Based on recent research, second intention wounds may be at greater risk for postoperative infection compared with sutured wounds. Accurate diagnosis of postoperative wound infections on the lower ...leg can be challenging and result in unnecessary antibiotic administration.
The objective of this study was to identify bacterial organisms that commonly colonize second intention surgical wounds after Mohs micrographic surgery (MMS) and isolate pathogenic organisms.
Patients with second intention surgical wounds on the lower leg were evaluated 2 weeks after MMS. Wounds were swabbed for bacteria and categorized as infected or not infected based on clinical appearance. Any colonizing bacteria were recorded once the culture results were reported.
Twenty-five clinically infected wounds and 26 control wounds were cultured. Staphylococcus aureus was the most common bacteria, colonizing 8 infected wounds (15.7%) and 5 control wounds (9.8%). Eight cultures (32%) from clinically infected wounds grew normal skin flora alone.
Staphylococcus aureus is the most common bacteria colonizing wounds healing by second intention on the lower extremity. Thirty-two percent of clinically infected wounds grew normal skin flora, demonstrating the challenge of accurately diagnosing infection in lower extremity second intention wounds.
Mohs micrographic surgery (MMS) is becoming increasingly popular for the treatment of cutaneous melanoma (CM) as multiple studies have demonstrated favorable outcomes for local recurrence and overall ...survival.
To analyze the outcomes of noninvasive (NIM) and invasive melanomas (IM) using MMS with fresh frozen sections. The primary outcome was local recurrence. The secondary outcome was to identify mean surgical margins based on tumor type and location.
Retrospective cohort study of 224 cases of CM treated from 2006 to 2016 at a tertiary academic center with MMS and fresh frozen sections by a single Mohs surgeon.
The overall recurrence rate was 2.6% with a mean follow-up of 36.2 months. The recurrence rate for NIM versus IM was 1.6% and 7%, respectively. The mean margins for NIM and IM were 7.9 mm and 10.1 mm, respectively. These varied by tumor site and location.
This study supports the use of MMS in the treatment of CM and highlights how narrower surgical margins for NIM of the head and neck can be achieved without increasing risk of local recurrence.
An appropriate immune response requires a tight balance between pro- and anti-inflammatory mechanisms. IL-10 is induced at late time-points during acute inflammatory conditions triggered by ...TLR-dependent recognition of infectious agents and is involved in setting this balance, operating as a negative regulator of the TLR-dependent signaling pathway. We identified miR-125a~99b~let-7e as an evolutionary conserved microRNA cluster late-induced in human monocytes exposed to the TLR4 agonist LPS as an effect of this IL-10-dependent regulatory loop. We demonstrated that microRNAs generated by this cluster perform a pervasive regulation of the TLR signaling pathway by direct targeting receptors (TLR4, CD14), signaling molecules (IRAK1), and effector cytokines (TNFα, IL-6, CCL3, CCL7, CXCL8). Modulation of miR-125a~99b~let-7e cluster influenced the production of proinflammatory cytokines in response to LPS and the IL-10-mediated tolerance to LPS, thus identifying this gene as a previously unrecognized major regulatory element of the inflammatory response and endotoxin tolerance.
We use the optimized skew-spectrum as well as the skew-spectra associated with the Minkowski functionals to test the possibility of using the cross-correlation of the integrated Sachs–Wolfe effect ...(ISW) and lensing of the cosmic microwave background (CMB) radiation to detect deviations in the theory of gravity away from General Relativity (GR). We find that the although both statistics can put constraints on modified gravity, the optimized skew-spectra are especially sensitive to the parameter B
0 that denotes the Compton wavelength of the scalaron at the present epoch. We investigate three modified gravity theories, namely the post-parametrized Friedmann formalism; the Hu–Sawicki model and the Bertschinger–Zukin (BZ) formalism. Employing a likelihood analysis for an experimental setup similar to ESA's Planck mission, we find that, assuming GR to be the correct model, we expect the constraints from the first two skew-spectra,
$S_{\ell }^{(0)}$
and
$S_{\ell }^{(1)}$
, to be the same: B
0 < 0.45 at 95 per cent confidence level (CL) and B
0 < 0.67 at 99 per cent CL in the BZ model. The third skew-spectrum does not give any meaningful constraint. We find that the optimal skew-spectrum provides much more powerful constraint, giving B
0 < 0.071 at 95 per cent CL and B
0 < 0.15 at 99 per cent CL, which is essentially identical to what can be achieved using the full bispectrum.
Natural leather is a very attractive material for applications involving industries ranging from that of technical clothes to fashion. Microencapsulated Phase Change Materials (PCMs) can be coated ...onto natural leathers using a polymer binder to add the thermoregulating properties demanded by modern consumers. The use of microcapsules enhances the thermal response of the leather during heating or cooling and the degree of thermal sensitivity depends on the percentage of microcapsules added onto the leather. The thermoregulating properties of leathers have been evaluated by both differential scanning calorimetry (DSC) and infrared thermocamera (IRT); water vapour transmission and mechanical properties were analyzed and compared to those of uncoated leather. The results of mechanical characterization indicate that tensile strength and elongation at break are not significantly affected by this coating treatment.
We generalize the concept of the ordinary skew-spectrum to probe the effect of non-Gaussianity on the morphology of cosmic microwave background (CMB) maps in several domains: in real space (where ...they are commonly known as cumulant-correlators), and in harmonic and needlet bases. The essential aim is to retain more information than normally contained in these statistics, in order to assist in determining the source of any measured non-Gaussianity, in the same spirit as Munshi & Heavens skew-spectra were used to identify foreground contaminants to the CMB bispectrum in Planck data. Using a perturbative series to construct the Minkowski functionals (MFs), we provide a pseudo-
based approach in both harmonic and needlet representations to estimate these spectra in the presence of a mask and inhomogeneous noise. Assuming homogeneous noise, we present approximate expressions for error covariance for the purpose of joint estimation of these spectra. We present specific results for four different models of primordial non-Gaussianity local, equilateral, orthogonal and enfolded models, as well as non-Gaussianity caused by unsubtracted point sources. Closed form results of next-order corrections to MFs too are obtained in terms of a quadruplet of kurt-spectra. We also use the method of modal decomposition of the bispectrum and trispectrum to reconstruct the MFs as an alternative method of reconstruction of morphological properties of CMB maps. Finally, we introduce the odd-parity skew-spectra to probe the odd-parity bispectrum and its impact on the morphology of the CMB sky. Although developed for the CMB, the generic results obtained here can be useful in other areas of cosmology.
Background
Osteosarcoma (OSA) should be differentiated from other less frequent primary bone neoplasms, metastatic disease, and tumor‐like lesions, as treatment and prognosis can vary accordingly. ...Hence, a preoperative histologic diagnosis is generally preferred. This requires collection of multiple biopsies under general anesthesia, with possible complications, including pathological fractures. Fine‐needle aspiration cytology would allow an earlier diagnosis with a significant reduction of discomfort and morbidity.
Hypothesis/Objectives
The aim of this study was to compare the accuracy of cytological and histologic biopsies in the diagnosis of canine osteodestructive lesions.
Animals
Sixty‐eight dogs with bone lesions.
Methods
Retrospective study. Accuracy was assessed by comparing the former diagnosis with the final histologic diagnosis on surgical or post‐mortem samples or, in the case of non‐neoplastic lesions, with follow‐up information.
Results
The study included 50 primary malignant bone tumors (40 OSAs, 5 chondrosarcomas, 2 fibrosarcomas, and 3 poorly differentiated sarcomas), 6 carcinoma metastases, and 12 non‐neoplastic lesions. Accuracy was 83% for cytology (sensitivity, 83.3%; specificity, 80%) and 82.1% for histology (sensitivity, 72.2%; specificity, 100%). Tumor type was correctly identified cytologically and histologically in 50 and 55.5% of cases, respectively.
Conclusions and Clinical Importance
The accuracy of cytology was similar to histology, even in the determination of tumor type. In no case was a benign lesion diagnosed as malignant on cytology. This is the most important error to prevent, as treatment for malignant bone tumors includes aggressive surgery. Being a reliable diagnostic method, cytology should be further considered to aid decisions in the preoperative setting of canine bone lesions.
Aims: WHO data report that 15-20% of couples suffer from fertility problems with serious implications for the mental, physical, social and couple wellbeing. Aims of the study were to evaluate: ...possible differences between women and men regarding quality of life, alexithymia, romantic attachment dimensions and quality of marital relationship during an Assisted Reproductive Treatment (ART); the predictive effect of these variables on the quality of life of women and men during the ART. Methods: 84 women (age m=38.1 sd=5.5) and 25 men (m=37.5 sd=5.6) were recruited in an assisted reproduction clinic of Rome. At the beginning of the ART women and men completed a socio-demographic questionnaire, the Fertility Quality of Life (FertiQuoL), the 20-item Toronto Alexithymia Scale (TAS-20), the Experience in Close Relationship-Revised (ECR-R) and the Couple Relation Inventory (CRI). Results: Differences between women and men emerged in FertiQuoL Total (p=.02) Emotional (p=.001). Mind-Body (p=.05) and Toler-ability (p=.001) subscales scores, in the direction of a lower quality of life in women. Furthermore, women scored significantly higher in Difficulty in Identifying Feelings (TAS-20: p=.04) and Idealization (CRI; p=.01), whereas men scored significantly higher in Erotic Fantasy (CRI; p=.04). Several significant association among quality of life, alexithymia. quality of marital relationship and attachment dimensions were reported in women and men. Regression analysis showed the predictive effect of Difficulty in Identifying Feelings (p=001) and Attunement with partner (CRI; p=.01) on women's quality of life. In the group of men no significant predictive effect emerged. Conclusion: The findings support a more severe effect of infertility and its treatments on women than men. The findings highlight the predictive effect of the difficulty in identifying feeling and attunement with the partner on the quality of life of women during the ART. Clinical interventions in this field may be focused on the promotion of these abilities in the members of the couple, with possible implications on ART successes.
Summary
This study aimed to analyse whether the functional quality of spermatozoa is associated with body mass index (BMI). Semen samples were obtained from 1824 men undergoing fertility ...evaluation/treatment. Semen analysis was performed using World Health Organization (WHO) criteria, and morphology was evaluated with the motile sperm organelle morphology examination (MSOME). The percentages of sperm DNA fragmentation (using TdT (terminal deoxynucleotidyl transferase)‐mediated dUTP nick‐end labelling (TUNEL) assays), sperm chromatin packaging/underprotamination (using chromomycin A3/CMA3), mitochondrial damage (using MitoTracker Green) and apoptosis (using annexin V) were also assessed. At least 200 spermatozoa were examined in each evaluation. The following BMI values were used as cut‐off points: ≤24.9 kg/m2, 25–29.9 kg/m2 (overweight) and ≥30 kg/m2 (obese). High BMI negatively affects sperm concentration, vitality, motility and morphology (p < .05). Conversely, high BMI does not seem to be associated with impaired sperm DNA integrity, as assessed by DNA fragmentation, sperm protamination and sperm apoptosis (p > .05). However, increased BMI is associated with increased mitochondrial damage in spermatozoa (p < .05). In conclusion, given the adverse consequences of obesity and the possible effect of male BMI on assisted reproduction technology (ART) outcomes, the benefits of weight reduction should be discussed when counselling couples interested in fertility treatment.
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