Evaluation of Neonatal Sepsis Based on Measurement of Red Cell Distribution Width

Background: Infant morbidity as well as mortality are frequently caused by neonatal sepsis. Neonatal sepsis can be predicted using the red cell distribution width (RDW), according to several researches. Objective: To determine if RDW can be employed as a marker for the evaluation of newborn sepsis and the assessment of its severity. Patients and Methods: 40 newborns, 20 of whom were infected and the other 20 of whom were non infected, participated in this case-control research. Patients and controls were collected from neonatal intensive care unit (NICU), Zagazig University Hospitals. Full history was taken from all participants parent, with clinical and laboratory examination were done; complete blood picture, and creatinine, blood culture, and serum level of C-reactive protein(CRP). Results: We revealed significant link between RDW and all of total leukocyte count (TLC), immature to total neutrophil ratio (I/T ratio), absolute neutrophil count (ANC), CRP, procalcitonin, severity of sepsis, and mortality. RDW and platelet count, on the other hand, have a strong negative association. With a sensitivity of 83.3 percent, specificity of 50 percent, a positive predictive value (PPV) of 71.4 percent, and a negative predictive value (NPV) of 66.7 percent, accuracy of 70 percent (p>0.05), the best RDW cutoff for diagnosing newborn sepsis severity was ≥17.9. Conclusion: Predictors of illness severity and death in newborn sepsis may be accurately predicted using baseline RDW measurements, which is critical for treatment of neonates who are at great risk of sepsis

SlicerDMRI: Open Source Diffusion MRI Software for Brain Cancer Research

International audienceDiffusion magnetic resonance imaging (dMRI) is the only non-invasive method for mapping white matter connections in the brain. We describe SlicerDMRI, a software suite that enables visualization and analysis of dMRI for neuroscientific studies and patient-specific anatomical assessment. SlicerDMRI has been successfully applied in multiple studies of the human brain in health and disease, and here we especially focus on its cancer research applications. As an extension module of the 3D Slicer medical image computing platform, the SlicerDMRI suite enables dMRI analysis in a clinically relevant multimodal imaging workflow. Core SlicerDMRI functionality includes diffusion tensor estimation, white matter tractography with single and multi-fiber models, and dMRI quantification. SlicerDMRI supports clinical DICOM and research file formats, is open-source and cross-platform, and can be installed as an extension to 3D Slicer (www.slicer.org). More information, videos, tutorials, and sample data are available at dmri.slicer.org

Automated white matter fiber tract identification in patients with brain tumors

We propose a method for the automated identification of key white matter fiber tracts for neurosurgical planning, and we apply the method in a retrospective study of 18 consecutive neurosurgical patients with brain tumors. Our method is designed to be relatively robust to challenges in neurosurgical tractography, which include peritumoral edema, displacement, and mass effect caused by mass lesions. The proposed method has two parts. First, we learn a data-driven white matter parcellation or fiber cluster atlas using groupwise registration and spectral clustering of multi-fiber tractography from healthy controls. Key fiber tract clusters are identified in the atlas. Next, patient-specific fiber tracts are automatically identified using tractography-based registration to the atlas and spectral embedding of patient tractography. Results indicate good generalization of the data-driven atlas to patients: 80% of the 800 fiber clusters were identified in all 18 patients, and 94% of the 800 fiber clusters were found in 16 or more of the 18 patients. Automated subject-specific tract identification was evaluated by quantitative comparison to subject-specific motor and language functional MRI, focusing on the arcuate fasciculus (language) and corticospinal tracts (motor), which were identified in all patients. Results indicate good colocalization: 89 of 95, or 94%, of patient-specific language and motor activations were intersected by the corresponding identified tract. All patient-specific activations were within 3mm of the corresponding language or motor tract. Overall, our results indicate the potential of an automated method for identifying fiber tracts of interest for neurosurgical planning, even in patients with mass lesions

Toxicity profile of bevacizumab in the UK Neurofibromatosis Type 2 cohort

Bevacizumab is considered an established part of the treatment strategies available for schwannomas in patients with Neurofibromatosis Type 2(NF2). In the UK, it is available through NHS National Specialized Commissioning to NF2 patients with a rapidly growing target schwannoma. Regrowth of the tumour on suspension of treatment is often observed resulting in prolonged periods of exposure to bevacizumab to control the disease. Hypertension and proteinuria are common events with bevacizumab use and there are concerns with regards to the long-term risks of prolonged treatment. Dosing, demographic and adverse event(CTCAE 4.03) data from the UK NF2 bevacizumab cohort are reviewed with particular consideration of renal and cardiovascular complications. Eighty patients (48 male:32female), median age 24.5 years (range 11-66years), were followed for a median of 32.7 months (range 12.0–60.2months). The most common adverse events were fatigue, hypertension and infection. A total of 19/80 patients (24%) had either a grade 2 or grade 3 hypertension event and 14/80 patients (17.5%) had proteinuria. Of 36 patients followed for 36 months, 78% were free from hypertension and 86% were free of proteinuria. Logistic regression modeling identified age and induction dosing regime to be predictors of development of hypertension with dose of 7.5mg/kg three weekly and age >30years having higher rates of hypertension. Proteinuria persisted in one of three patients after cessation of bevacizumab. One patient developed congestive heart failure and the details of this case are described. Further work is needed to determine optimal dosing regimes to limit toxicity without impacting on efficacy

Publicly provided housing in Libya with special reference to Tripoli An analysis of residential satisfaction as a basis for public housing policy

SIGLEAvailable from British Library Document Supply Centre- DSC:D186497 / BLDSC - British Library Document Supply CentreGBUnited Kingdo

Représentation(s) du dictateur dans les arts et la littérature du monde arabe et musulman

International audienc