Serum procalcitonin level and leukocyte antisedimentation rate as early predictors of respiratory dysfunction after oesophageal tumour resection

INTRODUCTION: Postoperative care after oesophageal tumour resection holds a high risk of respiratory complications. We therefore aimed to determine the value of systemic inflammatory markers in predicting arterial hypoxaemia as the earliest sign of developing lung injury after oesophageal tumour resection. METHODS: In a prospective observational study, 33 consecutive patients were observed for three days (T1–T3) after admission (T0) to an intensive care unit following oesophageal tumour resection. The daily highest values of the heart rate, axillary temperature, leukocyte count and PaCO(2 )were recorded. Serum C-reactive protein and procalcitonin concentrations and the leukocyte antisedimentation rate (LAR) were determined at T1 and T2. Respiratory function was monitored 6-hourly measurement of the PaO(2)/FIO(2 )ratio, and the lowest value was recorded at T3. Patients were categorised as normoxaemic or hypoxaemic using the cutoff value of 300 mmHg for PaO(2)/FIO(2). RESULTS: Seventeen out of 33 patients were classified as hypoxaemic and 16 patients as normoxaemic at T3. Increases of temperature at T0 and of the procalcitonin and LAR values at T2 were predictive of hypoxaemia at T3 (P < 0.05, P < 0.01 and P < 0.001, respectively). The area under the receiver-operating characteristic curve was 0.65 for the temperature at T0, which was significantly lower than that for the procalcitonin level at T2 (0.83; 95% confidence interval, 0.69–0.97; P < 0.01) and that for LAR at T2 (0.89; 95% confidence interval, 0.77–1.00; P < 0.001). CONCLUSION: These results suggest that an elevated LAR (>15%) and an elevated procalcitonin concentration (>2.5 ng/ml) measured on the second postoperative day can predict next-day arterial hypoxaemia (PaO(2)/FIO(2 )< 300 mmHg) after oesophageal tumour resection

MANAGEMENT OF SEPTIC SHOCKAND HYPOXIA INDUCED CONJUGATED HYPERBILIRUBINAEMIA IN CASE OF MAJOR CHEST TRAUMA – CASE REPORT

This case report describes a 50-year-old male trauma patient with multiple crushed thoracic lesions: flail chest, bilateral hemopneumothorax, myocardial infarction and pulmonary contusion. In the ICU he developed ARDS and pulmonary infection which lead to septic shock. Hypoxia due to inadequate ventilation and reduced visceral perfusion due to shock induced elevated levels of conjugated bilirubin. Continuous veno-venous hemofiltration (CVVH) sessions in combination with CytoSorb® filters and MARS® were needed. After surgical fixation of the flail segment ventilatory parameters improved significantly

Correlation between Adolescent’s Caries Prevalence and Caries Related Factors in Two Hungarian Cities

Svrha istraživanja bila je procijeniti učestalost karijesa u usporedbi s održavanjem higijene usne šupljine u omladine koja živi u različitim dijelovima Mađarske, kako bi se uočila moguća korelacija sa socijalno-ekonomskim čimbenicima. Učestalost karijesa i održavanje higijene usne šupljine istraženi su u 586 ispitanika u dobi od 14 do 16 godina. Bez karijesa bilo je 5,1 % ispitanika, njihova je vrijednost DMFT iznosila 6,97±4,67, a vrijednost DMFS 9,95±7,94. Indeks VPI bio je 41,6±32,7% (srednja vrijednost ± standardna devijacija, SD) i pokazao je pozitivnu korelaciju s učestalošću karijesa. Vrijednosti DMFT i DMFS, kao i VPI smanjivale su se s porastom obrazovne razine roditelja (oca). Vrijednosti DMFT, DMFS i VPI pogoršavale su se s porastom broja braće/sestara. Uočen je određeni odnos između ranije profilakse fluoridom i smanjenja vrijednosti DMF, no taj se odnos nije pokazao statistički znatnim. Ovi nalazi ukazuju na veliku potrebu poduzimanja organiziranih mjera dentalne prevencije.The aim of the study was to assess the caries prevalence and oral hygiene in groups of adolescents living in different Hungarian localities and to establish correlations with socio-economic factors. Examinations of caries and oral hygiene were performed in 586 14-16 year old children. The percentage of caries free children was 5.1%, the DMFT and DMFS values were 6.97±4.67 and 9.95±7.94 respectively. The VPI index was 41.6±32.7% (mean±S.D.), and showed positive correlation with the caries prevalence. The DMFT and DMFS values, as well as VPI decreased as the educational level of the father increased. The number of siblings had a worsening effect on DMFT, DMFS and VPI values. There was some relationship between the previous fluoride prophylaxis and decrease of DMF values, although the difference proved to be statistically non significant. These findings indicate the necessity of organized dental preventive measures

Correlation between Adolescent’s Caries Prevalence and Caries Related Factors in Two Hungarian Cities

Svrha istraživanja bila je procijeniti učestalost karijesa u usporedbi s održavanjem higijene usne šupljine u omladine koja živi u različitim dijelovima Mađarske, kako bi se uočila moguća korelacija sa socijalno-ekonomskim čimbenicima. Učestalost karijesa i održavanje higijene usne šupljine istraženi su u 586 ispitanika u dobi od 14 do 16 godina. Bez karijesa bilo je 5,1 % ispitanika, njihova je vrijednost DMFT iznosila 6,97±4,67, a vrijednost DMFS 9,95±7,94. Indeks VPI bio je 41,6±32,7% (srednja vrijednost ± standardna devijacija, SD) i pokazao je pozitivnu korelaciju s učestalošću karijesa. Vrijednosti DMFT i DMFS, kao i VPI smanjivale su se s porastom obrazovne razine roditelja (oca). Vrijednosti DMFT, DMFS i VPI pogoršavale su se s porastom broja braće/sestara. Uočen je određeni odnos između ranije profilakse fluoridom i smanjenja vrijednosti DMF, no taj se odnos nije pokazao statistički znatnim. Ovi nalazi ukazuju na veliku potrebu poduzimanja organiziranih mjera dentalne prevencije.The aim of the study was to assess the caries prevalence and oral hygiene in groups of adolescents living in different Hungarian localities and to establish correlations with socio-economic factors. Examinations of caries and oral hygiene were performed in 586 14-16 year old children. The percentage of caries free children was 5.1%, the DMFT and DMFS values were 6.97±4.67 and 9.95±7.94 respectively. The VPI index was 41.6±32.7% (mean±S.D.), and showed positive correlation with the caries prevalence. The DMFT and DMFS values, as well as VPI decreased as the educational level of the father increased. The number of siblings had a worsening effect on DMFT, DMFS and VPI values. There was some relationship between the previous fluoride prophylaxis and decrease of DMF values, although the difference proved to be statistically non significant. These findings indicate the necessity of organized dental preventive measures

Recombination Events Shape the Genomic Evolution of Infectious Bronchitis Virus in Europe

Infectious bronchitis of chicken is a high morbidity and mortality viral disease affecting the poultry industry worldwide; therefore, a better understanding of this pathogen is of utmost importance. The primary aim of this study was to obtain a deeper insight into the genomic diversity of field infectious bronchitis virus (IBV) strains using phylogenetic and recombination analysis. We sequenced the genome of 20 randomly selected strains from seven European countries. After sequencing, we created a genome sequence data set that contained 36 European origin field isolates and 33 vaccine strains. When analyzing these 69 IBV genome sequences, we identified 215 recombination events highlighting that some strains had multiple recombination breaking points. Recombination hot spots were identified mostly in the regions coding for non-structural proteins, and multiple recombination hot spots were identified in the nsp2, nsp3, nsp8, and nsp12 coding regions. Recombination occurred among different IBV genotypes and involved both field and vaccine IBV strains. Ninety percent of field strains and nearly half of vaccine strains showed evidence of recombination. Despite the low number and the scattered geographical and temporal origin of whole-genome sequence data collected from European Gammacoronaviruses, this study underlines the importance of recombination as a major evolutionary mechanism of IBVs