Charakter wzrostu gruczolaków przysadki typu prolactinoma zależy od stężenia prolaktyny i płci pacjentów, ale nie od wartości wskaźnika Ki-67

Introduction: The objective of this study was to investigate the effects of some clinical and pathological features of prolactinomas on tumour behaviour.Material and methods: The study included 113 patients with prolactinoma (27 male, 86 female), with a mean age at diagnosis of 34.4 ± 10.0 years (40.3 ± 12.6 in males, 32.6 ± 8.3 in females). Patients were grouped as invasive or non-invasive according to radiological imaging findings. Ki-67 levels were evaluated if possible.Results: The mean adenoma size (longest dimension) was 38.6 ± 21.6 mm and 10.8 ± 9.4 mm in male and female patients. Pre-treatment serum levels of prolactin were defined as mean 1,926 ± 6,662 ng/mL in all, 124.8 ± 63.4 and 4,675 ± 10,049 ng/mL in the noninvasive and invasive groups (p < 0.05). A positive correlation was found between the serum levels of prolactin and tumour size. The rate of patients with Ki-67 ≥ 0.03 was 37.5% and 47.8% in the noninvasive and invasive groups. The reduction rates were 60.8% and 80.4% in tumour sizes and 81.1% and 93.8% in prolactin level in the noninvasive and invasive groups, respectively, (p < 0.05).Conclusions: We found a strong correlation between prolactin levels and invasiveness in male patients compared to females. Ki-67 index was not found to have a place in defining the prognosis.Wstęp: Celem badania była analiza zależności pomiędzy wybranymi danymi klinicznymi i cechami patomorfologicznymi a przebiegiem klinicznym u pacjentów z gruczolakiem przysadki wydzielającym prolaktynę (prolactinoma)/lub z gruczolakiem prolaktynowym przysadki.Materiał i metody: Do badania włączono 113 pacjentów, u których rozpoznano guzy typu prolactinoma (27 mężczyzn, 86 kobiet). Średni wiek pacjentów w momencie rozpoznania wynosił 34,4 ± 10,0 lat (40,3 ± 12,6 u mężczyzn, 32,6 ± 8,3 u kobiet). Na podstawie badań obrazowych/badań radiologicznych guzów pacjentów podzielono na dwie grupy — z gruczolakami inwazyjnymi i gruczolakami nieinwazyjnymi. Wskaźnik Ki-67 oceniono w tych preparatch, gdzie było to możliwe.Wyniki: Średni wymiar gruczolaka (mierzony według najdłuższej osi) wyniósł 38,6 ± 21,6 mm u mężczyzn i 10,8 ± 9,4 mm u kobiet. Średnie stężenie prolaktyny w surowicy przed leczeniem wynosiło 1926 ± 6662 ng/ml w całej grupie badanej, 124,8 ± 63,4 w grupie guzów nienaciekających i 4675 ± 10049 ng/ml w przypadku guzów naciekających (p < 0,05). Stwierdzono istnienie dodatniej zależności pomiędzy stężeniem prolaktyny w surowicy i wymiarem guza. Odsetki pacjentów, u których wartość wskaźnika Ki-67 była duża (≥ 0,03) wyniosły odpowiednio 37,5% w grupie guzów nienaciekających i 47,8% w grupie guzów naciekających. W grupie nowotworów nienaciekających zmniejszenie wymiarów gruczolaka nastąpiło u 60,8% a zmniejszenie stężenia prolaktyny u 81,1% pacjentów, natomiast w grupie guzów naciekających odpowiednie wartości wyniosły 80,4% i 93,8% (p < 0,05).Wnioski: U mężczyzn stwierdzono istnienie wyraźnej zależności pomiędzy stężeniem prolaktyny w surowicy a charakterem naciekającym guza, czego nie wykazano u kobiet. Wskaźnik Ki-67 nie miał związku z charakterem wzrostu guza

Time-Kill Kinetics and In Vitro Antifungal Susceptibility of Non-fumigatus Aspergillus Species Isolated from Patients with Ocular Mycoses

Aspergillus species can cause ocular morbidity and blindness, and thus, appropriate antifungal therapy is needed. We investigated the in vitro activity of itraconazole, voriconazole, posaconazole, caspofungin, anidulafungin, and amphotericin B against 14 Aspergillus isolates obtained from patients with ocular mycoses, using the CLSI reference broth microdilution methodology. In addition, time-kill assays were performed, exposing each isolate separately to 1-, 4-, and 16-fold concentrations above the minimum inhibitory concentration (MIC) of each antifungal agent. A sigmoid maximum-effect (Emax) model was used to fit the time-kill curve data. The drug effect was further evaluated by measuring an increase/decrease in the killing rate of the tested isolates. The MICs of amphotericin B, itraconazole, voriconazole, and posaconazole were 0.5–1.0, 1.0, 0.5–1.0, and 0.25 µg/ml for A. brasiliensis, A. niger, and A. tubingensis isolates, respectively, and 2.0–4.0, 0.5, 1.0 for A. flavus, and 0.12–0.25 µg/ml for A. nomius isolates, respectively. A. calidoustus had the highest MIC range for the azoles (4.0–16.0 µg/ml) among all isolates tested. The minimum effective concentrations of caspofungin and anidulafungin were ≤0.03–0.5 µg/ml and ≤0.03 µg/ml for all isolates, respectively. Posaconazole demonstrated maximal killing rates (Emax = 0.63 h−1, r2 = 0.71) against 14 ocular Aspergillus isolates, followed by amphotericin B (Emax = 0.39 h−1, r2 = 0.87), voriconazole (Emax = 0.35 h−1, r2 = 0.098), and itraconazole (Emax = 0.01 h−1, r2 = 0.98). Overall, the antifungal susceptibility of the non-fumigatusAspergillus isolates tested was species and antifungal agent dependent. Analysis of the kinetic growth assays, along with consideration of the killing rates, revealed that posaconazole was the most effective antifungal against all of the isolates

Design requirements for a tendon rehabilitation robot: results from a survey of engineers and health professionals

Exoskeleton type finger rehabilitation robots are helpful in assisting the treatment of tendon injuries. A survey has been carried out with engineers and health professionals to further develop an existing finger exoskeleton prototype. The goal of the study is to better understand the relative importance of several design criteria through the analysis of survey results and to improve the finger exoskeleton accordingly. The survey questions with strong correlations are identified and the preferences of the two respondent groups are statistically compared. The results of the statistical analysis are interpreted and insights obtained are used to guide the design process. The answers to the qualitative questions are also discussed together with their design implications. Finally, Quality Function Deployment (QFD) has been employed for visualizing these functional requirements in relation to the customer requirements

Psikiyatri kliniğinde çalışan hemşirelerin psikiyatri hemşiresinin rollerine ilişkin görüşleri

Psikiyatri kliniğinde çalışan hemşirelerin psikiyatri hemşiresinin rollerine ilişkin görüşleri Amaç: Bu çalışma, psikiyatri kliniklerinde çalışan hemşirelerin psikiyatri hemşiresinin rollerine ilişkin görüşlerinin belirlenmesi amacıyla gerçekleştirilmiştir. Yöntem: Tanımlayıcı tipte olan bu çalışma, Ocak 2011 ile Mayıs 2011 tarihleri arasında yapılmıştır. Çalışmada örneklem seçimine gidilmemiş, çalışmayı kabul eden 195 hemşire örneklemi oluşturmuştur. Veriler araştırmacılar tarafından oluşturulan 4 açık uçlu, toplam 27 sorudan oluşan anket formu ile toplanmıştır. Çalışma verileri tanımlayıcı istatistiksel analizlerle değerlendirilmiştir. Bulgular: Araştırmaya katılan hemşirelerin %80.4’ü kadındır ve yaş ortalaması 34.27±1.19’dur. Psikiyatri kliniklerinde çalışan hemşireler, klinikte yaptıkları temel girişimlerin, %76.8’inin psikofarmakolojik tedavi, %52.6’sının gözlem, %41.8’inin hastaların öz bakımını sağlamak olduğunu belirtmişler ve terapötik iletişim, atölye/uğraş terapisi ve bireysel/grup terapileri gibi girişimleri daha az yaptıklarını çoğunlukla evrak işleri ile uğraştıklarını ifade etmişlerdir. Sonuç: Çalışma kapsamındaki hemşirelerin tamamına yakını (%96.4) rol ve sorumluluklarının net olmadığını, yasalarda da yer almadığını düşündüklerini ifade etmişlerdir. Çalışma bulguları sonucunda psikiyatri hemşirelerinin rollerinin ve yetkilerinin net olarak tanımlanması gerektiği söylenebilir