scholarly journals Screening Patterns in Abusive Abdominal Trauma

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Doriann M. Alcaide Amador ◽  
Megan Marine ◽  
Boaz Karmazyn
Keyword(s):  
Child Abuse ◽  
High Sensitivity ◽  
Ct Scans ◽  
Control Group ◽  
Abdominal Injuries ◽  
Abdominal Ct ◽  
Specificity And Sensitivity ◽  
Elevated Liver Enzymes ◽  
Single Positive ◽  
Elevated Transaminases

Background: Diagnosis of abusive abdominal trauma (AAT) is often clinically occult. Abdominal CT is the preferred method to diagnose abdominal injuries. However, due to risk of ionizing radiation, and cost, it is performed only in selected children. Recently, elevated liver enzymes were used to screen for occult AAT, but its accuracy is unknown due to inconsistent methodology and results.     Objective: To determine the accuracy of elevated liver enzymes (transaminases) in the diagnosis of AAT and if pancreatic enzymes and clinical findings help in patients’ selection for abdominal CT.       Methods:   A retrospective (2011-2020) study on children younger than 3 years suspected of child abuse. The study group included children that had abdominal CT for suspected AAT, while the control group included similar number of children randomized from 5208 children evaluated for child abuse without an abdominal CT. Patients who had an incomplete medical record, were evaluated for cardiac arrest, or had a CT without contrast were excluded.    Results:   AAT is rare 0.6% (30/5434) in children suspected of child abuse. Transaminases were obtained in 99.1% of the AAT patients and 55.3% of the control cases. 93.1% (27/29) patients with abdominal injuries had elevated transaminases. The specificity and sensitivity for the transaminases in detecting positive abdominal CT was 93.3% and 90.0%, respectively. Only one additional case was identified with elevated pancreatic enzymes and negative transaminases. There was no clinical or imaging findings that could differentiate between patients with negative and positive abdominal CT scans. Based only on elevated transaminases, 11 CT scans need to be performed for a single positive study.   Conclusion/Potential Impact: Transaminases have high sensitivity in predicting AAT. Universal use of transaminases in all children suspected of child abuse may result in 11 CT scans for one positive study. Therefore, more clinical judgement is necessary in selecting patients for CT. 

scholarly journals Oxidative Stress Biomarkers in Urine of Metal Carpentry Workers Can Be Diagnostic for Occupational Exposure to Low Level of Welding Fumes from Associated Metals

Cancers ◽  
2021 ◽  
Vol 13 (13) ◽  
pp. 3167
Author(s):  
Flavia Buonaurio ◽  
Maria Luisa Astolfi ◽  
Daniela Pigini ◽  
Giovanna Tranfo ◽  
Silvia Canepari ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Occupational Exposure ◽  
Oxidation Products ◽  
Control Group ◽  
Welding Fumes ◽  
Oxidative Stress Biomarkers ◽  
Limit Values ◽  
Stress Biomarkers ◽  
Specificity And Sensitivity ◽  
The Impact

Urinary concentrations of 16 different exposure biomarkers to metals were determined at the beginning and at the end of a working shift on a group of workers in the metal carpentry industry. Five different oxidative stress biomarkers were also measured, such as the oxidation products of RNA and DNA metabolized and excreted in the urine. The results of workers exposed to metals were compared to those of a control group. The metal concentrations found in these workers were well below the occupational exposure limit values and exceeded the mean concentrations of the same metals in the urine of the control group by a factor of four at maximum. Barium (Ba), mercury (Hg), lead (Pb) and strontium (Sr) were correlated with the RNA oxidative stress biomarker, 8-oxo-7, 8-dihydroguanosine (8-oxoGuo), which was found able to discriminate exposed workers from controls with a high level of specificity and sensitivity. The power of this early diagnostic technique was assessed by means of the ROC curve. Ba, rubidium (Rb), Sr, tellurium (Te), and vanadium (V) were correlated with the level of the protein oxidation biomarker 3-Nitrotyrosine (3-NO2Tyr), and Ba, beryllium (Be), copper (Cu), and Rb with 5-methylcytidine (5-MeCyt), an epigenetic marker of RNA damage. These effect biomarkers can help in identifying those workers that can be defined as “occupationally exposed” even at low exposure levels, and they can provide information about the impact that such doses have on their health.

scholarly journals Assessing the Effects of Childhelp’s Speak Up be Safe Child Abuse Prevention Curriculum for High School Students

2021 ◽  
Author(s):  
Marisol Juarez Diaz ◽  
Diane Moreland ◽  
Wendy Wolfersteig
Keyword(s):  
High School ◽  
Child Abuse ◽  
High School Students ◽  
Child Maltreatment ◽  
Child Abuse Prevention ◽  
Control Group ◽  
Abuse Prevention ◽  
School Students ◽  
Prevention Curriculum ◽  
Speak Up

Abstract Purpose This study examined the Childhelp Speak Up Be Safe (CHSUBS) child abuse prevention curriculum for high school students and addressed a gap in evidence-based child maltreatment prevention programs. CHSUBS is grounded in theory and was developed to 1) provide students with the skills they need to prevent or interrupt child abuse, bullying, and neglect, and 2) increase student knowledge about safety related to abuse. Methods Utilizing a cluster-randomized controlled trial design, the three high schools were randomly assigned to participate in the CHSUBS curriculum or the control group. Survey items measured the efficacy of the curriculum in grades 9 through 12. Surveys were implemented at baseline, immediately after the intervention, and after 6 months for a follow-up. Analyses included exploratory factor analyses and a paired samples t–test to determine whether increases in child maltreatment knowledge and resistance skills were gained. Results Findings showed positive significant results that child maltreatment knowledge and resistance skills were significantly different from pre to post for the CHSUBS group and showed no significant control group changes. Conclusions High school students in the CHSUBS group appeared to gain both child maltreatment knowledge and resistance skills. Future studies on prevention programming for high school students might show results that lead to a reduction in child maltreatment and an increase in better health outcomes for adolescents.

Aortic tortuosity index as a predictor of type A aortic dissection

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
F Scalbert ◽  
O Milleron ◽  
M Para ◽  
R Raffoul ◽  
Q Pellenc ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Type A ◽  
Ct Scans ◽  
Control Group ◽  
Type A Aortic Dissection ◽  
Total Length ◽  
A Value ◽  
Straight Line ◽  
Patients At Risk ◽  
Geometric Length

Abstract Introduction The risk ok type A aortic dissection (AAD) depends on the degree of aortic wall's alteration, which can result in dilatation or tortuosity. The estimate of this risk relies solely on the evaluation of the diameter of the ascending aorta. Purpose The purpose of this study is to evaluate the presence and importance of aortic tortuosity in patients with type A aortic dissection. Method Postoperative CT scans of patients with type A aortic dissection were compared with CT scans from controls matched for gender and age. After 3D reconstruction, total length (actual distance along aortic center line = Ltot) and geometric length (length of a straight line between start and end of the aortic segment = Lgeo) were measured to calculate the tortuosity index (TI = Ltot / Lgeo). Results Ltot, Lgeo and TI from different aortic segments of the AAD group were higher than in the control group. Ltot and TI of the whole aorta (from aortic valve to bifurcation) were greater in patients with type A aortic dissection (527.7±46.1 mm vs. 475.8±39.7, p<0.0001; and 2.05±0.24 vs. 1.98±0.21, p=0.002 respectively). Total length and TI were greater after exclusion of the ascending part, and a value of this TI >1.3 identifies AAD patients with an accuracy of 74.8% (AUC = 0.792, p<0.0001). TI is altered by risk factors for aortic dissection: it increases with hypertension and age but not by tobacco use, and TI decreases in diabetes. Conclusions Type A aortic dissection is associated with longer aorta and increased aortic tortuosity. This index may help recognize patients at risk for type A aortic dissection. Calculation of tortuosity indexes Funding Acknowledgement Type of funding source: None

scholarly journals Highly Sensitive Fluorescent Detection of Acetylcholine Based on the Enhanced Peroxidase-Like Activity of Histidine Coated Magnetic Nanoparticles

Nanomaterials ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 1207
Author(s):  
Hong Jae Cheon ◽  
Quynh Huong Nguyen ◽  
Moon Il Kim
Keyword(s):  
Magnetic Nanoparticles ◽  
High Sensitivity ◽  
High Specificity ◽  
Choline Oxidase ◽  
Fluorescent Detection ◽  
One Pot ◽  
Site Structure ◽  
Specificity And Sensitivity ◽  
Highly Sensitive ◽  
Peroxidase Mimics

Inspired by the active site structure of natural horseradish peroxidase having iron as a pivotal element with coordinated histidine residues, we have developed histidine coated magnetic nanoparticles (His@MNPs) with relatively uniform and small sizes (less than 10 nm) through one-pot heat treatment. In comparison to pristine MNPs and other amino acid coated MNPs, His@MNPs exhibited a considerably enhanced peroxidase-imitating activity, approaching 10-fold higher in catalytic reactions. With the high activity, His@MNPs then were exploited to detect the important neurotransmitter acetylcholine. By coupling choline oxidase and acetylcholine esterase with His@MNPs as peroxidase mimics, target choline and acetylcholine were successfully detected via fluorescent mode with high specificity and sensitivity with the limits of detection down to 200 and 100 nM, respectively. The diagnostic capability of the method is demonstrated by analyzing acetylcholine in human blood serum. This study thus demonstrates the potential of utilizing His@MNPs as peroxidase-mimicking nanozymes for detecting important biological and clinical targets with high sensitivity and reliability.

Evaluation of the Clinical Role of Strain Elastography in Patients Diagnosed With Congenital Torticollis

2021 ◽  
pp. 875647932098324
Author(s):  
Elif Özyazici Özkan ◽  
Mehmet Burak Ozkan ◽  
İshak Abdurrahman İsik
Keyword(s):  
Area Under The Curve ◽  
Muscle Group ◽  
Receiver Operating Curve ◽  
Control Group ◽  
Clinical Role ◽  
Congenital Muscular Torticollis ◽  
Cutoff Value ◽  
Strain Elastography ◽  
Specificity And Sensitivity ◽  
Muscular Torticollis

Objective: The objective of this study was to determine the elasticity of sternocleidomastoid muscle (SCM) in patients with congenital muscular torticollis (CMT). Methods: In all, 41 patients and 22 controls were included in the study, and the elasticity of the patients’ SCM was measured. Echogenicity, thickness, and strain values of the SCM were also obtained. Results: The thickness and strain values of the SCM were higher in the patient group than in the control group ( P = .02 and P = .15). For median values, there was no difference in echogenicity and strain. In the strain elastography evaluation of the receiver operating curve (ROC) for muscle echogenicity in the isoechoic muscle group, the specificity and sensitivity were determined to be 100% and 22%, respectively, for the area under the curve (AOC) value of 0.558 (95% confidence interval [CI], 0.424–0.6686), and the cutoff value was <1.4. In the hyperechoic muscle group, the ROC for AUC values was found to be 0.542 (95% CI, 0.411–0.6686), and the cutoff value was >1.4 with 100% sensitivity and 20.75 specificity. Conclusions: The strain elastography technique can be used in the diagnosis of CMT.

scholarly journals Clinical Value and Time Course of Pericoronary Fat Inflammation in Patients with Angiographically Nonobstructive Coronaries: A Preliminary Report

2021 ◽  
Vol 10 (8) ◽  
pp. 1786
Author(s):  
Valeria Pergola ◽  
Marco Previtero ◽  
Annagrazia Cecere ◽  
Vittorio Storer ◽  
Teresa Castiello ◽  
...  
Keyword(s):  
Cardiac Troponin ◽  
Preliminary Report ◽  
Time Course ◽  
Coronary Artery Stenosis ◽  
High Sensitivity ◽  
Control Group ◽  
Clinical Value ◽  
Coronary Ct ◽  
Electrocardiographic Changes ◽  
Acute Event

The introduction of high-sensitivity cardiac troponin allowed identifying a proportion of subjects with chest pain and electrocardiographic changes suggestive of myocardial infarction showing <50% coronary artery stenosis. PFAI is a coronary CT marker proved to predict outcome in ischemic heart disease. Based on CMR findings, patients were divided into myocarditis (n = 15), MINOCA (n = 14) and TTS (n = 9) groups. The aim was to estimate the value of pFAI in these groups compared to 12 controls. To evaluate the coronary inflammation “time course,” 20 patients underwent CMR and coronary CT scan within 8 days from the onset, the others within 60 days. There were higher values of pFAI in myocarditis (−86.45 HU), MINOCA (−84.63 HU) and TTS (−84.79 HU) compared to controls (−96.02 HU; p = 0.0077). Among patients who underwent CT within 8 days from onset, the MINOCA had a significantly higher pFAI value (−76.91 HU) compared to the control group (−96.02 HU; p = 0.0001). In the group that underwent CT later than 8 days, elevated pFAI values persisted only in the myocarditis and TTS groups, and there was no difference between MINOCA and controls. Our study shows that in patients with a diagnosis of MINOCA, there is acute coronary inflammation, which is more evident within one week from the acute event but tends to disappear with time.

scholarly journals The Relevant Hormonal Levels and Diagnostic Features of Polycystic Ovary Syndrome in Adolescents

2020 ◽  
Vol 9 (6) ◽  
pp. 1831
Author(s):  
Elena Khashchenko ◽  
Elena Uvarova ◽  
Mikhail Vysokikh ◽  
Tatyana Ivanets ◽  
Lyubov Krechetova ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Polycystic Ovary Syndrome ◽  
Diagnostic Accuracy ◽  
Polycystic Ovary ◽  
Regression Function ◽  
High Sensitivity ◽  
Sex Hormone Binding Globulin ◽  
Control Group ◽  
Ovary Syndrome ◽  
Diagnostic Features

Relevance: The clinical picture of polycystic ovary syndrome (PCOS) is extremely polymorphic, especially in adolescence. At the same time, the diagnostic criteria of PCOS in adolescence are still under discussion, and the hormonal parameters, including anti-Mullerian hormone range and hyperandrogenism, are not determined. The aim of the present study was to characterize the pivotal clinical and hormonal features of PCOS in adolescents and to establish the age-specific thresholds of the most essential hormonal parameters. Design: A case-control study. Methods: The study included 130 girls with PCOS according to the complete Rotterdam criteria, aged 15 to 17 years. The control group consisted of 30 healthy girls with a regular menstrual cycle of the same age. A complete clinical and laboratory examination, hormonal assays, and ultrasound of the pelvic organs were performed. The serums anti-Mullerian hormone (AMH), follicle-stimulating hormone (FSH), luteinizing hormone (LH), LH/FSH, prolactin, estradiol, 17α-OH progesterone (17α-OHP), androstenedione, testosterone (T), dehydroepiandrosterone sulfate (DHEAS), sex hormone-binding globulin (SHBG), leptin, and free androgen index (FAI) were analyzed. The diagnostic accuracy of AMH, FAI, LH/FSH, T, and androstenedione levels in predicting PCOS in adolescents was established using a logistic regression model and calculating area under the receiver operator characteristic (ROC) curve (AUC). Results: The serum levels of LH (9.0 (5.4–13.8) vs. 3.7 (2.5–4.7) IU/L; p < 0.0001), LH/FSH (1.6 (1.0–2.3) vs. 0.7 (0.5–1.1); p < 0.0001), 17α–OHP (4.1 (3.2–5.1) vs. 3.4 (2.7–3.8) nmol/L; p = 0.0071), cortisol (464.0 ± 147.6 vs. 284.0 ± 129.7 nmol/L; p < 0.0001), prolactin (266.0 (175.0–405.0) vs. 189.0 (142.0–269.0) mIU/L; p = 0.0141), T (1.9 (1.2–2.5) vs. 0.8 (0.7–1.1) nmol/L; p < 0.0001), androstenedione (15.8 (11.6–23.2) vs. 8.3 (6.5–10.8) ng/mL; p < 0.0001), AMH (9.5 (7.5–14.9) vs. 5.8 (3.8–6.9) ng/mL; p < 0.0001), FAI (5.5 (2.8–7.0) vs. 1.6 (1.1–2.3); p < 0.0001), SHBG (37.0 (24.7–55.5) vs. 52.9 (39.0–67.6) nmol/L; p = 0.0136), DHEAS (6.8 ± 3.2 vs. 5.1 ± 1.5 μmol/L; p = 0.0039), and leptin (38.7 ± 27.1 vs. 23.7 ± 14.0 ng/mL; p = 0.0178) were significantly altered in the PCOS patients compared to the controls. Multivariate analysis of all studied hormonal and instrumental parameters of PCOS in adolescents revealed as the most essential: AMH level > 7.20 ng/mL, FAI > 2.75, androstenedione > 11.45 ng/mL, total T > 1.15 nmol/L, LH/FSH ratio > 1.23, and the volume of each ovary > 10.70 cm3 (for each criterion sensitivity ≥ 75.0–93.0%, specificity ≥ 83.0–93.0%). The diagnostic accuracy of PCOS determination was 90.2–91.6% with the combined use of either four detected indexes, which was significantly higher than the use of each index separately. The accuracy of PCOS diagnostics reached 92% using AMH and leptin concentrations when the value of the logistic regression function [85.73 − (1.73 × AMH) − (0.12 × Leptin)] was less than 70.72. Conclusions: The results of the study estimate the threshold for AMH, FAI, androstenedione, testosterone, LH/FSH, and ovarian volume, which could be suggested for use in the PCOS diagnostics in adolescents with a high sensitivity and specificity. Moreover, the combination of either four determined indexes improved the diagnostic accuracy for the PCOS detection in adolescents.

scholarly journals Patients With a History of Idiopathic Deep Venous Thrombosis Have Long-Term Increased Levels of Inflammatory Markers and Markers of Endothelial Damage

2016 ◽  
Vol 23 (2) ◽  
pp. 124-131 ◽  
Author(s):  
Mateja Kaja Jezovnik ◽  
Jawed Fareed ◽  
Pavel Poredos
Keyword(s):  
Inflammatory Markers ◽  
High Sensitivity ◽  
Endothelial Damage ◽  
Control Group ◽  
Necrosis Factor Alpha ◽  
Reactive Protein ◽  
Inflammatory Parameters ◽  
History Of ◽  
Hemostatic Markers

Introduction: Although the role of inflammation in DVT has been investigated in different studies, there is no definite answer as to whether increased systemic inflammation is the cause or the consequence of DVT. Aim: To follow inflammatory parameters in a cohort of patients with idiopathic DVT. Methods: Out of 49 patients with an acute idiopathic DVT, which were investigated four months after an acute episode (DEVTA 1), 43 patients were included in the follow-up study investigating inflammatory markers and hemostatic markers of endothelial damage five years after an acute DVT (DEVTA 2). A control group consisted of 43 sex and age matched healthy subjects (CONTROLS). Results: The levels of inflammatory markers were significantly higher in DEVTA 2 in comparison to CONTROLS: tumor necrosis factor alpha 2.0 pg/mL (1.1-2.3) vs 1.3 pg/mL (0.8-1.9), p < .001, high sensitivity C-reactive protein 3.2 mg/L (1.5-5.2) vs 1.7 mg/L (0.9-3.0), p = .008, interleukin-6 (IL-6) 2.7 pg/mL (2.0-3.5) vs 2.1 pg/mL (1.5-2.6), p = .025, IL-8 5.0 pg/mL (3.6-7.3) vs 2.4 pg/mL (1.8-2.8), p < .001. IL-10 was significantly decreased (0.9 pg/mL (0.7-1.8) vs 1.8 (1.5-2.2), p < .001. Most of the proinflammatory markers remained elevated in the DEVTA 2 in comparison to DEVTA 1. Markers of endothelial damage were higher in DEVTA 2 in comparison to CONTROLS and higher than in DEVTA 1. Conclusion: Patients with idiopathic DVT have long-term increased inflammatory markers and markers of endothelial damage. These findings favor the hypothesis that inflammation is a cause and not merely a consequence of acute DVT.

scholarly journals Irisin levels in relation to metabolic and liver functions in Egyptian patients with metabolic syndrome

2016 ◽  
Vol 94 (4) ◽  
pp. 359-362 ◽  
Author(s):  
Fatma H. Rizk ◽  
Samah A. Elshweikh ◽  
Amira Y. Abd El-Naby
Keyword(s):  
Metabolic Syndrome ◽  
Liver Enzymes ◽  
Resistance Index ◽  
Control Group ◽  
Model Assessment ◽  
Group Iii ◽  
Group I ◽  
Elevated Liver Enzymes ◽  
Liver Functions ◽  
Group Ii

Irisin is a new myokine that is suspected to influence metabolic syndrome (MetS). However, there is a great controversy with respect to its level in cases of MetS and its correlation with different metabolic parameters. The present study assesses irisin levels in MetS patients and studies its relationship to metabolic and liver functions to evaluate the possible role of the liver in regulation of this level. Sixty subjects were included in this experiment, who were divided into 3 groups: group I (normal control), group II (MetS patients with normal liver enzymes), and group III (MetS with elevated liver enzymes and fatty liver disease). Serum irisin levels showed significant increases in groups II and III compared with group I, and significant increases in group III compared with group II. Also, irisin levels were positively correlated with body mass index, serum triglycerides, homeostatic model assessment of insulin resistance index (HOMA-IR), and liver enzymes. We concluded that serum irisin levels increased in patients with MetS, especially those with elevated liver enzymes, and had a positive correlation with parameters of lipid metabolism and glucose homeostasis with the possibility of hepatic clearance to irisin.

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