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1.
Front Microbiol ; 15: 1423044, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39228383

RESUMO

Dengue is an important vector-borne disease occurring globally. Dengue virus (DENV) infection can result in a potentially life-threatening disease. To date, no DENV-specific antiviral treatment is available. Moreover, an equally effective pan-serotype dengue virus vaccine is not available. Recently, two DENV vaccines, Dengvaxia and Qdenga, were licensed for limited use. However, none of them have been approved in Bangladesh. DENV is transmitted by Aedes mosquitoes, and global warming caused by climate change favoring Aedes breeding plays an important role in increasing DENV infections in Bangladesh. Dengue is a serious public health concern in Bangladesh. In the year 2023, Bangladesh witnessed its largest dengue outbreak, with the highest number of dengue cases (n = 321,179) and dengue-related deaths (n = 1,705) in a single epidemic year. There is an increased risk of severe dengue in individuals with preexisting DENV-specific immunoglobulin G if the individuals become infected with different DENV serotypes. To date, vector control has remained the mainstay for controlling dengue; therefore, an immediate, strengthened, and effective vector control program is critical and should be regularly performed for controlling dengue outbreaks in Bangladesh. In addition, the use of DENV vaccine in curbing dengue epidemics in Bangladesh requires more consideration and judgment by the respective authority of Bangladesh. This review provides perspectives on the control and prevention of dengue outbreaks. We also discuss the challenges of DENV vaccine use to reduce dengue epidemics infection in Bangladesh.

2.
Int J Med Mushrooms ; 26(11): 75-80, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39241165

RESUMO

This study integrates bioinformatics and computer-aided drug discovery to assess suillin's therapeutic potential, particularly its interaction with acetylcholinesterase (AChE). Alzheimer's disease presents profound challenges, necessitating effective treatments to mitigate cognitive decline and improve patients' quality of life. Although current medications offer symptomatic relief, they often entail adverse effects and do not address the underlying disease progression. Natural sources, such as macrofungi mushrooms, hold promise for novel drug discovery due to their bioactive compounds' diverse therapeutic properties. Suillin, derived from Suillus luteus mushrooms, shows promise as a mixed-type AChE inhibitor, crucial for maintaining acetylcholine levels in neurodegenerative disorders like Alzheimer's disease. Computational docking studies reveal suillin's distinctive interactions with AChE, suggesting potential modulation of enzyme function through various bonding mechanisms. The Molinspiration drug-likeness score further supports suillin's efficacy, indicating its suitability for enzyme inhibition. By combining computational and bioinformatics approaches, this study elucidates suillin's molecular interactions and underscores its potential as a therapeutic agent.


Assuntos
Acetilcolinesterase , Inibidores da Colinesterase , Simulação de Acoplamento Molecular , Acetilcolinesterase/metabolismo , Acetilcolinesterase/química , Inibidores da Colinesterase/farmacologia , Inibidores da Colinesterase/química , Simulação por Computador , Agaricales/enzimologia , Agaricales/química , Humanos
3.
Br J Clin Pharmacol ; 2024 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-39284639

RESUMO

AIMS: Healthcare accounts for 5% of global greenhouse gas emissions, with medicines making a sizeable contribution. Product-level medicine emission data is limited, hindering mitigation efforts. To address this, we created Medicine Carbon Footprint (MCF) Classifier, to estimate, standardize, stratify and visualize medicine carbon footprints. METHODS: We used molecular weight and chemical structure to estimate the process mass intensity and global warming potential of the active pharmaceutical ingredient in small molecule medicines. This allowed us to estimate medicine carbon footprints per dose, which we categorized into MCF Ratings, accessible via a searchable web application, MCF Formulary. We performed comparison and sensitivity analyses to validate the ratings, and stratification analyses by therapeutic indication to identify priority areas for emission reduction interventions. RESULTS: We generated standardized medicine carbon footprints for 2214 products, with 38% rated LOW, 35% MEDIUM, 25% HIGH and 2% VERY HIGH. These products represented 2.2 billion NHS England prescribed doses in January 2023, with a total footprint of 140 000 tonnes CO2e, equivalent to the monthly emissions of 940 000 cars. Notably, three antibiotics-amoxicillin, flucloxacillin and penicillin V-contributed 15% of emissions. We estimate that implementing the recommended 20% antibiotic prescription reduction could save 4200 tonnes CO2e per month, equivalent to removing 29 000 cars. CONCLUSIONS: Standardized medicine carbon footprints have utility in assessing and addressing the carbon emissions of medicines, and the potential to inform and catalyse changes needed to align better healthcare and net zero commitments.

4.
Psychopathology ; : 1-20, 2024 Sep 27.
Artigo em Inglês | MEDLINE | ID: mdl-39342939

RESUMO

INTRODUCTION: The complex biopsychosocial pathways linking maternal mental health with preterm birth (PTB) are not well understood. This study aimed to explore allostatic load (AL) as a mediator and perceived chronic stress as a moderator in the pathway linking maternal mental health and PTB. METHODS: A cohort study of pregnant women (n = 1,567) recruited at clinic visits within 10-19 weeks of gestation was assessed for maternal mental health (i.e., pregnancy-related anxiety, state anxiety, depressive symptoms) and perceived chronic stress. Blood pressure and levels of cortisol, total cholesterol, C-reactive protein, and glycosylated hemoglobin were used to create a composite measure of AL. RESULTS: AL had the most significant effect on PTB (odds ratio (OR) = 1.84, 95% CI = 1.26-12.67, p = 0.001), while systolic blood pressure emerged as the only significant individual marker using variable selection (OR = 22%, 95% CI = 1.06-1.40, p < 0.001) in multiple logistic regression analysis. A mediation analysis revealed that maternal mental health did not have a significant direct effect on PTB (p = 0.824), but its indirect effect mediated by AL was significant (z = 2.33, p < 0.020). Low and high levels of perceived chronic stress, relative to the mean, moderated this indirect effect (z = 3.66, p < 0.001). CONCLUSIONS: AL has a significant direct influence on PTB and mediates the effect of maternal mental health on PTB; however, the indirect effect of AL is indistinguishable between women with higher or lower levels of perceived chronic stress than normal.

5.
PLoS One ; 19(9): e0308463, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39241024

RESUMO

INTRODUCTION: Patients with multiple myeloma (MM) face heightened infection susceptibility, particularly severe risks from COVID-19. This study, the first systematic review in its domain, seeks to assess the impacts of COVID-19 on MM patients. METHOD: Adhering to PRISMA guidelines and PROSPERO registration (ID: CRD42023407784), this study conducted an exhaustive literature search from January 1, 2020, to April 12, 2024, using specified search terms in major databases (PubMed, EMBASE, and Web of Science). Quality assessment utilized the JBI Critical checklist, while publication bias was assessed using Egger's test and funnel plot. The leave-one-out sensitivity analyses were performed to assess the robustness of the results by excluding one study at a time to identify studies with a high risk of bias or those that significantly influenced the overall effect size. Data synthesis involved fitting a random-effects model and estimating meta-regression coefficients. RESULTS: A total of 14 studies, encompassing a sample size of 3214 yielded pooled estimates indicating a hospitalization rate of 53% (95% CI: 40.81, 65.93) with considerable heterogeneity across studies (I2 = 99%). The ICU admission rate was 17% (95% CI: 11.74, 21.37), also with significant heterogeneity (I2 = 94%). The pooled mortality rate was 22% (95% CI: 15.33, 28.93), showing high heterogeneity (I2 = 97%). The pooled survival rate stood at 78% (95% CI: 71.07, 84.67), again exhibiting substantial heterogeneity (I2 = 97%). Subgroup analysis and meta-regression highlighted that study types, demographic factors, and patient comorbidities significantly contributed to the observed outcome heterogeneity, revealing distinct patterns. Mortality rates increased by 15% for participants with a median age above 67 years. ICU admission rates were positively correlated with obesity, with a 20% increase for groups with at least 19% obesity. Mortality rates rose by 33% for the group of patients with at least 19% obesity, while survival rates decreased by 33% in the same group. CONCLUSION: Our meta-analysis sheds light on diverse COVID-19 outcomes in multiple myeloma. Heterogeneity underscores complexities, and study types, demographics, and co-morbidities significantly influence results, emphasizing the nuanced interplay of factors.


Assuntos
COVID-19 , Mieloma Múltiplo , Humanos , COVID-19/epidemiologia , COVID-19/imunologia , COVID-19/mortalidade , Hospitalização/estatística & dados numéricos , Unidades de Terapia Intensiva/estatística & dados numéricos , Mieloma Múltiplo/complicações , Mieloma Múltiplo/epidemiologia , Mieloma Múltiplo/imunologia , Mieloma Múltiplo/mortalidade , Medição de Risco/métodos , SARS-CoV-2/isolamento & purificação
6.
Sci Total Environ ; 953: 176024, 2024 Nov 25.
Artigo em Inglês | MEDLINE | ID: mdl-39241889

RESUMO

The groundwater (GW) resource plays a central role in securing water supply in the coastal region of Bangladesh and therefore the future sustainability of this valuable resource is crucial for the area. However, there is limited research on the driving factors and prediction of phosphate concentration in groundwater. In this work, geostatistical modeling, self-organizing maps (SOM) and data-driven algorithms were combined to determine the driving factors and predict GW phosphate content in coastal multi-aquifers in southern Bangladesh. The SOM analysis identified three distinct spatial patterns: K+Na+pH, Ca2+Mg2+NO3-, and HCO3-SO42-PO43-F-. Four data-driven algorithms, including CatBoost, Gradient Boosting Machine (GBM), Long Short-Term Memory (LSTM), and Support Vector Regression (SVR) were used to predict phosphate concentration in GW using 380 samples and 15 prediction parameters. Forecasting accuracy was evaluated using RMSE, R2, RAE, CC, and MAE. Phosphate dissolution and saltwater intrusion, along with phosphorus fertilizers, increase PO43- content in GW. Using input parameters selected by multicollinearity and SOM, the CatBoost model showed exceptional performance in both training (RMSE = 0.002, MAE = 0.001, R2 = 0.999, RAE = 0.057, CC = 1.00) and testing (RMSE = 0.001, MAE = 0.002, R2 = 0.989, RAE = 0.057, CC = 0.998). Na+, K+, and Mg2+ significantly influenced prediction accuracy. The uncertainty study revealed a low standard error for the CatBoost model, indicating robustness and consistency. Semi-variogram models confirmed that the most influential attributes showed weak dependence, suggesting that agricultural runoff increases the heterogeneity of PO43- distribution in GW. These findings are crucial for developing conservation and strategic plans for sustainable utilization of coastal GW resources.

8.
J Cutan Med Surg ; : 12034754241269148, 2024 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-39215457
9.
Indian J Nephrol ; 34(4): 369-373, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39156860

RESUMO

Opportunistic infections saw a rise during the COVID-19 pandemic. We report rhinocerebral mucormycosis following COVID infection in six patients with kidney disease. Though there was a variable outcome with 50% mortality, it is prudent to assess the risk factors for development of life-threatening infection.

10.
BMC Health Serv Res ; 24(1): 964, 2024 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-39169337

RESUMO

BACKGROUND: Educating patients regarding surgery is an important aspect of the preoperative process. It helps individuals answer their queries, reduce anxiety, and improve overall satisfaction with the surgical experience. OBJECTIVE: To compare patients' expectations with their real-perioperative surgical experiences. Also, to evaluate the effectiveness of preoperative education and, thus, improve the doctor-patient relationship. METHODOLOGY: Through consecutive sampling, 65 adult patients were selected from the ENT department of Khyber Teaching Hospital. Preoperative education was provided to all the subjects using a 25-point pro-forma, and their queries were addressed. Postoperatively, all participants were interviewed regarding their expectations and real perioperative surgical experiences. The gaps were noted, and participants were asked about their preferences for addressing such gaps in future interactions. Postoperatively, patients were asked to give comments on how a certain part of preoperative education could have been better delivered. RESULTS: Among the 65 patients, 28 (43.1%) were male, and 37 (56.9%) were female. The majority (38.5%) had a primary/secondary school education. Eight (12.3%) patients had ear surgery, 19 (29.2%) had nose surgery, and 38 (58.5%) had throat surgery. Almost 39 (60%) patients had preoperative fear/anxiety. After preoperative education, 17 (26.2%) patients experienced perioperative fear/anxiety, which was a significant reduction (p = 0.001). Preoperative anxiety was greater in females (M: F = 8:13, p = 0.00), while perioperative anxiety was comparable among both genders after patient education (M: F = 5:12, p = 0.18). The greatest dissatisfaction was noted regarding the surgical schedule (33.8%), range of motion (16.9%), deep breathing exercises (13.8%), and preoperative fasting (12.3%). Most importantly, patients' comments were noted, when they were asked to suggest a better way to educate preoperatively in their respective area of dissatisfaction. Patients appreciated detailed explanations with practical demonstrations for range of motion exercises. One patient complained about no clear instructions on postoperative resumption of snuff. CONCLUSION: Preoperative patient education should be a two-way process involving active participation and continuous feedback. By educating patients properly through a multidisciplinary approach, healthcare providers can further enhance patient satisfaction, alleviate anxiety, and improve the overall quality of care.


Assuntos
Educação de Pacientes como Assunto , Satisfação do Paciente , Relações Médico-Paciente , Humanos , Feminino , Masculino , Estudos Transversais , Educação de Pacientes como Assunto/métodos , Adulto , Satisfação do Paciente/estatística & dados numéricos , Pessoa de Meia-Idade , Cuidados Pré-Operatórios/métodos , Idoso , Inquéritos e Questionários
11.
J Coll Physicians Surg Pak ; 34(8): 956-962, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-39113516

RESUMO

Packing of tympanic cavity is generally considered an essential step in myringoplasty. However, each packing material comes with one or another side effect. The objective of this meta-analysis was to compare the results of Type 1 myringoplasty with or without packing. Pubmed, Cochrane database, Embase, Google Scholar, and clinicaltrials.gov were searched using 'tympanoplasty or myringoplasty and packing' as the search query. All RCTs / quasi-RCTs comparing tympanoplasty Type 1 with packing (control) versus without packing (intervention) of tympanic cavity in the human population were included. For dichotomous and continuous outcomes, relative risks (RR) and mean differences (MD) were calculated with 95% confidence interval, respectively. Heterogeneity was assessed using I2 statistics. Publication bias was checked using funnel plot and Egger's test, if applicable. Quality of evidence was assessed for each outcome using GRADE approach. Eleven studies were deemed eligible. For graft uptake and functional success rate, RR of 1.01 and 1.05 were obtained, respectively, showing no significant differences between the intervention and control groups. At 1st and 3rd postoperative month, no-packing group showed 3.86 dB and 2.08 dB better air-bone gap (ABG) closure than the packing group, respectively. Also, intervention with no-packing was 9.28-minute shorter procedure. With RR 0.35, no-packing had significantly lesser postoperative aural fullness. Type 1 tympanoplasty performed with or without packing show comparable results in terms of graft uptake and functional success rate. However, if performed without packing, it takes shorter time, provides early hearing improvement and causes less aural fullness. Key Words: Tympanoplasty Type 1, Packing, Gelfoam, No-packing, Meta-analysis, Endoscopic myringoplasty.


Assuntos
Miringoplastia , Perfuração da Membrana Timpânica , Timpanoplastia , Humanos , Timpanoplastia/métodos , Miringoplastia/métodos , Resultado do Tratamento , Perfuração da Membrana Timpânica/cirurgia , Orelha Média/cirurgia
12.
Work ; 2024 Aug 07.
Artigo em Inglês | MEDLINE | ID: mdl-39121148

RESUMO

BACKGROUND: Neck discomfort, arising from strained muscles, poor posture, accidents, or underlying medical conditions, significantly impacts daily activities and overall well-being, presenting a substantial healthcare challenge. OBJECTIVE: This study aims to evaluate the efficacy of motor control therapeutic neck exercise and a Structured Exercise Program on neck pain and posture among automobile industrial workers. METHODS: Using a lottery technique, 106 participants aged 20 to 45 were selected from the vicinity of Chennai's auto industries based on predetermined eligibility and exclusion criteria. Subsequently, participants were randomly assigned to either the motor control therapeutic neck exercise group or the structured exercise program group, each comprising 53 individuals. Participants received a comprehensive overview of the study and respective interventions, and their informed consent was obtained. Demographic details, Neck Injury and Disability scores, and Assessment of Postural and Ergonomic Characteristics data were then collected. RESULTS: Statistical analysis revealed a significant difference between the groups, with the Motor Control Therapeutic Neck Exercise group demonstrating superior outcomes in reducing pain and improving posture, with p-values less than 0.001. CONCLUSIONS: This study highlights the efficacy of Motor Control Therapeutic Neck Exercise over Structured Exercise in improving neck pain and posture among automobile industrial workers. These findings contribute valuable insights for the development of targeted interventions in occupational health settings.

13.
Nanoscale Adv ; 6(15): 3747-3758, 2024 Jul 23.
Artigo em Inglês | MEDLINE | ID: mdl-39050946

RESUMO

To develop an inhalable drug delivery system, we synthesized poly (lactic-co-glycolic acid) nanoparticles with Remdesivir (RDV NPs) as an antiviral agent against SARS-CoV-2 replication and formulated Remdesivir-loaded nanocomposites (RDV NCs) via coating of RDV NPs with novel supramolecular cell-penetrating peptide nanofibers (NFs) to enhance cellular uptake and intracellular drug delivery. RDV NPs and RDV NCs were characterized using variou techniques, including Transmission Electron Microscopy (TEM), Dynamic Light Scattering (DLS), and fluorescent microscopy. The cytotoxicity of RDV NCs was assessed in Vero E6 cells and primary human lung epithelial cells, with no significant cytotoxicity observed up to 1000 µg mL-1 and 48 h. RDV NCs were spherically shaped with a size range of 200-300 nm and a zeta potential of ∼+31 mV as well as indicating the presence of coated nanofibers. Reverse Transcription-quantitative Polymerase Chain Reaction (RT-qPCR), immunofluorescence and plaque assays of SARS-CoV-2 infected Vero E6 treated with RDV NCs showed significantly higher antiviral activities compared to those of free drug and uncoated RDV NPs. RDV NCs exhibited high antiviral activity against SARS-CoV-2, and the nanocomposite platform has the potential to be developed into an inhalable drug delivery system for other viral infections in the lungs.

14.
Indian J Public Health ; 68(1): 21-25, 2024 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-38847628

RESUMO

BACKGROUND: Acute lymphoblastic leukemia (ALL) is the most common childhood cancer. Immunophenotype (IPT) and cytogenetics are essential for diagnosis, risk stratification, and management for ALL. OBJECTIVES: Evaluating the burden of immunophenotypic and cytogenetic profile of pediatric ALL patients. MATERIALS AND METHODS: A descriptive cross-sectional study was conducted on 100 patients of ALL (1-18 completed years) attending a tertiary-care center in Kolkata, Eastern India. RESULTS: Ninety-six percent of patients had B-cell ALL (94.00% pre-B ALL and 2.00% Pro-B ALL) and 4.0% had T-ALL. 60% B-cell ALL were CD19/CD10 positive, 10% were CD79a positive, 9% were only CD19 positive, and 7% were only CD10 positive. Thirty-three percent of T-ALL were CD3+, whereas 22% were positive each for CD4 and CD7. 51.0% of patients had diploid, 46.0% hyperdiploid, and 3.0% hypodiploid karyotype. Among hyperdiploids, 98% had good prednisolone response and 89% had measurable residual disease (MRD) <0.01. CONCLUSION: The most commonly diagnosed ALL by IPT was pre-B ALL. Among the detectable cytogenetic abnormalities, t(12; 21) ETV6-RUNX1 was the most common. ZNF-384 gene arrangement was also detected in our study. t(12;21) ETV6-RUNX1 had a good treatment response, while t(9;22) BCR-ABL, t(1;19) TCF3-PBX1, iAMP-21, MLL gene rearrangement, and ZNF-384 gene arrangement had poor treatment response in terms of MRD.


Assuntos
Imunofenotipagem , Leucemia-Linfoma Linfoblástico de Células Precursoras , Humanos , Índia/epidemiologia , Criança , Masculino , Feminino , Pré-Escolar , Adolescente , Estudos Transversais , Leucemia-Linfoma Linfoblástico de Células Precursoras/genética , Lactente , Análise Citogenética
15.
J Manag Care Spec Pharm ; 30(9): 954-966, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-38831661

RESUMO

BACKGROUND: Once-monthly paliperidone palmitate (PP1M) is a long-acting injectable antipsychotic approved for the treatment of schizophrenia and schizoaffective disorder (SCA) in adults. OBJECTIVE: To assess treatment patterns and schizophrenia/SCA-related hospitalization following payer rejection, patient reversal, or payment of an initial PP1M claim. METHODS: This was a retrospective cohort study using the IQVIA Formulary Impact Analyzer database linked to the Medical Claims, Hospital Charge Detail Master, and Experian consumer databases. Patients with schizophrenia/SCA and ≥1 PP1M pharmacy claim from January 1, 2018, to February 28, 2022, were identified and stratified into 3 cohorts based on the transaction status of the initial PP1M claim (index date): rejected (payer not approved), reversed (payer approved, patient abandoned), and paid (payer approved, patient filled). Patient characteristics during the 12 months before the index date, subsequent treatment patterns, and schizophrenia/SCA-related hospitalization for patients with >6 months of follow-up were assessed by cohort. RESULTS: The rejected, reversed, and paid cohorts included 1,260, 1,046, and 1,686 patients, respectively. Across these cohorts, the mean ages ranged between 39.2 and 44.5 years; more than half were male (50.8%-51.6%) and White (50.6%-58.3%); 19.8%-24.6% of patients had a Quan-Charlson Comorbidity Index score of ≥2. Rates of prior atypical oral and long-acting injectable antipsychotic use ranged between 76.4%-80.3% and 7.8%-12.7%, respectively. Among patients with ≥6 months of follow-up, 52.2% in the rejected and 53.1% in the reversed cohorts had a subsequent paid PP1M claim during the study period; the median (quartile 1-quartile 3) time to the first paid PP1M claim was 22 (5-74) days for rejection and 11 (1-41) days for reversal. In the rejected and reversed cohorts, 10.2% (n = 111) and 9.8% (n = 90) of patients, respectively, did not receive any paid claim for an antipsychotic after the initial PP1M rejection/reversal. The prevalence of schizophrenia/SCA-related hospitalization during follow-up was similar between patients with a paid (7.4%) and rejected PP1M claim (7.0%; P = 0.689) but higher among patients with a reversed claim (10.8%; P = 0.004). After adjusting for confounders, patients in the reversed cohort were 39% more likely to have a schizophrenia/SCA-related hospitalization than those in the paid cohort (odds ratio = 1.39; 95% CI = 1.03-1.87). CONCLUSIONS: Payer rejection and patient reversal of initial PP1M claims is a form of primary nonadherence and may influence patient trajectory. Data from this study suggest that patient reversal of PP1M may lead to an increased risk of schizophrenia/SCA-related hospitalizations, potentially caused by missed or delayed treatment. Policy initiatives that remove barriers to primary adherence or fulfillment may help improve patients' clinical outcomes.


Assuntos
Antipsicóticos , Preparações de Ação Retardada , Hospitalização , Palmitato de Paliperidona , Transtornos Psicóticos , Esquizofrenia , Humanos , Palmitato de Paliperidona/administração & dosagem , Palmitato de Paliperidona/economia , Palmitato de Paliperidona/uso terapêutico , Esquizofrenia/tratamento farmacológico , Esquizofrenia/economia , Masculino , Antipsicóticos/economia , Antipsicóticos/administração & dosagem , Antipsicóticos/uso terapêutico , Feminino , Estudos Retrospectivos , Adulto , Hospitalização/estatística & dados numéricos , Hospitalização/economia , Pessoa de Meia-Idade , Transtornos Psicóticos/tratamento farmacológico , Transtornos Psicóticos/economia , Adulto Jovem , Injeções , Estudos de Coortes
16.
Cureus ; 16(5): e60747, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38903296

RESUMO

Background Surgical excision is the primary treatment for juvenile nasopharyngeal angiofibroma (JNA), but this procedure is challenging due to its high vascularity and local aggressiveness. Moreover, preoperative embolization is a subject of debate. Objective The objective of this study is to assess the efficacy, safety, and feasibility of endoscope-assisted excision as a surgical intervention for non-embolized advanced JNA. Materials and methods This case series involved six male patients (mean age: 16 years) with JNA, classified as stages Ⅱc to Ⅲb according to the Radkowski classification. None underwent preoperative embolization. Results Two stage Ⅱc cases underwent total endoscopic endonasal excision. One patient with stage Ⅲa and another with stage Ⅲb underwent surgery via an endoscope-assisted sublabial approach. Two patients, one with stage Ⅱc JNA and another with Ⅲb, underwent a two-stage procedure. Postoperative CT scans showed no residual disease at the six-month mark. On average, each procedure required 1.5 units of blood transfusion. One patient experienced intraoperative bleeding, whereas the remaining patients were free of any major complications. The mean operation duration was 175 minutes per procedure. The mean length of stay at the hospital was 3.75 days per procedure. Conclusion Endoscope-assisted or purely endoscopic approaches can be safely and effectively employed for the complete excision of non-embolized advanced JNAs.

17.
Pulm Circ ; 14(2): e12390, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38903484

RESUMO

This retrospective study was conducted to evaluate all-cause healthcare resource utilization (HCRU) and costs in commercially insured patients living with pulmonary arterial hypertension (PAH) and explore end-of-life (EOL)-related HCRU and costs. Data from the IQVIA PharMetrics® Plus database (October 2014 to May 2020) were analyzed to identify adults (≥18 years) with PAH (PAH cohort) and those without PH (non-PH cohort). Patients were required to have data for ≥12 months before (baseline) and ≥6 months after (follow-up) the first observed PH diagnosis (index date) for PAH cohort or pseudo index date for non-PH cohort. A PAH EOL cohort was similarly constructed using a broader data window (October 2014 to March 2022) and ≥1 month of follow-up. Annualized all-cause HCRU and costs during follow-up were compared between PAH and non-PH cohorts after 1:1 matching on propensity scores derived from patient characteristics. EOL-related HCRU and costs were explored within 30 days and 6 months before the death date and estimated by a claims-based algorithm in PAH EOL cohort. The annual all-cause total ($183,616 vs. $20,212) and pharmacy ($115,926 vs. $7862; both p < 0.001) costs were 8 and 14 times higher, respectively, in the PAH cohort versus matched non-PH cohort (N = 386 for each). In PAH EOL cohort (N = 28), the mean EOL-related costs were $48,846 and $167,524 per patient within 30 days and 6 months before the estimated death, respectively. Hospitalizations contributed 58.8%-70.8% of the EOL-related costs. The study findings indicate substantial HCRU and costs for PAH. While pharmacy costs were one of the major sources, hospitalization was the primary driver for EOL-related costs.

18.
Nat Commun ; 15(1): 5123, 2024 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-38879612

RESUMO

Bacteroidales (syn. Bacteroidetes) are prominent members of the human gastrointestinal ecosystem mainly due to their efficient glycan-degrading machinery, organized into gene clusters known as polysaccharide utilization loci (PULs). A single PUL was reported for catabolism of high-mannose (HM) N-glycan glyco-polypeptides in the gut symbiont Bacteroides thetaiotaomicron, encoding a surface endo-ß-N-acetylglucosaminidase (ENGase), BT3987. Here, we discover an ENGase from the GH18 family in B. thetaiotaomicron, BT1285, encoded in a distinct PUL with its own repertoire of proteins for catabolism of the same HM N-glycan substrate as that of BT3987. We employ X-ray crystallography, electron microscopy, mass spectrometry-based activity measurements, alanine scanning mutagenesis and a broad range of biophysical methods to comprehensively define the molecular mechanism by which BT1285 recognizes and hydrolyzes HM N-glycans, revealing that the stabilities and activities of BT1285 and BT3987 were optimal in markedly different conditions. BT1285 exhibits significantly higher affinity and faster hydrolysis of poorly accessible HM N-glycans than does BT3987. We also find that two HM-processing endoglycosidases from the human gut-resident Alistipes finegoldii display condition-specific functional properties. Altogether, our data suggest that human gut microbes employ evolutionary strategies to express distinct ENGases in order to optimally metabolize the same N-glycan substrate in the gastroinstestinal tract.


Assuntos
Proteínas de Bactérias , Bacteroides thetaiotaomicron , Microbioma Gastrointestinal , Polissacarídeos , Polissacarídeos/metabolismo , Humanos , Bacteroides thetaiotaomicron/metabolismo , Bacteroides thetaiotaomicron/enzimologia , Bacteroides thetaiotaomicron/genética , Proteínas de Bactérias/metabolismo , Proteínas de Bactérias/genética , Cristalografia por Raios X , Especificidade por Substrato , Glicosídeo Hidrolases/metabolismo , Glicosídeo Hidrolases/genética , Manose/metabolismo , Manosil-Glicoproteína Endo-beta-N-Acetilglucosaminidase/metabolismo , Manosil-Glicoproteína Endo-beta-N-Acetilglucosaminidase/genética , Família Multigênica
19.
J Integr Med ; 22(4): 385-398, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38693014

RESUMO

Phytosomes (phytophospholipid complex) are dosage forms that have recently been introduced to increase the stability and therapeutic effect of herbal medicine. Currently, bioactive herbs and the phytochemicals they contain are considered to be the best remedies for chronic diseases. One promising approach to increase the efficacy of plant-based therapies is to improve the stability and bioavailability of their bio-active ingredients. Phytosomes employ phospholipids as their active ingredients, and use their amphiphilic properties to solubilize and protect herbal extracts. The unique properties of phospholipids in drug delivery and their use in herbal medicines to improve bioavailability results in significantly enhanced health benefits. The introduction of phytosome nanotechnology can alter and revolutionize the current state of drug delivery. The goal of this review is to explain the application of phytosomes, their future prospects in drug delivery, and their advantages over conventional formulations. Please cite this article as: Chauhan D, Yadav PK, Sultana N, Agarwal A, Verma S, Chourasia MK, Gayen JR. Advancements in nanotechnology for the delivery of phytochemicals. J Integr Med. 2024; 22(4): 385-398.


Assuntos
Sistemas de Liberação de Medicamentos , Nanotecnologia , Compostos Fitoquímicos , Compostos Fitoquímicos/química , Compostos Fitoquímicos/administração & dosagem , Compostos Fitoquímicos/farmacocinética , Humanos , Fosfolipídeos/química , Disponibilidade Biológica , Fitoterapia , Extratos Vegetais/administração & dosagem , Extratos Vegetais/química , Extratos Vegetais/farmacocinética
20.
Int J Phytoremediation ; 26(10): 1676-1682, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38702891

RESUMO

Arsenic (As) is one of the most important water pollutant of global concern due to its extreme hazard. In the present study, B. subtilis synthesized iron oxide nanoparticles (Fe3O4 NPs) were used for mitigation of harmful metalloid As from the aqueous solution. Initially, the arsenic removal efficiency was tested in a batch culture experiment across various concentrations (5, 10 and 15 ppm) of B. subtilis synthesized Fe3O4 NPs at different pH, time interval and agitation speed. Optimal removal efficiency of As by using B. subtilis synthesized Fe3O4 NPs was observed at pH 7, after 80 min, and with agitation at 200 rpm. Additionally, hydroponic culture experiment was designed to assess B. subtilis synthesized Fe3O4 NPs efficiency in removal of As from As-contaminated water used to irrigate rice plants. Results revealed that B. subtilis synthesized Fe3O4 NPs effectively removed As from the contiminated water and reduced its uptake by the different parts of rice plants (root, shoot and leaf). Furthermore, these B. subtilis synthesized Fe3O4 NPs also reduced the bioaccumulation and enhanced plant tolerance to As, suggesting their potential in mitigating heavy metal toxicity, especially As and promoting plant growth. Thus, this study proposes B. subtilis synthesized Fe3O4 NPs as nano-adsorbents in reducing arsenic toxicity in rice plants.


Assuntos
Arsênio , Bacillus subtilis , Biodegradação Ambiental , Nanopartículas Magnéticas de Óxido de Ferro , Oryza , Poluentes Químicos da Água , Oryza/metabolismo , Arsênio/metabolismo , Poluentes Químicos da Água/metabolismo , Bacillus subtilis/efeitos dos fármacos
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