An unusual presentation of tuberculosis

We describe a case of a male with no symptoms and normal chest X ray, diagnosed with TB. The chest computed tomography revealed a cavity formation on the upper left lobe

Recurrent catamenial hemothorax

Endometriosis is a common cause of chronic pelvic pain and infertility affecting women of reproductive age, but the disease in rare conditions may be extragenital so may be present with a variety of symptoms. This is a report of an unusual case of pelvic endometriosis that presented with a recurrent hemothorax

Carcinoid tumour behind bronchiectasis

This report describes a female patient with bronchiectasis, presented to our department with recurrent hemoptysis. Bronchoscopy revealed nothing else but blood arising from the upper lobe bronchus. High resolution computing tomography of the lung (HRCT) revealed bronchiectasis of the upper lobe. A right upper lobectomy was performed. Behind bronchiectasis multiple nodular lesions, 5-10 mm were observed. Histological and immunohistochemical examination revealed findings consistent with peripheral typical bronchial carcinoids

Association of ET-1 gene polymorphisms with COPD phenotypes in a Caucasian population

Background and Aim. The phenotypic expression of COPD consists of pulmonary emphysema and chronic bronchitis. An imprecise phenotypic definition may result in inconsistencies among genetic studies regarding COPD pathogenesis. Endothelin-1 gene polymorphisms have been linked to increased susceptibility of COPD development. The present study examined the involvement of +138 insA/delA and G198T ET-1 polymorphisms with emphysematous and bronchitic COPD phenotypes. Methods. In order to narrow down the phenotypic choices to either COPD-associated pulmonary emphysema or chronic bronchitis, a DLCO<60% predicted threshold was chosen as an indicator of severe emphysema.116 COPD smokers and 74 non-related, non-COPD smokers were evaluated. Results. Statistical analysis showed that the 4A allele of the +138insA/delA SNP and the 4A:T haplotype were associated predominantly with a chronic bronchitis phenotype, whereas the TT genotype of the G198T SNP was found to be protective from emphysema development. Conclusions. The presence of both the 4A and T allele seems to modify the final expression of COPD towards a chronic bronchitis phenotype, since the G:3A haplotype was associated with a predominantly emphysematous phenotype in our study

Methacholine bronchial provocation measured by spirometry versus wheeze detection in preschool children

BACKGROUND: Determination of PC(20)-FEV(1) during Methacholine bronchial provocation test (MCT) is considered to be impossible in preschool children, as it requires repetitive spirometry sets. The aim of this study was to assess the feasibility of determining PC(20)-FEV(1) in preschool age children and compares the results to the wheeze detection (PCW) method. METHODS: 55 preschool children (ages 2.8–6.4 years) with recurrent respiratory symptoms were recruited. Baseline spirometry and MCT were performed according to ATS/ERS guidelines and the following parameters were determined at baseline and after each inhalation: spirometry-indices, lung auscultation at tidal breathing, oxygen saturation, respiratory and heart rate. Comparison between PCW and PC(20)-FEV(1) and clinical parameters at these end-points was done by paired Student's t-tests. RESULTS AND DISCUSSION: Thirty-six of 55 children (65.4%) successfully performed spirometry-sets up to the point of PCW. PC(20)-FEV(1) occurred at a mean concentration of 1.70+/-2.01 while PCW occurred at a mean concentration of 4.37+/-3.40 mg/ml (p < 0.05). At PCW, all spirometry-parameters were markedly reduced: FVC by 41.3+/-16.4% (mean +/-SD); FEV(1) by 44.7+/-14.5%; PEFR by 40.5+/-14.5 and FEF(25–75) by 54.7+/-14.4% (P < 0.01 for all parameters). This reduction was accompanied by de-saturation, hyperpnoea, tachycardia and a response to bronchodilators. CONCLUSION: Determination of PC(20)-FEV(1) by spirometry is feasible in many preschool children. PC(20)-FEV(1) often appears at lower provocation dose than PCW. The lower dose may shorten the test and encourage participation. Significant decrease in spirometry indices at PCW suggests that PC(20)-FEV(1) determination may be safer

Does the presence of scrapie affect the ability of current statutory discriminatory tests to detect the presence of BSE?

Current European Commission (EC) surveillance regulations require discriminatory testing of all transmissible spongiform encephalopathy (TSE)-positive small ruminant (SR) samples in order to classify them as bovine spongiform encephalopathy (BSE) or non-BSE. This requires a range of tests, including characterization by bioassay in mouse models. Since 2005, naturally occurring BSE has been identified in two goats. It has also been demonstrated that more than one distinct TSE strain can coinfect a single animal in natural field situations. This study assesses the ability of the statutory methods as listed in the regulation to identify BSE in a blinded series of brain samples, in which ovine BSE and distinct isolates of scrapie are mixed at various ratios ranging from 99% to 1%. Additionally, these current statutory tests were compared with a new in vitro discriminatory method, which uses serial protein misfolding cyclic amplification (sPMCA). Western blotting consistently detected 50% BSE within a mixture, but at higher dilutions it had variable success. The enzyme-linked immunosorbent assay (ELISA) method consistently detected BSE only when it was present as 99% of the mixture, with variable success at higher dilutions. Bioassay and sPMCA reported BSE in all samples where it was present, down to 1%. sPMCA also consistently detected the presence of BSE in mixtures at 0.1%. While bioassay is the only validated method that allows comprehensive phenotypic characterization of an unknown TSE isolate, the sPMCA assay appears to offer a fast and cost-effective alternative for the screening of unknown isolates when the purpose of the investigation was solely to determine the presence or absence of BSE

Differences in the pattern and regulation of mineral deposition in human cell lines of osteogenic and non-osteogenic origin

Bone marrow-derived mesenchymal stem cells (MSCs) are widely used as a cellular model of bone formation, and can mineralize in vitro in response to osteogenic medium (OM). It is unclear, however, whether this property is specific to cells of mesenchymal origin. We analysed the OM response in 3 non-osteogenic lines, HEK293, HeLa and NTera, compared to MSCs. Whereas HEK293 cells failed to respond to OM conditions, the 2 carcinoma-derived lines NTera and HeLa deposited a calcium phosphate mineral comparable to that present in MSC cultures. However, unlike MSCs, HeLa and NTera cultures did so in the absence of dexamethasone. This discrepancy was confirmed, as bone morphogenetic protein inhibition obliterated the OM response in MSCs but not in HeLa or NTera, indicating that these 2 models can deposit mineral through a mechanism independent of established dexamethasone or bone morphogenetic protein signalling

Antianginal efficacy of the combination of trimetazidine-propranolol compared with isosorbide dinitrate-propranolol in patients with stable angina

Trimetazidine is a new anti-ischaemic drug that exerts cytoprotective effects without modifying coronary blood flow or systemic haemodynamics. We tested the antianginal efficacy of trimetazidine in combination with propranolol, using a double-blind isosorbide dinitrate-controlled design. Male patients (n = 53) with stable, effort-induced angina not sufficiently controlled with propranolol 40mg 3 times daily received at random either trimetazidine 20mg 3 times daily (n = 27) or isosorbide dinitrate 10mg 3 times daily (n = 26) for 2 months. From day 0 to day 60, in both groups, there was a decrease in the average number of anginal attacks per week (p &lt; 0.01) and in the weekly consumption of nitroglycerin (p &lt; 0.01), the latter being more decreased in the trimetazidine group (p &lt; 0.05). On exercise testing, both exercise duration and rime to I mm ST depression were improved in the trimetazidine group at day 60 compared with day 0 values (p &lt; 0.001), while no significant changes were observed in the isosorbide dinitrate group. The total workload increased significantly more in the trimetrtzidine group than in the isosorbide dinitrate group for patients performing the exercise test on a bicycle (n = 31, p &lt; 0.001), but not on a treadmill (n = 22, p = not significant). We concluded that in patients with stable induced angina not sufficiently controlled with propranolol, a better antianginal efficacy was observed with the addition of trimetazidine than with the addition of isosorbide dinitrate, and this confirmed the clinical interest in the new anti-ischaemic drug

English

This paper reports on curriculum analysis of climate change expectations in Canada’s provincial curricula. The research is focused on curriculum policy in Canadian provinces; however, it pertains to an international audience as Article 12 of the Paris Agreement, the international treaty on climate mitigation, adaptation and finance, calls for signatories to “enhance climate change education,” and the United Nations Educational, Scientific and Cultural Organization (UNESCO) have called for environmental education to be a core curriculum component by 2025, which will require all countries to evaluate and improve their curricula globally. Curriculum policy within Canada has not yet been aligned with these policy calls, and our analysis showed fractured and uneven inclusion of climate change. Data findings present explicit climate change education curriculum expectations for each province according to grade, subject, and mandatory versus elective courses. The review shows uneven inclusion of climate change topics, themes, and units within grade 7 – 12 curricula, with most expectations occurring in elective senior secondary courses. A second level of analysis with a ranking tool indicates shallow inclusion. The paper concludes with recommendations for addressing gaps