Perinephric abscess with renal cell carcinoma

A case of perinephric abscess with renal cell carcinoma is presented. Hematuria is uncommon in cases of perinephric abscess. When hematuria is present in a patient with perinephric abscess further evaluation is necessary to rule out an associated malignant process.     

SURVEY OF CARDIAC ARRESTS AND CARDIAC ARREST TROLLEYS IN A DISTRICT GENERAL HOSPITAL

SUMMARY In a 12-month period there were 137 cardiac arrests in a district general hospital. Cardiopulmonary resuscitation was instituted within 3 minutes in 82%. Delay in 18% was due to equipment failure. Survival at 6 months was 12%. Of the 18% of inappropriate arrests, 42% had ‘do-not-resuscitate’ orders in the casenotes. Survival did not depend on age, sex, location, presence of an anaesthetist, experience of house officer, time of day or admission diagnosis. Survival was more likely in the presence of ventricular fibrillation and absence of intubation. Of the 32 arrest trolleys, 66% were geographically acceptable to the area they served and 9% had significant deficiencies (these were situated in patient waiting areas and were infrequently checked).     

Correlation of anthropometry with CT in Mexican-American women

Measurement of regional fat has commonly been accomplished by extrapolation from anthropometric measures. Recent studies of White and Black women have demonstrated differences in intra-abdominal fat, using computerized tomographic (CT) techniques. These same estimates were computed for 48 Mexican American women who were undergoing CT for diagnostic purposes. Waist-hip ratios, waist-thigh ratios, and sagittal diameter index were also calculated. Four (7mm) CT slices between L-4 and L - 5 were analyzed with imaging software. The volume of both subcutaneous and visceral fat was estimated. Like other minority women, Mexican American women had less intra-abdominal fat than subcutaneous fat, which is important because of the association of excess intra-abdominal fat with cardiovascular risk. Intra-abdominal fat volume was significantly predicted by only one variable, sagittal abdominal diameter, while subcutaneous fat volume was predicted by hip and thigh circumferences.     

9:15-9:30. Use of a Spherical 3-D Blob Analysis Program as a Method of Determination of Standardized Uptake Value (SUV) for Following Tumor Response to Chemotherapeutic Agents (CTA)

Malignant tumors exhibit increased glucose metabolism which can be quantitated by SUV. SUV is criticized for its variability resulting from many factors including the method of drawing region of interest (ROI) over the tumor. The most common method manually draws or places ROI on various slices displaying highest FDG activity. This time consuming method is associated with significant individual variation. We describe a more reproducible, efficient spherical 3-D blob analysis method of SUV and tumor volume (TV) determination to evaluate CTA response. The spherical 3-D Blob analysis program is a completely automated method with data processing performed using IDL (RS Inc., Colorado). A threshold value is set for the ROI; all voxels above threshold are grouped by connectivity. Grouped voxels, called "blobs", are displayed and statistics are calculated for each group. The threshold set for blob extraction and SUV determination is usually three times above background and is constant on repeat scans. Eight patients with metastatic carcinoma underwent PET/CT/MRI prior to and one week after chemotherapy. Three patients also had scans at one month. Maximum and average SUV's and TV were determined and appeared to be very reproducible when there was no clinical response or change on CT/MR. In these patients, repeat SUV's and volumes of the lesions (n = 38) varied by less than 20% of baseline. An increase/decrease in maximum SUV or TV correlated with a similar change in lesion size on CT/MR. The average SUV did not change. The spherical 3-D blob analysis program appears to be a reliable, efficient method of determining maximum SUV and volumetric measurements for following tumor response to CTA.     

Associations between Maternal Diet,Body Composition and Gut Microbial Ecology in Pregnancy

Maternal body composition, gestational weight gain (GWG) and diet quality influence offspring obesity risk. While the gut microbiome is thought to play a crucial role, it is understudied in pregnancy. Using a longitudinal pregnancy cohort, maternal anthropometrics, body composition, fecal microbiome and dietary intake were assessed at 12, 24 and 36 weeks of gestation. Fecal samples (n = 101, 98 and 107, at each trimester, respectively) were utilized for microbiome analysis via 16S rRNA amplicon sequencing. Data analysis included alpha- and beta-diversity measures and assessment of compositional changes using MaAsLin2. Correlation analyses of serum metabolic and anthropometric markers were performed against bacterial abundance and predicted functional pathways. α-diversity was unaltered by pregnancy stage or maternal obesity status. Actinobacteria, Lachnospiraceae, Akkermansia, Bifidobacterium, Streptococcus and Anaerotuncus abundances were associated with gestation stage. Maternal obesity status was associated with increased abundance of Lachnospiraceae, Bilophila, Dialister and Roseburia. Maternal BMI, fat mass, triglyceride and insulin levels were positively associated with Bilophila. Correlations of bacterial abundance with diet intake showed that Ruminococcus and Paraprevotella were associated with total fat and unsaturated fatty acid intake, while Collinsella and Anaerostipes were associated with protein intake. While causal relationships remain unclear, collectively, these findings indicate pregnancy- and maternal obesity-dependent interactions between dietary factors and the maternal gut microbiome.     

Use of bi-level biotinylation for concurrent measurement of in vivo recovery and survival in two rabbit platelet populations

BACKGROUND: The objectives of this research were 1) to determine whether two populations of platelets may be labeled with different levels of biotin and followed concurrently in vivo by flow cytometry and 2) to determine whether the level of biotinylation affects the in vivo platelet recovery and survival. STUDY DESIGN AND METHODS: Two platelet aliquots were biotinylated under conditions that resulted in either a lower or a higher number of biotin molecules per platelet. After transfusion, the two populations were distinguished and quantitated by flow cytometry. RESULTS: In five animals, recoveries were 69.8 +/− 27.0 percent for low-biotin platelets and 72.6 +/− 26.7 percent for high-biotin platelets. For each animal, the recoveries agreed closely. Life span, determined by the multiple-hit method, was 2.68 +/− 0.63 days for low-biotin platelets and 2.58 +/− 0.69 days for high-biotin platelets. These values for recovery and life span are consistent with those measured in rabbits by using radioisotope labels. CONCLUSION: Platelet biotinylation offers a nonisotopic method for direct comparison of alternative harvest and storage conditions. It also offers the potential for simultaneous evaluation of the in vivo characteristics of platelets from at least two donors.