High-dose external beam irradiation inhibits neointima formation in stented pig coronary arteries.

PURPOSE: To evaluate high-dose external beam irradiation (EBRT) in a pig coronary stent preparation because low and intermediate-dose EBRT failed to show inhibition of neointima formation in stented animal models. METHODS AND MATERIALS: Thirty-five stents were implanted in the coronary arteries of 17 pigs. Seven pigs were exposed to a single dose of 21 Gy EBRT immediately after stenting. Ten stented, nonirradiated pigs served as controls. After 4 weeks, the study arteries and myocardium were examined by light and scanning electron microscopy. RESULTS: Compared with controls, 21 Gy EBRT resulted in a larger lumen area (7.57 +/- 1.67 mm2 vs. 4.00 +/- 1.63 mm2, p <0.001), a smaller neointima area (0.47 +/- 0.43 mm2 vs. 3.36 +/- 2.26 mm2, p <0.001) and a smaller maximal intimal thickness (0.16 +/- 0.09 mm vs. 0.68 +/- 0.31 mm, p <0.001). Unresorbed intramural hemorrhages and adherent mural thrombi were present in the irradiated vessels, which also showed incomplete re-endothelialization. The irradiated hearts demonstrated diffuse interstitial and perivascular inflammation and fibrosis. CONCLUSIONS: EBRT at 21 Gy to the entire heart significantly inhibited neointima formation in stented pig coronary arteries but also resulted in incomplete re-endothelialization, myocardial inflammation, and fibrosis. Improvements in localization and delivery techniques are required to allow clinical implementation of this technique.     

Advances in serological,imaging techniques and molecular diagnosis of <Emphasis Type="Italic">Toxoplasma gondii</Emphasis> infection

Background

Toxoplasmosis is worldwide distributed zoonotic infection disease with medical importance in immunocompromised patients, pregnant women and congenitally infected newborns. Having basic information on the traditional and new developed methods is essential for general physicians and infectious disease specialists for choosing a suitable diagnostic approach for rapid and accurate diagnosis of the disease and, consequently, timely and effective treatment.

Methods

We conducted English literature searches in PubMed from 1989 to 2016 using relevant keywords and summarized the recent advances in diagnosis of toxoplasmosis.

Results

Enzyme-linked immunosorbent assay (ELISA) was most used method in past century. Recently advanced ELISA-based methods including chemiluminescence assays (CLIA), enzyme-linked fluorescence assay (ELFA), immunochromatographic test (ICT), serum IgG avidity test and immunosorbent agglutination assays (ISAGA) have shown high sensitivity and specificity. Recent studies using recombinant or chimeric antigens and multiepitope peptides method demonstrated very promising results to development of new strategies capable of discriminating recently acquired infections from chronic infection. Real-time PCR and loop-mediated isothermal amplification (LAMP) are two recently developed PCR-based methods with high sensitivity and specificity and could be useful to early diagnosis of infection. Computed tomography, magnetic resonance imaging, nuclear imaging and ultrasonography could be useful, although their results might be not specific alone.

Conclusion

This review provides a summary of recent developed methods and also attempts to improve their sensitivity for diagnosis of toxoplasmosis. Serology, molecular and imaging technologies each has their own advantages and limitations which can certainly achieve definitive diagnosis of toxoplasmosis by combining these diagnostic techniques.

     

Survival prediction of trauma patients: a study on US National Trauma Data Bank

Background

Exceptional circumstances like major incidents or natural disasters may cause a huge number of victims that might not be immediately and simultaneously saved. In these cases it is important to define priorities avoiding to waste time and resources for not savable victims. Trauma and Injury Severity Score (TRISS) methodology is the well-known and standard system usually used by practitioners to predict the survival probability of trauma patients. However, practitioners have noted that the accuracy of TRISS predictions is unacceptable especially for severely injured patients. Thus, alternative methods should be proposed.

Methods

In this work we evaluate different approaches for predicting whether a patient will survive or not according to simple and easily measurable observations. We conducted a rigorous, comparative study based on the most important prediction techniques using real clinical data of the US National Trauma Data Bank.

Results

Empirical results show that well-known Machine Learning classifiers can outperform the TRISS methodology. Based on our findings, we can say that the best approach we evaluated is Random Forest: it has the best accuracy, the best area under the curve, and k-statistic, as well as the second-best sensitivity and specificity. It has also a good calibration curve. Furthermore, its performance monotonically increases as the dataset size grows, meaning that it can be very effective to exploit incoming knowledge. Considering the whole dataset, it is always better than TRISS. Finally, we implemented a new tool to compute the survival of victims. This will help medical practitioners to obtain a better accuracy than the TRISS tools.

Conclusion

Random Forests may be a good candidate solution for improving the predictions on survival upon the standard TRISS methodology.

     

Anti-CD38 autoimmunity in patients with chronic autoimmune thyroiditis or Graves' disease.

Autoantibodies directed against human CD38 (an enzyme catalysing the interconversion of NAD(+) and cyclic ADP-ribose) have been demonstrated recently in patients with type 2 diabetes. We tested 220 consecutive Caucasian patients with autoimmune chronic thyroiditis, 104 patients with Graves' disease, 220 subjects from the general population (control I) and 78 healthy control subjects not affected by thyroid autoimmune disorders (control II) for the presence of anti-CD38 autoimmunity. Using Western blot analysis and optical densitometry, a specific band corresponding to human recombinant CD38 was identified in the serum of several subjects. By defining anti-CD38 positivity as a standardized optical reading > 3 s.d. higher than the mean value of control I, 10.4% of patients with thyroiditis and 7.7% of Graves' patients were anti-CD38 positive (P = 0.0009 versus 1.8% of control I). Similarly, 13.1% of patients with thyroiditis and 10.5% of Graves' patients had a standardized optical reading > 3 s.d. higher than the mean value of the subjects not affected by thyroid autoimmune disorders (P = 0.002 versus 1.2% of control II). Anti-CD38 autoimmunity did not differ between euthyroid, hyperthyroid or hypothyroid patients or between patients with or without thyroid hypoechogenicity. Anti-CD38 autoantibodies were associated with higher levels of circulating antithyroid-peroxidase antibodies (P = 0.03) and they were more frequent in Graves' patients with ophthalmopathy (P < 0.05). Anti-CD38 autoantibodies are a new autoimmune marker in chronic autoimmune thyroiditis and Graves' disease. The specific role of CD38 and its autoantibodies in the modulation of thyroid cell function or growth remains to be investigated.     

Nonreducible rotational head tilt and lateral mass collapse. a prospective study of frequency,radiographic findings,and clinical features in patients with rheumatoid arthritis

Of 126 hospitalized, but otherwise unselected, patients with rheumatoid arthritis, 12 (10%) had a persisting nonreducible rotational head tilt deformity (NRRHT). These 12 were grouped with an additional 12 similar subjects, previously found to have the same condition, and all 24 were compared with the remaining 114 who did not have head tilt. Patients with NRRHT differed significantly from the others in that the former were more likely to have a destructive peripheral arthritis, headache, limited neck motion, and various cervical subluxations. All 24 subjects with NRRHT had predominately unilateral collapse of the lateral masses of the atlas and/or axis, compared with only 2 of the 114 with normal head position. The head always tilted to the side of the lateral mass collapse, which appeared to be the sole or major cause of the abnormal head position.     

Preparation and Characterization of Novel Microgels Containing Nano-SiO2 and Copolymeric Hydrogel Based on Poly (Acrylamide) and Poly (Acrylic Acid): Morphological,Structural and Swelling Studies

In this paper, novel microgels containing nano-SiO₂ were prepared by in situ copolymerization using nano-SiO₂ particles as a reinforcing agent, nanosilica functional monomer (silane-modified nano-SiO₂) as a structure and morphology director, acrylamide (AAm) as a monomer, acrylic acid (AAc) as a comonomer, potassium persulfate (KPS) as a polymerization initiator, and N,N′-methylene bis (acrylamide) (MBA) as a crosslinker. In addition, a conventional copolymeric hydrogel based on poly (acrylamide/acrylic acid) was synthesized by solution polymerization. The microgel samples, hydrogel and nanoparticles were characterized by transmission electron microscopy (TEM), field emission scanning electron microscopy (FESEM), Fourier transform infrared (FTIR) spectroscopy, thermogravimetric analysis (TGA) and differential scanning calorimetry (DSC). A FESEM micrograph of copolymeric hydrogel showed the high porosity and 3D interconnected microstructure. Furthermore, FESEM results demonstrated that when nano-SiO₂ particles were used in the AAm/AAc copolymerization process, the microstructure and morphology of product changed from porous hydrogel to a nanocomposite microgel with cauliflower-like morphology. According to FESEM images, the copolymerization of AAm and AAc monomers with a nanosilica functional monomer or polymerizable nanosilica particle as a seed led to a microgel with core–shell structure and morphology. These results demonstrated that the polymerizable vinyl group on nano-SiO₂ particles have controlled the copolymerization and the product morphology. FTIR analysis showed that the copolymeric chains of polyacrylamide (PAAm) and poly (acrylic acid) (PAAc) were chemically bonded to the surfaces of the nano-SiO₂ particles and silane-modified nano-SiO₂. The particulate character of microgel samples and the existence of long distance among aggregations of particles led to rapid swelling and increasing of porosity and therefore increasing of degree of swelling.     

High prevalence of thyroid autoimmunity and hypothyroidism in patients with psoriatic arthritis

OBJECTIVE:To evaluate the prevalence of thyroid disorders in a group of patients with psoriatic arthritis (PsA). METHODS: A complete thyroid investigation was carried out in 80 patients with PsA, in gender- and age-matched subjects (1:5) drawn from the general population (controls), and in 112 patients with rheumatoid arthrtitis (RA) with similar iodine intake. RESULTS: Anti-thyroid peroxidase antibodies (AbTPO), a hypoechoic thyroid, and subclinical hypothyroidism were significantly more frequent in women with PsA than in control women, and their frequency was similar to that in patients with RA (positive AbTPO titer 28%, 12%, and 31%; hypoechoic thyroid 31%, 16%, and 36%; subclinical hypothyroidism 25%, 8%, and 12%, respectively). Among men, positive AbTPO titers and a hypoechoic thyroid were found more frequently in the patients with PsA and RA than in controls (positive AbTPO titer 14%, 5%, and 2%; hypoechoic thyroid 16%, 10%, and 3%, respectively). All patients with PsA with subclinical hypothyroidism had polyarticular involvement (p 相似文献   

Nutritional factors and metabolic variables in relation to the risk of coronary heart disease: A case control study in Armenian adults

Introduction

Dietary factors can affect the coronary heart disease (CHD). Results of previous studies on the association between the diet and CHD are not consistent in different countries. There were no data on this association in Armenia.