Perinatal testicular torsion - Not an uncommon entity

Perinatal testicular torsion is a rare condition with an incidence of 1 in 7500 live births. 70% are prenatal and 30% postnatal. Postnatal torsion presents as an acute scrotum, whereas prenatal torsion may be usually missed as it is a non-tender hard mass. Management of prenatal torsion is controversial. We are reporting three such case series presenting within a period of 1 year. Prenatal testicular torsion is usually missed as it is asymptomatic and later presents as cryptorchid. Careful postnatal physical examination and documentation is essential, as a missed case can later present as cryptorchid and may lead to medicolegal issues. In torsion in the immediate perinatal period, the testis may be salvaged if promptly operated

High anorectal malformation in a five-month-old boy: a case report

<p>Abstract</p> <p>Introduction</p> <p>Anorectal malformation, one of the most common congenital defects, may present with a wide spectrum of defects. Almost all male patients present within first few days of life.</p> <p>Case presentation</p> <p>A five-month-old baby boy of Indian origin and nationality presented with anal atresia and associated rectourethral prostatic fistula. The anatomy of the malformation and our patient's good condition permitted a primary definitive repair of the anomaly. A brief review of the relevant literature is included.</p> <p>Conclusion</p> <p>Delayed presentation of a patient with high anorectal malformation is rare. The appropriate treatment can be rewarding.</p

Magneto-transport and magnetic susceptibility of SmFeAsO1-xFx (x = 0.0 and 0.20)

Bulk polycrystalline samples, SmFeAsO and the iso-structural superconducting SmFeAsO0.80F0.20 are explored through resistivity with temperature under magnetic field {\rho}(T, H), AC and DC magnetization (M-T), and Specific heat (Cp) measurements. The Resistivity measurement shows superconductivity for x = 0.20 sample with Tc(onset) ~ 51.7K. The upper critical field, [Hc2(0)] is estimated ~3770kOe by Ginzburg-Landau (GL) theory. Broadening of superconducting transition in magneto transport is studied through thermally activated flux flow in applied field up to 130 kOe. The flux flow activation energy (U/kB) is estimated ~1215K for 1kOe field. Magnetic measurements exhibited bulk superconductivity with lower critical field (Hc1) of ~1.2kOe at 2K. In normal state, the paramagnetic nature of compound confirms no trace of magnetic impurity which orders ferromagnetically. AC susceptibility measurements have been carried out for SmFeAsO0.80F0.20 sample at various amplitude and frequencies of applied AC drive field. The inter-granular critical current density (Jc) is estimated. Specific heat [Cp(T)] measurement showed an anomaly at around 140K due to the SDW ordering of Fe, followed by another peak at 5K corresponding to the antiferromagnetic (AFM) ordering of Sm+3 ions in SmFeAsO compound. Interestingly the change in entropy (marked by the Cp transition height) at 5K for Sm+3 AFM ordering is heavily reduced in case of superconducting SmFeAsO0.80F0.20 sample.Comment: 18 pages text + Figs: comments/suggestions welcome ([email protected]

Insulin-like peptide 3 (INSL3) in congenital hypogonadotrophic hypogonadism (CHH) in boys with delayed puberty and adult men

Background: Delayed puberty in males is almost invariably associated with constitutional delay of growth and puberty (CDGP) or congenital hypogonadotrophic hypogonadism (CHH). Establishing the cause at presentation is challenging, with “red flag” features of CHH commonly overlooked. Thus, several markers have been evaluated in both the basal state or after stimulation e.g. with gonadotrophin releasing hormone agonist (GnRHa). Insulin-like peptide 3 (INSL3) is a constitutive secretory product of Leydig cells and thus a possible candidate marker, but there have been limited data examining its role in distinguishing CDGP from CHH. In this manuscript, we assess INSL3 and inhibin B (INB) in two cohorts: 1. Adolescent boys with delayed puberty due to CDGP or CHH and 2. Adult men, both eugonadal and having CHH. Materials and methods: Retrospective cohort studies of 60 boys with CDGP or CHH, as well as 44 adult men who were either eugonadal or had CHH, in whom INSL3, INB, testosterone and gonadotrophins were measured. Cohort 1: Boys with delayed puberty aged 13-17 years (51 with CDGP and 9 with CHH) who had GnRHa stimulation (subcutaneous triptorelin 100mcg), previously reported with respect to INB. Cohort 2: Adult cohort of 44 men (22 eugonadal men and 22 men with CHH), previously reported with respect to gonadotrophin responses to kisspeptin-54. Results: Median INSL3 was higher in boys with CDGP than CHH (0.35 vs 0.15 ng/ml; p=0.0002). Similarly, in adult men, median INSL3 was higher in eugonadal men than CHH (1.08 vs 0.05 ng/ml; p<0.0001). However, INSL3 more accurately differentiated CHH in adult men than in boys with delayed puberty (auROC with 95% CI in adult men: 100%, 100-100%; boys with delayed puberty: 86.7%, 77.7-95.7%). Median INB was higher in boys with CDGP than CHH (182 vs 59 pg/ml; p<0.0001). Likewise, in adult men, median INB was higher in eugonadal men than CHH (170 vs 36.5 pg/ml; p<0.0001). INB performed better than INSL3 in differentiating CHH in boys with delayed puberty (auROC 98.5%, 95.9-100%), than in adult men (auROC 93.9%, 87.2-100%). Conclusion: INSL3 better identifies CHH in adult men, whereas INB better identifies CHH in boys with delayed puberty

Arterial oxygen content is precisely maintained by graded erythrocytotic responses in settings of high/normal serum iron levels, and predicts exercise capacity: an observational study of hypoxaemic patients with pulmonary arteriovenous malformations.

Oxygen, haemoglobin and cardiac output are integrated components of oxygen transport: each gram of haemoglobin transports 1.34 mls of oxygen in the blood. Low arterial partial pressure of oxygen (PaO2), and haemoglobin saturation (SaO2), are the indices used in clinical assessments, and usually result from low inspired oxygen concentrations, or alveolar/airways disease. Our objective was to examine low blood oxygen/haemoglobin relationships in chronically compensated states without concurrent hypoxic pulmonary vasoreactivity.165 consecutive unselected patients with pulmonary arteriovenous malformations were studied, in 98 cases, pre/post embolisation treatment. 159 (96%) had hereditary haemorrhagic telangiectasia. Arterial oxygen content was calculated by SaO2 x haemoglobin x 1.34/100.There was wide variation in SaO2 on air (78.5-99, median 95)% but due to secondary erythrocytosis and resultant polycythaemia, SaO2 explained only 0.1% of the variance in arterial oxygen content per unit blood volume. Secondary erythrocytosis was achievable with low iron stores, but only if serum iron was high-normal: Low serum iron levels were associated with reduced haemoglobin per erythrocyte, and overall arterial oxygen content was lower in iron deficient patients (median 16.0 [IQR 14.9, 17.4]mls/dL compared to 18.8 [IQR 17.4, 20.1]mls/dL, p<0.0001). Exercise tolerance appeared unrelated to SaO2 but was significantly worse in patients with lower oxygen content (p<0.0001). A pre-defined athletic group had higher Hb:SaO2 and serum iron:ferritin ratios than non-athletes with normal exercise capacity. PAVM embolisation increased SaO2, but arterial oxygen content was precisely restored by a subsequent fall in haemoglobin: 86 (87.8%) patients reported no change in exercise tolerance at post-embolisation follow-up.Haemoglobin and oxygen measurements in isolation do not indicate the more physiologically relevant oxygen content per unit blood volume. This can be maintained for SaO2 ≥78.5%, and resets to the same arterial oxygen content after correction of hypoxaemia. Serum iron concentrations, not ferritin, seem to predict more successful polycythaemic responses

Chemotactic response and adaptation dynamics in Escherichia coli

Adaptation of the chemotaxis sensory pathway of the bacterium Escherichia coli is integral for detecting chemicals over a wide range of background concentrations, ultimately allowing cells to swim towards sources of attractant and away from repellents. Its biochemical mechanism based on methylation and demethylation of chemoreceptors has long been known. Despite the importance of adaptation for cell memory and behavior, the dynamics of adaptation are difficult to reconcile with current models of precise adaptation. Here, we follow time courses of signaling in response to concentration step changes of attractant using in vivo fluorescence resonance energy transfer measurements. Specifically, we use a condensed representation of adaptation time courses for efficient evaluation of different adaptation models. To quantitatively explain the data, we finally develop a dynamic model for signaling and adaptation based on the attractant flow in the experiment, signaling by cooperative receptor complexes, and multiple layers of feedback regulation for adaptation. We experimentally confirm the predicted effects of changing the enzyme-expression level and bypassing the negative feedback for demethylation. Our data analysis suggests significant imprecision in adaptation for large additions. Furthermore, our model predicts highly regulated, ultrafast adaptation in response to removal of attractant, which may be useful for fast reorientation of the cell and noise reduction in adaptation.Comment: accepted for publication in PLoS Computational Biology; manuscript (19 pages, 5 figures) and supplementary information; added additional clarification on alternative adaptation models in supplementary informatio

Aurora kinase A drives the evolution of resistance to third-generation EGFR inhibitors in lung cancer.

Although targeted therapies often elicit profound initial patient responses, these effects are transient due to residual disease leading to acquired resistance. How tumors transition between drug responsiveness, tolerance and resistance, especially in the absence of preexisting subclones, remains unclear. In epidermal growth factor receptor (EGFR)-mutant lung adenocarcinoma cells, we demonstrate that residual disease and acquired resistance in response to EGFR inhibitors requires Aurora kinase A (AURKA) activity. Nongenetic resistance through the activation of AURKA by its coactivator TPX2 emerges in response to chronic EGFR inhibition where it mitigates drug-induced apoptosis. Aurora kinase inhibitors suppress this adaptive survival program, increasing the magnitude and duration of EGFR inhibitor response in preclinical models. Treatment-induced activation of AURKA is associated with resistance to EGFR inhibitors in vitro, in vivo and in most individuals with EGFR-mutant lung adenocarcinoma. These findings delineate a molecular path whereby drug resistance emerges from drug-tolerant cells and unveils a synthetic lethal strategy for enhancing responses to EGFR inhibitors by suppressing AURKA-driven residual disease and acquired resistance

An analysis of women's and children's health professional requirements in China in 2010 based on workload

Background: To make health services more equitable and accessible for women and children and to achieve a universal coverage, human resources for women and children&apos;s health (WCH) should be evaluated. However, since there is still no consensus on the real situation of Chinese WCH professionals, we aim with this study to compare the actual and required amount of WCH professionals for China. Methods: The data of the actual number of WCH professionals and workload of each service type was obtained by a national institution-based sampling survey. We then estimated the time that a WCH professional spends at work (annually), the time norm of each service schedule and the required number of WCH professionals based on workload. We evaluated the situation of Chinese WCH professionals in 2010 by comparing the actual and required WCH professionals and by calculating the ratios of the actual-to-required number of staff. Results: There were 515,778 health professionals providing WCH services in the investigated 5,168 medical/health institutions in 2010. Workloads of most WCH services in east areas were larger than that in the central and the west. For women&apos;s health, the numbers of required WCH professionals were 48510, 43992, 40571 and 133073 for the east, the central, the west areas and the whole nation respectively. For children&apos;s health professionals, the corresponding numbers were 56241, 36818, 40618 and 133677 for the east, the central, the west and the whole nation. Conclusions: The WCH professionals in China were sufficient for workload in 2010, there were still lots of potential capacities to provide better services, especially for women. Strategies should be taken to improve the quality of WCH professionals or their working motivation.http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000347346200001&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=8e1609b174ce4e31116a60747a720701Health Care Sciences &amp; ServicesSCI(E)[email protected]

PHANGS: Constraining Star Formation Timescales Using the Spatial Correlations of Star Clusters and Giant Molecular Clouds

In the hierarchical view of star formation, giant molecular gas clouds (GMCs) undergo fragmentation to form small-scale structures made up of stars and star clusters. Here we study the connection between young star clusters and cold gas across a range of extragalactic environments by combining the high resolution (1") PHANGS-ALMA catalogue of GMCs with the star cluster catalogues from PHANGS-HST. The star clusters are spatially matched with the GMCs across a sample of 11 nearby star-forming galaxies with a range of galactic environments (centres, bars, spiral arms, etc.). We find that after 4-6 Myr the star clusters are no longer associated with any gas clouds. Additionally, we measure the autocorrelation of the star clusters and GMCs as well as their cross-correlation to quantify the fractal nature of hierarchical star formation. Young ($\leq$ 10 Myr) star clusters are more strongly autocorrelated on kpc and smaller spatial scales than the >10 Myr stellar populations, indicating that the hierarchical structure dissolves over time.Comment: 15 pages, 11 figures, 4 tables. Accepted to MNRAS Sept 6 202