Appendicolith appendicitis: should we be operating sooner? A retrospective cohort study.

INTRODUCTION: Evidence suggests that delaying an appendicectomy for up to 24 hours does not increase the risk of complicated appendicitis. Appendicoliths are a risk factor for perforation. No study has explored the temporal relationship between appendicolith presence and time to perforation. In this retrospective cohort study, we hypothesise that the presence of an appendicolith confirmed on preoperative computerised tomography scan (pCT) leads to a shorter time to complicated appendicitis. METHODS: We undertook a retrospective single-centre study of patients admitted between 2018 and 2020. Inclusion criteria included: age ≥18 years, appendicitis confirmed on histopathology following an operation and a pCT scan. Complicated appendicitis was defined intraoperatively as an appendicular abscess, gangrenous or perforated appendix. RESULTS: Some 310 patients were included in the study. Forty-five per cent presented with complicated appendicitis (n = 138). Appendicoliths were present in 79 (25.5%) patients. Multivariate logistic regression identified an appendicolith as a significant risk factor for perforation (odds ratio 3.50, 95% confidence interval [CI] 1.16-10.59; p = 0.027). Within the first 12 hours of admission, patients with an appendicolith accounted for a significantly greater proportion of those with complicated appendicitis intraoperatively compared with those without (56.7% vs 43.3%, respectively; p = 0.003). Within 12 hours of admission, those with an appendicolith were 2.05 times more likely to suffer from complicated appendicitis than those without (95% CI 1.28-3.29). CONCLUSIONS: Patients with an appendicolith appendicitis should be considered for an early appendicectomy. Future large-scale multicentre prospective studies are required to explore this further, perhaps informing future guidelines.

Immunological and bacteriological quality of fresh cow colostrum and passive immunity transfer in selected dairy farms in Fars, Iran.

Background: The quality of colostrum is affected by IgG level and microbial load. Aims: The quality of colostrum used in feeding dairy calves and passive immunity transfer in selected dairy farms in Fars province, Iran was investigated. Methods: A total of 75 colostrum and neonatal blood samples were collected from 11 herds. The immunological quality of colostrum was assessed using a Brix digital refractometer. The bacteriological quality was assessed by performing total plate count (TPC), total coliform count (TCC), spore-former count, fungi count, and species-specific PCR assay to detect some bacterial species. Results: The mean Brix of colostrum samples was 25.4% and 72% of the samples had a Brix score ≥22%. The mean serum Brix and the prevalence of failure of passive transfer (FPT) were 10% and 4%, respectively. The mean TPC, TCC, spore-former count, and fungi count were 3.6 × 105, 2.8 × 104, 3.2 × 104, and 1.1 × 104 CFU/ml, respectively. The results showed that 50, 5.9, and 4% of colostrum samples were positive for Staphylococcus spp., Salmonella spp. and Maycobacterium paratuberculosis, respectively. There was no evidence of contamination with Brucella spp., Corynebacterium bovis and Mycoplasma bovis. Conclusion: Considering all colostrum quality indicators comprehensively, only 37.3% of the studied samples met the industry standard. A large number of calves were at risk of receiving poor quality colostrum, especially in terms of microbial contamination. Further researches are needed to evaluate the colostrum management and the effect of bacterial contamination of colostrum on the health of neonate calves in this region.

Alteration of fatty acid profile of milk in Holstein cows fed Bacillus coagulans as probiotic: a field study.

BACKGROUND: Probiotics may improve milk quality and the general health status of animals. AIMS: The effects of dietary Bacillus coagulans PRM101 on milk components, milk fatty acids (FA), and some health indicators of dairy cows were investigated. METHODS: The probiotic was added to the feed of 12 Holstein cows (2 g/cow: 2 × 1011 CFU/cow) for 63 days compared to a control group fed on the basal ration (n=11). Milk and blood samples were taken on days 0, 21, 42, and 63. RESULTS: The yields of milk and energy corrected milk (ECM; computed from milk weight and its fat and protein content) decreased linearly and similarly (P=0.60) in both groups. The treatment cows, however, showed quadratic increases in the weights of milk (P=0.03) and ECM (P=0.04) at d42 of the study. Energy corrected milk (d42, P<0.05) and crude protein content of milk (d42, P<0.05; d63, P<0.1) were higher in the cows receiving the probiotic. The proportions of heptadecanoic (C17:0; P=0.002) and linoleic (C18:2; P=0.077) acids in milk fat (g/100 g fat) were higher in the treatment cows on d63. Milk total antioxidant capacity (TAC), malondialdehyde (MDA), and similarly, amyloid A (AA) and haptoglobin (Hp) of milk and blood were not affected. Total antioxidant capacity and MDA were negatively correlated in the control group (r=-0.669, P=0.005). Heptadecanoic acid correlated negatively with milk MDA (r=-0.611, P=0.035) and positively (r=0.591, P=0.043) with serum Hp in the treatment cows. CONCLUSION: Dietary B. coagulans PRM101 may improve the proportions of C17:0 and C18:2 FA in milk. Some improvements in milk protein and the health status of the cows may also be anticipated.

In vitro effect of some nucleoside reverse transcriptase inhibitors against HSV-1 replication.

OBJECTIVE: The current study was designed to investigate the effects of some nucleoside reverse transcriptase inhibitors (NRTIs) on HSV-1 infection. MATERIALS AND METHODS: Initially, the SwissTargetPrediction server was used to predict the interactions between HSV-1 thymidine kinase and acyclovir, stavudine, zidovudine, didanosine, and entecavir. The effect of each component on Vero cell viability was assessed by the MTT assay. After treatment, the cell supernatants were collected, and HSV-1 replication was analyzed by quantitative real-time PCR. RESULTS: The qPCR results revealed that viral titers were reduced 41, 40, 19, 44, and 31-fold in the presence of acyclovir, zidovudine, stavudine, didanosine, and entecavir, respectively. CONCLUSIONS: Our findings indicate that NRTIs significantly reduce HSV-1 replication in cell culture.

The effects of post-partum drops in body condition on indices of energy metabolism in mid-lactation Holstein cows.

BACKGROUND: Evaluation of energy metabolism indices in mid-lactation Holstein cows is critical to monitor health status. Aims: The objective of this study was to assess the effects of low (≤0.75) vs. high (>0.75) drops in body condition score (BCS) until day 60 post-partum on energy metabolism indices during mid-lactation in Holstein cows. METHODS: Twenty-eight Holstein cows were included in the study from the day of calving to day 120 of lactation. Whole blood samples were taken on 60, 90, and 120 days in milk (DIM). Serum was analyzed for insulin, glucose, non-esterified fatty acids (NEFA) and beta-hydroxybutyrate (BHB) levels. RESULTS: In cows with low BCS drop (LoD group), insulin did not change significantly through days 60 to 120 of lactation, but increased in high drop cows (HiD group) (P<0.001). Glucose concentrations decreased linearly in the LoD cows (P=0.039) and showed a quadratic increase in the HiD group on day 90 (P=0.028). Concentrations of non-esterified fatty acids showed both linear (P=0.04) and quadratic (P=0.002) changes in the HiD group. The HiD cows had significantly higher concentrations of insulin on day 120 (P=0.017) compared to the LoD group. Glucose concentration was lower (P<0.01) in HiD cows on 60 DIM. The concentration of non-esterified fatty acids was higher in HiD cows on day 90 (P<0.01). Surrogate indices of insulin resistance (calculated based on the concentrations of the measured metabolites) were different between the groups on day 90, indicating decreased insulin sensitivity in the HiD cows. CONCLUSION: Greater depletion of body reserves during early lactation may result in some inconsistencies in energy metabolism during mid-lactation periods. Controlling BCS loss during early lactation may help alleviate such alterations possibly through modifying insulin sensitivity of the tissues.

Compromised liver functions during the breeding period of clinically healthy Holstein cows.

BACKGROUND: The sub-clinical carry-over effects of post-partum (PP) conditions and the problems independent of parturition may affect the cows' performance during the breeding period. AIMS: It was hypothesized that some mid-lactation cows may have compromised liver functions and calculating liver activity index (LAI; -1.5 to +1.5) may be helpful in detecting such conditions. METHODS: Plasma lipid and protein profiles, retinol and ceruloplasmin were measured in 37 Holstein cows on days 60, 90, and 120 PP. Liver activity index was calculated using the measures of cholesterol, albumin and retinol. The results were interpreted using some health and performance indices. RESULTS: The mean LAI was 0.00 ± 0.61. Sixteen cows (45.7%) were LAI‾ and 19 cows (54.3%) were LAI+. In LAI+ cows the concentrations of cholesterol and albumin were unchanged, but in LAI‾ cows both of them increased through the study (P<0.05). Greater concentrations of low density lipoproteins (LDL) (P<0.01) and lower concentrations of γ- and total globulins (P<0.05; day 60) were detected in LAI+ cows. Ceruloplasmin was not different between the LAI groups with the highest level on day 90. Cholesterol had the strongest and the most repeated correlations with LAI during the study. The correlation of albumin with LAI faded on day 120 and vitamin A had a relationship only on day 60 PP. Triglycerides (TGs), very low density lipoproteins (VLDL) (day 60) and LDL (days 60 and 90) had positive correlations with LAI. All globulin fractions showed negative correlations with LAI on day 60. Seventy percent of the cows without endometritis (day 30 PP) and 33% of the infected cows were LAI+ during the breeding period. About 79% of the cows with body condition score (BCS) loss ≤0.75 (day 60) and 38% of the cows with BCS loss >0.75 were LAI+ during the breeding period. CONCLUSION: Compromised liver functions may exist in dairy cows during the breeding period and may be detected by calculating LAI. The relationship of LAI during the progressed lactation with herd's performance needs to be investigated.

A field study on glucose, non-esterified fatty acids, beta-hydroxybutyrate and thyroid hormones in dairy cows during the breeding period in Fars province, Iran.

BACKGROUND: It was hypothesized that under apparently good management practices in dairy farms, some cows may not be metabolically perfect during the breeding period and this may affect their performance. AIMS: This study was conducted to assess probable metabolic drawbacks in mid-lactation dairy cows affecting their performance. METHODS: Thirty-seven clinically healthy Holstein cows were assessed for plasma concentrations of glucose, non-esterified fatty acids (NEFA), beta-hydroxybutyrate (BHB), thyroxin (T4), and tri-iodothyronine (T3) on days 60, 90 and 120 of lactation. The relationships of the measured analytes with some performance indices were also studied. RESULTS: Continuous declines in plasma glucose (within reference values; P<0.006), T4 (P<0.001) and T3 (0.003) were found during the study. Non-esterified fatty acids showed relatively high levels through the study with a rise at day 90 (P<0.041). Beta-hydroxybutyrate concentrations did not change significantly (P>0.05) but were higher than those reported by others in mid-lactation cows. By progress in lactation 27% of cows had glucose concentrations <2.5 mmol/L, 62% had NEFA concentrations >0.40 mmol/L and 13.5% had BHB levels above 1200 µmol/L, which are the threshold levels of peri- and post-parturient problems. Milk production had negative correlations with glucose and T4 while the correlation was positive with NEFA. The interval between calving to the 1st heat had positive correlations with BHB concentrations. The interval between calving and the 1st insemination was inversely correlated with glucose and positively correlated with NEFA levels. CONCLUSION: The changes of the studied analytes in mid-lactation cows resembled those that would happen during negative energy balance in early lactation cows and feed restriction in mid-lactation cows and may affect the general health and the performance of the cows.

Uncovering the pharmacological response of novel sesquiterpene derivatives that differentially alter gene expression and modulate the cell cycle in cancer cells.

The present study aimed to assess the pharmacological anticancer profile of three natural and five synthetic sesquiterpenes developed by total chemical synthesis. To this end, their properties at the cellular and molecular level were evaluated in a panel of normal and cancer cell lines. The results obtained by performing cytotoxicity assays and gene expression analysis by reverse transcription-quantitative polymerase chain reaction showed that: i) Among the sesquiterpene derivatives analyzed, VDS58 exhibited a notable anticancer profile within attached (U-87 MG and MCF-7) and suspension (K562 and MEL-745) cancer cell cultures; however, U-87 MG cells were able to recover their proliferation capacity rapidly after 48 h of exposure; ii) gene expression profiling of U-87 MG cells, in contrast to K562 cells, showed a transient induction of cyclin-dependent kinase inhibitor 1A (CDKN1) expression; iii) the expression levels of transforming growth factor ß1 (TGFB1) increased after 12 h of exposure of U-87 MG cells to VDS58 and were maintained at this level throughout the treatment period; iv) in K562 cells exposed to VDS58, TGFB1 expression levels were upregulated for 48 h and decrease afterwards; and v) the re-addition of VDS58 in U-87 MG cultures pretreated with VDS58 resulted in a notable increase in the expression of caspases (CASP3 and CASP9), BCL2­associated agonist of cell death (BAD), cyclin D1, CDK6, CDKN1, MYC proto-oncogene bHLH transcription factor (MYC), TGFB1 and tumor suppressor protein p53. This upregulation persisted only for 24 h for the majority of genes, as afterwards, only the expression of TGFB1 and MYC was maintained at high levels. Through bioinformatic pathway analysis of RNA-Seq data of parental U-87 MG and K562 cells, substantial variation was reported in the expression profiles of the genes involved in the regulation of the cell cycle. This was associated with the differential pharmacological profiles observed in the same cells exposed to VDS58. Overall, the data presented in this study provide novel insights into the molecular mechanisms of action of sesquiterpene derivatives by dysregulating the expression levels of genes associated with the cell cycle of cancer cells.

Retraction Note: Rare causes of scoliosis and spine deformity: experience and particular features.

[This retracts the article DOI: 10.1186/1748-7161-2-15.].

AEgIS at ELENA: outlook for physics with a pulsed cold antihydrogen beam.

The efficient production of cold antihydrogen atoms in particle traps at CERN's Antiproton Decelerator has opened up the possibility of performing direct measurements of the Earth's gravitational acceleration on purely antimatter bodies. The goal of the AEgIS collaboration is to measure the value of g for antimatter using a pulsed source of cold antihydrogen and a Moiré deflectometer/Talbot-Lau interferometer. The same antihydrogen beam is also very well suited to measuring precisely the ground-state hyperfine splitting of the anti-atom. The antihydrogen formation mechanism chosen by AEgIS is resonant charge exchange between cold antiprotons and Rydberg positronium. A series of technical developments regarding positrons and positronium (Ps formation in a dedicated room-temperature target, spectroscopy of the n=1-3 and n=3-15 transitions in Ps, Ps formation in a target at 10 K inside the 1 T magnetic field of the experiment) as well as antiprotons (high-efficiency trapping of [Formula: see text], radial compression to sub-millimetre radii of mixed [Formula: see text] plasmas in 1 T field, high-efficiency transfer of [Formula: see text] to the antihydrogen production trap using an in-flight launch and recapture procedure) were successfully implemented. Two further critical steps that are germane mainly to charge exchange formation of antihydrogen-cooling of antiprotons and formation of a beam of antihydrogen-are being addressed in parallel. The coming of ELENA will allow, in the very near future, the number of trappable antiprotons to be increased by more than a factor of 50. For the antihydrogen production scheme chosen by AEgIS, this will be reflected in a corresponding increase of produced antihydrogen atoms, leading to a significant reduction of measurement times and providing a path towards high-precision measurements.This article is part of the Theo Murphy meeting issue 'Antiproton physics in the ELENA era'.

Progesterone concentration and lambing rate of Karakul ewes treated with prostaglandin and GnRH combined with the ram effect during breeding and non-breeding seasons.

The combination of ram effect with two injections of PGF2α 10-days apart and the same protocol plus an additional injection of GnRH prior to the first injection of PGF2α were examined in Karakul ewes during breeding and non-breeding seasons, respectively. Plasma progesterone (P4) concentrations (to detect the presence of active corpus luteum), twin lambing, litter size and synchronization of lambing were evaluated. In each study 70 ewes (2-4 years old) were divided to a treatment (n = 40) and a control (n = 30) group. During the breeding season, on days -10 and 0 before ram release, the treatment group was injected intramuscularly with PGF2α (D-Cloprostenol; 0.15 mg). During the non-breeding season, on day -15 before ram release the treatment group was injected with GnRH (buserelin; 4.2 µg) intramuscularly followed by two injections of PGF2α on days -10 and 0. In both studies, the rams were released into the ewe flock after the second prostaglandin injection (day 0). Blood samples of ewes were collected on days -10, 0, 20 and 70 of the study in breeding season and on days -15, -10, 0, 20 and 70 during non-breeding season. The treatment group had higher P4 concentrations compared to the control ewes on day 0 in the breeding season (5.80 ± 0.61 vs. 5.0 ± 0.93 ng/mL) and day -10 in the non-breeding season (3.50 ± 0.33 vs. 2.70 ± 0.35 ng/mL) though the differences were not significant (P > 0.05). Based on plasma P4 concentrations (>1 ng/mL) on day 70, in the breeding season all control ewes (100%) and 91.9% of the treatment ewes were detected to have active corpus luteum (P = 0.09). An almost inverse result (90% vs. 97.5%; P = 0.2) was detected in the non-breeding season. The lambing rate was higher (P = 0.03) in the treatment group compared to the control ewes during the non-breeding season (90% vs. 70%), but tended to be lower (P = 0.07) in the breeding season (73% vs. 90%). Twin lambing rate was higher in the treatment group compared to the control ewes in the breeding (40.7% vs. 0.0%; P < 0.05) and non-breeding (22.2% vs. 0.0%; P < 0.05) seasons. The litter size of the control and treated ewes were 1.0 ± 0.0 vs. 1.40 ± 0.10 in the breeding and 1.0 ± 0.0 vs. 1.22 ± 0.10 in the non-breeding season (P < 0.05). No effect was observed regard to synchronization of the treated ewes. In the breeding season two injections of PGF2α ten days apart combined with ram effect, may lower the lambing rate, but may enhance twin pregnancies and litter size in Karakul ewes. In the non-breeding season, however, the GnRH-PGF2α treatment plus ram effect may enhance the lambing rate, twin pregnancies and litter size.

Crosstalk between E2f1 and c-Myc mediates hepato-protective effect of royal jelly on taxol-induced damages.

Previous histopathological studies have shown the hepatotoxicity of paclitaxel (TXL). However, there is little known about the molecular pathway(s) of TXL-induced hepatotoxicity. Therefore, this study aimed to uncover the role of two transcription factors in the TXL-induced hepatotoxicity. Moreover, the hepato-protective effect of royal jelly (RJ) on TXL-induced toxicity was investigated. Wistar rats were divided into control and test groups. The test groups along with TXL received various doses of RJ (0, 50, 100 and 150 mg/kg, body weight). Biochemical hepatic functional assays, histopathological studies and hepatic superoxide dismutase level were determined. Additionally, the expression of E2f1 and cellular-myelocytomatosis (c-Myc) at messenger RNA (mRNA) level in the liver was evaluated. The hepatic functional biomarkers showed a significant ( p < 0.05) elevation in the TXL-received animals, while RJ administration for 28 days resulted in a remarkable reduction in TXL-elevated alkaline phosphatase, alanine transaminase and lactate dehydrogenase levels. The TXL-treated animals showed a significant ( p < 0.05) up-regulation of E2f1 and down-regulation of c-Myc at mRNA level, respectively. RJ lowered the expression of E2f1 while enhanced the expression of c-Myc in a dose-dependent manner. Our data suggest the hepato-protective effects of RJ on TXL-induced toxicity, which may attribute to a clear crosstalk between E2f1 and c-Myc as two regulators of liver growth.

Towards Elucidating Carnosic Acid Biosynthesis in Lamiaceae: Functional Characterization of the Three First Steps of the Pathway in Salvia fruticosa and Rosmarinus officinalis.

Carnosic acid (CA) is a phenolic diterpene with anti-tumour, anti-diabetic, antibacterial and neuroprotective properties that is produced by a number of species from several genera of the Lamiaceae family, including Salvia fruticosa (Cretan sage) and Rosmarinus officinalis (Rosemary). To elucidate CA biosynthesis, glandular trichome transcriptome data of S. fruticosa were mined for terpene synthase genes. Two putative diterpene synthase genes, namely SfCPS and SfKSL, showing similarities to copalyl diphosphate synthase and kaurene synthase-like genes, respectively, were isolated and functionally characterized. Recombinant expression in Escherichia coli followed by in vitro enzyme activity assays confirmed that SfCPS is a copalyl diphosphate synthase. Coupling of SfCPS with SfKSL, both in vitro and in yeast, resulted in the synthesis miltiradiene, as confirmed by 1D and 2D NMR analyses (1H, 13C, DEPT, COSY H-H, HMQC and HMBC). Coupled transient in vivo assays of SfCPS and SfKSL in Nicotiana benthamiana further confirmed production of miltiradiene in planta. To elucidate the subsequent biosynthetic step, RNA-Seq data of S. fruticosa and R. officinalis were searched for cytochrome P450 (CYP) encoding genes potentially involved in the synthesis of the first phenolic compound in the CA pathway, ferruginol. Three candidate genes were selected, SfFS, RoFS1 and RoFS2. Using yeast and N. benthamiana expression systems, all three where confirmed to be coding for ferruginol synthases, thus revealing the enzymatic activities responsible for the first three steps leading to CA in two Lamiaceae genera.

What do general practitioners think about acupuncture?

The goal of the study was to observe the opinion of the GPs of one of the two Turin Local Health Unit (from now on LHU) and compare them to what emerges from literature. We employed a questionnaire administered via phone to all the 389 GPs active in the LHU in October 2013. The percentage of responders was 81.5%. Among the responders, 95% are in favor of acupuncture, 84.2% believe that it is scientifically based, 6% practice acupuncture, 25.2% use it on themselves, and 66.2% have sent at least one patient to an acupuncturist in the last year. 82% of responders are in favour of adding acupuncture training to their own professional practice, and 71.9% believe it would be useful to include acupuncture in specific training for general practice. 64% believe that acupuncture should be included into the benefits offered by the NHS. Data show that interest for acupuncture is higher than that observed in previous international studies carried out on the same topics in the last 20 years; in our opinion, such an increase in confidence and trust in acupuncture is due to the skilled performance offered by the public service in this LHU, which is also guaranteed by a prestigious acupuncture school.

Effect of a home bleaching agent on the fracture toughness of resin composites, using short rod design.

STATEMENT OF PROBLEM: Resin composites are brittle materials and their major shortcomings are manifested in their sensitivity to flaws and defects. Although various mechanical properties of resin composites have been described, few studies are available on assessing the effect of bleaching agents on resin composites using the short rod design. PURPOSE: To place various resin composites into distilled water at 37°C for 21 days and determine the effect of immersion time in distilled water, with and without exposure to 10% carbamide peroxide by employing short rod design fracture toughness test. MATERIALS AND METHOD: Specimens were prepared from three resin composites; Rok (SDI), Esthet (Dentsply), and Estelite (Tokuyama). For each material, a total of 24 disc-shaped specimens were prepared using a custom-made mould. Specimens were randomly divided into 3 groups of 8 and conditioned in 37°C distilled water for either 24 hours, or 21 days. 21 day specimens were tested both with and without applying bleaching agent; Polanight (SDI). Study group specimens were bleached for 21 days, 2 hours a day. The specimens were loaded using a universal testing machine with a crosshead speed of 0.5 mm per minute. The maximum load at specimen failure was recorded and the KIc (MPa. M (0.5)) was calculated. RESULTS: Statistical analysis using two-way ANOVA showed a significant relationship between material and time (p< 0.05).Tukey's test showed that after 24 h of immersion in distilled water, Rok revealed the highest KIc followed by Esthet and Estelite. The bleaching agent significantly improved the fracture toughness values of Esthet while it decreased that of Estelite. CONCLUSION: The fracture toughness of the resin composites was affected by the bleaching agent and distilled water. In comparison with Rok and Estelite, fracture toughness of Esthet was increased due to aging and application of bleaching agent.

Anxiety and dysthymia: local prevalence estimates based on drug prescriptions by general practitioners in Turin (Italy).

BACKGROUND: The aim of the study was to obtain local estimates of the prevalence of anxiety and dysthymic disorders among attendees of primary care at local level, useful to pursue a better management of the health care services. METHODS: The study was conducted in the Health District no. 2 of Turin (industrial town in northwest Italy). The criteria for identification of cases were based on the drugs prescriptions made by general practitioners (GPs), selected in order to assure high specificity. The study involved 86 physicians (with 87,885 attendees). RESULTS: As expected, the crude and standardized prevalences were higher in women (anxiety: 2.9% vs 1.3% in men; dysthymia: 3.8% vs 1.7% in men), with a peak in women aged over 75 yrs (anxiety: 4.8%; dysthymia: 6.2%). In comparison to male GPs, female GPs had an higher prevalence of patients with anxious disorders, whereas the prevalences of dysthymia were similar. CONCLUSIONS: Despite the discussed limitations, the used methodology allows to obtain sufficiently reliable estimates of prevalence of common mental disorders at local level, providing informations useful for organizing the primary care in the Health district.

Radiolabeled peptides: valuable tools for the detection and treatment of cancer.

Human cancer cells overexpress many peptide receptors as molecular targets. Radiolabeled peptides that bind with high affinity and specificity to the receptors on tumor cells hold great potential for both diagnostic imaging and targeted radionuclide therapy. The advantage of solid-phase peptide synthesis, the availability of different chelating agents and prosthetic groups and bioconjugation techniques permit the facile preparation of a wide variety of peptide-based targeting molecules with diverse biological and tumor targeting properties. Some of these peptides, including somatostatin, bombesin, vasoactive intestinal peptide, gastrin, neurotensin, exendin and RGD are currently under investigation. It is anticipated that in the near future many of these peptides may find applications in nuclear oncology. This article presents recent developments in the field of small peptides, and their applications in the diagnosis and treatment of cancer.

Comparing the Effect of Phenytoin Syrup and Triamcinolone Acetonide Ointment on Aphthous Ulcers in Patients with Behcet's Syndrome.

BACKGROUND: Recurrent aphthous stomatitis (RAS) appears to be the most common type of oral ulcers. The lesion is usually self limited but its painful presentation results in some difficulties. Therefore, an efficient therapeutic strategy is required and currently existing therapies seem to be inadequate because of its unclear etiology. Here the therapeutic effect of triamcinolone acetonide ointment as a relatively expensive medication has been compared with phenytoin syrup on aphthous ulcers in patients with Behcet's syndrome. METHODS: Thirty out of 60 our patients with Behcet's syndrome were randomly treated by phenytoin syrup and the remaining were advised to use 0.1% triamcinolone acetonide ointment. After a week, they were visited again to determine the status of aphthous ulcers. RESULT: Positive response in the triamcinolone acetonide group and phenytoin group was 86.7% and 53.3%, respectively. CONCLUSION: The effectiveness of triamcinolone acetonide ointment was more than phenytoin on aphthous ulcers in patients with Behcet's syndrome.

Comparison of 800 and 3700 MBq iodine-131 for the postoperative ablation of thyroid remnant in patients with low-risk differentiated thyroid cancer.

INTRODUCTION: The initial treatment of differentiated thyroid cancer is thyroidectomy, followed by remnant ablation with iodine-131 (I-131) in some patients. However, controversy exists concerning the appropriate radioiodine dose. The aim of the study is to compare the success rate of low and high activities of I-131 for postoperative remnant ablation. PATIENTS AND METHODS: A total of 108 nonmetastatic low-risk patients (mean age: 46, 85% women) with papillary and follicular carcinoma had I-131 ablation for the postoperative thyroid remnant. Fifty-three patients received a low dose (L) (800 MBq) and 55 patients received a high dose (H) (3700 MBq) of I-131. After total thyroidectomy, thyroid bed I-131 uptake (RAIU) and neck ultrasonography (USG) were performed to determine the remnant volume and the iodine avidity, which were used to calculate the dose delivered to the remnant tissue. The success rate of I-131 ablation was assessed with four different criteria based on serum thyroglobulin (Tg) and USG with and without the utilization of I-131 diagnostic whole-body scintigraphy (DxWBS). Ablation was considered to be successful if patients fulfilled all of the following criteria. (a) Strict criteria based on three tests: (i) USG negative, (ii) no tracer uptake or less than twice the background activity in the thyroid bed on DxWBS and/or up to 0.2% RAIU, and (iii) Tg < 0.2 ng/ml; (b) lax criteria based on three tests: (i) USG negative, (ii) no tracer uptake or less than twice the background activity in the thyroid bed on DxWBS and/or ≤ 0.2% RAIU, and (iii) Tg < 2 ng/ml; (c) strict criteria based on two tests: (i) USG negative and (ii) Tg < 0.2 ng/ml; (d) lax criteria based on two test: (i) USG negative and (ii) Tg < 2 ng/ml. RESULTS: When three tests were used to define successful ablation, in group L, 32 out of 53 (60%) and 43 out of 53 (81%) patients were successfully treated versus 35 out of 55 (64%) and 42 out of 55 (76%) for group H on the basis of strict and lax criteria, respectively (P=NS). The differences were not statistically significant between the two groups when only two tests were used to define ablation success (62 vs. 69% with strict and 89 vs. 87% with lax criteria, respectively). CONCLUSION: Our findings suggest that remnant thyroid tissue in patients with low-risk, well-differentiated thyroid cancer after total thyroidectomy can be ablated with 800 MBq of I-131. The success rate is not different from that obtained with 3700 MBq I-131.

Computerized scar detection on renal cortical scintigraphy images.

OBJECTIVE: Renal cortical scintigraphy is a well-established functional imaging technique for visual analysis of radiopharmaceutical tracer distribution. However, the visual evaluation is subjective, causing interobserver variability, especially in a quantifiable number of scars. The purpose of this study was to develop new computerized methods in renal cortical scintigraphy image interpretation, particularly addressing activity distribution and cortex continuity (scars). METHODS: The proposed methods involve preprocessing stages of model-based automatic kidney segmentation using active-shape model and image normalization (transforming each kidney image into a standardized image vector). For our previous computer-aided diagnosis scheme, two new image-based features [localized activity drop and principal component analysis (PCA)] were defined. Their performance was evaluated and compared with our previous scheme by using free-response receiver operating characteristic that is in terms of sensitivity (true-positive fraction) and the mean number of false positives (FPs) per image. RESULTS: Clinical tests were conducted in 297 patients (231 normal and 66 abnormal). The PCA-based image feature presented the best scar detection performance, followed by the localized activity drop feature. Both schemes were found to be superior to our previous computer-aided diagnosis scheme. In the PCA-based scheme, for sensitivity of 0.90 (76/84), the mean number of FPs was measured as 4.52 (1343/297). For another setting with reduced sensitivity of 0.79 (66/84), the mean number of FPs improved to 1.21 (360/297). Finally, a decision fusion scheme using 'majority voting' was also proposed, the sensitivity and mean number of FPs of which were measured as 0.83 (70/84) and 1.90 (563/297), respectively. CONCLUSION: The proposed methods have potential to provide effective second-reader information to nuclear medicine specialists in finding scar regions. Possible ways to improve the FP rate were also proposed.