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Abstract

Efflux pumps play an important role in the emergence of antibiotic-resistant Pseudomonas aeruginosa strains. The present study aimed to assess the expression of the MexAB-OprM, MexCD-OprJ, MexEF-OprN, and MexXY-OprM efflux pumps in carbapenem-resistant and multidrug-resistant (MDR) P. aeruginosa strains isolated from clinical specimens between June 2019 and January 2022 in Ardabil city. The presence of efflux pump-encoding genes, i.e. mexA, mexC, mexE, and mexY, was assessed using the polymerase chain reaction (PCR) technique in 48 carbapenem-resistant and MDR P. aeruginosa strains. Real-time reverse transcription PCR was employed to evaluate the expression levels of mexA, mexC, mexE, and mexY genes. All 48 carbapenem-resistant and MDR P. aeruginosa strains harbored efflux pump-encoding genes including mexA, mexC, mexE, and mexY according to the PCR results. Overexpression of the MexAB-OprM, MexCD-OprJ, MexEF-OprN, and MexXY-OprM efflux pumps was detected in 75% (n = 36), 83.3% (n = 40), 10.4% (n = 5) and 41.6% (n = 20) of the clinical isolates of P. aeruginosa, respectively. This study revealed that the presence and overexpression of efflux pumps are associated with the emergence of carbapenem-resistant and MDR P. aeruginosa strains. Therefore, research on efflux pump inhibitors of P. aeruginosa will be a worthwhile endeavor to increase the clinical efficiency of available antibiotics and prevent ensuing treatment failure.

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Hungarian Medical Journal
Authors:
Valentin Brodszky
,
Viktor Nagy
,
Csaba Farsang
,
Krisztián Kárpáti
, and
László Gulácsi

First-line antihypertensive treatment’s drugs have to be able to decrease the cardiovascular morbidity and mortality. This kind of efficacy of thiazide-type diuretics has been published earlier in several studies. The efficacy of indapamide was investigated in several studies, but there is no analysis which is including all of the indapamide-studies. Objective: We conducted a meta-analysis of all relevant randomized-controlled-trials with indapamide. Efficacy of indapamide was analyzed in different cardiovascular and safety outcomes. Methods: We searched the MEDLINE database 1995–2006 for indapamide-trials. Only double-blind, parallel-group design trials were involved. Both the fixed effect model and the random effect model were used for data synthesis, results were probed with Mantel–Hanzel test and inverse variance test. Results: Data were combined from 9 trials that included 10,108 patients. Indapamide treatment of 48 patients with a history of stroke prevents one stroke (NNT = 47.8 95% CI: 29.6–126.6). Data from 5 trials including 7,085 patients show that indapamide is superior to placebo in reducing blood pressure, the differences are: 7.28 mm Hg (95% CI: 6.37–8.19) in systolic blood pressure and 3.50 mm Hg (95% CI: 2.99–4.01) in diastolic blood pressure. Data from 5 trials including 2,856 patients show that indapamide is superior to active controls in reducing systolic blood pressure, the difference is significant: 1.30 mm Hg (95% CI: 0.28–2.31). The difference in diastolic blood pressure was not significant. Data of 505 patients show that indapamide reduced left ventricular mass index significantly more than enalapril 20 mg, the difference is 6.50 g/m 2 (95% CI: 0.81–12.19). Data of 6,206 patients show that the frequency of adverse drug reaction is similar in the indapamide and placebo groups (RR = 0.97 95% CI: 0.76–1.22). Conclusions: Indapamide is efficacious in the prevention of further stroke, reduces effectively the blood pressure and the left ventricular mass index. Indapamide treatment is well tolerated.

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Abstract

This study was conducted to evaluate the pharmacokinetics of cefquinome in camel calves after a single intramuscular injection in a dose of 2 mg/kg body weight (kg b. w.). Cefquinome concentrations were measured by ultra-high performance liquid chromatography–mass spectrometry (UPLC-MS/MS). A non-compartmental pharmacokinetic model was used to fit the time–concentration curve and estimate the pharmacokinetic parameters. The peak serum concentration (Cmax) was 28.4 μg/mL at the time of maximum concentration (Tmax) of 25 min. The elimination half-life (t1/2) was 17.4 h. The area under the concentration–time curve (AUC0–∞) was 103.7 μg/ml−1h and the mean residence time (MRT0–∞) was 21.3 h. In comparison with other animal species, the pharmacokinetics of cefquinome in Arabian camel calves showed faster absorption from the site of injection and slower elimination. Since cefquinome, as other beta-lactams, is a time-dependent antimicrobial agent, a single dose of 2 mg/kg b. w. might be sufficient against the most sensitive organisms in camel calves owing to its prolonged elimination phase. However, dose readjustment is required for cases needing concentrations above 2 µg/mL for 12 h or above 1 µg/mL for 24 h.

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Abstract

Objective

Engaging in practices of intimacy meant to develop and sustain intimacy can be beneficial for couples. Psychoactive substances such as 3,4-Methylenedioxymethamphetamine (MDMA) have shown to facilitate bonding within couples and it is hypothesised that classic psychedelics, due to their property to increase prosocial behaviours, can similarly promote interactional intimacy. This study explores shared experiences of altered states of consciousness within romantic couples and their impact on intimacy in relationships.

Participants

Twelve participants (six couples) between 19 and 29 years of age who had used psychedelics with their current partner were recruited.

Method

Qualitative data was gathered via simultaneous interviews with both members of a couple. The semi-structured interviews featured an in-depth exploration of multiple shared psychedelic experiences. Reflexive thematic analysis was employed to analyse the resulting transcripts.

Results

Three themes with subsequent subthemes were identified, portraying couples' experiences during psychedelic-induced altered states of consciousness: navigating anxiety (subthemes: novelty, preparation, shifting environment, and calming presence), reshaping practices (subthemes: excessive worrying, spirited discussions, and straight talking), and encountering bliss (subthemes: meeting the unexpected, the beauty around us, leaving the everyday behind, and breaking through).

Conclusions

Couples' experiences with classic psychedelics align with criteria for interactional intimacy (i.e., self-exposure, positive involvement, and shared understanding), but their distinct nature warrants a novel definition of psychedelic intimacy. The unique pair bonding during shared psychedelic experiences could be utilized by psychedelic-assisted couples therapy.

Open access
Interventional Medicine and Applied Science
Authors:
Kornanong Yuenyongchaiwat
,
Chusak Thanawattano
,
Sasipa Buranapuntalug
,
Khajonsak Pongpanit
, and
Patcharin Saengkrut

: Device-guided breathing in the home setting: Technology, performance and clinical outcomes . Biol Psychol 84 , 150 – 156 ( 2010 ) 10.1016/j.biopsycho.2010.02.013 12. Nicoll

Open access

Az alsó tápcsatornai endoszkópos ultrahangvizsgálat

Endoscopic ultrasound in the lower gastrointestinal tract

Orvosi Hetilap
Authors:
Anna Fábián
,
Renáta Bor
,
Zsófia Bősze
,
Tibor Tóth
,
Péter Bacsur
,
Anita Bálint
,
Klaudia Farkas
,
Tamás Resál
,
Mariann Rutka
,
Tamás Molnár
, and
Zoltán Szepes

Az endoszkópiát és az ultrahangtechnikát ötvöző, a tápcsatorna falának és a környező szerveknek és szöveteknek a vizualizálására minimálisan invazív módon alkalmas endoszkópos ultrahangvizsgálat az 1980-as évekbeli kifejlesztése óta jelentős technikai fejlesztéseken esett át. Ezáltal a vizsgálat indikációs köre folyamatosan bővül, így a diagnosztikus indikációk mellett már terápiás beavatkozásokra is lehetőséget biztosíthat. A rectumtumorok stádiummeghatározásában a legfrissebb ajánlások alapján a rectalis ultrahangvizsgálat – néhány speciális esettől eltekintve – elsősorban másodvonalbeli, kiegészítő modalitásként jön szóba a mágneses rezonanciás képalkotás mellett. Előretekintő echoendoszkópok és a munkacsatornán bevezethető ultrahangos miniszondák alkalmazásával a proximálisabb vastagbél területére is kiterjeszthető az endoszkópos ultrahangvizsgálat alkalmazása. A rectalis vizsgálat emellett a subepithelialis laesiók differenciáldiagnosztikájában, a rectalis varixok azonosításában, valamint a gyulladásos bélbetegségek és a perianalis szövődmények diagnosztikájában is fontos szerepet játszhat. Az eljárás diagnosztikus pontossága bizonyos esetekben ultrahangvezérelt mintavétellel növelhető. A rectalis ultrahangvizsgálat terápiás alkalmazási területei egyelőre inkább ígéretes lehetőségek, mintsem a bevett klinikai gyakorlat részei, a jövőben azonban várhatóan egyre nagyobb teret nyerhetnek. A jelen összefoglaló célja az alsó tápcsatornai ultrahangvizsgálattal kapcsolatos általános ismeretek bemutatása mellett a vizsgálat indikációs körének áttekintése, beleértve a diagnosztikus és a terápiás indikációkat is. Orv Hetil. 2023; 164(30): 1176–1186.

Open access

Abstract

Background

Preeclampsia is characterized by hypertension, dyslipidemia, and systemic inflammatory response. The aim of this study was to determine the level of serum level of soluble vascular cell adhesion molecule-1 (sVCAM-1) and high-sensitive C-reactive protein (hsCRP) in preeclampsia and to compare normal pregnant, mild preeclamptic, and severe preeclamptic women.

Methods

A cross-sectional study was conducted to determine the plasma concentrations of sVCAM-1 and hsCRP in peripheral blood obtained from normal pregnant (n=40), mild preeclamptic (n=37), and severe preeclamptic women (n=38). A concentration of soluble adhesion molecule was determined with enzymelinked immunosorbent assay. hsCRP was measured with immunoturbidometric.

Results

There was significant difference in the means serum hsCRP between normal pregnant women and mild preeclamptic women (P<0.05). Serum concentration of hsCRP and sVCAM-1 (ng/mL) were significantly higher in severe preeclampsia (P<0.05) than normal pregnancy. There were also significant differences in hsCRP and sVCAM-1 levels between mild and severe (P<0.05). There was no difference in the mean sVCAM-1 between normal pregnant and mild preeclamptic women.

Conclusion

We have determined the serum concentration of VCAM-1 and hsCRP in normal pregnancy and preeclampsia. sVCAM-1 is elevated in severe preeclampsia compared with normal pregnancy, and hsCRP is elevated in severe preeclampsia compared with mild preeclampsia and normal pregnancy.

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Abstract

Globally, the spread of carbapenem-resistant strains has limited treatment options for multidrug-resistant (MDR) Pseudomonas aeruginosa infections. This study aimed to determine the role of point mutations as well as the expression level of the oprD gene in the emergence of imipenem-resistant Paeruginosa strains isolated from patients referred to Ardabil hospitals. A total of 48 imipenem-resistant clinical isolates of P. aeruginosa collected between June 2019 and January 2022 were used in this study. Detection of the oprD gene and its amino acid alterations was performed using the polymerase chain reaction (PCR) and DNA sequencing techniques. The expression level of the oprD gene in imipenem-resistant strains was determined using the real-time quantitative reverse transcription PCR (RT-PCR) method. All imipenem-resistant P. aeruginosa strains were positive for the oprD gene based on the PCR results, and also five selected isolates indicated one or more amino acid alterations. Detected amino acid alterations in the OprD porin were Ala210Ile, Gln202Glu, Ala189Val, Ala186Pro, Leu170Phe, Leu127Val, Thr115Lys, and Ser103Thr. Based on the RT-PCR results, the oprD gene was downregulated in 79.1% of imipenem-resistant P. aeruginosa strains. However, 20.9% of strains showed overexpression of the oprD gene. Probably, resistance to imipenem in these strains is associated with the presence of carbapenemases, AmpC cephalosporinase, or efflux pumps. Owing to the high prevalence of imipenem-resistant P. aeruginosa strains due to various resistance mechanisms in Ardabil hospitals, the implementation of surveillance programs to reduce the spread of these resistant microorganisms along with rational selection and prescription of antibiotics is recommended.

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Abstract

Aino virus infection is responsible for epizootic and/or sporadic outbreaks of abortions, stillbirths and premature delivery among pregnant ruminants. The epizootiology of Aino virus infection is poorly defined in South Korea, therefore our aim was to assess its seroprevalence among sheep and goats. We also wanted to evaluate management and regional risk factors that might influence the frequency of infection. Between 2012 and 2013, 26 of 331 flocks (7.9%) and 139 of 915 heads (15.2%) were found serologically positive. In 2018, when samples were again collected in the same regions, 35 of 308 flocks (11.4%) and 89 of 735 heads (12.1%) showed serum-neutralising antibodies against Aino virus. Our results revealed that the age class and history of reproductive problems in the flocks are connected to an increased risk of being positive. The management risk factor attributes showed that preventive measures, such as the routine application of insecticide in farms, decreased the odds for seropositivity to Aino virus (OR = 0.453, P = 0.001). We observed a significant difference in the individual likelihood of being positive in the southern and western provinces with respect to that in the northern and eastern provinces, respectively (OR = 2.199, P < 0.001 and OR = 2.177, P < 0.001). The results of this study may serve as a basis for future epizootic studies on Aino virus infection in South Korea.

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