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1.
Apoorva Challa Neeraj Mahajan Seema Sood Arti Kapil Bimal Kumar Das Vishnubhatla Sreenivas Somesh Gupta 《Indian journal of medical microbiology》2022,40(3):433-435
Treatment guidelines for management of uncomplicated gonorrhoeae have been recently modified owing to alarming upsurge in azithromycin resistance. This study investigated the prevalence and genetic determinants of gonococcal azithromycin resistance in India. Four (5.7%) of 70 gonococcal isolates were resistant to azithromycin. Of 16 isolates investigated for molecular mechanisms of resistance, 13 (81.3%) and 6 (37.5%) isolates exhibited mutations in coding and promoter regions of mtrR gene, respectively. However, ermA, ermB and ermC genes or mutations in rrl gene were absent in all isolates. Azithromycin resistance is low in India posing no immediate threat to use of dual-therapy for syndromic management. 相似文献
2.
Bimal Bhindi Christine M. Lohse Phillip J. Schulte Ross J. Mason John C. Cheville Stephen A. Boorjian Bradley C. Leibovich R. Houston Thompson 《European urology》2019,75(5):766-772
Background
Partial nephrectomy (PN) is generally favored for cT1 tumors over radical nephrectomy (RN) when technically feasible. However, it can be unclear whether the additional risks of PN are worth the magnitude of renal function benefit.Objective
To develop preoperative tools to predict long-term estimated glomerular filtration rate (eGFR) beyond 30 d following PN and RN, separately.Design, setting, and participants
In this retrospective cohort study, patients who underwent RN or PN for a single nonmetastatic renal tumor between 1997 and 2014 at our institution were identified. Exclusion criteria were venous tumor thrombus and preoperative eGFR <15 ml/min/1.73 m2.Intervention
RN and PN.Outcome measurements and statistical analysis
Hierarchical generalized linear mixed-effect models with backward selection of candidate preoperative features were used to predict long-term eGFR following RN and PN, separately. Predictive ability was summarized using marginal , which ranges from 0 to 1, with higher values indicating increased predictive ability.Results and limitations
The analysis included 1152 patients (13 206 eGFR observations) who underwent RN and 1920 patients (18 652 eGFR observations) who underwent PN, with mean preoperative eGFRs of 66 ml/min/1.73 m2 (standard deviation [SD] = 18) and 72 ml/min/1.73 m2 (SD = 20), respectively. The model to predict eGFR after RN included age, diabetes, preoperative eGFR, preoperative proteinuria, tumor size, time from surgery, and an interaction between time from surgery and age (marginal ). The model to predict eGFR after PN included age, presence of a solitary kidney, diabetes, hypertension, preoperative eGFR, preoperative proteinuria, surgical approach, time from surgery, and interaction terms between time from surgery and age, diabetes, preoperative eGFR, and preoperative proteinuria (marginal ). Limitations include the lack of data on renal tumor complexity and the single-center design; generalizability needs to be confirmed in external cohorts.Conclusions
We developed preoperative tools to predict renal function outcomes following RN and PN. Pending validation, these tools should be helpful for patient counseling and clinical decision-making.Patient summary
We developed models to predict kidney function outcomes after partial and radical nephrectomy based on preoperative features. This should help clinicians during patient counseling and decision-making in the management of kidney tumors. 相似文献3.
Infection with an extended-spectrum beta-lactamase-producing strain of Serratia marcescens following tongue reconstruction 下载免费PDF全文
Dhawan B Bonnet R Shukla NK Mathur P Das BK Kapil A 《Journal of clinical microbiology》2003,41(5):2233-2234
We report a case of postsurgical wound infection of polymicrobial etiology caused by Serratia marcescens and Pseudomonas aeruginosa following the use of a radial forearm free flap for oncological tongue reconstruction. S. marcescens was a producer of SHV-12 extended-spectrum beta-lactamase (ESBL). This is the first report from India of this ESBL. S. marcescens and P. aeruginosa were resistant to the empirical perioperative antibiotics administered. Delay in the recognition of the type of infection and in the institution of appropriate therapy resulted in total loss of the free flap. 相似文献
4.
Andrew Daly Steven McAfee Bimal Dey Christine Colby Leah Schulte Beow Yeap Robert Sackstein Nancy J Tarbell David Sachs Megan Sykes Thomas R Spitzer 《Biology of blood and marrow transplantation》2003,9(6):373-382
Infections are a common complication of allogeneic bone marrow transplantation and the leading cause of transplantation-related mortality. It had been hypothesized that transplantation following nonmyeloablative preparative regimens would result in fewer infections by causing less mucosal injury, less graft-versus-host disease, and allowing earlier immune reconstitution. We have retrospectively reviewed the infectious complications of 65 consecutive patients with advanced hematologic malignancies who underwent bone marrow transplantation using a novel preparative regimen consisting of cyclophosphamide, thymic irradiation, and in vivo T-cell depletion. Cytomegalovirus (CMV) infection occurred in 52% of cases in which the donor or recipient had evidence of prior CMV exposure. Using a strategy of preemptive therapy and secondary prophylaxis with ganciclovir, no CMV disease occurred. Infections with gram-positive bacteria predominated over the first 100 days after bone marrow transplantation. Thereafter, the relative proportion of gram-negative infections increased without a significant increase in episodes of neutropenia. The rate of bacterial infections was not influenced by relapse of the underlying malignancy. Seven patients developed infections with Aspergillus species, which was the most common infectious cause of death in these patients. Infections with viruses other than CMV (n=10) and with protozoan organisms (n=2) also occurred. The use of HLA-mismatched donors, the occurrence of grade II-IV acute graft-versus-host disease, and treatment with corticosteroids did not influence the risk of CMV or bacterial or fungal infections in patients who underwent transplantation following this preparative regimen. Overall, the incidence and spectrum of infections in this series was similar to the reported incidence of infections following conventional myeloablative allogeneic stem cell transplantation. We conclude that a quantitative T-cell deficiency in these extensively T-cell depleted patients may be a risk factor for infection, even in the absence of graft-versus-host disease. 相似文献
5.
Nigel A. Cunliffe Bimal K. Das Madhumati Ramachandran Maharaj K. Bhan Roger I. Glass Jon R. Gentsch 《Virus genes》1997,15(1):39-44
We have sequenced the genes encoding the inner capsid protein VP6 and the nonstructural proteins NSP1 and NSP4 of the Indian
neonatal serotype P8[11]G9 human/bovine reassortant candidate vaccine rotavirus strain 116E. These three genes share a high
degree of sequence and deduced amino acid homology with human prototype strain Wa. Our results confirm and extend those of
previous RNA-RNA hybridization studies which suggested that these genes are of human origin, and will facilitate examination
of the host immune response to 116E induced by natural infection and vaccination.
This revised version was published online in July 2006 with corrections to the Cover Date. 相似文献
6.
ObjectiveThere is no information available on the prevalence of type 2 diabetes from rural population of Haryana. Therefore, a study was conducted to find out the prevalence rate and risk factors associated with type 2 diabetes.MethodsA retrospective study and prospective study was done in OPD of M M Institute of Medical Science and Research.ResultsAmong the hospital based patients the overall prevalence of type 2 diabetes was 4.70%. The prevalence was more number in females than males, respectively. Waist circumference, waist hip ratio, systolic blood pressure and fasting blood glucose was statistically significant among type 2 diabetes patients than normal controls. Multivariate logistic regression analyses revealed that the risk of type 2 diabetes mellitus was significantly associated with body mass index and fasting blood glucose.ConclusionsThis study showed that the prevalence of type 2 diabetes mellitus in rural population was low compared to previous studies on urban population of Haryana. Prevalence is influenced by body mass index and fasting blood glucose. 相似文献
7.
8.
Usaid K. Allahwala John C. Murphy Gregory I.C. Nelson Ravinay Bhindi 《Cardiovascular Revascularization Medicine》2013,14(4):213-217
PurposeThe ‘smoker's paradox’ refers to the observation of favorable prognosis in current smokers following an acute myocardial infarction (AMI). Initial positive findings were in the era of fibrinolysis, with more contemporary studies finding conflicting results. We sought to determine the presence of a ‘smoker's paradox’ in a cohort of ST Elevation Myocardial Infarction (STEMI) patients identified via field triage, treated with primary percutaneous coronary intervention (pPCI).MethodsThis was a single center retrospective cohort study identifying consecutive STEMI patients presenting for pPCI via field triage. The primary end points were all cause mortality, major adverse cardiac events (MACE), major bleeding, in-hospital cardiac arrest and length of stay (LOS).ResultsA total of 382 patients were included in the study. Current smokers were more likely to be younger (p < 0.00001), male (p < 0.001) and have fewer comorbidities, including renal impairment (p < 0.01) and a history of AMI (p < 0.05). Current smokers also had a shorter ischemic time (p < 0.05), were less likely to have collateral circulation (p < 0.05), and more likely to have signs of pulmonary edema at presentation (p < 0.05). There was no difference between smoking groups and all cause mortality (p = 0.67), MACE (p = 0.49), major bleeding (p = 0.49) or in-hospital cardiac arrest (p = 0.43). Current smokers had a shorter LOS (p < 0.05). In multivariate analysis smoking status did not correlate with primary outcomes.ConclusionThe ‘smoker's paradox’ does not appear to be relevant among STEMI patients undergoing pPCI, identified via field triage. The previously documented ‘smoker's paradox’ may have been an indication of patient characteristics and the historical treatment of STEMI with thrombolysis. Further studies with larger numbers may be warranted. 相似文献
9.
Kannan BR Sivasankaran S Tharakan JA Titus T Ajith Kumar VK Francis B Krishnamoorthy KM Harikrishnan S Padmakumar R Nair K 《Indian heart journal》2003,55(2):161-166
BACKGROUND: There is a paucity of data regarding the long-term outcome of patients operated for ventricular septal defect with severe pulmonary arterial hypertension and elevated pulmonary vascular resistance. METHODS AND RESULTS: We evaluated the long-term follow-up results of a selected cohort of patients with nonrestrictive ventricular septal defect and elevated pulmonary vascular resistance (>6 Wood units). Thirty-eight patients, median age 7.5 years (range 6 months-27 years), with nonrestrictive ventricular septal defect with severe pulmonary hypertension were operated between 1985 and 1996 at our institute. Preoperative pulmonary vascular resistance, ratio of pulmonary blood flow to systemic blood flow, and ratio of pulmonary vascular resistance to systemic vascular resistance were 7.63+/-1.8 Wood units, 1.9+/-0.48, and 0.41+/-0.12, respectively. The majority (68.4%) had perimembranous ventricular septal defect. Thirty patients (79%) had a good outcome and were asymptomatic at a mean follow-up of 8.7 years, with significant reduction in pulmonary artery pressures. Eight patients (21%) had a poor outcome, which included 5 immediate postoperative deaths, 1 late death and 2 surviving patients with persistent severe pulmonary arterial hypertension. There was no significant difference regarding hemodynamic parameters at baseline between those who had a good outcome and those who did not. Eleven patients with a preoperative pulmonary blood flow to systemic blood flow ratio of <2:1. who had a good outcome following surgery, underwent repeat catheterization at follow-up. There was a significant reduction in their mean pulmonary vascular resistance (8.03+/-1.4 v. 4.16+/-1.6 Wood units, p=0.001) and pulmonary vascular resistance to systemic vascular resistance ratio (0.41+/-0.12 v. 0.19+/-0.06, p=0.05). CONCLUSIONS: The late results of surgery on this selected group of patients with nonrestrictive ventricular septal defect with high pulmonary vascular resistance are encouraging. Operative correction of the ventricular septal defect should be actively considered in all children presenting with nonrestrictive ventricular septal defect with a significant left-to-right shunt, despite moderately elevated pulmonary vascular resistance. Even among older patients with ventricular septal defect and moderately elevated pulmonary vascular resistance, there is a specific group that does well after operation. 相似文献
10.
Although fiberoptic colonoscopy has gained wide popularity
as a diagnostic and therapeutic tool, there remains an
inherent complication rate following colonoscopic evaluation.
Endoscopically induced bowel perforation and uncontrolled
bleeding often necessitate immediate surgical intervention.
Another often-unrecognized complication is the
introduction of air into the vertebral venous system. A case
of vertebral venous air embolism after routine diagnostic
colonoscopy is reported with a review of current literature. 相似文献