Range of blood lactate values in farm pigs prior to experimental surgery

In biomedical research the pig is widely used as an animal model for experimental surgery. Feasible monitoring tools during anaesthesia are pivotal for successful and reliable research outcome. Blood lactate values are a monitoring tool and prognostic indicator during surgery both in humans and animals. Lactate levels in pigs might be influenced by various parameters including stressful handling, breed and weight differences. To determine blood lactate levels present prior to experimental surgery, values of 124 female farm pigs were measured in venous blood samples. Pigs presented with blood lactate concentrations ranging from 0.5 to 5.5 mmol/L (median, 1.2 mmol/L; interquartile range [IQR] 1.2). Considering genetic background, Rheinhybrid/Pietrain pigs (n = 51; median, 1.4 mmol/L; IQR, 1) had significantly higher blood lactate levels compared with Landrace/Pietrain crossbred animals (n = 73; median, 1.1 mmol/L; IQR, 1; P < 0.05). Body weight had no significant effect on blood lactate levels within the evaluated range. This report can benefit research projects monitoring blood lactate values in farm pigs during experimental surgery.

[Therapeutic approaches in Melanoma - a paradigm for personalized medicine]

Progress in molecular biology has facilitated a new classification for melanoma. Melanomas today are considered as a heterogeneous group of tumors. The different subtypes are characterized by specific genetic alterations, including mutations in kinase, such as B-RAF or c-kit. New medications like vemurafenib have been developed and are available for the systemic therapy of advanced melanomas in subpopulations identified by mutation tests. In addition, interferon therapy holds the highest promises to dates in subpopulations of patients characterized by microscopic lymph node involvement and ulceration of the primary tumor. These developments are the first steps resulting in a personalized treatment approach for individuals affected by melanoma.

Microbiological community analysis of vermicompost tea and its influence on the growth of vegetables and cereals

Vermicompost, the digestion product of organic material by earthworms, has been widely reported to have a more positive effect on plant growth and plant health than conventional compost. A study was conducted to investigate the effects of different vermicompost elutriates (aerated compost teas) on soils and plant growth. The teas were analyzed by chemical, microbiological, and molecular methods accompanied by plant growth tests at laboratory and field scale. The number of microorganisms in the teas increased during the extraction process and was affected by substrate addition. The vermicompost tea found to increase plant growth best under laboratory tests was applied to cereals (wheat and barley) and vegetables ( Raphanus sativus , Rucola selvatica , and Pisum sativum ) in a field study. The results revealed no effects of tea application on plant yield; however, sensoric tests indicated an improvement in crop quality. The soils from laboratory and field studies were investigated to detect possible microbial or chemical changes. The results indicated that minor changes to the soil microbial community occurred following tea application by foliar spray in both the laboratory-scale and field-scale experiments.

Constitutional intraepidermal ascent of melanocytes: a potential pitfall in the diagnosis of melanocytic lesions

BACKGROUND

Transepidermal melanocytic migration (TEM) is an important diagnostic criterion for malignancy, especially in association with cytologic atypia. However, TEM may also be observed in benign melanocytic tumors, such as Spitz nevus, acral nevi, or nevi in infancy. We discuss the value of TEM for the diagnosis of melanocytic tumors in a young patient previously diagnosed as having 11 cutaneous melanomas.

OBSERVATION

A 17-year-old patient with a history of 11 cutaneous melanomas diagnosed in the past 3 years by different expert dermatopathologists presented in our department. The previous histological diagnoses of melanoma were mainly based on the presence of important TEM. A reevaluation of all histological specimens in light of the clinical context and the lack of genomic aberrations as detected by array-comparative genomic hybridization led to a revision of the previous diagnoses. The striking TEM observed represents, in our opinion, a constitutional element of the melanocytic nevi in this patient and not a marker of malignancy.

CONCLUSION

Awareness of this finding is important to avoid overdiagnosis of melanoma in cases of melanocytic nevi.

Updated Swiss guidelines for the treatment and follow-up of cutaneous melanoma

Melanoma is the most common lethal cutaneous neoplasm. In order to harmonise treatment and follow-up of melanoma patients, guidelines for the management of melanoma in Switzerland were inaugurated in 2001 and revised in 2006. A new classification and recent results in randomised trials necessitated changes concerning staging and modifications of the recommendations of therapy and follow-up.

Dermoscopy of pigmented lesions of the mucosa and the mucocutaneous junction: results of a multicenter study by the International Dermoscopy Society (IDS)

OBJECTIVE

To better characterize the dermoscopic patterns of mucosal lesions in relation to the histopathologic characteristics.

DESIGN

Retrospective and observational study.

SETTING

Fourteen referral pigmented lesion clinics in 10 countries.

PATIENTS

A total of 140 pigmented mucosal lesions (126 benign lesions, 11 melanomas, 2 Bowen disease lesions, and 1 metastasis) from 92 females (66%) and 48 males (34%) were collected from October 2007 through November 2008.

MAIN OUTCOME MEASURES

Scoring the dermoscopic patterns (dots, globules, or clods, circles, lines, or structureless) and colors (brown, black, blue, gray, red, purple, and white) and correlation with the histopathologic characteristics.

RESULTS

Based on univariate analysis and 2 diagnostic models, the presence of structureless zones inside the lesions with blue, gray, or white color (the first model) had a 100% sensitivity for melanoma and 92.9% sensitivity for any malignant lesion, and 82.2% and 83.3% specificity for benign lesions in the group with melanoma lesions and the group with malignant lesions, respectively. Based on the colors (blue, gray, or white) only (the second model), the sensitivity for the group with melanoma was 100% and for the group with any malignant lesion was 92.9%, and the specificity was 64.3% and 65.1%, respectively. Patients with malignant lesions were significantly older than patients with benign lesions (mean [SD] ages, 60.1 [22.8] years vs 43.2 [17.3] years, respectively).

CONCLUSION

The combination of blue, gray, or white color with structureless zones are the strongest indicators when differentiating between benign and malignant mucosal lesions in dermoscopy.

[Apical root end resection (Apicoectomy) as treatment option in cases of dental trauma in young patient]

Apical root end resection is becoming popular procedure as a treatment option in cases of ortho-grade endodontic failure. In this case report it has been shown that root end resection (Apicoectomy) had succeed to preserve a tooth after dental trauma with root fractured in the apical third. Any other conservative endodontic treatment failed. One-year follow-up revealed complete healing of the area. Apical root end resection might serve as a viable treatment option in cases of dental trauma in young patient in carefully selected patients.

Congenital melanocytic naevi

Congenital melanocytic naevi, consisting of clusters of naevo-melanocytes, develop in utero. Although many congenital naevi are visible at birth, some may not become evident until later in life. The timing of naevo-melanocyte proliferation, senescence and melanogenesis may all contribute towards determining when a naevus will become clinically manifest on the skin. Besides the fact that congenital melanocytic naevi may be aesthetically displeasing, resulting in a multitude of psychosocial issues, they also increase the risk for developing cutaneous melanoma, leptomeningeal melanoma, neurocutaneous melanocytosis, malformations of the brain and, rarely, other tumours such as rhabdomyosarcoma and liposarcoma. Whereas the risk of developing malignancy in association with congenital naevi is dependent, to some extent, on the size of the naevus, the risk of developing neurocutaneous melanocytosis correlates best with the number of satellite naevi. Management of patients with congenital melanocytic naevi requires individualization, taking into account the naevus size and location, and the risk of developing cutaneous melanoma or neurocutaneous melanocytosis. When contemplating treatment options, it is important to set realistic expectations and to address the possible aesthetic and functional outcomes, while at the same time addressing the risk for developing cutaneous and/or extracutaneous melanoma.

Impact of robotic dispensing machines in german pharmacies on business performance indicators

Aims and objectives

To assess the impact of robotic dispensing machines in community pharmacies on staff efficiency and sales of over-the-counter drugs.

Setting

The study was done on 253 community pharmacies in Germany that use a robotic dispensing machine manufactured by ROWA during 2008.

Method

Data concerning the financial and economic impact of using a robotic dispensing machine in community pharmacies was gathered using a structured questionnaire and analysed in terms of its financial implications.

Key findings

The response rate was 29%. In most pharmacies (79%) the robotic dispensing machine was retrofitted. In 59% of the pharmacies additional space was gained for self-service and behind-the-counter display. As a result of using a robotic dispensing machine, personnel costs were reduced by an average of 4.6% during the first 12 months after start-up. Over-the-counter sales increased in the same period by an average of 6.8%. Despite average initial costs of 118,000 euros, total costs within the first 12 months fell in 50% of cases and at least remained the same in 44%.

Conclusions

On average, robotic dispensing machines lead to modest savings in personnel costs and slight increases in sales of over-the-counter drugs. Substantial savings can be achieved only if the staffing level is adapted to the changed personnel requirements.

Reflectance confocal microscopy and features of melanocytic lesions: an internet-based study of the reproducibility of terminology

OBJECTIVE

To test the interobserver and intraobserver reproducibility of the standard terminology for description and diagnosis of melanocytic lesions in in vivo confocal microscopy.

DESIGN

A dedicated Web platform was developed to train the participants and to allow independent distant evaluations of confocal images via the Internet.

SETTING

Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy.

PARTICIPANTS

The study population was composed of 15 melanomas, 30 nevi, and 5 Spitz/Reed nevi. Six expert centers were invited to participate at the study. Intervention Evaluation of 36 features in 345 confocal microscopic images from melanocytic lesions.

MAIN OUTCOME MEASURE

Interobserved and intraobserved agreement, by calculating the Cohen kappa statistics measure for each descriptor.

RESULTS

High overall levels of reproducibility were shown for most of the evaluated features. In both the training and test sets there was a parallel trend of decreasing kappa values as deeper anatomic skin levels were evaluated. All of the features, except 1, used for melanoma diagnosis, including roundish pagetoid cells, nonedged papillae, atypical cells in basal layer, cerebriform clusters, and nucleated cells infiltrating dermal papillae, showed high overall levels of reproducibility. However, less-than-ideal reproducibility was obtained for some descriptors, such as grainy appearance of the epidermis, junctional thickening, mild atypia in basal layer, plump bright cells, small bright cells, and reticulated fibers in the dermis. Conclusion The standard consensus confocal terminology useful for the evaluation of melanocytic lesions was reproducibly recognized by independent observers.

Improved flux limits for neutrinos with energies above 10(22) eV from observations with the Westerbork Synthesis Radio Telescope

Particle cascades initiated by ultrahigh energy neutrinos in the lunar regolith will emit an electromagnetic pulse with a time duration of the order of nanoseconds through a process known as the Askaryan effect. It has been shown that in an observing window around 150 MHz there is a maximum chance for detecting this radiation with radio telescopes commonly used in astronomy. In 50 h of observation time with the Westerbork Synthesis Radio Telescope array we have set a new limit on the flux of neutrinos, summed over all flavors, with energies in excess of 4x10(22) eV.

Enhanced ammonium removal from liquid anaerobic digestion residuals in an advanced sequencing batch reactor system

When treating effluents from anaerobic processing of organic wastes, the challenge lies in the large quantity of recalcitrant COD and in the high nitrogen content. The data presented in this study illustrate an advanced SBR concept that is able to significantly reduce the organic load. It was found that undigested mashed bio-waste bypassing the anaerobic digestion is highly suitable as an external carbon source to compensate deficiencies of readily biodegradable BOD required for denitrification. In order to utilize the carbon source as efficiently as possible, the SBR was operated in a mode by which nitrification/denitrification is achieved by a shortcut process using nitrite. This procedure reduced the requirement of an external carbon source to only 5% (v/v). Moreover, through an optimized SBR sequence for an influent concentration of 14,000 mg COD/l and 3,800 mg TN/l, nearly complete removal of nitrogen (>95%) was achieved. The average removal rates for COD and BOD were 83% and 86%, respectively. The applied hydraulic retention time (HRT) of the SBR was 6.8 days. The elevated temperature of 30-41 degrees C in the reactor as a result of the high biological activity was advantageous in terms of enhanced reaction kinetics and also provided better process stability.