Children and adolescents with type 1 diabetes mellitus in Nigeria: clinical characteristics and compliance with care.

OBJECTIVES: The prevalence of type 1 diabetes mellitus (T1DM) is increasing in most developed and developing countries. This study described the clinical characteristics and compliance with care among Nigerian children and adolescents with T1DM. METHODS: This was a cross-sectional descriptive multi-center study of children seen at the paediatric endocrinology clinic of seven selected tertiary health facilities in Nigeria. Information was collected on socio-demographics, clinical characteristics and compliance of the children with dietary recommendations and insulin therapy. Compliance with dietary recommendations and insulin therapy was graded as either good or poor based on defined criteria. RESULTS: The mean age of children was 13.1 ± 4.7 years. The mean age of children at the diagnosis of T1DM was 9.9 ± 4.2 years. Sixty-nine (60%) children were female while about half (47.8%) of the children were from the lower socioeconomic class. Compliance with insulin administration was good in 39.1% of the children and was significantly associated with the father's (p=0.001) and mother's educational status (p=0.024) while compliance with dietary recommendations was good in 20.0% of the children and was significantly associated with mother's educational status (p=0.034) and family socioeconomic class (p=0.010). Only the mother's level of education was independently and significantly associated with compliance to recommendations on insulin therapy (OR 4.2, 95% CI=1.5-11.6, p=0.007). CONCLUSIONS: The compliance of children with dietary recommendations and insulin therapy was poor. Efforts should be strengthened at all healthcare facilities to educate parents on the need for compliance with management guidelines.

A rare concurrence: bee venom associated acute tubular necrosis and acute interstitial nephritis.

Acute kidney injury (AKI) is generally associated with increased morbidity and mortality and is even more devastating in patients with comorbidities. Although AKI due to multiple bee stings is well established in the literature, it is still a rare entity with complex pathophysiologic mechanisms. The most commonly reported histological findings in AKI due to bee stings is acute tubular necrosis (ATN), with a few studies attributing it to acute interstitial nephritis (AIN), whereas the concurrence of both ATN and AIN is rarely reported. We hereby present a 50-year-old known Type 2 diabetes mellitus patient with a prior normal renal function, who developed AKI following multiple stings from >1000 bees. He had a kidney biopsy on account of non-recovery of his kidney function despite being on intermittent hemodialysis that showed combined features of ATN and AIN. He subsequently had a full recovery of his renal function following appropriate management.

Food security, diet quality, nutritional knowledge, and attitudes towards research in adults with heart failure during the COVID-19 pandemic.

BACKGROUND: The impact of the novel coronavirus disease 2019 (COVID-19) pandemic on diet and nutrition among older adults with chronic medical conditions have not been well-described. METHODS: We conducted a survey addressing (1) food access, (2) diet quality and composition, (3) nutritional understanding, and (4) attitudes towards research among adults with heart failure (HF) within an integrated health system. Adults (≥18 years) with diagnosed HF and at least one prior hospitalization for HF within the last 12 months were approached to complete the survey electronically or by mail. Outcomes included all-cause and HF-specific hospitalizations and all-cause death was ascertained via the electronic health record. RESULTS: Among 1212 survey respondents (32.5% of eligible patients) between May 18, 2020 and September 30, 2020, mean ± SD age was 77.9 ± 11.4 years, 50.1% were women, and median (25th-75th) left ventricular ejection fraction was 55% (40%-60%). Overall, 15.1% of respondents were food insecure, and only 65% of participants answered correctly more than half of the items assessing nutritional knowledge. Although most respondents were willing to participate in future research, that number largely declined for studies requiring blood draws (32.2%), study medication (14.4%), and/or behavior change (27.1%). Food security, diet quality, and nutritional knowledge were not independently associated with outcomes at 90 or 180 days. CONCLUSION: In a cohort of older adults with HF and multiple comorbidities, a significant proportion reported issues with food access, diet quality, and nutritional knowledge during the COVID-19 pandemic. Future research should evaluate interventions targeting these domains in at-risk individuals.

Kolaviron pre-treatment suppresses 7, 12 dimethylbenzanthracene-induced alterations in estrogen receptor-α, CYP 1A1, oxidative stress and inflammation in female Wistar rats.

Due to the need to develop locally available, cheaper, and efficacious treatment regimens for breast cancer, the chemopreventive effect of kolaviron (KV), an extract of Garcinia kola seeds was examined. Fifty (50) female Wistar rats (120-180 g) were assigned to five groups (control group, 7, 12 dimethylbenzanthracene [DMBA] groups, tamoxifen group) of 10 rats each. They were pre-treated with KV thrice a week for four weeks except control. Estrogen receptor-α (ER-α) levels were determined in the pre-treated rats before induction of mammary carcinogenesis. After the four weeks pre-treatment period, 80 mg/kg of DMBA was used for induction. A hundred and fifty (150) days after induction, the rats were sacrificed humanely. Significantly higher levels of ER-α, formation of lobular neoplastic cells, epithelial hyperplasia, lymphocyte infiltration, increased cytokines (interleukin-6 [IL-6] and tumor necrosis factor-α [TNF-α]), CYP1A1 activity and malondialdehyde (MDA) with a corresponding decrease in superoxide dismutase (SOD), catalase and glutathione peroxidase were observed in DMBA-induced rats. Pre-treatment with KV at 200 mg/kg body weight significantly (p < .05) decreased ER-α levels by 19.01% and 37.52%, [IL-6] by 36.37% and 20.55%, TNF-α by 42.2% and 12.33% in serum and mammary tissue respectively. Also, a significant (p < .05) decrease in serum CYP1A1 activity, MDA with concomitant increase in SOD, catalase and glutathione peroxidase activities were observed in serum and mammary tissue respectively. Collectively, the results suggest that KV could be further explored in targeting chemoprevention of DMBA-induced mammary damage. PRACTICAL APPLICATIONS: Garcinia kola is widely cultivated in West and Central Africa with kolaviron (KV) as its major constituents. The seeds which have a bitter astringent taste are widely consumed by people in the region. Locals claim that consumption of the seeds provides relief for the management of several ailments including cancer. However, scientific investigations that provide a basis for these claims are still needed. This study provides evidence that points to the ameliorative potential of KV on breast cancer model. The results will be beneficial to local communities who hitherto had no knowledge on the potential of G. kola in chemoprevention. The results from this study will also attract further research attention from the international scientific community to examine the anti-cancer benefits of G. kola. This will also be beneficial to the global community due to the increasing number of breast cancer cases recorded annually.

Factors Determining Consumer Acceptance of Biofortified Food: Case of Zinc-Fortified Wheat in Pakistan's Punjab Province.

Zinc (Zn) is a fundamental micronutrient required by all living organisms. Zn deficiency among children under 5 years, pregnant, and child-bearing women has been identified in developing countries such as Pakistan. Biofortified crops can increase micronutrient levels and decrease deficiencies. Meanwhile, consumer acceptance is essential, given that genetic alterations can occur during biofortification, resulting in changes in sensory traits and the quality of grains. Therefore, the present study focuses on the determining factors for consumer acceptance of Zn-biofortified wheat., an experimental survey was conducted to achieve the study's objectives. Qualitative and quantitative data were collected and analyzed from 203 respondents in the Punjab province. The results regarding sensory perceptions revealed that people attached great importance to the appearance of the chapati prepared with Zn-biofortified wheat. Therefore, they were willing to purchase Zn-biofortified wheat when asked to choose between the conventional wheat and the Zn-biofortified wheat. Moreover, the probit model illustrates that the level of education in the family and having young children aged under 5 years in the household positively impacted the acceptance of Zn-biofortified wheat among the participants. The findings suggest that there is significant scope for promoting Zn-biofortified wheat in the country. It is also imperative to ensure its availability across various regions so that households with weak purchasing power can buy and address their Zn deficiency. Furthermore, policymakers could introduce reforms targeting business communities for food management, keeping Zn-biofortified wheat in the priority stream.

Rationale and design of the pragmatic randomized trial of icosapent ethyl for high cardiovascular risk adults (MITIGATE).

OBJECTIVE: The MITIGATE study aims to evaluate the real-world clinical effectiveness of pre-treatment with icosapent ethyl (IPE), compared with usual care, on laboratory-confirmed viral upper respiratory infection (URI)-related morbidity and mortality in adults with established atherosclerotic cardiovascular disease (ASCVD). BACKGROUND: IPE is a highly purified and stable omega-3 fatty acid prescription medication that is approved for cardiovascular risk reduction in high-risk adults on statin therapy with elevated triglycerides. Preclinical data and clinical observations suggest that IPE may have pleiotropic effects including antiviral and anti-inflammatory properties that may prevent or reduce the downstream sequelae and cardiopulmonary consequences of viral URIs. METHODS: MITIGATE is a virtual, electronic health record-based, open-label, randomized, pragmatic clinical trial enrolling ∼16,500 participants within Kaiser Permanente Northern California - a fully integrated and learning health care delivery system with 21 hospitals and >255 ambulatory clinics serving ∼4.5 million members. Adults ≥50 years with established ASCVD and no prior history of coronavirus disease 2019 (COVID-19) will be prospectively identified and pre-randomized in a 1:10 allocation ratio (∼ 1,500 IPE: ∼15,000 usual care) stratified by age and previous respiratory health status to the intervention (IPE 2 grams by mouth twice daily with meals) vs the control group (usual care) for a minimum follow-up duration of 6 months. The co-primary endpoints are moderate-to-severe laboratory-confirmed viral URI and worst clinical status due to a viral URI at any point in time. CONCLUSION: The MITIGATE study will inform clinical practice by providing evidence on the real-world clinical effectiveness of pretreatment with IPE to prevent and/or reduce the sequelae of laboratory-confirmed viral URIs in a high-risk cohort of patients with established ASCVD.

Assessment of occupational violence towards pharmacists at practice settings in Nigeria

BACKGROUND: Occupational Violence is prevalent among healthcare workers, including pharmacists, and poses a big threat to their job satisfaction, safety, and social wellbeing. OBJECTIVE: This study seeks to assess the incidents and factors associated with occupational violence towards pharmacists in Nigeria. METHODS: A cross-sectional study was conducted among pharmacists practicing in Nigeria, using an online survey (Google FormTM). Occupational violence was assessed using a validated questionnaire. The survey was conducted and reported based on the Checklist for Reporting Results of Internet E-Surveys (CHERRIES). Participants were recruited by sharing the survey link via social media platforms including WhatsApp, Facebook, LinkedIn, and Twitter. RESULTS: A total of 263 respondents returned the online questionnaire, with a completion rate of 99.2%. The prevalence of occupational violence was 92.7% (95% CI, 90 to 96). Violent events occurred among 48.7% of pharmacists with at least six years of experience, and 68.4% of hospital pharmacists. The commonly reported factors associated with the violence include long waiting times in the pharmacy (36.5%), refusal to fulfil aggressor's demands (22.1%), and counseling/poor communication (21.7%). Events related to verbal abuse were reported among 95% of the participants. The prevalence of violence was significantly higher among hospital pharmacists, compared with those practicing in administration/regulatory, and in community pharmacies (chi-square=10.213 (2); p = 0.006). Similarly, physical aggression was higher among hospital pharmacists (chi-square=10.646 (2), p = 0.005). CONCLUSIONS: The prevalence of occupational violence towards pharmacists practicing in Nigeria appeared to be high. Major factors associated with the violence were refusal to fulfil aggressors' demands and frustrations due to long waiting times at pharmacy. Recommended strategies to slowdown the incidences of violence were improved pharmacists' workforce, interprofessional harmony, and penalties against perpetrators

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Assessment of occupational violence towards pharmacists at practice settings in Nigeria.

BACKGROUND: Occupational Violence is prevalent among healthcare workers, including pharmacists, and poses a big threat to their job satisfaction, safety, and social wellbeing. OBJECTIVE: This study seeks to assess the incidents and factors associated with occupational violence towards pharmacists in Nigeria. METHODS: A cross-sectional study was conducted among pharmacists practicing in Nigeria, using an online survey (Google Form™). Occupational violence was assessed using a validated questionnaire. The survey was conducted and reported based on the Checklist for Reporting Results of Internet E-Surveys (CHERRIES). Participants were recruited by sharing the survey link via social media platforms including WhatsApp, Facebook, LinkedIn, and Twitter. RESULTS: A total of 263 respondents returned the online questionnaire, with a completion rate of 99.2%. The prevalence of occupational violence was 92.7% (95% CI, 90 to 96). Violent events occurred among 48.7% of pharmacists with at least six years of experience, and 68.4% of hospital pharmacists. The commonly reported factors associated with the violence include long waiting times in the pharmacy (36.5%), refusal to fulfil aggressor's demands (22.1%), and counseling/poor communication (21.7%). Events related to verbal abuse were reported among 95% of the participants. The prevalence of violence was significantly higher among hospital pharmacists, compared with those practicing in administration/regulatory, and in community pharmacies (chi-square=10.213 (2); p=0.006). Similarly, physical aggression was higher among hospital pharmacists (chi-square=10.646 (2), p = 0.005). CONCLUSIONS: The prevalence of occupational violence towards pharmacists practicing in Nigeria appeared to be high. Major factors associated with the violence were refusal to fulfil aggressors' demands and frustrations due to long waiting times at pharmacy. Recommended strategies to slowdown the incidences of violence were improved pharmacists' workforce, interprofessional harmony, and penalties against perpetrators.

Baseline Functional Capacity and Transcatheter Mitral Valve Repair in Heart Failure With Secondary Mitral Regurgitation.

OBJECTIVES: The aim of this study was to determine the prognostic utility of baseline functional status and its impact on the outcomes of transcatheter mitral valve repair (TMVr) in patients with heart failure (HF) with secondary mitral regurgitation (SMR). BACKGROUND: The COAPT (Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart Failure Patients With Functional Mitral Regurgitation) trial demonstrated that TMVr with the MitraClip in patients with HF with moderate to severe or severe SMR improved health-related quality of life. The clinical utility of a baseline assessment of functional status for evaluating prognosis and identifying candidates likely to derive a robust benefit from TMVr has not been previously studied in patients with HF with SMR. METHODS: The COAPT study was a multicenter, randomized, controlled, parallel-group, open-label trial of TMVr with the MitraClip plus guideline-directed medical therapy (GDMT) versus GDMT alone in patients with HF, left ventricular ejection fraction 20% to 50%, and moderate to severe or severe SMR. Baseline functional status was assessed by 6-min walk distance (6MWD). RESULTS: Patients with 6MWD less than the median (240 m) were older, were more likely to be female, and had more comorbidities. After multivariate modeling, age (p = 0.005), baseline hemoglobin (p = 0.007), and New York Heart Association functional class III/IV symptoms (p < 0.0001) were independent clinical predictors of 6MWD. Patients with 6MWD <240 m versus ≥240 m had a higher unadjusted and adjusted rate of the 2-year composite of all-cause death or HF hospitalization (64.4% vs. 48.6%; adjusted hazard ratio: 1.53; 95% confidence interval: 1.19 to 1.98; p = 0.001). However, there was no interaction between baseline 6MWD and the relative effectiveness of TMVr plus GDMT versus GDMT alone with respect to the composite endpoint (p = 0.633). CONCLUSIONS: Baseline assessment of functional capacity by 6MWD was a powerful discriminator of prognosis in patients with HF with SMR. TMVr with the MitraClip provided substantial improvements in clinical outcomes for this population irrespective of baseline functional capacity.

Novel anti-tumour necrosis factor receptor-1 (TNFR1) domain antibody prevents pulmonary inflammation in experimental acute lung injury.

BACKGROUND: Tumour necrosis factor alpha (TNF-α) is a pleiotropic cytokine with both injurious and protective functions, which are thought to diverge at the level of its two cell surface receptors, TNFR1 and TNFR2. In the setting of acute injury, selective inhibition of TNFR1 is predicted to attenuate the cell death and inflammation associated with TNF-α, while sparing or potentiating the protective effects of TNFR2 signalling. We developed a potent and selective antagonist of TNFR1 (GSK1995057) using a novel domain antibody (dAb) therapeutic and assessed its efficacy in vitro, in vivo and in a clinical trial involving healthy human subjects. METHODS: We investigated the in vitro effects of GSK1995057 on human pulmonary microvascular endothelial cells (HMVEC-L) and then assessed the effects of pretreatment with nebulised GSK1995057 in a non-human primate model of acute lung injury. We then tested translation to humans by investigating the effects of a single nebulised dose of GSK1995057 in healthy humans (n=37) in a randomised controlled clinical trial in which subjects were subsequently exposed to inhaled endotoxin. RESULTS: Selective inhibition of TNFR1 signalling potently inhibited cytokine and neutrophil adhesion molecule expression in activated HMVEC-L monolayers in vitro (P<0.01 and P<0.001, respectively), and also significantly attenuated inflammation and signs of lung injury in non-human primates (P<0.01 in all cases). In a randomised, placebo-controlled trial of nebulised GSK1995057 in 37 healthy humans challenged with a low dose of inhaled endotoxin, treatment with GSK1995057 attenuated pulmonary neutrophilia, inflammatory cytokine release (P<0.01 in all cases) and signs of endothelial injury (P<0.05) in bronchoalveolar lavage and serum samples. CONCLUSION: These data support the potential for pulmonary delivery of a selective TNFR1 dAb as a novel therapeutic approach for the prevention of acute respiratory distress syndrome. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov NCT01587807.

Wear behavior of Al-7%Si-0.3%Mg/melon shell ash particulate composites.

The present study examined wear characteristics of A356/melon shell ash particulate composites. Dry-sliding the stainless steel ball against specimen disc revealed the abrasive wear behavior of the composites under loads of 2 and 5N. The composite showed lower wear rate of 2.182 × 10-4 mm3/Nm at 20 wt% reinforced material under load of 5N. Results showed that wear rate decreased significantly with increasing weight percentage of melon shell ash particles. Microstructural analyses of worn surfaces of the composites reveal evidence of plastic deformation of matrix phase. The wear resistance of A356 increased considerably with percentage reinforcement. In other words, the abrasive mass loss decreased with increasing percentage of reinforcement addition at the both applied loads. The control sample suffered a highest mass loss at 5 N applied load.

Sleep Pattern and Sleep Hygiene Practices among Nigerian Schooling Adolescents.

BACKGROUND: Sleep problems, especially in the adolescent stage of development, may be associated with excessive daytime sleepiness, impaired neurocognitive function, and a host of others leading to suboptimal performance. OBJECTIVES: To determine the pattern of sleep problems in school-going adolescents based on the bedtime problems; excessive daytime sleepiness; awakenings during the night and problems falling back asleep; regularity and duration of sleep; sleep-disordered breathing (BEARS) sleep screening algorithm. MATERIALS AND METHODS: This is a cross-sectional descriptive study involving 353 secondary school-going adolescents in Kano metropolis. Subjects were selected for the study using multistage sampling technique. The study lasted from March 2015 to July 2015. Sleep problems were screened for using the BEARS sleep screening algorithm. Tables were used to present the qualitative data. The various BEARS sleep patterns were assessed, and comparison between stages of adolescence was done using Chi-square test (and Fisher's exact test where necessary). A significant association was considered at P < 0.05. RESULTS: Of the 353 adolescents studied, 61.8% were males while 38.2% were females with male, female ratio of 1.6:1. Early, middle, and late adolescents constituted 13.9%, 39.9%, 46.2% respectively. BEARS sleep screening revealed awakenings during the night (34.6%) as the most common sleep-related problem reported, and this was followed by excessive daytime sleepiness (21.0%). Age-group dependent sleep duration was 7.19 ± 1.26, 7.13 ± 1.13, 7.16 ± 1.28, with P > 0.05. Although 62.9% of all the adolescents watched TV/play video games until 1 h before going to bed and this was highest in late adolescence, it was not statistically significantly associated with any of the sleep problems. CONCLUSION: Both the quality and quantity of sleep in Nigerian adolescents in Kano is suboptimal. Adolescent and sleep medicine should receive more attention in our environment.

Characterisation of eppin function: expression and activity in the lung.

Eppin is a serine protease inhibitor expressed in male reproductive tissues.The aim of this study was to investigate the localisation and regulation of eppin expression in myeloid and epithelial cell lines, and explore its potential role as a multifunctional host defence protein.Using immunohistochemistry and Western blotting, eppin was detected in the lungs of patients with acute respiratory distress syndrome and cystic fibrosis lung disease. Expression of eppin in monocytic cells was unaffected by stimulation with Toll-like receptor agonists, cytokines and hormone receptor agonists. However, upregulated expression and secretion of eppin was observed following treatment of monocytes with epidermal growth factor. Incubation of recombinant eppin with monocytic cells resulted in significant inhibition of lipopolysaccharide-induced chemokine production. Furthermore, eppin inhibited lipopolysaccharide-induced NF-κB activation by a mechanism which involved accumulation of phosphorylated IκBα. In an in vivo model of lung inflammation induced by lipopolysaccharide, eppin administration resulted in decreased recruitment of neutrophils to the lung with a concomitant reduction in the levels of the neutrophil chemokine macrophage inflammatory protein-2.Overall, these results suggest a role for eppin outside of the reproductive tract and that eppin may have a role in the innate immune response in the lung.

Effect of Insulin on Visuo-Spatial Memory and Histology of Cerebral Cortex in the Presence or Absence of Nitric Oxide Inhibition.

Insulin has emerged from its traditional 'peripheral' glucose-lowering function to become increasingly regarded as a brain hormone that controls a wide range of functions including learning and memory. Insulin action on learning and memory is linked to nitric oxide (NO) signalling, but its effects on memory and histology of cerebral cortex in conditions of varied NO availability is unclear. This research sought to determine the effect of insulin on visuo-spatial learning, memory and histology of cerebral cortex during NO deficiency. Twenty-four mice weighing 21-23 g, were divided into four groups (n = 6) and treated daily for seven days with 0.2 ml distilled water subcutaneously (s.c.) (control), 10 I.U/kg insulin s.c., 10 I.U/kg insulin + 50 mg/kg L-NAME intraperitoneally (i.p.), and 50 mg/kg i.p. L-NAME s.c., respectively. The 3-day MWM paradigm was used to assess memory. Brain tissue was examined for histological changes. There was no significant difference between day 1 and day 2 latencies for all the groups. The mice in all (but L-NAME) groups spent more time in the target quadrant, and the difference was significant within but not between groups. There was significant reduction in number of platform site crossings (4.83 ± 0.5, 0.67 ± 0.3, 0.50 ± 0.3 and 0.50 ± 0.3 for control, insulin, insulin+L-NAME and L-NAME groups, respectively) in all the groups compared to control. Normal histology of the cortex and absence of histological lesions were observed in brain slides of control and treatment groups. It was concluded that insulin administration impairs visuo-spatial memory to a greater extent in the presence of NO block, and to a lesser extent in the absence of NO block. Nitric oxide has a role in insulin-induced memory impairment. Insulin administration in the presence or absence of NO block had no effect on histology of cortex.

Validation of a Yoruba version of the arthritis self-efficacy scale.

BACKGROUND: The Arthritis Self Efficacy Scale (ASES) measures a patient's perceived efficacy to cope with the consequences of chronic arthritis. The aim of this, study was to translate ASES in to Yoruba, one of the indigenous Nigerian languages, and to investigate the validity and reliability of the translated version. METHODS: Forty one (21 males; 20 females).patients diagnosed with arthritis participated in this cross sectional survey, although only thirty seven (87.8%) were available for the reliability study. The ASES was translated to Yoruba language using forward-backward translations. Participants completed both English and Yoruba version of ASES on the first day while the second administration of the two versions of ASES was.. completed at one week after the first administrations. Data was analyzed -using descriptive statistics, Spearman correlation and intra-class correlation (at p=0.05). RESULTS: There was a significant direct correlation (p<0.0001) between the scores obtained on the English and Yoruba versions (r=0.933). Also there was a significant direct correlation (p<0.0001) between the scores obtained on the first and second administrations of the English and Yoruba version of the ASES. CONCLUSION: The Yoruba version of the ASES is a valid and reliable outcome measure for health outcomes assessment in Yoruba-speaking populations.

Aspirin therapy in patients with acute respiratory distress syndrome (ARDS) is associated with reduced intensive care unit mortality: a prospective analysis.

INTRODUCTION: Acute respiratory distress syndrome (ARDS) is a common clinical syndrome with high mortality and long-term morbidity. To date there is no effective pharmacological therapy. Aspirin therapy has recently been shown to reduce the risk of developing ARDS, but the effect of aspirin on established ARDS is unknown. METHODS: In a single large regional medical and surgical ICU between December 2010 and July 2012, all patients with ARDS were prospectively identified and demographic, clinical, and laboratory variables were recorded retrospectively. Aspirin usage, both pre-hospital and during intensive care unit (ICU) stay, was included. The primary outcome was ICU mortality. We used univariate and multivariate logistic regression analyses to assess the impact of these variables on ICU mortality. RESULTS: In total, 202 patients with ARDS were included; 56 (28%) of these received aspirin either pre-hospital, in the ICU, or both. Using multivariate logistic regression analysis, aspirin therapy, given either before or during hospital stay, was associated with a reduction in ICU mortality (odds ratio (OR) 0.38 (0.15 to 0.96) P = 0.04). Additional factors that predicted ICU mortality for patients with ARDS were vasopressor use (OR 2.09 (1.05 to 4.18) P = 0.04) and APACHE II score (OR 1.07 (1.02 to 1.13) P = 0.01). There was no effect upon ICU length of stay or hospital mortality. CONCLUSION: Aspirin therapy was associated with a reduced risk of ICU mortality. These data are the first to demonstrate a potential protective role for aspirin in patients with ARDS. Clinical trials to evaluate the role of aspirin as a pharmacological intervention for ARDS are needed.

Cytotoxicity of hemostatic agents on the human gingival fibroblast.

BACKGROUND: Achieving of moisture control especially gingival bleeding control is great challenge in clinical practice. Various hemostatic agents and techniques have been promoted for bleeding control during dental operation. But few studies have focused on the cytotoxicity of hemostatic solutions. AIM: The aim of this study was to evaluate cytotoxic effect of hemostatic agents on human gingival fibroblast cells by using real-time cell analysis method. MATERIALS AND METHODS: Two hemostatic solutions, Hemoban (Sultan Healthcare, Hackensack, NJ, USA) and Hemasatic Solutions (W.P. Dental, Hamburg, Germany) that includes mainly aluminum chloride were used with different concentration. Gingival fibroblasts were isolated from gingival connective tissue during crown lengthening surgery of systemically healthy subjects. Gingival fibroblasts were maintained with Dulbecco's modified eagle medium containing 10% fetal bovine serum. A real-time cell analyzer (RT-CES, xCELLigence; Roche Applied Science, Mannheim, Germany, and ACEA Biosciences, San Diego, CA, USA) was used to evaluate cell survival. After seeding 200 mL of the cell suspensions into the wells (10,000 cells/well) of the E-plate 96, gingival fibroblasts were treated with hemostatic solutions (1/2, 1/4 and 1/8 dilutions) and monitored every 15 minutes for 72 hours. For the proliferation experiments, the statistical analyses used were 1-way analysis of variance (ANOVA) and Tukey HSD multiple comparisons tests. RESULTS: According to statistically analysis, when evaluated at 48 and 72 hours, there were significant differences between the cell indexes of the control and all hemostatic agents groups (p < 0.001). Agent reduced cell index value significantly when compared to untreated control group. CONCLUSIONS: The results indicate that using of Hemoban or Hemostatic Solutions as astringent solutions have a significant cytotoxic effect on gingival fibroblast cells.

Effects of vitamin E administration on Plasmodium berghei induced pathological changes and oxidative stress in mice.

The effects of daily intraperitoneal doses of 1000 i.u/kg body weight of vitamin E on the course of Plasmodium berghei NK 65 infection and the parasite-induced anemia as well as alterations in the relative weight of some selected organs and antioxidant status in mice were investigated. The number of parasitized red cells were not initially affected by the vitamin administration but were persistently lowered after 11th day post infection to the termination of the experiment. The P. berghei infection was found to induce anemia, significantly (P<0.05) increased the relative weight of liver, spleen and kidney but significantly decreased (P<0.05) the relative brain weight. However, all the parasite-induced changes in these parameters were significantly (P<0.05) ameliorated by the vitamin administration. Furthermore, malonydialdehyde concentration in the serum, liver and brain of infected animals was significantly (P<0.05) increased whereas superoxide dismutase and catalase activities were significantly (P<0.05) decreased by the infection. But vitamin E administration was found to, a significant degree (P<0.05), reversed the disease-induced alterations in these oxidative stress markers. It was concluded that vitamin E at the dose and route used prevented P. berghei induced anemia as well as alterations in relative organ weight and antioxidant status in mice.

Effects of vitamin E administration on Plasmodium berghei induced pathological changes and oxidative stress in mice

Abstract. The effects of daily intraperitoneal doses of 1000 i.u/kg body weight of vitamin E on the course of Plasmodium berghei NK 65 infection and the parasite-induced anemia as well as alterations in the relative weight of some selected organs and antioxidant status in mice were investigated. The number of parasitized red cells were not initially affected by the vitamin administration but were persistently lowered after 11th day post infection to the termination of the experiment. The P. berghei infection was found to induce anemia, significantly (P<0.05) increased the relative weight of liver, spleen and kidney but significantly decreased (P<0.05) the relative brain weight. However, all the parasite-induced changes in these parameters were significantly (P<0.05) ameliorated by the vitamin administration. Furthermore, malonydialdehyde concentration in the serum, liver and brain of infected animals was significantly (P<0.05) increased whereas superoxide dismutase and catalase activities were significantly (P<0.05) decreased by the infection. But vitamin E administration was found to, a significant degree (P<0.05), reversed the disease-induced alterations in these oxidative stress markers. It was concluded that vitamin E at the dose and route used prevented P. berghei induced anemia as well as alterations in relative organ weight and antioxidant status in mice

Compton suppression method and epithermal NAA in the determination of nutrients and heavy metals in Nigerian food and beverages.

We used in this study Compton suppression method and epithermal neutron activation analysis to determine the concentration of nutrients and heavy metals in Nigerian food and beverages. The work was performed at the University of Texas TRIGA Reactor by short, medium, and long irradiation protocols, using thermal flux of 1.4x10(12)n cm(-2)s(-1) and epithermal flux of 1.4x10(11)n cm(-2)s(-1). Application of Compton suppression method has reduced interferences from Compton scattered photons thereby allowing easy evaluation of Na, Cl, Ca, Cu, Mn, Mg, Co, Cr, Rb, Fe, and Se. The epithermal NAA method has enabled determination of Cd, As, Ba, Sr, Br, I, and V with little turn-around time. Quality Control and Quality Assurance of the method was tested by analyzing four Standard Reference Materials (non-fat powdered milk, apple leaves, citrus leaves, and peach leaves) obtained from National Institute for Standards and Technology. Our results show that sorghum, millet, and maize have high values of Zn, Mn, Fe, low values of Cd, As, and Se. Powdered milks, rice, beans, and soybeans were found to have moderate amounts of all the elements. Tobacco recorded high content of Cd, Mn, and As, whereas tea, tsobo leaves, Baobab leaves, and okro seed have more As values than others. However, biscuits, macaroni, spaghetti, and noodles show lower concentrations of all the elements. The distribution of these nutrients and heavy metals in these food and beverages shows the need to fortify biscuits and pastas with micro and macro-nutrients and reduce the use of tobacco, tea, tsobo leaves, Baobab leaves, and Okro seed to avoid intake of heavy elements.