Are routine chest radiographs still indicated after central line insertion? A scoping review.

Introduction: Central venous catheters are increasingly inserted using point-of-care ultrasound (POCUS) guidance. Following insertion, it is still common to request a confirmatory chest radiograph for subclavian and internal jugular lines, at least outside of the operating theater. This scoping review addresses: (i) the justification for routine post-insertion radiographs, (ii) whether it would better to use post-insertion POCUS instead, and (iii) the perceived barriers to change. Methods: We searched the electronic databases, Ovid MEDLINE (1946-) and Ovid EMBASE (1974-), using the MESH terms ("Echography" OR "Ultrasonography" OR "Ultrasound") AND "Central Venous Catheter" up until February 2023. We also searched clinical practice guidelines, and targeted literature, including cited and citing articles. We included adults (⩾18 years) and English and French language publications. We included randomized control trials, prospective and retrospective cohort studies, systematic reviews, and surveys. Results: Four thousand seventy-one articles were screened, 117 full-text articles accessed, and 41 retained. Thirteen examined cardiac/vascular methods; 5 examined isolated contrast-enhanced ultrasonography; 7 examined isolated rapid atrial swirl sign; and 13 examined combined/integrated methods. In addition, three systematic reviews/meta-analyses and one survey addressed barriers to POCUS adoption. Discussion: We believe that the literature supports retiring the routine post-central line chest radiograph. This is not only because POCUS has made line insertion safer, but because POCUS performs at least as well, and is associated with less radiation, lower cost, time savings, and greater accuracy. There has been less written about perceived barriers to change, but the literature shows that these concerns- which include upfront costs, time-to-train, medicolegal concerns and habit- can be challenged and hence overcome.

High-precision measurement of the 19Ne half-life and implications for right-handed weak currents.

We report a precise determination of the (19)Ne half-life to be T(1/2)=17.262±0.007 s. This result disagrees with the most recent precision measurements and is important for placing bounds on predicted right-handed interactions that are absent in the current standard model. We are able to identify and disentangle two competing systematic effects that influence the accuracy of such measurements. Our findings prompt a reassessment of results from previous high-precision lifetime measurements that used similar equipment and methods.

Hormone sensitivity of primary breast carcinoma.

PURPOSE: This study was designed to evaluate hormonal sensitivity of primary breast cancer by way of determination of estrogen receptors (ER) and progesterone receptors (PR) status as an important prognostic and predictive parameter of breast cancer. METHODS: The study enrolled 449 breast cancer patients surgically treated at the Surgical Clinic Nis, in a period covering 3 years, who continued treatment at the Clinic of Oncology, Clinical Centre Nis. All of the patients were divided into 4 groups depending on the positive or negative status of ER and PR, and 2 subgroups, those with positive or negative HER2 status. Standard descriptive statistical parameters were calculated and several types of tests were applied: Student's t-test for paired and unpaired samples, chi-square test, Mantel- Haenszel test, Fisher's test of exact probability and binary logistic regression model. RESULTS: The level of ER and PR status positively correlated with patient age, postmenopausal status, lower clinical stage, lower histologic grade (HG) and nuclear grade (NG) and better prognosis. Amplification/overexpression of HER2 positively correlated with premenopausal status and ER negative breast cancer phenotype. According to the model of binary logistic regression, clinical stage and NG of the breast primary were significantly associated with hormonal sensitivity of the tumor. CONCLUSION: Measurements of receptor macromolecules in clinical oncology is very important, especially in breast cancer patients. ER and PR analysis is an integral part of breast cancer study since it can provide information essential for both treatment and prognosis.

Spectrophotometric and HPLC determination of fleroxacin in tablets.

The paper describes and compares spectrophotometric and HPLC determination of fleroxacin in commercial tablets. The optimum conditions for spectrophotometric assay were found to be at pH < 3.5 (0.1 M HCl) at a wave length of 286 nm. HPLC analysis was carried out on a Beckman ODS 5 microns column in a pH 3 phosphoric acid solution (detector wave length 254 nm).

Voltammetric methods for analytical determination of fleroxacin in quinodis tablets.

The direct current (dc) and differential pulse (dp) polarographic reduction of fleroxacin was done in a wide pH range from 2.48 to 13.00. The appropriate buffer choice was made for its dp polarographic determination in a range from 1.845 to 16.926 microg /ml, at pH 8.50. The adsorptive properties of fleroxacin were investigated in order to achieve an increase in sensitivity and a possibility of fleroxacin determination by applying the adsorptive stripping voltammetric method. The adsorptive processes at the hanging mercury drop electrode were investigated in Britton-Robinson and borate buffers. Adsorptive preconcentration followed by differential-pulse cathodic stripping showed one wave at approximately - 1.1 V being the most sensitive for analytical determination of fleroxacin. Two linear ranges were obtained, the first one from 18.465 to 258.51 ng/ml, and the second one from 3.693 to 18.465 ng/ml.

Serum tryptophan to large neutral amino acid ratio and urinary tryptophan in three patients with phenylketonuria in a family. A clinical and biochemical study.

In this work clinical and biochemical findings are presented in three untreated children with phenylketonuria in a family. Their clinical pictures were not typical for classical phenylketonuria. As a result, diagnosis was missed. It has been shown that patterns of large neutral amino acids in serum and urine were somewhat different. Significantly lower serum TRP/LNAA ratio was observed in all patients with phenylketonuria, compared to the control group. These findings suggest that there was subnormal tryptophan availability in the central nervous system leading to its decreased metabolism through the serotonin and kynurenine pathways. These results may explain decreased children's growth and their mental deficiency.

Inhibition of catalase by sulfite and oxidation of sulfite by H2O2 cooperating with ascorbic acid.

An oxidative detoxification of sulfite, which originates from sulfur dioxide taken up into a leaf, has not yet been fully understood. In this study, we discuss that redox reactions between sulfite and H2O2 have an important role for the detoxification of sulfite. Sulfite was oxidized by H2O2 and during the redox reaction, oxygen consumption was observed. The oxygen consumption was partially inhibited by superoxide dismutase, indicating that O2- is generated during the redox reaction. Oxidation of sulfite by H2O2 was also observed in the presence of ascorbic acid, and during the oxidation, no significant oxidation of ascorbic acid and no consumption of oxygen were observed. Sulfite inhibited catalase of cell-free extracts of spinach, pea and broad bean leaves. These results suggest that when leaves are fumigated with SO2 in the light, catalase is inactivated resulting in the accumulation of H2O2 in leaves, which can oxidize sulfite without generating active oxygen species like O2- as long as ascorbate is present in leaves.

Study of acid-base equilibria of fleroxacin.

The acid-base equilibria of fleroxacin were studied by means of potentiometry and spectrophotometry. It was established that fleroxacin undergoes a complex acid-base equilibrium due to its zwitterionic nature and two proton-binding sites of similar acidity. The stoichiometric equilibrium constants were determined at 25 degrees C and constant ionic strength 0.1 M (NaCl). The acidity constants pK1 = 5.59 +/- 0.01 and pK2 = 8.08 +/- 0.04 were found by potentiometry, and pK1 = 5.61 +/- 0.03 and pK2 = 8.11 +/- 0.06 by spectrophotometry. The distribution diagram of the corresponding ionic species is given.

Spectrophotometric and polarographic investigation of the Ofloxacin-Cu(II) complexes.

By means of spectrophotometric methods it was found that ofloxacin reacts with copper(II) ions to form complexes with molar ratios of ofloxacin: Cu(II) of 1:1 at pH 4.00, 2:1 at pH 7.02 and 3:1 at pH 8.30. The stability constants of the complexes were determined. The formation of ofloxacin:Cu(II) 1:1 and 3:1 complexes was confirmed by a polarographic method and the corresponding overall stability constant was evaluated.

[Undescended testes and paratesticular anomalies]. / Nespusten testis i paratestikularne anomalije.

In the field of developmental paratesticular anomalies there are numerous questions without answers. The goal of this paper is to give some information on embryology of normal and disturbed development parallely, as well as to describe the occurrence of certain anomalies with a special review on anomalies of epididymis and deferent ductus considering their importance in urology. Results and statistical data from our work have been reported.

Differential pulse polarographic determination of nizatidine in pharmaceutical formulations.

A sensitive dp polarographic method was applied to the analytical determination of nizatidine, a new histamine H2-receptor antagonist. Determination was performed in Britton-Robinson buffer, at pH approximately equal to 3, ionic strength mu = 0.2. Linear dependence was achieved in a concentration range of 1.33 to 165.72 micrograms/ml for different sensitivities. The method proposed was applied to the determination of nizatidine in capsules and injections.

Polarographic and potentiometric investigation of Co(II) complexes with 5-hydroxytryptophan.

The formation of the complexes between Co(II) and 5-hydroxytryptophan has been studied by means of polarographic and potentiometric methods. The real stability constants of mono and bis-chelato complexes of Co(II) with 5-hydroxytryptophan, obtained by polarographic method, in Britton-Robinson buffer were found to be, log beta 1 = 4.98 and log beta 2 = 8.45. By applying the potentiometric method, in aqueous medium of ionic strength mu = 0.2, the stability constants, log beta 1 = 4.42 and log beta 2 = 8.57 were obtained. The complexes defined by polarographic method have been used in a purpose of analytical determination of 5-hydroxytryptophan.

Urinary excretion of 5-hydroxyindolacetic acid in occupational exposure to polyvinyl chloride and polyurethane foams.

The effect of plastics as polyurethane foams and polyvinyl chloride on the metabolism of tryptophan was investigated by determining the concentration of 5-hydroxyindoleacetic acid (5-HIAA) as its metabolic end product excreted in the urine. Investigation of persons occupationally exposed to polyurethane and polyvinyl chloride showed that these plastics inhibit the metabolism of tryptophan, causing increased excretion of its easily measurable metabolite 5-HIAA. This fact points to the possibility of practical use of this laboratory test which, together with other biological parameters, could improve methods for early detection of occupational exposure to polyurethanes and polyvinyl chloride.