Aspergillosis encompasses a wide range of clinical conditions based on the interaction between
Aspergillu
s and the host. It ranges from colonization to invasive aspergillosis. The human lung ...provides an entry door for
Aspergillus
.
Aspergillus
has virulence characteristics such as conidia, rapid growth at body temperature, and the production of specific proteins, carbohydrates, and secondary metabolites that allow
A. fumigatus
to infiltrate the lung’s alveoli and cause invasive aspergillosis. Alveolar epithelial cells play an important role in both fungus clearance and immune cell recruitment via cytokine release. Although the innate immune system quickly clears conidia in immunocompetent hosts,
A. fumigatus
has evolved multiple virulence factors in order to escape immune response such as ROS detoxifying enzymes, the rodlet layer, DHN-melanin and toxins. Bacterial co-infections or interactions can alter the immune response, impact
Aspergillus
growth and virulence, enhance biofilm formation, confound diagnosis, and reduce treatment efficacy. The gut microbiome’s makeup influences pulmonary immune responses generated by
A. fumigatus
infection and vice versa. The real-time PCR for
Aspergillus
DNA detection might be a particularly useful tool to diagnose pulmonary aspergillosis. Metagenomics analyses allow quick and easy detection and identification of a great variety of fungi in different clinical samples, although optimization is still required particularly for the use of NGS techniques. This review will analyze the current state of aspergillosis in light of recent discoveries in the microbiota and mycobiota.
Takayasu arteritis (TA) is a large vessel vasculitis affecting predominantly females below the age of 40. Patients with TA seem to be at increased risk for adverse pregnancy outcomes, resulting in ...mother or child complications. Although few studies analyzed the presence of antiphospholipid antibodies (APLA) in TA patients, an association between antiphospholipid syndrome (APS) and TA is rarely reported in the literature, mainly in the form of case reports. In fact, very few data regarding pregnancy outcomes in patients with TA and APS are available. An active form of Crohn’s disease (CD) might be another risk factor strongly affecting the fertility rate. Here, we would like to present a 33-year-old woman with TA, double-positive APS and Crohn’s disease (CD). The report is followed by the literature review of the association of APLA and/or APS with TA, focusing on analyzing the pregnancy outcomes. To our knowledge, this is the first case describing two successful, naturally occurring pregnancies, in a patient suffering from TA, APS and CD, and maintained on infliximab, azathioprine, and a corticosteroid-free regimen.
Introduction. Massive haemorrhage requires infusion of fluids that do not contain coagulation factors, which leads to dilutional coagulopathy. Blood products therapy based on the results of the ...coarse screening tests can be unpurposeful. Case report. A 75-year-old patient was addmited to the surgical intensive care unit (ICU) Clinical Center 'Zvezdara; as an emergency with the symptoms of hypovolemic shock. In order to compensate the lost fluid volume administered as crystalloids, colloids, concentrated red cells and fresh frozen plasma. The patient was quickly transported to the operation room for surgical treatment, with the additional lost about 3 L of blood during surgery. Continued treatment with the administration of crystalloid and 5% albumin in relation 1.3:1, concentrated red blood cells, fresh frozen plasma, with the vasoactive support. During the surgery, it was observed that the diffuse bleeding starts. In order to prevent further deterioration of the situation, an analysis of rotation thrombelastometry (ROTEM) is conducted, which showed a low value of MCF <50s in EXTEM and INTEM test, in the FIBTEM less than 9 mm which implies a lack of fibrinogen, and extended CT in INTEM, which indicated a lack of coagulation factors. Also, the extended value of CFT and shortened α angle in EXTEM and INTEM pointed to dysfunction of platelet and low fibrinogen. The therapy was furher continued with application of cryoprecipitate, platelet transfusion and tranexamic acid. The control finding of ROTEM analysis showed prolonged CT> 240s in INTEM, as well as in APTEM, the MCF at the lower limit of the FIBTEM, which indicated the need for replacement of fresh frozen plasma and platelets. Therapy is continued, after which thebleeding is stopped, and at the end of surgery, the patient was hemodynamically stable, adequated urine output, transported to the ICU. Conclusion. Application of modern additional tests of coagulation allows quick differential diagnosis of pathophysiological mechanisms of coagulopathy in massive bleeding.
Studies of structural and phase properties obtained on several ferroelectric liquid crystalline materials with 2-alkoxypropionate group used as a chiral centre and without any lateral substitution ...are presented. In dependence on the chiral chain length these compounds exhibit the cholesteric N* phase, the ferroelectric smectic C* and a low-temperature SmX phase. Values of the spontaneous polarization and spontaneous tilt angle have been determined within the whole range of the SmC* phase. A low-temperature SmX phase has been identified as the orthogonal hexatic SmB* phase. The molecular parameters, namely the layer spacing in the SmC* and SmB* phases and the average intermolecular distances (D) between neighbouring parallel molecules in all investigated phases have been determined using the results of the X-ray diffraction obtained on non-oriented samples. The effect of the chiral chain length on mesomorphic, structural and physical properties of the studied ferroelectric liquid crystalline materials is discussed.
New chiral thiols with three aromatic rings and the azo group in the molecular core have been synthesized and grafted on polybutadiene diols backbone. The resulting diols possess the OH end groups ...promising for preparation of the liquid crystal ordered networks. The mesomorphic and physical properties of the synthesized thiols and resulting diols have been studied by polarizing optical microscopy, differential scanning calorimetry, X-ray studies and dielectric spectroscopy. The resulting side-chain diols show the liquid crystalline behaviour. The effects of side-chain structure of the thiols and density of grafting on the polybutadiene diols has been studied and discussed.
Nowadays, cardiovascular diseases are the leading cause of maternal morbidity and mortality in the current obstetric practice. PHYSIOLOGICALLY ADAPTED MECHANISMS OF THE CARDIOVASCULAR SYSTEM IN ...PREGNANCY: It is normal that during pregnancy some physiological adaptive changes of the cardiovascular system occur and they may contribute to the deterioration of the clinical cardiac status of a patient with preexisting or acquired cardiovascular disease. The most prominent adaptive mechanisms include the increase of circulating blood volume, decrease of peripheral vascular resistance and decrease of plasma colloid-oncotic pressure. MOST FREQUENT DISEASES OF THE CARDIOVASCULAR SYSTEM IN PREGNANCY: Due to these changes, pregnant women are prone to tachycardia, palpitations and peripheral edema. Maternal counseling is obligatory for each pregnant woman in order to decrease the maternal morbidity and mortality. The most important predictors of maternal mortality for pregnant women with cardiovascular diseases are severity of pulmonary hypertension, hemodynamic significance of valvular lesion, cyanosis and functional status in heart failure. Cardiovascular diseases in pregnant women may be congenital or acquired. The most frequent congenital cardiac diseases are atrial and ventricular septal defects as well as persistent ductus arteriosus. These diseases are mainly diagnosed and corrected before the pregnancy, or left untreated if hemodynamically insignificant. The most frequent acquired cardiovascular diseases during pregnancy include arrhythmias, ischemic heart disease, rheumatic mitral stenosis and insufficiency, arterial hypertension and aortic dissection.
In all cases of pregnancy associated with cardiovascular diseases, early recognition of cardiovascular disease is crucial, as well as correct diagnosis and referral to a tertiary centre equipped for a multidisciplinary approach of specialists experienced in high-risk pregnancies and deliveries in order to prevent maternal mortality.
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