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BACKGROUND/OBJECTIVES: Cyclosporine A (CSA) dosing has been complicated by considerable intra-patient and inter-patient variability in pharmacokinetics, which is affected by different factors. We aimed to assess the various factors that might affect the CSA dose and its plasma level. PATIENTS AND METHODS: This retrospective study included paediatric cancer patients who underwent allogeneic hematopoietic stem cell transplant at the Children's Cancer Hospital Egypt 57357 from matched related donors with CSA as graft versus host disease prophylaxis. The CSA initial dose was 1.5â mg/kg IV Q12H. Then, it was titrated according to the level and drug toxicity. Cyclosporine A trough levels were assessed two to three times per week using the Emit 2000 cyclosporine-specific assay. Moreover, factors that may affect cyclosporine levels, such as age, sex, weight and the antifungal used, were analyzed to determine their effect on CSA plasma levels. RESULTS: There were 119 patients included in the study. The median age was 10 years; and 43% of them used voriconazole as a prophylactic antifungal. The multivariate analysis revealed that female patients, those >9 years or on voriconazole reached the target level at low initial CSA doses. A higher probability (93%) of reaching the desired plasma level with doses 1.5â mg/kg IV Q12H was observed among patients >9 years, and on voriconazole. While those who were ≤9 years and not on voriconazole required doses >1.5â mg/kg IV Q12H, with an 89% probability of reaching the desired level. CONCLUSION: This study suggests that the initial CSA dose should consider the patient's age and the antifungal used. Patients >9 years and/or on voriconazole may require lower initial CSA doses and could start with 1.5â mg/kg IV Q12H.
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BACKGROUND: Neuromyelitis optica spectrum disease (NMOSD) and multiple sclerosis (MS) share clinical presentations including optic neuritis and brainstem syndromes. Internuclear ophthalmoplegia (INO) is characterized by slowed ipsilateral adduction saccades and results from a lesion in the medial longitudinal fasciculus (MLF). Although INO is a common clinical finding in MS, its prevalence in NMOSD is unknown. The objective of this work is to determine the comparative frequencies of INO in patients with NMOSD and MS and compare clinical features of both disease processes. METHODS: This is a retrospective study of patients 18 years and older who have an established diagnosis of NMOSD or MS and were evaluated by both neuro-ophthalmology and neuro-immunology specialists between 2014 and 2020. Electronic medical records were screened for documentation of an acute INO at any time during follow-up. Incidence rates were calculated from number of cases of new-onset INO and patient years observed. Logistic regression was used to evaluate the likelihood of developing an INO at any time point for NMOSD vs MS patients. Multivariable analysis was performed by adjusting for age, race, gender, and length of follow-up. RESULTS: Two hundred eighty patients (80 NMOSD, 200 MS) were included. Age range was 18-79 years with a mean age of 35.14 (SD ± 12.41 years). Average length of follow-up in MS and NMOSD patients was 4.18 years vs 3.79 years, respectively (P > 0.05), and disease duration before the start of the study in MS and NMOSD was 8.76 years vs 4.65 years, respectively (P < 0.01). Mean disease duration and follow-up time of both groups was 7.58 years and 4.07 ± 2.51 years, respectively. NMOSD patients were predominantly seropositive for AQP4 antibody (61.25%, n = 49). Individuals who had MOG antibody but also met NMOSD criteria were also included (18.75%, n = 15). The frequency of INO at any time point was 1.25% (n = 1) in NMOSD compared with 16% (n = 32) in MS. The incidence rate of new-onset INO in NMOSD (excluding MOGAD) was 3.8/1,000 person years and 23.9/1,000 person years in MS. Adjusted analysis showed that NMOSD patients were 13.89 times (odds ratio [OR] 0.07, 95% confidence interval [CI] 0.01-0.598, P = 0.015) less likely to develop an INO compared with those with MS when including MOGAD patients, 12.5 times less likely (OR 0.08, 95% CI: 0.10-0.67, P = 0.02) when excluding MOGAD patients and 9.62 times less likely (OR 0.10, 95% CI: 0.01-0.87, P = 0.036) for AQP4+ patients. CONCLUSIONS: Our study shows that the incidence of new INO (3.8 vs 23.9 per 1,000 person years), and the odds of having INO at any time point are significantly lower in NMOSD than MS. This suggests that INO and consequently MLF lesions are less common in NMOSD. The presence of an INO may help in the differentiation of NMOSD from MS and may aid in earlier implementation of disease appropriate therapy.
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Esclerosis Múltiple , Neuromielitis Óptica , Trastornos de la Motilidad Ocular , Adolescente , Adulto , Anciano , Acuaporina 4 , Autoanticuerpos , Humanos , Persona de Mediana Edad , Esclerosis Múltiple/complicaciones , Esclerosis Múltiple/diagnóstico , Esclerosis Múltiple/epidemiología , Glicoproteína Mielina-Oligodendrócito , Neuromielitis Óptica/complicaciones , Neuromielitis Óptica/diagnóstico , Neuromielitis Óptica/epidemiología , Estudios Retrospectivos , Adulto JovenRESUMEN
INTRODUCTION: There is a lack ofevidence about resource use and costs of childhood cancer care in Egypt. Knowledge about resource use/costs can help in better resource planning to improve care and outcomes efficiently. In this study, we estimated patterns and trends of hospital resource use and costs for children with cancer (n = 8886, aged 0-18 years) treated at Children's Cancer Hospital, Egypt (CCHE), between 2013 and 2017, by ICCC-3 groups, at one and three years post-diagnosis. METHODS: We estimated costs from the healthcare provider perspective, expressed in USD 2019. We also studied resource use/cost trends, and factors associated with inpatient days and costs. RESULTS: For all cancers combined, median costs were $14,774 (IQR: $6,559-$23,738) at one year and $19,799 (IQR: $8,921-$34,204) at three years post-diagnosis. Median inpatient days were 38 days (IQR: 17-60) at one year, and 43 days (IQR: 20-74) at three years post-diagnosis. Patients with acute lymphoblastic leukemia (ALL), acute myeloid leukemia (AML), and neuroblastoma imposed the greatest financial burden on CCHE, representing 53.1% of total costs. AML patients had the highest costs/resource use of all childhood cancers. Cost trends decreased by 2.9% (P < 0.001) for all cancers combined, due to economic instability in Egypt between 2013 and 2017. The use of IV supportive drugs increased by 24.3% (P < 0.001) over time for children with solid tumors. CONCLUSION: These findings will inform hospital resource planning and budgeting to promote value in care delivery, with implications for pediatric oncology practice and policy in Egypt/CCHE. Estimated costs provide the foundation for cost-effectiveness analysis.
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Instituciones Oncológicas , Recursos en Salud , Costos de Hospital , Instituciones Oncológicas/economía , Niño , Estabilidad Económica , Egipto , Humanos , Leucemia Mieloide Aguda/economía , Neuroblastoma/economía , Leucemia-Linfoma Linfoblástico de Células Precursoras/economía , Estudios RetrospectivosRESUMEN
A facile one-pot method was utilized at room-temperature for the synthesis of novel ternary nanocomposite of Ag@RGO/ZnO, which is introduced as a low cost, efficient and reliable UV absorber. The crystalline, morphological, structural, and optical characteristics of the as-synthesized samples were investigated by various techniques such as XRD, FE-SEM, HR-TEM, XPS, and DRS. The measurements confirm the successful fabrication of the Ag@RGO/ZnO ternary nanocomposite. Optical characterization showed the synergetic role of Ag NPs and RGO NSs in the enhancement of the light absorption of the ternary nanocomposite in the UV portion compared to the bare ZnO NPs. Additionally, band-gap narrowing was observed due to the Ag-doping impact where potential applications for the proposed nanocomposite have been suggested.
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Recent studies suggest abnormal microRNA (miRNA) expression may have potential prognostic value in childhood acute lymphoblastic leukemia (ALL). In this systematic review, we searched different databases (PubMed, ASH, ASCO, and SIOP) for studies published from 2008 to 2018 that evaluated the prognostic impact of miRNAs in childhood ALL. We also used DIANA-miRPath v3.0 to further characterize the functional role of the significant prognostic miRNAs identified in our systematic review. Here we evaluate 15 studies with a total of 38 different miRNAs and 1545 children with B-cell ALL (B-ALL) or T-cell ALL (T-ALL) recruited over approximately 3 decades (1984-2016) with different treatment protocols and ethnicities. Out of the 15 studies examined, 14 reported 32 dysregulated miRNAs with significant prognostic impact in pediatric ALL patients. Only one Brazilian study reported no significant prognostic effect of 7 miRNAs, while the seventh miRNA (miR-100) showed prognostic significance in a Chinese study. Using DIANA-TarBase v7.0 of DIANA-miRPath v3.0, pathway enrichment analysis revealed 25 miRNAs modulated 24 molecular pathways involved in cancer development. To remove the effect of salvage therapy, 9 studies carried out multivariate cox regression analysis for both relapse-free survival and disease-free survival to develop a panel of 23 miRNAs acting as independent prognostic biomarkers. To enhance the clinical application, utility, and validity of the miRNAs discussed here, their potential prognostic value should be confirmed in larger cohort studies within different ethnicities and different ALL protocols adjusted for other contemporary validated prognostic factors in childhood ALL.
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MicroARNs/genética , Leucemia-Linfoma Linfoblástico de Células Precursoras/genética , Biomarcadores de Tumor/genética , Niño , Humanos , MicroARNs/biosíntesisRESUMEN
Introduction and importance: Bladder diverticula are commonly due to obstruction of the bladder outlet and are typically treated conservatively. However, the rarity and complexity of multiple giant diverticula require a tailor-made surgical approach. Case presentation: We report on a 72-year-old male who presented with severe urinary symptoms and lumbar pain, diagnosed with multiple giant bladder diverticula, including one compressing the ureter. The complex presentation of the patient, including his age and comorbidities, added layers of complexity to the clinical decision-making process. Interventions and outcomes: The patient underwent a two-stage surgery consisting of transurethral prostate resection followed by resection of three diverticula. Postoperatively, the patient showed a remarkable improvement in urinary symptoms, resolution of hydronephrosis, and, more importantly, no complications, demonstrating the efficacy and safety of the surgical strategy chosen. Relevance and impact: This case underscores the challenges in managing complex bladder diverticula, highlighting the importance of personalized treatment strategies and further research in atypical urological conditions. Furthermore, this case highlights the need to increase awareness and research on rare urological conditions. By sharing detailed insights from this case, we aim to enrich the clinical knowledge base, ultimately improving patient outcomes in similar challenging scenarios.
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This work was designed to evaluate the advantages of using multi-strain probiotics feed (Bacillus subtilis, Bacillus licheniformis and Clostridium butyricum) (PRO) and alpha-monolaurin (AML) on laying performance, criteria of egg quality, blood parameters, and yolk fatty acids' profile in laying hens. One hundred forty of Bovans brown laying hens at 45 weeks old (25th week of egg production) were randomly allocated into four groups, with seven replicates of five birds each in a complete randomized design. The first group was fed a basal diet without feed additives (0 g/kg diet), and the second, third, and fourth groups received diets containing 1 g PRO, 1 g AML, and 1 g PRO + 1 g AML/kg diet, respectively. No significant impacts of PRO, AML, or their mixture on body weight (BW), body weight gain (BWG), feed intake (FI), or egg weight. Egg production, egg mass, and feed conversion ratio (FCR) were enhanced by 1 g PRO/kg and /or 1 g AML/kg supplementation in laying hen diets. Furthermore, egg shape index, eggshell thickness, and yolk color were statistically higher by PRO and AML supplementation at 55 weeks. However, oviduct, infundibulum, and uterus weights were significantly decreased by 1 g PRO or/and 1 g AML. Additionally, total cholesterol, triglycerides, low density lipoprotein (LDL), glucose, and glutamate pyruvate transaminase (GPT) levels were decreased by PRO and AML supplementation. In conclusion, it seems that dietary inclusion with 1 g PRO/kg, 1 g of AML/kg, and 1 g PRO + 1 g AML improved egg production, egg mass, FCR, and yolk fatty acids profile and lowered total cholesterol and malondialdehyde (MDA) contents in laying hens.
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Alimentación Animal , Pollos , Huevos , Ácidos Grasos , Lauratos , Probióticos , Animales , Pollos/fisiología , Pollos/crecimiento & desarrollo , Probióticos/administración & dosificación , Probióticos/farmacología , Femenino , Ácidos Grasos/metabolismo , Ácidos Grasos/análisis , Huevos/análisis , Alimentación Animal/análisis , Lauratos/farmacología , Bacillus subtilis , Clostridium butyricum , Bacillus licheniformis , Yema de Huevo/química , Suplementos Dietéticos/análisis , Dieta/veterinaria , Óvulo , MonoglicéridosRESUMEN
Barium phosphate (Ba3(PO4)2) is a class of material that has attracted significant attention thanks to its chemical stability and versatility. However, the use of Ba3(PO4)2 as a photocatalyst is scarcely reported, and its use as a photocatalyst has yet to be reported. Herein, Ba3(PO4)2 nanoflakes synthesis is optimized using sol-gel and hydrothermal methods. The as-prepared Ba3(PO4)2 powders are investigated using physicochemical characterizations, including XRD, SEM, EDX, FTIR, DRS, J-t, LSV, Mott-Schottky, and EIS. In addition, DFT calculations are performed to investigate the band structure. The oxidation capability of the photocatalysts is investigated depending on the synthesis method using rhodamine B (RhB) as a pollutant model. Both Ba3(PO4)2 samples prepared by the sol-gel and hydrothermal methods display high RhB photodegradation of 79% and 68%, respectively. The Ba3(PO4)2 obtained using the sol-gel process exhibits much higher stability under light excitation after four regeneration cycles. The photocatalytic oxidation mechanism is proposed based on the active species trapping experiments where O2 â¢â is the most reactive species. The finding shows the promising potential of Ba3(PO4)2 photocatalysts and opens the door for further investigation and application in various photocatalytic applications.
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Background and objective While the potential of machine learning (ML) in healthcare to positively impact human health continues to grow, the potential for inequity in these methods must be assessed. In this study, we aimed to evaluate the presence of racial bias when five of the most common ML algorithms are used to create models with minimal processing to reduce racial bias. Methods By utilizing a CDC public database, we constructed models for the prediction of healthcare access (binary variable). Using area under the curve (AUC) as our performance metric, we calculated race-specific performance comparisons for each ML algorithm. We bootstrapped our entire analysis 20 times to produce confidence intervals for our AUC performance metrics. Results With the exception of only a few cases, we found that the performance for the White group was, in general, significantly higher than that of the other racial groups across all ML algorithms. Additionally, we found that the most accurate algorithm in our modeling was Extreme Gradient Boosting (XGBoost) followed by random forest, naive Bayes, support vector machine (SVM), and k-nearest neighbors (KNN). Conclusion Our study illustrates the predictive perils of incorporating minimal racial bias mitigation in ML models, resulting in predictive disparities by race. This is particularly concerning in the setting of evidence for limited bias mitigation in healthcare-related ML. There needs to be more conversation, research, and guidelines surrounding methods for racial bias assessment and mitigation in healthcare-related ML models, both those currently used and those in development.
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In 1981, Danish physician Jens Thomsen conducted the first and only documented sham-controlled surgical trial in the history of otolaryngology. This trial is historically significant as it was the first in the field to use a methodologically sound study design to address a frustratingly complex disorder such as Ménière's disease. Despite this, historical interpretations of this work have varied, and questions about the results have been raised. We review the fascinating historical context of this landmark trial and detail how it was influenced by the rise of the randomized controlled trial. We examine how subsequent statistical analyses and interpretations of this historical work have affected surgical treatment paradigms in Ménière's disease, and we look forward to suggest the legacy of this work as a sham-controlled surgical trial in otolaryngology.
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Saco Endolinfático , Enfermedad de Meniere , Humanos , Saco Endolinfático/cirugía , Enfermedad de Meniere/cirugía , Ensayos Clínicos Controlados Aleatorios como AsuntoRESUMEN
Ameloblastic carcinoma (AC) is a rare and aggressive malignant epithelial odontogenic tumor making up less than 1% of malignant head and neck tumors. The majority of cases occur in the mandible with a minority occurring in the maxilla. Most occur de novo, while rare cases of AC have resulted from transformation from ameloblastoma. Here, we present a case in which a 30-year-old man presented with proptosis and a recurrent right temporal mass, which had been previously diagnosed as ameloblastoma on surgical pathology. CT findings demonstrated local invasion, and he was subsequently taken to the operating room for right craniotomy, infratemporal and middle cranial fossa tumor resection, and right modified radical neck dissection with reconstruction. Final pathology, which included areas of early focal necrosis, loss of peripheral palisading, and hyperchromatism, confirmed the diagnosis of ameloblastoma with transformation to AC. We further discuss radiologic and histopathological signs of this rare tumor, as well as recommended treatment modalities.
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INTRODUCTION AND IMPORTANCE: A femoral hernia is a protrusion of the peritoneum through a defect in the femoral ring into the femoral canal. A rare form of a femoral hernia is a femorocele, which requires a highly skilled physician for accurate diagnosis and management. Clinical examination is the gold standard for diagnosis, with a CT used to confirm clinical suspicion. Once diagnosed, the only curative option is surgery. This case report provides evidence for the use of robotics to treat a femorocele. CASE PRESENTATION: A 23-year-old female with a two-year history of a non-reducible fluid-filled swelling in the right groin presented to the surgical clinic. Upon clinical suspicion and CT imaging, a femorocele was diagnosed. The surgeon opted for a femoral hernia repair using the da Vinci surgical system. Peritoneal connection with the hernia sac was noted, confirming the diagnosis. The content of the cystic mass was reduced; further to that, the omental content was also reduced and the hernia was repaired. The patient tolerated the procedure with no complications. CLINICAL DISCUSSION: This case highlights the use of robotics to treat a rare clinical entity. Robotics was used for this case as it provided exceptional ergonomics, three-dimensional visualization, and wristed movements. CONCLUSION: A femorocele is a rare form of a femoral hernia that requires accurate diagnosis and proper management. In this case, we demonstrated the possibility of using robotics as a viable option for treatment of a femorocele.
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Solar hydrogen (H2 ) generation via photocatalytic water splitting is practically promising, environmentally benign, and sustainably carbon neutral. It is important therefore to understand how to controllably engineer photocatalysts at the atomic level. In this work, atomic-level engineering of defected ReSe2 nanosheets (NSs) is reported to significantly boost photocatalytic H2 evolution on various semiconductor photocatalysts including TiO2 , CdS, ZnIn2 S4 , and C3 N4 . Advanced characterizations, such as atomic-resolution aberration-corrected scanning transmission electron microscopy (AC-STEM), synchrotron-based X-ray absorption near edge structure (XANES), in situ X-ray photoelectron spectroscopy (XPS), transient-state surface photovoltage (SPV) spectroscopy, and transient-state photoluminescence (PL) spectroscopy, together with theoretical computations confirm that the strongly coupled ReSe2 /TiO2 interface and substantial atomic-level active sites of defected ReSe2 NSs result in the significantly raised activity of ReSe2 /TiO2 . This work not only for the first time realizes the atomic-level engineering of ReSe2 NSs as a versatile platform to significantly raise the activities on different photocatalysts, but, more importantly, underscores the immense importance of atomic-level synthesis and exploration on 2D materials for energy conversion and storage.
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PURPOSE: The aim of this systematic review and meta-analysis is to evaluate the effect of mindfulness-based interventions (MBIs) on post-surgical pain in patients undergoing a total hip replacement (THR) or total knee replacement (TKR). METHODS: We performed a systematic review and meta-analysis in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. A search of multiple databases, including PubMed and EMBASE, was performed for studies from database inception through March 2nd, 2022. Data were extracted, and pooled estimates of standardized mean differences in pain scores were calculated using a random effects model and inverse probability weighting. RESULTS: Two randomized control trials were eligible for inclusion (299 patients). The average ages of participants in each study were similar at 65.5 and 64.8 years, and both studies were predominantly female at 72.4% and 61.9%. The mindfulness intervention ranged from an eight-week program to a 20-minute session. Both individual studies reported statistically significant reductions in postoperative pain for MBI groups. The pooled standardized mean difference in pain scores for the MBI groups compared to the control groups was -1.94 (-3.39; -0.48). CONCLUSIONS: There exists preliminary evidence for the beneficial effect of MBIs on reducing the postoperative pain experience in this patient population. Given the significant consequences of postoperative pain and the necessity for non-opioid forms of analgesia, this topic represents a promising area of research that warrants future randomized control trials to better understand the role of MBIs for postoperative analgesia.
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Water pollution is one of the global threats severely affecting our planet and human health. Organic textile dyes are one of the common organic water pollutants that are presentient to degradation by traditional physical methods. Semiconductor-assisted photocatalysis is considered a green, efficient, and sustainable technology for wastewater treatment. To maximize the efficient utilization of solar radiation, it is of pivotal significance to explore novel organic molecules to be employed as efficient dye sensitizers for wide-bandgap semiconductors to extend their performance to the Visible-light region. Hence, in this work, we are proposing the design and synthesis of novel structures of QAD molecule as a dye photosensitizer with extended visible light absorptivity due to the extended π-π/n-π conjugations, to promote the performance of TiO2 nanoparticles to the visible-light region and enhance the charge separation. The physicochemical characterizations confirmed the successful synthesis of QAD, TiO2, and QAD/TiO2 samples with the proposed structures. The anchoring of QAD molecules on the surface of TiO2 caused a substantial improvement in the optical characteristics of TiO2 as well as overcoming its common drawbacks by decreasing its bandgap energy to 2.6 eV, a remarkable reduction of PL intensity indicating reducing the e-h recombination and enhancing the charge separation, and creation of efficient visible light-harvesting antenna in the range of 400-600 nm. Besides, the QAD/TiO2 sample achieved a 3-fold enhancement in the observed rate constant of the photodegradation of Rhodamine B dye compared to the bare TiO2. The parameters affecting the photodegradation process were optimized and the sample displayed outstanding stability after 4 consecutive cycles. Finally, the effect of the scavengers was investigated and [Formula: see text] was proposed to be the most reactive species and the mechanism of the enhancement was suggested based on the electron injection from the QAD's HOMO level to the TiO2's CB. Finally, this work opens the door for various studies for the investigation of the proposed structures or similar structures in various photocatalytic/biomedical applications.
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We report on the electrochemical determination of one the most effective and widely used chemotherapeutic, anti-inflammatory, and immunomodulator agents, methotrexate (MTX), using low-cost, green, and facile one-pot prepared graphitic carbon nitride (g-CN ) nanosheets. The g-CN nanosheets have been characterized utilizing Fourier transform infrared spectroscopy, X-ray diffraction(XRD), scanning electron microscopy(SEM), and density functional theory (DFT). In comparison to the bare carbon paste electrode (CPE), the g-CN -modified electrode showed a spectacular enhancement in the electrochemical oxidation and detection abilities of MTX. The proposed material exhibits very low limits of detection (12.45 nM) and quantification (41.5 nM), while possessing a wide linear range of 0.22-1.11 µM and 1.11-27.03 µM under optimized conditions at pH 7.0. Due to the ease of preparation of g-CN, it can be adopted for the cost-effective detection of MTX in industrial and clinical analyses.
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Grafito , Metotrexato , Técnicas Electroquímicas/métodos , Grafito/química , Carbono/química , Factores InmunológicosRESUMEN
Background: The direction toward incorporating clinical pharmacy services is increasing worldwide but there are many barriers that hinder its implementation in many countries. The types of barriers vary among countries according to their culture, population, education & economic status. Objective: This study aims to investigate factors hindering the implementation of clinical pharmacy practice in Egyptian hospitals. Methods: Hundred hospital pharmacists working in various reputable hospitals in Egypt participated in a descriptive cross-sectional survey designed as a questionnaire representing the main factors previously reported in the literature to hinder clinical pharmacy implementation in different countries around the world. Cronbach alpha was calculated to test the reliability of the questionnaire. Likert plot was used to graphically present the participants' responses. Results: The most significant factors that participants reported to hinder the implementation of clinical pharmacy practice in Egyptian hospitals were the lack of clear career path, financial resources, and leadership support. The percentage of participants who agreed that such factors were key players in hindering the implementation of clinical pharmacy practice was 76%, 74%, and 57% respectively. Conclusion: A number of factors were found to impede clinical pharmacy implementation in Egyptian hospitals. Taking corrective measures to resolve such hindrances should ensure proper hospital pharmacy practice and should positively reflect on patient healthcare services provided at the national level.
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INTRODUCTION: The 0.19 mg fluocinolone acetonide (FAc) intravitreal implant delivers a continuous intravitreal corticosteroid dose for the treatment of refractory diabetic macular oedema (DMO). The aim of this study was to assess the impact of an FAc intravitreal implant on intraocular pressure (IOP). METHODS: We retrospectively collected anonymised data on the patients' characteristics, DMO treatment, and IOP and IOP-lowering treatments before and after the FAc intravitreal implant between September 2013 and March 2020 in several European centres. RESULTS: A total of 221 eyes from 179 patients were included. The mean follow-up duration was 13.4 (± 12.5, range 2.4-33.5) months. Overall, 194 eyes (88.2%) had received an intravitreal dexamethasone injection before the FAc intravitreal implant. For 25 eyes (11.3%) there was a history of glaucoma, and 52 eyes (23.5%) had previous IOP-lowering treatment. Mean IOP before injection was 14.7 (3.4) mmHg and increased to 16.9 (3.7) mmHg 12 months after injection (P < 0.0001). During follow-up, 55 eyes (24.9%) required the addition or initiation of topical IOP-lowering medication, only one patient (0.5%) had laser trabeculoplasty and one patient (0.5%) a minimally invasive glaucoma surgery, and no patient required incisional IOP-lowering surgery. CONCLUSION: The FAc intravitreal implant led to substantial IOP elevation. This elevation was monitored most of the time with addition or initiation of topical IOP-lowering medication.
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Pristine and Co-doped TiO2 mesocrystals have been synthesized via a simple sol-gel method and their antimicrobial activity has been investigated. The antimicrobial performance was evaluated in terms of zone of inhibition, minimum inhibitory concentration (MIC), antibiofilm activity, and effect of UV illumination in liquid media. The Co-doped TiO2 mesocrystals showed very promising MIC of 0.390 µg/mL and 0.781 µg/mL for P. mirabilis and P. mirabilis, respectively. Additionally, the material showed an MIC of 12.5 µg/mL against C. albicans, suggesting its use as antifungal agent. Upon the addition of 10.0 µg/mL of Co-doped TiO2 mesocrystals, the biofilm inhibition% reaches 84.43% for P. aeruginosa, 78.58% for P. mirabilis, and 77.81% for S. typhi, which can be ascribed to the created active oxygen species that decompose the tested microbial cells upon illumination. Thus the fabricated Co-doped TiO2 mesocrystals exhibit sufficient antimicrobial features under visible light, qualifying them for use as antimicrobial agents against pathogenic bacteria and fungi and subsequently inhibit their hazardous effects.