Bouveret's syndrome as an unusual cause of gastric outlet obstruction: a case report

An 83 year old caucasian gentleman presented with vomiting and left sided abdominal pain. A subsequent upper GI endoscopy demonstrated a large smooth mass impacted within the duodenum. A cholecysto-duodenal fistula was discovered at laparotomy, with a large gallstone impacted in the duodenum. A diagnosis of Bouveret's syndrome was made. The management of this rare cause of gastric outlet obstruction is discussed

Synthesis of E. faecium wall teichoic acid fragments.

The first synthesis of different Enterococcus faecium wall teichoic acid (WTA) fragments is presented. The structure of these major cell wall components was elucidated recently and it was shown that these glycerolphosphate (GroP) based polymers are built up from -6-(GalNAc-α(1-3)-GalNAc-β(1-2)-GroP)- repeating units. We assembled WTA fragments up to three repeating units in length, in two series that differ in the stereochemistry of the glycerolphosphate moiety. The key GalNAc-GalNAc-GroP synthons, required for the synthesis, were generated from galactosazide building blocks that were employed in highly stereoselective glycosylation reactions to furnish both the α- and β-configured linkages. By comparing the NMR spectra of the synthesized fragments with the isolated material it appears that the hereto undefined stereochemistry of the glycerol phosphate moiety is sn-glycerol-3-phosphate. The generated fragments will be valuable tools to study their immunological activity at the molecular level.Bio-organic Synthesi

Memory-experience gap in early adolescents' happiness reports

Studies among adult populations show that estimates of how happy one has felt in the past tend to be more positive than average happiness as assessed using time sampling techniques. This ‘memory-experience gap’ is attributed to cognitive biases, among which fading affect bias. In this paper we report a study among 352 pupils of a secondary school in the Netherlands. These youngsters reported subsequently: 1) how happy they had felt yesterday, 2) how happy they had felt during the last month, 3) what they had done the previous day and 4) how the

Pneumococcal carriage in sub-Saharan Africa--a systematic review.

BACKGROUND: Pneumococcal epidemiology varies geographically and few data are available from the African continent. We assess pneumococcal carriage from studies conducted in sub-Saharan Africa (sSA) before and after the pneumococcal conjugate vaccine (PCV) era. METHODS: A search for pneumococcal carriage studies published before 2012 was conducted to describe carriage in sSA. The review also describes pneumococcal serotypes and assesses the impact of vaccination on carriage in this region. RESULTS: Fifty-seven studies were included in this review with the majority (40.3%) from South Africa. There was considerable variability in the prevalence of carriage between studies (I-squared statistic = 99%). Carriage was higher in children and decreased with increasing age, 63.2% (95% CI: 55.6-70.8) in children less than 5 years, 42.6% (95% CI: 29.9-55.4) in children 5-15 years and 28.0% (95% CI: 19.0-37.0) in adults older than 15 years. There was no difference in the prevalence of carriage between males and females in 9/11 studies. Serotypes 19F, 6B, 6A, 14 and 23F were the five most common isolates. A meta-analysis of four randomized trials of PCV vaccination in children aged 9-24 months showed that carriage of vaccine type (VT) serotypes decreased with PCV vaccination; however, overall carriage remained the same because of a concomitant increase in non-vaccine type (NVT) serotypes. CONCLUSION: Pneumococcal carriage is generally high in the African continent, particularly in young children. The five most common serotypes in sSA are among the top seven serotypes that cause invasive pneumococcal disease in children globally. These serotypes are covered by the two PCVs recommended for routine childhood immunization by the WHO. The distribution of serotypes found in the nasopharynx is altered by PCV vaccination

Generation of glucosylated sn-1-glycerolphosphate teichoic acids: glycerol stereochemistry affects synthesis and antibody interaction

Lipoteichoic acids (LTAs) have been addressed as possible antigen candidates for vaccine development against several opportunistic Gram-positive pathogens. The study of structure-immunogenicity relationship represents a challenge due to the heterogenicity of LTA extracted from native sources. LTAs are built up from glycerol phosphate (GroP) repeating units and they can be substituted at the C-2-OH with carbohydrate appendages or d-alanine residues. The substitution pattern, but also the absolute chirality of the GroP residues can impact the interaction with chiral biomolecules including antibodies and biosynthesis enzymes. We have generated a set of diastereomeric GroP hexamers bearing a glucosyl modification at one of the residues. The chirality of the glycerol building block had an important impact on the stereoselectivity of the glycosylation reaction between the glycosyl donor and the glycerol C-2-OH acceptor. The GroP C-2-chirality also played an important role in the interaction with TA recognizing antibodies. These findings have important implications for the design and synthesis of synthetic TA fragments for diagnostic and therapeutic applications.Host-parasite interactio

Wellness through a comprehensive Yogic breathing program – A controlled pilot trial

<p>Abstract</p> <p>Background</p> <p>Increasing rates of psychosocial disturbances give rise to increased risks and vulnerability for a wide variety of stress-related chronic pain and other illnesses. Relaxation exercises aim at reducing stress and thereby help prevent these unwanted outcomes. One of the widely used relaxation practices is yoga and yogic breathing exercises. One specific form of these exercises is Sudarshan Kriya and related practices (SK&P) which are understood to have favourable effects on the mind-body system. The goal of this pilot study was to design a protocol that can investigate whether SK&P can lead to increased feeling of wellness in healthy volunteers.</p> <p>Methods</p> <p>Participants were recruited in a small university city in Sweden and were instructed in a 6-day intensive program of SK&P which they practiced daily for six weeks. The control group was instructed to relax in an armchair each day during the same period. Subjects included a total of 103 adults, 55 in the intervention (SK&P) group and 48 in the control group. Various instruments were administered before and after the intervention. Hospital Anxiety Depression Scale measured the degree of anxiety and depression, Life Orientation Test measured dispositional optimism, Stress and Energy Test measured individual's energy and stress experiences. Experienced Deviation from Normal State measured the experience of altered state of consciousness.</p> <p>Results</p> <p>There were no safety issues. Compliance was high (only 1 dropout in the SK&P group, and 5 in the control group). Outcome measures appeared to be appropriate for assessing the differences between the groups. Subjective reports generally correlated with the findings from the instruments. The data suggest that participants in the SK&P group, but not the control group, lowered their degree of anxiety, depression and stress, and also increased their degree of optimism (ANOVA; p < 0.001). The participants in the yoga group experienced the practices as a positive event that induced beneficial effects.</p> <p>Conclusion</p> <p>These data indicate that the experimental protocol that is developed here is safe, compliance level is good, and a full scale trial is feasible. The data obtained suggest that adult participants may improve their wellness by learning and applying a program based on yoga and yogic breathing exercises; this can be conclusively assessed in a large-scale trial.</p> <p>Trial Registration</p> <p>Australian Clinical Trial Registry ACTRN012607000175471.</p

Children’s subjective well-being: Multi-group analysis among a sample of children from two socio-economic status groups in the Western Cape, South Africa

Recent advancements in child well-being research have shown an increased importance of subjective well-being in understanding children and adolescents’ quality of life. These advancements have raised questions concerning the extent to which children’s subjective perceptions and experiences of well-being can be compared between countries and across diverse cultures. With a dearth of empirical data on cross-cultural comparisons, the validation of existing measures and cross-cultural comparisons have been identified by a number of researchers as critical in contributing to this process, and ultimately to the international dialogue on children’s overall quality of life. The aim of the current study was to test two measures of subjective well-being (the Students’ Life Satisfaction Scale and the Personal Well-Being Index-School Children) among a sample of children in the Western Cape region of South Africa. Noting the diversity of living experiences between children from different socio-economic status groups in South Africa, the study further aimed to determine the extent to which the measures are comparable across socio-economic status groups. Data from the first wave of the Children’s World Survey were used; and included a sample of 1004 12 year old children randomly selected from 15 schools within the Cape Town Metropole. Located within the goodness of fit theoretical framework, confirmatory factor analysis and structural equation modelling was used to test the overall fit structure; while multi-group factor analysis was used to test measurement invariance across socio-economic status groups. The results show appropriate fit structure for the overall model, with metric and scalar factor invariance tenable across socio-economic status groups. The overall findings suggest that the two measures are appropriate for use with children from low and middle socio-economic status groups in the Western Cape province of South Africa and that the two groups can be compared by correlations, regressions and means.IS

Cross-National Measurement Invariance of the Teacher and Classmate Support Scale

The cross-national measurement invariance of the teacher and classmate support scale was assessed in a study of 23202 Grade 8 and 10 students from Austria, Canada, England, Lithuania, Norway, Poland, and Slovenia, participating in the Health Behaviour in School-aged Children (HBSC) 2001/2002 study. A multi-group means and covariance analysis supported configural and metric invariance across countries, but not full scalar equivalence. The composite reliability was adequate and highly consistent across countries. In all seven countries, teacher support showed stronger associations with school satisfaction than did classmate support, with the results being highly consistent across countries. The results indicate that the teacher and classmate support scale may be used in cross-cultural studies that focus on relationships between teacher and classmate support and other constructs. However, the lack of scalar equivalence indicates that direct comparison of the levels support across countries might not be warranted