Admission inflammatory markers and isolation of a causative organism in patients with spontaneous spinal infection

Introduction

The purpose of this study was to investigate the significance of the inflammatory markers on admission in the isolation of a causative pathogen in patients with spinal infection. Spinal infection is treated frequently at spinal units and can encompass a broad range of clinical entities. Its diagnosis is often delayed because of the difficulty of identifying the responsible pathogen.

Methods

Patients with spinal infection treated in our institution over a period of eight years were identified and their notes studied retrospectively. Admission C-reactive protein (CRP), white cell count (WCC) as well as co-morbidities and mode of pathogen identification were recorded. Overall, 96 patients were included in the study.

Results

The CRP levels on admission were correlated significantly with the overall potential for isolation of a pathogen (p<0.0001) and positive biopsy cultures (p=0.0016). Admission WCC levels were associated significantly with the overall potential for isolation of a pathogen (p=0.0003) and positive biopsy cultures (p=0.0023). Both CRP and WCC levels were significantly negatively correlated with the duration of the preceding symptoms (p=0.0003 and p<0.0001 respectively). Delay in presentation was significantly negatively correlated with organism isolation (p=0.0001). Multivariate analyses identified the delay in presentation as the strongest independent variable for organism isolation (p=0.014) in cases of spontaneous spinal infection when compared with the admission CRP level (p=0.031) and WCC (p=0.056).

Conclusions

In spontaneous spinal infection, delay in presentation is the strongest independent variable for organism isolation. High inflammatory marker levels on admission are a useful prognostic marker for the overall potential of isolating a causative organism either by blood cultures or by biopsy in patients with negative blood cultures. Furthermore, the admission inflammatory marker levels allow for treating surgeons to counsel their patients of the likelihood of achieving a positive microbiological yield from biopsy.     

Physical and Biochemical Characterization of Chemically Treated Pollen Shells for Potential Use in Oral Delivery of Therapeutics

Allergen-free pollen shells obtained from natural pollen grains have recently attracted attention as microcapsules for oral therapeutic delivery. We have recently developed a chemical treatment method that enables successful retrieval of hollow pollen shells from diverse species. A comprehensive characterization is critical to characterize the effects of chemical treatment which will not only benchmark the pollen treatment process but can also lay the foundation of quality control procedures to check allergen-removal efficiency during pollen treatment. Therefore, in this study, we followed the effects of chemical treatment on 4 different pollen species using electron microscopy, elemental analysis, gel electrophoresis, confocal microscopy, Fourier-transform infrared spectroscopy, and thermogravimetric analysis. These analyses revealed that acetone treatment removed lipids from the pollen surface. Phosphoric acid treatment removed proteins and nucleic acids from the pollen core and transformed esters into carboxylic acids. Potassium hydroxide hydrolysis changed carbohydrate composition of the pollen wall. Chemically treated pollen shells exhibited hydroxyl and carboxyl functional groups on their surface. Overall, we propose that confocal microscopy could be used as a rapid scanning technique to visualize the removal of biomolecules, whereas Fourier-transform infrared combined with gel electrophoresis could be used as a more objective approach for analysis and benchmarking.     

Imaging prostate cancer (PCa) with [99mTc(CO)3]finasteride dithiocarbamate

This investigation aimed to modify finasteride ( 1 ) to finasteride dithiocarbamate ( 2 ) for subsequent synthesis of the rhenium analogue ( 3 ) and [^99mTc]tricarbonyl complexes ( 4 ), to assess its prostate cancer (PCa) targeting potential in a rat model. To validate the identity of ( 4) , reference ( 3) has been synthesized by using fac‐[Net₄]₂[ReBr₃(CO)₃] precursor and characterized by ¹H‐NMR, ¹³C‐NMR, ESI‐MS, and elemental analysis. The analogue ( 4) was synthesized by using fac‐[^99mTc(H₂O)₃(CO)₃]⁺ precursor, and its structure was confirmed by comparative HPLC by using ( 3) as a reference. Further, the suitability of ( 4) as a PCa imaging agent was investigated in vitro and in vivo. At room temperature, ( 4) had ≥99% radiochemical purity and remained ≥84% stable in serum. In preclinical studies, biodistribution of ( 4) in histopathologically established rat model showed adequately high in vivo uptake in the prostate attracting the possibility of using it for noninvasive imaging of PCa.     

Small area estimation of under-5 mortality in Bangladesh,Cameroon, Chad,Mozambique, Uganda,and Zambia using spatially misaligned data

Background

The under-5 mortality rate (U5MR) is an important metric of child health and survival. Country-level estimates of U5MR are readily available, but efforts to estimate U5MR subnationally have been limited, in part, due to spatial misalignment of available data sources (e.g., use of different administrative levels, or as a result of historical boundary changes).

Methods

We analyzed all available complete and summary birth history data in surveys and censuses in six countries (Bangladesh, Cameroon, Chad, Mozambique, Uganda, and Zambia) at the finest geographic level available in each data source. We then developed small area estimation models capable of incorporating spatially misaligned data. These small area estimation models were applied to the birth history data in order to estimate trends in U5MR from 1980 to 2015 at the second administrative level in Cameroon, Chad, Mozambique, Uganda, and Zambia and at the third administrative level in Bangladesh.

Results

We found substantial variation in U5MR in all six countries: there was more than a two-fold difference in U5MR between the area with the highest rate and the area with the lowest rate in every country. All areas in all countries experienced declines in U5MR between 1980 and 2015, but the degree varied both within and between countries. In Cameroon, Chad, Mozambique, and Zambia we found areas with U5MRs in 2015 that were higher than in other parts of the same country in 1980. Comparing subnational U5MR to country-level targets for the Millennium Development Goals (MDG), we find that 12.8% of areas in Bangladesh did not meet the country-level target, although the country as whole did. A minority of areas in Chad, Mozambique, Uganda, and Zambia met the country-level MDG targets while these countries as a whole did not.

Conclusions

Subnational estimates of U5MR reveal significant within-country variation. These estimates could be used for identifying high-need areas and positive deviants, tracking trends in geographic inequalities, and evaluating progress towards international development targets such as the Sustainable Development Goals.

     

Risk modeling of non-communicable diseases using socio-demographic characteristics,lifestyle and family disease history among university students in Bangladesh

Aim

The objective of this study was to determine risk factors for non-communicable diseases (NCDs) on the basis of socio-demographic characteristics, lifestyle-related determinants, environmental and psychological characteristics, and individual and family disease history among university students in Bangladesh.

Study design

Cross-sectional survey.

Methods

Using the WHO STEPwise approach for NCDs, a cross-sectional study was conducted among 1,140 students. The collected data were analyzed using the Statistical Package for Social Sciences (SPSS) software, version 22.

Results

In all, 29.2% of the respondents (BMI?≥?23.00 kg/m²) were overweight and/or obese, and almost two-thirds (65%) of them did not take part in any physical activity (PA). A third (33.3%, p?=?0.002) of male smokers reported health problems and it was found that environmental tobacco smoke (ETS) was significantly responsible for developing asthma (OR?=?0.55; CI?=?0.33–0.93). Individual and family history of NCDs was statistically significant for obesity and asthma and considerably increased the odds ratio for heart disease.

Conclusion

This study shows that the number of students suffering from different types of NCDs is not negligible. Their lifestyle and family history of NCDs are responsible for this to a significant extent. Urgent initiatives should be taken to rein in the spread of NCDs among the youth of Bangladesh.