Hypertonic saline nasal irrigation in the management of allergic rhinitis and chronic sinusitis

Allergic rhinitis is a disease characterized by the classic symptoms of rhinorrhea, obstruction of the nasal passage, sneezing and itching, all occurring in a temporal relationship to allergen exposure. Conventional treatment options include antihistamines, decongestants, anticholinergics and corticosteroids.peer-reviewe

A short review of the evidence base for Dead Sea Salt topical treatment and balneotherapy for skin and joint pathologies

The beneficial influence of the Dead Sea and t he clinical benefits of its mineral salts in different illnesses were first documented by the ancient historian Josephus Flavius about 2000 years ago. In recent years, scientific studies have confirmed a clinical evidence base for the lasting improvement of dermatological and rheumatological conditions following baineotherapy and topical treatments with Dead Sea salts and their commercial derivativespeer-reviewe

Bilateral microform cleft lip

Microform cleft lip (MCL), also called congenital healed cleft lip or cleft lip "frustré", is a rare congenital anomaly. MCL has been described as having the characteristic appearance of a typical cleft lip which has been corrected in utero. We present a girl with bilateral microform cleft lip associated with a preauricular sinus and bilateral camptodactyly.peer-reviewe

The re-emergence of the B1 cell compartment : is this a pre-lymphoma stage?

Chronic Lymphocytic Leukemia (CLL) are in some cases stereotyped for immunoglobulin variants in different populations, suggesting emergence of B cell subsets following presentation of the same antigen. CLL cells may originate from CD5+ naïve cells and from CD5 memory cells. Gene expression studies characterized a common cell of origin of the two clinical categories of CLL; the unmutated aggressive type and the mutated indolent type. The aim of this study was to investigate the presence of CD5 positive B cells in the elderly and their potential stimulation with exosomes derived from tumor cells. The findings from this study is aimed to create a model to identify instigating carcinomatous factors that may stimulate B1 cells to transform into a CLL-like model. In this study we show that CD19\textsuperscript+ cells (B cells) in cord blood have a high expression of CD5. CD19/CD5 staining of blood samples from senior citizens showed the presence of B cells which also express the CD5 marker, though at a lower expression when compared to CLL cells (CD19+/CD5 dim B cells). Measurement of clonality using λ/Κ flow cytometry staining show a monoclonal origin of the human CD19+/CD5 dim B cells. Monoclonal B cell Lymphocytosis in the elderly is a potential cell compartment that represents the origin of B cell proliferative disorders. The origin of the B cell proliferative disease requires antigen stimulation. A preliminary experiment showed that sorted lymphocytes can be stimulated by exosomes isolated from 2 cancer cells lines, A549 (lung epithelial) and PC3 (prostate cell line). In comparison with phytohaemagglutinin (PHA) and phorbolmyristate acetate (PMA), known lymphocyte stimulators, the exosomes stimulated the proliferation of monocytic-like cells. Further characterization is required to know the origin of these cells. The result shows that one can speculate that exosomes present cancer-derived antigens and stimulate cell proliferation. Further studies are required to evaluate the potential transformation capacity of cancer-derived exosomes. In addition, various cytokines were measured in the sera of senior citizens to investigate a differential release of cytokines in the presence or absence of the CD19+/CD5 dim B cells. Cytokines examined were not significantly different between the 2 groups and further evaluation of cytokine levels is required.peer-reviewe

Mitral valve infective endocarditis following device occlusion of a coronary artery fistula

A three year old girl, with a right coronary artery fistula and signs of a hyperdynamic circulation, underwent uncomplicated closure of the fistula using an occluding device introduced via the femoral arterial route and covered with appropriate antibiotics. Two months later she presented with a persistent fever, signs of infective endocarditis (IE) and embolic phenomena in the left lower limb. Mitral valve endocarditis was confirmed immediately and treated effectively. However, initial ultrasound and doppler did not show the femoral artery thrombo-occlusion that was only confirmed on magnetic resonance angiography (MRA) one month later. This case highlights the usefulness of MRA in diagnosing suspected vessel occlusion in young children, and is in keeping with the latest NICE guidelines that suggest that prophylactic antibiotics do not always prevent IE. Parent and patient education on ‘what to look out for’, combined with careful clinical vigilance is paramount in the early detection of IE with a consequent reduction in morbidity and mortality.peer-reviewe

Acquired and Intrinsic Resistance to Colorectal Cancer Treatment

First line therapy for colorectal cancer (CRC) is usually fluoropyrimidine monotherapy and oxaliplatin, or irinotecan-based therapy. Additionally, targeted therapies such as bevacizumab, aflibercept, ramucirumab, regorafenib, cetuximab and panitumumab are indicated in combination with chemotherapy in metastatic CRC. Resistance of CRC to treatment is the principal rationale for treatment failure. Resistance can be intrinsic (primary resistance) or acquired (secondary resistance). Here, we discuss the classical model of resistance, which focuses primarily on mechanisms involving alterations in drug metabolism, increased drug efflux, secondary mutations in drug targets, inactivation of apoptotic pathways, p53 and DNA damage repair. Other resistance mechanisms, including the Warburg effect, cancer stem cells, intra-tumor heterogeneity and pharmacoepigenomic mechanisms will also be discussed. We conclude the chapter with a systems medicine approach to predict response to treatment for the discovery and validation of predictive biomarkers that are urgently needed

Mechanical characterisation of nanocrystalline graphite using micromechanical structures

Conductive nanocrystalline graphite has been deposited using plasma-enhanced chemical vapour deposition at 750 °C, directly onto silicon substrates without any catalyst and fabricated into micromechanical membrane and beam structures. Using the buckling profile of the membrane and beam structures, we measure a built-in strain of - 0.0142 and through wafer-bow measurement, a compressive stress of 436 MPa. From this we have calculated the Young's modulus of nanographite as 23.0 ± 2.7 GPa. This represents a scalable method for fabricating nanographite MEMS and NEMS devices via a microfabrication-compatible process and provides useful mechanical properties to enable design of future devices

Parametric design of non-axisymmetric separate-jet aero-engine exhaust systems

Future civil air vehicles are likely to feature propulsion systems which are more closely integrated with the airframe. For a podded underwing configuration, this close coupling is expected to require non-axisymmetric design capabilities for the aero-engine exhaust system. This work presents the development of a novel parametric representation of non-axisymmetric aero-engine exhaust system geometries based on Intuitive Class Shape Transformation (iCST) curves. An exhaust design method was established and aerodynamic analyses of a range of non-axisymmetric configurations was demonstrated. At typical flight conditions, the introduction of non-axisymmetric separate jet nozzles was shown to increase the engine net propulsive force by 0.12% relative to an axisymmetric nozzle

Our proposed plan for the development of a cost effective, accurate, digital flow meter using piezoresistive technology

Flow meters are a tool used to measure the volume of fluid that passes through a pipe in a given amount of time. Industry uses these tools in a variety of applications to keep track of their systems and to measure the volume of material that they are using. Presently, digital flow meters on the market command high prices, sometimes reaching several thousand dollars. Inexpensive alternatives to these flow meters do not provide a high level of accuracy. Our objective is to design a cost effective digital flow meter capable of taking readings over a wide range of flows. This meter will use piezoresistive technology with a microprocessor and electronic filtration to convert pressure input into a digitally displayed electronic readout. This flow meter will also have an analog output to interface with a computer for data logging

Design optimisation of separate-jet exhausts for the next generation of civil aero-engines

This paper presents the development and application of a computational framework for the aerodynamic design of separate-jet exhaust systems for Very-High-Bypass-Ratio (VHBR) gas-turbine aero-engines. An analytical approach is synthesised comprising a series of fundamental modelling methods. These address the aspects of engine performance simulation, parametric geometry definition, viscous/compressible flow solution, design space exploration, and genetic optimisation. Parametric design is carried out based on minimal user-input combined with the cycle data established using a zero-dimensional (0D) engine analysis method. A mathematical approach is developed based on Class-Shape Transformation (CST) functions for the parametric geometry definition of gas-turbine exhaust components such as annular ducts, nozzles, after-bodies, and plugs. This proposed geometry formulation is coupled with an automated mesh generation approach and a Reynolds Averaged Navier–Stokes (RANS) flow-field solution method, thus forming an integrated aerodynamic design tool. A cost-e ective Design Space Exploration (DSE) and optimisation strategy has been structured comprising methods for Design of Experiment (DOE), Response Surface Modelling (RSM), as well as genetic optimisation. The integrated framework has been deployed to optimise the aerodynamic performance of a separate-jet exhaust system for a large civil turbofan engine representative of future architectures. The optimisations carried out suggest the potential to increase the engine’s net propulsive force compared to a baseline architecture, through optimum re-design of the exhaust system. Furthermore, the developed approach is shown to be able to identify and alleviate adverse flow-features that may deteriorate the aerodynamic behaviour of the exhaust system