Language Intervention Instead of Speech Intervention for Children With Cochlear Implants

Cochlear implants are a standard rehabilitation option for children with severe hearing loss or deafness, allowing access to speech sounds necessary for the development of spoken language. However, the speech-language outcomes of pediatric cochlear implant users vary widely and are not directly or exclusively linked to technology but to combinations of individual audiological, personal, technical, and habilitational factors. These combinations may not favor spoken language development, which may further be linked to the issue of prior insistence on spoken language learning and associated with a high risk of language deprivation. Here, we discuss the outcomes of cochlear implantation from a habilitative perspective and lay down the efforts and resources necessary for the development of communication competence after cochlear implantation rather than the achievement of specific hearing, language, or speech skills that have limited socioemotional and educational contributions and do not guarantee an independent or productive life.

Innovative strategies developed to mitigate the impact of COVID-19 pandemic on polio surveillance in Nigeria, 2020

Introduction: following the spread of the COVID-19 pandemic to Nigeria, the Federal Government of Nigeria restricted human and vehicular movements to curb the spread of the disease. This action had a negative impact on Acute Flaccid Paralysis (AFP) surveillance, with a resultant reduction in the number of AFP cases reported. This paper describes the impact of the COVID-19 pandemic on poliovirus surveillance in Nigeria and the proactive interventions by Nigeria´s polio program to mitigate the impact of COVID-19 on polio surveillance. Methods: nine innovative strategies were implemented in all 774 Local Government Areas (LGA) of the 36 states and Federal Capital Territory (FCT) of the country. These strategies were developed by the national surveillance officers and operationalized by sub-national surveillance officers with different strategies starting at different epidemiological weeks from week 14 to 23, 2020. Many of the strategy innovations were technology-based and included: the use of mobile phones to send the AFP case definition and video by WhatsApp or by SMS, the use of state-specific toll-free numbers and Mobile Telephone Network (MTN) (mobile service provider) CallerfeelTM to community informants (CI) who were the main targets of the interventions to increase case detection and reporting. Others included the use of abridged e-surveillance integrated supportive supervision (ISS) checklists, virtual monthly DSNO meetings, and batched AFP stool specimen transportation network. Results: compared to the same period in 2019, the cumulative rate of AFP case detection and reporting had gradually declined from 39.1% in January to 16.7% before the commencement of the interventions in week 20, 2020. However, the detection and reporting increased by 57.% from week 20 to week 47 compared to the same period in 2019. This is because with COVID-19, hospital visitation dropped, and the sick remained in the communities, so the CI network was relied on to detect and report AFP cases. The cumulative proportion of AFP cases reported by community informants as of week 47 increased from 13% in 2018 to 21% in 2020. This indicates an increase of 38%. Thirty-five AFP cases were detected and reported using the MTN Caller Feel strategy, while 15 cases were reported through state-specific toll-free numbers. Conclusion: the implementation of the innovative strategies was able to mitigate the low AFP case detection and reporting observed at the initial stage of the COVID-19 pandemic. The use of technology facilitated reaching the CI network, which was more instrumental in detecting and reporting the cases.

Physicochemical and UV/VIS measurements of UHD solutionsof water, potentized water,and different potencies of organic substance

Conventional science regards the study of UHD (highly homeopathically potentized) solutions as pseudo-science. However, an increasing number of rigorous scientific investigations demonstrate differences in physicochemical and physical characteristics of such solutions. Strictly chemically regarded, they correspond to highly distilled water. Our research team developed a system of physicochemical and UV spectrographic measurements, whereby the differences may be consistently confirmed with high statistical significance.Methods:For measurement of the physicochemical parameters,we usedpH,electrical conductivity,and oxidation-reduction potential (ORP)sensors.For UV/VIS spectroscopymeasurements,we useda Macherey-Nagelspectrophotometer.For UHD research, we used two batches of substances: Russian (R) and Brazilian (B). In R, distilled water (W) was used for dilutions and potencies as follows: potentized water (W cH9), potentized dilution of antibodies to interferon-gamma (Abs IFNγ cH9), the same original substance in the form of a mixture of potencies (Abs IFNγ cH12, cH30, cH50, shortly Abs IFNγ mix). Furthermore, we prepared higher potencies of the substances (supplementary potentiation) in a specially prepared solution and measured their characteristics. In B, the solution was used for further dilutions and potencies as follows: potentized water (W cH1) and Glyphosate potencies (Gly cH6 => cH8, cH30 => cH 32, and cH200 => cH 202).For direct or post-hoc analysis, we used Wilcoxon signed-rank test, two-tailed.Results:UV-VIS spectroscopy (R): measurements of received liquids potentized for further cH1 show statistically significant differences between all substances, except between water W and W cH9 at 260 nm. Significant differences (p-values) were as follows: Abs IFNγ mixvs. W= 0.007; Abs IFNγ mixvs.W cH9=0.008; Abs IFNγ cH9vs. W=0.044; Abs IFNγ cH9vs.W cH9= 0.026; Abs IFNγ mixvs.W cH9= 0.007; W vs.W cH9= 0.506.Physicochemical measurements:R: measurementsdemonstrated statistical difference only in pH (Abs IFNγ mix towards all others). Significant differences (p-values) were as follows: Abs IFNγ mixvs. W=0.022; Abs IFNγ mixvs.W cH9=0.005; Abs IFNγ mixvs.Abs IFNγ cH9=0.025. After supplementarypotentiation, we obtained a more conspicuous picture with many statistical differences in conductivity and ORP, ranging from p= 0.001 to 0.046.A difference between water and potentized water has also been demonstrated.B: the measurements demonstrated statistical differences mainly in pH between Gly cH8 and the rest and between Gly cH202 and W cH1.Significant differences (p-values) were as follows:Gly cH8vs. Gly cH32 =0.027; Gly cH8vs. Gly cH202 = 0.011; Gly cH8vs. W cH1= 0.014; Gly cH202vs. W cH1= 0.034.Conclusion:UV/VIS at wavelength 260 nm Abs IFNγ mix discloses a pattern similar to exclusion zone (EZ)water at 270 nm.By additional potentiation and with physicochemical measurements, we obtained higher statistical differences than in the original dilutions.In contrast, UV/VIS spectroscopy showed more conspicuous results without additional potentiation. However, the very act of succussion becomes very distinct

Contemporary Unplanned Readmission Trends Following Management of Type B Aortic Dissection

Purpose@#Large studies have demonstrated improved survival outcomes with thoracic endovascular aortic repair (TEVAR) at two and five years compared to medical therapy; however, early TEVAR for acute type B aortic dissection (TBAD) remains controversial. We aimed to evaluate trends and clinical predictors of hospital readmissions in patients undergoing medical management and TEVAR for acute TBADs. @*Materials and Methods@#The Nationwide Readmissions Database was queried for all 30-day and 90-day index readmissions (30D-IR and 90D-IR, respectively) after a diagnosis of a TBAD from January 2012 to September 2015. Data on readmission diagnosis, patient demographics, and hospital characteristics were collected from readmitted patients and analyzed. Multivariable logistic regression models were used to identify the predictors of readmission after TEVAR or medical medical management of TBAD. @*Results@#We identified 53,117 patients with acute TBAD. Medical management was the initial treatment modality in 46,985 (88.4%) patients, while 6,132 (11.5%) underwent TEVAR. Factors including older patient age, lower household income, severity of comorbidities, initial hospital length of stay, and urgent procedure demonstrated an increased likelihood of experiencing 30D-IR and 90D-IR (P<0.05).The rate of unplanned readmission for patients undergoing medical management remained stable (11.3% vs. 10.0% for 30D-IR; 19.1% vs. 15.5% for 90D-IR). Reasons for unplanned readmission in the TEVAR cohort were largely related to technical complications. There was no significant difference in readmission costs between medical management and TEVAR. @*Conclusion@#Number of unplanned readmissions in the TEVAR arm decreased significantly over time, whereas the number of readmissions for medical management remained stable.

Índice Hemodinâmico Agudo Prediz Mortalidade Intra-Hospitalar de Pacientes com Insuficiência Cardíaca Aguda Descompensada / Acute Hemodynamic Index Predicts In-Hospital Mortality in Acute Decompensated Heart Failure

Resumo Fundamento O exame físico permite a avaliação prognóstica de pacientes com insuficiência cardíaca (IC) descompensada, porém não é suficientemente confiável e depende da experiência clínica do profissional. Considerando as respostas hemodinâmicas a situações do tipo "luta ou fuga" tais como a admissão no serviço de emergência, foi proposto o índice hemodinâmico agudo (IHA), calculado a partir da frequência cardíaca e pressão de pulso. Objetivo avaliar a capacidade prognóstica intra-hospitalar do IHA na IC descompensada. Métodos estudo prospectivo, multicêntrico e observacional baseado no registro BREATHE, incluindo dados de hospitais públicos e privados no Brasil. Foram utilizadas análises ROC (Receiver Operating Characteristic), de estatística c e de regressão multivariada, assim como o critério de informação de Akaike, para testar a capacidade prognóstica do IHA. O valor-p < 0,05 foi considerado estatisticamente significativo. Resultados Foram analisados dados de 463 pacientes com IC com fração de ejeção reduzida a partir do registro BREATHE. A mortalidade intra-hospitalar foi de 9%. A mediana do IHA foi considerada o valor de corte (4 mmHg⋅bpm). Um baixo IHA (≤ 4 mmHg⋅bpm) foi encontrado em 80% dos pacientes falecidos. O risco de mortalidade intra-hospitalar em pacientes com baixo IHA foi 2,5 vezes maior que aquele para pacientes com IHA > 4 mmHg⋅bpm. O IHA foi capaz de predizer independentemente a mortalidade intra-hospitalar na IC aguda descompensada [sensibilidade: 0,786; especificidade: 0,429; AUC (área sob a curva): 0,607 (0,540-0,674), p = 0,010] mesmo depois dos ajustes para comorbidades e uso de medicamentos [razão de chances (RC): 0,061 (0,007-0,114), p = 0,025]. Conclusões O IHA é capaz de predizer independentemente a mortalidade intra-hospitalar na IC aguda descompensada. Esse índice simples e realizado à beira do leito pode se mostrar útil em serviços de emergência. (Arq Bras Cardiol. 2021; 116(1):77-86)

Abstract Background The physical examination enables prognostic evaluation of patients with decompensated heart failure (HF), but lacks reliability and relies on the professional's clinical experience. Considering hemodynamic responses to "fight or flight" situations, such as the moment of admission to the emergency room, we proposed the calculation of the acute hemodynamic index (AHI) from values of heart rate and pulse pressure. Objective To evaluate the in-hospital prognostic ability of AHI in decompensated HF. Methods A prospective, multicenter, registry-based observational study including data from the BREATHE registry, with information from public and private hospitals in Brazil. The prognostic ability of the AHI was tested by receiver-operating characteristic (ROC) analyses, C-statistics, Akaike's information criteria, and multivariate regression analyses. p-values < 0.05 were considered statistically significant. Results We analyzed data from 463 patients with heart failure with low ejection fraction. In-hospital mortality was 9%. The median AHI value was used as cut-off (4 mmHg⋅bpm). A low AHI (≤ 4 mmHg⋅bpm) was found in 80% of deceased patients. The risk of in-hospital mortality in patients with low AHI was 2.5 times that in patients with AHI > 4 mmHg⋅bpm. AHI independently predicted in-hospital mortality in acute decompensated HF (sensitivity: 0.786; specificity: 0.429; AUC: 0.607 [0.540-0.674]; p = 0.010) even after adjusting for comorbidities and medication use [OR: 0.061 (0.007-0.114); p = 0.025). Conclusions The AHI independently predicts in-hospital mortality in acute decompensated HF. This simple bed-side index could be useful in an emergency setting. (Arq Bras Cardiol. 2021; 116(1):77-86)

A well-orchestrated EXIT strategy: A case of a successful ex utero intrapartum treatment procedure for Cystic Hygroma / Philippine Journal of Obstetrics and Gynecology

@#A fetal neck mass such as cystic hygroma imposes a challenge in the continuing prenatal care and birth strategy for a 26-year-old gravida 2 para 1 (1001) with a scarred uterus from previous low transverse cesarean section (CS). An intricate delivery for the fetus with a potential airway obstruction necessitates an ex utero intrapartum treatment (EXIT) delivery. The patient was initially scheduled to undergo the procedure at 38 weeks of gestation, but preterm labor ensued. Close antenatal monitoring was done which carried the pregnancy to term. The multidisciplinary approach and planning requires consensus among varied specialties as this maternal–fetal surgery differs immensely from a regular CS. This aims to document and discuss the preoperative, operative and postoperative management done for this patient. The EXIT procedure was performed at 38 weeks' age of gestation with good maternal outcomes. The fetus was delivered safely.

Desmoplastic small round cell tumor of the ovary: A case report with a new modality of treatment and review of the literature

Abstract Objective Desmoplastic small round cell tumor (DSRCT) is a rare intraabdominal neoplasm that grows along serosal surfaces and is primarily found in young men. To Keywords date, only 16 cases of ovarian DSRCT have been previously reported in women in the English literature, and no large population-based studies on this topic exist. Case Report We report the case of a 19-year-old virgo with unremarkable past medical history, initially presented with abdominal fullness. After being treated with the optimal treatment modality (primary and secondary surgical debulking, unique chemotherapy, protocol and adjuvant radiotherapy), the patient has remained without tumor disease for 40 months. Conclusion Although the best therapy for patients with DSRCT has yet to be determined, combining complete surgical resection, adjuvant chemotherapy, and radiotherapy is required to prolong survival and to achieve proper quality of life.

Antioxidant and antihyperlipidemic effects of aqueous seed extract of Daucus carota L. in triton ×100-induced hyperlipidemic mice

Daucus carota (carrot) seed is used medicinally in the treatment and management of diabetes mellitus, in whichoxidative stress and hyperlipidemia are associated complications. The study evaluated the antioxidant andantihyperlipidemic effects of aqueous seed extract of D. carota aqueous extract (AQEDCS) in triton ×100-inducedhyperlipidemic mice. The in vitro antioxidant activities of the extract (0.2–1.0 mg/ml) were evaluated using totalantioxidant capacity, 2,2-diphenyl-1-picrylhydrazyl, nitric oxide, and ferric ion scavenging. In vivo antioxidantand antihyperlipidemic properties of AQEDCS extract were evaluated using triton ×100-induced oxidative stressand hyperlipidemia in mice. AQEDCS contains alkaloids, tannins, phenols, and produced significant antioxidanteffects in vitro compared to Vitamin C. AQEDCS significantly (P < 0.05) decreased levels of plasma cholesterol,triacylglycerol, low-density lipoprotein, coronary artery, cardiac, and atherogenic indices and increased circulatinghigh-density lipoprotein levels when compared to untreated hyperlipidemic mice. AQEDCS significantly (P < 0.05)decreased the level of malondialdehyde compared to untreated hyperlipidemic mice. AQEDCS and simvastatindecreased (P < 0.05) reduced glutathione concentration in plasma, with no difference (P > 0.05) in the liver of micecompared to untreated hyperlipidemic mice. Similarly, no significant difference (P > 0.05) was observed in plasmanitrite levels, superoxide dismutase, and glutathione S-transferase except in AQEDCS mice that received 100 mg/kgbody weight dose of AQEDCS extract when compared with non-induced control. The results indicated that AQEDCSpossesses antioxidant and antihyperlipidemic effects, and could complement antioxidant defense system in vivoduring oxidative stress as well as prevent further complications that could arise from hyperlipidemia during its usagefor diabetes mellitus treatments.

Clinical Efficacy on Chaihu Shugansan Combined with Saccharomyces boulardii in Treatment of Functional Dyspepsia in Children / 中国实验方剂学杂志

Objective:To explore the clinical efficacy of Chaihu Shugansan combined with saccharomyces boulardii in treating functional dyspepsia (FD) in children and the effect on serum cytokines and gastrointestinal hormones expression. Method:Totally 120 cases were divided into control group (60 cases) and observation group (60 cases)．The control group was treated with Duopanlitong Pian 0.3 mg·kg-1, po， tid， and Saccharomyces boulardii 0.25 g，po，bid. The observation group was treated with Chaihu Shugansan, po，qd， and saccharomyces boulardii 0.25 g，po，bid. Four weeks was a course of treatment．The changes of serum Gastric Hunger Hormone and cytokines, Hamilton depression scale (HAMD) score, symptoms improvement time and clinical effect in the two groups were observed. And the recurrence rate was observed after 6 months follow-up. Result:The total effective rate was compared between control group (76.67%，46/60) and observation group (96.15%，57/60)，with significant differences (P<0.01). After treatment, serum tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) in both groups were decreased, while serum levels of ghrelin of both group were increased. However，the decreasing range and the increasing range of observation group were statistically obvious than those of control group (P<0.01). HAMD score and disappearance time of clinical symptoms in observation group was significantly different from those in control group (P<0.01). In adverse reactions during treatment, the control group was inferior to the observation group (P<0.05). After the 6-month follow-up, the recurrence rate in observation group was lower than that in control group (P<0.01). Conclusion:Chaihu Shugansan combined with Saccharomyces boulardii was effective in treatment of FD in children, with a low recurrence rate and good compliance. The mechanism may be related to the effective regulation of brain-intestinal axis, balance of intestinal flora, inhibition of inflammatory reaction, regulation of cytokines and gastrointestinal hormone levels.

Evalution of Anti-Diabetic Potential of Aqueous Extract of “Luffa cylindrica” (Native Sponge/Sponge Gourd) Leaf and Seed on Alloxan Induced Diabetic Wistar Rats

The study was carried out to evaluate the anti-diabetic effect of Luffa cylindrical (nativesponge/spongegourd) seed and leaf extracts in alloxan-induced diabetic rats. Sixteen experimental rats were divided into four groups of four rats each: a, diabetic control; b, normal control; c, diabetic rats treated with seed extract (400mg/kg) and d, diabetic rats treated with leaf extract (400mg/kg). The groups A, C and D rats were induced with diabetes intraperitoneally with alloxan (150mg/kg bw). Phytochemical screening was carried out on the plant seed and leaf extracts and the following biochemical tests were carried out: blood glucose, serum lipid profile, serum alanine aminotransferase, serum aspartate aminotransferase, serum alkaline phosphatase, total protein, albumin, creatinine, urea, uric acid and some electrolytes likeNa+, K+, HCO3-, and Cl-the administration of alloxan to experimental rats resulted in an increased level of most biochemical parameters; blood glucose, serum alanine aminotransferase, serum aspartate aminotransferase and serum alkaline phosphatase, serum total cholesterol, triglyceride, low density lipoprotein, creatinine, urea and uric acid. Luffa cylindricaseed and leaf extractswas administered to groups c and d diabetic rats respectively for two weeks, results werecompared with normal control and diabetic control rats these parameters were found to be significantly (p<0.05) high in the diabetic groups than in the normal control groups. Treatment with the plant extract significantly (p<0.05) reduced elevated blood levels of glucose, cholesterol, triglyceride, alkaline phosphatase, amylase, aspartate aminotransferase, alanine aminotransferase, creatinine, urea, uric acid associated with alloxan-induced diabetic rats. The plant tested positive for alkaloids, flavonoids, saponins and tannins, negative for cardiac glycosides, phenols, resins, terpenes and steroids. Extracts of Luffa cylindricaseed and leaf has shown to have anti-diabetic and anti-lipidemic effects generally on alloxan induced diabetic rats. The study’s findings has shown that the plant possess hypoglycaemic and hypolipidaemic property and has supported the traditional use of Luffa cylindricaplant in the management of diabetes and its complications.

Endocardite fúngica por trichosporon Asahii: relato de um caso raro em imunocompetentes / Fungal endocarditis due to trichosporon Asahii: a rare case report in immunocompetent subject

Relatar o caso de um paciente com múltiplas trocas valvares aórticas, imunocompetente, com diagnóstico de endocardite fúngica por T. asahii. Relato do caso: Homem, 63 anos, com história de febre reumática e quatro trocas da valva aórtica que evoluiu com sintomas de insuficiência cardíaca aguda e febre. Não foi encontrada nenhuma evidência de imunossupressão. Os exames laboratoriais demonstraram anemia e plaquetopenia leves, com leucograma normal e elevação de lactato desidrogenase e proteína C reativa. O ecocardiograma revelou insuficiência aórtica importante e múltiplas vegetações na valva aórtica. T. asahii foi isolado em duas hemoculturas, sendo iniciada a administração de anfotericina B. O paciente necessitou de cirurgia de emergência para nova troca valvar por deterioração clínica. Em decorrência de complicações intraoperatórias, evoluiu para óbito. Discussão: O diagnóstico e o tratamento da endocardite por T. asahii não estão bem estabelecidos na literatura. Os antifúngicos disponíveis atualmente são triazóis e anfotericina B, com evidências que sugerem superioridade dos triazóis, mas a cirurgia é necessária por ineficácia desses fármacos isoladamente. Conclusões: Faltam dados sobre o tratamento medicamentoso mais eficaz e seguro para a endocardite por T. asahii. Neste caso, as trocas valvares prévias agregaram dificuldade técnica ao novo procedimento, que resultou em evolução desfavorável. Não há dados de literatura sobre o momento ideal para troca valvar em pacientes com múltiplas trocas valvares prévias

To present the case report of an immunocompetent patient with multiple aortic valve replacements, diagnosed with fungal endocarditis due to T. asahii. Case report: A 63-year-old male patient with a history of rheumatic fever and four aortic valve replacements, who progressed with symptoms of acute heart failure and fever. No evidence of immunosuppression was found. Laboratory tests detected mild anemia and thrombocytopenia, with normal leukogram and elevated lactate dehydrogenase and C-reactive protein levels. The echocardiogram revealed severe aortic insufficiency and multiple aortic valve vegetations. T. asahii was isolated in two blood cultures, and administration of amphotericin B was initiated. The patient required emergency surgery for a further valve replacement due to clinical deterioration. The patient later died as a result of intraoperative complications. Discussion: Diagnosis and treatment of T. asahii endocarditis are not well established in the literature. The currently available antifungals are triazoles and amphotericin B, with evidence suggesting superiority of the former, but surgery is required because of the ineffectiveness of these drugs alone. Conclusions: There is insufficient data on the safest and most effective pharmaceutical treatment for T. asahii endocarditis. In this case, the previous valve replacements added technical difficulty to the new procedure, which resulted in an unfavorable outcome. There is no data in the literature on the optimal timing for valve replacement in patients with multiple prior replacements

Clinical Efficacy of Xiaoer Anorexia Granule Combined with Saccharomyces Brassicus in Treatment of Pediatric Anorexia and Its Effect on Serum Cytokines / 中国实验方剂学杂志

Objective: To investigate the clinical efficacy of Xiaoer anorexia granule combined with Saccharomyces brassicus in the treatment of infantile anorexia and its effect on serum cytokines. Method: Totally 240 cases of infantile anorexia treated in Jinhua People's Hospital from October 2015 to October 2017 were randomly divided into three groups. Group A (combination group) orally took Xiaoer anorexia granule, 1 pack/time for 1-3 years old, 2 packs/time for 4-6 years old, 3 times a day, and combined with saccharomyces brasiliensis, 0.5 g/time, 2 times a day, 15-30 min before meal. Group B took saccharomyces brasiliensis by the same method as the combination group. Group C took Xiaoer anorexia granules by the same method as above,with 80 cases in each group. 8 weeks is a course of treatment. Serum inflammatory cytokines leptin, SP and Ghrelin were also detected. The clinical efficacy, body weight, height improvement and serum cytokine levels were observed in 3 groups. Result: The total improvement rate of group A was 91.25%, which was significantly higher than 71.25%of group B and 73.75%of group C, with statistically significant differences (PPPPPPPConclusion: Treatment of infantile anorexia with Xiaoer anorexia granules combined with Saccharomyces cerevisiae can improve the total clinical effective rate, adjust serum cytokine levels and increase height and body mass.

Clinical Efficacy of Modified Sinisan Combined with Saccharomyces Brasiliensis on Functional Dyspepsia in Children and Its Effect on Serum Cytokines / 中国实验方剂学杂志

Objective: To discuss the clinical efficacy of modified Sinisan (Qizhi Weitong granule) and saccharomyces boulardi in treating functional dyspepsia (FD) in children, and its effect on changes in serum cytokine and gastrointestinal hormones.Method: Totally 156 cases were divided into control group (78 cases) and observation group (78 cases). The control group was treated with saccharomyces boulardi, 0.25 g, po, bid, after meal. In addition to the therapy of control group, the observation group was also given modified Sinisan (Qizhi Weitong granule), 2.5 g, po, tid, 30 minutes before meal. Four weeks was a course of treatment. Then the clinical efficacy, the time of symptom improvement and the change of serum cytokine and gastrointestinal hormones were observed.Result: The total effective rate of observation group (96.15%) was higher than that of control group (82.05%), with statistical difference (Pγ(IFN-γ), tumor necrosis factor-α(TNF-α), plasma motilin(MTL) and Leptin of both groups had no statistical difference before treatment. After treatment, the serum levels of IL-10, MTL of both group were increased, while the serum levels of IFN-γ, TNF-α, Leptin of both group were decreased. However, the decreasing range and the increasing range of observation group were statistically obvious than those of control group (PConclusion: Modified Sinisan(Qizhi Weitong granule) combined with saccharomyces boulardi have an obvious clinical efficacy in treating child's FD, with a low recurrence. The mechanism may be correlated with the effect of integrated Chinese and Western medicines in regulating serum cytokine and gastrointestinal hormones levels.

Streptomyces globosus DK15 and Streptomyces ederensis ST13 as new producers of factumycin and tetrangomycin antibiotics

ABSTRACT Fifty seven soil-borne actinomycete strains were assessed for the antibiotic production. Two of the most active isolates, designed as Streptomyces ST-13 and DK-15 exhibited a broad range of antimicrobial activity and therefore they were selected for HPLC fractionation against the most suppressed bacteria Staphylococcus aureus (ST-13) and Chromobacterium violaceum (DK-15). LC/MS analysis of extracts showed the presence of polyketides factumycin (DK15) and tetrangomycin (ST13). The taxonomic position of the antibiotic-producing actinomycetes was determined using a polyphasic approach. Phenotypic characterization and 16S rRNA gene sequence analysis of the isolates matched those described for members of the genus Streptomyces. DK-15 strain exhibited the highest 16S rRNA gene sequence similarity to Streptomyces globosus DSM-40815 (T) and Streptomyces toxytricini DSM-40178 (T) and ST-13 strain to Streptomyces ederensis DSM-40741 (T) and Streptomyces phaeochromogenes DSM-40073 (T). For the proper identification, MALDI-TOF/MS profile of whole-cell proteins led to the identification of S. globosus DK-15 (accession number: KX527570) and S. ederensis ST13 (accession number: KX527568). To our knowledge, there is no report about the production of these antibiotics by S.globosus and S. ederensis, thus isolates DK15 and ST13 identified as S. globosus DK-15 and S.ederensis ST-13 can be considered as new sources of these unique antibacterial metabolites.

Study of the therapeutic efficacy of Montelucast and Cetirizine on allergic rhinitis in children and their effects on the level of serum cytokines / 中国耳鼻咽喉头颈外科

[ABSTRACT]OBJECTIVETo study the therapeutic efficacy of Montelucast and Cetirizine on allergic rhinitis in children and their effects on the level of serum IFN-γ and IL-4.METHODS Sixty allergic rhinitis children were randomly divided into treatment group (30 children) and control group (30 children). The control group were treated with cetirizine drops (po, ages 2-6, 5 mg, qd, ages >6, 10 mg, qd.). Treatment group were treated with cetirizine drops combined with Montelucast (po, ages 2-5, 4 mg, qn, ages 6-12, 5 mg, qn, ages >12, 10 mg.). Thirty health children were selected as health group.RESULTSBefore treatment, the level of serum IFN-γ in treatment group and control group were significantly lower than that in health group (P0.05). After treatment, the level of serum IFN-γ of both groups increased, and the level of serum IL-4 of both groups decreased. However, the level of serum IL-4 and IFN-γ in treatment group changed significantly (P<0.01). After treatment, VAS scores were lower than that of before treatment, however that of the treatment group was the lowest (P<0.01). After one month follow-up, there was no significant difference between the two groups.CONCLUSIONThe mechanism of Montelucast and cetirizine on treatment of allergic rhinitis may be related to the correction of the disorder of IFN-γ and IL-4.

A comparative study on lower extremity amputation (LEA) stump outcome in diabetic and non-diabetic patients in a tertiary care hospital of Raipur City, Chhattisgarh, India.

Background: Amputation is among the oldest operation known to man. It is the surgical removal of a limb or body part and performed to remove diseased tissue or relieve pain. Amputation is associated with some complications. Infection and failure of stump to heal are major complications. The Diabetes related Lower Extremity Amputation (LEA) is likely to be associated with a worse outcome as compared to the non-diabetic amputations because of the presence of several risk factors which hamper the wound healing process. Amputees with diabetes are more likely to undergo amputation at a younger age and need higher-level amputations when compared with patients without diabetes. With this background, the present study was planned to understand the factors that place diabetic patients at increased risk of amputation in the study area so that further morbidity can be prevented. Methods: The current prospective study was conducted in the Department of Surgery, Dr. B.R.A.M. Hospital, Pt. JNM Medical College, Raipur (C.G.) India, among 60 patients admitted in the General Surgery wards during January 2013 to August 2014. Study subjects were categorized into those related to diabetes mellitus and those due to other causes. All Investigations relevant to the study (Random blood sugar, Serum albumin, Complete blood count, renal function test and Doppler) were done in all the patients. Postoperatively the cases were examined for various complications of amputation stump in post operative period were noted. Results: Mean age for diabetic cases was 50 years and that for non-diabetic cases was 47 years. In this study, among the diabetic amputations, 84 % were males and 16 % were females. Total 60 amputations were performed in the study. Stump infection (50 % in diabetics and 29 % in non-diabetics) was the most common stump complication. Followed by wound dehiscence (25 % in diabetics and 11 % in non-diabetics) Conclusion: Diabetic amputations are at a higher risk of complications. They need to be carefully screened and selected for appropriate level of amputation and watched meticulously for occurrence of complications.

Combinação de cirurgia ortognática e tratamento protético para má oclusão esquelética classe III de Angle / Combined orthognathic surgery and prosthetic treatment for class III skeletal malocclusion

Este caso clínico descreve a situação de uma paciente parcialmente desdentada com má oclusão esquelética classe III de Angle que apresentava pobre função mastigatória e desagradável aparência estética, originada pela grave discrepância anteroposterior entre as arcadas dentárias e pela perda de dimensão vertical de oclusão. Sua reabilitação funcional e estética foi realizada através de cirurgia ortognática e tratamento protético mediante a instalação de uma prótese parcial removível tipo overlay. Ao final do tratamento, a paciente foi reabilitada funcionalmente e esteticamente com sucesso através do restabelecimento da dimensão vertical de oclusão e correção da discrepância anteroposterior entre os arcos dentários. A prótese parcial removível tipo overlay é uma alternativa simples e rápida para o tratamento de pacientes parcialmente desdentados com má oclusão esquelética classe III e pequena discrepância anteroposterior entre os arcos dentários. Neste caso clínico, foi obtido de forma satisfatória o restabelecimento estético e funcional do sistema estomatognático através da combinação de cirurgia ortognática e tratamento protético...

This clinical report discusses the case of a partially edentulous patient with class III skeletal malocclusion, suffering from poor masticatory function and esthetic appearance caused by severe anteroposterior discrepancy between the dental arches and loss of occlusal vertical dimension. The functional and esthetic rehabilitation was performed with orthognathic surgery followed by prosthetic treatment using an overlay removable partial denture. At the end of the treatment, the patient was successfully rehabilitated, both functionally and esthetically, through reestablishment of the occlusal vertical dimension and correction of the anteroposterior discrepancy between the dental arches. The overlay removable partial denture is a simple and time-efficient alternative in the treatment of partially edentulous patients with class III skeletal malocclusions and small anteroposterior discrepancies between dental arches. Additionally, an esthetic smile and functional rehabilitation of the stomatognathic system was satisfactorily obtained with orthognathic surgery followed by prosthetic treatment...

Impact of hypertension in liver regeneration in rats / Repercussão da hipertensão arterial na regeneração hepática em ratos

PURPOSE: To determine the impact of hypertension in liver regeneration, in rats by examining gain in liver mass and the replication of hepatocytes and stellate cells. METHODS: Forty Wistar rats were allocated into two groups of twenty, the control and experiment group. The experiment group animals were submitted to induction of renovascular hypertension. A week later, all the animals underwent a partial hepatectomy. Measurements were taken after 24 hours and seven days, when ten animals in each group were euthanized. Thus, four subgroups were obtained. The livers were excised and sent for histopathological analysis. RESULTS: The control group had a greater gain in liver mass than the experiment group seven days after partial hepatectomy (p=0.0051). The difference in the activate stellate cell count was not statistically significant following analysis after both 24 hours and seven days (p=1.0). A higher number of dividing hepatocytes was observed in the control group seven days after partial hepatectomy (p=0.0014). CONCLUSION: In rats, hypertension had no direct influence on stellate cell replication, but led to a delay in liver mass gain and were shown to be a reduction factor on hepatocyte replication seven7 days after partial hepatectomy.

OBJETIVO: Determinar o impacto da hipertensão arterial sistêmica na regeneração hepática, em ratos, através da análise do ganho de massa hepática e da replicação dos hepatócitos e das células estreladas. MÉTODOS: Alocaram-se 40 ratos Wistar em dois grupos de 20 animais, os grupos controle e experimento. Os do grupo experimento submeteram-se a indução da hipertensão renovascular. Uma semana após, realizou-se hepatectomia parcial em todos os animais. Colheram-se os dados com 24 horas e sete dias, quando dez animais de cada grupo submeteram-se a eutanásia. Assim, obtiveram-se quatro subgrupos. Os fígados foram retirados e enviados para análise histopatológica. RESULTADOS: O grupo controle apresentou maior ganho de massa hepática do que o grupo experimento sete dias após a hepatectomia parcial (p=0,0051). A diferença na contagem das células estreladas ativadas não foi estatisticamente significante nas análises de 24 horas e de sete dias (p=1,0). Um maior número de hepatócitos em divisão foi observado no grupo controle, sete dias após a hepatectomia parcial (p=0,0014). CONCLUSÃO: Em ratos, a hipertensão não teve influência direta sobre a replicação de células estreladas, mas levou ao atraso no ganho de massa hepática e mostrou ser um fator de redução na replicação de hepatócitos sete dias após a hepatectomia parcial.