1,371 research outputs found

    Bloodstream infections following different types of surgery in a Finnish tertiary care hospital, 2009-2014

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    The risk and outcome of bloodstream infections (BSIs) were evaluated following surgery. BSIs were identified in Helsinki University Hospital during 2009-2014 as part of the national surveillance. Of 711 BSIs identified, 51% were secondary and 49% primary. The rate was highest after cardiovascular surgery (8.7 per 1000 procedures) and lowest after gynaecologic (1.0 per 1000). Surgical site infection was the most frequent source of secondary BSIs (34%) and 45% of primary BSIs were central-line-associated. The 28-day case fatality ranged from zero in gynaecology/obstetrics to 21% in cardiovascular surgery. Besides BSIs related to surgical site infections, half of BSIs were primary, providing additional foci for prevention. (C) 2017 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.Peer reviewe

    The basal dunite of the Precambrian mafic-ultramafic Narankavaara intrusion : Petrogenetic considerations and implications to exploration

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    Several mafic-ultramafic layered intrusions were emplaced in the Fennoscandian Shield during wide-spread mantle-sourced magmatism at 2.5-2.4 Ga. The Narankavaara intrusion (surface area 5 x 30 km(2)), northeastern Finland, contains a 1.5-2 km thick basal dunite (not dated), and a 1.5 km thick layered series (2436 +/- 5 Ma). A newly discovered marginal series between the basal dunite and the layered series indicates that the basal dunite is older, and highlights the need for further study on their relationship. Along its southern basement contact, the basal dunite contains a 200-300 m thick zone of olivine ortho- and mesocumulates, but the bulk of it is composed of olivine adcumulates and lesser olivine-orthopyroxene heteradcumulates. Based on whole-rock geochemistry, the basal dunite is divided into a low-Fe zone (average FeOt 10.2 wt% and Ni 2250 ppm) and a high-Fe zone (average FeOt 12.5 wt% and Ni 1700 ppm). Both zones have high MgO (32-47 wt%) and varying Cr (830-5160 ppm) and Al2O3/TiO2 (16-26). Textural and geochemical layering is similar along the 30 km strike of the basal dunite. A LREE-enriched high-MgO basaltic parental magma composition (13-18 wt% MgO) is inferred for the basal dunite from olivine-melt mixing trends in orthocumulates. The dunite exhibits at least two geochemical reversals as well as abundant low-porosity adcumulates, poikilitic chromite, and bimodal olivine, suggesting formation in a high-volume open magmatic system. Significant similarity in major and trace element compositions with the Narankavaara layered series and the Burakovsky intrusion and Vetreny belt extrusives in Russian Karelia suggests that the basal dunite belongs to the Fennoscandian 2.5-2.4 Ga mafic layered intrusions. An Archean komatiitic origin for the dunite body cannot be completely ruled out, however. Distinct Ni-depletion in olivine is found in the basal dunite from the low-Fe zone to the high-Fe zone (3200 versus 2200 ppm). This depletion does not correlate with Fo contents, which suggests that it is not related to olivine fractionation. The basal dunite may thus have potential for Ni-(Cu-Co-PGE) sulfide mineralization.Peer reviewe

    Treatment of keloid scars with intralesional triamcinolone and 5-fluorouracil injections - a randomized controlled trial

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    Keloids have high recurrence rates. Current first-line therapy is triamcinolone (TAC) injection, but it has been suggested that approximately 50% of keloids are steroid resistant. We compared the efficacy of intralesional 5-fluorouracil (5-FU) and triamcinalone injections in a double-blind randomized controlled trial. Forty-three patients with 50 keloid scars were treated with either intralesional TAC or 5-FU-injections over 6 months. There was no statistically significant difference in the remission rate at 6 months between the 5-FU and TAC groups (46% vs 60%, respectively). Local adverse effects were higher in the TAC group compared to the 5-FU group. Occurrence of skin atrophy in TAC group was 44% and in the 5-FU group 8% (p <0.05). Also the occurrence of telangiectasia in the TAC group was 50% and in the 5-FU 21% (p <0.05). Vascularity of the keloids, assessed by spectral imaging and immunohistochemical staining for blood vessels, after treatment decreased in the TAC group, but not in the 5-FU group (p <0.05). Fibroblast proliferation evaluated by Ki-67 staining significantly decreased in the TAC group (p <0.05) but increased in the 5-FU group (p <0.05). TAC and 5-FU injections did not differ in their clinical effectivity in this randomized study, but 5-FU injections lead to increased proliferation rate and did not affect vascular density in histological assessment. Due to the greater number of adverse effects observed after TAC treatment, 5-FU injections may be preferable for cosmetically sensitive skin areas. (C) 2018 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.Peer reviewe

    Deep Vascular Imaging in Wounds by Two-Photon Fluorescence Microscopy

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    Deep imaging within tissue (over 300 mu m) at micrometer resolution has become possible with the advent of two-photon fluorescence microscopy (2PFM). The advantages of 2PFM have been used to interrogate endogenous and exogenous fluorophores in the skin. Herein, we employed the integrin (cell-adhesion proteins expressed by invading angiogenic blood vessels) targeting characteristics of a two-photon absorbing fluorescent probe to image new vasculature and fibroblasts up to approximate to 1600 mu m within wound (neodermis)/granulation tissue in lesions made on the skin of mice. Reconstruction revealed three dimensional (3D) architecture of the vascular plexus forming at the regenerating wound tissue and the presence of a fibroblast bed surrounding the capillaries. Biologically crucial events, such as angiogenesis for wound healing, may be illustrated and analyzed in 3D on the whole organ level, providing novel tools for biomedical applications

    Minimal important difference and patient acceptable symptom state for common outcome instruments in patients with a closed humeral shaft fracture - analysis of the FISH randomised clinical trial data

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    Background: Two common ways of assessing the clinical relevance of treatment outcomes are the minimal important difference (MID) and the patient acceptable symptom state (PASS). The former represents the smallest change in the given outcome that makes people feel better, while the latter is the symptom level at which patients feel well.Methods: We recruited 124 patients with a humeral shaft fracture to a randomised controlled trial comparing surgery to nonsurgical care. Outcome instruments included the Disabilities of Arm, Shoulder, and Hand (DASH) score, the Constant-Murley score, and two numerical rating scales (NRS) for pain (at rest and on activities). A reduction in DASH and pain scores, and increase in the Constant-Murley score represents improvement. We used four methods (receiver operating characteristic [ROC] curve, the mean difference of change, the mean change, and predictive modelling methods) to determine the MID, and two methods (the ROC and 75th percentile) for the PASS. As an anchor for the analyses, we assessed patients'satisfaction regarding the injured arm using a 7-item Likert-scale.Results: The change in the anchor question was strongly correlated with the change in DASH, moderately correlated with the change of the Constant-Murley score and pain on activities, and poorly correlated with the change in pain at I rest (Spearman's rho 0.51, -0.40, 0.36, and 0.15, respectively).Depending on the method, the MID estimates for DASH ranged from -6.7 to -11.2, pain on activities from -0.5 to -1.3, and the Constant-Murley score from 6.3 to 13.5.The ROC method provided reliable estimates for DASH (-6.7 points, Area Under Curve [AUC] 0.77), the Constant-Murley Score (7.6 points, AUC 0.71), and pain on activities (-0.5 points, AUC 0.68).The PASS estimates were 14 and 10 for DASH, 2.5 and 2 for pain on activities, and 68 and 74 for the Constant-Murley score with the ROC and 75th percentile methods, respectively.Conclusion: Our study provides credible estimates for the MID and PASS values of DASH, pain on activities and the Constant-Murley score, but not for pain at rest. The suggested cut-offs can be used in future studies and for assessing treatment success in patients with humeral shaft fracture.Peer reviewe

    ARC Newsletter Volume 1, Issue 3

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    https://digitalcommons.lasalle.edu/arc_newsletter/1002/thumbnail.jp

    The holographic quantum effective potential at finite temperature and density

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    We develop a formalism that allows the computation of the quantum effective potential of a scalar order parameter in a class of holographic theories at finite temperature and charge density. The effective potential is a valuable tool for studying the ground state of the theory, symmetry breaking patterns and phase transitions. We derive general formulae for the effective potential and apply them to determine the phase transition temperature and density in the scaling region.Comment: 27 page
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