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A spectrofluorimetric method using fluorescent carbon dots (CDs) was developed for the selective detection of azelnidipine (AZEL) pharmaceutical in the presence of other drugs. In this study, N-doped CDs (N-CDs) were synthesized through a single-step hydrothermal process, using citric acid and urea as precursor materials. The prepared N-CDs showed a highly intense blue fluorescence emission at 447 nm, with a photoluminescence quantum yield of ~21.15% and a fluorescence lifetime of 0.47 ns. The N-CDs showed selective fluorescence quenching in the presence of all three antihypertensive drugs, which was used as a successful detection platform for the analysis of AZEL. The photophysical properties, UV-vis light absorbance, fluorescence emission, and lifetime measurements support the interaction between N-CDs and AZEL, leading to fluorescence quenching of N-CDs as a result of ground-state complex formation followed by a static fluorescence quenching phenomenon. The detection platform showed linearity in the range 10-200 µg/ml (R2 = 0.9837). The developed method was effectively utilized for the quantitative analysis of AZEL in commercially available pharmaceutical tablets, yielding results that closely align with those obtained from the standard method (UV spectroscopy). With a score of 0.76 on the 'Analytical GREEnness (AGREE)' scale, the developed analytical method, incorporating 12 distinct green analytical chemistry components, stands out as an important technique for estimating AZEL.
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Ácido Azetidinocarboxílico , Carbono , Di-Hidropiridinas , Pontos Quânticos , Espectrometria de Fluorescência , Di-Hidropiridinas/análise , Di-Hidropiridinas/química , Carbono/química , Ácido Azetidinocarboxílico/análise , Ácido Azetidinocarboxílico/análogos & derivados , Ácido Azetidinocarboxílico/química , Pontos Quânticos/química , Química Verde , Comprimidos/análise , Corantes Fluorescentes/química , Preparações Farmacêuticas/química , Preparações Farmacêuticas/análise , Estrutura MolecularRESUMO
The fine-tuning of neuroinflammation is crucial for brain homeostasis as well as its immune response. The transcription factor, nuclear factor-κ-B (NFκB) is a key inflammatory player that is antagonized via anti-inflammatory actions exerted by the glucocorticoid receptor (GR). However, technical limitations have restricted our understanding of how GR is involved in the dynamics of NFκB in vivo. In this study, we used an improved lentiviral-based reporter to elucidate the time course of NFκB and GR activities during behavioral changes from sickness to depression induced by a systemic lipopolysaccharide challenge. The trajectory of NFκB activity established a behavioral basis for the NFκB signal transition involved in three phases, sickness-early-phase, normal-middle-phase, and depressive-like-late-phase. The temporal shift in brain GR activity was differentially involved in the transition of NFκB signals during the normal and depressive-like phases. The middle-phase GR effectively inhibited NFκB in a glucocorticoid-dependent manner, but the late-phase GR had no inhibitory action. Furthermore, we revealed the cryptic role of basal GR activity in the early NFκB signal transition, as evidenced by the fact that blocking GR activity with RU486 led to early depressive-like episodes through the emergence of the brain NFκB activity. These results highlight the inhibitory action of GR on NFκB by the basal and activated hypothalamic-pituitary-adrenal (HPA)-axis during body-to-brain inflammatory spread, providing clues about molecular mechanisms underlying systemic inflammation caused by such as COVID-19 infection, leading to depression.
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Depressão/metabolismo , NF-kappa B , Receptores de Glucocorticoides , Animais , Encéfalo/metabolismo , Sistema Hipotálamo-Hipofisário/metabolismo , Camundongos , NF-kappa B/metabolismo , Sistema Hipófise-Suprarrenal/metabolismo , Receptores de Glucocorticoides/metabolismoRESUMO
Objective: Ischemic stroke is one of the leading causes of disability in adults worldwide. The present study was aimed to evaluate the efficacy of Narirutin-rich fraction (NRF), obtained from grape fruit peel, on cerebral ischemia/reperfusion injury in rats.Methods: Male Wistar rats (180-200â g) were subjected to bilateral carotid artery occlusion for 30â min followed by reperfusion for 24â h to induce cerebral ischemia/reperfusion injury. NRF (150, 300â mg/kg, oral) was administered for 7 days continuously before animals were subjected to ischemia/reperfusion injury. Various behavioral tests (for measurement of motor coordination, locomotor activity, and spatial memory), biochemical parameters (lipid peroxidation, superoxide dismutase, and catalase activity), and histopathological alterations were assessed.Results: Seven-day NRF (150 and 300â mg/kg) pretreatment significantly improved neurobehavioral alterations and histological findings as compared to the disease control group. Further NRF treatment significantly reduced oxidative damage as indicated by improved lipid peroxidation, superoxide dismutase, and catalase activity as compared to disease control animals.Conclusion: The present study demonstrated the protective effect of NRF against cerebral ischemia/reperfusion injury in rats. The results suggest that NRF can be a potential pretreatment option against cerebral ischemia/reperfusion injury.
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Isquemia Encefálica , Ataque Isquêmico Transitório , Traumatismo por Reperfusão , Vitis , Animais , Antioxidantes/farmacologia , Isquemia Encefálica/prevenção & controle , Catalase , Dissacarídeos , Flavanonas , Frutas , Masculino , Estresse Oxidativo , Ratos , Ratos Wistar , Traumatismo por Reperfusão/patologia , Superóxido Dismutase/metabolismoRESUMO
ABSTRACT: Electroconvulsive therapy (ECT) is a highly therapeutic and cost-effective treatment for severe and/or treatment-resistant major depression. However, because of the varied clinical practices, there is a great deal of heterogeneity in how ECT is delivered and documented. This represents both an opportunity to study how differences in implementation influence clinical outcomes and a challenge for carrying out coordinated quality improvement and research efforts across multiple ECT centers. The National Network of Depression Centers, a consortium of 26+ US academic medical centers of excellence providing care for patients with mood disorders, formed a task group with the goals of promoting best clinical practices for the delivery of ECT and to facilitate large-scale, multisite quality improvement and research to advance more effective and safe use of this treatment modality. The National Network of Depression Centers Task Group on ECT set out to define best practices for harmonizing the clinical documentation of ECT across treatment centers to promote clinical interoperability and facilitate a nationwide collaboration that would enable multisite quality improvement and longitudinal research in real-world settings. This article reports on the work of this effort. It focuses on the use of ECT for major depressive disorder, which accounts for the majority of ECT referrals in most countries. However, most of the recommendations on clinical documentation proposed herein will be applicable to the use of ECT for any of its indications.
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Transtorno Depressivo Maior , Transtorno Depressivo Resistente a Tratamento , Eletroconvulsoterapia , Depressão , Documentação , Humanos , Resultado do TratamentoRESUMO
WHAT IS KNOWN AND OBJECTIVE: Metabolic syndrome is a well-documented adverse effect of second-generation antipsychotics (SGAs). Patients with metabolic syndrome are at an increased risk of potentially fatal cardiovascular events, including myocardial infarction and stroke. This elevated risk prompted the creation of a national guideline on metabolic monitoring for patients on SGAs in 2004. However, monitoring practices remained low at our clinic. To address this concern, a clinical decision support system was developed to alert providers of monitoring requirements. The purpose of this study is to determine the effect of the best practice alert (BPA), and to assess the impact of provider and patient characteristics on metabolic laboratory (lab) order rates. METHODS: A retrospective chart review was conducted at a large outpatient psychiatric clinic. Data were collected from all adult patients who were prescribed an SGA and triggered the BPA (indicating lab monitoring is needed for the patient). Data collection included a variety of patient, provider and alert variables. The primary outcome was a composite of fasting blood glucose (FBG), haemoglobin A1c (HbA1c) and/or fasting lipid panel order rates. Secondary outcomes included the rate of valid response, which considered appropriate reasons for not ordering labs (ie monitoring already completed during recent primary care visit), as well as order rates of individual labs. RESULTS AND DISCUSSION: Data from 1112 patients were collected and analysed. Patients with a thought disorder diagnosis had significantly more labs ordered than those without. No other patient factors affected order rates. Resident psychiatrists and nurse practitioners ordered significantly more labs and had significantly more valid responses than attending psychiatrists. An active alert, which fired during medication order entry, was associated with a higher rate of lab ordering and valid response compared to a passive alert, which fired whenever a prescribing healthcare provider opened the chart. WHAT IS NEW AND CONCLUSION: Prescribers may associate metabolic syndrome with schizophrenia or with use of SGAs specifically in thought disorders, even though these medications pose a risk for all indications. Higher rates of monitoring by resident physicians may have been due to spending more time with patients during the encounter and in documentation. Lastly, the active BPA was an effective tool to increase metabolic monitoring in patients taking SGAs. Continued education on the importance of regular metabolic monitoring should be implemented for all providers.
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Antipsicóticos/administração & dosagem , Monitoramento de Medicamentos/métodos , Transtornos Mentais/tratamento farmacológico , Síndrome Metabólica/induzido quimicamente , Adulto , Antipsicóticos/efeitos adversos , Glicemia/análise , Sistemas de Apoio a Decisões Clínicas , Feminino , Hemoglobinas Glicadas/análise , Humanos , Masculino , Sistemas de Registro de Ordens Médicas , Transtornos Mentais/fisiopatologia , Pessoa de Meia-Idade , Pacientes Ambulatoriais , Estudos RetrospectivosRESUMO
Accumulating data advocates that inflammatory mediators may contribute to depression in experimental models as well as in humans. Nonetheless, whether anti-inflammatory treatments can prevent depression still remains controversial. To substantiate our hypothesis, we used an interferon-α-2b model of depression using Sprague Dawley rats. Interferon-α-2b is a cytokine which activates immune response and also produces depression. The animals were treated for 21 days with aspirin (10 mg/kg, per oral (p.o.)) dexamethasone (1 mg/kg p.o.) and amitriptyline (10 mg/kg p.o.). Amitriptyline was used as reference standard, and given concurrently with aspirin and dexamethasone to examine any synergy. Interferon-α-2b (6000 IU/kg, intraperitoneal (i.p.)) was administered in all the above groups daily, except normal control. Tests performed included sucrose preference test, behavioural tests like forced swim test, elevated plus maze, light dark box and locomotor activity along with biochemical estimations like serum cortisol and brain neurotransmitters. The rats in the group treated with Interferon-α-2b produced depressive behaviour in rats. We found that animals treated with aspirin decreased immobility time in forced swim test, increased sucrose preference, decreased serum cortisol and increased brain serotonin levels signifying antidepressant action. In contrast, there was no effect in groups treated with dexamethasone. Our results suggest that aspirin can serve as a potential antidepressant both individually and as adjuvant agent in the treatment of depression. Inhibition of the cyclo-oxygenase-2 levels and prostaglandins concentration or any other potential physiological and biochemical mechanisms may be involved in antidepressant effect.
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Anti-Inflamatórios não Esteroides/uso terapêutico , Aspirina/uso terapêutico , Depressão/induzido quimicamente , Depressão/tratamento farmacológico , Interferon-alfa/toxicidade , Animais , Anti-Inflamatórios não Esteroides/farmacologia , Aspirina/farmacologia , Inibidores de Ciclo-Oxigenase 2/farmacologia , Inibidores de Ciclo-Oxigenase 2/uso terapêutico , Depressão/metabolismo , Dexametasona/farmacologia , Dexametasona/uso terapêutico , Interferon alfa-2 , Locomoção/efeitos dos fármacos , Locomoção/fisiologia , Masculino , Ratos , Ratos Sprague-Dawley , Resultado do TratamentoRESUMO
BACKGROUND: Latent reservoirs of HIV-1 provide a major challenge to its cure. There are increasing reports of interplay between HIV-1 replication and host miRNAs. Several host miRNAs, which potentially target the nef-3'LTR region of HIV-1 RNA, including miR-29a, are proposed to promote latency. FINDINGS: We used two established cellular models of HIV-1 latency - the U1 monocytic and J1.1 CD4+ T cell lines to show an inverse relationship between HIV-1 replication and miR-29a levels, which was mediated by the HIV-1 Nef protein. Using a miR-29a responsive luciferase reporter plasmid, an expression plasmid and an anti-miR29a LNA, we further demonstrate increased miR-29a levels during latency and reduced levels following active HIV replication. Finally, we show that miR-29a levels in the PBMCs and plasma of HIV infected persons also correlate inversely with latency and active viral replication. CONCLUSIONS: The levels of miR-29a correlate inversely with active HIV-1 replication in cell culture models and in HIV infected persons. This links miR-29a to viral latency and suggests another approach to activate and destroy latent HIV-1 reservoirs.
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HIV-1/fisiologia , Interações Hospedeiro-Patógeno , MicroRNAs/metabolismo , Latência Viral , Linfócitos T CD4-Positivos/virologia , Linhagem Celular , Estudos de Coortes , Humanos , Monócitos/virologia , Replicação ViralRESUMO
The worldwide HIV cases were 39.0 million (33.1-45.7 million) in 2022. Due to genetic variations, HIV-1 is more easily transmitted than HIV-2 and favours CD4 + T cells and macrophages, producing AIDS. Conventional HIV drug therapy has many drawbacks, including adherence issues leading to resistance, side effects that lower life quality, drug interactions, high costs limiting global access, inability to eliminate viral reservoirs, chronicity requiring lifelong treatment, emerging toxicities, and a focus on managing infections. Conventional dosage forms have bioavailability issues due to intestinal P-glycoprotein (P-gp) efflux, which can reduce anti-retroviral drug efficacy and lead to resistance. Use of phyto-constituents with P-gp regulating actions has great benefits for semi-synthetic modification to create formulations with greater bioavailability and reduced toxicity, which improves drug effectiveness. Lipid-based nanocarriers, solid lipid nanoparticles, nanostructured lipid carriers, polymer-based nanocarriers, and inorganic nanoparticles may inhibit P-gp efflux. Employing potent P-gp inhibitors within nanocarriers as a Trojan horse approach can enhance the intracellular accumulation of anti-retroviral drugs (ARDs), which are substrates for efflux transporters. This technique increases oral bioavailability and offers lower-dose options, boosting HIV patient compliance and lowering costs. Molecular docking of the inhibitor with P-gp may anticipate optimum binding and function, allowing drug efflux to be minimised.
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Membro 1 da Subfamília B de Cassetes de Ligação de ATP , Infecções por HIV , Nanopartículas , Humanos , Membro 1 da Subfamília B de Cassetes de Ligação de ATP/antagonistas & inibidores , Membro 1 da Subfamília B de Cassetes de Ligação de ATP/metabolismo , Infecções por HIV/tratamento farmacológico , Fármacos Anti-HIV/farmacologia , Fármacos Anti-HIV/administração & dosagem , Fármacos Anti-HIV/farmacocinética , Disponibilidade Biológica , Portadores de Fármacos/química , HIV-1/efeitos dos fármacos , Antirretrovirais/farmacologia , AnimaisRESUMO
Due to the high prevalence of cancer, progress in the management of cancer is the need of the hour. Most cancer patients develop chemotherapeutic drug resistance, and many remain insidious due to overexpression of Multidrug Resistance Protein 1 (MDR1), also known as Permeability-glycoprotein (P-gp) or ABCB1 transporter (ATP-binding cassette subfamily B member 1). P-gp, a transmembrane protein that protects vital organs from outside chemicals, expels medications from malignant cells. The blood-brain barrier (BBB), gastrointestinal tract (GIT), kidneys, liver, pancreas, and cancer cells overexpress P-gp on their apical surfaces, making treatment inefficient and resistant. Compounds that compete with anticancer medicines for transportation or directly inhibit P-gp may overcome biological barriers. Developing nanotechnology-based formulations may help overcome P-gp-mediated efflux and improve bioavailability and cell chemotherapeutic agent accumulation. Nanocarriers transport pharmaceuticals via receptor-mediated endocytosis, unlike passive diffusion, which bypasses ABCB1. Anticancer drugs and P-gp inhibitors in nanocarriers may synergistically increase drug accumulation and chemotherapeutic agent toxicity. The projection of desirable binding and effect may be procured initially by molecular docking of the inhibitor with P-gp, enabling the reduction of preliminary trials in formulation development. Here, P-gp-mediated efflux and several possible outcomes to overcome the problems associated with currently prevalent cancer treatments are highlighted.
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Antineoplásicos , Neoplasias , Humanos , Resistência a Múltiplos Medicamentos , Simulação de Acoplamento Molecular , Resistencia a Medicamentos Antineoplásicos , Antineoplásicos/química , Subfamília B de Transportador de Cassetes de Ligação de ATP/metabolismo , Preparações Farmacêuticas , Neoplasias/tratamento farmacológicoRESUMO
Introduction: Treatment-emergent sexual dysfunction (TESD) is a commonly reported side effect of antidepressant medications in clinical trials. Limited literature exists exploring the role of routine use of the Arizona Sexual Experience Scale (ASEX) in identification of TESD in clinical practice. Therefore, we completed a retrospective study with the primary goal of capturing the rates of sexual dysfunction associated with antidepressant use among adult patients at an outpatient encounter with a psychiatric clinical pharmacist between June 2020 and March 2022. Methods: Rates of identification of sexual dysfunction were compared pre-ASEX survey (June 2020 to June 2021) to post-ASEX survey (July 2021 to March 2022). Results: There was a significant increase in the identification of sexual dysfunction following implementation of the ASEX scale (10% in the pre-ASEX group versus 59% meeting sexual dysfunction criteria with the ASEX scale). Approximately 70% of patients in the post-ASEX group shared they would not have reported symptoms unless directly asked. Discussion: In conclusion, a validated survey (ASEX) in an ambulatory psychiatry clinic improves identification of sexual dysfunction associated with antidepressants. Use of interdisciplinary care teams in the setting of medication follow-up can assist with identifying tolerability concerns between visits with patients' prescribing clinicians.
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Objective: Ketamine is contraindicated in pregnancy given the lack of knowledge about potential effects on a developing fetus. This study aimed to characterize current clinical practices specific to pregnancy and reproduction related to the use of ketamine for the treatment of psychiatric illness.Methods: Online surveys were sent to outpatient ketamine clinics across the United States inquiring about practices related to pregnancy. Responses were collected between September and November 2023. Additionally, a retrospective medical record review was conducted to ascertain the frequency of pregnancy testing and contraception use with ketamine treatments administered at a large academic health system. Online, publicly available informed consent documents were also reviewed for language related to pregnancy.Results: Fewer than half of survey respondents (n = 126) discuss specific risks related to pregnancy and fetal ketamine exposure during the informed consent process. Twenty percent of clinics require pregnancy tests prior to treatment, and 10.5% require subsequent testing during treatment; however, 22.9% of clinics do not have a standard process for testing. Only 13.7% of clinics specifically recommend or require use of contraception. Retrospective record review revealed that all patients who received intravenous ketamine for psychiatric indications in an academic medical center were pregnancy tested weekly, but only half were using contraception during treatment.Conclusion: Many women with the potential to become pregnant are treated with ketamine for psychiatric illness. Results of the present study reveal that risks of fetal ketamine exposure are often overlooked, indicating a need for increased awareness about reproductive concerns when prescribing ketamine for the treatment of psychiatric disorders.
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Aconselhamento , Consentimento Livre e Esclarecido , Ketamina , Humanos , Ketamina/efeitos adversos , Ketamina/administração & dosagem , Feminino , Gravidez , Estudos Retrospectivos , Estados Unidos , Transtornos Mentais/tratamento farmacológico , Testes de Gravidez , Complicações na Gravidez/tratamento farmacológico , Adulto , Inquéritos e Questionários , Padrões de Prática Médica/estatística & dados numéricosRESUMO
Adverse early life experience, such as childhood abuse, neglect, and trauma, increases lifetime risk for mental illness. To investigate underlying mechanisms, the maternal separation (MS) paradigm was developed and validated as an animal model of early adversity in rats, reliably effecting long-term changes to anxiety, gene expression, and stress response. However, across-species validation of core findings in mice has met with limited success. To re-visit parameters governing the effectiveness of MS in mice, this study investigated the effect of MS on maternal care, offspring behavior, and offspring stress-induced corticosterone response in the c57bl/6 mouse strain. The results from this study suggest that: (i) levels of maternal care increase as a function of separation duration immediately after daily MS, but long-term care remains unchanged; and (ii) c57bl/6 mice are resilient to MS, exhibiting subtle decreases in anxiety and unchanged stress-induced corticosterone response as adults, irrespective of separation duration.
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Comportamento Animal/fisiologia , Corticosterona/sangue , Comportamento Materno/fisiologia , Privação Materna , Camundongos Endogâmicos C57BL/fisiologia , Estresse Psicológico/fisiopatologia , Animais , Animais Recém-Nascidos , Ansiedade/metabolismo , Ansiedade/fisiopatologia , Feminino , Masculino , Camundongos , Camundongos Endogâmicos C57BL/metabolismo , Camundongos Endogâmicos C57BL/psicologia , Testes Neuropsicológicos , Estresse Psicológico/metabolismo , Fatores de TempoRESUMO
Coping with intermittent social stress is an essential aspect of living in complex social environments. Coping tends to counteract the deleterious effects of stress and is thought to induce neuroadaptations in corticolimbic brain systems. Here we test this hypothesis in adult squirrel monkey males exposed to intermittent social separations and new pair formations. These manipulations simulate conditions that typically occur in male social associations because of competition for limited access to residency in mixed-sex groups. As evidence of coping, we previously confirmed that cortisol levels initially increase and then are restored to prestress levels within several days of each separation and new pair formation. Follow-up studies with exogenous cortisol further established that feedback regulation of the hypothalamic-pituitary-adrenal axis is not impaired. Now we report that exposure to intermittent social separations and new pair formations increased hippocampal neurogenesis in squirrel monkey males. Hippocampal neurogenesis in rodents contributes to spatial learning performance, and in monkeys we found that spatial learning was enhanced in conditions that increased hippocampal neurogenesis. Corresponding changes were discerned in the expression of genes involved in survival and integration of adult-born granule cells into hippocampal neural circuits. These findings support recent indications that stress coping stimulates hippocampal neurogenesis in adult rodents. Psychotherapies designed to promote stress coping potentially have similar effects in humans with major depression.
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Adaptação Psicológica/fisiologia , Hipocampo/crescimento & desenvolvimento , Neurogênese/fisiologia , Estresse Psicológico/fisiopatologia , Animais , Proliferação de Células , Perfilação da Expressão Gênica , Regulação da Expressão Gênica no Desenvolvimento , Hipocampo/citologia , Hipocampo/metabolismo , Hidrocortisona/análise , Hibridização In Situ , Aprendizagem/fisiologia , Masculino , Neurogênese/genética , Neurônios/citologia , Neurônios/metabolismo , Neurônios/fisiologia , Análise de Sequência com Séries de Oligonucleotídeos , Saimiri , Comportamento SocialRESUMO
Cayman ataxia is a recessive congenital ataxia restricted to one area of Grand Cayman Island. Comparative mapping suggested that the locus on 19p13.3 associated with Cayman ataxia might be homologous to the locus on mouse chromosome 10 associated with the recessive ataxic mouse mutant jittery. Screening genes in the region of overlap identified mutations in a novel predicted gene in three mouse jittery alleles, including the first mouse mutation caused by an Alu-related (B1 element) insertion. We found two mutations exclusively in all individuals with Cayman ataxia. The gene ATCAY or Atcay encodes a neuron-restricted protein called caytaxin. Caytaxin contains a CRAL-TRIO motif common to proteins that bind small lipophilic molecules. Mutations in another protein containing a CRAL-TRIO domain, alpha-tocopherol transfer protein (TTPA), cause a vitamin E-responsive ataxia. Three-dimensional protein structural modeling predicts that the caytaxin ligand is more polar than vitamin E. Identification of the caytaxin ligand may help develop a therapy for Cayman ataxia.
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Ataxia/genética , Distonia/genética , Mutação , Sequência de Aminoácidos , Animais , Mapeamento Cromossômico , Cromossomos Humanos Par 19 , Modelos Animais de Doenças , Humanos , Camundongos , Dados de Sequência Molecular , Homologia de Sequência de AminoácidosRESUMO
This case report described a new technique for immediately loading an implant-supported fixed screw-retained bridge that has flat abutments to achieve a superior passive fit. The definitive prosthetic bridge was placed within 72 hours from surgery and follow-up data over a 5-year period are presented. Good aesthetic results were achieved, and at the end of the follow-up period neither biological nor biomechanical complications were observed.
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Prótese Dentária Fixada por Implante , Prótese Total Superior , Carga Imediata em Implante Dentário , Resinas Acrílicas/química , Adulto , Periodontite Agressiva/terapia , Ligas de Cromo/química , Projeto do Implante Dentário-Pivô , Adaptação Marginal Dentária , Materiais Dentários/química , Planejamento de Dentadura , Retenção de Dentadura , Estética Dentária , Feminino , Seguimentos , Defeitos da Furca/cirurgia , Humanos , Extração Dentária , Mobilidade Dentária/terapia , Alvéolo Dental/cirurgiaRESUMO
When in extreme distress, it is difficult to remember the coping strategies and resources available to you. The purpose of a safety plan is to make it easier for individuals to make wise choices in moments of crisis. By virtue of this, we should strive to have safety plans as easy and convenient to use as possible. The Stanley-Brown safety plan is a template for this style of intervention and has been adapted and adopted in numerous institutions.1 A pillar of this intervention is ready-at-hand contact information for mental health agencies and crisis resources. Although the classic paper safety plan remains an invaluable tool, integration of digital resources may be necessary to meet our young patients "where they live."2 Generation Z are "digital natives" with great fluency and comfort with smart devices. Expansion of the audio-only National Suicide Prevention Lifeline to the audio, SMS, and Web-based instant messaging capabilities of the 988 Crisis & Suicide Lifeline recognizes this shift.3 At the University of Michigan, we developed a quick response (QR) code to save these resources directly onto youths' smartphones.
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Suicídio , Humanos , Adolescente , Suicídio/psicologia , Prevenção do Suicídio , Adaptação Psicológica , Smartphone , Saúde MentalRESUMO
Angiotensin converting enzyme 2 (ACE2) is a homolog of ACE (a transmembrane bound dipeptidyl peptidase enzyme). ACE2 converts angiotensinogen to the heptapeptide angiotensin-(1-7). ACE2 and its product, angiotensin-(1-7), have counteracting effects against the adverse actions of other members of renin-angiotensin system (RAS). ACE2 and its principal product, angiotensin-(1-7), were considered an under recognized arm of the RAS. The COVID-19 pandemic brought to light this arm of RAS with special focus on ACE2. Membrane bound ACE2 serves as a receptor for SARS-CoV-2 viral entry through spike proteins. Apart from that, ACE2 is also involved in the pathogenesis of various other diseases like cardiovascular disease, cancer, respiratory diseases, neurodegenerative diseases and infertility. The present review focuses on the molecular mechanism of ACE2 in neurodegenerative diseases, cancer, cardiovascular disease, infertility and respiratory diseases, including SARS-CoV-2. This review summarizes unveiled roles of ACE2 in the pathogenesis of various diseases which further provides intriguing possibilities for the use of ACE2 activators and RAS modulating agents for various diseases.
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OBJECTIVE: This study examined the impact of high-reliability changes to how measurement-based care questionnaires were administered to patients on rates of questionnaire completion. METHODS: Medical record data were abstracted from 44,305 adult outpatient return visits to a psychiatry outpatient clinic within two 10-month periods (before and after process changes were implemented). Linear mixed models tested the change in questionnaire completion rates and the interaction effects between time and age, sex, and race. RESULTS: Patient completion of questionnaires increased by 79% after process changes. Women were more likely to complete questionnaires regardless of the process. After process changes, older patients and White patients were more likely to complete questionnaires. CONCLUSIONS: High-reliability process changes to measurement-based care questionnaire administration were associated with higher questionnaire completion rates. Racial, age, and sex disparities in questionnaire completion rates were notable and deserve attention in future measurement-based care implementation efforts.
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Instituições de Assistência Ambulatorial , Psiquiatria , Adulto , Humanos , Feminino , Reprodutibilidade dos Testes , Inquéritos e Questionários , Pacientes AmbulatoriaisRESUMO
Sodium hydrogen exchanger (SHE) inhibitor is one of the most important targets in treatment of myocardial ischemia. In the course of our research into new types of non-acylguanidine, SHE inhibitory activities of 5-tetrahydroquinolinylidine aminoguanidine derivatives were used to build pharmacophore and 3D-QSAR models. Genetic Algorithm Similarity Program (GASP) was used to derive a 3D pharmacophore model which was used in effective alignment of data set. Eight molecules were selected on the basis of structure diversity to build 10 different pharmacophore models. Model 1 was considered as the best model as it has highest fitness score compared to other nine models. The obtained model contained two acceptor sites, two donor atoms and one hydrophobic region. Pharmacophore modeling was followed by substructure searching and virtual screening. The best CoMFA model, representing steric and electrostatic fields, obtained for 30 training set molecules was statistically significant with cross-validated coefficient (q(2)) of 0.673 and conventional coefficient (r(2)) of 0.988. In addition to steric and electrostatic fields observed in CoMFA, CoMSIA also represents hydrophobic, hydrogen bond donor and hydrogen bond acceptor fields. CoMSIA model was also significant with cross-validated coefficient (q(2)) and conventional coefficient (r(2)) of 0.636 and 0.986, respectively. Both models were validated by an external test set of eight compounds and gave satisfactory prediction (r(pred)(2)) of 0.772 and 0.701 for CoMFA and CoMSIA models, respectively. This pharmacophore based 3D-QSAR approach provides significant insights that can be used to design novel, potent and selective SHE inhibitors.
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Guanidinas/química , Modelos Moleculares , Relação Quantitativa Estrutura-Atividade , Quinolinas/química , Trocadores de Sódio-Hidrogênio/antagonistas & inibidores , Desenho de Fármacos , Ligação de Hidrogênio , Interações Hidrofóbicas e Hidrofílicas , Trocadores de Sódio-Hidrogênio/metabolismoRESUMO
Catharanthus roseus synthesizes bioactive therapeutic metabolites, known as monoterpenoid indole alkaloids (MIAs), including antineoplastic vinblastine and vincristine, which have high global demand, and antihypertensive ajmalicine, a serpentine. However, the in planta biosynthesis and accumulation of these phytopharmaceuticals are very low, attributed to their high cytotoxicity in the plant. Considering the low in planta concentration and over-harvesting of plant resources, biotechnological interventions have been undertaken to enhance the production of MIAs in plant systems. The present study was carried out to mutation through chemical and physical mutagenesis with sodium azide, ethyl methane sulfonate and X-rays, respectively, on C. roseus to determine their possible effects on the transcriptional modulation of MIA biosynthetic pathways in planta. The chemical mutagenesis resulted in delayed seed pod development in mutated C. roseus plants, with distinct leaf morphology and flower color. However, X-ray mutagenesis resulted in pollen-less sterile flowers. An HPLC analysis confirmed the higher catharanthine, vindoline and vinblastine content in sodium azide and X-ray mutants, and was further supported by higher PRX1 transcript levels estimated through real-time PCR analysis. The transcription factors WRKY1 and ORCA2 were found negatively regulated along with major MIA pathway genes in chemical mutants and their M1 generation, but showed positive regulation in X-ray M0 mutants. The induced mutagenesis of C. roseus provides a prospective strategy to modulate plant transcriptomes and enhance the biosynthesis of pharmaceutically important antineoplastic vinblastine in the plant.