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1.
J Mol Graph Model ; 133: 108858, 2024 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-39232488

RESUMO

Corynebacterium diphtheriae is a multi-drug resistant bacteria responsible for the life-threatening respiratory illness, diphtheria which can lead to severe Nervous system disorders, mainly infecting the lungs, heart, and kidneys if left untreated. In the current study, Corynebacterium diphtheriae MtrA response regulator protein was targeted, which regulates a two-component system of bacterial pathogenesis, and initiates DNA replication and cell division. In the current study a computational approach have been described for drug development against C. diphtheriae infections by inhibiting MtrA protein by small molecules acting as potential inhibitors against it. Molecular docking analysis of the equilibrated MtrA protein revealed compound-0.2970, compound-0.3029, and compound-0.3016 from Asinex Library as the promising inhibitors based on their lowest binding energies (-9.8 kJ/mol, -9.2 kJ/mol, and -8.9 kJ/mol), highest gold scores (40.53, 47.41, and 48.41), drug-likeness and pharmacokinetic properties. The MD simulation studies of the identified top-ranked inhibitors at 100 ns elucidated the system stability and fluctuations in the binding pocket of MtrA protein. Molecular Dynamics Simulations of the top three docked complexes further revealed that the standard binding pocket was retained ensuring the system stability. The rearrangements of H-bonds, van der Waals, pi-pi, and solid hydrophobic interactions were also observed. The binding free energy calculations (MM/PBSA and MM/GBSA) suggested a fundamental binding capability of the ligand to the target receptor MtrA. Therefore, the current study has provided excellent candidates acting as potent inhibitors for developing therapeutic drugs against C. diphtheriae infections. However, in vivo and in vitro animal experiments and accurate clinical trials are needed to validate the potential inhibitory effect of these compounds.

2.
Vasc Endovascular Surg ; : 15385744241284876, 2024 Sep 12.
Artigo em Inglês | MEDLINE | ID: mdl-39264598

RESUMO

BACKGROUND: Radiofrequency ablation (RFA) is a minimally invasive treatment for lower limb varicose veins. Studies indicate that RFA results in immediate occlusion of 90%-100% of treated long saphenous veins. Evidence suggests that post-operative scans rarely alter patient management or outcomes. OBJECTIVE: The aim of this study was to assess the potential necessity of routine postoperative scanning in the treatment of varicose veins. METHOD: Retrospective data were collected for the patients who had RFA under a single consultant from November 2015 to June 2018. Descriptive statistics were calculated to summarize patient demographics, procedural details, and outcome measures. RESULTS: A total of 124 patients underwent radiofrequency ablation (RFA). Most of the patients (n = 114, 92%) demonstrated complete ablation, indicating a high success rate for the procedure. CONCLUSION: This study suggested that routine postoperative scanning should be discontinued as this did not alter patient management in over 99% of cases. The resources currently used for postoperative scans could be redirected towards other critical areas.

3.
Proc (Bayl Univ Med Cent) ; 37(5): 769-773, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39165822

RESUMO

Background: Statin therapy is widely utilized for preventing atherosclerotic cardiovascular disease, both as a primary and secondary measure. Despite the American Association for the Study of Liver Diseases' endorsement of statin use in cirrhotic patients, practitioners exhibit hesitancy, primarily due to concerns regarding hepatotoxicity. This study aimed to evaluate statin prescription patterns in cirrhotic patients by primary care physicians (PCPs) and cardiologists through a survey. Methods: A voluntary survey via Survey Monkey with nine objective-type questions was sent to 220 PCPs and 75 cardiologists within Allegheny Health Network. Survey results were collected, and a chi square test was used to compare the two groups. A P value ≤ 0.05 was considered statistically significant. Results: A total of 64 PCPs (29.1%) and 15 cardiologists (20%) completed the survey. Overall, 12.6% did not prescribe statins for primary prevention of atherosclerotic cardiovascular disease in compensated cirrhotic patients. While all cardiologists prescribed statins for secondary prevention, over 50% preferred lower-intensity options. Conversely, 14.1% of PCPs avoided statin prescriptions for secondary prevention. Cardiologists were significantly more inclined to prescribe statins, especially for cirrhosis due to metabolic dysfunction-associated steatotic liver disease compared to PCPs (73.3% vs 45.3%, P = 0.05). Conclusions: Despite increasing evidence favoring use of statins in cirrhosis for improving portal hemodynamics and decreasing ascites, hepatic encephalopathy, the incidence of hepatocellular carcinoma, and mortality, there is still hesitation on the part of prescribers for the fear of worsening liver disease. Wider dissemination of current guidelines and education practices may help to bridge this gap.

4.
J Palliat Care ; : 8258597241276318, 2024 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-39194375

RESUMO

OBJECTIVE: Necrotizing pancreatitis (NP) is a severe form of pancreatitis that often necessitates intensive care and can result in significant morbidity and mortality. This study aimed to investigate racial and gender disparities in palliative care (PC) utilization among mechanically-ventilated patients with NP. METHODS: In this retrospective analysis using the National Inpatient Sample from 2016 to 2020, we investigated 84 335 patients with NP requiring invasive mechanical ventilation, and the utilization of PC services and their disparities based on gender and race. To adjust for potential confounding factors, we employed multivariable logistic regression, ensuring that our findings account for various influencing variables and provide a robust analysis of the data. RESULTS: Among the patients studied, 15.4% utilized PC consultations. Notably, female patients were 12% more likely to utilize PC than their male counterparts (OR 1.1, 95% CI: 1.003-1.2; P = .008). Racial disparities were pronounced: African Americans (OR 0.8, 95% CI 0.7-0.9, P < .001), Hispanic (OR 0.8, 95% CI 0.7-0.9, P = .001), and Asian or Pacific Islander patients (OR 0.74, 95% CI 0.57-0.97; P = .03) had significantly lower odds of utilizing PC compared to White patients. The cohort utilizing PC had a higher in-hospital mortality rate (74.7% vs 24.8%; OR 8.2, 95% CI 7.7-9.2) but a shorter mean hospital stays and lower associated costs. CONCLUSIONS: Our findings indicate significant racial and gender disparities in the utilization of PC for intubated patients with NP, with lower utilization among males and minority populations. These findings emphasize the urgent requirement for comprehensive changes in healthcare protocols.

5.
PLoS One ; 19(7): e0304847, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38968206

RESUMO

This paper presents a novel approach to enhance the accuracy of patch-level Gleason grading in prostate histopathology images, a critical task in the diagnosis and prognosis of prostate cancer. This study shows that the Gleason grading accuracy can be improved by addressing the prevalent issue of label inconsistencies in the SICAPv2 prostate dataset, which employs a majority voting scheme for patch-level labels. We propose a multi-label ensemble deep-learning classifier that effectively mitigates these inconsistencies and yields more accurate results than the state-of-the-art works. Specifically, our approach leverages the strengths of three different one-vs-all deep learning models in an ensemble to learn diverse features from the histopathology images to individually indicate the presence of one or more Gleason grades (G3, G4, and G5) in each patch. These deep learning models have been trained using transfer learning to fine-tune a variant of the ResNet18 CNN classifier chosen after an extensive ablation study. Experimental results demonstrate that our multi-label ensemble classifier significantly outperforms traditional single-label classifiers reported in the literature by at least 14% and 4% on accuracy and f1-score metrics respectively. These results underscore the potential of our proposed machine learning approach to improve the accuracy and consistency of prostate cancer grading.


Assuntos
Aprendizado Profundo , Gradação de Tumores , Neoplasias da Próstata , Humanos , Masculino , Neoplasias da Próstata/patologia , Redes Neurais de Computação , Próstata/patologia , Algoritmos
6.
BMC Pulm Med ; 24(1): 371, 2024 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-39085906

RESUMO

BACKGROUND: Spontaneous pneumothorax (PTX) is more prevalent among COVID-19 patients than other critically ill patients, but studies on this are limited. This study compared clinical characteristics and in-hospital outcomes among COVID-19 patients with concomitant PTX to provide insight into how PTX affects health care utilization and complications, which informs clinical decisions and healthcare resource allocation. METHODS: The 2020 Nationwide Inpatient Sample was used analyze patient demographics and outcomes, including age, race, sex, insurance status, median income, length of hospital stay, mortality rate, hospitalization costs, comorbidities, mechanical ventilation, and vasopressor support. Propensity score matching was employed for additional analysis. RESULTS: Among 1,572,815 COVID-19 patients, 1.41% had PTX. These patients incurred significantly higher hospitalization costs ($435,508 vs. $96,668, p < 0.001) and longer stays (23.6 days vs. 8.6 days, p < 0.001). In-hospital mortality was substantially elevated for PTX patients (65.8% vs. 14.4%, p < 0.001), with an adjusted odds ratio of 14.3 (95% CI 12.7-16.2). Additionally, these patients were more likely to require vasopressors (16.6% vs. 3.3%), mechanical circulatory support (3.5% vs. 0.3%), hemodialysis (16.6% vs. 5.6%), invasive mechanical ventilation (76.9% vs. 15.1%), non-invasive mechanical ventilation (19.1% vs. 5.8%), tracheostomy (13.3% vs. 1.1%), and chest tube placement (59.8% vs. 0.8%). CONCLUSIONS: Our findings highlight the severe impact of PTX on COVID-19 patients, characterized by higher mortality, more complications, and increased resource utilization. Also, being Hispanic, male, or obese increased the risk of developing concomitant PTX with COVID-19.


Assuntos
COVID-19 , Mortalidade Hospitalar , Pneumotórax , Pontuação de Propensão , Humanos , COVID-19/mortalidade , COVID-19/terapia , COVID-19/complicações , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Estados Unidos/epidemiologia , Pneumotórax/mortalidade , Pneumotórax/terapia , Adulto , Tempo de Internação/estatística & dados numéricos , Bases de Dados Factuais , Respiração Artificial/estatística & dados numéricos , Respiração Artificial/economia , SARS-CoV-2 , Hospitalização/estatística & dados numéricos , Hospitalização/economia , Comorbidade , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Estudos Retrospectivos
7.
J Family Med Prim Care ; 13(6): 2511-2515, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-39027825

RESUMO

Hereditary motor and sensory neuropathy (HMSN), also known as Charcot-Marie-Tooth disease (CMT), is a member of the inherited neuropathy family with specific clinical and genetical manifestations. More than twenty genes have been linked to HMSN, and the number might increase. Regarding diagnosis, a healthcare provider should be suspicious if the patient is young with a family history. Integrative diagnosis, which includes electrophysiological, radiological, and genetic screening, is of great value to exclude metabolic, nutritive-toxic, infectious, and inflammatory or autoimmunological causes and to reach the exact subtype of hereditary neuropathy. Nowadays, next-generation sequencing-based analysis is becoming a routine diagnostic tool for inherited neuropathy, but if this facility is not available, electrophysiological and radiological diagnoses are the best diagnostic tools to be used. Differentiation between hereditary neuropathy and diabetic neuropathy is essential for primary care physicians to have the right plan.

8.
Front Med (Lausanne) ; 11: 1385524, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38988354

RESUMO

Introduction: In the evolving healthcare landscape, we aim to integrate hyperspectral imaging into Hybrid Health Care Units to advance the diagnosis of medical diseases through the effective fusion of cutting-edge technology. The scarcity of medical hyperspectral data limits the use of hyperspectral imaging in disease classification. Methods: Our study innovatively integrates hyperspectral imaging to characterize tumor tissues across diverse body locations, employing the Sharpened Cosine Similarity framework for tumor classification and subsequent healthcare recommendation. The efficiency of the proposed model is evaluated using Cohen's kappa, overall accuracy, and f1-score metrics. Results: The proposed model demonstrates remarkable efficiency, with kappa of 91.76%, an overall accuracy of 95.60%, and an f1-score of 96%. These metrics indicate superior performance of our proposed model over existing state-of-the-art methods, even in limited training data. Conclusion: This study marks a milestone in hybrid healthcare informatics, improving personalized care and advancing disease classification and recommendations.

9.
Cureus ; 16(6): e62388, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-39006654

RESUMO

Background  Foot ulcer is a common complication of poorly controlled diabetes and peripheral vascular disease (PVD). The current standard of treatment for diabetic foot ulcers includes the management of underlying risk factors, wound debridement, use of antibiotics for infection, off-loading with cast, and revascularisation surgery. The glyceryl trinitrate (GTN) patch is currently off-licence in treating PVD or diabetic foot ulcers. This study aims to evaluate the effectiveness of the GTN patch in preventing amputation, improving pain control, and reducing the size of tissue loss (ulcer/gangrene) or localised ischaemic area. Method This is a pilot study of 30 patients who were started on the GTN patch from February 2020 to October 2021. Inclusion criteria were patients who have critical limb-threatening ischaemia (CLTI) and with no viable options or are at high risk for revascularisation, both endovascular and open surgery. Patients who were on a GTN patch for less than six weeks at the time of data collection or had unclear outcomes were excluded. The outcomes were retrospectively collected on prevention of amputation, improvement in pain control, and reduction in tissue loss (the size of ulcer/gangrene) or localised ischaemic area with the use of a GTN patch. The binomial test was used to compare the observed outcome of the GTN patch and the expected outcome, which was assumed to be 50% in this study. Results  Ninety-three per cent (93%) of the patients who had GTN patches successfully avoided amputation (p<0.0001). Eighty-four per cent (84%) of patients reported better pain control (p=0.0022) and improvement in the size of ulcer/gangrene/localised ischaemic areas (p=0.0005). Conclusion The GTN patch is effective in preventing amputation, improving pain control, and reducing the size of ulcer/gangrene/localised ischaemic areas in patients who have end-stage CLTI and no viable options or who are at high risk for revascularisation surgery.

10.
Micromachines (Basel) ; 15(6)2024 Jun 09.
Artigo em Inglês | MEDLINE | ID: mdl-38930741

RESUMO

Non-diffractive beams, also known as diffraction-free beams, are a class of optical beams that maintain their intensity profile over a long distance without spreading out due to diffraction [...].

11.
BMC Infect Dis ; 24(1): 500, 2024 May 17.
Artigo em Inglês | MEDLINE | ID: mdl-38760732

RESUMO

BACKGROUND: Dengue Viral Infection (DVI) has become endemic in Pakistan since the first major outbreak in Karachi in 1996. Despite aggressive measures taken by relevant authorities, Pakistan has been dealing with a worsening dengue crisis for the past two decades. DHF is severe form of dengue infection which is linked with significant morbidity and mortality. Early identification of severe dengue infections can reduce the morbidity and mortality. In this context we planned current study in which we find out the different factors related with DHF as well as clinical laboratory features of DHF and compare them to DF so that patients can be best evaluated for DHF and managed accordingly at admission. METHODS: Retrospective study conducted over a period of 6 years (2013-2018) in two tertiary care hospitals in Pakistan. Data were collected by using a pre-structured data collection form. Data were statistically analyzed to determine the clinical and laboratory characteristics of DVI and risk factors of dengue hemorrhagic fever (DHF). RESULTS: A total 512 dengue cases (34.05 ± 15.08 years; Male 69.53%) were reviewed. Most common clinical manifestations of DVI were fever (99.60%), headache (89.1%), chills (86.5%), rigors (86.5%), myalgia (72.3%). Less common clinical manifestations were vomiting (52.5%), arthralgia (50.2%) and skin rashes (47.5%). Furthermore, nasal bleeding (44.1%), gum bleeding (32.6%), pleural effusion (13.9%) and hematuria (13.1%) were more profound clinical presentations among DHF patients. Mortality rate was 1.5% in this study. Logistic regression analysis indicated that delayed hospitalization (OR: 2.30) and diabetes mellitus (OR:2.71), shortness of breath (OR:2.21), association with risk groups i.e., living near stagnant water, travelling to endemic areas, living in endemic regions (OR:1.95), and presence of warning signs (OR:2.18) were identified as risk factors of DHF. Statistically we found that there is strong association of diabetes mellitus (DM) with DHF while the patient suffering from DM individually had higher odds (2.71) of developing DHF than patients without disease. CONCLUSIONS: The current study demonstrated that the clinical and laboratory profiles of DF and DHF are significantly distinct. Significant predictors of DHF were advanced age, diabetes mellitus, ascites, pleural effusion, thick gallbladder and delayed hospitalization. The identification of these factors at early stage provides opportunities for the clinicians to identify high risk patients and to reduce dengue-related morbidity and mortality.


Assuntos
Dengue Grave , Humanos , Estudos Retrospectivos , Dengue Grave/epidemiologia , Masculino , Feminino , Fatores de Risco , Adulto , Pessoa de Meia-Idade , Paquistão/epidemiologia , Adulto Jovem , Vírus da Dengue/patogenicidade , Adolescente , Dengue/epidemiologia , Dengue/mortalidade , Idoso
12.
Pak J Pharm Sci ; 37(1): 95-105, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38741405

RESUMO

Hydrophilic drugs could be incorporated into the skin surface by manes of Lipogel. This study aimed to prepare miconazole lipogel with natural ingredients to enhance drug permeability using dimethyl Sulfoxide (DMSO). The miconazole lipogels, A1 (without DMSO) and A2 (with DMSO) were formulated and evaluated for organoleptic evaluation, pH, viscosity, stability studies, freeze-thawing, drug release profile and drug permeation enhancement. Results had stated that prepared lipogel's pH falls within the acceptable range required for topical delivery (4 to 6) while both formulations show good results in organoleptic evaluation. The A2 formulation containing DMSO shows better permeation of miconazole (84.76%) on the artificial skin membrane as compared to A1 lipogel formulation (50.64%). In in-vitro drug release studies, A2 for-mulation showed 87.48% drug release while A1 showed just 60.1% drug release from lipogel. Stability studies were performed on model formulations under environmental conditions and both showed good spreadibility, stable pH, free of grittiness and good consistency in formulation. The results concluded that A2 formulation containing DMSO shows better results as compared to DMSO-free drug lipogel.


Assuntos
Dimetil Sulfóxido , Liberação Controlada de Fármacos , Géis , Miconazol , Permeabilidade , Miconazol/administração & dosagem , Miconazol/química , Miconazol/farmacocinética , Dimetil Sulfóxido/química , Viscosidade , Estabilidade de Medicamentos , Concentração de Íons de Hidrogênio , Absorção Cutânea/efeitos dos fármacos , Química Farmacêutica , Composição de Medicamentos , Antifúngicos/administração & dosagem , Antifúngicos/química , Antifúngicos/farmacocinética , Administração Cutânea
13.
Sci Bull (Beijing) ; 69(11): 1607-1611, 2024 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-38704356
14.
J Endocr Soc ; 8(6): bvae085, 2024 Apr 06.
Artigo em Inglês | MEDLINE | ID: mdl-38745824

RESUMO

Context: Data on germline genetics of pituitary adenomas (PAs) using whole-exome sequencing (WES) are limited. Objective: This study investigated the germline genetic variants in patients with PAs using WES. Methods: We studied 134 consecutive functioning (80.6%) and nonfunctioning (19.4%) PAs in 61 female (45.5%) and 73 male patients (54.5%). Their median age was 34 years (range, 11-85 years) and 31 patients had microadenomas (23.0%) and 103 macroadenomas (77%). None of these patients had family history of PA or a known PA-associated syndrome. Peripheral blood DNA was isolated and whole-exome sequenced. We used American College of Medical Genetics and Genomics (ACMG) criteria and a number of in silico analysis tools to characterize genetic variant pathogenicity levels and focused on previously reported PA-associated genes. Results: We identified 35 variants of unknown significance (VUS) in 17 PA-associated genes occurring in 40 patients (29.8%). Although designated VUS by the strict ACGM criteria, they are predicted to be pathogenic by in silico analyses and their extremely low frequencies in 1000 genome, gnomAD, and the Saudi Genome Project databases. Further analysis of these variants by the Alpha Missense analysis tool yielded 8 likely pathogenic variants in 9 patients in the following genes: AIP:c.767C>T (p.S256F), CDH23:c.906G>C (p.E302D), CDH23:c.1096G>A (p.A366T), DICER1:c.620C>T (p.A207V), MLH1:c.955G>A (p.E319K), MSH2:c.148G>A (p.A50T), SDHA:c.869T>C (p.L290P) and USP48 (2 patients): c.2233G>A (p.V745M). Conclusion: This study suggests that about 6.7% of patients with apparently sporadic PAs carry likely pathogenic variants in PA-associated genes. These findings need further studies to confirm them.

15.
J Mech Behav Biomed Mater ; 156: 106581, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38776740

RESUMO

Patient-specific fabrication of scaffold/implant requires an engineering approach to manufacture the ideal scaffold. Herein, we design and 3D print scaffolds comprised of polyether-ether-ketone (PEEK) and sodium-carboxymethyl cellulose (Na-CMC). The fabricated scaffold was dip coated with Zn and Mn doped bioactive glass nanoparticles (Zn-Mn MBGNs). The synthesized ink exhibit suitable shear-thinning behavior for direct ink write (DIW) 3D printing. The scaffolds were crafted with precision, featuring 85% porosity, 0.3 mm layer height, and 1.5 mm/s printing speed at room temperature. Scanning electron microscopy images reveal a well-defined scaffold with an average pore size of 600 ± 30 µm. The energy dispersive X-ray spectroscopy analysis confirmed a well dispersed/uniform coating of Zn-Mn MBGNs on the PEEK/Na-CMC scaffold. Fourier transform infrared spectroscopy approved the presence of PEEK, CMC, and Zn-Mn MBGNs. The tensile test revealed a Young's modulus of 2.05 GPa. Antibacterial assays demonstrate inhibition zone against Staphylococcus aureus and Escherichia Coli strains. Chick Chorioallantoic Membrane assays also present significant angiogenesis potential, owing to the antigenic nature of Zn-Mn MBGNs. WST-8 cell viability assays depicted cell proliferation, with a 103% viability after 7 days of culture. This study suggests that the PEEK/Na-CMC scaffolds coated with Zn-Mn MBGNs are an excellent candidate for osteoporotic fracture treatment. Thus, the fabricated scaffold can offer multifaceted properties for enhanced patient outcomes in the bone tissue regeneration.


Assuntos
Benzofenonas , Carboximetilcelulose Sódica , Vidro , Cetonas , Manganês , Nanopartículas , Polietilenoglicóis , Polímeros , Impressão Tridimensional , Staphylococcus aureus , Alicerces Teciduais , Zinco , Porosidade , Benzofenonas/química , Vidro/química , Cetonas/química , Cetonas/farmacologia , Alicerces Teciduais/química , Staphylococcus aureus/efeitos dos fármacos , Carboximetilcelulose Sódica/química , Nanopartículas/química , Zinco/química , Zinco/farmacologia , Polímeros/química , Manganês/química , Polietilenoglicóis/química , Antibacterianos/química , Antibacterianos/farmacologia , Animais , Escherichia coli/efeitos dos fármacos , Teste de Materiais , Humanos
16.
Micromachines (Basel) ; 15(5)2024 Apr 30.
Artigo em Inglês | MEDLINE | ID: mdl-38793183

RESUMO

In this study, a comprehensive numerical analysis is conducted on a hybrid plasmonic waveguide (HPWG)-based racetrack ring resonator (RTRR) structure, tailored specifically for refractive index sensing applications. The sensor design optimization yields remarkable results, achieving a sensitivity of 275.7 nm/RIU. Subsequently, the boundaries of sensor performance are pushed even further by integrating a subwavelength grating (SWG) structure into the racetrack configuration, thereby augmenting the light-matter interaction. Of particular note is the pivotal role played by the length of the SWG segment in enhancing device sensitivity. It is observed that a significant sensitivity enhancement can be obtained, with values escalating from 377.1 nm/RIU to 477.7 nm/RIU as the SWG segment length increases from 5 µm to 10 µm, respectively. This investigation underscores the immense potential of HPWG in tandem with SWG for notably enhancing the sensitivity of photonic sensors. These findings not only advance the understanding of these structures but also pave the way for the development of highly efficient sensing devices with unprecedented performance capabilities.

17.
Cureus ; 16(2): e55251, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38558603

RESUMO

Background In cirrhotic patients with ascites, primary prevention of spontaneous bacterial peritonitis (SBP) is a key strategy to lower morbidity and death. Rifaximin and fluoroquinolone used alternately as main prophylaxis are as effective as reported. This study aimed to compare the frequency of occurrence of SBP in patients with decompensated chronic liver disease treated with rifaximin alone and in combination with fluoroquinolone. Methodology A total of 76 patients with hepatitis C virus-related decompensated chronic liver disease and ascites were divided into two groups based on matching age, sex, and Child-Pugh class. Group A (38 patients) received rifaximin 1,100 mg/day in two divided doses with daily fluoroquinolone 400 mg/day, whereas group B (38 patients) received rifaximin 1,100 mg/day alone as a two dosage. The patients were monitored for up to three months. The study's endpoints were SBP, hepatocellular carcinoma, compliance failure, death, or liver transplantation. Results In this comparative study involving 76 patients, the demographic and clinical characteristics were assessed across two treatment groups: rifaximin alone (n = 38) and rifaximin with fluoroquinolone (n = 38). The combination therapy demonstrated a statistically significant reduction in SBP compared to rifaximin alone. Additionally, the overall survival rate was higher in the combination group. These findings suggest potential benefits of the combined approach in managing hepatic encephalopathy-related complications. Conclusions When compared to rifaximin alone for primary SBP prophylaxis, the combination of rifaximin with fluoroquinolone exhibited greater effectiveness with the same safety profile.

18.
Int J Biol Macromol ; 266(Pt 2): 131393, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38582476

RESUMO

Biocomposites developed using natural fibers serve as a sustainable alternative to synthetic composite materials. However, narrowing the performance gap between synthetic composites and biocomposites requires serious efforts. A promising approach is the modification of natural fibers using various chemical treatments. This paper investigates the potential of tannic acid (TA) treatment as a sustainable approach to enhance mechanical performance and reduce moisture absorption of flax fabric-reinforced biocomposites. The methodology involves the treatment of flax woven fabric with tannic acid, a naturally occurring polyphenolic compound, followed by the fabrication of biocomposite using a green epoxy matrix. The variables studied during treatment are TA concentration and processing time. Characterization of untreated and treated flax fabric and its composites was done using various analytical techniques such as FTIR spectroscopy, moisture absorption and mechanical testing (tensile strength, flexural strength, and impact resistance). FTIR spectroscopy of TA-treated flax confirmed attachment of aromatic rings and carbon double bond formation, thus serving for properties enhancement. The mechanical characterization of composites showed that properties are enhanced up to an optimum limit of concentration and processing time i.e., 1 % concentration and 30 min of processing. Moisture absorption of the TA-treated composite also reduced significantly as compared to untreated composites. These findings contribute towards the advancement in sustainable biocomposites and pave the way for their utilization in various applications.


Assuntos
Linho , Polifenóis , Taninos , Resistência à Tração , Têxteis , Taninos/química , Linho/química , Espectroscopia de Infravermelho com Transformada de Fourier , Fenômenos Mecânicos , Materiais Biocompatíveis/química
19.
J Pharm Policy Pract ; 17(1): 2322107, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38650677

RESUMO

Introduction: Diabetes increases preventative sickness and costs healthcare and productivity. Type 2 diabetes and macrovascular disease consequences cause most diabetes-related costs. Type 2 diabetes greatly costs healthcare institutions, reducing economic productivity and efficiency. This cost of illness (COI) analysis examines the direct and indirect costs of treating and managing type 1 and type 2 diabetes mellitus. Methodology: According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, Cochrane, PubMed, Embase, CINAHL, Scopus, Medline Plus, and CENTRAL were searched for relevant articles on type 1 and type 2 diabetes illness costs. The inquiry returned 873 2011-2023 academic articles. The study included 42 papers after an abstract evaluation of 547 papers. Results: Most articles originated in Asia and Europe, primarily on type 2 diabetes. The annual cost per patient ranged from USD87 to USD9,581. Prevalence-based cost estimates ranged from less than USD470 to more than USD3475, whereas annual pharmaceutical prices ranged from USD40 to more than USD450, with insulin exhibiting the greatest disparity. Care for complications was generally costly, although costs varied significantly by country and problem type. Discussion: This study revealed substantial heterogeneity in diabetes treatment costs; some could be reduced by improving data collection, analysis, and reporting procedures. Diabetes is an expensive disease to treat in low- and middle-income countries, and attaining Universal Health Coverage should be a priority for the global health community.

20.
Nanomaterials (Basel) ; 14(8)2024 Apr 17.
Artigo em Inglês | MEDLINE | ID: mdl-38668191

RESUMO

Photonic neural networks (PNNs), utilizing light-based technologies, show immense potential in artificial intelligence (AI) and computing. Compared to traditional electronic neural networks, they offer faster processing speeds, lower energy usage, and improved parallelism. Leveraging light's properties for information processing could revolutionize diverse applications, including complex calculations and advanced machine learning (ML). Furthermore, these networks could address scalability and efficiency challenges in large-scale AI systems, potentially reshaping the future of computing and AI research. In this comprehensive review, we provide current, cutting-edge insights into diverse types of PNNs crafted for both imaging and computing purposes. Additionally, we delve into the intricate challenges they encounter during implementation, while also illuminating the promising perspectives they introduce to the field.

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