Syndrome of birt-hogg-dubé, a histopathological pitfall with similarities to tuberous sclerosis: a report of three cases.

: Birt-Hogg-Dubé Syndrome (BHD) is a rare condition, transmitted as an autosomal-dominant trait. The etiology is due to a mutation in the BHD gene, which encodes folliculin (FLCN), located on chromosome 17p. The skin changes observed are benign skin tumors consisting of hamartomas of the hair follicle with dermal changes. Patients with BHD have an increased risk of spontaneous pneumothorax due to rupture of lung cysts and an increased risk of kidney tumors. We report 3 new cases of BHD and discuss their clinical features, histopathological findings, and molecular diagnostics. We highlight the importance of genetic analysis to confirm the diagnosis because of the clinical pitfalls involved in establishing a diagnosis. Finally, we discuss the histopathological features in BHD and tuberous sclerosis complex and focus on their overlapping criterias. A correct diagnosis is essential as it can be life saving for patients.

Appropriate maintenance treatment for Crohn's disease: results of a multidisciplinary international expert panel - EPACT II

Introduction: Biological. therapy has dramatically changed management of Crohn's disease (CD). New data have confirmed the benefit and relative long-term safety of anti-TNF alpha inhibition as part of a regular scheduled administration programme. The EPACT appropriateness criteria for maintenance treatment after medically-induced remission (MIR) or surgically-induced remission (SIR) of CD thus required updating. Methods: A multidisciplinary international expert panel (EPACT II, Geneva, Switzerland) discussed and anonymously rated detailed, explicit clinical indications based on evidence in the literature and personal expertise. Median ratings (on a 9-point scale) were stratified into three assessment categories: appropriate (7-9), uncertain (4-6 and/or disagreement) and inappropriate (1-3). Experts ranked appropriate medication according to their own clinical practice, without any consideration of cost. Results: Three hundred and ninety-two specific indications for maintenance treatment of CD were rated (200 for MIR and 192 for SIR). Azathioprine, methotrexate and/or anti-TNF alpha antibodies were considered appropriate in 42 indications, corresponding to 68% of all appropriate interventions (97% of MIR and 39% of SIR). The remaining appropriate interventions consisted of mesalazine and a "wait-and-see" strategy. Factors that influenced the panel's voting were patient characteristics and outcome of previous treatment. Results favour use of anti-TNF alpha agents after failure of any immunosuppressive therapy, while earlier primary use remains controversial. Conclusion: Detailed explicit appropriateness criteria (EPACT) have been updated for maintenance treatment of CD. New expert recommendations for use of the classic immunosuppressors as well as anti-TNF alpha agents are now freely available online (www.epact.ch). The validity of these criteria should now be tested by prospective evaluation. (C) 2009 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.

Coeficientes médios da equação de Angström-Prescott, radiação solar e evapotranspiração de referência em Brasília

O objetivo deste trabalho foi estimar os coeficientes médios a e b da equação de Angström-Prescott, em Brasília, e seus efeitos sobre o cálculo da radiação solar global (Rs) e da evapotranspiração de referência (ETo). Foram utilizados dados da estação meteorológica da Embrapa Hortaliças, do período de 1978 a 2003. Os coeficientes médios foram determinados por análise de regressão linear, no período todo e em períodos mensais e anuais. Utilizando-se o coeficiente calculado e os propostos pela FAO (0,25 e 0,50) estimaram-se Rs e ETo, e avaliaram-se os seus desempenhos. Os coeficientes médios mensais a variaram de 0,241 a 0,345, e b de 0,430 a 0,515. Os coeficientes médios anuais a e b foram 0,278 e 0,498, e os do período geral foram 0,282 e 0,490, respectivamente. A performance entre esses coeficientes na estimativa da radiação não diferiu. No mês de julho, foram verificados as piores estimativas e os piores desempenhos. Com as estimativas de Rs e os coeficientes médios calculados, as estimativas de ETo não diferiram dos observados, tendo-se constatado um ótimo desempenho, independentemente do coeficiente utilizado. Dependendo do tipo de aplicação final dos dados, recomenda-se utilizar, por sua simplicidade, os coeficientes médios obtidos para o período geral.

Techniques for Estimating Flood-Frequency Discharges for Streams in Iowa, HR-395A, 2001

A statewide study was conducted to develop regression equations for estimating flood-frequency discharges for ungaged stream sites in Iowa. Thirty-eight selected basin characteristics were quantified and flood-frequency analyses were computed for 291 streamflow-gaging stations in Iowa and adjacent States. A generalized-skew-coefficient analysis was conducted to determine whether generalized skew coefficients could be improved for Iowa. Station skew coefficients were computed for 239 gaging stations in Iowa and adjacent States, and an isoline map of generalized-skew-coefficient values was developed for Iowa using variogram modeling and kriging methods. The skew map provided the lowest mean square error for the generalized-skew- coefficient analysis and was used to revise generalized skew coefficients for flood-frequency analyses for gaging stations in Iowa. Regional regression analysis, using generalized least-squares regression and data from 241 gaging stations, was used to develop equations for three hydrologic regions defined for the State. The regression equations can be used to estimate flood discharges that have recurrence intervals of 2, 5, 10, 25, 50, 100, 200, and 500 years for ungaged stream sites in Iowa. One-variable equations were developed for each of the three regions and multi-variable equations were developed for two of the regions. Two sets of equations are presented for two of the regions because one-variable equations are considered easy for users to apply and the predictive accuracies of multi-variable equations are greater. Standard error of prediction for the one-variable equations ranges from about 34 to 45 percent and for the multi-variable equations range from about 31 to 42 percent. A region-of-influence regression method was also investigated for estimating flood-frequency discharges for ungaged stream sites in Iowa. A comparison of regional and region-of-influence regression methods, based on ease of application and root mean square errors, determined the regional regression method to be the better estimation method for Iowa. Techniques for estimating flood-frequency discharges for streams in Iowa are presented for determining ( 1) regional regression estimates for ungaged sites on ungaged streams; (2) weighted estimates for gaged sites; and (3) weighted estimates for ungaged sites on gaged streams. The technique for determining regional regression estimates for ungaged sites on ungaged streams requires determining which of four possible examples applies to the location of the stream site and its basin. Illustrations for determining which example applies to an ungaged stream site and for applying both the one-variable and multi-variable regression equations are provided for the estimation techniques.

Post-mortem β-hydroxybutyrate determination in synovial fluid.

β-hydroxybutyrate concentrations were determined in blood and synovial fluid in a series of medico-legal cases including hypothermia fatalities, individuals found dead in a cold environment and non-hypothermia cases with various, non-traumatic causes of death. Hypothermia was considered to be the cause of death according to circumstantial elements indicating exposure to cold, autopsy findings, biochemical investigation results and exclusion of other causes of death. The intention of this study was to characterize β-hydroxybutyrate distribution in synovial fluid and assess its usefulness for the postmortem diagnosis of antemortem abnormalities in blood β-hydroxybutyrate levels. Unenhanced CT scans, autopsies, histology, neuropathology, toxicology, and biochemistry were systematically performed. Within the limited number of subjects included in the study, the results indicate that abnormalities in antemortem β-hydroxybutyrate blood levels, as may be observed in hypothermia fatalities, are reflected in postmortem synovial fluid values. These preliminary findings notwithstanding, synovial fluid analysis to determine β-hydroxybutyrate is unlikely to be generally applied due to the more invasive collection technique it requires and could be limited to special cases in which biological fluids systematically collected upon autopsy are unavailable.

Effects of parental larval diet on egg size and offspring traits in Drosophila.

If a mother's nutritional status predicts the nutritional environment of the offspring, it would be adaptive for mothers experiencing nutritional stress to prime their offspring for a better tolerance to poor nutrition. We report that in Drosophila melanogaster, parents raised on poor larval food laid 3-6% heavier eggs than parents raised on standard food, despite being 30 per cent smaller. Their offspring developed 14 h (4%) faster on the poor food than offspring of well-fed parents. However, they were slightly smaller as adults. Thus, the effects of parental diet on offspring performance under malnutrition apparently involve both adaptive plasticity and maladaptive effects of parental stress.

Iowa Department of Transportation Major Items - Preliminary Quantity Report, December 15, 2015; With Addendums

Weekly letting report

Peroxisome proliferator-activated receptor agonists.

The peroxisome proliferator-activated receptors are a family of three ligand-activated transcription factors. Fibrate antihyperlipidemic drugs and thiazolidinedione antihyperglycemic drugs were recently identified as synthetic ligands for these receptors. In addition, certain unsaturated fatty acids and eicosanoids were shown to bind the receptors, and thus represent naturally occurring PPAR ligands. The synthetic and natural ligands have proven to be powerful tools in dissecting the biology of these orphan receptors.