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Purpose: To evaluate and compare the effect of black and green tea on initial enamel caries like lesions of extracted human permanent teeth through microhardness analysis and polarized light microscopic evaluation. Materials and methods: Fifty extracted young premolars with a standardized window on enamel were immersed in a demineralizing solution for 48 hours to produce subsurface enamel lesions. They were divided into two groups according to the type of treatment (n= 25), group I: teeth were treated by black tea infusion; group II: teeth were treated by green tea infusion. The enamel surface microhardness was measured at baseline, after the incipient enamel lesion, and after treatment. Additional twenty young premolars were selected and prepared for evaluation of the changes in enamel birefringence using the polarized light microscope. Results: Both groups showed a statistically significant increase in enamel surface microhardness after treatment as compared to the demineralization phase. By comparing the two groups, there was a statistically significant difference in the percentage of surface microhardness recovery after treatment in favor of the black tea group (P

Nephrotoxicity is a serious side effect for the immunosuppressant drug cyclosporine A(CSA). In this study, we tested the hypothesis that administration of calcium channel blockers such as verapamil or nifedipine ameliorates renal CSA-induced renal dysfunction. Furthermore, our study investigates the roles of inflammatory, oxidative, and fibrotic pathways in CSA-induced renal dysfunction. Six groups of male rats ( n = 6/group) were used and received one of the following treatments for seven consecutive days: vehicle (Cremophor EL ip), CSA (25 mg·kg−1·day−1ip), verapamil (2 mg·kg−1·day−1ip), nifedipine (3 mg·kg−1·day−1ip), CSA in the presence or absence of either verapamil, or nifedipine. Biochemical and histomorphometric analyses showed that rats treated with CSA exhibited clear signs of nephrotoxicity that included 1) proteinuria and elevations in serum creatinine and blood urea nitrogen, 2) mesangial expansion, 3) increases in glomerular and tubular type IV collagen expression, and 4) increases in the glomerulosclerosis and tubulointerstitial fibrosis indices. Although the single administration of nifedipine or verapamil had no significant effect on renal pathology, or its biochemical and physiological function, the concurrent use of either calcium channel blockers significantly and equipotently ameliorated the biochemical, morphological, and functional derangements caused by CSA. More importantly, we report that the oxidative (reactive oxygen species production, NADPH-oxidase activity, and dual oxidase 1/2 levels), fibrotic (transforming growth factor-β1 expression), and inflammatory (NF-κB expression) manifestations of renal toxicity induced by CSA were significantly reversed upon administration of nifedipine or verapamil. Together, these results highlight the efficacy of calcium channel-blocking agents in attenuating CSA-induced nephrotoxicity and predisposing biochemical and molecular machineries.

Purpose Understanding the underlying cause of mortality in sepsis has broad implications for both clinical care and interventional trial design. However, reasons for death in sepsis remain poorly understood. We sought to characterize reasons for in-hospital mortality in a population of patients with sepsis or septic shock. Materials and methods We performed a retrospective review of patients admitted to the intensive care unit with sepsis or septic shock who died during their index admission. Reasons for death were classified into 6 categories determined a priori by group consensus. Interrater reliability was calculated and Fleiss κ reported. The associations between selected patient characteristics (eg, serum lactate) and reason for death were also assessed. Results One hundred fifteen patients were included. Refractory shock (40%) and comorbid withdrawal of care (44%) were the most common reasons for death. Overall interrater agreement was substantial (κ = 0.61, P

Four-leg voltage source inverter is an evolution of the three-leg inverter, and was ought about by the need to handle the non-linear and unbalanced loads. In this work Matlab/ Simulink model is presented using space vector modulation technique. Simulation results for worst conditions of unbalanced linear and non-linear loads are obtained. Observation for the continuity of the fundamental inverter output voltages vector in stationary coordinate is detected for better performance. Matlab programs are executed in block functions to perform switching vector selection and space vector switching.

VITAL is a novel P2P indexing structure that provides on top of exact search a similarity search of multidimensional vectors. It is designed to scale to millions of peers and billions of shared documents and to adapt to high network dynamics. To exploit peer heterogeneity, VITAL is a super-peer (SP) network where every peer is an SP candidate and a simple election protocol is run to select SPs. On the other hand, every SP locally monitors its “vital” signs of memory, processing, and bandwidth and initiates the SP election protocol based on its capacity and load limits. In addition, the SP overlay is structured as CAN distributed hash table to guarantee both the correctness and responsiveness of the query protocol. A novel data replication model is introduced, where every peer clusters its shared documents to local clusters (LCs) and each LC summary is published at few SPs to achieve content-based clustering and firework query propagation. Every peer establishes TCP connections with many SPs that maintain its LC summaries. VITAL has no central component and does not require global knowledge, however it requires identifying a set of global cluster (GC) centriods to be disjointly managed by the elected SPs. In addition, CAN zone overloading is seamlessly applied to relief overwhelmed SPs and it provided an extra layer of physical proximity clustering. The scalability analysis shows that peer index requires less than 3 % of extra storage and a query (on average) can be satisfied by visiting 1.6 % of the number of established TCP connections.

Ni x Mn 0.8− x Mg 0.2 Fe 2 O 4 ; 0.1 ≤ x ≤ 0.35 was prepared by standard ceramic technique at sintering temperature 1200 °C using heating / cooling rate 4 °C/min. The samples were irradiated by Nd YAG pulsed laser with energy of the pulse 250 mJ. X-ray diffractograms reveal cubic spinel structure for all the samples before and after laser irradiation. After laser irradiation, better crystallinity was obtained in a form of an increase in the calculated crystal size. This increase was discussed as due to the change in the valence of some ions like Fe 3+ , Ni 2+ and Mn 2+ . The conductivity of all the investigated samples decreases after laser irradiation and becomes temperature independent for a wider range than that before irradiation. This was ascribed to electron rearrangement after laser irradiation. Accordingly, these ferrites are recommended to be useful in electronic devices.

The worlds’ current food production system is focused on a limited number of crops. However, international food demand is increasingly looking for more diversified supplies. In the Venezuelan State Amazonas, the Piaroa indigenous people collect and cultivate several indigenous species with local, regional, national and even international potential. A participatory approach was used to select, in cooperation with these Piaroa people, a list of products for in-depth economic analysis and for introduction in agroforestry trials in a later phase. Seven agroforestry food products of this list were identified as underutilized. Primary data collected through consumer and trader surveys on the local markets and participatory exercises in selected Piaroa communities revealed that the main causes of underutilization are the general lack of transport, processing and market infrastructure in Amazonas; the lack of demand, due to a lack of product information; the lack of market information and cooperation between the different market chain actors; and the low productivity of the traditional slash and burn plots. Solutions to overcome the infrastructural constraints are sought by looking at the example set by a local NGO.

Oxytetracycline (OTC) production byStreptomyces rimosus was studied in batch and fed-batch cultures in shake flask and bioreactor levels using semi-defined medium. First, the effect of glucose concentration on OTC production and growth kinetics was studied intensively. The optimal glucose concentration in the medium was 15 g/L. Higher glucose concentrations supported higher biomass production by less volumetric and specific antibiotic production. Based on these data, cultivations were carried out at semi-industrial scale 15 L bioreactor in batch culture. At bioreactor level, cell growth and OTC production were higher compared to the shake flask culture by about 18 and 38%, respectively. During the bioreactor cultivation, glucose was totally consumed after only 48 h. Thus, the fed-batch experiment was designed for mono-glucose feeding and complete medium feeding to increase the OTC production by overcoming carbon limitations. The results showed that the fed-batch culture using constant glucose feeding strategy with rate of 0.33 g/L/h produced 1072 mg/L. On the other hand, feeding with complete medium resulted in 45% higher biomass but less OTC production by about 26% compared to mono-glucose fed culture. A further improvement in this process was achieved in by keeping the dissolved oxygen (DO) value at 60% saturation by cascading the glucose feeding pump with the DO controller. The later feeding strategy resulted in higher antibiotic production, reaching 1414 mg/L after 108 h.

Summary Background Systemically administered sirolimus has demonstrated efficacy in psoriasis in a multicentre European study. Objectives To determine the efficacy and safety of topically applied sirolimus in treating psoriasis. Methods In vitro studies were followed by a pilot study designed to determine if sirolimus penetrates human skin, and by a randomized, double-blind, left–right comparative, dose-ranging study consisting of treatment with 2·2% sirolimus for 6 weeks and 8% sirolimus for an additional 6 weeks in 24 patients with stable, chronic plaque psoriasis. The primary outcome measure was clinical score. Secondary measures were ultrasound plaque thickness, plaque erythema, and computerized image analysis of immunohistochemical stains for immunocytes and proliferating cells. Pharmacokinetics and blood chemistry monitoring for safety were also performed. Results A significant reduction in the clinical score (P = 0·03) (mean score 9·1 following sirolimus vs. 11·2 in control) was achieved with topical sirolimus. Measurements of plaque thickness and erythema did not show significant improvement with treatment. Computerized image analysis of biopsies showed a significant reduction in CD4+ cells (P = 0·0054) and proliferating cells (stained by Ki-67) in the epidermis (P = 0·0153) with sirolimus treatment compared with control. Conclusions Topically applied sirolimus penetrates normal skin and may have some antipsoriatic and immunosuppressive activity.

This study investigated the effects of chronic exposure of Wistar rats to the immunosuppressant drug cyclosporine on blood pressure, heart rate, and their variability and the role of sympathovagal balance in this interaction. The blood pressure variability was determined as the standard deviation of the mean arterial pressure (SDMAP). Two time-domain heart rate variability indices were employed, the standard deviation of beat-to-beat intervals (SDRR) and the root mean square of successive beat-to-beat differences in R-R interval durations (rMSSD). Subcutaneous cyclosporine administration (20 mg/kg/day) for 12 days had no effect on blood pressure or its variability index (SDMAP). In contrast, the average level of heart rate and its variability indices (SDRR and rMSSD) showed significant increases and decreases, respectively, in cyclosporine- compared with vehicle-treated rats. Vagal (atropine) or beta -adrenergic (propranolol) blockade had no effect on blood pressure but elicited increases and decreases, respectively, in heart rate. Compared with control rats, cyclosporine-treated rats exhibited lesser tachycardic responses to atropine and greater bradycardic responses to propranolol, suggesting alterations of cardiac vagal (attenuation) and sympathetic (enhancement) activity by cyclosporine. Further, atropine reduced indices of heart rate variability (rMSSD and SDRR) in control rats, effects that were blunted by cyclosporine treatment. On the other hand, propranolol had no effect on heart rate variability in either cyclosporine-treated or control rats. These findings implicate vagally-mediated alterations in the cardiac sympathovagal balance in the cyclosporine-induced impairment of heart rate oscillations.

Cyclosporine A (CyA), an immunosuppressant drug, has been shown to attenuate the baroreflex control of heart rate (HR). This study investigated whether or not the CyA-induced baroreflex dysfunction is due to alterations in the autonomic (sympathetic and parasympathetic) control of the heart. We evaluated the effect of muscarinic or beta-adrenergic blockade by atropine and propranolol, respectively, on reflex HR responses in conscious rats treated with CyA (20 mg·kg–1·day–1 dissolved in sesame oil) for 11–13 days or the vehicle. Baroreflex curves relating changes in HR to increases or decreases in blood pressure (BP) evoked by phenylephrine (PE) and sodium nitroprusside (NP), respectively, were constructed and the slopes of the curves were taken as a measure of baroreflex sensitivity (BRSPE and BRSNP). Intravenous administration of PE and NP produced dose-related increases and decreases in BP, respectively, that were associated with reciprocal changes in HR. CyA caused significant (P < 0.05) reductions in reflex HR responses as indicated by the smaller BRSPE (–0.97 ± 0.07 versus –1.47 ± 0.10 beats·min–1·mmHg–1 (1 mmHg = 133.322 Pa)) and BRSNP (–2.49 ± 0.29 versus –5.23 ± 0.42 beats·min–1·mmHg–1) in CyA-treated versus control rats. Vagal withdrawal evoked by muscarinic blockade elicited significantly lesser attenuation of BRSPE in CyA compared with control rats (40.2 ± 8.0 versus 57.7 ± 4.4%) and abolished the BRSPE difference between the two groups, suggesting that CyA reduces vagal activity. CyA also appears to impair cardiac sympathetic control because blockade of beta-adrenergic receptors by propranolol was less effective in reducing reflex tachycardic responses in CyA compared with control rats (41.6 ± 4.2 versus 59.5 ± 4.5%). These findings confirm earlier reports that CyA attenuates the baroreceptor control of HR. More importantly, the study provides the first pharmacological evidence that CyA atten uates reflex chronotropic responses via impairment of the autonomic modulation of the baroreceptor neural pathways.Key words: cyclosporine A, baroreflex sensitivity, autonomic control, atropine, propranolol.

To the Editor: Inflammatory breast cancer (IBC), the most lethal form of breast cancer, constitutes 1‐2% of all breast cancers in the United States (1). Breast cancer comprises 352% of women’s cancers in the Gharbiah cancer registry (GCR) of Egypt (2). Hospital-based studies from the National Cancer Institute of Cairo University (NCI-Cairo) in Egypt suggested that IBC accounts for 10% of breast cancers (3). However, these estimates lacked confirmation from populationbased studies. To remedy this deficit, we performed this study to evaluate the frequency and features of IBC in GCR. Our initial review of GCR data between 1999 and 2003 showed that IBC did not exist despite the clinical experience with frequent cases of IBC at the GCR and the 10% relative frequency of the disease at NCICairo. A multi-disciplinary group of physicians in Egypt and the United States, who were experienced in the diagnosis and management of IBC, collaboratively developed an 84-item checklist of symptoms, signs, and clinical characteristic suggestive of IBC to facilitate and standardize abstraction of information from medical records. IBC cases were identified using the simplified clinical definition of Merajver and Sabel (4) that used erythema, edema, and peau d’orange as the three main clinical features of IBC. Subsequently, cases were grouped as follows: most-likely IBC exhibited all three features, possible IBC cases had any two of the three symptoms or had peau d’orange only, and non-IBC cases had edema only, erythema only, or had none of these three clinical features. IBC status was based on clinical criteria for IBC diagnosis (erythema, edema, and peau d’orange). The checklist was applied to all cases that had at least one of the three defining features of IBC and missing data was denoted. The study population had 659 cases, comprising four with most-likely IBC, 69 with possible IBC, and 586 who were non-IBC. IBC proportion was calculated according to two different definitions. Under the most stringent definition, most-likely IBC cases were considered as IBC, the proportion of IBC was 0.6%. Under a definition that both most-likely IBC cases and possible IBC cases were considered as IBC, the IBC proportion was 11.1%. There was no difference in age, parity, menopausal status, concurrent lactation, or family history between the IBC versus non-IBC groups. Warmth, diffuse enlargement, and nipple retraction were significantly higher among the IBC group compared with the non-IBC group (5.5% versus 0.2% with warmth, p < 0.01; 8.2% versus 0.7% with diffuse enlargement, p < 0.01; and 60.9% versus 8.2% with nipple retraction, p < 0.01, among IBC versus non-IBC groups, respectively). There were no significant differences between the two groups in bruising, palpable mass, or ulceration. The IBC group had 12.5% tumor emboli compared with 3.6% among the non-IBC group (p = 0.02). More patients (42.5%) in the IBC group received neo-adjuvant chemotherapy compared with 15.4% in the non-IBC group (p < 0.01). While 81.9% of the non-IBC group received surgical resection or radiotherapy (73.4%), this proportion was significantly higher than patients receiving resection or radiotherapy among the IBC group (53.5% and 51.9%, both p < 0.01). There was no significant difference between the IBC versus non-IBC groups in tumor grade, angiolymphatic invasion, or adjuvant chemotherapy. IBC cases had higher rate of metastasis (41.7%) compared with 27.8% for the non-IBC group (p = 0.10). Hormone receptors were higher in the IBC group than the non-IBC group (36.4% versus 16.7%, p < 0.01 for ER; 58.3% versus 36.2%, p = 0.04 for PR). After adjusting for warmth and systemic symptoms, nipple retraction was independently and significantly predictive of IBC (OR = 18.8, 95% CI: 9.6‐37.7). For the first time, this population-based study confirmed what hospital-based and anecdotal reports sug

AIM:We hypothesized that microcirculatory dysfunction, similar to that seen in sepsis, occurs in post-cardiac arrest patients and that better microcirculatory flow will be associated with improved outcome. We also assessed the association between microcirculatory dysfunction and inflammatory markers in the post-cardiac arrest state.METHODS:We prospectively evaluated the sublingual microcirculation in post-cardiac arrest patients, severe sepsis/septic shock patients, and healthy control patients using Sidestream Darkfield microscopy. Microcirculatory flow was assessed using the microcirculation flow index (MFI) at 6 and 24h in the cardiac arrest patients, and within 6h of emergency department admission in the sepsis and control patients.RESULTS:We evaluated 30 post-cardiac arrest patients, 16 severe sepsis/septic shock patients, and 9 healthy control patients. Sublingual microcirculatory blood flow was significantly impaired in post-cardiac arrest patients at 6h (MFI 2.6 [IQR: 2-2.9]) and 24h (2.7 [IQR: 2.3-2.9]) compared to controls (3.0 [IQR: 2.9-3.0]; pCONCLUSION:Microcirculatory dysfunction occurs early in post-cardiac arrest patients. Better microcirculatory function at 24h may be associated with good neurologic outcome.

This study investigated the role of K(ATP) channels in morphine-induced antinociception and hepatic oxidative stress in acute and inflammatory pain. The K(ATP) channel modulators (K(ATP) channel opener, diazoxide 100 mg/kg, p.o, and K(ATP) channel blocker, glibenclamide, 3 mg/kg i.p.) were administered with morphine (80 mg/kg, i.p.). Antinociception was assessed by the tail-flick and formalin tests in rats and measured by the area under the curve values and the maximum percent effect for 3 h. The indices of hepatic oxidative stress: glutathione, glutathione peroxidase, and malondialdehyde were then determined in the liver homogenates obtained from the treated animals. In both tests, glibenclamide antagonized morphine-induced antinociception, whereas diazoxide augmented it in the tail-flick test only. In the formalin test, glibenclamide alone has a significant hyperalgesic effect, whereas diazoxide decreased the number of flinches. Coadministration of glibenclamide with morphine antagonized the hepatotoxic effect of morphine in both animal models. In the tail-flick test, glibenclamide administered alone significantly increased malondialdehyde's level. Coadministration of diazoxide with morphine increased glutathione level in the formalin test. Diazoxide administered alone exacerbated the hepatic oxidative stress in both animal models. These findings suggest a role of K(ATP) channel modulators on morphine-induced antinociception and hepatic oxidative stress. The administration of glibenclamide may prevent morphine-induced hepatotoxicity. The effectiveness of diazoxide in the management of pain is limited due to its deleterious effect on the liver. However, the interaction of the K(ATP) channel modulators with morphine depends on the differential sensitivity to the pain stimulus.

Bladder cancer is the most common malignancy among Egyptian males and previously has been attributed to Schistosoma infection, a major risk factor for squamous cell carcinoma (SCC). Recently, transitional cell carcinoma (TCC) incidence has been increasing while SCC has declined. To investigate this shift, we analyzed the geographical patterns of all bladder cancers cases recorded in Egypt’s Gharbiah Population-Based Cancer Registry from 1999 through 2002. Data on tumor grade, stage, and morphology, as well as smoking, community of residence, age and sex, were collected on 1,209 bladder cancer cases. Age-adjusted incidence rates were calculated for males, females, and the total population for the eight administrative Districts and 316 communities in Gharbiah. Incidence Rate Ratios (IRR) and 95% Confidence Intervals (CI) were computed using Poisson Regression. The male age-adjusted incidence rate (IR) in Gharbiah Province was 13.65/100,000 person years (PY). The District of Kotour had the highest age-adjusted IR 28.96/100,000 among males. The District of Kotour also had the highest IRR among all Districts, IRR=2.15 95% CI (1.72, 2.70). Kotour’s capital city had the highest bladder cancer incidence among the 316 communities (IR=73.11/100,000 PY). Future studies on sources and types of environmental pollution and exposures in relation to the spatial patterns of bladder cancer, particularly in Kotour District, may improve our understating of risk factors for bladder cancer in the region.

This paper presents WhatAreYouLOOKing4 (WAY-LOOK4) system, a novel framework for content-based image retrieval (CBIR). Local descriptors are used to describe the visual contents of an image. Image signatures and similarity retrieval are based on the images' color and texture features. The main motivation of the system design is to use simple and efficient techniques to maintain reasonable computational and storage cost. The proposed technique has three system components: feature extraction, image database indexing and similarity retrieval. First, the use of circular sectors is proposed to represent local first order moment for the color feature. In addition, a local direction technique is used for texture feature extraction. Secondly, the hash indexing of the images' color properties is used to map the database images into classes. Hash indexing speeds up the search and enhances the system scalability for large image databases. Thirdly, for similarity retrieval, a degree of similarity is defined based on a weighted sum of the color and texture features. In addition, the similarity retrieval incorporates a minimum accepted degree of similarity provided by the user. The test of similarity is performed in two stages. In the first stage, the index is used to directly hit a class to which the query image may belong. In the second stage, a detailed sequential search is performed to retrieve the most similar images within that class. The simple design of the system and experimental selection of system parameters guarantee that the system maintains reasonable storage and computational cost. Our experiments demonstrate that the average precision of retrieved images is enhanced especially for higher accepted degrees of similarity.

Increased central sympathetic outflow secondary to afferent sympathetic excitation has been implicated in the hypertensive effect of the immunosuppressant drug cyclosporine (CSA). The present study investigated the roles of central alpha(2)-adrenoceptors and I(1)-imidazoline receptors in modulating the hypertensive action of CSA. The blood pressure (BP) response to CSA in conscious rats was assessed in the absence and presence of peripherally or centrally acting sympatholytic drugs. Also, the effect of selective pharmacologic blockade of alpha(2) or I(1) receptors by yohimbine and efaroxan, respectively, on the pressor response to CSA was evaluated. CSA (20 mg/kg i.v.) produced a rapid increase in BP that peaked (25+/-4 mm Hg) after approximately 4 min and continued for the 45 min study duration. Ganglionic (hexamethonium 20 mg/kg) or alpha(1)-adrenoceptor (prazosin 1 mg/kg) blockade reduced the pressor effect of CSA. Pressor responses to phenylephrine (alpha(1)-adrenoceptor agonist) were not affected by CSA, thereby eliminating a possible role for alterations of vascular alpha(1)-adrenoceptor responsiveness in CSA hypertension. CSA hypertension was attenuated in rats pretreated intravenously with drugs that reduce central sympathetic tone including clonidine (mixed alpha(2)/I(1)-receptor agonist, 30 microg/kg) or moxonidine (selective I(1)-receptor agonist, 100 microg/kg) in contrast to no effect for guanabenz (selective alpha(2)-receptor agonist, 30 microg/kg). Intracisternal (i.c.) administration of moxonidine also reduced CSA hypertension. Selective blockade of central I(1) (efaroxan, 0.15 microg/rat, i.c.) but not alpha(2) (yohimbine, 25 microg/5 microl/rat, i.c.) receptors abolished the hypertensive response to CSA. Together, these findings highlight that CSA elicits its hypertensive effect via disruption of central sympathoinhibitory pathways which include I(1)-imidazoline receptors.

Background Anesthetic techniques may modulate the extent of endocrine–metabolic response to surgery. Attenuation of the endocrine–metabolic response may reduce the frequency of postoperative complications. The aim of this study was to compare the effect of two different anesthetic techniques (combined general anesthesia with epidural blockade vs. combined spinal–epidural blockade) on acute stress proteins including serum albumin, C-reactive protein, leptin, cortisol, and d-dimer in patients undergoing lower limb orthopedic surgery. Materials and methods After approval of the ethics committee of Alexandria Faculty of Medicine and having an informed consent from every patient, the present study was carried out on 40 patients ASA I or II physical status. Group I; 20 patients received combined general anesthesia with epidural blockade and group II; 20 patients received combined spinal–epidural blockade. Epidural analgesia was activated just before wound closure. Results The blood loss was statistically significantly low in group II. The mean values of serum albumin were significantly lower in the group II at 3 and 24 h postoperatively. There were no significant differences between preoperative and 24 h postoperative serum cortisol. Serum cortisol levels were significantly lower in the group II at 3 h postoperatively. There were no significant differences in serum leptin concentrations and preoperative plasma d-dimer. Plasma d-dimer concentrations were significantly higher in the group I at 3 h postoperatively and at 24 h postoperatively. Conclusion Subarachnoid block decreases postoperative pain score and reduces blood loss in comparison with general anesthesia. It reduces the acute stress response and acute stress proteins (albumin, cortisol). It did not reduce C-reactive protein. It reduces plasma d-dimer level after lower-limb orthopedic surgery in comparison with general anesthesia.

Objective: A comprehensive website review was conducted to assess the quality, content and readability of online information for teens with sickle cell anemia (SCA). Methods. Key words relevant to SCA were searched across the five most commonly used search engine domains. Websites that contained information about the diagnosis and management of SCA were reviewed. Quality of the information was appraised using the validated DISCERN tool. Two physicians rated website content completeness and accuracy independently. Readability of the sites was documented using SMOG scores and the Flesch Reading ease scoring system. Results. Search results yielded more than 600 sites of which 25 websites met the criteria for DISCERN quality review. The majority of sites targeted parents and only 5/25 (20%) were specific to teens with SCA. The overall quality of the website information was "fair", with the average DISCERN quality rating score being 50.1 (± 9.3, range 31.0-67.5). Only 12/25(48%)of the websites had DISCERN scores above 50 (mean 57.37 + 4.93, range 52.17-67.50). The average completeness score of the sites was 20 out of 29 (±5; range 12-27) and accuracy was consistently rated 4/4, indicating high accuracy with moderate completeness. The average SMOG score was 12.44 (±2.01; range 10.21-16.08), and the mean Flesch Reading Ease score was 46.45 (±13.22; range 17.50-66.10) indicating that the material was written well above the acceptable level for patient education materials. Conclusion. Given the paucity of high quality Internet health information at an appropriate reading level for teens with SCA, there is a critical need for the development of Internet programs to meet their unique self-management needs. Disclosures No relevant conflicts of interest to declare.

The recently developed technique of ultrafast third harmonic generation (THG) micro-spectroscopy is discussed. The approach is easily adapted to a standard laser scanning microscope and allows for two and three photon resonances to be identified in non-fluorescent unlabeled samples. This work provides nonlinear microscopists with a tool for further understanding the contrast and damage mechanisms they will encounter under nonlinear excitation. Here, we use THG micro-spectroscopy to investigate the nonlinear optical properties of hemoglobin over the spectral range of 770 -1000 nm with 100-fs duration, ~1-nJ energy laser pulses. We demonstrate the ability of this approach to distinguish different ligand binding states in physiological solutions of human hemoglobin.

Reported clinical and experimental findings have shown that baroreflex control of heart rate is attenuated in women compared with men. This study investigated whether the sexual dimorphism in baroreflex function relates to the ability of the male hormone testosterone to facilitate baroreflex responsiveness. Relative contributions of the vagal and sympathetic autonomic components to testosterone modulation of baroreflex function were also investigated. Baroreflex curves relating changes in heart rate to increases or decreases in blood pressure evoked by phenylephrine and sodium nitroprusside, respectively, were constructed in sham-operated rats and castrated rats with and without testosterone replacement. Slope of the curves was taken as an index of baroreflex sensitivity (BRS PE and BRS NP ). Castration (for 10 days) significantly reduced plasma testosterone levels and attenuated reflex bradycardia, as indicated by significantly smaller BRS PE in castrated rats compared with values in sham-operated rats (-0.85 +/- 0.07 vs. -1.51 +/- 0.10 beats/min per mm Hg). Testosterone replacement in castrated rats restored plasma testosterone and BRS PE to levels similar to those of sham-operated rats. Muscarinic blockade by atropine caused 55% reduction in BRS PE in sham-operated rats, an effect that was significantly (p < 0.05) attenuated in castrated rats and restored to intact levels after testosterone supplementation. beta-Adrenergic blockade by propranolol caused slight and insignificant decreases in BRS PE. Castration and testosterone supplementation had no effect on BRS NP, ruling out a modulatory effect of testosterone on reflex tachycardia. These data provide the first experimental evidence of a favorable role for testosterone in baroreceptor control of reflex bradycardia. Further, baroreflex modulation by testosterone appears to be autonomically mediated and involves an enhancement of cardiomotor vagal activity.

ResumenLos traumatismos son una importante causa de morbimortalidad en el mundo y en Chile, constituyendo en nuestro país un 10% de los egresos hospitalarios y representando la cuarta causa de muerte global con un 8,9%, lo que aumenta dramáticamente a 39% en el grupo de 10 a 49 años de edad. Las imágenes constituyen una herramienta fundamental en la evaluación inicial y posterior seguimiento de los pacientes politraumatizados, abarcando la radiografía simple, ecografía y especialmente en los últimos años la tomografía computada multidetector debido al rápido desarrollo tecnológico de estos equipos y a la mayor disponibilidad de ellos.Una adecuada y rápida evaluación de estos pacientes es fundamental para el pronóstico posterior, por lo que se requiere personal multidisciplinario entrenado en trauma disponible las 24 horas y rápido acceso a estudios de imágenes y a su interpretación.La tomografía computada multidetector emerge como una herramienta fundamental en la atención del politraumatizado por su rapidez y exactitud diagnóstica.SummaryInjuries are a major cause of morbidity and mortality worldwide and in Chile, in our country constitute 10% of hospital discharges and representing the fourth leading cause of global death by 8.9%, which increases dramatically to 39% in the group of 10 to 49 years of age.The images are an essential tool in the initial evaluation and subsequent monitoring of trauma patients, covering plain radiography, ultrasound, and especially in recent years multidetector computed tomography due to rapid technological development of these teams and the increased availability of them.Adequate and rapid evaluation of these patients is critical to the subsequent prognosis, so it requires multidisciplinary staff trained in trauma 24-hours and rapid access to imaging studies and their interpretation.Multidetector computed tomography is emerging as a fundamental tool in the care of seriously injured in speed and diagnostic accuracy.