Volatile Oil Containing Plants as Phytopharmaceuticals to Treat Psoriasis: A Review.

INTRODUCTION: Psoriasis is a chronic skin condition caused by an autoimmune response that accelerates the life cycle of skin cells, resulting in the characteristic symptoms of scaling, inflammation, and itching. METHODS: Palliative treatment options for psoriasis often prioritize the use of volatile oils. These oils contain monoterpenes, sesquiterpenes, and phenylpropanoids that are intricately linked to the molecular cascades involved in the pathogenesis and symptoms of psoriasis. To evaluate the antipsoriatic efficacy of volatile oils and their components, we conducted a systematic review of scientific studies. Our literature search encompassed various online databases, including PubMed, BIREME, SCIELO, Open Grey, Scopus, and ScienceDirect. The selected studies included experimental in vitro/in vivo assessments as well as clinical studies that examined the potential of volatile oils and their extracts as antipsoriatic agents. We excluded conference proceedings, case reports, editorials, and abstracts. Ultimately, we identified and evaluated a total of 12 studies for inclusion in our analysis. RESULTS: The data collected, compiled, and analyzed strongly support the interaction between volatile oils and their constituents with the key molecular pathways involved in the pathogenesis of psoriasis and the development of its symptoms. Volatile oils play a significant role in the palliative treatment of psoriasis, while their chemical constituents have the potential to reduce the symptoms and recurrence of this condition. CONCLUSION: The current review highlights that the constituents found in volatile oils offer distinct chemical frameworks that can be regarded as promising starting points for the exploration and development of innovative antipsoriatic agents.

Multi-Level Influences of Smoke-Free Policies in Subsidized Housing: Applying the COM-B Model and Neighborhood Assessments to Inform Smoke-Free Policies.

Smoke-free policies in multi-unit housing are associated with reduced exposure to secondhand smoke (SHS); however, attitudes toward comprehensive smoke-free policies among residents in subsidized multi-unit housing are unknown. In this mixed-methods study, we explored the socio-ecological context for tobacco and cannabis use and attitudes toward policies restricting indoor use of these products through interviews with residents (N = 134) and staff (N = 22) in 15 federally subsidized multi-unit housing in San Francisco, California. We conducted a geo-spatial and ethnographic environmental assessment by mapping alcohol, cannabis, and tobacco retail density using ArcGIS, and conducted systematic social observations of the neighborhood around each site for environmental cues to tobacco use. We used the Capability, Opportunity, and Motivation behavior (COM-B) model to identify factors that might influence implementation of smoke-free policies in multi-unit housing. Knowledge and attitudes toward tobacco and cannabis use, social norms around smoking, neighborhood violence, and cannabis legalization were some of the social-ecological factors that influenced tobacco use. There was spatial variation in the availability of alcohol, cannabis, and tobacco stores around sites, which may have influenced residents' ability to maintain smoke-free homes. Lack of skill on how to moderate indoor smoking (psychological capability), lack of safe neighborhoods (physical opportunity), and the stigma of smoking outdoors in multi-unit housing (motivation) were some of the barriers to adopting a smoke-free home. Interventions to increase adoption of smoke-free policies in multi-unit housing need to address the co-use of tobacco and cannabis and commercial and environmental determinants of tobacco use to facilitate smoke-free living.

Rise of the SARS-CoV-2 Variants: can proteomics be the silver bullet?

INTRODUCTION: The challenges posed by emergent strains of SARS-CoV-2 need to be tackled by contemporary scientific approaches, with proteomics playing a significant role. AREAS COVERED: In this review, we provide a brief synthesis of the impact of proteomics technologies in elucidating disease pathogenesis and classifiers for the prognosis of COVID-19 and propose proteomics methodologies that could play a crucial role in understanding emerging variants and their altered disease pathology. From aiding the design of novel drug candidates to facilitating the identification of T cell vaccine targets, we have discussed the impact of proteomics methods in COVID-19 research. Techniques varied as mass spectrometry, single-cell proteomics, multiplexed ELISA arrays, high-density proteome arrays, surface plasmon resonance, immunopeptidomics, and in silico docking studies that have helped augment the fight against existing diseases were useful in preparing us to tackle SARS-CoV-2 variants. We also propose an action plan for a pipeline to combat emerging pandemics using proteomics technology by adopting uniform standard operating procedures and unified data analysis paradigms. EXPERT OPINION: The knowledge about the use of diverse proteomics approaches for COVID-19 investigation will provide a framework for future basic research, better infectious disease prevention strategies, improved diagnostics, and targeted therapeutics.

Compliance with San Francisco's flavoured tobacco sales prohibition.

BACKGROUND: In June 2018, San Francisco voters upheld the first comprehensive prohibition on sales of flavoured tobacco products (all products including menthol, everywhere in the city with no exceptions). METHODS: This paper used data collected by the San Francisco Department of Public Health as part of its implementation and enforcement of San Francisco's city-wide ban on the sale of flavoured tobacco products. Every licensed tobacco retailer was visited and inspected. The San Francisco Department of Public Health and volunteers conducted an educational campaign from September 2018 to December 2018, including emailing all licensed tobacco retailers about the law, mailing a fact sheet poster, conducting four listening sessions and visiting permitted tobacco retailers to educate them about the law and solicit questions. RESULTS: Compliance inspections started in December 2018, which found that compliance was 17%. Compliance increased in January 2019 and averaged 80% between January 2019 and December 2019. After the phase-in period, all retailers were visited as part of routine inspections. This effort resulted in 80% compliance. CONCLUSION: Including retailer education prior to enforcement can result in compliance with a comprehensive ban on the sale of menthol and other flavoured tobacco products.

Neighborhood Ethnic Composition and Self-rated Health Among Chinese and Vietnamese American Immigrants.

Immigrants tend to live in areas with higher co-ethnic density, and the effect of neighborhood ethnic composition could be particularly salient for health. This study explored associations between neighborhood ethnic composition and self-rated health among Asian immigrants. We analyzed data collected at baseline from 670 Chinese and Vietnamese immigrants enrolled in a lifestyle intervention trial. Residential addresses were geocoded and combined with neighborhood socio-demographic profiles based on census data. We used generalized estimating equations to examine neighborhood ethnic composition and self-rated health. Independent of individual-level factors, living in neighborhoods more densely populated by whites was associated with poor/fair self-rated health. Neighborhood household income and density of participants' own ethnic group were not associated with poor/fair self-rated health. More research is warranted to disentangle reasons why Chinese and Vietnamese immigrants living in white-concentrated neighborhoods reported poorer self-rated health, including investigating effects of discrimination, relative deprivation, and availability of social resources.

Disentangling individual and neighborhood differences in the intention to quit smoking in Asian American male smokers.

Numerous studies have assessed individual-level factors associated with intention to quit smoking. However, fewer studies have assessed how neighborhood and built environment also contribute towards individual-level behavior. We used baseline data of 340 Chinese and Vietnamese male daily smokers from August 2015 to November 2017 living in the San Francisco Bay Area, who enrolled in a lifestyle intervention trial. The outcome variable was intention to quit in 30 days. To understand the role of contextual factors participants' residential addresses were geocoded, and neighborhood median income, ethnic composition, and tobacco retail density were computed. Individual level analysis suggested that Vietnamese American men had greater intention to quit smoking (OR = 2.90 CI = 1.59, 5.26) in comparison to Chinese Americans. However, after adding neighborhood level factors to the model, no ethnic group difference was observed. Neighborhood household median income (OR = 0.74, CI = 0.64, 0.86) and tobacco retail counts (OR = 0.79, CI = 0.67, 0.94) were negatively associated with intention to quit. Years lived in the U.S. was the only individual level factor associated with intention to quit. By comparing two Asian American groups that live in heterogeneous neighborhoods, we identify key environmental and policy drivers that are associated with quit intention. Future studies aimed at influencing individual-level behavior should take into consideration the neighborhood context and built environment characteristics.

Examining the role of a retail density ordinance in reducing concentration of tobacco retailers.

Neighborhood characteristics and the built environment are important determinants in shaping health inequalities. We evaluate the role of a retail density ordinance in reducing concentration of tobacco stores based on neighborhood characteristics and land use pattern in San Francisco. The study evaluated the spatial distribution of tobacco retailers before and after the ordinance to identify geographic pockets where the most significant reduction had occurred. A generalized additive model was applied to assess the association between the location of the closure of tobacco retailer and socio-demographic characteristics and land use pattern. We did not find a meaningful change in the overall concentration of retailers based on neighborhood income and ethnicity but found a significant association based on patterns of land use. Our findings suggest that future polices must account for the differential distribution of retailers based on land use mix to lower concentration in areas where it is needed the most.

Understanding Spatial and Contextual Factors Influencing Intraregional Differences in Child Vaccination Coverage in Bangladesh.

In Bangladesh, policy discourse has mostly focused on regional inequities in health, including child immunization coverage. Knowledge of local geographical and contextual factors within regions, however, becomes pertinent in efforts to address these inequities. We used the Bangladesh Demographic and Health Survey 2011 to examine factors that influence intraregional differences in vaccination coverage using a multilevel analysis. We found that in spite of the provision of health facilities at each level of administrative governance, only distance to the Upazilla Health Complex was a consistent predictor for each dose of vaccine, highlighting the remote locations of the communities that remain underserved. Our analysis demonstrates the value of subregional analyses that identify the characteristics of communities that are vulnerable to incomplete immunization coverage. Unless specific policy actions are taken to increase coverage in these remote areas, geographic inequities are likely to persist within regions, and desired targets will not be achieved.

Understanding causes of fall and struck-by incidents: What differentiates construction safety in the Arabian Gulf region?

Rapid growth in the Arabian Gulf region has fueled an explosive pace of construction and a rise in risks of occupational injury. Scarcity of pertinent data, however, makes it hard to determine whether accident characteristics, causal factors and remedial interventions identified elsewhere apply to the Gulf in comparable ways. This difficulty stems from unusual construction sector characteristics, notably a heterogeneous mix of expatriate laborers and firms working without a common language, work culture or labor practices. Does this change the mix of accident types or the ranking of main causes and priority remedies? To answer this question, a sample of 519 incident records was analyzed to determine whether accident types and frequencies are comparable to elsewhere. Site safety experts were then interviewed to determine whether rankings of factors and interventions should be similar. Findings are that types are indeed comparable, but the rankings of factors and interventions may not be. Main factors have to do with worker skills and training, experience, use of safety gear and risk perception. The overarching safety issue, however, is that firms and governments do not have strong incentive to address these factors.

Role of spatial tools in public health policymaking of Bangladesh: opportunities and challenges.

In spite of the increasing efforts to gather spatial data in developing countries, the use of maps is mostly for visualization of health indicators rather than informed decision-making. Various spatial tools can aid policymakers to allocate resources effectively, predict patterns in communicable or infectious diseases, and provide insights into geographical factors which are associated with utilization or adequacy of health services. In Bangladesh, the launch of District Health Information System 2, along with recent efforts to gather spatial data of facilities location, provides an interesting opportunity to study the current landscape and the potential barriers in advancing the use of spatial tools for informed decision making. This study assessed the current level of map usage and spatial tools for health sector planning in Bangladesh, focusing on investigating why map usage and spatial tools remained at a basic level for the purpose of health policy. The study design involved in-depth interviews, followed by an expert survey (n = 39) obtained through snowball sampling.Our survey revealed that assessing areas with shortage of community health workers emerged as the top most for basic map usage or primarily for visualization purpose, while planning for emergency and obstetric care services, and disease mapping was the most frequent category for intermediate and advanced map usage, respectively. Furthermore, we found lack of inter-institutional collaboration, lack of continuous availability of trained personnel, and lack of awareness on the use of geographic information system (GIS) as a decision-making tool as three most critical barriers in the current landscape. Our findings highlight the barriers in increasing the adoption of spatial tools for health policymaking and planning in Bangladesh.

Surprising cause of dysphagia in an elderly male.

A 73 year old man presented to his primary care physician with sudden onset dysphagia to solids and liquids. He urgently completed a barium swallow study showing what was believed to be a coin. Endoscopic removal subsequently revealed it was a lithium battery. Consequences and management of lithium battery ingestion are discussed.

Thrombolysis in acute pulmonary thromboembolism.

Acute pulmonary embolism (PE) is a common clinical condition with presentations that may vary from asymptomatic subsegmental emboli to massive vascular obstruction and shock with high risk of death. Identifying patients at highest risk for death is critical to select those who would benefit most from thrombolytic therapy. New and evolving clinical prediction models, serum tests, and imaging modalities are being used to improve our ability to identify potential thrombolytic candidates. We review the evolution of the present guidelines on the management of PE, specifically regarding the evolving role of thrombolytics; outcomes following thrombolytic therapy, including mortality, hemorrhage, hemodynamic improvement, and prevention of chronic thromboembolic pulmonary hypertension; and our strategy for risk stratification of pulmonary embolism.

An unusual presentation of necrotizing enterocolitis on an echocardiogram.

This report describes the spontaneous intracardiac air contrast found on the echocardiogram of a 5 day-old term neonate with Down syndrome and a complete atrioventricular septal defect who had experienced sudden-onset tachypnea and systemic desaturation. The stream of air contrast was tracked coming from the hepatic veins, and a diagnosis of necrotizing enterocolitis was suspected. An abdominal radiograph and ultrasound confirmed the diagnosis.

A rare case of simultaneous pulmonary and paradoxical emboli with a thrombus straddling a patent foramen ovale.

BACKGROUND: Paradoxical embolism is a rare event and the exact contribution of patent foramen ovale in stroke is unclear. Intracardiac thrombi or 'embolus-in-transit' are associated with high mortality. Acutely elevated pulmonary arterial pressure due to pulmonary embolism or Valsalva maneuver make foramen ovale patent and promote right to left migration of intraatrial clot. A large thrombus trapped during its passage produces impending paradoxical embolism, which though proposed, is documented very rarely in live patients. This is a high-risk situation. Surgical embolectomy, like our case, has shown to have better outcomes in overall patient survival. CASE: A 66-year-old female with acute left main cerebral artery infarct and acute bilateral pulmonary embolism. In initial assessment, lower extremities venous Doppler study revealed left leg deep venous thrombosis and transthoracic echocardiogram showed a long biatrial clot straddling through patent foramen ovale and a right-to-left interatrial shunt. After heparinization and inferior vena caval filter placement, she underwent successful surgical embolectomy along with closure of patent foramen ovale with subsequent uneventful recovery. CONCLUSION: 'Embolus in transit' is a high-risk situation and should be actively searched for in patients of pulmonary embolism and stroke. We recommend surgical embolectomy over other treatment modalities in such situations.

Successful treatment of thyroid storm with plasmapheresis in a patient with methimazole-induced agranulocytosis.

OBJECTIVE: To report a case of a patient with Graves disease presenting with agranulocytosis induced by methimazole, with subsequent thyroid storm and successful therapeutic use of plasmapheresis. METHODS: The clinical features and laboratory findings in a patient with agranulocytosis and thyroid storm are presented, and the available literature on utilization of plasmapheresis in the setting of thyrotoxicosis is reviewed. RESULTS: A 40-year-old Vietnamese woman with Graves disease was admitted with methimazole-induced agranulocytosis. Treatment with methimazole was discontinued, and therapy with antibiotics, granulocyte colony-stimulating factor, and ibuprofen was initiated. During hospitalization of the patient, her clinical status deteriorated, with development of pericarditis, thrombocytopenia, and thyroid storm. Treatment with plasmapheresis yielded near-euthyroidism in 3 days. Subsequently, she underwent successful total thyroidectomy. CONCLUSION: Our case highlights the effectiveness of plasmapheresis when clinical situations prohibit the use of traditional treatment methods for thyrotoxicosis or thyroid storm (or both).

Modulatory effect of distillate of Ocimum sanctum leaf extract (Tulsi) on human lymphocytes against genotoxicants.

OBJECTIVE: To study the modulatory effect of distillate of Ocimum sanctum (traditionally known as Tulsi) leaf extract (DTLE) on genotoxicants. METHODS: In the present investigation, we studied the antigenotoxic and anticlastogenic effect of distillate of Tulsi leaf extract on (i) human polymorphonuclear leukocytes by evaluating the DNA strand break without metabolic activation against mitomycin C (MMC) and hexavalent chromium (Cr+6) and (ii) human peripheral lymphocytes (in vitro) with or without metabolic activation against mitomycin C (MMC), hexavalent chromium (Cr+6) and B[a]P by evaluating chromosomal aberration (CA) and micronucleus assay (MN). Three different doses of DTLE, 50 microL/mL, 100 microL/mL, and 200 microL/mL were selected on the basis of cytotoxicity assay and used for studying DNA strand break, chromosomal aberration and micronucleus emergence. The following positive controls were used for inducing genotoxicity and clastogenicity: MMC (0.29 micromol/L) for DNA strand break, chromosomal aberration and 0.51 micromol/L for micronucleus assay; Potassium dichromate (Cr+6) 600 micromol/L for DNA strand break and 5 micromol/L for chromosomal aberration and micronucleus assay; Benzo[a]pyrene (30 micromol/L) for chromosomal aberration and 40 micromol/L for micronucleus assay. The active ingredients present in the distillate of Tulsi leaf extract were identified by HPLC and LC-MS. RESULTS: Mitomycin C (MMC) and hexavalent chromium (Cr+6) induced statistically significant DNA strand break of respectively 69% and 71% (P<0.001) as revealed by fluorometric analysis of DNA unwinding. Furthermore, the damage could be protected with DTLE (50 microL/mL, 100 microL/mL, and 200 microL/mL) on simultaneous treatment. Chromosomal aberration and micronucleus formation induced by MMC, Cr+6 and B[a]P were significantly protected (P<0.001) by DTLE with and without metabolic activation. CONCLUSION: Distillate of Tulsi leaf extract possesses antioxidants contributed mainly by eugenol, luteolin and apigenin as identified by LC-MS. These active ingredients may have the protective effect against genotoxicants.