Direct monitoring of lipid transfer on exposure of citrem nanoparticles to an ethanol solution containing soybean phospholipids by combining synchrotron SAXS with microfluidics.

Lipid exchange among citrem nanoparticles and an ethanol micellar solution containing soy phosphatidylcholine was investigated in situ by coupling small angle X-ray scattering with a microfluidic device. The produced soy phosphatidylcholine/citrem nanoparticles have great potential in the development of hemocompatible nanocarriers for drug delivery.

TB drug susceptibility testing in high fluoroquinolone resistance settings.

BACKGROUND: The insurgence of resistance to key drugs of the BPaLM (bedaquiline + pretomanid + moxifloxacin) regimen is a major concern. In settings with widespread resistance to fluoroquinolones (FQs), like Pakistan, new technologies, such as Xpert® MTB/XDR, may ensure drug resistance upfront screening. This study aims to assess MTB/XDR's performance in detecting FQs and isoniazid resistance, proposing a renewed diagnostic algorithm for drug-resistant TB (DR-TB). METHODS: This cross-sectional prospective study, approved by the local ethical committee, collected samples from people newly and previously diagnosed with TB over 6 months. Xpert® MTB/RIF Ultra, MTB/XDR, Genotype® MTBDRplus, Genotype® MTBDRsl, culture, and phenotypic drug susceptibility testing (pDST) for relevant drugs (including bedaquiline and levofloxacin) were performed. Next-generation sequencing (NGS) resolved discordances between MTB/XDR and pDST results. RESULTS: The analysis showed that MTB/XDR has 91.5% and 88.2% sensitivity and 99.5% and 97.7% specificity in detecting respectively isoniazid (INH) and resistance to FQs, demonstrating that MTB/XDR meets the WHO targets for INH resistance detection at the peripheral level. NGS effectively resolved discordances between MTB/XDR and pDST results. CONCLUSIONS: The obtained results allowed designing the proposed diagnostic algorithm for rapid identification of DR-TB, ensuring rapid and equitable access to drug susceptibility testing for TB, ultimately improving TB care and control.

CONTEXTE: La recrudescence de la résistance aux médicaments clés du régime BPaLM (bédaquiline + prétomanide + moxifloxacine) est une préoccupation majeure. Dans les contextes où la résistance aux fluoroquinolones (FQ) est répandue, comme le Pakistan, de nouvelles technologies, telles que Xpert® MTB/XDR, peuvent assurer un dépistage initial de la résistance aux médicaments. Cette étude vise à évaluer la performance de MTB/XDR dans la détection des FQ et de la résistance à l'isoniazide, en proposant un algorithme de diagnostic renouvelé pour la TB pharmacorésistante (DR-TB, pour l'anglais «drug-resistant TB ¼ ). MÉTHODES: Cette étude prospective transversale, approuvée par le comité d'éthique local, a recueilli des échantillons de personnes nouvellement diagnostiquées et précédemment diagnostiquées avec la TB pendant 6 mois. Xpert® MTB/RIF Ultra, MTB/XDR, le GenoType® MTBDRplus, le GenoType® MTBDRsl, la culture et des tests phénotypiques de sensibilité aux médicaments (pDST, pour l'anglais «phenotypic drug susceptibility testing ¼ ) pour les médicaments pertinents (y compris la bédaquiline et la lévofloxacine) ont été effectués. Le séquençage de nouvelle génération (NGS, pour l'anglais «next-generation sequencing ¼ ) a résolu les discordances entre les résultats MTB/XDR et pDST. RÉSULTATS: L'analyse a montré que le MTB/XDR a une sensibilité de 91,5% et 88,2% et une spécificité de 99,5% et 97,7% dans la détection respectivement de l'isoniazide et de la résistance aux FQ, démontrant que le MTB/XDR répond aux objectifs de l'OMS pour la détection de la résistance à l'isoniazide au niveau périphérique. NGS a efficacement résolu les discordances entre les résultats MTB/XDR et pDST. CONCLUSIONS: Les résultats obtenus ont permis de concevoir l'algorithme de diagnostic proposé pour l'identification rapide de la DR-TB, garantissant un accès rapide et équitable aux tests de sensibilité aux médicaments pour la TB, améliorant ainsi la prise en charge et le contrôle de la TB.

Free circulating tumor DNA as a diagnostic marker for breast cancer.

BACKGROUND: Cell-free DNA (cfDNA) in the plasma of patients with both malignant and benign breast lesions was analyzed to determine whether the findings may have diagnostic and prognostic implications and to analyze the association between the levels of cfDNA and prognostic parameters. METHODS: Plasma samples were obtained from 99 subjects; 42 with breast cancer (BC), 30 with benign breast lesions, and 27 healthy women as normal controls. Circulatory cfDNA was extracted from the plasma samples and quantified using a real-time quantitative PCR method. Immunohistochemistry was done on formalin-fixed paraffin-embedded sections to evaluate the status of hormonal receptors (estrogen receptor [ER] and progesterone receptor [PR]), and the protein expression of both Her2/neu and Topoisomerase IIα. RESULTS: The level of cfDNA in the BC group was significantly higher than in the benign lesions and control groups. cfDNA level was associated with malignant tumor size, lymph node involvement, stage, and grade as well as Her2/neu and Topoisomerase IIα expression, while it was not associated with ER or PR status. CONCLUSIONS: The present study suggests that the level of cfDNA can be easily quantified using plasma samples. Thus, level of plasma cfDNA might constitute an important noninvasive diagnostic and prognostic valuable tool in cancer breast patients' management.

Presence of Helicobacter spp. DNA in the gallbladder of Egyptian patients with gallstone diseases.

Earlier reports on the detection of Helicobacter DNA in the gallbladder tissue of patients with biliary diseases have shown discordant results. This study aimed to detect the presence of Helicobacter in gallstone, gallbladder tissue and bile specimens from subjects with H. pylori-positive gastritis with cholelithiasis. The presence of H. pylori in antrum biopsies was confirmed by rapid urease test and/or histopathological examination. DNA was extracted from gallbladder, bile and gallstone samples from 50 patients undergoing cholecystectomy. The presence of Helicobacter genus-specific DNA (16S rRNA genes) was determined by nested polymerase chain reaction assay. Helicobacter DNA was detected in the gallbladder tissue and bile of 28% and 18% respectively of the patients, but was not detected in any of the gallstones. These results do not rule out the possibility of Helicobacter infection as a contributing agent or cofactor in the development of biliary diseases.

Cosmeceutical awareness among community pharmacists in Jeddah, Saudi Arabia: The case of sunscreens and moisturizers.

BACKGROUND: Although cosmetic products such as sunscreens and moisturizers are generally considered safe, they can be less effective or harmful if used improperly. Thus, pharmacist's awareness about cosmeceuticals is pivotal in counseling about the ingredients and the proper use of such products. OBJECTIVE: To evaluate the awareness level of community pharmacists regarding cosmetic products particularly sunscreens and moisturizers in Jeddah, Saudi Arabia. METHODS: This is a cross-sectional study conducted on 310 community pharmacists in Jeddah, Saudi Arabia, in the duration (June-November 2019). RESULTS: With respect to the level of awareness toward sunscreen products, 74% of the participants demonstrated a clear understanding of Sun Protection Factor (SPF). In terms of sunscreen counseling and the impact of these products on drug-induced photosensitivity, the average awareness of participants was 62% and 55%, respectively. However, only 16% of participants were aware of the expiry date. The average pharmacist's knowledge of the expiration date of the moisturizers and the proper use/ingredients was 86% and 58%, respectively, while only 42% of participants responded correctly to the instructions for application of moisturizers. Cross-tabulation between the level of education and the need to acquire knowledge about cosmetics has shown that the majority of pharmacists has indicated that they need more knowledge about cosmetics. CONCLUSION: Around 53% of community pharmacists are aware about the sunscreen part, while 62% have the knowledge about moisturizers. Hence, more cosmetic courses and workshops are recommended to raise level of awareness.

Irritable bowel syndrome among nurses working in King Abdulaziz University Hospital, Jeddah, Saudi Arabia.

BACKGROUND: Irritable bowel syndrome (IBS) is a highly prevalent gastrointestinal disorder that can cause disability and economic burden. Nurses are a vital part of the medical team and their well-being is an important issue. Yet, few studies have been done concerning IBS among nurses. OBJECTIVES: To determine the prevalence, severity, and predictors of IBS among nurses working at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. MATERIALS AND METHODS: A cross-sectional study was conducted among 229 nurses who fulfilled the eligibility criteria. They were selected by stratified random sampling during 2014-2015. A validated, confidential, self-administered data collection sheet was used for collection of personal and sociodemographic data. Rome III Criteria, IBS Severity Scoring System (IBS-SSS), Hospital Anxiety and Depression Scale (HADS), and Pittsburgh Sleep Quality Index (PSQI) were included. Both descriptive and inferential statistics were done. A multiple logistic regression analysis was done to determine the predictors of IBS. RESULTS: The prevalence of IBS among nurses was 14.4%, and IBS-Mixed type was the commonest variety (54.5%). Positive family history of IBS, working in outpatient clinics, having day shift, poor sleep quality, and high anxiety and depression scale scores were significantly associated with IBS. After controlling for confounding factors in regression analysis, the predictors of IBS were food hypersensitivity (aOR=4.52; 95% CI: 1.80-11.33), morbid anxiety (aOR=4.34; 95% CI: 1.49-12.67), and positive family history of IBS (aOR=3.38; 95% CI: 1.12-13.23). CONCLUSION: The prevalence of IBS was 14.4%. Food hypersensitivity, morbid anxiety, and family history were the predictors of IBS. Screening and management of IBS, food hypersensitivity, and psychological problems among nurses are recommended.

Elevated serum tumor necrosis factor alpha and ferritin may contribute to the insulin resistance found in HCV positive Egyptian patients.

OBJECTIVE: There is evidence of an increased incidence of insulin resistance and diabetes mellitus (DM) in patients with hepatitis C virus (HCV) infection. Several mechanisms have been proposed, including inadequate insulin secretion or interference with signaling within the insulin receptor. We assessed serum tumor necrosis factor alpha (TNFalpha) and ferritin levels as potential mediators of insulin resistance in HCV positive Egyptian patients. PATIENTS AND RESULTS: Patients (n = 27) with HCV infection, patients (n = 23) with hepatitis C and DM (HCV + DM), patients (n = 22) with DM, and sex- and age-matched controls (n = 18) were included in this study. The degree of insulin resistance (HOMA index) was significantly higher in the HCV, HCV + DM and DM groups compared to the controls. The mean +/- SD of the HOMA index was 4.53 +/- 2.84, 6.1 +/- 2.36, 3.69 +/- 2.2 and 1.32 +/- 0.49, in HCV, HCV + DM, DM and controls, respectively. Serum TNFalpha levels were significantly higher in the HCV, HCV + DM groups compared with the healthy controls and DM patients (p < 0.001). The median (range) values of TNFalpha in HCV, HCV + DM, DM patients and controls subjects were 25.5 (0.43-124.0), 19.8 (0.51-139), 0.85 (0-10.5) and 0.32 (0-5.8) pg/mL, respectively. There was a significant positive correlation between the HCV load and both HOMA index and TNF alpha level. HCV and HCV + DM patients also had significantly higher serum ferritin levels compared with healthy controls and patients with DM. The mean +/- SD of serum ferritin in HCV, HCV + DM, DM patients and controls subjects was 258.1 +/- 116.2, 285.8 +/- 124.3, 86.9 +/- 41.8 and 159.9 +/- 76.9 ng/mL, respectively. CONCLUSION: Patients with HCV infection had a significantly higher level of TNFalpha and ferritin which may explain their insulin resistance. HOMA index and serum TNFalpha levels correlated positively with the HCV load.

Comparison between the short-term results of onlay and sublay mesh placement in the management of uncomplicated para-umbilical hernia: a prospective randomized study.

PURPOSE: The aim of this study was to compare between the short-term results of onlay and sublay mesh placement in the prosthetic repair of uncomplicated para-umbilical hernia (PUH). METHODS: Eighty patients with a defect size ranging from 4 to 10 cm were prospectively randomized to either the onlay group (40 patients) or the sublay group (40 patients). The operative time, postoperative complications and short-term recurrence were reported. RESULTS: There were no statistically significant differences between both study groups as regards the patients' demographics, associated co-morbidities and mean defect size. The median operative time was significantly shorter in the onlay group compared to that in the sublay group (52 vs. 91 min respectively, p < 0.001). No statistically significant difference was found in the daily median pain score throughout the first postoperative week. The time required to remove the suction drain was significantly shorter in the sublay group compared to that in the onlay group (3 vs. 7 days respectively, p < 0.001).Complications were encountered in 4 patients (10%) in the onlay group compared to 3 patients (7.5%) in the sublay group (p = 1.000). Superficial wound infection was encountered in 1 patient (2.5%) in the sublay group, Seroma was encountered in 2 patients (5%) in the onlay group, Deep vein thrombosis was encountered in 1 patient (2.5%) in the onlay group, Chest infection was encountered in 2 patients (5%) in the sublay group compared to 1 patient (2.5%) in the onlay group. Throughout the 22 months median follow-up duration (range 6-42 months), 2 recurrences (5%) were encountered in either study group. CONCLUSIONS: Both techniques are safe, efficient and are associated with comparable complication and recurrence rates.

A comparative study of the effect of some steroid hormones on the response of rats to other drugs.

The effect of a series of steroid hormones on the pentetrazol convulsing action, hexobarbital narcotic action and hepatic drug metabolizing enzyme activities was determined in rats. All steroid compounds used antagonized the pentetrazol effect: the most potent was cortisone and the least potent testosterone. Glucocorticoids and androgens shortened the hexobarbital sleeping time and increased the hepatic drug metabolizing enzyme activity. Estradiol exhibited the opposite effect, whereas progesterone and desoxycorticosterone did not affect these two parameters.

[The use of Surgisis® optimizes and simplifies partial nephrectomy for large renal tumors]. / Anwendung von Surgisis® zur Optimierung und Vereinfachung der Nierenteilresektion bei größeren renalen Neoplasmen.

BACKGROUND: With lower rates of postoperative renal failure, diabetes and cardiovascular disease, partial nephrectomy achieves longer overall survival and equally long tumor-specific survival. It is thus the current gold standard treatment for renal tumors and now also for those ≥ 4 cm in size. The main complications of nephron-sparing surgery, particularly for large and centrally located tumors, are postoperative parenchymal bleeding and urinary fistulas after opening the urinary collecting system (UCS). MATERIAL AND METHODS: Between August 2003 and April 2012, 76 partial nephrectomies for tumors ≥ 4 cm in size were performed using porcine small intestinal submucosa (SIS, Surgisis®) to close the capsular, renal and in some cases, UCS defects. RESULTS: The median tumor size was 5.0 cm (range 4.0-13.0 cm) and the intervention was performed with warm ischemia in 25 cases (32.8 %), with cold perfusion in 16 cases (21.2 %) and without ischemia in 35 cases (46.0 %). A total of 4 patients (5.5 %) developed postoperative urinary fistulas and 4 (5.5 %) required revision surgery because of significant postoperative bleeding. There were no local infections or allergic reactions to the foreign material. CONCLUSIONS: Surgisis® enables a quick and technically uncomplicated closure of the renal defect after partial nephrectomy for tumors. It has the potential to further minimize postoperative bleeding and urinary fistulas and to facilitate the intervention to the extent that nephron-sparing surgery will gain broader acceptance even in patients with tumors ≥4 cm in size.

[Palliative care and medicamentous therapy during the final episode of life]. / Palliativmedizin und medikamentöse Therapie in der Sterbephase.

The idea of modern palliative care goes back to the times of Dame Cicely Mary Strode Saunders in 1967, a British nurse and physician. Modern palliative care is a multimodal therapeutic and supportive concept for the patient, when curative care has failed or seems to be not reasonable. In this article we review the basics of current palliative care and focus in particular on specific medicamentous therapy during the final episode of life.

[Renal masses in pregnancy. Diagnostics and therapeutic management]. / Nierentumore in der Schwangerschaft. Diagnostik und therapeutisches Management.

Cancer is the second most common cause of death in women of childbearing age. However, renal cell carcinoma (RCC) is a rare tumor in this collective with an incidence far below 5/100,000 cases per year. Therefore, medical experience with respect to diagnostics and therapeutic management of newly diagnosed RCC in pregnant women is scarce and the number of published cases low. However, recent studies indicated that higher estrogen levels and multigravidity could be associated with a higher risk of RCC. The aim of this article is to summarize the clinical experience in treating pregnant women with renal cancer against the background of those cases published in the literature.

Study on the transient characteristic in the human visual system using masking experiments.

In this paper the visual masking effect is interpreted on the basic of the transient characteristic in two dimensional neuronal networks. The study investigates the suitability of the effect for use as a measurement method. It is shown that the stimulus distribution in space can be scanned at different points in time and that various dynamic characteristic values of the system can be measured.

Observations on coprophagy and the transmission of Hymenolepis nana infections in mice.

Young, previously uninfected white mice became infected with Hymenolepis nana when exposed in small cages to parasite eggs which had been sprinkled in suspension onto the floor of their cage, or to faeces from mice with patent infections. The mean daily probabilities of infection for individual eggs under these two conditions were 2-9 X 10(-6) and 5-4 X 10(-6) respectively. If the mice were starved for 24 h prior to exposure to faeces, then the mean daily probability of infection increased to 2-6 X 10(-4). These differences in transmission are interpreted as being due to differences in the extent of coprophagy; they are not due to any effect of starvation on the hatchability of eggs.