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Background: Nonalcoholic fatty liver disease (NAFLD) has become one of the major problems of chronic liver disease worldwide. It not only causes damage to the liver but also engenders chronic hepatitis and cirrhosis. Recent studies have shown that regulating Bacillus coagulans can improve NAFLD. Objectives: This trial explores whether B. coagulans TCI711 (BCT) could ameliorate NAFLD. Methods: A total of 57 patients with NAFLD were recruited through FibroScan liver fibrosis scanner and divided into placebo (n = 28) and BCT-supplemented groups (n = 29). Specifically, 1 BCT probiotic capsule was supplemented daily for 8 wk. Furthermore, the blood, stool, and fatty liver content were then examined. Results: Parameters evaluated for liver and kidney indicators showed no side effects after supplementing BCT. A significant reduction of 8.7% in the fatty liver was achieved by effectively suppressing the grade of fatty liver as revealed by controlled attenuation parameter. BCT also regulated gut microbiota profiles, with significant increases observed in Bifidobacterium, Eubacterium, Ruminococcaceae, and Sellimonas compared with the baseline. Conclusions: BCT may improve NAFLD by regulating gut microbiota, and parameters evaluated for liver and kidney indicate no side effects.
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OBJECTIVE: The primary goals of managing incontinence-associated dermatitis (IAD) are to control the incontinence and to stop the progress of dermatitis. This study evaluated the effectiveness of using a combination of topical antibiotic and topical antifungal medication to manage IAD. METHOD: Patients with grade 2 IAD treated with a combination of topical antibiotic Biomycin (CBC Biotechnological and Pharmaceutical, Taiwan) and antifungal clotrimazole (Sinphar Group, Taiwan) between January 2017 and January 2019 were included in this retrospective study. Data collected included patients' age, sex, diagnosis, body mass index, comorbidities and surface area involved. Patients were reviewed fortnightly until the wounds had healed, the patient was discharged or had died. RESULTS: A total of 76 patients were included. There were 39 men and 37 women with a mean age of 74 years. In 58 (76%) patients, the surface area involved was >50cm2, in 13 (17%) patients the involved area was 20-50cm2 and in five (7%) patients the area involved was <20cm2. The mean number of days treated was 10.3 (range: 1-53). A total of 46 (61%) patients showed total healing of their IAD, 17 (22%) patients showed improvement of >50% of the involved area, seven (9%) patients showed improvement of 0-50%, five (7%) patients showed no improvement and one (1%) patient showed an increase in the area involved. CONCLUSION: This combination of treatment was effective in the management of IAD. It was cheap, easy to apply, easy to remove and easily accessible. It could be used efficiently by the hospital staff and the patient's family.
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Antifúngicos/uso terapéutico , Dermatitis/tratamiento farmacológico , Incontinencia Fecal/complicaciones , Anciano , Antibacterianos/uso terapéutico , Antifúngicos/administración & dosificación , Dermatitis/etiología , Femenino , Humanos , Masculino , Estudios Retrospectivos , Cuidados de la PielRESUMEN
OBJECTIVE: To describe the nationwide trends in the utilization of trachelectomy among Taiwanese women with surgically resectable cervical cancer over the past decade, and to compare associated demographic characteristics, in-hospital complications and related outcomes using a population-based dataset from 1998 to 2013. MATERIALS AND METHODS: We conducted a population-based, cohort study using inpatient admission claims data of Taiwan's National Health Insurance program. Women who underwent trachelectomy for cervical cancers were compared by age at surgery (younger than 40 years, 40-59 years, and 60 years or older). RESULTS: Our study cohort consisted of 156 women. The overall utilization increased considerably during the study period, particularly in younger women aged 30-39 years. Compared with older women who had trachelectomy, women younger than 40 years were diagnosed more frequently in the later years of study (2007-2013, 69.9% vs 37.3%), were treated more frequently at medical centers (89.0% vs 60.2%) by physicians aged 55 years or older (50.7% vs 22.9%) with high case volume (50.7% vs 26.5%), were less likely to undergo concomitant surgeries for bilateral oophorectomy (1.4% vs 21.7%) and lysis of peritoneal adhesion (2.7% vs 24.1%), and were more likely to undergo lymph node excision (74.0% vs 47.0%) (P < 0.05 for all). During a median of follow-up of 5.4 (2.4-9.5) years, 5.1% received future hysterectomy after trachelectomy (n = 8) with a median time-to-future hysterectomy of 0.6 (0.2-5.0) years. The estimated risks of disease recurrence for cervical cancer and readmission within 30-days (n = 35) were 3.8% and 22.4%, respectively. Women's age at trachelectomy had no apparent association with the length of hospital stay (P = 0.11), in-hospital mortality, readmission within 30-days (P = 0.33), future hysterectomy (P = 0.14), and in-hospital complications (P = 0.47). CONCLUSION: Substantial increase in the trend of delayed childbearing may have influenced the decision-making of Taiwanese women with cervical cancer in favor of trachelectomy over hysterectomy over the past 16-years from 1998 to 2013. When considering the uterine preservation for future fertility, women should be counseled about the risk of disease recurrence for cervical cancer before making surgical decision for trachelectomy over hysterectomy.
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Histerectomía/estadística & datos numéricos , Aceptación de la Atención de Salud/estadística & datos numéricos , Complicaciones Posoperatorias/epidemiología , Traquelectomía/estadística & datos numéricos , Neoplasias del Cuello Uterino/cirugía , Adulto , Factores de Edad , Estudios de Cohortes , Femenino , Humanos , Histerectomía/tendencias , Persona de Mediana Edad , Complicaciones Posoperatorias/etiología , Taiwán/epidemiología , Traquelectomía/efectos adversos , Traquelectomía/tendencias , Resultado del TratamientoRESUMEN
Over the past few years, a 'One World, One Health' (OWOH) policy framework has become the guiding principle for international responses to avian influenza and other zoonotic infectious diseases. Several specialised inter-governmental agencies, including the World Health Organization, the Food and Agricultural Organization and World Organization for Animal Health, jointly endorsed and promoted this framework. This article attempts to explain why international agencies advocated OWOH despite its vagueness. By examining how these international agencies gradually reframed avian flu problems, this article illustrates the crucial roles of international agencies in constructing disease knowledge and relevant policy responses. It shows that the three agencies adopted an all-inclusive approach to reduce conflicts, defend their legitimacy, and facilitate commitment for collaboration. Not only has this new framework reduced tensions between agencies, it has also reshaped the interests and interactions of other global actors. The case thus illustrates how these organisational actors actively manufacture new cognitive frames and policy regimes that advance their own legitimacy and influence.
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Toma de Decisiones , Salud Global , Agencias Internacionales , Modelos Organizacionales , Animales , Aves , Difusión de Innovaciones , Práctica Clínica Basada en la Evidencia/métodos , Política de Salud , Humanos , Subtipo H5N1 del Virus de la Influenza A , Gripe Aviar/prevención & control , Gripe Aviar/transmisión , Gripe Humana/prevención & control , Gripe Humana/transmisión , Agencias Internacionales/organización & administración , Agencias Internacionales/normas , Evaluación de la Tecnología Biomédica , Organización Mundial de la SaludRESUMEN
Sulfate is an essential ion required for numerous functions in mammalian physiology. Due to its hydrophilic nature, cells require sulfate transporters on their plasma membranes to allow entry of sulfate into cells. In this study, we identified a new mouse Na(+)-sulfate cotransporter (mNaS2), characterized its tissue distribution and determined its cDNA and gene (Slc13a4) structures. mNaS2 mRNA was expressed in placenta, brain, lung, eye, heart, testis, thymus and liver. The mouse NaS2 cDNA spans 3384 nucleotides and its open frame encodes a protein of 624 amino acids. Slc13a4 maps to mouse chromosome 6B1 and contains 16 exons, spanning over 40 kb in length. Its 5'-flanking region contains CAAT- and GC-box motifs and a number of putative transcription factor binding sites, including GATA-1, MTF-1, STAT6 and HNF4 consensus sequences. This is the first study to define the tissue distribution of mNaS2 and resolve its cDNA and gene structures, which will allow us to investigate mNaS2 gene expression in vivo and determine its role in mammalian physiology.
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Proteínas de Transporte de Anión/genética , Proteínas de Transporte de Anión/metabolismo , Simportadores/genética , Simportadores/metabolismo , Región de Flanqueo 5' , Secuencia de Aminoácidos , Animales , Secuencia de Bases , Clonación Molecular , ADN Complementario/análisis , Expresión Génica , Ratones , Datos de Secuencia Molecular , ARN Mensajero/metabolismo , Elementos Reguladores de la Transcripción , Homología de Secuencia de Aminoácido , Transportadores de Sulfato , Distribución TisularRESUMEN
Inorganic sulfate is essential for numerous functions in mammalian physiology. In the present study, we characterized the functional properties of the rat Na+-sulfate cotransporter NaS2 (rNaS2), determined its tissue distribution, and identified its gene (slc13a4) structure. Expression of rNaS2 protein in Xenopus oocytes led to a Na+-dependent transport of sulfate that was inhibited by phosphate, thiosulfate, tungstate, selenate, oxalate, and molybdate, but not by citrate, succinate, or DIDS. Transport kinetics of rNaS2 determined a K(M) for sulfate of 1.26 mM. Na+ kinetics determined a Hill coefficient of n=3.0+/-0.7, suggesting a Na+:SO4 (2-) stoichiometry of 3:1. rNaS2 mRNA was highly expressed in placenta, with lower levels found in the brain and liver. slc13a4 maps to rat chromosome 4 and contains 17 exons, spanning over 46 kb in length. This gene produces two alternatively spliced transcripts, of which the transcript lacking exon 2 is the most abundant form. Its 5' flanking region contains CAAT- and GC-box motifs and a number of putative transcription factor binding sites, including GATA-1, SP1, and AP-2 consensus sequences. This is the first study to characterize rNaS2 transport kinetics, define its tissue distribution, and resolve its gene (slc13a4) structure and 5' flanking region.