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1.
Artigo em Inglês | MEDLINE | ID: mdl-35337975

RESUMO

Thermosensation is crucial for the survival of any organism. In animals, changes in brain temperature are detected via sensory neurons, their cell bodies are located in the trigeminal ganglia. Transient receptor potential (TRP) ion channels are the largest temperature sensing family. In mammals, 11 thermoTRPs are known, as in poultry, there are only three. This research further elucidates TRP mRNA expression in the brain of broiler embryo's. Three incubation treatments were conducted on 400 eggs each: the control (C) at 37.6 °C; T1 deviating from C by providing a + 1 °C heat stimuli during embryonic day (ED) 15-20 for 8 h a day; and T2, imposing a + 2 °C heat stimuli. After each heat stimuli, 12 eggs per treatment were taken for blood sampling from the chorioallantoic membrane and brain harvesting. Incubation parameters such has residual yolk (free embryonic) weight, chick quality and hatch percentage were collected. After primer optimization, 22 target genes (13 TRPs and 9 non-TRPs) were measured on mRNA of the brain using a nanofluidic biochip (Fluidigm Corporation). Four target genes (ANO2, TRPV1, SCN5A, TRAAK) have a significant treatment effect - independent of ED. Another four (TRPM8, TRPA1, TRPM2, TRPC3) have a significant treatment effect visible on one or more ED. Heat sensitive channels were increased in T2 and to a lesser degree in T1, which could be part of an acclimatisation process resulting in later life heat tolerance by increased heat sensitivity. T2, however, resulted in a lower hatch weight, quality and hatchability. No hormonal differences were detected.


Assuntos
Galinhas , Temperatura Alta , Animais , Encéfalo , Embrião de Galinha , Galinhas/genética , Canais Iônicos , Mamíferos/genética , RNA Mensageiro/genética , Temperatura
2.
Sensors (Basel) ; 21(23)2021 Dec 05.
Artigo em Inglês | MEDLINE | ID: mdl-34884136

RESUMO

This study introduces machine learning predictive models to predict the future values of the monitored vital signs of COVID-19 ICU patients. The main vital sign predictors include heart rate, respiration rate, and oxygen saturation. We investigated the performances of the developed predictive models by considering different approaches. The first predictive model was developed by considering the following vital signs: heart rate, blood pressure (systolic, diastolic and mean arterial, pulse pressure), respiration rate, and oxygen saturation. Similar to the first approach, the second model was developed using the same vital signs, but it was trained and tested based on a leave-one-subject-out approach. The third predictive model was developed by considering three vital signs: heart rate (HR), respiration rate (RR), and oxygen saturation (SpO2). The fourth model was a leave-one-subject-out model for the three vital signs. Finally, the fifth predictive model was developed based on the same three vital signs, but with a five-minute observation rate, in contrast with the aforementioned four models, where the observation rate was hourly to bi-hourly. For the five models, the predicted measurements were those of the three upcoming observations (on average, three hours ahead). Based on the obtained results, we observed that by limiting the number of vital sign predictors (i.e., three vital signs), the prediction performance was still acceptable, with the average mean absolute percentage error (MAPE) being 12%,5%, and 21.4% for heart rate, oxygen saturation, and respiration rate, respectively. Moreover, increasing the observation rate could enhance the prediction performance to be, on average, 8%,4.8%, and 17.8% for heart rate, oxygen saturation, and respiration rate, respectively. It is envisioned that such models could be integrated with monitoring systems that could, using a limited number of vital signs, predict the health conditions of COVID-19 ICU patients in real-time.


Assuntos
COVID-19 , Saturação de Oxigênio , Humanos , Unidades de Terapia Intensiva , SARS-CoV-2 , Sinais Vitais
3.
Sensors (Basel) ; 20(16)2020 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-32823883

RESUMO

The chicken embryo is a widely used experimental animal model in many studies, including in the field of developmental biology, of the physiological responses and adaptation to altered environments, and for cancer and neurobiology research. The embryonic heart rate is an important physiological variable used as an index reflecting the embryo's natural activity and is considered one of the most difficult parameters to measure. An acceptable measurement technique of embryonic heart rate should provide a reliable cardiac signal quality while maintaining adequate gas exchange through the eggshell during the incubation and embryonic developmental period. In this paper, we present a detailed design and methodology for a non-invasive photoplethysmography (PPG)-based prototype (Egg-PPG) for real-time and continuous monitoring of embryonic heart rate during incubation. An automatic embryonic cardiac wave detection algorithm, based on normalised spectral entropy, is described. The developed algorithm successfully estimated the embryonic heart rate with 98.7% accuracy. We believe that the system presented in this paper is a promising solution for non-invasive, real-time monitoring of the embryonic cardiac signal. The proposed system can be used in both experimental studies (e.g., developmental embryology and cardiovascular research) and in industrial incubation applications.


Assuntos
Algoritmos , Embrião de Galinha/fisiologia , Frequência Cardíaca , Monitorização Fisiológica/veterinária , Fotopletismografia/veterinária , Animais , Processamento de Sinais Assistido por Computador
4.
Sensors (Basel) ; 20(15)2020 Jul 30.
Artigo em Inglês | MEDLINE | ID: mdl-32751653

RESUMO

Animal welfare remains a very important issue in the livestock sector, but monitoring animal welfare in an objective and continuous way remains a serious challenge. Monitoring animal welfare, based upon physiological measurements instead of the audio-visual scoring of behaviour, would be a step forward. One of the obvious physiological signals related to welfare and stress is heart rate. The objective of this research was to measure heart rate (beat per minutes) in pigs with technology that soon will be affordable. Affordable heart rate monitoring is done today at large scale on humans using the Photo Plethysmography (PPG) technology. We used PPG sensors on a pig's body to test whether it allows the retrieval of a reliable heart rate signal. A continuous wavelet transform (CWT)-based algorithm is developed to decouple the cardiac pulse waves from the pig. Three different wavelets, namely second, fourth and sixth order Derivative of Gaussian (DOG), are tested. We show the results of the developed PPG-based algorithm, against electrocardiograms (ECG) as a reference measure for heart rate, and this for an anaesthetised versus a non-anaesthetised animal. We tested three different anatomical body positions (ear, leg and tail) and give results for each body position of the sensor. In summary, it can be concluded that the agreement between the PPG-based heart rate technique and the reference sensor is between 91% and 95%. In this paper, we showed the potential of using the PPG-based technology to assess the pig's heart rate.


Assuntos
Algoritmos , Frequência Cardíaca , Monitorização Fisiológica , Movimento , Fotopletismografia , Animais , Processamento de Sinais Assistido por Computador , Suínos
5.
Sensors (Basel) ; 20(22)2020 Nov 18.
Artigo em Inglês | MEDLINE | ID: mdl-33218084

RESUMO

In this prospective, interventional, international study, we investigate continuous monitoring of hospitalised patients' vital signs using wearable technology as a basis for real-time early warning scores (EWS) estimation and vital signs time-series prediction. The collected continuous monitored vital signs are heart rate, blood pressure, respiration rate, and oxygen saturation of a heterogeneous patient population hospitalised in cardiology, postsurgical, and dialysis wards. Two aspects are elaborated in this study. The first is the high-rate (every minute) estimation of the statistical values (e.g., minimum and mean) of the vital signs components of the EWS for one-minute segments in contrast with the conventional routine of 2 to 3 times per day. The second aspect explores the use of a hybrid machine learning algorithm of kNN-LS-SVM for predicting future values of monitored vital signs. It is demonstrated that a real-time implementation of EWS in clinical practice is possible. Furthermore, we showed a promising prediction performance of vital signs compared to the most recent state of the art of a boosted approach of LSTM. The reported mean absolute percentage errors of predicting one-hour averaged heart rate are 4.1, 4.5, and 5% for the upcoming one, two, and three hours respectively for cardiology patients. The obtained results in this study show the potential of using wearable technology to continuously monitor the vital signs of hospitalised patients as the real-time estimation of EWS in addition to a reliable prediction of the future values of these vital signs is presented. Ultimately, both approaches of high-rate EWS computation and vital signs time-series prediction is promising to provide efficient cost-utility, ease of mobility and portability, streaming analytics, and early warning for vital signs deterioration.


Assuntos
Escore de Alerta Precoce , Monitorização Fisiológica , Sinais Vitais , Dispositivos Eletrônicos Vestíveis , Hospitalização , Humanos , Oxigênio/sangue , Estudos Prospectivos , Taxa Respiratória
6.
Bioorg Med Chem Lett ; 29(13): 1580-1585, 2019 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-31078409

RESUMO

Diabetic nephropathy (DN) is one of the most serious complications of diabetes worldwide. It is depicted as the leading cause of end-stage renal disease. Oxidative stress plays a key role in hyperglycemia-induced DN. The preparation and characterization of novel mono-, di-, and trisubstituted-s-triazines endowed with uracil and/or thymine are described in this paper. The synthesis of the title compounds was realized through selective nucleophilic substitution reactions of cyanuric chloride with the corresponding hydrazide nucleobases. In this study, we assessed the effects of these derivatives on the progression of diabetic nephropathy. Our results show that trisubstituted-s-triazines endowed with acylhydrazides attenuate high-glucose induced glomerular mesangial cells proliferation and matrix protein accumulation in vitro. Notably, these derivatives also display anti-oxidative properties. This suggests that the novel trisubstituted-s-triazine derivatives provide renal protection through a reactive oxygen species (ROS)-dependent mechanism. Our data provide evidence that these derivatives may serve as potential therapeutic candidates in the treatment of DN.


Assuntos
Nefropatias Diabéticas/tratamento farmacológico , Pirimidinas/uso terapêutico , Proliferação de Células , Humanos , Células Mesangiais , Pirimidinas/farmacologia , Espécies Reativas de Oxigênio
7.
Infection ; 46(6): 823-835, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30143988

RESUMO

PURPOSE: In this study, we assessed the incidence, contributing factors and outcome of prolonged neutropenia above 7 days and of bacteraemia in patients with lymphoma and multiple myeloma who underwent autologous haematopoietic stem cell transplantation (AHSCT) without antibacterial prophylaxis. METHODS: This is a retrospective chart review of 190 adult patients who underwent AHSCT between 2005 and 2015 at a Lebanese hospital. RESULTS: Neutropenia of 7 days duration and longer was documented in 66% of the patient population. Through univariate analysis, patients with lymphoma were significantly more likely to have prolonged neutropenia (≥ 7 days) compared to those with myeloma. Mucositis above grade 3, diarrhoea and fever were more likely to occur in patients with prolonged neutropenia. Bacteraemia was documented in 12.6% of the patients. Total mortality rate was 3.7%, and that attributed to bacteraemia was 12.5% in the bacteraemia subgroup. Among bacterial isolates recovered from clinical specimens (89 isolates), 70% were Gram-negative, of which 57% were fluoroquinolone susceptible. Ninety-five percent of the Gram-negative bacteria causing bacteraemia were susceptible to fluoroquinolones. CONCLUSION: Bacterial pathogens causing bacteraemia were still highly susceptible to fluoroquinolones, despite the high prevalence of fluoroquinolone-resistant strains in the general bacterial ecology. Accordingly, the pertinence of fluoroquinolone prophylaxis in the AHSCT setting warrants further investigation. Moreover, continuous surveillance of local antibiograms in this patient population has become a must in an era of preponderant antibiotic resistance.


Assuntos
Antibacterianos/uso terapêutico , Bacteriemia/mortalidade , Farmacorresistência Bacteriana , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Complicações Pós-Operatórias/epidemiologia , Transplante Autólogo/efeitos adversos , Adulto , Antibioticoprofilaxia/estatística & dados numéricos , Bacteriemia/epidemiologia , Bacteriemia/microbiologia , Feminino , Humanos , Líbano/epidemiologia , Pessoa de Meia-Idade , Neutropenia/etiologia , Complicações Pós-Operatórias/microbiologia , Complicações Pós-Operatórias/mortalidade , Estudos Retrospectivos
8.
Sensors (Basel) ; 18(3)2018 Mar 06.
Artigo em Inglês | MEDLINE | ID: mdl-29509691

RESUMO

Four novel EEG signal features for discriminating phase-coded steady-state visual evoked potentials (SSVEPs) are presented, and their performance in view of target selection in an SSVEP-based brain-computer interfacing (BCI) is assessed. The novel features are based on phase estimation and correlations between target responses. The targets are decoded from the feature scores using the least squares support vector machine (LS-SVM) classifier, and it is shown that some of the proposed features compete with state-of-the-art classifiers when using short (0.5 s) EEG recordings in a binary classification setting.

9.
Prep Biochem Biotechnol ; 47(5): 473-480, 2017 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-28278111

RESUMO

Enzymes do not have long-term storage stability in soluble forms, thus drying methods could minimize the loss of enzymatic activity, the spray dryer removes water under high temperatures and little time. The aims of this study were to improve the stability of enzymatic extract from Myceliophthora thermophila for potential applications in industry and to evaluate the best conditions to remove the water by spray drying technique. The parameters were tested according to Box-Behnken and evaluated by analysis of variance (ANOVA), all the parameters measured were found to influence the final enzyme activity and spray drying process yield ranged from 38.65 to 63.75%. Enzyme powders showed increased storage stability than extract and maintained about 100% of collagenolytic activity after 180 days of storage at 30°C. The results showed that the microbial enzymes maintained activity during the spray drying process and were stable during long-term storage; these are promising characteristics for industrial applications.


Assuntos
Peptídeo Hidrolases/metabolismo , Sordariales/enzimologia , Análise de Variância , Colágeno/metabolismo , Dessecação , Estabilidade Enzimática , Microbiologia Industrial , Peptídeo Hidrolases/química , Peptídeo Hidrolases/isolamento & purificação , Proteólise , Sordariales/crescimento & desenvolvimento , Sordariales/metabolismo
10.
Environ Monit Assess ; 187(5): 224, 2015 May.
Artigo em Inglês | MEDLINE | ID: mdl-25838060

RESUMO

Obtaining information about the spatial distribution of desert plants is considered as a serious challenge for ecologists and environmental modeling due to the required intensive field work and infrastructures in harsh and remote arid environments. A new method was applied for assessing the spatial distribution of the halophytic species (HS) in an arid coastal environment. This method was based on the object-based image analysis for a high-resolution Google Earth satellite image. The integration of the image processing techniques and field work provided accurate information about the spatial distribution of HS. The extracted objects were based on assumptions that explained the plant-pixel relationship. Three different types of digital image processing techniques were implemented and validated to obtain an accurate HS spatial distribution. A total of 2703 individuals of the HS community were found in the case study, and approximately 82% were located above an elevation of 2 m. The micro-topography exhibited a significant negative relationship with pH and EC (r = -0.79 and -0.81, respectively, p < 0.001). The spatial structure was modeled using stochastic point processes, in particular a hybrid family of Gibbs processes. A new model is proposed that uses a hard-core structure at very short distances, together with a cluster structure in short-to-medium distances and a Poisson structure for larger distances. This model was found to fit the data perfectly well.


Assuntos
Meio Ambiente , Monitoramento Ambiental/métodos , Plantas/classificação , Plantas Tolerantes a Sal/classificação , Modelos Teóricos , Tolerância ao Sal , Análise Espacial , Processos Estocásticos
11.
J Therm Biol ; 44: 14-9, 2014 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-25086968

RESUMO

Homeothermic animals, including birds, try to keep their body temperature at a constant level within certain boundaries by using thermoregulatory mechanisms. However, during incubation, the thermoregulatory system of the chicken embryo evolves through different stages from a poikilothermic to a homeothermic system. Hence, the thermal response of the fertile egg to changes in ambient temperature is different from one day to another during the embryonic development. The incubated egg can be considered as a physical (thermal) system, which transfers energy (heat) down a potential gradient (temperature difference). The heat flow between the micro-environment and the eggshell under a thermal driving force (temperature difference) has been studied in the past by using the analogy to the flow of electric charge under an electromotive-force. In this work, the thermal-response of incubated eggs to a step-increase in ambient-air temperature is studied and modelled. It is shown that the incubated egg is reacting as a first-order system between embryonic days ED01 and ED13, while, starting from ED14, the egg is reacting as a second-order system. This extends the existing RC (resistor-capacitor) circuit analogue to an RLC (resistor-inductor-capacitor) circuit analogue at the later stage of incubation. The concept of considering the fertile egg and its surrounding environment as an energy-handling device is introduced in this paper. It is suggested that the thermoregulation of the embryo has a thermal induction-like effect starting from ED14 and increasing gradually till hatching.


Assuntos
Regulação da Temperatura Corporal , Modelos Biológicos , Animais , Embrião de Galinha , Eletricidade , Termodinâmica
12.
Mol Genet Genomic Med ; 12(1): e2282, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37800653

RESUMO

BACKGROUND: Transcobalamin II (TCN2) defect is a rare metabolic disorder associated with a range of neurological manifestations, including mild developmental delay, severe intellectual disability, ataxia, and, in some cases, seizures. Cobalamin, an essential nutrient, plays a crucial role in central nervous system myelination. CLINICAL PRESENTATION: We present a family with an index patient who exhibited progressive neurodevelopmental regression starting at 9 months of age, accompanied by myoclonic seizures, ataxia, and tremor. No significant hematological abnormalities were observed. Exome sequencing analysis identified a novel homozygous mutation, c.3G>A - P(Met1I), affecting the acceptor site of intron 4 of the TCN2 gene (chromosome 22: 31003321, NM_000355.4), leading to likely pathogenic variant potentially affecting translation. Following treatment with hydroxocobalamin, the patient demonstrated partial clinical improvement. He has a sibling with overt hematological abnormalities and subtle neurological abnormalities who is homozygous to the same mutation. Both parents are heterozygous for the same mutation. CONCLUSIONS: In infants presenting with unexplained non-specific neurological symptoms, irrespective of classical signs of vitamin B12 deficiency, evaluation for TCN2 defect should be considered. Early diagnosis and appropriate management can lead to favorable outcomes.


Assuntos
Ataxia Cerebelar , Epilepsia Generalizada , Epilepsia , Humanos , Lactente , Masculino , Ataxia/tratamento farmacológico , Ataxia/genética , Mutação , Convulsões/tratamento farmacológico , Convulsões/genética , Transcobalaminas/genética , Transcobalaminas/metabolismo , Vitamina B 12/uso terapêutico
13.
PLoS One ; 18(4): e0285131, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37104506

RESUMO

This study introduces the global-local least-squares support vector machine (GLocal-LS-SVM), a novel machine learning algorithm that combines the strengths of localised and global learning. GLocal-LS-SVM addresses the challenges associated with decentralised data sources, large datasets, and input-space-related issues. The algorithm is a double-layer learning approach that employs multiple local LS-SVM models in the first layer and one global LS-SVM model in the second layer. The key idea behind GLocal-LS-SVM is to extract the most informative data points, known as support vectors, from each local region in the input space. Local LS-SVM models are developed for each region to identify the most contributing data points with the highest support values. The local support vectors are then merged at the final layer to form a reduced training set used to train the global model. We evaluated the performance of GLocal-LS-SVM using both synthetic and real-world datasets. Our results demonstrate that GLocal-LS-SVM achieves comparable or superior classification performance compared to standard LS-SVM and state-of-the-art models. In addition, our experiments show that GLocal-LS-SVM outperforms standard LS-SVM in terms of computational efficiency. For instance, on a training dataset of 9, 000 instances, the average training time for GLocal-LS-SVM was only 2% of the time required to train the LS-SVM model while maintaining classification performance. In summary, the GLocal-LS-SVM algorithm offers a promising solution to address the challenges associated with decentralised data sources and large datasets while maintaining high classification performance. Furthermore, its computational efficiency makes it a valuable tool for practical applications in various domains.


Assuntos
Algoritmos , Máquina de Vetores de Suporte , Aprendizado de Máquina , Análise dos Mínimos Quadrados
14.
Case Rep Oncol ; 16(1): 13-20, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36743882

RESUMO

The management of R/M HNSCC is rapidly evolving with new available treatment molecules and combination modalities. Anti-EGFR cetuximab (CTX) and immune checkpoint inhibitors (ICI) can be used either alone or in combination with conventional platinum-based doublet chemotherapy (with taxanes or fluorouracil). No data have been reported to date on the association of doublet chemotherapy concomitantly with both CTX and ICI. We present a case series of patients treated with 4 cycles of quadritherapy, every 3 weeks, including paclitaxel 175 mg/m2, carboplatin AUC 5, pembrolizumab 200 mg, and weekly 250 mg/m2 CTX. All patients achieved an objective response (6 complete responses, 2 partial responses). Clinical response was fast, so 1 patient avoided an emergency tracheostomy for laryngeal dyspnea. Four patients furtherly benefited from cisplatin-based chemoradiotherapy on residual tumor sites after the response to quadritherapy. Adverse events were manageable, except for an ICI-related liver toxicity in a patient. Overall, this short series indicates that a quadruple therapy with carboplatin-paclitaxel-CTX and pembrolizumab seems to be safe and active in patients with R/M HNSCC. This observation could be confirmed through further clinical trials.

15.
CJC Open ; 5(3): 191-199, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37013071

RESUMO

Background: Direct oral anticoagulants are frequently used to treat post-myocardial infarction (MI) left ventricular thrombus (LVT). This study was conducted to evaluate the efficacy and safety of use of apixaban, compared to the standard warfarin therapy, in post-MI LVT. Methods: This open-label, randomized controlled trial included patients with post-acute or recent anterior wall MI with transthoracic echocardiography-confirmed LVT. Patients were randomized to receive either apixaban 5 mg twice daily or warfarin to achieve an international normalized ratio of 2-3, in addition to dual antiplatelet therapy. The primary endpoint was LVT resolution at 3 months, with a noninferiority margin of 95% for apixaban compared to warfarin. The secondary endpoint was major adverse cardiovascular events (MACE) or any relevant bleeding according to the Bleeding Academic Research Consortium (BARC) classification. Results: Fifty patients were enrolled from 3 centres. The use of dual or single antiplatelet agents was similar in the 2 groups. The number of 1-, 3-, and 6-month LVT resolutions were 10 (40.0%), 19 (76.0%), and 23 (92.0%) in the apixaban group, and 14 (56%), 20 (80.0%), and 24 (96.0%) in the warfarin group, respectively, without significant differences (P < 0.036 for noninferiority at 3 months). Patients taking warfarin required longer hospital stays and more outpatient visits. Multivariate adjustment analysis revealed left ventricular aneurysm, larger baseline LVT area and lower left ventricular ejection fraction to be independent predictors of LVT persistence at 3 months. No MACE occurred in either group; 1 BARC-2 bleeding event occurred with warfarin. Conclusions: Apixaban was not inferior to warfarin in the resolution of post-MI LVT.


Contexte: Les anticoagulants oraux directs sont souvent utilisés pour traiter un thrombus du ventricule gauche (TVG) après un infarctus du myocarde (IM). Cette étude a été réalisée afin d'évaluer l'efficacité et l'innocuité de l'apixaban, comparativement au traitement de référence par la warfarine dans les cas de TVG consécutif à un IM. Méthodologie: Cette étude en mode ouvert, contrôlée et à répartition aléatoire portait sur des patients ayant subi un IM aigu ou un IM récent de la paroi antérieure et présentant un TVG confirmé par échocardiographie transthoracique. Les patients ont été répartis aléatoirement pour recevoir l'apixaban à 5 mg deux fois par jour ou la warfarine en vue d'obtenir un ratio international normalisé de 2-3, en plus d'une bithérapie antiplaquettaire. Le critère d'évaluation principal était la résolution du TVG à trois mois, avec une marge de non-infériorité de 95 % pour l'apixaban comparativement à la warfarine. Le critère d'évaluation secondaire était la survenue d'événements cardiovasculaires indésirables majeurs ou de tout saignement associé, selon la classification du Bleeding Academic Research Consortium (BARC). Résultats: Cinquante patients provenant de trois centres ont été sélectionnés. L'utilisation d'un seul ou de deux agents antiplaquettaires était similaire dans les deux groupes. Le nombre de résolutions du TVG à 1 mois, à 3 mois et à 6 mois était de 10 (40,0 %), 19 (76,0 %) et 23 (92,0 %) respectivement dans le groupe apixaban, et de 14 (56,0 %), 20 (80,0 %) et 24 (96,0 %) respectivement dans le groupe warfarine, sans différence significative (p < 0,036 pour la non-infériorité à 3 mois). Les patients qui prenaient de la warfarine ont dû être hospitalisés plus longtemps et consulter plus souvent en externe. L'analyse multivariée sur les ajustements a révélé que l'anévrisme du ventricule gauche, plus grande zone TVG de base et une faible fraction d'éjection du ventricule gauche étaient des facteurs prédictifs indépendants de la persistance du TVG à trois mois. Aucun événement cardiovasculaire indésirable majeur ne s'est produit dans les deux groupes; un saignement de classe 2 selon le BARC s'est produit dans le groupe prenant de la warfarine. Conclusions: L'apixaban n'était pas inférieur à la warfarine dans la résolution du TVG après un IM.

16.
Clin Med Insights Case Rep ; 16: 11795476231158509, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36874375

RESUMO

Introduction: In children, idiopathic intracranial hypertension (IIH) is relatively uncommon. It is characterized by an increase in intracranial pressure, in the absence of evidence of underlying brain disease, structural abnormalities, hydrocephalus, or abnormal meningeal improvement. However, very rarely it can occur without papilledema, even though it is the most recognizable clinical sign. Due to this, a delay in diagnosis can lead to severe visual impairments. Case presentation: We describe a patient with a chronic headache but no papilledema. His neurological and systemic examinations were otherwise unremarkable. A lumbar puncture revealed a high opening pressure of 450 mmH2O and normal cerebrospinal fluid (CSF) parameters. Magnetic resonance imaging of the brain revealed only tortuous optic nerves, no parenchymal lesions, and no evidence of venous sinus thrombosis. He required acetazolamide treatment. Our patient's symptoms improved significantly in 2 months with medical treatment, weight loss, and exercise, with no development of papilledema. Conclusion: There is a wide range of clinical manifestations of IIH, making it difficult to decide when to begin treatment.

17.
Curr Vasc Pharmacol ; 21(4): 285-292, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37431901

RESUMO

AIM: To assess the current dyslipidemia management in the Arabian Gulf region by describing the demographics, study design, and preliminary results of out-patients who achieved low-density lipoprotein cholesterol (LDL-C) goals at the time of the survey. BACKGROUND: The Arabian Gulf population is at high risk for atherosclerotic cardiovascular disease at younger ages. There is no up-to-date study regarding dyslipidemia management in this region, especially given the recent guideline-recommended LDL-C targets. OBJECTIVE: Up-to-date comprehensive assessment of the current dyslipidemia management in the Arabian Gulf region, particularly in view of the recent evidence of the additive beneficial effects of ezetimibe and proprotein convertase subtilisin/kexin-9 (PCSK-9) inhibitors on LDL-C levels and cardiovascular outcomes. METHODS: The Gulf Achievement of Cholesterol Targets in Out-Patients (GULF ACTION) is an ongoing national observational longitudinal registry of 3000 patients. In this study, adults ≥18 years on lipidlowering drugs for over three months from out-patients of five Gulf countries were enrolled between January 2020 and May 2022 with planned six-month and one-year follow-ups. RESULTS: Of the 1015 patients enrolled, 71% were male, aged 57.9±12 years. In addition, 68% had atherosclerotic cardiovascular disease (ASCVD), 25% of these patients achieved the LDL-C target, and 26% of the cohort were treated using combined lipid-lowering drugs, including statins. CONCLUSION: The preliminary results of this cohort revealed that only one-fourth of ASCVD patients achieved LDL-C targets. Therefore, GULF ACTION shall improve our understanding of current dyslipidemia management and "guideline gaps" in the Arabian Gulf region.


Assuntos
Anticolesterolemiantes , Aterosclerose , Doenças Cardiovasculares , Dislipidemias , Inibidores de Hidroximetilglutaril-CoA Redutases , Adulto , Humanos , Masculino , Feminino , LDL-Colesterol , Doenças Cardiovasculares/tratamento farmacológico , Pacientes Ambulatoriais , Colesterol , Inibidores de Hidroximetilglutaril-CoA Redutases/efeitos adversos , Aterosclerose/tratamento farmacológico , Dislipidemias/diagnóstico , Dislipidemias/tratamento farmacológico , Dislipidemias/epidemiologia , Anticolesterolemiantes/efeitos adversos
18.
Int J Surg Case Rep ; 98: 107594, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36067534

RESUMO

Adamantinoma is rare, representing less than 1 % of all primary bone tumors. It is a slow growing low grade tumor which is often clinically, radiologically and histologically mistaken for many other tumors. In this report, we present a case of Adamantinoma in a 17-year-old Syrian adolescent. The patient presented with pain and swelling anterior aspect of his left leg for last six months. We analyzed the clinical, radiographical and pathological characteristics of our patient, which helped us to reach the final diagnosis. The aim of this report is to document the presence of Adamantinoma in Syria to help other Syrian physicians considering this disease in the differential diagnosis if they face similar presentations.

19.
Expert Opin Drug Discov ; 17(12): 1377-1405, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-36373806

RESUMO

INTRODUCTION: Sesquiterpene lactones (SLs) are one of the most diverse bioactive secondary metabolites found in plants and exhibit a broad range of therapeutic properties . SLs have been showing promising potential in cancer clinical trials, and the molecular mechanisms underlying their anticancer potential are being uncovered. Recent evidence also points to a potential utility of SLs in cancer prevention. AREAS COVERED: This work evaluates SLs with promising anticancer potential based on cell, animal, and clinical models: Artemisinin, micheliolide, thapsigargin dehydrocostuslactone, arglabin, parthenolide, costunolide, deoxyelephantopin, alantolactone, isoalantolactone, atractylenolide 1, and xanthatin as well as their synthetic derivatives. We highlight actionable molecular targets and biological mechanisms underlying the anticancer therapeutic properties of SLs. This is complemented by a unique assessment of SL mechanisms of action that can be exploited in cancer prevention. We also provide insights into structure-activity and pharmacokinetic properties of SLs and their potential use in combination therapies. EXPERT OPINION: We extract seven major lessons learned and present evidence-based solutions that can circumvent some scientific limitations or logistic impediments in SL anticancer research. SLs continue to be at the forefront of cancer drug discovery and are worth a joint interdisciplinary effort in order to leverage their potential in cancer therapy and prevention.


Assuntos
Neoplasias , Sesquiterpenos , Animais , Sesquiterpenos/farmacologia , Sesquiterpenos/uso terapêutico , Neoplasias/tratamento farmacológico , Neoplasias/prevenção & controle , Lactonas/farmacologia , Lactonas/uso terapêutico
20.
ACS Omega ; 7(30): 26871-26880, 2022 Aug 02.
Artigo em Inglês | MEDLINE | ID: mdl-35936437

RESUMO

Herein, we report a new approach to synthesize a series of 1,2,4-[e]-benzotriazine and cinnoline derivatives from 3-substituted isoindolin-1-one. All the reported products are obtained through an economical two-step synthetic procedure resulting in fair-to-high yields. Cinnolines (a) and 1,2,4-[e]-benzotriazines (b) result from an intramolecular cyclization of the corresponding 3-substituted isoindolin-1-ones, which, in turn, are prepared by an addition reaction from 2-cyanobenzaldehyde and 2-(2-nitrophenyl) acetonitrile (a) or 2-nitroaniline derivatives (b). A proposed mechanism for this transformation is presented.

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