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1.
J Mol Recognit ; 37(4): e3088, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38760976

RESUMO

Despite the necessity of the study of therapeutic drug monitoring of clonazepam (CLZ), there are only a few fast detection methods available for determining CLZ in biological media. This study aims to develop a cost-effective and ratiometric probe for the quantification of CLZ in plasma samples. Fluorescent polydopamine nanoparticles were produced through a self-polymerization process at a pH of 8.5. Rhodamine B molecules were employed as a fluorescent reference material, emitting stable fluorescence in the visible range. The fabricated probe exhibited a specific detection capability for CLZ. The fluorescence emission of the probe was enhanced in two concentration ranges: from 50 ng/mL to 1.0 µg/mL and from 1.0 to 15.0 µg/mL with a lower limit of quantification of 50 ng/mL, indicating the sensitivity of the probe for detecting CLZ plasma levels. The accuracy of the probe is favorable which could be recommended for CLZ monitoring in the biological media. Furthermore, this probe is highly specific towards CLZ in the presence of various interfering agents which is mainly caused by its ratiometric nature. The developed platform showed high reliability in quantifying CLZ concentrations in patients' plasma samples. Hence, the fabricated probe could be recommended as a reliable method for the routine detection of CLZ in clinical settings.


Assuntos
Clonazepam , Corantes Fluorescentes , Nanopartículas , Espectrometria de Fluorescência , Clonazepam/sangue , Clonazepam/química , Humanos , Nanopartículas/química , Corantes Fluorescentes/química , Espectrometria de Fluorescência/métodos , Polímeros/química , Rodaminas/química , Indóis/química , Indóis/sangue , Limite de Detecção , Monitoramento de Medicamentos/métodos
2.
Diabetes Metab Res Rev ; 40(4): e3806, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38757421

RESUMO

BACKGROUND: The management of Type 1 Diabetes Mellitus (T1DM) is a significant clinical challenge. This study evaluated the efficacy of teplizumab, an immunomodulatory drug, in patients with T1DM, using a systematic review and meta-analysis approach. METHODS: We systematically searched multiple databases including Medline, Scopus, and others up to 10 January 2024, without language or regional restrictions. We included randomized controlled trials (RCTs) comparing teplizumab with placebo in T1DM patients. RESULTS: Our analysis incorporated 8 RCTs, predominantly involving participants aged 7-35 years, diagnosed with T1DM and treated with 14-day courses of teplizumab. The primary outcomes included insulin use, C-peptide levels, and HbA1c levels. We observed a significant reduction in insulin use in the teplizumab group standardised mean difference of -0.50 (95% Confidence Interval [CI]: -0.76 to -0.23, p < 0.001; I2 = 49%). C-peptide levels were consistently higher in the teplizumab group, indicating improved endogenous insulin production. However, no significant change was noted in HbA1c levels between the groups. Quality assessment indicated a low risk of bias in most studies. CONCLUSIONS: Teplizumab has a significant impact on reducing insulin dependence and enhancing endogenous insulin production in T1DM patients. However, its effect on long-term glycaemic control, as indicated by HbA1c levels, remains inconclusive.


Assuntos
Anticorpos Monoclonais Humanizados , Diabetes Mellitus Tipo 1 , Ensaios Clínicos Controlados Aleatórios como Assunto , Adolescente , Humanos , Anticorpos Monoclonais Humanizados/uso terapêutico , Diabetes Mellitus Tipo 1/tratamento farmacológico , Hemoglobinas Glicadas/análise , Hipoglicemiantes/uso terapêutico , Insulina/uso terapêutico , Prognóstico , Resultado do Tratamento , Criança , Adulto Jovem , Adulto
3.
Org Biomol Chem ; 22(3): 561-567, 2024 Jan 17.
Artigo em Inglês | MEDLINE | ID: mdl-38116654

RESUMO

A thiol-free procedure for regioselective preparation of (Z)-ß-alkenyl sulfides via a three-component reaction of aryl/alkyl halides, phenylacetylene, and potassium isopropylxanthate in the presence of copper iodide as a catalyst in polyethylene glycol is reported. In this study, a xanthate salt is used as an odorless source of sulfur. The reactions proceed in a one-pot and single-step pathway with the formation of the carbothionate intermediate identified using NMR data as well as exclusively forming the Z isomer.

4.
J Basic Microbiol ; 64(5): e2300490, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38227394

RESUMO

Currently, zinc oxide (ZnO) particles are used in nanotechnology to destroy a wide range of microorganisms. Although pentavalent antimony compounds are used as antileishmanial drugs, they are associated with several limitations and side effects. Therefore, it is always desirable to try to find new and effective treatments. The aim of this research is to determine the antileishmanial effect of ZnO particles in comparison to the Antimoan Meglumine compound on promastigotes and amastigotes of Leishmania major (MRHO/IR/75/ER). After the extraction and purification of macrophages from the peritoneal cavity of C57BL/6 mice, L. major parasites were cultured in Roswell Park Memorial Institute-1640 culture medium containing fetal bovine serum (FBS) 10% and antibiotic. In this experimental study, the effect of different concentrations of nanoparticles was investigated using the 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyl-tetrazolium bromide (MTT) colorimetric method, in comparison to the glucantime on promastigotes, amastigotes and healthy macrophages in the culture medium. The amount of light absorption of the obtained color from the regeneration of tetrazolium salt to the product color of formazan by the parasite was measured by an enzyme-linked immunosorbent assay (ELISA) reader, and the IC50 value was calculated. IC50 after 24 h of incubation was calculated as IC50 = 358.6 µg/mL. The results showed, that the efficacy of ZnO nanoparticles was favorable and dose-dependent. The concentration of 500 µg/mL of ZnO nanoparticles induced 84.67% apoptosis after 72. Also, the toxicity of nanoparticles was less than the drug. Nanoparticles exert their cytotoxic effects by inducing apoptosis. They can be suitable candidates in the pharmaceutical industry in the future.


Assuntos
Antiprotozoários , Leishmania major , Antimoniato de Meglumina , Óxido de Zinco , Óxido de Zinco/farmacologia , Óxido de Zinco/química , Animais , Leishmania major/efeitos dos fármacos , Camundongos , Antiprotozoários/farmacologia , Antimoniato de Meglumina/farmacologia , Camundongos Endogâmicos C57BL , Nanopartículas/química , Macrófagos/parasitologia , Macrófagos/efeitos dos fármacos , Concentração Inibidora 50 , Macrófagos Peritoneais/parasitologia , Macrófagos Peritoneais/efeitos dos fármacos , Nanopartículas Metálicas/química
5.
J Stroke Cerebrovasc Dis ; 33(5): 107637, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38360251

RESUMO

BACKGROUND: The pattern of surgical treatments for Idiopathic Intracranial Hypertension (IIH) in the United States is not well-studied, specifically the trend of utilizing endovascular venous stenting (EVS) as an emerging technique. METHODS: In this cross-sectional study, we aimed to explore the national trend of utilizing different procedures for the treatment of IIH including EVS, Optic Nerve Sheath Fenestration (ONSF), and CSF Shunting, with a focus on novel endovascular procedures. Moreover, we explored rates of 90-day readmission and length of hospital stay following different procedures, besides the effects of sociodemographic and clinical parameters on procedure choice. RESULTS: 36,437 IIH patients were identified from records between 2010 and 2018. Those in the EVS group were 29 years old on average, and 93.4 % were female. Large academic hospital setting was independently associated with higher EVS utilization, while other factors were not predictive of procedure choice. The proportion of EVS use in IIH hospitalizations increased significantly from 2010 to 2018 (P < 0.001), while there was a relative decline in the frequency of shunting procedures (P = 0.001), with ONSF utilization remaining stable (P = 0.39). The rate of 90-day readmission and length of hospital stay were considerably lower following EVS compared to other procedures (Ps < 0.001). CONCLUSION: This study presents novel population-level data on national trends in the frequency and outcome of EVS for IIH therapy. EVS was associated with shorter length of hospital stays and fewer readmission rates. In addition, a continuous increase in venous stenting compared to other procedures suggests an increasing role for endovascular therapies in IIH.


Assuntos
Procedimentos Endovasculares , Hipertensão Intracraniana , Pseudotumor Cerebral , Humanos , Feminino , Adulto , Masculino , Pseudotumor Cerebral/cirurgia , Estudos Transversais , Procedimentos Neurocirúrgicos/efeitos adversos , Procedimentos Neurocirúrgicos/métodos , Procedimentos Endovasculares/efeitos adversos , Stents
6.
Int Wound J ; 21(6): e14907, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38822706

RESUMO

Recent randomised controlled trials (RCTs) have investigated the analgesic activity of sesame oil among patients with limb trauma; nevertheless, their findings are inconsistent. Hence, this review aimed to clarify the impact of topical administration of sesame oil on acute pain of adult outpatients with minor limb trauma. The online databases (e.g., Scopus, PubMed, Web of Science) were searched up to 31 January 2024. The RCTs were included if they compared the effect of applying standard treatments plus topical sesame oil to administering standard treatments alone or with a placebo/sham treatment. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) and the Cochrane Collaboration's risk of bias tool were applied to address the evidence quality and the study's methodological rigour, respectively. Four RCTs had the inclusion criteria, and their findings were pooled in a meta-analysis employing a random-effects approach. According to the pooled analysis, the reduction in mean change of the pain score from baseline to the second/third intervention day was significantly higher in favour of clients who received standard care plus daily massage of the trauma site with sesame oil compared to those who received a control condition (weighted mean difference: -1.10; 95% confidence interval [-1.62, -0.57]; p < 0.001). However, the evidence quality was moderate, and only two studies had good methodological rigour. Hence, more high-quality studies are needed to make a solid evidence-based conclusion about the favourable consequence of topical sesame oil on alleviating acute traumatic limb pain.


Assuntos
Administração Tópica , Ensaios Clínicos Controlados Aleatórios como Assunto , Óleo de Gergelim , Humanos , Óleo de Gergelim/uso terapêutico , Óleo de Gergelim/administração & dosagem , Manejo da Dor/métodos , Manejo da Dor/normas , Adulto , Feminino , Masculino , Analgésicos/administração & dosagem , Analgésicos/uso terapêutico , Medição da Dor/métodos , Pessoa de Meia-Idade , Extremidades/lesões
7.
BMC Endocr Disord ; 23(1): 67, 2023 Mar 27.
Artigo em Inglês | MEDLINE | ID: mdl-36973700

RESUMO

BACKGROUND: Choline is an important metabolite involved in phospholipids synthesis, including serum lipids, and is the immediate precursor of betaine. There are numerous studies with inconsistent results that evaluated the association between dietary choline intakes with cardiovascular risk factors. In addition, the association between dietary betaine and choline intakes with cardio-metabolic risk factors is not well studied. In the current study, our aim was to evaluate dietary choline and betaine intakes in the usual diet of obese individuals and to assess its association with serum lipids, blood pressure and glycemic markers among obese individuals. METHODS: We recruited a total number of 359 obese people aged between 20 and 50 years in the present study. A semi-quantitative food frequency questionnaire (FFQ) was used for dietary assessment; dietary choline and betaine intakes were calculated using the United States Department of Agriculture (USDA) database. National cholesterol education program adult treatment panel (NCEP-ATP)-III criteria was used metabolic syndrome (MetS) definition. Enzymatic methods were used to assess biochemical variables. Body composition was measured with the bioelectrical impedance analysis (BIA) method. RESULTS: Higher body mass index (BMI), waist to hip ratio (WHR), fat-free mass (FFM) and basal metabolic rate (BMR) were observed in higher tertiles of dietary choline intake (P < 0.01). There was no significant difference in terms of biochemical parameters among different tertiles of dietary choline intake, while systolic blood pressure (SBP) and diastolic blood pressure (DBP) were reduced in higher betaine tertiles (P < 0.05). For total dietary choline and betaine intakes, there was a reduction in DBP and low density lipoprotein (LDL) concentrations (P < 0.05). Also, a non-significant reduction in serum total cholesterol (TC), triglyceride (TG) and MetS prevalence was observed in higher tertiles of dietary choline and betaine intakes. After classification of the study population according to MetS status, there was no significant difference in biochemical variables in subjects with MetS (P > 0.05), while in the non-MetS group, SBP, DBP, TG and insulin levels reduced in higher tertiles of dietary betaine and choline (P > 0.05). CONCLUSION: According to our findings, higher dietary intakes of choline and betaine were associated with lower levels of blood pressure and LDL concentrations among obese individuals. Further studies are warranted to confirm the results of the current study.


Assuntos
Betaína , Fatores de Risco Cardiometabólico , Colina , Dieta , Síndrome Metabólica , Obesidade , Adulto , Humanos , Pessoa de Meia-Idade , Adulto Jovem , Colesterol/sangue , Dieta/estatística & dados numéricos , Síndrome Metabólica/sangue , Síndrome Metabólica/epidemiologia , Síndrome Metabólica/metabolismo , Obesidade/sangue , Obesidade/epidemiologia , Obesidade/metabolismo , Sobrepeso/sangue , Sobrepeso/epidemiologia , Sobrepeso/metabolismo , Prevalência , Fatores de Risco , Triglicerídeos/sangue , Ingestão de Alimentos , Biomarcadores/sangue
8.
BMC Endocr Disord ; 23(1): 206, 2023 Sep 26.
Artigo em Inglês | MEDLINE | ID: mdl-37752490

RESUMO

BACKGROUND: The predisposition of humans to metabolic syndrome is affected by many factors, including diet and lifestyle. Fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) are a set of carbohydrates that are fermented by gut microbiota. In animal studies, supplementation with FODMAP-rich diets as prebiotics can alter body composition and gut microbiota. This study evaluates any relationship between FODMAP and metabolic syndrome risk factors among adults with metabolic syndrome in Iran. METHODS: This cross-sectional study is based on sociodemographic information from 347 overweight and obese participants selected from outpatient clinics through public declaration. Participants body composition and anthropometric measures were also determined. A validated Food Frequency Questionnaire (FFQ) with 168 questions was used to collect dietary data. Biochemical parameters, including serum total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), fasting serum glucose (FSG), and insulin levels, were determined by enzymatic methods. In addition, the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) and Quantitative Insulin Sensitivity Check Index (QUICKI) were calculated. RESULTS: In moderate FODMAP and low FODMAP groups, lower waist-to-hip ratio (WHR) and higher fat-free mass (FFM) were achieved in higher tertiles. In high FODMAP groups, higher systolic blood pressure (SBP) was shown in the higher tertile (P < 0.05). Higher insulin, HOMA-IR, and lower QUICKI in the second tertile of the high FODMAP group were also observed. CONCLUSION: Findings of this study highlight the potential role of FODMAP in managing metabolic syndrome and open a new field of research.


Assuntos
Insulinas , Síndrome Metabólica , Adulto , Humanos , Sobrepeso , Síndrome Metabólica/epidemiologia , Síndrome Metabólica/etiologia , Estudos Transversais , Obesidade , HDL-Colesterol
9.
BMC Endocr Disord ; 23(1): 3, 2023 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-36600237

RESUMO

BACKGROUND: Several previous studies revealed the role of dietary energy density (DED) in developing obesity and related disorders. However, the possible role of DED in triggering cardiometabolic risk factors of individuals with obesity has not been studied yet. This study aimed to evaluate the association between DED and anthropometric parameters, blood pressure, and components of metabolic syndrome (MetS) (such as glycemic markers, lipid profile, and blood pressure) among individuals with obesity. METHODS: In this cross-sectional study, we included 335 adults with obesity (BMI ≥ 30 kg/m2) aged 20-50 years in Tabriz and Tehran, Iran. Dietary intake was assessed by a validated semi-quantitative Food Frequency Questionnaire (FFQ), including 168 food items; then, DED was calculated. MetS was defined based on the guidelines of the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III). Enzymatic methods were used to assess serum lipids, glucose, and insulin concentrations. Blood pressure was measured by sphygmomanometer and body composition by bioelectrical impedance analysis (BIA). RESULTS: Participants in the higher tertiles of DED had more intake of carbohydrate, dietary fat, saturated fatty acid (SFA), monounsaturated fatty acid (MUFA), polyunsaturated fatty acid (PUFA), and meat, fish, poultry (MFP). Increasing the DED in both methods had no association with systolic blood pressure (SBP), fasting blood sugar (FBS), low-density lipoprotein cholesterol (LDL-C), insulin, triglyceride (TG), and homeostatic model assessment of insulin resistance (HOMA-IR) even after adjustment for confounders. However, diastolic blood pressure (DBP) decreased in second tertile of DED I (ß = 0.921, P = 0.004). The quantitative insulin-sensitivity check index (QUICKI) in second tertile of both DED methods had significant positive association with DED. In the second tertile of DED II, while total cholesterol (TC) significantly decreased (P crude = 0.036, P adjusted = 0.024), high-density lipoprotein cholesterol (HDL-C) increased (ß = 1.096, p = 0.03). There was no significant changes in biochemical parameters in third tertile of DED I and II even after adjustment for covariates. Also, higher tertiles of DED was associated with reduced prevalence of MetS. CONCLUSION: High DED was associated with lower levels of blood pressure and TC but elevated levels of HDL and QUICKI independent of such confounders as age, BMI, sex, and physical activity. Further longitudinal studies are warranted to better elucidate casual associations.


Assuntos
Síndrome Metabólica , Obesidade , Humanos , Pressão Sanguínea , Estudos Transversais , Irã (Geográfico)/epidemiologia , Obesidade/complicações , Síndrome Metabólica/epidemiologia , Síndrome Metabólica/etiologia , Colesterol , Insulina , Glicemia/análise , Fatores de Risco , Índice de Massa Corporal
10.
Mol Divers ; 27(1): 159-165, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-35294672

RESUMO

The reaction of dibenzyl disulfide with various bromine complexes as oxidants and DMSO as solvent can produce thioamides in high yield at 110 °C. Tertiary amines like pyridine and quinoline, which were utilized in this catalyst, are known to generate bromine-addition complexes. The approach is metal- and additive-free, making it a simple and cost-effective way to make a variety of thioamides under favorable circumstances.


Assuntos
Aminas , Quinolinas , Acoplamento Oxidativo , Bromo , Tioamidas , Catálise
11.
Mol Divers ; 27(6): 2887-2894, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36515805

RESUMO

A one-pot, efficient oxidative-condensation process for constructing both 4-alkyl and 4-aryl-5-(arylthio) thiazol-2-amines using DMSO/I2 is introduced. In this procedure, methyl ketones, thiourea, DMSO, and thiols are reacted together in the presence of molecular I2 at 80 °C simply to produce 4-alkyl or aryl-5-(arylthio)thiazol-2-amines due to formation of a C-S bond between thiourea and methyl carbon linked to carbonyl group and the another C-S bond formation between thiol and thiazol ring. Under reaction conditions, both aryl and alkyl methyl ketones including acetophenone and substituted acetophenones also, 2-alkanones such as acetone, 2-butanone, 2-pentanone, and 2-heptanone yield those products successfully.


Assuntos
Acetona , Dimetil Sulfóxido , Tiazóis/química , Tioureia , Compostos de Sulfidrila , Cetonas/química , Catálise , Aminas/química , Estresse Oxidativo
12.
Am J Emerg Med ; 65: 53-58, 2023 03.
Artigo em Inglês | MEDLINE | ID: mdl-36584540

RESUMO

BACKGROUND: Although many studies have evaluated the diagnostic value of the National Emergency X-ray Utilization Studies (NEXUS) chest rules in assessment of traumatic chest injuries, there still is no consensus on this subject matter. Therefore, this systematic review and meta-analysis aims to review the current existing literature in order to evaluate the diagnostic value of NEXUS chest rules for assessment of traumatic chest injuries. METHOD: Databases of Medline, Embase, Scopus and Web of Science were searched until August 20th, 2022. Two independent reviewers screened the articles related to the diagnostic value of NEXUS chest radiography, NEXUS chest CT-all and NEXUS chest-Major. RESULTS: Data of 6 studies, on 23,741 patients, were included in this review. Since only one article assessed the value of NEXUS chest CT scan, the meta-analysis was performed only on NEXUS chest radiography rule. Pooled analysis on the results of 5 articles showed that the AUC of NEXUS chest radiography rule in assessment of traumatic chest injuries was 0.98 (95% CI: 0.96 to 0.99), with a sensitivity and specificity of 0.99 (95% CI: 0.98 to 0.99) and 0.32 (95% CI: 0.17 to 0.52), respectively. Positive and negative likelihood ratio of NEXUS chest radiography rule were 1.46 (95% CI: 1.12 to 1.90) and 0.04 (95% CI: 0.03 to 0.06). Overall diagnostic odds ratio was calculated to be 36.67 (95% CI: 19.17 to 70.16). CONCLUSION: Our findings indicate that NEXUS chest radiography rule is a sensitive decision rule for assessment of traumatic chest injuries, but its specificity was found to be low. However, few articles have investigated the diagnostic value of NEXUS chest rules, especially the NEXUS chest CT scan, and more studies need to be done in order to strengthen the currently provided results.


Assuntos
Traumatismos Torácicos , Ferimentos não Penetrantes , Humanos , Raios X , Radiografia , Traumatismos Torácicos/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Ferimentos não Penetrantes/diagnóstico por imagem , Sensibilidade e Especificidade
13.
Clin Med Res ; 21(1): 14-25, 2023 03.
Artigo em Inglês | MEDLINE | ID: mdl-37130787

RESUMO

Objective: We evaluated the triage and prognostic performance of seven proposed computed tomography (CT)-severity score (CTSS) systems in two different age groups.Design: Retrospective study.Setting: COVID-19 pandemic.Participants: Admitted COVID-19, PCR-positive patients were included, excluding patients with heart failure and significant pre-existing pulmonary disease.Methods: Patients were divided into two age groups: ≥65 years and ≤64 years. Clinical data indicating disease severity at presentation and at peak disease severity were recorded. Initial CT images were scored by two radiologists according to seven CTSSs (CTSS1-CTSS7). Receiver operating characteristic (ROC) analysis for the performance of each CTSS in diagnosing severe/critical disease on admission (triage performance) and at peak disease severity (prognostic performance) was done for the whole cohort and each age group separately.Results: Included were 96 patients. Intraclass correlation coefficient (ICC) between the two radiologists scoring the CT scan images were good for all the CTSSs (ICC=0.764-0.837). In the whole cohort, all CTSSs showed an unsatisfactory area under the curve (AUC) in the ROC curve for triage, excluding CTSS2 (AUC=0.700), and all CTSSs showed acceptable AUCs for prognostic usage (0.759-0.781). In the older group (≥65 years; n=55), all CTSSs excluding CTSS6 showed excellent AUCs for triage (0.804-0.830), and CTSS6 was acceptable (AUC=0.796); all CTSSs showed excellent or outstanding AUCs for prognostication (0.859-0.919). In the younger group (≤64 years; n=41), all CTSSs showed unsatisfactory AUCs for triage (AUC=0.487-0.565) and prognostic usage (AUC=0.668-0.694), excluding CTSS6, showing marginally acceptable AUC for prognostic performance (0.700).Conclusion: Those CTSSs requiring more numerous segmentations, namely CTSS2, CTSS7, and CTSS5 showed the best ICCs; therefore, they are the best when comparison between two separate scores is needed. Irrespective of patients' age, CTSSs show minimal value in triage and acceptable prognostic value in COVID-19 patients. CTSS performance is highly variable in different age groups. It is excellent in those aged ≥65 years, but has little if any value in younger patients. Multicenter studies with larger sample size to evaluate results of this study should be conducted.


Assuntos
COVID-19 , Humanos , Idoso , COVID-19/diagnóstico por imagem , Estudos Retrospectivos , Triagem/métodos , Prognóstico , Pandemias , Tomografia Computadorizada por Raios X/métodos
14.
BMC Palliat Care ; 22(1): 180, 2023 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-37968669

RESUMO

BACKGROUND: High quality end-of-life care is essential. Yet for those experiencing heart failure, the provision of high-quality end- of -life care can be challenging. The aim of this study was to explore Iranian nurses' perceptions of the challenges involved in providing of end-of-life care to people with heart failure. METHODS: Conventional content analysis was used to analyze qualitative data collected from nurses (n = 33) using semi-structured and individual interviews. Participants were aged between 29 and 51 years. The majority of participants were women (n = 20). Most had a bachelor's degree (n = 24), and work experience of between 7 and 18 years. RESULTS: Nurses challenges in providing end-of-life care to those with heart failure included (1) adverse consequences relating to compassion fatigue and continued futility in care and (2) lack of palliative care services with regards to a lack of specialists, lack of support from health systems, and poor teamwork. CONCLUSIONS: This is the first qualitative study to explore Iranian nurses' challenges in providing end-of-life care to those with heart failure. Investment is required in education and research in this area. Particular attention must be paid to prevention of compassion fatigue. Law changes would enable the delivery of higher-quality palliative care in this context overall.


Assuntos
Fadiga de Compaixão , Insuficiência Cardíaca , Enfermeiras e Enfermeiros , Assistência Terminal , Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Irã (Geográfico) , Pesquisa Qualitativa , Insuficiência Cardíaca/terapia
15.
J Stroke Cerebrovasc Dis ; 32(9): 107286, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37541026

RESUMO

OBJECTIVES: Comorbid cancer with stroke is a complex situation with multiple factors affecting quality of life (QoL). No specific questionnaire exists to assess current drivers of QoL and future concerns and priorities in patients with cancer-related stroke. METHODS: After developing a structured survey instrument, we prospectively interviewed patients with recent ischemic stroke and active cancer to assess views about their condition, factors currently impacting QoL, concerns for the future, and preferences regarding antithrombotic treatment strategy. RESULTS: In 2021-2022, at two quaternary-care stroke and cancer centers, we surveyed 50 patients with cancer-related stroke (mean age 70 years, 42% women). Most (87%) had solid cancers with lung, prostate, and breast cancers being the most prevalent. The most frequent adverse feelings were sadness and anxiety about another stroke. Disability from stroke, pain from cancer, and dependency were the items rated to have the highest current effect on patients' QoL and were ranked as the number one effector on QoL in 25%, 23%, and 16% of surveys, respectively; bleeding was ranked the lowest. Cognitive/memory impairment (ranked first in 28% of surveys), dependency on others (ranked first in 18%), and speech disturbance (ranked first in 16%) were the highest ranked future concerns; bleeding and pain were ranked the lowest. When questioned about antithrombotic treatment preferences to prevent further stroke, 50% favored a more aggressive approach with anticoagulant therapy, 16% favored a less aggressive approach with antiplatelet therapy, and 34% were neutral/unsure. CONCLUSIONS: Patients with cancer-related stroke reported that stroke disability and cancer pain were their most impactful current issues, while long-term cognitive impairment, functional dependence, and speech disturbance were their most important future concerns. These patients seemed to be more concerned about future stroke than bleeding events and tended to prefer a more aggressive antithrombotic strategy, although considerable variability existed.


Assuntos
Neoplasias da Mama , AVC Isquêmico , Acidente Vascular Cerebral , Masculino , Humanos , Feminino , Idoso , Qualidade de Vida/psicologia , Estudos Prospectivos , Fibrinolíticos , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/prevenção & controle , Inquéritos e Questionários , Hemorragia
16.
J Stroke Cerebrovasc Dis ; 32(12): 107450, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37924781

RESUMO

OBJECTIVES: Thrombectomy improves outcomes in patients with basilar artery (BA) occlusion. We hypothesized that the anatomic configuration of the BA bifurcation, classified as T- or Y-shaped, may impact the outcome as a T-shaped BA would involve more deep penetrating arteries of the midbrain and thalamus. MATERIALS AND METHODS: In this 2-center retrospective cohort study, we included patients with stroke due to distal BA occlusion and performed blinded classification of their BA distal bifurcation as either T- or Y-shaped. The primary outcomes were favorable outcome at 90-days (modified Rankin Scale 0 - 2) and successful recanalization (TICI scores 2B or 3). RESULTS: 70 patients (mean age 66 years, 36% women) were included. 38 had T- and 32 had Y-shaped bifurcations. Baseline characteristics were similar for both groups, including demographics, onset to arterial puncture time, baseline NIHSS, THRIVE score, posterior circulation collateral score, and presence of tandem occlusion. Comparing the T- to the Y- shape, there was no difference in the likelihood of successful recanalization (RR: 1.02, CI: [0.86-1.21], p=1.00) nor 90-day favorable mRS (0-2) score (RR: 0.58, CI: [0.25-1.32]; p=0.18). Similarly, mortality at 30 and 90-days were not significantly affected by the type of bifurcation. CONCLUSIONS: The configuration of the basilar artery does not significantly impact on recanalization success or stroke outcome in our study. Further studies are needed to confirm our observations.


Assuntos
Arteriopatias Oclusivas , Procedimentos Endovasculares , Acidente Vascular Cerebral , Humanos , Feminino , Idoso , Masculino , Artéria Basilar/diagnóstico por imagem , Estudos Retrospectivos , Acidente Vascular Cerebral/diagnóstico por imagem , Acidente Vascular Cerebral/terapia , Acidente Vascular Cerebral/etiologia , Trombectomia/efeitos adversos , Arteriopatias Oclusivas/etiologia , Resultado do Tratamento
17.
Int Nurs Rev ; 70(1): 59-77, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-36418147

RESUMO

AIM: This study aimed to clarify the value of caring programs developed according to Orem's Self-Care Deficit Nursing Theory regarding quality of life and self-care as the primary outcomes and self-efficacy, anxiety, depression, and stress as the secondary outcomes among individuals aged 18-70 years with chronic diseases. BACKGROUND: Chronically ill patients need to receive appropriate self-care training, counseling, and support. In this regard, the use of caring programs developed based on theories is highly suggested. Orem's Nursing Theory is the most well-known theory that provides a structure to involve patients in their self-care activities. INTRODUCTION: Orem's Nursing Theory has been increasingly applied to guide practice for patients with chronic health conditions. However, recent trials have reported conflicting findings on the value of its application. METHODS: Eight information sources (e.g., Web of Science Core Collection, PubMed, and Scopus) and the International Clinical Trials Registry Platform were searched up to 30 March 2022. RESULTS: A total of 46 studies and 11 study register entries were eligible. Orem's theory-based interventions significantly improved the quality of life, self-care, and self-efficacy as well as significantly reduced anxiety and depression. However, the value of the interventions on stress was uncertain, as performing the meta-analysis was not possible. DISCUSSION: Orem's Nursing Theory can help nurses in different fields to dynamically and carefully evaluate patients' self-care ability and implement appropriate nursing measures tailored to their needs, interests, and problems. Considering the inconsistent evidence to support the empirical adequacy of this theory, high-quality reviews are essential. CONCLUSION: Orem's theory-based programs had a favorable effect on taking care of adults with chronic diseases. IMPLICATIONS: This study augments the previous reviews related to the applicability of Orem's Nursing Theory. Considering the undesirable evidence quality and the high between-study heterogeneity, further well-designed trials are required to draw an evidence-based conclusion.


Assuntos
Teoria de Enfermagem , Qualidade de Vida , Humanos , Adulto , Autocuidado , Doença Crônica , Autoeficácia
18.
J Food Sci Technol ; 60(3): 856-867, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-36908364

RESUMO

The objective was to determine the effect of rosemary essential oil (REO) as nitrite substitute on the physicochemical, microbiological and sensory quality of sausage from broilers fed different levels of thymus essential oil (TEO) and rapeseed oil (RO). Broiler chicks fed TEO (0, 300 and 500 ppm) and RO (1, 3 and 5%) in a 3 × 3 factorial design. Sausages were made from meat of chicken fed TEO (0 and 500 ppm) treated with REO (120 ppm), REO:nitrite (60:60 ppm), nitrite (120 ppm) or without REO and nitrite in a 2 × 4 factorial design. Results showed that TEO increased water holding capacity and pH value and decreased malondialdehyde concentration. RO (1 and 3%) × TEO (500 ppm) group had higher unsaturated to saturated fatty acids ratio in the meat. Results showed that treatments of REO (120 ppm) decreased lipid oxidation and increased pH value of meat. Sausage produced by nitrite (120 ppm) or REO:nitrite (60:60 ppm) had lower total microbial count, lightness but higher redness and yellowness. Based on the results, TEO in chicken feed decreased lipid oxidation of sausages. Furthermore, substitution at least 60 ppm nitrite with REO had more preserving effect on quality of produced sausages.

19.
Beilstein J Org Chem ; 19: 1170, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37592936

RESUMO

[This retracts the article DOI: 10.3762/bjoc.11.141.].

20.
Environ Res ; 207: 112157, 2022 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-34619122

RESUMO

This paper investigates the synthesis, antibacterial, and photocatalytic properties of silver ion-exchanged natural zeolite/TiO2 photocatalyst nanocomposite. Zeolite is known to have a porous surface structure, making it an ideal substrate and framework in different nanocomposites. Moreover, natural zeolite has a superior thermal and chemical stability, with hardly any reactivity with chemicals. Finding an effective and low-cost method to remove both antibiotics and bacteria from water resources has become a vital global issue due to the worldwide excessive use of chemicals and antibiotics. This research aims to propose a facile method to synthesize Ag-ion-exchanged zeolite/TiO2 catalyst for anti-bacterial purposes and photocatalytic removal of atibiotics from wastewaters. TiO2 particles were deposited on the surface of natural zeolite. Ag ion exchanging was performed via a liquid ion-exchange method using 0.1 M AgNO3 solution. X-ray diffractometry (XRD), scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDS), and Fourier-transform infrared spectroscopy (FTIR) were used to evaluate the structure of synthesized powders. Antibacterial activities of samples were assessed, using Staphylococcus aureus ATCC 25923 and Escherichia coli ATCC 25922 by disc diffusion method. It was shown that Ag-containing nanocomposite samples have an improved antibacterial performance in both cases. Results showed that the synthesized catalyst has promising potentials in wastewater treatment.


Assuntos
Nanocompostos , Zeolitas , Antibacterianos/química , Antibacterianos/farmacologia , Nanocompostos/química , Titânio/química , Zeolitas/química
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