease in quality of life. We examined the extent to which IENFD is being used as a tool in human and mouse models and compared the degree of fiber loss between diseases to gain a broader understanding of the existing data collected using this common technique. Methods: We conducted a scoping review of publications that used IENFD as a biomarker in human and non-human research. PubMed was used to identify 1,004 initial articles that were then screened to select articles that met the criteria for inclusion. Criteria were chosen to standardize publications so they could be compared rigorously and included having a control group, measuring IENFD in a distal limb, and using protein gene product 9.5 (PGP9.5). Results: We analyzed 397 articles and collected information related to publication year, the condition studied, and the percent IENFD loss. The analysis revealed that the use of IENFD as a tool has been increasing in both human and non-human research. We found that IENFD loss is prevalent in many diseases, and metabolic or diabetes-related diseases were the most studied conditions in humans and rodents. Our analysis identified 74 human diseases in which IENFD was affected, with 71 reporting IENFD loss and an overall average IENFD change of -47%. We identified 28 mouse and 21 rat conditions, with average IENFD changes of -31.6 % and - 34.7% respectively. Additionally, we present data describing sub-analyses of IENFD loss according to disease characteristics in diabetes and chemotherapy treatments in humans and rodents. Interpretation: Reduced IENFD occurs in a surprising number of human disease conditions. Abnormal IENFD contributes to important complications, including poor cutaneous vascularization, sensory dysfunction, and pain. Our analysis informs future rodent studies so they may better mirror human diseases impacted by reduced IENFD, highlights the breadth of diseases impacted by IENFD loss, and urges exploration of common mechanisms that lead to substantial IENFD loss as a complication in disease.

Strong Neutron Pairing in core+4n Nuclei.

The emission of neutron pairs from the neutron-rich N=12 isotones ^{18}C and ^{20}O has been studied by high-energy nucleon knockout from ^{19}N and ^{21}O secondary beams, populating unbound states of the two isotones up to 15 MeV above their two-neutron emission thresholds. The analysis of triple fragment-n-n correlations shows that the decay ^{19}N(-1p)^{18}C^{*}→^{16}C+n+n is clearly dominated by direct pair emission. The two-neutron correlation strength, the largest ever observed, suggests the predominance of a ^{14}C core surrounded by four valence neutrons arranged in strongly correlated pairs. On the other hand, a significant competition of a sequential branch is found in the decay ^{21}O(-1n)^{20}O^{*}→^{18}O+n+n, attributed to its formation through the knockout of a deeply bound neutron that breaks the ^{16}O core and reduces the number of pairs.

Quasifree (p, 2p) Reactions on Oxygen Isotopes: Observation of Isospin Independence of the Reduced Single-Particle Strength.

Quasifree one-proton knockout reactions have been employed in inverse kinematics for a systematic study of the structure of stable and exotic oxygen isotopes at the R^{3}B/LAND setup with incident beam energies in the range of 300-450 MeV/u. The oxygen isotopic chain offers a large variation of separation energies that allows for a quantitative understanding of single-particle strength with changing isospin asymmetry. Quasifree knockout reactions provide a complementary approach to intermediate-energy one-nucleon removal reactions. Inclusive cross sections for quasifree knockout reactions of the type ^{A}O(p,2p)^{A-1}N have been determined and compared to calculations based on the eikonal reaction theory. The reduction factors for the single-particle strength with respect to the independent-particle model were obtained and compared to state-of-the-art ab initio predictions. The results do not show any significant dependence on proton-neutron asymmetry.

Consumption of psychoactive substances in educational institutions: an inquiry into the state of affairs in the schools of Córdoba.

This study describes and analyses the consumption of psychoactive substances in educational institutions, the school environment conditions and its relation to the school standing of the students. In the first stage, a quantitative evaluation was performed, based on the records of the Second National Survey of Secondary School Students carried out in Córdoba in 2005; the second stage used a qualitative approach. A multistage probabilistic sample of 4593 students was used for the quantitative assessment. The analysis comprised summary measurements, multivariate and factorial correspondence analysis, in all cases with a significance level of p < 0.05. For the qualitative stage, an ethnographic approach was applied. The state schools were chosen using an intentional, cumulative and sequential sampling method. Ten in-depth interviews were carried out to gather qualitative data that was analyzed using the comparative constant method. Results evince that consumption is lower among morning-shift students and that grade repetition and behavior problems are associated to consumption of illegal drugs. Furthermore, it was detected that students in night-shift schools with low academic and disciplinary demand standards have a higher probability of consumption. It is clear that as academic standards decrease, consumption increases.

Consumption of psychoactive substances in educational institutions: an inquiry into the state of affairs in the schools of Córdoba / Consumption of psychoactive substances in educational institutions: an inquiry into the state of affairs in the schools of Córdoba.

This study describes and analyses the consumption of psychoactive substances in educational institutions, the school environment conditions and its relation to the school standing of the students. In the first stage, a quantitative evaluation was performed, based on the records of the Second National Survey of Secondary School Students carried out in Córdoba in 2005; the second stage used a qualitative approach. A multistage probabilistic sample of 4593 students was used for the quantitative assessment. The analysis comprised summary measurements, multivariate and factorial correspondence analysis, in all cases with a significance level of p < 0.05. For the qualitative stage, an ethnographic approach was applied. The state schools were chosen using an intentional, cumulative and sequential sampling method. Ten in-depth interviews were carried out to gather qualitative data that was analyzed using the comparative constant method. Results evince that consumption is lower among morning-shift students and that grade repetition and behavior problems are associated to consumption of illegal drugs. Furthermore, it was detected that students in night-shift schools with low academic and disciplinary demand standards have a higher probability of consumption. It is clear that as academic standards decrease, consumption increases.

Mortalidad por trastornos mentales y por causas externas: análisis de una Década en Argentina / Mortality due to mental disorders and external causes: analysis of a decade in Argentina

Objetivo: analizar las tasas de mortalidad de Trastornos Mentales y del Comportamiento (TMyC) y de las Causas Externas (CE) en las Estadísticas Vitales de Argentina, periodo 2000-2009.Metodología: se utilizó las bases de datos de defunciones, Argentina, años 2000 a 2009, de la Dirección de Estadísticas e Información en Salud Ministerial. Se construyeron tasas generales y específicas. Las estimaciones poblacionales, se obtuvieron a partir del aplicativo AGEINT. Según la distribución de la variable, se utilizó análisis de la varianza o test no paramétricos. Resultados: se observa un comportamiento disímil de la tasa de mortalidad por TMyC según sexo, pero con un comportamiento similar por cada año. Los TMyC y las CE, comprometen a la población adulta del país, con tasas mayores en el grupo de varones.Conclusión: tener en cuenta el impacto de los TMyC y CE, permite diseñar políticas públicas en salud adecuadas a las realidades de cada contexto

Objective: To analyze mortality rates due to mental and behavioral disorders (MBD) and external causes (EC) using Vital Statistics of Argentina, 2000-2009.Methods: Mortality data 2000-2009 were obtained from the Bureau of Statistics and Information, Ministry of Health, Argentina. General and specific rates were set up. Population estimates were obtained from the AGEINT application. According to the distribution of the variable, analysis of variance or nonparametric tests were used.Results: Dissimilar MBD mortality rates according to sex were observed, but with a similar pattern each year. The MBD and EC affect the adult population of the country, with higher rates in the male group.Conclusion: Taking into account the impact of MBD and EC, allows the design of public policies suitable to the realities of each health context

Análisis de los indicadores de salud infantil en argentina, en relacion a los objetivos de desarrollo del milenio / Analysis of child health indicators in Argentina, in connection with millennium development goals set by the United Nations / Análise dos indicadores de saúde infantil naArgentina, em relação com os objecivos do milniotraçados pela organização das Nações Unidas

Objetivos: A la luz del 4° Objetivo de Desarrollo del Milenio trazado por Naciones Unidas, este trabajo tuvo como objetivos analizar la epidemiología de la mortalidad de menores de 1 año y menores de 5 años en la Argentina entre los años 1990 y 2011, y describir la cobertura de vacunación antisarampionosa en niños de 1 año entre 1990 y 2009.Método: Se midieron indicadores epidemiológicos con datos nacionales de fuentes secundarias: Tasa de mortalidad infantil y tasa de mortalidad en menores de 5 años; y porcentaje de cobertura de vacunación antisarampionosa en Argentina.Resultados: Los resultados muestran un descenso del 54,2% en la tasa de mortalidad infantil, y del 54,5% en la mortalidad de menores de 5 años. Las causas de muerte más frecuentes durante los primeros 5 años de vida están asociadas principalmente a las afecciones perinatales y anomalías congénitas. En relación a la cobertura de vacunación antisarampionosa, se observa una evolución positiva de ese indicador llegando en el año 2009 al 100% de cobertura.Conclusiones: La mortalidad infantil representa un indicador indiscutible de muertes evitables e innecesarias, que pueden prevenirse mediante acciones sanitarias y políticas sociales orientadas a influir sobre los determinantes sociales y económicos, en ese sentido se torna indispensable avanzar hacia la reducción prevista entre los compromisos que las Naciones Unidas establecieron en el marco de los Objetivos de Desarrollo del Milenio

Aim: In view of the 4th Millennium Development Goal set by the UN, this study aimed at analyzing the epidemiology of mortality of children under age 1 and under age 5 in Argentina between 1990 and 2009. Methods: Epidemiological indicators were measured using national data from secondary sources: Infant mortality rate and mortality rate in children under 5; and percentage of coverage in measles vaccination in Argentina Results: Results show a 54.2% decrease in infant mortality rate, and 54.5% in mortality of children under 5. The most common causes of death during the first five years of life are usually associated to perinatal problems and congenital anomalies. In relation to measles vaccination coverage, there is a positive evolution of this indicator, reaching 100% coverage in 2009.Conclusions: Infant mortality represents an undeniable indicator of avoidable and unnecessary deaths that can be prevented by health actions and social policies designed to influence social and economic determinants. In this regard, it becomes essential to move towards the reduction considered among the commitments established by the United Nations within the framework of the Millennium Development Goals

Laparoscopic repair of incarcerated inguinal hernia. A safe and effective procedure to adopt in children.

BACKGROUND: The purpose of our retrospective study was to describe the efficacy and the advantages of laparoscopic approach to treat incarcerated inguinal hernia (IIH) in pediatric patients. METHODS: In a 2-year period, 601 children underwent a laparoscopic inguinal hernia repair, 46 (7.6 %) of them presented an IIH. Our study will be focused on these 46 patients: 30 boys and 16 girls (age range 1 month-8 years). RESULTS: Twenty-one/46 hernias (45.6 %) were reduced preoperatively and then operated laparoscopically (RH), 25/46 (54.4 %) were irreducible and they were operated directly in laparoscopy (IRH). We have no conversions in our series. The length of surgery in RH group was in median 23 min and in IRH group was in median 30 min. Hospital stay was variable between 6 h and 3 days (median 36 h).With a minimum follow-up of 14 months, we had 2/46 recurrences (4.3 %). CONCLUSION: The laparoscopic approach to IIH appears easy to perform from the technical point of view. The 3 main advantages of laparoscopic approach are that all edematous tissue are surgically bypassed and the cord structures are not touched; the reduction is performed under direct visual control, and above all, an inspection of the incarcerated organ is performed at the end of procedure.

Polarization transfer of bremsstrahlung arising from spin-polarized electrons.

We report on a study of the polarization transfer between transversely polarized incident electrons and the emitted x rays for electron-atom bremsstrahlung. By means of Compton polarimetry we performed for the first time an energy-differential measurement of the complete properties of bremsstrahlung emission related to linear polarization, i.e., the degree of linear polarization as well as the orientation of the polarization axis. For the high-energy end of the bremsstrahlung continuum the experimental results for both observables show a high sensitivity on the initial electron spin polarization and prove that the polarization orientation is virtually independent of the photon energy.

Laparoscopic inguinal hernia repair in premature babies weighing 3 kg or less.

PURPOSE: This retrospective study aims to evaluate the feasibility, safety and complication rate of laparoscopic inguinal hernia repair for small babies weighing 3 kg or less. METHODS: A retrospective analysis was performed on the surgical charts of 67 infants (47 boys and 20 girls) weighing 3 kg or less who underwent laparoscopic hernia repair in a 3-year period. A regular 5-mm scope was used for visualization, and 2 or 3-mm instruments were used for the closure of the inner inguinal ring using 3/0 non-absorbable suture. The median weight at surgery was 2,600 g (range 1,450-3,000 g). All except three were premature. RESULTS: Of the 67 infants, 15 (22.3 %) presented with an irreducible hernia. In three cases of irreducible hernias, we also performed a transumbilical appendectomy at the end of the hernia repair. Minor problems related with anesthesia were noted in four cases. Hernia recurrence was observed in three patients (4.4 %). No cases of testicular atrophy occurred. In 10 boys, we observed 12 cases of high testes, only 4 testes requiring subsequent orchiopexy. CONCLUSIONS: Laparoscopic inguinal hernia repair for babies weighing 3 kg or less is feasible, safe and perhaps even less technically demanding than open inguinal herniotomy.

An update on the screening, diagnosis, management, and treatment of vitamin D deficiency in individuals with cystic fibrosis: evidence-based recommendations from the Cystic Fibrosis Foundation.

OBJECTIVE: The objective was to develop evidence-based clinical care guidelines for the screening, diagnosis, management, and treatment of vitamin D deficiency in individuals with cystic fibrosis (CF). PARTICIPANTS: The guidelines committee was comprised of physicians, registered dietitians, a pharmacist, a nurse, a parent of an individual with CF, and a health scientist, all with experience in CF. PROCESS: Committee members developed questions specific to vitamin D health in individuals with CF. Systematic reviews were completed for each question. The committee reviewed and graded the available evidence and developed evidence-based recommendations and consensus recommendations when insufficient evidence was available. Each consensus recommendation was voted upon by an anonymous process. CONCLUSIONS: Vitamin D deficiency is common in CF. Given the limited evidence specific to CF, the committee provided consensus recommendations for most of the recommendations. The committee recommends yearly screening for vitamin D status, preferably at the end of winter, using the serum 25-hydroxyvitamin D measurement, with a minimal 25-hydroxyvitamin D concentration of 30 ng/ml (75 nmol/liter) considered vitamin D sufficient in individuals with CF. Recommendations for age-specific vitamin D intake for all individuals with CF, form of vitamin D, and a stepwise approach to increase vitamin D intake when optimal vitamin D status is not achieved are delineated.

Coverage and use of insecticide-treated bed nets in households with children aged under five years in Liberia.

SETTING: St John's District, Grand Bassa County, Liberia. OBJECTIVES: In households with children aged <5 years, to examine the coverage and use of long-lasting insecticide-treated bed nets (LLINs), factors associated with non-use and the characteristics and conditions of bed nets. DESIGN: Cross-sectional study involving interviews with mothers and visual inspection of LLINs. RESULTS: Of 663 households visited, 492 (74%) had no LLIN and 135 (20%) had one LLIN. Of 171 households with LLINs, these were consistently used by 73 (43%) children. The main reasons for inconsistent use included LLINs being old or damaged, and LLINs generating too much heat for 20-30% of children. Visual inspection of LLINs in 130 households showed that 98% of LLINs were white, 20% were not hung above the child's sleeping place, 30% had holes, 84% were double-bed sized and 82% had been washed in the previous 6 months. CONCLUSION: Despite reports of 100% LLIN coverage in St John's District, this study showed that only a quarter of households had an LLIN, over half of the children used LLINs inconsistently and the LLINs had several deficiencies. More surveys should be conducted to determine the true coverage of LLINs in Liberia, and measures must be taken to improve the use of LLINs.

Measurement of the correlation between electron spin and photon linear polarization in atomic-field bremsstrahlung.

Atomic-field bremsstrahlung has been studied with a longitudinally polarized electron beam. The correlation between the initial orientation of the electron spin and the angle of photon polarization has been measured at the photon high energy tip region. In the time reversal this corresponds to a so-far unobserved phenomenon of production of longitudinally polarized electrons by photoionization of unpolarized atoms with linearly polarized photons. The results confirm the fully relativistic calculations for radiative recombination and suggest a new method for electron beam polarimetry.

The protective role of the pericellular matrix in chondrocyte apoptosis.

INTRODUCTION: This study was designed to quantify the role of the pericellular matrix (PCM) in chondrocyte apoptosis using chondrons, which are a cartilage functional unit including a chondrocyte and its associated PCM. METHODS: Chondrocytes and chondrons were enzymatically isolated from human articular cartilage and exposed to monosodium iodoacetate (MIA) and staurosporine for apoptosis induction. Chondrons were defined by the presence of type VI collagen, a basic component of the PCM. Apoptosis of chondrocytes and chondrons was measured with annexin V binding by flow cytometry and verified with terminal dUTP nick end-labeling staining. In a separate experiment, isolated chondrocytes were treated with soluble type VI collagen, before or after apoptosis induction with MIA, and cell death was measured by the activity of LDH and terminal dUTP nick end-labeling staining. RESULTS: Chondrocytes treated with MIA incurred 27% cell death, compared with 12% in chondrons. On treating with MIA, 9% of chondrocytes underwent apoptosis, compared with only 1.6% of chondrons. Similarly, staurosporine induced 13% apoptosis in chondrocytes, whereas it was 3% in chondrons. Preincubation of type VI collagen effectively prevented chondrocytes from MIA-induced cell death. After apoptosis was induced with MIA, however, treatment with type VI collagen failed to rescue chondrocytes from death. CONCLUSION: The PCM, a native microenvironment of chondrocytes, protects chondrocytes from apoptosis. Type VI collagen is a functional component of the PCM that contributes to the survival of chondrocytes.

Stent-free tubularized incised plate (TIP) repair of distal and mid-shaft hypospadias irrespective of age.

PURPOSE: Aim of this study was to report our experiences with tubularized incised plate (TIP) repair without placement of a postoperative urethral stent in 41 cases. PATIENTS AND METHODS: Since October 2005, we have performed TIP repair for distal penile hypospadias without using a postoperative urethral stent. A urethral stent is used intraoperatively for the tubularization of the neourethra and is removed at the end of the procedure. Follow-up included clinical examination and a structured telephone interview on parental satisfaction. RESULTS: The group included 41 boys, 60% with coronal or distal hypospadias and 40% with mid-shaft hypospadias (aged 6 months to 16 years, median: 3 years). In 7 cases, the prepuce was also reconstructed. There were 2 cases with fistula and one case of meatal stenosis. No glans dehiscence, severe bleeding, or wound infection was observed. No urinary retention requiring catheterization was observed, irrespective of age. All but one patient was discharged the day after surgery. Follow-up ranged from 8 to 48 months (average: 22 months). Most parents (87.5%) were satisfied or very satisfied. CONCLUSION: Based on our preliminary experiences, patient comfort and safety, parental satisfaction and the rate of complications seem to be promising with this technique.

Towards monitoring real-time cellular response using an integrated microfluidics-matrix assisted laser desorption ionisation/nanoelectrospray ionisation-ion mobility-mass spectrometry platform.

The combination of microfluidic cell trapping devices with ion mobility-mass spectrometry offers the potential for elucidating in real time the dynamic responses of small populations of cells to paracrine signals, changes in metabolite levels and delivery of drugs and toxins. Preliminary experiments examining peptides in methanol and recording the interactions of yeast and Jurkat cells with their superfusate have identified instrumental set-up and control parameters and online desalting procedures. Numerous initial experiments demonstrate and validate this new instrumental platform. Future outlooks and potential applications are addressed, specifically how this instrumentation may be used for fully automated systems biology studies of the significantly interdependent, dynamic internal workings of cellular metabolic and signalling pathways.

Laparoscopic inguinal herniorrhaphy in premature infants.

INTRODUCTION: We report the clinical, operative, and outcome results in 58 premature infants (with maximum weight of 5,000 g at time of surgery) undergoing laparoscopic herniorrhaphy. PATIENTS AND METHODS: This study was designed as a prospective, non-randomized single center feasibility study. The inclusion criteria were: symptomatic inguinal hernia, gestational age up to 37 weeks and maximum weight of 5,000 g at the time of surgery. Out of 58 premature infants (42 boys and 16 girls), 24 had bilateral, 20 had right-sided and 14 had left-sided hernias. 14 (24.1%) infants were operated on for an irreducible hernia. RESULTS: The median gestational age at birth was 33 weeks (range 23-37) and the median gestational age at operation was 41 weeks (range 33-52). The body weight at surgery ranged from 1,450 g to 5,000 g (median 3 900 g); 11 infants (19%) weighed less than 2 500 g. No intraoperative surgical complications occurred. Anesthesia complications were noted in 7 cases. At median follow-up of 25 months (range 6-51 months), there were 3 hernia recurrences in 2 infants (3.6%). In 5 boys, we observed high testes requiring subsequent orchiopexy. Regression analysis showed that the risk of undescended testes increased by 65.5% for every 1 kilo lower weight at surgery. CONCLUSION: Based on our early results, it seems that laparoscopic hernia repair in preterm infants and very low birth weight babies is a safe and feasible procedure and has some procedural benefits compared to the standard open technique.

An inflammatory myofibroblastic tumor of the stomach as a rare cause of gastric outlet obstruction in an 8-month-old infant.

Inflammatory myofibroblastic tumors (IMT) are a rare entity. Localization in the stomach is extremely seldom and almost exclusively seen in children. Invasive growth of IMT may lead to irresectability or recurrence. In an 8-month-old girl presented with repetitive vomiting for several days. Complete surgical resection of a gastric IMT was possible.

CD rats as an animal model in the experimental study of laparoscopic hernia repair.

PURPOSE: The aim of this study was to evaluate the technical feasibility and efficacy of a sutureless laparoscopic hernia repair in a small animal model. The objective was to occlude the processus vaginalis with biocompatible fleece and/or fibrin glue as an alternative to suturing. METHODS: Sixty-three male CD rats were randomly assigned to one of three groups. In group A (n=21), the internal inguinal ring was filled with 0.5 ml fibrin glue. The second group (B, n=21) also received fibrin glue, and a biocompatible fleece was placed on top. The third group consisted of control animals (C, n=21). Eleven rats in each group underwent laparoscopic surgery. The remaining rats were operated using an open technique, and the paraductal lipomas were resected in addition to inguinal ring closure. RESULTS: Complete closure of the internal hernia ring was not achieved in any of the rats, neither in the laparoscopic group nor in the open group or the control group. The paraductal lipoma grew back to its normal size, although resection of the lipoma was performed during the first procedure. CONCLUSION: The physiology of paraductal lipomas in this animal appears to make it an inadequate model for the study of laparoscopic inguinal hernia repair.