RESUMO
Benjamin Franklin, one of the founding fathers of the United States, was not just a politician and a political philosopher but an inventor with a scientific temperament. He was overweight and likely suffered from the consequences of metabolic syndrome including gout. He woke up with a gout attack on October 22, 1780 and wrote the "Dialogue Between Franklin and the Gout." His observations on the risk factors for gout are re-examined in the modern context 243 years later.
Assuntos
Pessoas Famosas , Gota , Síndrome Metabólica , Masculino , Humanos , Estados Unidos , Gota/etiologia , Fatores de Risco , Síndrome Metabólica/complicações , Pessoal AdministrativoRESUMO
This study aimed to evaluate the routine identification tools available in Lebanon for differentiation of Escherichia coli and Shigella spp. The identification of 43 isolates defined as Shigella spp. by Api 20E was accessed using MALDI-TOF, serological testing, duplex PCR targeting ipaH (present in Shigella spp. and enteroinvasive E. coli "EIEC") and lacY (found in E. coli including EIEC but not Shigella spp.) as well as gyrB gene sequencing. Antibiotic susceptibility was investigated as well as Shiga-toxin production. All isolates were identified as E. coli by MALDI-TOF while the PCR showed a disparate group of 26 EIEC, 11 Shigella spp., 5 E. coli and 1 inactive E. coli. However, the sequencing of gyrB gene, which was recently described as a suitable marker for distinguishing E. coli and Shigella spp., identified all isolates as E. coli. Antibiotic resistance was noticeable against ß-lactams, rifampicin, trimethoprim-sulfamethoxazole, gentamicin, and ciprofloxacin. The most common variants of beta-lactamase genes were blaTEM-1, blaCTX-M-15, and blaCTX-M-3. A great discordance between the used methods in identification was revealed herein. An accurate identification technique able to distinguish E. coli from Shigella spp. in routine laboratories is a pressing need in order to select the appropriate treatment and assess the epidemiology of these bacteria.
Assuntos
Disenteria Bacilar/diagnóstico , Escherichia coli Enteropatogênica/isolamento & purificação , Tipagem Molecular/métodos , Shigella/isolamento & purificação , Antígenos de Bactérias/genética , Proteínas de Bactérias/genética , DNA Girase/genética , Farmacorresistência Bacteriana Múltipla/genética , Disenteria Bacilar/microbiologia , Escherichia coli Enteropatogênica/classificação , Escherichia coli Enteropatogênica/genética , Proteínas de Escherichia coli/genética , Humanos , Líbano , Testes de Sensibilidade Microbiana , Proteínas de Transporte de Monossacarídeos/genética , Toxina Shiga/metabolismo , Shigella/classificação , Shigella/genética , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por Matriz , Simportadores/genéticaRESUMO
Aortic regurgitation (AR) is grouped into acute or chronic AR. Acute AR, unlike chronic AR, can manifest with significant hemodynamic compromise. Acute AR is typically due to endocarditis or aortic dissection, and less commonly due to blunt trauma or iatrogenic causes. We present a patient with cardiogenic shock due to severe acute AR from anterior leaflet perforation without an identifiable rheumatologic or infectious etiology.
RESUMO
Esophageal cancer is one of the most common types of gastrointestinal malignancies that is encountered. It has a global distribution and affects males and females, and is linked to significant morbidity and mortality. The mechanisms underlying pathophysiology are multifactorial and involve the interaction of genetic and environmental factors. This review article describes the immunological and metabolic changes that occur in malignancy of the esophagus.