Bed Site Research Articles

Observations from opening of a novel geotextile tube connection in field test site

A novel connection configuration for geotextile tubes was proposed, involving the insertion of an auxiliary tube between two main tubes, to ensure proper alignment and leveling when connecting them in a series, thus consolidating individual tubes into a unified structure while maintaining a consistent horizontal level. The novel connection was implemented at a test bed site in the Saemangeum reclaimed area, South Korea, to test exposure to the marine environment including sea waves, sun light exposure and reclamation process. This study presents the observations made upon opening the connection tube after 8 years. The observation shows that the connected geotextile tubes using the proposed auxiliary tube are suitable for use in long-term reclamation projects.

A pyritized Ordovician leanchoiliid arthropod.

The "short-great-appendage" arthropods (Megacheira), such as Leanchoilia, have featured heavily in discussions of arthropod evolution, particularly related to the head and its appendages.1,2,3,4 Megacheirans are subject to competing interpretations, either as a clade4 or a grade,5 in the stem group of Euarthropoda6 or, alternatively, Chelicerata.4 They are most diverse in Cambrian Burgess-Shale-type deposits, where the family Leanchoiliidae is represented by six genera,7,8,9,10,11,12 characterized by the presence of three distal flagella on the great appendage with a presumed sensory function. We describe the first post-Cambrian member of this family, Lomankus edgecombei gen. et sp. nov, from the Upper Ordovician (Katian) Beecher's Trilobite Bed site of New York State-the first post-Cambrian megacheiran with the exception of the Silurian and Devonian Enaliktidae. Micro-computed tomography (micro-CT) scanning reveals the morphology of the short great appendage with elongate flagella, four biramous cephalic limbs, 11 trunk segments with biramous limbs and dorsal tergites, and an elongate telson unique within Leanchoiliidae. The great appendage is also unique: the long endites that bear the flagella in other leanchoiliids are absent (or at least greatly reduced) and each flagellum appears to attach directly to an individual podomere, suggesting a sensory rather than a raptorial function. The remarkable preservation of a well-developed ventral plate (epistome-labrum complex) anterior of the mouth reinforces a deutocerebral origin2,13 of the short great appendages. Lomankus edgecombei unveils the three-dimensional (3D) head morphology of leanchoiliids in unparalleled detail and demonstrates that these iconic fossil arthropods ranged into dysaerobic environments in the Ordovician, where Lomankus occupied a deposit-feeding niche.

3D-Printed Auxetic Skin Scaffold for Decreasing Burn Wound Contractures at Joints.

For patients with severe burns that consist of contractures induced by fibrous scar tissue formation, a graft must adhere completely to the wound bed to enable wound healing and neovascularization. However, currently available grafts are insufficient for scar suppression owing to their nonuniform pressure distribution in the wound area. Therefore, considering the characteristics of human skin, which is omnidirectionally stretched via uniaxial stretching, we proposed an auxetic skin scaffold with a negative Poisson's ratio (NPR) for tight adherence to the skin scaffold on the wound bed site. Briefly, a skin scaffold with the NPR effect was fabricated by creating a fine pattern through 3D printing. Electrospun layers were also added to improve adhesion to the wound bed. Fabricated skin scaffolds displayed NPR characteristics (-0.5 to -0.1) based on pulling simulation and experiment. Finger bending motion tests verified the decreased marginal forces (<50%) and deformation (<60%) of the NPR scaffold. In addition, the filling of human dermal fibroblasts in most areas (>95%) of the scaffold comprising rarely dead cells and their spindle-shaped morphologies revealed the high cytocompatibility of the developed scaffold. Overall, the developed skin scaffold may help reduce wound strictures in the joints of patients with burns as it exerts less pressure on the wound margin.

MINDER Smart home test bed site – embedding dementia research into primary health and social care. Wingfield, D. Daniels, S. Norman, C. Lai, H. Hassim, N. Nilforooshan, R. Barnarghi, P. Sharp, D

AbstractBackgroundDigitally enabled healthcare is becoming mainstream NHS (1) and adoption has been accelerated in response to the COVID‐19 pandemic (2) The UK Dementia Research Institute Care Research &amp; Technology Centre, established in 2019, explores the value of using technology in people’s homes to improve care and has developed a system (MINDER) using IOT/smart home technology and medical devices, integrating activity and health data for research purposes and generating health alerts to the mainstream provider via a clinical monitoring team. Initially launched in Surrey and Borders Partnership NHS Trust (n = 40); in April 2021, an additional research site was established within primary care in North West London.MethodWe collated data from both sites and describe an integrated delivery model for research within primary health and social care. Cohort description and case studies illustrate the challenges and benefits of conducting this research across urban and sub‐urban settings.ResultsOver 55 participants are currently enrolled on the study. 15 of these from primary care/general practice in the London Borough of Hammersmith and Fulham. Opportunities arising from this setting include leveraging the patient – provider (nurse/doctor/allied health professional/social care) relationship to introduce the study and recruit, and rapid escalation of any problems arising in a research context to the clinical/care teams responsible to delivering care (for example; potential urinary tract infections). Challenges to recruitment have included lack of specialist confirmation of dementia diagnosis in primary care records, lack of consistent engagement/availability of the required MINDER study partner as well as the impact of the COVID 19 pandemic limited face to face contact.ConclusionEarly data suggests that a complex dementia study can be embedded successfully in General Practice and leads to strengthening of relations with care giving bodies. This offers the opportunity for development and translation of new technologies within front line primary and social care, that can be fully evaluated within the real world context of service delivery.References 1)The NHS Long Term Plan (2019) gov.uk 2) Baird B, Maguire D. Understanding factors that enabled digital service change in general practice during the Covid‐19 pandemic. London: The King’s Fund. 2021 Feb.

Complications Rate of Conventional Percutaneous Nephrolithotomy (PCNL) in a tertiary care center

Aim: To observe the complication rate of conventional percutaneous nephrolithotomy (PCNL) in a tertiary care Hospital. Methods: This Retrospective study conducted from January 2016 to January 2020 in the Department of Urology at Lady Reading Hospital in Peshawar, Pakistan.The research included a total of 449 patients who underwent conventional PCNL.Non-contrast CT KUB was performed on all patients before surgery. After passing 6fr Ureteric catheter through a cystoscope in lithotomy position patient was then shifted into prone position. Under the guidance of fluoroscopy, all procedures were carried out while the patient was lying flat and conventional 30FR amplatz sheath was used as working channel. Results: Complications were reported in 46.9% of cases.The majority of the complications occurred in patients with clavien grades I and II, with 120(27%) and 54(12%) patients, respectively. In Grade I complicationstransient feveroccurred in 67(15%) patients treated with antipyretics while 53(12%) patients had nephrostomy site leakage managed with simple pressure dressing at bed site. In grade II complication 45(10%) patients had bleeding which required transfusion and 9(2%) patients developed sepsis treated with parenteral antibiotics. 10(2%) patients developed grade IIIa complication such as persistent bleeding in 4(0.8%) patients managed with percutaneous angioembolization and 6(1.2%) patients required percutaneous drainage of perinephric collection. 25(5.5%) patients had grade IIIb complications, in 24( 5.3%) patients DJ stenting was done for PCS injury or persistent leakage from nephrostomy site while 1(0.2%) patient needed colostomy for colonic injury. Conclusion: The chance of serious complications during percutaneous nephrolithotomy is very minimal. It is also safe, cost effective and well-tolerated. Transient fever or nephrostomy site leakage are the most frequently occurring minor complications often subside spontaneously. Keywords: Nephrostomy, percutaneous nephrolithotomy

PBMNCs Treatment in Critical Limb Ischemia and Candidate Biomarkers of Efficacy.

When in critical limb ischemia (CLI) the healing process aborts or does not follow an orderly and timely sequence, a chronic vascular wound develops. The latter is major problem today, as their epidemiology is continuously increasing due to the aging population and a growth in the incidence of the underlying diseases. In the US, the mean annualized prevalence of necrotic wounds due to the fact of CLI is 1.33% (95% CI, 1.32–1.34%), and the cost of dressings alone has been estimated at USD 5 billion per year from healthcare budgets. A promising cell treatment in wound healing is the local injection of peripheral blood mononuclear cells (PBMNCs). The treatment is aimed to induce angiogenesis as well to switch inflammatory macrophages, called the M1 phenotype, into anti-inflammatory macrophages, called M2, a phenotype devoted to tissue repair. This mechanism is called polarization and is a critical step for the healing of all human tissues. Regarding the clinical efficacy of PBMNCs, the level of evidence is still low, and a considerable effort is necessary for completing the translational process toward the patient bed site. From this point of view, it is crucial to identify some candidate biomarkers to detect the switching process from M1 to M2 in response to the cell treatment.

Repair of postoperative and recurrent nasal septal perforations using L-strut overlay flap.

Despite the many described techniques, surgical repair of iatrogenic nasal septal perforations is still challenging. The authors present a novel technique for endoscopic closure of postoperative and recurrent nasal septal perforations. The technique is based on the elevation of a vascularized flap from the L-strut area and the creation of the bed site without dissection of the surrounding septum. Seven patients were operated using "L-strut overlay" flap from June 2018 to October 2020. All patients had their perforations closed 12months after surgery. Early results of our surgical technique have proven its simplicity and high effectiveness.

Combined intracranial Acriflavine, temozolomide and radiation extends survival in a rat glioma model

Glioblastomas have been historically difficult to treat with poor long-term survival. With novel strategies focused on targeting hypoxia-inducible factor (HIF) regulatory pathways, recent evidence has shown that Acriflavine (ACF) can effectively target glioma invasiveness and recurrence. However, local delivery of ACF and its combinatory effects with Temozolomide (TMZ) and radiation therapy (XRT) have not yet been optimized. In this study we test a novel polymeric matrix that can gradually release ACF at the tumor bed site in combination with systemic TMZ and XRT. In vitro cytotoxicity assays of ACF in combination with TMZ and XRT were performed on rodent and human cell lines with CCK-8 and flow cytometry. In vitro drug release was measured and intracranial safety was assessed in tumor-free animals. Finally, efficacy was assessed in an intracranial gliosarcoma model and combination therapy with TMZ and XRT evaluated. Combination therapy of ACF, TMZ, and XRT was able to reduce cell viability and induce apoptosis in glioma cells. In vitro and in vivo release of ACF was measured in benchtop and animal models. Efficacy was established in an in vivo gliosarcoma model in which intracranial ACF (p < 0.01) significantly improved median survival and the combination therapy of ACF, TMZ and XRT (p < 0.01) significantly improved median survival and led to long-term survival (LTS). We provide evidence that ACF, combined with TMZ and XRT, led to LTS in an intracranial model of rat gliosarcoma. These findings, in combination with the use of a novel polymeric matrix that allows more gradual drug delivery, constitute a first step in the translation of this novel strategy to human use.

Bed site selection by female North American black bears (Ursus americanus)

Abstract Sleep is important for memory consolidation and maintaining metabolic homeostasis, but sleep can expose animals to inclement weather and predators. Consequently, selection of sleeping sites is important. We tested three sets of hypotheses related to selection of bed sites by female American black bears (Ursus americanus) at two study sites. During 2009–2013, we outfitted 14 female black bears west of Ely, Minnesota, with Global Positioning System collars that reported bear locations every 10 min. We visited 101 bed sites, each identified from clusters of estimated locations where a bear was on site for ≥4 h on two or more occasions, and recorded bed characteristics, forest composition, canopy closure, and ground cover. We matched each bed site with a control site where we collected the same data. During 1987–1991, we outfitted three female black bears south of Ely with very high-frequency transmitter collars and walked with the bears to collect detailed behavioral data. We used the written data records to identify 62 bed sites where bears slept ≥2 h and where bed characteristics were documented. We matched each bed site with a control site approximately 6 h different when the bear was active. Of the bed sites, 132 were used during night and 31 during day. The two study areas differed in the amount of lowland habitats. At both sites, female bears chose bed sites disproportionately in lowland sites with high canopy cover and next to a tree, especially a white pine. Female bears with cubs selected upland bed sites more often than did females without cubs and also more often selected sites adjacent to a tree with coarse bark, which cubs could climb easily. Distances to roads and houses did not affect selection of bed sites by females either with or without cubs.

Preclinical Safety of a 3D-Printed Hydroxyapatite-Demineralized Bone Matrix Scaffold for Spinal Fusion.

Prospective, randomized, controlled preclinical study. The objective of this study was to compare the host inflammatory response of our previously described hyperelastic, 3D-printed (3DP) hydroxyapatite (HA)-demineralized bone matrix (DBM) composite scaffold to the response elicited with the use of recombinant human bone morphogenetic protein-2 (rhBMP-2) in a preclinical rat posterolateral lumbar fusion model. Our group previously found that this 3D-printed HA-DBM composite material shows promise as a bone graft substitute in a preclinical rodent model, but its safety profile had yet to be assessed. Sixty female Sprague-Dawley rats underwent bilateral posterolateral intertransverse lumbar spinal fusion using with the following implants: 1) type I absorbable collagen sponge (ACS) alone; 2) 10 μg rhBMP-2/ACS; or 3) the 3DP HA-DBM composite scaffold (n = 20). The host inflammatory response was assessed using magnetic resonance imaging, while the local and circulating cytokine expression levels were evaluated by enzyme-linked immunosorbent assays at subsequent postoperative time points (N = 5/time point). At both 2 and 5 days postoperatively, treatment with the HA-DBM scaffold produced significantly less soft tissue edema at the fusion bed site relative to rhBMP-2-treated animals as quantified on magnetic resonance imaging. At every postoperative time point evaluated, the level of soft tissue edema in HA-DBM-treated animals was comparable to that of the ACS control group. At 2 days postoperatively, serum concentrations of tumor necrosis factor-α and macrophage chemoattractant protein-1 were significantly elevated in the rhBMP-2 treatment group relative to ACS controls, whereas these cytokines were not elevated in the HA-DBM-treated animals. The 3D-printed HA-DBM composite induces a significantly reduced host inflammatory response in a preclinical spinal fusion model relative to rhBMP-2.Level of Evidence: N/A.

The Role of “Robotic Assisted Intensivist” As Solution Of Resources Management In Covid-19 Pandemic Era

Providing expertise in the care of critically ill patients is one of the main needs of critical care medicine, especially in the COVID-19 pandemic era. This goal is particularly challenging, given the acknowledged shortage of intensive care specialists. We need the bedside nurse to have real-time access to get continuous reporting monitoring. The intensivist also has access to bed site examination at some time when they are not possible for coming to the intensive care unit (ICU). The big problems during COVID-19 are the limited personal protective equipment, the limited number of intensivist doctors, and the nature of the disease was very contagious and deadly. It is necessary to find a solution so as not to cause new problems, namely the death of medical staff and nurses due to frequent contact with Covid-19 patients. In this article, the author wants to open a view to getting solutions to problems in the field by presenting human replacement technology.

ADVANTAGES OF NIEMFE METHOD IN GEOLOGICAL STATE MONITORING WHEN SOLVING APPLIED ENGINEERING PROBLEMS

Problem Statement and Purpose Finding effective methods for monitoring the state of engineering structures and geological conditions in their localization is an extreme­ly urgent issue today. The method of natural impulse electromagnetic field of the Earth (NIEMFE) is widely used for the solution of applied engineering-ecological, geological, geophysical and hydrogeological problems. The purpose of this work is to study the dynamics and the geological environment forecasting in conditions of increasing man-made load and prove the effectiveness of NIEMFE method in solving problems related to the violation of the engineering facilities operating conditions.Data &amp; Methods Data from field observations conducted by employees of the De­partment of Geotechnogenic Safety and Geoinformatics of Ivano-Frankivsk National University of Oil and Gas were used to build the initial models. In particular, measure­ments by the NIEMFE method were performed on the territory of the school in the vil­lage Yunashkiv in the Rohatyn district and on the territory of the university building.Results The efficiency of using the NIEMFE method for solving geological engineer­ing problems is confirmed by the example of two diverse objects. The observations results obtained during the rocks stress-strain state study in the Yunashkiv village school in the Rogatyn district are considered. The NIEMFE method measurements allowed us to establish the stress-strain zones of the study area, which are related to the karst processes development. The analysis of the anomalies distribution and their intensities show that the territory is not stable and one should expect further karst manifestations and earth's surface and building deformation. The monitoring obser­vation results by the NIEMFE method are presented in order to track the dynamics of the change in the the IFNTUOG building state. The reason for the building damage, namely the design on the ancient river bed site, which led to the rocks strength loss due to the suffusion processes and the decomposition of the clay rocks underlying the foundation was identified. The influence of significant rainfall on the stress-strain state change of the studied territory was confirmed. It is proved that the NIEMFE method is a promising method for studying the rock mass stress-strain state in terms of determining the engineering structures stability and providing the deformation pro­cesses forecast.

Habitat selection of white-tailed deer fawns and their dams in the Northern Great Plains

Habitat availability can affect important life-history traits such as survival; however, little information exists on how microhabitat characteristics found at parturition sites selected by dams and bed sites selected by their offspring differ from the surrounding area and from each other. Therefore, we assessed how vegetation affected maternal parturition and offspring bed site selection for white-tailed deer (Odocoileus virginianus) in the Northern Great Plains. Dams selected for sites with decreased vegetation height, potentially improving their visibility, which may increase their ability to escape approaching predators. Conversely, there was no variation between vegetative characteristics at neonate bed sites and their associated random sites, indicating grasslands provide adequate concealment for neonates. Dams possess the ability to flee from approaching predators, thus increasing the importance of visibility while giving birth. Conversely, neonates depend on fear bradycardia as their main antipredator defense, so concealment is more important. Our results suggest that vegetation structure is an important characteristic to white-tailed deer as habitat needs vary between adults and neonates.

PARE0030 PEER SUPPORT OF PATIENT AND PUBLIC INVOLVEMENT AND ENGAGEMENT IN RESEARCH: THE ‘RUG-BUDDY’

Background:Since 2006, The School of Primary, Community and Social Care, Keele University has a long standing commitment to Patient and Public Involvement and Engagement (PPIE) in research. The School’s Research User Group (RUG) has 133 members in January 2020, compared to 80 members in September 2016. Supporting the practical and emotional needs of a growing number of RUG members to support their long-term involvement is of prime importance.Arising from Keele’s role as a test bed site for the new UK Public Involvement Standards, a new peer support role (the ‘RUG-Buddy’) was co-produced to facilitate the support of RUG members.Objectives:The RUG-Buddy is a peer support and mentoring scheme. More experienced RUG members attend research meetings with less experienced members to provide support and reassurance. The scheme aims to provide:•A welcoming and friendly environment for RUG members•Extra support for all RUG members before, during and after research meetings•Help new RUG members ease into public involvement•Support with discussions between researchers and RUG members, e.g. avoiding research jargon••Reassurance to new members - learning from those with greater experience of public involvement•Someone to talk to and confide in from people who have personal experience of PPIE•Practical advice on completing payment forms, parking issues, etc.Methods:Peer support is provided by a panel of existing RUG members who have substantial experience of PPIE in research. This is anadditionalmethod of supporting the RUG members alongside support provided by the School’s PPIE team. RUG-Buddies will be supported in their role by the PPIE team and provided with an induction and training. RUG-Buddies are offered payment for their time and have their travel expenses reimbursed. The RUG-Buddies scheme will be piloted during an initial 6-month period, after which it will be reviewed, with feedback from RUG-Buddies and RUG members.Results:A role description for the RUG-Buddy role has been coproduced by Keele’s PPIE team and its RUG Steering Group (Table 1). A panel of 10 RUG members have been recruited for the RUG-Buddy role and have received an induction and training (e.g. Health and Safety, Information Governance). RUG-Buddies have provided support to and attended research meetings with other RUG members. The RUG-Buddy role will be reviewed in September 2020.Table 1.Summary of the RUG-Buddy role descriptionQualities of a RUG-BuddyRUG-Buddy responsibilitiesPPIE team responsibilitiesWilling to share personal experienceTo attend up to the first three PPIE meetings of a research projectTo provide a training session for all RUG-BuddiesFriendly and approachableTo introduce new member to RUG members and research teamTo meet RUG-Buddies every two months to provide review/feedback of the roleEnthusiastic and knowledgeable about PPIE in researchTo encourage contribution to the meetingTo have a named PPIE lead for any questions/queries that may ariseBe reliable and punctualTo provide support and respond to RUG members’ questionsTo work alongside RUG-Buddy to meet and greet public membersConclusion:The RUG-Buddy is an innovative peer support scheme to support the involvement of patients and the public in research. The support provided by RUG-Buddies offers a different perspective from people with real-life experience of involvement in research. It is anticipated that this additional support will enrich the experience of RUG members and facilitate a more welcoming and conducive environment for active and meaningful public involvement. Furthermore, it has also provided an opportunity for the RUG-Buddies to gain valuable new skills and also give something back to the PPIE team and researchers who have supported their own involvement for many years.Acknowledgments:This project is funded by the National Institute for Health Research (NIHR) School for Primary Care Research (project reference 440). Thank you to the Keele Research User Group for all their great workDisclosure of Interests:None declared

Novel Molecular Mechanisms of Pulmonary Hypertension: A Search for Biomarkers and Novel Drug Targets-From Bench to Bed Site.

Pulmonary hypertension (PH) is defined as increased mean pulmonary artery pressure (mPAP) above 25 mmHg, measured at rest by right heart catheterization. The exact global prevalence of PH is difficult to estimate, mainly due to the complex aetiology, and its spread may be underestimated. To date, numerous studies on the aetiology and pathophysiology of PH at molecular level were conducted. Simultaneously, some clinical studies have shown potential usefulness of well-known and widely recognized cardiovascular biomarkers, but their potential clinical usefulness in diagnosis and management of PH is poor due to their low specificity accompanied with numerous other cardiovascular comorbidities of PH subjects. On the other hand, a large body of basic research-based studies provides us with novel molecular pathomechanisms, biomarkers, and drug targets, according to the evidence-based medicine principles. Unfortunately, the simple implementation of these results to clinical practice is impossible due to a large heterogeneity of the PH pathophysiology, where the clinical symptoms constitute only a common denominator and a final result of numerous crosstalking metabolic pathways. Therefore, future studies, based mostly on translational medicine, are needed in order to both organize better the pathophysiological classification of various forms of PH and define precisely the optimal diagnostic markers and therapeutic targets in particular forms of PH. This review paper summarizes the current state of the art regarding the molecular background of PH with respect to its current classification. Novel therapeutic strategies and potential biomarkers are discussed with respect to their limitations in use in common clinical practice.

Keeping cool in the warming Arctic: thermoregulatory behaviour by Svalbard reindeer (Rangifer tarandus platyrhynchus)

In animals with long generation times, evolution of physiological and morphological traits may not be fast enough to keep up with rapid climate warming, but thermoregulatory behaviour can possibly serve as an important buffer mitigating warming effects. In this study, we investigated if the cold-adapted Svalbard reindeer (Rangifer tarandus platyrhynchus (Vrolik, 1829)) used cool bed sites as a thermoregulatory behaviour in the summer. We recorded habitat variables and ground temperature at 371 bed sites with random “control” sites 10 and 100 m distant. Using case-control logistic regression, we found that reindeer selected bed sites on cool substrates (snow and mire), as well as cold, dry ground on days with warm ambient temperatures, while they avoided such sites on cold days. Selection of both cool substrates and cool ground did not depend on age or sex. The study was conducted in an environment where neither predatory threat nor insect harassment influenced bed site selection. Our findings suggest that the thermal landscape is important for habitat selection of cold-adapted Arctic ungulates in summer. Thus, behavioural strategies may be important to mitigate effects of climate change, at least in the short term.

Patterns of settlement within a restored mussel bed site

The failure of depleted bivalve populations to recover naturally is often due to a breakdown in recruitment processes, such as a lack of larvae or suitable settlement substrate. The identification of these recruitment limitations are a critical initial step for determining an appropriate strategy for restoration. A lack of larval supply and settlement substrate have both been suggested as possible causes of the failure of natural recovery in the green‐lipped mussel population in the Hauraki Gulf, New Zealand, and were therefore examined in this study. Larval mussels settled throughout most of the year directly onto artificial collectors placed within restored adult mussel beds and in the immediate vicinity of the beds at comparatively lower levels than for remnant populations throughout New Zealand. This low settlement coupled with a lack of recruitment to the restored mussel beds suggests larval supply may be limited in the Hauraki Gulf and warrants further examinations into larval dispersal and retention. Larval settlement was also higher on collectors within mussel beds, suggesting the presence of adults enhances larval settlement and highlights the importance of transplanting adult mussels for reestablishing mussel populations.

Complications of radio- and radiochemotherapy in patients undergoing major salivary gland cancer surgery.

The aim of this retrospective study was to present the prevalence of early and late radiation-induced reaction and factors affecting its formation and severity in patients after adjuvant radio- or radiochemotherapy in salivary gland cancer. A total of 113 patients with early and 91 with late radiation-induced reaction, irradiated in 2006-2016 were enrolled in the study. The frequency of acute mucosal radiation-induced reaction, time of onset, intensity, healing time, as well as the incidence of late radiation-induced reaction from the skin and subcutaneous tissue were analyzed. Factors that could influence the development and intensity of reaction were identified. Acute severity and the presence of late radiation-induced reaction do not affect overall survival. Dosage in the tumor bed site, as well as the dosage in the nodal region, affect the severity of the acute radiation-induced mucosal reaction. The severity of the early radiation-induced reaction is higher in men, more advanced patients (higher T and N+ in TNM classification), irradiated into a larger area, and those in whom two-dimensional planning and complementary chemoradiotherapy were applied. The late reaction of the skin and subcutaneous tissue was dominated by patients irradiated in the nodal regions and those with a higher intensity of early radiation-induced reaction. Supplementary radiotherapy or radiochemotherapy in salivary gland cancer is associated with acceptable toxicity which has no effect on overall survival.

Efficacy of early imaging with 68Ga-PSMA-I&T in the discrimination of pelvic lesions in prostate cancer patients.

68Ga-PSMA-uptake shows accumulation in the malignant lesions of prostate cancer patients as early as 5min p.i. Studies indicate the value of adding an early image of the pelvis to the imaging protocol of 68Ga-PSMA-11 PET/CT scan showed contradictory results. In this study we planned to assess the significance of an additional early imaging in 68Ga-PSMA-I&T PET/CT imaging in prostate cancer patients. A total of 35 prostate cancer patients referred to 68Ga-PSMA-I&T PET/CT imaging for restaging of the disease due to suspicion of relapse after definitive therapy were enrolled. First an early static pelvic image was obtained at a maximum of 300s following injection of the radiotracer. Sixty minutes postinjection a whole-body PET/CT scan was conducted with an emission time of 3min per bed position. The lesions which were categorized as local recurrence, bone lesion and lymph node metástasis in the early images, were compared with the late images in terms of number of lesions detected and SUVmax values. 68Ga-PSMA-I&T PET/CT was positive in 23 of 35 patients (65.7%). A pathological uptake was observed in the prostatic bed site, in the pelvic lymph nodes, and in the bones in 17 patients (48.5%), 12 patients (34.2%), and 13 patients (37.1%), respectively. In one patient, focal pathological increased uptake in the prostatic bed with a SUVmax value of 5.8 was detected but this lesion disappeared in the late images. The average SUVmax values of the lesions in the prostatic bed were 13.7±12.1 versus 26.3±23.8 in the 5min and 60min studies respectively (p<0.001). In one patient, the pathological uptake in the lymph node in the early study cleared in the late study, whereas in another accumulation of activity was detected in a pelvic lymph node in the late study, while there was no lymph node detected in the early study. The average SUVmax values of the lymph nodes were 12.1±8.8 versus 26.3±22.6 in the 5min and 60min studies respectively (p<0.001). The average SUVmax values of the bone lesions were 11.4±6.9 versus 15±10.7 in the 5min and 60min studies respectively. Our study is the first in the literature to evaluate the impact of adding an early static pelvic image to the 68Ga-PSMA-I&T scan, in the detection rate of the lesions. Although there was no marked discordance between the 2sets of images, the addition of an early image to the imaging protocol of 68Ga-PSMA-I&T scan would increase the efficacy of detection of malignant lesions in the pelvis, which might show rapid clearance and has the risk of being masked by the urinary system activity.

A Documentation of Hepatitis Outbreak in Chittagong

Introduction: Hepatitis E Virus (HEV) causes outbreaks of jaundice and it is associated with morbidity and higher maternal mortality. There is a recent outbreak of hepatitis in the Chittagong city and present study is aimed to observe the clinical and serological trends along with outcome of hepatitis cases visiting two tertiary care hospitals Chittagong, Bangladesh.&#x0D; Methods: It was an observational study done in two tertiary care hospital of Chittagong in a period of 3 months (May, June &amp; July 2018) among 230 patients of hepatitis. After inclusion with written informed consent patients were introduced a questionnaire. Their demographic data, risk behaviors were noted, history related to hepatitis were recorded. Examination was done and evaluation regarding presence of hepatic encephalopathy at bed site was noted. Later serological findings were evaluated. After collection of all data it were compiled and analyzed by SPSS- 20.&#x0D; Results: Among 230 cases age group, gender and locality of the study patients were analyzed where younger age groups specially 21-30 years 114(49.6%) and 31-40 years 38(16.5%) were the most affected group. Gender distribution was found mostly same. Halishahar area which is located in western part of the Chittagong city was found mostly affected 196(85.2%). Use of water from WASA (Water and Sewerage Authority) supply was 168(73%) and deep tubewel water was 56(24.3%). Among them 80(34.8%) subjects do not boil water Anorexia (74.8%) nausea (77.4%) vomiting (83.5%) history of fever (89.6%) passage of dark color urine (99.1%) and weakness (97.4%) were some common presenting complaints. Family history of jaundice was found in 40.9% of cases. Among all 216(93.91%) had clinical jaundice, 91(39.56%) had right upper quadrant of the abdomen pain, 41(17.8%) had hepatomegally, 14(6.1%) had spleenomegally, 24(10.4%) had signs of hepatic failure and 34(14.8%) female were pregnant. Anti HEV was found positive in 164(71.3%) cases, 12(5.2%) were positive for anti HAV, 6(2.6%) were positive for HBsAg. None was found anti HCV positive. Among all 4(1.8%) cases died due to hepatic failure or multi-organ failure with AKI. All of them were pregnant. Two pregnant lady had missed abortion. Among all 11(4.7%) cases loosed follow and 213(92.60%) cases had uneventful recovery.&#x0D; Conclusion: This outbreak of HEV was of usual pattern of morbidity and mortality, and therefore points to water supply and sanitation issues.&#x0D; Chatt Maa Shi Hosp Med Coll J; Vol.17 (2); Jul 2018; Page 2-5