CT obstructive index and systolic blood pressure at the time of diagnosis of pulmonary thromboemboli

Background: Recognition of imaging findings in pulmonary emboli and their association with homodynamic factors is important for prompt diagnosis, treatment, and reduction of its morbidity. The main objective in current study was to determine the correlation between CT obstructive index in pulmonary thromboembolism and systolic blood pressure at the time of diagnosis.Materials and Methods: In this observational cross-sectional comparative study, 70 consecutive patients with pulmonary emboli admitted in Modarress Hospital (Tehran, Iran) among 2013-17 were enrolled and correlation between CT obstructive index on pulmonary CT angiography and systolic blood pressure at the time of diagnosis was determined.Results: The correlation between CT index and hypotension (systolic blood pressure≤90) in our studied patients was significant (P=0.0001) and the mean CT index in hypotensive and normotensive patients was 56.4% and 27.5%, respectively. The CT obstructive index cut-off point of 53.75% resulted in sensitivity and specificity of 87.5% and 96.3%, for hypotension prediction.Conclusion: According to the obtained results it may be concluded that there is significant correlation between CT obstructive Index in patients with pulmonary thromboembolic and systolic blood pressure at the time of diagnosis and be calculating the CT obstructive index the possibility of hypotension related to massive emboli could be predicted

A Corpus-driven Scoping Systematic Review of Four Decades of Teacher Professional Development Research: Exploring Research Foci, Content Areas, Designs Methods and Trends

This study represents the findings of a systematic review (SR) of literature in the teacher professional development (TPD) domain to outline the research patterns through content examination of 199 research articles (RAs) in the area of TPD over the previous 40 years (1982 -2021). RAs were investigated and their research content areas, utilized research methods, data collection procedures, and findings were analyzed and coded. The broad investigation of the RAs showed a wide variety of themes that corresponded to 22 research areas. TPD program effects, TPD & technology, and TPD & Sociolinguistics were the most searched content areas. It was also found that the qualitative method with 52.26% of occurrences appeared to be the dominant research method used in RAs. Exploring data collection procedures, it was uncovered that interview, questionnaire and observation were the main data collection strategies utilized within the TPD RAs. Analyzing the findings, changes in teacher practices, attitudes and knowledge, learner achievements, and determining priorities for TPD programs were the most reported findings in TPD RAs. This corpus-driven SR underpins the notion that TPD makes a difference in altering teachers’ practices and attitudes and improves learner abilities if specific characteristics are taken into account in the planning and administration of TPD programs

Elevating the expression level of biologically active recombinant human alpha 1-antitrypsin in Pichia pastoris

Background: Human alpha 1-antitrypsin (AAT) is a potent inhibitor of multiple serine proteases, and protects tissues against their harmful effects. Individuals with reduced or abnormal production of this inhibitor need intravenous administration of exogenous protein. In this study, we employed the methylotrophic (methanol utilizing) yeast Pichia pastoris (P. pastoris) as a preferential host for efficient production and secretion of recombinant AAT. Furthermore, we examined different strategies to maximize the yield of the secreted protein. Results: Our findings revealed that optimizing the codon usage of AAT gene for P. pastoris had positive effects on the level of secreted AAT under the control of inducible alcohol oxidase 1 (AOX1) and constitutive glycerol aldehyde phosphate dehydrogenase (GAP) promoters. Compared to AOX1, the GAP promoter increased the yield of AAT by more than two fold. It was also demonstrated that the human AAT native signal sequence was more effective than the well-known yeast signal sequence, alpha mating factor (\u3b1-MF). Doubling gene dosage nearly doubled the production of AAT, though dosages exceeding this limit had negative effects on the yield. Conclusion: P. pastoris is shown to be an efficient expression system for production of recombinant and biologically active AAT. Also different strategies could be used to elevate the amount of this secretable protein

Three rare cases of anthrax arising from the same source

Anthrax is an acute bacterial infection caused by Bacillus anthracis. Humans become infected under natural conditions by contact with infected animals or contaminated animal products. About 95% of human anthrax is cutaneous and 5% respiratory. Gastrointestinal anthrax is very rare, and has been reported in less than 1% of all cases. Anthrax meningitis is a rare complication of any of the other three forms of disease. We report three rare cases of anthrax (gastrointestinal, oropharyngeal and meningitis) arising from the same source. The three patients were from a single family and were admitted with different clinical pictures after the ingestion of half-cooked meat from a sick sheep. These cases emphasize the need for awareness of anthrax in the differential diagnosis in areas where the disease remains endemic

Type I anaphylactic reaction due to contrast induced angioedema causing neck swelling: the role of sitting fiberoptic bronchoscopy in emergent intubation

Contrast induced angioedema is a rapidly progressive state involving a number of organ systems including the upper airway tract; which is usually a type I anaphylactic reaction also known as immediate hypersensitivity reaction. Prompt preservation of the respiratory tract is the cornerstone of this situation. The use of fiberoptic bronchoscope for tracheal intubation though very helpful, has some special considerations due to the anatomic distortions created by edema.This manuscript describes a patient with contrast induced angioedema managed successfully. Serum levels of IgE were highly increased during the first hours after the event; while serum levels of complement were normal. However, rapid airway management and prophylactic intubation saved the patient and prevented the possible aftermath of airway obstruction.Keywords: airway management; type I anaphylactic reaction, angioedema; fiberoptic bronchoscope.Conflict of interest: none of the authors has any conflict of interest

Determinants of perivascular adipose tissue stranding as a novel imaging marker and its relation to inflammatory biomarker high-sensitivity C-reactive protein

Purpose: This study aimed to examine the relationship of perivascular adipose tissue (PVAT) stranding in coronary computed tomography angiography (CCTA) with high-sensitivity C-reactive protein (hsCRP) and the determinants of PVAT stranding in coronary artery disease (CAD) patients. Material and methods: This retrospective cross-sectional study was done by collecting data from CAD patients who were referred to Rajaie Cardiovascular Centre between January 2018 and September 2020, with CCTA and hsCRP test 72 hours apart from the CCTA. PVAT stranding was defined as irregular obscuration of PVAT adjacent to the coronary arteries. An attempt was made to find a correlation between included variables and PVAT stranding by comparing them between 2 groups: patients with and without PVAT stranding. Results: From 92 patients, 31 participants had PVAT stranding, and statistically significant higher levels of hsCRP were detected in them (p = 0.007). We demonstrated significantly higher prevalence of history of hyperlipidaemia (OR = 3.83, p = 0.029), high-risk plaque features (OR = 11.80, p = 0.015), and obstructive coronary luminal stenosis (OR = 3.25, p = 0.025) in patients with PVAT stranding. Also, significantly higher PVAT attenuation was detected in patients with PVAT stranding (p < 0.001) independently from mean attenuation of epicardial fat. Conclusion: PVAT stranding could be used as a novel non-invasive marker in CCTA of CAD patients. More studies focusing on patient outcomes are required to better evaluate the reliability and prognostic value of this marker

Evaluation of different total leishmania amazonensis antigens for the development of a first-generation vaccine formulated with a toll-like receptor-3 agonist to prevent cutaneous leishmaniasis

Unfortunately, no any vaccine against leishmaniasis has been developed for human use. Therefore, a vaccine based on total Leishmania antigens could be a good and economic approach; and there are different methodologies to obtain these antigens. However, it is unknown whether the method to obtain the antigens affects the integrity and immune response caused by them. OBJECTIVES: to compare the protein profile and immune response generated by total L. amazonensis antigens (TLA) produced by different methods, as well as to analyse the immune response and protection by a first-generation vaccine formulated with sonicated TLA (sTLA) and polyinosinic:polycytidylic acid [Poly (I:C)]. METHODS: TLA were obtained by four different methodologies and their integrity and immune response were evaluated. Finally, sTLA was formulated with Poly (I:C) and their protective immune response was measured. FINDINGS: sTLA presented a conserved protein profile and induced a strong immune response. In addition, Poly (I:C) improved the immune response generated by sTLA. Finally, sTLA + Poly (I:C) formulation provided partial protection against L. amazonensis infection. MAIN CONCLUSIONS: The protein profile and immune response depend on the methodology used to obtain the antigens. Also, the formulation sTLA + Poly (I:C) provides partial protection against cutaneous leishmaniasis in mice.Fil: Germano, Maria Jose. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto de Medicina y Biología Experimental de Cuyo; ArgentinaFil: Lozano, Esteban Sebastián. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto de Medicina y Biología Experimental de Cuyo; ArgentinaFil: Sanchez, María Victoria. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto de Medicina y Biología Experimental de Cuyo; ArgentinaFil: Bruna, Flavia Alejandra. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto de Medicina y Biología Experimental de Cuyo; ArgentinaFil: Garcia Bustos, Maria Fernanda. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Salta. Instituto de Patología Experimental. Universidad Nacional de Salta. Facultad de Ciencias de la Salud. Instituto de Patología Experimental; ArgentinaFil: Sosa Lochedino, Arianna Lourdes. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto de Medicina y Biología Experimental de Cuyo; ArgentinaFil: Salomón, María Cristina. Universidad Nacional de Cuyo; ArgentinaFil: Fernandes, Ana Paula. Universidade Federal de Minas Gerais; BrasilFil: Mackern Oberti, Juan Pablo. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto de Medicina y Biología Experimental de Cuyo; ArgentinaFil: Cargnelutti, Diego Esteban. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto de Medicina y Biología Experimental de Cuyo; Argentin

Survey of practitioners’ competency for diagnosis of acute diseases manifest on chest X-ray

Abstract Background Chest X-ray (CXR) is a common imaging modality that could impact immediate decision-making for acute chest pathologies. We sought to examine the non-radiologists proficiency of diagnosing acute pathologies manifest on CXR. Methods We selected 9 clinical vignettes, each associated with a CXR, wherein only a single acute chest pathology was manifest. We also added a low-risk vignette associated with a normal CXR. We built an electronic survey with the CXR-embedded vignettes and also inquired about the participants’ confidence in the diagnosis, and prior exposure to the topics. We distributed the survey to senior medical students and general practitioners (GPs) in Tehran, Iran. We scored each correct answer per each vignette as 1 and each incorrect answer as 0; leading into a sum score from 0 to10 for the entire survey for each participant. Results Of the 136 candidates, 100 had legible survey results (67 medical students and 33 GPs). The overall score (mean [standard error]) was 3.57 [0.20], with no significant difference between the students and GPs (P = 0.15). The lowest rate of correct response occurred for acute respiratory distress syndrome (8%), foreign body (12%), and normal CXR (15%), while the best-answered vignettes were diaphragmatic herniation (77%) and pneumoperitoneum (67%). Self-reported confidence was associated with correct response for pneumoperitoneum, tension pneumothorax, and pulmonary edema (P < 0.05 for all). Conclusions Diagnostic proficiency of practitioners for acute chest pathologies in our study was poor, including for distinction of a normal CXR. Such dramatic knowledge deficiencies for common or life-threatening chest pathologies should be prioritized in the educational and continuous education curricula. Secure electronic tools for transferring the CXRs to specialists in case of acute pathologies would be an interim pragmatic alternative