Once weekly azithromycin in secondary prevention of rheumatic fever.

Rheumatic fever and rheumatic heart disease (RHD) are still important problems in developing countries. Secondary prophylaxis which is the most cost-effective method in preventing recurrences of rheumatic fever is fraught with problems of drug compliance. The utility of 500 mg once weekly azithromycin (AZT), an orally effective long-acting antibiotic was evaluated against oral penicillin (phenoxy methyl penicillin 250 mg twice daily) in this study.

Cushing disease with pregnancy.

Pregnancy occurs rarely in patients with Cushing syndrome (CS) due to hypercortisolism. So far, about 150 cases of CS in pregnancy have been reported in the literature. We describe a 22-year-old female who presented in pregnancy with clinical features of CS.

Applications of circular dichroism for structural analysis of gelatin and antimicrobial peptides.

Circular dichroism (CD) is a useful technique for monitoring changes in the conformation of antimicrobial peptides or gelatin. In this study, interactions between cationic peptides and gelatin were observed without affecting the triple helical content of the gelatin, which was more strongly affected by anionic surfactant. The peptides did not adopt a secondary structure in the presence of aqueous solution or Tween 80, but a peptide secondary structure formed upon the addition of sodium dodecyl sulfate (SDS).

Research without results: inadequate public reporting of clinical trial results.

Objective: In order to increase transparency in the medical literature, the Food and Drug Administration (FDA) Modernization Act of 1997 and the FDA Amendment Act of 2007 required registration of all "applicable trials" with required "basic results" reporting. We evaluated the rate of compliance with the FDA mandatory results reporting in www.clinicaltrials.

Cerebellar toxoplasmosis in HIV/AIDS infant: case report and review of the literature.

Cerebellar mass lesion is an uncommon presentation of toxoplasmosis. The authors report one rare case in an 11-month-old HIV/AIDS female infant who presented with deterioration in her developmental milestones. CT scan revealed a ring-enhancing mass lesion in the right cerebellar hemisphere with secondary obstructive hydrocephalus.

Hyperinfection with Strongyloides in a HIV-negative elderly male.

Strongyloides stercoralis is an intestinal nematode producing mild infection in the immunocompetent and fatal hyperinfection syndrome in the immunocompromised. An elderly HIV-negative male presented with symptoms of chronic respiratory disease and vague abdominal symptoms. Examination of sputum and stools showed larvae of S.

IL-23-dependent IL-17 drives Th1-cell responses following Mycobacterium bovis BCG vaccination.

The generation of effective type 1 T helper (Th1)-cell responses is required for immunity against intracellular bacteria. However, some intracellular bacteria require interleukin (IL)-17 to drive Th1-cell immunity and subsequent protective host immunity. Here, in a model of Mycobacterium bovis Bacille Calmette-Guerin (BCG) vaccination in mice, we demonstrate that the dependence on IL-17 to drive Th1-cell responses is a host mechanism to overcome bacteria-induced IL-10 inhibitory effects.

IL-23 is required for long-term control of Mycobacterium tuberculosis and B cell follicle formation in the infected lung.

IL-23 is required for the IL-17 response to infection with Mycobacterium tuberculosis, but is not required for the early control of bacterial growth. However, mice deficient for the p19 component of IL-23 (Il23a(-/-)) exhibit increased bacterial growth late in infection that is temporally associated with smaller B cell follicles in the lungs. Cxcl13 is required for B cell follicle formation and immunity during tuberculosis.

Bioinformatics in crosslinking chemistry of collagen with selective cross linkers.

Background: Identifying the molecular interactions using bioinformatics tools before venturing into wet lab studies saves the energy and time considerably. The present study summarizes, molecular interactions and binding energy calculations made for major structural protein, collagen of Type I and Type III with the chosen cross-linkers, namely, coenzyme Q10, dopaquinone, embelin, embelin complex-1 & 2, idebenone, 5-O-methyl embelin, potassium embelate and vilangin.

Results: Molecular descriptive analyses suggest, dopaquinone, embelin, idebenone, 5-O-methyl embelin, and potassium embelate display nil violations.

Reversed sequence enhances antimicrobial activity of a synthetic peptide.

A class of cationic antimicrobial peptides involved in host defense consists of sequences rich in Lys and Trp. Small peptides, (WK)(3) and (KW)(3) , were designed by the combination of alternating Lys (K) and Trp (W) amino acids, and then their antimicrobial and hemolytic activities were determined. It was noticed that the reversed sequence of (KW)(3) showed more activity against all strains than did (WK)(3) .

IL-17 in protective immunity to intracellular pathogens.

The identification of a new T cell subset referred to as T helper 17 (Th17) cells and its role in protective immunity against extracellular bacterial infections is well established. In contrast, initial studies suggested that the IL-23-IL-17 pathway was not required for protection against intracellular pathogens such as mycobacterial infections. However, recent studies demonstrate that Th17-IL-23 pathway may play a crucial role in protective immunity against other intracellular pathogens by regulating the innate and adaptive immune responses.

Regulation of chemokine responses in intestinal epithelial cells by stress and Toxoplasma gondii infection.

Infection with Toxoplasma gondii induces chemokine up-regulation in several cell types. Here, we investigated the role of stress products (norepinephrine, NE) on chemokine production in mouse intestinal epithelial cells (IECs). Purified IECs were used to determine the expression levels of chemokines by real-time PCR.

Laser-induced chlorophyll fluorescence: a technique for detection of dimethoate effect on chlorophyll content and photosynthetic activity of wheat plant.

Laser-induced chlorophyll fluorescence (LICF) spectra and fluorescence induction kinetics (FIK) curves of wheat plant leaves treated with different concentrations (50, 100 and 200 ppm) of dimethoate are recorded. LICF spectra are recorded in the region of 650-780 nm using violet diode laser (405 nm) and FIK curve at 685 and 730 nm with red diode laser (635 nm) for excitation. The fluorescence intensity ratios (FIR) are determined from LICF spectra and vitality index (R(fd)) from FIK curves.

Clinical profile of insulinoma: analysis from a tertiary care referral center in India.

Objective: To describe the clinical presentation, localization techniques, surgical procedures and outcome in patients with insulinoma.

Methods: Retrospective analysis of case records of patients diagnosed with insulinoma between January 1993 and June 2009 at a tertiary-care hospital was done. Seventeen patients underwent diagnostic 72-h fast.

Phenotype and radiological correlation in patients with growth hormone deficiency.

Objective: To confirm that MRI findings like hypoplastic anterior pituitary, thin or interrupted pituitary stalk, and ectopic posterior pituitary (EPP) in patients with growth hormone deficiency are a good indicator of the severity of hypopituitarism.

Methods: MR images were obtained for 44 patients (IGHD: CPHD; 30:14) and analyzed to define one or more of the following triad of abnormalities: small/absent anterior pituitary, thin or interrupted pituitary stalk, and EPP, as well as for any other associated anomalies. The findings were correlated with the clinical and biochemical presentation.

Predictors of persistent burnout in internal medicine residents: a prospective cohort study.

Purpose: Resident burnout continues to be a major problem despite work hours restrictions. The authors conducted a longitudinal study to determine whether burnout in internal medicine residents is persistent and what factors predispose residents to persistent burnout.

Method: The authors mailed a survey to internal medicine residents at the University of Colorado Denver Health Science Center each May, from 2003 through 2008.

ACR Appropriateness Criteria® on Induction and Adjuvant Therapy for Stage N2 Non-Small-Cell Lung Cancer: expert panel on radiation oncology-lung.

"The American College of Radiology seeks and encourages collaboration with other organizations on the development of the ACR Appropriateness Criteria through society representation on expert panels. Participation by representatives from collaborating societies on the expert panel does not necessarily imply society endorsement of the final document."

Bone age and factors affecting skeletal maturation at diagnosis of paediatric Cushing's disease.

Paediatric Cushing's disease (CD) is usually associated with growth retardation, but there are only few published data on skeletal maturation at diagnosis. We analysed factors contributing to skeletal maturation and final height in Asian Indian patients with paediatric CD. We conducted retrospective analysis of 48 patients (29 males; 19 females) with mean age: 14.

Antibiotic and synergistic effect of Leu-Lys rich peptide against antibiotic resistant microorganisms isolated from patients with cholelithiasis.

Pseudomonas aeruginosa has eventually developed resistance against flomoxef sodium, isepamicin and cefpiramide. Therefore, in this study, the antibacterial activity and synergistic effects of the amphipathic-derived P5-18mer antimicrobial peptide were tested against pathogens associated with cholelithiasis that have developed resistance against commonly used antibiotics. The results were then compared with the activities of the amphipathic-derived peptide, P5-18mer, melittin and common antibiotics.

Clinical profile of primary hyperparathyroidism from western India: a single center experience.

Background: Primary hyperparathyroidism (PHPT) has a variable clinical presentation and symptomatic PHPT is still the predominant form of the disease in India. Data from western India is lacking.

Aim: To present the clinical profile of PHPT from western India.

Efficacy of cabergoline in uncured (persistent or recurrent) Cushing disease after pituitary surgical treatment with or without radiotherapy.

Objective: To evaluate the efficacy of cabergoline therapy in patients with Cushing disease who remained uncured (had persistent or recurrent disease) after a pituitary surgical procedure with or without radiotherapy.

Methods: We undertook a prospective, open-label, single-arm study, with short-term (5 months) and longterm (1 year) evaluations. In 20 patients with uncured Cushing disease, treatment was initiated with cabergoline at a dosage of 1 mg/wk, with a monthly increment of 1 mg, until midnight serum cortisol (MNSC) or low-dose dexamethasone suppression serum cortisol (LDSC) (or both) normalized or a maximal dosage of 5 mg/wk was reached.

A case of neonatal diabetes.

A one month old baby was admitted for diabetic keto-acidosis. There was no neurological or dysmorphic features. On genetic analysis a heterozygous missense mutation of ABCC8 gene which codes for SUR1 was detected.

Radiotherapy in paediatric Cushing's disease: efficacy and long term follow up of pituitary function.

Pituitary radiotherapy (RT) is an effective second-line treatment for paediatric Cushing's disease (CD). We report long-term efficacy and anterior pituitary function in a cohort of paediatric CD patients treated with RT. Between 1988 and 2008, from our cohort of 48 paediatric CD patients, eight paediatric CD patients (5 males and 3 females) underwent second-line pituitary RT (45 Gy in 25 fractions), following unsuccessful transsphenoidal surgery.

Prognostic implication of dual-phase PET in adenocarcinoma of the lung.

Unlabelled: The purpose of this study was to determine whether dual-phase (18)F-FDG PET could be a prognostic factor for adenocarcinoma of the lung.

Methods: One hundred patients with histologically proven adenocarcinoma of the lung were included in this retrospective analysis. All patients underwent dual-phase pretherapy (18)F-FDG PET for which, after the intravenous administration of (18)F-FDG, both early (approximately 60 min) and delayed (approximately 90 min) PET were acquired.

Treatment of hypogonadism with testosterone in patients with type 2 diabetes mellitus.

Objective: To investigate the effect of testosterone treatment on insulin resistance, glycemic control, and dyslipidemia in Asian Indian men with type 2 diabetes mellitus (T2DM) and hypogonadism.

Methods: We conducted a double-blind, placebo-controlled, crossover study in 22 men, 25 to 50 years old, with T2DM and hypogonadism. Patients were treated with intramuscularly administered testosterone (200 mg every 15 days) or placebo for 3 months in random order, followed by a washout period of 1 month before the alternative treatment phase.