▶ Intracerebral hemorrhage induces a profound reduction of systemic immune cells. ▶ Despite this cellular immunosupression, Treg trend to be constant in number. ▶ After large hematomas animals are ...susceptible to infections.
Inflammatory cascades are increasingly recognized as an important pathophysiological mechanism in intracerebral hemorrhage (ICH). In contrast, the effect of ICH on the systemic immune system has barely been investigated. We examined the effects of different hematoma volumes on immune cell subpopulations in experimental murine ICH. In C57BL/6 mice, ICH was induced by striatal injection of autologous blood (10, 30 or 50μL). Control animals received the respective sham operation. Three days after ICH induction, differential blood leukocyte counting was performed. Lymphocyte subpopulations were further characterized by flow cytometry in blood, spleen, lymph node and thymus. Infectious complications were studied using microbiological cultures of blood and lungs. Only after large ICH a marked decrease of leukocyte counts and most lymphocyte subsets was observed in all organs. Despite this general leukocytopenia, a significant, up to 10-fold increase, was detected in the monocyte population after extensive hemorrhage. After moderate ICH induction, only specific lymphocyte subpopulations were differentially affected. Mature thymic cells were unaffected while immature CD4+CD8+ cells were depleted by over 90% after large ICH. A significant proportion of mice with extensive ICH (36.4%) developed spontaneous pneumonia and/or bacteremia while none of the sham operated mice had infectious complications. The ICH size determines the extent of systemic immunomodulation. Large ICH predisposes animals to infections.
Chronic colitis in T‐cell deficient Tgε26 mice develops due to a dysfunction of the thymus which generates colitogenic T cells after bone marrow (BM) transplantation. Regulatory CD4+CD25+ T cells ...have been shown to prevent colitis in this model by normalizing the peripheral T‐cell pool. We tested the hypothesis that T‐cell normalization takes place in the thymus. Tgε26 mice were transplanted with BM (BM→Tgε26 mice) and consequently received either CD4+CD25+ or CD4+CD25− cells from syngenic wild type mice. Furthermore, untransplanted Tgε26 mice received CD4+CD25+ or CD4+CD25− cells or complete mesenteric lymph node cells. Transfer of regulatory. CD4+CD25+ cells normalized the total number of thymocytes and the percentage and number of double positive CD4+CD8+ cells in transplanted mice while percentage of single positive CD4+ and CD8+ thymocytes in BM→Tgε26 mice was reduced upon CD4+CD25+ transfer. Timing of CD4+CD25+ cell injection was important as transfer later than 7 days after BM transplantation failed to prevent abnormal thymic T‐cell distribution in BM→Tgε26 mice. Isolated CD4+CD25+ cell transfer without preceding BM transplantation failed to reconstitute thymic architecture. Differences of thymic cell composition could not be exclusively explained by presence or absence of colitis, respectively, because 19 days after BM transplantation when both groups showed no histological signs of colitis, animals transferred with CD4+CD25+ T cells had a significantly higher percentage and number of CD4+CD25+ thymocytes and CD4+Foxp3+ cells than BM→Tgε26 mice. In conclusion, early CD4+CD25+ cotransfer prevents thymic dysfunction which underlies immune‐mediated bowel inflammation in BM→Tgε26 mice.
To examine the influence of illness perceptions, pain catastrophizing and psychological distress on self-reported symptom severity and functional status in patients diagnosed with carpal tunnel ...syndrome (CTS).
A total of 674 patients with CTS scheduled for surgery at an outpatient treatment center for hand and wrist conditions (September 2017 to August 2018) completed online questionnaires regarding demographic and psychosocial characteristics and self-reported CTS severity. Self-reported severity of CTS was measured with the functional status scale and the symptom severity scale of the Boston Carpal Tunnel Questionnaire. To measure psychosocial factors, the Patient Health Questionnaire-4, Pain Catastrophizing Scale and the Brief Illness Perception Questionnaire were used. Pearson correlation coefficients were calculated to assess univariable relations. Hierarchical linear regression models were used to examine the relation between psychosocial factors and self-reported severity, and the relative contribution of psychosocial factors to self-reported severity, adjusting for patient characteristics and comorbidities.
Medium-sized correlations (range 0.32–0.44) with self-reported severity were observed for psychological distress, pain catastrophizing, consequences, identity, concern and emotional representation. Furthermore, these factors (except for concern) were also associated with self-reported severity, when adjusted for baseline characteristics and comorbidities. Hierarchical linear regression models showed that these psychosocial factors explained an additional 20–25% of the variance in self-reported severity of CTS.
This study shows that psychological distress, pain catastrophizing and illness perceptions play an independent role in self-reported severity of CTS. Clinicians should take these psychosocial factors into account when they are consulted by patients with CTS.
•Psychosocial factors are associated with severity of carpal tunnel syndrome.•Consequences and identity are important illness perceptions in relation to severity.•Psychosocial factors explain 20–25% additional variance in self-reported severity.
Kras downstream signaling in pancreatic ductal adenocarcinoma Yan, Hongkai; Schönhuber, Nina; Veltkamp, Christian ...
Pancreatology : official journal of the International Association of Pancreatology (IAP) ... et al.,
June 2018, 2018-06-00, 20180601, Letnik:
18, Številka:
4
Journal Article
This study examined patients' preferences for coercive measures in case of emergency situations on acute psychiatric wards.
From November 2004 until January 2006, 104 adult patients completed a ...questionnaire after they underwent seclusion, nonconsensual medication, or both on one of three acute psychiatric wards in the Netherlands.
Equal numbers of patients preferred seclusion and medication, and both measures were equal in perceived aversiveness and perceived efficacy. Men more often than women expressed a preference for seclusion. Patients who understood why the measure was necessary and acquiesced to it retrospectively held more positive views of the efficacy of the measure.
Many patients on acute psychiatric wards have a clear preference between seclusion and medication. Patients appreciated receiving explanations of the reasons for the use of a restrictive measure and discussing their preferences with staff.
OBJECTIVESTo inform selective and efficient use of appendix ultrasound (US) beyond adult parameters of body mass index (BMI) of less than 25 kg/m, we correlate abdominal wall thickness (AWT) with age ...and BMI to generate parameters for male and female children. Information presented in chart format can aid in the decision to utilize US for the evaluation of appendicitis.
METHODSIn this observational study, 1600 pediatric computed tomography scans of the abdomen and pelvis were analyzed to obtain measurements of AWT in the right lower quadrant. Measurements were correlated by patient age, BMI, and sex. Results and consensus-based recommendations were presented in chart format with color-coded groupings to allow for convenient referencing in the clinical setting.
RESULTSOne thousand four hundred eighty-eight computed tomography scans and AWT measurements were included. All age groups with BMI of less than 25 kg/m and all male and female groups younger than 6 years regardless of BMI had median AWT of less than 4 cm resulting in strong recommendation for US. Males older than 6 years and all female age groups with BMI of greater than 30 kg/m and female older than 15 years and BMI of greater than 25 kg/m had AWT of more than 5 cm resulting in low recommendation for US.
CONCLUSIONSWhile the BMI cutoff standard of less than 25 kg/m for usefulness of appendix US holds in the adult population, our data expand the acceptable range in children younger than 9 years regardless of BMI and male children with BMI up to 30 kg/m. Female children younger than 15 years with a BMI up to 30 kg/m may also be amenable to right lower quadrant US based on AWT. These parameters inform selective and efficient use of US for appendix evaluation.
Scene understanding of large-scale 3D point clouds of an outer space is still a challenging task. Compared with simulated 3D point clouds, the raw data from LiDAR scanners consist of tremendous ...points returned from all possible reflective objects and they are usually non-uniformly distributed. Therefore, it's cost-effective to develop a solution for learning from raw large-scale 3D point clouds. In this track, we provide large-scale 3D point clouds of street scenes for the semantic segmentation task. The data set consists of 80 samples with 60 for training and 20 for testing. Each sample with over 2 million points represents a street scene and includes a couple of objects. There are five meaningful classes: building, car, ground, pole and vegetation. We aim at localizing and segmenting semantic objects from these large-scale 3D point clouds. Four groups contributed their results with different methods. The results show that learning-based methods are the trend and one of them achieves the best performance on both Overall Accuracy and mean Intersection over Union. Next to the learning-based methods, the combination of hand-crafted detectors are also reliable and rank second among comparison algorithms.
The purpose of this study was to report prospectively collected patient-reported outcomes of patients who underwent open thumb ulnar collateral ligament (UCL) repair and to find risk factors ...associated with poor patient-reported outcomes.
Patients undergoing open surgical repair for a complete thumb UCL rupture were included between December 2011 and February 2021. Michigan Hand Outcomes Questionnaire (MHQ) total scores at baseline were compared to MHQ total scores at three and 12 months after surgery. Associations between the 12-month MHQ total score and several variables (i.e., sex, injury to surgery time, K-wire immobilization) were analyzed.
Seventy-six patients were included. From baseline to three and 12 months after surgery, patients improved significantly with a mean MHQ total score of 65 (standard deviation SD 15) to 78 (SD 14) and 87 (SD 12), respectively. We did not find any differences in outcomes between patients who underwent surgery in the acute (<3 weeks) setting compared to a delayed setting (<6 months).
We found that patient-reported outcomes improve significantly at three and 12 months after open surgical repair of the thumb UCL compared to baseline. We did not find an association between injury to surgery time and lower MHQ total scores. This suggests that acute repair for full-thickness UCL tears might not always be necessary.
Therapeutic II.
Patients with a triangular fibrocartilage complex (TFCC) injury report ulnar-sided wrist pain and impaired function. The surgical procedure of TFCC reinsertion aims to improve function in patients ...with this injury in whom conservative treatment has failed. The purpose of this study was to investigate the outcomes of open TFCC reinsertion.
The study involved 274 patients who underwent open repair of the TFCC between December 2013 and December 2018. The patients completed the Patient-Rated Wrist Evaluation (PRWE) questionnaire, and scored pain and function using a visual analogue scale (VAS). Range of motion (ROM) was assessed by experienced hand therapists.
Clinically significant improvements were reported in pain, function, and grip strength in 220 patients (80%) three and 12 months postoperatively.
These data will help surgeons to make decisions about the outcomes of open repair of the TFCC and to counsel patients appropriately. Level of evidence: III Cite this article:
2021;103-B(4):711-717.
Within a greenschist facies calcite marble shear zone, isolated quartz grains change shape across the shear zone profile. Whereas quartz grains have a spherical to elongated shape in the coarse ...grained marble protolith and protomylonite, they are asymmetric
σ-shaped porphyroclasts with wedge shaped appendages (wings) in ultramylonites. In all cases quartz grains are single-crystals. They are sometimes twinned but never recrystallized. Stress-induced dissolution–precipitation creep is the favourable shape-controlling process during deformation providing a relatively undeformed core, truncation of pre-existing cathodoluminescence (CL) patterns and syntaxial precipitation of wings. The necessary fluids may have been released from fluid inclusions during dynamic recrystallization of the calcite matrix. The development of
σ-shape is not related to the crystallographic orientation of the quartz porphyroclasts. Crystallographic orientation analysis by electron backscatter diffraction (EBSD) and CL analyses exclude crystal-plasticity as a shape-controlling mechanism of quartz grains during mylonitisation. However, in ultramylonites quartz clasts have a strong crystallographic preferred orientation (CPO), with
c-axes (sub)parallel to the shear direction. This fabric is uncommon for quartz under greenschist facies conditions. It might be explained by a strengthening of a pre-existing weak CPO during mylonitisation by rigid particle rotation of elongated quartz grains.
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