Varicella-zoster virus-related neurological complications: From infection to immunomodulatory therapies.

The Varicella-zoster virus (VZV), classified as a neurotropic member of the Herpesviridae family, exhibits a characteristic pathogenicity, predominantly inducing varicella, commonly known as chickenpox, during the initial infectious phase, and triggering the reactivation of herpes zoster, more commonly recognized as shingles, following its emergence from a latent state. The pathogenesis of VZV-associated neuroinflammation involves a complex interplay between viral replication within sensory ganglia and immune-mediated responses that contribute to tissue damage and dysfunction. Upon primary infection, VZV gains access to sensory ganglia, establishing latent infection within neurons. During reactivation, the virus can spread along sensory nerves, triggering a cascade of inflammatory mediators, chemokines, and immune cell infiltration in the affected neural tissues. The role of both adaptive and innate immune reactions, including the contributions of T and B cells, macrophages, and dendritic cells, in orchestrating the immune-mediated damage in the central nervous system is elucidated. Furthermore, the aberrant activation of the natural defence mechanism, characterised by the dysregulated production of immunomodulatory proteins and chemokines, has been implicated in the pathogenesis of VZV-induced neurological disorders, such as encephalitis, myelitis, and vasculopathy. The intricate balance between protective and detrimental immune responses in the context of VZV infection emphasises the necessity for an exhaustive comprehension of the immunopathogenic mechanisms propelling neuroinflammatory processes. Despite the availability of vaccines and antiviral therapies, VZV-related neurological complications remain a significant concern, particularly in immunocompromised individuals and the elderly. Elucidating these mechanisms might facilitate the emergence of innovative immunomodulatory strategies and targeted therapies aimed at mitigating VZV-induced neuroinflammatory damage and improving clinical outcomes. This comprehensive understanding enhances our grasp of viral pathogenesis and holds promise for pioneering therapeutic strategies designed to mitigate the neurological ramifications of VZV infections.

Debridement, antibiotics and implant retention (DAIR) following hip and knee arthroplasty: results and findings of a multidisciplinary approach from a non-specialist prosthetic infection centre.

INTRODUCTION: Prosthetic joint infection (PJI) is a catastrophic complication following arthroplasty surgery. Recently a debridement, antibiotics and implant retention (DAIR) procedure has gained popularity for PJI where a thorough debridement, irrigation and modular component exchange is undertaken. METHOD: We present the outcome for DAIR, data collected prospectively, in a busy orthopaedic unit but not one specialising in PJI. All patients with PJI were included without loss of data or patients from 2012 to 2018 with a minimum follow-up of 5 years. RESULTS: Four total knee replacements, 17 total hip replacements, one revision total hip replacement and three hip hemiarthroplasties are included with an average duration from onset of symptoms to the DAIR procedure of 11 days (range 1-22 days). Staphylococcus aureus (24%) and Staphylococcus epidermidis (32%) were the most common causative organisms, and the most common antibiotic regimens included intravenous teicoplanin and flucloxacillin. Average follow-up was 67 months (range 9-104 months). Only four patients went on to require revision surgery. An analysis of midterm patient outcome measures for 6 of the total hip replacement (THR) DAIR patients were compared with a database of 792 THRs (with a minimum two-year follow-up) carried out by the same surgeon revealed no significant difference in Oxford hip scores at one-year post-surgery (OHS DAIR 36.2 vs 39 for control group). CONCLUSION: This study includes 25 consecutive patients treated with DAIR with only one reinfection, with a mean follow-up period of 5 years. Using a strict protocol, DAIR appears to offer a successful treatment strategy for the management of early PJI.

A novel luminescent terbium-3-carboxycoumarin probe for time-resolved fluorescence sensing of pesticides methomyl, aldicarb and prometryne.

The luminescence arising from lanthanide cations offers several advantages over organic fluorescent molecules: sharp, distinctive emission bands allow for easy resolution between multiple lanthanide signals; long emission lifetimes (µs-ms) make them excellent candidates for time-resolved measurements; and high resistance to photo bleaching allow for long or repeated experiments. A time-resolved (gated) luminescence-based method for determination of pesticides methomyl, aldicarb and prometryne in microtiterplate format using the long-lived terbium-3-carboxycoumarin in 1:3 metal:ligand ratio has been developed. The limit of detection is 1.20×10(6), 5.19×10(5) and 2.74×10(6)ng L(-1) for methomyl, prometryne and aldicarb, respectively. The quantum yield (QY=0.08) of Tb(III)-3-carboxycoumarin was determined using 3-(2-benzothiazolyl)-7-diethylamino-coumarin (coumarin 6). Stern-volmer studies at different temperatures indicate that collisional quenching dominates for methomyl, aldicarb and prometryne. Binding constants were determined at 303, 308 and 313 K by using Lineweaver-Burk equation. A thermodynamic analysis showed that the reaction is spontaneous with negative ΔG. Effect of some relevant interferents on the detection of pesticides has been investigated.

Bypass anillado ¿cuál es su real utilidad?: estudio comparativo a diez años / Banded gastric bypass: a ten years evaluation

Background: Placing a ring around the gastric reservoir could improve the weight lowering effects of gastric bypass. Previous studies have shown positive results of banded gastric bypass. Aim: To evaluate the long-term outcome of patients subjected to banded gastric bypass (GB) and non-banded GB procedures. Material and Methods: Ten years follow up of260 non randomized obese patients who underwent banded GB and 218 patients in whom the ring was not placed. Excess weight loss (EWL), quality of life (QOL), food tolerance (FT), and correction of comorbidities were assessed. Results: The percentage EWL at ten years of follow up was 82 and 63 percent among patients subjected to banded and non-banded gastric bypass, respectively (p < 0.01). In three patients with banded GB, there was a migration of the ring to the interior of the stomach. Stenosis of the gastro-jejuno anastomosis occurred in 4 and 0.4 percent of patients subjected to banded and non-banded GB Perception of quality of life was similar in both groups. The outcome in terms of comorbidities was not conclusive. Conclusions: There is a clear advantage in terms of EWL among patients subjected to banded GB. No differences in quality of life were found in both groups.

Introducción: Muchos cirujanos han procurado mejorar los resultados del bypass gástrico agregando algún mecanismo restrictivo, como es la instalación de un anillo alrededor del bolsillo. Estudios previos han mostrado resultados positivos con el bypass gástrico anillado (BPGA), sin embargo, no hay estudios comparativos con resultados en el largo plazo para establecer la real utilidad de agregar un anillo durante la cirugía del bypass gástrico. Objetivo: Este estudio está dirigido a comparar el resultado a largo plazo entre el bypass gástrico (BPG) y el bypass gástrico anillado (BPGA). Material y Método: Estudiamos 260 pacientes obesos operados con anillo y 218 sin anillo. Fueron seguidos por 10 años, y se investigaron la pérdida de exceso de peso (PEP), Ia calidad de vida (CDV), tolerancia a la alimentación, y resolución de comorbilidades. Resultados: Hay una clara diferencia en el por ciento PEP desde el tercer año de control; alcanza a un 19 por ciento de diferencia en favor del BPGA al término del estudio, cifra altamente significativa. El anillo disminuye en parte la facilidad de ingesta pero esto no es sentido por los pacientes como una disminución de la calidad de vida (CDV). Los resultados en cuanto a comorbilidades no son concluyentes. Conclusiones: Hay una clara diferencia en el resultado en cuanto a PEP La calidad de vida es similar en ambos grupos. Es importante seleccionar el material adecuado y el correcto tamaño del anillo para mejorar los resultados y evitar complicaciones.

Fluorescence and electrochemical recognition of nucleosides and DNA by a novel luminescent bioprobe Eu(III)-TNB.

The luminescence arising from lanthanide cations offers several advantages over organic fluorescent molecules: sharp, distinctive emission bands allow for easy resolution between multiple lanthanide signals; long emission lifetimes (µs -ms) make them excellent candidates for time-resolved measurements; and high resistance to photo bleaching allow for long or repeated experiments. A method is presented for determination of nucleosides using the effect of enhancement of fluorescence of the easily accessible europium(III)-TNB in presence of different nucleosides. The latter coordinates to Eu(III) -TNB and enhances its luminescence intensity as a result of the displacement of water from the inner coordination sphere of the central metal. A similar method for the determination of DNA based on the quenching of Eu(III)-TNB has been established. The interaction of Eu(III)-4,4,4 trifluoro-1-(2-naphthyl)1,3-butanedione (TNB) complex with nucleosides (NS) (guanosine, adenosine, cytidine, inosine) and DNA has been studied using normal and time-resolved luminescence techniques. Binding constants were determined at 293 K, 298 K, 303 K, 308 K and 313 K by using Benesi-Hildebrand equation. A thermodynamic analysis showed that the reaction is spontaneous with ΔG being negative. The enthalpy ΔH and the entropy ΔS of reactions were all determined. The formation of binary and ternary complexes of Eu(III) with nucleosides and TNB has been studied potentiometrically at (25.0 ± 0.1) °C and ionic strength I = 0.1 mol.dm(-3) (KNO3) . The formation of the 1:1 binary and 1:1:1 ternary complexes are inferred from the corresponding titration curves. Initial estimates of the formation constants of the resulting species and the protonation constants of the different ligands used have been refined with the HYPERQUAD computer program. Electrochemical investigations for the systems under investigations have been carried out using cyclic voltammetry (CV), differential pulse polarography (DPP), and square wave voltammetry (SWV) on a glassy carbon electrode in I = 0.1 mol/L p-toluenesulfonate as supporting electrolyte.

Fluorescence and electrochemical sensing of pesticides methomyl, aldicarb and prometryne by the luminescent europium-3-carboxycoumarin probe.

This work describes the application of time resolved fluorescence in microtiterplates and electrochemical methods on glassy carbon electrode for investigating the interactions of europium-3-carboxycoumarin with pesticides aldicarb, methomyl and prometryne. Stern-volmer studies at different temperatures indicate that static quenching dominates for methomyl, aldicarb and prometryne. By using Lineweaver-Burk equation binding constants were determined at 303 K, 308 K and 313 K. A thermodynamic analysis showed that the reaction is spontaneous with ΔG being negative. The enthalpy ΔH and the entropy ΔS of reactions were all determined. A time-resolved (gated) luminescence-based method for determination of pesticides in microtiterplate format using the long-lived europium-3-carboxycoumarin has been developed. The limit of detection is 4.80, 5.06 and 8.01 µmol L(-1) for methomyl, prometryne and aldicarb, respectively. This is the lowest limit of detection achieved so far for luminescent lanthanide-based probes for pesticides. The interaction of the probe with the pesticides has been investigated using cyclic voltammetry (CV), differential pulse polarography (DPP), square wave voltammetry (SWV) and linear sweep voltammetry (LSV) on a glassy carbon electrode in I = 0.1 mol L(-1) p-toluenesulfonate at 25 °C. The diffusion coefficients of the reduced species are calculated. The main properties of the electrode reaction occurring in a finite diffusion space are the quasireversible maximum and the splitting of the net SWV peak for Eu(III) ions in the ternary complex formed . It was observed that the increase of the cathodic peak currents using LSV is linear with the increase of pesticides concentration in the range 5 × 10(-7) to 1 × 10(-5) mol L(-1). The detection limit (DL) were about 1.01, 2.23 and 1.89 µmol L(-1) for aldicarb, methomyl and prometryne, respectively. In order to assess the analytical applicability of the method, the influence of various potentially interfering species was examined. Influence of interfering species on the recovery of 10 µmol L(-1) pesticides has been investigated.

Descenso ponderal y calidad de vida mediante la cirugía de Bypass gástrico con y sin anillo de calibración / Weight loss in patients subjected to gastric bypass with or without calibration ring

Hay evidencias de que en la técnica habitual de bypass gástrico, la gastroyeyunostomía se puede dilatar. Por esta razón la técnica de bypass de Capella y Fobi, incluye la instalación de una banda de silastix u otro material alrededor del bolsillo gástrico, con el objeto de evitar que la pasada se dilate y permita una ingesta más rápida y abundante. El objetivo de este estudio prospectivo es comparar bypass gástrico con bypass gástrico anillado, en cuanto a baja de peso y calidad de vida. Material y Método: Seleccionamos 244 pacientes con bypass anillado (Grupo A) y 194 sin anillo (Grupo B). Los dos grupos son clínicamente comparables. Se analizó el por ciento de baja de exceso de peso ( por ciento EWL) a los 3, 6, 12, 18, 24 y 36 meses. Se consideró significativo p<0,05, con prueba t de Student. Se controlaron las comorbilidades y se efectuó encuesta BAROS II, para calidad de vida. Resultados: A veinticuatro meses el por ciento EWL es de 80,5 y 69,6 y respectivamente, y a los 36 meses 81 y 63,9, diferencias significativas entre ambos grupos. Encuesta BAROS II es similar en los grupos. En grupo A se mantuvo por más tiempo un grado de disfagia. En grupo B, hubo más estenosis de gastroyeyunoanastomosis. Conclusiones: EWL es mejor en el largo plazo en los pacientes con bypass anillado, en cuanto a la baja de peso y tienen menos estenosis porque permiten hacer una gastroenteroanastomosis más amplia ya que la calibración está dada por el anillo. La calidad de vida y corrección de comorbilidades, son similares en ambos grupos.

Background: In gastric bypass, the diameter of gastrojejunal anastomosis may increase with time. It is not clear if a higher weight reduction can be achieved if a ring is added to the pouch. Aim: To compare the results of gastric bypass with and without the addition of a ring. Material and methods: Prospective study of patients subjected to gastric bypass using Capella and Fobi technique. In a group of 244 patients (201 women), operated in one surgical center, a 6 cm ring was attached around the gastric pouch. In 194 patients (163 women) operated in other two centers, the ring was not used. Patients were followed for 36 months. Excess weight loss (EWL) and quality of life using BAROS II score were evaluated in both groups. Results: EWL at 24 months were 80.8 + 17 and 69.6 + 19 percent in groups with and without ring, respectively (p < 0.05). The figures at 36 months were 81+16 and 71.9 + 14 percent, respectively (p <0.05). Strictures of thegastrojejunal anastomosis were observed in 12 patients without ring (6.1 percent) and in 2 patients with ring (0.8 percent). Patients with ring had higher rates of disphagia. Quality of life scores were similar in both groups. Conclusions: Patients with banded bypass had a higher weight loss but a higher frequency of disphagia. Patients without band had a higher frequency of gastrojejunal anastomosis strictures.

Experiencia de 10 años con el bypass gástrico / Long term results of gastric bypass for morbid obesity

Introducción: El bypass gástrico es el estándar para el obeso mórbido. Es importante un seguimiento apropiado para conocer su real utilidad. Material y método: 1000 pacientes operados con bypass y seguidos entre Mayo 1996 y Marzo 2006. 545 pacientes tuvieron un seguimiento prolongado, algunos hasta 10 años. Controles de peso periódicos, midiendo el porcentaje de baja del exceso de peso ( por ciento EWL). Evolución de las comorbilidades, complicaciones postoperatorias. Encuesta BAROS II, para la calidad de vida. Resultados: por ciento EWL se estabiliza entre 72 y 79 por ciento entre los 12 y 84 meses. Pero a más largo plazo, a los 120 meses los pocos pacientes que hay recuperan peso, manteniendo el EWL en 55 por ciento. BAROS muestra un 84 por ciento de excelentes y buenos resultados 14 por ciento regular y 2 por ciento disconforme. Complicaciones: Tromboembolismo 0,2 por ciento, hemorragia digestiva 0,3 por ciento (3 casos); uno requirió gastrectomía, filtraciones 2 por ciento (11 casos), 6 requirieron reoperación, un caso de fasceítis necrotizante grave, hemoperitoneo 0,3 por ciento, neumopatía aguda 2 por ciento, un fallecido, por tromboembolismo pulmonar masivo. Infección herida operatoria 1 por ciento. En el largo plazo hernias 4 por ciento, colecistolitiasis 3 por ciento, caída del cabello 15 por ciento, anemia hipocroma 5 por ciento, úlcera de boca anastomótica 2 por ciento, una úlcera perforada, obstrucción intestinal 1,5 por ciento, 3 por estenosis mesocolon, 1 por hernia interna 2 por bridas, 1 por migración anillo de PTFE, 2 migraciones de anillo al interior del estómago. Estenosis de anastomosis gastroyeyunal 2 por ciento. Las complicaciones son más frecuentes en bypass laparoscópico. Reducción comorbilidades cercano 100 por ciento. Conclusiones: La evolución del peso es excelente en el bypass, pero hay una tendencia a recuperar peso en el largo plazo, especialmente en los pacientes que no se someten a control periódico. Las comorbilidades y la...

Background: Gastric bypass is the standard surgical procedure for morbid obesity. Aim: To evaluate long term results of gastric bypass. Patients and methods: Prospective follow up of 1000 consecutive patients (800 women) subjected to gastric bypass between May 1996 and March 2006. A long term follow up was achieved in 545 patients. Percentage of excess weight loss ( percent EWL), postoperative complications and evolution of complications associated to obesity were studied. Quality of life was assessed using the BAROS II test . Results: percent EWL stabilizes in a range from 72 to 79 percent and between 12 to 84 months after operation. However, patients followed for 120 months, gain weight and percent EWL is reduced to 55 percent. According to BAROS II, 84 percent of patients considered results as excellent or good, 14 percent considered results regular and 2 percent were dissatisfied with surgical outcome. Complications recorded were thromboembolism in 0.5 percent, gastrointestinal bleeding in 0.1 percent, leaks in 2 percent, necrotizing fasciitis in 0.1 percent, hemoperitoneum in 0.3 percent acute pneumonia in 2 percent and wound infection in 1 percent. One patient died due to a massive pulmonary embolism. As late complications, hernias appeared in 4 percent, cholelithiasis in 3 percent, hair loss in 15 percent, hypocromic anemia 5 percent, anastomotic ulcers in 2 percent, intestinal Obstruction in 1.5 percent, PTFE ring migration and anastomosis obstruction in 2 percent. Complications were more common in laparoscopic bypass. In all patients there was a reduction of complications associated to obesity. Conclusions: percent EWL is excellent with gastric bypass, but there is weight gain in the long term follow up. Complications associated to obesity are almost always corrected.

School mental health screening: a model for developing countries.

Using the experience derived from a screening programme of all school-going children in the Al Ain District, United Arab Emirates, this article reports on a cost-effective model that can be used in other developing countries. The need for training child health and school professionals in identifying mental and developmental disorders is discussed.

Obesidad mórbida: tratamiento quirúrgico: gastroplastía / Morbid obesity: surgical treatment: gastroplasty

La obesidad mórbida constituye un problema estético, social y sicológico, con morbilidad y mortalidad propias. El tratamiento médico de la obesidad morbida tiene un alto porcentaje de fracaso, mas del 80 por ciento a 5 años. La gastroplastía representa una técnica mas fisiológica y con menor morbilidad alejada que el puente. Se presentan 30 pacientes operados con sobrepeso entre 52 y 204 por ciento , con su estudio clínico, metabólico y endocrinológico, evaluando la técnica quirúrgica, patologías agregadas y resultados. De los 30 pacientes 9 recuperaron su peso por dilatación de la boca de comunicación digestiva entre 8 y 16 meses de operados. A los restantes se les efectuó refuerzo con malla, con resultados francamente mejores, mas permanentes y muy superiores al tratamiento médico, con comunicación en la curvatura mayor. La gastroplastía con bolsillo gástrico de 70 a 100 ml con aporte calórico de 500 calorías y una comunicación gástrica en curvatura menor con refuerzo de malla, ha demostrado ser una buena técnica, con baja morbilidad y sin mortalidad en el manejo de estos pacientes

Isolation and identification of African horsesickness virus from naturally infected dogs in Upper Egypt.

African horsesickness virus was isolated from blood samples of street dogs in Aswan Province in Arab Republic of Egypt. Of six isolated "dog strain" African horsesickness viruses, three viruses designated D2, D6 and D10 have been identified as type 9 African horsesickness virus. Methods of isolation, tissue culture adaptation, serological indentification and typing are described. Horses experimentally infected with dog viruses showed febrile reaction and characteristic clinical and pathological signs of African horsesickness. Reisolation of African horsesickness virus type 9 was achieved from the horses during serial passages.