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1.
Trop Anim Health Prod ; 56(4): 157, 2024 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-38727951

RESUMO

Pakistan is endowed with many established indigenous zebu Bos indicus type (humped) cattle breeds including Sahiwal, Red Sindhi, Bhagnari and Cholistani. Amongst these indigenous cattle breeds, Sahiwal and Red Sindhi have extensively been navigated and hence these two are acclaimed as internationally recognized breeds. However, research work on Cholistani cattle breed actually initiated in 2010 and has attained a steady pace. This breed was a new entrant in Livestock Census of Pakistan since 2006. Cholistani is a hardy, tick-resistant, adaptable cattle breed being reared under pastoral nomadism of the Cholistan desert, Pakistan. The present narrative review is the first of its kind intended to sum-up all the research work conducted about this indigenous cattle breed, and to put forth research gaps for this formerly neglected cattle breed. The review discusses the research work conducted on Cholistani cattle breed under five major research subjects/domains i.e. production attributes, theriogenology-related attributes, hematochemical attributes, disease, epidemiologic and therapeutic attributes, and genetic attributes. Future horizon for research avenues has also been given. It is the dire need of time that specific breed-oriented conservation and propagation programs may be initiated in the country so that sustained livestock and enhance socioeconomic profiling of rural communities may be attained.


Assuntos
Conservação dos Recursos Naturais , Animais , Bovinos/genética , Paquistão , Cruzamento , Doenças dos Bovinos/genética , Doenças dos Bovinos/epidemiologia , Criação de Animais Domésticos/métodos
2.
Artigo em Inglês | MEDLINE | ID: mdl-38709411

RESUMO

Hesperidin (HSP), a flavonoid, is a potent antioxidant, metal chelator, mediator of signaling pathways, and regulator of metal uptake in plants. The study examined the ameliorative effects of HSP (100 µM) on Bassia scoparia grown under excessive levels of heavy metals (zinc (500 mg kg-1), copper (400 mg kg-1), cadmium (100 mg kg-1), and chromium (100 mg kg-1)). The study clarifies the underlying mechanisms by which HSP lessens metabolic mayhem to enhance metal stress tolerance and phytoremediation efficiency of Bassia scoparia. Plants manifested diminished growth because of a drop in chlorophyll content and nutrient acquisition, along with exacerbated deterioration of cellular membranes reflected in elevated reactive oxygen species (ROS) production, lipid peroxidation, and relative membrane permeability. Besides the colossal production of cytotoxic methylglyoxal, the activity of lipoxygenase was also higher in plants under metal toxicity. Conversely, hesperidin suppressed the production of cytotoxic ROS and methylglyoxal. Hesperidin improved oxidative defense that protected membrane integrity. Hesperidin caused a more significant accumulation of osmolytes, non-protein thiols, and phytochelatins, thereby rendering metal ions non-toxic. Hydrogen sulfide and nitric oxide endogenous levels were intricately maintained higher in plants treated with HSP. Hesperidin increased metal accumulation in Bassia scoparia and thereby had the potential to promote the reclamation of metal-contaminated soils.

3.
Heliyon ; 10(9): e28993, 2024 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-38694070

RESUMO

Scientists have studied fluid flow over a stretching sheet to explore its potential applications in industries. This study investigates the exponential stretching flow of a bioconvective magnetohydrodynamic (MHD) hybrid nanofluid in porous medium taking into consideration thermal radiations, heat generation, chemical reaction, porosity, and dissipation. Moreover, microorganisms are present in the fluid, so the fluid is more stable, which is crucial in biotechnology, biomicrosystems, and bio-nano coolant systems. Silver and titanium dioxide in a water-based medium are the prototypical nanoparticles. The present study involves a transformation of the governing system into a set of dimensionless, coupled and nonlinear partial differential equations (PDEs) using nonsimilar techniques. The local non-similarity (LNS) technique is used to truncate these equations to ordinary differential equations (ODEs). This technique is also used to estimate transformed equations numerically until the second level of truncation takes place via the bvp4c algorithm, which is a built-in MATLAB solver. Furthermore, tables are provided that presents the drag coefficients, Nusselt numbers, Sherwood numbers, and densities of motile microorganisms. Results show a negative correlation between the velocity and the magnetic field parameter as well as the porosity parameter, as evidenced by a decrease in velocity corresponds to rises in these parameters. The temperature distribution exhibits a positive correlation with the rising values of both radiation parameter and Eckert number. The concentration profiles also exhibit a negative correlation with the increasing values of Lewis and bioconvection Lewis number, chemical reaction parameter, Peclet number and the differences in microbial concentration. This study will improve the future research on hybrid nanofluid regarding industrial applications. There haven't been any previous publications that have investigated the use of this model with the local non-similarity method. The main objective of this article is to enhance the heat transfer performance in a hybrid nanofluid.

4.
Int J Pharm ; 654: 123958, 2024 Apr 10.
Artigo em Inglês | MEDLINE | ID: mdl-38442797

RESUMO

Clinicians face numerous challenges when delivering medications to the eyes topically because of physiological barriers, that can inhibit the complete dose from getting to the intended location. Due to their small size, the ability to deliver drugs of different polarities simultaneously, and their biocompatibility, liposomes hold great promise for ocular drug delivery. This study aimed to develop and characterise a dual loaded liposome formulation encapsulating Bevacizumab (BEV) and Dexamethasone (DEX) that possessed the physicochemical attributes suitable for topical ocular delivery. Liposomes were prepared by using thin film hydration followed by extrusion, and the formulations were optimised using a design of experiments approach. Physicochemical characterisation along with cytocompatibility and bioactivity of the formulations were assessed. Liposomes were successfully prepared with a particle size of 139 ± 2 nm, PDI 0.03 ± 0.01 and zeta potential -2 ± 0.7 mV for the optimised formulation. BEV and DEX were successfully encapsulated into the liposomes with an encapsulation efficiency of 97 ± 0.5 % and 26 ± 0.5 %, respectively. A sustained release of BEV was observed from the liposomes and the bioactivity of the formulation was confirmed using a wound healing assay. In summary, a potential topical eye drop drug delivery system, which can co-load DEX and BEV was developed and characterised for its potential to be used in ocular drug delivery.


Assuntos
Sistemas de Liberação de Medicamentos , Lipossomos , Bevacizumab , Olho , Dexametasona , Tamanho da Partícula
5.
PLoS One ; 19(3): e0295107, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38547098

RESUMO

The study was designed to ascertain the diagnostic efficacy of hand-held digital refractometer in determining total protein (TP). The Sipli sheep (n = 128) were grouped as per gender (females = 99, males = 29) and age (G1 = up till 1 year, n = 35; G2 = from 1 to 2 years, n = 63; G3 = above 2 years, n = 30). The results regarding the overall mean (±SE) values for the TPs attained through serum chemistry analyzer (TP1) and hand-held digital refractometer (TP2) were non-significantly (P≥0.05) different (59.2±1.6g/L and 59.8±0.5g/L, respectively). However, the reference intervals (RIs) were quite different for the two TPs being 45.1-95.7g/L and 57.0-67.0g/L for TP1 and TP2, respectively. Similar results were seen for gender-wise and group-wise results. On the contrary, the results regarding correlation coefficient and logilinear regression showed a negative correlation between the two TPs (r = -0.0244) with an adjusted r-square of 0.059 (5.9% probability). Furthermore, the three tests implied to assess the level of agreement between the two methods (Cronbach alpha, Intraclass correlation coefficient, and Bland & Altman test) revealed least agreement between the two methods. In a nutshell, the results of TP through digital refractometer were not in concordance with those attained through serum chemistry analyzer. However, it can cautiously be used if these results are compared with relevant corrected RIs.


Assuntos
Proteínas Sanguíneas , Refratometria , Masculino , Feminino , Animais , Ovinos , Paquistão , Refratometria/métodos
6.
Pancreatology ; 24(3): 370-377, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38431446

RESUMO

BACKGROUND: Acute pancreatitis (AP) often presents with varying severity, with a small fraction evolving into severe AP, and is associated with high mortality. Complications such as intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are intricately associated with AP. OBJECTIVE: To assess the clinical implications and predictors of ACS in AP patients. METHODS: We conducted a retrospective study using the National Inpatient Sample (NIS) database on adult AP patients, further stratified by the presence of concurrent ACS. The data extraction included demographics, underlying comorbidities, and clinical outcomes. Multivariate linear and logistic regression analyses were performed using STATA (v.14.2). RESULTS: Of the 1,099,175 adult AP patients, only 1,090 (0.001%) exhibited ACS. AP patients with ACS had elevated inpatient mortality and all major complications, including septic shock, acute respiratory distress syndrome (ARDS), requirement for total parenteral nutrition (TPN), and intensive care unit (ICU) admission (P < 0.01). These patients also exhibited increased odds of requiring pancreatic drainage and necrosectomy (P < 0.01). Predictor analysis identified blood transfusion, obesity (BMI ≥30), and admission to large teaching hospitals as factors associated with the development of ACS in AP patients. Conversely, age, female gender, biliary etiology of AP, and smoking were found less frequently in patients with ACS. CONCLUSION: Our study highlights the significant morbidity, mortality, and healthcare resource utilization associated with the concurrence of ACS in AP patients. We identified potential factors associated with ACS in AP patients. Significantly worse outcomes in ACS necessitate the need for early diagnosis, meticulous monitoring, and targeted therapeutic interventions for AP patients at risk of developing ACS.


Assuntos
Hipertensão Intra-Abdominal , Pancreatite , Adulto , Humanos , Feminino , Pancreatite/complicações , Hipertensão Intra-Abdominal/etiologia , Estudos Retrospectivos , Incidência , Doença Aguda
7.
ACS Omega ; 9(8): 9503-9515, 2024 Feb 27.
Artigo em Inglês | MEDLINE | ID: mdl-38434809

RESUMO

Synthetic oil spill dispersants have become essential in offshore oil spill response strategies. However, their use raises significant concerns regarding toxicity to phyto- and zooplankton and other marine organisms, especially in isolated and vulnerable areas such as the Arctic and shorelines. Sustainable alternatives may be developed by replacing the major active components of commercial dispersants with their natural counterparts. During this study, interfacial properties of different types of glycolipid-based biosurfactants (rhamnolipids, mannosylerythritol lipids, and trehalose lipids) were explored in a crude oil-seawater system. The best-performing biosurfactant was further mixed with different nontoxic components of Corexit 9500A, and the interfacial properties of the most promising dispersant blend were further explored with various types of crude oils, weathered oil, bunker, and diesel fuel in natural seawater. Our findings indicate that the most efficient dispersant formulation was achieved when mannosylerythritol lipids (MELs) were mixed with Tween 80 (T). The MELs-T dispersant blend significantly reduced the interfacial tension (IFT) of various crude oils in seawater with results comparable to those obtained with Corexit 9500A. Importantly, no leaching or desorption of MELs-T components from the crude oil-water interface was observed. Furthermore, for weathered and more viscous asphaltenic bunker fuel oil, IFT results with the MELs-T dispersant blend surpassed those obtained with Corexit 9500A. This dispersant blend also demonstrated effectiveness at different dosages (dispersant-to-oil ratio (DOR)) and under various temperature conditions. The efficacy of the MELs-T dispersant was further confirmed by standard baffled flask tests (BFTs) and Mackay-Nadeau-Steelman (MNS) tests. Overall, our study provides promising data for the development of effective biobased dispersants, particularly in the context of petroleum exploitation in subsea resources and transportation in the Arctic.

8.
Scand J Gastroenterol ; 59(5): 615-622, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38305194

RESUMO

BACKGROUND: This retrospective study, conducted using the U.S. National Inpatient Sample (NIS), examines the outcomes and management of nonvariceal upper gastrointestinal bleeding (NVUGIB) in COVID-19 patients and identifies predictive factors to enhance patient prognosis. METHODS: We analyzed the 2020 U.S. NIS data involving adult patients (≥18 years) admitted with NVUGIB and categorized them based on the presence of COVID-19. Primary and secondary outcomes, NVUGIB-related procedures, and predictive factors were evaluated. RESULTS: Of 184,885 adult patients admitted with NVUGIB, 1.6% (2990) had COVID-19. Patients with NVUGIB and COVID-19 showed higher inpatient mortality, acute kidney injury, need for intensive care, and resource utilization metrics. Notably, there was a lower rate of early esophagogastroduodenoscopy (EGD). Multivariate logistic regression revealed conditions like peptic ulcer disease, mechanical ventilation, and alcohol abuse as significant positive predictors for NVUGIB in COVID-19 patients, whereas female gender and smoking were negative predictors. CONCLUSION: Our findings suggest that COVID-19 significantly increases the risk of mortality and complications in NVUGIB patients. The observed decrease in early EGD interventions, potentially contributing to higher mortality rates, calls for a review of treatment strategies. Further multicenter, prospective studies are needed to validate these results and improve patient care strategies.


Assuntos
COVID-19 , Hemorragia Gastrointestinal , Mortalidade Hospitalar , Humanos , COVID-19/complicações , COVID-19/epidemiologia , COVID-19/mortalidade , Masculino , Feminino , Hemorragia Gastrointestinal/etiologia , Hemorragia Gastrointestinal/mortalidade , Hemorragia Gastrointestinal/terapia , Estudos Retrospectivos , Pessoa de Meia-Idade , Idoso , Estados Unidos/epidemiologia , Adulto , SARS-CoV-2 , Fatores de Risco , Pacientes Internados/estatística & dados numéricos , Idoso de 80 Anos ou mais , Prognóstico , Endoscopia do Sistema Digestório , Hospitalização/estatística & dados numéricos
9.
Influenza Other Respir Viruses ; 18(2): e13262, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38387887

RESUMO

INTRODUCTION: Influenza A viruses cause global health concerns due to their high amino acid substitution rates. They are linked to yearly seasonal epidemics and occasional pandemics. This study focused on sequencing influenza A virus strains in Pakistan. MATERIALS AND METHODS: We analyzed the genetic characteristics of influenza A(H1N1)pdm09 and A(H3N2) viruses circulating in Pakistan from January 2020 to January 2023. Whole genome sequences from influenza A (n = 126) virus isolates were amplified and sequenced by the Oxford Nanopore (MinION) platform. RESULTS: The HA genes of influenza A(H1N1)pdm09 underwent amino acid substitutions at positions K54Q, A186T, Q189E, E224A, R259K, and K308R in sequenced samples. The HA genes of influenza A(H3N2) had amino acid substitutions at G53D, E83K, D104G, I140M, S205F, A212T, and K276R in the sequenced samples. Furthermore, the HA gene sequences of influenza A(H1N1)pdm09 in this study belonged to subclade 6B.1A.5a.2a. Similarly, the HA gene sequences of influenza A(H3N2) were classified under six subclades (3C.3a.1 and 3C.2a1b.2a [2, 2a.1, 2b, 2c, and 2a.3b]). Notably, amino acid substitutions in other gene segments of influenza A(H1N1)pdm09 and A(H3N2) were also found. CONCLUSION: These findings indicate influenza A(H1N1)pdm09 and A(H3N2) viruses co-circulated during the 2020-2023 influenza season in Pakistan. Continued surveillance is crucial for real-time monitoring of possible high-virulence variation and their relevance to existing vaccine strains.


Assuntos
Vírus da Influenza A Subtipo H1N1 , Vírus da Influenza A , Influenza Humana , Humanos , Influenza Humana/epidemiologia , Vírus da Influenza A Subtipo H3N2 , Estações do Ano , Paquistão/epidemiologia , Filogenia , Glicoproteínas de Hemaglutininação de Vírus da Influenza/genética , Evolução Molecular
10.
RSC Adv ; 14(10): 7112-7123, 2024 Feb 21.
Artigo em Inglês | MEDLINE | ID: mdl-38419676

RESUMO

Escherichia coli biofilms are a major cause of gastrointestinal tract diseases, such as esophageal, stomach and intestinal diseases. Nowadays, these are the most commonly occurring diseases caused by consuming contaminated food. In this study, we evaluated the efficacy of probiotics in controlling multidrug-resistant E. coli and reducing its ability to form biofilms. Our results substantiate the effective use of probiotics as antimicrobial alternatives and to eradicate biofilms formed by multidrug-resistant E. coli. In this research, surface enhanced Raman spectroscopy (SERS) was utilized to identify and evaluate Escherichia coli biofilms and their response to the varying concentrations of the organometallic compound bis(1,3-dihexylimidazole-2-yl) silver(i) hexafluorophosphate (v). Given the escalating challenge of antibiotic resistance in bacteria that form biofilms, understanding the impact of potential antibiotic agents is crucial for the healthcare sector. The combination of SERS with principal component analysis (PCA) and partial least squares discriminant analysis (PLS-DA) enabled the detection and characterization of the biofilm, providing insights into the biochemical changes induced by the antibiotic candidate. The identified SERS spectral features served as indicators for elucidating the mode of action of the potential drug on the biofilm. Through PCA and PLS-DA, metabolic variations allowing the differentiation and classification of unexposed biofilms and biofilms exposed to different concentrations of the synthesized antibiotic were successfully identified, with 95% specificity, 96% sensitivity, and a 0.75 area under the curve (AUC). This research underscores the efficiency of surface enhanced Raman spectroscopy in differentiating the impact of potential antibiotic agents on E. coli biofilms.

12.
Proc (Bayl Univ Med Cent) ; 37(1): 16-24, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38174025

RESUMO

Background: This retrospective study analyzed factors influencing all-cause inpatient mortality in 80,930 adult patients (2016-2020) with diffuse large B cell lymphoma using the National Inpatient Sample database. Methods: Utilizing ICD-10 codes, patients were identified, and statistical analysis was conducted using STATA. Fisher's exact and Student's t tests compared proportions and variables, multivariate logistic regression examined mortality predictors, and a 5-year longitudinal analysis identified mortality and resource utilization trends. Results: The inpatient mortality rate was found to be 6.56% with a mean age of 67.99 years. Several hospital- and patient-level factors including specific comorbidities such as congestive heart failure, atrial fibrillation, acute kidney injury, chronic obstructive pulmonary disease, liver failure, pancytopenia, tumor lysis syndrome, and severe protein-calorie malnutrition were independently associated with inpatient mortality. Hospitalization costs showed an increasing trend, impacting the overall population and survivors. Conclusion: These insights may refine risk assessment, treatment selection, and interventions.

13.
Pancreatology ; 24(1): 6-13, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38072685

RESUMO

BACKGROUND: Acute pancreatitis (AP) is a significant gastrointestinal cause of hospitalization with increasing incidence. Risk stratification is crucial for determining AP outcomes, but the association between frailty and AP outcomes is poorly understood. Moreover, age disparities in severity indices for AP complicate risk assessment. This study investigates frailty's impact on local and systemic complications in AP, readmission rates, and healthcare resource utilization. METHODS: Using the National Readmission Database from 2016 to 2019, we identified adult AP patients and assessed frailty using the Frailty Risk Score. Our analysis included local and systemic complications, resource utilization, readmission rates, procedures performed, and hospitalization outcomes. Multivariate regression was employed, and statistical significance was set at P < 0.05 using Stata version 14.2. RESULTS: Among 1,134,738 AP patients, 6.94 % (78,750) were classified as frail, with a mean age of 63.42 years and 49.71 % being female. Frail patients experienced higher rates of local complications (e.g., pseudocyst, acute pancreatic necrosis, walled-off necrosis) and systemic complications (e.g., pleural effusion, acute respiratory distress syndrome, sepsis, abdominal compartment syndrome) compared to non-frail patients. Frailty was associated with increased readmission rates and served as an independent predictor of readmission. Frail patients had higher inpatient mortality (7.11 % vs. 1.60 %), longer hospital stays, and greater hospitalization costs. CONCLUSION: Frailty in AP patients is linked to elevated rates of local and systemic complications, increased mortality, and higher healthcare costs. Assessing frailty is crucial in AP management as it provides a valuable tool for risk stratification and identifying high-risk patients, thereby improving overall outcomes.


Assuntos
Fragilidade , Pancreatite , Adulto , Humanos , Feminino , Pessoa de Meia-Idade , Masculino , Fragilidade/complicações , Fragilidade/epidemiologia , Pancreatite/complicações , Pancreatite/epidemiologia , Pancreatite/terapia , Doença Aguda , Hospitalização , Fatores de Risco , Custos de Cuidados de Saúde , Complicações Pós-Operatórias/epidemiologia , Estudos Retrospectivos , Readmissão do Paciente
15.
J Exp Zool A Ecol Integr Physiol ; 341(2): 123-129, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38010902

RESUMO

The present study is the first of its kind being reported for an indigenous sheep breed of Pakistan with objectives to (a) assess the diagnostic efficacy of a human-based "serum hemolysis reference palette" for sheep serum, (b) deduce normal reference intervals (RIs) for hemoglobin (Hb) and bilirubin, and (c) devise a novel serum color chart for on-field estimation of Hb and bilirubin through color matching of sheep serum. Apparently, healthy Sipli sheep (n = 130) were bled twice attaining whole blood and serum samples (n = 260). The study animals were grouped on the basis of gender, that is, males (n = 51) and females (n = 79) and age, that is, G1 (up till 1 year) (n = 41), G2 (from 1 to 2 years) (n = 46), and G3 (from 2 to 3 years) (n = 43). None of the 260 serum samples of the sheep matched the color given on the human-based "hemolysis reference palette." The G1 animals revealed marked variation in their serum color. Hence, on the basis of RIs, the serum samples (n = 178) of adult sheep (G2 and G3) showing three main color bands were used in devising a novel serum Hb and bilirubin estimation chart for adult sheep serum. In conclusion, the human-based serum hemolysis palette is not valid for sheep serum. The RIs attained in the study could provide a yardstick for assessment of health in indigenous sheep breeds whereas the serum color chart may be of value in estimating Hb and bilirubin in a quick, reliable, and cheaper way for the resource-poor settings of the world.


Assuntos
Bilirrubina , Doenças dos Ovinos , Masculino , Feminino , Ovinos , Animais , Humanos , Hemólise , Paquistão , Hemoglobinas
16.
J Gastroenterol Hepatol ; 39(3): 560-567, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37953474

RESUMO

BACKGROUND: Hepatorenal syndrome (HRS) frequently complicates alcoholic hepatitis (AH) and portends poor survival in this population. Published literature indicates mixed benefits from renal replacement therapy (RRT) for HRS refractory to medical management. Therefore, we sought to assess the utilization of RRT in AH and clinical outcomes at a national level. METHODS: Using the International Classification of Diseases, Tenth Revision (ICD-10) codes, we identified adult patients with AH with a coexisting diagnosis of HRS from the National Readmission Database 2016 through 2019. Mortality, morbidity, and resource utilization were compared. We compared proportions using the Fisher exact test and computed adjusted P-values based on multivariate regression analysis. Analyses were performed using Stata, version 14.2, considering a two-sided P < 0.05 as statistically significant. RESULTS: A total of 73 203 patients with AH were included in the analysis (mean age 46.2 years). A total of 3620 individuals had HRS diagnosis (5%), of which 14.7% (n: 532) underwent RRT. HRS patients receiving RRT had a higher mortality rate than those who did not (adjusted odds ratio [aOR] 1.8, 95% confidence interval [CI]: 1.3-2.6, P: 0.01), along with higher resource utilization. Only those patients with HRS who underwent liver transplantation (LT) experienced a mortality reduction (24.4% for those not receiving RRTs and 36.5% for those receiving RRT). CONCLUSIONS: RRT is associated with higher mortality and morbidity when offered to patients with AH and HRS, who do not undergo LT. Therefore, our results suggest careful selection of AH patients when deciding to initiate RRT for HRS.


Assuntos
Hepatite Alcoólica , Síndrome Hepatorrenal , Transplante de Fígado , Adulto , Humanos , Pessoa de Meia-Idade , Síndrome Hepatorrenal/diagnóstico , Síndrome Hepatorrenal/etiologia , Síndrome Hepatorrenal/terapia , Hepatite Alcoólica/diagnóstico , Hepatite Alcoólica/cirurgia , Estudos Retrospectivos , Resultado do Tratamento , Terapia de Substituição Renal/métodos
18.
Artigo em Inglês | MEDLINE | ID: mdl-38085501

RESUMO

BACKGROUND/AIMS: Transjugular intrahepatic portosystemic shunt (TIPS) is a commonly performed procedure in patients with liver cirrhosis to treat portal hypertension-related conditions, including variceal bleeding and refractory ascites. However, while the increased risk of hepatic encephalopathy (HE) after TIPS is important to consider when determining whether a patient is a good candidate for TIPS, currently there is no widely used method to predict the development of post-TIPS HE, although the model for end-stage liver disease (MELD) score is used to predict post-TIPS mortality. We conducted a systematic review and meta-analysis to evaluate sarcopenia as a risk factor for HE and mortality in patients undergoing TIPS. METHODS: A comprehensive search strategy was used to identify reports of post-TIPS HE and mortality in sarcopenia vs. non-sarcopenia patients with liver cirrhosis who received TIPS in March 2023. Open Meta Analyst was used to compute the results. RESULTS: Twelve studies with 2056 patients met inclusion criteria and were included in the final meta-analysis. Sarcopenia was associated with a significantly higher post-TIPS HE rate than non-sarcopenia (risk ratio [RR]: 1.68, 95% CI: 1.48-1.92, p < 0.00001, I2 = 65%), as well as a significantly higher post-TIPS mortality rate (RR: 1.73, 95% CI: 1.14-2.64, p < 0.00001, I2 = 87%). CONCLUSION: Patients with sarcopenia have a significantly increased risk of post-TIPS HE and mortality. Presence of sarcopenia should be considered when weighing the risks and benefits of performing TIPS in patients with cirrhosis. Further studies are needed to determine the clinical utility of important risk factors such as sarcopenia on post-TIPS outcomes.

19.
Front Pharmacol ; 14: 1269605, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38074133

RESUMO

Background: Berberine is a poorly absorbed natural alkaloid widely used as nutraceutical to counteract diarrhoea and to lower cholesterol and hyperglycaemia. It has also been reported to reduce signs and symptoms of polycystic ovary syndrome (PCOS). Objective: To explore, through a multi-centric, randomized, controlled and prospective study, the possible role played by a form berberine that is more easily absorbed (Berberine Phytosome®, BP) in 130 Pakistani women with a diagnosis of PCOS and fertility problems due to menstrual and ovary abnormalities. Results: Ninety days of supplementation with BP, administered at 550 mg x2/die, determined (i) resumption of regular menstruation in about 70% of women (versus 16% in the control group; p < 0.0001), (ii) normalization of the ovaries anatomy in more than 60% of women (versus 13% in the control group; p < 0.0001), (iii) acne improvement in 50% of women (versus 16% in the control group; p = 0.0409) and (iv) hirsutism reduction in 14% of women (versus 0% in the control group; p = 0.0152). The metabolic and the hormonal profiles of the women in the two groups did not significantly differentiate at the end of the study. BP was well-tolerated and no specific side-effects were registered. Respectively after one, two and 8 years of trying, three women supplemented with BP became and are currently pregnant. Conclusion: Our study showed the positive effects of BP supplementation in women with PCOS and confirmed the high safety profile of this nutraceutical. Clinical Trial Registration: https://clinicaltrials.gov/, identifier NCT05480670.

20.
Viruses ; 15(12)2023 11 30.
Artigo em Inglês | MEDLINE | ID: mdl-38140599

RESUMO

Pedilanthus leaf curl virus (PeLCV) is a monopartite begomovirus (family Geminiviridae) discovered just a few decades ago. Since then, it has become a widely encountered virus, with reports from ca. 25 plant species across Pakistan and India, indicative of its notable evolutionary success. Viruses mutate at such a swift rate that their ecological and evolutionary behaviors are inextricably linked, and all of these behaviors are imprinted on their genomes as genetic diversity. So, all these imprints can be mapped by computational methods. This study was designed to map the sequence variation dynamics, genetic heterogeneity, regional diversity, phylogeny, and recombination events imprinted on the PeLCV genome. Phylogenetic and network analysis grouped the full-length genome sequences of 52 PeLCV isolates into 7 major clades, displaying some regional delineation but lacking host-specific demarcation. The progenitor of PeLCV was found to have originated in Multan, Pakistan, in 1977, from where it spread concurrently to India and various regions of Pakistan. A high proportion of recombination events, distributed unevenly throughout the genome and involving both inter- and intraspecies recombinants, were inferred. The findings of this study highlight that the PeLCV population is expanding under a high degree of genetic diversity (π = 0.073%), a high rate of mean nucleotide substitution (1.54 × 10-3), demographic selection, and a high rate of recombination. This sets PeLCV apart as a distinctive begomovirus among other begomoviruses. These factors could further exacerbate the PeLCV divergence and adaptation to new hosts. The insights of this study that pinpoint the emergence of PeLCV are outlined.


Assuntos
Begomovirus , Geminiviridae , Filogenia , Doenças das Plantas , Geminiviridae/genética , Variação Genética , DNA Viral/genética , Análise de Sequência de DNA
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