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1.
Cerebrovasc Dis ; 2024 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-38359810

RESUMO

BACKGROUND: The use of Alteplase (ALT) bridging to endovascular mechanical thrombectomy (MT) has become the standard approach in treating patients with large vessel stroke (LVO). Tenecteplase (TNK) has emerged as an equivalent fibrinolytic agent in treating ischemic stroke due to its remarkable pharmacological characteristics. This study aims to compare the use of intravenous TNK to ALT bridging to MT in patients with LVO. METHODS: We included observational and randomized controlled trials of patients with LVO who received bridging TNK vs ALT before undergoing MT. Efficacy outcomes included functional independence which is indicated by a modified Rankin Scale [mRS] score of 0-2 at 90 days. Radiological outcomes included the rate of successful recanalization post-MT (Modified Treatment in Cerebral Ischemia [mTICI] score of 2b/3), and the rate of pre-MT recanalization, indicated by an mTICI of 2b/3 at the first angiographic assessment. The all-cause mortality at 90 days (mRS of 6) was considered the primary safety outcome, while the symptomatic intracranial hemorrhage (sICH) rate was reported as an adverse event. RESULTS: We identified 5 comparative observational studies and 1 randomized controlled trial, totaling 4,186 patients with LVO. The crude odds ratio for post-MT recanalization in patients with LVO who received TNK was comparable to those who received ALT (OR = 1.14; 95% CI 0.57-2.27, I² = 54%). The rate of pre-MT recanalization was significantly higher in those given TNK as a bridging therapy to MT compared to those who received ALT (OR = 2.66; 95% CI 1.60-4.41, I² = 0%; P = <0.001). Functional independence at 90 days was not significantly different between patients with stroke who received TNK and those who were given ALT before MT (OR = 1.41; 95% CI 0.84-2.35; I² = 45%). The 90-day mortality was similar between patients with LVO who received TNK and those who were given ALT prior to undergoing MT (OR = 0.74; 95% CI 0.46-1.21; I² = 0%). CONCLUSIONS: Patients with LVO who received TNK as the primary fibrinolytic agent bridging to MT demonstrated higher rates of pre-MT recanalization, similar rates in post-MT recanalization, and equivalent functional independence outcomes at 90 days compared to those who received ALT. The administration of TNK before MT showed comparable results in the 90-day all-cause mortality rate compared to those who received ALT. These results warrant further trials for TNK to be used as a superior fibrinolytic agent to ALT in LVO-MT candidates.

2.
Phys Rev Lett ; 132(4): 045001, 2024 Jan 26.
Artigo em Inglês | MEDLINE | ID: mdl-38335335

RESUMO

Laser wakefield acceleration is paving the way for the next generation of electron accelerators, for their own sake and as radiation sources. A controllable dual-wake injection scheme is put forward here to generate an ultrashort triplet electron bunch with high brightness and high polarization, employing a radially polarized laser as a driver. We find that the dual wakes can be driven by both transverse and longitudinal components of the laser field in the quasiblowout regime, sustaining the laser-modulated wakefield which facilitates the subcycle and transversely split injection of the triplet bunch. Polarization of the triplet bunch can be highly preserved due to the laser-assisted collective spin precession and the noncanceled transverse spins. In our three-dimensional particle-in-cell simulations, the triplet electron bunch, with duration about 500 as, six-dimensional brightness exceeding 10^{14} A/m^{2}/0.1% and polarization over 80%, can be generated using a few-terawatt laser. Such an electron bunch could play an essential role in many applications, such as ultrafast imaging, nuclear structure and high-energy physics studies, and the operation of coherent radiation sources.

3.
PLoS One ; 19(1): e0281208, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38232095

RESUMO

BACKGROUND: Early identification of a patient with infection who may develop sepsis is of utmost importance. Unfortunately, this remains elusive because no single clinical measure or test can reflect complex pathophysiological changes in patients with sepsis. However, multiple clinical and laboratory parameters indicate impending sepsis and organ dysfunction. Screening tools using these parameters can help identify the condition, such as SIRS, quick SOFA (qSOFA), National Early Warning Score (NEWS), or Modified Early Warning Score (MEWS). We aim to externally validate qSOFA, SIRS, and NEWS/NEWS2/MEWS for in-hospital mortality among adult patients with suspected infection who presenting to the emergency department. METHODS AND ANALYSIS: PASSEM study is an international prospective external validation cohort study. For 9 months, each participating center will recruit consecutive adult patients who visited the emergency departments with suspected infection and are planned for hospitalization. We will collect patients' demographics, vital signs measured in the triage, initial white blood cell count, and variables required to calculate Charlson Comorbidities Index; and follow patients for 90 days since their inclusion in the study. The primary outcome will be 30-days in-hospital mortality. The secondary outcome will be intensive care unit (ICU) admission, prolonged stay in the ICU (i.e., ≥72 hours), and 30- as well as 90-days all-cause mortality. The study started in December 2021 and planned to enroll 2851 patients to reach 200 in-hospital death. The sample size is adaptive and will be adjusted based on prespecified consecutive interim analyses. DISCUSSION: PASSEM study will be the first international multicenter prospective cohort study that designated to externally validate qSOFA score, SIRS criteria, and EWSs for in-hospital mortality among adult patients with suspected infection presenting to the ED in the Middle East region. STUDY REGISTRATION: The study is registered at ClinicalTrials.gov (NCT05172479).


Assuntos
Sepse , Síndrome de Resposta Inflamatória Sistêmica , Adulto , Humanos , Estudos de Coortes , Serviço Hospitalar de Emergência , Mortalidade Hospitalar , Estudos Multicêntricos como Assunto , Escores de Disfunção Orgânica , Prognóstico , Estudos Prospectivos , Estudos Retrospectivos , Curva ROC , Sepse/diagnóstico
4.
Cureus ; 15(7): e42661, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-37644933

RESUMO

Introduction The aim of the present study was to describe our institution's nine years of experience in the endoscopic endonasal management of cerebrospinal fluid (CSF) rhinorrhea and to discuss the causes, sites, and outcomes.  Methodology The medical records of patients diagnosed with CSF rhinorrhea in King Abdulaziz Medical City-Jeddah (KAMC-J) between 2014 and 2023 were retrospectively reviewed, and all relevant information including body mass index, medical and surgical history, and postoperative outcomes were obtained. Results A total of 20 cases were included in the present study, sixteen (80%) of which were females and four (20%) were males. The mean age of participants was 42.59±13.9 years. Nine cases (45%) were spontaneous CSF rhinorrhea and 11 (55%) were traumatic; within the traumatic group, six cases (54%) were iatrogenic either following previous neurosurgery or functional endoscopic sinus surgery, while the remaining five cases were related to motor vehicle accidents. The mean body mass index for the spontaneous CSF leak was 32 Kg/m2, and 33 Kg/m2 for the traumatic leaks, no statistically significant difference was noted. The cribriform plate was the most common site of leakage (65%). A multilayer surgical technique using facia lata graft with nasoseptal flap was the most common choice for reconstruction with a first-attempt success rate approximating 90%. A recurrence was observed in two patients only. No major complications were reported. The average length of stay was nine days. Conclusion The endoscopic endonasal repair of CSF leak is a safe and reliable procedure and is associated with high success rates and low risk of complications. Therefore, it should be preferred as a first-line treatment for CSF rhinorrhea.

5.
Healthcare (Basel) ; 11(6)2023 Mar 09.
Artigo em Inglês | MEDLINE | ID: mdl-36981463

RESUMO

The factors that influence the organizational commitment of healthcare professionals, particularly organizational communication and work satisfaction, are essential for all healthcare organizations. This is particularly important for those who are under the pressure of high demand, economic constraints, and staff shortages. This study examined the relationship between organizational communication satisfaction and organizational commitment among healthcare professionals and the mediating role of work satisfaction in the relationship. A validated self-administered questionnaire and a universal sampling approach were used to conduct a cross-sectional survey of 235 healthcare professionals in the Gaza Strip, Palestine. The data were analyzed using SPSS version 25 and SmartPLS software to perform partial least squares structural equation modeling (PLS-SEM). A STROBE checklist was used to report the results. The results show a significant positive correlation between all measured variables. Work satisfaction partially mediates the relationship between organizational communication satisfaction and organizational commitment. The results of the PLS-SEM analyses suggest that communication satisfaction and work satisfaction account for 61% of the variation in organizational commitment. This study reveals that work satisfaction and communication satisfaction are imperative to building a sense of commitment in healthcare professionals. These results reinforce the existing evidence on the factors that influence the organizational commitment of healthcare professionals. Strategies to better shape internal communication practices and improve the work environment through regular feedback to healthcare professionals are essential to strengthening their organizational commitment.

6.
Int J Mol Sci ; 23(13)2022 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-35806249

RESUMO

Deoxynivalenol (DON) is a secondary fungal metabolite that is associated with many adverse toxicological effects in agriculture as well as human/animal nutrition. Bioremediation efforts in recent years have led to the discovery of numerous bacterial isolates that can transform DON to less toxic derivatives. Both 3-keto-DON and 3-epi-DON were recently shown to exhibit reduced toxicity, compared to DON, when tested using different cell lines and mammalian models. In the current study, the toxicological assessment of 3-keto-DON and 3-epi-DON using in planta models surprisingly revealed that 3-keto-DON, but not 3-epi-DON, retained its toxicity to a large extent in both duckweeds (Lemna minor L.) and common wheat (Triticum aestivum L.) model systems. RNA-Seq analysis revealed that the exposure of L. minor to 3-keto-DON and DON resulted in substantial transcriptomic changes and similar gene expression profiles, whereas 3-epi-DON did not. These novel findings are pivotal for understanding the environmental burden of the above metabolites as well as informing the development of future transgenic plant applications. Collectively, they emphasize the fundamental need to assess both plant and animal models when evaluating metabolites/host interactions.


Assuntos
Fusarium , Tricotecenos , Animais , Biotransformação , Fusarium/metabolismo , Mamíferos/metabolismo , Tricotecenos/metabolismo , Tricotecenos/toxicidade , Triticum/metabolismo
7.
J Med Case Rep ; 16(1): 231, 2022 Jun 09.
Artigo em Inglês | MEDLINE | ID: mdl-35676712

RESUMO

INTRODUCTION: Hepatitis A virus infections are mostly asymptomatic or mildly symptomatic, and generally this disease has a benign course and resolves spontaneously. However, intrahepatic and rarer extrahepatic manifestations can complicate typical cases of acute hepatitis. Pleural effusion is an extremely rare extrahepatic entity with 20 cases reported in literature. CASE PRESENTATION: We report herein a recent case of both pleural effusion and ascites accompanying hepatitis A infection in a 5-year-old middle eastern child, diagnosed using serological testing and imaging studies, who was treated with supportive management with full resolution after 2 weeks. In addition, we review available literature regarding hepatitis A virus associated with pleural effusion using PubMed and summarize all reported cases in a comprehensive table. RESULTS: Literature contains 20 reported cases of serology-confirmed hepatitis A virus presenting with pleural effusion, most in the pediatric population with average age at presentation of 9 years 8 months. The majority of reported patients had right-sided pleural effusion (50%) or bilateral effusion (45%), while only 5% presented with pleural effusion on the left side. Hepatomegaly and ascites occurred concurrently in 80% and 70% respectively. Supportive treatment without invasive procedures (except one chylothorax case) yielded complete recovery in 95% of cases, while only one case progressed to fulminant liver failure followed by death. CONCLUSION: Acute hepatitis A virus rarely presents with pleural effusion, usually following a benign course with spontaneous resolution in most patients. Pleural effusion does not change the prognosis or require any invasive treatment. Thus, further invasive procedures are not recommended and would only complicate this self-resolving benign condition.


Assuntos
Quilotórax , Vírus da Hepatite A , Hepatite A , Derrame Pleural , Ascite/etiologia , Criança , Pré-Escolar , Quilotórax/diagnóstico , Hepatite A/complicações , Hepatite A/diagnóstico , Humanos , Derrame Pleural/complicações , Derrame Pleural/etiologia
8.
J Nurs Manag ; 30(1): 214-225, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34590378

RESUMO

AIM: To assess the impact of organisational communication satisfaction (OCS) on the work engagement of health care professionals (HCPs). BACKGROUND: Organisational communication can influence employees' work engagement, which is an essential component of an organisation's effectiveness. However, these concepts have not been broadly investigated in health care organisations. METHODS: A cross-sectional survey was administered to 235 HCPs in the Gaza Strip, Palestine. The SPSS statistical software (version 25) and partial least squares structural equation modelling (PLS-SEM) were used to analyse the collected data. RESULTS: The HCPs reported a moderate level of OCS (M = 4.96, SD = 0.94) and work engagement (M = 5.56, SD = 0.96). The impact of OCS on work engagement was found to be positive and statistically significant (ß = .524, p < .05). No significant difference was revealed in level of OCS or work engagement among the HCPs according to their job categories. Only years of experience significantly influenced their OCS. CONCLUSION: Improving HCPs' satisfaction with organisational communication is vital in enhancing their work engagement and, ultimately, sustaining health care manpower. IMPLICATIONS FOR NURSING MANAGEMENT: Strategies for improving the quantity and quality of organisational communication must be prioritized to strengthen work engagement among HCPs. These strategies include management's role in and ways of communicating essential information about their organisations to HCPs.


Assuntos
Satisfação Pessoal , Engajamento no Trabalho , Comunicação , Estudos Transversais , Pessoal de Saúde , Humanos , Satisfação no Emprego , Inquéritos e Questionários
9.
J Imaging ; 7(2)2021 Jan 20.
Artigo em Inglês | MEDLINE | ID: mdl-34460612

RESUMO

Automatic event recognition in sports photos is both an interesting and valuable research topic in the field of computer vision and deep learning. With the rapid increase and the explosive spread of data, which is being captured momentarily, the need for fast and precise access to the right information has become a challenging task with considerable importance for multiple practical applications, i.e., sports image and video search, sport data analysis, healthcare monitoring applications, monitoring and surveillance systems for indoor and outdoor activities, and video captioning. In this paper, we evaluate different deep learning models in recognizing and interpreting the sport events in the Olympic Games. To this end, we collect a dataset dubbed Olympic Games Event Image Dataset (OGED) including 10 different sport events scheduled for the Olympic Games Tokyo 2020. Then, the transfer learning is applied on three popular deep convolutional neural network architectures, namely, AlexNet, VGG-16 and ResNet-50 along with various data augmentation methods. Extensive experiments show that ResNet-50 with the proposed photobombing guided data augmentation achieves 90% in terms of accuracy.

10.
Front Bioeng Biotechnol ; 9: 630551, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33644021

RESUMO

Recombinant proteins are becoming increasingly important for industrial applications, where Escherichia coli is the most widely used bacterial host for their production. However, the formation of inclusion bodies is a frequently encountered challenge for producing soluble and functional recombinant proteins. To overcome this hurdle, different strategies have been developed through adjusting growth conditions, engineering host strains of E. coli, altering expression vectors, and modifying the proteins of interest. These approaches will be comprehensively highlighted with some of the new developments in this review. Additionally, the unique features of protein inclusion bodies, the mechanism and influencing factors of their formation, and their potential advantages will also be discussed.

11.
BMJ Simul Technol Enhanc Learn ; 7(3): 126-133, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-37534698

RESUMO

Background: COVID-19 pandemic is presenting serious challenges to the world's healthcare systems. The high communicability of the COVID-19 necessitates robust medical preparedness and vigilance. Objective: To report on the simulation-based training and test preparedness activities to prepare healthcare workers (HCWs) for effective and safe handling of patients with COVID-19. Methodology: Two activities were conducted: simulation-based training to all HCWs and a full-scale unannounced simulation-based disaster exercise at King Fahad Medical City (KFMC). The online module was designed to enhance the knowledge on COVID-19. This module was available to all KFMC staff. The five hands-on practical part of the course was available to frontliner HCWs. The unannounced undercover simulated patients' full-scale COVID-19 simulation-based disaster exercise took place in the emergency department over 3 hours. Six scenarios were executed to test the existing plan in providing care of suspected COVID-19 cases. Results: 2620 HCWs took the online module, 17 courses were conducted and 337 frontliner HCWs were trained. 94% of learners were satisfied and recommended the activity to others. The overall compliance rate of the full-scale COVID-19 disaster drill with infection control guidelines was 90%. Post-drill debriefing sessions recommended reinforcing PPE training, ensuring availability of different sizes of PPEs and developing an algorithm to transfer patients to designated quarantine areas. Conclusion: Simulation-based training and preparedness testing activities are vital in identifying gaps to apply corrective actions immediately. In the presence of a highly hazardous contagious disease like COVID-19, such exercises are a necessity to any healthcare institution.

12.
Respir Care ; 66(1): 41-49, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32753531

RESUMO

BACKGROUND: Congenital diaphragmatic hernia is associated with a high risk of neonatal mortality and long-term morbidity due to lung hypoplasia, pulmonary hypertension, and prolonged exposure to positive-pressure ventilation. Ventilator-associated lung injury may be reduced by using approaches that facilitate the transition from invasive ventilation to noninvasive ventilation (NIV), such as with neurally-adjusted ventilatory assist (NAVA). We reported our use of NAVA in neonatal patients with congenital diaphragmatic hernia during the transition from invasive ventilation to NIV. METHODS: A retrospective analysis of neonatal subjects with congenital diaphragmatic hernia admitted to a tertiary care children's hospital between December 2015 and May 2018 was conducted. Subject data and factors that affected the use of NAVA were analyzed. RESULTS: Ten neonatal subjects with congenital diaphragmatic hernia were placed on NAVA, and 6 were successfully transitioned, after surgery, from pressure control synchronized intermittent mandatory ventilation to invasive ventilation with NAVA and then to NIV with NAVA without the need for re-intubation. The transition from pressure control synchronized intermittent mandatory ventilation to invasive ventilation with NAVA resulted in a decrease in peak inspiratory pressure, mean airway pressure, and [Formula: see text]. Barriers to the use of NAVA included symptomatic pleural effusion or chylothorax and pulmonary sequestration. CONCLUSIONS: Both invasive ventilation with NAVA and NIV with NAVA were used successfully in subjects with congenital diaphragmatic hernia during the transition from invasive ventilation to NIV. The transition to NAVA was associated with a decrease in peak inspiratory pressure, mean airway pressure, and the need for supplemental oxygen. A prospective trial is needed to determine the short- and long-term impacts of this mode of ventilation in neonates with congenital diaphragmatic hernia.


Assuntos
Hérnias Diafragmáticas Congênitas , Suporte Ventilatório Interativo , Extubação , Criança , Hérnias Diafragmáticas Congênitas/terapia , Humanos , Recém-Nascido , Estudos Prospectivos , Estudos Retrospectivos
14.
ACS Omega ; 5(19): 10782-10793, 2020 May 19.
Artigo em Inglês | MEDLINE | ID: mdl-32455198

RESUMO

The mechanisms of cellular absorption and transport underlying the differences between flavonoid aglycones and glycosides and the effect of the structural feature are not well established. In this study, aglycone, mono-, and diglycosides of quercetin and cyanidin were selected to examine the effects of the structural feature on the bioavailability of flavonoids using hexose transporters SGLT1 and GLUT2 in a Caco-2 BBe1 cell model. Cellular uptake and transport of all glycosides were significantly different. The glycosides also significantly inhibited cellular uptake of d-glucose, indicating the involvement of the two hexose transporters SGLT1 and GLUT2 in the absorption, and the potential of the glycosides in lowering the blood glucose level. The in silico prediction model also supported these observations. The absorption of glycosides, especially diglycosides but not the aglycones, was significantly blocked by SGLT1 and GLUT2 inhibitors (phloridzin and phloretin) and further validated in SGLT1 knockdown Caco-2 BBe1 cells.

15.
Case Rep Dermatol Med ; 2020: 6274053, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32082644

RESUMO

Body reactions to drugs can manifest as Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). TEN is the most severe form of cutaneous reactions with an incidence rate of 1-2 per million cases per year. Despite TEN being a critical and life-threatening condition, there is little to no evidence of clear management protocol. We reported a 5-year-old male child who presented with lamotrigine-induced TEN and was successfully treated with intravenous immune globulin (IVIG) with a burn unit care level, while TEN treatment with IVIG is an appropriate approach with predictable good outcomes, burn unit care is also effective in creating highly favorable effects. Upon reviewing the literature, several studies indicate that TEN patients treated with the combination of IVIG and burn unit care lead to decreased levels of morbidity and mortality than when treated with IVIG or burn unit care alone. Therefore, treatment involving both IVIG and burn unit care should be considered for TEN patients.

16.
Analyst ; 145(6): 2345-2356, 2020 Mar 16.
Artigo em Inglês | MEDLINE | ID: mdl-31993615

RESUMO

The use of nanoparticles (NP) as dose enhancers in radiotherapy (RT) is a growing research field. Recently, the use of NP has been extended to charged particle therapy in order to improve the performance in radioresistant tumors. However, the biological mechanisms underlying the synergistic effects involved in NP-RT approaches are not clearly understood. Here, we used the capabilities of synchrotron-based Fourier Transform Infrared Microspectroscopy (SR-FTIRM) as a bio-analytical tool to elucidate the NP-induced cellular damage at the molecular level and at a single-cell scale. F98 glioma cells doped with AuNP and GdNP were irradiated using several types of medical ion beams (proton, helium, carbon and oxygen). Differences in cell composition were analyzed in the nucleic acids, protein and lipid spectral regions using multivariate methods (Principal Component Analysis, PCA). Several NP-induced cellular modifications were detected, such as conformational changes in secondary protein structures, intensity variations in the lipid CHx stretching bands, as well as complex DNA rearrangements following charged particle therapy irradiations. These spectral features seem to be correlated with the already shown enhancement both in the DNA damage response and in the reactive oxygen species (ROS) production by the NP, which causes cell damage in the form of protein, lipid, and/or DNA oxidations. Vibrational features were NP-dependent due to the NP heterogeneous radiosensitization capability. Our results provided new insights into the molecular changes in response to NP-based RT treatments using ion beams, and highlighted the relevance of SR-FTIRM as a useful and precise technique for assessing cell response to innovative radiotherapy approaches.


Assuntos
Nanopartículas Metálicas/química , Radiossensibilizantes/farmacologia , Animais , Linhagem Celular Tumoral , Gadolínio/química , Gadolínio/efeitos da radiação , Luz , Lipídeos/química , Nanopartículas Metálicas/efeitos da radiação , Microespectrofotometria/métodos , Microespectrofotometria/estatística & dados numéricos , Conformação de Ácido Nucleico/efeitos dos fármacos , Ácidos Nucleicos/química , Ácidos Nucleicos/efeitos dos fármacos , Análise de Componente Principal , Conformação Proteica/efeitos dos fármacos , Proteínas/química , Proteínas/efeitos dos fármacos , Radiossensibilizantes/efeitos da radiação , Ratos , Prata/química , Prata/efeitos da radiação , Síncrotrons
17.
Front Pharmacol ; 10: 1098, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31798443

RESUMO

Deoxynivalenol (DON) is a major fusarium toxin widely detected in cereal grains. The inadvertent exposure to this fungal secondary-metabolite gives rise to a myriad of adverse health effects including appetite loss, emesis, and suppression of the immune system. While most of the attention this mycotoxin has gained in the past four decades was related to its eukaryotic toxicity (monogastric animals and plants more precisely), recent studies have begun to reveal its negative influence on prokaryotes. Recently presented evidence indicates that DON can negatively affect many bacterial species, raising the possibility of DON-induced imbalances within the microbiota of the human and animal gut, in addition to other environmental niches. This in turn has led to a greater interest in understanding bacterial responses toward DON, and the involved mechanism(s) and metabolic pathways, in order to build a more comprehensive picture of DON-induced changes in both prokaryotes and eukaryotes alike. This study reveals the transcriptomic profiling of Devosia mutans strain 17-2-E-8 after the inclusion of DON within its growth medium. The results highlight three adaptive mechanisms involved in the response of D. mutans 17-2-E-8 to this mycotoxin, which include: (a) activation of adenosine 5'-triphosphate-binding cassette transporters; (b) engagement of a toxin-specific pyrroloquinoline quinone-dependent detoxification pathway; and finally (c) the upregulation of auxiliary coping proteins such as porins, glutathione S-transferases, and phosphotransferases. Some of the identified mechanisms are universal in nature and are shared with other bacterial genera and species.

18.
Prehosp Disaster Med ; 34(6): 580-587, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31615584

RESUMO

BACKGROUND: Political unrest in the Middle East heightens the possibility of catastrophe due to violent conflict and/or terrorist attacks. However, the disaster risk reduction strategy in the Saudi health care system appears to be a reactive approach focused more on flood hazards than other threats. Given the current unstable political situation in its neighboring countries and Saudi Arabia's key role in providing humanitarian assistance and disaster relief to those affected by internal conflicts and wars, it is essential to develop a framework for training standards related to complex humanitarian disasters to provide the requisite skills and knowledge in a gradual manner, according to local context and international standards. This framework could also support the World Health Organization's (WHO; Geneva, Switzerland) initiative for establishing a national disaster assistance team in Saudi Arabia. PROBLEM: The main aim of this study is to provide Saudi health care providers with a competencies-based course in Basic Principles of Complex Humanitarian Emergency. METHODS: The interactive, competencies-based course in Basic Principles of Complex Humanitarian Emergency was designed by five experts in disaster medicine and humanitarian relief in three stages, accordance to international standards and the local context. The course was piloted over five days at the Officers Club of the Ministry of Interior (MOI; Riyadh, Saudi Arabia). The 33 participants were from different health disciplines of the government sectors in-country. The participants completed the pre- and post-tests and attended three pilot workshops for disaster community awareness. RESULTS: The overall knowledge scores were significantly higher in the post-test (62.9%) than the pre-test (44.2%). There were no significant differences in the pre- and post-knowledge scores for health care providers from the different government health disciplines. A 10-month, post-event survey demonstrated that participants were satisfied with their knowledge retention. Importantly, three of them (16.6%) had the opportunity to put this knowledge into practice in relation to humanitarian aid response. CONCLUSION: Delivering a competencies-based course in Basic Principles of Complex Humanitarian Emergency for health care providers can help improve their knowledge and skills for humanitarian assistance and disaster relief, which is crucial for disaster preparedness augmentation in Saudi Arabia.


Assuntos
Serviços Médicos de Emergência , Capacitação em Serviço , Socorro em Desastres , Currículo , Planejamento em Desastres , Humanos , Projetos Piloto , Avaliação de Programas e Projetos de Saúde , Arábia Saudita
19.
Analyst ; 144(21): 6352-6364, 2019 Oct 22.
Artigo em Inglês | MEDLINE | ID: mdl-31560361

RESUMO

The inclusion of nanoparticles (NP) in radiotherapy has been shown to increase the damaging effect on tumor cells. However, the mechanisms of action of NP combined with radiotherapy, and the influence of NP parameters and cell type on their radiosensitization capability at molecular and cellular levels still remain unclear. Gold NP (AuNP) have become particularly popular due to their multiple advantages. Within this context, our research work aimed to study the biochemical radiosensitization capacity of F98 and U87-MG glioma cell lines to 1.9 nm AuNP combined with X-ray irradiation. For this purpose, synchrotron-based infrared microspectroscopy (SR-FTIRM) was used as a powerful tool for biochemical composition and treatment response assessment of cells at a single-cell level. SR-FTIRM data, supported by multivariate analysis, revealed clear AuNP-induced changes in the DNA, protein and lipid spectral regions. The AuNP-related biochemical alterations appear prior to the irradiation, which gave us a first indication on the AuNP radiosensitization action. Biochemical modifications induced by the AuNP in the presence of radiotherapy irradiations include enhanced conformational changes in the protein secondary structures, variations in the intensity and position in the phosphodiester bands, and changes in the CH2 and CH3 stretching modes. These changes are better manifested at 24 hours post-irradiation time. SR-FTIRM results showed a clear heterogeneity in the biochemical cell response, probably due to the distinct cell-NP interactions and thus, to different DNA damage and cell death processes.


Assuntos
Glioma/metabolismo , Nanopartículas Metálicas/química , Radiossensibilizantes/farmacologia , Animais , Linhagem Celular Tumoral , Sobrevivência Celular/efeitos dos fármacos , DNA/metabolismo , Dano ao DNA/efeitos dos fármacos , Ouro/química , Ouro/efeitos da radiação , Humanos , Nanopartículas Metálicas/efeitos da radiação , Análise de Componente Principal , Proteínas/metabolismo , Radiossensibilizantes/química , Radiossensibilizantes/efeitos da radiação , Ratos , Espectrofotometria Infravermelho , Síncrotrons , Raios X
20.
J Agric Food Chem ; 67(35): 9705-9718, 2019 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-31393722

RESUMO

Antimicrobial resistance is among the most urgent global challenges facing sustainable animal production systems. The use of antibiotics as growth promoters and for infectious disease prevention in intensive animal-farming practices has translated into the selection and spread of antimicrobial resistance genes in an unprecedented fashion. Several multi-resistant bacterial strains have been isolated from food-producing animals, thus constituting an alarming food-safety issue. Many industrial byproducts with potential antimicrobial properties are currently being investigated to identify empirical and affordable solutions/alternatives that can potentially be used in feed for animals. Grape pomace is among such byproducts that gained the attention as a result of its low cost, abundance, and, most importantly, its bioactive and antibacterial properties. This review discusses the recently reported studies with regard to exploring the use of grape pomace (and its extracts) in animal production to control pathogens, along with the promotion of beneficial bacterial species in the gut to ultimately alleviate antibacterial resistance. The review further summarizes realistic expectations connected with grape pomace usage and lists the still-to-be-addressed concerns about its application in animal agriculture.


Assuntos
Ração Animal/análise , Antibacterianos/administração & dosagem , Infecções Bacterianas/veterinária , Extratos Vegetais/administração & dosagem , Vitis/química , Resíduos/análise , Animais , Antibacterianos/química , Antibacterianos/metabolismo , Infecções Bacterianas/tratamento farmacológico , Infecções Bacterianas/metabolismo , Infecções Bacterianas/microbiologia , Extratos Vegetais/química , Extratos Vegetais/metabolismo , Vitis/metabolismo
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