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OBJECTIVE: Plasma D-dimer levels >0.5 mg/L are encountered in various conditions besides venous thromboembolism (VTE). Recent studies use them as a prognostic indicator for systemic and inflammatory diseases. The clinical significance of abnormal levels is unclear in osteomyelitis patients with baseline elevation. Our study reviews the occurrence and significance of >0.5 mg/L D-dimer levels in different types of osteomyelitis. PATIENTS AND METHODS: This study involved 125 individuals, out of which 94 were male and 31 were female. The patients were divided into two groups based on the results of bacterial culture testing. Group A comprised those who tested positive for bacterial culture, while group B included those who tested negative. Out of 68 samples tested, 56% were found to have Staphylococcus aureus. All 125 patients underwent blood testing, which included measuring the D-dimer levels, neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), lymphocyte to monocyte ratio (LMR), and MHR monocyte to high-density lipoprotein cholesterol (HDL-C) ratio in different types of osteomyelitis. The statistical analysis of these tests was carried out. RESULTS: Although there were no significant differences in white blood cell (WBC) count, Neutrophil count, Lymphocyte count, or erythrocyte sedimentation rate (ESR) as well as the NLR, PLR, LMR, MHR, HDL-C ratio. The C-reactive protein (CRP) levels were significantly higher in group A (26.13±50.30) than in group B (10.76±18.70) (p<0.05). D-dimer levels were elevated in 40.8% of patients with bacterial culture-positive osteomyelitis, negative culture osteomyelitis, implants with fractures, and no trauma osteomyelitis. No correlation was found between the increase in D-dimer levels and the presence of bacterial culture or implant-related osteomyelitis in patients. CONCLUSIONS: No significant correlation was found between D-dimers and osteomyelitis, including positive bacterial cultures, implant-related osteomyelitis, or osteomyelitis without trauma. However, 40% of the patients had higher D-dimer levels.
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Productos de Degradación de Fibrina-Fibrinógeno , Osteomielitis , Humanos , Masculino , Femenino , Recuento de Leucocitos , Linfocitos , Neutrófilos , Osteomielitis/diagnóstico , Monocitos , Estudios RetrospectivosRESUMEN
Gastric cancer (GC) is a highly aggressive malignant tumor, and, therefore, the prognosis evaluation of this disease is important. Proteasome activator subunit 3 (PSME3) is highly expressed in GC; however, its exact role in GC has yet to be clarified. The gene expression profiles for GC were downloaded to find a candidate prognostic biomarker, and PSME3 was selected. The expression level of the PSME3 gene in GC tissues was analyzed using a public database. The biological processes and signal pathways that PSME3 was involved in were further analyzed. Immunohistochemical staining of 181 GC tissues was performed to detect the expression of the PSME3 protein. The correlation between PSME3 expression and GC prognosis and its clinical and pathological parameters were investigated. It was found that PSME3 mRNA expression was higher in GC than in adjacent gastric tissues, and high PSME3 expression was significantly correlated with tumor stage, histological subtype, lymph node metastasis status, and Helicobacter pylori infection in patients with GC (all p<0.01). Bioinformatics showed that PSME3 mainly played an oncogenic role in the development of GC by regulating the cell cycle and inhibiting apoptosis. The PSME3 protein was overexpressed in 64.6% (117/181) of the analyzed samples, and overexpression of PSME3 was associated with a significantly poor prognosis. In addition, multivariate analysis suggested that PSME3 overexpression, tumor, node, metastasis stage, and tumor size are independent prognostic biomarkers for GC. We conclude that the overexpression of PSME3 was associated with a poor prognosis in patients with GC, and PSME3 might play an oncogenic role in the occurrence and development of GC.
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Infecciones por Helicobacter , Helicobacter pylori , Neoplasias Gástricas , Humanos , Neoplasias Gástricas/genética , Neoplasias Gástricas/metabolismo , Complejo de la Endopetidasa Proteasomal/genética , Complejo de la Endopetidasa Proteasomal/metabolismo , Biomarcadores de Tumor/análisis , PronósticoRESUMEN
A method for lead (Pb) detection in soil is presented. Pb is a dangerous environmental pollutant that is present in soils, posing a health risk to millions of people worldwide, and regular monitoring of Pb contamination in soils is essential to public health. Many sensitive methods for detection of heavy metals in solid matrices exist, but they cannot be performed on-site because they are costly (>$30 per sample), require trained personnel, and many classical sample preparation methods are not safe to bring into the field. We describe an alternative process, combining a safer sample preparation method with electrochemical analysis. The process requires minimal training, making it an attractive overall method for regular environmental screening of Pb in soils. Extract obtained from the soil is pH adjusted and analyzed using a stencil-printed carbon electrode and square wave anodic stripping voltammetry. In this work, a study of 15 neighborhood soils examining the concentration of Pb present post-extraction was performed to demonstrate the method. The limit of detection for the electrochemical analysis was calculated to be 16 ppb-well below the United States Environmental Protection Agency's action limit for Pb in soils (400 mg kg-1 or 4000 ppb)-and third party inductively coupled plasma-optical emission spectroscopy analysis validated the results obtained in this study to within ±17% on average.
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Metales Pesados , Contaminantes del Suelo , Monitoreo del Ambiente , Contaminación Ambiental , Humanos , Plomo , Metales Pesados/análisis , Suelo , Contaminantes del Suelo/análisisRESUMEN
BACKGROUND: Ophthalmoscopy and its interpretation are complex. We aimed to compare the diagnostic accuracy of smartphone fundoscopy with traditional direct ophthalmoscopy for optic disc interpretation, with e-learning support. METHODS: We conducted a randomised, crossover study of 102 medical students. Students were offered e-learning for optic disc interpretation. A fundoscopy objective structured clinical examination was conducted after an introductory lecture and 10-min practical training session on smartphone fundoscopy and traditional ophthalmoscopy. Participants examined patients and simulator slides with a randomised crossover between smartphone [D-eye (Padova, Italy) or iExaminer (Welch Allyn, Macquarie Park, Australia)] and traditional ophthalmoscopy (Welch Allyn). Optic discs were graded independently by three masked ophthalmologists. The primary outcome was the ability to interpret an optic disc as normal or abnormal. Secondary outcomes included other optic disc aspects; student preferences; and e-learning performance. RESULTS: Students' agreement with the gold standard for an abnormal or normal disc was significantly greater using a smartphone (74.4%) than with direct ophthalmoscopy (68.1%, p = 0.032). More students preferred smartphone (74%) over direct ophthalmoscopy (26%, p < 0.001). E-learning led to an improvement in optic disc interpretation scores (mean improvement = 4.5%, 95% CI = 3.7-5.2, p < 0.001). CONCLUSIONS: Medical students are more accurate at recognising an abnormal optic disc using smartphone fundoscopy than traditional direct ophthalmoscopy, and have a strong preference for smartphone fundoscopy. E-learning may improve the interpretation of optic disc abnormalities. Smartphone fundoscopy may mitigate some technical challenges of fundoscopy and reinvigorate use of this valuable clinical examination.
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Instrucción por Computador , Disco Óptico , Estudiantes de Medicina , Estudios Cruzados , Humanos , Oftalmoscopía , Teléfono InteligenteRESUMEN
BACKGROUND: Weight loss is important in the management of idiopathic intracranial hypertension (IIH); however, extremely caloric restrictive diets have been used in published studies, which may not be practical for all patients. We aim to review the weight loss outcomes of IIH patients and weight loss methods used by patients who achieve clinical remission (CR) in a standard clinical setting. METHODS: The medical records of IIH patients were retrospectively reviewed. Measures evaluated included: reported symptoms, visual acuity, retinal nerve fiber layer analysis, automated visual fields, optic disc appearance, and cessation of medications. Patients were divided into different outcome groups and weight changes were compared. Patients who achieved CR were contacted to assess weight loss methods used. RESULTS: Of the 39 patients included in the analysis, 28 patients (71.8%) achieved CR with concomitant weight loss, 6 patients (15.4%) improved clinically with concomitant weight loss but did not achieve CR. Among the patients with CR, 10 patients (35.7%) were successfully weaned off their medications completely, whereas another 10 patients (35.7%) are in the process of this. Median weight loss from baseline to lowest weight for this group was 10.5 kg (11.5%) achieved using self-directed methods. CONCLUSION: This study demonstrated that a large proportion of IIH patients were able to achieve CR or improvement with self-directed weight loss regimens, reinforcing the evidence and the practicality of weight loss in the management of IIH in the clinical setting.
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Hipertensión Intracraneal , Disco Óptico , Seudotumor Cerebral , Humanos , Hipertensión Intracraneal/complicaciones , Seudotumor Cerebral/complicaciones , Seudotumor Cerebral/diagnóstico , Seudotumor Cerebral/terapia , Estudios Retrospectivos , Campos Visuales , Pérdida de PesoRESUMEN
Fasciolosis is a zoonotic parasitic disease that seriously endangers the development of animal husbandry and human health. In order to develop a rapid serological diagnostic method for fasciolosis in ruminants, the CatL1D and CatB4 genes of Fasciola hepatica were amplified by reverse transcription polymerase chain reaction (PCR) and cloned, respectively, and then the CatL-B fusion gene (MeCatL-B) was constructed by gene splicing by overlap extension PCR technique. The recombinant rCatL1D, rCatB4 and rMeCatL-B proteins were then prepared by prokaryotic expression, respectively, and the recombinant protein with high specificity and sensitivity was screened via indirect enzyme-linked immunosorbent assay. Using the selected recombinant protein rCatL1D as a diagnostic antigen, we developed a colloidal gold immunochromatographic assay (CGIA) for detecting F. hepatica-specific antibodies, and 426 serum samples of slaughtered sheep were used to evaluate the sensitivity and specificity of F. hepatica CGIA assay. The results showed that the sensitivity and specificity of rCatL1D protein (100%, 96.67%) were higher than those of rCatB4 (94.29%, 80%) and rMeCatL-B (91.43%, 90%). Compared with the gold standard post-mortem inspection, the specificity and sensitivity of the CGIA method was 100% and 97%, respectively, and the consistency rate between these two methods was 99.3%. These results confirmed that the CGIA method based on rCatL1D protein could be a promising approach for rapid diagnosis of sheep fasciolosis because of its high sensitivity and specificity.
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Fasciola hepatica/aislamiento & purificación , Fascioliasis/veterinaria , Proteínas del Helminto/sangre , Inmunoensayo/métodos , Enfermedades de las Ovejas/diagnóstico , Animales , Anticuerpos Antihelmínticos/sangre , Fasciola hepatica/genética , Fasciola hepatica/inmunología , Fascioliasis/sangre , Fascioliasis/diagnóstico , Fascioliasis/parasitología , Oro Coloide/química , Proteínas del Helminto/genética , Proteínas del Helminto/inmunología , Inmunoensayo/instrumentación , Sensibilidad y Especificidad , Pruebas Serológicas , Ovinos , Enfermedades de las Ovejas/sangre , Enfermedades de las Ovejas/parasitologíaRESUMEN
We retrospectively analysed the reliability of anastomosis of the deep venous system as a salvage technique for a free radial forearm flap that has developed venous compromise. The primary predictors were the salvage techniques, which comprised anastomosis of the deep venous system and a repeat of the original anastomosis, and the primary outcome measure was the rate of success. The potential confounders included original venous outflow, the original causes of the venous compromise, and the number of venous anastomoses. The chi squared test, Fisher's exact test, and the Cochran-Mantel-Haenszel test were used for statistical analysis as appropriate. The final sample comprised 42 patients who required re-exploration for venous compromise. The salvage rates were 15/18 when anastomosis of the deep venous system was chosen as a salvage technique and 9/24 and when the original anastomosis was done again (p=0.003, OR 2.222, 95% CI 1.274 to 3.876). The salvage rate of venous compromise was higher in patients who had anastomoses of the deep venous system than in those in whom the original anastomosis was repeated.
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Antebrazo/cirugía , Neoplasias de Cabeza y Cuello/cirugía , Terapia Recuperativa , Colgajos Quirúrgicos/irrigación sanguínea , Colgajos Quirúrgicos/trasplante , Venas/cirugía , Anciano , Anciano de 80 o más Años , Anastomosis Quirúrgica , Femenino , Humanos , Masculino , Persona de Mediana Edad , Arteria Radial , Reoperación , Estudios RetrospectivosAsunto(s)
Colecistectomía/efectos adversos , Remoción de Dispositivos/métodos , Migración de Cuerpo Extraño/etiología , Migración de Cuerpo Extraño/cirugía , Gastrectomía/efectos adversos , Instrumentos Quirúrgicos/efectos adversos , Anciano , Colecistectomía/instrumentación , Conducto Colédoco/diagnóstico por imagen , Conducto Colédoco/lesiones , Conducto Colédoco/cirugía , Diseño de Equipo , Migración de Cuerpo Extraño/diagnóstico por imagen , Gastrectomía/instrumentación , Hepatectomía/métodos , Humanos , Masculino , Radiografía , Resultado del TratamientoRESUMEN
BACKGROUND & AIMS: Common bile duct ligation (CBDL) rats is an accepted experimental model of hepatopulmonary syndrome (HPS), defined as liver disease and intrapulmonary vascular dilatation and hypoxaemia. Pulmonary Akt and ERK activation followed by angiogenesis in the later stages of CBDL, contribute to the pathogenesis of HPS. However, the mechanisms behind Akt and ERK activation remain undefined. Pulmonary injury induced by increased bilirubin, endotoxin and inflammatory mediators occurs in the early stages of CBDL. We assessed the effects of relieving pulmonary injury on Akt and ERK activation and on the development of HPS following CBDL. METHODS: Pulmonary injury, angiogenesis, arterial oxygenation, cell proliferation and, phospho-Akt and ERK1 were evaluated in CBDL animals with or without caspase-3 inhibition (Z-DEVD-FMK). Pulmonary injury was assessed by histology and quantifying apoptosis and aquaporin-1 (AQP1) levels. Lung angiogenesis was assessed by quantifying AQP1 level, vWF-positive cells and microvessel count. RESULTS: Pulmonary apoptosis and caspase-3 activation were markedly increased in the early stages of CBDL. Caspase-3 inhibition alleviated apoptosis, the reduction in AQP1, phospho-Akt and ERK1 levels and pulmonary injury 1 week after CBDL. Caspase-3 inhibition also reduced AQP1, phospho-Akt and ERK1 levels, vWF-positive cells, cell proliferation, microvessel count, and microvascular dilatation and improved arterial oxygenation 3 weeks following CBDL. CONCLUSIONS: Caspase-3 inhibition alleviates pulmonary injury, thereby preventing angiogenesis as well as the development of HPS in CBDL rats. These effects are related to the regulation of the Akt and ERK1 pathways.
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Caspasa 3/metabolismo , Inhibidores de Caspasas/farmacología , Conducto Colédoco/cirugía , Síndrome Hepatopulmonar/prevención & control , Lesión Pulmonar/prevención & control , Pulmón/efectos de los fármacos , Oligopéptidos/farmacología , Animales , Apoptosis/efectos de los fármacos , Acuaporina 1/metabolismo , Proliferación Celular/efectos de los fármacos , Modelos Animales de Enfermedad , Activación Enzimática , Síndrome Hepatopulmonar/enzimología , Síndrome Hepatopulmonar/patología , Ligadura , Pulmón/irrigación sanguínea , Pulmón/enzimología , Pulmón/patología , Lesión Pulmonar/enzimología , Lesión Pulmonar/patología , Masculino , Proteína Quinasa 3 Activada por Mitógenos/metabolismo , Neovascularización Fisiológica/efectos de los fármacos , Oxígeno/sangre , Fosforilación , Proteínas Proto-Oncogénicas c-akt/metabolismo , Ratas Sprague-Dawley , Transducción de Señal/efectos de los fármacos , Factores de Tiempo , Factor de von Willebrand/metabolismoRESUMEN
Water quality information of Beijiang River, a tributary of Pearl River in Guangdong, China, was analyzed to provide an overview of the hydrochemical functioning of a major agricultural/rural area and an industrial/urban area. Eighteen water quality parameters were surveyed at 13 sites from 2005 to 2006 on a monthly basis. A bivariate correlation analysis was carried out to evaluate the regional correlations of the water quality parameters, while the principal component analysis (PCA) technique was used to extract the most influential variables for regional variations of river water quality. Six principal components were extracted in PCA which explained more than 78% and 84% of the total variance for agricultural/rural and industrial/urban areas, respectively. Physicochemical factor, organic pollution, sewage pollution, geogenic factor, agricultural nonpoint source pollution, and accumulated pesticide usage were identified as potential pollution sources for agricultural/rural area, whereas industrial wastewaters pollution, mineral pollution, geogenic factor, urban sewage pollution, chemical industrial pollution, and water traffic pollution were the latent pollution sources for industrial/urban area. A multivariate linear regression of absolute principal component scores (MLR-APCS) technique was used to estimate contributions of all identified pollution sources to each water quality parameter. High coefficients of determination of the regression equations suggested that the MLR-APCS model was applicable for estimation of sources of most water quality parameters in the Beijiang River Basin.
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Monitoreo del Ambiente , Ríos , Contaminantes Químicos del Agua/análisis , China , Análisis Multivariante , Análisis de Componente PrincipalRESUMEN
Near infra-red spectroscopy (NIRS) is a comparatively new method for monitoring the oxygenation in blood and tissue in the brain of the fetus and the neonate. Absorption of light in the wavelength range 700-1000 nm through such tissue is measured, which is then used to calculate changes in the concentration of cerebral oxygenated and de-oxygenated haemoglobin (HbO2 and Hb) and hence cerebral blood volume (CBV). Studies carried out on several groups of newborn babies have shown clear changes in HbO, Hb and CBV with hypoxia and bradycardia. These changes may well have implications in the occurrence of hypoxic/ischaemic brain injury. Intra partum NIR measurements on the fetal brain have demonstrated clear changes in HbO2, Hb and CBVm, coinciding with the onset of contractions.