Management of traumatic pancreatic transection – experience in a single surgical unit

Introduction: Pancreatic transection (PT) is a rare entity of pancreatic injury encountered following blunt abdominal trauma. Management of PT is controversial and treatment depends on patient’s injury status, facilities and expertise available for diagnosis and treatment. Isolated PT is a diagnostic challenge. We present four patients with PT following blunt trauma, their management and outcome.Case report: Case-1 A 24-year old male presented four months after blunt trauma to abdomen with a bicycle-handle, with abdominal pain & distension. CT showed pseudocyst communicating with main pancreatic duct and lacerated neck of pancreas. Pancreatic duct was stented at endoscopic-retrograde-cholangio-pancreatography (ERCP) and patient recovered. Case-2 A 26-year old male presented with acute abdomen following road-traffic-accident underwent emergency exploratory laparotomy. PT was initially managed conservatively. Pancreatic duct was stented at ERCP. Patient later developed a pseudocyst and elective distal-pancreatectomy is planned. Case-3 A 26-year old male with acute abdomen following road-traffic-accident underwent exploratory laparotomy at a Provincial General Hospital. PT identified and distal pancreatic segment anastomosed to a jejunal-loop. Patient deteriorated post-operatively and transferred. Re-exploration revealed necrosed distal pancreas with anastomotic leakage. Patient succumbed due to acute severe pancreatitis and multi-organ failure. Case-4 A 27-year old male with acute abdomen following run-over injury underwent exploratory laparotomy and distal pancreatectomy performed. Patient had an uneventful recovery.Discussion: High-index of suspicion is needed for the mechanism of initial injury when diagnosing isolated pancreatic injury which presents late. ERCP is safe and reliable when treating stable patients with PT. Damage control surgery is recommended than reconstructive surgery in unstable patients

Dissipation curve of imazapyr in irrigation water drain subsequently to its application to control cattail

O herbicida sistêmico imazapyr foi usado no controle da taboa (Typha subulata Crespo & Peres-Moreau f.) em drenos de irrigação, como alternativa ao controle mecânico. O resíduo do princípio ativo do herbicida na água foi analisado por cromatografia líquida de alta performance (HPLC). A curva de dissipação de imazapyr mostrou que o herbicida pode ser usado para o controle de taboa em drenos de irrigação, sem causar danos a culturas vizinhas, desde que a água seja usada, no mínimo, depois de 1,6 a 3,7 dias da aplicação das doses de 500 a 1500 g ha-1, respectivamente.Imazapyr, a systemic herbicide, was used to control cattail (Typha subulata Crespo & Peres-Moreau f.) in irrigation project drains as an alternative for mechanical control. Residue of this herbicide was analysed in water by high performance liquid chromatography (HPLC). Imazapyr dissipation curve with applied doses ranging from 500 to 1500 g ha-1 showed that it could be used to control cattail without injuring neighbor crops, as long as water drain be used at least 1.6 to 3.7 days after application

Whole-genome sequencing reveals host factors underlying critical COVID-19

Critical COVID-19 is caused by immune-mediated inflammatory lung injury. Host genetic variation influences the development of illness requiring critical care1 or hospitalization2,3,4 after infection with SARS-CoV-2. The GenOMICC (Genetics of Mortality in Critical Care) study enables the comparison of genomes from individuals who are critically ill with those of population controls to find underlying disease mechanisms. Here we use whole-genome sequencing in 7,491 critically ill individuals compared with 48,400 controls to discover and replicate 23 independent variants that significantly predispose to critical COVID-19. We identify 16 new independent associations, including variants within genes that are involved in interferon signalling (IL10RB and PLSCR1), leucocyte differentiation (BCL11A) and blood-type antigen secretor status (FUT2). Using transcriptome-wide association and colocalization to infer the effect of gene expression on disease severity, we find evidence that implicates multiple genes—including reduced expression of a membrane flippase (ATP11A), and increased expression of a mucin (MUC1)—in critical disease. Mendelian randomization provides evidence in support of causal roles for myeloid cell adhesion molecules (SELE, ICAM5 and CD209) and the coagulation factor F8, all of which are potentially druggable targets. Our results are broadly consistent with a multi-component model of COVID-19 pathophysiology, in which at least two distinct mechanisms can predispose to life-threatening disease: failure to control viral replication; or an enhanced tendency towards pulmonary inflammation and intravascular coagulation. We show that comparison between cases of critical illness and population controls is highly efficient for the detection of therapeutically relevant mechanisms of disease

Dissipation curve of imazapyr in irrigation water drain subsequently to its application to control cattail

O herbicida sistêmico imazapyr foi usado no controle da taboa (Typha subulata Crespo & Peres-Moreau f.) em drenos de irrigação, como alternativa ao controle mecânico. O resíduo do princípio ativo do herbicida na água foi analisado por cromatografia líquida de alta performance (HPLC). A curva de dissipação de imazapyr mostrou que o herbicida pode ser usado para o controle de taboa em drenos de irrigação, sem causar danos a culturas vizinhas, desde que a água seja usada, no mínimo, depois de 1,6 a 3,7 dias da aplicação das doses de 500 a 1500 g ha-1, respectivamente.Imazapyr, a systemic herbicide, was used to control cattail (Typha subulata Crespo & Peres-Moreau f.) in irrigation project drains as an alternative for mechanical control. Residue of this herbicide was analysed in water by high performance liquid chromatography (HPLC). Imazapyr dissipation curve with applied doses ranging from 500 to 1500 g ha-1 showed that it could be used to control cattail without injuring neighbor crops, as long as water drain be used at least 1.6 to 3.7 days after application.Em processament

Gene expression of estrogen and oxytocin receptors in the uterus of pregnant and parturient bitches

In the canine species, the precise mechanisms of pregnancy maintenance and the initiation of parturition are not completely understood. The expression of genes encoding the receptors for estrogen (ERα mRNA) and oxytocin (OTR mRNA) was studied in the endometrium and myometrium during pregnancy and parturition in dogs. Real-time PCR was performed to quantify the levels of ERα mRNA and OTR mRNA in the uterus of bitches during early (up to 20 days of gestation), mid (20 to 40 days) and late pregnancy (41 to 60 days), and parturition (first stage of labor). All tissues expressed ERα and OTR mRNA, and are thus possibly able to respond to eventual estrogen and oxytocin hormonal stimuli. No statistically significant differences in the expression of ERα mRNA were verified in the endometrium and myometrium throughout pregnancy and parturition, but expression of OTR mRNA increased at both parturition and late pregnancy. We concluded that the increase of endometrial and myometrial OTR mRNA expression in dogs is not an event dependent on estrogenic stimulation. Moreover, the contractility response of the canine uterus to oxytocin begins during pregnancy and maintains myometrial activity. The expression of OTR mRNA in canine uterine tissues varied over time, which supports an interpretation that the sensitivity and response to hormone therapy varies during the course of pregnancy and labor. Further studies are needed to elucidate the factors underlying the synthesis of uterine oxytocin receptors and the possible role of ERβ rather than ERα in the uterine tissues during pregnancy and parturition in dogs