Conflict, healthcare and professional perseverance: A qualitative study in a remote hospital in an Anglophone Region of Cameroon.

Armed conflicts are a major contributor to global disease burden owing to their deleterious effects on health and healthcare delivery. The Anglophone crisis in Cameroon is one of the ongoing conflicts in Sub-Saharan Africa and has led to massive displacement of healthcare workers (HCWs). However, some HCWs have stayed back and continued working.

Idiopathic Omental Infarction Presenting With Recurrent Abdominal Pain.

Omental infarction is a rare cause of acute abdominal pain, and its rarity is mainly due to its relatively rich blood supply by multiple collateral vessels. It usually presents with right lower quadrant pain, as left-sided torsion is infrequent and is usually diagnosed intraoperatively. Since omental infarction is frequently diagnosed by CT scan, conservative management should be considered in most patients to avoid subjecting the patients to unnecessary surgical intervention.

Subcutaneous emphysema of the extremities: Be wary of necrotizing fasciitis, but also consider occult rupture or perforation.

Not all causes of subcutaneous emphysema are attributable to necrotizing fasciitis. Consider other causes of subcutaneous emphysema in the differential diagnosis.

Radiological Manifestations of Ketamine Abuse.

Awareness of the radiological manifestations helps recognition of ketamine abuse.

A rectal metastasis of an unknown lobular breast carcinoma and its management.

Breast cancer is the most common cancer in women but gastro- intestinal metastases of breast cancer are rare. They can occur years after the diagnosis or at the diagnosis of breast cancer. We report the case of a patient complaining of dyschesia, tenesmus and anal incontinence leading to the discovery of a rectal metastasis of an unknown breast neoplasia.

Tooth enamel ESR doses and cytogenetic doses of Nagasaki atomic-bomb survivors in comparison with DS02R1 doses.

Purpose: Cancer risks for Nagasaki survivors once appeared to be lower than for Hiroshima survivors. The possibility that this was due to overestimation of the doses for the Nagasaki survivors was tested by measuring biological doses of Nagasaki survivors and comparing them with DS02R1 individual doses as previously done for Hiroshima survivors.

Materials And Methods: The electron spin resonance (ESR) method and cytogenetic method were used to estimate radiation doses for 24 Nagasaki survivors, and the results were compared to calculated DS02R1 doses.

Awareness and Vaccine Coverage of Hepatitis B among Cameroonian Medical Students.

Background: The endemic nature of the hepatitis B virus (HBV) in Sub-Saharan Africa is a significant public health problem that places health care providers (medical students inclusive) at increased risk of occupational exposure. However vaccination against HBV is not systematic among medical students in Cameroon. Thus, we sought to evaluate awareness and HBV vaccine coverage among medical students in Cameroon.

Cytogenetic Reconstruction of Gamma-Ray Doses Delivered to Atomic Bomb Survivors: Dealing with Wide Distributions of Photon Energies and Contributions from Hematopoietic Stem/Progenitor Cells.

Retrospective estimation of the doses received by atomic bomb (A-bomb) survivors by cytogenetic methods has been hindered by two factors: One is that the photon energies released from the bomb were widely distributed, and since the aberration yield varies depending on the energy, the use of monoenergetic Co gamma radiation to construct a calibration curve may bias the estimate. The second problem is the increasing proportion of newly formed lymphocytes entering into the lymphocyte pool with increasing time intervals since the exposures. These new cells are derived from irradiated precursor/stem cells whose radiosensitivity may differ from that of blood lymphocytes.

Treatment of the edentulous atrophic maxilla using zygomatic implants: evaluation of survival rates over 5-10 years.

The aim of this retrospective observational cohort study was to analyse and report the 5-10-year survival rates of endosseous zygomatic implants used in the rehabilitation of the atrophic maxilla. Forty-three consecutive zygomatic implant placements in 25 patients were evaluated over a 5-10-year period. All zygomatic implant surgery was carried out under general anaesthesia.

Synthesis of the C1-C20 and C15-C27 segments of aplyronine A.

The synthesis of C1-C20 and C15-C27 segments of Aplyronine A is described. Oxidative cleavage of cyclic vinyl sulfones has been used to prepare key fragments of Aplyronine A. Key precursors are united by Horner-Wadsworth-Emmons and Julia-Kociensky olefination for the respective elaboration of the C1-C20 and C15-C27 segments.

Biological dosimetry by the triage dicentric chromosome assay: potential implications for treatment of acute radiation syndrome in radiological mass casualties.

Biological dosimetry is an essential tool for estimating radiation dose. The dicentric chromosome assay (DCA) is currently the tool of choice. Because the assay is labor-intensive and time-consuming, strategies are needed to increase throughput for use in radiation mass casualty incidents.

Reagent-directed allylic quadraselection. Chemoselective anti- and syn-Lawton S(N)2' methylation of seven-membered epoxyvinylsulfones.

Methods have been developed for regio- and stereoselective 1,4-syn or 1,4-anti methylation of seven-membered epoxyvinylsulfones. 1,4-Syn addition is achieved via the combination of Me(2)Zn and catalytic Li(2)CuCl(4), a hitherto unexplored reagent combination. The complementary 1,4-anti addition relies on Cu(I) catalyzed methyl Grignard addition or (CH(3))(3)Al assisted CH(3)Cu addition.

Interlaboratory comparison of the dicentric chromosome assay for radiation biodosimetry in mass casualty events.

This interlaboratory comparison validates the dicentric chromosome assay for assessing radiation dose in mass casualty accidents and identifies the advantages and limitations of an international biodosimetry network. The assay's validity and accuracy were determined among five laboratories following the International Organization for Standardization guidelines. Blood samples irradiated at the Armed Forces Radiobiology Research Institute were shipped to all laboratories, which constructed individual radiation calibration curves and assessed the dose to dose-blinded samples.

Second-generation synthesis of syn- and anti-cycloheptadienylsulfone polyketide stereodiads.

Stereodiad sulfones 18a and 18b are key intermediates for polyketide synthesis. This note describes the synthesis of 18a and 18b from enantiopure epoxide 2. The two sequences have been optimized for large-scale synthesis to give 80-85% overall yields in one operation (one operation implies that no crystallization or distillation is required throughout the synthesis) while avoiding chromatography.

Conversion of cyclic vinyl sulfones to transposed vinyl phosphonates.

Functionalized cyclic vinyl sulfones were directly converted to the "polarity reversed" vinyl phosphonates through an efficient one pot procedure. Ozonolysis of these vinyl sulfones and vinyl phosphonates furnish complementary sets of termini-differentiated ester-aldehydes. This strategy has been applied for preparation of segments needed for the synthesis of Aplyronine A.

Asymmetric synthesis of all eight seven-carbon dipropionate stereotetrads.

Enantiopure cycloheptadienyl sulfones 6 and 7 are diastereoselectively epoxidized to yield epoxyvinyl sulfones 8, 9, 14, and 16 in high yields and diastereomeric ratios. Syn and anti methylation of epoxides 8, 9, 14, and 16 enables access to all eight possible diastereomeric stereotetrads, seven of which are commonly found in polypropionate natural products. Anti methylations of the above epoxides are possible by either the reaction of methyl organometallics promoted by copper(I), or via reaction with trimethylaluminum to yield stereotetrads 11, 12, 22, and 24.

Double lawton SN2'addition to epoxyvinyl sulfones: selective construction of the stereotetrads of aplyronine A.

[reaction: see text] Enantiopure epoxyvinyl sulfones function as templates for the diastereoselective construction of the three stereotetrads of aplyronine A. Lawton S(N)2' addition of 3,5-dimethylpyrazole followed by its displacement in an alcohol-directed Lawton S(N)2' reaction establishes the required product stereochemistry with high selectivity.

A method to differentiate between the levels of ESR signals induced by sunlight and by ionizing radiation in teeth from atomic bomb survivors.

Electron spin resonance (ESR, or electron paramagnetic resonance, EPR) analysis of tooth enamel is an effective method for the retrospective estimation of individual radiation doses. One problem with this technique is that the observed ESR signal may include a contribution from ultraviolet (UV) light exposure from sunlight, especially in front teeth. Thus there has been a need to find ways to estimate the UV-light effect in the total signal so that the net ESR dose from ionizing radiation can be determined.

Clonally expanded T-cell populations in atomic bomb survivors do not show excess levels of chromosome instability.

Radiation-induced genomic instability has been studied primarily in cultured cells, while in vivo studies have been limited. One major obstacle for in vivo studies is the lack of reliable biomarkers that are capable of distinguishing genetic alterations induced by delayed radiation effects from those that are induced immediately after a radiation exposure. Here we describe a method to estimate cytogenetic instability in vivo using chromosomally marked clonal T-cell populations in atomic bomb survivors.

Validity of original studies in health technology assessment reports: significance of standardized assessment and reporting.

Objectives: As health technology assessments (HTA) may have considerable impact on health-care decisions, it is essential to guarantee the expected quality of these assessments. Variations in the methods used or lack of transparency can affect the important role of HTA reports.

Methods: In our study, we analyzed the methods used in two corresponding HTA reports to assess the validity of two key papers, which were included in both reports.

Tea tree oil: in vitro efficacy in otitis externa.

Objective: The purpose of this study was to determine the susceptibility of organisms causing otitis externa (OE) to the essential oil of Melaleuca alternifolia, or tea tree oil (TTO).

Methods: Fifty-seven swabs were taken from the ears of 52 patients with OE for culture and sensitivity. A broth microdilution method was used to determine the minimum inhibitory concentration (MIC) of TTO for each organism.

Immunotherapy for advanced renal cell cancer.

Background: The course of advanced renal cell carcinoma is extremely variable, ranging from spontaneous remission to disease progression refractory to chemotherapy. Immunotherapy has held promise of improved outcomes based on uncontrolled studies and randomized controlled trials generally limited by small size and low power.

Objectives: To evaluate immunotherapy for advanced renal cell carcinoma by comparing: (1) high dose interleukin-2 to other options and (2) interferon-alfa to other options.

Human fetuses do not register chromosome damage inflicted by radiation exposure in lymphoid precursor cells except for a small but significant effect at low doses.

Human fetuses are thought to be highly sensitive to radiation exposure because diagnostic low-dose X rays have been suggested to increase the risk of childhood leukemia. However, animal studies generally have not demonstrated a high radiosensitivity of fetuses, and the underlying causes for the discrepancy remain unidentified. We examined atomic bomb survivors exposed in utero for translocation frequencies in blood lymphocytes at 40 years of age.