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Aims Treatment decisions in patients with scimitar syndrome (SS) are often challenging, especially in patients with isolated SS who are often asymptomatic and who might be diagnosed accidentally. We queried a large multi-institutional registry of SS patients to evaluate the natural history of this condition and to determine the efficacy of surgical treatment in terms of survival and clinical status. Methods and results We collected data on 485 SS patients from 51 institutions; 279 (57%) patients were treated surgically (STPs) and 206 (43%) were clinically monitored (CMPs). Median age at last follow-up was 11.6 years (interquartile range 4-22 years). Overall survival probability at 30 years of age was 88% [85-92% confidence intervals (CI)] and was lower in patients with associated congenital heart disease (CHD) (P

An experimental model using rats is described, in which a state of copper deficiency was produced in pregnant dams and their offspring. In 100% of the neonates from the copper-deficient group (10/10), 20% (2/10) from the control group, and 40% (4/10) from the pair-fed group, the ductus arteriosus was found to remain patent. These figures were highly significant in statistical terms (X2 test; p less than 0.0009). The possible physiopathology of the persistence of the ductus arteriosus in copper-deficient neonates is discussed.

The emerging increase of antibiotic resistance constitutes an important risk to human health. Two million patients acquire nosocomial infections in U.S. hospitals each year. Of these infections, 60% involve resistant bacteria. In the last decade, only a few new antibiotics with new mechanisms of action were approved by the FDA, but additional costs for preventing the spread of bacteria, side effects and resistance may limit their long-term usefulness. Therefore, the number of therapeutic options is limited and necessitates exploration of novel antibacterial agents/approaches to treat hospital- and community-acquired infections. The challenge in antibacterial research is to find appropriate structurally novel antibacterial agents inhibiting bacterial targets. The XF drug series, having a dicationic porphyrin structure, which is distinct from all other known antibiotic classes, are rapidly active against a broad range of bacteria. Another new strategy is called photodynamic inactivation of bacteria (PDIB), which utilizes visible light in combination with photosensitizing molecules to efficiently kill bacteria via reactive oxygen species. The XF drugs act additionally as photosensitizers to inactivate bacteria upon light activation. This review summarizes the efficacy of the XF series and describes it as a new class of antibacterial agents or as new photo-sensitizers.

OBJECTIVE. The purpose of this study was to determine the diagnostic performance of hepatobiliary phase hypointensity and Liver Imaging Reporting and Data System (LI-RADS) major imaging features in the diagnosis of hepatocellular carcinoma (HCC) in hepatic lesions with arterial phase hyperenhancement (APHE) measuring 10-19 mm in patients at high risk of HCC. MATERIALS AND METHODS. A composite reference standard of pathologic analysis and imaging follow-up was used. The diagnostic performance (sensitivity and specificity) of hepatobiliary phase hypointensity and LI-RADS major imaging features other than APHE for the diagnosis of HCC was assessed and compared by means of a logistic regression model. RESULTS. This retrospective dual-institution study included 189 LI-RADS LR-3 and LR-4 lesions measuring 10-19 mm and having APHE in 144 consecutively registered patients (96 men, 48 women; mean age, 58 years). Hepatobiliary phase hypointensity had significantly higher sensitivity (84% [92/109], p < 0.00001) than major imaging features in the diagnosis of HCC but lower specificity (84% [67/80]; p = 0.01). However, hepatobiliary phase hypointensity in LR-3 observations measuring 10-19 mm and having APHE had moderately elevated sensitivity (73% [44/60]) and specificity (85%, 64/75). All three major imaging features had high specificity for the diagnosis of HCC, including 95% (76/80) for washout, 100% (80/80) for enhancing capsule, and 99% (79/80) for threshold growth. CONCLUSION. Major imaging features have high specificity for the diagnosis of HCC in lesions measuring 10-19 mm that have APHE. The finding of hepatobiliary phase hypointensity significantly improves sensitivity while moderately high specificity is maintained for the diagnosis of HCC in LR-3 lesions measuring 10-19 mm that exhibit APHE.

Objective: Involuntary treatment in mental health care is a sensitive but rarely studied issue. This study was part of the European Evaluation of Coercion in Psychiatry and Harmonization of Best Clinical Practice (EUNOMIA) project. It assessed and compared the use of coercive measures in psychiatric inpatient facilities in ten European countries. Methods: The sample included 2,030 involuntarily admitted patients. Data were obtained on coercive measures (physical restraint, seclusion, and forced medication). Results: In total, 1,462 coercive measures were used with 770 patients (38%). The percentage of patients receiving coercive measures in each country varied between 21% and 59%. The most frequent reason for prescribing coercive measures was patient aggression against others. In eight of the countries, the most frequent measure used was forced medication, and in two of the countries mechanical restraint was the most frequent measure used. Seclusion was rarely administered and was reported in only six countries. A diagnosis of schizophrenia and more severe symptoms were associated with a higher probability of receiving coercive measures. Conclusions: Coercive measures were used in a substantial group of involuntarily admitted patients across Europe. Their use appeared to depend on diagnosis and the severity of illness, but use was also heavily influenced by the individual country. Variation across countries may reflect differences in societal attitudes and clinical traditions. (Psychiatric Services 61: 1012-1017, 2010)