Omental Torsion After Repeated Abdominal Blunt Trauma

Omental torsion is caused by the rotation of the greater omentum on its axis which may lead to tissue infarction and necrosis. It is a rare cause of acute abdomen. Signs, symptoms and paraclinical data are not specific. The patients usually undergo laparotomy for acute abdomen of poorly defined origin. High index of suspicious is required for the diagnosis of this entity. The diagnosis is usually confirmed after an explorative laparotomy. We present clinical characteristics and imaging findings of omental torsion in a young man following repeated blunt abdominal trauma

Correlation Between Intra-Abdominal Free Fluid and Solid Organ Injury in Blunt Abdominal Trauma

Background: In previous studies, the diagnostic value of Focused Assessment with Sonography for Trauma (FAST) has been evaluated but few studies have been performed on the relationship between the amount of free intra-abdominal fluid and organ injury in blunt abdominal trauma. To select patients with a higher probability of intra-abdominal injuries, several scoring systems have been proposed based on the results of FAST. Objectives: The aim of this study was to determine the prognostic value of FAST according to the Huang scoring system and to propose a cut-off point for predicting the presence of intra-abdominal injuries on the Computed Tomography (CT) scan. The correlation between age and Glasgow Coma Scale (GCS) and the presence of intra-abdominal injuries on the CT scan was also assessed. Patients and Methods: This study was performed on 200 patients with severe blunt abdominal trauma who had stable vital signs. For all patients, FAST-ultrasound was performed by a radiologist and the free fluid score in the abdomen was calculated according to the Huang score. Immediately, an intravenous contrast-enhanced abdominal CT scan was performed in all patients and abdominal solid organ injuries were assessed. Results were analyzed using Kruskal-Wallis test, Mann-Whitney test and ROC curves. The correlation between age and GCS and the presence of intra-abdominal injuries on CT-scan was also evaluated. Results: The mean age of the patients was 29.6 ± 18.3 years and FAST was positive in 67% of the subjects. A significant correlation was seen between the FAST score and the presence of organ injury on CT scan (P < 0.001). Considering the cut-off point of 3 for the free fluid score (with a range of 0-8), sensitivity, specificity, positive predictive value and negative predictive value were calculated to be 0.83, 0.98, 0.93, and 0.95, respectively. Age and GCS showed no significant correlation with intra-abdominal injuries. Conclusions: It seems that FAST examination for intra-abdominal fluid in blunt trauma patients can predict intra-abdominal injuries with very high sensitivity and specificity. Using the scoring system can more accurately determine the probability of the presence of abdominal injuries with a cut-off point of three

Detection of Drug Resistance Gene in Cutaneous Leishmaniasis by PCR in Some Endemic Areas of Iran

Background: Cutaneous leishmaniasis is still a health problem in many rural and urban regions of Iran and drug resistance has emerged as a major impediment in the treatment of leishmaniasis. This study aims to determine the drug resistance gene in cutaneous leishmaniasis by PCR in some endemic areas of Iran. Methods: Ninety seven samples were collected from ulcers of leishmaniasis patients from some endemic areas of Iran. The Giemsa stained samples were examined microscopically and cultured in NNN and RPMI 1640 mediums for parasite detection. After DNA extraction, PCR was done by a pair of specific primers. For detection of mutation in DNA, first PCR products were electrophoresed on CSGE gel. The suspected samples were compared by sequencing and RFLP results were demonstrated. Comparison of DNA derived from a wild type cell and mutant cell was undertaken by CSGE and sequencing methods. Results: Among 90 isolates (92.8) examined for detection of mutation in gene with CSGE and RFLP, 10 (11.1) revealed a disorder in sequencing selection for unresponsive to drug. Conclusion: Drug resistance in cutaneous leishmaniasis to sodium stiboglocanat is probably due to a mutation in a genome. A field study is needed to determine the distribution of drug resistance and other gene mutations involved in unresponsiveness to drugs in leishmaniasis endemic areas of Iran. © Iranian Red Crescent Medical Journal

Study on ITS1 Gene of Iranian Trichomonas vaginalis by Molecular Methods

Background: Trichomoniasis is a worldwide protozoan parasitic disease and metronidazole is a choice drug for its treatment. Because of disease importance in public health and its controversial ideas about the prevalence of drug resistance, this study was carried out.Methods: Fifty-two suspected vaginal samples were collected from 2006 to 2007 in Gynecology Maryam Hospital, Tehran, Iran. All isolates were examined by microscopic, culture and PCR tech­niques. The PCR products were analyzed by RFLP and CSGE methods and two suspected samples were sequenced.Results: Trichomonas vaginalis was identified from all 52 samples. Of 52 isolates, 45 samples were successfully cultured and amplified by PCR except one. Seven were positive only by PCR. Finally, ITS1 fragment was successfully amplified in 51 of 52. CSGE analysis and PCR products di­gestion by MspI followed by sequencing showed nucleotide mutation at position 209 (C209T) of the ITS1 fragment in two (3.9%) of them.Conclusion: The results showed mutation in ITS1 fragment of T. vaginalis in two (3.9%) of Ira­nian isolates which may be related to metronidazole resistance

A low-dose chest CT protocol for the diagnosis of COVID-19 pneumonia: a prospective study

Purpose: The increasing trend of chest CT utilization during the COVID-19 pandemic necessitates novel protocols with reduced dose and maintained diagnostic accuracy. We aimed to investigate the diagnostic accuracy of 30-mAs chest CT protocol in comparison with a 150-mAs standard-dose routine protocol for imaging of COVID-19 pneumonia. Methods: Upon IRB approval, consecutive laboratory-confirmed positive COVID-19 patients aged 50 years or older who were referred for chest CT scan and had same-day normal CXR were invited to participate in this prospective study. First, a standard-dose chest CT scan (150 mAs) was performed. Only if typical COVID-19 pneumonia features were identified, then a low-dose CT (30 mAs) was done immediately. Diagnostic accuracy of low-dose and standard-dose CT in the detection of typical COVID-19 pneumonia features were compared. Results: Twenty patients with a mean age of 64.20 ± 13.8 were enrolled in the study. There was excellent intrareader agreement in detecting typical findings of COVID-19 pneumonia between low-dose and standard-dose (intraclass correlation coefficient ICC = 0.98–0.99, P values &lt; 0.001 all readers). The mean effective dose values in standard- and low-dose groups were 6.60 ± 1.47 and 1.80 ± 0.42 mSv, respectively. Also, absolute cancer risk per mean cumulative effective dose values obtained from the standard- and low-dose CT examinations were 2.71 × 10−4 and 0.74 × 10−4, respectively. Conclusions: According to our study, it was found that proposed low-dose CT chest protocol is reliable in detecting COVID-19 pneumonia in daily practice with significant reduction in radiation dose and estimated cancer risk. © 2020, American Society of Emergency Radiology

Povećanje oslobađanja gliklazida iz smjesa dobivenih geometrijskim miješanjem

The poorly water soluble antidiabetic drug gliclazide was selected to study the effect of excipients on dissolution rate enhancement. Ordered mixtures of micronized gliclazide with lactose, mannitol, sorbitol, maltitol and sodium chloride were prepared by manual shaking of glass vials containing the drug and excipient(s). Different water soluble excipients, addition of surfactant and superdisintegrant, drug concentration and carrier particle size influenced the dissolution rate of the drug. Dissolution rate studies of the prepared ordered mixtures revealed an increase in drug dissolution with all water soluble excipients. The order of dissolution rate improvement for gliclazide was mannitol > lactose > maltitol > sorbitol > sodium chloride. Composite granules of the particle size range 355-710 µm were superior in increasing the drug dissolution rate from ordered mixtures. Reducing the carrier particle size decreased the dissolution rate of the drug, as well as the increase in drug concentration. Kinetic modeling of drug release data fitted best the Hixson-Crowell model, which indicates that all the ordered mixture formulations followed the cube root law fairly well.Teško topljivi antidijabetik gliklazid izabran je za proučavanje utjecaja pomoćnih tvari na povećanje oslobađanja. Homogene smjese mikroniziranog gliklazida s laktozom, manitolom, sorbitolom, maltitolom i natrijevim kloridom pripravljene su ručnim tresenjem staklenih bočica s lijekom i pomoćnom tvari/tvarima. Na oslobađanje lijeka utjecali su vrsta vodotopljivog ekscipijensa, dodatak surfaktanta i superdezintegratora, udio lijeka i veličina čestica punila. Sve vodotopljive pomoćne tvari povećavale su oslobađanje ljekovite tvari i to sljedećim redom: manitol > laktoza > maltitol > sorbitol > natrijev klorid. Najbolje oslobađanje lijeka bilo je iz kompozitnih granula veličine 355 do 710 µm. Iz smjesa s manjom veličinom čestica punila i većim udjelom lijeka oslobađanje lijeka bilo je manje. Kinetičko modeliranje oslobađanja najbolje je odgovaralo Hixson-Crowellovom modelu, što ukazuje na to da sve formulacije prilično dobro slijede zakon trećeg korijena

The Internet of Things as Smart City Enabler:The Cases of Palo Alto, Nice and Stockholm

Part 5: Smart Cities and Smart HomesInternational audienceDue to rapid urbanization, city populations are rapidly increasing all over the world creating new problems and challenges. Solving some of these problems requires innovative approaches; one increasingly popular approach is to transform cities to Smart Cities. Smart Cities implement innovative approaches based on IoT technologies and convert many services to digital services. These services are implemented within the different components of a Smart City, helping city administrators to improve the life of the citizens, addressing different service, security and administrative challenges. The objective of this paper is to explore and determine how three well-known cities - Nice, Palo Alto and Stockholm - implemented the Smart City concept. The study indicates that a successful implementation of a Smart City model requires addressing a number of critical challenges: citizen involvement, business collaboration and strong leadership prove to be key success factors in the Smart City development process

A multi-center study of COVID-19 patient prognosis using deep learning-based CT image analysis and electronic health records

Purpose: As of August 30th, there were in total 25.1 million confirmed cases and 845 thousand deaths caused by coronavirus disease of 2019 (COVID-19) worldwide. With overwhelming demands on medical resources, patient stratification based on their risks is essential. In this multi-center study, we built prognosis models to predict severity outcomes, combining patients� electronic health records (EHR), which included vital signs and laboratory data, with deep learning- and CT-based severity prediction. Method: We first developed a CT segmentation network using datasets from multiple institutions worldwide. Two biomarkers were extracted from the CT images: total opacity ratio (TOR) and consolidation ratio (CR). After obtaining TOR and CR, further prognosis analysis was conducted on datasets from INSTITUTE-1, INSTITUTE-2 and INSTITUTE-3. For each data cohort, generalized linear model (GLM) was applied for prognosis prediction. Results: For the deep learning model, the correlation coefficient of the network prediction and manual segmentation was 0.755, 0.919, and 0.824 for the three cohorts, respectively. The AUC (95 CI) of the final prognosis models was 0.85(0.77,0.92), 0.93(0.87,0.98), and 0.86(0.75,0.94) for INSTITUTE-1, INSTITUTE-2 and INSTITUTE-3 cohorts, respectively. Either TOR or CR exist in all three final prognosis models. Age, white blood cell (WBC), and platelet (PLT) were chosen predictors in two cohorts. Oxygen saturation (SpO2) was a chosen predictor in one cohort. Conclusion: The developed deep learning method can segment lung infection regions. Prognosis results indicated that age, SpO2, CT biomarkers, PLT, and WBC were the most important prognostic predictors of COVID-19 in our prognosis model. © 202

Optimized cross-layer forward error correction coding for H.264 AVC video transmission over wireless channels

Forward error correction (FEC) codes that can provide unequal error protection (UEP) have been used recently for video transmission over wireless channels. These video transmission schemes may also benefit from the use of FEC codes both at the application layer (AL) and the physical layer (PL). However, the interaction and optimal setup of UEP FEC codes at the AL and the PL have not been previously investigated. In this paper, we study the cross-layer design of FEC codes at both layers for H.264 video transmission over wireless channels. In our scheme, UEP Luby transform codes are employed at the AL and rate-compatible punctured convolutional codes at the PL. In the proposed scheme, video slices are first prioritized based on their contribution to video quality. Next, we investigate the four combinations of cross-layer FEC schemes at both layers and concurrently optimize their parameters to minimize the video distortion and maximize the peak signal-to-noise ratio. We evaluate the performance of these schemes on four test H.264 video streams and show the superiority of optimized cross-layer FEC design.Peer reviewedElectrical and Computer Engineerin

Raman Spectroscopy and Regenerative Medicine: A Review

The field of regenerative medicine spans a wide area of the biomedical landscape—from single cell culture in laboratories to human whole-organ transplantation. To ensure that research is transferrable from bench to bedside, it is critical that we are able to assess regenerative processes in cells, tissues, organs and patients at a biochemical level. Regeneration relies on a large number of biological factors, which can be perturbed using conventional bioanalytical techniques. A versatile, non-invasive, non-destructive technique for biochemical analysis would be invaluable for the study of regeneration; and Raman spectroscopy is a potential solution. Raman spectroscopy is an analytical method by which chemical data are obtained through the inelastic scattering of light. Since its discovery in the 1920s, physicists and chemists have used Raman scattering to investigate the chemical composition of a vast range of both liquid and solid materials. However, only in the last two decades has this form of spectroscopy been employed in biomedical research. Particularly relevant to regenerative medicine are recent studies illustrating its ability to characterise and discriminate between healthy and disease states in cells, tissue biopsies and in patients. This review will briefly outline the principles behind Raman spectroscopy and its variants, describe key examples of its applications to biomedicine, and consider areas of regenerative medicine that would benefit from this non-invasive bioanalytical tool