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1.
Curr Cardiol Rep ; 23(9): 130, 2021 08 07.
Artigo em Inglês | MEDLINE | ID: mdl-34363148

RESUMO

PURPOSE OF REVIEW: Additional imaging modalities, such as FDG-PET/CT, have been included into the workup for patients with suspected infective endocarditis, according to major international guidelines published in 2015. The purpose of this review is to give an overview of FDG-PET/CT indications and standardized approaches in the setting of suspected infective endocarditis. RECENT FINDINGS: There are two main indications for performing FDG-PET/CT in patients with suspected infective endocarditis: (i) detecting intracardiac infections and (ii) detection of (clinically silent) disseminated infectious disease. The diagnostic performance of FDG-PET/CT for intracardiac lesions depends on the presence of native valves, prosthetic valves, or implanted cardiac devices, with a sensitivity that is poor for native valve endocarditis and cardiac device-related lead infections, but much better for prosthetic valve endocarditis and cardiac device-related pocket infections. Specificity is high for all these indications. The detection of disseminated disease may also help establish the diagnosis and/or impact patient management. Based on current evidence, FDG-PET/CT should be considered for detection of disseminated disease in suspected endocarditis. Absence of intracardiac lesions on FDG-PET/CT cannot rule out native valve endocarditis, but positive findings strongly support the diagnosis. For prosthetic valve endocarditis, standard use of FDG-PET/CT is recommended because of its high sensitivity and specificity. For implanted cardiac devices, FDG-PET/CT is also recommended, but should be evaluated with careful attention to clinical context, because its sensitivity is high for pocket infections, but low for lead infections. In patients with prosthetic valves with or without additional aortic prosthesis, combination with CTA should be considered. Optimal timing of FDG-PET/CT is important, both during clinical workup and technically (i.e., post tracer injection). In addition, procedural standardization is key and encompasses patient preparation, scan acquisition, reconstruction, subsequent analysis, and clinical interpretation. The recommendations discussed here will hopefully contribute to improved standardization and enhanced performance of FDG-PET/CT in the clinical management of patients with suspected infective endocarditis.


Assuntos
Endocardite Bacteriana , Endocardite , Próteses Valvulares Cardíacas , Infecções Relacionadas à Prótese , Endocardite/diagnóstico por imagem , Endocardite Bacteriana/diagnóstico por imagem , Fluordesoxiglucose F18 , Próteses Valvulares Cardíacas/efeitos adversos , Humanos , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Infecções Relacionadas à Prótese/diagnóstico por imagem , Compostos Radiofarmacêuticos , Padrões de Referência
2.
Eur J Nucl Med Mol Imaging ; 48(1): 241-253, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32594196

RESUMO

BACKGROUND: Left ventricular assist devices (LVADs) are increasingly used for the treatment of advanced heart failure. LVADs improve quality of life and decrease mortality, but the driveline carries substantial risk for major infections. These device-related LVAD and driveline infections are difficult to diagnose with conventional imaging. We reviewed and analysed the current literature on the additive value of 18F-fluorodeoxyglucose positron emission tomography combined with computed tomography (FDG-PET/CT) imaging for the diagnosis of LVAD-related infections." MATERIALS/METHODS: We performed a systematic literature review using several databases from their inception until the 31st of December, 2019. Studies investigating the diagnostic performance of FDG-PET/CT in patients with suspected LVAD infection were retrieved. After a bias risk assessment using QUADAS-2, a study-aggregate meta-analysis was performed on a per examination-based analysis. RESULTS: A total of 10 studies were included in the systematic review, eight of which were also eligible for study-aggregate meta-analysis. For the meta-analysis, a total of 256 FDG-PET/CT scans, examining pump/pocket and/or driveline infection, were acquired in 230 patients. Pooled sensitivity of FDG-PET/CT was 0.95 (95% confidence interval (CI) 0.89-0.97) and pooled specificity was 0.91 (95% CI 0.54-0.99) for the diagnosis of device-related infection. For pump/pocket infection, sensitivity and specificity of FDG-PET/CT were 0.97 (95%CI 0.69-1.00) and 0.93 (95%CI 0.64-0.99), respectively. For driveline infection, sensitivity and specificity were 0.96 (95%CI 0.88-0.99) and 0.99 (95%CI 0.13-1.00) respectively. Significant heterogeneity existed across studies for specificity, mostly caused by differences in scan procedures. Predefined criteria for suspicion of LVAD and/or driveline infection were lacking in all included studies. CONCLUSIONS: FDG-PET/CT is a valuable tool for assessment of device-related infection in LVAD patients, with high sensitivity and high, albeit variable, specificity. Standardization of FDG-PET/CT procedures and criteria for suspected device-related LVAD infections are needed for consistent reporting of FDG-PET/CT scans.


Assuntos
Coração Auxiliar , Infecções Relacionadas à Prótese , Fluordesoxiglucose F18 , Coração Auxiliar/efeitos adversos , Humanos , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Tomografia por Emissão de Pósitrons , Infecções Relacionadas à Prótese/diagnóstico por imagem , Qualidade de Vida , Compostos Radiofarmacêuticos , Sensibilidade e Especificidade
3.
Sci Total Environ ; 751: 141728, 2021 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-32890797

RESUMO

Trees significantly impact land-atmosphere feedbacks through evapotranspiration, photosynthesis and isoprene emissions. These processes influence the local microclimate, air quality and can mitigate temperature extremes and sequester carbon dioxide. Despite such importance, currently only 5 out of 15 atmospheric chemistry climate models even partially account for the presence of cropland trees. We first show that the tree cover over intensely farmed regions in Asia, Australia and South America is significantly underestimated (e.g. only 1-3% tree cover over north-India) in the Model of Emissions of Gases and Aerosol from Nature (MEGAN) and absent in Noah land-surface module of the Weather Research and Forecasting (WRF-Chem) Model. By including the actual tree cover (~10%) over the north-west Indo Gangetic Plain in the Noah land-surface module of the WRF-Chem and the MEGAN module, during the rice growing monsoon season in August, we find that the latent heat flux alone increases by 100%-300% while sensible heat flux reduces by 50%-100%, leading to a reduction in daytime boundary layer height by 200-400 m. This greatly improves agreement between the modelled and measured temperature, boundary layer height and surface ozone, which were earlier overestimated and isoprene and its oxidation products which were earlier underestimated. Mitigating peak daytime temperatures and ozone improves rice production by 10 to 20%. Our findings from north west Indo-Gangetic Plain establish that such plantations mitigate heat stress, and have beneficial effects on crop yields while also sequestering carbon. Expanding agroforestry practices to 50% of the cropland area could result in up to 40% yield gain regionally. Implementing such strategies globally could increase crop production and sequester 0.3-30 GtC per year, and therefore future climate mitigation and food security efforts should consider stakeholder participation for increased cropland agroforestry in view of its beneficial effects.


Assuntos
Poluentes Atmosféricos , Ozônio , Poluentes Atmosféricos/análise , Ásia , Atmosfera , Austrália , Produtos Agrícolas , Monitoramento Ambiental , Índia , Ozônio/análise , América do Sul , Temperatura , Árvores
4.
Ned Tijdschr Geneeskd ; 1642020 06 02.
Artigo em Holandês | MEDLINE | ID: mdl-32749808

RESUMO

On 3 March 2020, the document 'Drug treatment options for patients with COVID-19 (infections with SARS-CoV-2)' was published on the website of the Dutch Working Party on Antibiotic Policy (StichtingWerkgroepAntibioticabeleid, SWAB). Based on a 7-step analysis of the literature, hydroxychloroquine (HCQ) and chloroquine (CQ) were initially included in the SWAB document as possible drug treatments for hospitalised adult COVID-19 patients. However, recent weeks have seen the publication of the results of various studies into the effectiveness of treatment with HCQ and CQ in patients with COVID-19. On the basis of these results, we conclude that there is insufficient evidence to consider HCQ and CQ as meaningful treatment options in patients with COVID-19. Clinically relevant QTc prolongation occurs in at least 1 in 10 COVID-19 patients treated with HCQ or HQ.


Assuntos
Betacoronavirus , Cloroquina/uso terapêutico , Infecções por Coronavirus/tratamento farmacológico , Hidroxicloroquina/uso terapêutico , Pneumonia Viral/tratamento farmacológico , Adulto , Antimaláricos/uso terapêutico , Antivirais/uso terapêutico , COVID-19 , Inibidores Enzimáticos/uso terapêutico , Humanos , Pandemias , SARS-CoV-2
5.
Clin Microbiol Infect ; 26(10): 1291-1299, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32061798

RESUMO

BACKGROUND: Machine learning (ML) is increasingly being used in many areas of health care. Its use in infection management is catching up as identified in a recent review in this journal. We present here a complementary review to this work. OBJECTIVES: To support clinicians and researchers in navigating through the methodological aspects of ML approaches in the field of infection management. SOURCES: A Medline search was performed with the keywords artificial intelligence, machine learning, infection∗, and infectious disease∗ for the years 2014-2019. Studies using routinely available electronic hospital record data from an inpatient setting with a focus on bacterial and fungal infections were included. CONTENT: Fifty-two studies were included and divided into six groups based on their focus. These studies covered detection/prediction of sepsis (n = 19), hospital-acquired infections (n = 11), surgical site infections and other postoperative infections (n = 11), microbiological test results (n = 4), infections in general (n = 2), musculoskeletal infections (n = 2), and other topics (urinary tract infections, deep fungal infections, antimicrobial prescriptions; n = 1 each). In total, 35 different ML techniques were used. Logistic regression was applied in 18 studies followed by random forest, support vector machines, and artificial neural networks in 18, 12, and seven studies, respectively. Overall, the studies were very heterogeneous in their approach and their reporting. Detailed information on data handling and software code was often missing. Validation on new datasets and/or in other institutions was rarely done. Clinical studies on the impact of ML in infection management were lacking. IMPLICATIONS: Promising approaches for ML use in infectious diseases were identified. But building trust in these new technologies will require improved reporting. Explainability and interpretability of the models used were rarely addressed and should be further explored. Independent model validation and clinical studies evaluating the added value of ML approaches are needed.


Assuntos
Sistemas de Apoio a Decisões Clínicas , Registros Eletrônicos de Saúde , Aprendizado de Máquina , Sepse/diagnóstico , Sepse/terapia , Algoritmos , Infecção Hospitalar/diagnóstico , Infecção Hospitalar/terapia , Humanos , Prognóstico , Infecção da Ferida Cirúrgica/diagnóstico , Infecção da Ferida Cirúrgica/terapia , Infecções Urinárias/diagnóstico , Infecções Urinárias/terapia
6.
Sci Total Environ ; 689: 295-304, 2019 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-31276997

RESUMO

We report the first ambient measurements of thirteen VOCs for investigations of emissions and air quality during fog and non-fog wintertime conditions at a tower site (28.57° N, 77.11° E, 220 m amsl) in the megacity of Delhi. Measurements of acetonitrile (biomass burning (BB) tracer), isoprene (biogenic emission tracer in daytime), toluene (a traffic exhaust tracer) and benzene (emitted from BB and traffic), together with soluble and reactive oxygenated VOCs such as methanol, acetone and acetaldehyde were performed during the winters of 2015-16 and 2016-17, using proton transfer reaction mass spectrometry. Remarkably, ambient VOC composition changes during fog were not governed by solubility. Acetaldehyde, toluene, sum of C8-aromatics (e.g. xylenes), sum of C9-aromatics (e.g. trimethyl benzenes) decreased by ≥30% (>95% confidence interval), whereas acetonitrile and benzene showed significant increases by 20% (>70% confidence interval), even after accounting for boundary layer dilution. During fog, the lower temperatures appeared to induce an emissions feedback from enhanced open BB within Delhi for warming, releasing both gaseous and aerosol pollutants with consequences for fog chemistry, sustenance and intensity. The potential feedback is important to consider for improving current emission parametrizations in models used for predicting air quality and fog in such atmospheric environments.


Assuntos
Poluentes Atmosféricos/análise , Poluição do Ar/análise , Monitoramento Ambiental , Incêndios , Compostos Orgânicos Voláteis/análise , Biomassa , Cidades , Índia , Estações do Ano , Tempo (Meteorologia)
7.
Heliyon ; 5(3): e01431, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30976701

RESUMO

The present study aimed to investigate the nutritional properties and antioxidant activities of six underutilized wild edible plants viz. Ipomoea aquatica, Achyranthes aspera, Aasystasia ganjetica, Enhydra fluctuans, Oldenlandia corymbosa and Amaranthus viridis that are commonly consumed as food in the India The antioxidant properties of the plants were evaluated by using 1,1-diphenyl-2-picryl hydrazyl (DPPH) radical scavenging activity, ABTS radical scavenging ability, reducing power capacity, metal chelating activity, lipid peroxidation assay, estimation of total phenolic content and flavonoids content in different solvent extraction system like benzene, chloroform, methanol and 70% aqueous (aq.) ethanol. The quantitation of phenolic acids and flavonoids and water soluble vitamins in these plants were carried out by HPLC using Acclaim C 18 column (5 µm particle size, 250 × 4.6 mm), Dionex Ultimate 3000 liquid chromatograph and detection was carried out in photo diode array (PDA) detector. The results of investigation showed that these plants are rich sources of protein, carbohydrate minerals and vitamins, especially the B group of vitamins that can contribute immensely to nutrition, food security, and health and therapeutic benefits. The different levels of antioxidant activities were found in the solvent systems used. The HPLC analysis also showed the presence of phenolic acids and flavonoids in various amounts in these plants which could be utilized as natural antioxidant.

8.
Artigo em Inglês | MEDLINE | ID: mdl-29760945

RESUMO

Background: Therapy for Type 2 diabetes (T2D) has been transformed by the introduction of newer agents like Glucagon like Peptide Receptor Agonists (GLP-1RA) and Sodium-glucose linked transporter inhibitors (SGLT2i). However with co-initiation of SGLT2i and GLP-1RA in the DURATION 8 trial an improvement in HbA1c was noted but the beneficial effect was not equal to the sum of its parts. In view of this we proceeded to test the hypothesis that sequential addition of GLP-1RA therapy to metformin and SGLT-2i may be more beneficial. Methods: A retrospective real world observational case note study conducted in two diabetes care centres in India analyzed the first 60 consecutive T2D patients who could afford this therapy and had not achieved their glycaemic target (HbA1c < 7%)on metformin and SGLT2i. All these patients were additionally treated with either Dulaglutide or Liraglutide and followed up for 13 weeks. Results: Across the entire 13-week study period, both liraglutide and dulaglutide proved to be an excellent add on to metformin and SGLT-2 inhibitor. There was significant reduction in HbA1c and body weight. Liraglutide had an additional significant impact on systolic blood pressure reduction in contrast to the dulaglutide arm. Comparatively, liraglutide and dulaglutide achieved similar metabolic control. However, a larger proportion of patients achieved HbA1c below 7.0% in the liraglutide arm (63.3%) compared to the dulaglutide arm (30%) and this difference was statistically significant. Conclusion: In this retrospective study in Indian type 2 diabetic patients poorly controlled with metformin and SGLT-2 inhibitor we found a meaningful impact of adding a GLP-1 RA on all metabolic parameters. There were additional advantages seen with liraglutide as far achieving target HbA1c of less than 7% and also on the quantum of weight loss and systolic blood pressure reduction.

10.
Clin Microbiol Infect ; 24(9): 944-955, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29787889

RESUMO

BACKGROUND: Bloodstream infections are a major cause of death with increasing incidence and severity. Blood cultures are still the reference standard for microbiological diagnosis, but are rather slow. Molecular methods can be used as add-on complementary assays. They can be useful to speed up microbial identification and to predict antimicrobial susceptibility, applied to direct blood samples or positive blood cultures. AIM: To review recent developments in molecular-based diagnostic platforms used for the identification of bloodstream infections, with a focus on assays performed directly on blood samples and positive blood cultures. SOURCES: Peer reviewed articles, conference abstracts, and manufacturers' websites. CONTENT: We give an update on recent developments of molecular methods in diagnosing BSIs. We first describe the currently available molecular methods to be used for positive blood cultures including: a) in situ hybridization-based methods; b) DNA-microarray-based hybridization technology; c) nucleic acid amplification-based methods; and d) combined methods. Subsequently, molecular methods applied directly to whole blood samples are discussed, including the use of nucleic acid amplification-based methods, T2 magnetic resonance-based methods, and metagenomics for diagnosing BSIs. IMPLICATIONS: Advances in molecular-based methods complementary to conventional blood culture diagnostics and antimicrobial stewardship programmes may optimize infection management by allowing rapid identification of pathogens and relevant antimicrobial resistance genes. Rapid diagnosis of the causing microorganism and relevant resistance determinants is important for early administration and modification of appropriate antimicrobial therapy. Ultimately, this may lead to improved quality and cost-effectiveness of health care, as well as reduced antimicrobial resistance selection.


Assuntos
Bacteriemia/diagnóstico , Técnicas Bacteriológicas/métodos , Técnicas de Diagnóstico Molecular/métodos , Bactérias/classificação , Bactérias/genética , Bactérias/isolamento & purificação , Hemocultura , Humanos
12.
Occup Med (Lond) ; 67(4): 308-310, 2017 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-28398532

RESUMO

Background: We present the case of a 35-year-old male who developed a chronic hypersensitivity pneumonitis (HP) following inhalational exposure to a fluorocarbon waterproofing aerosol spray, caused by his work for an upholstery and soft furnishings retailer. This is the first case report from inhalational fluorocarbon exposure with histological evidence of chronic HP. This is then discussed in the context of previous reports of interstitial lung disease and lung injury, caused by similar occupational and non-occupational exposures.


Assuntos
Alveolite Alérgica Extrínseca/etiologia , Fluorcarbonetos/toxicidade , Exposição Ocupacional/efeitos adversos , Adulto , Alveolite Alérgica Extrínseca/diagnóstico , Alveolite Alérgica Extrínseca/patologia , Biópsia , Humanos , Exposição por Inalação/efeitos adversos , Pulmão/patologia , Doenças Pulmonares Intersticiais , Masculino
13.
J Environ Manage ; 197: 89-95, 2017 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-28334647

RESUMO

Rice the staple food is a notable intake source of arsenic to the rural population of eastern India through food-chain. A field survey was carried out to study the variation of arsenic load in different parts of rice genotype Shatabdi (most popular genotype of the region) exposed to varying level of arsenic present in the irrigation water and soil. As irrigation is the primary source of arsenic contamination, a study was conducted to assess arsenic load in rice ecosystem under deficit irrigation practices like intermittent ponding (IP), saturation (SAT) and aerobic (AER) imposed during stress allowable stage (16-40 days after transplanting) of the crop (genotype Shatabdi). Present survey showed that arsenic content in water and soil influenced the arsenic load of rice grain. Variation in arsenic among different water and soil samples influenced grain arsenic load to the maximum extent followed by straw. Deviation in root arsenic load due to variation in water and soil arsenic content was lowest. Arsenic concentration of grain is strongly related to the arsenic content of both irrigation water and soil. However, water has 10% higher impact on grain arsenic load over soil. Translocation of arsenic from root to shoot decreased with the increase in arsenic content of water. Imposition of saturated and aerobic environment reduced both yield and grain arsenic load. In contrast under IP a marked decrease in grain arsenic content recorded with insignificant reduction in yield. Deficit irrigation resulted in significant reduction (17.6-25%) in arsenic content of polished rice and the values were lower than that of the toxic level (<0.2 mg kg-1). In contrast the decrease in yield was to the tune of 0.9% under IP regime over CP.


Assuntos
Arsênio , Poluentes do Solo , Irrigação Agrícola , Humanos , Índia , Oryza , Solo
14.
J Colloid Interface Sci ; 497: 181-192, 2017 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-28284072

RESUMO

Polycrystalline CoFe2O4 thin films are deposited onto the quartz substrates by spray pyrolysis technique. Rietveld refinement analysis confirmed the films are polycrystalline in nature with spinel cubic crystal structure. Rietveld refinement analysis was employed to estimate the cation distribution in spinel lattice sites. Surface micrographs shows the granular morphology with average grain size decreases with increase in solution concentration. The presence of two characteristic absorption bands around 579 and 391cm-1 in the FTIR study confirms the formation of single phase CoFe2O4. Vibrating sample magnetometer measurement confirmed the predominant ferrimagnetic nature of thin films which confirms the maximum saturation magnetization with moderate coercivity was useful for making effective gas sensor. The gas response towards different operating temperatures, gas concentrations and solution concentrations was systematically studied. The films show the maximum gas response 70% at 0.1M solution concentration at 150°C operating temperature. The films are well selective towards NO2 as compared with other test gases with good reproducibility.

15.
J Postgrad Med ; 63(1): 29-35, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-27853040

RESUMO

BACKGROUND: Different definitions used for chronic obstructive pulmonary disease (COPD) preclude getting reliable prevalence estimates. Study objective was to find the prevalence of COPD as per standard Global Initiative for Chronic Obstructive Lung Disease definition, risk factors associated, and treatment seeking in adults >30 years. METHODOLOGY: Community-based cross-sectional study was conducted in Delhi, among 1200 adults, selected by systematic random sampling. Pretested questionnaire was used to interview all subjects and screen for symptoms of COPD. Postbronchodilator spirometry was done to confirm COPD. STATISTICAL ANALYSIS: Adjusted odds ratio (aOR) was calculated by multivariable analysis to examine the association of risk factors with COPD. Receiver operating characteristic (ROC) curve was developed to assess predictability. RESULTS: The prevalence of COPD was 10.1% (95% confidence interval [CI] 8.5, 11.9%). Tobacco smoking was the strongest risk factor associated (aOR 9.48; 95% CI 4.22, 14.13) followed by environmental tobacco smoke (ETS), occupational exposure, age, and biomass fuel. Each pack-year of smoking increased 15% risk of COPD. Ex-smokers had 63% lesser risk compared to current smokers. Clinical allergy seems to preclude COPD (aOR 0.06; 95% CI 0.02, 0.37). ROC analysis showed 94.38% of the COPD variability can be assessed by this model (sensitivity 57.4%; positive predictive value 93.3%). Only 48% patients were on treatment. Treatment continuation was impeded by its cost. CONCLUSION: COPD prevalence in the region of Delhi, India, is high, and our case-finding population study identified a high rate of patients who were not on any treatment. Our study adds to creating awareness on the importance of smoking cessation, early diagnosis of COPD, and the need for regular treatment.


Assuntos
Exposição Ambiental/efeitos adversos , Exposição Ocupacional/efeitos adversos , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Fumaça/efeitos adversos , Fumar/efeitos adversos , Poluição por Fumaça de Tabaco/efeitos adversos , Madeira , Adulto , Idoso , Pesquisa Participativa Baseada na Comunidade , Estudos Transversais , Feminino , Humanos , Índia/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Doença Pulmonar Obstrutiva Crônica/etiologia , Fumar/epidemiologia , Poluição por Fumaça de Tabaco/estatística & dados numéricos
16.
Plant Pathol J ; 32(2): 95-101, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-27147929

RESUMO

Inheritance of resistance to Fusarium wilt (FW) disease caused by Fusarium udum was investigated in pigeonpea using four different long duration FW resistant genotypes viz., BDN-2004-1, BDN-2001-9, BWR-133 and IPA-234. Based on the F2 segregation pattern, FW resistance has been reported to be governed by one dominant gene in BDN-2004-1 and BDN-2001-9, two duplicate dominant genes in BWR-133 and two dominant complimentary genes in resistance source IPA-234. Further, the efficacy of six simple sequence repeat (SSR) markers namely, ASSR-1, ASSR-23, ASSR-148, ASSR-229, ASSR-363 and ASSR-366 reported to be associated with FW resistance were also tested and concluded that markers ASSR-1, ASSR-23, ASSR-148 will be used for screening of parental genotypes in pigeonpea FW resistance breeding programs. The information on genetics of FW resistance generated from this study would be used, to introgress FW resistance into susceptible but highly adopted cultivars through marker-assisted backcross breeding and in conventional breeding programs.

17.
Infection ; 44(3): 395-439, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-27066980

RESUMO

INTRODUCTION: In the time of increasing resistance and paucity of new drug development there is a growing need for strategies to enhance rational use of antibiotics in German and Austrian hospitals. An evidence-based guideline on recommendations for implementation of antibiotic stewardship (ABS) programmes was developed by the German Society for Infectious Diseases in association with the following societies, associations and institutions: German Society of Hospital Pharmacists, German Society for Hygiene and Microbiology, Paul Ehrlich Society for Chemotherapy, The Austrian Association of Hospital Pharmacists, Austrian Society for Infectious Diseases and Tropical Medicine, Austrian Society for Antimicrobial Chemotherapy, Robert Koch Institute. MATERIALS AND METHODS: A structured literature research was performed in the databases EMBASE, BIOSIS, MEDLINE and The Cochrane Library from January 2006 to November 2010 with an update to April 2012 (MEDLINE and The Cochrane Library). The grading of recommendations in relation to their evidence is according to the AWMF Guidance Manual and Rules for Guideline Development. CONCLUSION: The guideline provides the grounds for rational use of antibiotics in hospital to counteract antimicrobial resistance and to improve the quality of care of patients with infections by maximising clinical outcomes while minimising toxicity. Requirements for a successful implementation of ABS programmes as well as core and supplemental ABS strategies are outlined. The German version of the guideline was published by the German Association of the Scientific Medical Societies (AWMF) in December 2013.


Assuntos
Anti-Infecciosos , Doenças Transmissíveis/tratamento farmacológico , Serviço de Farmácia Hospitalar , Guias de Prática Clínica como Assunto , Qualidade da Assistência à Saúde , Anti-Infecciosos/administração & dosagem , Anti-Infecciosos/uso terapêutico , Resistência a Medicamentos , Alemanha , Humanos , Prescrição Inadequada/prevenção & controle
18.
Neth J Med ; 73(10): 481-2, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26687265

RESUMO

Tularemia is thought to be rare in the Netherlands. Here we describe a cluster of two patients who contracted tularaemia after field dressing of a hare found dead. Additionally, infection from the same source is suggested in three animals.


Assuntos
Tularemia , Adulto , Animais , Cães , Furões , Lebres/microbiologia , Humanos , Masculino , Pessoa de Meia-Idade , Países Baixos
19.
Euro Surveill ; 20(30)2015 Jul 30.
Artigo em Inglês | MEDLINE | ID: mdl-26250069

RESUMO

Two patients from Eritrea, recently arrived in the Netherlands, presented with fever and were investigated for malaria. Bloodfilms showed spirochetes but no blood parasites. Louse-borne relapsing fever caused by Borrelia recurrentis was diagnosed. Treatment was complicated by severe Jarisch-Herxheimer reactions in both patients. Physicians should be aware of the possibility of B. recurrentis infection in migrant populations who travel under crowded conditions, especially after passing through endemic areas such as Ethiopia and neighbouring countries.


Assuntos
Antibacterianos/administração & dosagem , Borrelia/isolamento & purificação , Ceftriaxona/administração & dosagem , Doxiciclina/administração & dosagem , Infestações por Piolhos/diagnóstico , Pediculus/microbiologia , Febre Recorrente/diagnóstico , Animais , Antibacterianos/efeitos adversos , Borrelia/genética , Ceftriaxona/efeitos adversos , DNA Bacteriano/genética , DNA Bacteriano/isolamento & purificação , Doxiciclina/efeitos adversos , Hipersensibilidade a Drogas/prevenção & controle , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Eritreia , Feminino , Humanos , Infestações por Piolhos/tratamento farmacológico , Masculino , Países Baixos , RNA Ribossômico 16S/genética , Reação em Cadeia da Polimerase em Tempo Real , Febre Recorrente/tratamento farmacológico , Febre Recorrente/microbiologia , Viagem , Resultado do Tratamento , Adulto Jovem
20.
J Postgrad Med ; 61(3): 169-75, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26119436

RESUMO

BACKGROUND AND OBJECTIVES: Allergic Rhinitis is rather erroneously viewed as a trivial disease. It is important in that it can significantly affect quality of life. There is paucity of community based prevalence studies on the disease in India. This study was planned to assess the prevalence of allergic rhinitis in adults, the proportion of asthmatics among them, risk factors associated and treatment seeking behaviour among the patients. MATERIALS AND METHODS: A community based cross sectional study was conducted in Mehrauli, South Delhi among 1200 adults, aged 30 years and over selected by systematic random sampling from two randomly selected wards. A pre-tested questionnaire was used to collect information regarding symptoms, risk factors and treatment seeking behaviour. Allergic Rhinitis was diagnosed as per ARIA guidelines. Spirometry was done to diagnose asthma among them. Multivariate logistic regression analysis was done to find the association of risk factors with disease. RESULTS: The prevalence of Allergic Rhinitis was found to be 11% (132 subjects) and 33.3% (44 patients) among them also had asthma. Overcrowding (aOR = 6.4), absence of cross-ventilation (aOR = 2.5), occupational exposure to dust/ smoke (aOR = 2.1), tobacco smoking (aOR = 2.1), family history of allergic diseases (aOR = 2.7) and clinical allergy (aOR = 10.2) were found to be independent risk factors associated with Rhinitis. More patients of Rhinitis with asthma (75%) took treatment, relative to those without asthma (40%) who, mostly relied on home remedies (42%) or, did not seek any treatment (18%) (P = 0.031). Interpretations and Conclusion: The burden of Allergic Rhinitis is high with a considerable overlap with asthma. These allergic diseases and emphasize the importance of early and regular treatment.


Assuntos
Asma/epidemiologia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Qualidade de Vida , Rinite Alérgica/diagnóstico , Rinite Alérgica/epidemiologia , Fumar/efeitos adversos , Adulto , Idoso , Idoso de 80 Anos ou mais , Pesquisa Participativa Baseada na Comunidade , Estudos Transversais , Poeira , Feminino , Humanos , Índia/epidemiologia , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Doenças Negligenciadas , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Prevalência , Fatores de Risco , Fumar/epidemiologia , Inquéritos e Questionários
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