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2.
Artigo em Inglês | MEDLINE | ID: mdl-34595718

RESUMO

The efficiency of nitrogenous fertilizers in South Asia is on a declining trajectory due to increased losses. Biochar (BC) and slow-releasing nitrogen fertilizers (SRNF) have been found to improve nitrogen use efficiency (NUE) in certain cases. However, field-scale studies to explore the potential of BC and SRNF in south Asian arid climate are lacking. Here we conducted a field experiment in the arid environment to demonstrate the response of BC and SRNF on cotton growth and yield quality. The treatments were comprised of two factors, (A) nitrogen sources, (i) simple urea, (ii)neem-coated urea, (iii)sulfur-coated urea, (iv) bacterial coated urea, and cotton stalks biochar impregnated with simple urea, and (B) nitrogen application rates, N1=160 kg ha-1, N2 = 120 kg ha-1, and N3 = 80 kg ha-1. Different SRNF differentially affected cotton growth, morphological and physiological attributes, and seed cotton yield (SCY). The bacterial coated urea at the highest rate of N application (160 kg ha-1) resulted in a higher net leaf photosynthetic rate (32.8 µmol m-2 s-1), leaf transpiration rate (8.10 mmol s-1), and stomatal conductance (0.502 mol m-2 s-1), while leaf area index (LAI), crop growth rate (CGR), and seed cotton yield (4513 kg ha-1) were increased by bacterial coated urea at 120 kg ha-1 than simple urea. However, low rate N application (80 kg ha-1) of bacterial coated urea showed higher nitrogen use efficiency (39.6 kg SCY kg-1 N). The fiber quality (fiber length, fiber strength, ginning outturn, fiber index, and seed index) was also increased with the high N application rates than N2 and N3 application. To summarize, the bacterial coated urea with recommended N (160 kg ha-1) and 75% of recommended N application (120 kg ha-1) may be recommended for farmers in the arid climatic conditions of Punjab to enhance the seed cotton yield, thereby reducing nitrogen losses.

3.
Health Res Policy Syst ; 19(Suppl 3): 103, 2021 Oct 12.
Artigo em Inglês | MEDLINE | ID: mdl-34641912

RESUMO

BACKGROUND: Community health workers (CHWs) play a critical role in grassroots healthcare and are essential for achieving the health-related Sustainable Development Goals. While there is a critical shortage of essential health workers in low- and middle-income countries, WHO and international partners have reached a consensus on the need to expand and strengthen CHW programmes as a key element in achieving Universal Health Coverage (UHC). The COVID-19 pandemic has further revealed that emerging health challenges require quick local responses such as those utilizing CHWs. This is the second paper of our 11-paper supplement, "Community health workers at the dawn of a new era". Our objective here is to highlight questions, challenges, and strategies for stakeholders to consider while planning the introduction, expansion, or strengthening of a large-scale CHW programme and the complex array of coordination and partnerships that need to be considered. METHODS: The authors draw on the outcomes of discussions during key consultations with various government leaders and experts from across policy, implementation, research, and development organizations in which the authors have engaged in the past decade. These include global consultations on CHWs and global forums on human resources for health (HRH) conferences between 2010 and 2014 (Montreux, Bangkok, Recife, Washington DC). They also build on the authors' direct involvement with the Global Health Workforce Alliance. RESULTS: Weak health systems, poor planning, lack of coordination, and failed partnerships have produced lacklustre CHW programmes in countries. This paper highlights the three issues that are generally agreed as being critical to the long-term effectiveness of national CHW programmes-planning, coordination, and partnerships. Mechanisms are available in many countries such as the UHC2030 (formerly International Health Partnership), country coordinating mechanisms (CCMs), and those focusing on the health workforce such as the national Human Resources for Health Observatory and the Country Coordination and Facilitation (CCF) initiatives introduced by the Global Health Workforce Alliance. CONCLUSION: It is imperative to integrate CHW initiatives into formal health systems. Multidimensional interventions and multisectoral partnerships are required to holistically address the challenges at national and local levels, thereby ensuring synergy among the actions of partners and stakeholders. In order to establish robust and institutionalized processes, coordination is required to provide a workable platform and conducive environment, engaging all partners and stakeholders to yield tangible results.

4.
Proteins ; 2021 Oct 12.
Artigo em Inglês | MEDLINE | ID: mdl-34642975

RESUMO

KDM5A over-expression mediates cancer cell proliferation and promotes resistance towards chemotherapy through epigenetic modifications. As its complete mechanism of action is still unknown, there is no KDM5A specific drug available at clinical level. In the current study, lead compounds for KDM5A were determined through pharmacophore modeling and high-throughput virtual screening from Asinex libraries containing 0.5 million compounds. These virtual hits were further evaluated and filtered for ADMET properties. Finally, 726 compounds were used for docking analysis against KDM5A. On the basis of docking score, 10 top-ranked compounds were selected and further evaluated for non-CNS and CNS drug-like properties. Among these compounds, N-{[(7-Methyl-4-oxo-1,2,3,4-tetrahydrocyclopenta [c] chromen-9-yl) oxy]acetyl}-L-phenylalanine (G-score: -11.363 kcal/mol) was estimated to exhibit non-CNS properties while 2-(3,4-Dimethoxy-phenyl)-7-methoxy-chromen-4-one (G-score: -7.977 kcal/mol) was evaluated as CNS compound. Docked complexes of both compounds were finally selected for molecular dynamic simulation to examine the stability. This study concluded that both these compounds can serve as lead compounds in the quest of finding therapeutic agents against KDM5A associated cancers.

5.
Artigo em Inglês | MEDLINE | ID: mdl-34554620

RESUMO

INTRODUCTION: Defibrillation testing (DT) is recommended during the subcutaneous defibrillator (S-ICD) placement. We sought to compare 10 J shock impedance in sinus rhythm (SR) with 65 J defibrillation impedance and evaluate device position on a postimplant chest X-ray (CXR) using an intermuscular (IM) technique. METHODS: Consecutive S-ICD implantations between 12/2019 and 12/2020 at The Ohio State University were reviewed. All implantations were performed using a two-incision IM technique. Standard DT with 65 J shock and 10 J shock in SR were performed unless contraindicated. The PRAETORIAN score was calculated based on CXR. RESULTS: A total of 37 patients (age: 47.2 ± 15.8 years old, male: n = 26 [70.3%], body mass index: 30.1 ± 6.7 kg/m2 ) underwent IM S-ICD implantation, and of those, 27 (73%) underwent both 65 J shock and 10 J shock in SR. The coefficient of determination (R2 ) between 10 J shock impedance and 65 J shock impedance was 0.84. The mean of an impedance difference was 1.6 ± 4.8 Ω (minimum - 11 and maximum 8). Postimplant CXR was available for 33 out of 37 patients (89.2%). The PRAETORIAN score was less than 90 in all patients and the mean score was 32.7 ± 8.8. CONCLUSION: We demonstrated that 10 J shock impedance in SR correlated well with 65 J defibrillation impedance during IM S-ICD implantation. An IM implantation technique provides excellent generator location on postimplant CXR. The IM technique combined with 10 J shock in SR may be sufficient to predict and ensure the defibrillation efficacy of the S-ICD.

6.
BMC Infect Dis ; 21(1): 1014, 2021 Sep 27.
Artigo em Inglês | MEDLINE | ID: mdl-34579646

RESUMO

BACKGROUND: Convalescent plasma(CP) was utilized as potential therapy during COVID-19 pandemic in Pakistan. The study aimed at appraisal of CP transfusion safety and usefulness in COVID pneumonia. METHODS: Single arm, MEURI study design of non-randomized open label trial was conducted in five centers. Patients werecategorized as moderately severe, severe, and critical. The primary endpoint was a) improvement in clinical status and change in category of disease severity; secondary endpoint was b) CP ability to halt disease progression to invasive ventilation. CP transfused to hospitalized patients. Statistical tests including median (interquartile ranges), Mann-Whitney U test, Fisher's exact test using SPSS ver. 23, ANOVA and Chi-square test were applied for the analysis of results parameters before and after CP treatment. SOFA score was applied for multiorgan failure in severe and critical cases. RESULTS: A total of 50 adult patients; median age 58.5 years (range: 29-92 years) received CP with infusion titers; median 1:320 U/mL (Interquartile range 1:80-1:320) between April 4 to May 5, 2020. The median time from onset of symptoms to enrollment in trial was 3 to 7 days with shortness of breath and lung infiltration as severity criterion. In 35 (70%) recipients, oxygen saturation improved from 80 to 95% within 72h, with resolution of lung infiltrates. Primary endpoint was achieved in 44 (88%) recipients whereas secondary endpoint was achieved in 42 (84%). No patient experienced severe adverse events. A high SOFA score (> 7) correlated with deaths in severe and critical patients. Eight (16%) patients expired due to comorbidities; cardiac arrest in 2 (4%), multiorgan failure secondary to cytokine storm in 5 (10%) and ventilator associated complications in 1 (2%). CONCLUSION: CP transfusion can be used as a safe and useful treatment in moderately severe and severe patients. TRIAL REGISTRATION: The trial registration number is NCT04352751  ( https://www.irct.ir/search/result?query=IRCT20200414047072N1 ). Trial Registration date is 28th April 2020.


Assuntos
COVID-19 , Pandemias , Adulto , Idoso , Idoso de 80 Anos ou mais , Transfusão de Componentes Sanguíneos , COVID-19/terapia , Humanos , Imunização Passiva , Pessoa de Meia-Idade , Paquistão , Plasma , SARS-CoV-2 , Resultado do Tratamento
7.
Int J Biol Macromol ; 191: 861-871, 2021 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-34571126

RESUMO

Compressed tablet formation from granular drug require binder with Cohesiveness property. Plants mucilage as pharmaceutical excipients are available. In this study, biocompatible date palm mucilage was encapsulated with silver nano particles for sustained drug release to provoke an immune response. Nano formulated mucilage was characterized by UV/VIS, FTIR, XRD, SEM/EDX spectrophotometry. UV/VIS spectra revealed an intense surface plasmon resonance peak at 406 nm for spherical mono dispersed silver nano formulated mucilage resulted from efficient reduction of silver ions to AgNPs. Zeta sizer disclosed the emergence of single peak at 139.7 nm with 100% intensity. Crude mucilage exhibited number of peaks in the region of 4000-500 cm-1 by FT-IR spectroscopy whereas purified as well as nano formulated samples showed somewhat different pattern of peaks in addition to peaks of crude sample. XRD spectra of crude mucilage revealed somewhat regular pattern while purified and modified mucilage displayed irregular structure. In SEM analysis, crude mucilage was appeared as granular that turned into porous network with entangled tiny silver nano spheres. A controlled release of drug levofloxacin hemihydrate was evaluated using crude/ nano formulated mucilage as excipient. Nano formulated mucilage delayed the onset exposure of drug in gastric medium giving recommendations as value added bio binder for drug to the target organ.

8.
Artigo em Inglês | MEDLINE | ID: mdl-34537938

RESUMO

Pakistan is one of the most climate change- and natural disaster-affected country of the world where livelihood and lives of inhabitants are often affected due to these disasters. In the scenario of various disasters and risks, flood disasters are the most recurrent hazards that cause Bait households' livelihood to be more vulnerable. Hence, this research work has focused to investigate livelihood vulnerability of flood-prone Bait households in southern Punjab of Pakistan. This study used multistage sampling technique for collection of the cross-sectional data of 398 flood disasters vulnerable Bait household's respondents from three high-risk flood-prone districts Muzaffargarh, Rajanpur, and Rahim Yar Khan. Face-to-face interview procedure and well-developed pre-tested questionnaire were used for data collection in this research work. This study applied vulnerability framework of LVI-IPCC and LVI in the direction of comparing the level of vulnerabilities in preferred three Bait district households. Empirical estimates of LVI major components and framework of IPCC vulnerability have indicated Bait households of Muzaffargarh more vulnerable owing to higher exposure and sensitivity and lower adaptive capacity than other districts. In contrast to other districts, Muzaffargarh households have investigated more vulnerable to flood disasters more particularly in LVI sub-components such as health (0.460), water (0.360), and food (0.515) access. These research findings will be helpful to policymakers to work out and put into practice effectual programs and strategies such as constructing more water reserves, developing overhead infrastructure, easy access of institutional loans, and generating off-farm income sources. These local-based feasible measures will be helpful for native inhabitants to reduce frequency of floods in the direction of lessened vulnerability and increased resilience via recovering generally the livelihood of vulnerable Bait households in Punjab Pakistan and particularly the district Muzaffargarh.

9.
Biol Futur ; 72(2): 187-199, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34554472

RESUMO

The genus Solanum exhibits a wide range of variability in morphology, flavor, and tolerance to biotic and abiotic stresses. Phenotypic and genetic variability using ISSR and RAPD markers of Solanum incanum distributed in Al-Baha province of the Kingdom of Saudi Arabia is assessed. Thirty samples are representing three different locations: Baljershy, Aqeeq, and Tohama, besides twenty-five samples representing five different commercial cultivars tested. Growth type, the number of leaves per plant, fruit size (phenotypic traits), crude protein, carbohydrates, digestive organic matter, and Mg, Ca, P were the principal contributors in the PCA. Molecular analysis showed that 114 ISSR and 80 RAPD alleles with a 100% polymorphism were recorded. The polymorphism information content (PIC) values ranged from 0.84 to 0.91 for ISSR and from 0.59 to 0.89 for RAPD data. Similarity values ranged from 0.16 to 1.00, with an average of 0.47 for ISSR and from 0.01 to 0.97, with an average of 0.36 for RAPD. It resulted in a positive and significant correlation between morphological, molecular, nutritional, and chemical analysis of fruits using Mantel analysis. UPGMA and PCA for morphological traits and molecular data discriminated commercial cultivars and wild relatives. Solanum incanum was more diverse than commercial varieties. This study revealed a wide genetic diversity among and within collected eggplant accessions and may use in breeding programs of eggplants. There is a need to increase the present eggplant collection to widen the genetic diversity of cultivated eggplant varieties in Saudi Arabia.

11.
Am J Med Genet A ; 2021 Sep 27.
Artigo em Inglês | MEDLINE | ID: mdl-34569147

RESUMO

We present five members of a consanguineous Pakistani kinship with the most severe familial tetramelic transverse autopod deficiency reported to date and additionally having some of the common autosomal recessive Robinow syndrome-1 (RRS1) features including short stature, short neck, severe vertebral anomalies of kyphoscoliosis, hemivertebrae, fusion of thoracic vertebrae, broad forehead, and dental crowding. We mapped the locus of this atypical RRS and detected homozygous 8-nucleotide deletion c.1353_1360del (p.(Met452Alafs*4)) in ROR2, the gene responsible for RRS1. We did not find any other variant shared by all affected individuals that could possibly act as a modifier of limb defect. Autopods are affected in RRS1, but severe autopod deficiency is not a characteristic feature. Over 30 biallelic variants dispersed throughout the gene are known in ROR2-related RS, with no genotype-phenotype correlation for specific RRS1 features. Considering together with the sporadic case homozygous for variant p.(Arg442*) and the case homozygous for p.(Arg441Thrfs*16) in a family where heterozygous members have brachydactyly type B1, we propose that homozygous truncating variants that originate at residues 441-452 can cause severe autopod reduction anomalies, suggesting some genotype-phenotype correlation for this particular phenotype.

12.
Infect Immun ; : IAI0040021, 2021 Sep 07.
Artigo em Inglês | MEDLINE | ID: mdl-34491792

RESUMO

During its progression from the nasopharynx to other sterile and non-sterile niches of its human host, Streptococcus pneumoniae must cope with changes in temperature. We hypothesised that the temperature adaptation is an important facet of pneumococcal survival in the host. Here, we evaluated the effect of temperature on pneumococcus and studied the role of glutamate dehydrogenase (GdhA) in thermal adaptation associated with virulence and survival. Microarray analysis revealed a significant transcriptional response to changes in temperature, affecting the expression of 252 genes in total at 34°C and 40°C relative to at 37°C. One of the differentially regulated genes was gdhA, which is upregulated at 40°C and downregulated at 34°C relative to 37°C. Deletion of gdhA attenuated the growth, cell size, biofilm formation, pH survival, and biosynthesis of proteins associated with virulence in a temperature-dependent manner. Moreover, deletion of gdhA stimulated formate production irrespective of temperature fluctuation. Finally, ΔgdhA grown at 40°C was less virulent compare to other temperatures or than the wild type at the same temperature in a Galleria mellonella infection model, suggesting that GdhA is required for pneumococcal virulence at elevated temperature.

13.
BMJ Case Rep ; 14(8)2021 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-34417242

RESUMO

Mucosal melanoma is a rare subtype of melanoma and represents a unique diagnosis and treatment challenge. Immune-checkpoint inhibitors (ICIs) have revolutionised metastatic melanoma treatment, and one of the leading regimens is the combination of ipilimumab (anti-cytotoxic T lymphocyte-associated antigen 4: CTLA4) and nivolumab (anti-programmed cell death protein 1: PD1). We report a case of a patient with metastatic mucosal melanoma treated with ipilimumab and nivolumab who developed multiple immune-related adverse events (irAEs) including uveitis, type I diabetes complicated by diabetic ketoacidosis, destructive thyroiditis, hepatitis and vitiligo. Endocrinopathies including type 1 diabetes and hypothyroidism were treated with insulin and levothyroxine. Hepatitis was responsive to steroids. She had sustained complete response 12 months after discontinuation of the combination therapy. With the wide usage of ICIs in multiple types of malignancies, it is important for general practioners to recognise common and serious irAEs due to ICIs.


Assuntos
Melanoma , Nivolumabe , Anticorpos Monoclonais/efeitos adversos , Protocolos de Quimioterapia Combinada Antineoplásica , Feminino , Humanos , Ipilimumab/efeitos adversos , Melanoma/tratamento farmacológico , Nivolumabe/efeitos adversos
14.
Sensors (Basel) ; 21(15)2021 Jul 28.
Artigo em Inglês | MEDLINE | ID: mdl-34372351

RESUMO

Recent progress in deep learning has led to accurate and efficient generic object detection networks. Training of highly reliable models depends on large datasets with highly textured and rich images. However, in real-world scenarios, the performance of the generic object detection system decreases when (i) occlusions hide the objects, (ii) objects are present in low-light images, or (iii) they are merged with background information. In this paper, we refer to all these situations as challenging environments. With the recent rapid development in generic object detection algorithms, notable progress has been observed in the field of deep learning-based object detection in challenging environments. However, there is no consolidated reference to cover the state of the art in this domain. To the best of our knowledge, this paper presents the first comprehensive overview, covering recent approaches that have tackled the problem of object detection in challenging environments. Furthermore, we present a quantitative and qualitative performance analysis of these approaches and discuss the currently available challenging datasets. Moreover, this paper investigates the performance of current state-of-the-art generic object detection algorithms by benchmarking results on the three well-known challenging datasets. Finally, we highlight several current shortcomings and outline future directions.


Assuntos
Aprendizado Profundo , Redes Neurais de Computação , Algoritmos , Humanos
15.
Artigo em Inglês | MEDLINE | ID: mdl-34454881

RESUMO

OBJECTIVE: The aim of this study was to assess temporal changes and clinical implications of peridevice leak (PDL) after left atrial appendage closure. BACKGROUND: Endocardial left atrial appendage closure devices are alternatives to long-term oral anticoagulation (OAC) for patients with atrial fibrillation. PDL > 5 mm may prohibit discontinuation of OAC. METHODS: Patients included in the study had: 1) successful Watchman device implantation without immediate PDL; 2) new PDL identified at 45 to 90 days using transesophageal echocardiography; 3) eligibility for OAC; and 4) 1 follow-up transesophageal echocardiographic study for PDL surveillance. Relevant clinical and imaging data were collected by chart review. The combined primary outcome included failure to stop OAC after 45 to 90 days, transient ischemic attack or stroke, device-related thrombi, and need for PDL closure. RESULTS: Relevant data were reviewed for 1,039 successful Watchman device implantations. One hundred eight patients (10.5%) met the inclusion criteria. The average PDL at 45 to 90 days was 3.2 ± 1.6 mm. On the basis of a median PDL of 3 mm, patients were separated into ≤3 mm (n = 73) and >3 mm (n = 35) groups. In the ≤3 mm group, PDL regressed significantly (2.2 ± 0.8 mm vs 1.6 ± 1.4 mm; P = 0.002) after 275 ± 125 days. In the >3 mm group, there was no significant change in PDL (4.9 ± 1.4 mm vs 4.0 ± 3.0 mm; P = 0.12) after 208 ± 137 days. The primary outcome occurred more frequently (69% vs 34%; P = 0.002) in the >3 mm group. The incidence of transient ischemic attack or stroke in patients with PDL was significantly higher compared with patients without PDL, irrespective of PDL size. CONCLUSIONS: New PDL detected by transesophageal echocardiography at 45 to 90 days occurred in a significant percentage of patients and was associated with worse clinical outcomes. PDL ≤ 3 mm tended to regress over time.

16.
J Hazard Mater ; 422: 126926, 2021 Aug 16.
Artigo em Inglês | MEDLINE | ID: mdl-34449346

RESUMO

Water scarcity is a major threat to agriculture and humans due to over abstraction of groundwater, rapid urbanization and improper use in industrial processes. Industrial consumption of water is lower than the abstraction rate, which ultimately produces large amounts of wastewater such as from tannery industry containing high concentration of chromium (Cr). Chromium-contaminated tannery industry wastewater is used for irrigation of food crops, resulting in food safety and public health issues globally. In contrast to conventional treatment technologies, constructed wetlands (CWs) are considered as an eco-friendly technique to treat various types of wastewaters, although their application and potential have not been discussed and elaborated for Cr treatment of tannery wastewater. This review briefly describes Cr occurrence, distribution and speciation in aquatic ecosystems. The significance of wetland plant species, microorganisms, various bedding media and adsorbents have been discussed with a particular emphasis on the removal and detoxification of Cr in CWs. Also, the efficiency of various types of CWs is elaborated for advancing our understanding on Cr removal efficiency and Cr partitioning in various compartments of the CWs. The review covers important aspects to use CWs for treatment of Cr-rich tannery wastewater that are key to meet UN's Sustainable Development Goals.

17.
BMC Med Educ ; 21(1): 436, 2021 Aug 18.
Artigo em Inglês | MEDLINE | ID: mdl-34407810

RESUMO

BACKGROUND: The educational efficacy in neonatal resuscitation relies on the subject and teaching strategies. Therefore, it is imperative to test diverse educational methods if they are more instructive to engage students in active learning and practicing knowledge. Hence, the present study aims to investigate the efficacy of a pedagogical framework in neonatal resuscitation skill learning among nursing students in a resource-limited setting. METHODS: A single-blind randomized controlled trial was conducted between October 2020 to March 2021. Sixty nursing students in the 3rd and 4th year of professional training were randomly allocated to the pedagogy and the traditional group. The pedagogy group learned via 6-step LSPPDM (Learn, See, Practice, Prove, Do, Maintain) pedagogy including lectures, video, clinical observation, skill sessions under supervision, and self-directed practice. The traditional group learned through 2-step (Learn, Practice) method that included lectures and skill sessions under supervision. The outcomes measured included technical and non-technical skills in neonatal resuscitation. The technical skill deals with steps such as stimulation, ventilation, oxygenation, intubation, chest compression, medications, and reporting. Non-technical skills refer to teamwork skills that focus on the interaction between leader and helper. Both skills were measured through previously published validated tools two times before and after the intervention by blinded assessors in a simulated delivery room. RESULTS: Overall, the skill was significantly improved in both groups after intervention. Yet, the results showed that the mean difference of technical skill score in the pedagogy group (24.3 ± 3.5) was significantly higher (p <  0.001) compared to the traditional group (16.2 ± 2.4). Likewise, the mean difference of non-technical skill score in the pedagogy (36.9 ± 1.9) was highly significant (p <  0.001) compared to the traditional group (31.2 ± 1.7). CONCLUSIONS: The LSPPDM pedagogy was found more effective in enhancing technical and non-technical skills in neonatal resuscitation compared to the traditional method. The results of this study support the efficacy of the 6-step LSPPDM pedagogy in the education of nursing students regarding neonatal resuscitation in a resource-limited setting. TRIAL REGISTRATION: Prospectively registered at ClinicalTrials.gov ( NCT04748341 ).


Assuntos
Ressuscitação , Estudantes de Enfermagem , Competência Clínica , Humanos , Recém-Nascido , Aprendizagem , Método Simples-Cego
18.
Future Microbiol ; 16: 931-933, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34402686

RESUMO

Meningitis caused by Salmonella typhi is rare and is generally seen in infants. We report a case of a 9-year-old boy with extensively drug-resistant S. typhi meningitis. The patient was diagnosed using a culture sensitivity test and successfully treated with meropenem. Culture sensitivity may be included in routine testing for the diagnosis of S. typhi especially in developing countries due to high burden of disease and emergence of drug resistance.

20.
J Proteomics ; 247: 104318, 2021 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-34224905

RESUMO

BACKGROUND/OBJECTIVES: Cereal products like flour and bread are known to trigger diseases such as wheat allergy, celiac disease and non-celiac wheat sensitivity (NCWS). Some of these diseases are caused by allergenic proteins, the expression of which might vary depending on the grain type and manufacturing processes. Therefore, we examined the protein composition and abundance of potentially allergenic proteins in flours from bread wheat, spelt and rye, and corresponding breads. MATERIALS AND METHODS: Using Nano-LC-ESI-MS/MS and label free quantification (LFQ) we analyzed the proteome of six different bread flours (wholegrain and superfine flours from rye, spelt and bread wheat) and 14 bread types (yeast and sourdough fermented breads from all flours and wheat breads plus/minus bread improver). Potentially allergenic proteins in flours and breads were functionally categorized using the Pfam database and relatively quantified by LFQ. RESULTS: We could show that almost equal numbers of proteins can be identified in rye- and spelt samples compared to wheat samples using the Uniprot bread wheat protein database, indicating high sequence conservation between cereals. In total, 4424 proteins were identified in the 20 flour and bread samples. The average number of identified proteins in flour (2719 ± 243) was slightly higher than in bread (2283 ± 232; P < 0.001). In wheat- and spelt wholegrain flour higher protein numbers (wheat: 2891 ± 90; spelt: 2743 ± 140) were identified on average than in superfine flour (wheat: 2562 ± 79; P = 0.009; spelt: 2431 ± 140; P = 0.004). Neither the absolute number nor the abundance distribution of potentially allergenic proteins were dependent on the flour type or the fermentation process, but known allergenic proteins like gliadins showed higher relative abundance in spelt- and wheat samples, compared to rye samples. CONCLUSION: We provide comprehensive proteome data for six flour types and related breads showing that the grain species have greater influence on proteome composition than milling and fermentation processes. Our data indicate that allergenic proteins are not selectively degraded during bread production and are more abundant in bread wheat and spelt compared to rye. SIGNIFICANCE: Our proteomics study revealed that bread contains a number of potentially and proven allergenic proteins. Most likely allergenicity is not dependent on milling or conventional fermentation processes, but on the grain type. Relative abundance of allergenic proteins was higher in spelt- and wheat samples than in rye samples. Considering rye bread as better suited to atopic individuals predisposed to react to cereal allergens, clinical trials are warranted to verify this assumption.

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