An Accessible Diagnostic Toolbox to Detect Bacterial Causes of Ovine and Caprine Abortion

Results of laboratory investigations of ovine and caprine cases of abortion in the lambing season 2015–2016 were analyzed, using pathology records of submissions to Royal GD (Deventer, the Netherlands) from January until and including April 2016, in comparison with the results of two accessible alternative techniques for sampling aborted lambs and kids, swabbing the fetal oropharynx and puncture of the fetal lung. Chlamydia abortus was the main cause of abortion in sheep as well as in goats. Other causes of abortion were Campylobacter spp., Listeria spp., Escherichia coli, and Yersinia enterocolitica. Ovine pathological submissions resulted more often in detecting an infectious agent compared to caprine submissions. For the three main bacterial causes of abortion, Campylobacter spp., Listeria spp., and Chlamydia spp., compared to results of the pathological examination, oropharynx mucus, and fetal lung puncture samples showed an observed agreement of 0.87 and 0.89, an expected agreement of 0.579 and 0.584, and a kappa value of 0.691 and 0.737 (95% CI: 0.561–0.82 and 0.614–0.859), respectively. The agreement between the results of the pathological examination and both fetal lung puncture and oropharynx mucus samples was classified as good. In conclusion, although a full step-wise post-mortem examination remains the most proper way of investigating small ruminant abortions, the easily accessible, low-threshold tools for practitioners and farmers as described in this paper not only provide reliable results compared to results of the post-mortem examination but also stimulates farmers and veterinarians to submit fetuses and placentas if necessary. Suggestions for further improvement of both alternatives have been summarized. Both alternatives could also be tailor-made for specific regions with their specific causes of abortion.

Prognostic significance of NDRG2 combined with EGFR-sensitizing mutations in lung adenocarcinoma

Background: N-myc downstream-regulated gene 2 (NDRG2) plays a substantial role in lung adenocarcinoma (LUAD). Epidermal growth factor receptor (EGFR)-sensitizing mutation could significantly improve prognosis in patients with LUAD. Here, we aimed to elucidate the prognostic value of NDRG2 combined with EGFR-sensitizing mutations in patients with LUAD. Methods: Lung parenchyma specimens obtained during surgery or CT-guide percutaneous lung puncture biopsy for the NDRG2 protein and EGFR genomic testing were obtained. Associations between NDRG2/EGFR and clinicopathological characteristics of patients with LUAD were extracted from the Tianjin First Central Hospital in China between June 2013 and June 2014. Results: The expression of NDRG2 was significantly decreased in patients with LUAD. Expressions of NDRG2 and EGFR-sensitizing mutations showed positive correlations with survival. ROC curve analyses showed that the diagnostic value of NDRG2 combined with EGFR in LUAD was significantly higher than that of each biomarker alone. Expression of NDRG2 and EGFR-sensitizing mutations were associated with the longer overall survival (OS), disease-free survival (DFS) and progression-free survival (PFS). Advanced stages were significantly associated with low expression of NDRG2. In multivariate analysis, compared with other patients, NDRG2 (+)/EGFR (+) was independently associated with prolonged OS and PFS. Conclusion: NDRG2 combined with EGFR-sensitizing mutations might be valuable markers to evaluate the prognosis of LUAD patients.

Prognostic significance of NDRG2 combined with EGFR-sensitizing mutations in lung adenocarcinoma

Background: N-myc downstream-regulated gene 2 (NDRG2) plays a substantial role in lung adenocarcinoma (LUAD). Epidermal growth factor receptor (EGFR)-sensitizing mutation could significantly improve prognosis in patients with LUAD. Here, we aimed to elucidate the prognostic value of NDRG2 combined with EGFR-sensitizing mutations in patients with LUAD. Methods: Lung parenchyma specimens obtained during surgery or CT-guide percutaneous lung puncture biopsy for the NDRG2 protein and EGFR genomic testing were obtained. Associations between NDRG2/EGFR and clinicopathological characteristics of patients with LUAD were extracted from the Tianjin First Central Hospital in China between June 2013 and June 2014. Results: The expression of NDRG2 was significantly decreased in patients with LUAD. Expressions of NDRG2 and EGFR-sensitizing mutations showed positive correlations with survival. Expression of NDRG2 and EGFR-sensitizing mutations were associated with the longer overall survival (OS), disease-free survival (DFS) and progression-free survival (PFS). Advanced stages were significantly associated with low expression of NDRG2. In multivariate analysis, compared with other patients, NDRG2 (+)/EGFR (+) was independently associated with prolonged OS and PFS. Conclusion: NDRG2 combined with EGFR-sensitizing mutations might be valuable markers to evaluate the prognosis of LUAD patients.

A Case Analysis on CT Guided Percutaneous Lung Puncture Biopsy of Lymphocyte Mesenchymal Pneumonia

Objective: To explore the application and diagnostic value of high-resolution CT in the process of lymphocytic interstitial pneumonia clinical diagnosis, and analyze one case of CT-guided percutaneous lung biopsy lymphocytic interstitial pneumonia. Methods: The medical record of a patient with lymphocyte interstitial pneumonia (LIP) who came to the clinic on 2014-04-22 were analyzed and summarized retrospectively. Results: The patient was a 55 years old female farmer. The CT-guided percutaneous lung biopsy was performed at her first visit; on 2014-07-09, the patient returned to our outpatient clinic with the main complaint of "1 week of coughing and blood in sputum and phlegm". Pathology consultation report from the PLA General Hospital on 2014-07-29 showed: (right lower lung) pneumonic pseudo-tumor; Zhejiang First Hospital’s pathology consultation report on 2014-08-11 showed: lymphocyte interstitial pneumonia. Conclusion: The diagnosis of lymphocyte interstitial pneumonia (LIP) with high-resolution CT may be used to increase its clinical diagnosis rate, reduce misdiagnosis and improve early detection.

A Novel Breast Stabilization Device for MRI-Guided Interventions

A breast stabilization device or breast cradle has been developed for use in interventional procedures. The device is a three-dimensional collapsible linkage that, when actuated, lightly compresses the breast while pulling it away from the chest wall. The compression provides the pressure needed to hold the breast firm during needle biopsy, ablation, or other procedures while being more comfortable than bilateral compression plates. By collapsing radially in an open configuration, the cradle provides nearly full access to the breast, as compared to the restrictive two-dimensional layout of grid-based bilateral compression plates. By pulling the breast away from the chest wall, the breast cradle may reduce the incidence of lung puncture or other medical errors. Several iterations of the device were developed, including rigid-joint models and a compliant-joint model. The rigid models more precisely show the kinematics of the device, but the manufacturability and assembly of the joints may be tedious in a production environment. Conversely, the compliant model may be more easily mass-produced, although the design would be more complex and costly. To provide a proof-of-concept for the compliant-joint design, a rapid prototyping machine was used to quickly produce several models that could be produced by other means (i.e. vacuum forming or injection molding) in full production. These models will be tested with breast phantoms in a magnetic resonance imaging (MRI) environment to ensure compatibility. Other tests will be performed to ensure patient comfort amongst various breast sizes and shapes.

Nasopharyngeal bacterial carriage and antimicrobial resistance in underfive children with community acquired pneumonia

Lung puncture is the best way to determine the etiology of pneumonia since it yields the highest rate of positive cultures. However, this procedure is difficult, especially for a study in the community. According to WHO, isolates to be tested for antimicrobial resistance in the community should be obtained from nasopharyngeal (NP) swabs. Previous studies support the use of NP isolates to determine antimicrobial resistance patterns of isolates from children with pneumonia. The aim of our study was to know the bacterial patterns of the nasopharynx in underfive children with community acquired pneumonia and their antimicrobial resistance. The study was carried out in 4 Primary Health Clinics in Majalaya sub-district, Bandung, Indonesia. All underfives with cough or difficult breathing and classified as having non-severe pneumonia (WHO guidelines), were included in the study. Nasopharyngeal swabs (CDC/WHO Manual) were obtained by the doctor, the swabs were placed in Amies transport medium and stored in a sterile jar before taken to the laboratory in the same day. All children were treated with co-trimoxazole. During the nine month study, 698 children with clinical signs of non-severe pneumonia were enrolled. About 25% of the nasopharyngeal specimens yielded bacterial isolates; the two most frequently found were S. pneumoniae and S. epidermidis. The antimicrobial resistance test to co-trimoxazole showed 48.2% S. pneumoniae strain had full resistance and 32.7% showed intermediate resistance to co-trimoxazole. This result is almost similar to other studies from Asian countries. It seems that H. influenzae is not a problem in the study area; however, further studies are needed.