Outcome of Percutaneous Nephrostomy for the Management of Pyonephrosis

ObjectiveThe aim of this study was to evaluate the efficacy of percutaneous nephrostomy (PCN) drainage for the interim management of pyonephrosis.MethodsNinety-two consecutive patients (29 men, 63 women; mean age, 57 years; range, 23-88) who underwent PCN for the treatment of pyonephrosis from 1996 to 1999 were evaluated retrospectively. The clinical presentation, bacteriology and patient outcomes were analyzed.ResultsThe majority (77%) of patients had underlying obstructing urinary calculi. Other causes of obstruction included strictures (9%), papillary necrosis (7%), pelvi-ureteric junction obstruction (4%) and malignant stricture (3%). The microorganisms cultured were Escherichia coli (30%), Klebsiella (19%), Proteus (8%), Pseudomonas (5%), Enterococcus (5%), and Candida spp (5%). The microorganisms were sensitive to gentamicin (79%), ceftriaxone (71%), cephalexin (54%), nitrofurantoin (40%), cotrimoxazole (35%), nalidixic acid (32%) and ampicillin (29%). Only 30% of bladder urine cultures were positive for microorganisms; the addition of PCN cultures improved this yield to 58%. The antibiotic regimen was revised according to the PCN culture whenever there was a discrepancy. After PCN, 69% of patients underwent minimally invasive procedures as definitive treatment of the obstructing lesion. Only 14% of patients required open surgery. There was low procedure-related morbidity (14%) and low overall mortality (2%).ConclusionsPCN cultures yield important bacteriological information. The procedure is associated with minimal morbidity, facilitates definitive treatment and provides therapeutic benefit. (Asian J Surg 2002;25(3):215-9

Fisher profiles and perceptions of sea turtle-fishery interactions: case study of East Coast Peninsular Malaysia

The paper focuses on coastal fisheries, particularly examining sea turtle-fishery interactions and determining the socioeconomic profile and perception of local fishers about sea turtle issues along the East Coast of Peninsular Malaysia.Turtle fisheries, Nature conservation, Coastal fisheries, Man-induced effects, ISEW, Malaysia, Malaya, Pahang, Malaysia, Malaya, Kelantan, Malaysia, Malaya, Terengganu,

The quantitative soil pit method for measuring belowground carbon and nitrogen stocks

Many important questions in ecosystem science require estimates of stocks of soil C and nutrients. Quantitative soil pits provide direct measurements of total soil mass and elemental content in depth-based samples representative of large volumes, bypassing potential errors associated with independently measuring soil bulk density, rock volume, and elemental concentrations. The method also allows relatively unbiased sampling of other belowground C and nutrient stocks, including roots, coarse organic fragments, and rocks. We present a comprehensive methodology for sampling these pools with quantitative pits and assess their accuracy, precision, effort, and sampling intensity as compared to other methods. At 14 forested sites in New Hampshire, nonsoil belowground pools (which other methods may omit, double-count, or undercount) accounted for upward of 25% of total belowground C and N stocks: coarse material accounted for 4 and 1% of C and N in the O horizon; roots were 11 and 4% of C and N in the O horizon and 10 and 3% of C and N in the B horizon; and soil adhering to rocks represented 5% of total B-horizon C and N. The top 50 cm of the C horizon contained the equivalent of 17% of B-horizon carbon and N. Sampling procedures should be carefully designed to avoid treating these important pools inconsistently. Quantitative soil pits have fewer sources of systematic error than coring methods; the main disadvantage is that because they are time-consuming and create a larger zone of disturbance, fewer observations can be made than with cores

Ethenzamide–gentisic acid–acetic acid (2/1/1)

In the title co-crystal solvate, 2-ethoxy­benzamide–2,5-dihydroxy­benzoic acid–ethanoic acid (2/1/1), 2C9H11NO2·C7H6O4·C2H4O2, two nonsteroidal anti-inflammatory drugs, ethenzamide (systematic name: 2-ethoxy­benzamide) and gentisic acid (systematic name: 2,5-dihydroxy­benzoic acid), together with acetic acid (systematic name: ethanoic acid) form a four-component mol­ecular assembly held together by N—H⋯O and O—H⋯O hydrogen bonds. This assembly features two symmetry-independent mol­ecules of ethenzamide, forming supra­molecular acid–amide heterosynthons with gentisic acid and acetic acid. These heterosynthons involve quite strong O—H⋯O [O⋯O = 2.5446 (15) and 2.5327 (15) Å] and less strong N—H⋯O [N⋯O = 2.9550 (17) and 2.9542 (17) Å] hydrogen bonds. The overall crystal packing features several C—H⋯O and π–π stacking inter­actions [centroid–centroid distance = 3.7792 (11) Å]

Serological response in RT-PCR confirmed h1n1-2009 influenza a by hemagglutination inhibition and virus neutralization assays: An observational study

10.1371/journal.pone.0012474PLoS ONE58

2009 Influenza A(H1N1) seroconversion rates and risk factors among distinct adult cohorts in Singapore

10.1001/jama.2010.404JAMA - Journal of the American Medical Association303141383-139

Impact of a TLR9 agonist and broadly neutralizing antibodies on HIV-1 persistence: the randomized phase 2a TITAN trial

Inducing antiretroviral therapy (ART)-free virological control is a critical step toward a human immunodeficiency virus type 1 (HIV-1) cure. In this phase 2a, placebo-controlled, double-blinded trial, 43 people (85% males) with HIV-1 on ART were randomized to (1) placebo/placebo, (2) lefitolimod (TLR9 agonist)/placebo, (3) placebo/broadly neutralizing anti-HIV-1 antibodies (bNAbs) or (4) lefitolimod/bNAb. ART interruption (ATI) started at week 3. Lefitolimod was administered once weekly for the first 8 weeks, and bNAbs were administered twice, 1 d before and 3 weeks after ATI. The primary endpoint was time to loss of virologic control after ATI. The median delay in time to loss of virologic control compared to the placebo/placebo group was 0.5 weeks (P = 0.49), 12.5 weeks (P = 0.003) and 9.5 weeks (P = 0.004) in the lefitolimod/placebo, placebo/bNAb and lefitolimod/bNAb groups, respectively. Among secondary endpoints, viral doubling time was slower for bNAb groups compared to non-bNAb groups, and the interventions were overall safe. We observed no added benefit of lefitolimod. Despite subtherapeutic plasma bNAb levels, 36% (4/11) in the placebo/bNAb group compared to 0% (0/10) in the placebo/placebo group maintained virologic control after the 25-week ATI. Although immunotherapy with lefitolimod did not lead to ART-free HIV-1 control, bNAbs may be important components in future HIV-1 curative strategies. ClinicalTrials.gov identifier: NCT03837756

Population differences in associations of serotonin transporter promoter polymorphism (5HTTLPR) di- and triallelic genotypes with blood pressure and hypertension prevalence

Based on prior research finding the 5HTTLPR L allele associated with increased cardiovascular reactivity to laboratory stressors and increased risk of myocardial infarction, we hypothesized that the 5HTTLPR L allele will be associated with increased blood pressure (BP) and increased hypertension prevalence in 2 large nationally representative samples in the United States and Singapore. Methods Logistic regression and linear models tested associations between triallelic (L′S′, based on rs25531) 5HTTLPR genotypes and hypertension severity and mean systolic and diastolic blood pressure (SBP and DBP) collected during the Wave IV survey of the National Longitudinal Study of Adolescent to Adult Health (Add Health, N = 11,815) in 2008–09 and during 2004–07 in 4196 Singaporeans. Results In US Whites, L′ allele carriers had higher SBP (0.9 mm Hg, 95% CI = 0.26-1.56) and greater odds (OR = 1.23, 95% CI = 1.10-1.38) of more severe hypertension than those with S′S′ genotypes. In African Americans, L′ carriers had lower mean SBP (−1.27 mm Hg, 95% CI = −2.53 to −0.01) and lower odds (OR = 0.78, 95% CI = 0.65-0.94) of more severe hypertension than those with the S′S′ genotype. In African Americans, those with L′L′ genotypes had lower DBP (−1.13 mm Hg, 95% CI = −2.09 to −0.16) than S′ carriers. In Native Americans, L′ carriers had lower SBP (−6.05 mm Hg, 95% CI = −9.59 to −2.51) and lower odds of hypertension (OR = 0.34, 95% CI = 0.13-0.89) than those with the S′S′ genotype. In Asian/Pacific Islanders those carrying the L′ allele had lower DBP (−1.77 mm Hg, 95% CI = −3.16 to −0.38) and lower odds of hypertension (OR = 0.68, 95% CI = 0.48-0.96) than those with S′S′. In the Singapore sample S′ carriers had higher SBP (3.02 mm Hg, 95% CI = 0.54-5.51) and DBP (1.90 mm Hg, 95% CI = 0.49-3.31) than those with the L′L′ genotype. Conclusions These findings suggest that Whites carrying the L′ allele, African Americans and Native Americans with the S′S′ genotype, and Asians carrying the S′ allele will be found to be at higher risk of developing cardiovascular disease and may benefit from preventive measures