The orderly migration of various white blood cell types to inflammatory sites is a highly regulated process that involves a diversity of adhesion and signaling molecules. This cellular influx is initiated by relatively low affinity interactions that allow for leukocytes to roll along the vascular surfa ce. This rolling phe­ nomenon is mediated by adhesive interactions between lectin containing ad­ hesion molecules, termed selectins, on both the vascular endothelium and leukocytes, and car bohydrate ligands immobilized on mucin-like scaffolds. This adhesion allows for a rapid recognition of various cell types under the conditions of vascular flow, with the result that inflammatory cells are spe­

Interactions and the initiation of the inflammatory response

https://doi.org/10.1016/j.lansea.2022.05.005

Epidemiology and pathophysiology of vascular thrombosis in acclimatized lowlanders at high altitude: A prospective longitudinal study

High blood pressure (BP) affects over one billion people and is the leading risk factor for global mortality. While many lifestyle and genetic risk factors are well-accepted to increase BP, the role of the external environment is typically overlooked. Mounting evidence now supports that numerous environmental factors can promote an elevation in BP. Broadly speaking these include aspects of the natural environment (e.g., cold temperatures, higher altitude, and winter season), natural disasters (e.g., earthquakes, volcanic eruptions), and man-made exposures (e.g., noise, air pollutants, and toxins/chemicals). This is important for health care providers to recognize as one (or several) of these environmental factors could be playing a clinically meaningful role in elevating BP or disrupting hypertension control among their patients. At the population level, certain environmental exposures may even be contributing to the growing pandemic of hypertension. Here we provide an updated review of the literature linking environment exposures with high BP and outline practical recommendations for clinicians.

Echoes from Gaea, Poseidon, Hephaestus, and Prometheus: environmental risk factors for high blood pressure.

Lymphatic filariasis is a neglected tropical disease caused by the parasite Wuchereria bancrofti. Involvement of the breast is relatively uncommon and may affect only 10% of individuals with lymphatic filariasis. We present a case of an elderly woman with breast pathology. The condition clinically appeared as a malignancy. Routine diagnostic tests including tissue histopathological studies failed to clinch a diagnosis. However, a serological test helped in identifying the pathology, which turned out to be a manifestation of breast filariasis, and aided in instituting appropriate therapy for this condition.

/pdf/breast-filariasis-or-inflammatory-breast-carcinoma-reaching-2pdylosmqy.pdf

Breast filariasis or inflammatory breast carcinoma? Reaching a diagnosis

Background Increased pulmonary ventilation helps lowlanders and natives to maintain arterial oxygenation at high altitudes. Natives of Ladakh have been shown to have similar ventilatory parameters as Tibetans at 3300 m. But there is limited literature comparing these parameters in Ladakhi natives with acclimatized lowland sojourners. Methods End-tidal carbon dioxide partial pressure (EtCO2), blood oxygen saturation (SpO2) and hemoglobin concentration (Hb) were measured in 276 participants, 126 native highlanders (NHL – 40 females, 86 males) and 150 acclimatized lowlanders (ALL – 60 females, 90 males). Results EtCO2 was greater in the NHL compared to the ALL, (33.8 ± 3.3 vs 31 ± 2.5 mmHg) although SpO2 was lower (90.9 ± 2.4 vs 91.7 ± 2.3%). When grouped by sex, NHL males had significantly greater EtCO2 than NHL females, ALL males and ALL females. Hb and calculated arterial oxygen content was similar in Ladakhis and acclimatized lowlanders, although greater in males compared to females. Systemic blood pressure, heart rate and the proportion of hypertensives was significantly greater in the ALL. Conclusion Native Ladakhis, have a significantly greater resting EtCO2 (especially in males) and lower SpO2 than acclimatized lowlanders. Blood Hb concentration and oxygen content is, however, similar in natives and acclimatized lowlanders of the same sex.

Ventilatory parameters at rest after months of stay at 3300 m: A comparison between acclimatized lowlanders and natives at Leh

Background Chronic intermittent hypoxia is known to induce systemic arterial hypertension whereas chronic hypoxia causes pulmonary arterial hypertension. High altitude (HA) induced systemic hypertension (HASH) in previously normotensive lowlanders following acclimatisation and prolonged stay at moderate HA is a commonly encountered medical problem. HASH has been attributed to increased sympathetic discharge. Endothelial dysfunction (ED) is implicated in hypertension in the plains hence this study was conducted in HA. This is relevant especially because of the established role of ED in the aetiopathogenesis of HA illnesses. Since hypoxia may induce ED, we aimed at studying the association of endothelial dysfunction with HASH in temporary residents at HA. Methods In this case–control single-centre study, we evaluated ED, by measuring endothelial molecular markers, soluble intercellular adhesion molecule-1 (sICAM-1), vascular cell adhesion molecule-1 (VCAM-1), vascular endothelial growth factor (VEGF) and endothelial selectin (E-Selectin) in 24 cases with HASH and 25 age, sex matched normotensive controls at moderate high altitude (11,500 ft). Results The levels of sICAM-1 (patients: 214.3 ± 34.2 μg/L, controls: 196.2 ± 28.5 μg/L; p = 0.049) and VCAM-1 (patients 766.1 ± 123.4 ng/mL, controls: 668.6 + 117.6 ng/mL; p = 0.007) were statistically higher in the patient group. However, VEGF and E-Selectin were not significantly different between the groups. sICAM-1 significantly correlated with levels of systolic and diastolic blood pressure (r = 0.401, p = 0.003 and 0.486, p = 0.000) respectively. Conclusion HASH is associated with endothelial dysfunction in form of raised levels of sICAM-1 and VCAM-1.

Endothelial markers in high altitude induced systemic hypertension (HASH) at moderate high altitude.

Filariasis is a common occurrence in India.1 However, filariasis of the breast lump diagnosed on FNAC is rare.2 Conventional mode of diagnosis is by demonstration of microfilaria in the peripheral blood smear.1–3 It is infrequent to find microfilaria in Fine needle aspiration cytology smears and body fluids. In the present case report, the patient had a rare presentation of induration of skin over left breast with a subcutaneous lump left breast and nipple secretion right breast. FNAC of left breast lump and right nipple secretion cytology showed evidence of filariasis.

Filariasis of the breast.

Ballantyne syndrome or Mirror syndrome or triple edema syndrome is a rare and dangerous disorder affecting pregnant women. It describes unusual association of fetal and placental hydrops with maternal edema. It was first described in 1882 by John William Ballantyne. Awareness of the syndrome is important due to associated fetal and maternal risks [1]. We present a case of Ballantyne syndrome in Rhesus isoimmunised pregnancy with severe fetal hydrops.

Ballantyne Syndrome in Rhesus Isoimmunised Pregnancy

The Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome is characterized by congenital aplasia of the uterus and the upper part (2/3) of the vagina. The first sign of MRKH syndrome is primary amenorrhea in young women presenting otherwise with normal development of secondary sexual characteristics and normal external genitalia, with normal and functional ovaries and karyotype 46, XX [1].

The vaginal agenesis in this syndrome can be treated by various methods, both surgical and nonsurgical. We present a case treated by creating a neovagina using amnion as a graft for the vaginoplasty.

Vaginal Agenesis in Mayer Rokitansky Kuster Hauser Syndrome

Based on spatial and fleeting enormous information, location-based services (LBSs) get significant consideration because of their capability to make urban areas more brilliant. In any case, LBS gives the usefulness by extricating individual information from clients, which may bring about security spillage chance, for example, interruption, robbery, and unapproved offer of touchy data. Consequently, the mass piece of the pie of LBS relies upon the security of subjects ensured. Particularly contemplate the security threats in LBSs. Characterizing distinctive sorts of LBSs and investigating security spillage introduced every kind. In the wake of outlining the best in class chip away at location protection and question security, we propose an inquiry content safeguarding method with the point of furnishing precise LBS reply with null server learning on questions. At long last, we demonstrate some open issues that may develop future research on LBS insurance preservation.

/pdf/identifying-the-node-presence-mobile-wireless-networks-to-4exwxtkd7b.pdf

Identifying the Node Presence Mobile Wireless Networks to Provide Location Based Services

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