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Discourse Analysis stands out as a relevant tool in the field of health, since it allows a clearer understanding of the health-disease process by seeking an approach of the professional with the interpretation of the user's language. In this context, this research sought to identify and analyze, through the national and international scientific literature, the contributions of Discourse Analysis theories for Nursing and the most used theoretical references. The study revealed that the French Discourse Analysis was the most prevalent, Michel Foucault the most cited author and also pointed to the scarcity of studies on this subject at the national level. [ABSTRACT FROM AUTHOR]

A retrospective study was conducted in a large sample of acutely hospitalized older patients who underwent therapeutic drug monitoring during levofloxacin treatment. The aim was to assess the population pharmacokinetics (popPK) and pharmacodynamics of levofloxacin among older patients. PopPK and Monte Carlo simulation were performed to define the permissible doses in older patients according to various degrees of renal function. Classification and regression tree (CART) analysis was used to detect the cutoff 24-hour area under the concentration-time curve (AUC 24 )/MIC ratio that best correlated with the clinical outcome. The probability of target attainment (PTA) of this value was calculated against different pathogens. A total of 168 patients were included, and 330 trough and 239 peak concentrations were used for the popPK analysis. Creatinine clearance (CrCL) was the only covariate that improved the model fit (levofloxacin CL = 0.399 + 0.051 × CrCL CKD-EPI [creatinine clearance estimated by means of the chronic kidney disease epidemiology]). Drug doses ranged between 500 mg every 48 h and 500 mg every 12 h in relation to different renal functions. The identified cutoff AUC 24 /MIC ratio (≥95.7) was the only covariate that correlated with a favorable clinical outcome in multivariate regression analysis (odds ratio [OR], 20.85; 95% confidence interval [CI], 1.56 to 186.73). PTAs were optimal (>80%) against Escherichia coli and Haemophilus influenzae , borderline against Staphylococcus aureus , and suboptimal against Pseudomonas aeruginosa The levofloxacin doses defined in our study may be effective for the treatment of infections due to bacterial pathogens, with an MIC of ≤0.5 mg/liter in older patients with various degrees of renal function, while minimizing the toxicity risk. Conversely, the addition of another active antimicrobial should be considered whenever treating infections caused by less susceptible pathogens., (Copyright © 2017 American Society for Microbiology.)

Biopolymers are an attractive class of compounds for being used in biomedical applications as they are widely available from biomass. Their drawback is the lack of mechanical stability and the ability to tune this properly. Covalent chemical cross-linking is an often used approach but it limits usability due to legislation as well as the need of advanced and specialized knowledge by end users such as clinicians. Here, increased and tunable mechanical properties are achieved of alginate-based hydrogels with non-covalent approaches using linear polyethyleneimine (LPEI) as a polyelectrolyte rather than only multivalent metal ions (Ca 2+ ). Gel stiffness increases with increasing LPEI content. Gel morphology changes from a thin fibrous mesh for alginate-Ca 2+ to thicker fibrous networks when LPEI is introduced. The gels are able to efficiently release encapsulated small molecular dyes and the gels are able to host cells. For the cell encapsulation human skin fibroblasts (HSkF) and human bone marrow-derived mesenchymal stem cells (hBM-MSC) are used. HSkF can be successfully incorporated without diminished viability while the matrix components and gel preparation method are not compatible with hBM-MSC. The newly developed alginate-based system is regarded as a potential candidate for wound dressing materials., (© 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.)

We here report the case of a patient with systemic capillary leak syndrome (SCLS). This syndrome is a rare condition characterized by recurrent episodes of hypotension with hemoconcentration and hypoproteinemia. It is due to unexplained episodic capillary hyperpermeabilty that results in fluid and protein shift from the intravascular to the interstitial space: generalized edema, shock and renal failure follow. A 59 yo man was admitted to our intensive care unit because of unexplained shock with hemoconcentration, renal failure, and metabolic acidosis. Previous attemps to reverse shock in a medical ward with crystalloids and dopamine failed. An abdominal CT scan, a TEE, and chest X ray study were inconclusive. No sign or history of major infections or anaphylaxis were present. The patient was resuscitated with massive fluid infusions and norepinephrine on the guide of a Swan Ganz catheter. The diagnosis was made on the basis of a previous episode of severe shock complicated with renal failure and a compartment syndrome, the hemoconcentration, and the negative cardiopulmonary findings. A small amount of monoclonal immunoglobulin G, kappa chain, found in the serum confirmed the diagnosis. The SCLS should be considered in the differential diagnosis of idiopathic and anaphylactic shock. Patients may benefit from a prophylactic treatment with theophilline and terbutaline.

Recent reports have suggested that the immunodetection of tumor cells in bone marrow of small-cell lung cancer (SCLC) patients is by far more effective than traditional cytohistological methods and that this may be clinically relevant. This study aimed to evaluate whether the level of detection of tumor cells in bone marrow is affected by different immunostaining methods. Using two anti-NCAM monoclonal antibodies (MAbs), we compared four different "sandwich" methods on cytospin preparations of the N592 human SCLC cell line and of bone marrow aspirates from 37 SCLC patients. Our data indicate that the combination of the alkaline phosphatase-anti-alkaline phosphatase and streptavidin-biotin-alkaline phosphatase complex methods provides the best results in terms of sensitivity and specificity, and of intensity of immunoreaction and absence of staining background. Moreover, bone marrow micrometastases detected by this method were prognostically relevant and identified, among patients with apparently limited disease according to conventional staging procedures, a subgroup with shorter survival. We suggest that the choice of a sensitive immunostaining technique may significantly increase the detection rate of SCLC cells in bone marrow, mirroring the biological aggressiveness of the disease.

The ability of cancer cells to attach to laminin has been correlated with their metastatic potential and highly metastatic cancer cells seem to express on their surface significantly more laminin receptors than do their much less metastatic or benign counterparts. The expression of 67-kDa laminin receptors (LR) was investigated in a group of 75 patients who underwent gastrectomy for advanced gastric cancer, with special reference to the possible role in the tumor progression and in the overall survival. The tumor LR expression was immunohistochemically determined in paraffin-embedded sections using the MLuC5 monoclonal antibody which recognizes the 67-kDa LR and the avidin-biotin immunoperoxidase method. Of the 75 cases analyzed, 43 cases (57.3%) displayed a positive reaction. The cumulative 5-year survival rate was 72.6% (95% CI 52.5-85.3) for patients without expression of LR and 46.6% (29.8-61.8) for those with positive LR expression. A significant association between LR expression and depth of tumor invasion (0.022) was found. By univariate analysis the presence of laminin receptors seemed to be associated with a higher risk of death [RR 1.72 (95% CI 0.71-4.20], but this effect disappeared after controlling for depth of tumor invasion. In conclusion, these results suggest that tumor expression of laminin receptors could be correlated with tumor aggressiveness. However, the prognostic significance of laminin receptor expression is already provided by the depth of tumor invasion.

Background: Infectious diarrhea is a worldwide problem, with differences from country to country, and it is an important cause of infant morbidity and mortality in the underdeveloped countries., Methods: The present study is a retrospective assessment on bacterial intestinal infections, referring to a hospital survey during the 1995-1996 period. The aim of the work is to verify epidemiological and clinical weight of this diseases. The total number of notifications appears rather small, although the limit relating to non-inclusion of paediatric admissions and Clostridium difficile infections. With regard to this problem, it must be emphasized that non-serious and speed recovering clinical pictures probably escape hospitalization., Results: In the personal research it has been proved the clear supremacy of the group D Salmonella, as referred in other Italian studies. In our investigation, the greater number of cases occurred in summer and the suspected vehicle of infection was frequently foul eggs. The analysis of case reports proved that no importance was ascribed to the research of fecal leucocytes in the diagnostics of diarrhea. With regard to this easy examination, it must be stressed the non-specific role as a screening test for bacterial enteroinvasive infections., Conclusions: The treatment effected constantly involved the maintenance of adequate fluid-electrolyte balance. However the use of an antimicrobical agent recurred frequently, with preference for ciprofloxacin. In relation to the literature reports, this specifical therapeutic approach is discussed.

Exposure to dusts and benzene was studied in 65 traffic policemen. Samples of total dusts showed that mean personal exposure was 0.44 (SD = 0.30) mg/m3, with peaks of about 2 mg/m3. Exposure to 1-nitropyrene (1-NP), the main compound occurring in emissions from diesel engines, which was estimated from concentrations in dusts collected with high-flow samplers, was 0.28 (SD = 0.19) ng/m3 (range: 0.06-1.24 ng/m3). The mean concentration of benzene in the breathing zone was 41 (SD = 20) micrograms/m3, although a level of 100 micrograms/m3 was slightly exceeded in one subject. In urine samples collected before and after workshifts, two biological indicators of exposure to benzene were measured, urinary benzene and urinary trans, trans-muconic acid (MA). The mean values of urinary benzene before and after workshift were similar (98, SD = 81 and 83, SD = 55 ng/l; n = 63; Wilcoxon's T-test = not significant), while a moderate increase in the metabolite was observed (MA = 0.08, SD = 0.11; 0.11, SD = 0.09 mg/g creatinine, in pre- and post-shift samples respectively; Wilcoxon's T-test, z = 3.00; p < 0.01). The levels of exposure to dusts and 1-NP deriving from diesel engine emissions were comparable to those of other occupational groups with this type of risk (garage mechanics, workers operating diesel engine machinery, etc.). Traffic police exposure to benzene was similar to that of the whole population of Padova (40 micrograms/m3, mean annual 24-hour value). However, the values of urinary MA, like those reported by other authors for non-smoker controls, increased after the workshift, indicating low occupational exposure to this pollutant. It should be noted that traffic police exposure to benzene is much lower than that of other occupational categories, e.g., fuel pump distributors.

Cytospins of the MCF-7 cell line and 93 consecutive smears of human malignant neoplasms were immunochemically evaluated for the expression of proliferating cell nuclear antigen (PCNA) and Ki-67-related antigen. Results expressed as the labeling index (LI) were compared with histologic sections. The PCNA LI and Ki-67 LI were lower in cytologic smears than in histologic sections, though the differences were not statistically significant. A positive linear relationship was found between these markers in both cytologic and histologic samples. The PCNA LI was generally lower than the Ki-67 LI, but in seven malignant neoplasms, PCNA LI was greater than the corresponding values of the KI-67 LI. We conclude that cell proliferation can be reliably evaluated on cytologic preparations; PCNA may behave as a Ki-67-like reagent in some tumors, and PCNA may sometimes overestimate the cell growth fraction assessed by Ki-67 immunoreactivity.

Sixty-six unselected breast cancers were analyzed in cytologic smears and histologic sections for the expression of Ki-67, proliferating cell nuclear antigen (PCNA), estrogen receptor protein (ERP), and p53 protein using a standard immunochemical method. The results, expressed as both positive cases and labelling index (LI), were compared with clinical and pathobiological variables. Ki-67 and PCNA immunostaining was seen in all cases, whereas ERP was detectable in 46/63 cases and p53 protein in 20/66 cases. The expression of these markers was generally lower in cytology than in histology, though the differences were not statistically significant. PCNA-LI and Ki-67-LI were closely correlated (P < 0.001), the mean PCNA:Ki-67 ratio being 0.92 +/- 0.57. Occasional discrepancies, however, were found. PCNA and Ki-67 expression was associated with an increase in histologic grade and a decrease in ERP content of tumors, whereas p53 was statistically associated with no clinical or pathobiological variables. The data suggest that proliferative activity and oncogene overexpression may be reliably evaluated in breast cancer by FNA cytology, though PCNA is not a suitable indicator for cell proliferation. The results do not resolve the issue as to whether immunostaining for p53 protein constitutes a dedifferentiation product of the tumor, or is a fundamental aspect of the malignant progression. Survival studies in a larger series of tumors are thus needed to elucidate this point.

A case of chloroquine-resistant falciparum malaria imported into Italy from Angola is reported. It represents a further demonstration that R III resistance to 4-aminoquinolines has spread to countries of the Central Africa Atlantic Coast with important implications for the treatment of patients and individual chemoprophylaxis.