Hyperechogenic renal parenchyma in potential live related kidney donors: Does it justify exclusion?

The aim of this work is to asses theimportance of ultrasonic grade I echogenicity inpotential kidney donors in the absence of urinaryabnormality and with perfect renal function.Thirty four living related kidney donors with thisabnormality were included, age range between 23-48years. Ten matched healthy donors were studied ascontrols.All cases were thoroughly investigated includingmeasuring GFR by isotopic scan and estimation ofrenal reserve by dopamine and aminoacid infusion.Renal biopsy was done for 17 cases of theechogenicity group and 8 controls. Our resultsshowed that the renal reserve was comparable in bothgroups. Glomerular changes were found in 41% ofapparently normal donors and only one case ofcontrols.Conclusion: Grade I echogenicity may be sign ofunrecognised kidney disease. Renal biopsy ismandatory when such related donors are the onlyavailable

Selective deployment of transcription factor paralogs with submaximal strength facilitates gene regulation in the immune system

In multicellular organisms, duplicated genes can diverge through tissue-specific gene expression patterns, as exemplified by highly regulated expression of Runx transcription factor paralogs with apparent functional redundancy. Here we asked what cell type-specific biologies might be supported by the selective expression of Runx paralogs during Langerhans cell and inducible regulatory T cell differentiation. We uncovered functional non-equivalence between Runx paralogs. Selective expression of native paralogs allowed integration of transcription factor activity with extrinsic signals, while non-native paralogs enforced differentiation even in the absence of exogenous inducers. DNA-binding affinity was controlled by divergent amino acids within the otherwise highly conserved RUNT domain, and evolutionary reconstruction suggested convergence of RUNT domain residues towards sub-maximal strength. Hence, the selective expression of gene duplicates in specialized cell types can synergize with the acquisition of functional differences to enable appropriate gene expression, lineage choice and differentiation in the mammalian immune system

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

Global variation in anastomosis and end colostomy formation following left-sided colorectal resection

Background End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001). Conclusion Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone

Assessment of Endometritis in Arabian Mare

This study aimed to employ different methods for diagnosis of endometritis in Arabian mare. The study was conducted on 88 barren Arabian mares. After establishing the breeding history and completing the clinical examination, 50 of them were diagnosed as endometritis. Two swabs were obtained for bacteriological culture and cytological smears. Biopsy specimens were taken from the endometrium for histological examination. The results revealed that the ageing and the abnormal vulvar conformation were predisposing factors for endometritis. The number of mares affected with endometritis were 10, (20%) 13 (26%) and 27 (54%) in nullipara, primipara and pluripara mares respectively. Mares affected with endometritis were 6 (12%), 20 (40%), 18 (36%) and 6 (12%) in relation to body scoring 1, 2, 3 and 4 respectively. Bacteriological and mycological examinations of the uterine culture were positive in 41 (82%) and in 5 (10%) animals respectively. No growth was recorded in 4 swabs (8%).  Streptococcus equi zooepidemicus were found to be the most common potential uterine bacterial pathogens (39.1% ) followed by E coli (21.7%). Cytological examination was positive in 60% (n=30) and negative in 40 % (n=40). The histopathological investigation revealed that 10/50 cases (20%), 18/40 cases (45.0%), 11/40 cases (27.5%), 7/40 cases (17.5%) and 4/40 cases (10.0%) were diagnosed as normal endometrium (Grade I), mild endometritis (Grade II A), moderate endometritis (Grade II B), severe endometritis (Grade III) and uterine atrophy respectively. Keywords: Arabian mare, biopsy, cytology, endometritis   Animal Production 14(2):99-10

Conductivity of cell membrane investigated by a novel dielectrophoretic technique

This article succeeded to introduce a new method, that mimics the radio broadcasting, used amplitude modulation to deliver the low range frequencies to the cell membrane. Consequently, avoiding the ACEO which prevents the measurement of DEP spectrum. In addition to the use of quinine and NBBP as ion channel blockers along with the modulated dielectrophoresis technique enabled the measurement of membrane conductivity providing a low cost method. © 2013 Trade Science Inc.-INDIA

Conductivity of cell membrane investigated by a novel dielectrophoretic technique

This article succeeded to introduce a new method, that mimics the radio broadcasting, used amplitude modulation to deliver the low range frequencies to the cell membrane. Consequently, avoiding the ACEO which prevents the measurement of DEP spectrum. In addition to the use of quinine and NBBP as ion channel blockers along with the modulated dielectrophoresis technique enabled the measurement of membrane conductivity providing a low cost method. © 2013 Trade Science Inc.-INDIA