Biochemical Abnormalities Associated With Sudden Infant Death Syndrome: A Case Report.

Sudden infant death is a complex event characterized by biochemical features that are difficult to understand in general settings. Herein, we present a case report of a three-month-old infant who succumbed to sudden infant death syndrome (SIDS), focusing on the biochemical abnormalities identified through post-mortem analysis. The infant, previously healthy and meeting developmental milestones, was found lifeless in the crib during sleep. An autopsy revealed no anatomical abnormalities or signs of external trauma, consistent with SIDS diagnosis. Biochemical analysis of SIDS continued after post-mortem samples revealed dysregulation in neurotransmitter pathways, particularly serotonin, within the brain stem. These findings suggest a potential disruption in serotonin signaling, which may contribute to the vulnerability of infants to sudden death during sleep. Furthermore, metabolic profiling revealed deficiencies in enzymes involved in mitochondrial energy metabolism, particularly those related to fatty acid oxidation. These metabolic disturbances may compromise cellular function and contribute to the pathogenesis of SIDS. Environmental factors were also explored, with analysis revealing elevated levels of nicotine metabolites in post-mortem samples, suggesting maternal smoking exposure during pregnancy. Nicotine and its derivatives have known effects on neurotransmitter systems, potentially exacerbating underlying biochemical vulnerabilities in susceptible infants. This case report underscores the complex interplay of biochemical factors in the pathogenesis of SIDS and highlights the importance of multidisciplinary approaches in unraveling its mysteries. Further research is warranted to elucidate the precise mechanisms underlying these biochemical abnormalities and to develop targeted interventions aimed at reducing the incidence of SIDS and safeguarding infant health.

Painful lower limb nodules as first symptom of resectable pancreatic acinar cell cancer: a case report.

BACKGROUND: Pancreatic panniculitis is characterized by subcutaneous fat necrosis and is a rare presentation of an underlying pancreatic disease, appearing in approximately 2-3% of all patients with a pancreatic disease. The nodules usually involve the lower extremities. Pancreatic panniculitis is commonly associated with acute or chronic pancreatitis, and occasionally with pancreatic cancer, especially acinar cell carcinoma. CASE PRESENTATION: A 77-year-old Caucasian woman with no significant medical history was referred to our center with multiple painful, itchy, and warm red/blue cutaneous nodules on the left lower leg. These skin lesions were consistent with the clinical diagnosis of panniculitis. The skin biopsy obtained showed a predominantly lobular panniculitis with fat necrosis of which the aspect was highly suspicious for pancreatic panniculitis. Further analysis revealed high lipase serum of > 3000 U/L (normal range < 60 U/L), and on computed tomography scan a mass located between the stomach and the left pancreas was seen. Endoscopic ultrasonography-guided fine-needle biopsy confirmed the diagnosis of acinar cell carcinoma. After discussing the patient in the pancreatobiliary multidisciplinary team meeting, laparoscopic distal pancreatectomy including splenectomy and en bloc wedge resection of the stomach due to tumor in-growth was performed. The cutaneous nodules on both legs disappeared 1-2 days after surgery. No long-term complications were reported during follow-up. One year after surgery, the patient presented with similar symptoms as preoperatively. Computed tomography scan showed local recurrence and distal metastases, which were subsequently confirmed by biopsy. She started with palliative folinic acid-fluorouracil-irinotecan-oxaliplatin chemotherapy but stopped after two cycles because of disease progression. The patient died 2 months later, 13 months after surgical resection. CONCLUSION: This case illustrates the importance of clinically recognizing cutaneous nodules and pathological recognizing the specific microscopic changes as sign of a (malignant) pancreatic disease.

Surgical Complications and Its Grading: A Literature Review.

The demand for improvement in healthcare delivery has been increasing. Thus, a standardized method allows quality assessment of data and its comparison between various institutions over time. Many attempts have been made to classify surgical complications before 1990; however, none of those attempts gained popularity and acceptance. Clavien and his colleagues started the wave by explaining negative outcomes on the basis of complications, failure to cure, and sequelae. Complications were primarily defined as "any deviation from the normal postoperative course". Since then, many such classification systems and grading systems have been introduced and studied for analyzing the post-operative complications. The purpose of this study was to review the revolution in the classification systems for surgical complications, its validation, and to analyze the results of various qualitative indicators for post-operative complications obtained by using these classification systems. A global set of keywords were built such as "grading of surgical complications", "abdominal surgery", "classification of surgical complications", and the "Clavien Dindo Classification". A literature review was done using PubMed, Medline, and Google Scholar. A list of reference articles concerning the literature on classification systems for surgical complications was manually analyzed from the year 1992 and the data was summarized.

Wild bees respond differently to sampling traps with vanes of different colors and light reflectivity in a livestock pasture ecosystem.

Wild bees are important pollinators and monitoring their abundance and diversity is necessary to develop conservation protocols. It is imperative to understand differences in sampling efficiency among different trap types to help guide monitoring efforts. This study used a new vane trap design to collect bees in a livestock pasture ecosystem and examined the impact of six different vane colors on wild bee sampling. We recorded 2230 bees comprising 49 species and five families. The most abundant species were Augochlorella aurata (25.8%), Lasioglossum disparile (18.3%), Lasioglossum imitatum (10.85%), Agapostemon texanus (10.8%), Melissodes vernoniae (9.9%) and Halictus ligatus (4.7%). Traps with bright blue vanes captured the greatest number and diversity of bees as compared to traps with bright yellow, dark blue, dark yellow, and purple vanes. Red vanes had the lowest captures rates of individuals and species. Different colors were associated with different bee species arrays and only nine species were found in all vane color types. Vanes with higher light reflectance properties (within 400-600 nm range) attracted the greatest number of bees. These results show that different light wavelengths and reflectivity of vane traps influence bee capture rates, and such findings can help optimize bee sampling methods in different ecosystems.

Biology, Genetic Diversity, and Conservation of Wild Bees in Tree Fruit Orchards.

Different species of bees provide essential ecosystem services by pollinating various agricultural crops, including tree fruits. Many fruits and nuts depend on insect pollination, primarily by wild and managed bees. In different geographical regions where orchard crops are grown, fruit growers rely on wild bees in the farmscape and use orchard bees as alternative pollinators. Orchard crops such as apples, pears, plums, apricots, etc., are mass-flowering crops and attract many different bee species during their bloom period. Many bee species found in orchards emerge from overwintering as the fruit trees start flowering in spring, and the active duration of these bees aligns very closely with the blooming time of fruit trees. In addition, most of the bees in orchards are short-range foragers and tend to stay close to the fruit crops. However, the importance of orchard bee communities is not well understood, and many challenges in maintaining their populations remain. This comprehensive review paper summarizes the different types of bees commonly found in tree fruit orchards in the fruit-growing regions of the United States, their bio-ecology, and genetic diversity. Additionally, recommendations for the management of orchard bees, different strategies for protecting them from multiple stressors, and providing suitable on-farm nesting and floral resource habitats for propagation and conservation are discussed.

Color of Pan Trap Influences Sampling of Bees in Livestock Pasture Ecosystem.

The decline in insect pollinators has increased the importance of accurately monitoring pollinator diversity and abundance over time. Sampling techniques include the use of passive insect traps such as pan traps, yet there is still discussion over their utility and effectiveness in different ecosystems. The objective was to examine four different colors of pan traps (blue, green, yellow, and purple) for their utility in sampling bees in native forages rotationally grazed by sheep and to compare the relative abundance, richness, similarity, and community assemblage patterns among the four trap colors. Most bees were from the Halictidae family (89%). The most abundant species were Lasioglossum imitatum (42.2%), Augochlorella aurata (8.3%), L. subviridatum (6.8), Agapostemon texanus (6.4), and L. birkmani (4.1%). Blue color traps exhibited the highest rates of bee capture and species accumulation. Purple and yellow colored traps were moderately effective in capturing bees, while the green color pan traps were least effective. Similarly, observed and extrapolated species richness was highest in blue trap, followed by purple, yellow, and green. Notably, the blue trap captured the highest number of unique species, followed by purple, yellow and green traps. Considering the total number of insects collected (including bees and other insects), yellow and green traps captured a significantly higher number of insects than other colored traps. The light reflectance from blue, purple, green and yellow pan traps had peaks at ~450, 400, 550, and 600 nm, respectively. Since different insects respond to different light intensities, wavelengths, and reflectivity, these results could be used to guide future trapping protocols targeting certain insect groups in livestock pasture and similar ecosystems.

Evaluation of Serum and Urinary Neopterin Levels as a Biomarker for Occupational Exposure to Crystalline Silica.

BACKGROUND: Crystalline silica is a commonly used mineral in various industries and construction activities, and it is so important introducing potential biomarkers to identify early indicators of biological effects in its high-risk occupational exposures. AIM: The present study was aimed to assess the blood and urinary neopterin as an early biomarker of exposure in the workers of an insulator manufacturing plant who are exposed to crystalline silica. SUBJECTS AND METHODS: This analytical descriptive study was done among two groups of exposed workers (n = 55) and unexposed office workers (n = 38) of an insulator manufacturing plant. Statistical software R was used to determine sample size and select the participants by random sampling among nonsmoker workers. Sampling of airborne silica in breathing zone of participants was done based on the National Institute for Occupational Safety and Health method 7601. The urinary and blood samples were collected and prepared for analysis by high-performance liquid chromatography to determine the level of urinary and serum neopterin. All of the statistical analyses were carried out using SPSS 22. RESULTS: The airborne silica concentration was significantly different between two exposed and unexposed groups (P < 0.001, 0.27 [0.11] vs. 0.0028 [0.0006] mg/m3, respectively). The urinary neopterin in exposed group is significantly higher than the unexposed one (P < 0.001, 97.67 [30.24] vs. 55.52 [2.18] µmol/mol creatinine, respectively). Neopterin level of serum in exposed group is higher than the unexposed group, and there is a significant difference between them (P < 0.001, 6.90 [2.70] vs. 2.20 [1.20] nmol/l, respectively). The positive significant correlations were found between silica exposure concentration with urinary and serum neopterin (P < 0.001, r = 0.36 and 0.59, respectively). CONCLUSIONS: Considering the sensitively and easily measurement of neopterin in biological fluid and also the statistically significant positive relationships which were found between the airborne silica concentration and neopterin levels in the present study, the serum and urinary neopterin levels can be considered the potential biomarkers of silica exposure for doing further comprehensive studies in this area.

mtDNA variation of the critically endangered hawksbill turtle (Eretmochelys imbricata) nesting on Iranian islands of the Persian Gulf.

Genetic diversity of sea turtles (hawksbill turtle) was studied using sequencing of mitochondrial DNA (mtDNA, D-loop region). Thirty dead embryos were collected from the Kish and Qeshm Islands in the Persian Gulf. Analysis of sequence variation over 890 bp of the mtDNA control region revealed five haplotypes among 30 individuals. This is the first time that Iranian haplotypes have been recorded. Nucleotide and haplotype diversity was 0.77 and 0.001 for Qeshm Island and 0.64 and 0.002 for Kish Island, respectively. Total haplotype diversity was calculated as 0.69, which demonstrates low genetic diversity in this area. The data also indicated very high rates of migration between the populations of these two islands. A comparison of our data with data from previous studies downloaded from a gene bank showed that turtles of the Persian Gulf migrated from the Pacific and the Sea of Oman into this area. On the other hand, evidence of migration from populations to the West was not found.

High levels of protein C are determined by PROCR haplotype 3.

BACKGROUND: Genetic determinants of plasma levels of protein C (PC) are poorly understood. Recently, we identified a locus on chromosome 20 determining high PC levels in a large Dutch pedigree with unexplained thrombophilia. Candidate genes in the LOD-1 support interval included FOXA2, THBD and PROCR. OBJECTIVES: To examine these candidate genes and their influence on plasma levels of PC. PATIENTS/METHODS: Exons, promoter and 3'UTR of the candidate genes were sequenced in 12 family members with normal to high PC levels. Four haplotypes of PROCR, two SNPs in the neighboring gene EDEM2 and critical SNPs encountered during resequencing were genotyped in the family and in a large group of healthy individuals (the Leiden Thrombophilia Study (LETS) controls). Soluble endothelial protein C receptor (sEPCR) and soluble thrombomodulin (sTM) plasma levels were measured in the family. RESULTS: PROCR haplotype 3 (H3) and FOXA2 rs1055080 were associated with PC levels in the family but only PROCR H3 was also associated with plasma levels in the healthy individuals. Carriers of both variants had higher PC levels than carriers of only PROCR H3 in the family but not in healthy individuals, suggesting that a second determinant is present. EDEM2 SNPs were associated with PC levels, but their effect was small. PC and sEPCR levels were associated in both studies. sTM was not associated with variations of THBD or PC levels. CONCLUSIONS: Chromosome 20 harbors genetic determinants of PC and sEPCR levels and the analysis of candidate genes suggests that the PROCR locus is responsible.

Risk factors of arterial cardiovascular complications in patients with prior venous thromboembolism.

BACKGROUND: The effect of cardiovascular risk factors (CVRs) and thrombophilic defects on the risk of arterial cardiovascular complications in patients with prior venous thromboembolism (VTE) is unclear. OBJECTIVE: We investigated whether the risk of arterial cardiovascular complications is increased after VTE and whether CVRs and thrombophilic defects influence this risk. METHODS: Subjects were selected from three family cohorts of probands with VTE or arterial cardiovascular complication before the age of 50 and thrombophilic defects (i.e. hyperhomocysteinaemia, prothrombin G20210A or elevated FVIII). For this analysis, probands with arterial cardiovascular complications before inclusion and their relatives as well as relatives without the studied thrombophilic defects were excluded. We calculated the incidence of arterial cardiovascular complications (e.g. myocardial infarction, ischaemic stroke, transient ischaemic attack or peripheral arterial disease) in subjects with and without VTE and adjusted the relative risk for at least one CVR, two or more thrombophilic defects and quintiles of a propensity score (considering risk factors conditional to VTE history). RESULTS: 861 subjects were included, of whom 399 had experienced VTE before inclusion. Twelve arterial cardiovascular complications occurred in subjects with and nine in subjects without VTE history. Hence the annual incidence was 1.0 (95% CI 0.5 to 1.7) and 0.7 (0.3 to 1.2) in subjects with and without VTE (RR 1.5, 0.6 to 3.6). Adjusting for possible confounders did not change this relative risk. CONCLUSION: The mildly elevated risk of arterial cardiovascular complications in patients with prior VTE appears to be independent of cardiovascular risk factors and thrombophilic defects.