[White sponge naevus. Report of a family with respect to histopathologic, cytopathologic and DNA-cytometric aspects]

The white sponge naevus is a rare benign, hereditary autosomal dominant disorder of the mucosa. The oral mucosa is most often affected, but vaginal and anal mucosal surfaces may also be involved. Clinically, a whitish-grey, ragged, and folded surface that has no clear demarcation and appears sponge-like is characteristic, often creating problems in differential diagnosis. A potential risk for malignant transformation of white sponge naevus lesions has not been reported. The therapy for this benign hereditary disorder is unknown, however does not appear to be necessary. In the present report of a family with known white sponge naevus in three different generations, clinical, histopathologic, cytopathologic, DNA-cytomertric, and genetic aspects are described and discussed.

Lung volume, breathing pattern and ventilation inhomogeneity in preterm and term infants

BACKGROUND: Morphological changes in preterm infants with bronchopulmonary dysplasia (BPD) have functional consequences on lung volume, ventilation inhomogeneity and respiratory mechanics. Although some studies have shown lower lung volumes and increased ventilation inhomogeneity in BPD infants, conflicting results exist possibly due to differences in sedation and measurement techniques. METHODOLOGY/PRINCIPAL FINDINGS: We studied 127 infants with BPD, 58 preterm infants without BPD and 239 healthy term-born infants, at a matched post-conceptional age of 44 weeks during quiet natural sleep according to ATS/ERS standards. Lung function parameters measured were functional residual capacity (FRC) and ventilation inhomogeneity by multiple breath washout as well as tidal breathing parameters. Preterm infants with BPD had only marginally lower FRC (21.4 mL/kg) than preterm infants without BPD (23.4 mL/kg) and term-born infants (22.6 mL/kg), though there was no trend with disease severity. They also showed higher respiratory rates and lower ratios of time to peak expiratory flow and expiratory time (t(PTEF)/t(E)) than healthy preterm and term controls. These changes were related to disease severity. No differences were found for ventilation inhomogeneity. CONCLUSIONS: Our results suggest that preterm infants with BPD have a high capacity to maintain functional lung volume during natural sleep. The alterations in breathing pattern with disease severity may reflect presence of adaptive mechanisms to cope with the disease process.

Late Glacial and Holocene environmental history of the Pirin Mountains (SW Bulgaria): a paleolimnological study of Lake Dalgoto (2310 m)

Diatoms, Cladocera, and chironomids preserved in the sediments of Lake Dalgoto were studied to reconstruct the history of the lake ecosystem in the context of the vegetation history as represented by the pollen stratigraphy. Younger Dryas silty sediments at the base of the core are characterized by low diversity of aquatic organisms. The transition to the Holocene is indicated by a sharp change from silt to clay-gyttja. The migration and expansion of trees at lower elevations between 10200 and 8500 14C-yr BP, along with higher diversities and concentrations of aquatic organisms and the decreased proportion of north-alpine diatoms, point to rapidly rising summer temperatures. After 6500 14C-yr BP the expansion of Pinus mugo in the catchment coincides with signs of natural eutrophication as recorded by an increase of planktonic diatoms. In the late Holocene (4000–0 14C-yr BP) Pinus peuce and Abies are reduced and Picea expands. Cereal grains and disturbance indicators suggest late-Holocene human modification of the vegetation.

What supports students' education in the operating room? A focus group study including students' and surgeons' views.

BACKGROUND AND METHODS We conducted a focus group analysis with students and surgeons on factors which influence medical school students' education in the operating room (OR). The interviews were analyzed using grounded theory. RESULTS The analysis resulted in 18 detailed and easily applyable themes, which were grouped into the four categories: "Students' preparation and organizational aspects", "Learning objectives", "Educational strategies for the teacher", and "Social-environmental aspects". CONCLUSION By including students and surgeons, we were able to extend existing knowledge and enable better understanding of factors influencing teaching in the OR.

The Gut Microbiome and Cirrhosis: Basic Aspects

In this chapter the basic aspects helping to understand the microbiome in terms of quantity, diversity, complexity, function, and interaction with the host are discussed. First the nomenclature, definitions of taxa, and measures of diversity as well as methods to unravel this kingdom are outlined. A brief summary on its physiological relevance for general health and the functions exerted specifically by the microbiome is presented. Differences in the composition of the microbiome along the gastrointestinal tract and across the gut wall and its interindividual variations, enterotypes, and stability are highlighted. The reader will be familiarized with all different modulators impacting on the microbiome, namely, intrinsic and extrinsic factors. Intrinsic factors include gastrointestinal secretions (gastric acid, bile, pancreatic juice, mucus), antimicrobial peptides, motility, enteric nervous system, and host genotype. Extrinsic factors are mainly dietary choices, hygiene, stress, alcohol consumption, exercise, and medications. The second part of the chapter focuses on quantitative and qualitative changes in microbiome in liver cirrhosis. The mechanisms contributing to dysbiosis, small intestinal bacterial overgrowth, and bacterial translocation are delineated underscoring their role for the liver-gut axis.

Bedouin in the Negev and Environmental Studies: Current and Future Research Prospects

Environmental aspects are increasingly being integrated in Negev Bedouin studies by both, NGO activists and scholars. We will present these recent works and discuss new concepts and methodologies of environmental studies with potential relevance in the field of Negev Bedouin studies. We will then identify research areas where environmental and development approaches converge or diverge with mainstream social sciences on this specific field of research. While most of the Bedouin population in southern Israel lives in urban centers in the Northern Negev, a large part of Bedouin people live in unrecognized clusters of houses in remote areas. Extensive livestock rearing is an important source of livelihood at least for non-urbanized Bedouin, the latter forming the lowest economic strata of the Israeli spectrum of incomes. Numerous stressors affect this Bedouin community enduring uncertain livelihood and access to land. The erratic precipitations from year to year and long-term changes in precipitation trends are a source of great uncertainty. With a significant price increase for feeding supplements to compensate for dry years, livestock rearing has become a harsher source of livelihood. Land scarcity for grazing adds to the difficulty in ensuring enough income for living. Studies in the last 15 years have described several livelihood strategies based on a livestock rearing semi-nomadic economy in the Negev. A number of other analyses have shown how Bedouin herders and governmental agencies have found agreements at the advantage of both, the agencies and the herders. New concepts such as transformability, resilience and adaptation strategies are important tools to analyze the capacity of vulnerable communities to cope with an ever increasing livelihood uncertainty. Such research concepts can assist in better understanding how Bedouin herders in the Negev may adapt to climate and political risks.

Problems in functioning from the patient perspective using the International Classification of Functioning, Disability and Health (ICF) as a reference

We conducted a qualitative, multicenter study using a focus group design to explore the lived experiences of persons with any kind of primary sleep disorder with regard to functioning and contextual factors using six open-ended questions related to the International Classification of Functioning, Disability and Health (ICF) components. We classified the results using the ICF as a frame of reference. We identified the meaningful concepts within the transcribed data and then linked them to ICF categories according to established linking rules. The six focus groups with 27 participants yielded a total of 6986 relevant concepts, which were linked to a total of 168 different second-level ICF categories. From the patient perspective, the ICF components: (1) Body Functions; (2) Activities & Participation; and (3) Environmental Factors were equally represented; while (4) Body Structures appeared poignantly less frequently. Out of the total number of concepts, 1843 concepts (26%) were assigned to the ICF component Personal Factors, which is not yet classified but could indicate important aspects of resource management and strategy development of those who have a sleep disorder. Therefore, treatment of patients with sleep disorders must not be limited to anatomical and (patho-)physiological changes, but should also consider a more comprehensive view that includes patient's demands, strategies and resources in daily life and the contextual circumstances surrounding the individual.