Red Urine Research Articles

Impact of HIV Infection and Zidovudine Therapy on RBC Parameters and Urine Methylmalonic Acid Levels.

Background. Anaemia is a common complication of human immunodeficiency virus (HIV) infection. The aim of this study was to investigate the impact of HIV infection and zidovudine on red blood cells (RBC) parameters and urine methylmalonic acid (UMMA) levels in patients with HIV infection. Material and Methods. A cross-sectional study involving 114 subjects, 94 of which are HIV-infected nonanaemic and 20 HIV negative subjects (Cg) as control. Full blood count parameters and urine methylmalonic acid (UMMA) level of each subject were determined. Associations were determined by Chi-square test and logistic regression statistics where appropriate. Results. Subjects on zidovudine-based ART had mean MCV (93 fL) higher than that of control group (82.9 fL) and ART-naïve (85.9 fL) subjects and the highest mean RDW. Mean UMMA level, which reflects vitamin B12 level status, was high in all HIV-infected groups but was significantly higher in ART-naïve subjects than in ART-experienced subjects. Conclusion. Although non-zidovudine therapy may be associated with macrocytosis (MCV > 95 fL), zidovudine therapy and ART naivety may not. Suboptimal level of vitamin B12 as measured by high UMMA though highest in ART-naïve subjects was common in all HIV-infected subjects.

Lack of Response to Olfactory Lures Among Mammals in Riparian Habitat in Southern Wisconsin

Non-invasive mammal surveys often employ olfactory stimuli on the assumption that they will attract mammals and increase the success of monitoring projects. However, information on the effectiveness of scent lures is variable and often relies on data generated from mammal tracks or sign, which can be challenging to quantify. Therefore, we sought to determine whether certain olfactory stimuli are more effective than others at eliciting a response from mammals along riparian corridors in Southern Wisconsin, using camera traps to monitor response to four scents and a control of de-ionized water. We recorded the number of times each species responded as well as the length of time spent investigating scents (Muskrat gland, mink gland, Red fox urine, crayfish oil) and the control. We recorded 2812 passes by 16 mammal species during our 12-month study, with Virginia Opossum (Didelphis virginiana), Woodchuck (Marmota monax), Eastern Gray Squirrel (Sciurus carolinensis), Eastern Fox Squirrel (Sciurus niger), Raccoon (Procyon lotor), Coyote (Canis latrans), and White-tailed Deer (Odocoileus virginianus)observed on cameras most frequently. However, 72% of observations involved mammals passing through without investigating any scents or the control, and among the 28% of observations where mammals did investigate, we found no significant differences in their response to specific scents or the control or in response by season. Further analysis revealed no significant differences in the time mammals spent investigating individual scents or the control. The lack of response suggests that factors other than scent may have attracted wildlife to our stations. Although under some circumstances olfactory attractants may increase the level of response to monitoring stations, we suggest that attraction to our stations was largely a behavioural response to novel stimuli in the environment.

A Cerebral Malaria Simulating an Epileptic Seizure

The occurrence of tonic clonic convulsion in an irregularly monitored epileptic patient may pose a problem of differential diagnosis with other convulsant pathologies such as cerebral malaria. We are reporting a case of cerebral malaria that occurred in an epileptic patient whose seizures had been taken as a status epilepticus, the consequence of which was a delay diagnosis of malaria. The objective is to contribute to better monitoring of people with epilepsy. This is about a young 27-year-oldepileptic person who had stopped his treatment and was admitted to hospital on August 12th 2015 for subintrant tonic clonic seizures associated with loss of consciousness. The examination upon admission revealed a general poor condition with a clouded consciousness, colored anicteric conjunctiva, an infectious syndrome with a temperature at 39°C, severe dehydration, Heart Function at 137 beats/min, Blood Pressure at 140/90 mmHg, claret red urine (hemoglobinuria). Bicarbonates were reduced to 15 mmol/l (acidosis), the creatinine 154.6 mmol/l (functional renal failure) and thick smear came back positive with a parasite density at 819 parasites/ml. Under treatment with artemether, Depakine and amlodipine, the outcome was favorable and he was discharged/released from hospital on August 18th 2015. The occurrence of subintrant tonic-clonic seizures in an epileptic patient must lead to search and quickly eliminate an infectious cause of convulsions such as cerebral malaria.

Hyperhaemolysis in Sickle Cell Disease Is Not Necessarily a Transfusion Reaction

Hyperhaemolysis is a rare life threatening complication in sickle cell disease with rapidly dropping haemoglobin, intravascular haemolysis and haemoglobinuria leading to multi organ failure and death. The literature reports that hyperhaemolysis in sickle cell disease is a complication of red cell transfusion (Aragona et al., 2014 J. Pediatr. Hematol. Oncol.) and suggests management based on with holding further transfusion to avoid aggravating the haemolysis and using immunosuppression (Win 2009 Expert Rev. Hematol.). In the literature, all cases of hyperhaemolysis in addition to a recent blood transfusion, were in or had had a recent sickle cell crisis.We report a case of life threatening Hyperhaemolysis in a 5 year old child following a sickle cell crisis who had never previously been transfused. We suggest that, at least in this case, the hyperhaemolysis cannot be transfusion related. The theoretical case for management of withholding transfusion may not be sound and potentially dangerous.A female child with known sickle cell disease presented with temperature and chest pains, she had a Hb 72g/L (stable over a few years). She initially improved with oxygen, fluids and antibiotics. 36 hours after admission she acutely deteriorated with increasing pallor and dropping oxygen saturations. She started passing frank red urine which initially was considered to be haematuria but on investigation was haemoglobinuria. Her Hb dropped to 47g/L with no evidence of blood loss. Within hours of developing haemoglobinuria she required intensive care for respiratory support. She rapidly developed multi-organ failure requiring oscillatory ventilation, inotropes, and haemofiltration for renal support.She was managed with emergency red cell transfusion (her first ever) and within 12 hours of haemoglobinuria received a full red cell exchange transfusion. There were ongoing antibiotics for clinical respiratory infection and she was later confirmed to have influenza B. No steroids or other immune suppression were given. There was no evidence of acute bleeding to explain a drop in haemoglobin at any point. With maximum intensive care support including further transfusions she gradually improved and has made a full recovery. No deterioration was observed following transfusion. She has remained well since. She is now 13 years old and following such a dramatic episode she has remained on a transfusion programme with successful oral iron chelation. She has not experienced any further episodes of hyperhaemolysis and no red cell antibody has been detected at any time.This case demonstrates that hyperhaemolysis in sickle cell disease does not require a previous transfusion. We suggest that it is possible the previous reported cases are also not due to blood transfusion but are an acute form of haemolysis seen on the background of a chronic haemolytic disease. An increase in the rate of haemolysis may be related to other acute complications of sickle cell disease.We propose that the optimum management of hyperhaemolysis should include full supportive care including maintaining haemoglobin by transfusion. Immunosuppression in this case could have led to a worse outcome as influenza pneumonia was the likely initial trigger of the episode. DisclosuresNo relevant conflicts of interest to declare.

Risk factors and prognostic factors of acute kidney injury in children: A retrospective study between 2003 and 2013.

Recent report on epidemiology of acute kidney injury (AKI) is lacking for Chinese children. We aimed to investigate the risk factors for stage and prognostic factors for renal recovery in hospitalized children. Pediatric patients (≤18 years old) admitted during 2003 to 2013 were enrolled in this study. AKI was defined and staged using Kidney Disease Improving Global Outcomes (KDIGO) criteria. Logistic regression analysis was performed to determine the risk factors and prognostic factors. The morbidity of pediatric AKI was 0.31% (205/65 237). There were 45 (22.0%) cases in stage III, 30 (14.6%) cases in stage II and 130 (63.4%) cases in stage III. The majority of etiologies were intrinsic renal defects (85.4%). Age, weight, vomit, etiology, blood urea nitrogen (BUN) at admission and several blood gas measurements were associated with AKI stage III. Age (OR=0.894; 95% CI, 0.832-0.962; P=0.003), vomit (OR=2.375; 95% CI, 1.058-5.333; P=0.036) and BUN at admission (OR=1.135; 95% CI, 1.085-1.187; P<0.001) were identified as independent risk factors for AKI stage III. After treatment, 172 (83.9%) patients achieved complete or partial recovery. The mortality was 3.9%. Variables were found as prognostic factors for renal recovery, such as age, stage, hospital stay, BUN at discharge, white blood cells, red blood cells, platelets (PLTs), blood pH and urine blood. Among them, AKI stage (stage III vs. stage I; OR, 6.506; 95% CI, 1.640-25.816; P=0.008), BUN at discharge (OR, 0.918; 95% CI, 0.856-0.984; P=0.016) and PLTs (OR, 1.007; 95% CI, 1.001-1.013; P=0.027) were identified as independent prognostic factors. AKI is still common in Chinese hospitalized children. Identified risk factors and prognostic factors provide guiding information for clinical management of AKI.

Total Exposure Study Analysis consortium: a cross-sectional study of tobacco exposures.

BackgroundThe Total Exposure Study was a stratified, multi-center, cross-sectional study designed to estimate levels of biomarkers of tobacco-specific and non-specific exposure and of potential harm in U.S. adult current cigarette smokers (≥one manufactured cigarette per day over the last year) and tobacco product non-users (no smoking or use of any nicotine containing products over the last 5 years). The study was designed and sponsored by a tobacco company and implemented by contract research organizations in 2002–2003. Multiple analyses of smoking behavior, demographics, and biomarkers were performed. Study data and banked biospecimens were transferred from the sponsor to the Virginia Tobacco and Health Research Repository in 2010, and then to SRI International in 2012, for independent analysis and dissemination.MethodsWe analyzed biomarker distributions overall, and by biospecimen availability, for comparison with existing studies, and to evaluate generalizability to the entire sample. We calculated genome-wide statistical power for a priori hypotheses. We performed clinical chemistries, nucleic acid extractions and genotyping, and report correlation and quality control metrics.ResultsVital signs, clinical chemistries, and laboratory measures of tobacco specific and non-specific toxicants are available from 3585 current cigarette smokers, and 1077 non-users. Peripheral blood mononuclear cells, red blood cells, plasma and 24-h urine biospecimens are available from 3073 participants (2355 smokers and 719 non-users). In multivariate analysis, participants with banked biospecimens were significantly more likely to self-identify as White, to be older, to have increased total nicotine equivalents per cigarette, decreased serum cotinine, and increased forced vital capacity, compared to participants without. Effect sizes were small (Cohen’s d-values ≤ 0.11). Power for a priori hypotheses was 57 % in non-Hispanic Black (N = 340), and 96 % in non-Hispanic White (N = 1840), smokers. All DNA samples had genotype completion rates ≥97.5 %; 68 % of RNA samples yielded RIN scores ≥6.0.ConclusionsTotal Exposure Study clinical and laboratory assessments and biospecimens comprise a unique resource for cigarette smoke health effects research. The Total Exposure Study Analysis Consortium seeks to perform molecular studies in multiple domains and will share data and analytic results in public repositories and the peer-reviewed literature. Data and banked biospecimens are available for independent or collaborative research.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-2212-5) contains supplementary material, which is available to authorized users.

The Case | Acute renal failure after antibiotic treatment for bronchitis

A 61-year-old woman presented with fever, fatigue, red urine, and a rash. Two weeks prior to presentation, she had acute bronchitis treated with prednisone and cephalexin. A week after starting antibiotics, she experienced fever, flank pain followed by dyspnea, rash on extremities, and red urine. Physical examination was notable for temperature of 101.7° F and a maculo-papular rash on lower extremities. The rest of her physical examination was normal. Labs revealed hemoglobin of 7.5 g/dl, platelets 212,000/μl, WBC 11,700/μl, blood urea nitrogen 54 mg/dl (19.2 mmol/l), and creatinine 3.78 mg/dl (334 mmol/l). Urine analysis showed presence of blood, bilirubin, protein 100 mg/dl, WBC 0–2/h.p.f., and RBC 2–5/h.p.f.

Biomarkers: background, classification and guidelines for applications in nutritional epidemiology.

One of the main problems in nutritional epidemiology is to assess food intake as well as nutrient/food component intake to a high level of validity and reliability. To help in this process, the need to have good biomarkers that more objectively allow us to evaluate the diet consumed in a more standardized, valid and precise way has often been commented upon. There are various definitions of biomarkers and also different classifications of the same. In general a biomarker can be defined as a characteristic that can objectively measure different biological samples and that can be evaluated as an exposure marker of normal or pathogenic biological processes or of responses to a certain intervention. The biological samples most commonly used in nutritional epidemiology are blood, red blood cells, plasma, serum, urine, nails, saliva, faeces and samples of different tissues. Exposure biomarkers (dietary intake), biomarkers of effects and biomarkers of disease status can be determined from these samples. In turn, exposure biomarkers can be temporarily categorized into markers of acute, medium term or chronic effects. Many difficulties arise in identifying good biomarkers. Currently, advances in omics are opening up new possibilities for obtaining new biomarkers of various kinds, using genomics, epigenomics, transcriptomics, lipidomics, proteomics and metabolomics. We shall review the present situation of biomarkers in nutritional epidemiology as well as the future trends of the new omic biomarkers.

Hepatoerythropoietic Porphyria Caused by a Novel Homoallelic Mutation in Uroporphyrinogen Decarboxylase Gene in Egyptian Patients

Porphyrias are metabolic disorders resulting from mutations in haem biosynthetic pathway genes. Hepatoerythropoietic porphyria (HEP) is a rare type of porphyria caused by the deficiency of the fifth enzyme (uroporphyrinogen decarboxylase, UROD) in this pathway. The defect in the enzymatic activity is due to biallelic mutations in the UROD gene. Currently, 109 UROD mutations are known. The human disease has an early onset, manifesting in infancy or early childhood with red urine, skin photosensitivity in sun-exposed areas, and hypertrichosis. Similar defects and links to photosensitivity and hepatopathy exist in several animal models, including zebrafish and mice. In the present study, we report a new mutation in the UROD gene in Egyptian patients with HEP. We show that the homozygous c.T163A missense mutation leads to a substitution of a conserved phenylalanine (amino acid 55) for isoleucine in the enzyme active site, causing a dramatic decrease in the enzyme activity (19 % of activity of wild-type enzyme). Inspection of the UROD crystal structure shows that Phe-55 contacts the substrate and is located in the loop that connects helices 2 and 3. Phe-55 is strictly conserved in both prokaryotic and eukaryotic UROD. The F55I substitution likely interferes with the enzyme-substrate interaction.

Acute Poststreptococcal Glomerulonephritis: The Most Common Acute Glomerulonephritis

Acute Poststreptococcal Glomerulonephritis: The Most Common Acute Glomerulonephritis

The first recorded epidemic of leptospirosis in sheep in Egypt.

An outbreak of leptospirosis in sheep is recorded as the first epidemic of ovine leptospirosis in Egypt. The sick animals showed typical symptoms such as fever, jaundice, red urine and abortion, with a fatal course. Acute and convalescent sera were tested for demonstration of seroconversion using the microscopic agglutination testto confirm infection. Long-acting tetracycline was successfully used for treatment.

Correlation of gross urine color with diagnostic findings in male cats with naturally occurring urethral obstruction.

Seventy-five male cats with urethral obstruction were prospectively enrolled to evaluate gross urine color at urinary catheter placement for correlation with diagnostic findings. Cats with darker red urine were more likely to be azotemic (serum creatinine concentration >2.0 mg/dl [177 µmol/l]), and urine color correlated well with serum creatinine and serum potassium concentrations. Darker urine color was negatively correlated with urine specific gravity. Urine color was not associated with the presence or absence of lower urinary tract stones on radiographs or ultrasound. Cats with darker red urine at the time of urinary catheter placement are likely to have more significant metabolic derangements and may require more aggressive supportive care.

Red urine in children

Red Urine (RU) is an uncommon finding in an unselected population of children; its prevalence was reported as 0.13 % based on a retrospective USA review of children. However, RU may signify disorders ranging from benign conditions such as medications and food coloring to more serious conditions such as urinary tract infection, hereditary cystic renal diseases and glomerulonephritis. In the clinical approach and management of these children, it is important to firstly differentiate true gross hematuria from non-gross hematuria, and subsequently dissecting out the different causes of gross hematuria (GH). To determine the prevalence and the etiology of GH in an italian general pediatric setting we undertook a prospective study of all patients with GH in pediatric emergency walk-in clinic for consecutive 15 months. Study protocol: all patients who complained of RU were referred to the pediatric nephrologist for complete evaluation until diagnosis was made. Over the 15-month period 82,934 children visited the Emergency Clinic at our Children’s Hospital; 85 patients made visit in which they complained of RU (1.1/ 1,000 visits). Sex ratio showed a male preponderance (M 50/F 35); mean age was 7.06 ± 4.6 (range 0.5-16.1 years). Among diagnosis, glomerulopathies accounted for 59.5% : Post infectious acute glomerulonephritis (37), primary (7) and secondary to Schonlein-Henoch purpura (3) IgA nephropathy (10), SLE (1), Alport Syndrome (3). 14/85 patients with GH had UTI ( 12 documented bacterial UTI and 2 with a presuntive adenovirus cystitis); 16.5% had Idiopathic Hypercalciuria (6 out showed microcalculi at ultrasonography); 2 patients suffered from hyperuricosuria; 1 child was affected by haemolytic uremic syndrome, 2 myoglobinuria from rabdomyolisis and in 1 case no diagnosis was made. Our prospective study indicates that in our country, according to the previous report, the prevalence of GH is relatively uncommon, but the most common causes are represented by hematuric glomerulonephritis (mainly PIAGN and IGAN) in boys, and not by proven (26%) and unproven (23%) UTI mainly in girls; just one child was categorized as “unknown etiology” vs 9% of USA children. Two main reasons may explain such a difference: 1) the health social assurance systems, namely the availability in Italy of the family pediatrician which avoid that children with GH from trivial causes such as hemorragic cystitis, will turn to ER and 2) the systematic evaluation of all cases of GH, in our experience, directly by the paediatric nephrologist who could assure a definite diagnosis.

Transplantation of endothelial progenitor cells in treating rats with IgA nephropathy

BackgroundTherapeutic options in IgAN are still limited. The aim of this study is to explore the feasibility of using endothelial progenitor cell to treat IgAN in rat model.MethodsRat bone marrow mononuclear cells (BM-MNCs) obtained with density gradient centrifugation were cultured in vitro, and induced into endothelial progenitor cells (EPCs). EPCs were identified by surface marker CD34, CD133 and VEGFR2 (FLK-1) and by Dil-Ac-LDL/FITC-UEA-1 double staining. EPCs were labeled with PKH26 prior to transplantation. Rat model of IgAN was established by oral administration of bovine serum albumin together with lipopolysaccharide via the caudal vein and subcutaneous injection of CCL4. Kidney paraffin sections were stained by H&E and PAS. Immunofluorescence was used to assess IgA deposition in the glomeruli. Peritubular capillary (PTC) density was determined by CD31 staining. Monocyte chemoattrant protein-1 (MCP-1), hypoxia-inducible factor-1α (HIF-1α) and CD105 were also measured by immunohistochemistry, western blotting and real-time fluorescent quantitative PCR.ResultsThe transplanted BM-EPCs were successfully located in IgAN rat kidney. After transplantation, Urinary red blood cell, urine protein, BUN, Scr and IgA serum level were significantly decreased, so were the areas of glomerular extracellular matrix and the IgA deposition in the glomeruli. In addition, PTC density was elevated. And the expression levels of HIF-1α and MCP-1 were significantly down-regulated, while the expression of CD105 was up-regulated. All these changes were not observed in control groups.ConclusionThe BM-EPCs transplantation significantly decreases the expansion of glomerular extracellular matrix and the deposition of IgA in the glomeruli; lowers the expression of inflammatory factors; increases PTC density; improves ischemic-induced renal tissue hypoxia, all of which improves the renal function and slows the progress of IgA nephropathy.

Quiz Page May 2014: Acute Kidney Injury With Red Urine

Quiz Page May 2014: Acute Kidney Injury With Red Urine

METABOLIC PROFILE OF YOUNG WOMEN IN EARLY PREGNANCY AND AFTER INDUCED ABORTION

The metabolic profile was estimated in young pregnant women 15-19 years old as the level of substances of low and middle molecular mass in blood serum, red blood cells and urine. The assessment was provided in the early period before the 12th week of gestation and after the medical abortion. Metabolic changes were indicated in 59,5% of patients. The endogenous intoxication was found in one third of patients (30,5%). The activation of metabolic processes during the fetal growth, the presence of toxicosis and acute inflammation diseases can be considered as possible reasons of the endogenous intoxication. Pregnancy interruption didn't lead to disappearance of endogenous intoxication and metabolic damages. On the contrary in a week after induced abortion the metabolic profile in a half of patients worsened due to accumulation of substances of catabolic origin in the biological environment. Postponed adverse metabolic changes were also found. The level of substances of low and middle molecular mass approached to normal in a month after abortion. There is an evidence that interruption of pregnancy by the means of surgical abortion turned out to be a high-powered factor for the metabolic disorders of different degree of manifestation.

Index of Suspicion

The reader is encouraged to write possible diagnoses for each case before turning to the discussion. We invite readers to contribute case presentations and discussions. Please inquire first by contacting Dr. Deepak Kamat at DKamat@med.wayne.edu. An 18-year-old male with a 3-year history of alcohol abuse is referred from a rehabilitation center for fever, nausea, and nonbloody diarrhea for 3 days. Six weeks ago, he enrolled in an alcohol rehabilitation program and stopped drinking alcohol. Three weeks later, he noticed yellowing of his eyes and skin, difficulty sleeping, and dyspnea. On examination, his temperature is 100.6°F (38.1°C), blood pressure is 99/62 mm Hg, pulse is 124 beats per minute, and respiratory rate is 24 breaths per minute. He is slow to answer questions. There is no asterixis. He appears thin and jaundiced with enlarged parotid glands. Decreased breath sounds are noted on the right. A tender, enlarged liver and mild abdominal distension are noted. Trace bilateral lower-extremity edema is present. No stigmata of chronic liver disease are found. Laboratory findings reveal the following: white blood cell count, 25,600/μL (25.6 × 109/L) (87% neutrophils); hemoglobin, 8.2 g/dL (82 g/L); mean corpuscular volume, 106 fL; platelets, 40 × 103/μL (40 × 109/L); sodium, 135 mEq/L (135 mmol/L); potassium, 3.5 mEq/L (3.5 mmol/L); chloride, 106 mEq/L (106 mmol/L); bicarbonate, 15 mEq/L (15 mmol/L); blood urea nitrogen, 24 mg/dL (8.6 mmol/L); creatinine, 1.01 mg/dL (89 μmol/L); glucose, 118 mg/dL (6.6 mmol/L); alkaline phosphatase, 182 U/L; aspartate aminotransferase (AST), 194 U/L; alanine aminotransferase (ALT), 71 U/L; total bilirubin, 11.8 mg/dL (201.8 μmol/L); direct bilirubin, 7.3 mg/dL (124.9 μmol/L); albumin, 2.7 g/dL (27 g/L); prothrombin time, 19.2 seconds; and international normalized ratio, 1.4. Ethanol and acetaminophen were not detected in the serum. A chest radiograph reveals a right pleural effusion …

Intraoperative predictors of early tracheal extubation after living-donor liver transplantation.

BackgroundProlonged mechanical ventilation after liver transplantation has been associated with deleterious clinical outcomes, so early tracheal extubation posttransplant is now increasing. However, there is no universal clinical criterion for predicting early extubation in living-donor liver transplantation (LDLT). We investigated specific predictors of early extubation after LDLT.MethodsPerioperative data of adult patients undergoing LDLT were reviewed. "Early" extubation was defined as tracheal extubation in the operating room or intensive care unit (ICU) within 1 h posttransplant, and we divided patients into early extubation (EX) and non-EX groups. Potentially significant (P < 0.10) perioperative variables from univariate analyses were entered into multivariate logistic regression analyses. Individual cut-offs of the predictors were calculated by area under the receiver operating characteristic curve (AUC) analysis.ResultsOf 107 patients, 66 (61.7%) were extubated early after LDLT. Patients in the EX group showed shorter stays in the hospital and ICU and lower incidences of reoperation, infection, and vascular thrombosis. Preoperatively, model for end-stage liver disease score, lung disease, hepatic encephalopathy, ascites, and intraoperatively, surgical time, transfusion of packed red blood cell (PRBC), urine output, vasopressors, and last measured serum lactate were associated with early extubation (P < 0.05). After multivariate analysis, only PRBC transfusion of ≤ 7.0 units and last serum lactate of ≤ 8.2 mmol/L were selected as predictors of early extubation after LDLT (AUC 0.865).ConclusionsIntraoperative serum lactate and blood transfusion were predictors of posttransplant early extubation. Aggressive efforts to ameliorate intraoperative circulatory issues would facilitate successful early extubation after LDLT.

Identification of Allosteric Nucleotide Sites of Tetramethylrhodamine-Labeled Aptamer for Noncompetitive Aptamer-Based Fluorescence Anisotropy Detection of a Small Molecule, Ochratoxin A

Aptamer-based fluorescence anisotropy (FA) assay combines the advantages of affinity aptamers in good stability, easy generation, and facile labeling and the benefits of FA in homogeneous analysis, such as robustness, simplicity, and high reproducibility. By using a fluorophore-labeled aptamer, FA detection of a small molecule is not as easy as detection of protein because the binding of a small molecule cannot cause significant increase of molecular weight of the dye-labeled aptamer. The intramolecular interaction between labeled tetramethylrhodamine (TMR) and DNA aptamer bases dramatically affects the local rotation and FA of TMR. This intramolecular interaction can be altered by aptamer conformation change upon target binding, leading to a significant change of FA of TMR. Taking this unique feature of a TMR-labeled aptamer, we described a noncompetitive aptamer-based fluorescence anisotropy assay for detection of small molecules by using ochratoxin A (OTA) as a model. We successfully identified the specific TMR-labeling sites of aptamers with sensitive FA response to OTA from the 5'-end, 3'-end and the internal thymine (T) bases. The aptamer with a TMR labeled on the 10th T base exhibited a remarkable FA reduction response to OTA (Δr = 0.078), without requiring any proteins or nanomaterials as FA signal enhancers. This FA approach for OTA showed high sensitivity with a detection limit of 3 nM, a dynamic range from 3 nM to 3 μM, and good selectivity over the tested compounds with similar structures to OTA. The new strategy allowed the detection of OTA in diluted red wine and urine samples.

The Roles of Some Scorpions,Hemiscorpius lepturusandAndroctonus crassicauda, in a Scorpionism Focus in Ramhormorz, Southwestern Iran

Scorpion stings are a common and important health problem in Iran, particularly in south and southwestern Iran, including the province of Khuzestan. In the area of Khuzestan near the city of Ramhormoz, Hemiscorpius lepturus (Scorpionida: Hemiscorpioiidae) and Androctonus crassicauda (Buthidae) are present. Ramhormoz is in southwestern Iran and is one of the most important foci of the scorpion sting problem. The current study was carried out to gain both epidemiological and medical information about scorpion stings in and around the city of Ramhormoz. In total, 179 people who were admitted to the Emergency Department of Ramhormoz Imam Khomeini Hospital during 2008 and 2009 after being stung by scorpions were monitored. Epidemiological and medical parameters including sex of the victim; the part of the body stung; the month when stung; the biochemical parameters comprising blood sugar (BS), blood urea nitrogen (BUN), and creatinine (CR); hematological parameters including white blood cells (WBC), count blood cells (CBC), red blood cells (RBC), hemoglobin (Hb), hematocrit (HCT), platelet (PLT); and urine analysis including hemoglobinuria were recorded. The current study showed that most of the victims were stung by H. lepturus, while very few were stung by A. crassicaud, but in over half of the cases the species was not known. Stings were most common from May to Aguust. 73% of the victims were female. The limbs were the part of the body most likely to be stung. Hemogobinuria was very common in H. lepturus victims.