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Osteoarthritis (OA) is one of the most common musculoskeletal diseases. OA is characterized by degeneration of the articular cartilage as well as the underlying subchondral bone. Post-traumatic osteoarthritis (PTOA) is a subset of OA caused by mechanical trauma. Mouse models, such as destabilization of the medial meniscus (DMM), are useful to study PTOA. Ex vivo micro-Computed Tomography (microCT) imaging is the predominant technique used to scan the mouse knee in OA studies. Nevertheless, in vivo microCT enables the longitudinal assessment of bone microstructure, reducing measurement variability and number of animals required. The effect of image resolution in measuring subchondral bone parameters was previously evaluated only for a limited number of parameters. The aim of this study was to evaluate the ability of in vivo microCT imaging in measuring the microstructural properties of the mouse tibia trabecular and cortical subchondral bone, with respect to ex vivo high resolution imaging, in a DMM model of PTOA. Sixteen male C57BL/6J mice received DMM surgery or sham operation at 14 weeks of age (N=8 per group). The right knee of each mouse was microCT scanned in vivo (10.4mm voxel size) and ex vivo (4.35mm voxel size) at the age of 26 weeks. Each image was aligned to a reference image using rigid registration. The subchondral cortical bone plate thickness was measured at the lateral and medial condyles. Standard morphometric parameters were measured in the subchondral trabecular bone. In vivo microCT imaging led to significant underestimation of bone volume fraction (-14%), bone surface density (-3%) and trabecular number (-16%), whereas trabecular thickness (+3%) and separation (+5%) were significantly overestimated. Nevertheless, most trabecular parameters measured in vivo were well correlated with ex vivo measurements (R2 = 0.69-0.81). Degree of anisotropy, structure model index and connectivity density were measured in vivo with lower accuracy. Excellent accuracy was found for cortical thickness measurements. In conclusion, this study identified what bone morphological parameters can be reliably measured by in vivo microCT imaging of the subchondral bone in the mouse tibia. It highlights that this approach can be used to study longitudinal effects of diseases and treatments on the subchondral cortical bone and on most subchondral trabecular bone parameters, but systematic over-or underestimations should be considered when interpreting the results. [ABSTRACT FROM AUTHOR]

Computational model was designed for feeding systems of small dairy farms in Egypt under Mixed Farming System (MFS) (Crops/livestock). The present case study was selected from El-Beheira governorate, where the three common dairy animals (Local cows, Crossbred cows and buffaloes) are available. The main objectives of this study were 1- To find out the optimum combination of inputs from farm green forage and cash crops to minimize animal feeding costs. 2- Asses the possibilities of increasing the farm income by least cost rations formulation using available feed resources for dairy cattle. Technical coefficients of the models were obtained from previous studies under Egyptian condition. The model proposed three scenarios: Scenario I (S I) calculated the actual feeding situation from the case study without any changes as base run, scenario II (S II) proposed to cover animal feeding requirements of the same herd in scenario (S I) from the same available feed resources according to NRC (2001) and scenario III (S III) operating on the available feeding package quantities or reallocated farm feed resources for the same herd. The model used the common feed in summer and winter seasons (300 days) while, two months were considered as transitional period between two seasons, where irregular animal feeding regime is adopted. The results showed that area cultivated with green forages can be reduced by 17% and 25% of total planted area in SII for winter and summer, respectively, compared to base run (SI). Where as in S III, the green forage cultivated areas reduced by 30% and 25% for winter and summer, respectively in comparison with SI, feeding costs in SII were reduced by 51.11% and 38.97% in winter and summer, respectively. Using available feeding packages and reallocated farm resources in SIII reduced feeding costs by 47.78% and 27.67% for winter and summer, respectively. It can be concluded that using available feeding packages or reallocated animal feeding resources either in SII and SIII achieved a considerable reduction on animal feeding costs of small-scale mixed farms compared to base run scenario (SI). [ABSTRACT FROM AUTHOR]

Periprocedural management of patients on long-term warfarin therapy remains a common and important clinical issue, with little high-quality data to guide this complex process. The current accepted practice is cessation of warfarin five days preoperatively, but this is not without risk and can be complicated, particularly if bridging is required. An alternative method utilising low-dose intravenous vitamin K the day before surgery has been shown previously to be efficacious, safe and convenient in an elective surgical population receiving chronic warfarin therapy. The efficacy and utility of this 'fast-track' warfarin reversal protocol in surgical patients with cancer, who were at high risk of both thromboembolism and bleeding was investigated in a prospective, single-arm study at a dedicated cancer centre. Seventy-one patients underwent 82 episodes of fast-track warfarin reversal (3 mg intravenous vitamin K 18 to 24 hours before surgery). No patient suffered an adverse reaction to intravenous vitamin K, all but one achieved an International Normalized Ratio =1.5 on the day of surgery, and no surgery was deferred. Assays of vitamin K-dependent factor levels pre- and post-vitamin K demonstrated restoration of functional activity to within an acceptable range for surgical haemostasis. While this alternative method requires further validation in a larger prospective randomised study, we have now extended our use of fast-track warfarin reversal using vitamin K to patients with cancer, on the basis of our experience of its safety, convenience, reliability and efficacy. [ABSTRACT FROM AUTHOR]

Background and Purpose: Chronic elevation in intracellular Ca(2+) concentration participates in death of skeletal muscle from mdx mice, a model for Duchenne muscular dystrophy (DMD). Candidate pathways mediating this Ca(2+) overload involve store-operated channels (SOCs) and stretch-activated channels (SACs), which are modulated by the Ca(2+) -independent form of PL A2 (iPLA2 ). We investigated the effect of doxorubicin (Dox), a chemotherapeutic agent reported to inhibit iPLA2 in other systems, on the activity of this enzyme and on the consequences on Ca(2+) handling and muscle function in mdx mice.Experimental Approach: Effects of Dox on iPLA2 activity, reactive oxygen species production and on Ca(2+) influx were investigated in C2C12 and mdx myotubes. The mechanism of Dox-mediated iPLA2 inhibition was evaluated using purified 6x histidine-tagged enzyme. Aequorin technology was used to assess Ca(2+) concentrations underneath the plasma membrane. Isolated muscles were exposed to fatigue protocols and eccentric contractions to evaluate the effects of Dox on muscle function.Key Results: Dox at 1-30 μM inhibited iPLA2 activity in cells and in the purified enzyme. Dox also inhibited SAC- but not SOC-mediated Ca(2+) influx in myotubes. Stimulated elevations of Ca(2+) concentrations below the plasmalemma were also blocked. Exposure of excised muscle to Dox was not deleterious to force production and promoted recovery from eccentric contractions.Conclusions and Implications: Dox showed efficacy against targets known to play a role in the pathology of DMD, namely iPLA2 and SAC. The potent SAC inhibitory effect of Dox is a novel finding that can explain partly the cardiomyopathy seen in chronic anthracycline treatment. [ABSTRACT FROM AUTHOR]

Background and Purpose Chronic elevation in intracellular Ca2+ concentration participates in death of skeletal muscle from mdx mice, a model for Duchenne muscular dystrophy ( DMD). Candidate pathways mediating this Ca2+ overload involve store-operated channels ( SOCs) and stretch-activated channels ( SACs), which are modulated by the Ca2+-independent form of PL A2 ( iPLA2). We investigated the effect of doxorubicin ( Dox), a chemotherapeutic agent reported to inhibit iPLA2 in other systems, on the activity of this enzyme and on the consequences on Ca2+ handling and muscle function in mdx mice. Experimental Approach Effects of Dox on iPLA2 activity, reactive oxygen species production and on Ca2+ influx were investigated in C2C12 and mdx myotubes. The mechanism of Dox-mediated iPLA2 inhibition was evaluated using purified 6x histidine-tagged enzyme. Aequorin technology was used to assess Ca2+ concentrations underneath the plasma membrane. Isolated muscles were exposed to fatigue protocols and eccentric contractions to evaluate the effects of Dox on muscle function. Key Results Dox at 1-30 μM inhibited iPLA2 activity in cells and in the purified enzyme. Dox also inhibited SAC- but not SOC-mediated Ca2+ influx in myotubes. Stimulated elevations of Ca2+ concentrations below the plasmalemma were also blocked. Exposure of excised muscle to Dox was not deleterious to force production and promoted recovery from eccentric contractions. Conclusions and Implications Dox showed efficacy against targets known to play a role in the pathology of DMD, namely iPLA2 and SAC. The potent SAC inhibitory effect of Dox is a novel finding that can explain partly the cardiomyopathy seen in chronic anthracycline treatment. [ABSTRACT FROM AUTHOR]

We conducted a cross-sectional survey to determine the prevalence of, and factors affecting, spousal violence among 3271 ever-married women attending 12 randomly selected family health centres in Alexandria Governorate. More than three-quarters of the participants (77%) reported experiencing spousal violence during their marital life. Emotional violence was the most common type reported (71.0%), followed by physical (50.3%), economic (40.8%) and sexual (37.1%) violence. The study confirms the high prevalence of spousal violence across all socioeconomic strata. Logistic regression analysis indicated large family size, divorce or separation, low educational attainment of husband, smoking habit and drug use in husband, husband’s psychological status and history of exposure to physical violence during adolescence were associated with spousal violence. This high rate of spousal violence highlights the urgent need for government and civil society to address the issue, which hinders progress toward Egypt’s development goals. [ABSTRACT FROM AUTHOR]

2-Alkylcyclobutanones are routinely used as chemical markers for irradiated foods containing lipids. However, current extraction procedures (soxhlet-Florisil chromatography) for the isolation of these markers involve a long and tedious clean-up regime prior to GC-MS identification. A simple and rapid method for the isolation of these markers using carbon dioxide as a super critical fluid is described for low lipid content fish samples (fresh and sea water) irradiated up to 8kGy. The presence of 2-dodecylcyclobutanone (2-DCB), a radiolytic marker, was confirmed in all irradiated fish samples at all doses. This was a clear indication that the fish samples had been irradiated and that both methods of isolation (florisil and supercritical fluid extraction) were capable of qualitatively extracting this marker. Supercritical fluid extraction is proposed as an alternative extraction procedure to the florisil chromatography method currently in use and has the added advantage of a considerably shorter extraction time. [ABSTRACT FROM AUTHOR]

Seven clinical tests have been used to study the recovery of arm function in 92 patients over 2 years following their stroke. These tests are simple and quick, and can be used by any interested observer. They form a hierarchical scale that measures recovery. Statistically significant improvement is only seen in the first 3 months. Fifty-six patients initially had non-functional arms; eight made a "complete recovery" and 14 a partial recovery. The tests described are inadequate on their own because they are not sufficiently sensitive at the upper range of ability. While recovery of lost function does relate to the degree of initial neurological loss in the arm, it seems to be largely independent of the overall severity of the stroke. [ABSTRACT FROM AUTHOR]

Each month, we will present a challenging Case of the Month for Green Journal readers, who must use their clinical acumen to arrive at the correct answer. We will also post the case each month on the Journal's web site (http://www.ajmselect.com). Several possible answers may be consistent with the case presentation; use your best judgment. Please send your answer (one per respondent) to The Green Journal at editors@amjmed.org or via FAX to (415) 447-2799. Indicate the case to which you are responding and include your complete address. The correct answer will appear in the next issue of the Journal. The first five persons who submit correct answers will receive a free one-year subscription to the Journal. Because of the volume of answers we receive, neither correct nor incorrect answers can be individually acknowledged. Colleagues of Drs. Ismail H and Bhat at Kasturba Medical College in Mangalore are not eligible for this month's case. If you would like to contribute a case, please submit a brief synopsis (<250 words) to the editorial office. [ABSTRACT FROM AUTHOR]

Purpose: Insulin resistance plays a pivotal role in the preclinical stages of type 1 diabetes (T1D)., Objective: This study aims at exploring the genetic, metabolic, and immunological features associated with insulin resistance among individuals at risk of developing T1D., Methods: We retrospectively selected relatives of individuals with T1D from participants in the TrialNet Pathway to Prevention study. They were categorized into two groups: high-H (n = 27) and low-H (n = 30), based on the upper and lower quartiles of insulin resistance assessed using the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR). Genetic predisposition was determined using the T1D Genetic Risk Score 1 (GRS1). Additionally, glucose control was evaluated through an oral glucose tolerance test and levels of metabolic hormones and inflammatory cytokines were measured in the serum. Flow cytometry analysis was employed to assess frequency and phenotype of islet-specific CD8 T cells., Results: While GRS1 were similar between the low-H and high-H groups, high-H individuals displayed a distinct metabolic profile, characterized by compensatory hyperinsulinemia, even while maintaining normoglycemia. Circulating cytokine levels were similar between the two groups. However, immune profiling revealed a central memory and activated profile of GAD65-specific CD8 T cells, along with an increased frequency of insulin-specific CD8 T cells in high-H individuals. The enrichment in insulin-specific CD8 T cells was independent of body mass., Conclusion: These findings highlight the intricate interplay between insulin resistance, genetic factors, and immune activation in the context of T1D susceptibility, indicating potential connections between insulin resistance and immune responses specific to islet cells., Competing Interests: Declarations. Competing interests: The authors have no relevant financial or non-financial interests to disclose. Ethics approval: This research study was conducted retrospectively from data obtained for clinical purposes. On selected subjects immunological parameters were tested on biobanked biological material. This study involving human participants was in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The OSR Ethics Committee approved this study (IRB# NHPROT32803-TN01). Consent to participate: Informed consent was obtained from all individual or from legal guardians’ participants included in the study., (© 2024. The Author(s).)

Insecticide-treated nets (ITNs) are the most effective method for malaria prevention in Africa. Using near-infrared video tracking in a laboratory environment, we recorded and assessed bednet entry and exit by a northern Tanzanian population of Anopheles arabiensis at a human-occupied untreated net and a PermaNet® 2.0 ITN. Both had 12 holes, each 10 cm in diameter, punctured at specific locations, and the ITN was washed 20 times to further simulate the wear and tear of ageing. Washing reduced the insecticide content of ITNs by 61%, which then showed similar rates to the untreated nets for net entry (39% entered untreated net and 41% entered ITN; p = 0.84) and exit (37% and 43%, respectively; p = 0.67). Regardless of treatment, approximately 40% of mosquitoes entered nets within 20 s of first appearing in the field of view and reached the volunteer's skin within 5 s of entering the net. Mortality rates post-exposure were significantly higher ( p = 0.048) at ITNs (26.6%; 95% CI 13.4%-39.7%) than at untreated controls (6.4%; 95% CI 1.8%-14.6%). The washed and aged ITN provided little additional personal protection for the sleeper over an untreated net. Simple adjustments to materials and design that could extend the effective lifespan of ITNs are discussed., Competing Interests: We declare we have no competing interests., (© 2024 The Authors.)

Objective: Obtain the undergraduate medical students' evaluation of an objective structured clinical examination (OSCE) formed by two stations in neurology., Methods: The fifth-year medical students taking the neurology course at King Faisal University during the first rotation of academic year 1420-1421H (2000-2001G) made the evaluation. The time for each station was seven minutes. After finishing the examination, each student completed a six-item questionnaire on coverage, question clarity, time, patients, educational usefulness and organization of the examination with yes, no or don't know responses., Results: A total of 48 students (30 males and 18 females) took the examination. The average time to complete the examination for a group of 16 students was 2 hours. The responses were positive for clarity of questions and organization of the examination 41(85%), and allotted time 36(75%). Thirty-two students (67%) found the structured examination a useful educational experience. About half the students expressed their concern about the coverage of taught material and the number of patients seen in the examination as representative of those seen during the course, and 11 students (23%) requested more time., Conclusions: The students' response to the use of the structured clinical examination as an objective tool for evaluation of clinical skills in neurology was favorable and comparable to reports from other parts of the world. Improvement is required in the number of patients, coverage and allotted time to optimize outcome by improving content validity and reducing stress on participating patients.

The clinical patterns, including history, examination, and electroencephalographic (EEG) and computed tomography (CT) findings were examined prospectively in 263 children (153 boys, 110 girls) with newly diagnosed recurrent seizures. The overall mean age was 4. 2 years, with a range of 0.05-13 years. The age of onset was within the first year of life in 128 (48.7%) of the patients. Hypoxic-ischemic encephalopathy (14.8%), febrile seizures (9.1%) and developmental delay (4.6%) were the predominant signs in this age group. Consanguinity of the parents was present in 29.7% cases. The main EEG abnormalities were epileptiform activity, which was generalized in 133 (50.6%) and focal in 80 (30.4%). Other abnormalities included slow wave activity in 41 (15.6%) and hypsarrhythmia in 3 (1.1%). The main seizure types were generalized in 60.4% and partial in 32.7%. The types of epileptic syndromes included localization-related (28.1%), generalized (23.2%), undetermined (37.4%) and (special) syndromes 11.4%. The cranial CT findings were normal in 60.5%, and the predominant abnormality was cerebral atrophy in 25.3%. The pattern of seizure types and the peak presentation in early childhood are comparable to those in western reports.

As part of a public health campaign in Egypt, various chemical parameters of oil which are considered good indices in assessing the degree of thermal abuse, oxidation and overall quality (acid values, iodine values, peroxide values, etc.) were studied with respect to different frying oils. Ingestion of decomposition products formed as a results of thermal abuse and oxidation of frying oils are known to lead to a variety of symptoms and diseases (allergies, atherosclerosis, coronary heart disease). Results show that the oil most commonly used by street vendors in Egypt (blend of cotton seed and sunflower oil) is the least suitable for frying, while palm oil on the basis of the various chemical parameters studied, is the ideal choice. However, from the nutritional and public health stand point, the use of saturated oils is to be discouraged. Corn oil is therefore the next best choice from both the chemical and nutritional stand point, and is recommended for public use in a country in which deep-fried vegetable patties ('fallafel') forms the staple food item in the diet.

The pattern of electroencephalographic (EEG) abnormalities was studied in 68 patients (41 male, 27 female, age range 1 month to 17 years) with hydrocephalus. They all had standardized EEG recordings, which were read by the same electroencephalographer. In 48 children the EEG was performed after ventriculo-peritoneal shunting. The EEG abnormalities in the shunted group included slow waves in 26 patients [focal 2 (4.2%), generalized asynchronous 22 (45.8%), generalized synchronous 2 (4.2%)]; amplitude abnormalities in 2 (focal 1, generalized 1); epileptiform activity in 26 [partial 11 (22.9%), generalized 15 (31.3%)] and hypsarrhythmia in 4 (8.3%). Only 4 (8.3%) traces were normal, giving an overall percentage abnormality of 92%. In the unshunted group generalized asynchronous slow waves were found in 12 patients (60%), generalized amplitude abnormality in 1, focal epileptiform activity in 3 (15%), and generalized epileptiform activity in 6 (30%); 2 tracings in this group were normal, giving an overall percentage abnormality of 90%. Hydrocephalus in children, regardless of the cause, may be associated with generalized or focal EEG abnormalities. This may reflect the heterogeneity of the neural generator in the underlying disease process.

This study reports the electrophysiological findings in patients with newly diagnosed non-insulin-dependent diabetes mellitus (NIDDM) studied in the Neurodiagnostic Laboratory of the King Fahd Hospital of the University (KFHU), Al-Khobar, Saudi Arabia. Twenty-nine patients (22 males, 7 females, mean ages 47 and 37 years, respectively) were studied within four weeks of establishing the diagnosis. They were all given nerve conduction studies by the same examiner. Comparison was made with data from a group of 64 normal control subjects. In the study patients, the mean distal sensory peak latency in milliseconds (ms) +/- standard deviation (SD) was 3.5 +/- 0.41 ms in 35 median nerves, 3.2 +/- 0.72 ms in 35 ulnar nerves, 1.9 +/- 0.34 ms in 23 superficial radial nerves and 3.5 7plusmn; 0.61 in 36 sural nerves. The mean distal motor latency +/- SD was 4.6 +/- 0.95 ms in 39 median nerves, 3.5 +/- 0.58 ms in 38 ulnar nerves, 4.8 +/- 1.02 ms in 44 tibial nerves and 6.0 +/- 1.08 ms in 36 peroneal nerves. The electromyogram examination was performed on 24 patients and showed evidence of denervation and/or chronic reinnervation in seven (29%). The frequency of abnormalities in the studied peripheral nerves was 60% for median, 63% ulnar, 33% peroneal, 16% tibial and 8% sural.

Although antimicrobial agents from a number of classes have been used with a good degree of clinical success for acute bacterial exacerbations of chronic bronchitis, the incidence of resistance by beta-lactamase-producing strains to certain penicillins and cephalosporins continues to increase and represents a growing clinical problem. There also have been reports of significant resistance by Streptococcus pneumoniae to tetracyclines and of treatment failures caused by this organism among patients receiving fluoroquinolones. The emergence of penicillin-resistant pneumococci in North America also is of concern. Although first-generation cephalosporins are no longer regarded as first-line therapy or optimal alternatives for acute exacerbations of chronic bronchitis, more recently developed agents of this class have better activity against the primary pathogens, and their efficacy and safety have been demonstrated in a number of clinical trials. Newer macrolide agents probably should be reserved for infections caused by atypical organisms.

Physiological tests of work performance and measurement of field productivity were made in 194 Sudanese cane cutters in order to study the effect of Schistosoma mansoni infection. The cane cutters were selected from two age ranges (16-24 and 25-45 years) and subdivided into three clinical groups: not infected, infected with, and infected without clinical signs of hepatosplenomegaly. Men infected with Schistosoma haemotobium, malaria (blood film), or with hemoglobin levels less than 10 g/100 ml were excluded. There was a statistically significant (P less than 0.002) higher mean hemoglobin concentration in those not infected but the mean difference was less than 1 g/100 ml. Submaximal responses to exercise on a stationary bicycle ergometer, oxygen intake, ventilation, tidal volume, cardiac frequency and estimated maximal aerobic power output calculated both in absolute terms and relative to lean body mass and leg volume were similar in the six groups of cane cutters. No significant differences were found in physique, body composition or in thermoregulatory function tests. The cane cutters were found to have little natural acclimatization to heat in terms of sweating capacity when compared with a group of fully acclimatized Sudanese soldiers. The mean productivity (mean daily weight of cane cut per man) was significantly correlated with the individual's estimated maximum aerobic capacity determined in the laboratory, but not with the degree of S. mansoni infection. The noninfected group was less "efficient" (mean productivity:oxygen intake) during cutting than the infected groups but a larger proportion of the noninfected were in their first season of cutting. There was a positive correlation between the number of seasons' cutting experience and the individual's age, degree of infection and mean productivity. Cane cutters studied in this investigation were a relatively fit, active population from whom the more seriously ill were excluded. These results do not, therefore necessarily reflect the effects of S. mansoni on physiological work capacity and productivity of more static populations in areas of high endemicity.