Leachates of weathering plastics from an urban sandy beach: Toxicity to sea urchin fertilization and early development

Plastic leachates have chemical and biological implications for marine environments. This study experimentally evaluated acute effects of weathering plastic leachates (0, 25, 50, 75 and 100 %) on fertilization and early development of the sea urchin Lytechinus variegatus. Fertilization, embryonic and larval development were drastically inhibited (~75 %) when gametes were exposed to intermediate and high leachate concentrations or delayed when exposed to the lowest concentration. Fertilization and first cleavage stages were highly affected by exposure to intermediate and high leachate concentrations. None of the cells incubated at concentrations from 50 % reached blastula stage, suggesting that embryonic development was the most sensitive stage. Abnormalities in embryos and larvae were observed in all leachate treatments. Chemical analysis detected high concentration of bisphenol A, which may induce these observed effects. Our results highlight the potential threats of plastic pollution to sea urchin populations, which may severely affect the structure and functioning of coastal ecosystems.

Brain Magnetic Resonance Imaging Abnormalities in Acute Flaccid Myelitis

BACKGROUND

Acute flaccid myelitis (AFM) presents with acute onset of flaccid paralysis with involvement of the gray matter on magnetic resonance imaging (MRI) of the spinal cord. Studies have reported brain MRI abnormalities, but the characteristics have not been fully defined. In this multicenter study, we assessed the acute features and evolution of brain MRI abnormalities in AFM.

METHODS

We reviewed brain MRIs of patients with AFM who presented to four referral hospitals between 2012 and 2018. Cases met established criteria for AFM. We analyzed the initial and follow-up brain MRIs. Areas were divided into supratentorial, infratentorial, and subdivisions within those regions.

RESULTS

A total of 66 patients were included. Brain MRI abnormalities were present in 34 (52%). Infratentorial abnormalities were more common, occurring in 33 (97%) cases with the dorsal pons being the most frequently affected area (88%). Abnormalities were also present in the medulla (74%), cerebellum (41%), and midbrain (38%). Nine subjects (26%) exhibited both supratentorial and infratentorial abnormalities, whereas isolated supratentorial changes were present in only one (3%). Contrast-enhancing abnormalities were encountered in 9% of cases and meningeal involvement in 6%. On follow-up, most abnormalities, 20 of 24 (83%), were stable, improving, or had resolved.

CONCLUSIONS

Brain MRI abnormalities occur in about half of the cases of AFM and commonly resolve with time. Dorsal pontine involvement is a characteristic MRI feature, whereas isolated supratentorial abnormalities are rare. Clinicians should consider that brain imaging abnormalities do not exclude a diagnosis of AFM in patients with typical presentations.

Benthic Foraminifera as Pollution Biomarkers: a Morphological Approach

Coastal areas are often intervened by anthropic activities, which increase the contamination of toxic agents such as heavy metals. This causes adverse morphological effects on benthic microorganisms, such as foraminifera. This group is one of the most susceptible to environmental deterioration, so they can be used as pollution biomarkers by identifying shell abnormalities. Therefore, 28 sediment samples from northern Chile were analyzed, calculating the Abnormality Index-FAI and its spatio-temporal distributions in benthic foraminifera, as well as the minimum and maximum abnormality percentages and their relationship with heavy metal concentrations, using a generalized non-linear model and a principal component analysis. The results indicated a proportion of abnormal shells within the ranges described for polluted areas conditions, revealing environmental stress conditions. This reflected a change in the environmental conditions in the most recent sediments of the bay. The highest FAI values were observed to the southwest of the bay, caused by the local current system. The species Bolivina seminuda, Buliminella elegantissima, and Epistominella exigua presented a greater number of deformities, allowing them to be used as contamination biomarkers. A significant correlation was found between Ti, Mn, Ni, Va, and Ba with decreased chamber sizes, wrong coiling, scars, and number of abnormality types. This suggests the effect of the particular geochemical conditions of the area on the heavy metals that cause toxic effects on foraminifera. These analyses are an efficient tool for identifying the effects of environmental stress before they occur in higher organisms, mitigating the environmental impact on marine biodiversity.

Assessment of real-time electrocardiogram effects on interpretation quality by emergency physicians

BACKGROUND

Electrocardiogram (ECG) is one of the most commonly performed examinations in emergency medicine. The literature suggests that one-third of ECG interpretations contain errors and can lead to clinical adverse outcomes. The purpose of this study was to assess the quality of real-time ECG interpretation by senior emergency physicians compared to cardiologists and an ECG expert.

METHODS

This was a prospective study in two university emergency departments and one emergency medical service. All ECGs were performed and interpreted over five weeks by a senior emergency physician (EP) and then by a cardiologist using the same questionnaire. In case of mismatch between EP and the cardiologist our expert had the final word. The ratio of agreement between both interpretations and the kappa (k) coefficient characterizing the identification of major abnormalities defined the reading ability of the emergency physicians.

RESULTS

A total of 905 ECGs were analyzed, of which 705 (78%) resulted in a similar interpretation between emergency physicians and cardiologists/expert. However, the interpretations of emergency physicians and cardiologists for the identification of major abnormalities coincided in only 66% (k: 0.59 (95% confidence interval (CI): 0.54-0.65); P-value = 1.64e-92). ECGs were correctly classified by emergency physicians according to their emergency level in 82% of cases (k: 0.73 (95% CI: 0.70-0.77); P-value ≈ 0). Emergency physicians correctly recognized normal ECGs (sensitivity = 0.91).

CONCLUSION

Our study suggested gaps in the identification of major abnormalities among emergency physicians. The initial and ongoing training of emergency physicians in ECG reading deserves to be improved.

European Association of Urology Guidelines on Penile Size Abnormalities and Dysmorphophobia: Summary of the 2023 Guidelines

CONTEXT

Recommendations regarding the management of penile size abnormalities and dysmorphophobia are important in guiding evidence-based clinical practice.

OBJECTIVE

To present a summary of the 2023 European Association of Urology sexual and reproductive health evidence-based recommendations for the management of penile size abnormalities and dysmorphophobia.

EVIDENCE ACQUISITION

A broad and comprehensive scoping exercise covering all areas of the guidelines was performed. Databases searched included Medline, EMBASE, and the Cochrane Libraries. A level of evidence and a strength of recommendation were assigned for each recommendation according to the evidence identified. The evidence cutoff date for the 2023 guidelines is June 1, 2022.

EVIDENCE SYNTHESIS

Well-structured studies reporting high level of evidence, with standardized PROMS were deficient on penile size abnormalities and dysmorphohobia. A shared definition for short penis/micropenis was also lacking. Categorisation of penile abnormalities according to congenital, acquired, and dysmorphophobic aetiology is deemed compulsory. A detailed medical and psychosexual history and precise measurements of penile size are essential in the diagnostic pathway. Patients with normal penile size who are seeking penile augmentation should be referred for psychological evaluation for potential dysmorphophobic disorders. Penile length and girth enhancements can be achieved via a multitude of treatments, but a personalised management plan is crucial for satisfactory results. Endocrinological therapies, when indicated, are effective in the prepubertal setting only. Vacuum therapy has a limited evidence base in treatment protocols, although acceptable outcomes have been reported for penile traction therapy. Surgical techniques to enhance penile length and girth have limited evidence and should only be proposed after extensive patient counselling.

CONCLUSIONS

Management of penile abnormalities and dysmorphophobia is a complex issue with considerable ethical concerns. The adoption of a structured diagnostic and therapeutic pathway is crucial, as recommended in the guidelines.

PATIENT SUMMARY

Requests for medical/surgical treatments to increase penis size have increased dramatically worldwide. Several conservative and surgical treatments are available. However, few patients receive clear information on the benefits and possible harms of these treatments. These guidelines aim to provide a structured path to guide both physicians and patients in the selection of appropriate treatment(s) to increase penis size.

Severe COVID-19 pneumonia leads to post-COVID-19 lung abnormalities on follow-up CT scans

Purpose

To investigate the association of the maximal severity of pneumonia on CT scans obtained within 6-week of diagnosis with the subsequent development of post-COVID-19 lung abnormalities (Co-LA).

Methods

COVID-19 patients diagnosed at our hospital between March 2020 and September 2021 were studied retrospectively. The patients were included if they had (1) at least one chest CT scan available within 6-week of diagnosis; and (2) at least one follow-up chest CT scan available ≥ 6 months after diagnosis, which were evaluated by two independent radiologists. Pneumonia Severity Categories were assigned on CT at diagnosis according to the CT patterns of pneumonia and extent as: 1) no pneumonia (Estimated Extent, 0%); 2) non-extensive pneumonia (GGO and OP, <40%); and 3) extensive pneumonia (extensive OP and DAD, >40%). Co-LA on follow-up CT scans, categorized using a 3-point Co-LA Score (0, No Co-LA; 1, Indeterminate Co-LA; and 2, Co-LA).

Results

Out of 132 patients, 42 patients (32%) developed Co-LA on their follow-up CT scans 6-24 months post diagnosis. The severity of COVID-19 pneumonia was associated with Co-LA: In 47 patients with extensive pneumonia, 33 patients (70%) developed Co-LA, of whom 18 (55%) developed fibrotic Co-LA. In 52 with non-extensive pneumonia, 9 (17%) developed Co-LA: In 33 with no pneumonia, none (0%) developed Co-LA.

Conclusions

Higher severity of pneumonia at diagnosis was associated with the increased risk of development of Co-LA after 6-24 months of SARS-CoV-2 infection.

Root Canal Treatment of a Geminated Maxillary Second Molar with C-shaped Canal System: A Case Report

Gemination is a rare phenomenon in the maxillary posterior teeth. Endodontic treatment of these teeth requires special care due to the bizarre anatomy particularly when it is accompanied by a C-shaped canal system. This report illustrates a patient with a rare geminated C-shaped maxillary second molar comprised of two sections in its crown, including a geminated section attached to a normal coronal of a second maxillary molar diagnosed with the pulpal status "necrosis" and "irreversible pulpitis" in geminated section and the molar respectively. Thus, endodontic treatment was performed on both parts of the tooth. Two months follow-up revealed well-functioning teeth with normal status of periapical tissue with no mobility or abnormality. Successful treatment of unusual anatomical teeth requires adherence to biomechanical principles of canal preparation and coronal restoration.

Examining abnormal Silurian trilobites from the Llandovery of Australia

Abnormal trilobites present insight into how arthropods with fully biomineralised exoskeletons recovered from injuries, genetic malfunctions, and pathologies. Records of abnormal Silurian trilobites in particular show an abundance of specimens with teratologies and a limited record of injuries. Here we expand the record of abnormal Silurian trilobites by presenting seven new abnormal specimens of Odontopleura (Sinespinaspis) markhami from the early Silurian (Llandovery, Telychian) Cotton Formation, New South Wales. We use these specimens to illustrate novel evidence for asymmetric distribution of pleural thoracic spine bases. These abnormal bases likely reflect genetic complications, resulting in morphologies that would unlikely have aided the fitness of abnormal individuals. In considering records of malformed Silurian trilobites more broadly, we propose that the largest trilobites may have been prey at this time. This indicates a possible change in the trophic position of trilobites when compared to Cambrian and Ordovician palaeoecosystems.

Morphological abnormalities in Hyalomma dromedarii and Hyalomma rufipes (Acari: Ixodidae) collected from dromedary camels (Camelus dromedarius) in Aswan, Egypt

The present study reports anomalies in Hyalomma dromedarii and Hyalomma rufipes adults collected from dromedary camels (Camelus dromedarius) in Aswan, Egypt, between January and June 2022. A total of 52 adult ticks displayed one or several local and/or general anomalies. A wide variety of local anomalies was observed including atrophy of one or multiple legs, ectromely, absence of accessory adanal and subanal plates, fusion of adanal and accessory plates, and presence of sclerotized formation in the ventral plate, as well as abnormalities of the spiracle, anal groove, festoon, parma, and posteromedian groove. General anomalies comprised of asymmetries and gynandromorphism. Local anomalies were documented among H. dromedarii and H. rufipes, whereas general anomalies were documented only from H. dromedarii. The present work represents the first report of deuterogynander intrigue gynandromorphism in H. dromedarii, as well as the first report of morphological abnormalities in H. dromedarii and H. rufipes from Egypt.

Missed urethral duplication associated with hypospadias, post-hypospadias repair urethral stenosis, and recurrent urinary tract infections in an adult: a case report

Background

Duplication of urethra is a very rare congenital disorder. Several types of this anomaly have been reported around the world, and are also discussed in this report. However, the mechanism of this anomaly is still unclear.

Case

A 45-year-old Persian man with a complaint of recurrent urinary tract infection was referred to our clinic. He had a history of repairing penoscrotal hypospadias in childhood along with obstructive and irritating symptoms in adolescence. On his last voiding cystourethrogram and retrograde urethrogram, stenosis was observed in the proximal bulbar urethra along with a double urethra in the dorsal region of the main urethra. The double urethra was removed with operation, and he was followed for 1 month after surgery. He had no complaints of recurrence or urinary incontinence.

Conclusions

This report shows the different classification systems, types of double urethra, and approach and management, which mainly involves surgery; however, surgical management should be done according to the anatomical findings of the abnormality.

Assessment of the psoas muscle changes following the oblique lateral interbody fusion (OLIF) approach: A prospective observational study

Background

Traditional open posterior fusion techniques involve stripping of the posterior paraspinal muscles with protracted retraction, which can lead to ischemia and denervation. This may result in poor clinical outcomes despite a well-performed surgery. Oblique lumbar interbody fusion (OLIF) is a minimally invasive modified retroperitoneal anterior approach in the corridor between the psoas major (PM) and great vessels. The purpose of this research was to study changes in psoas properties and clinical outcomes in terms of the loss of hip flexion in patients undergoing OLIF surgery.

Methods

Patients with lumbar pathologies who underwent instrumented OLIF at our center were included. These patients were examined clinically at baseline and 6 months postoperatively. The Oswestry disability index (ODI) and visual analog scale (VAS) scores for back pain and leg pain were noted. Magnetic resonance imaging (MRI) scans were obtained preoperatively and postoperatively (minimum 6 months) to compare the cross-sectional areas (CSAs) of the PM.

Results

In total, 17 patients (male: female = 8:9) with a mean age of 46.06 ± 10.49 years were included. The operation time was 154.94 ± 32.33 min, estimated blood loss was 190 ± 56 mL, and mean CSAs of the right and left psoas were, respectively, 9.94 ± 3.19 and 10.65 ± 3.74 cm2 preoperatively and 10.00 ± 3.06 and 8.53 ± 2.81 cm2 at follow-up. Qualitative measurements revealed that muscle atrophy on the left side (approach side) was 19.12% ± 3.14% and fatty degeneration had occurred in 13 of 17 (76.5%) patients. Postoperatively, all patients had significant improvement in the VAS (back and leg) and ODI scores. Furthermore, 3 of 17 (17.6%) patients had mild hip weakness (4/5) on the left side immediately postoperatively, but it resolved in 6 months. Moreover, 2 of 17 (11.8%) patients complained of paraesthesia.

Conclusion

OLIF does cause injury to the PM but it is clinically insignificant according to MRI scans and clinical evaluations.

Menstrual hygiene practices and associated factors among Indian adolescent girls: a meta-analysis

BACKGROUND

Menstrual hygiene management (MHM) and practices by adolescent females of low and middle-income countries (LMICs) are a severe public health issue. The current systematic review and meta-analysis aimed to estimate the pooled proportion of the hygiene practices, menstrual problems with their associated factors, and the effectiveness of educational interventions on menstrual hygiene among adolescent school girls in India.

METHODS

PRISMA checklist and PICO guidelines were used to screen the scientific literature from 2011 to 2021. The Newcastle-Ottawa Scale was used to assess the quality of studies. Four themes were developed for data analysis, including hygiene practices, type of absorbent used, menstruation associated morbidities and interventions performed regarding menstruation. Eighty-four relevant studies were included and a meta-analysis, including subgroup analysis, was performed.

RESULTS

Pooled data revealed a statistically significant increase in sanitary pad usage "(SMD = 48.83, 95% CI = 41.38-57.62, p < 0.00001)" and increased perineum practices during menstruation "(SMD = 55.77, 95% CI = 44.27-70.26, p < 0.00001)". Results also reported that most prevalent disorders are dysmenorrhea "(SMD = 60.24, 95% CI = 50.41-70.06, p < 0.0001)", Pre-menstrual symptoms "(SMD = 62.67, 95% CI = 46.83-78.50, p < 0.00001)", Oligomenorrhea "(SMD = 23.57, CI = 18.05-29.10, p < 0.00001), Menorrhagia "(SMD = 25.67, CI = 3.86-47.47, p < 0.00001)", PCOS "(SMD = 5.50, CI = 0.60-10.40, p < 0.00001)", and Polymenorrhea "(SMD = 4.90, CI = 1.87-12.81, p < 0.0001)". A statistically significant improvement in knowledge "(SMD = 2.06, 95% CI = 0.75-3.36, p < 0.00001)" and practice "(SMD = 1.26, 95% CI = 0.13-2.65, p < 0.00001)" on menstruation was observed. Infections of the reproductive system and their repercussions can be avoided with better awareness and safe menstruation practices.

CONCLUSIONS

Learning about menstrual hygiene and health is essential for adolescent girls' health education to continue working and maintaining hygienic habits. Infections of the reproductive system and their repercussions can be avoided with better awareness and safe menstruation practices.

Acetabular cartilage abnormalities in elderly patients with femoral neck fractures

INTRODUCTION

Both hemiarthroplasty (HA) and total hip arthroplasty (THA) are widely accepted surgical procedures for hip replacement following displaced femoral neck fractures. However, in cases involving an intact joint line before surgery, the choice between HA and THA remains debatable. This study investigated the prevalence of acetabular cartilage and labral abnormalities in elderly patients with femoral neck fractures.

METHODS

Thirty-seven patients underwent hip arthroplasty for femoral neck fractures between April 2020 and February 2021. After excluding 4 patients, 33 patients (6 men and 27 women; mean age = 82.2 [range = 67-98] years) with fractures in 12 left and 21 right hips were included. After femoral head removal during arthroplasty, the acetabulum was macroscopically examined for the presence of cartilage and labral lesions. Acetabular cartilage abnormalities were classified as either overall degeneration or partial damage according to the cartilage damage classification system.

RESULTS

Acetabular cartilage abnormalities, including overall degeneration or partial damage, were found in all hips (100%). Out of the 33 hips, overall degeneration, partial damage, and labral abnormalities were detected in 32 (96.9%), 16 (48.4%), and 9 (27.2%) hips, respectively.

DISCUSSION

In this study, most elderly patients with femoral neck fractures exhibited acetabular cartilage and labral abnormalities, which were already present at the time of surgery. Therefore, surgeons should carefully examine these abnormalities as they may impact postoperative outcomes such as pain and function.

Audiological characteristics and effect of endoscopic surgery for simple congenital malformation of ossicular chain

OBJECTIVE

To analyze the audiological characteristics and surgical results in patients undergoing surgery for simple congenital ossicular chain malformation, and the effect of endoscopic surgery.

METHODS

A retrospective review was performed on 86 patients who underwent surgery for the congenital malformation of the ossicular chain. Clinical characteristics and audiometric data were analyzed. Fifty-eight patients had detailed postoperative data, and the preoperative and postoperative audiometric results were compared. The subjects were further divided into endoscopic and microscopic groups, and their surgical effects were examined.

RESULTS

The preoperative audiometry results in the low-frequency group were worse than those in the high-frequency group (P < 0.05). A postoperative air-bone gap closure to 20 dB or less was achieved in 73.33% of the 60 ears of patients postoperatively. The postoperative air conduction and air-bone gap were significantly better than the preoperative ones (P < 0.05), and the improvement effect was the best in class III patients (P < 0.05). Postoperative hearing had no significant differences between the endoscopic and microscopic groups. However, endoscopic surgery also was more advantageous in terms of operating time (P < 0.05).

CONCLUSIONS

Preoperative pure tone audiometric results showed moderate or moderate-severe hearing loss, especially in the low-frequency area. The reconstruction of the auditory ossicle chain can achieve satisfactory results, especially in class III patients. Endoscopic and microscopic surgery in the treatment of simple congenital ossicular chain malformations can effectively improve postoperative hearing.

Morphological abnormalities and multiple mitochondrial clades of Rhipicephalus haemaphysaloides (Ixodida: Ixodidae)

Rhipicephalus haemaphysaloides is endemic in South and Southeast Asia, and it is known to parasitise domestic animals such as cattle, horses, sheep, and dogs. Despite infestation on multiple hosts, little attention has been paid to its morphological and molecular variation. The present study describes local morphological abnormalities for the first time in R. haemaphysaloides from Malaysia, and highlights the presence of three cytochrome c oxidase subunit I (COI) operational taxonomic units with 0.46-9.81% distances within the so-called R. haemaphysaloides in Malaysia, Thailand, and Pakistan.

Aberrant right subclavian artery with right type 1 proatlantal artery and segmental dysplasia of the right internal carotid artery: a case report

PURPOSE

We present a case of an aberrant right subclavian artery (ARSA) with extremely rare vascular anomalies.

CASE REPORT

A 69-year-old woman was suspected to have right internal carotid artery (ICA) stenosis. Computed tomography angiography demonstrated an ARSA and hypoplasia of the right ICA. The proximal segment of the right vertebral artery (VA) was aplasia, and a right type 1 proatlantal artery (PA) arose from the right common carotid artery. Cerebral angiography demonstrated segmental dysplasia of the right ICA. The ascending intrapetrous segment and the ascending foramen lacerum-horizontal intracavernous segment of the right ICA demonstrated hypoplasia. The collateral pathways promoted reconstitution of each of the distal segments. Left internal carotid angiography demonstrated anterior communicating artery aneurysm and sufficient cross flow to the contralateral middle cerebral artery via the AcomA.

DISCUSSION

A type 1 PA with an ARSA may result in the regression of the right dorsal aorta with persistence of the first cervical intersegmental artery. Although there are few findings of a relationship between an ARSA and intracranial artery anomalies, a developmental error of the right dorsal aorta may cause such complex vascular anomalies.

CONCLUSION

Knowledge of anatomical variations in patients with ARSA is useful when performing angiography or endovascular therapy, as well as during clinical follow-up.

Multiparametric CT-based assessment of pretracheal anatomical relationships for safe tracheotomy: A long-forgotten issue revisited

OBJECTIVES

To assess the anatomical relationships and variations in the pretracheal space and to guide tracheotomy procedures in a safe manner with image-based evidence.

MATERIALS AND METHODS

A retrospective study was conducted on unirradiated patients requiring elective tracheotomies. Preoperative contrast-enhanced CT (CECT)/CT venography (CTV) was applied for an anatomical evaluation of the pretracheal region. Vascular morphologies were compared for three vessels: the anterior jugular vein (AJV), the innominate artery (IA) and the inferior thyroid vascular plexus (ITVP). The relationships between the thyroid isthmus and the 2nd-4th tracheal rings were also analyzed.

RESULTS

A total of 120 patients were identified, most of whom (n = 110, 91.7%) had head and neck squamous cell carcinomas. Patients with recognizable AJVs (n = 118) were divided into 3 groups: single-branch (n = 11, 9.2%), double-branch (n = 105, 87.5%), and multibranch (n = 2, 1.7%). In addition, IAs were categorized as low-bifurcation (n = 51, 42.5%), high-bifurcation (n = 40, 33.3%), platform (n = 27, 22.5%) and variant types (n = 2, 1.7%). Within the platform types, high-lying IAs (n = 15, 8.3%) might have interfered with the standard tracheal incisions due to possible IA-tracheal overlay. This interference was also related to the height of intraoperative tracheal incisions (r_n = 0.364, P = 0.001). Within ITVPs, independent-trunk types were found in 71 cases (59.2%), while common-trunk types were found in 45 (37.5%). In addition, a low thyroid isthmus (suprasternal-isthmus distance <3 cm) was found in 83 cases (69.2%).

CONCLUSIONS

CT image-based evidence can prepare junior practitioners with important pretracheal anatomical information, thereby facilitating safer tracheotomy procedures. Our results shed light on vascular relationships for emergent tracheotomy.

Temporal and spatial toxicogenetic damage in estuarine catfish Cathorops spixii from a marine protected area with evidence of anthropogenic influences

Taking action to contribute to the preservation of the natural coastal environment, which maintains a diversity of life, is important in today's world. In estuarine ecosystems that are included in marine protected areas (MPA), it is important to conduct biomonitoring over time to monitor the effects of xenobiotics on bioindicator species such as the catfish Cathorops spixii. This study aims to evaluate the toxicogenetic signals in C. spixii from a MPA (Cananéia-Iguape region, Brazilian coast). These genotoxic signals are demonstrated by the presence of micronuclei (MN) and abnormalities in erythrocytes (AE). This study also takes into account the environmental differences signaled by the water's properties (temperature, salinity, pH, DO, dissolved nutrients, and particulate material) over time (2009, 2014, 2017, and 2018). The results show that in the northern region of the estuary, and mainly in 2009, the water properties reveal the influence of the river in the form of the lowest levels of salinity and pH and the highest levels of nutrients. The most significant levels of suspended particulate material and chlorophyll-a are found in the southern region of the estuary, mainly in 2017 and 2018. In general, the C. spixii from the northern region had better well-being than catfish from the more preserved (southern) region. The data on MN and AE show evidence of toxicogenetic damage occurring over time and clastogenic/aneugenic effects mainly in fish sampled in 2018. The presence of a new AE, first recorded in C. spixii sampled in 2018, and named here as double bubbled, is another indicator of toxicogenetic effects. Finally, although the southern region of the estuary has better abiotic properties and conditions for primary production, the obtained toxicogenetic data for C. spixii reinforces the need for - and encourages the implementation of - monitoring actions in this marine protected area using bioindicator species of contamination.

Brain structural and functional anomalies associated with simultanagnosia in patients with posterior cortical atrophy

Simultanagnosia is a common symptom of posterior cortical atrophy, and its association with brain structural and functional changes remains unclear. In our study, 18 posterior cortical atrophy patients with simultanagnosia, 29 patients with Alzheimer’s disease and 20 cognitively normal controls were recruited and subjected to full neuropsychological evaluation, including simultanagnosia tests, and structural and resting-state functional MRI. The gray matter volume was assessed by voxel-based morphometry, while the intrinsic functional connectivity was evaluated using the reduced gray matter volume regions of interest as the seed. In contrast to the patients with Alzheimer’s disease, those with posterior cortical atrophy showed the following: (1) markedly lower simultanagnosia test scores, (2) an altered regional gray matter volume of the left middle occipital gyrus and ventral occipital areas, and (3) lowered intrinsic functional connectivity with the left middle occipital gyrus, left lingual gyrus and right middle occipital gyrus separately. Additionally, the gray matter volume of the left middle occipital gyrus and left inferior occipital gyrus were each correlated with simultanagnosia in posterior cortical atrophy patients. The intrinsic functional connectivity of the left middle occipital gyrus with the right superior occipital gyrus and that of the right middle occipital gyrus with the left superior parietal gyrus were also correlated with simultanagnosia in posterior cortical atrophy patients. In summary, this study indicated that simultanagnosia is associated with gray matter reductions and decreased functional connectivity in the left middle occipital gyrus and the left inferior occipital gyrus in patients with posterior cortical atrophy.

Protective role of Mas Cotek (Ficus deltoidea) against the toxic effects of bisphenol A on morphology and sex steroid receptor expression in the rat uterus

BACKGROUND

Numerous scientific studies have found that young women are at a high risk of reproductive infertility due to their routine exposure to numerous bisphenol A (BPA) products. This risk is highly associated with the production of reactive oxygen species from BPA products. Ficus deltoidea, which has strong antioxidant properties, was selected as a potential protective agent to counter the detrimental effects of BPA in the rat uterus.

METHODS

Female Sprague-Dawley rats were allocated into four groups (n = 8) as follows: (i) the Normal Control group (NC), (ii) the BPA-exposed group (PC), (iii) the group concurrently treated with BPA and F. deltoidea (FC) and (iv) the group treated with F. deltoidea alone (F).

RESULTS

After 6 weeks of concurrent treatment with F. deltoidea, uterine abnormalities in the BPA-exposed rats showed a significant improvement. Specifically, the size of stromal cells increased; interstitial spaces between stromal cells expanded; the histology of the glandular epithelium and the myometrium appeared normal and mitotic figures were present. The suppressive effects of BPA on the expression levels of sex steroid receptors (ERα and ERβ) and the immunity gene C3 were significantly normalised by F. deltoidea treatment. The role of F. deltoidea as an antioxidant agent was proven by the significant reduction in malondialdehyde level in BPA-exposed rats. Moreover, in BPA-exposed rats, concurrent treatment with F. deltoidea could normalise the level of the gonadotropin hormone, which could be associated with an increase in the percentage of rats with a normal oestrous cycle.

CONCLUSION

F. deltoidea has the potential to counter the toxic effects of BPA on the female reproductive system. These protective effects might be due to the phytochemical properties of F. deltoidea. Therefore, future study is warranted to identify the bioactive components that contribute to the protective effects of F. deltoidea.

Double anus in an Ixodes scapularis nymph, a medically important tick vector

BACKGROUND

Ixodes scapularis ticks are medically important arthropod vectors that transmit several pathogens to humans. The observations of morphological abnormalities, including nanism, missing leg, extra leg, and gynandromorphism, have been reported in these ticks. In this study, we report the presence of two anuses in a laboratory-reared I. scapularis nymph.

RESULTS

Larval ticks were allowed to feed on mice and to molt to nymphs. Two anuses were observed in one of the freshly molted nymphs. Stereo and scanning electron microscopy confirmed the presence of two anuses in one nymph within a single anal groove.

CONCLUSIONS

This report confirms the rare occurrence of double anus in I. scapularis.

Intracranial Abnormalities with Diffusion Restriction

Multiple pathologic conditions can cause changes in the random movement of water, which can be detected with diffusion-weighted imaging (DWI). DWI plays a powerful clinical role in detecting restricted diffusion associated with acute brain infarction. Other disorders can also result in restricted diffusion. This article focuses on showing examples of common and uncommon disorders that have restricted diffusion secondary to cytotoxic and/or intramyelinic edema. These disorders include ischemia, infection, noninfectious demyelinating diseases, genetic mutations affecting metabolism, acquired metabolic disorders, toxic or drug exposures, neoplasms and tumorlike lesions, radiation treatment, trauma, and denervation.

Congenital lateral facial teratoma: A case report and review of literature

Facial teratomas are uncommon tumours in children that distort the face and may be associated with functional problems. They are less common than cervical teratomas though they are often grouped together and considered an emergency due to their tendency to cause respiratory compromise. They tend to be large and cause cosmetic issues; hence usually noticed early and medical help sought promptly by parents. The close proximity of facial teratomas to structures like eyes, parotid gland, facial nerve, vessels and brain makes them challenging and requires a patient and meticulous exploration during surgery. We present a case of an 11 month old girl with left sided temporal teratoma. Well planning of the incision and complete excision of the tumour with careful sparing of the facial nerves and parotid gland yielded good result.

Investigation of morphological abnormalities in red blood cells among dental laboratory technicians

A variety of materials are used in dental prosthesis laboratories (DPL), especially metal alloys and methyl methacrylate (MMA)-based monomers and polymers. These metal alloys contain elements such as cobalt, chromium, nickel, molybdenum, lead, and mercury that can have toxic effects on human health when excessive amounts of exposure occur. This study aims to investigate the cytotoxic effects of occupational exposure due to dental prosthesis manufacturing operations on erythrocyte cells. Thirty DPL workers were compared with the 30 control group and the questionnaire forms were applied including the symptoms due to their occupational exposure. Blood was taken from the experimental group and the control group into tubes with EDTA, and the erythrocyte morphologies were examined by the peripheral smear technique. Morphological anomalies determined from the experimental group and the control group are statistically significant (p < .005, p < .01). On the other hand, it was revealed that the sub-variables, namely age range, alcohol, and smoking, did not significantly affect the anomalies. With these results, it was concluded that DPL employees should strictly comply with occupational health precautions.

Effects on anatomy of some abundantly growing herbs in the effluents contaminated soil of oil refinery

The soil contaminations from refinery effluents are still a burning problem in the oil-producing nations of the globe. In the present study, the effect of oil refinery effluents on anatomical characteristics of some selected herbs has been studied. The abundantly growing herb species of the contaminated sites that includes Ageratum conyzoides, Alternanthera paronychioides, and Cyperus brevifolius were selected for the anatomical investigation. The samplings site of these herbs was adjacent to Numaligarh oil refinery, Assam, India, where a huge amount of oil effluents are released every day. For comparison, the same plant species were collected from the control sites where effluent contamination was not evident. The results showed that anatomical sections of both shoots and roots of the studied herbs are adversely affected by oil refinery effluents contamination and showed various structural abnormalities. Dark/blackish depositions were traced in the different tissues that include the epidermis, cortex, vascular bundles and pith region in the plant samples collected from the effluents contaminated areas. The results also revealed widening, thickening, and reduction of different tissues of the studied plants besides affecting overall shoot diameter; cell sizes; and length of epidermis, cortex, vascular bundles, and pith as a defense mechanism against the adverse condition created due to effluent contamination. Such abnormalities were not observed in control plants.

A Cadaveric Study of Splenic Fissures and Bilobed Spleen

Objectives

Anatomical knowledge regarding the external morphology of the spleen is essential for surgical intervention and radiological diagnosis. A characteristic feature of the spleen is the presence of splenic notches at the superior border; however, such notches rarely extend deep enough to be considered fissures or to separate the spleen into multiple lobes. To date, there are very few cadaveric reports of splenic fissures. This study aimed to examine the anatomy and morphological structure of spleens collected from cadavers in order to identify the prevalence and clinical significance of splenic notches, fissures and lobation.

Methods

This study was conducted at the Department of Anatomy, Katuri Medical College and Hospital, Guntur, Andhra Pradesh, India. A total of 50 spleens were collected from cadavers over a period of seven years from 2012-2019 and examined to determine the presence of splenic notches or fissures.

Results

Of the 50 spleens, 40% had notches at the superior border, 10% had notches at the inferior border and 50% had no notches at either border. Fissures were present in five spleens (10%); of these, three showed incomplete fissures and the remaining two had complete fissures that divided the spleen into two lobes.

Conclusion

The findings of this study provide valuable information regarding the anatomy and prevalence of splenic fissures and bilobed spleens. A bilobed spleen is a rare congenital malformation which should be considered distinct from other known splenic anomalies. The presence of splenic fissures in bilobed spleens can serve as a guide for surgeons during conservatory splenectomy procedures.

External jugular vein pierced by supraclavicular branches in a neonatal cadaver: a case report

Anatomical variations in the venous structure and drainage patterns in the neck are not uncommon. However, this is the first known report on the external jugular vein being pierced by supraclavicular branches. In the lateral cervical region of a neonatal cadaver, the supraclavicular branches penetrated the external jugular vein superior to the clavicle, resulting in a circular venous channel formed around the nerve trunk. Variations such as these are important to note in order to minimize possible intra-operative complications sustained during surgical interventions such as venous catherization or nerve grafts.

Single coronary artery arising from an atretic pulmonary trunk

Coronary artery anomalies are a diverse group of disorders with highly variable manifestations and pathophysiological mechanisms. The origin of a single coronary artery from an atretic pulmonary trunk is a rare anomaly. We encountered this in an 8-day-old female newborn. This report should alert the cardiac surgical community to this fatal coronary malformation. Surgeons should bear this anomaly in mind when they face unusual myocardial behavior intraoperatively.

Wooden breast myopathy on broiler breast fillets affects quality and consumer preference

INTRODUCTION

The emergence of myopathies such as wooden breast in the poultry industry generally associated with the fast development of the breast muscle of broilers has provided changes in the morphological structure of muscle tissues, as well as problems of meat qualitative attributes. The aim of this study was to evaluate physical, chemical, qualitative, and sensorial attributes of broiler fillets associated with severity levels of wooden breast (WB) myopathy in a poultry slaughterhouse.

MATERIALS AND METHODS

Three hundred fillets in a poultry slaughterhouse were classified into three severity levels: normal (100 samples), moderate (100 samples), and severe (100 samples).

RESULTS

After identification, classification, and description of changes, fillets with a severe WB level presented higher levels of red (a*), yellow (b*), and final pH. The lowest shear force and the highest myofibrillar fragmentation index were observed in fillets with a severe level when compared with normal fillets. The collagen content increased according to severity level. Tasters better evidenced the characteristic taste of chicken meat when tasting fillets with a severe WB level when compared with normal and moderate fillets. The succulence and preference of the Brazilian testers increased according to the severity level of the myopathy.

CONCLUSION

In general, fillets with moderate and severe WB myopathy were affected not only in appearance but also in qualitative, physical, chemical, and sensory characteristics.

Studying the multiple faces of nevoid basal-cell carcinoma syndrome: A case series

Nevoid basal-cell carcinoma syndrome (NBCCS) or Gorlin–Goltz syndrome is an autosomal dominant-inherited condition that exhibits high penetrance and variable expressivity; however, this disorder can arise spontaneously. In 1960, Gorlin and Goltz described the syndrome as a condition, comprising the principle triad of multiple basal cell carcinoma, odontogenic keratocysts, and skeletal anomalies. The diagnostic findings of NBCCS in four patients were studied and compared with other reports in the Indian population. Early diagnosis of this syndrome is important for counseling of patients to prevent the life-long complications of this syndrome which includes the malignancy, oro-maxillofacial deformation, and destruction; this may be reduced if the diagnosis and treatment are made feasible at the earliest.

Repair of pulmonary artery sling with tracheal and intracardiac defects

BACKGROUND

Pulmonary artery sling is commonly associated with tracheal stenosis and intracardiac anomalies. While surgical repair is standardized, coexistent anomalies often determine outcomes. With the paucity of risk stratification, this study aimed to review our experience and stratify risk factors for the surgical outcome of complex pulmonary artery sling repair in the presence of airway or intracardiac lesions.

METHODS

Seventy-nine consecutive children with pulmonary artery sling were evaluated retrospectively following surgical repair. Median age at surgery was 5 months (interquartile range 3-9). Surgical approaches included pulmonary artery sling alone (n = 10), pulmonary artery sling with tracheoplasty (n = 41), and pulmonary artery sling with both intracardiac and tracheal surgery (n = 28).

RESULTS

There were 7 early (8.8%) deaths. Two patients after left pulmonary artery reimplantation needed revision of the anastomosis. The median intensive care and hospital stay were 11 (interquartile range 9.2-24.8) and 17.9 (interquartile range 4.3-19.8) days, and considerably longer when associated tracheal surgery (p = 0.002). Follow-up was complete in 66/69 and 3 (3.8%) children died late: 2.7, 10.2, and 17 months after surgery. Univariate analysis showed abnormal lung and coexisting structural heart disease as risk factors. Multivariate analysis revealed total cardiopulmonary bypass time as an independent predictor of overall mortality.

CONCLUSION

Complex pulmonary artery sling repair can be performed with a good surgical outcomes even when associated with airway malformations or structural heart diseases. Lung abnormality and longer cardiopulmonary bypass time as a surrogate marker of complex surgery, are possible risk factors.

Stavudine exposure results in developmental abnormalities by causing DNA damage, inhibiting cell proliferation and inducing apoptosis in mouse embryos

Stavudine is an anti-AIDS drug widely used to prevent HIV transmission from pregnant mothers to the fetuses in underdeveloped countries for its low price. However, there is still a controversy on whether stavudine affects embryo development. In the current study, embryotoxicity of stavudine was evaluated using cultured mouse embryos with the concentrations: 5, 10, 15 μM and vehicle control. The data indicated that the effect of stavudine was dose-dependent at early neurogenesis. Stavudine exposure reduced somite numbers, yolk sac diameter, crown-rump length, and increased the rate of embryonic degeneration compared with the control. We chose the lowest but clearly toxic concentration: 5 μM to investigate the molecular mechanisms of the damage. At the molecular level, stavudine produced DNA damage, increased the levels of the phospho-CHK1 and cleaved-caspase-3, and decreased the expression level of proliferating cell nuclear antigen. These changes indicated that stavudine caused a coordinated DNA damage response, inhibited cell proliferation, and induced apoptosis in the embryos. Collectively these results suggest that stavudine exposure disturbs the embryonic development, and its use in pregnant mothers should be re-examined.

Exploring abnormal Cambrian-aged trilobites in the Smithsonian collection

Biomineralised trilobite exoskeletons provide a 250 million year record of abnormalities in one of the most diverse arthropod groups in history. One type of abnormality-repaired injuries-have allowed palaeobiologists to document records of Paleozoic predation, accidental damage, and complications in moulting experienced by the group. Although Cambrian trilobite injuries are fairly well documented, the illustration of new injured specimens will produce a more complete understanding of Cambrian prey items. To align with this perspective, nine new abnormal specimens displaying healed injuries from the Smithsonian National Museum of Natural History collection are documented. The injury pattern conforms to the suggestion of lateralised prey defence or predator preference, but it is highlighted that the root cause for such patterns is obscured by the lumping of data across different palaeoecological and environmental conditions. Further studies of Cambrian trilobites with injuries represent a key direction for uncovering evidence for the Cambrian escalation event.

Chondrocutaneous transposition flap for congenital tragal malformation with dystopic cartilage

Due to the variety in the shape of dysmorphic cartilage, tragus reconstruction is one of the most challenging goals in otoplasty. The authors describe a method to reconstruct a prominent tragus in a simple way suitable for accounting for the size, shape, and location of the remaining ear. We present a case of tragus deformity in an 11-year-old female patient after a previous excision of pretragal skin tags. There was a small remnant of the deeply located dystopic cartilage in a horizontal orientation. The dystopic cartilage was used to reconstruct the tragus using a chondrocutaneous transposition flap. Only a small portion of the pre-existing cartilage was used to create a chondrocutaneous transposition flap that supplemented the portion of cartilage during tragus reconstruction. The result was a new tragus that showed acceptable improvement in shape, location, and projection. Patients with a small portion of pre-existing cartilage near the tragal wall may benefit from the use of this method for tragus reconstruction.

Hyperbaric Oxygen for Radiation Necrosis of the Brain

INTRODUCTION

Hyperbaric oxygen therapy (HBOT) shows promising results in treating radionecrosis (RN) but there is limited evidence for its use in brain RN. The purpose of this study is to report the outcomes of using HBOT for symptomatic brain RN at a single institution.

METHODS

This was a retrospective review of patients with symptomatic brain RN between 2008 and 2018 and was treated with HBOT. Demographic data, steroid use, clinical response, radiologic response and toxicities were collected. The index time for analysis was the first day of HBOT. The primary endpoint was clinical improvement of a presenting symptom, including steroid dose reduction.

RESULTS

Thirteen patients who received HBOT for symptomatic RN were included. The median time from last brain radiation therapy to presenting symptoms of brain RN was 6 months. Twelve patients (92%) had clinical improvement with median time to symptom improvement of 33 days (range 1-109 days). One patient had transient improvement after HBOT but had recurrent symptomatic RN at 12 months. Of the eight patients with evaluable follow-up MRI, four patients had radiological improvement while four had stable necrosis appearance. Two patients had subsequent deterioration in MRI appearances, one each in the background of initial radiologic improvement and stability. Median survival was 15 months with median follow-up of 10 months. Seven patients reported side effects attributable to HBOT (54%), four of which were otologic in origin.

CONCLUSIONS

HBOT is a safe and effective treatment for brain RN. HBOT showed clinical and radiologic improvement or stability in most patients. Prospective studies to further evaluate the effectiveness and side effects of HBOT are needed.

Frequency and characteristics of congenital intraspinal abnormalities in a cohort of 128 patients with congenital scoliosis

OBJECTIVES

The aims of this study were to determine the incidence and main characteristics of associated intraspinal anomalies in patients with congenital scoliosis (CS) and to analyze the different factors that influence the curve progression.

DESIGN

This was a retrospective comparative study.

METHODS

This was a retrospective study of 128 patients with CS.

MAIN OUTCOME MEASUREMENTS

The incidence of the patients with intraspinal anomalies and their demographic, clinical, and radiological values was described.

RESULTS

Intraspinal anomalies were present in 13.3% of the patients. Among them, the most frequent anomaly was syringomyelia. The most frequent curve was the thoracic curve. The main deformity based on McMaster classification was formation failure. The curve progression during follow-up did not show significant differences between vertebral anomalies, syringomyelia, presence of thoracic anomalies, and gender (P > 0.05).

CONCLUSIONS

Our study showed a lower percentage of spinal anomalies compared to other series. As other studies, the progression of the scoliosis curve in patients with spinal anomalies seems primarily to be determined by the type of vertebral malformation.

LEVEL OF EVIDENCE

Level II.

Amniotic Band Syndrome Associated with Exencephaly: A Case Report and Literature Review

Amniotic band syndrome (ABS) is a rare congenital disease with variable manifestations ranging from simple constriction rings at the extremities to major defects such as exencephaly. Here we report the case of a female baby born full term (39 weeks) from a 35-year-old primiparous mother by cesarean section. In addition to the constriction rings at the extremities (fingers), the newborn presented facial malformations and a cranial anomaly suggestive of exencephaly. Supportive treatment was chosen because of the poor prognosis, and the child died 5 months later. Depending on the anomaly associated with ABS and its complexity, as in our case, genetic studies should be performed whenever possible, and the parents should be informed about the possibility of recurrences and incompatibility with life.

Teratogenicity and accumulation of triclosan in the early life stages of four food fish during the bioassay

TCS [5-chloro-2-(2,4-dichlorophenoxy)phenol] caused a concentration dependent delay in embryonic development, delay and decline in hatching and reduction in length and weight of hatchlings along with an increase in abnormal/deformed embryos and larvae and percent mortality. These parameters varied in a species specific manner and increased with TCS residue in body. The 96 h LC₅₀ values of TCS for Cyprinus carpio, Ctenopharyngodon idella, Labeo rohita and Cirrhinus mrigala were estimated at 0.315, 0.116, 0.096 and 0.131 mg/L, respectively. Hatching got delayed by 16.33 h for C. carpio (0.47 and 0.50 mg/L TCS) and C. idella (0.20 mg/L TCS) but by 18.07 h for L. rohita (0.15 mg/L TCS) and by 19.33 h for C. mrigala (0.18 mg/L TCS). Spine malformations, oedema (yolk sac and cardiac) and deflated swim bladder were present in 100% larvae of C. carpio, C. idella, L. rohita and C. mrigala at 0.30, 0.08, 0.13 and 0.14 mg/L TCS, respectively. TCS also caused hemorrhage (all but C. idella, only 3.33%), albinism and deformed caudal fin (C. idella), hypopigmentation and rupturing of yolk sac (C. mrigala), gas bubble disease (C. mrigala and L. rohita), fusion of eyes (C. carpio) and degeneration of digestive tract (L. rohita) in 10-40% hatchlings. Exposed hatchlings were very weak and paralyzed, could not swim and remained settled at the bottom of jars. Embryonic development was observed to be an early indicator of the toxicity of TCS as oedema and bubbles in yolk were observed in 40-100% embryos/hatchlings at 0.08 mg/L TCS while 100% mortality was observed between 0.15 and 0.50 mg/L TCS. L. rohita was most sensitive and C. carpio was least sensitive to the stress of TCS. Accumulation of TCS in the hatchlings (1/10 of TCS in water) after 96 h exposure hints that even small quantities of TCS may change species diversity in natural waters.

A case of right ductus and left innominate artery from the pulmonary trunk

Right-sided aortic arch is a rare anatomic variation of aortic arch anomaly, which may coexist with or without other cardiac defects. We report an extremely rare case of right-sided aortic arch with a right ductus arteriosus and isolation of the left brachiocephalic trunk, without other associated intracardiac lesions. We describe the successful surgical management of this anomaly in a neonate who had bilateral choanal atresia without DiGeorge syndrome or Down syndrome. However, our patient had clinical signs of hearing loss in the postoperative follow-up period.

Identification of a Dental Anomaly in a Tiriyo Indigenous Park Patient by Computed Tomography: A Case Report

This report describes anatomical variations in an indigenous patient from the Brazilian Amazon. A 13-year-old indigenous girl attended the dental clinic for a routine examination. Clinically, a change in the coronary morphology of all upper incisors was observed; characterized by a shovel-shaped lingual surface-a feature considered a polygenic hereditary trait commonly found in native American people. The x-ray examination revealed the presence of a root anomaly in the left upper central incisor. A cone-beam computed tomography (CBCT) scan was performed, revealing the presence of a supernumerary root located on the lingual surface. A single wide canal, which bifurcated in the middle-third level into two canals with different foramina, was observed in the cervical portion. It is essential for dental surgeons to be aware of possible anatomical differences, especially considering the origin of the patient, to avoid interference in treatment success.

Cervical Spine Malformations Associated With a 5q34-5q35.2 Micro-interstitial Deletion: A Case Report

We report a female proband carrying a de novo 5q34-q35.2 deletion breakpoint, and review the unique skeletal phenotype and possible genotype related to this mutation. The patient presented with a persistent head tilt and limited head rotation. Non-contrast-enhanced three-dimensional computed tomography of the cervical spine revealed several malformations including a bone cleft in the right pars interarticularis, a bone defect in both C5 lamina and the transverse foramen at C2-C3, agenesis of the right articular process of C5, bony fusion of C4-C5, and subluxation of the craniocervical joints. Several deformities of the cervical spine seen in this patient have not been associated with the 5q deletion. A review of 5q-related mutations suggests that abnormalities associated with MSX2 gene might cause cervical spine abnormalities.

Congenital left ventricular aneurysm diagnosed with atrial septal defect

An 8-year-old girl with no history of chest pain or exertional dyspnea was admitted for atrial septal defect closure. Transthoracic echocardiography showed a sac in the right atrium, protruding from the left ventricle. A left ventricular aneurysm was confirmed by cardiac catheterization. At surgery, the protruding saccular aneurysm arising from the left ventricle was located between the atrial septal defect and the tricuspid valve. We closed the orifice with interrupted sutures from the right atrium. The atrial septal defect was closed with an autologous pericardial patch. Histology showed the aneurysmal wall had no myocardial layer, being replaced by fibrous tissue.

Seroprevalence of human Toxoplasma gondii infection among pregnant women in Charsadda, KP, Pakistan

Toxoplasmosis is a very common and asymptomatic infection caused by Toxoplasma gondii. Pregnant women can develop serious complications if the infection passes to the developing fetus. Primary infection in the pregnant women during the gestation period will result in the development of severe systemic disease with temporary parasitemia and will affect the developing fetus. Several clinical complications can be observed in the congenitally infected children which include mild disease to serious health defects such as mental retardation. The aim of the current study was to determine the seroprevalence among pregnant women in District Charsadda, KP, Pakistan. From various maternity homes and other health care centers 200 random samples were collected. Serum was extracted from the blood and was subjected to the specific serological technique by using Latex Agglutination Kit. Out of 200 random samples collected from pregnant women, 69 (34.5%) were detected positive for the parasite and the remaining 131 (65.5%) were found negative. The seroprevalence of the parasite was also determined in the pregnant women based on various age groups. The infection was more prevalent in the age group of 26-40 years with a total of 54.55% of the total studied population while low seroprevalence of the parasite was recorded in the age group 41-55 years with about 21.87%. However, the age group 15-25 years showed a moderate infection of about 23.63%. Abnormalities were also observed in the newborns of the pregnant women infected with the parasite. From Charsadda 76.1%, 45.1% from Tangi and 72.1% babies from tehsil Shabqadar were born with congenital abnormalities. With proper health care, development and utilization of effective diagnostic and therapeutic strategies the epidemics of the infection can be significantly reduced. The routine serological test is recommended for all the pregnant women.

A new perspective to aberrations caused by barium and vanadium ions on Lens culinaris Medik

This study investigates aberrations caused by barium and vanadium on meristematic cells of Lens culinaris Medik. Barium and vanadium ions at various concentrations (0.05 M, 0.1 M, 0.25 M, 0.5 M, and 1.0 M) were exposed to the seeds of the plant at fixed time interval (12 h). After seedlings, with a microscopic examination images were captured about the root tips. Those images showed that several abnormalities occurred on the plant such as chromosome breakings, chromosome dispersion, bridge chromosome, chromosome adherence, ring chromosome. Variety and number of abnormalities were counted and compared to each other statistically. The results show an increase in abnormalities caused by for both ions with increasing treatment time. Chromosome adherence and chromosome breaking have reverse relationship in which number of occurrence for one of them decreases with increase on other one. Fish bone and chromosome adherence have a positive relationship in which number of one increases with the raise in other's number. Exposed metals have caused formation of ligands with proteins which can prevent the persistence of metal ions in DNA protein cross-links that are involved in DNA formation process.

Whole Exome Sequencing: Applications in Prenatal Genetics

Prenatal whole exome sequencing (WES) has the potential to increase the ability to provide more diagnostic capabilities in fetuses with sonographic abnormalities, which would then improve the ability to counsel families. It is also often the first step in improving the path toward informed diagnosis and treatment, which is especially important in the era of advancing in utero fetal therapy. This article discusses the current literature regarding prenatal WES, clinical indications for WES, challenges with interpretation/counseling (variants of unknown significance), research priorities, ethical issues, and potential future advances.

Transchem project - Part II: Transgenerational effects of long-term exposure to pendimethalin at environmental concentrations on the early development and viral pathogen susceptibility of rainbow trout (Oncorhynchus mykiss)

In the Transchem project, rainbow trout genitors were exposed to environmental concentrations of pendimethalin over a period of 18 months and two new first generations of offspring, F1_2013 and F1_2014, were obtained. We investigated the impact of direct chemical exposure on juveniles as well as the potential cumulative transgenerational and direct effects on the larval development and on the pathogen susceptibility of offspring. Depending on the chemical treatment or not of the adults, their offspring were distributed in the tanks of our experimental system, in two batches i.e. juveniles from the control genitors (G-) and others from the contaminated ones (G+), and then, half of the tanks were exposed daily to pendimethalin (Off+) while the others were used as controls (Off-). Viral challenges were performed on the offspring, before and after three months of direct chemical exposure, with strains of infectious hematopoietic necrosis virus (IHNV), viral haemorrhagic septicemia virus (VHSV) and sleeping disease alphavirus (SDV). Direct and transgenerational macroscopic effects were observed on offspring, with a percentage of abnormalities in offspring derived from the genitors exposed to pendimethalin (G+) significantly higher compared to those from the genitors from non-exposed group (G-). Before the direct chemical exposure, similar kinetics of mortality was observed between the offspring from the contaminated or control genitors after VHSV infection. With IHNV, the G+ group died in a slightly larger proportion compared to the G- group and seroconversion was greater for the G- group. For the SDV challenge, the mortality was delayed for the G+ offspring compared to the G- and seroconversion reached 65% in the G+ group compared to 45% in the G-, with similar antibody titres. After three months of direct chemical exposure, kinetics of mortality induced by IHNV infection were similar for all groups studied. Infection with SDV resulted in a cumulative mortality of 40% for the G- groups (Off- and Off+), significantly higher than those observed from the contaminated genitors G+. Proportion of seropositivity for SDV varied from 24 to 47% depending on the group, with very low quantities of secreted antibodies. Lastly, the direct exposure of offspring could impact the capacity of fish to adapt their haematological parameters to environmental and physiological changes, and underlines the potential toxic effects on the next generations.

The importance of phospholipids combined with long-chain PUFA in formulated diets for pikeperch (Sander lucioperca) larvae

Dietary phosphoglycerides and n-3 long-chain PUFA (LC-PUFA) play important functions in the development of pikeperch (Sander lucioperca) larvae. This study aimed to determine optimal dietary levels of soyabean lecithin (SBL)-derived phospholipids (PL) in starter feeds for pikeperch larvae 10-30 d post-hatch (DPH) and examine performance and ontogeny by additional supplementation of n-3 LC-PUFA in the form of Algatrium DHA 70 (glyceride product; 660-700 mg/g DHA; EPA 60-75 mg/g). In total, six isoproteic and isoenergetic extruded diets were formulated with increasing levels of PL (3·7, 8·3 or 14·5 % wet weight (w.w.), respectively); however, three of the diets were supplemented with three levels of Algatrium DHA 70 (0·6, 2·0 or 3·4 %, respectively). Liver proteomic analyses of larvae at 30 DPH were included for effects of PL and primarily DHA on performance, physiological expression and interactions in larval proteins. In addition, bone anomalies, digestive enzymatic activity, candidate gene expression and skeleton morphogenesis were examined. Results confirmed the importance of dietary PL levels of at least 8·2 % w.w., and an additional beneficiary effect of supplementation with DHA plus EPA. Thus, combined supplementation of SBL (up to 14·51 % w.w. PL) and n-3 LC-PUFA (1·004 % DM DHA and 0·169 % DM EPA) in the form of TAG resulted in highest growth and lowest incidence of anomalies, improved digestive enzyme activity and had differential effect on liver proteomics. The results denote that essential fatty acids can be supplemented as TAG to have beneficial effects in pikeperch larvae development.

Electroencephalography abnormalities in generalized epilepsy and their predictors: A multicenter experience

Background:

In spite of the overwhelming significance of knowledge of basic elements of electroencephalography (EEG) in its application to the diagnostic workup and the management of patients with suspected or already established generalized epilepsy (GE), there is a dearth of data on the pattern and utility of clinical variables that can independently determine EEG abnormalities in GE.

Objective:

The study was designed to evaluate the frequency and pattern of EEG abnormality as well as assess the utility of clinical variables in predicting the likelihood of an abnormal EEG in GE.

Methods:

It was a cross-sectional study involving the analysis of EEGs of consecutive patients with clinical diagnosis of idiopathic GE from three centers over a 7-year period. Information on sociodemographic and seizure variables was obtained. The International Federation of Societies for Electroencephalography and Clinical Neurophysiology definition of interictal epileptiform discharges (interictal epileptiform activity [IEA]) was adopted in the study.

Results:

A total of 403 patients comprising 242 (60%) males and 161 (40%) females with clinical diagnosis of GE had EEG. Their age ranged between 2 weeks and 70 years, with a median age of 21 years and an interquartile age of 26 years. Two hundred and thirty-seven (58.8%) and 213 (52.9%) patients had abnormal EEG and IEA, respectively. Before adjustment for confounders, female gender (P = 0.0001), pediatric age group (P = 0.0388), duration of epilepsy of 1–4 years (P = 0.01387), uncontrolled seizure (P = 0.0060), and seizure frequency (P = 0.0001) were significantly associated with the presence of abnormal EEG. However, age, female gender, poor seizure control, and seizure frequencies were the independent predictors of EEG abnormality.

Conclusion:

The study showed that about 58% of patients with GE patients had abnormal EEG. Age, poor seizure control, and high frequency of seizure were independent predictors of the presence of EEG abnormality.

Surgery for tricuspid regurgitation in a case of anomalous systemic venous return

A 75-year-old woman presented with severe tricuspid regurgitation requiring surgical repair. She had extremely rare anomalies in systemic venous return in spite of situs solitus: persistent left superior vena cava with absent right superior vena cava, infrahepatic inferior vena cava interruption, and hemiazygos continuation to a persistent left superior vena cava. These unusual systemic venous anomalies had significantly enlarged the coronary sinus, and the stretched coronary sinus orifice changed the geometry of the tricuspid annulus and triggered tricuspid regurgitation. There were technical difficulties in establishing cardiopulmonary bypass and achieving successful tricuspid valve repair.

Duplex collecting system in a pelvic kidney - an unusual combination

Pelvic kidney is a relatively common renal malformation as well as duplex kidney; however, the unilateral coexistence of these abnormalities is not frequently found. We present a case of a young woman with a history of hypertension in whom a pelvic and dysmorphic left kidney was discovered during ultrasound examination performed for the study of the renal arteries. Magnetic resonance imaging and computed tomography imaging revealed a duplex pelvic kidney. This combination is very rare; we have not found a similar case reported in the literature.