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BACKGROUND: It is unclear whether an implantable cardioverter-defibrillator (ICD) is generally beneficial in survivors of out-of-hospital cardiac arrest (OHCA). OBJECTIVE: We studied the association between ICD implantation prior to discharge and survival in patients with cardiac aetiology or initial shockable rhythm in OHCA. DESIGN: We conducted a retrospective cohort study in the Swedish Registry for Cardiopulmonary Resuscitation. Treatment associations were estimated using propensity scores. We used gradient boosting, Bayesian additive regression trees, neural networks, extreme gradient boosting and logistic regression to generate multiple propensity scores. We selected the model yielding maximum covariate balance to obtain weights, which were used in a Cox regression to calculate HRs for death or recurrent cardiac arrest. PARTICIPANTS: All cases discharged alive during 2010 to 2020 with a cardiac aetiology or initial shockable rhythm were included. A total of 959 individuals were discharged with an ICD, and 2046 were discharged without one. RESULTS: Among those experiencing events, 25% did so within 90 days in the ICD group, compared with 52% in the other group. All HRs favoured ICD implantation. The overall HR (95% CI) for ICD versus no ICD was 0.38 (0.26 to 0.56). The HR was 0.42 (0.28 to 0.63) in cases with initial shockable rhythm; 0.18 (0.06 to 0.58) in non-shockable rhythm; 0.32 (0.20 to 0.53) in cases with a history of coronary artery disease; 0.36 (0.22 to 0.61) in heart failure and 0.30 (0.13 to 0.69) in those with diabetes. Similar associations were noted in all subgroups. CONCLUSION: Among survivors of OHCA, those discharged with an ICD had approximately 60% lower risk of death or recurrent cardiac arrest. A randomised trial is warranted to study this further.
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Reanimação Cardiopulmonar , Serviços Médicos de Emergência , Parada Cardíaca Extra-Hospitalar , Humanos , Estudos Retrospectivos , Teorema de Bayes , Suécia/epidemiologia , Sistema de RegistrosRESUMO
Purpose: Wounds with dead tissue, purulent wounds, and gangrene are good options for larval therapy. We aim to investigate the effect of larval therapy on diabetic wounds and compare it with traditional treatment. Methods: The sterile larvae were used in wound treatment and the infection rate, Erythrocyte Sedimentation Rate (ESR), and wound size were measured and compared before and after the treatment. Results: The scars of 40 patients in the larval therapy group were evaluated every 10 days and the mean size of the scar decreased from 38.5 cm (36.6 cm) before treatment to 5.0 cm (6.6 cm) after 60 days. ESR mean was decreased from 57.3 (18.3) before treatment to 15.8 (4.8) after treatment in the larval therapy group. These parameters were significantly decreased compared to the debridement group (p < 0.001). Conclusions: Larval therapy is effective in diabetic wound healing. The size of the wound after larval treatment is smaller than before. There was no difference between the two groups for infection rate. ESR was significantly decreased in the larval therapy group that indicating the lower inflammation in this group. Supplementary Information: The online version contains supplementary material available at 10.1007/s40200-022-00973-w.
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Football exposes its players to traumatic brain, neck, and spinal injury. It is unknown whether the adolescent football player develops imaging abnormalities of the brain and spine that are detectable on magnetic resonance imaging (MRI). The objective of this observational study was to identify potential MRI signatures of early brain and cervical spine (c-spine) injury in high school football players. Eighteen football players (mean age, 17.0 ± 1.5 years; mean career length, 6.3 ± 4.0 years) had a baseline brain MRI, and 7 had a follow-up scan 9-42 months later. C-spine MRIs were performed on 11 of the 18 subjects, and 5 had a follow-up scan. C-spine MRIs from 12 age-matched hospital controls were also retrospectively retrieved. Brain MRIs were reviewed by a neuroradiologist, and no cerebral microbleeds were detected. Three readers (a neuroradiologist, a neurosurgeon, and an orthopedic spine surgeon) studied the cervical intervertebral discs at six different cervical levels and graded degeneration using an established five-grade scoring system. We observed no statistically significant difference in disc degeneration or any trend toward increased disc degeneration in the c-spine of football players as compared with age-matched controls. Further research is needed to validate our findings and better understand the true impact of contact sports on young athletes.
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BACKGROUND: Cystic echinococcosis (CE) is a life-threatening disease in many countries. Albendazole, as the drug of choice for medical treatment of CE, is accompanied by adverse effects and may be ineffective in 20%-40% of cases; hence, new and more effective compounds are urgently needed to optimize the management of the disease. This study was performed to evaluate the efficacy of Zataria multiflora essential oil (ZMEO) versus albendazole against human liver CE. MATERIALS AND METHODS: In this nonrandomized and single-blinded clinical trial, thirty patients who were infected with liver CE were divided into two groups (15 in each) and treated with albendazole (800 mg daily) and ZMEO (60 mg daily), respectively. Albendazole and ZMEO were administered orally for 180 consecutive days. The volume of hydatid cysts was measured by ultrasonography before and 2, 4 and 6 months after the start of treatment. Simultaneously, biochemical analysis was performed on the blood samples of patients to assess the possible side effects of the two treatment regimens. RESULTS: Two, 4 and 6 months after the start of treatment, ZMEO indicated a significantly higher ability in reduction of the volume of the hydatid cysts, compared to albendazole (P < 0.05). The mean values of aspartate aminotransferase, alanine transaminase and alkaline phosphatase were also significantly lower in the patients treated with ZMEO in comparison to those treated with albendazole (P < 0.05). No clinical adverse effects were observed in the patients treated by ZMEO. CONCLUSION: From the point of view of efficacy and safety, ZMEO indicated a significant superiority to albendazole. Hence, ZMEO may be considered as an alternative for albendazole in the medical treatment of liver CE.
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There are various drug delivery systems (DDSs) among which nanoliposomal formulations are among the most prominent. Despite the superiority of nanoliposomal DDSs compared to conventional drug delivery methods, recent reports have claimed that they can deliver small amounts of the injected dose to target site by passive targeting. However, our understanding of tumor microenvironment features, including dysregulation of pH, the high intracellular concentration of glutathione, change in the amount and expression of some enzymes, reactive oxygen species, hypoxia, and ATP concentrations, has driven the scope of research into the use of these endogenous stimuli for a design of smart linkers. These linkers optimize the release of payloads in favorable target sites and avoid premature releasing in non-favorable off-target sites. In this review, we discuss particular linkers, which are able to respond to the specific endogenous conditions, and could be used in nanoliposomal DDSs, based on pathophysiological changes that occur in tumors. Furthermore, structural and chemical properties of these linkers and other potential linkers, which could be used in nanoliposomal DDSs, have been reviewed.
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Antineoplásicos/administração & dosagem , Sistemas de Liberação de Medicamentos , Nanopartículas/administração & dosagem , Neoplasias/tratamento farmacológico , Animais , Antineoplásicos/química , Humanos , Lipossomos , Nanopartículas/química , Microambiente TumoralRESUMO
OBJECTIVE: In the current investigation, we aimed to study the combined cytotoxicity of curcumin, as a nanomicellar formulation, and galbanic acid (Gal), dissolved in DMSO against the murine C26 and human Caco-2 colon carcinoma cells. Further, curcumin potential for cisplatin and doxorubicin (Dox) co-therapy was studied. MATERIALS AND METHODS: The combined cytotoxic effect of these phytochemicals at varying dose ratios were examined using the MTT colorimetric assay. Moreover, the time-dependent toxicity of curcumin, cisplatin, Dox, and pegylated liposomal Dox (Doxil) was determined. The interactive anti-proliferative behavior of these compounds was examined using the CompuSyn software. RESULTS: Nanomicellar curcumin showed considerable cytotoxicity in C26 cells 24 hr post-treatment. Co-treatment of cells with curcumin nanomicelles: Gal had a synergistic effect in C26 (at 10:1 molar ratio), and Caco-2 (at 1:5 molar ratio) cell lines in cell cultures. Nanomicellar curcumin showed strong and mild synergistic inhibitory effects in C26 cells when co-administered with Doxil and cisplatin, respectively. CONCLUSION: Curcumin nanomicelles and Gal had a synergistic effect in C26 and Caco-2 cell lines. It is speculated that nanomicellar curcumin shows synergistic cancer cell killing if administered 24-hr post-injection of Doxil and cisplatin.
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Tumor cell invasion and metastasis are the definitive cause of mortality in breast cancer (BC). Hypoxia and pro-inflammatory cytokines upregulate the CD73 gene in the tumor microenvironment. Subsequently, CD73 triggers molecular and cellular signaling pathways by both enzymatic and nonenzymatic pathways, which finally leads to breast tumor progression and development. In this paper, we summarize current advances in the understanding of CD73-driven mechanisms that promote BC development and mortality. Furthermore, we evaluate the therapeutic potential of CD73 targeting in BC.
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OBJECTIVE: The methanolic extracts of Nigella sativaL. seeds (MENS) and Berberis vulgaris L.(MEBV) were investigated for treatment of Haemoproteus columbae-infected pigeons (Columba livia domestica). MATERIALS AND METHODS: One hundred twenty naturally-infected pigeons were randomly divided into four groups of thirty each. Two groups were treated separately with the extracts, while the positive and negative control groups were given buparvaquone (Butalex®) and distilled water, respectively. The parasitaemia rate was calculated in all groups before and after the experiment at four-day intervals for16 days. RESULTS: The results showed a high therapeutic effect for MENS with a progressive decrease in average parasitaemia rate from 18.17% before treatment to 0.73% at the end of treatment (p<0.05), while Butalex® was able to suppress the parasitemia rate from 18.90% before treatment to 0.23% at the end of experiment (p<0.05). However, no significant changes in parasitemia rate were evident in groups treated with MEBV (p>0.05). CONCLUSION: Methanolic extracts of N. sativa showed therapeutic effects against H. columbae and may be regarded as a suitable choice for further studies to develop new drugs against blood parasites, in both animals and human beings.
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Angiogenesis is known as one of the hallmarks in cancer which could play a key role in providing oxygen and nutrients for tumor cells. It has been shown that tumor cannot grow without sufficient development of new blood vessels. Accordingly, targeting angiogenesis, especially endothelial cells, could be considered as a common therapeutic target in tumors and more investigation on already existing biomarkers and potentially new biomarkers of endothelial cells seems to be necessary in cancer therapy. Moreover, the use of effective targeting approaches such as proteins and peptides, aptamers, and small molecules is an important step for targeting biomarkers associated with endothelial cells and angiogenesis in cancer therapy. These agents are FDA approved, or are currently under investigation in pre-clinical and clinical studies. Among various biomarkers for angiogenesis microRNAs are suitable candidates for target therapy. These molecules play key roles in tumor angiogenesis which exert their effect via targeting a variety of cellular and molecular pathways involved in tumor angiogenesis. Here, we summarize a variety of biomarkers which their expressions or their functions could change the function of endothelial cells in tumor microenvironments. Moreover, we highlighted various therapeutic agents which could target these biomarkers.
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Biomarcadores Tumorais/metabolismo , Neoplasias/irrigação sanguínea , Neovascularização Patológica/metabolismo , Animais , Humanos , Ligantes , Proteínas de Neoplasias/metabolismo , Transdução de SinaisRESUMO
Dicrocoeliosis, caused by Dicrocoelium dendriticum is a hepatic parasitic disease of clinical and financial significance in ruminant breeding, which causes direct losses due to condemnation of parasitized livers. The purpose of our study was to assess the effects of natural dicrocoeliosis on the antioxidant defence capability of the liver in sheep. For this purpose, livers of 40 infected sheep with D. dendriticum along with livers of 20 healthy (control) sheep were collected from animals slaughtered in Khuzestan province, Iran. An increase in malondialdehyde concentrations accompanied by decreased activities of SOD and GPX of infected liver was noticed when compared with control values. Our data indicate that through dicrocoeliosis insufficient scavenging of reactive oxygen species takes place and caused oxidative liver damage.
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Varroa destructor is the most serious pest of honeybee (Apis mellifera), causing high economic losses in the beekeeping industry worldwide. The intensive utilization of many chemical substances against the mites resulted in resistance development. One of the applicable and alternative treatments being used for their control is plant-derived products (PDSS). The aim of this study was to evaluate the acaricidal activity of Lepidium latifolium and Zataria multiflora leaf extracts on V. destructor in field conditions. Four different concentrations (100, 200, 400, and 500 ppm) of the methanolic extracts were sprayed to treat each colony. The efficacy and side effects on adult bees were compared to Apistan chemical strips (ACSS). The acaricidal activity was the highest (100%) for L. latifolium extract at 500 ppm after 12 days and 86.26% for Z. multiflora. The infestation rate was decreased to 0.0% with L. latifolium and to 13.74% with Z. multiflora. The highest reduction was observed with L. latifolium followed by Z. multiflora extract at 500 ppm concentration. Both of the extracts showed negligible effect on bees, and it can be concluded that these PDSS as biodegradable agents could be used for V. destructor control in honeybee colonies.