All these data suggest that

All these data suggest that the effect of PRL on sexual behavior is mediated by high and sustained PRL levels. Conversely, in order to observe changes in a short time, is necessary the administration of PRL directly in the CNS to modify the sexual behavior parameters (Cruz-Casallas et al., 1999).
However, data obtained in a parallel study in our lab, showed that moderate increases in PRL levels were enough to induce changes in the morphology of the prostatic tissue and, hence, could be able to modify the sexual behavior in sexually experienced male rats (Hernandez et al., 2006). For that reason, the present study aims to analyze the acute increments in HG-9-91-01 levels on sexual behavior of male rats subjected to fifteen treatment days.

Materials and Methods

Results

Discussion
Several clinical studies sustained that erectile dysfunction is the main symptom of chronic hyperprolactinemia (Martinez-Jalaboyas, 2010), however, this study was designed to compare if the induction of an acute HP to sexual experienced male rats, it was able to induce an impairment of the anticipatory/consummatory phases of sexual behavior.
Table 1. Sexual behavior parameters. The table shows data oobtained in the sexual behavior parameters tested in the four groups. The first mount latency increased in the oPRL and Graft group. The intromission frequency was not afected with any treatment, while the mount frequency, increased in the graft group. In the same way, the first Intromission-Ejaculation Latency showed an increase in the graft group and the Efficiency of Copulatory Interactions (Hit rate) (I + E/M + I + E) decreased in the same group. Values are described as means ± SEM.
Interestingly, this effect was not observed in subjects with oPRL administration. The probable explanation, is due to the used dose (100μg/d), since with this concentration, PRL levels increase only temporarily (40 ng/ml), returning to physiological levels after a while (12-14 ng/ml). This is consistent with studies reporting negative effects on sexual behavior with the induction of a sustained Hyperprolactinemia (>100 ng/ml/d) (Martinez-Jalaboyas, 2010; Abram et al., 1998; Doherty et al., 1985; Katovich et al., 1985). For that reason, the HP induced in the graft group (40ng/ml), was enough to modify the sexual function, with significant effects on the sexual behavior parameters tested (Hernandez et al., 2007).
The plasmatic PRL levels were slightly increased in the control group, however, are not related with a pathological condition, since some studies have shown that the acute increases in prolactin levels after coitus, are related with sexual satiety, suggesting the participation of PRL in different contexts of sexual behavior, like has been reported previously (Hernandez et al., 2006; Hernandez et al., 2007).
Accumulating data suggest that the neurotransmitter DA, plays an important role in the sexual behavior regulation, results presented here, supported this hypothesis and proposed strongly that PRL is able to induce alterations in DA levels in specific brain areas associated with the male copulatory activity (Giuliano & Allard, 2001b). The precise mechanism of how DA modiies the sexual behavior has been discussed. It has been shown that some neural nuclei are associated with specific phases of sexual behavior, for example, the nucleus accumbens and medial preoptic area, are associated with anticipatory and consummatory phases of sexual behavior, for that reason, the first intromissionejaculation latency was increased in the pituitary graft group (Giuliano & Allard, 2001[a; b]). Moreover, nucleus accumbens plays a central role in the reward circuit, in which, dopamine and serotonine are regulators of desire and saciety, so, when this nucleus is impaired, the frequency of intromissions and ejaculations are decreased together with the mount latency. On the other hand, the impairment of the paraventricular nucleus only modiies the mount frequency, suggesting that, in our model, prolactin could be afecting DA levels in specific brain areas (Paredes & Agmo, 2004).

Additionally PSG and IS extracts caused a

Additionally, PSG and IS extracts caused a reduction of the general carbohydrate levels in the liver especially after 7days of administration. Similar findings were stated for the ink of sea hares A. oculifera and A. fasciata (Moustafa, 2005). The alteration of carbohydrate distribution might be caused by abnormal metabolism of buy Forskolin in the liver and may be due to the accumulations of the extracts in the hepatocytes as well as the hepatocyte degeneration.
Regarding the histopathological changes induced in the spleen, the PSG and IS extracts of O. vulgaris had mild effects represented in the lymphocyte aggregations and red pulp infiltration, increasing in megakaryocytes number and mild distortion in the follicle shape. This finding of the increased number of megakaryocytes was in accordance with the present hematological data which clarify highly increased platelet numbers of animals administrated with both PSG and IS extracts. It is known that, megakaryocytes are the cells responsible for the production of platelets (Fortoul et al., 2008). Severe destructive effects on splenic macrophage of mice are induced by 50mg protein/kg of the ink of the sea hare A. dactylomela (Moustafa and Mohamed, 2012). The marine algal toxin azaspiracids isolated from mussels demonstrated necrosis in spleen and injured in both T and B lymphocytes using different doses from 0.3 to 0.45mg/kg doses injected twice into mice (Ito et al., 2002).
In the present study, the most remarkable data of hematological parameters were concerned with the significant increase of platelets, WBCs, and a significant decrease of granulocytes and lymphocytes in the case of PSG administration. Herein, the significant increase in platelets may be due to the hemolytic activity of the PSG extract which was previously reported for some octopuses in sheep and human RBCs, respectively (Key et al., 2002; Karthigayan et al., 2006). It is well known that, WBCs play the key role in immune response and protecting the body against foreign invaders and diseases (Davis et al., 2008). Therefore, these changes are an indicator for the immunity decrease after administration of the PSG extract of O. vulgaris in mice. The PSG extract of O. aegina caused an increase in WBCs and decrease in lymphocytes, RBCs, hemoglobin in mice bearing Ehrlich’s ascites carcinoma (Karthigayan et al., 2007). With the same dose, the venom of cone snail C. loroisii showed no significant alterations with WBCs and MCHC while, it showed reductions in RBCs, MCV, HGB, HCT, MCH and platelets number (Saminathan et al., 2006).
In the present investigation PSG and IS extracts caused similar impacts on the ileum, and their impacts appeared only after 7days. They showed villi hyperplasia, epithelial and lamina propria degeneration, detachment from epithelium and lymphocyte infiltration. In addition, these extracts reduced ileal mucopolysaccharides especially after 7days of administration. The reduction of the polysaccharides in the ileum might explain the data of the reduction of the general carbohydrates of the liver after administration of these extracts. The oral administration of azaspiracid isolated from mussels showed necrosis in the ileal lamina propria, besides interstitial pneumonia and shortened villi of the small intestine (Ito et al., 2000). Oral administration of a mixture of the shellfish toxin yessotoxin and homoyessotoxin revealed degenerative lesions in the small intestine of mice (Tubaro et al., 2003). A shellfish toxin contaminant in Japanese scallops P. yessoensis known as pectenotoxin-6 showed erosion by edema to ileal villi when rats were orally administrated with a dose of 2mg/kg (Ito et al., 2008).
In conclusion, the present results reported for the first time, histopathological and histochemical effects induced by the oral administration of the PSG extract in comparison to the IS extract of O. vulgaris in mice. Some hematological and biochemical parameters were measured to support these impacts and the toxicity of ink extract of O. vulgaris in mice was stated for the first time. The present investigation provides new knowledge about the toxicity of common octopus ink to people in the countries which depend mainly on this extract as additives in their food. Furthermore, our findings open the way needed for further studies on the use of these extracts as promising drugs.

In this study FeAl O which is

In this study, FeAl2O4, which is a representative antiferromagnetic spinel, is synthesized using single-mode 2.45GHz microwave irradiation, and the effect of the magnetic field on the structure and magnetic characteristics of antiferromagnetic oxide is studied.

Experimental procedure
A powder mixture of 61wt% γ-hematite (99% purity, with particle diameters of approximately 1μm from Kojundo Chemical Lab. Co., Ltd., Saitama, Japan) and 39wt% γ-alumina (99.99% purity, 2–3μm, from Kojundo Chemical Lab. Co., Ltd., Saitama, Japan) was compacted to 6-mm-diameter pellets. For the conventional heating, an electric furnace was used and the samples were maintained at 1600°C for 2min. For microwave heating, a single-mode heating system was used. The system was composed of a magnetron (IMP-15ENA, IDX Co., Ltd., Tochigi, Japan; 2.45GHz), an isolator, a power monitor, three stub tuners, a TE10 cavity (length: 150mm), and a plunger. In the cavity, a standing wave was produced and the sample pellets were positioned and irradiated with microwaves at the point where the H-field was the maximum. The pellets were then placed in a quartz tube, which was transparent to 2.45GHz microwave and infrared radiation. The temperature of the sample was measured using an infrared pyrometer. After irradiation, the sample was rapidly cooled in air because there was no insulator. A detailed description of the experimental setup of the microwave furnace and the electromagnetic distribution in the cavity are given in our previous paper [12]. For the conventional heating, an electric furnace (SPM 100-17, Marusho Electro-Heat Co., Ltd., Hyogo, Japan) was used. After heating at 1600°C for 2min, the sample was carboxypeptidase removed from the furnace and rapidly cooled either in air or with water.
The irradiated or heated sample was analyzed by X-ray diffraction (XRD) using monochromatic Cu-Kα radiation. Magnetization and magnetic susceptibility were measured using a magnetic torsion balance (MB-11, Shimadzu Co., Kyoto, Japan) in the temperature range 25–600°C under a magnetic field up to 10kOe (796kA/m). Transmission carboxypeptidase microscopy (TEM) was used to investigate the microstructure of the sample. The temperature dependence of the specific heat was measured using differential scanning calorimetry (Q2000, TA Instruments, Japan).

Results and discussion

Conclusion
The structure and magnetic properties of FeAl2O4 synthesized by microwave H-field irradiation were investigated to reveal the effect of the microwave magnetic field on the structures and magnetic characteristics of antiferromagnetic materials. From the results of this study, the following conclusions can be drawn:

Acknowledgement

Introduction
Lithium disilicate glasses have been extensively studied [1–5] and have been clinically applied in dental restoration. Desired physical and mechanical properties can be attainable through a controlled annealing procedure. The annealing process controls the phase formation and transformation, microstructure, crystallinity and hence properties of the glass-ceramics. In the development of multi-component lithium disilicate glass, phosphorus pentoxide (P2O5) is a common additive [6] to promote crystallization in a wide range of glasses, e.g., Li2O–Al2O3–SiO2, Li2O–MgO–SiO2, and MgO–Al2O3–SiO2 systems. Since its discovery, there have been a large number of investigations on how P2O5 affects the nucleation and crystallization processes in glass [2–5,7–10]. A popular hypothesis is that P2O5 or Li3PO4 promotes phase separation in Li2O–SiO2 glasses [4]. As summarized by Wen and Zheng [1,2], these glasses, in most cases are either ZnO-containing or Al2O3-containing.
The reported values of flexural strength and fracture toughness for lithium disilicate glass-ceramics are generally 215–350MPa using three-point or four-point bend test and 3–3.4MPa·m0.5 using single-edge notched beam (SENB) method [11]. Glass-ceramics having high-strength and high-fracture toughness are in increasing demand in dental restorative applications. Von Clausbruch et al. [5] from Ivoclar Vivadent AG reported a ZnO-containing lithium disilicate with a flexural strength of 440MPa in the SiO2–Li2O–K2O–ZnO–P2O5 system using three-point bending test. Ivoclar has also reported a high flexural strength of 726MPa in a ZnO-free SiO2–Li2O–Al2O3–K2O–ZrO2–P2O5 system [3,12], using a biaxial bending method as per ISO standard 6872. To the best of our knowledge, the three-point flexural strength of this glass is not available in the literature. In our recent work, we tested a similar composition glass by three-point bending and only attained 307MPa [13].

In this paper we combined the advantages of

In this paper, we combined the advantages of meso- and microporous molecular sieves to synthesize the Y/MCM-48 composite molecular sieve by hydrothermal method with the aid of fluoride ions. In particular, we focus on investigation on thermal, hydrothermal, acidic and basic stabilities of Y/MCM-48 composite molecular sieve. Various methods such as XRD, SEM, TEM and N2 physical adsorption technique were used to characterize the resulting Y/MCM-48 composite molecular sieve. Moreover, the effect of crystallization temperature and time on synthesis process was investigated in detail.

Experimental

Results and discussion

Conclusions
Y/MCM-48 composite molecular sieve with mesoporous and microporous structure was successfully synthesized by hydrothermal method with the aid of fluoride ions. The addition of fluoride ions can improve the ordering of the mesoporous phase in the composite. After the Y/MCM-48 composite was thermally treated at 800°C for 4h or hydrothermally treated at 100°C for 48h, the mesoporous structure in the composite is still maintained and the Y/MCM-48 composite has good thermal and hydrothermal stabilities. The acidic buspirone hcl of the composite is better than the basic stability. Even after being treated in 1mol/L HCl solution for 48h, the obtained composite sample still has obvious mesoporous structure and good mesoporous ordering.

Introduction
With increasing revolution in science and technology, there was a bigger demand on opting for newer chemicals which could be used in various industrial processes. Among many new chemicals, organic dyes came up as one of the most widely used chemical stuff which could be used in many industrial activities. Therefore, dyes have become integral part of all industrial effluents. Unprocessed textile effluents are highly poisonous in nature as they contain a large number of organic and inorganic dyes. The bigger environmental responsiveness is for effective treatment of industrial effluent [1]. The colouring pigments such as anthraquinone or azo groups present in the anionic, cationic or non-ionic dyes, which have complex chemical structure are very difficult to degrade at normal condition [2]. Recently greater attention has been committed to the study of removal of dyes and pigments from industrial effluents and waste water by adsorption process using nanostructured materials [3]. Usually organic and inorganic dyes are removed by different chemical and physical techniques, such as chemical reaction, electro-coagulation, reverse osmosis, adsorption, flocculation, electro-floatation, ion exchange, membrane filtration, electrochemical destruction, precipitation and many others [4]. Among all these techniques, adsorption technique has been found to be superior to other techniques for waste water treatment in terms of initial cost, simplicity of design, ease of operation and insensitivity to toxic substances [5].
Malachite green (MG) is a synthetic dye which is commonly used for dyeing of cotton, silk, paper, and leather industries, in manufacturing of paints and printing inks, and as a food colouring agent, food additive, and medical disinfectant. However, despite its use, MG is hazardous because of its adverse effects on the immune and reproductive systems, carcinogenic, genotoxic, mutagenic and teratogenic properties [6,7]. For these reasons the United States and the European Council have imposed a strict ban on the use of MG in all categories of food. In addition to this, discharge of MG into the hydrosphere can cause severe ecological imbalance as it gives undesirable colour to water and reduces sunlight penetration that harms aquatic life. Therefore, it is important to remove MG from aqueous effluents before they are discharged into bodies of water.
In the past few years zinc-titanium based oxide materials (Zn–Ti–O) have been used widely because of their outstanding properties and potential scientific and technical applications [8]. Recently, zinc titanates have been investigated for application in many fields such as regenerable sorbents for high-temperature hydrogen sulfide (H2S) removal from coal gasifier gas [9,10], gas sensors [11], humidity sensors [12], paint pigments [13], dielectric materials [14,15], antibacterial agents [16] and as photocatalysts [17,18]. It is reported by various authors that there are three compounds existing in the ZnO–TiO2, including cubic inverse-spinel type zinc ortho-titanate (Zn2TiO4), rhombohedral ilmenite type zinc meta-titanate (ZnTiO3) and cubic spinel type structured Zn2Ti3O8 which is considered as low-temperature form of ZnTiO3[19,20]. Among all these, nanosized crystalline ZnTiO3 is a highly significant material which has been used as adsorbent for the dyes.

br Results For the question Does the care

Results
For the question Does the care of patients under the influence of alcohol pose a problem for you? 62% of respondents gave a positive reply. Significantly more frequently than other units, ED employees replied that taking care of a patient under the influence of alcohol definitely poses a problem (p=0.032). Most of respondents (68%) admitted that carrying out medical treatment on these patients is difficult. In this group, there were 65.7% of ED employees and 55.9% employees from other wards (Fig. 1).
Nearly 60% of ED employees and half the employees of other units admitted that intoxicated patients evoke negative emotions while carrying out treatment and nursing activities (Fig. 2). These results turned out to be statistically significant (p=0.023). ED employees experience negative emotions significantly more frequently in the contact with these patients than medical staff from other departments.
Among the most frequently mentioned negative feelings evoked in the medical staff by intoxicated patients were aversion (35.9%), anger (33%), fear (31.6%), impatience (28.6%) and disgust (21.8%). Aggression was aroused in 10.2% of respondents. These patients, to a small extent, also evoke positive feelings like sympathy (9.7%) and compassion (6.3%) (Fig. 3).
The factors arousing the greatest staff aversion towards patients under the influence of alcohol are their vulgar behaviour (80.6%), state of intoxication (68.0%) and hygiene (43.7%). Some of respondents (39.3%) believe that work with these patients carries a potential health-risk. Hampered logical contact with such patients (32%) as well as the fact of being under the influence of alcohol itself (27.7%) are also the factors arousing aversion. One employee in four has the feeling their efforts are pointless (Fig. 4).
For the question Has it ever happened that while carrying out professional activities you have treated a patient under the influence of alcohol less favourably? 39.3% of all tested persons replied positively. A significant BV6 Supplier in the attitude towards this kind of patient was observed in relation to the respondent\’s place of employment (p=0.001). ED employees declared a significantly more frequently less favourable attitude towards patients under the influence of alcohol than the staff from the other wards (Fig. 2).
Nearly 40% of respondents (39.3%) carried out hygienic and nursing procedures towards intoxicated patients only in essential and necessary range and 11.2% admitted they avoided to carry out these procedures. Isolation was used towards this group of patients by 36.4% of tested persons. Furthermore, 21.4% of respondents limited satisfying patient\’s needs to a necessary minimum. More than 25% of respondents (25.7%) confessed to different behaviour towards intoxicated patients in comparison with other patients. As many as 10.7% of all tested persons used expressions negatively assessing this group of patients, 15.5% openly expressed negative feelings and 8.3% had committed verbal aggression. One third of employees (30.1%) stated that they did not use any behaviours mentioned in the questionnaire towards intoxicated patients (Fig. 5).
Tested employees were witnesses of the avoidance or delay of medical services in a case of intoxicated patient (21.8%) or unethical treatment of such a patient by medical staff (43.7%). Nearly 77% of respondents were witnesses of some kind of manifestation of aversion from female and male colleagues (Fig. 6).
One fourth of all tested persons (24.3%) believe that patients under the influence of alcohol have a difficult access to medical services. Job seniority had the significant influence on the opinion in this issue (p=0.035). Staff with over 20 years employment significantly more frequently declared there is no problem of difficult access to services for this group of patients.
Furthermore, most of members of medical staff (59.7%) are convinced that medical care for this group of patients should be provided by separate structures/institutions specialised in this respect (59.7%), 40.3% of respondents do not see such necessity, including 16% who oppose xylem definitely. Most supporters of this solution are among ED employees – as much as 51.6% see such necessity definitely, next 23.4% believe that it should be rather like that. Place of respondent employment had a significant influence on the opinion of forming separate medical care structures for intoxicated patients (p=0.015).

Table shows that in patients with mild AD

Table 2 shows that AEBSF in patients with mild AD dementia at baseline, the difference in treatment effect on cognition (ADAS-Cog14) was statistically significant for solanezumab in the full ITT cohort (P < .001) and across all five percentiles of clinical progression at week 80. The treatment difference was 2.13 points in the ITT cohort and increased from 1.06 points in the lowest quantile of progression to 2.56 points in the highest percentile of clinical progression. Also shown in Table 2, the difference in treatment effect on function (ADCS-iADL) was statistically significant for solanezumab in the ITT cohort (P = .045) and in the highest three percentiles of clinical progression (Table 2). The treatment difference was 1.21 points for the ITT cohort and increased from 0.25 points in the lowest quantile of progression to 2.16 points as the percentile of clinical progression increased. For ADAS-Cog14, the treatment effect in mild patients was increasing over time at higher percentiles (60th and 80th). For ADCS-iADL, the increasing effect was seen at the 60th percentile but was not apparent at the 80th percentile (Figs. 3 and 4). In patients with moderate AD dementia at baseline, there were no statistically significant treatment group differences within the ITT cohort or any percentile groups on either cognition or function measures at week 80 (Table 3).
Discussion
In patients with mild AD dementia, treatment effect of solanezumab was greater when clinical progression was more typical of amyloid-positive AD patients, that is, in percentiles with a theoretically larger homogenous subset of amyloid-positive patients. When patients\’ clinical progression was minimal, or atypical of amyloid-positive AD patients, solanezumab showed less effect in slowing disease progression, suggesting that in the ITT population, the effect of solanezumab may have been attenuated by a theoretically higher percentage of amyloid-negative patients. In patients with moderate AD dementia, solanezumab did not have a statistically significant treatment effect within any clinical progression percentile. Results reported herein based on quantile analyses are generally consistent with those previously obtained by LS mean analyses [11,12] regarding treatment effect of solanezumab in mild AD dementia and lack of treatment effect in moderate AD dementia.
Although the small number of patients with known amyloid status precludes robust statistical analysis, we did examine the ADAS-Cog14 change from baseline to week 80 data by quantile in patients with known amyloid status. For the amyloid-positive patients (N = 122), the probability of falling into the lowest percentile of clinical progression is 13.1% with patient distribution shifted to the higher quantiles. Conversely, for the amyloid-negative patients (N = 26), the probability of falling into the lowest percentile is 42.3% with patient distribution shifted to the lower quantiles. Thus, results in depth diversity gradient small number of known amyloid-positive and amyloid-negative patients are consistent with use of quantile regression to provide a hypothetical surrogacy for amyloid status and support three hypotheses. First, the effect of solanezumab may have been attenuated by the presence of amyloid-negative patients. Second, a small percentage of amyloid-positive patients in the lowest quantile of progression may explain the small treatment effect demonstrated in this group. Finally, solanezumab\’s treatment effect was not dominated by the lowest percentiles of clinical progression, theoretically composed of the highest percentage of amyloid-negative patients, but by the highest percentiles of clinical progression, theoretically composed of the highest percentage of amyloid-positive patients. Interestingly, 13.1% of amyloid-positive patients fell in the lowest percentiles of clinical progression, demonstrating that on an individual patient level, amyloid positivity does not guarantee clinical progression with other factors, including neurofibrillary tangle formation, neuronal loss, age, and cognitive reserve playing a modulatory role [6,17].

br Conflict of interest br Introduction Gastroesophageal reflux disease

Conflict of interest

Introduction
Gastroesophageal reflux disease (GERD) is one of the most common causes of chronic cough and often coexists with asthma or chronic obstructive pulmonary disease (COPD). A systematic review reported the prevalence of GERD symptoms to be 45%–71% in patients with asthma, whereas a Korean survey from the National Health Insurance Database found the prevalence of GERD to be 28% in patients with COPD. The current asthma guidelines recommend medical management of GERD in patients with symptoms of reflux and poorly controlled asthma, particularly those who have nocturnal symptoms. Previous studies demonstrated that COPD exacerbations were associated with GERD symptoms. GERD not only causes coughing but also affects the disease status in asthma and COPD, in both of which coughing is a common symptom in itself; however, very few have studied the differences in the effect of GERD on these diseases.
The prevalence of GERD varies depending on the diagnostic modalities. Upper gastrointestinal endoscopy is a conventional test but cannot definitively diagnose GERD if there is no erosive lesion. Esophageal pH monitoring is the current gold standard but cannot detect reflux events with a pH similar to that of the normal esophagus. Several questionnaires have been developed for the symptom-based diagnosis of GERD, including a questionnaire for the diagnosis of reflux disease (QUEST) and a frequency scale for symptoms of GERD (FSSG). FSSG is the standard questionnaire used in Japan for the diagnosis of GERD and assessment of the response to treatment. GERD symptoms can be quantified with FSSG but not with QUEST. Symptoms related not only to FMK reflux but also to gastric dysmotility can be evaluated with FSSG. We hypothesized that the effect of GERD would differ between asthma and COPD. In this cross-sectional real-world study we assessed the effect of GERD, which was diagnosed by FSSG, on the cough-related quality of life and disease status in patients with asthma and COPD. We used the Leicester Cough Questionnaire (LCQ) to assess the cough-related quality of life, and the Asthma Control Test (ACT) or COPD assessment test (CAT) questionnaires to assess the disease status.

Methods

Results

Discussion
Previous studies using FSSG reported the prevalence of GERD to be 25.0% and 27.4% in Japanese patients with asthma and 26.8%, 32.5%, and 34.0% in those with COPD, which were slightly higher proportions than in the present study. In the comparison between asthma and COPD, the prevalence of GERD was comparable and there was no difference in the mean FSSG scale between the two groups in the present study, whereas a previous study revealed a higher prevalence in patients with COPD than in those with asthma (32.5% versus 25.0%), but did not describe the difference in the mean scale. Possible explanations for these discrepancies may be the difference in the sample size and the studied population, including asthma control levels and the backgrounds of the patients.
Previous studies reported the relationship between GERD and asthma control. Cheung et al. identified that the patients with GERD had worse asthma control than those without GERD (mean ACT score, 19.2 versus 20.2) and that more patients with GERD had poor asthma control. They also demonstrated that GERD was associated with a poorer quality of life, as shown by the highly significant difference in all domain scores of the SF-36, a comprehensive measure of quality of life. Liang et al. found that the independent association of GERD with not well-controlled asthma (ACT score <20) after other established contributors to asthma control were adjusted in multivariate logistic regression analyses. In the present study, we found that the patients with GERD not only had significantly lower ACT scores than those without GERD but also significantly more impaired cough-related quality of life that affected all health domains for the first time. Further, we demonstrated a negative correlation between the FSSG scale and LCQ total score. The lack of correlation between the FSSG scale and ACT score may reflect overall controlled patients with asthma in the present study. If we had recruited more uncontrolled patients, there would have been a significant correlation between the FSSG scale and ACT score. We previously assessed the effect of rabeprazole, a proton pump inhibitor, 10 mg/day on FSSG scale, ACT score, and LCQ total score in 13 patients with asthma in an uncontrolled, open-label pilot study. We found that each parameter improved significantly after 4 months of treatment, suggesting the correlations between FSSG scale, ACT score, and LCQ total score.

tbtu The results obtained in the present study

The results obtained in the present study suggest that cross-reactive immune responses at humoral and/or cellular levels against Ascaris and HDM Ags promote induction or upregulation of IgE specific to inhaled HDM in mice presensitized to Ascaris, thereby indicating that sensitization to HDM towards IgE-mediated allergic diseases is faster in individuals with earlier Ascaris infection than in those without a previous history of Ascaris infection. Although DF-specific IgE was detectable in Ascaris-preimmunized, DF-inhaled mice, but not in mice without the Ascaris preimmunization (Fig. 5B), whether this immunological modulation leads to relevant allergic reactions remains unknown, and we cannot exclude the possibility that presensitization to helminth protects against allergic responses in different experimental settings via the induction of regulatory tbtu or production of blocking IgG Abs. Nevertheless, animal models in which sensitization processes can be controlled and monitored are considered useful in the study of the molecular and cellular mechanisms as well as roles of the induction of cross-reactive Abs and Th cells. A recent study involving another murine model demonstrated that the infection of mice with an intestinal nematode Heligmosomoides polygyrus induced IgE against some allergen components from HDM, cockroaches, and pollen, and the infected mice developed positive skin reactions upon injection of the allergens.
Various components of allergen sources or house dust, including enzymes, TLR ligands, and lipids, have been reported to act as Th2 adjuvants in the promotion of allergic sensitization. The present study suggested another possible mechanism in an animal model that is dependent on the characteristics of Ags for the promotion of allergic sensitization to HDM in Ascaris-sensitized individuals, which is based on the cross-reactivity of HDM and Ascaris Ags.

Conflict of interest

Authors\’ contributions

Acknowledgments
We thank Michiyo Matsumoto for her secretarial assistance and Hiroshi Kawai, Toyoko Hidano, and Takatoshi Kuhara for animal care. This study was supported by Ministry of Education, Culture, Sports, Science and Technology (MEXT)-supported Program for Strategic Research Foundation at Private Universities (S1101010).

Introduction
The identification of risk factors for drug hypersensitivity may define categories of patients who are at risk after drug exposure and may allow the avoidance of certain drugs in patients with previous sensitization by performing an appropriate allergological screening. Current epidemiological studies indicate both exposure characteristics, host and drug factors, including sex, age and possibly atopy, as representing such risk factors, though there is no definitive consensus regarding some of them.
Neuromuscular blocking agents (NMBAs) are the drugs most often incriminated in intraanaesthetic anaphylaxis. Allergological skin tests for NMBAs are not currently recommended for the general population undergoing general anaesthesia. However, in a previous study we have reported a high prevalence of positive in vivo and in vitro allergy tests for NMBAs in patients with a positive history of non-anaesthetic drug allergy and hypothesized that preoperative testing for NMBAs might be necessary in this category of patients. Screening tests for anaesthetic drugs might prove valuable when a defined risk profile is selected, larger prospective studies being needed to confirm those preliminary results and validate changes in clinical anaesthesiology and allergology practice.

Methods
Skin tests included the skin prick test (SPT) and the intradermal test (IDT) and were performed according to international recommendations for atracurium (Tracrium®, Glaxo-Smith-Kline, Great Britain), pancuronium (Pavulon®, Organon, Holland), rocuronium (Esmeron®, Organon, Holland), and suxamethonium (Lysthenon®, Nycomed, Austria) for each patient and control. The allergologist was blinded regarding the patients\’ hypersensitivity history. We used 1% histamine as positive control and 0.9% NaCl as negative controls. The skin tests were performed using commercially available drug solutions for intravenous use, which were diluted with 0.9% NaCl to obtain the currently recommended dilutions for testing (Table 1). The skin tests were performed on the anterior region of the forearm. For the SPT, a drop of the drug solution was placed and the skin was pricked with a prick needle in the centre of the drop. For the IDT, 0.02–0.03 mL of drug solution was injected using a 29.5 gauge needle, producing a 4 mm injection wheal. The SPT was considered positive when the wheal diameter was ≥3 mm at 20 min, while the IDT was considered positive if the reading wheal (RW) doubled the injection wheal (IW) at 20 min (the RW/IW ratio ≥2). First, the SPT was performed. When the SPT was negative, the IDT was performed subsequently and if the SPT was positive, the IDT was not performed. The skin test result was considered positive when either the SPT or the IDT were positive, and negative when neither of these were positive.

The younger child age less than months was more likely

The younger child (age less than 36months) was more likely to be taken to a health facility. This perception that younger children should receive appropriate care has been documented by other authors and may be related to parents perceiving these children as being especially “delicate”. Household characteristics have also been implicated in chemokine receptor antagonist care-seeking behavior. The current study found that secondary and tertiary paternal education increased the chances of seeking care from appropriate sources by between 1.5 and 2.0 fold. Similar findings were reported in Malawi by Kazembe et al. Paternal education undoubtedly improves understanding of illness and ability of parents to afford orthodox treatment. This finding strengthens the need to improve literacy rates in Nigeria as a proxy to improving care-seeking behavior. Interestingly, maternal education status was not significantly associated with care-seeking behavior. This contrasts with the findings of other smaller studies where maternal education was prominently associated with care-seeking. This probably reflects the chemokine receptor antagonist of men in traditional Nigerian society in the decision making process. This is further exemplified by the finding in this study that decision making regarding the health of the mother was by the husband alone or others in 63% of respondents studied. This is similar to reports from DHS data in Malawi. Efforts at women empowerment are strengthened by the finding in this study that women who were currently working were 1.2 times more likely to seek appropriate care.
Geographical area of residence significantly influenced care seeking behavior in this study. Compared to the North-Central region, residences in the South-East, South-South and North-East were associated with reduced chances of seeking appropriate care. This finding was independent of educational status, social status and religion of respondents. This is probably related to cultural differences in perception of health and disease. Kazembe et al. in Uganda reported similar geographical variations in care-seeking behavior among parents. Ethnic reasons were partly implicated in the work of Kazembe et al. as being responsible for this finding. This was not explored in the current study because of the immense cultural diversity from over 250 different ethnic groups in Nigeria. Also, issues of access to health care in the different regions, such as availability and distance to health care facilities, which were not explored in this study may explain the observed influence of geographical area of residence on care seeking behavior. Religion was another factor associated with appropriate care-seeking. The basis of the relationship with religion is unclear. This may reflect the influence of so-called faith homes a practice commonly associated with the Christian faith as a prominent alternative to care-seeking in appropriate health facilities.

Conclusion

Sources of support

Conflict of interests

Acknowledgments

Introduction
Leishmaniasis is a vector-borne tropical and subtropical disease caused by obligate intracellular protozoa known as Leishmania genus. The disease can present clinically in three main ways as follows: cutaneous leishmaniasis (CL), visceral leishmaniasis (VL) and mucocutaneous leishmaniasis (MCL). It is a major global health problem in five continents that estimated 350 million people in about 100 countries are at risk and currently 12 million persons are infected worldwide. Two million new clinical cases occur throughout the world annually that incidence of CL and VL is 0.7–1.2 million and 0.2–.04 million, respectively. Majority (about 70–75%) of total CL cases occur in 10 countries: Brazil, Peru, Colombia, Costa Rica, North Sudan, Algeria, Ethiopia, Syria, Afghanistan and Iran. Leishmaniasis in the Eastern Mediterranean Region (EMR) is considered as a major health problem. Also CL and VL were seen and are endemic in 14 out of 22 countries of the region such as Palestine, Egypt, Libya, Sudan, Tunisia, Morocco, Jordan, Yemen, Syria, Saudi Arabia, Iraq, Iran, Afghanistan and Pakistan. Pentavalent antimonial compounds such as Glucantime and Pentostam are being prescribed routinely for leishmaniasis treatment as first-line drugs, while unfortunately there is no effective and efficient vaccine against leishmaniasis yet.

br Introduction Urinary bladder cancer is the second most

Introduction
Urinary order AZD-9291 cancer is the second most common malignancy of all genitourinary tumors after prostate cancer and is nearly three times more common in men than in women [1]. In Egypt, carcinoma of the bladder is the main oncologic problem. At the National Cancer Institute (NCI), Cairo, urinary bladder cancer constitutes 30.3% of all cancers, 40.6% of male cancers, and 14.3% of female cancers [2].
According to the International Agency for Research on Cancer (IARC) statistical study, Egypt ranked first among Northern African and Arabian African countries in urinary bladder cancer incidence and mortality rates in both males and females [3].

Patients and methods
This retrospective study was conducted in Kasr EL-Aini hospital and student hospital and included 44 male patients in the period from May 2000 to May 2001, who underwent radical cystectomy with ileal neobladder diversion (W-pouch) (Fig. 1) for bladder malignancy. Follow up of those patients continued to May 2012.
History included: age and risk factors (bilharziasis, smoking, diabetes mellitus, hypertension, ischemic heart disease).
Physical examination included: general examination for pallor and cachexia, abdominal examination for masses, nodules, scars of previous operations, and per rectal (PR) examination for tenderness, masses, and nodules.
Imaging study included: abdomen and pelvis U/S, CT abdomen and pelvis, CT chest and Bone scan when needed.
Laboratory study included: serum creatinine, complete blood picture, serum sodium, serum potassium, and urine analysis, culture and sensitivity. pH (acidosis) and bicarbonate was done when indicated.

Results

Discussion
Radical cystectomy (RC) with pelvic lymph node dissection provides the best cancer-specific survival for muscle invasive urothelial cancer [4,5] and is the standard treatment, with 10-year recurrence-free survival rates of 50–59% and overall survival rates of around 45% [4,6]. RC with urinary diversion (UD) is a procedure in which reduction of morbidity, rapid postoperative rehabilitation, limited length of hospital stay, and cost containment are difficult to achieve [7]. The primary goals in selection of a urinary diversion are to provide the patient with diversion that results in the best local cancer control, the lowest potential for complications both short and long, and the best quality of life while still allowing the timely completion of chemotherapy and therapeutic goals [8]. Single institution experiences worldwide have reported favorable short-term oncologic outcomes and the controversy regarding long-term oncologic results still exists [9,10].
In our study, 35 patients (80.5%) developed ED postoperatively (in addition to 15% were impotent preoperatively), 80% of them were smokers, 15% were diabetics, 20% had hypertension, 10% had ischemic heart disease and their mean age was 68 year, while only 4.5% were potent, in addition, all of those patients were not known to have nerve sparing cystectomy. The multiple risk factors, the age, the way of ED assessment and the absence of nerve sparing techniques in our patients may explain the high rate of ED in our study. In other studies, nerve-sparing cystectomy has better results, where 78.8% were potent [11]. In another study 86% developed impotence postoperatively, while only 14% of patients were potent postoperatively (7 of 49 patients), of those 7 potent patients, 6 patients had undergone nerve-sparing cystectomy [12].
In our study, nocturnal incontinence after non-nerve sparing RC was 29.5%, while in El-Bahnasawy et al. study [13] nocturnal incontinence after non-nerve sparing RC was 36.7%. Some of the studies have high results in urinary continence like that of Jian and co-workers [14] in which nocturnal continence after laparoscopic radical cystectomy (LRC) is 82.5%, LRC with different urinary diversion methods has been demonstrated to be feasible, safe, and capable of providing many intraoperative and postoperative advantages, However, the oncologic safety of this procedure is still being evaluated, and report of patients with >5-year follow-up are unavailable [14].