Complete Healing of a Giant Wart in a Severely Immune-Compromised Patient with HIV Infection Treated with Acupuncture

Giant warts are infrequent dermatological viral infections caused by Papillomavirus (HPV) in immune-compromised patients. Treatment may often be difficult and unsatisfactory, either by surgery or cytotoxic agents, because of poor immune control of viral activity in such hosts. Here we report on the case of a patient with advanced and persistent immune suppression caused by HIV disease, who developed a monstrous wart covering the entirety of the radial district of his right hand. He was completely healed after a long treatment with traditional Chinese acupuncture, in spite of minimal immune recovery induced by efficacious antiretroviral therapy. To the best of our knowledge, therefore, the present report may be the first direct clinical evidence that acupuncture may be effective in the treatment of cutaneous warts also in HIV-infected patients

Unveiling Dust-enshrouded Star Formation in the Early Universe: a Sub-mm Survey of the Hubble Deep Field

The advent of sensitive sub-mm array cameras now allows a proper census of dust-enshrouded massive star-formation in very distant galaxies, previously hidden activity to which even the faintest optical images are insensitive. We present the deepest sub-mm survey of the sky to date, taken with the SCUBA camera on the James Clerk Maxwell Telescope and centred on the Hubble Deep Field. The high source density found in this image implies that the survey is confusion-limited below a flux density of 2 mJy. However, within the central 80 arcsec radius independent analyses yield 5 reproducible sources with S(850um) > 2 mJy which simulations indicate can be ascribed to individual galaxies. We give positions and flux densities for these, and furthermore show using multi-frequency photometric data that the brightest sources in our map lie at redshifts z~3. These results lead to integral source counts which are completely inconsistent with a no-evolution model, and imply that massive star-formation activity continues at redshifts > 2. The combined brightness of the 5 most secure sources in our map is sufficient to account for 30 - 50% of the previously unresolved sub-mm background, and we estimate statistically that the entire background is resolved at about the 0.3 mJy level. Finally we discuss possible optical identifications and redshift estimates for the brightest sources. One source appears to be associated with an extreme starburst galaxy at z~1, whilst the remaining four appear to lie in the redshift range 2 < z < 4. This implies a star-formation density over this redshift range that is at least five times higher than that inferred from the ultraviolet output of HDF galaxies.Comment: 19 pages, 6 figures (to appear as a Nature Article

A Submillimetre Survey of the Hubble Deep Field: Unveiling Dust-Enshrouded Star Formation in the Early Universe

The advent of sensitive sub-mm array cameras now allows a proper census of dust-enshrouded massive star-formation in very distant galaxies, previously hidden activity to which even the deepest optical images are insensitive. We present the deepest sub-mm survey, taken with the SCUBA camera on the James Clerk Maxwell Telescope (JCMT) and centred on the Hubble Deep Field (HDF). The high source density on this image implies that the survey is confusion-limited below a flux density of 2 mJy. However within the central 80 arcsec radius independent analyses yield 5 reproducible sources with S(850um) > 2 mJy which simulations indicate can be ascribed to individual galaxies. These data lead to integral source counts which are completely inconsistent with a no evolution model, whilst the combined brightness of the 5 most secure sources in our map is sufficient to account for 30-50% of the previously unresolved sub-mm background, and statistically the entire background is resolved at about the 0.3 mJy level. Four of the five brightest sources appear to be associated with galaxies which lie in the redshift range 2 < z < 4. With the caveat that this is a small sample of sources detected in a small survey area, these submm data imply a star-formation density over this redshift range that is at least five times higher than that inferred from the rest-frame ultraviolet output of HDF galaxies.Comment: to appear in the proceedings of `The Birth of Galaxies', Xth Rencontres de Blois, 4 pages, 1 postscript figure, uses blois.sty (included

Carotid endarterectomy impairs blood pressure homeostasis by reducing the physiologic baroreflex reserve

ObjectiveTo assess the impact of carotid endarterectomy on blood pressure homeostasis and baroreflex function, with particular reference to the presence or absence of significant contralateral carotid artery disease, we conducted a prospective study in 80 patients with symptomatic extracranial carotid disease undergoing carotid endarterectomy in a regional teaching hospital over 2 years.MethodsPatients were divided into two groups: the control group (n = 37) had no significant contralateral carotid disease; patients in the diseased group (n = 23) had either >70% stenosis or occlusion of the contralateral carotid artery. Seventeen patients with abnormal heart rhythms, poor quality recordings, or with intermediate degrees of contralateral carotid stenosis were excluded. Three patients who had previously undergone contralateral carotid endarterectomy were separately evaluated. Atheromatous plaque was removed from carotid lumen and the baroreflex mechanism received direct intraoperative stimulation before and after carotid endarterectomy. The main outcome measures were (1) the hemodynamic response to the carotid endarterectomy, baroreflex sensitivity, and operating set point (the resting blood pressure, which the baroreflex mechanism maintains) before and after removal of the atheromatous plaque, and (2) the responsiveness of the ipsilateral baroreceptor mechanism to direct stimulation. The impact of the presence of contralateral carotid stenosis on these variables was also evaluated.ResultsPatients in the two groups were comparable for preoperative demographic, medication, and hemodynamic variables. Carotid endarterectomy led to a rise in mean arterial pressure from 81.3 ± 3.9 mm Hg to 103.5 ± 4.6 mm Hg (P < .00001) and from 87.6 ± 4.3 mm Hg to 94.0 ± 4.5 mm Hg (P < .003) in the diseased and control groups, respectively. The magnitude of blood pressure response was significantly greater in the diseased group than in the control group (P < .00001). This hypertensive shift was not accompanied by the expected fall in heart rate. Direct baroreflex stimulation prior to carotid endarterectomy caused a significantly greater response in the diseased group, suggesting sensitization of the ipsilateral carotid baroreceptor in the presence of contralateral carotid disease. Furthermore, the baroreflex response was obliterated after endarterectomy. There were significant reductions in baroreflex sensitivity and a hypertensive shift in the operating set point, the magnitude of which was significantly greater in patients with contralateral carotid disease.ConclusionsCarotid endarterectomy impairs blood pressure homeostasis through surgical destruction of the ipsilateral carotid baroreflex mechanism. Patients with contralateral carotid stenosis have a reduced baroreflex reserve and show greater baroreflex dysfunction and hemodynamic instability after endarterectomy. These patients are at greater risk of postendarterectomy complications and should be monitored closely

Feeding of soy protein isolate to rats during pregnancy and lactation suppresses formation of aberrant crypt foci in their progeny's colons: interaction of diet with fetal alcohol exposure

Soy protein isolate (SPI) in the diet may inhibit colon tumorigenesis. We examined azoxymethane (AOM)-induced aberrant crypt foci (ACF) in male rats in relation to lifetime, pre-weaning, or post-weaning dietary exposure to SPI and also within the context of fetal alcohol exposure. Pregnant Sprague Dawley rats were fed AIN-93G diets containing casein (20%, the control diet) or SPI (20%) as the sole protein source starting on gestation day 4 (GD 4). Progeny were weaned on postnatal day (PND) 21 to the same diet as their dams and were fed this diet until termination of the experiment at PND 138. Rats received AOM on PND 89 and 96. Lifetime (GD 4 to PND 138) feeding of SPI led to reduced frequency of ACF with 4 or more crypts in the distal colon. Progeny of dams fed SPI only during pregnancy and lactation or progeny fed SPI only after weaning exhibited similarly reduced frequency of large ACF in distal colon. Number of epithelial cells, in the distal colon, undergoing apoptosis was unaffected by diet. SPI reduced weight gain and adiposity, but these were not correlated with fewer numbers of large ACF. Lifetime SPI exposure similarly inhibited development of large ACF in Sprague Dawley rats whose dams were exposed to ethanol during pregnancy. In summary, feeding of SPI to rat dams during pregnancy and lactation suppresses numbers of large ACF in their progeny, implying a long-term or permanent change elicited by the maternal diet. Moreover, results support the use of ACF as an intermediate endpoint for elucidating effects of SPI and its biochemical constituents in colon cancer prevention in rats

Ecological performance differs between range centre and trailing edge populations of a cold-water kelp:implications for estimating net primary productivity

Kelp forests are extensive, widely distributed and highly productive. However, despite their importance, reliable estimates of net primary productivity (NPP) are currently unknown for most species and regions. In particular, how performance and subsequent NPP change throughout a species range is lacking. Here, we attempted to resolve this by examining growth and performance of the boreal kelp, Laminaria digitata, from range centre and trailing edge regions in the United Kingdom. During the peak growth season (March/April), range-centre individuals were up to three times heavier and accumulated biomass twice as fast as their trailing-edge counterparts. This was not apparent during the reduced growth season (August/September), when populations within both regions had similar biomass profiles. In total, annual NPP estimates were considerably lower for trailing-edge (181±34 g C m−2 year−1) compared to range-centre (344±33 g C m−2 year−1) populations. Our first-order UK estimates of total standing stock and NPP for L. digitata suggest this species makes a significant contribution to coastal carbon cycling. Further work determining the ultimate fate of this organic matter is needed to understand the overall contribution of kelp populations to regional and global carbon cycles. Nevertheless, we highlight the need for large-scale sampling across multiple populations and latitudes to accurately evaluate kelp species’ contributions to coastal carbon cycling

The dusty environment of Quasars. Far-IR properties of Optical Quasars

We present the ISO far-IR photometry of a complete sub-sample of optically selected bright quasars belonging to two complete surveys selected through multicolour (U,B,V,R,I) techniques. The ISOPHOT camera on board of the ISO Satellite was used to target these quasars at wavelengths of 7.3, 11.5, 60, 100 and 160 micron. Almost two thirds of the objects were detected at least in one ISOPHOT band. The detection rate is independent of the source redshift, very likely due to the negative K-correction of the far-IR thermal emission. More than a half of the optically selected QSOs show significant emission between 4 and 100 micron in the quasar rest-frame. These fluxes have a very likely thermal origin, although in a few objects an additional contribution from a non-thermal component is plausible in the long wavelength bands. In a colour-colour diagram these objects span a wide range of properties from AGN-dominated to ULIRG-like. The far-IR composite spectrum of the quasar population presents a broad far-IR bump between 10 and 30 micron and a sharp drop at wavelengths greater than 100 micron in the quasar restframe. The amount of energy emitted in the far-IR, is on average a few times larger than that emitted in the blue and the ratio L(FIR)/L(B) increases with the bolometric luminosity. Objects with fainter blue magnitudes have larger ratios between the far-IR (wavelengths > 60 micron) fluxes and the blue band flux, which is attributed to extinction by dust around the central source. No relation between the blue absolute magnitude and the dust colour temperature is seen, suggesting that the dominant source of FIR energy could be linked to a concurrent starburst rather than to gravitational energy produced by the central engine.Comment: Astronomical Journal, in pres

Short-term health and social impacts of energy-efficiency investments in low-income communities: a controlled field study

Background During 2012–15, £45 million was invested to improve the energy-efficiency of 4800 houses in low-income areas across Wales. Houses received measures such as external wall insulation, new windows and doors, upgrades to the heating system, and connection to the gas network. This study aimed to establish the short-term health and social impacts of these investments. Methods A quasi-experimental field study with a controlled, before and after design was conducted (364 individuals in improved houses [intervention], 418 in houses with no improvements [control]). Any adult living in 24 selected intervention areas and matched control areas (n=23) was eligible for inclusion. Self-completed questionnaires, administered via a drop-off-and-collect method, were collected in the winter months (December to February) before and after installation of the energy efficiency measures. Health outcomes were mental health composite scale (MCS) and physical health composite scale (PCS) scores of the SF-12v2, SF-6D utility scores derived from the SF-12v2, self-reported respiratory symptoms, and subjective wellbeing. Social outcomes were financial difficulties and stress, food security, thermal comfort, housing conditions, and social isolation. The study used measures validated in previous research. Linear, ordered multinomial, and logistic multilevel models were constructed with measurement occasions nested within individuals. Findings After controlling for sex, age, housing benefit, household income, and smoking status, we found that investments were not associated with improvements in MCS (B=0·00, 95% CI −1·60 to 1·60) or PCS (0·98, −0·34 to 2·28) scores, SF-6D utilities (−0·01, −0·04 to 0·02), or self-reported respiratory symptoms (−0·14, −0·54 to 0·26). However, people who received energy-efficiency measures reported improved subjective wellbeing compared with controls (B=0·38, 95% CI 0·12 to 0·65), and fewer financial difficulties (−0·15, −0·25 to −0·05); they reported higher thermal comfort (odds ratio 3·83, 95% CI 2·40 to 5·90), higher satisfaction with the improvement of their homes (3·87, 2·51 to 5·96), and less reluctance to invite friends or family to their homes (0·32, 0·13 to 0·77). Interpretation Although there is no evidence that energy-efficiency investments provide physical health benefits in the short term, they improve social and economic conditions that are conducive to better health. Longer term studies are needed to establish the health impacts of energy-efficiency investments

Seasonal variation in diagnosis of invasive cutaneous melanoma in Eastern England and Scotland.

BACKGROUND: Worldwide, the incidence of cutaneous melanoma has been reported to be highest in the summer and lowest in the winter. Northern Irish data suggested seasonal variation for women only, especially those with thinner melanomas, sited on limbs. We interrogated two larger UK cancer registries for temporal differences in melanoma diagnosis and associated patient characteristics. METHODS: Melanomas diagnosed from 2006 to 2010 in the Eastern England and Scottish cancer registries (n=11,611) were analysed by month of diagnosis, patient demographics and melanoma characteristics, using descriptive and multivariate modelling methods. RESULTS: More patients with melanoma were diagnosed in the summer months (June 9.9%, July 9.7%, August 9.8%) than the winter months (December 7.2%, January 7.2%, February 7.1%) and this pattern was consistent in both regions. There was evidence that the seasonal patterns varied by sex (p=0.015), melanoma thickness (p=0.002), body site (p=0.006), and type (superficial spreading melanomas p=0.005). The seasonal variation was greatest for diagnosis of melanomas occurring on the limbs. CONCLUSION: This study has confirmed seasonal variation in melanoma diagnosis in Eastern England and Scotland across almost all population demographics and melanoma characteristics studied, with higher numbers diagnosed in the summer months, particularly on the limbs. Seasonal patterns in skin awareness and related help-seeking are likely to be implicated. Targeted patient interventions to increase sun awareness and encourage year-long skin inspection are warranted.The paper was materially supported by the National Institute for Health Research (NIHR-CS-012-030), supporting FMW through a Clinician Scientist award. The views expressed in this publication are those of the authors and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health. During this project, GL was supported by a post-doctoral fellowship by the National Institute for Health Research (PDF-2011-04-047) to the end of 2014; and by a Cancer Research UK Clinician Scientist Fellowship award (A18180) from March 2015.This is the final version of the article. It first appeared from Elsevier via http://dx.doi.org/10.1016/j.canep.2015.06.00