Intrahepatic type II gall bladder perforation by a gall stone in a CAPD patient

<p>Abstract</p> <p>Introduction</p> <p>Perforation of the gall bladder represents a rare, but life-threatening complication of cholecystitis. Clinical presentation may vary between severe peritonism in acute perforation and absence of symptoms in subacute or chronic progression of perforation. Abdominal imaging like ultrasound or CT-scan are important tools for immediate diagnose of gall bladder perforation.</p> <p>Case presentation</p> <p>We report a case of a 30-year old female patient with end-stage kidney disease treated by continuous ambulatory peritoneal dialysis (CAPD) who was admitted to the emergency room with fever and mild abdominal pain. A type II gall bladder perforation by a solitary gall stone with development of a liver abscess was detected by abdominal ultrasound.</p> <p>Conclusion</p> <p>Gall bladder perforations are rare but have to be considered in patients with abdominal pain and fever. Abdominal ultrasound is a reliable tool to establish diagnosis.</p

Multiple liver abscesses with isolation of streptococcus intermedius related to a pyogenic dental infection in an immuno-competent patient

<p>Abstract</p> <p>Introduction</p> <p><it>Streptococcus intermedius </it>- a member of the <it>Streptococcus anginosus </it>group - is part of the normal microbial flora of the oral cavity. Despite being regarded as a harmless apathogenic commensal, <it>Streptococcus intermedius </it>has been described to cause abscesses in various locations of the body.</p> <p>Case Presentation</p> <p>We report the clinical case and course of treatment of a 18-year-old male patient presenting with multiple hepatic abscesses associated with an untreated pyogenic dental infection.</p> <p>Conclusion</p> <p><it>Streptococcus intermedius </it>can cause liver abscesses emerging from dental infectious foci even in previously healthy patients without underlying innate or aquired immunodeficiency. The case illustrates the potential danger and underestimated risk associated with untreated dental infections.</p

Wireless capsule endoscopy for the detection of small bowel diseases in HIV-1-infected patients

<p>Abstract</p> <p>Background and Aims</p> <p>In HIV-infected patients, manifestations of the disease are common in the gastrointestinal tract. The objective of our study was to evaluate the diagnostic yield of the Given^®Video Capsule System (Given Imaging, Yoqneam, Israel) in these patients.</p> <p>Methods</p> <p>After exclusion of GI-tract stenosis by anamnestic exploration, 49 patients were included into the study. Stratification: Group A (n = 19): HIV-positive, CD₄cell count < 200/μl, gastrointestinal symptoms present. Group B: HIV-positive, CD₄< 200/μl, without gastrointestinal symptoms (n = 19 Group) C: healthy volunteers (n = 11).</p> <p>Results</p> <p>In group A there was a total of 30 pathological findings, 15 of which with therapeutic implications. In group B, there was a total of 22 pathological findings, 5 relevant for therapy. In group C there was a total of 13 pathological findings, 3 with therapeutic relevance. In 89% (group A) vs. 26% (group B), pathological findings were detected distal the ligament of Treitz (p = 0.001). All capsules were recovered without complications after 12 to 96 h from the stool.</p> <p>Conclusion</p> <p>Wireless capsule endoscopy of the small intestine should be considered for HIV-infected patients with marked immunosuppression and gastrointestinal symptoms.</p

Electrophysiological effects of progesterone on hepatocytes

AbstractThe addition of progesterone (1–100 μmol/l) to the extracellular fluid bathing rat hepatocytes led to a rapid and fully reversible depolarization of the cell membrane. The progesterone-induced depolarization was paralleled by a decrease of potassium selectivity and an increase of cell membrane resistance and was abolished in the presence of the potassium channel blocker barium. Accordingly, in whole cell recordings, progesterone led to a decrease of the cell membrane conductance. 17 α-Hydroxyprogesterone and β-estradiol were less effective by a factor of 10, whereas cholesterol, corticosterone and hydrocortisone did not significantly alter the potential difference across the cell membrane. In conclusion, acute administration of progesterone depolarized rat hepatocytes by decreasing the potassium conductance of the cell membrane

Maraviroc in treatment-experienced patients with HIV-1 infection - experience from routine clinical practice

<p>Abstract</p> <p>Objective</p> <p>Few data are available about the efficacy of maraviroc (MVC) during routine use. We characterized indications for MVC use and the efficacy of MVC in clinical practice.</p> <p>Methods</p> <p>Thirty-two patients treated with MVC at our institution between 2006 and 2009 were included. Genotypic (n = 31) and phenotypic (n = 13) tropism analysis was performed. We determined indications for MVC use, characteristics of antiretroviral combination partners and treatment outcome.</p> <p>Results</p> <p>Complete suppression of viral replication was achieved in 78% after 6 months. A median increase of 124 CD4⁺cells/μl after 6 months was observed. Concordance between phenotypic and genotypic tropism was found in 75%. Indications for MVC treatment included treatment failure (n = 15), intolerance to previous antiretrovirals (n = 6) and add-on MVC for intensification without changing the current regimen (n = 11). The add-on strategy was used in patients with a relatively low viremia in order to achieve complete viral load suppression or in situations with suppressed viral load but judged as unstable due to an extensive resistance pattern. Salvage drugs most frequently combined with MVC were darunavir (n = 14) and raltegravir (n = 14).</p> <p>The genotypic assay had predicted CXCR4 tropism in 5 patients, using a false positive rate (FPR) of 20%. Lowering the FPR to 5% predicted CCR5 tropism in 4 cases, still resulting in sustained complete viral response under MVC use.</p> <p>Conclusions</p> <p>MVC containing salvage regimens achieve relevant CD4 cell increases and high viral response rates. In patients with few remaining treatment options it may be justified to lower the FPR-cutoff to 5% when predicting the coreceptor usage. Hereby, MVC could still be applied in selected patients with otherwise limited treatment options.</p

Nuclear magnetic resonance as a quantitative tool to study interactions in biomacromolecules

High-resolution nuclear magnetic resonance (NMR) has emerged as one of the most versatile tools for the quantitative study of structure, kinetics, and thermodynamics of biomolecules and their interactions at atomic resolution. Traditionally, nuclear Overhauser enhancements (NOEs) and chemical shift perturbation methods are used to determine molecular geometries and to identify contact surfaces, but more recently, weak anisotropic orientation, anisotropic diffusion, and scalar couplings across hydrogen bonds provide additional information. Examples of such technologies are shown as applied to the quantitative characterization of function and thermodynamics of several biomacromolecules. In particular, (1) the structural and dynamical changes of the TipA multidrug resistance protein are followed upon antibiotic binding, (2) the trimer-monomer equilibrium and thermal unfolding of foldon, a small and very efficient trimerization domain of the T4 phagehead, is described in atomic detail, and (3) the changes of individual protein hydrogen bonds during thermal unfolding are quantitatively followed by scalar couplings across hydrogen bond

ИССЛЕДОВАНИЕ ВОЗДЕЙСТВИЯ АПОЛЯРНЫХ РЕАГЕНТОВ НА ТЕКУЧЕСТЬ ВОДОУГОЛЬНЫХ СУСПЕНЗИЙ

В последнее время возник интерес к поведению водоугольных суспензий в связи с поиском альтернативных видов энергоресурсов [1-4]. Повышенный интерес к водо угольному топливу вызван ростом цен на нефть и нефтепродукты и ограниченностью запасов этого сырья. Водоугольные смеси широко изучаются в различных странах мира, так как они могут заменить и традиционное пылевидное топливо, перед которым имеют ряд существенных преимуществ. Особенности горения водоугольного топлива позволяют относить его к разряду экологически чистых видов топлива. При сжигании угля в виде водоугольной суспензии увеличивается скорость выгорания углерода, снижаются выбросы вредных веществ в атмосферу и образование оксидов азота