Voiding cystourethrogram in the diagnosis of vesicoureteric reflux in children with antenatally diagnosed hydronephrosis

Prenatal ultrasonography has revolutionized the detection and management of many urological abnormalities. Vesicoureteric reflux (VUR) which develops in 10% to 15% of cases of prenatal hydronephrosis, is difficult to predict prenatally. While all children with prenatal hydronephrosis should undergo ultrasonography within the first few weeks of life, there seems to be controversy regarding the role of voiding cystourethrogram (VCUG) in the assessment of these children

Laparoscopic Approach to Vesicovaginal Fistula: Our Experience

AbstractIntroduction: Most Vesicovaginal fistulas  in the industrialized world are iatrogenic, Though they may also result from congenital anomalies, malignant disease, inflammation and infection, radiation therapy, iatrogenic (surgical) or external tissue trauma, ischemia, parturition and a variety of other processes. Vesicovaginal fistulas (VVF) represent, by far, the most common type of acquired fistula of the urinary tract. The goal of treatment of these fistulas is the rapid cessation of urine leakage with return of normal and complete urinary and genital function.Materials and Methods: Female patients presenting with iatrogenic Vesicovaginal fistula formed the study group. A detailed history and physical examination was carried out. Imaging included intravenous urogram, cystogram, computerised tomography, MR imaging and retrograde ureterogram as felt necessary.  Surgical repair of Vesicovaginal fistula was carried out through a laparoscopic approach.Results: 24 women presented with VVF, of these 19 underwent laparoscopic transperitoneal repair, whereas 5 underwent laparoscopic transvesicoscopic repair. The intraoperative blood loss was minimal (< 100 ml) and no major perioperative complications were noted. Conclusions: Minimally invasive approaches to repair vesico-vaginal fistulas are feasible, safe and associated with minimal blood loss, hospital stay and morbidity.Keywords: Laparoscopy, Minimally invasive, Vesicovaginal fistul

Production of soy protein concentrate with the recovery of bioactive compounds: from destruction to valorization

This work aimed to develop a novel methodology based on aqueous micellar systems (AMS), for producing soy protein concentrates (SPC) from soybean flour and recovering high-valuable bioactive compounds as by-products. Ethoxylated aliphatic alcohols Tergitol 15-S-7 and Tergitol 15-S-9, non-toxic and biodegradable surfactants, were selected to form the AMS. The methodology consisted of an extractive stage of soybean flour with AMS, which rendered both a pellet, i.e., the SPC, and a supernatant containing the extracted bioactive compounds. The latter was further heated above the cloud point temperature, thus resulting in a biphasic system formed by a micelle-rich phase (MP) and an aqueous phase (AP). Obtained SPC showed a noticeable loss (∼90%) of trypsin inhibitor activity, a total protein content close to 60%, soluble protein amounts varying from 19% to 34%, and remarkable released (by simulated digestion) antioxidant and antihypertensive activities. Those indicators are similar to or even better than those corresponding to SPC from the classical acid-extraction method. The AMS also exhibited an enhanced efficiency for extracting antinutrients such as non-digestible oligosaccharides, trypsin inhibitors, and lectins mostly recovered at the AP and separated from isoflavones, which were concentrated and isolated at the MP. The recovery of all the mentioned bioactive compounds, whether beneficial or undesirable, broadens their uses in research, food, and pharmacological fields. This successful performance, simplicity, scalability, and sustainability make the proposed AMS-based extraction a powerful tool for processing plant derivatives and valorizing their by-products.info:eu-repo/semantics/publishedVersio

Pollutant-Induced Modulation in Conformation and β-Lactamase Activity of Human Serum Albumin

Structural changes in human serum albumin (HSA) induced by the pollutants 1-naphthol, 2-naphthol and 8-quinolinol were analyzed by circular dichroism, fluorescence spectroscopy and dynamic light scattering. The alteration in protein conformational stability was determined by helical content induction (from 55 to 75%) upon protein-pollutant interactions. Domain plasticity is responsible for the temperature-mediated unfolding of HSA. These findings were compared to HSA-hydrolase activity. We found that though HSA is a monomeric protein, it shows heterotropic allostericity for β-lactamase activity in the presence of pollutants, which act as K- and V-type non-essential activators. Pollutants cause conformational changes and catalytic modifications of the protein (increase in β-lactamase activity from 100 to 200%). HSA-pollutant interactions mediate other protein-ligand interactions, such as HSA-nitrocefin. Therefore, this protein can exist in different conformations with different catalytic properties depending on activator binding. This is the first report to demonstrate the catalytic allostericity of HSA through a mechanistic approach. We also show a correlation with non-microbial drug resistance as HSA is capable of self-hydrolysis of β-lactam drugs, which is further potentiated by pollutants due to conformational changes in HSA

A Prognostic Model for Estimating the Time to Virologic Failure in HIV-1 Infected Patients Undergoing a New Combination Antiretroviral Therapy Regimen

<p>Abstract</p> <p>Background</p> <p>HIV-1 genotypic susceptibility scores (GSSs) were proven to be significant prognostic factors of fixed time-point virologic outcomes after combination antiretroviral therapy (cART) switch/initiation. However, their relative-hazard for the time to virologic failure has not been thoroughly investigated, and an expert system that is able to predict how long a new cART regimen will remain effective has never been designed.</p> <p>Methods</p> <p>We analyzed patients of the Italian ARCA cohort starting a new cART from 1999 onwards either after virologic failure or as treatment-naïve. The time to virologic failure was the endpoint, from the 90^thday after treatment start, defined as the first HIV-1 RNA > 400 copies/ml, censoring at last available HIV-1 RNA before treatment discontinuation. We assessed the relative hazard/importance of GSSs according to distinct interpretation systems (Rega, ANRS and HIVdb) and other covariates by means of Cox regression and random survival forests (RSF). Prediction models were validated via the bootstrap and c-index measure.</p> <p>Results</p> <p>The dataset included 2337 regimens from 2182 patients, of which 733 were previously treatment-naïve. We observed 1067 virologic failures over 2820 persons-years. Multivariable analysis revealed that low GSSs of cART were independently associated with the hazard of a virologic failure, along with several other covariates. Evaluation of predictive performance yielded a modest ability of the Cox regression to predict the virologic endpoint (c-index≈0.70), while RSF showed a better performance (c-index≈0.73, p < 0.0001 vs. Cox regression). Variable importance according to RSF was concordant with the Cox hazards.</p> <p>Conclusions</p> <p>GSSs of cART and several other covariates were investigated using linear and non-linear survival analysis. RSF models are a promising approach for the development of a reliable system that predicts time to virologic failure better than Cox regression. Such models might represent a significant improvement over the current methods for monitoring and optimization of cART.</p

The size, shape, density and ring of the dwarf planet Haumea from a stellar occultation

Haumea—one of the four known trans-Neptunian dwarf planets—is a very elongated and rapidly rotating body1, 2, 3. In contrast to other dwarf planets4, 5, 6, its size, shape, albedo and density are not well constrained. The Centaur Chariklo was the first body other than a giant planet known to have a ring system7, and the Centaur Chiron was later found to possess something similar to Chariklo’s rings8, 9. Here we report observations from multiple Earth-based observatories of Haumea passing in front of a distant star (a multi-chord stellar occultation). Secondary events observed around the main body of Haumea are consistent with the presence of a ring with an opacity of 0.5, width of 70 kilometres and radius of about 2,287 kilometres. The ring is coplanar with both Haumea’s equator and the orbit of its satellite Hi’iaka. The radius of the ring places it close to the 3:1 mean-motion resonance with Haumea’s spin period—that is, Haumea rotates three times on its axis in the time that a ring particle completes one revolution. The occultation by the main body provides an instantaneous elliptical projected shape with axes of about 1,704 kilometres and 1,138 kilometres. Combined with rotational light curves, the occultation constrains the three-dimensional orientation of Haumea and its triaxial shape, which is inconsistent with a homogeneous body in hydrostatic equilibrium. Haumea’s largest axis is at least 2,322 kilometres, larger than previously thought, implying an upper limit for its density of 1,885 kilograms per cubic metre and a geometric albedo of 0.51, both smaller than previous estimates1, 10, 11. In addition, this estimate of the density of Haumea is closer to that of Pluto than are previous estimates, in line with expectations. No global nitrogen- or methane-dominated atmosphere was detected.J.L.O. acknowledges funding from Spanish and Andalusian grants MINECO AYA-2014-56637-C2-1-P and J. A. 2012-FQM1776 as well as FEDER funds. Part of the research leading to these results received funding from the European Union’s Horizon 2020 Research and Innovation Programme, under grant agreement no. 687378. B.S. acknowledges support from the French grants ‘Beyond Neptune’ ANR-08-BLAN-0177 and ‘Beyond Neptune II’ ANR-11-IS56-0002. Part of the research leading to these results has received funding from the European Research Council under the European Community’s H2020 (2014-2020/ERC grant agreement no. 669416 ‘Lucky Star’). A.P. and R.S. have been supported by the grant LP2012-31 of the Hungarian Academy of Sciences. All of the Hungarian contributors acknowledge the partial support from K-125015 grant of the National Research, Development and Innovation Office (NKFIH). G.B.-R., F.B.-R., F.L.R., R.V.-M., J.I.B.C., M.A., A.R.G.-J. and B.E.M. acknowledge support from CAPES, CNPq and FAPERJ. J.C.G. acknowledges funding from AYA2015-63939-C2-2-P and from the Generalitat Valenciana PROMETEOII/2014/057. K.H. and P.P. were supported by the project RVO:67985815. The Astronomical Observatory of the Autonomous Region of the Aosta Valley acknowledges a Shoemaker NEO Grant 2013 from The Planetary Society. We acknowledge funds from a 2016 ‘Research and Education’ grant from Fondazione CRT. We also acknowledge the Slovakian project ITMS no. 26220120029