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Infantile hemangiomas are the most common benign vascular tumors in children. They present a characteristic natural history of spontaneous involution after a phase of initial proliferation. A small but significant minority demonstrates incomplete regression or complications and requires prompt intervention. Prediction of the evolution of infantile hemangiomas is challenging because of their morphological and behavioral heterogeneity. The decision between referral for treatment and observation is sometimes difficult, especially among non‐expert physicians, with the risk of missing the period for optimizing outcomes in case of delayed intervention. The aim of this review is to update our knowledge, especially of the primary care providers, regarding the ongoing difficulties of the early clinical evaluation of infantile hemangiomas, and to outline the importance of current practical scoring tools for the identification of the lesions which require expert consultation and referral. [ABSTRACT FROM AUTHOR]

Aims: Study aims: (1) developing and validating a novel questionnaire for measuring fear of hyperglycaemia among parents of children with type 1 diabetes (T1D) – the Hyperglycaemia Fear Survey – Parent version (FoHyper‐P); (2) investigating correlations between parental fear of hyperglycaemia and objective measures of glycaemic control. Methods: A multi‐centre, multinational study of 152 parents of children with T1D was conducted in three large diabetes clinics from Israel, Poland, and Greece. Inclusion criteria were parents of children aged 6–16 years, at least 6 months from diagnosis, at least 3 months of CGM use and parental involvement in care. Parents filled the FoHyper‐P and the Hypoglycaemia Fear Survey – Parent Version (HFS‐P). Patient data were obtained via electronic medical records and informative questionnaires. Bonferroni correction was performed to counteract multiple comparisons. Results: Significant strong‐moderate correlations were found between FoHyper‐P and HFS‐P including total questionnaires scoring (r = 0.747, pBonf < 0.001), worries subscales (r = 0.735, pBonf <0.001), and behaviour subscales (r = 0.532, pBonf <0.001). Using linear regression models, we found a positive association between the worry subscale and HbA1C. Weak correlations (p < 0.05, not significant after Bonferroni correction) were found between time in range, time above range and parental fear of hyperglycaemia as well as between worry subscales and a higher HbA1C in the past year, percent of hyperglycaemia and lower TIR. Conclusions: The FoHyper‐P is a novel, validated tool for assessing parental fear of hyperglycaemia. Integrating it into clinical practice addresses an underestimated aspect of parental diabetes management, enabling better care for children with T1D. [ABSTRACT FROM AUTHOR]

Diazoxide is the first‐line treatment in children with hyperinsulinaemic hypoglycaemia (HH); however, limited information is available on the duration of diazoxide treatment in children who require over 2 years of it. Hence, we retrospectively reviewed the clinical and biochemical aspects, as well as the duration of therapy and neurodevelopmental assessment, in genetically uncharacterised diazoxide‐responsive HH patients admitted to a tertiary hospital over the last 16 years, who had successfully discontinued diazoxide and remained euglycaemic. To exclude transient HH forms, only patients that required diazoxide for over 2 years were studied. We identified a total of 17 patients (70% males), in whom HH was diagnosed between 1 day and 18 months of age, and 88% were born at term with a median birth weight of 3.79 kg. All children responded to diazoxide at a median dose of 11.5 mg/kg/day, and it was stopped at a median age of 8.5 years, with a median duration of therapy of 7.25 years. The cases that required diazoxide the longest manifested no specific biochemical or clinical characteristics. Fasting tests performed after diazoxide discontinuation showed no longer requirement of diazoxide in all the cases. A total of 64.7% of the children showed mild to moderate developmental delay. Therefore, it seems that long‐term resolution of HH in children with negative genetics for KATP channel genes who required diazoxide for over 2 years will ensue, and thus regular evaluation is crucial. The possible molecular mechanisms involved are unclear. [ABSTRACT FROM AUTHOR]

Aim: To investigate the prevalence of overweight, obesity and central obesity in students of primary and secondary education, and the association with lifestyle parameters.Methods: A total of 3504 students, aged 10-16 years old, from Western Greece participated in this cross-sectional epidemiological study (participation rate: 90%). Demographic, socioeconomic, dietary, physical activity and screen time data were obtained using a questionnaire. Anthropometric measurements were also obtained. Overweight and obesity were estimated using the Centers for Disease Control and Prevention (CDC) and International Obesity Task Force (IOTF) criteria and central obesity using the WHtR ≥0.5 and IDF criteria.Results: The prevalence of overweight and obesity was 19.2% and 12.1% with CDC criteria, respectively, and 20.9% and 7.2%, with IOTF criteria respectively. Central obesity was 31.1 and 32.8% using the Waist-to-Height ratio (WHtR) ≥0.5 and International Diabetes Federation (IDF) criteria respectively. Male gender, small number of meals, breakfast skipping, frequent consumption of school food and sweets and the presence of a computer in children's rooms, were identified as the strongest lifestyle factors affecting weight.Conclusion: Overweight, obesity and central obesity rates remain high among children and adolescents in Greece. The identification of risk factors associated with the manifestation of obesity and central obesity, may contribute to the implementation of targeted prevention and treatment interventions. [ABSTRACT FROM AUTHOR]

Background: Type 1 diabetes mellitus (DM1), a chronic metabolic disorder of autoimmune origin, has been associated with oxidative stress (OS), which plays a central role in the onset, progression, and long‐term complications of DM1. The markers of OS lipid peroxidation products, lipid hydroperoxides (LOOH), and also malondialdehyde (MDA) and thiobarbituric reactive substances (TBARS) that oxidatively modify proteins (Pr) (i.e., PrMDA and PrTBARS, respectively), have been associated with DM2, DM1, diabetic neuropathy, and microalbuminuria. Objective/Subjects: Here, we investigated LOOH, PrMDA and PrTBARS in 50 children and adolescents with DM1 and 21 controls. Results: The novel OS marker PrTBARS was assessed for the first time in children and adolescents with DM1. LOOH and the pair PrMDA/PrTBARS, representing early and late peroxidation stages, respectively, are found to be significantly higher (130%, 50/90%, respectively, at p < 0.001) in patients with DM1 compared to controls. The studied OS parameters did not differ with age, age at diagnosis, sex, duration of DM1, presence of recent ketosis/ketoacidosis, or mode of treatment. Conclusions: We propose that LOOH, PrMDA and the new marker PrTBARS could serve as potential diagnostic clinical markers for identifying OS in children and adolescents with DM1, and may, perhaps, hold promise as a prognostic tool for future complications associated with the disease. [ABSTRACT FROM AUTHOR]

Composite materials are made from two or more constituent materials with distinct physical or chemical properties that, when combined, produce a material with characteristics which are at least to some degree different from its individual components. Nanocomposite materials are composed of different materials of which at least one has nanoscale dimensions. Common types of nanocomposites consist of a combination of two different elements, with a nanoparticle that is linked to, or surrounded by, another organic or inorganic material, for example in a core‐shell or heterostructure configuration. A general family of nanoparticle composites concerns the coating of a nanoscale material by a polymer, SiO2 or carbon. Other materials, such as graphene or graphene oxide (GO), are used as supports forming composites when nanoscale materials are deposited onto them. In this Review we focus on magnetic nanocomposites, describing their synthetic methods, physical properties and applications. Several types of nanocomposites are presented, according to their composition, morphology or surface functionalization. Their applications are largely due to the synergistic effects that appear thanks to the co‐existence of two different materials and to their interface, resulting in properties often better than those of their single‐phase components. Applications discussed concern magnetically separable catalysts, water treatment, diagnostics‐sensing and biomedicine. [ABSTRACT FROM AUTHOR]

Objective: Hyperinsulinaemic hypoglycaemia (HH) is one of the commonest causes of hypoglycaemia in children. The molecular basis includes defects in pathways that regulate insulin release. Syndromic conditions like Beckwith‐Wiedemann (BWS), Kabuki (KS) and Turner (TS) are known to be associated with a higher risk for HH. This systematic review of children with HH referred to a tertiary centre aims at estimating the frequency of a syndromic/multisystem condition to help address stratification of genetic analysis in infants with HH. Methods: We performed a retrospective study of 69 patients with syndromic features and hypoglycaemia in a specialist centre from 2004 to 2018. Results: Biochemical investigations confirmed HH in all the cases and several genetic diagnoses were established. Responsiveness to medications and the final outcome following medical treatment or surgery were studied. Conclusions: This study highlights the association of HH with a wide spectrum of syndromic diagnoses and that children with features suggestive of HH‐associated syndromes should be monitored for hypoglycaemia. If hypoglycaemia is documented, they should also be screened for possible HH. Our data indicate that most syndromic forms of HH are diazoxide‐responsive and that HH resolves over time; however, a significant percentage continues to require medications years after the onset of the disease. Early diagnosis of hyperinsulinism and initiation of treatment is important for preventing hypoglycaemic brain injury and intellectual disability. [ABSTRACT FROM AUTHOR]

Raising awareness about primary TAS, a rare and aggressive mesenchymal tumor, is important so that early diagnosis and undelayed radical surgery along with complementary radiation are possible. Extending the existing knowledge on the course and final outcome of the disease may help identify the best treatment approach to improve survival. [ABSTRACT FROM AUTHOR]

Aim: The appendix testis (AT) is a vestigial remnant of Müller's paramesonephric duct. Insulin-like 3 hormone (INSL3) is produced in the Leydig cells of the testis. We investigated the possible correlation between AT length and plasma INSL3 concentrations in patients with congenital cryptorchidism (CCO) and patients with hydrocele, who served as controls.Methods: A total of 40 patients with CCO and 34 patients with hydrocele and orthotopic testes were investigated. Sixteen patients presented high cryptorchidism and 24 low cryptorchidism. During surgery, AT was identified in 34 patients with CCO (high cryptorchidism:15, low cryptorchidism:19) and 28 controls. Plasma INSL3 levels were measured with a spectrophotometry enzyme immunoassay Elisa sandwich technique.Results: AT was present in 85.0% of the boys with CCO and 82.4% of the controls. A significant positive correlation was found between the AT length and INSL3 concentrations in CCO patients.Conclusions: A longer AT may reflect better testicular function in boys with CCO, since it is correlated with higher INSL3 concentrations. [ABSTRACT FROM AUTHOR]

The different types of drug resistance encountered in chronic lymphocytic leukemia (CLL) cannot be fully accounted for by the 17p deletion (and/or TP53 mutation), a complex karyotype (CK), immunoglobulin heavy‐chain variable region genes (IGHV) status and gene mutations. Hence, we sought to assess the associations between recurrent genomic abnormalities in CLL and the disease's development and outcome. To this end, we analyzed 64 samples from patients with CLL and gain of the short arm of chromosome 2 (2p+), which is frequent in late‐stage and relapsed/refractory CLL. We found that fludarabine/cyclophosphamide/rituximab (a common first‐line treatment in CLL) is not effective in removing the 2p+ clone ‐ even in samples lacking a CK, the 17p deletion or unmutated IGHV. Our results suggest strongly that patients with CLL should be screened for 2p+ (using karyotyping and fluorescence in situ hybridization) before a treatment option is chosen. Longer follow‐up is now required to evaluate bendamustine‐rituximab, ibrutinib, and idelalisib‐rituximab treatments. [ABSTRACT FROM AUTHOR]

The article presents a case study of 14-yar-old boy, with symptoms of malaise, vomiting and fever. It expresses the results of chest radiography and echocardiography revealing severe aortic coarctation (CoA), a bicuspid aortic valve, and the analyzing the diagnosis of mycotic aneurysm, representing congenital heart defects.

The article presents two case studies of two male infants with 16p11.2 microdeletion syndrome that presented with hyperinsulinaemic hypoglycaemia. The first case deals with a full-term infant presented with distended abdomen failure at day 1 of life, and the second case involves a male infant with recurrent hypoglycaemia. The article discusses the clinical characteristics of deletions of chromosome 16p11.2 and congenital hyperinsulinism.

Glioma stem cells (GSCs) are glioblastoma (GBM) cells that are resistant to therapy and can give rise to recurrent tumors. The identification of patient‐related factors that support GSCs is thus necessary to design effective therapies for GBM patients. Glucocorticoids (GCs) are used to treat GBM‐associated edema. However, glucocorticoids participate in the physiological response to psychosocial stress, which has been linked to poor cancer prognosis. This raises concern that glucocorticoids affect the tumor and GSCs. Here, we treated primary human GBM cells with dexamethasone and evaluated GC‐driven changes in cell morphology, proliferation, migration, gene expression, secretory activity and growth as neurospheres. Dexamethasone treatment of GBM cells appeared to promote the development of a GSC‐like phenotype and conferred resistance to physiological stress and chemotherapy. We also analyzed a potential correlation between GC treatment and tumor recurrence after surgical excision in a population‐based consecutive cohort of 48 GBM patients, adjusted for differences in known prognostic factors concerning baseline and treatment characteristics. In this cohort, we found a negative correlation between GC intake and progression‐free survival, regardless of the MGMT methylation status. In conclusion, our findings raise concern that treatment of GBM with GCs may compromise the efficacy of chemotherapy and may support a GSC population, which could contribute to tumor recurrence and the poor prognosis of the disease. [ABSTRACT FROM AUTHOR]

Donohue syndrome is a rare congenital syndrome of insulin-resistance and abnormal glucose homeostasis, caused by mutations in the insulin receptor ( INSR) gene. It is characterized by specific phenotypic and clinical features and the diagnosis is based on clinical, biochemical and genetic criteria. We report 2 siblings with Donohue syndrome (cases 1, 2) with multiple clinical and biochemical characteristics. Both patients shared the same mutation and presented with intra-uterine growth restriction, failure to thrive, fasting hyperinsulinaemic hypoglycaemia and episodic post-prandial hyperglycaemia. Less common clinical features were also present, such as atrial septal defect and biventricular hypertrophy, clotting disorders, abnormal liver function tests and nephrocalcinosis. Interestingly, 2 previously unrecognized manifestations of the syndrome were also identified: severe gastrointestinal dysmotility (case 1) and exocrine pancreatic insufficiency (case 2). The co-existence of all the above clinical features makes these cases extremely rare. Gastrointestinal dysmotility should always be considered as a potentially fatal feature in patients with the syndrome, due to the complexity of the possible co-morbidities. In addition, our clinical experience for the first time suggests that pancreatic exocrine insufficiency may offer a possible explanation for the growth retardation observed in some patients with this syndrome. Our finding that replacement treatment with pancreatic enzymes improved weight gain (case 2) implies that all patients with Donohue syndrome should be investigated for exocrine pancreatic insufficiency. [ABSTRACT FROM AUTHOR]

Introduction Diagnostic error is a major threat to patient safety in the context of family practice. The patient safety implications are severe for both patient and clinician. Traditional approaches to diagnostic decision support have lacked broad acceptance for a number of well-documented reasons: poor integration with electronic health records and clinician workflow, static evidence that lacks transparency and trust, and use of proprietary technical standards hindering wider interoperability. The learning health system (LHS) provides a suitable infrastructure for development of a new breed of learning decision support tools. These tools exploit the potential for appropriate use of the growing volumes of aggregated sources of electronic health records. Methods We describe the experiences of the TRANSFoRm project developing a diagnostic decision support infrastructure consistent with the wider goals of the LHS. We describe an architecture that is model driven, service oriented, constructed using open standards, and supports evidence derived from electronic sources of patient data. We describe the architecture and implementation of 2 critical aspects for a successful LHS: the model representation and translation of clinical evidence into effective practice and the generation of curated clinical evidence that can be used to populate those models, thus closing the LHS loop. Results/Conclusions Six core design requirements for implementing a diagnostic LHS are identified and successfully implemented as part of this research work. A number of significant technical and policy challenges are identified for the LHS community to consider, and these are discussed in the context of evaluating this work: medico-legal responsibility for generated diagnostic evidence, developing trust in the LHS (particularly important from the perspective of decision support), and constraints imposed by clinical terminologies on evidence generation. [ABSTRACT FROM AUTHOR]

The Learning Health System (LHS) describes linking routine healthcare systems directly with both research translation and knowledge translation as an extension of the evidence-based medicine paradigm, taking advantage of the ubiquitous use of electronic health record (EHR) systems. TRANSFoRm is an EU FP7 project that seeks to develop an infrastructure for the LHS in European primary care. Methods. The project is based on three clinical use cases, a genotype-phenotype study in diabetes, a randomised controlled trial with gastroesophageal reflux disease, and a diagnostic decision support system for chest pain, abdominal pain, and shortness of breath. Results. Four models were developed (clinical research, clinical data, provenance, and diagnosis) that form the basis of the projects approach to interoperability. These models are maintained as ontologies with binding of terms to define precise data elements. CDISC ODM and SDM standards are extended using an archetype approach to enable a two-level model of individual data elements, representing both research content and clinical content. Separate configurations of the TRANSFoRm tools serve each use case. Conclusions. The project has been successful in using ontologies and archetypes to develop a highly flexible solution to the problem of heterogeneity of data sources presented by the LHS. [ABSTRACT FROM AUTHOR]

A strain of the lineage Brachionus 'Nevada' was batch cultured with two diets, differing in biochemical composition: baker's yeast (treatment 1), which has higher protein:lipid ratio compared with CULTURE SELCO (treatment 2). The biochemical composition ( DNA, RNA, lipid, protein content) and fatty acid profile of rotifers of both treatments was analysed and related to previously published population structure data. CULTURE SELCO-fed rotifers showed higher DNA, RNA, lipid, n-3 highly unsaturated fatty acids ( HUFA) average content, compared with yeast-fed rotifers, which had higher protein content. Rotifer lipid content showed significant diurnal variation in yeast-fed rotifers. Rotifer lipid and n-3 HUFA content was associated with reproductive output. DNA and RNA content was related to embryonic development while protein content, to somatic growth and mixis. The saturated and monounsaturated fatty acid rotifer content was stable irrespective of feed, in contrast to eicosapentanoic acid ( EPA) and DHA. The levels of AA were similar in both rotifer populations, but those of EPA and docosahexaenoic acid ( DHA) were about half in yeast-fed compared with CULTURE SELCO-fed rotifers. CULTURE SELCO resulted in a temporally stable rotifer lipid profile and a better enriched parthenogenetic population. [ABSTRACT FROM AUTHOR]

This study describes the rotifer mass culture protocol developed at the Institute of Aquaculture (HCMR) in Crete. Rotifers were cultured semi-continuously at a density of 257.6 ± 2.6 ind. mL−1, with a daily dilution rate of 25%. An automatic feeder was used to administer dry feed (Selco Sparkle®) every 10 min. A number of factors were investigated so as to provide an in-depth analysis of the advantages and disadvantages of the two systems, especially when compared with traditional protocols such as batch culture. The use of these two systems resulted in a culture of considerable duration (41 days) and daily yield (0.21 ± 0.01 ind. 106 day−1 L−1), using exclusively dry feed. Both systems can be easily applied in hatcheries, requiring few modifications on existing protocols and contribute to a stable and predictable production. Further improvements include manipulation of the dilution rate, food ration, culture volume and duration, as well as choice of a phytoplankton-based diet. [ABSTRACT FROM AUTHOR]

Background: We aimed at evaluating the long-term effects of cardiac resynchronization therapy (CRT) in nonambulatory New York Heart Association (NYHA) IV heart failure patients (NAIVHFP). Methods: Eighteen patients, 15 men and three women, eight with ischemic and 10 with nonischemic cardiomyopathy, who underwent biventricular pacemaker implantation while they were in nonambulatory NYHA IV class, were studied. Patients' age was 58 ± 9 years and left ventricular ejection fraction (LVEF) 18 ± 3 %. Follow-up data were obtained through review of follow-up visits notes, stored echocardiographic studies, device interrogation data, and death certificates. Results: After a mean duration of 1223 ± 846 days, 11 patients were alive, including five patients who underwent heart transplantation (OCT) and seven dead. Three of 11 patients who received a CRT-defibrillator, experienced at least one appropriate discharge, but eventually they either died or received an OCT during follow-up. Sustained improvements in NYHA class (Z = 2.4, P = 0.015) and 6-minute walk distance (0 vs 212 ± 95 m, P ≪ 0.001) were documented after a median duration of 855 days postimplantation. Cumulative proportion of death or OCT at 18 months-when full follow-up data were available-was 18%, which compared favorably with historical controls. Full echocardiographic and clinical follow-up data at 12-months postimplantation were available for 10 patients, documenting a significant reduction in end-systolic volume (248 ± 82 vs 269 ± 97 mL, P = 0.039). Conclusions: CRT can be safely applied in this subset of extreme severity heart failure patients, achieving encouraging survival rates and reverse remodeling effects. These observations can form an evidence-based rationale for including NAIVHFP in randomized CRT trials. (PACE 2011; 34:1553-1560) [ABSTRACT FROM AUTHOR]

Autonomic Disorders in Brugada Syndrome. Introduction: The aim of this study was to examine autonomic disorders in patients with Brugada syndrome by performing a cardiac sympathetic innervation evaluation, a head-up tilt-test (HUT) and heart rate variability (HRV) analysis. Methods and Results: We enrolled 20 patients with Brugada syndrome (mean age 42.5 ± 8.8 years), 9 with spontaneous and 11 with an induced type 1 electrocardiogram (ECG) in the setting of symptoms and 20 age-matched controls. All subjects underwent a HUT with parallel measurements of plasma catecholamines and cortisol, a 123I-metaiodobenzylguanidine single photon emission tomography, and HRV evaluation. Ten control subjects participated in the innervation portion of the study. The tilt-test with clomipramine challenge was positive in 15 of 20 (75%) patients (7 spontaneous, 8 induced) and in 1 in controls (P < 0.01). A sympathoadrenal imbalance was shown in positive tests. The pattern of innervation in all groups was heterogenic and similar to controls with a trend towards lower measurements in patients with a spontaneous type 1 ECG and a positive HUT. HRV analysis did not reveal any significant differences during day and night. Four patients (20%) had sustained ventricular arrhythmias during a follow-up of 31.1 ± 8.6 months, but no correlations with innervation or response to tilting were found. Conclusion: A high susceptibility to vasovagal syncope was observed in patients with Brugada syndrome, which could be disease-related symptoms. Conversely, sympathetic innervation was observed to follow a physiological, heterogenic pattern; however, these factors did not have prognostic value for life-threatening arrhythmias. (J Cardiovasc Electrophysiol, Vol. pp. 773-780, July 2010) [ABSTRACT FROM AUTHOR]

The rotifer Brachionus plicatilis is an important component of aquaculture as a larval feed. Its taxonomic status has been recently re-defined as a species complex, consisting of at least 14 new species/lineages. This study deals with the lineage Brachionus‘Nevada’, which has been shown to occur in European hatcheries. A strain of B. ‘Nevada’ was mass cultured using two commonly applied feeding regimes and analysed in terms of its morphometry. A new formula was proposed for the calculation of volume, which can be used as an index of adequacy of rotifers as feed for fish larvae. The results were related to life cycle parameters. The pre-reproductive and reproductive phases were divided into distinct size groups. Differences were also found between the two diets in morphometry and demography. Rotifers of a larger size (yeast-based diet) showed a lower growth rate and a longer reproductive period, lifespan and mean generation time compared with smaller-sized rotifers (Culture Selco®-based diet). In terms of lorica length, the present study's strain of B. ‘Nevada’ (238.5 μm) was intermediate between values reported for Brachionus ibericus (193.5 μm) and B. plicatilis sensu stricto (299 μm). [ABSTRACT FROM AUTHOR]

Presents the case of a 56-year-old white female patient with pure osteosarcoma of the uterus. Finding of an intramural uterine tumor by gross pathologic examination; Use of immunohistochemical stains to show positivity for vimenthin and white stains for cytokeratins; Common symptoms of osteosarcoma.

The article presents a comprehensive analysis of the climate variability in the eastern Mediterranean. In this study, the spatial patterns of temperature were identified to be more coherent and counted less on the characteristics of local topography than those for precipitation. Moreover, winter patterns generally exhibited more pronounced structures, and that atmospheric circulation associated with anticyclonic centres results to invasions of cold air into the study region and rather dry conditions across the region.

A strain of Brachionus‘Nevada’, which belongs to the Brachionus plicatilis species complex, and is commonly found in European hatcheries, was investigated in terms of its mixis potential. Two feeding regimes used for mass culturing were employed. Rotifer populations were fed on phytoplankton ( Tetraselmis suecica) and either baker's yeast, Saccharomyces cerevisiae (treatments A) or Culture Selco® (treatments B). In order to promote mixis, the salinity of the culture medium was reduced from 40 to 20 g L−1. Indeed, the rotifer populations of lower salinity (A 20, B 20) showed a twofold increase in mixis rates compared with those of higher salinity (A 40, B 40). In addition, treatment A 20 showed significantly higher levels of mixis (22.59±2.07%) compared with B 20 (16.56±1.46%). The opposite trend was observed for the parthenogenetic growth rates (A 20: 0.46±0.01; B 20: 0.62±0.01). It is thus concluded that Culture Selco leads to a higher abundance of amictic ovigerous females, whereas yeast supports a higher abundance of males and mictic females carrying resting eggs. The two types of feeding regimes can be used for different purposes in a hatchery. [ABSTRACT FROM AUTHOR]

The article presents a study concerning eastern Mediterranean's comprehensive analysis on its climate variability. The combined analysis of the temporal and spatial variation of rotated principal components of sea-level pressure are the methodology adopted to determine the circulation patterns. It presents and discusses on a catalogue of characteristic seasonal composites. It mentions that a significant increase in the anticyclonic types, especially in winter, were exhibited based on a linear trend analysis for the period 1958-2000. In relation, statistics shows that negative trends have been found in all seasons particularly for types relative with depressjonal activity in the central Mediterranean.

Abstract: Background: The early diagnosis and treatment of heart failure in β-thalassaemic patients is related to survival. Iron alone or in combination with other factors causes diastolic dysfunction, which usually precedes systolic dysfunction. NT-proBNP is a sensitive biomarker of ventricular dysfunction. Aim: To evaluate NT-proBNP in non heart failure β-thalassaemic patients. Methods: Fifty-two β-thalassaemia major patients (mean age: 27.2±12.5 years) with normal LV systolic function, underwent NT-proBNP measurement and a thorough Doppler-echocardiographic and pulsed tissue-Doppler study, 4 days following blood transfusion. Fifty-two age matched healthy controls were also studied. Results: NT-proBNP and E/E′ ratio were increased in thalassaemic patients compared with controls [(469±171 vs 262±51 pmol/l, p <0.001) and (10.8±4.0 vs 6.6±1.1, p <0.001)] and were well correlated (r: 0.54, p <0.01). Although NT-proBNP levels were increased in patients with higher E/E′ ratios (E/E′ <8: 354±119, 8–15: 516±177, >15: 565±114 pmol/l, ANOVA p: 0.002) this increase only became statistically significant in the 3rd decade of life, while E/E′ ratio increased in the 4th decade. Conclusion: NT-proBNP increases in β-thalassaemia major patients and is related to age and LV diastolic dysfunction. NT-proBNP appears to be an early biomarker of LV diastolic dysfunction, compared with the conventional Echo-Doppler indexes. [Copyright &y& Elsevier]

Dieulafoy's lesion is a rare, however, underdiagnosed condition. Advances in endoscopy have increased the rate of diagnosis of Dieulafoy's lesions to 70% of patients and that of successful treatment to 90%. Additional clinical features include hypotension and iron-deficiency anaemia.1 Diagnostic and treatment approach The gold standard for establishing the diagnosis is endoscopy. [Extracted from the article]

Background: Cardiac resynchronization therapy (CRT) pacing has been proposed as an additional treatment to medical therapy to improve heart failure patients with left ventricular asynchrony. The aim of this study was to evaluate the influence of CRT treatment on proinflammatory cytokines in patients with heart failure. Methods: Twenty patients, with a mean age 64 ± 2 years, with severe chronic heart failure NYHA class II–IV (mean ejection fraction 25 ± 2%), were included in the study. Patients were treated with CRT pacing, after failure of optimal therapy. Blood samples were taken at baseline, 3 months after pacing therapy, and after a subsequent 3-month period of no pacing for the assessment of proinflammatory cytokines TNF-α and its receptors (sTNFR-I, sTNFR-II), IL-6, adhesion molecules sICAM-1 and sVCAM-1, and the apoptotic indices sFas and sFas-Ligand. Results: Levels of TNF-α, sTNFR-I, and sTNFR-II were reduced at the end of 3 months of CRT therapy and further reduced at the end of the no pacing period (P < 0.05, compared to baseline). Levels of IL-6 also declined after 3 months of CRT pacing (from 8.9 ± 2.5 pg/mL to 4.7 ± 1.3 pg/mL, P < 0.05) and this was maintained during the no pacing period (3.9 ± 1.1 pg/mL P < 0.05 compared to baseline). The adhesion molecule sICAM-1 levels also reduced (from 265 ± 17 ng/mL to 235 ± 12, P < 0.05) after 3 months of CRT pacing and remained unchanged at the end of the no pacing period (219 ± 12 ng/mL, P < 0.05 compared to baseline values). Conclusion: Major proinflammatory cytokines and the adhesion molecule sICAM-1 are reduced with CRT therapy and this effect is maintained for at least 3 months after discontinuation of pacing. [ABSTRACT FROM AUTHOR]

Most riverflow records in the United Kingdom are relatively short, with some of the longest continuous series beginning in the late 1950s. In contrast, rainfall records are plentiful with many extending back into the early decades of the nineteenth century. Earlier works have developed a method for reconstructing riverflow data from the longer rainfall series. The work reported here extends previous reconstructions from the middle of the 1990s to 2002. The inclusion of recent very wet periods has allowed a more comprehensive validation of the reconstruction model. Comparisons of reconstructed and observed flows for 1980-2002 imply that land-use changes have had little effect on flows, at least at the monthly time step. In addition, for some catchments, the inadequacy of flow-gauging installations under such extreme flow conditions is discussed. The reconstructions could prove useful for flow naturalisation for some catchments. The wet autumn of 2000 and the ensuing hydrological extremes during 2000 and 2001 are put into the context of the full 1865-2002 flow reconstructions. For 1980-2002, there were few low flow periods. The years 1984, 1989 and especially 1995 rank in the five lowest flows since 1865 on more than one catchment, but low flows during 1870, 1887, 1921, 1933/4 and 1976 were more spatially extensive. Copyright © 2005 Royal Meteorological Society. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The aims of this study were to evaluate dentists' knowledge of the emergency treatment of traumatic injuries to young permanent incisors, and to investigate barriers to treatment. DESIGN: A closed-ended questionnaire was sent to 1023 general dental practitioners (GDPs) and community dental officers (CDOs) in West/North Yorkshire and Humberside, UK. METHODS: The questionnaire comprised 17 questions. Six questions asked for general information about the participants (i.e. profession, age, gender, year of graduation, training or education on dental trauma, and willingness to provide emergency care), 10 were relevant to the emergency treatment of crown fractures, root fractures, luxation and avulsion injuries, and the last question queried any perceived barriers to treatment. Results. Seven hundred and twenty-four questionnaires were returned, a response rate of 71%, and these indicated that dentists' knowledge of the emergency treatment of dentoalveolar trauma in children was inadequate. The CDOs were significantly more knowledgeable than the GDPs, as were younger and more recently graduated dentists compared with older ones. The GDPs regarded the difficulty of treating children and the inadequate fees of the UK National Health Service as important barriers to treatment. Dentists who attended continuing dental education courses on dental traumatology had a more thorough knowledge than those who did not. CONCLUSION: Overall, the dentists' knowledge of the emergency treatment of dentoalveolar trauma in children was inadequate. Greater emphasis on undergraduate and postgraduate education in this area is indicated. [ABSTRACT FROM AUTHOR]

The aim of this study was to examine the effect of intravenous immunoglobulin G (IVIG) compared with that of gadolinium chloride (GdCl3) in the inhibition of Kupffer cell activation on lipid peroxidation after severe total hepatic ischemia/reperfusion (I/R). Male Wistar rats (n = 40) were randomly divided into four equal groups: a sham-operation group, a control I/R group, and two I/R groups pretreated with either MG or GdCl3 intravenously. Following 60 minutes Of total hepatic ischemia and 120 minutes of reperfusion, the rats were sacrificed and liver and blood samples collected. Additional animals (n = 80) were followed up for surreal rate determination. Results showed that I/R decreased the survival rate to 10%, increased the levels of asparthte (AST) and alanine (ALT) transaminase and lactate dehydrogenase (LDH) in serum to 2487, 2189, and 4236 IU/L, respectively, and increased malondialdehyde (MDA) levels in fiver to 1.552 nmol/g compared with 1.114 nmol/g in the sham operation group. Pretreatment with GdCl3 increased the survival rate to 50% and decreased the levels of AST, ALT, and LDH in serum to 1496, 1298, and 3245 IU/I, respectively. Pretreatment with IVIG increased the survival rate to 60% and decreased the levels of AST, ALT, and LDH in serum to 449, 367, and 1456 IU/I, respectively, and the levels of MDA in fiver to 1.153 and 1.148 mol/g for GdCl3 and MG respectively. Histologic examination showed protection of fiver parenchyma in the animals treated with GdCl3 or IVIG. [ABSTRACT FROM AUTHOR]

The rates of litter decomposition, organic matter loss and nutrient release for Dactylis glomerata (Gramineae) and Vicia villosa (Leguminosae) were studied at two sites in north Greece, which differed in soil pH, soil particle distribution and nutrient availability. Climate, soil characteristics and taxonomic plant differences affected the rates of litter decomposition. Litter loss was higher at site A (neutral soil) than at site B (acid soil). Organic matter loss was generally low. Dry weather affected both parameters. Nitrogen release from litter was higher for both species at site A. The rate of P and K release was higher in the neutral soil than in the acid soil for both species, while that of Ca for both species and of Mg for Vicia was higher in the acid soil. Phosphorus, Ca and Na release from the litter of the leguminous species began earlier than from the graminaceous species. P mineralization from Vicia litter seemed to start just after its incorporation into the soil. [ABSTRACT FROM AUTHOR]

The article presents information on a study which reveals that a Babesia-lengau-like organism may be responsible for haemolytic diseases in sheep. The study analyzed sheeps affected by typical signs of babesiosis, a haemoparasitosis of domestic and wild animals. It is said that further studies should be conducted to confirm the findings of the study.

A letter to the editor is presented about a study that assesses the expression of a panel of markers which have been shown to be implicated in the regulation of cell growth, proliferation and apoptosis in a population of extragonadal and gonadal germ cell tumors.

An unusual case of pelvic echinococcus cyst is presented, appearing initially on transvaginal ultrasound as a pelvic mass mimicking a multicystic ovary. A similar mass in the liver raised preoperatively the suspicion of echinococcosis, making an open surgical procedure preferable to laparoscopy. Diagnosis was confirmed pathologically after removal of the cyst. Though their location in the pelvis is rare, echinococcal cysts should be considered in the differential diagnosis of pelvic masses, especially in patients from endemic areas. Evaluation of previous medical history and current symptoms, together with the ultrasonographic findings, is important for correct diagnosis and appropriate management. [ABSTRACT FROM AUTHOR]

The article describes the case of a 10-year-old boy with fever and sore throat for three days and yellow coloration of skin and sclera for two days, along with vomiting. Topics discussed include results of the laboratory tests conducted on the boy, moderate growth of group C beta-haemolytic streptococcus found from throat and skin swabs from the blister, and possible mechanisms suggested by authors.

A three‐year study was conducted on the occurrence of disinfection by‐products (DBPs)—trihalomethanes (THMs), haloacetic acids (HAAs), and haloacetonitriles—in drinking water of regions of Europe where epidemiology studies were being carried out. Thirteen systems in six countries (i.e., Italy, France, Greece, Lithuania, Spain, United Kingdom) were sampled. Typically chlorinated DBPs dominated. However, in most of Catalonia (Spain) and in Heraklion (Greece), brominated DBPs dominated. The degree of bromine incorporation into the DBP classes was in general similar among them. This is important, as brominated DBPs are a greater health concern. In parts of Catalonia, the reported levels of tribromoacetic acid were higher than in other parts of the world. In some regions, the levels of HAAs tended to be peaked in concentration in a different time period than when the levels of THMs peaked. In most epidemiology studies, THMs are used as a surrogate for other halogenated DBPs. This study provides exposure assessment information for epidemiology studies. [ABSTRACT FROM AUTHOR]

Presents a letter to the editor about malignant pleural effusion of post-transplant neutrophil-rich anaplastic large cell lymphoma.

Sertoli-Leydig cell tumors constitute only 1% of sex cordstromal neoplasms and therefore less than 0.5% of primary ovarian tumors (1), but they often pose diagnostic problems because of their wide spectrum of histologic patterns and appearances. Tumors with a retiform pattern, which usually occur in younger patients (2), or tumors with heterologous elements may mimic a large variety of ovarian neoplasms. A stromal heterologous component is encountered in 5% of all Sertoli-Leydig cell tumors and includes mainly cartilaginous elements and/or immature skeletal muscle (3). The clinical and endocrinological profiles of these tumors are similar to those of Sertoli-Leydig cell tumors without heterologous elements, but the androblastomatous component is almost always poorly differentiated when stromal heterologous elements are present. We have recently encountered a case of Sertoli-Leydig cell tumor of intermediate differentiation exhibiting a heterologous rhabdomyoblastic component, which we are reporting briefly. [ABSTRACT FROM AUTHOR]

An abstract of the article "NT-pro BNP is a better biomarker than BNP for the identification of left ventricular dysfunction in beta-thalassemia major patients," by E. Hamodraka and colleagues is presented.