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1.
Int J Dev Disabil ; 70(2): 173-183, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38481463

RESUMO

Objective: This review summarizes evidence pertaining to the impact of the COVID-19 pandemic on the psychological health of children and adolescents with autism spectrum disorder (ASD). Materials and Methods: An electronic search was conducted using four major databases: PubMed, ScienceDirect, Web of Science, and Google Scholar. Using an umbrella methodology, the reference lists of relevant papers were reviewed, and citation searches were conducted. The study included articles written in English between January 2020 and March 2021 that focused on the psychological health of autistic children and adolescents. Results: All eight studies included in the final review were cross-sectional. Three of the eight studies were conducted in Italy, two in Turkey, and one study each in Portugal, Spain, and the United Kingdom, with a total of 1,407 participants. All studies used a mixture of standardized and non-standardized questionnaires to collect data. The total number of patients were 1407 at a mean age of 9.53 (SD = 2.96) years. Seven studies report gender; male 74.7% (657/880) and female 25.3% (223/880). The finding showed that behavioral issues in children and adolescents with ASD have significantly increased; 521 (51.9 percent) of the 1004 individuals with ASD presented with behavioral changes, including conduct problems, emotional problems, aggression, and hyperactivity. Some studies also found increased anxiety and difficulties managing emotions. Only one study reported clinical stabilization in children with ASD during COVID-19. Finally, 82.7% of families and caregivers of children with ASD (544 out of 658) faced challenges during COVID-19. Conclusion: Although the studies in this review suggest a general worsening of ASD children's clinical status, it remains difficult to draw definitive conclusions at this moment, with newer COVID-19 variants on the rise worldwide. During this difficult pandemic period, caregivers, families, and healthcare professionals are recommended to pay more attention to the ASD patients' health and care needs.

2.
Expert Opin Pharmacother ; : 1-10, 2024 Mar 27.
Artigo em Inglês | MEDLINE | ID: mdl-38515004

RESUMO

INTRODUCTION: We systematically reviewed extant studies evaluating the efficacy and tolerability of xanomeline and xanomeline-trospium (KarXT) for treatment of adults with schizophrenia. METHODS: In accordance with PRISMA guidelines, articles were systematically searched for in databases and clinical trial registries. RESULTS: A total of 4 preclinical trials and 3 randomized controlled trials (RCTs) were included in this review. A 4-week RCT observed a difference of 24.0 points (SD 21.0) in the Positive and Negative Syndrome Scale (PANSS) total score between xanomeline and placebo groups (p = 0.039). A 5-week RCT observed PANSS total score changes from baseline to week 5, including -17.4 and -5.9 points in KarXT and placebo groups, respectively (LSMD -11.6 points; 95% CI -16.1 to -7.1; p < 0.001; d = 0.75). Another 5-week RCT observed PANSS total score changes from baseline to week 5, including -21.2 (SE 1.7) and -11.6 (SE 1.6) points in KarXT and placebo groups, respectively (LSMD -9.6; 95% CI -13.9 to -5.2; p < 0.0001; d = 0.61). Side effects include constipation, nausea, vomiting, dyspepsia, and dry mouth. CONCLUSION: KarXT offers an innovative non-D2 blocking approach, representing a promising treatment avenue for schizophrenia.

3.
Surg Endosc ; 2024 Mar 20.
Artigo em Inglês | MEDLINE | ID: mdl-38509391

RESUMO

BACKGROUND: Roux-en-Y gastric bypass (RYGB) has consistently demonstrated excellent weight loss and comorbidity resolution. However, outcomes vary based on patient's BMI. Single anastomosis duodeno-ileostomy with sleeve (SADI-S) is a novel procedure with promising short-term results. The long-term outcomes of SADI-S in patients with BMI ≥ 50 kg/m2 are not well described. We aim to compare the safety and efficacy of SADI-S with RYGB in this patient population. METHODS: We performed a multicenter retrospective study of patients with a BMI ≥ 50 kg/m2 who underwent RYGB or SADI-S between 2008 and 2023. Patient demographics, peri- and post-operative characteristics were collected. Complication rates were reported at 6, 12, 24, and 60 months postoperatively. A multivariate linear regression was used to evaluate and compare weight loss outcomes between both procedures. RESULTS: A total of 968 patients (343 RYGB and 625 SADI-S; 68.3% female, age 42.9 ± 12.1 years; BMI 57.3 ± 6.7 kg/m2) with a mean follow-up of 3.6 ± 3.6 years were included. Patients who underwent RYGB were older, more likely to be female, and have a higher rate of sleep apnea (p < 0.001), hypertension (p = 0.015), dyslipidemia (p < 0.001), and type 2 diabetes (p = 0.016) at baseline. The rate of bariatric surgery-specific complications was lower after SADI-S compared to RYGB. We reported no bariatric surgery related deaths after 1 year following both procedures. SADI-S demonstrated statistically higher and sustained weight loss at each time interval compared to RYGB (p < 0.001) even after controlling for multiple confounders. Lastly, the rate of surgical non-responders was lower in the SADI-S cohort. CONCLUSIONS: In our cohort, SADI-S was associated with higher and sustained weight-loss results compared to RYGB. Comorbidity resolution was also higher after SADI-S. Both procedures demonstrate a similar safety profile. Further studies are required to validate the long-term safety of SADI-S compared to other bariatric procedures.

4.
ACS Omega ; 9(8): 9003-9012, 2024 Feb 27.
Artigo em Inglês | MEDLINE | ID: mdl-38434887

RESUMO

The trends in food packaging technologies are shifting toward utilizing natural and environmentally friendly materials prepared from biopolymers such as kappa carrageenan to replace synthetic polymers. In the current study, varying amounts (0.1, 0.2, and 0.3%) of grapefruit essential oil (GFO) were incorporated in kappa carrageenan-based edible films to improve their physicochemical properties. The developed film samples were characterized for their barrier, mechanical, morphological, optical, thermal, antioxidant, and biodegradable properties. The results obtained showed that the tensile strength of the carrageenan films enhanced significantly from 65.20 ± 4.71 to 98.21 ± 6.35 MPa with the incorporation of GFO in a concentration-dependent manner. FTIR and SEM analysis confirmed the intermolecular bonding between carrageenan and GFO, resulting in the formation of compact films. Incorporating GFO significantly enhanced the thermal resistance of oil-loaded films, as confirmed by TGA, DSC, and DTG analysis. The addition of GFO led to a substantial increase in the radical scavenging activity of the films, as evidenced by the DPPH and ABTS assays. Furthermore, the developed films were biodegradable in soil and seawater environments, indicating their potential as a sustainable alternative to traditional plastics. Findings demonstrated that GFO can be used as a natural antioxidant agent in kappa carrageenan-based films for potential applications in food packaging.

5.
Int J Biol Macromol ; 264(Pt 2): 130463, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38423442

RESUMO

Sodium tripolyphosphate (STPP), an inorganic and non-toxic polyphosphate, has potential applications as a crosslinking agent in the fabrication of edible films. This study utilized STPP in the development of sodium alginate-chitosan composite films, with a focus on their suitability for food packaging applications. The results indicate that the incorporation of STPP led to an increase in film thickness (from 0.048 ± 0.004 to 0.078 ± 0.008 mm), elongation at break (from 11.50 ± 1.49 % to 15.88 ± 2.14 %), water permeation (from 0.364 ± 0.010 to 0.521 ± 0.021 gmm/(m2h*kPa)), and moisture content (from 25.98 ± 0.20 % to 28.12 ± 0.17 %). In contrast, there was a decrease in tensile strength (from 30.23 ± 2.08 to 25.60 ± 1.22 MPa) and swelling index (from 752.9 ± 17.1 to 533.5 ± 8.9 %). Scanning electron microscopy (SEM) analysis revealed the formation of distinctive needle-like microcrystals with the incorporation of STPP. Fourier-transform infrared spectroscopy (FTIR) analysis indicated intermolecular interactions between STPP and the film-forming biopolymers. The data obtained from Thermogravimetric analysis (TGA) and Differential Scanning Calorimetry (DSC) demonstrated enhanced thermal stability of STPP-loaded films at elevated temperatures. Furthermore, the films exhibited increased DPPH scavenging activity with the addition of STPP. This study underscores the potential of STPP as a crosslinking agent for the development of composite edible films, suggesting applications in the field of food packaging.


Assuntos
Alginatos , Quitosana , Alginatos/química , Quitosana/química , Resistência à Tração , Polifosfatos , Embalagem de Alimentos
6.
Heliyon ; 10(2): e24210, 2024 Jan 30.
Artigo em Inglês | MEDLINE | ID: mdl-38304764

RESUMO

Plasticizers are employed to stabilize films by safeguarding their physical stability and avoiding the degradation of the loaded therapeutic drug during processing and storage. In the present study, the plasticizer effect (glycerol) was studied on bioadhesive films based on sodium alginate (SA), carboxymethyl cellulose (CMC) and gelatin (GE) polymers loaded with amphotericin B (AmB). The main objective of the current study was to assess the morphological, mechanical, thermal, optical, and barrier properties of the films as a function of glycerol (Gly) concentration (0.5-1.5 %) using different techniques such as Scanning Electron Microscope (SEM), Texture analyzer (TA), Differential Scanning Calorimeter (DSC), X-Ray Diffraction (XRD), and Fourier Transforms Infrared Spectroscopy (FTIR). The concentration increase of glycerol resulted in an increase in Water Vapor Permeability (WVP) (0.187-0.334), elongation at break (EAB) (0.88-35.48 %), thickness (0.032-0.065 mm) and moisture level (17.5-41.76 %) whereas opacity, tensile strength (TS) (16.81-0.86 MPa), and young's modulus (YM) (0.194-0.002 MPa) values decreased. Glycerol incorporation in the film-Forming solution decreased the brittleness and fragility of the films. Fourier Transform Infrared (FTIR) spectra showed that intermolecular hydrogen bonding occurred between glycerol and polymers in plasticized films compared to control films. Furthermore, molecular docking was applied to predict the binding interactions betweem AmB, CMC, gelatin, SA and glycerol, which further endorsed the stabilizing effects of glycerol in the complex formation between AmB, CMC, SA, and gelatin. The Findings of the current study demonstrated that this polymeric blend could be used to successfully prepare bioadhesive films with glycerol as a plasticizer.

7.
Obes Surg ; 34(4): 1232-1237, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38409622

RESUMO

BACKGROUND: Obesity is a well-known risk factor for gastroesophageal reflux disease (GERD). Even though symptoms may be mitigated or resolved with the weight loss caused by sleeve gastrectomy (SG), it may be associated with higher incidences of postoperative GERD. Ligamentum teres cardiopexy (LTC) is an alternative to Roux-en-Y gastric bypass, the gold standard treatment for GERD. METHODS: This study was a retrospective single-center chart review, all patients in this cohort underwent LTC to treat refractory GERD at our institution. The option for LTC was presented after patients' refusal to undergo RYGB conversion. We collected baseline characteristics, standard demographics, pre-operative tests and imaging, and SG information, as well as intraoperative and perioperative data regarding LTC, and postoperative complications. RESULTS: Our cohort included 29 patients; most were Caucasian (44.8%) females (86.2%). The mean weight and BMI before LTC were 216.5 ± 39.3 lb and 36.1 ± 5.4 kg/m2, respectively. Mean total body-weight loss (TBWL) at 12 and 24 months were 28.7% ± 9.5% and 28.4% ± 12.4%, respectively. The mean interval between the index bariatric surgery and LTC was 59.9 ± 34.9 months, mean operative time was 67 ± 18.2 min, and median length of stay (LOS) was 1 day (IQR = 1-2 days). Twelve patients (57.1%) were able to discontinue antisecretory medications, while 9 (42.9%) still required them to remain asymptomatic. Mortality and reoperation rates were 0% and the incidence of complication was 19.4% (n = 6). CONCLUSIONS: LTC is a safe and effective surgical alternative to treat refractory GERD symptoms after SG.


Assuntos
Derivação Gástrica , Refluxo Gastroesofágico , Laparoscopia , Obesidade Mórbida , Ligamentos Redondos , Feminino , Humanos , Masculino , Obesidade Mórbida/cirurgia , Estudos Retrospectivos , Refluxo Gastroesofágico/etiologia , Derivação Gástrica/métodos , Laparoscopia/métodos , Reoperação/métodos , Gastrectomia/métodos , Ligamentos Redondos/cirurgia , Redução de Peso , Resultado do Tratamento
8.
Heliyon ; 10(3): e25501, 2024 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-38371972

RESUMO

This research focused on the development of films based on pectin and xanthan gum composite loaded with different concentrations of grapefruit essential oil (GFO). The fabricated films were characterized to assess the effect of GFO on the structural, mechanical, barrier, chemical, and antioxidant properties. The addition of GFO enhanced the functional properties of the films, as confirmed by FTIR analysis showing molecular interactions within the film matrix. SEM observations revealed that films with higher GFO content had a smoother, more compact structure with uniform oil distribution. Films loaded with oil demonstrated enhanced water resistance, as their decreased permeability ranged from 0.733 ± 0.009 to 0.561 ± 0.020 (g mm)/(m2.h.kPa). Additionally, these films showed a notable increase in tensile strength, ranging from 2.91 ± 0.19 to 8.55 ± 0.62 MPa. However, the addition of oil led to a reduction in the elongation at break of the films, which decreased from 52.84 ± 3.41 % to 12.68 ± 1.52 %, and a decline in transparency from 87.57 ± 0.65 % to 76.18 ± 1.12 %. Fabricated films exhibited enhanced antioxidant properties, as evidenced by increased DPPH• and ABTS•+ radical scavenging activities with the addition of GFO. The findings of the current study suggest that GFO is an effective natural additive for enhancing the physiochemical properties of pectin and xanthan gum-based films, making them more suitable for food packaging applications.

9.
Int J Biol Macromol ; 261(Pt 1): 129698, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38272421

RESUMO

The present study aimed to develop food packaging films by using a combination of pectin (PE) and sodium alginate (SA) enriched with Acetyl-11-keto-beta-boswellic acid (AKBA) as a functional or active ingredient. The fabricated films underwent comprehensive evaluation of their morphological, chemical, mechanical, barrier, optical, thermal, antioxidant, and antimicrobial properties. SEM and FTIR analysis showed that AKBA had good compatibility with film-forming components. The AKBA-loaded film samples exhibited a decrease in their barrier properties and tensile strength, but enhancements in both elongation at break and thickness values was observed. With the addition of AKBA, a significant increase (p < 0.05) in the ultraviolet barrier properties of the films and total colour variation (ΔE) was observed. TGA analysis of the films unveiled an improvement in thermal resistance with the incorporation of AKBA. Moreover, the films loaded with AKBA exhibited potent antioxidant activity in the ABTS and DPPH assay methods. Disk diffusion analysis showed the antimicrobial activity of AKBA-loaded films against P. aeruginosa, highlighting the potential of AKBA as a natural antimicrobial agent for the safety of food products. The results demonstrate the practical application of PE and SA active films loaded with AKBA, particularly within the food packaging industry.


Assuntos
Anti-Infecciosos , Triterpenos , Alginatos/química , Pectinas , Anti-Infecciosos/farmacologia , Anti-Infecciosos/química , Triterpenos/farmacologia , Antioxidantes/farmacologia , Antioxidantes/química , Embalagem de Alimentos/métodos
10.
Obes Surg ; 34(2): 602-609, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38177556

RESUMO

BACKGROUND: Malnutrition and liver impairment after duodenal switch (DS) are possible and undesired complications, often conservatively treated. However, in specific cases, surgical revision may be necessary. This study aims to describe outcomes achieved by two bariatric surgery centers and address effectiveness and safety of revisional surgical procedures to resolve these complications. METHODS: A retrospective chart review was performed in two bariatric surgery centers from 2008 to 2022. Patients who required revisional surgery to treat malnutrition and/or liver impairment refractory to nutritional and total parenteral nutrition intervention (TPN) after duodenal switch were included. No comparisons were performed due to the descriptive nature of this study. RESULTS: Thirteen patients underwent revisional surgery, the mean age was 44.7, the 53.8% were females, and the mean preoperative BMI was 54.7 kg/m2; the mean time between DS and revisional procedure was 26.5 months, and 69.1% of patients were placed on TPN. One patient developed hepatic encephalopathy; one patient presented with ascites, pleural effusion, and renal insufficiency, undergoing reoperation after revisional procedure due to a perforated ileal loop. Mortality rate was 0%; all patients regained weight after the revisional procedure, and the mean total protein and albumin blood levels 12 months after surgery were 6.3 and 3.6 g/dl, respectively. CONCLUSIONS: While refractory malnutrition and/or liver failure are rare among patients post-DS, if underdiagnosed and untreated, this can lead to irreversible outcomes and death. All revisional procedures included in this study resulted in improvement of the nutritional status and reversal of liver impairment, with low complication rates.


Assuntos
Cirurgia Bariátrica , Desvio Biliopancreático , Derivação Gástrica , Hepatopatias , Desnutrição , Obesidade Mórbida , Feminino , Humanos , Adulto , Masculino , Obesidade Mórbida/cirurgia , Desvio Biliopancreático/efeitos adversos , Desvio Biliopancreático/métodos , Estudos Retrospectivos , Desnutrição/etiologia , Desnutrição/cirurgia , Cirurgia Bariátrica/efeitos adversos , Cirurgia Bariátrica/métodos , Gastrectomia/métodos , Hepatopatias/cirurgia , Derivação Gástrica/métodos , Duodeno/cirurgia
11.
Hip Int ; 34(1): 49-56, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37306146

RESUMO

INTRODUCTION: Radiolucent lines occasionally develop around the proximal aspect of fully hydroxyapatite (HA)-coated tapered femoral stems after total hip arthroplasty (THA). It was hypothesised that distal wedging of stems may predispose to proximal radiolucent line formation, which may negatively impact clinical outcome. METHODS: All primary THA performed with a collarless fully HA-coated stem that had a minimum of 1 year of radiographic follow-up were identified in a surgical database (n = 244). Radiographic measures of proximal femoral morphology and femoral canal fill at the middle and distal thirds of the stem were analysed for association with the presence of proximal radiolucent lines. Linear regression was used to explore any association between radiolucent lines and patient reported outcome measures (PROMs), available in 61% of patients. RESULTS: Proximal radiolucent lines developed in 31 cases (12.7%) at final follow-up. Dorr A femoral morphology and increased canal-fill at the distal ⅓ of the stem correlated with the development of radiolucent lines (p < 0.001). No correlation was observed between pain or PROMs and the presence of proximal radiolucent lines. DISCUSSION: We observed an unexpectedly high incidence of proximal femoral radiolucent lines about collarless fully HA coated stems. Distal-only implant wedging in Dorr A bone may compromise proximal fixation. Although this finding did not correlate with short-term outcomes, the long-term clinical impact requires further study.


Assuntos
Artroplastia de Quadril , Prótese de Quadril , Humanos , Artroplastia de Quadril/efeitos adversos , Artroplastia de Quadril/métodos , Durapatita , Desenho de Prótese , Fêmur/diagnóstico por imagem , Fêmur/cirurgia , Fêmur/anatomia & histologia , Seguimentos , Estudos Retrospectivos
12.
Int J Biol Macromol ; 254(Pt 3): 128045, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37956812

RESUMO

In the current study, sodium caseinate and chitosan-based composite edible films were developed with the incorporation of black pepper (Piper nigrum) essential oil (BPO) in various concentrations (0.05, 0.1 and 0.15 %) for potential food packaging applications. The chemical composition of BPO was determined using GCMS and the major compound detected were ß-caryophyllene, limonene, ß-phellandren, pinene, copaene and α-humulene. The addition of BPO resulted in an increase in the thickness, EAB, WVP, moisture content and swelling index values of the films; however, the TS and water solubility decreased. The inclusion of BPO led to a substantial enhancement in the DPPH and ABTS radical scavenging capabilities of the edible films. SEM micrographs demonstrated intermolecular interaction between BPO, sodium caseinate, and chitosan. FTIR spectra confirmed the interaction of the functional groups of the polymers and BPO. The incorporation of the BPO increased the crystallinity of the films. Moreover, the thermal analysis including TGA, DSC and DTG demonstrated an increase in the thermal stability of the edible films with the addition of the BPO. These findings demonstrated that sodium caseinate and chitosan composite based edible films loaded with BPO can be used as sustainable active food packaging material.


Assuntos
Quitosana , Filmes Comestíveis , Óleos Voláteis , Piper nigrum , Quitosana/química , Antioxidantes/química , Caseínas , Embalagem de Alimentos/métodos
13.
J Biotechnol ; 379: 1-5, 2024 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-37944902

RESUMO

Considering global economic and environmental -benefits, green renewable biofuels such as ethanol and butanol are considered as sustainable alternatives to fossil fuels. Thus, developing a co-culture strategy for ethanol and butanol production by Saccharomyces cerevisiae and Clostridium beijerinckii has emerged as a promising approach for biofuel production from lignocellulosic biomass. This study developed a co-culture of S. cerevisiae and C. beijerinckii for ethanol and butanol production from non-detoxified corn stover hydrolysate. By firstly inoculating 3 % S. cerevisiae and then 7 % C. beijerinckii with 8-10 h time intervals, the optimized co-culture process gave 24.0 g/L ABE (20.8 g/L ethanol and 2.4 g/L butanol), obtaining ABE yield and productivity of 0.421 g/g and 0.55 g/L/h. The demonstrated co-culture strategy made full use of hexose and pentose in hydrolysate and contributed to total yield and efficiency compared to conventional ethanol or ABE fermentation, indicating its great potential for developing economically feasible and sustainable bioalcohols production.


Assuntos
Clostridium beijerinckii , Saccharomyces cerevisiae , Etanol , Zea mays , Técnicas de Cocultura , Acetona , Butanóis , 1-Butanol , Fermentação
14.
J Fluoresc ; 34(2): 655-666, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37338726

RESUMO

Morphology (size, shape) and structural variations (bonding pattern, crystallography, and atomic arrangements) have significant impacts on the efficacy of the metallic nanoparticles. Fabrication of these metal nanoparticles through green synthesis using plant extracts has increased attention due to their low cost, less hazardous byproducts, and multiple applications. In present study, Eucalyptus globulus extract was used to synthesize silver nanoparticles (AgNPs). Change of color from light brown to reddish brown and UV-visible spectral peak at 423 nm confirmed the formation of AgNPs. The shifting of FTIR spectra peaks indicated the potential role of the functional groups in extract as capping agents. The DLS evaluated the average size and stability of the nanoparticles while the surface morphology, size and the elemental composition of the AgNPs was established by the FESEM and EDX analysis. The SEM images revealed spherical nanoparticles of size ranging from 40-60 nm. Biogenic AgNPs showed better DPPH radical scavenging activity with IC50 (13.44 ± 0.3) as compared to leaves extract with IC50 (10.57 ± 0.2). The synthesized AgNPs showed higher zones of inhibition (ZOI) by well diffusion method against Escherichia coli, Staphylococcus aureus and Klebsiella pneumoniae. Results of present study highlights the potential benefits of Eucalyptus globulus leaves extract-based AgNPs for various biomedical uses.


Assuntos
Eucalyptus , Nanopartículas Metálicas , Antibacterianos/farmacologia , Antibacterianos/química , Prata/química , Nanopartículas Metálicas/química , Temperatura , Extratos Vegetais/farmacologia , Extratos Vegetais/química , Escherichia coli , Concentração de Íons de Hidrogênio
15.
J Psychiatr Res ; 170: 90-110, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38134724

RESUMO

Neurological manifestations have been widely reported in adults with COVID-19, yet the extent of involvement among the pediatric population is currently poorly characterized. The objective of our systematic review is to evaluate the association of SARS-CoV-2 infection with neurological symptoms and neuroimaging manifestations in the pediatric population. A literature search of Cochrane Library; EBSCO CINAHL; Global Index Medicus; OVID AMED, Embase, Medline, PsychINFO; and Scopus was conducted in accordance with the Peer Review of Electronic Search Strategies form (October 1, 2019 to March 15, 2022). Studies were included if they reported (1) COVID-19-associated neurological symptoms and neuroimaging manifestations in individuals aged <18 years with a confirmed, first SARS-CoV-2 infection and were (2) peer-reviewed. Full-text reviews of 222 retrieved articles were performed, along with subsequent reference searches. A total of 843 no-duplicate records were retrieved. Of the 19 identified studies, there were ten retrospective observational studies, seven case series, one case report, and one prospective cohort study. A total of 6985 individuals were included, where 12.8% (n = 892) of hospitalized patients experienced neurocognitive impairments which includes: 1) neurological symptoms (n = 294 of 892, 33.0%), 2) neurological syndromes and neuroimaging abnormalities (n = 223 of 892, 25.0%), and 3) other phenomena (n = 233 of 892, 26.1%). Based on pediatric-specific cohorts, children experienced more drowsiness (7.3% vs. 1.3%) and muscle weakness (7.3% vs. 6.3%) as opposed to adolescents. Agitation or irritability was observed more in children (7.3%) than infants (1.3%). Our findings revealed a high prevalence of immune-mediated patterns of disease among COVID-19 positive pediatric patients with neurocognitive abnormalities.


Assuntos
COVID-19 , Lactente , Adolescente , Adulto , Criança , Humanos , COVID-19/complicações , SARS-CoV-2 , Estudos Prospectivos , Estudos Retrospectivos , Prevalência
16.
Surg Obes Relat Dis ; 20(4): 399-405, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38151416

RESUMO

Patients undergoing metabolic and bariatric surgery (MBS) with body mass index (BMI) ≥ 70 kg/m2 are considered a high-risk group. There is limited literature to guide surgeons on the perioperative safety as well as the different procedural outcomes of MBS in this cohort. Our aim is to compare the safety profiles, early- and medium-term outcomes of sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), and duodenal switch (DS) in patients with BMI ≥ 70 kg/m2. A total of 156 patients with BMI ≥ 70kg/m2 underwent MBS (SG = 40, RYGB = 40, and DS = 76). Mean baseline BMI was 75.5 kg/m2. Total weight loss (%TWL) at 24 months was highest in the DS group compared to RYGB (40.6% versus 33.8%, P value = .03) and SG (40.6% versus 28.5%, P value = .006). There was no significant difference in %TWL between RYGB and SG (33.8% versus 28.5%, P value = .20). The 30-day complication rates were similar [SG (7.5%), RYGB (10%), and DS (9.2%) (P value = 1.0)]. There was one reported leak (DS). The 30-day mortality was zero. MBS is safe and effective in patients with BMI ≥ 70 kg/m2. All procedures had comparable safety profiles and complication rates. While DS achieved the highest %TWL at 24 months, similar comorbidity resolution rates among the procedures attenuate its clinical significance.


Assuntos
Derivação Gástrica , Obesidade Mórbida , Humanos , Derivação Gástrica/métodos , Obesidade Mórbida/cirurgia , Índice de Massa Corporal , Seguimentos , Estudos Retrospectivos , Gastrectomia/métodos , Resultado do Tratamento , Estudos Multicêntricos como Assunto
17.
Int J Occup Saf Ergon ; : 1-13, 2023 Dec 20.
Artigo em Inglês | MEDLINE | ID: mdl-38124384

RESUMO

Objectives. Current research aims to identify factors that affect the occupational safety climate in university laboratories despite their perception as low-risk areas compared to industrial environments. Methods. A safety climate survey was conducted in science laboratories across various engineering universities in Pakistan. The survey questionnaire was administered to 406 personnel, and a quantitative method for analysis was selected to examine the socio-demographic variables. A 5-point Likert scale (1 = strongly disagree to 5 = strongly agree) was used to perceive responses from participants. Additionally, a scale reliability test was conducted, and multivariate analysis of variance was performed to determine the relationship between selected dependent and independent variables. Results. The study found an overall safety climate score of 3.16 ± 0.55, indicating a moderate to high perception of safety on a scale of 1-5. Parameters such as role in the laboratory, departments/disciplines, accident experience and safety training significantly affected the safety climate score, while gender, age group, duration in university and accident witnessing did not. Conclusion. Upper management involvement, safety communication and direct supervision are crucial for improving the safety climate of university laboratories. The study recommends the consideration of the identified significant safety climate dimensions in laboratory safety policy-making at academic institutes.

18.
Biology (Basel) ; 12(9)2023 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-37759575

RESUMO

The process by which spermatogonial stem cells (SSCs) continuously go through mitosis, meiosis, and differentiation to produce gametes that transmit genetic information is known as spermatogenesis. Recapitulation of spermatogenesis in vitro is hindered by the challenge of collecting spermatogonial stem cells under long-term in vitro culture conditions. Coilia nasus is a commercially valuable anadromous migrant fish found in the Yangtze River in China. In the past few decades, exploitation and a deteriorating ecological environment have nearly caused the extinction of C. nasus's natural resources. In the present study, we established a stable spermatogonial stem cell line (CnSSC) from the gonadal tissue of the endangered species C. nasus. The cell line continued to proliferate and maintain stable cell morphology, a normal diploid karyotype, and gene expression patterns after more than one year of cell culture (>80 passages). Additionally, CnSSC cells could successfully differentiate into sperm cells through a coculture system. Therefore, the establishment of endangered species spermatogonial stem cell lines is a model for studying spermatogenesis in vitro and a feasible way to preserve germplasm resources.

19.
J Clin Med ; 12(17)2023 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-37685666

RESUMO

BACKGROUND: The current design of biliopancreatic diversion with duodenal switch (BPD/DS) and single anastomosis duodenal-ileal bypass with sleeve (SADI-S) emphasizes the importance of the pylorus' preservation to reduce the incidence of marginal ulcer (MU) and dumping. However, no institutional studies have yet reported data on their prevalence. We aimed to assess the incidence of MU and dumping after duodenal switch (DS) and identify the associative factors. METHODS: A multi-center review of patients who underwent BPD/DS or SADI-S between 2008 and 2022. Baseline demographics, symptoms, and management of both complications were collected. Fisher's exact test was used for categorical variables and the independent t-test for continuous variables. RESULTS: A total of 919 patients were included (74.6% female; age 42.5 years; BMI 54.6 kg/m2) with mean follow-up of 31.5 months. Eight patients (0.9%) developed MU and seven (0.8%) had dumping. Patients who developed MU were more likely to be using non-steroidal anti-inflammatory drugs (NSAID) (p = 0.006) and have a longer operation time (p = 0.047). Primary versus revisional surgery, and BDP/DS versus SADI-S were not associated with MU or dumping. CONCLUSIONS: The incidences of MU and dumping after DS were low. NSAID use and a longer operation time were associated with an increased risk of MU, whereas dumping was attributed to poor dietary habits.

20.
J Med Internet Res ; 25: e42786, 2023 09 22.
Artigo em Inglês | MEDLINE | ID: mdl-37738092

RESUMO

BACKGROUND: Many people living with major depressive disorder (MDD) in China do not receive treatment owing to a lack of mental health services, along with significant stigma toward mental illness. Internet-based cognitive behavioral therapy (ICBT) has been proposed to increase access to mental health care for people with MDD. OBJECTIVE: The aims of this study were to (1) evaluate the efficacy of ICBT for depressive symptoms in patients with MDD; (2) evaluate the effect of ICBT on anxiety symptoms, nonspecific psychological distress, general self-efficacy, depression stigma, social function, and health-related quality of life (HRQoL); and (3) explore the acceptability of and satisfaction with the ICBT program among participants. METHODS: Patients with MDD were enrolled and randomized to the ICBT group or the waiting-list control (WLC) group. The ICBT group received ICBT delivered through a WeChat mini-program with general support by nonspecialists. Participants in the 2 groups were self-evaluated online at baseline and posttreatment for changes in the primary outcome (ie, depressive symptoms) and secondary outcomes (ie, anxiety symptoms, nonspecific psychological distress, general self-efficacy, depression stigma, social functional impairment, and HRQoL). Changes in outcomes were measured by changes in overall scores on respective scales, and response and remission rates were calculated based on depressive symptoms. The acceptability of and satisfaction with the ICBT program were measured by treatment adherence and participants' feelings (ie, modules seriously completed, perceived benefit, and satisfaction). RESULTS: We included 40 patients who were randomly assigned to the ICBT group and 44 who were assigned to the WLC group. Compared with the WLC group, the ICBT group had fewer depressive symptoms, fewer anxiety symptoms, less nonspecific psychological distress, and greater general self-efficacy. Moreover, the ICBT group had higher response (18/31, 58%) and remission rates (17/31, 55%). The adherence rate in the ICBT group was 78% (31/40), and the majority of participants who completed all ICBT modules were satisfied with the ICBT program. CONCLUSIONS: ICBT demonstrated greater improvements in depressive symptoms, anxiety symptoms, nonspecific psychological distress, and general self-efficacy among selected patients with MDD in comparison with the findings in waiting-list controls. The ICBT program in this study had good acceptability and satisfaction among participants. TRIAL REGISTRATION: Chinese Clinical Trial Registry (ChiCTR2100046425); https://tinyurl.com/bdcrj4zv.


Assuntos
Terapia Cognitivo-Comportamental , Transtorno Depressivo Maior , Humanos , Transtorno Depressivo Maior/terapia , Qualidade de Vida , Autoeficácia , Internet
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