Absence of gastrointestinal infections in a cohort of patients with Zollinger-Ellison syndrome and other acid hypersecretors receiving long-term acid suppression with lansoprazole

<p>Abstract</p> <p>Background</p> <p>The relationship between proton pump inhibitor therapy and other acid suppressing medications and the risk of gastrointestinal infections remains controversial.</p> <p>Methods</p> <p>Patients enrolled in a long-term trial of lansoprazole for Zollinger-Ellison syndrome and other acid hypersecretory states had interval histories taken every six months regarding hospitalizations or other intercurrent medical conditions. All medications taken were also reviewed at each visit. In addition, available patients were specifically queried during the study period 2006–2007 regarding the development of any gastrointestinal infections, hospitalizations, and prescriptions for antibiotics.</p> <p>Results</p> <p>Ninety patients were enrolled in our long-term study and 81 were available for review. The median basal gastric pH for the cohort after stabilization on therapy was 2.9 and ranged from 1.1 – 8.4 with a median pentagastrin stimulated gastric pH of 1.60 (range 1.0 – 8.2). No patient developed a clinically significant gastrointestinal infection during the study. The median patient years of follow-up were 6.25 years.</p> <p>Conclusion</p> <p>In a cohort of patients with gastric acid hypersecretion in whom acid secretion status was monitored on lansoprazole, all were free of significant gastrointestinal infections on long-term follow-up.</p> <p>Trial registration</p> <p>NCT00204373</p

Molecular Determinants of S100B Oligomer Formation

Background: S100B is a dimeric protein that can form tetramers, hexamers and higher order oligomers. These forms have been suggested to play a role in RAGE activation. Methodology/Principal Findings: Oligomerization was found to require a low molecular weight trigger/cofactor and could not be detected for highly pure dimer, irrespective of handling. Imidazol was identified as a substance that can serve this role. Oligomerization is dependent on both the imidazol concentration and pH, with optima around 90 mM imidazol and pH 7, respectively. No oligomerization was observed above pH 8, thus the protonated form of imidazol is the active species in promoting assembly of dimers to higher species. However, disulfide bonds are not involved and the process is independent of redox potential. The process was also found to be independent of whether Ca 2+ is bound to the protein or not. Tetramers that are purified from dimers and imidazol by gel filtration are kinetically stable, but dissociate into dimers upon heating. Dimers do not revert to tetramer and higher oligomer unless imidazol is again added. Both tetramers and hexamers bind the target peptide from p53 with retained stoichiometry of one peptide per S100B monomer, and with high affinity (lgK = 7.360.2 and 7.260.2, respectively in 10 mM BisTris, 5 mM CaCl 2, pH 7.0), which is less than one order of magnitude reduced compared to dimer under the same buffer conditions. Conclusion/Significance: S100B oligomerization requires protonated imidazol as a trigger/cofactor. Oligomers ar

Histopathological diagnosis of myocarditis in a dengue outbreak in Sri Lanka, 2009

<p>Abstract</p> <p>Background</p> <p>In 2009, an outbreak of dengue caused high fatality in Sri Lanka. We conducted 5 autopsies of clinically suspected myocarditis cases at the General Hospital, Peradeniya to describe the histopathology of the heart and other organs.</p> <p>Methods</p> <p>The diagnosis of dengue was confirmed with specific IgM and IgG ELISA, HAI and RT-PCR techniques. The histology was done in tissue sections stained with hematoxylin and eosin.</p> <p>Results</p> <p>Of the 319 cases of dengue fever, 166(52%) had severe infection. Of them, 149 patients (90%) had secondary dengue infection and in 5 patients, DEN-1 was identified as the causative serotype. The clinical diagnosis of myocarditis was considered in 45(27%) patients. The autopsies were done in 5 patients who succumbed to shock (3 females and 2 males) aged 13- 31 years. All had pleural effusions, ascites, bleeding patches in tissue planes and histological evidence of myocarditis. The main histological findings of the heart were interstitial oedema with inflammatory cell infiltration and necrosis of myocardial fibers. One patient had pericarditis. The concurrent pulmonary abnormalities were septal congestion, pulmonary haemorrhage and diffuse alveolar damage; one case showed massive necrosis of liver.</p> <p>Conclusions</p> <p>The histology supports occurrence of myocarditis in dengue infection.</p

Factors associated with dental visit and barriers to utilisation of oral health care services in a sample of antenatal mothers in Hospital Universiti Sains Malaysia

<p>Abstract</p> <p>Background</p> <p>The aims of this study were to determine factors associated with dental visit and to describe barriers to utilisation of oral health care services among antenatal mothers attending the Obstetric and Gynaecology Specialist clinic in Hospital Universiti Sains Malaysia.</p> <p>Methods</p> <p>A structured, self-administered questionnaire was used obtain information on the variables of interest pertaining to the current pregnancy from 124 antenatal mothers.</p> <p>Results</p> <p>The majority of the mothers claimed that their oral health status was good (67.0%) or very good (2.4%). On the contrary, most of them admitted of having had at least one oral health problem (59.7%) including cavitated (43.5%) and painful teeth (15.3%), bleeding gum (21.0%), and bad breath (10.5%). However, only 29% of the mothers visited dentist during the current pregnancy. Factors associated with the mothers' dental visit were exposure to oral health education before the pregnancy and awareness of relationship between poor maternal oral health and adverse pregnancy outcomes with odds ratio of 4.06 (95% CI: 1.67-9.78) and 3.57 (95% CI: 1.30-9.77) respectively. Common excuses given by most mothers include perceptions of not having any oral health problems (65.9%), long waiting time at the clinic (71.6%), and no immediate treatment given by the dentist (64.8%).</p> <p>Conclusions</p> <p>Utilisation of oral health care services among antenatal mothers was low. Mothers who reported dental visit were more likely to be those who had received oral health education before the current pregnancy and knew of the association between poor maternal oral health and adverse pregnancy outcomes. Dissatisfaction with the services rendered and perceptions of not having any oral health problems were the main barriers.</p

The Properties of Lion Roars and Electron Dynamics in Mirror Mode Waves Observed by the Magnetospheric MultiScale Mission

Mirror mode waves are ubiquitous in the Earth's magnetosheath, in particular behind the quasi‐perpendicular shock. Embedded in these nonlinear structures, intense lion roars are often observed. Lion roars are characterized by whistler wave packets at a frequency ∼100 Hz, which are thought to be generated in the magnetic field minima. In this study, we make use of the high time resolution instruments on board the Magnetospheric MultiScale mission to investigate these waves and the associated electron dynamics in the quasi‐perpendicular magnetosheath on 22 January 2016. We show that despite a core electron parallel anisotropy, lion roars can be generated locally in the range 0.05–0.2fce by the perpendicular anisotropy of electrons in a particular energy range. We also show that intense lion roars can be observed up to higher frequencies due to the sharp nonlinear peaks of the signal, which appear as sharp spikes in the dynamic spectra. As a result, a high sampling rate is needed to estimate correctly their amplitude, and the latter might have been underestimated in previous studies using lower time resolution instruments. We also present for the first‐time 3‐D high time resolution electron velocity distribution functions in mirror modes. We demonstrate that the dynamics of electrons trapped in the mirror mode structures are consistent with the Kivelson and Southwood (1996) model. However, these electrons can also interact with the embedded lion roars: first signatures of electron quasi‐linear pitch angle diffusion and possible signatures of nonlinear interaction with high‐amplitude wave packets are presented. These processes can lead to electron untrapping from mirror modes

Electron-scale measurements of magnetic reconnection in space

Magnetic reconnection is a fundamental physical process in plasmas whereby stored magnetic energy is converted into heat and kinetic energy of charged particles. Reconnection occurs in many astrophysical plasma environments and in laboratory plasmas. Using very high time resolution measurements, NASA’s Magnetospheric Multiscale Mission (MMS) has found direct evidence for electron demagnetization and acceleration at sites along the sunward boundary of Earth’s magnetosphere where the interplanetary magnetic field reconnects with the terrestrial magnetic field. We have (i) observed the conversion of magnetic energy to particle energy, (ii) measured the electric field and current, which together cause the dissipation of magnetic energy, and (iii) identified the electron population that carries the current as a result of demagnetization and acceleration within the reconnection diffusion/dissipation region

Separable functions of wingless in distal and ventral patterning of the Tribolium leg

The gene wingless (wg) in Drosophila is an important factor in leg development. During embryonic development wg is involved in the allocation of the limb primordia. During imaginal disk development wg is involved in distal development and it has a separate role in ventral development. The expression pattern of wg is highly conserved in all arthropods (comprising data from insects, myriapods, crustaceans, and chelicerates), suggesting that its function in leg development is also conserved. However, recent work in other insects (e.g. the milkweed bug Oncopeltus fasciatus) argued against a role of wg in leg development. We have studied the role of wg in leg development of the flour beetle Tribolium castaneum. Using stage-specific staggered embryonic RNAi in wild-type and transgenic EGFP expressing enhancer trap lines we are able to demonstrate separable functions of Tribolium wg in distal and in ventral leg development. The distal role affects all podomeres distal to the coxa, whereas the ventral role is restricted to cells along the ventral midline of the legs. In addition, severe leg defects after injection into early embryonic stages are evidence that wg is also involved in proximal development and limb allocation in Tribolium. Our data suggest that the roles of wg in leg development are highly conserved in the holometabolous insects. Further studies will reveal the degree of conservation in other arthropod groups