Cochin University of Science and Technology

About: Cochin University of Science and Technology is a education organization based out in Kochi, Kerala, India. It is known for research contribution in the topics: Thin film & Natural rubber. The organization has 5382 authors who have published 7690 publications receiving 103827 citations. The organization is also known as: CUSAT & Cochin University.

Systemic antifungal therapy for proven or suspected invasive candidiasis: the AmarCAND 2 study

Abstract: In the context of recent guidelines on invasive candidiasis (IC), how French intensive care units (ICUs) are managing IC? This is a prospective observational multicenter cohort study. During 1 year (2012–2013), 87 French ICUs enrolled consecutive patients with suspected or proven IC (SIC or PIC) and receiving systemic antifungal therapy (SAT). Data were collected up to 28 days after inclusion. We studied 835 patients, 291 with PIC and 544 with SIC. At SAT initiation, patients with SIC were significantly more severe (SAPS II 50.1 ± 18.7 vs. 46.2 ± 18.0). Severe sepsis or septic shock prompted to initiate empiric SAT in 70 % of SIC. Within 4 days in median, the initial SAT was modified in 49 % of patients with PIC vs. 33 % patients with SIC. Modifications were most often motivated by mycological results, and de-escalation was the most frequent change. Regarding compliance to IC management guidelines, echinocandin was used for 182 (62.5 %) patients with PIC, and 287 (52.7 %) of those with SIC; central venous catheter was removed in 87 (54.3 %) of patients with candidaemia, and 43 of the remaining patients received echinocandin; and de-escalation was undertaken after 5 days of SAT in 142 patients, after 10 days in 13 patients. As 20.6 % of SIC were secondarily documented, 403/835 (48 %) patients had finally a proven IC. Candida albicans was the main pathogen (65.3 %), then Candida glabrata (15.9 %). The 28-day mortality rates were 40.0 % in candidaemia, 25.4 % in cIAI, and 26.7 % in deep-seated candidiasis. In the overall population of patients with proven IC, four independent prognostic factors were identified: immunosuppression (Odds Ratio (OR) = 1.977: 1.03–3.794 95 % confidence interval (CI), p = 0.04), age (OR = 1.035; 1.017–1.053 95 % CI; p 46 on ICU admission (OR = 2.894; 1.81–4.626 95 % CI; p < 0.001), and surgery just before or during ICU stay (OR = 0.473; 0.29–0.77 95 % CI; p < 0.001). When SAT is initiated in French ICUs, the IC is ultimately proven for 48 % of patients. Empiric SAT is initiated in severely ill ICU patients. The initial SAT is often adapted, with de-escalation to fluconazole when possible. Mortality rate remains high.

Ferrospinels based on Co and Ni prepared via a low temperature route as efficient catalysts for the selective synthesis of o-cresol and 2,6-xylenol from phenol and methanol

Abstract: The alkylation of phenol with methanol is conducted over Ni 1− x Co x Fe 2 O 4 ( x =0, 0.2, 0.5, 0.8 and 1.0) type systems prepared via low temperature route. Alkylation leads to predominantly ortho methylation of phenol, yielding o -cresol and 2,6-xylenol as the products. Under optimized conditions, the total ortho selectivity was ≥94%, regardless of the catalyst composition. Only traces of anisole is formed and hardly any other xylenol or cresol isomers are detected. Phenol conversion and the individual selectivities for o -cresol and 2,6-xylenol depend strongly on the catalyst composition. Selectivity for o -cresol was maximum for NiFe 2 O 4 (i.e., when x =0), whereas upon progressive substitution of Co 2+ ions for Ni 2+ ions, the 2,6-xylenol selectivity increases with a concomitant decrease in the o -cresol selectivity. Maximum phenol conversion and 2,6-xylenol selectivity (also total ortho selectivity) were observed over CoFe 2 O 4 ( x =1). The activity and selectivity were shown to be strongly dependent on the surface acid–base properties of the system. The influences of surface acidity, cation distribution in the spinel lattice and various reaction parameters are discussed.

Functional results after extended myotomy for diffuse oesophageal spasm.

Abstract: Background: The role of surgery in the management of patients with diffuse oesophageal spasm (DOS) remains controversial. The aim of this study was to assess functional results after extended myotomy for DOS. Methods: This prospective study evaluated 20 patients who had extended myotomy (14 cm on the oesophagus and 2 cm below the oesophagogastric junction) with anterior fundoplication via a laparotomy for severe DOS. Median follow-up was 50 (range 6–84) months. Functional data were assessed by means of dysphagia (range 0–3), chest pain (range 0–3) and overall clinical (range 0–12, including dysphagia, chest pain, regurgitation, gastro-oesophageal reflux) scores. Results: All patients had severe DOS. The median preoperative overall clinical score was 6 (range 3–8) with a dysphagia score of at least 2. Median postoperative functional scores were significantly lower than preoperative values (overall clinical score 1 versus 6, dysphagia score 0 versus 3, chest pain score 0 versus 2). At final follow-up, good or excellent results were obtained for overall clinical score in 16 patients, for dysphagia score in 18 and for chest pain score in all 20 patients. Postoperative gastro-oesophageal reflux was noted in two of the 20 patients. Conclusion: Extended myotomy with anterior fundoplication is an effective treatment for severe DOS. Medium-term postoperative functional results were excellent, especially in terms of dysphagia and chest pain. Copyright © 2007 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.