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Diabetes Insipidus in Deceased Donors and Outcomes in Kidney Transplant Recipients. Am J Kidney Dis 2023:S0272-6386(23)00999-X. [PMID: 38160701 DOI: 10.1053/j.ajkd.2023.10.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 09/27/2023] [Accepted: 10/20/2023] [Indexed: 01/03/2024]
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DCD liver transplant in patients with a MELD over 35. Front Immunol 2023; 14:1246867. [PMID: 37731493 PMCID: PMC10507358 DOI: 10.3389/fimmu.2023.1246867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 08/17/2023] [Indexed: 09/22/2023] Open
Abstract
Introduction Donation after circulatory death (DCD) liver transplantation (LT) makes up well less than 1% of all LTs with a Model for End-Stage Liver Disease (MELD)≥35 in the United States. We hypothesized DCD-LT yields acceptable ischemia-reperfusion and reasonable outcomes for recipients with MELD≥35. Methods We analyzed recipients with lab-MELD≥35 at transplant within the UCSF (n=41) and the UNOS (n=375) cohorts using multivariate Cox regression and propensity score matching. Results In the UCSF cohort, five-year patient survival was 85% for DCD-LTs and 86% for matched-Donation after Brain Death donors-(DBD) LTs (p=0.843). Multivariate analyses showed that younger donor/recipient age and more recent transplants (2011-2021 versus 1999-2010) were associated with better survival. DCD vs. DBD graft use did not significantly impact survival (HR: 1.2, 95%CI 0.6-2.7). The transaminase peak was approximately doubled, indicating suggesting an increased ischemia-reperfusion hit. DCD-LTs had a median post-LT length of stay of 11 days, and 34% (14/41) were on dialysis at discharge versus 12 days and 22% (9/41) for DBD-LTs. 27% (11/41) DCD-LTs versus 12% (5/41) DBD-LTs developed a biliary complication (p=0.095). UNOS cohort analysis confirmed patient survival predictors, but DCD graft emerged as a risk factor (HR: 1.5, 95%CI 1.3-1.9) with five-year patient survival of 65% versus 75% for DBD-LTs (p=0.016). This difference became non-significant in a sub-analysis focusing on MELD 35-36 recipients. Analysis of MELD≥35 DCD recipients showed that donor age of <30yo independently reduced the risk of graft loss by 30% (HR, 95%CI: 0.7 (0.9-0.5), p=0.019). Retransplant status was associated with a doubled risk of adverse event (HR, 95%CI: 2.1 (1.4-3.3), p=0.001). The rejection rates at 1y were similar between DCD- and DBD-LTs, (9.3% (35/375) versus 1,541 (8.7% (1,541/17,677), respectively). Discussion In highly selected recipient/donor pair, DCD transplantation is feasible and can achieve comparable survival to DBD transplantation. Biliary complications occurred at the expected rates. In the absence of selection, DCD-LTs outcomes remain worse than those of DBD-LTs.
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National Practice Patterns in Malignant Peritoneal Mesothelioma: Updates in Management and Survival. Ann Surg Oncol 2023; 30:5119-5129. [PMID: 37140748 DOI: 10.1245/s10434-023-13528-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 04/03/2023] [Indexed: 05/05/2023]
Abstract
BACKGROUND Malignant peritoneal mesothelioma (MPM) is a rare malignancy with a historically poor prognosis. Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) has emerged as an effective therapy for patients with peritoneal malignancies. A contemporary analysis of trends in management of and survival from MPM is warranted. METHODS Patients with MPM were identified from the National Cancer Database (2004-2018). Patients were categorized by treatment (CRS-HIPEC, CRS-chemotherapy, CRS only, chemotherapy only, no treatment), and joinpoint regression was employed to compute the annual percent change (APC) in treatment over time. Multivariable Cox proportional hazards models were used to analyze factors associated with survival. RESULTS Of 2683 patients with MPM, 19.1% underwent CRS-HIPEC, and 21.1% received no treatment. Joinpoint regression revealed a statistically significant increase in the proportion of patients undergoing CRS-HIPEC over time (APC 3.21, p = 0.01), and a concurrent decrease in the proportion of patients who underwent no treatment (APC - 2.21, p = 0.02). Median overall survival was 19.5 months. Factors independently associated with survival included CRS-HIPEC, CRS, histology, sex, age, race, Charlson Comorbidity Index, insurance, and hospital type. Although there was a strong association between year of diagnosis and survival on univariate analysis (2016-2018 HR 0.67, p < 0.001), this association was attenuated after adjustment for treatment. CONCLUSIONS CRS-HIPEC is increasingly employed as a treatment for MPM. In parallel, there has been a decrease in patients receiving no treatment with an increase in overall survival. These findings suggest that patients with MPM may be receiving more appropriate therapy; however, a substantial proportion of patients may remain undertreated.
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ASO Visual Abstract: National Practice Patterns in Malignant Peritoneal Mesothelioma-Updates in Management and Survival. Ann Surg Oncol 2023; 30:5131. [PMID: 37221399 DOI: 10.1245/s10434-023-13615-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
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A Multi-Modal Approach to Islet and Pancreas Transplantation With Calcineurin-Sparing Immunosuppression Maintains Long-Term Insulin Independence in Patients With Type I Diabetes. Transpl Int 2023; 36:11367. [PMID: 37359825 PMCID: PMC10285771 DOI: 10.3389/ti.2023.11367] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 05/24/2023] [Indexed: 06/28/2023]
Abstract
Long-term success in beta-cell replacement remains limited by the toxic effects of calcineurin inhibitors (CNI) on beta-cells and renal function. We report a multi-modal approach including islet and pancreas-after-islet (PAI) transplant utilizing calcineurin-sparing immunosuppression. Ten consecutive non-uremic patients with Type 1 diabetes underwent islet transplant with immunosuppression based on belatacept (BELA; n = 5) or efalizumab (EFA; n = 5). Following islet failure, patients were considered for repeat islet infusion and/or PAI transplant. 70% of patients (four EFA, three BELA) maintained insulin independence at 10 years post-islet transplant, including four patients receiving a single islet infusion and three patients undergoing PAI transplant. 60% remain insulin independent at mean follow-up of 13.3 ± 1.1 years, including one patient 9 years after discontinuing all immunosuppression for adverse events, suggesting operational tolerance. All patients who underwent repeat islet transplant experienced graft failure. Overall, patients demonstrated preserved renal function, with a mild decrease in GFR from 76.5 ± 23.1 mL/min to 50.2 ± 27.1 mL/min (p = 0.192). Patients undergoing PAI showed the greatest degree of renal impairment following initiation of CNI (56% ± 18.7% decrease in GFR). In our series, repeat islet transplant is ineffective at maintaining long-term insulin independence. PAI results in durable insulin independence but is associated with impaired renal function secondary to CNI dependence.
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Steroid Avoidance After Adult Living Donor Liver Transplant: A Cohort Analysis. Transplant Direct 2023; 9:e1488. [PMID: 37250489 PMCID: PMC10212610 DOI: 10.1097/txd.0000000000001488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 03/14/2023] [Accepted: 04/04/2023] [Indexed: 05/31/2023] Open
Abstract
Although steroid avoidance (SA) has been studied in deceased donor liver transplant, little is known about SA in living donor liver transplant (LDLT). We report the characteristics and outcomes, including the incidence of early acute rejection (AR) and complications of steroid use, in 2 cohorts of LDLT recipients. Methods Routine steroid maintenance (SM) after LDLT was stopped in December 2017. Our single-center retrospective cohort study spans 2 eras. Two hundred forty-two adult recipients underwent LDLT with SM (January 2000-December 2017), and 83 adult recipients (December 2017-August 2021) underwent LDLT with SA. Early AR was defined as a biopsy showing pathologic characteristics within 6 mo after LDLT. Univariate and multivariate logistic regressions were performed to evaluate the effects of relevant recipient and donor characteristics on the incidence of early AR in our cohort. Results Neither the difference in early AR rate between cohorts (SA 19/83 [22.9%] versus SM 41/242 [17%]; P = 0.46) nor a subset analysis of patients with autoimmune disease (SA 5/17 [29.4%] versus SM 19/58 [22.4%]; P = 0.71) reached statistical significance. Univariate and multivariate logistic regressions for early AR identified recipient age to be a statistically significant risk factor (P < 0.001). Of the patients without diabetes before LDLT, 3 of 56 (5.4%) on SA versus 26 of 200 (13%) on SM needed medications prescribed for glucose control at the time of discharge (P = 0.11). Patient survival was similar between SA and SM cohorts (SA 94% versus SM 91%, P = 0.34) 3 y after transplant. Conclusions LDLT recipients treated with SA do not exhibit significantly higher rates of rejection or increased mortality than patients treated with SM. Notably, this result is similar for recipients with autoimmune disease.
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117 Interleukin-6 and short-palate lung and nasal epithelium clone 1 fluctuations as sex-specific markers of acute cystic fibrosis exacerbation. J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)00808-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Abstract
Colleges and universities are increasingly concerned about respect for diversity and tolerance of individual differences on their campuses. Nevertheless, no comprehensive measure of peer victimization has been developed and validated for use with college student populations. The Peer Victimization in College Survey (PVIC) is the first such measure. Study 1 (N = 733) reports how PVIC items were empirically derived to ensure construct coverage. Study 2 (N = 100) reports how intuitive PVIC subscales were established to distinguish between subtypes of college peer victimization. Study 3 (N = 520) provides evidence of convergent, discriminant, and construct validity for the PVIC, including its relations to risk factors and to outcomes such as depressive symptoms, anxiety, stress, and college sense of belonging. Study 4 (N = 633) validates several PVIC scaling methods and provides evidence of incremental validity of the measure over current (unvalidated) measures. The PVIC can assess subtypes of peer victimization on college campuses, evaluate the effectiveness of campus intervention efforts, and test hypotheses about the causes and effects of peer victimization. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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P1010Association between left atrial fibrosis detected by cardiac magnetic resonance and endocardial electroanatomic mapping in the evaluation of the electrophysiological substrate in atrial fibrillation. Europace 2020. [DOI: 10.1093/europace/euaa162.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Atrial fibrillation (AF) is related to left atrial fibrosis, but its identification by late magnetic resonance imaging (LGE) with gadolinium (LGE) persists in controversy due to heterogeneous results in its correlation with the electroatomic map (EAM) and the difficulty of perform histological studies in humans.
Purpose
We try to examine the point-by-point association between high density EAM and LGE-MRI using an automatic and reproducible method.
Methods
A LGE-MRI was performed in 16 patients prior to ablation. Three different areas were established depending on the intensity of normalized enhancement for each patient according to their blood group with the image intensity ratio (IIR) (healthy <1.20, border area (BZ) ≥1.20 <1.32 and scar ≥1.32). The high density electroanatomic maps of the left atrium (LA) were projected onto the MRI, obtaining an automatic correlation point by point.
Results
The study obtained significant differences (p < 0.001) between voltage (mV) and CV (mm/ms) among healthy, BZ and scar areas, as well a significant inverse correlation (p < 0.001) between voltage and IIR (R=-0.39). It obtained too a significant correlation between CV and IIR (R=-0.24), but this showed a greater correlation in those patients who have the least dilated LA (p = 0.02).
Conclusions
LGE-MRI and EAM showed good correlation in delineating potential pathologic substrate in AF, but left atrium dilation could reduce the performance of the CMR in this task. Conduction velocity could be more sensitive than voltage and LGE-MRI to detect incipient substrate in AF.
Voltage and conduction velocity values Area /IIR Velocity (mm/ms) Voltage (mV) I / <.20 1.036(0.913-1.158) 1.593(1.489-1.696) 2 / ≥1.20 and <1.32 0.722(0.590-0.850) 0.792 (0.649-0,935) 3 / ≥1.32 0.623(0.473-0,733) 0.444(0.245-0.642) Voltage and conduction velocity values in the three areas of the LGE-RMN.
Abstract Figure. Correlation among voltage, VC and LA
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Expression of Stromal Progesterone Receptor and Differential Methylation Patterns in the Endometrium May Correlate with Response to Progesterone Therapy in Endometrial Complex Atypical Hyperplasia. Reprod Sci 2020; 27:1778-1790. [PMID: 32124398 PMCID: PMC7395059 DOI: 10.1007/s43032-020-00175-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Accepted: 02/03/2020] [Indexed: 12/22/2022]
Abstract
Progesterone therapy is a viable treatment for complex atypical hyperplasia (CAH) and endometrial adenocarcinoma, though reliable molecular determinants of response are not available. To explore if analysis of pre-therapy endometrial biopsies could yield biomarkers of response to progesterone, patients with CAH or adenocarcinoma undergoing treatment with progestins were included in this cross-sectional study. Immunohistochemistry for progesterone receptor (PR) was performed. Manual PR expression scores (PRES) were first calculated for biopsies by counting PR-positive nuclei in 12 sensitive vs 9 resistant samples. Significant differences in manual PRES were detected in the stroma (p < 0.01) and total endometrium (p < 0.01) for sensitive vs resistant patients. Manual PRES in the stroma had the highest accuracy in segregating sensitive vs resistant patients (96%). Differences in epithelial PRES were not significant. To validate these findings, a correlation between manual PRES and visual PRES was performed in the 21 patients. An additional 11 patients were analyzed to test if visual PRES would be predictive of response to progesterone. Visual PRES in epithelia and stroma in the 32 specimens was calculated. Significant differences in visual PRES were detected in the stroma for sensitive vs resistant samples (p < 0.01), while differences in epithelial and total endometrium were not significant. Whole genome bisulfite sequencing was performed on DNA isolated using pre-therapy biopsies from 6 sensitive and 6 resistant patients in this cohort. Differentially methylated regions were identified in the stroma and epithelium when evaluating sensitive vs resistant samples. Pathways involved in cell adhesion demonstrated the greatest difference in methylation in these samples.
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Analysis of the endometrial stroma may play an important role in predicting progestin response in complex atypical hyperplasia or grade I adenocarcinoma. Gynecol Oncol 2019. [DOI: 10.1016/j.ygyno.2019.04.551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Interim Safety and Toxicity Analysis of a Prospective Phase II Randomized Trial of Checkpoint Blockade Immunotherapy Combined with Stereotactic Body Radiation Therapy in Advanced Metastatic Disease. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.1046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Obesity and weight misperception among adults in the Eastern Caribbean Health Outcomes Research Network (ECHORN) Cohort Study. Obes Sci Pract 2018; 4:367-378. [PMID: 30151231 PMCID: PMC6105698 DOI: 10.1002/osp4.280] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 05/04/2018] [Accepted: 05/07/2018] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE Prior studies have suggested that weight misperception - underestimating one's actual weight - may be associated with reduced engagement in weight loss programmes, decreasing the success of initiatives to address obesity and obesity-related diseases. The purpose of this study was to examine the factors associated with weight misperception among Eastern Caribbean adults and its influence on engagement in weight control behaviour. METHODS Data from the Eastern Caribbean Health Outcomes Research Network (ECHORN) Cohort Study were analysed (adults aged 40 and older, residing in the US Virgin Islands, Puerto Rico, Barbados and Trinidad). Weight misperception is defined as participants who under-assess their weight measured by body mass index (BMI). Multivariable logistic regression (n = 1,803 participants) was used to examine the association of weight misperception with BMI category, age, gender, education, history of non-communicable disease and attempt to lose weight. RESULTS Weight misperception was common, with 54% of overweight (BMI 25-29 kg m-2), and 23% of obese class I (BMI 30-34.9 kg m-2) participants under-assessing their actual weight. Participants with higher levels of education, versus lower, had decreased odds of weight misperception (OR 0.5, p < 0.001). There were no significantly reduced odds of weight misperception in women versus men (OR 1.13, p = 0.367) or in individuals with history of diabetes versus none (OR 0.88, p = 0.418). Participants with weight misperception had 85% (p < 0.0001) lower odds of attempting weight loss than those with accurate weight perception. CONCLUSION Weight misperception is common among adults with overweight and obesity in the Eastern Caribbean and is associated with lower likelihood of attempting weight loss. Obesity interventions, targeting similar populations, should incorporate approaches for addressing weight misperception to achieve measurable success.
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P4695Transient ST-elevation ECG pattern in acute coronary syndrome: friend or foe? Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p4695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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P3667Evaluation of the diagnostic precision of a single determination of high sensitivity troponin in the screening of acute coronary syndrome in the emergency room. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p3667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Birinapant sensitizes platinum-resistant carcinomas with high levels of cIAP to carboplatin therapy. Gynecol Oncol 2017. [DOI: 10.1016/j.ygyno.2017.03.062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Use of second generation supra-glottic airway devices during laparoscopic cholecystectomy: a prospective, randomized comparison of LMA Proseal™, LMA SupremeTM and igel™. ACTA ANAESTHESIOLOGICA BELGICA 2016; 67:121-128. [PMID: 29873467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
INTRODUCTION Supra-glottic airway devices (SADs) with an inbuilt drain channel, such as the LMA Proseal™ (LMA-P), LMA SupremeTM (LMA-S) and i-gel™ (i-gel), have been used for laparoscopic cholecystectomy. We compared safety, efficacy, and ease of use, as well as the incidence of adverse events between these devices. METHODS One hundred and eighty adult, ASA 1-3 patients scheduled to undergo elective cholecystectomy under general anesthesia were randomly allocated to one of three groups: LMA-P, LMA-S or i-gel. The primary outcome was to evaluate oropharyngeal leak pressure (OLP). Secondary outcomes were to evaluated speed of insertion, ease of insertion of the device and the drain tube, as well as the incidence of intraoperative adverse events and postoperative oropharyngeal discomfort (POPD). RESULTS Mean OLP was significantly higher for LMA-P (LMA-P 30.87; i-gel 29.28; LMA-S 29.02 cm H₂0, P = 0.007). OLP was correlated with a higher maximum tidal achieved volume (P = 0.025). Insertion times were shorter for the i-gel, which was 1.7 s faster to insert than LMA-P (P = 0.04). The success rate on first attempt was higher for the LMA-S (P = 0.004). The drain tube was easily inserted in the LMA-S group (p < 0.001). I-gel showed higher sore throat scoring 2 hours postoperatively (P = 0.008) and reported slower POPD decrease during that time (P < 0.001). CONCLUSIONS Among SAD's, LMA-S is the easiest to insert (including the drain tube), LMA-P achieved the best leak pressure, and i-gel fastest to insert, although associated with the worst POPD scoring.
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Extensive surgical history prior to cytoreductive surgery and hyperthermic intraperitoneal chemotherapy is associated with poor survival outcomes in patients with peritoneal mucinous carcinomatosis of appendiceal origin. Eur J Surg Oncol 2015; 41:881-5. [DOI: 10.1016/j.ejso.2015.02.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Revised: 01/30/2015] [Accepted: 02/12/2015] [Indexed: 11/28/2022] Open
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Systemic chemotherapy (SC) before cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) in patients with peritoneal mucinous carcinomatosis of appendiceal origin (PMCA). Eur J Surg Oncol 2015; 41:707-12. [PMID: 25633641 DOI: 10.1016/j.ejso.2015.01.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Revised: 12/08/2014] [Accepted: 01/07/2015] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The role of SC before CRS/HIPEC for patients with PMCA is unclear. This study explores the effect of SC prior to CRS/HIPEC on overall survival (OS) in patients with PMCA. METHODS 72 patients with recently diagnosed PMCA who underwent CRS/HIPEC were identified from a prospective database. Thirty patients had SC before CRS/HIPEC (Group 1) and 42 did not (Group 2). Patients who were referred to our center after multiple lines of SC were excluded from this analysis. OS was estimated. RESULTS Median follow-up was 3.2 years. Groups were similar regarding lymph node positivity, postoperative SC and rate of complete cytoreduction. Twenty-four (80%) patients in Group 1 and 21 (50%) in Group 2 had high grade histology (HG) (p = 0.01). OS from CRS/HIPEC at 1, 2, and 3 years was 93, 68, 51% in Group 1 and 82, 64, 60% in Group 2, respectively (p = 0.74). Among HG patients 3-year survival was 36% in the SC group vs. 35% in the group without SC (p = 0.67). The 3-year OS for patients with low grade (LG) tumors was 100% in the SC group vs. 79% in the group with no prior SC (p = 0.26). Among patients with signet ring cell (SRC) histology, 1, 2 and 3-year survival was 94, 67 and 22% in the SC group vs. 43, 14, 14% in the group with no SC, respectively (p = 0.028). There were only 6 patients with LG PMCA who received prior SC. CONCLUSIONS Preoperative SC could improve the prognosis of patients with high-grade PMCA with SRC histology.
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Microbial specialists in below-grade foundation walls in Scandinavia. INDOOR AIR 2014; 24:543-51. [PMID: 24527795 DOI: 10.1111/ina.12095] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2013] [Accepted: 01/07/2014] [Indexed: 05/20/2023]
Abstract
Below-grade foundation walls are often exposed to excessive moisture by water infiltration, condensation, leakage, or lack of ventilation. Microbial growth in these structures depends largely on environmental factors, elapsed time, and the type of building materials and construction setup. The ecological preferences of Actinomycetes (Actinobacteria) and the molds Ascotricha chartarum, Myxotrichum chartarum (Ascomycota), Geomyces pannorum, and Monocillium sp. (Hyphomycetes) have been addressed based on analyses of 1764 samples collected in below-grade spaces during the period of 2001-2012. Our results show a significant correlation between these taxa and moist foundation walls as ecological niches. Substrate preference was the strongest predictor of taxa distribution within the wall, but the taxa's physiological needs, together with gradients of abiotic factors within the wall structure, also played a role. Our study describes for the first time how the wall environment affects microbial growth.
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Acute kidney injury in Latin America: a view on renal replacement therapy resources. Nephrol Dial Transplant 2014; 29:1369-76. [DOI: 10.1093/ndt/gfu078] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Increased Chest Compression Depth is Associated With Improved Survival from Out-of-Hospital Cardiac Arrest. Ann Emerg Med 2013. [DOI: 10.1016/j.annemergmed.2013.07.219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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CHF5074 Reduces Biomarkers of Neuroinflammation in Patients with Mild Cognitive Impairment: A 12-Week, Double-Blind, Placebo-Controlled Study. Curr Alzheimer Res 2013:CAR-EPUB-54900. [PMID: 23952019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2012] [Accepted: 08/01/2013] [Indexed: 06/02/2023]
Abstract
As neuroinflammation is an early event in the pathogenesis of Alzheimer's disease, new selective anti-inflammatory drugs could lead to promising preventive strategies. We evaluated the safety, tolerability, pharmacokinetics and pharmacodynamics of CHF5074, a new microglial modulator, in a 12-week, double-blind, placebo-controlled, parallel groups, ascending dose study involving 96 MCI patients. Subjects were allocated into three successive study cohorts to receive ascending, titrated doses of CHF5074 (200, 400 or 600 mg/day) or placebo. Vital signs, cardiac safety, neuropsychological performance and safety clinical laboratory parameters were assessed on all subjects. Plasma samples were collected throughout the study for measuring drug concentrations, soluble CD40 ligand (sCD40L) and TNF-α. At the end of treatment, cerebrospinal fluid (CSF) samples were optionally collected after the last dose to measure drug levels, β-amyloid1-42 (Aβ42), tau, phospho-tau181, sCD40L and TNF-α. Ten patients did not complete the study: one in the placebo group (consent withdrawn), two in the 200-mg/day treatment group (consent withdrawn and unable to comply) and seven in the 400-mg/day treatment group (five AEs, one consent withdrawn and one unable to comply). The most frequent treatment-emergent adverse events were diarrhea, dizziness and back pain. There were no clinically significant treatment-related clinical laboratory, vital sign or ECG abnormalities. CHF5074 total body clearance depended by gender, age and glomerular filtration rate. CHF5074 CSF concentrations increased in a dose-dependent manner. At the end of treatment, mean sCD40L and TNF-α levels in CSF were found to be inversely related to the CHF5074 dose (p=0.037 and p=0.001, respectively). Plasma levels of sCD40L in the 600-mg/day group were significantly lower than those measured in the placebo group (p=0.010). No significant differences between treatment groups were found in neuropsychological tests but a positive dose-response trend was found on executive function in APOE4 carriers. This study shows that CHF5074 is well tolerated in MCI patients after a 12-week titrated treatment up to 600 mg/day and dose-dependently affects central nervous system biomarkers of neuroinflammation.
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Human cardiac Kir2.1, but not Kir2.3, channel expression is regulated by Nav1.5. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht310.p5019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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27
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Peritoneal dialysis. Clin Kidney J 2011. [DOI: 10.1093/ndtplus/4.s2.54] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Factors associated with membrane carbonic anhydrase IX (mCAIX) immunohistochemistry (IHC) in non-small cell lung cancer (NSCLC). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e21125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Prevention of histamine formation in cheese by bacteriocin-producing lactic Acid bacteria. Appl Environ Microbiol 2010; 62:1178-81. [PMID: 16535285 PMCID: PMC1388823 DOI: 10.1128/aem.62.4.1178-1181.1996] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The susceptibility of 13 amine-forming lactobacilli to several bacteriocins was investigated by an agar diffusion assay. All strains were susceptible to nisin and to five bacteriocins of enterococcal origin. Pediocin PA-1, bavaricin A, lactococcin A, and a bacteriocin from Enterococcus faecalis 1061 did not show inhibitory activity. Two bacteriocin-producing enterococci and a nisin-producing Lactococcus lactis strain were employed as starters in separate cheese-making experiments. Outgrowth of histamine producer Lactobacillus buchneri St2A, which was added to the milk at levels of up to 190 CFU/ml, was almost completely inhibited. No histamine formation was detected in the cheeses made with bacteriocin-producing starters. In the control cheese without bacteriocin, St2A reached levels of 1.1 x 10(sup8) CFU/g, and 200 mg of histamine per kg was found after 4 months of ripening. To our knowledge, this is the first report of bacteriocin-mediated inhibition of histamine formation in foods.
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Prognostic value of biomarkers in tissue microarrays (TMAs) of squamous cell carcinomas of the oral tongue (SCCOT). J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.5548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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31
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Evaluation of Src Tyr419 as a predictive biomarker in a neoadjuvant trial using dasatinib in resectable malignant pleural mesothelioma. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.7042] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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The Sea Giveth, The Sea Taketh: The Role of Marine Resources in Northern Ostrobotnia, Finland, 4000-2000 B.C. ARCTIC ANTHROPOLOGY 2009. [DOI: 10.1353/arc.0.0021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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33
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Evaluation of Patients with Head and Neck Cancer by Means of 99mTc-Glucarate. J Nucl Med Technol 2009; 37:229-32. [DOI: 10.2967/jnmt.109.062927] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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34
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Effect of planting date on Lissorhoptrus oryzophilus (Coleoptera: Curculionidae) density-yield relationship on rice in southeastern Texas. JOURNAL OF ECONOMIC ENTOMOLOGY 2009; 102:1536-1545. [PMID: 19736766 DOI: 10.1603/029.102.0418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Results of planting date and insecticide efficacy experiments targeting Lissorhoptrus oryzophilus Kuschel (Coleoptera: Curculionidae) on rice, Oryza sativa L., in southeastern Texas between 2002 and 2007 were used to determine density-yield relationships as a function of planting date. Soil core samples were collected on two dates during main crop development to estimate immature L. oryzophilus populations followed by main and ratoon crop harvests. Analysis of covariance (ANCOVA) revealed that planting date did not affect the density-main crop yield relationship during most years and that these relationships varied substantially among years. For ratoon crop yield, an effect of main crop L. oryzophilus immature infestation was detected during some years, but the real effect of these populations on ratoon crop yield remains unclear. Using estimates of yield reduction per L. oryzophilus immature, economic injury levels were calculated. Main crop yields from treated plots and first soil core sample L. oryzophilus immature populations from untreated plots were significantly higher in plots planted at recommended dates than in plots planted earlier or later. This suggests that the presence of high populations of reproductive L. oryzophilus coincides with the period when rice fields planted at optimum dates are flooded. Results from this study reinforce the importance of managing L. oryzophilus populations when planting rice at recommended dates in southeastern Texas.
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Tumor CTR1 copper transporter modulation by decitabine (DAC) and relationship to global DNA methylation and time from prior therapy. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.11088] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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36
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QSAR as a Tool for the Development of Potent Antiproliferative Agents by Inhibition of Choline Kinase. Curr Comput Aided Drug Des 2007. [DOI: 10.2174/157340907782799354] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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37
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A Technique for estimating regional surface albedos using geostationary satellite data. ACTA ACUST UNITED AC 2006. [DOI: 10.1002/joc.3370070103] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Regionalization of epididymal duct and epithelium in rats and mice by automatic computer-aided morphometric analysis. Asian J Androl 2005; 7:267-75. [PMID: 16110355 DOI: 10.1111/j.1745-7262.2005.00042.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
AIM To establish a rat and mouse epididymal map based on the use of the Epiquatre automatic software for histologic image analysis. METHODS Epididymides from five adult rats and five adult mice were fixed in alcoholic Bouin's fixative and embedded in paraffin. Serial longitudinal sections through the medial aspect of the organ were cut at 10 microm and stained with hematoxylin and eosin. As determined from major connective tissue septa, nine subdivisions of the rat epididymis and seven for the mouse were determined, consisting of five sub-regions in the caput (rat and mouse), one (mouse) or three (rat) in the corpus and one in the cauda (rat and mouse). Using the Epiquatre software, several tubular, luminal and epithelial morphometric parameters were evaluated. RESULTS Statistical comparison of the quantitative parameters revealed regional differences (2-5 in the rat, 3-6 in the mouse, dependent on parameters) with caput regions 1 and 2 being largely distinguishable from the similar remaining caput and corpus, which were in turn recognizable from the cauda regions in both species. CONCLUSION The use of the Epiquatre software allowed us to establish regression curves for different morphometric parameters that can permit the detection of changes in their values under different pathological or experimental conditions.
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Reply. Clin Infect Dis 2004. [DOI: 10.1086/421270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Quality of care in institutionalized deliveries: the paradox of the Dominican Republic. Int J Gynaecol Obstet 2003; 82:89-103; discussion 87-8. [PMID: 12834953 DOI: 10.1016/s0020-7292(03)00148-6] [Citation(s) in RCA: 111] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To better understand the paradox in the Dominican Republic of a relatively high maternal mortality ratio despite nearly universal institutionalized deliveries with trained attendants, a rapid assessment using an adaptation of the strategic assessment method was conducted. METHODS A multi-disciplinary team reviewed national statistics and hospital records, inventoried facilities, and observed peripartum client-provider interactions at 14 facilities. RESULTS The major referral hospitals, where more than 40% of births in the country occur, were overcrowded and understaffed, with inexperienced residents overseeing care provided by medical students, interns and nurses. Uncomplicated labor and deliveries were overmedicalized, while complicated ones were not managed appropriately; emergencies were not dealt with in a timely fashion. In the peripheral hospitals physicians were seldom present and clients were either turned away or delivered by unprepared nursing staff. Providers in the busiest facilities suffered from compassion fatigue, and were demoralized and overworked. In all facilities, quality of care was lacking and the delivery and birthing process was dehumanized. CONCLUSIONS Access and availability of institutional delivery alone is not enough to decrease MMR, it is also the quality of emergency obstetric care that saves lives.
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Diffusive alignment of the magnetic field in active regions of plasmas. PHYSICAL REVIEW. E, STATISTICAL PHYSICS, PLASMAS, FLUIDS, AND RELATED INTERDISCIPLINARY TOPICS 2000; 62:7266-7270. [PMID: 11102085 DOI: 10.1103/physreve.62.7266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2000] [Indexed: 05/23/2023]
Abstract
Regions of high magnetic field within plasmas tend to keep this field aligned in a dominant direction. This occurs both in observed phenomena and in simulations of kinematic and nonlinear dynamos. Although most of this effect is due to the particular dynamics of each case, magnetic diffusion also plays an important role. It is shown here that the unitary magnetic field vector satisfies a certain estimate that bounds its possible variations. The dependence of the bound on the plasma parameters is analyzed.
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Estradiol and estrone serum concentrations in postmenopausal women after administration of estrogel gel and a 7-day transdermal system. Obstet Gynecol 2000. [DOI: 10.1016/s0029-7844(00)00619-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Diuretics for hypertension. JAMA 1999; 282:523; author reply 525. [PMID: 10450705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
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Clinical images. Esophageal foreign body. Dig Dis 1997; 15:368. [PMID: 9439901 DOI: 10.1159/000171612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Taking the 5000 year old "Jettböle skeletons" out of the closet: a palaeo-medical examination of human remains from the Aland (Ahvenanmaa) Islands. Int J Circumpolar Health 1997; 56:30-9. [PMID: 9300844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Results of a somewhat preliminary bioanthropological study on the skeletal material from the Pitted ware site of jettböle, excavated in the parish of jomala, Aland (Ahvenanmaa) Islands, some 85-90 years ago are presented, and the causes for the disorderly distribution, including the possibility of cannibalism, are discussed.
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Abstract
Samples of caprine milk from bulk tanks of 405 farms in central Spain were analyzed for Listeria spp. once per season over a 1-yr period. Listeria monocytogenes and Listeria innocua were detected in 2.56 and 1.73% of the 1445 samples, respectively. Listeria ivanovii (0.21% samples) and Listeria seeligeri (0.07% samples) were rarely isolated. Only 6 milk samples were contaminated by more than one Listeria species. Most farms (92.59%) produced milk that was apparently free from L. monocytogenes throughout the sampling period, and 88.40% produced milk that was apparently free from Listeria spp. Milk contamination by Listeria spp. was seasonal; incidence in autumn (9.33%) and winter (5.14%) samples was higher than incidence in spring (0.85%) and summer (0.85%) samples. Occurrence of Listeria spp. was lower in samples from mountain farms (1.25%) than in samples from plateau farms (7.03%).
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Purification and characterization of enterocin 4, a bacteriocin produced by Enterococcus faecalis INIA 4. Appl Environ Microbiol 1996; 62:4220-3. [PMID: 8900014 PMCID: PMC168244 DOI: 10.1128/aem.62.11.4220-4223.1996] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
A simple two-step procedure was developed to obtain pure enterocin 4, a bacteriocin produced by Enterococcus faecalis INIA 4. Chemical and genetic characterization revealed that the primary structure of enterocin 4 is identical to that of peptide antibiotic AS-48 from Enterococcus faecalis S-48. In contrast to the reported inhibitory spectrum of AS-48, enterocin 4 displayed no activity against gram-negative bacteria.
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