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Title : Importance of Invasive Diagnostic Techniques in the Early Detection of Pulmonary Mucormycosis in Diabetic Patients: A Case Series
Name : Dr. Rajwinder Kaur
University : Geetanjali Medical College & Hospital, Udaipur, Rajasthan
Country : India
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Background: Pulmonary mucormycosis is an aggressive and potentially fatal angio-invasive fungal infection predominantly affecting immunocompromised individuals, especially those with uncontrolled diabetes mellitus. Early diagnosis remains challenging due to nonspecific clinical and radiological features, often resulting in delayed treatment and high mortality rates.
Objective: To highlight the importance of invasive diagnostic techniques in the early and definitive diagnosis of pulmonary mucormycosis in diabetic patients.
Methods: This case series describes five patients with uncontrolled diabetes mellitus who presented with severe respiratory symptoms and radiological features suggestive of pulmonary infection. Initial sputum microscopy and cultures were inconclusive in most cases. All patients underwent invasive diagnostic procedures including bronchoscopy, transbronchial lung biopsy, bronchoalveolar lavage, or thoracoscopy. Histopathological examination confirmed the diagnosis by demonstrating broad, aseptate, irregularly branching fungal hyphae consistent with Mucorales species.
Results: All five patients exhibited severe clinicoradiological disease, including cavitary lesions, ground-glass opacities, pleural effusion, and airway obstruction. Noninvasive diagnostic methods failed to establish the diagnosis in the majority of cases. Invasive modalities enabled early histopathological confirmation, facilitating prompt initiation of antifungal therapy with amphotericin B and management of underlying risk factors. Early diagnosis and aggressive treatment contributed to improved clinical outcomes.
Conclusion: Pulmonary mucormycosis in diabetic patients requires a high index of suspicion. Invasive diagnostic techniques play a crucial role in timely confirmation when noninvasive methods are inconclusive. Early histopathological diagnosis combined with prompt antifungal therapy significantly improves patient outcomes in this life-threatening infection.
Keywords: Pulmonary mucormycosis, Diabetes mellitus, Bronchoscopy, Thoracoscopy, Amphotericin B, Invasive diagnosis.
Title : Comparison of Genotoxic and Cytotoxic Effects of Single-Walled and Multi-walled Carbon Nanotubes on Chlorella Vulgaris
Name : Atena Sheibani nia
University : Islamic Azad University
Country : Iran
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Title : Immunohistochemical Characterisation of Dopaminergic and Cholinergic Alterations in the Prefrontal Cortex and Hippocampus of MPTP-Treated Marmosets
Name : Sanaa Khosla
University : King’s College London
Country : United kingdom
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Title : Identification and Evaluation of Blood Transcriptional Biomarker for Tuberculosis Screening
Name : Qian Gao
University : Fudan University
Country : China
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Title : Failed Endovascular Abdominal Aortic Aneurysm Repair due to Mycobacterium Bovis Infection Following Intravesical Bacillus Calmette-Guérin Therapy
Name : Toshifumi Kudo
University : Medical and Dental University
Country : Japan
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Title : Multidrug-Resistant Staphylococcus capitis: An Emerging Challenge in Clinical Settings Found in Adult Patients in Saudi Arabia
Name : Nawal Sulaiman Alshammari
University : University of Sheffield
Country : Saudi Arabia
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Title : Antimicrobial peptides from house fly
Name : Yao Liu
University : College of Health and Medicine, University of Tasmania
Country : Australia
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Title : The role of genetic polymorphisms of interleukin-1 (IL-1R1 and IL-1RN) in primary knee osteoarthritis in Indonesia
Name : Imelda Lumban Gaol
University : Nicolaas Institute of Constructive Orthopaedic Research & Education Foundation for Arthroplasty & Sports Medicine at Medistra Hospital
Country : Indonesia
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Title : Bacillus velezensis DSM 33864 reduces Clostridioides difficile colonization without disturbing commensal gut microbiota composition
Name : Ida Søgaard Larsen
University : Novozymes A/S, Bagsværd
Country : Denmark
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Up to 25% of the US population harbor Clostridioides difficile in the gut. Following antibiotic disruption of the gut microbiota, C. difficile can act as an opportunistic pathogen and induce potentially lethal infections. Consequently, reducing the colonization of C. difficile in at-risk populations is warranted, prompting us to identify and characterize a probiotic candidate specifically targeting C. difficile colonization. We identified Bacillus velezensis DSM 33864 as a promising strain to reduce C. difficile levels in vitro. We further investigated the effects of B. velezensis DSM 33864 in an assay including human fecal medium and in healthy or clindamycin-treated mouse models of C. difficile colonization. The addition of B. velezensis DSM 33864 to human fecal samples was shown to reduce the colonization of C. difficile in vitro. This was supported in vivo where orally administered B. velezensis DSM 33864 spores reduced C. difficile levels in clindamycin-treated mice. The commensal microbiota composition or post-antibiotic reconstitution was not impacted by B. velezensis DSM 33864 in human fecal samples, short-, or long-term administration in mice. In conclusion, oral administration of B. velezensis DSM 33864 specifically reduced C. difficile colonization in vitro and in vivo without adversely impacting the commensal gut microbiota composition.
Title : Lack of Association between YEASTONE Antifungal Susceptibility of Cryptococcus Meningitis Cerebrospinal Fluid Isolates and Risk Factors for Poor Prognosis
Name : Jeng-How Yang
University : New Taipei Municipal TuCheng Hospital
Country : Taiwan
Download AbstractBackground: Cryptococcal meningitis (CM) is associated with high mortality. The relation between antifungal susceptibility and treatment outcomes is not well characterized. There is paucity of surveillance data of cerebrospinal fluid (CSF) isolates of cryptococcus investigated with YEASTONE colorimetric broth microdilution susceptibility testing.
Methods: This was a retrospective study of laboratory-confirmed CM patients at a single-center between 2010 and 2016. Antifungal susceptibility of CSF isolates was determined by YEASTONE colorimetric broth microdilution. Clinical parameters, CSF laboratory indices, and antifungal susceptibility results were analyzed to identify risk factors for mortality.
Results: There were 53 isolates. High rates of resistance to fluconazole and flucytosine were observed in this cohort. Voriconazole showed the lowest MIC (0.06 µg/mL) and lowest rate of resistance (3.8%). There was no significant correlation between antifungal susceptibility and mortality. On univariate analysis, hematological malignancy, concurrent cryptococcemia, high Sequential Organ Failure Assessment (SOFA) score, low Glasgow coma scale (GCS) score, low CSF glucose level, high CSF cryptococcal antigen titer, and high serum cryptococcal antigen burden were associated with mortality. On multivariate analysis, meningitis with concurrent cryptococcemia, GCS score, and high CSF cryptococcus burden, were independent predictors of poor prognosis.
Conclusion: Concomitant cryptococcemia, low CSF glucose level, high CSF and serum cryptococcus antigen burden were risk factors for mortality. CM patients with fluconazole MIC ≥64 µg/mL showed extremely high mortality. However, both early and late mortality rates were not significantly different between CM wild type and non-wild type species.
Title : Pituitary Abscess Causing Panhypopituitarism in a Patient with Neurobrucellosis: Case Report
Name : Gustavo De la Peña-Sosa
University : Salvador Zubirán National Institute of Medical Sciences and Nutrition.
Country : Mexico
Download AbstractBackground: pituitary abscess is a rare but potentially life-threatening disease that could lead to panhypopituitarism. It is important to suspect the diagnosis, especially in regions of the world with endemic infectious diseases.
Clinical Case: a 55-year, farmer, with a history of consumption of unpasteurized dairy products, began in February 2023 with headache, impaired consciousness and fever. Initial tests were consistent with neuroinfection: lumbar puncture with cerebrospinal fluid (CSF) with elevated proteins (>200 mg/dL, n <45 mg/dL), decreased glucose (14 mg/dL with a serum glucose of 76 mg/dl), pleocytosis (800 mm3, n <5 mm3). Head CT-scan did not report alterations. Treatment with ceftriaxone, vancomycin, ampicillin and acyclovir was started due to diagnosis of acute meningitis. Later Brain MRI was performed showing ventriculitis; the pituitary gland was heterogeneous with the presence of an 8x8mm abscess. Pituitary axis hormones were evaluated, showing results compatible with panhypopituitarism with central hypothyroidism (normal serum TSH 1.05 mIU/L (n 0.3-5 mIU/L), decreased free T4 0.57 ng/dL (n 0.63-1.34 ng/dL), decreased total T3 0.47 ng/mL (n 0.64-1.81 ng/mL)), central hypocortisolism (decreased morning cortisol levels 5.72 mcg/dL (n 6.7-22.6 mcg/dL) and ACTH 20 pg/mL (n 10-50 pg/ml)), central hypogonadism (decreased LH <0.20 mUI/mL (n 1.24-862 mUI/mL), decreased FSH 0.37 mUI/mL (n 1.27-19.26 mUI/mL), decreased testosterone 0.24 ng/mL (n 1.75-7.81 ng/mL)), growth hormone deficiency (decreased IGF-1 9.99 ng/mL (n 61-206 ng/mL)). Hormone replacement treatment with hydrocortisone and levothyroxine was started. Due to the epidemiological background, Rose Bengal test for Brucella spp. was performed, with positive results (n negative) and 2-mercaptoethanol Brucella agglutination test was also positive >1:20 (n <1:20). Diagnosis of neurobrucellosis was made and treatment with doxycycline, rifampin and ceftriaxone was started. Neurosurgery service suggested conservative management with antibiotics. Patient showed improvement in his
neurological status and infectious symptoms disappeared. Subsequent pituitary MRI showed pituitary intraglandular abscess with a 15% decrease. The patient was discharged six weeks later with prednisone, levothyroxine, somatropin and testosterone, as well as doxycycline and rifampin for another 4 months.
Conclusion: Pituitary abscess should be considered in a differential diagnosis of patients with neuro infection symptoms, panhypopituitarism and heterogenous image in the MRI. Opportune medical management may result in a lower mortality and a higher recovery of pituitary hormone function.
Title : Cyclotides from Cameroonian pharmacopeia: Isolation, Synthesis and antimicrobial activities
Name : Ndogo Eteme Olivier
University : University of Yaoundé I
Country : Cameroon
Download AbstractTraditional medicine and the use of medicinal plants are well established in the African health system. For example, Violaceae plants are used for antimicrobial or anti-inflammatory applications in traditional medicine. This study describes the phytochemical analysis and bioactivity screening of four species of the purple Allexis tribe found in Cameroon. Allexis cauliflora, Allexis obanensis, Allexis batangae and Allexis zygomorpha were assessed for the expression of circular peptides (cyclotides) by mass spectrometry. The unique cystine-rich cyclic motif was identified in several peptides from all four species. Knowing that members of this family of peptides are endowed with antimicrobial properties, the plant extracts and two cyclotides (Alca1 and Alca2) newly isolated and described and synthesized as well as their analogues were evaluated for antibacterial inhibition. These macrocycle peptides and plant extracts were tested against nine strains of microbes. The peptides were specific for Gram-positive Staphylococcus aureus with a minimum inhibition concentration of approximately 0.32 microM. Alca1 showed potent activity against Escherichia coli with a minimum inhibitory concentration of 0.82 microM. Both peptides were inactive against Candida albicans. These macrocycles are cytotoxic and lyse human red blood cells with a 40% lethal dose of 400 microM. Modification of the Arg residue in Alca1 with a keto aldehyde significantly reduced its activity against S. aureus, whereas blocking the Arg in Alca2 produced no significant effects. The two-disulfide variants and their scrambled disulfide isomers exhibited antimicrobial profiles and potency similar to their native peptides. However, in high-salt assays (100 mM NaCl), few of these macrocyclic peptides, native or analogues, retained their antimicrobial activity. These results show that macrocyclic peptides possess specific and potent salt-dependent antimicrobial activity and that their initial interactions with microbial surfaces can be electrostatic, an effect commonly observed in defensin antimicrobial peptides. Furthermore, their end-to-end ring structure with a cystine knot motif represents a molecular structure of antimicrobials and may provide a useful model for the design of new peptide antibiotics
Title : Bacterial Keratitis In A Tertiary Hospital In São Paulo: A 21-Year Review Of The Epidemiological, Laboratory, And Clinical Data
Name : Beatriz Avila Zaccaron
University : Private practice as Ophthalmologist in Criciúma
Country : Brazil
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Infectious keratitis is a sight-threatening condition that is usually an ocular emergency. The visual outcome depends on prompt and accurate clinical management as well as geographic and epidemiological awareness. We conducted a retrospective observational study to define the epidemiological and laboratory profile, as well as the clinical course of bacterial keratitis in a tertiary hospital in São Paulo over 21 years. Information about age, sex, predisposing factors, topical and surgical treatment, visual acuity, ulcers’ classification, bacterioscopy, culture, and antibiotic sensitivity tests were collected. This study included 160 patients. The mean age was 65,1 ± 18,4 years and risk factors were identified in 83,1% of the patients. Empirical topical fortified cephalosporin with an aminoglycoside or fourth-generation fluoroquinolone was curative for 66,2% of the cases. The mean treatment duration was 22,5 ± 9 days. The mean variation of visual acuity was -0,25 logMAR, p<0,001. Culture revealed 64% of Gram-positive bacteria. All Gram-positive bacteria were sensitive to cephalothin, vancomycin, and quinolones. All Gram-negative bacteria were sensitive to gentamicin, tobramycin, amikacin, and ciprofloxacin. These findings reinforce the importance of prompt empirical treatment of severe corneal ulcers with a fortified cephalosporin and aminoglycoside or a fourth-generation fluoroquinolone as there are equally effective. Collected data was insufficient to evaluate resistance of ocular infections over time in this population.
Title : High Activity of N-Acetylcysteine in Combination with Beta-Lactams against Carbapenem-Resistant Klebsiella pneumoniae and Acinetobacter baumannii
Name : Maria Teresa Mascellino
University : Sapienza University of Rome
Country : Italy
Download AbstractIntroduction and aim: Multi-drug resistant Gram-negative bacteria represent a big issue in the management of diseases. Aim of our study was to evaluate the in-vitro activity of N-acetil-cysteine (NAC) alone or in combination with a single antibiotic or more antibiotics.
Material and methods: Fifteen Acinetobacter baumannii (Ab) and 10 Klebsiella pneumoniae (Kp) both resistant to carbapenems isolated from different types of infections, were included. The antibacterial activity of NAC and of the single antibiotics was tested by MIC and MBC measurements. Synergy testing of NAC in association with antibiotics was evaluated by qualitative methods (chekerboard FIC index) and quantitative tests (Time Killing Curves TKC, bactericidal activity). Morphological changes at scanning electron microscopy (SEM) were also examined.
Results: MICs 50/90 (μg/ml) for Ab and Kp were the following: MEM (meropenem) 128/512 and 256/1024, COL (colistin) 0.25/4 and 256/1024, RIF (rifampicin) 2/4 and 32/256 respectively, TIG (tigecycline) 0.5/1 for both, A/S (ampicillin/sulbactam) only for Ab 64/256 and ERT (ertapenem) only for Kp 1024/2048, NAC 2.5/5 and 5/5 mg/ml for Ab and Kp. As for the strains of Ab, NAC alone was bactericidal at 2.5 mg/ml (1/2 MIC) after 2 hrs up to the end of the experiment (24 hrs). The association of NAC resulted as being 100% synergic with MEM and A/S, 93% with RIF whereas was indifferent with COL and TIG. Following the TKC, NAC was able to completely restore the activity of MEM and A/S at concentrations easily achievable in the serum (8-16 μg/ml) which, alone, don’t result effective. As for the strains of Kp, a marked synergism between MEM at 8 μg/ml and NAC at 0.5 MIC was detected. The association COL (2 μg/ml)+0.5 MIC MER (512 μg/ml) was inactive whereas in the presence of NAC at sub-MIC and MEM at 8 μg/ml resulted as fully synergistic. TKC showed that the addition of NAC to MEM at concentrations without bactericidal effect alone, induced a fast and lasting bactericidal activity that persisted overtime. Morphological alterations at SEM (bacterium lengthening and formation of outer membrane vescicles) were strongly evident in the cultures with antibiotics + NAC or with NAC alone compared with the controls.
Conclusions: In summary, NAC not only seems to show a considerable activity against difficult-to-treat bacteria but results as being able to restore the efficacy of the antibiotics associated, at concentrations achievable in the serum.
Title : Anisakiosis & anisakidosis: between zoonosis and safety
Name : Andrea Paloma Zepeda
University : Autonomous University of the State of Hidalgo.
Country : Mexico
Download AbstractAbstract: The Anisakidae family nematodes are potentially zoonotic parasites; that infect a wide variety of aquatic species worldwide, with marine fish being the paratenic hosts. This family of eight genera could infest a wide variety of aquatic hosts during the development of their larval stages, mainly marine mammals, aquatic birds, such as pelicans, and freshwater fish, such crucian carp, these being the hosts where the life cycle is completed. These of clinical importance to human health are highlighted: Anisakis pegreffi, A. simplex sensu stricto, Contracaecum osculatum, Pseudoterranova azarazi, P. cattani, P. decipiens and P. krabbei. The geographical distribution of these genera and species is located mainly in the European continent, Asia, and South America, as well as in North and Central America and Australia. Its ability to adapt to the human organism has led to it being considered as a zoonotic agent. The disease in humans manifests nonspecifically, however the consumption of raw or semi-raw seafood is crucial information to link the presentation of the parasite with the disease. But what we need to know about the zoonosis, how do I know I have possible clinical presentation, and when I need to doubt if maybe I´m sick. We need to focus on knowledge education and clinical strategies.