Can mean platelet volume be used as a biomarker for asthma?

Introduction : Platelets play important roles in airway inflammation and are activated in inflammatory lung diseases, including asthma. Aim :We evaluated the mean platelet volume (MPV), used as a marker of platelet activation, in asthmatic patients during asymptomatic periods and exacerbations compared to healthy controls to determine whether MPV can be used as an indicator of inflammation. Material and methods :Our patient group consisted of95 children with exacerbation of asthma who were admitted to our allergy clinic. The control group consisted of 100 healthy children matched for age, gender, and ethnicity. Mean platelet volume values of the patient group obtained during exacerbation of asthma were compared to those of the same group during the asymptomatic period and with the control group. We investigated factors that can affect the MPV values of asthma patients, including infection, atopy, immunotherapy treatment, and severity of asthma exacerbation. Results :The patient group consisted of 50 (52.6%) boys and 45 (47.4%) girls with a mean age of 125 ±38 months old. Mean MPV values in the exacerbation period, the healthy period, and in the control group were 8.1 ±0.8 fl, 8.1 ±1.06 fl, and 8.2 ±0.9 fl, respectively; there were no significant differences between groups (p > 0.05). The severity of asthma, severity of asthma exacerbation, immunotherapy, coinfection, eosinophil count, and IgE level also had no effect on MPV (p > 0.05). Conclusions : Although platelets play a rolein the pathophysiology of asthma, MPV measurement is insufficient to detect inflammation through platelet

Protective intraoperative ventilation with higher versus lower levels of positive end-expiratory pressure in obese patients (PROBESE): study protocol for a randomized controlled trial

Background: Postoperative pulmonary complications (PPCs) increase the morbidity and mortality of surgery in obese patients. High levels of positive end-expiratory pressure (PEEP) with lung recruitment maneuvers may improve intraoperative respiratory function, but they can also compromise hemodynamics, and the effects on PPCs are uncertain. We hypothesized that intraoperative mechanical ventilation using high PEEP with periodic recruitment maneuvers, as compared with low PEEP without recruitment maneuvers, prevents PPCs in obese patients. Methods/design The PRotective Ventilation with Higher versus Lower PEEP during General Anesthesia for Surgery in OBESE Patients (PROBESE) study is a multicenter, two-arm, international randomized controlled trial. In total, 2013 obese patients with body mass index ≥35 kg/m2 scheduled for at least 2 h of surgery under general anesthesia and at intermediate to high risk for PPCs will be included. Patients are ventilated intraoperatively with a low tidal volume of 7 ml/kg (predicted body weight) and randomly assigned to PEEP of 12 cmH2O with lung recruitment maneuvers (high PEEP) or PEEP of 4 cmH2O without recruitment maneuvers (low PEEP). The occurrence of PPCs will be recorded as collapsed composite of single adverse pulmonary events and represents the primary endpoint. Discussion To our knowledge, the PROBESE trial is the first multicenter, international randomized controlled trial to compare the effects of two different levels of intraoperative PEEP during protective low tidal volume ventilation on PPCs in obese patients. The results of the PROBESE trial will support anesthesiologists in their decision to choose a certain PEEP level during general anesthesia for surgery in obese patients in an attempt to prevent PPCs. Trial registration ClinicalTrials.gov identifier: NCT02148692. Registered on 23 May 2014; last updated 7 June 2016. Electronic supplementary material The online version of this article (doi:10.1186/s13063-017-1929-0) contains supplementary material, which is available to authorized users

Production of vaccines and vaccine components in corn

Newly emerging infectious agents along with already existing ones, extended lifespan and increased population in the modern age, and the threat of biological warfare increase the demand for high amounts of pharmaceutical/diagnostic recombinant protein production. Plants are safe and cost efficient for production of recombinant pharmaceuticals for humans and livestock. This work investigated potential of corn to serve as a production and delivery vehicle for subunit vaccines and vaccine components. Highly immunogenic antigens LT-B and CT-B from enterotoxigenic strains of Escherichia coli ( E. coli) and Vibrio cholera (V. cholera ) were used in this study as vaccine/component candidates;This study indicated that corn derived LT-B is capable of inducing immune memory formation. Mice were immunized with LT-B corn through feeding when they were young. They showed a rapid immune memory response in the form of elevated levels of LT-B specific IgG and IgA antibodies upon receiving a booster dose 11 months after initial immunization. This work provided evidence that immunization through feeding with antigens produced in palatable parts of plants would be effective as conventional subunit vaccines in terms of immune memory formation;The B subunit of cholera toxin (CT-B) was expressed in transgenic corn seeds at high levels. Biochemical and immunological analysis indicated that corn derived CT-B, like the bacterial protein, is assembled into pentamers and binds to GM1 gangliosides. Although the bacterial signal peptide of CT-B appears to not cleaved in corn seed tissue, unlike its counter part LT-B, it is able to induce murine immune system to produce CT-B specific antibodies. This work also provided evidence that administration of a mixture of corn derived CT-B and LT-B together has potential to induce higher levels of specific antibodies than when they were administered alone. This finding opens the possibilities of using these two corn derived antigens in combination and may lead to more efficacious vaccines against both cholera and enderotoxigenic E. coli induced diarrhea;This work indicated that a major food and feed crop corn holds great potential to be utilized as a production and delivery vehicle for production of vaccine antigens and components which could be used for prevention of both human and animal diseases.</p

Abscopal Effect of Radiotherapy in the Immunotherapy Era: Systematic Review of Reported Cases

Mounting evidence suggests that radiation stimulates the immune system and this contributes to the abscopal effect, which is defined as "response at a distance from the irradiated volume." Though identified more than 50 years ago, the abscopal effect is revisited today. One rationale is that the abscopal effect is often observed with efficient immunotherapy. Here, we give an overview of the clinical data on the abscopal effect, generated by a combination of immunotherapy and radiotherapy (RT). Only papers that included RT in combination with immunotherapy were evaluated according to four main categories including RT parameters, sequencing of therapies, the definition of the abscopal effect, and patient selection. Twenty-four cases in 15 reports were reviewed. The results varied. Patient ages ranged from 24 to 74. RT dose (median total dose 18-58 Gy) varied. Biologically effective dose (BED) 10 was calculated to be a median 49.65 Gy (28-151 Gy). The time to a documented abscopal response ranged from less than a month to 12 months. The large variation concerning fractionation and sequencing of therapies indicates that these conflicting points need to be resolved, to generate for the abscopal effect to be clinically significant

Detection of serum protein and circulating mRNA of cMET, HGF EGF and EGFR levels in lung cancer patients to guide individualized therapy

BACKGROUND: Reseptor tyrosine kinases (cMET and EGFR) are important in lung cancer targeted therapy. We believe if we can use them as markers for clinicians to help decide the diagnosis of lung cancer. This parameter will be important in serum samples of patients with lung cancer diagnosis and treatment. The aim of this study is aimed to evaluate the clinical utility of serum protein and circulating mRNA of cMET and HGF in lung cancer patients. We also analyzed the correlation of mRNA expression with clinicopathologic parameters

The Effect of Using the Intermediate Dose Calculation Module on Volumetric Modulated Arc Technique Plan Quality in Esophagus Cancer

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Factors Affecting Treatment and Prognosis in Thymomas: A Multi-Center Experience

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Severe Neck and Face Edema in an Adolescent-Delayed Hypersensitivity Reaction to Hair Dye

Allergic contact reactions to hair dyes arise mostly due to sensitization to para-phenylenediamine (PPD). Para-phenylenediamine, a derivative of p-nitroanaline, is widely used as an oxydizable hair dye and is also found in black henna tattoo. Subsequent exposure to PPD may lead to delayed type IV hypersensitivity reaction manifesting as acute contact dermatitis. Here, a 15-year-old girl is presented, who developed a hypersensitivity reaction after first exposure to hair dye. She was found to have been sensitized to PPD before, through application of black henna tatto

Factors Affecting Treatment and Prognosis in Thymomas: A Multi-Center Experience

OBJECTIVEThymomas, a rare malignancy, are located in 95% anterior mediastinum. They are associated with para-neoplastic syndromes, especially myasthenia graves. Although many classifications are used considering the depth of invasion, presence of metastasis, predominant cell type, or immunohistochemical proper-ties in staging, Masoaka classification is commonly used. Surgery is the most effective method in the treatment of thymoma, and neoadjuvant chemotherapy is recommended in advanced stages (III-IV). Adjuvant radiotherapy has proven efficacy in advanced and inoperable patients. in this study, we aimed to evaluate treatment outcomes and factors affecting prognosis in thymoma patients.METHODSPatients with thymoma who were included in this study voluntarily from seven centers between January 2002 and August 2018 were evaluated retrospectively.RESULTSOf the 158 patients with thymoma, 125 patients with complete data were included in this study. the mean age of the patients was 51.84 (18-84), and 72 were male. Myasthenia graves were present in 64 patients. One hundred thirteen patients were operated and 12 were inoperable. One hundred patients were stage 2, 9 were stage 3, and 16 were stage 4. in our study, 3-year survival was 84.4%, and 5-year survival was 74.9%; inoperable patients, surgical margin positivity, advanced disease and radiotherapy dose less than 50.4’Gy were found to be negative factors affecting survival. in patients with myasthenia graves (MG), survival was higher in patients with stage 2B and less. Survival was lower in epithelial type B3 and type C histologic types. Age, sex, and capsule involvement did not seem to affect survival.CONCLUSIONThymoma is a locally controlled disease with long survival and the results of our study are consistent with the literature. the number of patients should be increased to better define prognostic factors