Solar-driven seawater desalination via plasmonic hybrid MOF/polymer and its antibacterial activity.

In recent years, solar seawater desalination has been considered to be a promising and cost-effective technique to produce clean sources for water treatment and water deficiency. In addition, this technique shows high photothermal conversion efficiency by solar collectors to transfer solar energy into heat and the transformation of molecules in the capillaries of solar evaporators. In this study, we report the preparation of graphene-supported MIL-125 with polyurethane foam (MGPU) for solar steam generation. We modified MGPU by using the plasmonic nanoparticles of Ag and a polymer of polyaniline to increase the evaporation rate. Polyurethane foam can float on the surface of water and self-pump water by its hydrophilic porous structure, superior thermal insulation capabilities, and easy fabrication. MIL-125 has a high salt rejection and higher water permeability. It can reduce the affinity between water molecules and the pore surface of membrane, making it simple for water molecules to move through the pores. GO is a great alternative for steam generation applications since it exhibits broad-band light. The strong solar absorption, photothermal conversion efficiency, and photoreaction efficiency are enhanced by the use of silver nanoparticles in the photoreaction. The salt resistance capability is enhanced in saline water in the presence of polyaniline in a composite. Under one solar irradiation, the Ag/PANI/GO@MIL-125 (Ag-PMG) nanocomposite demonstrates an average 1.26 kg m2 h-1 rate of evaporation and an efficiency as high as 90%. The composite exhibits remarkable stability and durability after more than 10 cycles of use without a noticeable decrease in activity. In addition, the composite exhibits excellent organic dye removal from contaminated water and generates pure condensed freshwater. The antibacterial photoactivity of the photocatalysts was examined against B. subtilis and E. coli. The results demonstrate that Ag-PMG shows higher antibacterial activity than MIL-125 and PMG. It was shown that the presence of rGO, PANI, and Ag in the sample enhances the antimicrobial activity.

Herbal Approaches to Pediatric Functional Abdominal Pain.

Chronic abdominal pain is one of the most common problems seen by both pediatricians and pediatric gastroenterologists. Abdominal-pain-related functional gastrointestinal disorders (AP-FGIDs) are diagnosed in children with chronic and recurrent abdominal pain meeting clinical criteria set forth in the Rome IV criteria. AP-FGIDs affect approximately 20% of children worldwide and include functional dyspepsia (FD), irritable bowel syndrome (IBS), functional abdominal pain (FAP), and abdominal migraine. IBS accounts for 45% of pediatric AP-FGIDs. The pathophysiology of functional abdominal pain involves an interplay of factors including early life events, genetics, psychosocial influences, and physiologic factors of visceral sensitivity, motility disturbance, altered mucosal immune function, and altered central nervous system processing. Treatment approaches are varied and can include dietary, pharmacologic, and complementary medicine interventions, as well as psychosocial support, depending on the many aspects of the disorder and the needs of the individual patient. There is a strong interest in complementary and integrative medicine approaches to pediatric pain from both patients, providers, and families. In this article, we discuss popular herbal treatments typically used in the field of complementary medicine to treat pediatric AP-FGIDs: peppermint oil, Iberogast®, cannabis, fennel, and licorice. While high-quality data are rather limited, studies generally show that these remedies are at least as effective as placebo, and are well tolerated with minimal side effects. We will need more placebo-controlled, double-blind, and unbiased prospective studies to document and quantify efficacy.

Green construction of eco-friendly phosphotungstic acid Sr-MOF catalysts for crystal violet removal and synthesis of coumarin and xanthene compounds.

There is an urgent need to improve engineering and synthetic chemistry, either through the use of eco-friendly starting materials or the proper design of novel synthesis routes. This reduces the contamination of toxic chemicals and helps the disposal of organic dyes. In the current work, a metal-organic framework-based Sr(ii) was fabricated to achieve the desired goal for dye removal and catalysis. Sr-MOF-based phosphotungstic acid (PWA/Sr-MOF) was hydrothermally synthesized to study its adsorption and catalytic activities. Remarkably, about 99.9% of crystal violet (CV) dye was removed using PWA/Sr-MOF within 90 min at room temperature. Various factors have been studied to investigate the optimum conditions such as pH of solution, initial dye concentration, contact time, and temperature. The maximum adsorption capacity of CV dye was reached after 90 min and well fitted the pseudo-second kinetic order and Langmuir adsorption isotherm. Coumarin and xanthene reactions were chosen to test the catalytic activity of the prepared PWA/Sr-MOF at 373 K. Furthermore, structural and chemical characterization of the fabricated samples was obtained using FT-IR, XRD, TGA, DTA, TEM, EDX, and XPS. PWA/Sr-MOF can be considered as a promising and green framework in the material design used to study catalytic and adsorption performances.

Management of incidentally detected gallbladder carcinomas in a high prevalence area of gallbladder cancer.

BACKGROUND: There is an increasing incidence of advanced unresectable gallbladder cancer even in patients who undergo re-exploration and these cases are marked by poor survival even after undergoing curative resection and adjuvant chemotherapy. Lack of suspicion during primary surgery, unavailability of frozen section facilities and delayed referrals are believed to contribute to this high incidence. AIM: Our aim was to evaluate the results of re-surgery in incidental gallbladder cancers detected after open or laparoscopic cholecystectomy and to assess the outcome in patients who underwent complete radical cholecystectomy and adjuvant therapy. METHOD: We retrospectively analyzed the data from a prospectively maintained computerized database of all patients with incidentally detected gallbladder cancers operated in the Department of Surgical Oncology, from June 2006 to January 2013. RESULTS: Forty-two patients with incidental gallbladder cancer were re-explored. The median time of re-exploration after initial surgery was 65 days. Eighteen (43%) patients were found inoperable due to locally advanced unresectable or metastatic disease. Among the 24 (57%) patients who underwent completion radical cholecystectomy, 11 developed recurrence over a median time of 11 months. CONCLUSION: Despite the dismal prognosis, more than half of the incidentally detected gallbladder carcinoma patients could receive curative treatment. Identification of patients with incidentally discovered gallbladder cancer and early referral to an oncology center may ensure these patients receive curative resection thereby increasing their chances for long-term disease free survival.

A prospective, parallel group, open-labeled, comparative, multi-centric, active controlled study to evaluate the safety, tolerability and benefits of fixed dose combination of acarbose and metformin versus metformin alone in type 2 diabetes.

OBJECTIVE: The present study was a prospective, parallel group, open-labeled, comparative, multicentric, active controlled study to evaluate the safety, tolerability and benefits of fixed dose combination of acarbose and metformin versus metformin alone in type 2 diabetic patients. METHODS: A total of 229 patients with type 2 diabetes were enrolled at 5 medical centers across India. They received either acarbose (50 mg) + metformin (500 mg) bid/tid (n=115) or metformin monotherapy (500 mg) bid/ tid (n=114) for 12 weeks. Primary objective was to evaluate safety and tolerability based on the adverse events reported. Secondary objective was efficacy assessment based on changes in fasting, post prandial blood glucose and HbA1c values. RESULTS: In the acarbose + metformin group 10 patients reported 14 adverse events while in metformin group 9 patients reported 10 adverse events. No patient reported any serious adverse event or was withdraw from study because of adverse events. In the acarbose plus metformin group fasting blood glucose (FBG) decreased from a baseline of 158.85 +/- 18.14 mg/dl to 113.55 +/- 19.38 mg/dl (p < 0.0001) (decrease of 45.30 +/- 15.30 mg/dl) at 12 weeks, while in the metformin group fasting blood glucose decreased from a baseline of 158.31 +/- 26.53 mg/dl to 130.55 +/- 28.31 mg/dl (p < 0.0001) (decrease of 27.76 +/- 22.91 mg/dl) at 12 weeks. In the acarbose plus metformin group postprandial blood glucose (PPBG) decreased from a baseline of 264.65 +/- 34.03 mg/dl to 173.22 +/- 31.40 mg/dl (p < 0.0001) (decrease of 91.43 +/- 28.65 mg/dl) at 12 weeks, while in the metformin group PPBG decreased from a baseline of 253.56 +/- 36.28 mg/dl to 205.36 +/- 39.49 mg/dl (p < 0.0001) (decrease of 48.20 +/- 32.72 mg/dl) at 12 weeks. In the acarbose plus metformin group glycosylated haemoglobin (HbA1c) decreased from a baseline of 9.47 +/- 0.69% to 7.71 +/- 0.85% (p < 0.0001) (% decrease of 1.76 +/- 1.11) at 12 weeks, while in the metformin group HbAlc decreased from a baseline of 9.32 +/- 0.65% to 8.26 +/- 0.68% (p < 0.0001) (% decrease of 1.06 +/- 0.66) at 12 weeks. The combination of acarbose and metformin was found to be significantly superior in lowering the FBC (p < 0.0001), PPBG (p < 0.0001) and HbA1c (p < 0.0001) at 12 weeks as compared to metformin monotherapy. CONCLUSIONS: Fixed dose combination of acarbose and metformin was well tolerated and it was superior to metformin monotherapy in controlling FBG, PPBG and HbA(1C) levels in Type 2 Diabetes Mellitus patients.

Significant morbidity associated with RSV infection in immunosuppressed children following liver transplantation: case report and discussion regarding need of routine prophylaxis.

Respiratory syncytial virus (RSV) is an important cause of lower respiratory tract infection in infants and young children. In immunocompromised children, RSV infection poses a serious health threat with significantly increased and prolonged virus shedding and the development of severe respiratory disease. We report two patients, eight months and 20 months of age, who were admitted with severe RSV infection two months and 10 months post-transplant respectively. Major risk factors for severe infection is the degree of immunosuppression and the age of the patient (<24 months). Based on the significant morbidity associated with RSV infection in these patients, we recommend randomized trials in larger pediatric solid organ transplant centers to evaluate the use of palivizumab prophylaxis is efficacious to prevent morbidity in patients under the age of 24 months, while we emphasize good hygienic practices to prevent RSV nosocomial infection.

Removal of copper(II) from some environmental samples by sorptive-flotation using powdered marble wastes as sorbents and oleic acid as surfactant.

A simple and economic experimental sorptive -flotation procedure is presented for the removal of copper(II) species from aqueous solutions. It is based on using powdered marble wastes (PMW), which are widespread and inexpensive and may represent an environmental problem, as the effective inorganic sorbent and oleic (HOL) as the surfactant. The main parameters (i.e. initial solution pH, sorbent, surfactant and copper concentrations, stirring times, ionic strength, temperature and the presence of foreign ions) influencing the flotation of PMW and /or Cu(II) were examined. Nearly, 100% of PMW and Cu(II) were removed from aqueous solutions at pH7 after stirring for 10 min and at room temperature, (approximately 25 degrees C). The procedure was successfully applied to recover Cu(II) spiked to some natural water samples. A mechanism for sorption and flotation is suggested.

Treatment of Helicobacter pylori in Pediatrics.

Helicobacter pylori (H. pylori) is among the most common bacterial infections in humans. In 1982, H. pylori was discovered by Marshal and Warren, demonstrating an association between H. pylori and ulcer disease. H. pylori is a gram-negative, S-shaped rod that produces enzymes like urease, catalase and oxidase. The mechanism of acquisition and transmission of H. pylori is unclear, although the most likely mode of transmission is fecal-oral and oral-oral. The mode of transmission is supported by studies that demonstrate viable H. pylori organisms can be cultured from the stool or vomitus of infected patients. Risk factors such as minimal education and low socio-economic status during childhood affect the prevalence. Children infected with H. pylori develop histologic chronic active gastritis despite the fact that they are generally asymptomatic. A small percentage of these children will go on to develop peptic ulcer disease, and even gastric cancer. In contrast, the association of abdominal pain and H. pylori infection remains controversial. In the year 2000, the North American Society of Pediatric Gastroenterology guidelines on H. pylori reported that there is no evidence demonstrating a link between H. pylori-associated gastritis and abdominal pain, except in rare cases in which gastric or duodenal ulcer disease is present. Currently, treatment with a combination of two antimicrobial agents in conjunction with a proton pump inhibitor (PPI) continues to be recommended for the treatment of H. pylori associated peptic ulcer disease.

Helicobacter pylori in children and adolescents.

There is now considerable evidence that suggests that the H. pylori organism isa human pathogen. The strong association between H. pylori and gastroduodenal disease is well documented. A number of hypotheses have been suggested for the pathogenic mechanisms of H. pylori-induced gastroduodenal disease, including the presence of bacterial virulence factors, the production of inflammatory mediators, disregulation of acid secretion, and the host immune response. At the present time, treatment with a combination of a proton pump inhibitor and antimicrobial agents continues to be recommended for the treatment of H. pylori-associated peptic ulcer disease.

Comparison of the efficacy, safety and tolerability of telmisartan with losartan in Indian patients with mild to moderate hypertension: a pilot study.

A prospective, randomised, double-blind, parallel group study was carried out to compare the efficacy, safety and tolerability of telmisartan 40 mg once daily with losartan 50 mg once daily in Indian patients with mild to moderate hypertension. It had a placebo run-in period of 2 weeks followed by drug treatment (telmisartan 40 mg, once daily or losartan 50 mg once daily) for 8 weeks. Supine BP was assessed at the end of every 2 weeks. Tolerability and safety was assessed by physical examination, laboratory parameters and evaluation of adverse events. Treatment with telmisartan resulted in a significant reduction of SBP of 10.3% and 13.7% as compared to 6.6% and 10.6% in losartan group at the end of 6th and 8th weeks respectively. At the end of 6th and 8th weeks, the reduction was 14.3% and 18.1% among telmisartan which was significantly more as compared to 8.8% and 14.3% in losartan group respectively. The laboratory values were within normal limits. Both drugs were well tolerated. Telmisartan monotherapy in a dose of 40 mg once daily has a clinically better therapeutic effect as compared to losartan 50 mg and a good tolerability profile in patients with mild to moderate hypertension.

Efficacy and safety of the first parenteral selective COX-2 inhibitor, parecoxib sodium, in adult patients with postoperative pain.

Parecoxib, a prodrug of valdecoxib, a selective COX-2 inhibitor, has been recently introduced for the treatment of moderate to severe postoperative pain. This prospective, open, multicentric study enrolled 260 patients undergoing orthopaedic, gynaecological, dental and general surgery. Postoperatively, patients were treated with parecoxib, 40 mg IM/IV. There was a statistically significant decrease in the mean pain intensity score (p<0.05). At the end of 24 hours, 89.6% of total cases had a very good to total relief of pain. The mean duration of analgesia was 19.26 hours and mean time of onset of analgesia was 16.25 minutes ranging from 11-20 minutes. The laboratory values were within normal limits. The drug was well tolerated. There was no report of any hypersensitivity reaction. This study suggests that parecoxib, in a dose of 40 mg IM/IV, is an effective and safe option for the management of postoperative pain.

Helicobacter pylori inflammation and immunity.

Gastric inflammation is a significant contributor to the disease process associated with Helicobacter pylori infection. It appears that both bacterial genes and differential host responses make interrelated contributions to gastritis and disease outcome after H. pylori infection. While the cag pathogenicity island (PAI) continues to be a focus for much of this investigation on the bacterial side, other bacterial genes/proteins are certainly important as well. On the host cell side, significant progress is being made defining the eucaryotic signaling cascades induced after host cells interact with H. pylori. The role of host cell cytokines, gastric acid, and mast cells is also being actively studied. Prospects for control of H. pylori associated disease continue to include vaccination. The mechanism(s) for vaccine-mediated control of H. pylori infection and disease remain ill-defined but recent evidence from animal models suggests that the inflammatory response may be involved. Manipulating the host response to H. pylori infection in humans to take advantage of the possible beneficial effects of inflammation, while minimizing its detrimental effects is a significant challenge for the future.

Accelerated atherosclerosis.

The process of accelerated atherosclerosis appears to share common pathophysiologic mechanisms, namely, endothelial injury with early platelet involvement and subsequent progressive smooth muscle cell proliferation and thrombosis leading to vascular occlusion. Understanding the mechanisms of this process has made it possible to include strategies to limit vascular injury and reduce subsequent thrombotic and proliferating cellular responses. In contrast to spontaneous atherosclerosis, a more significant denuding endothelial injury appears to be the critical initiating event, followed by intense platelet involvement and thrombus formation, leading to an initial predominant process of smooth muscle cell proliferation in accelerated atherosclerosis. Risk factors like cigarette smoking and hypertension play an important role in this process. This accelerated proliferative process appears to be the cause of premature coronary occlusion in patients undergoing heart and kidney transplantation, coronary vein graft bypass and percutaneous transluminal coronary angioplasty and diabetes. This accounts for significant morbidity and mortality in these patients. Prophylactic anticalcinotic vasoprotection by suitable calcium antagonists may offer a more appropriate way of anti-arteriosclerotic arterial protection than the other procedures hitherto used. Calcium channel blockers have positive effects on a number of processes that may be associated with restenosis, including reduction of platelet aggregation, minimisation of vasospasm and inhibition of mitogens. In this article the role of nifedipine in accelerated atherosclerosis has been reviewed.

Remifentanil- and fentanyl-based anesthesia for intraoperative monitoring of somatosensory evoked potentials.

We sought to compare effects of remifentanil- and fentanyl-based anesthesia on the morphology of somatosensory evoked potentials (SSEPs) and speed of recovery from anesthesia. Forty-one patients undergoing spinal surgery and requiring intraoperative monitoring of SSEPs were randomized into two groups. In Group 1, anesthesia was induced with sodium thiopental and maintained with fentanyl, 50% nitrous oxide in oxygen, and 0.5%--0.75% isoflurane. In Group 2, anesthesia was induced with sodium thiopental and maintained with remifentanil, 50% oxygen in air, and 0.5%--0.75% isoflurane. The variables compared included hemodynamic changes during the induction and intubation, the interval from the end of anesthesia to extubation, intraoperative blood loss and fluid administration, and changes in latency and amplitude of the P37--N45 component of posterior tibial nerve somatosensory evoked potentials and the N20--P24 component of median nerve somatosensory evoked potentials. The two groups were matched for demographics, ASA physical status, and duration of surgery. Hemodynamic profiles after the induction and intubation were similar. There were significant differences between groups in time intervals from the end of anesthesia to extubation (15.3 +/- 12.8 vs 5.3 +/- 2.3 min; P = 0.0001) and ability to follow verbal commands (14.6 +/- 11.9 vs 4.5 +/- 2.4 min; P = 0.0001), with the Remifentanil group showing earlier recovery. Variability (coefficient of variation) of P37--N45 latency was greater (0.026 vs 0.014; P = 0.001) in the Fentanyl group.

Evaluation of a cerebral oximeter as a monitor of cerebral ischemia during carotid endarterectomy.

BACKGROUND: Stroke is an important contributor to perioperative morbidity and mortality associated with carotid endarterectomy (CEA). This investigation was designed to compare the performance of the INVOS-3100 cerebral oximeter to neurologic function, as a means of detecting cerebral ischemia induced by carotid cross-clamping, in patients undergoing carotid endarterectomy with cervical plexus block. METHODS: Ninety-nine patients undergoing 100 CEAs with regional anesthesia (deep or superficial cervical plexus block) were studied. Bilateral regional cerebrovascular oxygen saturation (rSO2) was monitored using the INVOS-3100 cerebral oximeter. Patients were retrospectively assigned to one of two groups: those in whom a change in mental status or contralateral motor deficit was noted after internal carotid clamping (neurologic symptoms; n = 10) and those who did not show any neurologic change (no neurologic symptoms; n = 90). Data from 94 operations (neurologic symptoms = 10 and no neurologic symptoms = 84) were adequate for statistical analyses for group comparisons. A relative decrease in ipsilateral rSO2 after carotid occlusion (calculated as a percentage of preocclusion value) during all operations (n = 100) was also calculated to determine the critical level of rSO2 decrease associated with a change in neurologic function. RESULTS: The mean (+/- SD) decrease in rSO2 after carotid occlusion in the neurologic symptoms group (from 63.2 +/- 8.4% to 51.0 +/- 11.6%) was significantly greater (P = 0.0002) than in the no neurologic symptoms group (from 65.8 +/- 8.5% to 61.0 +/- 9.3%). Logistic regression analysis used to determine if a change in rSO2, calculated as a percentage of preclamp value, could be used to predict change in neurologic function was highly significant (likelihood ratio chi-square = 13.7; P = 0.0002). A 20% decrease in rSO2 reading from the preclamp baseline, as a predictor of neurologic compromise, resulted in a sensitivity of 80% and specificity of 82.2%. The false-positive rate using this cutoff point was 66.7%, and the false-negative rate was 2.6%, providing a positive predictive value of 33.3% and a negative predictive value of 97.4%. CONCLUSION: Monitoring rSO2 with INVOS-3100 to detect cerebral ischemia during CEA has a high negative predictive value, but the positive predictive value is low.

A comparison of remifentanil and fentanyl in patients undergoing surgery for intracranial mass lesions.

UNLABELLED: We compared the effects of remifentanil versus fentanyl during surgery for intracranial space-occupying lesions. Patients were randomly assigned to receive either remifentanil (0.5 microg. kg(-1). min(-1) IV during the induction of anesthesia reduced to 0.25 microg. kg(-1). min(-1) after endotracheal intubation; n = 49) or fentanyl (dose per usual practice of the anesthesiologist; n = 54). Anesthesia maintenance doses of isoflurane, nitrous oxide, and opioid were at the anesthesiologist's discretion for both groups. There were no differences between opioid groups for the frequency of responses (hemodynamic, movement, and tearing) to intubation, pinhead holder placement, skin incision, or closure of the surgical wound. Adverse event frequencies were similar between groups. Times to follow verbal commands (P < 0.001) and tracheal extubation (P = 0. 04) were more rapid for remifentanil. The percentage of patients with a normal recovery score (were alert or arousable to quiet voice, were oriented, were able to follow commands, had motor function unchanged from their preoperative evaluation, were not agitated, and had modified Aldrete Scores of 9-10) at 10 min after surgery was more for remifentanil (45% vs 18%; P = 0.005). By 20 min, no difference between groups existed (P = 0.27). Anesthesiologists used more isoflurane in the fentanyl group (4.22 vs 1.93 minimum alveolar anesthetic concentration hours). Neurosurgeons, blinded to treatment group, favored the use of remifentanil. Similar frequencies of light anesthesia responses and other adverse events suggest that intraoperative depths of anesthesia were similar in the two groups. Under these conditions, emergence was more rapid with remifentanil. This is consistent with the necessity for less isoflurane use in the remifentanil group and the intrinsic rapid clearance of this opioid. IMPLICATIONS: Patients given remifentanil-based anesthesia for craniotomy had faster recovery times from anesthesia than did those given fentanyl-based anesthesia.

Upstream tissue inhibitor of metalloproteinases-1 (TIMP-1) element-1, a novel and essential regulatory DNA motif in the human TIMP-1 gene promoter, directly interacts with a 30-kDa nuclear protein.

Elevated expression of the tissue inhibitor of metalloproteinases-1 (TIMP-1) protein and mRNA has been reported in human diseases including cancers and tissue fibrosis. Regulation of TIMP-1 gene expression is mainly mediated at the level of gene transcription and involves the activation of several well known transcription factors including those belonging to the AP-1, STAT, and Pea3/Ets families. In the current study, we have used DNase-1 footprinting to identify a new regulatory element (5'-TGTGGTTTCCG-3') present in the human TIMP-1 gene promoter. Mutagenesis and transfection studies in culture-activated rat hepatic stellate cells and the human Jurkat T cell line demonstrated that the new element named upstream TIMP-1 element-1 (UTE-1) is essential for transcriptional activity of the human TIMP-1 promoter. Electrophoretic mobility shift assay studies revealed that UTE-1 can form protein-DNA complexes of distinct mobilities with nuclear extracts from a variety of mammalian cell types and showed that induction of a high mobility UTE-1 complex is associated with culture activation of freshly isolated rat hepatic stellate cells. A combination of UV-cross-linking and Southwestern blotting techniques demonstrated that UTE-1 directly interacts with a 30-kDa nuclear protein that appears to be present in all cell types tested. We conclude that UTE-1 is a novel regulatory element that in combination with its cellular binding proteins may be an important component of the mechanisms controlling TIMP-1 expression in normal and pathological states.