Elucidating the role of microstructural modification on stress corrosion cracking of biodegradable Mg4Zn alloy in simulated body fluid.

This paper investigates the effect of microstructure modification by heat treatment on stress corrosion cracking (SCC) behavior of Mg4Zn alloy in simulated body fluid (SBF). Mg4Zn alloy in as cast, solution heat treated and peak aged conditions was susceptible to SCC in SBF when strained at 3.6 × 10-6 s-1. SCC index based on fracture energy is least for solutionized alloy (0.84), while 0.88 for as cast and peak aged alloys. Fractographic analysis indicates predominantly intergranular SCC for solution treated alloy initiated by anodic dissolution near grain boundaries. As cast and peak aged alloy shows mainly transgranular failure due to hydrogen embrittlement adjacent to secondary phase particles.

Saline irrigation for the management of skin extravasation injury in neonates.

BACKGROUND: Extravasation injury, a complication commonly seen in the neonatal intensive care unit, can result in scarring with cosmetic and functional sequelae. A wide variety of treatments are available, including subcutaneous irrigation with saline (with or without hyaluronidase), liposuction, use of specific antidotes, topical applications, and normal wound care with dry or wet dressings. All such treatments aim to prevent or reduce the severity of complications. OBJECTIVES: Primary objective To compare the efficacy and safety of saline irrigation or saline irrigation with prior hyaluronidase infiltration versus no intervention or normal wound care for tissue healing in neonates with extravasation injury. Secondary objectives To evaluate by subgroup analysis of controlled trials the influence of type of extravasate, timing of irrigation following extravasation, and postmenstrual age (PMA) of the neonate at the time of injury on outcomes and adverse effects.Specifically, we planned to perform subgroup analysis for the primary outcome, if appropriate, by examining:1. time to irrigation from identified extravasation injury (< 1 hour or ≥ 1 hour);2. type of extravasate (parenteral nutrition fluid or other fluids or medications);3. amount of saline used (< 500 mL or ≥ 500 mL); and4. PMA at injury (< 37 completed weeks or ≥ 37 completed weeks). SEARCH METHODS: We used the standard search strategy of the Cochrane Neonatal Review Group to search the Cochrane Central Register of Controlled Trials (CENTRAL; 2017, Issue 1), MEDLINE via PubMed (1966 to 2 February 2017), Embase (1980 to 2 February 2017), and the Cumulative Index to Nursing and Allied Health Literature (CINAHL; 1982 to 2 February 2017). We also searched clinical trial databases, conference proceedings, and reference lists of retrieved articles for randomised controlled trials and quasi-randomised trials. We used the Google Scholar search tool for reverse citations of relevant articles. SELECTION CRITERIA: Randomised controlled trials (RCTs) and quasi-randomised controlled trials comparing saline irrigation with or without hyaluronidase infiltration versus no intervention or normal wound care for the management of extravasation injury in neonates. DATA COLLECTION AND ANALYSIS: Three review authors independently reviewed and identified articles for possible inclusion in this review. We used the GRADE approach to assess the quality of evidence. MAIN RESULTS: We found no eligible studies. Our search revealed 10 case reports or case series describing successful outcomes with different interventions for this condition. AUTHORS' CONCLUSIONS: To date, no RCTs have examined the effects of saline irrigation with or without prior hyaluronidase infiltration for management of extravasation injury in neonates. Saline irrigation is frequently reported in the literature as an intervention for management of extravasation injury in neonates. Research should focus first on evaluating the efficacy and safety of this intervention through RCTs. It will also be important for investigators to determine effect size by examining the timing of the intervention, the nature of the infusate, and severity of injury at the time of intervention.

Saline irrigation for the management of skin extravasation injury in neonates.

BACKGROUND: Extravasation injury is a common complication of neonatal intensive care and can result in scarring with cosmetic and functional sequelae. A wide variety of treatments are used in practice including subcutaneous irrigation with saline (with or without hyaluronidase), liposuction, use of specific antidotes, different topical applications and normal wound care with dry or wet dressings. All such treatments aim to prevent or reduce the severity of complications. OBJECTIVES: To determine the efficacy and safety of saline irrigation or saline irrigation with prior hyaluronidase infiltration on tissue healing in neonates with extravasation injury when compared to no intervention or normal wound care. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2011, Issue 2), MEDLINE (1950 to June 2011), EMBASE (Jan 1980 to June 2011), CINAHL (Jan 1988 to June 2011) and the Web of Science (up to July 2011). SELECTION CRITERIA: Randomised controlled trials (RCT) and quasi-randomised controlled trials comparing saline irrigation with or without hyaluronidase infiltration with no intervention or normal wound care in the management of extravasation injury in neonates. DATA COLLECTION AND ANALYSIS: Three review authors independently reviewed and identified articles for possible inclusion in this review. MAIN RESULTS: No eligible studies were found. There were a few case reports and case series describing successful outcomes with different interventions in this condition. AUTHORS' CONCLUSIONS: To date, no randomised controlled trial is available that examines the effects of saline irrigation with or without prior hyaluronidase infiltration in the management of extravasation injury in neonates. Saline irrigation is a frequently reported intervention in the literature that is used in the management of extravasation injury in neonates. Research should be initially directed at evaluating the efficacy and safety of this intervention through randomised controlled trials. It will also be important to determine the size of the effect according to timing of intervention, nature of the infusate and the severity of injury at the time of intervention.

Acute myocardial infarction following transfusion reaction.

Indications for blood transfusion in critically-ill patients in general have become very restrictive. Still, the role for blood transfusion in the setting of acute coronary syndrome is unclear, as evidence regarding outcomes with different blood transfusion strategies has been conflicting. We report a 53-year-old Hispanic woman with acute ST-elevation myocardial infarction (STEMI) following a febrile nonhaemolytic transfusion reaction. Coronary angiogram showed complete occlusion of intracoronary stent in the left anterior descending (LAD) artery. Angiogram done earlier in the day had shown complete patency of the LAD stent with good distal flow. This suggests a possible role for the febrile nonhaemolytic transfusion reaction in triggering the stent occlusion and development of the STEMI.

Tobacco use in Kerala: findings from three recent studies.

BACKGROUND: We reviewed the literature on tobacco use in Kerala and present data from three recently conducted unpublished studies. METHODS: Three cross-sectional studies were conducted; a community-based study of 1,298 individuals aged 15 years and above (mean age 37.4 years, men 630), a school-based study of 1,323 boys (mean age 14.7 years), and a college-based study of 1,254 male students (mean age 18.2 years). Information on tobacco use and sociodemographic variables was collected using pre-tested, structured interview schedules and questionnaires. RESULTS: In the community study, 72% of men and 6% of women had ever used tobacco. Compared to men with > 12 years of schooling, those with < 5 years of schooling were 7 times more likely to smoke (OR 7, CI 3.2-15.6). The age at initiation of smoking was 19 years among those < 25 years of age compared to 25.5 years among ever smokers > 44 years. In the school study, the age at initiation among boys aged < or = 1 3 years was 10.7 years compared with 13.2 years among > or = 16-year-old boys. Boys whose fathers and friends used tobacco were 2 times and 2.9 times more likely to use tobacco (OR 2.0, CI 1.3-3.1 and OR 2.9, CI 1.6-5.1), respectively, compared with their counterparts. In the college study, 29% of the commerce students used tobacco compared with 5.3% of polytechnic students (p < 0.001). CONCLUSION: Survey data suggest that the age at initiation of tobacco use appears to be falling. A series of cross-sectional studies with larger sample sizes of the youth is required to confirm this impression. Tobacco use habits of fathers and peers are significant influences on youth smoking. There is a need to focus on particular types of colleges as these appear to have high-risk tobacco use environments.

A study on the comparison between clinical and microbiological diagnoses of sexually transmitted diseases.

The efficacy of microbiological diagnosis in sexually transmitted diseases (STDs) has been evaluated in comparison with the clinical diagnosis. Amongst the clinical diagnoses of single STDs, syphilis, genital warts, gonorrhoea and herpes genitalis were the predominant ones. Syphilis was the most predominant infection in both the single and mixed STD infections in Chennai. Clinical diagnoses of trichomoniasis, genital chlamydiasis and genital herpes were more accurate and correlated well with laboratory investigations. On the other hand, clinical diagnoses of gonorrhoea, candidiasis and syphilis were less accurate. More over many of these cases, clinically diagnosed as single, infection, were also positive for other STDs in the laboratory investigations. Double infections were clinically diagnosed only in 7 cases as against 11 cases in microbiological tests and one triple infection diagnosed in microbiological tests was diagnosed only as single disease clinically. Therefore, the laboratory/microbiological investigations have been emphasised to have better accuracy of diagnosis of STDs.

Prevalence of dental fluorosis and associated risk factors in Alappuzha district, Kerala.

BACKGROUND: Fluorosis is considered endemic in 15 states of India. Dental fluorosis is the most convenient biomarker of exposure to fluoride. In Kerala, although the condition is reported to be endemic in the districts of Alappuzha and Palakkad, there are no systematic epidemiological studies evaluating dental fluorosis. We studied the prevalence of dental fluorosis among school children in Ambalappuzha taluk, Alappuzha district, Kerala and evaluated the contribution of potential risk factors. METHODS: We conducted a community-based, cross-sectional survey of 1142 school children (630 girls, 512 boys) in the age group of 10-17 years, using a multistage random cluster sampling technique. A pre-tested structured questionnaire was used to assess exposure to various sources of fluoride. A dental specialist examined all the children to determine the presence or absence of dental fluorosis and graded the degree of dental fluorosis using Dean's Index. The water fluoride content in the study area was obtained from the district water authority department. Bivariate associations were examined using the Chi-square and Chi-square trend tests, while multiple logistic regression was used to evaluate the association of select risk factors with the presence or absence of dental fluorosis. RESULTS: The overall prevalence of dental fluorosis in our study sample was 35.6% and the community fluorosis index was 0.69. The prevalence of dental fluorosis was higher in the urban compared to the rural areas (55.3% v. 16.8%; p < 0.001), and in girls compared to boys (39.2% v. 31.3%; p < 0.01). The prevalence of dental fluorosis was higher among children who consumed pipe water as compared to children who consumed well water (44.8% v. 12.7%; p < 0.001). We noted a step-wise increase in the prevalence of dental fluorosis with a corresponding increase in water fluoride content in different panchayats (p = 0.024). The principal factor associated with the presence of dental fluorosis was a high fluoride content of drinking water (OR 1.85, 95% Cl: 1.17-2.92). We did not observe any significant association between dental fluorosis and the intake of brick-tea, consumption of fish or the use of toothpaste. CONCLUSION: Dental fluorosis is a public health problem in the Ambalappuzha taluk. Active steps must be taken to partially defluoridate the water before distribution to reduce the morbidity associated with dental fluorosis in this area. Similar surveys are required in other parts of India to identify areas with high water fluoride content and determine the extent and manner in which defluoridation can be carried out.

Pulmonary tuberculosis and coexisting carcinoma: a 10-year experience and review of the literature.

Of 7,986 patients admitted to Mount Wilson State Hospital for Pulmonary Diseases between 1960 and 1970, 72 were proven to have coexisting pulmonary tuberculosis and bronchogenic carcinoma. The patients usually were in the older age group, and usually smoked. There was a high predilection for the tumor to occur in the upper lobes. Active tuberculosis was present in 50 per cent of the patients and tumor and tuberculosis was present in the same area 80 per cent of the time. Cell diagnosis was possible in 60 per cent of the patients without thoracotomy. Diagnosis was usually made late in the course of the disease and therapeutic results were poor. Only 13 patients were operable and only four are presently alive. Earlier recognition is vital to adequate treatment. A plan for earlier recognition based on a high degree of suspicion is presented.

Antibody affinity. VIII. Measurement of affinity of anti-lactose antibody by fluorescence quenching with a DNP-containing ligand.

The method of fluorescence quenching by bound ligand for the measurement of antibody affinity has been extended to anti-lactose antibodies. The basis for this extension is the use of a lactosyl ligand covalently linked to the 2,4-dinitrophenyl (DNP) group. This group serves as a sensor of the bound state by causing fluorescence quenching similar to that observed with anti-DNP antibody. The synthesis and characterization of this new ligand, N-(Nalpha-acetyl,Nepsilon-DNP-L-lysyl)-rho-aminophenyl-beta-lactoside, are described. The affinity of its interaction with three rabbit IgG and one equine IgM antilactose antibody preparations has been measured. The Qmax values range from 24 to 47% and the calculated association constants from 2.5 times 10-5 M-1 to 7.2 times 10-5 M-1. For one IgG preparation, measurement of the association constant by equilibrium dialysis with the tritiated ligand gave a value of 6.75 times 10-5 M-1 compared to the value of 7.2 times 10-5 M-1 obtained by fluorescence quenching. It is evident that with monoclonal anti-lactose antibody the accurate determination of Qmax, which is possible in this system, provides another structurally dependent clonal characterization of the variable region of the antibody. This optical probe along with others can be used for the identification of individual clones of antibody-producing cells through time and inheritance.

Affinity labeling of anti-lactose antibodies with bromoacetylaminolac dye in dark.

Affinity labeling of rabbit IgG anti-lactose antibodies of restricted heterogeneity by bromacetylaminolac dye was carried out in dark and the label on the isolated chains determined by SDS gel electrophoresis. The pattern of labeling was compared with that obtained when the reaction was carried out in light using the same reagent. Differences were observed in the mode of labeling of chains. Possible use of mapping the active site of the antibody by the same labeling reagent which can exist in two geometrical forms under dark and light conditions is discussed.