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1.
Respirology ; 29(8): 722-730, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38769707

RESUMO

BACKGROUND AND OBJECTIVE: The identification of factors associated with long-term prognosis after community-onset pneumonia in elderly patients should be considered when initiating advance care planning (ACP). We aimed to identify these factors and develop a prediction score model. METHODS: Patients aged 65 years and older, who were hospitalized for pneumonia at nine collaborating institutions, were included. The prognosis of patients 180 days after the completion of antimicrobial treatment for pneumonia was prospectively collected. RESULTS: The total number of analysable cases was 399, excluding 7 outliers and 42 cases with missing data or unknown prognosis. These cases were randomly divided in an 8:2 ratio for score development and testing. The median age was 82 years, and there were 68 (17%) deaths. A multivariate analysis showed that significant factors were performance status (PS) ≥2 (Odds ratio [OR], 11.78), hypoalbuminemia ≤2.5 g/dL (OR, 5.28) and dementia (OR, 3.15), while age and detection of antimicrobial-resistant bacteria were not associated with prognosis. A scoring model was then developed with PS ≥2, Alb ≤2.5, and dementia providing scores of 2, 1 and 1 each, respectively, for a total of 4. The area under the curve was 0.8504, and the sensitivity and specificity were 94.6% and 61.7% at the cutoff of 2, respectively. In the test cases, the sensitivity and specificity were 91.7% and 63.1%, respectively, at a cutoff value of 2. CONCLUSION: Patients meeting this score should be considered near the end of life, and the initiation of ACP practices should be considered.


Assuntos
Infecções Comunitárias Adquiridas , Pneumonia , Humanos , Feminino , Masculino , Infecções Comunitárias Adquiridas/microbiologia , Infecções Comunitárias Adquiridas/diagnóstico , Infecções Comunitárias Adquiridas/tratamento farmacológico , Prognóstico , Idoso , Idoso de 80 Anos ou mais , Pneumonia/diagnóstico , Pneumonia/microbiologia , Pneumonia/tratamento farmacológico , Pneumonia/mortalidade , Estudos Prospectivos , Fatores de Risco , Antibacterianos/uso terapêutico , Valor Preditivo dos Testes , Demência/diagnóstico , Demência/epidemiologia
2.
J Infect Chemother ; 30(7): 597-602, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38190963

RESUMO

BACKGROUND: Nursing- and healthcare-associated pneumonia (NHCAP) constitutes most of the pneumonia in elderly patients including aspiration pneumonia in Japan. Lascufloxacin (LSFX) possesses broad antibacterial activity against respiratory pathogens, such as Streptococcus spp. And anaerobes inside the oral cavity. However, the efficacy and safety of LSFX in NHCAP treatment remains unknown. We aimed to evaluate the efficacy and safety of LSFX tablets in the treatment of patients with NHCAP. METHODS: In this single-arm, open-label, uncontrolled study, LSFX was administered to patients with NHCAP at 24 facilities. The study participants were orally administered 75 mg LSFX once daily for 7 days. The primary endpoint was the clinical efficacy at the time of test of cure (TOC). The secondary endpoints included clinical efficacy at the time of end of treatment (EOT), early clinical efficacy, microbiological efficacy, and safety analysis. RESULT: During the study period, 75 patients provided written informed consent to participate and were included. Finally, 56 and 71 patients were eligible for clinical efficacy and safety analyses, respectively. The median age of the patients was significantly high at 86 years. All patients were classified as having moderate disease severity using the A-DROP scoring system. LSFX tablets demonstrated high efficacy rates of 78.6 % at TOC and 89.3 % at EOT. The risk factors for resistant bacteria or aspiration pneumonia did not affect clinical efficacy. No severe adverse events associated with the study drugs were observed. CONCLUSION: Oral LSFX is an acceptable treatment option for moderate NHCAP in elderly patients who can take oral medications.


Assuntos
Antibacterianos , Fluoroquinolonas , Pneumonia Associada a Assistência à Saúde , Humanos , Masculino , Feminino , Idoso de 80 Anos ou mais , Idoso , Antibacterianos/uso terapêutico , Antibacterianos/efeitos adversos , Antibacterianos/administração & dosagem , Fluoroquinolonas/uso terapêutico , Fluoroquinolonas/efeitos adversos , Fluoroquinolonas/administração & dosagem , Japão , Pneumonia Associada a Assistência à Saúde/tratamento farmacológico , Pneumonia Associada a Assistência à Saúde/microbiologia , Resultado do Tratamento , Administração Oral , Pessoa de Meia-Idade
3.
Catheter Cardiovasc Interv ; 101(4): 764-772, 2023 03.
Artigo em Inglês | MEDLINE | ID: mdl-36786488

RESUMO

OBJECTIVES: This study aimed to determine whether drug-coated balloon (DCB) angioplasty following intraplaque wiring and the use of modified balloons is safe and effective in the percutaneous treatment of coronary chronic total occlusions (CTOs). BACKGROUND: DCB is an alternative therapeutic option without the limitations of permanent vascular implants. However, its efficacy in CTOs has yet to be confirmed. The combination of modified balloons and DCB can be effectively applied when the intraplaque passage of the guidewire is achieved in CTOs. METHODS: Data from 124 consecutive CTO lesions (105 patients) treated at our hospital between February 2016 and December 2020 were screened for inclusion and retrospectively analyzed. Among the 118 lesions successfully recanalized, intraplaque wiring was achieved in 108, and 85 were treated by the DCB-only approach following cutting/scoring balloon dilatation. RESULTS: Follow-up data were available for 82 lesions (71 patients). The median occlusion length was 18.5 mm, and the J-CTO score was 1.7 ± 0.9. No in-hospital major adverse cardiac events occurred, including abrupt vessel closure. During the median 29-month follow-up period, target lesion revascularization was performed for 10 lesions. Follow-up coronary angiography (8.7 ± 3.9 months after the index procedure) was performed for 64 lesions, demonstrating late lumen loss of -0.15 mm (interquartile range -0.4 to 0.23 mm), binary restenosis (diameter stenosis ≥50%) in 12 lesions (18.8%), and late lumen enlargement in 37 (57.8%). CONCLUSION: The DCB-only approach following the use of modified balloons is a promising strategy for coronary CTOs when intraplaque wiring is achieved.


Assuntos
Oclusão Coronária , Reestenose Coronária , Intervenção Coronária Percutânea , Humanos , Oclusão Coronária/terapia , Vasos Coronários , Estudos Retrospectivos , Intervenção Coronária Percutânea/efeitos adversos , Resultado do Tratamento , Angiografia Coronária , Materiais Revestidos Biocompatíveis , Reestenose Coronária/etiologia
4.
J Am Chem Soc ; 144(40): 18650-18671, 2022 Oct 12.
Artigo em Inglês | MEDLINE | ID: mdl-36153993

RESUMO

Oxidative addition of CH4 to the catalyst surface produces CH3 and H. If the CH3 species generated on the surface couple with each other, reductive elimination of C2H6 may be achieved. Similarly, H's could couple to form H2. This is the outline of nonoxidative coupling of methane (NOCM). It is difficult to achieve this reaction on a typical Pt catalyst surface. This is because methane is overoxidized and coking occurs. In this study, the authors approach this problem from a molecular aspect, relying on organometallic or complex chemistry concepts. Diagrams obtained by extending the concepts of the Walsh diagram to surface reactions are used extensively. C-H bond activation, i.e., oxidative addition, and C-C and H-H bond formation, i.e., reductive elimination, on metal catalyst surfaces are thoroughly discussed from the point of view of orbital theory. The density functional theory method for structural optimization and accurate energy calculations and the extended Hückel method for detailed analysis of crystal orbital changes and interactions play complementary roles. Limitations of monometallic catalysts are noted. Therefore, a rational design of single atom alloy (SAA) catalysts is attempted. As a result, the effectiveness of the Pt1/Au(111) SAA catalyst for NOCM is theoretically proposed. On such an SAA surface, one would expect to find a single Pt monatomic site in a sea of inert Au atoms. This is desirable for both inhibiting overoxidation and promoting reductive elimination.

5.
Catheter Cardiovasc Interv ; 99(6): 1758-1765, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35253349

RESUMO

OBJECTIVES: This study aimed to examine whether the combination of excimer laser coronary atherectomy (ELCA) and drug-coated balloon (DCB) angioplasty can provide feasible clinical outcome in patients with ST-segment elevation myocardial infarction (STEMI) with 8-month and 2-year scheduled follow-up angiography. BACKGROUND: Intracoronary thrombus elevates the risk of interventional treatment in patients with STEMI and hampers drug absorption into the vasculature released from DCB. METHODS: Sixty-two patients with STEMI within 24 h after the onset of symptoms were enrolled in this prospective, single-center, single-arm study. RESULTS: The laser catheter was successfully crossed distal to the culprit lesion in all cases. No ELCA-related adverse events occurred. Bail-out stenting was required in two patients (3.2%) after adjunctive ballooning; thus, the remaining 60 patients were completed with DCB angioplasty without stenting. Scheduled angiography at 8 months and 2 years was completed in 100% and 85.2%, respectively, and minimal lumen diameters were 3.4 ± 0.5, 3.4 ± 0.6, and 3.4 ± 0.5 mm after the procedure, at 8 months and at 2 years, respectively. Binary restenosis was observed in five patients (8.1%) in whom target lesion revascularization was performed. The duration of dual antiplatelet therapy was 2.3 ± 2.2 months, and neither abrupt vessel closure, reinfarction, cardiac death nor major bleeding was observed. CONCLUSION: A combination of DCB angioplasty with ELCA is a feasible therapeutic option for STEMI.


Assuntos
Stents Farmacológicos , Terapia a Laser , Infarto do Miocárdio com Supradesnível do Segmento ST , Angiografia Coronária , Humanos , Lasers , Estudos Prospectivos , Infarto do Miocárdio com Supradesnível do Segmento ST/diagnóstico por imagem , Infarto do Miocárdio com Supradesnível do Segmento ST/terapia , Resultado do Tratamento
6.
Angew Chem Int Ed Engl ; 61(40): e202209675, 2022 Oct 04.
Artigo em Inglês | MEDLINE | ID: mdl-35912811

RESUMO

Bonding dissimilar elements to provide synergistic effects is an effective way to improve the performance of metal catalysts. However, as the properties become more dissimilar, achieving synergistic effects effectively becomes more difficult due to phase separation. Here we describe a comprehensive study on how subnanoscale alloying is always effective for inter-elemental synergy. Thirty-six combinations of both bimetallic subnanoparticles (SNPs) and nanoparticles (NPs) were studied systematically using atomic-resolution imaging and catalyst benchmarking based on the hydrogen evolution reaction (HER). Results revealed that SNPs always produce greater synergistic effects than NPs, the greatest synergistic effect was found for the combination of Pt and Zr. The atomic-scale miscibility and the associated modulation of electronic states at the subnanoscale were much different from those at the nanoscale, which was observed by annular-dark-field scanning transmission electron microscopy (ADF-STEM) and X-ray photoelectron spectroscopy (XPS), respectively.

7.
J Interv Cardiol ; 2021: 5590109, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34393666

RESUMO

OBJECTIVES: We evaluated the thrombus-vaporizing effect of excimer laser coronary angioplasty (ELCA) in patients with ST-segment elevation myocardial infarction (STEMI) by optical coherence tomography (OCT). BACKGROUND: Larger intracoronary thrombus elevates the risk of interventional treatment and mortality in patients with STEMI. METHODS: A total of 92 patients with STEMI who presented within 24 hours from the onset and underwent ELCA following manual aspiration thrombectomy (MT) were analyzed. RESULTS: The mean baseline thrombolysis in myocardial infarction flow grade was 0.4 ± 0.6, which subsequently improved to 2.3 ± 0.7 after MT (p < 0.0001) and 2.7 ± 0.5 after ELCA (p=0.0001). The median residual thrombus volume after MT was 65.7 mm3, which significantly reduced to 47.5 mm3 after ELCA (p < 0.0001). Plaque rupture was identified by OCT in only 22 cases (23.9%) after MT, but was distinguishable in 36 additional cases after ELCA (total: 58 cases; 63.0%). Ruptured lesions contained a higher proportion of red thrombus than nonruptured lesions (75.9% vs. 43.3%, p=0.001). Significantly larger thrombus burden after MT (69.6 mm3 vs. 56.3 mm3, p < 0.05) and greater thrombus reduction by ELCA (21.2 mm3 vs. 11.8 mm3, p < 0.01) were observed in ruptured lesions than nonruptured lesions. CONCLUSIONS: ELCA effectively vaporized intracoronary thrombus in patients with STEMI even after MT. Lesions with plaque rupture contained larger thrombus burden that was frequently characterized by red thrombus and more effectively reduced by ELCA.


Assuntos
Trombose Coronária , Terapia a Laser , Infarto do Miocárdio , Intervenção Coronária Percutânea , Infarto do Miocárdio com Supradesnível do Segmento ST , Idoso , Angiografia Coronária , Trombose Coronária/diagnóstico por imagem , Trombose Coronária/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio com Supradesnível do Segmento ST/diagnóstico por imagem , Infarto do Miocárdio com Supradesnível do Segmento ST/cirurgia , Trombectomia , Tomografia de Coerência Óptica , Resultado do Tratamento
8.
Med Mycol ; 58(7): 965-972, 2020 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31943043

RESUMO

There is an urgent need for development of better diagnostic strategies to improve outcomes in patients with invasive pulmonary aspergillosis (IPA). We hypothesized that lung perfusion single-photon emission computed tomography (SPECT) may be more sensitive and specific than computed tomography (CT) of the chest for detection of IPA because it is an angioinvasive pulmonary infection with characteristics that are different from those of bacterial pneumonia. We used SPECT with injection of technetium-99m-labeled macroaggregated albumin ([99mTc]MAA) to measure pulmonary perfusion in noninfected mice, mice with IPA, and mice with bacterial pneumonia. Histopathologic analysis was performed to evaluate the correlation between the perfusion defect and mould invasion. We also attempted to quantitatively evaluate the SPECT images to identify differences in decreased perfusion levels in affected areas in the mouse lung. Histopathologic analysis in the IPA mouse model showed a clear match between areas with a perfusion defect and the presence of mold, indicating that the location of the perfusion defect on a SPECT image reflects angioinvasion of the mould in the lungs. Some of these perfusion defects could be seen before appearance of the infiltrate of CT images. Quantitative analysis confirmed that perfusion in the affected areas was significantly decreased in the IPA model but not in the bacterial pneumonia model (P < .0001). This imaging method may be preferable to the alternative methods presently used to identify the presence of mold in a patient's lungs.


Assuntos
Aspergillus fumigatus/isolamento & purificação , Aspergilose Pulmonar Invasiva/diagnóstico , Aspergilose Pulmonar Invasiva/veterinária , Doenças dos Roedores/diagnóstico , Agregado de Albumina Marcado com Tecnécio Tc 99m , Tomografia Computadorizada de Emissão de Fóton Único/métodos , Tomografia Computadorizada por Raios X/métodos , Animais , Modelos Animais de Doenças , Feminino , Camundongos , Camundongos Endogâmicos ICR
9.
J Chem Phys ; 153(2): 024120, 2020 Jul 14.
Artigo em Inglês | MEDLINE | ID: mdl-32668912

RESUMO

A machine-learning approach to draw landscape maps in a low-dimensional control-parameter space is examined through a case study of three-dimensional alignment control of the asymmetric-top molecule SO2. As a minimal model, we consider the control by using a set of mutually orthogonal, linearly polarized laser pulses that are parameterized by the time delay and fluence ratio. The parameters are represented either by points in the parameter space or by time- and frequency-resolved spectra. Machine-learning models based on convolutional neural networks together with two considerably different representations, which are trained by using a reasonably small number of training samples, construct maps that have sufficient accuracy to predict temperature-dependent control mechanisms.

10.
Langmuir ; 35(25): 8445-8451, 2019 06 25.
Artigo em Inglês | MEDLINE | ID: mdl-31140811

RESUMO

The property and structure of spread films of meibum extruded from rabbit eyelids and its fractions were investigated using the Langmuir film balance technique and Brewster angle microscopy in order to understand the influence of endogenous ingredients in meibum on the structure and stability of the tear film lipid layer against mechanical stimulus. Surface pressure (?)?film area ( A) isotherms for meibum were measured upon repetitive high-speed compression?expansion cycles and were found almost identical to each other with very small hysteresis, indicating the high stability of the meibum film. Brewster angle microcopy observation implied the spontaneous formation of condensed-phase network structures which consist primarily of wax esters and cholesteryl esters as nonpolar ingredients, coexisting with a monolayer phase of polar lipids two-dimensionally confined by the networks, which were spontaneously formed in the meibum film. The networks were gathered densely and deformed when the film was laterally compressed with barriers of Langmuir trough, but returned to the dispersed networks when expanded. The influence of temperature and salts dissolved in an aqueous subphase was also investigated. The results indicated that the temperature change (20 and 35 ?C) induced a difference of surface pressure at the same film areas in rather compressed films, and the presence of salts in the subphase expanded the films. However, the features of isotherm and surface morphology of the film, including their reversibility, were maintained. Phospholipid-removed meibum also formed a stable film, but slight changes were found in the hysteresis and film morphology compared to those in the meibum film. In contrast, in a film of phospholipid- and cholesterol-removed meibum, three-dimensional aggregates grew upon the first compression and not redispersed by the subsequent expansion, giving noticeable hysteresis between the isotherms. It is considered that high deformability upon compression and resilience upon expansion of the networks as well as reversible collapse and spreading property of the confined monolayer phase would hold the stability of the meibum film against repeated compressions.

11.
Ann Vasc Surg ; 58: 91-100, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30769058

RESUMO

BACKGROUND: Chronic total occlusion (CTO) of femoropopliteal artery (FP) continues to be a lesion subset where maintaining long-term patency after endovascular treatment is challenging. We evaluated the efficacy of cutting balloon angioplasty (CBA) for de novo FP-CTOs in patients with symptomatic lower limb ischemia. METHODS: Seventy-three limbs of 67 symptomatic patients with de novo FP-CTOs successfully recanalized using CBA alone were enrolled in this study. Primary patency was defined as the absence of recurrent symptoms and no deterioration of the ankle-brachial index (ABI) >0.10 from the immediate postinterventional value. RESULTS: The mean age was 73.5 ± 7.3 years, and 59.7% of patients had diabetes mellitus. Most lesions were classified as Trans-Atlantic Inter-Society Consensus II type C (n = 18; 24.7%) or type D (n = 44; 60.3%), with mean lesion and occluded lengths of 24.8 ± 11.4 and 17.8 ± 11.2 cm, respectively. No procedure-related adverse events occurred, except one distal embolization. The ABI significantly increased after intervention from 0.52 ± 0.12 to 0.80 ± 0.15 (P < 0.0001), with marked improvement in clinical symptoms (Rutherford stage: 2.7 ± 1.0 to 1.1 ± 1.2, P < 0.0001). The mean follow-up period was 31.2 ± 18.0 months, and the primary patency rates at 12 and 24 months were 75.3% and 60.6%, respectively. The independent predictive factors of failed patency were baseline hemoglobin A1c (P = 0.031, hazard radio [HR] 1.51 per 1%), occluded length ≥15 cm (P = 0.036, HR 2.90), and severe dissection (P = 0.033, HR 2.85). Vessel calcification and diameter did not affect primary patency. CONCLUSIONS: CBA is a feasible option for endovascular treatment of FP-CTOs. Diabetic status, occlusion length, and severe dissection after CBA are independent negative predictors of long-term patency.


Assuntos
Angioplastia com Balão/métodos , Artéria Femoral/cirurgia , Doença Arterial Periférica/cirurgia , Artéria Poplítea/cirurgia , Idoso , Idoso de 80 Anos ou mais , Angiografia , Angioplastia com Balão/efeitos adversos , Índice Tornozelo-Braço , Doença Crônica , Constrição Patológica , Feminino , Artéria Femoral/diagnóstico por imagem , Artéria Femoral/fisiopatologia , Humanos , Masculino , Doença Arterial Periférica/diagnóstico , Doença Arterial Periférica/fisiopatologia , Artéria Poplítea/diagnóstico por imagem , Artéria Poplítea/fisiopatologia , Fatores de Tempo , Resultado do Tratamento , Ultrassonografia Doppler Dupla , Grau de Desobstrução Vascular
12.
J Infect Chemother ; 25(11): 886-893, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31113725

RESUMO

Oral treatment for elderly outpatients with pneumonia is becoming increasingly important in this super-aged society from the perspective of cost-effectiveness and limited hospital capacities. We evaluated the efficacy and safety of two oral respiratory quinolones, sitafloxacin and garenoxacin, in elderly patients with pneumonia. This randomized, multicenter, open-label trial was conducted among patients aged ≥65 years with clinically and radiographically confirmed pneumonia in Japan. Patients were randomly assigned (1:1) to receive either sitafloxacin (100 mg/day) or garenoxacin (400 mg/day) for 3-10 days. The primary efficacy endpoint was the clinical cure rate at 5-10 days after the end of treatment. From December 2013 to November 2017, we enrolled 120 patients at 11 hospitals and randomly assigned 59 patients to the sitafloxacin group (1 patient withdrew) and 61 patients to the garenoxacin group. These included 30 patients with nursing and healthcare-associated pneumonia (NHCAP) (18 receiving sitafloxacin, 12 receiving garenoxacin) and 37 patients with aspiration pneumonia (16 receiving sitafloxacin, 21 receiving garenoxacin). The clinical cure rates in the sitafloxacin and garenoxacin groups were 88.5% (95% confidence interval: 76.6-95.6) and 88.9% (95% confidence interval: 77.4-95.8), respectively. No significant differences were observed in the incidence rates of drug-related adverse events between the sitafloxacin (20.7%; 12/58 patients) and garenoxacin (27.9%; 17/61 patients) groups. The most common adverse event was hepatic dysfunction, which occurred in seven patients in each group. We conclude that sitafloxacin and garenoxacin are comparably effective and safe for the treatment of pneumonia, including NHCAP and aspiration pneumonia, in elderly patients.


Assuntos
Antibacterianos/efeitos adversos , Antibacterianos/uso terapêutico , Fluoroquinolonas/efeitos adversos , Fluoroquinolonas/uso terapêutico , Pneumonia/tratamento farmacológico , Idoso , Idoso de 80 Anos ou mais , Infecções Comunitárias Adquiridas/tratamento farmacológico , Feminino , Humanos , Japão , Masculino , Quinolonas/efeitos adversos , Quinolonas/uso terapêutico
13.
J Chem Phys ; 149(6): 064302, 2018 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-30111151

RESUMO

We apply nonlinear optimal control simulation to design a non-resonant control pulse that maximizes the probability of specified photodissociation of IBr by utilizing the non-resonant dynamic Stark effect in the presence of a predetermined pump pulse. The optimal pulses are always composed of several subpulses that increase the target probability considerably depending on the wavelength of the pump pulse. Focusing on the cases of high target probabilities, we systematically examine how the subpulses cooperate with each other on the basis of pulse-partitioning analyses. We show that the subpulses largely cooperate with the pump pulse, which can explain their irradiation timings. On the other hand, the cooperation between the subpulses is mainly expressed as the sum of the contribution from each subpulse.

14.
Med Mycol ; 54(2): 120-7, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26531100

RESUMO

Patients with chronic pulmonary aspergillosis (CPA) have a poor prognosis and CPA occurs in patients with various underlying diseases. Recently, the number of patients with CPA complicated by nontuberculous mycobacteria (NTM) has increased. Additionally, complications of both diseases have several problems like drug interactions. Since the impact of NTM on the outcome of CPA is not well understood, we investigated the risk factors for developing CPA and the clinical characteristics of CPA patients with or without NTM. We retrospectively investigated the medical records of NTM and CPA patients who were admitted to Nagasaki University Hospital between April 2008 and September 2013. Comorbid diseases, causative microorganisms, radiological findings, and outcomes were evaluated. During the study period, 82 and 41 patients were diagnosed as having NTM and CPA, respectively. Nine patients were coinfected with NTM and CPA, and cavitary type NTM and steroid usage were independent risk factors of development of CPA. Mortality rates in the coinfection group were significantly higher than those of the NTM without CPA group (P = .003, log-rank test). The rate of treatment initiation in the co-infection group (33.3%) was significantly lower than in the CPA without NTM group (84.4%) (P = .006). However, there were no significant differences in cumulative survival rate between both groups (P = .760, log-rank test). Cavity formation and steroid usage were the independent risk factors for NTM patients to develop CPA within long observation period, and development of CPA made outcomes poor. It is important to diagnose the development of CPA early and initiate treatment for CPA.


Assuntos
Coinfecção/patologia , Infecções por Mycobacterium não Tuberculosas/complicações , Infecções por Mycobacterium não Tuberculosas/patologia , Aspergilose Pulmonar/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Coinfecção/epidemiologia , Coinfecção/mortalidade , Feminino , Humanos , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Infecções por Mycobacterium não Tuberculosas/epidemiologia , Infecções por Mycobacterium não Tuberculosas/mortalidade , Aspergilose Pulmonar/epidemiologia , Aspergilose Pulmonar/mortalidade , Estudos Retrospectivos , Fatores de Risco , Análise de Sobrevida
15.
Heliyon ; 10(10): e31464, 2024 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-38803887

RESUMO

Candida vulturna is a recently discovered and not widely documented ascomycetous yeast phylogenetically related to the outbreak-causing and multidrug-resistant Candida auris. A middle-aged Japanese man with no discernible immunodeficiency was admitted to hospital with ileal diverticulitis. Following laparoscopic right hemicolectomy against abscess formation on postoperative day (POD) 7, continuous fungemia occurred due to Candida haemulonii, identified using a conventional method by confirming the biochemical phenotype. Micafungin was initiated; however, the fungus was persistently isolated from blood cultures. Eventually, the antifungal agent was changed to a combination of liposomal amphotericin B (L-AMB) and caspofungin (CPFG), which cleared the infection, and no pathogens were detected in the blood cultures on POD 31. Contrast-enhanced computed tomography showed septic emboli in the lungs and spleen; however, no evidence of vasculitis was observed. Moreover, sequential echocardiography did not reveal any signs of infectious endocarditis. Finally, CPFG and L-AMB were administered to the patient for 7 and 9 weeks, respectively, during which the patient's symptoms did not relapse. The strain was later genetically identified as C. vulturna. This case report illustrates a clinical presentation of C. vulturna and provides the diagnostic approach and treatment methods for this pathogen.

16.
Respir Investig ; 62(3): 322-327, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38401245

RESUMO

BACKGROUND: Evidence regarding the association of the usage of biologic agents (Etanercept, Tocilizumab, adalimumab and so on), such as anti-tumor necrosis factor α, with the incidence and risk factors of non-tuberculous Mycobacteria (NTM) infection is limited. Therefore, this study aimed to investigate the incidence and risk factors of NTM and their associations with biologic agents' usage, and also investigated the potential of Mycobacterium avium complex (MAC) antibodies as a predictor of NTM infection development. METHODS: This retrospective study included 672 patients with autoimmune diseases from four hospitals in Nagasaki, Japan, from January 1, 2011, to June 30, 2019, who fulfilled the inclusion criteria. RESULTS: Of the 672 patients, 9 (1.3%) developed complicated NTM infection, including two with disseminated infection, after the introduction of biologic agents. Of the nine patients, two died due to NTM infection but none tested positive for MAC antibodies prior to initiation of biologic agents. The mortality rate was higher in patients complicated with NTM than without NTM (22.2% vs 2.6%, P = 0.024). The corticosteroids dosage at the time of initiating the biologic agents was significantly higher in the NTM group than in the non-NTM group (median, 17 mg vs 3 mg, P = 0.0038). CONCLUSION: In the patients undergoing therapy with biologic agents, although NTM complication was rare, it could be fatal. In particular, for patients on a relatively high dose corticosteroids, careful observation is essential for identifying NTM complication, even if the MAC antibody test is negative.


Assuntos
Artrite Reumatoide , Produtos Biológicos , Infecções por Mycobacterium não Tuberculosas , Infecção por Mycobacterium avium-intracellulare , Humanos , Infecções por Mycobacterium não Tuberculosas/tratamento farmacológico , Infecções por Mycobacterium não Tuberculosas/epidemiologia , Infecções por Mycobacterium não Tuberculosas/complicações , Estudos Retrospectivos , Complexo Mycobacterium avium , Micobactérias não Tuberculosas , Artrite Reumatoide/complicações , Artrite Reumatoide/tratamento farmacológico , Infecção por Mycobacterium avium-intracellulare/epidemiologia , Fatores Biológicos/uso terapêutico , Fatores de Risco , Corticosteroides/uso terapêutico , Produtos Biológicos/efeitos adversos
17.
Chem Commun (Camb) ; 59(80): 11947-11950, 2023 Oct 05.
Artigo em Inglês | MEDLINE | ID: mdl-37668093

RESUMO

We present a partially-oxidised bimetallic Mo-Pt subnanoparticle (Mo4Pt8Ox) enabling thermally-driven CO2 hydrogenation to CO at room temperature and atmospheric pressure. A mechanistic study explained the full catalytic cycle of the reaction from CO2 activation to catalyst reactivation. DFT calculations revealed that alloying with Mo lowers the activation barrier by weakening the CO adsorption. This finding could be a first step for low-energy CO2 conversion.

18.
Thorac Cancer ; 14(14): 1320-1324, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-36967655

RESUMO

Hypertrophic osteoarthropathy (HOA) is a paraneoplastic syndrome, the exact pathogenesis of which remains to be elucidated. The case of a 69-year-old man who developed intractably painful HOA secondary to lung cancer is presented. Contrast-enhanced computed tomography of the chest showed an 80-mm solid nodule with a large low-density area. The patient was diagnosed as having stage IIIA undifferentiated non-small cell lung cancer. The combination of carboplatin and paclitaxel with bevacizumab reduced tumor size and plasma vascular endothelial growth factor (VEGF) levels, relieving his leg pain. On immunohistochemical examination, lung cancer cells were positive for VEGF. A hypoxic tumor microenvironment may have caused some lung cancer cells to express hypoxia-inducible factor-1α, which contributed, at least in part, to the production of VEGF. The deep dermis vessels showed proliferation in the shin, with their thickened walls positive for VEGF. These findings may encourage investigators to explore novel management strategies for painful HOA.


Assuntos
Carcinoma Pulmonar de Células não Pequenas , Neoplasias Pulmonares , Idoso , Humanos , Masculino , Subunidade alfa do Fator 1 Induzível por Hipóxia , Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/metabolismo , Microambiente Tumoral , Fator A de Crescimento do Endotélio Vascular/metabolismo , Fatores de Crescimento do Endotélio Vascular
19.
J Vet Med Sci ; 84(7): 1001-1009, 2022 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-35650112

RESUMO

Sea turtles have well developed lacrimal glands for their electrolyte homeostasis. In turtles, stapedial artery and palatine artery send branches to supply orbital region, but supply artery for lacrimal glands was not identified. Micro-CT scans showed dorsoventrally large lacrimal glands of sea turtle are supplied by both stapedial artery and palatine artery. The circulatory pattern in cranial region was reconstructed based on the micro-CT scans, showing that sea turtle has basically similar pattern with the common snapping turtle: stapedial artery supplies orbital region and mandibular artery is ramified from stapedial artery. We also investigate the foramen stapedio-temporalis in turtles using osteological specimens. The foramen stapedio-temporalis, where the stapedial artery passes through, has different size among four families of turtles. We compared the sum of cross sections of left and right foramen stapedio-temporalis since homeostasis of one individual is maintained by a pair of lacrimal glands. The size difference may reflect primarily the share of stapedial artery against palatine artery in cranial circulation pattern and blood supply of orbital regions. Our observations confirmed a significantly larger cross-section in the foramen stapedio-temporalis of sea turtles than other freshwater/terrestrial turtles. Since the circulatory pattern is shared, the size difference of foramen stapedio-temporalis reflects the amount of arterial blood supply to lacrimal glands. Therefore, the size of the foramen stapedio-temporalis may indicate marine adaptation of turtles and are applicable to both fossil and osteological specimens.


Assuntos
Tartarugas , Animais , Artérias/anatomia & histologia , Eletrólitos , Homeostase , Crânio/anatomia & histologia , Tartarugas/anatomia & histologia
20.
ACS Omega ; 7(49): 45403-45408, 2022 Dec 13.
Artigo em Inglês | MEDLINE | ID: mdl-36530308

RESUMO

Binary alloy catalysts have the potential to exhibit higher activity than monometallic catalysts in nitrogen activation reactions. However, owing to the multiple possible combinations of metal elements constituting binary alloys, an exhaustive search for the optimal combination is difficult. In this study, we searched for the optimal binary alloy catalyst for nitrogen activation reactions using a combination of Bayesian optimization and density functional theory calculations. The optimal alloy catalyst proposed by Bayesian optimization had a surface energy of ∼0.2 eV/Å2 and resulted in a low reaction heat for the dissociation of the N≡N bond. We demonstrated that the search for such binary alloy catalysts using Bayesian optimization is more efficient than random search.

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