Association between dietary patterns and pregnancy induced hypertension: a case control study from Sudan.

Background: Dietary patterns and its associated factors and can play an essential role in development of preeclampsia and implication in pregnancy-induced hypertension (PIH). Objective: This study was performed to determine nutritional factors associated with PIH among pregnant women in Khartoum, Sudan. Methods: This study was a case-control involving 100 women with PIH and 200 normotensive pregnant women. Results: The mean current weight in the control and PIH groups was 70.25 ± 12.35 and 72.42 ± 12.33 kg; whereas the mean energy intake in the control and PIH groups was 1991.58 ±140.72 and 2154.37 ± 130.85 kcal, respectively. The study results indicated a significantly lower risk of PIH among women ingesting fruits and legumes (odds ratio, 8.44 and 4.07, respectively; 95% confidence interval; P < 0.05). Conclusion: PIH was positively associated with higher energy, fat, and protein intake. A lower risk of PIH was calculated for women whose dietary habits included fruits and legumes. Measures with which to ensure proper nutrition education are needed to obtain good health and pregnancy outcomes. PIH is a multifactorial disease with an unclear etiology, and the findings of this study will serve as a baseline for future studies in this field.

Marking fin spine of juvenile sturgeon (Acipenseriformes: Acipenseridae) using oxytetracycline and the comparing of growth performance / [Marcação da espinha da nadadeira de esturjão juvenil (Acipenseriformes: Acipenseridae) usando-se oxitetraciclina e comparação do desempenho de crescimento]

This study aimed to describe and validate the formation of the rings in the spine of the pectoral fin and to determine the coherence of the OTC mark with the rings of three species of Caspian Sea sturgeon, the Persian sturgeon (Acipenser persicus), the Starry sturgeon (Acipenser stellatus) and Ship sturgeon (Acipenser nudiventris). Validation was achieved by comparing the total radius of the fin spine of fish of known age after one and two years of growth with the measured radius of the first and second rings in the zone. There was no overlap between the measured radius for the first year and the increase for the second. The Ship sturgeon showed the largest width of the second ring followed by the Persian sturgeon and Stellate sturgeon. The results indicate that the highest growth parameter belongs to the juvenile Ship sturgeon. This research showed that chemically marking the fin spines of juvenile Acipenseridae leads to unbiased estimates and contributes to the knowledge of the population dynamics of these species. The study found that the combination of the dial ring of the pectoral fin spine with growth validated the age estimation in juvenile sturgeon Ship, Persian, and Starry sturgeon.(AU)

O objetivo deste estudo foi descrever e validar a formação dos anéis na espinha da nadadeira peitoral de três espécies de esturjão do mar Cáspio: o esturjão-persa (Acipenser persicus), o esturjão-estrelado (Acipenser stellatus) e o esturjão-de-navio (Acipenser nudiventris), bem como determinar a coerência da marca OTC com os anéis dessas três espécies. A validação foi alcançada comparando-se o raio total da espinha da nadadeira de peixes de idade conhecida, após um e dois anos de crescimento, com o raio medido do primeiro e segundo anéis na zona. Não houve sobreposição entre o raio medido no primeiro ano e o aumento no segundo. O esturjão-de-navio mostrou a maior largura do segundo anel, seguido pelo esturjão-persa e pelo esturjão-estrelado. Os resultados indicam que o maior parâmetro de crescimento pertence ao esturjão-de-navio juvenil. Esta pesquisa mostrou que a marcação química dos espinhos das nadadeiras de juvenis de Acipenseridae leva a estimativas imparciais e contribui para o conhecimento da dinâmica populacional dessas espécies. O estudo descobriu que a combinação do anel do mostrador da barbatana peitoral espinhal com o crescimento validou a estimativa de idade em esturjão-de-navio juvenil, esturjão-persa e esturjão-estrelado.(AU)

The effectiveness of trabeculectomy with mitomycin C and releasable suture in posner-schlossman syndrome with secondary glaucoma: A case series.

The aim of this study is to describe the effectiveness of trabeculectomy with mitomycin C and releasable suture in Posner-Schlossman syndrome (PSS) with secondary glaucoma. Early treatment is the key to successful management of PSS with secondary glaucoma. However, unremitting exposure of high intraocular pressure (IOP) because of the high recurrence rate of PSS may cause further optic nerve damage and visual field defect. It is assumed that trabeculectomy may become the surgical treatment of choice in order to prevent further damage to the optic nerve despite recurring attack of PSS. Trabeculectomy with mitomycin C and releasable suture was performed in 5 patients (3 females and 2 males) with recurring attacks of PSS and secondary glaucoma after acute attack had subsided. Before surgery, these patients had already suffered more than 3 acute attacks which were alleviated with antiglaucoma and anti-inflammatory medications; however, optic nerve damage and visual field defect had already developed. After trabeculectomy, 4 patients experienced no recurrent attacks during the follow-up period. One patient only suffered another episode of acute attack; however, an abrupt increase in IOP of more than 22 mmHg did not occur. In all cases, blebs were well formed, and no further optic nerve damage or visual field defects were observed up until final follow-up. In PSS with secondary glaucoma, medication may alleviate the IOP increase and inflammation; however, there is still a chance of damage occurring to the optic nerve each time an attack recurs. Trabeculectomy may be considered a safe and effective surgical treatment modality in PSS with secondary glaucoma in order to prevent further optic nerve damage due to the extreme IOP spike in each recurrent attack.

Cypho-scoliose thoracique et volumineuse cardiomégalie révélatrice d'une maladie de Davies

La maladie de Davies ou Fibrose Endomyocardique Constrictive (FEMC) est une cardiomyopathie restrictive d'étiologie inconnue. Objectif : Montrer l'intérêt incontournable de l'échocardiographie trans-thoracique bidimensionnelle comme technique non-invasive référentielle dans le diagnostic et dans le suivi de la FEMC dans notre contexte de travail. Les auteurs présentent l'observation d'un adulte jeune de 22 ans qui habitait une zone forestière. Il avait comme antécédents une tuberculose osseuse et de régulières piqûres de moucherons. Il consultait pour une insuffisance cardiaque globale à prédominance droite évoluant depuis 3 semaines. L'examen clinique retrouvait une altération de l'état général, une cyphoscoliose dorsale, une tachycardie à 100 battements par minute, des souffles d'insuffisance mitro-tricuspidienne, des râles sous-crépitants à la base pulmonaire droite, des signes de défaillance cardiaque droite et une tension artérielle à 110/80 mm Hg. La radiographie thoracique montrait une volumineuse cardiomégalie aux dépens des oreillettes, une dilatation des artères pulmonaires et une cyphoscoliose dorsale.L'électrocardiogramme en rythme sinusal montrait un bloc bi-fasciculaire, une hypertrophie auriculaire gauche et un trouble non-spécifique de la repolarisation de ST. L'hémogramme révélait une hyper éosinophilie à 1500 éléments/mm3, une créatininémie à 148 µmol/l avec une clairance de la créatine à 65ml/mn. L'échocardiographie trans thoracique bidimensionnelle, après avoir écarté le cœur pulmonaire chronique et de la péricardite chronique constrictive, avait montré les critères majeurs de la maladie de Davies contrairement aux autres techniques de diagnostic disponibles. Le traitement médical est décevant voire palliatif. Conclusion : La maladie de Davies est une fibrose endomyocardique tropicale, d'étiologie inconnue. La défaillance cardiaque est le mode d'expression clinique. L'évolution est marquée par des récidives fréquentes caractérisées par des poussées d'insuffisance cardiaque. L'échocardiographie bidimensionnelle est l'examen référentiel du diagnostic et du suivi de cette affection. Le traitement médical est décevant

Human papillomavirus detection using in situ hybridization and correlations with histological and cytological findings.

BACKGROUND AND OBJECTIVE: The human papillomavirus (HPV) is the main causative agent of cancerous and precancerous lesions in cervical cancers. The infection detection is performed by cytological and histological examination. However, molecular testing for HPV infection remains necessary to distinguish nonspecific inflammatory lesions from HPV-related lesions. We aimed to compare cytological and histological diagnosis of HPV lesions and to confront histological findings with molecular detection of HPV by in situ hybridization (ISH). MATERIAL AND METHODS: A total of 2399 pap smears were collected between 1997 and 2002. Twenty-nine of them presented with lesions indicative of HPV infection. Colposcopy and biopsy were performed on 23 of these 29 pap smears, with a comparison of the cytological and histological findings. Molecular testing for HPV by ISH was performed on 11 pap smears. RESULTS: A 79% cytological and histological agreement was observed. ISH revealed the presence of the virus in seven case patients, amounting to a 63% histological and molecular agreement. Seven HPV genotypes were categorized (6-11-16-18-31-33-51). CONCLUSION: HPV detection by ISH adds little to the diagnosis of HPV-associated lesions based on cytological and histological features. It, however, helps improve the specificity of the diagnosis and determine the viral genotype which, in turn, helps better define the lesion prognosis.

Péricardite liquidienne observée chez l'adulte drépanocytaire homozygote à l'hôpital général de Loandjili (Pointe-Noire Congo). A propos de cinq cas

La péricardite liquidienne du drépanocytaire homozygote présente des particularités.Objectif : Déterminer les aspects cliniques, biologiques et thérapeutiques de la péricardite liquidienne chez le drépanocytaire homozygote dans notre contexte de travail.Patients et méthode : Il s'est agi d'une étude descriptive, transversale et uni variée réalisée dans le service de cardiologie de l'hôpital général de Loandjili entre avril 2013 et mai 2014 (soit 13 mois) concernant les patients drépanocytaires homozygotes hospitalisés pour une péricardite liquidienne.Résultats : Quatorze patients étaient hospitalisés pour péricardite liquidienne, dont 5 étaient drépanocytaires homozygotes, soit une fréquence relative de 35,7%. L'âge moyen était de 24,2 ± 5 ans avec des extrêmes de 19-30 ans dont 4 hommes et 1 femme. Les douleurs thoraciques étaient chez 5 patients, la dyspnée d'effort chez 5 patients, la fièvre chez 4 patients, la toux sèche chez 1 patient. L'asthénie physique était retrouvée chez 5 patients. La tachycardie régulière et la pâleur conjonctivale étaient chez 5 patients. Un patient présentait un ictère conjonctival. La tension artérielle basse était retrouvée chez 5 patients. Un patient présentait une adénopathie cervicale. L'hépato-splénomégalie était observée chez 2 patients, et un ulcère de jambe existait chez 1 patient. La cardiomégalie était retrouvée chez tous les patients. Le rapport cardio-thoracique moyen était de 73 ± 5,43% avec des extrêmes de 70 à 81%. Tous les patients présentaient une anémie et l'hémoglobine moyenne était de 7,62 &plus 1,94 g/dl avec des extrêmes de 4,3 à 9,3 g/dl. Trois patients présentaient une hyperleucocytose. La leucopénie était chez 1 patient. Un patient était séropositif à VIH. Le test tuberculinique était phlycténulaire chez un patient. Tous les patients avaient un épanchement péricardique. Le diamètre moyen du décollement péricardique était de 36,4 ± 10,31 mm avec des extrêmes de 23,4 à 52,4 mm. Tous les patients avaient reçu un culot globulaire, des anti-inflammatoires non-stéroïdiens, de l'acide folique et des anti-sécrétoires. Un patient était sous antituberculeux. Deux patients étaient sous triple antibiothérapie synergique. Un patient était sous traitement anti-rétroviral. Le traitement anti-comitial était prescrit chez 2 patients. Les étiologies étaient virales, bacillaires et purulente. L'évolution était émaillée de complications mortelles.Conclusion : La péricardite liquidienne chez le drépanocytaire est grave. Les complications hématologiques, neurologiques, digestives et cardiaques majorent la mortalité

Profil épidémiologique et clinique de l'hypertrophie ventriculaire gauche d'origine hypertensive chez 33 patients suivis à l'hôpital général de Loandjili (Pointe-Noire - Congo Brazzaville)

L'hypertrophie Ventriculaire Gauche (HVG) est l'une des complications de l'hypertension Artérielle (HTA), et elle peut être responsable d'autres complications secondaires.Objectif : Déterminer le profil épidémiologique et clinique des complications secondaires à l'HVG.Patients et méthodes : Il s'est agi d'une étude descriptive et transversale réalisée dans le service de cardiologie de l'hôpital général de Loandjili du 1er mai 2008 au 30 avril 2015, soit 84 mois. Ont été inclus tous les patients suivis pour une HTA avec HVG, pour une sténose aortique serrée (RAC) et pour une cardiomyopathie hypertrophique (CMH), présentant une ou plusieurs complications ultérieures.Résultats : Trente-trois (33) patients étaient retenus sur 1500 hypertendus, soit une fréquence relative de 2,2%. Le sex-ratio était de 1,53, correspondant à 20 hommes (61%) pour 13 femmes (39%). L'âge moyen était de 56,18 ± 11,53 ans, avec des extrêmes allant de 32-83 ans. La symptomatologie était caractérisée par quinze (15) cas d&rsqu o;IVG (45,4%), quatorze (14) cas d'IC globale (42,4%), deux (2) cas (6%) de douleurs thoraciques, et deux (2) cas (6%) de perte de connaissance. Quarante-trois (43) complications secondaires étaient observées : 7 cas (14%) d'accident vasculaire cérébral (AVC), 13 cas (30,2%) de cardiopathies hypertensives (CHTA), 13 cas (30,2%) de cardiomyopathie dilatée (CMD), 5 cas (11,6%) d'insuffisance coronarienne, 2 cas (4,7%) d'arythmie complète par fibrillation atriale (ACFA), 2 cas (4,7%) (CMH), 1 cas (2,3%) RAC et 1 cas (2,3%) d'ischémie des membres. Le délai d'apparition moyen des complications secondaires était de 3,42 ± 2,7 ans, avec des extrêmes 1 an à 10 ans. Ce délai n'était pas statistiquement lié au sexe (p > 0,05), ni aux complications secondaires (p > 0,05), ni non plus à l'âge (p > 0,05). Conclusion: L'HVG est précoce, et représente une source insidieuse de complications secondaires neurologiques, cardiaques et vasculaires. Ces complications secondaires à l'HVG ont des délais d'apparition variables, indépendamment de l'âge et du sexe

How Do Patients and Parents Decide for Orthodontic Treatment-Effects of Malocclusion, Personal Expectations, Education and Media.

OBJECTIVES: To examine patients' and parents' perceptions and expectations from orthodontic treatment. STUDY DESIGN: 491 patients (274 female, 217 male) aged 14-22 years, and 399 parents (245 female, 154 male) completed a questionnaire about preferences, needs and expectations about orthodontic treatment, and scored the present problem. Continuous variables were compared by Mann-Whitney U and Kruskal-Wallis tests, whereas Chi-square test was used for categorical variables. RESULTS: Patients'(77.1%) and parents'(84.6%), decision about orthodontic treatments were influenced by suggestion of dentists. Patients who decided to attend to clinic by themselves were higher than parents (p=0.006). Dental aesthetics was the determinant factor for treatment demand for patients(61.0%) and parents(57.3%). Improvement in oral functions was more important for Class III patients than Class I patients (p=0.040). Adult patients/parents with higher education gave more importance to oral functions as well as dental aesthetics (p=0.031). There was no difference among Angle classifications regarding orthodontic problem scores. Parents found media sources valuable (p=0.018) but majority expected dentists for information about orthodontic treatments. Education degree of adult patients/parents effected this decision(p=0.002). CONCLUSIONS: Desire to have better dental aesthetics was the primary motivating factor for all participants. Clinicians should consider concerns of Class III patients about oral functions during treatment planning.

Comparative morphology of the sagittal otolith in three species of south Caspian gobies.

Sagittal otolith shapes were investigated in order to identify three sympatric species of south Caspian gobies (Caspian goby Neogobius caspius, deepwater goby Ponticola bathybius and bighead goby Ponticola gorlap). The sagittal otoliths in P. bathybius have a rectangular shape and are thick, whereas in N. caspius they are relatively round and thin. In P. gorlap, otoliths have an elongated shape and are relatively thick. The noticeable difference among the otoliths of the three species is the presence of one anterior and one posterior projection in the otoliths of N. caspius and P. gorlap. Among shape indices, form factor (irregularity of surface area), circularity, aspect ratio and rectangularity are the foremost that indicate interspecific variability. The canonical discriminant analysis correctly classifies 94·7% of the original group cases. The overall analyses show the relevance of applying otolith shape for interspecific distinction of the three species of Caspian gobies.

Correlates of the desire for improved cosmetic results after breast-conserving therapy and mastectomy in breast cancer patients.

The aim of this survey was to evaluate correlates for the patient's desire for surgical improvement of the cosmetic outcome after the primary operation for breast cancer. A cross-sectional study was carried out in a single follow-up outpatient clinic using a questionnaire. Patients were asked to assess their degree of satisfaction with the cosmetic results of their primary surgery and to state if they would like to undergo a further breast surgery to improve the appearance. Patients' characteristics were correlated with this desire. After breast-conserving surgery, 21.6% of the patients stated that they desired surgical improvement, in comparison with 29.8% of the patients who underwent mastectomy. In the latter group, the desire for improvement remained constant up to 5years after the initial operation, whereas it declined in the group of patients after breast-conserving surgery. Furthermore, a younger age and the perception that the appearance negatively influences femininity, partnership or sexual life were associated with a desire for further surgery. Breast reconstruction after mastectomy can be discussed with the patients even after a long follow-up, especially when the appearance seems to influence partnership issues.

Virological control of groundwater quality using biomolecular tests.

Deep groundwater, even if generally protected, could be contaminated by surface or rain water infiltration through soil fractures, septic tanks, cesspits, land irrigation, disposal of wastewater and disposal of muds from depuration systems. The sanitary importance of such possible contamination is related to the different uses of the water and it is at the maximum level when it is intended for human use. Routine microbiological analyses do not consider viruses, only bacterial parameters, as contamination indicators. However, it is known that enteric viruses can survive a long time in deep aquifers and that they may not always be associated with bacterial indicators. The virological analysis of waters intended for drinking use is provided only as an occasional control exercised at the discretion of the sanitary authority. Technological difficulties with obtaining data about groundwater viral contamination led to a study to devise rapid and efficient methods for their detection and the application of these methods to samples from different sources. Four acid nucleic extraction techniques have been tested (classic proteinase K- phenol/chloroform, QIAamp Viral RNA Kit (Qiagen), SV Total RNA Isolation System (Promega) and NucleoSpin Virus L (Macherey-Nagel). Sensitivity and specificity of RT-PCR protocols for entero- (EV), hepatitis A (HAV) and small round structured (SRSV) viruses have been verified. Deep groundwater samples (100 L) were concentrated (2-step tangential flow ultrafiltration) and the concentrate contaminated with serial 10-fold dilutions of a known titre of poliovirus type 3. Extracted RNA was concentrated (microcon-100) and analysed by RT-PCR using specific EV primers and visualising amplification products by agarose gel electrophoresis. In addition, two different methods of RT-PCR for non-cultivable viruses have been tested: (a) RT-PCR and nested RT-PCR for HAV and (b) RT-PCR with generic primers and RT-PCR with specific primers for SRSV. Different specificity tests have been carried out in the presence of some of the commoner microorganisms. The most efficient, sensitive and specific protocols were used to test 35 x 100L deep groundwater samples. Sample concentrates were split with one part treated with chloroform and analysed by cell culture (BGM and Frp/3, derived from FrHK/4, cells) and the other tested by RT-PCR for HAV, EV and SRSV. Results demonstrated the high efficiency of the classic and QIAamp methods. Microcon-100 did not increase the sensitivity of the technique used. The highest sensitivity was observed for RT-PCR with specific primers for SRSV and for nested RT-PCR for HAV. One sample showed a cytopathic effect, not confirmed at the third subculture, while the RT-PCR allowed the detection of echovirus 7. Cell culture did not allow detection of the majority of the enteric viruses while PCR gave sensitive, specific and rapid detection of a range of agents in the same samples. Even if it was impossible to fix a virological quality standard, it would be necessary to find a viral indicator in order to achieve a complete preventive check which would be particularly useful in some cases (e.g. water never used before, after pollution accidents, for seasonal checking).

Incidence of cerebrospinal fluid leak after microsurgical removal of vestibular schwannomas.

OBJECTIVES: Cerebrospinal fluid (CSF) leak still remains an unresolved problem after microsurgical removal of vestibular schwannomas (VS). METHODS: 14 (6%) Cases of cerebrospinal fluid rhinorrhea and 3 cases with subcutaneous retro-auricular CSF collection, occurring in a series of 224 patients operated on by the senior author (JMG) on VS between 1989-2000 via the suboccipital retrosigmoidal approach were studied retrospectively. Prophylaxis of CSF leak was usually attempted by packing the unroofed posterior wall of internal acoustic meatus with muscle. The mastoid air cells were packed first with collagen then with muscle and bone dust. RESULTS: All CSF leaks were diagnosed within 2-7 days after surgery. We found no relation to tumour size. Treatment was initiated in all patients with continuous external lumbar cerebrospinal fluid drainage (CELCFD) for 7 days. In 11 cases with CSF rhinorrhea and all cases with retro-auricular CSF collection, the CSF leak was stopped. However, in 3 cases the CSF leak persisted despite the lumbar drain. These patients were operated on again with sealing the IAM and the mastoid cells again with muscle and collagen. No recurrence of CSF leak was noted after the second operation. There was no case of late onset CSF leak during the follow-up of one year. CONCLUSION: Although CSF leak is a common complication (6%) after vestibular schwannoma removal, aggressive treatment is required only in a few cases (1%). Most of the cases are successfully treated by (CELCFD). The suboccipital approach offers an advantage of opening only a part of mastoid air cells, which are in our opinion the second most common site of CSF leakage.

[Lumbar dislocation fracture with paraplegia after pelvic seat belt injury. Case report]. / Lumbale Luxationsfraktur mit Paraplegie nach Beckengurtverletzung. Fallbericht.

This report details a traumatic spinal column lesion due to a lap seat belt. A healthy 22-year-old woman was involved in a car accident and suffered a lumbar luxation fracture at the level L1-L2. She developed acute transsectional symptoms with paraplegia and severe hyperpathia in her legs. Plain radiographs (antero-posterior and lateral projection) and lumbar CT scans demonstrated an instable flexion-distraction fracture with ventral compression of the vertebral body of L2 and ventrolisthesis of L1 over L2. Surgical reposition of the luxation fracture and removal of a spinal epidural hematoma was performed 4 h after the trauma. Stabilization was achieved by monosegmental dorsal transpedicular spondylodesis with a fixateur interne. In follow-up the neurological deficits markedly improved. Six months after the trauma, the patient is able to walk, has no paresis and no genitourinary disturbances: only mild dysesthesia remains. This posttraumatic course confirms that spinal traumas below L1 which spare the conus have a favorable prognosis, because the peripheral nerves of the cauda equina are able to recover. This injured patient was the only one using a lap seat belt; the other four passengers in the same compact car-wearing lap and diagonal seat belts-suffered no harm. We conclude that lap seat belts are not acceptable as an adequate security standard in modern automobile technology.

[Emotions and psychopathology]. / Emozioni e psicopatologia.

The study of the emotions and their relation with the numerous symptoms of mental pathologies is made extremely difficult given that different meanings have been given to these terms by various authors. The cognitive and affective evaluation of events is decisive for emotional reaction (emotion) which forms part of a complex biological and behavioural system in which there is no causal linearity between event, stress and emotion, but rather an interactive modulatory relationship. Based on their experience and on data published by specialized clinics, the authors affirm that a given temperament or psychopathological condition influences research into the event as well as the emotion experienced.

[Clinical and therapeutic aspects of alcohol withdrawal syndrome]. / Aspetti clinici e terapeutici della sindrome d'astinenza da alcol.

In this review the authors describe the symptomatology, and the etiopathogenetic hypothesis of alcohol withdrawal syndrome. Many drugs are used in the treatment of alcohol withdrawal syndrome: carbamazepine, clonidine, chlormethiazole, phenytoin and other compounds; actually benzodiazepines are the most important drugs for symptomatic relief to prevent major withdrawal syndrome. Particularly attention is recommended to the period of suspension with the aim of reducing alcohol consumption and correcting alcohol-related psychosocial problems.