Microbiome-induced Increases and Decreases in Bone Tissue Strength can be Initiated After Skeletal Maturity.

Recent studies in mice have indicated that the gut microbiome can regulate bone tissue strength. However, prior work involved modifications to the gut microbiome in growing animals and it is unclear if the same changes in the microbiome, applied later in life, would change matrix strength. Here we changed the composition of the gut microbiome before and/or after skeletal maturity (16 weeks of age) using oral antibiotics (ampicillin + neomycin). Male and female mice (n=143 total, n=12-17/group/sex) were allocated into five study groups:1) Unaltered, 2) Continuous (dosing 4-24 weeks of age), 3) Delayed (dosing only 16-24 weeks of age), 4) Initial (dosing 4-16 weeks of age, suspended at 16 weeks), and 5) Reconstituted (dosing from 4-16 weeks following by fecal microbiota transplant from Unaltered donors). Animals were euthanized at 24 weeks of age. In males, bone matrix strength in the femur was 25-35% less than expected from geometry in mice from the Continuous (p= 0.001), Delayed (p= 0.005), and Initial (p=0.040) groups as compared to Unaltered. Reconstitution of the gut microbiota, however, led to a bone matrix strength similar to Unaltered animals (p=0.929). In females, microbiome-induced changes in bone matrix strength followed the same trend as males but were not significantly different, demonstrating sex-related differences in the response of bone matrix to the gut microbiota. Minor differences in chemical composition of bone matrix were observed (Raman spectroscopy). Our findings indicate that microbiome-induced impairment of bone matrix in males can be initiated and/or reversed after skeletal maturity. The portion of the femoral cortical bone formed after skeletal maturity (16 weeks) is small; however, this suggests that microbiome-induced changes in bone matrix occur without osteoblast/osteoclast turnover using an, as of yet unidentified mechanism. These findings add to evidence that the mechanical properties of bone matrix can be altered in the adult skeleton.

Periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis recurrence temporally associated with allergen-specific immunotherapy in a female adolescent: a case report.

Periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) syndrome is the most common periodic fever syndrome in pediatric patients. It is clinically characterized by fever flares lasting 3-7 days, reappearing every 2-8 weeks with a distinctive clockwork regularity. PFAPA generally begins before 5 years of age and usually ceases 3-5 years after onset. Recurrences may be observed in adolescence and adulthood in up to 20% of cases. The authors aim to describe a case of PFAPA recurrence in adolescence temporally associated with allergen-specific immunotherapy (ASIT). A 16-year-old female patient was referred to the rheumatology unit due to recurrent episodes of fever one month after initiating ASIT for allergic rhinitis. These episodes occurred every 4 weeks and lasted 3 days. During these episodes, she also presented with a sore throat, tonsillar exudates, and cervical lymphadenopathy. Abortive treatment with oral prednisolone was attempted in these episodes, with complete resolution of fever after a single dose. After reviewing her medical background, she had previously experienced febrile episodes accompanied by aphthous ulcers and tonsillar exudates occurring every 7-8 weeks from age 2-7. The etiopathogenesis of PFAPA remains uncertain. Environmental triggers, particularly those with immunomodulator effects, may interfere with the immune responses responsible for PFAPA occurrence, but the mechanisms are still unclear. The authors describe the first report of the reappearance of PFAPA flares, possibly due to ASIT. Further studies are needed to fully clarify if ASIT constitutes a true environmental trigger of PFAPA.

Stimulator of interferon genes is required for Toll-Like Receptor-8 induced interferon response.

The innate immune system is equipped with multiple receptors to detect microbial nucleic acids and induce type I interferon (IFN) to restrict viral replication. When dysregulated these receptor pathways induce inflammation in response to host nucleic acids and promote development and persistence of autoimmune diseases like Systemic Lupus Erythematosus (SLE). IFN production is regulated by the Interferon Regulatory Factor (IRF) transcription factor family of proteins that function downstream of several innate immune receptors such as Toll-like receptors (TLRs) and Stimulator of Interferon Genes (STING). Although both TLRs and STING activate the same downstream molecules, the pathway by which TLRs and STING activate IFN response are thought to be independent. Here we show that STING plays a previously undescribed role in human TLR8 signaling. Stimulation with the TLR8 ligands induced IFN secretion in primary human monocytes, and inhibition of STING reduced IFN secretion from primary monocytes from 8 healthy donors. We demonstrate that TLR8-induced IRF activity was reduced by STING inhibitors. Moreover, TLR8-induced IRF activity was blocked by inhibition or loss of IKKε, but not TBK1. Bulk RNA transcriptomic analysis supported a model where TLR8 induces transcriptional responses associated with SLE that can be downregulated by inhibition of STING. These data demonstrate that STING is required for full TLR8-to-IRF signaling and provide evidence for a new framework of crosstalk between cytosolic and endosomal innate immune receptors, which could be leveraged to treat IFN driven autoimmune diseases. Background: High levels of type I interferon (IFN) is characteristic of multiple autoimmune diseases, and while TLR8 is associated with autoimmune disease and IFN production, the mechanisms of TLR8-induced IFN production are not fully understood. Results: STING is phosphorylated following TLR8 signaling, which is selectively required for the IRF arm of TLR8 signaling and for TLR8-induced IFN production in primary human monocytes. Conclusion: STING plays a previously unappreciated role in TLR8-induced IFN production. Significance: Nucleic acid-sensing TLRs contribute to development and progression of autoimmune disease including interferonopathies, and we show a novel role for STING in TLR-induced IFN production that could be a therapeutic target.

Uveitis in patients with oligoarticular juvenile idiopathic arthritis and juvenile spondyloarthritis/enthesitis related arthritis: is there any difference?

Juvenile idiopathic arthritis (JIA) is the most common systemic disease causing uveitis in childhood and adolescence.

The Silent Threat-Alkali Foot Burn: A Case Report.

Despite current workplace protection measures, chemical burn accidents are not uncommon. Among these, alkali burn is the most challenging due to its silent behaviour and aggressive mechanism. Characterized by its initial painless onset, allowing a prolonged exposure, it tends to result in deeper and more destructive burns, creating major reconstructive and therapeutic challenges. This case concerns a 53-year-old male who sustained a full thickness burn of his left instep foot after prolonged contact with an alkali substance. The wound was submitted to several surgical debridement procedures, with preservation of the major tendinous and vascular-nervous structures. The skin defect was then repaired with skin graft. Early recognition and prompt management with copious and prolonged wound irrigation is paramount. As in this type of burn it is difficult to initially assess its true depth, even after initial surgical debridement, a more cautious approach is recommended. Chronic pain is associated with chemical burns and it should be treated early in the process with the use of multimodal analgesia in order to prevent future complications. No matter the absence of major complaints in the 4 week-postoperative evaluation, the possible long-term consequences are still unknown. Despite the prolonged exposure time and the initial presentation with a deep burn, after several surgical debridement procedures, preservation of major tendon and neurovascular structures was assured, which allowed a plain approach for reconstruction of the wound with a skin graft. The case illustrates different challenges associated with evaluation and treatment of patients with deep alkali burns. Also, usage auditing and awareness of regular users appear to be essential.

Les brûlures chimiques au travail restent relativement fréquentes malgré les mesures de protection. Les atteintes par agent alcalin sont particulièrement problématiques car elles sont insidieuses bien que très destructrices. Le temps de contact est prolongé et les destructions sont majeures, posant de difficiles problèmes de reconstruction, en raison de leur caractère initialement indolore. Nous présentons le cas d'un homme de 53 ans victime d'une brûlure du cou de pied gauche après contact prolongé avec un agent alcalin. Les excisions successives ont permis de préserver les éléments nobles et de greffer secondairement la zone touchée. Il est indispensable de diagnostiquer précisément l'atteinte et de laver la région atteinte à grande eau. La profondeur réelle est difficile à apprécier initialement si bien que les excisions doivent être prudentes. Les douleurs chroniques ne sont pas rares dans ces cas et peuvent être prévenues par la qualité de l'analgésie initiale, multimodale. A un mois, le patient ne se plaint de rien, ce qui ne préjuge pas de complications plus tardives. Malgré un temps de contact prolongé et un aspect initial profond, les éléments nobles on pu être préservés, permettant une couverture par simple greffe. Ce cas illustre les difficultés dans le diagnostic et le traitement des brûlures profondes par base. Il est essentiel d'éduquer et surveiller les usagers réguliers de ces produits.

Transcriptional downregulation of ABC transporters is related to follicular degeneration after vitrification and in vitro culture of ovine ovarian tissue.

ATP-binding cassette (ABC) transporters perform multiple functions in reproductive tissues. During ovarian tissue vitrification, the plasma membrane has important functions in the influx or efflux of water, and substances such as cryoprotectants and channel proteins that are required in this process. Thus, the present study aimed to verify the relative abundance of mRNA transcript of ABC transporters ABCB1, ABCG2, and MRP2 after vitrification and in vitro culture (IVC) of ovine ovarian tissue. For this study, the ovarian cortex fragments were proportioned into four groups as fresh control, vitrified control, fresh culture, and vitrified culture groups. After vitrification and in vitro culture, the ovarian tissue was evaluated using morphological procedures. Further, relative abundance of ABCB1, ABCG2, and MRP2 transporter mRNA transcripts in the ovarian cortex subjected to aforementioned treatment conditions were evaluated using qPCR. Our results showed a negative association between degenerated follicles and mRNA transcript abundances of ABCB1 and ABCG2. In addition, the percentage of growing follicles in the ovine ovarian cortex after vitrification was similar to that of the fresh control tissue without in vitro culture. The in vitro culture of fresh and vitrified tissue however, showed a significant decrease in the percentage of growing follicles. To the best of our knowledge, we believe that our data for the first time has studied the relative abundances of ABCB1 and ABCG2 mRNA transcripts in the ovine ovarian cortex. In addition, alterations of these protein channels may be indicative of a deleterious effect of osmotic stress on follicular survival during vitrification. Furthermore, these effects were detectable only after the IVC of the ovarian tissues. Nonetheless, further studies are required to investigate the functions of ABC transporters in ovine folliculogenesis, especially after in vitro culture of ovarian tissue.

The Role Of Comorbidities On Outcome Prediction In Acute Burn Patients.

Burn trauma is a leading cause of mortality and morbidity. None of the currently available formulas for mortality prediction take into account the impact of comorbidities on burn patients' outcome. In this study, we evaluate the impact of comorbidities on in-hospital mortality and prolonged length of hospital stay (≥30 days). A retrospective analysis of burn patients' medical records, over a 5-year period, was undertaken. A total of 677 patients were included. The mortality rate was 6.5%. Deceased patients and survivors with length of hospital stay (LOS) of 30 or more days were significantly older, had larger %TBSA burned, were more likely to have inhalation injury and comorbidities, and had higher Charlson Comorbidity Index (CCI) scores. On the multivariate logistic regression models, age, %TBSA burned, CCI score and the presence of inhalation injury were independently associated with mortality and prolonged LOS. In conclusion, the authors suggest that the inclusion of comorbidities should be considered on burn admission scores in an attempt to better predict burn mortality.

Les brûlures sont responsables de morbidité et de mortalité élevées. Aucun des scores prédictifs actuels ne prend en compte les comorbidités des patients. Cette étude évalue leur impact sur le devenir et la durée d'hospitalisation prolongée (≥30 jours). Il s'agit d'une étude rétrospective fondée sur l'analyse des dossiers de 667 patients hospitalisés pendant une période de 5 ans, chez lesquels la mortalité s'est avérée être de 6,5%. Les patients décédés et à la durée de séjour ≥30 jours étaient significativement plus âgés, brûlés sur une plus grande surface, avaient plus fréquemment inhalé des fumées et avaient plus de comorbidités (reflétées par un score de Charlson- SCh- plus élevé). En analyse multivariée, l'âge, la surface brûlée, l'inhalation de fumées et le SCh était des facteurs indépendants de séjour prolongé et de mortalité. Les auteurs suggèrent donc d'inclure les comorbidités dans les scores prédictifs concernant les brûlés.

Determination of multi-class polyaromatic compounds in sediments by a simple modified matrix solid phase dispersive extraction.

A simple, efficient matrix solid phase dispersive extraction (MSPD) method was optimised to analyse simultaneously polycyclic aromatic hydrocarbons (PAHs) and polychlorobiphenyls (PCBs) from sediments, and was compared to microwave-assisted extraction (MAE). New dispersing agents were tested to improve MSPD extraction. 3-chloropropyl-bonded silica particles, in addition to Florisil, increased significantly the polyaromatics desorption capacity. A compromise was found for eluting both families of compounds from sediments, using a small volume of hexane/acetone. Low procedural detection limits could be reached (0.06-0.22 ng g-1 and 0.3-1.1 ng g-1 for PAHs and PCBs, respectively). Mean total extraction recoveries were good for PAHs (>67%, depending on the sediment) and for PCBs (>89%), with good precision (6-9% and 4-10% inter-day precision for PAHs and PCBs, respectively). Higher recoveries for PCBs could be reached in comparison with formerly developed sonication or Soxhlet extraction methods, but also with MAE. MSPD offered significant decrease of sample amount, of solvent consumption and allowed more efficient cleaning of the sediment matrix, leading to less matrix effects compared to MAE, removing lots of interfering compounds without additional purification step. The robustness of the MSPD methodology could be demonstrated extracting quantitatively sediments from different sources and with various mineralogical characteristics.

Data integration for infrastructure asset management in small to medium-sized water utilities.

Water utilities collect, store and manage vast data sets using many information systems (IS). For infrastructure asset management (IAM) planning those data need to be processed and transformed into information. However, information management efficiency often falls short of desired results. This happens particularly in municipalities where management is structured according to local government models. Along with the existing IS at the utilities' disposal, engineers and managers take their decisions based on information that is often incomplete, inaccurate or out-of-date. One of the main challenges faced by asset managers is integrating the several, often conflicting, sources of information available on the infrastructure, its condition and performance, and the various predictive analyses that can assist in prioritizing projects or interventions. This paper presents an overview of the IS used by Portuguese water utilities and discusses how data from different IS can be integrated in order to support IAM.

The effects of metabolic syndrome, obesity, and the gut microbiome on load-induced osteoarthritis.

OBJECTIVE: Metabolic syndrome is characterized by obesity, hyperglycemia, hypertension, insulin resistance, and dyslipidemia. Metabolic syndrome is associated with osteoarthritis (OA), but it is unclear if the association is attributable to increased mechanical loading on joints caused by obesity or other aspects of metabolic syndrome. Here we examined the effects of altered metabolism, obesity, and the gut microbiome on load-induced OA. DESIGN: Cartilage damage was induced through cyclic compressive loading in four groups of adult male mice: Toll-like receptor-5 deficient (TLR5KO) mice that develop metabolic syndrome due to alterations in the gut microbiome, TLR5KO mice submitted to chronic antibiotics to prevent metabolic syndrome (TLR5KOΔMicrobiota), C57BL/6J mice fed a high fat diet to cause obesity (HFD), and untreated C57BL/6J mice (WT). Loading was applied for 2 weeks (n = 10-11/group) or 6 weeks (n = 10-11/group). RESULTS: After 2 weeks of loading, cartilage damage (OARSI score) was not different among groups. After 6 weeks of loading, HFD mice had increased load-induced cartilage damage, while TLR5KO mice had cartilage damage comparable to WT mice. TLR5KOΔMicrobiota mice had less cartilage damage than other groups. HFD mice had elevated serum inflammatory markers. Each group had a distinct gut microbiome composition. CONCLUSIONS: Severe obesity increased load-induced cartilage damage, while milder changes in adiposity/metabolic syndrome seen in TLR5KO mice did not. Furthermore, the effects of systemic inflammation/obesity on cartilage damage depend on the duration of mechanical loading. Lastly, reduced cartilage damage in the TLR5KOΔMicrobiota mice suggests that the gut microbiome may influence cartilage pathology.

Zero discharge: Pilot project for biodegradation of cattle effluent by pyroclastic "lapilli" treatment for fodder irrigation.

Livestock effluents are a nutrient supply that is beneficial for crops, so their use is essential to guarantee the sustainability of the global management of farms. Zero discharge cattle effluent management to irrigate fodder crops is a mitigation option, so it is considered a key factor for adaptation to climate change. This paper presents the result of an "on site" pilot scale (three-stage, vertical flow filtration system using lapilli). This is a low-cost solution in terms of finance and energy, which does not require the addition of chemicals, to treat a cattle effluent. The effluent's quality obtained allowed it to be injected in a drip system with low risks of obstruction. And the pilot system allowed to obtain elimination values for the main parameters of effluent's quality (TSS and COD, 98% and 80% respectively) similar or greater than the ones obtained in other treatments of low cost and energy, and gives values contemplated in reclaimed water reuse guidelines of many countries. Furthermore, elimination rate for the BOD5 obtained 35 mgL-1 in treated effluent. High removal rates were obtained for N, P, K, Cu, Fe and Mn, medium for Ca, Mg and Zn and low for B and Na. These shows that the pilot system and fodder crop combination provide an optimal solution to small farms, controlling sanitary risks. The tested flow allows the use of this system by conventional small farms, which represented 94% of total cow farms in Canary Islands.

Microcystin and pyriproxyfen are toxic to early stages of development in Rhamdia quelen: An experimental and modelling study.

The recent increase of freshwater eutrophication has favored cyanobacteria blooms and consequently the increase of toxins such as microcystin-LR in aquatic environments, but few is know about the associated effect of toxin and other compounds. Pyriproxyfen is an insecticide indicated by WHO (World Health Organization) to control Aedes aegypti mosquito (vector of Dengue, Chikungunya and Zika diseases), however, the effects are not well described to non-target species, such as fish. The early life stages (ELS) of fish are more sensitive to chemical stress due to higher metabolic rate, immature immune system and high superficial area/volume ratio. In the current study, ELS of R. quelen a Neotropical fish were exposed to environmentally realistic concentrations of microcystin (1, 10 and 100 µg L-1; M1, M2 and M3 groups, respectively) from an algal extract, pyriproxyfen (1 and 10 µg L-1, P1 and P2) and their association (co-exposure). The hatching, survival and larvae deformities were analyzed, and applied a mathematical model to evaluate the effects on the population size along further generations. Both compounds were toxic to embryos/larvae of fish, but the effects were more pronounced in M2, P1M2 and P2M1 for hatching and M2, P1M2, P2M1 and P1 for survival. Deformities prevailed in groups exposed to the chemicals at 48 hpf (hours post-fertilization) were suggestions of toxicological interaction in P1M2, P2M1 and P2M2 at 48 and 72 hpf. In 96 hpf, the levels of deformities were lower than in previous times. Model predicted population density over 100 years decreased to lower than 0.5 (50%) in all groups, except for P1M1, indicating risk of extinction. P1M2 had the worse results, followed by M2, P1M3 and P2M1. Cyanobacterial blooms can lead to microcystin-LR levels higher than M2 (10 µg L-1), and the suggestion of toxicological interaction with pyriproxyfen is relevant because both compounds may potentially coexist in aquatic environments. Finally, mathematical models may provide an ecological interpretation of the risk of exposure of fish.

A down-shifting Eu3+-doped Y2WO6/TiO2 photoelectrode for improved light harvesting in dye-sensitized solar cells.

Y1.86Eu0.14WO6 phosphors were prepared using a solid-state reaction method. Their optical properties were analysed, and they was mixed with TiO2, sintered, and used as a photoelectrode (PE) in dye-sensitized solar cells (DSSCs). The as-prepared photoelectrode was characterized by photoluminescence spectroscopy, diffuse reflectance, electrochemical impedance spectroscopy (EIS) and X-ray diffraction. The photoelectric conversion efficiency of the DSSC with TiO2:Y1.86Eu0.14WO6 (100:2.5) was 25.8% higher than that of a DSCC using pure TiO2 as PE. This high efficiency is due to the ability of the luminescent material to convert ultraviolet radiation from the sun to visible radiation, thus improving the solar light harvesting of the DSSC.

The role of microsurgical flaps in primary burn reconstruction.

Despite the wide and growing use of microsurgery, its application in primary burn reconstruction is not very frequent as it faces a number of additional challenges in this setting. A retrospective analysis of the clinical records of all patients submitted to microvascular free tissue transfer for primary burn reconstruction over an 8-year period (from January 2009 to December 2016) was performed. An evaluation of the indications, timing, principles of flap selection, complications and outcomes of free tissue transfer in primary burn reconstruction was made. Fourteen patients required 18 microsurgical flaps for acute soft tissue reconstruction (1.1% of all patients admitted). 64.3% of the patients were male. The mean age was 59.64 years, and mean TBSA was 10.5%. The majority of the injuries were caused by flames (71.4%), followed by electrical contact (21.4%). The primary indication for microsurgical reconstruction was tissue deficit with exposure of tendons, nerves, vessels, bone and/or joints after debridement. The procedure was more often performed in the early period after injury (between the 5th and 22nd day). The most frequently used flaps were the Latissimus dorsi and the anterolateral thigh flap. Major complications included 2 total flap failures (11.1%) and a partial flap failure that required reconstruction with another free flap. Microsurgical free flaps have a valuable role in primary burn reconstruction. Despite the reported higher complication rate in this specific clinical scenario, their use may reduce the total number of surgeries needed to achieve wound closure.

Bien que de plus en plus utilisée, la microchirurgie est rarement utilisée dans la prise en charge initiale des brûlés, et doit faire face à plusieurs difficultés supplémentaires dans cette indication. Nous avons effectué une analyse rétrospective des dossiers de tous les patients brûlés entre janvier 2009 et décembre 2016 ayant bénéficié au stade d'un lambeau libre (LL). Nous avons évalué l'indication, le délai, la sélection du site donneur, les complications et l'évolution du lambeau. Quatorze patients (1,1% du total) dont 64,5% d'hommes ont bénéficié de 18 LL. L'âge moyen était de 59,64 ans, la surface brûlée de 10,5%. La majorité des brûlures (71,4%) étaient dues à une flamme, 21,4% à l'électricité. L'indication principale était l'exposition ostéo-articulaire ou d'éléments nobles (tendons, nerfs, vaisseaux) après excision. La réalisation du LL était précoce (J5-J22). Les sites donneurs étaient Latissimus dorsi et la région antéro-latérale de cuisse. Deux lambeaux ont totalement nécrosé, un partiellement, ce qui a nécessité la réalisation d'un second LL. Les LL ont une place dans la prise en charge initiale des brûlés. Bien de grevés d'un taux de complications plus élevé dans cette indication, ils peuvent permettre de diminuer le nombre d'interventions nécessaires à la cicatrisation.

The role of the vaginal microbiome in gynaecological cancer.

Human microbiome research has shown commensal bacteria to be a major factor in both wellness and disease pathogenesis. Interest in the microbiome has recently expanded beyond the gut to include a multitude of other organ systems for which the microbiome may have health implications. Here, we review the role of the vaginal microbiome in health and disease, with a particular focus on gynaecologic malignancies. Further, we suggest that it may be possible to expand the use of probiotics in the treatment of gynaecological cancers. TWEETABLE ABSTRACT: A review of the research to date on the relation between the vaginal microbiome and gynaecological cancers.

In vitro growth and maturation of isolated caprine preantral follicles: Influence of insulin and FSH concentration, culture dish, coculture, and oocyte size on meiotic resumption.

The aims of this study were: (1) to evaluate the effect of different insulin concentrations, alone or in combination with either a fixed FSH concentration or increasing FSH concentrations on the in vitro culture of isolated caprine preantral follicles and (2) to analyze the efficiency of two IVM media and maturation culture systems (with or without coculture with in vivo grown oocytes) on the meiosis resumption. Secondary follicles were cultured for 18 days in a basic medium supplemented with low- or high-insulin concentration alone or with a fixed FSH concentration or with increasing FSH concentrations. Oocytes grown in vivo or in vitro were matured alone or cocultured. The high-insulin concentration associated with fixed FSH treatment had higher meiotic resumption rate (P < 0.05) and was the only treatment capable of producing oocytes in metaphase II. The rates of germinal vesicle, germinal vesicle breakdown, metaphase I, metaphase II (MII), meiotic resumption, and oocyte diameter were similar between the maturation media. In conclusion, a basic medium supplemented with 10-µg/mL insulin and 100-µg/mL FSH throughout the culture period improved meiotic resumption rate and produced MII oocytes from caprine preantral follicles cultured in vitro. The MII rate was similar between in vivo and in vitro grown oocytes ≥110 µm.

Complications of external cephalic version: a retrospective analysis of 1121 patients at a tertiary hospital in Sydney.

OBJECTIVE: To report the complication rate associated with external cephalic version (ECV) at term. DESIGN: Single-centre retrospective study. SETTING: A major tertiary hospital in Sydney, Australia. POPULATION OR SAMPLE: All women who underwent an ECV at Royal Prince Alfred Hospital from 1995-2013 were included. METHODS: ECV was attempted on all consenting women with a breech presentation at term in the absence of contraindications. Complications were classified as minor (transient cardiotocography abnormalities, ruptured membranes, small antepartum haemorrhage) or serious (fetal death, placental abruption, fetal distress requiring emergency caesarean section, fetal bone injury, cord prolapse). ECV success rates and rate of reversion to breech were recorded. MAIN OUTCOME MEASURES: The primary outcome was the incidence of serious complications. Secondary outcome measures were the rate of minor complications and reversion to breech. RESULTS: Of 1121 patients that underwent ECV, five (0.45%) experienced a serious complication. There was one placental abruption, one emergency caesarean section for fetal distress and two cord prolapses. There was one fetal death attributable to a successful ECV. Forty-eight women (4.28%) experienced a minor complication. Reversion to the breech occurred in sixteen patients (3.32%). CONCLUSION: ECV at term is associated with a low rate of serious complications. TWEETABLE ABSTRACT: Study of 1121 consecutive ECV attempts shows low rate of complications although one fetal death reported.

Electrical burns: a retrospective analysis over a 10-year period.

Although electrical burns have a rather low incidence, they are considered one of the most devastating injuries. The aim of this retrospective study was to analyse specific aspects of electrical injuries and to delineate a prevention strategy. A retrospective analysis of medical records of all the patients admitted to our Unit with electrical burns over a 10-year period (2006/01/01-2015/12/31) was undertaken. Demographic data, mechanism of injury and electric current voltage, total burn surface area (TBSA), location and depth of burns, acute complications, surgical interventions and length of hospital stay (LOS) were analysed. Out of 1695 burn patients admitted to our Unit, 99 subjects (5.84%) suffered electrical burns. 97% of these patients were male. The mean age was 38.3±13.7years and mean TBSA was 11.9%±13.2%. The mechanism of injury was occupational in 75 cases. Injuries were classified as low-voltage burns (24.2%), highvoltage burns (30.3%) and flash burns (45.5%). TBSA (p=0.014), mean LOS (p=0.002) and serum creatinine kinase levels (p<0.001) were significantly higher in patients with high-voltage injury in comparison to low-voltage injury, as well as the incidence of escharotomy/ fasciotomy (p=0.049) and flap surgeries (p=0.004). Although there was a higher incidence of amputations in this group (16.7% vs. 12.5%), the difference was not statistically significant (p=0.487). The high prevalence of electrical burns in males and workers emphasizes the need to review occupational safety regulations. Educational efforts regarding potential hazards of electricity and reinforcing compliance with safety measures are essential to avoid these injuri.

Bien que plutôt rares, les brûlures électriques sont considérées comme les plus délabrants des accidents. Le but de cette étude était d'analyser les aspects spécifiques des brûlures électriques et de définir une stratégie de prévention. Elle a consister en l'analyse des dossiers de tous les patients admis pour brûlure électrique entre le 1er janvier 2006 et les 31 décembre 2015. Les données démographiques, le mécanisme exact de l'accident, le voltage, la surface brûlée (SB), la localisation, la profondeur, les complications initiales, les interventions chirurgicales et la durée moyenne de séjour (DMS) ont été analysées. Quatre vingt dix neuf (5,84%) des 1 695 patients hospitalisés pour brûlure avaient subi un accident électrique, 97% d'entre eux étaient des hommes. Leur âge moyen était de 38,3 +/- 13,7 ans, la surface brûlée de 11,9 +/- 13,2%. Soixante quinze accidents étaient survenus au travail. On recensait 24,2% de brûlures électrothermiques par bas voltage, 30,3% par haut voltage et 45,5% de flashes. La surface brûlés (p=0,014), la DMS (p=0,002), le niveau de CPK sanguine (p<0,001), l'incidence des incisions de décharge et aponévrotomies (p=0,049) et de lambeaux (p=0,004) était plus élevés en cas d'atteinte par haut voltage. Bien que plus élevée chez ces patients (16,7% VS 12,5%), l'incidence des amputation n'était pas statistiquement significative (p=0,487). L'incidence élevée des accidents électriques chez les hommes au travail est une indication à revoir la législation. Des efforts de formation et de contrôle de l'application de la législation sont nécessaires pour éviter ces accidents.

Anti-Müllerian hormone reduces growth rate without altering follicular survival in isolated caprine preantral follicles cultured in vitro.

The aim of the present study was to evaluate the effect of anti-Müllerian hormone (AMH), with and without FSH, on the in vitro development of isolated caprine preantral follicles, as well as follicular steroid production and mRNA levels of AMH, hormone receptors (AMH and FSH), CYP19A1 (cytochrome P450, family 19, subfamily A, polypeptide 1), CYP17 (cytochrome P450, family 17, subfamily A, polypeptide 1), HSD3B (3-beta-hydroxysteroid dehydrogenase) and Myc (myelocytomatosis oncogene). Isolated secondary follicles were cultured in minimum essential medium alpha (α-MEM+) alone or supplemented with 50ng mL-1 AMH and/or 100ng mL-1 FSH added sequentially on different days of culture. Follicles were cultured for a total of 18 days, with different media during the first (Days 0-9) and second (Days 10-18) halves of the culture period, resulting in six treatment groups, as follows: α-MEM+/α-MEM+, FSH/FSH, AMH/AMH, AMH+FSH/AMH+FSH, AMH/FSH, and FSH/AMH. Follicle development was evaluated on the basis of follicular growth, oocyte maturation and steroid secretion. There was a decrease in follicular growth rate in the AMH, AMH+FSH and AMH/FSH treatment groups compared with α-MEM+ and FSH treatment groups (P<0.05). However, the different culture conditions had no effect on rates of meiotic resumption and steroid secretion (P>0.05). Moreover, follicles cultured in the presence of FSH had lower levels of AMH receptor type II (AMHRII) mRNA compared with non-cultured control (freshly isolated follicles), and the AMH and AMH/FSH treatment groups. In conclusion, AMH reduces the follicular growth rate of isolated goat preantral follicles in vitro without affecting follicular survival.