Microplastic in Dredged Sediments: From Databases to Strategic Responses.

Microplastics (MPs) accumulate in sediments, yet guidelines for evaluating MP risks in dredged sediments are lacking. The objective of this study was to review existing literature on MPs in sediments to improve fundamental knowledge of MP exposures and develop a publicly available database of MPs in sediments. Twelve percent of the reviewed papers (nine studies) included sediment core samples with MP concentrations generally decreasing with depth, peaking in the top 15 cm. The remaining papers evaluated surficial grab samples (0 to 15 cm depth) from various water bodies with MPs detected in almost every sample. Median MP concentrations (items/kg dry sediment) increased in this order: lakes and reservoirs (184), estuarine (263), Great Lakes nearshore areas and tributaries (290), riverine (410), nearshore marine areas (487), dredge activities (817), and harbors (948). Dredging of recurrent shoaling sediments could be expected to contain MPs at various depths with concentrations influenced by the time elapsed since the last dredging event. These results offer key insights into the presence and variability of MPs in dredged sediments, informing environmental monitoring and risk assessment strategies.

Observational study to estimate the proportion of surgical site infection following excision of ulcerated skin tumours (OASIS study).

BACKGROUND: Ulceration is a recognized risk factor for surgical site infection (SSI); however, the proportion of patients developing SSI after excision of an ulcerated skin cancer is unknown. AIM: To determine the proportion of participants with SSI after surgical excision of an ulcerated skin cancer. A secondary aim was to assess feasibility outcomes to inform the design of a randomized controlled trial to investigate the benefits and harms of perioperative antibiotics following excision of ulcerated tumours. METHODS: This was a multicentre, prospective, observational study of patients undergoing excision of an ulcerated skin cancer between March 2019 and March 2020. Prior to surgical excision, surface swabs of the ulcerated tumours of participants recruited from one centre were undertaken to determine organism growth. At 4 weeks after surgery, all participants were e-mailed or posted the Wound Healing Questionnaire (WHQ) to determine whether they had developed SSI. RESULTS: In total, 148 participants were recruited 105 (70.9%) males; mean ± SD age 77.1 ± 12.3 years. Primary outcome data were available for 116 (78.4%) participants, of whom 35 (30.2%) were identified as having an SSI using the WHQ with a cutoff score of 8, and 47 (40.5%) were identified with a cutoff score of 6. Using the modified WHQ in participants with wounds left to heal by secondary intention, 33 (28.4%) and 43 (37.1%) were identified to have SSI respectively. CONCLUSION: This prospective evaluation of SSI identified with the WHQ following excision of ulcerated skin cancers demonstrated a high proportion with SSI. The WHQ was acceptable to patients; however, further evaluation is required to ensure validity in assessing skin wounds.

Head and neck ultrasound: technical advances, novel applications and the role of elastography.

High-resolution ultrasound (US) provides superb anatomical detail in the superficial anatomy of the neck and has become the first-line imaging investigation for neck lumps and a crucial component of clinical pathways. In this article, a wide range of advances in neck US are described with a focus on the emerging role of ultrasound elastography. Selected examples of clinical utility are presented across a spectrum of scenarios with discussion of newer applications, service delivery, and training issues. The changing role of the neck ultrasound practitioner and the future of the technique in the head and neck are considered.

Does elastography reduce the need for thyroid FNAs?

OBJECTIVE: Ultrasound elastography (USE) assesses lesion stiffness by evaluating tissue distortion in response to stress; it is emerging as a potentially useful tool to augment the ultrasound characterisation of thyroid nodules. The aim of this study was to assess the accuracy of USE examination of thyroid nodules compared with pathological outcome, especially to determine whether USE could reliably detect benign nodules and reduce the numbers of ultrasound guided fine needle aspiration cytology (USgFNAC). DESIGN: Over a three-year period, thyroid nodules were initially characterised by B-mode ultrasound (US) findings. Where USgFNAC was indicated by clinical concern and/or the sonographic appearances, the lesion was then subjected to USE by an experienced operator prior to the USgFNAC. PATIENTS: 147 thyroid nodules were examined by USE and USgFNAC in 146 patients. MEASUREMENTS: The elastographic appearance was subjectively categorized at the time of the examination (soft, intermediate or hard) and subsequently compared with the cytological/histological outcome. RESULTS: A total of 122 nodules were non-neoplastic, 5 nodules were benign neoplasms, 10 nodules had indeterminate cytology and 10 were malignant neoplasms. The sensitivity of USE for malignancy was 90.0%, specificity was 79.6%, PPV was 24.3%, NPV was 99.1% and accuracy was 80.3%. CONCLUSION: Thyroid nodules that are soft at USE have a high likelihood of being non-neoplastic and subjective USE assessment of thyroid nodules by an experienced operator can be a useful means of avoiding USgFNAC for benign nodules. In contrast, we suggest that all nodules that are intermediate or hard on USE undergo USgFNAC.

CT staging of colorectal cancer: what do you find in the chest?

AIM: To clarify the chest computed tomography (CT) findings in patients with a new diagnosis of colorectal adenocarcinoma. MATERIALS AND METHODS: Patients diagnosed with colorectal cancer (CRC) over a 3-year period were retrospectively studied. All CT examinations were performed within a single NHS Trust using the same CT system and protocol. Two primary outcomes were assessed: the presence of pulmonary metastases and the identification of a significant, unexpected chest abnormality. RESULTS: Five hundred and fourteen out of 568 (90.5%) CRC patients underwent complete CT staging. Thirty-one patients (6%) had lung metastases, of which four (0.8%) were isolated. Three hundred and fifty-three (68.7%) had no evidence of pulmonary metastases, but 130 (25.3%) had indeterminate lung nodules (ILNs). The ILNs of 12 patients were subsequently confirmed as metastases on follow-up. A major non-metastatic finding (pulmonary embolism or synchronous primary malignancy) was found in 15/514 patients (3%). CONCLUSIONS: Thoracic CT altered the initial TNM stage in fewer than 1% of CRC patients, but the detection of significant incidental chest disease and the establishment of an imaging baseline are useful outcomes of this imaging strategy. One-quarter of all staging examinations demonstrated ILNs.

Ultrasonography for suspected deep vein thrombosis: how useful is single-point augmentation?

AIMS: To assess the role of single-point augmentation of spectral Doppler flow in the diagnosis of acute deep vein thrombosis (DVT). Secondary objectives included identifying the augmentation response in non-DVT diagnoses. METHODS: Patients attending the ultrasound departments of two hospitals for investigation of suspected acute DVT during an 8-month period were recruited to the study group. Spectral Doppler assessment of the superficial femoral vein was recorded during Valsalva and calf compression manoeuvres in the asymptomatic and symptomatic legs. The Doppler waveforms from the symptomatic limb were characterized as "normal" or "abnormal" by the operator. Standard compression ultrasonography of the symptomatic leg was then performed with the presence of DVT or an alternative diagnosis documented. RESULTS: One hundred and sixty-seven patients underwent ultrasound examinations using the study methodology. Nine patients were subsequently excluded due to bilateral DVT or inability to tolerate calf compression. The mean age of the remaining 158 patients was 65.4 years with 28 DVTs identified (18% of patients). Calf compression elicited a normal response in 118/130 of non-DVT examinations (specificity 91%) and an abnormal response in 18/28 DVT examinations (sensitivity 64%). Diminished or absent augmentation was identified in alternative diagnoses that included haematoma and Baker's cyst. CONCLUSIONS: This study demonstrates that single-point augmentation has a low sensitivity in suspected lower-limb DVT, and that the majority of undetected DVTs are isolated to the calf veins. An abnormal augmentation response is a poor predictor of lower-limb DVT as alternative diagnoses can produce diminished or reduced augmentation. Therefore, single-point augmentation does not add to the standard compression ultrasound examination for suspected DVT and should not be routinely performed.

The utility of Google Trends data to examine interest in cancer screening.

OBJECTIVES: We examined the utility of January 2004 to April 2014 Google Trends data from information searches for cancer screenings and preparations as a complement to population screening data, which are traditionally estimated through costly population-level surveys. SETTING: State-level data across the USA. PARTICIPANTS: Persons who searched for terms related to cancer screening using Google, and persons who participated in the Behavioral Risk Factor Surveillance System (BRFSS). PRIMARY AND SECONDARY OUTCOME MEASURES: (1) State-level Google Trends data, providing relative search volume (RSV) data scaled to the highest search proportion per week (RSV100) for search terms over time since 2004 and across different geographical locations. (2) RSV of new screening tests, free/low-cost screening for breast and colorectal cancer, and new preparations for colonoscopy (Prepopik). (3) State-level breast, cervical, colorectal and prostate cancer screening rates. RESULTS: Correlations between Google Trends and BRFSS data ranged from 0.55 for ever having had a colonoscopy to 0.14 for having a Pap smear within the past 3 years. Free/low-cost mammography and colonoscopy showed higher RSV during their respective cancer awareness months. RSV for Miralax remained stable, while interest in Prepopik increased over time. RSV for lung cancer screening, virtual colonoscopy and three-dimensional mammography was low. CONCLUSIONS: Google Trends data provides enormous scientific possibilities, but are not a suitable substitute for, but may complement, traditional data collection and analysis about cancer screening and related interests.

The hypothermic response of mice to delta-9-tetrahydrocannabinol is enhanced by chlorpromazine, thioxanthenes, alpha-adrenoceptor antagonists and pentolinium but not by SCH 23390 or sulpiride.

Chlorpromazine, given either subcutaneously (0.375 mg/kg) or unilaterally into the preoptic/anterior hypothalamic area through a chronically implanted cannula (20 micrograms), was found to enhance the hypothermic response to delta-9-tetrahydrocannabinol (THC; 5 mg/kg i.p.) in unrestrained adult male MF1 mice, kept at 22 degrees C. In mg/kg terms, chlorpromazine was no more potent when injected into the preoptic/anterior hypothalamic area than when given subcutaneously. Phentolamine (54 micrograms) had no significant effect on hypothermia induced by THC when injected into the hypothalamus although it did enhance this response when given subcutaneously (15 mg/kg). Hypothermia induced by THC was also enhanced by flupentixol (0.375 mg/kg s.c.), piflutixol (23.4 micrograms/kg s.c.), pentolinium (5 mg/kg s.c.), prazosin (0.1875 mg/kg s.c.) and indoramin (6 mg/kg s.c.) but not by SCH 23390 (6 mg/kg s.c.) or sulpiride (40 mg/kg s.c.). When taken together with the results from a previous study, these data support the hypothesis that chlorpromazine enhances hypothermia induced in mice by THC by antagonizing alpha-adrenoceptors so as to decrease the capacity of the animals to minimise peripheral blood flow by vasoconstriction. The present data also support the hypothesis that flupentixol and piflutixol interacted with THC not by antagonizing dopamine at D1 or D2 receptors but rather by blocking alpha-adrenoceptors.

Single-strand nuclease action on heat-denatured spermiogenic chromatin.

The aim of this study was to compare the sensitivity of chromatin from representative cellular stages of spermiogenesis to a single-strandeded nuclease after heat denaturation. Thermal denaturation of chromatin was assayed in situ in fixed round, elongating and elongated spermatids and in testicular sperm from mice. Production of single-stranded deoxyribonucleic acid (DNA) at elevated temperatures was monitored by digesting chromatin with endonuclease specific for single-stranded DNA (S1 nuclease), staining the residual DNA with gallocyanin-chrome alum (GAC) and measuring the stain content by absorption cytophotometry. Changes in GCA staining were minimal over the temperature range of 22-90 degrees C in each cell type not exposed to nuclease. Staining of undigested cells decreased progressively with advancing cell maturity. Nuclease had no effect on the GCA content of round spermatids below 60 degrees C, but above this temperature there was a progressive decrease in GCA-stainable chromatin. Both round and elongating spermatid stages showed a significantly greater sensitivity to nuclease digestion than did more mature stages; sperm showed no effects of nuclease action below 80 degrees C. Progressive chromatin condensation and a concomitant decrease in the number of available DNA phosphate groups during spermiogenic cell maturation may be responsible for the observed decline in sensitivity to nuclease and decreased GCA staining. Thermal denaturation of round spermatids labeled with 3H-thymidine produced no change in autoradiographic mean nuclear grain counts, indicating no loss of thymidine-labeled DNA from the slides during denaturation. When round spermatids and sperm were hydrolyzed with hot tricholoroacetic acid before staining, both nuclear GCA content and autoradiograph grain count were partially reduced, indicating incomplete DNA removal. Almost complete loss of Feulgen-stainable material occurred in these cells and may be due to depurination and elimination of Feulgren-reactant aldehyde groups.

An annular erythema of infancy.

An unusual annular and arciform erythema in an infant is reported. Skin lesions appeared when the child was 4 days old, and multiple lesions have been present during the subsequent two years. Individual lesions gradually enlarge over a period of a few weeks, and they resolve spontaneously without any residual cutaneous abnormality. This annular erythema is clinically and histologically distinct from previously described annular erythemas of infancy, with which it is compared.

Stimulus competition and ear differences in memory for sentences.

Recognition memory was compared within subjects for meaningful sentences presented either non-competitively (monaural condition) or accompanied by non-verbal (monaural-noise condition) or verbal (dichotic condition) input. A right-ear advantage for sentence memory occurred with dichotic but not with monaural presentation. Error analyses showed evidence of qualitative differences in processing under competitive and non-competitive conditions. These results suggest that different types of linguistic processing may be involved in investigations of auditory asymmetries which employ monaural and dichotic presentation.

The pathology of Mycobacterium ulcerans infection.

The pathology of cutaneous ulcers resulting from Mycobacterium ulcerans infection is reviewed. Initial infection causes ulceration with necrosis of the dermis and a septate panniculitis in subcutaneous fat. There is little cellular reaction despite the presence of large numbers of organisms. Recurrent or persistent infection produces a granulomatous reaction with epithelioid macrophages, variable numbers of giant cells of the Langhans type, and relatively few organisms. This type of reaction is associated with more successful treatment of the disease and appears analogous to the tuberculoid form of leprosy.

Reports of the experience of epilepsy in a rural South African village.

It has become increasingly acknowledge that the social and psychological consequences of epilepsy may be more debilitating than the epileptic seizures themselves. This study, which formed part of an ongoing community health project which was carried out in the South African village of Mamre, was aimed at gaining an understanding of some of these psychosocial aspects. Sixteen respondents were as well as their families, had accepted the epilepsy and learnt to cope with it, although some respondents felt stigmatized by the epilepsy and made various attempts to conceal it from outsiders. Problems which were caused by epilepsy included the fear of going out unaccompanied, as well as forgetfulness and irritable mood. Few respondents had epilepsy which could be described as well-controlled, yet none admitted being dissatisfied with their treatment. Implications of the study included the need to assist the respondents and their families to better understand the management of epilepsy, so that every effort would be made to attain maximal seizure control.

Noradrenergic feeding system in monkey hypothalamus is altered by localized perfusion of glucose, insulin, 2-DG and eating.

Hypothalamic sites in the monkey were labelled by micro-injections of 3H-NE and successive push-pull perfusions were carried out at a rate of 25 mul/min. When the monkey was fed, 3H-NE within the perifornical region increased. When 2-deoxy-D-glucose (2-DG) was added to the perfusate, 3H-NE release was also enhanced, whereas insulin perfused at the same rate caused a delated increase in catecholamine levels as reflected by increased radioactivity. Glucose supressed the release of 3H-NE, suggesting overall that the noradrenergic feeding system in the hypothalamus of the monkey is modulated by the regional level of glucose as well as the local concentration of insulin.

The dental health status of five-year-old children in north and west Belfast.

OBJECTIVE: To investigate the influence of social deprivation upon the diet, dental health behaviours and dental health status of five-year-old children in Northern Ireland. DESIGN: Cross-sectional study. SETTING: Fifty-eight primary schools in North and West Belfast. SUBJECTS: A nine per cent (240) random sample of 2,666 five-year-old children resident and attending school in North and West Belfast. MAIN OUTCOME MEASURES: Dental health status measured by dmft index; parental assessments of the child's dental health behaviours: parental dental attendance patterns and attitudes towards dental health; parental assessments of the child's diet and snacking behaviours: parental attitudes towards snack foods; and demographic profile of child's family. RESULTS: One hundred and sixty-three children were examined, a 68 per cent response. The majority of the families were either in low income employment or unemployed. Sixty-eight per cent of children had experience of dental caries. Dental decay was unrelated to parental employment status but more children from unemployed families attended when in pain. The diet of the children was related to both employment status and parental attitude and was reflected in their caries experience. Caries experience was dependent upon parental dental attendance, the consumption of carbonated drinks and sugar containing bedtime drinks. CONCLUSIONS: The results suggest that unemployment and parental attitudes are important as determinants of dental caries in five-year-old children from North and West Belfast. These factors may influence the child's dental health care as well as type of diet.

Bullous autoimmune skin disease in the dog: (1) clinical and pathological assessment.

The clinical and pathological findings of two cases of pemphigus vulgaris and four cases of bullous pemphigoid in the dog are reported. Clinically these cases were typified by ulcerative lesions of the oral mucous membranes, mucocutaneous junctions and skin. Pathologically there were intraepithelial separation and bulla formation in one of the cases of pemphigus and subepithelial separation and bulla formation in all cases of pemphigoid.

Bullous autoimmune skin disease in the dog: (2) immunopathological assessment.

The immunological examinations of two cases of pemphigus vulgaris and four cases of bullous pemphigoid in the dog are reported. Deposits of immunoglobulin and complement were identified betweeen epithelial cells of the pemphigus cases and at the epithelial/connectivce tissue junction in the pemphigoid dogs. The bullous autoimmune diseases must be considered in the differential diagnosis of mucosal and skin ulceration in the dog.