Delayed presentation of blunt duodenal injuries in children. Case report and review of literature

Background. Duodenal injuries are rare in children and classically present following a fall over the handle bar. Retroperitoneal location of the duodenum may lead to delay in diagnosis, and missed injuries are associated with increased morbidity and mortality. Case report. A 5-year-old child was admitted to the National Trauma Center, in Tirana (Albania), 28 hours after a Motor Vehicle Crash (MVC), complaining of mild abdominal pain. He was febrile (39°C) and had a white blood cells count of 18,000 mm3. On physical exam he had mild tenderness. Plain abdominal X-rays and Focused Abdominal Sonography for Trauma (FAST) were negative for free air or free fluid. The CT scan of the abdomen demonstrated free air and fluid in the retroperitoneal space. At laparatomy, a perforation of the second portion of the duodenum was found. A single layer suture repair of the duodenum with wide drainage was performed. The patient was discharged from the hospital tolerating oral feeding 8 days later. Conclusion. Duodenal injuries in children are rare. Most duodenal hematomas are managed non-operatively. This is a case of MCV with delayed presentation that was treated surgically for perforation successfully.

Modulação da capacidade antioxidante e de detoxificação no peixe Cyprinus carpio (Cyprinidae) após tratamento com nanocápsulas de ácido lipóico

O metabolismo aeróbico é muito eficiente no processo de geração de energia, no entanto, é uma fonte de produção de espécies reativas de oxigênio (ERO). Para a prevenção dos efeitos potencialmente danosos dessas ERO, os organismos desenvolveram um sistema de defesa antioxidante (SDA), que inclui compostos enzimáticos e não enzimáticos. O ácido lipóico (AL) é uma molécula lipo e hidro solúvel, com capacidade de atravessar membranas celulares. Ele possui propriedades antioxidantes, auxiliando na eliminação de ERO, induzindo a expressão de genes importantes nas defesas antioxidantes, quelando metais e interagindo com outros antioxidantes. Trabalhos prévios demonstraram que nanocápsulas poliméricas de ácido lipóico favoreceram a proteção deste antioxidante, aumentando sua estabilidade físico- química em comparação com formulações contendo ácido lipóico livre. O objetivo deste estudo foi avaliar e comparar o efeito do AL livre e do AL em nanocápsulas sobre a atividade de enzimas antioxidantes (glutamato-cisteína ligase, GCL e glutationa-S- transferase, GST), a concentração de glutationa reduzida (GSH) e sub-produtos da peroxidação lipídica (malondealdeído, método TBARS) e da expressão de genes que codificam para as diferentes formas da enzima GST (alfa e pi). Para isso o peixe Cyprinus carpio (Cyprinidae) foi exposto a uma dose de 40 mg/kg a diferentes formas de AL (livre e em nanocápsulas) por injeção intraperitoneal (duas injeções, sendo a primeira no tempo 0 e a segunda após 24 h), sendo logo sacrificados a diferentes tempos da primeira injeção (48 h, 96 h e uma semana), sendo dissecados o cérebro, fígado e músculo dos peixes de cada tratamento. Os resultados obtidos indicam que os órgãos respondem de forma diferente. A curto prazo, o fígado foi o principal órgão a apresentar respostas antioxidantes após tratamento com AL, enquanto que a longo prazo o cérebro e o músculo se mostraram mais responsivos em termos antioxidantes quando 6 comparado ao fígado. Foi também importante a forma em que o AL é administrado, livre ou em nanocápsulas, sendo observado que um mesmo órgão em um mesmo tempo de exposição pode responder de forma diferente de acordo com o tipo de AL que está sendo utilizado. Além disso, o efeito antioxidante do AL nanoencapsulado parece ser mais efetivo quando utilizado a longo prazo, sugerindo que a forma nanoencapsulada libera o antioxidante em forma mais lenta. Os resultados também indicam que a composição da nanocápsulas deve ser levada em consideração, uma vez que foi observado um efeito antioxidante significativo nos tratamentos que continham apenas a nanocápsulas, sem o AL. Sugere-se que este efeito ocorra devido à produção endógena do próprio antioxidante em questão, favorecida pela composição da própria nanocápsula, que possui ácido octanóico, substrato para a síntese de AL. Também se observou um efeito pró-oxidante em alguns tratamentos onde foi utilizada esta formulação, sugerindo que alguns componentes da nanocápsula, como por exemplo, o surfactante que é utilizado para estabilizar a suspensão, possam aumentar a suscetibilidade dos órgãos ao estresse oxidativo.

Solastalgia y conductas pro-ambientales en un conflicto socioambiental por la construcción de una hidroeléctrica

Introducción: La construcción de megaproyectos hídricos implica una reconfiguración territorial donde se ven afectadas las fuentes de agua dulce, la biodiversidad terrestre y acuática, y los asentamientos humanos que colindan con dichas construcciones. Objetivo: estimar la asociación entre las conductas proambientales con la solastalgia entre las personas que se encuentran ejerciendo un proceso de resistencia social contra la Central Hidrosogamoso en el departamento de Santander, Colombia. Metodología: se utilizó un diseño de estudio transversal en el que se entrevistaron integrantes y no integrantes de grupos ambientalistas de las zonas de influencia del proyecto. Se realizó un análisis descriptivo de las variables sociodemográficas de los dos grupos de comparación presentando frecuencias absolutas y relativas y diferencias significativas por medio de la prueba ji cuadrado, exacta de Fisher y U de Mann Whitney. Se utilizó un modelo de regresión lineal múltiple en el que la variable dependiente fue el puntaje de solastalgia y las variables independientes fueron las escalas de las conductas proambientales: altruismo, austeridad, equidad, conducta ecológica, deliberación, indignación y aprecio por lo natural, además, se ajustó por algunas variables sociodemográficas de interés. Resultados: los grupos comparados presentaron diferencias importantes en cuanto a la zona de procedencia, condiciones económicas y organización social. El incremento de 5 puntos en la escala del sentimiento de indignación incrementó 0.98 la escala de solastalgia (IC95%: 0.19; 1.78). Las personas sin pareja estable tuvieron 3.02 puntos menos de solastalgia comparadas con personas casadas o en unión libre (IC95%: -4.96; -1.44), mientras que aquellas con alto nivel educativo obtuvieron 2.02 puntos menos que las personas con primaria y bachillerato (IC95%: -3.99; -0.06). Un modelo alterno mostró que no pertenecer a un grupo ambientalista disminuye en 2.29 puntos la solastalgia, comparado con pertenecer a un grupo (IC95%: -4.31; -0.28),. Conclusión: posiblemente las motivaciones por las cuales los actores involucrados se resisten a las transformaciones territoriales ocasionadas por la construcción de las represas son más un reflejo de la condición socioeconómica que de la preocupación de los actores por el daño del medio ambiente y además, esta resistencia es un fenómeno que se limita a aquellos que están afectados directamente en el área de influencia del proyecto

Body composition and appetite : fat-free mass (but not fat mass or BMI) is positively associated with self-determined meal size and daily energy intake in humans

The idea of body weight regulation implies that a biological mechanism exerts control over energy expenditure and food intake. This is a central tenet of energy homeostasis. However, the source and identity of the controlling mechanism have not been identified, although it is often presumed to be some long-acting signal related to body fat, such as leptin. Using a comprehensive experimental platform, we have investigated the relationship between biological and behavioural variables in two separate studies over a 12-week intervention period in obese adults (total n 92). All variables have been measured objectively and with a similar degree of scientific control and precision, including anthropometric factors, body composition, RMR and accumulative energy consumed at individual meals across the whole day. Results showed that meal size and daily energy intake (EI) were significantly correlated with fat-free mass (FFM, P values ,0·02–0·05) but not with fat mass (FM) or BMI (P values 0·11–0·45) (study 1, n 58). In study 2 (n 34), FFM (but not FM or BMI) predicted meal size and daily EI under two distinct dietary conditions (high-fat and low-fat). These data appear to indicate that, under these circumstances, some signal associated with lean mass (but not FM) exerts a determining effect over self-selected food consumption. This signal may be postulated to interact with a separate class of signals generated by FM. This finding may have implications for investigations of the molecular control of food intake and body weight and for the management of obesity.

Free vibration of rectangular plates of arbitrary thickness with one or more edges clamped

Frequencies of free vibration of rectangular plates of arbitrary thickness, with different support conditions, are calculated by using the Method of Initial Functions (MIF), proposed by Vlasov. Sixth and fourth order MIF theories are used for the solution. Numerical results are presented for three square plates for three thickness ratios. The support conditions considered are (i) three sides simply supported and one side clamped, (ii) two opposite sides simply supported and the other two sides clamped and (iii) all sides clamped. It is found that the results produced by the MIF method are in fair agreement with those obtained by using other methods. The classical theory gives overestimates of the frequencies and the departures from the MIF results increase for higher modes and larger thickness ratios.

A stabilization approach for mesh-free simulations of systems developing shocks or extreme strain localizations

A new stabilization scheme, based on a stochastic representation of the discretized field variables, is proposed with a view to reduce or even eliminate unphysical oscillations in the mesh-free numerical simulations of systems developing shocks or exhibiting localized bands of extreme deformation in the response. The origin of the stabilization scheme may be traced to nonlinear stochastic filtering and, consistent with a class of such filters, gain-based additive correction terms are applied to the simulated solution of the system, herein achieved through the element-free Galerkin method, in order to impose a set of constraints that help arresting the spurious oscillations. The method is numerically illustrated through its Applications to inviscid Burgers' equations, wherein shocks may develop as a result of intersections of the characteristics, and to a gradient plasticity model whose response is often characterized by a developing shear band as the external load is gradually increased. The potential of the method in stabilized yet accurate numerical simulations of such systems involving extreme gradient variations in the response is thus brought forth. (C) 2014 Elsevier Ltd. All rights reserved.

Ion channel behavior of amphotericin B in sterol-free and cholesterol- or ergosterol-containing supported phosphatidylcholine bilayer model membranes investigated by electrochemistry and spectroscopy

Amphotericin B (AmB) is a popular drug frequently applied in the treatment of systemic fungal infections. In the presence of ruthenium (II) as the maker ion, the behavior of AmB to form ion channels in sterol-free and cholesterol- or ergosterol-containing supported phosphatidylcholine bilayer model membranes were studied by cyclic votammetry, AC impedance spectroscopy, and UV/visible absorbance spectroscopy. Different concentrations of AmB ranging from a molecularly dispersed to a highly aggregated state of the drug were investigated. In a fixed cholesterol or ergosterol content (5 mol %) in glassy carbon electrode-supported model membranes, our results showed that no matter what form of AmB, monomeric or aggregated, AmB could form ion channels in supported ergosterol-containing phosphatidylcholine bilayer model membranes. However, AmB could not form ion channels in its monomeric form in sterol-free and cholesterol-containing supported model membranes. On the one hand, when AmB is present as an aggregated state, it can form ion channels in cholesterol-containing supported model membranes; on the other hand, only when AmB is present as a relatively highly aggregated state can it form ion channels in sterol-free supported phosphatidylcholine bilayer model membranes. The results showed that the state of AmB played an important role in forming ion channels in sterol-free and cholesterol-containing supported phosphatidylcholine bilayer model membranes.

An Oriental land of the free, or, Life and mission work among the Laos of Siam, Burma, China and Indo-China / by John H. Freeman.

http://www.archive.org/details/anorientallandof00freeuoft

Nature or nurture BMI and blood pressure at 90. Findings from the Belfast Elderly longitudinal free-living aging study Belfast

Hypertension is a key risk factor for stroke, cardiovascular disease and dementia. Although the link between weight, sodium and hypertension is established in younger people, little is known about their inter-relationship in people beyond 80 years of age. Associations between blood pressure, anthropometric indices and sodium were investigated in 495 apparently healthy, community-living participants (age 90, SD 4.8; range 80–106), from the cross-sectional Belfast Elderly Longitudinal Free-living Aging STudy (BELFAST) study. In age-sex-adjusted logistic regression models, blood pressure =140/90 mmHg significantly associated with body mass index (BMI) [odds ratio (OR)?=?1.28/ kg/m2], with weight (OR?=?1.22/kg) approaching significance (P?=?0.07). In further age-sex-adjusted models, blood pressure above the 120/80 mmHg normotensive reference value significantly associated with BMI (OR?=?1.44/kg/m2), weight (OR?=?1.36/kg), skin-fold-thickness (OR?=?1.33/mm) and serum sodium (OR?=?1.37 mmol/l). In BELFAST participants over 80 years old, blood pressure =140/90 mmHg is associated with BMI, in apparently similar ways to younger groups.

Psychosocial and academic characteristics of extremely low birth weight (<or =800 g) adolescents who are free of major impairment compared with term-born control subjects

To compare academic and cognitive ability, attention, attitudes, and behavior of extremely low birth weight (ELBW) adolescents who are free of major impairments at 17 years of age with term-born control subjects.

Plasma free fatty acids do not provide the link between obesity and insulin resistance or β-cell dysfunction: results of the Reading, Imperial, Surrey, Cambridge, Kings (RISCK) study

Aims To investigate the relationship between adiposity and plasma free fatty acid levels and the influence of total plasma free fatty acid level on insulin sensitivity and β-cell function. Methods An insulin sensitivity index, acute insulin response to glucose and a disposition index, derived from i.v. glucose tolerance minimal model analysis and total fasting plasma free fatty acid levels were available for 533 participants in the Reading, Imperial, Surrey, Cambridge, Kings study. Bivariate correlations were made between insulin sensitivity index, acute insulin response to glucose and disposition index and both adiposity measures (BMI, waist circumference and body fat mass) and total plasma free fatty acid levels. Multivariate linear regression analysis was performed, controlling for age, sex, ethnicity and adiposity. Results After adjustment, all adiposity measures were inversely associated with insulin sensitivity index (BMI: β = −0.357; waist circumference: β = −0.380; body fat mass: β = −0.375) and disposition index (BMI: β = −0.215; waist circumference: β = −0.248; body fat mass: β = −0.221) and positively associated with acute insulin response to glucose [BMI: β = 0.200; waist circumference: β = 0.195; body fat mass β = 0.209 (P values <0.001)]. Adiposity explained 13, 4 and 5% of the variation in insulin sensitivity index, acute insulin response to glucose and disposition index, respectively. After adjustment, no adiposity measure was associated with free fatty acid level, but total plasma free fatty acid level was inversely associated with insulin sensitivity index (β = −0.133), acute insulin response to glucose (β = −0.148) and disposition index [β = −0.218 (P values <0.01)]. Plasma free fatty acid concentration accounted for 1.5, 2 and 4% of the variation in insulin sensitivity index, acute insulin response to glucose and disposition index, respectively. Conclusions Plasma free fatty acid levels have a modest negative association with insulin sensitivity, β-cell secretion and disposition index but no association with adiposity measures. It is unlikely that plasma free fatty acids are the primary mediators of obesity-related insulin resistance or β-cell dysfunction.