Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 86
Filtrar
Más filtros

Banco de datos
País/Región como asunto
Tipo del documento
Intervalo de año de publicación
1.
Mol Biol Rep ; 51(1): 381, 2024 Mar 02.
Artículo en Inglés | MEDLINE | ID: mdl-38430361

RESUMEN

BACKGROUND: The development of sheath blight (ShB) resistance varieties has been a challenge for scientists for long time in rice. Activation tagging is an efficient gain-of-function mutation approach to create novel phenotypes and to identify their underlying genes. In this study, a mutant population was developed employing activation tagging in the recalcitrant indica rice (Oryza sativa L.) cv. BPT 5204 (Samba Mahsuri) through activation tagging. METHODS AND RESULTS: In this study, we have generated more than 1000 activation tagged lines in indica rice, from these mutant population 38 (GFP- RFP+) stable Ds plants were generated through germinal transposition at T2 generation based on molecular analysis and seeds selected on hygromycin (50 mg/L) containing medium segregation analyses confirmed that the transgene inherited as mendelian segregation ratio of 3:1 (3 resistant: 1 susceptible). Of them, five stable activation tagged Ds lines (M-Ds-1, M-Ds-2, M-Ds-3, M-Ds-4 and M-Ds-5) were selected based on phenotypic observation through screening for sheath blight (ShB) resistance caused by fungal pathogen Rhizoctonia solani (R. solani),. Among them, M-Ds-3 and M-Ds-5 lines showed significant resistance for ShB over other tagged lines and wild type (WT) plants. Furthermore, analysed for launch pad insertion through TAIL-PCR results and mapped on corresponding rice chromosomes. Flanking sequence and gene expression analysis revealed that the upregulation of glycoside hydrolase-OsGH or similar to Class III chitinase homologue (LOC_Os08g40680) in M-Ds-3 and a hypothetical protein gene (LOC_Os01g55000) in M-Ds-5 are potential candidate genes for sheath blight resistance in rice. CONCLUSION: In the present study, we developed Ac-Ds based ShB resistance gain-of-functional mutants through activation tagging in rice. These activation tagged mutant lines can be excellent sources for the development of ShB resistant cultivars in rice.


Asunto(s)
Oryza , Oryza/genética , Oryza/microbiología , Perfilación de la Expresión Génica
2.
Dysphagia ; 35(1): 73-83, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-30929058

RESUMEN

BACKGROUND AND AIMS: This retrospective study was aimed at assessing the efficacy of endoscopic dilation for esophageal anastomotic strictures, and to compare response between caustic anastomotic strictures (CAS) and non-caustic anastomotic strictures (NCAS). MATERIALS AND METHODS: Patients with anastomotic strictures (enrolled during January 1996-December 2015) were analyzed. Short- and long-term outcomes of dilation, in terms of clinical success, refractory, and recurrent strictures were compared between NCAS and CAS. Patients with refractory and recurrent strictures were managed with adjunctive therapy including intralesional steroids. Factors predicting refractoriness at start of dilation and reasons for more than ten lifetime dilations were also evaluated. RESULTS: Of the 142 patients, 124 (mean age-44.02; males-74) underwent dilation. Clinical success was achieved in 113 (91.3%) patients requiring a median [Interquartile range (IQR)] of 4 (2-10) sessions. The number of dilations to achieve clinical success, refractory strictures, and recurrent strictures, and the use of adjunctive therapy were significantly higher for CAS than for NCAS. Intralesional steroid use decreased periodic dilation index (PDI) significantly in CAS. Caustic etiology and starting dilation diameter of < 10 mm were found to be predictors of refractoriness, with the former alone being an independent predictor of more than ten lifetime dilations. No patient had free perforation; however, five required revision surgery. CONCLUSION: Patients with CAS fared worse than those with NCAS in terms of number of dilations, refractoriness, recurrence of strictures, and need of adjunctive therapy. Endoscopic dilation can successfully ameliorate dysphagia due to anastomotic strictures in a majority of patients.


Asunto(s)
Quemaduras Químicas/cirugía , Dilatación/estadística & datos numéricos , Estenosis Esofágica/etiología , Estenosis Esofágica/cirugía , Esofagoscopía/estadística & datos numéricos , Adulto , Quemaduras Químicas/complicaciones , Trastornos de Deglución/etiología , Trastornos de Deglución/cirugía , Dilatación/métodos , Esofagoscopía/métodos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Resultado del Tratamiento
3.
Surg Radiol Anat ; 41(9): 1087-1092, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31115596

RESUMEN

PURPOSE: To report rare and clinically significant anatomic variations in the biliary drainage of right hepatic lobe. METHODS: Unique variations in the extra- and intrahepatic biliary drainage of right hepatic lobe were observed in 6 cadaveric livers during dissection on 100 formalin-fixed en bloc cadaveric livers. RESULTS: There was presence of aberrant drainage of right segmental and sectorial ducts in four cases and of accessory right posterior sectorial duct in two cases. CONCLUSIONS: We encountered some extensively complicated biliary drainage of right hepatic lobe, unsuccessful recognition of which can lead to serious biliary complications during hepatobiliary surgeries and biliary interventions.


Asunto(s)
Variación Anatómica , Conductos Biliares Intrahepáticos/anomalías , Adulto , Cadáver , Disección , Humanos , Masculino , Adulto Joven
4.
Reumatismo ; 71(3): 166-170, 2019 Oct 24.
Artículo en Inglés | MEDLINE | ID: mdl-31649382

RESUMEN

Systemic sclerosis (SSc) is an uncommon connective tissue disorder characterized by multisystem involvement with fibrosis of skin and internal organs. Antibody formation is one of the hallmarks of SSc. Antinuclear antibodies (ANA) are positive in 97% of patients with SSc. We report a rare case where the patient was negative for ANA, Anti-topoisomerase I, Anti-centromere and Anti-RNA polymerase III antibodies.


Asunto(s)
Autoanticuerpos/sangre , Esclerodermia Sistémica/sangre , Edad de Inicio , Anticuerpos Antinucleares/sangre , ADN-Topoisomerasas de Tipo I/inmunología , Femenino , Humanos , Persona de Mediana Edad , ARN Polimerasa III/inmunología , Esclerodermia Sistémica/diagnóstico , Esclerodermia Sistémica/inmunología
5.
Phys Chem Chem Phys ; 19(14): 9444-9456, 2017 Apr 05.
Artículo en Inglés | MEDLINE | ID: mdl-28332657

RESUMEN

The present investigation describes the synergistic role of Li4(BH4)(NH2)3 and ZrFe2 in the hydrogen storage behaviour of a Li-Mg-N-H hydride system. The onset desorption temperature of ZrFe2-catalysed Mg(NH2)2-LiH-Li4(BH4)(NH2)3 is ∼122 °C, which is 83 °C, 63 °C, and 28 °C lower than that of thermally treated 2LiNH2-1MgH2, 2LiNH2-1MgH2-4 wt%ZrFe2, and 2LiNH2-1MgH2-0.1LiBH4 composites, respectively. Native Mg(NH2)2-LiH-Li4(BH4)(NH2)3 absorbed only 2.78 wt% of H2 within 30 min. On the other hand, the ZrFe2-catalysed Mg(NH2)2-LiH-Li4(BH4)(NH2)3 sample absorbed 3.70 wt% of hydrogen within 30 min and 5 wt% of H2 in 6 h at 180 °C and 7 MPa H2 pressure. Mg(NH2)2-LiH-Li4(BH4)(NH2)3 catalyzed with ZrFe2 shows negligible degradation of the storage capacity even after repeated cycles of de/rehydrogenation. The effect of ZrFe2 and Li4(BH4)(NH2)3 on a Mg(NH2)2/LiH composite has been described and discussed with the help of structural (X-ray diffraction), microstructural (electron microscopy), and vibrational modes of molecules through FTIR studies. The present results suggest that an optimum catalysis may originate from the synergistic action of an in situ formed quaternary hydride (Li4(BH4)(NH2)3) and an intermetallic-like ZrFe2, which acts as a pulverizer cum catalyst.

6.
Surg Radiol Anat ; 39(12): 1405-1407, 2017 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-28523348

RESUMEN

During routine dissection, duplication of main pancreatic duct extending from body to head region of pancreas was observed in a 78-year-old formalin fixed male cadaver. Main pancreatic duct gave a prominent branch which joined back the parent duct in head resulting in the formation of a closed loop. This gave the appearance of focal duplication in the form of a closed loop, an unusual variant. This was an incidental finding. Such cases usually remain asymptomatic; however, if undetected may be the cause of postoperative pancreatic fistula following pancreaticobiliary surgery. Knowledge of variable anatomy of pancreatic duct system became important to reduce the risk of postoperative complication and during various endoscopic guided procedures like drainage of pseudocyst or placement of stent into the duct.


Asunto(s)
Conductos Pancreáticos/anatomía & histología , Anciano , Variación Anatómica , Cadáver , Humanos , Hallazgos Incidentales , Masculino
8.
J Nanosci Nanotechnol ; 16(3): 3084-9, 2016 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-27455765

RESUMEN

The present report describes the catalytic activity of mechanically activated nano quasicrystalline Al65Cu20Fe15 and related nano crystalline Al50Cu28Fe22 for the synthesis of carbon nanotubes (CNTs). CNTs are synthesized by catalytic decomposition of ethanol through nano quasicrystalline Al65Cu20Fe15 and related crystalline Al50Cu28Fe22 alloys as a catalyst. The synthesized multi-walled CNTs exhibits tube diameter ranging from 5 to 25 nm. The synthesized CNTs are characterized by scanning and transmission electron microscopy. It is found that Al65Cu20Fe15 nanoquasicystal shows better catalytic behaviour as compared to nano-crystalline Al50Cu28Fe22 alloys for decomposition of ethanol during the synthesis of multi-walled CNTs.


Asunto(s)
Nanopartículas , Nanotubos de Carbono , Catálisis , Microscopía Electrónica de Rastreo , Microscopía Electrónica de Transmisión , Difracción de Polvo
9.
J Chem Phys ; 142(9): 094703, 2015 Mar 07.
Artículo en Inglés | MEDLINE | ID: mdl-25747095

RESUMEN

The use of quasicrystals as precursors to catalysts for the steam reforming of methanol is potentially one of the most important applications of these new materials. To develop application as a technology requires a detailed understanding of the microscopic behavior of the catalyst. Here, we report the effect of leaching treatments on the surface microstructure, chemical composition, and valence band of the icosahedral (i-) Al-Cu-Fe quasicrystal in an attempt to prepare a model catalyst. The high symmetry fivefold surface of a single grain i-Al-Cu-Fe quasicrystal was leached with NaOH solution for varying times, and the resulting surface was characterized by x-ray photoelectron spectroscopy (XPS), ultraviolet photoelectron spectroscopy (UPS), scanning electron microscopy (SEM), and atomic force microscopy (AFM). The leaching treatments preferentially remove Al producing a capping layer consisting of Fe and Cu oxides. The subsurface layer contains elemental Fe and Cu in addition to the oxides. The quasicrystalline bulk structure beneath remains unchanged. The subsurface gradually becomes Fe3O4 rich with increasing leaching time. The surface after leaching exhibits micron sized dodecahedral cavities due to preferential leaching along the fivefold axis. Nanoparticles of the transition metals and their oxides are precipitated on the surface after leaching. The size of the nanoparticles is estimated by high resolution transmission microscopy to be 5-20 nm, which is in agreement with the AFM results. Selected area electron diffraction (SAED) confirms the crystalline nature of the nanoparticles. SAED further reveals the formation of an interface between the high atomic density lattice planes of nanoparticles and the quasicrystal. These results provide an important insight into the preparation of model catalysts of nanoparticles for steam reforming of methanol.

10.
Nano Lett ; 14(3): 1184-9, 2014 Mar 12.
Artículo en Inglés | MEDLINE | ID: mdl-24528205

RESUMEN

Quasicrystals are materials with long-range ordering but no periodicity. We report scanning tunneling microscopy (STM) observations of quasicrystalline molecular layers on 5-fold quasicrystal surfaces. The molecules adopt positions and orientations on the surface consistent with the quasicrystalline ordering of the substrate. Carbon-60 adsorbs atop sufficiently separated Fe atoms on icosahedral Al-Cu-Fe to form a unique quasicrystalline lattice, whereas further C60 molecules decorate remaining surface Fe atoms in a quasi-degenerate fashion. Pentacene (Pn) adsorbs at 10-fold symmetric points around surface-bisected rhombic triacontahedral clusters in icosahedral Ag-In-Yb. These systems constitute the first demonstrations of quasicrystalline molecular ordering on a template.

11.
Opt Express ; 22(19): 22802-7, 2014 Sep 22.
Artículo en Inglés | MEDLINE | ID: mdl-25321749

RESUMEN

We demonstrate refractive index sensors based on single mode tapered fiber and its application as a biosensor. We utilize this tapered fiber optic biosensor, operating at 1550 nm, for the detection of protein (gelatin) concentration in water. The sensor is based on the spectroscopy of mode coupling based on core modes-fiber cladding modes excited by the fundamental core mode of an optical fiber when it transitions into tapered regions from untapered regions. The changes are determined from the wavelength shift of the transmission spectrum. The proposed fiber sensor has sensitivity of refractive index around 1500 nm/RIU and for protein concentration detection, its highest sensitivity is 2.42141 nm/%W/V.


Asunto(s)
Técnicas Biosensibles , Tecnología de Fibra Óptica/instrumentación , Fibras Ópticas , Refractometría/instrumentación , Análisis Espectral/instrumentación , Transductores , Diseño de Equipo , Humanos , Interferometría/instrumentación
12.
Clin Exp Rheumatol ; 32(3): 432-9, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-24564946

RESUMEN

OBJECTIVES: Juvenile idiopathic arthritis (JIA) is a chronic inflammatory disease of children which might persist into adulthood. Systemic inflammation seen in adult RA patients has been shown to be associated with alteration in endothelial function, arterial wall mechanics and intima media thickness. Our study was planned to assess similar changes in JIA patients. METHODS: Thirty-one newly diagnosed JIA patients and a similar number of age- and sex-matched controls were enrolled in the study. Endothelial function was assessed by measuring flow mediated dilation and glyceryl trinitrate (GTN)-mediated dilation of the brachial artery. To assess arterial stiffness, various arterial wall mechanic parameters such as cross-sectional compliance, cross-sectional distensibility, shear stress and elastic modulus were derived. Intima media thickness of the common carotid artery was measured as a marker of subclinical atherosclerosis. RESULTS: The brachial artery diameter at rest was found to be slightly lower in the patients than controls (0.258 ± 0.042 vs. 0.264 ± 0.039; p=0.54). No significant difference was found in flow mediated dilation (17.71 ± 9.26 vs. 16.31 ± 8.23; p=0.53), GTN mediated dilation (25.25 ± 10.02 vs. 23.66 ± 9.79; p=0.53) or FMD: GTN mediated dilation ratio (0.730 ± 0.432 vs. 0.717 ± 0.280; p=0.89) between the cases and controls. There was also no significant difference in carotid artery intima media thickness (0.065 ± 0.0068 vs. 0.068 ± 0.007; p=0.084) between cases and controls. Cases in different subsets of JIA were also analysed separately with regards to FMD, GTN mediated dilation and cIMT but no difference was found between cases in each subset and their controls. Cross-sectional compliance was significantly lower in cases than controls (0.0016 ± 0.0005 vs. 0.002 ± 0.001; p=0.034). Cross-sectional distensibility (0.009 ± 0.003 vs. 0.011 ± 0.006; p=0.14) was also found to be lower whereas diastolic wall shear stress (299.9 ± 47.08 vs. 294.9 ± 59.5; p=0.72) and elastic modulus (1138.5 ± 1085.8 vs. 911 ± 453; p=0.19) were found to be higher in cases as compared to controls. But these differences were not statistically significant. When the subsets were analysed separately for vessel wall indices, cross-sectional compliance was found to be significantly lower in systemic arthritis patients as compared to controls. A high level of intra- and inter-observer agreement was found for all the ultrasonographically evaluated parameters. CONCLUSIONS: Arterial wall indices were found altered in JIA patients indicating increased arterial stiffness. Larger studies are required to assess endothelial dysfunction, intima media thickness and arterial stiffness in each subset of JIA patients.


Asunto(s)
Artritis Juvenil/diagnóstico por imagen , Artritis Juvenil/fisiopatología , Endotelio Vascular/fisiopatología , Túnica Media/diagnóstico por imagen , Adolescente , Arteria Braquial/fisiología , Arteria Carótida Común/diagnóstico por imagen , Arteria Carótida Común/fisiopatología , Niño , Preescolar , Adaptabilidad/efectos de los fármacos , Estudios Transversales , Endotelio Vascular/diagnóstico por imagen , Femenino , Humanos , Masculino , Nitroglicerina , Ultrasonografía , Rigidez Vascular/fisiología , Vasodilatación/efectos de los fármacos , Vasodilatación/fisiología , Vasodilatadores
13.
J Clin Exp Hepatol ; 14(3): 101355, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38389866

RESUMEN

Organ transplantation is the primary therapy for organ failure caused by telomere biology disorder (TBD). We describe the first documented case of simultaneous liver and kidney transplantation (SLKTx) for TBD, although the diagnosis of TBD was reached only three months following SLKTx. The patient was born prematurely, displayed growth retardation, and developed chronic kidney and liver diseases. His pre-SLKTx autoimmune, metabolic, and viral assessments were negative, and persistent pancytopenia (bone marrow cellularity 70-80%) was attributed to renal disease-associated bone marrow changes. Following SLKTx, he was discharged with stable graft function on tacrolimus and prednisolone. Although mycophenolate mofetil was discontinued on the second postoperative day, his pancytopenia persisted. Despite extensive evaluations, including drug, immune, nutritional, and viral assessments, all results were negative. A bone marrow biopsy conducted three months post-transplant revealed significant hypocellularity (40-50%). Whole genome sequencing revealed a likely pathogenic variant of the TINF2 gene. The patient was subsequently treated with danazol. At the nine-month follow-up post-SLKTx, he exhibited stable graft function and improved cell counts while maintaining triple-drug immunosuppression. Given the lack of uniform diagnostic criteria for TBD, healthcare providers must be vigilant with patients presenting with multi-organ failure and persistent cytopenias. Effective pre-transplant screening for TBD can lead to timely diagnoses, better management, and improved post-transplant outcomes.

14.
Dig Dis Sci ; 58(6): 1781-3, 2013 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-23361568

RESUMEN

We report two cases of pneumoperitoneum following endoscopic retrograde cholangiopancreatography for retained common bile duct (CBD) stones. These post-cholecystectomy patients underwent sphincterotomy, CBD clearance, and "T" tube removal at the same time. Post-procedure, both of the patients developed pneumoperitoneum. Pneumoperitoneum developed as a result of air traversing from the duodenum to the peritoneum through the ruptured "T" tube tract. "T" tube removal in the same sitting as sphincterotomy and CBD clearance may lead to pneumoperitoneum, which can be managed conservatively.


Asunto(s)
Colangiopancreatografia Retrógrada Endoscópica/efectos adversos , Coledocolitiasis/cirugía , Enfermedades Duodenales/diagnóstico , Perforación Intestinal/diagnóstico , Neumoperitoneo/etiología , Adulto , Colecistectomía , Diagnóstico Diferencial , Enfermedades Duodenales/etiología , Femenino , Humanos , Perforación Intestinal/etiología , Persona de Mediana Edad , Neumoperitoneo/diagnóstico , Reoperación , Esfinterotomía Endoscópica
15.
Sci Rep ; 13(1): 20200, 2023 11 18.
Artículo en Inglés | MEDLINE | ID: mdl-37980377

RESUMEN

The interaction of tyramine neurotransmitter with silver nano-particle (Ag6) cluster is explored in terms of the molecular structure, electronic properties and NBO analysis of tyramine-AgNPs bio-molecular conjugate. The adsorption mechanism of tyramine onto the Ag6 cluster has been investigated through computing of the electronic and geometrical properties in addition to the adsorption energies in various possible configurations. The magnitude of adsorption energy corresponding to the most favorable tyramine-Ag6 bio-molecular conjugate has been computed to be - 14.36 kcal/mol in the gas phase, which infers a good adsorption of tyramine with AgNPs cluster suggesting the practical applications of tyramine-AgNPs bio-molecular conjugates in bio-sensing, drug delivery, bio-imaging and other applications. Different electronic properties such as the energy gap of HOMO-LUMO, Fermi level and work function have been investigated in detail. Moreover, the effect of aqueous media on adsorption energy and electronic properties of the most favorable tyramine-AgNPs bio-molecular conjugate is investigated in order to understand the impact of the real biological situation.


Asunto(s)
Tiramina , Agua , Estructura Molecular , Adsorción , Plata/química
16.
Sci Rep ; 13(1): 22264, 2023 Dec 14.
Artículo en Inglés | MEDLINE | ID: mdl-38097755

RESUMEN

The present communication deals with the adsorption of tyramine neurotransmitter over the surface of pristine, Boron (B) and Silicon (Si) doped fullerenes. Density functional theory (DFT) calculations have been used to investigate tyramine adsorption on the surface of fullerenes in terms of stability, shape, work function, electronic characteristics, and density of state spectra. The most favourable adsorption configurations for tyramine have been computed to have adsorption energies of - 1.486, - 30.889, and - 31.166 kcal/mol, respectively whereas for the rest three configurations, it has been computed to be - 0.991, - 6.999, and - 8.796 kcal/mol, respectively. The band gaps for all six configurations are computed to be 2.68, 2.67, 2.06, 2.17, 2.07, and 2.14 eV, respectively. The band gap of pristine, B and Si doped fullerenes shows changes in their band gaps after adsorption of tyramine neurotransmitters. However, the change in band gaps reveals more in B doped fullerene rather than pristine and Si doped fullerenes. The change in band gaps of B and Si doped fullerenes leads a change in the electrical conductivity which helps to detect tyramine. Furthermore, natural bond orbital (NBO) computations demonstrated a net charge transfer of 0.006, 0.394, and 0.257e from tynamine to pristine, B and Si doped fullerenes.

17.
Urol Int ; 88(2): 215-24, 2012.
Artículo en Inglés | MEDLINE | ID: mdl-22377534

RESUMEN

BACKGROUND: Large pelvic masses pose unique diagnostic and therapeutic challenges due to varied aetiology, paucity of characteristic imaging features, lack of therapeutic algorithms and surgical difficulties in resection inside the narrow confines of the pelvis with close proximity of vital structures. METHODS: Records of 22 patients with large pelvic masses in the last six years were analysed. Their demographic and clinical features were noted, along with imaging features, preoperative biopsy, surgical procedure, intraoperative difficulties, complications, adjuvant therapy and outcome. RESULTS: There were 14 men and 8 women with a median age of 45 years. Presenting symptoms were abdominal mass, pain, lower urinary tract symptoms, urinary retention and constipation. Imaging was mostly unable to determine the organ of origin of the tumour. Histopathology revealed pelvic fibromatosis (2), chondrosarcoma (1), liposarcoma (1), haemangioendothelioma (1), lymphangioma (2), fibroleiomyoma (1), leiomyosarcoma (3), schwannoma (4), malignant nerve sheath tumour (1), rectal gastrointestinal stromal tumour (1), retrovesical hydatid cysts (3), sacral chordoma (1) and Ewing's sarcoma (1). In 5 patients complete excision was not possible because of extension into vital structures. Fifteen patients were alive at 1-5 years of follow-up. CONCLUSIONS: Urologists, being the 'gatekeepers of the pelvis', are usually involved in the management of large pelvic masses. Good outcome can be achieved with careful surgical planning.


Asunto(s)
Neoplasias Pélvicas , Urología , Adulto , Anciano , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Biopsia , Quimioterapia Adyuvante , Niño , Femenino , Humanos , India , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Neoplasias Pélvicas/complicaciones , Neoplasias Pélvicas/patología , Neoplasias Pélvicas/terapia , Radioterapia Adyuvante , Estudios Retrospectivos , Resultado del Tratamiento , Procedimientos Quirúrgicos Urológicos , Adulto Joven
18.
Eur Ann Otorhinolaryngol Head Neck Dis ; 139(3): 146-152, 2022 May.
Artículo en Inglés | MEDLINE | ID: mdl-34489194

RESUMEN

INTRODUCTION: Rhinocerebral mucormycosis is extremely fatal, with mortality rates ranging from 85-93% despite the best treatment in immunocompromised patients. We emphasize the importance of early diagnosis, repeated debridement, and aggressive antifungal treatment to reduce mortality. CASE SUMMARY: We report six cases (five male and one female), with a mean age of 51 years who were diagnosed to have mucormycosis from 2017 to 2019. All patients were diabetic. Intracranial involvement and orbital involvement were found in four cases. Facial nerve palsy was seen in two cases, one without any apparent otological involvement. Aggressive serial debridement and amphotericin B was started. Posaconazole was added subsequently to the treatment in two cases. One patient succumbed to the disease five months after discharge. The other five patients are on regular follow-up for a mean duration of 14 months at the end of which two had residual disease which was under control. DISCUSSION: Repeated surgical debridement with an early aggressive and combination antifungal therapy can result in good outcomes even in advanced mucormycosis. Concurrent management of the underlying pathology, monitoring of liver and kidney functions, and therapeutic drug monitoring are useful to ensure smooth and effective treatment.


Asunto(s)
Diabetes Mellitus , Mucormicosis , Anfotericina B/uso terapéutico , Antifúngicos/uso terapéutico , Desbridamiento , Diabetes Mellitus/tratamiento farmacológico , Femenino , Humanos , Masculino , Persona de Mediana Edad , Mucormicosis/diagnóstico , Mucormicosis/terapia
19.
J Glob Antimicrob Resist ; 24: 260-265, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33476838

RESUMEN

OBJECTIVES: Antimicrobial stewardship (AMS) in resource-limited settings lacks models that can be readily adapted to their settings. Here we discuss the impact of a combined strategy of AMS and monitoring of infection control practices in a tertiary-care centre of a developing country. METHODS: This study was undertaken in the surgical unit of a tertiary-care hospital over an 8-month period. In the first 2 months (baseline phase), prospective audit and feedback alone was undertaken, while in the next 6 months (intervention phase) this was supplemented with strategies such as antimicrobial timeout, correction of doses and bundle approach for prevention of hospital-acquired infections. RESULTS: A total of 337 patients were included (94 in the baseline phase and 243 in the intervention phase). There was a decrease in days of therapy per 1000 patient-days (1000PD) (1112.3 days vs. 1048.6 days), length of therapy per 1000PD (956 days vs. 936.3 days) and defined daily doses (DDD) per 1000PD for most antimicrobials. A decrease in double cover for Gram-negative infections (9.6% vs. 2.9%) but an increase in double anaerobic cover (4.2% vs. 7.4%) was observed. There was a decrease in the incidence of ventilator-associated pneumonia per 1000 ventilator-days in the intervention phase (46.4 vs. 35.4), whereas central line-associated bloodstream infections per 1000 central line-days remained the same (14.7 vs. 14.8). CONCLUSION: This study shows that implementation of routine AMS activities with monitoring of infection control practices can help decrease overall antimicrobial use. With furtherance of measures to control infection, antimicrobial use may be further curtailed.


Asunto(s)
Programas de Optimización del Uso de los Antimicrobianos , Cuidados Críticos , Humanos , India/epidemiología , Control de Infecciones , Centros de Atención Terciaria
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA