Features of pulmonary tuberculosis in elders

Nicolae Testemitanu State University of Medicine and Pharmacy, Chisinau, Republic of Moldova, The 6th International Medical Congress for Students and Young Doctors, May 12-14, 2016Introduction. At elders pulmonary tuberculosis develops most often due to the reactivation of endogenous tuberculous infection, but the exogenous infection predisposes the reactivation of latent TB infection. Diagnosis difficulties and errors, as well as comorbidities and hospital care worsen epidemiological indices. Objective of the study. Assessment of clinical, paraclinical and treatment outcomes of pulmonary tuberculosis at elders. Material and methods. A retrospective, descriptive and selective study was realized on 95 new pulmonary tuberculosis elder patients is > 65 years old, treated in IMSF SMF during 2013 year. Results. Distrbution by sex reveald a non-significant predomination of men (71,7%) vs women (28,3% ). Case management established that the most of them were detected by passive way (68,5%), with an AFB positive smear only in 27,2% cases. Pulmonary infiltrative TB was diagnosed at 79,3%, fibrocavitary TB – 1,1% at and disseminated TB at - 17,4%, with parenchimal destructions at 37,5%, affecting both lungs in 31,5% cases. The most frequent clinical errors were bronchitic (26,8%) and pneumonic (19,6%) masks, that determined the transfer from somatic hospitals into pneumophtysiological services. Bacteriologicaly was identified positive results on conventional medium at 48,9% cases, with molecular-genetic positive test GeneXpert RIF at 30,4% cases. Treatment outcomes reflect the epidemiological situation of tuberculosis, so successfully treated were 67,4%, lost from follow up-5,4%, dead-9,8% cases. Conclusions. diagnosis difficulties and errors, expressed by high rate of passive detected cases and low rate of microscopic AFB identification demonstrates the epidemiological danger of elders patients, worsened by the medical care in other than phtysiopneumological services

Гиперплазия эндометрия и рак эндометрия два патогенные и лечения вопросы.

Endometrial hyperplasia and two pathogenic types of endometrial cancer and treatment aspects.Cancerele endometrale se întâlnesc cu aceeaşi frecventă maximală în două decade: perioada 50-59 ani, care poate fi numită perimenopauzală, şi perioada 60-69 ani, cea postmenopauzală. Cancerul perimenopauzal, cum mărturisesc datele obţinute, poate avea ca precursori hiperplaziile endometrale, îndeosebi cele atipice, foarte frecvent însoţite de manifestări clinice dishormonale. Al doilea tip de cancer endometral, cel postmenopauzal, poate avea ca precursor numai hiperplaziile atipice care mai persistă în această perioadă, sau se dezvoltă intru-un endometru aparent atrofic. Tratamentul hormonal local cu relizing sistem „Mirena” poate fi apreciat ca o alternativă efectivă a tratamentului conservativ sistemic hormonal a stărilor precursore a cancerului endometrial, ce permite a exclude efectele secundare negative specifice pentru tratament cu progestine prolangate şi cu agonişti de relizing factori, folosite până în prezent.Гиперплазия эндометрия и рак эндометрия два патогенные и лечения вопросы

Aspecte clinico-morfologice de diagnostic şi tratament ale precursorilor cancerului vulvar

Deşi cancerul vulvei e o localizare vizual accesibilă, mai mult de 50% de paciente se adresează pentru tratament cu forme răspândite ale maladiei. Leucoplazia, crauroza şi afectul mixt vulvar sunt asociate cu afecţiunile ce anticipă apariţia cancerului vulvar şi se încadrează în noţiunea de precursori ai cancerului de vulvă. Scopul acestui studiu a fost: a defi ni aspectele clinico-morfologice ale leucoplaziei, craurozei şi afectul mixt vulvar şi a aprecia efi cacitatea diverselor metode de tratament aplicate lor. Pentru a realiza acest scop au fost cercetate datele clinice, morfologice, electronomicroscopice a 105 paciente: 18 cazuri de crauroză, 35 cazuri de leucoplazie şi 52 cazuri de afect mixt vulvar, care au fost tratate prin metoda conservativă, criodistrucţie şi vulvectomie. Reieşind din datele obţinute s-a constatat că simptomatologia leucoplaziei, craurozei şi afectului mixt vulvar se caracterizează în 71,4% cazuri prin prurită, arsuri şi furnicături, ceea ce condiţionează adresarea la medic în primele 7-11 luni a 83,8% paciente. La mai bine de jumătate de paciente sau 57,1% afecţiunile au un caracter difuz, iar la 65,3% leziunile se încadrează în limitele de la 3≤4 cm2. Au fost create criterii de selecţie, care ne-au servit drept punct de reper în alegerea metodei curative efective. Leucoplazia este un afect cu mare potenţial de malignizare ce constituie 17,1% pentru leucoplazia cu atipie şi 13,5% pentru carcinom in situ, iar terapia conservativă neefectivă nu trebuie să depăşească termenul de 3 cure. Crioterapia este o metodă efi cientă în tratamentul formelor rezistente ale leucoplaziei, craurozei şi afectelor mixte vulvare, asigurând în 80,0% cazuri vindecarea completă, fi ind minitraumatizantă şi, deci, nonmutilantă în raport cu organele genitale. Displaziile atipice şi carcinom in situ ale vulvei, necesită tratamentul chirurgical în volum de vulvectomie, care în 95,0% cazuri poartă un caracter radical. S-a constatat că, până la dezvoltarea carcinomului in situ leucoplazia şi crauroza se pot dezvolta ca două procese suverane, dar care mai frecvent se combină, iar focarele de leucoplazie se transformă în crauroză. În concluzie menţionăm, că datele obţinute se prezintă ca un factor esenţial în profi laxia apariţiei cancerului vulvar pe fond de leucoplazie, crauroză şi afect mixt

Methodologies for “Wiring” Redox Proteins/Enzymes to Electrode Surfaces

The immobilization of redox proteins or enzymes onto conductive surfaces has application in the analysis of biological processes, the fabrication of biosensors, and in the development of green technologies and biochemical synthetic approaches. This review evaluates the methods through which redox proteins can be attached to electrode surfaces in a “wired” configuration, that is, one that facilitates direct electron transfer. The feasibility of simple electroactive adsorption onto a range of electrode surfaces is illustrated, with a highlight on the recent advances that have been achieved in biotechnological device construction using carbon materials and metal oxides. The covalent crosslinking strategies commonly used for the modification and biofunctionalization of electrode surfaces are also evaluated. Recent innovations in harnessing chemical biology methods for electrically wiring redox biology to surfaces are emphasized

Performance-oriented strategies for integration and wiring of the photosystem I inside 2D and 3D architectures and coupling photocatalysis with enzymatic catalysis

In der vorliegenden Arbeit sind unterschiedliche Kopplungsstrategien des natürlichen Photosystems I (PSI) aus Cyanobakterium Thermosynechococcus elongatus mit verschiedenen Elektrodenoberflächen sowie Interaktion mit Nanomaterialien und Enzymen bearbeitet worden. Zum einen wurde gezeigt, dass die Immobilisierung des PSI auf modifizierten mehr-wandigen Kohlenstoffnanoröhrchen zur funktionalen Photobiohybridelektrode führt. Dabei wurde das PSI mit der Elektrode elektrisch mit Hilfe eines Redoxproteins, Cytochrom c (cyt c), verknüpft. Das System (PSI-cyt c) wurde auch auf eine dreidimensionale Elektrodenoberfläche des Metaloxids Indiumzinnoxid (eng. ITO) übertragen. Hierbei wurde zusätzlich die TransparenzEigenschaft solcher Oberflächen ausgenutzt. Die Präparation solcher transparenter Elektroden wurde optimiert, um höhere Photoströme zu generieren. Weiterhin wurde eine neue Methode der elektrischen Kontaktierung des PSI mit der Elektrode etabliert. Hierfür wurden Fullerene eingesetzt. Durch erhöhte molekulare Effizienz wurde gezeigt, dass Fullerene effektivere Elektronvermittler zwischen PSI und der Elektrode sind als das cyt c. Zusätzlich wurden im Rahmen dieser Doktorarbeit die photokatalytischen Eigenschaften von PSI mit den biokatalytischen Eigenschaften des Enzyms humane Sulphit Oxidase (hSOx) kombiniert. Hierbei wurde das Enzym als ein alternativer und effizienter Elektronzulieferer für PSI eingesetzt. Ein drittes Protein, das cyt c, fungierte als elektrisches Bindeglied und sicherte die elektrische Kommunikation zwischen den katalytischen Proteinen im System und der Elektrode. Die Komplexität des PSI sowie seine Kommunikation mit anorganischen Nanomaterialien und anderen komplexen Biomolekülen, wie z.B. Enzymen, zeigt ein großes Potential des Einsatzes von PSI-basierter Biohybriden in den Biotechnologien der Zukunft.In this thesis, different strategies for coupling of the natural complex photosystem I from the cyanobacterium Thermosynechococcus elongatus with different electrode surfaces, and the interaction of PSI with nanomaterials and enzymes has been investigated. First, it was shown that immobilization of PSI on modified multi-walled carbon nanotubes (MWNT) leads to a functional photobiohybrid electrode. Here, PSI has been electrically wired to the electrode via a redox-active protein, cytochrome c (cyt c). The system (PSI-cyt c) has been scaled up to the three-dimensional surface of a metal-oxide, indium tin oxide (ITO). Here, additionally the high transparency property of this material has been exploited. The new preparation procedure of such transparent electrodes has been optimized in order to achieve high pohotocurrents. Furthermore, a new method of electric wiring of the PSI with the electrode has been established. Here, fullerenes have been employed. The high molecular efficiency of such a system proves that fullerenes are more effective wiring agents between the PSI and the electrode as compared to the cyt c. Additionally, in this thesis the photocatalytic property of the PSI has been combined with the biocatalytic property of the enzyme human sulphite oxidase, hSOx. Here, the enzyme has been employed as an alternative electron supplier for PSI. The third protein, cyt c, acted as an electric wiring agent and ensured electric communication between both catalytic proteins of the system and the electrode. The versatility of the PSI as well as its communication with anorganic nanomaterials and biological molecules, e.g. such as enzymes, shows a great potential for use of PSI-based biohybrids in the future biotechnological applications

Reliable Surface Analysis Data of Nanomaterials in Support of Risk Assessment Based on Minimum Information Requirements

The minimum information requirements needed to guarantee high-quality surface analysis data of nanomaterials are described with the aim to provide reliable and traceable information about size, shape, elemental composition and surface chemistry for risk assessment approaches. The widespread surface analysis methods electron microscopy (SEM), energy dispersive X-ray spectroscopy (EDS), X-ray photoelectron spectroscopy (XPS) and secondary ion mass spectrometry (SIMS) were considered. The complete analysis sequence from sample preparation, over measurements, to data analysis and data format for reporting and archiving is outlined. All selected methods are used in surface analysis since many years so that many aspects of the analysis (including (meta)data formats) are already standardized. As a practical analysis use case, two coated TiO2 reference nanoparticulate samples, which are available on the Joint Research Centre (JRC) repository, were selected. The added value of the complementary analysis is highlighted based on the minimum information requirements, which are well-defined for the analysis methods selected. The present paper is supposed to serve primarily as a source of understanding of the high standardization level already available for the high-quality data in surface analysis of nanomaterials as reliable input for the nanosafety community

Engineering of supramolecular photoactive protein architectures: the defined co-assembly of photosystem I and cytochrome c using a nanoscaled DNA-matrix

The engineering of renewable and sustainable protein-based light-to-energy converting systems is an emerging field of research. Here, we report on the development of supramolecular light-harvesting electrodes, consisting of the redox protein cytochrome c working as a molecular scaffold as well as a conductive wiring network and photosystem I as a photo-functional matrix element. Both proteins form complexes in solution, which in turn can be adsorbed on thiol-modified gold electrodes through a self-assembly mechanism. To overcome the limited stability of self-grown assemblies, DNA, a natural polyelectrolyte, is used as a further building block for the construction of a photo-active 3D architecture. DNA acts as a structural matrix element holding larger protein amounts and thus remarkably improving the maximum photocurrent and electrode stability. On investigating the photophysical properties, this system demonstrates that effective electron pathways have been created

Influence of the Morphology on the Functionalization of Graphene Nanoplatelets Analyzed by Comparative Photoelectron Spectroscopy with Soft and Hard X‐Rays

Abstract Since its isolation, graphene has received growing attention from academia and industry due to its unique properties. However, the “what is my material” barrier hinders further commercialization. X‐ray photoelectron spectroscopy (XPS) is considered as a method of choice for the determination of the elemental and chemical composition. In this work the influence of the morphology of graphene particles on the XPS results is studied and investigated as a function of X‐ray energy, using conventional XPS with Al Kα radiation and hard X‐ray photoemission spectroscopy (HAXPES) using Cr Kα radiation. Thereby, the information depth is varied between 10 and 30 nm. For this purpose, two commercial powders containing graphene nanoplatelets with lateral dimensions of either ≈100 nm or in the micrometer range are compared. These larger ones exist as stack of graphene layers which is inspected with scanning electron microscopy. Both kinds of particles are then functionalized with either oxygen or fluorine. The size of the graphene particles is found to influence the degree of functionalization. Only the combination of XPS and HAXPES allows to detect the functionalization at the outermost surface of the particles or even of the stacks and to provide new insights into the functionalization process

Bioelectronic Circuit on a 3D Electrode Architecture: Enzymatic Catalysis Interconnected with Photosystem I

Artificial light-driven signal chains are particularly important for the development of systems converting light into a current, into chemicals or for light-induced sensing. Here, we report on the construction of an all-protein, light-triggered, catalytic circuit based on photosystem I, cytochrome <i>c</i> (cyt <i>c</i>) and human sulfite oxidase (hSOX). The defined assembly of all components using a modular design results in an artificial biohybrid electrode architecture, combining the photophysical features of PSI with the biocatalytic properties of hSOX for advanced light-controlled bioelectronics. The working principle is based on a competitive switch between electron supply from the electrode or by enzymatic substrate conversion