Phytochemical Analysis and In-vitro Antioxidant Activities of Some Selected Higher Fungi from Oyo State, South West of Nigeria

Higher-fungi (Hf) of the polypore mushrooms are considered to have unique secondary metabolites, making them reservoirs of therapeutically significant bioactive compounds. Phytochemical and antioxidant properties of the Hf were accessed in this study. Four Hf, which were found in several wild locations in Oyo state, Nigeria, were collected. At the University of Ibadan Botany Department Laboratory, the species of the four Hf were determined. In-vitro antioxidant activity were assessed using the 1,1-Diphenyl-2-picrylhydrazyl (DPPH), Ferric Reducing Antioxidant Power (FRAP), and Hydrogen peroxide (H2O2) assays using methanol extracts of air-dried and powdered Hf. Results were presented as Mean SEM, graphs were created in Excel, one-way ANOVA was used for the analysis, and p ?0.05 was regarded as significant. These Hf were identified as Lycoperdon rimlatum (Lr) FFUI1, Trametes versicolor (Tv) FFUI2, Ganoderma lucidum (Gl) FFUI3, and Daedelia quarcina (Dq) FFUI4 and were recorded on the NCBI with accession numbers EU833664.1, JQ621899, JQ520179.1 and KP171209.1, respectively. All the Hf showed positive tests for the presence of saponin, tannin, alkaloid, terpenoid, carbohydrate,tannin and flavonoids. The Hf showed antioxidant activities, the highest DPPH inhibition was by Tv (94.48%), FRAP was by Gl (0.16 mg/g) and H2O2 inhibition was by Lr (70.90%). The antioxidant activities observed were due to the presence of useful phytochemicals making them therapeutically significant.

Outcomes of Ahmed glaucoma valve and transscleral cyclophotocoagulation in neovascular glaucoma

Purpose: To determine the outcomes of Ahmed glaucoma valve (AGV) and transscleral diode cyclophotocoagulation (CPC) in neovascular glaucoma (NVG). Methods: This was a single?center retrospective comparative case series involving chart review of consecutive patients who underwent AGV or CPC for treatment of NVG and had ?6 months of follow?up. Surgical failure at 6 months, defined as an IOP of >21 or <6 mm Hg with hypotony maculopathy after 1 month, progression to no light perception (NLP) vision, glaucoma reoperation, or removal of AGV were the main outcome measures. Results: In total, 121 eyes of 121 patients were included (70 AGV and 51 CPC). Baseline demographics, visual acuity (VA), and intraocular pressure (IOP) were comparable between groups. At 6 months, failure was significantly higher in the CPC group than in the AGV group (43.1% vs. 17.1%, P = 0.020). Both groups had similar IOP and medication number at 6 months, but VA was significantly lower in the CPC group compared to the AGV group (2.4 � 0.8 vs. 1.9 � 1.0, P = 0.017). More CPC eyes required reoperation for glaucoma than AGV eyes (11.8% vs. 1.4%, P = 0.041). Multivariate regression analysis identified higher preoperative IOP (P = 0.001) and CPC surgery (P = 0.004) as independent predictors of surgical failure at 6 months. Age, sex, race, NVG etiology, bilaterality of the underlying retinal pathology, perioperative retina treatment, and prior or combined vitrectomy were not significant. Conclusion: AGV and CPC had comparable IOP and medication reduction in NVG eyes at 6 months. CPC was more frequently associated with failure, reoperation for glaucoma, and worse visual outcomes. High preoperative IOP and CPC surgery independently predicted surgical failure.

Documento de consenso sobre el uso de los iSGLT2 en el tratamiento de pacientes con diabetes mellitus tipo 2 / Consensus on the use of iSGLT2 in the treatment of patients with type 2 diabetes mellitus

Resumen Aunque en los últimos años en México ha mejorado la calidad de la atención de la diabetes mellitus (DM) y ha aumentado el acceso a servicios de salud y medicamentos, existe una falta de apego a las recomendaciones de las guías de práctica clínica, que podría explicar la falta de un control glucémico adecuado en muchos de los pacientes con DM. Los inhibidores del cotransportador de sodio-glucosa tipo 2 (iSGLT2) han sido la última clase de agentes antidiabéticos en recibir la aprobación de la Food and Drug Administration (FDA) y de la Comisión Federal para la Protección contra Riesgos Sanitarios de México (COFEPRIS). Con el fin de mejorar el uso de los iSGLT2 en la práctica clínica en México, en este documento se presentan las recomendaciones emitidas por un panel de 11 expertos mexicanos con base en las nuevas evidencias publicadas para el tratamiento de los pacientes con DM2.

Abstract Although in recent years in Mexico the quality of diabetes mellitus (DM) care has improved and access to health services and medications has increased, there is a lack of adherence to the recommendations of the clinical guidelines, which could explain the poor glycemic control in many of the patients with DM. Sodium-glucose cotransporter type 2 (iSGLT2) inhibitors have been the last class of antidiabetic agents to receive approval from the Food and Drug Administration (FDA) and COFEPRIS (Mexico). In order to improve the use of SGLT2i in clinical practice in Mexico, this paper presents the recommendations issued by a panel of eleven Mexican experts based on the new published evidence for the treatment of patients with DM2.

Mental toughness of resident physicians in a private tertiary hospital in Davao City, Philippines using the mental toughness index

Background@#Mental toughness is believed to be one of the key factors that may help resident physicians endure their training. Objective: Determine the mental toughness of resident physicians in a private tertiary hospital in Davao City, Philippines using the Mental Toughness Index.@*Methods@#The researchers utilized the MTI and added open ended questions to identify positive and negative factors for the Resident’s MTI scores. The questionnaires were distributed to the residents using the online platform. The responses were recorded using the Likert scales and the short answers given were categorized as nominal data.@*Results@#The study had 37 respondents out of 42 total residents with an over-all response rate of 88.09%. The survey showed that female residents have a significantly higher scores. Resident with the age of 31 years and above have greater scores than younger co-residents. The Departments of Surgery and Obstetrics and Gynecology (OB-GYNE) had the highest scores (50.4, SD, +/- 4.04 vs 50.4, SD, +/- 2.79) among all the clinical departments. The Department of Pediatrics had the lowest mean score of 43.67 (SD, +/- 4.39). The study showed that junior residents have the highest MTI mean scores (49, +/- 3.47) and the mid-level of trainees had the lowest mean MTI scores (46.10, SD +/- 3.51). Residents with previous residency training experience have higher mean scores (50.67, SD +/- 4.37). Support Group was the most cited positive factor identified by the trainees. On the other hand, Personal Reasons were the most frequent negative factor that affect their mental toughness.@*Conclusion@#The study showed female residents, residents aged greater than 31 years, Surgical and OB GYNE residents, Junior Residents and Residents with previous residency training have better MTI scores. Social support groups and personal reasons could positively and negatively impact in their mental toughness, respectively.

YouTube as a source of patient education information for elbow ulnar collateral ligament injuries: a quality control content analysis

Background@#While online orthopedic resources are becoming an increasingly popular avenue for patient education, videos on YouTube are not subject to peer review. The purpose of this cross-sectional study was to evaluate the quality of YouTube videos for patient education in ulnar collateral ligament (UCL) injuries of the elbow. @*Methods@#A search of keywords for UCL injury was conducted through the YouTube search engine. Each video was categorized by source and content. Video quality, reliability, and accuracy were assessed by two independent raters using five metrics: (1) Journal of American Medical Association (JAMA) benchmark criteria (range 0–4) for video reliability; (2) modified DISCERN score (range 1–5) for video reliability; (3) Global Quality Score (GQS; range 1–5) for video quality; (4) ulnar collateral ligament-specific score (UCL-SS; range 0–16), a novel score for comprehensiveness of health information presented; and (5) accuracy score (AS; range 1–3) for accuracy. @*Results@#Video content was comprised predominantly of disease-specific information (52%) and surgical technique (33%). The most common video sources were physician (42%) and commercial (23%). The mean JAMA score, modified DISCERN score, GQS, UCL-SS, and AS were 1.8, 2.4, 1.9, 5.3, and 2.7 respectively. @*Conclusions@#Overall, YouTube is not a reliable or high-quality source for patients seeking information regarding UCL injuries, especially with videos uploaded by non-physician sources. The multiplicity of low quality, low reliability, and irrelevant videos can create a cumbersome and even inaccurate learning experience for patients.

The sum of kidney donor profile index and estimated post-transplant survival scale and their correlation with egfr decline in deceased donor kidney recipients

Background: The impact of donor quality on post-kidney transplant survival may vary by candidate condition. Objective: Analyzing the combined use of the Kidney Donor Profile Index (KDPI) and the estimated post-transplant survival (EPTS) scale and their correlation with the estimated glomerular filtration rate (eGFR) decline in deceased-donor kidney recipients (DDKR). Methods: This was a retrospective, observational cohort study. We included DDKRs between 2015 and 2017 at a national third-level hospital. Results: We analyzed 68 DDKR. The mean age at transplant was 41 ± 14 years, 47 (69%) had sensitization events, 18 (26%) had delayed graft function, and 16 (23%) acute rejection. The graft survival at 12 and 36 months was 98.1% (95% CI 94-100) and 83.7% (95% CI 65-100), respectively. The Pearson correlation coefficient between the percentage reduction in the annual eGFR and the sum of EPTS and KDPI scales was r = 0.61, p < 0.001. The correlation coefficient between the percentage reduction in the annual eGFR and the EPTS and KDPI scales separately was r = 0.55, p < 0.001, and r = 0.53, p < 0.001, respectively. Conclusions: The sum of EPTS and KDPI scales can provide a better donor-recipient relationship and has a moderately positive correlation with the decrease in eGFR in DDKR.

A comparison of actual versus estimated weights among Filipino children using the original and updated Advanced Paediatric Life Support (APLS) Formulae, Mercy Method and Broselow Tape: A prospective study

@#<p style="text-align: justify;"><strong>Introduction.</strong> In resuscitating children, actual weight should be obtained before intervention. However, this is not always possible in the emergency setting. Identifying a simple, accurate, and precise method of weight estimation is essential in the delivery of optimal care for Filipino children seen at the emergency department.</p><p style="text-align: justify;"><strong>Objectives.</strong> To evaluate and compare the accuracy and precision of different weight estimation methods in Filipino children.</p><p style="text-align: justify;"><strong>Methods.</strong> A cross-sectional, single-center study was conducted among patients aged >28 days-12 years seen at the Philippine General Hospital Emergency Room. The traditional and updated Advanced Pediatric Life Support (APLS), Broselow tape, and Mercy Method were used for weight estimation. Bland Altman analysis was performed to see the mean difference and limits of agreement between actual and estimated weights of the children.</p><p style="text-align: justify;"><strong>Results.</strong> Broselow tape gave the closest average weight estimate, overestimating it by 0.7 kg, followed by Mercy method at 0.955 kg higher than actual. Traditional APLS yielded 1.565 kg and the Updated APLS 3.299 kg. Mercy Method had the narrowest limit of agreement.</p><p style="text-align: justify;"><strong>Conclusion.</strong> Among the four weight estimation methods, Broselow tape is the most accurate while the Mercy method is the most precise. Traditional APLS performed better than the updated APLS. Length-based methods and anthropometric surrogates proved to be more reliable than age-based formulae.</p>

Concordance of multiparameteric MRI and MRI ultrasound fusion-guided prostate biopsy

@#Multiparametric MRI (mpMRI) of the prostate is recently becoming more and more utilized in the detection of prostate cancer. Studies have shown that a higher PIRADS score correlated to a higher chance of obtaining a clinically significant prostate cancer but few studies have correlated PIRADS score to a specific Gleason score.@*OBJECTIVE@#This study aimed to determine the concordance of PIRADS score to the Gleason score result of MRI ultrasound fusion-guided prostate biopsy.@*METHODS@#All patients who had at least a PIRADS 2 lesion on mpMRI and underwent MRI ultrasound fusion-guided biopsy of the prostate from August 2018 up to November 2019 at St. Luke’s Medical Center, Global City were included in the study. An ambispective collection of data was done until the ideal sample size of greater than 100 positive lesions was obtained, in order to derive concordance rate.@*RESULTS@#One hundred and sixty-two patients were included in the study with a total of 212 lesions analyzed. Forty three percent were benign while 57% were found to be malignant. PIRADS 2 lesions had zero high grade cancers, and the percentage steadily increased with 37.8% of PIRADS lesions considered high grade. Concordance was computed to be 0.38 showing a fair, direct concordance between PIRADS and Gleason score with significant result (p<0.05).@*CONCLUSION@#A result of PIRADS 4 or 5 lesion on mpMRI will have a higher urgency of doing a prostate biopsy and subsequent management to prevent unfavorable outcomes as opposed to PIRADS 3 lesions.

Multidisciplinary perspectives on newly revised 2018 FIGO staging of cancer of the cervix uteri / 부인종양

No abstract available.

A rare case of asymptomatic leiomyoma of the urinary bladder

@#Leiomyoma of the urinary bladder is not often encountered, occurring in only 0.43% of all bladder tumors. Among the known cases, patients usually present with obstructive symptoms, irritative symptoms or hematuria. This is a rare case of a 50-year-old male who was incidentally diagnosed to have a bladder mass. After cystoscopy, an open partial cystectomy was done with complete resection of the bladder mass. Final histopathology and immunochemical stains confirmed the diagnosis of leiomyoma of the urinary bladder.

Microsurgical subinguinal varicocelectomy-technique and preliminary results

INTRODUCTION@#Varicoceles represent the most common attributable cause of primary and secondaryinfertility in the male. A number of studies have established the effect of performing varicocelectomyin order to improve semen parameters. Several techniques of varicocelectomy has been described inliterature, however, the microsurgical technique has been considered as the gold standard in doingthis procedure.@*OBJECTIVES@#The study primarily aims to establish the effect of microsurgical varicocelectomy onpostoperative semenalysis when compared to baseline semenalysis. It also aimed to establish theimpregnation rate and the span at which impregnation occurs following varicocelectomy. Lastly, thestudy also describes the technique and modifications of microsurgical subinguinal varicoelectomyperformed by a single surgeon using an operating microscope and microdoppler throughout theprocedure.@*MATERIALS AND METHODS@#Microsurgical subinguinal varicocelectomy was performed on 37 patients inSLMC from June 2015 to May 2017 by a single microsurgeon (DGL). Patient age, varicocele grade,operative time, intraoperative findings, postoperative complication, and 3-month follow-upsemenalysis results were recorded and compared. Successful impregnation of the partner and thenumber of months from the operation to the successful impregnation were also recorded.@*RESULTS@#Three months postoperative semenalysis parameters were compared to the baselinesemenalysis. The total sperm motility was noted to have increased from 27.95± 15.02 to 50.95±12.60,postoperatively with p-value of 0.010. There was no significant difference observed in the totalcount, concentration, and percent immature forms. Eleven or 30% of patients were able tosuccessfully impregnate their partners in an average span of 9 months from the time of surgery.@*CONCLUSION@#In their experience, Microsurgical subinguinal varicocelectomy has improved the semenanalysis after 3 months with a 30% chance of impregnation at an average span of 9 months,postoperatively. Furthermore, the use of microdoppler ultrasound in microsurgical varicocelectomyfacilitated better identification of the testicular arteries.

Perioperative and oncologic outcomes of anterior versus posterior approach robot-assisted laparoscopic radical prostatectomy

INTRODUCTION@#Robot-assisted laparoscopic radical prostatectomy is now considered the gold standardtreatment of prostate adenocarcinoma in the modern world. There are two approaches to the precisedissection of seminal vesicles (anterior and posterior) during a laparoscopic radical prostatectomy,each of which with unique advantages and disadvantages. Primarily, the authors compared theintraoperative and oncological outcomes of these two approaches. Secondary objective included theestablishment of the minimum number of cases before a surgeon can enter the competent phase of thelearning curve.@*MATERIALS AND METHODS@#Chart review was performed on 111 patients who underwent RALP from2014-2016 performed by 3 experienced robotic surgeons with interchangeability of role as consoleoperator. Two arms were developed based on the approach of seminal vesicle dissection, that is,anterior and posterior approach. Cumulative summation of the console time was performed to obtaina chart with a) negative slope-learning phase and b) positive slope-competent phase. Patients underthe competent phases were included for analysis.@*RESULTS@#There were no significant differences in age, body mass index, prostate volume, preoperativeprostate specific antigen (PSA), gleason score and oncologic risk. Pathology was almost similar inmajority of cases under the anterior approach arm being gleason 7 (3+4) and posterior approach armbeing gleason 6 (3+3). With a p-value of <0.05, console time was significantly shorter in the posteriorapproach at 121±25.95 when compared to anterior approach at 148±30.25 minutes. The otherperioperative and postoperative outcomes were not significantly different between the groups.@*CONCLUSION@#Posterior approach has provided a shorter console time, while the overall oncologic andperioperative outcomes for both approaches were similar. The learning curve for the anterior approachis less steep than that of the posterior approach with only 14 versus 26 consecutive cases, respectively,to be able to competently perform RALP.

Comparative analysis on the efficacy and safety profile of upper calyceal versus lower calyceal access in the percutaneous nephrolithotomy (PCNL): A retrospective cross-sectional study

INTRODUCTION: The goal of PCNL is to achieve a high stone-free rate while minimizing complications. Its success results from an interplay of patient, stone and renal anatomical characteristics, the access site and the level of surgical expertise. Data comparing upper versus lower calyceal PCNL as regard to efficacy and safety are limited.OBJECTIVE: To compare the clinical efficacy and safety outcomes of upper versus lower calyceal access in patients who underwent PCNL at St. Luke's Medical Center.METHODS: A retrospective chart review was done on patients who underwent PCNL at SLMC from January 2010-January 2015. The patients were classified based on the renal access site: Group 1 (upper calyceal) and Group 2 (lower calyceal). The stones were classified according to Guy Stone score and complications were summarized using the modified Clavien classification.RESULTS: A total pf 91 patients underwent PCNL during the study period. Of these, only 84 patients were analyzed. Seven were excluded due to lack or incomplete postoperative imaging on follow up. Forty-one were included in Group 1, while 43 were included in Group 2. According to the Guy Stone score, the stones in Group 1 were 21(IV), 6(III), 7(II) and 6(I) while in Group 2, 18(IV), 5(III), 8(II), 12(I) (p-value=0.52) with a mean stone volume of 38.2± 44.24cm3 and 28.0± 31.04cm3 in Groups 1 and 2 respectively (p-value= 0.23). Success rate was 80.5% and 83.7% for Groups 1 and 2 (p-value=0.70), respectively and mean stone clearance rates of 98.5% and 95.8% (p-value=0.13),respectively. The mean operative time was 181.0±82.26 and 169.5±52.12mins for Groups 1 and 2 (p-value=0.451),respectively. A total of 36 complications (13 from Group 1 and 23 from Group 2) were evaluated. Fever (Grade 1) occurred in 10 (24%) and 17(39%) for Groups 1 and 2, respectively. Blood transfusion (Grade 2) was observed in 4(9%) patients and 3(7%) in Groups 1 and 2, respectively. Two patients (5%) in Group 2 required postoperative double-J sent insertion due to ureteral stone migration (Grade 3). There was no significant difference noted among the groups as regards complication rates (p-value=0.097) and length of hospital stay (p-value=0.687). There was no mortality in either group.CONCLUSION: Based on our experience, both upper and lower calyceal access PCNL achieve equivalent efficacy and comparable safety profile in the treatment of complex renal stones.

Comparative analysis of the efficacy and safety profile of upper calyceal versus lower calyceal access in the percutaneous nephrolithotomy (PCNL): A retrospective cross-sectional study

@#<p style="text-align: justify;"><strong>INTRODUCTION:</strong> The goal of PCNL is to achieve a high stone-free rate while minimizing complications. Its success results from an interplay of patient, stone and renal anatomical characteristics, the access site and the level of surgical expertise. Data comparing upper versus lower calyceal PCNL as regard to efficacy and safety are limited.<br /><strong>OBJECTIVE:</strong> To compare the clinical efficacy and safety outcomes of upper versus lower calyceal access in patients who underwent PCNL at St. Luke's Medical Center.<br /><strong>METHODS:</strong> A retrospective chart review was done on patients who underwent PCNL at SLMC from January 2010-January 2015. The patients were classified based on the renal access site: Group 1 (upper calyceal) and Group 2 (lower calyceal). The stones were classified according to Guy Stone score and complications were summarized using the modified Clavien classification.<br /><strong>RESULTS:</strong> A total pf 91 patients underwent PCNL during the study period. Of these, only 84 patients were analyzed. Seven were excluded due to lack or incomplete postoperative imaging on follow up. Forty-one were included in Group 1, while 43 were included in Group 2. According to the Guy Stone score, the stones in Group 1 were 21(IV), 6(III), 7(II) and 6(I) while in Group 2, 18(IV), 5(III), 8(II), 12(I) (p-value=0.52) with a mean stone volume of 38.2± 44.24cm3 and 28.0± 31.04cm3 in Groups 1 and 2 respectively (p-value= 0.23). Success rate was 80.5% and 83.7% for Groups 1 and 2 (p-value=0.70), respectively and mean stone clearance rates of 98.5% and 95.8% (p-value=0.13),respectively. The mean operative time was 181.0±82.26 and 169.5±52.12mins for Groups 1 and 2 (p-value=0.451),respectively. A total of 36 complications (13 from Group 1 and 23 from Group 2) were evaluated. Fever (Grade 1) occurred in 10 (24%) and 17(39%) for Groups 1 and 2, respectively. Blood transfusion (Grade 2) was observed in 4(9%) patients and 3(7%) in Groups 1 and 2, respectively. Two patients (5%) in Group 2 required postoperative double-J sent insertion due to ureteral stone migration (Grade 3). There was no significant difference noted among the groups as regards complication rates (p-value=0.097) and length of hospital stay (p-value=0.687). There was no mortality in either group.<br /><strong>CONCLUSION:</strong> Based on our experience, both upper and lower calyceal access PCNL achieve equivalent efficacy and comparable safety profile in the treatment of complex renal stones.</p>

environmental deposition of influenza virus from patients infected with influenza A [H1N1] pdm09: Implications for infection prevention and control

In a multi-center, prospective, observational study over two influenza seasons, we sought to quantify and correlate the amount of virus recovered from the nares of infected subjects with that recovered from their immediate environment in community and hospital settings. We recorded the symptoms of adults and children with A [H1N1] pdm09 infection, took nasal swabs, and sampled touched surfaces and room air. Forty-two infected subjects were followed up. The mean duration of virus shedding was 6.2 days by PCR [Polymerase Chain Reaction] and 4.2 days by culture. Surface swabs were collected from 39 settings; 16 [41%] subject locations were contaminated with virus. Overall, 33 of the 671 [4.9%] surface swabs were PCR positive for influenza, of which two [0.3%] yielded viable virus. On illness Day 3, subjects yielding positive surface samples had significantly higher nasal viral loads [geometric mean ratio 25.7; 95% Cl 1.75, 376.0, p = 0.021] and a positive correlation [r = 0.47, ' p = 0.006] was observed between subject nasal viral loads and viral loads recovered from the surfaces around them. Room air was sampled in the vicinity of 12 subjects, and PCR positive samples were obtained for five [42%] samples. Influenza virus shed by infected subjects did not detectably contaminate the vast majority of surfaces sampled. We question the relative importance of the indirect contact transmission of influenza via surfaces, though our data support the existence of super-spreaders via this route. The air sampling results add to the accumulating evidence that supports the potential for droplet nuclei [aerosol] transmission of influenza

Karyotypic and morphological divergence between two cryptic species of Eigenmannia in the Amazon basin with a new occurrence of XX/XY sex chromosomes (Gymnotiformes: Sternopygidae)

Eigenmannia species are widely distributed in the Neotropics, with eight valid species currently recognized. Populations of Eigenmannia from three locations in the eastern Amazon were investigated using cytogenetic and morphological techniques, revealing two taxa designated here as Eigenmannia sp. "A" and Eigenmannia sp. "B". The species differ in three morphometric characters, two meristic characters, and one osteological character. Eigenmannia sp. "A" presents 2n = 34 (22 m/sm+12 st/a) and Eigenmannia sp. "B" presents 2n = 38 (14 m/sm+24st/a) and simple differentiated sex chromosomes of the type XX/XY. In both species the Constitutive Heterochromatin (CH) rich in A-T bases is distributed in the centromeric region of all chromosomes. Eigenmannia sp. "B" also presents CH blocks in the interstitial region of chromosome pairs 8, 9 and X which are positively stained with CMA3, indicating G-C rich regions. The NOR is located on the short arm of chromosome pair 17 of Eigenmannia sp. "A" and on the short arm of pair 14 of Eigenmannia sp. "B". FISH with rDNA probes hybridized to different-sized regions between homologs, suggesting heteromorphism. The differentiation of the X chromosome in Eigenmannia sp. "B" could be the result of amplification of repetitive DNA sequences.

Espécies de Eigenmannia estão amplamente distribuídas na região Neotropical, com oito espécies válidas atualmente reconhecidas. Populações de Eigenmannia de três localidades do leste da Amazônia foram investigadas usando técnicas citogenéticas e morfológicas, revelando dois táxons designados aqui como Eigenmannia sp. "A" e Eigenmannia sp. "B". As espécies diferem em três caracteres morfométricos, dois merísticos e um osteológico. Eigenmannia sp. "A" apresenta 2n = 34 (22 m/sm+12st/a) e Eigenmannia sp. "B" apresenta 2n = 38 (14 m/sm+24st/a) e cromossomos sexuais de diferenciação simples, do tipo XX/XY. Em ambas espécies a Heterocromatina Constitutiva (HC) rica em bases A-T está distribuída na região centromérica de todos os cromossomos. Eigenmannia sp. "B" também apresenta blocos de HC na região intersticial dos pares cromossômicos 8, 9 e X que coraram positivamente para CMA3, indicando regiões ricas em G-C. A NOR está localizada no braço curto do par 17 em Eigenmannia sp. "A" e no braço curto do par 14 em Eigenmannia sp. "B". FISH com sondas de rDNA hibridizaram em regiões de tamanhos diferentes entre os homólogos, sugerindo heteromorfismo. A diferenciação do cromossomo X em Eigenmannia sp. "B" pode ser o resultado de amplificação de sequências repetitivas de DNA.

Intravenous non-opioid analgesia for peri- and postoperative pain management: a scientific review of intravenous acetaminophen and ibuprofen / 대한마취과학회지

Pain is a predictable consequence following operations, but the management of postoperative pain is another challenge for anesthesiologists and inappropriately controlled pain may lead to unwanted outcomes in the postoperative period. Opioids are indeed still at the mainstream of postoperative pain control, but solely using only opioids for postoperative pain management may be connected with risks of complications and adverse effects. As a consequence, the concept of multimodal analgesia has been proposed and is recommended whenever possible. Acetaminophen is one of the most commonly used analgesic and antipyretic drug for its good tolerance and high safety profiles. The introduction of intravenous form of acetaminophen has led to a wider flexibility of its use during peri- and postoperative periods, allowing the early initiation of multimodal analgesia. Many studies have revealed the efficacy, safety and opioid sparing effects of intravenous acetaminophen. Intravenous ibuprofen has also shown to be well tolerated and demonstrated to have significant opioid sparing effects during the postoperative period. However, the number of randomized controlled trials confirming the efficacy and safety is small and should be used in caution in certain group of patients. Intravenous acetaminophen and ibuprofen are important options for multimodal postoperative analgesia, improving pain and patient satisfaction.

Evaluation of inter-pandemic influenza vaccine effectiveness during eight consecutive winter seasons in England and Wales in patients with cardiovascular risk factors

We evaluated the effectiveness of inactivated influenza vaccine in persons aged >/= 45 years with co-morbidities [including essential hypertension] likely to have prompted consideration of prophylactic statin therapy. Using case-control analyses, we measured the impact of vaccination on General Practitioner [GP] reported new episodes of illness for clinically diagnosed influenza-like illness [ILI] and total acute respiratory infection [TARI] during eight consecutive winters, adjusting for potential confounders using multivariable techniques. Although the study failed to demonstrate the effectiveness of influenza vaccine, we identified important potential confounding related to a greater likelihood of vaccinees than non-vaccinees to consult with a GP for respiratory infections. Future researchers should consider and account for this phenomenon

Transdermal drug delivery treatment for overactive bladder

Overactive bladder is commonly treated with oral anticholinergic drugs such as oxybutynin chloride. Although oral anticholinergic agents have been effective in controlling urinary urgency and incontinence, adverse events, particularly dry mouth, often cause patients to discontinue oral therapy and to endure incontinence. Oxybutynin can be delivered transcutaneously, maintaining the efficacy of oral oxybutynin while significantly minimizing side effects (e.g., dry mouth) that may complicate therapy. By avoiding hepatic and gastrointestinal metabolism of oxybutynin, less N-desethyloxybutynin (N-DEO) is produced and this compound is deemed to be responsible for anticholinergic side effects such as dry mouth. This novel oxybutynin formulation offers patients with OAB and urge urinary incontinence a well-tolerated option for managing the symptoms of overactive bladder.