An evaluation of risk factors for Staphylococcus aureus colonization in a pre-surgical population

Staphylococcus aureus (SA) colonization has significant implications in healthcare-associated infections. Here we describe a prospective study conducted in pre-surgical outpatients, done with the aim of identifying demographic and clinical risk factors for SA colonization. We found younger age to be a potential predictor of SA colonization.

DECREASE OF β-DEFENSIN-2 LEVEL IN THE GINGIVAL CREVICULAR FLUID AS A POTENTIAL PREDICTOR OF THE DEVELOPMENT OF INFLAMMATORY PERIODONTAL DISEASES

β-defensin-2 (HBD-2) is a peptide of innate immunity that provides the first line of defenсe of the oral mucosa from the introduction of the pathobionts. Under inflammatory conditions epithelial cells and gingival fibroblasts produce HBD-2. The defective defensin secretion may play a crucial role in the development of inflammatory periodontal diseases. The study aimed to compare the levels of HBD-2 in the gingival fluid and/or the content of the periodontal pockets in patients with dental plaque-induced gingivitis (PG), aggressive periodontitis (AgP), chronic generalized periodontitis (CP) and in the periodontally healthy subjects (Control). We examined 142 patients (45.0 ± 1.03 years) from Moscow, including 11 patients with PG (35.7 ± 3.69 years), 43 patients with AgP (35.4 ± 0.84 years), 71 patients with CP (54.4 ± 0.86 years) and 17 controls (36.1 ± 2.92 years). We determined the periodontal tissues condition in all patients during the periodontal and X-ray examination. The samples of the gingival crevicular fluid and periodontal pocket content were collected by paper points from the gingival sulcus and periodontal pockets at 8 teeth of both jaws. The concentration (C) of β-defensin-2 was determined by enzyme immunoassay (ELISA Kit for Defensin Beta 2, Cloud-Clone Corp., USA). Mann-Whitney U-test (U), the Kruskal-Wallis test (H) and the Dwass-Steel-Critchlow-Fligner post hoc test (W) determined the difference significance between the parameters. We estimated the parameter relationship and its strength using the Spearmanʼs rank correlation coefficient (rS). The critical significance level was p ≤ 0.05.The present study showed that the progression of the periodontal inflammation is accompanied by a sharp decrease in the concentration of HBD-2 in patients’ samples (H = 42.8, df =3, p < 0.001). Thus, the concentration of HBD-2 in the gingival crevicular fluid of the periodontally healthy subjects (control group) ranged from 225 to 1720 pg/ml (C = 738 [477; 1114] pg/ml). In patients with PG the median value of the peptide concentration was 242 [42.5; 610] pg/ml (Cmin = 19 pg/ml, Cmax = 1000 pg/ml). In patients with periodontitis it dropped to critically low levels: CAgP = 54 [3; 195] pg/ml (Cmin = 0, Cmax = 478 pg/ml) and ССP = 25.5 [0; 125] pg/ml (Cmin = 0, Cmax = 298 pg/ml). Thus, we can consider the level of HBD-2 in the gingival crevicular fluid – a potential predictor of the development of inflammatory periodontal diseases.

Diagnostic Re-Evaluation and Potential Predictor Factors of Transient and Permanent Congenital Hypothyroidism in Eutopic Thyroid Gland

Background: The incidence of congenital hypothyroidism (CH) has increased over the years, and many predictors for detecting newborns with transient forms (TCH) as early as possible have been considered. Methods: All newborns diagnosed with primary CH and eutopic gland in the Piedmont region of Italy in the period of January 2014–June 2019 were enrolled and re-evaluated at the age of 2 years. Results: 105 newborns were diagnosed with CH during the study period. Dyshormonogenesis was observed in 55/105. At re-evaluation, we found that 52.7% had permanent CH (PCH), while 47.3% had TCH. Male/female rate, TSH levels at diagnosis, levothyroxine requirement at withdrawal and extra-thyroid congenital malformations rate were higher in the PCH group (p = 0.02, p = 0.009, p = 0.02 and p = 0.01), while fT4 levels at diagnosis were lower (p = 0.03). Sensitivity of 72.4% and specificity of 80.7% for serum TSH above 60 mcUI/mL, sensitivity of 73% and specificity of 72.4% for serum fT4 level below 7.2 pg/mL and sensitivity of 66% and specificity of 68% for drug requirement above 2.25 mcg/kg/day were observed in PCH. Conclusions: Demographic, clinical and hormonal data at diagnosis and levothyroxine requirement during the first two years should be adequately monitored to identify infants who are most likely to discontinue therapy after the age of 24 months.

18F-FDG PET/CT as a Potential Predictor of Lung Inflammation After Arc-Based Radiotherapy for Esophageal Cancer: A Pilot Study

PurposeFluorine-18-fuorodeoxyglucose (18F-FDG) positron emission tomography/computerized tomography (PET/CT) scan serves as a useful tool not only for tumor detection, radiotherapy (RT) target volume delineation but also for the assessment of the inflammatory changes in normal organs. Previously we proposed the volume-based algorithm (VBA) method to reduce low dose-volume of lung by improving the arc angle in dynamic arc-based RT. The aim of this study was to assess lung inflammation by integrating 18F-FDG PET/CT with VBA before and after arc-based RT for esophageal cancer (EC).MethodsThirty EC patients underwent 18F-FDG PET/CT imaging before RT (pre-RT) and after RT (post-RT) on a retrospective pilot study. The VBA was used to define the high dose (HD) (≧ 5 Gy) region and the low dose (LD) (< 5 Gy) region in the lungs. The maximum standardized uptake value (SUVmax), mean standardized uptake value (SUVmean), and global lung glycolysis (GLG) of the HD and LD regions in the lungs were quantified. The pre-RT and post-RT SUVmax, SUVmean, and GLG of HD and LD regions in lungs were analyzed in radiation pneumonitis (RP) ≧ grade 1 and non-radiation pneumonitis (nRP) lungs. The mean lung dose (MLD), V5, V10, V15, V20, V25, V30 in lungs were analyzed. Vx indicates the organ volume percentage exceeding a radiation dose of x (Gy). Receiver-operating characteristic curves were used to identify optimal cut-off values for RP after RT.ResultsIn RP lungs (n = 30), the SUVmax, SUVmean and GLG of the HD region between pre-RT and post-RT showed significant increases (all p < 0.05). Whereas there were no significant differences in those of the HD and LD regions in nRP lungs (n = 22). The post-RT SUVmax (2.78 vs. 2.07, p = 0.000) and post-RT SUVmean (0.64 vs. 0.52, p = 0.015) of the HD region in RP lungs were significantly higher than those in nRP lungs. The MLD (10.15 Gy vs. 8.11 Gy, p = 0.041), lung V5 (49.78% vs. 38.07%, p = 0.010) and lung V10 (32.25% vs. 24.71%, p = 0.017) in the RP lungs were significantly higher than those in nRP lungs. The area under the curve (AUC) of post-RT SUVmax of the HD regions was 0.852, and the AUC of the lung V5 was 0.727. For predicting RP, the optimal cut-off values of post-RT SUVmax and lung V5 were > 2.28 and > 47.14%. respectively. ConclusionThis study successfully integrated 18F-FDG PET/CT with VBA to assess RP in EC patients undergoing dynamic arc-based RT. The post-RT SUVmax and post-RT SUVmean of HD (≧5 Gy) regions can be used to evaluate RP. The post-RT SUVmax > 2.28 of HD regions and lung V5 > 47.14% may be a potential predictor of RP. 18F-FDG PET/CT is a promising tool to detect RP for EC patients treated with arc-based RT.

Disentangling the Evolutionary Drivers of Social Complexity in Human History: a Comprehensive Test of Hypotheses

During the Holocene the scale and complexity of human societies increased dramatically. Generations of scholars have proposed different theories explaining this expansion, which range from functionalist explanations, focusing on the provision of public goods, to conflict theories, emphasizing the role of class struggle or warfare. To quantitatively test these theories, we develop a general dynamical model, based on the theoretical framework of cultural macroevolution. Using this model and Seshat: Global History Databank we test 17 potential predictor variables proxying mechanisms suggested by major theories of sociopolitical complexity (and &gt;100,000 combinations of these predictors). The best-fitting model indicates a strong causal role played by a combination of increasing agricultural productivity and invention/adoption of military technologies (most notably, iron weapons and cavalry in the first millennium BCE).

MRI characteristics of brain edema in preeclampsia/eclampsia patients with posterior reversible encephalopathy syndrome

Background The neuroimaging manifestations of eclampsia and preeclampsia often overlap, mainly presenting as posterior reversible encephalopathy syndrome (PRES). The purpose of this retrospective study was to compare the extent and nature of brain edema in eclampsia and preeclampsia patients with PRES based on MRI characteristics. Methods One hundred fifty women diagnosed with preeclampsia-eclampsia and undergoing cranial MRI were enrolled; 24 of these were diagnosed as having eclampsia. According to clinicoradiologic diagnosis of PRES, eligible patients were classified as having eclampsia with PRES (group E-PRES) and preeclampsia with PRES (group P-PRES). A scale on T2W FLAIR-SPIR images was established to evaluate the extent of brain edema, and the score of brain edema (SBE) of both groups was compared. In patients of the two groups who also underwent DWI sequence, the presence or absence of hyperintensity on DWI and hypointensity on ADC maps were determined to compare the nature of brain edema. Furthermore, clinical and biochemical data of the two groups were compared. Results The incidence of PRES in eclampsia patients was significantly higher than that in preeclampsia patients (87.50% vs. 46.03%, P<0.001). The SBE of all regions and typical regions in group E-PRES patients were significantly higher than those in group P-PRES patients (15.88±8.72 vs. 10.90±10.21, P=0.021; 8.52±3.87 vs. 5.01±4.19, P=0.002; respectively). The presence of hyperintensity on DWI was determined more frequently in group E-PRES patients than group P-PRES patients (71.43% vs. 32.00%, P=0.024). Age, systolic blood pressure, white blood cell count, neutrophil count and percentage of neutrophils were significantly different between the two groups (P<0.05). Conclusions Certain MRI characteristics that reflect the extent and nature of brain edema were different between eclampsia and preeclampsia patients with PRES. Additional prospective studies are still required to explore whether these MRI characteristics of brain edema may further become a potential predictor for eclamptic seizures in preeclampsia patients with PRES.