Nephrotoxicity of amphotericin B in the treatment of cryptococcal meningitis in acquired immunodeficiency syndrome patients

Objectives: To describe the incidence of renal dysfunction, hypokalaemia and hypomagnesaemia in AIDS patients with cryptococcal meningitis and on amphotericin B treatment. Secondary objective was to determine all-cause mortality in the same group.Design: Prospective, observational study.Setting: Kenyatta National Hospital (KNH), Nairobi, Kenya.Subjects: Seventy consecutive patients with AIDS and cryptococcal meningitis on amphotericin B.Results: About 58.6% of the patients had at least 100% rise in the creatinine level. Thirty eight point six per cent of patients experienced a rise in serum creatinine of at least 50%. Ninty three per cent of the patients developed hypokalaemia and 80% had hypomagnesaemia at trough magnesium level. Only 54.3% of patients completed the intended 14-day treatment. Thirty point five per cent of patients died within the two week follow-up period.Conclussion: The incidences of amphotericin B associated nephrotoxicity, hypokalemia and hypomagnesaemia were high in this studied populatio

Effects of salinity on germination, growth and yield of five groundnut genotypes

The effects of salinity on germination, growth and yield parameters as well as phenotypic variance and heritability of five groundnut genotypes (Ex-Dakar, RRB 12, RMP 12, RMP 91 and Esan Local) wereinvestigated. Saline treatments were imposed by irrigating the seeds and plants with varying concentrations of brackish water having electrical conductivities of 0.015, 1.50, 2.60, 4.68, 8.90 and 17.0mS/cm. The results revealed that salinity significantly delayed germination and also reduced the final percentages at electrical conductivities greater than 2.60 mS/cm. Seedling emergence, radicleelongation, plant height and dry matter weight also tended to decrease with increasing salinity. Agronomic characters such as number of leaves/plant and number of branches/plant were significantlyreduced with salinities higher than 2.60 mS/cm. The genotypes under study proved more salt tolerant during the germination than during the vegetative stage of growth and the result identified Esan- Local,Ex-Dakar and RRB 12 as being more salt tolerant than the other genotypes under study. Treated plants maintained high heritability and genetic advance values in characters such as 100 seed weight,pods/plant and seeds/pod, indicating that the characters under study were controlled by additive genes and could be improved by selection. Thus salt tolerant traits from the tolerant genotypes (Esan-Local,RRB 12 and Ex-Dakar) could be a source for developing salt tolerant variants in groundnut

Micronucleus Assay and Heavy Metals Characterization of E-waste Dumpsites in Lagos and Osun States, Southwest Nigeria

The contamination of the aquatic ecosystem with heavy metals arising from the discharge of electronic waste (e-waste) or seepage of leachate from open waste dumpsites is on the increase. The impact of e-waste leachate on the micronucleus (MN) of Tilapia guineensis and the levels of heavy metals ( Pb, Cd, Cr, As, Hg, Al and Ba) in the sediments, water, leachate and aquatic fauna (Tilapia guineensis, Callinectes amnicola and Cardiosoma armatum) found in and around e-waste dumpsites in Lagos and Osun States was studied. The levels of heavy metals were determined using PyeUnicam model 969 Atomic Absorption Spectrophotometry and Inductive Coupling Plasma Atomic Absorption Spectrophotometry (ICP-AAS).The heavy metal concentrations decreased in the order: Pb ˃ Cd ˃ Cr ˃ Hg ˃ Al ˃Ba ˃As in the samples. The level of Cd in fish muscle from Lagos (1.4mg/kg) exceeded the Environment Canada threshold effect level (EC TEL, 2006) recommended for sea food (1.0mg/kg). The calculated bioconcentration factor (BCF) for fish gills (1.4 and1.0) and fish muscles. (3.6 and 1.2) from Lagos and Osun States respectively as well as the bioaccumulation factor (BAF) for crabs (1.78 and 1.36) are strong indications of the ability of the organisms to bioaccumulate the heavy metals. The MN assay showed an initial increase in the frequency of mionccronuclei on the 7th day which gradually decreased on the 14th and 21st day. The result of this study reveals the toxic impacts of e-waste contamination on ecological and human health in a developing economy

Influence of severe plastic deformation on the precipitation hardening of a FeSiTi steel

The combined strengthening effects of grain refinement and high precipitated volume fraction (~6at.%) on the mechanical properties of FeSiTi alloy subjected to SPD processing prior to aging treatment were investigated by atom probe tomography and scanning transmission electron microscopy. It was shown that the refinement of the microstructure affects the precipitation kinetics and the spatial distribution of the secondary hardening intermetallic phase, which was observed to nucleate heterogeneously on dislocations and sub-grain boundaries. It was revealed that alloys successively subjected to these two strengthening mechanisms exhibit a lower increase in mechanical strength than a simple estimation based on the summation of the two individual strengthening mechanisms

The impact of low erythrocyte density in human blood on the fitness and energetic reserves of the African malaria vector Anopheles gambiae

Background Anaemia is a common health problem in the developing world. This condition is characterized by a reduction in erythrocyte density, primarily from malnutrition and/or infectious diseases such as malaria. As red blood cells are the primary source of protein for haematophagous mosquitoes, any reduction could impede the ability of mosquito vectors to transmit malaria by influencing their fitness or that of the parasites they transmit. The aim of this study was to determine the impact of differences in the density of red blood cells in human blood on malaria vector (Anopheles gambiae sensu stricto) fitness. The hypotheses tested are that mosquito vector energetic reserves and fitness are negatively influenced by reductions in the red cell density of host human blood meals commensurate with those expected from severe anaemia. Methods Mosquitoes (An. gambiae s.s.) were offered blood meals of different packed cell volume(PCV) of human blood consistent with those arising from severe anaemia (15%) and normalPCV (50%). Associations between mosquito energetic reserves (lipid, glucose and glycogen)and fitness measures (reproduction and survival) and blood meal PCV were investigated. Results The amount of protein that malaria vectors acquired from blood feeding (indexed by haematin excretion) was significantly reduced at low blood PCV. However, mosquitoes feeding on blood of low PCV had the same oviposition rates as those feeding on blood of normal PCV, and showed an increase in egg production of around 15%. The long-term survival of An. gambiae s.s was reduced after feeding on low PCV blood, but PCV had no significant impact on the proportion of mosquitoes surviving through the minimal period required to develop and transmit malaria parasites (estimated as 14 days post-blood feeding). The impact of blood PCV on the energetic reserves of mosquitoes was relatively minor. Conclusions These results suggest that feeding on human hosts whose PCV has been depleted due to severe anaemia does not significantly reduce the fitness or transmission potential of malaria vectors, and indicates that mosquitoes may be able exploit resources for reproduction more efficiently from blood of low rather than normal PCV

Extraction of cocoa proanthocyanidins and their fractionation by sequential centrifugal partition chromatography and gel permeation chromatography

Erworben im Rahmen der Schweizer Nationallizenzen (http://www.nationallizenzen.ch)Cocoa beans contain secondary metabolites ranging from simple alkaloids to complex polyphenols with most of them believed to possess significant health benefits. The increasing interest in these health effects has prompted the need to develop techniques for their extraction, fractionation, separation, and analysis. This work provides an update on analytical procedures with a focus on establishing a gentle extraction technique. Cocoa beans were finely ground to an average particle size of <100 μm, defatted at 20°C using n-hexane, and extracted three times with 50 % aqueous acetone at 50°C. Determination of the total phenolic content was done using the Folin-Ciocalteu assay, the concentration of individual polyphenols was analyzed by electrospray ionization high performance liquid chromatography-mass spectrometry (ESI-HPLC/MS). Fractions of bioactive compounds were separated by combining sequential centrifugal partition chromatography (SCPC) and gel permeation column chromatography using Sephadex LH-20. For SCPC, a two-phase solvent system consisting of ethyl acetate/n-butanol/water (4:1:5, v/v/v) was successfully applied for the separation of theobromine, caffeine, and representatives of the two main phenolic compound classes flavan-3-ols and flavonols. Gel permeation chromatography on Sephadex LH-20 using a stepwise elution sequence with aqueous acetone has been shown for effectively separating individual flavan-3-ols. Separation was obtained for (-)-epicatechin, proanthocyanidin dimer B2, trimer C1, and tetramer cinnamtannin A2. The purity of alkaloids and phenolic compounds was determined by HPLC analysis and their chemical identity was confirmed by mass spectrometry

Optimal traffic organisation in ants under crowded conditions

Efficient transportation, a hot topic in nonlinear science, is essential for modern societies and the survival of biological species. Biological evolution has generated a rich variety of successful solutions, which have inspired engineers to design optimized artificial systems. Foraging ants, for example, form attractive trails that support the exploitation of initially unknown food sources in almost the minimum possible time. However, can this strategy cope with bottleneck situations, when interactions cause delays that reduce the overall flow? Here, we present an experimental study of ants confronted with two alternative routes. We find that pheromone-based attraction generates one trail at low densities, whereas at a high level of crowding, another trail is established before traffic volume is affected, which guarantees that an optimal rate of food return is maintained. This bifurcation phenomenon is explained by a nonlinear modelling approach. Surprisingly, the underlying mechanism is based on inhibitory interactions. It implies capacity reserves, a limitation of the density-induced speed reduction, and a sufficient pheromone concentration for reliable trail perception. The balancing mechanism between cohesive and dispersive forces appears to be generic in natural, urban and transportation systems.Comment: For related work see http://www.helbing.or

Retropubic, laparoscopic and mini-laparoscopic radical prostatectomy : a prospective assessment of patient scar satisfaction

Published online: 26 October 2014PURPOSE: To compare patient scar satisfaction after retropubic, standard laparoscopic, mini-laparoscopic (ML) and open radical prostatectomy (RP). METHODS: Patients undergoing RP for a diagnosis of localized prostate cancer at a single academic hospital between September 2012 and December 2013 were enrolled in this prospective nonrandomized study. The patients were included in three study arms: open surgery, VLP and ML. A skin stapler was used for surgical wound closure in all cases. Demographic and main surgical outcomes, including perioperative complications, were analyzed. Surgical scar satisfaction was measured using the Patient and Observer Scar Assessment Questionnaire (POSAS) and the two Body Image Questionnaire (BIQ) scales, respectively, recorded at skin clips removal and either at 6 months after surgery. RESULTS: Overall, 32 patients were enrolled and completed the 6 month of follow-up. At clips removal, laparoscopic approaches offered better scar result than open surgery according to the POSAS. However, at 6 months, no differences were detected between VLP and open, whereas ML was still associated with a better scar outcome (p = 0.001). This finding was also confirmed by both BIQ scales, including the body image score (ML 9.8 ± 1.69, open 15.73 ± 3.47, VLP 13.27 ± 3.64; p = 0.001) and the cosmetic score (ML 16.6 ± 4.12, open 10 ± 1.9, LP 12.91 ± 3.59; p = 0.001). Small sample size and lack of randomization represent the main limitations of this study. CONCLUSIONS: ML RP offers a better cosmetic outcome when compared to both open and standard laparoscopic RP, representing a step toward minimal surgical scar. The impact of scar outcome on RP patients' quality of life remains to be determined

Declining Rates in Male Circumcision amidst Increasing Evidence of its Public Health Benefit

BACKGROUND: Recent experimental evidence has demonstrated the benefits of male circumcision for the prevention of human immunodeficiency virus (HIV) infection. Studies have also shown that male circumcision is cost-effective and reduces the risk for certain ulcerative sexually transmitted diseases (STDs). The epidemiology of male circumcision in the United States is poorly studied and most prior reports were limited by self-reported measures. The study objective was to describe male circumcision trends among men attending the San Francisco municipal STD clinic, and to correlate the findings with HIV, syphilis and sexual orientation. METHODS AND FINDINGS: A cross sectional study was performed by reviewing all electronic records of males attending the San Francisco municipal STD clinic between 1996 and 2005. The prevalence of circumcision over time and by subpopulation such as race/ethnicity and sexual orientation were measured. The findings were further correlated with the presence of syphilis and HIV infection. Circumcision status was determined by physical examination and disease status by clinical evaluation with laboratory confirmation. Among 58,598 male patients, 32,613 (55.7%, 95% Confidence Interval (CI) 55.2-56.1) were circumcised. Male circumcision varied significantly by decade of birth (increasing between 1920 and 1950 and declining overall since the 1960's), race/ethnicity (Black: 62.2%, 95% CI 61.2-63.2, White: 60.0%, 95% CI 59.46-60.5, Asian Pacific Islander: 48.2%, 46.9-49.5 95% CI, and Hispanic: 42.2%, 95% CI 41.3-43.1), and sexual orientation (gay/bisexual: 73.0%, 95% CI 72.6-73.4; heterosexual: 66.0%, 65.5-66.5). Male circumcision may have been modestly protective against syphilis in HIV-uninfected heterosexual men (PR 0.92, 95% C.I. 0.83-1.02, P = 0.06). CONCLUSIONS: Male circumcision was common among men seeking STD services in San Francisco but has declined substantially in recent decades. Male circumcision rates differed by race/ethnicity and sexual orientation. Given recent studies suggesting the public health benefits of male circumcision, a reconsideration of national male circumcision policy is needed to respond to current trends

Mortality among Norwegian doctors 1960-2000

<p>Abstract</p> <p>Background</p> <p>To study the mortality pattern of Norwegian doctors, people in human service occupations, other graduates and the general population during the period 1960-2000 by decade, gender and age. The total number of deaths in the study population was 1 583 559.</p> <p>Methods</p> <p>Census data from 1960, 1970, 1980 and 1990 relating to education were linked to data on 14 main causes of death from Statistics Norway, followed up for two five-year periods after census, and analyzed as stratified incidence-rate data. Mortality rate ratios were computed as combined Mantel-Haenzel estimates for each sex, adjusting for both age and period when appropriate.</p> <p>Results</p> <p>The doctors had a lower mortality rate than the general population for all causes of death except suicide. The mortality rate ratios for other graduates and human service occupations were 0.7-0.8 compared with the general population. However, doctors have a higher mortality than other graduates. The lowest estimates of mortality for doctors were for endocrine, nutritional and metabolic diseases, diseases in the urogenital tract or genitalia, digestive diseases and sudden death, for which the numbers were nearly half of those for the general population. The differences in mortality between doctors and the general population increased during the periods.</p> <p>Conclusions</p> <p>Between 1960 and 2000 mortality for doctors converged towards the mortality for other university graduates and for people in human service occupations. However, there was a parallel increase in the gap between these groups and the rest of the population. The slightly higher mortality for doctors compared with mortality for other university graduates may be explained by the higher suicide rate for doctors.</p