Anthropometric Analysis of Cuboid Bones in a South Indian Population.

Purpose Cuboid bone and its fibromuscular supports maintain the lateral longitudinal arch in weight transmission during different gait cycle phases. Morphometry of the cuboid bone is essential for designing a cuboid prosthesis for foot reconstruction and establishing an individual's biological profile. The present study aims to assess the morphology and morphometry of the cuboid bone. Materials and methods The study used 103 cuboid bones (right 50, left 53) of unknown sex. Different shapes of cuboid articular facets were observed, and the morphometric parameters such as length, breadth, and height of cuboid, and the dimensions of articular facets in cuboid (calcaneal facet, fourth and fifth metatarsal facets, ecto-cuneiform facet, navicular facet, and facet for os peroneum) were analyzed. Results The mean length, breadth, and height of the cuboid bone were 33.69 ± 2.61 mm, 25.43 ± 2.87 mm, and 23.03 ± 2.43 mm, respectively. The mean transverse and vertical diameters were 23.22 ± 2.4 mm and 15.97 ± 1.85 mm, respectively. Facet for os peroneum was observed in 74.76% and for navicular bone in 26.2%. The mean transverse and vertical diameters were 7.16 ± 2.08 and 6.78 ± 1.78 mm, respectively. The depth of the peroneal groove was 4.30 ± 1.11 mm. Conclusion The morphometric data from the present study could assist in preoperative planning and designing of prostheses for foot reconstruction, and in establishing the biological profile of an individual, which can help the anthropologists in identifying the unknown remains.

Roles of Cholesteryl-α-Glucoside Transferase and Cholesteryl Glucosides in Maintenance of Helicobacter pylori Morphology, Cell Wall Integrity, and Resistance to Antibiotics.

Infection of the human stomach caused by Helicobacter pylori is very common, as the pathogen colonizes more than half of the world's population. It is associated with varied outcomes of infection, such as peptic ulcer disease, gastric ulcers, and mucosa-associated lymphoid tissue lymphoma, and is generally considered a risk factor for the development of gastric adenocarcinoma. Cholesteryl glucosides (CGs) constitute a vital component of the cell wall of H. pylori and contribute to its pathogenicity and virulence. The hp0421 gene, which encodes cholesteryl-α-glucoside transferase (CGT), appears critical for the enzymatic function of integrating unique CGs into the cell wall of H. pylori, and deletion of this gene leads to depletion of CGs and their variants. Herein, we report that the deletion of hp0421 and consequent deficiency of cholesterol alter the morphology, shape, and cell wall composition of H. pylori cells, as demonstrated by high-resolution confocal microscopy and flow cytometry analyses of two different type strains of H. pylori, their isogenic knockouts as well as a reconstituted strain. Moreover, measurement of ethidium bromide (EtBr) influx by flow cytometry showed that lack of CGs increased cell wall permeability. Antimicrobial susceptibility testing revealed that the hp0421 isogenic knockout strains (Hp26695Δ421 and Hp76Δ421) were sensitive to antibiotics, such as fosfomycin, polymyxin B, colistin, tetracycline, and ciprofloxacin, in contrast to the wild-type strains that were resistant to the above antibiotics and tended to form denser biofilms. Lipid profile analysis of both Hp76 and Hp76Δ421 strains showed an aberrant profile of lipopolysaccharides (LPS) in the Hp76Δ421 strain. Taken together, we herein provide a set of mechanistic evidences to demonstrate that CGs play critical roles in the maintenance of the typical spiral morphology of H. pylori and its cell wall integrity, and any alteration in CG content affects the characteristic morphological features and renders the H. pylori susceptible to various antibiotics.IMPORTANCEHelicobacter pylori is an important cause of chronic gastritis leading to peptic ulcer and is a major risk factor for gastric malignancies. Failure in the eradication of H. pylori infection and increasing antibiotic resistance are two major problems in preventing H. pylori colonization. Hence, a deeper understanding of the bacterial survival strategies is needed to tackle the increasing burden of H. pylori infection by an appropriate intervention. Our study demonstrated that the lack of cholesteryl glucosides (CGs) remarkably altered the morphology of H. pylori and increased permeability of the bacterial cell wall. Further, this study highlighted the substantial role of CGs in maintaining the typical H. pylori morphology that is essential for retaining its pathogenic potential. We also demonstrated that the loss of CGs in H. pylori renders the bacterium susceptible to different antibiotics.

Pre-stroke glycemia in patients with diabetes.

AIMS: Hyperglycemia in type 2 diabetes mellitus (T2D) remains uncontrolled in approximately 50% of patients in the United States. Uncontrolled T2D is associated with various vascular complications, including stroke. We studied demographic and clinical factors association with pre-stroke glycemia, indicated by glycated hemoglobin (HbA1c), in acute stroke patients with T2D. METHODS: Using a questionnaire, we collected demographic, socioeconomic, and clinical information from 300 acute ischemic and hemorrhagic stroke patients in one hospital. We analyzed factors associated with HbA1c in patients with history of T2D. RESULTS: There were 111 patients with history of T2D and HbA1c measured on admission. In multivariable analyses factors associated with higher HbA1c were treatment with insulin (p=0.05), history of hyperlipidemia (p=0.01), and total cholesterol level (p=0.02). Poor adherence to T2D treatment was associated with higher HbA1c levels (p=0.006) only in a subgroup of patients with HbA1c ≥8%. CONCLUSION: Insulin treatment and hyperlipidemia are associated with higher HbA1c levels in acute stroke patients with T2D. Poor adherence to diabetes treatment is associated with higher HbA1c levels only among patients with HbA1c ≥8%.

Synthesis of Hydrogels with Antifouling Properties As Membranes for Water Purification.

Hydrogels have been widely utilized to enhance the surface hydrophilicity of membranes for water purification, increasing the antifouling properties and thus achieving stable water permeability through membranes over time. Here, we report a facile method to prepare hydrogels based on zwitterions for membrane applications. Freestanding films can be prepared from sulfobetaine methacrylate (SBMA) with a crosslinker of poly(ethylene glycol) diacrylate (PEGDA) via photopolymerization. The hydrogels can also be prepared by impregnation into hydrophobic porous supports to enhance the mechanical strength. These films can be characterized by attenuated total reflection Fourier transform infrared spectroscopy (ATR-FTIR) to determine the degree of conversion of the (meth)acrylate groups, using goniometers for hydrophilicity and differential scanning calorimetry (DSC) for polymer chain dynamics. We also report protocols to determine the water permeability in dead-end filtration systems and the effect of foulants (bovine serum albumin, BSA) on membrane performance.

Comparison of Ischemic Colitis in the Young and the Elderly.

BACKGROUND: Ischemic colitis is traditionally known as a disease of the elderly; however, its recognition among the young recently has increased. The aim of this study was to illustrate the features of ischemic colitis in a younger population. METHODS: Medical records of patients with ischemic colitis from January 2007 to January 2013 were reviewed. The study was conducted in 2 hospitals, and the patients were divided into 2 groups: < 50 and ≥ 50 years old. RESULTS: A total of 118 patients with ischemic colitis were identified. Fifteen patients (12.7%) were < 50 years of age; 103 patients (87.3%) were ≥ 50 years old. While drugs and vasculitis­as a group­was the most common precipitating factor for ischemic colitis in the younger age group, constipation was the most common precipitating factor in the older age group. All patients in the younger group had rectal bleeding vs 70.9% in the older group (P = 0.009). History of coronary artery disease, dyslipidemia, and hypertension were higher in the older group. Length of hospital stay was shorter in the younger group (3.4 days) than the older group (7.2 days). CONCLUSION: In this study, 12.7% of the patients were under age 50. All patients in this "young" age group experienced rectal bleeding and their hospital stay was shorter.

Is CT Angiogram of the Abdominal Vessels Needed following the Diagnosis of Ischemic Colitis? A Multicenter Community Study.

Background. CT angiogram is frequently obtained after diagnosis of ischemic colitis (IC). Aims. To investigate the vascular findings of CT angiogram as compared to contrast-enhanced CT scan and whether this modality changes the management or prognosis of IC. Methods. We conducted a retrospective analysis of patients with IC from 2007 to 2013. Results. CT angiogram was performed in 34 patients (28.81%), whereas contrast-enhanced CT scan was performed in 54 patients (45.76%). In CT angiogram group, 8 patients (23.5%) had atherosclerotic changes. Stenosis was found in 12 patients (35.3%) (9: celiac trunk, 3: SMA). Among this group, one patient underwent colectomy and another underwent angioplasty of the celiac trunk who died within 30 days. Among contrast-enhanced CT scan group, 5 patients (9.3%) had atherosclerotic changes. Stenosis was found in 5 patients (9.3%) (3: celiac trunk, 1: SMA, and 1: IMA). Among this group, 3 patients had colectomy and one died within 30 days. There was no statistical difference between both groups in all vascular findings except the stenosis which was higher in CT angiogram group (P = 0.0025). Neither the need for surgery nor all-cause mortality was different between both groups. Conclusion. CT angiogram did not provide any useful findings that altered the management or the prognosis of IC.

Ischemic colitis: A forgotten entity. Results of a retrospective study in 118 patients.

OBJECTIVE: The aim of our study was to document our 6-year experiences in identifying the clinical characteristics, laboratory findings, risk factors and the outcomes of patients with ischemic colitis (IC) in a community hospital setting. METHODS: The medical records of patients who were diagnosed with IC from 2007 to 2013 in two community hospitals were retrospectively reviewed. Their clinical characteristics, laboratory results, radiological, endoscopic and histological evidence, anatomic location of the lesion, comorbidities, concomitant use of drugs, and so on, were collected. RESULTS: A total of 118 patients with IC was identified, most were elderly individuals with a female predominance. The most common symptoms were abdominal pain, rectal bleeding and diarrhea. Hypertension, hyperlipidemia, coronary artery disease and diabetes mellitus were the most common comorbidities. Erythema, edema and erosions/ulcerations were the most common endoscopic findings. Left colon was the most affected location of lesion (84.8%), and there was one case of pancolitis. The descending colon was the most common affected segment, while rectum was the least affected segment. Severe IC occurred in 12.7% of the patients. Death within 30 days from the diagnosis of the disease occurred in 4.2%. CONCLUSIONS: IC is majorly occurred in elderly with a female predominance. Cardiovascular disease and its associated risk factors are the most common comorbidities. Left colon is the most affected location of the disease and the overall mortality rate was 4.2%. Physicians should make every effort to identify these patients, especially those with high risks.

The influence of kinesiophobia on trunk muscle voluntary responses with pre-programmed reactions during perturbation in patients with chronic low back pain.

The purpose of this study was to examine the relation between fear of movement and perturbation induced electromyographic global trunk muscle voluntary responses with pre-programmed reactions among persons with chronic low back pain (CLBP). CLBP subjects (n = 25) were challenged to unexpected and expected perturbations on stable and unstable surfaces. 'Tampa scale for kinesiophobia - Adjusted version-13' was used to measure kinesiophobia. Regression analysis revealed significant negative correlation between kinesiophobia scores and voluntary responses of rectus abdominis (RA) for unexpected perturbations on stable (r = -0.69, 95% of CI: -0.85 to -0.40, p < 0.000, r(2) = 0.41) and unstable surfaces (r = -0.47, 95% of CI: -0.72 to -0.09, p < 0.018, r(2) = 0.29). The activity of erector spinae was not influenced by most of testing conditions in the study except task on unstable surface for expected perturbation (r = -0.593, 95% of CI: -0.8 to -0.25, p = 0.002, r(2) = 0.15). RA activity and kinesiophobia score of the CLBP population was significantly inversely associated during anteriorly directed unexpected perturbations. In our study, the significant association between fear of movement and the trunk muscle responses was differentially influenced by expected and unexpected postural demands.

The magnitude of pre-programmed reaction dysfunction in back pain patients: experimental pilot electromyography study.

BACKGROUND: Preprogrammed reactions (PPR) appear at a latency of higher than 40 ms, but before the voluntary muscle responds (approximately 120 ms) to postural perturbations. OBJECTIVE: To examine the difference in magnitude of preprogrammed reactions in patients with chronic low back pain (CLBP) and without low back pain. METHODS: we analyzed electromyographic Root Mean Square (RMS) amplitudes of asymptomatic (n=25) and CLBP patients (n=25) on stable and unstable surfaces during expected and unexpected perturbations for rectus abdominus and erector spinae muscles. The mean PPR and PPR-combined voluntary response RMS amplitudes (VRPPR) were compared between the two groups. To find the presence of PPR in LBP patients, a criteria was set that the obtained PPR RMS amplitude value should exceed 60% mean reflex RMS amplitude that occur within 50 ms after perturbation. RESULTS: Fleiss' kappa revealed a good agreement (kappa = 0.7 to 0.9) among raters for absence of PPR in patients with CLBP and presence of PPR in asymptomatic population. The two way ANOVA revealed significantly different mean PPR and VRPPR RMS amplitudes between asymptomatic and LBP population for rectus abdominus and erector spinae muscles (p<0.05). CONCLUSION: PPR responses were found absent (<60% of Mean Reflex RMS) in patients with CLBP. Further, patients with CLBP demonstrated lower PPR amplitudes with higher peak voluntary responses compared to asymptomatic population, indicating difficulties in presetting of voluntary responses for regaining postural stability after perturbation.