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1.
J Family Med Prim Care ; 13(5): 2037-2043, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38948635

RESUMO

Background: Hypertension is one of the leading causes of death worldwide, affecting over one billion people. It is responsible for roughly half of all heart disease and stroke-related deaths globally. Because hypertension does not cause any symptoms on its own, it is commonly referred to as "the silent killer." Objective: This study aimed to determine (1) the prevalence of hypertension and its associated risk factors and (2) the level of awareness of hypertension status among study participants. Material and Methods: A facility-based cross-sectional analytical study was conducted for 3 months during January-March 2023 at the teaching institution in Etawah District, Uttar Pradesh. It was conducted among 392 study participants who were ≥18 years old. Data were collected through a predesigned, pretested, semi-structured questionnaire, and anthropometric measurement was determined using standard guidelines. Results: The overall prevalence of hypertension screening was 69.4% (male: 33.8% and female: 66.2%), respectively. The majority of hypertensives were found in female participants. Tobacco and alcohol consumption, obesity, physical inactivity, stress and strain, and an unhealthy diet were also associated with hypertension. Among 392 study participants, only 67 (24.6%) were aware of their hypertension status. Conclusion: We conclude that hypertension has been described as an "Iceberg disease" as those who suffer are usually unaware and hence usually seek healthcare services at a very late stage. Preventive measures should be needed to improve hypertension screening, awareness, treatment, and control.

2.
Epilepsy Behav ; 116: 107788, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33581600

RESUMO

OBJECTIVE: This study was conducted to evaluate the effect of embelin (EMB) on various epileptic models and related brain inflammation. METHODS: Male Swiss albino mice were administered EMB (5, 10, and 20 mg/kg/p.o.) in acute and chronic study for 7 days and 35 days, respectively. Acute study included increasing current electroshock (ICES) and pentylenetetrazol (PTZ)-induced seizure test. Step-down latency (SDL) and forced swim test (FST) were performed to evaluate cognitive functions and depression-like behavior, respectively. Chronic study included PTZ-induced kindling. Levels of inflammatory biomarkers, namely interleukin-1 beta (IL-1ß), interleukin-1 receptor antagonist (IL-1Ra), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α), were estimated in the hippocampus and cortex of the kindled brains by ELISA technique. Further, neurotransmitters (NTs), namely gamma aminobutyric acid (GABA), glutamate, and dopamine, were estimated by using validated liquid chromatography-mass spectrometry (LC-MS) method followed by ultra-high-performance liquid chromatography (UHPLC). RESULTS: Embelin (EMB) treatment increased the seizure threshold to hind limb extension (HLE) in the ICES test and decreased the seizure scores in the kindling experiment. Significantly low levels of IL-1ß, IL-1Ra, IL-6, and TNF-α were observed in the hippocampus of PTZ + EMB (10 and 20 mg/kg)-treated groups compared with PTZ+ vehicle-treated group. Significantly lower levels of IL-1Ra, IL-6, and TNF-α compared with PTZ+ vehicle-treated group were observed in the cortex of PTZ + EMB (10 and 20 mg/kg)-treated groups, while IL-1ß levels were found to be significantly lower only in the cortex of PTZ + EMB (20 mg/kg)-treated group. Increased levels of dopamine and GABA and decreased levels of glutamate in both hippocampus and cortex were observed in EMB + PTZ-treated groups compared with vehicle + PTZ-treated group. Latency of step down was found to be increased and immobility time in FST was decreased in EMB + PTZ groups compared with vehicle + PTZ group. CONCLUSION: Embelin suppressed epileptogenesis in the kindled mice via neurochemical modulation of neurotransmitters and inhibiting the inflammatory pathway. Further, EMB was also observed to be protecting the kindled animals from cognition and depression-like behavior.


Assuntos
Disfunção Cognitiva , Encefalite , Excitação Neurológica , Animais , Benzoquinonas , Masculino , Camundongos , Pentilenotetrazol/toxicidade
3.
Pharmacol Biochem Behav ; 200: 173073, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33186562

RESUMO

BACKGROUND: Emerging hypotheses in the pathophysiology of major depressive disorder (MDD) indicate the role of neurotrophic factors and inflammation. This study assessed the association between therapeutic response of bupropion and serum brain-derived neurotrophic factor (BDNF) and tumour necrosis factor-α (TNF-α) levels in patients with MDD. METHODS: Thirty patients (aged 18 to 60 years) with MDD diagnosed by DSM-5 criteria, with Hamilton Depression Rating scale (HAM-D) score ≥ 20 were included in the study. Patients were given bupropion sustained release (SR) in the doses of 150 mg once daily. All patients were followed up for 12 weeks. RESULTS: HAM-D score at the start of the treatment was 25.57 ± 1.85 which significantly reduced to 10.8 ± 4.24 at 12 weeks of treatment. The serum BDNF level increased significantly (p < 0.05) from 2.42 ± 0.19 ng/ml to 2.97 ± 0.10 ng/ml and the levels of serum TNF-α reduced significantly (p < 0.05) from 4.45 ± 0.95 pg/ml to 2.11 ± 0.84 pg/ml at 12 weeks of treatment, in responders to treatment. CONCLUSION: The results of our study suggest that bupropion SR monotherapy is effective and well tolerated in MDD patients with moderate to severe depression, and its therapeutic efficacy is accompanied by an increase in serum BDNF levels and a decrease in serum TNF-α levels.


Assuntos
Antidepressivos de Segunda Geração/uso terapêutico , Fator Neurotrófico Derivado do Encéfalo/sangue , Bupropiona/uso terapêutico , Transtorno Depressivo Maior/tratamento farmacológico , Fator de Necrose Tumoral alfa/sangue , Adolescente , Adulto , Biomarcadores/sangue , Transtorno Depressivo Maior/sangue , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Escalas de Graduação Psiquiátrica , Resultado do Tratamento , Adulto Jovem
4.
J Cancer Res Ther ; 16(Supplement): S84-S89, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33380658

RESUMO

AIM: Zinc, a trace element, is known for downregulating several proangiogenic growth factors and cytokines. However, its antiangiogenic activity is not adequately studied. The present study was aimed to evaluate the possible antiangiogenic activity of zinc via the chick chorioallantoic membrane (CAM) assay. Furthermore, the antiangiogenic activity of the combination therapy of zinc with various doses of sorafenib, a tyrosine kinase inhibitor, was evaluated. MATERIALS AND METHODS: A pilot study was initially conducted so as to select suitable doses of zinc and sorafenib. The antiangiogenic activity after combining zinc 2.5 µg/embryo with sorafenib 1 and 2 µg/embryo was also evaluated. The antiangiogenic activity was quantified in terms of total length of blood vessels, number of junctions, number of branching points, and mean length of the blood vessels. RESULTS: Zinc 2.5 µg/embryo showed significant (P < 0.05) antiangiogenic activity, as compared to the control group. However, its effect was not comparable to that of sorafenib 2 µg/embryo. The combination of zinc 2.5 µg/embryo with sorafenib 2 µg/embryo did not show an additive/synergistic effect. The combination of zinc 2.5 µg/embryo with sorafenib 1 µg/embryo produced an antiangiogenic activity which was comparable (P > 0.05) to that of sorafenib 2 µg/embryo. CONCLUSION: Zinc caused significant antiangiogenic activity in the CAM assay. The lack of addition/synergism in the zinc-sorafenib combination could have been due to the variability in the dose/ratio selection. Addition of zinc to sorafenib therapy could improve treatment tolerability, reduce cost of therapy, and reduce the emergence of drug resistance. Future mechanistic studies could identify the exact pharmacodynamics of zinc as an angiogenesis inhibitor.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/farmacologia , Neoplasias/tratamento farmacológico , Neovascularização Patológica/tratamento farmacológico , Sorafenibe/farmacologia , Zinco/farmacologia , Inibidores da Angiogênese/farmacologia , Inibidores da Angiogênese/uso terapêutico , Animais , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Embrião de Galinha , Membrana Corioalantoide/irrigação sanguínea , Relação Dose-Resposta a Droga , Avaliação Pré-Clínica de Medicamentos , Resistencia a Medicamentos Antineoplásicos/efeitos dos fármacos , Sinergismo Farmacológico , Humanos , Neoplasias/irrigação sanguínea , Projetos Piloto , Sorafenibe/uso terapêutico , Zinco/uso terapêutico
6.
Clin Infect Dis ; 70(8): 1695-1700, 2020 04 10.
Artigo em Inglês | MEDLINE | ID: mdl-31247064

RESUMO

BACKGROUND: Botulism is a rare and potentially fatal paralytic disease caused by botulinum neurotoxin (BoNT). In April 2017, 4 California residents from 2 adjacent counties were hospitalized with suspected foodborne botulism, precipitating an investigation by state and local public health departments in California. METHODS: We interviewed suspected botulism patients and their families, inspected the suspect establishment, and collected suspect food. We tested patient sera, stool, and gastric aspirates using mouse bioassay for BoNT and/or culture for Clostridium botulinum. We tested suspect food and environmental samples for BoNT and confirmed presumptive positives using direct mouse bioassay and culture. We performed whole-genome sequencing on food and clinical isolates. RESULTS: From April 2017 through May 2017, 10 patients in the Sacramento area were hospitalized with laboratory-confirmed botulism; 7 required mechanical ventilation, and 1 died. Of 9 patients with information, all had visited Gas Station X before illness onset, where 8 reported consuming a commercial cheese sauce. BoNT/A and/or BoNT/A-producing C. botulinum were detected from each patient and from leftover cheese sauce. Clostridium botulinum isolates from 4 patients were closely related to cheese sauce isolates by whole-genome high-quality single-nucleotide polymorphism analysis. No other botulism cases associated with this cheese sauce were reported elsewhere in the United States. CONCLUSIONS: This large foodborne botulism outbreak in California was caused by consumption of commercial cheese sauce dispensed at a gas station market. The epidemiologic and laboratory evidence confirmed the cheese sauce as the outbreak source. The cheese sauce was likely locally contaminated, although the mechanism is unclear.


Assuntos
Botulismo , Queijo , Clostridium botulinum , Animais , Botulismo/epidemiologia , Clostridium botulinum/genética , Surtos de Doenças , Humanos , Camundongos , Saúde Pública
7.
Indian J Med Microbiol ; 37(1): 105-108, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31424019

RESUMO

Historical specimens collected from hospitalized children were tested for the following 13 viruses: influenza A and B; respiratory syncytial virus (RSV); parainfluenza viruses 1-3; human metapneumovirus; rhinovirus; coronaviruses 229E, OC43, NL63 and HKU1 and Adenovirus using monoplex real-time reverse transcriptase polymerase chain reaction (rRT-PCR). They were retested using TaqMan Array Card (TAC), a micro-fluidic system, capable of simultaneous multi-pathogen testing, to evaluate its sensitivity and specificity against monoplex rRT-PCR. TAC showed high sensitivity (71%-100%) and specificity (98%-100%) for these viruses in comparison to monoplex rRT-PCR. Multi-specimen detection with high sensitivity and specificity makes TAC a potentially useful tool for both surveillance and outbreak investigations.


Assuntos
Dispositivos Lab-On-A-Chip , Técnicas Analíticas Microfluídicas/métodos , Reação em Cadeia da Polimerase em Tempo Real/métodos , Infecções Respiratórias/diagnóstico , Infecções Respiratórias/virologia , Pré-Escolar , Humanos , Índia , Lactente , Recém-Nascido , Técnicas de Diagnóstico Molecular/métodos , Sensibilidade e Especificidade , Vírus/isolamento & purificação
8.
MMWR Morb Mortal Wkly Rep ; 67(5152): 1415-1418, 2019 Jan 04.
Artigo em Inglês | MEDLINE | ID: mdl-30605447

RESUMO

During September 29-October 6, 2017, the County of San Diego Public Health Services (COSD) was notified of two patients with suspected wound botulism and a history of using black tar heroin. On October 9, COSD, which had reported an average of one wound botulism case per year during 2001-2016, sent a health alert through the California Health Alert Network, notifying Southern California providers of these two patients, including their signs and symptoms and black tar heroin exposure. In collaboration with the California Department of Public Health, COSD conducted an investigation to identify additional cases, determine risk factors for illness, estimate cost of medical care, and develop recommendations to prevent further illness. By April 18, 2018, nine (eight confirmed and one probable) patients with wound botulism were identified, all of whom were hospitalized; one of the nine died. All nine were persons who inject drugs; seven specifically reported using black tar heroin and six practiced subcutaneous injection known as skin popping. Clinically compatible signs and symptoms included muscle weakness, difficulty swallowing, blurred vision, drooping eyelids, slurred speech, difficulty breathing, loss of facial expression, or descending paralysis. All patients were treated with heptavalent botulism antitoxin (BAT). Wound botulism is likely underrecognized because of its rarity and the overlapping signs and symptoms with opioid intoxication, overdose, and other neurologic syndromes including Guillain-Barré syndrome, the Miller Fisher variant of Guillain-Barré syndrome, and myasthenia gravis. Prompt diagnosis, administration of BAT, and provision of supportive care can help stop the progression of paralysis and be lifesaving.


Assuntos
Botulismo/epidemiologia , Surtos de Doenças , Dependência de Heroína/complicações , Infecção dos Ferimentos/epidemiologia , California/epidemiologia , Humanos
9.
Open Forum Infect Dis ; 5(4): ofy061, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29946553

RESUMO

BACKGROUND: Real-time polymerase chain reaction (PCR) on respiratory specimens and serology on paired blood specimens are used to determine the etiology of respiratory illnesses for research studies. However, convalescent serology is often not collected. We used multiple imputation to assign values for missing serology results to estimate virus-specific prevalence among pediatric and adult community-acquired pneumonia hospitalizations using data from an active population-based surveillance study. METHODS: Presence of adenoviruses, human metapneumovirus, influenza viruses, parainfluenza virus types 1-3, and respiratory syncytial virus was defined by positive PCR on nasopharyngeal/oropharyngeal specimens or a 4-fold rise in paired serology. We performed multiple imputation by developing a multivariable regression model for each virus using data from patients with available serology results. We calculated absolute and relative differences in the proportion of each virus detected comparing the imputed to observed (nonimputed) results. RESULTS: Among 2222 children and 2259 adults, 98.8% and 99.5% had nasopharyngeal/oropharyngeal specimens and 43.2% and 37.5% had paired serum specimens, respectively. Imputed results increased viral etiology assignments by an absolute difference of 1.6%-4.4% and 0.8%-2.8% in children and adults, respectively; relative differences were 1.1-3.0 times higher. CONCLUSIONS: Multiple imputation can be used when serology results are missing, to refine virus-specific prevalence estimates, and these will likely increase estimates.

11.
Nepal J Ophthalmol ; 10(20): 130-138, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31056555

RESUMO

INTRODUCTION: Assessment of prescribing pattern at regular interval is essential to avoid inappropriate use of drugs, especially of antimicrobial drugs. OBJECTIVES: The present study was performed to evaluate the prescribing pattern of antimicrobial drugs in the Ophthalmology Out-Patient Department (OPD) of Santosh Medical College and Hospital, Ghaziabad, India. MATERIAL AND METHOD: The present study included a total 600 prescriptions of patients attending OPD. A structured proforma was used to record all necessary information of each patient including demographic profi le of patient, diagnosis, total number of drugs and antimicrobials prescribed, group of antimicrobial prescribed, the percentage of antimicrobials prescribed by generic name etc. Results: Total 600 prescriptions were evaluated. Mean age of the study subjects was 28.4 ± 15.05 years. Total 720 antimicrobials were prescribed and the average number of antimicrobial drugs per prescription was 1.2. Fluoroquinolones were most commonly prescribed antimicrobial drugs followed by aminoglycosides and macrolides. 85% of drugs were prescribed in the form of eye drops while 15% were in the form of an ointment. 1.2% of antimicrobial drugs were prescribed by generic names. Out of total antimicrobials drugs, 420 drugs were in the form of fi xed dose combination. Only 1.6% of drugs were prescribed from National Essential Medicines List (NEML) 2015, India. CONCLUSION: Most of the antimicrobials were prescribed by brand names which require important consideration to promote rational use of antimicrobial drugs. In addition, the number of drugs prescribed from NEML was very less, indicating the need of sensitization among prescribers for the promotion of rational use of drugs.


Assuntos
Instituições de Assistência Ambulatorial , Antibacterianos/farmacologia , Prescrições de Medicamentos/estatística & dados numéricos , Uso de Medicamentos/estatística & dados numéricos , Auditoria Médica , Padrões de Prática Médica , Centros de Atenção Terciária , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Humanos , Índia , Masculino , Pessoa de Meia-Idade , Oftalmologia , Pacientes Ambulatoriais , Estudos Prospectivos , Adulto Jovem
12.
J Infect Dis ; 216(6): 688-696, 2017 09 15.
Artigo em Inglês | MEDLINE | ID: mdl-28934425

RESUMO

Background: The role of human bocavirus (HBoV) in respiratory illness is uncertain. HBoV genomic DNA is frequently detected in both ill and healthy children. We hypothesized that spliced viral capsid messenger RNA (mRNA) produced during active replication might be a better marker for acute infection. Methods: As part of the Etiology of Pneumonia in the Community (EPIC) study, children aged <18 years who were hospitalized with community-acquired pneumonia (CAP) and children asymptomatic at the time of elective outpatient surgery (controls) were enrolled. Nasopharyngeal/oropharyngeal specimens were tested for HBoV mRNA and genomic DNA by quantitative polymerase chain reaction. Results: HBoV DNA was detected in 10.4% of 1295 patients with CAP and 7.5% of 721 controls (odds ratio [OR], 1.4 [95% confidence interval {CI}, 1.0-2.0]); HBoV mRNA was detected in 2.1% and 0.4%, respectively (OR, 5.1 [95% CI, 1.6-26]). When adjusted for age, enrollment month, and detection of other respiratory viruses, HBoV mRNA detection (adjusted OR, 7.6 [95% CI, 1.5-38.4]) but not DNA (adjusted OR, 1.2 [95% CI, .6-2.4]) was associated with CAP. Among children with no other pathogens detected, HBoV mRNA (OR, 9.6 [95% CI, 1.9-82]) was strongly associated with CAP. Conclusions: Detection of HBoV mRNA but not DNA was associated with CAP, supporting a pathogenic role for HBoV in CAP. HBoV mRNA could be a useful target for diagnostic testing.


Assuntos
Bocavirus/isolamento & purificação , Proteínas do Capsídeo/genética , Infecções por Parvoviridae/diagnóstico , Pneumonia Viral/diagnóstico , RNA Mensageiro/isolamento & purificação , RNA Viral/isolamento & purificação , Doença Aguda , Bocavirus/genética , Estudos de Casos e Controles , Criança , Pré-Escolar , Infecções Comunitárias Adquiridas/diagnóstico , Infecções Comunitárias Adquiridas/virologia , Hospitalização , Humanos , Lactente , Masculino , Nasofaringe/virologia , Orofaringe/virologia , Estudos Prospectivos , Manejo de Espécimes
13.
J Infect Dis ; 215(12): 1873-1882, 2017 06 15.
Artigo em Inglês | MEDLINE | ID: mdl-28520948

RESUMO

Background: The effect of body mass index (BMI) on community-acquired pneumonia (CAP) severity is unclear. Methods: We investigated the relationship between BMI and CAP outcomes (hospital length of stay [LOS], intensive care unit [ICU] admission, and invasive mechanical ventilation) in hospitalized CAP patients from the Centers for Disease Control and Prevention Etiology of Pneumonia in the Community (EPIC) study, adjusting for age, demographics, underlying conditions, and smoking status (adults only). Results: Compared with normal-weight children, odds of ICU admission were higher in children who were overweight (adjusted odds ratio [aOR], 1.7; 95% confidence interval [CI], 1.1-2.8) or obese (aOR, 2.1; 95% CI, 1.4-3.2), and odds of mechanical ventilation were higher in children with obesity (aOR, 2.7; 95% CI, 1.3-5.6). When stratified by asthma (presence/absence), these findings remained significant only in children with asthma. Compared with normal-weight adults, odds of LOS >3 days were higher in adults who were underweight (aOR, 1.6; 95% CI, 1.1-2.4), and odds of mechanical ventilation were lowest in adults who were overweight (aOR, 0.5; 95% CI, .3-.9). Conclusions: Children who were overweight or obese, particularly those with asthma, had higher odds of ICU admission or mechanical ventilation. In contrast, adults who were underweight had longer LOS. These results underscore the complex relationship between BMI and CAP outcomes.


Assuntos
Índice de Massa Corporal , Hospitalização/estatística & dados numéricos , Obesidade/complicações , Pneumonia/epidemiologia , Adolescente , Adulto , Idoso , Asma/complicações , Criança , Pré-Escolar , Infecções Comunitárias Adquiridas/epidemiologia , Comorbidade , Feminino , Humanos , Unidades de Terapia Intensiva/estatística & dados numéricos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Razão de Chances , Pneumonia/complicações , Estudos Prospectivos , Respiração Artificial/estatística & dados numéricos , Resultado do Tratamento , Adulto Jovem
14.
J Clin Microbiol ; 55(1): 79-89, 2017 01.
Artigo em Inglês | MEDLINE | ID: mdl-27795341

RESUMO

Both molecular and serological assays have been used previously to determine the etiology of community-acquired pneumonia (CAP). However, the extent to which these methods are correlated and the added diagnostic value of serology for respiratory viruses other than influenza virus have not been fully evaluated. Using data from patients enrolled in the Centers for Disease Control and Prevention (CDC) Etiology of Pneumonia in the Community (EPIC) study, we compared real-time reverse transcription-PCR (RT-PCR) and serology for the diagnosis of respiratory syncytial virus (RSV), human metapneumovirus (HMPV), parainfluenza virus 1 to 3 (PIV1, PIV2, and PIV3), and adenovirus (AdV) infections. Of 5,126 patients enrolled, RT-PCR and serology test results were available for 2,023, including 1,087 children below the age of 18 years and 936 adults. For RSV, 287 (14.2%) patients were positive by RT-PCR and 234 (11.6%) were positive by serology; for HMPV, 172 (8.5%) tested positive by RT-PCR and 147 (7.3%) by serology; for the PIVs, 94 (4.6%) tested positive by RT-PCR and 92 (4.6%) by serology; and for AdV, 111 (5.5%) tested positive by RT-PCR and 62 (3.1%) by serology. RT-PCR provided the highest number of positive detections overall, but serology increased diagnostic yield for RSV (by 11.8%), HMPV (by 25.0%), AdV (by 32.4%), and PIV (by 48.9%). The method concordance estimated by Cohen's kappa coefficient (κ) ranged from good (for RSV; κ = 0.73) to fair (for AdV; κ = 0.27). Heterotypic seroresponses observed between PIVs and persistent low-level AdV shedding may account for the higher method discordance observed with each of these viruses. Serology can be a helpful adjunct to RT-PCR for research-based assessment of the etiologic contribution of respiratory viruses other than influenza virus to CAP.


Assuntos
Infecções Comunitárias Adquiridas/diagnóstico , Técnicas de Diagnóstico Molecular/métodos , Pneumonia Viral/diagnóstico , Testes Sorológicos/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Hospitalização , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase em Tempo Real/métodos , Reação em Cadeia da Polimerase Via Transcriptase Reversa/métodos , Sensibilidade e Especificidade , Adulto Jovem
15.
J Infect Dis ; 213(4): 584-91, 2016 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-26180044

RESUMO

BACKGROUND: The clinical significance of viruses detected in patients with community-acquired pneumonia (CAP) is often unclear. METHODS: We conducted a prospective study to identify the prevalence of 13 viruses in the upper respiratory tract of patients with CAP and concurrently enrolled asymptomatic controls with real-time reverse-transcriptase polymerase chain reaction. We compared age-stratified prevalence of each virus between patients with CAP and controls and used multivariable logistic regression to calculate attributable fractions (AFs). RESULTS: We enrolled 1024 patients with CAP and 759 controls. Detections of influenza, respiratory syncytial virus, and human metapneumovirus were substantially more common in patients with CAP of all ages than in controls (AFs near 1.0). Parainfluenza and coronaviruses were also more common among patients with CAP (AF, 0.5-0.75). Rhinovirus was associated with CAP among adults (AF, 0.93) but not children (AF, 0.02). Adenovirus was associated with CAP only among children <2 years old (AF, 0.77). CONCLUSIONS: The probability that a virus detected with real-time reverse-transcriptase polymerase chain reaction in patients with CAP contributed to symptomatic disease varied by age group and specific virus. Detections of influenza, respiratory syncytial virus, and human metapneumovirus among patients with CAP of all ages probably indicate an etiologic role, whereas detections of parainfluenza, coronaviruses, rhinovirus, and adenovirus, especially in children, require further scrutiny.


Assuntos
Infecções Comunitárias Adquiridas/virologia , Pneumonia Viral/virologia , Sistema Respiratório/virologia , Vírus/isolamento & purificação , Adolescente , Adulto , Fatores Etários , Idoso , Doenças Assintomáticas , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Reação em Cadeia da Polimerase em Tempo Real , Vírus Sinciciais Respiratórios , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Vírus/classificação
16.
J Pediatr ; 167(4): 869-874.e1, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26231828

RESUMO

OBJECTIVE: To assess the relationship between secondhand smoke (SHS) exposure and disease severity among children hospitalized with community-acquired pneumonia (CAP). STUDY DESIGN: Children hospitalized with clinical and radiographic CAP were enrolled between January 1, 2010, and June 30, 2012 at 3 hospitals in Tennessee and Utah as part of the Centers for Disease Control and Prevention's Etiology of Pneumonia in the Community study. Household SHS exposure was defined based on the number of smokers in the child's home. Outcomes included hospital length of stay, intensive care unit admission, and mechanical ventilation. Proportional hazards and logistic regression models were used to assess associations between SHS exposure and outcomes. All models were adjusted for age, sex, race/ethnicity, household education level, government insurance, comorbidities, enrollment site, year, and season. RESULTS: Of the 2219 children included in the study, SHS exposure was reported in 785 (35.4%), including 325 (14.8%) with ≥2 smokers in the home. Compared with nonexposed children, the children exposed to ≥2 smokers had longer length of stay (median, 70.4 hours vs 64.4 hours; adjusted hazard ratio, 0.85; 95% CI, 0.75-0.97) and were more likely to receive intensive care (25.2% vs 20.9%; aOR, 1.44; 95% CI, 1.05-1.96), but not mechanical ventilation. Outcomes in children exposed to only 1 household smoker were similar to those in nonexposed children. CONCLUSION: Children hospitalized with CAP from households with ≥2 smokers had a longer length of stay and were more likely to require intensive care compared with children from households with no smokers, suggesting that they experienced greater pneumonia severity.


Assuntos
Infecções Comunitárias Adquiridas/diagnóstico , Pneumonia/diagnóstico , Poluição por Fumaça de Tabaco/efeitos adversos , Criança , Pré-Escolar , Infecções Comunitárias Adquiridas/fisiopatologia , Exposição Ambiental/efeitos adversos , Feminino , Hospitalização , Humanos , Lactente , Tempo de Internação , Masculino , Pneumonia/fisiopatologia , Modelos de Riscos Proporcionais , Análise de Regressão , Respiração Artificial , Tennessee , Utah
17.
N Engl J Med ; 372(9): 835-45, 2015 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-25714161

RESUMO

BACKGROUND: Incidence estimates of hospitalizations for community-acquired pneumonia among children in the United States that are based on prospective data collection are limited. Updated estimates of pneumonia that has been confirmed radiographically and with the use of current laboratory diagnostic tests are needed. METHODS: We conducted active population-based surveillance for community-acquired pneumonia requiring hospitalization among children younger than 18 years of age in three hospitals in Memphis, Nashville, and Salt Lake City. We excluded children with recent hospitalization or severe immunosuppression. Blood and respiratory specimens were systematically collected for pathogen detection with the use of multiple methods. Chest radiographs were reviewed independently by study radiologists. RESULTS: From January 2010 through June 2012, we enrolled 2638 of 3803 eligible children (69%), 2358 of whom (89%) had radiographic evidence of pneumonia. The median age of the children was 2 years (interquartile range, 1 to 6); 497 of 2358 children (21%) required intensive care, and 3 (<1%) died. Among 2222 children with radiographic evidence of pneumonia and with specimens available for bacterial and viral testing, a viral or bacterial pathogen was detected in 1802 (81%), one or more viruses in 1472 (66%), bacteria in 175 (8%), and both bacterial and viral pathogens in 155 (7%). The annual incidence of pneumonia was 15.7 cases per 10,000 children (95% confidence interval [CI], 14.9 to 16.5), with the highest rate among children younger than 2 years of age (62.2 cases per 10,000 children; 95% CI, 57.6 to 67.1). Respiratory syncytial virus was more common among children younger than 5 years of age than among older children (37% vs. 8%), as were adenovirus (15% vs. 3%) and human metapneumovirus (15% vs. 8%). Mycoplasma pneumoniae was more common among children 5 years of age or older than among younger children (19% vs. 3%). CONCLUSIONS: The burden of hospitalization for children with community-acquired pneumonia was highest among the very young, with respiratory viruses the most commonly detected causes of pneumonia. (Funded by the Influenza Division of the National Center for Immunization and Respiratory Diseases.).


Assuntos
Hospitalização/estatística & dados numéricos , Pneumonia/epidemiologia , Adolescente , Distribuição por Idade , Criança , Pré-Escolar , Infecções Comunitárias Adquiridas/epidemiologia , Infecções Comunitárias Adquiridas/microbiologia , Feminino , Humanos , Lactente , Recém-Nascido , Pulmão/diagnóstico por imagem , Masculino , Metapneumovirus/isolamento & purificação , Mycoplasma pneumoniae/isolamento & purificação , Pneumonia/diagnóstico por imagem , Pneumonia/microbiologia , Pneumonia Viral/epidemiologia , Vigilância da População , Radiografia , Vírus Sinciciais Respiratórios/isolamento & purificação , Tennessee/epidemiologia , Utah/epidemiologia
18.
Nutr Neurosci ; 18(5): 210-6, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-24559058

RESUMO

OBJECTIVE: Cinnamomum zeylanicum (CZ) is commonly known as cinnamon in traditional system of medicine having antibacterial, antioxidant, antidiabetic, hypolipidemic, and other activities. The present study was designed to assess the effect of extract of CZ bark on cognitive performance of scopolamine (SCOP)-treated rats and on associated altered oxidative stress markers in the brain of rats. METHODS: The extract was administered orally in three doses (100, 200, and 400 mg/kg) for a period of 21 days. SCOP was administered in the dose of 1.0 mg/kg intraperitoneally. The Morris water maze and passive avoidance step-down tasks were performed to assess cognitive functions. At the end of the study, oxidative stress parameters namely, malondialdehyde (MDA) and reduced glutathione (GSH) were also analyzed in the brain tissue of rats. RESULTS: SCOP-treated group showed significantly impaired acquisition and retention of memory as compared to the saline- and vehicle-treated groups. Pretreatment with CZ extract (200 and 400 mg/kg) for 21 days significantly reversed SCOP-induced amnesia as evidenced by increased step-down latency in passive avoidance and decreased latency in Morris water maze test compared to the SCOP-treated group. SCOP administration also caused the increase of MDA and reduction of GSH levels. Pretreatment with CZ extract (200 and 400 mg/kg) resulted in a significant decrease in MDA levels and increase in GSH levels as compared to the SCOP-treated animals. DISCUSSION: The results suggest that CZ can induce cognitive improvement in SCOP-treated rats and this effect can be attributed to a certain extent to decreased oxidative stress.


Assuntos
Cinnamomum zeylanicum/química , Transtornos Cognitivos/tratamento farmacológico , Estresse Oxidativo/efeitos dos fármacos , Extratos Vegetais/farmacologia , Escopolamina/efeitos adversos , Administração Oral , Animais , Encéfalo/efeitos dos fármacos , Encéfalo/metabolismo , Cognição/efeitos dos fármacos , Transtornos Cognitivos/induzido quimicamente , Relação Dose-Resposta a Droga , Glutationa/metabolismo , Masculino , Malondialdeído/metabolismo , Aprendizagem em Labirinto/efeitos dos fármacos , Memória/efeitos dos fármacos , Casca de Planta/química , Ratos , Ratos Wistar
19.
Food Chem Toxicol ; 49(6): 1404-9, 2011 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-21440025

RESUMO

Bisphenol A (BPA) is commonly used as a monomer in polycarbonate plastics. The present study was designed to investigate the effect of BPA on cognitive functions and oxidative stress in the brain tissue of rats and if co-administration of N-acetylcysteine (NAC), an antioxidant, can modulate the effect of BPA on cognitive functions and prevent any possible oxidative stress. The BPA was administered per orally (p.o) in two doses 2 and 20 µg/kg for 28 days. Cognitive functions were assessed using step-down latency (SDL) on a passive avoidance apparatus and spatial navigation task on Morris water maze. Oxidative stress was assessed by examining brain malondialdehyde (MDA) and reduced glutathione (GSH) levels. A significant reduction in SDL, and prolongation of latency in spatial navigation task were observed in BPA (2 and 20 µg/kg) treated group as compared to control group. The co-administration of NAC (100 mg/kg, p.o) antagonized the effect of BPA on SDL and spatial navigation test. NAC treatment also attenuated the BPA-induced increased MDA levels and decreased GSH levels in brain. Results of the present study show that NAC has potential to reverse cognitive dysfunction and oxidative stress induced by BPA exposure in rats.


Assuntos
Acetilcisteína/farmacologia , Antioxidantes/farmacologia , Encéfalo/efeitos dos fármacos , Transtornos Cognitivos/prevenção & controle , Estresse Oxidativo/efeitos dos fármacos , Fenóis/toxicidade , Animais , Aprendizagem da Esquiva/efeitos dos fármacos , Compostos Benzidrílicos , Encéfalo/metabolismo , Encéfalo/fisiopatologia , Transtornos Cognitivos/induzido quimicamente , Transtornos Cognitivos/psicologia , Modelos Animais de Doenças , Antagonismo de Drogas , Glutationa/metabolismo , Peroxidação de Lipídeos/efeitos dos fármacos , Masculino , Malondialdeído/metabolismo , Aprendizagem em Labirinto/efeitos dos fármacos , Memória/efeitos dos fármacos , Ratos , Ratos Wistar , Percepção Espacial/efeitos dos fármacos
20.
Naunyn Schmiedebergs Arch Pharmacol ; 383(4): 385-92, 2011 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-21318336

RESUMO

The present study was carried out to investigate the effect of trimetazidine on the course of pentylenetetrazole (PTZ)-induced chemical kindling and oxidative stress markers in PTZ-kindled mice. Kindling was induced by repeated injections of a subconvulsive dose of PTZ (30 mg/kg, i.p.) on alternate days for 5 weeks or until stage 4 of the seizure score was evoked on three consecutive administrations. Trimetazidine was administered daily in three doses (5, 10 and 20 mg/kg) per orally (p.o.) along with alternate-day PTZ. Following PTZ kindling, oxidative stress parameters, i.e. levels of malondialdehyde (MDA) and reduced glutathione (GSH), were assessed in isolated homogenized whole brain tissue. The results showed that PTZ treatment progressively increased the seizure score in control mice. Biochemical analysis revealed a significant increase in MDA levels and decreased GSH levels in the brain homogenate of PTZ-kindled mice. Daily treatment with trimetazidine in doses of 10 and 20 mg/kg significantly decreased the PTZ-induced seizure score. However, a low dose of trimetazidine (5 mg/kg) failed to improve the seizure score. Pretreatment of trimetazidine in all doses showed an ameliorating effect on biochemical alteration induced by PTZ treatment. The results of the present study indicate the potential anticonvulsant activity of trimetazidine against PTZ-induced kindling in mice.


Assuntos
Anticonvulsivantes/farmacologia , Antioxidantes/farmacologia , Excitação Neurológica/efeitos dos fármacos , Trimetazidina/farmacologia , Animais , Anticonvulsivantes/administração & dosagem , Antioxidantes/administração & dosagem , Modelos Animais de Doenças , Relação Dose-Resposta a Droga , Epilepsia/tratamento farmacológico , Glutationa/metabolismo , Masculino , Malondialdeído/metabolismo , Camundongos , Estresse Oxidativo/efeitos dos fármacos , Pentilenotetrazol , Trimetazidina/administração & dosagem
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