Utility of MRI in detection of PET-CT proven local recurrence of pancreatic adenocarcinoma after surgery.

The aim of this prospective study was to investigate the accuracy and inter-observer reliability of MRI in detection of local recurrence (LR) of pancreatic adenocarcinoma (PAC) after surgery, which was proved by PET-CT and access correlation between functional MRI and PET parameters. Forty-five patients who underwent PET-CT and MRI for follow-up purposes after radical operation of PAC were included. Twenty-three were PET positive (study group) and 22 negative for LR (control group). MR examination was performed within one month after PET-CT and three readers who were blind for PET-CT findings searched LR in T2W, 3D-dynamic post-contrast T1W-FS and DWI sequences, respectively. Sensitivity and specificity were calculated while inter-reader agreement was estimated by Cronbach's Alpha reliability coefficient (CARC). Apparent diffusion coefficient (ADC) of LR was correlated with the size (maximal diameter) and functional PET-CT parameters: mean and maximum standardized uptake values (SUVmean, SUVmax), metabolic tumor volume (MTV) and total lesion glycolysis (TLG), using Spearman's correlation coefficient (rS). Sensitivity and specificity among three readers in detecting the LR were 70% and 77-84% in T2W (CARC 0.806), 91-100% and 100% in 3D post-contrast T1W-FS (CARC 0.980), and both 100% in DWI sequences (CARC 1.000). Moderate inverse correlation was found between the ADC and SUVmean (rS = - 0.484), MTV (rS = - 0.494), TLG (rS = - 0.519) and lesion size (rS = - 0.567). MRI with DWI shows high diagnostic accuracy in detecting the LR of PAC in comparison to PET-CT as reference standard. ADC significantly inversely correlates with standard and advanced PET parameters and size of LR.

Comparative evaluation of physicochemical profile and bioactive properties of red edible seaweed Chondrus crispus subjected to different drying methods.

Dehydration of the edible seaweed Chondrus crispus was performed by freeze-drying, conventional oven-drying and emerging microwave hydrodiffusion and gravity (MHG). In this work, the drying kinetics and modelling, estimating specific energy consumption and environmental impact of distinct processes were tested. Color and microstructural features of the dried macroalgae were also evaluated, as well as their nutritive characterization, chemical profile and bioactive potential (antioxidant and antimicrobial activities). Moreover, collected liquid phases from both the defrosted and MHG treated samples were also characterized. All methodologies provided solid phases with an adequate final moisture content. MHG significantly reduced the needed time, specific energy consumption and environmental impact, providing C. crispus with intermediate color and histological structure characteristics. Overall, this trend was also defined to tested chemical parameters and bioactivities. MHG provided aqueous extracts with potential bioactive compounds from this red alga, increasing the efficiency of this drying method.

Nuclear poly(ADP-ribose) activity is a therapeutic target in amyotrophic lateral sclerosis.

Amyotrophic lateral sclerosis (ALS) is a devastating and fatal motor neuron disease. Diagnosis typically occurs in the fifth decade of life and the disease progresses rapidly leading to death within ~ 2-5 years of symptomatic onset. There is no cure, and the few available treatments offer only a modest extension in patient survival. A protein central to ALS is the nuclear RNA/DNA-binding protein, TDP-43. In > 95% of ALS patients, TDP-43 is cleared from the nucleus and forms phosphorylated protein aggregates in the cytoplasm of affected neurons and glia. We recently defined that poly(ADP-ribose) (PAR) activity regulates TDP-43-associated toxicity. PAR is a posttranslational modification that is attached to target proteins by PAR polymerases (PARPs). PARP-1 and PARP-2 are the major enzymes that are active in the nucleus. Here, we uncovered that the motor neurons of the ALS spinal cord were associated with elevated nuclear PAR, suggesting elevated PARP activity. Veliparib, a small-molecule inhibitor of nuclear PARP-1/2, mitigated the formation of cytoplasmic TDP-43 aggregates in mammalian cells. In primary spinal-cord cultures from rat, Veliparib also inhibited TDP-43-associated neuronal death. These studies uncover that PAR activity is misregulated in the ALS spinal cord, and a small-molecular inhibitor of PARP-1/2 activity may have therapeutic potential in the treatment of ALS and related disorders associated with abnormal TDP-43 homeostasis.

Real-time chest-wall-motion tracking by a single optical fibre grating: a prospective method for ventilator triggering.

OBJECTIVE: The ventilators involved in non-invasive mechanical ventilation commonly provide ventilator support via a facemask. The interface of the mask with a patient promotes air leaks that cause errors in the feedback information provided by a pneumatic sensor and hence patient-ventilator asynchrony with multiple negative consequences. Our objective is to test the possibility of using chest-wall motion measured by an optical fibre-grating sensor as a more accurate non-invasive ventilator triggering mechanism. APPROACH: The basic premise of our approach is that the measurement accuracy can be improved by using a triggering signal that precedes pneumatic triggering in the neuro-ventilatory coupling sequence. We propose a technique that uses the measurement of chest-wall curvature by a long-period fibre-grating sensor. The sensor was applied externally to the rib-cage and interrogated in the lateral (edge) filtering scheme. The study was performed on 34 healthy volunteers. Statistical data analysis of the time lag between the fibre-grating sensor and the reference pneumotachograph was preceded by the removal of the unwanted heartbeat signal by wavelet transform processing. MAIN RESULTS: The results show a consistent fibre-grating signal advance with respect to the standard pneumatic signal by (230 ± 100) ms in both the inspiratory and expiratory phases. We further show that heart activity removal yields a tremendous improvement in sensor accuracy by reducing it from 60 ml to 0.3 ml. SIGNIFICANCE: The results indicate that the proposed measurement technique may lead to a more reliable triggering decision. Its imperviousness to air leaks, non-invasiveness, low-cost and ease of implementation offer good prospects for applications in both clinical and homecare ventilation.

Models of spin-orbit-coupled oligomers.

We address the stability and dynamics of eigenmodes in linearly shaped strings (dimers, trimers, tetramers, and pentamers) built of droplets in a binary Bose-Einstein condensate (BEC). The binary BEC is composed of atoms in two pseudo-spin states with attractive interactions, dressed by properly arranged laser fields, which induce the (pseudo-) spin-orbit (SO) coupling. We demonstrate that the SO-coupling terms help to create eigenmodes of particular types in the strings. Dimer, trimer, and pentamer eigenmodes of the linear system, which correspond to the zero eigenvalue (EV, alias chemical potential) extend into the nonlinear ones, keeping an exact analytical form, while tetramers do not admit such a continuation, because the respective spectrum does not contain a zero EV. Stability areas of these modes shrink with the increasing nonlinearity. Besides these modes, other types of nonlinear states, which are produced by the continuation of their linear counterparts corresponding to some nonzero EVs, are found in a numerical form (including ones for the tetramer system). They are stable in nearly entire existence regions in trimer and pentamer systems, but only in a very small area for the tetramers. Similar results are also obtained, but not displayed in detail, for hexa- and septamers.

Correlation between antimicrobial consumption and antimicrobial resistance of Pseudomonas aeruginosa in a hospital setting: a 10-year study.

WHAT IS KNOWN AND OBJECTIVE: Antimicrobial resistance is one of the greatest threats to human health. One of the most important factors leading to the emergence of resistant bacteria is overuse of antibiotics. The purpose of this study was to investigate the correlation between antimicrobial usage and bacterial resistance of Pseudomonas aeruginosa (P. aeruginosa) over a 10-year period in the Clinical Center Nis, one of the biggest tertiary care hospitals in Serbia. We focused on possible relationships between the consumption of carbapenems and beta-lactam antibiotics and the rates of resistance of P. aeruginosa to carbapenems. METHODS: We recorded utilization of antibiotics expressed as defined daily doses per 100 bed days (DBD). Bacterial resistance was reported as the percentage of resistant isolates (percentage of all resistant and intermediate resistant strains) among all tested isolates. RESULTS AND DISCUSSION: A significant increasing trend in resistance was seen in imipenem (P < 0·05, Spearman ρ = 0·758) and meropenem (P < 0·05, ρ = 0·745). We found a significant correlation between aminoglycoside consumption and resistance to amikacin (P < 0·01, Pearson r = 0·837) and gentamicin (P < 0·01, Pearson r = 0·827). The correlation between the consumption of carbapenems and resistance to imipenem in P. aeruginosa shows significance (P < 0·01, Pearson r = 0·795), whereas resistance to meropenem showed a trend towards significance (P > 0·05, Pearson r = 0·607). We found a very good correlation between the use of all beta-lactam and P. aeruginosa resistance to carbapenems (P < 0·01, Pearson r = 0·847 for imipenem and P < 0·05, Pearson r = 0·668 for meropenem). WHAT IS NEW AND CONCLUSION: Our data demonstrated a significant increase in antimicrobial resistance to carbapenems, significant correlations between the consumption of antibiotics, especially carbapenems and beta-lactams, and rates of antimicrobial resistance of P. aeruginosa to imipenem and meropenem.

Correction: Impact of metallurgical activities on the content of trace elements in the spatial soil and plant parts of Rubus fruticosus L.

Correction for 'Impact of metallurgical activities on the content of trace elements in the spatial soil and plant parts of Rubus fruticosus L.' by M. M. Nujkicet al., Environ. Sci.: Processes Impacts, 2016, 18, 350-360.

Impact of metallurgical activities on the content of trace elements in the spatial soil and plant parts of Rubus fruticosus L.

The concentrations of the trace elements (TEs), Cu, Zn, Pb, As, Cd, Ni, were determined in parts of Rubus fruticosus L. and in topsoil, collected from eight different locations around the copper smelter in Bor, Serbia. Extremely high concentrations of Cu were determined in the soil and in R. fruticosus L., and for arsenic at some locations. The enrichment factors for TEs in soil showed enrichment with Cu, Zn, Pb, and As among which extremely high values were determined for Cu (EFsoil = 8.5-126.1) and As (EFsoil = 6.6-44.4). The enrichment factors for the parts of R. fruticosus L. showed enrichment with all TEs, except for nickel. The most extreme enrichment was found to occur in roots and stems for Cu (EFplant = 56.2 and 51.1) and leaves for Pb (EFplant = 45.68). The mean values of the three ratios of concentrations between plant parts for all TEs indicated pollution via the atmosphere while leaves appeared to be the best indicators for this kind of pollution. Numerous and very strong Pearson's correlations between TEs in the R. fruticosus L. parts confirmed these results. Principal Component Analysis showed that the major pollution source is the copper smelter that contaminates vegetation through soil and air.

Impact of anesthetic regimen on the respiratory pattern, EEG microstructure and sleep in the rat model of cholinergic Parkinson's disease neuropathology.

OBJECTIVES: We hypothesized that the impact of distinct anesthetic regimens could be differently expressed during anesthesia and on post-anesthesia sleep in the neurodegenerative diseases. Therefore, we followed the impact of ketamine/diazepam and pentobarbital anesthesia in a rat model of the severe Parkinson's disease cholinergic neuropathology on the electroencephalographic (EEG) microstructure and respiratory pattern during anesthesia, and on the post-anesthesia sleep. METHODS: We performed the experiments on adult, male, spontaneously breathing Wistar rats chronically instrumented for sleep recording. The bilateral pedunculopontine tegmental nucleus (PPT) lesion was done by ibotenic acid microinfusion. Following postoperative recovery, we recorded sleep for 6h, induced anesthesia 24h later using ketamine/diazepam or pentobarbital, and repeated sleep recordings sessions 48h and 6days later. During 20min of each anesthesia we recorded both the EEG and respiratory movements. For sleep and EEG analysis, Fourier analysis was applied on 6-h recordings, and each 10-s epoch was differentiated as a state of wakefulness (Wake), non-rapid eye movement (NREM) or rapid eye movement (REM). Additionally, the group probability density distributions of all EEG frequency band relative amplitudes were calculated for each state, with particular attention during anesthesia. For respiratory pattern analysis we used Monotone Signal Segments Analysis. The PPT lesion was identified through nicotinamide adenine dinucleotide phosphate (NADPH) diaphorase histochemistry. RESULTS AND CONCLUSIONS: Our data show that the ketamine/diazepam anesthetic regimen in the PPT-lesioned rats induces more alterations in the EEG microstructure and respiratory pattern than does the pentobarbital anesthesia. In addition, the equal time required to establish an anesthetized state, and the long-term effect on post-anesthesia sleep in the PPT-lesioned vs. control rats suggest this anesthetic regimen as potentially more beneficial both for anesthesia induction and for post-anesthesia sleep in the surgical procedures of the elderly, and Parkinson's, and Alzheimer's patients.

Monitoring of antibiotic consumption and development of resistance by enterobacteria in a tertiary care hospital.

WHAT IS KNOWN AND OBJECTIVE: Antibiotics are the most frequently used drugs in hospitalized patients, but studies have shown that the prescribed antibiotics may be inappropriate and may contribute to antibiotic resistance. We carried out a survey of antibiotic consumption and antibiotic resistance in our tertiary care university hospital, from 2005 to 2013. We focus on cephalosporins, one of the most prescribed groups of antibiotics in the tertiary health care. The objective was to identify any relationship between ceftriaxone consumption and resistance by enterobacteria. METHODS: Antibiotics consumption and antimicrobial resistance were monitored in the tertiary care university hospital from 2005 to 2013. Data on the use of antibiotics in surgical inpatients were obtained and expressed as defined daily doses per 100 bed days. Bacterial resistances were given as percentages of resistant isolates. RESULTS AND DISCUSSION: There was an increasing trend in cephalosporins consumption from 9·56 DBD (2005) to 23·32 DBD (2013), with ceftriaxone as the most frequently used cephalosporin, 3·6 DBD (2005) to 10·78 DBD (2013). E. coli and P. mirabilis resistance to ceftriaxone increased significantly from 22% in 2005 to 47% in 2013 and from 31% in 2005 to 60% in 2013, respectively. We found a significant correlation between ceftriaxone consumption and E. coli resistance (r = 0·895, P < 0·05). WHAT IS NEW AND CONCLUSION: Our study shows that cephalosporin consumption increased from 2005 to 2013, with ceftriaxone as the most prescribed antibiotic. E. coli and P. mirabilis resistance to ceftriaxone increased significantly over the study period. E. coli resistance increased with ceftriaxone consumption.

Structure-function analysis of SAP97, a modular scaffolding protein that drives dendrite growth.

Activation of AMPA receptors assembled with the GluA1 subunit can promote dendrite growth in a manner that depends on its direct binding partner, SAP97. SAP97 is a modular scaffolding protein that has at least seven recognizable protein-protein interaction domains. Several complementary approaches were employed to show that the dendrite branching promoting action of full length SAP97 depends on ligand(s) that bind to the PDZ3 domain. Ligand(s) to PDZ1, PDZ2 and I3 domains also contribute to dendrite growth. The ability of PDZ3 ligand(s) to promote dendrite growth depends on localization at the plasma membrane along with GluA1 and SAP97. These results suggest that the assembly of a multi-protein complex at or near synapses is vital for the translation of AMPA-R activity into dendrite growth.

Rib-cage-movement measurements as a potential new trigger signal in non-invasive mechanical ventilation.

Non-invasive ventilation performed through an oronasal mask is a standard in clinical and homecare mechanical ventilation. Besides all its advantages, inevitable leaks through the mask cause errors in the feedback information provided by the airflow sensor and, hence, patient-ventilator asynchrony with multiple negative consequences. Here we investigate a new way to provide a trigger to the ventilator. The method is based on the measurement of rib cage movement at the onset of inspiration and during breathing by fibre-optic sensors. In a series of simultaneous measurements by a long-period fibre grating sensor and pneumotachograph we provide the statistical evidence of the 200 ms lag of the pneumo with respect the fibre-optic signal. The lag is registered consistently across three independent delay metrics. Further, we discuss exceptions from this trend and identify the needed improvements to the proposed fibre-sensing scheme.

Reading the phase of a Raman excitation with a multi-state atomic interferometer.

Atomic memories for flying photonic qubits are an essential ingredient for many applications like e.g. quantum repeaters. Verification of the coherent transfer of information from a light field to an atomic superposition is usually obtained using an optical read-out. In this paper we report the direct detection of the atomic coherence by means of atom interferometry. We experimentally verified both that a bichromatic laser field closing a Raman transition imprints a distinct, controllable phase on the atomic coherence and that it can be recovered after a variable time delay.

Non-invasive respiratory monitoring using long-period fiber grating sensors.

In non-invasive ventilation, continuous monitoring of respiratory volumes is essential. Here, we present a method for the measurement of respiratory volumes by a single fiber-grating sensor of bending and provide the proof-of-principle by applying a calibration-test measurement procedure on a set of 18 healthy volunteers. Results establish a linear correlation between a change in lung volume and the corresponding change in a local thorax curvature. They also show good sensor accuracy in measurements of tidal and minute respiratory volumes for different types of breathing. The proposed technique does not rely on the air flow through an oronasal mask or the observation of chest movement by a clinician, which distinguishes it from the current clinical practice.

Mucinous adenocarcinoma of the urinary bladder after long-term duodeno-renal and colovesical fistula--case report.

Primary adenocarcinoma of the urinary bladder is a rare neoplasm. It accounts for 1-2% of all bladder carcinomas and sometimes may be found in the bladder diverticula. Fistula between duodenum and renal pelvis is another rarity while colovesical fistula is not so uncommon. We present a case of a 40 years old man who had surgery for colovesical and duodenorenal fistula and subsequently developed adenocarcinoma of the urinary bladder.

Sacral schwannoma found incidentally--report of a case.

Sacral schwannoma is a rare retrorectal tumor in adults. Postoperative sacral neurological deficit is difficult to avoid. Currently, there is no established consensus regarding best treatment options. We present a case of a 33 years old patient with atypical discomfort in lower abdomen and no neurological complaints who was diagnosed with a pelvic mass by abdominal ultrasound. CT, MRI and MSCT showed an inhomogeneous presacral mass involving right S1 sacral foramen. Although there were no neurological complaints, EMG and ENG showed a minor chronic lesion of L5 root bilaterally, more on the right side, affecting the fibers to the small muscles of the feet. We treated this patient with total extirpation of the mass without additional curretage. No radiotherapy was applied and postoperative neurological functions were preserved.

Analysis of antibiotic utilization and bacterial resistance changes in a surgical clinic of Clinical Centre, Nis.

WHAT IS KNOWN AND OBJECTIVE: There is little published information about antibiotic utilization and resistance amongst hospital inpatients in Serbia. The purpose of this study was to analyse the variation of antibiotic utilization and the relation between antibiotic utilization and bacterial resistance. METHODS: This analysis was performed in the surgical clinic of one of the biggest Serbian tertiary hospitals, during 2005-2008. Data on the use of antibiotics in surgical inpatients were obtained and expressed as defined daily doses per 100 bed-days. Bacterial resistances were given as percentages of resistant isolates. Following the implementation of a restriction policy in 2005, the prescription of reserve antibiotics was placed under control. RESULTS AND DISCUSSION: During the investigation period the total consumption of antibiotics decreased significantly by 37·8%. Hospital aminoglycoside consumption continued to decrease from 25·1% of the total consumption in 2005 to 5·1% in 2008. During the same period there was a substantial decrease in the use of ceftriaxone (47·8%), ciprofloxacin and metronidazole. Reduction in Escherichia coli resistance to gentamicin correlated significantly with its utilization, while the resistance for all isolates decreased from 58·5% to 44·8%. WHAT IS NEW AND CONCLUSION: This analysis confirms the association between the use of antibiotics and the prevalence of resistance in a surgical clinic. Surveillance of bacterial resistance should be done periodically according to local guidelines for antibiotic therapy of surgical infections, as well as for external comparison.

Caspofungin for post solid organ transplant invasive fungal disease: results of a retrospective observational study.

OBJECTIVE: This study was designed to determine clinical outcomes with caspofungin in patients with proven or probable invasive fungal infection (IFI) after a solid organ transplant (SOT) procedure. METHODS: In this retrospective observational study, data were collected for a single episode of IFI in patients with an SOT between January 2004 and June 2007. Response was determined by the investigator as favorable (complete or partial) or unfavorable (stable disease or failure) at the end of caspofungin therapy (EOCT). The primary effectiveness population was the proportion of patients who received >or=5 doses of caspofungin (modified all-patients-treated population). Safety was assessed for patients who received >or=1 dose of caspofungin. RESULTS: A total 81 of patients from 13 sites in China, Germany, Italy, and the United Kingdom were enrolled, including 49 (60%) liver, 22 (27%) heart, 5 (6%) lung, 2 (2%) kidney, 2 (2%) liver and kidney, and 1 (1%) pancreas and kidney recipients. Candidiasis was diagnosed in 64/81 patients (79%) and aspergillosis in 22/81 patients (27%). Most patients received caspofungin monotherapy (75%). Caspofungin was given as first-line therapy to 59 (73%) patients. The overall favorable response at EOCT was 87% (58/67; 95% confidence interval [CI]: 76%, 94%), with favorable responses in 88% (43/49; 95% CI: 75%, 95%) of patients receiving caspofungin monotherapy and 83% (15/18; 95% CI: 59%, 96%) of patients receiving combination therapy with caspofungin (modified all-patients-treated population). Response by type of SOT was as follows: liver 87% (39/45), heart 93% (14/15), kidney 100% (5/5), and lung 50% (2/4). An overall survival rate (all-patients-treated) of 69% (56/81; 95% CI: 59%, 79%) was observed at 7 days post EOCT. No serious drug-related adverse events were reported. CONCLUSION: In this study, caspofungin was effective and well tolerated in the treatment of IFIs involving SOT recipients.