In vitro susceptibility of 15 strains of zygomycetes to nine antifungal agents as determined by the NCCLS M38-A microdilution method

The in vitro susceptibility of 15 strains of six genera of zygomycetes including Rhizopus oryzae (Rhizopus arrhizus), Rhizopus stolonifer, Mucor circinelloides (three), Absidia corymbifera (three), Rhizomucor pusillus (three), Cunninghamella bertholletiae (two), and Syncephalastrum racemosum (two) to nine antifungal agents were determined by the NCCLS M38-A broth microdilution method. Geometric means of the minimal inhibitory concentrations (MIC) were: amphotericin B 0.07 mg l(-1) (range 0.03-0.5 mg l(-1)), nystatin 0.83 mg l(-1) (range 0.25-4 mg l(-1)), itraconazole 0.59 mg l(-1) (range 0.03 to >8 mg l(-1)), voriconazole 6.50 mg l(-1) (range 2 to >8 mg l(-1)), ciclopiroxolamine 1.59 mg l(-1) (range 0.5-4 mg l(-1)), and amorolfine 9.19 mg l(-1) (range 1 to >16 mg l(-1)). All strains were resistant to 5-flucytosine, fluconazole (MIC >64 mg l(-1)) and caspofungin (MIC >16 mg l(-1)).     

Multispiral computed tomographic angiography of renal arteries of live potential renal donors: a review of 118 cases

OBJECTIVES: Review of the angiographic data of 118 live kidney donors was performed to assess the renal vessel anatomy; compare the findings with the perioperative findings using multislice spiral (MS) computed tomographic angiography (CTA) with the use of 50 mL of intravenous contrast; determine the sensitivity of this technique in the workup of live potential renal donors; and finally to discuss and compare the results of the present study with the reported results using single-slice spiral (SS) CTA, magnetic resonance angiography (MRA), and conventional angiography (CA). METHODS: Retrospective analysis of the angiographic data of 118 of prospective live kidney donors was performed. All donors underwent renal angiography on MSCTA scanning using 50 mL of intravenous contrast with 1.25-mm slice thickness followed by maximum intensity projection and virtual rendering techniques postprocessing algorithms. Analysis was made on imaging and intraoperatively for the number of renal arteries as well as their bifurcation pattern, location, vessel caliber, length, and venous anatomy, and these were then compared with each other. RESULTS: MSCTA showed clear delineation of the main renal arteries in all the donors with detailed vessel morphology. The study also revealed a 100% sensitivity in the detection of accessory renal vessels, which had an overall incidence of 26.67%, with the most common distribution in the perihilar region. CONCLUSIONS: The present study showed a 100% sensitivity and specificity in the visualization and detection of main and accessory renal vessels with the use of only 50 mL of intravenous contrast with similar results seen with CA which has so far been considered the "gold standard." The results on MSCTA were also better than those with the use of SSCTA and MRA in the workup of liver renal donors, with the above technique also proving to be more cost effective. The overall incidence of supernumerary vessels was the same as reported in the literature; however, a higher incidence of single aberrant vessels was seen on the right side, contrary to what has been suggested so far and was attributable to improved detection of accessory vessels less then 2 mm in diameter.     

Ungual and trans-ungual iontophoretic delivery of terbinafine for the treatment of onychomycosis

The application of iontophoresis was demonstrated in the nail drug delivery of terbinafine (TH) recently. This study explored a systematic assessment of this approach to enhance the drug delivery using a novel topical formulation, and the subsequent release of TH from the drug loaded nails. For the first time, a nail on-agar plate model was used to study the release of drug from the iontophoresis (0.5 mA/cm²) loaded nails. In addition, the activity of the drug released from the drug loaded nail plate was studied against Trichophyton rubrum. An increase in applied current density and current duration enhanced the transport of TH into and through the nail plate. In vitro release of drug from the iontophoretic loaded nails into agar plates exhibited 2-phase release pattern. The amount of drug released in both of the in vitro models was comparable, and the nails loaded using iontophoresis continued to release levels of TH > 2 orders of magnitude above the minimum inhibitory concentration over at least 52 days. Results indicate that iontophoresis enhances the delivery of terbinafine into and through the nail plate and suggest that the use of this treatment approach could result in a safe and more efficacious outcome with less frequent treatments. © 2009 Wiley-Liss, Inc. and the American Pharmacists Association J Pharm Sci 98:4130–4140, 2009     

The spatial attention network interacts with limbic and monoaminergic systems to modulate motivation-induced attention shifts

How does the human brain integrate information from multiple domains to guide spatial attention according to motivational needs? To address this question, we measured hemodynamic responses to central cues predicting locations of peripheral attentional targets (food or tool images) in a novel covert spatial attention paradigm. The motivational relevance of food-related attentional targets was experimentally manipulated via hunger and satiety. Amygdala, posterior cingulate, locus coeruleus, and substantia nigra showed selective sensitivity to food-related cues when hungry but not when satiated, an effect that did not generalize to tools. Posterior parietal cortex (PPC), including intraparietal sulcus, posterior cingulate, and the orbitofrontal cortex displayed correlations with the speed of attentional shifts that were sensitive not just to motivational state but also to the motivational value of the target. Stronger functional coupling between PPC and posterior cingulate occurred during attentional biasing toward motivationally relevant food targets. These results reveal conjoint limbic and monoaminergic encoding of motivational salience in spatial attention. They emphasize the interactive role of posterior parietal and cingulate cortices in integrating motivational information with spatial attention, a process that is critical for selective allocation of attentional resources in an environment where target position and relevance can change rapidly.     

Randomized controlled trial comparing the Franseen needle with the Fork-tip needle for EUS-guided fine-needle biopsy

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Cataract surgical reach: Falling short to catch white cataracts!

Purpose:The aim of this study was to know proportion of white cataracts from among patients coming for cataract surgery, and to find causes delaying uptake of cataract surgery.Methods:A hospital-based, prospective study enrolled patients of senile cataract between April 2018 and March 2019. The proportion of white cataract was calculated and underlying causes delaying uptake of cataract surgery studied.Results:White cataracts constituted 13.5% of total 3634 senile cataract patients, with gender disparity disfavoring women. Bilateral white cataract was presentation in 39 (8%) patients and lens-related glaucoma in 24 (5%) patients. Pseudophakia in the other eye was single most common cause of delay.Conclusion:A large proportion of white cataracts suggest that penetration of cataract surgical services in not reaching to the most eligible individual.