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1.
Sci Rep ; 14(1): 6647, 2024 03 19.
Artigo em Inglês | MEDLINE | ID: mdl-38503772

RESUMO

Glioblastoma (GBM) is a heterogenous primary brain tumour that is characterised with unfavourable patient prognosis. The identification of biomarkers for managing brain malignancies is of utmost importance. MicroRNAs (miRNAs) are small, non-coding RNAs implicated in cancer development. This study aimed to assess the prognostic significance of miRNAs and their gene targets in GBM. An in silico approach was employed to investigate the differentially expressed miRNAs in GBM. The most dysregulated miRNAs were identified and analysed via Sfold in association with their gene target. The candidate gene was studied via multi-omics approaches, followed by in vitro and in vivo experiments. The in silico analyses revealed that miR-128a and miR-34a were significantly downregulated within GBM. Both miRNAs displayed high binding affinity to the synaptic vesicle glycoprotein 2B (SV2B) 3' untranslated region (3'UTR). SV2B exhibited upregulation within brain regions with high synaptic activity. Significantly higher SV2B levels were observed in high grade brain malignancies in comparison to their normal counterparts. SV2B expression was observed across the cytoplasm of GBM cells. Our findings underscored the downregulated expression patterns of miR-128a and miR-34a, alongside the upregulation of SV2B in GBM suggesting the importance of the SV2B/miR-34a/miR-128 axis as a potential prognostic approach in GBM management.


Assuntos
Neoplasias Encefálicas , Glioblastoma , MicroRNAs , Humanos , Glioblastoma/patologia , Prognóstico , MicroRNAs/genética , MicroRNAs/metabolismo , Encéfalo/metabolismo , Neoplasias Encefálicas/patologia , Regulação Neoplásica da Expressão Gênica , Linhagem Celular Tumoral
2.
Braz. j. biol ; 84: e253613, 2024. tab
Artigo em Inglês | LILACS, VETINDEX | ID: biblio-1345548

RESUMO

Abstract Soybean meal is an inexpensive plant origin protein which has been used in practical diets as a replacement of animal protein such as fish meal or chicken meal, due to the uneconomical price of animal protein diets. Consequently, a research study was conducted on some commercial species of Indian major carps i.e. Catla (Cattla cattla), Rohu (Labeo rohita) and Mrigala (Cirhinus mrigala) (Hamilton, 1822) to estimate optimum dietary protein requirement of soy bean meal in diet in an intensive polyculture. Three different diets (SBM I, SBM II and SBM III) were formulated by 80%, 50% and 20% replacement of fish meal with soybean meal from a 45% fish meal diet (control).Highest monthly mean weight gain was obtained by SBM II (with 35% CP and about 50% substitution of fish meal), while SBM III (45% Crude Protein and about 20% substitution of fish meal) was stood second. All tested diets respond enormously by producing high yield as compare to control diet, though SBM II generated highest yield among all. On the bases of the following research, it was revealed that the SBM can surrogate even50% fish meal without any augmentation of other amino acids in the diet of Indian major carps.


Resumo O farelo de soja é uma proteína de origem vegetal de baixo custo que tem sido usada em dietas práticas como um substituto da proteína animal, como farinha de peixe ou farinha de frango, devido ao preço não econômico das dietas com proteína animal. Consequentemente, um estudo/pesquisa foi realizado com algumas espécies comerciais de carpas principais indianas, ou seja, Catla (Cattla cattla), Rohu (Labeo rohita) e Mrigala (Cirhinus mrigala) (Hamilton, 1822), para estimar a necessidade ideal de proteína dietética de farelo de soja na dieta em uma policultura intensiva. Três dietas diferentes (SBM I, SBM II e SBM III) foram formuladas por 80%, 50% e 20% de substituição de farinha de peixe por farelo de soja de uma dieta de 45% de farinha de peixe (controle). O maior ganho de peso médio mensal foi obtido por SBM II (com 35% PB e cerca de 50% de substituição de farinha de peixe), enquanto SBM III (45% de proteína bruta e cerca de 20% de substituição de farinha de peixe) ficou em segundo lugar. Todas as dietas testadas respondem enormemente produzindo alto rendimento em comparação com a dieta controle, embora SBM II tenha gerado o maior rendimento entre todas. Com base na pesquisa a seguir, foi revelado que o SBM pode substituir até 50% da farinha de peixe sem qualquer aumento de outros aminoácidos na dieta das carpas principais indianas.


Assuntos
Animais , Carpas , Cyprinidae , Soja , Alimentos Marinhos , Dieta/veterinária , Ração Animal/análise , Fenômenos Fisiológicos da Nutrição Animal
3.
Braz. j. biol ; 842024.
Artigo em Inglês | LILACS-Express | LILACS, VETINDEX | ID: biblio-1469250

RESUMO

Abstract Soybean meal is an inexpensive plant origin protein which has been used in practical diets as a replacement of animal protein such as fish meal or chicken meal, due to the uneconomical price of animal protein diets. Consequently, a research study was conducted on some commercial species of Indian major carps i.e. Catla (Cattla cattla), Rohu (Labeo rohita) and Mrigala (Cirhinus mrigala) (Hamilton, 1822) to estimate optimum dietary protein requirement of soy bean meal in diet in an intensive polyculture. Three different diets (SBM I, SBM II and SBM III) were formulated by 80%, 50% and 20% replacement of fish meal with soybean meal from a 45% fish meal diet (control).Highest monthly mean weight gain was obtained by SBM II (with 35% CP and about 50% substitution of fish meal), while SBM III (45% Crude Protein and about 20% substitution of fish meal) was stood second. All tested diets respond enormously by producing high yield as compare to control diet, though SBM II generated highest yield among all. On the bases of the following research, it was revealed that the SBM can surrogate even50% fish meal without any augmentation of other amino acids in the diet of Indian major carps.


Resumo O farelo de soja é uma proteína de origem vegetal de baixo custo que tem sido usada em dietas práticas como um substituto da proteína animal, como farinha de peixe ou farinha de frango, devido ao preço não econômico das dietas com proteína animal. Consequentemente, um estudo/pesquisa foi realizado com algumas espécies comerciais de carpas principais indianas, ou seja, Catla (Cattla cattla), Rohu (Labeo rohita) e Mrigala (Cirhinus mrigala) (Hamilton, 1822), para estimar a necessidade ideal de proteína dietética de farelo de soja na dieta em uma policultura intensiva. Três dietas diferentes (SBM I, SBM II e SBM III) foram formuladas por 80%, 50% e 20% de substituição de farinha de peixe por farelo de soja de uma dieta de 45% de farinha de peixe (controle). O maior ganho de peso médio mensal foi obtido por SBM II (com 35% PB e cerca de 50% de substituição de farinha de peixe), enquanto SBM III (45% de proteína bruta e cerca de 20% de substituição de farinha de peixe) ficou em segundo lugar. Todas as dietas testadas respondem enormemente produzindo alto rendimento em comparação com a dieta controle, embora SBM II tenha gerado o maior rendimento entre todas. Com base na pesquisa a seguir, foi revelado que o SBM pode substituir até 50% da farinha de peixe sem qualquer aumento de outros aminoácidos na dieta das carpas principais indianas.

4.
Rhinology ; 61(6): 531-540, 2023 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-37453138

RESUMO

BACKGROUND: Loss of sense of smell is one of the most burdensome symptoms of chronic rhinosinusitis with nasal polyps (CRSwNP) but its relationship to sinus disease on imaging is unclear. Dupilumab improves sense of smell and radiographic severity of sinus disease in patients with CRSwNP. We investigated the relationship of sinus opacification severity and loci to olfactory impairment and dupilumab efficacy in patients with CRSwNP from the SINUS-24/SINUS-52 (NCT02912468/NCT02898454) studies. METHODS: Sinus opacification was evaluated using the Lund-Mackay computed tomography (LMK-CT) score and sense of smell using patient-reported loss of smell (LoS) score, University of Pennsylvania Smell Identification Test (UPSIT) score and the 22-item Sino-Nasal Outcome Test (SNOT-22) smell/taste item. RESULTS: At baseline, 95% of patients (688/724) had impaired sense of smell and opacification was extensive across all sinuses. Greater olfactory impairment was associated with greater opacification, especially in the ethmoid, sphenoid and frontal sinuses. At Week 24, reductions in LMK-CT total score and ethmoid and sphenoid sinus scores with dupilumab were weakly correlated with improvements in sense of smell assessed by LoS, UPSIT and SNOT-22 smell/taste item. More dupilumab than placebo patients achieved clinically meaningful improvement in LMK-CT total score at Week 24 and Week 52. CONCLUSION: Radiographic disease severity on imaging was associated with smell outcomes in this cohort. Opacification of the ethmoid, sphenoid and frontal sinuses was associated with severe smell loss. These data suggest that dupilumab effects on smell may be partly mediated through reduced sinus inflammation.


Assuntos
Seio Frontal , Pólipos Nasais , Transtornos do Olfato , Rinite , Sinusite , Humanos , Pólipos Nasais/complicações , Pólipos Nasais/tratamento farmacológico , Olfato , Rinite/complicações , Rinite/diagnóstico por imagem , Rinite/tratamento farmacológico , Sinusite/complicações , Sinusite/tratamento farmacológico , Doença Crônica , Transtornos do Olfato/etiologia , Transtornos do Olfato/complicações
5.
Eur Rev Med Pharmacol Sci ; 27(10): 4792-4800, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-37259762

RESUMO

OBJECTIVE: Even before the outbreak of the COVID-19 pandemic, concerns regarding college students' mental health were on the rise due to the increasing number of students afflicted with mental health issues. Exposure to numerous pandemic-related measures exacerbated existing issues with anxiety, depression, and stress. This study aimed to assess depression, anxiety, and stress levels among university students in the Aseer region in Saudi Arabia. SUBJECTS AND METHODS: Data were collected from eligible individuals using a web-based, self-administered DASS-21 questionnaire. This questionnaire consists of 21 questions with a rating scale of 0-3. Each of the psychological factors of depression, anxiety, and stress was categorized as normal, mild, moderate, severe, and extremely severe. Results were expressed using descriptive statistics as proportions, and the Mann-Whitney/Kruskal-Wallis' test was used to evaluate the presence of a significant difference between each of the socio-demographic factors of the respondents and the psychological outcomes. RESULTS: Respondents aged between 18-24 years reported higher rates of extremely severe depression than other age groups. Females had higher rates of depression, especially severe and extremely severe forms. Extremely severe anxiety had a relatively high prevalence across all age groups. Extremely severe stress was more common among respondents aged between 18-24 years, while respondents older than 34 years reported the highest prevalence of severe stress. The Mann-Whitney/Kruskal-Wallis' tests showed statistically significant differences between participants in the different groups. CONCLUSIONS: The COVID-19 pandemic had a high psychological impact on university students, which indicates that a psychological support program should be implemented to reduce this impact.


Assuntos
COVID-19 , Feminino , Humanos , Adolescente , Adulto Jovem , Adulto , COVID-19/epidemiologia , Pandemias , Estudos Transversais , Bem-Estar Psicológico , SARS-CoV-2 , Depressão/epidemiologia , Depressão/psicologia , Ansiedade/epidemiologia , Ansiedade/psicologia , Estudantes/psicologia , Estresse Psicológico/epidemiologia , Estresse Psicológico/psicologia
8.
Sci Rep ; 12(1): 12843, 2022 07 27.
Artigo em Inglês | MEDLINE | ID: mdl-35902676

RESUMO

In the present study, a method for the synthesis of gelatin-stabilized copper oxide nanoparticles was developed. Synthesis was carried out by direct chemical precipitation. Copper sulfate, chloride, and acetate were used as precursors for the copper oxide synthesis. Gelatin was used as a stabilizer. It was found that the formation of monophase copper oxide II only occurred when copper acetate was used as a precursor. Our results showed that particles of the smallest diameter are formed in an aqueous medium (18 ± 6 nm), and those of th largest diameter-in an isobutanol medium (370 ± 131 nm). According to the photon correlation spectroscopy data, copper oxide nanoparticles synthesized in an aqueous medium were highly stable and had a monomodal size distribution with an average hydrodynamic radius of 61 nm. The study of the pH effect on the colloidal stability of copper oxide nanoparticles showed that the sample was stable in the pH range of 6.8 to 11.98. A possible mechanism for the pH influence on the stability of copper oxide nanoparticles is described. The effect of the ionic strength of the solution on the stability of the CuO nanoparticles sol was also studied, and the results showed that Ca2+ ions had the greatest effect on the sample stability. IR spectroscopy showed that the interaction of CuO nanoparticles with gelatin occurred through the hydroxyl group. It was found that CuO nanoparticles stabilized with gelatin have a fungicidal activity at concentration equivalent 2.5 · 10-3 mol/L and as a material for food nanopackaging can provide an increase in the shelf life of products on the example of strawberries and tomatoes. We investigated the possibility of using methylcellulose films modified with CuO nanoparticles for packaging and storage of hard cheese "Holland". The distribution of CuO nanoparticles in the methylcellulose film was uniform. We found that methylcellulose films modified with CuO nanoparticles inhibited the growth and development of QMAFAM, coliforms, yeast and mold in experimental cheese sa mples. Our research has shown that during the cheese storage in thermostat at 35 ± 1 °C for 7 days, CuO nanoparticles migrated to the product from the film. Nevertheless, it is worth noting that the maximum change in the concentration of copper in the experimental samples was only 0.12 µg/mg, which is not a toxic concentration. In general, the small value of migration of CuO nanoparticles confirms the high stability of the developed preparation. Our results indicated that the CuO nanoparticles stabilized with gelatin have a high potential for use in food packaging - both as an independent nanofilm and as part of other packaging materials.


Assuntos
Nanopartículas Metálicas , Nanopartículas , Cobre/química , Embalagem de Alimentos , Gelatina , Nanopartículas Metálicas/química , Metilcelulose , Óxidos
10.
J Breath Res ; 16(2)2022 03 03.
Artigo em Inglês | MEDLINE | ID: mdl-35168217

RESUMO

Clinical assessment of children with asthma is problematic, and non-invasive biomarkers are needed urgently. Monitoring exhaled volatile organic compounds (VOCs) is an attractive alternative to invasive tests (blood and sputum) and may be used as frequently as required. Standardised reproducible breath-sampling is essential for exhaled-VOC analysis, and although the ReCIVA (Owlstone Medical Limited) breath-sampler was designed to satisfy this requirement, paediatric use was not in the original design brief. The efficacy of the ReCIVA at sampling breath from children has been studied, and 90 breath-samples from 64 children (5-15 years) with, and without asthma (controls), were collected with two different ReCIVA units. Seventy samples (77.8%) contained the specified 1 l of sampled-breath. Median sampling times were longer in children with acute asthma (770.2 s, range: 532.2-900.1 s) compared to stable asthma (690.6 s, range: 477.5-900.1 s;p= 0.01). The ReCIVA successfully detected operational faults, in 21 samples. A leak, caused by a poor fit of the face mask seal was the most common (15); the others were USB communication-faults (5); and, a single instance of a file-creation error. Paediatric breath-profiles were reliably monitored, however synchronisation of sampling to breathing-phases was sometimes lost, causing some breaths not to be sampled, and some to be sampled continuously. This occurred in 60 (66.7%) of the samples and was a source of variability. Importantly, multi-variate modelling of untargeted VOC analysis indicated the absence of significant batch effects for eight operational variables. The ReCIVA appears suitable for paediatric breath-sampling. Post-processing of breath-sample meta-data is recommended to assess the quality of sample-acquisition. Further, future studies should explore the effect of pump-synchronisation faults on recovered VOC profiles, and mask sizes to fit all ages will reduce the potential for leaks and importantly, provide higher levels of comfort to children with asthma.


Assuntos
Testes Respiratórios , Compostos Orgânicos Voláteis , Criança , Expiração , Humanos , Estudos Prospectivos , Escarro/química , Compostos Orgânicos Voláteis/análise
11.
Chemosphere ; 296: 133934, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35176295

RESUMO

Synthetic rubber emissions from automobile tires are common in aquatic ecosystems. To assess potential impacts on exposed organisms, early life stages of the estuarine indicator species Inland Silverside (Menidia beryllina) and mysid shrimp (Americamysis bahia) were exposed to three tire particle (TP) concentrations at micro and nano size fractions (0.0038, 0.0378 and 3.778 mg/L in mass concentrations for micro size particles), and separately to leachate, across a 5-25 PSU salinity gradient. Following exposure, M. beryllina and A. bahia had significantly altered swimming behaviors, such as increased freezing, changes in positioning, and total distance moved, which could lead to an increased risk of predation and foraging challenges in the wild. Growth for both A. bahia and M. beryllina was reduced in a concentration-dependent manner when exposed to micro-TP, whereas M. beryllina also demonstrated reduced growth when exposed to nano-TP (except lowest concentration). TP internalization was dependent on the exposure salinity in both taxa. The presence of adverse effects in M. beryllina and A. bahia indicate that even at current environmental levels of tire-related pollution, which are expected to continue to increase, aquatic ecosystems may be experiencing negative impacts.


Assuntos
Ecossistema , Poluentes Químicos da Água , Animais , Crustáceos , Peixes , Poluentes Químicos da Água/análise , Poluentes Químicos da Água/toxicidade
12.
Braz J Biol ; 84: e253613, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34730702

RESUMO

Soybean meal is an inexpensive plant origin protein which has been used in practical diets as a replacement of animal protein such as fish meal or chicken meal, due to the uneconomical price of animal protein diets. Consequently, a research study was conducted on some commercial species of Indian major carps i.e. Catla (Cattla cattla), Rohu (Labeo rohita) and Mrigala (Cirhinus mrigala) (Hamilton, 1822) to estimate optimum dietary protein requirement of soy bean meal in diet in an intensive polyculture. Three different diets (SBM I, SBM II and SBM III) were formulated by 80%, 50% and 20% replacement of fish meal with soybean meal from a 45% fish meal diet (control).Highest monthly mean weight gain was obtained by SBM II (with 35% CP and about 50% substitution of fish meal), while SBM III (45% Crude Protein and about 20% substitution of fish meal) was stood second. All tested diets respond enormously by producing high yield as compare to control diet, though SBM II generated highest yield among all. On the bases of the following research, it was revealed that the SBM can surrogate even50% fish meal without any augmentation of other amino acids in the diet of Indian major carps.


Assuntos
Carpas , Cyprinidae , Ração Animal/análise , Fenômenos Fisiológicos da Nutrição Animal , Animais , Dieta/veterinária , Alimentos Marinhos
13.
Facts Views Vis Obgyn ; 13(2): 169-174, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34184846

RESUMO

INTRODUCTION: Vaginal sacrospinous fixation and sacrospinous hysteropexy (SSF/SSHP) are highly effective procedures for apical compartment prolapse. The established technique is the posterior vaginal approach. The alternative anterior approach through an anterior vaginal incision, although occasionally mentioned in the literature, is less well established. However, this approach is a more appropriate route if posterior vaginal surgery is not indicated. The aim of this paper is to review surgical outcomes of anterior approach in our centre and to compare outcomes of SSF vs SSHP. METHODS: Retrospective case note review of 60 patients who underwent anterior SSF for prolapse between 2009-2017 was performed. Preoperative and postoperative symptoms and findings were recorded. Anterior SSF involved an anterior vaginal incision and paravaginal access to the ligament for dissection and fixation to either the cervix or vault. RESULTS: SSF was performed in 39 patients, out of which 8 underwent vaginal hysterectomy concomitantly. SSHP for uterine prolapse was performed in 21 patients. There were no cases of recurrent apical prolapse in the cohort at mean follow-up of 1 year. No intra-operative visceral injuries were observed. Recurrence of anterior wall prolapse and postoperative voiding dysfunction was observed in 8.3% and short-term buttock pain in 6.6% of patients. CONCLUSION: Anterior approach SSF and SSHP is a safe and effective technique for apical prolapse and is the recommended route when posterior vaginal surgery is not required.

14.
QJM ; 114(3): 182-189, 2021 May 19.
Artigo em Inglês | MEDLINE | ID: mdl-33580251

RESUMO

BACKGROUND: Elderly patients with COVID-19 disease are at increased risk for adverse outcomes. Current data regarding disease characteristics and outcomes in this population are limited. AIM: To delineate the adverse factors associated with outcomes of COVID-19 patients ≥75 years of age. DESIGN: Retrospective cohort study. METHODS: Patients were classified into mild/moderate, severe/very severe and critical disease (intubated) based on oxygen requirements. The primary outcome was in-hospital mortality. RESULTS: A total of 355 patients aged ≥75 years hospitalized with COVID-19 between 19 March and 25 April 2020 were included.Mean age was 84.3 years. One-third of the patients developed critical disease. Mean length of stay was 7.10 days. Vasopressors were required in 27%, with the highest frequency in the critical disease group (74.1%). Overall mortality was 57.2%, with a significant difference between severity groups (mild/moderate disease: 17.4%, severe/very severe disease: 71.3%, critical disease: 94.9%, P < 0.001).Increased age, dementia, and severe/very severe and critical disease groups were independently associated with increased odds for mortality while diarrhea was associated with decreased odds for mortality (OR: 0.12, 95% CI: 0.02-0.60, P < 0.05). None of the cardiovascular comorbidities were significantly associated with mortality. CONCLUSION: Age and dementia are associated with increased odds for mortality in patients ≥75 years of age hospitalized with COVID-19. Those who require intubation have the greatest odds for mortality. Diarrhea as a presenting symptom was associated with lower odds for mortality.


Assuntos
COVID-19/terapia , Tomada de Decisões , Pneumonia Viral/terapia , Respiração Artificial , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , COVID-19/epidemiologia , COVID-19/mortalidade , Feminino , Mortalidade Hospitalar , Humanos , Masculino , Cidade de Nova Iorque/epidemiologia , Pneumonia Viral/epidemiologia , Pneumonia Viral/mortalidade , Pneumonia Viral/virologia , Estudos Retrospectivos , Fatores de Risco , SARS-CoV-2 , Índice de Gravidade de Doença
15.
Int J Tuberc Lung Dis ; 24(8): 763-769, 2020 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-32912379

RESUMO

BACKGROUND: Non-conversion on auramine smear microscopy indicates a lack of treatment response, possibly associated with initial rifampicin-resistant tuberculosis (RR-TB). However, dead bacteria still stain positive and may be detected. Fluorescein diacetate smear microscopy (FDA) shows live mycobacteria only. Therefore, we studied the potential of 2-month (2M) FDA for the identification of initial RR-TB.METHODS: Between 2015 and 2018, we enrolled new smear-positive pulmonary TB patients from five local centres in Bamako, Mali. After baseline screening, sputum samples were collected at 1M, 2M, 5M and 18M. We used rpoB sequencing to identify initial RR-TB.RESULTS: Of 1359 patients enrolled, 1019 (75%) had rpoB sequencing results. Twenty-six (2.6%, 95%CI: 1.7-3.7) had mutations conferring rifampicin resistance. Most frequent rpoB mutations were located at the codons Asp435Val (42.4%) and Ser450Leu (34.7%). Among patients with initial RR-TB, 72.2% were FDA-negative at 2M (P = 0.2). The positive and negative predictive value of 5M FDA for culture-based failure was respectively 20.0% and 94.7%.CONCLUSION: FDA did not identify the majority of patients with initial RR-TB or culture-based failure. As the full spectrum of mutations identified on sequencing was identified using Xpert, our data support its rapid universal implementation in Mali.


Assuntos
Mycobacterium tuberculosis , Tuberculose Resistente a Múltiplos Medicamentos , Farmacorresistência Bacteriana , Fluoresceínas , Humanos , Mali , Técnicas de Diagnóstico Molecular , Mycobacterium tuberculosis/genética , Rifampina , Sensibilidade e Especificidade , Escarro
17.
QJM ; 113(8): 546-550, 2020 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-32569363

RESUMO

BACKGROUND: COVID-19 is an ongoing threat to society. Patients who develop the most severe forms of the disease have high mortality. The interleukin-6 inhibitor tocilizumab has the potential to improve outcomes in these patients by preventing the development of cytokine release storm. AIMS: To evaluate the outcomes of patients with severe COVID-19 disease treated with the interleukin-6 inhibitor tocilizumab. METHODS: We conducted a retrospective, case-control, single-center study in patients with severe to critical COVID-19 disease treated with tocilizumab. Disease severity was defined based on the amount of oxygen supplementation required. The primary endpoint was the overall mortality. Secondary endpoints were mortality in non-intubated patients and mortality in intubated patients. RESULTS: A total of 193 patients were included in the study. Ninety-six patients received tocilizumab, while 97 served as the control group. The mean age was 60 years. Patients over 65 years represented 43% of the population. More patients in the tocilizumab group reported fever, cough and shortness of breath (83%, 80% and 96% vs. 73%, 69% and 71%, respectively). There was a non-statistically significant lower mortality in the treatment group (52% vs. 62.1%, P = 0.09). When excluding intubated patients, there was statistically significant lower mortality in patients treated with tocilizumab (6% vs. 27%, P = 0.024). Bacteremia was more common in the control group (24% vs. 13%, P = 0.43), while fungemia was similar for both (3% vs. 4%, P = 0.72). CONCLUSION: Our study showed a non-statistically significant lower mortality in patients with severe to critical COVID-19 disease who received tocilizumab. When intubated patients were excluded, the use of tocilizumab was associated with lower mortality.


Assuntos
Anticorpos Monoclonais Humanizados/uso terapêutico , Betacoronavirus , Infecções por Coronavirus/tratamento farmacológico , Imunossupressores/uso terapêutico , Pneumonia Viral/tratamento farmacológico , Adulto , Idoso , COVID-19 , Estudos de Casos e Controles , Infecções por Coronavirus/mortalidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cidade de Nova Iorque/epidemiologia , Oxigenoterapia , Pandemias , Pneumonia Viral/mortalidade , Receptores de Interleucina-6/antagonistas & inibidores , SARS-CoV-2 , Índice de Gravidade de Doença , Resultado do Tratamento , Tratamento Farmacológico da COVID-19
18.
Drugs Today (Barc) ; 56(3): 203-210, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32282867

RESUMO

Irritable bowel syndrome (IBS) is among the most common gastrointestinal disorders encountered in primary and secondary care and is associated with impaired quality of life, increased healthcare utilization, and significant costs to patients and society. There are three primary phenotypes of IBS, categorized according to stool pattern: IBS with diarrhea (IBS-D), IBS with constipation (IBS-C) and IBS with a mixed bowel pattern (IBS-M). The treatment approach to all forms of IBS is typically hierarchal, with initial therapies consisting of dietary and lifestyle modifications. When these interventions are impractical or ineffective, pharmacotherapy with over-the-counter and prescription therapies is often employed. Tenapanor is a locally acting, minimally absorbed, selective small-molecule inhibitor of the intestinal sodium/hydrogen exchanger 3 (NHE3) that was approved in September 2019 by the U.S. Food and Drug Administration (FDA) for IBS-C. This agent works by increasing the sodium level in the intestinal lumen and promoting the efflux of fluid into the gut lumen to maintain osmotic balance in addition to having an antinociceptive effect. Tenapanor has been shown to improve bowel movement frequency/form and abdominal pain in patients with IBS-C. This article will elaborate on the clinical development program for tenapanor for this indication.


Assuntos
Constipação Intestinal/tratamento farmacológico , Fármacos Gastrointestinais/uso terapêutico , Síndrome do Intestino Irritável/tratamento farmacológico , Isoquinolinas/uso terapêutico , Sulfonamidas/uso terapêutico , Constipação Intestinal/complicações , Humanos , Síndrome do Intestino Irritável/complicações , Trocador 3 de Sódio-Hidrogênio/antagonistas & inibidores
19.
Sleep Disord ; 2020: 7302828, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32148967

RESUMO

BACKGROUND: Restless legs syndrome (RLS) is a neurological disorder characterized by an uncomfortable sensation in the legs which gets worse in the evening or night, relieved upon movement. The aim of this study was to specify the prevalence of RLS in the group of young medical students and to assess the effect of RLS on sleep, as sleep disturbance is one of the chief complaints of RLS patients. We also studied its association with smoking as it is considered an aggravating factor. METHOD: This was a cross-sectional study conducted from June 2017 to July 2018 in Karachi. A total of 300 students (220 females and 80 males) participated and were given questionnaires to detect RLS based on criteria proposed by the International Restless Legs Syndrome Study Group. Subjects who were positive for RLS were further asked questions about sleep by using the Epworth Sleepiness Scale and severity of RLS by using RLS Rating Scale. They were also asked about their smoking status. RESULTS: The frequency of RLS is 8% among young adults. Out of 300 medical students, 24 students were classified positive for RLS with a female preponderance (66.7% were females and 33.3% were males). The severity of RLS was more rated to be mild to moderate. The effect of RLS on sleep was in the mild range. The p value of smoking status comparing with gender came out to be <0.001, and p value of smoking status comparing with gender came out to be <0.001, and. CONCLUSION: It is concluded that we found RLS to be present significantly in our population that is without comorbidities. Our results showed female preponderance and a mild sleep disturbance in our study population. More attention is needed to recognize RLS and to manage the aggravating factors of RLS.

20.
J Clin Tuberc Other Mycobact Dis ; 17: 100128, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31788570

RESUMO

INTRODUCTION: Diabetes Mellitus (DM) increases worldwide, mostly in low- and middle-income countries. In Mali, the prevalence in the adult population is estimated at 1.8%, but tuberculosis (TB) patients are not systematically screened. The goal of our study was to determine the prevalence of DM among newly diagnosed TB patients. METHODS: We conducted a cross sectional study and a pilot prospective cohort study in four health centers in Bamako. All patients underwent fasting capillary-blood glucose (FCBG) test at Day 0, and repeated after one-week of TB treatment. Venous FBG test was performed for discrepancies between the two FCBG results. Thereafter, FCBG was performed for pilot study at month-2 (M2) and M5 of TB treatment. RESULTS: Two hundred and one patients were enrolled in this study. Impaired fasting blood glucose was identified in 17 (8.5%), of whom 11 (5.5%) had DM (VFBG >7 mmol/L). Among patients with DM, seven (63.6%) had successful TB treatment outcome, versus 142 (74.7%) of those without DM (p = 0.64), and (OR: 1.69, 95%CI 0.47-6.02). CONCLUSION: The prevalence of DM among TB patients in Bamako exceeds that of the general population and screening at TB diagnosis suffices to identify those with DM. Systematic screening of both diseases will allow better treatment.

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