Comparison of transcutaneous incisions used for exposure of the infraorbital rim and orbital floor: a retrospective study.

One hundred and five patients were investigated for functional and aesthetic impairments following treatment of orbital trauma through subciliary, mid-lower eyelid, or infraorbital incisions. The progress of impairments with time was assessed, and the merits and shortcomings of each of the three approaches were established. The results showed that impairments persisting up to 6 months postoperatively have virtually not receded even after 6 years. The infraorbital incision showed the highest frequency of impairments, followed by the subciliary incision. The mid-lower eyelid incision showed the best results, with an impairment frequency well below those of the other two approaches. This approach seems to combine the advantages of the infraorbital incision with the unnoticeable scar formation associated with the subciliary incision.     

The use of Teflon in orbital floor reconstruction following blunt facial trauma: a 20-year experience

A myriad of materials have been used for reestablishing continuity of the orbital floor following blunt facial trauma. Traditionally, autogenous grafts have been the material of choice for orbital floor reconstruction; however, alloplastic materials have gained popularity because of their availability and ease of use. A large clinical experience with long-term treatment results has never been reported for any substance used in orbital floor reconstruction. The purpose of this study was to review our long-term treatment results using Teflon for orbital floor reconstruction following blunt trauma, with emphasis on the incidence of infection, extrusion, and implant displacement. This report presents a 20-year review of 230 Teflon implants for reconstruction of traumatic orbital floor defects. With a mean follow-up period of 30 months, there was only one implant infection and no complications of extrusion or implant displacement. These findings support the use of Teflon as a safe and effective material for the reconstruction of orbital floor defects following blunt facial trauma.     

Long-term variations of epilimnetic phytoplankton in an artificial reservoir during a 10-year survey

Vieux-Pré is an artificial reservoir in the north-east part of France (61 Mm³), created in 1986 for hydraulic management. The phytoplankton and several environmental parameters in the upper part of the lake were monitored at a mid-lake station, from 1988 to 1997. The specific composition of the community changed during this period, from a predominantly pennate-diatom phytoplankton (Asterionella formosa, Fragilaria crotonensis), the lake passed to dominance by a sparse, motile nanoplankton (Mallomonas akrokomos, M. caudata, Cryptomonas erosa, Chroomonas/Rhodomonas, a.o.) and then by large colonies of small-celled species (Uroglena americana, Dinobryon spp., Radiocystis geminata, Aphanothece clathrata, Coelosphaerium kuetzingianum a.o.). This paper describes the algal successions involved and shows the decisive effects of the decrease of trophic level from an eutrophic stage to an oligo-mesotrophic condition. In the beginning, externally imposed disturbances (flooding and dewatering) were frequent, while now the lake has stabilised as a deep, stratified pelagic system. Under these conditions, autogenic phytoplankton appear to dominate.     

The Manchester regional screening programme: a 10-year exercise in patient and family care.

Up to the end of 1978 the Willink Biochemical Genetics Unit had screened 506821 babies for metabolic abnormalities over 10 years--98-99% of the children born in the region. Sixty-nine cases of phenylketonuria (PKU), 42 cases of histidinaemia, and six cases of homocystinuria were detected. As well as treating affected children, the staff of the unit have concentrated on providing full support for their families and maintaining good communications with parents, general practitioners, health visitors, and midwives. A clinic liaison sister has provided valuable support for health visitors and an important link between the unit and community services. A study of the costs of screening and treating cases of PKU for the year 1978 showed that this was cheaper, by pound 569000, than the costs of looking after patients with untreated PKU.     

Dinophyceae fluctuations in two alpine lakes of contrasting size during a 10-year fortnightly survey

Colbricon Superiore and Inferiore are two small adjacent high-mountain lakes located in the Paneveggio Natural Park (Italy) that offer the rare opportunity to study two iso-ecologic water environments differing only by area and volume in a ratio of 2:1 and 3:1, respectively. We took advantage of this setting to investigate phytoplankton dynamics, compare variability and productivity differences between the two basins, and assess size-dependent issues. The phytoplankton group of the Dinophyceae was chosen as the indicator organisms of ecological perturbation owing to their high sensitivity to environmental variations, as well as their acknowledged nature of versatile proxy to report global climatic changes. The study was conducted for over 10 years with fortnightly samplings. Results indicated that (a) the Dinophyceae communities in the smaller lake were significantly more resistant to changes exerted by the fluctuation of lakewater transparency and pH; and (b) the smaller lake sustained a consistently higher production with an average Dinophyceae density 1.73 fold higher than that of the larger lake. The coefficients of variation show that the chemical parameters in the smaller lake display higher time-related fluctuation while being spatially homogeneous and that such conditions correlate with a higher stability of the Dinophyceae assemblage. The use of this setting is also proposed as a model to test relationships between ecosystem production and physical stability.     

Historical trends in the epidemiology of candidaemia: analysis of an 11-year period in a tertiary care hospital in Brazil

Candida species are an important cause of bloodstream infections (BSI). To evaluate the epidemiological, clinical and microbiological aspects of two cohorts {1994-1999 [period 1 (P1) ]; 2000-2004 [period 2 (P2) ]} of candidaemic patients, we performed a retrospective analysis from a laboratory-based survey. A total of 388 candidaemias were identified, with an incidence of 0.20/1,000 patient-days and a significant increase in P2 vs. P1 (0.25 vs. 0.15, p = 0.04). Cancer and prior antibiotic use were frequent and Candida albicans was the most prevalent species found (42.4%). Resistance to fluconazole was found in 2.47% of the strains. No differences were observed in the species distribution of Candida during the study periods. In the P2 cohort, there were higher prevalence of elderly individuals, cardiac, pulmonary and liver diseases, renal failure, central venous catheters and antibiotic therapy. In P1, there were higher prevalence of neurological diseases and chemotherapy. The crude mortality was 55.4%. In conclusion, our incidence rates remained high. Furthermore, the distribution pattern of Candida species and the fluconazole resistance profile remained unchanged. Moreover, we found a clear trend of higher prevalence of candidaemia among the elderly and among patients with comorbidities. Finally, it is necessary to discuss strategies for the prevention and control of Candida BSI in Brazil.     

Analysis of preterm deliveries below 35 weeks' gestation in a tertiary referral hospital in the UK. A case-control survey

Background

Preterm birth remains a major public health problem and its incidence worldwide is increasing. Epidemiological risk factors have been investigated in the past, but there is a need for a better understanding of the causes of preterm birth in well defined obstetric populations in tertiary referral centres; it is important to repeat surveillance and identify possible changes in clinical and socioeconomic factors associated with preterm delivery. The aim of this study was to identify current risk factors associated with preterm delivery and highlight areas for further research.

Findings

We studied women with singleton deliveries at St Michael's Hospital, Bristol during 2002 and 2003. 274 deliveries between 23-35 weeks' gestation (preterm group), were compared to 559 randomly selected control deliveries at term (37-42 weeks) using standard statistical procedures. Both groups were >80% Caucasian. Previous preterm deliveries, high maternal age (> 39 years), socioeconomic problems, smoking during pregnancy, hypertension, psychiatric disorders and uterine abnormalities were significantly associated with preterm deliveries. Both lean and obese mothers were more common in the preterm group. Women with depression/psychiatric disease were significantly more likely to have social problems, to have smoked during pregnancy and to have had previous preterm deliveries; when adjustments for these three factors were made the relationship between psychiatric disease and pregnancy outcome was no longer significant. 53% of preterm deliveries were spontaneous, and were strongly associated with episodes of threatened preterm labour. Medically indicated preterm deliveries were associated with hypertension and fetal growth restriction. Preterm premature rupture of the membranes, vaginal bleeding, anaemia and oligohydramnios were significantly increased in both spontaneous and indicated preterm deliveries compared to term controls.

Conclusions

More than 50% of preterm births are potentially preventable, but remain associated with risk factors such as increased uterine contractility, preterm premature rupture of the membranes and uterine bleeding whose aetiology is unknown. Despite remarkable advances in perinatal care, preterm birth continues to cause neonatal deaths and long-term morbidity. Significant breakthroughs in the management of preterm birth are likely to come from research into the mechanisms of human parturition and the pathophysiology of preterm labour using multidisciplinary clinical and laboratory approaches.

     

Scientific publications in nephrology and urology journals from Chinese authors in East Asia: a 10-year survey of the literature

Background

Diseases of the kidneys and genitourinary tract are common health problems that affect people of all ages and demographic backgrounds. In this study, we compared the quantity and quality of nephrological and urological articles published in international journals from the three major regions of China: the mainland (ML), Hong Kong (HK), and Taiwan (TW).

Methods

Nephrological and urological articles originating from ML, TW, and HK that were published in 61 journals from 1999–2008 were retrieved from the PubMed database. We recorded the numbers of total articles, clinical trials, randomized controlled trials, case reports, impact factors (IF), citations, and articles published in the leading general-medicine journals. We used these data to compare the quantity and quality of publication output from the three regions.

Results

The total number of articles increased significantly from 1999 to 2008 in the three regions. The number of articles from ML has exceeded that from HK since 2004, and surpassed that from TW in 2008. Publications from TW had the highest accumulated IF, total citations of articles, and the most articles published in leading general-medicine journals. However, HK publications had the highest average IF. Although ML produced the largest quantity of articles, it exhibited the lowest quality among the three regions.

Conclusion

The number of nephrological and urological publications originating from the three major regions of China increased significantly from 1999 to 2008. The annual number of publications by ML researchers exceeded those from TW and HK. However, the quality of articles from TW and HK was higher than that from ML.     

Molecular profiling of adult acute myeloid and lymphoid leukemia in a major referral center in Lebanon: a 10-year experience report and review of the literature

Molecular Biology Reports - Recurrent genetic abnormalities confer distinct morphologic features and play a role in determining the clinical behavior, prognosis and adequate treatment of acute...     

Management of pressure sores in a specialty center. A reappraisal.

We report a study on the surgical management of 145 pressure sores in 115 patients treated in a spinal cord injury center. There is a definite trend toward better education of these patients, who do not develop their first pressure sores until years following the injury. When the patient comes in for an ulcer, he is usually healthy and the ulcer is small and clean. In such instances the ulcer can be excised and closed, preferably with a myocutaneous flap, and the patient can usually begin sitting by the 21st post-operative day. In the ideal setting he may be discharged to his home on a custom-fitted (for pressure) cushion within 4 to 5 weeks, without increasing the risk of recurrence. Prophylaxis for the future is, probably, the most essential part of the treatment.     

A review of current proteomics technologies with a survey on their widespread use in reproductive biology investigations

Proteomics is very much a technology-driven field. The ambition is to identify, quantify and to assess the state of posttranslational modification and interaction partners for every protein in the cell. The proteome is in a state of flux and is thus extremely complex. Analysis of the proteome is exacerbated by the huge dynamic concentration range of proteins in the cellular environment. The impact that mass spectrometry-based proteomics has had on the field of biology has heavily depended on dramatic improvements in mass spectrometry that have been made in recent years. We examined 1541 reports indexed in PubMed relating to proteomics and reproduction to identify trends in the field and to make some broad observations for future work. To set the scene, in the first part of the report, we give a comprehensive overview of proteomics and associated techniques and technologies (such as separations and mass spectrometry). The second part examines the field in light of these techniques and suggests some opportunities for application of these tools in the area of reproduction.     

Quality and professionalism in health care: a review of current initiatives in the NHS.

Since the start of the 1990s the NHS and the clinical professions have made significant investments in quality management in health care, and a plethora of initiatives has been aimed at service improvement. From a patient''s perspective the extent to which these exercises have been cost effective is uncertain, although they have certainly involved great effort and enterprise on the part of many clinicians and managers. An important opportunity now exists to integrate this work into the mainstream of clinical and general service management. If clinicians can accept quality management concepts as central to their professional ethos and regulatory structures this could help them to maintain their professional authority and protect them and their patients from imposed decisions based on inadequate understanding of health care costs and benefits.     

Phytoplankton group dynamics in the Bay of Marseilles during a 2-year survey based on analytical flow cytometry.

BACKGROUND: The Bay of Marseilles is under the influence of a large urban concentration and its maritime activities. All of them discharge compounds (hydrocarbons, excess nutrients, heavy metals, chemicals, etc.) that can alter the marine ecosystem. To investigate whether ultraphytoplankton (<10 microm) could be used as biosensors for their own ecosystem, a 2-year survey was conducted in the Bay of Marseilles. METHODS: Seven stations monitored water mass and potential anthropic effects in the bay. Seawater samples were collected monthly or bimonthly at three depths, prefiltered, fixed, and kept in liquid nitrogen until flow cytometric analysis. RESULTS: Five categories were created: Prochlorococcus, picoeukaryotes (<2 microm), nanoeukaryotes I (2--6 microm), nanoeukaryotes II (6--10 microm), and Synechococcus (<1.5 microm). Artificial neural network analysis (Kohonen self-organizing maps) produced the same number of clusters as cluster analysis with Winlist software (Verity Software House). CONCLUSIONS: In addition to the wide variabilities in abundance and biomass, there were a strong seasonal signal and sporadic events. Lessons are derived from this study for future monitoring of marine microorganisms.