Volume 7, Issue 4

According to the universal biological findings, cellular bodies are covered with an intense coating of glycans. Diversity of glycan chains, linked to lipids and proteins is due to isomeric and conformational modifications of various sugar residues, giving rise to unique carbohydrate structures with a wide range of sequences and anomeric configurations. Proteins and lipids, carrying specific sugar residues (like Galactose) with particular stereochemical properties (sequence, anomery and linkages) are involved in broad spectrums of biological processes, including intercellular and intracellular interactions, microbial adhesion and cellular signaling. By studying the role of specific seterochemical features of galactose (Gal), we have improved our understanding about the normal physiology and diseases in human bodies.

The purpose of this study was to explore perceptions of health-related issues among youth residing in Chişinău, Moldova, through a combination of photovoice and focus group methodologies. During June, 2011, 13 youth, aged 10 to 17, participated in photovoice and focus group sessions. Participants were instructed to take between 10 and 20 photographs, over a 7 day period, representing health-related issues in their community. During focus group sessions, participants, as a group, were asked to sort photographs into piles based on similarly and/or themes. The SHOWeD mnemonic method was used to guide discussion about photographs from a personal to social level. Content analyses were used to summarize and interpret collected data. Seven common themes emerged across both focus groups, including: (1) abundance of garbage in public spaces; (2) homeless dogs wandering the streets; (3) unsafe drinking water; (4) individuals engaging in risky health behaviors, including cigarette smoking and alcohol use; (5) large number of individuals with limited financial resources; (6) considerable number of individuals forced to live in suboptimal living conditions; and (7) poor road and sidewalk conditions. CBPR methods, including photovoice and focus groups, offer promise in gathering valuable information to inform health-related policy in Moldova in the future.

This study investigates whether daily Internet use time is related to the school performance of Korean adolescents. We therefore analyzed raw data from the 2009 Korea Youth Risk Behavior Web-based Survey-V (KYRBWS-V), in which 75,066 students from the middle-school first grade to the high-school third grade participated. We assessed the association between daily Internet use time and school performance by using multivariate logistic regression analysis adjusted for age, body mass index, education level of parents, and economic status of the family. For boys, the odds ratio (OR) [95% confidence interval (CI)] for recording ≥ average school performance and daily time spent on Internet use was 1.876 (1.752–2.008, p < 0.001) for ≤1 hour, 1.564 (1.467–1.667, p < 0.001) for >1–≤2 hours, 1.158 (1.079–1.242, p < 0.001) for >2–≤3 hours, and 0.759 (0.695–0.828, p < 0.001) for over 4 hours, when compared to those who never used the Internet. For girls, the OR (95% CI) for recording ≥ average school performance and daily Internet use time was 1.729 (1.607–1.860, p < 0.001) for ≤1 hour, 1.503 (1.399–1.616, p < 0.001) for >1–≤2 hours, 1.193 (1.100–1.293, p < 0.001) for >2–≤3 hours, and 0.809 (0.725–0.903, p < 0.001) for over 4 hours, when compared to those who never used the Internet. It was concluded that Korean adolescents who spend ≤3 hours per day on the Internet are predisposed to an increase in performance levels at school, whereas those who spend over 4 hours per day on the Internet are predisposed to a decrease in school performance levels.

Seasonal influenza epidemics regularly lead to an increase in population-based mortality in Germany and other industrialized nations. This study aimed to investigate seasonal variations in waves of influenza and cause-specific mortality rates. We analyzed influenza case data, monthly mortality rates and environmental temperature in the state of Baden-Wuerttemberg, Germany, between 2001 and 2006 using visual methods and bivariate statistics. Peaks in overall mortality rates were associated with waves of influenza and preceded by a drop in the environmental temperature. During an influenza epidemic, many cause-specific mortality rates increased, that is to say, there were coinciding peaks for diseases of the respiratory and the circulatory system. There are several reasons which might explain the observed temporal associations between reported cases of influenza and cause-specific mortality: 1) the general physical impairment of persons with chronic diseases; 2) the combined effect of low environmental temperatures and seasonal waves of influenza; 3) the system of coding underlying disease in death certificates. Our findings point to an underestimated role of influenza in mortality in Germany.

The content of 8 heavy metals (Cd, Cr, Cu, Fe, Mn, Ni, Pb and Zn) was evaluated in infusions prepared from 13 different herbal compositions commercially available in drug or herbal stores. The mixtures were produced by a Polish manufacturer “Herbapol”. The concentration of heavy metals was determined using flame atomic absorption spectrometry (FAAS). In the herbal infusions Mn was found in the highest concentration varying from 3.03 to 129.01 mg/kg. The element of the lowest content was Cd in the range of 0.024–0.153 mg/kg. According to interquartile ranges the concentrations of studied heavy metals in infusions decreased in the following descending order: Mn>Fe>Zn>Cu>Ni>Cr>Pb>Cd. Cluster analysis allowed for the division of herbal infusions into groups described by comparable levels of heavy metals. In water extracts made from Urosan, Nervosan, Infektoten and Cholagoga, distinctive levels of Mn, Fe and Cr were determined. According to WHO regulations, the concentrations of the elements did not exceed the allowable limits.

An attempt is made to assess a set of biochemical, kinetic and anthropometric data for patients suffering from alcohol abuse (alcoholics) and healthy patients (non-alcoholics). The main goal is to identify the data set structure, finding groups of similarity among the clinical parameters or among the patients. Multivariate statistical methods (cluster analysis and principal components analysis) were used to assess the data collection. Several significant patterns of related parameters were found to be representative of the role of the liver function, kinetic and anthropometric indicators (conditionally named “liver function factor”, “ethanol metabolism factor”, “body weight factor”, and “acetaldehyde metabolic factor”). An effort is made to connect the role of kinetic parameters for acetaldehyde metabolism with biochemical, ethanol kinetic and anthropometric data in parallel.

Uncontrolled inflammation and endotoxin play a central role in septic shock. Statins may possess anti-inflammatory properties, and removal of endotoxin by hemoperfusion with polymyxin B-immobilized fiber (PMX-F) could have favorable effects on sepsis. We examined retrospectively whether pre-existing statin and hemoperfusion with PMX-F at the time of admission were separately and independently associated with decreased overall 28-day mortality in septic shock patients. Consecutive 173 patients with septic shock (71.2±10.7 years old, 115 male and 58 female) were included in the present study. All patients underwent a complete history and physical examination, determination of blood chemistries. Multiple stepwise regression analysis revealed that albumin, creatinine (inversely), statin use, hemoperfusion with PMX-F and HDL-cholesterol were independently correlated to 28-day survival in septic shock patients (R2=0.464). Our present study suggests that pre-existing statin use and hemoperfusion with PMX-F may separately and independently contribute to blunt the process of septic shock.

The aim of this study was to investigate the influence of acute stress on salivary fluoride bioavailability. Acute psychological stress was induced using a standardized model of public speaking. The saliva of male subjects was collected before and after the public speaking task and immediately, 10, 30, and 120 minutes after tooth brushing according to the Bass method with a dentifrice containing amine fluoride (AmF) or oral hygiene tablets containing sodium fluoride (NaF). Subjective psychological responses to public speaking were evaluated using the State-Trait Anxiety Inventory (STAI). Saliva cortisol levels were analyzed as an objective stress marker. The saliva secretion rate was measured both before and after public speaking. Saliva fluoride content was measured. Group comparisons were calculated using a univariate analysis of variance (ANOVA). In all analyses, the alpha-level was set at 0.05. Public speaking significantly increased state anxiety (p<0.001) and salivary cortisol concentrations (p<0.001). Acute stress did not influence salivary secretion rates. In the AmF group, stressed individuals exhibited statistically significant (p=0.044) lower fluoride concentration in saliva compared with the nonstressed subjects Acute psychological stress reactions do not cause hyposalivation but decrease fluoride bioavailability after using a dentifrice containing AmF. Fluoride bioavailability during acute stress is dependent on fluoride formulation.

The aim of this study was to examine the effect of treatment type on anxiety in patients with cervical cancer. Subjects and methods: This prospective study was conducted in 60 patients with cervical cancer treated by radiotherapy. The study was done before treatment, and 3 and 6 months after initial testing. For assessment of anxiety the Hamilton Anxiety Scale (HAM-A) was used.: At baseline, the values of the scale of anxiety in patients who were treated surgically were significantly higher than in patients who had been treated by radiotherapy, but the intensity of anxiety gradually decreased in both groups. In this study, pain and irregular menstrual bleeding were the most important risk factors for the development of anxiety.: Routine assessment should be introduced in clinical practice for the detection and monitoring of anxiety in all patients with cervical cancer, and a psychiatrist should be included in the multidisciplinary team for their treatment.

Synovial sarcomas are malignant tumors of mesenchymal origin, extremely rarely located in the area of the head and neck. Histologically they can be monophasic, biphasic or poorly differentiated with numerous differential diagnostic dilemmas. A 54-year-old male with synovial sarcoma of the carotid space is presented. The patient refused suggested postoperative radiotherapy and, nine months after the primary surgery, local relapse was verified. Following surgical resection of the local relapse, postoperative radiotherapy treatment was utilized. Ten months after the second surgery, secondary deposits in the lungs were radiographically confirmed, and local recurrence was noticed again. Treatment was continued with symptomatic therapy and eleven months later patient died. Synovial sarcomas of the carotid space are extremely rare, with complex surgical approaches and pathohistological differential diagnostic dilemmas. Diagnosis requires determination of the immunophenotype of the tumor cells, whereas therapy requires an aggressive surgical approach and postoperative radiotherapy.

The objective of our project is to reveal the possible etiological factors of different congenital cardiovascular abnormalities. In this study, we evaluated single ventricular septal defect (VSD) after surgical correction or with lethal outcome. The birth outcomes of these cases in the function of maternal socio-demographic features were evaluated. Data are based on 1,659 VSD cases, 2,534 matched controls and 38,151 all controls without any defects, in addition in the mothers of 19,393 malformed controls with other isolated defects in the population-based large dataset of the Hungarian Case-Control Surveillance of Congenital Abnormalities. VSD had mild female excess with a higher rate of preterm birth and mainly low birth weight indicating intrauterine growth restriction of affected fetuses, particularly in males and full-term or average weighted cases. The mothers of cases with VSD had lower socioeconomic status and higher rate of smoking and particularly drinking habit. The evaluation of medically recorded pregnancy complications showed an association of gestational diabetes with a higher risk of VSD. In conclusion, the association of small localized size of VDS and obvious fetal growth restriction needs further explanation in these cases, while gestational diabetes, lower socioeconomic status and adverse lifestyle of pregnant women may have a role in the origin of VSD.

A case of a female patient with thalidomide-induced phocomelia and additional dermal complications associated with the prosthesis itself is presented herein.

Idiopathic thrombocytopenic purpura (ITP) is the most common cause of acquired thrombocytopenia in children. In 20% of cases, this condition is classified as chronic when the thrombocytopenia is persistent 6 months after diagnosis. The aim of the present study is to identify the potential factors correlating with a favorable outcome in patients with chronic ITP. Some 71 patients affected by ITP were retrospectively analyzed. Results show a higher rate of spontaneous recovery that is statistically significant for patients with platelet count at diagnosis <20,000/µL. These observations suggest the possibility to delay or avoid aggressive surgical treatment for these patients.

An extracorporeal membrane oxygenation was long a golden standard in the pediatric population with acute cardiac failure for short-term mechanical circulatory support. It gives the limited availability of pediatric-sized pumps and the outcomes remain disproportionately poor. The Levitronix PediVAS system (Levitronix LLC, Waltham, MA) offers expanded options for short-term support for this population. We report our experience with the successful use of the PediVAS (left heart bypass) in the 3-year-old male patient as a bridge to recovery after Fontan surgery in acute heart failure. Short-term circulatory support with the Levitronix PediVAS has proven to be a less invasive, safe, and effective for our pediatric patient.

We studied the effect of melatonin on morphological and functional disorders using serum markers of liver dysfunction such as cholinesterase and gamma glutamyl transpeptidase, hepatic protein content and malondialdehyde in a burned-rat model. Melatonin (10 mg/kg (−1), i.p) was administered immediately and then 12 h after 30% of total body surface area burns of male Wistar rats. The burns induced an increase of hepatic malondialdehyde levels by 166% (p<0.001), and also vascular congestion, leukocyte infiltration around the central veins, intracellular vacuolization, hepatic cell degeneration and apoptotic bodies (Councilman’s bodies). These changes were associated with significantly reduced serum cholinesterase (36%), gamma glutamyl transpeptidase (76%), hepatic proteins (52%) and serum albumin (37%) (p<0.001–0.0001). Treatment with melatonin reduced elevated hepatic malondialdehyde values by 50% (p<0.01). Melatonin restricted degenerative alteration in the hepatocytes: it protected the burninduced decrease of serum gamma glutamyl transpeptidase activity by 48% (p<0.01), hepatic proteins by 64% (p<0.01), and serum activity of cholinesterase as the only marker of liver damaged synthetic function by 57% (p<0.0001) but did not exert any significant influence on serum albumin concentration. Melatonin repaired the pathomorphological lesions and functional disorders. It could restore liver damage following thermal injury in humans.

The principle of patient autonomy dominates the contemporary debate in medical ethics. Twenty-five years ago, most major medical decisions were left exclusively in the hands of physicians. Such decisions were usually made with beneficent intent but without open discussion, much less the full participation of the patient. Our case involves a patient’s decision to treat an infection with Candida species, the most common fungi affecting humans in a broad spectrum of opportunistic infections, including bones and joints. Only four recent cases of delayed reimplantation arthroplasty for candidal prosthetic joint infection have been reported, and there are no reports, besides ours, of successful non-surgical resolution of candidal prosthetic joint arthritis. We report this case as a patient’s choice with an excellent outcome.

Angiokeratomas are papular vascular lesions characterized by marked ectasia of the superficial dermal blood vessels. Dermatological examination of angiokeratomas of Fordyce is characterized by papular keratotic lesions of erythematous-violet color. They are more common in the scrotum, and vulval involvement is rarely reported. This article reports the cases of angiokeratoma of Fordyce in a 25-year-old man and a 42-year-old woman. Diagnosis were made by history and physical examination. Dermoscopy has shown well-demarcated round dark lacunae in both patients. As the lesions were asymptomatic, the patients requested no further treatment.

Postoperative arthrofibrosis after primary and revision total knee arthroplasty is a severe complication for the affected patient. Several risk factors have been identified for this diagnosis. We present a series of 3 patients with arthrofibrosis after (revision) total knee arthroplasty. Approximately 2 hours before the operative revision procedure, all patients were irradiated once with 7.01 gray. At latest follow-up, all 3 patients showed a distinct improvement of range of motion. Before revision total knee arthroplasty due to arthrofibrosis, a single dose of pre- or postoperative irradiation should be considered.

Omental cysts are the least common cystic lesions of the abdomen. Large intraabdominal cysts can mimic ascites. The incidence of 1 in 20000 pediatric hospital admissions makes them hard to diagnose. We report a three year-old boy with accidentally discovered intraperitoneal fluid collection on ultrasonography. The patient was scheduled for operative treatment with working diagnosis of ascites, but finding of no fluid in Morison’s pouch brought to massive cystic intraabdominal lesion as differential diagnosis. The cyst was emptied; altered parts of the greater omentum were completely excised. Final pathology confirmed lymphangioma. Explorative laparotomy led to correct diagnosis and proper surgical treatment.

Ectrodactyly-ectodermal dysplasia-cleft (EEC) syndrome is a rare congenital disease, occurring in 7 per 10,000 live newborns. It runs in families as an inherited autosomal dominant; it can also occur spontaneously as a point missense mutation in the DNA-binding domain of the p63 transcription factor (TP63) gene. Clinical diagnosis of a complete EEC syndrome involves a patient who presents with ectrodactyly, ectodermal dysplasia, and cleft lip and/or palate. This paper presents outcome of 10 years of interdisciplinary therapy for an EEC child with special consideration of the facial presentation of the disease. The management of cases of EEC syndrome requires multidisciplinary action because of the great variability in clinical expression. In an individual patient, treatment should be based on clinical findings and symptoms. Early interdisciplinary therapy will allow a patient with EEC syndrome to reinstate oral functions, satisfactory appearance, and social integration.