The frequency of carcinoma in solitary thyroid nodules and in multinodular goitres

A retrospective study of all patients with goitre seen from 1988 to 1992 inclusive  at the Muhimbili Medical Centre, Dar es Salaam was made to determine the  frequency of malignancy in patients with solitary non-toxic thyroid nodule (STN) and in those with multinodular goitre (MNG). There were 60 cases of STN and 178 with MNG. Nodular goitre was found to be predominantly a disease of females with sex ratios of M:F;1:7 for the STN group and of M:F;1:13 in the MNG group. The final  diagnosis in all cases was made by histology which found malignancy in 10% of STN and in 5% of MNG patients, a difference which was not statistically significant. Patients in the 20-29 years age group with STN appeared to have an increased risk of malignancy when compared with the MNG group. No cause for this was  discovered. The predominant malignancy in the STN group of patients was papillary carcinoma, while that in the MNG group was follicular carcinoma. Key Words: thyroid, malignancy, solitary nodule, multinodular goitr

Reduction of seafood processing wastewater using technologies enhanced by swim–bed technology

The increasing growth of the seafood processing industries considerably requires more industrial process activities and water consumption. It is estimated that approximately 10–40 m3 of wastewater is generated from those industries for processing one-tonne of raw materials. Due to limitations and regulations in natural resources utilization, a suitable and systematic wastewater treatment plant is very important to meet rigorous discharge standards. As a result of food waste biodegradability, the biological treatment and some extent of swim-bed technology, including a novel acryl-fibre (biofilm) material might be used effectively to meet the effluent discharge criteria. This chapter aims to develop understanding on current problems and production of the seafood wastewater regarding treatment efficiency and methods of treatment

Association of Obesity-Mediated Insulin Resistance and Hypothalamic Volumes: Possible Sex Differences

The hypothalamus is important in hunger and metabolism. Although a lot is known about the basic role of the human hypothalamus, less is known about how the in vivo volume is affected in obesity, particularly among adolescents. Based on pediatric body mass index percentiles, 95 participants were assigned to lean or obese groups. All subjects had medical evaluations, including fasting blood tests, to assess insulin sensitivity and circulating CRP and neurotrophins (NGF and BDNF) and an MRI of the brain. Hypothalamic volumes were measured by a segmentation method combining manual and automated steps. Overall, obese participants had descriptively smaller hypothalamic volumes, although this difference did not reach statistical significance; however, among obese participants, females had significantly smaller hypothalamic volumes than their male counterparts. There was a significant interaction between insulin resistance and sex on hypothalamus volume; obese females with significant insulin resistance have smaller hypothalamic volumes than obese males. Obese adolescents had higher circulating CRP and neurotrophin levels. Furthermore, among obese females, BDNF concentrations were inversely associated with hypothalamus volumes ( = −0.48). Given this negative association between BDNF and hypothalamus volumes among obese insulin-resistant females, elevated neurotrophin levels may suggest an attempt at protective compensation

Correlation Between Tumor Necrosis Factor Alpha and Proteinuria in Type-2 Diabetic Patients

Introduction: Diabetic Nephropathy (DN) is the single most common cause of end stage renal disease (ESRD) in many countries. Inflammation is a potential factor in the development and progression of DN and recent data indicate that diabetes includes an inflammatory component which may contribute to diabetic complications. Methods: This study was conducted at Ain Shams University Hospital on 95 patients with type-2 diabetes mellitus complicated with retinopathy and fifteen age- and sex-matched healthy volunteers. Diabetic patients were divided into 4 groups according to the degree of proteinuria. Serum tumor necrosis factor-α (TNF-α), urine TNF-α and C-reactive protein (CRP) levels were measured in all subjects. Correlations between these inflammatory parameters and degree of proteinuria, duration of diabetes and degree of glycemic control were examined. Results: Levels of the three inflammatory parameters were significantly higher in diabetic patients when compared to control subjects, and they were positively correlated to urinary protein excretion. There was significant positive correlation between serum and urine TNF-α and duration of diabetes, as well as between serum TNF-α and glycemic control. Serum and urine TNF-α remained as independent predictors of urine protein excretion in diabetic patients with overt proteinuria after forward stepwise multiple regression analysis. Conclusion: Serum and urine TNF-α and CRP levels are significantly elevated in this group of diabetic patients, and correlate positively with severity of proteinuria. This suggests a significant role for TNF-α in the pathogenesis and progression of renal injury in diabetes mellitus. Keywards: Diabetic nephropathy; Proteinuria; Tumor necrosis factor-

Neonatal conjunctivitis a review

Ophthalmia neonatorum remains a significant cause of ocular morbidity, blindness and even death in underdeveloped countries. The organisms causing ophthalmia neonatorum are acquired mainly from the mother’s birth canal during delivery and a small percentage of cases are acquired by other ways. Chlamydia and Neisseria are the most common pathogens responsible for the perinatal infection. Fortunately in most cases, laboratory studies can identify the causative organism and unlike other form of conjunctivitis, this perinatal ocular infection has to be treated with systemic antibiotics to prevent systemic colonization of the organism. Routine prophylaxis with 1% silver nitrate solution (crédés method) has been discontinued in many developed nations for the fear of development of chemical conjunctivitis

Safety and efficacy of endoscopic submucosal dissection for rectal neoplasia: a multicenter North American experience.

Background and aims  Rectal lesions traditionally represent the first lesions approached during endoscopic submucosal dissection (ESD) training in the West. We evaluated the safety and efficacy of rectal ESD in North America. Methods  This is a multicenter retrospective analysis of rectal ESD between January 2010 and September 2018 in 15 centers. End points included: rates of en bloc resection, R0 resection, adverse events, comparison of pre- and post-ESD histology, and factors associated with failed resection. Results  In total, 171 patients (median age 63 years; 56 % men) underwent rectal ESD (median size 43 mm). En bloc resection was achieved in 141 cases (82.5 %; 95 %CI 76.8-88.2), including 24 of 27 (88.9 %) with prior failed endoscopic mucosal resection (EMR). R0 resection rate was 74.9 % (95 %CI 68.4-81.4). Post-ESD bleeding and perforation occurred in 4 (2.3 %) and 7 (4.1 %), respectively. Covert submucosal invasive cancer (SMIC) was identified in 8.6 % of post-ESD specimens. There was one case (1/120; 0.8 %) of recurrence at a median follow-up of 31 weeks; IQR: 19-76 weeks). Older age and higher body mass index (BMI) were predictors of failed R0 resection, whereas submucosal fibrosis was associated with a higher likelihood of both failed en bloc and R0 resection. Conclusion  Rectal ESD in North America is safe and is associated with high en bloc and R0 resection rates. The presence of submucosal fibrosis was the main predictor of failed en bloc and R0 resection. ESD can be considered for select rectal lesions, and serves not only to establish a definitive tissue diagnosis but also to provide curative resection for lesions with covert advanced disease

A Cell-Centred CVD-MPFA Finite Volume Method for Two-Phase Fluid Flow Problems with Capillary Heterogeneity and Discontinuity

A novel finite-volume method is presented for porous media flow simulation that is applicable to discontinuous capillary pressure fields. The method crucially retains the optimal single of freedom per control-volume being developed within the flux-continuous control-volume distributed multi-point flux approximation (CVD-MPFA) framework (Edwards and Rogers in Comput Geosci 02(04):259–290, 1998; Friis et al. in SIAM J Sci Comput 31(02):1192–1220, 2008) . The new methods enable critical subsurface flow processes involving oil and gas trapping to be correctly resolved on structured and unstructured grids. The results demonstrate the ability of the method to resolve flow with oil/gas trapping in the presence of a discontinuous capillary pressure field for diagonal and full-tensor permeability fields. In addition to an upwind approximation for the saturation equation flux, the importance of upwinding on capillary pressure flux via a novel hybrid formulation is demonstrated

Effects of pedunculopontine nucleus stimulation on human bladder function

AIMS: The pedunculopontine nucleus (PPN) is a deep brain stimulation target for Parkinson's disease (PD). Unilateral PPN stimulation has been described in a previous case report to provoke urinary frequency, urgency and detrusor overactivity, due to probable activation of the pontine micturition center. Our aim was to evaluate the effect of bilateral PPN DBS on urodynamic parameters and to investigate the likely mechanisms using probabilistic tractography. METHODS: Six male PD subjects with bilateral PPN deep brain stimulators were recruited. Urodynamic bladder filling assessments were carried out with the stimulators ON and OFF. Two subjects also had diffusion-weighted and T1-weighted MRI scans performed and probabilistic tractography was carried out to describe white matter connections with the stimulated area. RESULTS: Five subjects completed urodynamic testing. PPN DBS did not give rise to detrusor overactivity or lower sensory thresholds during bladder filling. However, there was a significant increase in maximal bladder capacity with stimulation: mean bladder volume at maximal capacity was 199 mL (range 103-440) ON stimulation compared with 131 mL (range 39-230) OFF stimulation. Tractography demonstrated extensive connectivity to cortical and subcortical regions, some of which have been implicated in bladder control. Fiber pathways also passed close to the vicinity of the pontine micturition center. CONCLUSIONS: Bilateral PPN DBS did not have a detrimental effect on urodynamic filling parameters or produce detrusor overactivity, but did slightly increase maximal capacity. Possible mechanisms include long-range connectivity or local effects at the pontine micturition center

The Urologist's View of Male Overactive Bladder: Discrepancy between Reality and Belief in Practical Setting

PURPOSE: In order to gain insight into the physicians' awareness of and attitude towards management of overactive bladder (OAB) in males, we performed a nationwide survey of the current strategies that urologists use to diagnose and manage OAB in male patients. MATERIALS AND METHODS: A probability sample was taken from the Korean Urological Association Registry of Physicians, and a random sample of 289 Korean urologists were mailed a structured questionnaire that explored how they manage benign prostatic hyperplasia (BPH). RESULTS: A total of 185 completed questionnaires were returned. The consent rate in the survey was 64.5%. Eighty-one (44%) urologists believed that of all males with lower urinary tract symptoms (LUTS), 20% or more had OAB and 72 (39%) believed that 10-20% had OAB. Half of the urologists surveyed believed that the most bothersome symptom in male OAB patients was nocturia. Seventy-three percent of respondents reported that they prescribed alpha blockers with anticholinergics for first line management, while 19% of urologists prescribed alpha blocker monotherapy but not anticholinergics for OAB patients. Though acute urinary retention (AUR) was considered the anticholinergic adverse event of most concern, the most frequently observed adverse event was dry mouth (95%). CONCLUSION: The present study provides insights into urologist views of male OAB. There is a discrepancy between the awareness of urologists and actual patterns of diagnosis and treatment of male OAB. This finding indicates the need to develop further practical guidelines based on solid clinical data.ope

Inclusive J/ψ production at mid-rapidity in pp collisions at √s = 5.02 TeV

Inclusive J/ψ production is studied in minimum-bias proton-proton collisions at a centre-of-mass energy of s = 5.02 TeV by ALICE at the CERN LHC. The measurement is performed at mid-rapidity (|y| < 0.9) in the dielectron decay channel down to zero transverse momentum pT, using a data sample corresponding to an integrated luminosity of Lint = 19.4 ± 0.4 nb−1. The measured pT-integrated inclusive J/ψ production cross sec- tion is dσ/dy = 5.64 ± 0.22(stat.) ± 0.33(syst.) ± 0.12(lumi.) μb. The pT-differential cross section d2σ/dpTdy is measured in the pT range 0–10 GeV/c and compared with state-of- the-art QCD calculations. The J/ψ 〈pT〉 and 〈pT2〉 are extracted and compared with results obtained at other collision energies. [Figure not available: see fulltext.]