Transcriptomic and genomic analysis provides new insights in molecular and genetic processes involved in zucchini ZYMV tolerance.

BACKGROUND: Cucurbita pepo is highly susceptible to Zucchini yellow mosaic virus (ZYMV) and the resistance found in several wild species cannot be considered as complete or broad-spectrum resistance. In this study, a source of tolerance introgressed in C. pepo (381e) from C. moschata, in True French (TF) background, was investigated 12 days post-inoculation (DPI) at transcriptomic and genomic levels. RESULTS: The comparative RNA-sequencing (RNA-Seq) of TF (susceptible to ZYMV) and 381e (tolerant to ZYMV) allowed the evaluation of about 33,000 expressed transcripts and the identification of 146 differentially expressed genes (DEGs) in 381e, mainly involved in photosynthesis, transcription, cytoskeleton organization and callose synthesis. By contrast, the susceptible cultivar TF triggered oxidative processes related to response to biotic stimulus and activated key regulators of plant virus intercellular movement. In addition, the discovery of variants located in transcripts allowed the identification of two chromosome regions rich in Single Nucleotide Polymorphisms (SNPs), putatively introgressed from C. moschata, containing genes exclusively expressed in 381e. CONCLUSION: 381e transcriptome analysis confirmed a global improvement of plant fitness by reducing the virus titer and movement. Furthermore, genes implicated in ZYMV tolerance in C. moschata introgressed regions were detected. Our work provides new insight into the plant virus recovery process and a better understanding of the molecular basis of 381e tolerance.

Dental caries management at a rural district hospital in northern Rwanda: a neglected disease.

SETTING: While some studies have reported the prevalence of dental caries in sub-Saharan Africa, little is known about care-seeking behavior or how dental caries are managed, particularly at rural district hospitals. OBJECTIVE: To describe the management of patients seeking care for dental caries at Butaro District Hospital (BDH) in rural Rwanda. DESIGN: This cross-sectional descriptive study was conducted in BDH, in northern Rwanda. A sample of 287 patient encounters for dental caries between January and December 2013 was randomly selected and stratified by age group (⩽5 years, 6-21 years and >21 years). We estimated the treatment received with 95% confidence intervals in each age group, and differences between age groups were assessed using Fisher's exact test. RESULTS: Nearly all patients (97.6%) underwent tooth extraction, and this did not vary significantly by age group (P = 0.558). In addition to dental caries, most patients also had chronic pulpitis (74.9%). CONCLUSION: Caries prevention and care should be prioritized through a developed community program on oral health. We recommend introducing advanced training, equipment and materials for dental caries management other than tooth extraction, and increasing the number of qualified dentists.

Contexte : Si certaines études rapportent des taux de prévalence des caries dentaires en Afrique sub-saharienne, on sait peu de choses sur le comportement en termes de recherche de soins ni de prise en charge des caries, surtout dans les hôpitaux de district ruraux.Objectif : Décrire la prise en charge des patients sollicitant des soins pour caries dentaires à l'Hôpital de District de Butaro (BDH) en zone rurale du Rwanda.Schéma : Cette étude descriptive transversale a été réalisée au BDH, au nord du Rwanda. Un échantillon de 287 consultations de patients pour caries dentaires entre janvier et décembre 2013 a été sélectionné de façon aléatoire et stratifié sur l'âge (⩽5 ans, 6­21 ans et >21 ans). Nous avons estimé le traitement reçu avec des intervalles de confiance de 95% dans chaque tranche d'âge et les différences entre les groupes d'âge ont été évaluées grâce au test exact de Fisher.Résultats : Presque tous les patients (97,6%) ont eu une extraction de la dent cariée et cela n'a pas varié de façon significative en fonction du groupe d'âge (P = 0,558). En plus des caries, la majorité des patients avait également une pulpite chronique (74,9%).Conclusion : La prévention des caries et les soins conservateurs devraient être une priorité grâce à un programme de santé orale communautaire. Nous recommandons l'introduction d'une formation avancée, d'équipement et de matériels de prise en charge des caries dentaires autres que l'extraction des dents et l'augmentation du nombre de dentistes qualifiés.

Marco de referencia: Algunos estudios han notificado la prevalencia de caries dental en África subsahariana, pero se conoce poco sobre el comportamiento de búsqueda de atención o el tratamiento de la caries dental, sobre todo en los hospitales distritales de las zonas rurales.Objetivo: Describir el tratamiento de los pacientes que buscan atención por caries dental en el Hospital Distrital de Butaro, en una zona rural de Rwanda.Métodos: El presente estudio transversal se llevó a cabo en el Hospital Distrital de Butaro en el norte de Rwanda. Se escogió una muestra aleatoria de 287 citas de pacientes que acudían por caries dental de enero a diciembre del 2013 y se estratificó por grupos de edad (⩽5 años, 6 a 21 años y >21 años). Se evaluaron las proporciones del tipo de tratamiento recibido con un intervalo de confianza del 95% en cada grupo etario y las diferencias entre los grupos se analizaron con una prueba exacta de Fisher.Resultados: En casi todos los pacientes se practicó la extracción (97,6%) y no se observaron diferencias significativas en los grupos de edad (P = 0,558). Además de la caries, la mayoría de pacientes presentaba pulpitis crónica (74,9%).Conclusión: Es preciso priorizar la prevención y el tratamiento de la caries mediante un programa comunitario de salud bucodental. Se recomienda introducir una capacitación avanzada, suministrar equipos y materiales de tratamiento de la caries dental diferente de la extracción y aumentar la cantidad de odontólogos calificados.

Fostering interest in research: evaluation of an introductory research seminar at hospitals in rural Rwanda.

SETTINGS: Partners In Health Rwanda, in collaboration with the Ministry of Health, leads a multipronged approach to develop research capacity among health workers, particularly in rural areas. OBJECTIVES: To describe the characteristics of participants and to assess the impact of an introductory research seminar series in three district hospitals in rural Rwanda. DESIGN: This was a retrospective cohort study of seminar participants. Data were sourced from personnel records, assessment sheets and feedback forms. RESULTS: A total of 126 participants, including 70 (56%) clinical and 56 (44%) non-clinical staff, attended the research seminar series; 61 (48%) received certification. Among those certified, the median assessment score on assignments was 79%. Participants read significantly more articles at 6 and 12 months (median 2 and 4 respectively, compared to 1 at baseline, P < 0.01). There was also a significant increase (P ⩽ 0.05) in self-reported involvement in research studies (28%, baseline; 59%, 12 months) and attendance at other research training (36%, baseline; 65%, 12 months). CONCLUSION: The introductory research seminar series provided an important opportunity for engagement in research among clinical and non-clinical staff. Such an activity is a key component of a comprehensive research capacity building programme at rural sites, and serves as an entry point for more advanced research training.

Contexte : Partners In Health Rwanda, en collaboration avec le Ministère de la Santé, mène une approche multiple afin de développer les capacités de recherche du personnel de santé, surtout dans les zones rurales.Objectifs : Décrire les caractéristiques des participants et évaluer l'impact d'une série de séminaires d'introduction à la recherche dans trois hôpitaux de district ruraux du Rwanda.Schéma : Etude rétrospective de cohorte des participants au séminaire. Les données ont été recueillies à partir de dossiers personnels, de formulaires d'évaluation et de rétroaction.Résultats : Des 126 participants qui ont assisté à la série de séminaires de recherche, 70 (56%) étaient cliniciens et 56 (44%) personnel non-clinicien. Soixante et un (48%) ont obtenu leur certificat. Parmi ces derniers, le score médian d'évaluation des travaux était de 79%. Les participants lisaient beaucoup plus d'articles à 6 et 12 mois (médiane = 2 et 4 respectivement, comparé à 1 au départ, P < 0,01). On notait également une augmentation significative (P ⩽ 0,05) de l'implication dans des travaux de recherche rapportée par les intéressés eux-mêmes (28% au départ contre 59% à 12 mois) ainsi que de la participation à d'autres formations relatives à la recherche (36% au départ contre 65% à 12 mois).Conclusion : La série de séminaires d'introduction à la recherche a fourni une opportunité majeure d'engagement dans la recherche du personnel clinicien et non clinicien. Une telle activité est un élément clé d'un programme complet de renforcement des capacités de recherche dans les zones rurales et sert de point d'entrée pour des formations à la recherche plus avancées.

Marco de referencia: La organización Partners In Health de Rwanda, en colaboración con el Ministerio de Salud, dirige un proyecto multidimensional de creación de capacidad de investigación, dirigida a los profesionales que se ocupan de la salud, especialmente en las zonas rurales.Objetivos: Describir las características de los participantes y evaluar el efecto de la realización de una serie de seminarios introductorios a la investigación, en tres hospitales distritales de zonas rurales en Rwanda.Método: Fue este un estudio retrospectivo de cohortes de los participantes a los seminarios. Se obtuvieron datos a partir de los registros personales, las hojas de evaluación y los formularios de retroalimentación.Resultados: Participaron a la serie de seminarios 126 personas, de las cuales 70 pertenecían al personal asistencial (56%) y 56 a personal de otras esferas (44%). Sesenta y un participantes recibieron la certificación (48%). De las personas certificadas, la mediana de puntuación de la evaluación fue 79%. Los participantes leyeron más artículos a los seis y a los doce meses de la intervención (mediana = 1 y 4 respectivamente; P < 0,01) que al comienzo de la misma (mediana = 1; P ⩽ 0,05). Se observó además un aumento significativo de la intervención autorreferida en estudios de investigación (28% al comienzo y 59% a los 12 meses) y de la participación en otras capacitaciones científicas (36% al comienzo y 65% a los 12 meses).Conclusión: La serie de seminarios introductorios a la investigación ofreció al personal asistencial y a otros miembros del personal una importante oportunidad de participar en las actividades científicas. Este tipo de intervención constituye un componente primordial del programa integral de creación de capacidad de investigación en los centros rurales y representa una puerta de entrada a las capacitaciones científicas más avanzadas.

Preoperative sonographic features of borderline ovarian tumors.

OBJECTIVE: To determine the sonographic findings that distinguish borderline ovarian tumors (BOT) from both benign and invasive malignant tumors, thus allowing conservative treatment and laparoscopic management of these tumors. METHODS: We reviewed retrospectively transvaginal sonograms of 33 women who, when evaluated further by surgery and histology, were found to have BOT. Twenty-three were premenopausal and 10 were postmenopausal (mean age +/- SD, 45.8 +/- 15.7 years). For each mass, size and morphological features and power Doppler characteristics were evaluated. We compared these findings with those of 337 patients with benign ovarian tumors and those of 82 patients with invasive malignant ovarian tumors. Patients with dermoid cysts were not included in the study. RESULTS: Of the 33 BOT, 15 were mucinous and 18 were serous cystadenomas. The presence of papillae, defined as a small number of solid tissue projections, 1-15 mm in height and 1-10 mm in width (base) and length (base), into the cyst cavity from the cyst wall, was significantly more frequent in BOT (48%) than it was in benign (4%) and invasive (4%) malignant tumors. Intracystic solid tissue (> 15 mm in height or > 10 mm in width or length) was observed in 48% of invasive malignant masses but in only 18% of BOT and in 7% of benign tumors (P < 0.001). No sonographically unilocular, hypoechoic, smooth-walled adnexal cysts were invasively malignant but three unilocular cysts with a diameter of > 6 cm were serous BOT. Although close attention was paid to the cyst wall at ultrasound examination we did not observe in these three cysts the very small papillae which were found at histological analysis. CONCLUSIONS: The most frequent diagnostic feature on imaging BOT is the presence of papillae within the cyst. However, neither papillae nor other sonographic features constituted highly sensitive sonographic markers of BOT.

Eccrine spiradenoma of the ear: case report.

A case of eccrine spiradenoma of the left pinna is described. To the best of our knowledge, this is the first report regarding this site. The treatment was a surgical excision in safe margins. This rare benign tumour should be considered for the differential diagnosis of solitary or multiple soft tissue lesions of the head and neck.

Mucoceles of the frontal sinus. Clinical and therapeutical considerations.

BACKGROUND: Mucocele is an epithelial lined mucus-containing sac completely filling a paranasal sinus and capable of expansion by virtue of a dynamic process of bone resorption and new bone formation. It is the most common lesion causing expansion of the paranasal sinuses. Even though mucoceles of paranasal sinuses are increasingly treated by endoscopic surgery, the external approach with or without the obliteration of the sinus still remains a useful and sometimes the only tool in the treatment of this disease. METHODS: The results obtained in seven patients observed at the ENT Department of the University of Ferrara (Italy) in the period ranging from 1989 to 1999 are presented; they were affected by massive fronto-ethmoidal mucoceles and treated with the external approach alone or combined with an endonasal approach and osteoplastic flap. They were five males and two females, with a mean age of 56.5 years. Locations were bilateral in one mucocele, while in six patients only one side was involved, with a prevalence of the left frontal sinus (4:2). RESULTS: No patient showed any local or general complication in the postoperative period. The follow-up showed no recurrence of the disease. CONCLUSIONS: Since the osteoplastic flap was introduced one hundred years ago, it still remains the optimal surgical treatment for fronto-ethmoidal mucoceles. Even though, today, endoscopic surgery represents the new horizon in the management of the sinonasal disease, mucoceles need a surgical treatment which allows the total vision of the cavity to obtain radical treatment and any recurrence of disease.

Hearing loss evaluation of Sjögren's syndrome using distortion product otoacoustic emissions.

Sjögren's syndrome (SS) is a cell-mediated immune disorder primarily affecting the exocrine glands and hearing loss may be the first otological manifestation of this autoimmune disease. In order to assess the degree of sensorineural hearing loss in SS, 22 female patients were examined by means of standard audiometric tests (pure-tone audiometry, acoustic reflexes and impedance testing) and using distortion product otoacoustic emissions (DPOAEs). The results indicated that only 36.3% of the patients had mild sensorineural hearing loss. Hearing level and distortion product threshold estimates were found to be significantly correlated. No relationship was found between the duration of the disease and the DPOAE and hearing threshold variables. The data suggest that SS may not directly cause sensorineural hearing loss.

[A case of temporal arteritis presenting with sensorineural hearing loss]. / Vasculite ad esordio otorinolaringoiatrico.

The inflammatory lesions in giant cell arteritis involve the cranial branches of the arteries originating from the arch of the aorta most prominently. The vessels are thickened tender, and nodular with absent or reduced pulsation. In literature sensorineural hearing loss and Horton's arteritis are rarely associated. A case of temporal arteritis presenting with sensorineural hearing loss is described.

Clinical and radiological findings in subjects with unilateral Ménière's disorder.

In order to contribute to the knowledge of the possible causes of Ménière's disorder, the authors have conducted systematic studies based on blood analysis and on petrous bone radiological examinations in patients suffering from unilateral Ménière's disorder and in two control groups, one of patients with unilateral sudden sensorineural deafness and the other one of normally hearing subjects suffering from neurological diseases. Blood tests have revealed systemic disorders (dyslipidosis, hypoglycaemia, hyperglycaemia, hypothyroidism lues) in 49%, 48% and in 50% of the subjects respectively with Ménière's disorder, with sudden deafness, and with normal hearing. As to the radiological study, changes of the temporal bone (absence or small cells pneumatization and/or absence or narrowing of the vestibular aqueduct) were found in 78% of ears with Ménière's disorder, in 34% of ears with sudden deafness and in 46% of normal ears.

Clinical experience with remote masking.

Remote masking (RM) consists of a rise of the threshold for low-pitched tones when the ear is exposed to a high-frequency noise band delivered with high intensity. This phenomenon has been attributed to mechanical non-linear distortion of the cochlear partition, as an effect of the envelope of a non-uniform signal. The authors studied RM in patients suffering from unilateral Menière's disorder, acoustic neuromata, other sensorineural lesions and presbyacusis. The behaviour of RM in the different experimental groups shows that the RM value is normal in acoustic neuromata; it is variable and not related to the severity of the hearing loss in sensorineural losses, and it is reduced in the affected ear in patients suffering from Menière's disorder. Finally, RM is reduced as a function of ageing, progressively and symmetrically in both ears in presbyacusic subjects. The results of the research seem to confirm the hypothesis that RM may be due to mechanical effects in the inner ear and suggest the possibility of using RM as a test of cochlear partition rigidity.

[Acoustic reflexometry in presbyacusis (author's transl)]. / Presbyacousie et réflexométrie stapédienne.

The authors have studied the relations between crossed and uncrossed acoustic stapedius reflex thresholds in presbyacusic subjects in order to verify whether ageing produces brain stem auditory lesions. The results showed in 55% of the presbyacusics a brain stem disorder characterized by the absence of one, several or all the acoustic reflexes; very often there was only an abnormal difference between crossed and uncrossed acoustic reflex thresholds.

Remote masking in presbycusis.

Remote Masking (RM) (a rise in threshold for low-frequency tones when the ear is exposed to a high intensity noise band of high frequency) has been attributed to mechanical nonlinear distortion of the cochlear partition, as an effect of the envelope of a nonuniform signal. Clinical studies using RM have revealed RM is normal only when both the endolabyrinthine pressure and the cochlear hydrodynamics are normal. Increasing the stiffness of the cochlear partition affects adversely the mechanism of motion of the cochlear duct and reduces RM values. We studied RM in normal young Ss and in patients with presbycusis in order to determine whether aging of the inner ear also induces stiffness of the cochlear partition. In presbycusic Ss the RM values were indeed reduced symmetrically in both ears and progressively as a result of aging. Thus RM demonstrates the existence of cochlear conductive presbycusis and can be considered a useful test of stiffness of the cochlear partition.