Mmc - Dept. Of Anesthesiology 111 East 210Th Street
Bronx NY 10467
Medical School: Other - Unknown
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License #: 148875
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Chlorhexidine for routine PD catheter exit-site care. - International urology and nephrology
Although guidelines suggest the routine use of mupirocin or gentamicin at the exit site of PD catheter, our PD unit has been using chlorhexidine gluconate 0.5Â % as exit-site care protocol. The aim of this study was to ascertain whether mupirocin application is superior to the traditionally applied chlorhexidine-regarding prevention of exit-site infections and peritonitis in our unit.Stable incident and prevalent patients of our unit were randomized to apply mupirocin or chlorhexidine at exit site. The study started on July 1, 2010, and continued till December 2014. End point was the first episode of exit-site infection or peritonitis.Sixty-two patients (mean age 58.5Â Â±Â 14.6Â years) were randomized. At the end of follow-up, there were 33 patients on mupirocin treatment and 29 on chlorhexidine. The two groups had no differences in age, sex, PD vintage or PD mode. The only difference between the two groups was the percentage of patients with diabetes, 28Â % in chlorhexidine group versus 10Â % in mupirocin group. Mean time of follow-up was 28.46Â Â±Â 16.37Â months. Twenty-four episodes of infections (peritonitis and exit site) were recorded. Time to first infection episode was 32Â months in mupirocin group (95Â % CI 21.4-42.5) versus 29Â months (95Â % CI 8.6-49.4) in chlorhexidine group. The Kaplan-Meier survival analysis revealed no difference in the infections between the two protocols (log-rank test, pÂ =Â 0.477).Mupirocin is not superior in preventing infections comparing with chlorhexidine in this cohort of patients.
Antibiotic resistance profiles of Pseudomonas aeruginosa isolated from various Greek aquatic environments. - FEMS microbiology ecology
A large number of antibiotic-resistantP. aeruginosaisolates are continuously discharged into natural water basins mainly through sewage. However, the environmental reservoirs of antibiotic resistance factors are poorly understood. In this study, the antibiotic resistance patterns of 245 isolates from various aquatic sites in Greece were analysed. Twenty-three isolates with resistanceÂ patternsÂ cefotaxime-aztreonam-ceftazidime,Â cefotaxime-aztreonam-meropenem,Â cefotaxime-ceftazidime-meropenem,Â cefotaxime-ceftazidime-aztreonam-meropenemÂ andÂ cefotaxime-ceftazidime-cefepime-aztreonam-meropenem were screened phenotypically for the presence of extended spectrum Î²-lactamases (ESBLs), while 77 isolates with various resistant phenotypes were screened for the presence of class 1 and class 2 integrase genes. The aztreonam-resistant isolates and ESBL producers were the main resistant phenotypes in all habitats tested. In 13/77 isolates class 1 integron was detected, while all tested isolates were negative for the presence of the class 2 integrase gene. CTX-M group 9 Î²-lactamase was present in a small number of isolates (three isolates) highlighting the emergence of ESBL genes in aquatic environments. As a conclusion, it seems that Greek water bodies could serve as a potential reservoir of resistantP. aeruginosaisolates posing threats to human and animal health.Â© FEMS 2016. All rights reserved. For permissions, please e-mail: email@example.com.
Educational improvement in Medical English Practice: Questionnaire survey to sophomore medical students of Hokkaido University. - [Hokkaido igaku zasshi] The Hokkaido journal of medical science
In the past, we made several efforts making curriculum changes to Medical English Practice, however, these changes did not improve motivation effectively. We have completely modified the curriculum in 2012, and performed a questionnaire survey to 112 sophomore medical students. In the final exam, students answered a questionnaire assessing all classes of the course by scoring 3 points (no change required), 2 points (minor change required), and 1 point (major change required or discontinue). In addition, students could write free comments about potential contents they would like to add to the curriculum. Each class was assessed as more than or equal to 2.5 points on average (range: 2.50-2.96). Potential contents students want to add are: 1. Speaking (45 students [55%]), 2. Listening (30 students [37%]), 3. Reading (6 students [7%]), 4. Writing (1 student [1%]). The most frequent suggestion was to include group discussions in speaking (27 students [33%]), followed by listening on topics of healthcare systems (11 students [13%]). Many students suggested to include conversation classes in small groups, or classes in which international students introduce the structure of healthcare systems of their home countries to the curriculum. Increasing the participation of international faculty, staff and students in the Medical English Practice might contribute to the improvement of medical students' motivation.
Coencapsulation of Ferulic and Gallic acid in hp-b-cyclodextrin. - Food chemistry
The complexes formed by two polyphenols, trans-Ferulic acid (FA) and Gallic acid (GA) with 2-hydroxypropyl-b-cyclodextrin (HPÎ²CD), by the spray-drying method, were studied. Encapsulation-efficiencies (EE) of the complexes prepared were evaluated by HPLC. In the case of co-encapsulation, the EE of GA was lowered, whereas that of FA was almost stable, indicating a possible antagonistic relationship between the two phenols for the HPÎ²CD cavity. The physicochemical characterization of the complexes was carried out by Fourier Transform Infrared Spectroscopy (FT-IR), Differential Scanning Calorimetry (DSC), and Scanning Electron Microscopy (SEM). SEM observations revealed that the coencapsulated phenolic complex resulted in a more rounded shape outer surfaces of HPÎ²CD than when encapsulated separately. FT-IR and DSC data indicated that the two polyphenols exhibit a possible interaction in the coencapsulated complex. The complexes showed no loss of their ability to scavenge DPPH radical relatively to the single agent at the concentrations used.Copyright Â© 2015. Published by Elsevier Ltd.
Impact of transplant eligibility and availability of a human leukocyte antigen-identical matched related donor on outcome of older patients with acute lymphoblastic leukemia. - Leukemia & lymphoma
The role of allogeneic hematopoietic cell transplant (allo-HCT) in elderly patients with acute lymphoblastic leukemia (ALL) is unclear. We conducted a prospective study including 110 homogeneously treated patients with ALL aged 50-70 years. Their outcomes were analyzed by intention-to-treat on a donor-versus-no donor basis. Fifty-five patients (50%) underwent human leukocyte antigen (HLA) typing and were considered potential allo-HCT candidates, although only 25 (23%) eventually received an allo-HCT. Among potential allo-HCT candidates, patients with (n = 28) and without (n = 27) an HLA-identical sibling showed similar leukemia-free survival, overall survival (OS) and relapse risk, and the only variable associated with a better outcome was achievement of first complete remission (CR1) after induction therapy. Among the 25 patients who actually received an allo-HCT, the 4-year non-relapse mortality and OS were 42% (95% confidence interval 31-53%) and 37% (95% confidence interval 27-47%), respectively. In conclusion, having an HLA-identical sibling donor was not associated with a better outcome in patients with ALL aged 50-70 years.
Management of acid burns: experience from Bangladesh. - Burns : journal of the International Society for Burn Injuries
Acid burn injuries in Bangladesh primarily occur as a result of intentional attacks although there are incidences of accidental acid burns in industry, on the street, and at home. A total of 126 patients with acid burns, 95 from attacks and 31 from accidents, were studied from July 2004 to December 2012. A diagnosis of acid burn was made from history, physical examination and in some cases from chemical analysis of the patients' clothing. Alkali burns were excluded from the study. In the burn unit of Dhaka Medical College Hospital, we applied a slightly different protocol for management of acid burns, beginning with plain water irrigation of the wound, which effectively reduced burn depth and the requirement of surgical treatment. Application of hydrocolloid dressing for 48-72 h helped with the assessment of depth and the course of treatment. Early excision and grafting gives good results but resultant acid trickling creates a marble cake-like appearance of the wound separated by the vital skin. Excision with a scalpel and direct stitching of the wounds are often a good option. Observation of patients on follow-up revealed that wounds showed a tendency for hypertrophy. Application of pressure garments and other scar treatments were given in all cases unless the burn was highly superficial.Copyright Â© 2014 Elsevier Ltd and ISBI. All rights reserved.
Complex exercise rehabilitation program for women of the II period of age with metabolic syndrome. - Journal of exercise rehabilitation
The purpose of this study was to develop a complex exercise program integrating Eastern and Western complex exercise rehabilitation programs in order to examine the effects of it on the human body with the subjects for women of the II period of mature age with metabolic syndrome. The subjects of this study are 60 II period of mature aged women with metabolic syndrome living in G City, and the experimental group conducted Taekwon-aerobic exercise, European rehabilitation gymnastics, gym ball exercise, and elastic band exercise while the control group performed European rehabilitation gymnastics, gym ball exercise, and elastic band exercise which is the rehabilitation program being presently conducted in Russia, for 90 min per day for three weeks. Two-way ANOVA with repeated measures was utilized to verify pre and post-intergroup difference, and the significant level was set as P< 0.05. Whereas body weight, % fat, WHR, SBP, DBP and blood glucose were significant decreased, muscle weight and pulse wave velocity were significant increased after complex exercise rehabilitation programs Both Eastern and Western complex exercise rehabilitation programs showed positive effects on the body of the II period of mature aged women with metabolic syndrome, and if various exercise programs are conducted, it will be more effective in improving II period of mature aged women's metabolic syndrome afterwards.
Effect of phenol-induced changes in lipid composition on conformation of OmpF-like porin of Yersinia pseudotuberculosis. - FEBS letters
The present work aimed to compare the effects of different lysophosphatidylethanolamine (LPE) content in lipids derived from Yersinia pseudotuberculosis cells exposed and not exposed to phenol on the conformation of OmpF-like porin of these bacteria. Differential scanning calorimetry and intrinsic protein fluorescence showed that the 2.5-fold increase of LPE content and the corresponding increase in the phase transition temperature of bacterial lipids were accompanied by enhanced protein thermostability. Integral conformational rearrangement of protein was supported by drastic changes in the microenvironment of the tryptophan residues, likely resulting in a convergence of monomers in trimeric porin and exposure of outer tryptophan residues to the water environment. These conformational changes may impede the porin channel permeability under stress conditions in bacteria.Copyright Â© 2013 Federation of European Biochemical Societies. Published by Elsevier B.V. All rights reserved.
Thr92Ala polymorphism of human type 2 deiodinase gene (hD2) affects the development of Graves' disease, treatment efficiency, and rate of remission. - Clinical & developmental immunology
Clinical symptoms vary in thyrotoxicosis, and severity of these depends on many factors. Over the last years, impact of genetic factors upon the development and clinical significance of thyrotoxic symptoms became evident. It is known that a production of T3 in various tissues is limited by deiodinase 2 (D2). Recent studies revealed that certain single nucleotide polymorphisms (including threonine (Thr) to alanine (Ala) replacement in D2 gene codon 92, D2 Thr92Ala) affect T3 levels in tissues and in serum. Individuals with Ala92Ala genotype have lower D2 activity in tissues, compared with that in individuals with other genotypes. In our study, we have assessed an association of D2 Thr92Ala polymorphism with (1) frequency of disease development, (2) severity of clinical symptoms of thyrotoxicosis, and (3) rate of remissions, in Graves' disease patients.
[Molecular diagnostic tests for thrombophilia in patients referred to genetic counseling clinic because due to recurrent pregnancy failure. One center's experience]. - Ginekologia polska
The loss of three or more subsequent pregnancies before the end of the 22nd week is observed in 0.4-1% of women. Despite great advances in medicine, the causes of pregnancy failure (miscarriages, missed abortions and stillbirths), and the birth of a child or children with congenital abnormalities, are still not determined preciselyThe purpose of the research was to determine the association of polymorphisms and mutations of coagulation factors II and V genes, as well as methylenetethrahydrofolate reductase (MTHFR) gene polymorphism, with the course of pregnancy and the type of reproductive failure.The research was performed in a group of 116 women referred to the Genetic Outpatient Clinic of the NCU SM in Bydgoszcz between 2009-2010 due to reproductive failures. The molecular tests for thrombophilia, i.e. mutation of the factor V Leiden, prothrombin gene mutation 20210G>A, and MTHFR polymorphism 677C>T were done in all patients.The Leiden mutation was found in 8 women (homozygotic in 2 of them) and prothrombin gene mutation in 3.85 women had the heterozygotic MTHFR polymorphism, while 24 the homozygotic one. Coexistence of the Leiden mutation and the MTHFR polymorphism was found in 3 patients with history of miscarriages.1. The presence of the mutations that promote thrombophilia in the genes responsible for the foliate metabolism and for the plasma coagulation is often associated with pregnancy failures and may be their basic cause in some cases. 2. The percentage of women with pregnancy failures being heterozygotes (73.3%), homozygotes (20.7%) or both (94%) of the MTHFR gene 677C>T polymorphism is statistically significantly higher than the highest prevalence of these changes in the general population (55, 13%, and 68%, respectively). 3. The factor V gene Leiden mutation is associated mainly with recurrent spontaneous abortions. In the present study it was found only in the group of women with both early and late miscarriages.
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Mmc - Dept. Of Anesthesiology 111 East 210Th Street Bronx, NY 10467
111 E 210Th St Montefiore Medical Center
111 E 210Th St Department Of Pediatrics
3444 Kossuth Ave Family Care Center, Pediatric Practice C
111 E 210Th St
111 E 210Th St Montefiore Medical Ctr Klau 2 Psychiatry
3415 Bainbridge Ave The Children's Hospital At Montefiore Medical Ctr
Mmc - Stern Stroke Ctr 111 East. 210Th St, Nw8 Blue Z