目的:应用主观整体评估(Subjective global assessment,SGA)、全球领导人营养不良倡议(Global leadership initiative on malnutrition,GLIM)标准诊断采用营养风险筛查2002(Nutritional risk screening2002,NRS2002)量表筛查有营养风险...目的:应用主观整体评估(Subjective global assessment,SGA)、全球领导人营养不良倡议(Global leadership initiative on malnutrition,GLIM)标准诊断采用营养风险筛查2002(Nutritional risk screening2002,NRS2002)量表筛查有营养风险的脑卒中康复期患者的营养不良发生情况,并比较其一致性。方法:选取2019年10月-2023年12月期间本院康复科等病区收治的39~90岁脑卒中康复期、并且经NRS2002筛查有营养风险的住院患者223例作为研究对象。分别采用GLIM标准、SGA标准评定患者营养不良情况。并分析其诊断诊断结果的一致性。结果:采用GLIM标准诊断营养不良200例,阳性率89.7%,不同年龄段、性别营养不良发生率差异无统计学意义(P>0.05)。采用SGA标准诊断营养不良195例,阳性率87.44%,不同年龄段营养不良发生率差异有统计学意义(P<0.01)。以GLIM为标准,SGA诊断营养不良的kappa值为0.613(P<0.01),灵敏度为96.0%,特异度为87.0%。结论:有营养风险的脑卒中康复期患者有必要尽早进行营养不良诊断,GLIM和SGA一致性良好,均可作为脑卒中康复期患者营养不良诊断工具。展开更多
Two-third of the world's population lives in the Asia Pacific region where prevalence of diabetes has reached epidemic proportion.With China and India being the most populous nations on the globe,it is believed th...Two-third of the world's population lives in the Asia Pacific region where prevalence of diabetes has reached epidemic proportion.With China and India being the most populous nations on the globe,it is believed that over 150 million diabetes reside in the region with more than 95%being of type 2 diabetes mellitus(T2DM).Furthermore,other Pacific islands in the region have high rales of T2DM including Tonga.Fiji.French Polynesia,and Nauru.The latter has the highest prevalence of T2DM per population in the world.Over the past two decades,in Australia and New Zealand,the prevalence of T2DM has more than doubled,mainly amongst the Aboriginal and Torres Strait Islander and Maori peoples respectively.With the increasing prevalence of dialietes in the Asia Pacific region coupled with the limited number of resources,use of a reliable and effective mode of diagnosis for T3DVI is warranted.Yet to date,only New Zealand has adopted the American Diabetes Association recommendation of using hemoglobin A1C in the diagnosis of the disease.The aim of this review is to discuss the clinical usefulness of hemoglobin A1C and highlight its diagnostic role in the Asia Pacific region where T2DM is increasingly encountered.展开更多
AIM： To determine the diagnostic value of the rabeprazole test in patients seen by general practitioners. METHODS： Eighty-three patients with symptoms suggestive of GERD were enrolled by general practitioners in thi...AIM： To determine the diagnostic value of the rabeprazole test in patients seen by general practitioners. METHODS： Eighty-three patients with symptoms suggestive of GERD were enrolled by general practitioners in this multi-centre, randomized and doubleblind study. All patients received either rabeprazole （20 mg bid） or a placebo for one week. The diagnosis of GERD was established on the presence of mucosal breaks at endoscopy and/or an abnormal esophageal 24-h pH test. The test was considered to be positive if patients reported at least a ＂clear improvement＂ of symptoms on a 7-point Likert scale. RESULTS： The sensitivities of the test for rabeprazole and the placebo were 83% and 40%, respectively. The corresponding specificity, positive and negative predictive values were 45% and 67%, 71% and 71%, and 62% and 35%, respectively. A receiver operating characteristics （ROC） analysis confirmed that the best discriminatory cut-off corresponded to description of ＂clear improvement＂ CONCLUSION： The poor specificity of the proton-pump inhibitor （PPI） test does not support such an approach to establish a diagnosis of GERD in a primary care setting.展开更多
Rapid diagnostic methods for classifying avian leukosis subgroups in the field were needed for routine, large-scale screening. As a first step in method development, we inserted the avian leukosis virus subgroup A （A...Rapid diagnostic methods for classifying avian leukosis subgroups in the field were needed for routine, large-scale screening. As a first step in method development, we inserted the avian leukosis virus subgroup A （ALV-A） env gene into plasmid pcDNA3.1/Zeo （＋） and used this construct to transfect DF-1 cells. Zeocin-resistant cells were obtained after 2 weeks of zeocin selection. Then, the cells were analyzed using PCR, immunofluorescence, and Western blot for expression of the envA-encoded envelope protein after 30 serial passages. The DF-1/A cell line was completely resistant to 104 TCIDso/0.1 mL （50% tissue culture infective dose）ALV-A and was partially resistant to 10~ TCIDs0/0.1 mL ALV-A viral particles. By comparing the DF-1/A and DF-1 cell lines, an ALV-A isolate was identified using a gag-specific ELISAfor capsid protein p27. Thus, we established a DF-1/A cell line that was resistant to ALV-A infection. This cell line will be useful as a diagnostic tool.展开更多
The diagnosis and treatment of fever of unknown origin (FUO) are huge challenges to clinicians.Separating the etiologies of FUO into infectious and non-infectious disease is conducive to clinical physicians not only o...The diagnosis and treatment of fever of unknown origin (FUO) are huge challenges to clinicians.Separating the etiologies of FUO into infectious and non-infectious disease is conducive to clinical physicians not only on making decisions rapidly concerning the prescription of suitable antibiotics but also on further analysis of the final diagnosis.In order to develop and validate a diagnostic tool to efficiently distinguish the etiologies of adult FUO patients as infectious or non-infectious disease,FUO patients from the departments of infectious disease and internal medicine in three Chinese tertiary hospitals were enrolled retrospectively and prospectively.By using polynomial logistic regression analysis,the diagnostic formula and the associated scoring system were developed.The variables included in this diagnostic formula were from clinical evaluations and common laboratory examinations.The proposed tool could discriminate infectious and noninfectious causes of FUO with an area under receiver operating characteristic curve (AUC) of 0.83,sensitivity of 0.80 and specificity of 0.75.This diagnosis tool could predict the infectious and non-infectious causes of FUO in the validation cohort with an AUC of 0.79,sensitivity of 0.79 and specificity of 0.70.The results suggested that this diagnostic tool could be a reliable tool to discriminate between infectious and non-infectious causes of FUO.展开更多
Purpose:To construct a symptoms-based prediction tool to assess the likelihood of superior canal dehiscence(SSCD)on high-resolution CT.Materials and methods:Mathematical modeling was employed to predict radiologic evi...Purpose:To construct a symptoms-based prediction tool to assess the likelihood of superior canal dehiscence(SSCD)on high-resolution CT.Materials and methods:Mathematical modeling was employed to predict radiologic evidence of SSCD at a tertiary neurotology referral center.Results:A total of 168 patients were included,of which 118 had imaging-confirmed SSCD.On univariate analysis significant predictors of SSCD presence were:sound/pressure-induced vertigo(p?0.006),disequilibrium(p?0.008),hyperacusis(p?0.008),and autophony(p?0.034).Multivariate analysis enabled a 14-point symptom-weighted tool to be developed,wherein a score of6 raised the suspicion of SSCD(70%likelihood of being present),R2?0.853.Conclusions:The likelihood of SSCD on CT scan can be determined with a high degree of certainty based on symptoms recorded at presentation.Using the evidenced-based diagnostic tool validated herein,a score6 with any symptom combination justifies ordering a CT scan.展开更多
BACKGROUND: To evaluate the diagnostic accuracy of clinical signs combined with the tongue blade test(TBT) to detect maxillary and mandibular fractures.METHODS: A cross-sectional study enrolled patients with maxillary...BACKGROUND: To evaluate the diagnostic accuracy of clinical signs combined with the tongue blade test(TBT) to detect maxillary and mandibular fractures.METHODS: A cross-sectional study enrolled patients with maxillary and mandibular injuries in the emergency department. Physical examination and the TBT were performed, followed by radiological imaging(facial X-ray or computed tomography [CT]). The diagnostic accuracy was calculated for individuals and a combination of clinical findings at predicting maxillary and mandibular fractures.RESULTS: A total of 98 patients were identified, of whom 31.6% had maxillary fractures and9.2% had mandibular fractures. The combination of malocclusion, tenderness on palpation and swelling with positive TBT had 100% specificity to detect maxillary and mandibular fractures. In the absence of malocclusion, the combination of tenderness on palpation and swelling with positive TBT produced a specificity of 97.8% for maxillary fracture and a specificity of 96.2% for mandibular fracture. A clinical decision tool consisting of malocclusion, tenderness on palpation, swelling and TBT revealed a specificity of 100% and a positive predictive value of 100%.CONCLUSION: The clinical decision tool is potentially useful to rule out mandibular fractures,thus preventing unnecessary radiation exposure.展开更多
The cytological study of gallbladder bile is a diagnostic tool used very often in the treatment of gallbladder cancer. The diagnosis of gall bladder cancer is done by morphological examinations such as ultrasound, com...The cytological study of gallbladder bile is a diagnostic tool used very often in the treatment of gallbladder cancer. The diagnosis of gall bladder cancer is done by morphological examinations such as ultrasound, computed tomography in 80% of cases, but in some difficult cases, benign lesions associated with malignant lesions, such as pseudo-tumoral cholecystitis, adenomyosis or adenoma and cancers requiring medical treatment by chemotherapy or radiotherapy, is without the possibility of surgical treatment. Cytology can help resolve a number of difficult situations, such as the presence of an intra-gallbladder lesion in the form of a polyp or nodule. Some studies have reported very interesting results from gallbladder cytology to cancer diagnosis with results up to 85% sensitivity. The purpose of this study is to analyze the contribution of the cytological study of gallbladder bile to the positive diagnosis of gallbladder cancer.展开更多
Premised on international good practices,the Tax Administration Diagnostic Assessment Tool(TADAT)provides a standardized and objective framework for conducting an evidence-based and outcome-focused assessment of the k...Premised on international good practices,the Tax Administration Diagnostic Assessment Tool(TADAT)provides a standardized and objective framework for conducting an evidence-based and outcome-focused assessment of the key strengths and weaknesses of a country’s tax administration system.TADAT is a global tool that applies to any country’s system of tax administration.The results of a TADAT assessment provide country authorities,supported by their capacity development partners,with a baseline to strengthen or develop,and monitor tax administration reform strategies and work plans.展开更多
Background: Hypertension and pre-hypertension in children and adolescents are frequently missed despite current screening recommendations and the potential benefit for early diagnosis and intervention. Difficulty in i...Background: Hypertension and pre-hypertension in children and adolescents are frequently missed despite current screening recommendations and the potential benefit for early diagnosis and intervention. Difficulty in interpretation of office blood pressure readings in children has been partially blamed for the significant under-diagnosis of childhood hypertension. The objective of our group was to develop and evaluate a simple tool designed to assist primary health care physicians to interpret office blood pressure readings in children and adolescents. Methods: A multi-disciplinary advisory group in our institution undertook the development of a diagnostic tool based on currently accepted gold standard parameters. Input from Family Physicians and Pediatricians was used in the design process. The tool was then distributed among Family Physicians in our catchment area and evaluated with a post-distribution survey. Results: A laminated one page summary of pediatric blood pressure parameters and initial approach to pediatric hypertension was created and distributed. Feedback from primary care physicians was mostly positive and supportive of this initiative. Conclusions: Innovating and simplifying the screening process for hypertension and pre-hypertension in childhood may promote early detection and intervention however the effect of such initiatives on the rate of diagnosis of pediatric hypertension will need to be tested prospectively by appropriately designed studies.展开更多
Mesenchymal stem cells(MSCs) are progenitor cells capable of self-renewal that can differentiate in multiple tissues and, under specific and standardizedculture conditions, expand in vitro with little phenotypic alter...Mesenchymal stem cells(MSCs) are progenitor cells capable of self-renewal that can differentiate in multiple tissues and, under specific and standardizedculture conditions, expand in vitro with little phenotypic alterations. In recent years, preclinical and clinical studies have focused on MSC analysis and understanding the potential use of these cells as a therapy in a wide range of pathologies, and many applications have been tested. Clinical trials using MSCs have been performed(e.g., for cardiac events, stroke, multiple sclerosis, blood diseases, auto-immune disorders, ischemia, and articular cartilage and bone pathologies), and for many genetic diseases, these cells are considered an important resource. Considering of the biology of MSCs, these cells may also be useful tools for understanding the physiopathology of different diseases, and they can be used to develop specific biomarkers for a broad range of diseases. In this editorial, we discuss the literature related to the use of MSCs for diagnostic applications and we suggest new technologies to improve their employment.展开更多
AIM To evaluate the diagnostic value of serial biochemical blood tests in the diagnosis of biliary colic.METHODS Files were reviewed of 1039 patients who were admitted to the Share'e Zedek Medical Center emergency...AIM To evaluate the diagnostic value of serial biochemical blood tests in the diagnosis of biliary colic.METHODS Files were reviewed of 1039 patients who were admitted to the Share'e Zedek Medical Center emergency department between the years 2012-2013, and received the coding of acute biliary disease. Of these, the first 100 cases were selected that met the following criteria:(1) a diagnosis of biliary colic or symptomatic cholelithiasis;(2) at least two biochemical blood tests performed; and(3) 18 years of age or older. Patients with other acute biliary diseases were excluded. The biochemical profile of the patients was analyzed as were their clinical and radiological findings.RESULTS Three-quarters of the patients were women, whose average age of 37 years was younger than the averageof the men, at 50 years. According to their histories, 47% of the patients had previously known cholelithiasis. Pain in either the right upper quadrant or the epigastrium was the presenting symptom in 93% cases. The greatest change in serum biochemical results was seen during the first day of the patients' admissions. Alanine aminotransferase(ALT) showed the highest initial rise above the reference range, followed by aspartate aminotransferase(AST), gamma-glutamyl transferase(GGT), bilirubin and alkaline phosphatase(ALKP)- all these increases were statistically significant(P < 0.05). AST showed the sharpest decline followed by bilirubin and ALT. GGT and ALKP did not fall. A sharp rise and fall in liver enzymes, especially during the first day, most prominently in AST and ALT, was seen in 70% percent of cases. In 65% of cases trans-abdominal sonography did not give diagnostic findings.CONCLUSION Serial serum liver enzyme measurements are helpful in the initial diagnosis of acute biliary colic.展开更多
AIM: To investigate adenoviral transduction in mesenchymal stem cells(MSCs) and effects on stemness in vitro and function as a cell therapy in vivo.METHODS: Bone marrow-derived adult and fetal MSC were isolated from a...AIM: To investigate adenoviral transduction in mesenchymal stem cells(MSCs) and effects on stemness in vitro and function as a cell therapy in vivo.METHODS: Bone marrow-derived adult and fetal MSC were isolated from an equine source and expanded in monolayer tissue culture. Polyethylenimine(PEI)-mediated transfection of pc DNA3-e GFP or adenoviral transduction of green fluorescent protein(GFP) was evaluated in fetal MSCs. Adenoviral-mediated transduction was chosen for subsequent experiments. All experiments were carried out at least in triplicate unless otherwise noted. Outcome assessment was obtained by flow cytometry or immunohystochemistry and included transduction efficiency, cell viability, stemness(i.e., cell proliferation, osteogenic and chondrogenic cell differentiation), and quantification of GFP expression. Fetal and adult MSCs were then transduced with an adenoviral vector containing the gene for the bone morphogenic protein 2(BMP2). In vitro BMP2 expression was assessed by enzyme linked immunosorbent assay. In addition, MSC-mediated gene delivery of BMP2 was evaluated in vivo in an osteoinduction nude mouse quadriceps model. New bone formation was evaluated by microradiography and histology.RESULTS: PEI provided greater transfection and viability in fetal MSCs than other commercial chemical reagents. Adenoviral transduction efficiency was superior to PEI-mediated transfection of GFP in fetal MSCs(81.3% ± 1.3% vs 35.0% ± 1.6%, P < 0.05) and was similar in adult MSCs(78.1% ± 1.9%). Adenoviral transduction provided significantly greater expression of GFP in fetal than adult MSCs(7.4 ± 0.1 vs 4.4 ± 0.3 millions of mean fluorescence intensity units, P < 0.01) as well as significantly greater in vitro BMP2 expression(0.16 pg/cell-day vs 0.10 pg/cell-day, P < 0.01). Fraction of fetal MSC GFP positive cells decreased significantly faster than adult MSCs(1.15% ± 0.05% vs 11.4% ± 2.1% GFP positive at 2 wk post-transduction, P < 0.05). Cell proliferation and osteogenic differentiation in vitrowere not af展开更多
文摘目的:应用主观整体评估(Subjective global assessment,SGA)、全球领导人营养不良倡议(Global leadership initiative on malnutrition,GLIM)标准诊断采用营养风险筛查2002(Nutritional risk screening2002,NRS2002)量表筛查有营养风险的脑卒中康复期患者的营养不良发生情况,并比较其一致性。方法:选取2019年10月-2023年12月期间本院康复科等病区收治的39~90岁脑卒中康复期、并且经NRS2002筛查有营养风险的住院患者223例作为研究对象。分别采用GLIM标准、SGA标准评定患者营养不良情况。并分析其诊断诊断结果的一致性。结果:采用GLIM标准诊断营养不良200例,阳性率89.7%,不同年龄段、性别营养不良发生率差异无统计学意义(P>0.05)。采用SGA标准诊断营养不良195例,阳性率87.44%,不同年龄段营养不良发生率差异有统计学意义(P<0.01)。以GLIM为标准,SGA诊断营养不良的kappa值为0.613(P<0.01),灵敏度为96.0%,特异度为87.0%。结论:有营养风险的脑卒中康复期患者有必要尽早进行营养不良诊断,GLIM和SGA一致性良好,均可作为脑卒中康复期患者营养不良诊断工具。
基金Supported by Australia's James Cook University Faculty Research(Grant No.JCL-ECR 6250-2013)
文摘Two-third of the world's population lives in the Asia Pacific region where prevalence of diabetes has reached epidemic proportion.With China and India being the most populous nations on the globe,it is believed that over 150 million diabetes reside in the region with more than 95%being of type 2 diabetes mellitus(T2DM).Furthermore,other Pacific islands in the region have high rales of T2DM including Tonga.Fiji.French Polynesia,and Nauru.The latter has the highest prevalence of T2DM per population in the world.Over the past two decades,in Australia and New Zealand,the prevalence of T2DM has more than doubled,mainly amongst the Aboriginal and Torres Strait Islander and Maori peoples respectively.With the increasing prevalence of dialietes in the Asia Pacific region coupled with the limited number of resources,use of a reliable and effective mode of diagnosis for T3DVI is warranted.Yet to date,only New Zealand has adopted the American Diabetes Association recommendation of using hemoglobin A1C in the diagnosis of the disease.The aim of this review is to discuss the clinical usefulness of hemoglobin A1C and highlight its diagnostic role in the Asia Pacific region where T2DM is increasingly encountered.
文摘AIM： To determine the diagnostic value of the rabeprazole test in patients seen by general practitioners. METHODS： Eighty-three patients with symptoms suggestive of GERD were enrolled by general practitioners in this multi-centre, randomized and doubleblind study. All patients received either rabeprazole （20 mg bid） or a placebo for one week. The diagnosis of GERD was established on the presence of mucosal breaks at endoscopy and/or an abnormal esophageal 24-h pH test. The test was considered to be positive if patients reported at least a ＂clear improvement＂ of symptoms on a 7-point Likert scale. RESULTS： The sensitivities of the test for rabeprazole and the placebo were 83% and 40%, respectively. The corresponding specificity, positive and negative predictive values were 45% and 67%, 71% and 71%, and 62% and 35%, respectively. A receiver operating characteristics （ROC） analysis confirmed that the best discriminatory cut-off corresponded to description of ＂clear improvement＂ CONCLUSION： The poor specificity of the proton-pump inhibitor （PPI） test does not support such an approach to establish a diagnosis of GERD in a primary care setting.
基金The work was founded by the National Key R&D Program of China(2016YFD0501606)the Public Industry Research Program,the Ministry of Agriculture of China(201203055)+2 种基金the Program of Science and Technology Development of Guangdong Province,China(2015A020209145)the China Meat-Type Chicken Research System(CARS-42-G09)the Modern Agriculture Talents Support Program,Ministry of Agriculture of China([2012] no.160)
文摘Rapid diagnostic methods for classifying avian leukosis subgroups in the field were needed for routine, large-scale screening. As a first step in method development, we inserted the avian leukosis virus subgroup A （ALV-A） env gene into plasmid pcDNA3.1/Zeo （＋） and used this construct to transfect DF-1 cells. Zeocin-resistant cells were obtained after 2 weeks of zeocin selection. Then, the cells were analyzed using PCR, immunofluorescence, and Western blot for expression of the envA-encoded envelope protein after 30 serial passages. The DF-1/A cell line was completely resistant to 104 TCIDso/0.1 mL （50% tissue culture infective dose）ALV-A and was partially resistant to 10~ TCIDs0/0.1 mL ALV-A viral particles. By comparing the DF-1/A and DF-1 cell lines, an ALV-A isolate was identified using a gag-specific ELISAfor capsid protein p27. Thus, we established a DF-1/A cell line that was resistant to ALV-A infection. This cell line will be useful as a diagnostic tool.
文摘The diagnosis and treatment of fever of unknown origin (FUO) are huge challenges to clinicians.Separating the etiologies of FUO into infectious and non-infectious disease is conducive to clinical physicians not only on making decisions rapidly concerning the prescription of suitable antibiotics but also on further analysis of the final diagnosis.In order to develop and validate a diagnostic tool to efficiently distinguish the etiologies of adult FUO patients as infectious or non-infectious disease,FUO patients from the departments of infectious disease and internal medicine in three Chinese tertiary hospitals were enrolled retrospectively and prospectively.By using polynomial logistic regression analysis,the diagnostic formula and the associated scoring system were developed.The variables included in this diagnostic formula were from clinical evaluations and common laboratory examinations.The proposed tool could discriminate infectious and noninfectious causes of FUO with an area under receiver operating characteristic curve (AUC) of 0.83,sensitivity of 0.80 and specificity of 0.75.This diagnosis tool could predict the infectious and non-infectious causes of FUO in the validation cohort with an AUC of 0.79,sensitivity of 0.79 and specificity of 0.70.The results suggested that this diagnostic tool could be a reliable tool to discriminate between infectious and non-infectious causes of FUO.
文摘Purpose:To construct a symptoms-based prediction tool to assess the likelihood of superior canal dehiscence(SSCD)on high-resolution CT.Materials and methods:Mathematical modeling was employed to predict radiologic evidence of SSCD at a tertiary neurotology referral center.Results:A total of 168 patients were included,of which 118 had imaging-confirmed SSCD.On univariate analysis significant predictors of SSCD presence were:sound/pressure-induced vertigo(p?0.006),disequilibrium(p?0.008),hyperacusis(p?0.008),and autophony(p?0.034).Multivariate analysis enabled a 14-point symptom-weighted tool to be developed,wherein a score of6 raised the suspicion of SSCD(70%likelihood of being present),R2?0.853.Conclusions:The likelihood of SSCD on CT scan can be determined with a high degree of certainty based on symptoms recorded at presentation.Using the evidenced-based diagnostic tool validated herein,a score6 with any symptom combination justifies ordering a CT scan.
文摘BACKGROUND: To evaluate the diagnostic accuracy of clinical signs combined with the tongue blade test(TBT) to detect maxillary and mandibular fractures.METHODS: A cross-sectional study enrolled patients with maxillary and mandibular injuries in the emergency department. Physical examination and the TBT were performed, followed by radiological imaging(facial X-ray or computed tomography [CT]). The diagnostic accuracy was calculated for individuals and a combination of clinical findings at predicting maxillary and mandibular fractures.RESULTS: A total of 98 patients were identified, of whom 31.6% had maxillary fractures and9.2% had mandibular fractures. The combination of malocclusion, tenderness on palpation and swelling with positive TBT had 100% specificity to detect maxillary and mandibular fractures. In the absence of malocclusion, the combination of tenderness on palpation and swelling with positive TBT produced a specificity of 97.8% for maxillary fracture and a specificity of 96.2% for mandibular fracture. A clinical decision tool consisting of malocclusion, tenderness on palpation, swelling and TBT revealed a specificity of 100% and a positive predictive value of 100%.CONCLUSION: The clinical decision tool is potentially useful to rule out mandibular fractures,thus preventing unnecessary radiation exposure.
文摘The cytological study of gallbladder bile is a diagnostic tool used very often in the treatment of gallbladder cancer. The diagnosis of gall bladder cancer is done by morphological examinations such as ultrasound, computed tomography in 80% of cases, but in some difficult cases, benign lesions associated with malignant lesions, such as pseudo-tumoral cholecystitis, adenomyosis or adenoma and cancers requiring medical treatment by chemotherapy or radiotherapy, is without the possibility of surgical treatment. Cytology can help resolve a number of difficult situations, such as the presence of an intra-gallbladder lesion in the form of a polyp or nodule. Some studies have reported very interesting results from gallbladder cytology to cancer diagnosis with results up to 85% sensitivity. The purpose of this study is to analyze the contribution of the cytological study of gallbladder bile to the positive diagnosis of gallbladder cancer.
文摘Premised on international good practices,the Tax Administration Diagnostic Assessment Tool(TADAT)provides a standardized and objective framework for conducting an evidence-based and outcome-focused assessment of the key strengths and weaknesses of a country’s tax administration system.TADAT is a global tool that applies to any country’s system of tax administration.The results of a TADAT assessment provide country authorities,supported by their capacity development partners,with a baseline to strengthen or develop,and monitor tax administration reform strategies and work plans.
文摘Background: Hypertension and pre-hypertension in children and adolescents are frequently missed despite current screening recommendations and the potential benefit for early diagnosis and intervention. Difficulty in interpretation of office blood pressure readings in children has been partially blamed for the significant under-diagnosis of childhood hypertension. The objective of our group was to develop and evaluate a simple tool designed to assist primary health care physicians to interpret office blood pressure readings in children and adolescents. Methods: A multi-disciplinary advisory group in our institution undertook the development of a diagnostic tool based on currently accepted gold standard parameters. Input from Family Physicians and Pediatricians was used in the design process. The tool was then distributed among Family Physicians in our catchment area and evaluated with a post-distribution survey. Results: A laminated one page summary of pediatric blood pressure parameters and initial approach to pediatric hypertension was created and distributed. Feedback from primary care physicians was mostly positive and supportive of this initiative. Conclusions: Innovating and simplifying the screening process for hypertension and pre-hypertension in childhood may promote early detection and intervention however the effect of such initiatives on the rate of diagnosis of pediatric hypertension will need to be tested prospectively by appropriately designed studies.
文摘Mesenchymal stem cells(MSCs) are progenitor cells capable of self-renewal that can differentiate in multiple tissues and, under specific and standardizedculture conditions, expand in vitro with little phenotypic alterations. In recent years, preclinical and clinical studies have focused on MSC analysis and understanding the potential use of these cells as a therapy in a wide range of pathologies, and many applications have been tested. Clinical trials using MSCs have been performed(e.g., for cardiac events, stroke, multiple sclerosis, blood diseases, auto-immune disorders, ischemia, and articular cartilage and bone pathologies), and for many genetic diseases, these cells are considered an important resource. Considering of the biology of MSCs, these cells may also be useful tools for understanding the physiopathology of different diseases, and they can be used to develop specific biomarkers for a broad range of diseases. In this editorial, we discuss the literature related to the use of MSCs for diagnostic applications and we suggest new technologies to improve their employment.
文摘AIM To evaluate the diagnostic value of serial biochemical blood tests in the diagnosis of biliary colic.METHODS Files were reviewed of 1039 patients who were admitted to the Share'e Zedek Medical Center emergency department between the years 2012-2013, and received the coding of acute biliary disease. Of these, the first 100 cases were selected that met the following criteria:(1) a diagnosis of biliary colic or symptomatic cholelithiasis;(2) at least two biochemical blood tests performed; and(3) 18 years of age or older. Patients with other acute biliary diseases were excluded. The biochemical profile of the patients was analyzed as were their clinical and radiological findings.RESULTS Three-quarters of the patients were women, whose average age of 37 years was younger than the averageof the men, at 50 years. According to their histories, 47% of the patients had previously known cholelithiasis. Pain in either the right upper quadrant or the epigastrium was the presenting symptom in 93% cases. The greatest change in serum biochemical results was seen during the first day of the patients' admissions. Alanine aminotransferase(ALT) showed the highest initial rise above the reference range, followed by aspartate aminotransferase(AST), gamma-glutamyl transferase(GGT), bilirubin and alkaline phosphatase(ALKP)- all these increases were statistically significant(P < 0.05). AST showed the sharpest decline followed by bilirubin and ALT. GGT and ALKP did not fall. A sharp rise and fall in liver enzymes, especially during the first day, most prominently in AST and ALT, was seen in 70% percent of cases. In 65% of cases trans-abdominal sonography did not give diagnostic findings.CONCLUSION Serial serum liver enzyme measurements are helpful in the initial diagnosis of acute biliary colic.
基金The Ohio State University College of Medicine Roessler Research Scholarship(In part)in part by National Cancer Institution of the United States grant No.P30 CA016058(Our histological examination was performed at The OSU Comparative Pathology and Mouse Phenotyping Shared Resource)
文摘AIM: To investigate adenoviral transduction in mesenchymal stem cells(MSCs) and effects on stemness in vitro and function as a cell therapy in vivo.METHODS: Bone marrow-derived adult and fetal MSC were isolated from an equine source and expanded in monolayer tissue culture. Polyethylenimine(PEI)-mediated transfection of pc DNA3-e GFP or adenoviral transduction of green fluorescent protein(GFP) was evaluated in fetal MSCs. Adenoviral-mediated transduction was chosen for subsequent experiments. All experiments were carried out at least in triplicate unless otherwise noted. Outcome assessment was obtained by flow cytometry or immunohystochemistry and included transduction efficiency, cell viability, stemness(i.e., cell proliferation, osteogenic and chondrogenic cell differentiation), and quantification of GFP expression. Fetal and adult MSCs were then transduced with an adenoviral vector containing the gene for the bone morphogenic protein 2(BMP2). In vitro BMP2 expression was assessed by enzyme linked immunosorbent assay. In addition, MSC-mediated gene delivery of BMP2 was evaluated in vivo in an osteoinduction nude mouse quadriceps model. New bone formation was evaluated by microradiography and histology.RESULTS: PEI provided greater transfection and viability in fetal MSCs than other commercial chemical reagents. Adenoviral transduction efficiency was superior to PEI-mediated transfection of GFP in fetal MSCs(81.3% ± 1.3% vs 35.0% ± 1.6%, P < 0.05) and was similar in adult MSCs(78.1% ± 1.9%). Adenoviral transduction provided significantly greater expression of GFP in fetal than adult MSCs(7.4 ± 0.1 vs 4.4 ± 0.3 millions of mean fluorescence intensity units, P < 0.01) as well as significantly greater in vitro BMP2 expression(0.16 pg/cell-day vs 0.10 pg/cell-day, P < 0.01). Fraction of fetal MSC GFP positive cells decreased significantly faster than adult MSCs(1.15% ± 0.05% vs 11.4% ± 2.1% GFP positive at 2 wk post-transduction, P < 0.05). Cell proliferation and osteogenic differentiation in vitrowere not af
