Contralateral Fracture of the Penis with Concomitant Urethral Injury – Report of a Rare Case

Penile refracture is a rare urological emergency, more so on the side contralateral to the previous fracture. A 55-year-old male was referred 70 hours after sudden detumescence during sexual intercourse, with a history of blood at the urethral meatus. The patient had had a fracture of the penis four years previously. Examination revealed ecchymosis and swelling of the proximal shaft and purulent discharge from a laceration in the penile skin over the proximal corpora. Ultrasonography revealed laceration of the right tunica albuginea and corpus cavernosum. Exploration revealed scar tissue at the site of the previous operation on the left side and a fresh laceration, 1cm in size, in the right corpus cavernosum in the mid shaft, and a urethral defect of 0.5 cm. The patient had normal erections post-operatively and no complications at 6 months followup. On literature review, anecdotal cases of contralateral refracture of the penis were found. High suspicion, prompt diagnosis and expedient surgical management are essential for a good outcome with minimal complication

A Multi-Center Assessment of Thyroid Function Test Precision in Chemiluminescence Immunoassay (CLIA) Systems

Background: Chemiluminiscence immunoassay (CLIA) is exclusively pragmatic technology for the analysis of biomarker for diagnosis of thyroid disorders. However, performance characteristics of different chemiluminescence immunoassay (CLIA) systems supplied by different manufacturers in diverse set up for thyroid function test (TFT) has not yet been studied well. Objective: Our aim is to evaluate laboratory results by assessment of the reproducibility and repeatability of TFTs in three different diagnostic set up to assure the quality of thyroid hormone assay using chemiluminescence immunoassay (CLIA) instruments: Advia Centaur CP (Siemens), Access 2 (Beckman Coulter) and Liaison (Diasorin). Materials and Methods: Among the adult male and female individuals visited for thyroid hormone assay, 51 normal individuals were selected for the study. Three aliquots of serum samples were distributed to assess the reproducibility of three different CLIA equipments operated in three diagnostic centers. Additional three aliquots of serum were analyzed weekly for TFT (fFT3, fFT4 and TSH) to check the repeatability of assay in ADVIA Centaur CP set up. Assay precision was determined by reproducibility and repeatability of test results. Results: Results of TFTs of serum samples obtained from three different interlaboratory assays using different CLIA systems have achieved good precision showing minimal variance (P>0.05) and acceptable reproducibility. Results are also precise with adequate repeatability showing minimal variance (P >0.05) obtained from the three different intra-laboratory assays in a single CLIA system using ADVIA Centaur CP by same team. Conclusion: Our study elucidates the thyroid hormone assay performance of CLIA systems in three centers, which has shown assay precision with good reproducibility and repeatability of thyroid hormone assay. Thus, the analysis of precision as an essential component of quality control is necessary to deliver precise diagnostic services

Australian Sphingidae – DNA Barcodes Challenge Current Species Boundaries and Distributions

© 2014 Rougerie et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. The attached file is the published version of the article

Persistence of anticancer activity in berry extracts after simulated gastrointestinal digestion and colonic fermentation

Fruit and vegetable consumption is associated at the population level with a protective effect against colorectal cancer. Phenolic compounds, especially abundant in berries, are of interest due to their putative anticancer activity. After consumption, however, phenolic compounds are subject to digestive conditions within the gastrointestinal tract that alter their structures and potentially their function. However, the majority of phenolic compounds are not efficiently absorbed in the small intestine and a substantial portion pass into the colon. We characterized berry extracts (raspberries, strawberries, blackcurrants) produced by in vitro-simulated upper intestinal tract digestion and subsequent fecal fermentation. These extracts and selected individual colonic metabolites were then evaluated for their putative anticancer activities using in vitro models of colorectal cancer, representing the key stages of initiation, promotion and invasion. Over a physiologically-relevant dose range (0–50 µg/ml gallic acid equivalents), the digested and fermented extracts demonstrated significant anti-genotoxic, anti-mutagenic and anti-invasive activity on colonocytes. This work indicates that phenolic compounds from berries undergo considerable structural modifications during their passage through the gastrointestinal tract but their breakdown products and metabolites retain biological activity and can modulate cellular processes associated with colon cancer

A study of empyema thoracis and role of intrapleural streptokinase in its management

BACKGROUND: Clinical spectrum, microbiology and outcome of empyema thoracis are changing. Intrapleural instillation of fibrinolytic agents is being increasingly used for management of empyema thoracis. The present study was carried out to describe the clinical profile and outcome of patients with empyema thoracis including those with chronic empyema and to study the efficacy and safety of intrapleural streptokinase in its management. METHODS: Clinical profile, etiological agents, hospital course and outcome of 31 patients (mean age 40 ± 16 years, M: F 25: 6) with empyema thoracis treated from 1998 to 2003 was analyzed. All patients were diagnosed on the basis of aspiration of frank pus from pleural cavity. Clinical profile, response to therapy and outcome were compared between the patients who received intrapleural streptokinase (n = 12) and those who did not (n = 19). RESULTS: Etiology was tubercular in 42% of the patients (n = 13) whereas the rest were bacterial. Amongst the patients in which organisms could be isolated (n = 13, 42%) Staphylococcus aureus was the commonest (n = 5). Intrapleural streptokinase was instilled in 12 patients. This procedure resulted in increase of drainage of pleural fluid in all patients. Mean daily pleural fluid drainage after streptokinase instillation was significantly higher for patients who received intrapleural streptokinase than those who did not (213 ml vs 57 ml, p = 0.006). Only one patient who was instilled streptokinase eventually required decortication, which had to be done in five patients (16.1%). Mean hospital stay was 30.2 ± 17.6 days whereas two patients died. CONCLUSIONS: Tubercular empyema is common in Indian patients. Intrapleural streptokinase appears to be a useful strategy to preserve lung function and reduce need for surgery in patients with late stage of empyema thoracis

Pulmonary hemorrhage syndrome associated with dengue fever, High-resolution computed tomography findings: a case report

Dengue hemorrhagic fever is an acute infectious disease caused by dengue virus. We described the high-resolution CT findings in a 70-year-old male with the disease, which was diagnosed by clinical examination and confirmed by serological methods. High-resolution CT demonstrated bilateral areas of consolidation with air bronchogram and ground glass opacities, as well as small bilateral pleural effusions. Dengue hemorrhagic fever should be considered in the differential diagnosis of diffuse pulmonary hemorrhage