Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 114
Filtrar
Más filtros

Banco de datos
Tipo del documento
Intervalo de año de publicación
1.
Cell ; 186(22): 4956-4973.e21, 2023 10 26.
Artículo en Inglés | MEDLINE | ID: mdl-37852260

RESUMEN

The complement system is a critical part of our innate immune response, and the terminal products of this cascade, anaphylatoxins C3a and C5a, exert their physiological and pathophysiological responses primarily via two GPCRs, C3aR and C5aR1. However, the molecular mechanism of ligand recognition, activation, and signaling bias of these receptors remains mostly elusive. Here, we present nine cryo-EM structures of C3aR and C5aR1 activated by their natural and synthetic agonists, which reveal distinct binding pocket topologies of complement anaphylatoxins and provide key insights into receptor activation and transducer coupling. We also uncover the structural basis of a naturally occurring mechanism to dampen the inflammatory response of C5a via proteolytic cleavage of the terminal arginine and the G-protein signaling bias elicited by a peptide agonist of C3aR identified here. In summary, our study elucidates the innerworkings of the complement anaphylatoxin receptors and should facilitate structure-guided drug discovery to target these receptors in a spectrum of disorders.


Asunto(s)
Anafilatoxinas , Receptores de Complemento , Transducción de Señal , Anafilatoxinas/metabolismo , Complemento C3a/metabolismo , Inmunidad Innata , Receptores de Complemento/metabolismo , Humanos , Animales , Ratones
2.
Mol Cell ; 83(12): 2091-2107.e7, 2023 Jun 15.
Artículo en Inglés | MEDLINE | ID: mdl-37209686

RESUMEN

Agonist-induced GPCR phosphorylation is a key determinant for the binding and activation of ß-arrestins (ßarrs). However, it is not entirely clear how different GPCRs harboring divergent phosphorylation patterns impart converging active conformation on ßarrs leading to broadly conserved functional responses such as desensitization, endocytosis, and signaling. Here, we present multiple cryo-EM structures of activated ßarrs in complex with distinct phosphorylation patterns derived from the carboxyl terminus of different GPCRs. These structures help identify a P-X-P-P type phosphorylation motif in GPCRs that interacts with a spatially organized K-K-R-R-K-K sequence in the N-domain of ßarrs. Sequence analysis of the human GPCRome reveals the presence of this phosphorylation pattern in a large number of receptors, and its contribution in ßarr activation is demonstrated by targeted mutagenesis experiments combined with an intrabody-based conformational sensor. Taken together, our findings provide important structural insights into the ability of distinct GPCRs to activate ßarrs through a significantly conserved mechanism.


Asunto(s)
Endocitosis , Transducción de Señal , Humanos , beta-Arrestinas/metabolismo , Fosforilación , Transducción de Señal/fisiología , Dominios Proteicos , Receptores Acoplados a Proteínas G/metabolismo
3.
Gene Ther ; 2024 Sep 25.
Artículo en Inglés | MEDLINE | ID: mdl-39322766

RESUMEN

Dent disease type 1 is caused by changes in the chloride voltage-gated channel 5 (CLCN5) gene on chromosome X, resulting in the lack or dysfunction of chloride channel ClC-5. Individuals affected by Dent disease type 1 show proteinuria and hypercalciuria. Previously we found that lentiviral vector-mediated hCLCN5 cDNA supplementary therapy in ClC-5 null mice was effective only for three months following gene delivery, and the therapeutic effects disappeared four months after treatment, most likely due to immune responses to the ClC-5 proteins expressed in the treated cells. Here we tried two strategies to reduce possible immune responses: 1) confining the expression of ClC-5 expression to the tubular cells with tubule-specific Npt2a and Sglt2 promoters, and 2) performing gene therapy in newborn mutant mice whose immune system has not fully developed. We found that although Npt2a and Sglt2 promoters successfully drove ClC-5 expression in the kidneys of the mutant mice, the treatment did not ameliorate the phenotypes. However, gene delivery to the kidneys of newborn Clcn5 mutant mice enabled long-term transgene expression and phenotype improvement. Our data suggest that performing gene therapy on Dent disease affected subjects soon after birth could be a promising strategy to attenuate immune responses in Dent disease type 1 gene therapy.

4.
Nucleic Acids Res ; 50(7): 3944-3957, 2022 04 22.
Artículo en Inglés | MEDLINE | ID: mdl-35323942

RESUMEN

Most insertions or deletions generated by CRISPR/Cas9 (clustered regularly interspaced short palindromic repeats/CRISPR-associated protein 9) endonucleases are short (<25 bp), but unpredictable on-target long DNA deletions (>500 bp) can be observed. The possibility of generating long on-target DNA deletions poses safety risks to somatic genome editing and makes the outcomes of genome editing less predictable. Methods for generating refined mutations are desirable but currently unavailable. Here, we show that fusing Escherichia coli DNA polymerase I or the Klenow fragment to Cas9 greatly increases the frequencies of 1-bp deletions and decreases >1-bp deletions or insertions. Importantly, doing so also greatly decreases the generation of long deletions, including those >2 kb. In addition, templated insertions (the insertion of the nucleotide 4 nt upstream of the protospacer adjacent motif) were increased relative to other insertions. Counteracting DNA resection was one of the mechanisms perturbing deletion sizes. Targeting DNA polymerase to double-strand breaks did not increase off-targets or base substitution rates around the cleavage sites, yet increased editing efficiency in primary cells. Our strategy makes it possible to generate refined DNA mutations for improved safety without sacrificing efficiency of genome editing.


Asunto(s)
Sistemas CRISPR-Cas , Edición Génica , Proteína 9 Asociada a CRISPR/genética , Proteína 9 Asociada a CRISPR/metabolismo , ADN/genética , ADN/metabolismo , ADN Polimerasa Dirigida por ADN/metabolismo , Edición Génica/métodos
5.
J Environ Manage ; 360: 121182, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38772237

RESUMEN

The emergence of algal biorefineries has garnered considerable attention to researchers owing to their potential to ensure carbon neutrality via mitigation of atmospheric greenhouse gases. Algae-derived biofuels, characterized by their carbon-neutral nature, stand poised to play a pivotal role in advancing sustainable development initiatives aimed at enhancing environmental and societal well-being. In this context, algae-based wastewater treatment systems are greatly appreciated for their efficacy in nutrient removal and simultaneous bioenergy generation. These systems leverage the growth of algae species on wastewater nutrients-including carbon, nitrogen, and phosphorus-alongside carbon dioxide, thus facilitating a multifaceted approach to pollution remediation. This review seeks to delve into the realization of carbon neutrality through algae-mediated wastewater treatment approaches. Through a comprehensive analysis, this review scrutinizes the trajectory of algae-based wastewater treatment via bibliometric analysis. It subsequently examines the case studies and empirical insights pertaining to algae cultivation, treatment performance analysis, cost and life cycle analyses, and the implementation of optimization methodologies rooted in artificial intelligence and machine learning algorithms for algae-based wastewater treatment systems. By synthesizing these diverse perspectives, this study aims to offer valuable insights for the development of future engineering applications predicated on an in-depth understanding of carbon neutrality within the framework of circular economy paradigms.


Asunto(s)
Carbono , Purificación del Agua , Biocombustibles , Dióxido de Carbono/análisis , Nitrógeno , Fósforo , Eliminación de Residuos Líquidos/métodos , Aguas Residuales , Purificación del Agua/métodos
6.
Nanotechnology ; 34(42)2023 Jul 31.
Artículo en Inglés | MEDLINE | ID: mdl-37402363

RESUMEN

CoMn2O4, known for its extensive range of applications, has been subject to limited investigations regarding its structure dependent magnetic properties. Here, we have examined the structure dependent magnetic properties of CoMn2O4nanoparticles synthesized through a facile coprecipitation technique and are characterized using x-ray diffractometer, x-ray photoelectron spectroscopy (XPS), RAMAN spectroscopy, transmission electron microscopy and magnetic measurements. Rietveld refinement of the x-ray diffraction pattern reveals the coexistence of 91.84% of tetragonal and 8.16% of cubic phase. The cation distribution for tetragonal and cubic phases are (Co0.94Mn0.06)[Co0.06Mn1.94]O4and (Co0.04Mn0.96)[Co0.96Mn1.04]O4, respectively. While Raman spectra and selected area electron diffraction pattern confirm the spinel structure, both +2 and +3 oxidation states for Co and Mn confirmed by XPS further corroborate the cation distribution. Magnetic measurement shows two magnetic transitions, Tc1at 165 K and Tc2at 93 K corresponding to paramagnetic to a lower magnetically ordered ferrimagnetic state followed by a higher magnetically ordered ferrimagnetic state, respectively. While Tc1is attributed to the cubic phase having inverse spinel structure, Tc2corresponds to the tetragonal phase with normal spinel. In contrast to general temperature dependentHCobserved in ferrimagnetic material, an unusual temperature dependentHCwith high spontaneous exchange bias of 2.971 kOe and conventional exchange bias of 3.316 kOe at 50 K are observed. Interestingly, a high vertical magnetization shift (VMS) of 2.5 emu g-1is observed at 5 K, attributed to the Yafet-Kittel spin structure of Mn3+in the octahedral site. Such unusual results are discussed on the basis of competition between the non-collinear triangular spin canting configuration of Mn3+cations of octahedral sites and collinear spins of tetrahedral site. The observed VMS has the potential to revolutionize the future of ultrahigh density magnetic recording technology.

7.
Environ Res ; 237(Pt 2): 117100, 2023 Nov 15.
Artículo en Inglés | MEDLINE | ID: mdl-37689336

RESUMEN

The levels of pesticides in air, water, and soil are gradually increasing due to its inappropriate management. In particular, agricultural runoff inflicts the damages on the ecosystem and human health at massive scale. Present study summarizes 70 studies in which investigations on removal or treatment of pesticides/insecticides/herbicides are reported. A bibliometric analysis was also done to understand the recent research trends through the analysis of 2218 publications. The specific objectives of this study are as follows: i) to inventorize the characteristics details of agriculture runoff and analyzing the occurrence and impacts of pesticides, ii) analyzing the role and interaction of pesticides in different environmental segments, iii) investigating the fate of pesticides in agriculture runoff treatment systems, iv) summarizing the experiences and findings of most commonly technology deployed for pesticides remediation in agriculture runoff including target pesticide(s), specifications, configuration of technological intervention. Among the reported technologies for pesticide treatment in agriculture runoff, constructed wetland was at the top followed by algal or photobioreactor. Among various advanced oxidation processes, photo Fenton method is mainly used for pesticides remediation such as triazine, methyl parathion, fenuron and diuron. Algal bioreactors are extensively used for a wide range of pesticides treatment including 2,4-Dichlorophenoxyacetic acid, 2-methyl-4-chlorophenoxyacetic acid, alachlor, diuron, chlorpyrifos, endosulfan, and imidacloprid; especially at lower hydraulic retention time of 2-6 h. This study highlights that hybrid approaches can offers potential opportunities for effective removal of pesticides in a more viable manner.

8.
BMC Biol ; 18(1): 155, 2020 10 29.
Artículo en Inglés | MEDLINE | ID: mdl-33121486

RESUMEN

BACKGROUND: CREB-dependent transcription necessary for long-term memory is driven by interactions with CREB-binding protein (CBP), a multi-domain protein that binds numerous transcription factors potentially affecting expression of thousands of genes. Identifying specific domain functions for multi-domain proteins is essential to understand processes such as cognitive function and circadian clocks. We investigated the function of the CBP KIX domain in hippocampal memory and gene expression using CBPKIX/KIX mice with mutations that prevent phospho-CREB (Ser133) binding. RESULTS: We found that CBPKIX/KIX mice were impaired in long-term memory, but not learning acquisition or short-term memory for the Morris water maze. Using an unbiased analysis of gene expression in the dorsal hippocampus after training in the Morris water maze or contextual fear conditioning, we discovered dysregulation of CREB, CLOCK, and BMAL1 target genes and downregulation of circadian genes in CBPKIX/KIX mice. Given our finding that the CBP KIX domain was important for transcription of circadian genes, we profiled circadian activity and phase resetting in CBPKIX/KIX mice. CBPKIX/KIX mice exhibited delayed activity peaks after light offset and longer free-running periods in constant dark. Interestingly, CBPKIX/KIX mice displayed phase delays and advances in response to photic stimulation comparable to wildtype littermates. Thus, this work delineates site-specific regulation of the circadian clock by a multi-domain protein. CONCLUSIONS: These studies provide insight into the significance of the CBP KIX domain by defining targets of CBP transcriptional co-activation in memory and the role of the CBP KIX domain in vivo on circadian rhythms.


Asunto(s)
Proteína de Unión a CREB/genética , Ritmo Circadiano/genética , Memoria a Largo Plazo , Dominios Proteicos , Animales , Proteína de Unión a CREB/química , Proteína de Unión a CREB/metabolismo , Femenino , Masculino , Ratones
9.
Biomed Chromatogr ; 33(9): e4582, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31077435

RESUMEN

A high-throughput and sensitive liquid chromatography-tandem mass spectrometry (LC-MS/MS) method has been developed and validated for the determination of flunarizine in human plasma. Liquid-liquid extraction under acidic conditions was used to extract flunarizine and flunarizine-d8 from 100 µL human plasma. The mean extraction recovery obtained for flunarizine was 98.85% without compromising the sensitivity of the method. The chromatographic separation was performed on Hypersil Gold C18 (50 × 2.1 mm, 3 µm) column using methanol-10 mm ammonium formate, pH 3.0 (90:10, v/v) as the mobile phase. A tandem mass spectrometer (API-5500) equipped with an electrospray ionization source in the positive ion mode was used for detection of flunarizine. Multiple reaction monitoring was selected for quantitation using the transitions, m/z 405.2 → 203.2 for flunarizine and m/z 413.1 → 203.2 for flunarizine-d8. The validated concentration range was established from 0.10 to 100 ng/mL. The accuracy (96.1-103.1%), intra-batch and inter-batch precision (CV ≤ 5.2%) were satisfactory and the drug was stable in human plasma under all tested conditions. The method was used to evaluate the pharmacokinetics of 5 and 10 mg flunarizine tablet formulation in 24 healthy subjects. The pharmacokinetic parameters Cmax and AUC were dose-proportional.


Asunto(s)
Cromatografía Líquida de Alta Presión/métodos , Flunarizina/sangre , Flunarizina/farmacocinética , Espectrometría de Masas en Tándem/métodos , Flunarizina/química , Flunarizina/aislamiento & purificación , Ensayos Analíticos de Alto Rendimiento , Humanos , Modelos Lineales , Extracción Líquido-Líquido , Reproducibilidad de los Resultados , Sensibilidad y Especificidad
10.
Prep Biochem Biotechnol ; 49(5): 444-452, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30861359

RESUMEN

Enzymatic interesterification was carried out between high-oleic canola oil and fully hydrogenated soybean oil using indigenously immobilized Thermomyces lanuginosus lipas substrate concentration, moisture content of enzyme, and enzyme load. Interesterification resulted in a decrease in the concentration of tri-unsaturated and trisaturated TAG and an increase of mono- and di-saturated TAG as observed by reversed-phase HPLC. The alteration in TAG composition and the presence of new TAG species after interesterification was correlated with extended plasticity characterized by lower slip melting point with a significant change in functionality and consistency of the interesterified product. Thermal and structural properties of the blends before and after interesterification were assessed by differential scanning calorimetry (DSC), X-ray diffraction and polarized light microscopy. Trans-fat analysis indicated the absence of any trans fatty acid in the final interesterified product. The resultant interesterified products with varying slip melting points can be used in the formulation of healthier fat and oil products and address a critical industrial demand for trans free formulations for base-stocks of spreads, margarines, and confectionary fats.


Asunto(s)
Enzimas Inmovilizadas/química , Lipasa/química , Triglicéridos/química , Brassica rapa/química , Esterificación , Eurotiales/enzimología , Tecnología Química Verde/métodos , Aceite de Brassica napus/química , Aceite de Soja/química , Glycine max/química , Estereoisomerismo , Ácidos Grasos trans/análisis , Triglicéridos/análisis , Agua/química
12.
Biomed Chromatogr ; 32(2)2018 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-28906001

RESUMEN

An improved, precise and reliable ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) method has been developed for the quantification of trimetazidine, using trimetazidine-d8 as the internal standard (IS). Interference owing to plasma phospholipids during sample preparation was overcome using a hybrid solid-phase extraction-phospholipid ultra cartridge. The mean extraction recovery of trimetazidine (98.66%) and trimetazidine-d8 (97.63%) from spiked plasma was consistent and reproducible. Chromatographic analysis was performed on a UPLC Ethylene Bridged Hybrid (BEH) C18 (50 × 2.1 mm, 1.7 µm) column with isocratic elution using acetonitrile-5 mm ammonium formate, pH 3.5 (40:60, v/v) as the mobile phase. The parent → product ion transitions for trimetazidine (m/z 267.1 → 181.1) and trimetazidine-d8 (m/z 275.2 → 181.1) were monitored on a triple quadrupole mass spectrometer with electrospray ionization functioning in the positive multiple reaction monitoring mode. The linearity of the method was established in the concentration range of 0.05-100 ng/mL for trimetazidine. The intra-batch and inter-batch accuracy and precision (CV) were 97.3-103.1 and 1.7-5.3%, respectively. Qualitative and quantitative assessment of matrix effect showed no interference of endogenous/exogenous components. The developed method was used to measure plasma trimetazidine concentration for a bioequivalence study with 12 healthy subjects.


Asunto(s)
Cromatografía Líquida de Alta Presión/métodos , Fosfolípidos/aislamiento & purificación , Espectrometría de Masas en Tándem/métodos , Trimetazidina/sangre , Humanos , Modelos Lineales , Masculino , Fosfolípidos/sangre , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Extracción en Fase Sólida/métodos , Equivalencia Terapéutica , Trimetazidina/administración & dosificación , Trimetazidina/farmacocinética
13.
J Asthma ; 54(6): 584-593, 2017 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-27780376

RESUMEN

INTRODUCTION: Even though IL-6 and MMP-9 are associated with airway inflammation in asthma, there is paucity of data in Indian population. OBJECTIVE: To determine the levels of IL-6 and MMP-9 in the serum of patients suffering from asthma, and correlate with (a) disease severity, as per GINA guidelines; (b) clinical phenotypes; and (c) response to treatment. METHODOLOGY: The levels of IL-6 and MMP-9 were compared between moderate persistent asthma (n = 25), severe persistent asthma (n = 25) and normal controls (n = 30). IL-6 and MMP-9 were measured by ELISA (R&D Systems Inc., USA and Canada) and compared between controls and asthmatics and between groups of different asthma severity, clinical variables, spirometry, and allergen sensitization. Spirometry was repeated after 2 months of ICS+LABA to assess response to treatment in relation to baseline IL-6 and MMP-9 levels. RESULTS: We observed a significant difference in both IL-6 and MMP-9 levels among asthmatics versus controls (p < 0.001), moderate versus severe persistent asthma (p < 0.001). A significant negative correlation was observed between MMP-9 and pre-bronchodilator FEV1 and FVC, but not with IL-6. There was no association between IL-6 and MMP-9 with asthma duration, total IgE, AEC, number of allergens sensitized and degree of sensitization. No significant correlation (p > 0.5) was observed with IL-6 and MMP-9 levels and FEV1 improvement after 2 months of ICS+LABA. CONCLUSION: Higher levels of IL-6 and MMP-9 were observed in asthmatics as compared to controls and in severe persistent asthma as compared to moderate persistent asthma, higher levels of MMP-9 was associated with lower lung functions.


Asunto(s)
Asma/inmunología , Mediadores de Inflamación/sangre , Interleucina-6/sangre , Metaloproteinasa 9 de la Matriz/sangre , Adulto , Asma/sangre , Biomarcadores , Índice de Masa Corporal , Canadá , Estudios de Casos y Controles , Femenino , Humanos , Hipersensibilidad/sangre , Inmunoglobulina E/sangre , India , Masculino , Persona de Mediana Edad , Pruebas de Función Respiratoria , Índice de Severidad de la Enfermedad
14.
Prep Biochem Biotechnol ; 47(10): 1050-1058, 2017 Nov 26.
Artículo en Inglés | MEDLINE | ID: mdl-28976245

RESUMEN

Enzymatic synthesis of glyceryl monoundecylenate (GMU) was performed using indigenously immobilized Candida anatarctica lipase B preparation (named as PyCal) using glycerol and undecylenic acid as substrates. The effect of molar ratio, enzyme load, reaction time, and organic solvent on the reaction conversion was determined. Both batch and continuous processes for GMU synthesis with shortened reaction time were developed. Under optimized batch reaction conditions such as 1:5 molar ratio of undecylenic acid and glycerol, 2 h of reaction time at 30% substrate concentration in tert-butyl alcohol, conversion of 82% in the absence of molecular sieve, and conversion of 93% in the presence of molecular sieve were achieved. Packed bed reactor studies resulted in high conversion of 86% in 10-min residence time. Characterization of formed GMU was performed by FTIR, MS/MS. Enzymatic process resulted in GMU as a predominant product in high yield and shorter reaction time periods with GMU content of 92% and DAG content of 8%. Optimized GMU synthesis in the present study can be used as a useful reference for industrial synthesis of fatty acid esters of glycerol by the enzymatic route.


Asunto(s)
Candida/enzimología , Enzimas Inmovilizadas/metabolismo , Proteínas Fúngicas/metabolismo , Lipasa/metabolismo , Monoglicéridos/metabolismo , Reactores Biológicos , Candida/metabolismo , Emulsiones , Esterificación , Glicerol/metabolismo , Microbiología Industrial , Temperatura , Ácidos Undecilénicos/metabolismo
15.
Neurol India ; 62(6): 618-24, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-25591673

RESUMEN

BACKGROUND: Flow diversion is a novel method of therapy wherein an endoluminal sleeve, the flow diverter stent is placed across the neck of complex aneurysms to curatively reconstruct abnormal vasculature. We present the first Indian single center experience with the pipeline embolization device (PED) and 6 months follow-up results of 5 patients. SUBJECTS AND METHODS: Five complex or recurrent intracranial aneurysms in five patients were treated with PED. The patients were followed-up with magnetic resonance angiography (MRA) after 4 weeks and conventional angiography after 6 months. Feasibility, complications, clinical outcome, early 1-month MRA and 6 months conventional angiographic follow-up results were analyzed. RESULTS: Of the five aneurysms treated, four were in the anterior circulation and one in the posterior circulation. All five patients were treated with a single PED in each, and additionally coils were used in one patient. At 1-month MRA follow-up, complete occlusion was seen in 2 (40%) of the five cases. Post 6 months conventional angiography showed complete occlusion of the aneurysm sac in all five cases (100%). Side branch ostia were covered in three patients, all of which were patent (100%). There was no incidence of major neurological morbidity or mortality. One patient (20%) who had basilar top aneurysm experienced minor neurological disability after 5 days which partially improved. CONCLUSIONS: Pipeline embolization device for complex and recurrent aneurysms is technically feasible, safe, offers low complication rate, and definitive vascular reconstruction. PED can be used without fear of occlusion of covered eloquent side branches and perforators.


Asunto(s)
Embolización Terapéutica/instrumentación , Embolización Terapéutica/métodos , Aneurisma Intracraneal/terapia , Stents , Adulto , Anciano , Angiografía de Substracción Digital , Femenino , Humanos , India , Aneurisma Intracraneal/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Resultado del Tratamiento
16.
JNMA J Nepal Med Assoc ; 62(273): 343-346, 2024 Apr 30.
Artículo en Inglés | MEDLINE | ID: mdl-39356889

RESUMEN

ABSTRACT: Paraquat poisoning poses a significant and emerging public health challenge in developing countries. The distribution and usage of Paraquat, a potent herbicide, remain unrestricted in many regions despite its high fatality rate and absence of a specific antidote. Paraquat mostly involves lungs but can also involve the kidneys and liver. Diagnostic challenges and a lack of available samples at presentation contribute to underreporting and limited awareness among healthcare providers, making paraquat poisoning a neglected toxicological emergency. Herein, we present a case of a 40-year-old male who presented to the emergency department on the fourth day after ingesting paraquat in a suicidal attempt. Upon presentation, he had erosion on the tongue and posterior pharyngeal wall, along with deranged renal function tests and elevated serum creatinine levels. The patient developed acute kidney injury, with serum creatinine levels rapidly rising from normal to 3.85 mg/dl, accompanied by a decrease in daily urine output. He was managed conservatively, and his hospital stay was uneventful.


Asunto(s)
Lesión Renal Aguda , Herbicidas , Paraquat , Intento de Suicidio , Humanos , Masculino , Lesión Renal Aguda/inducido químicamente , Paraquat/envenenamiento , Adulto , Herbicidas/envenenamiento , Creatinina/sangre
17.
Lung India ; 41(4): 272-277, 2024 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-38953190

RESUMEN

INTRODUCTION: The coexistence of insomnia and obstructive sleep apnea (OSA) poses a complex and challenging clinical scenario, commonly referred to as comorbid insomnia and OSA (COMISA). The bidirectional relationship between these two sleep disorders is explored, illuminating how the presence of one can exacerbate the severity and manifestations of the other. We under took this study to understand the prevalence of COMISA in Indians which is never studied. AIM: To study the prevalence of COMISA in tertiary hospital in India. METHODS: All OSA patients diagnosed with polysomnography were interviewed with insomnia severity index. Patients having score of more than 15 were considered to have insomnia. Demographic factors, clinical and physical examination and polysomnography values were noted. RESULTS: 25% of 64 patients were diagnosed to have COMISA. Female gender, BMI, and STOP BANG score had positive association with COMISA, whereas age was not associated with increased risk. CONCLUSION: COMISA can be more complex to diagnose and manage than insomnia or OSA alone. The symptoms and mechanisms of each condition have synergistic effect and is a barrier to treating COMISA.

18.
Ann Med Surg (Lond) ; 86(3): 1669-1675, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38463083

RESUMEN

Introduction: Medulloblastoma, a highly malignant embryonal tumor predominantly found in the pediatric population, typically arises within the cerebellum. This case report holds particular importance due to the rarity of medulloblastoma within the cerebellopontine angle (CPA). The distinct anatomical challenge posed by the CPA complex neurovascular structures, along with the absence of pathognomonic clinical or radiographic features, highlights the unique diagnostic and management challenge of this case. Case presentation: A 5-year-old boy presented with mild, progressively worsening headaches on CT/MRI imaging, which revealed a solid mass in the left CPA. Radiologically, the lesion closely resembled a CPA meningioma. The patient underwent a left retrosigmoid suboccipital craniectomy, utilizing a modified park bench position and careful burrhole creation. Intraoperatively, the tumor exhibited well-defined margins, firm adherence to cranial nerves, and complex tissue characteristics. Postoperatively, histopathological analysis identified nodular medulloblastoma, WHO grade IV, with immunohistochemical markers confirming its subtype. Discussion: This case highlights the critical role of surgical intervention in addressing rare tumors, emphasizing the need for multidisciplinary collaboration in both diagnosis and management to achieve a favorable outcome. Uncommon tumor locations, such as the CPA, require tailored approaches, and the utilization of advanced diagnostic techniques, including immunohistochemistry, aids in accurate subtype classification. Conclusion: This case highlights the critical role of surgical intervention in addressing rare tumors, emphasizing the need for multidisciplinary collaboration in both diagnosis and management to achieve a favorable outcome.

19.
Int J Surg Case Rep ; 120: 109809, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38796938

RESUMEN

INTRODUCTION: Median arcuate ligament syndrome (MALS) is a rare condition caused by the compression of the celiac trunk by the median arcuate ligament, leading to a typical symptom triad: postprandial abdominal pain, weight loss, nausea, and vomiting. CASE PRESENTATION: A 41-year-old female patient presented to our center with mild postprandial abdominal pain over the epigastric region, and bloating sensation. Ultrasonography of the abdomen showed multiple stones in the gall bladder lumen, and the computed tomography scan showed median arcuate ligament impingement along the proximal aspect of the celiac trunk causing moderate narrowing with post-stenotic dilation. Laparoscopic release of the median arcuate ligament with laparoscopic cholecystectomy was performed. DISCUSSION: The diagnosis of Median Arcuate Ligament Syndrome is based on the classical post-prandial symptoms and abdominal imaging technologies like Doppler ultrasonography, computed tomography angiography, or magnetic resonance angiography. Exclusion of other intestinal disorders should be considered before making the diagnosis. Celiac artery decompression through different means is the principle of treatment of this condition. CONCLUSION: The diagnosis of median arcuate ligament syndrome should be considered in patients with postprandial abdominal pain that does not have an established etiology. Celiac artery decompression by releasing the median arcuate ligament is the treatment.

20.
Int J Surg Case Rep ; 120: 109768, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38805842

RESUMEN

INTRODUCTION: Hydatidosis, caused by Echinococcus granulosus, is endemic in regions where cattle rearing is prevalent. While liver and lung involvement are common, isolated splenic hydatid cysts are rare, particularly among adolescents. We present a rare case of a 14-year-old female with an isolated giant splenic hydatid cyst. CASE PRESENTATION: A 14-year-old female presented with left upper quadrant pain. Imaging revealed a large splenic cyst without evidence of liver or lung involvement. A total splenectomy was performed, and a histological examination confirmed the diagnosis of a hydatid cyst. The patient underwent postoperative albendazole therapy and remained asymptomatic during follow-up. CLINICAL DISCUSSION: Isolated splenic hydatid cysts are rare in the pediatric population. Imaging techniques such as ultrasound and CT play a crucial role in diagnosis. Surgical resection and Puncture-aspiration-injection-reaspiration remain the choice of treatment, supplemented by anti-parasitic therapy. Postoperative follow-up is essential to monitor for recurrence. CONCLUSION: Isolated splenic hydatid cysts are exceptionally rare in pediatric patients. Prompt diagnosis, surgical intervention, and postoperative surveillance are crucial for successful management and prevention of recurrence.

SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA