Использование повязки с отрицательным давлением при гангрене легкого

ЛЕГКИХ БОЛЕЗНИ /терГАНГРЕНА /терПОВЯЗКИТОРАКОСТОМИ

Early severe inflammatory responses to uropathogenic E. coli predispose to chronic and recurrent urinary tract infection

Chronic infections are an increasing problem due to the aging population and the increase in antibiotic resistant organisms. Therefore, understanding the host-pathogen interactions that result in chronic infection is of great importance. Here, we investigate the molecular basis of chronic bacterial cystitis. We establish that introduction of uropathogenic E. coli (UPEC) into the bladders of C3H mice results in two distinct disease outcomes: resolution of acute infection or development of chronic cystitis lasting months. The incidence of chronic cystitis is both host strain and infectious dose-dependent. Further, development of chronic cystitis is preceded by biomarkers of local and systemic acute inflammation at 24 hours post-infection, including severe pyuria and bladder inflammation with mucosal injury, and a distinct serum cytokine signature consisting of elevated IL-5, IL-6, G-CSF, and the IL-8 analog KC. Mice deficient in TLR4 signaling or lymphocytes lack these innate responses and are resistant, to varying degrees, to developing chronic cystitis. Treatment of C3H mice with the glucocorticoid anti-inflammatory drug dexamethasone prior to UPEC infection also suppresses the development of chronic cystitis. Finally, individuals with a history of chronic cystitis, lasting at least 14 days, are significantly more susceptible to redeveloping severe, chronic cystitis upon bacterial challenge. Thus, we have discovered that the development of chronic cystitis in C3H mice by UPEC is facilitated by severe acute inflammatory responses early in infection, which subsequently are predisposing to recurrent cystitis, an insidious problem in women. Overall, these results have significant implications for our understanding of how early host-pathogen interactions at the mucosal surface determines the fate of disease

Organic ISFET Based on Poly (3-hexylthiophene)

We have fabricated organic field-effect transistors (OFETs) with regioregular poly(3-hexylthiophene) (P3HT) operable at low-voltages in liquid solutions, suitable for in vitro biosensing applications. Measurements in electrolytes have shown that the performance of the transistors did not deteriorate and they can be directly used as ion-sensitive transducers. Furthermore, more complex media have been tested, with the perspective of cell analysis. Degradation effects acting on the device operating in liquid could be partly compensated by adopting an alternate current measuring mode

Neuromorphic Time-Dependent Pattern Classification with Organic Electrochemical Transistor Arrays

Based on bottom‐up assembly of highly variable neural cells units, the nervous system can reach unequalled level of performances with respect to standard materials and devices used in microelectronic. Reproducing these basic concepts in hardware could potentially revolutionize materials and device engineering which are used for information processing. Here, an innovative approach that relies on both iono‐electronic materials and intrinsic device physics to show pattern classification out of a 12‐unit biosensing array is presented. The reservoir computing and learning concept to demonstrate relevant computing based on the ionic dynamics in 400 nm channel‐length organic electrochemical transistor is used. It is shown that this approach copes efficiently with the high level of variability obtained by bottom‐up fabrication using a new electropolymerizable polymer, which enables iono‐electronic device functionality and material stability in the electrolyte. The effect of the array size and variability on the performances for a real‐time classification task paving the way to new embedded sensing and processing approaches is investigate

Explanation and relations. How do general practitioners deal with patients with persistent medically unexplained symptoms: a focus group study

Contains fulltext : 80758.pdf (publisher's version ) (Open Access)BACKGROUND: Persistent presentation of medically unexplained symptoms (MUS) is troublesome for general practitioners (GPs) and causes pressure on the doctor-patient relationship. As a consequence, GPs face the problem of establishing an ongoing, preferably effective relationship with these patients. This study aims at exploring GPs' perceptions about explaining MUS to patients and about how relationships with these patients evolve over time in daily practice. METHODS: A qualitative approach, interviewing a purposive sample of twenty-two Dutch GPs within five focus groups. Data were analyzed according to the principles of constant comparative analysis. RESULTS: GPs recognise the importance of an adequate explanation of the diagnosis of MUS but often feel incapable of being able to explain it clearly to their patients. GPs therefore indicate that they try to reassure patients in non-specific ways, for example by telling patients that there is no disease, by using metaphors and by normalizing the symptoms. When patients keep returning with MUS, GPs report the importance of maintaining the doctor-patient relationship. GPs describe three different models to do this; mutual alliance characterized by ritual care (e.g. regular physical examination, regular doctor visits) with approval of the patient and the doctor, ambivalent alliance characterized by ritual care without approval of the doctor and non-alliance characterized by cutting off all reasons for encounter in which symptoms are not of somatic origin. CONCLUSION: GPs feel difficulties in explaining the symptoms. GPs report that, when patients keep presenting with MUS, they focus on maintaining the doctor-patient relationship by using ritual care. In this care they meticulously balance between maintaining a good doctor-patient relationship and the prevention of unintended consequences of unnecessary interventions

Does weight loss improve semen quality and reproductive hormones? results from a cohort of severely obese men

<p>Abstract</p> <p>Background</p> <p>A high body mass index (BMI) has been associated with reduced semen quality and male subfecundity, but no studies following obese men losing weight have yet been published. We examined semen quality and reproductive hormones among morbidly obese men and studied if weight loss improved the reproductive indicators.</p> <p>Methods</p> <p>In this pilot cohort study, 43 men with BMI > 33 kg/m²were followed through a 14 week residential weight loss program. The participants provided semen samples and had blood samples drawn, filled in questionnaires, and had clinical examinations before and after the intervention. Conventional semen characteristics as well as sperm DNA integrity, analysed by the sperm chromatin structure assay (SCSA) were obtained. Serum levels of testosterone, estradiol, sex hormone-binding globulin (SHBG), luteinizing hormone (LH), follicle-stimulating hormone (FSH), anti-Müllerian hormone (AMH) and inhibin B (Inh-B) were measured.</p> <p>Results</p> <p>Participants were from 20 to 59 years of age (median = 32) with BMI ranging from 33 to 61 kg/m². At baseline, after adjustment for potential confounders, BMI was inversely associated with sperm concentration (p = 0.02), total sperm count (p = 0.02), sperm morphology (p = 0.04), and motile sperm (p = 0.005) as well as testosterone (p = 0.04) and Inh-B (p = 0.04) and positively associated to estradiol (p < 0.005). The median (range) percentage weight loss after the intervention was 15% (3.5 - 25.4). Weight loss was associated with an increase in total sperm count (p = 0.02), semen volume (p = 0.04), testosterone (p = 0.02), SHBG (p = 0.03) and AMH (p = 0.02). The group with the largest weight loss had a statistically significant increase in total sperm count [193 millions (95% CI: 45; 341)] and normal sperm morphology [4% (95% CI: 1; 7)].</p> <p>Conclusion</p> <p>This study found obesity to be associated with poor semen quality and altered reproductive hormonal profile. Weight loss may potentially lead to improvement in semen quality. Whether the improvement is a result of the reduction in body weight per se or improved lifestyles remains unknown.</p

Flexible Multifunctional Sensors for Wearable and Robotic Applications

This review provides an overview of the current state-of-the-art of the emerging field of flexible multifunctional sensors for wearable and robotic applications. In these application sectors, there is a demand for high sensitivity, accuracy, reproducibility, mechanical flexibility, and low cost. The ability to empower robots and future electronic skin (e-skin) with high resolution, high sensitivity, and rapid response sensing capabilities is of interest to a broad range of applications including wearable healthcare devices, biomedical prosthesis, and human–machine interacting robots such as service robots for the elderly and electronic skin to provide a range of diagnostic and monitoring capabilities. A range of sensory mechanisms is examined including piezoelectric, pyroelectric, piezoresistive, and there is particular emphasis on hybrid sensors that provide multifunctional sensing capability. As an alternative to the physical sensors described above, optical sensors have the potential to be used as a robot or e-skin; this includes sensory color changes using photonic crystals, liquid crystals, and mechanochromic effects. Potential future areas of research are discussed and the challenge for these exciting materials is to enhance their integration into wearables and robotic applications.</p