Objectives: To assess the relationship of variation of blood pressure and neurological deterioration (ND) in ischemic stroke patients. Methods: We recruited patients with the fi rst-ever ischemic stroke at a teaching hospital. The National Institutes of Health Stoke Score (NIHSS) of each patient was monitored for 2 months. ND was defi ned as an increase of ≥ 2 points in NIHSS during the fi rst 7 days after stroke. Blood pressure was measured every 6 hours for fi rst 7 days. We analyzed blood pressure data in the fi rst 36 hours to study the relationship between variation of blood pressure and ND. Successive variation of systolic (svSBP) and diastolic (svDBP) blood pressure was calculated as svSBP= |SBPn+1 – SBPn | and svDBP= |DBPn+1 – DBPn | respectively. The largest svSBP in the fi rst 36 hours of hospitalization or before ND was defi ned as maximum variation of systolic blood pressure (maxvSBP). Then, the mean variation of systolic (mvSBP) and diastolic (mvDBP) blood pressure was calculated as mvSBP= svSBP/N and mvDBP= svDBP/N respectively. Results: A total of 121 patients were included in this study, and 38 of them had ND. The mvSBP was higher in the ND Group (17.9±8.4 mmHg vs. 13.7±4.4 mmHg, p=0.006) but the difference in mvDBP did not reach statistical signifi cance (9.8±3.5mmHg vs. 8.6±3.0 mmHg p=0.06). The ND Group had a larger maxvSBP (35.2±17.2 vs. 27.6±11.6 mmHg, p =0.01), which was more frequently over 30mmHg than that in the stable group (P=0.02). Conclusions: A large svSBP is associated with an increased risk for ND. The study highlights the importance of close monitoring of blood pressure in ischemic stroke patients.

Purpose: To investigate urothelial cell proliferation, cytoskeleton, inflammation, and barrier function protein expressions in patients with interstitial cystitis/bladder pain syndrome (IC/BPS) after intravesical platelet-rich plasma (PRP) injections Methods: A total of 19 patients with IC/BPS underwent 4 monthly intravesical PRP injections. Bladder biopsies were taken at the first and fourth PRP treatment. The bladder specimens were analyzed using the Western blot and immunochemical staining for progenitor cell markers for sonic hedgehog (Shh), CD34, and cytoskeleton proteins cytokeratin 5 (CK5), CK14, CK20; barrier function markers for zonula occludens-1 (ZO-1), E-cadherin, and intercellular adhesive molecule-1, tryptase and transforming growth factor-β (TGF-β). Global response assessment (GRA) was used to evaluate treatment outcomes. Results: The mean age of patients was 55.6 years. After PRP injections, the functional bladder capacity and maximum flow rate increased, and the visual analogue scale (VAS) of pain, interstitial cystitis (IC) symptom index, IC problem index, O’Leary-Sant symptom score, and GRA improved in all patients. Urothelium Shh, CK5, ZO-1, E-cadherin, and TGF-β expressions increased significantly after repeated PRP injections. By subgrouping, according to PRP treatment outcomes, significant increases in Shh, E-cadherin, and ZO-1 expressions were noted only in patients with GRA ≥1 or improved VAS, but not in patients with GRA=0 and no improvement in VAS. Conclusions The level of urothelial barrier function protein and cell proliferation protein expression in the patients with IC/BPS was increased after repeat intravesical PRP injections. Intravesical repeat PRP injections may have potential to improve urothelial health and result in symptoms improvement in the patients with IC/BPS.

PURPOSE: To compare the clinical and computed tomography (CT) appearances of liver abscesses caused by non-Klebsiella pneumoniae bacterial pathogens in elderly and nonelderly patients. MATERIALS AND METHODS: Eighty patients with confirmed non-Klebsiella pneumoniae liver abscesses (non-KPLAs) were enrolled and divided into two age groups: elderly (age > or =65 years, n=42) and nonelderly (age <65 years, n=38). Diagnosis of non-KPLA was established by pus and/or blood culture. We compared clinical presentations, outcomes, and CT characteristics of the two groups, and performed multivariate analysis for significant variables and receiver-operating-characteristic analysis to determine the cutoff value of abscess diameter for predicting non-KPLA. RESULTS: Elderly patients with non-KPLA were associated with a longer hospital stay (p<0.01). Regarding etiology, biliary sources had a strong association in the elderly group (p<0.01), and chronic liver diseases were related to the nonelderly group (p<0.01). Non-KPLAs (52.5%) tended to show a large, multiloculated appearance in the elderly group and were associated with bile duct dilatation (p<0.01), compared with the nonelderly group. The abscess diameter (cutoff value, 5.2 cm; area under the curve, 0.78) between the two groups was predicted. In multivariate analysis, underlying biliary tract disease [odds ratio (OR), 3.58, p<0.05], abscess diameter (OR, 2.40, p<0.05), and multiloculated abscess (OR, 1.19, p<0.01) independently predicted elderly patients with non-KPLA. CONCLUSION: In the elderly patients with non-KPLA, a large, multiloculated abscess with a diameter greater than 5.2 cm was the predominant imaging feature.
Adult ; Aged ; Aged, 80 and over ; Bacterial Infections/*complications/*radiography ; Female ; Humans ; Klebsiella Infections/microbiology ; Klebsiella pneumoniae ; Length of Stay ; Liver Abscess/complications/microbiology/*radiography ; Logistic Models ; Male ; Microscopy ; Middle Aged ; Multivariate Analysis ; ROC Curve ; Retrospective Studies ; Tomography, X-Ray Computed/*methods

PURPOSE: To compare the clinical and computed tomography (CT) appearances of liver abscesses caused by non-Klebsiella pneumoniae bacterial pathogens in elderly and nonelderly patients. MATERIALS AND METHODS: Eighty patients with confirmed non-Klebsiella pneumoniae liver abscesses (non-KPLAs) were enrolled and divided into two age groups: elderly (age > or =65 years, n=42) and nonelderly (age <65 years, n=38). Diagnosis of non-KPLA was established by pus and/or blood culture. We compared clinical presentations, outcomes, and CT characteristics of the two groups, and performed multivariate analysis for significant variables and receiver-operating-characteristic analysis to determine the cutoff value of abscess diameter for predicting non-KPLA. RESULTS: Elderly patients with non-KPLA were associated with a longer hospital stay (p<0.01). Regarding etiology, biliary sources had a strong association in the elderly group (p<0.01), and chronic liver diseases were related to the nonelderly group (p<0.01). Non-KPLAs (52.5%) tended to show a large, multiloculated appearance in the elderly group and were associated with bile duct dilatation (p<0.01), compared with the nonelderly group. The abscess diameter (cutoff value, 5.2 cm; area under the curve, 0.78) between the two groups was predicted. In multivariate analysis, underlying biliary tract disease [odds ratio (OR), 3.58, p<0.05], abscess diameter (OR, 2.40, p<0.05), and multiloculated abscess (OR, 1.19, p<0.01) independently predicted elderly patients with non-KPLA. CONCLUSION: In the elderly patients with non-KPLA, a large, multiloculated abscess with a diameter greater than 5.2 cm was the predominant imaging feature.
Adult ; Aged ; Aged, 80 and over ; Bacterial Infections/*complications/*radiography ; Female ; Humans ; Klebsiella Infections/microbiology ; Klebsiella pneumoniae ; Length of Stay ; Liver Abscess/complications/microbiology/*radiography ; Logistic Models ; Male ; Microscopy ; Middle Aged ; Multivariate Analysis ; ROC Curve ; Retrospective Studies ; Tomography, X-Ray Computed/*methods

BACKGROUND: Particulate matter (PM) < 2.5 μm (PM METHODS: We obtained DNA methylation and exercise data of 496 participants (aged between 30 and 70 years) from the Taiwan Biobank (TWB) database. We also extracted PM RESULTS: DLEC1 methylation and PM CONCLUSIONS We found significant positive associations between PM
Adult ; Aged ; Air Pollutants/adverse effects* ; DNA Methylation/drug effects* ; Environmental Exposure/adverse effects* ; Exercise ; Female ; Humans ; Male ; Middle Aged ; Particulate Matter/adverse effects* ; Taiwan ; Tumor Suppressor Proteins/metabolism*