Revisiting Africa's Stroke Obstacles and Services (SOS).

Background: As one of the most common non-communicable diseases in Africa, Stroke ought to be dealt with properly with intensifying efforts to control its burden and to face obstacles in its management.

Methods And Results: In this follow-up study we reanalyzed stroke services and related obstacles in 17 African countries that were previously studied in 2021/22 in aspects related to manpower, acute stroke services, rehabilitation programs, number of stroke units/centers, telestroke services, awareness campaigns, and national and international stroke registries through a survey that was sent to stroke specialists and national stroke societies. Overall, there is an improvement in many fields yet many obstacles in the implementation of telestroke services, acute management, secondary prevention, post-discharge services, and follow-ups whether governmental, medical, or societal are prevalent.

Stroke services in Africa: What is there and what is needed.

Background: Over the past few years, the incidence and prevalence of stroke has been rising in most African countries and has been reported as one of the leading causes of morbidity and mortality. To study this problem, we need to realize the quality and availability of stroke care services as a priori to improve them.

Methods And Results: In this study, we investigated the availability of different stroke-related services in 17 countries from different African regions.

Surface Modification of Cellulose Nanocrystals via RAFT Polymerization of CO-Responsive Monomer-Tuning Hydrophobicity.

Cellulose nanocrystals (CNCs) were converted into a CO-responsive composite nanomaterial by grafting poly(dimethylaminoethyl methacrylate) (PDMAEMA), poly(diethylaminoethyl methacrylate) (PDEAEMA), and poly(diisopropylaminoethyl methacrylate) (PDPAEMA) onto its surface using both grafting-to and grafting-from approaches. The zeta potential (ζ) of the graft-modified CNC could be reversibly switched by protonation/deprotonation of the tertiary amine groups simply by sparging with CO and N, respectively. Depending on the grafting density and the molecular weight of the polymer grafts, CNC can form stable aqueous dispersions at either mildly acidic pH (under CO) or mildly basic (under N) conditions.

The Use of Incremental Peritoneal Dialysis in a Large Contemporary Peritoneal Dialysis Program.

Background: The use of an incremental peritoneal dialysis (PD) strategy in a large contemporary patient population has not been described.

Objective: We report the use of this strategy in clinical practice, the prescriptions required, and the clearances achieved in a large center which has routinely used this approach for more than 10 years.

Design: This is a cross-sectional observational study.

Has the 'Fast-Track' referral system affected the route of presentation and/or clinical outcomes in patients with colorectal cancer?

Background: The aim of this study is to determine whether the 'Fast-Track' referral system has changed the route by which patients present with colorectal cancer (CRC) and whether the route of presentation has any effect on clinical outcome.

Methods: A retrospective cohort study of patients diagnosed with CRC under the care of two consultant colorectal surgeons between April 2006 and December 2012. The route by which patients presented was categorised as Fast-Track (FT), non-Fast-Track (non-FT) or acute.

Short communication: Nalpha-lauroyl-L-arginine ethylester monohydrochloride reduces bacterial growth in pasteurized milk.

Effective strategies for extending fluid milk product shelf-life by controlling bacterial growth are of economic interest to the dairy industry. To that end, the effects of addition of l-arginine, Nalpha-lauroyl ethylester monohydrochloride (LAE) on bacterial numbers in fluid milk products were measured. Specifically, LAE was added (125, 170, or 200 mg/L) to conventionally homogenized and pasteurized 3.

Molecular subtyping and characterization of psychrotolerant endospore-forming bacteria in two New York State fluid milk processing systems.

Psychrotolerant endospore-forming bacteria Bacillus and Paenibacillus spp. are important spoilage organisms in fluid milk. A recently developed rpoB subtyping method was applied to characterize the diversity and phylogenetic relationships among Bacillus and related sporeformers associated with milk processing systems.

Tracking spore-forming bacterial contaminants in fluid milk-processing systems.

The presence of psychrotolerant Bacillus species and related spore formers (e.g., Paenibacillus spp.

Prostaglandin F2alpha increases the sensitivity of the contractile proteins to Ca2+ in human myometrium.

It is not known whether agonists (other than oxytocin) increase the contractile protein sensitivity to intracellular calcium ([Ca2+]i) in human myometrium. We determined the calcium-tension relationship in the presence and absence of prostaglandin F2alpha (PGF2alpha). PGF2alpha increased the calcium sensitivity during both the contractile (rising) and relaxation (falling) phases of a contraction.

Anti-inflammatory and relaxatory effects of prostaglandin E2 in myometrial smooth muscle.

The onset of human labour is complex and involves multiple mediators, prostaglandins, cytokines and chemokines. However, whilst prostaglandins are routinely used for labour induction and inhibitors of prostaglandin synthesis are used to prevent pre-term labour, these practices are not invariably successful, and the rationale for their use is equivocal. As COX-2 and prostaglandin E(2) (PGE(2)) production is increased towards term, we have investigated the effect of PGE(2) and other cAMP-elevating agents on events associated with labour induction.

A prospective randomised trial of probiotics in critically ill patients.

Background And Aims: Probiotics exert a beneficial effect on the host through modulation of gastrointestinal microflora. The aim of this study was to investigate the effect of the probiotic Lactobacillus plantarum 299v on gut barrier function and the systemic inflammatory response in critically ill patients.

Subjects And Methods: One hundred and three critically ill patients were randomised to receive an oral preparation containing L.

An investigation into the effect of a probiotic on gut immune function in surgical patients.

Background: The gut-associated lymphoid tissue (GALT) is an important component of the gut barrier. We have previously demonstrated a significant increase in various parameters of gut immune function in association with bacterial translocation. Animal studies have suggested that the probiotic Lactobacillus plantarum 299v improves the immunological status of the intestinal mucosa.

Optimal nutritional support.

There is ongoing debate about the respective roles of enteral and parenteral nutrition. The present short review suggests that these two feeding modalities are not mutually exclusive and that optimal nutritional support may necessitate the concomitant administration of enteral together with parenteral nutrition.

What factors affect lymph node yield in surgery for rectal cancer?

Objective: The detection of lymph node metastases is of vital importance in patients undergoing excisional surgery for rectal cancer as it provides important prognostic information and facilitates decision-making with regards to adjuvant therapy. It has been suggested that patients in whom only a small number of nodes are present in the excised specimen have a worse prognosis, presumably due to inadequate lymphadenectomy and consequent understaging of the disease. The aim of this study was to determine which factors affect the yield of lymph nodes.

Effect of an oxytocin receptor antagonist and rho kinase inhibitor on the [Ca++]i sensitivity of human myometrium.

Objective: The purpose of this study was to assess the possible mechanism and effect of oxytocin receptor on the sensitization of the contractile proteins to [Ca(++)](i).

Study Design: Myometrial strips were prepared from biopsy specimens that had been taken at term (37-40 weeks of gestation) cesarean delivery from 22 women, before the onset of labor. Simultaneous measurements of [Ca(++)](i) and tension were performed on spontaneously contracting strips.

An investigation into the sensitivities of translocating bacteria to a prophylactic antibiotic regimen.

Introduction: It is well established that bacterial translocation is associated with a significant increase in septic morbidity. The purpose of this study was to determine the antibiotic sensitivities of translocating bacteria on the basis that this information may influence antibiotic prophylaxis in surgical patients.

Methods: Routine microbiological techniques were used to assess the antibiotic sensitivities of those bacteria cultured from a mesenteric lymph node harvested at laparotomy in a large series of patients.

A prospective randomised study of the probiotic Lactobacillus plantarum 299V on indices of gut barrier function in elective surgical patients.

Background: Bacterial translocation occurs in surgical patients and may predispose to postoperative septic morbidity. Many factors are thought to influence the prevalence of bacterial translocation, one of which is the composition of the gut microflora. The aim of this prospective and randomised study was to assess the effect of the probiotic Lactobacillus plantarum 299v on the incidence of bacterial translocation, gastric colonisation, and septic complications in elective surgical patients.

Gastric colonisation, intestinal permeability and septic morbidity in acute pancreatitis.

Introduction: Bacterial translocation (BT) may represent an important cause of septic morbidity in patients with acute pancreatitis. We have previously demonstrated an association between BT, septic morbidity and colonisation of the proximal GI tract. Alterations in intestinal permeability (IP) may also predispose to BT.

Bacterial translocation and immunohistochemical measurement of gut immune function.

Aims: The local immune response in the small bowel mucosa might play a role in bacterial translocation (BT). The aim of this study was to quantify immune cells and secretory antibodies in the small bowel mucosa, and relate this to BT as assessed by culture of a mesenteric lymph node.

Methods: Immunohistochemical techniques were used to measure the frequency of plasma cells and IgA and IgM positive cells in the lamina propria and semiquantitatively to assess mucosal surface IgA and IgM values in small bowel specimens obtained from 11 patients in whom positive evidence of BT had been identified in a mesenteric lymph node harvested at the time of laparotomy.

In a medium containing glucose, lactate carbon is incorporated by gonococci predominantly into fatty acids and glucose carbon incorporation is increased: implications regarding lactate stimulation of metabolism.

The reason for stimulation by lactate of metabolism of gonococci growing in a medium containing glucose, which enhances pathogenicity by increasing growth rate, lipopolysaccharide (LPS) synthesis and protein formation, has been investigated. Tricine dodecylpolyacrylamide gel electrophoresis (SDS-PAGE) and thin layer chromatography (TLC) on homogenates of gonococci grown in this medium with [14C]lactate showed that lactate carbon was preferentially incorporated into lipid and LPS. Nuclear magnetic resonance (NMR) spectroscopy on lipid extracted from gonococci grown in the glucose containing medium with [13C]lactate showed that lactate carbon was incorporated into fatty acid moieties and not into ethanolamine or glycerol moieties.

Enteral versus parenteral nutrition: a pragmatic study.

Controversy persists as to the optimal means of providing adjuvant nutritional support. The aim of this study was to compare enteral nutrition (EN) and parenteral nutrition (TPN) in terms of adequacy of nutritional intake, septic and nonseptic morbidity, and mortality. This was a prospective pragmatic study, whereby the route of delivery of nutritional support was determined by the attending clinician's assessment of gastrointestinal function.

Oral dietary supplements in pre- and postoperative surgical patients: a prospective and randomized clinical trial.

It has been suggested that the routine provision of oral dietary supplements (ODS) in postoperative surgical patients is of benefit in terms of morbidity and length of hospital stay. The aim of this study was to evaluate the effects of both pre- and postoperative ODS in patients undergoing an elective laparotomy. Patients requiring elective major gastrointestinal surgery were prospectively randomized into one of four groups: Group I received ODS in addition to normal diet both pre- and postoperatively, Group II were given ODS in the preoperative period only, Group III received ODS only in the postoperative period, and Group IV did not receive any supplements.

Bacterial translocation in patients undergoing abdominal aortic aneurysm repair.

Background: Bacterial translocation occurs in humans and is associated with an increased incidence of septic morbidity. The aims of this study were to determine the prevalence of bacterial translocation in patients undergoing open abdominal aortic aneurysm (AAA) repair and to identify any association with postoperative septic complications.

Methods: This was a prospective observational study in which patients undergoing aneurysm repair were assessed for evidence of bacterial translocation by culture of a mesenteric lymph node (MLN), small bowel serosal exudate and thrombus within the aneurysm.