PCNL in supine position is safe, effective and suitable for the patients. It offers the potential advantages of better urethral access, less patient handling, needing drape only once, ability to perform simultaneous PCNL and ureteroscopic procedures, better control of the airway during procedures, thus reducing over-all operative time compared to traditional prone position and performing PCNL while the surgeon is sitting. It may be considered for most patients requiring PCNL.
One-shot dilation was proved to be safe and effective like metal telescopic dilation even in patients with a history of ipsilateral open renal surgery. In this procedure, X-ray exposure is lower.
PCNL in patients who previously underwent open renal surgery is effective and safe. We found no difference in results between the two groups based on the number of stones and the number of accesses. The step 1 of dilatation was the only difference between the two groups.
Context: Leptospirosis is a worldwide zoonotic infection which appears to be a re-emerging health problem. The clinical features of the disease are broad ranging, but are often similar to those of other infections. As a result, the accuracy of a clinical diagnosis of leptospirosis is low and confirmation requires the use of laboratory tests. Evidence Acquisition: The disease is usually diagnosed in the laboratory by different methods such as direct microscopy, culture, serological methods and molecular methods. The microscopic agglutination test (MAT) is considered the reference test among the several serological methods for leptospirosis diagnosis. However, isolation and identification of the microorganism allows for definitive diagnosis, and provides for epidemiological and prophylactic studies of this disease. Therefore, culture is a golden standard method. Polymerase chain reaction is a rapid, sensitive and specific means of detecting leptospiral infection, in contrast to serology tests. Further benefit is the ability to identify early infection especially during the first few days of the disease even before antibodies are detectable. Conclusions: Choice of test for diagnosis of leptospirosis depends on the stage of the disease. An ideal test will need to discriminate between leptospirosis and a broad spectrum of diseases that cause acute febrile illness and have overlapping clinical presentations. Although detection of antibodies is by itself no proof of a current infection, serological methods (such as MAT and ELISA) are often the most appropriate diagnostic methods.
During last decades, diphtheria has remained as a serious disease that still outbreaks and can occur worldwide. Recently, new vaccine delivery systems have been developed by using the biodegradable and biocompatible polymers such as alginate. Alginate nanoparticles as a carrier with adjuvant and prolong release properties that enhance the immunogenicity of vaccines. In this study diphtheria toxoid loaded nanoparticles were prepared by ionic gelation technique and characterized with respect to size, zeta potential, morphology, encapsulation efficiency, release profile, and immunogenicity. Appropriate parameters (calcium chloride and sodium alginate concentration, homogenization rate and homogenization time) redounded to the formation of suitable nanoparticles with a mean diameter of 70±0.5 nm. The loading studies of the nanoparticles resulted in high loading capacities (>90%) and subsequent release studies showed prolong profile. The stability and antigenicity of toxoid were evaluated by sodium dodecyl sulfate polyacrylamide gel electrophoresis and ouchterlony test and proved that the encapsulation process did not affect the antigenic integrity and activity. Guinea pigs immunized with the diphtheria toxoid-loaded alginate nanoparticles showed highest humoral immune response than conventional vaccine. It is concluded that, with regard to the desirable properties of nanoparticles and high immunogenicity, alginate nanoparticles could be considered as a new promising vaccine delivery and adjuvant system.
Background:A few studies are available comparing either minimum inhibitory concentration (MIC) values with the Clinical and Laboratory Standards Institute (CLSI) disc diffusion method or MIC with the Australian Gonococcal Surveillance Program (AGSP) method.Aim:This study was conducted with the aim to identify the most feasible and cost-effective method for antimicrobial susceptibility testing of Neisseria gonorrhoeae.Materials and Methods:Antimicrobial susceptibility testing of N. gonorrhoeae was performed using, in parallel, the E-test for MIC determination and disc diffusion by CLSI and AGSP techniques, and were compared. Susceptibility to penicillin, ciprofloxacin, tetracycline, ceftriaxone and spectinomycin and cefixime were determined by CSLI and AGSP method and Kappa statistics used to analyse the data with SPSS software.Results:All isolates were susceptible to ceftriaxone and spectinomycin by three methods. Ninety-nine (99%) strains were resistant to ciprofloxacin, while 1% showed intermediate susceptibility to ciprofloxacin by all methods. Statistically, there was a moderate level of agreement between the methods for penicillin.Conclusion:All three methods gave reproducible results. Although the media used in the disc diffusion by the AGSP method is easy and cheap to prepare, the CLSI method of disc diffusion testing is recommended for susceptibility testing of gonococcal isolates because of its feasibility and 100% accuracy, with MIC by E-test as the reference method.
Campylobacter jejuni, a zoonotic bacterial pathogen with worldwide distribution, infects about 400 million humans in the world annually. In order to reduce C. jejuni colonization in the gastrointestinal tracts of broilers and make chickens less susceptible to colonization, four commercial products based on organic acid, probiotics, and medicinal plants were used. In this experiment, 210 one-day-old male broiler chicks (Ross 308) were assigned to 7 treatment groups randomly with 3 replications and 10 birds in each pen. Birds were challenged on day 21 by 1 mL of 6 × 10 7 CFU/mL C. jejuni live suspension and samples were collected on days 28 and 42. The immune system's efficiency was evaluated by lymphoid organ development assessment and two specific and nonspecific immune system tests. The cecal contents and liver were considered for C. jejuni enumeration. According to the results, all treatments except one showed a significant difference from the control in terms of cecal colonization (P ≤ 0.001). Probiotic and Echinacea purpurea treatments could significantly increase the immune system's efficiency (P ≤ 0.001). In general, in this study we provide evidence that some commercial feed and water additives can reduce chickens' susceptibility to C. jejuni colonization and also can effectively increase immune system efficiency.
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