scholarly journals Post-Treatment Bacterial Endocarditis Mimicking Fungal Organisms: A Morphologic Comparison and Tips for Avoiding this Diagnostic Pitfall

2021 ◽  
pp. 107382
Author(s):  
David A. Pacheco ◽  
Omar Saldarriaga ◽  
Morgan Killian ◽  
Jennifer A. Perone ◽  
Beilin Wang ◽  
...  
Keyword(s):  
Bacterial Endocarditis ◽  
Post Treatment ◽  
Diagnostic Pitfall ◽  
Fungal Organisms

Filamentous bacteria masquerading as fungi: a diagnostic pitfall in direct smear interpretation with report of two cases

2011 ◽  
Vol 64 (10) ◽  
pp. 927-929 ◽  
Author(s):  
Brian J Sutton ◽  
Amy C Parsons ◽  
Elizabeth L Palavecino
Keyword(s):  
Antibacterial Agents ◽  
Fungal Infections ◽  
Body Fluids ◽  
Filamentous Bacteria ◽  
Diagnostic Pitfall ◽  
Inappropriate Treatment ◽  
Fungal Hyphae ◽  
Common Response ◽  
Bacterial Morphology ◽  
Fungal Organisms

Bacteria, particularly Gram-negative bacilli, can develop abnormal morphology after the administration of subinhibitory concentrations of antibacterial agents. Filamentation is a common response in which bacteria replicate but incompletely divide, leading to long slender chains that resemble fungal hyphae. Pathologists are frequently consulted to examine direct smears of body fluids, which often contain microorganisms. Antibiotic-related filamentous morphology may resemble fungal hyphae and this potential misinterpretation can lead to inappropriate treatment for presumed fungal infections. Two cases are described in which direct smears of body fluids were examined by on-call pathology residents who misinterpreted filamentous bacteria as fungal organisms, with one case leading to the initiation of antifungal medication. Although well-established within the field of microbiology, many residents and practising pathologists are less familiar with antibiotic-related bacterial morphology, as it may not be routinely encountered. It is important for pathologists to be aware of this phenomenon in order to avoid misinterpretation.

Ultrastructure of bronchopulmonary lavage cells from bovines administered 3-methylindole: II. 24 hours post-treatment

1984 ◽  
Vol 42 ◽  
pp. 202-203
Author(s):  
Amreek Singh ◽  
Judith M. McLaren ◽  
Onkar S. Atwal ◽  
Peter Eyre
Keyword(s):  
Plasma Cells ◽  
Ciliated Cell ◽  
Lavage Fluid ◽  
Treated Group ◽  
Post Treatment ◽  
Lung Edema ◽  
Ciliated Cells ◽  
Thin Sections ◽  
Variable Diameter ◽  
Cell Pellet

Introduction3-methylindole (MI), a rumen metabolite of the amino acid L-tryptophan, has been shown to produce bovine pulmonary edema and emphysema. The airways contain free and exfoliated cells. A morphologic analysis of these cells may complement the understanding of the mechanism of lung edema. Ultrastructure of the bronchopulmonary lavage (BL) cells 24 h following MI oral administration to calves is described in this experiment. The 12 hours post-treatment results were described earlier.Materials and MethodsTwo Holstein-Friesian calves were each administered an oral dose of 0.2 g MI/Kg body weight and another two calves served as controls. The animals were euthanized with sodium pentabarbitol 24 h after receiving the compound. The lungs and trachea were removed and 0.1 M sodium phosphate buffered saline was infused into the lungs through the trachea. Glutaraldehyde fixative was added to the recovered BL fluid so as to form a 1% solution. The fluid was centrifuged and the resulting cell pellet was suspended in the buffer. The procedures were repeated on the suspension; the pellet was post-fixed in osmium tetroxide and was processed by conventional methods of section preparations for TEM examination. Lung samples from caudal lobes were fixed in 1.5% glutaraldehyde to obtain tissue sections for TEM.Results and DiscussionPulmonary alveolar macrophages (AM), neutrophils, ciliated epithelial cells, globule leukocytes and plasma cells were recovered from the BL fluid of the control and Mi-administered calves. Ciliated cells and globule leukocytes could not be harvested from the controls. The AM obtained from the treated calves (Fig. 1) in comparison with similar cells from the controls were larger, and contained large membrane-limited inclusions (phagolysosomes). There was a remarkable similarity between the lavaged AM and the AM studied in thin sections of lung (cf. Fig. 1 and Fig. 2). The neutrophil was the second most abundant cell type retrieved from the lavage fluid from the calves of control or treated group. Except for scanty pseudopodia in the neutrophils obtained from the Mi-receiving calves, the cells appeared unaltered (Fig. 3). Ciliated cells were abundant in the BL fluid of Mi-ingesting calves. A heterogeneous collection of vesicles filled the ciliated cell cytoplasm (Fig. 3). Globule leukocytes were commonly observed among BL cells of treated calves. The globule leukocytes were ca. 15 μm in diameter and contained round or elliptical nuclei with conspicuous nucleoli. The cytoplasmic granules, which are a prominent feature of globule leukocytes, were electron-opaque and had a variable diameter (0.5-3.0 μm). A one-line account of globule leukocytes in the bronchi of steers administered MI has appeared. Plasma cells were rare. Ultrastructure of BL cells is compatible with their response to chemical insult by MI.

Continuous Positive Airway Pressure (CPAP) Therapy for the Treatment of Hypernasality: A Single Case Study

2014 ◽  
Vol 24 (2) ◽  
pp. 48-58 ◽  
Author(s):  
Lakshmi Kollara ◽  
Graham Schenck ◽  
Jamie Perry
Keyword(s):  
Continuous Positive Airway Pressure ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Single Case ◽  
Treatment Method ◽  
Post Treatment ◽  
Subjective Perception ◽  
Cpap Therapy ◽  
Long Term Follow Up

Studies have investigated the applications of Continuous Positive Airway Pressure (CPAP) therapy in the treatment of hypernasality due to velopharyngeal dysfunction (VPD; Cahill et al., 2004; Kuehn, 1991; Kuehn, Moon, & Folkins, 1993; Kuehn et al., 2002). The purpose of this study was to examine the effectiveness of CPAP therapy to reduce hypernasality in a female subject, post-traumatic brain injury (TBI) and pharyngeal flap, who presented with signs of VPD including persistent hypernasality. Improvements in mean velopharyngeal orifice size, subjective perception of hypernasality, and overall intelligibility were observed from the baseline to 8-week post-treatment assessment intervals. Additional long-term assessments completed at 2, 3, and 4 months post-treatment indicated decreases in immediate post-treatment improvements. Results from the present study suggest that CPAP is a safe, non-invasive, and relatively conservative treatment method for reduction of hypernasality in selected patients with TBI. More stringent long-term follow up may indicate the need for repeated CPAP treatment to maintain results.

Lutein Complex Supplementation Increases Ocular Blood Flow Biomarkers in Healthy Subjects

2019 ◽  
Vol 89 (1-2) ◽  
pp. 5-12
Author(s):  
Alon Harris ◽  
Brent Siesky ◽  
Amelia Huang ◽  
Thai Do ◽  
Sunu Mathew ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Blood Flow ◽  
Diastolic Blood Pressure ◽  
Healthy Subjects ◽  
Ocular Blood Flow ◽  
Capillary Blood ◽  
Post Treatment ◽  
Capillary Blood Flow ◽  
Doppler Imaging ◽  
Retinal Capillary

Abstract. Introduction: To investigate the effects of a lutein complex supplementation on ocular blood flow in healthy subjects. Materials and Methods: Sixteen healthy female patients (mean age 36.8 ± 12.1 years) were enrolled in this randomized, placebo-controlled, double-blinded, two-period crossover study. Subjects received daily an oral dose of the lutein with synergistic phytochemicals complex (lutein (10 mg), ascorbic acid (500 mg), tocopherols (364 mg), carnosic acid (2.5 mg), zeaxanthin (2 mg), copper (2 mg), with synergistic effects in reducing pro-inflammatory mediators and cytokines when administered together in combination) and placebo during administration periods. Measurements were taken before and after three-week supplementation periods, with crossover visits separated by a three-week washout period. Data analysis included blood pressure, heart rate, intraocular pressure, visual acuity, contrast sensitivity detection, ocular perfusion pressure, confocal scanning laser Doppler imaging of retinal capillary blood flow, and Doppler imaging of the retrobulbar blood vessels. Results: Lutein complex supplementation produced a statistically significant increase in mean superior retinal capillary blood flow, measured in arbitrary units (60, p = 0.0466) and a decrease in the percentage of avascular area in the superior (−0.029, p = 0.0491) and inferior (−0.023, p = 0.0477) retina, as well as reduced systolic (−4.06, p = 0.0295) and diastolic (−3.69, p = 0.0441) blood pressure measured in mmHg from baseline. Data comparison between the two supplement groups revealed a significant decrease in systemic diastolic blood pressure (change from pre- to post-treatment with lutein supplement (mean (SE)): −3.69 (1.68); change from pre- to post-treatment with placebo: 0.31 (2.57); p = 0.0357) and a significant increase in the peak systolic velocity (measured in cm/sec) in the central retinal artery (change from pre- to post-treatment with lutein supplement: 0.36 (0.19); change from pre- to post-treatment with placebo: −0.33 (0.21); p = 0.0384) with lutein complex supplement; data analyses from the placebo group were all non-significant. Discussion: In healthy participants, oral administration of a lutein phytochemicals complex for three weeks produced increased ocular blood flow biomarkers within retinal vascular beds and reduced diastolic blood pressure compared to placebo.

Cytoprotective Effect of Tocotrienol-Rich Fraction and α-Tocopherol Vitamin E Isoforms Against Glutamate-Induced Cell Death in Neuronal Cells

2014 ◽  
Vol 84 (3-4) ◽  
pp. 0140-0151 ◽  
Author(s):  
Thilaga Rati Selvaraju ◽  
Huzwah Khaza’ai ◽  
Sharmili Vidyadaran ◽  
Mohd Sokhini Abd Mutalib ◽  
Vasudevan Ramachandran ◽  
...  
Keyword(s):  
Vitamin E ◽  
Cell Viability ◽  
Neuronal Cells ◽  
Positive Control ◽  
Post Treatment ◽  
Mitochondrial Activity ◽  
Before And After ◽  
Pre Treatment ◽  
Tocotrienol Rich Fraction ◽  
Major Mediator

Glutamate is the major mediator of excitatory signals in the mammalian central nervous system. Extreme amounts of glutamate in the extracellular spaces can lead to numerous neurodegenerative diseases. We aimed to clarify the potential of the following vitamin E isomers, tocotrienol-rich fraction (TRF) and α-tocopherol (α-TCP), as potent neuroprotective agents against glutamate-induced injury in neuronal SK-N-SH cells. Cells were treated before and after glutamate injury (pre- and post-treatment, respectively) with 100 - 300 ng/ml TRF/α-TCP. Exposure to 120 mM glutamate significantly reduced cell viability to 76 % and 79 % in the pre- and post-treatment studies, respectively; however, pre- and post-treatment with TRF/α-TCP attenuated the cytotoxic effect of glutamate. Compared to the positive control (glutamate-injured cells not treated with TRF/α-TCP), pre-treatment with 100, 200, and 300 ng/ml TRF significantly improved cell viability following glutamate injury to 95.2 %, 95.0 %, and 95.6 %, respectively (p < 0.05).The isomers not only conferred neuroprotection by enhancing mitochondrial activity and depleting free radical production, but also increased cell viability and recovery upon glutamate insult. Our results suggest that vitamin E has potent antioxidant potential for protecting against glutamate injury and recovering glutamate-injured neuronal cells. Our findings also indicate that both TRF and α-TCP could play key roles as anti-apoptotic agents with neuroprotective properties.

The Assessment of Fear of Flying: Elaboration and Validation of a Videotape as an Analogous Situation of a Flight1

1997 ◽  
Vol 13 (2) ◽  
pp. 118-130 ◽  
Author(s):  
Juan I. Capafóns ◽  
Carmen D. Sosa ◽  
Manuel Herrero ◽  
Conrado Viña
Keyword(s):  
Heart Rate ◽  
Discriminant Analysis ◽  
Post Treatment ◽  
Subjective Measure ◽  
Physiological Measures ◽  
Personal Safety ◽  
Metal Detector ◽  
Fear Of Flying ◽  
Situational Anxiety ◽  
Treatment Measures

The results are presented for the validation of a videotape as an analogous situation for a flight. The video includes the most significant elements of a flight by air: confirmation of the flight, packing, going to the airport, checking-in, going through the metal-detector, departure lounge, boarding the plane, demonstration of the personal safety drills, interiors and exteriors during the flight and landing. Two physiological measures are used for validation (heart rate and temperature) and a subjective measure (situational anxiety, SA). The results (both t-tests and the discriminant analysis) indicate that the videotape is able to discriminate between phobics and non-phobics of flying in the three variables considered. With respect to sensitivity in detecting change produced by various treatments in clients with phobia of flying, the results are also satisfactory. A greater differentiation is produced between the pre-post treatment measures, both in subjective and in the physiological measures.

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