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1.
Artigo em Inglês | MEDLINE | ID: mdl-38959160

RESUMO

Introduction: Surgical site infection (SSI) is a substantial cause of peri-operative morbidity among patients undergoing radical cystectomy (RC). The purpose of this study was to identify the risk factors of SSI after RC and to classify and characterize treatment of SSIs. Methods: We retrospectively analyzed peri-operative characteristics and SSI, for patients undergoing RC from 2007 to 2022. Patients were stratified by SSI versus no SSI and differences were assessed. Uni-variable/multi-variable logistic regression analyses were performed to identify factors associated with SSI. SSIs were categorized by the Centers for Disease Control and Prevention (CDC) type: Superficial incisional, deep incisional, and organ/space confined. Results: Three hundred and ninety-eight patients had RC, 279 open, and 119 robotic; 78 (19.6%) developed SSI. Cohorts were similar demographically. Length of stay (LOS) was longer in the SSI cohort (8.8 d versus 12.4 d, p < 0.001), and body mass index (BMI) was greater in patients with SSI (24.34 vs. 25.39, p = 0.0003). On uni-variable analysis, age, gender, Charlson Comorbidity Index, diabetes mellitus, diversion, odds ratio (OR) time, blood loss, and open versus robotic technique were not substantial SSI predictors. BMI was an independent risk factor for SSI on both uni-variable (OR: 1.07, 95% confidence interval [CI]: 1.018-1.115, p = 0.0061) and multi-variable analysis (OR: 1.06, 95% CI: 1.009-1.109, p = 0.02) for 10 (12.8%) and 24 (30.8%) superficial and deep-incisional SSIs, respectively. Superficial wound SSI was treated conservatively with 60% receiving antibiotic agents and no procedural intervention. Deep SSIs received antibiotic agents and 50% required surgical intervention. There were 44 (56.4%) organ/space SSIs, and the most common treatment was antibiotic agents (100%) and IR drain placement (30, 68.2%). Conclusion: In patients undergoing RC, BMI was an independent risk factor for SSI. Type of the surgical procedure, robotic versus open, was not predictive of SSI. LOS was longer for patients with SSI. SSI was managed differently depending on CDC classification.

2.
Glob Health Action ; 17(1): 2375829, 2024 Dec 31.
Artigo em Inglês | MEDLINE | ID: mdl-38979658

RESUMO

BACKGROUND: Chewing betel quid (BQ) - a preparation commonly containing areca nut and slaked lime wrapped in betel leaf - is entrenched in South Asia. Although BQ consumption during pregnancy has been linked to adverse birth outcomes, its effect on postnatal growth remains largely unexplored. OBJECTIVE: We examined the associations of BQ use during pregnancy with children's height-for-age and body mass index-for-age z-scores (HAZ and BAZ, respectively) and fat and fat-free mass along with sex-based differences in association in rural Bangladesh. METHODS: With a prospective cohort design, we assessed BQ use among mothers enrolled in the Preterm and Stillbirth Study, Matlab (n = 3140) with a structured questionnaire around early third trimester. Children born to a subset of 614 women (including 134 daily users) were invited to follow-up between October 2021 and January 2022. HAZ and BAZ were calculated from anthropometric assessment, and fat and fat-free mass were estimated using bioelectric impedance. Overall and sex-specific multiple linear regression models were fitted. RESULTS: Growth data were available for 501 children (mean age 4.9 years): 43.3% of them were born to non-users, 35.3% to those using prior to or less-than-daily during the survey, and 21.3% to daily users. No statistically significant associations were observed after adjusting for sex, parity, maternal height and education, and household wealth. CONCLUSIONS: There was no effect of BQ use during pregnancy on postnatal growth in this study. Longitudinal studies following up those born to heavy users beyond childhood are warranted for capturing long-term implications of prenatal BQ exposure.


Main findings: In this cohort study, no association was observed between maternal betel quid use during pregnancy and children's growth around five years of age.Added knowledge: Although catch-up growth among those born to heavy users may have attenuated any negative impact of prenatal exposure to betel quid on postnatal growth, such catch-up growth often involves greater acquisition and a more centralized distribution of body fat and insulin resistance later in life; leading to a potential heightening of cardiometabolic risk.Global health impact for policy and action: Given that betel quid consumption during pregnancy remains socially acceptable across south and south-east Asia, this study highlights the need for following up those born to betel quid users beyond childhood for capturing long-term health implications of prenatal betel quid exposure.


Assuntos
Areca , Desenvolvimento Infantil , População Rural , Humanos , Feminino , Bangladesh/epidemiologia , Gravidez , Areca/efeitos adversos , Estudos Prospectivos , Pré-Escolar , Desenvolvimento Infantil/efeitos dos fármacos , Adulto , Masculino , Efeitos Tardios da Exposição Pré-Natal/epidemiologia , Índice de Massa Corporal
3.
MethodsX ; 12: 102772, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38948243

RESUMO

Lead (Pb) is a neurotoxin, and children are vulnerable due to their evolving physiology and high-risk behaviours. Soil remediation interventions have proven effective in reducing Pb exposure. The primary objective is to measure the effectiveness of soil remediation at abandoned used lead acid battery (ULAB) recycling sites, nearby household cleaning, and community awareness in reducing blood lead levels (BLLs) in children. Additionally, this study aims to examine associations of Pb exposure with hematological, cardiovascular, renal, immunological, and endocrinological parameters in children aged 0-12 years. This study employs a quasi-experimental design, with abandoned ULAB sites as intervention sites and two control sites in Bangladesh. The intervention includes soil remediation coupled with community education. Data will be collected prior to the intervention and at a 12-month follow-up, including a comprehensive Pb exposure survey and collect environmental, turmeric samples, and blood from the child. Pb concentrations in environmental samples and turmeric samples will be determined using XRF analyser. Child BLL will be measured using Graphite Furnace Atomic Absorption Spectrometry (GF-AAS) and proposed biochemical parameters will be analysed using routine laboratory methods. This study could provide valuable insights for designing targeted interventions in similar settings and mitigating exposure to Pb.

4.
PLoS Comput Biol ; 20(6): e1012215, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38857308

RESUMO

New sublineages of SARS-CoV-2 variants-of-concern (VOCs) continuously emerge with mutations in the spike glycoprotein. In most cases, the sublineage-defining mutations vary between the VOCs. It is unclear whether these differences reflect lineage-specific likelihoods for mutations at each spike position or the stochastic nature of their appearance. Here we show that SARS-CoV-2 lineages have distinct evolutionary spaces (a probabilistic definition of the sequence states that can be occupied by expanding virus subpopulations). This space can be accurately inferred from the patterns of amino acid variability at the whole-protein level. Robust networks of co-variable sites identify the highest-likelihood mutations in new VOC sublineages and predict remarkably well the emergence of subvariants with resistance mutations to COVID-19 therapeutics. Our studies reveal the contribution of low frequency variant patterns at heterologous sites across the protein to accurate prediction of the changes at each position of interest.


Assuntos
COVID-19 , Farmacorresistência Viral , Evolução Molecular , Mutação , SARS-CoV-2 , Glicoproteína da Espícula de Coronavírus , SARS-CoV-2/genética , Humanos , Glicoproteína da Espícula de Coronavírus/genética , Glicoproteína da Espícula de Coronavírus/química , COVID-19/virologia , COVID-19/genética , Farmacorresistência Viral/genética , Biologia Computacional/métodos , Tratamento Farmacológico da COVID-19 , Antivirais/uso terapêutico
6.
Arch Dermatol Res ; 316(6): 334, 2024 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-38844710

RESUMO

Pityriasis rubra pilaris (PRP) is a rare and chronic inflammatory dermatologic condition characterized by hyperkeratotic salmon-colored plaques and palmoplantar keratoderma. Traditional therapeutic modalities have shown limited efficacy and often entail potential adverse effects, highlighting the need for alternative treatment options. Our review aims to summarize the current evidence on the off-label use of IL-23 inhibitors, risankizumab and guselkumab, in the treatment of PRP. These biologic agents have been approved for psoriasis, and their potential role in managing PRP has recently garnered interest. We conducted a comprehensive literature search on PubMed and Scopus databases, identifying relevant studies published in English up to June 2023 following PRISMA guidelines. A total of 10 studies were selected for data extraction and review. Results from the selected studies demonstrated encouraging outcomes with both risankizumab and guselkumab in managing PRP. Among 11 patients treated with risankizumab, 10 showed notable improvements in various disease manifestations, including pruritus, erythema, and affected body surface area. DLQI scores and BSA percentages reported a significant improvement before and after risankizumab treatment (p = 0.0322; p = 0.0216). However, two cases also reported symptom aggravation or even disease worsening. Patients treated with guselkumab exhibited ultimate improvement in all five cases, with complete clearance in three out of five cases. DLQI and BSA percentages also reported significant improvement with treatment with guselkumab (p = 0.0172; p < 0.0001). While most cases demonstrated positive outcomes, there were isolated instances of worsening symptoms, emphasizing the need for caution and further investigation. Further research with larger sample sizes and longer follow-up periods is necessary to establish the efficacy, optimal dosing, and long-term safety of risankizumab and guselkumab in treating PRP. Overall, we provide valuable insights into the potential use of IL-23 inhibitors, risankizumab, and guselkumab, as promising treatment options for PRP. These biologics have shown efficacy in improving symptoms in treatment-resistant cases, offering new avenues for clinicians to explore in the treatment of PRP.


Assuntos
Anticorpos Monoclonais Humanizados , Pitiríase Rubra Pilar , Humanos , Anticorpos Monoclonais/uso terapêutico , Anticorpos Monoclonais/efeitos adversos , Anticorpos Monoclonais Humanizados/uso terapêutico , Anticorpos Monoclonais Humanizados/efeitos adversos , Anticorpos Monoclonais Humanizados/administração & dosagem , Fármacos Dermatológicos/uso terapêutico , Fármacos Dermatológicos/efeitos adversos , Interleucina-23/antagonistas & inibidores , Interleucina-23/imunologia , Uso Off-Label , Pitiríase Rubra Pilar/tratamento farmacológico , Resultado do Tratamento
7.
Environ Int ; 189: 108798, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38875814

RESUMO

BACKGROUND: In experimental studies, several polycyclic aromatic hydrocarbons (PAHs) have shown endocrine disrupting properties, but very few epidemiological studies have examined their impact on pubertal development and results have been heterogenous. OBJECTIVE: To explore if maternal PAH exposure during pregnancy was associated with the offspring's timing of pubertal onset. METHODS: We studied 582 mother-daughter dyads originating from a population-based cohort in a rural setting in Bangladesh. Maternal urinary samples, collected in early pregnancy (on average, gestational week 8), were analyzed for monohydroxylated metabolites of phenanthrene (1-OH-Phe, Σ2-,3-OH-Phe, and 4-OH-Phe), fluorene (Σ2-,3-OH-Flu), and pyrene (1-OH-Pyr) using liquid chromatography with tandem mass spectrometry (LC-MS/MS). The girls were interviewed on two separate occasions concerning date of menarche, as well as breast and pubic hair development according to Tanner. Associations were assessed using Kaplan-Meier analysis and multivariable-adjusted Cox proportional hazards regression or ordered logistic regression. RESULTS: In early pregnancy, the mothers' median urinary concentrations of Σ1-,2-,3-,4-OH-Phe, Σ2-,3-OH-Flu, and 1-OH-Pyr were 3.25 ng/mL, 2.0 ng/mL, and 2.3 ng/mL respectively. At the second follow-up, 78 % of the girls had reached menarche, and the median age of menarche was 12.7 ± 0.81 years. Girls whose mothers belonged to the second and third quintiles of ΣOH-Phe metabolites had a higher rate of menarche, indicating a younger menarcheal age (HR 1.39; 95 % CI 1.04, 1.86, and HR 1.41; 95 % CI 1.05, 1.88, respectively), than girls of mothers in the lowest quintile. This trend was not observed in relation to either breast or pubic hair development. None of the other maternal urinary PAH metabolites or the sum of all thereof in early pregnancy were associated with age at menarche or pubertal stage. CONCLUSIONS: Indications of non-monotonic associations of prenatal phenanthrene exposure with the daughters' age of menarche were found, warranting further investigation.


Assuntos
Exposição Materna , Hidrocarbonetos Policíclicos Aromáticos , Efeitos Tardios da Exposição Pré-Natal , População Rural , Humanos , Feminino , Gravidez , Hidrocarbonetos Policíclicos Aromáticos/urina , Bangladesh , Exposição Materna/estatística & dados numéricos , Adulto , Adolescente , Puberdade , Criança , Estudos Longitudinais , Poluentes Ambientais/urina , Menarca , Estudos de Coortes , Adulto Jovem
8.
J Environ Manage ; 365: 121503, 2024 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-38908157

RESUMO

Investigating the complex interactions among physicochemical variables that influence the adsorptive removal of pollutants is a challenge for conventional one-variable-at-a-time (OVAT) batch methods. The adoption of machine learning-based chemometric prediction models is expected to be more accurate than the conventional method. This study proposed a novel modeling framework for predicting and optimizing the adsorptive removal of N-Nitrosodiphenylamine (NDPhA). Initially, models were trained by using OVAT data, with their hyperparameters subsequently fine-tuned through Bayesian optimization. In the second phase, the particle swarm optimization (PSO) technique was adopted to identify optimal parameters, specifically time, concentration, temperature, pH, and dose, to ensure the highest removal. The adopted analytical method enhances both prediction accuracy and removal efficiency. Utilizing OVAT data for NDPhA removal, the XGBoost regressor significantly outperformed other models. With a correlation coefficient of 0.9667 in the testing dataset, the XGBoost model exhibited its accuracy, emphasized by its low mean squared errors of 28.45 and mean absolute errors of 0.0982. Feature importance analysis consistently identified time and concentration as the most critical factors across all models.

9.
Arch Dermatol Res ; 316(7): 339, 2024 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-38847876

RESUMO

Itch is a common symptom of dermatologic diseases associated with significant impairment of health-related quality of life (QoL). This study reveals disparities in itch symptom experience and itch impact on QoL. A retrospective study of patient-reported outcome measure (PRO) data (ItchyQoL, Itch NRS, Pain Interference, Anxiety) for 387 outpatient dermatology visits to characterize the impact of itch on patients' QoL and itch symptom experience based on skin color in patients with dermatologic disease. Most patients were Caucasian females (67%) with mean age of 48 years. Correlative analyses showed mild itch associated with emotional impacts on QoL (p < 0.01), while severe itch associated with functional and emotional impacts on QoL (p < 0.01). African American (AA) patients reported more "severe-range" answers for 15 (68%) ItchyQoL items and had higher ItchyQoL mean scores (p = 0.001). ItchyQoL demonstrated an emotional impact on QoL by mild itch, but a functional and emotional impact on QoL by severe itch. Further, AAs suffered from greater itch-related impairment in QoL than Caucasian patients, especially due to scarring and sleeplessness.


Assuntos
Negro ou Afro-Americano , Medidas de Resultados Relatados pelo Paciente , Prurido , Qualidade de Vida , Índice de Gravidade de Doença , População Branca , Humanos , Prurido/psicologia , Prurido/diagnóstico , Prurido/etiologia , Feminino , Qualidade de Vida/psicologia , Pessoa de Meia-Idade , Masculino , Estudos Retrospectivos , Adulto , População Branca/psicologia , População Branca/estatística & dados numéricos , Negro ou Afro-Americano/psicologia , Negro ou Afro-Americano/estatística & dados numéricos , Dermatopatias/psicologia , Dermatopatias/diagnóstico , Idoso
10.
Crit Rev Food Sci Nutr ; : 1-11, 2024 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-38832654

RESUMO

Rheumatoid arthritis (RA) is a significant global health issue. Recent research highlights the gut microbiota's critical role in RA's development, noting how dietary factors can alter these microbial communities. This has led to an increased focus on how the gut microbiota (GM) influences RA and the potential for dietary ingredients to offer anti-RA benefits by modifying GM. This review presents a concise examination of the GM associated with RA, identifying specific microbial taxa at various levels that are implicated in the disease. It delves into dietary components known for their anti-RA properties through GM modulation and their mechanisms. Findings from numerous studies, including both animal and human research, show significant differences in the GM composition between individuals with early and established RA. Certain microbes like Tenericutes, Synergistetes, and Proteobacteria have been linked to RA progression, whereas Bacteroidetes and some strains of Lactobacillus are shown to have protective effects against RA. Dietary elements such as fibers, polysaccharides, resistant starch, and peptides have been identified as influential in combating RA. These components work by altering the GM's metabolites and impacting immune cells related to the GM. This review suggests the potential for developing functional foods aimed at treating RA by targeting GM.

11.
Artigo em Inglês | MEDLINE | ID: mdl-38771489

RESUMO

BACKGROUND: Little is known about the relationship of physical activity (PA) and fitness with cardiometabolic risk among rural adolescents in low- and middle-income countries. Thus, we examined the associations of PA and fitness with selected cardiometabolic indicators along with potential gender-based differences in a birth cohort of rural adolescents from southeast Bangladesh. METHODS: We utilized data from the 15-year follow-up of Maternal and Infant Nutrition Interventions in Matlab (MINIMat) cohort (n = 2253). Wrist-worn ActiGraph wGT3x-BT accelerometers were used to estimate sedentary time (ST) and PA. Fitness was assessed using: handgrip strength, standing long jump, and Chester Step Test. Anthropometric parameters, systolic blood pressure (SBP), and fasting lipid, insulin and glucose levels were measured. We calculated insulin resistance using the Homeostasis Model Assessment equation (HOMA-IR). Linear regression and isotemporal substitution models were fitted. RESULTS: The adolescents spent 64 min/day (inter-quartile range: 50-81) in moderate-to-vigorous physical activity (MVPA). A 10-minute-per-day higher vigorous PA (VPA) was associated with: 4.9% (95% confidence interval (CI): 2.9-6.8%) lower waist circumference (WC), 3.2 mmHg (95% CI: 1.5-4.8) lower SBP, 10.4% (95% CI: 2.9-17.3%) lower TG, and 24.4% (95% CI: 11.3-34.9%) lower HOMA-IR. MVPA showed similar associations of notably smaller magnitude. Except for WC, the associations were more pronounced among the boys. Substituting ST with VPA of equal duration was associated with lower WC, SBP, triglyceride and HOMA-IR. Grip strength was favorably associated with all indicators, displaying considerably large effect sizes. CONCLUSION: Our findings indicated beneficial roles of PA- particularly VPA- and muscular fitness in shaping cardiometabolic profile in mid-adolescence. VPA and grip strength may represent potential targets for preventive strategies tailored to adolescents in resource-limited settings.

12.
Surg Infect (Larchmt) ; 25(4): 272-290, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38700753

RESUMO

Background: Improvements in liver transplant (LT) outcomes are attributed to advances in surgical techniques, use of potent immunosuppressants, and rigorous pre-LT testing. Despite these improvements, post-LT infections remain the most common complication in this population. Bacteria constitute the most common infectious agents, while fungal and viral infections are also frequently encountered. Multi-drug-resistant bacterial infections develop because of polymicrobial overuse and prolonged hospital stays. Immediate post-LT infections are commonly caused by viruses. Conclusions: Appropriate vaccination, screening of both donor and recipients before LT and antiviral prophylaxis in high-risk individuals are recommended. Antimicrobial drug resistance is common in high-risk LT and associated with poor outcomes; epidemiology and management of these cases is discussed. Additionally, we also discuss the effect of coronavirus disease 2019 (COVID-19) infection and monkeypox in the LT population.


Assuntos
COVID-19 , Transplante de Fígado , Transplantados , Humanos , Infecções Bacterianas/epidemiologia , Infecções Bacterianas/tratamento farmacológico , Infecções Bacterianas/prevenção & controle , COVID-19/epidemiologia , Transplante de Fígado/efeitos adversos , Micoses/epidemiologia , Micoses/tratamento farmacológico , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/prevenção & controle , SARS-CoV-2 , Viroses/epidemiologia , Viroses/prevenção & controle
14.
BMC Nurs ; 23(1): 322, 2024 May 11.
Artigo em Inglês | MEDLINE | ID: mdl-38734635

RESUMO

BACKGROUND: Understanding the stressors and coping strategies of nursing students in their first clinical training is important for improving student performance, helping students develop a professional identity and problem-solving skills, and improving the clinical teaching aspects of the curriculum in nursing programmes. While previous research have examined nurses' sources of stress and coping styles in the Arab region, there is limited understanding of these stressors and coping strategies of nursing students within the UAE context thereby, highlighting the novelty and significance of the study. METHODS: A qualitative study was conducted using semi-structured interviews. Overall 30 students who were undergoing their first clinical placement in Year 2 at the University of Sharjah between May and June 2022 were recruited. All interviews were recorded and transcribed verbatim and analyzed for themes. RESULTS: During their first clinical training, nursing students are exposed to stress from different sources, including the clinical environment, unfriendly clinical tutors, feelings of disconnection, multiple expectations of clinical staff and patients, and gaps between the curriculum of theory classes and labatories skills and students' clinical experiences. We extracted three main themes that described students' stress and use of coping strategies during clinical training: (1) managing expectations; (2) theory-practice gap; and (3) learning to cope. Learning to cope, included two subthemes: positive coping strategies and negative coping strategies. CONCLUSIONS: This qualitative study sheds light from the students viewpoint about the intricate interplay between managing expectations, theory practice gap and learning to cope. Therefore, it is imperative for nursing faculty, clinical agencies and curriculum planners to ensure maximum learning in the clinical by recognizing the significance of the stressors encountered and help students develop positive coping strategies to manage the clinical stressors encountered. Further research is required look at the perspective of clinical stressors from clinical tutors who supervise students during their first clinical practicum.

15.
PeerJ ; 12: e17361, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38737741

RESUMO

Phytoplankton are the world's largest oxygen producers found in oceans, seas and large water bodies, which play crucial roles in the marine food chain. Unbalanced biogeochemical features like salinity, pH, minerals, etc., can retard their growth. With advancements in better hardware, the usage of Artificial Intelligence techniques is rapidly increasing for creating an intelligent decision-making system. Therefore, we attempt to overcome this gap by using supervised regressions on reanalysis data targeting global phytoplankton levels in global waters. The presented experiment proposes the applications of different supervised machine learning regression techniques such as random forest, extra trees, bagging and histogram-based gradient boosting regressor on reanalysis data obtained from the Copernicus Global Ocean Biogeochemistry Hindcast dataset. Results obtained from the experiment have predicted the phytoplankton levels with a coefficient of determination score (R2) of up to 0.96. After further validation with larger datasets, the model can be deployed in a production environment in an attempt to complement in-situ measurement efforts.


Assuntos
Aprendizado de Máquina , Fitoplâncton , Tecnologia de Sensoriamento Remoto , Tecnologia de Sensoriamento Remoto/métodos , Tecnologia de Sensoriamento Remoto/instrumentação , Oceanos e Mares , Monitoramento Ambiental/métodos , Aprendizado de Máquina Supervisionado
16.
Dermatol Ther (Heidelb) ; 14(5): 1359-1366, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38722558

RESUMO

Basal cell carcinoma (BCC) is the most common skin cancer. Skin cancers may present either as a non-invasive tumor or an invasive malignancy. The terminology of carcinoma in situ is used when the tumor is either just limited to epidermis or not present as single cells or nests in the dermis. However, currently the terminology superficial BCC is inappropriately used instead of BCC in situ when the skin cancer is limited to epidermis. In this study we compare the pathologic changes of superficial, nodular, and infiltrative BCCs using electron microscopy to identify the ultrastructural characteristics and validate the previously proposed terminology. Three cases of BCC (superficial BCC, nodular BCC, and infiltrative BCC) diagnosed by dermatopathologists at our institute were selected for review. Paraffin block tissues from these cases were sent for electron microscopy studies which demonstrated disruption of basal lamina in both nodular and infiltrative type of BCC, while it remains intact in BCC superficial type after extensive examination. Therefore, similar to other in situ skin cancers, there is no invasion of the neoplasm in superficial BCC into the dermis. Hence, the older term superficial BCC should be appropriately replaced with the newer terminology BCC in situ.

17.
Nanomedicine (Lond) ; 19(12): 1035-1050, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38686958

RESUMO

Background: To prepare ocular emulsions containing bipartitioned oil droplets to entrap cyclosporin A (0.05% w/w) and etodolac (0.2% w/w) by using castor, olive and silicon oils. Methods: The physicochemical characterizations of prepared emulsions were performed. The drug's biodistribution profiles and pharmacokinetic parameters from emulsions were checked using the ultraperformance liquid chromatography-tandem mass spectrometry method in the ocular tissues of the healthy rabbit eye model. Results: The emulsions displayed 365.13 ± 7.21 nm size and 26.45 ± 2.09 mV zeta potential. The ferrying of two drugs after releasing from emulsions occurred across corneal/conjunctival tissues to enter the vitreous and sclera following a single drop administration into the rabbit's eyes. Conclusion: The dual drug-loaded emulsions were more likely to produce synergistic anti-inflammatory activity for managing moderate-to-severe dry eye disease.


[Box: see text].


Assuntos
Ciclosporina , Emulsões , Etodolac , Coelhos , Animais , Emulsões/química , Ciclosporina/farmacocinética , Ciclosporina/administração & dosagem , Ciclosporina/química , Etodolac/química , Distribuição Tecidual , Tamanho da Partícula , Síndromes do Olho Seco/tratamento farmacológico , Óleo de Rícino/química , Cátions/química , Óleos de Silicone/química , Azeite de Oliva/química , Córnea/efeitos dos fármacos , Córnea/metabolismo , Soluções Oftálmicas/química , Humanos , Liberação Controlada de Fármacos
18.
Sex Reprod Healthc ; 40: 100973, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38678678

RESUMO

BACKGROUND AND OBJECTIVES: Bangladesh's high maternal mortality ratio is exacerbated by delivery-related complications, particularly in hard-to-reach (HtR) areas with limited healthcare access. Despite this, few studies have explored delivery-related complications and factors contributing to these complications among the disadvantaged population. This study aimed to investigate the factors contributing to delivery-related complications and their consequences among the mothers residing in the HtR areas of Bangladesh. METHODS: Data were collected using a cross-sectional study design from 13 HtR sub-districts of Bangladesh between September 2019 and October 2019. Data from 1,290 recently delivered mothers were analysed. RESULTS: Around 32% (95% CI: 29.7-34.8) of the mothers reported at least one delivery-related complication. Prolonged labour pain (21%) was the highest reported complication during the delivery, followed by obstructive labour (20%), fever (14%), severe headache (14%). Mothers with higher education, a higher number of antenatal care (ANC) visits, complications during ANC, employed, and first-time mothers had higher odds of reporting delivery-related complications. More than one-half (51%) of these mothers had normal vaginal delivery. Nearly one-fifth (20%) of mothers who reported delivery-related complications were delivered by unskilled health workers at homes. On the other hand, about one-fifth (19%) of the mothers without any complications during delivery had a caesarean delivery. Nine out of ten of these caesarean deliveries were done at the private facilities. CONCLUSION: Delivery-related complications are significantly related to a woman's reproductive history and other background characteristics. Unnecessary caesarean delivery is prominent at private facilities.


Assuntos
Parto Obstétrico , Complicações do Trabalho de Parto , Cuidado Pré-Natal , Humanos , Bangladesh/epidemiologia , Feminino , Gravidez , Adulto , Estudos Transversais , Complicações do Trabalho de Parto/epidemiologia , Complicações do Trabalho de Parto/etiologia , Parto Obstétrico/efeitos adversos , Parto Obstétrico/estatística & dados numéricos , Cuidado Pré-Natal/estatística & dados numéricos , Adulto Jovem , Acessibilidade aos Serviços de Saúde , Cesárea/estatística & dados numéricos , Cesárea/efeitos adversos , Adolescente , Mortalidade Materna , Cefaleia/etiologia , Cefaleia/epidemiologia , Febre/etiologia , Febre/epidemiologia , Dor do Parto , Escolaridade
19.
J Orthop Case Rep ; 14(3): 119-123, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38560308

RESUMO

Introduction: Osteoarticular tuberculosis (OATB) contributes to around 10% of extrapulmonary tuberculosis of which the spine is the most common site. Isolated involvement of ulna diaphysis is extremely rare. We present a case of unifocal tuberculous osteomyelitis of ulna diaphysis in a 3 -year-old male child and highlight its resemblance with musculoskeletal tumors and stress the importance of GeneXpert mycobacterium tuberculosis (MTB)/resistance to rifampicin (RIF) in the diagnosis of OATB. Case Report: A mother of a 2-year-old male child incidentally noticed that her son complained of left forearm pain. She was not sure of any fall or trauma to the forearm. No history of fever or other constitutional symptoms was present. Clinical examination was uneventful except for local tenderness in over the dorsomedial aspect of the left mid forearm. A plain radiograph revealed an oval solitary lytic lesion over distal one-third ulna diaphysis. A needle biopsy was done after clinical, hematological, and radiological evaluation, and finally, GeneXpert detected tuberculosis without RIF. No further tests were required and the child was started on antitubercular therapy (ATT) which resulted in complete healing without any symptoms. Conclusion: The authors conclude that it is therefore essential to consider tuberculosis in the differential diagnosis while evaluating a lytic bone lesion. Where possible, all patients should have a biopsy of the lesion and provide a specimen for GeneXpert MTB/RIF to confirm the diagnosis and drug susceptibility testing.

20.
Dermatitis ; 2024 Apr 17.
Artigo em Inglês | MEDLINE | ID: mdl-38634840

RESUMO

Although psychedelic and hallucinogenic substances have gained popularity for therapeutic use, their dermatologic adverse effects are poorly characterized. This review characterizes the cutaneous reactions associated with psychedelic and hallucinogenic drugs. A review of PubMed and Scopus was conducted from the inception of databases to August 31, 2023. Search terms included drug names and classes (cannabis, MDMA, ecstasy, 3,4-methylenedioxymethamphetamine, psychedelics, hallucinogens, peyote, marijuana, lysergic acid diethylamide, LSD, ketamine, dimethyltryptamine, DMT, phencyclidine, PCP, dextromethorphan, psilocybin, and ayahuasca), and dermatosis terms (dermatitis, contact dermatitis, drug eruption, skin reaction, and urticaria). Studies were included if there was an association with a psychedelic or hallucinogenic and any cutaneous reaction; studies without both components were excluded. Twenty-two studies met inclusion criteria, describing reactions to cannabis (10 studies), MDMA (5 studies), ketamine (4 studies), and psilocybin (3 studies). Forty total patients were included. Among cannabis-related reactions, the most common reaction was type I hypersensitivity by topical exposure (n = 21). Three patients reported type IV hypersensitivity reactions to contact with cannabis or cannabis-derived oils, all of whom experienced vesicular contact dermatitis. Two additional patients presented with an erythema-multiforme-like reaction and acute generalized exanthematous pustulosis after systemic administration, respectively. MDMA was associated with acneiform eruptions (2 cases), an urticarial eruption, a guttate psoriasis-like reaction, a fixed drug eruption, and Stevens-Johnson syndrome (1 case). Four patients reported type I hypersensitivity reactions to ketamine. Four patients reported vesicular eruptions, cyanosis, or widespread jaundice to psilocybin. Of the cases, 8 patients had cutaneous reactions that resolved with drug cessation, 10 resolved with cessation plus treatment, and resolution in 7 cases was not reported. Zero studies were found describing other psychedelic or hallucinogenic compounds. Further research is required to characterize reactions and treatments linked to the variety of extant psychedelics and hallucinogens.

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