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1.
Med Teach ; 46(8): 1021-1026, 2024 08.
Artículo en Inglés | MEDLINE | ID: mdl-38146711

RESUMEN

BACKGROUND: Crafting quality assessment questions in medical education is a crucial yet time-consuming, expertise-driven undertaking that calls for innovative solutions. Large language models (LLMs), such as ChatGPT (Chat Generative Pre-Trained Transformer), present a promising yet underexplored avenue for such innovations. AIMS: This study explores the utility of ChatGPT to generate diverse, high-quality medical questions, focusing on multiple-choice questions (MCQs) as an illustrative example, to increase educator's productivity and enable self-directed learning for students. DESCRIPTION: Leveraging 12 strategies, we demonstrate how ChatGPT can be effectively used to generate assessment questions aligned with Bloom's taxonomy and core knowledge domains while promoting best practices in assessment design. CONCLUSION: Integrating LLM tools like ChatGPT into generating medical assessment questions like MCQs augments but does not replace human expertise. With continual instruction refinement, AI can produce high-standard questions. Yet, the onus of ensuring ultimate quality and accuracy remains with subject matter experts, affirming the irreplaceable value of human involvement in the artificial intelligence-driven education paradigm.


Asunto(s)
Inteligencia Artificial , Educación Médica , Evaluación Educacional , Humanos , Educación Médica/métodos , Evaluación Educacional/métodos
2.
Mol Cancer ; 22(1): 87, 2023 05 25.
Artículo en Inglés | MEDLINE | ID: mdl-37226188

RESUMEN

The advent of nanotechnology has opened new possibilities for bioimaging. Metal nanoparticles (such as gold, silver, iron, copper, etc.) hold tremendous potential and offer enormous opportunities for imaging and diagnostics due to their broad optical characteristics, ease of manufacturing technique, and simple surface modification. The arginine-glycine-aspartate (RGD) peptide is a three-amino acid sequence that seems to have a considerably greater ability to adhere to integrin adhesion molecules that exclusively express on tumour cells. RGD peptides act as the efficient tailoring ligand with a variety of benefits including non-toxicity, greater precision, rapid clearance, etc. This review focuses on the possibility of non-invasive cancer imaging using metal nanoparticles with RGD assistance.


Asunto(s)
Nanopartículas del Metal , Neoplasias , Humanos , Secuencia de Aminoácidos , Glicina , Oligopéptidos
3.
Mol Cancer ; 22(1): 98, 2023 06 21.
Artículo en Inglés | MEDLINE | ID: mdl-37344887

RESUMEN

Cancer is a grievous disease whose treatment requires a more efficient, non-invasive therapy, associated with minimal side effects. Gold nanoparticles possessing greatly impressive optical properties have been a forerunner in bioengineered cancer therapy. This theranostic system has gained immense popularity and finds its application in the field of molecular detection, biological imaging, cancer cell targeting, etc. The photothermal property of nanoparticles, especially of gold nanorods, causes absorption of the light incident by the light source, and transforms it into heat, resulting in tumor cell destruction. This review describes the different optical features of gold nanoparticles and summarizes the advance research done for the application of gold nanoparticles and precisely gold nanorods for combating various cancers including breast, lung, colon, oral, prostate, and pancreatic cancer.


Asunto(s)
Nanopartículas del Metal , Nanotubos , Neoplasias , Masculino , Humanos , Oro/uso terapéutico , Nanopartículas del Metal/uso terapéutico , Neoplasias/tratamiento farmacológico , Diagnóstico por Imagen , Línea Celular Tumoral
4.
Scand J Immunol ; 98(5): e13318, 2023 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-38441343

RESUMEN

T cell subsets (CD4 and CD8) play a prominent role in the development of chronic rhinosinusitis with nasal polyposis (CRSwNP). Colonization with Aspergillus flavus is recognized as a trigger for the growth of nasal polyps. The fungal proteins initiate the recruitment of T cells into the nasal mucosa, which contributes to the progression of nasal polyps. The study included 50 cases of CRSwNP and 50 healthy controls. Biopsies were subjected to KOH and culture for mycological investigation. We examined the changes in T helper (CD4+) and T cytotoxic (CD8+) in total T cells (CD3+) and expression of naive (CD45RA) and memory (CD45RO) cell markers in T cell subsets in peripheral blood mononuclear cells (PBMCs) challenged by A. flavus antigens in cases before and after treatment and in healthy controls by flow cytometry. Predominantly, A. flavus (86%) identified in nasal polyp biopsies of patients. An increased percentage of CD3+CD4+ T cells observed after A. flavus stimulation in patients when compared with healthy controls. The expression of CD4+CD45RA+ cells was significantly (P < .05) reduced in patients and increased CD4+CD45RO+ was observed upon stimulation with A. flavus in patients when compared with healthy control. Continuous exposure to inhaled fungal spores may induce aberrant immune responses to A. flavus spores, causing an allergic immunological reaction with high CD4+T cell responses, resulting in an unfavourable outcome. Elevated CD4+CD45RO+ T cells may transform the pathogenic response and highlight the chances of A. flavus reactive T cells involvement in prompting inflammation in CRSwNP.


Asunto(s)
Hipersensibilidad , Pólipos Nasales , Rinosinusitis , Humanos , Aspergillus flavus , Leucocitos Mononucleares , Subgrupos de Linfocitos T , Antígenos Comunes de Leucocito
5.
Environ Res ; 233: 116455, 2023 09 15.
Artículo en Inglés | MEDLINE | ID: mdl-37356522

RESUMEN

Breast carcinoma is a molecularly diverse illness, and it is among the most prominent and often reported malignancies in female across the globe. Surgical intervention, chemotherapy, immunotherapy, gene therapy, and endocrine treatment are among the currently viable treatment options for the carcinoma of breast. Chemotherapy is among the most prevalent cancer management strategy. Doxorubicin (DOX) widely employed as a cytostatic medication for the treatment of a variety of malignancies. Despite its widespread acceptance and excellent efficacy against an extensive line up of neoplasia, it has a variety of shortcomings that limit its therapeutic potential in the previously mentioned indications. Employment of nanoparticulate systems has come up as a unique chemo medication delivery strategy and are being considerably explored for the amelioration of breast carcinoma. Polylactic-co-glycolic acid (PLGA)-based nano systems are being utilized in a number of areas within the medical research and medication delivery constitutes one of the primary functions for PLGA given their inherent physiochemical attributes, including their aqueous solubility, biocompatibility, biodegradability, versatility in formulation, and limited toxicity. Herein along with the different application of PLGA-based nano formulations in cancer therapy, the present review intends to describe the various research investigations that have been conducted to enumerate the effectiveness of DOX-encapsulated PLGA nanoparticles (DOX-PLGA NPs) as a feasible treatment option for breast cancer.


Asunto(s)
Neoplasias de la Mama , Nanopartículas , Nanoestructuras , Femenino , Humanos , Glicoles/uso terapéutico , Copolímero de Ácido Poliláctico-Ácido Poliglicólico/uso terapéutico , Línea Celular Tumoral , Doxorrubicina/uso terapéutico , Neoplasias de la Mama/tratamiento farmacológico
6.
Environ Geochem Health ; 45(5): 1807-1818, 2023 May.
Artículo en Inglés | MEDLINE | ID: mdl-35674977

RESUMEN

Exponential industrialization and anthropogenic activities have resulted in water contamination by various heavy metals in Kanpur city, India. Heavy metal pollution, an issue of great concern, is not only affecting river water, but contamination of groundwater is creating health issues and worries. In the present investigation, blood samples were collected from selected volunteers, water and sediment samples from four sites of river Ganga and drinking groundwater samples from 23 locations of Kanpur city. Heavy metals analysis in river water, sediment, and human blood, was done by inductively coupled plasma optical emission spectroscopy (ICP-OES) and atomic absorption spectroscopy (AAS) was used for groundwater samples. Human blood showed a high concentration of arsenic (As) (66.6 ± 0.00 and 76.9 ± 0.01 µg L-1 in males and female subjects, respectively) and thallium (Tl) (13.4 ± 0.004 and 16.6 ± 0.005 µg L-1 in males and female subjects, respectively) with higher concentrations in females than males. Other heavy metals (Nickle, Beryllium, Cadmium, Cobalt, Chromium, Lithium, Molybdenum, Lead) were not observed in any of the tested human blood samples. However, in groundwater sampling, iron (Fe), copper (Cu), and arsenic (As) were detected, one sample had the presence of chromium (Cr), and two samples showed lead (Pb) contamination. River water [Cu (32-125 µg L-1), Cr (19-725 µg L-1), Cd (1-59 µg L-1), Pb (37-163 µg L-1), As (32-153 µg L-1), Th (26.75 µg L-1)] showed a high level of the heavy metals, as compared to reference values of BIS, CPCB (2016a), WHO, EPA and USEPA. River sediment [Cu (4168-34,470 µg Kg-1), Cr (4040-145,650 µg Kg-1), Cd (326-5340 µg Kg-1), Pb (1840-19,350 µg Kg-1), As (103-188 µg Kg-1)] also showed high concentration when compared to reference values of USEPA and PASS. River site 4, with high Cr (725 µg L-1), also showed Cr levels (19.8 µg L-1) in the groundwater samples, indicating Cr contamination in groundwater while Pb was observed at groundwater samples close to two industrial sites. Drinking water might be the primary exposure pathway for As and Tl to enter the human body. The study recommends periodic monitoring of river water, sediment, groundwater, and human blood samples for contamination of heavy metals.


Asunto(s)
Arsénico , Agua Subterránea , Metales Pesados , Contaminantes Químicos del Agua , Humanos , Femenino , Arsénico/análisis , Cadmio/análisis , Plomo/análisis , Monitoreo del Ambiente/métodos , Metales Pesados/análisis , Cromo/análisis , Agua/análisis , India , Contaminantes Químicos del Agua/análisis , Medición de Riesgo
7.
J Mol Recognit ; 35(12): e2989, 2022 12.
Artículo en Inglés | MEDLINE | ID: mdl-36054496

RESUMEN

Structural information about drug-receptor interactions is paramount in drug discovery and subsequent optimization processes. Drugs can bind to multiple potential targets as they contain common chemical entities in their structures. Understanding the details of such interactions offer possibilities for repurposing and developing potent inhibitors of disease pathways. Vinblastine (VLB) is a potent anticancer molecule showing multiple receptor interactions with different affinities and degrees of structural perturbations. We have investigated the multi-target binding profile of VLB with DNA and human serum albumin (HSA) in a dynamic physiological environment using spectroscopic, molecular dynamics simulations, and quantum mechanical calculations to evaluate the structural features, mode, ligand and receptor flexibility, and energetics of complexation. These results confirm that VLB prefers to bind in the major groove of DNA with some inclination toward Thymidine residue and the TR-5 binding site in HSA with its catharanthine half making important contacts with both the receptors. Spectroscopic investigation at multiple temperatures has also proved that VLB binding is entropy driven indicating the major groove and TR-5 binding site of interaction. Finally, the overall binding is facilitated by van der Waals contacts and a few conventional H-bonds. VLB portrays reasonable conformational diversity on binding with multiple receptors.


Asunto(s)
Albúmina Sérica Humana , Vinblastina , Humanos , Vinblastina/química , Vinblastina/farmacología , Simulación del Acoplamiento Molecular , Unión Proteica , Espectrometría de Fluorescencia , Termodinámica , Albúmina Sérica Humana/química , Sitios de Unión , ADN/química , Dicroismo Circular
8.
Glia ; 68(3): 656-669, 2020 03.
Artículo en Inglés | MEDLINE | ID: mdl-31702864

RESUMEN

Microglia are the main form of immune defense in the central nervous system. Microglia express phosphatidylinositol 3-kinase (PI3K), which has been shown to play a significant role in synaptic plasticity in neurons and inflammation via microglia. This study shows that microglial PI3K is regulated epigenetically through histone modifications and posttranslationally through sumoylation and is involved in long-term potentiation (LTP) by modulating the expression of brain-derived neurotrophic factor (BDNF), which has been shown to be involved in neuronal synaptic plasticity. Sodium butyrate, a histone deacetylase inhibitor, upregulates PI3K expression, the phosphorylation of its downstream effectors, AKT and cAMP response element-binding protein (CREB), and the expression of BDNF in microglia, suggesting that BDNF secretion is regulated in microglia via epigenetic regulation of PI3K. Further, knockdown of SUMO1 in BV2 microglia results in a decrease in the expression of PI3K, the phosphorylation of AKT and CREB, as well as the expression of BDNF. These results suggest that microglial PI3K is epigenetically regulated by histone modifications and posttranslationally modified by sumoylation, leading to altered expression of BDNF. Whole-cell voltage-clamp showed the involvement of microglia in neuronal LTP, as selective ablation or disruption of microglia with clodronate in rat hippocampal slices abolished LTP. However, LTP was rescued when the same hippocampal slices were treated with active PI3K or BDNF, indicating that microglial PI3K/AKT signaling contributes to LTP and synaptic plasticity. Understanding the mechanisms by which microglial PI3K influences synapses provides insights into the ways it can modulate synaptic transmission and plasticity in learning and memory.


Asunto(s)
Potenciación a Largo Plazo/fisiología , Microglía/metabolismo , Plasticidad Neuronal/fisiología , Sinapsis/metabolismo , Animales , Epigénesis Genética , Hipocampo/metabolismo , Memoria/fisiología , Neuronas/metabolismo , Fosfatidilinositol 3-Quinasas/metabolismo , Ratas , Transducción de Señal/fisiología
9.
Microb Cell Fact ; 19(1): 215, 2020 Nov 25.
Artículo en Inglés | MEDLINE | ID: mdl-33238997

RESUMEN

BACKGROUND: T helper (Th)17 and regulatory T (Treg) cells with toll-like receptor (TLR)-2 have been acknowledged to play a critical role in chronic rhinosinusitis with nasal polyposis (CRSwNP). However, its pathogenesis has been perplexed by conflicting reports on the role of Th17/Treg cells in patients of distinct ethnicities. We attempted to understand the role of Th responses induced during host defense against Aspergillus flavus. RESULTS: The percentages of Th17 (CD4+CD161+IL23R+) and Treg (CD4+CD25+FoxP3+) cell populations and various cytokine profiles in peripheral blood mononuclear cells (PBMCs) challenged by A. flavus antigens were characterized from 50 CRSwNP cases, before and after treatment, and in 50 healthy controls. TLR-2 expression was analyzed in tissues of cases and controls for disease co-relation. The major pathogen identified in our study was A. flavus by mycological investigations. A marked immune imbalance was noted with elevated Th17 and decreased Tregs in PBMCs of CRSwNP patients after A. flavus stimulation. Comparatively, interleukin (IL)-17 and IL-10 levels were increased, with low transforming growth factor (TGF)-ß levels in A. flavus stimulated PBMC supernatants of patients. The mRNA expression of TLR-2 in polyps of CRSwNP patients indicated significant (p = 0.001) upregulation in comparison to the controls. CONCLUSIONS: Our data highlights the excessive expression of TLR-2 in nasal polyps contributing to the imbalance in Th17/Tregs population in patients. After therapy, recovery of Tregs cells indicates restoration and tissue homeostasis, though high circulating CD4+CD161+ Th17 cells may continue to be a threat to patients predisposed to future recurrences. The constant exposure and tendency of A. flavus to colonize nasal cavities can lead to a Th17 driven airway inflammation. Dysregulated Th17 with TLR-2 promote resistance to treatment and progression to the chronicity of the disease.


Asunto(s)
Aspergilosis/inmunología , Citocinas/inmunología , Pólipos Nasales/inmunología , Linfocitos T Reguladores/inmunología , Células Th17/inmunología , Receptor Toll-Like 2/inmunología , Adolescente , Adulto , Aspergillus flavus , Enfermedad Crónica , Femenino , Regulación de la Expresión Génica , Interacciones Huésped-Patógeno , Humanos , Interleucina-10/inmunología , Interleucina-17/inmunología , Masculino , Persona de Mediana Edad , ARN Mensajero/inmunología , Rinitis/inmunología , Rinitis/microbiología , Sinusitis/inmunología , Sinusitis/microbiología , Receptor Toll-Like 2/genética , Adulto Joven
10.
Environ Geochem Health ; 42(7): 2059-2079, 2020 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-31786716

RESUMEN

Despite heavy investments and a number of government schemes, deterioration in water quality of river Ganga and its tributaries is an issue of serious concern. Among all the cities, thriving on Ganga, Kanpur is considered to add maximum pollution in the river. In the present study, water samples were collected seasonally from nine selected sites within the middle stretch of river Ganga from Haridwar to Kanpur. The velocity, temperature, pH, alkalinity, hardness, dissolved oxygen (DO), biological oxygen demand (BOD) and chemical oxygen demand (COD) were analyzed during winter (November-January), summer (March-June) and monsoon (July-September) season from November 2016 to September 2017 along with heavy metal analysis of water and sediment samples of the winter season. The levels of Cr, Cu, Cd and Pb were analyzed by atomic absorption spectrophotometer. Water quality was evaluated by water quality index (WQI) using BIS and WHO standards. The WQI values showed good water quality at Haridwar site (< 100) while it was very poor at other sites and Kanpur (> 100) which renders it highly unfit for human consumption and survival of some fish species because of low DO value (4.65 ± 1.08 mg L-1) and high values of pH (8.82 ± 0.10), alkalinity (187.88 ± 8.88 mg L-1), BOD (66.64 ± 2.19 mg L-1) and COD (240.00 ± 17.33 mg L-1). WQI showed highly unsuitable water quality at all sites except control site, of which S9 (Siddhanath Ghat) was highly polluted. Lead concentration was higher at Kannauj sites while high Cr was observed at Siddhanath Ghat (S9), Kanpur. The examined metals, such as Cr, Cu, and Pb, were far above the prescribed limits of various standards.


Asunto(s)
Sedimentos Geológicos/análisis , Metales Pesados/análisis , Ríos , Contaminantes Químicos del Agua/análisis , Análisis de la Demanda Biológica de Oxígeno , Monitoreo del Ambiente/métodos , Concentración de Iones de Hidrógeno , India , Oxígeno/análisis , Estaciones del Año , Espectrofotometría Atómica , Agua/análisis , Calidad del Agua
11.
J Cell Biochem ; 119(5): 4142-4149, 2018 05.
Artículo en Inglés | MEDLINE | ID: mdl-29243845

RESUMEN

Despite large number of investigations, the etiology of chronic rhinosinusitis (CRS) remains unclear. Several factors are likely involved in its onset. The genetic susceptibility of IgE-responsiveness likely caused by polymorphism(s) in high affinity receptor for IgE (FcɛR1α) gene can help in understanding the pathophysiology of CRS with nasal polyposis (CRSwNP). A population-based case-control association analysis was conducted to assess the risk of CRSwNP conferred by single nucleotide polymorphisms (SNPs) in FcɛR1α gene in a North Indian cohort. Two promoter and three exonic regions of FcɛR1α gene were amplified and sequenced to investigate five SNPs: rs2427827, rs2251746, rs2298804, rs2298805, and rs2269718. BLAST analysis and subsequent multiple alignments, with known sequences available in the NCBI database, were performed. Total serum IgE and FcɛR1α antibody levels were estimated. Patient IgE level of 461.22 ± 436.43 in comparison to 83.62 ± 58.043 IU/mL in controls (P < 0.0001), and FcɛR1α antibody level of 292.38 ± 115.27 in comparison to 160.56 ± 105.9 in controls (P < 0.0001), depicts their highly significant associations with CRSwNP disease. However, no SNP showed evidence of association with CRSwNP; although relatively higher Odds ratios were observed with rs2427827, rs2251746, and rs2298804. Patient stratification revealed a significant association (P < 0.05) of rs2427827 SNP with high IgE level CRSwNP patients. Nonetheless, we found no SNP associated with low serum IgE level patients. SNP (rs2427827) in the FcɛR1α gene region and high IgE levels may confer susceptibility to CRSwNP in north Indian population. However, further studies including larger sample size, gene-gene, and gene-environment interactions are required for its elucidation.


Asunto(s)
Inmunoglobulina E/sangre , Pólipos Nasales , Polimorfismo de Nucleótido Simple , Receptores de IgE , Rinitis , Sinusitis , Adulto , Enfermedad Crónica , Femenino , Humanos , Masculino , Pólipos Nasales/sangre , Pólipos Nasales/genética , Pólipos Nasales/patología , Receptores de IgE/biosíntesis , Receptores de IgE/genética , Rinitis/sangre , Rinitis/genética , Rinitis/patología , Sinusitis/sangre , Sinusitis/genética , Sinusitis/patología
12.
J Pediatr ; 198: 265-272.e3, 2018 07.
Artículo en Inglés | MEDLINE | ID: mdl-29730147

RESUMEN

OBJECTIVE: To assess olfactory function in children and to create and validate an odor identification test to diagnose olfactory dysfunction in children, which we called the Universal Sniff (U-Sniff) test. STUDY DESIGN: This is a multicenter study involving 19 countries. The U-Sniff test was developed in 3 phases including 1760 children age 5-7 years. Phase 1: identification of potentially recognizable odors; phase 2: selection of odorants for the odor identification test; and phase 3: evaluation of the test and acquisition of normative data. Test-retest reliability was evaluated in a subgroup of children (n = 27), and the test was validated using children with congenital anosmia (n = 14). RESULTS: Twelve odors were familiar to children and, therefore, included in the U-Sniff test. Children scored a mean ± SD of 9.88 ± 1.80 points out of 12. Normative data was obtained and reported for each country. The U-Sniff test demonstrated a high test-retest reliability (r27 = 0.83, P < .001) and enabled discrimination between normosmia and children with congenital anosmia with a sensitivity of 100% and specificity of 86%. CONCLUSIONS: The U-Sniff is a valid and reliable method of testing olfaction in children and can be used internationally.


Asunto(s)
Odorantes , Trastornos del Olfato/congénito , Trastornos del Olfato/diagnóstico , Olfato/fisiología , Niño , Preescolar , Femenino , Humanos , Internacionalidad , Masculino , Reproducibilidad de los Resultados , Sensibilidad y Especificidad
14.
Med Oral Patol Oral Cir Bucal ; 20(3): e284-91, 2015 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-25662547

RESUMEN

BACKGROUND: FNAC of intraosseous jaw lesions has not been widely utilized for diagnosis due to rarity and diversity of these lesions, limited experience and lack of well established cytological features. Aim of the study was to determine the role of FNAC in the diagnosis of intraosseous jaw swellings. MATERIAL AND METHODS: 42 patients underwent FNAC over a period of 7 years (2007-2013), of which 37 (88.1%) aspirates were diagnostic. Histopathology correlation was available in 33 cases and diagnostic accuracy of FNAC was calculated. RESULTS: Lesions were categorized into inflammatory 3, cysts/hamartomas 15 and neoplasms 19. Mandibular and maxillary involvement was seen in 21 and 16 patients respectively. Of these, benign cysts and malignant lesions were commonest, accounting for 27% lesions (10 cases) each. One case of cystic ameloblastoma was misdiagnosed as odontogenic cyst on cytology. Overall, sensitivity and specificity of FNAC were 94.7% and 100% respectively with a diagnostic accuracy of 97.3%. Definitive categorization of giant cell lesions, fibro-osseous lesions, odontogenic tumors and cystic lesions was not feasible on FNAC. CONCLUSIONS: FNAC is a simple, safe and minimally invasive first line investigation which can render an accurate preoperative diagnosis of intraosseous jaw lesions, especially the malignant ones in the light of clinic-radiological correlation.


Asunto(s)
Biopsia con Aguja Fina , Enfermedades Óseas/patología , Enfermedades Maxilomandibulares/patología , Adolescente , Adulto , Anciano , Niño , Preescolar , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos
15.
J Anaesthesiol Clin Pharmacol ; 31(3): 404-6, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-26330725

RESUMEN

Foreign body airway (FBA) is a common problem among the children. Variable presentation makes it difficult to diagnose a case of FBA, particularly, when no definite history of aspiration is available. Subcutaneous emphysema (SCE) and pneumomediastinum are rare presentations. We report a case of FBA who presented with SCE without any history of aspiration. A 3-year-old female child was admitted with respiratory distress, fever and SCE over the right side of chest, neck and face. Initially, she was diagnosed as a case of pneumonitis with barotrauma. X-ray of the chest revealed SCE with pneumomediastinum without pneumothorax. Diagnostic bronchoscopy with rigid ventilating bronchoscope was done under general anesthesia. A plastic foreign body with sharp projections embedded in the mucosa was detected and retrieved from right main bronchus. Postoperatively SCE regressed gradually.

16.
CEN Case Rep ; 13(5): 356-365, 2024 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-38416370

RESUMEN

Multilocular cystic nephroma (MLCN) is an unusual, benign slow-growing renal cystic neoplasm which mimics other cystic renal lesions and has such clinical, radiological, and morphological features that causes diagnostic dilemma. MLCN lies in the spectrum of mixed epithelial and stromal tumor (MEST) family of kidney. According to World Health Organization (WHO 2016 classification), MEST encompasses spectrum of tumors ranging from predominantly cystic tumors, adult cystic nephroma (ACN) to tumors that are variably solid (MEST), thus creating diagnostic dilemma. Moreover, it has several benign and malignant differentials due to its several overlapping histomorphological features which when not cautiously dealt with may result in misdiagnosing it as malignant lesion. We hereby present a case of a woman in late twenties who presented with left flank swelling and pain since 6 months which was misdiagnosed as renal cell carcinoma on radiology which turned out to be ACN on histology and further verified on immunohistochemistry.


Asunto(s)
Neoplasias Renales , Humanos , Femenino , Neoplasias Renales/patología , Neoplasias Renales/diagnóstico , Neoplasias Renales/diagnóstico por imagen , Diagnóstico Diferencial , Carcinoma de Células Renales/patología , Carcinoma de Células Renales/diagnóstico , Carcinoma de Células Renales/diagnóstico por imagen , Errores Diagnósticos , Adulto , Tomografía Computarizada por Rayos X/métodos , Enfermedades Renales Quísticas/diagnóstico , Enfermedades Renales Quísticas/patología , Enfermedades Renales Quísticas/diagnóstico por imagen , Inmunohistoquímica
17.
Indian J Nephrol ; 34(3): 257-260, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39114403

RESUMEN

Microfilarial parasites can obstruct the lymphatic tree giving rise to varying lymphatic and extra-lymphatic symptoms. Renal manifestations can range from asymptomatic proteinuria, chyluria, and nephrotic syndrome, to acute glomerulonephritis. The diagnosis of filariasis is usually made by the demonstration of the parasite in the peripheral blood smear, with or without eosinophilia. The renal involvement by this parasite has been sparsely reported in the literature. We hereby report five cases of filariasis detected on histopathological examination of renal biopsies, performed for other indications, along with a brief report of the additional histological findings. Three native and two graft biopsies were included. All our patients were male, with a mean age of 47 years (range 37 to 66 years). The serum creatinine ranged from 1.2 to 12.9 mg/dL. The mean 24-hour urinary protein was 3.6 gm/day. Peripheral blood eosinophilia was not recorded in any case, however, ESR was raised in all cases. Urine examination revealed varying proteinuria, with hematuria in two cases. Histological examination revealed microfilaria in all five biopsies, along with focal segmental glomerulosclerosis in two cases, combined cellular and humoral rejection, minimal change disease and acute tubular necrosis in one case each respectively. All patients were treated with diethylcarbamazine 6mg/kg/day or 12 days, in addition to the renal medications. Diagnosing the parasite is crucial as the patient is likely to benefit due to the timely treatment of the disease. Reporting this case series highlights an interesting finding in nephropathology.

18.
Indian J Endocrinol Metab ; 28(3): 273-278, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39086566

RESUMEN

Introduction: The aetiologies in unilateral and bilateral adrenal lesions can be different with different clinical implications and management guidelines, the latter having aetiologies like hyperplasia, infections, infiltrative lesions and neoplasia. Bilateral tumours are more likely to have hereditary/syndromic associations. There is limited data on the clinical and pathological profile of bilateral adrenal lesions. Methods: This was a retrospective study where patients with bilateral adrenal lesions were selected from a total of 266 patients with adrenal lesions who presented to our institute between January 2016 and August 2022. The demographic, laboratory and imaging data were retrieved from the Hospital Information System and patient case files. Results: The study included 51 patients; the mean age at presentation was 51.15 years (range 14 to 82 years). Forty-eight patients (94.1%) were symptomatic at presentation with an average duration of symptoms being 10.68 months (range 10 days to 1 year). The most common presentation was adrenal insufficiency in 18 cases (38%), followed by fever in 17 cases (36%). The commonest aetiology, as revealed on histopathology, was histoplasmosis (n = 22, 43%), followed by pheochromocytoma (n = 11, 21.5%), metastases (n = 6, 11.7%), adrenal hyperplasia (n = 5, 9.8%), adrenocortical adenoma (n = 1, 1.9%), lymphoma (n = 3, 5.8%), neuroblastoma (n = 1, 1.9%), myelolipoma (n = 1, 1.9%) and tuberculosis (n = 1, 1.9%). Histoplasmosis and metastatic lesions were commonly seen in older people, and pheochromocytoma was associated with young age. 6/11 patients with a diagnosis of bilateral pheochromocytoma were associated with family history, genetic mutation and extra-adrenal involvement. Conclusion: The approach to bilateral adrenal lesions differs from that of unilateral lesions due to differences in aetiologies and the more significant role of genetics in some bilateral tumours. The age at presentation, presenting symptoms, lesion size and biochemical features help delineate varied underlying aetiologies.

19.
Sci Rep ; 14(1): 22378, 2024 09 27.
Artículo en Inglés | MEDLINE | ID: mdl-39333695

RESUMEN

This study conducts a comprehensive analysis and comparison of Bombyx mori cuticles across different developmental stages, ranging from larval to adult, utilizing advanced solid-state NMR techniques. The primary objective is to elucidate the underlying reasons for the contrasting hardness of adult cuticles and softness of larval cuticles. Notably, PXRD analysis reveals a prominent broad peak at 19.34°, indicating the predominantly amorphous nature of both larval and adult cuticles. Analysis of 13C CP-MAS SSNMR spectra highlights an elevated proportion of phenoxy carbon in adult cuticles (6.77%) compared to larval cuticles (1.24%). Furthermore, a distinctive resonance line at 144 ppm is exclusively observed in adult cuticles, due to catechols, suggesting potential biochemical pathway variations during development. Significant variations in the primary components of 13C chemical shift anisotropy (CSA) tensors for aliphatic carbons of amino acids, catechols, and lipids between adult and larval cuticles indicate alterations in electronic environments. Additionally, the shorter spin-lattice relaxation time of carbon nuclei in larval cuticles compared to adult cuticles implies slower motional dynamics with enhanced degree of sclerotization in adults. By investigating the internal structure and dynamics of cuticles, this research not only contributes to biomimetic material development but also enhances our understanding of structural changes across different developmental stages of B. mori.


Asunto(s)
Bombyx , Larva , Espectroscopía de Resonancia Magnética , Bombyx/crecimiento & desarrollo , Animales , Larva/crecimiento & desarrollo , Espectroscopía de Resonancia Magnética/métodos
20.
ACS Biomater Sci Eng ; 10(8): 5300-5312, 2024 Aug 12.
Artículo en Inglés | MEDLINE | ID: mdl-39087496

RESUMEN

The development of well-adherent, amorphous, and bioactive glass coatings for metallic implants remains a critical challenge in biomedical engineering. Traditional bioactive glasses are susceptible to crystallization and exhibit a thermal expansion mismatch with implant materials. This study introduces a novel approach to overcome these limitations by employing systematic Na2O substitution with CaO in borosilicate glasses. In-depth structural analysis (MD simulations, Raman spectroscopy, and NMR) reveals a denser network with smaller silicate rings, enhancing thermal stability, reducing thermal expansion, and influencing dissolution kinetics. This tailored composition exhibited optimal bioactivity (in vitro formation of bone-like apatite within 3 days) and a coefficient of thermal expansion closely matching Ti-6Al-4V, a widely used implant material. Furthermore, a consolidation process, meticulously designed with insights from crystallization kinetics and the viscosity-temperature relationship, yielded a crack-free, amorphous coating on Ti-6Al-4V substrates. This novel coating demonstrates excellent cytocompatibility and strong antibacterial action, suggesting superior clinical potential compared with existing technologies.


Asunto(s)
Materiales Biocompatibles Revestidos , Vidrio , Titanio , Vidrio/química , Materiales Biocompatibles Revestidos/química , Materiales Biocompatibles Revestidos/farmacología , Titanio/química , Prótesis e Implantes , Antibacterianos/química , Antibacterianos/farmacología , Ensayo de Materiales , Propiedades de Superficie , Aleaciones/química , Humanos
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