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1.
J Family Community Med ; 31(1): 48-56, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38406221

RESUMO

BACKGROUND: The preparticipation physical evaluation (PPE) monograph is a vital resource for medical providers aimed at ensuring the safety and well-being of athletes during sports participation by screening for injuries and disease risk factors. However, the concept of PPE is relatively new in Saudi Arabia, where primary care physicians (PCPs) often lack the proper training for it. This study's aim was to assess PCPs' knowledge and practice of PPE and identify associated factors. MATERIALS AND METHODS: A self-administrated web-based questionnaire was distributed to PCPs in the Eastern Province of Saudi Arabia. The questionnaire covered the various aspects of PPE knowledge (including general principles, components, contraindications of sports participation, concerning history and physical findings, electrocardiography interpretations, and ethical considerations) as well as PPE practice. Initial treatment of data included descriptive statistics.; Chi-square tes or Fisher's exact test as, as appropriate, were used to determine association of knowledge and practices with various independent variables. RESULTS: Of the 240 contacted PCPs, 192 responded yielding a response rate of 80%; 50.5% had no prior PPE training. About 43% of the PCPs had not encountered PPE during their examination, but the remainder performed monthly PPE. Notably, 82.8% demonstrated a poor level of knowledge regarding PPE and only 43% had a satisfactory level of practice. CONCLUSION: This study revealed that a significant proportion of PCPs displayed poor knowledge of PPE and <½ of our sample showed satisfactory practice levels. Recommendations to establish the local guidelines regarding PPE for PCPs to follow should be emphasized and PPE training integrated into both undergraduate and postgraduate family medicine curricula. These measures are crucial for the enhancement of the safety of athletes in Saudi Arabia.

2.
Niger J Clin Pract ; 26(6): 825-831, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-37470659

RESUMO

Background: Specific death due to DR-TB has significantly contributed to tuberculosis (TB) mortality and overall global deaths. Aim: This study examines the predictors of mortality among DR-TB patients in Kaduna State, Nigeria. Subject and Method: This was a retrospective longitudinal study of DR-TB mortality carried out among 370 DR-TB patients from the 23 LGAs in Kaduna State. It involves a retrospective review of the MDR-TB records of the patients over a period of 10 years (2012-2021). Demographic and clinical data of all DR-TB patients enrolled in Kaduna State, Nigeria, between April 1, 2012, and March 31, 2021, were used. Survival analysis was performed with SPSS version 25, using Kaplan-Meier and Cox proportional hazard regression modeling, at 5% significance level. Results: The majority of the patients, 255 (68.9%), were below the age of 40 years, while 53 (14.3%) of the patients died within the study period. Most deaths 26 (49.1%) were associated with HIV co-infection and the disease severity. Results for the Cox proportional model show that there was a significantly lower risk of death when a patient had MDR-TB compared to pre-XDR-TB (adjusted hazard ratio, AHR = 0.34, 95% CI = 0.16-0.72, P = 0.04). Both models show that age, sex, residence, or year of treatment had no significant association with survival or death. Conclusion: HIV co-infection and DRTB with progression to more resistant and difficult-to-treat strains contributed to higher deaths. There is a need for concerted efforts from all DR-TB stakeholders to control the disease.


Assuntos
Coinfecção , Infecções por HIV , Tuberculose Resistente a Múltiplos Medicamentos , Tuberculose , Humanos , Adulto , Estudos Retrospectivos , Estudos Longitudinais , Nigéria/epidemiologia , Tuberculose Resistente a Múltiplos Medicamentos/tratamento farmacológico , Tuberculose Resistente a Múltiplos Medicamentos/epidemiologia , Tuberculose/epidemiologia , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia
3.
Funct Integr Genomics ; 23(2): 102, 2023 Mar 27.
Artigo em Inglês | MEDLINE | ID: mdl-36973604

RESUMO

Ischemic stroke represents a significant societal burden across the globe. Rare high penetrant monogenic variants and less pathogenic common single nucleotide polymorphisms (SNPs) have been described as being associated with risk of diseases. Genetic studies in Saudi Arabian patients offer a greater opportunity to detect rare high penetrant mutations enriched in these consanguineous populations. We performed whole exome sequencing on 387 ischemic stroke subjects from Saudi Arabian hospital networks with up to 20,230 controls from the Saudi Human Genome Project and performed gene burden analyses of variants in 177 a priori loci derived from knowledge-driven curation of monogenic and genome-wide association studies of stroke. Using gene-burden analyses, we observed significant associations in numerous loci under autosomal dominant and/or recessive modelling. Stroke subjects with modified Rankin Scale (mRSs) above 3 were found to carry greater cumulative polygenic risk score (PRS) from rare variants in stroke genes (standardized PRS mean > 0) compared to the population average (standardized PRS mean = 0). However, patients with mRS of 3 or lower had lower cumulative genetic risk from rare variants in stroke genes (OR (95%CI) = 1.79 (1.29-2.49), p = 0.0005), with the means of standardized PRS at or lower than 0. In conclusion, gene burden testing in Saudi stroke populations reveals a number of statistically significant signals under different disease inheritance models. However, interestingly, stroke subjects with mRS of 3 or lower had lower cumulative genetic risk from rare variants in stroke genes and therefore, determining the potential mRS cutoffs to use for clinical significance may allow risk stratification of this population.


Assuntos
AVC Isquêmico , Acidente Vascular Cerebral , Humanos , Sequenciamento do Exoma , Arábia Saudita , Estudo de Associação Genômica Ampla , Fatores de Risco , Acidente Vascular Cerebral/genética , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/epidemiologia , Predisposição Genética para Doença
4.
Cureus ; 14(11): e31081, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36475133

RESUMO

BACKGROUND:  Migraine is a primary headache and a complicated neurological disorder with sensory and autonomic abnormalities. Many variables, including genetic and psychological ones, contribute to migraine onset and development. Anxiety and depression are typical psychiatric comorbidities among migraineurs. This kind of comorbidity increased migraine chronicity, treatment effectiveness, and the likelihood of additional comorbidities. The purpose of this research was to determine the prevalence of depression among Saudi migraine sufferers in AlAhsa. METHODS:  Descriptive cross-sectional research of 101 migraine patients at King Fahd Hospital-Hofuf, AlAhsa, Saudi Arabia from May to December 2021. Depression was assessed by Patient Health Questionnaire which is a reliable tool (PHQ-9). The PHQ-9 measures the presence and severity of depression. Consider sociodemographic, clinical, and individual variations that impact migraine development and prognosis.  Results: The inclusion criteria were satisfied by 94 migraine patients in total, with a mean age of 36.9 ± 9 years and they are predominantly females 75.5%. The majority of the participants (76.6%) were on medication to relieve migraine attacks and only 13.9% reported that >75% of attacks were relieved by medication. Almost all of the patients (96.8%) used to drink coffee and tea. The prevalence of depression and migraine was revealed to be 42.6% mild and 8.5% severe among the participants. Four statistically significant correlations (p < 0.05) were young age, being female, low level of education at higher risk to have depression compared to another group of migraineurs. CONCLUSION:  A neurological disorder that commonly causes disability is migraine. Numerous studies have shown that mood disorders and migraines are often co-occurring, and these individuals are more likely to have a migraine-related disability. This research has shown that it is beneficial to prevent psychiatric comorbidity by using PHQ-9 as a regular screening tool for migraine patients.

5.
Int J Biol Macromol ; 219: 304-311, 2022 Oct 31.
Artigo em Inglês | MEDLINE | ID: mdl-35934075

RESUMO

The present work aims at evaluating the in vitro biocompatibility, antibacterial activity and antioxidant capacity of the fabricated and optimized Alginate/Chitosan nanoparticles (ALG/CSNPs) and quercetin loaded Alginate/Chitosan nanoparticles (Q-ALG/CSNPs) with an improved biological efficacy on the hydrophobic flavonoid.The physicochemical properties were determined by TEM and FTIR analysis. The nanoparticles evaluated for the encapsulation of quercetin exerted % encapsulation efficiency (EE) that varied between 76 and 82.4 % and loading capacity (LC) from 31 to 46.5 %. Potential cytotoxicity of the ALG/CSNPs and Q-ALG/CSNPs upon L929 fibroblast cell line was evaluated by MTT reduction Assay and expressed as % cell viability. The in vitro antibacterial property was studied by well diffusion method against gram-positive bacteria Staphylococcus aureus (ATCC 25925) and gram-negative bacteria Escherichia coli (ATCC 25923). The inhibitory efficacy by scavenging free radical intermediates was evaluated by 1,1, diphenyl 2-picrylhydrazyl (DPPH) assay. The results of in vitro cytotoxicity showed biocompatibility towards L929 cells. Quercetin loaded Alginate/Chitosan nanoparticles inhibited the growth of microorganisms than pure quercetin. The 1,1-diphenyl-2-picrylhydrazyl (DPPH) radical scavenging results have shown a high level of antioxidant property for encapsulated Quercetin in Alginate/Chitosan nanoparticles compared to free Quercetin. The findings of our study suggest that the developed ALG/CSNPs and Q-ALG/CSNPs possess the prerequisites and be proposed as a suitable system for delivering quercetin with enhanced therapeutic effectuality.


Assuntos
Quitosana , Nanopartículas , Alginatos/farmacologia , Antibacterianos/farmacologia , Antioxidantes/química , Antioxidantes/farmacologia , Compostos de Bifenilo , Quitosana/química , Escherichia coli , Nanopartículas/química , Quercetina/química , Quercetina/farmacologia
6.
Saudi J Biol Sci ; 29(6): 103280, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35521357

RESUMO

In human diet, poultry meat is an important component due to the presence of vitamins, proteins and minerals. But poultry meat can be contaminated by pathogenic bacteria which are responsible for food borne infections. The current study was therefore aimed at identification of Escherichia coli, a common pathogen causing food borne infections, in chicken samples (n = 400) collected from three districts of KhyberPukhtunkhwa; Peshawar, Kohat and Nowshera. The isolates were identified by Gram staining, API strips and through PCR (Universal Stress Protein). A total of 174 samples were positive for E. coli among the collected chicken samples. The isolates were resistant to TE, NOR and NA while were sensitive to MEM, TZP and FOS. The results were statistically significant having value P ≤ 0.05 in ANOVA. The isolates showed different antibiotic resistance genes; OXA-1, CTX-M15, blaTEM, QnrS, TetA, AAC, AAD, sul1 and sul2 which is the molecular explanations of their antibiotic resistance pattern. The PCR products were sequenced by Next Generation Sequencing (NGS) and the results revealed mutations in AAC gene (M120T and R197T) and CTX-M15 (A85V, N122D, A148S and G247D). To prevent and treat pathogenic diseases, the use of antimicrobial agents in animal husbandry are of utmost concern. The over-use and misuse of antimicrobial agents has made pathogenic E. coli multi drugs resistant making it a causative agent for many diseases in human beings. The results of the current study may be helpful for the physicians the better management of the diseases caused by E. coli.

7.
Cureus ; 13(11): e19210, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34873540

RESUMO

Background Migraine is a major public health issue that leads to frequent visits to medical care. It is generally considered a disabling disease among individuals below the age of 50 years old predominantly seen in females. Migraine headache has a strong influence on disability, functional impairments, and psychological effects. The majority of the physicians fail to address the degree and extent of impediment caused by a migraine, which contributes to low quality of life and disability. Thus, this study aims to assess the health-related quality of life (QOL) and disability among migraine sufferers in AlAhsa, Saudi Arabia. Material and methods This descriptive cross-sectional study was carried out in the neurology clinics at King Fahad Hospital-Hofuf, AlAhsa, Saudi Arabia, from May to August 2021. The data were collected through a self-administered questionnaire. The migraine-specific quality of life questionnaire (MSQ), version 2.1, was used. MSQ is measured in three domains, including role function restrictive (RR), preventive (RP), and emotional function (EF). Disability related to migraine was assessed by the Migraine Disability Assessment Test (MIDAS). MIDAS classifies disability from no disability to severe disability. Two-tailed with an alpha level of 0.05 considering the significance of a p-value less than or equal to 0.05. The mean scores of QOL domains were compared by one-way analysis of variance (ANOVA) and independent t-tests. Results A total of 101 out of 359 participants were identified to have a migraine. Eighty-two participants met the inclusion criteria, 75.6% were females. The age of the participants ranged from 18 to more than 45 years with a mean age of 36.4 ± 11.9 years old. The mean score of QOL in the restrictive, preventive, and emotional domains were 46.3% ± 21.5%, 52.1% ± 24.3%, and 61.5% ± 30.8%, respectively. More than half of the participants (57.3%) suffered from a severe disability caused by migraines as compared to 20.7% with a moderate disability. Low QOL scores were associated with females and a significant relationship was found between migraine-associated disability and patients' emotional function in QOL. Conclusion Clinicians should routinely evaluate disability related to migraine and QOL as a complementary approach to migraine patients to ensure that patients are receiving proper treatment and whether additional strategies are needed or not.

8.
Eur J Med Res ; 26(1): 141, 2021 Dec 09.
Artigo em Inglês | MEDLINE | ID: mdl-34886916

RESUMO

BACKGROUND: Extracorporeal membrane oxygenation (ECMO) has been used as a rescue strategy in patients with severe with acute respiratory distress syndrome (ARDS) due to SARS-CoV-2 infection, but there has been little evidence of its efficacy. OBJECTIVES: To describe the effect of ECMO rescue therapy on patient-important outcomes in patients with severe SARS-CoV-2. METHODS: A case series study was conducted for the laboratory-confirmed SARS-CoV-2 patients who were admitted to the ICUs of 22 Saudi hospitals, between March 1, 2020, and October 30, 2020, by reviewing patient's medical records prospectively. RESULTS: ECMO use was associated with higher in-hospital mortality (40.2% vs. 48.9%; p = 0.000); lower COVID-19 virological cure (41.3% vs 14.1%, p = 0.000); and longer hospitalization (20.2 days vs 29.1 days; p = 0.000), ICU stay (12.6 vs 26 days; p = 0.000) and mechanical ventilation use (14.2 days vs 22.4 days; p = 0.000) compared to non-ECMO group. Also, there was a high number of patients with septic shock (19.6%) and multiple organ failure (10.9%); and more complications occurred at any time during hospitalization [pneumothorax (5% vs 29.3%, p = 0.000), bleeding requiring blood transfusion (7.1% vs 38%, p = 0.000), pulmonary embolism (6.4% vs 15.2%, p = 0.016), and gastrointestinal bleeding (3.3% vs 8.7%, p = 0.017)] in the ECMO group. However, PaO2 was significantly higher in the 72-h post-ECMO initiation group and PCO2 was significantly lower in the 72-h post-ECMO start group than those in the 12-h pre-ECMO group (62.9 vs. 70 mmHg, p = 0.002 and 61.8 vs. 51 mmHg, p = 0.042, respectively). CONCLUSION: Following the use of ECMO, the mortality rate of patients and length of ICU and hospital stay were not improved. However, these findings need to be carefully interpreted, as most of our cohort patients were relatively old and had multiple severe comorbidities. Future randomized trials, although challenging to conduct, are highly needed to confirm or dispute reported observations.


Assuntos
COVID-19/terapia , Estado Terminal , Oxigenação por Membrana Extracorpórea/métodos , Síndrome do Desconforto Respiratório/terapia , SARS-CoV-2 , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Comorbidade , Feminino , Humanos , Unidades de Terapia Intensiva , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Prospectivos , Respiração Artificial , Arábia Saudita/epidemiologia , Temperatura , Adulto Jovem
9.
Diabetol Metab Syndr ; 13(1): 120, 2021 Oct 26.
Artigo em Inglês | MEDLINE | ID: mdl-34702335

RESUMO

BACKGROUND: One possible reason for increased mortality due to SARS-CoV-2 in patients with diabetes is from the complication of diabetic ketoacidosis (DKA). OBJECTIVES: To re-evaluate the association of SARS-CoV-2 and development of DKA and analyse the demographic and biochemical parameters and the clinical outcomes in COVID-19 patients with DKA. DESIGN: A systematic review and meta-analysis. Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement was followed. METHODS: Electronic databases (Proquest, Medline, Embase, Pubmed, CINAHL, Wiley online library, Scopus and Nature) were searched from 1 December 2019 to 30 June 2021 in the English language using the following keywords alone or in combination: COVID-19 OR SARS-CoV-2 AND diabetic ketoacidosis OR DKA OR ketosis OR ketonemia OR hyperglycaemic emergency OR hyperglycaemic crisis. We included studies in adults and children of all ages in all healthcare settings. Binary logistic regression model was used to explore the effect of various demographic and biochemical parameters variables on patient's final treatment outcome (survival or death). RESULTS: Of the 484 papers that were identified, 68 articles were included in the systematic review and meta-analysis (54 case report, 10 case series, and 4 cohort studies). Studies involving 639 DKA patients with confirmed SARS-CoV-2 [46 (7.2%) were children and 334 (52.3%) were adults] were analyzed. The median or mean patient age ranged from < 1 years to 66 years across studies. Most of the patients (n = 309, 48.3%) had pre-existing type 2 diabetes mellitus. The majority of the patients were male (n = 373, 58.4%) and belonged to Hispanic (n = 156, 24.4%) and black (n = 98, 15.3%) ethnicity. The median random blood glucose level, HbA1c, pH, bicarbonate, and anion gap in all included patients at presentation were 507 mg/dl [IQR 399-638 mg/dl], 11.4% [IQR 9.9-13.5%], 7.16 [IQR 7.00-7.22], 10 mmol/l [IQR 6.9-13 mmol/l], and 24.5 mEq/l [18-29.2 mEq/l]; respectively. Mortality rate was [63/243, 25.9%], with a majority of death in patients of Hispanic ethnicity (n = 17, 27%; p = 0.001). The odd ratios of death were significantly high in patients with pre-existing diabetes mellitus type 2 [OR 5.24, 95% CI 2.07-15.19; p = 0.001], old age (≥ 60 years) [OR 3.29, 95% CI 1.38-7.91; p = 0.007], and male gender [OR 2.61, 95% CI 1.37-5.17; p = 0.004] compared to those who survived. CONCLUSION: DKA is not uncommon in SARS-CoV-2 patients with diabetes mellitus and results in a mortality rate of 25.9%. Mortality key determinants in DKA patients with SARS-CoV-2 infection are individuals with pre-existing diabetes mellitus type 2, older age [≥ 60 years old], male gender, BMI ≥ 30, blood glucose level > 1000 mg/dl, and anion gap ≥ 30 mEq/l.

10.
Br J Oral Maxillofac Surg ; 59(6): 690-694, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34078553

RESUMO

Oral submucous fibrosis (OSMF) is an insidious chronic disease of the oral mucosa that is characterised by severely limited mouth opening, blanching of the oral mucosa, and a burning sensation in the oral cavity. Consumption of betel nut and/or gutka are the known risk factors. We undertook this study to correlate the frequency and duration of gutka intake with the severity of OSMF and to determine the predictors of severe OSMF (mouth opening <20mm). A cross sectional study was conducted on 300 participants (who were known gutka chewers) selected at the Baqai Dental College and Fatima Hospital, Karachi, Pakistan. Participants' medical and dental histories were recorded. Informed consent was obtained, and clinical oral examination was done. Information regarding the extent of mouth opening, chewing habits, frequency and duration of gutka intake, the site of placing gutka, duration of chewing, and whether they swallowed or spat out the gutka were collected. A standardised questionnaire was used to document the findings. Binary logistic regression was applied using the severity of OSMF (mouth opening <20mm) as an outcome variable. Out of 300 participants, 172 (57.3%) were males; mean (SD) age of the sample was 38.2 (12.3) years. A total of 156 (52%) participants had the habit of chewing gutka, of which 213 (71%) had clinical stage I OSMF, 75 (25%) had stage II, and 12 (4%) had stage III. As per functional staging, 18 (6%) subjects had mouth opening <20mm. Nearly 144 (48%) participants were consuming other forms of tobacco in addition to the gutka. Patients with palpable bands = 232 (77.3%), ulcerative lesions = 212 (70.7%), altered taste sensation = 210 (70%) and altered hunger = 252 (85.7%) were common findings. The duration of gutka intake was found to be positively correlated with the severity of OSMF; however; its frequency was not. Among intraoral findings, the presence of red and white lesions inside the mouth was the most significant predictor of the severity of OSMF.


Assuntos
Fibrose Oral Submucosa , Tabaco sem Fumaça , Adulto , Areca/efeitos adversos , Estudos Transversais , Humanos , Modelos Logísticos , Masculino , Fibrose Oral Submucosa/epidemiologia , Fibrose Oral Submucosa/etiologia , Tabaco sem Fumaça/efeitos adversos
11.
Neurosciences (Riyadh) ; 24(3): 192-198, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31380818

RESUMO

OBJECTIVE: To describe the prevalence, knowledge and attitudes about complementary and alternative medicine (CAM) use and the proportion that seek advice from their physician about CAM use. METHODS: This cross-sectional observational study was performed in multiple sclerosis (MS) clinic of King Fahd Hospital of Universityin Alkhobar, Kingdom of Saudi Arabia from January-June 2017. A total of 133 patients have completed the survey. RESULTS: The mean age of patients was 32.3+/-7.6 years and 84 (63.2%) were female. Approximately 83.5% of the patients reported the use of CAM. Among all the reported forms of CAM, vitamins were the most prevalent form, followed by cupping, special prayers and meditation. The majority of patients (62%) obtained knowledge of CAM through social media. A significant number of patients (75.6%) did not disclose the use of CAM to their physician. There was a trend for using CAM more in highly educated, older age, and female patients. The most commonly reported rationale to use CAM was overall improvement in health status. CONCLUSION: The use of CAM among Saudi patients with MS is highly prevalent, without disclosure of its use to physicians. These factors should be taken into account in the doctor-patient consultation to avoid adverse events.


Assuntos
Ventosaterapia/estatística & dados numéricos , Meditação , Esclerose Múltipla/terapia , Adulto , Feminino , Humanos , Masculino , Esclerose Múltipla/tratamento farmacológico , Esclerose Múltipla/psicologia , Relações Médico-Paciente , Religião , Arábia Saudita , Autoadministração/estatística & dados numéricos , Vitaminas/administração & dosagem , Vitaminas/uso terapêutico
12.
Case Rep Genet ; 2019: 6148425, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-32089906

RESUMO

Adrenoleukodystrophy (ALD) is an X-linked peroxisomal disorder with classical features, which can be also recognised in a low resource setting. It had been described in various populations across the globe, but very few cases have been reported from Africa. In a boy with features of a progressive central nervous system condition and adrenal failure, ABCD1 gene screening was performed based on a clinical history and basic radiological features which were compatible with ALD. A common ABCD1 mutation was identified in this patient, which is the first report of genetically confirmed ALD in Sub-Saharan Africa. ALD is likely under recognised in those areas where there is no neurologist. This genetic confirmation widens geographical distribution of ABCD1-associated disease, and illustrates recognisability of this disorder, even when encountered in a low-resource environment.

13.
Case Rep Cardiol ; 2018: 5498052, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30647974

RESUMO

A 73-year-old female with multiple comorbidities including coronary artery disease was admitted for an elective PCI of a lesion detected in the RCA. On the day of the planned PCI, shortly after right femoral artery cannulation, the patient developed a sudden complete heart block requiring the administration atropine and insertion of a temporary pacemaker. Concomitantly, the patient developed acute pulmonary edema, hypotension, and hypoxia requiring intubation for mechanical ventilation. Vasopressors were administered. A coronary angiogram showed patent left and right coronary arteries, unchanged when compared to the previous angiogram. An echocardiogram performed in the cardiac catheterization lab revealed global hypokinesis of the left and right ventricles, with severe LV systolic dysfunction (EF < 20%). Following an insertion of an intra-aortic balloon pump, the patient was transferred to the CICU. A repeat echocardiogram in the CICU two hours later revealed a classical echocardiographic presentation of Takotsubo syndrome, apical hypokinesis. By the next morning the patient's hemodynamic status significantly improved, the balloon pump was removed, and vasopressors were discontinued. Another echocardiogram was performed 24 hours after the event occurred and revealed a marked improvement in LV systolic function (EF 60%), with complete resolution of apical and septal wall motion abnormalities. Three days after the event, the patient was successfully discharged and asymptomatic at two-month follow-up. This case illustrates an atypical presentation of Takotsubo syndrome that was witnessed from onset to its complete resolution during the patient's hospital stay.

15.
J Laryngol Otol ; 129(11): 1140-2, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26399179

RESUMO

OBJECTIVE: To report three cases illustrating that it is not unusual for a primary eyelid tumour to metastasise to the parotid gland and vice versa. CASE REPORTS: Two patients with malignant parotid tumours underwent radical parotidectomy and presented subsequently with eyelid lesions. Biopsy showed that both eyelid lesions were histologically similar to the primary parotid tumour. A third patient was noted to have ipsilateral upper eyelid and parotid gland tumours. Histology and immunocytochemistry were used to differentiate the primary tumour and the metastasis. CONCLUSION: These cases illustrate that tumours involving eyelids and parotid glands can present simultaneously or sequentially, and either of these structures could be the focus of primary or metastatic tumour. The important message for oculoplastic and parotid surgeons is to routinely assess both the periocular and parotid area when patients present with a mass in either structure.


Assuntos
Neoplasias da Mama/secundário , Carcinoma de Células Escamosas/secundário , Neoplasias Palpebrais/secundário , Neoplasias Parotídeas/patologia , Adulto , Idoso , Neoplasias da Mama/terapia , Carcinoma de Células Escamosas/terapia , Quimiorradioterapia/métodos , Diagnóstico Diferencial , Neoplasias Palpebrais/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Neoplasias Parotídeas/terapia , Procedimentos de Cirurgia Plástica , Procedimentos Cirúrgicos Operatórios
16.
Cancer Gene Ther ; 22(8): 396-401, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-26227824

RESUMO

Elevated levels of eukaryotic translation initiation factor 4E (eIF4E) enhance translation of many malignancy-related proteins, such as vascular endothelial growth factor (VEGF), c-Myc and osteopontin. In non-small-cell lung cancer (NSCLC), levels of eIF4E are significantly increased compared with normal lung tissue. Here, we used an antisense oligonucleotide (ASO) to inhibit the expression of eIF4E in NSCLC cell lines. eIF4E levels were significantly reduced in a dose-dependent manner in NSCLC cells treated with eIF4E-specific ASO (4EASO) compared with control ASO. Treatment of NSCLC cells with the 4EASO resulted in decreased cap-dependent complex formation, decreased cell proliferation and increased sensitivity to gemcitabine. At the molecular level, repression of eIF4E with ASO resulted in decreased expression of the oncogenic proteins VEGF, c-Myc and osteopontin, whereas expression of ß-actin was unaffected. Based on these findings, we conclude that eIF4E-silencing therapy alone or in conjunction with chemotherapy represents a promising approach deserving of further investigation in future NSCLC clinical trials.


Assuntos
Carcinoma Pulmonar de Células não Pequenas/genética , Fator de Iniciação 4E em Eucariotos/genética , Neoplasias Pulmonares/genética , Terapia de Alvo Molecular/métodos , Oligonucleotídeos Antissenso/farmacologia , Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Linhagem Celular Tumoral , Proliferação de Células/efeitos dos fármacos , Proliferação de Células/genética , Desoxicitidina/análogos & derivados , Desoxicitidina/farmacologia , Relação Dose-Resposta a Droga , Fator de Iniciação 4E em Eucariotos/metabolismo , Humanos , Neoplasias Pulmonares/tratamento farmacológico , Oligonucleotídeos Antissenso/genética , Osteopontina/metabolismo , Fator A de Crescimento do Endotélio Vascular/metabolismo , Gencitabina
17.
Colloids Surf B Biointerfaces ; 122: 505-511, 2014 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-25092583

RESUMO

Development of novel antidiabetic agents using various organic compounds and biomolecules has been in practice for a long time. Recently, nanomaterials are also being used in antidiabetic studies for their unique properties such as small size, biocompatibility and ability to penetrate cell membrane for carrying drugs. Herein, in vivo antidiabetic activity of gold nanoparticles (AuNPs) synthesized using the antidiabetic potent plant Gymnema sylvestre R. Br on wistar albino rats has been evaluated. The formation of AuNPs and their morphology were confirmed using spectroscopic and microscopic analyses, respectively. The treatment of AuNPs has shown significant reduction in blood glucose level on diabetic rats. AuNPs were also tested for its anti-inflammatory effect by estimating the serum levels of tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6) and high-sensitive C-reactive protein (CRP).


Assuntos
Ouro/química , Nanopartículas Metálicas , Aloxano , Animais , Diabetes Mellitus Experimental/terapia , Microscopia de Força Atômica , Ratos , Ratos Wistar , Espectrofotometria Ultravioleta
18.
Colloids Surf B Biointerfaces ; 117: 480-6, 2014 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-24507239

RESUMO

In the present investigation, the cardioprotective nature of proanthocyanidin (PAC)-synthesized gold nanoparticles (AuNPs) is addressed in detail. There was a rapid reduction of gold metal ions by PAC and the new-genre AuNPs exhibited remarkable in vitro stability both in biological and chemical solutions. Transmission electron microscopy (TEM) indicated that the newly formed nanoparticles ranged in size from 17 to 29 nm (∼24 nm). MTT assay carried out with peripheral blood mononuclear cells demonstrated the non-toxic nature of AuNPs. PAC-synthesized AuNPs showed cardioprotective action in isoproterenol-induced myocardial injury at a lowest dosage (9 mg kg(-1)). Cardiac marker enzymes and antioxidant parameters in serum and heart tissue were also measured.


Assuntos
Cardiotônicos/farmacologia , Ouro/farmacologia , Nanopartículas Metálicas/química , Proantocianidinas/farmacologia , Animais , Materiais Biocompatíveis/farmacologia , Humanos , Masculino , Nanopartículas Metálicas/ultraestrutura , Ratos Wistar , Espectrometria por Raios X , Espectrofotometria Ultravioleta , Espectroscopia de Infravermelho com Transformada de Fourier , Difração de Raios X
19.
Artigo em Inglês | MEDLINE | ID: mdl-23973575

RESUMO

In the present investigation, functionalization of gold nanoparticles synthesized using propanoic acid 2-(3-acetoxy-4,4,14-trimethylandrost-8-en-17-yl) (PAT) an active biocomponent isolated from Cassia auriculata is studied in detail. On reaction of PAT with aqueous HAuCl4, rapid formation of stable gold nanoparticles was achieved. Formation of gold nanoparticles was confirmed by UV-vis spectroscopy, XRD, GC-MS,FTIR, TEM and SEM with EDAX. Gold nanoparticles mostly were monodisperse, spherical in shape and ranged in size 12-41 nm. Gold nanoparticles synthesised using PAT was administered to alloxan (150 mg/kg body weight) induced diabetic male albino rats at different doses (0.25, 0.5, 0.75 and 1.0mg/kg body weight) for 28 days. Plasma glucose level, cholesterol and triglyceride were significantly (p<0.001) reduced in experimental animals treated with gold nanoparticles at dosage of 0.5mg/kg body weight and plasma insulin increased significantly. The newly genre green gold nanoparticles exhibit remarkable protein tyrosine phosphatase 1B inhibitory activity.


Assuntos
Cassia/química , Diabetes Mellitus Experimental/tratamento farmacológico , Ouro/uso terapêutico , Hipoglicemiantes/uso terapêutico , Nanopartículas/uso terapêutico , Extratos Vegetais/uso terapêutico , Animais , Glicemia/análise , Peso Corporal/efeitos dos fármacos , Cloretos/química , Diabetes Mellitus Experimental/sangue , Diabetes Mellitus Experimental/enzimologia , Diabetes Mellitus Experimental/metabolismo , Ouro/química , Compostos de Ouro/química , Química Verde , Hipoglicemiantes/química , Masculino , Nanopartículas/química , Nanopartículas/ultraestrutura , Extratos Vegetais/química , Proteína Tirosina Fosfatase não Receptora Tipo 1/antagonistas & inibidores , Ratos
20.
Mol Psychiatry ; 18(11): 1171-7, 2013 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-23958959

RESUMO

It is believed that in utero environmental factors contribute to autism spectrum disorder (ASD). The goal of this study was to demonstrate, using the largest cohort reported so far, that mothers of an ASD child have an elevated frequency of anti-brain antibodies and to assess whether brain reactivity is associated with an autoimmune diathesis of the mother. We screened plasma of 2431 mothers of an ASD child from Simon Simplex Collection and plasma of 653 unselected women of child-bearing age for anti-brain antibodies using immunohistology on mouse brain. Positive and negative plasma from mothers with an ASD child were analyzed for anti-nuclear antibodies and for autoimmune disorders. Mothers of an ASD child were four times more likely to harbor anti-brain antibodies than unselected women of child-bearing age (10.5 vs 2.6%). A second cohort from The Autism Genetic Resource Exchange with multiplex families displayed an 8.8% prevalence of anti-brain antibodies in the mothers of these families. Fifty-three percent of these mothers with anti-brain antibodies also exhibited anti-nuclear autoantibodies compared with 13.4% of mothers of an ASD child without anti-brain antibodies and 15% of control women of child-bearing age. The analysis of ASD mothers with brain-reactive antibodies also revealed an increased prevalence of autoimmune diseases, especially rheumatoid arthritis and systemic lupus erythematosus. This study provides robust evidence that brain-reactive antibodies are increased in mothers of an ASD child and may be associated with autoimmunity. The current study serves as a benchmark and justification for studying the potential pathogenicity of these antibodies on the developing brain. The detailed characterization of the specificity of these antibodies will provide practical benefits for the management and prevention of this disorder.


Assuntos
Autoanticorpos/efeitos adversos , Autoanticorpos/imunologia , Autoimunidade/imunologia , Encéfalo/imunologia , Transtornos Globais do Desenvolvimento Infantil/imunologia , Imunoglobulina G/imunologia , Mães , Adolescente , Adulto , Autoanticorpos/sangue , Encéfalo/embriologia , Estudos de Casos e Controles , Criança , Transtornos Globais do Desenvolvimento Infantil/etiologia , Feminino , Humanos , Imunoglobulina G/efeitos adversos , Imunoglobulina G/sangue , Pessoa de Meia-Idade , Estados Unidos
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