scholarly journals An uncommon organism causing necrotizing pneumonia in a toddler

2021 ◽  
Vol 8 (12) ◽  
pp. 1990
Author(s):  
Manju Reka S. B. ◽  
Arulkumaran Arunagirinathan ◽  
Anupriya Chandrasekaran ◽  
Yuvarajan S.
Keyword(s):  
Computed Tomography ◽  
Pseudomonas Aeruginosa ◽  
Bronchoalveolar Lavage ◽  
Bacterial Pneumonia ◽  
Severe Pneumonia ◽  
Poor Response ◽  
Paediatric Population ◽  
Necrotizing Pneumonia ◽  
First Line ◽  
Uncommon Complication

Necrotizing pneumonia (NP) is an uncommon complication of bacterial pneumonia in children, which must be looked into if a severe pneumonia has poor response to recommended antibiotics. The present case is a toddler with NP in whom fever and cough persisted despite treatment with first-line antimicrobial therapy, computed tomography (CT) scan revealed consolidation with multiple cavities, pseudomonas aeruginosa was the pathogen isolated from bronchoalveolar lavage, which a very uncommon organism is causing NP. Community acquired necrotizing pneumonia caused by pseudomonas is not reported in paediatric population. Hence, we report this case.

scholarly journals AHR-dependent genes and response to MTX therapy in rheumatoid arthritis patients

2021 ◽  
Author(s):  
Anna Wajda ◽  
Ewa Walczuk ◽  
Barbara Stypińska ◽  
Jakub Lach ◽  
Danat Yermakovich ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Lymphoblastic Leukemia ◽  
Mrna Level ◽  
Poor Response ◽  
Evolutionary Analysis ◽  
First Line ◽  
Aryl Hydrocarbon ◽  
First Line Therapy ◽  
Genes Expression ◽  
Ahr Gene

AbstractMethotrexate (MTX) is the first-line therapy for rheumatoid arthritis. Nevertheless, MTX resistance is quite a common issue in clinical practice. There are some premises that aryl hydrocarbon receptor (AhR) gene battery may take part in MTX metabolism. In the present retrospective study, we analyzed genes expression of AHR genes battery associated with MTX metabolism in whole blood of RA patients with good and poor response to MTX treatment. Additionally, sequencing, genotyping and bioinformatics analysis of AHR repressor gene (AHRR) c.565C > G (rs2292596) and c.1933G > C (rs34453673) have been performed. Theoretically, both changes may have an impact on H3K36me3 and H3K27me3. Evolutionary analysis revealed that rs2292596 may be possibly damaging. Allele G in rs2292596 and DAS28 seems to be associated with a higher risk of poor response to MTX treatment in RA. RA patients with poor response to MTX treatment revealed upregulated AhR and SLC19A1 mRNA level. Treatment with IL-6 inhibitor may be helpful to overcome the low-dose MTX resistance. Analysis of gene expression revealed possible another cause of poor response to MTX treatment which is different from that observed in the case of acute lymphoblastic leukemia.

scholarly journals Radiological Findings in Multidetector Computed Tomography (MDCT) of Hereditary and Sporadic Pulmonary Veno-Occlusive Disease: Certainties and Uncertainties

Diagnostics ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 141
Author(s):  
Marta Pérez Núñez ◽  
Sergio Alonso Charterina ◽  
Carmen Pérez-Olivares ◽  
Yolanda Revilla Ostolaza ◽  
Rafael Morales Ruiz ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Multidetector Computed Tomography ◽  
Poor Response ◽  
Occlusive Disease ◽  
Diagnostic Tools ◽  
Lung Edema ◽  
Consecutive Series ◽  
Radiological Findings ◽  
Vasodilator Treatment ◽  
Aggressive Clinical Course

Pulmonary veno-occlusive disease (PVOD) is a very infrequent form of pulmonary arterial hypertension with an aggressive clinical course, poor response to specific vasodilator treatment, and low survival. Confirming a definitive diagnosis is essential to guide treatment and assess lung transplantation. However, in the absence of histological or genetic confirmation, the diagnosis is complex, requiring a clinical suspicion. Multidetector computed tomography (MDCT) is an essential part of the non-invasive diagnostic tools of PVOD. We retrospectively reviewed the MDCT findings from a consecutive series of 25 patients diagnosed with PVOD, 9 with the sporadic form and 16 with the hereditary form of the disease. The presence and extent of typical findings of the diagnostic triad were assessed in all patients (ground glass parenchymal involvement, septal lines, and lymphadenopathy). In our series, 92% of patients showed at least two of the radiological findings described as typical of the disease. All patients presented at least one typical radiological characteristic. The incidence of radiological findings considered typical is very high, however was not associated with greater hemodynamic severity nor to the development of acute lung edema. No significant differences were found between the two groups. A poorly expressive MDCT does not exclude the disease.

scholarly journals Contrast-Enhanced Ultrasound (CEUS) in Non-Traumatic Abdominal Emergencies

2020 ◽  
Vol 06 (03) ◽  
pp. E76-E86
Author(s):  
Diletta Cozzi ◽  
Simone Agostini ◽  
Elena Bertelli ◽  
Michele Galluzzo ◽  
Emanuela Papa ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Ultrasound Imaging ◽  
Acute Inflammation ◽  
Emergency Setting ◽  
Contrast Enhanced Ultrasound ◽  
First Line ◽  
Additional Information ◽  
Contrast Enhanced ◽  
Conventional Ultrasound ◽  
Abdominal Emergencies

AbstractConventional ultrasound imaging (US) is the first-line investigation in acute non-traumatic abdominal emergencies, but sometimes it needs further examinations, such as computed tomography (CT), to reach a certain diagnosis. Contrast-enhanced ultrasound (CEUS), through injection of contrast medium, may provide the radiologist with additional information that could not be investigated with baseline US. It could help reach a diagnosis and rapidly determine the proper therapy in an emergency setting. The purpose of this review is to explain and illustrate the various possibilities and limitations of CEUS in acute non-traumatic abdominal diseases, in particular acute inflammation, parenchymal infarcts, and hemorrhages.

Diagnostic value of bronchoalveolar lavage in patients with opportunistic and nonopportunistic bacterial pneumonia

Infection ◽  
1993 ◽  
Vol 21 (5) ◽  
pp. 291-296 ◽  
Author(s):  
K. Dalhoff ◽  
J. Braun ◽  
R. Lipp ◽  
K. -J. Wießmann ◽  
H. Hollandt ◽  
...  
Keyword(s):  
Bronchoalveolar Lavage ◽  
Bacterial Pneumonia ◽  
Diagnostic Value

scholarly journals Factors Predicting the Success of Adhesiolysis Using a Steerable Catheter in Lumbar Failed Back Surgery Syndrome: A Retrospective Study

2021 ◽  
Vol 10 (5) ◽  
pp. 913
Author(s):  
Ji Yeong Kim ◽  
Yong Ho Lee ◽  
Subin Yoo ◽  
Ji Young Kim ◽  
Mina Joo ◽  
...  
Keyword(s):  
Poor Response ◽  
Failed Back Surgery Syndrome ◽  
Foraminal Stenosis ◽  
Outer Diameter ◽  
Lumbar Surgery ◽  
First Line ◽  
Failed Back Surgery ◽  
Back Surgery ◽  
Reasonable Evidence ◽  
Reduction Effect

Failed back surgery syndrome (FBSS) is a commonly encountered disease after lumbar surgery. There are many cases where it is difficult to choose a treatment because no specific cause can be found. Nevertheless, according to recent reports, adhesiolysis has shown reasonable evidence. However, considering its poor cost-effectiveness, adhesiolysis cannot be used as the first line of treatment. FBSS patients often suffer from chronic pain; accordingly, they become frustrated when this treatment produces a poor response. Therefore, before the procedure, the target group must be selected carefully. We sought to identify the pre-procedure factors predicting the effect of adhesiolysis in FBSS. A total of 150 patients were evaluated and analyzed retrospectively. Of these 150 patients, 69 were classified as responders three months after the procedure (46%). The outer diameter of the catheter during the procedure and grade of foraminal stenosis were correlated with the procedure effect. In conclusion, of the 2.1 mm diameter of the catheter, 1.7 mm of it was used during the procedure, and the milder the foraminal stenosis, the greater the pain reduction effect was three months after the procedure.

scholarly journals CBCT in orthodontics: a systematic review on justification of CBCT in a paediatric population prior to orthodontic treatment

2018 ◽  
Vol 41 (4) ◽  
pp. 381-389 ◽  
Author(s):  
Annelore De Grauwe ◽  
Irem Ayaz ◽  
Sohaib Shujaat ◽  
Simon Dimitrov ◽  
Logan Gbadegbegnon ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Systematic Review ◽  
Orthodontic Treatment ◽  
Cleft Lip ◽  
Treatment Options ◽  
Correct Diagnosis ◽  
Conventional Radiography ◽  
Paediatric Population ◽  
Treatment Optimization ◽  
Diagnostic Efficacy

Summary Background Taking into account radiation doses, safety, and protection, we highlighted the features in which cone-beam computed tomography (CBCT) can offer an advantage compared to the conventional two-dimensional imaging in paediatric dentistry before orthodontic treatment. Objective The aim of this article was to conduct a systematic review to assess the diagnostic efficacy of CBCT in the paediatric population at a pre-orthodontic phase. Search methods MEDLINE via PubMed was searched to identify all peer-reviewed articles potentially relevant to the review until 1 July 2018. Relevant publications were selected by two reviewers independently. Selection criteria The literature selection for this systematic review was carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and was based on predetermined inclusion criteria. Data collection and analysis Data were collected on overall study characteristics and examination characteristics of the selected studies. Methodological quality of the selected studies was evaluated. Original studies were assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool. Thereafter, levels of evidence were obtained according to Grading of Recommendations Assessment, Development and Evaluation criteria. Results As a result of the QUADAS assessment, a total of 37 articles were included in the protocol. Following a proper protocol, CBCT was regarded as a reliable tool for assessment and management of impacted canine and root fracture. It provided a better evaluation of normal and pathological condylar shape and volume. CBCT was a superior choice for pre-surgical diagnostic applications in cleft lip and/or palate over a medical computed tomography based on its lower radiation exposure, shorter investigation time, and low purchase costs. Conclusions CBCT is justified only in those cases where conventional radiography fails to provide a correct diagnosis of pathology. Therefore, it cannot be regarded as a standard method of diagnosis. CBCT imaging may also be justified when it positively affects treatment options or provides treatment optimization. Registration None. Conflict of interest None to declare.

scholarly journals A Rapid Phenotypic Whole-Cell Screening Approach for the Identification of Small-Molecule Inhibitors That Counter β-Lactamase Resistance in Pseudomonas aeruginosa

2017 ◽  
Vol 23 (1) ◽  
pp. 55-64 ◽  
Author(s):  
Deanna Collia ◽  
Thomas D. Bannister ◽  
Hao Tan ◽  
Shouguang Jin ◽  
Taimour Langaee ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Small Molecule ◽  
Small Molecule Inhibitors ◽  
Laboratory Strain ◽  
Multidrug Resistant ◽  
First Line ◽  
Strain Pao1 ◽  
Whole Cell ◽  
Bacterial Sensitivity ◽  
Opportunistic Human Pathogen

Pseudomonas aeruginosa is an opportunistic human pathogen that is prevalent in hospitals and continues to develop resistance to multiple classes of antibiotics. Historically, β-lactam antibiotics have been the first line of therapeutic defense. However, the emergence of multidrug-resistant (MDR) strains of P. aeruginosa, such as AmpC β-lactamase overproducing mutants, limits the effectiveness of current antibiotics. Among AmpC hyperproducing clinical isolates, inactivation of AmpG, which is essential for the expression of AmpC, increases bacterial sensitivity to β-lactam antibiotics. We hypothesize that inhibition of AmpG activity will enhance the efficacy of β-lactams against P. aeruginosa. Here, using a highly drug-resistant AmpC-inducible laboratory strain PAO1, we describe an ultra-high-throughput whole-cell turbidity assay designed to identify small-molecule inhibitors of the AmpG. We screened 645,000 compounds to identify compounds with the ability to inhibit bacterial growth in the presence of cefoxitin, an AmpC inducer, and identified 2663 inhibitors that were also tested in the absence of cefoxitin to determine AmpG specificity. The Z′ and signal-to-background ratio were robust at 0.87 ± 0.05 and 2.2 ± 0.2, respectively. Through a series of secondary and tertiary studies, including a novel luciferase-based counterscreen, we ultimately identified eight potential AmpG-specific inhibitors.

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