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Objective: To investigate the relationship between genes and clinical characteristics in children and adolescents with metastatic differentiated thyroid cancer (caDTC). Methods: A cross sectional study. A total of 67 caDTC patients with lymph node metastasis or distant metastasis in Peking Union Medical College Hospital from December 2020 to December 2022 were included, according to the inclusion and exclusion criteria. Then the differences in clinicopathologic features and iodine intake were compared among different genomes, and the age subgroups divided by the age of 12 were further analyzed. Results: Among the 67 cases of caDTC, the diagnosed age [M(Q1, Q3)]was 13.2 (9.7, 16.9) years old, with 23 males and 44 females. There were 68.7% (46/67) of patients have distant metastasis (M1 stage). Pathogenic or potentially pathogenic gene variants were detected in 68.7% (46/67) of the patients, with RET or NTRK fusion (RET/NTRK) being the most common [43.3%(29/67)], BRAF V600E mutation followed [19.4%(13/67)].There was only 1 caDTC with NRAS Q61R mutation. The patients were divided into RET/NTRK fusion group (n=29), BRAF mutation group (n=12), other mutation group (n=4), and non-mutation group (n=21) (1 patient was not included in the gene mutation subgroup comparison due to the presence of NRAS Q61R mutation and BRAF V600E mutation). The comparison of gene feature groups showed that compared to the BRAF mutation group, caDTC with RET/NTRK fusion tended to have a lower age at diagnosis [12.6(9.3, 15.9) vs 17.2(15.5, 18.1) years old, P<0.001], the proportion of mutation load≥2 was higher (10.4% vs 8.3%, P=0.027), with statistically significant difference. Among 46 M1 stage patients, 71.7% (33/46) had initial iodine intake, and 30.4% (14/46) developed radioiodine-refractory (RAIR). In age group comparison, the<12 year old group had a higher proportion of male patients (51.9% vs 22.5%, P=0.013) and a lower incidence of BRAF V600E mutations (0 vs 32.5%, P<0.001) compared to the≥12 year old group, and the differences were statistically significant. Conclusions: The incidence of RET/NTRK fusion ranks first in metastatic caDTC, featured with younger age at diagnosis and higher rate of distant metastasis. Although most metastatic lesions initially consume iodine, they are prone to RAIR. Attention should be paid to the potential role of RET/NTRK fusion in the invasion and iodine resistance of young caDTC patients.
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Mutação , Neoplasias da Glândula Tireoide , Humanos , Masculino , Neoplasias da Glândula Tireoide/genética , Neoplasias da Glândula Tireoide/patologia , Feminino , Adolescente , Criança , Estudos Transversais , Metástase Linfática , Proteínas Proto-Oncogênicas B-raf/genética , Proteínas Proto-Oncogênicas c-ret/genética , GTP Fosfo-Hidrolases/genética , Proteínas de Membrana/genética , Receptor trkA/genéticaRESUMO
The single-nucleotide polymorphism (SNP) rs2235371 (IRF6 V274I) is associated with nonsyndromic cleft lip with or without cleft palate (NSCL/P) in Han Chinese and other populations but appears to be without a functional effect. To find the common etiologic variant or variants within the haplotype tagged by rs2235371, we carried out targeted sequencing of an interval containing IRF6 in 159 Han Chinese with NSCL/P. This study revealed that the SNP rs12403599, within the IRF6 promoter, is associated with all phenotypes of NSCL/P, especially nonsyndromic cleft lip (NSCLO) and a subphenotype of it, microform cleft lip (MCL). This association was replicated in 2 additional much larger cohorts of cases and controls from the Han Chinese. Conditional logistic analysis indicated that association of rs2235371 with NSCL/P was lost if rs12403599 was excluded. rs12403599 contributes the most risk to MCL: its G allele is responsible for 38.47% of the genetic contribution to MCL, and the odds ratios of G/C and G/G genotypes were 2.91 and 6.58, respectively, for MCL. To test if rs12403599 is functional, we carried out reporter assays in a fetal oral epithelium cells (GMSM-K). Unexpectedly, the risk allele G yielded higher promoter activity in GMSM-K. Consistent with the reporter studies, expression of IRF6 in lip tissues from NSCLO and MCL patients with the G/G phenotype was higher than in those from patients with the C/C phenotype. These results indicate that rs12403599 is tagging the risk haplotype for NSCL/P better than rs2235371 in Han Chinese and supports investigation of the mechanisms by which the allele of rs12403599 affects IRF6 expression and tests of this association in different populations.
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Fenda Labial , Fissura Palatina , Humanos , Fenda Labial/genética , Fatores Reguladores de Interferon/genética , Fissura Palatina/genética , Genótipo , Polimorfismo de Nucleotídeo Único/genética , Predisposição Genética para Doença/genética , Estudos de Casos e ControlesRESUMO
Various methods of evaluating a humectant's moisture retention have unique mechanisms. Hence, for designing advanced or efficient ingredients of cosmetic products, a clear understanding of differences among methods is required. The aim of this study was to analyze the moisture-retention capacity of glycerin, a common ingredient in cosmetic products. Specifically, this study applied gravimetric analysis, transepidermal water loss (TEWL) analysis, and differential scanning calorimetry (DSC) to examine the evaporation of glycerin solutions of different concentrations. The results revealed that the moisture-retention capacity of glycerin increased with the glycerin concentration from 0 to 60 wt%, and glycerin at concentration of 60-70 wt% did not exhibit weight change during the evaporation process. When the glycerin concentration exceeded 70 wt%, moisture sorption occurred in the glycerin solution. Furthermore, the results revealed a deviation between the evaporation rates measured using gravimetric analysis and those measured using TEWL analysis. However, normalizing the results of these analyses yielded the relative evaporation rates to water, which were consistent between these two analyses. DSC thermograms further confirmed the consistent results and identified two hydrated water microstructures (nonfreezable water and free water) in the glycerin solutions, which explained why the measured evaporation rate decreased with the glycerin concentration. These findings can be applied to prove the moisture-retention capacity of a humectant in cosmetic products by different measuring methods.
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Cosméticos , Glicerol , Varredura Diferencial de Calorimetria , Cosméticos/análise , Glicerol/química , Higroscópicos , Água/químicaRESUMO
OBJECTIVES: Tooth loss, which usually leads to malnutrition, is common in the elderly. However, limited information is available regarding its association with sarcopenia. This study aimed to investigate the relationship between loss of occlusal pairs of tooth and sarcopenia. DESIGN: A cross-sectional retrospective study was performed. SETTING: The elderly who participated in the National Basic Public Health Project in the Maigaoqiao Community Medical Center in Nanjing, Jiangsu Province, China. PARTICIPANTS: A total of 2850 individuals aged ≥60 years were enrolled. MEASUREMENTS: Sarcopenia was defined according to the criteria proposed by the Asian Working Group for Sarcopenia. A trained dentist assessed oral health status and counted the number of present teeth. Logistic regression analyses were performed to evaluate the association between the loss of occlusal pairs and sarcopenia. RESULTS: The prevalence of sarcopenia was 7.1% (201/2850). Univariate logistic regression analysis showed that loss of occlusal pairs was associated with sarcopenia [anterior occlusal pairs (AOPs): odd ratio (OR) = 1.292, 95% confidence interval (CI) = 1.158-1.442; posterior occlusal pairs (POPs): OR = 1.147, 95% CI = 1.018-1.221]. Multivariate logistic regression analysis indicated that loss of POPs was still an independent risk for sarcopenia (OR = 1.108, 95% CI = 1.007-1.220) after adjustment for traditional confounders. Subgroup analysis showed that loss of POPs was more significantly linked to sarcopenia in those with advanced age (≥80years) (OR = 1.307, 95% CI = 1.116-1.532) and in females (OR = 1.165, 95%CI = 1.038-1.308). Compared to individuals with ≥5 occluding pairs of POPs, those with <5 occluding pairs of POPs had a higher incidence of sarcopenia. CONCLUSIONS: Loss of POPs is associated with an increased risk of sarcopenia in the elderly in a Chinese population. Further research on the mechanism of the observed causal relationship is needed.
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Sarcopenia , Idoso , China/epidemiologia , Estudos Transversais , Feminino , Avaliação Geriátrica , Humanos , Vida Independente , Prevalência , Estudos Retrospectivos , Sarcopenia/complicações , Sarcopenia/epidemiologiaRESUMO
Silver diamine fluoride (SDF) is used topically to prevent or arrest dental caries and has been tested clinically in toddlers to elderly adults. Following SDF application, small quantities of silver can be swallowed and absorbed. To monitor silver concentrations, pharmacokinetic studies can be performed. However, pharmacokinetic studies are time-consuming, resource intensive, and challenging to perform in young children. The objective of this study was to develop a physiologically based pharmacokinetic (PBPK) model to predict silver disposition in children. The PBPK model for silver was developed using Simcyp software (version 17.0) based on information obtained from literature sources. The predictive performance of the model was assessed by comparing the predicted PK profiles and parameters with the observed data from published rat and human data following intravenous or oral silver administration. The predicted silver concentrations were within 2-fold of observed blood and tissue silver concentrations in rats and within the 95% confidence interval of observed plasma silver concentrations in healthy human adults. The PBPK model was applied to the pediatric population by accounting for developmental physiological changes. For a given SDF dose, the simulated peak silver concentrations were 5.2-, 4.3-, 2.7-, and 1.3-fold higher in children aged 1 to 2, 2 to 4, 5 to 10, and 12 to 17 y, respectively, compared to adults. As silver is reportedly excreted in the bile, the half-life of silver was comparable in all ages and plasma and tissue silver concentrations were predicted to return to baseline levels within 2 wk after SDF application. The simulation in children suggests that conventional SDF application to teeth to prevent or arrest dental caries results in plasma and tissue silver concentrations lower than toxic concentrations. PBPK modeling offers a novel approach to studying dental exposures in younger children, where pharmacokinetic studies would be difficult to conduct.
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Compostos de Amônio Quaternário/farmacologia , Compostos de Prata/farmacologia , Animais , Cariostáticos , Cárie Dentária , Fluoretos Tópicos/farmacologia , Humanos , RatosRESUMO
BACKGROUND: Clinical outcomes of patients undergoing a cardiac implantable electronic device (CIED) implantation following a recent non-device related infection are unknown. AIM: To evaluate the clinical outcomes of patients with recent infection before CIED implantation. METHODS: Consecutive patients (N = 1237) were classified as patients with recent infection (N = 72) and without recent infection (N = 1165). A recent infection was established by reviewing medical records, including symptoms and clinical manifestations, diagnosis of systemic inflammatory response syndrome, and quick Sequential Organ Failure Assessment (qSOFA) score. Multiple stepwise logistic regression analysis was used to identify independent predictors of in-hospital all-cause mortality. FINDINGS: During nearly three years of follow-up, 17 patients had CIED infection (1.4%), and the incidence of CIED infection did not significantly differ between patients with and without recent infection according to symptoms and clinical manifestations (2.8% vs 1.3%, respectively; not significant). However, patients with recent infection had a significantly higher in-hospital mortality rate compared to those without recent infection (22.2% vs 0.9%, respectively; P < 0.05). In multivariate analysis, predictors of in-hospital mortality were recent infection before CIED implantation (odds ratio: 20.3; 95% confidence interval: 8.4-49.3; P < 0.001) and end-stage renal disease (4.3; 1.4-12.8; P = 0.009). CONCLUSION: A CIED implantation is feasible in patients with recent infection if the patient is afebrile and has received an adequate duration of antibiotic therapy. Participants in shared decision-making before implant should be advised that recent infection increases in-hospital mortality risk, especially in patients with a qSOFA score of ≥2.
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Desfibriladores Implantáveis/efeitos adversos , Desfibriladores Implantáveis/normas , Eletrodos Implantados/efeitos adversos , Eletrodos Implantados/normas , Infecções Relacionadas à Prótese/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/uso terapêutico , Bacteriemia/tratamento farmacológico , Eletrônica , Feminino , Mortalidade Hospitalar , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Infecções Relacionadas à Prótese/tratamento farmacológico , Infecções Relacionadas à Prótese/mortalidade , Estudos Retrospectivos , Medição de Risco , Fatores de RiscoRESUMO
BACKGROUND: Cardiac implantable electronic device (CIED) infection, a major complication of a CIED implant procedure, can prolong hospitalization and cause mortality. AIM: To evaluate the efficacy of a bundled skin antiseptic preparation for preventing infection after implantation of a complex CIED. METHODS: This study analysed 1163 consecutive patients who had received a bundled skin antiseptic preparation before CIED implantation from July 2012 to December 2017. According to the complexity of the CIED implant procedure, the patients were divided into a complex CIED group (N = 370) and a non-complex CIED group (N = 793). A complex procedure was defined as a pacemaker replacement, implantation of implantable cardioverter defibrillator and cardiac resynchronization therapy, device upgrade, or lead revision. FINDINGS: During a mean follow-up of 2.9 ± 1.7 years, CIED infection developed in 15 patients (1.3%), and the incidence of minor and major infection was 1.1% and 0.2%, respectively. The incidence of CIED infection did not significantly differ between the complex CIED group and the non-complex CIED group (1.1% vs 1.4%, respectively; non-significant). Multivariate analysis indicated that procedural complexity was not an independent predictor of CIED infection. After 2:1 propensity score matching, the matched non-complex CIED group and the matched complex CIED group still showed no significant difference in the incidence of CIED infection. CONCLUSION: Bundled skin antiseptic preparation is an effective and widely applicable strategy for decreasing infection risk after a complex CIED implantation.
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Antissepsia/métodos , Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Pacotes de Assistência ao Paciente/métodos , Cuidados Pré-Operatórios/métodos , Implantação de Prótese/efeitos adversos , Infecção da Ferida Cirúrgica/prevenção & controle , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Adulto JovemRESUMO
Objective: To analyze the clinical characteristics and appropriate surgical procedures, and discuss the classification of congenital middle ear malformation. Methods: All cases were from the Center of Otorhinolaryngology, the Sixth Medical Center of Department of PLA General Hospital. All of these cases, including 26 male patients (ears) , 10 female patients (11 ears) , aged from 7 to 57 years old, had normal external auditory canal, tympanic membrane, conductive hearing loss, type A tympanogram and negative Gelle's test. Tympanoplasty was performed in all cases. The deformity was classified to three types,i.e., Type I (stapes foot plate mobility): â a, ossicular chain deformity with normal stapes suprastructure; â b, ossicular chain deformity with abnormal stapes suprastructure; Type â ¡ (stapes foot plate fixation): â ¡ a,normal ossicular chain, â ¡ b, ossicular chain malformation; and Type â ¢: vestibular window osseous atresia or undeveloped, or with round window atresia. The malformation of type â ¡ and â ¢ may be accompanied with abnormal facial nerve. In addition, the papers on middle ear malformation published from 1982 to 2017 were analyzed retrospectively. The clinical data of 451 ears malformation were summarized. Results: According to the revisional classification criteria in 37 ear samples from our hospital, 20 ears were type I. 6 type â a cases were used PORP (partial ossicular replacement prosthesis) to reconstruct the ossicular chain; 14 type â b cases were used TORP (total ossicular replacement prosthesis) to reconstruct the ossicular chain. For the 5 ears of type â ¡, 2 of which were type â ¡ a and 3 were type â ¡ b. 4 ear samples of type â ¡ were implanted with Piston ossicular prosthesis, 1 was implanted with TORP in which the ossificated foot plate was removed with periosteum preserved. 12 ear samples were type â ¢, with vestibular window osseous atresia, facial nerve malformation, and stapes suprastructure malformation. The pistons ossicular prosthesis were implanted in vestibular window in 3 ears with facial nerve covering vestibular window partially. The surgery had to be given up in 5 ears, and TORP was implanted in 4 ears at the opening with preserved periosteum at the beginning of the tympanic scala because of facial nerve covering vestibular window totally. 30 ears with complete follow-up data had no sensorineural hearing loss and the average air-bone conduction decreased 23.3±10.7 dB (P<0.05).There were 234 ears of type â in 451 ears of congenital middle ear malformation reported in the literature. 113 of which were type â a, the basic surgery was ossicular chain shaking and artificial or autogenous PORP implantation. Type â b was 121 ears, with autogenous or artificial TORP and PORP. Type â ¡ was125 ears, including type â ¡a 22 ears, â ¡b 60 ears, and no subclassification for 43 ears. The surgery of type â ¡ was the same as otosclerosis. The vestibular window atresia of type â ¢ was 92 ears, the surgery of 17 ears had to be abandoned, the other ears underwent vestibular window, promontory or semicircular canal opening to reconstruct hearing with Piston, autogenous or artificial TORP. Conclusion: Referring to the classification of congenital middle ear malformation combining with appropriate surgical materials and methods, otologists can better understand and choose appropriate surgical method to the middle ear malformation.
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Anormalidades Congênitas/classificação , Anormalidades Congênitas/cirurgia , Ossículos da Orelha/cirurgia , Orelha Média/anormalidades , Adolescente , Adulto , Criança , Ossículos da Orelha/anormalidades , Orelha Média/cirurgia , Feminino , Perda Auditiva Condutiva/congênito , Perda Auditiva Condutiva/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Prótese Ossicular , Estudos Retrospectivos , Membrana Timpânica/anormalidades , Membrana Timpânica/cirurgia , Timpanoplastia , Adulto JovemRESUMO
We designed and fabricated a new type of superconducting quantum interference device (SQUID) susceptometers for magnetic imaging of quantum materials. The 2-junction SQUID sensors employ 3D Nb nano-bridges fabricated using electron-beam lithography. The two counter-wound balanced pickup loops of the SQUID enable gradiometric measurement and they are surrounded by a one-turn field coil for susceptibility measurements. The smallest pickup loop of the SQUIDs were 1 µm in diameter and the flux noise was around 1 µÐ¤0/âHz at 100 Hz. We demonstrate scanning magnetometry, susceptometry and current magnetometry on some test samples using these nano-SQUIDs.
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Semiconducting 2D metal oxides have attracted great research interests for gas-sensing applications because of their considerable specific surface area and highly homogeneous surface. Developing a method for fabricating thin films of 2D metal oxides is crucial for minimizing the negative effects on sensing performance caused by slow diffusion. In this work, a simple, versatile, and highly reproducible self-assembly method is developed for fabricating monolayer film sensors made from metal oxide nanosheets with much superior sensing performance compared with their thick film counterparts. To prepare the monolayer film sensors, a monolayer film of metal oxide nanosheets, self-assembled at the air-water interface, is transferred onto a sensor substrate. The CuO monolayer sensors prepared with this self-assembly method show much improved gas sensitivity (sensor signal: 350% vs 100% at 5 ppm of H2S) and faster response and recovery rate (τres: 20 s vs 110 s; τrec: 120 s vs 320 s) than the thick film sensors prepared from the same sensing material. The enhanced sensing performance demonstrated by the monolayer film of CuO nanosheets is explained quantitively with a modified coupled reaction-diffusion model. Similar enhancement on gas-sensing performance is also observed for the ZnO-nanosheet-based monolayer sensors prepared by the same self-assembly method.
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Cobre/química , Gases/análise , Nanoestruturas/química , Óxido de Zinco/química , Hidrogênio/análise , Semicondutores , Propriedades de SuperfícieRESUMO
Radioiodine-131((131)I) therapy as one of the post-surgical targeted therapies has been proven as an effective treatment modality in reducing the risk of recurrence and mortality in intermediate and high risk differentiated thyroid cancer (DTC). With increasing evidence over recent years, improvements in the management of DTC have been observed. In this review, several points and their influences on DTC decision making are discussed, including the purpose of (131)I therapy, evaluating system for risks and on-going response to therapy, as well as the significance of molecular features such as thyroglobulin, molecular pathology and nuclear medicine molecular imaging.
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Radioisótopos do Iodo/uso terapêutico , Neoplasias da Glândula Tireoide/radioterapia , Humanos , Cuidados Pós-Operatórios , Tireoglobulina/genética , Neoplasias da Glândula Tireoide/cirurgiaRESUMO
This paper reports synthesis of graphene oxide (GO) membranes with narrow interlayer free spacing on scalable polyester substrates using GO sheets prepared by Brodie's method. The GO membranes show interlayer free spacing of â¼3.2 Å with significantly improved hydrogen perm-selectivity than the GO membranes with the large inter-sheet spacing reported in literature.
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BACKGROUND: The ventilatory efficiency represented cardiovascular, pulmonary, and musculoskeletal performance into an integrate index has been used as long-term and short-term prognostic variables in congestive heart failure. The heart failure patients post heart transplantation, whether the ventilatory efficiency was also normalized is still unknown. METHODS: This was a cross-sectional study. We measured ventilation to carbon dioxide production slope and oxygen consumption in peak exercise (peak VO2) by cardiopulmonary exercise test, which represented ventilatory efficiency and functional capacity respectively. Strength of hand grip, the 30-second chair stand test, and 6-minute walking test were also evaluated. Patients with ventilation to carbon dioxide production slope <30 were defined as the normal group; others were defined as the abnormal group. Independent t tests and paired t tests were used when appropriate. The level of statistical significance was set at .05. RESULTS: There were 51 clinically stable post-heart transplantation patients (age 53 ± 12.4 years; 86.3% were male) at 65.14 ± 41.17 months after transplantation. The ventilation to carbon dioxide production slope was 29.2 ± 5.6, which significantly improved compared to that recorded 1 month after heart transplantation (32.6 ± 6.4). There were 20 patients in the abnormal group, characterized by lower 6-minute walking test distance (normal vs abnormal, 422.5 ± 97.8 vs 532.6 ± 87.6 m) and peak VO2 (normal vs abnormal, 14.9 ± 5.3 vs 18.8 ± 5.1 mL/kg/min). The abnormal ventilation to carbon dioxide production slope was significantly correlated with 6-minute walking test distances in multivariate analyses. CONCLUSION: Our findings indicate that the ventilation to carbon dioxide production slope is partially abnormal among patients post-heart transplantation. A ventilation to carbon dioxide production slope above the normal range is characterized by a lower peak VO2 during cardiopulmonary exercise test and lower 6-minute walking test distance. The ventilation to carbon dioxide production slope is also significantly negatively correlated with peak VO2, peak work rate, and 6-minute walking test distance. The prognostic utility of the ventilation to carbon dioxide production slope for patients post-heart transplantation requires further investigation.
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Insuficiência Cardíaca/diagnóstico , Insuficiência Cardíaca/fisiopatologia , Transplante de Coração , Ventilação Pulmonar/fisiologia , Idoso , Estudos Transversais , Teste de Esforço , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Consumo de Oxigênio , Prognóstico , Testes de Função RespiratóriaRESUMO
OBJECTIVES: The ventilatory efficiency and functional capacity measured by the cardiopulmonary exercise test (CPET) have been used as important prognostic variables in congestive heart failure. This study sought to identify whether these predictors before heart transplantation (HTX) play a key role in predicting adverse events in patients with heart failure after HTX. METHODS: This was a retrospective cohort study design. HTX recipients were included for analysis. Ventilation to carbon dioxide production slope (VE/VCO2 slope) and oxygen consumption (VO2) during exercise were collected by CPET, which represented ventilator efficiency and functional capacity respectively. Cardiac-related events 2 years after HTX were recorded by chart review. We divided patients into 2 groups based on VE/VCO2 slope = 34, peak VO2 = 14 mL/kg/min and VO2 at aerobic threshold (AT) = 11 mL/kg/min. Kaplan-Meier survival curves was used to represent the events rate between groups and Log rank test was used to test significance. RESULTS: A total of 87 patients after HTX were included. Mean (SD) age was 48 (11) years and 73 were male; 28 subjects suffered from events, and 76 cardiac events were recorded. The mean (SD) data of peak VO2, VO2 at AT, and VE/VCO2 slope analyzed from CPET were 17.8 (5.6) mL/kg/min, 15.4 (4.4) mL/kg/min, and 33.1 (8.2) mL/kg/min, respectively. Lower VO2 at AT contributed to increase events rate (P < .05). CONCLUSION: Aerobic capacity may better predict 2-year cardiac events in patients after HTX. Strategies to improve aerobic capacity should be focused on in the cohort.
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Limiar Anaeróbio/fisiologia , Insuficiência Cardíaca/fisiopatologia , Transplante de Coração/efeitos adversos , Adulto , Idoso , Estudos de Coortes , Teste de Esforço , Tolerância ao Exercício/fisiologia , Feminino , Insuficiência Cardíaca/diagnóstico , Insuficiência Cardíaca/mortalidade , Transplante de Coração/mortalidade , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos RetrospectivosRESUMO
BACKGROUND: Postherpetic neuralgia (PHN) is the most distressful complication of herpes zoster. PHN results in an impaired quality of life and higher healthcare utilization. Vitamin B12 has been proven to be effective in pain relief for various conditions. OBJECTIVE: We conducted a systematic review and a meta-analysis to evaluate the efï¬cacy of vitamin B12 supplementation in PHN patients. METHODS: PubMed, Embase, Cochrane Library, CINAHL, and ClinicalTrials.gov registry were searched. Randomised control trials evaluating the efï¬cacy and safety of vitamin B12 in PHN patients were selected. Eligible trials were abstracted and assessed for the risk of bias by two reviewers, and the results of pain indicators in the selected trials were analysed. RESULTS: Four trials including 383 participants were published between 2013 and 2016. Compared with the placebo group, the Vitamin B12 group exhibited a signiï¬cant decrease in the Numeric Rating Scale score, with a mean difference of -4.01 (95% confidence interval = -4.70 to -3.33). Vitamin B12 administration improved the quality of life of PHN patients with moderate quality evidence and significantly decreased the number of patients using analgesics. CONCLUSION: Vitamin B12 appears to be an attractive complementary therapy for PHN patients. Further investigation is needed before conclusive recommendations can be made.
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Neuralgia Pós-Herpética/tratamento farmacológico , Vitamina B 12 , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Vitamina B 12/administração & dosagem , Vitamina B 12/uso terapêuticoRESUMO
BACKGROUND: As Mycobacterium tuberculosis is an aerobic microbe, hyperbaric oxygen therapy (HBOT) could trigger progression from latent tuberculous infection (LTBI) to active tuberculosis (TB) disease. OBJECTIVE: To evaluate the effect of HBOT on TB reactivation. DESIGN: Our study sample was from the National Health Insurance Research Database containing one million beneficiaries. We identified a group of patients who underwent HBOT, and matched this group with individuals without HBOT. We compared the incidence of activation of TB between these two groups. RESULTS: A total of 2258 patients were identified, with each group comprising 1129 patients. One year after exposure to hyperbaric oxygen, the number of cases of active TB was significantly higher in the HBOT group than in the non-HBOT group (11 cases vs. 1 case, P = 0.006). Multiple regression analysis showed that HBOT was the only statistically significant contributor to TB activation. CONCLUSION: HBOT is likely to trigger the reactivation of TB. High-risk patients should undergo the tuberculin skin test or interferon-gamma release assays before HBOT to identify patients with LTBI.
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Oxigenoterapia Hiperbárica/efeitos adversos , Tuberculose Latente/microbiologia , Mycobacterium tuberculosis/isolamento & purificação , Tuberculose/epidemiologia , Bases de Dados Factuais , Progressão da Doença , Feminino , Humanos , Oxigenoterapia Hiperbárica/métodos , Incidência , Testes de Liberação de Interferon-gama/métodos , Tuberculose Latente/epidemiologia , Masculino , Pessoa de Meia-Idade , Análise de Regressão , Estudos Retrospectivos , Fatores de Risco , Teste Tuberculínico/métodos , Tuberculose/diagnóstico , Tuberculose/etiologiaRESUMO
Researchers have suggested that combining topical fluoride with an antiseptic to reduce cariogenic bacteria may be more effective than fluoride application alone in preventing dental caries. In previous studies, povidone iodine (PVP-I), a widely used bactericidal antiseptic, and sodium fluoride (NaF), used to foster remineralization of enamel, were applied sequentially topically and shown to be safe and effective. The study aim was to characterize the kinetics of iodine and fluoride following topical application of a single combination PVP-I and NaF anticaries varnish in healthy adults. Sixteen participants (aged 23 to 57 y) participated in a pharmacokinetics study following the application of 0.4 mL varnish containing 10% (w/v) PVP-I and 5% (w/v) NaF. Serum and urine samples were collected at various time points over 24 h following application of varnish. Iodine and fluoride concentrations were analyzed, and for each time point, baseline concentrations were subtracted from observed values. Following varnish application, 2 of 16 participants had nearly undetectable baseline-corrected iodine and fluoride levels, suggesting minimal absorption, lack of release of iodine and fluoride from the varnish, or inconsistent dosing. The average peak concentrations were 57 ± 33 ng/mL iodine and 60 ± 34 ng/mL (0.060 ± 0.034 ppm) fluoride and occurred within 3 h of application. The average elimination half-life was 5.5 ± 1.4 h and 3.1 ± 1.6 h for iodine and fluoride, respectively. Renal clearance of iodine and fluoride was similar to literature values. No adverse events related to the study varnish were observed by the investigative team or reported by the participants. In this study, serum fluoride and iodine transiently increased but were within normal range 24 h after application of the varnish. This study has shown that the combination of PVP-I and NaF in a proposed anticaries varnish was well tolerated. Knowledge Transfer Statement: This clinical study demonstrated that a dental varnish combining 10% (w/v) povidone iodine and 5% (w/v) sodium fluoride is well tolerated. Serum fluoride and iodine transiently increased but were within normal range after 24 h. Further studies should be conducted to assess the efficacy of a combination in preventing dental caries, especially in high-risk populations.