RESUMO
INTRODUCTION: In Alzheimer's disease (AD), early diagnosis facilitates treatment options and leads to beneficial outcomes for patients, their carers and the healthcare system. The neuropsychological battery of the Uniform Data Set (UDSNB3.0) assesses cognition in ageing and dementia, by measuring scores across different cognitive domains such as attention, memory, processing speed, executive function and language. However, its neuroanatomical correlates have not been investigated using 7 Tesla MRI (7T MRI). METHODS: We used 7T MRI to investigate the correlations between hippocampal subfield volumes and the UDSNB3.0 in 24 individuals with Amyloidß-status AD and 18 age-matched controls, with respective age ranges of 60 (42-76) and 62 (52-79) years. AD participants with a Medial Temporal Atrophy scale of higher than 2 on 3T MRI were excluded from the study. RESULTS: A significant difference in the entire hippocampal volume was observed in the AD group compared to healthy controls (HC), primarily influenced by CA1, the largest hippocampal subfield. Notably, no significant difference in whole brain volume between the groups implied that hippocampal volume loss was not merely reflective of overall brain atrophy. UDSNB3.0 cognitive scores showed significant differences between AD and HC, particularly in Memory, Language, and Visuospatial domains. The volume of the Dentate Gyrus (DG) showed a significant association with the Memory and Executive domain scores in AD patients as assessed by the UDSNB3.0.. The data also suggested a non-significant trend for CA1 volume associated with UDSNB3.0 Memory, Executive, and Language domain scores in AD. In a reassessment focusing on hippocampal subfields and MoCA memory subdomains in AD, associations were observed between the DG and Cued, Uncued, and Recognition Memory subscores, whereas CA1 and Tail showed associations only with Cued memory. DISCUSSION: This study reveals differences in the hippocampal volumes measured using 7T MRI, between individuals with early symptomatic AD compared with healthy controls. This highlights the potential of 7T MRI as a valuable tool for early AD diagnosis and the real-time monitoring of AD progression and treatment efficacy. CLINICALTRIALS: GOV: ID NCT04992975 (Clinicaltrial.gov 2023).
Assuntos
Doença de Alzheimer , Região CA1 Hipocampal , Giro Denteado , Imageamento por Ressonância Magnética , Transtornos da Memória , Humanos , Doença de Alzheimer/diagnóstico por imagem , Doença de Alzheimer/patologia , Masculino , Imageamento por Ressonância Magnética/métodos , Feminino , Idoso , Giro Denteado/diagnóstico por imagem , Giro Denteado/patologia , Pessoa de Meia-Idade , Região CA1 Hipocampal/diagnóstico por imagem , Região CA1 Hipocampal/patologia , Transtornos da Memória/diagnóstico por imagem , Transtornos da Memória/patologia , Adulto , Peptídeos beta-Amiloides/metabolismoRESUMO
BACKGROUND: Schistosomiasis is a parasitic disease caused by trematodes of the genus Schistosoma. The intravascular worms acquire the nutrients necessary for their survival from host blood. Since all animals are auxotrophic for riboflavin (vitamin B2), schistosomes too must import it to survive. Riboflavin is an essential component of the coenzymes flavin mononucleotide (FMN) and flavin adenine dinucleotide (FAD); these support key functions of dozens of flavoenzymes. METHODS: Here, using a combination of metabolomics, enzyme kinetics and in silico molecular analysis, we focus on the biochemistry of riboflavin and its metabolites in Schistosoma mansoni (Sm). RESULTS: We show that when schistosomes are incubated in murine plasma, levels of FAD decrease over time while levels of FMN increase. We show that live schistosomes cleave exogenous FAD to generate FMN and this ability is significantly blocked when expression of the surface nucleotide pyrophosphatase/phosphodiesterase ectoenzyme SmNPP5 is suppressed using RNAi. Recombinant SmNPP5 cleaves FAD with a Km of 178 ± 5.9 µM and Kcat/Km of 324,734 ± 36,347 M- 1.S- 1. The FAD-dependent enzyme IL-4I1 drives the oxidative deamination of phenylalanine to produce phenylpyruvate and H2O2. Since schistosomes are damaged by H2O2, we determined if SmNPP5 could impede H2O2 production by blocking IL-4I1 action in vitro. We found that this was not the case; covalently bound FAD on IL-4I1 appears inaccessible to SmNPP5. We also report that live schistosomes can cleave exogenous FMN to generate riboflavin and this ability is significantly impeded when expression of a second surface ectoenzyme (alkaline phosphatase, SmAP) is suppressed. Recombinant SmAP cleaves FMN with a Km of 3.82 ± 0.58 mM and Kcat/Km of 1393 ± 347 M- 1.S- 1. CONCLUSIONS: The sequential hydrolysis of FAD by tegumental ecto-enzymes SmNPP5 and SmAP can generate free vitamin B2 around the worms from where it can be conveniently imported by the recently described schistosome riboflavin transporter SmaRT. Finally, we identified in silico schistosome homologs of enzymes that are involved in intracellular vitamin B2 metabolism. These are riboflavin kinase (SmRFK) as well as FAD synthase (SmFADS); cDNAs encoding these two enzymes were cloned and sequenced. SmRFK is predicted to convert riboflavin to FMN while SmFADS could further act on FMN to regenerate FAD in order to facilitate robust vitamin B2-dependent metabolism in schistosomes.
Assuntos
Mononucleotídeo de Flavina , Flavina-Adenina Dinucleotídeo , Riboflavina , Schistosoma mansoni , Riboflavina/metabolismo , Mononucleotídeo de Flavina/metabolismo , Animais , Flavina-Adenina Dinucleotídeo/metabolismo , Schistosoma mansoni/metabolismo , Schistosoma mansoni/genética , Camundongos , Humanos , Esquistossomose mansoni/parasitologia , Esquistossomose mansoni/metabolismoRESUMO
The main objective of the study is to evaluate the antioxidant, anticancer, and antimicrobial activities of Anchusa officinalis L. in vitro and in silico. The dried aerial parts of A. officinalis L. were extracted with methanol. Total phenolic and flavonoid content was analyzed. Antioxidant and antimicrobial effects were tested against both gram-positive and gram-negative bacteria. Gas chromatography-mass spectrometry analysis revealed the presence of 10 phytochemical compounds, and cyclobutane (26.07%) was identified as the major photochemical compound. The methanol extract exhibited the maximum amount of total phenolic content (118.24 ± 4.42 mg QE/g dry weight of the dry extract) (R2 = 0.994) and the total flavonoid content was 94 ± 2.34 mg QE/g dry weight of the dry extract (R2 = 0.999). The IC50 value for 2,2'-azino-bis (3-ethylbenzothiazoline-6-sulfonic acid was 107.12 ± 3.42 µg/mL, and it was high for 1,1-diphenyl-2-picryl hydrazyl (123.94 ± 2.31 µg/mL). The IC50 value was 72.49 ± 3.14 against HepG2 cell lines, and a decreased value was obtained (102.54 ± 4.17 g/mL) against MCF-7 cell lines. The methanol extract increased the expression of caspase mRNA and Bax mRNA levels when compared to the control experiment (p < .05). The conclusions, A. officinalis L. aerial parts extract exhibited antibacterial, antifungal, and antioxidant activities.
Assuntos
Antioxidantes , Metanol , Componentes Aéreos da Planta , Extratos Vegetais , Extratos Vegetais/farmacologia , Extratos Vegetais/química , Humanos , Componentes Aéreos da Planta/química , Antioxidantes/farmacologia , Antioxidantes/química , Antioxidantes/isolamento & purificação , Metanol/química , Testes de Sensibilidade Microbiana , Antibacterianos/farmacologia , Antibacterianos/química , Antibacterianos/isolamento & purificação , Bactérias Gram-Negativas/efeitos dos fármacos , Bactérias Gram-Positivas/efeitos dos fármacos , Antineoplásicos Fitogênicos/farmacologia , Antineoplásicos Fitogênicos/química , Antineoplásicos Fitogênicos/isolamento & purificação , Anti-Infecciosos/farmacologia , Anti-Infecciosos/química , Células MCF-7 , Simulação por Computador , Flavonoides/farmacologia , Flavonoides/química , Fenóis/farmacologia , Fenóis/química , Apoptose/efeitos dos fármacosRESUMO
BACKGROUND: Since 2021, the Centers for Medicare and Medicaid Services have mandated that patients have open access to their medical records. Many institutions use online portals, which allow patients to access their health information and communicate with care teams. Our research aimed to evaluate demographic patterns for online patient portal utilization in patients undergoing total knee arthroplasty (TKA). Further, we assessed if and how portal engagement contributes to perioperative outcomes. METHODS: This study retrospectively reviewed primary and elective TKA from 2017 to 2022 at a single academic institution. Patients were stratified into 2 groups based on their online portal status: activated (A) or not-activated (NA). Baseline characteristics and postoperative outcomes were collected from the electronic medical record and compared. RESULTS: In total, 10,995 patients were included: 8,330 (75.8%) were A and 2,625 (24.2%) were NA. The NA group was significantly older (P < .001); more likely to be Black (P < .001), women (P < .001), single/divorced/widowed (P < .001), non-English speaking (P < .001), and Medicare or Medicaid insured (P < .001); from zip codes with median incomes below $50,000 (P < .001), and more likely to be American Society of Anesthesiologists class III or IV (P < .001). Patient-reported outcome measure completion rates were significantly lower in the NA group (15.3 versus 47.7%, P < .001). Lengths of stay (LOS) were significantly higher in the NA group (2.7 versus 2.1 days, P < .001). The NA group was significantly more likely to be discharged to skilled nursing facilities (P < .001). Comparable rates of 90-day emergency department visits, readmissions, as well as 90-day and 2-year revisions, were observed across groups. CONCLUSIONS: There are significant disparities in online portal activation status based on patient demographics. Patients who have A portals had significantly higher Patient-reported outcome measure completion rates, shorter LOS, and higher rates of home discharge. Further research should determine which other factors may affect patient portal utilization and inform interventions to improve portal utilization among minority populations.
RESUMO
BACKGROUND: Isolated acetabular component revision is an effective treatment for revision total hip arthroplasty patients who have well-fixed femoral implants. We aimed to evaluate the modes of acetabular failure following primary total hip arthroplasty and to identify factors associated with increased morbidities and postoperative outcomes. METHODS: We conducted a retrospective analysis and identified 318 isolated aseptic acetabular revisions. We separated patients by ≤90 days, 91 days to 2 years, and >2 years for acetabular revisions and compared demographics, reasons for revision, 90-day readmissions, rerevisions, and postrevision infections. Revisions ≤90 days, 91 days to 2 years, and >2 years accounted for 10.7, 19.2, and 70.1% of revisions, respectively. Revisions ≤90 days, 91 days to 2 years, and >2 years had their primary total hip arthroplasty at a mean age of 66, 63, and 55 years (P < .001), respectively. RESULTS: Revisions within 90 days were mainly indicated for dislocation/instability (58.8%) or periprosthetic fracture (23.5%) while revisions over 2 years were indicated for polyethylene wear/osteolysis (37.2%). Patients with revisions past 90 days were more likely to require rerevision compared to patients with revisions within 90 days (P < .001). There were no differences in readmissions (P = .28) or infection rates (P = .37). CONCLUSIONS: Acetabular revisions within 90 days were more commonly indicated for instability and periprosthetic fracture, while those over 2 years were indicated for polyethylene wear. Revisions past 90 days were more likely to require subsequent rerevisions without increased 90-day readmissions or infections. LEVEL III EVIDENCE: Retrospective cohort study.
Assuntos
Artroplastia de Quadril , Prótese de Quadril , Fraturas Periprotéticas , Humanos , Artroplastia de Quadril/efeitos adversos , Estudos Retrospectivos , Prótese de Quadril/efeitos adversos , Fraturas Periprotéticas/epidemiologia , Fraturas Periprotéticas/etiologia , Fraturas Periprotéticas/cirurgia , Falha de Prótese , Desenho de Prótese , Acetábulo/cirurgia , Polietileno , ReoperaçãoRESUMO
The current study aims to use a facile and novel method to remove Congo red (CR) and Methyl Orange (MO) dyes from contaminated water with Maize offal biomass (MOB) and its nanocomposite with magnetic nanoparticles (MOB/MNPs). The MOB and MOB/MNPs were characterized with Fourier-transform infrared (FTIR), scanning electron microscopy (SEM), BET, XRD and point of zero charge (pHPZC). The influence of initial CR and MO levels (20-320 mg/L), adsorbent dosage (1-3 g/L), pH (3-9), co-exiting ions, temperature (25-45 °C) and time (15-180 min) was estimated. The findings demonstrated that MOB/MNPs exhibited excellent adsorption of 114.75 and 29.0 mg/g for CR and MO dyes, respectively while MOB exhibited 81.35 and 23.02 mg/g adsorption for CR and MO dyes, respectively at optimum pH-5, and dose 2 g/L. Initially, there was rapid dye removal which slowed down until equilibrium was reached. The interfering/competing ions in contaminated water and elevated temperature favored the dyes sequestration. The MOB/MNPs exhibited tremendous reusability and stability. The dyes adsorption was spontaneous, and exothermic with enhanced randomness. The adsorption effects were well explained with Freundlich model, pseudo second order and Elovich models. It is concluded that MOB/MNPs showed excellent, eco-friendly, and cost-effective potential to decontaminate the water.
Nanocomposite of Maize offal biomass demonstrated higher dyes removal.FTIR, SEM, BET, XRD and pHPZC provided vital evidence for dyes adsorption.MOB/MNPs displayed excellent stability and reusability for dyes adsorption.Groundwater samples exposed a higher dyes removal.Results were validated with equilibrium and kinetic adsorption models.
Assuntos
Compostos Azo , Nanocompostos , Poluentes Químicos da Água , Vermelho Congo , Corantes/química , Zea mays , Biomassa , Biodegradação Ambiental , Adsorção , Íons , Água , Nanocompostos/química , Fenômenos Magnéticos , Cinética , Poluentes Químicos da Água/química , Concentração de Íons de HidrogênioRESUMO
INTRODUCTION: The influence of prior colostomy or ileostomy on patients undergoing joint arthroplasty remains poorly understood. Our study aimed to assess whether patients with an ostomy undergoing hip and knee arthroplasties have worse postoperative outcomes and increased rates of revisions. METHOD: A single-center, retrospective review of patients with a history of bowel ostomy who underwent a primary total hip arthroplasty (THA), hemiarthroplasty (HA), and total knee arthroplasty (TKA) from 2012 to 2021. A total of 24 THAs, 11 HAs, and 25 TKAs in patients with open small or large bowel stoma were identified. A ten-to-one propensity score match was utilized to establish cohorts with comparable demographics but no prior ostomy procedure. RESULTS: Patients with stomas undergoing elective THA showed greater 90-day ED visits (20.0 vs. 5.0%, P = 0.009), 90-day all-cause readmissions (20.0 vs. 5.0%, P = 0.009), 90-day non-orthopedic readmissions (10.0 vs. 0.5%, P < 0.001), 90-day readmissions for infection (5.0 vs. 0.5%, P = 0.043), all-cause revisions (15.0 vs. 0.5%, P < 0.001), revisions for PJI (5.0 vs. 0%, P = 0.043), and revisions for peri-prosthetic fracture (10.0 vs. 0%, P < 0.001). Patients with stomas undergoing non-elective hip arthroplasties exhibited a longer mean LOS (12.1 vs. 7.0 days, P < 0.001) and increased 90-day all-cause readmissions (40.0 vs. 17.3%, P = 0.034), 90-day orthopedic readmissions (26.7 vs. 6.0%, P = 0.005), all-cause revisions (13.3 vs. 2.0%, P = 0.015), revisions for peri-prosthetic fracture (6.7 vs. 0%, P = 0.002), and revisions for aseptic loosening (6.7 vs. 0%, P = 0.002). There were no significant differences in readmission or revision rates between ostomy patients undergoing TKA and a matched control group. CONCLUSION: Patients undergoing hip arthroplasties with an open stoma are at an increased risk of hospital encounters and revisions, whereas TKA patients with stomas are not at increased risk of complications. These findings emphasize the importance of recognizing and addressing the unique challenges associated with this patient population.
RESUMO
PURPOSE: Venous thromboembolism (VTE) is a known complication of hip arthroplasty for femoral neck fractures (FNF) with various prophylactic anticoagulants utilized to decrease risk. The purpose of this study was to assess the efficacy and perioperative outcomes associated with aspirin for VTE prophylaxis following arthroplasty for FNF. METHODS: Medical records of 1,220 patients who underwent hip hemiarthroplasty (HHA) or total hip arthroplasty (THA) at an urban academic center from 2011 to 2022 were retrospectively reviewed. Patient characteristics and perioperative outcomes, including length of stay (LOS), VTE, 90-day hospital encounters, and discharge disposition, were collected. Outcomes for patients prescribed aspirin (n = 214) were compared to those prescribed non-aspirin VTE prophylaxis (n = 1006) using propensity score matching. RESULTS: Patients who received aspirin had higher rates of THA (36.0 vs 26.7%; p = 0.008). There were no significant risk-adjusted differences in the incidence of VTE (0.5 vs 0.5%, p = 1.000) and 90-day readmissions (10.4 vs 12.3%, p = 0.646) between patients prescribed aspirin and non-aspirin VTE prophylaxis, respectively. Patients prescribed non-aspirin agents had higher rates of non-home discharge (73.9 vs 58.5%; p < 0.001) and longer LOS (143.5 vs 124.9 h; p = 0.005). Sub-analysis of patients prescribed aspirin and non-aspirin prophylaxis based on comorbidity scores demonstrated no difference in VTE incidence for low (0.0 vs 1.6%, p = 1.000) and high scores (0.0 vs 0.0%, p = 1.000), respectively. CONCLUSION: Aspirin is not associated with increased incidence of VTE after HHA or THA for FNF. Aspirin prophylaxis should be considered in hip fracture patients to mitigate bleeding risk, particularly those with low to intermediate VTE risk. LEVEL OF EVIDENCE: Level III, Retrospective study.
Assuntos
Artroplastia de Quadril , Fraturas do Colo Femoral , Tromboembolia Venosa , Humanos , Tromboembolia Venosa/etiologia , Tromboembolia Venosa/prevenção & controle , Estudos Retrospectivos , Aspirina/efeitos adversos , Anticoagulantes/efeitos adversos , Artroplastia de Quadril/efeitos adversos , Fraturas do Colo Femoral/complicaçõesRESUMO
Schistosomes are long lived, intravascular parasitic platyhelminths that infect >200 million people globally. The molecular mechanisms used by these blood flukes to dampen host immune responses are described in this review. Adult worms express a collection of host-interactive tegumental ectoenzymes that can cleave host signaling molecules such as the "alarmin" ATP (cleaved by SmATPDase1), the platelet activator ADP (SmATPDase1, SmNPP5), and can convert AMP into the anti-inflammatory mediator adenosine (SmAP). SmAP can additionally cleave the lipid immunomodulator sphingosine-1-phosphate and the proinflammatory anionic polymer, polyP. In addition, the worms release a barrage of proteins (e.g., SmCB1, SjHSP70, cyclophilin A) that can impinge on immune cell function. Parasite eggs also release their own immunoregulatory proteins (e.g., IPSE/α1, omega1, SmCKBP) as do invasive cercariae (e.g., Sm16, Sj16). Some schistosome glycans (e.g., LNFPIII, LNnT) and lipids (e.g., Lyso-PS, LPC), produced by several life stages, likewise affect immune cell responses. The parasites not only produce eicosanoids (e.g., PGE2, PGD2-that can be anti-inflammatory) but can also induce host cells to release these metabolites. Finally, the worms release extracellular vesicles (EVs) containing microRNAs, and these too have been shown to skew host cell metabolism. Thus, schistosomes employ an array of biomolecules-protein, lipid, glycan, nucleic acid, and more, to bend host biochemistry to their liking. Many of the listed molecules have been individually shown capable of inducing aspects of the polarized Th2 response seen following infection (with the generation of regulatory T cells (Tregs), regulatory B cells (Bregs) and anti-inflammatory, alternatively activated (M2) macrophages). Precisely how host cells integrate the impact of these myriad parasite products following natural infection is not known. Several of the schistosome immunomodulators described here are in development as novel therapeutics against autoimmune, inflammatory, and other, nonparasitic, diseases.
Assuntos
Proteínas de Helminto/imunologia , Fatores Imunológicos/imunologia , Schistosoma/imunologia , Esquistossomose/imunologia , Animais , HumanosRESUMO
In this work, we report on the synthesis of flower-like tungsten oxide nanoparticles (WO3 NPs) using a simple precipitation method. This paper reports a simple method for synthesizing flower-like WO3 NPs, which can be used for environmentally treating hazardous organic pollutants. The photocatalytic degradation of model artificial Orange II and Congo red was assessed under natural sunlight irradiation. The surface morphologies, crystallinity, and binding energy of the synthesized WO3 NPs were determined. The synthesized WO3 NPs exhibited good photodegradation percentages of approximately Orange II (97.6%) and Congo red dye (98.2%) after 120 min of irradiation. Furthermore, the WO3 NPs maintained their degradation ability for up to three cycles. In addition, WO3 NPs were examined in different metal ions sensing (Hg2+, Fe2+, Cu2+, Ni2+, and Cd2+) in an aqueous solution. The results showed that the WO3 NPs exhibited excellent Cd2+ ion sensing. Based on the investigations, WO3 NPs proved to be an efficient photocatalyst and hold promise as the best material for future applications in preventing water pollution.
Assuntos
Nanopartículas Metálicas , Nanopartículas , Vermelho Congo , Cádmio , Metais , CorantesRESUMO
Infection with schistosomes (blood flukes) can result in the debilitating disease schistosomiasis. These parasites survive in their host for many years, and we hypothesize that proteins on their tegumental surface, interacting with the host microenvironment, facilitate longevity. One such ectoenzyme - the nucleotide pyrophosphatase/phosphodiesterase SmNPP5 can cleave ADP (to prevent platelet aggregation) and NAD (likely preventing Treg apoptosis). A second tegumental ectoenzyme, the glycohydrolase SmNACE, also catabolizes NAD. Here, we undertake a comparative biochemical characterization of these parasite ectoenzymes. Both are GPI-linked and exhibit different optimal pH ranges. While SmNPP5 requires divalent cations, SmNACE does not. The KM values of the two enzymes for NAD at physiological pH differ: SmNPP5, KM = 340â µM ± 44; SmNACE, KM = 49â µM ± 4. NAD cleavage by each enzyme yields different products. SmNPP5 cleaves NAD to form nicotinamide mononucleotide (NMN) and AMP, whereas SmNACE cleaves NAD to generate nicotinamide (NAM) and adenosine diphosphate ribose (ADPR). Each enzyme can process the other's reaction product. Thus, SmNACE cleaves NMN (to yield NAM and ribose phosphate) and SmNPP5 cleaves ADPR (yielding AMP and ribose phosphate). Metabolomic analysis of plasma containing adult worms supports the idea that these cleavage pathways are active in vivo. We hypothesize that a primary function of SmNPP5 is to cleave NAD to control host immune cell function and a primary function of SmNACE is to cleave NMN to generate the vital nutrient nicotinamide (vitamin B3) for convenient uptake by the worms. Chemical inhibition of one or both ectoenzymes could upset worm metabolism and control schistosome infection.
Assuntos
NAD , Schistosoma mansoni , Adenosina Difosfato Ribose , Monofosfato de Adenosina , Animais , NAD/metabolismo , NiacinamidaRESUMO
BACKGROUND: Intra-articular hyaluronic acid (IAHA) has been commonly used in the management of knee osteoarthritis (OA). This study sought to assess patient-reported outcomes (PRO) following different formulations of hyaluronic acid injections for patients who have knee OA. METHODS: A retrospective analysis was performed on patients who have knee OA and received IAHA knee injections from October 2018 to May 2022 in sports medicine (SM) and adult reconstructive (AR) clinics. Patients completed PRO measures including the Patient-Reported Outcome Measurement Information System (PROMIS) Mobility, Pain Interference, and Pain Intensity at baseline, 6-week, 6-month, and 12-month follow-up. Univariate and multivariate analyses were used to evaluate changes in PRO measures between baseline and follow-up periods and to evaluate differences between the SM and AR divisions. A total of 995 patients received IAHA for knee OA and completed PRO assessments. RESULTS: There was no difference in the PROMIS measures based on molecular weight at 6 weeks, 6 months, and 12 months. Except for 6-month Mobility scores between the SM and AR patients (-0.52 ± 5.46 versus 2.03 ± 6.95; P = .02), all other PROMIS scores were similar. Mobility scores at 6 months were significantly different based on Kellgren and Lawrence grade (P = .005), but all other PROMIS scores were similar. CONCLUSION: Average change in PROMIS scores were significantly different only for 6-month Mobility scores based on divisions and Kellgren and Lawrence grade but did not achieve minimally clinical important difference at most timepoints. Further studies are needed to investigate whether improvement is observed in specific patient populations.
Assuntos
Ácido Hialurônico , Osteoartrite do Joelho , Adulto , Humanos , Ácido Hialurônico/uso terapêutico , Osteoartrite do Joelho/tratamento farmacológico , Osteoartrite do Joelho/cirurgia , Estudos Retrospectivos , Resultado do Tratamento , Injeções Intra-Articulares , Medidas de Resultados Relatados pelo PacienteRESUMO
BACKGROUND: Hippocampal formation atrophy is a well-established imaging biomarker of several neurological diseases, including Alzheimer's disease, temporal lobe epilepsy, and schizophrenia. The hippocampus is divided into subfields that have different functions and vary in sensitivity to different diseases. This study investigates the potential interaction between COVID-19 and the various hippocampus subfields, which may shed light on the long-term neurological consequences of the virus. METHOD: We obtained high-resolution T1-weighted (T1w) and T2-weighted (T2w) MRI images using 7T scanners located at three sites in two countries: Pittsburgh (n = 14) and Texas (San Antonio and Houston) (n = 40) in the USA, and Nottingham, UK (n = 33). We evaluated the hippocampus subfields using the ASHS package [1-3]. Imaging sets of 51 subjects with minimal or no manual segmentation corrections (Figures 1 and 2) were included in the analysis. We conducted T-tests with Bonferroni correction, adjusting for age and intracranial volume to identify the differences in hippocampus subfield volumes across groups. RESULT: Participants who needed admission into the ICU due to Covid-19 showed a significantly lower (p-value = 0.0034) left CA1 volume compared to participants who did not require ICU (Figure 3). In addition, several other non-significant trends were observed. CONCLUSION: Our preliminary findings suggest that Covid-19 may impact the hippocampus, particularly in patients who required intensive care. However, the study - as of to date - has a small sample size and lacks a comparison group with patients who were admitted into ICU for acute illnesses other than Covid-19. Additionally, longitudinal data is needed to track the long-term effects of the disease on the hippocampal subfields. FUNDING: NIH R56AG074467, R01MH111265 and R01AG063525 References: 1. Berron et al. Neuroimage 2017 2. Yushkevich et al. Human Brain Mapping 2015 3. Santini et al. Neuroimage: clinical 2021.
Assuntos
COVID-19 , Hipocampo , Imageamento por Ressonância Magnética , Humanos , Hipocampo/diagnóstico por imagem , Hipocampo/patologia , Masculino , Feminino , Pessoa de Meia-Idade , Atrofia/patologia , SARS-CoV-2 , IdosoRESUMO
Starches from different botanical sources are affected in the presence of enzymes. This study investigated the impact of α-amylase on several properties of pre-gelatinized starches derived from chickpea (Cicer arietinum L.), wheat (Triticum aestivum L.), corn (Zea mays L.), white beans (Phaseolus vulgaris), and sweet potatoes (Ipomoea batatas L.). Specifically, the water holding capacity, freezable water content, sugar content, and water sorption isotherm (adsorption and desorption) properties were examined. The source of α-amylase utilized in this study was a germinated sorghum (Sorghum bicolor L. Moench) extract (GSE). The starch samples were subjected to annealing at temperatures of 40, 50, and 60 °C for durations of either 30 or 60 min prior to the process of gelatinization. A significant increase in the annealing temperature and GSE resulted in a notable enhancement in both the water-holding capacity and the sugar content of the starch. The ordering of starches in terms of their freezable water content is as follows: Chickpea starch (C.P.S) > white beans starch (W.B.S) > wheat starch (W.S) > chickpea starch (C.S) > sweet potato starch (S.P.S). The Guggenheim-Anderson-de Boer (GAB) model was only employed for fitting the data, as the Brunauer-Emmett-Teller (BET) model had a low root mean square error (RMSE). The application of annealing and GSE treatment resulted in a shift of the adsorption and desorption isotherms towards greater levels of moisture content. A strong hysteresis was found in the adsorption and desorption curves, notably within the water activity range of 0.6 to 0.8. The GSE treatment and longer annealing time had an impact on the monolayer water content (mo), as well as the C and K parameters of the GAB model, irrespective of the annealing temperature. These results can be used to evaluate the applicability of starch in the pharmaceutical and food sectors.
Assuntos
Ipomoea batatas , Sorghum , Grão Comestível , Amilose , Amido , alfa-Amilases , Água , Açúcares , Extratos VegetaisRESUMO
PURPOSE: The purpose of the current study was to determine if differences exist between cruciate-retaining (CR) and posterior-stabilized (PS) implant articulations for total knee arthroplasty (TKA) with regards to early post-operative pain. METHODS: We retrospectively reviewed patients who underwent primary TKA, with the same TKA implant design, at our institution between January 2018 and July 2021. Patients were stratified based on whether they received a CR or non-constrained PS (PSnC) articulation and propensity score matched in a 1:1 ratio. A sub-analysis matching patient who received a constrained PS implant (PSC) to those undergoing CR TKA and PSnC TKA was also carried out. Opioid dosages were converted to morphine milligram equivalents (MME). RESULTS: 616 patients after CR TKA were matched 1:1 to 616 patients with a PSnC implant. There were no significant differences between demographic variables. There were no statistically significant differences in opioid usage measured by MME on post-operative day (POD) 0 (p = 0.171), POD1 (p = 0.839), POD2 (p = 0.307), or POD3 (p = 0.138); VAS pain scores (p = 0.175); or 90-day readmission rate for pain (p = 0.654). A sub-analysis of CR versus PSC TKA demonstrated no significant differences in opioid usage on POD0 (p = 0.765), POD1 (p = 0.747), POD2 (p = 0.564), POD3 (p = 0.309); VAS pain scores (p = 0.293); and 90-day readmission rate for pain (p > 0.9). CONCLUSION: Our analysis demonstrated no significant difference in post-operative VAS pain scores and MME usage based on implant. The results suggest that neither the type of articulation or constraint used for primary TKA has a significant impact on immediate post-operative pain and opioid consumption. LEVEL III EVIDENCE: Retrospective Cohort Study.
Assuntos
Artroplastia do Joelho , Endrin/análogos & derivados , Prótese do Joelho , Osteoartrite do Joelho , Ligamento Cruzado Posterior , Humanos , Ligamento Cruzado Posterior/cirurgia , Artroplastia do Joelho/efeitos adversos , Artroplastia do Joelho/métodos , Articulação do Joelho/cirurgia , Estudos Retrospectivos , Analgésicos Opioides/uso terapêutico , Amplitude de Movimento Articular , Dor Pós-Operatória/diagnóstico , Dor Pós-Operatória/etiologia , Osteoartrite do Joelho/cirurgiaRESUMO
The effectiveness of hydrocolloids (2% maximum in various combinations) from various sources, including maltodextrins (MD) with polymerization degree (DP) 18 and ziziphus gum (ZG), on the dough properties and quality of panned bread, as well as the possibility of using them to delay the bread staling process, have been investigated after 24, 72, and 96 h of storage. By evaluating the pasting capabilities of wheat flour slurry, dough properties, and the final product, the effects of the ziziphus gum (ZG) and maltodextrins (MD) were ascertained. A TA-TXT texture analyzer, a texture profile analysis test, and Micro-doughLab were used to evaluate the dough mixing properties. Additionally, a hedonic sensory evaluation of the overall acceptance of the bread, as well as its texture, aroma, taste, and color, was done. It is clear that MD had a more distinct impact than ZG on the way dough was mixed, the texture of the gel, and the finished product. The combination of MD and ZG significantly altered the bread's physical characteristics and its aging over time. The decreased peak viscosity and noticeably smaller setback of wheat flour gels, which corresponded to lower gel hardness, serve as evidence of reduced amylose retrogradation. At 2%, MD outperformed ZG in terms of increasing water absorption, dough stability, and bread loaf volume. With the exception of the blend that included three times as much MD as ZG, all mixes, including the control, exhibited an increase in bread firmness as a function of time after storage. Overall, the panelists liked (score of 5 and above) the bread made with mixes that had either MD or ZG, or a combination of both.
Assuntos
Pão , Farinha , Pão/análise , Farinha/análise , Triticum , PolissacarídeosRESUMO
Acacia (AG) and cactus gums (CG) were mixed into wheat flour at the 3% and 6% levels. The flour blends were tested for their pasting, dough development, and extensibility behaviors. The blends were used to make cookies, which were then evaluated for their physical, textural, and sensory qualities. Both types of gum reduced the setback viscosities, water absorption, and farinograph quality numbers while increasing the water retention capacity, dough development time, and extensibility. The thickness and diameter of the cookies decreased in the presence of the cactus gum, while the acacia gum resulted in greater thickness and diameter. The addition of more gums increased the hardness of the cookies while decreasing their fracturability. All the cookie types were acceptable for all the sensory attributes studied. When compared to the control, the panelists preferred the color of the cookies with a higher level of gum. Overall, the presence of gums in the formulation resulted in the development of cookies with improved technological and sensory attributes. Likewise, the cookies with higher levels of gum can deliver 6% more soluble fiber without compromising their overall acceptability.
Assuntos
Acacia , Fabaceae , Opuntia , Farinha , Triticum , Fibras na Dieta , ÁguaRESUMO
The influence of 2% and 5% Cordia (CG) and Ziziphus (ZG) gums on dough characteristics and cookie quality was investigated. Micro-DoughLab, a texture analyzer (TA), a rapid viscoanalyzer (RVA), and solvent retention capacity were used to examine the effect of CG and ZG gums on dough physicochemical parameters (SRC) and cookie quality. The diameter, thickness, spread, and sensory evaluation of cookies were evaluated. With the addition of CG and ZG, dough softness, mixing time, and mixing tolerance index (MTI) increased, whereas stability and water absorption decreased. TA data showed that adding gums resulted in softer and less sticky doughs than the control, whereas RVA data showed that adding CG resulted in a significant increase in peak viscosity, but no change in flour gel setback. In comparison to the control and CG samples, the ZG samples exhibited the most dough extensibility. The thickness and diameter of the cookies increased but the spread decreased, due to the added gums. The gum-containing cookies had a lower overall acceptability by panelists than the control, although only by a small margin. Gum-containing cookies, on the other hand, can deliver up to 5% soluble fiber.
Assuntos
Cordia , Ziziphus , Fenômenos Químicos , Farinha , ReologiaRESUMO
This study was planned to explore the locally available natural sources of gum hydrocolloids as a natural modifier of different starch properties. Corn (CS), sweet potato (SPS), and Turkish bean (TBS) starches were mixed with locally extracted native or acetylated cactus (CG) and acacia (AG) gums at 2 and 5% replacement levels. The binary mixtures (starch-gums) were prepared in water, freeze dried, ground to powder, and stored airtight. A rapid viscoanalyzer (RVA), differential scanning calorimeter (DSC), texture analyzer, and dynamic rheometer were used to explore their pasting, thermal, textural, and rheological properties. The presence of acetylated AG or CG increased the final viscosity (FV) in all three starches when compared to starch pastes containing native gums. Plain SPS dispersion had a higher pasting temperature (PT) than CS and TBS. The addition of AG or CG increased the PT of CS, SPS, and TBS. The thermograms revealed the overall enthalpy change of the starch and gum blends: TBS > SPS > CS. The peak temperature (Tp) of starches increased with increasing gum concentration from 2 to 5% for both AG and CG native and modified gums. When compared to the control gels, the addition of 2% CG, either native or modified, reduced the syneresis of starch gels. However, further addition (5% CG) increased the gels' syneresis. Furthermore, the syneresis for the first cycle on the fourth day was higher than the second cycle on the eighth day for all starches. The addition of native and acetylated CG reduced the hardness of starch gels at all concentrations tested. All of the starch dispersions had higher G' than Gâ³ values, indicating that they were more elastic and less viscous with or without the gums. The apparent viscosity of all starch gels decreased as shear was increased, with profiles indicating time-dependent thixotropic behavior. All of the starch gels, with or without gums, showed a non-Newtonian shear thinning trend in the shear stress vs. shear rate graphs. The addition of acetylated CG gum to CS resulted in a higher activation energy (Ea) than the native counterparts and the control. More specifically, starch gels with a higher gum concentration (5%) provided greater Ea than their native counterparts.
Assuntos
Fabaceae/metabolismo , Ipomoea batatas/metabolismo , Zea mays/metabolismo , Acacia , Coloides , Fabaceae/crescimento & desenvolvimento , Goma Arábica/metabolismo , Ipomoea batatas/crescimento & desenvolvimento , Opuntia/metabolismo , Gomas Vegetais , Reologia/métodos , Arábia Saudita , Amido/metabolismo , Temperatura , Termodinâmica , Viscosidade , Zea mays/crescimento & desenvolvimentoRESUMO
Although surgical procedures have been occurring as early at 6500 BC, the modern sense of the operating room (OR) did not exist until more recently. As aseptic techniques and surgical procedures began to evolve, so too did the OR table. The OR table began to transition from a static, wooden table to a dynamic table with the ability to position patients for a variety of procedures. With the advent of intraoperative imaging for orthopaedic procedures, OR tables have adapted and allow for imaging of bony anatomy by using radiolucent materials. These changes have led to the development of numerous OR tables, each with their own sets of advantages and disadvantages. There is currently no summary of the development, indications, benefits, and disadvantages of the various OR tables available to orthopaedic surgeons in the literature. The purpose of this review is to provide a comprehensive review of orthopaedic operating tables for both the junior orthopaedic resident and experienced attending surgeon.