Nephrogenic systemic fibrosis

Nephrogenic systemic fibrosis, initially called nephrogenic fibrosing dermopathy, has been strongly linked to exposure to gadolinium-based contrast media used in magnetic resonance imaging in patients with renal insufficiency. This review discusses recent advances in our understanding of the pathophysiology and clinical approach to patients with chronic kidney disease who require diagnostic imaging with gadolinium-based contrast media

Evaluación de los efectos genotóxicos del herbicida 2,4-D en Piaractus mesopotamicus a través del test de micronúcleos

The herbicide 2,4-D is currently one of the most used agrochemicals in agriculture. The fish are target of contamination, these when being in contact with toxics develop later alterations that can be studied, reason why they are used as models in the evaluation of aquatic ecosystems. There is scarce information about the effects of these pesticides in fish. Because of this, the objective of this work was to evaluate the possible impact of a contamination with 2,4-D, in sub-lethal concentrations in Piaractus mesopotamicus, through the frequency of micronuclei (MN) and alterations in the shape of the nuclei (NMA) in peripheral blood erythrocytes in chronic conditions (70 days). Two trials were conducted, one with the herbicide 2,4-D pure (P) and another with a commercial formulation (2,4-D bitter amine) (FC). Each experience was composed of five aquariums with two specimens in each, where different concentrations of the pesticide were administered (1 ppm, 1.8 ppm, 3.2 ppm, 5.6 ppm and 10 ppm), and in another with well water (control). A total of 4000 cells per individual were analyzed. Through the test MN and NMA the presence of diverse nuclear alterations was evidenced. The mentioned test for P and dilutions 1 ppm, 1.8 ppm, 3.2 ppm, 5.6 ppm of FC did not show significant differences with the control, while the concentration of 10 ppm of FC differed statistically from its control, this could be due to additional components in FC.Los herbicidas están siendo abundantemente utilizados haciendo que los mismos no solo lleguen al organismo específico sino también contaminen el medio ambiente donde son empleados. El herbicida 2,4-D es en la actualidad uno de los agroquímicos más utilizado en la agricultura. Los peces son blanco de la contaminación, éstos al estar en contacto con tóxicos desarrollan posteriormente alteraciones que pueden ser estudiadas, por lo cual son utilizados como modelos en la evaluacion de ecosistemas acuáticos. Existe escasa información acerca de los efectos de estos pesticidas en peces, siendo el actual trabajo el primero en evaluar efectos crónicos. El objetivo de la presente investigación fue evaluar el posible impacto de una contaminación con 2,4-D en concentraciones subletales en Piaractus mesopotamicus, a través de la frecuencia de micronúcleos (MN) y de las alteraciones en la forma de los núcleos (NMA) en eritrocitos de sangre periférica en condiciones crónicas (70 días). Se realizaron dos ensayos, uno con el herbicida 2,4-D puro (P) y otro con una formulación comercial (2,4-D amina Sumargo) (FC). Cada experiencia estuvo compuesta por cinco acuarios con dos ejemplares en cada uno, donde se administraron difererentes concentraciones del plaguicida (1 ppm, 1,8 ppm, 3,2 ppm, 5,6 ppm y 10 ppm), y en otra con agua de pozo (control). Se analizó un total de 4000 células por individuo. A través del test MN y NMA se evidenció la presencia de diversas alteraciones nucleares. El mencionado test para P y las diluciones 1 ppm, 1,8 ppm, 3,2 ppm, 5,6 ppm de FC no mostraron diferencias significativas con el control, mientras que la concentración de 10 ppm de FC se diferenció estadísticamente de su control. El presente trabajo aporta luz de los potenciales efectos nocivos del 2,4-D en el medio ambiente y posibilita nuevos estudios prospectivos y retrospectivos

Avian mycobacteriosis in chickens from a rural area of Argentina

An outbreak of avian tuberculosis was detected in chickens from a rural area of Chaco Province, northeastern Argentina. The hens were emaciated and presented granulomatous lesions of various sizes throughout the internal organs. The lesions observed in three necropsied birds consisted of granulomas containing alcohol/acid-fast bacilli. All the lesions found were diagnosed histopathologically as tuberculosis, Mycobacterium avium subsp. avium were isolated from the cultures and confirmed by polymerase chain reaction techniques

A copper-catalyzed asymmetric oxime propargylation enables the synthesis of the gliovirin tetrahydro-1,2-oxazine core

The bicyclic tetrahydro-1,2-oxazine subunit of gliovirin is synthesized through a diastereoselective copper-catalyzed cyclization of an N-hydroxyamino ester. Oxidative elaboration to the fully functionalized bicycle was achieved through a series of mild transformations. Central to this approach was the development of the first catalytic, enantioselective propargylation of an oxime to furnish a key N-hydroyxamino ester intermediate

Locking-free two-layer Timoshenko beam element with interlayer slip

A new locking-free strain-based finite element formulation for the numerical treatment of linear static analysis of two-layer planar composite beams with interlayer slip is proposed. In this formulation, the modified principle of virtual work is introduced as a basis for the finite element discretization. The linear kinematic equations are included into the principle by the procedure, similar to that of Lagrangian multipliers. A strain field vector remains the only unknown function to be interpolated in the finite element implementation of the principle. In contrast with some of the displacement-based and mixed finite element formulations of the composite beams with interlayer slip, the present formulation is completely locking-free. Hence, there are no shear and slip locking, poor convergence and stress oscillations in these finite elements. The generalization of the composite beam theory with the consideration of the Timoshenko beam theory for the individual component of a composite beam represents a substantial contribution in the field of analysis of non-slender composite beams with an interlayer slip. An extension of the present formulation to the non-linear material problems is straightforward. As only a few finite elements are needed to describe a composite beam with great precision, the new finite element formulations is perfectly suited for practical calculations. (c) 2007 Elsevier B.V. All rights reserved

Validation of key behaviourally based mental health diagnoses in administrative data: suicide attempt, alcohol abuse, illicit drug abuse and tobacco use

<p>Abstract</p> <p>Background</p> <p>Observational research frequently uses administrative codes for mental health or substance use diagnoses and for important behaviours such as suicide attempts. We sought to validate codes (<it>International Classification of Diseases, 9^thedition, clinical modification </it>diagnostic and E-codes) entered in Veterans Health Administration administrative data for patients with depression versus a gold standard of electronic medical record text ("chart notation").</p> <p>Methods</p> <p>Three random samples of patients were selected, each stratified by geographic region, gender, and year of cohort entry, from a VHA depression treatment cohort from April 1, 1999 to September 30, 2004. The first sample was selected from patients who died by suicide, the second from patients who remained alive on the date of death of suicide cases, and the third from patients with a new start of a commonly used antidepressant medication. Four variables were assessed using administrative codes in the year prior to the index date: suicide attempt, alcohol abuse/dependence, drug abuse/dependence and tobacco use.</p> <p>Results</p> <p>Specificity was high (≥ 90%) for all four administrative codes, regardless of the sample. Sensitivity was ≤75% and was particularly low for suicide attempt (≤ 17%). Positive predictive values for alcohol dependence/abuse and tobacco use were high, but barely better than flipping a coin for illicit drug abuse/dependence. Sensitivity differed across the three samples, but was highest in the suicide death sample.</p> <p>Conclusions</p> <p>Administrative data-based diagnoses among VHA records have high specificity, but low sensitivity. The accuracy level varies by different diagnosis and by different patient subgroup.</p

Demographic and Clinical Variation in Veterans Health Administration Provision of Assistive Technology Devices to Veterans Poststroke

Objectives: To examine variation in provision of assistive technology (AT) devices and the extent to which such variation may be explained by patient characteristics or Veterans Health Administration (VHA) administrative region. Design: Retrospective population-based study. Setting: VHA. Participants: Veterans poststroke in fiscal years 2001 and 2002 (N=12,046). Interventions: Not applicable. Main Outcome Measure: Provision of 8 categories of AT devices. Results: There was considerable regional variation in provision of AT. For example, differences across administrative regions in the VHA ranged from 5.1 to 28.1 standard manual wheelchairs per 100 veterans poststroke. Using logistic regression, with only demographic variables as predictors of standard manual wheelchair provision, the c statistic was .62, and the pseudo R2 was 2.5%. Adding disease severity increased the c statistic to .67 and the pseudo R2 to 6.2%, and adding Veteran Integrated Network System further increased the c statistic to .72 and pseudo R2 to 9.8%. Conclusions: Our research showed significant variation in the provision of AT devices to veterans poststroke, and it showed that patient characteristics accounted for only 6.2% of the variation. VHA administrative region and disability severity accounted for equivalent amounts of the variation

Gadolinium and nephrogenic systemic fibrosis: time to tighten practice

Nephrogenic systemic fibrosis (NSF) is a relatively new entity, first described in 1997. Few cases have been reported, but the disease has high morbidity and mortality. To date it has been seen exclusively in patients with renal dysfunction. There is an emerging link with intravenous injection of gadolinium contrast agents, which has been suggested as a main triggering factor, with a lag time of days to weeks. Risk factors include the severity of renal impairment, major surgery, vascular events and other proinflammatory conditions. There is no reason to believe that children have an altered risk compared to the adult population. It is important that the paediatric radiologist acknowledges emerging information on NSF but at the same time considers the risk:benefit ratio prior to embarking on alternative investigations, as children with chronic kidney disease require high-quality diagnostic imaging

Diagnostics and data fusion of robotic sensors

Robotic systems for remediation of hazardous waste sites must be highly reliable to avoid equipment failures and subsequent possible exposure of personnel to hazardous environments. Safe, efficient cleanup operations also require accurate, complete knowledge of the task space. This paper presents progress made on a 18 month program to meet these needs. To enhance robot reliability, a conceptual design of a monitoring and diagnostic system is being developed to predict the onset of mechanical failure modes, provide maximum lead time to make operational changes or repairs, and minimize the occurrence of on-site breakdowns. To ensure safe operation, a comprehensive software package is being developed that will fuse data from multiple surface mapping sensors and poses so as to reduce the error effects in individual data points and provide accurate 3-D maps of a work space

Long-Term Changes in Physical Activity Following a One-Year Home-Based Physical Activity Counseling Program in Older Adults with Multiple Morbidities

This study assessed the sustained effect of a physical activity (PA) counseling intervention on PA one year after intervention, predictors of sustained PA participation, and three classes of post-intervention PA trajectories (improvers, maintainers, and decliners) in 238 older Veterans. Declines in minutes of PA from 12 to 24 months were observed for both the treatment and control arms of the study. PA at 12 months was the strongest predictor of post-intervention changes in PA. To our surprise, those who took up the intervention and increased PA levels the most, had significant declines in post-intervention PA. Analysis of the three post-intervention PA trajectories demonstrated that the maintenance group actually reflected a group of nonresponders to the intervention who had more comorbidities, lower self-efficacy, and worse physical function than the improvers or decliners. Results suggest that behavioral counseling/support must be ongoing to promote maintenance. Strategies to promote PA appropriately to subgroups of individuals are needed