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

The effects of mindfulness-based stress reduction program on the mental health of family caregivers: a randomized controlled trial

<b>Background</b> Caregivers of people with chronic conditions are more likely than non-caregivers to have depression and emotional problems. Few studies have examined the effectiveness of mindfulness-based stress reduction (MBSR) in improving their mental well-being. <p></p> <b>Methods</b> Caregivers of persons with chronic conditions who scored 7 or above in the Caregiver Strain Index were randomly assigned to the 8-week MBSR group (n = 70) or the self-help control group (n = 71). Validated instruments were used to assess the changes in depressive and anxiety symptoms, quality of life, self-efficacy, self-compassion and mindfulness. Assessments were conducted at baseline, post-intervention and at the 3-month follow-up. <p></p> <b>Results </b>Compared to the participants in the control group, participants in the MBSR group had a significantly greater decrease in depressive symptoms at post-intervention and at 3 months post-intervention (p < 0.01). The improvement in state anxiety symptoms was significantly greater among participants in the MBSR group than those of the control group at post-intervention (p = 0.007), although this difference was not statistically significant at 3 months post-intervention (p = 0.084). There was also a statistically significant larger increase in self-efficacy (controlling negative thoughts; p = 0.041) and mindfulness (p = 0.001) among participants in the MBSR group at the 3-month follow-up compared to the participants in the control group. No statistically significant group effects (MBSR vs. control) were found in perceived stress, quality of life or self-compassion. <p></p> <b>Conclusions </b>MBSR appears to be a feasible and acceptable intervention to improve mental health among family caregivers with significant care burden, although further studies that include an active control group are needed to make the findings more conclusive

Observation of hard scattering in photoproduction events with a large rapidity gap at HERA

Events with a large rapidity gap and total transverse energy greater than 5 GeV have been observed in quasi-real photoproduction at HERA with the ZEUS detector. The distribution of these events as a function of the $\gamma p$ centre of mass energy is consistent with diffractive scattering. For total transverse energies above 12 GeV, the hadronic final states show predominantly a two-jet structure with each jet having a transverse energy greater than 4 GeV. For the two-jet events, little energy flow is found outside the jets. This observation is consistent with the hard scattering of a quasi-real photon with a colourless object in the proton.Comment: 19 pages, latex, 4 figures appended as uuencoded fil

Collisionless and hydrodynamic excitations of trapped boson-fermion mixtures

Within a scaling ansatz formalism plus Thomas-Fermi approximation, we investigate the collective excitations of a harmonically trapped boson-fermion mixture in the collisionless and hydrodynamic limit at low temperature. Both the monopole and quadrupole modes are considered in the presence of spherical as well as cylindrically symmetric traps. In the spherical traps, the frequency of monopole mode coincides in the collisionless and hydrodynamic regime, suggesting that it might be undamped in all collisional regimes. In contrast, for the quadrupole mode, the frequency differs largely in these two limits. In particular, we find that in the hydrodynamic regime the quadrupole oscillations with equal bosonic and fermionic amplitudes generate an exact eigenstate of the system, regardless of the boson-fermion interaction. This resembles the Kohn mode for the dipole excitation. We discuss in some detail the behavior of monopole and quadrupole modes as a function of boson-fermion coupling at different boson-boson interaction strength. Analytic solutions valid at weak and medium fermion-boson coupling are also derived and discussed.Comment: 29 pages + 7 figures, resubmitted to Physical Review

Global, regional, and national age-sex-specific mortality and life expectancy, 1950–2017: a systematic analysis for the Global Burden of Disease Study 2017

BACKGROUND: Assessments of age-specific mortality and life expectancy have been done by the UN Population Division, Department of Economics and Social Affairs (UNPOP), the United States Census Bureau, WHO, and as part of previous iterations of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD). Previous iterations of the GBD used population estimates from UNPOP, which were not derived in a way that was internally consistent with the estimates of the numbers of deaths in the GBD. The present iteration of the GBD, GBD 2017, improves on previous assessments and provides timely estimates of the mortality experience of populations globally. METHODS: The GBD uses all available data to produce estimates of mortality rates between 1950 and 2017 for 23 age groups, both sexes, and 918 locations, including 195 countries and territories and subnational locations for 16 countries. Data used include vital registration systems, sample registration systems, household surveys (complete birth histories, summary birth histories, sibling histories), censuses (summary birth histories, household deaths), and Demographic Surveillance Sites. In total, this analysis used 8259 data sources. Estimates of the probability of death between birth and the age of 5 years and between ages 15 and 60 years are generated and then input into a model life table system to produce complete life tables for all locations and years. Fatal discontinuities and mortality due to HIV/AIDS are analysed separately and then incorporated into the estimation. We analyse the relationship between age-specific mortality and development status using the Socio-demographic Index, a composite measure based on fertility under the age of 25 years, education, and income. There are four main methodological improvements in GBD 2017 compared with GBD 2016: 622 additional data sources have been incorporated; new estimates of population, generated by the GBD study, are used; statistical methods used in different components of the analysis have been further standardised and improved; and the analysis has been extended backwards in time by two decades to start in 1950. FINDINGS: Globally, 18·7% (95% uncertainty interval 18·4–19·0) of deaths were registered in 1950 and that proportion has been steadily increasing since, with 58·8% (58·2–59·3) of all deaths being registered in 2015. At the global level, between 1950 and 2017, life expectancy increased from 48·1 years (46·5–49·6) to 70·5 years (70·1–70·8) for men and from 52·9 years (51·7–54·0) to 75·6 years (75·3–75·9) for women. Despite this overall progress, there remains substantial variation in life expectancy at birth in 2017, which ranges from 49·1 years (46·5–51·7) for men in the Central African Republic to 87·6 years (86·9–88·1) among women in Singapore. The greatest progress across age groups was for children younger than 5 years; under-5 mortality dropped from 216·0 deaths (196·3–238·1) per 1000 livebirths in 1950 to 38·9 deaths (35·6–42·83) per 1000 livebirths in 2017, with huge reductions across countries. Nevertheless, there were still 5·4 million (5·2–5·6) deaths among children younger than 5 years in the world in 2017. Progress has been less pronounced and more variable for adults, especially for adult males, who had stagnant or increasing mortality rates in several countries. The gap between male and female life expectancy between 1950 and 2017, while relatively stable at the global level, shows distinctive patterns across super-regions and has consistently been the largest in central Europe, eastern Europe, and central Asia, and smallest in south Asia. Performance was also variable across countries and time in observed mortality rates compared with those expected on the basis of development. INTERPRETATION: This analysis of age-sex-specific mortality shows that there are remarkably complex patterns in population mortality across countries. The findings of this study highlight global successes, such as the large decline in under-5 mortality, which reflects significant local, national, and global commitment and investment over several decades. However, they also bring attention to mortality patterns that are a cause for concern, particularly among adult men and, to a lesser extent, women, whose mortality rates have stagnated in many countries over the time period of this study, and in some cases are increasing

Ribosomal RNA genes of Endomyces fibuliger: Isolation, sequencing and the use of the 26S rRNA gene in integrative transformation of Saccharomyces cerevisiae for efficient expression of the α-amylase gene of Endomyces fibuliger

World Journal of Microbiology and Biotechnology131103-117WJMB

Effect of Intraperitoneal Administration of Zinc on C57/6J Mouse Liver-A Light Microscopic Study

Okajimas Folia Anatomica Japonica746279-292OFAJ

Variation of electrophoretic karyotypes in genetically different strains of Saccharomycopsis fibuligera and Yarrowia lipolytica

Microbiology1413705-711MROB

Up-regulation of metallothionein isoforms in keloid keratinocytes.

International journal of molecular medicine.172385-38