Candida tropicalis brain abscess in a neonate: An emerging nosocomial menace

Fungi are a relatively uncommon cause of brain abscess in neonates and early infancy. They are usually associated with predisposing factors like prematurity, low birth weight, use of broad-spectrum antibiotics, and prolonged stay in the intensive care unit. Candida tropicalis (C. tropicalis) is rapidly emerging as a nosocomial threat in the neonatal intensive care settings. This case report describes a neonate with C. tropicalis brain abscess who was diagnosed early and managed aggressively with a favorable outcome. Inadvertent use of intravenous antibiotics can have serious complications such as invasive fungal infection. Correct microbiological diagnosis is the key to successful treatment of deep-seated pyogenic infection. Fungal etiology should always be studied in relevant clinical settings.     

Patient Education and Engagement through Social Media

This review addresses the demographics of social media users and their relative health literacy. Means of overcoming health inequities via social media and the role of social media in patient education and engagement are explored. This review discusses forms of appropriate patient engagement, including the pitfalls of social media use.     

Potential and Prospects of Shikonin Production Enhancement in Medicinal Plants

Proceedings of the National Academy of Sciences, India Section B: Biological Sciences - Plants are a rich source of valuable chemicals that are used as herbal and modern medicines. Shikonin, a...     

Elimination of myeloma cells from bone marrow by using monoclonal antibodies and magnetic immunobeads

The efficacy of immunomagnetic beads to purge human myeloma cells from bone marrow ex vivo was evaluated. The optimal conditions for purging were studied first by using three myeloma cell lines: RPMI-8226, SKO- 007, and SKMM-2. Myeloma cells labeled with the vital fluorescent dye Hoechst 33342 were admixed with normal bone marrow cells, and two monoclonal antibodies reactive with the myeloma cells (PCA-1 and BL-3) were added alone or in combination with the cells. Magnetic beads coated with goat antimouse immunoglobulin G were then added, and the tumor cells to which beads were attached were separated from the mixture with a magnet. The efficacy of tumor cell removal was dependent on the bead-to-tumor ratio; a ratio of more than 500 was optimal in the presence of excess normal marrow cells. The combination of monoclonal antibodies PCA-1 and BL-3 increased the tumor cell removal as compared with either antibody alone. Two cycles of treatment were more effective than one cycle was. Under optimal conditions, 2.3 to 4 logs of tumor cells could be removed from the mixture containing 10% myeloma cells without a significant loss of normal hematopoietic progenitors as measured by CFU-GM, CFU-GEM, and BFU-E. When the efficacy of this procedure was tested on fresh bone marrow from patients with multiple myeloma (MM) by using the combination of PCA-1, BL-3, and J-5, 1.6 to 2.5 logs of tumor cells could be removed by one cycle of treatment, even from marrows containing less than 10% myeloma cells. These observations support the use of monoclonal antibody combinations and immunobeads as a reliable and nontoxic method to eliminate contaminating myeloma cells ex vivo in preparation for autologous bone marrow transplantation in patients with MM.     

Conditions for Using DNA Polymerase I as an RNA-Dependent DNA Polymerase

Conditions are described for using Escherichia coli DNA polymerase I for synthesizing complementary DNA copies of natural RNA molecules, which are suitable for use in hybridization experiments. The molar ratio of enzyme to template is critical; below a certain level, synthesis is not observed. Hybrids formed with the complementary DNA are of comparable specificity and stability to those formed with complementary DNAs synthesized by viral RNA-directed DNA polymerase. Synthesis of dA-dT polymers, a common occurrence with this enzyme, can be eliminated by including distamycin in the reaction mixture.     

Renal Denervation for Hypertension

Hypertension is the leading cause of mortality worldwide. Effective therapies are needed for resistant hypertension, a common condition characterized by inadequate blood pressure control despite 3 or more medications, which is associated with increased cardiovascular mortality. Percutaneous catheter-based renal denervation is a promising new treatment offering the potential to improve blood pressure control, reduce cardiovascular risk, and target end-organ damage in patients with resistant hypertension. Initial studies have demonstrated procedural safety and effectiveness in blood pressure reduction up to 2 years after procedure. Large randomized control trials are necessary and currently underway to define further the role of renal denervation and long-term consequences in the treatment of resistant hypertension.     

Sensitization,pathologic, and imaging findings comparing symptomatic and quiescent failed renal allografts

Late allograft failure (LAF) is a common cause of end stage renal disease. These patients face interrelated challenges regarding immunosuppression management, risk of graft intolerance syndrome (GIS), and sensitization. This retrospective study analyzes sensitization, pathology, imaging, and transfusion requirements in 33 LAFs presenting either with GIS (22) or grafts remaining quiescent (11). All patients underwent immunosuppression weaning to discontinuation at LAF. Profound increases in sensitization were noted for all groups and occurred in the GIS group prior to transplant nephrectomy (TxN). Patients with GIS experienced a major upswing in sensitization at, or before the time of their symptomatic presentation. For both GIS and quiescent grafts, sensitization appeared to be closely linked to immunosuppression withdrawal. Most transfusion naïve patients became highly sensitized. Fourteen patients in the GIS group underwent TxN which revealed grade II acute cellular rejection or worse, with grade 3 chronic active T‐cell‐mediated rejection. Blinded comparisons of computed tomography scan of GIS group revealed swollen allografts with fluid collections compared with the quiescent allografts (QAs), which were shrunken and atrophic. The renal volume on imaging and weight of explants nearly matched. Future studies should focus on interventions to avoid sensitization and GIS.     

The effect of X-irradiation on skeletal muscle regeneration in the adult rat

Muscle regeneration was induced by transplanting the extensor digitorum longus (EDL) muscle in adult rats to examine the effect of X-irradiation on muscle regeneration. The EDL muscles were removed, irradiated with X-rays to administer 650 R, 2,000 R or 10,000 R, and transplanted into the original animal and location. Muscles from non-irradiated control group and each irradiated group were analyzed morphologically at 4, 7, 14 and 30 days post-transplantation. The regeneration pattern in the non-irradiated and 650-R irradiated muscles was similar. A majority of myofibers underwent degeneration followed by regeneration from the precursor myosatellite cells. The myosatellite cells proliferated, differentiated into myoblasts and then fused to form myotubes and myofibers. Muscles exposed to 2,000 R underwent initial degeneration and myosatellite cell activation, however, considerably fewer myotubes regenerated in these muscles. In muscles exposed to 10,000 R, again myofiber degeneration and myosatellite cell activation was evident, but these cells remained undifferentiated and did not fuse to form myotubes. These results show a dose-dependent inhibition in muscle regeneration due to irradiation.