Eye lid and canalicular laceration due to obstetric trauma. Case report. / Laceración palpebral y canalicular asociada a trauma obstétrico. Descripción de un caso.

Ocular injuries associated with birth trauma are rare. Their incidence increases in cases of instrument-assisted delivery, emergency cesarean section, and abnormal presentation of the fetus. We present the clinical case of a premature Asian male baby, aged 33+2 weeks and weighing 1,500g. The infant was born out of a twin pregnancy and was delivered by emergency cesarean section. Following delivery, a 5mm long lower eyelid laceration was observed in the inner corner of the left eye, with injury to the inferior canaliculus. A Mini-Monoka® (FCI, Issy-Les Moulineaux, France) monocanalicular intubation stent was inserted on the seventh day with anastomosis of the proximal and distal ends of the canaliculus laceration. The skin was then sutured with a polyglactin 8/0 (Vicryl 8/0, Ethicon, Johnson & Johnson S. A., Madrid, Spain) suture. The postoperative treatment consisted of tobramycin and dexamethasone eye drops four times per day for 10 days. A good progression was observed, the position of the inferior lacrimal punctum was adequate, and syringation was normal. The Mini-Monoka® was removed after 14 weeks.

Optical neuropathy due to inhaled cocaine, causality or chance. / Neuropatía óptica secundaria a consumo de cocaína inhalada. Causalidad o casualidad.

A 44-year-old man, active cocaine consumer, who referred decrease in visual acuity in the right eye in 24 hours of evolution, being 0,05 in that eye and 1 in the left eye. The examination showed a relative afferent pupil defect and a swelling head of optic nerve. The systemic studies performed were normal, except the nuclear magnetic resonance of the brain that showed a thickening of the maxillary and frontal sinus mucosa, compatible with sinusitis. Hospital admission and the start of intravenous corticosteroid treatment were decided, with a favourable evolution, a visual acuity of 1.0 in both eyes and an anatomical improvement of the optic nerve head. Due to the medical history of the patient and the assessment of other plausible alternative diagnoses, we established the diagnosis of optical neuropathy due to inhaled cocaine abuse.

Features of intracranial hemorrhage in cerebral venous thrombosis.

BACKGROUND: Cerebral venous thrombosis (CVT) is associated with intracranial hemorrhage. AIM: To identify clinical and imaging features of CVT-associated intracranial hemorrhage. We hypothesized that higher clot burden would be associated with a higher risk of intracranial hemorrhage. METHODS: We performed a retrospective analysis of an international, multicenter cohort of patients with confirmed cerebral venous thrombosis who underwent computed tomography within 2 weeks of symptom onset. Clinical and imaging features were compared between patients with and without intracranial hemorrhage. Clot burden was assessed by counting the number of thrombosed venous sinuses and veins on confirmatory imaging. RESULTS: We enrolled 260 patients from 10 institutions in Europe and Mexico. The mean age was 42 years and 74% were female. Intracranial hemorrhage was found in 102 (39%). Among them parenchymal hemorrhage occurred in 64 (63%), in addition, small juxta-cortical hemorrhage was found in 30 (29%), subarachnoid hemorrhage in 24 (24%) and subdural hemorrhage in 11 (11%). Multiple concomitant types of hemorrhage occurred in 23 (23%). Older age and superior sagittal thrombosis involvement were associated with presence of hemorrhage. The number of thrombosed venous sinuses was not associated with intracranial hemorrhage (median number IQRInterquartile ratio] of sinuses/veins involved with hemorrhage 2 (1-3) vs. 2 (1-3) without hemorrhage, p = 0.4). CONCLUSION: The high rate of intracranial hemorrhage in cerebral venous thrombosis is not explained by widespread involvement of the venous sinuses. Superior sagittal sinus involvement is associated with higher bleeding risk.

Correction to: Features of intracranial hemorrhage in cerebral venous thrombosis.

The original version of this article unfortunately contained mistakes. The correct information is given below.

pH-specific synthetic chemistry and solution studies in the binary system of iron(III) with the alpha-hydroxycarboxylate substrate quinic acid: potential relevance to iron chemistry in plant fluids.

Iron is an essential metal ion in plant growth and development. Mobilization and further use of that metal by cellular structures in metabolic pathways entails the existence of soluble forms complexed with indigenous organic substrates, such as the low molecular mass d-(-)-quinic acid. In an effort to understand the relevant aqueous chemistry involving well-defined forms of iron, research efforts were carried out on the binary Fe(III)-quinic acid system. pH-specific reactions of FeCl(3).6H(2)O with quinic acid in a molar ratio 1:3 led to the isolation of the mononuclear Fe(III)-quinate complexes, K[Fe(C(7)H(11)O(6))(3)].(OH).3H(2)O (1), (NH(4))[Fe(C(7)H(11)O(6))(3)].(OH) (2), and Na[Fe(C(7)H(11)O(6))(3)].(OH).8H(2)O (3). Compounds 1-3 were characterized by analytical, spectroscopic techniques (UV/vis, FT-IR, Electron Paramagnetic Resonance (EPR), and Mossbauer spectroscopy), cyclic voltammetry, and magnetic susceptibility measurements. Compound 1 crystallizes in P2(1)3, with a = 15.1693(9) A, V = 3490.6(4) A(3), and Z = 4. Compound 2 crystallizes in P2(1)3, with a = 15.2831(9) A, V = 3569.7(4) A(3), and Z = 4. Compound 3 crystallizes in P2(1)3, with a = 15.6019(14) A, V = 3797.8(6) A(3), and Z = 4. The X-ray crystal structures of 1-3 reveal a mononuclear Fe(III) ion bound by three quinates in an octahedral fashion. Each quinate ligand binds Fe(III) through the alpha-hydroxycarboxylate group as a singly deprotonated moiety, retaining the alcoholic hydrogen. EPR measurements in solution suggest that 1 dissociates, releasing free quinate. Solution speciation studies of the binary system (a) unravel the aqueous species distribution as a function of pH and reagent molar ratio, and (b) corroborate the EPR results proposing the existence of a neutral Fe(III)-quinate complex form. The collective physicochemical properties of 1-3 formulate a well-defined profile for the Fe(III) assembly in aqueous media and project structural features consistent with solubilized Fe(III)-hydroxycarboxylate binary forms potentially mobilized into plant (bio)chemical processes.

Aqueous V(V)-peroxo-amino acid chemistry. Synthesis, structural and spectroscopic characterization of unusual ternary dinuclear tetraperoxo vanadium(V)-glycine complexes.

Vanadium participation in cellular events entails in-depth comprehension of its soluble and bioavailable forms bearing physiological ligands in aqueous distributions of binary and ternary systems. Poised to understand the ternary V(V)-H(2)O(2)-amino acid interactions relevant to that metal ion's biological role, we have launched synthetic efforts involving the physiological ligands glycine and H(2)O(2). In a pH-specific fashion, V(2)O(5), glycine, and H(2)O(2) reacted and afforded the unusual complexes (H(3)O)(2)[V(2)(O)(2)(mu(2):eta(2):eta(1)-O(2))(2)(eta(2)-O(2))(2)(C(2)H(5)NO(2))] x 5/4 H(2)O (1) and K(2)[V(2)(O)(2)(mu(2):eta(2):eta(1)-O(2))(2)(eta(2)-O(2))(2)(C(2)H(5)NO(2))] x H(2)O (2). 1 crystallizes in the triclinic space group P1, with a = 7.805(4) A, b = 8.134(5) A, c = 12.010(7) A, alpha = 72.298(9) degrees, beta = 72.991(9) degrees, gamma = 64.111(9) degrees, V = 641.9(6) A(3), and Z = 2. 2 crystallizes in the triclinic space group P1, with a = 7.6766(9) A, b = 7.9534(9) A, c = 11.7494(13) A, alpha = 71.768(2) degrees, beta = 73.233(2) degrees, gamma = 65.660(2) degrees, V = 610.15(12) A(3), and Z = 2. Both complexes 1 and 2 were characterized by UV/visible, LC-MS, FT-IR, Raman, NMR spectroscopy, cyclic voltammetry, and X-ray crystallography. The structures of 1 and 2 reveal the presence of unusual ternary dinuclear vanadium-tetraperoxo-glycine complexes containing [(V(V)=O)(O(2))(2)](-) units interacting through long V-O bonds and an effective glycinate bridge. The latter ligand is present in the dianionic assembly as a bidentate moiety spanning both V(V) centers in a zwitterionic form. The collective physicochemical properties of the two ternary species 1 and 2 project the chemical role of the low molecular mass biosubstrate glycine in binding V(V)-diperoxo units, thereby stabilizing a dinuclear V(V)-tetraperoxo dianion. Structural comparisons of the anions in 1 and 2 with other known dinuclear V(V)-tetraperoxo binary anionic species provide insight into the chemical reactivity of V(V)-diperoxo species in key cellular events such as insulin mimesis and antitumorigenicity, potentially modulated by the presence of glycinate and hydrogen peroxide.

Sensor system based on flexible screen-printed electrodes for electrochemical detection of okadaic acid in seawater.

The monitoring of marine dinophysistoxin okadaic acid in seawater can serve as an early alert system for preventing the potential negative effects this toxin can have on the food industry and human health in general. A disposable sensor system for electrochemical detection of this toxin has been developed using screen-printed electrodes. The method described is based on the inhibition of protein phosphatase type 2A by okadaic acid, evaluating the enzyme activity. p-Nitrophenyl phosphate, 4-methylumbelliferyl phosphate and phenyl phosphate have been tested as substrates achieving good limits of detection of 2.7·10-12 M of okadaic acid. The proposed method has been successfully applied to okadaic acid determination in seawater samples. A study of divalent cations present in seawater that can interfere with the measurement has been carried out. The electrode systems were printed on both rigid and textile backing materials to observe the influence of those materials on the final performance of the sensor.

Comparison of backing materials of screen printed electrochemical sensors for direct determination of the sub-nanomolar concentration of lead in seawater.

An anodic stripping voltammetric method is reported in this study for the determination of sub-nanomolar Pb concentration using disposable sensors, each consisting of three (counter, working and reference) screen-printed electrodes. Sensor performance was optimized for the determination of Pb through several surface modifications, by using single-walled carbon nanotubes, electro-reduced graphene oxide and gold nanoparticles. A scanning electron microscopy study of the deposition of electrogenerated gold nanoparticles of various sizes on the working electrode surface showed that spherical nanoparticles of around 100 nm provided the best results. The modification of working electrodes with graphene and gold nanoparticles permitted the determination of Pb2+ in seawater (Detection Limit: 3.21·10-10 M) without modifying the pH of the sample. The electrode systems were printed on both rigid and textile backing materials, to observe the influence of those materials on the final performance of the sensor.

Surveillance of severe acute respiratory syndrome (SARS) in the post-outbreak period.

INTRODUCTION: This retrospective one-month survey evaluated the practicality of post-severe acute respiratory syndrome (SARS) surveillance recommendations in previously SARS-affected countries, namely Singapore. These included staff medical sick leave for febrile illness, inpatient fevers, inpatient pneumonia, atypical pneumonia, febrile illnesses with significant travel history and sudden unexplained deaths from pneumonia/ adult respiratory distress syndrome (ARDS). METHODS: Surveillance data on medical sick leave of staff, all inpatient fevers, all febrile (temperature greater than or equal to 38 degrees Celsius) inpatient pneumonia, including atypical pneumonia, and deaths from pneumonia were collected from sick leave reports, ward reports, isolation room rounds and mortuary reports from 1 to 28 September 2003. RESULTS: Baseline results show 167 (1.4/1000 staff-days) observed in staff sick leave for febrile illnesses, and 1798 (71.3/1000 bed-days) observed for inpatient fever. There were 40, 31 and 12 instances, respectively, of staff having temperatures of high fever (greater than or equal to 38 degrees Celsius), prolonged sick leave (3 days or more), and repeated sick leave (within 7 days) for febrile illnesses. An average of 4.6 wards a day potentially fulfilled the World Health Organisation SARS alert criteria. Of 27 cases with fever, pneumonia and a total white count of less than 10,000 cells per cubic mm as per Ministry of Health, Singapore criteria for the diagnosis of atypical pneumonia, only five were identified by clinicians. CONCLUSION: Surveillance is time-consuming and current recommendations are not specific enough to be used practically. Surveillance indicators for inpatients must overcome a high degree of background noise.

Changes in cathepsin D activity of maternal tissues during lactation and weaning in rats.

BACKGROUND: A loss of proteins from maternal tissues during lactation has been demonstrated. Protein loss could be explained by intracellular proteolysis. METHODS: Cathepsin D activity was studied in the liver, muscle and mammary gland of lactating and weaned rat dams. Lactation was studied at maximal milk production (L-14) and at the final stage of lactation (L-21). RESULTS: Basal activity (virgin rats) was three times higher in liver and mammary gland than in muscle. At both stages, L-14 and L-21, cathepsin D activity increased in liver (50%) as well as in the gland (164%), but no change was observed in muscle, when compared with controls. Twenty-four hours after litter separation, enzyme activity in the liver decreased to basal levels, while in the mammary gland cathepsin D activity showed a significant decrease but remained higher than control levels. CONCLUSION: Our results show that liver exhibits adaptive changes in the catabolism of proteins in response to the increased demands imposed by lactation on the maternal organism, and when the stimuli disappear activity returns to basal levels. The high activity in mammary gland indicates fast turnover of structures and biomolecules as an answer to the high synthetic activity in this tissue. Activity remained higher in the weaning rats, as a result of the regression process which the mammary gland is undergoing.

[Evaluation of the status of access to emergency care of subjects with myocardial infarction]. / Evaluation des conditions d'accès aux soins d'urgence des sujets atteints d'infarctus du myocarde.

This study, undertaken in the Bas-Rhin area of France by the MONICA Register, presents the evaluation of the procedures followed for 323 subjects under 65 years old suffering from an acute myocardial infarction and subsequently hospitalized for this reason. We observe that 87.5% of the patients first consult a private practitioner -- for the most part a non specialist -- while 9% first contact a mobile coronary unit. 3.5% of patients go directly to hospital. Concerning delays in hospitalization, 35% of patients more than 6 hours to consult a doctor, while the median time between the onset of symptoms and the first call for medical aid is 2 hours. The median delay between the onset of symptoms and arrival at hospital is 5hrs 45 min., 28% of the subjects requiring more than 24 hours to be hospitalized.

Low variability of growth parameters among six O157:H7 and non-O157:H7 Escherichia coli strains.

Five Escherichia coli O157:H7 strains and one nonpathogenic E. coli strain were used. All strains were cultured in brain heart infusion broth and were inoculated in 16-well disposable module cassettes of a Bactometer impedance system. Two initial concentrations were obtained in the wells: 1.37 × 10(3) and 1.36 × 10(5) CFU/ml. The impedance measurements were monitored for 72 h at 5, 10, or 15°C, 48 h at 20°C, and 24 h at 25, 30, 35, 40, 45, 50 or 55°C. The lag time and the generation time of each culture were calculated from the detection time data. The coefficients of variation between the strains' growth parameters were low (0.009 to 0.105 for generation time and 0.074 to 0.475 for lag time). An F test showed no significant differences between strains at 5 or 1% confidence levels.

Assessment of PTEN tumor suppressor activity in nonmammalian models: the year of the yeast.

Model organisms have emerged as suitable and reliable biological tools to study the properties of proteins whose function is altered in human disease. In the case of the PI3K and PTEN human cancer-related proteins, several vertebrate and invertebrate models, including mouse, fly, worm and amoeba, have been exploited to obtain relevant functional information that has been conserved from these organisms to humans along evolution. The yeast Saccharomyces cerevisiae is an eukaryotic unicellular organism that lacks a canonical mammalian-like PI3K/PTEN pathway and PIP3 as a physiological second messenger, PIP2 being essential for its life. The mammalian PI3K/PTEN pathway can be reconstituted in S. cerevisiae, generating growth alteration phenotypes that can be easily monitored to perform in vivo functional analysis of the molecular constituents of this pathway. Here, we review the current nonmammalian model systems to study PTEN function, summarize our knowledge of PTEN orthologs in yeast species and propose the yeast S. cerevisiae as a sensitive biological sensor of PI3K oncogenicity and PTEN tumor suppressor activity.

Experimental and interventional dietary study in humans on the role of HDL fatty acid composition in PGI2 release and Cox-2 expression by VSMC.

BACKGROUND: High-density lipoproteins (HDLs) induce prostacyclin (PGI2) release in vascular smooth muscle cells (VSMCs) by up-regulation of cyclooxygenase-2 (Cox-2). Our goal was to analyze the role of human HDL lipid moiety on Cox-2-dependent PGI2 synthesis in human VSMCs and to assess the impact that the intake of diets with different fatty acid composition exert on HDL-induced PGI2 release. MATERIALS AND METHODS: Human VSMCs were treated with HDL or fatty acids in the presence or absence of different cell signalling inhibitors and PGI2 (by enzyme immunoassay) and Cox-2 protein levels (by Western blot) were analyzed. High-density lipoproteins were obtained from a plasma pool or from plasma of 12 volunteers subjected to a longitudinal dietary interventional study of three consecutive diets periods enriched in monounsaturated fatty acids (MUFAs), polyunsaturated fatty acids n-6 (PUFA n-6) or n-3 (PUFA n-3). RESULTS: High-density lipoprotein delipidation attenuated the effect of HDL on both PGI2 synthesis and Cox-2 up-regulation, while arachidonic acid (AA) but not other fatty acids mimicked the effects of HDL. Arachidonic acid induced PGI2 synthesis and Cox-2 expression through similar mechanisms to those activated by HDL [pertussis toxin-sensitive G proteins, p42/44 mitogen-activated protein kinase (MAPK), p38MAPK, and c-Jun N-terminal kinase-1 (JNK-1) pathways]. Finally, we observed that HDL from the PUFA n-3 dietary period induced lower PGI2 release than that from the PUFA n-6 period (64% vs. 100%). CONCLUSIONS: Our results suggest that lipid moiety modulates HDL-induced PGI2 release/Cox-2 up-regulation in human VSMCs, and that changes in fatty acids as accomplished with the diet can modulate vascular PGI2 homeostasis.