Assuntos
Encefalocele/congênito , Encefalocele/diagnóstico por imagem , Meningocele/congênito , Meningocele/diagnóstico por imagem , Base do Crânio/anormalidades , Osso Esfenoide/diagnóstico por imagem , Diagnóstico Diferencial , Feminino , Humanos , Imageamento por Ressonância Magnética/métodos , Pessoa de Meia-Idade , Base do Crânio/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodosRESUMO
OBJECTIVE: The objective of the present study was to analyze the effects of different factors impacting the caliber of the common bile duct (CBD) and a comparison of maximum extrahepatic bile duct caliber in patients with and without a history of cholecystectomy. MATERIAL AND METHODS: A retrospective data analysis was undertaken of 8534 patients (4480 females; 4054 males; average age: 59.2±18.0 years) with sonographic documentation of bile duct caliber.âMaximum intra- and extrahepatic bile duct diameters were studied. The normal maximum diameter of the extrahepatic bile duct was defined as 7âmm. In patients who had undergone prior cholecystectomy, a maximum bile duct diameter<10âmm was considered normal. RESULTS: The average maximum diameter of the CBD amounted to 5.3±3.0âmm for the overall collective. In patients who had undergone prior cholecystectomy, maximum CBD diameters in the normal range (<7âmm) were documented in 55%, while larger diameters (>7âmm) were observed in 45%. In the collective of patients without prior cholecystectomy, CBD diameters in the normal range (<7âmm) were found in 81%, with larger diameters observed in only 18.4% of patients. In both subgroups, there was a significant association between age and bile duct diameter (for those with prior cholecystectomy, p=0.0003; without prior cholecystectomy, p<0.0001). No statistically significant influence on CBD diameter was observed for either prior cholecystectomy (p=0.2116) or time interval since cholecystectomy (p=0.3537). Females, both with and without a history of prior cholecystectomy, showed a 1.4-1.5-fold higher risk of exhibiting a CBD diameter>7âmm (for those with prior cholecystectomy, p=0.0485; without prior cholecystectomy, p<0.001). CONCLUSIONS: Our data show a positive correlation between age and CBD diameter. There was no statistically significant relationship between CBD diameter and prior cholecystectomy, postoperative interval and BMI.
Assuntos
Colecistectomia/estatística & dados numéricos , Doenças do Ducto Colédoco/diagnóstico por imagem , Doenças do Ducto Colédoco/epidemiologia , Ducto Colédoco/diagnóstico por imagem , Complicações Pós-Operatórias/diagnóstico por imagem , Ultrassonografia/estatística & dados numéricos , Adolescente , Adulto , Distribuição por Idade , Feminino , Alemanha/epidemiologia , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Especificidade de Órgãos , Complicações Pós-Operatórias/epidemiologia , Reprodutibilidade dos Testes , Estudos Retrospectivos , Fatores de Risco , Sensibilidade e Especificidade , Adulto JovemRESUMO
Infections caused by multiresistant Gram-positive bacteria represent a major health burden in the community as well as in hospitalized patients. Enterococci, especially Enterococcus faecium, are well-known pathogens of hospitalized patients and are frequently linked with resistance against multiple antibiotics, which compromises effective therapy. Rabbit immune serum raised against heat-killed E. faecium E155, a HiRECC clone, was used in an opsonophagocytic assay, an inhibition assay and a mouse bacteraemia model to identify targets of opsonic and protective antibodies. Serum against whole heat-killed bacteria was opsonic and recognized a protein of about 72 kDa that was abundantly secreted. This protein, identified as SagA by LC-ES-MS/MS, was expressed in Escherichia coli and purified. Rabbit serum raised against the purified protein showed opsonic killing activity that was inhibited by almost 100% using 100 µg purified protein ml(-1). In a mouse bacteraemia model, a statistically significant reduction of the colony counts in blood was shown with immune rabbit serum compared with preimmune serum using the homologous and a heterologous vancomycin-resistant enterococci (VRE) strain. These results indicate that SagA could be used as a promising vaccine target to treat and/or prevent VRE bacteraemia.