Clinical importance of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio and systemic immune-inflammation index in dogs with leishmaniasis.

Leishmaniasis is a zoonotic disease caused by Leishmania spp., impacts multiple systems and organs. While hematological and biochemical profiles aren't definitive for diagnosis, recent studies have identified the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and systemic immune-inflammation index (SII) as predictors of morbidity and mortality in critically ill human and dog patients. This study examined 100 dogs diagnosed with leishmaniasis, categorized by the International Renal Interest Society (IRIS) stages 1-4. Additionally, the dogs were divided based on whether they survived less or more than one year (L1Y and G1Y). Control group consisted of 43 dogs. The NLR increased as the disease progressed (IRIS 1-4), presenting statistically significant differences (P<0.05) when compared to the control group (2,37±2,08) IRIS 3 and 4 (4,59±13,39 and 6,99±12,86, respectively), and G1Y and L1Y (3,60±4,02 and 4,87±5,82, respectively). Significant changes in SII were only evident in short-term survivors (L1Y 951,93±1402) and advanced renal disease cases (IRIS 4 stage 1073,68±1901,09). Conversely, PLR remained largely unchanged. In conclusion, these results suggest that the neutrophil-to-lymphocyte ratio (NLR) and systemic immune-inflammation index (SII) may serve as potential markers for assessing disease progression and prognosis in dogs diagnosed with leishmaniasis.

Practical applications of digital tomosynthesis of the chest.

Digital tomosynthesis is a radiographic technique that generates a number of coronal raw images of a patient from a single pass of the x-ray tube. Tomosynthesis provides some of the tomographic benefits of computed tomography (CT), but at a much lower dose of radiation and cost when compared to CT. This review illustrates the range of practical applications of digital tomosynthesis of the chest.

Intravenous pyelogram artefacts unique to digital tomosynthesis reconstruction.

Recent advances in technology have led to the realisation of digital tomosynthesis (DT) imaging in routine investigations such as intravenous pyelogram (IVP). The major advantage this technology has over other technologies is its ability to perform a retrospective reconstruction of an arbitrary number of coronal image planes from a single data set consisting of a series of low dose discrete projections acquired over a limited angular range using a stationary detector. It is well documented that because DT relies on an angular limited acquisition, the data set is incomplete. This, in combination with the image reconstruction algorithm, results in reconstructed images containing non-focused information from outside the immediate focal plane. This article describes and suggests the cause of two artefacts unique to DT that cannot be explained by blurring alone. We believe the two artefacts are caused by breathing during data acquisition together with a combination of other factors, including the anatomy of the renal system, the method of data acquisition and the reconstructive algorithm used. This could lead to the unaware reporting radiologist falsely diagnosing a duplex collecting system. To avoid these artefacts, we recommend DT IVP should only be used in patients who can adequately perform a breath-hold for the duration of the data acquisition. In addition, we suggest that the study should be performed with breath-held following expiration.

Gender differences in immediate memory in bipolar disorder.

BACKGROUND: Gender is known to modulate the clinical course and severity of bipolar disorder (BD). Although cognitive abnormalities are an established feature of BD, there is limited information regarding whether gender also influences the pattern and severity of cognitive impairment. METHOD: We evaluated the performance of 86 remitted patients with BD, type 1, (BD-I) (36 male and 50 female) and 46 healthy participants (21 male and 25 female) on tasks of general intellectual ability, memory encoding, recognition and retrieval, response inhibition and executive function (abstraction and perseveration). The impact of illness severity in patients was assessed using the global assessment of functioning (GAF). RESULTS: We found a gender effect and an interaction between diagnosis and gender on immediate memory, implicating encoding and retrieval processes, both showing male BD-I patients being disadvantaged compared with female patients and healthy controls. Immediate memory correlated with GAF scores and this association was statistically significant for male BD-I patients. CONCLUSIONS: Our findings suggest that gender differences in BD-I are associated with memory function, particularly processes relating to encoding and retrieval, and may contribute to poor functional outcome particularly in men.

Selective mode excitation in hollow-core photonic crystal fiber.

Modes are selectively excited by launching light through the cladding from the side into a hollow-core photonic crystal fiber. Measuring the total output power at the end of the fiber as a function of the angle of incidence of the exciting laser beam provides a powerful diagnostic for characterizing the cladding bandgap. Furthermore, various types of modes on either side of the bandgap are excited individually, and their near-field images are obtained.

Needle-stick injuries in the National Health Service: a culture of silence.

Injury by contaminated sharp instruments and needles constitutes a major occupational hazard for healthcare workers. In a confidential survey at a district general hospital, 300 healthcare professionals were asked about their personal experience of needle-stick injury and their attitudes to reporting. 279 individuals responded, of whom 38% had experienced at least one needle-stick (mean 1.8) in the past year and 74% had sustained such an injury during their careers (mean 3.0). Although 80% of respondents were aware that such incidents should be notified, only 51% of those affected had reported all needle-stick injuries. Doctors were less likely to report than nurses, despite a higher liability to injury. This survey adds to evidence of a culture of silence pertaining to needle-stick injuries. The consequent risks to health, and the ethical and financial implications, remain uncertain.

Effects of 10 mg and 15 mg oral procyclidine on critical flicker fusion threshold and cardiac functioning in healthy human subjects.

The critical flicker fusion threshold (CFFT) is thought to index alertness and cortical arousal. Sedative drugs reduce CFFT while psychostimulants increase it. Procyclidine is an anticholinergic that is used to control the extrapyramidal side-effects of antipsychotics in schizophrenia. This study examined the effects of clinically relevant doses of oral procyclidine administration on CFFT and heart rate in two separate experiments (Experiment 1, drug dose: 10 mg, n = 16; Experiment 2, drug dose: 15 mg, n = 12) involving healthy subjects using a double-blind, placebo-controlled, cross-over design. 10 mg procyclidine had no significant effect on CFFT, heart rate or self-ratings of mood, but the 15 mg dose significantly lowered CFFT at 1 h and 2 h after procyclidine administration, increased drowsiness ratings and produced a drop in heart rate. The effects observed in this study may have implications for treatment compliance of schizophrenic patients, choice of antipsychotics, prescribing to patients with heart disease and monitoring of cardiac function under treatment. Further investigations are required to quantify the effects of procyclidine on CFFT and cardiac function in patients with schizophrenia.

Effects of procyclidine on prepulse inhibition of the acoustic startle response in healthy human volunteers.

RATIONALE: Prepulse inhibition (PPI) of the startle response refers to an attenuation in response to a strong stimulus (pulse) if this is preceded shortly by a weak non-startling stimulus (prepulse). Patients with schizophrenia have repeatedly been found to show reduced PPI when compared to healthy people. Anticholinergic drugs are often used to control extrapyramidal symptoms induced by antipsychotic medication in schizophrenic patients. Antipsychotic medication, in particular with atypical drugs, has been shown to improve a range of cognitive functions and normalize PPI deficits in schizophrenia, whereas anticholinergic drugs disrupt cognitive functions in both normal and schizophrenic populations and also impair PPI in experimental animals. No previous study has investigated the effects of anticholinergic drugs on human PPI. OBJECTIVES: This study determined the effects of procyclidine, an anticholinergic drug, on PPI in healthy male volunteers, employing a double-blind placebo-controlled cross-over design. METHODS: Subjects underwent testing for PPI on two occasions: once after the oral administration of a placebo and once after the oral administration of procyclidine in two separate experiments. Experiment 1 examined the effects of 10 mg procyclidine, whereas experiment 2 examined the effects of 15 mg procyclidine. RESULTS: Procyclidine at a 10 mg dose, as compared to placebo, had no effect on PPI, but caused impairments at a 15 mg dose. In both experiments, procyclidine reduced response amplitude over the pulse-alone trials and heart rate 1-2 h post-administration. CONCLUSIONS: PPI of the human acoustic startle response is modulated by procyclidine. The use of anticholinergics needs to be considered in PPI studies in schizophrenia.

Osteochondritis dissecans of the elbow: diagnosis, treatment, and prevention.

Osteochondritis dissecans (OCD) is an inflammation of the bone and cartilage that usually affects adolescents and young adults. A 16-year-old baseball player who had chronic elbow pain illustrates the typical course of OCD of the elbow. Radiographs may be diagnostic, but bone scan is a more sensitive diagnostic tool, and magnetic resonance imaging offers information for staging and characterization of lesions. If symptoms do not resolve with rest, surgery is recommended, including loose-body removal with curettage or drilling. The prognosis is good with early diagnosis and treatment. Left untreated, OCD may progress to degenerative joint disease. Prevention includes strengthening and stretching exercises and limits on throwing activities.

Use of Hylan G-F 20 for viscosupplementation of the temporomandibular joint for the management of osteoarthritis: a case report.

Viscosupplementation is a relatively new treatment concept for restoring the normal rheologic properties of the osteoarthritic joint. It is most often used for the knee. This case report describes results that were achieved using viscosupplementation following conservative therapy for a patient with osteoarthritis of the temporomandibular joint. Further study in the use of these treatments is recommended.

Attitudes of health care professionals towards patients who take overdoses.

The attitudes of health care professionals in Malta towards patients who take drug overdoses were studied. It was found that the intention of the overdose had a marked effect on the attitude of the health care professional towards the patients. Differences between different professionals were noted and the Maltese results were compared with those of a similar study in London.