The diagnostic value of fine needle aspiration in parotid lumps

INTRODUCTION

Fine needle aspiration (FNA) is a safe and quick method of diagnosing superficial lumps, which aids preoperative planning. However, FNA of the parotid gland has not gained the widespread acceptance noted in other head and neck lumps. The aim of this study was to determine the ability of FNA of the parotid gland to differentiate benign and malignant disease, and to determine the impact on surgical outcome.

METHODS

A retrospective analysis of 201 consecutive parotid operations with preoperative FNA in a large district hospital in the UK was performed. The diagnostic characteristics were calculated for benign and malignant disease, and the impact on surgical procedure was determined.

RESULTS

In identifying benign disease, FNA has a sensitivity of 85% and a specificity of 76%. In detecting malignant disease, FNA has a sensitivity and specificity of 52% and 92% respectively. A false positive on FNA was associated with a higher incidence of neck dissection.

CONCLUSIONS

FNA is a useful diagnostic test. However, owing to low sensitivity, it is necessary to interpret it in the context of all other clinical information.

Interaction between the ionic liquids 1-alkyl-3-methylimidazolium tetrafluoroborate and Pluronic® P103 in aqueous solution: a DLS, SANS and NMR study

The effect of three ionic liquids (ILs) 1-alkyl 3-methyl imidazlolium tetraflouroborates (C(n)mim BF(4)n=4, 6, 8) on micellar solutions of an ethylene oxide-propylene oxide block copolymer (PEO-PPO-PEO), Pluronic® P103 was examined from scattering and NMR techniques. The ILs alter the cloud point and micelle size dependant on their alkyl chain length and the results are discussed in terms of their behavior as cosolvent/cosurfactant. Cloud point data support the hydrogen bonding between the imidazolium cation and P103 while dynamic light scattering (DLS) and small angle neutron scattering (SANS) reveal that presence of ionic liquid is not conducive to the micelle formation of P103. The selective nuclear Overhauser effect (NOESY) indicates that the PPO block of the P103 interacts with the alkyl group of the C(n)mim(+) cation by hydrophobic interaction. Through this kind of interactions, C(n)mim BF(4) and P103 can form mixed micelles. This result indicates that the presence of ILs hinders the micelle formation of P103 in solution and promotes P103 to orient at air/water interface.

Safe and adequate placement of nasogastric tubes in the presence of a cuffed tracheostomy tube

This case report and review of the literature aims to highlight the importance of the use of a chest radiograph to check the placement of nasogastric tubes after insertion in an awake patient with an inflated cuffed tracheostomy tube regardless of an acidic pH test.

Efficacy of isavuconazole, voriconazole and fluconazole in temporarily neutropenic murine models of disseminated Candida tropicalis and Candida krusei

OBJECTIVES

The aim of this study was to assess the dose-response of isavuconazole, voriconazole and fluconazole in disseminated Candida tropicalis and Candida krusei infections.

METHODS

Mice were immunosuppressed using either one dose [temporarily neutropenic (TN)] or two doses [persistently neutropenic (PN)] of cyclophosphamide. Treatment was started 5 h after infection with oral isavuconazole (6, 15, 30, 60, 90, 120 or 150 mg/kg equivalent active compound), intravenous voriconazole (5, 20 or 40 mg/kg plus grapefruit gavage twice daily) or oral fluconazole (15, 50 or 150 mg/kg) all administered twice daily. Kidney burden was assessed for C. tropicalis, and kidney and brain burden for C. krusei.

RESULTS

Vehicle controls developed a non-lethal infection with high burdens in both models. In the TN models, isavuconazole, voriconazole and fluconazole (>50 mg/kg) reduced kidney burden compared with controls; >60 mg/kg isavuconazole and 50 mg/kg fluconazole were superior to alternative treatments (other than voriconazole 40 mg/kg). Isavuconazole (all doses) reduced brain burden (P<0.05) in the C. krusei model; fluconazole (all doses) and voriconazole (5 and 20 mg/kg) did not. In the C. krusei kidney burden model, isavuconazole 120 and 150 mg/kg and voriconazole 40 mg/kg were superior to controls and fluconazole. In the C. tropicalis model, PN isavuconazole (all doses), voriconazole (>5 mg/kg) and fluconazole (all doses) reduced kidney burden (P<0.05). Only isavuconazole (all doses) and 40 mg/kg voriconazole were effective against C. krusei in the brain, isavuconazole and voriconazole reduced tissue burden (P<0.05). Fluconazole had no significant effect on brain burden even at 150 mg/kg.

CONCLUSIONS

Isavuconazole significantly reduced kidney burden in mice infected with C. tropicalis and both kidney and brain burdens in mice infected with C. krusei. Isavuconazole was as effective as voriconazole and much more effective than fluconazole at reducing brain burden.

Evidence for a long-range component in the pion emission source in Au+Au collisions at sqrt sNN=200 GeV

Emission source functions are extracted from correlation functions constructed from charged pions produced at midrapidity in Au+Au collisions at sqrt[s(NN)]=200 GeV. The source parameters extracted from these functions at low k(T) give first indications of a long tail for the pion emission source. The source extension cannot be explained solely by simple kinematic considerations. The possible role of a halo of secondary pions from resonance emissions is explored.

Dense-medium modifications to jet-induced hadron pair distributions in Au+Au collisions at sqrt s NN=200 GeV

Azimuthal correlations of jet-induced high-p(T) charged hadron pairs are studied at midrapidity in Au+Au collisions at sqrt[s(NN)]=200 GeV. The distribution of jet-associated partner hadrons (1.0<p(T)<2.5 GeV/c) per trigger hadron (2.5<p(T)<4.0 GeV/c) is found to vary with collision centrality, in both shape and yield, indicating a significant effect of the nuclear collision medium on the jet fragmentation process.

Common suppression pattern of eta and pi0 mesons at high transverse momentum in Au + Au collisions at square root S(NN) = 200 GeV

Inclusive transverse momentum spectra of eta mesons have been measured within p(T) = 2-10 GeV/c at midrapidity by the PHENIX experiment in Au + Au collisions at square root S(NN) = 200 GeV. In central Au+Au the eta yields are significantly suppressed compared to peripheral Au + Au, d + Au, and p + p yields scaled by the corresponding number of nucleon-nucleon collisions. The magnitude, centrality, and p(T) dependence of the suppression is common, within errors, for eta and pi0. The ratio of eta to pi0 spectra at high p(T) amounts to 0.40 < R(eta/pi)0 < 0.48 for the three systems, in agreement with the world average measured in hadronic and nuclear reactions and, at large scaled momentum, in e+e- collisions.

Single electrons from heavy-flavor decays in collisions at

The invariant differential cross section for inclusive electron production in p+p collisions at [FORMULA: SEE TEXT] has been measured by the PHENIX experiment at the BNL Relativistic Heavy Ion Collider over the transverse momentum range 0.4<or=pT<OR=5.0 GeV/c in the central rapidity region ([FORMULA: SEE TEXT]). The contribution to the inclusive electron spectrum from semileptonic decays of hadrons carrying heavy flavor, i.e., charm quarks or, at high , bottom quarks, is determined via three independent methods. The resulting electron spectrum from heavy-flavor decays is compared to recent leading and next-to-leading order perturbative QCD calculations. The total cross section of charm quark-antiquark pair production is determined to be [FORMULA: SEE TEXT].

Measurement of identified and inclusive photon second-harmonic parameter and implications for direct photon production in [FORMULA: SEE TEXT] Au+Au

The azimuthal distribution of identified pi0 and inclusive photons has been measured in [FORMULA: SEE TEXT] Au+Au collisions with the PHENIX experiment at the Relativistic Heavy-Ion Collider (RHIC). The second-harmonic parameter (nu2) was measured to describe the observed anisotropy of the azimuthal distribution. The measured inclusive photon is consistent with the value expected for the photons from hadron decay and is also consistent with the lack of direct photon signal over the measured pT range 1-6 GeV/c. An attempt is made to extract nu2 of direct photons.

Nuclear modification of electron spectra and implications for heavy quark energy loss in Au+Au collisions at [FORMULA: SEE TEXT]

The PHENIX experiment has measured midrapidity ([FORMULA: SEE TEXT]) transverse momentum spectra ([FORMULA: SEE TEXT]) of electrons as a function of centrality in Au+Au collisions at [FORMULA: SEE TEXT]. Contributions from photon conversions and from light hadron decays, mainly Dalitz decays of pi0 and eta mesons, were removed. The resulting nonphotonic electron spectra are primarily due to the semileptonic decays of hadrons carrying heavy quarks. Nuclear modification factors were determined by comparison to nonphotonic electrons in p+p collisions. A significant suppression of electrons at high pT is observed in central Au+Au collisions, indicating substantial energy loss of heavy quarks.

Measurement of transverse single-spin asymmetries for midrapidity production of neutral pions and charged hadrons in polarized p + p collisions at square root(s) = 200 GeV

Transverse single-spin asymmetries to probe the transverse-spin structure of the proton have been measured for neutral pions and nonidentified charged hadrons from polarized proton-proton collisions at midrapidity and square root(s) = 200 GeV. The data cover a transverse momentum (pT) range 1.0-5.0 GeV/c for neutral pions and 0.5-5.0 GeV/c for charged hadrons, at a Feynman-x value of approximately zero. The asymmetries seen in this previously unexplored kinematic region are consistent with zero within errors of a few percent. In addition, the inclusive charged hadron cross section at midrapidity from 0.5 < pT < 7.0 GeV/c is presented and compared to next-to-leading order perturbative QCD (pQCD) calculations. Successful description of the unpolarized cross section above approximately 2 GeV/c suggests that pQCD is applicable in the interpretation of the asymmetry results in the relevant kinematic range.

Saturation of azimuthal anisotropy in Au + Au collisions at (square root)s(NN) = 62-200 GeV

New measurements are presented for charged hadron azimuthal correlations at midrapidity in Au+Au collisions at (square root)s(NN) = 62.4 and 200 GeV. They are compared to earlier measurements obtained at (square root)s(NN) = 130 GeV and in Pb + Pb collisions at (square root)s(NN) = 17.2 GeV. Sizeable anisotropies are observed with centrality and transverse momentum (pT) dependence characteristic of elliptic flow (upsilon2). For a broad range of centralities, the observed magnitudes and trends of the differential anisotropy, upsilon2(pT), change very little over the collision energy range (square root)s(NN) = 62-200 GeV, indicating saturation of the excitation function for upsilon2 at these energies. Such a saturation may be indicative of the dominance of a very soft equation of state for (square root)s(NN) approximately 60-200 GeV.

Centrality dependence of direct photon production in (square root)S(NN) = 200 GeV Au + Au collisions

The first measurement of direct photons in Au + Au collisions at (square root)S(NN) = 200 GeV is presented. The direct photon signal is extracted as a function of the Au + Au collision centrality and compared to next-to-leading order perturbative quantum chromodynamics calculations. The direct photon yield is shown to scale with the number of nucleon-nucleon collisions for all centralities.

Deuteron and antideuteron production in Au+Au collisions at square root of s(NN)=200 GeV

The production of deuterons and antideuterons in the transverse momentum range 1.1<p(T)<4.3 GeV/c at midrapidity in Au+Au collisions at square root of s(NN)=200 GeV has been studied by the PHENIX experiment at RHIC. A coalescence analysis, comparing the deuteron and antideuteron spectra with that of proton and antiproton, has been performed. The coalescence probability is equal for both deuterons and antideuterons and it increases as a function of p(T), which is consistent with an expanding collision zone. Comparing (anti)proton yields, p /p=0.73+/-0.01, with (anti)deuteron yields, d /d=0.47+/-0.03, we estimate that n /n=0.64+/-0.04. The nucleon phase space density is estimated from the coalescence measurement.

Centrality dependence of charm production from a measurement of single electrons in Au+Au collisions at sqrt[s(NN)]=200 GeV

The PHENIX experiment has measured midrapidity transverse momentum spectra (0.4<p(T)<4.0 GeV/c) of single electrons as a function of centrality in Au+Au collisions at sqrt[s(NN)]=200 GeV. Contributions from photon conversions and Dalitz decays of light neutral mesons are measured by introducing a thin (1.7% X0) converter into the PHENIX acceptance and are statistically removed. The subtracted nonphotonic electron spectra are primarily due to the semileptonic decays of hadrons containing heavy quarks, mainly charm at lower p(T). For all centralities, the charm production cross section is found to scale with the nuclear overlap function, T(AA). For minimum-bias collisions the charm cross section per binary collision is N(cc )/T(AA)=622+/-57(stat)+/-160(syst) microb.

Bose-Einstein correlations of charged pion pairs in Au + Au collisions at square root sNN = 200 GeV

Bose-Einstein correlations of identically charged pion pairs were measured by the PHENIX experiment at midrapidity in Au + Au collisions at square root s(NN)=200 GeV. The Bertsch-Pratt radius parameters were determined as a function of the transverse momentum of the pair and as a function of the centrality of the collision. Using the standard core-halo partial Coulomb fits, and a new parametrization which constrains the Coulomb fraction as determined from the unlike-sign pion correlation, the ratio R(out)/R(side) is within 0.8-1.1 for 0.25< <k(T)> <1.2 GeV/c. The centrality dependence of all radii is well described by a linear scaling in N(1/3)(part), and R(out)/R(side) for <k(T)> approximately 0.45 GeV/c is approximately constant at unity as a function of centrality.

Secretory Phospholipase A2Deposition on Contact Lenses and Its Effect on Bacterial Adhesion

PURPOSE

Secretory phospholipase A2 (sPLA2) is a potent antibacterial enzyme in tears and has been found to kill Staphylococcus aureus rapidly in vitro. The purpose was to determine whether sPLA2 deposition is associated with contact lens (CL) type, if sPLA2 remains active on CLs, and if this has an effect on bacterial adhesion.

METHODS

Ionic (etafilcon A) and nonionic (Polymacon) high-water, soft CLs were used. CLs were worn for 6 hours (daily wear, n = 39) or 6 nights on an extended-wear schedule (n = 25). Tears were collected from patients and worn contact lenses were removed and protein and active enzymes extracted for estimation of their levels. The number of S. aureus adhering to sPLA2-soaked CLs in vitro was also quantified.

RESULTS

There was no significant difference in the concentration of sPLA2 in tears between groups of daily CL wearers. Significantly less sPLA2 was recovered from Polymacon CLs for both daily and extended wear compared with etafilcon A CLs (daily wear: 3 vs. 5 ng/lens; extended wear: 3 vs. 6 ng/lens; P < 0.05). sPLA2 activity correlated with protein amounts from lenses. Relatively less active sPLA2 was recovered from Polymacon contact lenses. sPLA2 reduced adhesion of Staphylococcus to contact lenses in vitro.

CONCLUSIONS

Etafilcon A CLs absorb more active sPLA2 than Polymacon CLs, which increases with length of CL wear. The sequestering of sPLA2 onto CLs did not affect amounts of the enzyme in tears. sPLA2 adsorbed to a CL can reduce the viable Staphylococcus adhering to the CL, which may protect the eye from colonization by this pathogen.

Measurement of nonrandom event-by-event fluctuations of average transverse momentum in square root of (sNN)=200 GeV Au+Au and p+p collisions

Event-by-event fluctuations of the average transverse momentum of produced particles near midrapidity have been measured by the PHENIX Collaboration in square root of (sNN)=200 GeV Au+Au, and p+p collisions at the Relativistic Heavy Ion Collider. The fluctuations are observed to be in excess of the expectation for statistically independent particle emission for all centralities. The excess fluctuations exhibit a dependence on both the centrality of the collision and on the pT range over which the average is calculated. Both the centrality and pT dependence can be well reproduced by a simulation of random particle production with the addition of contributions from hard-scattering processes.