RESUMO
We report progressive necrotizing fungal cellulitis and myositis in the leg of a patient with glioblastoma multiforme treated with temozolomide and corticosteroids. While the morphologic appearance of the isolate and its ability to grow at temperatures greater than 32°C were suggestive of Mycoleptodiscus indicus, some of the conidia were atypical for this species in that they had single septa and occasional lateral appendages. Furthermore, the isolate was different from M. indicus based on the sequencing analysis of two rDNA regions. This is the first case of Mycoleptodiscus invasive fungal disease in which the causative agent could not be resolved at the species level because of inconsistencies between morphological and molecular data.
Assuntos
Ascomicetos/isolamento & purificação , Celulite (Flegmão)/diagnóstico , Celulite (Flegmão)/microbiologia , Micoses/diagnóstico , Micoses/microbiologia , Miosite/diagnóstico , Miosite/microbiologia , Corticosteroides/administração & dosagem , Adulto , Anti-Inflamatórios/administração & dosagem , Antineoplásicos Alquilantes/administração & dosagem , Celulite (Flegmão)/complicações , Celulite (Flegmão)/patologia , Análise por Conglomerados , DNA Fúngico/química , DNA Fúngico/genética , DNA Ribossômico/química , DNA Ribossômico/genética , DNA Espaçador Ribossômico/química , DNA Espaçador Ribossômico/genética , Dacarbazina/administração & dosagem , Dacarbazina/análogos & derivados , Glioblastoma/complicações , Glioblastoma/tratamento farmacológico , Humanos , Perna (Membro)/patologia , Masculino , Dados de Sequência Molecular , Micoses/complicações , Micoses/patologia , Miosite/complicações , Miosite/patologia , Filogenia , Análise de Sequência de DNA , TemozolomidaRESUMO
To lead effectively within their organizations, nurse executives must possess quality and safety literacy and be able to engage and motivate clinicians to participate in safety and quality initiatives. Given the paucity of research in Canada, a study was undertaken to explore nurse executives' understanding of the key concepts and strategies associated with patient safety and quality improvement, and their engagement with patient safety and quality improvement in their hospitals and healthcare systems. This study used an exploratory qualitative design with a content analysis approach on 20 nurse executives working in hospitals in Ontario. Three key themes emerged from the narrative data set including: (1) being a strategic and system thinker while possessing the emotional intelligence to influence staff; (2) building credibility and relationships with point-of-care staff, board of directors, and leadership team and (3) creating a culture of safety and high reliability. Study findings can be useful in informing future learning opportunities for nurse executives and nurses leaders at all levels to enhance their quality and safety literacy.
Assuntos
Hospitais/normas , Liderança , Enfermeiros Administradores/psicologia , Papel do Profissional de Enfermagem/psicologia , Recursos Humanos de Enfermagem Hospitalar/psicologia , Segurança do Paciente/normas , Melhoria de Qualidade/normas , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ontário , Cultura Organizacional , Reprodutibilidade dos TestesRESUMO
Some interesting growth characteristics of Mycoleptodiscus terrestris were discovered while evaluating the fungus as a potential bioherbicide for management of the submersed macrophyte, Hydrilla verticillata. Microsclerotia were produced readily in a liquid culture medium containing a basal salts solution supplemented with corn steep liquor powder and glucose. Dried microsclerotia were capable of germinating hyphally within 24 h and sporogenically within 72 h. Initiation of spore production was not dependent on the presence of host plant material or light.