The impact of vitamin A supplementation on thyroid function and insulin sensitivity: implication of deiodinases and phosphoenolpyruvate carboxykinase in male Wistar rats.

PURPOSE: Vitamin A is an essential nutrient with vital biological functions. The present study investigated the effect of different doses of vitamin A palmitate at different time intervals on thyroid hormones and glycemic markers. METHODS: Male rats were administrated vitamin A palmitate at different doses (0, 0.7, 1.5, 3, 6, and 12 mg/kg, oral) and samples were collected at different time intervals of 2, 4, and 6 weeks. The levels of vitamin A, thyroid hormones (T3, T4, and TSH), deiodinases (Dio1 and Dio3), glycemic markers (blood insulin and fasting glucose levels, HOMA IR and HOMA ß), retinol-binding protein 4 (RBP4) and the gluconeogenic enzyme phosphoenolpyruvate carboxykinase (PEPCK) were measured. RESULTS: The findings demonstrated that long-term supplementation with high doses of vitamin A palmitate resulted in hypothyroidism (lower T3 and T4 levels and elevated TSH levels) as well as upregulation of Dio1 and Dio3 expression levels. This effect was associated with elevated glucose and insulin levels, enhanced HOMA IR, and decreased HOMA B index. In addition, prolonged vitamin A supplementation significantly increased RBP4 levels that upregulated the expression of PEPCK. CONCLUSION: High doses of vitamin A supplementation increased the risk of hypothyroidism, modulated insulin sensitivity, and over a long period, increased the incidence of type 2 diabetes mellitus associated with oxidative stress and hepatitis.

Sepsis-related anemia in a pediatric intensive care unit: transfusion-associated outcomes.

BACKGROUND: Pediatric patients with sepsis in intensive care units are at high risk of developing anemia, which might have adverse effects on their prognosis. This study aimed to evaluate the impact of red blood cell (RBC) transfusion on the outcomes of patients admitted to a pediatric intensive care unit (PICU) with sepsis. METHODS: We conducted a prospective randomized clinical trial, enrolling 67 children, aged 2 to 144 months who were admitted to a PICU with a new episode of sepsis from November 2017 to April 2018. Patients were allocated randomly to two groups: Group 1, liberal transfusion strategy group, including 33 patients who had initial hemoglobin (Hb) between 7 or greater and less than 10 g/dL and received an RBC top-up transfusion to 12 g/dL; and Group 2, restrictive strategy group, including 34 patients who had the same Hb range and did not receive RBCs. Patients with Hb less than 7 or greater than 10 g/dL were excluded. RESULTS: Of 33 patients who received liberal transfusions, 31 (93.94%) required ventilation, and 29 (87.88%) had multiorgan dysfunction. They had a significantly lengthier hospital stay and a higher incidence of acute respiratory distress syndrome and acute lung injury. Moreover, mortality was significantly higher in the liberal transfusion group (42.4% vs. 17.6%). CONCLUSIONS: Compared to the restrictive transfusion strategy, liberal transfusion might be associated with a worse outcome. However, the possible role of other known and unknown confounding factors and minor protocol violations should be taken into consideration. We recommend minimizing factors worsening anemia in PICU patients to reduce the need for transfusion.

mHealth App Barriers, Usability, and Personalization: A Cross-Sectional Study from Egypt and Saudi Arabia.

Mobile health (mHealth) has emerged as a substantial segment of eHealth. Herein, we conducted a cross-sectional study to investigate mHealth app barriers, usability, and personalization in Egypt and Saudi Arabia. We used a Google survey to recruit participants from both countries between the 15th of September and the 15th of October 2022. Among 299 participants (247 from Egypt and 52 from Saudi Arabia), aged ≥ 18 years, 27.4% reported mHealth app use. In the age-, sex-, and country-adjusted regression models, age > 25 years: OR (95% CI) = 1.98 (1.11, 3.54), residing in Saudi Arabia: OR (95% CI) = 4.33 (2.22, 8.48), and physical activity: OR (95% CI) = 2.53 (1.44, 4.44) were associated with mHealth app use. The main mHealth app purposes were lifestyle promotion (35.4%), diet and nutrition (30.5%), and administrative services (13.4%). On a scale from 20 to 100, mHealth app usability scores were 46.3% (20−40), 7.3% (41−60), 31.7% (61−80), and 14.7% (81−100). According to 93.9% of users, mHealth app features were modifiable to meet personal health goals, while 37% stated that mHealth apps helped them set new personal health goals. In conclusion, age, residing in Saudi Arabia (compared to Egypt), and physical activity were positively associated with mHealth app use. mHealth app feature personalization and helping users set new personal health goals were largely reported, suggesting that mHealth has the potential to help put personalized healthcare into practice.

Evaluation of marginal fit and microleakage of monolithic zirconia crowns cemented by bio-active and glass ionomer cements: In vitro study / Avaliação da adaptação marginal e microinfiltração de coroas monolíticas de zircônia cimentadas com cimentos bioativos e ionômero de vidro: estudo in vitro

Objective: to evaluate the marginal fit and microleakage of monolithic zirconia crowns cemented by bio-active cements (Ceramir) compared to that cemented with glass ionomer cement, and to evaluate the effect of thermocycling on marginal fit. Material and Methods: Twenty sound human molar teeth were prepared to receive monolithic zirconia crowns. Teeth were divided randomly into two equal groups according to the type of luting cement: Group I (glass ionomer cement) and group II (Ceramir cement). After cementation, the vertical marginal gap was assessed using stereomicroscope before and after thermocycling. Twenty equidistant measurement points were taken for each crown. Leakage assessment was carried out using Fuchsin dye penetration followed by digital photography under a stereomicroscope. Data were analyzed by Mann-Whitney U test to compare between the two luting cements. Wilcoxon signed-rank test was used to evaluate the effect of thermocycling on the marginal fit (P ≤ 0.05). Results: Whether before or after thermocycling, the results showed no significant difference between the marginal gap values of the two tested groups. For both groups, there was a significant increase in marginal gap values after thermocycling. Also, there was no significant difference between leakage scores of the two tested groups. Conclusion: Similarity in the physical properties and chemical composition of the two cements resulted in a nonsignificant effect on the vertical marginal fit and the extent of microleakage of translucent zirconia crowns. Thermocycling had a negative impact on the vertical marginal gap of the two tested luting agents. (AU)

Objetivo: avaliar a adapatação marginal e a microinfiltração de coroas monolíticas de zircônia cimentadas com cimentos bioativos (Ceramir) em comparação com o cimento de ionômero de vidro e avaliar o efeito da termociclagem na adaptação marginal. Material e Métodos: Vinte molares humanos sadios foram preparados para receber coroas monolíticas de zircônia. Os dentes foram divididos aleatoriamente em dois grupos iguais, de acordo com o tipo de cimento: Grupo I (cimento de ionômero de vidro) e grupo II (cimento Ceramir). Após a cimentação, a adaptação marginal vertical foi avaliada com estereomicroscópio antes e após a termociclagem. Vinte pontos de medição equidistantes foram obtidos para cada coroa. A avaliação da infiltração foi realizada utilizando a penetração do corante de fucsina, seguida de fotografia digital sob estereomicroscópio. Os dados foram analisados pelo teste de Mann-Whitney para comparação entre os dois cimentos. O teste de Wilcoxon foi usado para avaliar o efeito da termociclagem na adaptação marginal (P ≤ 0,05). Resultados: Antes ou depois da termociclagem, os resultados não mostraram diferença significativa entre os valores de fenda marginal dos dois grupos testados. Para ambos os grupos, houve um aumento significativo nos valores de fenda marginal após a termociclagem. Além disso, não houve diferença significativa entre os escores de infiltração dos dois grupos testados. Conclusão: A similaridade nas propriedades físicas e na composição química dos dois cimentos resultou em um efeito não significativo na adaptação marginal vertical e na extensão da microinfiltração de coroas translúcidas de zircônia. A termociclagem teve um impacto negativo na fenda marginal vertical dos dois agentes de cimentação testados. (AU)