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Not AvailableTraditionally, fish species identification is based on morphological characters, yet, in many cases it is difficult to establish identity as in the case of seahorses which lack key species-diagnostic morphological features. The spotted or yellow seahorse - Hippocampus kuda has a complex identity and the samples collected from the east and west coasts of India were analyzed for the species identification and phylogenetic relationship, based on partial sequence information of mitochondrial genes - 16S rRNA and Cytochrome Oxidase subunit I (COI). Estimates of genetic divergence with both 16S rRNA and COI genes, when compared with the sequence divergence values of H. kuda from other continents (as obtained from NCBI accessions) were sufficient enough to discriminate individuals of the same species from Indian waters. Pair-wise fST values using AMOVA indicated significant levels of genetic differentiation of H. kuda populations among east coast, Kerala and Konkan populations; however, no significant genetic partitioning was observed between the Palk Bay and Gulf of Mannar populations.Not Availabl

Prevalence of the double-line sign when performing focused assessment with sonography in trauma (FAST) examinations

The double-line sign (DLS) is a wedge-shaped hypoechoic area in Morison\u27s pouch bounded on both sides by echogenic lines. It represents a false-positive finding for free intraperitoneal fluid when performing focused assessment with sonography in trauma examinations. The purpose of this study was to determine the prevalence of DLS. Secondarily, the study will further investigate the relationship between the presence of a DLS and body mass index (BMI). This was a prospective study that enrolled patients over a 7-month period. Inclusion criteria were patients a parts per thousand yen18 years of age presenting to the Emergency Department (ED) requiring a FAST examination as part of the patient\u27s standard medical care. Each examination was performed by one of six experienced ultrasonographers. Presence or absence of the DLS was established in real time and gender, height, weight, and BMI were recorded for each patient. The overall prevalence rate of DLS and the corresponding 95 % confidence interval were calculated, as well as the prevalence rates broken down by BMI characterized as underweight, normal weight, overweight, and obese; and age category (18-29, 30-64, and 65+). The Chi-square test and a Fisher\u27s exact test for BMI category were used to compare the prevalence rates of positive DLS among the different demographic groups. 100 patients were enrolled in the study; the overall prevalence was 27 %. There was no statistical significance among the different demographic groups or BMI. The DLS is a prevalent finding. We believe this sign has become more apparent due to improved imaging technology and resolution

Prostate cancer disparities in South Carolina: early detection, special programs, and descriptive epidemiology.

Available evidence suggests that there may be qualitative differences in the natural history of PrCA by race. If this is true then additional etiologic research is needed to identify places in the causal chain where we can intervene to lower PrCA rates in AA men. South Carolina may prove to be a useful context in which to study prostate cancer etiology, because of the presence of unique environmental exposures. For example, soil selenium and cadmium concentrations unique to South Carolina might have a differential affect in the rural areas of the state where ground water use is more common and where AAs are more likely to live. These metals are important in terms of prostate metabolism and cancer. The possible interaction of geological factors with underlying biological factors such as metal transporter gene expression by race needs to be explored in South Carolina. Diet and exercise are consistently seen as possible primary prevention strategies for prostate and other cancers, as noted above. There may be very good reasons to intervene on diet and physical activity, but if the intention is to make a health claim with real, specific meaning for PrCA prevention and control then studies must be designed to test the effect of these modalities in rigorous ways at specific points in the natural history of prostate carcinogenesis. Nutrition and exercise programs need to be developed in South Carolina that are seen as acceptable by people at risk of PrCA; and they will need to focus on effective ways to prevent the development of PrCA, other cancers, and other health outcomes. Implementing diet and nutrition programs in rural parts of the state, possibly through schools or churches, offer benefit to both youth and adults alike. So, it would be possible, indeed it would be desirable, to create programs that may be used for research in one part of the population (e.g., men with PrCA), but are equally beneficial for others (e.g., their spouses and children). Organizing studies that can focus on promising new areas of research and changing the paradigms under which the research community currently operates probably will require re-conceptualizing research strategies employing methods that entail CBPR approaches. Because much of South Carolina's African-American population resides in rural parts of the state, outreach presents a challenge for both researchers and clinicians. Individuals living in rural areas are more likely than urban residents to live in poverty, report poorer health status, and not have private health insurance. Americans living in rural areas face disparities in access to basic public health services compared to those living in metropolitan areas. In very practical ways, local public health departments are absent in many rural communities, and rural hospitals continue to close, removing needed services. Closing of public hospitals has been shown to significantly increase the percentage of people without a primary health care provider as well as the percentage of people denied care. Public health departments are of particular importance to rural residents as they serve as the main avenue for public health and clinical care for this group. Issues such as access to care, lack of frequent physician's visits and quality of medical care have a negative impact on outcomes for men with PrCA, particularly in relationship to staging. If better outcomes are to be achieved in South Carolina, then more must be done to reach the community and provide better access to care in more rural areas of the state. Small media interventions, such as those presented in churches and barbershops may be an effective means for reaching the rural AA population. Our ability to reach out to and interact with the high-risk pockets in the state will be necessary for screening, treatment, and research (which, if conducted competently, will affect screening efficacy, treatment effectiveness, and primary prevention). It is believed that currently available decision-making materials for PrCA screening may not be appropriate due to socioeconomic as well as health literacy differences present in all male groups. It is unclear whether men in the lower socioeconomic groups are given appropriate information that allows them to make educated, informed decisions around PrCA screenings. Considering the number of males in the lower socioeconomic groups in South Carolina and the large AA male population, research evaluating the appropriateness of the existing materials could have an impact --both within the state and in national efforts. Patient education is a promising strategy, but educating the patient in the context of his family seems to be a more effective strategy for this population. Family networks and faith-based networks offer a strong support base for the patient when making health-related decisions, particularly for the African-American male. In collaboration with the SCCDCN, the South Carolina Cancer Alliance (SCCA) is currently developing a proposal to create a decision guide for prostate screening that is targeted toward the African-American male. The SCCA plans to pilot test new, culturally appropriate materials in the Low Country of South Carolina because of its comparatively large African-American population and its high rate of residential stability. South Carolina is one of only a few states to adopt expanded Medicaid coverage for the treatment of breast cancer. PrCA needs to receive equal recognition. This year alone in South Carolina 3,290 women will be diagnosed with breast cancer and 630 will die from the disease. Likewise, the American Cancer Society estimated 3,770 men in South Carolina would be diagnosed with prostate cancer and 440 will die from the disease in 2006. The 1 million dollars set aside in South Carolina budget by lawmakers for treatment of breast and cervical cancer patients makes no mention of prostate cancer, which is an unfair omission. Finally, there currently exists a number of high-quality PrCA treatment, research, and referral resources in the state. Collaborations across agencies, institutes and organizations throughout South Carolina would prove to be beneficial in reaching the most rural (and therefore hardest to reach) populations. Collaborative arrangements will be pursued to increase positive outcomes and better futures for South Carolinians

Saline Flush Test Can Bedside Sonography Replace Conventional Radiography for Confirmation of Above-the-Diaphragm Central Venous Catheter Placement?

Objectives Resuscitation often requires rapid vascular access via central venous catheters. Chest radiographyis the reference standard to confirm central venous catheter placement and exclude complications. However, radiographs are often untimely. The purpose of this study was to determine whether dynamic sonographic visualization of a saline flush in the right side of the heart after central venous catheter placement could serve as a more rapid confirmatory study for above-the-diaphragm catheter placement. Methods A consecutive prospective enrollment study was conducted in the emergency departments of 2 major tertiary care centers. Adult patients of the study investigators who required an above-the-diaphragm central venous catheter were enrolled during the study period. Patients had a catheter placed with sonographic guidance. After placement of the catheter, thoracic sonography was performed. The times for visualization of the saline flush in the right ventricle and sonographic exclusion of ipsilateral pneumothorax were recorded. Chest radiography was performed per standard practice. Results Eighty-one patients were enrolled; 13 were excluded. The mean catheter confirmation time by sonography was 8.80 minutes (95% confidence interval, 7.46-10.14 minutes). The mean catheter confirmation time by chest radiograph availability for viewing was 45.78 minutes (95% confidence interval, 37.03-54.54 minutes). Mean sonographic confirmation occurred 36.98 minutes sooner than radiography (