Optic nerve sheath diameter, intensive care unit admission and COVID-19-related-in-hospital mortality.

BACKGROUND: Hypoxia and hypercapnia due to acute pulmonary failure in patients with coronavirus disease 2019 (COVID-19) can increase the intracranial pressure (ICP). ICP correlated with the optic nerve sheath diameter (ONSD) on ultrasonography and is associated with a poor prognosis. AIM: We investigated the capability of ONSD measured during admission to the intensive care unit (ICU) in patients with critical COVID-19 in predicting in-hospital mortality. METHODS: A total of 91 patients enrolled in the study were divided into two groups: survivor (n = 48) and nonsurvivor (n = 43) groups. ONSD was measured by ultrasonography within the first 3 h of ICU admission. RESULTS: The median ONSD was higher in the nonsurvivor group than in the survivor group (5.95 mm vs. 4.15 mm, P < 0.001). The multivariate Cox proportional hazard regression analysis between ONSD and in-hospital mortality (contains 26 covariates) was significant (adjusted hazard ratio, 4.12; 95% confidence interval, 1.46-11.55; P = 0.007). The ONSD cutoff for predicting mortality during ICU admission was 5 mm (area under the curve, 0.985; sensitivity, 98%; and specificity, 90%). The median survival of patients with ONSD >5 mm (43%; n = 39) was lower than those with ONSD ≤5 mm (57%; n = 52) (11.5 days vs. 13.2 days; log-rank test P = 0.001). CONCLUSIONS: ONSD ultrasonography during ICU admission may be an important, cheap and easy-to-apply method that can be used to predict mortality in the early period in patients with critical COVID-19.

Prenatal counseling--implications of the cultural background of pregnant women on information processing, emotional response and acceptance.

PURPOSE: Providing information about prenatal diagnosis (PND) that leads to an informed decision is ethically and psychologically challenging, especially in an intercultural context. The aim was to investigate cultural differences in information processing, test interpretation, evaluation of an established information leaflet, emotional response during screening and acceptance of PND. MATERIALS AND METHODS: This prospective study compared 30 pregnant Turkish immigrants with 30 women from Switzerland and countries within the European Union (EU). They completed a questionnaire prior to (T1) and after risk assessment between 11-14 weeks (T2) and after receiving the results (T3). The questionnaire focused on the perception of, experiences with and knowledge about the risk assessment and included the hospital anxiety and depression scale (HADS). χ(2) tests were used for dichotomous variables and Student's t-tests for scores on perception, experience, knowledge, depression and anxiety. Groups were compared over time by 2-factorial ANOVA. RESULTS: Regarding the 6 questions on knowledge, the rate of correct answers was between 32.2% and 62.5% at T1 and 35.1% and 75.0% at T2. The Turkish women's knowledge level was significantly lower. They rated the information leaflet as less helpful and found the counseling significantly more unsettling. The acceptance of PND was higher in Turkish women. CONCLUSION: Considering the information and knowledge deficits, informed consent was not given in every case, especially in Turkish women. Nevertheless, the acceptance of PND was good. Further studies will have to focus on counseling strategies that take into account the specific needs and expectations of pregnant women with different cultural backgrounds.

Effects of fruit collection date on Phillyrea latifolia L. seed germination.

This study was conducted to determine the effects of date of fruit collection on the germination of Phillyrea latifolia L. Fruits were collected between September and December of 2007, in Egirdir, Turkey. It was found that the one thousand seed weight for the species seeds was 400 g, with significant differences among dates of fruit collection. The highest germination percentage of 58% was obtained from the seeds collected on the ground from previous years on the 1st of September 2007. The seeds from crown on the 1st of September 2007 had a germination percentage of 42%. Moreover, seeds from crown on the 1st of November and December 2007 and 15th of October and November 2007 did not germinate. In conclusion, P. latifolia seeds collected on the ground from previous years could be sown in early autumn to obtain a high germination rate.

Paraneoplastic neurologic syndromes: pathogenesis and physiopathology.

Since 1965 when the first paraneoplastic antineuronal antibody was reported by Wilkinson and Zeromski (55), the number of immunological responses detected in association with paraneoplastic syndromes of the nervous system has steadily increased. These responses are characterized by the presence of antineuronal antibodies in serum and CSF and/or infiltrates of T-cells in the tumor and nervous system. A few syndromes are mediated by antibodies; they include those resulting from dysfunction of the neuromuscular junction at the pre- or post-synaptic level (Lambert-Eaton myasthenic syndrome, myasthenia gravis) or ion channel dysfunction in the peripheral nervous system (i.e, Voltage-gated potassium channel and neuromyotonia). In most other paraneoplastic syndromes, including those involving the central nervous system, the pathogenic role of highly specific antineuronal antibodies (anti-Hu, anti-Yo, etc.) has not been established; nevertheless these antibodies should be regarded as useful markers of specific paraneoplastic syndromes and tumors. Moreover, there is increasing evidence that in some of these syndromes T-cell mediated mechanisms can cause the neurologic dysfunction and contribute to tumor rejection. Some paraneoplastic syndromes are caused by the tumor secretion of antibodies (macroglobulinemia and MAG antibodies), hormones, and cytokines. In other instances, the tumor may compete with the nervous system for an essential substrate (glucose, tryptophan) and result in neurologic dysfunction.

Latent Epstein-Barr virus infection demonstrated in low-grade leiomyosarcomas of adults with acquired immunodeficiency syndrome, but not in adjacent Kaposi's lesion or smooth muscle tumors in immunocompetent patients.

BACKGROUND: Incidence of smooth muscle tumors is increased in patients with human immunodeficiency virus infection and organ transplant recipients. Smooth muscle tumors in immunocompromised patients often occur in unusual locations and exhibit evidence of latent infection by clonal, presumably tumorigenic, Epstein-Barr virus (EBV). OBJECTIVE: To investigate the presence of EBV latent infection in smooth muscle tumors in patients with acquired immunodeficiency syndrome and in immunocompetent patients. DESIGN: Twenty-two extrauterine, extraintestinal smooth muscle and myofibroblastic tumors were reviewed pathologically, and clinical charts were screened. Tumors were malignant (15 patients), benign (6 patients), and borderline (1 patient). Tissue specimens were investigated for latent EBV infection by latent membrane protein immunocytochemistry and EBV-encoded RNA in situ hybridization. SETTING: University Hospital of the University of Nancy, France. PATIENTS: Patients were 18 adults and four children. Two adults had acquired immunodeficiency syndrome. Both had low-grade leiomyosarcomas located in adrenal gland. Moreover, in patient 1, leiomyosarcoma was multifocal in pericardium and lymph node; in lymph node, muscle tumor was adjacent to nodal and skin Kaposi's lesions. RESULTS: In both patients with acquired immunodeficiency syndrome and leiomyosarcoma, latent infection by EBV could be demonstrated in tumor cells, contrasting with absence of detectable EBV infection in adjacent non-neoplastic tissues and nearby Kaposi's lesions. Latent infection by EBV could not be demonstrated in smooth muscle and myofibroblastic tumors in immunocompetent patients. CONCLUSIONS: Latent EBV infection is associated with smooth muscle cell tumors in immunocompromised patients, but not in immunocompetent patients.

The use of polyvinylidenedifluoride membranes as a general blotting matrix.

A fast chemical staining of protein by Coomassie blue on a stable nonshrinking membrane of polyvinylidenedifluoride is described. The procedure is especially useful for detection of nonlabeled marker proteins in comparison to specifically detected proteins. The membrane is highly suitable for other chemical stains like silver, gold, or india ink for immunostaining, lectin binding, and binding of radioactive ligands like 45Ca. Blocking of the background against nonspecific binding to proteins was studied using different reagents. A multiple slit plate is described for volume-saving simultaneous application of multiple reactants on one protein-loaded membrane.

Protein blotting: techniques and application in virus hepatitis research.

The protein-blotting technique is a very practical way to detect and characterize certain proteins in a complex sample by various reagents like polyclonal and monoclonal antibodies, lectins, nucleic acids, or other ligands. This article discusses several options to perform this technique with special reference to viral hepatitis. We give a detailed description of denaturing gel electrophoresis, blotting and specific detection methods. At the beginning of each section a general outline of a certain technique is given, thereafter the reagents, equipment, suppliers, and techniques are described in a way that a beginner may be able to perform the assay.

Calcium binding proteins: purification of hepatocalcin-55 from bovine liver.

1. Bovine liver was homogenized and the proteins were fractionated by two DEAE-Sephadex steps and a gel filtration. 2. All 150 fractions collected from the DEAE-Sephadex column were electrophoresed and combined to give ten groups of proteins with different SDS-electrophoresis patterns. 3. Fractions G and H, showing fast migrating proteins, were transblotted to a polyvinylidenedifluoride membrane. By incubation with 45CaCl2 and subsequent autoradiography one protein revealed strong calcium binding. 4. This protein, named hepatocalcin-55, was obtained in a pure form from the gel filtration through Sephadex G-75. The molecular weight (55,000) was determined by gel filtration. Since SDS electrophoresis shows one protein band at Mr = 27,000 the native hepatocalcin must be a dimer. Its isoelectric point was found to be at 4.9. 5. Gamma-carboxyglutamate could not be detected in alkaline hydrolyzates of the protein under study. No carbohydrates were found in the hepatocalcin.