ABSTRACT
Background and Aims: Age cutoff is an important factor in deciding whether esophagogastroduodenoscopy (EGD) is necessary for patients presenting with upper gastrointestinal symptoms. However, the cutoff value is significantly different across populations. We aimed to determine the age cutoff for EGD that assures a low rate of missing upper gastrointestinal malignancy (UGIM) and to assess the yield of prompt EGD in Vietnamese patients presenting with upper gastrointestinal symptoms. Methods: All EGDs performed in outpatients during a 6-year period (2014-2019) at a tertiary hospital that provided an open-access endoscopy service were retrospectively reviewed. Repeat or surveillance EGDs were excluded. Different age cutoffs were evaluated in terms of their prediction of the absence of UGIM. The yield of endoscopy to detect one malignancy (YoE) was also calculated. Results: Of 472,744 outpatients presenting with upper gastrointestinal symptoms, there were 2198 (0.4%) patients with UGIM. The median age and male-to-female ratio of patients with UGIMs were 57.9 ± 12.5 years and 2.5 : 1, respectively. The YoEs in patients <40, 40-60, and >60 years of age were <1, 1-10, and >10 per 1000 EGDs, respectively. The age cutoffs of 30 years in females and 35 years in males could detect 98.2% (95% CI: 97.7%-98.8%) of UGIM cases with a YoE of about 1 per 1000 EGDs. Conclusions: The age cutoff for EGD in Vietnamese should be lower than that recommended by current international guidelines. The strategy of prompt EGD showed a low YoE, and its cost-effectiveness requires further investigation.
Subject(s)
Gastrointestinal Neoplasms , Upper Gastrointestinal Tract , Adult , Asian People , Endoscopy, Digestive System , Endoscopy, Gastrointestinal , Female , Gastrointestinal Neoplasms/diagnosis , Gastrointestinal Neoplasms/epidemiology , Humans , Male , Retrospective StudiesABSTRACT
Excess adipose tissue predisposes to an enhanced inflammatory state and can contribute to the pathogenesis and severity of asthma. Vitamin D has anti-inflammatory properties and low-serum levels are seen in children with asthma and in children with obesity. Here we review the intersection of asthma, obesity, and hypovitaminosis D in children. Supplementation with vitamin D has been proposed as a simple, safe, and inexpensive adjunctive therapy in a number of disease states. However, little research has examined the pharmacokinetics of vitamin D and its therapeutic potential in children who suffer from obesity-related asthma.
Subject(s)
Asthma , Dietary Supplements , Obesity , Vitamin D , Vitamins , Asthma/blood , Asthma/diet therapy , Asthma/etiology , Child , Humans , Inflammation/blood , Inflammation/diet therapy , Obesity/blood , Obesity/complications , Obesity/diet therapy , Obesity/metabolism , Vitamin D/blood , Vitamin D/pharmacokinetics , Vitamin D/therapeutic use , Vitamin D Deficiency/blood , Vitamin D Deficiency/diet therapy , Vitamins/blood , Vitamins/pharmacokinetics , Vitamins/therapeutic useABSTRACT
BACKGROUND: The aim of this study was to develop and compare polymeric micelles of fucoidan, a sulfated polysaccharide, and hydrophobic drugs such as paclitaxel and curcumin. Paclitaxel and curcumin are both known for their medicinal properties, including anticancer efficacy. However, their very low water solubility, absorption and rapid metabolism leads to reduced bioavailability. To redress these problems and enhance anti-cancer therapeutics using fucoidan, polymeric micelles were synthesized from conjugates of fucoidan and hydrophobic drugs. METHODS: The chemical conjugation of fucoidan and hydrophobic drugs has been achieved by utilizing reactive functional groups on the molecules, such as carboxylic groups and hydroxyl groups. RESULTS: The micelles revealed a homogeneous spherical morphology, size, negative surface charge. Fourier transform infrared spectroscopy was used to investigate the physicochemical properties of the polymeric micelles, which form a self-assembled polymeric micelle in aqueous medium. The results of the in vitro release of curcumin and fucoidan showed that their release rates were higher at a pH of 4.5 than at a pH of 7.4. In contrast, the paclitaxel conjugate had a similar release profile at pH of 4.5 and pH of 7.4. CONCLUSION: In the present work, we also found an effective drug delivery system that had the ability to release two types of anticancer drugs, fucoidan and hydrophobic drugs, in the tumour environment.
Subject(s)
Antineoplastic Agents/chemistry , Curcumin/analogs & derivatives , Paclitaxel/analogs & derivatives , Polysaccharides/chemistry , Drug Carriers/chemistry , Drug Delivery Systems , Drug Liberation , Hydrogen-Ion Concentration , Hydrophobic and Hydrophilic Interactions , Micelles , Particle Size , SolubilityABSTRACT
Glycosphingolipids are a diverse family of biologically important glycolipids. In addition to variations on the lipid component, more than 300 glycosphingolipid glycans have been characterized. These glycans are directly involved in various molecular recognition events. Several naturally occurring sialic acid forms have been found in sialic acid-containing glycosphingolipids, namely gangliosides. However, ganglioside glycans containing less common sialic acid forms are currently not available. Herein, highly effective one-pot multienzyme (OPME) systems are used in sequential for high-yield and cost-effective production of glycosphingolipid glycans, including those containing different sialic acid forms such as N-acetylneuraminic acid (Neu5Ac), N-glycolylneuraminic acid (Neu5Gc), 2-keto-3-deoxy-d-glycero-d-galacto-nononic acid (Kdn), and 8-O-methyl-N-acetylneuraminic acid (Neu5Ac8OMe). A library of 64 structurally distinct glycosphingolipid glycans belonging to ganglio-series, lacto-/neolacto-series, and globo-/isoglobo-series glycosphingolipid glycans is constructed. These glycans are essential standards and invaluable probes for bioassays and biomedical studies.