Pleural Fluid Cholesterol and Lactate Dehydrogenase to Differentiate Exudates and Transudate and Comparing it with Light’s Criteria

BACKGROUND: Light’s criteria is the routinely used criteria to differentiate exudative and transudative pleural effusion. It requires four biochemical parameters for estimation which may not be feasible in developing countries like India, due to economic constraints. AIM OF THE STUDY: To evaluate usefulness of pleural fluid cholesterol and lactate dehydrogenase (LDH) in differentiating exudates and transudate and comparing it with light’s criteria. Study design: Cross Sectional study. Setting: Government Royapettah Hospital, Chennai. Study population: Patients admitted in medical wards and diagnosed to have pleural effusion clinically and radiologically. MATERIALS AND METHODS: A total of 50 patients were studied from January 2015 to august 2015.The data obtained from patients were collected, analysed and observations noted down. Statistical analysis: Sensitivity, specificity, Positive predictive value, Negative predictive value of pleural fluid cholesterol and LDH test is compared and analysed with Light’s criteria using SPSS 20 software. RESULTS: In this study 40 patients are exudates and 10 are transudates. Using a cut off value of over 45mg/dl for cholesterol and over 200IU/L for LDH to differentiate exudates from transudate, pleural fluid cholesterol and LDH test showed 95% sensitivity and 80% specificity, with significant measure of agreement with Light’s criteria. CONCLUSION: The measurement of pleural fluid cholesterol and LDH is as useful as Light’s criteria to differentiate exudates and transudate, with advantage of requiring only two laboratory parameters and no simultaneous blood sample especially in India, where economic and technical constraints are immense

Fluorescence characterization of clinically-important bacteria

Healthcare-associated infections (HCAI/HAI) represent a substantial threat to patient health during hospitalization and incur billions of dollars additional cost for subsequent treatment. One promising method for the detection of bacterial contamination in a clinical setting before an HAI outbreak occurs is to exploit native fluorescence of cellular molecules for a hand-held, rapid-sweep surveillance instrument. Previous studies have shown fluorescence-based detection to be sensitive and effective for food-borne and environmental microorganisms, and even to be able to distinguish between cell types, but this powerful technique has not yet been deployed on the macroscale for the primary surveillance of contamination in healthcare facilities to prevent HAI. Here we report experimental data for the specification and design of such a fluorescence-based detection instrument. We have characterized the complete fluorescence response of eleven clinically-relevant bacteria by generating excitation-emission matrices (EEMs) over broad wavelength ranges. Furthermore, a number of surfaces and items of equipment commonly present on a ward, and potentially responsible for pathogen transfer, have been analyzed for potential issues of background fluorescence masking the signal from contaminant bacteria. These include bedside handrails, nurse call button, blood pressure cuff and ward computer keyboard, as well as disinfectant cleaning products and microfiber cloth. All examined bacterial strains exhibited a distinctive double-peak fluorescence feature associated with tryptophan with no other cellular fluorophore detected. Thus, this fluorescence survey found that an emission peak of 340nm, from an excitation source at 280nm, was the cellular fluorescence signal to target for detection of bacterial contamination. The majority of materials analysed offer a spectral window through which bacterial contamination could indeed be detected. A few instances were found of potential problems of background fluorescence masking that of bacteria, but in the case of the microfiber cleaning cloth, imaging techniques could morphologically distinguish between stray strands and bacterial contamination

Association between the microbiota and women's cancers � Cause or consequences?

Breast, ovarian and uterine cancers are the most common neoplasms among women. Several mechanisms may be involved in oncogenesis and these include environmental and genetic factors. Bacteria may affect the development of some cancers, with bacterial components, their products and metabolites interacting with susceptible tissues. Commensalism and dysbiosis are important potential mechanisms involved in oncogenesis, and an effective strategy for diagnosis and treatment is required. The purpose of this review was to analyze the complex associations between these cancers in women, and the microbiota, specifically bacterial microbes. However, several cancers have an increased prevalence among individuals with HIV and HPV so the relationship between viral infections and malignancies in women is also referred to. We described how different phylum of bacteria, particularly in the gut, mammary tissue and vaginal microbiome may be involved in carcinogenesis; and we discuss the potential pathways involved: (I), that lead to cell proliferation, (II), immune system perturbation, (III), cell metabolic changes (e.g., hormonal factors), and (IV), DNA damage. Studies investigating the differences between the composition of the bacterial microbiota of healthy women compared to that present in various conditions, and the clinical trials are summarized for the few studies that have addressed the microbiota and related conditions, are also reviewed. © 2020 The Author

The role of hypoxia in the tumor microenvironment and development of cancer stem cell: a novel approach to developing treatment

Hypoxia is a common feature of solid tumors, and develops because of the rapid growth of the tumor that outstrips the oxygen supply, and impaired blood flow due to the formation of abnormal blood vessels supplying the tumor. It has been reported that tumor hypoxia can: activate angiogenesis, thereby enhancing invasiveness and risk of metastasis; increase survival of tumor, as well as suppress anti-tumor immunity and hamper the therapeutic response. Hypoxia mediates these effects by several potential mechanisms: altering gene expression, the activation of oncogenes, inactivation of suppressor genes, reducing genomic stability and clonal selection. We have reviewed the effects of hypoxia on tumor biology and the possible strategiesto manage the hypoxic tumor microenvironment (TME), highlighting the potential use of cancer stem cells in tumor treatment. © 2021, The Author(s)

Development of an Agrobacterium transformation system for onion (Allium cepa L.)

Onion (Allium cepa) bulbs of the New Zealand-bred cultivars 'Pukekohe Longkeeper' and 'Early Longkeeper' produced tumourous growths after inoculation with 25 virulent strains of Agrobactenum tumefaciens, A. rubi and A. rhizogenes. The majority of these tumours produced nopaline, indicating that tumour cells were transformed. Some excised tumours produced roots in sterile culture. Eight onion genotypes were screened in tissue culture for callus formation, regeneration of plantlets from callus and clonal multiplication by shoot proliferation. All genotypes could be clonally multiplied and four were readily regenerable from callus. A technique for plantlet multiplication, which uses longitudinally-bisected stems of in vitro-germinated onion seedlings as explants, was developed. Onion (‘Pukekohe Longkeeper', 'Southport White Globe', 'Japanese Saporo Yellow' and 'Hikeeper Fl ') protoplasts were isolated and cultured on a range of media. These protoplasts formed new cell walls and sometimes divided, but only first divisions were regularly seen. Kanamycin, geneticin (G418), hygromycin and chlorsulfuron were evaluated for their use as selective agents in onion transformation experiments. Tissues surveyed for sensitivity to these selective agents included seeds and seedlings on germination and callusing media, established callus on callusing and regeneration media, and shoot cultures on shoot proliferation medium. Hygromycin was shown to be the antibiotic most toxic to tissues of all the surveyed onion cultivars, with effects being obvious in all tissues after 4-5 weeks of culture on concentrations as low as 20 mgl-1. Kanamycin was shown to be the least toxic of the selection agents surveyed. The kanamycin analogue G418 was considerably more toxic to most onion cultures than kanamycin. However, responses of cultures to G418 were slower than those to hygromycin. The herbicide chlorsulfuron was also shown to be toxic to onion seedlings and shoot cultures. The ability of Agrobacterium tumefaciens to transfer foreign genes to A. cepa was demonstrated. A single, putatively transformed plantlet (RC1), was regenerated from an onion seedling stem via callus, following co-cultivation of stem explants with Agrobacterium strain LBA4404 harbouring the binary vector pKIWI110. In addition, 41 auxiliary or adventitious shoots which grew directly from basal plates injected in vitro with four strains of A. tumefaciens (each harbouring the binary vectors pKIWI110 or pGA643) exhibited resistance to G418 in culture. The binary vectors used carry the neomycin phosphotransferase II gene (nptII) controlled by the nopaline synthase (nos) promoter. Both RC1 and some of the shoots growing from basal plate explants produced roots when grown on culture media supplemented with G418. Southern analyses showed that fragments of DNA from RC1 and from five of the 41 G418-resistant shoots hybridized to a 1.25 kbp nptII probe. (β- glucuronidase (GUS) activity was detected in over half of the plantlets derived from basal plate tissue injected with A. tumefaciens strains LBA4404 or C58, both of which harboured pKIWI110. Molecular and phenotypic evidence suggested that the putatively transformed plants produced from injected basal plate tissues were chimeric

Complicated skin, skin structure and soft tissue infections - are we threatened by multi-resistant pathogens?

Tissue infections or skin, skin structure, and deep seated soft tissue infections are general terms for infections of the entire skin layer including the subcutaneous and muscle tissue layers and their respective fascia structures. Infections of the different mediastinal fascias (mediastinitis) and retroperitoneal fascia infections also belong to this category. Due to the variability of their clinical presentation, skin and soft tissue infections can be classified according to different features. The following aspects can be used for classification

Transmission of MRSA between Companion Animals and Infected Human Patients Presenting to Outpatient Medical Care Facilities

Methicillin-resistant Staphylococcus aureus (MRSA) is a significant pathogen in both human and veterinary medicine. The importance of companion animals as reservoirs of human infections is currently unknown. The companion animals of 49 MRSA-infected outpatients (cases) were screened for MRSA carriage, and their bacterial isolates were compared with those of the infected patients using Pulsed-Field Gel Electrophoresis (PFGE). Rates of MRSA among the companion animals of MRSA-infected patients were compared to rates of MRSA among companion animals of pet guardians attending a “veterinary wellness clinic” (controls). MRSA was isolated from at least one companion animal in 4/49 (8.2%) households of MRSA-infected outpatients vs. none of the pets of the 50 uninfected human controls. Using PFGE, patient-pets MRSA isolates were identical for three pairs and discordant for one pair (suggested MRSA inter-specie transmission p-value = 0.1175). These results suggest that companion animals of MRSA-infected patients can be culture-positive for MRSA, representing a potential source of infection or re-infection for humans. Further studies are required to better understand the epidemiology of MRSA human-animal inter-specie transmission

Application of microarray technology in pulmonary diseases

Microarrays are a powerful tool that have multiple applications both in clinical and cell biology arenas of common lung diseases. To exemplify how this tool can be useful, in this review, we will provide an overview of the application of microarray technology in research relevant to common lung diseases and present some of the future perspectives

Intestinal carriage of Staphylococcus aureus: How does its frequency compare with that of nasal carriage and what is its clinical impact?

The bacterial species Staphylococcus aureus, including its methicillin-resistant variant (MRSA), finds its primary ecological niche in the human nose, but is also able to colonize the intestines and the perineal region. Intestinal carriage has not been widely investigated despite its potential clinical impact. This review summarizes literature on the topic and sketches the current state of affairs from a microbiological and infectious diseases' perspective. Major findings are that the average reported detection rate of intestinal carriage in healthy individuals and patients is 20% for S. aureus and 9% for MRSA, which is approximately half of that for nasal carriage. Nasal carriage seems to predispose to intestinal carriage, but sole intestinal carriage occurs relatively frequently and is observed in 1 out of 3 intestinal carriers, which provides a rationale to include intestinal screening for surveillance or in outbreak settings. Colonization of the intestinal tract with S. aureus at a young age occurs at a high frequency and may affect the host's immune system. The frequency of intestinal carriage is generally underestimated and may significantly contribute to bacterial dissemination and subsequent risk of infections. Whether intestinal rather than nasal S. aureus carriage is a primary predictor for infections is still ill-defined