Diagnosing skull fracture in children with closed head injury using point-of-care ultrasound vs. computed tomography scan.

Diagnostic and therapeutic interventions in children for traumatic brain injury, which is known as the most important complication in trauma, require special attention. This study aimed to evaluate the accuracy of point-of-care ultrasound (POCUS) in diagnosing skull fracture in children with closed head injury in comparison with computed tomography (CT) scan. The current prospective cross-sectional study was conducted on children (0-14 years old), who were referred to the emergency department of a general teaching hospital in Shiraz, southern Iran (January-March 2018), with close head injury and were suspected of bone fracture. The participants were selected using a convenience sampling. The results of POCUS performed by emergency medicine (EM) residents were compared with the results of CT scan, which was reported by radiologists and considered a gold standard. Then, diagnostic tests were calculated. A total of 168 children were enrolled, with the mean ± standard deviation age of 6.21 ± 3.99. The most affected areas in the skull were the frontal (34.5%) and occipital areas (33.3%). POCUS had a sensitivity and specificity of 81.8% (95%CI, 48.2-97.7%) and 100% (95%CI, 97.7-100%), respectively. Positive and negative predictive values were 100% and 98.7%, with an accuracy of 98.8% in comparison with CT scan in the diagnosis of skull fracture.Conclusion: The results showed that POCUS with a portable ultrasonography machine, performed by the EM's physicians, have high diagnostic precision and can be considered a tool in the management of patients with closed head injury. What is Known: • Some studies have investigated the accuracy of ultrasound in diagnosing skull bone fractures in children with closed head injury, but before conducting this survey, no definite evidence recommended POCUS for skull fracture in children with closed head trauma in the ED. What is New: • POCUS with a portable ultrasonography machine, performed by the EM's physicians, has high diagnostic precision and can be considered a tool in the management of patients with closed head injury.

Accuracy of three-point compression ultrasound for the diagnosis of proximal deep-vein thrombosis in emergency department.

BACKGROUND: This study aimed to assess the accuracy of three-point compression ultrasonography (3PCUS) performed for the diagnosis of proximal deep-vein thrombosis (DVT) in Emergency Department (ED) compared with the results of duplex US (DUS) (whole-leg compression ultrasound). MATERIALS AND METHODS: The current prospective cross-sectional study with diagnostic test assessment was conducted on adult patients who were referred to the ED of a general teaching hospital in Shiraz, southern part of Iran (September 2016-May 2017), suspected of lower-extremity DVT, using a convenience sampling. The results of 3PCUS performed by ED residents were compared with the results of DUS performed by the radiology residents, which was considered as a criterion standard. RESULTS: A total of 240 patients were enrolled, with a mean (standard deviation) age of 59.46 (16.58). 3PCUS has a sensitivity and a specificity of 100% (95% confidence interval [CI], 96.55%-100%) and 93.33% (95% CI, 87.72%-96.91%), respectively, in comparison with DUS (whole-leg compression ultrasound). Negative predictive value and positive predictive value were 100% and 92.11% (95% CI, 86.12%-95.64%), respectively, with an accuracy of 96.25% (95% CI, 93%-98.27%). CONCLUSION: The results of this study showed that 3PCUS of the lower extremities with a portable US machine, performed by the ED's residents, can accurately identify the presence or absence of lower-extremity DVT.

Role of the Vibrio cholerae matrix protein Bap1 in cross-resistance to antimicrobial peptides.

Outer membrane vesicles (OMVs) that are released from Gram-negative pathogenic bacteria can serve as vehicles for the translocation of effectors involved in infectious processes. In this study we have investigated the role of OMVs of the Vibrio cholerae O1 El Tor A1552 strain in resistance to antimicrobial peptides (AMPs). To assess this potential role, we grew V. cholerae with sub-lethal concentrations of Polymyxin B (PmB) or the AMP LL-37 and analyzed the OMVs produced and their effects on AMP resistance. Our results show that growing V. cholerae in the presence of AMPs modifies the protein content of the OMVs. In the presence of PmB, bacteria release OMVs that are larger in size and contain a biofilm-associated extracellular matrix protein (Bap1). We demonstrated that Bap1 binds to the OmpT porin on the OMVs through the LDV domain of OmpT. In addition, OMVs from cultures incubated in presence of PmB also provide better protection for V. cholerae against LL-37 compared to OMVs from V. cholerae cultures grown without AMPs or in presence of LL-37. Using a bap1 mutant we showed that cross-resistance between PmB and LL-37 involved the Bap1 protein, whereby Bap1 on OMVs traps LL-37 with no subsequent degradation of the AMP.

Sulfonic Acid-Functionalized Magnetic Nanoparticles as an Efficient Catalyst for the Synthesis of Benzo[4, 5]imidazo[1, 2-a]pyrimidine Derivatives, 2-Aminobenzothia Zolomethylnaphthols and 1-Amidoalkyl-2-naphthols.

BACKGROUND: Carbon-based sulfonated catalysts have several advantages but their separation by filtration is still a challenge. On the other hand, the synthesis of magnetic sulfonated carbon nanoparticle indicated that the magnetic separation could be an efficient way to separate the catalyst from the reaction mixture. OBJECTIVE: In order to synthesize a separable magnetic Fe3O4@C-SO3H nanoparticle (MNPs) with high catalytic activity in organic transformation, three environmental-benign and low-cost sulfonic acidfunctionalized magnetic nanoparticle (Fe3O4@C-SO3H) were successfully synthesized. MATERIALS AND METHODS: The Nano catalysts were prepared by solvothermal carbonization of Sucrose (Suc), Starch (Sta) or Cellulose (Cel) in the presence of Fe3O4 Nanoparticle and then grafting of the sulfonic groups on the surface of resulted Fe3O4@C nanoparticles in the presence of p-Toluenesulfonic. Then the Nano catalysts were characterized using XRD, FESEM and FT-IR. RESULTS: Three Fe3O4@C-SO3H were successfully synthesized. The resulted MNPs were used for the synthesis of benzo [4, 5] imidazo[1, 2-a]-pyrimidine derivatives, 2/-aminobenzothiazolomethylnaphthols and 1-amidoalkyl-2-naphthols under solvent-free conditions in excellent yields. It was found that high catalytic activity and easy magnetic separation from the reaction mixture are important achievement with regard to the efficiency and reusability of the catalyst in synthesis. CONCLUSION: The MNPs were synthesized and used as an efficient catalysts for the one-pot synthesis of benzo [4, 5] imidazo[1, 2-a]-pyrimidine derivatives, 2/-aminobenzothiazolomethylnaphthols, and 1-amidoalkyl-2- naphthols under solvent-free conditions in excellent yields. High catalytic activity and easy magnetic separation from the reaction mixture are two factors for evaluating the performance of Fe3O4@C-SO3H nanoparticles in the organic transformations.

Swimming exercise attenuates psychological dependence and voluntary methamphetamine consumption in methamphetamine withdrawn rats.

OBJECTIVES: This study evaluated the effect of swimming exercise during spontaneous methamphetamine (METH) withdrawal on the anxiety, depression, obsessive-compulsive disorder (OCD) and voluntary METH consumption in METH-dependent rats. MATERIALS AND METHODS: Male Wistar rats were repeatedly administered with bi-daily doses of METH (2 mg/kg, subcutaneous) over a period of 14 days. Exercised rats were submitted to swimming sessions (45 min/day, five days per week, for 14 days) during spontaneous METH-withdrawal. Then, all animals were tested for the assessment of anxiety by using the elevated plus-maze (EPM), the grooming behaviors (OCD), and depression using forced swimming test (FST) and voluntary METH consumption using a two-bottle choice (TBC) paradigm for the assessment of craving. RESULTS: The results showed that the swimmer METH-withdrawn rats exhibited an increase in EPM open arm time and entries and a reduction of immobility and grooming behaviors compared with the sedentary METH groups. Also, voluntary METH consumption was less in the swimmer METH-withdrawn rats than the sedentary METH groups throughout 5-8 days. CONCLUSION: This study showed that regular swimming exercise reduced voluntary METH consumption in animal models of craving by reducing anxiety, OCD, and depression in the METH-withdrawn rats. Thus, physical training may be ameliorating some of the withdrawal behavioral consequences of METH.