Pilot Programs in Medical Research

Metallurgical and Materials Transactions A - Ballistic impact experiments were conducted on 12.5 mm thick commercial purity titanium and Ti-6 pct Al-4 pct V alloy plates using steel...

This patent search tool allows you not only to search the PCT database of about 2 million International Applications but also the worldwide patent collections. This search facility features: flexible search syntax; automatic word stemming and relevance ranking; as well as graphical results.

Background Early sepsis diagnosis is crucial for the correct management of burn patients, and it clearly influences outcomes. The systemic inflammatory response triggered by burns mimics sepsis presentation and complicates early sepsis diagnosis. Biomarkers were advocated to aid the diagnosis of early sepsis. Serum procalcitonin (PCT) exhibits fair accuracy and good correlation with sepsis severity, being used in diverse clinical settings. However, few studies have evaluated perioperative changes in PCT levels in burn patients. The present study evaluated PCT kinetics during the first days after burn injury and subsequent surgical interventions to assess PCT utility in distinguishing septic from non-septic inflammatory responses. Methods This study was a retrospective observational study of all burn patients admitted to the Coimbra Burns Unit (Portugal) between January 2011 and December 2014 who presented with a total burn surface area ≥ 15% and who underwent subsequent surgery. PCT kinetics were investigated a) during the first five days after burn injury and b) preoperatively during the five days after surgery in three subsets of patients, including those with no preoperative and no postoperative sepsis (NN), no preoperative but postoperative sepsis (NS), and preoperative and postoperative sepsis (SS). A total of 145 patients met the selection criteria and were included in the analysis. Results PCT levels in the first five days after burn injury were significantly higher in patients who developed at least one sepsis episode (n = 85) compared with patients who did not develop sepsis (n = 60). PCT values > 1.00 ng/mL were clearly associated with sepsis. Study participants (n = 145) underwent a total of 283 surgical interventions. Their distribution by preoperative/postoperative sepsis status was 142 (50.2%) in NN; 62 (21.9%) in NS; and 79 (27.9%) in SS. PCT values exhibited a parallel course in the three groups that peaked on the second postoperative day and returned to preoperative levels on the third day or later. The lowest PCT values were found in NN, and the highest values were observed in SS; the NS values were intermediate. Conclusions PCT kinetics coupled with a clinical examination may be helpful for sepsis diagnosis during the first days after burn injury and burn surgery.

Scientific Reports - 3D Dental Subsurface Imaging Using Enhanced Truncated Correlation-Photothermal Coherence Tomography

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Nature Communications - Whether accelerated Arctic warming is favorable for more frequent severe winter weather remains controversial. Here the authors present an observational analysis that links...

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Clinical specimens are each inherently unique, limited and non-renewable. As such, small samples such as tissue biopsies are often completely consumed after a limited number of analyses. Here we present a method that enables fast and reproducible conversion ...

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Updating the imaging standard of care to include artificial intelligence as a second reader is one solution that takes some burden off individual physicians.

This course involves instruction in different types of troubleshooting techniques, procedures, and methods used to solve process problems. Topics include...

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BACKGROUND AND PURPOSE: The Patlak model has been applied to first-pass perfusion CT (PCT) data to extract information on blood-brain barrier permeability (BBBP) to predict hemorrhagic transformation in patients with acute stroke. However, the Patlak model was originally described for the delayed steady-state phase of contrast circulation. The goal of this study was to assess whether the first pass or the delayed phase of a contrast bolus injection better respects the assumptions of the Patlak model for the assessment of BBBP in patients with acute stroke by using PCT. MATERIALS AND METHODS: We retrospectively identified 125 consecutive patients (29 with acute hemispheric stroke and 96 without) who underwent a PCT study by using a prolonged acquisition time up to 3 minutes. The Patlak model was applied to calculate BBBP in ischemic and nonischemic brain tissue. Linear regression of the Patlak plot was performed separately for the first pass and for the delayed phase of the contrast bolus injection. Patlak linear regression models for the first pass and the delayed phase were compared in terms of their respective square root mean squared errors (√MSE) and correlation coefficients ( R ) by using generalized estimating equations with robust variance estimation. RESULTS: BBBP values calculated from the first pass were significantly higher than those from the delayed phase, both in nonischemic brain tissue (2.81 mL × 100 g−1 × min−1 for the first pass versus 1.05 mL × 100 g−1 × min−1 for the delayed phase, P < .001) and in ischemic tissue (7.63 mL × 100 g−1 × min−1 for the first pass versus 1.31 mL × 100 g−1 × min−1 for the delayed phase, P < .001). Compared with regression models from the first pass, Patlak regression models obtained from the delayed data were of better quality, showing significantly lower √MSE and higher R . CONCLUSION: Only the delayed phase of PCT acquisition respects the assumptions of linearity of the Patlak model in patients with and without stroke.

BACKGROUND AND PURPOSE: Perfusion CT (PCT) has the ability to measure quantitative values and produce maps of cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT). We assessed cerebral hemodynamics by using these parameters and acetazolamide challenge in patients with cerebrovascular steno-occlusive disease. METHODS: Fifteen patients underwent PCT with acetazolamide challenge. Comparison of mean CBF, CBV, and MTT was determined between hemispheres and before and after acetazolamide challenge. Hemispheric ratio and percent change due to acetazolamide administration were also calculated. Absolute values and percent changes 2 SDs outside the mean from the nonstenotic hemispheres were defined as abnormal. RESULTS: Significant decreases in CBF (−25.1%, P = .003) and significant increases in MTT (47.1%, P < .001) were found in stenotic hemispheres. After acetazolamide challenge, significant changes in CBF (−39.5%, P < .001) and MTT (92.9%, P < .001) were also seen. The acetazolamide test significantly decreased CBF hemispheric ratio (−20.3%, P < .001) and increased MTT hemispheric ratio (30.8%, P = .002), making both maps more asymmetric. Significance in CBF and MTT percent changes ( P < .001 and P = .005, respectively) was found between hemispheres. When CBF percent changes were assumed to represent the true determinant of hemodynamic impairment, normal ranges of baseline MTT value and MTT percent changes demonstrated sensitivities of 66.7% and 100% and specificities of 58.3% and 75%, respectively, for detecting patients with hemodynamic impairment. CONCLUSION: Parameters obtained from PCT with acetazolamide are promising for the evaluation of cerebral hemodynamics in patients with cerebrovascular steno-occlusive disease.

Objective: To determine diagnostic performance of serum PCT-Q (BRAHMS procalcitonin commercial kit) for bacterial lower respiratory tract infection among COPD patient with exacerbation. Material and methods: Prospective study was conducted in 40 hospitalized COPD patients with exacerbation between June 2008 and January 2009. Patient clinical profiles including the presence of infiltrate on chest roentgenogram, leukocytosis, positive sputum culture for bacteria and clinical outcome (mortality, length of stay and mechanical ventilation requirement) were determined. Serum procalcitonin concentration was measured by both PCT-Q commercial kits and standard quantitative assay on the first day of admission. Result: The diagnostic yield of PCT-Q for pneumonic exacerbation (the presence of pulmonary infiltrate) exhibits sensitivity and specificity of 100% and 71.9% whereas the test exhibits 50.0% sensitivity and 73.3% specificity for the presence of leukocytosis. However, positive PCT-Q provides 40.9 % sensitivity and 50.0%specificity for determining bacterial causes of exacerbation (defined by bacterial culture positivity in sputum). There is no significant correlation between positive PCT-Q and the mechanical ventilator requirement (p=0.864) as well as an average length of stay (p=0.139). The correlation between the positive PCT-Q and positive standard serum assay is noted. Conclusion: PCT-Q can be used as biomarker for pneumonic exacerbation in COPD patients whereas the PCT-Q level is poorly correlated with the clinical outcome. In addition, correlation of kits and standard assay is noted. However, the benefit of PCT-Q is shorter turnaround time.

Aims: To study the clinical significance and prognostic value of monitoring procalcitonin (PCT) and interleukin 6 (IL-6) levels in acute respiratory distress syndrome (ARDS) patients with multiple organ dysfunction (MODS). Methods: We enrolled 24 ARDS ...