2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS guideline for the diagnosis and management of patients with stable ischemic heart disease

The recommendations listed in this document are, whenever possible, evidence based. An extensive evidence review was conducted as the document was compiled through December 2008. Repeated literature searches were performed by the guideline development staff and writing committee members as new issues were considered. New clinical trials published in peer-reviewed journals and articles through December 2011 were also reviewed and incorporated when relevant. Furthermore, because of the extended development time period for this guideline, peer review comments indicated that the sections focused on imaging technologies required additional updating, which occurred during 2011. Therefore, the evidence review for the imaging sections includes published literature through December 2011

BIOPROCESSING - PERSPECTIVES ON BIOPROCESSING II

Like Martin, my perspective on bioprocessing is broad and has largely been shaped by my career experiences within the biopharmaceutical industries of Australia and the US, as well as my academic experiences. It is also an area that we are focusing on within the newly formed Fermentation and Bioprocessing Group (FBG) at CSIRO Molecular Science in Clayton..

Immobilized metal ion affinity chromatography of proteins

No summary available

Purification and characterisation of a 4-hydroxy benzaldehyde dehydrogenase cloned from Acinetobacter baylyi

4-Hydroxy benzaldehyde dehydrogenase catalyses a step in a well-studied pathway for the catabolism of 4-hydroxy-substituted cinnamates in Acinetobacter baylyi, oxidising a benzaldehyde group to the corresponding benzoic acid, with the concomitant reduction of NAD+ to NADH. Although much genetic and in vivo data for the enzyme have been presented, there have been no reports of the purification and in vitro characterisation of this enzyme. In this work, 4-hydroxy benzaldehyde dehydrogenase from A. baylyi was cloned to incorporate a hexahistidine affinity tag, heterologously expressed in Escherichia coli, purified and characterised. The enzyme was found to be stable up to 45 °C, losing only 25% of its activity over 9 h at this temperature. NAD+ was the preferred cofactor. The enzyme was found to act on a number of benzaldehyde substrates, and steady-state kinetics suggested that 4-hydroxy and 3,4-dihydroxy benzaldehydes were preferred substrates to benzaldehyde, or 4-hydroxy 3-methoxy benzaldehyde (vanillin)

Hematometra presenting as an acute abdomen in a 13-year-old postmenarchal girl: a case report

Introduction Most underlying diseases for abdominal pain in children are not dangerous. However some require rapid diagnosis and treatment, such as acute ovarian torsion or appendicitis. Since reaching a diagnosis can be difficult, and delayed treatment of potentially dangerous diseases might have significant consequences, exploratory laparoscopy is a diagnostic and therapeutic option for patients who have unclear and potentially hazardous abdominal diseases. Here we describe a case where the anomaly could not be identified using a laparoscopy in an adolescent girl with acute abdomen. Case presentation A 13-year old postmenarchal caucasian female presented with an acute abdomen. Emergency sonography could not exclude ovarian torsion. Accurate diagnosis and treatment were achieved only after an initial laparoscopy followed by a laparotomy and after a magnetic resonance imaging scan a further laparotomy. The underlying disease was hematometra of the right uterine horn in a uterus didelphys in conjunction with an imperforate right cervix. Conclusion This report demonstrates that the usual approach for patients with acute abdominal pain may not be sufficient in emergency situations

The syndromology of anorectal malformations revisited: from patterns of associated malformations to the recognition of syndromes

ackground: Although the frequency of associated malformation is high, the incidence of inheritable syndromes is widely underestimated in children with anorectal malformation (ARM). Data sources: OMIM database, patient records and charts of the Department of Pediatric Surgery, Johannes Gutenberg-University, Mainz, Germany. Methods: We analyzed all associations, sequences and syndromes listed in the OMIM database that can be accompanied by ARM. A large cohort of children born with ARM was then retrospectively investigated as to the type of ARM, presence of additional malformations and possible categorization as a syndrome, sequence or association. For this process a syndrome finder was developed and employed. This simplistic tool allows for a rapid first check of possible syndromes before a more complex analysis is started using the OMIM database and consulting specialists. Results: Among 317 children with ARM, associated malformations were present in 77.7% of 127 children with high ARM, in 68.7% of 32 with intermediate ARM, and in 25.3% of 158 with a low type ARM. Three or more organ systems were involved in 29.1% children with high type ARM and 25% with intermediate ARM and 8.2% with a low type ARM. An association of the vertebral anal tracheo-esophageal renal (VATER) and vertebral anal cardiac tracheo-esophageal renal limb (VACTERL) type was found in a total of 35 patients. Before analysis, 11 syndromes and 35 associations which were not clear previously in this patient cohort were described. In other 17 patients, 14 syndromes and 3 associations were identified. Conclusions: The high number of only retrospectively identified syndromes suggests that a routine search is necessary in every patient with ARM and additional malformations

Microbial biotransformations: Steroselective synthesis of pharmaceutical drug precursors

Biotransformations are becoming increasingly popular in the production of enantio- and regiopure- intermediates for synthesis of complex organic compounds. Whole microbial cells or enzymes can be used to carry out such specific chemical reactions that are otherwise difficult to achieve synthetically. Chemoenzymatic synthesis is of particular interest in the pharmaceutical industry where some steps can be carried out enzymatically to obtain chiral synthons for further enzymatic/chemical processing. In this report, we discuss some recent developments in the field together with a few examples

BIOPROCESSING - MICROBIAL BIOTRANSFORMATIONS: STEREOSELECTIVE SYNTHESIS OF PHARMACEUTICAL DRUG PRECURSORS

Biotransformations are becoming increasingly popular in the production of enantio- and regiopure- intermediates for synthesis of complex organic compounds. Whole microbial cells or enzymes can be used to carry out such specific chemical reactions that are otherwise difficult to achieve synthetically. Chemoenzymatic synthesis is of particular interest in the pharmaceutical industry where some steps can be carried out enzymatically to obtain chiral synthons for further enzymatic/chemical processing. In this report, we discuss some recent developments in the field together with a few examples

Handlebar injuries in children

Introduction: Handlebar injuries in children may lead to severe organ lesions despite minimal initial signs and without visible skin bruise. We present our experiences applying a diagnostic and therapeutic algorithm for blunt abdominal trauma, and present the history of two selected cases. Materials and methods: We retrospectively assessed the charts of children below 16 years of age, only who were observed for 24 h or more in our institution due to a handlebar injury between 2004 and 2011. All children were treated according to an institutional algorithm. Results: 40 patients with a median age of 9.5 years were included. Diagnosed lesions were: ruptures of the liver (n = 6), spleen (n = 5), kidney (n = 1), and pancreas (n = 2), small bowel perforation (n = 3), and hernias of the abdominal (n = 2) or thoracic wall (n = 1). Surgical interventions were performed in 8 patients. The outcome was favorable in all the cases. Overall median hospitalization duration was 4.5 days (range 1–19 days). The overall duration between the accident and arrival at our emergency unit was 2.75 h (median, range 1–19 h). 20 children presented directly at our emergency unit after a median of 1.7 h (range 1–19.5 h). 20 children were referred by a family physician or a primary hospital after a median of 4.0 h (range 1–46 h). Conclusion: Handlebar injuries in children resulted in serious trunk lesions in half of the present patient series. The spectrum of injuries in handlebar accidents varies widely, especially injuries to the abdomen can unmask often only in the course. We advocate close observation of patients with thoracic and abdominal handlebar injuries which may be regarded as blunt stab wounds. An institutional algorithm for blunt abdominal trauma management is supportive for emergency care in patients with handlebar injuries