Perifollicular erythema as a trichoscopy sign of progression in frontal fibrosing alopecia

INTRODUCTION

Frontal fibrosing alopecia (FFA) in an entity characterized by the recession of the frontotemporal hairline (FTHL) with alopecic scarring change. In recent years there are numerous articles discussing the usefulness of dermoscopy for the clinical diagnosis of different types of scarring alopecia.

MATERIALS AND METHODS

We value 79 patients diagnosed with FFA, evaluating some trichoscopical findings described as typical for FFA: Absence of follicular opening, follicular hyperkeratosis, follicular plugs and erythema.

RESULTS

In a population of 79 women, 100% showed no follicular opening, 72.1% follicular hyperkeratosis, 66.3% perifollicular erythema and 44.8% follicular plugs. Thus, 100% of patients had at least one of the dermoscopic elements described as suggestive of FFA, 53% two of them, 45% three and 27%, all those elements. Perifollicular erythema was present in 95% of cases in which the disease was active.

CONCLUSIONS

We consider that the presence of perifollicular erythema will be a direct marker of FFA activity.

Plasticity of both planar cell polarity and cell identity during the development of Drosophila

Drosophila has helped us understand the genetic mechanisms of pattern formation. Particularly useful have been those organs in which different cell identities and polarities are displayed cell by cell in the cuticle and epidermis (Lawrence, 1992; Bejsovec and Wieschaus, 1993; Freeman, 1997). Here we use the pattern of larval denticles and muscle attachments and ask how this pattern is maintained and renewed over the larval moult cycles. During larval growth each epidermal cell increases manyfold in size but neither divides nor dies. We follow individuals from moult to moult, tracking marked cells and find that, as cells are repositioned and alter their neighbours, their identities change to compensate and the pattern is conserved. Single cells adopting a new fate may even acquire a new polarity: an identified cell that makes a forward-pointing denticle in the first larval stage may make a backward-pointing denticle in the second and third larval stages.

DOI:http://dx.doi.org/10.7554/eLife.01569.001

Fly larvae grow in an unusual way. Most embryos grow by increasing the number of cells in the embryo, but fly larvae grow by increasing the size of their cells. The epidermal cells in the growing larvae secrete a hard skin or cuticle that is renewed three times as they grow. This cuticle is decorated with teeth called denticles that the larvae use to grip surfaces as they crawl on them. The denticles are arranged in six rows during all three larval stages.

It has long been assumed that if a cell in the first larval stage makes the denticles belonging to a given row, then the same cell will make denticles in the same row in the second and third larval stages. Now Saavedra et al. report that this assumption is mistaken and that the epidermal cells rearrange extensively between the first and second larval stages, and that cells acquire different identities to keep the pattern constant.

Saavedra et al. marked small groups of cells in the embryo and plotted the positions of these cells as the larvae progressed through the three stages of development. These measurements showed that as the larvae grow, the cells changed their positions relative to each other. This meant that, in order to keep essentially the same pattern of denticle rows, the cells had to change their identity.

Some of these changes were quite dramatic. Consider, for example, the embryonic cells that make the denticles in the second of the six rows during the first larval stage. In the embryo, these cells are tendons and attach to the muscles needed for crawling. Saavedra et al. found that these cells remain attached to the same muscles throughout growth, but that they do not make denticles during the second and third larval stages. Instead, the denticles in the second row of later larval stages are made by other cells, and these new second row cells are not attached to any muscles. In another example of these changes, some cells make denticles that point away from the head during the first larval stage, and then make denticles that point towards the head during later stages. Thus, cells can change both their identity (e.g., whether they are attached to muscles or not) and their orientation (also known as the cell polarity) during the development of a larva.

The work of Saavedra et al. illustrates how organisms adapt developmental mechanisms that have been stabilised for millions of years and for this reason limit the kinds of morphological changes that are possible.

DOI:http://dx.doi.org/10.7554/eLife.01569.002

Trauma during pregnancy in a Nigerian setting: Patterns of presentation and pregnancy outcome

Context:

Trauma is an important health concern during pregnancy in developing nations though it is under-reported.

Aims:

The aim of this study was to determine the patterns of presentation and feto- maternal outcomes of trauma during pregnancy in a Nigerian setting.

Settings and Design:

A hospital-based retrospective analysis of database of entire patient population who presented in Ebonyi State University Teaching Hospital, Abakaliki, with trauma during pregnancy.

Materials and Methods:

The data on demographics, obstetrics, and injury characteristic in addition to the outcome of all injured pregnant women hospitalized from January 2002 to December 2010 were analyzed.

Statistical Analysis:

SPSS version 16 and quantitative skills software SISA were used in data analysis.

Results:

Trauma-necessitated hospitalization in 12 per 1000 pregnant women admitted in antenatal ward and was a complication of pregnancy in 4.7 per 1000 live birth in the hospital. Physical assault was the predominant causative factor and accounted for 46% of injuries whereas road traffic accident (motorcycle injury related in over 80%) was involved in 30.2% of the patients. The parity of the patients was significantly related to the trimester of pregnancy at the time of injury - 73% of grand-multiparae and about 60% of primigravida involved presented with injury in the 3^rd and 2^nd trimester, respectively (P < 0.017). Preterm delivery (7.9%), abruptio placentae (4.8%), and stillbirth (4.8%) were common obstetric complications observed. Maternal mortality of 1.6% and fetal loss of 7.9% were associated with trauma.

Conclusions:

Injury prevention measures during pregnancy deserve a place in any policy response aimed at reducing feto-maternal morbidity and mortality in developing countries.

Distribution pattern of surgically treated symptomatic prolapsed lumbar and sacral intervertebral discs in males

Background:

The pattern of distribution of surgically treated symptomatic prolapsed lumbar and sacral intervertebral discs has been published, though scantily, especially in males. We decided to look at our own series, compare and contrast ours with some of those published.

Materials and Methods:

We treated 88 locations of this lesion in 68 males. The clinical features were those of lower back pains, with or without radiation into the lower extremities, sensory loss and paresis of the limbs. There was a case of loss of urinary bladder and ano-rectal control. All lesions were confirmed through cauda-equinograms and treated under general anaesthesia in knee-chest position (MECCA position). The patients were followed up for 3-6 months post-operatively.

Results:

There were 88 locations in 68 males of 21-70 years of age, with 29 prolapses occurring during the age range 31-40 years, while 54 locations were on the left and 48 at L4/5. The procedures were well tolerated by all patients and there were no post-operative complications.

Conclusion:

This lesion in our series occurred mostly on the left, at the L4/5 level and peaked at 31-40 years age range. The predictability of occurrence of this disease, using side, level and age is still not feasible in males from our series.

Over-the-counter medication patterns in households in Sharjah, United Arab Emirates

Background

Self-medication and acquisition of over-the-counter (OTC) medications are emerging community health issues. Besides being a cheap alternative for treating common illnesses, the behavior entails serious ramifications, such as medication wastage, increasing pathogen resistance, and adverse drug reactions. The present study was conducted to explore the extent of OTC medications in households in Sharjah, United Arab Emirates (UAE), including native UAE and expatriate families.

Methods

The study employed a population-based, cross-sectional, analytical study design. The study population included native and expatriate households residing in the Emirate of Sharjah, UAE. The snowball sampling technique was used, and the sample included a total of 335 households.

Results

Expatriate households acquired more OTC medications than did native households (adjusted odds ratio [aOR]=1.7). The demographic determinants for expatriate households were number of family members (aOR=1.6), age of children in the family (aOR=1.8), and annual income (aOR=0.5). Expatriate households purchased more OTC medication practices than did native households (aOR=2.2). In the statistical sense, expatriate household practices were buying medication upon relatives’ advice (aOR=0.3), storage condition of medication (aOR=2.4), and disposal of expired medication (aOR=0.6). The highest percentages of OTC medications in native and expatriate households were those related to gastric and ear, nose, and throat illnesses.

Conclusion

The presence of OTC medications in expatriate households was two-fold more common than in native households in Sharjah, UAE. There were significant associations for behaviors related to the reasons why OTC medications were purchased and stored within the household for both native and expatriate families.

Pattern, severity, and management of cranio-maxillofacial soft-tissue injuries in Port Harcourt, Nigeria

Background:

The pattern of craniofacial soft-tissue injuries occurring either in isolation or in association with fractures vary in different societies and is multiply influenced. The effects are enormous because of the prominence of the face; therefore, the purpose of this study was to document any changing pattern, severity and management of these craniofacial injuries in our center.

Patients and Method:

Cranio-maxillofacial region was classified into upper, middle and lower face. The cause, type, and site of the injuries were documented. Gunshot injuries were further categorized as penetrating, perforating or avulsions. Further, classification of injuries into mild, moderate, and severe was carried out based on multiple factors.

Result:

A total of 126 patients with soft-tissue injuries presented to our hospital out of which 85 (67.5%) were males and 41 (32.5) were females. The age range of the patients was between 10 months and 90 years with a mean ± SD of 26.4 ± 15.5 years. Road traffic accident was the most common etiology of which vehicular accidents constituted 50 (54.9%) and the motorcycle was 2 (2.2%). Assault contributed 16 (17.6%) while cases due to gun shots were 13 (14.3%). A total of 19 (15.1%) patients had associated head injuries, 11 (8.7%) patients had craniofacial fractures involving any of the bones while 3 (2.4%) patients had limb fractures and 2 (1.6%) patients had rib fractures. There were 51 (41.8%) cases classified as mild injuries, 37 (30.3%) cases as moderate injuries and 24 (19.7%) cases as severe injuries. Total of 126 cases managed, 121 (96.0%) received primary closure of the wounds while 5 (4.0%) received delayed closure under general anesthesia.

Trade-off between camouflage and sexual dimorphism revealed by UV digital imaging: the case of Australian Mallee dragons (Ctenophorus fordi)

Colour patterns displayed by animals may result from the balance of the opposing requirements of sexual selection through display and natural selection through camouflage. Currently, little is known about the possibility of the dual purpose of an animal colour pattern in the UV region of the spectrum, which is potentially perceivable by both predators and conspecifics for detection or communication purposes. Here, we implemented linearised digital UV photography to characterise and quantify the colour pattern of an endemic Australian Agamid lizard classically regarded as monomorphic when considering data from the visible region of the spectrum. Our results indicate a widespread presence of UV elements across the entire body of the lizards and these patterns vary significantly in intensity, size and frequency between sexes. These results were modelled considering either lizard or avian visual characteristics, revealing that UV reflectance represents a trade-off between the requirements of sexual displaying to conspecifics and concealment from avian predators.

Action at a distance: dependency sensitivity in a New World primate

Sensitivity to dependencies (correspondences between distant items) in sensory stimuli plays a crucial role in human music and language. Here, we show that squirrel monkeys (Saimiri sciureus) can detect abstract, non-adjacent dependencies in auditory stimuli. Monkeys discriminated between tone sequences containing a dependency and those lacking it, and generalized to previously unheard pitch classes and novel dependency distances. This constitutes the first pattern learning study where artificial stimuli were designed with the species' communication system in mind. These results suggest that the ability to recognize dependencies represents a capability that had already evolved in humans’ last common ancestor with squirrel monkeys, and perhaps before.

Patterns of species diversity and phylogenetic structure of vascular plants on the Qinghai-Tibetan Plateau

Large-scale patterns of species richness and the underlying mechanisms regulating these patterns have long been the central issues in biogeography and macroecology. Phylogenetic community structure is a result of combined effects of contemporary ecological interactions, environmental filtering, and evolutionary history, and it links community ecology with biogeography and trait evolution. The Qinghai-Tibetan Plateau provides a good opportunity to test the influence of contemporary climate on shaping species richness because of its unique geological history, cold climate, and high biodiversity. In this study, based on high-resolution distributions of ˜9000 vascular plant species, we explored how species richness and phylogenetic structure of vascular plants correlate with climates on the highest (and species rich) plateau on the Earth. The results showed that most of the vascular plants were distributed on the eastern part of the plateau; there was a strong association between species richness and climate, even after the effects of habitat heterogeneity were controlled. However, the responses of richness to climate remarkably depended on life-forms. Richness of woody plants showed stronger climatic associations than that of herbaceous plants; energy and water availability together regulated richness pattern of woody plants; whereas water availability predominantly regulated richness pattern of herbaceous plants. The phylogenetic structure of vascular species clustered in most areas of the plateau, suggesting that rapid speciation and environment filtering dominated the assembly of communities on the plateau. We further propose that biodiversity conservation in this area should better take into account ecological features for different life-forms and phylogenetic lineages.

Pattern of underreporting falls in a general psychiatric hospital in Japan

PURPOSE

To examine the pattern of underreporting of fall incidents in a general psychiatric hospital in Japan.

DESIGN AND METHODS

All fall incidents were analyzed and stratified by ward.

FINDINGS

A discrepancy in fall rates was found in acute psychiatric and dementia wards. The following indicators were suggestive of underreporting: "zero fall/1,000 patient-days," "proportion of falls without injury," and "proportion of falls identified as occurring in the bedroom as a fall location during certain time periods."

PRACTICE IMPLICATIONS

Ward-specific fall rates, with further stratifications by time and location of the fall, were useful for identifying a pattern of underreporting.

Morphological differences among egg nests and adult individuals of Cicadatra persica (Hemiptera, Cicadidae), distributed in Erneh, Syria

The aim of this study is determining the different patterns of egg nests and the morphological differences between the specimens of Cicadatra persica Kirkalidy, 1909 (Hemiptera: Cicadidae) distributed in fruit orchards in Erneh located on AL-Sheikh mountain south west of Syria. The appearance of 80 egg nests was studied, and the results showed that there were two basic patterns of egg nests laid by Cicadatra persica, 90% of the egg nests were of the first pattern (consists of several adjacent slits), while 10% of them were of the second pattern (consists of several divergent slits). A random sample consisting of 300 specimens (150 males and 150 females) were also studied concentrating on the differences in the color of the supra-antennal plate and in the number of spurs on the tibia of the hind legs. The results showed that there were two basic patterns of individuals based on the differences in the color of supra-antennal plate. The first pattern (individuals with yellow supra-antennal plates), constituted more than 90%, and the second one (individuals with black supra-antennal plates) constituted less than 10%. The results also showed that there were 27 different patterns based on the number of spurs on the tibia of the hind legs. One of them was a common pattern (2, 3) whose individuals have 2 spurs on the upper side of the tibia of the hind legs and 3 spurs on the lateral side of the tibia of the hind legs. The total percent of this common pattern was 76%. The other 26 patterns were different from each other, and the total percent of all these different patterns was 24%.

Pattern and survival of biliary atresia patients; experience in southern Nigeria

BACKGROUND

Biliary atresia (BA) has been a challenge to surgeons worldwide. Beyond the revolutionary surgical technique popularised by Kasai, liver transplantation has added renewed hope in the long-term outcome. In Nigeria, where late presentation is very common, there is need to assess the long-term results of the treatment options available to us.

AIM

We aimed to evaluate the presentation and management outcome of BA and the long-term survival of BA patients seen in our practice.

MATERIALS AND METHODS

Cases of BA seen between January 2007 and December 2011 in three tertiary health facilities in South East Nigeria were included. Data obtained included age at presentation, clinical features, treatment offered and age at the time of death. Analysis was with the SPSS 17.0.

RESULTS

Twenty four patients comprising 10 (41.7%) males and 14 (58.3%) females were included in the study. The mean age of presentation was 4.02 (±214) months; range 1.75-11.0 months. Fifteen (62.5%) patients had surgery while 9 (37.5%) received medical treatment only. The mean age at death was 14.2 (±8.1) months; range 2.5-30 months.

CONCLUSION

BA poses a daunting challenge in our practice. Outcome of treatment is still discouraging. We identified late presentation, lack of facilities to make early diagnosis, lack of adequately trained manpower to manage these children and lack of post-operative care and support for patients as the major challenges in the management of BA children in our region.

Pattern, awareness and perceptions of health hazards associated with self medication among adult residents of kano metropolis, northwestern Nigeria

Background:

Kano State is the most populous state, and one of those states pronounced with the highest prevalence of drug abuse in Nigeria. However, there is lack of documented data to back the assertion.

Objective:

We determined the pattern, awareness and perceptions of the adult residents of Kano metropolis about self medication.

Materials and Methods:

We used a descriptive cross-sectional design to study a random sample of 380 adult in Kano metropolis. Data was collected using semi-structured questionnaires that were pretested outside the study area. Data analysis was with Epi Info® 3.5.1.

Results:

The mean age of the subjects was 35.43 ± 15.10 years, majority were males (66.32%), singles (47.11%) and had at least secondary education (67.63%). About three-quarter (78.95%) admitted using drug (s) in the past without prescription. Drugs commonly consumed were antimalarials (42.10%), analgesics (40.56%), antibiotics (29.41%), and cough mixtures (13.31%). Common sources of drugs were patent medicine stores (62.54%) and the market (19.81%). Common reasons for self medication were long queues in the hospitals (38.39%), and in-accessibility to doctors (25.08%). About two-thirds (65.00%) correctly perceived that self medication could be hazardous; and half (51.58%) were aware of at least one hazard of self medication.

Conclusion/Recommendations:

Irrational drug use is a growing challenge to public health in Kano, Nigeria. Thus, drug regulatory agencies in Nigeria should work together to ensure that all drug retail outlets and drug sellers are registered, controlled drugs are dispensed only on prescription of the physicians; and the laws safeguarding drug use are duly enforced. Health authorities should also strengthen efforts towards health educating the public.

Atrial fibrillation patterns and risks of subsequent stroke, heart failure, or death in the community

Background

Atrial fibrillation (AF) patterns and their relations with long‐term prognosis are uncertain, partly because pattern definitions are challenging to implement in longitudinal data sets. We developed a novel AF classification algorithm and examined AF patterns and outcomes in the community.

Methods and Results

We characterized AF patterns between 1980 and 2005 among Framingham Heart Study participants who survived ≥1 year after diagnosis. We classified participants based on their pattern within the first 2 years after detection as having AF without recurrence, recurrent AF, or sustained AF. We examined associations between AF patterns and 10‐year survival using proportional hazards regression. Among 612 individuals with AF, mean age was 72.5±10.8 years, and 53% were men. Of these, 478 participants had ≥2 electrocardiograms (median, 3; limits 2 to 23) within 2 years after initial AF and were classified as having AF without 2‐year recurrence (n=63, 10%), recurrent AF (n=162, 26%) or sustained AF (n=207, 34%), although some (n=46, 8%) were indeterminate. Of 432 classified participants, 363 died, 75 had strokes, and 110 were diagnosed with heart failure during the next 10 years. Relative to individuals without AF recurrence, the multivariable‐adjusted mortality was higher among people with recurrent AF (hazard ratio [HR], 2.04; 95% confidence interval [CI], 1.26 to 3.29) and sustained AF (HR, 2.36; 95% CI, 1.49 to 3.75).

Conclusions

In our community‐based AF sample, only 10% had AF without early‐term (2‐year) recurrence. Compared with individuals without 2‐year AF recurrences, the 10‐year prognosis was worse for individuals with either sustained or recurrent AF. Our proposed AF classification algorithm may be applicable in longitudinal datas ets.

Prevalence of obesity among adolescents in Ile-Ife, Osun state, Nigeria using body mass index and waist hip ratio: A comparative study

Background:

Obesity is a global epidemic not just among adults but also among children and adolescents. This study described the prevalence and pattern of obesity among in-school adolescents in Ile-Ife, Osun State using two standard methods, Body Mass Index (BMI) and Waist Hip Ratio (WHR) with a view of comparing the two methods as well as identifying any correlation between the two methods.

Materials and Methods:

Five hundred male and female respondents, aged 10-19 years, were randomly selected through a multistage sampling technique from private and public schools in Ife Central Local Government Area. Quantitative data were collected with the aid of a pre-tested, semi-structured, self-administered questionnaire. Anthropometric measurements of respondents, BMI and WHR, were recorded. Chi square and linear regression analyses were used. Statistical significance was tested at the 5% level.

Results:

The prevalence of obesity was 4.2% using BMI of which 12 (57.1%) were females and nine (42.9%) were males. There was significant association between sex and BMI, χ² = 9.490 (P = 0.020). Using WHR, the prevalence was 37.2% of which 180 (96.8%) were females and six (3.2%) were males. There was also significant association between sex and WHR (P < 0.001). Weak correlation (r = 0.02) was found between BMI and WHR among the females, P = 0.043.

Conclusion:

There was a difference in the prevalence of obesity using the two methods. Although, the correlation between the two methods was weak among females, WHR yielded a higher prevalence for obesity with remarkable difference especially among the females. Prevention of adolescent obesity should be encouraged especially among females.

Sister Mary Joseph's nodule at a University teaching hospital in northwestern Tanzania: a retrospective review of 34 cases

BACKGROUND

Sister Mary Joseph's nodule is a metastatic tumor deposit in the umbilicus and often represents advanced intra-abdominal malignancy with dismal prognosis. There is a paucity of published data on this subject in our setting. This study was conducted to describe the clinicopathological presentation and treatment outcome of this condition in our environment and highlight challenges associated with the care of these patients, and to proffer solutions for improved outcome.

METHODS

This was a retrospective study of histologically confirmed cases of Sister Mary Joseph's nodule seen at Bugando Medical Centre between March 2003 and February 2013. Data collected were analyzed using descriptive statistics.

RESULTS

A total of 34 patients were enrolled in the study. Males outnumbered females by a ratio of 1.4:1. The vast majority of patients (70.6%) presented with large umbilical nodule > 2 cm in size. The stomach (41.1%) was the most common location of the primary tumor. Adenocarcinoma (88.2%) was the most frequent histopathological type. Most of the primary tumors (52.9%) were poorly differentiated. As the disease was advanced and metastatic in all patients, only palliative therapy was offered. Out of 34 patients, 11 patients died in the hospital giving a mortality rate of 32.4%. Patients were followed up for 24 months. At the end of the follow-up period, 14(60.9%) patients were lost to follow-up and the remaining 9 (39.1%) patients died. Patients survived for a median period of 28 weeks (range, 2 to 64 weeks). The nodule recurred in 6 (26.1%) patients after complete excision.

CONCLUSION

Sister Mary Joseph's nodule of the umbilicus is not rare in our environment and often represents manifestation of a variety of advanced intra-abdominal malignancies. The majority of the patients present at a late stage and many with distant metastases. The patient's survival is very short leading to a poor outcome. Early detection of primary cancer at an early stage may improve the prognosis.

Zinc uptake and radial transport in roots of Arabidopsis thaliana: a modelling approach to understand accumulation

BACKGROUND AND AIMS

Zinc uptake in roots is believed to be mediated by ZIP (ZRT-, IRT-like proteins) transporters. Once inside the symplast, zinc is transported to the pericycle, where it exits by means of HMA (heavy metal ATPase) transporters. The combination of symplastic transport and spatial separation of influx and efflux produces a pattern in which zinc accumulates in the pericycle. Here, mathematical modelling was employed to study the importance of ZIP regulation, HMA abundance and symplastic transport in creation of the radial pattern of zinc in primary roots of Arabidopsis thaliana.

METHODS

A comprehensive one-dimensional dynamic model of radial zinc transport in roots was developed and used to conduct simulations. The model accounts for the structure of the root consisting of symplast and apoplast and includes effects of water flow, diffusion and cross-membrane transport via transporters. It also incorporates the radial geometry and varying porosity of root tissues, as well as regulation of ZIP transporters.

KEY RESULTS

Steady-state patterns were calculated for various zinc concentrations in the medium, water influx and HMA abundance. The experimentally observed zinc gradient was reproduced very well. An increase of HMA or decrease in water influx led to loss of the gradient. The dynamic behaviour for a change in medium concentration and water influx was also simulated showing short adaptation times in the range of seconds to minutes. Slowing down regulation led to oscillations in expression levels, suggesting the need for rapid regulation and existence of buffering agents.

CONCLUSIONS

The model captures the experimental findings very well and confirms the hypothesis that low abundance of HMA4 produces a radial gradient in zinc concentration. Surprisingly, transpiration was found also to be a key parameter. The model suggests that ZIP regulation takes place on a comparable timescale as symplastic transport.

CoLIde: a bioinformatics tool for CO-expression-based small RNA Loci Identification using high-throughput sequencing data

Small RNAs (sRNAs) are 20-25 nt non-coding RNAs that act as guides for the highly sequence-specific regulatory mechanism known as RNA silencing. Due to the recent increase in sequencing depth, a highly complex and diverse population of sRNAs in both plants and animals has been revealed. However, the exponential increase in sequencing data has also made the identification of individual sRNA transcripts corresponding to biological units (sRNA loci) more challenging when based exclusively on the genomic location of the constituent sRNAs, hindering existing approaches to identify sRNA loci. To infer the location of significant biological units, we propose an approach for sRNA loci detection called CoLIde (Co-expression based sRNA Loci Identification) that combines genomic location with the analysis of other information such as variation in expression levels (expression pattern) and size class distribution. For CoLIde, we define a locus as a union of regions sharing the same pattern and located in close proximity on the genome. Biological relevance, detected through the analysis of size class distribution, is also calculated for each locus. CoLIde can be applied on ordered (e.g., time-dependent) or un-ordered (e.g., organ, mutant) series of samples both with or without biological/technical replicates. The method reliably identifies known types of loci and shows improved performance on sequencing data from both plants (e.g., A. thaliana, S. lycopersicum) and animals (e.g., D. melanogaster) when compared with existing locus detection techniques. CoLIde is available for use within the UEA Small RNA Workbench which can be downloaded from: http://srna-workbench.cmp.uea.ac.uk.

The subparietal and parietooccipital sulci: an anatomical study

The subparietal and parietooccipital sulci are both located on the medial surface of the brain. Both of these sulci reveal significant variability in pattern and complexity. Both subparietal and parietooccipital sulci play an important role as surgical landmarks using posterior interhemispheric parietooccipital approach to lesions located adjacent to the ventricular trigon deep to the cingulate gyrus. The aim of this study is to analyze variations in the patterns of the subparietal and parietooccipital sulci and to emphasize their surgical importance. Fifty-six formalin-fixed cadaveric cerebral hemispheres from 28 adult humans are examined. Subparietal and parietal sulci patterns, variations and their relationship with the cingulate sulcus are studied according to the terminology introduced by Ono et al. The H-pattern was observed in 50% (n = 28) of all hemispheres, being the most common pattern of the subparietal sulcus. The Straight pattern was observed in the 30.4% (n = 17) of all hemispheres, being the most common pattern of the parietooccipital sulcus. Furthermore, more detailed results among the patterns, connections, side branches and the relationship with the adjacent sulci are given. Our study further confirms the complexities in the patterns of the subparietal and parietooccipital sulci and demonstrates that these sulci fall within an expected range of variations. Better knowledge of these variations will further help neurosurgeons to navigate easily during approaches involving the medial surface of the parietal lobe. Clin. Anat. 26:667-674, 2013. © 2013 Wiley Periodicals, Inc.

Episodes of breathlessness: types and patterns - a qualitative study exploring experiences of patients with advanced diseases

BACKGROUND

Despite the high prevalence and impact of episodic breathlessness, information about characteristics and patterns is scarce.

AIM

To explore the experience of patients with advanced disease suffering from episodic breathlessness, in order to describe types and patterns.

DESIGN AND PARTICIPANTS

Qualitative design using in-depth interviews with patients suffering from advanced stages of chronic heart failure, chronic obstructive pulmonary disease, lung cancer or motor neurone disease. As part of the interviews, patients were asked to draw a graph to illustrate typical patterns of breathlessness episodes. Interviews were tape-recorded, transcribed verbatim and analysed using Framework Analysis. The graphs were grouped according to their patterns.

RESULTS

Fifty-one participants (15 chronic heart failure, 14 chronic obstructive pulmonary disease, 13 lung cancer and 9 motor neurone disease) were included (mean age 68.2 years, 30 of 51 men, mean Karnofsky 63.1, mean breathlessness intensity 3.2 of 10). Five different types of episodic breathlessness were described: triggered with normal level of breathlessness, triggered with predictable response (always related to trigger level, e.g. slight exertion causes severe breathlessness), triggered with unpredictable response (not related to trigger level), non-triggered attack-like (quick onset, often severe) and wave-like (triggered or non-triggered, gradual onset). Four patterns of episodic breathlessness could be identified based on the graphs with differences regarding onset and recovery of episodes. These did not correspond with the types of breathlessness described before.

CONCLUSION

Patients with advanced disease experience clearly distinguishable types and patterns of episodic breathlessness. The understanding of these will help clinicians to tailor specific management strategies for patients who suffer from episodes of breathlessness.

Assessment of the impact of pattern of cocaine dosing schedule during conditioning and reconditioning on magnitude of cocaine CPP, extinction, and reinstatement

RATIONALE AND OBJECTIVE

We sought to examine the impact of differing cocaine administration schedules and dosing on the magnitude of cocaine conditioned place preference (CPP), extinction, and stress- and cocaine-induced reinstatement of CPP.

METHODS

First, in C57Bl/6J mice, we investigated whether total cocaine administration or pattern of drug exposure could influence the magnitude of cocaine CPP by conditioning mice with a fixed-low dose (FL; 7.5 mg/kg; total of 30 mg/kg), a fixed-high dose (FH; 16 mg/kg; total of 64 mg/kg), or an ascending dosing schedule (Asc; 2, 4, 8, and 16 mg/kg; total of 30 mg/kg). Next, we investigated if cocaine or saline is more effective at extinguishing preference by reconditioning mice with either a descending dosing schedule (Desc; 8, 4, 2, and 1 mg/kg) or saline. Finally, we examined if prior conditioning and reconditioning history alters stress (~2-3-min forced swim test) or cocaine-induced (3.5 mg/kg) reinstatement.

RESULTS

We replicated and extended findings by Itzhak and Anderson (Addict. Biol. 17(4): 706-16, 2011) demonstrating that Asc conditioning produces a greater CPP than either the FL or FH conditioning schedules. The magnitude of extinction expressed was similar in the Desc reconditioned and saline groups. Moreover, only the saline, and not the Desc reconditioned mice, showed stress and cocaine-induced reinstatement of CPP.

CONCLUSIONS

Our results suggest that the schedule of cocaine administration during conditioning and reconditioning can have a significant influence on the magnitude of CPP and extinction of preference and the ability of cocaine or a stressor to reinstate CPP.

Blast injuries to the hand: Pathomechanics, patterns and treatment

Purpose:

To characterize the common patterns of injury in detail in cases of blast injuries to the hand and to outline the possible pathomechanics of these patterns of injury while describing the treatment modalities for the same as practiced in our center.

Materials and Methods:

A review of admitted patients in our department from september 2009 through december 2010 of blast injuries to the hand was made. Each patient had a careful characterization of their injuries as mild, moderate or severe with the help of X-rays, clinical photographs and operative notes. The treatment of these patients during hospital stay was also documented.

Results:

Of the 55 patients studied, 5 patients suffered mild injuries with no bony injuries or dislocations, 26 patients had moderate injuries characterized by fractures and dislocations in addition to soft tissue injuries and 24 patients had severe injuries characterized by variable degrees of amputations. The most common injury type was to the radial aspect of the hand characterized by a first web split and a dislocation of the CMC joint of the thumb associated with fracture of the central metacarpals and amputations of the index and long fingers in some cases. Injury to the ulnar aspect was rare. Injuries were treated by repair as well as replacement done mostly in a serial fashion.

Conclusion:

Depending on the mode of injury, blast injuries to the hand can have varying patterns of injury, which can have important implications in the treatment and rehabilitation of a patient.

Patterns of mortality in public and private hospitals of Addis Ababa, Ethiopia

BACKGROUND

Ethiopia is encountering a growing burden of non-communicable diseases along with infectious diseases, perinatal and nutritional problems that have long been considered major problems of public health importance. This retrospective analysis was carried out to examine the mortality patterns from communicable diseases and non communicable diseases in public and private hospitals of Addis Ababa.

METHODS

Approximately 47,153 deaths were captured over eight years (2002-2010) in forty three public and private hospitals of Addis Ababa, Ethiopia. Data collectors (43 hospital clerks) and coordinators (3 nurses) had been extensively trained on how to review hospital death records. Information obtained included: dates of admission and death, age, sex, address, and principal cause of death. Only the diseases responsible for deaths are taken as the cause of death. Cause of death was coded using International Classification of Diseases (ICD-10) and data were double entered. Diseases were classified into: Group I (communicable diseases, maternal conditions and nutritional deficiencies); Group II (non-communicable causes); and Group III (injuries). Percentages, proportional mortality ratios, 95% confidence intervals (CI) and Adjusted odd ratios (OR) were calculated.

RESULTS

Overall, 59% of the deaths were attributed to Group I diseases, and 31% to Group II diseases and 12% to injuries. Nearly 56% of the males and 68% of the females deaths were due to five leading causes (conditions arising during perinatal period, HIV/AIDS, tuberculosis, cardiovascular diseases and respiratory infections). Significantly larger proportions of females died from Group I (67%) and Group II diseases (32%) compared with males (where the respective proportions were 52% and 30%). Significantly higher proportion of males (17%) than females (6%) were dying from Group III diseases. Deaths due to Group I diseases decreased while those due to Group II diseases increased with age. Overall Group I diseases and HIV/AIDS, tuberculosis and still birth mortality in particular have showed decreasing trend while Group II and III increasing over time. Double burden in mortality was highly observed in the age groups of 15-64 years. Those aged >45 years were dying more likely with non-communicable diseases compared with children. Children aged below 15 years were 16 times more likely to die from communicable, perinatal and nutritional conditions compared with elders. Mortality variation with age has been identified between public and private hospitals.

CONCLUSIONS

The results of the present study shows that, in addition to the common Group I causes of death, emerging group II diseases are contributing to high proportions of mortality in the public and private hospitals of Addis Ababa, Ethiopia. Thus, priority should be given to the prevention and management of conditions arising during perinatal period such as low birth weight and still birth, HIV/AIDS; tuberculosis, respiratory infections, cardiovascular diseases, malignant neoplasm, chronic respiratory diseases and road traffic accident. The planning of health resources and activities should take into account the double burden in mortality due to Group I and Group II diseases. This calls for strengthening approaches towards the control and prevention of non-communicable diseases such as cardiovascular and malignant neoplasm.

Measuring the pattern of high temperature areas in urban greenery of Nanjing City, China

Most studies are concerned with the cooling effect of urban greenery, but some have also revealed that some patches changed from normal temperature areas (NTAs) into high temperature areas (HTAs). Landsat TM images and ArcGIS software are used to analyze the HTA patterns in Nanjing, China. The HTAs’ lower limit temperature was defined as the 30.26 °C and the percentage of the HTAs in all greenery was 24.87%. The disturbance on the cooling effect existed but not evidently. The average impervious ratio (IR) and surface temperature (ST) of HTAs, respectively, were 3.76 times and higher 2.86 °C than those of NTAs. The structure of NTAs’ IR levels was extremely uneven but the HTAs’ were relatively even. However, the co-coefficient between the IR and ST in the whole greenery was small. Sampling analysis with the same ST and IR revealed that the complex environment in green buffer affected temperature differences; The adjacent HTAs, with its 89.78% in the study area, largely along the green patch, were far more than independent HTAs and presented a ring shape. Thus, the significantly heterogeneous urban environment inevitably resulted in diverse factors forming HTAs.

Pattern of risky sexual behavior and associated factors among undergraduate students of the University of Port Harcourt, Rivers State, Nigeria

INTRODUCTION

Age at sexual debut had decreased in the developing countries recently. Few documented studies have looked into the pattern of risky sexual behaviour and associated factors among undergraduate students in Rivers state of recent. This study examined the pattern of sexual risky behaviour of undergraduate in University of Port-Harcourt, Rivers State, Nigeria.

METHODS

A descriptive cross sectional survey was adopted and three hundred students were purposively recruited. Data were collected by a self -administered semi-structured questionnaire and analysed using descriptive and chi-square statistics at 0.05 significant level.

RESULTS

The mean age of respondents was 21.3 ± 2.8 years; more than half (57.4%) were females. Almost a quarter (24.5%) was each in 200 and 300 level of study respectively and more than a quarter (26.7%) lives alone. Sixty-one percent of the respondents had ever taken alcohol beverage with 36.1% of them were current users. More than half (52.0%) the respondents had either boy/girlfriend and a total of 144 (52.0%) had ever had sexual intercourse; of these 13% reportedly had only one sexual partner in their lifetime; girl/boy friend topped the list of their sexual partner; 48.6% respondents were currently sexually active and 32% used a form of protection during their last sexual activity. The mean age at sexual debut was 17.0 ± 4.5 years. Few (13.4%) have had sex in exchange for gifts and 5.1% of these was with a friend. Higher proportions of respondents who reported lifetime use of alcohol were sexually active (p<0.005).

CONCLUSION

Respondents exhibits risky sexual behavior as more had sex without any form of protection. Public enlightenment programmes and targeted behavioral change interventions are therefore recommended.

Metal electrode integration on macroporous silicon: pore distribution and morphology

: In this work, a new approach for the one-step integration of interdigitated electrodes on macroporous silicon substrates is presented. Titanium/gold interdigitated electrodes are used to pattern p-type silicon substrates prior the anodization in an organic electrolyte. The electrolyte characteristics, conductivity, and pH have been found to affect the adherence of the metal layer on the silicon surface during the electrochemical etching. The impact of the metal pattern on size distribution and morphology of the resulting macroporous silicon layer is analyzed. A formation mechanism supported by finite element simulation is proposed.

Condylar disarticulation; analysis of 20 cases from a nigerian tertiary centre

Background:

A disarticulation resection is a variant of mandibular segmental resection in which the condylar articulation is sacrificed. Indication varies from primary condylar lesions to jaw conditions involving the condyle.

Aim:

This retrospective analysis was carried out to highlight the pattern of disarticulation resections carried out in our centre over a five-year period.

Materials and Methods:

Cases of mandibular resection were identified from the operation book. The medical records of patients who had disarticulation resection were then retrieved and analyzed for demography, indications for disarticulations, methods of reconstruction and complications.

Results:

A total of 20 cases of disarticulation with complete records were obtained, this constituted 24.7% of total mandibular resections in the department. There were 9 males and 11 females with a male: female ratio of 1:1.2. The age ranged between 13 and 59 years with a mean of 30.4 years (std. 12.0). Sixteen patients received autogenous bone graft; two were stabilized using Steinman's pins and two with reconstruction plates. One bone graft and one reconstruction plate were removed because of infection and exteriorization respectively. Condyle was not replaced in any case. Outcomes were satisfactory but jaw deviation on opening was a common complaint in all cases.

Conclusion:

Condylar disarticulation accounts for a considerably high percentage of mandibular resection in our centre. Non vascularized immediate bone grafting without actual joint reconstruction was common. No disarticulation was carried out for traumatic reasons.

Pattern of Assault-induced Oral and Maxillofacial Injuries in Ado-Ekiti, Nigeria

Background:

Assault, though a major cause of maxillofacial injuries in the developed nations, has not been adequately investigated among Nigerian population. This study aimed to analyze the pattern of maxillofacial injuries caused by assault in our institution.

Methods:

A descriptive clinical survey of patients with assault-induced oral and maxillofacial injuries presenting to our maxillofacial surgery clinic/emergency ward was carried out. Demographic data and pattern of injuries obtained from patients’ record and department trauma database were analyzed.

Results:

156 patients presented with oral and maxillofacial injuries between October 2009 and December 2010. Thirty-four cases were due to assault and male to female ratio was 1.8:1. The mean age of the patients was 21.4±6.26 years (age range 2–48 years). 23.6% (n=8) of the injuries were due to domestic violence between spouses while 35.3% (n=12) resulted from fight. Students unrest and armed robbery attack accounted for six cases each (17.7%, n=6), while there were two cases due to child battering. 64.3% (n=22) of the injuries sustained involved soft tissues while 35.7% involved hard tissues. Contusion was the most common isolated soft tissue injury accounting for 56% (n=10) while dentoalveolar fracture was the most encountered hard tissue injury (62.5%, n=16).

Conclusion:

There is need for preventive strategies to reduce the incidence of assault-induced maxillofacial injuries.

Changing pattern of substance abuse in patients attending a de-addiction centre in north India (1978-2008)

BACKGROUND & OBJECTIVES

The patterns of abused psychoactive substances change over time, and it is important to document such changes. The present retrospective study was carried out to document these changes in patients registered in a de-addiction centre in north India over three decades.

METHODS

Case notes of all patients registered in the centre from September 1978 till December 31, 2008 were reviewed. Comparisons were made among three decades (1978-1988, 1989-1998, and 1999-2008).

RESULTS

The number of registered subjects increased eight-fold over the decades, and age of the subjects presenting for the treatment decreased. The percentages of subjects presenting for the treatment with opioid dependence were 36.8 per cent (n=204), 42.9 per cent (n=809) and 53.2 per cent (n=2219), respectively for the three decades (P<0.001). The proportion of subjects using natural opioids decreased over the three decades (47.4, 26.5 and 18.3%; P<0.001), with a concomitant emergence and/or increase of newer and prescription opioids such as buprenorphine, codeine and dextropropoxyphene. Dependence on tobacco and sedative-hypnotics also increased, and inhalant abuse was reported especially in the third decade. Polysubstance dependence increased significantly over the decades (P<0.001).

INTERPRETATION & CONCLUSIONS

Our results showed major shifts in the patterns of substance abuse in clinic-attending patients in north India over the three decades from 1978 till 2008. These have important implications for all the stakeholders concerned with combating the challenge of psychoactive substance abuse in our society.

Analysis of Gleason grade and scores in 90 Nigerian Africans with prostate cancer during the period 1994 to 2004

OBJECTIVES

To determine the relative frequency of prostate cancer among surgical specimens, and among prostate specimens received at the pathology department ,University Hospital Calabar.

METHODS

Histology records were reviewed for the following: total number of histology specimens received; total number of prostate specimens; total number of prostate cancer; and the total number of cancers in males during the study period. Histology sections 4-5microns thick were cut from paraffin blocks and stained by Haematoxylin and Eosin (H&E). Histopathologic specimens were classified using the grading system of tumour differentiation described by Gleason and associates.

RESULTS

One hundred and twenty three cancers of the prostate were received, constituting 2% of the total surgical specimens and 31% of prostate specimens. Thirty three cases (27%) could not be analyzed; therefore the study is based on 90 prostate cancer specimens. Eighty nine (99%) cases were epithelial tumours (adenocarcinoma.) There was a single mesenchymal tumour (rhabdomyosarcoma) (1%). The commonest grade in this study was the high grade (Gleason grade IV).

CONCLUSIONS

We observed that prostate cancer is a common among males (all sites) diagnosed at the University Hospital Calabar, with a peak incidence between the ages of 61 - 70 years (seventh decade).

Rickets and osteomalacia in Saudi children and adolescents attending endocrine clinic, Riyadh, Saudi Arabia

This is a retrospective study in which we report our clinical experience during the period from January 1990 to December 2009, from a paediatric endocrine clinic at King Khalid University Hospital (KKUH), Riyadh, Saudi Arabia. The diagnosis of rickets and oestomalacia was based on clinical, biochemical and radiological data. Eighty-one (34 males and 47 females) children and adolescents with rickets or osteomalacia aged 2 to 18 years (mean; 9.5 years) were evaluated. The commonest causes were nutritional; either low Vitamin D or calcium, or both. In 58 (71.60%) patients, eight patients (9.87%) were due to chronic use of anticonvulsant medications, while five (6.17%) patients were diagnosed to have celiac disease. Non-specific symptoms, such as bone pain and fatigue were the most common presenting symptoms which may indicate that other cases were possibly missed. Lack of direct sun exposure and malnutritional practices were evident. Several genetically inherited disorders were diagnosed; including; hypophosphataemic rickets in three (3.70%), vitamin D-dependent-rickets type 2 in five (6.17%) and pseudohypo-hyperparathyroidism in one (1.23%) child. Rickets was secondary to chronic renal failure in only one patient (1.23%). In conclusion, a diversity of disorders caused rickets or osteomalacia in our series. Paediatricians should be familiar with such different types and able to differentiate them from disorders mimicking rickets. rickets, such as hypophosphatasia, and metaphyseal dysplasias. An active plan should be put in place to prevent rickets and osteomalacia among young age groups.

Representative landscapes in the forested area of Canada

Canada is a large nation with forested ecosystems that occupy over 60% of the national land base, and knowledge of the patterns of Canada's land cover is important to proper environmental management of this vast resource. To this end, a circa 2000 Landsat-derived land cover map of the forested ecosystems of Canada has created a new window into understanding the composition and configuration of land cover patterns in forested Canada. Strategies for summarizing such large expanses of land cover are increasingly important, as land managers work to study and preserve distinctive areas, as well as to identify representative examples of current land-cover and land-use assemblages. Meanwhile, the development of extremely efficient clustering algorithms has become increasingly important in the world of computer science, in which billions of pieces of information on the internet are continually sifted for meaning for a vast variety of applications. One recently developed clustering algorithm quickly groups large numbers of items of any type in a given data set while simultaneously selecting a representative-or "exemplar"-from each cluster. In this context, the availability of both advanced data processing methods and a nationally available set of landscape metrics presents an opportunity to identify sets of representative landscapes to better understand landscape pattern, variation, and distribution across the forested area of Canada. In this research, we first identify and provide context for a small, interpretable set of exemplar landscapes that objectively represent land cover in each of Canada's ten forested ecozones. Then, we demonstrate how this approach can be used to identify flagship and satellite long-term study areas inside and outside protected areas in the province of Ontario. These applications aid our understanding of Canada's forest while augmenting its management toolbox, and may signal a broad range of applications for this versatile approach.

Migraine: Clinical pattern and psychiatric comorbidity

BACKGROUND

Migraine is a common disorder which has psychiatric sequelae.

OBJECTIVE

The objective of this study was to determine the clinical pattern and psychiatric comorbidity of migraine.

MATERIALS AND METHODS

100 cases of migraine seen over a period of one year were analysed to know the sociodemographic characteristics, clinical pattern and psychiatric morbidity.

RESULTS

Maximum patients were between 31-40 years of age group (40%), females (78.0%), married (76%) and housewives (56.0%). Family history of migraine was present in 12% cases. Average age of onset was 22 years. Unilateral and throbbing type of headache was most common. The commonest frequency was one to two per week. Migraine without aura was commonest sub-type (80%). Generalized anxiety disorder (F41.1) was the most common psychiatric disorder (34%), followed by mixed anxiety and depressive disorder (F41.2) (18%) and depressive episode (F32) (14%). In 22% cases, no psychiatric disorder could be elicited.

CONCLUSION

The present study confirms that majority patients with migraine had psychiatric disorders. This needs timely detection and appropriate intervention to treat and control the migraine effectively.

Selective growth of α-sexithiophene by using silicon oxides patterns

A process for fabricating ordered organic films on large area is presented. The process allows growing sexithiophene ultra-thin films at precise locations on patterned Si/SiO(x) substrates by driving the orientation of growth. This process combines the parallel local anodic oxidation of Si/SiO(x) substrates with the selective arrangement of molecular ultra-thin film. The former is used to fabricate silicon oxide arrays of parallel lines of 400 nm in width over an area of 1 cm(2). Selective growth arises from the interplay between kinetic growth parameters and preferential interactions with the patterned surface. The result is an ultra-thin film of organic molecules that is conformal to the features of the fabricated motives.

On-call emergency workload of a general surgical team

Background:

To examine the on-call emergency workload of a general surgical team at a tertiary care teaching hospital to guide planning and provision of better surgical services.

Patients and Methods:

During six months period from August to January 2007; all emergency calls attended by general surgical team of Surgical Unit II in Accident and Emergency department (A and E) and in other units of Civil, Hospital Karachi, Pakistan were prospectively recorded. Data recorded includes timing of call, diagnosis, operation performed and outcome apart from demography.

Results:

Total 456 patients (326 males and 130 females) were attended by on-call general surgery team during 30 emergency days. Most of the calls, 191 (41.9%) were received from 8 am to 5 pm. 224 (49.1%) calls were of abdominal pain, with acute appendicitis being the most common specific pathology in 41 (9.0%) patients. Total 73 (16.0%) calls were received for trauma. Total 131 (28.7%) patients were admitted in the surgical unit for urgent operation or observation while 212 (46.5%) patients were discharged from A and E. 92 (20.1%) patients were referred to other units with medical referral accounts for 45 (9.8%) patients. Total 104 (22.8%) emergency surgeries were done and the most common procedure performed was appendicectomy in 34 (32.7%) patients.

Conclusion:

Major workload of on-call surgical emergency team is dealing with the acute conditions of abdomen. However, significant proportion of patients are suffering from other conditions including trauma that require a holistic approach to care and a wide range of skills and experience. These results have important implications in future healthcare planning and for the better training of general surgical residents.

Digital quantification of five high-grade prostate cancer patterns, including the cribriform pattern, and their association with adverse outcome

Proper grading of the cribriform prostate cancer pattern has not previously been supported by outcome-based evidence. Among 153 men who underwent radical prostatectomy, 76 with prostate-specific antigen (PSA) failure (≥0.2 ng/mL [0.2 μg/L]) were matched to 77 without failure. Frequencies of high-grade patterns included fused small acini, 83.7%; papillary, 52.3%; large cribriform, 37.9%; small (≤12 lumens) cribriform, 17.0%; and individual cells, 22.9%. A cribriform pattern was present in 61% (46/76) of failures but 16% (12/77) of nonfailures (P < .0001). Multivariate analysis showed the cribriform pattern had the highest odds ratio for PSA failure, 5.89 (95% confidence interval, 2.53-13.70; P < .0001). The presence of both large and small cribriform patterns was significantly linked to failure. The cumulative odds ratio of failure per added square millimeter of cribriform pattern was 1.173 (P = .008), higher than for any other pattern. All 8 men with a cribriform area sum of 25 mm(2) or more had failure (range, 33-930). Regrading cribriform cancer as Gleason 5 improved the grade association with failure, although half of all cases with individual cells also had a cribriform pattern, precluding a precise determination of the independent importance of the latter. The cribriform pattern has particularly adverse implications for outcome.

Pattern and determinants of obesity among adolescent females in private and public schools in the Olorunda Local Government Area of Osun State, Nigeria: a comparative study

The prevalence of obesity has continued to rise at an alarming rate worldwide to such an extent that it has been described as a global epidemic. Our study aims to investigate the pattern and determinants of obesity among adolescent females in private and public schools in the Olorunda Local Government Area of Osun State, Nigeria. This is a cross-sectional descriptive study. Using the multistage sampling technique, 520 pre-tested, semi-structured questionnaires were administered to 257 girls from private schools and 263 girls from public schools. Most of the respondents from private schools (65.2%) had good knowledge about obesity and related matters while most of those from public schools (65.9%) had poor knowledge. The dietary practice of the majority of the girls from private schools (60.2%) was unhealthy while most of the girls from public schools (68.7%) had healthy dietary practices. Most of the respondents from private schools (64.2%) lived sedentary lifestyles while most from public schools (64.0%) lived active lifestyles. Using the BMI, the majority of the girls from private schools were underweight (52%), 10 (4.0%) were overweight and 3 (1.2%) were obese. For public schools, the majority (55.4%) fell within the normal group, 6 (2.3%) were overweight and none was obese. The prevalence of being overweight and of obesity was higher among the girls in private schools than among girls attending public schools. We concluded that awareness should be created to promote a healthy balance of food, drink and physical activity within and outside the school.

Prevalence and Pattern of Pain Presentation among Patients Attending a Tertiary Dental Center in a Southern Region of Nigeria

Background and aims

Orofacial pain is one of the most common reasons for attendance at the dental clinic. The prevalence and the sources of orofacial pain vary from place to place and patients’ response to pain also differs. The aim of this study was to determine the prevalence and pattern of orofacial pain as well as the factors influencing patients’ response to orofacial pain among patients presenting for dental treatment in our center.

Materials and methods

Consecutive patients presenting with orofacial pain at the Dental Center, University of Port Harcourt Teaching Hospital during the one-year period of the study were recruited into the study. Patients’ demographic data were collected and recorded in special forms. Patients were later examined to confirm the specific cause of pain. This was also recorded. Data generated were analyzed using SPSS for Windows.

Results

Four hundred and forty-eight patients out of the 2,426 patients seen during the study period had orofacial pain, yielding a prevalence rate of 18.5%. There were 255 females and 193 males with most patients in the 17-27-year age group (49.1%). Lower jaw was commonly affected. Most patients presented after a period of at least one month, with severe and spontaneous pain. Most patients had drug therapy before presentation. Caries was the most common source of orofacial pain.

Conclusion

Orofacial pain was not uncommon in our center and it accounted for about 20% of patients’ attendance in the center. Dental caries and periodontal diseases were the most common sources of orofacial pain while temporomandibu-lar joint pain and atypical facial pain were not common in our center. Young adults and females were most commonly affected.

Pattern of sexually transmitted infections in a tertiary care centre at Puducherry

Background:

The prevalence of sexually transmitted infections (STI) varies widely from region to region in our country.

Aims:

To highlight the pattern of STIs and the profile of patients with HIV infection in STD patients as seen at our hospital.

Methods:

A retrospective chart analysis of clients attending STI clinic, JIPMER, Puducherry, from June 2004 to June 2006 was done.

Results:

A total of 866 clients attended our STI clinic, out of whom 435 (50.2%) had proven STI. STIs were more common in men, with a male (290): female (145) ratio of 2:1. Their age ranged from 1 year to 75 years (mean age = 32.38 years) with the maximum number of patients in the age group of 21-30 years, while children constituted only 2.8%. Herpes genitalis (107 patients, 32.8%) was the most common ulcerative STI, while genital wart was the most common nonulcerative STI (56 patients, 17.1%). Non-gonococcal urethritis (46 patients, 14.1%) was more common than gonococcal urethritis. HIV infection was the most common STI in our study, at an alarmingly high rate of 34.5% (151/435). HIV seropositivity was more common in patients who presented with ulcerative STIs than with nonulcerative STIs.

Conclusions:

Herpes genitalis was the most common ulcerative STD, while genital wart was the most common nonulcerative STI in our study. The prevalence of HIV among STI clients in India has been on the rise, but has quite alarmingly become the most common STI in our study.

Emergent complexity in simple neural systems

The ornate and diverse patterns of seashells testify to the complexity of living systems. Provocative computational explorations have shown that similarly complex patterns may arise from the collective interaction of a small number of rules. This suggests that, although a system may appear complex, it may still be understood in terms of simple principles. It is still debatable whether shell patterns emerge from some undiscovered simple principles, or are the consequence of an irreducibly complex interaction of many effects. Recent work by Boettiger, Ermentrout and Oster on the biological mechanisms of shell patterning has provided compelling evidence that, at least for this system, simplicity produces diversity and complexity.

Domain organization of long autotransporter signal sequences

Bacterial autotransporters represent a diverse family of proteins that autonomously translocate across the inner membrane of Gram-negative bacteria via the Sec complex and across the outer bacterial membrane. They often possess exceptionally long N-terminal signal sequences. We analyzed 90 long signal sequences of bacterial autotransporters and members of the two-partner secretion pathway in silico and describe common domain organization found in 79 of these sequences. The domains are in agreement with previously published experimental data. Our algorithmic approach allows for the systematic identification of functionally different domains in long signal sequences.

Pattern of heart failure in a Nigerian teaching hospital

BACKGROUND

Congestive cardiac failure (CCF) has emerged as a major public health problem worldwide and imposes an escalating burden on the health care system.

OBJECTIVE

To determine the causes and mortality rate of CCF in the University of Port Harcourt Teaching Hospital (UPTH), south Nigeria, over a five-year period from January 2001 to December 2005.

METHODS

A retrospective study of CCF cases were identified from the admission and discharge register of the medical wards of UPTH and the case notes were retrieved from the medical records department and analyzed.

RESULTS

There were 423 patients: 242 males and 181 females. Their ages ranged from 18 to 100 years with a mean of 54.4 +/- 17.3. The commonest causes of CCF were hypertension (56.3%) and cardiomyopathy (12.3%). Chronic renal failure, rheumatic heart disease, and ischemic heart disease accounted for 7.8%, 4.3%, and 0.2% of CCF, respectively. Peripartum heart disease was rare despite being commonly reported in northern Nigerian females. Eighteen patients died from various complications with a mortality rate of 4.3%.

CONCLUSION

The burden of CCF in the Niger Delta is mainly attributed to hypertension. Efforts should be geared towards hypertension awareness, detection, treatment, and prevention in the region.

Potential prescription patterns and errors in elderly adult patients attending public primary health care centers in Mexico City

Introduction

Six out of every 10 elderly persons live in developing countries.

Objective

To analyze and assess the drug prescription patterns and errors in elderly outpatients attending public health care centers in Mexico City, Mexico.

Materials and methods

A descriptive and retrospective study was conducted in 2007. Fourteen hundred prescriptions were analyzed. Prescriptions of ambulatory adults aged >70 years who were residents of Mexico City for at least two years were included. Prescription errors were divided into two groups: (1) administrative and legal, and (2) pharmacotherapeutic. In group 2, we analyzed drug dose strength, administration route, frequency of drug administration, treatment length, potential drug–drug interactions, and contraindications. Variables were classified as correct or incorrect based on clinical literature. Variables for each drug were dichotomized as correct (0) or incorrect (1). A Prescription Index (PI) was calculated by considering each drug on the prescription. SPSS statistical software was used to process the collected data (95% confidence interval; p <0.05).

Results

The drug prescription pattern in elderly outpatients shows that 12 drugs account for 70.72% (2880) of prescribed drugs. The most prescribed drugs presented potential pharmacotherapeutic errors (as defined in the present study). Acetylsalicylic acid–captopril was the most common potential interaction (not clinically assessed). Potential prescription error was high (53% of total prescriptions). Most of the prescription errors were due to omissions of dosage, administration route, and length of treatment and may potentially cause harm to the elderly outpatients.

Conclusions

A high number of potential prescription errors were found, mainly due to omissions. The drug prescription pattern of the study population is mainly constituted by 12 drugs. The results indicate that prescription quality depends on the number of prescribed drugs per prescription (p < 0.000).

An audit of pattern of patients' presentation at the periodontics clinic of the university college hospital, ibadan

Objectives:

This study is aimed at assessing the various reasons why patients present at the periodontics clinic of the University College Hospital, Ibadan.

Materials and Methods:

A six months retrospective review of patients treated in the periodontics clinic of the University College Hospital, Ibadan was conducted. Case file records were retrieved and information on patients’ bio-data, occupation and their various presenting complaint during their first consultation at the clinic were reviewed. Three hundred patients were seen in the clinic during the period under review but records of four of them were incomplete and were therefore excluded from the study. The association between the gender of the patients and their various initial presenting complaints was assessed using chi-square tests, p set at (<0.05).

Results:

Records of two hundred and ninety-six patients were reviewed comprising of 150 males and 146 female (M/F, 1:1). Out of these patients, only eighty-four (28.4%) had been coming for regular check-up while the remaining 71.6% reported with various complaints. Majority (45.3%) presented with pain of which there were slightly more females than males (M/F =1:1.1). Gum bleeding and poor oral hygiene were other reasons why patients presented at the clinic. The younger age groups were noticed to be more frequent at the clinic on routine basis than the older ones during the period under review.

Conclusion:

The finding of this study further confirmed that majority of people only seek dental care to alleviate their pain. We therefore suggest that efforts should be intensified towards public enlightenment, as prevention is better and cheaper than cure.

Value of self-monitoring blood glucose pattern analysis in improving diabetes outcomes

Self-monitoring of blood glucose (SMBG) is an important adjunct to hemoglobin A1c (HbA1c) testing. This action can distinguish between fasting, preprandial, and postprandial hyperglycemia; detect glycemic excursions; identify and monitor resolution of hypoglycemia; and provide immediate feedback to patients about the effect of food choices, activity, and medication on glycemic control. Pattern analysis is a systematic approach to identifying glycemic patterns within SMBG data and then taking appropriate action based upon those results. The use of pattern analysis involves: (1) establishing pre- and postprandial glucose targets; (2) obtaining data on glucose levels, carbohydrate intake, medication administration (type, dosages, timing), activity levels and physical/emotional stress; (3) analyzing data to identify patterns of glycemic excursions, assessing any influential factors, and implementing appropriate action(s); and (4) performing ongoing SMBG to assess the impact of any therapeutic changes made. Computer-based and paper-based data collection and management tools can be developed to perform pattern analysis for identifying patterns in SMBG data. This approach to interpreting SMBG data facilitates rational therapeutic adjustments in response to this information. Pattern analysis of SMBG data can be of equal or greater value than measurement of HbA1c levels.

Photolithographic Approaches for Fabricating Highly Ordered Nanopatterned Arrays

In this work, we report that large area metal nanowire and polymer nanotube arrays were successfully patterned by photolithographic approach using anodic aluminum oxide (AAO) templates. Nanowires were produced by electrochemical deposition, and nanotubes by solution-wetting. The highly ordered patterns of nanowire and nanotube arrays were observed using scanning electron microscopy (SEM) and found to stand free on the substrate. The method is expected to play an important role in the application of microdevices in the future.

Structural organization of the cytoskeleton in SV40 human corneal epithelial cells cultured on nano- and microscale grooves

The basement membrane of human corneal epithelial cells (HCECs) has a three-dimensional nanoscale architecture, which includes pores, bumps and fibers that may influence cell-substrate adhesion and spreading in the overlying cells. We previously demonstrated that nano- and microscale groove and ridge patterns influence the morphological response and the adhesive response of HCECs to a nominal wall shear stress. Cell-substrate adhesion is mediated by adhesion receptors that bind to extracellular matrix components and anchor the cytoskeleton (CSK) of cells to extracellular elements. Here we investigate the CSK organization in SV40-transformed HCECs grown on nano- and microscale groove and ridge patterns. X-ray lithography was used to fabricate uniform groove and ridge patterns with features ranging in size from 200 nm to 2 microm grooves. Scanning electron microscopy and transmission electron microscopy were used to investigate CSK structure and the distribution of -beta1 integrin adhesion receptors. CSK elements aligned with the patterns; however, the spatial organization of these elements was influenced by feature size. Larger CSK bundles lay on top of the ridges and ran parallel to the patterns, whereas smaller CSK bundles, whose width was proportional to the groove size, spanned the grooves. -Beta1 integrins co-localized with the CSK and had a higher density at the poles of aligned spindle-shaped cells. Differences in organization seen on the different topographical feature sizes may be indicative of differences in extracellular matrix organization. This may explain, in part, previous observations regarding the dependence of cell adhesive responses on the size of topographic features in the substrate.

Prevalence and pattern of use of herbal medicines during pregnancy in tumpat district, kelantan

The objective of this cross-sectional study is to determine the prevalence and pattern of herbal medicines use during pregnancy among women in Tumpat district, Kelantan. A total of 210 mothers were interviewed using a structured questionnaire. There were 108 mothers (51.4%) who used at least one type of herbal medicines during pregnancy. The most common herbal medicines used (63.9%) was coconut oil which was ingested during the third trimester of pregnancy only. The most common indication was (89.8%) to facilitate labour. The majority of users (79.6%) used herbal medicines during the third trimester of pregnancy only. Many of them (81.5%) believed that herbal medicines were effective to solve their health problems and fulfilled the indications for use. The older generation like parents and in laws (63.9%) were the most common persons who suggested using herbal medicines. The majority of them used the herbs only once (56.5%) and one type (87.0%) throughout the pregnancy. Further research focusing on local commonly used herbal medicines is to be carried out to evaluate the safety and efficacy of the herbs.

Specification of stomatal fate in Arabidopsis: evidences for cellular interactions

Stomata are bi-celled epidermal structures distributed in predictable patterns providing plants with pathways for gas exchange with the atmosphere. In Arabidopsis thaliana, stomatal formation is emerging as an elegant and powerful model system to study the genetic and molecular control of cell fate specification and pattern formation in multicellular organisms. In this review, we describe the mechanisms that regulate stomatal distribution in this model plant. The emerging view indicates that cellular interactions play a relevant role during stomatal pattern formation. These cellular interactions are not restricted to a cell layer and signalling within the epidermis, between the epidermis and the underlying tissues and between organs seem to play a relevant role during stomatal formation. Whatever the nature of the different signals, the stomatal pattern must arise as the result of the integration by the epidermal cells of multiple inputs. Uncovering the molecular nature of such signals and understanding the specific role during stomatal development provides a formidable task for the future.