Multidrug resistance in Vibrio cholerae.
Explore the source record for details and available documents.
Anti-Bacterial Agents↗
Biomedical subjects
S Arora
Publications and source records attributed to S Arora.
Proline accumulates in plants exposed to UV radiation and protects them against UV induced peroxidation.
Proline accumulated in the shoots of seedlings of rice (Oryza sativa), mustard (Brassica juncea) and mung bean (Vigna radiata) exposed to UV radiations. The level of proline in the seedlings increased significantly with increase in UV exposure time. The production of malondialdehyde (an indice of lipid peroxidation) was also higher in the shoots of seedlings exposed to UV radiation as compared to controls, suggesting that UV radiations promote lipid peroxidation. The extent of UV radiation promoted enhancement in the levels of proline as well as that of malondialdehyde was higher in the seedlings of rice than those of mung bean or mustard. This lead us to believe that UV radiation induced proline accumulation protects plants against UV radiation promoted peroxidative processes. UV radiations also promoted peroxidation in linolenic acid micelles. The presence of proline along with linolenic acid micelles during UV exposure caused a considerable reduction in the production of malondialdehyde. This study, for the first time shows that plants exposed to UV radiations accumulate proline and proline can protect plant cells against UV radiation induced peroxidative processes.
Free Radical Scavengers↗
The influence of reduced dietary fat absorption induced by orlistat on the pharmacokinetics of digoxin in healthy volunteers.
To assess the influence of an orlistat-induced reduction in dietary fat absorption on the pharmacokinetics of digoxin, an open-label, placebo-controlled, randomized, two-way crossover study was performed in 12 healthy volunteers. Each subject received single 0.4-mg doses of digoxin (soft gelatin capsules) administered orally on the fourth day of orlistat (120 mg three times daily for 6 days) and placebo (three times daily for 6 days) treatment, separated by at least an 11-day washout period. Serial blood samples were collected before and at appropriate intervals after each digoxin dose to determine plasma concentrations of unchanged digoxin. The 90% confidence intervals for the ratio of geometric least-squares means (for Cmax, AUC0-48, AUC0-t, and AUC) and for the difference of arithmetic least-squares means (for tmax and lambda z) indicate that the pharmacokinetics of digoxin was not altered by treatment with orlistat. This results suggests that a approximately 30% reduction in dietary fat absorption will not change the efficacy of digoxin in cardiac patients.
Adolescent↗
Safety and efficacy of controlled-release mesalamine for maintenance of remission in ulcerative colitis. Pentasa UC Maintenance Study Group.
This 12-month, double-blind, placebo-controlled study randomized 205 ulcerative colitis patients in remission to placebo or controlled-release mesalamine at 4 g/day for 12 months. Patients were stratified to either pancolitis or left-sided disease, based on previous diagnosis. Maintenance of remission was defined as a sigmoidoscopic index of < 5, less than five stools per day, and the absence of rectal bleeding. A significantly greater number of patients maintained remission on mesalamine 4 g/day than on placebo at each of five study visits, following the first one-month visit (P < 0.05). The estimated 12-month remission rates for the mesalamine group were 64% (38% for placebo, P = 0.0004). Baseline subgroups (disease location, time since last flare of active disease, and previous response to oral/rectal steroids or sulfasalazine) did not influence remission rates. Treatment-related adverse events were rare. Controlled-release mesalamine is a safe and efficacious single agent for maintaining remission of ulcerative colitis.
Adult↗
Prophylactic colectomy or surveillance for chronic ulcerative colitis? A decision analysis.
BACKGROUND & AIMS: The treatment of patients with long-standing ulcerative colitis involving the entire colon is controversial. The aim of this study was to examine the effectiveness of surveillance colonoscopy or prophylactic colectomy on colon cancer mortality in patients with chronic ulcerative colitis. METHODS: Using decision analysis, computer cohort simulation of patients with ulcerative colitis was performed to evaluate 17 strategies including no colonoscopic surveillance, surveillance at varying intervals, and prophylactic proctocolectomy with ileal pouch-anal anastomosis. The model examined which biopsy results (low-grade dysplasia, high-grade dysplasia, or cancer) should lead to proctocolectomy and ileal pouch-anal anastomosis. Published data on the incidence of cancer with ulcerative colitis, the sensitivity and specificity of colonoscopy with biopsy, the risks of colonoscopy and surgery, and the prognosis with colon cancer were used. RESULTS: For a 30-year-old patient with pancolitis for 10 years, the model suggests that prophylactic colectomy would increase life expectancy by 2-10 months compared with surveillance and by 1.1-1.4 years compared with no surveillance. Surveillance would improve life expectancy by 7 months to 1.2 years compared with no surveillance. In sensitivity analysis, results were most affected by the cumulative incidence of cancer in patients with chronic ulcerative colitis. CONCLUSIONS: Either surveillance or prophylactic colectomy should increase life expectancy in patients with ulcerative colitis.
Adult↗
Non-invasive impedance analysis: a new non-invasive test for graft surveillance.
Detection of failing grafts with early reoperation is clearly associated with better long-term patency than intervention after graft failure. Duplex ultrasonography is more accurate than ankle:brachial index for graft surveillance, but is expensive, time consuming and technically demanding. Non-invasive estimation of graft impedance is now possible. The present study was undertaken to evaluate the utility of non-invasive impedance in detecting the failing vein graft. Sixty-nine grafts in 51 patients were followed over a period of 12 months (April 1992-March 1993). High risk infrainguinal arterial vein bypass patients were entered into a graft surveillance program. Ankle:brachial index, non-invasive impedance and duplex ultrasonography were performed upon discharge, 1 month after surgery and then at 3-monthly intervals. Non-invasive impedance was measured using a mean Doppler flow signal obtained from both upper and lower ends of the graft paired with the mean pulse volume recording obtained from the distal arterial bed. The mean pulse volume recording and flow signals were digitized by discrete Fourier transform and an impedance index generated. An impedance index > or = 0.5 was considered abnormal. Impedance results were compared with ankle:brachial index, duplex ultrasonography and angiography when appropriate, and detected 28 failing and five failed grafts. Non-invasive impedance achieved a sensitivity of 91% and a specificity of 94%. Similarly, duplex ultrasonography was 91% sensitive and 97% specific, while ankle:brachial index was 58% sensitive and 94% specific. Non-invasive impedance is a simple, inexpensive and effective test which detects the failing graft and is an appropriate first-line alternative to duplex ultrasonography for postoperative graft surveillance.
Adult↗
Nitric oxide activity in the human coronary circulation. Impact of risk factors for coronary atherosclerosis.
The bioavailability of nitric oxide (NO) in the human coronary circulation at rest and after acetylcholine (ACH)-induced vasodilation was investigated in 32 patients with angiographically normal coronary arteries. The effects of intracoronary L-NG monomethyl arginine (L-NMMA) were investigated at rest and after ACH, sodium nitroprusside, and adenosine. L-NMMA (64 mumol/min) increased resting coronary vascular resistance by 22% (P < 0.001), reduced distal epicardial coronary artery diameter by 12.6% (P < 0.001), and inhibited ACH-induced coronary epicardial and microvascular vasodilation. These effects were reversed with intracoronary L-arginine. L-NMMA did not inhibit dilation in response to sodium nitroprusside and adenosine. 23 patients were exposed to one or more coronary risk factors. The vasoconstrictor effect of L-NMMA on the epicardial and microvessels was greater in patients free of risk factors: Coronary vascular resistance was 36% higher in patients without risks, compared to 17% higher in patients with risks (P < 0.05). Both epicardial and microvascular dilator effects of ACH were greater in patients without risk factors, and the inhibition of these effects by L-NMMA was also greater in patients without risk factors. Thus: (a) NO contributes importantly to resting epicardial and coronary microvascular tone, (b) coronary vascular dilation in response to ACH is predominantly due to increased production of NO, and (c) despite the absence of angiographic evidence of atherosclerosis, exposure to coronary risk factors is associated with reduced resting and stimulated bioavailability of NO from the human coronary circulation.
Acetylcholine↗
Complications from enteroclysis tube insertion.
Explore the source record for details and available documents.
Aged↗
Cerebrospinal fluid C-reactive protein in meningitis.
Explore the source record for details and available documents.
Biomarkers↗
Ascitic fluid cholesterol in malignant and tubercular ascites.
Cholesterol was estimated in ascitic fluid of 44 patients (29 malignant and 15 tubercular). Mean ascitic cholesterol level was significantly higher in malignant ascites (89.52 mg/dl) as compared to tubercular ascites (35.07 mg/dl). At a cut off value of 54.5 mg/dl (mean in tubercular ascites + 2SD), the sensitivity, specificity, positive and negative predictive value and overall diagnostic accuracy for differentiating malignant from tubercular ascites was found to be 89.65%, 100%, 100%, 83.33% and 93.18% respectively. Ascitic fluid cholesterol estimation is a reliable and simple test for differentiating malignant ascites from tubercular ascites.
Adult↗
A study of infective aetiology of chronic diarrhoea in children in Amritsar.
Examination of 150 stool samples from children of less than 3 years of age of chronic diarrhoea showed the presence of various enteropathogens in 58.7% cases. Cryptosporidium in pure form, Entamoeba histolytica and Giardia lamblia were detected in 1.3%, 2% and in 4% cases respectively. In 1.3% children Candida albicans was isolated. The predominant bacterial isolate was enteropathogenic Escherichia coli (21.4%). Salmonella typhimurium, shigella and campylobacter were isolated in 8.6%, 4% and 0.7% children respectively.
Child, Preschool↗
Enterotoxigenic enteric bacteria causing secretory diarrhoea.
Two hundred and fifty enteric bacteria isolated from cases of secretory diarrhoea of all age groups were studied for their enterotoxigenicity and prevalence of drug resistance. The principal pathogens were Escherichia coli 44.4%, Vibrio cholerae 28.8%, Salmonella typhimurium 19.2% and Campylobacter jejuni 2.4%. 104 (42.6%) strains were enterotoxigenic; V. cholerae (100%), Escherichia coli (25.2%) and Non-E. coli enterobacteria (6.5%). While 89.3% and 100% Enterotoxigenic Escherichia coli and Salmonella typhimurium strains were multi drug resistant, 40% and 100% respectively showed transfer of R-plasmids to standard receipt strains. In V. cholerae multi drug resistance was observed in only 5.5% strains.
Adolescent↗
Predictive value of blood clotting tests in cardiac surgical patients.
This study prospectively evaluated numerous tests of clotting function in 897 consecutive adult cardiac surgical patients over 18 months. This included coronary operation, valve replacement, and reoperative patients. The tests included activated clotting time, activated partial thromboplastin time, prothrombin time, thrombin time, fibrinogen, fibrin/fibrinogen degradation products, platelet count, and Duke's earlobe bleeding time. Other variables such as age, sex, and cardiopulmonary bypass duration were included in the multivariate analysis. Statistically significant correlations were found between 16-hour mediastinal drainage and activated partial thromboplastin time, fibrinogen, activated clotting time, fibrin/fibrinogen degradation products, platelet count, and prothrombin time. Scatter plots indicate that these relationships, although statistically significant, had little predictive value and were largely significant as a result of the large number of patients in each group, which permitted weak correlations to reach statistical significance. The best multivariate model constructed could explain only 12% of the observed variation in postoperative blood loss. Because the predictive values of the tests are so low, it does not appear sensible to screen patients routinely using these clotting tests shortly after cardiopulmonary bypass.
Adult↗
Bacteriology of acute appendicitis with special reference to anaerobes.
Bacterial flora of 105 patients of acute appendicitis of which 101 showed acute inflammation and 4 a normal appendix, was studied. A total of 121 anaerobes and 149 aerobes were isolated with an average of 1.15 anaerobes and 1.41 aerobes per specimen. Mixed flora was found in 100 (95.2%) specimens. Bacteroides fragilis and Escherichia coli were the most predominant anaerobes and aerobes respectively and their combination was most frequently seen. There were no significant differences in the rate of isolation of B. fragilis between the perforated/non perforated and inflamed/normal appendices. Hundred percent anaerobes were sensitive to clindamycin and 93.38% to metronidazole.
Acute Disease↗
Presumptive identification & antibiotic susceptibility of group B Streptococci.
Three presumptive identification tests were conducted on 60 strains of beta haemolytic group B streptococci (GBS) & evaluated for their sensitivity as compared to the standard serological grouping. The GBS were further subjected to serotyping and antibiotic sensitivity testing. Hippurate was hydrolysed by 96.6%, the CAMP test was positive in 83.3% & pigment was produced by 95%. The commonest serotype was la (33.3%) followed by lb (30%). Hundred percent strains were sensitive to Penicillin, Ampicillin, Erythromycin & Cephlexin. 76.7% showed MIC of 50 ug/ml or more for Tetracycline & 66.7% were inhibited by 3.2 ug/ml or less of Gentamicin.
Anti-Bacterial Agents↗
A guide for surveillance of patients with Barrett's esophagus.
OBJECTIVE: Barrett's esophagus (columnar metaplasia of the distal esophagus due to chronic gastroesophageal reflux) affects nearly 700,000 people in the United States, and carries a risk of esophageal adenocarcinoma that is 30-125 times that of an age-matched population. Patients who develop high grade dysplasia are at greatest risk. Current recommendations are for endoscopic surveillance to detect dysplasia and to diagnose carcinoma while it is in an early and possibly treatable stage. In addition, some authorities recommend esophagectomy for high grade dysplasia, whereas others reserve esophagectomy only for those with cancer. There are no controlled trials demonstrating that surveillance increases life expectancy in patients with Barrett's esophagus. Furthermore, endoscopic surveillance of this large group with Barrett's esophagus may be costly, and associated with considerable morbidity. Therefore, our objective was to assess the effectiveness and cost-effectiveness of endoscopic surveillance in patients with Barrett's esophagus. METHODS: Design--Decision analysis using a computer cohort simulation (Markov). We examined 12 strategies: (A) no endoscopic surveillance. Esophagectomy is performed only if cancer is detected by biopsy. (B) no surveillance. Esophagectomy is performed if high grade dysplasia is detected by biopsy: (C1-C5) surveillance at intervals from 1 to 5 yr, with esophagectomy if cancer is diagnosed, and (D1-D5) surveillance at intervals from 1 to 5 yr with esophagectomy if high grade dysplasia is diagnosed. We measured life expectancy, quality-adjusted life expectancy, and incremental cost-effectiveness ratios for each strategy. Data Sources--Medline Search and bibliographies of retrieved articles; expert opinion when published data were not available. RESULTS AND CONCLUSIONS: Annual surveillance with esophagectomy for high grade dysplasia prevents cancer and is the preferred strategy, if only length of life (life expectancy) is considered. For those who consider both length and quality of life, endoscopy every 2-3 yr will provide the greatest quality-adjusted life expectancy. When costs are considered, endoscopy every 5 yr also increases life expectancy and has an incremental cost-effectiveness ratio similar to common medical practices. The cumulative incidence of cancer and the quality of life with an esophagectomy had the greatest impact on the decision for surveillance and the optimal surveillance strategy.
Adenocarcinoma↗
Reversal of lipaemia retinalis with dietary control.
Lipaemia retinalis occurs as the result of a marked elevation of serum lipids. Combined hyperlipidaemia may occur as a primary familial or secondary acquired abnormality. A case of lipaemia retinalis is described, documented by fundus photographs. A complete lipid profile of the patient revealed marked hyperlipidaemia. The lipoprotein lipase level was found to be reduced 0.3 cu (normal 0.5-2.0 cu). The patient was put on a low-fat diet, after which serial fundus photographs showed an improvement in the fundus appearance. Follow-up lipid profile estimations showed a decrease in triglyceride and cholesterol levels. After 6 months of follow-up complete reversal of lipaemia retinalis was documented. In this case, reversal of lipaemia retinalis occurred with dietary therapy alone.
Adolescent↗