The outcome of keratoplasty is progressively getting worse with time in pseudophakic or traumatic keratopathies whereas survival rates are still stable from 10 to 17 years in grafts performed after keratoconus or herpetic keratitis.
The purpose of this study was to investigate the influence of 3 subjective cultural variables--self-construals (independence and interdependence), ethnic identity (bicultural, assimilation, traditional, and marginal), and cultural health attributions (equity and behavioral-environmental attributions)--on source, message, and channel preferences for receiving breast health information by Hispanic women age 35 or older. Subjective cultural variables collectively accounted for 2% to 28% of the variance in communication preferences. In addition, several associations were discovered: (a) having an interdependent self-construal was associated positively with preferences for significant other as a source, family sources, fear messages, media channels, and face-to-face channels; (b) having a bicultural identity was associated positively with preferences for family sources and media channels, but negatively with a desire for no information; and (c) having a marginal identity and equity attributions were associated positively with preferences for fear messages and a desire for no information, but negatively with preferences for expert sources. These findings are discussed in the context of tailoring breast health information to Hispanic women using computer technology and entertainment-education.
Acinetobacter baumannii is classified
as a highest threat pathogen, urgently necessitating novel antimicrobials
that evade resistance to combat its spread. Quaternary ammonium compounds
(QACs) have afforded a valuable first line of defense against antimicrobial
resistant pathogens as broad-spectrum amphiphilic disinfectant molecules.
However, a paucity of innovation in this space has driven the emergence
of QAC resistance. Through this work, we sought to identify next-generation
disinfectant molecules with efficacy against highly resistant A. baumannii clinical isolates. We selected 12 best-in-class
molecules from our previous investigations of quaternary ammonium
and quaternary phosphonium compounds (QPCs) to test against a panel
of 35 resistant A. baumannii clinical
isolates. The results highlighted the efficacy of our next-generation
compounds over leading commercial QACs, with our best-in-class QAC
(2Pyr-11,11) and QPC (P6P-10,10) displaying improved activities with
a few exceptions. Furthermore, we elucidated a correlation between
colistin resistance and QAC resistance, wherein the only pan-resistant
isolate of the panel, also harboring colistin resistance, exhibited
resistance to all tested QACs. Notably, P6P-10,10 maintained efficacy
against this strain with an IC90 of 3 μM. In addition,
P6P-10,10 displayed minimum biofilm eradication concentrations as
low as 32 μM against extensively drug resistant clinical isolates.
Lastly, examining the development of disinfectant resistance and cross-resistance,
we generated QAC-resistant A. baumannii mutants and observed the development of QAC cross-resistance. In
contrast, neither disinfectant resistance nor cross-resistance was
observed in A. baumannii under P6P-10,10
treatment. Taken together, the results of this work illustrate the
need for novel disinfectant compounds to treat resistant pathogens,
such as A. baumannii, and underscore
the promise of QPCs, such as P6P-10,10, as viable next-generation
disinfectant molecules.
Background: Gastrojejunal anastomotic stenosis of laparoscopic Roux-en-Y gastric bypass (LRYGB) for morbid obesity occurs in 3–25% of cases. The aim of this report was to evaluate the utility of endoscopic balloon dilation for the therapy of anastomotic strictures after LRYGB. Patients and Methods: 111 consecutive patients were treated with endoscopic dilation under sedation with propofol. Dilations were performed with through-the-scope over-the-wire balloons, with sizes ranging from 6 to 18 mm. The outcomes of the procedure were analyzed. Results: 200 endoscopic balloon dilations were performed in 111 patients. Repeated dilations were necessary in patients with complex stenosis. In 75% of the patients it was possible to dilate to 12 mm during the first session. Only in 2% of the cases was it impossible to introduce the endoscope through the stenosed anastomosis after dilation. On follow-up a repeat dilation was necessary in 26% of the cases. Minor complications occurred in 2.7% of patients (2 concealed perforations and 1 hematoma of the esophagus). These were treated conservatively. None of the patients required operation. Conclusions: Endoscopic balloon dilation is a safe and effective therapy for anastomotic strictures occurring after LRYGB.
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