Creek systems in restored coastal wetlands: Morphological evolution and design implications.

Saltmarsh restoration such as managed realignment (MR) projects often include excavation of simplified tidal creek networks to improve drainage and marsh functioning, but their design is based on limited evidence. This paper compares the morphological evolution of creek networks in current MR projects in the UK with creek networks in natural saltmarshes, in order to provide improved guidance. The evolution of creek networks was monitored for 2-20 years post-breach at 10 MR sites across the UK by semi-automatically extracting 12 morphological creek parameters from lidar. The rates of creek evolution in MR sites are linked to the initial tidal, morphological and sedimentological conditions using principal component analysis, then compared with power law relationships of morphological equilibrium defined from 13 mature natural saltmarshes. MR creeks evolved into larger, more complex, better distributed systems, with a total creek length and volume statistically similar to their natural counterparts. However, the creek volume remains poorly distributed, with a mean distance between creeks ranging from 33 to 101 m versus 5-15 m for natural mature saltmarshes. MR creeks are also clustered around the breach area, leaving the marsh interior poorly drained. MR creek network morphologies remain strongly influenced by the initial creek template, as evidenced by unnaturally straight creeks inherited from former drainage ditches. A combination of external conditions (i.e., tidal range, sediment concentration in the wider estuary) and local conditions (i.e., site elevation, topographical heterogeneity, soil compaction) controls how easily creeks can form within MR sites. This in turn determines the amount of engineering effort required to help achieve reference site conditions. The end goal of creek design is to create MR sites that closely resemble reference site conditions, however the final design is also likely to be affected by a range of practical factors (e.g. engineering/cost) unique to each site and project.

Future intensification of extreme Aleutian low events and their climate impacts.

Extreme Aleutian Low (AL) events have been associated with major ecosystem reorganisations and unusual weather patterns in the Pacific region, with serious socio-economic consequences. Yet, their future evolution and impacts on atmosphere-ocean interactions remain uncertain. Here, a large ensemble of historical and future runs from the Community Earth System Model is used to investigate the evolution of AL extremes. The frequency and persistence of AL extremes are quantified and their connection with climatic variables is examined. AL extremes become more frequent and persistent under the RCP8.5 scenario, associated with changes in precipitation and air temperature patterns over North America. Future changes in AL extremes also increase the variability of the sea surface temperature and net heat fluxes in the Kuroshio Extension, the most significant heat and energy flux region of the basin. The increased frequency and persistence of future AL extremes may potentially cause substantial changes in fisheries and ecosystems of the entire Pacific region as a knock-on effect.

[Primary infection with cytomegalovirus: An infectious cause of splenic infarction]. / Primo-infection à cytomégalovirus : une cause infectieuse d'infarctus splénique.

INTRODUCTION: Cytomegalovirus-associated thrombosis has been extensively reported in the medical literature, mainly in immune-compromised patients. However, the association with splenic infarcts has rarely been reported. CASE REPORT: We report a 32-year-old Caucasian and immunocompetent woman who presented with a splenic infarction during a primary infection with CMV. The differential diagnostic ruled out embolic, hematologic, gastrointestinal and coagulation disorders. The outcome was favorable with symptomatic treatment. CONCLUSION: A primary infection with CMV must be added to the diagnostic work-up in the presence of a febrile splenic infarction, especially when it is associated with a biological mononucleosis reaction.

Pre-hospital and hospital delay in patients with non-ST elevation acute coronary syndromes in tertiary care.

BACKGROUND: Early presentation is desirable in all cases of acute prolonged chest pain. Causes of delayed presentation vary widely across geographic regions because of different patients' profile and different healthcare capabilities. OBJECTIVES: To detect causes of delay of Non-ST elevation acute coronary syndrome (NSTE-ACS) patients in our country. METHODS: Patients admitted with NSTE-ACS were included. We recorded the time delay between the onsets of acute severe symptoms till their arrival to the hospital (Pre-hospital delay). We also recorded the time delay between the arrival to hospital and the institution of definitive therapy (hospital delay). Causes of pre-hospital delay are either patient- or transportation-related, while hospital delay causes are either staff- or system-related. RESULTS: We recruited 315 patients, 200 (63.5%) were males, 194 (61.6%) hypertensives, 180 (57.1%) diabetics, 106 (33.7%) current smokers and 196 (62.2%) patients had prior history of cardiac diseases. The mean pre-hospital delay time was 8.7 ± 9.7 h. Sixty-six percent of this time was due to patient-related causes and 34% of pre-hospital delay time was spent in transportation. The mean hospital delay time was 2.3 ± 0.95 h. In 89.8% of cases, the hospital delay was system-related while in 10.2% the reason was staff-related. The mean total delay time to definitive therapy was 11.0 ± 9.8 h. CONCLUSION: Pre-hospital delay was mainly patient-related. Hospital delay was mainly related to healthcare resources. Governmental measures to promote ambulance emergency services may reduce the pre-hospital delay, while improving the utilization of healthcare resources may reduce hospital delay.

Atheroprotective potentials of curcuminoids against ginger extract in hypercholesterolaemic rabbits.

The anti-atherogenic potentials of total ginger (Zingiber officinale) extract (TGE) or curcuminoids extracted from turmeric (Curcuma longa), members of family Zingiberaceae, were compared in hypercholesterolaemia. Rabbits were fed either normal or atherogenic diet. The rabbits on atherogenic diet received treatments with TGE or curcumenoids and placebo concurrently for 6 weeks (n = 6). The anti-atherogenic effects of curcuminoids and ginger are mediated via multiple mechanisms. This effect was correlated with their ability to lower cholesteryl ester transfer protein activity. Ginger extract exerted preferential effects on plasma lipids, reverse cholesterol transport, cholesterol synthesis and inflammatory status. Curcuminoids, however, showed superior antioxidant activity.

Biotin-responsive basal ganglia disease: neuroimaging features before and after treatment.

BACKGROUND AND PURPOSE: Biotin-responsive basal ganglia disease is an autosomal recessive neurometabolic disorder presenting with subacute encephalopathy that can cause death if left untreated. The purpose of this study is to assess the neuroimaging and clinical features of the disease before and after treatment with biotin. MATERIALS AND METHODS: We retrospectively reviewed the clinical, laboratory, and neuroimaging features of 15 genetically-proved Middle Eastern cases of biotin-responsive basal ganglia disease. Brain MR imaging was done at the onset of symptoms in all cases and within 2-8 weeks after biotin and thiamine therapy in 14 patients. The MR imaging datasets were analyzed according to lesion location, extent, and distribution. RESULTS: Brain MR imaging showed bilateral lesions in the caudate nuclei with complete or partial involvement of the putamen and sparing of the globus pallidus in all cases. In 80%, discrete abnormal signals were observed in the mesencephalon, cerebral cortical-subcortical regions, and thalami. In 53%, when the disease was advanced, patchy deep white matter affection was found. The cerebellum was involved in 13.3%. The signal abnormality of the mesencephalon, cortex, and white matter disappeared after treatment whereas the caudate and putamen necrosis persisted in all patients, including those who became asymptomatic. CONCLUSIONS: Biotin-responsive basal ganglia disease is a treatable underdiagnosed disease. It should be suspected in pediatric patients with unexplained encephalopathy whose brain MR imaging shows bilateral and symmetric lesions in the caudate heads and putamen, with or without involvement of mesencephalon, thalami, and cortical-subcortical regions, as the therapeutic trial of biotin and thiamine can be lifesaving.

Bioassays guided isolation of compounds from Chaetomium globosum.

The aim of the present study was to evaluate different biological activities of the fungus Chaetomium globosum (family Chaetomiaceae). The evaluation was done through testing its antimicrobial, antioxidant and anticancer effects. C. globosum was isolated from the Cucumber soil (rhizosphere) and caused inhibition of the mycelial growth of Fusarium solani, Rhizoctonia solani and Sclerotium rolfsii in the biculture test. Petroleum ether and ethyl acetate extracts of the liquid culture of C. globosum showed potent in vitro antioxidant activity. C. globosum proved potent antibacterial activity against Bacillus subtilis, Escherichia coli and Pseudomonas fluorescens. It also recorded significant antifungal activity against Candida albicans, F. solani, Fusarium oxysporum, R. solani and Pythium ultimum. It exerted cytotoxic effect on human hepatocellular carcinoma cell line (HepG2). Unsaponifiable and saponifiable matters of the petroleum ether extract showed the presence of hydrocarbons, sterols and fatty acids. The ethyl acetate extract showed the presence of prenisatin, chrysophanol, chrysazin, chaetoviridin A and B. The isolated secondary metabolites proved significant antioxidant and antimicrobial activity on B. subtilis, E. coli and R. solani. In conclusion, this fungus showed different biological activities. Further studies must be done to apply its use in the agricultural and medicinal field.

[Chronic cough as the presenting feature of temporal arteritis]. / Toux chronique révélant une maladie de Horton.

We report a 70-year-old woman who presented with a chronic cough of 3-month duration, secondarily associated with fever and weight loss. She had no other symptoms. Physical examination was unremarkable and laboratory tests showed an increase level of acute phase reactants. Thoracic, abdominal and sinus computed tomographic scan was normal and bronchoscopy showed a non specific mucosa inflammation. Despite the absence of characteristic manifestations of temporal arteritis, a temporal artery biopsy was performed and disclosed evidence of typical temporal arteritis.

Value of duplex scanning in differentiating embolic from thrombotic arterial occlusion in acute limb ischemia.

BACKGROUND: Management of acute limb ischemia (ALI) is largely based on the etiology of arterial occlusion (embolic vs. thrombotic). To our knowledge, the ability of duplex scanning to differentiate embolic from thrombotic occlusion has not been previously reported. PURPOSE: To determine the ability of duplex scanning to differentiate embolic from thrombotic acute arterial occlusion. METHODS: We prospectively recruited 97 patients (50.3 ± 19.7 years; 55% males) with 107 nontraumatic ALI in native arteries. All patients underwent surgical revascularization. Preoperative duplex scan detected arterial occlusion in the following arteries: iliac (11), femoral (38), popliteal (38), infrapopliteal (3), subclavian (3), axillary (1), brachial (9), and forearm arteries (4). We measured the arterial diameters at the site of occlusion (d(occl)) and at the corresponding contralateral healthy side (d(CONTRA)). The difference (Δ) between the two diameters was calculated as d(OCCL)-d(CONTRA). Duplex scan was also used to assess the state of the arterial wall whether healthy or atherosclerotic and the presence of calcification or collaterals. According to surgical findings, limbs were classified into embolic (E group=55 limbs) and thrombotic (T group=52 limbs) groups. RESULTS: Both groups were comparable regarding age, diabetes, hypertension, smoking, atrial fibrillation, and time of presentation. The status of arterial wall at the site of occlusion and presence of calcification or collaterals were all similar in both groups. Δ in the E group was 0.95 ± 0.92 mm vs. -0.13 ± 1.02 mm in the T group (P<.001). A value of ≥ 0.5 mm for Δ had 85% sensitivity and 76% specificity for the diagnosis of embolic occlusion (CI 0.72-0.90, P<.001), whereas a value of less than -0.5 mm for Δ had 85% sensitivity and 76% specificity for thrombotic occlusion (CI 0.72-0.90, P<.001). CONCLUSION: In acute arterial occlusion, ≥ 0.5 mm dilatation or diminution in the occluded artery diameter is a useful duplex sign for diagnosing embolic or thrombotic occlusion, respectively.

Biological activity resulting from exposure to aquatic environmental genotoxic pollutants in northern Egypt.

We estimated pollution in Lake Edku and the Mediterranean Sea, El-Maadiya Region, with 3 aromatic amines (1-naphthylamine, 2-naphthylamine and benzidine) in the muscle tissue of fish. There were marked seasonal variations in the aromatic amine levels. We also determined oxidative stress (blood glutathione, and catalase activity) and genotoxic effects (chromosomal aberrations and urinary metabolites) in fishermen from each area. The fishermen suffered from oxidative stress and had high levels of the urinary metabolite sulfanilamide [mean (microg/mg creatinine): Lake Edku 20.7, Mediterranean 14.5, controls 5.3]. Frequencies for total chromosomal aberrations were significantly raised in the peripheral blood lymphocytes of fishermen in both areas [frequency (per 100 metaphases): Mediterranean 67, Lake Edku 45, controls 14].

[Ascites with high protein concentration 2 months after C-section delivery: diagnosis using adenosine deaminase analysis combined with iconography]. / Ascite riche en protides survenant deux mois après un accouchement par césarienne: diagnostic par association du dosage de l'adénosine-désaminase et de l'imagerie.

We report the case of a 38-year-old woman, born and raised in Congo, in France for 7 years, who developed ascites 2 months after delivery by C-section. Thrombopenia at 95,000 elements per millimeter cube was diagnosed during her pregnancy and her obstetrician initiated a treatment with corticosteroids. Analysis of the ascitic fluid showed a high concentration of proteins (55.7 g/l), with 2000 elements, 80% of which were lymphocytes, and very high levels of adenosine deaminase. Thoracoabdominal tomodensitometry revealed ascites, a multinodular spleen, and hyperemia of the peritoneum; but the liver and the lungs were normal and no adenoma was identified. Laparoscopy was not performed and the suspected diagnosis of peritoneal tuberculosis was confirmed by only one culture of ascitic fluid.

Biological activity resulting from exposure to aquatic environmental genotoxic pollutants in northern Egypt

We estimated pollution in Lake Edku and the Mediterranean Sea, El-Maadiya Region, with 3 aromatic amines [1-naphthylamine, 2-naphthylamine and benzidine] in the muscle tissue of fish. There were marked seasonal variations in the aromatic amine levels. We also determined oxidative stress [blood glutathione, and catalase activity] and genotoxic effects [chromosomal aberrations and urinary metabolites] in fishermen from each area. The fishermen suffered from oxidative stress and had high levels of the urinary metabolite sulfanilamide [mean [microg/mg creatinine]: Lake Edku 20.7, Mediterranean 14.5, controls 5.3]. Frequencies for total chromosomal aberrations were significantly raised in the peripheral blood lymphocytes of fishermen in both areas [frequency [per 100 metaphases]: Mediterranean 67, Lake Edku 45, controls 14]

[Hyperkalemia induced by atenolol]. / Hyperkaliémie secondaire à la prise d'aténolol.

We report a 53-year-old woman with hyperkaliemia secondary to treatment with atenolol. The diagnosis of atenolol induced hyperkaliemia was obtained after excluding other causes of hyperkaliemia and normalization of potassium serum level following the discontinuation of this medication without any other modification (treatment or diet). Furthermore, when atenolol was again introduced, serum potassium level increased and normalized when atenol was definitively discontinued. The mechanism of hyperkaliemia we suspected is probably a reduction of potassium intracellular transfer.

Maternal transmission of Wolbachia in Phlebotomus papatasi (Scopoli).

Attempts have been made to transfer Wolbachia from infected to uninfected, laboratory-reared Phlebotomus papatasi, through mating, and to determine whether the incompatibility phenotype could be expressed through crosses between infected and uninfected flies. In order to test for the intraspecific transmission of Wolbachia in crosses between infected females and uninfected males, or those between uninfected females and infected males, a PCR based on Wolbachia -specific wsp primers was used to test the progeny of each cross and, subsequently, 50 individual flies from the F(3) generation. All the individual flies tested from the F(1) progeny of the crosses between infected males and uninfected females were found to be uninfected. In the crosses involving infected females and uninfected males, however, Wolbachia were found in the progeny of five matings out of the 23 that produced viable eggs. In the F(3), Wolbachia were not detected in any of the individuals resulting from the cross between uninfected females and infected males but they were detected in 52% (26) of the 50 tested individuals resulting from the cross between infected females and uninfected males. No evidence of cytoplasmic incompatibility (CI) was observed in any of the crosses. The absence of CI expression and relatively low frequencies of maternal transmission could hamper the potential use of Wolbachia in a transgenic strategy for the control of leishmaniases.

Vaginal reconstruction with a greater omentum-pedicled graft combined with a vicryl mesh after anterior pelvic exenteration. Surgical approach with long-term follow-up.

Resection of anterior vaginal wall that occurs with some cases of anterior pelvic exenteration leaves the patient with a small and narrow vagina. This affects their sexual life leading to major psychologic problems, especially in young women. The aim of this study is to evaluate a new technique of vaginal reconstruction following anterior pelvic exenteration with clinical and cytohistologic follow-up. Between March 2002 and November 2004, ten sexually active female patients underwent vaginal reconstruction after radical cystectomy that required en bloc removal of the anterior vaginal wall, with a pedicle graft of greater omentum combined with a vicryl mesh. The mean age of the patients was 38 years. The mean operative time of the reconstructive procedure was 50 min. There were no complications regarding the reconstructive procedure. On follow-up, the neovagina accepted two fingers easily and showed a pink-colored smooth lining. Seven patients reported successful attempts of sexual intercourse. It was concluded that reconstruction of vagina after anterior pelvic exenteration in sexually active women can be done safely with the use of vicryl mesh combined with a pedicled omental graft. It is a simple, reliable, and not time-consuming technique. The long-term follow-up was very beneficial in detection of complete healing, postoperative infections, and hormonal activity of the graft and recurrence of malignancy.

Insulin therapy during Ramadan fast for Type 1 diabetes patients.

Patients with Type 1 diabetes (T1D) are normally exempt from the Ramadan fast; however, some patients insist on following the fast, often without the approval of their physicians. The aim of this study is to provide patients with T1D, who insist on fasting, with the most appropriate insulin regimen during the month of Ramadan. Seventeen patients with T1D who insisted on fasting were studied. Prior to Ramadan, the intermediate insulin was changed to ultralente in all patients. The total dose of insulin given to fasting patients by the end of Ramadan (45.7 +/- 14.4 U/day) was less than the total dose of insulin given before fasting (52.8 +/- 13.1 U/day) p<0.05. The ultralente and regular insulin constituted 70 and 30%, respectively, of the total insulin dose by the end of Ramadan, divided equally between Suhur (before sunrise) and Iftar (after sunset). There was no change in the glycosylated hemoglobin before and after fasting. Patients were instructed to break their fast after any episode of hypoglycemia. There were no severe daytime hypoglycemia episodes. We recommend that patients with T1D wishing to fast be switched to long acting insulin such as ultralente. The total insulin dose should consist of around 85% of their initial insulin dose and it should be composed of around 70% ultralente and 30% rapid insulin, divided equally between Suhur and Iftar.

Wolbachia infection and the expression of cytoplasmic incompatibility in sandflies (Diptera: Psychodidae) from Egypt.

A PCR-based method was used to screen four laboratory colonies of sandflies for Wolbachia infection. The colonies - one of Phlebotomus langeroni, one of P. bergeroti and two of P. papatasi - were all derived from sandflies collected in Egypt. Only one of the colonies, derived from P. papatasi collected in Sinai, was found infected. The sequence of the PCR product for this colony was identical to that previously reported for the Wolbachia in P. papatasi from Israel. The induction with tetracycline of cytoplasmic incompatibility (CI) in flies from the P. papatasi (Sinai) colony was then investigated, through reciprocal crosses between treated and untreated P. papatasi siblings. Partial CI expression was attained in the crosses involving antibiotic-treated (i.e. uninfected) females, whether the males used were infected with Wolbachia or had also been cleared of Wolbachia by antibiotic treatment. Most (75%) of the eggs oviposited by uninfected females that had been crossed with infected males, and most (58%) of those laid by uninfected females that had been crossed with uninfected males, failed to hatch. These results provide the first published evidence showing that Wolbachia infection in sandflies is advantageous to the insects. The failure to detect Wolbachia in one of the colonies derived from Egyptian P. papatasi or in the colonies derived from Egyptian P. bergeroti and P. langeroni may indicate that the inter- and intra-specific spread of Wolbachia is discontinuous, even within one country.

Ovarian development and blood-feeding activity in Phlebotomus bergeroti Parrot (Diptera: Psychodidae) from Egypt.

The ovarian development and blood-feeding of Phlebotomus bergeroti were investigated using a laboratory colony derived from Egyptian flies. Most (89%) of the females in this colony were autogenous. The level of ovarian development observed at the time of blood-feeding varied between Christophers' stages IIB and V, indicating that vitellogenesis did not inhibit blood-feeding and that the females that ingested blood before their initial egg-laying were facultative, not obligatory, blood-feeders. The females ingested blood 2-8 days after they had emerged, the probability of a female taking an offered bloodmeal being highest between days 4 and 7 post-emergence. Blood-feeding significantly increased fecundity, significantly reduced the number of eggs that were not laid although apparently mature, and decreased the mean duration of the gonotrophic cycle by almost 1 day. Bloodmeals increased fecundity by stimulating the previtellogenic primary follicles of the autogenous females to precipitate yolk, possibly by initiating concurrent vitellogenesis in the primary and secondary follicles of the same ovarioles. Autogeny in P. bergeroti probably has little influence on the transmission of Leishmania parasites by this species.

Evaluation of avermectins as sandfly control agents.

The potential of avermectins as environmentally safe agents for the control of the sandfly vectors of Leishmania spp. was investigated in the laboratory. Female Phlebotomus papatasi and P. langeroni were fed either bloodmeals containing laboratory-grade ivermectin or sugarmeals containing a commercial-product based on abamectin. Low concentrations of either avermectin killed the sandflies, with median lethal concentrations (LC(50)) of just 13 ng ivermectin or 0.5 ng abamectin/ml for P. papatasi and 44 ng ivermectin or 35 ng abamectin/ml for P. langeroni. The feeding of female sandflies of both species with generally sublethal doses (LC(30)) of ivermectin in blood led to markedly reduced survival and fecundity (i.e. number of eggs laid/ovipositing female). However, addition of ivermectin to the bloodmeal (or of abamectin to the sugarmeal) of the females had no statistically significant effect on the proportion of their eggs that hatched. The results indicate that very small amounts of avermectin in their blood- or sugar-meals could control P. papatasi and P. langeroni, by killing many flies and, in the case of ivermectin, by reducing the fecundity of the survivors.

Telomerase activity in bilharzial bladder cancer. Prognostic implications.

Background: Bladder cancer is a common malignancy in Egypt and other developing countries in which infection with Schistosoma haematobium is prevalent. Bladder cancer caused by bilharziasis has different clinical and biological characters than that observed in the western world. In this study, we used the TRAP technique to estimate telomerase activity in bilharzial bladder cancer specimens and we correlated the findings with other clinical and pathological findings. Patients and methods: Bladder cancer specimens were obtained from 57 patients who underwent radical cystectomy and pathological diagnosis was obtained in all patients. Tissue samples were frozen in liquid nitrogen and stored at -80 degrees C. Telomerase activity by PCR-ELISA technique was measured using TRAP technique. Results: Our patient group included 45 males and 12 females with a median age of 49 years. The majority of our patients (35/57) have squamous histology and they have proven bilharzial history shown in the pathology specimens. Stage P3b was encountered in 29/57 patients whereas thirty-five patients have grade II tumors. The majority of our patients (41/57) were negative for pelvic nodes metastases. Telomerase activity was detected in 27/57 patients (47.4%). The mean level of telomerase was 0.85+/-0.77 in positive patients and 0.029+/-0.025 in negative patients. The expression of telomerase and its mean level in patients above age of 60, in males and in those with squamous pathology, higher grade of tumors or positive node was higher than those without but the difference did not reach statistical significance (P>0.05). Alternatively, expression was significantly higher in those with stages (P1-P3a) compared with P3b-P4a disease stages (66.6% vs. 37.1, P=0.03). Conclusion: Telomerase activity is increased in bilharzial bladder cancer although to a lesser degree than that reported for TCC in the western world, which could be explained, by different biological behavior or different assay methods. Further larger studies with more number of patients are still needed to determine its potential value for early detection and possible use as a therapeutic target.