Hemoperitoneum in segmental portal hypertension caused by pancreatic pseudocyst

A case of haemoperitoneum during segmentary portal hypertension due to pancreatic pseudocyst is reported. After a short general review, certain physiopathological and therapeutic aspects of particular practical interest are presented.     

Incidence,risk factors and outcome of acute kidney injury (AKI) in patients with COVID-19

Clinical and Experimental Nephrology - Acute kidney injury (AKI) is a severe complication of coronavirus disease-2019 (COVID-19). This study aims to evaluate incidence, risk factors and...     

Performance Evaluation of Three Blood Glucose Monitoring Systems Using ISO 15197: 2013 Accuracy Criteria,Consensus and Surveillance Error Grid Analyses,and Insulin Dosing Error Modeling in a Hospital Setting

Background:

Blood glucose monitoring is an essential component of diabetes management. Inaccurate blood glucose measurements can severely impact patients’ health. This study evaluated the performance of 3 blood glucose monitoring systems (BGMS), Contour® Next USB, FreeStyle InsuLinx®, and OneTouch® Verio™ IQ, under routine hospital conditions.

Methods:

Venous blood samples (N = 236) obtained for routine laboratory procedures were collected at a Spanish hospital, and blood glucose (BG) concentrations were measured with each BGMS and with the available reference (hexokinase) method. Accuracy of the 3 BGMS was compared according to ISO 15197:2013 accuracy limit criteria, by mean absolute relative difference (MARD), consensus error grid (CEG) and surveillance error grid (SEG) analyses, and an insulin dosing error model.

Results:

All BGMS met the accuracy limit criteria defined by ISO 15197:2013. While all measurements of the 3 BGMS were within low-risk zones in both error grid analyses, the Contour Next USB showed significantly smaller MARDs between reference values compared to the other 2 BGMS. Insulin dosing errors were lowest for the Contour Next USB than compared to the other systems.

Conclusions:

All BGMS fulfilled ISO 15197:2013 accuracy limit criteria and CEG criterion. However, taking together all analyses, differences in performance of potential clinical relevance may be observed. Results showed that Contour Next USB had lowest MARD values across the tested glucose range, as compared with the 2 other BGMS. CEG and SEG analyses as well as calculation of the hypothetical bolus insulin dosing error suggest a high accuracy of the Contour Next USB.     

Tumor associated glycoprotein-72 (TAG-72) levels in patients with non-malignant and malignant disease.

TAG-72 is a tumor-associated antigen identified by the monoclonal antibody B72.3. Serum levels of TAG-72 were measured in patients with non-malignant and malignant disease. TAG-72 is not a specific marker of cancer and slightly elevated levels of this antigen can also be detected in the serum of healthy subjects. However, our results show that specificity (92%) and positive predictive value (86%) of this marker are very high. TAG-72 levels above the cut-off limit of 6 U/mL were found in patients with tumors of various organs, including gastrointestinal, ovarian, lung and breast cancer. TAG-72 assay sensitivity is related to tumor stage with values being highest with advanced disease, especially in patients with gastric cancer and lung adenocarcinoma.     

In Vivo Selectivity of Nonsteroidal Antiinflammatory Drugs and Gastrointestinal Ulcers in Rats

The aim of the present work was to study in vivo COX-2–COX-1 selectivity of 16 nonsteroidal anti-inflammatory drugs (NSAIDs) in equipotent ulcerogenic doses in two in vivo experimental models. Indomethacin, ibuprofen, nimesulide, aceclofenac, aspirin, sodium diclofenac, meloxicam, naproxene, paracetamol, piroxicam, tenoxicam, nabumetone, ketoprofen, mefenamic acid, etodolac, and ketorolac were administered to female Wistar rats (N = 10 each group). In experiment I, solid food plus subcutaneous NSAIDs were given. In experiment II, NSAIDs were given by oral gavage and in bolus. Macroscopic gastric antral ulcer area (30%) and intestinal erosiva area (295 mm2) in experiment I and necrotic gastric fundus area (65%) and erosive intestinal area (182 mm2), in vivo the NSAIDs COX-1 was showed. Neutrofilia assessed in gastric intestinal mucosa where also ibuprofen and paracetamol not given neotrophilic infiltration. In conclusion, COX-2–COX-1 selectivity was demonstrated in vivo with the drugs aceclofenac, nabumetone, meloxicam, nimesulide, and paracetamol.     

Muscle enzyme and fiber type‐specific sarcomere protein increases in serum after inertial concentric‐eccentric exercise

Muscle damage induced by inertial exercise performed on a flywheel device was assessed through the serum evolution of muscle enzymes, interleukin 6, and fiber type‐specific sarcomere proteins such as fast myosin (FM) and slow myosin (SM). We hypothesized that a model of muscle damage could be constructed by measuring the evolution of serum concentration of muscle proteins following inertial exercise, according to their molecular weight and the fiber compartment in which they are located. Moreover, by measuring FM and SM, the type of fibers that are affected could be assessed. Serum profiles were registered before and 24, 48, and 144 h after exercise in 10 healthy and recreationally active young men. Creatine kinase (CK) and CK‐myocardial band isoenzyme increased in serum early (24 h) and returned to baseline values after 48 h. FM increased in serum late (48 h) and remained elevated 144 h post‐exercise. The increase in serum muscle enzymes suggests increased membrane permeability of both fast and slow fibers, and the increase in FM reveals sarcomere disruption as well as increased membrane permeability of fast fibers. Consequently, FM could be adopted as a fiber type‐specific biomarker of muscle damage.     

Dysfunction of serotonergic activity and emotional responses across the light-dark cycle in mice lacking melatonin MT2 receptors

Melatonin (MLT) levels fluctuate according to the external light/dark cycle in both diurnal and nocturnal mammals. We previously demonstrated that melatonin MT₂ receptor knockout (MT₂^−/−) mice show a decreased nonrapid eye movement sleep over 24 hours and increased wakefulness during the inactive (light) phase. Here, we investigated the role of MT₂ receptors in physiological light/dark cycle fluctuations in the activity of dorsal raphe nucleus (DRN) serotonin (5-HT) neurons and anxiety- and depression-like behavior. We found that the 5-HT burst-firing activity was tonically reduced across the whole 24 hours in MT₂^−/− mice compared with MT₂^+/+ mice.  Importantly, the physiological changes in the spontaneous firing activity of DRN 5-HT neurons during the light/dark cycle were nullified in MT₂^−/− mice, with a higher DRN 5-HT neural firing activity during the light phase in MT₂^−/− than in MT₂^+/+ mice. The role of MT₂ receptors over DRN 5-HT neurons was confirmed by acute pharmacological studies in which the selective MT₂ receptors agonist UCM1014 dose dependently inhibited DRN 5-HT activity, mostly during the dark phase. Compared with MT₂^+/+, MT₂^−/− mice displayed an anxiety-like phenotype in the novelty-suppressed feeding and in the light/dark box tests; while anxiety levels in the light/dark box test were lower during the dark than during the light phase in MT₂^+/+ mice, the opposite was seen in MT₂^−/− mice. No differences between MT₂^+/+ and MT₂^−/− mice were observed for depression-like behavior in the forced swim and in the sucrose preference tests. These results suggest that MT₂ receptor genetic inactivation impacts 5-HT neurotransmission and interferes with anxiety levels by perturbing the physiologic light/dark pattern.     

An effective algorithm for quick fractal analysis of movement biosignals

The problem of numerically classifying patterns, of crucial importance in the biomedical field, is here faced by means of their fractal dimension. A new simple algorithm was developed to characterize biomedical mono-dimensional signals avoiding computationally expensive methods, generally required by the classical approach of the fractal theory. The algorithm produces a number related to the geometric behaviour of the pattern providing information on the studied phenomenon. The results are independent of the signal amplitude and exhibit a fractal measure ranging from 1 to 2 for monotonically going-forwards monodimensional curves, in accordance with theory. Accurate calibration and qualification were accomplished by analysing basic waveforms. Further studies concerned the biomedical field with special reference to gait analysis: so far, well controlled movements such as walking, going up and downstairs and running, have been investigated. Controlled conditions of the test environment guaranteed the necessary repeatability and the accuracy of the practical experiments in setting up the methodology. The algorithm showed good performance in classifying the considered simple movements in the selected sampleof normal subjects. The results obtained encourage us to use this technique for an effective on-line movement correlation with other long-term monitored variables such as blood pressure, ECG, etc.