Scalpel-free surgery could reduce surgeons' risk of HIV and hepatitis

The risk of intraoperative Human Immunodeficiency Virus (HIV) infection poses a challenge to practicing surgeons worldwide, particularly in sub-Saharan Africa with its high HIV prevalence. The risk of acquiring HIV infection from one infected percutaneous exposure is 0.3-0.4%. Prior to extensive screening, blood transfusions were responsible for an estimated 5-10% of new HIV infections in sub-Saharan Africa. In this paper we describe the experience of minimally invasive techniques as alternatives to surgery in urology patients. Trans-urethral ethanol ablation of the prostate (TEAP) for prostatic enlargement, phenol sclerotherapy for hydroceles, and percutaneous aspiration and sclerotherapy for symptomatic renal cysts may result in reduced blood loss, and diminished contact with the patients' exposed tissues or body fluids compared with more invasive surgical options.Keywords: Sepsis, HIV, management, bloodstream infectio

A comparative study of sclerotherapy with phenol versus surgical treatment for hydrocoele

Background: A comparision for the effectiveness, side effects and outcome of sclerotherapy using phenol and surgical treatment for hydrocoele was done at UTH in Lusaka, Zambia..Materials: A total of 80 patients were randomly divided into 2 groups of 40 hydrocoeles each. Group A underwent phenol sclerotherapy and Group B underwent hydrocelectomy.Results: In sclerotherapy group 47.5%, 32.5%, and 15% of the hydrocoele were cured with 1 to 3 injections, respectively, but 4% were not cured. There were no complaints of localized pain or infection in these cases. All patients returned to normal activities on the same day. In hydrocelectomy group, all the patients were cured. There was pain postoperatively in 73.5% of the patients and localized infection in 9%, while 65% required an average of 4 days of rest and were absent from work for 10 days.Conclusion: Sclerotherapy for hydrocoele using phenol is as efficient as hydrocelectomy for cure, has a low risk of complications and allows the patients to return to normal activity on the same day. Sclerotherapy is recommended as an option for treatment of hydrocoele

Les formes graves de la grippe A(H1N1) 2009 chez la femme enceinte: expérience du centre hospitalier universitaire de Fès, Maroc et revue de la littérature

Introduction: Le but de cette étude est de décrire les caractéristiques épidémiologiques, cliniques, paracliniques ainsi que l’évolution des femmes enceintes ou en post partum atteintes de formes graves de Grippe A(H1N1) 2009. Méthodes: C’est une étude prospective observationnelle monocentrique, menée au sein de notre service de réanimation mère et enfant au centre hospitalier universitaire Hassan II à Fès, sur une période de 3 mois, allant de novembre 2009 à janvier 2010. Résultats: L’âge moyen était de 28 ans, dans 85% des cas la grossesse se situaient au troisième trimestre, le syndrome grippal était constant, la SpO2 initiale était en moyenne de 86%. A la radiographie thoracique, un syndrome alvéolaire bilatéral était toujours présent. L’infection virale était confirmée dans tous les cas par la polymerase chain reaction. Chez 3 patientes la PaO2/FiO2 était inférieure à 300. L’Oseltamivir était l’antiviral utilisé chez toutes les parturientes. Un syndrome de détresse respiratoire aigu a été développé chez 28% des parturientes, elles ont été ventilées artificiellement avec des niveaux de pressions expiratoires positives à 14 +/- 1 cmH2O. L’évolution était favorable dans 71% des cas, cependant, 2 décès ont été déplorés. Conclusion: Les résultats rejoignent les données de la littérature, à savoir, un risque accru pour la femme enceinte de développer une forme grave, une présentation clinique similaire au reste de la population, l’intérêt de la vaccination et d’un traitement antiviral précoce et le rôle de l’ECMO dans le traitement des hypoxémies réfractaires

Piqures massives par un essaim d’abeilles chez un enfant

Les piqûres multiples d’abeilles sont responsables d’envenimation sévère. Nous rapportons un cas d’une attaque massive par un essaim d’abeilles chez un enfant de sept ans. Sa gravité est liée à la localisation céphalique et au nombre important des piqûres qui était d’environ 270. Ses complications étaient l’insuffisance rénale, l’anémie et une conjonctivite. La prise en charge était symptomatique avec bonne évolution clinique et biologique.Key words: Abeille, envenimation, anaphylaxie, allergie, choc, Maro

The Pattern of Urological Cancers in Zambia

Objective: To examine the pattern of urological malignancies, particularly cancer of the bladder, seen at the University Teaching Hospital (UTH) in Lusaka and to compare the findings with previous studies on the same parameters done at UTH. Material and Methods: A retrospective study of urological cancers in Zambia was performed, based on histopathology reports of specimens reviewed at the UTH Pathology Laboratory inLusaka, Zambia, between January 1990 and December 2005. The parameters studied were the histological type of the cancer, patient age and trends over a 15-year period. Results: In total, 8829 cancers were diagnosed during the study period, of which 749 (8.5%) were urological malignancies affecting the kidney, bladder, prostate, testis or penis. The maleto- female ratio of the urological cancers was 10.7 to 1. Cancer of the prostate was the most common urological malignancy (54.6%), followed by bladder cancer (21.1%) and penile cancer (18.6%). The histological type of bladder cancer was mainly squamous cell carcinoma (46.2%), transitional cell carcinoma (23.4%) and adenocarcinoma (22.2%); other types (8.2%) included rhabdomyosarcoma, small cell carcinoma and lymphoma. The majority of patients (79%) with bladder cancer were between 56 and 65 years of age. Whereas 20 years ago prostate cancer comprised only 26% of urological malignancies, it accounted for 55% of urological cancersdiagnosed in Zambia between 1990 and 2005. In contrast, cancer of the penis, kidney and testis have shown no change in frequency distribution compared to 20 years ago. Conclusion:Over the last 15 years there has been an increasing proportion of cancer of the prostate and squamous cell carcinoma of the bladder. This is associated with high levels of schistosomiasis, cystitis (some of which is HIV-related) and bladder stones. It may also be due to the extension of urological services and the diagnostic armamentarium (PSA, cystoscopy and histologicaldiagnosis) to indigent rural populations, where the incidence of squamous cell carcinoma is likely to be higher than in affluent urban populations

Bone Activity Biomarkers and Bone Mineral Density in Children with Chronic Kidney Disease

Introduction: Chronic kidney disease - mineral and bone disorder (CKD-MBD) is a spectrum of bone minerals changes that range from high turnover lesions of secondary hyperparathyroidism to the low turnover lesions of adynamic bone disease. Bone biopsy is the gold standard for the diagnosis, but it is not routinely performed because it is invasive technique. Methods: Fifteen CKD children on regular hemodialysis (group I) and 15 CKD children on conservative management (group II) were selected from the nephrology clinics of Zagazig University Hospitals along with 15 age and sex-matched healthy controls. Participants were subjected to biochemical assessment that included osteocalcin (OC), total and bone-specific alkaline phosphatase (tALP and bALP), isomerized beta form of type I collagen cross-linked telopeptide (β-Crosslaps) and intact parathyroid hormone (iPTH) levels. Patients with CKD also had their bone mineral density (BMD) measured using dual energy X-ray absorptiometry (DEXA) at lumbar spine and femoral neck. Results: Serum β-Crosslaps, OC and bALP were significantly higher in patient groups than controls and in group I compared to group II .There was a negative significant correlation between mean Z-score at lumbar spines and bALP, OC and iPTH in group I and with β-Crosslaps in both patient groups. The mean Z-score at femoral neck correlated negatively with bALP in group I, with OC in group II and with iPTH and β-Crosslaps in both groups. Conclusion: Biochemical bone markers and assessment of BMD in patients with CKD may have a role in the early detection of CDK-MBD. Keywords: chronic kidney disease; bone mineral density; bone biomarker

The Effects of Cocaine on Different Redox Forms of Cysteine and Homocysteine, and on Labile, Reduced Sulfur in the Rat Plasma Following Active versus Passive Drug Injections

Received: 28 November 2012 / Revised: 19 April 2013 / Accepted: 6 May 2013 / Published online: 16 May 2013 The Author(s) 2013. This article is published with open access at Springerlink.comThe aim of the present studies was to evaluate cocaine-induced changes in the concentrations of different redox forms of cysteine (Cys) and homocysteine (Hcy), and products of anaerobic Cys metabolism, i.e., labile, reduced sulfur (LS) in the rat plasma. The above-mentioned parameters were determined after i.p. acute and subchronic cocaine treatment as well as following i.v. cocaine self-administration using the yoked procedure. Additionally, Cys, Hcy, and LS levels were measured during the 10-day extinction training in rats that underwent i.v. cocaine administration. Acute i.p. cocaine treatment increased the total and protein-bound Hcy contents, decreased LS, and did not change the concentrations of Cys fractions in the rat plasma. In turn, subchronic i.p. cocaine administration significantly increased free Hcy and lowered the total and protein-bound Cys concentrations while LS level was unchanged. Cocaine self-administration enhanced the total and protein-bound Hcy levels, decreased LS content, and did not affect the Cys fractions. On the other hand, yoked cocaine infusions did not alter the concentration of Hcy fractions while decreased the total and protein-bound Cys and LS content. This extinction training resulted in the lack of changes in the examined parameters in rats with a history of cocaine self-administration while in the yoked cocaine group an increase in the plasma free Cys fraction and LS was seen. Our results demonstrate for the first time that cocaine does evoke significant changes in homeostasis of thiol amino acids Cys and Hcy, and in some products of anaerobic Cys metabolism, which are dependent on the way of cocaine administration

Ctf4 Is a Hub in the Eukaryotic Replisome that Links Multiple CIP-Box Proteins to the CMG Helicase

Replisome assembly at eukaryotic replication forks connects the DNA helicase to DNA polymerases and many other factors. The helicase binds the leading-strand polymerase directly, but is connected to the Pol α lagging-strand polymerase by the trimeric adaptor Ctf4. Here, we identify new Ctf4 partners in addition to Pol α and helicase, all of which contain a "Ctf4-interacting-peptide" or CIP-box. Crystallographic analysis classifies CIP-boxes into two related groups that target different sites on Ctf4. Mutations in the CIP-box motifs of the Dna2 nuclease or the rDNA-associated protein Tof2 do not perturb DNA synthesis genome-wide, but instead lead to a dramatic shortening of chromosome 12 that contains the large array of rDNA repeats. Our data reveal unexpected complexity of Ctf4 function, as a hub that connects multiple accessory factors to the replisome. Most strikingly, Ctf4-dependent recruitment of CIP-box proteins couples other processes to DNA synthesis, including rDNA copy-number regulation.We gratefully acknowledge the support of the Medical Research Council (core grant MC_UU_12016/13), the Wellcome Trust (references 097945/B/11/Z for flow cytometry, 102943/Z/13/Z for award to K.L., and 104641/Z/14/Z for award to L.P.), and the Gates Cambridge PhD programme (A.C.S.) for funding our work

Do replication forks control late origin firing in Saccharomyces cerevisiae?

Recent studies of eukaryotic DNA replication timing profiles suggest that the time-dependent rate of origin firing, I(t), has a universal shape, which ensures a reproducible replication completion time. However, measurements of I(t) are based on population averages, which may bias the shape of the I(t) because of imperfect cell synchrony and cell-to-cell variability. Here, we measure the population-averaged I(t) profile from synchronized Saccharomyces cerevisiae cells using DNA combing and we extract the single-cell I(t) profile using numerical deconvolution. The single cell I(t) and the population-averaged I(t) extracted from DNA combing and replication timing profiles are similar, indicating a genome scale invariance of the replication process, and excluding cell-to-cell variability in replication time as an explanation for the shape of I(t). The single cell I(t) correlates with fork density in wild-type cells, which is specifically loosened in late S phase in the clb5Δ mutant. A previously proposed numerical model that reproduces the wild-type I(t) profile, could also describe the clb5Δ mutant I(t) once modified to incorporate the decline in CDK activity and the looser dependency of initiation on fork density in the absence of Clb5p. Overall, these results suggest that the replication forks emanating from early fired origins facilitate origin firing in later-replicating regions