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Peripartum replacement of factor VIII and von Willebrand factor is not usually required in type 1 von Willebrand disease, as the levels of endogenous factors tend to increase to within the normal range as a physiological change of pregnancy. However, there is wide heterogeneity of genotypes and phenotypes associated with type 1 von Willebrand disease. Here, we describe the anesthetic management of a parturient with type 1C von Willebrand disease, a subtype characterized by decreased plasma von Willebrand factor survival. [ABSTRACT FROM AUTHOR]

Abstract: A survey was undertaken to determine the extent of Leratiomyces ceres (syn. Stropharia aurantiaca sensu auct.) in soil surrounding apparently isolated occurrences of fungal fruit bodies on woodchip mulch. A molecular detection system with specific primers identified the fungus in the soil below woodchip in which fruit bodies had been noted in the previous year, and also in adjacent soil beyond the mulched area where fruiting had not been observed. The results indicate that L. ceres is widespread in the soil in the survey area, and possible reasons for this finding, and their implication for distribution studies are discussed. [Copyright &y& Elsevier]

Abstract: Polymerase chain reaction (PCR) primers ST1 and ST2 were designed for the specific amplification of ribosomal DNA from Stropharia aurantiaca, and a nested PCR method was developed for the detection of S. aurantiaca in garden soils and mulches. The results of PCR screening of garden soils and mulches indicated that S. aurantiaca could be detected in the absence of visible fruiting bodies. The occurrence of S. aurantiaca in soil and mulch was investigated to determine if the application of wood-chip mulch resulted in the introduction of the fungus or the stimulation of an already present population. [Copyright &y& Elsevier]

Systemic antimicrobial treatments are commonly prescribed to dogs with acute diarrhoea, while nutraceuticals (prebiotics, probiotics, and synbiotics) are frequently administered as an alternative treatment. The aim of this systematic review and meta-analysis was to assess the effectiveness of antimicrobials and nutraceutical preparations for treatment of canine acute diarrhoea (CAD). The results of this study will be used to create evidence-based treatment guidelines. PICOs (population, intervention, comparator, and outcome) were generated by a multidisciplinary expert panel taking into account opinions from stakeholders (general practitioners and dog owners). The Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology was used to evaluate the certainty of the evidence. The systematic search yielded six randomised controlled trials (RCT) for antimicrobial treatment and six RCTs for nutraceutical treatment meeting the eligibility criteria. Categories of disease severity (mild, moderate, and severe) were created based on the presence of systemic signs and response to fluid therapy. Outcomes included duration of diarrhoea, duration of hospitalization, progression of disease, mortality, and adverse effects. High certainty evidence showed that antimicrobial treatment did not have a clinically relevant effect on any outcome in dogs with mild or moderate disease. Certainty of evidence was low for dogs with severe disease. Nutraceutical products did not show a clinically significant effect in shortening the duration of diarrhoea (based on very low to moderate certainty evidence). No adverse effects were reported in any of the studies. • Systematic review of antimicrobial and nutraceutical use in canine acute diarrhoea. • Meta-analyses of available data were performed. • Antimicrobials did not have a clinical effect on canine acute diarrhoea. • Nutraceuticals did not have a clinical effect on canine acute diarrhoea. • High certainty evidence was found for dogs with mild and moderate diarrhoea. [ABSTRACT FROM AUTHOR]

Background: A strong rationale supports the role of antiangiogenic drugs in urothelial cancer. This trial was designed to assess the activity of sunitinib as first-line treatment in patients with metastatic urothelial cancer ineligible for cisplatin and to explore molecular and imaging variables predictive of clinical benefit.Patients and methods: This was a multicenter phase II trial with sunitinib 50 mg daily in 4/2-week schedule. Eligibility criteria were as follows: creatinine clearance 30–60 ml/min, Eastern Cooperative Oncology Group Pperformance Sstatus of one or less, and adequate hepatic and hematologic function. Twelve circulating cytokines were evaluated at baseline and sequentially using Luminex xMAP® (Austin, TX). Baseline and treatment-related changes in perfusion were evaluated in a patient subgroup using contrast-enhanced computed tomography.Results: On intention-to-treat analysis, 38 patients showed 3 (8%) partial responses (PRs) and 19 (50%) presented with stable disease (SD), 17 (45%) of them ≥3 months. Clinical benefit (PR + SD) was 58%. Median time to progression (TTP) was 4.8 months and median overall survival 8.1 months. Toxicity was consistent with previous reports for sunitinib. Low interleukin-8 (IL-8) baseline levels were significantly associated with increased TTP. Baseline tumor contrast enhancement with >40 Hounsfield units was associated with clinical benefit.Conclusions: This study highlights the potential role of the angiogenic pathway as a therapy target in urothelial cancer. Baseline IL-8 serum levels and contrast enhancement of lesions warrant further study. [ABSTRACT FROM AUTHOR]

Abstract: Background: Rett disorder (RD) is a progressive neurodevelopmental entity caused by mutations in the MECP2 gene. It has been postulated that there are alterations in the levels of certain neurotransmitters and folate in the pathogenesis of this disease. Here we re-evaluated this hypothesis. Patients and methods: We evaluated CSF folate, biogenic amines and pterines in 25 RD patients. Treatment with oral folinic acid was started in those cases with low folate. Patients were clinically evaluated and videotaped up to 6 months after therapy. Results: CSF folate was below the reference values in 32% of the patients. Six months after treatment no clinical improvement was observed. Three of the four patients with the R294X mutation had increased levels of a dopamine metabolite associated to a particular phenotype. Three patients had low levels of a serotonin metabolite. Two of them were treated with fluoxetine and one showed clinical improvement. No association was observed between CSF folate and these metabolites, after adjusting for the patients age and neopterin levels. Conclusion: Our results support that folinic acid supplementation has no significant effects on the course of the disease. We report discrete and novel neurotransmitter abnormalities that may contribute to the pathogenesis of RD highlighting the need for further studies on CSF neurotransmitters in clinically and genetically well characterized patients. [Copyright &y& Elsevier]

Abstract: Dating climatic and environmental records with accuracy and precision is critical if we are to robustly test hypotheses of synchronous change between the hemispheres. In the southern hemisphere, the advance of the New Zealand Franz Josef Glacier to the Waiho Loop terminal moraine has been used as evidence of synchronous global change during the Younger Dryas Chronozone. However, radiocarbon ages for wood incorporated into the sediments associated with the advance span an interval of ∼900 years. Here we demonstrate that weathered ‘old’ wood was incorporated into the deposit prior to, or during, the advance, and that this material is highly susceptible to contamination by young carbon, resulting in the wide range of age estimates reported previously. We have identified material with little evidence of reworking (well-preserved wood with bark attached) that provides a statistically robust mean radiocarbon age of 11,062±30BP (∼13.1ka) for the advance of the Franz Josef Glacier. The timing of this event falls within the later part of the Antarctic Cold Reversal. Comparison with local, regional and global records suggests that cold conditions in the Southern Ocean were probably experienced in New Zealand at this time, driving the glacial advance. [Copyright &y& Elsevier]

Steroidal quaternary ammonium compounds 12 and 13 with quaternised nitrogen at positions 3 and 16 of the steroidal nucleus in androstane series were synthesised and their neuromuscular blocking activities and ganglion blocking activities were studied using chick biventer and anaesthetised cat as the models. The bisquaternary compounds 12 and 13 have been found to be greater in potency than d-tubocurarine. Acetoxy derivative 13 has been found to be more potent than pipecuronium bromide taking d-tubocurarine as the standard compound indicating the need of acetoxy function at position 16. [Copyright &y& Elsevier]