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1.
Expert Rev Pharmacoecon Outcomes Res ; 24(3): 405-412, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38064312

RESUMO

OBJECTIVES: Currently, there is an urgent need to implement an Antimicrobial Stewardship Program (ASP) in outpatient settings since nearly half of the antibiotic prescribing is inappropriate or unnecessary. The implementation of ASP should emphasize educational interventions that are more interactive. This study examines the adoption of outpatient ASP by physicians in Jordan. METHODS: A cross-sectional study was conducted between 2 March 2022 and 20 May 2022 at major hospitals in Jordan. The survey was distributed randomly among (n = 187) Jordanian physicians. RESULTS: It was found that more than half of the physicians were females (51.9%). The participants who reported not including antibiotic stewardship-related duties in position descriptions were (40.1%). While (46.5%) of participants reported writing and displaying public commitments supporting antibiotic stewardship in ambulatory care settings. Physicians' adoption of (action) core elements of ASPs in ambulatory care settings was positive. Almost (24.6%) reported a lack of self-evaluation of their antibiotic-prescribing practices. It was reported that (69.5%) of physicians used effective communication strategies to educate patients about when antibiotics are necessary. CONCLUSION: It was fair adoption of the core elements in the ambulatory care settings among Jordanian physicians. Progress necessitates a comprehensive strategy tailored to the needs of the health system.


Assuntos
Gestão de Antimicrobianos , Médicos , Feminino , Humanos , Masculino , Jordânia , Estudos Transversais , Antibacterianos/uso terapêutico , Assistência Ambulatorial , Prescrição Inadequada , Padrões de Prática Médica
2.
Future Sci OA ; 9(9): FSO889, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37752914

RESUMO

Aim: The study aims to assess factors associated with premenstrual syndrome (PMS) and the frequency of using painkillers to relieve premenstrual pain. Methods: This is a cross-sectional study of 1580 premenopausal women. An online self-administered questionnaire consists of sociodemographics, and the diagnostic criteria using the Arabic Premenstrual Syndrome Scale (A-PMS). Results: The prevalence of PMS among Jordanian females was 94%. Moreover, a significant correlation was found between several factors, including BMI, family history of PMS, smoking, and herbal tea consumption and the psychological, physical and behavioral symptoms of PMS. Furthermore, analgesic use for pain relief and food cravings were significantly associated with psychological, physical and behavioral PMS symptoms. Conclusion: PMS is highly prevalent and affects women in different life aspects.


Premenstrual syndrome (PMS) is a set of symptoms that affect women for a week or two before their period. PMS influences women's emotions, physical health and behavior. Symptoms usually resolve within a few days of menstruation. This study confirms the epidemiological surveys worldwide that reported 80­90% of females experience PMS symptoms. We reported multiple risk factors for PMS including age, weight, family history of PMS, marital status, smoking, herbal tea consumption, fast food consumption and other dietary habits. Furthermore, analgesic use for pain relief and food cravings were significantly associated with psychological, physical and behavioral PMS.

3.
Clin Nutr Open Sci ; 49: 118-129, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-37266308

RESUMO

Background and aim: The outbreak of coronavirus (COVID-19) has made a global public health disaster. Little information is known about how to combat this infection. Therefore, preventive health measures that can reduce the severity and progression of this disease are needed. Some dietary supplements and herbal products have antiviral and anti-inflammatory effects. Thus, it may be used to enhance immunity and reduce the risk of COVID-19 infection. In this study, we reviewed selected supplements that may play a key role in the prevention and management of COVID-19 (e.g. vitamin D, vitamin C, and zinc), and that was to determine the level of knowledge and attitudes toward them by the adult population in Jordan. Methodology: This is a cross-sectional study design, in which an online questionnaire was conducted and distributed on different social media websites. People who are above 18 years old were included in this study. Demographic, Attitudes, and knowledge data were collected and then analyzed using the Statistical Package for Social Sciences (SPSS 23). Results: In this study, (62.8%) of participants became more concerned with their health during the COVID-19 pandemic, and (49.2%) of them used dietary and herbal supplements to protect themselves from the coronavirus. In addition, (18.5%) of participants reported that they had used these supplements for a while and then stopped. Conclusion: The findings of our study provided evidence that the general population in Jordan has a reasonable level of knowledge and acceptance of dietary and herbal supplements used during the COVID-19 pandemic.

4.
Artigo em Inglês | MEDLINE | ID: mdl-37191454

RESUMO

OBJECTIVES: This study was undertaken to evaluate the prescribing practice of albumin in the intensive care unit (ICU) and to compare the clinical and economic outcomes associated with intravenous (IV) albumin compared to crystalloids in the ICU. METHODS: This was a retrospective cohort study of ICU adult patients admitted to King Abdullah University Hospital during 2018-2019. Patient demographics, clinical characteristics, and admission charges were retrieved from medical records and billing system. Survival analysis, multivariable regression models, and propensity score matching estimator were performed to evaluate the impact of IV resuscitation fluid types on the clinical and economic outcomes. RESULTS: Albumin administration in the ICU was associated with significantly lower hazards of ICU death (HR = 0.57; P value <0.001), but without improving overall death probability compared to crystalloids. Albumin was associated with significant prolongation in the ICU length of stay (5.86 days; P value <0.001). Only 88 patients (24.3%) were prescribed albumin for Food and Drug Administration (FDA)-approved indications. Admission charges were significantly higher for patients treated with albumin (p value <0.001). CONCLUSIONS: IV Albumin use in the ICU was not associated with significant improvement in clinical outcomes, but with a remarkable increase in economic burden. The majority of patients received albumin for non-FDA-approved indications.


Assuntos
Albuminas , Unidades de Terapia Intensiva , Adulto , Humanos , Estudos Retrospectivos , Soluções Cristaloides , Administração Intravenosa , Tempo de Internação
5.
Heliyon ; 8(8): e10076, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35982844

RESUMO

Background: Bloodstream infections (BSIs) are one of the most critical illnesses requiring intensive care unit (ICU) admission. Antimicrobial therapy (AMT) is one of the vital management strategies for the treatment of BSIs; it should be chosen appropriately to reduce mortality. Objectives: This is the first study to investigate the types of antimicrobial agents administered in the ICU setting and the predictor variables associated with mortality. Methods: This retrospective study was conducted at King Abdullah University Hospital (KAUH). All hospitalized patients admitted to the ICU and received at least one antimicrobial agent over 3 years period (January 1, 2017, to December 31, 2019) were included in the study. Electronic patients' medical records were used to collect patients' demographic and clinical characteristics, patient general health status, events that occurred during hospitalization, and events after obtaining the blood culture. Descriptive analysis was done to identify the types of antimicrobials used and the distribution of the microorganisms among the study participants. The susceptibility test of the bloodstream culture was checked for each patient. Moreover, crude mortality and its associated factors were investigated. Results: A total of 1051 patients were enrolled in the study, where 650 patients (61.84%) were treated with three or more antimicrobial agents. The most frequent antimicrobials used were piperacillin/tazobactam followed by teicoplanin, meropenem, and levofloxacin. About half of the patients died within 30-days of BSI, which was associated with several factors including advanced age, presence of co-morbidities, nosocomial infections or healthcare-associated infections, length of ICU stay, respiratory tract infections, receiving vasopressor during the hospital stay, concurrent positive culture other than blood with BSI, receiving combination antimicrobial therapy, those who were complicated with septic shock or renal failure, receiving total parenteral protein (TPN) nutrition, and inappropriate empiric antimicrobial therapy. Conclusion: In conclusion, the administration of the antimicrobials among ICU patients was highly based on a combination of three or more agents covering a broad spectrum of microorganisms. The mortality rate was high among patients which were associated with inappropriate empirical therapy. Therefore, the antimicrobial stewardship (ASP) protocol has to be evaluated in the hospital for ICU patients. Moreover, we suggest recommending that hospital policies should apply the ASP protocol, infection control, implement the antimicrobial de-escalation protocol, and do best controlling on the co-morbid conditions, especially for ages 65 years or more to reduce the mortality rate in the ICU.

6.
Int J Crit Illn Inj Sci ; 12(2): 82-90, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35845122

RESUMO

Background: Bloodstream infections (BSIs) are one of the most critical illnesses requiring intensive care unit (ICU) admission. This study assessed patterns of antimicrobial use and resistance in ICU patients with BSIs. Methods: Inpatients admitted to the ICU and who received at least one antimicrobial agent between January 1, 2017, and December 31, 2019, were included in the study. Electronic patients' medical records were used to collect patients' demographic, clinical, and microbiological data. Results: A total of 1051 patients were enrolled in the study, where 650 patients (61.84%) were treated with three or more antimicrobial agents. The most frequently used antimicrobials were piperacillin/tazobactam followed by teicoplanin, meropenem, and levofloxacin. The most predominant multidrug-resistant pathogens were Acinetobacter baumannii, followed by Escherichia coli, Methicillin-resistant Staphylococcus aureus (MRSA), Klebsiella pneumonia, and Pseudomonas aeruginosa. Conclusions: The administration of the antimicrobials among ICU patients was highly based on a combination of three or more broad-spectrum agents. MDR pathogens were found to be highly prevalent among ICU patients with BSI. Therefore, we suggest recommending that hospital policies should apply the antimicrobial stewardship protocols, infection control, and implement antimicrobial de-escalation protocol to reduce the harm pressure of antimicrobial resistance.

7.
Int J Crit Illn Inj Sci ; 12(2): 106-114, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35845119

RESUMO

Medication errors (MEs) present a significant issue in health care area, as they pose a threat to patient safety and could occur at any stage of the medication use process. The objective of this systematic review was to review studies reporting the rates, prevalence, and/or incidence of various MEs in different health care clinical settings in Jordan. We searched PubMed, HINARI, Google, and SCOPUS for relevant published studies. We included observational, cross-sectional or cohort studies on MEs targeting adults in different health-care settings in Jordan. A total of 411 records were identified through searching different databases. Following the removal of duplicates, screening of title, abstract and full-text screening, 24 papers were included for the final review step. Prescribing errors was the most common error reported in the included studies, where it was reported in 15 studies. The prevalence of prescribing errors ranged from 0.1% to 96%. Two studies reported unintentional discrepancies and documentation errors as other types of MEs, where the prevalence of unintentional discrepancies ranged from 47% to 67.9%, and the prevalence of documentation errors ranged from 33.7% to 65%. In conclusion, a wide variation was found between the reviewed studies in the error prevalence rates. This variation may be due to the variation in the clinical settings, targeted populations, methodologies employed. There is an imperative need for addressing the issue of MEs and improving drug therapy practice among health-care professionals by introducing education and training.

8.
Stem Cells Int ; 2021: 5212852, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34795766

RESUMO

Liver diseases are major causes of morbidity and mortality. Dental pulp pluripotent-like stem cells (DPPSCs) are of a considerable promise in tissue engineering and regenerative medicine as a new source of tissue-specific cells; therefore, this study is aimed at demonstrating their ability to generate functional hepatocyte-like cells in vitro. Cells were differentiated on a collagen scaffold in serum-free media supplemented with growth factors and cytokines to recapitulate liver development. At day 5, the differentiated DPPSC cells expressed the endodermal markers FOXA1 and FOXA2. Then, the cells were derived into the hepatic lineage generating hepatocyte-like cells. In addition to the associated morphological changes, the cells expressed the hepatic genes HNF6 and AFP. The terminally differentiated hepatocyte-like cells expressed the liver functional proteins albumin and CYP3A4. In this study, we report an efficient serum-free protocol to differentiate DPPSCs into functional hepatocyte-like cells. Our approach promotes the use of DPPSCs as a new source of adult stem cells for prospective use in liver regenerative medicine.

9.
Materials (Basel) ; 14(20)2021 Oct 19.
Artigo em Inglês | MEDLINE | ID: mdl-34683810

RESUMO

BACKGROUND: Bioactive chemical surface modifications improve the wettability and osseointegration properties of titanium implants in both animals and humans. The objective of this animal study was to investigate and compare the bioreactivity characteristics of titanium implants (BLT) pre-treated with a novel bone bioactive liquid (BBL) and the commercially available BLT-SLA active. METHODS: Forty BLT-SLA titanium implants were placed in in four foxhound dogs. Animals were divided into two groups (n = 20): test (BLT-SLA pre-treated with BBL) and control (BLT-SLA active) implants. The implants were inserted in the post extraction sockets. After 8 and 12 weeks, the animals were sacrificed, and mandibles were extracted, containing the implants and the surrounding soft and hard tissues. Bone-to-implant contact (BIC), inter-thread bone area percentage (ITBA), soft tissue, and crestal bone loss were evaluated by histology and histomorphometry. RESULTS: All animals were healthy with no implant loss or inflammation symptoms. All implants were clinically and histologically osseo-integrated. Relative to control groups, test implants demonstrated a significant 1.5- and 1.7-fold increase in BIC and ITBA values, respectively, at both assessment intervals. Crestal bone loss was also significantly reduced in the test group, as compared with controls, at week 8 in both the buccal crests (0.47 ± 0.32 vs 0.98 ± 0.51 mm, p < 0.05) and lingual crests (0.39* ± 0.3 vs. 0.89 ± 0.41 mm, p < 0.05). At week 12, a pronounced crestal bone loss improvement was observed in the test group (buccal, 0.41 ± 0.29 mm and lingual, 0.54 ± 0.23 mm). Tissue thickness showed comparable values at both the buccal and lingual regions and was significantly improved in the studied groups (0.82-0.92 mm vs. 33-48 mm in the control group). CONCLUSIONS: Relative to the commercially available BLT-SLA active implants, BLT-SLA pre-treated with BBL showed improved histological and histomorphometric characteristics indicating a reduced titanium surface roughness and improved wettability, promoting healing and soft and hard tissue regeneration at the implant site.

10.
Life Sci ; 284: 119898, 2021 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-34453942

RESUMO

AIMS: Waterpipe smoking (WPS) is a popular form of tobacco smoking. This is due to the misperception that WPS is less detrimental than cigarette smoking. This review aimed to present the adverse effects of WPS on health outcomes through utilizing animal models. MAIN METHODS: The design of the current study is systematic review. PubMed, HINARI, Google, and SCOPUS databases were searched for the adverse effects of WPS on general health in rodents. Certain key information was extracted and collected from the included studies. KEY FINDINGS: After screening different databases and removal of duplicates, 43 papers were included in this review. It was found that WPS was able to negatively affect the oxidative stress and inflammatory biomarkers in mice. Furthermore, WPS increased the levels of Tumor necrosis factor-α and 8-isoprostane, and DNA damage in mice lung homogenates. Additionally, chronic exposure to WPS increased the serum levels of creatinine and blood urea nitrogen in mice; indicating injury to renal tissues. The negative effect of WPS extends to affect offspring rats following prenatal WPS, in which WPS in utero lead to remarkable increase in the levels of testosterone, estrogen and follicle-stimulating hormones in WPS exposed animals. SIGNIFICANCE: This systematic review highlighted the adverse effects of WPS on health outcomes at cellular and biochemical levels in different tissues and organs of rodents. The current reviews' findings highlighted the great hazards presented by WPS in the selected rodents' model and the essential necessity for future improved management of WPS indoor consumption.


Assuntos
Saúde , Fumaça , Tabaco para Cachimbos de Água , Animais , Humanos , Memória , Modelos Animais , Roedores
11.
Antibiotics (Basel) ; 10(8)2021 Aug 11.
Artigo em Inglês | MEDLINE | ID: mdl-34439013

RESUMO

Evidence based information sources for physicians are needed for informed antibiotic prescribing practices. The aim of this study was to explore physicians' preferred sources of information and evaluate physicians' awareness of available information and initiatives on prudent antibiotic prescribing in Jordan. A cross-sectional study was conducted utilizing an online questionnaire and included physicians (n = 409) from all sectors and specialties in Jordan. Published guidelines (31.8%), the workplace (25.7%), colleagues or peers (20.0%), group or conference training (18.3%), and the medical professional body (18.1%) were the main sources of information about avoiding unnecessary antibiotic prescribing, with the influence of these sources on changing prescribers' views being 34.7%, 17.1%, 11%, 13.4%, and 7.6%, respectively. One-third of physicians (33.7%) reported no knowledge of any initiatives on antibiotic awareness and resistance. Regarding awareness of national action plans on antimicrobial resistance, 10.5%, 34%, and 55.5% of physicians were aware, unaware, and unsure of the presence of any national action plans, respectively. Physicians showed interest in receiving more information on resistance to antibiotics (58.9%), how to use antibiotics (42.2%), medical conditions for which antibiotics are used (41.3%), prescribing of antibiotics (35.2%), and links between the health of humans, animals, and the environment (19.8%). The findings can inform interventions needed to design effective antimicrobial stewardship, enabling physicians to prescribe antibiotics appropriately.

12.
Int J Clin Pract ; 75(9): e14409, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34051030

RESUMO

BACKGROUND: Pseudomonas aeruginosa (P aeruginosa) is a leading cause of nosocomial bloodstream infections worldwide. This study aimed to evaluate the incidence of P aeruginosa bloodstream infections and to identify predictors of 30-day mortality. METHODS: A retrospective study was conducted in an academic tertiary hospital in Jordan. The medical records of patients hospitalised over ten years (1 January 2008-31 December 2017) were reviewed to identify patients' positive blood culture of P aeruginosa. Annual incidence, antimicrobial susceptibility patterns and risk factors for 30-day mortality were analysed. RESULTS: A total of 169 cases of P aeruginosa bloodstream infection were identified, with an overall incidence rate of 0.23 case/1000 admission. The overall crude 30-day mortality was 36.7%. Receipt of corticosteroids (OR = 4.5; P = .0017), severe sepsis and septic shock (OR = 2.7; P = .0476), admission to intensive care unit (OR = 5.9; P = .0004), end-stage renal disease (OR = 4.1; P = .0123), inappropriate empirical therapy (OR = 3.2; P = .0143) and inappropriate definitive therapy (OR = 2.9; P = .0110) were identified as independent risk factors for mortality. CONCLUSION: The annual incidence of P aeruginosa BSIs was fluctuating over ten years period. Several predictors for 30-day mortality in patients with P aeruginosa BSIs were identified, including inappropriate empirical and definitive therapy.


Assuntos
Bacteriemia , Infecção Hospitalar , Sepse , Antibacterianos/uso terapêutico , Bacteriemia/tratamento farmacológico , Bacteriemia/epidemiologia , Infecção Hospitalar/tratamento farmacológico , Infecção Hospitalar/epidemiologia , Humanos , Pseudomonas aeruginosa , Estudos Retrospectivos , Fatores de Risco , Sepse/tratamento farmacológico , Centros de Atenção Terciária
13.
Int J Infect Dis ; 105: 746-752, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33737132

RESUMO

BACKGROUND: Antimicrobial resistance is a serious threat to global health. Antimicrobial Stewardship Programs (ASPs) are adopted by healthcare systems worldwide. This review aimed to evaluate the published practices of ASPs in Middle Eastern countries. METHODS: Searches were carried out in PubMed/MEDLINE, Embase, EBSCO, Cochrane Library, Google, and Google Scholar electronic databases for studies published from January 2005 to December 2020 that assessed ASP practices in Middle Eastern countries, following PRISMA guidelines. RESULTS: Of the 422 titles identified, 20 studies met the inclusion criteria. Eight studies were conducted in the Kingdom of Saudi Arabia, five in Qatar, two each in Lebanon and Jordan, and one each in Palestine and UAE; there was also one multinational study. Different ASP practices, including prospective auditing and feedback, pre-authorization, tracking, antibiotic restriction, education, de-escalation, and intravenous-to-oral switch, were reported. ASP practices correlated with improved susceptibility rates and decreases in antimicrobial use. CONCLUSION: The outcomes of this review reveal the scarcity of data on ASP practices. The introduction of ASPs in hospitals in Middle Eastern countries has led to favorable clinical effects. Policymakers and stakeholders should promote and invest in implementing these programs as an essential component of their healthcare systems.


Assuntos
Gestão de Antimicrobianos , Implementação de Plano de Saúde/métodos , Antibacterianos/uso terapêutico , Farmacorresistência Bacteriana , Saúde Global , Educação em Saúde , Hospitais , Humanos , Jordânia , Líbano , Oriente Médio , Estudos Prospectivos , Catar , Arábia Saudita
14.
Int J Gen Med ; 14: 77-87, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33469347

RESUMO

BACKGROUND AND OBJECTIVES: Coronavirus disease-2019 (COVID-19) is an emerging disease threatening the world with a rapid increase in cases and deaths since it was first identified in December 2019. Adequate knowledge, practice, and attitudes (KPA) toward COVID-19 among physicians at the frontline defense against the COVID-19 pandemic may enhance their ability to avoid the risk of self-infection, decrease mortality, and provide adequate medical care service in this pandemic. This study aimed to assess KPA toward COVID-19 among physicians in Jordan and Palestine. METHODS: This is a cross-sectional study using an online survey conducted from 10 April to 26 April 2020 among Jordan and Palestine physicians. Invitations were sent to physician groups on Facebook and WhatsApp. This survey contains 36-items, divided into four main sections to assess the participants' socio-demographic characteristics, knowledge, practice, and attitude about COVID-19. RESULTS: A total of 454 physicians participated in this study. The mean score of basic knowledge was 4.4 ± 0.8 (range 2-4). There were significant differences between basic knowledge mean scores among physicians in different professional degrees and physicians in various health sectors (P=0.0315, P=0.0137, respectively). The mean scores of self-protection measures, were 6.1 ± 1.1 (range 3-7) and measures if physician self-suspected of COVID-19 were 9.9± 1.1 (range 5-11). The mean score of attitudes toward COVID-19 was 41.5 ± 3.3 (range 21-45) and significantly related to the age and different experience years (P=0.0022, P=0.0077, respectively). CONCLUSION: As the global threat of COVID-19 continues to emerge, physicians from Jordan and Palestine showed adequate KPA toward COVID-19. There was a significant difference in knowledge level and attitude between physicians. Policymakers and physicians should keep continuous educational activities, training, and follow-up updates during this pandemic.

15.
Expert Rev Anti Infect Ther ; 19(8): 1047-1051, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-33307895

RESUMO

OBJECTIVE: To quantify antimicrobial use in inpatients setting as part of antimicrobial stewardship program surveillance. METHOD: Antimicrobial use was obtained using a pre-designed data collection form in this point prevalence study. Setting: The study was conducted in a tertiary academic hospital in the North of Jordan on 13 August 2018. Main outcome measures: antimicrobial use was determined using two methods: defined daily use (DDD) and days of therapy (DOT). RESULTS: This study identified antimicrobial use in 144 patients. Carbapenems, glycopeptides, and piperacillin-tazobactam were the most utilized antimicrobials in the inpatients' setting in both measures DDD and DOT. The highest prescription rate of antibiotics was in the internal medicine wards (49.8 DDD/100 admissions), followed by surgery wards (33.2 DDD/100 admissions) and intensive care unit (20.6 DDD/100 admissions). CONCLUSION: This surveillance study addressed patterns of antimicrobial usage in inpatients settings in a tertiary care hospital in Jordan. This practice is feasible and could be adopted routinely by antimicrobial stewardship programs.


Assuntos
Anti-Infecciosos/administração & dosagem , Gestão de Antimicrobianos , Padrões de Prática Médica/estatística & dados numéricos , Adolescente , Adulto , Criança , Estudos Transversais , Feminino , Humanos , Unidades de Terapia Intensiva/estatística & dados numéricos , Jordânia , Masculino , Pessoa de Meia-Idade , Prevalência , Centros de Atenção Terciária , Adulto Jovem
16.
Life Sci ; 261: 118353, 2020 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-32877649

RESUMO

AIMS: Polycystic ovary syndrome (PCOS) is a widespread chronic reproductive disorder that is associated with metabolic disturbances. Traditionally, the marjoram plant is well-known to restore hormonal balance and regulate the menstrual cycle. We aimed to investigate the ameliorative effects of marjoram extract on hormonal profiles, body and ovaries weight, insulin sensitivity, inflammation, and oxidative stress in a rat model of PCOS. MAIN METHODS: A 75 postpubertal (42 days old) female Wistar rats were randomly assigned into five groups (control, dehydroepiandrosterone (DHEA) induced-PCOS model, marjoram-treated PCOS rats, metformin-treated PCOS rats and the combination of marjoram+metfomin treated PCOS model). PCOS induction was performed by subcutaneous injection of DHEA 60 mg/kg daily for 24 days. Ovaries weight, adiponectin, hormonal levels, inflammatory, and oxidative stress biomarker levels were measured at the end of the treatment period using ELISA assay. KEY FINDINGS: The current study showed that marjoram significantly decreased ovaries' weight and the estradiol levels (P-value<0.05) compared to the DHEA group. Interestingly, marjoram improved insulin sensitivity as manifested by a significant increase in the adiponectin serum levels (P-value<0.05). Marjoram alone or in combination with metformin prominently decreased the IL-6 level and improved the levels of ovarian SOD and GPx enzymes (P-value<0.05). Additionally, the group treated with the combination of marjoram and metformin remarkably decreased the level of TBARS (P-value<0.05). SIGNIFICANCE: The present study established the beneficial effects of marjoram administration on DHEA-induced PCOS in female Wistar rats. The mechanistic effect includes improvement in the hormonal levels, ovaries weight, insulin sensitivity, antioxidants, and anti-inflammatory parameters.


Assuntos
Origanum/química , Síndrome do Ovário Policístico/induzido quimicamente , Síndrome do Ovário Policístico/tratamento farmacológico , Adiponectina/sangue , Animais , Biomarcadores/sangue , Peso Corporal/efeitos dos fármacos , Desidroepiandrosterona , Feminino , Hormônios Esteroides Gonadais/sangue , Mediadores da Inflamação/sangue , Tamanho do Órgão/efeitos dos fármacos , Ovário/efeitos dos fármacos , Ovário/patologia , Estresse Oxidativo/efeitos dos fármacos , Extratos Vegetais/farmacologia , Extratos Vegetais/uso terapêutico , Síndrome do Ovário Policístico/sangue , Ratos Wistar
17.
J Asthma ; 57(3): 231-240, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-30714822

RESUMO

Objective: To evaluate clinical and economic burden associated with respiratory tract infection (RTI)-induced asthma exacerbations and to identify risk factors associated with these exacerbations. Factors associated with these exacerbations are understudied and little information is available about consequent expenditures. Methods: In this retrospective case-control study, medical records and pharmacy data in King Abdullah University Hospital in Northern Jordan were reviewed for adults with asthma aged 40 years and older, over the period 2013-2016. Cases of RTI-induced asthma exacerbations were identified, and controls were selected randomly from asthmatic adults who did not experience any RTI-induced asthma exacerbation during the same period. Independent-samples t-tests and chi-square tests were conducted to compare patient characteristics of cases and controls. Predictors of RTI-induced asthma exacerbations and the resultant complications were evaluated using multivariable logistic regression. Multivariable regression on log-transformed charges was used to predict expenditures of these exacerbations. Results: A total of 137 cases and 548 controls were identified. Using inhaled corticosteroid + long-acting beta-agonists (ICS + LABA) was significantly associated with lower odds of RTI-induced asthma exacerbations (OR = 0.4; 95% CI, 0.21-0.77; p = 0.006), and lower odds of resultant serious complications (OR = 0.23; 95% CI, 0.07-0.69; p = 0.009), compared to being untreated with any asthma maintenance treatment. Asthma severity and co-morbidities were associated with increased susceptibility to these exacerbations. The average charges of RTI-induced asthma admissions and outpatient exacerbations were 1042.9 JD ($1471.0) and 81.1 JD ($114.4), respectively. Conclusions: ICS + LABA, asthma severity and co-morbidities appeared to affect the clinical and economic burden associated with RTI-induced asthma exacerbations. Efforts to prevent these exacerbations in patients with risk factors are warranted.


Assuntos
Antiasmáticos/uso terapêutico , Asma/epidemiologia , Efeitos Psicossociais da Doença , Infecções Respiratórias/epidemiologia , Exacerbação dos Sintomas , Administração por Inalação , Agonistas de Receptores Adrenérgicos beta 2/administração & dosagem , Idoso , Asma/tratamento farmacológico , Asma/economia , Asma/imunologia , Estudos de Casos e Controles , Comorbidade , Prescrições de Medicamentos/estatística & dados numéricos , Feminino , Glucocorticoides/administração & dosagem , Preços Hospitalares/estatística & dados numéricos , Hospitalização/economia , Hospitalização/estatística & dados numéricos , Humanos , Jordânia/epidemiologia , Masculino , Pessoa de Meia-Idade , Infecções Respiratórias/complicações , Infecções Respiratórias/economia , Infecções Respiratórias/imunologia , Estudos Retrospectivos , Fatores de Risco , Índice de Gravidade de Doença
18.
Brain Res ; 1715: 182-187, 2019 07 15.
Artigo em Inglês | MEDLINE | ID: mdl-30914251

RESUMO

Diabetes is a global public health crisis worldwide, particularly in developing countries. Diabetes is characterized by a consistent elevation in blood glucose level which leads to several complications including cognitive impairment. Hippocampus, a brain structure responsible for memory, is vulnerable to damage caused by hyperglycemia-induced oxidative stress. In this study, we evaluated the effect of cilostazol, a selective phosphodiesterase 3 inhibitor, on hippocampal memory and oxidative stress biomarkers in streptozotocin-induced diabetes model. Cilostazol was administered to rats intraperitoneally at dose 3 mg/kg. Spatial learning and memory were tested using radial arm water maze (RAWM). BDNF protein, TBARS levels and different antioxidant biomarkers were assessed after dissection of the hippocampus. The diabetic rats showed an increase in the number of the errors during RAWM performance. However, treatment with cilostazol could not showed an improvement in animal's learning and memory performance. The results revealed that diabetic rats showed an increase in TBARS levels and a decrease in an antioxidant enzyme activities (superoxide dismutase (SOD) and glutathione peroxidase (GPx)). Moreover, cilostazol was able to normalize diabetes-induced reduction in the hippocampus activity of SOD and GPx. Moreover, administration of cilostazol normalized diabetes-induced increase in TBARS level, without any significant effect on BDNF level or catalase activity. In conclusion, cilostazol showed no improvement in the learning and memory functions which could be due to the lack of significant cognitive impairment induced by streptozotocin administration. However, cilostazol had shown antioxidant activity through normalization of hippocampal oxidative stress biomarkers.


Assuntos
Cilostazol/farmacologia , Hipocampo/efeitos dos fármacos , Estresse Oxidativo/efeitos dos fármacos , Animais , Fator Neurotrófico Derivado do Encéfalo/metabolismo , Catalase/metabolismo , Diabetes Mellitus Experimental/metabolismo , Diabetes Mellitus Experimental/fisiopatologia , Glutationa/metabolismo , Glutationa Peroxidase/metabolismo , Masculino , Aprendizagem em Labirinto/efeitos dos fármacos , Memória/efeitos dos fármacos , Transtornos da Memória/etiologia , Ratos , Ratos Wistar , Aprendizagem Espacial/efeitos dos fármacos , Estreptozocina/farmacologia , Superóxido Dismutase/metabolismo
19.
Infection ; 46(4): 495-501, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29748840

RESUMO

PURPOSE: To assess incidence rate, risk factors and susceptibility patterns associated with extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli or Klebsiella pneumoniae in community-acquired urinary tract infections (CA-UTIs). METHODS: A prospective, case-control study was conducted at a tertiary teaching hospital from Jan 2015 to Dec 2016. The results of microbiology cultures were initially screened to include only patients with positive E. coli or K. pneumoniae urine cultures. Afterwards, clinical symptoms were assessed to confirm the UTI. To investigate the risk factors, patients with a positive urine culture for ESBL-producing isolates were assigned as cases, while patients with non-ESBL were assigned as controls. RESULTS: Out of 591 patients included in this study, 57.5% (n = 340) were included in the control group and 42.5% (n = 251) were in the case group. The incidence rate of ESBL-producing isolates was 3.465 cases per 1000-patient hospital admissions. Male gender (OR = 1.856, 95% CI = 1.192-2.889, p = 0.006), pediatrics (OR = 1.676, 95% CI = 1.117-2.517, p = 0.013), patients with comorbidity (OR = 1.542, 95% CI = 1.029-2.312, p = 0.036) and UTI in the previous 12 months (OR = 1.705, 95% CI = 1.106-2.628, p = 0.016) were independently associated with a higher risk of infection. The resistance rate for most commonly prescribed antibiotics was high. CONCLUSIONS: Our results suggest that the incidence of ESBL producers among CA-UTIs is high. Male gender, pediatrics, comorbidity and UTI in the previous 12 months were associated with a higher risk for infection. Continuous surveillance and prudent antibiotic use by healthcare professionals are important factors for effective control of ESBL associated infections.


Assuntos
Infecções Comunitárias Adquiridas/epidemiologia , Infecções Comunitárias Adquiridas/microbiologia , Infecções Urinárias/epidemiologia , Infecções Urinárias/microbiologia , Resistência beta-Lactâmica , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Estudos de Casos e Controles , Infecções Comunitárias Adquiridas/diagnóstico , Infecções Comunitárias Adquiridas/tratamento farmacológico , Feminino , Hospitais Universitários , Humanos , Incidência , Masculino , Testes de Sensibilidade Microbiana , Razão de Chances , Estudos Prospectivos , Fatores de Risco , Centros de Atenção Terciária , Infecções Urinárias/diagnóstico , Infecções Urinárias/tratamento farmacológico
20.
Curr Mol Pharmacol ; 11(2): 155-161, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-28762308

RESUMO

BACKGROUND AND OBJECTIVE: Imipenem has played an important role in the treatment of broad-spectrum bacterial infection. However, nephrotoxicity due to imipenem remains an important clinical challenge. The aim of this study is to test the hypothesis stating that N-acetyl-L-cysteine (NAC) and atorvastatin possess a nephroprotective effect against imipenem-induced nephrotoxicity. METHODS: Adult Sprague Dawley rats were randomly assigned into six groups (n=8-10 rats/group; total n=55). The groups were (control, imipenem only, NAC only, atorvastatin only, NAC with imipenem, and atorvastatin with imipenem). Rats were treated with NAC or atorvastatin for six weeks. Serum and urinary creatinine and blood urea nitrogen (BUN) levels were measured. Additionally, urinary protein, urinary glucose and kidney levels of oxidants/antioxidants biomarkers were measured. RESULTS: The administration of 300mg/kg/d imipenem induced nephrotoxicity as indicated by the significant reduction of serum creatinine, serum BUN and calculated GFR in the imipenem only-treated group compared to the control. These effects of imipenem were normalized by either NAC or atorvastatin. Moreover, the levels of catalase, superoxide dismutase and glutathione peroxidase were significantly reduced in the imipenem group. However, pre-administration of NAC and atorvastatin neutralized the levels of these enzymes and protected against imipenem-induced nephrotoxicity. CONCLUSION: We concluded that the pre-administration of either NAC or atorvastatin protects the kidneys from imipenem-induced nephrotoxicity, through their antioxidant effects.


Assuntos
Acetilcisteína/uso terapêutico , Atorvastatina/uso terapêutico , Imipenem/efeitos adversos , Nefropatias/induzido quimicamente , Nefropatias/tratamento farmacológico , Rim/patologia , Substâncias Protetoras/uso terapêutico , Acetilcisteína/farmacologia , Animais , Antioxidantes/metabolismo , Atorvastatina/farmacologia , Nitrogênio da Ureia Sanguínea , Creatinina/sangue , Creatinina/urina , Taxa de Filtração Glomerular , Glicosúria/complicações , Glicosúria/urina , Rim/efeitos dos fármacos , Rim/enzimologia , Rim/fisiopatologia , Nefropatias/sangue , Nefropatias/fisiopatologia , Masculino , Substâncias Protetoras/farmacologia , Proteinúria/complicações , Proteinúria/urina , Ratos Sprague-Dawley , Substâncias Reativas com Ácido Tiobarbitúrico/metabolismo , Ureia/urina
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