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The surgical wound in infrared: thermographic profiles and early stage test-accuracy to predict surgical site infection in obese women during the first 30?days after caesarean section
摘要： Background: Prophylactic antibiotics are commonly prescribed intra-operatively after caesarean section birth, often at high doses. Even so, wound infections are not uncommon and obesity increases the risk. Currently, no independent wound assessment technology is available to stratify women to low or high risk of surgical site infection (SSI). Study Aim: to investigate the potential of non-invasive infrared thermography (IRT), performed at short times after surgery, to predict later SSI. Methods: IRT was undertaken in hospital on day 2 with community follow up (days 7, 15, 30) after surgery. Thermal maps of wound site and abdomen were accompanied by digital photographs, the latter used for wound assessment by six experienced healthcare professionals. Confirmatory diagnosis of SSI was made on the basis of antibiotic prescribing by the woman’s community physician with logistic regression models derived to model dichotomous outcomes. Results: Fifty-three women aged 21–44 years with BMI 30.1–43.9 Kg.m? 2 were recruited. SSI rate (within 30 days) was 28%. Inter-rater variability for ‘professional’ opinion of wound appearance showed poor levels of agreement. Two regions of interest were interrogated; wound site and abdomen. Wound site temperature was consistently elevated (1.5 °C) above abdominal temperature with similar values at days 2,7,15 in those who did and did not, develop SSI. Mean abdominal temperature was lower in women who subsequently developed SSI; significantly so at day 7. A unit (1 °C) reduction in abdominal temperature was associated with a 3-fold raised odds of infection. The difference between the sites (wound minus abdomen temperature) was significantly associated with odds of infection; with a 1 °C widening in temperature associated with an odds ratio for SSI of 2.25 (day 2) and 2.5 (day 7). Correct predictions for wound outcome using logistic regression models ranged from 70 to 79%; Conclusions: IRT imaging of wound and abdomen in obese women undergoing c-section improves upon visual (subjective) wound assessment. The proportion of cases correctly classified using the wound-abdominal temperature differences holds promise for precision and performance of IRT as an independent SSI prognostic tool and future technology to aid decision making in antibiotic prescribing.
关键词： Antibiotics,Caesarean section,Obesity,Surgical site infection,Infrared thermography,Prognosis,Thermal mapping
更新于2025-09-23 15:22:29
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How to Utilize Coronary Computed Tomography Angiography in the Treatment of Coronary Artery Disease
摘要： Coronary computed tomography angiography (CCTA) has high negative predictive power for detecting coronary artery disease. However CCTA is limited by moderate positive predictive power in the detection of myocardial ischemia. This is not unexpected because the diameter of a stenosis is a poor indicator of myocardial ischemia and discrepancy between the severity of stenosis and noninvasive tests is not uncommon. The value of stenosis for predicting future development of acute coronary syndrome represented by plaque rupture has been questioned. CCTA identifies the characteristics of high-risk plaque including positive remodeling, low density plaque and spotty or micro-calcification. Also, additional evaluation of myocardial ischemia using computational flow dynamics, and luminal attenuation gradient are expected to increase both diagnostic performance for hemodynamically significant stenosis and the predictive power for future cardiovascular risk. Technical advances in CCTA would enable evaluation of both coronary artery stenosis and myocardial ischemia simultaneously with high predictive performance, and would improve vastly the clinical value of CCTA.
关键词： Functional ischemia,Coronary artery disease,Atherosclerosis,Prognosis,Coronary CT angiography,Myocardial mass
更新于2025-09-23 15:22:29
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Optical characteristics of silicon recombination random nanostructures for solar cells
摘要： Background: While enteral nutrition (EN) is the preferred route of nutrition support, and total EN often fails to meet the nutritional needs of patients. A combination of multiple nutritional strategies can reach nutritional goals earlier and improve clinical outcomes. Methods: Totally 108 critically ill patients with a body mass index (BMI) of <22 who were admitted to our intensive care unit (ICU) from May 2017 to December 2018 were randomly divided into EN group (EN support alone) and supplementary parenteral nutrition (SPN) group (EN followed by SPN), with 54 patients in each group. The actual nutrient intake and biochemical markers before and after nutritional support as well as the duration of mechanical ventilation, length of stay (LOS) in ICU, LOS in hospital, ICU/hospital mortality, and infection complications were compared between these two groups. Results: There were no significant differences in albumin, urea nitrogen, alanine aminotransferase, fasting blood glucose, and triglyceride between the EN group and the SPN group before the nutritional support therapy (P>0.05). After the treatment, the albumin level was significantly higher in SPN group than in EN group (P<0.05), although the levels of urea nitrogen, alanine aminotransferase, fasting blood glucose, and triglyceride showed no significant changes in both groups (all P>0.05). The actual calories and protein intakes in the SPN group were significantly higher than those in the control group (both P<0.05). The SPN group had a considerably shorter duration of mechanical ventilation, LOS in ICU, and LOS in hospital and considerably lower incidences of infection complications than the EN group (all P<0.05). The ICU and hospital mortality rates showed no significant difference between these two groups (both P>0.05). Conclusions: SPN can improve the caloric and protein intakes, shorten the duration of mechanical ventilation, LOS in ICU, and LOS in hospital, and reduce the incidences of infection complications without apparent impact on blood lipid and sugar profiles or liver/kidney functions.
关键词： intensive care therapy,body mass index (BMI),prognosis,Nutritional support,supplementary parenteral nutrition (SPN)
更新于2025-09-12 10:27:22
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Flat Panel Computed Tomography Pooled Blood Volume and Infarct Prediction in Endovascular Stroke Treatment
摘要： Background and Purpose—Patients with large-vessel stroke frequently need to be transferred to comprehensive stroke centers for endovascular treatment. An update of physiological perfusion parameters and stroke progression on arrival is desirable. We examined the reliability of preinterventional pooled blood volume (PBV)-maps acquired by flat-panel detector computed tomography (CT) in the interventional angiography suite. Methods—The volumes of preinterventional perfusion deficit in flat-panel detector CT-PBV source images were compared with final infarct volume on follow-up multislice-CT after endovascular treatment of 29 consecutive patients with occlusion of the middle cerebral artery (MCA) or the distal internal carotid artery (ICA). Results—Endovascular treatment was successful in 26 patients (Thrombolysis in Cerebral Infarction, 2b-3). Overall, the median preinterventional PBV-deficit was 9×larger than median final infarct volume on multislice-CT (86.4 mL [10.3; 111.6] versus 9.6 mL [3.6; 36.8]). This was especially evident in the subgroup of successful recanalization (PBV-deficit: 87.5 mL [10.6; 115.1], final infarct: 8.7 mL [3.6; 29]). In futile recanalization, the final infarct tended to be underestimated (PBV-deficit: 86.4 mL [5.9; –] and final infarct: 116.4 mL [3.5; –]). Conclusions—Flat panel detector CT-PBV is not reliable in predicting the final infarct volume and should not be used in clinical decision making for endovascular treatment of acute cerebral artery occlusions.
关键词： middle cerebral artery,angiography,prognosis,cerebral infarction,blood volume
更新于2025-09-11 14:15:04
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Flow Cytometry - Select Topics || Immunophenotyping of Acute Leukemias – From Biology to Clinical Application
摘要： Immunophenotyping is an essential part of the modern diagnostic workup of acute leukemias and thus for an appropriate treatment of these complex and heterogeneous diseases. It provides a lot of useful information in this setting that transfers directly from laboratory to clinical management of patients. Lineage definition is the first goal leading to proper initial therapy. Some phenotypic patterns define specific subsets correlating with poor (mixed phenotype, dendritic cell neoplasm) or favorable (cortical T-lymphoblastic leukemia) outcome, thus guiding the application of treatment modalities. An advanced analysis of phenotypic data can address specific issues, such as the still debated role of multilineage dysplasia. The quality of response to chemotherapy is monitored by the detection of minimal residual disease and peripheral blast clearance during chemotherapy delivering. That allows a sharp discrimination of prognosis and again can drive the intensity of therapies proportionally to the disease chemosensitivity.
关键词： diagnosis,minimal residual disease,chemosensitivity,prognosis,acute lymphoblastic leukemia,Acute myeloid leukemia
更新于2025-09-09 09:28:46
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Utility of first positron emission tomography-computed tomography scan as a prognostic tool following treatment of sinonasal and skull base malignancies
摘要： Background: The prognostic value of the first posttreatment whole body integrated positron emission tomography-computed tomography (PET/CT) scanning in patients with sinonasal/skull base malignancies is undetermined. Methods: We retrospectively reviewed the data of all patients that underwent surgery for sinonasal/skull base malignancies in 2000-2015. The results of the pretreatment and posttreatment PET/CT findings and the clinical course were retrieved. Results: Thirty-eight patients (average age 60.6 years, 20 males) were included. Sensitivity and specificity, positive predictive value, and negative predictive value of the first PET/CT scan for predicting persistent/recurrent disease were 85.7%, 87.5%, 80%, and 91.3%, respectively. Overall 5-year survival was significantly lower in the first posttreatment PET/CT-positive group (35%) compared to the PET/CT-negative group (93%) (P = .0008). Conclusion: Posttreatment PET/CT findings are highly prognostic in patients with sinonasal/skull base malignancies. Negative findings on the first posttreatment PET/CT scan predict a significantly better overall survival.
关键词： sinonasal malignancy,skull base,prognosis,PET/CT,survival
更新于2025-09-09 09:28:46
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The effects of ranibizumab injections on fluorescein angiographic findings and visual acuity recovery in age-related macular degeneration
摘要： The objective of the study reported here was to evaluate the effect of ranibizumab on retinal circulation times and vessel caliber and to analyze the correlation of these factors with visual acuity (VA) prognosis in patients with age-related macular degeneration (AMD).
关键词： central macular thickness,prognosis,retinal arteriole diameter,vessel caliber,retinal vein diameter
更新于2025-09-09 09:28:46