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101.

Background

Postoperative urinary retention (POUR) appears to be a common complication in lower limb joint arthroplasty; however, reports on its incidence vary. There is no general consensus on its definition and there is no scientific evidence on treatment principles. We performed a prospective observational study to establish the incidence of POUR and its risk factors, including the preoperative postvoid residual urine volume and the perioperative fluid balance, in fast-track total joint arthroplasty (TJA). The preoperative residual urine volume and the perioperative fluid balance have not been studied in previous literature in the context of TJA and POUR.

Methods

Three hundred eighty-one patients who underwent TJA of the lower limb were observed on developing POUR according to our local treatment protocol. Data on possible risk factors for POUR were collected including the perioperative fluid balance and the preoperative residual urine volume.

Results

In total, 46.3% of patients were catheterized. A preoperative postvoid urine retention is a significant predictor of catheterization for postoperative residual urine (P = .03). Spinal anesthesia was correlated with urinary retention (P = .01). There was no cause-effect relationship between POUR and the perioperative fluid balance.

Conclusion

This study underlines POUR as a common complication in fast-track lower limb arthroplasty, with spinal anesthesia as a risk factor. A higher preoperative residual urine volume leads to higher postoperative residual volume, but not to a higher change in urinary retention. Increased perioperative fluid administration is not correlated with the incidence of POUR. Furthermore, there seems to be little rationale for monitoring residual urine volume both preoperatively and postoperatively.  相似文献   
102.
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104.
Four nardosinone-type sesquiterpenes, nardosinone, isonardosinone, kanshone E, and kanshone B, were isolated from the hexane fraction of Nardostachys jatamansi (Valerianaceae) methanol extract. The structures of these compounds were mainly established by analyzing the data obtained from nuclear magnetic resonance (NMR) spectroscopy and mass spectrometry (MS). In this study, we investigated their anti-neuroinflammatory effects in lipopolysaccharide (LPS)-induced BV2 microglial cells. The results showed that nardosinone-type sesquiterpenes inhibited the production of pro-inflammatory mediators, such as nitric oxide (NO) and prostaglandin E2 (PGE2) in LPS-induced BV2 microglial cells. These inhibitory effects were correlated with the downregulation of inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2). Moreover, these sesquiterpenes also attenuated the mRNA expression of pro-inflammatory cytokines including interleukin-1β (IL-1β), IL-6, and tumor necrosis factor-α (TNF-α) in LPS-induced BV2 microglial cells. During the evaluation of the signaling pathways involved in these anti-neuroinflammatory effects, western blot analysis and DNA-binding activity assay revealed that the suppression of inflammatory reaction by these sesquiterpenes was mediated by the inactivation of nuclear factor-kappa B (NF-κB) pathway. These sesquiterpenes also suppressed the phosphorylation of extracellular signal-regulated kinase (ERK), c-Jun N-terminal kinase (JNK), and p38 mitogen-activated protein kinase (MAPK) signaling pathways in LPS-stimulated BV2 microglial cells. Taken together, these four nardosinone-type sesquiterpenes inhibited NF-κB- and MAPK-mediated inflammatory pathways, demonstrating their potential role in the treatment of neuroinflammation conditions.  相似文献   
105.
Parasitology Research - Sparganosis is a zoonosis caused by the spargana (larvae) of Spirometra sp. (Diphyllobothriidae). Reptiles are particularly important vectors for the transmission of this...  相似文献   
106.

Background

Local allergic rhinitis (LAR) is a relatively new disease.

Objective

To ascertain the effects of allergen-specific immunotherapy in LAR.

Methods

A randomized, double-blind, placebo-controlled trial of birch subcutaneous allergen immunotherapy (AIT) for LAR was performed in 28 patients. The therapy was performed for 24 months in 15 patients with AIT and 13 patients given placebo. The primary end point was decrease in symptom medication score (SMS). In addition, we monitored serum-specific immunoglobulin E (IgE), serum-specific immunoglobulin G4, nasal-specific IgE to Bet v 1, and safety and quality-of-life parameters.

Results

After 24 months of treatment, there was a significant decrease in the median area under the curve for SMS of the active group vs the placebo group: 2.14 (range, 1.22–4.51) vs 6.21 (range, 5.12–7.89), at the P?<?.05 level. During AIT, the active group showed a significant decrease in SMS of up to 65% vs baseline. A significant increase in immunoglobulin G4 and decrease in nasal-specific IgE were observed in the active group during AIT compared with the placebo group. AIT was well-tolerated and without systemic reactions.

Conclusion

This study demonstrates that AIT for birch pollen in patients with LAR was clinically effective and exhibited good tolerance.

Trial Registration

ClinicalTrials.gov Identifier: NCT03157505.  相似文献   
107.

Background

To develop an algorithm to predict the visually lossless thresholds (VLTs) of CT images solely using the original images by exploiting the image features and DICOM header information for JPEG2000 compression and to evaluate the algorithm in comparison with pre-existing image fidelity metrics.

Methods

Five radiologists independently determined the VLT for 206 body CT images for JPEG2000 compression using QUEST procedure. The images were divided into training (n?=?103) and testing (n?=?103) sets. Using the training set, a multiple linear regression (MLR) model was constructed regarding the image features and DICOM header information as independent variables and regarding the VLTs determined with median value of the radiologists’ responses (VLTrad) as dependent variable, after determining an optimal subset of independent variables by backward stepwise selection in a cross-validation scheme.The performance was evaluated on the testing set by measuring absolute differences and intra-class correlation (ICC) coefficient between the VLTrad and the VLTs predicted by the model (VLTmodel). The performance of the model was also compared two metrics, peak signal-to-noise ratio (PSNR) and high-dynamic range visual difference predictor (HDRVDP). The time for computing VLTs between MLR model, PSNR, and HDRVDP were compared using the repeated ANOVA with a post-hoc analysis. P?<?0.05 was considered to indicate a statistically significant difference.

Results

The means of absolute differences with the VLTrad were 0.58 (95% CI, 0.48, 0.67), 0.73 (0.61, 0.85), and 0.68 (0.58, 0.79), for the MLR model, PSNR, and HDRVDP, respectively, showing significant difference between them (p?<?0.01). The ICC coefficients of MLR model, PSNR, and HDRVDP were 0.88 (95% CI, 0.81, 0.95), 0.85 (0.79, 0.91), and 0.84 (0.77, 0.91). The computing times for calculating VLT per image were 1.5?±?0.1 s, 3.9?±?0.3 s, and 68.2?±?1.4 s, for MLR metric, PSNR, and HDRVDP, respectively.

Conclusions

The proposed MLR model directly predicting the VLT of a given CT image showed competitive performance to those of image fidelity metrics with less computational expenses. The model would be promising to be used for adaptive compression of CT images.
  相似文献   
108.
Temporal bone reconstruction is a persisting problem following middle ear cholesteatoma surgery. Seeking to advance the clinical transfer of stem cell therapy we attempted the reconstruction of temporal bone using a composite bioartificial graft based on a hydroxyapatite bone scaffold combined with human bone marrow-derived mesenchymal stromal cells (hBM-MSCs). The aim of this study was to evaluate the effect of the combined biomaterial on the healing of postoperative temporal bone defects and the preservation of physiological hearing functions in a guinea pig model. The treatment’s effect could be observed at 1 and 2 months after implantation of the biomaterial, as opposed to the control group. The clinical evaluation of our results included animal survival, clinical signs of an inflammatory response, and exploration of the tympanic bulla. Osteogenesis, angiogenesis, and inflammation were evaluated by histopathological analyses, whereas hBM-MSCs survival was evaluated by immunofluorescence assays. Hearing capacity was evaluated by objective audiometric methods, i.e. auditory brainstem responses and otoacoustic emission. Our study shows that hBM-MSCs, in combination with hydroxyapatite scaffolds, improves the repair of bone defects providing a safe and effective alternative in their treatment following middle ear surgery due to cholesteatoma.  相似文献   
109.

Objectives

Protective vaccinations are the most effective method of prevention of type B virus hepatitis. The aim of the study was to determine whether in children receiving immunosuppressive therapy due to inflammatory systemic connective tissue diseases the protective concentration of the anti-HBs antibodies produced after vaccination against type B virus hepatitis in infancy is maintained.

Material and methods

The concentration of anti-HBs antibodies was assessed in the sera of 50 children with inflammatory connective tissue diseases – 37 girls (74%) and 13 boys (26%), aged 1.5–17.5 years – during the immunosuppressive treatment, which lasted at least 6 months. The control group consisted of 50 healthy children – 28 girls (56%) and 22 boys (44%) aged 2–17 years. All children were vaccinated in infancy with Engerix B vaccine according to the 0–1–6 months schedule. The antibody concentration of ≥ 10 mIU/ml in patients is regarded as protective.

Results

No protective antibody concentrations were found in 25 cases (50%) in the group of diseased children and only in 2 children in the control group (4%).

Conclusions

The concentration of vaccine-induced antibodies should be assessed in children with inflammatory systemic connective tissue diseases and, in case of the absence of a protective concentration, revaccination should be started. The use of glucocorticosteroids, synthetic and biological disease-modifying antirheumatic drugs is no contraindication to vaccination against hepatitis B.  相似文献   
110.
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