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1.
Braz. j. biol ; 83: e246389, 2023. graf
Artigo em Inglês | LILACS-Express | MEDLINE, LILACSEXPRESS | ID: biblio-1285638

RESUMO

Abstract Poultry industry is expanding rapidly and producing million tons of feather waste annually. Massive production of keratinaceous byproducts in the form of industrial wastes throughout the world necessitates its justified utilization. Chemical treatment of keratin waste is proclaimed as an eco-destructive approach by various researchers since it generates secondary pollutants. Keratinase released by a variety of microbes (bacteria and fungi) can be used for the effective treatment of keratin waste. Microbial degradation of keratin waste is an emerging and eco-friendly approach and offers dual benefits, i.e., treatment of recalcitrant pollutant (keratin) and procurement of a commercially important enzyme (keratinase). This study involves the isolation, characterization, and potential utility of fungal species for the degradation of chicken-feather waste through submerged and solid-state fermentation. The isolated fungus was identified and characterized as Aspergillus (A.) flavus. In a trial of 30 days, it was appeared that 74 and 8% feather weight was reduced through sub-merged and solid-state fermentation, respectively by A. flavus. The pH of the growth media in submerged fermentation was changed from 4.8 to 8.35. The exploited application of keratinolytic microbes is, therefore, recommended for the treatment of keratinaceous wastes to achieve dual benefits of remediation.


Resumo A indústria avícola está se expandindo rapidamente e produzindo milhões de toneladas de resíduos de penas anualmente. A produção massiva de subprodutos queratinosos na forma de resíduos agrícolas e industriais em todo o mundo exige sua utilização justificada. O tratamento químico de resíduos de queratina é proclamado como uma abordagem ecodestrutiva por vários pesquisadores, uma vez que gera poluentes secundários. A queratinase liberada por uma variedade de micróbios (bactérias e fungos) pode ser usada para o tratamento eficaz de resíduos de queratina. A degradação microbiana de resíduos de queratina é uma abordagem emergente e ecológica e oferece benefícios duplos, ou seja, tratamento de poluente recalcitrante (queratina) e obtenção de uma enzima comercialmente importante (queratinase). Este estudo envolve o isolamento, caracterização e utilidade potencial de espécies de fungos para a degradação de resíduos de penas de frango por meio da fermentação submersa e em estado sólido. O fungo isolado foi identificado e caracterizado como Aspergillus (A.) flavus. Em um ensaio de 30 dias, constatou-se que 74% e 8% do peso das penas foram reduzidos por A. flavus, respectivamente, por meio da fermentação submersa e em estado sólido. O pH do meio de crescimento em fermentação submersa foi alterado de 4,8 para 8,35. A aplicação explorada de micróbios queratinolíticos é, portanto, recomendada para o tratamento de resíduos ceratinosos para obter benefícios duplos de remediação.

2.
Antioxidants (Basel) ; 10(11)2021 Nov 05.
Artigo em Inglês | MEDLINE | ID: mdl-34829641

RESUMO

Culinary spices and herbs have been used to impart a characteristic flavour and aroma in food due to their appealing fragrance. Recently, bioactive compounds from herbs, especially phenolics, have gained much attention due to their potential health outcomes. The aim of this study was to characterize and quantify the phenolic compounds from 10 widely used Australian-grown herbs (oregano, rosemary, bay, basil, sage, fenugreek, dill, parsley, mint and thyme). For this purpose, liquid chromatography mass spectrometry (LC-MS) was used for the complete profiling of polyphenolic compounds and quantification of abundant phenolic compounds was completed with high-performance liquid chromatography-photodiode array detection (HPLC-PDA). Polyphenols from Australian-grown herbs were estimated through total phenolic content (TP), total flavonoids (TF) and total tannins (TT) along with their in-vitro antioxidant activities. Oregano and mint were estimated with the highest value of TP (140.59 ± 9.52 and 103.28 ± 8.08 mg GAE/g, milligram gallic acid equivalent/gram) while rosemary and mint had the highest TF (8.19 ± 0.74 and 7.05 ± 0.43 mg QE (quercetin equivalent)/g). In this study, eighty-four (84) phenolic compounds were screened and confirmed through LC-MS/MS by comparing their masses and fragmentation pattern with published libraries. The results of this study validate the use of these herbs as bioactives and their positive impact on human health.

3.
Antioxidants (Basel) ; 10(10)2021 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-34679656

RESUMO

Bananas are an essential source of staple food and fruit worldwide and are widely regarded as the world's largest fruit crop, with more than 100 million tons total annual production. Banana peel, a by-product that represents about 40% of the entire banana's weight, and pulp are rich in bioactive compounds and have a high antioxidant capacity. As the production of polyphenols in fruit and vegetables is highly dependent on environmental conditions, genetic factors, and the level of maturity, this study aims to characterize six Australian banana cultivars in various stages of ripening for their phenolic compounds using the liquid chromatography-electrospray ionization quadrupole time of flight mass spectrometry (LC-ESI-QTOF-MS/MS), polyphenols quantification with the high-performance liquid chromatography coupled with photodiode array detector (HPLC-PDA), and their antioxidant capacity. All bananas were analysed for total polyphenols content (TPC), total flavonoids content (TFC), and total tannin content (TTC) and their antioxidant activities. Ripe Ducasse peel and pulp contained the highest amounts of total polyphenols content (1.32 and 1.28 mg gallic acid equivalent (GAE) per gram of sample), total tannin contents (3.34 mg catechin equivalent (CE) per gram of sample), and free radical scavenging capacity (106.67 mg ascorbic acid equivalent (AAE) per g of sample). In contrast, ripe Plantain peel had the greatest total flavonoids (0.03 mg quercetin equivalent (QE) per g of sample). On the other hand, unripe Ladyfinger pulp possessed the highest total antioxidant activity (1.03 mg AAE/g of sample). There was a positive correlation between flavonoids and antioxidant activities. By using LC-ESI-QTOF-MS/MS, a total of 24 phenolic compounds were tentatively characterized in this research, including six phenolic acids, 13 flavonoids, and five other polyphenols. Quantification of phenolic compounds by the high-performance liquid chromatography coupled with photodiode array detector (HPLC-PDA) revealed a higher content of phenolic acids. These findings confirmed that banana peel and pulp have considerable antioxidant activity and can be employed in human food and animal feed for variant health enhancement uses.

4.
Phys Chem Chem Phys ; 23(38): 21913-21922, 2021 Oct 06.
Artigo em Inglês | MEDLINE | ID: mdl-34559172

RESUMO

A range of ethaline and reline deep eutectic solvents (DESs) have been investigated in the absence and presence of Zn (0-0.3 M) and water (0-29 wt%) by one-dimensional 1H NMR spectroscopy, two-dimensional 1H-1H nuclear Overhauser effect and exchange spectroscopy, 1H T1 NMR relaxation times and 1H NMR diffusion. The role of zinc and water in controlling solvation and microstructure in reline and ethaline were investigated. We show that in ethaline there is proton exchange between hydroxyl groups in ethaline glycol and choline chloride. The rate of exchange between these protons is found to significantly increase in the presence of Zn, but decreases with increasing water content. In the case of reline, no proton exchange is observed between the amide protons in urea and hydroxyl protons in choline chloride. However, the addition of water decreases the viscosity of the system, as well as changes the distance between amide and hydroxyl protons in urea and choline chloride, respectively. The addition of Zn does not appear to change the interactions between urea and choline chloride species, but does reduce the rate of exchange between water and hydroxyl protons in reline formulations containing water.

5.
Neuro Endocrinol Lett ; 42(4): 257-264, 2021 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-34436840

RESUMO

OBJECTIVES: Primary hyperparathyroidism (PHPT) is considered the third endocrine disorder worldwide. However, the incidence of PHPT is variable in different populations. Since there are no studies on PHPT performed in Bahrain or the surrounding Arab Middle Eastern countries, this study aimed to determine the prevalence and incidence of PHPT and its variants in Bahrain. METHODS: A retrospective study was conducted over a 3-year period (2018-2020) at the Bahrain Defense Force Military Hospital. Patients' data with normal kidney function, age 14 years and older, and had related laboratory results (calcium, PTH, phosphorus, and vitamin D) were retrieved and analyzed for prevalence and incidence of hypercalcemia and PHPT according to age and sex. RESULTS: Out of 9650 patients, 417 patients had corrected hypercalcemia. Of these, 240, 125, and 88 patients per 100,000 had classic, non-classic, or early/normocalcemic PHPT, respectively. These numbers resulted in a prevalence of PHPT of 274 per 100,000 in Bahrain. The age-adjusted incidence of all types of PHPT was 179 per 100,000/year. Overall, PHPT incidence, whether classic or not, significantly increased in the 50 years age group and above (OR 1.023 with 95% CI 1.013-1.033). Furthermore, hypercalcemia and non-classic PHPT were predominant in females than males. Lastly, vitamin D level was significantly less in classic PHPT than the non-classic variant. CONCLUSION: The high prevalence and incidence of PHPT should alarm physicians and clinical practices in Bahrain and the Middle East region to investigate routinely for classic and non-classic PHPT to control and manage the complications that arise from PHPT. However, more epidemiological studies in the Middle East region are warranted to investigate the reasons behind the high incidence of PHPT.

6.
Artigo em Inglês | MEDLINE | ID: mdl-34310471

RESUMO

This study analyzes the general disease characteristics, impact of enzyme replacement therapy (ERT), and overall survival (OS) of 156 Egyptian patients with Gaucher disease (GD) enrolled on hormone replacement from 1998 to 2017. The mean age at diagnosis was 32.46±12.68 months. Anemia was noted at diagnosis in 50%, thrombocytopenia in 30.7%, severe splenomegaly in 58.7%, severe hepatomegaly in 11.9%, and skeletal findings were detected in 24.3% of the patients. The most prevalent GD type was type 3 (54.5%). Twenty-two of type 3 patients had no neurological manifestations at diagnosis, and 12 developed variable central nervous system manifestations during follow-up. The most common neurological features were limited eye movements, oculomotor apraxia, and squint. Of the 60 patients for whom genotypes were obtained, homozygous L444P was the most common (n=35/60, 58.3%). Treatment with ERT (imiglucerase) revealed significant improvements in blood indices, organ volumes, and growth parameters (P<0.05). Ten (11.7%) type 3 patients did not develop any neurological manifestations under ERT over 20 years. Mortality was 16%, and the 20-year OS was 73.3%. We conclude that in Egypt, type 3 is the most prevalent phenotype of GD, and homozygous L444P is the predominant GBA genotype of GD. Early age at diagnosis and treatment with ERT over 20 years revealed significant improvements in disease manifestations, with an OS of 73.3%.

7.
Braz J Biol ; 83: e246389, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34320050

RESUMO

Poultry industry is expanding rapidly and producing million tons of feather waste annually. Massive production of keratinaceous byproducts in the form of industrial wastes throughout the world necessitates its justified utilization. Chemical treatment of keratin waste is proclaimed as an eco-destructive approach by various researchers since it generates secondary pollutants. Keratinase released by a variety of microbes (bacteria and fungi) can be used for the effective treatment of keratin waste. Microbial degradation of keratin waste is an emerging and eco-friendly approach and offers dual benefits, i.e., treatment of recalcitrant pollutant (keratin) and procurement of a commercially important enzyme (keratinase). This study involves the isolation, characterization, and potential utility of fungal species for the degradation of chicken-feather waste through submerged and solid-state fermentation. The isolated fungus was identified and characterized as Aspergillus (A.) flavus. In a trial of 30 days, it was appeared that 74 and 8% feather weight was reduced through sub-merged and solid-state fermentation, respectively by A. flavus. The pH of the growth media in submerged fermentation was changed from 4.8 to 8.35. The exploited application of keratinolytic microbes is, therefore, recommended for the treatment of keratinaceous wastes to achieve dual benefits of remediation.


Assuntos
Galinhas , Plumas , Animais , Fermentação , Fungos , Resíduos Industriais , Queratinas/metabolismo
8.
BMJ Case Rep ; 14(6)2021 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-34187800

RESUMO

We report the case of a 78-year-old woman who presented with cardiovascular risk factors and a history of an atypical transient ischaemic attack. She was referred by her primary care physician to the vascular surgery department at our institution for evaluation of progressive weakness, fatigue, arm claudication and difficulty assessing the blood pressure in her right arm. She was being considered for surgical revascularisation, but a careful history and review of her imaging studies raised suspicion for vasculitis, despite her normal inflammatory markers. She was eventually diagnosed with biopsy-proven giant cell arteritis with diffuse large-vessel involvement. Her symptoms improved with high-dose glucocorticoids.


Assuntos
Arterite de Células Gigantes , Idoso , Braço , Diagnóstico por Imagem , Feminino , Arterite de Células Gigantes/complicações , Arterite de Células Gigantes/diagnóstico , Arterite de Células Gigantes/tratamento farmacológico , Glucocorticoides/uso terapêutico , Humanos , Procedimentos Cirúrgicos Vasculares
9.
Artigo em Inglês | MEDLINE | ID: mdl-33936857

RESUMO

Objective: To evaluate medical student and attending surgeon experiences with a novel interactive virtual Otolaryngology - Head and Neck Surgery (OHNS) medical student elective during the COVID-19 pandemic. Study design: A virtual OHNS elective was created, with three components: (1) interactive virtual operating room (OR) experience using live-stream video-conferencing, (2) telehealth clinic, (3) virtual didactics. Setting: OHNS Department at the University of Pennsylvania (May 2020 to June 2020). Methods: Six medical students from the University of Pennsylvania; five attending otolaryngologists. Two surveys were designed and distributed to participating medical students and attending surgeons. Surveys included 5-point Likert scale items, with 1 indicating "not at all" and 5 indicating "very much so". Results: Response rate was 100% for both surveys. Students on average rated the educational value of the telehealth experience as 4.2 ± 1.2, and the virtual OR experience as 4.0 ± 0.6. Most students (n = 5, 83%) indicated that they had enough exposure to faculty they met on this rotation to ask for a letter of recommendation (LOR) for residency if needed, while attending surgeons had an average response of 3.0 ± 1.0 when asked how comfortable they would feel writing a LOR for a student they met through the rotation. A majority of students (n = 4, 67%) felt they connected enough with faculty during the rotation to ask for mentorship. Half the students (n = 5, 50%) indicated that the rotation allowed them to evaluate the department's culture either "extremely well" or "somewhat well". Conclusions: Overall, participating students described this innovative virtual surgical rotation as an educationally and professionally valuable experience. With the continued suspension of visiting student rotations due to the COVID-19 pandemic, this virtual model may have continued relevance to medical education.

10.
Integr Cancer Ther ; 20: 15347354211006474, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34014116

RESUMO

BACKGROUND: Current treatment for head and neck cancers (HNCs) have led to an improved survival. However, the sequelae of cancer treatment often result in trismus, or reduced mouth opening. The purpose of this report is to identify interventional studies for trismus management in HNC patients. METHODS: A search of PubMed, Embase, Cumulated Index to Nursing and Allied Health Literature, and the Cochrane Library was conducted in March 2020 for randomized controlled trials (RCTs) involving interventions for trismus for head and neck cancer within 10 years. Intervention could involve the use of an exercise regime, jaw rehabilitation device, technological device, medication or massage therapy. The primary outcome was the measurement of mouth opening. RESULTS: Eleven RCTs involving a total of 685 patients with HNC were included. Six RCTs evaluated the effectiveness of a jaw mobilization device with exercises; there was no significant benefit of an exercise regime with a jaw mobilization device either initiated before, during or after treatment compared to no exercise. Two RCTs compared 2 intervention groups that involved exercises only, with 1 study assessing the benefit of weekly supervised physical therapy with gum chewing and another evaluating the benefit of immediate (1-2 days) versus delayed (7-10 days) initiation of exercise post-surgery; there was no significant difference between groups in either study. One RCT that recruited only patients with trismus demonstrated that an exercise regime in combination with low-level laser therapy or low-intensity ultrasound had superior results in mouth opening measurements compared to exercise alone. Two RCTs compared intervention groups with and without follow-up reminders; both studies showed a significant improvement in mouth opening measurements in groups with follow-up reminders. CONCLUSION: This systematic review did not convey a clear consensus as to optimal intervention for trismus in HNC patients. A variety of exercise regimens and jaw rehabilitation devices appear to have comparable effectiveness. However, efforts focused on increasing adherence to a particular intervention protocol may positively impact mouth opening measures in head and neck cancer patients. Also, low-level laser therapy and low-intensity ultrasound coupled with exercise may be beneficial for patients with trismus.


Assuntos
Neoplasias de Cabeça e Pescoço , Trismo , Terapia por Exercício , Humanos , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Trismo/etiologia , Trismo/terapia
11.
Am J Physiol Heart Circ Physiol ; 320(6): H2270-H2282, 2021 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-33834870

RESUMO

Despite a decline in popularity over the past several decades, cigarette smoking remains a leading cause of cardiovascular morbidity and mortality. Yet, the effects of cigarette smoking on vascular structure and function are largely unknown. To evaluate changes in the mechanical properties of the aorta that occur with chronic smoking, we exposed female apolipoprotein E-deficient mice to mainstream cigarette smoke daily for 24 wk, with room air as control. By the time of euthanasia, cigarette-exposed mice had lower body mass but experienced larger systolic/diastolic blood pressure when compared with controls. Smoking was associated with significant wall thickening, reduced axial stretch, and circumferential material softening of the aorta. Although this contributed to maintaining intrinsic tissue stiffness at control levels despite larger pressure loads, the structural stiffness became significantly larger. Furthermore, the aorta from cigarette-exposed mice exhibited decreased ability to store elastic energy and augment diastolic blood flow. Histological analysis revealed a region-dependent increase in the cross-sectional area due to smoking. Increased smooth muscle and extracellular matrix content led to medial thickening in the ascending aorta, whereas collagen deposition increased the thickness of the descending thoracic and abdominal aorta. Atherosclerotic lesions were larger in exposed vessels and featured a necrotic core overlaid by a thinned fibrous cap and macrophage infiltration, consistent with a vulnerable phenotype. Collectively, our data indicate that cigarette smoking decreases the mechanical functionality of the aorta, inflicts morphometric alterations to distinct segments of the aorta, and accelerates the progression of atherosclerosis.NEW & NOTEWORTHY We studied the effects of chronic cigarette smoking on the structure and function of the aorta in a mouse model of nose-only aerosol inhalation. Our data indicated that exposure to cigarette smoke impairs vascular function by reducing the ability of the aorta to store elastic energy and by decreasing aortic distensibility. Combined with a more vulnerable atherosclerotic phenotype, these findings reveal the biomechanical mechanisms that support the development of cardiovascular disease due to cigarette smoking.


Assuntos
Aorta/metabolismo , Fumar Cigarros/metabolismo , Matriz Extracelular/metabolismo , Músculo Liso Vascular/metabolismo , Remodelação Vascular , Animais , Aorta/patologia , Aorta/fisiopatologia , Fenômenos Biomecânicos , Fumar Cigarros/patologia , Fumar Cigarros/fisiopatologia , Modelos Animais de Doenças , Matriz Extracelular/patologia , Matriz Extracelular/fisiologia , Feminino , Interação Gene-Ambiente , Camundongos , Camundongos Knockout para ApoE , Músculo Liso Vascular/patologia , Músculo Liso Vascular/fisiopatologia , Fumaça
12.
Biochem Pharmacol ; 186: 114497, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33675775

RESUMO

Despite the recent substantial progress in the treatment of hepatocellular carcinoma (HCC) from viral etiology, non-alcoholic steatohepatitis (NASH) is on a trajectory to become the fastest growing indication for HCC-related liver transplantation. The Farnesoid X receptor (FXR) is a member of the nuclear receptor superfamily with multifaceted roles in several metabolic disorders, particularly NASH. Its role as a tumor suppressor was also highlighted. Herein, we investigated the effect of obeticholic acid (OCA), as an FXR agonist, on NASH-associated HCC (NASH-HCC) animal model induced by diethylnitrosamine and high fat choline-deficient diet, exploring the potential impact on the suppressor of cytokine signaling 3 (SOCS3)/Janus kinase 2 (Jak2)/signal transducer and activator of transcription 3 (STAT3) pathway. Results indicated that OCA treatment upregulated FXR and its key mediator, small heterodimer partner (SHP), with remarkable amelioration in the dysplastic foci observed in the NASH-HCC group. This was paralleled with noticeable downregulation of alpha fetoprotein along with reduction in interferon gamma and transforming growth factor beta-1 hepatic levels besides caspase-3 and p53 upregulation. Moreover, sirtuin-1 (SIRT-1), a key regulator of FXR that controls the regenerative response of the liver, was elevated following OCA treatment. Modulation in the SOCS3/Jak2/STAT3 signaling axis was also reported. In conclusion, OCA attenuated the development and progression of NASH-dependent HCC possibly by interfering with SOCS3/Jak2/STAT3 pathway suggesting the potential use of FXR activators in NASH-related disorders, even at later stages of the disease, to impede its progression to the more deteriorating condition of HCC.


Assuntos
Carcinoma Hepatocelular/metabolismo , Janus Quinase 2/metabolismo , Neoplasias Hepáticas/metabolismo , Hepatopatia Gordurosa não Alcoólica/metabolismo , Receptores Citoplasmáticos e Nucleares/metabolismo , Fator de Transcrição STAT3/metabolismo , Proteína 3 Supressora da Sinalização de Citocinas/metabolismo , Animais , Carcinoma Hepatocelular/tratamento farmacológico , Carcinoma Hepatocelular/patologia , Ácido Quenodesoxicólico/análogos & derivados , Ácido Quenodesoxicólico/farmacologia , Ácido Quenodesoxicólico/uso terapêutico , Neoplasias Hepáticas/tratamento farmacológico , Neoplasias Hepáticas/patologia , Masculino , Camundongos , Hepatopatia Gordurosa não Alcoólica/tratamento farmacológico , Hepatopatia Gordurosa não Alcoólica/patologia , Receptores Citoplasmáticos e Nucleares/agonistas , Transdução de Sinais/fisiologia
13.
Aesthetic Plast Surg ; 45(4): 1620-1627, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-33693981

RESUMO

BACKGROUND: Body contouring procedures provide patients with a meaningful improvement in health-related quality of life (QoL). We aim to compare the difference between the QoL in patients undergoing a single post-bariatric abdominal body contouring procedure (BCP) and those undergoing two or more concurrent procedures. METHODS AND MATERIALS: Patients evaluated for post-bariatric BCP were identified and administered the BODY-Q©. Patient demographics, clinical and operative characteristics, surgical outcomes, cost data, and absolute change in QoL scores were analyzed using descriptive statistics, chi-square, and Mann-Whitney U-test, between patients who underwent single (SP), double (DP), or triple (TP) concurrent procedures. RESULTS: A total of 45 patients were included. The median age was 52 years old ([IQR] ± 13). The majority were female (71.1%) and African-American (55.5%). The most common single procedure was panniculectomy (75%). Surgical site occurrences, readmissions, and the complication composite outcome did not differ between groups (p>0.05). No difference was seen between SP and DP QoL score (p>0.05). The DP had a statistically lower net QoL score compared with TP cohort in four domains. The SP had a statistically lower net QoL score compared with the TP in three domains. Average total cost for patients receiving an SP was $8,048.44, compared with $19,063.94 for DP (p<0.01), and $19,765.02 for TP (p>0.05). CONCLUSIONS: Body contouring procedures are associated with improvements in QoL irrespective of the number of concurrent procedures. Further improvement in psychological well-being occurs for patients who proceed with double concurrent procedures, albeit with an increase in cost. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .


Assuntos
Abdominoplastia , Contorno Corporal , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Estudos Retrospectivos , Resultado do Tratamento
14.
Sci Rep ; 11(1): 7121, 2021 03 29.
Artigo em Inglês | MEDLINE | ID: mdl-33782546

RESUMO

Estrogen signaling is crucial for breast cancer initiation and progression. Endocrine-based therapies comprising estrogen receptor (ER) modulators and aromatase inhibitors remain the mainstay of treatment. This study aimed at investigating the antitumor potential of the most potent compounds in citrus peels on breast cancer by exploring their anti-estrogenic and anti-aromatase activities. The ethanolic extract of different varieties of citrus peels along with eight isolated flavonoids were screened against estrogen-dependent breast cancer cell lines besides normal cells for evaluating their safety profile. Naringenin, naringin and quercetin demonstrated the lowest IC50s and were therefore selected for further assays. In silico molecular modeling against ER and aromatase was performed for the three compounds. In vivo estrogenic and anti-estrogenic assays confirmed an anti-estrogenic activity for the isolates. Moreover, naringenin, naringin and quercetin demonstrated in vitro inhibitory potential against aromatase enzyme along with anticancer potential in vivo, as evidenced by decreased tumor volumes. Reduction in aromatase levels in solid tumors was also observed in treated groups. Overall, this study suggests an antitumor potential for naringenin, naringin and quercetin isolated from citrus peels in breast cancer via possible modulation of estrogen signaling and aromatase inhibition suggesting their use in pre- and post-menopausal breast cancer patients, respectively.


Assuntos
Inibidores da Aromatase/farmacologia , Neoplasias da Mama/patologia , Citrus/química , Moduladores de Receptor Estrogênico/farmacologia , Extratos Vegetais/farmacologia , Animais , Aromatase/metabolismo , Neoplasias da Mama/enzimologia , Feminino , Humanos , Camundongos , Ensaios Antitumorais Modelo de Xenoenxerto
15.
Int J Clin Pract ; 75(6): e14104, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33617679

RESUMO

BACKGROUND: Iron overload-induced oxidative stress and transfusion-acquired hepatitis C virus (HCV) infection are the main reasons of liver damage in beta thalassemia major (ß-TM). OBJECTIVES: Based on metformin's hepatic benefits in nondiabetic populations, the study aims to investigate the safety and the potential hepatoprotective effect of metformin in HCV-infected ß-TM adolescent patients. METHODS: This was a prospective, randomised, parallel, controlled, open-label study in which 60 HCV-infected ß-TM adolescent patients aged 11 to 18 years and receiving no antiviral therapy were selected and randomly assigned to treatment or control group in 1:1 allocation. Both groups were receiving ß-TM standard-of-care regimen, whereas metformin (500 mg, twice daily) was added to the treatment group's regimen only. Patients were prospectively followed up for 6 months with assessment of liver biochemical profile, oxidative stress markers, liver fibrosis, clinical symptom improvement and metformin's adverse effects. RESULTS: Aspartate aminotransferase serum level decreased significantly over time in the treatment group only (P = .013). However, improvement was not clinically significant and did not attain normality. Change in total antioxidant capacity and malondialdehyde serum levels indicated significantly improved oxidative stress status in the treatment group versus significant deterioration in the control group (P < .001). Fibrosis grade improvement was observed in 14 patients in the treatment group versus one improved case in the control group. CONCLUSION: The use of metformin in HCV-infected ß-TM adolescent patients as an adjuvant antioxidant hepatoprotective agent is promising and can improve liver damage.


Assuntos
Hepatite C , Metformina , Talassemia beta , Adolescente , Criança , Hepacivirus , Humanos , Metformina/uso terapêutico , Estudos Prospectivos , Talassemia beta/complicações , Talassemia beta/tratamento farmacológico
16.
J Surg Educ ; 78(1): 346-350, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-32654999

RESUMO

OBJECTIVE: During the coronavirus 2019 pandemic, medical student involvement in direct patient care has been severely limited. Rotations mandatory not only for core curricula but also for informing decisions regarding specialty choice have been postponed during a critical window in the application cycle. Existing virtual rotations are largely observational or lack patient-facing components. SETTING: A virtual Otolaryngology - Head and Neck Surgery rotation at the University of Pennsylvania (Philadelphia, Pennsylvania) was implemented for medical students, comprising interactive live-streamed surgeries, outpatient telehealth visits, and virtual small group didactics. RESULTS: Medical students enrolled in the virtual surgical rotation were able to engage with attending surgeons and operating room staff while remotely viewing surgical procedures captured with first-person audiovisual technology. Students participated in several different aspects of care delivery in both the inpatient and outpatient setting, similar to their typical responsibilities of an in-person rotation. CONCLUSIONS: The authors will continue to develop the virtual surgical education methodology to further disseminate an interactive video-based medical student elective to other procedural specialties and institutions.


Assuntos
COVID-19/epidemiologia , Educação de Graduação em Medicina/métodos , Otolaringologia/educação , Telemedicina , Comunicação por Videoconferência , Currículo , Humanos , Pandemias , SARS-CoV-2
17.
AJR Am J Roentgenol ; 215(5): 1057-1064, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32877245

RESUMO

OBJECTIVE. The purpose of this article is to characterize the appearance on CT of e-cigarette or vaping product use-associated lung injury (EVALI) in a cohort with histopathologic evidence of this disorder. MATERIALS AND METHODS. Twenty-four patients with EVALI were identified. Chest CT examinations were reviewed by two radiologists for various chest CT findings. For comparison with pathologic findings, CT assessments were distilled into previously described patterns of EVALI seen on CT: acute lung injury (ALI), chronic eosinophilic pneumonia (CEP) or organizing pneumonia (OP), acute eosinophilic pneumonia (AEP), alveolar hemorrhage, hypersensitivity pneumonitis (HP), lipoid pneumonia, and mixed or unclassifiable patterns. RESULTS. Sixteen of 24 (67%) patients were men; the mean age was 34.5 years (range, 17-67 years). The most common CT finding was ground-glass opacities, which was present in 23 of 24 (96%) patients and the dominant finding in 18 of 24 (75%) patients. Consolidation was the next most common finding in 42% of patients. Interlobular septal thickening was present in 29%. Lobular low attenuation was conspicuous in six patients. Distribution was multifocal in 54% of patients, peripheral in 17%, and centrally predominant in 8%. Subpleural sparing was seen in 45%. The predominant CT pattern was ALI (42%), concordant with histopathologic findings in 75%; the next most predominant pattern was ground-glass opacity centrilobular nodules resembling HP (33%). A CT pattern of CEP or OP was seen in 13% of patients, all showing ALI on lung biopsy. No patient showed macroscopic lung parenchymal fat. Two patients with CT ALI patterns showed OP on histopathologic examination. Of the eight patients with ground-glass opacity centrilobular nodules resembling HP at CT, none showed HP at histopathologic examination. CONCLUSION. EVALI manifests at CT as ALI with multifocal ground-glass opacity, often with organizing consolidation, and a small centrilobular nodular pattern resembling HP.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina , Lesão Pulmonar/diagnóstico por imagem , Lesão Pulmonar/etiologia , Tomografia Computadorizada por Raios X , Vaping/efeitos adversos , Adolescente , Adulto , Idoso , Feminino , Humanos , Lesão Pulmonar/patologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
18.
Lung ; 198(5): 803-810, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32870374

RESUMO

PURPOSE: Bronchoalveolar lavage and transbronchial biopsy can be a useful tool in the evaluation of interstitial lung disease (ILD), but patient selection for this procedure remains poorly defined. Determining clinical characteristics that help with patient selection for bronchoscopy may improve confidence of ILD classification while limiting potential adverse outcomes associated with surgical lung biopsy. The purpose of this study is to identify factors that were associated with change in multidisciplinary ILD diagnosis (MDD) before and after incorporation of BAL and TBBx data. METHODS: We conducted a retrospective cohort study of ILD patients at a single center who underwent bronchoscopy in the diagnostic workup of ILD. We performed sequential MDD both pre- and post-bronchoscopy to calculate the frequency of change in diagnosis after incorporating information from BAL and TBBx and identify features associated with change in diagnosis. RESULTS: 245 patients were included in the study. Bronchoscopy led to a change in diagnosis in 58 patients (23.7%). The addition of TBBx to BAL increased diagnostic yield from 21.8 to 34.1% (p = 0.027). Identification of antigen, HRCT scan inconsistent with UIP, and absence of a pre-bronchoscopy diagnosis of CTD-ILD or IPAF were associated with a change in diagnosis after bronchoscopy. CONCLUSION: Our study suggests clinical features that may assist with patient selection for bronchoscopy. We suggest bronchoscopy in patients with identified antigen or an HRCT that is consistent with a non-IPF diagnosis. Appropriate patient selection for bronchoscopy may improve ILD diagnostic confidence and avoid potential complications from more invasive and higher risk procedures.


Assuntos
Alveolite Alérgica Extrínseca/diagnóstico , Biópsia , Lavagem Broncoalveolar , Broncoscopia , Doenças Pulmonares Intersticiais , Pulmão , Biópsia/efeitos adversos , Biópsia/métodos , Biópsia/estatística & dados numéricos , Lavagem Broncoalveolar/métodos , Lavagem Broncoalveolar/estatística & dados numéricos , Broncoscopia/métodos , Broncoscopia/estatística & dados numéricos , Diagnóstico Diferencial , Feminino , Humanos , Pulmão/diagnóstico por imagem , Pulmão/patologia , Doenças Pulmonares Intersticiais/diagnóstico , Doenças Pulmonares Intersticiais/epidemiologia , Masculino , Pessoa de Meia-Idade , Avaliação de Processos e Resultados em Cuidados de Saúde , Seleção de Pacientes , Estudos Retrospectivos , Tomografia Computadorizada por Raios X/métodos , Estados Unidos/epidemiologia
19.
Med Educ Online ; 25(1): 1798088, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32706306

RESUMO

BACKGROUND & OBJECTIVE: The COVID-19 pandemic and resulting cancellation of medical student clinical rotations pose unique challenges to students' educations, the impact of which has not yet been explored. DESIGN: This cross-sectional survey study collected responses from 13 April 2020 until 30 April 2020. Students at US allopathic medical schools completed the survey online. RESULTS: 1,668 responses were analyzed. A total of 337 (20.2%) respondents thought the pandemic would affect their choice of specialty, with differences across class years: 15.2% (53) of first-years (MS1s), 26.4% (92) of second-years (MS2s), 23.7% (162) of third-years (MS3s), and 9.7% (22) of fourth-years (MS4s) (p < 0.0001). Among all classes, the most common reason chosen was inability to explore specialties of interest (244, 72.4%), and the second was inability to bolster their residency application (162, 48.1%). Out of the MS3s who chose the latter, the majority were concerned about recommendation letters (68, 81.0%) and away rotations (62, 73.8%). As high as 17.4% (119) of MS3s said they were more likely to take an extra year during medical school as a result of the pandemic. Region of the US, number of local COVID cases, and number of local COVID deaths had no effect on whether respondents thought the pandemic would affect their specialty choice. CONCLUSIONS: Our study found that about one-fifth of surveyed medical students currently believe that the COVID-19 pandemic will affect their choice of specialty, with many of these citing concerns that they cannot explore specialties or obtain recommendation letters. With prolonged suspension of clinical rotations, targeted efforts by medical schools to address these concerns through enhanced virtual curriculum development and advising strategies will become increasingly important. Further study is needed to explore whether these cross-sectional student perspectives will manifest as changes in upcoming National Residency Matching Program data.


Assuntos
Escolha da Profissão , Infecções por Coronavirus/epidemiologia , Internato e Residência/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Estudantes de Medicina/estatística & dados numéricos , Betacoronavirus , COVID-19 , Estudos Transversais , Humanos , Pandemias , SARS-CoV-2 , Estudantes de Medicina/psicologia , Estados Unidos
20.
Head Neck ; 42(9): E12-E15, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32621314

RESUMO

BACKGROUND: The da Vinci single-port (SP) is utilized in transoral robotic surgery (TORS) procedures for malignant oropharyngeal tumors. We report a case utilizing the da Vinci SP in TORS for sialolith removal. METHODS AND RESULTS: A 75-year-old male with chronic right submandibular gland (SMG) sialadenitis underwent combined da Vinci SP TORS approach with sialendoscopy for multiple SMG sialoliths. We were unable to find a previous report of using the da Vinci SP in TORS for SMG sialolith removal. CONCLUSION: The da Vinci SP has been utilized in a combined TORS approach with sialendoscopy for SMG sialolith removal. The da Vinci SP's additional arm provides improved retraction, enabling optimal visualization, dissection, and preservation of important structures such as the lingual nerve.


Assuntos
Neoplasias Orofaríngeas , Procedimentos Cirúrgicos Robóticos , Robótica , Cálculos das Glândulas Salivares , Idoso , Humanos , Masculino , Cálculos das Glândulas Salivares/cirurgia , Glândula Submandibular/cirurgia
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