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1.
Curr Microbiol ; 79(10): 308, 2022 Sep 10.
Artículo en Inglés | MEDLINE | ID: mdl-36088515

RESUMEN

The profile of endophytic bacteria in groundnut and their potential contribution to the reduction of drought stress are incompletely understood. Therefore, the current study is concentrated on examining the groundnut-culturable endophytic bacterial diversity, which has practical implications for reducing drought stress. Polyethylene glycol (PEG 6000) was used to identify the osmotic stress-tolerant bacterial isolates, and 51 strains were selected based on their tolerance. Fourteen potential bacterial strains with drought alleviation capacity and plant growth-promoting properties were selected and their identity was confirmed using 16S rRNA analysis. These isolates were positive for 1-aminocyclopropane-1-carboxylate deaminase, ammonia, minerals solubilization, and indole acetic acid. When applied to the groundnut seeds under water deficit conditions, the bacterial consortium (A. deltaense AMT1/Rhizobium sp. (N-Fixer) Caballeronia zhejiangensis BPT9 (PSB), Burkholderia dolosa BPT8 (KRB), and Bacillus safensis BPT6 (Drought-Mitigating Isolate)) increased the peanut germination by 91%. Soil application improved the aggregate formation. Further testing was carried out in the pot culture, where bacterial consortium improved the shoot length, root length, relative water content, chlorophyll content, nodule number, oil content, and kernel yield at 75% Water Holding capacity (WHC). Moreover, the treatment with bacterial consortia further stimulated the drought-protective mechanisms and resulted in higher efficiency of nitrogen, phosphorous, potassium uptake, electrolytes leakage, and soil enzymes such as dehydrogenase and alkaline phosphatase at 75% WHC. Microbial consortia inoculation controlled groundnut water absorption, photosynthetic performance, and stress metabolites, reducing drought-induced damage; hence, it is believed that endophytes have potential application in the improvement of yields of crops.


Asunto(s)
Sequías , Suelo , Arachis , Bacterias/genética , ARN Ribosómico 16S/genética , Agua
3.
Int J Biochem Cell Biol ; 130: 105896, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-33253831

RESUMEN

Nonlinear microscopy is a technique that utilizes nonlinear interactions between light and matter to image fluorescence and scattering phenomena in biological tissues. Very high peak intensities from focused short pulsed lasers are required for nonlinear excitation due to the extremely low probability of the simultaneous arrival of multiple photons of lower energy to excite fluorophores or interact with selective structures for harmonic generation. Combined with reduced scattering from the utilization of longer wavelengths, the inherent spatial confinement associated with achieving simultaneous arrival of photons within the focal volume enables deep imaging with low out-of-focus background for nonlinear imaging. This review provides an introduction to the different contrast mechanisms available with nonlinear imaging and instrumentation commonly used in nonlinear microscopy. Furthermore, we discuss some recent advances in nonlinear microscopy to extend the imaging penetration depth, conduct histopathological investigations on fresh tissues and examine the molecular order and orientation of molecules using polarization nonlinear microscopy.


Asunto(s)
Aumento de la Imagen/métodos , Iluminación/métodos , Microscopía Óptica no Lineal/métodos , Fotones , Animales , Fluorescencia , Humanos , Dispersión de Radiación
4.
Opt Express ; 28(24): 36274-36285, 2020 Nov 23.
Artículo en Inglés | MEDLINE | ID: mdl-33379725

RESUMEN

Generation of terahertz radiation by optical rectification of intense near-infrared laser pulses in N-benzyl-2-methyl-4-nitroaniline (BNA) is investigated in detail by carrying out a complete characterization of the terahertz radiation. We studied the scaling of THz yield with pump pulse repetition rate and fluence which enabled us to predict the optimal operating conditions for BNA crystals at room temperature for 800 nm pump wavelength. Furthermore, recording the transmitted laser spectrum allowed us to calculate the nonlinear refractive index of BNA at 800 nm.

5.
Phys Rev E ; 100(5-1): 053204, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31869893

RESUMEN

Relativistic laser-solid target interaction is a powerful source of terahertz radiation where broadband terahertz radiation is emitted from the front and rear surfaces of the target. Even though several experimental works have reported the generation of subpicosecond duration gigawatt peak power terahertz pulses from the target rear surface, the underlying physical process behind their origin is still an open question. Here we discuss a numerical model that can accurately reproduce several aspects of the experimental results. The model is based on the charged particle dynamics at the target rear surface and the evolution of the charge separation field. We identify the major contributors that are responsible for broadband terahertz emission from the rear surface of the target.

6.
Phys Rev E ; 100(5-1): 053203, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31869948

RESUMEN

Single-cycle pulses with multimillion volts per centimeter field strengths and spectra in the terahertz (THz) band have attracted great interest due to their ability to coherently manipulate molecular orientations and electron spins resonantly and nonresonantly. The tremendous progress made in the development of compact and powerful terahertz sources have identified intense laser-thin foil interaction as a potential candidate for high-power broadband terahertz radiation. They are micrometers in size and deliver radially polarized terahertz pulses with millijoule energy and gigawatt peak power. Although several works have been carried out to investigate the terahertz generation process, their origin and angular distribution are still debated. We present here an indisputable study on their spatiotemporal characteristics and elaborate the underlying physical processes via recording the three-dimensional beam profile along with transient dynamics. These results are substructured with the quantitative visualization of the charge particle spectra.

7.
J Hematol ; 7(3): 107-111, 2018 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-32300422

RESUMEN

BACKGROUND: Mortality from trauma remains a major public health issue as it is the leading cause of death in persons aged 5 - 44 years. There is a dearth of information on polytrauma from developing countries such as ours. Hence, this topic was studied at our institute. The objective is to study the coagulation parameters in polytrauma patients at our institute and to correlate the findings with the prognosis. METHODS: A prospective study was carried out in the department of pathology in a tertiary care center, during a period of 20 months from December 2012 to July 2014. All the polytrauma patients (injury severity score (ISS) ≥ 15) with injuries to head and neck, face, thorax, abdomen, extremities and external (skin) were included. Sampling was done within 20 min of arrival during primary survey of the patient. Screening tests like bleeding time (BT) and clotting time (CT) were carried out bedside. Other tests carried out were complete blood count (CBC), prothrombin time (PT), activated thromboplastin time (aPTT), thrombin time (TT) and D-dimer assay. Tests were carried out on fresh samples within 2 h of collection. RESULTS: The incidence of coagulopathy was 59.86%. There was significant prolongation of PT, aPTT and TT in those patients who developed coagulopathy. PT was found to be a stronger predictor of mortality among polytrauma patients. CONCLUSION: A significant proportion of polytrauma patients were coagulopathic. Initial coagulation profile is very useful in predicting outcomes for major polytrauma patients. This study emphasizes the importance of early suspicion and basic screening for coagulopathy in polytrauma patients in developing countries.

8.
J Gastrointest Surg ; 21(10): 1643-1649, 2017 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-28785937

RESUMEN

PURPOSE: Biliary complications following liver transplantation are a significant source of morbidity, potentially leading to graft failure necessitating retransplantation. We sought to evaluate smoking as an independent risk factor for post-transplant biliary complications. METHODS: The clinical course of all adult primary deceased donor liver transplants at our center from 1992 to 2012 was reviewed. Eligible patients were assigned to cohorts based on their lifetime tobacco exposure: never smokers indicating 0 pack-year exposure and all others were ever smokers. Biliary complications were defined as strictures, leaks, or bilomas requiring intervention. Complication rates were analyzed using univariate regression models correlated with donor and recipient characteristics. Associations found during univariate analysis were included in the final multivariate Cox model. RESULTS: Eight hundred sixty-five subjects were followed for a median of 65 months; 482 (55.7%) of patients had a positive smoking history at the time of transplant. In univariate analysis, positive tobacco smoking history (HR = 1.36; p = 0.037) and increased time from quit date to transplantation (HR = 0.998; p = 0.011) were positive and negative predictors of biliary complication, respectively. Lifetime tobacco exposure remained a significant predictor of biliary complication on multivariate analysis (HR = 1.408; p = 0.023). CONCLUSIONS: Smoking status is an independent predictor of post-transplant biliary complications, and the data presented reinforces the importance of early smoking cessation in the pre-transplantation period.


Asunto(s)
Enfermedades de las Vías Biliares/etiología , Trasplante de Hígado , Complicaciones Posoperatorias/etiología , Fumar Tabaco/efectos adversos , Adolescente , Adulto , Anciano , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Análisis de Regresión , Estudios Retrospectivos , Factores de Riesgo , Adulto Joven
9.
Ann Oncol ; 28(7): 1436-1447, 2017 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-28379322

RESUMEN

In recent years, the number of approved and investigational agents that can be safely administered for the treatment of lymphoma patients for a prolonged period of time has substantially increased. Many of these novel agents are evaluated in early-phase clinical trials in patients with a wide range of malignancies, including solid tumors and lymphoma. Furthermore, with the advances in genome sequencing, new "basket" clinical trial designs have emerged that select patients based on the presence of specific genetic alterations across different types of solid tumors and lymphoma. The standard response criteria currently in use for lymphoma are the Lugano Criteria which are based on [18F]2-fluoro-2-deoxy-D-glucose positron emission tomography or bidimensional tumor measurements on computerized tomography scans. These differ from the RECIST criteria used in solid tumors, which use unidimensional measurements. The RECIL group hypothesized that single-dimension measurement could be used to assess response to therapy in lymphoma patients, producing results similar to the standard criteria. We tested this hypothesis by analyzing 47 828 imaging measurements from 2983 individual adult and pediatric lymphoma patients enrolled on 10 multicenter clinical trials and developed new lymphoma response criteria (RECIL 2017). We demonstrate that assessment of tumor burden in lymphoma clinical trials can use the sum of longest diameters of a maximum of three target lesions. Furthermore, we introduced a new provisional category of a minor response. We also clarified response assessment in patients receiving novel immune therapy and targeted agents that generate unique imaging situations.


Asunto(s)
Antineoplásicos/uso terapéutico , Linfoma no Hodgkin/diagnóstico por imagen , Linfoma no Hodgkin/tratamiento farmacológico , Tomografía de Emisión de Positrones/normas , Criterios de Evaluación de Respuesta en Tumores Sólidos , Tomografía Computarizada por Rayos X/normas , Antineoplásicos/efectos adversos , Consenso , Medios de Contraste/administración & dosificación , Progresión de la Enfermedad , Supervivencia sin Enfermedad , Determinación de Punto Final , Fluorodesoxiglucosa F18/administración & dosificación , Humanos , Linfoma no Hodgkin/mortalidad , Linfoma no Hodgkin/patología , Estadificación de Neoplasias , Valor Predictivo de las Pruebas , Factores de Tiempo , Resultado del Tratamiento , Carga Tumoral
10.
Ann Oncol ; 28(5): 1057-1063, 2017 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-28327905

RESUMEN

BACKGROUND: The phosphatidylinositol-3-kinase delta (PI3Kδ) inhibitor idelalisib has been shown to block downstream intracellular signaling, reduce the production of prosurvival chemokines and induce apoptosis in classical Hodgkin lymphoma (HL) cell lines. It has also been shown to inhibit regulatory T cells and myeloid-derived suppressor cells in other tumor models. We hypothesized that inhibiting PI3Kδ would have both direct and indirect antitumor effects by directly targeting the malignant cells as well as modulating the inflammatory microenvironment. We tested this hypothesis in a phase II study. PATIENTS AND METHODS: We enrolled 25 patients with relapsed/refractory HL with a median age of 42 years and who had previously received a median of five therapies including 18 (72%) with failed autologous stem cell transplant, 23 (92%) with failed brentuximab vedotin, and 11 (44%) with prior radiation therapy. Idelalisib was administered at 150 mg two times daily; an increase to 300 mg two times daily was permitted at the time of disease progression. RESULTS: The overall response rate to idelalisib therapy was 20% (95% confidence interval: 6.8%, 40.7%) with a median time to response of 2.0 months. Seventeen patients (68%) experienced reduction in target lesions with one complete remission and four partial remissions. The median duration of response was 8.4 months and median progression-free survival was 2.3 months. The most common grade ≥3 adverse event was elevation of alanine aminotransferase (two patients, 8%). Diarrhea/colitis was seen in three patients and was grade 1-2. There was one adverse event leading to death (hypoxia). CONCLUSIONS: Idelalisib was tolerable and had modest single-agent activity in heavily pretreated patients with HL. Rational combinations with other novel agents may improve response rate and duration of response. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov # NCT01393106.


Asunto(s)
Fosfatidilinositol 3-Quinasa Clase I/genética , Enfermedad de Hodgkin/tratamiento farmacológico , Recurrencia Local de Neoplasia/tratamiento farmacológico , Purinas/administración & dosificación , Quinazolinonas/administración & dosificación , Adulto , Anciano , Anciano de 80 o más Años , Fosfatidilinositol 3-Quinasa Clase I/antagonistas & inhibidores , Supervivencia sin Enfermedad , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos/clasificación , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos/fisiopatología , Femenino , Enfermedad de Hodgkin/genética , Enfermedad de Hodgkin/patología , Humanos , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia/genética , Recurrencia Local de Neoplasia/patología , Purinas/efectos adversos , Quinazolinonas/efectos adversos
11.
Rev Sci Instrum ; 87(11): 11E331, 2016 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-27910592

RESUMEN

We have designed and fabricated a structured streak camera photocathode to provide enhanced efficiency for high energy X-rays (1-12 keV). This gold coated photocathode was tested in a streak camera and compared side by side against a conventional flat thin film photocathode. Results show that the measured electron yield enhancement at energies ranging from 1 to 10 keV scales well with predictions, and that the total enhancement can be more than 3×. The spatial resolution of the streak camera does not show degradation in the structured region. We predict that the temporal resolution of the detector will also not be affected as it is currently dominated by the slit width. This demonstration with Au motivates exploration of comparable enhancements with CsI and may revolutionize X-ray streak camera photocathode design.

14.
Bone Marrow Transplant ; 51(10): 1330-1336, 2016 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-27214069

RESUMEN

Chemotherapeutic agents without cross-resistance to prior therapies may enhance PBSC collection and improve patient outcomes by exacting a more potent direct antitumor effect before autologous stem cell transplant. Bendamustine has broad clinical activity in transplantable lymphoid malignancies, but concern remains over the potential adverse impact of this combined alkylator-nucleoside analog on stem cell mobilization. We performed a prospective, nonrandomized phase II study including 34 patients with multiple myeloma (MM) (n=34; International Staging System (ISS) stages I (35%), II (29%) and III (24%); not scored (13%)) to evaluate bendamustine's efficacy and safety as a stem cell mobilizing agent. Patients received bendamustine (120 mg/m2 IV days 1, 2), etoposide (200 mg/m2 IV days 1-3) and dexamethasone (40 mg PO days 1- 4) (bendamustine, etoposide and dexamethasone (BED)) followed by filgrastim (10 µg/kg/day SC; through collection). All patients (100%) successfully yielded stem cells (median of 21.60 × 106/kg of body weight; range 9.24-55.5 × 106/kg), and 88% required a single apheresis. Six nonhematologic serious adverse events were observed in 6 patients including: neutropenic fever (1, grade 3), bone pain (1, grade 3) and renal insufficiency (1, grade 1). In conclusion, BED safely and effectively mobilizes hematopoietic stem cells.


Asunto(s)
Clorhidrato de Bendamustina/administración & dosificación , Dexametasona/administración & dosificación , Etopósido/administración & dosificación , Movilización de Célula Madre Hematopoyética/métodos , Mieloma Múltiple/terapia , Trasplante de Células Madre de Sangre Periférica/métodos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Femenino , Movilización de Célula Madre Hematopoyética/efectos adversos , Humanos , Masculino , Persona de Mediana Edad , Trasplante Autólogo , Resultado del Tratamiento
15.
J Clin Diagn Res ; 10(1): ZC67-70, 2016 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-26894180

RESUMEN

INTRODUCTION: Inspite of latest advances in the materials and techniques practiced for the treatment of pulpally infected teeth with better reported success rate, still the question arises for safety and effectiveness of these medicaments. AIM: The objective of the present study was to compare the effectiveness of the Low Level Laser Therapy to Mineral Trioxide Aggregate (MTA) when used for pulpotomy in vital human primary molars. MATERIALS AND METHODS: The sample consisted of 40 primary molars from 29 children aged four to seven years. The teeth were selected based on clinical, radiographic criteria and randomly allocated to two groups. All the 40 primary molars were subjected to standard pulpotomy procedure, where in 20 molars received MTA (Group I) and 20 molars received LLLT (Group II) pulpotomy. Children were recalled at 3, 6 and 12 months intervals and pulpotomised molars were examined clinically and radiographically. Data was analysed using chi-square test. RESULTS: MTA showed 94.7% success rate at all the three intervals, where as LLLT showed a success of 95% at three months, which decreased gradually to 85% at six months and 80% at 12 months. Intergroup comparisons were not significant. CONCLUSION: Low level laser therapy can be considered for primary teeth pulpotomy and its success is comparable to MTA pulpotomy technique.

16.
Bone Marrow Transplant ; 51(1): 67-71, 2016 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-26367217

RESUMEN

We aimed to examine whether doses of melphalan higher than 200 mg/m(2) improve response rates when used as conditioning before autologous transplant (ASCT) in multiple myeloma (MM) patients. Patients with MM, n=131, were randomized to 200 mg/m(2) (mel200) vs 280 mg/m(2) (mel280) using amifostine pretreatment. The primary end point was the proportion of patients achieving near complete response (⩾nCR). No treatment-related deaths occurred in this study. Responses following ASCT were for mel200 vs mel280, respectively, ⩾nCR 22 vs 39%, P=0.03, ⩾PR 57 vs 74%, P=0.04. The hazard of mortality was not statistically significantly different between groups (mel200 vs mel280; hazard ratio (HR)=1.15 (95% confidence interval (CI), 0.62-2.13, P=0.66)) nor was the rate of progression/mortality (HR=0.81 (0.52-1.27, P=0.36)). The estimated PFS at 1 and 3 years were 83 and 46%, respectively, for mel200 and 78 and 54%, respectively, for mel280. Amifostine and mel280 were well tolerated, with no grade 4 regimen-related toxicities and only one grade 3 mucositis (none with mel200) and three grade 3 gastrointestinal (GI) toxicities (two in mel200). Hospitalization rates were more frequent in the mel280 group (59 vs 43%, P=0.08). Mel280 resulted in a higher major response rate (CR+nCR) and should be evaluated in larger studies.


Asunto(s)
Melfalán/administración & dosificación , Mieloma Múltiple/mortalidad , Mieloma Múltiple/terapia , Trasplante de Células Madre , Acondicionamiento Pretrasplante , Adulto , Anciano , Autoinjertos , Supervivencia sin Enfermedad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Mieloma Múltiple/patología , Tasa de Supervivencia
17.
Adv Radiat Oncol ; 1(1): 35-42, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-28799575

RESUMEN

PURPOSE: To evaluate and compare outcome of stereotactic body radiation therapy (SBRT), yttrium-90 radioembolization, radiofrequency ablation (RFA), or transarterial chemoembolization (TACE) as bridge to liver transplant (LT) in patients with hepatocellular carcinoma. METHODS AND MATERIALS: We retrospectively reviewed patients treated at our institution with SBRT, TACE, RFA, or yttrium-90 as bridge to LT between 2006 and 2013. We analyzed radiologic and pathologic response and rate of failure after bridge therapy. Toxicities were reported using Common Terminology Criteria for Adverse Events, 4.0. Kaplan-Meier method was used to calculate disease-free survival (DFS) and overall survival after LT. RESULTS: Sixty patients with a median age 57.5 years (range, 44-70) met inclusion criteria. Thirty-one patients (50.7%) had hepatitis C cirrhosis, 14 (23%) alcoholic cirrhosis, and 8 (13%) nonalcoholic steatohepatitis cirrhosis. Patients received a total of 79 bridge therapies: SBRT (n = 24), TACE (n = 37), RFA (n = 9), and Y90 (n = 9). Complete response (CR) was 25% for TACE, 8.6% for SBRT, 22% for RFA, and 33% for Y90. Grade 3 or 4 acute toxicity occurred following TACE (n = 4) and RFA (n = 2). Transplant occurred at a median of 7.4 months after bridge therapy. Pathological response among 57 patients was 100% necrosis (n = 23, 40%), >50% necrosis (n = 20, 35%), <50% necrosis (n = 9, 16%), and no necrosis (n = 5, 9%). Pathologic complete response was as follows: SBRT (28.5%), TACE (41%), RFA (60%), Y90 (75%), and multiple modalities (33%). At a median follow-up of 35 months, 7 patients had recurrence after LT. DFS was 85.8% and overall survival was 79% at 5 years. CONCLUSION: All bridge therapies demonstrated good pathological response and DFS after LT. SBRT and Y90 demonstrated significantly less grade ≥3 acute toxicity. Choice of optimal modality depends on tumor size, pretreatment bilirubin level, Child-Pugh status, and patient preference. Such a decision is best made at a multidisciplinary tumor board as is done at our institution.

18.
Ann Oncol ; 26(11): 2323-8, 2015 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-26347113

RESUMEN

BACKGROUND: High-dose therapy and autologous stem cell transplantation (ASCT) improves outcomes for patients with mantle cell lymphoma (MCL), but relapse ultimately occurs in most patients. Recently presented interim results from a phase III prospective trial suggest maintenance rituximab (MR) after ASCT for MCL improves progression-free survival (PFS). The maturation of these data and any benefit of MR on overall survival (OS) remain to be defined. PATIENTS AND METHODS: In this retrospective study, we examined a cohort of consecutive patients with MCL that underwent ASCT for MCL at our center and evaluated their outcomes according to whether they received MR after ASCT (n = 50) or did not (n = 107). MR was treated as a time-dependent covariate to account for variation in timing of its initiation. RESULTS: MR was associated with an improved PFS [hazard ratio (HR) 0.44; confidence interval (CI) (0.24-0.80), P = 0.007] and overall survival (OS; HR 0.46; CI 0.23-0.93, P = 0.03) following a multivariate adjustment for confounding factors with a median follow-up of ∼5 years. Grade 4 neutropenia was increased (34% versus 18%, P = 0.04) in the MR group, but no effect on the rate of mortality unrelated to relapse was observed. CONCLUSIONS: These data support that MR after ASCT for MCL confers a benefit in PFS and additionally suggest it may improve OS. General application of this strategy will require confirmation of benefit in prospective randomized trials.


Asunto(s)
Trasplante de Células Madre Hematopoyéticas/tendencias , Linfoma de Células del Manto/diagnóstico , Linfoma de Células del Manto/terapia , Quimioterapia de Mantención/tendencias , Rituximab/administración & dosificación , Adulto , Anciano , Antineoplásicos/administración & dosificación , Estudios de Cohortes , Terapia Combinada/métodos , Terapia Combinada/tendencias , Supervivencia sin Enfermedad , Femenino , Estudios de Seguimiento , Trasplante de Células Madre Hematopoyéticas/métodos , Humanos , Quimioterapia de Mantención/métodos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Trasplante Autólogo/métodos , Trasplante Autólogo/tendencias
19.
Ann Med Health Sci Res ; 5(4): 317-20, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-26229724

RESUMEN

The present report describes a case of Noonan's syndrome from a dental viewpoint. Noonan syndrome is an autosomal dominant multisystem disorder. Congenital heart deformities, short stature, thoracic deformities, short neck with webbing, hypertelorism, and malocclusions are some of the frequently observed clinical features. Atypical dental anomalies such as multiple unerupted permanent teeth, multiple submerged and retained deciduous teeth, and supernumerary teeth were found in the present case. Oral prophylaxis and preventive resin restorations were done following which the supernumerary teeth were extracted. 54, 55, 64, 65, 74, 75 and 84 were extracted after orthodontic consultation to facilitate the eruption of permanent teeth. The patient is undergoing fixed orthodontic therapy for forced eruption of unerupted permanent teeth. General dentists should correlate dental anomalies with other systemic features in the diagnosis of such syndromes because of the variability in presentation and the need for multidisciplinary care.

20.
Bone Marrow Transplant ; 50(5): 663-7, 2015 May.
Artículo en Inglés | MEDLINE | ID: mdl-25730190

RESUMEN

Outcomes in multiple myeloma (MM) have improved significantly with novel agent therapy and autologous stem cell transplantation (ASCT). ASCTs are typically planned as either tandem or a single transplant with additional stored PBSCs available for a second salvage transplant. To accommodate these strategies, many centers routinely collect and store adequate PBSCs for two ASCTs. We analyzed the cost associated with this practice by determining the expenses of PBSC collection, cryopreservation and storage, and the ultimate use of additional cryopreserved PBSCs in patients who had undergone at least one ASCT. There were 889 MM patients transplanted between 1993 and 2011 at our center. Most (N=726) had residual PBSCs in storage after their first ASCT (ASCT1). Only 135 patients underwent a second ASCT within a median of 14 months after ASCT1. The percentage of patients receiving a second ASCT declined over time. The resources required to collect and store unused PBSCs added up to 336 extra patient days of apheresis and 41 587 extra patient months of cryopreservation, translating into an average extra cost per patient of US$4981.12. A reconsideration of conventional PBSC collection and storage practices would save significant cost for the majority of MM patients who never undergo a second ASCT.


Asunto(s)
Eliminación de Componentes Sanguíneos , Criopreservación , Mieloma Múltiple , Trasplante de Células Madre de Sangre Periférica , Adulto , Anciano , Autoinjertos , Eliminación de Componentes Sanguíneos/economía , Eliminación de Componentes Sanguíneos/métodos , Costos y Análisis de Costo , Criopreservación/economía , Criopreservación/métodos , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Mieloma Múltiple/economía , Mieloma Múltiple/terapia , Trasplante de Células Madre de Sangre Periférica/economía , Trasplante de Células Madre de Sangre Periférica/métodos , Estudios Retrospectivos
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