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Abstract: The purpose of this randomised comparative study was to evaluate the use of silver sulphadiazine (SSD) 1% cream (Group A) with the use of Procutase® (Group B) in treating burns with a TBSA <10% and a depth not greater than 2nd degree burns and thus suitable for outpatient management. The two groups were similar in age, gender, race, and extent of burn. Procutase® is an ionic hydrogel composed of natural hydrophilic polymers in an active ionic solution with an inhibitor of matrix metalloproteinases MMP-1, -3 and -9 (collagenase/gelatinase). Subjects were seen in follow-up biweekly, and wounds of patients in SSD group were compared with those of Procutase® group for healing time, pain score at dressing change, compliance with therapy and complication rate. The result of this study showed that Procutase® treated patients had statistically significantly less pain and shorter wound healing time. Procutase® can be used successfully in patients with burns that do not require hospital admission. [ABSTRACT FROM AUTHOR]

A major source of toxic per- and polyfluoroalkyl substances (PFAS) is aqueous film-forming foams (AFFF) used in firefighting and training at airports and military installations, however, PFAS have many additional sources in consumer products and industrial processes. A field study was conducted on fish tissues from three reaches of the Columbia Slough, located near Portland International Airport, OR, that are affected by AFFF and other PFAS sources. Fishes including largescale sucker (Catostomus macrocheilus), goldfish (Carassius auratus), and largemouth bass (Micropterus salmoides) were collected in 2019 and 2020. Fish blood, liver, and fillet (muscle) were analyzed for target and suspect PFAS by liquid chromatography high resolution mass spectrometry (LC-HRMS). Data were analyzed for patterns by fish species, tissue type, and river reach. Thirty-three out of 50 target PFAS and additional suspect compounds were detected at least once during the study, at concentrations up to 856 ng/g. Seven carboxylic acids (PFOA, PFNA, PFDA, PFUdA, PFDoA, PFTrDA, PFTeDA), three sulfonates (PFHxS, PFOS, PFDS), three electrofluorination-based compounds (FBSA, FHxSA, FOSA), and two fluorotelomer-based compounds (8:2 FTS, 10:2 FTS) were the most frequently detected compounds in all tissue types. The C6 (PFHxS) to C10 (PFDS) homologs were detected with PFOS and FHxSA at concentrations 1-3 orders of magnitude greater than the other PFAS detected. This is the first report of Cl-PFOS, FPeSA, and FHpSA detected in fish tissue. In all fish samples, fillet concentrations of PFAS were the lowest, followed by liver, and blood concentrations of PFAS were the highest. Differences in PFAS concentrations were driven primarily by tissue types and to a lesser extent fish species, but weakly by river reach. The Oregon Health Authority modified an existing fish consumption advisory on the Columbia Slough to recommend no whole-body consumption of most fish to avoid elevated levels of PFOS in fish liver. Measured PFAS concentrations in fish tissues indicate the potential for adverse ecological effects., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Published by Elsevier B.V.)

Early adversity such as depressed maternal care can have long-term physiological and behavioral effects on offspring and future generations. Exposure to chronic social stress (CSS), an ethologically model of postpartum depression and anxiety, during lactation impairs maternal care and exerts similar effects on the F1 dam offspring of the stressed F0 dams. These changes associate with increased corticosterone and neuroendocrine alterations. CSS F2 offspring further display decreased social behavior as juveniles and adults and decreased basal levels of corticosterone. This current study investigates the intergenerational inheritance of alterations in maternal behavior in F2 CSS dams together with neuroendocrine and immune markers to explore whether aspects of maternal behavior are intergenerationally inherited through immune and neuroendocrine mechanisms. We find that defects in maternal care behavior persist into the F2 generation with F2 dams exhibiting a pervasively depressed maternal care and increased restlessness throughout lactation. This occurs together with reduced basal cortisol (in contrast to an increase in F1 dams), a lack of changes in neuroendocrine gene expression, and reduced serum ICAM-1 (intercellular adhesion molecule-1) levels - a marker for inflammation and blood-brain barrier integrity. The data support the hypothesis that the effects of chronic social stress can accumulate across multiple generations to depress maternal care, increase restlessness and alter basal functioning of the immune system and hypothalamic pituitary adrenal axis., (Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.)

We investigated the consequences of chronic social instability (CSI) during adulthood on social and maternal behavior in females and social behavior of their offspring in a rat model. CSI consisted of changing the social partners of adult females every 2-3 days for 28 days, 2 weeks prior to mating. Females exposed to CSI behaved less aggressively and more pro-socially towards unfamiliar female intruders. Maternal care was not affected by CSI in a standard testing environment, but maternal behavior of CSI females was less disrupted by a male intruder. CSI females were quicker to attack prey and did not differ from control females in their saccharin consumption indicating, respectively, no stress-induced sensory-motor or reward system impairments. Offspring of CSI females exhibited slower growth and expressed more anxiety in social encounters. This study demonstrates continued adult vulnerability to social challenges with an impact specific to social situations for mothers and offspring., (© 2016 Wiley Periodicals, Inc.)

Fever of unknown origin (FUO) can be an unusual first clinical manifestation of pheochromocytoma. Pheochromocytomas are tumors that may produce a variety of substances in addition to catecholamines. To date, several cases of IL-6-producing pheochromocytomas have been reported. This report describes a 45-year-old woman with pheochromocytoma who was admitted with FUO, normal blood pressure levels, microcytic and hypochromic anemia, thrombocytosis, hyperfibrinogenemia, hypoalbuminemia, and normal levels of urine and plasma metanephrines. After adrenalectomy, fever and all inflammatory findings disappeared.

The non-medical use of prescription opiates, such as Vicodin(®) and MSContin(®), has increased dramatically over the past decade. Of particular concern is the rising popularity of these drugs in adolescent female populations. Use during this critical developmental period could have significant long-term consequences for both the female user as well as potential effects on her future offspring. To address this issue, we have begun modeling adolescent opiate exposure in female rats and have observed significant transgenerational effects despite the fact that all drugs are withdrawn several weeks prior to pregnancy. The purpose of the current set of studies was to determine whether adolescent morphine exposure modifies postpartum care. In addition, we also examined juvenile play behavior in both male and female offspring. The choice of the social play paradigm was based on previous findings demonstrating effects of both postpartum care and opioid activity on play behavior. The findings revealed subtle modifications in the maternal behavior of adolescent morphine-exposed females, primarily related to the amount of time females' spend nursing and in non-nursing contact with their young. In addition, male offspring of adolescent morphine-exposed mothers (MOR-F1) demonstrate decreased rough and tumble play behaviors, with no significant differences in general social behaviors (i.e., social grooming and social exploration). Moreover, there was a tendency toward increased rough and tumble play in MOR-F1 females, demonstrating the sex-specific nature of these effects. Given the importance of the postpartum environment on neurodevelopment, it is possible that modifications in maternal-offspring interactions, related to a history of adolescent opiate exposure, plays a role in the observed transgenerational effects. Overall, these studies indicate that the long-term consequences of adolescent opiate exposure can impact both the female and her future offspring.

During past decades, a considerable and debated speculation about the classification of intrathoracic goitre was more and more developing. One of the most reliable classifications we share is that considering the degree of the intrathoracic extension of the thyroid gland: i) largely intrathoracic (more than 80%), ii) partially intrathoracic (more than 50%, but less than 80%), and iii) sub-sternal goitre (more than 50% holding in the neck). Consistently with the above mentioned classification, this report deals with ninety-seven cases of completely intrathoracic goitre (64 females and 33 males, aging between 29 and 78 years). Sixty-eight patients out of these showed a goitre reaching the upper aortic border; the other 29 patients had a thyroid gland exceeding this degree of extension. Therefore the intrathoracic goitre is a not frequent thyroid disease: in our series, it represents the 3.67% of 2641 surgical interventions on the thyroid gland from January 1984 to December 1990, that is to say the 20% of the so-called plongeant goitres undergoing surgery during the same years. The aim of this survey was to study the clinical features of the intrathoracic goitre and to have a therapeutic and prognostic assessment in this thyroid disease, before the surgical intervention. To this purpose, the prodromic symptom or sign, the clinical course before surgery, the clinical examination (peculiarly about the neck) and the laboratory findings at admission, the preoperative imaging study (chest X-ray, ultrasound examination, scintiscan and tomoscan finding) were reviewed.(ABSTRACT TRUNCATED AT 250 WORDS)

Twelve patients with chronic cor pulmonale due to chronic obstructive pulmonary disease have been examined with 2D echocardiography, performing four-chamber view by apical and subcostal approaches, and the right ventricular outflow tract view by the subcostal approach. These views have permitted evaluation of right ventricular volumes, and hence right ventricular ejection fraction, by the use of three different geometrical formulae: the biplane area-length method, Simpson's rule and the pyramidal method. The ejection fraction values obtained from each method have been compared to those obtained by equilibrium radionuclide angiocardiography. Four-chamber apical and subcostal views were satisfactorily recorded in 10 of the 12 patients (83.3%), and right ventricular outflow tract view in 8 patients (66.6%). No significant statistical differences have been found between measurements obtained from the three different echocardiographic examinations performed on each subject by the same operator, so demonstrating a satisfactory reproducibility of the technique. The highest correlation coefficient for ejection fraction was shown by Simpson's rule (r = 0.96, p less than 0.001), with a very narrow confidence intervals, while the r values for the biplane area-length method was 0.63 (p less than 0.05) and for the pyramidal method 0.50 (not statistically significant), with increasingly wider confidence intervals. The statistically significant difference between the three correlation coefficients demonstrates the higher accuracy of Simpson's rule for the determination of right ventricular ejection fraction.

Two cases of 5-Fluorouracil (5FU) cardiotoxicity, chest pain with changes in ECG the former, and myocardial infarction the latter, are described. Review of literature shows the existence of 49 cases of cardiotoxicity due to 5FU (38 angina = 77.5% 8 myocardial infarction = 16.3%). This complication seems due to a "coronary toxicity" whose onset is very precocious and not dose-dependent. Since 5FU therapy could result very dangerous when cardiotoxicity occurs, it is strictly advisable to withdraw further administration of the drug. As a matter of fact 18 patients out of 21 who again were treated with 5FU, had more serious complications which resulted in 3 myocardial infarctions (2 deaths).

Forty-three patients treated with amiodarone hydrochloride with an average daily dose of 204.7 +/- 79.4 mg/day for a mean period of 37.1 +/- 25.3 months, were studied by clinical examination, chest roentgenograms, pulmonary function tests and blood gas analyses. The habits of cigarette smoking were also recorded and expressed as cigarette pack/years. Pulmonary function tests did not show any differences from control subjects and no correlation was found between exposure to drug and lung function. However, one patient developed abnormalities in the chest X-ray (interstitial type) and a reduction of carbon monoxide diffusion capacity as a possible manifestation of amiodarone lung toxicity. Nine patients (22%) had a 20% decrease from normal in carbon monoxide diffusion capacity and three (7%) had a 15% decrease in total lung capacity. More treated patients had interstitial abnormalities in the chest X-ray (14%) than controls (5.5%). Although pulmonary function test abnormalities could be detected in patients taking amiodarone, they were not usually severe enough to interfere with gas exchange. Our results confirm the rarity of amiodarone lung toxicity when a low dosage is used, and suggest the advisability of periodical monitoring, including clinical examination, chest X-ray and pulmonary function tests in order to detect the earliest signs of amiodarone lung toxicity.

The effects of ibopamine and furosemide on renal function given alone and in combination at single doses were studied in 6 men and 6 women aged 45 to 73 years with chronic congestive heart failure of NYHA class II. After 3 days of dietary stabilization, the patients received either ibopamine 200 mg, furosemide 40 mg, or furosemide 40 mg plus ibopamine 200 mg with 2-day washout between treatments, according to a double-blind, balanced three-way crossover design using all possible treatment sequences. On each treatment day urine collections were performed at 2-hourly intervals from 2 h before to 6 h after dosing, and urine volume and Na+, K+, Cl-, and creatinine concentrations were measured for every period. The patients received a standardized breakfast 3 h before treatment and then were allowed 250 ml tap water to drink before starting each urine collection period. Venous blood samples were taken before breakfast and midway between each urine collection period for analysis of serum Na+, K+, Cl-, creatinine, and glucose. Heart rate, blood pressure, and physical signs were recorded 2, 1 h, immediately before, and then 0.5, 1, 2, 3, 4, 5, and 6 h after treatment. At the same times the patients were asked for any symptoms. The time course of the diuretic effect of furosemide 40 mg was consistent with the data reported by other authors.(ABSTRACT TRUNCATED AT 250 WORDS)

Two adult patients (one in Italy and the other in the USA) are described with similar findings of paraaortic nodal aplasia, asplenism, multiple serous and chylous effusions, and retroperitoneal lymphatic dysplasia. Although the clinical courses are incomplete, this unusual constellation of signs in the setting of normal peripheral lymph trunks suggest an acquired rather than inborn anomaly and possibly a variant acquired immunodeficiency syndrome.

Circulating immune complexes were investigated by the E.A. and E.A.C. rosette inhibition test in sera samples from patients infested by Schistosoma haematobium. About 60% of the patients demonstrated significantly higher inhibition values than controls. The material inhibiting E.A.C. rosette formation was precipitated by 3.5% polyethilene glycol, thus excluding the role of C3 fragments and suggesting that inhibition was due to immune complexes.

Forty-six patients treated with amiodarone hydrochloride for a mean period of 41 +/- 3.5 months, with an average daily dose of 240 +/- 57 mg/day, have been studied. Thyroid function was assessed clinically and by laboratory tests, which included free-triiodothyronine (free-T3), free-thyroxine (free-T4) and thyrotropin. Antimicrosomal and antithyroglobulin antibodies were also looked for. Three patients (6.5%) were found to be hyperthyroid and two (4.3%) hypothyroid. Of the 41 clinically euthyroid patients, 19 (46.3%) showed one or more abnormalities in the thyroid function tests. In this group, only free-T4 was found significantly increased (p less than 0.05) as compared to both control populations. Antimicrosomal antibodies (titre greater than or equal to 1:1600) were present in 4 of 41 (9.7%) euthyroid patients, but not in hyper- or hypothyroid patients. There were no antithyroglobulin antibodies in any patients. Free hormone measurements have proved to significantly correlate with the clinical picture. Increases in free-T3 and free-T4 are the main features of hyperthyroidism, while a reduction in free-T4 serum level was specific for hypothyroidism. There are probably several mechanisms responsible for hyperthyroidism and some genetically controlled defects in synthesis and release of thyroid hormones might be among these. The presence of antithyroid antibodies could be due to deposits of amiodarone in the thyroid gland, with a consequent release of antigen from the follicle cell, but only in those patients with genetically determined defects in immunological surveillance could an autoimmune thyroiditis, with consequent hypothyroidism, develop.