Use of statins in patients with chronic hepatitis C.

Hepatitis C is a leading cause of liver failure and transplantation in the United States and a major public health issue. Studies have shown that patients with hepatitis C are at an increased risk of cardiovascular disease, which make statins of particular benefit in this patient population. However, the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) lists active or chronic liver disease as an absolute contraindication to statin therapy.

Retrospective study of technical aspects and complications of endoscopic submucosal dissection for laterally spreading tumors of the colorectum.

Background And Study Aims: Laterally spreading tumors - non granular type (LST-NG) are more often considered candidates for endoscopic submucosal dissection (ESD) than laterally spreading tumors - granular type (LST-G), because of their higher potential for submucosal invasion. However, ESD for LST-NG can be technically difficult. The aim of our study was to compare our ESD results for LST-NG and for LST-G.

Results of an exercise to estimate the costs of interpersonal violence in Jamaica.

Unlabelled: This report describes the application of a draft version of the World Health Organization (WHO)/ United States Centers for Disease Control and Prevention (CDC) Manual for estimating the economic costs of injuries due to interpersonal and self-directed violence to measure costs of injuries from interpersonal violence.

Methods: Fatal incidence data was obtained from the Jamaica Constabulary Force. The incidence of nonfatal violence-related injuries that required hospitalization was estimated using data obtained from patients treated at and/or admitted to three Type A government hospitals in 2006.

Emergency open cholecystectomy is associated with markedly lower incidence of postoperative nausea and vomiting (PONV) than elective open cholecystectomy: a retrospective cohort study.

Background: During a previous study to define and compare incidence risks of postoperative nausea and vomiting (PONV) for elective laparoscopic and open cholecystectomy at two hospitals in Jamaica, secondary analysis comparing PONV risk in elective open cholecystectomy to that after emergency open cholecystectomy suggested that it was markedly reduced in the latter group. The decision was made to collect data on an adequate sample of emergency open cholecystectomy cases and further explore this unexpected finding in a separate study.

Methods: Data were collected for 91 emergency open cholecystomy cases identified at the two participating hospitals from May 2007 retrograde, as was done for the 175 elective open cholecystectomy cases (from the aforementioned study) with which the emergency cases were to be compared.

Traditional facial tattoos disrupt face recognition processes.

Factors that are important to successful face recognition, such as features, configuration, and pigmentation/reflectance, are all subject to change when a face has been engraved with ink markings. Here we show that the application of facial tattoos, in the form of spiral patterns (typically associated with the Maori tradition of a Moko), disrupts face recognition to a similar extent as face inversion, with recognition accuracy little better than chance performance (2AFC). These results indicate that facial tattoos can severely disrupt our ability to recognise a face that previously did not have the pattern.

Anterior and posterior lumbar interbody fusion with percutaneous pedicle screws: comparison to muscle damage and minimally invasive techniques.

Study Design: Retrospective analysis of patients whom underwent one-level anterior lumbar interbody fusion or posterior lumbar interbody fusion with percutaneous pedicle screws.

Objective: To determine which minimally invasive fusion technique, anterior or posterior lumbar fusions, induces the least amount of muscle damage.

Summary Of Background Data: Creatine phosphokinase is recognized as a good marker for muscle damage occurring in patients after spine surgery.

Optical diagnosis of small colorectal polyps at routine colonoscopy (Detect InSpect ChAracterise Resect and Discard; DISCARD trial): a prospective cohort study.

Background: Accurate optical diagnosis of small (<10 mm) colorectal polyps in vivo, without formal histopathology, could make colonoscopy more efficient and cost effective. The aim of this study was to assess whether optical diagnosis of small polyps is feasible and safe in routine clinical practice.

Methods: Consecutive patients with a positive faecal occult blood test or previous adenomas undergoing surveillance at St Mark's Hospital (London, UK), from June 19, 2008, to June 16, 2009, were included in this prospective study.

Disseminated histoplasmosis presenting as granulomatous epididymo-orchitis.

Genital involvement is an unusual manifestation of histoplasmosis. We report a case of histoplasmosis presenting as granulomatous epididymo-orchitis and review 4 cases reported in the literature. Diagnosis of this infection is suggested by a compatible clinical picture and results of specific serology or antigen testing, but confirmation ultimately requires analysis of pathologic specimens.

Development of a novel esophageal stricture simulation.

Background And Study Aims: Esophageal stricture dilatation has a significant morbidity and mortality and training can be difficult to obtain. The aim of the study was to investigate the face validity of a novel stricture simulation and evaluate its utility for training in balloon-dilatation technique.

Methods: Single-use stricture simulations were used to adapt a mechanical model for use in esophageal stricture dilatation.

Postoperative nausea and vomiting in laparoscopic versus open cholecystectomy at two major hospitals in Jamaica.

Postoperative nausea and vomiting (PONV) is a distressing and potentially dangerous complication of general anaesthesia with volatile agents. The internationally reported average risk is 20 to 30%. It has been suggested that Jamaicans have a generally low risk of PONV and this is plausible since ethnic-based differences in response to emetogenic stimuli have been identified.

Sentinel lymph node biopsy for breast cancer using methylene blue dye manifests a short learning curve among experienced surgeons: a prospective tabular cumulative sum (CUSUM) analysis.

Background: The benefits of sentinel lymph node biopsy (SLNB) for breast cancer patients with histologically negative axillary nodes, in whom axillary lymph node dissection (ALND) is thereby avoided, are now established. Low false negative rate, certainly with blue dye technique, mostly reflects the established high inherent accuracy of SLNB and low axillary nodal metastatic load (subject to patient selection). SLN identification rate is influenced by volume, injection site and choice of mapping agent, axillary nodal metastatic load, SLN location and skill at axillary dissection.

Mycobacterium-avium-intracellulare complex immune reconstitution inflammatory syndrome in HIV/AIDS presenting as osteomyelitis.

We report a case of osteomyelitis due to Mycobacterium avium-intracellulare complex (MAC) in an AIDS patient shortly after the initiation of antiretroviral therapy with subsequent immune reconstitution inflammatory syndrome (IRIS). He improved after surgical debridement and treatment with clarithromycin, ethambutol, rifabutin, and low-dose corticosteroids. Antiretroviral therapy was not interrupted.

Importance of direct interactions with lipids for the function of the mechanosensitive channel MscL.

We have studied the effects of lipid structure on the function of the mechanosensitive channel of large conductance (MscL) from Escherichia coli to determine whether effects follow from direct interaction between the lipids and protein or whether they follow indirectly from changes in the curvature stress in the membrane. The G22C mutant of MscL was reconstituted into sealed vesicles containing the fluorescent molecule calcein, and the release of calcein from the vesicles was measured following opening of the channel by reaction with [2-(triethylammonium)ethyl] methanethiosulfonate (MTSET), which introduces five positive charges into the region of the pore constriction. The presence of anionic lipids in the vesicle membrane changed the rates and amplitudes of calcein release, the effects not correlating with calculated changes in lipid spontaneous curvature.

Narrow band imaging with magnification for the characterization of small and diminutive colonic polyps: pit pattern and vascular pattern intensity.

Background And Study Aims: Narrow band imaging (NBI) can accurately characterize colonic polyps using microvascular appearances. We aimed to assess whether the Kudo pit pattern classification is accurate when used with NBI (without dye-spray), and if microvascular appearances or NBI pit patterns maintain accuracy for polyp characterization at sizes < 10 mm.

Patients And Methods: 116 polyps < 10 mm in size were detected in 62 patients undergoing surveillance colonoscopy.

Effect of visualization display colour on polyp conspicuity at virtual colonoscopy.

Aim: To investigate the effect of different colour three-dimensional (3D) displays on polyp detection at virtual colonoscopy (VC).

Methods: Five VC trained observers were shown "brief flashes" (lasting 0.2s) of 125 3D endoluminal image snap-shots, repeated for each of six display colours (750 images total).

A comparative study of standard vs. high definition colonoscopy for adenoma and hyperplastic polyp detection with optimized withdrawal technique.

Background: Colonoscopy has a known miss rate for polyps and adenomas. High definition (HD) colonoscopes may allow detection of subtle mucosal change, potentially aiding detection of adenomas and hyperplastic polyps.

Aim: To compare detection rates between HD and standard definition (SD) colonoscopy.

Effect of artemisinins and amino alcohol partner antimalarials on mammalian sarcoendoplasmic reticulum calcium adenosine triphosphatase activity.

The aim of this study was to assess the ability of currently deployed antimalarials to inhibit mammalian sarcoendoplasmic reticulum calcium adenosine triphosphatase (SERCA). Artemisinins exert their antiplasmodial action by inhibiting parasite PfATP6, a SERCA enzyme, and possess neurotoxic potential; mefloquine is neurotoxic and inhibits mammalian SERCA, an orthologue of PfATP6. SERCA in rabbit muscle was tested in vitro for inhibition by artemisinin and amino alcohol antimalarials.

Sclerotherapy of idiopathic hydroceles and epididymal cysts: a historical comparison trial of 5% phenol versus tetracycline.

Operating time for idiopathic hydroceles and epididymal cysts is scarce as these conditions compete with an increasing caseload of more consequential surgical disease. Therapy is often relegated to repeated aspiration. Sclerotherapy appears to be effective in a majority of published trials, but comparative effectiveness, efficacy and safety of most agents, including phenol versus tetracycline, has not been established A deliberate strategy of re-treatment until cure is not universally practised, with surgery still being offered after single-treatment failures.