Operative Anatomy of the Skull Base: 3D Exploration with a Highly Detailed Interactive Atlas

xlomafota13 shared this article with you from Inoreader Operative Anatomy of the Skull Base: 3D Exploration with a Highly Detailed Interactive Atlas Via Journal of Neurological Surgery Part B: Skull Base J Neurol Surg B Skull Base DOI: 10.1055/s-0041-1729975 Objective We evaluated the usefulness of a three-dimensional (3D) interactive atlas to illustrate and teach surgical skull base anatomy in a clinical setting. Study Design A highly detailed atlas of the adult human skull base was created from multiple high-resolution magnetic resonance imaging (MRI) and computed tomography (CT) scans of a healthy Caucasian male. It includes the parcellated and labeled bony skull base, intra- and extracranial vasculature, cranial nerves, cerebrum, cerebellum, and brainstem. We are reporting retrospectively on our experiences with employing the atlas for the simulation and teaching of neurosurgical approaches and concepts in a clinical setting. Setting The study was conducted at the University Hospital Mainz, Germany, and Hirslanden Hospital, Zürich, Switzerland. Participants Medical students and neurosurgical residents participated in this study. Results Handling the layered graphical user interface of the atlas requires some training; however, navigating the detailed 3D content from intraoperative perspectives led to quick comprehension of anatomical relationships that are otherwise difficult to perceive. Students and residents appreciated the collaborative learning effect when working with the atlas on large projected screens and markedly improved their anatomical knowledge after interacting with the software. Conclusion The skull base atlas provides an effective way to study essential surgical anatomy and to teach operative strategies in this complex region. Interactive 3D computer graphical environments are highly suitable for conveying complex anatomy and to train and review surgical concepts. They remain underutilized in clinical practice. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany Article in Thieme eJournals: Table of contents  |  Abstract   |  Full text View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Association between pulmonary function and cardiac enzymes in sickle cell disease

xlomafota13 shared this article with you from Inoreader Association between pulmonary function and cardiac enzymes in sickle cell disease Via American Journal of Blood Research Am J Blood Res. 2021 Apr 15;11(2):199-205. eCollection 2021. ABSTRACT BACKGROUND: There is scarcity of data on association between lung function and cardiac markers in patients with sickle cell disease (SCD). Meanwhile, SCD affects multi-organs in any one population. There seem to be an association between reduced pulmonary function with cardiac dysfunction. The current study examined the association between pulomanry function with cardiac markers in patients with SCD. METHODOLOGY: This was a cross-sectional study with cases and controls. The cases (n=117) were made up of patients with SCD. The control subjects (n=58) were voluntary blood donors without SCD. The cellulose acetate electrophoresis was used to determine the genotypes of the study subjects. Blood samples were collected from all the study subjects for full blood count and measurement of cardiac enzymes. The cardiac enzymes measured were lactate dehydrogenase (LDH) and creatine kinase-myocardial band (CK-MB). Lung function test, using the vitalograph was done on all the study subjects. The Global Lung Initiative criteria were used to categorize lung disease as obstruction, restriction, mixed obstruction/restriction and normal. RESULTS: The prevalence of elevated CK-MB and LDH among the SCD patients was 76.92% and 9.40% respectively, higher than the non-SCD controls (51.72% and 0% for elevated CK-MB and LDH respectively). Of all the impaired lung function, lung restriction was prevalent in all the study groups (30.77% and 15.52% for SCD patients and non-SCD controls respectively). In the fully adjusted model, reduced FEV1 was associated with nearly 3.5-fold higher odds of elevated CK-MB (odds ratio 3.35, 95% CI 1.26-8.90, p-value 0.015) in individuals with SCD. CONCLUSION: Reduced FEV1 which reflects airflow impairments are associated with CK-MB elevations in patients with SCD, suggesting a possible damage to the card iomyocytes. PMID:34079635 | PMC:PMC8165713 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

ABO system combination with Rh, Kell and MN group in Georgian blood donors

xlomafota13 shared this article with you from Inoreader ABO system combination with Rh, Kell and MN group in Georgian blood donors Via American Journal of Blood Research Am J Blood Res. 2021 Apr 15;11(2):132-139. eCollection 2021. ABSTRACT There are numerous scientific data about the study of the prevalence of blood group antigens in the different donor population. Several studies showed that the profile of major blood group antigens is not similar in blood donors from different local areas. RESEARCH OBJECTIVE: Our scientific goal was to study of the prevalence blood group antigens in the Georgian blood donor population. In the current study, we analyzed the 48 phenotypically combinations based on four major (ABO, Rh, Kell, and MN) blood groups. RESEARCH METHODS: The blood of 1009 donors has been studied on RBC antigens. The sample were collected from the diagnostic laboratory of Medina Ltd Health Centre of Batumi. Blood typing of the sample has been carried out on the basis of the immunogenetics laboratory of Batumi Shota Rustaveli State University. The universal monoclone antibodies was u sed for identify minor blood group antigens. We used as forward as reverse grouping methods. For identification erythrocytes, blood group antigens also were used ID cards, such as ABO/D + Reverse Grouping. RESULT: 12 phenotypic combinations have been identified in each O, A, B, AB group of ABO system. Out of 48 theoretically possible phenotypic combinations, we can actually find 1,9 times less phenotypes and the real amount is 25 phenotypes. The remaining 23 phenotypic combinations have not been observed in the studied donors. These are: 1. O, Rh-K+ MM; 2. O, Rh-K- MN; 3. O, Rh-K- NN; 4. A, Rh-K+ MN; 5. A, Rh-K+ MM; 6. A, Rh-K+ NN; 7. A, Rh-K- MM; 8. A, Rh-K- NN; 9. B, Rh+K+ NN; 10. B, Rh-K+ MN; 11. B, Rh-K+ MM; 12. B, Rh-K + NN; 13. B, Rh-K- MN; 14. B, Rh-K- MM; 15. B, Rh-K- NN; 16. AB, Rh+K+ MN; 17. AB, Rh+K+ NN; 18. AB, Rh+K- NN; 19. AB, Rh+K- MM; 20. AB, Rh-K+ MN; 21. AB, Rh-K+ MM; 22. AB, Rh-K+ NN; 23. B, Rh-K- NN. The value of χ2 in the case is equal to 3221,16. The P-Value is < .00001. The result is significant at P < .05. Out of 1009 studied donors 349 are carriers of phenotypic group A (II), while 19 donors carry AB (IV) group specification. This means that 36.23% of the studied donors have A antigen on the surface of erythrocyte membrane. The majority of them A1 subgroup. CONCLUSION: As our research showed there is a quit high polymorphism of blood group phenotype combinations in Georgian blood donors in the example of one clinic. This kind of data is very important for the clinics' rational preparation of whole blood or blood components. PMID:34079626 | PMC:PMC8165715 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Proinflammatory cytokines as potential risk factors of acute graft-versus-host disease and infectious complications after allogeneic hematopoietic stem cell transplantation

xlomafota13 shared this article with you from Inoreader Proinflammatory cytokines as potential risk factors of acute graft-versus-host disease and infectious complications after allogeneic hematopoietic stem cell transplantation Via American Journal of Blood Research Am J Blood Res. 2021 Apr 15;11(2):149-156. eCollection 2021. ABSTRACT OBJECTIVE: Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is associated with a risk of graft-versus-host disease (GvHD) and infections. The pathogenesis of acute GvHD is related to T-lymphocytes, which identify alloantigens on host antigen-presenting cells, induce production of interferon (IFN) gamma and interleukin (IL)-2, recruit immune effector cells and destroy tissues and organs. MATERIAL AND METHODS: The study involved 62 patients, 30 (48%) men and 32 (52%) women [median age 49.5; (19-68) years] after myeloablative conditioning (MAC) n = 26 (42%) or reduced intensity conditioning (RIC) n = 36 (58%) therapy before allo-HSCT from a sibling (n = 12) or unrelated (n = 50) donor due to acute myeloid leukemia (AML). All patients received standard immunosuppressive therapy with cyclosporine A and methotrexate plus pre-transplant anti-thymocyte gl obulin in the unrelated transplant setting. Blood samples were collected pre-transplant before the start of and after conditioning therapy (1 day pre-transplant) and 2, 4, 6, 10, 20, 30 days following allo-HSCT. The analysis of potential risk factors included IL-2 and IFN-gamma concentrations, patients' age, the use of MAC/RIC and CR/non-CR status before transplantation. RESULTS: The statistical analysis revealed that independent risk factors for aGvHD included non-CR status before allo-HSCT [odds ratio (OR) = 10.52, P = 0.040], the use of MAC [hazard ratio (HR) = 4.80, P = 0.007] and a high level of IFN-gamma on day 6 post-transplant (HR = 1.03, P = 0.032). MAC was also the independent risk factor for infectious complications (OR = 4.04, P = 0.024). CONCLUSION: A high level of IFN-gamma on day 6 post-transplant, non-CR status before allo-HSCT and the use of MAC are independent risk factors for aGvHD. MAC is also the independent risk factor of infectious complications. PMID:34079628 | PMC:PMC8165716 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Diagnostic accuracy of reticulocyte parameters on the sysmex XN 1000 for discriminating iron deficiency anaemia and thalassaemia in Saudi Arabia

xlomafota13 shared this article with you from Inoreader Diagnostic accuracy of reticulocyte parameters on the sysmex XN 1000 for discriminating iron deficiency anaemia and thalassaemia in Saudi Arabia Via American Journal of Blood Research Am J Blood Res. 2021 Apr 15;11(2):172-179. eCollection 2021. ABSTRACT INTRODUCTION: Iron deficient erythropoiesis and Thalassaemia are both associated with microcytic erythropoiesis albeit from different pathological mechanisms. Given the high prevalence of Hemoglobinopathies in the Mediterranean region, discriminating these two conditions is important. Several algorithms using conventional red cell indices have been developed to facilitate diagnosis, however, their diagnostic accuracy is low. The new generation haematology analyzers enabled the use of more innovative parameters such as reticulocyte parameters. We aimed to evaluate the diagnostic performance of the reticulocyte parameters on the Sysmex XN 1000 to distinguish between IDA and Thalassemia in our population. METHODS: We performed a retrospective analysis of blood samples sent to our laboratory for haemoglobin electrophoresis screening. We categorized our cohort into Thalassemia and Iron Deficient patients based on known diagnostic criteria. We analyzed the reticulocyte parameters using receiver operator curve analysis (ROC) and determined the cut off value for each parameter. RESULTS: Reticulocyte parameters most accurate for discriminating IDA from Thalassemia patients was: RET, RET-HE and IRF. The RET-HE had the best statistical significance for IDA patients with AUC = 0.69 for cut off 22.25. The RET-HE for dual positive patients was more accurate with AUC = 0.78 for cut off 21.25. The IRF had the best statistical significance for Alpha Thalassemia with AUC = 0.66 for cut off value 18. CONCLUSION: An IRF cut off below 15.5 and RET-HE cut off below 22.25 was the most accurate variable in predicting IDA with a sensitivity of 59.4% and 68.3%. PMID:34079632 | PMC:PMC8165718 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Cutaneous methotrexate-related T-cell lymphoproliferative disorder with CD4, CD30, CD56, EBV-positive tumor cell infiltration: a case illustration and a brief review

xlomafota13 shared this article with you from Inoreader Cutaneous methotrexate-related T-cell lymphoproliferative disorder with CD4, CD30, CD56, EBV-positive tumor cell infiltration: a case illustration and a brief review Via American Journal of Blood Research Am J Blood Res. 2021 Apr 15;11(2):163-167. eCollection 2021. ABSTRACT Methotrexate (MTX) is a commonly used anti-metabolite agent. Long-term MTX treatment can cause MTX-related lymphoproliferative disorder (MTX-LPD). T-cell LPDs comprise a small fraction of MTX-LPDs. Epstein-Barr virus (EBV)+ tumor cells are rarely detected in MTX-related T-cell LPDs (MTX T-LPDs). Therefore, there have been very few reports of EBV+ MTX T-LPD. We encountered a case of cutaneous MTX T-LPD with a unique cellular phenotype. The patient was a 71-year-old Japanese man with rheumatoid arthritis treated with MTX for 6 years. He was referred to our department with a 6-month history of red plaques and ulcerated lesions in both lower legs and a 2-week history of high fever and fatigue. Cutaneous specimens showed that medium-sized atypical lymphocytes were positive for CD3, CD4, CD30, CD56, and in situ hybridization for EBV-encoded RNA. The p atient was diagnosed with cutaneous MTX T-LPD. Four months after discontinuation of MTX, the skin lesions had disappeared. This is the first report of cutaneous MTX T-LPD with CD4+CD30+CD56+EBV+ tumor cells. PMID:34079630 | PMC:PMC8165712 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Association of Hematologic biomarkers and their combinations with disease severity and mortality in COVID-19- an Indian perspective

xlomafota13 shared this article with you from Inoreader Association of Hematologic biomarkers and their combinations with disease severity and mortality in COVID-19- an Indian perspective Via American Journal of Blood Research Am J Blood Res. 2021 Apr 15;11(2):180-190. eCollection 2021. ABSTRACT BACKGROUND: COVID-19 is a systemic viral infection with a significant impact on the hematopoietic system, hemostasis as well as immune system. It would be of utmost importance to explore if the most routinely used tests could serve as an aid in determining patient's clinical status or predicting severity of the disease. METHODS: A prospective cross-sectional study was conducted on 506 Covid-19 positive patients and 200 controls over a period of two months (June and July 2020). The cases were sub-classified based on disease severity into mild to moderate (n=337), severe (n=118) and very severe (n=51) and based on survivor status into survivors (n=473) and non-survivors (n=33). RESULTS: There were statistically significant differences in WBC count, Absolute neutrophil count (ANC), Absolute lymphocyte count (ALC), absolute monocyte count (AMC), neutrophil-ly mphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), monocyte-lymphocyte ratio (MLR) Red blood cell distribution width (RDW-SD) and RDW CV between covid cases vs controls; among the clinical subgroups and among the survivors and non-survivors. There was a significant strong positive correlation between various parameters, that is, NLR and MLR (r: 0.852, P=0), MPV and PDW (r: 0.912, P=0), MPV and PLCR (r: 0.956, P=0), PDW and PLCR (r: 0.893, P=0). NLR (AUC: 0.676, P=0) was the best single parameter and NLR+RDW-CV was best combination parameter as per area under curve (0.871) of ROC to distinguish severe from mild to moderate disease. CONCLUSIONS: Leucocytosis, neutrophilia, lymphopenia and monocytosis were characteristic findings in covid cases while NLR and NLR+RDW-CV emerged as the most effective single and combination CBC parameters in distinguishing mild to moderate and severe cases respectively. PMID:34079633 | PMC:PMC8165721 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Lower hair cortisol among patients with sickle cell disease may indicate decreased adrenal reserves

xlomafota13 shared this article with you from Inoreader Lower hair cortisol among patients with sickle cell disease may indicate decreased adrenal reserves Via American Journal of Blood Research Am J Blood Res. 2021 Apr 15;11(2):140-148. eCollection 2021. ABSTRACT INTRODUCTION: Sickle cell disease (SCD) is a chronic illness that presents with a wide range of phenotypic variation. Stress may be a contributing factor to differences that are found in this population. OBJECTIVES: Our objective is to determine the relationship between hair cortisol content (HCC), a biomarker of stress, and other clinical measures in individuals with SCD. METHODS: We collected hair samples and other clinical measures from 73 subjects with SCD (mean age: 39 ± 12 years, 63% female). RESULTS: HCC was lower among individuals who had greater than 30% hemoglobin S, compared with those who had less than 30% hemoglobin S (W=272.5, P=0.01). Lower HCC was also associated with report of not being on a chronic transfusion program (β=48.34, SE=14.09, P=0.001) and higher ferritin levels (β=-0.006, SE=0.002, P=0.02). Furthermore, HCC was signi ficantly correlated with serum cortisol (rs=0.26, P=0.03) and corticosterone (rs=0.29, P=0.01). We also observed a consistent pattern of low steroid values among our population. CONCLUSION: Our findings suggest that individuals with higher hemoglobin S and ferritin, both markers of severe SCD, may have decreased cortisol levels. This is consistent with the relationship we observed between higher HCC among individuals who are on a chronic blood transfusion program, which typically increases quality of life. Our results suggest that hair cortisol may be an indicator in patients with SCD who could be at risk for developing adrenal insufficiency. We recommend that clinicians treating patients with SCD follow the Endocrine Society guidelines for testing for adrenal insufficiency and treat accordingly. PMID:34079627 | PMC:PMC8165714 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Hospital acquired infection in a department of hematology-oncology care in the Congo

xlomafota13 shared this article with you from Inoreader Hospital acquired infection in a department of hematology-oncology care in the Congo Via American Journal of Blood Research Am J Blood Res. 2021 Apr 15;11(2):191-198. eCollection 2021. ABSTRACT OBJECTIVES: Hospital Acquired Infection (HAI) is a major cause of morbidity and mortality in hemato-oncology. The study aims to report the incidence of hospital-acquired infections in patients with hematological malignancies and the risk factors associated with them. MATERIAL AND METHODS: An observational study with cross-sectional data collection was carried out from January 1, 2019, to April 30, 2020, in the department of hematology of Brazzaville University Hospital. The study concerned 77 patients diagnosed with hematological malignancies admitted for a course of chemotherapy. Written consent was obtained from each participant. Participants were divided into two groups: with HAI (n=50) and without HAI (n=27). They were compared using the chi-square test and Student's T-test. Univariate and multivariate analyses of the association of HAI with all the risk fa ctors were performed for analysis of the 2 x k contingency tables and repeated using logistic regression. RESULTS: The cumulative incidence was 64.9% with a 95% confidence interval of [53.8-74.7]. The time to onset of HAIs was 10.6±6.50 days. The incidence of HAI was significantly greater in acute myelogenous leukemia (80%), grade 4 neutropenia (80%). The risk factors were hospitalization stay of over 14 days (OR: 1.09), the regimen: daunorubicin-aracytine (OR: 5.96), the hemoglobin level on admission (OR: 0.72), and the neutropenia of grade 4 (OR: 7.9). The most common clinically identified focus of infection was peripheral venous infections. The fatality rate was 10%. CONCLUSION: The determination of HAI and the identification of its risk factors make it possible to establish prevention strategies. PMID:34079634 | PMC:PMC8165720 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Eltrombopag post autologous hematopoietic stem cell transplant - an emerging indication in younger pediatric patients

xlomafota13 shared this article with you from Inoreader Eltrombopag post autologous hematopoietic stem cell transplant - an emerging indication in younger pediatric patients Via American Journal of Blood Research Am J Blood Res. 2021 Apr 15;11(2):168-171. eCollection 2021. ABSTRACT BACKGROUND: Engraftment of neutrophils and platelets after hematopoietic stem cell transplant (HSCT) is imperative for optimal outcomes. Eltrombopag has been used in adults after HSCT to boost platelet production. Its use in pediatric post HSCT patients has been limited. METHODS: The clinical and laboratory details of a post autologous HSCT patient were fetched by a retrospective review of the records. RESULTS: A 5-year old male child had primary thrombocytopenia post autologous HSCT for refractory Hodgkin lymphoma. Although the stem cell dose infused was adequate, the child had a delay in the engraftment of platelets. After ruling out the causes of post HSCT thrombocytopenia, eltrombopag was started for the child. With the use of eltrombopag, normal thrombopoiesis was restored in the child. CONCLUSION: Eltrombopag was effective and safe in overcomi ng post-HSCT primary thrombocytopenia in our patient. PMID:34079631 | PMC:PMC8165717 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.