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OBJECTIVE: Pleural fluid pH measurement is recommended for tube thoracostomy decisions in complicated parapneumonic pleural effusions. However, pleural fluid pH may be affected by blood pH in critically ill patients with common systemic acid-base disorders. We aimed to investigate the use of pleural fluid lactate to distinguish culture-positive parapneumonic effusions from other pleural effusions. MATERIAL AND METHODS: This prospective observational study included 121 eligible patients (51 female and 70 male). All patients with pleural effusion who underwent thoracentesis were assessed. Pleural fluid lactate was measured by a blood gas analyzer. RESULTS: Of the 121 patients, 30 (24.8%) were transudate and 91 (75.2%) were exudate. Of the 91 patients with exudative pleural effusion, 61 were diagnosed as culture-negative parapneumonic, 13 as culture-positive parapneumonic, 9 as malignant, and 8 as other exudative effusion. There was a strong positive linear association between serum pH and pleural fluid pH (R = 0.77, P < .001). The post hoc tests for pleural fluid lactate revealed there was a significant difference between culture-positive parapneumonic versus culture-negative parapneumonic groups (P = .004), culture-positive parapneumonic versus transudative effusion groups (P < .001), culture-negative parapneumonic versus transudative effusion groups (P = .008) and lastly; malignant effusion versus transudative effusion groups (P = .001). Receiver operating characteristics curve analysis for culture-positive parapneumonic indicated a cutoff of 4.55 mmol/L for pleural fluid lactate to have a sensitivity of 76.9% and a specificity of 84.3% (positive predictive value: 37%, negative predictive value: 96.8%). CONCLUSION: A cutoff of 4.55 mmol/L of pleural fluid lactate can be used as a useful tool to distinguish culture-positive parapneumonic effusions from other effusions in critically ill patients. [ABSTRACT FROM AUTHOR]

Obwohl die Notwendigkeit eines Managements für die Blutversorgung im Krisenfall anerkannt ist, existieren in Deutschland derzeit noch keine bundesweit abgestimmten Maßnahmenpläne für akute oder chronische Versorgungsengpässe. Letztere könnten sich beispielsweise am Blood Supply Contingency and Emergency Plan des European Directorate for the Quality of Medicine & Health (EDQM) von 2022 orientieren. [ABSTRACT FROM AUTHOR]

Normally, horse urine is light-dark yellow and can be thread-like due to its high mucin content. The physiological pH value is 7–9, the urine specific gravity is 1.020–1.050 g/ml. The macroscopic examination of the urine provides important information. Dependent on the amount of fluid intake the colour of urine can range from almost colourless to dark brown discoloration. Furthermore, the colour depends on the substances that are excreted with the urine. The presence of blood in the urine is pathological and called haematuria. In this case, the urine is so heavily contaminated with blood that even blood clots can be excreted. However, if the urine is only reddish in colour, haematuria must be distinguished from haemoglobinuria or myoglobinuria. To differentiate it macroscopically alone can be difficult so that horse owners may wrongly report that their horse has passed bloody urine. The occurrence of haematuria involves a wide range of differential diagnoses that must be systematically clarified. It is essential to differentiate between systemic diseases and those of the urinary system. In the first place a general examination should be carried out. Then it should be followed by a hematological examination and an analysis of the urine. If the urine is collected spontaneously, the midstream urine is most suitable for further investigations, as contaminations have been flushed out before collection. If these investigations result that there is a disease of the urinary tract, transrectal palpation and transrectal and transabdominal sonographic examination should also be performed. Further diagnostic procedures such as urethroscopy and cystoscopy are also indicated. In the following case report, a twenty-three-year-old Oldenburg gelding with macrohematuria was presented. Cystoscopy revealed a mass whose surface was uneven, rough and partly covered with fibrin and blood clots. A transendoscopic biopsy was requested. Depending on the consistency and location of the growth, sampling may be difficult. A temporary perineal urethrotomy facilitates biopsy collection while providing the opportunity for direct visualization of the urinary bladder contents. Perineal urethrotomy is a well-known method in male patients with obstructive urinary tract disease for temporary diversion of urine. In the following case report, this method was performed to obtain a sufficiently large biopsy specimen using uterine biopsy forceps. The results of the mentioned examinations resulted in the diagnosis of a transitional cell carcinoma (TCC) in the urinary bladder. Primary bladder tumors are very rare in horses and often produce a reactive inflammatory change. The urinary tract is lined with transitional cell epithelium, so transitional cell carcinoma can occur in any section, but most commonly in the bladder wall in horses. It must be clarified whether there are already metastases. Depending on the stage, spread and size of this malignant tumour, therapy can be considered. Surgical removal of a bladder tumour in horses is difficult due to the anatomical location of the urinary bladder in the abdominal cavity and the tendency of these tumors to invade the bladder wall. However, various therapeutic approaches have been described in the literature. Authors report chemotherapy, irradiation with a diode laser or surgical ablation of the cancerous tissue and oral application of piroxicam. Pronounced clinical symptoms are only seen at an advanced stage of the tumour, so that the disease is diagnosed mostly too late for a curative approach. However, early diagnosis is crucial for the prognosis and therefore a detailed diagnostic investigation is required in the case of microhaematuria. Because of the late stage of the disease and the poor prognosis the patient of the current report was euthanized. [ABSTRACT FROM AUTHOR]

Die Zeiten, in denen nur Laktat und Kreatinkinase als blutbasierte Biomarker für die Belastungssteuerung zur Verfügung standen, sind lange vorbei. Heutzutage steht eine große Anzahl von Biomarkern aus Blut, Urin und Spei)chel zur Verfügung. Ob deren Einsatz zusätzlich zu Trackingsystemen und Fragebögen sinnvoll ist, sollte sorgfältig geprüft werden. Sowohl die Probenentnahme und die Analyse als auch die Interpretation der generierten Daten erfordern Expertise. [ABSTRACT FROM AUTHOR]

In scholarly exegetical literature, there exists an important debate concerning whether Luke interprets the death of Jesus soteriologically in Luke-Acts. The passages Luke 22:19–20 and Acts 20:28 have been the centre of attention in this discussion. This essay presents a contribution to the debate by focusing on Acts 20:28: Maintaining the primary meaning of the term ἴδιος ("separate," "distinct") the author suggests a new translation of the prepositional phrase διὰ τοῦ αἵµατος τοῦ ἰδίου. The new reading conveys a more ecclesiological interpretation of the death of Jesus and has the advantage of being able to integrate Acts 20:28 into Luke's wider conceptual framework. [ABSTRACT FROM AUTHOR]

In his De errore profanarum religionum, Firmicus Maternus fiercely attacks the traditional cults of the Roman Empire as well as the mysteries, which he considers to be the invention of the devil and a complete perversion of Christian sacraments. This paper analyses the motif of blood in his work. A close reading of the text reveals that Firmicus applies dichotomic functions to the use of blood in ritual contexts, such as poison and remedy, purity and pollution, and salvation and damnation. These dichotomies serve two purposes for him: First, they allow him to construct clear boundaries between the pagan religion (deliberately constructed as 'one' system and suppressing its diversity) and Christianity as two opposing religious systems. Second, by turning the tables, they allow him to undermine the traditional conceptions concerning ritually used blood. Thus, he presents 'pagan' blood as being venomous, polluting, and only leading on the road to perdition, whereas only the blood of Christ truly has the power to heal, to cleanse, to redeem, and to grant eternal salvation. [ABSTRACT FROM AUTHOR]

In accordance with the current German dementia guidelines, the dementia biomarkers amyloid beta 42, the tau peptides total tau and phosphorylated tau 181 are recommended for cerebrospinal fluid (CSF)-based diagnostics of dementia. Several studies have clearly shown that determination of the amyloid beta 42 to amyloid beta 40 peptide ratio is superior to the interpretation of amyloid beta 42 alone and should be implemented in the clinical work-up; however, in recent years different studies have presented many other innovative CSF and blood-based biomarkers. Besides CSF-based neurochemical diagnostics of dementia promising novel protocols for the detection of amyloid beta peptides in blood have meanwhile been published, which can currently be used in clinical studies for blood-based early diagnostics of Alzheimer's dementia. Following further validation and assay optimization these blood assays should be available for routine diagnostics in the near future. [ABSTRACT FROM AUTHOR]

Hämatopoetische Stammzellen sollen nach ihrer Transplantation beim Patienten für eine lebenslange, funktionelle Repopulation aller Linien des Blutes sorgen. Um das Potenzial der Stammzellpräparationen zur vollständigen Rekonstitution der Hämatopoese besser abschätzen zu können, ist deren detaillierte Charakterisierung essenziell. Eine Arbeitsgruppe der DGTI soll dafür die Grundlagen schaffen. [ABSTRACT FROM AUTHOR]

Derzeit sind 38 Blutgruppensysteme von der International Society of Blood Transfusion (ISBT) anerkannt, denen Polymorphismen in 45 Genen zugrunde liegen. Die meisten dieser Polymorphismen basieren auf Punktmutationen, die zu neuen Antigenen oder dem Fehlen von Antigenen führen. In der Diagnostik kommen bewährte Verfahren, wie die PCR-SSP, und neuere Verfahren, wie das Next Generation Sequencing, zum Einsatz. [ABSTRACT FROM AUTHOR]

The article informs on the classification principle of the immune system. It mentions classification is based on the distinction between innate versus acquired immune systems, and to detect hormones in the blood in the lowest concentrations using immunoassays and to produce specific drugs against tumor antigens or infectious agents such as SARS-CoV-2 on an industrial scale.

Human albumin (HA) is by far the most expensive option for volume replacement and correction of hypoalbuminemia but is still widely used. The value of HA in the clinical setting continues to be controversial and it remains unclear whether there is still a place for using such a high-priced substance in the present cost-consciousness climate. Thus the Medical Council has presented some recommendations with regard to blood and plasma products including HA. There appear to be no indications for HA to correct hypovolemia either perioperatively or in the intensive care setting including children and patients undergoing cardiac or liver surgery. For maintaining colloid oncotic pressure (COP) cheaper modern synthetic colloids can be alternatively given and the value of HA for correcting hypoalbuminemia is also not clearly justified. Some small uncontrolled studies have shown that only patients with liver cirrhosis, spontaneous bacterial peritonitis and massive ascites drainage may profit from HA. Theoretical benefits such as oxygen radical scavenging or binding of toxic substances are no indications for using HA as benefical clinical consequences have not yet been demonstrated. Experimental data from cell lines or animals must be viewed with skepticism because they do not mimic the clinical setting. According to the recommendations of the scientific advisory board of the Medical Council the use of HA should be considered very cautiously. [ABSTRACT FROM AUTHOR]

Over the past 10 years, the status of laboratory analysis in dementia has increasingly changed from its use for exclusion diagnoses for secondary causes of dementias to determining positive diagnoses of neurodegenerative dementias. This especially applies to the cerebrospinal fluid diagnosis of Alzheimer's disease (AD). Just a few years ago, a lumbar puncture was advised only with sufficiently founded clinical suspicion and with higher priority for the exclusion of inflammatory causes of cognitive dementias. In contrast, pathologically changed biomarkers in the cerebrospinal fluid have already been indexed as supportive attributes of the diagnosis in the 2007 amended research criteria of AD. The lumbar puncture is therefore increasingly becoming part of the clinical routine diagnosis of demential processes and has, to some extent, far-reaching consequences. In this article, we discuss some of the important aspects. [ABSTRACT FROM AUTHOR]

The article reports that the devices are currently being developed and methods rather towards optimizing existing test procedures as well in expanding the range for different target groups and laboratory sizes. It notes that the fully automatic machines for immunohematology determine blood groups and identify any irregular ones that may be present. It states that antibodies to prevent blood transfusion ensure the compatibility of the blood of the donor and recipient.

The article presents information on sepsis. It states that sepsis is a life-threatening disease as it causes bacteria and fungi in blood, and so its also called blood poisoning disease. It mentions that around 150000 people fall ill in Germany due to sepsis every year, and around 60000 of them die.

In 19 marathon runners of both sexes, plasma concentrations of total creatine kinase (CK) activity, CKMB mass, myoglobin and troponin I were determined before and immediately after the race. Total CK activity and myoglobin increased significantly in all runners and showed neither a correlation with the individual age of the runners nor with the time they needed to reach the goal. In 12 of the runners, CKMB mass increased during the race to a level suggesting myocardial necrosis. However, the runners did not show any detectable deterioration of cardiac function after the race. The appearance of considerable amounts of muscle proteins in plasma precipitated by the muscle strain during the race seems explained by damage of skeletal muscle detected by histological studies. These phenomena may also be a consequence of profoundly disturbed cellular permeability, perhaps due to a kind of local stunning of muscle tissue by prolonged muscular strain. [ABSTRACT FROM AUTHOR]

The cure of a tumor patient with gastrointestinal cancer is dependent on the extension of the primary tumor (TNM-classification) and the option of curative resection (RO-resection) at the time of operation. The additional application of multimodal therapy approaches has lead to an improvement of prognosis in different advanced tumor stages. Nevertheless. despite curative tumor resection about 50% of patients with locally advanced gastrointestinal cancer develop recurrent tumor disease or distant metastases and die tumor-related. A possible explanation is the seed of disseminated tumor cells in blood, bone marrow or lymph nodes pre-, intra- or postoperatively, but also during diagnostic procedures. Several studies have shown in the last years that the presence of minimal residual disease (MRD) influences the course of disease and the patient's prognosis after curative tumor resection. Although several groups have reported the prognostic impact of disseminated tumor cells in the different compartiments of bone marrow, lymph nodes and blood, the phenomenon of minimal residual disease is not acknowledged as an established prognostic factor and is not integrated into the classification of the UICC. Therefore, no therapeutic consequences were drawn at present from the detection of disseminated tumor cells in patients with gastrointestinal cancer. A possible explanation are missing multi-center-studies, which confirm the results of the several single-center-studies. Standardization of study designs and methodical procedures and the evidence of reproduction are mandatory in order to value and interpret the multitude of studies and the available data in this field. Only these results will allow to decide if the presence and detection of disseminated tumor cells can alter the tumor staging and individualize or possibly minimize further oncological therapy strategies. [ABSTRACT FROM AUTHOR]

Catheterization of the internal jugular vein is used for temporary access to the central vein in patients with acute or chronic renal failure. The most frequent problem is the arterial puncture and accidental placement of the large catheter in an artery. This case report describes a rare secondary complication by accidental catheterization of the right common carotid artery after intended dual lumen catheter insertion into the right internal jugular vein. A false aneurysm with pharyngeal hemorrhaging developed 2 weeks after the puncture. The diagnosis was made using colour-Doppler ultrasound and the aneurysm was treated with vascular surgery. [ABSTRACT FROM AUTHOR]