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1.
Food Res Int ; 151: 110819, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34980371

RESUMO

The link between gut microbiota and obesity or other metabolic syndromes is growing increasingly clear. Natural products are appreciated for their beneficial health effects in humans. Increasing investigations demonstrated that the anti-obesity bioactivities of many natural products are gut microbiota dependent. In this review, we summarized the current knowledge on anti-obesity natural products acting through gut microbiota according to their chemical structures and signaling metabolites. Manipulation of the gut microbiota by natural products may serve as a potential therapeutic strategy to prevent obesity.

2.
Braz. j. biol ; 82: e231134, 2022. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1249257

RESUMO

Abstract Chronic obstructive pulmonary disease (COPD) was estimated to be the third cause of global mortality by 2020. Acute exacerbation COPD (AECOPD) is a sudden worsening of COPD symptoms and could be due to virus/bacterial infections and air pollution. Increased expression of inflammatory markers in patients with AECOPD is associated with viral infection. This study aimed to detect different viruses and analyze the expression of various inflammatory markers associated with AECOPD patients. Three hundred and forty-seven patients diagnosed with COPD according to GOLD criteria were included in this study. Swab samples and blood were collected for the detection of viruses by RT-PCR and expression of inflammatory markers, respectively. Of the swab samples, 113 (32.6%) of samples were positive for virus detection. Of these, HRV (39.8%) was the predominant virus detected followed by FluB (27.4%) and FluA (22.1%). The presence of HRV was significantly higher (p=0.044) among the other detected viruses. When compared to healthy controls the expression levels of TNF-α, IL-6 and IL-8 were significantly higher (p<0.05) in virus-positive patients. The IL-6 and IL-8 were the next predominantly expressed in markers among the samples. The higher expression rate of IL-8 was significantly (p<0.05) associated with patients having COPD GOLD III severity level and smoking history. Although HRV was the predominant virus detected the combined prevalence of Influenza A and B surpassing the rate of HRV. The high-level expression of well known inflammatory markers of AECOPD, TNF-α, IL-6 and IL-8 indicates a chronic severe illness. These markers play an important role and could be used as a marker for determining the severity of AECOPD.


Resumo Estima-se que a doença pulmonar obstrutiva crônica (DPOC) seja a terceira causa de mortalidade global em 2020. A exacerbação aguda DPOC (AECOPD) é um agravamento súbito dos sintomas da DPOC e pode ser devido a infecções por vírus/bactérias e poluição do ar. O aumento da expressão de marcadores inflamatórios em pacientes com AECOPD está associado à infecção viral. Este estudo teve como objetivo detectar diferentes vírus e analisar a expressão de vários marcadores inflamatórios associados a pacientes com AECOPD. Trezentos e quarenta e sete pacientes com diagnóstico de DPOC de acordo com os critérios GOLD foram incluídos neste estudo. Amostras de swab e sangue foram coletadas para detecção de vírus por RT-PCR e expressão de marcadores inflamatórios, respectivamente. Das amostras de esfregaço, 113 (32,6%) amostras foram positivas para detecção de vírus. Nestas, o HRV (39,8%) foi o vírus predominante detectado, seguido do FluB (27,4%) e do FluA (22,1%). A presença de VFC foi significativamente maior (p = 0,044) entre os demais vírus detectados. Quando comparados a controles saudáveis, os níveis de expressão de TNF-α, IL-6 e IL-8 foram significativamente maiores (p <0,05) em pacientes com vírus positivo. A IL-6 e a IL-8 foram as próximas predominantemente expressas em marcadores entre as amostras. A maior taxa de expressão de IL-8 foi significativamente (p <0,05) associada a pacientes com grau de gravidade GOLD III da DPOC e história de tabagismo. Embora o HRV tenha sido o vírus predominante, a prevalência combinada de Influenza A e B ultrapassou a taxa de HRV. O alto nível de expressão de marcadores inflamatórios bem conhecidos de AECOPD, TNF-α, IL-6 e IL-8 indica uma doença crônica grave. Esses marcadores desempenham um papel importante e podem ser usados como um marcador para determinar a gravidade da AECOPD.

3.
Acta Pharm Sin B ; 11(11): 3542-3552, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34900535

RESUMO

The mammalian target of rapamycin (mTOR)-sterol regulatory element-binding proteins (SREBPs) signaling promotes lipogenesis. However, mTOR inhibitors also displayed a significant side effect of hyperlipidemia. Thus, it is essential to develop mTOR-specific inhibitors to inhibit lipogenesis. Here, we screened the endogenous inhibitors of mTOR, and identified that FKBP38 as a vital regulator of lipid metabolism. FKBP38 decreased the lipid content in vitro and in vivo via suppression of the mTOR/P70S6K/SREBPs pathway. 3,5,6,7,8,3',4'-Heptamethoxyflavone (HMF), a citrus flavonoid, was found to target FKBP38 to suppress the mTOR/P70S6K/SREBPs pathway, reduce lipid level, and potently ameliorate hyperlipidemia and insulin resistance in high fat diet (HFD)-fed mice. Our findings suggest that pharmacological intervention by targeting FKBP38 to suppress mTOR/P70S6K/SREBPs pathway is a potential therapeutic strategy for hyperlipidemia, and HMF could be a leading compound for development of anti-hyperlipidemia drugs.

4.
Adv Chronic Kidney Dis ; 28(3): 270-277, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-34906312

RESUMO

As point-of-care ultrasound (POCUS) is increasingly implemented into the routine clinical practice of nephrologists, it is important to consider the practical aspects of a POCUS workflow including documentation, image archiving, billing, and coding. Documentation of POCUS studies performed allows for accurate information exchange among all members of the care team and can be effectively implemented using preset documentation worksheets. Image archiving systems provide a mechanism for review, storage, and quality assurance processes that are directly linked to the patient's record. Understanding the coding components required for billing and developing efficient systems to support billing and coding can contribute to ensuring financial support for POCUS programs long term. Each individual component, documentation, image archiving, billing, and coding is necessary to incorporate into a POCUS workflow as documentation, archiving, and coding of studies are required for appropriate billing. Most importantly, incorporating these practical components creates opportunities for communicating clinically relevant findings among care teams and enhances the quality of patient care delivered in health systems.

5.
Phys Rev Lett ; 127(17): 172701, 2021 Oct 22.
Artigo em Inglês | MEDLINE | ID: mdl-34739292

RESUMO

We report the first (in)elastic scattering measurement of ^{25}Al+p with the capability to select and measure in a broad energy range the proton resonances in ^{26}Si contributing to the ^{22}Mg(α,p) reaction at type I x-ray burst energies. We measured spin-parities of four resonances above the α threshold of ^{26}Si that are found to strongly impact the ^{22}Mg(α,p) rate. The new rate advances a state-of-the-art model to remarkably reproduce light curves of the GS 1826-24 clocked burster with mean deviation <9% and permits us to discover a strong correlation between the He abundance in the accreting envelope of the photospheric radius expansion burster and the dominance of ^{22}Mg(α,p) branch.

6.
Osteoporos Int ; 2021 Sep 08.
Artigo em Inglês | MEDLINE | ID: mdl-34498096

RESUMO

In women of ages 75-80 years, a low one leg standing time (OLST) was associated with an increased risk of incident fractures, independently of bone mineral density and clinical risk factors. OLST contributed substantially to fracture probability, indicating that the test should be considered when evaluating fracture risk in older women. INTRODUCTION: Physical function and risk of falls are important risk factors for fracture. A few previous studies have suggested that a one leg standing time (OLST) less than 10 s predicts fracture risk, but the impact of OLST, in addition to known clinical risk factors, for fracture probability is unknown. The aim of this study was to determine the independent contribution of OLST to fracture probability in older women. METHODS: The Sahlgrenska University Hospital Prospective Evaluation of Risk of Bone Fractures (SUPERB) is a prospective population-based study of 3028 women 75-80 years old, recruited from the greater Gothenburg area in Sweden. At baseline, information on risk factors was collected using questionnaires, bone mineral density was measured with dual-energy X-ray absorptiometry (DXA), and OLST was performed. RESULTS: During a median follow-up of 3.6 years (IQR 1.5 years), X-ray-verified incident fractures were identified using health records. OLST was available in 2405 women. OLST less than 10 s was associated with an increased risk for incident hip fracture (Hazard Ratio (HR) 3.02, 95% Confidence Interval (CI) [1.49-6.10]), major osteoporotic fracture (HR 95% CI 1.76 [1.34-1.46]), and nonvertebral fracture (HR 95% CI 1.61 [1.26-2.05]) in Cox regression analyses adjusted for age, height, and weight. Depending on BMD, the 4-year fracture probability increased by a factor of 1.3 to 1.5 in a 75-year-old woman with a low OLST (<10 s). CONCLUSION: A low OLST has a substantial impact on fracture probability and should be considered when evaluating fracture risk in older women.

7.
Zhonghua Yi Xue Za Zhi ; 101(36): 2878-2884, 2021 Sep 28.
Artigo em Chinês | MEDLINE | ID: mdl-34587728

RESUMO

Objective: To explore the relationship between the daily incidence of human respiratory syncytial virus (HRSV) and meteorological parameters in the main urban area of Chongqing. Methods: This study took 3 107 children hospitalized with acute lower respiratory tract infections from June 2009 to June 2019 in department of Respiratory medicine, Children's Hospital of Chongqing Medical University (CHCMU). Nasopharyngeal aspirate (NPA) was collected on the day of admission to detect HRSV and common respiratory virus; combined with the meteorological data of the main urban area of ​​Chongqing during the same period, the correlation and distribution lag nonlinear model analysis of the daily incidence of HRSV and meteorological parameters were carried out. Results: Among 3 107 children, HRSV positive accounted for 34.53% (1 073 cases), the age was 6 (3, 13) months, and males accounted for 64.31% (690 cases). The daily incidence of HRSV was negatively correlated with minimum temperature (r=-0.220, P<0.001), maximum temperature (r=-0.221, P<0.001), average temperature (r=-0.221, P<0.001) and precipitation (r=-0.052, P<0.001), and positively correlated with sunshine time (r=0.011, P<0.001) and average relative humidity (r=0.095, P<0.001). Compared with the reference temperature (20 ℃), when the lowest temperature of 6-10 ℃ lags for 4-8 d, the RR value of HRSV was 1.11-1.14, and when the lowest temperature of 5-19 ℃ lags for 5 d and 2-19 ℃ lags for 10 d, the RR values were 1.02-1.14 and 1.00-1.03. When the cumulative lag is 5, 10, 15 and 21 d, compared with the reference temperature (20 ℃), the RR (95%CI) values at the lowest temperature of 10.4 ℃ were 1.93 (1.08-3.46), 3.49 (1.64-7.45), 5.00 (2.01-12.46) and 6.69 (2.18-20.48); the RR (95%CI) values of the lowest temperature of 22.1 ℃ were 0.87 (0.77-0.98), 0.77 (0.66-0.90), 0.74 (0.62-0.89) and 0.68 (0.55-0.85). In the cumulative effect, compared with the reference temperature (20 ℃), the gender stratification showed that the maximum RR (95%CI) values of the lowest temperature for boys and girls under different lag days were 7.24 (1.84-28.51) and 2.19 (1.07-4.46), the age stratification showed that the maximum RR (95%CI) values of the lowest temperature for children<6 months old and children ≥6 months old under different lag days were 4.72 (1.05-21.23) and 11.98 (1.70-84.35). Conclusions: In the main urban area of Chongqing, the daily incidence of HRSV in children is correlated with climatic parameters. Among them, the lowest temperature has a delayed and cumulative effect on HRSV infection. 6-10 ℃ has a greater impact on the incidence of HRSV when the lag is 4-8 days. The effect has a more obvious impact on the incidence of HRSV in boys and children ≥ 6 months.


Assuntos
Infecções por Vírus Respiratório Sincicial , Vírus Sincicial Respiratório Humano , Infecções Respiratórias , Criança , China/epidemiologia , Correlação de Dados , Feminino , Humanos , Incidência , Lactente , Masculino , Infecções por Vírus Respiratório Sincicial/epidemiologia
8.
Ann Palliat Med ; 10(9): 9902-9913, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34551570

RESUMO

BACKGROUND: Apatinib in combination with chemotherapy (CT) has been used in the treatment of ovarian cancer (OC), however, the safety and efficacy are unclear. The study aims at systematic evaluation of the safety and efficacy of the apatinib targeted therapy in combination with CT for the treatment of patients with advanced OC. METHODS: Literature about randomized controlled clinical trials was searched using search engines such as PubMed, EMBASE, Web of Science, CNKI, the Cochrane Library, CBM, VIP and the Wanfang. We collected the related clinical studies of apatinib in combination with CT in the treatment of OC. The duration of the data retrieval related to clinical studies was from the database establishment to September 2020. Adverse reactions (ADRs) due to treatment, disease control rate (DCR), and that of objective response rate (ORR), were collected as indicators to show treatment outcomes. The literature was independently screened by two researchers. They extracted the data and evaluated the risk of biases of the included studies. Then, Revman 5.4 software was employed for performing the meta-analysis. RESULTS: Twelve randomized controlled clinical trials with 698 patients having an advanced stage of OC were included. The results revealed that in comparison with the treatment with only CT, apatinib targeted therapy combination with CT showed significant improvement in the patients' ORR [OR =3.19, 95% CI: (2.06, 4.94), P<0.00001] and DCR [OR =4.97, 95% CI: (2.90, 8.52), P<0.00001]. The group that was treated with a combined therapy had shown proteinuria in higher amount (OR =3.08, 95% CI: 51.13-8.42, P<0.00001), while the analyses of other ADRs, such nausea and vomiting (OR =1.10, 95% CI: 0.67-1.79, P=0.71), hand-foot syndrome (OR =1.73, 95% CI: 0.97-3.10, P=0.06), hypertension (OR =1.18, 95% CI: 0.73-1.91, P=0.0.51), diarrhea (OR =1.05, 95% CI: 0.56-1.97, P=0.87), leucopenia (OR =1.22, 95% CI: 0.70-2.12, P=0.48), and myelosuppression (OR =1.00, 95% CI: 0.28-3.62, P=1.00), did not show any significant difference (P>0.05). DISCUSSION: The effects of apatinib combination with CT for the treatment of OC are significantly better than the CT used alone in ORR and DCR, despite with a relative low incidence of adverse effects. However, due to the very low number of studies available, the results need to be further verified using a high-quality, large sample and long-term studies.


Assuntos
Neoplasias Ovarianas , Piridinas , Feminino , Humanos , Neoplasias Ovarianas/tratamento farmacológico , Piridinas/efeitos adversos , Resultado do Tratamento
9.
Acad Med ; 2021 Sep 14.
Artigo em Inglês | MEDLINE | ID: mdl-34524135

RESUMO

PROBLEM: The COVID-19 pandemic significantly disrupted point-of-care ultrasound (POCUS) education. Medical schools and residency programs placed restrictions on bedside teaching and clinical scanning as part of risk mitigation. In response, POCUS faculty nationwide from 15 institutions collaborated on an alternative model of ultrasound education, A Distance-learning Approach to POCUS Training (ADAPT). APPROACH: ADAPT was repeated monthly from April 1 through June 30, 2020. It accommodated 70 learners, who included 1- to 4-week rotators and asynchronous learners. The curriculum included assigned pre-work and learning objectives covering 20 core POCUS topics. A rotating group of 30 faculty and fellows delivered daily virtual teaching sessions that included gamification to increase learner engagement and hands-on instruction through teleguidance. After participation, faculty and learners completed anonymous surveys. OUTCOMES: Educators reported a significant decrease in preparatory time (6.2 vs. 3.1 hours per week, P < .001) dedicated to ultrasound education after implementing ADAPT. The majority of 29 learners who completed surveys felt "somewhat confident" or "very confident" in their ability to acquire (n = 25, 86.2%) and interpret (n = 27, 93.1%) ultrasound images after the intervention; the majority of 22 educators completing surveys rated the program "somewhat effective" or "very effective" at contributing to learner's ability to acquire (n = 13, 59.1%) and interpret (n = 20, 90.9%) images. Most learners (n = 28, 96.6%) and all educators (n = 22, 100%) were "satisfied" or "very satisfied" with ADAPT as a whole, and the large majority of educators were "very likely" (n = 18, 81.8%) to recommend continued use of this program. NEXT STEPS: A virtual curriculum that pools the efforts of multiple institutions nationwide was implemented rapidly and effectively while satisfying educational expectations of both learners and faculty. This collaborative framework can be replicated and may be generalizable to other educational objectives.

10.
BMJ Open ; 11(9): e049277, 2021 09 13.
Artigo em Inglês | MEDLINE | ID: mdl-34518261

RESUMO

INTRODUCTION: Periodontal disease and osteoporosis are common chronic diseases, especially for the postmenopausal women. Several original studies explore the association, but there still controversial. Therefore, we will conduct this systematic review and meta-analysis to assess the association between periodontal disease and osteoporosis in postmenopausal women. METHODS AND ANALYSIS: This study adheres to the Preferred Reporting Items for Systematic Reviews and Meta-analyses for Protocols. We will systematically search Medline/PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science and Scopus from inception to August 2021 to collect all relevant publications, with no restrictions on publication date or languages. Study selection, data extraction and risk of bias assessment will be conducted independently by two trained reviewers independently. The Cochrane's tool for assessing risk of bias, Newcastle-Ottawa Scale and Agency for Healthcare Research and Quality will be used for the risk of bias assessment. OR, HR and risk ratio with 95% CI were considered as the effect size for dichotomous outcomes, weighted mean difference with 95% CI were calculated as the effect size for continuous outcomes. Random-effects models will be used. Heterogeneity between studies will be assessed via the forest plot and I². Publication bias will detected by funnel plots, Begg's test and Egger's test. The subgroup analyses and sensitivity ananlyses will also be used to explore and interpret the heterogeneity. ETHICS AND DISSEMINATION: This study does not require ethical approval. We will disseminate our findings by publishing results in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER: CRD42021225746.


Assuntos
Osteoporose , Doenças Periodontais , Feminino , Humanos , Metanálise como Assunto , Doenças Periodontais/complicações , Doenças Periodontais/epidemiologia , Pós-Menopausa , Projetos de Pesquisa , Revisões Sistemáticas como Assunto
11.
Osteoporos Int ; 2021 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-34414463

RESUMO

We compared, for women in Pakistan, the utility of intervention thresholds either at a T-score ≤ - 2.5 or based on a FRAX probability equivalent to women of average body mass index (BMI) with a prior fragility fracture. Whereas the FRAX-based intervention threshold identified women at high fracture probability, the T-score threshold was less sensitive, and the associated fracture risk decreased markedly with age. PURPOSE: The fracture risk assessment algorithm FRAX® has been recently calibrated for Pakistan, but guidance is needed on how to apply fracture probabilities to clinical practice. METHODS: The age-specific 10-year probabilities of a major osteoporotic fracture were calculated in women with average BMI to determine fracture probabilities at two potential intervention thresholds. The first comprised the age-specific fracture probabilities associated with a femoral neck T-score of - 2.5. The second approach determined age-specific fracture probabilities that were equivalent to a woman with a prior fragility fracture, without bone mineral density (BMD). The parsimonious use of BMD was additionally explored by the computation of upper and lower assessment thresholds for BMD testing. RESULTS: When a BMD T-score ≤ - 2.5 was used as an intervention threshold, FRAX probabilities in women aged 50 years were approximately two-fold higher than in women of the same age but with no risk factors and average BMD. The relative increase in risk associated with the BMD threshold decreased progressively with age such that, at the age of 80 years or more, a T-score of - 2.5 was actually protective. The 10-year probability of a major osteoporotic fracture by age, equivalent to women with a previous fracture, rose with age from 2.1% at the age of 40 years to 17%, at the age of 90 years, and identified women at increased risk at all ages. CONCLUSION: Intervention thresholds based on BMD alone do not effectively target women at high fracture risk, particularly in the elderly. In contrast, intervention thresholds based on fracture probabilities equivalent to a 'fracture threshold' target women at high fracture risk.

12.
J Dairy Sci ; 104(11): 11567-11579, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34419275

RESUMO

Our objective was to quantify the contribution of body weight (BW) change to the overall response of lactating dairy cows to a shortage of dietary protein. Lactating Holstein cows (n = 166; 92 primiparous, 74 multiparous) with initial milk yield of 41 ± 10 kg/d were fed high and low-protein diets in 7 blocks. Blocks were repeated in the same crossover design with periods of 28 to 35 d. Production of 69 of the 166 cows (42 primiparous, 27 multiparous) was also measured in late lactation. Low-protein diets were 14% crude protein (CP) in peak lactation and 13% CP in late lactation and were formulated to contain adequate rumen-degradable protein to maintain rumen function but inadequate rumen undegradable protein for the average cow in this study. High-protein diets were 18% CP in peak lactation and 16% CP in late lactation and contained extra expeller soybean meal to meet metabolizable protein requirements. Body weight changes were used to predict body energy and protein changes, which were added to milk components to calculate total captured energy and protein. Fixed effects of diet, parity, treatment sequence nested in each block, treatment period nested in block, interaction of diet and parity, and the random effects of block and cow nested within block were included in the model to compare cow responses to diets within each lactation stage. In peak lactation, reducing protein from 18 to 14% resulted in estimated daily losses of 2.9 Mcal of milk energy, 2.2 Mcal of body energy, 127 g of milk protein, and 16 g of body protein. Therefore, BW loss accounted for 43% of the decrease in captured energy and 11% of the decrease in captured protein when cows were fed deficient protein. In late lactation, BW loss accounted for 51% of the decrease in captured energy and 14% of the decrease in captured protein when cows were fed deficient protein. We suggest that BW change should be considered when assessing cow responses to changes in dietary protein.


Assuntos
Doenças dos Bovinos , Deficiência de Proteína , Animais , Peso Corporal , Bovinos , Dieta/veterinária , Dieta com Restrição de Proteínas/veterinária , Proteínas na Dieta , Feminino , Lactação , Gravidez , Deficiência de Proteína/veterinária , Rúmen
13.
Climacteric ; : 1-7, 2021 Jul 28.
Artigo em Inglês | MEDLINE | ID: mdl-34319208

RESUMO

Osteoporosis is a disease characterized by impaired bone microarchitecture and reduced bone mineral density (BMD) resulting in bone fragility and increased risk of fracture. In western societies, one in three women and one in five men will sustain an osteoporotic fracture in their remaining lifetime from the age of 50 years. Fragility fractures, especially of the spine and hip, commonly give rise to increased morbidity and mortality. In the five largest European countries and Sweden, fragility fractures were the cause of 2.6 million disability-adjusted life years in 2016 and the fracture-related costs increased from €29.6 billion in 2010 to €37.5 billion in 2017. In the European Union and the USA, only a small proportion of women eligible for pharmacological treatment are being prescribed osteoporosis medication. Secondary fracture prevention, using Fracture Liaison Services, can be used to increase the rates of fracture risk assessment, BMD testing and use of osteoporosis medication in order to reduce fracture numbers. Additionally, established primary prevention strategies, based on case-finding methods utilizing fracture prediction tools, such as FRAX, to identify women without fracture but with elevated risk, are recommended in order to further reduce fracture numbers.

14.
Climacteric ; : 1-7, 2021 Jul 28.
Artigo em Inglês | MEDLINE | ID: mdl-34319212

RESUMO

The introduction of the FRAX algorithms has facilitated the assessment of fracture risk on the basis of fracture probability. FRAX integrates the influence of several well-validated risk factors for fracture with or without the use of bone mineral density. Since age-specific rates of fracture and death differ across the world, FRAX models are calibrated with regard to the epidemiology of hip fracture (preferably from national sources) and mortality (usually United Nations sources). Models are currently available for 73 nations or territories covering more than 80% of the world population. FRAX has been incorporated into more than 80 guidelines worldwide, although the nature of this application has been heterogeneous. The limitations of FRAX have been extensively reviewed. Arithmetic procedures have been proposed in order to address some of these limitations, which can be applied to conventional FRAX estimates to accommodate knowledge of dose exposure to glucocorticoids, concurrent data on lumbar spine bone mineral density, information on trabecular bone score, hip axis length, falls history, type 2 diabetes, immigration status and recency of prior fracture.

15.
Clin Radiol ; 76(11): 829-837, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34243944

RESUMO

AIM: To undertaken a systematic review of the technical success and technique efficacy rates of percutaneous image-guided radiofrequency ablation (RFA) for adrenal tumours. MATERIALS AND METHODS: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, the electronic databases MEDLINE, EMBASE, and PubMed were searched for relevant studies from inception to the third week of January 2020. Only studies reporting effectiveness rates of percutaneous RFA for adrenal tumours were included. Data regarding sample size, tumours, effectiveness rates, outcomes, and complications were extracted in duplicate and recorded. RESULTS: A total of 15 studies evaluating 292 individuals with 305 tumours were included. Patient selection criteria included age ≥18 years, contraindication to surgical intervention, and no uncorrected coagulopathy. Cumulative technical success, primary technique efficacy, and secondary technique efficacy rates were 99%, 95.1% and 100%, respectively, indicating optimal immediate control of adrenal tumours. Technical success and technique efficacy rates of primary adrenal tumours were higher than adrenal metastases; however, formal statistical analyses were precluded due to lack of comparative studies. Local tumour progression rates for adrenal metastases were 20.3% at 3 months, 26.3% at 6 months, and 29.3% at 12 months. Overall survival rates for adrenal metastases were 81.8% at 6 months, 59.6% at 12 months, and 62.9% at 18 months. The intraprocedural complication rate was 30.2%, with the most frequency reported complication being procedural hypertensive crisis. CONCLUSION: The findings of this study suggest percutaneous image-guided RFA is a safe and efficacious procedure. Further studies are warranted to define patient selection criteria and long-term outcomes.

16.
Molecules ; 26(9)2021 May 02.
Artigo em Inglês | MEDLINE | ID: mdl-34063301

RESUMO

Amomum Villosum Lour. (A. villosum) is a folk medicine that has been used for more than 1300 years. However, study of the polysaccharides of A. villosum is seriously neglected. The objectives of this study are to explore the structural characteristics of polysaccharides from A. villosum (AVPs) and their effects on immune cells. In this study, the acidic polysaccharides (AVPG-1 and AVPG-2) were isolated from AVPs and purified via anion exchange and gel filtration chromatography. The structural characteristics of the polysaccharides were characterized by methylation, HPSEC-MALLS-RID, HPLC, FT-IR, SEM, GC-MS and NMR techniques. AVPG-1 with a molecular weight of 514 kDa had the backbone of → 4)-α-d-Glcp-(1 → 3,4)-ß-d-Glcp-(1 → 4)-α-d-Glcp-(1 →. AVPG-2 with a higher molecular weight (14800 kDa) comprised a backbone of → 4)-α-d-Glcp-(1 → 3,6)-ß-d-Galp-(1 → 4)-α-d-Glcp-(1 →. RAW 264.7 cells were used to investigate the potential effect of AVPG-1 and AVPG-2 on macrophages, and lipopolysaccharide (LPS) was used as a positive control. The results from bioassays showed that AVPG-2 exhibited stronger immunomodulatory activity than AVPG-1. AVPG-2 significantly induced nitric oxide (NO) production as well as the release of interleukin (IL)-6 and tumor necrosis factor alpha (TNF-α), and upregulated phagocytic capacities of RAW 264.7 cells. Real-time PCR analysis revealed that AVPG-2 was able to turn the polarization of macrophages to the M1 direction. These results suggested that AVPs could be explored as potential immunomodulatory agents of the functional foods or complementary medicine.


Assuntos
Amomum/química , Polissacarídeos/química , Polissacarídeos/metabolismo , Animais , Sobrevivência Celular , Cromatografia Líquida de Alta Pressão , Citocinas/metabolismo , Etanol , Fatores Imunológicos , Imunomodulação/efeitos dos fármacos , Lipopolissacarídeos/química , Macrófagos/metabolismo , Espectroscopia de Ressonância Magnética , Camundongos , Microscopia Eletrônica de Varredura , Peso Molecular , Óxido Nítrico/química , Fagocitose , Células RAW 264.7 , Espectroscopia de Infravermelho com Transformada de Fourier , Propriedades de Superfície
17.
Braz J Biol ; 82: e231134, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34076157

RESUMO

Chronic obstructive pulmonary disease (COPD) was estimated to be the third cause of global mortality by 2020. Acute exacerbation COPD (AECOPD) is a sudden worsening of COPD symptoms and could be due to virus/bacterial infections and air pollution. Increased expression of inflammatory markers in patients with AECOPD is associated with viral infection. This study aimed to detect different viruses and analyze the expression of various inflammatory markers associated with AECOPD patients. Three hundred and forty-seven patients diagnosed with COPD according to GOLD criteria were included in this study. Swab samples and blood were collected for the detection of viruses by RT-PCR and expression of inflammatory markers, respectively. Of the swab samples, 113 (32.6%) of samples were positive for virus detection. Of these, HRV (39.8%) was the predominant virus detected followed by FluB (27.4%) and FluA (22.1%). The presence of HRV was significantly higher (p=0.044) among the other detected viruses. When compared to healthy controls the expression levels of TNF-α, IL-6 and IL-8 were significantly higher (p<0.05) in virus-positive patients. The IL-6 and IL-8 were the next predominantly expressed in markers among the samples. The higher expression rate of IL-8 was significantly (p<0.05) associated with patients having COPD GOLD III severity level and smoking history. Although HRV was the predominant virus detected the combined prevalence of Influenza A and B surpassing the rate of HRV. The high-level expression of well known inflammatory markers of AECOPD, TNF-α, IL-6 and IL-8 indicates a chronic severe illness. These markers play an important role and could be used as a marker for determining the severity of AECOPD.


Assuntos
Doença Pulmonar Obstrutiva Crônica , Vírus , China/epidemiologia , Citocinas/genética , Humanos , Mongólia , Doença Pulmonar Obstrutiva Crônica/diagnóstico
18.
J Ethnopharmacol ; 277: 114216, 2021 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-34044076

RESUMO

ETHNOPHARMACOLOGICAL RELEVANCE: Aconitum carmichaelii Debeaux, a famous traditional medicinal herb for collapse, rheumatic fever, and painful joints, always raises global concerns about its fatal toxicity from toxic alkaloids when improperly processed. Therefore, it is urgent to clarify the internal molecular mechanism of processing detoxification on Aconitum and develop simple and reliable approaches for clinical application, which is also of great significance to the rational medicinal use of Aconitum. AIM OF THE STUDY: The study aimed at developing a complete molecular mechanism exploration strategy in complex medicinal herb decocting system, clarifying the internal molecular mechanism of processing detoxification on Aconitum, and exploring valid approaches for detoxification. MATERIALS AND METHODS: Aconiti Lateralis Radix Praeparata (Fuzi) was selected as the model for exploring the complex Aconitum detoxification mechanism using an advanced online real-time platform based on extractive electrospray ionization mass spectrometry. The methods realized the sensitive capture of dynamic trace intermediates, accurate qualitative and quantitative analysis, and real-time and long-term monitoring of multi-components with satisfactory accuracy and resistance to complex matrices. RESULTS: Components in the complex Aconitum decocting system were real-timely characterized and fat meat was discovered and verified to directionally detoxify Aconitum while reserving the therapy effect. More importantly, the dynamic detoxification mechanism in the chemically complex Aconitum decoction was molecularly profiled. A novel reaction pathway based on nucleophilic substitution reaction mechanism was proposed. As confirmed by the theoretic calculations at DFT B3LYP/6-31G (d) levels, fatty acids (e.g., palmitic acid) acted as a green, cheap, and high-performance catalyst and promote the decomposition of toxic diester alkaloids to non-toxic and active benzoyl-monoester alkaloids through the discovered mechanism. CONCLUSION: The study exposed a novel detoxification molecular mechanism of Aconitum and provided an effective method for the safe use of Aconitum, which could effectively guide the development of traditional processing technology and compatibility regulation of the toxic herb and had great value to the modernization and standardization development of traditional medicine.


Assuntos
Alcaloides/análise , Diterpenos/análise , Medicamentos de Ervas Chinesas/análise , Espectrometria de Massas por Ionização por Electrospray/métodos , Alcaloides/química , Alcaloides/toxicidade , Diterpenos/química , Diterpenos/toxicidade , Medicamentos de Ervas Chinesas/química , Medicamentos de Ervas Chinesas/toxicidade , Ácidos Graxos/metabolismo , Reprodutibilidade dos Testes
19.
J Dent Res ; 100(13): 1482-1491, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33906518

RESUMO

Mutations in the PHEX gene lead to X-linked hypophosphatemia (XLH), a form of inherited rickets featuring elevated fibroblast growth factor 23 (FGF23), reduced 1,25-dihydroxyvitamin D (1,25D), and hypophosphatemia. Hyp mutant mice replicate the XLH phenotype, including dentin, alveolar bone, and cementum defects. We aimed to compare effects of 1,25D versus FGF23-neutralizing antibody (FGF23Ab) monotherapies on Hyp mouse dentoalveolar mineralization. Male Hyp mice, either injected subcutaneously with daily 1,25D or thrice weekly with FGF23 blocking antibody from 2 to 35 d postnatal, were compared to wild-type (WT) controls and untreated Hyp mice. Mandibles were analyzed by high-resolution micro-computed tomography (micro-CT), histology, and immunohistochemistry. Both interventions maintained normocalcemia, increased serum phosphate levels, and improved dentoalveolar mineralization in treated versus untreated Hyp mice. 1,25D increased crown dentin volume and thickness and root dentin/cementum volume, whereas FGF23Ab effects were limited to crown dentin volume. 1,25D increased bone volume fraction, bone mineral density, and tissue mineral density in Hyp mice, whereas FGF23Ab failed to significantly affect these alveolar bone parameters. Neither treatment fully attenuated dentin and bone defects to WT levels, and pulp volumes remained elevated regardless of treatment. Both treatments reduced predentin thickness and improved periodontal ligament organization, while 1,25D promoted a more profound improvement in acellular cementum thickness. Altered cell densities and lacunocanalicular properties of alveolar and mandibular bone osteocytes and cementocytes in Hyp mice were partially corrected by either treatment. Neither treatment normalized the altered distributions of bone sialoprotein and osteopontin in Hyp mouse alveolar bone. Moderate improvements from both 1,25D and FGF23Ab treatment regimens support further studies and collection of oral health data from subjects receiving a newly approved anti-FGF23 therapy. The inability of either treatment to fully correct Hyp mouse dentin and bone prompts further experiments into underlying pathological mechanisms to identify new therapeutic approaches.

20.
Osteoporos Int ; 32(10): 1951-1960, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33813622

RESUMO

The National Osteoporosis Guideline Group (NOGG) has developed intervention thresholds based on FRAX® to characterise patients at high and very high risk of fracture. INTRODUCTION: Guidelines for the assessment of fracture risk have begun to categorise patients eligible for treatment into high and very high risk of fracture to inform choice of therapeutic approach. The aim of the present study was to develop intervention thresholds based on the hybrid assessment model of NOGG. METHODS: We examined the impact of intervention thresholds in a simulated cross-sectional cohort of women age 50 years or more from the UK with the distribution of baseline characteristics based on that in the FRAX cohorts. The prevalence of very high risk using the hybrid model was compared with age-dependent thresholds used by the International Osteoporosis Foundation and the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (IOF/ESCEO). The appropriateness of thresholds was tested based on the populations treated with anabolic agents. RESULTS: With an upper intervention threshold using the IOF/ESCEO criteria, 56% of women age 50 years or more would be characterised at very high risk. This compares with 36% using the IOF/ESCEO criteria and an age-specific intervention threshold over all ages. With an upper intervention threshold of 1.6 times the pre-existing intervention threshold, 10% of women age 50 years or more would be characterised at very high risk. The data from phase 3 studies indicate that most trial participants exposed to romosozumab or teriparatide would fall into the very high-risk category. CONCLUSIONS: Proposals for FRAX-based criteria for very high risk for the NOGG hybrid model categorise a small proportion of women age 50 years or more (10%) in this highest risk stratum. The level of risk identified was comparable to that of women enrolled in trials of anabolic agents.


Assuntos
Fraturas Ósseas , Osteoporose , Fraturas por Osteoporose , Densidade Óssea , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Osteoporose/tratamento farmacológico , Osteoporose/epidemiologia , Fraturas por Osteoporose/epidemiologia , Fraturas por Osteoporose/prevenção & controle , Medição de Risco , Fatores de Risco
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