Extreme weather conditions influence the frequency of epistaxis-related emergency room visits.

BACKGROUND: Climate change has been associated with an increase in extreme weather conditions. The aim of this study was to identify environmental factors and the effect of extreme weather events (95th percentile) on the risk for epistaxis-related emergency room visits (EV). METHODS: A total of 2179 epistaxis-related EVs were identified between 2015 and 2018. A distributed lag non-linear model was fitted to investigate the relationship between extreme weather conditions and the total number of epistaxis-related EVs per day. Cumulative relative risk (cRR) is defined as the cumulated daily risk of EV for epistaxis within a stated period after an extreme weather condition compared to the risk of EV at the median value of that weather condition. RESULTS: At a mean daily temperature of 27°C (P95), cRR for epistaxis-related EV was 2.00. At a relative humidity of 39% (P5), cRR was highest on day 3 at 1.59, while extremely high humidity (92%, P99) led to a decreased cRR of 0.7 on day 1. Intense precipitation of 24mm (P99) reduced the cRR on day 3 to 0.38. For prolonged extreme conditions over three days, extremely low wind speed, as well as both high and low atmospheric pressure events, diminished cRR. CONCLUSIONS: Extreme temperatures, relative humidity, and precipitation, as well as extended periods of extreme wind speeds and atmospheric pressure, significantly impact cRR for epistaxis-related EVs.

The genetic toolbox for Acidovorax temperans.

Environmental isolates belonging to the genus Acidovorax play a crucial role in degrading a wide range of pollutants. Studies on Acidovorax are currently limited for many species due to the lack of genetic tools. Here, we described the use of the replicon from a small, cryptic plasmid indigenous to Acidovorx temperans strain CB2, to generate stably maintained shuttle vectors. In addition, we have developed a scarless gene knockout technique, as well as establishing green fluorescent protein (GFP) reporter and complementation systems. Taken collectively, these tools will improve genetic manipulations in the genus Acidovorax.

Loss of genetic diversity in the endemic Hector's dolphin due to fisheries-related mortality.

The endemic New Zealand Hector's dolphin is considered the rarest species of marine dolphin with a total abundance of less than 4000. The species is listed as vulnerable because of fisheries-related mortality due to entanglement in set nets. The vulnerability of this species is further increased by its fidelity to local natal ranges and the genetic isolation of regional populations. Here we present evidence, based on 108 contemporary samples and 55 historical samples dating back to 1870, of a significant loss of mitochondrial DNA (mtDNA) diversity in two regional populations of Hector's dolphin. The haplotype diversity (h) was calculated from sequences of a 206 bp fragment in the mtDNA control region, designed to identify 13 out of the 14 known maternal lineages. Over the last 20 years, the North Island population has been reduced from at least three lineages (h = 0.41) to a single lineage (h = 0; p < 0.05). Given its small size, reproductive isolation and reduced genetic diversity, this population is likely to become extinct. The diversity of the East Coast South Island population has declined significantly from h = 0.65 to h = 0.35 (p < 0.05). Based on trend analysis of the mtDNA diversity, we predict that the East Coast population will lose all mtDNA diversity within the next 20 years. This time-series of reduction in genetic variation provides independent evidence of the severity of population decline and habitat contraction resulting from fisheries and perhaps other human activities.

Sudden onset of paralysis in a twenty year-old male patient.

We report on a twenty year-old male patient who presented with sudden onset of flaccid paralysis. After exclusion of central nervous system involvement, marked hypokalemia pointed to the diagnosis of hypokalemic periodic paralysis, which was completely reversible on oral and parenteral potassium substitution. A provocation test with glucose and insulin administration leading to hypokalemia and incipient paralysis of the limbs confirmed the diagnosis. Pathogenetically, this syndrome is characterized by an excessive shift of potassium ions into the muscle cells. Therapeutic measures include potassium-sparing diuretics, beta blockers, acetazolamide or diclofenamide. In less severe cases, oral potassium may be sufficient to reverse the symptoms.

[Rupture of a congenital right coronary sinus of Valsalva aneurysm as etiology of acute cardiac decompensation]. / Die Ruptur eines kongenitalen rechtskoronaren Sinus-Valsalva-Aneurysmas als Ursache einer akuten kardialen Dekompensation.

A 54 year old woman was admitted to a hospital because of acute thoracal pain, dyspnea, and clinical signs of overt right heart failure. Transthoracic and multiplane echocardiography established the diagnosis of a ruptured aneurysm of the right coronary sinus of valsalva into the right atrium which could be confirmed by cardiac catheterization. During heart surgery, which was done without complications, the defect was closed with a suture. Six months later echocardiography showed a normal right ventricle; the function of the aortic valve was regular. Acute heart failure may be due to a congenital structural cardiac anomaly in spite of the age of 54. In such conditions transthoracic and especially transesophageal echocardiography serve as noninvasive excellent tools to make an exact diagnosis.

Origin and radiation of Southern Hemisphere coastal dolphins (genus Cephalorhynchus).

The genus Cephalorhynchus (Gray 1846) consists of four species of small coastal dolphins distributed in cool temperate waters around the Southern Hemisphere. Each species is sympatric with other members of the subfamily Lissodelphininae but widely separated from other congeners. To describe the origin and radiation of these species, we examined 442 bp of mitochondrial DNA control region sequences of 307 individuals from the genus Cephalorhynchus and compared these to sequences from other members of the subfamily Lissodelphininae. We investigate the hypotheses that Cephalorhynchus is a monophyletic genus or, alternatively, that the four species have arisen separately from pelagic Lissodelphine species and have converged morphologically. Our results support the monophyly of Cephalorhynchus within the Lissodelphininae and a pattern of radiation by colonization. We confirm a pattern of shallow but diagnosable species clades with Heaviside's dolphin as the basal branch. We further examine the monophyly of maternal haplotypes represented by our large population sample for each species. Based on this phylogeographic pattern, we propose that Cephalorhynchus originated in the waters of South Africa and, following the West Wind Drift, colonized New Zealand and then South America. The Chilean and Commerson's dolphins then speciated along the two coasts of South America, during the glaciation of Tierra del Fuego. Secondary radiations resulted in genetically isolated populations for both the Kerguelen Island Commerson's dolphin and the North Island Hector's dolphin. Our results suggest that coastal, depth-limited odontocetes are prone to population fragmentation, isolation and occasionally long-distance movements, perhaps following periods of climatic change.

Population structure of nuclear and mitochondrial DNA variation among humpback whales in the North Pacific.

The population structure of variation in a nuclear actin intron and the control region of mitochondrial DNA is described for humpback whales from eight regions in the North Pacific Ocean: central California, Baja Peninsula, nearshore Mexico (Bahia Banderas), offshore Mexico (Socorro Island), southeastern Alaska, central Alaska (Prince Williams Sound), Hawaii and Japan (Ogasawara Islands). Primary mtDNA haplotypes and intron alleles were identified using selected restriction fragment length polymorphisms of target sequences amplified by the polymerase chain reaction (PCR-RFLP). There was little evidence of heterogeneity in the frequencies of mtDNA haplotypes or actin intron alleles due to the year or sex composition of the sample. However, frequencies of four mtDNA haplotypes showed marked regional differences in their distributions (phi ST = 0.277; P < 0.001; n = 205 individuals) while the two alleles showed significant, but less marked, regional differences (phi ST = 0.033; P < 0.013; n = 400 chromosomes). An hierarchical analysis of variance in frequencies of haplotypes and alleles supported the grouping of six regions into a central and eastern stock with further partitioning of variance among regions within stocks for haplotypes but not for alleles. Based on available genetic and demographic evidence, the southeastern Alaska and central California feeding grounds were selected for additional analyses of nuclear differentiation using allelic variation at four microsatellite loci. All four loci showed significant differences in allele frequencies (overall FST = 0.043; P < 0.001; average n = 139 chromosomes per locus), indicating at least partial reproductive isolation between the two regions as well as the segregation of mtDNA lineages. Although the two feeding grounds were not panmictic for nuclear or mitochondrial loci, estimates of long-term migration rates suggested that male-mediated gene flow was several-fold greater than female gene flow. These results include and extend the range and sample size of previously published work, providing additional evidence for the significance of genetic management units within oceanic populations of humpback whales.

Escherichia coli expression and purification of recombinant dog albumin, a cross-reactive animal allergen.

BACKGROUND: Animal hair-dander represents an important source of indoor allergens. Diagnosis and therapy of animal allergy would benefit from the availability of defined recombinant allergens. They may be preferred to animal-derived proteins, particularly for in vivo application in patients. OBJECTIVE: The purpose of this study was to express and purify recombinant dog albumin, an important cross-reactive animal allergen. METHODS: Complementary (c)DNA sequences coding for dog albumin were obtained by reverse transcription and subsequent PCR amplification from dog liver RNA. Dog albumin-encoding cDNA sequences were inserted into phage lambdagt11, and IgE-reactive phage clones were isolated by immunoscreening with serum IgE from a patient with dog allergy. Dog albumin was expressed as IgE-reactive recombinant protein in Escherichia coli and purified by inclusion body preparation, resolubilization, and diethylaminoethyl cellulose chromatography. Cross-reactivity of dog albumin with cat and human albumin was examined by immunoblot, as well as ELISA inhibition experiments. RESULTS: A cDNA sequence coding for complete dog albumin was obtained by reverse transcription and subsequent PCR amplification from dog liver. The cDNA and deduced amino acid sequence of dog albumin was highly homologous to the sequences of albumins from animals to human subjects, thus explaining the extensive cross-reactivities among albumins. Recombinant dog albumin was expressed in E coli and purified. It reacted with serum IgE from patients allergic to dog albumin and a monoclonal anti-human albumin antibody. Immunologic competition experiments performed with serum IgE from patients allergic to dog albumin and a mouse monoclonal antihuman albumin antibody indicated the presence of similar epitopes on dog, cat, and human albumin. CONCLUSION: Recombinant dog albumin may be used for diagnostic purposes to identify patients who are cross-sensitized to many animal species and perhaps for specific immunotherapy of sensitized individuals.