Search

Introduction Diagnostic algorithms are used for detection of periprosthetic joint infection (PJI) including sampling for histological evaluation (HE). The purpose was to assess the diagnostic significance of emergency HE of fresh-frozen intraoperative biomaterial as part of preoperative PJI screening of patients undergoing revision total knee arthroplasty (RTKA). Material and methods The prospective study included 83 patients who were admitted to two trauma and orthopaedic centers for RTKA. The European Bone and Joint Infection Society 2021 (EBJIS21) algorithm was used to detect PJI of the knee joint. The diagnostic value of screening PJI with/without regard to the results of an emergency HE was compared with the results of a microbiological study (MBI) of all types of biomaterials obtained from each patient. Subanalysis was additionally performed in patients with aseptic instability and antimicrobial spacer. Results Pathomorphological examination of freshly frozen and paraffin-embedded tissues showed the difference of 7.2 %, which did not significantly affect the interpretation of the results (p > 0.05). Diagnostically significant pathogens were identified in 83.3 % of cases with PJI confirmed by emergency HE (p < 0.001). A positive emergency HE result increased the chances of isolating diagnostically significant organisms by 34 times (95 % confidence interval (CI): 4.721 – 244.859) as compared with negative HE cases. The proportion of detected cases with emergency HE included in the screening increased from 2.4 to 8.4 %. The inclusion of emergency HE in the screening improved the diagnostic value both in the general cohort of patients and in the subanalysis of comparison groups due to a two-fold increase in sensitivity. Conclusion Relevance of the emergency HE results and the PJI criteria should be considered as a significant prognostic factor for an infectious process, however, this technique should be used only in a complex algorithm for PJI detection. Poor outcomes in 18.2 % of cases of probable PJI necessitated a change in the approach to managing this cohort of patients.

Background. Experimental data suggest that tumor growth depends on angiogenesis. Once the tumor reaches a size of up to a 1 mм in diameter, a further increase in the population of tumor cells requires the growth of new blood vessels. In contrast to benign lesions, a rapid growth of cancer cells results in the formation of pathological vessels of different diameter and chaotic distribution. therefore, determination of the type of vascularization of lesions is an important criterion in the diagnosis of breast cancer (Bc). color Doppler mapping (cDM) is an ultrasound technology that evaluates blood floor through a blood vessel; however, according to data from a variety of literature sources, cDM is not sensitive to slow (week) blood flow as it allows the visualization of only large vessels with a diameter of at least 100 µm. The purpose of the study was to evaluate the diagnostic value of cDM in determining the type of vascularization of malignant and benign breast tumors, as well as to detect their statistically significant Doppler characteristics by comparing with histological findings. material and methods. From 2017 to 2019, a total of 277 women with complaints of breast lump or pain underwent ultrasound examination using cDM. Results. statistically and diagnostically significant us characteristics of benign lesions included the presence of avascular or hypovascular types of blood flow. the most significant characteristic of malignant lesions was the presence of hypervascular mixed blood flow. the diagnostic value of ultrasound B-mode in combination with cDM in differential diagnosis of breast tumors was as follows: 77.6 % sensitivity, 51.7 % specificity and 58.8 %. accuracy. Conclusion. statistically and diagnostically significant signs observed by cDM allow one to use this ultrasound technology in the early diagnosis of breast cancer. However, low diagnostic efficiency of cDM dictate the need to search for new ultrasonic signs.

In this study the effects of S-adenosylmethionine (SAM) on experimental hepatic fibrotic rats induced by carbon tetrachloride (CCl(4)) and ethanol and the relevant potential mechanisms were explored. Hepatic fibrotic rat models were established with CCl(4) diluted in olive oil being drunk with 10% ethanol in water. SAM was used both for prevention and treatment. Histological evaluation was carried out by hematoxylin-eosin (HE) and Masson staining of hepatic samples. Serum biochemical assays showed that alanine aminotransferase (ALT) was increased and albumin (ALB) was decreased by CCl(4) and ethanol, and both effects were suppressed by preventing and treating use of SAM. The model control rats got significantly higher scores in fatty degeneration, lobular inflammation, and hepatocyte ballooning. A significant improvement was observed in the SAM-prevented rats and SAM-treated rats, which was consistent with the change of fibrosis scoring in each group. Smad3 was induced by CCl(4) and ethanol in the model control group, which was significantly down regulated by SAM. SAM reduced both total Smad3 and phospho-Smad3 in vitro. SAM had a protective effect on hepatic fibrosis in rats induced by CCl(4) combined with ethanol and the down-regulation of activity and expression of Smad3 were involved in the potential mechanisms.