A Comprehensive Bioinformatics Analysis of the Nudix Superfamily in Arabidopsis thaliana

Nudix enzymes are a superfamily with a conserved common reaction mechanism that provides the capacity for the hydrolysis of a broad spectrum of metabolites. We used hidden Markov models based on Nudix sequences from the PFAM and PROSITE databases to identify Nudix hydrolases encoded by the Arabidopsis genome. 25 Nudix hydrolases were identified and classified into 11 individual families by pairwise sequence alignments. Intron phases were strikingly conserved in each family. Phylogenetic analysis showed that all multimember families formed monophyletic clusters. Conserved familial sequence motifs were identified with the MEME motif analysis algorithm. One motif (motif 4) was found in three diverse families. All proteins containing motif 4 demonstrated a degree of preference for substrates containing an ADP moiety. We conclude that HMM model-based genome scanning and MEME motif analysis, respectively, can significantly improve the identification and assignment of function of new members of this mechanistically-diverse protein superfamily

Topical Glycopirrolate for the Management of Hyperhidrosis in Herpetic Neuralgia

Herpes zoster is a relapse of varicella. In certain cases, long-term pain and hyperhidrosis have been noted. Appearance of herpes zoster during pregnancy is infrequent. We described hyperhidrosis and pain treatment using glycopirrolate cream in a pregnant woman with herpetic neuralgia. A 32 year old woman, 21 weeks pregnant with second child, complained to her gynecologist of the appearance of a vesicular rash on the left half of the forehead that progressed toward her left eyelid, accompanied by lancinating pain, allodynia, hyperhidrosis and small edema, blepharitis and conjunctivitis. Following clinical and laboratory tests, she was diagnosed with herpes zoster ophtalmicus. Aciclovir therapy was administered 800 mg orally five times daily for seven days. Pain therapy was initiated with amitriptilline. We discontinued amitriptilline therapy after 10 days because of appearance of unwanted side effects. After skin changes ceased, we introduced Lidocaine patch into pain therapy which reduced the allodynia, but not the lancinating pain and hyperhidrosis. At that time we began using glycopirrolate cream which reduced pain intensity by 28.5% within 24 hours, and completely eliminated hyperhidrosis. After 48 hours of use, the pain completely disappeared. During the Glycopirrolate cream therapy, there were no side effects. This is a first report to document that a topical Glycopirrolate cream has a beneficial effect in a patient with hyperhidrosis and herpetic neuralgia

Histopathological diagnoses of adnexal masses: which parameters are relevant in preoperative assessment?

Objective: The aim of the study was to assess which clinical, laboratory and ultrasound characteristics of adnexal masses might predict the histopathological nature of the disease. Materials and Methods: The study involved all women treated at the Clinic of Gynecology and Obstetrics Clinical Centre of Serbia for adnexal tumors between July 1, 2010 and December 31, 2011. On admission, detailed anamnestic and laboratory data were obtained, expert ultrasound scan performed and RMI was calculated for all patients. Data were related to histopathological findings and statistically analyzed. Results: The study included 540 women out of which 85 had malignant (seven diagnoses), 435 benign (seven diagnoses) and 20 borderline tumors. All types of malignant and borderline tumors were more frequent in postmenopausal women (p=0.000). Only papillary adenocarcinoma significantly more often produced early metastases (p=0.000). Ascites is a common finding in Krukenberg tumors, granulose cell tumors and papillary adenocarcinomas. There were significant differences between tumor diagnoses regarding the levels of Ca 125 and CEA, erythrocyte sedimentation rate (ESR) and risk of malignancy index (RMI) (p0.05). Conclusions: In the light of our results, patient age, menopausal status, blood levels of Ca 125, CEA and ESR, as well as calculated RMI, can predict the nature of adnexal masses. Unfortunately, none of the examined parameters can accurately determine the exact histopathological diagnosis of the adnexal tumor

Online learning applied to a course on rational therapeutics: an international comparison between final year students of two medical schools

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/96234/1/bcp4370.pd

Differences in the Level of Morphological Characteristics, Speed Abilities and Aerobic Endurance in Relation to the Team Position of Top Female Football Players

The aim of this paper is to determine the differences in the level of morphological characteristics, speed abilities and aerobic endurance according to the team positions of top female football players. The study included 18 female football players (age 21.33±3.67, body mass index 20.94±1.95). Female football players are classified under the following team positions: defenders (n = 7; 23±16.4 years), midfielders (n = 6, 20.5±14.3 years) and attackers (n = 5; 20±31.3 years). The following tests were used: 0-5m sprint (s), 0-10m sprint (s), 0-20m sprint (s), 0-30m sprint (s) and Beep test. Body mass index (BMI) was calculated based on the ratio of body weight (kg) and body height (cm). Based on the Beep test, the maximum oxygen consumption (VO2max) was calculated and presented in its relative value (ml/kg/min). The attackers had a higher body height (170.1±7.46) and weight (59.60±8.84) than those playing in midfield and defense positions. Also, the attackers were faster in the sprint on the 5m (1.17±.06), 10m (1.91±.06), 20m (3.27±.10) and 30m (4.51±.17) than female players in midfield and defense positions. Midfield players had higher level of VO2max (50.03±2.69) than female players in defensive and offensive team positions. Test results of univariate analysis of variance (ANOVA) showed that there are significant differences in the level of morphological features, speed and aerobic endurance capabilities between the top female football players, regardless of their team position (p>0.05). It is obvious that good speed abilities on short sprint sections as well as high level of aerobic endurance at high intensity are required regardless of players team position in the women’s football. It is important to note that selection for team positions can not only be based on morphological characteristics, speed abilities and aerobic endurance of players. Also, tactical tasks as well as technical characteristics of players need to be considered for selection of team positions in the women’s football

Cost-effectiveness of the Perioperative Pain Management Bundle a registry-based study.

INTRODUCTION The Perioperative Pain Management Bundle was introduced in 10 Serbian PAIN OUT network hospitals to improve the quality of postoperative pain management. The Bundle consists of 4 elements: informing patients about postoperative pain treatment options; administering a full daily dose of 1-2 non-opioid analgesics; administering regional blocks and/or surgical wound infiltration; and assessing pain after surgery. In this study, we aimed to assess the cost-effectiveness of the Bundle during the initial 24 h after surgery. MATERIALS AND METHODS The assessment of cost-effectiveness was carried out by comparing patients before and after Bundle implementation and by comparing patients who received all Bundle elements to those with no Bundle element. Costs of postoperative pain management included costs of the analgesic medications, costs of labor for administering these medications, and related disposable materials. A multidimensional Pain Composite Score (PCS), the effectiveness measurement, was obtained by averaging variables from the International Pain Outcomes questionnaire evaluating pain intensity, interference of pain with activities and emotions, and side effects of analgesic medications. The incremental cost-effectiveness ratio (ICER) was calculated as the incremental change in costs divided by the incremental change in PCS and plotted on the cost-effectiveness plane along with the economic preference analysis. RESULTS The ICER value calculated when comparing patients before and after Bundle implementation was 181.89 RSD (1.55 EUR) with plotted ICERs located in the northeast and southeast quadrants of the cost-effectiveness plane. However, when comparing patients with no Bundle elements and those with all four Bundle elements, the calculated ICER was -800.63 RSD (-6.82 EUR) with plotted ICERs located in the southeast quadrant of the cost-effectiveness plane. ICER values differ across surgical disciplines. CONCLUSION The proposed perioperative pain management Bundle is cost-effective. The cost-effectiveness varies depending on the number of implemented Bundle elements and fluctuates across surgical disciplines

Characteristics of medical deserts and approaches to mitigate their health work-force issues : A scoping review of empirical studies in Western countries

Background Medical deserts are considered a problematic issue for many Western countries which try to employ multitude of policies and initiatives to achieve a better distribution of their health workforce (HWF). The aim of this study was to systematically map research and provide an overview of definitions, characteristics, contributing factors and approaches to mitigate medical deserts within the European Union (EU)-funded project “ROUTE-HWF” (a Roadmap OUT of mEdical deserts into supportive Health WorkForce initiatives and policies). Methods We performed a scoping review to identify knowledge clusters/research gaps in the field of medical deserts focusing on HWF issues. Six databases were searched till June 2021. Studies reporting primary research from Western countries on definitions, characteristics, contributing factors, and approaches were included. Two independent reviewers assessed studies for eligibility, extracted data and clustered studies according to the four defined outcomes. Results Two-hundred and forty studies were included (n = 116, 48% Australia/New Zealand; n = 105, 44% North America; n = 20, 8% Europe). All used observational designs except for five quasi-experimental studies. Studies provided definitions (n = 171, 71%), characteristics (n = 95, 40%), contributing factors (n = 112, 47%), and approaches to mitigate medical deserts (n = 87, 36%). Most medical deserts were defined by the density of the population in an area. Contributing factors to HWF issues in medical deserts consisted in work-related (n = 55, 23%) and lifestyle-related factors (n = 33, 14%) of the HWF as well as sociodemographic characteristics (n = 79, 33%). Approaches to mitigate them focused on training adapted to the scope of rural practice (n = 67, 28%), HWF distribution (n = 3, 1%), support/infrastructure (n = 8, 3%) and innovative models of care (n = 7, 3%). Conclusion Our study provides the first scoping review that presents and categorizes definitions, characteristics, contributing factors, and approaches to mitigate HWF issues in medical deserts. We identified gaps such as the scarcity of longitudinal studies to investigate the impact of factors contributing to medical deserts, and interventional studies to evaluate the effectiveness of approaches to mitigate HWF issues.©2023 Authors. Published by Kerman University of Medical Sciences. Reusing and publishing IJHPM published articles (main text, tables, and figures) is permitted by following Creative Commons user license: https://creativecommons.org/licenses/by/4.0/.fi=vertaisarvioitu|en=peerReviewed