RESUMO
BACKGROUND: Percutaneous transhepatic gallbladder drainage (PTGBD) plays an important role in the treatment of elderly patients and/or patients in poor health with acute cholecystitis (AC). The primary aim of this study is to determine how these factors influence the clinical outcome of PTGBD. Moreover, we assessed the timing and results of subsequent cholecystectomies. PATIENTS AND METHODS: We retrospectively examined the results of 162 patients undergoing PTGBD between 2010 and 2020 (male-female ratio: 51.23% vs. 48.77%; mean age: 71.43 ± 13.22 years). Patient's performance status and intervention outcomes were assessed with clinical success rates (CSR) and in-hospital mortality. The conversion rate (CR) of possible urgent or delayed, elective laparoscopic cholecystectomies (LC) after PTGBD were analysed. RESULTS: PTGBD was the definitive treatment in 42.18% of patients, while it was a bridging therapy prior to cholecystectomy (CCY) for the other patients. CSR was 87.97%, it was only 64.29% in grade III AC. In 9.87% of the cases, urgent LC was necessary after PTGBD, and its conversion rate was approximately equal to that of elective LC (18.18 vs. 17.46%, respectively, p = 0.2217). Overall, the post-PTGBD in-hospital mortality was 11.72%, while the same figure was 0% for grade I AC, 7.41% for grade II and 40.91% for grade III. Based on logistic regression analyses, in-hospital mortality (OR 6.07; CI 1.79-20.56), clinical progression (OR 7.62; CI 2.64-22.05) and the need for emergency CCY (OR 14.75; CI 3.07-70.81) were mostly determined by AC severity grade. CONCLUSION: PTGBD is an easy-to-perform intervention with promising clinical success rates in the treatment of acute cholecystitis. After PTGBD, the level of gallbladder inflammation played a decisive role in the course of AC. In a severe, grade III inflammation, we have to consider low CSR and high mortality.
Assuntos
Colecistectomia Laparoscópica , Colecistite Aguda , Idoso , Idoso de 80 Anos ou mais , Colecistectomia Laparoscópica/métodos , Colecistite Aguda/etiologia , Colecistite Aguda/cirurgia , Drenagem/métodos , Feminino , Vesícula Biliar/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Centros de Atenção Terciária , Resultado do TratamentoRESUMO
Diabetes is one of the largest public health problems nowadays. We have to consider appearance of micro- and macroangiopathic complications as early as the time of diagnosis. In diabetes mellitus type 2, one of the main complications is ischemic heart disease caused by atherosclerosis of the coronary arteries manifested clinically as angina pectoris and myocardial infarction. However, microangiopathy and secondary injury of myocardial tissue are also not uncommon complications. In the treatment of ischemic heart disease coronary interventions, medications dilating coronaries and decreasing blood pressure and heart rate are frequently applied. The authors draw attention to a drug having no hemodynamic effects, which improves the quality of life of patients via its effect on the metabolism of the myocardium.
Assuntos
Doença da Artéria Coronariana/complicações , Diabetes Mellitus Tipo 2/complicações , Angiopatias Diabéticas/tratamento farmacológico , Coração/efeitos dos fármacos , Trimetazidina/uso terapêutico , Vasodilatadores/uso terapêutico , Angina Pectoris/etiologia , Anti-Inflamatórios não Esteroides/uso terapêutico , Doença da Artéria Coronariana/etiologia , Angiopatias Diabéticas/etiologia , Humanos , Infarto do Miocárdio/etiologia , Isquemia Miocárdica/complicações , Miocárdio/metabolismoRESUMO
Diabetes mellitus as comorbidity is present in 20-25% of patients suffering from high blood pressure. Because simultaneous presence of these two diseases results in a significant increase of cardiovascular risk, various guidelines chiefly focus on the antihypertensive treatment of patients with diabetes. Combined drug therapy is usually required to achieve the blood pressure target value of <140/85 mmHg defined for patients with diabetes, which must be based on angiotensin converting enzyme-inhibitors or angiotensin receptor blockers. These can be/must be combined with low dose, primarily thiazide-like diuretics, calcium channel blockers with neutral metabolic effect, and further options include the addition of beta blockers, imidazoline-l-receptor antagonists, or alpha-1-adrenoreceptor blockers. Evidence-based guidelines are obviously present in local practice. Although most of the patients receive angiotensin converting enzyme-inhibitor+indapamide or angiotensin converting enzyme-inhibitor+calcium channel blocker combined therapy with favorable metabolic effects, yet the use of angiotensin converting enzyme-inhibitors containing hydrochlorothiazide having diabetogenic potential, and angiotensin receptor blocker fixed combinations is still widespread. Similarly, interesting therapeutic practice can be observed with the use of less differentiated beta blockers, where the 3rd generation carvedilol and nebivolol are still in minority.
Assuntos
Anti-Hipertensivos/uso terapêutico , Complicações do Diabetes/tratamento farmacológico , Prescrições de Medicamentos/estatística & dados numéricos , Hipertensão/tratamento farmacológico , Padrões de Prática Médica/estatística & dados numéricos , Antagonistas de Receptores Adrenérgicos alfa 1/uso terapêutico , Antagonistas de Receptores de Angiotensina/uso terapêutico , Inibidores da Enzima Conversora de Angiotensina/uso terapêutico , Pressão Sanguínea/efeitos dos fármacos , Determinação da Pressão Arterial , Carbazóis/uso terapêutico , Carvedilol , Diuréticos/uso terapêutico , Quimioterapia Combinada , Humanos , Hungria , Hidroclorotiazida/uso terapêutico , Hipertensão/etiologia , Hipertensão/fisiopatologia , Receptores de Imidazolinas/antagonistas & inibidores , Medicina Interna/estatística & dados numéricos , Médicos de Família/estatística & dados numéricos , Propanolaminas/uso terapêutico , Fatores de RiscoRESUMO
BACKGROUND: Agricultural landscapes provide resources for arthropod pests as well as their natural enemies. To develop integrated pest management (IPM) practices, it is important to understand how spatiotemporal location influences crop colonization and damage severity. We performed a 3-year (2016-2018) field experiment in winter oilseed rape (OSR, Brassica napus) fields in Estonia, where half of the fields were within 500 m of the location of the previous year's winter OSR field and half were outside this zone. We investigated how distance from the previous year's OSR crop influences the infestation and parasitism rates of two of its most important pests: the pollen beetle (Brassicogethes aeneus) and the cabbage seed weevil (Ceutorhynchus obstrictus). RESULTS: When the distance from the previous year's OSR crop was >500 m, we recorded significantly reduced pest pressure by both B. aeneus and C. obstrictus in the study fields. Biocontrol of both pests, provided by parasitic wasps, was high in each study year and commonly not affected by distance. Mean parasitism rates of B. aeneus were >31%, occasionally reaching >70%; for C. obstrictus, mean parasitism was >46%, reaching up to 79%, thereby providing effective biocontrol for both pest species. CONCLUSION: Spatiotemporal separation of OSR fields can reduce pest pressure without resulting in reduced parasitism of OSR pests. This supports a spatiotemporal field separation concept as an effective and sustainable technique for IPM in OSR. © 2023 The Authors. Pest Management Science published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.
Assuntos
Artrópodes , Brassica napus , Besouros , Vespas , Gorgulhos , Animais , Besouros/parasitologiaRESUMO
Transgenic banana (Musa acuminata 'Gros Michel') integrating either of two rice chitinase genes was generated and its resistance to Black Leaf Streak disease caused by the fungus Mycosphaerella fijiensis was tested using a leaf disk bioassay. PCR screening indicated the presence of the hpt selectable marker gene in more than 90 % of the lines tested, whereas more than three quarters of the lines contained the linked rice chitinase gene resulting in a co-transformation frequency of at least 71.4 %. Further, a unique stable integration of the transgenes in each line revealed some false negative PCR results and the expected co-transformation frequency of 100 %. The transgene insert number per line ranged from 1 to 5 and single transgene insert lines (25 % of all) were identified. Considerable delay in disease development (up to 63 days post-incoculation) over a monitoring period of 108 days occurred in nine lines with extracellularly targeted chitinase out of 17 transgenic lines tested and their necrotic leaf area decreased by 73-94 % compared to the untransformed susceptible control line. Finally, correlation between symptom development and rice chitinase expression was confirmed in two lines by Western analysis. The potential of rice chitinase genes to enhance resistance against M. fijiensis in banana was demonstrated as well as the usefulness of the leaf disk bioassay for early disease screening in transgenic banana lines.
Assuntos
Quitinases , Musa , Oryza/genética , Doenças das Plantas , Ascomicetos/genética , Ascomicetos/patogenicidade , Quitinases/biossíntese , Quitinases/genética , Resistência à Doença/genética , Regulação da Expressão Gênica de Plantas , Musa/genética , Musa/metabolismo , Musa/microbiologia , Doenças das Plantas/genética , Doenças das Plantas/microbiologia , Folhas de Planta/genética , Folhas de Planta/metabolismo , Folhas de Planta/microbiologiaRESUMO
Global biodiversity has suffered a decline primarily attributed to landscape simplification and intensified agricultural practices. Agricultural environments, characterized by homogeneity and frequent disturbances, are often suboptimal habitats for various insect species. While agricultural fields do favour pests, they generally fail to provide suitable habitats for natural enemies. The inclusion of diverse supporting habitats, such as semi-natural habitats, grassy and woody field margins etc. surrounding agricultural fields, play a crucial role in fostering effective biodiversity conservation. Moreover, determining the influence of different adjacent habitat types is essential in elucidating their influence on pest abundance and parasitism rates. Our two-year field study focused on assessing the abundance of Brassicogethes aeneus and its parasitism rate. The findings revealed that the adjacent habitat type did not significantly increase pest abundance and the parasitism rate of B. aeneus larvae consistently stayed over the threshold for effective biological control throughout the fields. This was attributed to the high proportion (35 and 38% in the 2 study years) of semi-natural habitats within most of the 1 km radius study areas. While our study did not identify any specific adjacent habitat type or habitat within a 1 km radius that directly impacted B. aeneus abundance, it emphasises the intricate interplay between the pests, parasitism and the surrounding environment because the interactive effect of distance from the crop edge and habitat type had a significant influence on B. aeneus infestation levels but not on parasitism. Decision tree analysis suggests that > 18% semi-natural habitat is needed to ensure sufficient levels of parasitism for effective biological control. A comprehensive understanding of habitats that influence not only B. aeneus but also other pests is critical for the successful implementation of IPM strategies and conservation initiatives within the agricultural sector.
Assuntos
Besouros , Controle Biológico de Vetores , Animais , Larva , Ecossistema , BiodiversidadeRESUMO
The most important disease of European chestnut (Castanea sativa Mill.) is chestnut blight caused by the fungus Cryphonectria parasitica (Murrill) Barr which induces yield reduction in Europe and North America. This study aimed to investigate the impacts of C. parasitica infection on the physiological and biochemical characteristics of European chestnut at two different growth stages, 3 and 6 weeks after the infection. The amount of photosynthetic pigments (chlorophyll-a, chlorophyll-b, and carotenoids), the relative chlorophyll content, and the photochemical efficiency of the photosystem II (PSII) were measured in the leaves above and below the virulent and hypovirulent C. parasitica infections. The highest values were measured in the control leaves, the lowest values were in the leaves of the upper part of virulent necrosis. Antioxidant enzyme activities such as ascorbate peroxidase (APX), guaiacol peroxidase (POD), and superoxide dismutase (SOD), proline, and malondialdehyde concentrations were also investigated. In each of these measured values, the lowest level was measured in the control leaves, while the highest was in leaves infected with the virulent fungal strain. By measuring all of these stress indicator parameters the responses of chestnut to C. parasitica infection can be monitored and determined. The results of this study showed that the virulent strain caused more pronounced defense responses of chestnut's defense system. The measured parameter above the infection was more exposed to the blight fungus disease relative to the leaves below the infection.
RESUMO
The main goal of this research was to investigate the effects of corn smut (Ustilago maydis DC. Corda) infection on the morphological (plant height, and stem diameter), and biochemical parameters of Zea mays L. plants. The biochemical parameters included changes in the relative chlorophyll, malondialdehyde (MDA), and photosynthesis pigments' contents, as well as the activities of antioxidant enzymes-ascorbate peroxidase (APX), guaiacol peroxidase (POD), and superoxide dismutase (SOD). The second aim of this study was to evaluate the impact of phytohormones (auxin, cytokinin, gibberellin, and ethylene) on corn smut-infected plants. The parameters were measured 7 and 11 days after corn smut infection (DACSI). Two hybrids were grown in a greenhouse, one fodder (Armagnac) and one a sweet corn (Desszert 73). The relative and the absolute amount of photosynthetic pigments were significantly lower in the infected plants in both hybrids 11 DACSI. Activities of the antioxidant enzymes and MDA content were higher in both infected hybrids. Auxin, cytokinin, and gibberellin application diminished the negative effects of the corn smut infection (CSI) in the sweet corn hybrid. Phytohormones i.e., auxin, gibberellin, and cytokinin can be a new method in protection against corn smut.
RESUMO
Woolly cupgrass (Eriochloa villosa (Thunb.) Kunth) is a new invasive weed in Hungary. This study was conducted to elucidate the effects of this weed on the biochemistry and growth of maize (Zea mays L. cv. Armagnac) under greenhouse conditions. Activities of the antioxidative enzymes (ascorbate peroxidase (APX), guaiacol peroxidase (POD), superoxide dismutase (SOD)), the contents of malondialdehyde (MDA), and protein were measured in the shoots and roots, whereas the content of the photosynthetic pigments was measured only in the shoots. The measured growth parameters included plant height, root length, root volume, root and shoot dry weight, and stem diameter. Results showed the allelopathic effects of woolly cupgrass on maize, with significant decreases in plant height, root length, root volume, and root dry weight. Woolly cupgrass infestation (WCI) induced significantly higher activities of APX and SOD in the shoots, whereas POD was only induced in the roots. The contents of chlorophyll-a, total chlorophyll (including relative chlorophyll), carotenoids, and root protein were substantially reduced by WCI, except for the leaf chlorophyll-b. The results suggest that high APX and SOD activities in the shoots could be involved in stabilizing the leaf chlorophyll-b, chlorophyll a/b, shoot protein, and shoot dry weight because all of these parameters were not inhibited when these two enzymes were induced. In contrast, high activity of POD in the roots is not effective in counteracting allelopathy. Therefore, it would be worthwhile to further investigate if an increase in the activities of APX and SOD in the shoots of WCI maize is responsible for stabilizing leaf chlorophyll-b, shoot protein, and shoot dry weight, which could contribute to improved maize yield under WCI.
RESUMO
The incidence of endometriosis, including atypical forms of the disease, has been continuously growing, thus increasingly challenging for the imaging specialists as well. We conducted a retrospective study to analyze the results of ultrasound-guided interventions between 2016 and 2018. All interventions were performed in female patients due to uncertain abdominal wall lesions at the University of Szeged, Hungary. The abdominal wall lesions were incidentally detected, one by CT, the others by ultrasound examinations. We identified 12 cases during the study period. The average age of the patients was 59 years (29-79), 8 of them had abdominal surgery in their medical history. The mean diameter of the masses was 34.4 mm (20-49 mm). Since the indication of imaging examinations was the evaluation of a known or suspected malignancy, four patients had undergone an MRI prior to the biopsy. In addition, ultrasound-guided biopsy was not performed in another two patients, and the diagnosis was established by histological examination of the surgically removed specimens. The histological examination revealed malignant primary serous epithelial tumor in one case, metastases in six cases, endometriosis in six patients and abdominal wall abscess was found in one patient. Endometriosis was more frequent in the younger patients. The likelihood of endometriosis as a cause of abdominal wall lesions of younger, premenopausal female patients is rather high, especially with obstetrical or gynaecological operations in the medical history. Ultrasound plays a primary role in the detection and therapy planning of these lesions. Orv Hetil. 2019; 160(35): 1395-1403.
Assuntos
Parede Abdominal/diagnóstico por imagem , Endometriose/diagnóstico por imagem , Parede Abdominal/patologia , Adulto , Idoso , Biópsia , Endometriose/patologia , Feminino , Humanos , Hungria , Pessoa de Meia-Idade , Radiologistas , Estudos Retrospectivos , UltrassonografiaRESUMO
BACKGROUND: This study investigated how infestation rates of an important oilseed rape pest, the cabbage seed weevil (Ceutorhynchus obstrictus) and rates of parasitization by its parasitoids are affected by land use, up to 1000 m from 18 focal fields. RESULTS: The mean proportion of C. obstrictus-infested pods per plant was 8% (2-19.5%). Infestation rates were higher if the adjacent habitat was a herbaceous semi-natural habitat than if it was either another crop or a woody habitat. Infestation rates were positively related to the area of herbaceous semi-natural vegetation, permanent grassland and wheat (which followed oilseed rape in the crop rotation) at a spatial scale of at least 1 km. The mean parasitism rate of C. obstrictus larvae was 55% (8.3-87%), sufficient to provide efficient biocontrol. Parasitism rates were unrelated to adjacent habitats, however, they were positively related to the presence of herbaceous linear elements in the landscape and negatively related to permanent grasslands at a spatial scale of 200 m. CONCLUSION: Proximity of herbaceous elements increased both infestation rates and parasitism, while infestation was also related to landscape factors at larger distances. The findings provide an empirical basis for designing landscapes that suppress C. obstrictus, at both field and landscape scales. © 2018 Society of Chemical Industry.
Assuntos
Brassica rapa/parasitologia , Ecossistema , Gorgulhos/fisiologia , Animais , Estônia , Pradaria , Himenópteros , Controle Biológico de Vetores , Dinâmica Populacional , Triticum , Gorgulhos/parasitologiaRESUMO
The drought-inducible DS2 genes of potatoes are members of the ASR (abscisic acid, stress and ripening) gene family. Previously it was shown that expression of DS2 genes is highly dehydration-specific in potato leaves, is not inducible by cold, heat, salt, hypoxia or oxidative stresses, and is independent of abscisic acid (ABA). Now it is shown that StDS2 does not respond either to sucrose or any plant hormones. Conservation of DS2 genes with this unique mode of regulation was studied in the solanaceous species with different relationships to potatoes. DS2 orthologues were identified by DNA sequence alignment in the closely related Lycopersicon and Capsicum species but not in the more distantly related Nicotiana sp. DNA and RNA gel blot analysis revealed the presence of a gene highly homologous to the potato gene StDS2 in tomato (LeDS2) with the same desiccation-specific expression in leaves and organ-specific expression in flowers and green fruits. The LeDS2 promoter was isolated and found to be almost identical in sequence with the promoter of StDS2, except for a 45-bp insertion in tomato. In contrast, no gene highly similar to StDS2 was detected in Nicotiana species on DNA gel blots. Neither StDS2 nor LeDS2 promoter regions were able to confer expression for the beta-glucuronidase (GUS) reporter gene in transgenic tobacco plants indicating that the trans regulatory factors necessary for DS2 expression are not conserved either in Nicotiana tabacum. These data suggest a narrow species-specificity and late evolution of the DS2-type genes within the family Solanaceae.
Assuntos
Desidratação/genética , Evolução Molecular , Proteínas de Plantas/genética , Regiões Promotoras Genéticas , Solanaceae/genética , Sequência de Bases , Regulação da Expressão Gênica de Plantas , Dados de Sequência Molecular , Fatores de Transcrição/genéticaRESUMO
WHIM (warts-hypogammaglobulinemia-infections-myelokathexis) syndrome is a recently described primary immunodeficiency disorder caused by mutation of the CXCR4 chemokine receptor gene. We report here of a 6.5-yr-old girl with bacterial infections, severe chronic neutropenia, and hypogammaglobulinemia. Sequencing the CXCR4 gene revealed a c.1013C > G sequence variant suggesting WHIM syndrome. Recurrent c.1013C > G sequence variant of the CXCR4 gene resulting in p.S338X truncation mutation of this chemokine receptor protein is first reported here.
Assuntos
Agamaglobulinemia/genética , Variação Genética , Síndromes de Imunodeficiência/genética , Receptores CXCR4/genética , Verrugas/genética , Criança , Feminino , Heterozigoto , Humanos , Mutação , Recidiva , Análise de Sequência de DNA , Deleção de Sequência , SíndromeRESUMO
In this paper we describe the first procedure for Agrobacterium tumefaciens-mediated genetic transformation of the desiccation tolerant plant Ramonda myconi (L.) Rchb. Previously, we reported the establishment of a reliable and effective tissue culture system based on the integrated optimisation of antioxidant and growth regulator composition and the stabilisation of the pH of the culture media by means of a potassium phosphate buffer. This efficient plant regeneration via callus phase provided a basis for the optimisation of the genetic transformation in R. myconi. For gene delivery, both a standard (method A) and a modified protocol (method B) have been applied. Since the latter has previously resulted in successful transformation of another resurrection plant, Craterostigma plantagineum, an identical protocol was utilized in transformation of R. myconi, as this method may prove general for dicotyledonous resurrection plants. On this basis, physical and biochemical key variables in transformation were evaluated such as mechanical microwounding of plant explants and in vitro preinduction of vir genes. While the physical enhancement of bacterial penetration was proved to be essential for successful genetic transformation of R. myconi, an additional two-fold increase in the transformation frequency was obtained when the above physical and biochemical treatments were applied in combination. All R0 and R1 transgenic plants were fertile, and no morphological abnormalities were observed on the whole-plant level.
Assuntos
Craterostigma/genética , Folhas de Planta/genética , Agrobacterium tumefaciens/genética , Antibacterianos/farmacologia , Cefotaxima/farmacologia , Ácidos Clavulânicos/farmacologia , Craterostigma/efeitos dos fármacos , Craterostigma/crescimento & desenvolvimento , Desidratação , Técnicas de Transferência de Genes , Folhas de Planta/efeitos dos fármacos , Folhas de Planta/crescimento & desenvolvimento , Folhas de Planta/microbiologia , Plantas Geneticamente Modificadas , Ticarcilina/farmacologia , Transformação GenéticaAssuntos
Colangite Esclerosante/complicações , Colite Ulcerativa/complicações , Poliendocrinopatias Autoimunes/complicações , Adulto , Colangite Esclerosante/diagnóstico , Colangite Esclerosante/tratamento farmacológico , Colite Ulcerativa/diagnóstico , Colite Ulcerativa/tratamento farmacológico , Humanos , Masculino , Poliendocrinopatias Autoimunes/diagnóstico , Poliendocrinopatias Autoimunes/tratamento farmacológico , PrognósticoRESUMO
Previously, it was shown that low temperature (Assuntos
Temperatura Baixa
, Regulação da Expressão Gênica de Plantas/genética
, Interferência de RNA
, RNA Antissenso/metabolismo
, RNA Interferente Pequeno/metabolismo
, Solanum tuberosum/genética
, Especificidade de Órgãos
, Folhas de Planta/genética
, Folhas de Planta/metabolismo
, Raízes de Plantas/genética
, Raízes de Plantas/metabolismo
, Tubérculos/genética
, Tubérculos/metabolismo
, Plantas Geneticamente Modificadas
, RNA Antissenso/genética
, RNA de Plantas/genética
, RNA de Plantas/metabolismo
, RNA Ribossômico/metabolismo
, RNA Interferente Pequeno/genética