Peroneal artery pseudoaneurysm--a case report and literature review.

BACKGROUND: Aneurysms of the peroneal artery are infrequent and consist mainly of pseudoaneurysms. CASE PRESENTATION: This report describes an unusual case of peroneal pseudoaneurysm developing after thromoboembolectomy with a Fogarty catheter. It was managed successfully using an endovascular technique consisting of selective catheterization and coil embolization. The coils were placed in the peroneal artery, both proximal and distal to the pseudoaneurysm. CONCLUSION: Endovascular technique can be successfully used to treat pseudoaneurysms in difficult settings.RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are

Microbicides development programme: engaging the community in the standard of care debate in a vaginal microbicide trial in Mwanza, Tanzania.

BACKGROUND: HIV prevention research in resource-limited countries is associated with a variety of ethical dilemmas. Key amongst these is the question of what constitutes an appropriate standard of health care (SoC) for participants in HIV prevention trials. This paper describes a community-focused approach to develop a locally-appropriate SoC in the context of a phase III vaginal microbicide trial in Mwanza City, northwest Tanzania. METHODS: A mobile community-based sexual and reproductive health service for women working as informal food vendors or in traditional and modern bars, restaurants, hotels and guesthouses has been established in 10 city wards. Wards were divided into geographical clusters and community representatives elected at cluster and ward level. A city-level Community Advisory Committee (CAC) with representatives from each ward has been established. Workshops and community meetings at ward and city-level have explored project-related concerns using tools adapted from participatory learning and action techniques e.g. chapati diagrams, pair-wise ranking. Secondary stakeholders representing local public-sector and non-governmental health and social care providers have formed a trial Stakeholders' Advisory Group (SAG), which includes two CAC representatives. RESULTS: Key recommendations from participatory community workshops, CAC and SAG meetings conducted in the first year of the trial relate to the quality and range of clinic services provided at study clinics as well as broader standard of care issues. Recommendations have included streamlining clinic services to reduce waiting times, expanding services to include the children and spouses of participants and providing care for common local conditions such as malaria. Participants, community representatives and stakeholders felt there was an ethical obligation to ensure effective access to antiretroviral drugs and to provide supportive community-based care for women identified as HIV positive during the trial. This obligation includes ensuring sustainable, post-trial access to these services. Post-trial access to an effective vaginal microbicide was also felt to be a moral imperative. CONCLUSION: Participatory methodologies enabled effective partnerships between researchers, participant representatives and community stakeholders to be developed and facilitated local dialogue and consensus on what constitutes a locally-appropriate standard of care in the context of a vaginal microbicide trial in this setting. TRIAL REGISTRATION: Current Controlled Trials ISRCTN64716212

Psychosocial intervention for carers of people with dementia: What components are most effective and when? A systematic review of systematic reviews

Psychosocial interventions for carers of people with dementia are increasingly recognized as playing an important role in dementia care. We aim to systematically review the evidence from existing systematic reviews of psychosocial interventions for informal carers of people with dementia.  Thirty-one systematic reviews were identified; following quality appraisal, data from 13 reviews, rated as high or moderate quality, were extracted.  Well-designed, clearly structured multi-component interventions can help maintain the psychological health of carers of people with dementia and delay institutionalization of the latter. To be most effective, such interventions should include both an educational and a therapeutic component; delivery through a support group format may further enhance their effectiveness.  Successful translation of evidence into practice in this area remains a challenge. Future research should focus on determining the most cost-effective means of delivering effective multi-component interventions in real-world settings; the cost-effective potential of technology-based interventions is considerable

Internet-delivered treatment: its potential as a low-intensity community intervention for adults with symptoms of depression: protocol for a randomized controlled trial

BACKGROUND: Depression is a high prevalence disorder, displaying high rates of lifetime incidence, early age onset, high chronicity, and role impairment. In Ireland 12-month prevalence of depression has been reported to be 10.3%. A large percentage of affected individuals have no medical diagnosis nor seek treatment. Cognitive Behavior Therapy (CBT) has established itself as an option for the treatment of depression. Many Irish adults with depression find it difficult to access evidence-based CBT, this is due to several factors, like stigma and costs. However, systematic factors including the shortage of trained professionals and the relative underdevelopment of services also make access difficult. Stepped-care can increase access to evidence-based CBT. One option is tailored internet-delivered treatment programs. Preliminary research from Ireland needs now to include large-scale studies on effectiveness. Thus the current study seeks to examine the potential of an internet-delivered low-intensity treatment for symptoms of depression in an Irish adult community sample. METHOD/DESIGN: The study is a randomized controlled trial of an online CBT (iCBT) program for the treatment of adults with depressive symptoms. The trial will include an active treatment group and a waiting-list control group. The active condition will consist of 8 weekly modules of iCBT, with post-session feedback support. Participants in the waiting list will receive access to the treatment at week 8. Participants will complete the Beck Depression Inventory (BDI-II) and eligibility criteria will also apply. Primary outcomes are depressive symptoms. Secondary outcomes include quality of life indicators, significant events and satisfaction with online treatment. Data will be collected at baseline and at post-treatment, week 8, and at follow-up week 20 (3-months) and week 32 (6-months). Analysis will be conducted on the intention-to-treat basis. DISCUSSION: The study seeks to evaluate the effectiveness of an online delivered treatment for depression in a community sample of Irish adults with symptoms of depression. The study will be a first contribution and depending on the sample recruited the results may be generalizable to people with similar difficulties in Ireland and may therefore give insight into the potential of low-intensity interventions for Irish people with depressive symptoms. TRIAL REGISTRATION NUMBER: Current Controlled Trials ISRCTN03704676. DOI: 10.1186/ISRCTN0370467

The effects of collagen concentration and crosslink density on the biological, structural and mechanical properties of collagen-GAG scaffolds for bone tissue engineering.

In this study, we examined the effects of varying collagen concentration and crosslink density on the biological, structural and mechanical properties of collagen-GAG scaffolds for bone tissue engineering. Three different collagen contents (0.25%, 0.5% and 1% collagen) and two different dehydrothermal (DHT) crosslinking processes [1] 105 degrees C for 24 h and [2] 150 degrees C for 48 h were investigated. These scaffolds were assessed for (1) pore size, (2) permeability (3) compressive strength and (4) cell viability. The largest pore size, permeability rate, compressive modulus, cell number and cell metabolic activity was all found to occur on the 1% collagen scaffold due to its increased collagen composition and the DHT treatment at 150 degrees C was found to significantly improve the mechanical properties and not to affect cellular number or metabolic activity. These results indicate that doubling the collagen content to 1% and dehydrothermally crosslinking the scaffold at 150 degrees C for 48 h has enhanced mechanical and biological properties of the scaffold making it highly attractive for use in bone tissue engineering

« Qu’importe le flacon pourvu qu’il y ait l’ivraie » : les constituants d’origine organique de la céramique de Koumbi Saleh (Mauritanie, VIe-XVIIe siècles AD), témoins de l’exploitation de sous-produits agricoles

Les matières organiques manipulées au cours de la fabrication des mélanges argileux destinés à la fabrication de la poterie sont fréquemment prélevées dans des milieux associés aux activités quotidiennes des artisans, relatives aux pratiques agricoles ou alimentaires. À ce titre, les structures d’origine organique, végétales ou animales, observables dans les produits céramiques cuits constituent une source d’informations paléoéconomiques de premier ordre, en particulier lorsque les données archéobotaniques ou archéozoologiques font défaut, comme c’est le cas pour le site de Koumbi Saleh. Koumbi Saleh (Mauritanie ve-xviie siècles AD) est l’un des plus anciens et plus importants complexes urbains historiques mis au jour en Afrique de l’Ouest. Les fouilles réalisées sur ce site ont livré un matériel céramique caractérisé par une abondante porosité d’origine organique. Afin de préciser l’origine de ces structures, une approche micro-analytique couplant microscopie stéréoscopique et microscopie optique à transmission a été développée. Une analyse des bioclastes associés à ces porosités a également été engagée à titre exploratoire. Enfin, dans le but de renforcer le diagnostic, un référentiel expérimental a été constitué. Les résultats de ce travail de caractérisation suggèrent que les potiers implantés sur le site ont sélectionné des produits secondaires provenant probablement d’herbivores domestiques mais aussi de sous-produits céréaliers.Organic-derived materials used during clay preparation prior to pottery shaping are frequently collected by potters in areas related to their day-to-day activities, such as farming lands, herding areas or places devoted to food processing. Porosity of organic origin in ceramic pastes may thus provide invaluable paleoeconomic information, especially where archaebotanical or archaeozoological data are lacking, as is the case for Koumbi Saleh. Koumbi Saleh (Mauritania, 5e-17e centuries AD) is one of the most ancient and important historical urban sites excavated in Western Africa and has yielded ceramics wih an abundant porosity of organic origin. In order to characterize these organic structures and determine their nature, a microanalytic approach combining stereoscopic and optical transmission microscopy was used, together with a preliminary analysis of the bioclast found in pottery sampless. An experimental reference study was also performed, allowing to strengthen the diagnostic. The results of this work indicate that pottery producers at Koumbi Saleh preferentially selected secondary products related to animal as well as crop exploitation