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1.
Int Arch Otorhinolaryngol ; 28(2): e314-e318, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38618605

RESUMO

Introduction Postoperative sore throat (POST) is a fairly common side effect of general anesthesia. The K-Y jelly is a well-known lubricant used in many medical procedures. Objective In this randomized study, we evaluated the use of throat packs soaked with K-Y jelly for POST outcomes in patients submitted to nasal surgery. Methods The present double-blinded, randomized, controlled study included 140 ASA I-II patients undergoing nasal surgery under general anesthesia. Patients received either or K-Y jelly or water-soaked X-ray detectable throat packs fully inserted into the mouth to occlude the oropharynx. Results Comparison between the studied groups regarding the severity of POST assessed by visual analog scale revealed significantly lower POST levels in the K-Y jelly group on recovery from anesthesia, and at 2, 4, and 6 hours postoperatively. Conclusions The use of K-Y jelly-soaked throat packs was associated with less severe POST after nasal surgery.

2.
J Multidiscip Healthc ; 17: 1053-1063, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38496326

RESUMO

Background: The validity of the Apple Watch to measure the heart rate (HR) and oxygen saturation (Spo2) for patients with chronic diseases such as diabetes mellitus (DM), dyslipidemia, and hypertension is still unclear. Therefore, this study aims to investigate the accuracy of the Apple Watch in measuring the Spo2 and HR in patients with chronic diseases. Methods: Forty-one patients with chronic diseases, including 20 with hypertension, 10 with diabetes, and 11 with dyslipidemia, completed a cross-sectional study. All participants used the Apple Watch against the Polar chest strap and the pulse oximeter at rest and during moderate intensity exercise sessions to measure HR and the SpO2 at rest for 5 minutes, during exercise for 16 minutes, and followed by 3 minutes of rest. The HR was measured during all previous periods, but evaluation of the Spo2 included 5 measures, done only before and after exercise, with a minute interval between each measure. Results: Overall, a strong correlation exists between measuring the SpO2 using the Apple Watch against the pulse oximeter (Contec) at rest (r = 0.92, p < 0.001) and after exercise (r = 0.86, p < 0.001) in all patients. The HR had a very strong correlation between the Apple Watch and the Polar chest strap (r = 0.99, p < 0.001) in all patients. There was no significant difference (p = 0.76) between the twenty-seven white and fourteen brown-skinned patients. Conclusion: The Apple Watch is valid to measure the HR and SpO2 in patients with chronic diseases. Clinical Trial Registration No: NCT05271864.

3.
Int J Biol Macromol ; 265(Pt 1): 130949, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38508545

RESUMO

This study addresses the growing interest in bio-based active food packaging by infusing Lepidium sativum (Garden cress) seeds extract (GRCE) into sodium alginate (SALG) films at varying concentrations (1, 3, and 5 %). The GRCE extract revealed six phenolic compounds, with gallic and chlorogenic acids being prominent, showcasing substantial total phenolic content (TPC) of 139.36 µg GAE/mg and total flavonoid content (TFC) of 26.46 µg RE/mg. The integration into SALG films significantly increased TPC, reaching 30.73 mg GAE/g in the film with 5 % GRCE. This enhancement extended to DPPH and ABTS activities, with notable rises to 66.47 and 70.12 %, respectively. Physical properties, including tensile strength, thickness, solubility, and moisture content, were positively affected. A reduction in water vapor permeability (WVP) was reported in the film enriched with 5 % GRCE (1.389 × 10-10 g H2O/m s p.a.). FT-IR analysis revealed bands indicating GRCE's physical interaction with the SALG matrix, with thermal stability of the films decreasing upon GRCE integration. SALG/GRCE5 effectively lowered the peroxide value (PV) of sunflower oil after four weeks at 50 °C compared to the control, with direct film-oil contact enhancing this reduction. Similar trends were observed in the K232 and K270 values.


Assuntos
Alginatos , Lepidium sativum , Alginatos/química , Espectroscopia de Infravermelho com Transformada de Fourier , Embalagem de Alimentos/métodos , Fenóis , Extratos Vegetais/química , Estresse Oxidativo
4.
Int J Pharm X ; 7: 100232, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38357578

RESUMO

Diabetes mellitus (DM) is the most prevalent cause of diabetic retinopathy (DRP). DRP has been recognized for a long time as a microvascular disease. Many drugs were used to treat DRP, including vildagliptin (VLD). In addition to its hypoglycemic effect, VLD minimizes ocular inflammation and improves retinal blood flow for individuals with type 2 diabetes mellitus. Nevertheless, VLD can cause upper respiratory tract infections, diarrhea, nausea, hypoglycemia, and poor tolerability when taken orally regularly due to its high water solubility and permeability. Effective ocular administration of VLD is achieved using solid lipid nanoparticles (SLNPs), which improve corneal absorption, prolonged retention, and extended drug release. Ocuserts (OCUs) are sterile, long-acting ocular dosage forms that diminish the need for frequent dosing while improving residence time and stability. Therefore, this study intends to develop VLD solid lipid nanoparticle OCUs (VLD-SLNPs-OCUs) to circumvent the issues commonly associated with VLD. SLNPs were prepared using the double-emulsion/melt dispersion technique. The optimal formula has been implemented in OCUs. Optimization and development of VLD-SLNPs-OCUs were performed using a Box-Behnken Design (BBD). VLD-SLNPs-OCUs loading efficiency was 95.28 ± 2.87%, and differential scanning calorimetry data (DSC) showed the full transformation of VLD to an amorphous state and the excellent distribution in the prepared OCUs matrices. The in vivo release of VLD from the optimized OCUs after 24 h was 35.12 ± 2.47%, consistent with in vitro drug release data of 36.89 ± 3.11. The optimized OCUs are safe to use in the eye, as shown by the ocular irritation test. VLD-SLNPs-OCUs provide extended VLD release, an advantageous alternative to conventional oral dose forms, resulting in fewer systemic adverse effects and less variation in plasma drug levels. VLD-SLNPs-OCUs might benefit retinal microvascular blood flow beyond blood glucose control and may be considered a promising approach to treating diabetic retinopathy.

5.
J Biomater Sci Polym Ed ; 35(6): 898-915, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38284331

RESUMO

Biopharmaceutical and biomedical applications of chitosan has evolved exponentially in the past decade, owing to its unique physicochemical properties. However, further applications can be garnered from modified chitosan, specifically, depolymerized chitosan, with potentially useful applications in drug delivery or biomedicine. The use of microwave irradiation in depolymerization of chitosan appears to be more consequential than other methods, and results in modification of key physicochemical properties of chitosan, including molecular weight, viscosity and degree of deacetylation. In-depth review of such microwave-depolymerized chitosan and subsequent potential biopharmaceutical or biomedical applications has not been presented before. Herein, we present a detailed review of key physicochemical changes in chitosan following various depolymerization approaches, with focus on microwave irradiation and how these changes impact relevant biopharmaceutical or biomedical applications.


Assuntos
Produtos Biológicos , Quitosana , Quitosana/química , Micro-Ondas , Viscosidade , Peso Molecular
7.
J Pediatr Nurs ; 73: e570-e578, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37926670

RESUMO

BACKGROUND: Nurses of pediatric acute critical care units routinely assess the Level of Consciousness (LOC). The precise, exact, and restriction-free evaluation tool aids pediatric nurses in LOC assessment and clinical decision-making. This study aimed to examine the effect of an educational program on pediatric nurses' knowledge, practice, and self-confidence about level of consciousness scales. METHODS: This pretest-post, single-group, quasi-experimental, double-site study included 49 pediatric nurses. The Glasgow Coma Scale (GCS)/Pediatric Glasgow Coma Scale (PGCS) and Pediatric Full Outline of UnResponsiveness Score Scale (PFSS) knowledge questionnaire and pediatric nurse practice checklist were developed and adopted. Self-reflection confidence statements were rated 1-5 (not confident-confident). RESULTS: The results of the study indicate that there were significant increases in knowledge, practice, and self-confidence after the intervention. The paired samples tests revealed that knowledge scores significantly increased from the pretest to the posttest for both GCS/PGCS (pretest mean:7.91, posttest mean:9.95) and PFSS (pretest mean:2.1, posttest mean:6.79). Practice scores also showed significant improvement for both GCS/PGCS (pretest mean: 4.12, post-test mean: 6.22) and PFSS (pretest mean: 2.46, post-test mean: 5.79). Furthermore, self-confidence significantly improved for GCS/PGCS (pretest mean:16.08, posttest mean:18.79) and PFSS (pretest mean:10.32, posttest mean:17.81). The statistical analyses supported the significance of these improvements (p < 0.001 for all except self-confidence in GCS/PGCS with p < 0.005). CONCLUSION: The educational program improved pediatric nurses' GCS/PGCS and PFSS knowledge, practice, and self-confidence. IMPLICATIONS TO PRACTICE: Effective teaching of pediatric nurses is required to address gaps in care practices and improve the use of the Consciousness Level Assessment Scales.


Assuntos
Enfermeiros Pediátricos , Enfermeiras e Enfermeiros , Humanos , Criança , Competência Clínica , Estado de Consciência , Escala de Coma de Glasgow
8.
Int J Mol Sci ; 24(19)2023 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-37834266

RESUMO

A novel derivative of ciprofloxacin (Cpx) was synthesized and characterized using various analytical techniques, including FT-IR spectroscopy, UV-Vis spectroscopy, TEM and SEM analysis, 1H NMR, 13C NMR, and HPLC analysis. The newly prepared Cpx derivative (Cpx-Drv) exhibited significantly enhanced antibacterial properties compared to Cpx itself. In particular, Cpx-Drv demonstrated a 51% increase in antibacterial activity against S. aureus and a 30% improvement against B. subtilis. It displayed potent inhibitory effects on topoisomerases II (DNA gyrase and topoisomerase IV) as potential molecular targets, with IC50 values of 6.754 and 1.913 µg/mL, respectively, in contrast to Cpx, which had IC50 values of 2.125 and 0.821 µg/mL, respectively. Docking studies further supported these findings, showing that Cpx-Drv exhibited stronger binding interactions with the gyrase enzyme (PDB ID: 2XCT) compared to the parent Cpx, with binding affinities of -10.3349 and -7.7506 kcal/mole, respectively.


Assuntos
Ciprofloxacina , Staphylococcus aureus , Ciprofloxacina/farmacologia , Ciprofloxacina/química , Cromatografia Líquida de Alta Pressão , Espectroscopia de Infravermelho com Transformada de Fourier , Testes de Sensibilidade Microbiana , Antibacterianos/química , DNA Girase , Simulação de Acoplamento Molecular , Inibidores da Topoisomerase II/farmacologia , Inibidores da Topoisomerase II/química
9.
Pharmaceutics ; 15(10)2023 Oct 04.
Artigo em Inglês | MEDLINE | ID: mdl-37896183

RESUMO

Wound healing is a significant healthcare problem that decreases the patient's quality of life. Hence, several agents and approaches have been widely used to help accelerate wound healing. The challenge is to search for a topical delivery system that could supply long-acting effects, accurate doses, and rapid healing activity. Topical forms of simvastatin (SMV) are beneficial in wound care. This study aimed to develop a novel topical chitosan-based platform of SMV with folic acid (FA) for wound healing. Moreover, the synergistic effect of combinations was determined in an excisional wound model in rats. The prepared SMV-FA-loaded films (SMV-FAPFs) were examined for their physicochemical characterizations and morphology. Box-Behnken Design and response surface methodology were used to evaluate the tensile strength and release characteristics of the prepared SMV-FAPFs. Additionally, Fourier transform infrared (FT-IR), differential scanning calorimetry (DSC), X-ray diffraction pattern (XRD), and animal studies were also investigated. The developed SMV-FAPFs showed a contraction of up to 80% decrease in the wound size after ten days. The results of the quantitative real-time polymerase chain reaction (RT-PCR) analysis demonstrated a significant upregulation of dermal collagen type I (CoTI) expression and downregulation of the inflammatory JAK3 expression in wounds treated with SMV-FAPFs when compared to control samples and individual drug treatments. In summary, it can be concluded that the utilization of SMV-FAPFs holds great potential for facilitating efficient and expeditious wound healing, hence presenting a feasible substitute for conventional topical administration methods.

10.
Pharmaceutics ; 15(2)2023 Feb 17.
Artigo em Inglês | MEDLINE | ID: mdl-36840004

RESUMO

Gefitinib (GFT) is a tyrosine kinase inhibitor drug used as a first-line treatment for patients with advanced or metastatic non-small cell lung, colon, and breast cancer. GFT exhibits low solubility and hence low oral bioavailability, which restricts its clinical application. One of the most important trends in overcoming such problems is the use of a vesicular system. Cubosomes are considered one of the most important vesicular systems used to improve solubility and oral bioavailability. In this study, GFT cubosomal nanoparticles (GFT-CNPs) were prepared by the emulsification method. The selected formulation variables were analyzed and optimized by full factorial design and response surface methodology. Drug entrapment efficiency (EE%), transmission electron microscopy, particle size, polydispersity index, in vitro release and its kinetics, and the effect of storage studies were estimated. The chosen GFT-CNPs were subjected to further investigations as gene expression levels of tissue inhibitors of metalloproteinases-1 (TIMP-1) and matrix metalloproteinases-7 (MMP-7), colon biomarkers, and histopathological examination of colon tissues. The prepared GFT-CNPs were semi-cubic in shape, with high EE%, smaller vesicle size, and higher zeta potential values. The in vivo data showed a significant decrease in the serum level of embryonic antigen (CEA), carbohydrate antigen 19-9 (CA 19-9), and gene expression level of TIMP-1 and MMP-7. Histopathological examination showed enhancement in cancer tissue and highly decreased focal infiltration in the lamina propria after treatment with GFT-CNPs.

11.
J Heart Lung Transplant ; 42(2): 275-282, 2023 02.
Artigo em Inglês | MEDLINE | ID: mdl-36437170

RESUMO

BACKGROUND: Pulmonary hypertension (PH) frequently co-exists in patients with severe aortic stenosis (AS). In this study, we sought to identify the implications of invasive pulmonary hemodynamics on major adverse cardiac events (MACE), biventricular function and NYHA functional class after transcatheter aortic valve replacement (TAVR). METHODS: Invasive hemodynamics via right heart catheterization (RHC) were performed pre-TAVR. Patients were stratified per mean PA pressure (mPAP), diastolic pulmonary gradient (DPG) and pulmonary vascular resistance (PVR), and followed at 1-month and 1-year intervals up to 6 years. MACE outcomes included cardiovascular death and heart failure hospitalizations post-TAVR. RESULTS: Among 215 patients, Kaplan-Meir estimates demonstrated an increased 1-year risk of MACE from 8% among those without pre-TAVR PH to 27% among patients with pre-existing PH. Specifically, the MACE risk was 32% among PH patients with PVR ≥ 3WU (p = .04) and 53% among PH patients with DPG ≥ 7 mm Hg (p < .01). On univariate Cox regression, RV stroke work index (RVSWI) (HR,1.02; p = .02), and pulmonary hemodynamic index (PHI) (HR,1.27; p = .047) were identified as additional predictors of MACE post-TAVR. On multivariable Cox regression analysis, SvO2 (HR, 0.95; p = .01) and PVR (HR, 1.2; p = .04) were demonstrated as predictive of MACE post-TAVR. A significant improvement in LVEF (2-Factor ANOVA, p < .01) and RV fractional area change (RVFAC%) (p < .01) was noted as assessed at baseline, 1-month and 1-year follow up post-TAVR. There was a significant interaction between pre-TAVR PH status and time post procedure with respect to NYHA functional class (p = .03), that is, the manner and degree of change in NYHA class over time depended on pre-TAVR PH status. CONCLUSIONS: Defining invasive pulmonary hemodynamics, such as mPAP, PVR, and DPG among patients with severe AS undergoing TAVR has significant prognostic implications. Routine risk stratification by utilizing invasive hemodynamics can better identify patients who will have functional improvement and improved outcomes post-TAVR.


Assuntos
Estenose da Valva Aórtica , Hipertensão Pulmonar , Substituição da Valva Aórtica Transcateter , Humanos , Substituição da Valva Aórtica Transcateter/efeitos adversos , Prognóstico , Estenose da Valva Aórtica/complicações , Estenose da Valva Aórtica/cirurgia , Resultado do Tratamento , Hemodinâmica , Hipertensão Pulmonar/complicações , Valva Aórtica , Fatores de Risco , Índice de Gravidade de Doença
12.
J Interv Card Electrophysiol ; 66(6): 1487-1497, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36572800

RESUMO

BACKGROUND: Recent trial data suggest a benefit to catheter ablation (CA) compared to medical therapy for atrial fibrillation (AF) in patients with heart failure (HF). Nevertheless, because of mixed trial evidence, contemporary guidelines give it a class 2 recommendation. Accordingly, we sought to assess the currently available evidence for CA in HF with AF. METHODS: Electronic databases were searched to identify randomized clinical trials (RCTs) comparing CA to medical therapy in patients with AF and HF. Study data was pooled using fixed and random effects, and the number needed to treat (NNT) was calculated to gauge absolute risk differences. Heterogeneity was quantified using I2. Our primary outcome was all-cause mortality. RESULTS: Nine trials (CA 1075 patients; medical therapy 1083 patients) were included. Ablation reduced the relative risk of all-cause mortality by 31.5% (95% CI 13.7 to 45.6%; NNT = 23), cardiovascular mortality by 39.3% (95% CI 10.9 to 58.7%; NNT = 31), cardiovascular hospitalization by 29.1% (95% CI 9.4 to 44.6%; NNT = 9), and heart failure hospitalization by 28.5% (95% CI 6.5 to 45.4%; NNT = 22). Improvements in quality of life were observed with CA using the Minnesota Living with Heart Failure Questionnaire (mean difference - 5.26; 95% CI - 2.73 to - 7.78) and the Atrial Fibrillation Effect on Quality of Life (mean difference 5.36; 95% CI 2.72 to 8.00). CONCLUSION: Compared to medical therapy, CA for AF in patients with HF reduces all-cause mortality, cardiovascular mortality, cardiovascular hospitalizations, and heart failure hospitalizations, and may improve quality of life.


Assuntos
Fibrilação Atrial , Ablação por Cateter , Insuficiência Cardíaca , Humanos , Antiarrítmicos/uso terapêutico , Ablação por Cateter/efeitos adversos , Insuficiência Cardíaca/terapia , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento
13.
Virus Res ; 323: 198953, 2023 Jan 02.
Artigo em Inglês | MEDLINE | ID: mdl-36209916

RESUMO

BACKGROUND: Chronic hepatitis B (HBV) and C virus (HCV) infections represent significant public health issues internationally. HBV vaccination has high sero-conversion rates in patients with mild to moderate chronic liver disease but has reduced efficacy in advanced stages. AIM: to evaluate the efficacy of hepatitis B vaccination in HCV-related chronic liver disease and identify possible factors that may contribute to hypo-responsiveness in those patients. METHODS: Our study was a retrospective observational clinical study carried out at the tropical medicine department. It was conducted on 500 individuals (400 chronic HCV patients and 100 healthy controls). Individuals were divided into 5 groups: A (control group), B (cirrhotic patient not receiving treatment), C (chronic hepatitis patients receiving treatment), D (cirrhotic patients receiving treatment), and E (HCC patients receiving treatment). All individuals were subjected for comprehensive history taking, clinical examination, laboratory investigations, and assessment of anti-HBs titer. RESULTS: There is an inverse relationship between the level of anti-HBs Abs and the duration of vaccine. Diabetes and presence of cirrhosis have statistically significant relationship with serum anti-HBs Abs titer (P = 0.007). Oral DAAs therapy is associated with reduced response to HBV vaccine (only 31.75% of the patients were protected). CONCLUSION: HCV infection and its complications significantly impair HBV vaccine response. Levels of anti-HBs Abs decline progressively with increasing duration from the last dose in immunization schedule of HBV vaccine. Diabetes and presence of cirrhosis being the main risk factors for vaccine hypo-responsiveness, also oral DAAs therapy is associated with reduced response to HBV vaccine.

14.
Eur Arch Otorhinolaryngol ; 280(1): 487-490, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36040518

RESUMO

BACKGROUND: Pharyngeal pouches are generally treated with surgery, via either an endoscopic or an external approach. Large pouches extending to the mediastinum carry an increased risk of post-operative mediastinitis in the event of a leak following external approach surgery, and may not always be amenable to endoscopic stapling. METHODS: Transcervical stapling is a newly described technique that uses the endoluminal stapling approach but in which the diverticuloscope is inserted into the pharynx via a neck incision. CONCLUSIONS: This technique has been used successfully on three patients with large pharyngeal pouches, where endoscopic stapling was not possible due to access limitations.


Assuntos
Doenças Faríngeas , Divertículo de Zenker , Humanos , Grampeamento Cirúrgico/efeitos adversos , Divertículo de Zenker/cirurgia , Endoscopia/métodos , Doenças Faríngeas/etiologia , Faringe/cirurgia
15.
Antibiotics (Basel) ; 11(10)2022 Oct 21.
Artigo em Inglês | MEDLINE | ID: mdl-36290105

RESUMO

Listeriosis is one of the most common foodborne diseases caused by Listeria monocytogenes (L. monocytogenes). A poor prognosis has been recorded for the invasive listeriosis, especially neurolisteriosis. In several countries throughout the world, foodborne infections with L. monocytogenes exceeded the legal safety limits in animal sourced foods. Therefore, we decided to investigate the variability, virulence and antimicrobial resistance profiles of this pathogen. Both phenotypic and genotypic methods were used for identifying L. monocytogenes isolates and confirming their virulence profiles. The antimicrobial resistances and their correlation analysis with the existence of virulence genes were detected. Additionally, sequencing and phylogenetic analysis based on L. monocytogenes inlA and inlB genes were undertaken. The prevalence rate (11.9%) and the resistance profiles of L. monocytogenes were shocking. The multi-drug resistance (MDR) phenotypes were common among our isolates (64.9%). Fortunately, the resistance phenotypes were always associated with low virulence arrays and the MDR strains possessed low virulence fitness. Herein, the high genotypic and phenotypic diversity of L. monocytogenes isolates and their weak clonality and adaptability highlighted the difficulty in controlling and managing this pathogen. Therefore, it is important to add more restriction guidelines from national authorities on the consumption of ready to eat foods.

16.
Pharmaceutics ; 14(9)2022 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-36145592

RESUMO

High mortality and morbidity rates are related to hepatocellular carcinoma (HCC), which is the most prevalent type of liver cancer. A new vision for cancer treatment and cancer cell targeting has emerged with the application of nanotechnology, which reduces the systemic toxicity and adverse effects of chemotherapy medications while increasing their effectiveness. It was the goal of the proposed work to create and investigate an anticancer C@Fe@Cu nanocomposite (NC) loaded with Doxorubicin (DOX) for the treatment of HCC. Scanning and transmission electron microscopes (SEM and TEM) were used to examine the morphology of the produced NC. The formulation variables (DOX content, C@Fe@Cu NC weight, and stirring speed) were analyzed and optimized using Box-Behnken Design (BBD) and Response Surface Methodology (RSM). Additionally, X-ray diffraction patterns (XRD) and Fourier Transform Infrared (FTIR) were investigated. Doxorubicin and DOX- loaded C@Fe@Cu NC (DOX-C@Fe@Cu NC) were also assessed against HEPG2 cells for anticancer efficacy (Hepatic cancer cell line). The results revealed the formation of C@Fe@Cu NC with a mean size of 7.8 nm. A D-R model with a mean size of 24.1 nm best fits the adsorption behavior of DOX onto the C@Fe@Cu NC surface. DOX-C@Fe@Cu NC has also been demonstrated to have a considerably lower IC50 and higher cytotoxicity than DOX alone in an in vitro investigation. Therefore, DOX-C@Fe@Cu NC is a promising DOX delivery vehicle for the full recovery of HCC.

17.
J Pain Palliat Care Pharmacother ; 36(4): 233-241, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-35939039

RESUMO

We aimed to evaluate the efficacy of superior hypogastric plexus (SHP) block in pain relief among women undergoing hysterectomy. Cochrane Library, PubMed, ISI web of science, and Scopus were searched from inception to May 2021 for the available randomized clinical trials (RCTs). We included RCTs that compared SHP block (intervention group) to saline (control group) in hysterectomy. Our primary outcomes were pain scores at different time intervals using the Visual Analog Scale (VAS). Our secondary outcomes were postoperative opioid consumption within 24 hours and postoperative nausea and vomiting incidence. We extracted the available data from included studies and pooled them in a meta-analysis model using RevMan software. Four RCTs with a total number of 289 patients met our inclusion criteria. The VAS pain scores were significantly declined at post-anesthesia care unit (PACU), 2, 6, and 12 hours postoperatively among SHP block group (p < 0.05). However, no significant difference was reported in VAS pain score 1 day postoperatively between intervention and control groups. Moreover, SHP block significantly reduced the postoperative opioid consumption and incidence of nausea and vomiting (p = 0.03 & p = 0.003). In conclusion, superior hypogastric plexus block effectively reduces postoperative pain, opioid consumption, and incidence of nausea and vomiting post-hysterectomy.


Assuntos
Analgésicos Opioides , Manejo da Dor , Feminino , Humanos , Analgésicos Opioides/uso terapêutico , Plexo Hipogástrico , Ensaios Clínicos Controlados Aleatórios como Assunto , Dor Pós-Operatória/tratamento farmacológico , Dor Pós-Operatória/etiologia , Náusea e Vômito Pós-Operatórios/epidemiologia , Náusea e Vômito Pós-Operatórios/prevenção & controle , Histerectomia/efeitos adversos
18.
Pharmaceutics ; 14(8)2022 Aug 04.
Artigo em Inglês | MEDLINE | ID: mdl-36015255

RESUMO

Hyperlipidemia is still the leading cause of heart disease in patients with hypertension. The purpose of this study is to make rosuvastatin calcium (ROS) and atenolol (AT) bilayer tablets to treat coexisting dyslipidemia and hypertension with a single product. ROS was chosen for the immediate-release layer of the constructed tablets, whereas AT was chosen for the sustained-release layer. The solid dispersion of ROS with sorbitol (1:3 w/w) was utilized in the immediate-release layer while hydroxypropyl methylcellulose (HPMC), ethylcellulose (EC), and sodium bicarbonate were incorporated into the floating sustained-release layer. The concentrations of HPMC and EC were optimized by employing 32 full factorial designs to sustain AT release. The bilayer tablets were prepared by the direct compression method. The immediate-release layer revealed that 92.34 ± 2.27% of ROS was released within 60 min at a pH of 1.2. The second sustained-release layer of the bilayer tablets exhibited delayed release of AT (96.65 ± 3.36% within 12 h) under the same conditions. The release of ROS and AT from the prepared tablets was found to obey the non-Fickian diffusion and mixed models (zero-order, Higuchi and Korsmeyer-Peppas), respectively. Preclinical studies using rabbit models investigated the impact of ROS/AT tablets on lipid profiles and blood pressure. A high-fat diet was used to induce obesity in rabbits. Bilayer ROS/AT tablets had a remarkable effect on decreasing the lipid profiles, slowing weight gain, and lowering blood pressure to normal levels when compared to the control group.

19.
Rev Bras Parasitol Vet ; 31(3): e007122, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35920470

RESUMO

Monogeneans Pricea multae naturally infested 42 of the 120 (35%) mackerel fish (Scomberomorus commerson) examined. For the first time, an infestation was discovered off the coast of Jubil in the Arabian Gulf of Saudi Arabia. Based on the structure clarified through light and electron microscopy of mounted specimens and molecular analysis of rDNA and measurements of this monogenean parasite was identified as P. multae. The tegumental surface of the parasite was characterized by tegumental ridges running transversally, generating folds in both the dorsal and ventral surfaces of the body at regular intervals. The study clarified the importance and function of the micro-structures, such as tegumental folds, perforations, sensory ganglia present on the parasite's surface, and the larger hamulus supported by a relatively unmodified internal spine. This monogenean parasite has adapted to its host infestation site uniquely.


Assuntos
Perciformes , Trematódeos , Animais , Peixes/parasitologia , Perciformes/parasitologia , Arábia Saudita
20.
Int J Oncol ; 61(2)2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35775377

RESUMO

Hydroxyderivatives of vitamin D3, including classical 1,25(OH)2D3 and novel CYP11A1­derived hydroxyderivatives, exert their biological activity by acting as agonists on the vitamin D receptor (VDR) and inverse agonists on retinoid­related orphan receptors (ROR)α and γ. The anticancer activities of CYP11A1­derived hydroxyderivatives were tested using cell biology, tumor biology and molecular biology methods in human A431 and SCC13 squamous (SCC)­ and murine ASZ001 basal (BCC)­cell carcinomas, in comparison with classical 1,25(OH)2D3. Vitamin D3­hydroxyderivatives with or without a C1α(OH) inhibited cell proliferation in a dose­dependent manner. While all the compounds tested had similar effects on spheroid formation by A431 and SCC13 cells, those with a C1α(OH) group were more potent in inhibiting colony and spheroid formation in the BCC line. Potent anti­tumorigenic activity against the BCC line was exerted by 1,25(OH)2D3, 1,20(OH)2D3, 1,20,23(OH)3D3, 1,20,24(OH)3D3, 1,20,25(OH)3D3 and 1,20,26(OH)3D3, with smaller effects seen for 25(OH)D3, 20(OH)D3 and 20,23(OH)2D3. 1,25(OH)2D3, 1,20(OH)2D3 and 20(OH)D3 inhibited the expression of GLI1 and ß­catenin in ASZ001 cells. In A431 cells, these compounds also decreased the expression of GLI1 and stimulated involucrin expression. VDR, RORγ, RORα and CYP27B1 were detected in A431, SCC13 and ASZ001 lines, however, with different expression patterns. Immunohistochemistry performed on human skin with SCC and BCC showed nuclear expression of all three of these receptors, as well as megalin (transmembrane receptor for vitamin D­binding protein), the level of which was dependent on the type of cancer and antigen tested in comparison with normal epidermis. Classical and CYP11A1­derived vitamin D3­derivatives exhibited anticancer­activities on skin cancer cell lines and inhibited GLI1 and ß­catenin signaling in a manner that was dependent on the position of hydroxyl groups. The observed expression of VDR, RORγ, RORα and megalin in human SCC and BCC suggested that they might provide targets for endogenously produced or exogenously applied vitamin D hydroxyderivatives and provide excellent candidates for anti­cancer therapy.


Assuntos
Carcinoma Basocelular , Carcinoma de Células Escamosas , Enzima de Clivagem da Cadeia Lateral do Colesterol , Vitamina D , Animais , Carcinoma Basocelular/tratamento farmacológico , Carcinoma Basocelular/metabolismo , Carcinoma Basocelular/patologia , Carcinoma de Células Escamosas/tratamento farmacológico , Carcinoma de Células Escamosas/metabolismo , Carcinoma de Células Escamosas/patologia , Colecalciferol/farmacologia , Enzima de Clivagem da Cadeia Lateral do Colesterol/farmacologia , Humanos , Proteína-2 Relacionada a Receptor de Lipoproteína de Baixa Densidade , Camundongos , Receptores de Calcitriol/metabolismo , Neoplasias Cutâneas/tratamento farmacológico , Neoplasias Cutâneas/metabolismo , Neoplasias Cutâneas/patologia , Vitamina D/análogos & derivados , Vitamina D/farmacologia , Proteína GLI1 em Dedos de Zinco/genética , beta Catenina/metabolismo
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