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1.
Molecules ; 29(9)2024 Apr 23.
Artículo en Inglés | MEDLINE | ID: mdl-38731401

RESUMEN

The burden of human schistosomiasis, a known but neglected tropical disease in Sub-Saharan Africa, has been worrisome in recent years. It is becoming increasingly difficult to tackle schistosomiasis with praziquantel, a drug known to be effective against all Schistosoma species, due to reports of reduced efficacy and resistance. Therefore, this study seeks to investigate the antischistosomal potential of phytochemicals from Azadirachta indica against proteins that have been implicated as druggable targets for the treatment of schistosomiasis using computational techniques. In this study, sixty-three (63) previously isolated and characterized phytochemicals from A. indica were identified from the literature and retrieved from the PubChem database. In silico screening was conducted to assess the inhibitory potential of these phytochemicals against three receptors (Schistosoma mansoni Thioredoxin glutathione reductase, dihydroorotate dehydrogenase, and Arginase) that may serve as therapeutic targets for schistosomiasis treatment. Molecular docking, ADMET prediction, ligand interaction, MMGBSA, and molecular dynamics simulation of the hit compounds were conducted using the Schrodinger molecular drug discovery suite. The results show that Andrographolide possesses a satisfactory pharmacokinetic profile, does not violate the Lipinski rule of five, binds with favourable affinity with the receptors, and interacts with key amino acids at the active site. Importantly, its interaction with dihydroorotate dehydrogenase, an enzyme responsible for the catalysis of the de novo pyrimidine nucleotide biosynthetic pathway rate-limiting step, shows a glide score and MMGBSA of -10.19 and -45.75 Kcal/mol, respectively. In addition, the MD simulation shows its stability at the active site of the receptor. Overall, this study revealed that Andrographolide from Azadirachta indica could serve as a potential lead compound for the development of an anti-schistosomal drug.


Asunto(s)
Azadirachta , Dihidroorotato Deshidrogenasa , Simulación del Acoplamiento Molecular , Oxidorreductasas actuantes sobre Donantes de Grupo CH-CH , Esquistosomiasis , Azadirachta/química , Animales , Esquistosomiasis/tratamiento farmacológico , Oxidorreductasas actuantes sobre Donantes de Grupo CH-CH/antagonistas & inhibidores , Oxidorreductasas actuantes sobre Donantes de Grupo CH-CH/metabolismo , Humanos , Fitoquímicos/farmacología , Fitoquímicos/química , Simulación de Dinámica Molecular , Schistosoma mansoni/efectos de los fármacos , Schistosoma mansoni/enzimología , NADH NADPH Oxidorreductasas/antagonistas & inhibidores , NADH NADPH Oxidorreductasas/metabolismo , Extractos Vegetales/química , Extractos Vegetales/farmacología , Simulación por Computador , Esquistosomicidas/farmacología , Esquistosomicidas/química , Esquistosomicidas/uso terapéutico , Complejos Multienzimáticos/antagonistas & inhibidores , Complejos Multienzimáticos/metabolismo , Praziquantel/farmacología , Praziquantel/química , Praziquantel/uso terapéutico
2.
Taiwan J Obstet Gynecol ; 63(3): 375-380, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38802201

RESUMEN

OBJECTIVES: α-thalassemia is an autosomal recessive monogenic blood disorder, affecting up to 5% of the world's population. The occurrence rate of the disease in Vietnam varies up to up to 51.5%, with high rate of mutation carriers, of couples consisting of two carriers at risk of bearing a child with fetal Hb Bart, which can develop into hydrops fetalis syndrome, threatening the well-being of the mother and the child. Our study aims to facilitate birth of healthy/asymptomatic children of α-thalassemia carrier couples who received reproductive service at our centre during the period of 2019-2022. MATERIALS AND METHODS: 89 couples at risks of having α-thalassemia offsprings requested IVF procedures and PGD at Post Hospital during 2019-2022 were recruited for investigation. Couple and additional family members' peripheral blood samples of couples and additional family members were subjected to haemoglobin electrophoresis, DNA extraction for α-thalassemia gene mutation detection and STRs linkage analysis. Data were observed and analysed on GeneMarker software. RESULTS: 91 cycles of PGD for α-thalassemia were carried out for 89 couples. α-thalassemia large deletion (--SEA/αα) was the most common mutation identified in 88 couples, in which 4 cases also carried ß-thalassemia point mutations. Combining results of PGS and PGD, 278/424 amplified embryos were transferable (HBA-mutation free or carriers of single heterozygous HBA mutation, without chromosomal abnormality). 64/89 couples have been transferred with the embryos (prioritizing mutation free ones over carriers), resulting in the birth of 36 α-thalassemia disease-free children, 17 ongoing pregnancies, and 11 with miscarriages. CONCLUSION: Successful application of microsatellite-based method in PGD facilitated the birth of 36 healthy children and 17 ongoing pregnancies for 53/64 couples with embryo-transferred. All resulted clinical births displayed confirmation results in line with the PGD results, thus demonstrating the feasibility and credibility of the use of STR markers in PGD.


Asunto(s)
Repeticiones de Microsatélite , Diagnóstico Preimplantación , Talasemia alfa , Humanos , Diagnóstico Preimplantación/métodos , Talasemia alfa/genética , Talasemia alfa/diagnóstico , Femenino , Repeticiones de Microsatélite/genética , Embarazo , Masculino , Adulto , Vietnam , Heterocigoto , Mutación , Fertilización In Vitro/métodos
3.
Front Pharmacol ; 15: 1358037, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38576490

RESUMEN

Objective: Medicinal herbs with a phytonutrient background has been applied globally as major alternatives to ameliorate the continuous increase in rheumatoid arthritis cases worldwide. We herein aimed to critically examine the bioactive components of the medicinal herb Piper sarmentosum Roxb leaf fractionated extract for its potential to inhibit the influx of interleukin-6 (IL-6) in rheumatoid arthritis. Methods: The Schrödinger platform was employed as the main computational acumen for the screening of bioactive compounds identified and reference compounds subjected to molecular simulation (MDS) for analyzing the stability of docked complexes to assess fluctuations and conformational changes during protein-ligand interactions. Results: The values of the simulatory properties and principal component analysis (PCA) revealed the good stability of these phytochemicals in the active pocket of interleukin-6 (IL-6). Discussion: Our findings reveal new strategies in which these phytochemicals are potential inhibitory agents that can be modified and further evaluated to develop more effective agents for the management of rheumatoid arthritis, thereby providing a better understanding and useful model for the reproduction and/or discovery of new drugs for the management of rheumatoid arthritis and its complications.

4.
Per Med ; 2024 Apr 04.
Artículo en Inglés | MEDLINE | ID: mdl-38573622

RESUMEN

Background: Copy number variation sequencing (CNV-seq) is a powerful tool to discover structural genomic variation, but limitations associated with its retrospective study design and inadequate diversity of participants can be impractical for clinical application. Aim: This study aims to use CNV-seq to assess chromosomal aberrations in pregnant Vietnamese women. Materials & methods: A large-scale study was conducted on 3776 pregnant Vietnamese women with abnormal ultrasound findings. Results: Chromosomal aberrations were found in 448 (11.86%) women. Of these, 274 (7.26%) had chromosomal aneuploidies and 174 (4.61%) carried pathogenic/likely pathogenic CNVs. Correlations were established between chromosomal aberrations and various phenotypic markers. Conclusion: This comprehensive clinical study illuminates the pivotal role of CNV-seq in prenatal diagnosis for pregnancies featuring fetal ultrasound anomalies.

5.
Hosp Pharm ; 59(2): 173-182, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38450358

RESUMEN

Background: No previous studies have examined the relationship between stress, anxiety, and depression among pharmacists in Vietnam. Objectives: This study aims to investigate the correlation between stress, anxiety, depression, and job satisfaction among hospital pharmacists in Vietnam. Methods: The study comprised a 12-month cross-sectional survey in Can Tho City, Vietnam, with 11 conveniently selected hospitals. Out of 305 the distributed questionnaires, 303 were completed (99.3% response rate). The 21-item depression, anxiety, and stress scale (DASS-21) assessed stress, anxiety, and depression (21 items), while job satisfaction was measured using a 44-item questionnaire. Results: The study revealed a prevalence of 15.5% for stress, 27.1% for anxiety, and 20.5% for depression among hospital staff. Additionally, the majority of hospital staff (72.9%) reported being satisfied with their job. Those with more than 2 children (95% CI = 1.183-14.519) were nearly 4 times as likely to experience higher stress. Female respondents (95% CI = 1.34-5.92) and those who rented (95% CI = 1.05-3.55) were more likely to encounter anxiety. Those living outside Can Tho City (95% CI = 1.32-9.88) were at a 3.61 times higher risk of depression, while individuals who had been working at the hospital for 5 to 10 years (95% CI = 0.17-0.82) had a lower risk of depression. Increased depression (aOR = 0.441; 95% CI = 0.21-0.94) was linked to job dissatisfaction. Conclusion: Depression was significantly associated with job dissatisfaction. The study findings suggest that management agencies should implement prevention and intervention strategies to reduce mental health issues among hospital pharmacists.

6.
J Biomol Struct Dyn ; : 1-14, 2024 Mar 25.
Artículo en Inglés | MEDLINE | ID: mdl-38525928

RESUMEN

The presence of HLA-DRB1 alleles that encode critical points associated with environmental interactions is associated with increased risk of rheumatoid arthritis caused by anti-citrullinated protein antibodies. Therefore, interleukin-6 (IL-6), a multifunctional cytokine that controls both local and systemic acute inflammatory responses through its ability to induce a phase response, plays a serious role. Its overexpression leads to pathological challenges such as rheumatoid arthritis and menopausal osteoporosis. However, targeting the IL-6 receptor and its region could be the major step in controlling the overexpression of this cytokine for therapeutic importance. Therefore, our research explored the computational insight needed to investigate the anti-RFA potential of phytochemicals from fractionated extracts of Morus alba L. against receptors, which have been implicated as druggable targets for the treatment of rheumatoid arthritis. In this study, fifty-nine (59) previously isolated and characterized phytochemicals from M. alba L. were identified from the literature and retrieved from the PubChem database. In silico screening was used to assess the mode of action of these phytochemicals from M. alba L. against receptors that may serve as therapeutic targets for rheumatoid arthritis. Molecular docking studies, toxicity prediction, drug visualization and molecular dynamics simulation (MD) of the ligands together with the receptor-identified target were carried out using the Schrodinger Molecular Drug Discovery Suite. The findings indicated that a selected group of ligands displayed significant binding strength to specific amino acid residues, revealing an important link between the building blocks of proteins (amino acids) and ligands at the inhibitor binding site through traditional chemical interactions, such as interactions between hydrophobic and hydrogen bonds. The binding affinities of the receptors were carefully checked via comparison with those of the approved ligands, and the results suggested structural and functional changes in the lead compounds. Therefore, the bioactive component from M. alba L. could be a lead foot interleukin-6 (IL-6) inhibitor and could be a promising lead compound for the treatment of rheumatoid arthritis and related challenges.Communicated by Ramaswamy H. Sarma.


Identified phytocompounds from the fractionated extract of Morus alba inhibit IL-6 production via molecular docking and molecular simulation analysisChanges in the structure and function of these hit compounds show promising potential in the treatment of rheumatoid arthritis and related challenges.

8.
Radiology ; 310(1): e231469, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-38259205

RESUMEN

Background Health care access disparities and lack of inclusion in clinical research have been well documented for marginalized populations. However, few studies exist examining the research funding of institutions that serve historically underserved groups. Purpose To assess the relationship between research funding awarded to radiology departments by the National Institutes of Health (NIH) and Lown Institute Hospitals Index rankings for inclusivity and community benefit. Materials and Methods This retrospective study included radiology departments awarded funding from the NIH between 2017 and 2021. The 2021 Lown Institute Hospitals Index rankings for inclusivity and community benefit were examined. The inclusivity metric measures how similar a hospital's patient population is to the surrounding community in terms of income, race and ethnicity, and education level. The community benefit metric measures charity care spending, Medicaid as a proportion of patient revenue, and other community benefit spending. Linear regression and Pearson correlation coefficients (r values) were used to evaluate the relationship between aggregate NIH radiology department research funding and measures of inclusivity and community benefit. Results Seventy-five radiology departments that received NIH funding ranging from $195 000 to $216 879 079 were included. A negative correlation was observed between the amount of radiology department research funding received and institutional rankings for serving patients from racial and/or ethnic minorities (r = -0.34; P < .001), patients with low income (r = -0.44; P < .001), and patients with lower levels of education (r = -0.46; P < .001). No correlation was observed between the amount of radiology department research funding and institutional rankings for charity care spending (r = -0.19; P = .06), community investment (r = -0.04; P = .68), and Medicaid as a proportion of patient revenue (r = -0.10; P = .22). Conclusion Radiology departments that received more NIH research funding were less likely to serve patients from racial and/or ethnic minorities and patients who had low income or lower levels of education. © RSNA, 2024 See also the editorial by Mehta and Rosen in this issue.


Asunto(s)
Servicio de Radiología en Hospital , Radiología , Estados Unidos , Humanos , Estudios Retrospectivos , Hospitales , Academias e Institutos
9.
Medicine (Baltimore) ; 103(4): e37088, 2024 Jan 26.
Artículo en Inglés | MEDLINE | ID: mdl-38277525

RESUMEN

Age and gender are 2 important factors in the treatment of end-stage chronic kidney disease with hemodialysis. Understanding the influence of these 2 factors can help optimize treatment for this population. This study evaluated gender and age differences in achievement of Kidney Disease Improving Global Outcomes (KDIGO) treatment targets. A cross-sectional study was conducted on 324 chronic hemodialysis patients at a tertiary referral hospital in Ho Chi Minh City, Vietnam. KDIGO treatment targets included treatment time, prescribed Qb, treated blood volume, urea reduction ratio, spKt/V, hemoglobin, albumin, phosphorus, calcium, and parathyroid hormone. Men had significantly higher treatment time (P = .003), prescribed Qb (P = .037) and hemoglobin (P = .031) than women. However, women had significantly higher treated blood volume (P < .001), spKt/V (P < .001) and URR (P < .001). No significant difference between men and women was found in albumin, calcium, phosphorus, and parathyroid hormone. Based on KDIGO treatment targets, women had a significantly higher rate of achievement of spKt/V > 1.2 (91.4% vs 80.7%, P = .005) and URR ≥ 70% (77.0% vs 54.7%, P < .001) than men. A significantly higher rate of treated volume of ≥ 1 L/kg/BW, and phosphorus 2.5 to 4.6 mg/dL was found in women (90.0% and 40.2%) compared to men (68.7% and 27.3%). In contrast, men had a significantly higher rate of prescribed Qb ≥ 300 mL/min (26.7% vs 12.6%, P = .001), albumin ≥ 40 g/L (36.7% vs 26.4%, P = .047), and Hb > 12 g/dL (22.0% vs 11.5%, P = .011) than women. There was no significant difference between men and women in the rate of calcium 8.4 to 10.4 mg/dL, and parathyroid hormone 150 to 600 pg/mL. These differences were not the same across 4 age categories (<60, 60-69, 70-79, and ≥ 80). Most of the differences above were among patients aged < 60 and 60 to 69 years. Although men had higher satisfactory treatment parameters than women, based on KDIGO treatment targets, women received hemodialysis more effectively than men. Treatment targets for patients on hemodialysis should consider gender and age differences.


Asunto(s)
Enfermedades Renales , Fallo Renal Crónico , Masculino , Humanos , Femenino , Calcio , Centros de Atención Terciaria , Estudios Transversales , Vietnam , Diálisis Renal , Fallo Renal Crónico/terapia , Hormona Paratiroidea , Fósforo , Hemoglobinas/análisis , Albúminas
10.
Sci Rep ; 13(1): 20058, 2023 11 16.
Artículo en Inglés | MEDLINE | ID: mdl-37973826

RESUMEN

Posttraumatic osteoarthritis is primarily characterized by articular cartilage destruction secondary to trauma or fracture events. Even while intra-articular scar tissue can be observed following ankle fractures, little is known about its nature and molecular events linking its biological activity and cartilage deterioration. Here, we investigated scar tissue's histological and molecular characteristics, and its relationship with localized articular cartilage alterations consistent with early osteoarthritic degeneration. Intra-articular scar tissues from sixty-two patients who underwent open reduction internal fixation for ankle fracture were obtained at hardware removal time (6-44 months after fracture). Histological analysis demonstrated that scar tissue has the nature of fibrosis with fibrous tissue hyperplasia, fibroblast proliferation, and chondrometaplasia. These fibrous scar tissues showed overexpressed pro-inflammatory cytokines and high mRNA expression levels of osteoarthritis-related markers (cytokines, chemokines, and enzymes) compared to the normal synovium. Furthermore, those transcriptional levels were significantly correlated with the grade of talar chondral degeneration. Our findings suggest that following an ankle fracture, the intra-articular fibrous scar tissue exhibits high catabolic and inflammatory activity, which has a long-lasting negative impact correlated to cartilage deterioration in the development of posttraumatic osteoarthritis.


Asunto(s)
Fracturas de Tobillo , Cartílago Articular , Osteoartritis , Humanos , Fracturas de Tobillo/cirugía , Cicatriz , Tobillo , Osteoartritis/etiología , Osteoartritis/metabolismo , Citocinas/metabolismo , Cartílago Articular/metabolismo
11.
Per Med ; 20(6): 467-475, 2023 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-37937420

RESUMEN

Background: Noninvasive prenatal tests for monogenic diseases (NIPT-SGG) have recently been reported as helpful in early-stage antenatal screening. Our study describes the clinical and genetic features of cases identified by NIPT-SGG. Materials & methods: In a cohort pregnancy with abnormal sonograms, affected cases were confirmed by invasive diagnostic tests concurrently, with NIPT-SGG targeting 25 common dominant single-gene diseases. Results: A total of 13 single-gene fetuses were confirmed, including Noonan and Costello syndromes, thanatophoric dysplasia, achondroplasia, osteogenesis imperfecta and Apert syndrome. Two novel variants seen were tuberous sclerosis complex (TSC2 c.4154G>A) and Alagille syndrome (JAG1 c.3452del). Conclusion: NIPT-SGG and standard tests agree on the results for 13 fetuses with monogenic disorders. This panel method of screening can benefit high-risk Vietnamese pregnancies, but further research is encouraged to expand on the causative gene panel.


Asunto(s)
Diagnóstico Prenatal , Displasia Tanatofórica , Embarazo , Femenino , Humanos , Vietnam , Displasia Tanatofórica/diagnóstico , Displasia Tanatofórica/genética , Receptor Tipo 3 de Factor de Crecimiento de Fibroblastos
12.
Environ Res ; 238(Pt 2): 117249, 2023 12 01.
Artículo en Inglés | MEDLINE | ID: mdl-37783331

RESUMEN

The medical plant research has received more attention among researchers especially after the Covid-19 pandemic. This research performed to evaluate the antifungal, anti-lung cancer (A549), and anti-hyperglycemic activities of aqueous extract of Andrographis paniculata flower. Interestingly, A. paniculata flower aqueous extract contains pharmaceutically valuable phytochemicals such as alkaloid, phenolics, terpenoids, tannins, flavonoids, and protein. It also showed fine antifungal activity against test fungal pathogens in the following order as: Aspergillus niger > Fusarium solani > Trichoderma harzianum > A. parasiticus > P. expansum > Penicillium janthinellum with lowest MIC values as ranged from 100 to 300 µg mL-1. Interestingly, this aqueous extract also showed considerable anti-lung cancer activity, evidenced by dose and time dependent lung cancer cell line (A549) growth/proliferation inhibition/cytotoxicity activity (65%) at 300 µg mL-1 concentration. This can be achieved by plant extract through inducing the secretion of apoptosis related proteins such as TNF α, IFN-γ, and interleukin 2 leads to apoptosis in A549 cells. It also showed fine anti-diabetic activity by inhibiting α -amylase (58.41%) than α-glucosidase (54.74%) at 200 µg mL-1 concentration. The UV as well as FTIR results demonstrated that the aqueous extract of A. paniculata flower contains pharmaceutically valuable bioactive compounds, which may be responsible for the wide range of biomedical applications.


Asunto(s)
Andrographis , Antifúngicos , Humanos , Antifúngicos/química , Antifúngicos/farmacología , Andrographis paniculata , Pandemias , Andrographis/química , Flores , Agua , Hipoglucemiantes/farmacología
13.
ACS Omega ; 8(40): 37540-37548, 2023 Oct 10.
Artículo en Inglés | MEDLINE | ID: mdl-37841154

RESUMEN

Aspergillus flavus (A. flavus) and Aspergillus niger (A. niger) mainly spread through airborne fungal spores. An effective control to impede the dissemination of the spores of Aspergillus in the air affecting the environment and food was carried out. This study focuses on the sustainable rice husk-extracted lignin, nanolignin, lignin/n-lignin capped silver nanoparticles used for fungal growth inhibition. These biomaterials inhibit the growth of fungi by altering the permeability of cell membranes and influencing intracellular biosynthesis. The antifungal indexes for A. flavus and A. niger on day 5 at a concentration of 2000 µg/100 µL are 50.8 and 43.6%, respectively. The results demonstrate that the hybrid biomaterials effectively prevent the growth or generation of fungal spores. The findings of this research hold significant implications for future investigations focused on mitigating the dissemination of Aspergillus during the cultivation of agricultural products or in the process of assuring agricultural product management, such as peanuts and onions.

14.
Per Med ; 20(5): 425-433, 2023 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-37623819

RESUMEN

Background: Over 60% of single-gene diseases in newborns are autosomal dominant variants. Noninvasive prenatal testing for monogenic conditions (NIPT-SGG) is cost-effective and timesaving, but not widely applied. This study introduces and validates NIPT-SGG in detecting 25 monogenic conditions. Methods: NIPT-SGG with a 30-gene panel applied next-generation sequencing and trio assays to confirm de novo variants. Diagnostic tests confirmed NIPT-detected cases. Results: Among 93 pregnancies with ultrasound findings, 11 (11.8%) fetuses were screened and diagnosed with monogenic diseases, mostly with Noonan syndrome. NIPT-SGG determined >99.99% of actual positive and negative cases, confirmed by diagnostic tests. No false-negatives or false-positives were reported. Conclusion: NIPT-SGG effectively identifies the fetuses affected with monogenic diseases, which is a promisingly safe and timely antenatal screening option for high-risk pregnancies.


Asunto(s)
Pruebas Prenatales no Invasivas , Embarazo , Femenino , Recién Nacido , Humanos , Vietnam , Diagnóstico Prenatal
15.
J Vet Med Sci ; 85(9): 929-936, 2023 Sep 01.
Artículo en Inglés | MEDLINE | ID: mdl-37407444

RESUMEN

Eurytrema spp. are pancreatic flukes belonging to the Dicrocoeliidae family. They are the cause of neglected diseases in Vietnam and are responsible for economic losses in ruminant production, particularly in water buffaloes and cattle. Eurytrema spp. have been widely reported in several Asian countries. Recently, morphological and molecular analyses to discriminate Eurytrema spp. have been conducted in Brazil, China, Bangladesh, Nepal, and Indonesia; however, similar analyses have not been performed in Vietnam. In the present study, we identified Eurytrema flukes collected from water buffaloes and cattle in northern Vietnam based on their morphology. Morphometric analyses were conducted on 15 samples each of Eurytrema cladorchis and Eurytrema coelomaticum. Representative samples from both species were selected for molecular analyses, and the nucleotide sequences of the 18S ribosomal RNA (18S rRNA) gene and internal transcribed spacer 2 (ITS2) were determined. Phylogenetic analyses based on 18S rRNA sequences revealed that E. cladorchis from Vietnam belongs to the same clade as that from Bangladesh. Similarly, E. coelomaticum isolates from Vietnam and China belonged to the same clade. Both clades were isolated from E. pancreaticum. This is the first study to describe the coexistence of E. cladorchis and E. coelomaticum in Vietnam and the first report of the ITS2 nucleotide sequence for E. coelomaticum, which can be used for molecular species discrimination.


Asunto(s)
Búfalos , Dicrocoeliidae , Animales , Bovinos , ARN Ribosómico 18S/genética , Filogenia , Vietnam/epidemiología , Dicrocoeliidae/genética
16.
Sci Rep ; 13(1): 10479, 2023 06 28.
Artículo en Inglés | MEDLINE | ID: mdl-37380704

RESUMEN

Hospital readmissions rate is reportedly high and has caused huge financial burden on health care systems in many countries. It is viewed as an important indicator of health care providers' quality of care. We examine the use of machine learning-based survival analysis to assess quality of care risk in hospital readmissions. This study applies various survival models to explore the risk of hospital readmissions given patient demographics and their respective hospital discharges extracted from a health care claims dataset. We explore advanced feature representation techniques such as BioBERT and Node2Vec to encode high-dimensional diagnosis code features. To our knowledge, this study is the first to apply deep-learning based survival-analysis models for predicting hospital readmission risk agnostic of specific medical conditions and a fixed window for readmission. We found that modeling the time from discharge date to readmission date as a Weibull distribution as in the SparseDeepWeiSurv model yields the best discriminative power and calibration. In addition, embedding representations of the diagnosis codes do not contribute to improvement in model performance. We find dependency of each model's performance on the time point at which it is evaluated. This time dependency of the models' performance on the health care claims data may necessitate a different choice of model in quality of care issue detection at different points in time. We show the effectiveness of deep-learning based survival-analysis models in estimating the quality of care risk in hospital readmissions.


Asunto(s)
Instituciones de Salud , Readmisión del Paciente , Humanos , Calibración , Personal de Salud , Calidad de la Atención de Salud
17.
Am J Sports Med ; 51(6): 1560-1570, 2023 05.
Artículo en Inglés | MEDLINE | ID: mdl-37014305

RESUMEN

BACKGROUND: Osteochondral defects of the talus can be effectively treated using microfracture, which is technically safe, accessible, and affordable. However, fibrous tissue and fibrocartilage comprise the majority of tissue repairs resulting from these procedures. These tissue types lack the mechanical characteristics of native hyaline cartilage and might significantly contribute to the decline in long-term outcomes. Recombinant human-bone morphogenetic protein-2 (rhBMP-2) has been shown to promote matrix synthesis and increase cartilage formation, thus enhancing chondrogenesis in vitro. PURPOSE: This study aimed to evaluate the treatment ability of combining rhBMP-2 with microfracture in rabbit talus osteochondral defect. STUDY DESIGN: Controlled laboratory study. METHODS: A full-thickness chondral defect (3 × 3 × 2 mm) was constructed in the center talar dome of 24 New Zealand White male rabbits, which were then divided into 4 groups of 6. Each group received the appropriate treatment: group 1 (control; no treatment of defect), group 2 (microfracture treatment), group 3 (rhBMP-2/hydroxyapatite treatment), and group 4 (microfracture combined with rhBMP-2/hydroxyapatite treatment). Animals were sacrificed at 2, 4, and 6 weeks postoperatively. The International Cartilage Regeneration & Joint Preservation Society macroscopic score, which considers the degree of defect repair, the integration to the border zone, and the macroscopic appearance, was used to assess the repaired tissue's macroscopic appearance. Subchondral bone regeneration in defects was analyzed using micro-computed tomography, and the histological findings were graded using a modified version of the Wakitani scoring system for osteochondral repair. RESULTS: At 2, 4, and 6 weeks, micro-computed tomography analysis revealed that groups 3 and 4 exhibited subchondral bone healing that was more significantly improved compared with groups 1. No sample showed excessive bone growth from the subchondral bone area. According to macroscopic and histological results, group 4 showed higher-quality cartilage and more accelerated cartilage regeneration than the other groups over time. CONCLUSION: These findings show that osteochondral defect repair in a rabbit talus model could be effectively accelerated and improved by combining rhBMP-2 with microfracture. CLINICAL RELEVANCE: Using rhBMP-2 in combination with microfracture may enhance the repair of talar osteochondral lesions.


Asunto(s)
Cartílago Articular , Fracturas por Estrés , Fracturas Intraarticulares , Astrágalo , Animales , Humanos , Masculino , Conejos , Cartílago Articular/patología , Fracturas por Estrés/cirugía , Fracturas por Estrés/patología , Hidroxiapatitas/farmacología , Fracturas Intraarticulares/patología , Astrágalo/cirugía , Microtomografía por Rayos X , Proteína Morfogenética Ósea 2/metabolismo
18.
Int J Biol Macromol ; 230: 123124, 2023 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-36599386

RESUMEN

Antibacterial materials have been developed for a long time but bacteria adapt very quickly and become resistant to these materials. This study focuses on the synthesis of a hybrid material system from lignin and silver/silica nanoparticles (Lig@Ag/SiO2 NPs) which were used against bacteria including Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus) and inhibited the growth of the fungal Aspergillus flavus (A. flavus). The results showed that the spherical diameter of Lig@Ag/SiO2 NPs has narrow Gaussian distribution with a range from 15 nm to 40 nm in diameter. Moreover, there was no growth of E. coli in samples containing Lig@Ag/SiO2 NPs during 72-h incubation while colonies of S. aureus were only observed at high concentrations (106 CFU/mL) although both species of bacteria were able to thrive even at low bacterial concentration when they were exposed to Ag/SiO2 or lignin. For fungal resistance results, Lig@Ag/SiO2 NPs not only reduced mycelial growth but also inhibited sporulation in A. flavus, leading to decreasing the spreading of spores into the environment. This result represents a highly effective fungal growth inhibition of Lig@Ag/SiO2 NPs compared to lignin or Ag/SiO2, which could not inhibit the growth of sporulation.


Asunto(s)
Nanopartículas del Metal , Nanopartículas , Oryza , Antifúngicos/farmacología , Staphylococcus aureus , Dióxido de Silicio/farmacología , Lignina/farmacología , Escherichia coli , Antibacterianos/farmacología , Bacterias
19.
Telemed J E Health ; 29(2): 209-221, 2023 02.
Artículo en Inglés | MEDLINE | ID: mdl-35758766

RESUMEN

Introduction: Telepharmacy is widely known as the delivery of pharmacy care offered by registered pharmacists and pharmacies using telecommunication technologies to patients at a distance. We conducted a systematic review of the reported usages, benefits, and limitations of telepharmacy models worldwide to further clarify the pros and cons of a telepharmacy model. Methods: A total of 39 relevant articles was included after searching for articles with a fixed term on four databases, including PubMed, Virtual Health Library (VHL), Global Health Library (GHL), and Google Scholar, as of April 2021. Results: Our review suggested that telepharmacy has played an essential role in addressing pharmacist shortages and helping patients both safely and effectively administer medications in underserved areas. During the COVID-19 pandemic, remote dispensing and counseling are effective measures to avoid infection. Conclusion: Telepharmacy could potentially replace or complement pharmaceutical-related activities, facilitating future innovation in the health care industry.


Asunto(s)
COVID-19 , Servicios Farmacéuticos , Telemedicina , Humanos , Pandemias
20.
J Matern Fetal Neonatal Med ; 36(1): 2155044, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-36514835

RESUMEN

OBJECTIVE: To demonstrate the prevalence of maternal mosaic monosomy X (MMXO) in a cohort of pregnant women in Vietnam. METHODS: All 105,594 singleton pregnant women undergoing noninvasive prenatal screening (NIPS) between January 2019 and February 2021 in Vietnam were analyzed by measuring discordance between size- and count-based z-scores for chromosome X (ChrX) to identify suspected cases of MMXO and validated by fluorescence in situ hybridization (FISH) on maternal blood. RESULTS: We identified 295 (0.279%) suspected MMXO cases. After FISH analysis, MMXO was confirmed in 125 cases (42.37%), revealing the MMXO prevalence of 0.118% (95% CI: 0.097-0.139%) in this cohort. CONCLUSION: We found a relatively high prevalence of MMXO in Vietnamese pregnant women and demonstrated a strong influence of MMXO on the ChrX z-score using a count-based method, resulting in false positives. The size-based method is not sensitive to MMXO and therefore achieves higher PPV.


Asunto(s)
Síndrome de Turner , Embarazo , Femenino , Humanos , Síndrome de Turner/diagnóstico , Síndrome de Turner/epidemiología , Síndrome de Turner/genética , Mujeres Embarazadas , Hibridación Fluorescente in Situ , Vietnam/epidemiología , Prevalencia , Diagnóstico Prenatal/métodos
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