Objective: Increasing the emergence of Metallo-β-lactamase (MBL) producing gram-negative bacteria and their dexterous horizontal transmission demands rapid and accurate detection. This study was conducted to determin...Objective: Increasing the emergence of Metallo-β-lactamase (MBL) producing gram-negative bacteria and their dexterous horizontal transmission demands rapid and accurate detection. This study was conducted to determine a suitable method to promptly detect MBL-producing gram-negative bacteria. Methods: A total of 103 gram-negative bacteria were identified from various clinical samples at a tertiary care hospital in Dhaka city. MBL producers were detected by two phenotypic methods, the Disk Potentiation Test (DPT) and the Double Disk Synergy Test (DDST) based on β-lactam chelator combinations where EDTA/SMA has been used as an inhibitor and Imipenem, Ceftazidime as substrates. Results: 103 isolates which were identified as Escherichia coli spp, Klebsiella spp, Pseudomonas spp, Acinetobacter spp, Proteus spp, Providencia spp were found to be multidrug-resistant in antibiogram test. Isolates showed complete resistance (100%) to Imipenem, Meropenem, and Amoxiclav. The highest carbapenem-resistant etiological agents were Acinetobacter spp 40 (38.8%) followed by Pseudomonas spp 27 (26.2%), Klebsiella spp 26 (25.2%), Escherichia coli 8 (7.8%), Proteus spp 1 (1%) and Providencia spp 1 (1%). DPT method detected significantly (p = 0.000009) a higher number of MBL-producers (Imipenem with 0.5 M EDTA n = 61, 59.2% & Ceftazidime with 0.5 M EDTA n = 56, 54.4%) compared to the DDST method (Imipenem -0.5 M EDTA n = 43, 41.7%, Imipenem – SMA n = 38, 36.9% & Ceftazidime -0.5 M EDTA n = 15, 14.6%). Conclusion: Pieces of evidence suggest that DPT is a more sensitive method than DDST and could be recommended for identifying MBL-producing bacteria in Bangladeshi hospitals for the proper management of patients, to reduce time constraints and treatment costs.展开更多
目的:探讨心肺运动试验指标在冠心病患者中对冠状动脉病变程度的预测价值,为冠心病患者应用无创检测手段预测冠脉病变程度提供客观依据,以及为冠心病患者制定运动处方予以客观指导。方法:入选2020年3月—2022年5月期间,在昆明医科大学...目的:探讨心肺运动试验指标在冠心病患者中对冠状动脉病变程度的预测价值,为冠心病患者应用无创检测手段预测冠脉病变程度提供客观依据,以及为冠心病患者制定运动处方予以客观指导。方法:入选2020年3月—2022年5月期间,在昆明医科大学附属心血管病医院就诊的冠心病患者53例,均完善冠脉造影检查及心肺运动试验(cardiopulmonary exercise test,CPET)检查,根据冠状动脉造影进行SYNTAX(synergy between percutaneous coronary intervention with Taxus and cardiac surgery,SYNTAX)评分,依据评分结果分为低分组(SYNTAX≤22分)30例和中高分组(SYNTAX>22分)23例,收集患者的一般资料,性别、年龄、BMI、并发症等,采集患者的心肺运动试验指标。结果:相较于中高分组而言,低分组最大摄氧量(_(max)imum oxygen uptake,VO_(2max))、最大摄氧量占预计值的百分比(_(max)imum oxygen uptake as a percentage of the predicted value,VO_(2max%P))、最大代谢当量(_(max)imum metabolic equivalent,METS_(max))、最大心率(_(max)imum heart rate,HR_(max))、最大心率占预计值的百分比(_(max)imum heart rate as a percentage of predicted value,HR_(%P))更高,组间差异有显著性意义(P<0.05);相较于中高分组而言,低分组心率储备(heart rate reserve,HRR)更低,组间差异具有显著性意义(P<0.05);SYNTAX评分与VO_(2max)、VO_(2max%P)、最大公斤摄氧量(_(max)imum oxygen uptake in kilograms,VO_(2max)/kg)、METS_(max)、HR_(max)、HR_(%P)呈负相关,与HRR呈正相关(P<0.05);HRR在预测冠心病中敏感性最高。结论:SYNTAX评分低分组即冠脉病变较轻的冠心病患者VO_(2max)、VO_(2max%P)、VO_(2max)/kg、METS_(max)、HR_(max)、HR_(%P)值更高,提示该组患者心肺储备功能更好,运动能力更强,高分组即冠脉病变较重的冠心病患者HRR更高,患者运动过程中最大心率与目标心率差距更大,更难达到目标心率。展开更多
目的测试基于Synergy加速器微光刀立体定向放射治疗系统(Dual Camera 2 mm Stereotactic Radiosurgery,D2SRS)的准确性和可靠性。方法对Synergy加速器机械性能进行测试,判断加速器现有状态是否满足D2SRS及相关放射治疗技术的使用条件。...目的测试基于Synergy加速器微光刀立体定向放射治疗系统(Dual Camera 2 mm Stereotactic Radiosurgery,D2SRS)的准确性和可靠性。方法对Synergy加速器机械性能进行测试,判断加速器现有状态是否满足D2SRS及相关放射治疗技术的使用条件。同时对D2SRS的多叶准直器系统、图像引导系统、治疗计划系统分别进行测试,确定其临床实施的可靠性和准确性。结果加速器性能测试各参数指标均符合相应标准,其中机架及小机头等中心旋转测试中,在150°机架时偏离基线最大(0.9 mm),在30°小机头角度时偏离基线最大(0.8 mm),且外挂多叶光栅(Multi-leaf Collimator,MLC)并未对其精度产生影响。D2SRS各参数精准度均在要求范围之内,MLC与加速器中心无偏差,位置精度验证中在(-5,-3)位置偏差最大为0.7 mm,具备了实施立体定向放射治疗技术的先决条件。结论对加速器现有状态及D2SRS各系统测试结果总体满足临床要求,在做好日常质量控制的基础上可用于患者治疗。展开更多
文摘Objective: Increasing the emergence of Metallo-β-lactamase (MBL) producing gram-negative bacteria and their dexterous horizontal transmission demands rapid and accurate detection. This study was conducted to determine a suitable method to promptly detect MBL-producing gram-negative bacteria. Methods: A total of 103 gram-negative bacteria were identified from various clinical samples at a tertiary care hospital in Dhaka city. MBL producers were detected by two phenotypic methods, the Disk Potentiation Test (DPT) and the Double Disk Synergy Test (DDST) based on β-lactam chelator combinations where EDTA/SMA has been used as an inhibitor and Imipenem, Ceftazidime as substrates. Results: 103 isolates which were identified as Escherichia coli spp, Klebsiella spp, Pseudomonas spp, Acinetobacter spp, Proteus spp, Providencia spp were found to be multidrug-resistant in antibiogram test. Isolates showed complete resistance (100%) to Imipenem, Meropenem, and Amoxiclav. The highest carbapenem-resistant etiological agents were Acinetobacter spp 40 (38.8%) followed by Pseudomonas spp 27 (26.2%), Klebsiella spp 26 (25.2%), Escherichia coli 8 (7.8%), Proteus spp 1 (1%) and Providencia spp 1 (1%). DPT method detected significantly (p = 0.000009) a higher number of MBL-producers (Imipenem with 0.5 M EDTA n = 61, 59.2% & Ceftazidime with 0.5 M EDTA n = 56, 54.4%) compared to the DDST method (Imipenem -0.5 M EDTA n = 43, 41.7%, Imipenem – SMA n = 38, 36.9% & Ceftazidime -0.5 M EDTA n = 15, 14.6%). Conclusion: Pieces of evidence suggest that DPT is a more sensitive method than DDST and could be recommended for identifying MBL-producing bacteria in Bangladeshi hospitals for the proper management of patients, to reduce time constraints and treatment costs.
文摘目的:探讨心肺运动试验指标在冠心病患者中对冠状动脉病变程度的预测价值,为冠心病患者应用无创检测手段预测冠脉病变程度提供客观依据,以及为冠心病患者制定运动处方予以客观指导。方法:入选2020年3月—2022年5月期间,在昆明医科大学附属心血管病医院就诊的冠心病患者53例,均完善冠脉造影检查及心肺运动试验(cardiopulmonary exercise test,CPET)检查,根据冠状动脉造影进行SYNTAX(synergy between percutaneous coronary intervention with Taxus and cardiac surgery,SYNTAX)评分,依据评分结果分为低分组(SYNTAX≤22分)30例和中高分组(SYNTAX>22分)23例,收集患者的一般资料,性别、年龄、BMI、并发症等,采集患者的心肺运动试验指标。结果:相较于中高分组而言,低分组最大摄氧量(_(max)imum oxygen uptake,VO_(2max))、最大摄氧量占预计值的百分比(_(max)imum oxygen uptake as a percentage of the predicted value,VO_(2max%P))、最大代谢当量(_(max)imum metabolic equivalent,METS_(max))、最大心率(_(max)imum heart rate,HR_(max))、最大心率占预计值的百分比(_(max)imum heart rate as a percentage of predicted value,HR_(%P))更高,组间差异有显著性意义(P<0.05);相较于中高分组而言,低分组心率储备(heart rate reserve,HRR)更低,组间差异具有显著性意义(P<0.05);SYNTAX评分与VO_(2max)、VO_(2max%P)、最大公斤摄氧量(_(max)imum oxygen uptake in kilograms,VO_(2max)/kg)、METS_(max)、HR_(max)、HR_(%P)呈负相关,与HRR呈正相关(P<0.05);HRR在预测冠心病中敏感性最高。结论:SYNTAX评分低分组即冠脉病变较轻的冠心病患者VO_(2max)、VO_(2max%P)、VO_(2max)/kg、METS_(max)、HR_(max)、HR_(%P)值更高,提示该组患者心肺储备功能更好,运动能力更强,高分组即冠脉病变较重的冠心病患者HRR更高,患者运动过程中最大心率与目标心率差距更大,更难达到目标心率。
文摘目的测试基于Synergy加速器微光刀立体定向放射治疗系统(Dual Camera 2 mm Stereotactic Radiosurgery,D2SRS)的准确性和可靠性。方法对Synergy加速器机械性能进行测试,判断加速器现有状态是否满足D2SRS及相关放射治疗技术的使用条件。同时对D2SRS的多叶准直器系统、图像引导系统、治疗计划系统分别进行测试,确定其临床实施的可靠性和准确性。结果加速器性能测试各参数指标均符合相应标准,其中机架及小机头等中心旋转测试中,在150°机架时偏离基线最大(0.9 mm),在30°小机头角度时偏离基线最大(0.8 mm),且外挂多叶光栅(Multi-leaf Collimator,MLC)并未对其精度产生影响。D2SRS各参数精准度均在要求范围之内,MLC与加速器中心无偏差,位置精度验证中在(-5,-3)位置偏差最大为0.7 mm,具备了实施立体定向放射治疗技术的先决条件。结论对加速器现有状态及D2SRS各系统测试结果总体满足临床要求,在做好日常质量控制的基础上可用于患者治疗。
