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Arquivos Brasileiros de Cardiologia 2024
PubMed: 38477765
DOI: 10.36660/abc.20230834 -
European Spine Journal : Official... Jun 2021To review the literature, analyze and discuss diagnostic and treatment options for the Bowhunter Syndrome. A clinical case of idiopathic rotatory C1-C2 subluxation... (Review)
Review
PURPOSE
To review the literature, analyze and discuss diagnostic and treatment options for the Bowhunter Syndrome. A clinical case of idiopathic rotatory C1-C2 subluxation causing dynamic vertebral artery occlusion is presented.
METHODS
Literature review between 1960 and 2019, discussion of diagnostic methods and treatment options. Description of diagnostic and treatment methods in the aforementioned case.
RESULTS
We present a patient with dynamic left vertebral artery occlusion associated with idiopathic rotatory C1-C2 subluxation. A dynamic Angio-CT showed rotatory C1-C2 subluxation with significant flow reduction at the left vertebral artery at the exit of the C2 transverse foramen until the V3 segment when the head rotated towards the right. Due to clinical and radiological worsening in the following months, posterior C1-C2 arthrodesis was performed, with the disappearance of the symptoms. There are 193 cases reported with dynamic vertebral artery occlusion, but in only two, the etiology was primary rotational atlantoaxial instability. The most prevalent etiology was degenerative.
CONCLUSION
Rotatory vertebral artery occlusion is a rare condition presented mostly in adults, aged 50-70 years. Vertebrobasilar insufficiency is triggered by the rotation of the head to the contralateral side of the dominant vertebral artery. Dynamic subtraction angiography is considered the diagnostic gold-standard method, but dynamic Angio-CT scan, Angio-MRI, or Doppler ultrasonography are less invasive options. The treatment options are conservative or surgical. Endovascular surgery is another option in specific cases.
Topics: Adult; Humans; Joint Dislocations; Mucopolysaccharidosis II; Rotation; Vertebral Artery; Vertebrobasilar Insufficiency
PubMed: 33389200
DOI: 10.1007/s00586-020-06680-5 -
Biomedica : Revista Del Instituto... May 2020San Andrés and Providencia are Colombian islands in the Caribbean Sea. San Andrés has 68,283 inhabitants and has registered cases of leprosy in immigrants from...
San Andrés and Providencia are Colombian islands in the Caribbean Sea. San Andrés has 68,283 inhabitants and has registered cases of leprosy in immigrants from continental Colombia. Providencia has 5,037 inhabitants and historically health programs did not have records of the disease, but in 2009 two cases of multibacillary histoid leprosy were confirmed and, subsequently, another two, which represents a prevalence of 8 cases per 10,000 inhabitants and places the island as a hyperendemic site for leprosy. Initially, a 14-year-old girl with histoid leprosy was diagnosed and, exploring this case, her father was diagnosed with the same clinical form of leprosy. Recently, a new intrafamilial patient with multibacillary leprosy and an extrafamilial case of a girl with undetermined leprosy were detected. The objective of this study was to present to the scientific community and the public health officers these clinical cases and to draw the attention of the sanitary authorities on the necessity of establishing continuous programs of leprosy epidemiological surveillance on the island using the new tools available in the Programa de Control de la Lepra (Leprosy Control Program).
Topics: Adolescent; Colombia; Female; Humans; Leprosy; Male; Middle Aged
PubMed: 32463605
DOI: 10.7705/biomedica.4974 -
Microbiology Spectrum Aug 2022Although the prevalence of carbapenem-resistant Enterobacterales remains low in Japan, these bacteria are a growing problem worldwide, owing to their multidrug...
Although the prevalence of carbapenem-resistant Enterobacterales remains low in Japan, these bacteria are a growing problem worldwide, owing to their multidrug resistance phenotype. We isolated a multidrug-resistant Providencia rettgeri strain, NR1418, harboring a rare variant, , a novel variant, designated , and . This strain is resistant to β-lactams, amikacin, levofloxacin, and colistin. Genomic analysis revealed that NR1418 carries two plasmids, designated pNR1418-1 and pNR1418-2. The pNR1418-1 plasmid harbors , , and , while the pNR1418-2 plasmid harbors , which is located in a class 1 integron. Both plasmids exhibit high similarities with the plasmid of the isolate BML2526, which also harbors and was identified in the same region of Japan as NR1418 at a different point in time. This indicates the possibility of the emergence and evolution of IMP-70-producing and suggests that the plasmid of BML2526 may have occurred following recombination of the two plasmids harbored by NR1418. Further, and were found on unique plasmids, indicating that they likely evolved through mutations and recombination. Although Providencia rettgeri is an opportunistic pathogen, its intrinsic resistance to colistin and tigecycline makes the treatment of carbapenem-resistant challenging. We isolated a multidrug-resistant strain which harbored a rare variant, , a novel variant, , and from a urinary sample obtained in Osaka, Japan. We investigated its genetic structure and evaluated the evolution of the plasmids carrying these genes. We show that , , and are present on unique plasmids and that they have high similarities to the plasmid of another IMP-70-producing isolate that was identified as being from the same location. The evolution of plasmids through mutations and recombination may play a role in the development and spread of multidrug resistance.
Topics: Anti-Bacterial Agents; beta-Lactamases; Carbapenems; Colistin; Microbial Sensitivity Tests; Plasmids; Providencia
PubMed: 35862988
DOI: 10.1128/spectrum.01204-22 -
International Journal of Environmental... Jan 2021Ciclovía Recreativa is a program in which streets are closed off to automobiles so that people have a safe and inclusive space for recreation and for being physically...
Ciclovía Recreativa is a program in which streets are closed off to automobiles so that people have a safe and inclusive space for recreation and for being physically active. The study aims were: (1) to compare participant's spatial trajectories in four Ciclovía Recreativa programs in Latin America (Bogotá, Mexico City, Santiago de Cali, and Santiago de Chile) according to socioeconomic characteristics and urban segregation of these cities; and (2) to assess the relationship between participants' physical activity (PA) levels and sociodemographic characteristics. We harmonized data of cross-sectional studies including 3282 adults collected between 2015 and 2019. We found the highest mobility for recreation in Bogotá, followed closely by Santiago de Cali. In these two cities, the maximum SES (socioeconomic status) percentile differences between the neighborhood of origin and the neighborhoods visited as part of the Ciclovía use were 33.58 (-value < 0.001) and 30.38 (-value < 0.001), respectively, indicating that in these two cities, participants were more likely to visit higher or lower SES neighborhoods than their average SES-of-neighborhood origin. By contrast, participants from Mexico City and Santiago de Chile were more likely to stay in geographic units similar to their average SES-of-origin, having lower overall mobility during leisure time: maximum SES percentile difference 1.55 (-value < 0.001) and -0.91 (-value 0.001), respectively. PA levels of participants did not differ by sex or SES. Our results suggest that Ciclovía can be a socially inclusive program in highly unequal and segregated urban environments, which provides a space for PA whilefacilitat physical proximity, exposure to new communities and environments, and interactions between different socioeconomic groups.
Topics: Adult; Chile; Cities; Cross-Sectional Studies; Exercise; Humans; Latin America; Mexico; Residence Characteristics; Social Class; Social Inclusion
PubMed: 33466637
DOI: 10.3390/ijerph18020655 -
Foot and Ankle Clinics Dec 2020There is no consensus on whether the deltoid ligament must be repaired in ankle fractures. Recent studies have shown better early radiologic results when the deltoid... (Review)
Review
There is no consensus on whether the deltoid ligament must be repaired in ankle fractures. Recent studies have shown better early radiologic results when the deltoid ligament is repaired, but no differences in long term functional outcomes. However, there is evidence suggesting that patients with high fibular fractures or injuries with concomitant syndesmotic instability may benefit from repair. The authors recommend repairing the deltoid ligament complex in bimalleolar equivalent fractures associated with syndesmotic or gross multiligamentous instability as well as in heavier patients with greater mechanical requirements.
Topics: Ankle Fractures; Ankle Joint; Fracture Fixation, Internal; Humans; Ligaments; Ligaments, Articular; Treatment Outcome
PubMed: 33543718
DOI: 10.1016/j.fcl.2020.08.009 -
Communications Biology Apr 2022Bacterial homologous lysine and arginine decarboxylases play major roles in the acid stress response, physiology, antibiotic resistance and virulence. The Escherichia...
Bacterial homologous lysine and arginine decarboxylases play major roles in the acid stress response, physiology, antibiotic resistance and virulence. The Escherichia coli enzymes are considered as their archetypes. Whereas acid stress triggers polymerisation of the E. coli lysine decarboxylase LdcI, such behaviour has not been observed for the arginine decarboxylase Adc. Here we show that the Adc from a multidrug-resistant human pathogen Providencia stuartii massively polymerises into filaments whose cryo-EM structure reveals pronounced differences between Adc and LdcI assembly mechanisms. While the structural determinants of Adc polymerisation are conserved only in certain Providencia and Burkholderia species, acid stress-induced polymerisation of LdcI appears general for enterobacteria. Analysis of the expression, activity and oligomerisation of the P. stuartii Adc further highlights the distinct properties of this unusual protein and lays a platform for future investigation of the role of supramolecular assembly in the superfamily or arginine and lysine decarboxylases.
Topics: Carboxy-Lyases; Escherichia coli; Providencia
PubMed: 35383285
DOI: 10.1038/s42003-022-03276-1 -
Environmental Technology Jun 2024Diesel degradation and bacterial growth were investigated in soil, marine water, and freshwater ecosystems using IITG19, IITG20, and their mixed culture. Both bacteria...
Diesel degradation and bacterial growth were investigated in soil, marine water, and freshwater ecosystems using IITG19, IITG20, and their mixed culture. Both bacteria were found to be effective in all three ecosystems, with the best degradation occurring in freshwater. IITG19 showed higher degradation (59%, 62%, and 76%) than (31%, 57%, and 67%) in soil, marine water, and freshwater, respectively. Alkanes showed higher degradation than naphthenes and aromatics for both strains. The mixed culture showed higher diesel degradation efficiency than individual strains in all ecosystems. The overall degradation was similar in soil and marine water (66%), while freshwater showed the highest degradation of 81%. In the presence of the mixed culture, the degradation of alkanes was more than 90%. Bacterial growth was highest in freshwater and lowest in soil for both bacteria and the mixed culture. Metabolite analysis confirmed alcoholic degradation for alkanes and cyclo-alcoholic degradation for naphthenes. The degradation rate for mixed culture was higher than that of both the individual strains. The mixed culture had highest degradation rate constant in freshwater at 0.11 day followed by that in marine ecosystem at 0.078 day. The rate constant was lowest for soil ecosystem at 0.066 day Thus the mixed culture showed effectiveness in all three ecosystems, with its highest effectiveness observed in the freshwater ecosystem.
PubMed: 38837716
DOI: 10.1080/09593330.2024.2361171 -
Microbiology Spectrum Jun 2022The indiscriminate use and overuse of various antibiotics have caused the rapid emergence of antibiotic-resistant bacteria (ARB) in poultry products and the surrounding...
The indiscriminate use and overuse of various antibiotics have caused the rapid emergence of antibiotic-resistant bacteria (ARB) in poultry products and the surrounding environment, giving rise to global public health issues. This study aimed to determine the prevalence of multidrug-resistant (MDR) Gram-negative bacteria (GNB) found in the environment of poultry farms and to evaluate the risk of contamination in these farms based on multiple antibiotic resistance (MAR) index values. Soil and effluent samples were collected from 13 poultry farms. The VITEK 2 system was used for bacterial identification and susceptibility testing of the isolates. The identified Gram-negative isolates were Acinetobacter spp., spp., Enterobacter spp., Klebsiella pneumoniae, Proteus spp., spp., Pseudomonas spp., and Sphingomonas paucimobilis. The results showed that Enterobacter spp. spp., and spp. exhibited the highest MDR rates and MAR indices; 14% of K. pneumoniae isolates (3/21 isolates) were resistant to 13 antibiotics and found to be extended-spectrum β-lactamase (ESBL)-producing bacteria. As for the tested antibiotics, 96.6% of the isolates (28/29 isolates) demonstrated resistance to ampicillin, followed by ampicillin-sulbactam (55.9% [33/59 isolates]) and cefazolin (54.8% [57/104 isolates]). The high percentage of MDR bacteria and the presence of ESBL-producing K. pneumoniae strains suggested the presence of MDR genes from the poultry farm environment, which poses an alarming threat to the effectiveness of the available antibiotic medicines to treat infectious diseases. Therefore, the use of antibiotics should be regulated and controlled, while studies addressing One Health issues are vital for combating and preventing the development and spread of ARB. The occurrence and spread of ARB due to high demand in poultry industries are of great public health concern. The widespread emergence of antibiotic resistance, particularly MDR among bacterial pathogens, poses challenges in clinical treatment. Some pathogens are now virtually untreatable with current antibiotics. However, those pathogens were rarely explored in the environment. In alignment with the concept of One Health, it is imperative to study the rate of resistance in the environment, because this domain plays an important role in the dissemination of bacteria to humans, animals, and other environmental areas. Reliable data on the prevalence of MDR bacteria are crucial to curb the spread of bacterial pathogens that can cause antimicrobial-resistant infections.
Topics: Angiotensin Receptor Antagonists; Angiotensin-Converting Enzyme Inhibitors; Animals; Anti-Bacterial Agents; Bacteria; Drug Resistance, Multiple, Bacterial; Farms; Gram-Negative Bacteria; Klebsiella pneumoniae; Microbial Sensitivity Tests; Poultry; beta-Lactamases
PubMed: 35467407
DOI: 10.1128/spectrum.02694-21 -
BMC Complementary Medicine and Therapies Jul 2022The rise of multidrug-resistant (MDR) bacteria is a real public health problem worldwide and is responsible for the increase in hospital infections. Donella welwitschii...
BACKGROUND
The rise of multidrug-resistant (MDR) bacteria is a real public health problem worldwide and is responsible for the increase in hospital infections. Donella welwitschii is a liana or shrub belonging to the family Sapotaceae and traditionally used to cure coughs.
OBJECTIVE
This study was conducted with the objective to validate the medicinal properties of this plant, the aerial part was studied for its phytochemical composition using column and PTLC chromatography and exploring its antibacterial and antibiotic-modifying activity as well as those of its phytochemicals.
METHODS
The structures of the compounds were elucidated from their physical and spectroscopic data in conjunction with literature. The antibacterial activity of the isolated metabolites was performed toward a panel of MDR Gram negative and Gram-positive bacteria. The broth micro-dilution method was used to determine antibacterial activities, efflux pump effect using the efflux pump inhibitor (EPI) (phenylalanine-arginine-ß-naphthylamide (PAβN)), as well as the modulating activity of antibiotics. Monitoring the acidification of the bacterial growth medium was used to study the effects of the samples on the bacterial proton-ATPase pumps and cellular ATP production.
RESULTS
Eleven compounds were isolated including pentacyclic triterpenes, C-glucosyl benzophenones. With a MIC value < 10 μg/mL, diospyric acid (7) significantly inhibited the growth of Escherichia coli AG102, Enterobacter aerogenes ATCC13048, Klebsiella pneumoniae KP55, Providencia stuartii NEA16 and Staphylococcus aureus MRSA3. 28-hydroxy-β-amyrin (8) significantly impaired the growth of Enterobacter aerogenes EA27, Klebsiella pneumoniae ATCC11296 and Staphylococcus aureus MRSA6; and oleanolic acid (9) strongly impaired the growth of Escherichia coli AG 102, Enterobacter aerogenes EA27 and Providencia stuartii PS2636. Diospyric acid (7) and 28-hydroxy-β-amyrin (8) induced perturbation of H-ATPase pump and inhibition of the cellular ATP production. Moreover, at MIC/2 and MIC/4, compounds 7, 8, and 9 strongly improved the antibacterial activity of norfloxacin, ciprofloxacin and doxycycline with antibiotic-modulating factors ranging between 2 and 64.
CONCLUSION
The overall results of the current work demonstrate that diospyric acid (7), 28-hydroxy-β-amyrin (8) and oleanolic acid (9) are the major bioactive constituents of Donella welwitschia towards Gram-negative bacteria expressing MDR phenotypes.
Topics: Adenosine Triphosphate; Anti-Bacterial Agents; Escherichia coli; Microbial Sensitivity Tests; Oleanolic Acid; Phenotype; Phytochemicals; Plant Components, Aerial; Plant Extracts; Providencia; Sapotaceae
PubMed: 35858857
DOI: 10.1186/s12906-022-03673-3