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1.
Ann Am Thorac Soc ; 2020 May 19.
Artigo em Inglês | MEDLINE | ID: mdl-32425051

RESUMO

COVID-19 is a potentially fatal illness with no proven therapy beyond excellent supportive care. Treatments are urgently sought. Adaptations to traditional trial logistics and design to allow rapid implementation, evaluation of trials within a global trials context, flexible interim monitoring, and access outside traditional research hospitals (even in settings where formal placebos are unavailable) may be helpful. Thoughtful adaptations to traditional trial designs-especially within the global context of related studies-may also foster collaborative relationships among government, community, and the research enterprise. We describe here the protocol for a pragmatic, active comparator trial in as many as 300 patients comparing two current "off-label" treatments for COVID-19-hydroxychloroquine and azithromycin-in academic and non-academic hospitals in Utah. We developed the trial in response to local pressures for widespread, indiscriminate off-label use of these medications. We employ a hybrid Bayesian-frequentist design for interim monitoring to allow rapid, contextual assessment of the available evidence. We also developed an inference grid for the interpretation of the range of possible results from this trial within the context of parallel trials and prepared for network meta-analysis of the resulting data. This trial was prospectively registered (NCT04329832) before enrollment of the first patient.

2.
Sci Total Environ ; 725: 138391, 2020 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-32302840

RESUMO

Naled, an organophosphate pesticide, received considerable attention during 2016 as it was applied aerially to control the first mosquito-borne Zika virus outbreak in the continental United States. Stakeholders living in affected areas raised concerns about its environmental impacts. One factor influencing environmental impacts is the persistence of the chemical applied. The objective of this study was to evaluate the persistence of naled - and its degradation bi-product, dichlorvos - in natural waters. Initial naled concentrations were measured at ground level after full-scale aerial spray activities. Laboratory experiments were designed to evaluate factors (fresh versus marine water chemistry, temperature, and sunlight) that may promote the degradation of naled and dichlorvos in the environment. Results show that natural fresh and marine water chemistry promoted naled degradation as experiments with de-ionized water resulted in half-lives greater than 6 days. The half-life in natural waters without light ranged from 5 to 20 h with lower half lives at higher temperatures. Under light exposure, degradation was accelerated and yielded more dichlorvos. Detectable levels (0.05 µM for naled and 0.10 µM for dichlorvos) were measured in water samples collected from the field during aerial spray events. Results can be used in risk assessments that consider both naled and dichlorvos to better understand ecological impacts and to develop improved public health recommendations.

3.
Medicine (Baltimore) ; 99(16): e19838, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32312006

RESUMO

Renal cell carcinoma (RCC) has been traditionally thought to be radioresistant. This retrospective cohort study aims to assess the outcomes of patients with spinal metastases from RCC treated with conventionally-fractionated external beam radiation therapy (cEBRT) in our institution.Patients diagnosed with histologically or radiologically-proven RCC who received palliative cEBRT to spinal metastases, using 3-dimensional conformal technique between 2009 and 2018 were reviewed. Local progression-free survival (PFS), overall survival (OS) and common terminology criteria for adverse events version 4.0-graded toxicity were assessed. Univariable and multivariable Cox proportional hazards regression analyses were performed to evaluate for predictors associated with survivals.Thirty-five eligible patients with forty spinal segments were identified, with a median follow-up of 7 months (range, 0-47). The median equivalent dose in 2 Gy fractions (EQD2) was 32.5 Gy 10 (range, 12-39). Thirty-seven percent of patients underwent surgical intervention. At the time of last follow-up, all but 1 patient had died. Seven patients developed local progression, with the median time to local progression of 10.2 months. The median local PFS and OS were 3.3 and 4.8 months. There was no grade 3 or higher toxicity. A higher radiation dose (equivalent dose to 2 Gy fraction <32.5 Gy 10 vs ≥32.5Gy 10) (hazard ratio [HR], 0.47; 95% confidence interval [CI], 0.17-3.18; P-value (P) = .68) and spinal surgery (HR, 2.35; 95% CI, 0.53-10.29; P = .26) were not significantly associated with local PFS on univariable analysis. Multivariable analysis showed that higher Tokuhashi score (HR, 0.41; 95% CI, 0.19-0.88; P = .02), lower number of spinal segments irradiated (HR, 1.18; 95% CI, 1.01-1.37; P = .04) and use of targeted therapy (HR, 0.41; 95% CI, 0.18-0.96; P = .04) were independent predictors for improved OS.For an unselected group of patients with RCC, there is no significant association between higher radiation dose and improved local control following cEBRT. This may be due to their short survivals. With the use of more effective systemic therapy, including targeted therapy and immunotherapy, survival will likely be prolonged. A tailored-approach is needed to identify patients with good prognosis who may still benefit from aggressive local treatments.


Assuntos
Carcinoma de Células Renais/complicações , Radiocirurgia/métodos , Neoplasias da Coluna Vertebral/radioterapia , Neoplasias da Coluna Vertebral/secundário , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Imunoterapia/métodos , Neoplasias Renais/patologia , Masculino , Pessoa de Meia-Idade , Terapia de Alvo Molecular/métodos , Intervalo Livre de Progressão , Radiocirurgia/efeitos adversos , Estudos Retrospectivos , Neoplasias da Coluna Vertebral/cirurgia , Coluna Vertebral/patologia , Coluna Vertebral/efeitos da radiação , Resultado do Tratamento
5.
Monaldi Arch Chest Dis ; 90(1)2020 Apr 07.
Artigo em Inglês | MEDLINE | ID: mdl-32253889

RESUMO

We aimed to evaluate the effects of stage-matched repeated individual behavioural counselling (RIBCS) on the basis of the transtheoretical model (TTM) as an intervention to reduce and stop smoking. This study was conducted over a period of one year where all smokers presenting to a chest clinic in a tertiary centre were enrolled, each was classified on the basis of stage of readiness to change and underwent repeated counselling for a period of six months and each session was preceded and succeeded with filling of Fagerstorm test for nicotine dependence. Over the period of a year, 207 patients participated in this study, the mean age was 50.74±14.74 years; mean duration of tobacco use was 29.43±14.72 years; 64.3% were illiterate, 11.6% primary education, 14.1% were matric and while 10.1% were graduate. About 73% of smokers reported high level of nicotine dependence (FTND score >5/10). In the present study mean dependence score was 6.0±1.96; 44 (21.3%) were in pre-contemplation stage, 93 (44.9%) were in contemplation, 57 (27.5%) were in preparation and 13 (6.3%) were in action. The point prevalence excellence rate in follow up-I was 15%, follow up-II was 35.3% and follow up-III was 61.9% which was statistically significant. When we took both abstinence and reduction in smoking behaviour as one, p-value was <0.05. The point prevalence of abstinence rate (questionnaire validated) 1 month to 6 months was almost 4 times. Our intervention (RIBCS) succeeded in increasing the abstinence rates during the study period among smokers with a lower motivation to quit (pre-contemplators and contemplators) as well as those ready to quit (preparators). This is significant because of most existing smoking-cessation interventions target only motivated smokers, with few having a positive effect in smokers with a lower motivation to quit.


Assuntos
Terapia Comportamental/métodos , Abandono do Hábito de Fumar/métodos , Abandono do Hábito de Fumar/psicologia , Fumar/terapia , Tabagismo/terapia , Adolescente , Adulto , Idoso , Aconselhamento/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Motivação , Estudos Prospectivos , Fumar/efeitos adversos , Fumar/psicologia , Inquéritos e Questionários , Tabagismo/complicações , Tabagismo/diagnóstico , Tabagismo/psicologia , Adulto Jovem
6.
Molecules ; 25(6)2020 Mar 18.
Artigo em Inglês | MEDLINE | ID: mdl-32197360

RESUMO

The dihydropyranoindole scaffold was identified as a promising target for improving the anti-cancer activity of HDAC inhibitors from the preliminary screening of a library of compounds. A suitable methodology has been developed for the preparation of novel dihydropyranoindoles via the Hemetsberger indole synthesis using azido-phenylacrylates, derived from the reaction of corresponding alkynyl-benzaldehydes with methyl azidoacetate, followed by thermal cyclization in high boiling solvents. Anti-cancer activity of all the newly synthesized compounds was evaluated against the SH-SY5Y and Kelly neuroblastoma cells as well as the MDA-MB-231 and MCF-7 breast adenocarcinoma cell lines. Biological studies showed that the tetracyclic systems had significant cytotoxic activity at higher concentration against the neuroblastoma cancer cells. More importantly, these systems, at the lower concentration, considerably enhanced the SAHA toxicity. In addition to that, the toxicity of designated systems on the healthy human cells was found to be significantly less than the cancer cells.

7.
J Epidemiol Glob Health ; 10(1): 42-45, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32175709

RESUMO

Tuberculosis (TB) remains a main hurdle for national programs due to increase in drug resistance to antitubercular drugs. World Health Organization (WHO)-endorsed Line Probe Assay, Genotype MTBDRsl Ver 2.0, gives opportunity for rapid diagnosis and molecular characterization of different mutations in drug targets of fluoroquinolone (FQ) and second-line injectable drugs (SLID). We, retrospectively, analyzed the data of Genotype MTBDRsl Ver 2.0 from January 2018 to June 2018. A total of 863 isolates of Mycobacterium tuberculosis, 687 rifampicin resistant and 176 isoniazid resistant only, were screened for drug resistance in FQ and SLID. All the isolates were tested for Genotype MTBDRsl Ver 2.0 according to the manufacturer's instructions. The FQ and SLID resistance were detected in 295 (34.2%) and 70 (8.1%) isolates, respectively. Among newly diagnosed and follow-up rifampicin-resistant TB (RR TB) patients, the FQ resistance was 25.8% and 44.5%, respectively. The most common mutation (42.7%) in FQ-resistant isolates was MUT3C in gyrA gene. Both SLID and FQ resistance were detected in 59 (6.8%) RR TB isolates. The mono SLID resistance was detected in 12 (1.7%) isolates of RR TB. Genotype MTBDRsl Ver 2.0 assay is a rapid and important tool for the diagnosis and molecular characterization of second-line drug resistance under programmatic conditions.

8.
Artigo em Inglês | MEDLINE | ID: mdl-32084318

RESUMO

Graphene is a highly desirable material for a variety of applications; in the case of nanocomposites, it can be functionalized and added as a nanofiller to alter the ultimate product properties, such as tensile strength. However, often the material properties of the functionalized graphene and the location of any chemical species, attached via different functionalization processes, are not known. Thus, it is not necessarily understood why improvements in product performance are achieved, which hinders the rate of product development. Here, a commercially available powder containing few-layer graphene (FLG) flakes is characterized before and after plasma or chemical functionalization with either nitrogen or oxygen species. A range of measurement techniques, including tip-enhanced Raman spectroscopy (TERS), time-of-flight secondary ion mass spectrometry (ToF-SIMS), and NanoSIMS, were used to examine the physical and chemical changes in the FLG material at both the micro- and nanoscale. This is the first reported TERS imaging of commercially available FLG flakes of submicron lateral size, revealing the location of the defects (edge versus basal plane) and variations in the level of functionalization. Graphene-polymer composites were then produced, and the dispersion of the graphitic material in the matrix was visualized using ToF-SIMS. Finally, mechanical testing of the composites demonstrated that the final product performance could be enhanced but differed depending on the properties of the original graphitic material.

9.
Environ Sci Technol ; 54(6): 3237-3244, 2020 03 17.
Artigo em Inglês | MEDLINE | ID: mdl-32069033

RESUMO

Groundwater contamination by As from natural and anthropogenic sources is a worldwide concern. Redox heterogeneities over space and time are common and can influence the molecular-level speciation of As, and thus, As release/retention but are largely unexplored. Here, we present results from a dual-domain column experiment, with natural organic-rich, fine-grained, and sulfidic sediments embedded as lenses (referred to as "reducing lenses") within natural aquifer sand. We show that redox interfaces in sulfur-rich, alkaline aquifers may release concerning levels of As, even when sediment As concentration is low (<2 mg/kg), due to the formation of mobile thioarsenates at aqueous sulfide/Fe molar ratios <1. In our experiments, this behavior occurred in the aquifer sand between reducing lenses and was attributed to the spreading of sulfidic conditions and subsequent Fe reductive dissolution. In contrast, inside reducing lenses (and some locations in the aquifer) the aqueous sulfide/Fe molar ratios exceeded 1 and aqueous sulfide/As molar ratios exceeded 100, which partitioned As(III)-S to the solid phase (associated with organics or as realgar (As4S4)). These results highlight the importance of thioarsenates in natural sediments and indicate that redox interfaces and sediment heterogeneities could locally degrade groundwater quality, even in aquifers with unconcerning solid-phase As concentrations.


Assuntos
Arsênico , Água Subterrânea , Poluentes Químicos da Água , Sedimentos Geológicos , Oxirredução
10.
Sci Rep ; 10(1): 770, 2020 Jan 21.
Artigo em Inglês | MEDLINE | ID: mdl-31964927

RESUMO

In this study, we describe the synthesis and molecular properties of anthranilamide-based short peptides which were synthesised via ring opening of isatoic anhydride in excellent yields. These short peptides were incorporated as low molecular weight gelators (LMWG), bola amphiphile, and C3-symmetric molecules to form hydrogels in low concentrations (0.07-0.30% (w/v)). The critical gel concentration (CGC), viscoelastic properties, secondary structure, and fibre morphology of these short peptides were influenced by the aromaticity of the capping group or by the presence of electronegative substituent (namely fluoro) and hydrophobic substituent (such as methyl) in the short peptides. In addition, the hydrogels showed antibacterial activity against S. aureus 38 and moderate toxicity against HEK cells in vitro.

11.
J Biomol Struct Dyn ; 38(2): 382-397, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30887884

RESUMO

Drug discovery for a vigorous and feasible lead candidate is a challenging scientific mission as it requires expertise, experience, and huge investment. Natural products and their derivatives having structural diversity are renowned source of therapeutic agents since many years. Tyrosol (a natural phenylethanoid) has been extracted from olive oil, and its structure was confirmed by elemental analysis, FT-IR, FT-NMR, and single crystal X-ray crystallography. The conformational analysis for tyrosol geometry was performed by Gaussian 09 in terms of density functional theory. Validation of bond lengths and bond angles obtained experimentally as well as theoretically were performed with the help of curve fitting analysis, and values of correlation coefficient (R) obtained as 0.988 and 0.984, respectively. The charge transfer within the tyrosol molecule was confirmed by analysis of HOMO→LUMO molecular orbitals. In molecular docking with COX-2 (PDB ID: 5F1A), tyrosol was found to possess satisfactory binding affinity as compared to other NSAIDs (Aspirin, Ibuprofen, and Naproxen) and a COX-2 selective drug (Celecoxib). ADMET prediction, drug-likeness and bioactivity score altogether confirm the lead/drug like potential of tyrosol. Further investigation of simulation quality plot, RMSD and RMSF plots, ligands behavior plot as well as post simulation analysis manifest the consistency of 5F1A-tyrosol complex throughout the 20 ns molecular simulation process that signifies its compactness and stability within the receptor pocket. AbbreviationsADMETAbsorption, Distribution, Metabolism, Excretion and ToxicityÅAngstromCOX-2Cyclooxygenase-2DFTDensity Functional TheoryDMFDimethylformamideFMOFrontier Molecular OrbitalFT-IRFourier-transform Infrared SpectroscopyFT-NMRNuclear Magnetic Resonance SpectroscopyHOMOHighest Occupied Molecular OrbitalLUMOLowest Unoccupied Molecular OrbitalMDMolecular DynamicsNSNanosecondNSAIDsNon-steroidal anti-inflammatory drugsOPEOsiris Property ExplorerRMSDRoot-Mean-Square DeviationRMSFRoot Sean Square FluctuationCommunicated by Ramaswamy H. Sarma.

12.
J Hazard Mater ; 387: 121722, 2020 Apr 05.
Artigo em Inglês | MEDLINE | ID: mdl-31806439

RESUMO

A constructed wetland (CW) microcosm based on conductive graphite gravel was investigated for hexavalent chromium (Cr(VI)) treatment from synthetic wastewater. Its performance was evaluated and compared with a traditional gravel-based CW microcosm. The microcosms were operated at varying initial Cr(VI) concentrations (5-20 mg/L) and hydraulic retention times (HRT) (3-7.5 h). Near complete treatment (99.9 ±â€¯0.06 %) was achieved in the graphite-based microcosm throughout the experiment. The performance was consistently high throughout with 42.9 % improvement in Cr (VI) treatment compared to a traditional gravel microcosm. Scanning electron microscopy with energy dispersive X-ray spectroscopy (SEM-EDX) analysis indicated that chromium was adsorbed to microbial biofilms. Moreover, microbial diversity profiling suggested that the microbial population in both microcosms differed in diversity and communities. The results suggest that the use of conductive materials in CW significantly enhances the treatment of Cr(VI) and more importantly, allows microbial activity even at high levels of Cr(VI) in the CW.

14.
Redox Biol ; 28: 101374, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31743887

RESUMO

A hallmark of cancer cells is their ability to reprogram nutrient metabolism. Thus, disruption to this phenotype is a potential avenue for anti-cancer therapy. Herein we used a phenotypic chemical library screening approach to identify molecules that disrupted nutrient metabolism (by increasing cellular oxygen consumption rate) and were toxic to cancer cells. From this screen we discovered a 1,4-Naphthoquinone (referred to as BH10) that is toxic to a broad range of cancer cell types. BH10 has improved cancer-selective toxicity compared to doxorubicin, 17-AAG, vitamin K3, and other known anti-cancer quinones. BH10 increases glucose oxidation via both mitochondrial and pentose phosphate pathways, decreases glycolysis, lowers GSH:GSSG and NAPDH/NAPD+ ratios exclusively in cancer cells, and induces necrosis. BH10 targets mitochondrial redox defence as evidenced by increased mitochondrial peroxiredoxin 3 oxidation and decreased mitochondrial aconitase activity, without changes in markers of cytosolic or nuclear damage. Over-expression of mitochondria-targeted catalase protects cells from BH10-mediated toxicity, while the thioredoxin reductase inhibitor auranofin synergistically enhances BH10-induced peroxiredoxin 3 oxidation and cytotoxicity. Overall, BH10 represents a 1,4-Naphthoquinone with an improved cancer-selective cytotoxicity profile via its mitochondrial specificity.

15.
Molecules ; 24(23)2019 Nov 27.
Artigo em Inglês | MEDLINE | ID: mdl-31783706

RESUMO

The bis-glyoxylamide peptidomimetics have been synthesized from bis-N-acetylisatins linked at C5 by ring-opening with alcohols, amines, and amino acid methyl ester hydrochlorides. X-ray images of single crystals of bis-glyoxylamide peptidomimetics have been obtained.

16.
Artigo em Inglês | MEDLINE | ID: mdl-31770332

RESUMO

STUDY DESIGN: Prospective cohort study. OBJECTIVE: To compare the long-term, radiographic coronal and sagittal outcomes of these two approaches at 10-year follow-up. SUMMARY OF BACKGROUND DATA: Both anterior and posterior instrumented fusions have been found to be safe and effective treatments for Lenke 5 adolescent idiopathic scoliosis with up to 2 to 5 years of follow-up. Few studies follow patients beyond this duration. METHODS: 36 patients who underwent anterior (n = 25) or posterior instrumented spinal fusion (n = 11) for Lenke 5 adolescent idiopathic scoliosis over a 4-year period were recruited and followed for 10 years. Preoperative clinical data include patient's age and age of menarche. Operative data included instrumented levels, duration of surgery, and surgical blood loss. Postoperative data included duration of hospital stay, duration of intensive care unit stay, and complications. Pre- and postoperative radiographic data collected include coronal Cobb angles for structural thoracolumbar/lumbar curves, and sagittal angles-sagittal vertical axis, thoracic kyphosis, global lumbar angle, pelvic incidence, pelvic tilt, sacral slope, and upper and lower end vertebrae. RESULTS: Posterior surgery had a shorter operative time (P < 0.010) and hospital stay (P < 0.010). Coronal plane deformity improved by a mean of 74% in the anterior group and 71% in the posterior group. There was no significant change at 10 years in both groups (anterior P = 0.455 and posterior P = 0.325). Sagittal parameters remained unchanged. There was a higher incidence of proximal junctional kyphosis in the posterior (45%) compared to the anterior (16%) group (P < 0.010). CONCLUSION: Both anterior and posterior instrumentation and fusion are successful surgeries after 10 years of follow-up. They are comparable with regards to their ability to achieve and maintain good correction of scoliotic deformities and have a low rate of pseudoarthrosis and instrument failure. Ideal sagittal parameters are maintained up to 10 years of follow-up. LEVEL OF EVIDENCE: 3.

17.
Cureus ; 11(9): e5639, 2019 Sep 12.
Artigo em Inglês | MEDLINE | ID: mdl-31700742

RESUMO

Introduction The management of vomiting and antiemetic therapy in young children with acute gastroenteritis (AGE) has not been standardized by any management guidelines. Antiemetic drugs including promethazine, prochlorperazine, metoclopramide, ondansetron, and domperidone are readily used in the emergency departments (EDs). The aim of this study was to compare the efficacy of ondansetron with domperidone in cessation of vomiting in pediatric AGE. Methods This open-label, two-arm trial was conducted in a pediatric ED in Pakistan. Children of age 1 to 60 months presenting with acute vomiting and no or mild-to-moderate dehydration associated with AGE were randomized into two groups. Group A children received ondansetron suspension orally at a dose of 0.15 mg/kg body weight. Group B received domperidone suspension orally at a dose of 0.5 mg/kg body weight. The primary outcome was the number of children in each group who did not have any episode of vomiting 24 hours posttreatment. The data were entered and analyzed using Statistical Package for the Social Sciences (SPSS) for Windows version 20.0 (IBM Corp., Armonk, NY). Results At 6 hours, 87% of children in the ondansetron group improved and their vomiting episodes ceased as compared to 81% of children in the domperidone group. The differences were statistically insignificant (p>0.05). At 24 hours, 95% in the ondansetron group had improved and only 85% in the domperidone group. The results were statistically significant favoring the end results of the ondansetron (p=0.01). Conclusions This study concluded that ondansetron is more efficacious than domperidone in cessation of vomiting associated with AGE and no or mild-to-moderate dehydration in children of age three months to five years.

18.
J Clin Med ; 8(10)2019 Oct 04.
Artigo em Inglês | MEDLINE | ID: mdl-31590324

RESUMO

Dry eye (DE) and allergic conjunctivitis may present similarly, and it remains unclear whether some individuals have an underlying allergic component to their DE. To better understand this relationship, we performed a cross-sectional study in 75 individuals with DE symptoms and/or signs. Immunoglobulin E (IgE) levels in tear samples were quantified and home environmental exposures assessed via standardized survey. Tears were collected by Schirmer strip, and total tear IgE levels were quantified using enzyme-linked immunosorbent assay (ELISA). Data were analyzed using descriptive statistics and linear and logistic regressions. The main outcome measures were total tear IgE levels and their association with environmental exposures. The mean age of the subjects was 66.2 ± 7.8 years. Sixty-two individuals had dry eye symptoms (Dry Eye Questionnaire-5 ≥ 6), and 75 had one or more signs of DE. Detectable total tear IgE levels were observed in 76% of subjects, and 17.3% had high levels (>1 ng/mL). Individuals with exposure to pet(s) (odds ratio (OR) 11.5, p = 0.002) and smoke (OR 38.6, p = 0.008) at home were more likely to have high IgE levels compared to those not exposed. Individuals with tears collected during spring or summer were 3.9 times (p = 0.028) more likely to have high IgE compared to those sampled at other times of year. Subjects born in the US were 3.45 times (p = 0.010) more likely to have high IgE compared to individuals born outside the US. To conclude, a majority of individuals with DE symptoms and/or signs had detectable IgE levels in their tears. High tear IgE levels were correlated with allergy season and exposures in the home linked with allergy.

19.
Technol Health Care ; 2019 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-31594266

RESUMO

BACKGROUND: The antibacterial properties are beneficial and desired for dental restorative composite materials. The incorporation of various antimicrobial agents into resin composites may compromise their physical and mechanical properties hence limiting their applications. OBJECTIVE: The aim of the current study is to evaluate the antibacterial activity and the hardness of microhybrid and flowable resin based composites (RBCs) modified using novel antimicrobial agent chitosan (CS). METHODS: The antibacterial activity of microhybrid and flowable RBCs modified with 0, 0.25, 0.5 and 1% w/w chitosan (CS) against Actinomyces viscous bacteria was explored using agar diffusion test and direct contact methods. The hardness of control and experimental RBCs was determined by Vickers hardness (VH) tester. RESULTS: The results revealed that control and experimental flowable and microhybrid RBCs did not demonstrate growth inhibition zone in the lawn growth of Actinomyces viscous. The direct contact test revealed that colony forming unit (CFU) count of Actinomyces viscous was comparable among the experimental and control materials. The flowable RBCs containing 1% CS had significantly higher VH compared to control and other experimental flowable RBC groups. The microhybrid RBCs consisting of 0.50% CS exhibited significantly higher VH compared to experimental microhybrid RBC group containing 1% CS.

20.
Cureus ; 11(7): e5102, 2019 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-31523533

RESUMO

Introduction Ventricular septal defect (VSD) is one of the more common congenital heart defects, and aortic regurgitation (AR) is its major complication if it remains unrepaired. We aim to determine the AR incidence in various types of VSD, its immediate and intermediate six to 12-month post-VSD repair outcomes of AR. Methods We conducted a retrospective review of medical records of all children aged 18 years or younger who were diagnosed with single VSD at our institution from 2016 to 2018. VSD was classified according to its location and relation to the tricuspid annulus and semilunar valve. AR severity grading was done according to the American Society of Echocardiography, and vena contracta width (VC) was taken as the main parameter for severity. We defined trivial-to-mild AR as VC width less than 0.3 cm, moderate AR was 0.3-0.6 cm VC width, and severe AR was VC width of more than 0.6 cm. Immediate and intermediate outcomes of surgical closure, such as residual VSD and AR, were observed. Results One hundred ninety patients with isolated single VSD were included in the study. Of those, 114 patients had perimembranous VSD (60.0%), 64 patients had muscular VSD (33.7%), and 12 patients had supracristal VSD (6.3%). The median age of our study cohort was six months, with a male to female ratio of 1.3:1. Aortic valve prolapse (28.9%; n = 55) and AR (23.2%; n = 44) were the most common findings on echocardiographic evaluation of VSD patients. Most cases of VSD with AR had trivial-to-mild AR, (68.2%; n = 30). AR was most commonly seen in supracristal VSD (83.3%; n = 10) followed by perimembranous VSD (28.9%; n = 33). VSD closed spontaneously in 34 patients (17.9%) and 98 patients (51.6%) patients underwent surgery. Residual VSD after surgical closure was present in 57.1% (56) and 17.3% (17) of the patients immediate postoperatively and six- to 12-month postoperative follow-up, respectively. Similarly, residual AR after surgical closure of VSD was present in 32.7% (32) and 15.3% (15) of the patients immediate postoperatively and six- to 12-month postoperative follow-up, respectively. Conclusion The incidence of AR with VSD was very high in our study; AR was most commonly associated with supracristal VSD. After surgical repair, mild AR decreased with time. Early corrective surgery of VSD can prevent this complication and help improve outcomes.

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