Analyses and web interfaces for protein subcellular localization and gene expression data

Cataloged from PDF version of article.In order to benefit maximally from large scale molecular biology data generated by recent developments, it is important to proceed in an organized manner by developing databases, interfaces, data visualization and data interpretation tools. Protein subcellular localization and microarray gene expression are two of such fields that require immense computational effort before being used as a roadmap for the experimental biologist. Protein subcellular localization is important for elucidating protein function. We developed an automatically updated searchable and downloadable system called model organisms proteome subcellular localization database (MEP2SL) that hosts predicted localizations and known experimental localizations for nine eukaryotes. MEP2SL localizations highly correlated with high throughput localization experiments in yeast and were shown to have superior accuracies when compared with four other localization prediction tools based on two different datasets. Hence, MEP2SL system may serve as a reference source for protein subcellular localization information with its interface that provides various search and download options together with links and utilities for further annotations. Microarray gene expression technology enables monitoring of whole genome simultaneously. We developed an online installable searchable open source system called differentially expressed genes (DEG) that includes analysis and retrieval interfaces for Affymetrix HG-U133 Plus 2.0 arrays. DEG provides permanent data storage capabilities with its integration into a database and being an installable online tool and is valuable for groups who are not willing to submit their data on public servers.Bilen, BiterM.S

Complicated acute myocardial infarction: free wall rupture

The rupture of the ventricular wall complicates 1- 3% of the patients suffering from acute myocardial infarction. On necroptic studies the percentage raises up to 7-24%. The risk factors are age>60 years, feminine gender and hypertension. The acute ruptures are characterized by shock through cardiac tamponade. The subacute ruptures are a challenge for surgeons; immediate postoperatory death varies between 0 to 60%. Death without surgery occurs in 100% of the cases. A 73 years old male patient is admitted to the hospital for intermittent claudication at 15-20m, with insignificant heredocolaterale history, smoker for approximately 60 years 1 package per day. The patient has no cardiological history. After his admission he presented syncope. The clinical exam showed turgescent jugular veins, diffuse abdominal pain, and the lower liver margin was palpable 2 cm under the right costal margin. Differential diagnosis was: mesenteric ischemia, cardiac tamponade and aortic dissection. The transtoracic echocardiography showed the presence of pericardial liquid of 25 mm in the right ventricle, an intrapericardial thrombus in the left ventricle. The final diagnosis is acute anteroapical myocardial infarction with cardiac rupture, intrapericardial thrombus, pericardial tamponade and obliterant arteriopathy of the inferior limbs, stage III. The patient was transferred to the Cardiology Center in Iasi and after the necessary investigations went directly to the operating room due to the mechanical complication of the infarction. The postoperatory evolution was good. The particularities of the case consist of: the sudden debut through the rupture of the myocardium without the typical retrosteral pain; the lack of EKG or the necrosis enzymes modifications and the good postoperatory evolution

Free range of chickens

Istražen je i opisan slobodan tov („free range“) pilića. Meso pilića preporučuje se za prehranu djece, sportaša, starijih osoba i bolesnika zato što je lako probavljivo, sadrži visok udio bjelančevina i nizak udio masti te značajne količine vitamina i minerala. Suvremeni tov pilića odvija se na konvencionalan, ekološki i slobodan način. Prilikom tova pilića na slobodan način treba koristiti hibride koji su selekcionirani za tu svrhu (spororastući suvremeni hibridi pilića). U početnom dijelu tova piliće treba smjestiti u objekte (do 28. dana), a nakon toga se drže na zatravljenom ispustu preko dana i tijekom lijepog vremena sve do kraja tova. Za razliku od intenzivnog, u tovu slobodnim načinom pilići se hrane jeftinijom hranom (u drugom dijelu tova) koju djelomično pronalaze na ispustu, uz dodatak žitarica i premiksa. Prema provedenim istraživanjima nisu utvrđene statistički značajne razlike (P>0,05) u odnosu na udjele (%) osnovnih dijelova trupa između pilića utovljenih na konvencionalni i slobodan način. Međutim, postoje razlike (P 0.05) in relation to equity (%) basic parts of the hull between chickens fattened on conventional and free range. However, there are differences (P <0.05) in body proportions with regard to gender. Roosters have a higher proportion of drumsticks with thighs, and female poultry have a larger share of the chest in the trunk. The productio

A Single-Center Comparison of Extended and Restricted THROMBOPROPHYLAXIS with LMWH after Metabolic Surgery

IntroductionMorbid obesity is an important risk factor for developing a venous thromboembolic events (VTE) after surgery. Fast-track protocols in metabolic surgery can lower the risk of VTE in the postoperative period by reducing the immobilization period. Administration of thromboprophylaxis can be a burden for patients. This study aims to compare extended to restricted thromboprophylaxis with low molecular weight heparin (LMWH) for patients undergoing metabolic surgery.MethodsIn this single center retrospective cohort study, data was collected from patients undergoing a primary Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG) between 2014 and 2018. Patients operated in 2014-2017 received thromboprophylaxis for two weeks. In 2018, patients only received thromboprophylaxis during hospital admission. Patients already using anticoagulants were analyzed as a separate subgroup. The primary outcome measure was the rate of clinically significant VTEs within three months. Secondary outcome measures were postoperative hemorrhage and reoperations for hemorrhage.Results3666 Patients underwent a primary RYGB or SG following the fast-track protocol. In total, two patients in the 2014-2017 cohort were diagnosed with VTE versus zero patients in the 2018 cohort. In the historic group, 34/2599 (1.3%) hemorrhages occurred and in the recent cohort 8/720 (1.1%). Postoperative hemorrhage rates did not differ between the two cohorts (multivariable analysis, p=0.475). In the subgroup of patients using anticoagulants, 21/347(6.1%) patients developed a postoperative hemorrhage. Anticoagulant use was a significant predictor of postoperative hemorrhage (

Low-pressure pneumoperitoneum with deep neuromuscular blockade in metabolic surgery to reduce postoperative pain:a randomized pilot trial

Background For metabolic laparoscopic surgery, higher pressures up to 20 mmHg are often used to create a surgical field of sufficient quality. This randomized pilot study aimed to determine the feasibility, safety and tolerability of low intraabdominal pressure (IAP) and deep neuromuscular blockade (NMB) to reduce postoperative pain. Methods In a teaching hospital in the Netherlands, 62 patients eligible for a laparoscopic Roux-en-Y gastric bypass (LRYGB) were randomized into one of four groups in a 2 x 2 factorial design: deep/moderate NMB and standard (20 mmHg)/low IAP (12 mmHg). Patient and surgical team were blinded. Primary outcome measure was the surgical field quality, scored on the Leiden-Surgical Rating Scale (L-SRS). Secondary outcome measures were (serious) adverse events, duration of surgery and postoperative pain. Results 62 patients were included. L-SRS was good or perfect in all patients that were operated under standard IAP with deep or moderate NMB. In 40% of patients with low IAP and deep NMB, an increase in IAP was needed to improve surgical overview. In patients with low IAP and moderate NMB, IAP was increased to improve surgical overview in 40%, and in 75% of these cases a deep NMB was requested to further improve the surgical overview. Median duration of surgery was 38 min (IQR34-40 min) in the group with standard IAP and moderate NMB and 52 min (IQR46-55 min) in the group with low IAP and deep NMB. Conclusions The combination of moderate NMB and low IAP can create insufficient surgical overview. Larger trials are needed to corroborate the findings of this study. Trial registration: Dutch Trial Register: Trial NL7050, registered 28 May 2018.

Markers for Major Complications at Day-One Postoperative in Fast-Track Metabolic Surgery:Updated Metabolic Checklist

Introduction: In fast-track metabolic surgery, the window to identify complications is narrow. Postoperative checklists can be useful tools in the decision-making of safe early discharge. The aim of this study was to evaluate the predictive value of a checklist used in metabolic surgery. Methods: Retrospective data from June 2018 to January 2021 was collected on all patients that underwent metabolic surgery in a high-volume bariatric hospital in the Netherlands. Patients without an available checklist were excluded. The primary outcome was major complications and the secondary outcomes were minor complications, readmission, and unplanned hospital visits within 30 days postoperatively.Results: Major complications within 30 days postoperatively occurred in 62/1589 (3.9%) of the total included patients. An advise against early discharge was significantly more seen in patients with major complications compared to those without major complications (90.3% versus 48.1%, P &lt; 0.001, respectively), and a negative checklist (advice for discharge) had a negative predictive value of 99.2%. The area under the curve for the total checklist was 0.80 (P &lt; 0.001). Using a cut-off value of ≥3 positive points, the sensitivity and specificity were 65% and 82%, respectively. Individual parameters from the checklist: oral intake, mobilization, calf pain, willingness for discharge, heart rate, drain (&gt;30 ml/24 h), hemoglobin, and leukocytes count were also significantly different between groups. Conclusion: This checklist is a valuable tool to decide whether patients can be safely discharged early. Heart rate appeared to be the most predictive parameter for the development of major complications. Future studies should conduct prediction models to identify patients at risk for major complications. Graphical Abstract: [Figure not available: see fulltext.].</p

Reducing complication rates and hospital readmissions while revising the enhanced recovery after bariatric surgery (ERABS) protocol

Background: To optimize the postoperative phase following bariatric surgery, the enhanced recovery after bariatric surgery pathway (ERABS) has been developed. The aim of ERABS is to create a care path that is as safe, efficient and patient-friendly as possible. Continuous evaluation and optimization of ERABS are important to ensure a safe treatment path and may result in better outcomes. The objective of this study was to compare the clinical outcomes of patients undergoing bariatric surgery over 2014–2017, during which the ERABS protocol was continuously evaluated and optimized. Methods: This is a retrospective cohort study. Data were collected from patients undergoing a primary Roux-en-Y gastric bypass or sleeve gastrectomy between January 2014 and December 2017. Outcomes were early complications, unplanned hospital revisits, readmissions, duration of surgery and length of hospital stay. Results: 2889 patients underwent a primary bariatric procedure in a single center. There was a significant decrease in minor complications over the years from 7.0 to 1.9% (p < 0.001). Hospital revisit rates decreased after 2015 (p < 0.001). Readmission rates decreased over time (p < 0.001). The mean duration of surgery decreased from 52 (in 2014) to 41 (in 2017) minutes (p < 0.001). Median length of hospital stay decreased from 1.8 to 1.5 days in 2015 (p = 0.002) and remained stable since. Conclusion: An improvement of the ERABS protocol was associated with a decrease in minor complication rates, number of unplanned hospital revisits and readmission rates after primary bariatric procedures

Predictive value of C-reactive protein/albumin ratio for no-reflow in patients with Non-ST-elevation myocardial infarction

Introduction: The focus of this research was to explore the link between CRP (C-reactive protein)/albumin ratio (CAR), a novel inflammatory response marker, and no-reflow (NR) phenomena in non-ST elevation myocardial infarction (non-STEMI) patients during percutaneous coronary intervention (PCI). Methods: The current study recruited 209 non-STEMI participants who underwent PCI. The patients were divided into two groups based on their post-intervention Thrombolysis in Myocardial Infarction (TIMI) flow grade; those with and without NR. Results: In all, 30 non-STEMI patients (6.9%) had NR after PCI. CAR values were substantially greater in the NR group. The CAR was identified to be a determinant of the NR (OR: 1.250, 95% CI: 1.033-1.513, P = 0.02), although CRP and albumin were not independently related with NR in the multivariate analysis. In our investigation, low density lipoprotein-cholesterol levels and high thrombus burden were also predictors of the occurrence of NR. According to receiver operating characteristic curve evaluation, the optimal value of CAR was > 1.4 with 60% sensitivity and 47% specificity in detecting NR in non-STEMI patients following PCI. Conclusion: To the best of knowledge, this is the first investigation to demonstrate that the CAR, a new and useful inflammatory marker, can be utilized as a predictor of NR in patients with non-STEMI prior to PCI

Prevalence of Subclinical Hypothyroidism among Patients with Acute Myocardial Infarction

Introduction. Subclinical hypothyroidism (SCH) is defined as a serum thyroid-stimulating hormone (TSH) level above the upper limit of normal despite normal levels of serum free thyroxine. There is growing evidence that SCH is associated with increased cardiovascular risk. We tried to investigate prevalence of SCH in acute myocardial infarction patients. Methods and Results. We evaluate free T3, free T4, and TSH levels of 604 patients (age 58.4) retrospectively, who have been admitted to the coronary intensive care unit between years 2004–2009 with the diagnosis of ST elevation (STEMI) or non-ST elevation acute myocardial infarction (NSTEMI). Mild subclinical hypothyroidism (TSH 4.5 to 9.9 mU/l) was present in 54 (8.94%) participants and severe subclinical hypothyroidism (TSH 10.0 to 19.9 mU/l) in 11 (1.82%). So 65 patients (10.76%) had TSH levels between 4.5 and 20. Conclusions. In conclusion, 65 patients (10.76%) had TSH levels between 4.5 and 20 in our study, and it is a considerable amount. Large-scale studies are needed to clarify the effects of SCH on myocardial infarction both on etiologic and prognostic grounds