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Loss of sensory innervation delays wound healing and administration of the neuropeptide substance P improves re-epithelialization. Keratinocyte hyperproliferation post-wounding may result from symmetric stem cell (SC) self-renewal, asymmetric SC self-renewal, committed progenitor divisions, or a combination of these. However, the effects of sensory denervation and of neuropeptides on SC proliferation are not known. Here we show that early after wounding both asymmetric and symmetric SC self-renewal increase, without significant committed progenitor (CP) activation. Decreased sensory innervation is associated with a decrease in both SC and CP proliferation. Based on previous work showing that substance P is decreased in capsaicin-treated mice and improves wound healing in normal skin, we examined the effects of substance P on SC and CP proliferation during wound healing. Substance P restored asymmetric SC proliferation in skin with decreased sensory innervation, both at baseline and following wounding. Epidermis with decreased sensory innervation was severely thinned. Consistent with this, substance P-induced asymmetric SC proliferation resulted in increased stratification in skin with both normal and decreased innervation. Lapatinib prevented the substance P-induced increase in asymmetric SC divisions in murine epidermis, as well as the increase in epidermal stratification, suggesting that asymmetric SC divisions are required for epidermal stratification.
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OBJECTIVE: This study aims to identify the characteristics of Egyptian patients suffering from type 2 diabetes mellitus (T2DM), determine disease control rates, and gain insights into clinical treatments. PATIENTS AND METHODS: A total of 2,516 patients with T2DM were recruited from 244 private clinics across Egypt in a one-month period from May to June 2017. Data collected from patients included glycemic control parameters of glycosylated hemoglobin, fasting plasma glucose, and postprandial glucose. Additional information gathered included patients' weight, age, level of physical activity, smoking habits, presence of comorbidities, type of treatment received for type 2 diabetes, number and severity of hypoglycemic events, as well as treatment modification by the physician in the last visit. The type of statistics used for the analysis is descriptive statistics and regression model. RESULTS: Only 18.4% of participating patients achieved the target level of glycosylated hemoglobin of 7% or below. The mean age of these patients was 54±11.2 years, and the mean duration since the first diagnosis was 6.6±6.4 years. A total of 33.4% of all patients had no known comorbidity, while the rest had one or more known and treated comorbidities. A total of 76% of patients received sulfonylurea either as monotherapy or in combination with other treatments. In addition, no treatment modifications or adjustments were provided for 32% of the study participants who did not reach their glycemic control target. CONCLUSIONS: In Egypt, there is a low rate of glycemic control among private patients and a high prevalence of comorbid conditions. This is likely to cause a significant health burden to people with T2DM, the healthcare system, and the economy due to a loss in productivity. This study presented an argument for better-managed measures to improve glycemic control in the population, such as patient education to increase patient awareness and adherence to treatment protocols as well as improved adherence to guidelines by clinicians.
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Diabetes Mellitus Tipo 2 , Humanos , Adulto , Persona de Mediana Edad , Anciano , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Diabetes Mellitus Tipo 2/epidemiología , Diabetes Mellitus Tipo 2/inducido químicamente , Egipto/epidemiología , Hemoglobina Glucada , Glucemia , HipoglucemiantesRESUMEN
Glioblastoma (GBM) with Primitive Neuroectodermal tumor (PNET) like features is an extremely rare tumor showing dual features of malignant glioma and primitive neuroectodermal tumour occurring mostly in adults. It poses diagnostics dilemma to the neuropathologist and treating oncologist team because of its rarity, tendency to spread to cerebrospinal fluid and dismal prognosis. We have described this tumor in a 11 years old male child in this case report. Keywords: glioma,glioblastoma,primitive neuroectodermal tumor, variant, pediatric.
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Glioblastoma , Glioma , Tumores Neuroectodérmicos Primitivos , Adulto , Masculino , Humanos , NiñoRESUMEN
OBJECTIVES: This study aimed at evaluating the effect of genicular nerve block (GNB) in juvenile idiopathic arthritis (JIA) patients with persistent unilateral knee arthritis on pain, inflammatory parameters, function, and range of motion. METHODS: A total of 104 JIA patients were diagnosed according to the International League Against Rheumatism (ILAR) criteria with persistent unilateral knee arthritis. They were allocated randomly into 2 groups: group 1 treated with GNB, while group 2 was treated with intra-articular triamcinolone (TA) only. Visual analogue scale (VAS) on pain, sonography of large joints in rheumatology (SOLAR) scoring system, and Lysholm scores were assessed at 0-, 2-, and 12-week intervals. Swelling and tenderness were clinically evaluated semi-quantitatively (0-3) at the same time intervals. RESULTS: VAS pain, tenderness, swelling, and SOLAR grey scale (GS) and power Doppler (PD) scores were significantly reduced after 2 weeks in both groups (p < 0.05). This was greater in the GNB group regarding VAS and tenderness, while SOLAR and swelling were stronger reduced in TA group. After 12 weeks, all outcome measures showed lower values in the GNB group compared to TA, and this was significant regarding VAS pain. Moreover, Lysholm functional score was significantly increased in both groups at both intervals; and higher values were seen in the TA group compared to GNB after 2 weeks. CONCLUSION: GNB was able to control pain and improve function and inflammation of the knee joint in JIA patients. Though steroid attained better results after 2 weeks, GNB achieved an equivalent longer-term improvement after 12 weeks. TRIAL REGISTRATION IDENTIFYING NUMBER: NCT04687930. Key Points ⢠Persistent knee arthritis treatment in JIA is always challenging. ⢠GNB was approved for treatment of pain in knee osteoarthritis. ⢠GNB in the present study succeeded to control active knee arthritis and this effect was comparable to intra-articular steroid injection.
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Artritis Juvenil , Bloqueo Nervioso , Osteoartritis de la Rodilla , Humanos , Artritis Juvenil/complicaciones , Artritis Juvenil/tratamiento farmacológico , Articulación de la Rodilla/diagnóstico por imagen , Dolor/tratamiento farmacológico , Osteoartritis de la Rodilla/tratamiento farmacológico , Triamcinolona/uso terapéutico , Resultado del Tratamiento , Inyecciones IntraarticularesRESUMEN
The essence of food security centers on ensuring availability and accessibility of foods in adequate amounts and quality for all populations at all times for an active and healthy life. Microorganisms are tiny bioreactors, which represent sustainable resources and promising approaches to bridging the gap between food production and consumption globally via various biotechnological applications. This review focuses on plant-growth promoting bacteria (PGPB) which exert their potential impacts on increasing soil fertility, plant growth, and productivity through a variety of processes, including direct, indirect, and synergistic mechanisms. PGPB plays a substantial role in accelerating nutrients' availability such as (N, P), producing phytohormones such as gibberellins, IAA, and bioactive compounds against biotic and abiotic stressors. Recent advances in PGPB will be addressed as a sustainable approach to satisfy global food demand.
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Bacterias , Desarrollo de la Planta , Suelo , Microbiología del Suelo , Seguridad AlimentariaRESUMEN
Significant food resource shortages are occurring worldwide. Plant growth-promoting rhizobacteria (PGPR) represent an ecofriendly and efficient approach for increasing soil fertility and plant productivity. The current study explored biostimulating traits of PGPR from the rhizosphere of Lotus corniculatus growing in the Al-Ahsa region. A bacterial isolate (LCK121) was obtained, characterized for phenotypic, and identified by 16S rRNA gene sequencing. In addition, its growth-stimulating effects on barley were investigated. The strain identity was confirmed via comparative analysis of the 16S rDNA sequences with Klebsiella oxytoca (99.3% similarity level). LCK121 exhibited multiple plant growth-promoting features, including indole-3-acetic acid (IAA) production (16.34 µg mL-1), 1-aminocyclopropane-1-carboxylic acid (ACC) deaminase activity (1.35±0.02 µmol α-ketobutyrate mg-1 h-1), phosphate solubilization, and nitrogen fixation. Furthermore, in vitro inoculation of barley with LCK121 significantly increased the root and shoot dry weights. The results highlight the potential of LCK121 for developing green fertilizers for sustainable agriculture.
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Lotus , Rizosfera , ADN Ribosómico , Fertilizantes , Klebsiella oxytoca/genética , Lotus/genética , Fosfatos , Raíces de Plantas , ARN Ribosómico 16S/genética , Suelo , Microbiología del SueloRESUMEN
Various factors influence the students' perception of universities and university image. This study explores five factors affecting university image among Graduate Alumni. Surveys, administered to 597 graduate alumni were assessed to determine Graduate Alumni perspectives toward their university. Findings revealed that the key factors that impacted graduate alumni affecting the university's image and reputation were gender, nationality, level of study, and the ability of the institution to equip graduates with certain specific skills. Based on these findings, the university should consider further examining these areas to provide a more in-depth understanding of how these factors work to shape graduate students' perspectives of the university and develop ways to address areas that need to be developed and improved.
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OBJECTIVE: The most prevalent endocrinopathy in women is polycystic ovarian syndrome (PCOS). Multiple gene abnormalities like Ar, Cyp19a1, Hsd3b1, Srd5a1, Bcl-2, and Bax genes are associated with PCOS. Herein, the PCOS model was induced by oral administration of dehydroepiandrosterone (DHEA). Metformin (Met) is one of the most common drugs affecting the most relevant genes involved in PCOS development but with unwanted side effects. Natural treatments have been known for their safer effects. Spirulina (SP) is a type of blue-green algae that contains nutrients and compounds that would treat PCOS and lower the possible side effects of Met in combination therapy. We aim to evaluate the clinical effectiveness and safety of SP on PCOS by multi confirmatory tests and to demonstrate its effects on regulating the expression of multiple genes that are responsible for the occurrence of PCOS in comparison to Met. MATERIALS AND METHODS: Herein, sixty adult female Wistar albino rats were subdivided into equal six groups with 10 rats in each group. All drugs were given orally once daily for one month. The expression of Ar, Cyp19a1, Hsd3b1, Srd5a1, Bcl-2, and Bax genes, were examined by quantitative real-time PCR (qRT-PCR). RESULTS: The present study showed that SP has a remarkable effect on the reduction of the development of PCOS by regulating the expression of the examined genes. As a result, it may be a useful therapy alternative for PCOS complications, symptoms, and infertility as well. CONCLUSIONS: Collectively, SP is considered a promising therapeutic drug in the treatment of PCOS-like symptoms induced by DHEA.
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Metformina , Síndrome del Ovario Poliquístico , Spirulina , Animales , Deshidroepiandrosterona , Modelos Animales de Enfermedad , Femenino , Humanos , Metformina/farmacología , Metformina/uso terapéutico , Complejos Multienzimáticos/uso terapéutico , Síndrome del Ovario Poliquístico/inducido químicamente , Síndrome del Ovario Poliquístico/tratamiento farmacológico , Síndrome del Ovario Poliquístico/genética , Proteínas Proto-Oncogénicas c-bcl-2 , Ratas , Ratas Wistar , Proteína X Asociada a bcl-2RESUMEN
Green synthesis of silver nanoparticles (AgNPs) is an ecofriendly, cost-effective and promising approach for discovery of novel therapeutics. The aim of the current work was to biogenic synthesize, characterize AgNPs using seed extracts of three economically important varieties of date palm (Iklas, Irziz and Shishi), and assess their anti-pathogenic bacterial activities. AgNPs were synthesised then characterised using electron microscopy and Fourier transform infrared analyses. The bactericidal activities of AgNPs against five different bacterial pathogens, Bacillus subtilis, Escherichia coli, Staphylococcus aureus, methicillin-resistant Staphylococcus aureus and Streptococcus pneumoniae, were determined in vitro. In particular, changes in membrane integrity of virulent bacterial strains in response to AgNPs were investigated. Results of lactate dehydrogenase, alkaline phosphatase activity assays, and measurement of membrane potential revealed that the cytotoxic effects of the AgNPs were mainly centred on the plasma membrane of bacterial cells, leading to loss of its integrity and eventually cell death. In conclusion, green synthesis of AgNPs is an efficient, cost-effective and promising strategy to combat virulent antibiotic-resistant strains.
A síntese verde de nanopartículas de prata (AgNPs) é uma abordagem ecologicamente correta, econômica e promissora para a descoberta de novas terapêuticas. O objetivo do presente trabalho foi sintetizar biogênica, caracterizar AgNPs usando extratos de sementes de três variedades economicamente importantes de tamareira (Iklas, Irziz e Shishi) e avaliar suas atividades bacterianas antipatogênicas. AgNPs foram sintetizados e caracterizados usando microscopia eletrônica e análise de infravermelho por transformada de Fourier. As atividades bactericidas de AgNPs contra cinco diferentes patógenos bacterianos, Bacillus subtilis, Escherichia coli, Staphylococcus aureus, Staphylococcus aureus resistente à meticilina e Streptococcus pneumoniae, foram determinadas in vitro. Em particular, foram investigadas alterações na integridade da membrana de cepas bacterianas virulentas em resposta a AgNPs. Os resultados da lactato desidrogenase, dos ensaios da atividade da fosfatase alcalina e da medição do potencial de membrana revelaram que os efeitos citotóxicos dos AgNPs estavam principalmente centrados na membrana plasmática das células bacterianas, levando à perda de sua integridade e, eventualmente, à morte celular. A síntese verde de AgNPs é uma estratégia eficiente, econômica e promissora para combater cepas virulentas resistentes a antibióticos.
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Antibiosis , Bacillus subtilis/efectos de los fármacos , Escherichia coli/efectos de los fármacos , Nanopartículas/análisis , Phoeniceae , Plata/análisis , Staphylococcus aureus/efectos de los fármacos , Streptococcus pneumoniae/efectos de los fármacos , Microscopía , Técnicas In VitroRESUMEN
Abstract Green synthesis of silver nanoparticles (AgNPs) is an ecofriendly, cost-effective and promising approach for discovery of novel therapeutics. The aim of the current work was to biogenic synthesize, characterize AgNPs using seed extracts of three economically important varieties of date palm (Iklas, Irziz and Shishi), and assess their anti-pathogenic bacterial activities. AgNPs were synthesised then characterised using electron microscopy and Fourier transform infrared analyses. The bactericidal activities of AgNPs against five different bacterial pathogens, Bacillus subtilis, Escherichia coli, Staphylococcus aureus, methicillin-resistant Staphylococcus aureus and Streptococcus pneumoniae, were determined in vitro. In particular, changes in membrane integrity of virulent bacterial strains in response to AgNPs were investigated. Results of lactate dehydrogenase, alkaline phosphatase activity assays, and measurement of membrane potential revealed that the cytotoxic effects of the AgNPs were mainly centred on the plasma membrane of bacterial cells, leading to loss of its integrity and eventually cell death. In conclusion, green synthesis of AgNPs is an efficient, cost-effective and promising strategy to combat virulent antibiotic-resistant strains.
Resumo A síntese verde de nanopartículas de prata (AgNPs) é uma abordagem ecologicamente correta, econômica e promissora para a descoberta de novas terapêuticas. O objetivo do presente trabalho foi sintetizar biogênica, caracterizar AgNPs usando extratos de sementes de três variedades economicamente importantes de tamareira (Iklas, Irziz e Shishi) e avaliar suas atividades bacterianas antipatogênicas. AgNPs foram sintetizados e caracterizados usando microscopia eletrônica e análise de infravermelho por transformada de Fourier. As atividades bactericidas de AgNPs contra cinco diferentes patógenos bacterianos, Bacillus subtilis, Escherichia coli, Staphylococcus aureus, Staphylococcus aureus resistente à meticilina e Streptococcus pneumoniae, foram determinadas in vitro. Em particular, foram investigadas alterações na integridade da membrana de cepas bacterianas virulentas em resposta a AgNPs. Os resultados da lactato desidrogenase, dos ensaios da atividade da fosfatase alcalina e da medição do potencial de membrana revelaram que os efeitos citotóxicos dos AgNPs estavam principalmente centrados na membrana plasmática das células bacterianas, levando à perda de sua integridade e, eventualmente, à morte celular. A síntese verde de AgNPs é uma estratégia eficiente, econômica e promissora para combater cepas virulentas resistentes a antibióticos.
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Green synthesis of silver nanoparticles (AgNPs) is an ecofriendly, cost-effective and promising approach for discovery of novel therapeutics. The aim of the current work was to biogenic synthesize, characterize AgNPs using seed extracts of three economically important varieties of date palm (Iklas, Irziz and Shishi), and assess their anti-pathogenic bacterial activities. AgNPs were synthesised then characterised using electron microscopy and Fourier transform infrared analyses. The bactericidal activities of AgNPs against five different bacterial pathogens, Bacillus subtilis, Escherichia coli, Staphylococcus aureus, methicillin-resistant Staphylococcus aureus and Streptococcus pneumoniae, were determined in vitro. In particular, changes in membrane integrity of virulent bacterial strains in response to AgNPs were investigated. Results of lactate dehydrogenase, alkaline phosphatase activity assays, and measurement of membrane potential revealed that the cytotoxic effects of the AgNPs were mainly centred on the plasma membrane of bacterial cells, leading to loss of its integrity and eventually cell death. In conclusion, green synthesis of AgNPs is an efficient, cost-effective and promising strategy to combat virulent antibiotic-resistant strains.
A síntese verde de nanopartículas de prata (AgNPs) é uma abordagem ecologicamente correta, econômica e promissora para a descoberta de novas terapêuticas. O objetivo do presente trabalho foi sintetizar biogênica, caracterizar AgNPs usando extratos de sementes de três variedades economicamente importantes de tamareira (Iklas, Irziz e Shishi) e avaliar suas atividades bacterianas antipatogênicas. AgNPs foram sintetizados e caracterizados usando microscopia eletrônica e análise de infravermelho por transformada de Fourier. As atividades bactericidas de AgNPs contra cinco diferentes patógenos bacterianos, Bacillus subtilis, Escherichia coli, Staphylococcus aureus, Staphylococcus aureus resistente à meticilina e Streptococcus pneumoniae, foram determinadas in vitro. Em particular, foram investigadas alterações na integridade da membrana de cepas bacterianas virulentas em resposta a AgNPs. Os resultados da lactato desidrogenase, dos ensaios da atividade da fosfatase alcalina e da medição do potencial de membrana revelaram que os efeitos citotóxicos dos AgNPs estavam principalmente centrados na membrana plasmática das células bacterianas, levando à perda de sua integridade e, eventualmente, à morte celular. A síntese verde de AgNPs é uma estratégia eficiente, econômica e promissora para combater cepas virulentas resistentes a antibióticos.
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Nanopartículas del Metal , Staphylococcus aureus Resistente a Meticilina , Phoeniceae , Plata , Extractos Vegetales/farmacología , Pruebas de Sensibilidad Microbiana , Antibacterianos/farmacologíaRESUMEN
OBJECTIVES: Studies have shown that acute kidney injury (AKI) occurrence post SARS-CoV-2 infection is complex and has a poor prognosis. Therefore, more studies are needed to understand the rate and the predications of AKI involvement among hospitalized COVID-19 patients and AKI's impact on prognosis while under different types of medications. PATIENTS AND METHODS: This study is a retrospective observational cohort study conducted at Bahrain Defence Force (BDF) Royal Medical Services. Medical records of COVID-19 patients admitted to BDF hospital, treated, and followed up from April 2020 to October 2020 were retrieved. Data were analyzed using univariate and multivariate logistic regression with covariate adjustment, and the odds ratio (OR) and 95% confidence (95% CI) interval were reported. RESULTS: Among 353 patients admitted with COVID-19, 47.6% developed AKI. Overall, 51.8% of patients with AKI died compared to 2.2% of patients who did not develop AKI (p< 0.001 with OR 48.6 and 95% CI 17.2-136.9). Besides, deaths in patients classified with AKI staging were positively correlated and multivariate regression analysis revealed that moderate to severe hypoalbuminemia (<32 g/L) was independently correlated to death in AKI patients with an OR of 10.99 (CI 95% 4.1-29.3, p<0.001). In addition, 78.2% of the dead patients were on mechanical ventilation. Besides age as a predictor of AKI development, diabetes and hypertension were the major risk factors of AKI development (OR 2.04, p<0.01, and 0.05 for diabetes and hypertension, respectively). Also, two or more comorbidities substantially increased the risk of AKI development in COVID-19 patients. Furthermore, high levels upon hospital admission of D-Dimer, Troponin I, and ProBNP and low serum albumin were associated with AKI development. Lastly, patients taking ACEI/ARBs had less chance to develop AKI stage II/III with OR of 0.19-0.27 (p<0.05-0.01). CONCLUSIONS: The incidence of AKI in hospitalized COVID-19 patients and the mortality rate among AKI patients were high and correlated with AKI staging. Furthermore, laboratory testing for serum albumin, hypercoagulability and cardiac injury markers maybe indicative for AKI development. Therefore, clinicians should be mandated to perform such tests on admission and follow-up in hospitalized patients.
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Lesión Renal Aguda/epidemiología , COVID-19/complicaciones , Lesión Renal Aguda/metabolismo , Lesión Renal Aguda/fisiopatología , Adulto , Anciano , Bahrein/epidemiología , COVID-19/fisiopatología , Estudios de Cohortes , Comorbilidad , Femenino , Mortalidad Hospitalaria , Hospitalización/tendencias , Hospitales , Humanos , Incidencia , Unidades de Cuidados Intensivos , Masculino , Persona de Mediana Edad , Pronóstico , Respiración Artificial/efectos adversos , Estudios Retrospectivos , Factores de Riesgo , SARS-CoV-2/metabolismo , SARS-CoV-2/patogenicidadRESUMEN
Green synthesis of silver nanoparticles (AgNPs) is an ecofriendly, cost-effective and promising approach for discovery of novel therapeutics. The aim of the current work was to biogenic synthesize, characterize AgNPs using seed extracts of three economically important varieties of date palm (Iklas, Irziz and Shishi), and assess their anti-pathogenic bacterial activities. AgNPs were synthesised then characterised using electron microscopy and Fourier transform infrared analyses. The bactericidal activities of AgNPs against five different bacterial pathogens, Bacillus subtilis, Escherichia coli, Staphylococcus aureus, methicillin-resistant Staphylococcus aureus and Streptococcus pneumoniae, were determined in vitro. In particular, changes in membrane integrity of virulent bacterial strains in response to AgNPs were investigated. Results of lactate dehydrogenase, alkaline phosphatase activity assays, and measurement of membrane potential revealed that the cytotoxic effects of the AgNPs were mainly centred on the plasma membrane of bacterial cells, leading to loss of its integrity and eventually cell death. In conclusion, green synthesis of AgNPs is an efficient, cost-effective and promising strategy to combat virulent antibiotic-resistant strains.
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Nanopartículas del Metal , Staphylococcus aureus Resistente a Meticilina , Phoeniceae , Antibacterianos/farmacología , Pruebas de Sensibilidad Microbiana , Extractos Vegetales/farmacología , PlataRESUMEN
Due to resistance to chloroquine and sulfadoxine/pyrimethamine, treatment for uncomplicated Plasmodium falciparum malaria switched to artemisinin-based combination therapy (ACT) in 2006 in Senegal. Several mutations in the gene encoding the kelch13 helix (pfk13-propeller) have been identified as associated with in vitro and in vivo artemisinin resistance in Southeast Asia. Additionally, three mutations in the pfcoronin gene (G50E, R100K and E107V) have been identified in two culture-adapted Senegalese field isolates that became resistant in vitro to artemisinin after 4 years of intermittent selection with dihydroartemisinin. The aims of this study were to assess the prevalence of pfcoronin and pfk13 mutations in Senegalese field isolates from Dakar and to investigate their association with artemisinin derivative clinical failures. A total of 348 samples of P. falciparum from 327 patients, collected from 2015-2019 in Dakar, were successfully analysed. All sequences had wild-type pfk13 allele. The three mutations (G50E, R100K and E107V), previously identified in parasites with reduced susceptibility to artemisinin, were not found in this study, but a new mutation (P76S) was detected (mean prevalence 16.2%). The P76S mutation was identified in 5 (31.3%) of 16 isolates collected from patients still parasitaemic on Day 3 after ACT treatment and in 31 samples (15.3%) among 203 patients considered successfully cured. There was no significant association between in vivo reduced efficacy to artemisinin derivatives and the P76S mutation (P = 0.151, Fisher's exact test). These data suggest that polymorphisms in pfk13 and pfcoronin are not the best predictive markers for artemisinin resistance in Senegal.
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Antimaláricos/uso terapéutico , Artemisininas/uso terapéutico , Resistencia a Medicamentos/genética , Malaria Falciparum/tratamiento farmacológico , Plasmodium falciparum/efectos de los fármacos , Plasmodium falciparum/genética , Proteínas Adaptadoras Transductoras de Señales/genética , Doxiciclina/uso terapéutico , Quimioterapia Combinada , Humanos , Lumefantrina/uso terapéutico , Proteínas de Microfilamentos/genética , Plasmodium falciparum/aislamiento & purificación , Polimorfismo de Nucleótido Simple/genética , Proteínas Protozoarias/genética , SenegalRESUMEN
AIM: This study aims to test the accuracy and feasibility of a measurement of femoral torsion of a 3D C-arm system (Linea aspera method) in a cadaver setting. MATERIALS AND METHODS: A total of 11 intact femora were used. Schanz screws were inserted in the femoral bone in a parallel manner with the help of a fixed drill sleeve. Femur bones were then fractured in a controlled manner and three different internal and external torsion angles were fixed with the help of a Goniometer. After that, a 3D scan was performed. The 3D data set was analyzed using a radiologic software (Visage 7, Visage Imaging Inc, USA). Measurements were then compared in the two methods with a dependent t test. RESULTS: Specific measurements for different angles did not show any differences between those two utilities. CONCLUSION: Intraoperative estimation of femoral antetorsion using a 3D C-Arm system and the Linea aspera method seems to be an accurate and feasible method. Nevertheless, more studies with higher patient numbers, comparison to CT seems to be the next step and can be recommended.
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Fracturas del Fémur , Fémur , Imagenología Tridimensional/métodos , Fracturas del Fémur/diagnóstico por imagen , Fracturas del Fémur/cirugía , Fémur/diagnóstico por imagen , Fémur/cirugía , Humanos , Cuidados Intraoperatorios , Radiografía , Rango del Movimiento ArticularRESUMEN
OBJECTIVES: Malrotation after surgical treatment of femoral shaft fractures is a common problem and often leads to follow-up procedures with uncertain outcome. The aim of this study is the validation of a new device (Rotational Fixator) to perform the correction safely and accurately. METHODS: In an in-vitro study, we tested the Rotational Fixator on 21 corpse bones against a commercially available standard goniometer for measurement inaccuracies. For this purpose, we varied the rotation width from 10 to 30° in inside and outside rotation. RESULTS: We found a small measurement inaccuracy of 1-2° with increasing rotation. The smallest differences are found at 10° IR with 0.9524° (SD ± 1.0713; p = 0.001) difference and 10° ER with at 0.5952° (SD ± 0.6823; p = 0.001) difference and increase up to 30° (IR 1.6667°, SD ± 1.7121, p < 0.000/ER 1.5000°, SD ± 1.0488, p < 0.000). CONCLUSIONS: The measurement results of the device show a constant deviation from the gold standard but are constant in the measurement error and slightly in relation to the desired correction range, so that a further review of the device and further testing in in vivo studies makes sense. LEVELS OF EVIDENCE: Level 3.
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BACKGROUND: Candida auris is an emerging superbug which was recently discovered and has spread widely across the world. With a steady rise in incidence involving multisystems, this presents a unique challenge to caregivers. CASE DESCRIPTION: A 50-year-old man with sickle cell disease, diabetes mellitus, and multiple surgeries presented with progressive low back pain radiating to bilateral limbs and intact neurology. Radiologic and laboratory investigations suggested spondylodiscitis with epidural collection, which was operated with posterior decompression and stabilization. The tissue analysis was reported as C. auris, which was accordingly treated with caspofungin. Magnetic resonance imaging at 4 months showed resolution of infection with return of inflammatory markers to normal. CONCLUSIONS: C. auris appears to be an emerging superbug, which is hospital-acquired. All practitioners must be aware of its existence and presentation. Given the low incidence, high mortality, and no clear guidelines of management so far, formulation of any such strategies is complicated. Further studies and research are needed for this superbug.
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Antifúngicos/uso terapéutico , Candidiasis/terapia , Caspofungina/uso terapéutico , Discitis/terapia , Discectomía , Fusión Vertebral , Anemia de Células Falciformes/epidemiología , Candida , Candidiasis/epidemiología , Candidiasis Invasiva , Comorbilidad , Desbridamiento , Descompresión Quirúrgica , Diabetes Mellitus/epidemiología , Discitis/epidemiología , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , OmánRESUMEN
We describe a patient with ANCA (antineutrophil cytoplasmic antibodies) associated vasculitis and acute-on-chronic renal failure. He had initially presented with severe pulmonary hemorrhage and anuric renal failure and improved rapidly with immunosuppressive therapy. Repeat renal biopsy revealed candida interstitial nephritis. Candida was also detected in bronchoalveolar lavage. Kidney function improved with long-term antifungal therapy. This report adds induction therapy for ANCA vasculitis to the conditions where invasive candidal infections including nephritis need to be considered.
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Vasculitis Asociada a Anticuerpos Citoplasmáticos Antineutrófilos/tratamiento farmacológico , Antifúngicos/uso terapéutico , Candida/aislamiento & purificación , Fallo Renal Crónico/diagnóstico , Enfermedad Aguda , Lesión Renal Aguda , Vasculitis Asociada a Anticuerpos Citoplasmáticos Antineutrófilos/complicaciones , Vasculitis Asociada a Anticuerpos Citoplasmáticos Antineutrófilos/microbiología , Anticuerpos Anticitoplasma de Neutrófilos/inmunología , Biopsia , Candida/clasificación , Candidiasis/diagnóstico , Candidiasis/tratamiento farmacológico , Ciclofosfamida/uso terapéutico , Humanos , Inmunosupresores/uso terapéutico , Fallo Renal Crónico/microbiología , Masculino , Persona de Mediana Edad , Nefritis Intersticial/tratamiento farmacológico , Nefritis Intersticial/patología , Resultado del TratamientoRESUMEN
INTRODUCTION AND CASE PRESENTATION: Acute traumatic patella dislocations are common injuries seen in emergency departments. We present a rare injury which involves an acute, irreducible intra-articular dislocation of the patella. In this particular case, we describe a horizontal type intra-articular dislocation of the patella in a 66-year-old lady, which was complicated by impaction into the distal femur. She underwent two failed closed reduction attempts, but subsequently reduced spontaneously on the orthopaedic floor as she was waiting for an open reduction in the operating room. DISCUSSION: The management of acute patellar dislocations can be divided into closed and open reduction methods. In cases where a closed reduction is unsuccessful, an open reduction under general anesthesia may be pertinent to treat this acute condition. CONCLUSION: We report a case of an intra-articular patella dislocation which has shown that spontaneous reduction is possible for cases following unsuccessful initial closed reduction, yet it still remains unadvisable to delay open reduction. We highlight, through this case, the importance of maintaining a high index of suspicion for these uncommon injuries.
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Multidrug-resistant enterococcal pathogens, especially vancomycin-resistant enterococci (VRE), are among the pathogens that require new antibiotic innovation. The colonization of the gut represents a major pathway by which VRE can cause infection and spread to other patients. In the current study, auranofin (FDA-approved rheumatoid arthritis drug) is evaluated for its potential use as a decolonizing agent for VRE. Auranofin was found to exert potent antimicrobial activity against a wide range of enterococcal clinical isolates with a minimum inhibitory concentration of 1 µg/mL. No resistant mutants could be developed against auranofin over the course of 14 passages. Auranofin was also found to exert potent anti-biofilm activity against VRE. Auranofin was superior to linezolid, the drug of choice for VRE infection treatment, in the in vivo mouse model. Auranofin significantly reduced the VRE burden in feces, cecum, and ileum contents after 8 days of treatment. Accordingly, this study provides valuable evidence that auranofin has significant promise as a novel gastrointestinal decolonizing agent for VRE.