Patient and Control CT Measurements.

<p>Patient and Control CT Measurements.</p

CT Scan Does Not Differentiate Patients with Hepatopulmonary Syndrome from Other Patients with Liver Disease

<div><p>Background</p><p>Hepatopulmonary syndrome (HPS) is defined by liver dysfunction, intrapulmonary vascular dilatations, and impaired oxygenation. The gold standard for detection of intrapulmonary vascular dilatations in HPS is contrast echocardiography. However, two small studies have suggested that patients with HPS have larger segmental pulmonary arterial diameters than both normal subjects and normoxemic subjects with cirrhosis, when measured by CT. We sought to compare CT imaging-based pulmonary vasodilatation in patients with HPS, patients with liver dysfunction without HPS, and matching controls on CT imaging.</p><p>Methods</p><p>We performed a retrospective cohort study at two quaternary care Canadian HPS centers. We analyzed CT thorax scans in 23 patients with HPS, 29 patients with liver dysfunction without HPS, and 52 gender- and age-matched controls. We measured the artery-bronchus ratios (ABRs) in upper and lower lung zones, calculated the “delta ABR” by subtracting the upper from the lower ABR, compared these measurements between groups, and correlated them with clinically relevant parameters (partial pressure of arterial oxygen, alveolar-arterial oxygen gradient, macroaggregated albumin shunt fraction, and diffusion capacity). We repeated measurements in patients with post-transplant CTs.</p><p>Results</p><p>Patients had significantly larger lower zone ABRs and delta ABRs than controls (1.20 +/- 0.19 versus 0.98 +/- 0.10, p<0.01; and 0.12 +/- 0.17 versus -0.06 +/- 0.10, p<0.01, respectively). However, there were no significant differences between liver disease patients with and without HPS, nor any significant correlations between CT measurements and clinically relevant parameters. There were no significant changes in ABRs after liver transplantation (14 patients).</p><p>Conclusions</p><p>Basilar segmental artery-bronchus ratios are larger in patients with liver disease than in normal controls, but this vasodilatation is no more severe in patients with HPS. CT does not distinguish patients with HPS from those with uncomplicated liver disease.</p></div

Suppelmentary Information from Somatic ERK activation during the transit amplification is essential for maintaining the synchrony of germline divisions in <i>Drosophila</i> testis

Supplemental Dat

Axial CT images of the right lower zone in a patient with hepatopulmonary syndrome (A), subclinical hepatopulmonary syndrome (B), liver dysfunction only (C), and control subject (D) with representative artery and accompanying bronchus highlighted (brackets).

<p>Axial CT images of the right lower zone in a patient with hepatopulmonary syndrome (A), subclinical hepatopulmonary syndrome (B), liver dysfunction only (C), and control subject (D) with representative artery and accompanying bronchus highlighted (brackets).</p

Additional file 1: of Effects of a 12-month multi-faceted mentoring intervention on knowledge, quality, and usage of spirometry in primary care: a before-and-after study

Spirometry Knowledge Test. Spirometry knowledge test used in the study. (DOC 765 kb

CT scans from a control subject demonstrating bronchovascular measurements.

<p>Axial images demonstrate measurements of the main pulmonary artery (A), the right pulmonary artery (B), and the left pulmonary artery (C). Coronal image from the same subject demonstrates location of the upper and lower zones for bronchovascular measurements (brackets) (D).</p

Revisting definition of bronchopulmonwry dysplaisa

Primary objective To determine which definition of BPD has better predictability for severe respiratory morbidity at 20-50 month corrected age. Study design Prospective cohort study, aiming to evaluate the ability of the current definitions of BPD to predict serious respiratory morbidity at 20-50 month corrected age. Methods sample included all babies with gestational age Results data included total of 348 babies . Total followup rate is 81.6 % .Yearly followup rate was 62 % , 88% , 85 % and 94 % for babies born in 2018, 2019, 2020, Jan-May 2021 respectively . 53.2 % of our population are males .80% of population gestational age ranged between 24-28 weeks. Chorioamnionitis was present in 9.5 % and 85% received antenatal steroids. Around 70% of babies required intubation during resuscitation . Almost 11 % had LOS . 4.9 % of our babies were discharged on oxygen. Total number of deaths were 19 . 3 of them died after transfer to Sidra hospital and 2 died as a result of cardiac arrest post discharge . BPD cases were divided into 2 groups of mild and Moderate/severe . Moderate / severe BPD cases were 34.8 % ( 122) , 18.5 % (65 ) and 29.3% (103) according to 2001, 2016 and 2019 respectively . Regarding comparison between different definitions, 2001 definition was significant for postnatal steroids use , discharge on home o2 , and > 3 hospital admissions . 2016 definition was significant for postnatal steroids , home o2 , tracheostomy . 2019 was significant for postnatal steroids , home o2 , > 3 hospital admissions. In conclusion all three definitions are comparable , however we encourage our institution to agree on one definition . We emphasize on the importance of evidence based medicine in research.</p

Effects of inhaled nitric oxide (iNO) in pulmonary hypertension secondary to arteriovenous malformations: a retrospective cohort study from the European iNO registry

This study aims to assess the effects of inhaled nitric oxide (iNO) on oxygenation in the management of pulmonary hypertension (PH) secondary to arteriovenous malformations (AVMs) in neonates. This is a matched retrospective cohort study from January 1, 2013, to December 31, 2017. The European inhaled nitric oxide registry from 43 neonatal and pediatric ICUs in 13 countries across Europe was used to extract data. The target population was neonates treated with iNO for the management of PH. The cases (PH secondary to AVMs treated with iNO) were matched (1:4 ratio) to controls (PH without AVMs treated with iNO). The main outcome measure was the absolute change of oxygenation index (OI) from baseline to 60 min after starting iNO in cases and controls. The primary outcome of our study was that the mean absolute change in OI from baseline to after 60 min was higher among cases 10.7 (14), than in controls 6 (22.5), and was not statistically different between the groups. The secondary outcome variable — death before discharge — was found to be significantly higher in cases (55%) than in controls (8%). All the other variables for secondary outcome measures remained statistically insignificant.    Conclusion: Infants with PH secondary to AVMs treated with iNO did not respond differently compared to those presented with PH without AVMs treated with iNO. Right ventricular dysfunction on echocardiography was higher in cases than controls (cases: 66.7% and controls: 28.6%) but was not statistically significant. What is Known:• Arterioenous malformation (AVM) is a well-known cause of persistent pulmonary hypertension in newborns. Inhaled nitric oxide (iNO) is most commonly used as first-line therapy for pulmonary hypertension in newborns.• Around 40–50% of vein of Galen malformations (VOGMs) are found to have congestive heart failure in the neonatal period. What is New:• Neonates may present with an isolated PH of the newborn as the main feature of the VOGMs. A large proportion of cases with AVMs have been associated with right ventricular cardiac dysfunction. • Results from one of the largest database registries in the world for iNO have been used to answer our research question. Other Information Published in: European Journal of Pediatrics License: https://creativecommons.org/licenses/by/4.0See article on publisher's website: http://dx.doi.org/10.1007/s00431-022-04602-9</p

Evaluation of the efficacy of a web-based work-related asthma educational tool

<p><i>Background</i>: Work-related asthma (WRA) has been estimated to account for 15–20% of adult asthma cases. Studies have indicated that a substantial number of asthma patients have inadequate knowledge of work-related effects on their disease, which may contribute to suboptimal asthma control. A Canadian web-based educational tool on WRA was developed to address this knowledge gap in the population. <i>Objective</i>: To evaluate the effectiveness of this web-based tool. <i>Methods</i>: Participants were recruited prior to a routine visit at a tertiary care asthma clinic in Toronto. A brief WRA knowledge questionnaire was developed and administered immediately before and after using of the web-based educational tool, and one year later. <i>Results</i>: The study sample (<i>N</i> = 34) was mostly female (68%) with a mean age of 50.7 (SD, 17.2). Participants demonstrated significant improvement in questionnaire scores following interaction with the tool. The mean score increased from 76% (SEM = 2.1) to 84% (SEM = 1.7) (<i>p</i> = 0.001). On average, scores improved on 12 of the 13 questionnaire items. A 1-year follow-up of a sample of 19 participants demonstrated a slight reduction in mean scores, from 86% (SEM = 1.9) to 84% (SEM = 1.9), but still demonstrated a trend towards a higher score than the baseline (78%; SEM = 2.9; <i>p</i> = 0.08). <i>Conclusions</i>: Our findings suggest that the educational tool has a positive effect on WRA knowledge, and that knowledge may be retained long-term. Future studies are needed in non-tertiary care clinic populations which may possess less baseline knowledge of WRA.</p

SNM and UNO_C form a stable heterodimeric complex.

(A) SNM and UNO_C, with N-terminally fused maltose-binding protein (MBP) and twin Strep-II affinity tag (Stag), respectively, form a stable SU_C complex. Size exclusion chromatography profile from the final purification step and Coomassie-stained gel for analysis of the indicated peak are shown. (B) Mass photometry analysis of SU_C. The indicated molecular mass was determined by a Gaussian fit of the distribution of counts calibrated against a molecular mass standard. (C) SEC-MALS analysis of SU_C, revealing the indicated molecular mass. (D) AF2 model of SU_C with predicted alignment plot on the right. Regions associated with high (30 Å) and low (0 Å) error as predicted by the algorithm are shown in red and blue, respectively. (E) Analysis of SU_C by cross-linking mass spectrometry (XL-MS). The observed cross-links (with false discovery rate 74], with separation distance of cross-linked positions color-coded. A plot with the distance distribution of the observed cross-links mapped to the AF2 model is presented on the right. The majority of cross-links fall within the distance range expected for the DSBU linker (~27 Å, see text and [42]. The longer distance outliers may be caused by errors in the model prediction, or flexibility within the structure.</p