Can an 8th grade student learn point of care ultrasound? / 世界急诊医学杂志（英文）

BACKGROUND@# Point-of-care ultrasound has gained widespread use in developing countries due to decreased cost and improved telemedicine capabilities. Ultrasound training, specifically image acquisition skills, is occurring with more frequency in non-medical personnel with varying educational levels in these underdeveloped areas. This study evaluates if students without a high school education can be trained to acquire useful FAST images, and to determine if an 8th grade student can teach peers these skills.@*METHODS@# The 8th grade students at a small middle school were divided into two groups. One group received training by a certified medical sonographer, while the other group received training by a peer 8th grade student trainer who had previously received training by the sonographer. After training, each student was independently tested by scanning the four FAST locations. A blinded ultrasound expert evaluated these images and deemed each image adequate or inadequate for clinical use.@*RESULTS@# Eighty video image clips were obtained. The overall image adequacy rate was 74%. The splenorenal window had the highest rate at 95%, followed by retrovesical at 90%, hepatorenal at 75%, and subxiphoid cardiac at 35%. The adequacy rate of the sonographer-trained group was 78%, while the adequacy rate of the student-trained group was 70%. The difference in image adequacy rate between the two groups was not significant (P-value 0.459).@*CONCLUSION@# The majority of 8th graders obtained clinically adequate FAST images after minimal training. Additionally, the student-trained group performed as well as the sonographer-trained group.

Functional nitric oxide conjugate systems state/restored heart thiols of rats in modeling isadrine-pituitrin’s myocardial infarction using metabolite-tropic cardioprotector “Angiolin.

Background: According to modern researches, endothelial dysfunction (ED) is one of the primary pathogenetic elements of cardiovascular diseases (myocardial infarction [MI], ischemic heart diseases, cerebral ischemic stroke, atherosclerosis, arterial hypertension, pulmonary hypertension, heart failure, and dilated cardiomyopathy) as well as obesity, hyperlipidemia, diabetes and hyperhomocysteinemia. The aim of this work was to study the infl uence of potential metabolitotropic cardioprotector “Angiolin” on the parameters of conjugate systems nitric oxide (NO)/restored thiols in heart under isadrine-pituitrin MI. Methods: This study was performed on Wistar white rats weighing 190-210 g. Biochemical, immune-enzyme analysis and histoimmunechemical study were performed. Results: In histological sections of hearts of the rats receiving Angiolin in parenteral dosing 50 mg/kg 30 mins before each pituitrin injection the density of endothelial NOsynthase (NOS)-positive cells increased by 29% and the density of inducible NOSpositive cells decreased by 23.3%. In cytosolic fraction of myocardium homogenate NOS activity increased by 27%, the concentration of NO stable metabolites increased by 70% and the content of nitrosative stress marker nitrotyrosine decreased by 42% when compared with control group. At the same time in similar samples of heart homogenate the increase of restored thiol groups’ level by 53.3%, methionine - by 35.1%, cysteine - by 170% and activity of glutathione reductase - by 186% was noted. The administration of reference drug mildronate to the animals with MI in dose 100 mg/kg did not result in signifi cant changes of the studied parameters of thiol-disulfi de system and NO system of the heart when compared with control group. Conclusions: Angiolin does not infl uence directly on NOS in MI, but at the same time protects NO from nitrosative stress increasing restored equivalents of thioldisulfi de system.

Causes of Adult Deaths by Verbal Autopsy in an Urban Slum of Ludhiana.

Twenty-three of the world’s 192 countries have high-quality death registration data and 75 have no cause-specific mortality data at all. Verbal autopsy (VA), an alternative method for collecting mortality data, enables investigators to establish the cause of death retrospectively. VA carries information on circumstances, events, signs, and symptoms of illness experienced by the deceased before death. It can ascertain the leading causes of death, reduce the misclassification of causes, reduce the proportion of adult (age 25 or older) deaths attributed to unspecified or unknown causes (from 54% to 23% in urban areas and from 41% to 26% in rural areas). A study was undertaken in a urban slum of Ludhiana, to find the cause specific mortality of adult deaths and get an insight into the mortality pattern of this sample population.

Cerebroprotective activity of 3-benzylxanthine derivative – compound Ale-15, in conditions of bilateral common carotid arteries ligation (ischemic stroke).

Background: Acute ischemic stroke is a leading cause of mortality, morbidity, long-term disability in industrialized countries. One of main parts of it pathogenesis is production of reactive oxygen species. The accumulation of them in neurons results in lipid peroxidation, protein oxidation, DNA damage, and finally cell death. Thereby the search of novel drugs, that have antioxidant action and can be used to complex treatment of cerebral strokes is reasonable. It is known, that xanthine derivatives exhibit a broad spectrum of biological activity, including antioxidant. So that, the goal of this research was to study in vivo neuroprotective action of water-soluble derivative of 3-benzylxanthine – morpholin-4-ium 3-benzylxanthinyl-8-methylthioacetate (Ale-15 compound) in comparison with neuroprotector-antioxidant – Mexidol. Methods: Experimental part was done on white Wistar rats of both sexes of 220-260 g weight. For assessment of neuroprotective action of compound we used a model of global incomplete cerebral ischemia, that was reproduced by bilateral common carotid arteries ligation. Results: It was studied an acute toxicity of Ale-15 compound, it influence on survival of laboratory animals, on progression of neuralgic deficit, on the content of adenylic nucleotides, on criteria of energy metabolism, on the activity of antioxidant enzymes and on oxidative modification of protein. Results of study showed, that injection of Ale-15 compound to animals with ischemic stroke intragastrically during 4 days positively reduced death rate and quantity of animals with serious neurologic symptoms. The main parts of Ale-15 cerebroprotective mechanism are antioxidant and anti-ischemic actions. Conclusions: The performed study revealed significant cerebroprotective features of Ale-15 compound in conditions of experimental cerebrovascular accident.

Biodynamic parameters of micellar diminazene in sheep erythrocytes and blood plasma

In this work, we used a preparation of diminazene, which belongs to the group of aromatic diamidines. This compound acts on the causative agents of blood protozoan diseases produced by both flagellated protozoa (Trypanosoma) and members of the class Piroplasmida (Babesia, Theileria, and Cytauxzoon) in various domestic and wild animals, and it is widely used in veterinary medicine. We examined the behavior of water-disperse diminazene (immobilized in Tween 80 micelles) at the cellular and organismal levels. We assessed the interaction of an aqueous and a water-disperse preparation with cells of the reticuloendothelial system. We compared the kinetic parameters of aqueous and water-disperse diminazene in sheep erythrocytes and plasma. The therapeutic properties of these two preparations were also compared. We found that the surface-active substances improved intracellular penetration of the active substance through interaction with the cell membrane. In sheep blood erythrocytes, micellar diminazene accumulated more than its aqueous analog. This form was also more effective therapeutically than the aqueous analog. Our findings demonstrate that use of micellar diminazene allows the injection dose to be reduced by 30%.

Pre-tertiary hospital care of patients with chronic kidney disease in India.

BACKGROUND & OBJECTIVES: There is paucity of data available on how chronic kidney disease (CKD) is treated before referral to a tertiary hospital. This study was conducted to assess pre-tertiary hospital care of patients with CKD 5 at their presentation to nephrology services at a tertiary care hospital. METHODS: Over a period of 8 months, consecutive patients with CKD 5 presenting at the Nephrology services at Christian Medical College, Vellore, Tamil Nadu, and their relatives were interviewed to assess the pre-tertiary hospital care and knowledge about CKD 5 and its treatment. RESULTS: A total of 561 patients with CKD 5 were enrolled. The mean duration (months) of known CKD was 12.4 +/- 23.1 and known CKD 5 was 3.2 +/- 3.5. Of these, 369 patients (65.8%) had been under the care of a nephrologist; 305 patients had CKD 5 as the initial presentation of renal illness. Vaccination against hepatitis B had been initiated in only 133 patients (23.7%). Only 172 patients(38%) had an adequately controlled blood pressure. Care under a nephrologist was more likely to result in appropriate investigation, treatment and patient education though blood pressure control did not differ. INTERPRETATION & CONCLUSION: Paucity of symptoms in the initial stages of certain forms of CKD probably led to 50 per cent of patients presenting with CKD 5 as the initial presentation of renal disease. Inadequate vaccination against hepatitis B infection highlights the need for appropriate vaccination. Prevention of CKD and its progression are important targets which requires physician awareness at all levels. Early referral to a nephrologist's care is more likely to result in appropriate investigations and treatment.

Prevalence of maternal group B streptococcal colonization and related risk factors in a Brazilian population

The objective of this study was to determine the prevalence of maternal group B Streptococcal (GBS) colonization and compare risk factor data related to GBS colonization. A prospective surveillance study of 598 pregnant women was conducted in two socioeconomically diverse maternity hospitals in Ribeirão Preto, Brazil between June and October 1999. Swabs from the lower vagina were obtained between 35 and 37 weeks gestation and cultured on selective media. Risk factor data were obtained by patient interview and chart review. The overall maternal GBS colonization prevalence rate was 17.9 percent. There was no association of GBS colonization with maternity hospital and no association of GBS colonization with previously identified risk factors, such as age, race, martial status, maternal education, parity, smoking, or alcohol use. There is a relatively high prevalence of maternal GBS colonization in this Brazilian population, although previously-identified-risk factors were not found to be important. This study provides baseline data for the creation of community-based GBS disease prevention protocols.

Prevalence of malocclusion and periodontal status in Tibetan school children of Kushalnagar, Mysore district.

A representative sample of 817 Tibetan school children aged 7 to 17 years of Mysore district were examined for malocclusion, gingival bleeding and calculus, using plane mouth mirror, sickle explorer and periodontal probes, under natural light. A very slight increase in malocclusion was noted in school girls, in addition to the statistically significant increase in gingival bleeding among 8-13 years and 17 year old girls and 7-10 years and 15-16 year old boys. Moreover, a highly statistically significant increase in calculus was perceived amongst girls. The present study thus showed an increasing demand for preventive and therapeutic dental treatment in these children and early identification of such individuals at risk, can lead to better disease management.

Arteriovenous malformation of the mandible--report of a case.

An eight-year-old girl was referred for the management of recurrent bleeding from the lower, left gingival region and a diffused swelling on the left side of her face. Doppler study and carotid angiogram were suggestive of an arteriovenous malformation. Segmental mandibular resection was performed after ligation of the left external carotid artery. Post-operative period was uneventful and there has been no recurrence of the lesion till date.

Capillary hemangioma--report of a case.

A ten-year-old girl was referred for the management of a recurrent lobulated mass present in the upper anterior region. Histopathological investigations were suggestive of capillary hemangioma. Surgical excision of the lesion was performed and postoperative recovery was uneventful.

Seroprevalence of retrovirus infection in a population of Tanzania bordering HIV-1 epidemic areas

A seroepidemiological survey in the Mara Region of Tanzania investigated a randomly selected population between the ages of 15 and 49 in rual and urban areas; as well as a group including high-risk individuals. Reports on 1272 individuals confirm HIV-1 seropositivity in the rural area at under 3 percent; HLTV-1 is present. Preliminary results in the other two groups suggest a higher seroprevelance

Seroprevalence of retrovirus infection in a population of Tanzania bordering HIV-1 epidemic areas

A seroepidemiological survey in the Mara Region of Tanzania investigated a randomly selected population between the ages of 15 and 49 in rural and urban areas; as well as a group including high-risk individuals. Reports on 1272 individuals confirm HIV-1 seropositivity in the rural area at under 3 percent; HLTV-1 is present. Preliminary results in the other two groups suggest a higher seroprevelance

The cell biology of mosquito vitellogenesis

Insect vitellogenesis involves coordinated activities of the fat body and oocytes. We have studied these activities at the cellular level in the mosquito. During each vitellogenic cycle, the fat body undergoes three successive stages: 1) proliferation of biosynthetic organelles, 2) vitellogenin synthesis, 3) termination of vitellogenin synthesis and degradation of biosynthetic organelles by lysosomes. Analysis with monoclonal antibodies and radiolabelling demonstrated that the mosquito yolk protein consists of two subunits (200-kDa and 65-kDa). Both subunits are glycosylated, their carbohydrate moieties are composed of high-mannose oligosaccharides. The yolk protein subunits are derived from a single 220 kDa precursor detected by an in vitro translation. Oocytes become competent to internalize proteins as a result of juvenile hormone-mediated biogenesis of endocytotic organelles. The yolk protein is then accumulated by receptor-mediated endocytosis. A pathway of the yold protein and factors determining its routing in the oocyte have been studied.