Detection of deposited drill cuttings on the sea floor - A comparison between underwater hyperspectral imagery and the human eye.

We surveyed the deposition of drill cuttings on the seafloor along a transect at eight drilling locations in the south-western Barents Sea and Norwegian Sea, comparing traditional visual surveying methods and underwater hyperspectral imagery (UHI). The locations range from newly-drilled to around 30 years post-drilling. The visual assessments detected deposited drill cuttings to extend to around 150-200 m from the drilling location at recently drilled sites and generally less than 50 m at older locations. Quantitative UHI analyses of relative change in the spectral signature of the sediments with increasing distance from the drilling location mostly showed a change-over to conditions resembling undisturbed sediments at approximately similar distances as the visual assessments. Biological faunal community analyses also reflected these trends. The UHI-based detection of drill cuttings thus in general supported the results of visual assessments and potentially could be further developed as a method for automated surveying of drilling sites.

Long-term efficacy and safety of biosimilar infliximab (CT-P13) after switching from originator infliximab: open-label extension of the NOR-SWITCH trial.

BACKGROUND AND OBJECTIVES: The 52-week, randomized, double-blind, noninferiority, government-funded NOR-SWITCH trial demonstrated that switching from infliximab originator to less expensive biosimilar CT-P13 was not inferior to continued treatment with infliximab originator. The NOR-SWITCH extension trial aimed to assess efficacy, safety and immunogenicity in patients on CT-P13 throughout the 78-week study period (maintenance group) versus patients switched to CT-P13 at week 52 (switch group). The primary outcome was disease worsening during follow-up based on disease-specific composite measures. METHODS: Patients were recruited from 24 Norwegian hospitals, 380 of 438 patients who completed the main study: 197 in the maintenance group and 183 in the switch group. In the full analysis set, 127 (33%) had Crohn's disease, 80 (21%) ulcerative colitis, 67 (18%) spondyloarthritis, 55 (15%) rheumatoid arthritis, 20 (5%) psoriatic arthritis and 31 (8%) chronic plaque psoriasis. RESULTS: Baseline characteristics were similar in the two groups at the time of switching (week 52). Disease worsening occurred in 32 (16.8%) patients in the maintenance group vs. 20 (11.6%) in the switch group (per-protocol set). Adjusted risk difference was 5.9% (95% CI -1.1 to 12.9). Frequency of adverse events, anti-drug antibodies, changes in generic disease variables and disease-specific composite measures were comparable between arms. The study was inadequately powered to detect noninferiority within individual diseases. CONCLUSION: The NOR-SWITCH extension showed no difference in safety and efficacy between patients who maintained CT-P13 and patients who switched from originator infliximab to CT-P13, supporting that switching from originator infliximab to CT-P13 is safe and efficacious.

An update on hearing impairment in patients with rheumatoid arthritis.

Rheumatoid arthritis (RA) is a systemic, autoimmune disease that present with intra-articular and extra-articular manifestations. Auditory system may be involved during the course of RA disease due to numbers of pathologies. The link between hearing impairment and RA has been discussed in the previous literature. In this study we provide an update on the clinical aspect of hearing impairment in RA. We suggest to test hearing in all newly diagnosed RA patients at diagnosis as well as regularly during the course of disease.

Level of Adherence to Prophylactic Osteoporosis Medication amongst Patients with Polymyalgia Rheumatica and Giant Cell Arteritis: A Cross-Sectional Study.

Objective. To estimate level of adherence to oral calcium and vitamin D supplementation as well as bisphosphonate amongst patients with PMR and GCA treated with glucocorticoids. Method. A total of 138 patients with the diagnosis of PMR and/or GCA registered in our department in December 2013. In this cross-sectional study we interviewed all the patients to measure level of adherence to calcium and vitamin D, as well as bisphosphonates. Results. Out of the 118 included patients, 88.9% of them were adherent to their prescription. Only 2 patients (1.7%) did not take calcium and vitamin D at all and 10 patients (8.5%) took their medication infrequently, 9 and 1 out of 10 patients took the medication 50-100% of the time and less than 50% of the prescribed dose, respectively. Sixty-one patients received additional treatment with bisphosphonate and 96.6% were adherent to this therapy. The remaining 3.4% of the patients did not take the medication at all. Forgetfulness, adverse side effects, and lack of understanding of treatment benefits were the most significant causes for nonadherence to calcium and vitamin D. Conclusions. Contrary to what we expected this study found that adherence to osteoporosis preventive medication in patients with PMR and GCA was high.

The long-term pharmacokinetics and safety of adding low-dose ritonavir to a nelfinavir 1,250 mg twice-daily regimen in HIV-infected patients.

OBJECTIVES: To evaluate the long-term pharmacokinetics and safety of adding ritonavir 100 mg twice-daily to a nelfinavir 1250 mg twice-daily regimen in HIV-infected patients. METHODS: This was a prospective, randomized, open-label, controlled 24-week study. Sixteen patients receiving a nelfinavir 1250 mg twice-daily regimen with plasma viral load <1000 HIV-1 RNA copies/mL were randomized to continue treatment or to have ritonavir 100 mg twice-daily added. Safety, including fasting lipid levels, was evaluated at weeks 4, 12 and 24. Patients who were randomized to have ritonavir added (n=9) participated in three 12-h pharmacokinetic evaluations at baseline, week 4 and week 24. RESULTS: Increases in median nelfinavir steady-state plasma concentrations at 12 h (C(12)) from 512 to 773 ng/mL [median difference 450 ng/mL; 95% confidence interval (CI) 116--1510 ng/mL] and in median active nelfinavir metabolite M 8 C(12) from 107 to 603 ng/mL (median difference 545 ng/mL; 95% CI 370--891) were seen after the addition of low-dose ritonavir (baseline to week 24). There were no differences between the nelfinavir or M 8 pharmacokinetic parameters at weeks 4 and 24. No significant changes or differences in the concentration of fasting total cholesterol, low-density lipoprotein (LDL) cholesterol or total triglycerides or in the occurrence of adverse events were observed within or between the two groups. CONCLUSIONS: Nelfinavir and especially M 8 concentrations are increased when low-dose ritonavir is added to a nelfinavir-containing regimen. The combination seems to be safe and the nelfinavir/ritonavir regimen could be an option in patients with low nelfinavir+M 8 concentrations.

Mercury content in rat teeth after administration of organic and inorganic mercury. The effects of interrupted exposure and of selenite.

Rat molars are indicators of exposure concentration and target organ content in chronic mercury vapor exposure. We wished to study the accumulation and persistence of organic and inorganic mercury in rat teeth and the effect of selenium on mercury retention. Male Wistar rats received either inorganic or organic mercury (with or without addition of selenite), selenite only, or no mercury or selenite (controls) in the drinking water for 4 weeks. Group A was killed after exposure. Group B was killed 20 weeks later. The mercury content was measured by cold-vapor atomic absorption spectrophotometry. The mercury content in the molars in group B was 66% and 77% less than in group A after inorganic and organic exposure, respectively. In the incisors the corresponding reductions were 90% and 97%. Selenite had limited effect on mercury retention in group A and none in group B. We suggest that rat molars and, by inference, human deciduous teeth may serve as indicators of organic and inorganic mercury exposure.

Carcinoma presenting as intrarenal haematoma, either spontaneously or after minor trauma.

When minor injury results in renal haematoma, evaluation must exclude an underlying malignant condition. Three cases and their diagnostic problems are presented. The value and limitations of ultrasonography, arteriography, percutaneous fine needle aspiration biopsy and CT-scan are discussed.

[Urease test for rapid demonstration of Helicobacter pylori in biopsies from the pyloric antrum]. / Ureasetest til hurtig påvisning af Helicobacter pylori i biopsier fra antrum ventriculi.

Helicobacter pylori (HP) is an important etiological factor in chronic gastritis and duodenal ulceration. Demonstration of HP by means of culture and histological examination is relatively time-consuming. The object of this investigation was to assess the validity of two rapidly read chemical tests: the buffered urease reagent (BR) and the unbuffered urease reagent (UBR) in demonstration of HP among patients referred for gastroscopy on account of upper abdominal dyspepsia. In 230 sets of biopsies investigated for HP by culture and histology, the following results were obtained by reading of the BR test three hours later at room temperature: Nosographic sensitivity 0.54, nosographic specificity 0.97, PVpos 0.93 and PVneg 0.71. In another material consisting of 57 sets of biopsies, both BR and UBR were performed. Reading of UBR after 15 minutes yielded the following results: Nosographic sensitivity 0.56, nosographic specificity 1.00, PVpos 1.00 and PVneg 0.61. It is concluded that positive results of the urease tests indicate the presence of HP. If the urease tests are negative, supplementary culture and/or histological examination for HP should be performed. UBR is preferable rather than BR.

Sarcomatous mesothelioma of the pleura with cerebral metastases.

A case of sarcomatous pleural mesothelioma in a 22-year-old woman is presented. There was no history of occupational exposure to asbestos. Twenty months after the first symptoms occurred the patient noticed weakness in the right arm. A computed tomography scan of the brain showed multiple metastases. The patient died 10 days later.

[Parotid tuberculosis]. / Tuberkulose i glandula parotis.

Two cases of tuberculosis in the parotid gland are presented. In both cases, the patients were submitted to operation on account of a suspected parotid tumour. Histological examination, revealed, surprisingly, tuberculosis. This is a rare form of extrapulmonary tuberculosis and only four cases were referred to the Tuberculosis Register in Denmark in 1988.

The diagnostic role of fiberoptic bronchoscopy in AIDS patients with suspected Pneumocystis carinii pneumonia.

Fiberoptic bronchoscopy was carried out in 17 consecutive AIDS patients with suspected opportunistic infections. A total number of 23 bronchoscopies were performed and a comparison was made about the effectiveness of the available diagnostic techniques, which included bronchoalveolar lavage, transbronchial lung biopsy and bronchial brushings. The most common cause of pulmonary parenchymal disease was Pneumocystis carinii (7 patients). In 6 of these HIV-positive patients the detection of infection was decisive in making a diagnosis of AIDS. The most effective procedure for diagnosing P. carinii pneumonia was transbronchial lung biopsy (5 patients), while bronchoalveolar lavage and bronchial brushings showed P. carinii and 5 and 4 patients respectively. Complications were minor and occurred only in those patients subjected to transbronchial biopsy. Our findings showed that transbronchial biopsy has the highest yield in the diagnosis of P. carinii infection. When all diagnostic components of the bronchoscopic procedures are carried out, very few cases with these infections should be missed.

Distribution of Campylobacter pylori in dyspeptic and non-dyspeptic gastroenterologic patients.

The presence of Campylobacter pylori (Cp) in antral biopsies from patients undergoing routine gastroscopy or ERCP was determined by microbiological and histological methods and correlated to the histopathology. 322 endoscopies were performed. Of 125 Cp positives only one did not present with histopathological evidence of gastritis. In patients with gastritis the percentage positive for Cp was highest (88.6) in severe gastritis. We also found a highly significant correlation of Cp to all types of ulcers. There was good agreement between microbiologically and histologically demonstrated Cp. Our findings were in agreement with previously published reports.

A re-evaluation of the slide flocculation test for the diagnosis of schistosomiasis with adult worms as antigen.

The present study was conducted to determine whether extracts from adult Schistosoma mansoni could be coated onto cholesterol-lecithin crystals. Of particular interest was the use of stunted schistosomes (SS) recovered from rabbits. The reactions obtained with this antigen in this slide flocculation (SF) test were compared with those employing antigens from cercariae and mature adult worms. The stunted schistosome SF test (SFSS) showed a high sensitivity and specificity while cercarial antigen showed extensive cross reaction with Trichinella spiralis, Ascaris lumbricoides, and Echinococcus granulosus antisera. Both SS and cercarial antigens reacted with syphilitic sera, but the former only with high titer sera. The antigen from mature adult worms could not be coated onto cholesterol crystals, a finding which is in agreement with previous investigations. The relative simplicity of the SFSS test and its apparent high sensitivity and specificity indicates that the test may be an ideal epidemiological tool for schistosomiasis surveys. The results obtained should encourage additional study of the procedure involved and investigation into the role of lipids in flocculation tests. In addition, the findings should stimulate immunological studies of the stunted schistosomes.