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Background: Laboratory risk indicator for necrotizing fasciitis (LRINEC score) is a simple laboratory tool used to distinguish between necrotizing soft-tissue infections (NSTI) and other soft-tissue infections. A LRINEC score of ‡6 is considered as denoting a high risk of necrotizing fasciitis. A certain LRINEC score might also be associated with mortality and other outcomes of patients with NSTI. Methods: A review of the medical charts of patients was carried out. The study sites were one tertiary academic centre and one community, university-affiliated hospital. All adult patients with necrotizing soft-tissue infections from 2002 to 2005 were selected then LRINEC scores were calculated for each patient. We enrolled patients where there was sufficient information to determine that the LRINEC score was either <6 or ‡6. Results: A total of two hundred and nine patients were enrolled and analysed. The overall mortality rate was 33 of 209 (15.8%) and amputation rate was 55 of 209 (26.3%). The amputation rates were defined as numbers of patients who received amputation divided by numbers of total patients. Enrolled patients were divided into two groups. Group I was those whose LRINEC score was <6 and group II was those whose LRINEC score was ‡6. Significant differences in mortality rate (P = 0.04) and amputation rate (P = 0.002) were noted between two groups. Conclusion: The LRINEC score is associated with the outcomes of patients with NSTI. Patients with a LRINEC score of ‡6 have a higher rate of both mortality and amputation.

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NCE supplementation was able to modulate the gut microbiota increased the Lactobacillus genus.

Background: At least one-third of epithelial ovarian cancers are associated with the development of ascites containing heterogeneous cell populations, including tumor cells, inflammatory cells, and stromal elements. The components of ascites and their effects on the tumor cell microenvironment remain poorly understood. This study aimed to isolate and characterize stromal progenitor cells from the ascites of patients with epithelial ovarian adenocarcinoma (EOA). Methods: Seventeen ascitic fluid samples and 7 fresh tissue samples were collected from 16 patients with EOA. The ascites samples were then cultured in vitro in varying conditions. Flow cytometry and immunocytochemistry were used to isolate and characterize 2 cell populations with different morphologies (epithelial type and mesenchymal type) deriving from the ascites samples. The in vitro cell culture model was established using conditional culture medium.

Thin polystyrene (PS) films embedded with multiwalled carbon nanotubes (MWNTs) grafted with PS chains were prepared via solution casting, and the nanomechanical behavior of the thin films was probed by using AFM, TEM, and SEM. Percolated network of entangled nanotubes was observed to be well-dispersed in the PS thin films, and the films demonstrated strikingly different mechanical properties as compared to the pristine PS film. The MWNT/PS films were very tough showing no microfracture at large strains beyond 20%. Although crazes of similar microstructure to those in pristine PS were developed upon stretching, they were short and narrow with a width no more than approximately 2 µm. AFM analyses revealed that crazes grew by following a micronecking mechanism, similar to that commonly observed in neat polymers, but craze widening was substantially restricted. As a result, nucleation of new crazes became the dominant process over widening of the existing crazes as the applied strain increased. No nanotubes were observed inside crazes; they appeared to be excluded from craze fibrillation and were observed to accumulate at the craze boundaries. The growth of crazes in the MWNT/ PS films was constrained by the nanotubes too rigid to be drawn into the crazes during the deformation.

IntroductionNecrotizing fasciitis (NF) is a life threatening infectious disease with a high mortality rate. We carried out a microbiological characterization of the causative pathogens. We investigated the correlation of mortality in NF with bloodstream infection and with the presence of co-morbidities.MethodsIn this retrospective study, we analyzed 323 patients who presented with necrotizing fasciitis at two different institutions. Bloodstream infection (BSI) was defined as a positive blood culture result. The patients were categorized as survivors and non-survivors. Eleven clinically important variables which were statistically significant by univariate analysis were selected for multivariate regression analysis and a stepwise logistic regression model was developed to determine the association between BSI and mortality.ResultsUnivariate logistic regression analysis showed that patients with hypotension, heart disease, liver disease, presence of Vibrio spp. in wound cultures, presence of fungus in wound cultures, and presence of Streptococcus group A, Aeromonas spp. or Vibrio spp. in blood cultures, had a significantly higher risk of in-hospital mortality. Our multivariate logistic regression analysis showed a higher risk of mortality in patients with pre-existing conditions like hypotension, heart disease, and liver disease. Multivariate logistic regression analysis also showed that presence of Vibrio spp in wound cultures, and presence of Streptococcus Group A in blood cultures were associated with a high risk of mortality while debridement > = 3 was associated with improved survival.ConclusionsMortality in patients with necrotizing fasciitis was significantly associated with the presence of Vibrio in wound cultures and Streptococcus group A in blood cultures.