Outcomes of Remote Patient Monitoring in Peritoneal Dialysis: A Meta-Analysis and Review of Practical Implications for COVID-19 Epidemics.

The present study seeks to determine clinical outcomes associated with remote patient monitoring of peritoneal dialysis (RPM-PD), with potential implications during COVID-19 outbreaks. We performed a systematic review in the PubMed, Embase, and Cochrane databases. We combined all study-specific estimates using the inverse-variant weighted averages of logarithmic relative risk (RR) in the random-effects models. Confidence interval (CI) including the value of 1 was used as evidence to produce a statistically significant estimate. Twenty-two studies were included in our meta-analysis. Quantitative analysis demonstrated that RPM-PD patients had lower rates of technique failure (log RR = -0.32; 95% CI, -0.59 to -0.04), lower hospitalization rates (standardized mean difference = -0.84; 95% CI, -1.24 to -0.45), and lower mortality rates (log RR = -0.26; 95% CI, -0.44 to -0.08) compared with traditional PD monitoring. RPM-PD has better outcomes in multiple spheres of outcomes when compared with conventional monitoring and likely increases system resilience during disruptions of healthcare operations.

Environmentally azithromycin pharmaceutical wastewater management and synergetic biocompatible approaches of loaded azithromycin@hematite nanoparticles.

Pharmaceutical wastewater contamination via azithromycin antibiotic and the continuous emergence of some strains of bacteria, cancer, and the Covid-19 virus. Azithromycin wastewater treatment using the biosynthesized Hematite nanoparticles (α-HNPs) and the biocompatible activities of the resulted nanosystem were reported. Biofabrication of α-HNPs using Echinacea purpurea liquid extract as a previously reported approach was implemented. An evaluation of the adsorption technique via the biofabricated α-HNPs for the removal of the Azr drug contaminant from the pharmaceutical wastewater was conducted. Adsorption isotherm, kinetics, and thermodynamic parameters of the Azr on the α-HNPs surface have been investigated as a batch mode of equilibrium experiments. Antibacterial, anticancer, and antiviral activities were conducted as Azr@α-HNPs. The optimum conditions for the adsorption study were conducted as solution pH = 10, 150 mg dose of α-HNPs, and Azr concentration 400 mg/L at 293 K. The most fitted isothermal model was described according to the Langmuir model at adsorption capacity 114.05 mg/g in a pseudo-second-order kinetic mechanistic at R2 0.9999. Thermodynamic study manifested that the adsorption behavior is a spontaneous endothermic chemisorption process. Subsequently, studying the biocompatible applications of the Azr@α-HNPs. Azr@α-HNPs antibacterial activity revealed a synergistic effect in the case of Gram-positive more than Gram-negative bacteria. IC50 of Azr@α-HNPs cytotoxicity against MCF7, HepG2, and HCT116 cell lines was investigated and it was found to be 78.1, 81.7, and 93.4 µg/mL respectively. As the first investigation of the antiviral use of Azr@α-HNPs against SARS-CoV-2, it was achieved a safety therapeutic index equal to 25.4 revealing a promising antiviral activity. An admirable impact of the use of the biosynthesized α-HNPs and its removal nanosystem product Azr@α-HNPs was manifested and it may be used soon as a platform of the drug delivery nanosystem for the biomedical applications.

Cefixime wastewater management via bioengineered Hematite nanoparticles and the in-vitro synergetic potential multifunction activities of Cefixime@Hematite nanosystem

The current paper evaluates the adsorption performance of the biofabrication of Alpha Hematite nanoparticles (α-HNPs) for the removal of the Cefixime (Cfx) drug from the pharmaceutical wastewater. Adsorption isotherms, kinetics, and thermodynamic studies have been investigated using batch mode procedures. The optimum conditions were conducted as solution pH 4, α-HNPs dose 100 mg, Cfx concentration 100 mg/L, and absolute temperature 298 K. Cfx adsorption found to follow the Langmuir isothermal model via maximum monolayer adsorption capacities of 147.1 mg/g, and equilibrium kinetic as pseudo-second-order. Thermodynamic parameters were derived as spontaneous chemisorption endothermic processes. The capability of the process for the adsorbent regeneration study revealed the utility of the α-HNPs efficiency up to 5 successive times. Antibacterial activity of the adsorbed Cfx at the surface of α-HNPs (Cfx@α-HNPs) was investigated manifesting highly potent against each of Gram-negative bacteria & Gram-positive. The synergistic impact of Cfx@α-HNPs as an anticancer agent against MCF7, HepG2, and HCT116 cell lines was conducted at IC50 108.5, 117.7, and 156.4 µg/mL respectively revealing a promising efficacy comparing use of the α-HNPs alone. α-HNPs and Cfx@α-HNPs could be suggested as a novel multidrug bacteria-resistant alternative approach in case of treatment for chronic wound infections. As the first investigation of antiviral use of Cfx@α-HNPs against SARS-CoV-2, it was achieved a safety therapeutic index equal to 2.6 revealing a promising antiviral activity.

Targeting host cell proteases as a potential treatment strategy to limit the spread of SARS-CoV-2 in the respiratory tract.

As the death toll of Coronavirus disease 19 (COVID-19) continues to rise worldwide, it is imperative to explore novel molecular mechanisms for targeting SARS-CoV-2. Rather than looking for drugs that directly interact with key viral proteins inhibiting its replication, an alternative and possibly add-on approach is to dismantle the host cell machinery that enables the virus to infect the host cell and spread from one cell to another. Excellent examples of such machinery are host cell proteases whose role in viral pathogenesis has been demonstrated in numerous coronaviruses. In this review, we propose two therapeutic modalities to tackle SARS-CoV-2 infections; the first is to transcriptionally modulate the expression of cellular proteases and their endogenous inhibitors and the second is to directly inhibit their enzymatic activity. We present a nonexhaustive collection of clinically investigated drugs that act by one of these mechanisms and thus represent promising candidates for preclinical in vitro testing and hopefully clinical testing in COVID-19 patients.