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1.
Clin Cosmet Investig Dent ; 16: 349-357, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39309317

RESUMEN

Introduction: Root canal retreatment is carried out in cases where previous endodontic therapies failed and involves the removal of root canal filling materials, followed by cleaning, shaping, and obturating of the canals. Aims: : The objective of this study was to collect information regarding attitudes, methods, and materials employed during the non-surgical endodontic retreatment (NSER) by general dentists working in Sousse Governorate, Tunisia. Materials and Methods: A descriptive cross-sectional survey was conducted among 147 general dentists working in the Sousse Governorate, Tunisia, from May to November 2021. Data were collected by sending a structured questionnaire to the dental practitioners through email. All the data were analyzed by using the SPSS 10 computer software. Results: A total of 96 dentists responded to this survey. The response rate was 63.5%, with a female predominance (53.2.3%). 81.2% of the respondents performed at least one non-surgical endodontic retreatment (NSER) weekly. Our study revealed that the mandibular first molar is the tooth that most often requires endodontic retreatment (83.5%). Half of the participants never used the rubber dam during this procedure. Moreover, the majority of respondents (61.9%) simultaneously used manual files and rotary nickel-titanium instruments for root canal desobturation. Most of the dentists (69.57%) systematically use solvents during root canal desobturation. Conclusion: Our survey highlights that the majority of general dentists have adequate knowledge about endodontic retreatment. Nevertheless, dentists are yet to start the application of these newer strategies towards the management of endodontic failures.

2.
Cell Biochem Biophys ; 2024 Sep 11.
Artículo en Inglés | MEDLINE | ID: mdl-39259407

RESUMEN

Type 2 Diabetes Mellitus (T2DM) presents a substantial health concern on a global scale, driving the search for innovative therapeutic strategies. Phytochemicals from medicinal plants, particularly Ocimum tenuiflorum (Holy Basil), have garnered attention for their potential in T2DM management. The increased focus on plant-based treatments stems from their perceived safety profile, lower risk of adverse effects, and the diverse range of bioactive molecules they offer, which can target multiple pathways involved in T2DM. Computational techniques explored the binding interactions between O. tenuiflorum phytochemicals and Human Omentin-1, a potential T2DM target. ADMET evaluation and targeted docking identified lead compounds: Luteolin (-4.84 kcal/mol), Madecassic acid (-4.12 kcal/mol), Ursolic acid (-5.91 kcal/mol), Stenocereol (-5.59 kcal/mol), and Apigenin (-4.64 kcal/mol), to have a better binding affinity to target protein compared to the control drug, Metformin (-2.01 kcal/mol). Subsequent molecular dynamics simulations evaluated the stability of Stenocereol, Luteolin, and Metformin complexes for 200 nanoseconds, analysing RMSD, RMSF, RG, SASA, PCA, FEL, and MM-PBSA parameters. Results indicated Stenocereol's strong binding affinity with Omentin-1, suggesting its potential as a potent therapeutic agent for T2DM management. These findings lay the groundwork for further experimental validation and drug discovery endeavours.

3.
Sci Rep ; 14(1): 21599, 2024 09 16.
Artículo en Inglés | MEDLINE | ID: mdl-39284902

RESUMEN

Mentha arvensis is an herbaceous plant commonly known as peppermint or Japanese mint. This study investigated the toxic potential and repellent efficacy of M. arvensis essential oil (MaEO) at varying concentrations (15.625-250 mg/mL) in Nauphoeta cinerea, along with its impact on biochemical parameters in N. cinerea. The potential of the major compounds as a new analgesic target was investigated using molecular docking. The essential oil was analyzed by gas Chromatography-mass spectrometry (GC-MS) and the toxic potential, repellent property, and changes in lipid peroxidation (LPO) levels were evaluated as markers of oxidative stress. GC-MS results revealed that the main components were oxygenated monoterpenes such as menthol (71.31%), mentone (13.34%) and isomentone (5.35%). MaEO significantly reduced lipid peroxidation (LPO), the levels of non-protein thiols and iron(II) at the concentration of 125 mg/mL in N. cinerea. Furthermore, the major components, L-(-)-Menthol and menthone demonstrated high gastrointestinal absorption and high affinity with the target protein, suggesting possible links that contribute to the analgesic effect of MaEO.


Asunto(s)
Antioxidantes , Peroxidación de Lípido , Mentha , Aceites Volátiles , Mentha/química , Antioxidantes/farmacología , Antioxidantes/química , Aceites Volátiles/farmacología , Aceites Volátiles/química , Peroxidación de Lípido/efectos de los fármacos , Animales , Simulación del Acoplamiento Molecular , Estrés Oxidativo/efectos de los fármacos , Cromatografía de Gases y Espectrometría de Masas , Repelentes de Insectos/farmacología , Repelentes de Insectos/química , Aceites de Plantas/farmacología , Aceites de Plantas/química
4.
Mol Divers ; 2024 Jul 16.
Artículo en Inglés | MEDLINE | ID: mdl-39009909

RESUMEN

Pyridone heterocycles, such as furo[2,3-b]pyridines, have emerged as prominent scaffolds in medicinal chemistry due to their versatile pharmacological properties, including significant anticancer activity. In this study, we successfully synthesized new pyridine-2(H)-one, nicotinonitrile, and furo[2,3-b]pyridine derivatives from chalcones bearing 4-(benzyloxy)phenyl and dichlorothiophenyl subunits to explore their therapeutic potential against breast cancer. By employing a synthetic strategy involving Claisen-Schmidt condensation followed by sequential cyclizations and functional modifications, we synthesized and characterized four compounds (MI-S0, MI-S1, MI-S2, and MI-S3) using various spectroscopic methods, including FT-IR, 1H-NMR, 13C-NMR, DEPT, H,H- and C,H-COSY, and HRMS. The in vitro cytotoxic activity of these compounds was evaluated against two breast cancer cell lines, MCF-7 and MDA-MB-231, and compared with a noncancerous breast cell line, MCF-10A. All compounds exhibited potent cytotoxic activities with minimal selectivity toward normal cells. Molecular docking studies targeting the serine/threonine kinase AKT1, estrogen receptor alpha (ERα), and human epidermal growth factor receptor 2 (HER2) revealed strong binding affinities, suggesting a mechanism involving the disruption of key cellular signaling pathways. These findings underscore the potential of furo[2,3-b]pyridine derivatives as promising candidates for further development into anticancer agents, laying the groundwork for future investigations into their selective therapeutic efficacy and molecular mechanisms of action.

5.
J Comput Chem ; 2024 Jul 12.
Artículo en Inglés | MEDLINE | ID: mdl-38997238

RESUMEN

Empirical rovibrational energy levels are presented for the third most abundant, asymmetric carbon dioxide isotopologue, 16O12C18O, based on a compiled dataset of experimental rovibrational transitions collected from the literature. The 52 literature sources utilized provide 19,438 measured lines with unique assignments in the wavenumber range of 2-12,676 cm-1. The MARVEL (Measured Active Rotational-Vibrational Energy Levels) protocol, which is built upon the theory of spectroscopic networks, validates the great majority of these transitions and outputs 8786 empirical rovibrational energy levels with an uncertainty estimation based on the experimental uncertainties of the transitions. Issues found in the literature data, such as misassignment of quantum numbers, typographical errors, and misidentifications, are fixed before including them in the final MARVEL dataset and analysis. Comparison of the empirical energy-level data of this study with those in the line lists CDSD-2019 and Ames-2021 shows good overall agreement, significantly better for CDSD-2019; some issues raised by these comparisons are discussed.

6.
Environ Sci Pollut Res Int ; 31(35): 47598-47610, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38997599

RESUMEN

Sodium chloride (NaCl) can cause oxidative stress in plants, which represents a potential obstacle to the development of monocultures worldwide. Onion (Allium cepa L.) is a famous vegetable consumed and used in world cuisine. In the present study, we analyzed the influence of soil physicochemical profile and the remedial capacity of linalool on seed emergence, roots, and leaf growth in onions subjected to salt stress, as well as its in vivo and in vitro antioxidant potential, Fe2+chelating activity, and reducing power of Fe3+. The outcome of the soil analysis established the following order of abundance: sulfur (S) > calcium (Ca) > potassium (K) > magnesium (Mg) > sodium (Na). NaCl (150 mM) significantly reduced the emergence speed index (ESI), leaf and root length, while increasing the peroxidation content. The length of leaves and roots significantly increased after treatment with linalool (300 and 500 µg/mL). Our data showed negative correlations between seed emergence and K+ concentration, which was reversed after treatments. Linalool (500 µg/mL) significantly reduced oxidative stress, but increased Fe2+ concentration and did not show potential to reduce Fe3+. The in vivo antioxidant effect of linalool is thought to primarily result from an enzymatic activation process. This mechanism underscores its potential as a therapeutic agent for oxidative stress-related conditions. Further investigation into this process could unveil new avenues for antioxidant therapy.


Asunto(s)
Monoterpenos Acíclicos , Antioxidantes , Cebollas , Cebollas/efectos de los fármacos , Monoterpenos Acíclicos/farmacología , Estrés Salino/efectos de los fármacos , Monoterpenos/farmacología , Estrés Oxidativo/efectos de los fármacos
7.
Int J Biol Macromol ; 273(Pt 1): 132780, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38825291

RESUMEN

Manufacturing a highly effective sorbent for removing UO22+ ions from aqueous effluents is vital for safeguarding the environment and recovering valuable resources. This research presents an innovative strategy employing adsorbents derived from pullulan, specifically tailored with furfuryl-amidoxime (FAO), to improve their affinity for UO22+ ions. The formation of a UO22+ ion-imprinted sorbent (U-II-P) was achieved by crosslinking the UO22+/FAO-modified pullulan (FAO-P) complex with bis(maleimido)ethane (BME) via click Diels-Alder (DA) cyclization, enhancing its attraction and specificity for UO22+ ions. Detailed characterization of the synthesis was performed using NMR and FTIR spectroscopy, and the sorbent's external textures were analyzed using scanning electron microscopy (SEM). The U-II-P sorbent showcased outstanding preference for UO22+ over other metallic ions, with the most efficient adsorption occurring at pH 5. It exhibited a significant adsorption capacity of 262 mg/g, closely aligning with the predictions of the Langmuir adsorption model and obeying pseudo-second-order kinetic behavior. This investigation underlines the effectiveness of FAO-P as a specialized solution for UO22+ ion extraction from wastewater, positioning it as a viable option for the remediation of heavy metals.


Asunto(s)
Glucanos , Oximas , Uranio , Glucanos/química , Oximas/química , Uranio/química , Adsorción , Química Clic/métodos , Cinética , Contaminantes Químicos del Agua/química , Contaminantes Químicos del Agua/aislamiento & purificación , Purificación del Agua/métodos , Concentración de Iones de Hidrógeno , Iones/química
8.
Philos Trans R Soc Lond B Biol Sci ; 379(1906): 20230237, 2024 Jul 29.
Artículo en Inglés | MEDLINE | ID: mdl-38853570

RESUMEN

The synaptic tagging and capture (STC) hypothesis lays the framework on the synapse-specific mechanism of protein synthesis-dependent long-term plasticity upon synaptic induction. Activated synapses will display a transient tag that will capture plasticity-related products (PRPs). These two events, tag setting and PRP synthesis, can be teased apart and have been studied extensively-from their electrophysiological and pharmacological properties to the molecular events involved. Consequently, the hypothesis also permits interactions of synaptic populations that encode different memories within the same neuronal population-hence, it gives rise to the associativity of plasticity. In this review, the recent advances and progress since the experimental debut of the STC hypothesis will be shared. This includes the role of neuromodulation in PRP synthesis and tag integrity, behavioural correlates of the hypothesis and modelling in silico. STC, as a more sensitive assay for synaptic health, can also assess neuronal aberrations. We will also expound how synaptic plasticity and associativity are altered in ageing-related decline and pathological conditions such as juvenile stress, cancer, sleep deprivation and Alzheimer's disease. This article is part of a discussion meeting issue 'Long-term potentiation: 50 years on'.


Asunto(s)
Encéfalo , Memoria , Plasticidad Neuronal , Sinapsis , Sinapsis/fisiología , Humanos , Plasticidad Neuronal/fisiología , Encéfalo/fisiología , Memoria/fisiología , Animales , Modelos Neurológicos
9.
J Pak Med Assoc ; 74(3): 576-579, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38591302

RESUMEN

Necrotizi ng fasciit is [NF] i s a m ultifaceted disease of the muscle fascia and body tissues which demands the earliest intervention. Past reviews have documented ver y few cases of Aeromonas Hydroph ila [AH] induced N F fol lo wing abdominal surgery. AH can cause fatal NF as seen in a 72 year old female patient reported at Liaquat National Hospital &Medical College; a ter tiary care center in Karachi, Pakistan on 2nd April, 2022. She had a k nown comorbidity of hypertension and presented with the chief complaint of symptomatic gallstones for which she unde rwent Laparoscopic Cholecystectomy (LAPCHOL). She developed NF of the lower ab domen post- oper atively. Following uneventful Laparoscopic Cholecystectomy our pati ent presented to the ER two days later with severe lower abdo minal pain and overlyi ng celluliti s. Fasc io to my revealed extensive myonecrosis with necrotizing soft tissue in fe ction. Despite u ndergoing extensive surgical debr idement and broad spectr um antibi ot ic administration; the patient died in the ICU on the fifth postoperat ive day followi ng septic complications. Histopathologica l an alysis, confirmed i nflammat ion and necrosis. Culture sensitivity of the debrided tissue revealed AH. Approach should lie towards analyzing the behaviour of such microbes in high risk patients through collective case studies. This is the first clinical case showcasing such parameters e ncountered in the General Surger y Department.


Asunto(s)
Colecistectomía Laparoscópica , Fascitis Necrotizante , Cálculos Biliares , Femenino , Humanos , Anciano , Fascitis Necrotizante/etiología , Aeromonas hydrophila , Colecistectomía Laparoscópica/efectos adversos , Comorbilidad , Cálculos Biliares/cirugía , Cálculos Biliares/complicaciones
10.
Plants (Basel) ; 13(3)2024 Jan 29.
Artículo en Inglés | MEDLINE | ID: mdl-38337932

RESUMEN

Droughts have become more severe and frequent due to global warming. In this context, it is widely accepted that for drought assessments, both water supply (rainfall) and demand (standardized precipitation evapotranspiration index, SPEI) should be considered. Using SPEI, we explored the spatial-temporal patterns of dry and wet annual and seasonal changes in five sub-regions of East Asia during 1902-2018. These factors are linked to excess drought frequency and severity on the regional scale, and their effect on vegetation remains an important topic for climate change studies. Our results show that the SPEI significantly improved extreme drought and mostly affected the SPEI-06 and SPEI-12 growing seasons in East Asia during 1981-2018. The dry and wet annual SPEI trends mostly affect the five sub-regions of East Asia. The annual SPEI had two extremely dry spells during 1936-1947 and 1978-2018. Japan, South Korea, and North Korea are wet in the summer compared to other regions of East Asia, with drought frequency occurring at 51.4%, respectively. The mean drought frequencies in China and Mongolia are 57.4% and 54.6%. China and Mongolia are the driest regions in East Asia due to high drought frequency and duration. The spatial seasonal analysis of solar radiation (SR), water vapor pressure (WVP), wind speed (WS), vegetation condition index (VCI), temperature condition index (TCI), and vegetation health index (VHI) have confirmed that the East Asia region suffered from maximum drought events. The seasonal variation of SPEI shows no clear drying trends during summer and autumn seasons. During the winter and spring seasons, there was a dry trend in East Asia region. During 1902-1990, a seasonal SPEI presented diverse characteristics, with clear wet trends in Japan, Mongolia, and North Korea in four different growing seasons, with dry trends in China and South Korea. During 1991-2018, seasonal SPEI presented clear dry trends in Japan, Mongolia, and North Korea in different growing seasons, while China and South Korea showed a wet trend during the spring, autumn, and winter seasons. This ecological and climatic mechanism provides a good basis for the assessment of vegetation and drought-change variations within East Asia. An understandings of long-term vegetation trends and the effects of rainfall and SPEI on droughts of varying severity is essential for water resource management and climate change adaptation. Based on the results, water resources will increase under global warming, which may alleviate the water scarcity issue in the East Asia region.

12.
Artículo en Inglés | MEDLINE | ID: mdl-38261226

RESUMEN

Abiotic stresses including sodium chloride (NaCl) are known to negatively affect plant physiology and seed germination by inducing a delay in establishing seedling emergence. The monoterpene carvacrol is the major component of several aromatic plants and seems to interfere with germination and seedling growth. In this study, we investigated whether treatment with carvacrol attenuates the effects of NaCl on the germination and development of Allium cepa, where biochemical parameters were also analyzed. The results showed that the Emergency Speed Index (ESI) was near to 2.0 in the control group. The groups NaCl, carvacrol alone, and in co-treatment with NaCl exhibited an ESI below 0.8, being significantly smaller when compared to the control. NaCl + carvacrol significantly inhibited seed emergence in relation to the NaCl group. Only the content of malondialdehyde was significantly altered by NaCl.

13.
J Comput Chem ; 45(13): 969-984, 2024 May 15.
Artículo en Inglés | MEDLINE | ID: mdl-38189163

RESUMEN

A set of empirical rovibrational energy levels, obtained through the MARVEL (measured active rotational-vibrational energy levels) procedure, is presented for the 13 C 16 O 2 isotopologue of carbon dioxide. This procedure begins with the collection and analysis of experimental rovibrational transitions from the literature, allowing for a comprehensive review of the literature on the high-resolution spectroscopy of 13 C 16 O 2 , which is also presented. A total of 60 sources out of more than 750 checked provided 14,101 uniquely measured and assigned rovibrational transitions in the wavenumber range of 579-13,735 cm - 1 . This is followed by a weighted least-squares refinement yielding the energy levels of the states involved in the measured transitions. Altogether 6318 empirical rovibrational energies have been determined for 13 C 16 O 2 . Finally, estimates have been given for the uncertainties of the empirical energies, based on the experimental uncertainties of the transitions. The detailed analysis of the lines and the spectroscopic network built from them, as well as the uncertainty estimates, all serve to pinpoint possible errors in the experimental data, such as typos, misassignment of quantum numbers, and misidentifications. Errors found in the literature data were corrected before including them in the final MARVEL dataset and analysis.

14.
Mol Neurobiol ; 61(1): 91-103, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-37582987

RESUMEN

Synapses are the cellular substrates of higher-order brain functions, and their dysfunction is an early and primary pathogenic mechanism across several neurological disorders. In particular, Alzheimer's disease (AD) is categorized by prodromal structural and functional synaptic deficits, prior to the advent of classical behavioral and pathological features. Recent research has shown that the development, maintenance, and plasticity of synapses depend on localized protein translation. Synaptosomes and synaptoneurosomes are biochemically isolated synaptic terminal preparations which have long been used to examine a variety of synaptic processes ex vivo in both healthy and pathological conditions. These ex vivo preparations preserve the mRNA species and the protein translational machinery. Hence, they are excellent in organello tools for the study of alterations in mRNA levels and protein translation in neuropathologies. Evaluation of synapse-specific basal and activity-driven de novo protein translation activity can be conveniently performed in synaptosomal/synaptoneurosomal preparations from both rodent and human brain tissue samples. This review gives a quick overview of the methods for isolating synaptosomes and synaptoneurosomes before discussing the studies that have utilized these preparations to study localized synapse-specific protein translation in (patho)physiological situations, with an emphasis on AD. While the review is not an exhaustive accumulation of all the studies evaluating synaptic protein translation using the synaptosomal model, the aim is to assemble the most relevant studies that have done so. The hope is to provide a suitable research platform to aid neuroscientists to utilize the synaptosomal/synaptoneurosomal models to evaluate the molecular mechanisms of synaptic dysfunction within the specific confines of mRNA localization and protein translation research.


Asunto(s)
Enfermedad de Alzheimer , Humanos , Enfermedad de Alzheimer/patología , Sinapsis/metabolismo , Encéfalo/metabolismo , ARN Mensajero/genética , ARN Mensajero/metabolismo , Biosíntesis de Proteínas , Péptidos beta-Amiloides/metabolismo
15.
Saudi Pharm J ; 31(12): 101832, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-38125951

RESUMEN

In the current work, cytotoxicity and genotoxicity of different organoselenium compounds were examined using Trypan blue exclusion and alkaline comet assays with silver staining respectively. Leukocytes were subjected to a 3-hour incubation with organoselenium compounds at concentrations of 1, 5, 10, 25, 50, and 75 µM, or with the control vehicle (DMSO), at a temperature of 37 °C. The viability of the cells was evaluated using the Trypan blue exclusion method, while DNA damage was analyzed through the alkaline comet assay with silver staining. The exposure of leukocytes to different organoselenium compounds including i.e. (Z)-N-(pyridin-2-ylmethylene)-1-(2-((2-(1-((E)-pyridin-2-ylmethyleneamino)ethyl)phenyl)diselanyl)phenyl)ethanamine (C1), 2,2'(1Z,1'E)-(1,1'-(2,2'-diselanediylbis(2,1-phenylene))bis(ethane-1,1-diyl)) bis(azan-1-yl-1-ylidene)bis -methan-1-yl-1-ylidene)diphenol (C2), and dinaphthyl diselenide (NapSe)2, At concentrations ranging from 1 to 5 µM, no significant DNA damage was observed, as indicated by the absence of a noteworthy increase in the Damage Index (DI). Our results suggest that the organoselenium selenium compounds tested were not genotoxic and cytotoxic to human leukocytes in vitro at lower concentration. This study offers further insights into the genotoxicity profile of these organochalcogens in human leukocytes. Their genotoxicity and cytotoxicity effects at higher concentration are probably mediated through reactive oxygen species generation and their ability to catalyze thiol oxidation.

16.
Ann Med Surg (Lond) ; 85(12): 6148-6151, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-38098581

RESUMEN

Introduction and importance: Cystic partially differentiated nephroblastoma (CPDN) is a rare cystic tumor that affects the kidney. It has a low potential for malignancy. It usually presents as an abdominal mass. It may be difficult to confirm the diagnosis of CPDN without a histopathological study. Case presentation: The authors report a case of an 18-month-old girl with abdominal distention, which was noticed by her parents. An abdominal computed tomography scan showed a large multilocular cystic mass arising from the lower pole of the left kidney. A left total nephrectomy was performed. Immature blastemal elements without evidence of malignant cells were observed on histological analysis. Conclusion: The authors report a case of an 18-month-old girl with CPDN managed by total nephrectomy. CPDN should be considered in the differential diagnosis of patients with cystic renal lesions. The authors would also like to affirm that partial or total nephrectomy should be done in all cases of CPDN and other cystic renal tumors.

17.
J Neuroimmunol ; 385: 578248, 2023 12 15.
Artículo en Inglés | MEDLINE | ID: mdl-37995595

RESUMEN

BACKGROUND: Progressive multifocal leukoencephalopathy (PML) is a rare demyelinating disease due to a lytic infection of oligodendrocytes caused by John Cunningham polyoma virus (JCV) infection. Idiopathic CD4+ T-cell lymphocytopenia (ICL) is a very rare cause of PML. METHODS: We present an individual with PML secondary to ICL treated with 3 doses of pembrolizumab, a Programmed-Death-1 Immune Checkpoint Inhibitor following with complete resolution of symptoms and conduct a review of the literature. CONCLUSION: This report illustrates the objective clinical and radiological improvement in a patient with PML due to ICL and suggests further study of immune checkpoint inhibitors as potential treatment for patients with PML.


Asunto(s)
Virus JC , Leucoencefalopatía Multifocal Progresiva , Linfocitopenia-T Idiopática CD4-Positiva , Humanos , Leucoencefalopatía Multifocal Progresiva/diagnóstico por imagen , Leucoencefalopatía Multifocal Progresiva/tratamiento farmacológico , Leucoencefalopatía Multifocal Progresiva/etiología , Linfocitopenia-T Idiopática CD4-Positiva/complicaciones , Linfocitopenia-T Idiopática CD4-Positiva/tratamiento farmacológico , Anticuerpos Monoclonales Humanizados/uso terapéutico
18.
Cureus ; 15(9): e46156, 2023 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-37905257

RESUMEN

INTRODUCTION: Diabetic-related foot condition is one of the most debilitating complications with a higher rate of failure in limb correction, reconstruction, or salvage surgery. Amputation is the final option after other surgical treatments have failed. Major amputation increases energy consumption, resulting in high dependency, decreased mobility, and poor prognosis. Consequently, minor amputation is preferred to resolve these problems but elevated wound complications leading to inadequate prosthesis fit, became a detriment to minor amputation. Strict selection of patients is crucial to ensure success and good functional outcomes as demonstrated in this retrospective study of this case series. Methods: This case series included six patients who underwent Pirogoff amputation with the modification described by Nather and reported the procedure's outcome. The inclusion criteria for subjects were the presence of palpable posterior tibial artery (PTA) or at least biphasic Doppler signal and ankle-brachial systolic index (ABSI) more than 0.70. Other demographic data as well as hematological, inflammatory, and biochemical parameters that may affect wound healing such as Hb, HbA1c, ESR, CRP, WBC, and albumin were recorded as well. The rate and time for wound healing and bone union, presence of complications, and final ambulatory status of patients were determined as the outcome of this study. RESULTS: All of the patients had diabetic foot infections involving only the forefoot region with the presence of either palpable PTA or biphasic Doppler signal. Although the majority of the cases had deranged blood parameters, soft tissue and bone healing were achieved at variable times. Four had good outcomes as they were able to ambulate. One case was complicated with chronic wound dehiscence and another one had Pirogoff stump infection and required transtibial amputation. CONCLUSION: With strict selection criteria, Pirogoff amputation may provide a good functional outcome with a lesser degree of complications compared to major amputation.

19.
Cureus ; 15(8): e43152, 2023 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-37692718

RESUMEN

Histoplasmosis is a fungal infection that, if left untreated, can result in very serious health outcomes, especially in patient populations that are immunocompromised. While the manifestations of the disease are very diverse and highly dependent on the individual health conditions of the patient, in severe cases, it can lead to serious pneumonia, acute respiratory distress syndrome, and death if rapid medical intervention is not performed. Here, we present the case of a patient with acquired immunodeficiency syndrome who suffered from histoplasmosis pneumonia with suspected superimposed Pneumocystis pneumonia. The patient rapidly decompensated shortly after admission to the hospital; he presented just one week after being discharged of a similar infection. After being transferred to the intensive care unit (ICU), aggressive intervention stabilized the patient's condition enough for him to be discharged several days later. We hope the unique circumstances of this patient's hospital stay can guide clinicians in managing serious infections in immunocompromised patients.

20.
Cureus ; 15(7): e42458, 2023 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-37637647

RESUMEN

Pelizaeus-Merzbacher disease is a tremendously rare genetic disorder caused by a mutation on the X chromosome. The mutation affects a gene critical to white matter myelination and results in significant neurological issues. Here, we present one such case of a child diagnosed with Pelizaeus-Merzbacher disease. A relatively normal gestation and birth belied the underlying issue until he presented to the emergency department a month after birth with seizure-like activity and failure to thrive. After intensive evaluation and treatment, the patient was diagnosed with the illness and received surgery to place a tracheostomy and a gastrostomy tube to treat the stridor and failure to thrive caused by his illness. After approximately a month and a half of inpatient treatment, the patient was able to be discharged home in stable condition.

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