The role of serum free light chain as biomarker of Myasthenia Gravis

Background and aim: Myasthenia gravis (MG) is a B lymphocyte\u2013mediated disease affecting neuromuscular transmission. The clinical course of MG is unpredictable due to the fluctuating nature and heterogeneity of the disease. Increased levels of free light chains (FLC), which reflect B cell activation, have been detected in different autoimmune disorders. In this study, we evaluated the potential role of FLC as diagnostic and prognostic biomarkers of MG. Materials and methods: 74 MG patients and 52 healthy individuals were included in the study. Serum FLC levels were measured by turbidimetric assay (Freelite, The Binding Site Group Ltd) on the Optilite Analyser System in both groups. In MG patients, anti-AChR and anti-MuSK autoantibodies were detected by enzyme-linked immunosorbent assay. Results: MG patients displayed significantly higher serum \u3ba and total FLC levels than controls, respectively for \u3baFLC 16.0 vs 13.8 mg/L and for total FLC 29.8 vs 25.9 mg/L. Moreover, increased \u3baFLC levels were observed in seropositive MG patients. No association was observed between serum FLC levels and clinical manifestations of disease as well as with severity, age at MG onset, thymoma and treatment. Conclusion: Increased levels of \u3baFLC and total FLC could serve as biomarkers to support the diagnosis of MG

Transverse momentum spectra of charged particles in proton-proton collisions at 1as=900 GeV with ALICE at the LHC

The inclusive charged particle transverse momentum distribution is measured in proton-proton collisions at s=900 GeV at the LHC using the ALICE detector. The measurement is performed in the central pseudorapidity region (|\u3b7|<0.8) over the transverse momentum range 0.15<10 GeV/c. The correlation between transverse momentum and particle multiplicity is also studied. Results are presented for inelastic (INEL) and non-single-diffractive (NSD) events. The average transverse momentum for |\u3b7|<0.8 is \u3008pT\u3009INEL=0.483\ub10.001 (stat.)\ub10.007 (syst.) GeV/c and \u3008pT\u3009NSD=0.489\ub10.001 (stat.)\ub10.007 (syst.) GeV/c, respectively. The data exhibit a slightly larger \u3008pT\u3009 than measurements in wider pseudorapidity intervals. The results are compared to simulations with the Monte Carlo event generators PYTHIA and PHOJET. \ua9 2010

Safety of hospital discharge before return of bowel function after elective colorectal surgery

Background: Ileus is common after colorectal surgery and is associated with an increased risk of postoperative complications. Identifying features of normal bowel recovery and the appropriateness for hospital discharge is challenging. This study explored the safety of hospital discharge before the return of bowel function. Methods: A prospective, multicentre cohort study was undertaken across an international collaborative network. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The main outcome of interest was readmission to hospital within 30 days of surgery. The impact of discharge timing according to the return of bowel function was explored using multivariable regression analysis. Other outcomes were postoperative complications within 30 days of surgery, measured using the Clavien\u2013Dindo classification system. Results: A total of 3288 patients were included in the analysis, of whom 301 (9\ub72 per cent) were discharged before the return of bowel function. The median duration of hospital stay for patients discharged before and after return of bowel function was 5 (i.q.r. 4\u20137) and 7 (6\u20138) days respectively (P &lt; 0\ub7001). There were no significant differences in rates of readmission between these groups (6\ub76 versus 8\ub70 per cent; P = 0\ub7499), and this remained the case after multivariable adjustment for baseline differences (odds ratio 0\ub790, 95 per cent c.i. 0\ub755 to 1\ub746; P = 0\ub7659). Rates of postoperative complications were also similar in those discharged before versus after return of bowel function (minor: 34\ub77 versus 39\ub75 per cent; major 3\ub73 versus 3\ub74 per cent; P = 0\ub7110). Conclusion: Discharge before return of bowel function after elective colorectal surgery appears to be safe in appropriately selected patients