A comparison of the efficacy and airway complications between Parker Flex-Tip tubes and standard endotracheal tubes during airway manipulation: A meta-analysis and trial sequential analysis
Background: Despite reported superior intubation outcomes associated with Parker Flex-Tip (PFT) tubes compared with those associated with standard polyvinylchloride tubes, the efficacy and safety of PFT tubes remain uncertain.
Objectives: To compare the intubation outcomes between PFT and conventional standard polyvinylchloride tubes.
Design: Meta-analysis of randomised controlled trials.DATA SOURCES Embase, Medline, Google Scholar, PubMed and the Cochrane controlled trials register from inception until 3 January 2021.ELIGIBILITY CRITERIA All randomised trials comparing intubation outcomes between PFT (PFT group) and standard polyvinylchloride (standard polyvinylchloride group) tubes.
Results: Analysis of the 13 eligible trials showed no significant difference in successful first-attempt intubation rate [risk ratio (RR) 1.20, 95% confidence interval (CI) 0.99 to 1.44] (6 trials, 568 participants), trauma risk (RR 0.83, 95% CI 0.67 to 1.03) (5 trials, 501 participants) as well as the overall risks of epistaxis (RR 0.58, 95% CI 0.26 to 1.31) (3 trials, 262 participants), sore throat (RR 0.90, 95% CI 0.70 to 1.17) (4 trials, 451 participants) and hoarseness (RR 0.71, 95% CI 0.44 to 1.14) (4 trials, 451 participants) between the two groups. However, the intubation time was slightly shorter (weighted mean difference -4.2 s, 95% CI -7.4 to -1.0 s) (8 trials, 759 participants) and the risks of severe epistaxis (RR 0.15, 95% CI 0.03 to 0.84) (3 trials, 262 participants) and overall difficulty in airway manipulation (RR 0.48, 95% CI 0.29 to 0.80) (8 trials, 647 participants) were lower in the PFT group than those in the standard polyvinylchloride group. Trial sequential analysis conclusively confirmed a shorter intubation time with PFT tubes than with standard polyvinylchloride tubes, whereas other intubation outcomes were inconclusive.
Conclusion: The use of PFT tubes for airway manipulation was associated with a shorter intubation time compared with the standard polyvinylchloride tubes. The results of trial sequential analysis suggest the need for further trials and meta-analysis to compare other intubation outcomes associated with the two devices.TRIAL REGISTRATION PROSPERO CRD42020197670.
Percutaneous management of complicated parapneumonic effusion and empyema after surgical tube thoracostomy failure in children: a retrospective study
Purpose: We aimed to evaluate the results of percutaneous management of complicated parapneumonic effusions (PPE) and empyema after surgical tube thoracostomy failure in children.
Methods: A total of 84 children treated percutaneously after surgical tube thoracostomy failure between 2004 and 2019 were included to this retrospective study. Technical success was defined as appropriate placement of the drainage catheter. Clinical success was defined as complete resolution of infection both clinically and radiologically. Management protocol included imaging-guided pigtail catheter insertion, fibrinolytic therapy, serial ultrasonographic evaluation, catheter manipulations as necessary (revision, exchange, or upsizing), and appropriate antibiotherapy. All patients were followed up at least 6 months.
Results: Technical success rate was 100%. Unilateral single, unilateral double, and bilateral catheter insertions were performed in 73, 9, and 2 patients, respectively. Inserted catheter sizes ranged from 8 F to 16 F. Streptokinase, urokinase, and tissue plasminogen activator were used as fibrinolytic agent in 29 (34%), 14 (17%), and 41 (49%) patients, respectively. In order to maintain effective drainage, 42 additional procedures (catheter exchange, revision, reposition, or additional catheter placement) were performed in 20 patients (24%). Clinical success was achieved in 83 of 84 patients (99%). Median catheter duration was 8 days (4-32 days). Median hospital stay during percutaneous management was 11.5 days (7-45 days). Factors affecting the median catheter duration were the presence of necrotizing pneumonia (p < 0.001) and bronchopleural fistulae (p < 0.001).
Conclusion: Percutaneous imaging-guided catheterization with fibrinolytic therapy should be the method of choice in pediatric complicated PPE and empyema patients with surgical tube thoracostomy failure. Percutaneous treatment is useful in avoiding more aggressive surgical options.
MWCNT Type 5 Carbon Nanotubes Multi Walled |
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41335-2 | Sisco Laboratories | 25 Gms | EUR 85.26 |
Description: Part C |
MWCNT Type 5 Carbon Nanotubes Multi Walled |
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41335-3 | Sisco Laboratories | 100 Gms | EUR 286.18 |
Description: Part C |
MWCNT Type 1 Carbon Nanotubes Multi Walled |
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57743 | Sisco Laboratories | 1 Gms | EUR 35.23 |
Description: Part C |
MWCNT Type 1 Carbon Nanotubes Multi Walled |
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57743-1 | Sisco Laboratories | 5 Gms | EUR 122.27 |
Description: Part C |
MWCNT Type 1 Carbon Nanotubes Multi Walled |
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57743-2 | Sisco Laboratories | 25 Gms | EUR 352.3 |
Description: Part C |
MWCNT Type 3 Carbon Nanotubes Multi Walled |
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68465 | Sisco Laboratories | 1 Gms | EUR 26.64 |
Description: Part C |
MWCNT Type 3 Carbon Nanotubes Multi Walled |
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68465-1 | Sisco Laboratories | 5 Gms | EUR 79.93 |
Description: Part C |
MWCNT Type 3 Carbon Nanotubes Multi Walled |
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68465-2 | Sisco Laboratories | 25 Gms | EUR 234.47 |
Description: Part C |
MWCNT Type 3 Carbon Nanotubes Multi Walled |
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68465-3 | Sisco Laboratories | 100 Gms | EUR 745.86 |
Description: Part C |
MWCNT Type 2 Carbon Nanotubes Multi Walled |
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88440 | Sisco Laboratories | 1 Gms | EUR 53.29 |
Description: Part C |
MWCNT Type 2 Carbon Nanotubes Multi Walled |
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88440-1 | Sisco Laboratories | 5 Gms | EUR 191.84 |
Description: Part C |
MWCNT Type 2 Carbon Nanotubes Multi Walled |
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88440-2 | Sisco Laboratories | 25 Gms | EUR 671.25 |
Description: Part C |
MWCNT Type 19 - Carbon Nanotubes Multi Walled (Conducting) |
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42927 | Sisco Laboratories | 1 Gms | EUR 191.84 |
Description: Part C |
MWCNT Type 19 - Carbon Nanotubes Multi Walled (Conducting) |
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42927-1 | Sisco Laboratories | 5 Gms | EUR 639.28 |
Description: Part C |
MWCNT-Ni Type 2 Carbon Nanotubes Multi Walled , Nickel coated |
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53105 | Sisco Laboratories | 1 Gms | EUR 111.91 |
Description: Part C |
MWCNT-Ni Type 2 Carbon Nanotubes Multi Walled , Nickel coated |
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53105-1 | Sisco Laboratories | 5 Gms | EUR 415.56 |
Description: Part C |
MWCNT-Ni Type 1 Carbon Nanotubes Multi Walled, Nickel coated |
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58908 | Sisco Laboratories | 1 Gms | EUR 111.91 |
Description: Part C |
MWCNT-Ni Type 1 Carbon Nanotubes Multi Walled, Nickel coated |
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58908-1 | Sisco Laboratories | 5 Gms | EUR 415.56 |
Description: Part C |
MWCNT-Ni Type 4 Carbon Nanotubes Multi Walled , Nickel coated |
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75288 | Sisco Laboratories | 1 Gms | EUR 111.91 |
Description: Part C |
MWCNT-Ni Type 4 Carbon Nanotubes Multi Walled , Nickel coated |
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75288-1 | Sisco Laboratories | 5 Gms | EUR 415.56 |
Description: Part C |
MWCNT-Ni Type 3 Carbon Nanotubes Multi Walled , Nickel coated |
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90500 | Sisco Laboratories | 1 Gms | EUR 111.91 |
Description: Part C |
MWCNT-Ni Type 3 Carbon Nanotubes Multi Walled , Nickel coated |
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90500-1 | Sisco Laboratories | 5 Gms | EUR 415.56 |
Description: Part C |
MWCNT Type 15 Carbon Nanotubes Multi-Walled |
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24968 | Sisco Laboratories | 500 Mg | EUR 23.49 |
Description: Part C |
MWCNT Type 15 Carbon Nanotubes Multi-Walled |
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24968-1 | Sisco Laboratories | 1 Gms | EUR 29.61 |
Description: Part C |
MWCNT Type 15 Carbon Nanotubes Multi-Walled |
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24968-2 | Sisco Laboratories | 5 Gms | EUR 69.08 |
Description: Part C |
MWCNT Type 13 Carbon Nanotubes Multi-Walled |
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28658 | Sisco Laboratories | 500 Mg | EUR 23.49 |
Description: Part C |
MWCNT Type 13 Carbon Nanotubes Multi-Walled |
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28658-1 | Sisco Laboratories | 1 Gms | EUR 42.63 |
Description: Part C |
MWCNT Type 13 Carbon Nanotubes Multi-Walled |
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28658-2 | Sisco Laboratories | 5 Gms | EUR 85.26 |
Description: Part C |
MWCNT Type 13 Carbon Nanotubes Multi-Walled |
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28658-3 | Sisco Laboratories | 25 Gms | EUR 277.11 |
Description: Part C |
MWCNT Type 11 Carbon Nanotubes Multi-Walled |
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29466 | Sisco Laboratories | 50 Mg | EUR 31.97 |
Description: Part C |
MWCNT Type 11 Carbon Nanotubes Multi-Walled |
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29466-1 | Sisco Laboratories | 100 Mg | EUR 47.96 |
Description: Part C |
MWCNT Type 11 Carbon Nanotubes Multi-Walled |
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29466-2 | Sisco Laboratories | 1 Gms | EUR 159.87 |
Description: Part C |
MWCNT Type 11 Carbon Nanotubes Multi-Walled |
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29466-3 | Sisco Laboratories | 5 Gms | EUR 479.51 |
Description: Part C |
MWCNT Type 9 Carbon Nanotubes Multi-Walled |
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46918 | Sisco Laboratories | 500 Mg | EUR 69.28 |
Description: Part C |
MWCNT Type 9 Carbon Nanotubes Multi-Walled |
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46918-1 | Sisco Laboratories | 1 Gms | EUR 106.58 |
Description: Part C |
MWCNT Type 10 Carbon Nanotubes Multi-Walled |
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58255 | Sisco Laboratories | 1 Gms | EUR 23.68 |
Description: Part C |
MWCNT Type 10 Carbon Nanotubes Multi-Walled |
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58255-1 | Sisco Laboratories | 5 Gms | EUR 74.01 |
Description: Part C |
MWCNT Type 14 Carbon Nanotubes Multi-Walled |
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65875 | Sisco Laboratories | 50 Mg | EUR 106.58 |
Description: Part C |
MWCNT Type 14 Carbon Nanotubes Multi-Walled |
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65875-1 | Sisco Laboratories | 100 Mg | EUR 159.87 |
Description: Part C |
MWCNT Type 8 Carbon Nanotubes Multi-Walled |
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73235 | Sisco Laboratories | 500 Mg | EUR 69.28 |
Description: Part C |
MWCNT Type 8 Carbon Nanotubes Multi-Walled |
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73235-1 | Sisco Laboratories | 1 Gms | EUR 106.58 |
Description: Part C |
MWCNT Type 12 Carbon Nanotubes Multi-Walled |
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82903 | Sisco Laboratories | 500 Mg | EUR 26.64 |
Description: Part C |
MWCNT Type 12 Carbon Nanotubes Multi-Walled |
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82903-1 | Sisco Laboratories | 1 Gms | EUR 47.96 |
Description: Part C |
MWCNT Type 12 Carbon Nanotubes Multi-Walled |
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82903-2 | Sisco Laboratories | 5 Gms | EUR 95.92 |
Description: Part C |
MWCNT Type 7 Carbon Nanotube Multi Walled (Graphitized) |
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35203 | Sisco Laboratories | 1 Gms | EUR 79.14 |
Description: Part C |
MWCNT Type 7 Carbon Nanotube Multi Walled (Graphitized) |
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35203-1 | Sisco Laboratories | 5 Gms | EUR 263.68 |
Description: Part C |
MWCNT Type 17 Carbon Nanotubes Multi-Walled Short |
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28174 | Sisco Laboratories | 500 Mg | EUR 29.61 |
Description: Part C |
MWCNT Type 17 Carbon Nanotubes Multi-Walled Short |
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28174-1 | Sisco Laboratories | 1 Gms | EUR 51.81 |
Description: Part C |
MWCNT Type 17 Carbon Nanotubes Multi-Walled Short |
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28174-2 | Sisco Laboratories | 5 Gms | EUR 197.37 |
Description: Part C |
MWCNT Type 16 Carbon Nanotubes Multi-Walled Short |
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33670 | Sisco Laboratories | 500 Mg | EUR 44.41 |
Description: Part C |
MWCNT Type 16 Carbon Nanotubes Multi-Walled Short |
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33670-1 | Sisco Laboratories | 1 Gms | EUR 69.08 |
Description: Part C |
MWCNT Type 16 Carbon Nanotubes Multi-Walled Short |
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33670-2 | Sisco Laboratories | 5 Gms | EUR 266.35 |
Description: Part C |
MWCNT Type 18 Carbon Nanotubes Multi-Walled Short |
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90797 | Sisco Laboratories | 1 Gms | EUR 53.29 |
Description: Part C |
MWCNT Type 18 Carbon Nanotubes Multi-Walled Short |
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90797-1 | Sisco Laboratories | 5 Gms | EUR 181.18 |
Description: Part C |
HMWCNT Type1- Carbon Nanotubes Multi Walled Helical |
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34528 | Sisco Laboratories | 250 Mg | EUR 121.78 |
Description: Part C |
HMWCNT Type1- Carbon Nanotubes Multi Walled Helical |
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34528-1 | Sisco Laboratories | 1 Gms | EUR 164.41 |
Description: Part C |
TCNT Type 1- Carbon Nanotubes Thin Walled |
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59800 | Sisco Laboratories | 25 Mg | EUR 121.78 |
Description: Part C |
TCNT Type 1- Carbon Nanotubes Thin Walled |
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59800-1 | Sisco Laboratories | 100 Mg | EUR 314.61 |
Description: Part C |
DWCNT Type 1 Carbon Nanotubes Double Walled |
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36078 | Sisco Laboratories | 100 Mg | EUR 213.16 |
Description: Part C |
DWCNT Type 1 Carbon Nanotubes Double Walled |
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36078-1 | Sisco Laboratories | 500 Mg | EUR 532.8 |
Description: Part C |
SWCNT Type 1 Carbon Nanotubes Single- Walled |
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73953 | Sisco Laboratories | 250 Mg | EUR 177.14 |
Description: Part C |
SWCNT Type 1 Carbon Nanotubes Single- Walled |
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73953-1 | Sisco Laboratories | 1 Gms | EUR 404.9 |
Description: Part C |
SWCNT Type 2 Carbon Nanotubes Single- Walled (Short) |
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20770 | Sisco Laboratories | 100 Mg | EUR 140.72 |
Description: Part C |
SWCNT Type 2 Carbon Nanotubes Single- Walled (Short) |
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20770-1 | Sisco Laboratories | 250 Mg | EUR 307.7 |
Description: Part C |
DWCNT Type 2 Carbon Nanotubes Double Walled (Short) |
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85143 | Sisco Laboratories | 100 Mg | EUR 223.32 |
Description: Part C |
SWCNT Type 3 Carbon Nanotubes Single- Walled COOH Functionalized |
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29129 | Sisco Laboratories | 25 Mg | EUR 69.08 |
Description: Part C |
SWCNT Type 3 Carbon Nanotubes Single- Walled COOH Functionalized |
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29129-1 | Sisco Laboratories | 100 Mg | EUR 128.29 |
Description: Part C |
SWCNT Type 6 Carbon Nanotubes Single-Walled |
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27404 | Sisco Laboratories | 50 Mg | EUR 159.87 |
Description: Part C |
SWCNT Type 6 Carbon Nanotubes Single-Walled |
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27404-1 | Sisco Laboratories | 250 Mg | EUR 617.96 |
Description: Part C |
SWCNT Type 4 Carbon Nanotubes Single-Walled |
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18989 | Sisco Laboratories | 50 Mg | EUR 95.92 |
Description: Part C |
SWCNT Type 4 Carbon Nanotubes Single-Walled |
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18989-1 | Sisco Laboratories | 250 Mg | EUR 287.66 |
Description: Part C |
SWCNT Type 4 Carbon Nanotubes Single-Walled |
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18989-2 | Sisco Laboratories | 1 Gms | EUR 831.02 |
Description: Part C |
DWCNT Type 3 Carbon Nanotubes Double-Walled |
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45565 | Sisco Laboratories | 50 Mg | EUR 116.94 |
Description: Part C |
SWCNT Type 5 Carbon Nanotubes Single-Walled |
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55024 | Sisco Laboratories | 50 Mg | EUR 105.49 |
Description: Part C |
SWCNT Type 5 Carbon Nanotubes Single-Walled |
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55024-1 | Sisco Laboratories | 250 Mg | EUR 287.66 |
Description: Part C |
DWCNT Type 4 Carbon Nanotubes Double-Walled |
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69072 | Sisco Laboratories | 50 Mg | EUR 116.94 |
Description: Part C |
DWCNT Type 4 Carbon Nanotubes Double-Walled |
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69072-1 | Sisco Laboratories | 250 Mg | EUR 365.33 |
Description: Part C |
SWCNT Type 11 Carbon Nanotubes Single-Walled ultrapure |
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81868 | Sisco Laboratories | 50 Mg | EUR 805.46 |
Description: Part C |
SWCNT Type 12 Single-Walled Carbon Nanotubes ultrapure |
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28989 | Sisco Laboratories | 50 Mg | EUR 805.46 |
Description: Part C |
SWCNT Type 9 Carbon Nanotubes Single-Walled in aq. media pure |
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42480 | Sisco Laboratories | 20 ml | EUR 575.33 |
Description: Part C |
SWCNT Type 7 Carbon Nanotubes Single-Walled in aq. media pure |
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95425 | Sisco Laboratories | 20 ml | EUR 489.08 |
Description: Part C |
SWCNT Type 8 Carbon Nanotubes Single-Walled in aq. media extrapure |
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52710 | Sisco Laboratories | 20 ml | EUR 671.25 |
Description: Part C |
SWCNT Type 10 Carbon Nanotubes Single-Walled in aq. media extrapure |
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68069 | Sisco Laboratories | 20 ml | EUR 1342.4 |
Description: Part C |
Boron Nitride Nanotubes (C) Cylindrical structure |
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45882 | Sisco Laboratories | 50 Mg | EUR 315.79 |
Description: Part C |
Carboy bottle HDPE heavy walled 10Lt - EACH |
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BOT3704 | Scientific Laboratory Supplies | EACH | EUR 61.83 |
Carboy bottle HDPE heavy walled 46mm Neck 5Lt - EACH |
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BOT3702 | Scientific Laboratory Supplies | EACH | EUR 58.86 |
Zeolite - Mesoporous Carbon Nanopowder (CMK-3 Type) |
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19366 | Sisco Laboratories | 100 Mg | EUR 129.57 |
Description: Part C |
Zeolite - Mesoporous Carbon Nanopowder (CMK-3 Type) |
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19366-1 | Sisco Laboratories | 250 Mg | EUR 196.88 |
Description: Part C |
PCR Tubes, thin walled without graduatio |
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PW1255-1X1000NO | EWC Diagnostics | 1 unit | EUR 51.13 |
Description: PCR Tubes, thin walled without graduatio |
Axygen 0.2ml thin walled flat cap PCR tube red - PK1000 |
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AXY2056 | Scientific Laboratory Supplies | PK1000 | EUR 89.1 |
The Arabidopsis Diacylglycerol Kinase 4 is involved in nitric oxide-dependent pollen tube guidance and fertilization
Nitric oxide (NO) is a key signaling molecule that regulates diverse biological processes in both animals and plants including important roles in male gamete physiology. In plants, NO is generated in pollen tubes (PTs) and affects intracellular responses through the modulation of Ca2+ signaling, actin organization, vesicle trafficking and cell wall deposition bearing consequences in pollen-stigma interactions and PT guidance. In contrast, the NO-responsive proteins that mediate these responses remains elusive. Here we show that PTs of Arabidopsis thaliana impaired in the pollen- specific Diacylglycerol Kinase 4 (DGK4) grow slower and become insensitive to NO-dependent growth inhibition and re-orientation responses.
Recombinant DGK4 protein yields NO-responsive spectral and catalytic changes in vitro which are compatible with a role in NO perception and signaling in PTs. In addition to the expected phosphatidic acid producing kinase activity, DGK4 recombinant protein also revealed guanylyl cyclase activity as hinted by sequence analysis. Our results are compatible with a role for the fast-diffusible NO gas in signaling and cell-cell communication via the modulation of DGK4 activity during the progamic phase of angiosperm reproduction.
PRP8A and PRP8B spliceosome subunits act co-ordinately to control pollen tube attraction in Arabidopsis
Precise guided pollen tube growth by the female gametophyte is a pre-requisite for successful sexual reproduction in flowering plants. Cysteine-rich proteins (CRPs) secreted from the embryo sac are known pollen tube attractants perceived by pollen tube receptor-like kinases (RLK’s). How pre-mRNA splicing facilitates this cell-to-cell communication is not understood. Here, we report novel function of Pre-mRNA PROCESSING factor 8 paralogs, PRP8A and PRP8B, as regulators of pollen tube attraction. Double mutant prp8a prp8b ovules cannot attract pollen tubes, and prp8a prp8b pollen tubes fail in sensing ovules attraction signals.
Only 3% of ovule-expressed genes were misregulated in prp8a prp8b. Combination of RNA-seq and MYB98/LURE1.2-YFP reporter revealed the expression of MYB98, LUREs and 49 other CRPs were downregulated suggesting loss of synergid cell fate. Differential Exon usage (DEU) and Intron-retention (IR) analysis revealed autoregulation of PPR8A/PRP8B splicing. In vivo, PRP8A coimmunoprecipitates with splicing enhancer AtSF3A1, suggesting involvement of PRP8A in 3′-splice site selection. Our data hint that PRP8A/PRP8B module exhibit spliceosome-autoregulation to facilitate pollen tube attraction via transcriptional regulation of MYB98, CRPs and LURE pollen tube attractants.
Residual Perforation Risk Assessment of Intratympanic Steroids via Tympanostomy Tube Versus Transtympanic Injections
Objectives/hypothesis: To investigate the risk of residual tympanic membrane (TM) perforation after intratympanic (IT) steroidal treatment administered via transtympanic injection compared with trans-tympanostomy tube (TyT).
Study design: Case series, systematic review and meta analysis.
Methods: Data were retrieved from the medical files of an original cohort of all consecutive patients with sudden sensorineural hearing loss necessitating IT steroidal treatment in a tertiary medical center between January 1, 2016 and November 20, 2020. A systematic literature search of “MEDLINE” via “PubMed,” “Embase,” and “Web of Science” on comparable published cases was performed and meta-analysis was established.
Results: Eighteen studies describing 818 ears were included in the quantitative meta-analysis in addition to a local cohort of 140 ears. The proportion of residual TM perforation was 1.11% and 1.14% (95% confidence interval: 0.01%-3.27% and 0.028%-2.38%) in the TyT and trans-tympanic groups, respectively, suggesting no significant difference in residual TM perforation risk between these techniques.
Conclusion: IT steroid therapy via trans-TyT is not associated with more residual perforations than IT steroid therapy via transtympanic injections.