Meaning in life after cancer: Validation of the sources of meaning card method among participants in cancer rehabilitation.

Cancer survivors may be struggling to re-create meaning in life. Addressing their personal sources of meaning can support them in this process. The sources of meaning card method (SoMeCaM) aims to map and explore personal sources of meaning in a 1-h session. It includes 26 cards, each with a statement on a source of meaning. The purpose of this study was to validate the statements on the sources of meaning cards for use among participants in cancer rehabilitation by examining whether participants attribute the same meaning to the statements as intended. The three step test interview method was used to assess response processes to the sources of meaning cards among 12 participants in a 5-day cancer rehabilitation program in Denmark. The interviews were transcribed verbatim and analyzed using framework analysis. Nineteen of the 26 statements were interpreted congruently, that is, in line with the underlying theory, by all participants. Issues of incongruency, ambiguity and confusion were observed in participants' interpretations of the statements on religiosity (n = 6), spirituality (n = 10), and reason (n = 6). Minor issues were observed for the statements on practicality, achievement, knowledge, and attentiveness. In most statements, cancer survivors' interpretation aligned with the underlying theory. Problems were apparent regarding the sources of meaning religiosity, spirituality and reason, and a reconsideration of the wording of the statements is recommended. These problems may be due to cultural and linguistic interpretations rather than to being a cancer survivor. Future studies could focus on these issues in other target populations. Despite these minor issues, the SoMeCaM has proven useful in addressing the important topic of meaning in life in the cancer rehabilitation setting. Clinicians should pay attention to nuances in participants' understanding of the cards.

Differential Coassembly of α1-GABAARs Associated with Epileptic Encephalopathy.

GABAA receptors (GABAARs) are profoundly important for controlling neuronal excitability. Spontaneous and familial mutations to these receptors feature prominently in excitability disorders and neurodevelopmental deficits following disruption to GABA-mediated inhibition. Recent genotyping of an individual with severe epilepsy and Williams-Beuren syndrome identified a frameshifting de novo variant in a major GABAAR gene, GABRA1 This truncated the α1 subunit between the third and fourth transmembrane domains and introduced 24 new residues forming the mature protein, α1Lys374Serfs*25 Cell surface expression of mutant murine GABAARs is severely impaired compared with WT, due to retention in the endoplasmic reticulum. Mutant receptors were differentially coexpressed with ß3, but not with ß2, subunits in mammalian cells. Reduced surface expression was reflected by smaller IPSCs, which may underlie the induction of seizures. The mutant does not have a dominant-negative effect on native neuronal GABAAR expression since GABA current density was unaffected in hippocampal neurons, although mutant receptors exhibited limited GABA sensitivity. To date, the underlying mechanism is unique for epileptogenic variants and involves differential ß subunit expression of GABAAR populations, which profoundly affected receptor function and synaptic inhibition.SIGNIFICANCE STATEMENT GABAARs are critical for controlling neural network excitability. They are ubiquitously distributed throughout the brain, and their dysfunction underlies many neurologic disorders, especially epilepsy. Here we report the characterization of an α1-GABAAR variant that results in severe epilepsy. The underlying mechanism is structurally unusual, with the loss of part of the α1 subunit transmembrane domain and part-replacement with nonsense residues. This led to compromised and differential α1 subunit cell surface expression with ß subunits resulting in severely reduced synaptic inhibition. Our study reveals that disease-inducing variants can affect GABAAR structure, and consequently subunit assembly and cell surface expression, critically impacting on the efficacy of synaptic inhibition, a property that will orchestrate the extent and duration of neuronal excitability.

Impaired microvascular reactivity in gestational diabetes is associated with altered glycemic parameters.

OBJECTIVES: To assess microvascular reactivity and glycemic parameters in GDM compared to age and GA matched controls. METHODS: This study involved 21 GDM patients and 31 controls. Microvascular reactivity was assessed using LDF and PORH. Microvascular parameters; PORHmax , PORHpeak , and time to peak perfusion (Tp) were recorded after the release of 3 minutes' upper arm occlusion. HOMA-IR was performed to evaluate insulin resistance. RESULTS: Average age and GA for subjects were 32.9 years and 29.2 weeks. Mean FBG and a 2-hour postprandial for GDM and controls were 4.87 ± 0.71 vs 3.99 ± 0.59 mmol/L; P < 0.001 and 9.50 ± 1.8 vs 5.67 ± 1.0 mmol/L; P < 0.001. Fasting insulin (13.88 ± 18.9 vs 8.37 ± 11.0 µLU/mL; P = 0.031) and HOMA-IR (3.14 ± 4.6 vs 1.52 ± 2.2; P = 0.004) were higher in GDM. Tp was prolonged in GDM (16.27 ± 4.3 vs 13.86 ± 2.1 seconds; P = 0.011). Positive correlations were seen between Tp and FBG and 2-hour postprandial levels. CONCLUSION: Tp was prolonged in GDM compared to age-matched controls, indicating impaired microvascular reactivity.

Assessment of undernutrition using Composite Index of Anthropometric Failure among children aged < 5 years in rural Yemen.

BACKGROUND: Impaired nutritional status is a major health problem affecting young children in developing countries that has a significant impact on child morbidity and mortality. AIMS: This study aimed to assess the prevalence of undernutrition among children aged < 5 years, using conventional indices and the Composite Index of Anthropometric Failure (CIAF), and then comparing their estimated results. METHODS: A community-based cross-sectional study was conducted and information was collected through house-tohouse visits using precoded structured records. We analysed data from 1292 children aged 6-59 months, from Ahwar and Al-Mahfed rural districts in Abyan Governate, South Yemen, with reference to the 2006 World Health Organization growth standards. RESULTS: CIAF identified undernutrition in 70.1% of children, while conventional anthropometric indices revealed 38.5% stunting, 39.9% wasting, and 55.1% underweight. Compared with conventional indices, CIAF aggregate recognized 31.6%, 30.2% and 15% more undernourished children than stunting, wasting and underweight separately. According to CIAF, 21% had a single anthropometric failure and 49.2% exhibited multiple failures. Stunting Index, Wasting Index and Underweight Index were 0.55, 0.57 and 0.79, respectively. CONCLUSIONS: CIAF gives a better estimate of undernutrition than currently used conventional indices; identifies more children with multiple anthropometric failures; and reflects a wider view of the extent and pattern of undernutrition of children living in communities with limited resource settings.

Effects of 1α-Calcidol (Alfacalcidol) on Microvascular Endothelial Function, Arterial Stiffness, and Blood Pressure in Type II Diabetic Nephropathy Patients.

OBJECTIVES: To determine the effects of six months alfacalcidol on microvascular endothelial function, arterial stiffness, and BP in DN patients. METHODS: Twenty-eight DN patients on alfacalcidol, 0.25 µg daily for six months were compared to 32 controls on conventional treatment. Measurements of microvascular endothelial function, arterial stiffness [AIx and PWV], hsCRP, and BP were performed; differences between baseline and six months treatment were evaluated. RESULTS: No difference was seen in microvascular endothelial function for both groups after six months. Improvement in CSBP (p = 0.027) with trends of improvement in AIx (p = 0.063), PWV (p = 0.075), and systolic BP (p = 0.088) were seen in the alfacalcidol group with no changes observed in controls. Subgroup analysis of alfacalcidol group showed that vitamin D-deficient patients had better response to treatment. hsCRP level remained unchanged in alfacalcidol group; significant increase was however seen in controls. CONCLUSION: Alfacalcidol did not have an effect on microvascular endothelial function in DN patients. Alfacalcidol significantly improved CSBP with trends of improvement in arterial stiffness and peripheral BP. Alfacalcidol appears to be more beneficial in vitamin D-deficient patients.

Major ions anomalies and contamination status by trace metals in sediments from two hot spots along the Mediterranean Coast of Egypt.

The major constituents and trace metals in the surface sediments collected from the Western Harbor and El-Mex Bay along the Egyptian Mediterranean Coast were studied. The concentrations of major constituents decreased in the following order: Ca > Si > Mg > Na > K for the Western Harbor and El-Mex Bay. Additionally, the ranking order of trace metals was Fe > Al > Pb > Zn > Mn > Cu > Sn > V > As > Cd > Se for the Western Harbor. For El-Mex Bay, the decreasing order was Fe > Al > Mn > Sn > Pb > Zn > Cu > V > As > Cd > Se. Fe, Al, Zn, Pb, Cu, V, Cd and Sn in the Western Harbor occurred in higher concentrations than in El-Mex Bay. A higher concentration of Mn was observed in El-Mex Bay. Two pollution indicators, enrichment factor (EF) and metal pollution index (MPI), and several sediment quality guidelines (SQGs) were used to evaluate the status of metal pollution. Based on the mean EF values of the studied metals, surface sediments of the Western Harbor and El-Mex Bay revealed that they are enriched with metals from anthropogenic sources. An analysis of variance (ANOVA) test showed that the mean measurements for all metals across the Western Harbor and El-Mex Bay are significantly different at a 0.05 significance level. Principal components analysis (PCA) was applied in result interpretation. The spatial distribution of the different parameters was illustrated.

Drought-Tolerant Bacteria and Arbuscular Mycorrhizal Fungi Mitigate the Detrimental Effects of Drought Stress Induced by Withholding Irrigation at Critical Growth Stages of Soybean (Glycine max, L.).

Considering current global climate change, drought stress is regarded as a major problem negatively impacting the growth of soybeans, particularly at the critical stages R3 (early pod) and R5 (seed development). Microbial inoculation is regarded as an ecologically friendly and low-cost-effective strategy for helping soybean plants withstand drought stress. The present study aimed to isolate newly drought-tolerant bacteria from native soil and evaluated their potential for producing growth-promoting substances as well as understanding how these isolated bacteria along with arbuscular mycorrhizal fungi (AMF) could mitigate drought stress in soybean plants at critical growth stages in a field experiment. In this study, 30 Bradyrhizobium isolates and 30 rhizobacterial isolates were isolated from the soybean nodules and rhizosphere, respectively. Polyethylene glycol (PEG) 6000 was used for evaluating their tolerance to drought, and then the production of growth promotion substances was evaluated under both without/with PEG. The most effective isolates (DTB4 and DTR30) were identified genetically using 16S rRNA gene. A field experiment was conducted to study the impact of inoculation with DTB4 and DTR30 along with AMF (Glomus clarum, Funneliformis mosseae, and Gigaspora margarita) on the growth and yield of drought-stressed soybeans. Our results showed that the bioinoculant applications improved the growth traits (shoot length, root length, leaf area, and dry weight), chlorophyll content, nutrient content (N, P, and K), nodulation, and yield components (pods number, seeds weight, and grain yield) of soybean plants under drought stress (p ≤ 0.05). Moreover, proline contents were decreased due to the bioinoculant applications under drought when compared to uninoculated treatments. As well as the count of bacteria, mycorrhizal colonization indices, and the activity of soil enzymes (dehydrogenase and phosphatase) were enhanced in the soybean rhizosphere under drought stress. This study's findings imply that using a mixture of bioinoculants may help soybean plants withstand drought stress, particularly during critical growth stages, and that soybean growth, productivity, and soil microbial activity were improved under drought stress.

Variation in Anti-inflammatory, Anti-arthritic, and Antimicrobial Activities of Different Extracts of Common Egyptian Seaweeds with an Emphasis on Their Phytochemical and Heavy Metal Contents.

The anti-inflammatory, anti-arthritic, and antimicrobial activities of some common Egyptian seaweeds in addition to their phytochemical and heavy metal contents were investigated. Phytochemical screening of the seaweed extracts showed the presence of different primary and secondary metabolites with different concentrations according to their species and the used solvent. The ethanolic extract of Colpmenia sinuosa (CSBE2) exhibited the maximum anti-inflammatory and anti-arthritic activity at 1000 µg/ml concentration compared to other seaweed extracts. The dichloromethane extract of Corallina officinalis (CORM) exerted the highest antimicrobial activity with an average inhibition zone diameter (AV) = 15.29 mm and activity index (AI) = 1.53 and with the highest antagonistic activity against Escherichia coli (28 mm). It is followed by Ulva linza ethanolic extract (ULGE2) which recorded (AV) of 14.71 mm and (AI) of 1.30 with the highest antifungal activity against Candida albicans (30 mm). The collected seaweeds would therefore be a very promising source for treating inflammatory, arthritic, and microbial diseases. Moreover, the investigated seaweeds showed variable concentrations of heavy metals among various species. The mean concentrations of the heavy metals took the following order: Fe > Zn > Mn > Ba > Cu > As > Cr > Ni > Pb > V > Cd > Se > Co > Mo. Based on the permissible limits set by the WHO and CEVA, Pb and Ni in the studied seaweeds were found to be within the permissible limits, whereas Cd and Zn contents were at the borderline. Significant correlations were observed between studied parameters. The estimated daily intakes for most heavy metals were lower than the recommended daily intakes.

Quantifying microplastics pollution in the Red Sea and Gulfs of Suez and Aqaba: Insights from chemical analysis and pollution load assessment.

Microplastics (MPs) constitute the majority of marine plastic litter. The pollution caused by MPs has been categorized as a gradual and persistent crisis, but little is known about its extent along the shores of the Red Sea, particularly on the Egyptian side. The Red Sea is a rapidly developing region and home to critical ecosystems with high levels of endemism. This study represents the first comprehensive survey investigating the extent of MP pollution along the Egyptian shores of the Red Sea, including the Gulf of Suez and Aqaba. Mean concentrations ranged from 23.3 ± 15.28 to 930.0 ± 181.9 MPs/kg DW. Out of 17 beaches surveyed, 12 had mean concentrations of <200 items/kg, indicating a low occurrence of MPs compared to the shores of the Mediterranean Coast of Egypt. The pollution load index varied from low to medium levels in most locations. Ras Mohamed, a marine protected area, showed high vulnerability to MP pollution. All the investigated particles were fragments of secondary MPs. The sources of pollution mainly come from maritime activities, including cargo shipping and intense recreational activities. Fourier Transform Infrared Spectroscopy identified four plastic polymers, with polyethylene and polypropylene being the most common. The surface morphology of plastic particles was examined using scanning electron microscopy combined with energy-dispersive X-ray spectroscopy. All the particles exhibited signs of degradation, which could generate countless plastic pieces with possible deleterious impacts. This work has highlighted the importance of conducting region-specific assessments of mismanaged plastic waste, focusing on the role of tourism and recreational navigation as contributors to plastic litter, to estimate plastic waste inputs into the waters of the Red Sea Coast of Egypt. Efforts are needed to develop strategic plans to reduce the disposal of plastic waste in the region.

Arterial stiffness, inflammatory and pro-atherogenic markers in gestational diabetes mellitus.

BACKGROUND: This study aims to determine whether gestational diabetes mellitus (GDM) is associated with increased arterial stiffness, inflammatory and pro-atherogenic markers compared to age matched controls. PATIENTS AND METHODS: This is a cross-sectional study involving 53 pregnant women in the early third trimester of pregnancy consisting of 31 women with normal pregnancy and 22 women with GDM. Subjects were grouped into GDM and control groups based on modified oral glucose tolerance test results; they were considered GDM if fasting blood glucose (FBG) was ≥ 6.1 mmol/L and/or the two hours post-glucose intake was ≥ 7.8 mmol/L. Arterial stiffness was assessed non-invasively using the parameters augmentation index (AIx) obtained via pulse wave analysis and carotid femoral pulse wave velocity (PWV). Tumor necrosis factor alpha (TNF-alpha), high sensitivity C- reactive protein (hsCRP) and plasminogen activator inhibitor-1 (PAI-1) were measured using enzyme linked immunoassay technique (ELISA). Aortic and brachial blood pressure (BP) indices were also recorded. RESULTS: Mean ages and gestational ages (GA) for the control and GDM groups showed no significant differences (31.1 ± 5.68 vs. 32.9 ± 8.46 years; 29.0 ± 2.43 vs. 29.6 ± 1.54 weeks respectively). FBG and 2 hour post-glucose levels were significantly higher in GDM; (5.27 ± 1.19 vs. 3.94 ± 0.44 mmol/L, p < 0.001; 9.66 ± 1.76 vs. 5.68 ± 1.10 mmol/L, p < 0.001). TNF-alpha, PAI-1 and hsCRP levels were significantly higher in GDM compared to controls (0.81 ± 0.15 vs. 0.72 ± 0.13 pg/ml, 54.48 ± 13.07 vs. 36.16 ± 15.58 cm/ml, 7.91 ± 1.16 vs. 6.70 ± 1.45 mg/l respectively). PWV (8.28 ± 1.48 vs. 7.97 ± 1.12) and AIx (16.73 ± 10.98 vs. 16.13 ± 9.64 %) were not significantly different between the two groups. No significant differences were seen for aortic and brachial BP, mean arterial pressure and body mass index. CONCLUSIONS: The inflammatory markers TNF-alpha and hsCRP, and the pro-atherogenic marker PAI-1 were elevated in GDM compared to age matched controls. No significant difference was seen between the two groups in their arterial stiffness.

Sudden death in racing Thoroughbred horses: an international multicentre study of post mortem findings.

REASONS FOR PERFORMING STUDY: To improve the understanding of exercise related sudden death in Thoroughbred racehorses. OBJECTIVES: To describe the post mortem findings in cases of sudden death associated with exercise in 268 Thoroughbred racehorses. METHODS: Gross and histological post mortem findings of 268 cases of sudden death were collated and reviewed. Cases originated from 6 racing jurisdictions around the world. Sudden death was defined as acute collapse and death in a closely observed and previously apparently healthy Thoroughbred racehorse, during, or within one hour after, exercise. Cause of death as determined by the attending pathologist was categorised as definitive, presumptive or unexplained and compared between the different populations. Cardiopulmonary lesions recorded at post mortem examination were compared between different populations. RESULTS: Pathologists recorded a definitive cause of death in 53% (143/268) of cases. Major definitive causes of sudden death included cardiac failure, apparent pulmonary failure, pulmonary haemorrhage, haemorrhage associated with pelvic fractures or with idiopathic blood vessel rupture, and spinal cord injury. A presumptive cause of death was made in 25% (67/268) of cases and death remained unexplained in 22% (58/268) of cases. There were several statistically significant inter-population differences in the cause of death and in reporting of cardiopulmonary lesions. CONCLUSIONS: Sudden death can be attributed to a variety of causes. Causes of sudden death and the lesions found in cases of exercise-related sudden death are similar in different racing jurisdictions. However, the lesions are often not specific for the cause of death and determination of the cause of death is therefore affected by interpretation by the individual pathologist.

Human Health Implication of Major and Trace Elements Present in Commercial Crustaceans of a Traditional Seafood Marketing Region, Egypt.

The present study focused on the distribution of some major and trace elements (S (as SO42-), Na, K, B, Ca, Mg, F, Li, Al, Fe, Zn, Cu, Mn, Ni, Co, Cd, and Pb) in both flesh (Fl) and total cephalon/exoskeleton (C/E) tissues of selected crustacean species obtained from an Egyptian traditional seafood marketing region. The sequence of studied elements in (Fl) and (C/E) tissues in descending orders was S (as SO42-) > Na > K > B > Mg > Ca > Li > F > Al > Zn > Fe > Cu > Pb > Ni > Mn > Co > Cd, and S (as SO42-) > Na > B > K > Mg > Ca > F > Li > Al > Fe > Cu > Zn > Mn > Pb > Ni > Co > Cd, respectively. Both length-weight relationship and Fulton's condition factor showed the physical and biological statuses of the crustaceans. Ion quotient calculations of the studied tissues pointed to their importance in decreasing hypertension, preeclampsia, and heart disease. Human health risk due to the consumption of the crustacean species was determined using some guideline limits, metal pollution index (MPI), estimated daily intake (EDI), health comparison values (CVs), dietary intake (DRI-ULs), target hazard quotient (THQ), total target hazard quotient (TTHQ), and provisional tolerable weekly intake (%PTWI). MPI values of cephalon/exoskeleton tissues were greater than those of the flesh with ranges between 11.4-24.0 and 4.6-14.3, respectively. Interestingly, the calculations of TTHQ of toddler and adult were lesser than one and not expected to pose any risk concern to human from crustaceans' consumption.

Older Age Group in Pregnancy is Associated with Increased Arterial Stiffness.

Arterial stiffness is an index of vascular health; normal pregnancy is associated with reduced arterial stiffness. This cross sectional study compared arterial stiffness in older (≥35 years) and the younger (≤34 years) age groups of pregnant women. Arterial stiffness was assessed noninvasively in 66 pregnant women between 23 - 32 weeks gestation (41 women ≤ 34 years, 25 women ≥ 35 years) using the parameters pulse wave analysis and pulse wave velocity. Blood pressure (BP), body mass index (BMI), serum total cholesterol (TC) and fasting blood glucose (FBS) were also recorded. Mean ages of the younger and older age groups were 27.6±0.62 and 39.3±0.58 years; no significant difference was seen between the groups in their BMI, TC, FBS, SBP, DBP and gestational age. The older age group of women have increased arterial stiffness (augmentation index 19.4±1.9% vs 13.2±1.6%, p=0.015) and aortic stiffness (pulse wave velocity 8.7±0.3 vs 7.7±0.2 m/s, p=0.004) compared to the younger women. Linear regression analysis showed a positive significant correlation between age and augmentation index (R=0.278, p=0.026), and pulse wave velocity (R=0.350, p=0.004). We conclude that older pregnant women has increased arterial stiffness compared to a younger age group of pregnant women suggesting that vascular changes due to ageing occurs in pregnancy despite cardiovascular adaptations occurring in pregnancy.

Blood Transfusion Frequency and Indications in Yemeni Children with Sickle Cell Disease.

BACKGROUND: Blood transfusion is an essential component in the care of patients with sickle cell disease (SCD), but it might be associated with serious acute and delayed complications. This study was aimed to describe red cell transfusion patterns and indications among hospitalized SCD children in a low-resource setting. Patients and Methods. A retrospective, descriptive study of all children (≤16 years) with SCD who received blood transfusion therapy during their hospital admissions in the pediatric department at Al-Sadaqa Teaching Hospital in Aden, Yemen, for a period of one year. RESULTS: Out of 217 hospitalized children with SCD, 169 (77.9%) were transfused and received 275 RBC transfusion episodes. The mean age of transfused children was 6.9 ± 4.6 years and 103 (60.9%) were males, with a male/female ratio of 1.6 : 1 (p=0.004). Hemoglobin (Hb) levels were significantly lower in the transfused than in the nontransfused (Hb 5.5 ± 1.5 vs. 7.7 ± 1.5 g/dL, p=0.03). Pretransfusion Hb levels were ˂7.0 g/dL in 86.2% and ˂5.0 g/dL in 39.3% of patients. Single transfusion was given to 122 (72.2%) and 5 or more transfusions in 9 (4.15%) of patients on different occasions. Simple (top-up) transfusion was used in all transfusion events. Commonest indications for transfusion were anemic crises (41.1%), vasoocclusive crises (VOC) (13.8%), VOC with anemic event (11.3%), acute chest syndrome (8.7%), and stroke (7.3%). CONCLUSION: Intermittent blood transfusion remains a common practice for the management of children with acute SCD complications. Main indications were acute anemic crises, severe pain crises, ACS, and stroke. In limited resource settings, such as Yemen, conservative transfusion policy appears to be appropriate.

Clinical, Paraclinical, and Evolutionary Profiles of Kidney Failure in Gold Miners Hospitalized in a Nephrological Service in a Sub-Saharan African Country.

Introduction. The purpose of this preliminary study is to describe the clinical, paraclinical, and evolutionary profiles of gold miner patients with kidney failure hospitalized in the nephrology and haemodialysis service in the Yalgado Ouédraogo University Hospital of Ouagadougou (CHU-YO). Patients and Methods. This was a longitudinal and descriptive study with a retrospective collection of data for the period from February 1, 2013, to March 31, 2018. Included were all gold miner patients who stayed and worked at an artisanal gold mining site for at least three months and who were diagnosed with acute or chronic kidney failure during hospitalization in the nephrology service. We collected sociodemographic, clinical, and paraclinical variables at admission and then three months later. RESULTS: We included 50 patients; all were male and the average age was 29.4 ± 7.7 years. All patients were exposed to mercury and/or cyanide for an average of 4.5 ± 2.8 years. The average consultation/referral time for patients at the CHU-YO was 25.4 ± 14.9 days. The average of creatininemia was 2338.0 ± 791.4 µmol/L. Kidney failure was acute in five cases (10%) and chronic in the remaining 45 cases or 90%. Extrarenal purification was indicated in 43 cases (86%). It was not performed in nine of the 43 cases due to lack of financial resources for patients (six cases) or death prior to the onset of haemodialysis (three cases). Thirty-two of the 50 patients in the study (64% of cases) died. CONCLUSION: Chronic kidney failure in gold miners appears to be common and late-managed. A prospective study of kidney disease and its causes at gold mining sites and surrounding areas will assess the extent of the problem in the country and better clarify the prevention of these diseases in our country.

[Surgical repair of extracardiac unruptured aneurysm of the sinus of Valsalva].

An isolated extracardiac unruptured aneurysm of the non-coronary sinus of Valsalva was detected incidentally in a 49-year-old woman with chronic obstructive pulmonary disease. The orifice of the aneurysm was closed with XAG-400 patch. The aortic valve was normal. 20 cases of successful operation have been reported in Japan with extracardiac unruptured aneurysm. In the review of the literature, patch closure of the orifice of the aneurysm was the standard procedure in most cases. However, aortic root replacement was required in some cases with concomitant cardiac and/or aortic disease.

Developing time-based model for the prediction of breeding activities of dengue vectors using early life cycle variables and epidemiological information in Northern Malaysia.

Autoregressive integrated moving average (ARIMA) was applied to make realtime predictions on the Aedes egg populations in three selected dengue hotspots of Penang, Malaysia. The weekly ovitrap collection was carried out to determine the abundance of Aedes eggs in field population in some selected areas. The ARIMA models were able to estimate actual egg abundance using two criteria. The first criteria is determine the reliability of statistics and the second is to measure the accuracy of forecasting ability of the model equation. The parsimonious model with a lowest order of AR or MA and RMSE value of the forecast for each data set was considered the best. ARIMA (1,0,0), ARIMA (2,0,0) and ARIMA (0,1,1) models were judged to be the best fit for the suburban, urban squatter and urban area data sets respectively. The models were able to forecast the number of eggs within a range of one to eleven weeks. The developed models were able to estimate the egg abundance adequately to permit their use in Aedes control programme in Penang Island. Thus, it can be a useful tool for health officials to improve the management of mosquito control and alert the public to reduce the possibility of dengue outbreaks.

Dose dependent elevation of plasma tocotrienol levels and its effect on arterial compliance, plasma total antioxidant status, and lipid profile in healthy humans supplemented with tocotrienol rich vitamin E.

UNLABELLED: Tocotrienols are a class of vitamin E reported to be potent antioxidants, besides having the ability to inhibit the HMG-CoA reductase enzyme. This study assessed the effects of 3 doses of tocotrienol-rich vitamin E (TRE) on plasma tocotrienol isomer concentration, arterial compliance, plasma total antioxidant status (TAS), aortic systolic blood pressure (ASBP), serum total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C) in healthy males. METHODOLOGY: This randomised, blinded end-point, placebo-controlled clinical trial with a parallel design involved 36 healthy male subjects who took either an oral placebo or TRE at doses of 80, 160 or 320 mg daily for 2 mo. Baseline and end-of-treatment measurements of vitamin E concentration, arterial compliance [assessed by aortic femoral pulse wave velocity (PWV) and augmentation index (AI)], ASBP, plasma TAS, serum TC and LDL-C were taken. RESULTS: Baseline tocotrienol isomer concentrations were low and not detectable in some subjects. Upon supplementation, all TRE-treated groups showed significant difference from placebo for their change in alpha, gamma and delta tocotrienol concentrations from baseline to end of treatment. There was a linear dose and blood level relationship for all the isomers. There was no significant difference between groups for their change in PWV, AI, plasma TAS, ASBP, TC or LDL-C from baseline to end of treatment. Groups 160 mg (p = 0.024) and 320 mg (p = 0.049) showed significant reductions in their ASBP. Group 320 mg showed a significant 9.2% improvement in TAS. CONCLUSION: TRE at doses up to 320 mg daily were well tolerated. Treatment significantly increased alpha, delta, and gamma tocotrienol concentrations but did not significantly affect arterial compliance, plasma TAS, serum TC or LDL-C levels in normal subjects.

Larval Distributions and breeding habitats of Aedes aegypti and Ae. albopictus in Kuala Terengganu.

Aedes aegypti and Ae. albopictus play an important role in spreading dengue and chikungunya virus in Malaysia. Currently dengue fever is still the most important threat to this country. The number of dengue cases are on the rise in some states despite the efforts made by the government to keep the surroundings of houses clean and free from Aedes breeding sites. This study was carried out to determine the breeding sites of Aedes in Kuala Terengganu. Samplings were carried out between August 2009 until February 2010 at six study sites from both the urban and rural areas. Samples collected were counted and the distribution classes (class 1 (C1) to class 5 (C5)) were determined. Water tank, glass container and used paint bucket were found to be the most preferable breeding sites in the study areas. Many Ae. aegypti larvae were collected in the urban areas and the highest number of Ae. albopictus larvae were collected from the rural areas. As for the larval distributions, Ae. aegypti recorded a frequent distribution (C4: 60.1-80%) in urban areas while Ae. albopictus recorded infrequent distribution (C2: 20.1-40%). Frequent distributions of Aedes larvae were recorded when relative humidity is high. Apart from environmental factors, human density also could affect the distributions of Aedes larvae in the urban area.

Clinical features of ovarian cancer in Japanese women with germ-line mutations of BRCA1.

We analyzed the clinical features of 25 ovarian cancer patients who were associated with germ-line mutations of BRCA1 from four site-specific ovarian cancer families and seven breast-ovarian cancer families in Japan. The average age at diagnosis was 51.1 years (range, 38-77 years). Histological examination revealed 24 serous cyst adenocarcinomas in 25 patients. In 23 patients with clear clinical records, 3 patients had stage I disease, 17 had stage III disease, and 3 had stage IV disease. Thirteen patients with stage III disease who were treated with cisplatin-containing chemotherapy following tumor reduction surgery showed more favorable outcomes in both the survival rate and disease-free intervals, compared with age- and treatment course-matched controls (5-year survival rate, 0.786 versus 0.303; median disease-free interval, 91.43 versus 40.92 months; P < 0.05 for both, by logarithmic rank test). Our statistical model for the inheritance of susceptibility to ovarian cancer was derived from the analysis of 26 patients and 19 healthy carriers of 12 families. The expected lifetime risk of ovarian cancer is about 80% for women with mutations of BRCA1. These results suggest that the clinical outcome of ovarian cancer with germ-line mutations of BRCA1 appears to be more favorable than that with sporadic cases and that the disease penetrance among pedigrees with germ-line mutations of the BRCA1 gene is substantially high.