Lung transplant in end-staged chronic obstructive pulmonary disease (COPD) patients: a concise review

Lung transplantation is commonly used for patients with end-stage lung disease. However, there is continuing debate on the optimal operation for patients with chronic obstructive pulmonary disease (COPD) and pulmonary fibrosis. Single-lung transplantation (SLT) provides equivalent short- and medium-term results compared with bilateral lung transplantation (BLT), but long-term survival appears slightly better in BLT recipients (especially in patients with COPD). The number of available organs for lung transplantation also influences the choice of operation. Recent developments suggest that the organ donor shortage is not as severe as previously thought, making BLT a possible alternative for more patients. Among the different complications, re-implantation edema, infection, rejection, and bronchial complications predominate. Chronic rejection, also called obliterative bronchiolitis syndrome, is a later complication which can be observed in about half of the patients. Improvement in graft survival depends greatly in improvement in prevention and management of complications. Despite such complications, graft survival in fibrosis patients is greater than spontaneous survival on the waiting list; idiopathic fibrosis is associated with the highest mortality on the waiting list. Patients should be referred early for the pre-transplantation work-up because individual prognosis is very difficult to predict.     

Familial exudative vitreoretinopathy (FEVR). Clinical profile and management

PURPOSE: To report our experience with the diagnosis and management of Familial Exudative Vitreoretinopathy (FEVR) in a predominantly older Indian population.. METHODS: This prospective interventional non-comparative case series included 38 patients of FEVR and their 23 family members. The diagnosis was established by clinical examination, fluorescein angiography and family screening. Prophylactic photocoagulation/cryotherapy or surgical treatment was done depending on the severity of the disease. RESULTS: The mean age of the patients was 23.6 years. The fundus/fluorescein angiographic findings in 116 eyes of our 61 patients (6 eyes phthisical) were as follows: forty eight (41.4%) eyes had only peripheral avascular zone, 8 (6.9%) eyes had peripheral new vessels, and 35 (30.1%) eyes had retinal detachments (RD)--10 (8.6%) exudative, 5 (4.3%) tractional and 20 (17.2%) rhegmatogenous. Prophylactic photocoagulation or cryotherapy was done in 34 eyes for retinal holes, local exudative detachments and bleeding new vessels. All the eyes retained stable vision over a mean follow-up of 16 months. Only 14 RDs were suitable for surgery: scleral buckling, vitrectomy or both. The reattachment rate was 85.7% (12 of 14) and the best-corrected visual acuity (BCVA) improved to 5/60 or better in 50% of these eyes over a 2-year follow-up. CONCLUSIONS: FEVR appears to be more common than reported. Timely diagnosis and intervention is essential in view of the lifelong progression of the disease, late exacerbations, frequent involvement of family members, and poor surgical results. A high index of suspicion, family screening and early prophylaxis are recommended to prevent avoidable blindness from this underdiagnosed disease.     

Solar-light-active mesoporous Cr–TiO2 for photodegradation of spent wash: an in-depth study using QTOF LC-MS

A dark-coloured effluent called “spent wash” is generated as an unwanted product in sugarcane-based alcohol distilleries. Most distilleries discharge this effluent into soil or water without any treatment, causing water and soil pollution. Herein, we report chromium-doped TiO₂ (Cr–TiO₂) as a photocatalyst for the degradation of spent wash colour under natural sunlight. Cr-doped TiO₂ nanoparticles were prepared using an aqueous titanium peroxide-based sol–gel method with titanium isopropoxide as the Ti precursor and chromium nitrate as the Cr precursor. To observe the effect of dopant on sol–gel behaviour and physicochemical properties, the Cr concentration was varied in the range 0.5–5 wt%. The crystallization temperature and time were optimized to obtain the required phase of Cr–TiO₂. The physicochemical characteristics of the Cr-doped TiO₂ catalyst were determined using X-ray diffraction, FE-SEM, FETEM, TG, XPS, the Brunauer–Emmett–Teller (BET) method, FT-IR, Raman, PL, ICP-MS, and UV visible spectroscopy. A shift in the absorption edge of TiO₂ by doping with chromium suggested an increase in visible light absorption due to a decrease in the effective band gap. The application potential of the Cr–TiO₂ catalyst was studied in the degradation of sugar-based alcohol distillery waste under natural sunlight, and the results were compared with those of undoped TiO₂ and Degussa P25 TiO₂. Degradation of the spent wash solution was monitored using UV-visible, gel permeation chromatography (GPC), and QTOF LC-MS. GPC and LC-MS showed significant changes in the molecular weight of spent wash colour-forming compounds due to the degradation reaction. QTOF LC-MS analysis suggested that acids, alcohols, glucosides, ketones, lipids, peptides, and metabolites were oxidized to low-molecular-weight counterparts. From the results, 5% Cr–TiO₂ showed the highest degradation rate among all Cr–TiO₂ samples, undoped TiO₂, and Degussa P25 TiO₂ under identical reaction conditions, with nearly 68–70% degradation achieved in 5 h.

A dark coloured effluent called “spent wash” is generated as an unwanted product in sugar based alcohol distillery which is degraded to less toxic compounds using visible light active Cr–TiO₂ photocatalyst under natural sunlight.     

Synthese und Antiserotoninaktivität einiger substituierter Tryptamine

Various N-substituted tryptamines are prepared by the oxalyl chloride method from 5-chloro- and 5-bromo-7-methylindole and 5-methyl-7-bromoindole. The antiserotonin activity of these substituted tryptamines on the isolated uterus of virgin rat is tested.     

Microtiter plate-based assay for inhibitors of penicillin-binding protein 2a from methicillin-resistant Staphylococcus aureus

Penicillin-binding protein 2a (PBP2a), the molecular determinant for high-level β-lactam resistance in methicillin-resistant Staphylococcus aureus (MRSA), is intrinsically resistant to most β-lactam antibiotics. The development and characterization of new inhibitors targeting PBP2a would benefit from an effective and convenient assay for inhibitor binding. This study was directed toward the development of a fluorescently detected β-lactam binding assay for PBP2a from MRSA. Biotinylated ampicillin and biotinylated cephalexin were tested as tagging reagents for fluorescence detection by using a streptavidin-horseradish peroxidase conjugate. Both bound surprisingly well to PBP2a, with binding constants of 1.6 ± 0.4 μM and 13.6 ± 0.8 μM, respectively. Two forms of the assay were developed, a one-step direct competition form of the assay and a two-step indirect competition form of the assay, and both forms of the assay gave comparable results. This assay was then used to characterize PBP2a binding to ceftobiprole, which gave results consistent with previous studies of ceftobiprole-PBP2a binding. This assay was also demonstrated for screening for PBP2a inhibitors by screening a set of 13 randomly selected β-lactams for PBP2a inhibition at 750 μM. Meropenem was observed to give substantial inhibition in this screen, and a follow-up titration experiment determined its apparent K(i) to be 480 ± 70 μM. The availability of convenient and sensitive microtiter-plate based assays for the screening and characterization of PBP2a inhibitors is expected to facilitate the discovery and development of new PBP2a inhibitors for use in combating the serious public health problem posed by MRSA.     

Role of Endobronchial Ultrasound Guided Transbronchial Needle Aspiration in the Diagnosis of Intraocular Inflammation in India – Our Experience

Purpose: To report our experience of using Endobronchial ultrasound-guided transbronchial lymph node aspiration (EBUS-TBNA) in assessing the etiology in uveitis from two tertiary eye-care centers in India.

Materials & Methods: Retrospective interventional case series.

Results: A total of 99 patients of uveitis who underwent EBUS-TBNA were included in the study. Mycobacterium tuberculosis (MTb) was detected on culture in 5 cases, 3 cases by polymerase chain reaction and caseating granulomas in 25 cases. None of these patients had any symptoms of systemic tuberculosis (TB). Biopsy was inconclusive in eight cases. Granulomatous inflammation was seen in 91 cases. In 51 cases, it was difficult to differentiate between sarcoidosis and TB on biopsy. None of the patients had any significant complications. There was a fair agreement between the biopsy diagnosis and the final ocular diagnosis.

Conclusions: In high TB endemic countries, procedures like EBUS-TBNA are useful in obtaining tissue diagnosis of TB when ocular diagnosis may be inconclusive due to paucity of ocular tissue.     

Synthesis and evaluation of a series of novel imidazolidinone analogues of 6-aminoflavone as anticancer and anti-inflammatory agents

The flavone moiety is a potential pharmacophore known for its diverse range of pharmacological activities. Aminoflavones have recently been the subject of considerable attention as lead molecules in several cancer research projects. Imidazolidinone heterocycles represent another biologically active scaffold with known cytotoxic properties. In an attempt to provide synergistic cytotoxic activity, these two moieties have been combined, and the resulting novel analogues evaluated for their anticancer and anti-inflammatory activities. The results revealed that the cytotoxicities of these compounds were fivefold greater than those of aminoflavone. DNA histograms obtained from cell cycle analysis in the presence of these compounds were apoptotic in their nature. Furthermore, the in vivo screening of these compounds using Ehrlich’s ascites tumour model showed an increase in life span, whereas an in vivo anti-inflammatory study resulted in the enhancement of the anti-inflammatory potential. The results therefore supported the hypothesis that there is a relationship between inflammation and cancer.