Pulmonary nodules studied by computed tomography

The authors analyzed 177 pulmonary nodules using thin-section computed tomography (CT), calculating the representative CT number (RCT#) from a computer printout. None of the 96 malignant nodules had an RCT# greater than 151 H. Of the 81 benign nodules, 14 were shown to be calcified by conventional radiography and had an RCT# ranging from 763 and 1,023 H. Thirty had an RCT# greater than 200 H; this included 24 which showed no calcification on conventional tomograms. The remaining 37 benign nodules had an RCT# less than 200 H; 6 of them were hamartomas, including 2 which were diagnosed as such due to their fat content.     

In-vitro antimicrobial activity of marine actinobacteria against multidrug resistance Staphylococcus aureus

Objective

To investigate the antibacterial activity of marine actinobacteria against multidrug resistance Staphylococcus aureus (MDRSA).

Methods

Fifty one actinobacterial strains were isolated from salt pans soil, costal area in Kothapattanam, Ongole, Andhra Pradesh. Primary screening was done using cross-streak method against MDRSA. The bioactive compounds are extracted from efficient actinobacteria using solvent extraction. The antimicrobial activity of crude and solvent extracts was performed using Kirby-Bauer method. MIC for ethyl acetate extract was determined by modified agar well diffusion method. The potent actinobacteria are identified using Nonomura key, Shirling and Gottlieb 1966 with Bergey''s manual of determinative bacteriology.

Results

Among the fifty one isolates screened for antibacterial activity, SRB25 were found efficient against MDRSA. The ethyl acetate extracts showed high inhibition against test organism. MIC test was performed with the ethyl acetate extract against MDRSA and found to be 1 000 µg/mL. The isolated actinobacteria are identified as Streptomyces sp with the help of Nonomura key.

Conclusions

The current investigation reveals that the marine actinobacteria from salt pan environment can be able to produce new drug molecules against drug resistant microorganisms.     

多囊卵巢综合征患者使用屈螺酮与心血管事件相关性分析

本研究探讨多囊卵巢综合征（PCOS）患者使用含屈螺酮的口服避孕药（OC）发生心血管事件的风险。28例PCOS（Rotterdam标准）患者,根据体重指数分成两组,其中16例体瘦者（A组）和12例体胖者（组B）,年龄在18—35岁,未使用激素治疗时间均在6个月以上。给予一种OC药治疗。观察治疗前与治疗6个月后来普汀、同型半胱氨酸、内皮素-1的水平和肱动脉血流介导的血管舒张等指标的变化。     

“Kiss myAsthma”: Using a participatory design approach to develop a self-management app with young people with asthma

Objective: Young people with asthma often lack engagement in self-management. Smartphone apps offer an attractive, immediate method for obtaining asthma information and self-management support. In this research we developed an evidence-based asthma app tailored to young peoples needs, created using a participatory design approach to optimize user engagement. This paper describes the participatory design process. Methods: This multi-phased research included concept generation and ideation of app design by young people with asthma, and development of asthma information by the research team. Clinical review was sought regarding safety and accuracy of app content. Participants suggestions for improvement and any problems with the app were logged throughout. Our young co-designers were invited back to test a high fidelity prototype app using a “think aloud” process and completed a usability questionnaire. Results: Twenty asthma patients aged 15-24 years contributed to the initial app design. Three respiratory specialists and two pharmacists suggested minor corrections to clinical terminology in the app which were all incorporated. Nine co-designers acted as expert reviewers of the prototype app, of whom eight completed a usability questionnaire. Median usability scores (maximum score 6) indicated high satisfaction with app content, usefulness and ease of use [median item score 5.3 (range 4.7-6.0)]. All feedback was incorporated to create an updated prototype app. Conclusions: A clinically sound asthma app has been developed which is considered highly acceptable to the young co-designers. A six-week test of the engagement, acceptability, and usefulness of the app in young people not involved in the participatory design will follow.     

Incongruent reduction following post-traumatic hip dislocations as an indicator of intra-articular loose bodies: A prospective study of 117 dislocations

Background:

Intra-articular loose bodies following simple dislocations can lead to early degeneration. Nonconcentric reduction may indicate retained loose bodies and offer a method to identify patients requiring exploration so that this undesirable outcome can be avoided.

Materials and Methods:

One hundred and seventeen consecutive simple dislocations of the hip presenting to the hospital from January 2000 to June 2006 were assessed for congruency after reduction by fluoroscopic assessment of passive motion in the operating room as well as with good quality radiographs. Computerized tomography (CT) scan with 2-mm cuts was done for confirmation of reduction and to identify the anatomy of loose bodies. Patients with nonconcentric reduction underwent open exploration to identify the etiology of the dislocation and for removal of loose bodies. Thomson and Epstein clinical and radiological criteria were used to assess the outcome.

Results:

Twelve of the one hundred and seventeen (10%) dislocations had incongruent reduction, which was identified by the break in Shenton’s line and increase in medial joint space in seven patients, increase in the superior joint space in three patients, or increase in the joint space as a whole in two patients. CT scan identified the origin of the osteocartilaginous fragment as being from the acetabulum in six patients, the femoral head in four, and from both in one. One patient had an inverted posterior labrum. Following debridement, congruent reduction was achieved in all patients. At an average follow-up of 5 years (range: 2 years 5 months to 8 years), the outcome as evaluated by Thompson and Epstein clinical criteria was excellent in eleven cases and good in one case; the radiological outcome was excellent in eight cases and good in four cases.

Conclusions:

Intra-articular loose bodies were identified by nonconcentric reduction in 12 out of 117 patients with simple hip dislocation. Careful evaluation by fluoroscopy and good quality radiographs are indicated following reduction of hip dislocations.     

Campylobacter diarrhea in children in South Asia: A systematic review

BackgroundCampylobacter spp. are one of the commonest causes of diarrhea in children under five and in resource poor settings also lead to malabsorption and stunting. The purpose of this systematic review was to understand the burden of Campylobacter spp. associated diarrhea among children in the South Asian countries.MethodsThis systematic review followed the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analysis) guidelines. Databases were searched with defined keywords for publications from the years 1998–2018. Data on proportion of positive samples was extracted to compare the rates of Campylobacter infection among children (under the age of 19) from different study populations.ResultsOf the 359 publications screened, 27 eligible articles were included in this systematic review and categorized based on study design. In 8 case-control studies, Campylobacter spp. was detected more frequently among diarrheal cases (range, 3.2–17.4%) than non-diarrheal cases (0–13%). Although there were variations in the study population, overall, children under the age of two years experienced Campylobacter diarrhea more often than older children. Most studies reported stool culture as the method used to detect Campylobacter spp. however retesting using PCR-based methods significantly increased detection rates. Limited data were available on Campylobacter species. In 4 studies that provided species data, C. jejuni (3.2–11.2%) was shown to be the most common species, followed by C. coli.ConclusionIn South Asia, Campylobacter spp. are one of the most common bacterial diarrheal pathogens affecting children but there is a paucity of data on species, risk factors and attributable sources. Although a few studies were available, the epidemiology of campylobacteriosis remains uncertain. To understand the true burden and sources of infection, more detailed studies are needed collecting data from human, animal and environmental sources and using both culture and genomic tools.