Acetabular fractures following rugby tackles: a case series

<p>Abstract</p> <p>Introduction</p> <p>Rugby is the third most popular team contact sport in the world and is increasing in popularity. In 1995, rugby in Europe turned professional, and with this has come an increased rate of injury.</p> <p>Case presentation</p> <p>In a six-month period from July to December, two open reduction and internal fixations of acetabular fractures were performed in young Caucasian men (16 and 24 years old) who sustained their injuries after rugby tackles. Both of these cases are described as well as the biomechanical factors contributing to the fracture and the recovery. Acetabular fractures of the hip during sport are rare occurrences.</p> <p>Conclusion</p> <p>Our recent experience of two cases over a six-month period creates concern that these high-energy injuries may become more frequent as rugby continues to adopt advanced training regimens. Protective equipment is unlikely to reduce the forces imparted across the hip joint; however, limiting 'the tackle' to only two players may well reduce the likelihood of this life-altering injury.</p

The potential biomarkers in predicting pathologic response of breast cancer to three different chemotherapy regimens: a case control study

<p>Abstract</p> <p>Background</p> <p>Preoperative chemotherapy (PCT) has become the standard of care in locally advanced breast cancer. The identification of patient-specific tumor characteristics that can improve the ability to predict response to therapy would help optimize treatment, improve treatment outcomes, and avoid unnecessary exposure to potential toxicities. This study is to determine whether selected biomarkers could predict pathologic response (PR) of breast tumors to three different PCT regimens, and to identify a subset of patients who would benefit from a given type of treatment.</p> <p>Methods</p> <p>118 patients with primary breast tumor were identified and three PCT regimens including DEC (docetaxel+epirubicin+cyclophosphamide), VFC (vinorelbine/vincristine+5-fluorouracil+cyclophosphamide) and EFC (epirubicin+5-fluorouracil+cyclophosphamide) were investigated. Expression of steroid receptors, HER2, P-gp, MRP, GST-pi and Topo-II was evaluated by immunohistochemical scoring on tumor tissues obtained before and after PCT. The PR of breast carcinoma was graded according to Sataloff's classification. Chi square test, logistic regression and Cochran-Mantel-Haenszel assay were performed to determine the association between biomarkers and PR, as well as the effectiveness of each regimen on induction of PR.</p> <p>Results</p> <p>There was a clear-cut correlation between the expression of ER and decreased PR to PCT in all three different regimens (<it>p </it>< 0.05). HER2 expression is significantly associated with increased PR in DEC regimen (<it>p </it>< 0.05), but not predictive for PR in EFC and VFC groups. No significant correlation was found between biomarkers PgR, Topo-II, P-gp, MRP or GST-pi and PR to any tested PCT regimen. After adjusted by a stratification variable of ER or HER2, DEC regimen was more effective in inducing PR in comparison with VFC and EFC regimens.</p> <p>Conclusion</p> <p>ER is an independent predictive factor for PR to PCT regimens including DEC, VFC and EFC in primary breast tumors, while HER2 is only predictive for DEC regimen. Expression of PgR, Topo-II, P-gp, MRP and GST-pi are not predictive for PR to any PCT regimens investigated. Results obtained in this clinical study may be helpful for the selection of appropriate treatments for breast cancer patients.</p

UriSed as a screening tool for presumptive diagnosis of urinary tract infection

Background: Although a quantitative urine culture is essential for the final diagnosis of urinary tract infection, it is time-consuming and an expensive procedure. Effective screening tests would be a promising alternative to provide immediate results for the clinician and eliminate unnecessary culturing for most of the negative samples. The aim of this study was to evaluate the performance of an automated sediment analyzer (UriSed) as screening tool for presumptive diagnosis of urinary tract infection. Methods: We studied 1379 fresh midstream clean-catch urine samples from children to elderly. All samples were submitted to automated sediment analysis (UriSed) and quantitative urine culture (CLED medium agar). Results: The sediment analyzer detected leukocyturia and/or significant bacteriuria with sensitivity of 97%, specificity of 59%, positive predictive value of 27%, negative predictive value of 99%, and accuracy of 64% at cutoff values of bacteria count >= 12.6 elements/hpf and WBC >= 6 cells/hpf. These data suggest a potential 52% reduction of unnecessary urine cultures. Conclusion: The UriSed seems to be an efficient tool for screening UTI with high sensitivity and low rate of falsenegative results. (C) 2013 Elsevier B.V. All rights reserved.425777

Electrophoretic pattern of concentrated urine: Comparison between 24-hour collection and random samples:

The electrophoretic pattern of concentrated urine samples can be used to identify the type of proteins leaking into the urine and has diagnostic and prognostic value, providing information about the location (glomerular or tubular) and degree of renal injury. This test usually requires a 24-hour urine collection, which can be inconvenient because of its heavy dependence on patient compliance and frequently is unreliable because of errors in collecting a complete 24-hour urine sample. In this study, we compared the electrophoretic pattern in 24-hour urine collections and random samples among patients with glomerular diseases and a wide range of proteinuria. Forty adult patients were evaluated; 24-hour urine collections and random urine samples were analyzed. Protein concentrations were determined using the sulfosalicylic acid method standardized with human serum. Electrophoresis was performed with concentrated urine samples (Ultrafree, PF/Millipore Corporation, Bedford, MA) using Beckman Paragon Electrophoresis System (agarose gels and blue staining; Beckman Instruments, Inc, Brea, CA). Densitometric scanning of electrophoretic pattern (Appraise Clinical Densitometer; Beckman Instruments, Inc) was performed, and the results were reported in percentages of each observed fraction. Our results revealed that despite the significant difference between protein concentration in 24-hour collections and in random samples, the pattern of protein excretion, in percentage basis, remains the same. There were no differences between the albumin, alpha(1)-globulin, alpha(2)-globulin, beta-globulln, and gamma-globulin fractions in both types of specimens. This study shows that, at least in glomerular proteinuria, the electrophoretic analysis of the urine can be performed accurately in random samples, avoiding the inconveniences and errors of a 24-hour urine collection. (C) 2002 by the National Kidney Foundation, Inc.39

Changes in Costs Over Time at a Medium-Sized Clinical Laboratory

This article aims to evaluate the changes in costs over time at a medium-sized Brazilian hospital laboratory through the use of financial and performance indicators. Retrospective and prospective data were collected from the laboratory information system (LIS) and hospital management system (HMS) and used as the basis for the indicators. During the analyzed period, there was a 37% growth in the number of tests produced. Staff numbers did not increase in the same proportion, and there was a 19% increase in general productivity. The average annual unit test cost in 2008 was 26% less than in the previous year. In light of the above, it is clear that cost and process management is essential for the stability and sustainability of the organization. The strengthening of participative management, the redesign of processes, and the appropriate use of information technology resources and quality tools play an important role in achieving satisfactory results.41314514

Accuracy of the urinary albumin to creatinine ratio as a predictor of albuminuria in adults with sickle cell disease

Aim: To test the usefulness of a random urine specimen albumin to creatinine ratio (A/C) in predicting 12 hour urinary albumin excretion (12UA) in patients with sickle cell disease. Methods: 12UA and A/C were measured in nocturnal urine collections and random morning urine samples, respectively, of 72 patients with sickle cell disease. Results: The correlation of A/C values with 12UA values did not provide support for the use of random urine specimens for predicting urinary albumin excretion (UAE) in these patients. However, values of A/C greater than or equal to 0.45 and < 0.45 were indicative of raised and normal UAE, respectively, The sensitivity, specificity, and accuracy of the test were 100.0%, 87.2%, and 91.7%, respectively. Conclusions: This method cannot be recommended for predicting 12UA in patients with sickle cell disease, but it is useful for selecting patients who should collect 12 hour urine for the estimation of UAE.551297397

Glomerular and non-glomerular haematuria: Preservation of urine sediment

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Renal haemodynamic responses to a chicken or beef meal in normal individuals

Background. In normal subjects, protein loading with soybean meal does not produce the same renal haemodynamic effects as those observed with a beef meal. The renal responses of an acute protein load in the form of chicken meal is unknown. Methods. To examine whether the renal response to a chicken meal differs from that to beef, we studied the renal function of eight normal healthy volunteers before and after a protein load with each of these meals. In a crossover randomized study, we measured the glomerular filtration rate (GFR; inulin clearance), renal plasma flow (RPF; para-aminohippurate clearance) and, plasma amino acid and glucagon levels. We also determined the amino acid content of a sample of chicken and beef. Results. GFR and RPF increased significantly 2 h after both the chicken and beef meals (chicken, 98 +/- 13 vs 119 +/- 18 and 476 +/- 123 vs 570 +/- 99ml/min/1.73 m(2); beef, 107 +/- 14 vs 122 +/- 16 and 501 +/- 118 vs 560 +/- 97 ml/min/1.73 m(2), for GFR and RPF at basal and 2 h respectively, P < 0.05). Renal vascular resistance decreased and the filtration fraction remained unchanged after both protein loads. The changes induced by the protein challenges in the plasma amino acid and glucagon levels were not different between the two protein sources. The amino acid contents of chicken and beef samples were similar. Conclusion. In normal subjects, chicken and beef meals induced a similar degree of hyperfiltration.1392261226

Control of vesicle fusion by a tyrosine phosphatase.

The tyrosine phosphatase PTP-MEG2 is targeted by its amino-terminal Sec14p homology domain to the membrane of secretory vesicles. There it regulates vesicle size by promoting homotypic vesicle fusion by a mechanism that requires its catalytic activity. Here, we identify N-ethylmaleimide-sensitive factor (NSF), a key regulator of vesicle fusion, as a substrate for PTP-MEG2. PTP-MEG2 reduced the phosphotyrosine content of NSF and co-localized with NSF and syntaxin 6 in intact cells. Furthermore, endogenous PTP-MEG2 co-immunoprecipitated with endogenous NSF. Phosphorylation of NSF at Tyr 83, as well as an acidic substitution at the same site, increased its ATPase activity and prevented alphaSNAP binding. Conversely, expression of a Y83F mutant of NSF caused spontaneous fusion events. Our results suggest that the molecular mechanism by which PTP-MEG2 promotes secretory vesicle fusion involves the local release of NSF from a tyrosine-phosphorylated, inactive state. This represents a novel mechanism for localized regulation of NSF and the first demonstrated role for a protein tyrosine phosphatase in the regulated secretory pathway