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1.
Braz J Biol ; 84: e278911, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38422295

RESUMEN

The mutations of pncA gene encoding pyrazinamidase/PZase in Mycobacterium tuberculosis are often associated with pyrazinamide/PZA resistance. The H and R1 isolates showed significant phenotypic differences to PZA. The H isolate was PZA sensitive, but R1 was PZA resistant up to 100 ug/ml. The paper reports the pncA profile for both isolates and the activity of their protein expressed in Escherichia coli BL21(DE3). The 0.6 kb of each pncA genes have been subcloned successfully into the 5.4 kb pET30a vector and formed the pET30a-pncA recombinant with a size of 6.0 kb. The pncAR1 profile exhibited base mutations, but not for pncAH against to pncA from the PZA-sensitive M. tuberculosis H37RV published in Genbank ID: 888260. Three mutations were found in pncAR1, ie T41C, G419A, and A535G that subsequently changed amino acids of Cys14Arg, Arg140His and Ser179Gly in its protein level. The mutant PZase R1 that expressed as a 21 kDa protein in E. coli Bl21(DE3) lost 32% of its performance in activating PZA drug to pyrazinoic acid/POA compared to the wild-type PZase H. The mutation in the pncAR1 gene that followed by the decreasing of its PZase activity underlies the emergence of pyrazinamide resistance in the clinical isolate. Structural studies for the R1 mutant PZase protein should be further developed to reveal more precise drug resistance mechanisms and design more effective TB drugs.


Asunto(s)
Amidohidrolasas , Escherichia coli , Mycobacterium tuberculosis , Escherichia coli/genética , Mycobacterium tuberculosis/genética , Pirazinamida/farmacología , Puntos de Acupuntura , Mutación/genética , Pruebas de Sensibilidad Microbiana
2.
ACS Omega ; 9(7): 7827-7834, 2024 Feb 20.
Artículo en Inglés | MEDLINE | ID: mdl-38405444

RESUMEN

The characterization of individual nanoparticles in a liquid constitutes a critical challenge for the environmental, material, and biological sciences. To detect nanoparticles, electronic approaches are especially desirable owing to their compactness and lower costs. While electronic detection in the form of resistive-pulse sensing has enabled the acquisition of geometric properties of various analytes, impedimetric measurements to obtain dielectric signatures of nanoparticles have scarcely been reported. To explore this orthogonal sensing modality, we developed an impedimetric sensor based on a microwave resonator with a nanoscale sensing gap surrounding a nanopore built on a 220 nm silicon nitride membrane. The microwave resonator has a coplanar waveguide configuration with a resonance frequency of approximately 6.6 GHz. The approach of single nanoparticles near the sensing region and their translocation through the nanopores induced sudden changes in the impedance of the structure. The impedance changes, in turn, were picked up by the phase response of the microwave resonator. We worked with 100 and 50 nm polystyrene nanoparticles to observe single-particle events. Our current implementation was limited by the nonuniform electric field at the sensing region. This work provides a complementary sensing modality for nanoparticle characterization, where the dielectric response, rather than ionic current, determines the signal.

3.
Cureus ; 16(1): e52299, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-38357057

RESUMEN

Background Coronary artery disease constitutes a critical public health issue due to its widespread prevalence, placing a significant burden on healthcare systems and posing considerable challenges to the well-being of the population. Limited recent data on coronary artery disease awareness in Saudi Arabia underscores the need for updated information to inform preventive programs. Methodology A cross-sectional questionnaire survey was conducted from August 2021 to October 2022, targeting individuals aged 18 and above in Saudi Arabia. The online survey collected demographic data and assessed knowledge and awareness of coronary artery disease risk factors. A scoring system categorized participants as possessing high, medium, or low levels of awareness and knowledge. Data analysis involved a multivariable regression approach to explore associations. Results The study included a total of 1,409 participants, representing a diverse demographic distribution. Knowledge scores revealed 70.3% high, 27.4% medium, and 2.3% low levels, while awareness scores showed 59.9% high, 32.9% medium, and 7.2% low levels. The study identified significant associations between knowledge scores and gender (p = 0.003) and age (p = 0.001). Similarly, awareness scores demonstrated associations with gender (p = 0.001), age (p = 0.001), marital status (p = 0.003), educational qualification (p = 0.036), and occupation (p = 0.001). These findings underscore the multifaceted nature of factors influencing awareness and knowledge levels. Conclusions The study highlights a strong foundation of knowledge and awareness among the Saudi population regarding coronary artery disease risk factors, indicating a positive starting point for preventive initiatives. However, targeted programs addressing regional variations and enhancing knowledge are recommended to improve early detection and treatment of coronary artery disease risk factors.

4.
Cureus ; 15(10): e47232, 2023 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-38022033

RESUMEN

Acute abdominal pain is a common presentation in emergency departments, often attributed to a myriad of potential causes. Among these, acute appendicitis remains a frequently diagnosed culprit. However, this case report presents a 32-year-old male who arrived at the emergency department with severe right lower quadrant abdominal pain, characterized by localized tenderness and guarding. The initial clinical diagnosis pointed to acute appendicitis. Before surgical intervention, a computed tomography scan was conducted and revealed a focal area of fat stranding, consistent with omental infarction, while the appendix appeared normal. The patient's management involved pain control and supportive care, leading to a complete resolution of abdominal pain at a two-week follow-up. This case emphasizes the significance of including omental infarction in the spectrum of diagnoses for acute abdominal pain, underlining the potential to prevent unnecessary surgical interventions.

5.
Cureus ; 15(9): e45491, 2023 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-37859888

RESUMEN

BACKGROUND: There are high prevalence of mental health co-morbidities in people with epilepsy, with major depressive disorder being the most common among them. OBJECTIVE: This study aims to investigate the prevalence of depression among epileptic patients in Saudi Arabia. We also explored some of the sociodemographic and clinical variables associated with depression in epilepsy. METHODS: This was a cross-sectional analysis executed across the four geographical regions of Saudi Arabia and the sample size is calculated to be 358. Data collection was facilitated through a digital self-administered questionnaire, which consisted of three parts: patients' sociodemographic variables, clinical variables, and patient health questionnaire (PHQ-9) depression score. Data processing and analytical procedures are undertaken using the SPSS software. RESULTS: Of the participants, 311 responded: 65.6% were females, and 34.4% were males. Approximately 50.5% had a confirmed epilepsy diagnosis and were included in the PHQ-9 depression score analysis. Notably, 84.7% manifested depressive symptoms, with the severe category being predominant at 84.7% and moderate at 3.8%. An intriguing observation was the heightened prevalence among the younger demographic (16 to 24 years), registering at 34.4%, a figure nearly 3% superior to older age brackets. CONCLUSION: The majority of participants manifested depressive symptoms, with a significant association noted between medication quantity and depression prevalence in epilepsy. It is imperative to broaden the scope of research, encompassing varied methodologies and spanning multiple urban centers, to procure more robust and generalizable conclusions.

6.
Int J Gen Med ; 16: 4077-4090, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37700743

RESUMEN

Objective: To investigate the knowledge, prevalence of chronic respiratory disorders, and utilization of their medications among the adults at Najran region, Saudi Arabia. Methods: An online cross-sectional survey was carried out in Najran region, Saudi Arabia. A self-administered questionnaire was distributed among a random sample of the general population, aged 18 or above between March and December 2022. The survey instrument included questions regarding history and exposure, physician diagnosed-disorders, respiratory symptoms, allergy, use of medications and possible risk-related factors. Results: This research had a total of 712 individuals. Nearly one-third of the participants in the survey (n = 218; 30.6%) said that they or a member of their family suffer from respiratory ailments. The majority of research participants (n = 167; 76.8%) identified asthma as their primary respiratory condition. A total of 32.0% of participants (n = 70) reported dealing with dust or chemicals such as paints, fertilizers, and cleaning products on a daily basis at work or at home. Around 62.0% of the participants (n = 134) said that exposure to gases, fragrances, and other such substances negatively impacts their health. Almost 78.0% (n = 169) of them indicated that summer weather affects their health, whereas 63.0% (n = 138) reported that winter cold affects their health. Participants aged 41-50 years were 38.0% less likely to have CRDs compared to others (p < 0.05). Conclusion: This study is among the first few studies that explored the knowledge, prevalence of chronic respiratory disorders, and utilization of their medications among the adults at Najran region, Saudi Arabia. In the southern area of Najran, respiratory symptoms are frequent among the inhabitants of Saudi Arabia. More research is required to discover avoidable risk factors and create countermeasures for them. It is recommended that healthcare personnel increase their efforts to educate their patients about respiratory illness prevention methods.

7.
Nat Biomed Eng ; 7(11): 1419-1436, 2023 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-37749310

RESUMEN

Small animals do not replicate the severity of the human foreign-body response (FBR) to implants. Here we show that the FBR can be driven by forces generated at the implant surface that, owing to allometric scaling, increase exponentially with body size. We found that the human FBR is mediated by immune-cell-specific RAC2 mechanotransduction signalling, independently of the chemistry and mechanical properties of the implant, and that a pathological FBR that is human-like at the molecular, cellular and tissue levels can be induced in mice via the application of human-tissue-scale forces through a vibrating silicone implant. FBRs to such elevated extrinsic forces in the mice were also mediated by the activation of Rac2 signalling in a subpopulation of mechanoresponsive myeloid cells, which could be substantially reduced via the pharmacological or genetic inhibition of Rac2. Our findings provide an explanation for the stark differences in FBRs observed in small animals and humans, and have implications for the design and safety of implantable devices.


Asunto(s)
Reacción a Cuerpo Extraño , Mecanotransducción Celular , Ratones , Humanos , Animales , Prótesis e Implantes , Células Mieloides/patología , Transducción de Señal
8.
Cureus ; 15(5): e38997, 2023 May.
Artículo en Inglés | MEDLINE | ID: mdl-37323335

RESUMEN

BACKGROUND: Low back pain is a prevalent and debilitating condition that affects a significant proportion of the adult population. Medical students are particularly vulnerable due to the demands of their rigorous curriculum. Therefore, this study aims to investigate the prevalence and risk factors associated with low back pain among medical students. METHODS: A cross-sectional survey was conducted among medical students and interns at King Faisal University in Saudi Arabia using a convenience sampling technique. An online questionnaire was distributed via social media applications to explore the prevalence and risk factors for low back pain. RESULTS: Out of 300 medical students who participated in the study, 94% reported experiencing low back pain, with a mean pain score of 3.91 ± 2.0 out of 10. The most common factor that aggravated the pain was prolonged sitting. Logistic regression analysis revealed that sitting for more than eight hours (OR=5.61; 95% CI: 2.92-21.42) and not engaging in physical exercise (OR=3.10; 95% CI: 1.34-6.57) were independently associated with a higher prevalence of low back pain. These findings highlight the increased risk of low back pain among medical students due to prolonged sitting and a lack of physical activity. CONCLUSION: This study provides evidence of the high prevalence of low back pain among medical students and identifies significant risk factors that exacerbate the condition. It emphasizes the need for targeted interventions to promote physical activity, reduce prolonged sitting, manage stress, and encourage good posture among medical students. The implementation of such interventions could help alleviate the burden of low back pain and improve the quality of life for medical students.

9.
Arch Razi Inst ; 78(1): 115-123, 2023 02.
Artículo en Inglés | MEDLINE | ID: mdl-37312694

RESUMEN

Scientists have been paying attention to the life-giving properties of medicinal plants for many years. Among these plants is the eucalyptus plant. This plant has various compounds such as cineole and terpenes. It also contains compounds such as flavonoids, aliphatic aldehydes, sesquiterpene, quinotanen, catechins, salts, and vitamins. In the present study, the hydroalcoholic extract of Eucalyptus leaves with concentrations of 175, 350, and 700 mg/kg body weight, and spermatogenesis were studied in 40 adult Wistar rats in five groups of eight. Adult male mice received the extract at the above concentrations by gavage for 28 days. Control mice received only solvent and water, while control mice received no substance other than municipal tap water and normal food. After the last administration of the drug, the animals were weighed and anesthetized, and then blood samples were taken from their hearts. Concentrations of LH, FSH, and testosterone were measured by an ELISA kit. The results showed that body weight and testis, seminiferous tube diameter, Leydig cell diameter, epithelium thickness, number of Leydig cells, spermatogonium, spermatocytes, spermatids, sperm, and testosterone concentration increased significantly with the group. But no significant difference was observed in the concentration of FSH and LH hormones or the number of Sertoli cells. Therefore, it can be concluded that eucalyptus leaf extract may increase the proliferation of sex cells in the seminiferous tubules of rats.


Asunto(s)
Eucalyptus , Testosterona , Masculino , Ratones , Ratas , Animales , Ratas Wistar , Semillas , Espermatozoides , Peso Corporal , Extractos Vegetales/farmacología , Hormona Folículo Estimulante
10.
J Water Health ; 21(6): 663-675, 2023 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-37387334

RESUMEN

Artisanal and small-scale gold mining (ASGM) activity in Way Ratai River produces heavy metal wastes; therefore, further information regarding heavy metal concentrations in the water was needed, especially in plankton samples. Furthermore, the determination of plankton diversity was also carried out in the waters of Way Ratai to determine the bioconcentration factor (BCF). Eight sampling sites were chosen along the river reaching the coast of Way Ratai. The research was conducted in November 2020 and March 2021. Ten heavy metals, Ag, Cd, Co, Cr, Cu, Fe, Mn, Pb, and Zn that are commonly found in mining areas, were determined in the water and plankton samples by using ICP-OES. The results indicated that the highest concentration found was Fe in plankton samples (0.725 mg/L in the river and 1.294 mg/L on the coast). Meanwhile, contents of Cd, Cu, Fe, Mn, and Zn in the river exceeded the predetermined water quality standards, while Ag and Pb metals were not detected. The Cd, Cr, Cu, Pb, and Zn content in seawater also exceeded quality standards. The highest BCF value (12.96) was found for Fe at station G, whereas the lowest BCF value (0.13) was found for Ag at stations G and H.


Asunto(s)
Bahías , Metales Pesados , Indonesia , Cadmio , Plomo , Plancton
11.
Cureus ; 15(4): e37783, 2023 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-37214014

RESUMEN

Acrodermatitis enteropathica is a rare genetic disorder caused by a defect in intestinal zinc absorption, resulting in zinc deficiency and various clinical manifestations, including dermatitis, diarrhea, alopecia, and nail abnormalities. Here we present the case of a 10-year-old male child with diarrhea, and abdominal pain for several months who was diagnosed with acrodermatitis enteropathica confirmed by low serum zinc levels. The child had multiple erythematous, scaly, and crusted lesions on the hands and elbows, which resolved after starting oral zinc sulfate supplementation (10 mg/kg/day) in three divided doses. The patient's serum zinc levels normalized (1.0 µg/mL), and the skin lesions completely resolved after six months of follow-up with a regular zinc-rich diet and gradual reduction of zinc sulfate dosage to a maintenance level (2-4 mg/kg/day). This case report emphasizes the importance of timely diagnosis and treatment of acrodermatitis enteropathica to prevent the harmful consequences of zinc deficiency and highlights the need for healthcare providers to consider this disorder in children presenting with skin lesions and diarrhea, particularly those with a positive family history or consanguinity.

12.
Rev Neurol (Paris) ; 179(4): 368-372, 2023 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-36336489

RESUMEN

The objectives were to analyze changes from 2012 to 2017 in different management times of stroke patients included in the Aquitaine stroke Observatory (ObA2). The studied times (onset-to-needle time-ONT, onset-to-door time-ODT, door-to-imaging time-DIT, door-to-needle time-DNT and imaging-to-needle time-INT) were described as median, interquartile ranges and proportion of patients within the recommended median time goals (ODT under 4hours, DIT within 20min; for thrombolyzed patients, DIT under 20min and a ONT under 4:30) to be compared with an objective of 50% of patients within said time goal. Globally, ODT was 160min, with 43.6% to 59.6% of patients within the ODT goal along the study period. With no improvement over time, the proportion of patients within the DIT goal stayed stable and at a low level (range: 5.5-7.0%) for all patients, decreasing from 25.2% to 11.4% for thrombolyzed patients. The proportion of thrombolyzed patients within the DNT goal varied from 15.1% to 30.3% during study period. These results highlight the urgent need for action to improve in-hospital management of stroke patients, focusing on delays between admission and imaging.


Asunto(s)
Hospitalización , Accidente Cerebrovascular , Humanos , Estudios de Cohortes , Accidente Cerebrovascular/diagnóstico , Accidente Cerebrovascular/terapia , Hospitales
13.
Cureus ; 14(10): e30798, 2022 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-36447718

RESUMEN

Cerebrovascular complications, including strokes, are relatively frequent during pregnancy. Artery of Percheron is an anatomic variant that supplies the paramedian thalamus. Occlusion of this artery results in bilateral thalamic infarction, which manifests clinically with altered mental status. We present the case of a 33-year-old pregnant woman who presented with drowsiness and headache. The patient was at 12 weeks of gestation. She had normal vital signs, including blood pressure, and no focal neurological deficits were noted on physical examination. Magnetic resonance imaging of the brain was performed. The scan demonstrated abnormal high signal intensity in both thalami on T2-weighted images and corresponding restricted diffusion and low apparent diffusion coefficient. Such findings were consistent with the artery of Percheron infarct. The patient received antiplatelet therapy and exhibited gradual improvement. On discharge, the patient had a near-complete resolution of symptoms. Artery of Percheron infarct is a rare type of stroke. Clinicians should be able to recognize its clinical and imaging features.

14.
Saudi Pharm J ; 30(4): 329-336, 2022 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-35527831

RESUMEN

Background: Medication error is a preventable adverse effect of medical care, whether or not it is evident or harmful to the patient. Disclosure of medication errors and improvement of patient safety are inexorably related, and they provide one of the strongest reasons to report and disclose errors, including near misses in which no harm comes to the patient. This study aimed to identify medication errors at the southern province of Saudi Arabia. Methods: A cross-sectional retrospective study was conducted by reviewing all medical records in the King Khaled Hospital in Najran, Saudi Arabia. Medication errors related information were extracted from the electronic medical system for the duration between 2018 and 2020. Results: During the study period of 2018 to 2020, a total of 4860 medication errors were identified. More than half of the reported medication errors (66.9%) were linked to ordering, prescribing, or transcribing medications. The most commonly reported medication errors connected to ordering/prescribing/transcribing were inappropriate dosage, dosage units, and therapeutic duplication of medication. The most commonly reported medication errors linked to administration were missing documentation during administration, not performing independent double-checks during the administration of high alert medications, and the administration of look-alike sound-alike (LASA) medications. The intensive care unit (ICU), female medical ward, and male medical ward were the most commonly reported locations for medication errors. Pharmacists detected more than half of the reported medication errors. Physicians were found to be responsible for 66.0% of reported medication errors, followed by nurses. Conclusion: Medication errors are common in hospital settings in Saudi Arabia's southern provinces. Efforts should be made to improve drug ordering, prescribing, and transcription in hospital settings. To guarantee optimum practices, the entire medical team should take responsibility for the patient's optimal medication administration.

15.
Arch Razi Inst ; 77(5): 1831-1835, 2022 10.
Artículo en Inglés | MEDLINE | ID: mdl-37123109

RESUMEN

This study aimed to evaluate the effect of Marjoram leaves (Oregano vulgar) as a feed supplement on sexual efficiency and semen quality in Awasian pollination rams. The study was conducted on ten rams in one of the private fields in the Babylon governorate. The rams were divided randomly into two groups. First group rams are regarded as a control group (group A) that feeds on exceptional concentric food for pollination rams. The second group consists of 5 rams (group B) provided with the same concentric food plus a supplement of 3 mg/kg of body weight of Oregano vulgar leaves (fresh) 3 times daily for 49 days before the pollination season (April and May). Semen samples were collected at the end of 49 days by artificial vagina to evaluate the volume of ejaculate, sperm number, concentration, motility, viability, and deformities, and to measure the sperm pleomorphic parameters of the head, nucleus, and acrosome. The antioxidant status of seminal plasma was evaluated by measuring superoxide dismutase (SOD), glutathione peroxidase (GPX), and total antioxidant capacity (TAC). ELISA tests were used on blood serum samples to measure the hormone levels of luteinizing hormone (LH), testosterone, and estrogen. The study demonstrated a significant increase in motility, the viability of sperm, and decreasing deformities. There was no significant variation in perimorphic parameters of the head, nucleus, and acrosome sperm after using the fresh leaves of Oregano vulgar as supplementation to Awasion sheep. However, there was an increase in the antioxidant enzymes (SOD, GPX, and TAC) in seminal plasma and an increase in LH, testosterone, and estrogen in the blood serum of experimental group B. These findings show that using fresh leaves of Oregano vulgar improved the sexual efficiency of pollinated rams and maintained the physiology and perimorphic parameters of semen and sperm.


Asunto(s)
Origanum , Análisis de Semen , Animales , Femenino , Masculino , Antioxidantes , Suplementos Dietéticos , Polinización , Semillas , Análisis de Semen/veterinaria , Ovinos , Oveja Doméstica , Testosterona
16.
Cureus ; 14(12): e32810, 2022 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-36694516

RESUMEN

Pituitary apoplexy is a rare and potentially life-threatening condition that usually occurs in the setting of a pre-existing pituitary tumor, which may be undiagnosed. There are a growing number of reports describing the pituitary apoplexy associated with coronavirus disease 2019 (COVID-19). We present the case of a 41-year-old man who presented with a gradually worsening headache for four days. It was a bilateral frontal headache of sharp quality with no radiation. He scored the headache as 9 out of 10 on the 10-point severity scale. He had no previous episodes of similar headaches. Fundoscopic examination revealed bilateral optic disc blurring suggestive of papilledema and cranial nerves examination revealed bilateral hemianopia. The patient was admitted for further investigation and management. As part of the admission protocol, the patent underwent a nasopharyngeal swab for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which yielded positive results. Computed tomography demonstrated a large solid intrasellar mass with areas of high density suggesting hemorrhage along with a small amount of subarachnoid hemorrhage space in the left parietal lobe. The findings were consistent with pituitary apoplexy in the setting of pituitary macroadenoma. Intravenous hydrocortisone was administered. The patient underwent transsphenoidal surgical resection of the pituitary tumor, which resulted in significant improvement in the patient's symptoms. Pituitary apoplexy is a rare condition. The case suggests that COVID-19 may predispose to the development of pituitary apoplexy.

17.
Adv Mater ; 33(34): e2102039, 2021 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-34270846

RESUMEN

Borophene, the lightest among all Xenes, possesses extreme electronic mobility along with high carrier density and high Young's modulus. To accomplish device-quality borophene, novel approaches of realization of monolayers need to be urgently explored. In this work, micromechanical exfoliation is discovered to result in mono- and few-layered borophene of device quality. Borophene sheets are successfully fabricated down to monolayer thickness. Distinct crystallographic phases of borophene viz. XRD study reveals crystallographic phase transition from rhombohedral to several other eigen phases of borophene. The role of the destination substrates is held crucial in determining the final phase of the transferred sheet. The exfoliation energy is calculated by density functional theory. Molecular dynamics simulations are used to simulate the exfoliation process. Heterolayers of borophene, with black phosphorene (BP) or with molybdenum disulfide (MoS2 ) atomic sheets, are found to result in photoexcited coupling quantum states. Gold-coated borophene bestows promising anchoring capability for surface-enhanced Raman spectroscopy (SERS). Successful demonstration of the electronic behavior of micromechanically exfoliated borophene and excitonic behavior of borophene-based heterolayers will guide future generation devices not only in electronics and excitonics, but also in thermal management, electronic packaging, hydrogen storage, hybrid energy storage, and clean energy solutions.

18.
Am J Case Rep ; 22: e929422, 2021 Jun 27.
Artículo en Inglés | MEDLINE | ID: mdl-34175884

RESUMEN

BACKGROUND Primary malignant ameloblastoma is a very rare tumor of the dental lamina epithelium. Similar to the benign ameloblastoma, the mass is without significant histological atypia, but the malignant type may present with metastases, most commonly to the lungs. The average age of diagnosis is 34 years, and the malignancy affects men and women equally. The tumors often present with an insidious growth and have a median survival from time of diagnosis of 17.6 years. Due to the rarity of this lesion, a standard of care has not yet been established. CASE REPORT A 38-year-old Haitian woman, who initially presented with a large primary malignant ameloblastoma of the angle of the mandible, experienced a recurrence in the floor of the mouth 30 months after surgical resection. In 2018, 2 years after the removal of the recurrent tumor, the patient presented with ascites, right-sided abdominal pain, weight loss, and a palpable liver mass. Laparoscopic exploration demonstrated a complex lateral right liver lobe cyst, suspicious for parasitic infection. Cytological analysis showed positive staining for cytokeratin 5/6, P63, and CD56, indicative of metastatic ameloblastoma of the liver. Consistent cell morphology from the primary tumor and liver cyst was also noted. Following drainage of the cyst, the patient returned to Haiti, where she died in 2020. In Haiti, she lacked appropriate local medical care, leading to the severe progression of her initial primary ameloblastoma and disease recurrence. CONCLUSIONS Malignant ameloblastoma accounts for less than 2% of all odontogenic tumors, as the benign variant is much more common. Distant metastases of these lesions are rare; to date, few cases have presented with hepatic metastases.


Asunto(s)
Ameloblastoma , Neoplasias Hepáticas , Tumores Odontogénicos , Adulto , Femenino , Haití , Humanos , Masculino , Recurrencia Local de Neoplasia
19.
J Pediatr Surg ; 56(7): 1192-1198, 2021 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-33836847

RESUMEN

INTRODUCTION: short bowel syndrome is marked by inadequate intestinal surface area to absorb nutrients. Current treatments are focused on medical management and surgical reconfiguration of the dilated intestine. We propose the use of spring-mediated distraction enterogenesis as a novel intervention to increase intestinal length. Given our previous success lengthening intestinal segments using springs with spring constant ~7 N/m that exerts 0.46 N or higher, we sought to determine the minimal force needed to lengthen porcine small intestinal segments, and to explore effects on intestine over time. METHODS: Juvenile Yucatan pigs underwent laparotomy with enterotomy to introduce nitinol springs intraluminally (n = 21 springs). Bowel segments (control, spring-distracted) were retrieved on post-operative day (POD) 7 and 14, and lengths measured. Thickness of cross-sectional intestinal layers were measured using H&E, and submucosal collagen fiber orientation measured using trichrome stained sections. RESULTS: all pigs survived to POD7 and 14. Spring constants of at least 2 N/m exerting a minimum force of 0.10 N significantly lengthened intestinal segments (p <0.0001). The stronger the spring force, the greater the induced thickness of various intestinal layers at POD7 and 14. Collagen fiber orientation was also more disordered because of stronger springs. CONCLUSION: a spring constant of approximately 2 N/m exerting 0.10 N and greater significantly lengthens intestinal segments and stimulates intestinal structural changes at POD7 and 14. This suggests a decreased force is capable of inducing spring-mediated distraction enterogenesis.


Asunto(s)
Síndrome del Intestino Corto , Dispositivos de Expansión Tisular , Animales , Estudios Transversales , Intestino Delgado/cirugía , Yeyuno/cirugía , Síndrome del Intestino Corto/cirugía , Porcinos , Expansión de Tejido
20.
Sci Rep ; 11(1): 1224, 2021 01 13.
Artículo en Inglés | MEDLINE | ID: mdl-33441660

RESUMEN

After nearly a century of vaccination and six decades of drug therapy, tuberculosis (TB) kills more people annually than any other infectious disease. Substantial challenges to disease eradication remain among vulnerable and underserved populations. The Guarani-Kaiowá people are an indigenous population in Paraguay and the Brazilian state of Mato Grosso do Sul. This community, marginalized in Brazilian society, experiences severe poverty. Like other South American indigenous populations, their TB prevalence is high, but the disease has remained largely unstudied in their communities. Herein, Mycobacterium tuberculosis isolates from local clinics were whole genome sequenced, and a population genetic framework was generated. Phylogenetics show M. tuberculosis isolates in the Guarani-Kaiowá people cluster away from selected reference strains, suggesting divergence. Most cluster in a single group, further characterized as M. tuberculosis sublineage 4.3.3. Closer analysis of SNPs showed numerous variants across the genome, including in drug resistance-associated genes, and with many unique changes fixed in each group. We report that local M. tuberculosis strains have acquired unique polymorphisms in the Guarani-Kaiowá people, and drug resistance characterization is urgently needed to inform public health to ensure proper care and avoid further evolution and spread of drug-resistant TB.


Asunto(s)
Mycobacterium tuberculosis/genética , Polimorfismo de Nucleótido Simple/genética , Tuberculosis Resistente a Múltiples Medicamentos/microbiología , Brasil , Farmacorresistencia Bacteriana Múltiple/genética , Genotipo , Humanos , Filogenia , Grupos de Población
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