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Background In cirrhosis, portal hypertension is associated with a spectrum of renal dysfunction that has significant implications for morbidity and mortality. Aim To discuss recent progress in the patho-physiological mechanisms and therapeutic options for portal hypertension-related renal dysfunction. Methods A literature search using Pubmed was performed. Results Portal hypertension-related renal dysfunction occurs in the setting of marked neuro-humoral and circulatory derangement. A systemic inflammatory response is a pathogenetic factor in advanced disease. Such physiological changes render the individual vulnerable to further deterioration of renal function. Patients are primed to develop acute kidney injury when exposed to additional 'hits', such as sepsis. Recent progress has been made regarding our understanding of the aetiopathogenesis. However, treatment options once hepatorenal syndrome develops are limited, and prognosis remains poor. Various strategies to prevent acute kidney injury are suggested. Conclusion Prevention of acute kidney injury in high risk patients with cirrhosis and portal hypertension-related renal dysfunction should be a clinical priority. [ABSTRACT FROM AUTHOR]

Background Liver transplantation is potentially a life-saving therapeutic intervention for patients with portopulmonary hypertension and hepatopulmonary syndrome. However, due to limited data, listing criteria for patients with these conditions have not been clearly established. Indeed, this has led some to speculate that transplantation may not be appropriate in cases of moderate-to-severe portopulmonary hypertension and severe hepatopulmonary syndrome. Aim To critically discuss the utility of LT for the treatment of hepatopulmonary syndrome and portopulmonary hypertension. Methods A literature search was conducted in 2012 on PubMed, Ovid Embase, Ovid Medline and Scopus using the following search terms: hepatopulmonary syndrome, portopulmonary hypertension, pulmonary arterial hypertension, liver transplantation. Relevant manuscripts were included in the review. Results Liver transplantation has established itself as an effective treatment for selected patients with hepatopulmonary syndrome and portopulmonary hypertension. A multidisciplinary team approach incorporating focused strategies (both pre- and post-operatively) aimed at improving oxygenation in patients with hepatopulmonary syndrome has led to a dramatic improvement in patient outcomes. Additionally, careful patient selection and the use of targeted pulmonary vascular therapies are successfully being used to treat portopulmonary hypertension and 'bridge' patients to successful liver transplantation. Conclusions Liver transplantation is an effective therapy for patients with hepatopulmonary syndrome and portopulmonary hypertension. However, rigorous screening and early identification of these conditions allied with aggressive pre-operative optimisation of physiology and diligent post-operative care are imperative to ensuring a good outcome. [ABSTRACT FROM AUTHOR]

A large degree of karyotypic diversity in the pouched mouse Saccostomus campestris, ranging from 2 n=28 to 2 n=46, is mostly due to centric fusions. The taxon comprises a complex of cryptic species, of which the 2 n=32 and 2 n=46 karyotypes represent two different species. Crossbreeding pure 2 n=32 and pure 2 n=46 karyotypes up to the F3 hybrid generation yielded F1 hybrids with 39 chromosomes, seven of which were unpaired. Unpaired chromosomes ranged in size from very long to short. We measured the growth rate, testis structure and litter size of these crosses and did not find any indication that the F1, F2 or F3 generations exhibit any degree of hybrid disadvantage or hybrid breakdown. The interpretation of these results is strongly affected by the species concept used, but weakens the conclusions of several other authors that S. campestris in southern Africa comprises a complex of cryptic species. [ABSTRACT FROM AUTHOR]

Gastric variceal bleeding can be challenging to the clinician. Tissue adhesives can control acute bleeding in over 80%, with rebleeding rates of 20–30%, and should be first-line therapy where available. Endoscopic ultrasound can assist in better eradication of varices. The potential risks of damage to equipment and embolic phenomena can be minimized with careful attention to technique. Variceal band ligation is an alternative to tissue adhesives for the management of acute bleeding, but not for secondary prevention due to a higher rate of rebleeding. Endoscopic therapy with human thrombin appears promising, with initial haemostasis rates typically over 90%. The lack of controlled studies for thrombin prevents universal recommendation outside of clinical trials. Balloon occluded retrograde transvenous obliteration is a recent technique for patients with gastrorenal shunts, although its use is limited to clinical trials. Transjugular intrahepatic portosystemic stent shunt is an option for refractory bleeding and secondary prophylaxis, with uncontrolled studies demonstrating initial haemostasis obtained in over 90%, and rebleeding rates of 15–30%. Non-cardioselective β-blockers are an alternative to transjugular intrahepatic portosystemic stent shunt for secondary prophylaxis, although the evidence is limited. Shunt surgery should be considered in well-compensated patients. Splenectomy or embolization is an option in patients with segmental portal hypertension. [ABSTRACT FROM AUTHOR]

Females of many taxa incur fitness costs from male sexual coercion and harassment leading to mating. Although male crickets cannot force copulations on females, female Gryllus bimaculatus in this study incurred significant reductions in longevity through being exposed to different levels of male courtship. Virgin females kept in isolation had the longest life spans. Reductions in longevity applied to females in sensory contact with males (without the opportunity to mate), females that courted and mated and females that mated but with fertilization being prevented. Females also incurred significant reductions in longevity when kept with other females, which may have been due to high levels of cannibalism. Consistent with previous studies, females appeared to incur no cost to longevity from receiving sperm or seminal fluid. It is known that female G. bimaculatus benefit genetically from multiple mating. However, this benefit could possibly be offset by the negative effect that male courtship and mating behaviour has on female longevity. [ABSTRACT FROM AUTHOR]

To evaluate dental implant survival in patients with ectodermal dysplasia (ED). To assess patterns of hypodontia in this patient group. A retrospective analysis of the use of dental implants in ED patients treated at the Royal Children's Hospital, Melbourne. Sixty-one implants were placed into 14 patients (nine male and five female). The mean age of patients receiving maxillary implants was 18 years 6 months (range 17 years 9 months−20 years 0 months) and mandibular implants was 17 years 5 months (range 12 years 2 months−21 years 11 months). The mean follow-up period was 3 years 4 months (range 1 year 18 months−5 years 1 month). Forty-three implants were placed in the anterior mandible, three in the posterior mandible and the remaining 15 in the anterior maxilla. Of the 61 implants placed, 54 [88·5%] successfully integrated and were able to be restored. Three of the 15 implants placed into the anterior maxilla [20%] failed, while four of the 46 in the anterior mandible failed [8·7%]. Five of the 14 patients [35·7%] had at least one implant fail prior to abutment connection. At the 12-month review appointments, 41 of the integrated 54 implants [76%] were reviewed and classed as successful, giving an overall success at follow up of 67·2%. Thirteen implants [21·3%] were unable to be reviewed owing to geographical reasons. Teeth most likely to be present in the maxilla were the central incisors [71%], first molars [54%] and canines [43%], whereas in the mandible they were the canines [53%] and the first premolars and first molars [40%]. Dental implants can be placed, restored and loaded in ED patients. Maxillary teeth most likely to be present are the central incisors, canines and first molars, whereas in the mandible the canines, first premolars and molars are most likely to be present. Prior to cessation of growth, implant placement in the symphyseal region of the anterior mandible may be performed with caution. Despite the limited numbers and with due consideration to jaw development, the results support the continual use of endosseous dental implants in this group of patients for optimal clinical outcomes. [ABSTRACT FROM AUTHOR]

Summary Variceal haemorrhage is a common medical emergency with a high mortality (30–50%). Adequate resuscitation is vital, and once stabilised the patient should be moved to a high-dependency area. Antibiotics reduce mortality, and the vasoactive drug terlipressin should be administered if early endoscopy is unavailable. Early endoscopy is essential both to make the diagnosis and to allow therapeutic measures to be performed. The evidence suggests that variceal band ligation is the most effective therapy for oesophageal varices. If gastric varices are found at the index endoscopy the evidence at present is inadequate to be certain which is the best treatment, but both endoscopic therapy with cyanoacrylate or thrombin and transjugular intrahepatic portosystemic stent shunt (TIPSS) have been reported to be of benefit. When initial treatments fail, rescue therapy should be initiated. Most authorities agree that TIPSS is the rescue therapy of choice. Many questions remain concerning the treatment of acute variceal bleeding, particularly the ideal therapy for gastric varices and the role of combination vasoactive and endoscopic therapy. Randomised controlled trials are required to answer these important issues. [ABSTRACT FROM AUTHOR]

Although there is a corpus of evidence that females of many taxa are choosy about males, there is less information on how males may react to females of different ‘quality’ (i.e. potential fecundity). The cricket Gryllodes sigillatus shows distinct mate guarding behaviour. We examined how long males mate guard females of different sizes (reflecting egg load and potential fecundity). We also examined the sperm number in ampullae donated to females of different sizes to see if males make a concomitant difference in investment in ejaculate. We also examined mate-guarding behaviour and ejaculate size of males mated to virgin and nonvirgin females of the same size to see if males equate size with increased age and increased likelihood of mating (increased sperm competition). The results showed that males mate guard larger females for longer but make no difference in ejaculate investment between sizes of female. Males make no significant difference in mate guarding investment or ejaculate investment between virgins and nonvirgins of the same size. There is evidence that other species of crickets do alter their ejaculate depending on the female size and mating history, but have less distinct guarding behaviour. We suggest that mate-guarding investment in G. sigillatus may serve a similar function to that of ejaculate investment in other crickets. [ABSTRACT FROM AUTHOR]

Summary Twenty-four grassland fragments were established in an area of high botanical diversity planted with Pinus patula plantations. This area is representative of the eastern Drakensberg escarpment, containing a large number of endemic plant taxa. The experimental fragments comprise six replicates of two fragment sizes (0.25 and 1.5 ha), with a similar grouping of control plots in adjacent undisturbed grassland designated for conservation. The plots form the basis of a long-term study on fragmented plant and animal communities. Vegetation surveys were performed using nearest neighbour step point and Braun–Blanquet techniques. Analysis of similarity (anosim) indicates that in neither the large nor small fragments do the control plots differ significantly in floristic structure from the experimental fragments. Five variations of the Themeda triandra -dominated grassland were identified, corresponding to slight variations in ground moisture. The experimental fragments and control plots were sufficiently similar to be analysed as replicates within the fragmentation study. This forms the foundation for the long-term analysis of plant communities within the fragments, as well as for analyses of insect and vertebrate communities within the fragments. [ABSTRACT FROM AUTHOR]

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Summary. The oral and facial manifestations of pycnodysostosis (Maroteaux-Lamy syndrome) are reviewed, and illustrated by a case in which the presenting feature was delayed and ectopic eruption of permanent teeth. Résumé. Les manifestations dentaires, orales et faciales de la pycnodysostose (syndrome de Maro-teaux-Lamy) sont rappelées et illustrées par un cas dans lequel ces caractéristiques se sont manifestées avec retard ainsi que l'éruption ectopique de dents permanentes. Zusammenfassung. Die dentalen oralen und fazialen Manifestationen der Pycondysostosis (Maro-teaux-Lamy-Sydrom) werden anhand eines Falles beschrieben. Der verspätete und ektopische Durchbruch der bleibenden Zähne sind die Hauptmerkmale. Resumen. Se hace una revisión de las manifestaciones dentales, orales y faciales de la picnodisos-tosis (Síndrome de Maroteaux-Lamy) y se ilustra el caso en el cual se presenta la característica de erupción ectópica y retardada de dientes permanentes. [ABSTRACT FROM AUTHOR]

Latex allergy may have severe consequences including development of anaphylaxis. This report describes a patient who underwent a reaction to latex dental dam manifesting as erythema, facial swelling and mild airway compromise. Restorative procedures under latex dental dam were performed under local anaesthesia on two occasions resulting in reactions of increasing severity. Following the first event the cause of the reaction was undetermined, but attributed to a possible allergy to local anaesthetic, and managed with corticosteroids and antihistamines. On a subsequent occasion the swelling was more severe, associated with difficulty in swallowing and mild airway compromise, and was managed as previously with adrenaline also being required. Latex allergy was subsequently confirmed. [ABSTRACT FROM AUTHOR]

The authors reflect on the safe use of beta blockers in monitoring the blood pressure of patients with chronic liver failure. They cite a study on non-cardio selective beta-blockers (NSBB) for prophylaxis of variceal haemorrhage and could increase mortality in patients with cirrhosis and refractory ascites. The authors believe that the benefits of NSBB may not be solely influenced by their ability to reduce portal pressure.

Abstract The Drakensberg escarpment in southern Africa is extensively afforested with pine plantations. The Afromontane grasslands in this area have large numbers of endemic plant taxa, but very little is known of their invertebrate fauna. We report on the microgeographical and broad-scale geographical characteristics of grasshoppers and their allies (Orthoptera) at the Groenvaly grassland fragmentation experiment site, South Africa. Pre-fragmentation sampling indicates that control sites and experimental fragments were comparable at the start of the experiment. Of the surveyed species (total 31 species) 25% are endemic to this grassland with another 33% occurring more widely in montane grasslands of south-eastern South Africa. The level of orthopteran endemicity is therefore similar to that of plants, emphasizing the conservation importance of this threatened habitat. There was a significant inverse relation between the degree of stenotopy of a species within the study site and its geographical range in southern Africa, with implications for interpreting the conservation importance of taxonomically and geographically unknown taxa such as the beetles (Coleoptera) in the Afromontane grassland. This information on endemicity of the Afromontane Orthoptera indicates that these grasslands harbour a diverse endemic fauna representing a significant part of southern African biodiversity. [ABSTRACT FROM AUTHOR]

A 42-year-old female presented with a 2.5 cm symptomless swelling on the left lateral surface of the tongue. Histologically, there were large, often pleomorphic, fibroblast-like and histiocyte-like cells, multinucleate giant cells and cells of variable morphology. Many of the cells had abundant vesicular cytoplasm. There were also aggregations of neutrophilic or cosinophilic leukocytes, or both. The cells in some areas formed a fascicular or storiform pattern, or both. Ultrastructurally, the vesicular appearance was due mostly to markedly dilated endoplasmic reticulum, but many of the neoplastic cells contained some lipid. There were sorer: myofibroblasts and a few xanthofibroblasts. The cells of variable morphology had many of the ultrastructural features of the fibroblast and histiocyte-like cells. There were also some small undifferentiated cells with minimal cytoplasm. These ultrastructural features confirmed the histological diagnosis of malignant fibrous histiocytoma. [ABSTRACT FROM AUTHOR]