Screening for significant chronic liver disease by using three simple ultrasound parameters

Objectives Chronic liver diseases remain asymptomatic for many years. Consequently, patients are diagnosed belatedly, when cirrhosis is unmasked by lifethreatening complications. We aimed to identify simple ultrasound parameters for the screening of patients with unknown significant chronic liver disease. Methods Three hundred and twenty seven patients with chronic liver disease, liver biopsy, and ultrasound examination were included in the derivation set. 283 consecutive patients referred for ultrasound examination were included in the validation set; those selected according to the ultrasound parameters identified in the derivation set were then referred for specialized consultation including non-invasive fibrosis tests and ultimately liver biopsy if liver fibrosis was suspected. Results In the derivation set, three ultrasound parameters were independent predictors of severe fibrosis: liver surface irregularity, spleen length (>110 mm), and demodulation of hepatic veins. The association of ≥2 of the three above parameters provided 49.1% sensitivity and 86.9% specificity. In the validation set, at ≥2 of the three parameters were present in 23 (8%) of the patients. Among these patients, 8 had liver fibrosis (F ≥ 1), 5 had significant fibrosis (F  ≥2) and two cirrhosis. Conclusion The generalized search of three simple ultrasound signs in patients referred for abdominal ultrasound examination may be an easy way to detect those with silent but significant chronic liver disease

Sarna sarcóptica dos suínos: estratégia de ação no controle e avaliação econômica.

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Ação do levamisol sobre infecções por Oesophagostomum dentatum em suínos.

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Ação do oxibendazole frente a migração de larvas de Ascaris suum em suinos.

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Stability analysis and \mu-synthesis control of brake systems

The concept of friction-induced brake vibrations, commonly known as judder, is investigated. Judder vibration is based on the class of geometrically induced or kinematic constraint instability. After presenting the modal coupling mechanism and the associated dynamic model, a stability analysis as well as a sensitivity analysis have been conducted in order to identify physical parameters for a brake design avoiding friction-induced judder instability. Next, in order to reduce the size of the instability regions in relation to possible system parameter combinations, robust stability via \mu-synthesis is applied. By comparing the unstable regions between the initial and controlled brake system, some general indications emerge and it appears that robust stability via \mu-synthesis has some effect on the instability of the brake system

Enhancement of Methacholine-Evoked Tracheal Contraction Induced by Bacterial Lipopolysaccharides Depends on Epithelium and Tumor Necrosis Factor

Inhaled bacterial lipopolysaccharides (LPSs) induce an acute tumour necrosis factor-alpha (TNF-α-) dependent inflammatory response in the murine airways mediated by Toll-like receptor 4 (TLR4) via the myeloid differentiation MyD88 adaptor protein pathway. However, the contractile response of the bronchial smooth muscle and the role of endogenous TNFα in this process have been elusive. We determined the in vivo respiratory pattern of C57BL/6 mice after intranasal LPS administration with or without the presence of increasing doses of methacholine (MCh). We found that LPS administration altered the basal and MCh-evoked respiratory pattern that peaked at 90 min and decreased thereafter in the next 48 h, reaching basal levels 7 days later. We investigated in controlled ex vivo condition the isometric contraction of isolated tracheal rings in response to MCh cholinergic stimulation. We observed that preincubation of the tracheal rings with LPS for 90 min enhanced the subsequent MCh-induced contractile response (hyperreactivity), which was prevented by prior neutralization of TNFα with a specific antibody. Furthermore, hyperreactivity induced by LPS depended on an intact epithelium, whereas hyperreactivity induced by TNFα was well maintained in the absence of epithelium. Finally, the enhanced contractile response to MCh induced by LPS when compared with control mice was not observed in tracheal rings from TLR4- or TNF- or TNF-receptor-deficient mice. We conclude that bacterial endotoxin-mediated hyperreactivity of isolated tracheal rings to MCh depends upon TLR4 integrity that signals the activation of epithelium, which release endogenous TNFα

Fishers who rely on mangroves: Modelling and mapping the global intensity of mangrove-associated fisheries

Mangroves are critical nursery habitats for fish and invertebrates, providing livelihoods for many coastal communities. Despite their importance, there is currently no estimate of the number of fishers engaged in mangrove associated fisheries, nor of the fishing intensity associated with mangroves at a global scale. We address these gaps by developing a global model of mangrove associated fisher numbers and mangrove fishing intensity. To develop the model, we undertook a three-round Delphi process with mangrove fisheries experts to identify the key drivers of mangrove fishing intensity. We then developed a conceptual model of intensity of mangrove fishing using those factors identified both as being important and for which appropriate global data could be found or developed. These factors were non-urban population, distance to market, distance to mangroves and other fishing grounds, and storm events. By projecting this conceptual model using geospatial datasets, we were able to estimate the number and distribution of mangrove associated fishers and the intensity of fishing in mangroves. We estimate there are 4.1 million mangrove associated fishers globally, with the highest number of mangrove fishers found in Indonesia, India, Bangladesh, Myanmar, and Brazil. Mangrove fishing intensity was greatest throughout Asia, and to a lesser extent West and Central Africa, and Central and South America

Minimal renal toxicity after Rituximab DHAP with a modified cisplatin application scheme in patients with relapsed or refractory diffuse large B-cell lymphoma

Background: Rituximab (R) in combination with DHAP is a widely accepted salvage regimen for patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL). A common adverse effect of this protocol is renal toxicity which may result in treatment discontinuation. Assuming that a lower single dose of cisplatin over several days would reduce renal toxicity, our institution has chosen to administer cisplatin in a dosage of 25 mg/m2 per day as a 3-h infusion over 4 consecutive days. Methods: In this study, we analyzed the renal function of 122 patients with relapsed or refractory DLBCL treated with R-DHAP at our institution. Overall, 256 R-DHAP cycles were administered. 31 (25 %), 61 (50 %), 14 (12 %) and 16 (13 %) patients received one, two, three or four R-DHAP courses, respectively. Results: A glomerular filtration rate (GFR) decrease was observed after each R-DHAP cycle. However, in none of the subgroups the median GFR was lower than 60 ml/min/1.73 m2. In most patients, only renal impairment stage I and II was observed. Renal impairment stage III was seen in 10 % and stage IV only in 1 % of patients. Conclusion: We conclude that a modified R-DHAP regimen with administration of cisplatin 25 mg/m2 over 4 consecutive cycles leads only to minimal renal toxicity