Accuracy of Ultrasound Diagnosis after Blunt Scrotal Trauma (10 Years Experience)

Objectives: To evaluate the role of ultrasonography (US) and its accuracy, sensitivity and specificity for the diagnosis of testicular rupture after blunt scrotal trauma. Moreover, tunica albuginea breach, testicular hematoma, testis avulsion, epididymal injuries and hematocele are particularly examined.Patients and Methods: Between 1998 and 2008, 24 patients presented to Suez Canal University Hospital after blunt scrotal trauma and underwent surgical exploration. All patients had an emergency scrotal US examination with the use of a 7.5-10 MHz linear transducer. US findings were compared with the surgical findings to calculate the sensitivity and specificity of US for each type of lesion.Results: Out of 24 patients, 12 were diagnosed as having testicular rupture and tunica albuginea breach was visualized on US in 6 patients. Sensitivity and specificity of US were 92% and 50% for testicular rupture, 85% and 75% for hematocele, 80% and 79% for testicular hematoma, and 100% and 96% for testicular avulsion, respectively. US diagnosis of epididymal injuries was poor as it failed to detect 3 out of 5 epididymal lesions.Conclusion: US was highly sensitive in the diagnosis of testis rupture. This can provide information on the integrity of the scrotal contents that can help the physician to determine the optimal treatment.Key Words: Ultrasonography, scrotal blunt trauma, testis ruptur

Response of the Hepatic Transcriptome to Aflatoxin B1 in Domestic Turkey (Meleagris gallopavo)

Dietary exposure to aflatoxin B1 (AFB1) is detrimental to avian health and leads to major economic losses for the poultry industry. AFB1 is especially hepatotoxic in domestic turkeys (Meleagris gallopavo), since these birds are unable to detoxify AFB1 by glutathione-conjugation. The impacts of AFB1 on the turkey hepatic transcriptome and the potential protection from pretreatment with a Lactobacillus-based probiotic mixture were investigated through RNA-sequencing. Animals were divided into four treatment groups and RNA was subsequently recovered from liver samples. Four pooled RNA-seq libraries were sequenced to produce over 322 M reads totaling 13.8 Gb of sequence. Approximately 170,000 predicted transcripts were de novo assembled, of which 803 had significant differential expression in at least one pair-wise comparison between treatment groups. Functional analysis linked many of the transcripts significantly affected by AFB1 exposure to cancer, apoptosis, the cell cycle or lipid regulation. Most notable were transcripts from the genes encoding E3 ubiquitin-protein ligase Mdm2, osteopontin, S-adenosylmethionine synthase isoform type-2, and lipoprotein lipase. Expression was modulated by the probiotics, but treatment did not completely mitigate the effects of AFB1. Genes identified through transcriptome analysis provide candidates for further study of AFB1 toxicity and targets for efforts to improve the health of domestic turkeys exposed to AFB1.published_or_final_versio

Concerns, perceived impacts and preparedness of health care workers in a referral hospital in Egypt in facing influenza (H1N1) epidemic

Objective. In Egypt, influenza A(H1N1) cases have been detected and deaths have been reported. The aim of this study was to investigate Concerns, Perceived Impacts and Preparedness of Physicians and Nurses of Chest Specialty Hospital in Cairo (Egypt) concerning Influenza A(H1N1). Methods. A questionnaire was applied to a total of 72 Physicians and 41 Nurses from Chest Specialty Hospital in Cairo (Egypt). Results. More than half of physicians (55.6%) were men, while most of nurses (92.7%) were women. The mean age in years of physicians was 36.6 ± 11.3 compared to 26.5 ± 8 in nurses. Physicians feel that they are at greater risk by their job to the pandemic100% compared to 87.6% among nurses and the difference is highly significant. More than one third of the studied physicians reported that they are not ready to face H1N1 pandemic. Residents feel less ready to face the danger of Influenza A(H1N1) compared with Consultants and Specialists/Assistant Specialists, with no statistical significant difference. In concordance, Residents reported less Personal Protective Equipment training compared with Consultants and Specialists/Assistant Specialists, with no statistical significant difference. All Consultants received Seasonal Influenza Vaccine compared with Specialists/Assistant Specialists (68.2%) and Residents (44.7%). Conclusion. Higher work related and non work related stress was found among physicians compared to nurses, which reflects the demand of more information and training courses for physicians about the pandemic nature and its consequences, complications, and methods infection prevention

Earliest signs and management of leakage after bariatric surgeries: Single institute experience

Background: The aim of this study was to describe the clinical presentation and outcomes of treatment in patients who develop gastrointestinal leaks after different bariatric surgeries.Methods: Retrospective review of 632 consecutive bariatric surgical procedures performed from 1999–2009 in Alexandria University Hospital, Egypt.Results: Leakage occurred in 10 patients. Symptoms and signs included tachycardia, fever, tachypnea, left shoulder pain, abdominal pain, chest pain, and/or change in the nature of the drain effluent. The earliest signs of presentation were tachycardia and unilateral decrease in air entry in all patients. The average time to diagnosis was 3.9± 2.6 days. In four patients contrast study was negative (40%). Six leaks occurred after laparoscopic sleeve gastrectomy (6.3%), 2 after laparoscopic gastric bypass (3.6%), one after open gastric bypass (2.3%), and 1 after laparoscopic vertical banded gastroplasty (2.4%). The most common leak location was at the esophagogastric junction (70%). Four patients (40%) required reoperations. A percutaneous abdominal drainage was placed in five patients (50%). In 2 patients (20%), the prophylactic drain was maintained in situ till cessation of leakage. Two patients (20%) died. Mean hospital length of stay was 13.9 ± 7.8 days.Conclusions: Tachycardia and unequal breath sound in the early postoperative course are worrisome signs that warrant laparoscopic exploration even if contrast studies were negative. Patients with signs of sepsis or hemodynamic instability require emergent exploration. Leaks that are more insidious may be treated successfully with percutaneous drainage or maintenance of prophylactic drains.Keywords: Morbid obesity; Bariatric surgery; Complication; Lea

Kota Qom Sebagai Pusat Pendidikan Madzhab Syi’ah: Sejarah dan Perkembangannya

Sensitive issues of the mazhaban between Sunni and Shi'a are increasingly rife in filling the information space of Indonesian society, especially after the outbreak of the Syrian Civil War. In addition, Indonesian students who graduated from the city of Qom, Iran, are considered to be the newest generation of Shiites who have a mission to spread syi'ahism and are often in conflict with other groups. This paper attempts to answer the formulation of the problem, "how is the history and development of the City of Qom as a center for Shi'a school of education in Iran?" The writing methodology used is based on a qualitative approach through historical investigations by conducting documentation data collection studies. This research proves that Qom has become an important Shiite base in Persia since many Alawites (descendants of Ali bin Abi Talib) migrated in the early centuries of Islamic times. Then, between the 9th and 10th centuries, two important sites for Shi'ite pilgrimage stood, namely the Tomb of Fatima Ma'shumah and the Jamkaran Mosque. In the same range, the Fuqaha of the Early Shi'a generation lived here, namely Shaykh Shaduq and Shaykh Al-Kulaini. However, Qom's vital role strengthened in the Safavid to Qajar periods between the 16th and 19th centuries with the Feiziyeh Madrasa as its icon. Shi'ite philosophers also worked there, including Mulla Shadra and Mulla Al-Razzaq Lahiji. Although weakened in the early 20th century, Ayatollah Haeri Yazdi's role in establishing the Qom Scholars' Seminary/Seminary in 1922 marked an advance that even rivaled Najaf as a center for Shi'i education. Ayatollah Khomeini was a major figure who graduated from that school which made Qom the base of the 1979 Iranian Revolution. Until now, this city has been taken into account in Islamic education.Isu-isu sensitif kemadzhaban antara Sunni dan Syi'ah kian marak memenuhi ruang informasi masyarakat Indonesia terutama pasca meletusnya Perang Saudara Suriah. Selain itu, para mahasiswa Indonesia lulusan Kota Qom, Iran, dianggap sebagai generasi Syi'ah terbaru yang memiliki misi menyebarkan kesyi'ahan dan kerap berkonflik dengan kelompok lain. Tulisan ini berusaha menjawab rumusan masalah, "bagaimana sejarah dan perkembangan Kota Qom sebagai pusat pendidikan madzhab Syi’ah di Iran ?." Metodologi penulisan yang dipakai ialah berdasarkan pendekatan kualitatif melalui penyelidikan historik dengan melakukan studi pengumpulan data dokumentasi. Penelitian ini membuktikan bahwa Qom telah menjadi basis penting kesyi'ahan di Persia sejak banyak Kaum Alawi (keturunan Ali bin Abi Thalib) bermigrasi di awal abad masa keislaman. Kemudian antara abad ke-9 hingga ke-10 berdiri dua situs penting perziarahan Syi'ah yakni Makam Fathimah Ma'shumah dan Masjid Jamkaran. Pada rentang yang sama Fuqaha generasi Awal Syi'ah bermukim di sini yakni Syaikh Shaduq dan Syaikh Al-Kulaini. Namun peran vital Qom menguat di masa Safawi hingga Qajar antara abad ke-16 hingga ke-19 dengan Madrasah Feiziyeh sebagai ikonnya. Filsuf Syi'ah juga sempat berkarya di sana, antara lain Mulla Shadra dan Mulla Al-Razzaq Lahiji. Meski melemah di awal abad ke-20, peran Ayatollah Haeri Yazdi dalam membangun Hauzah Ilmiah / Seminari Qom pada 1922 menandai kemajuan yang bahkan menyaingi Najaf sebagai pusat pendidikan Syi'ah. Ayatollah Khomeini adalah tokoh besar lulusan sekolah itu yang menjadikan Qom sebagai basis Revolusi Iran 1979. Hingga sekarang kota ini diperhitungkan dalam pendidikan kesyi'ahan

Testosterone fluctuations in response to a democratic election predict partisan attitudes toward the elected leader

Intergroup competitions such as democratic elections can intensify intergroup polarization and conflict. Partisan attitudes toward the elected leader can also shift from before to after an election, but the biology underlying these attitudinal shifts remains largely unknown. An important factor could be the hormone testosterone, which is theorized to fluctuate during competition and to influence status seeking. In a naturalistic study of 113 registered voters, we measured changes in testosterone levels and attitudes toward the winner of the 2012 US Presidential Election. We found that supporters of the losing candidate (Mitt Romney) showed acute increases in testosterone levels compared to supporters of the winner (Barack Obama) on the evening of Election Day. Supporters of the losing candidate also demonstrated flatter diurnal testosterone slopes on Election Day that persisted up to two days after the election. Furthermore, greater increases in acute testosterone levels and flatter diurnal slopes among supporters of the losing candidate were associated with less positive evaluations of the winning candidate. These testosterone-moderated attitudinal shifts observed in the days after the election showed a directionally similar pattern with a weaker effect size six months later. Finally, we confirmed that the main results were robust to alternative data analytic choices using multiverse specification curve analysis. The findings from this paper suggest that hormonal responses to large-scale intergroup competitions may shape how we perceive our elected leaders, shedding light on the biology of intergroup relations

Evaluating Maintainability Prejudices with a Large-Scale Study of Open-Source Projects

Exaggeration or context changes can render maintainability experience into prejudice. For example, JavaScript is often seen as least elegant language and hence of lowest maintainability. Such prejudice should not guide decisions without prior empirical validation. We formulated 10 hypotheses about maintainability based on prejudices and test them in a large set of open-source projects (6,897 GitHub repositories, 402 million lines, 5 programming languages). We operationalize maintainability with five static analysis metrics. We found that JavaScript code is not worse than other code, Java code shows higher maintainability than C# code and C code has longer methods than other code. The quality of interface documentation is better in Java code than in other code. Code developed by teams is not of higher and large code bases not of lower maintainability. Projects with high maintainability are not more popular or more often forked. Overall, most hypotheses are not supported by open-source data.Comment: 20 page

Enhancing continuous online microdialysis using dexamethasone: measurement of dynamic neurometabolic changes during spreading depolarization

Microdialysis is well established in chemical neuroscience as a mainstay technology for real time intracranial chemical monitoring in both animal models and human patients. Evidence shows that microdialysis can be enhanced by mitigating the penetration injury caused during the insertion of microdialysis probes into brain tissue. Herein, we show that retrodialysis of dexamethasone in the rat cortex enhances the microdialysis detection of K(+) and glucose transients induced by spreading depolarization. Without dexamethasone, quantification of glucose transients was unreliable by 5 days after probe insertion. With dexamethasone, robust K(+) and glucose transients were readily quantified at 2 h, 5 days, and 10 days after probe insertion. The amplitudes of the K(+) transients declined day-to-day following probe insertion, and the amplitudes of the glucose transients exhibited a decreasing trend that did not reach statistical significance. Immunohistochemistry and fluorescence microscopy confirm that dexamethasone is highly effective at preserving a healthy probe-brain interface for at least 10 days even though retrodialysis of dexamethasone ceased after 5 days

Temperate Performance Benefits after Heat, but Not Combined Heat and Hypoxic Training

© Copyright 2017 by the American College of Sports Medicine. Purpose Independent heat and hypoxic exposure can enhance temperate endurance performance in trained athletes, although their combined effects remain unknown. This study examined whether the addition of heat interval training during "live high, train low" (LHTL) hypoxic exposure would result in enhanced performance and physiological adaptations as compared with heat or temperate training. Methods Twenty-six well-trained runners completed 3 wk of interval training assigned to one of three conditions: 1) LHTL hypoxic exposure plus heat training (H + H; 3000 m for 13 h·d -1, train at 33°C, 60% relative humidity [RH]), 2) heat training with no hypoxic exposure (HOT, live at <600 m and train at 33°C, 60% RH), or 3) temperate training with no hypoxic exposure (CONT; live at <600 m and train at 14°C, 55% RH). Performance 3-km time-trials (3-km TT), running economy, hemoglobin mass, and plasma volume were assessed using magnitude-based inferences statistical approach before (Baseline), after (Post), and 3 wk (3wkP) after exposure. Results Compared with Baseline, 3-km TT performance was likely increased in HOT at 3wkP (-3.3% ± 1.3%; mean ± 90% confidence interval), with no performance improvement in either H + H or CONT. Hemoglobin mass increased by 3.8% ± 1.8% at Post in H + H only. Plasma volume in HOT was possibly elevated above H + H and CONT at Post but not at 3wkP. Correlations between changes in 3-km TT performance and physiological adaptations were unclear. Conclusion Incorporating heat-based training into a 3-wk training block can improve temperate performance at 3 wk after exposure, with athlete psychology, physiology, and environmental dose all important considerations. Despite hematological adaptations, the addition of LHTL to heat interval training has no greater 3-km TT performance benefit than temperate training alone