Αρχειοθήκη ιστολογίου

Δευτέρα 25 Ιανουαρίου 2016

Drug utilization pattern of antimicrobial drugs in intensive care unit of a tertiary care hospital attached with a medical college

2016-01-25T04-10-41Z
Source: International Journal of Basic & Clinical Pharmacology
Rutvij Hedamba, Chintan Doshi, Nishita H. Darji, Bansari Patel, Varsha Kumari, Hiren R. Trivedi.
Background: A number of antimicrobial drugs are prescribed to the patients in Intensive Care Unit (ICU). Drug utilization research was defined by WHO as the study of marketing, distribution, prescription, and use of drugs in a society, with special emphasis on the resulting medical, social and economic consequences. There is lack of information about the use of antimicrobial agents in the ICU at GGGH till date. So we decided to conduct this type of study. Methods: A prospective observational study was carried out for 12 months. Patients of age >18 of both sexes who was admitted in ICU were included in the study while pregnant and lactating women excluded. The prescribing pattern was analyzed by using World Health Organization basic drug indicators. Results: Among 611 patients, 373 (61.04%) were male and 238 (38.95%) were female. The most common emergency was post-operative 204 (33.38%).The most common prescribed antimicrobial drug group and drug was antiamoebic drugs and metronidazole respectively in 437 (24.04%) out of total drugs prescribed. The numbers of antimicrobial drugs prescribed per patient were 2.97. 68% drugs were prescribed from WHO and national EML list. Total 57.26% drugs were prescribed by generic name. Average antimicrobial drug cost per patient was 1805.34 rs. Conclusions: Despite of limitations of present study it gives important conclusion about how antimicrobial drugs are used in GGGH ICU. This information can be used for improvement of current treatment strategies.


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Drug prescribing patterns in patients visiting the emergency medicine department at a tertiary care teaching hospital: a prospective study

2016-01-25T04-10-41Z
Source: International Journal of Basic & Clinical Pharmacology
Krishna Pandey, Irfan A. Khan.
Background: Drug utilization studies seek to monitor, evaluate and suggest modifications in the prescribing practices with the aim of making the medical care rational and cost effective. A study of prescription patterns is an important tool to determine rational drug therapy and maximize utilization of resources. Methods: This study was a prospective, cross sectional & observative study of patients (N=250) who attended the emergency medicine department of TMMC & RC, Moradabad, U.P., India. Results: A total of 250 patients received 2004 drugs with the mean of 8.016±1.935/patient. The average stay of patients in the emergency medicine department was 3.025±1.010 days. Most common disorder was of cardiovascular system (N=65, 26%). Pantoperazole (N=180) was most common drug prescribed followed by ondansetron (N=148). Conclusions: Maximum number of patient attended in emergency medicine department was of cardiovascular disorder followed by respiratory disorder. pantoperazole and ondansetron were the most commonly prescribed drugs. Polypharmacy was prevalent. The result of our study highlights the importance of strategies that have to be implemented to optimize medication use in emergency medicine department.


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Study of current prescribing pattern of antimicrobial drugs in indoor cases of enteric fever in a tertiary care hospital

2016-01-25T04-10-41Z
Source: International Journal of Basic & Clinical Pharmacology
Pravin S. Rathod, Praveenkumar T. Patil, Balwant K. Choure, A. W. Patil.
Background: Rational antibiotic prescription is very important to prevent antimicrobial resistance. Hence the present study was conducted to evaluate the prescribing pattern of antimicrobial drugs in indoor enteric fever patients of medicine and paediatric department of a tertiary care hospital. Methods: A retrospective study of 2 months duration was undertaken during July and August of 2015. A total number of 97 enteric fever patients case sheets were utilized for our study from medicine and paediatric in-patients department of a tertiary care hospital. The data was analysed and results were expressed as percentage. Results: Out of 97 enteric fever patients, 54.64% were females. 13.4% of paediatric population were suffered because of enteric fever. The incidence of enteric fever was 74.23% in 13-40 years. Most commonly prescribed antimicrobials were 3rd generation cephalosporins and fluoroquinolones. 43.30% patients received more than one antibiotic. Antimalarials chloroquine, artemisinin derivatives and metronidazole were other drugs prescribed to enteric fever patients concurrently for associated clinical conditions. Conclusions: Interventional programme should focus on the use of rational antibiotic prescription aimed at minimizing unnecessary cost, adverse drug reactions and emergence of bacterial resistance.


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Effect of educational interventions on pharmacovigilance awareness among M.B.B.S. internee’s in a tertiary care teaching hospital

2016-01-25T04-10-41Z
Source: International Journal of Basic & Clinical Pharmacology
Navneeth Selvan, Revathy Saravanan, Sakthibalan M..
Background: Spontaneous reporting of adverse drug reactions (ADRs) has played a major role in detection of previously unobserved ADRs. In spite of setting up ADR monitoring centres, only 6-10% of all ADRs are reported which has been contributed to the lack of knowledge among healthcare professionals. This study was planned to address this aspect. To evaluate and compare the effect of educational intervention in enhancing the knowledge of MBBS internees regarding pharmacovigilance. Methods: A cross sectional, educational interventional observational study was conducted using two copies of a pretested validated questionnaire (pre & post CME) with 17 questions among 130 MBBS internees. They were subjected to a Continuous Medical Education on pharmacovigilance. A hands on training on ADR reporting was also conducted in which they were divided into 10 batches and asked to fill a Central Drugs Standard Control Organization Adverse Drug Reporting form on the case scenario given to them and forms were analyzed. Results: Out of 130 internees, 114 (87.69%) and 98 (75.38%) had completely filled them. The overall awareness about pharmacovigilance increased from 62.50% to 82.25% (p

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Study of patterns of prescribing antibiotics in geriatric patients admitted to the medical wards in a tertiary care hospital

2016-01-25T04-10-41Z
Source: International Journal of Basic & Clinical Pharmacology
Ankita Bist, Gajanan P. Kulkarni, Kashinath M. Gumma.
Background: Evidence indicates high prevalence of inappropriate prescribing of medicines especially in the elderly. This can cause increased incidence of adverse drug reactions, morbidity, mortality and cost of treatment. Also inappropriate use of antibiotics promotes emergence of antimicrobial resistance. This study aims to study the prescribing patterns of antibiotics administered in geriatric patients, disease conditions for which the antibiotics were prescribed and adherence of these antibiotic prescriptions to the 18th WHO essential medicine list. Methods: A prospective study was undertaken, over duration of 4 months at the government teaching hospital, Bidar Institute of Medical sciences, Bidar. Patients of either sex above 65 years of age admitted to medicine wards due to infections or those who acquired infection due to hospitalization and were on antibiotic treatment / prophylaxis were included. Data collection was done by scrutinizing the inpatient case sheets and investigation reports. Individual data was collected on preformed performa. Results: Out of the 140 patients 44.2% patients were admitted for treatment of respiratory tract infections. 17.1% of the patients received antibiotics prophylactically. Cefotaxime was observed to be the most commonly prescribed antimicrobial agent. It was included in 50% of antibiotic prescriptions. It was observed that 90% of antibiotics prescribed were in adherence to the WHO essential drug list. Conclusions: Polypharmacy is commonly observed practice in geriatric patients. Apart from increasing the cost of treatment it also promotes irrational prescription of drugs. Most of the prescriptions were in adherence with the WHOs Essential Medicine List but antibiotics were mainly prescribed empirically.


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Evaluation of burn wound healing property of ocimum sanctum by monitoring of period of re-epithelization in rabbits

2016-01-25T04-10-41Z
Source: International Journal of Basic & Clinical Pharmacology
Vaibhav K. Gupta, Swanand S. Pathak, Mahesh K. Jain.
Background: Burns remain a major public health problem all over the world, especially in developing countries. Pseudomonas aeruginosa is a major cause of infection and a contributing factor in the death of patients with burns. So, there is a growing need to develop drugs which will prevent infections and complications more effectively than the presently used drugs. Ocimum sanctum L. (Tulsi in Hindi) has been shown to have antioxidant properties, which may be responsible and favorable for faster wound healing. The present study was carried out to evaluate the wound healing property of O. sanctum by monitoring the period of re-epithelization in thermal burns with and without supportive treatment of ointment silver sulfadiazine. Methods: Wound healing property of O. sanctum was evaluated by monitoring the period of re-epithelization. Results: The period of re-epithelization, in Control group was 34 ± 1.26 days, in Standard group treated with ointment silver sulfadiazine was 30.33 ± 1.37 days, in group treated with O. sanctum was 30.50 ± 1.87 days and in group treated with ointment silver sulfadiazine + O. sanctum was 26 ± 1.41 days. Conclusions: Group treated with ointment silver sulfadiazine + O. sanctum showed minimum re-epithelization period. So, the most effective treatment for burn wound healing in this study was ointment silver sulfadiazine + O. sanctum.


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Evaluation of neuroprotective effect of flupirtine in brain of albino rats

2016-01-25T04-10-41Z
Source: International Journal of Basic & Clinical Pharmacology
Elango P, Darling Chellathai, Saravana Babu.
Background: Flupirtine (FP) is found to antagonize both glutamate and N methyl, D aspartate (NMDA) and the current study was undertaken to elucidate a possible neuroprotective role of flupirtine against NMDA induced neurotoxicity in experimental rat model. Methods: Excitotoxicty was produced in rat and it is counteracted by flupirtine. The animals were grouped as Group 1 (vehicle treated), Group 2 (received NMDA+vehicle), Group 3 (received FP+NMDA only), and Group 4 (received FP+vehicle) and were observed of animal behavior and oxidative stress biomarkers and also mRNA expression using reverse transcriptase-polymerase chain reaction (PCR PCR) was performed to determine the level of mRNA expression of acetyl cholinesterase (AChE) and muscarinic cholinergic receptor (MChR) in brain samples (hippocampus) of experimental animals. Results: Depression effect induced by NMDA was reversed by flupirtine. Decrease in oxidative stress bio-markers associated with increase in the antioxidant enzyme activities in group 3 and 4 compared to group 1 and 2. Gene expression were up-regulated in group 2 compared to 1, 3 and 4. Flupritine treatment reversed these alterations. Conclusions: This study represents the neuroprotective characteristics of flupiritne against the excitotoxicity induced by NMDA in an in vivo rat models.


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IJMS, Vol. 17, Pages 153: Decreased Expression of BNC1 and BNC2 Is Associated with Genetic or Epigenetic Regulation in Hepatocellular Carcinoma

The aberrant expression of transcription factor Basonuclin (BNC) had been reported in different kinds of tumors. Here, we investigated the expression and methylation status of two Basonuclin homologs, BNC1 and BNC2 in hepatocellular carcinoma (HCC). We found that the expression levels of both BNC1 and BNC2 were down-regulated in HCC cell lines and primary HCC tissues. The frequency and intensity of BNC1 promoter hypermethylation in tumor tissues was significantly higher than that in adjacent non-tumor tissues. 5-Aza-2'-Deoxycytidine treatment could significantly increase the BNC1 expression in the methylated HCC cell lines, which implicated that epigenetic modification contributed to the down-regulation of BNC1. In addition, BNC1 hypermethylation in tumor tissues was more likely to happen in female patients. No methylation of the BNC2 promoter was found in HCC tumor tissues. However, a frequent deletion of the BNC2 gene was observed, which indicated that the chromosomal loss of the BNC2 gene might be one important reason for its lower expression level in HCC. Our results suggested that BNC1 and BNC2 were down-regulated in HCC which may provide new insight into the tumorigenesis of HCC.

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IJMS, Vol. 17, Pages 152: Mesenchymal Stem Cells Preserve Working Memory in the 3xTg-AD Mouse Model of Alzheimer’s Disease

The transplantation of stem cells may have a therapeutic effect on the pathogenesis and progression of neurodegenerative disorders. In the present study, we transplanted human mesenchymal stem cells (MSCs) into the lateral ventricle of a triple transgenic mouse model of Alzheimer´s disease (3xTg-AD) at the age of eight months. We evaluated spatial reference and working memory after MSC treatment and the possible underlying mechanisms, such as the influence of transplanted MSCs on neurogenesis in the subventricular zone (SVZ) and the expression levels of a 56 kDa oligomer of amyloid β (Aβ*56), glutamine synthetase (GS) and glutamate transporters (Glutamate aspartate transporter (GLAST) and Glutamate transporter-1 (GLT-1)) in the entorhinal and prefrontal cortices and the hippocampus. At 14 months of age we observed the preservation of working memory in MSC-treated 3xTg-AD mice, suggesting that such preservation might be due to the protective effect of MSCs on GS levels and the considerable downregulation of Aβ*56 levels in the entorhinal cortex. These changes were observed six months after transplantation, accompanied by clusters of proliferating cells in the SVZ. Since the grafted cells did not survive for the whole experimental period, it is likely that the observed effects could have been transiently more pronounced at earlier time points than at six months after cell application.

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New editors in chief for the European Archives of Oto-Rhino-Laryngology.

New editors in chief for the European Archives of Oto-Rhino-Laryngology.

Eur Arch Otorhinolaryngol. 2016 Jan 23;

Authors: Olofsson J

PMID: 26803307 [PubMed - as supplied by publisher]



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Solvent-Dependent Regio- and Stereo­selective Oxidation of [2.2]Para­cyclophane-Derived Phenols

Abstract

The structure of the products formed upon oxidation of 4-hydroxy[2.2]paracyclophane and its derivatives with Cu(OH)Cl·TMEDA depends on the solvent used. In MeOH oxidation accompanied with nucleophilic attack of the solvent to furnish predominantly or exclusively ortho-cyclohexadienones (o-quinol methyl ethers) of (Rp*,Rp*) relative configuration. Oxidation carried out in CH2Cl2 results in regio- and stereoselective formation of para-cyclohexadienone dimers {variously substituted 7,7′-bis[2.2]paracyclophan-4,4′(7H,7′H)-diones} with (Sp*,Rc*,Rc*,Sp*) relative and (Rp,Sc,Rc,Sp) absolute configurations (two out of six possible diastereomers in each case), whereas oxidation of the enantiomerically pure phenol produced the respective single product. The dimeric cyclohexadienones can suffer aromatization to form the respective dimeric para-biphenols under the action of KOH in EtOH.

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Oxidation of 4-hydroxy[2.2]paracyclophane and its derivatives with Cu(OH)Cl·TMEDA in MeOH leads to ortho-cyclohexadienones of (Rp*,Rp*) relative configuration, whereas in CH2Cl2 regio- and stereoselective oxidative coupling occurs to produce variously substituted 7,7′-bis[2.2]paracyclophan-4,4′(7H,7′H)-diones with (Sp*,Rc*,Rc*,Sp*) and (Rp,Sc,Rc,Sp) relative configurations.



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Solvate Ionic Liquids as Reaction Media for Electrocyclic Transformations

Abstract

Solvate ionic liquids (SILs) consisting of lithium bis(trifluoromethylsulfonyl)imide dissolved in tri- or tetraglyme have recently emerged as a novel class of ionic liquids. Herein, the first use of solvate ionic liquids as a replacement for molecular solvents in electrocyclization reactions is reported. The SILs promoted both Diels–Alder and [2+2] cycloaddition reactions, compared to an appropriate molecular solvent, and 5 M lithium perchlorate in diethyl ether. The Gutmann acceptor number (AN) of these solvate ionic liquids has also been determined by 31P NMR spectroscopy to be 26.5, thus being modest Lewis acids.

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Solvate ionic liquids have been explored for their suitability as reaction media for organic transformations. These ILs are able to undergo typical optimisation procedures, are inexpensive, and easy to handle.



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Economic and size-tunable synthesis of InP/ZnE (E = S, Se) colloidal quantum dots

We present synthesis protocols, based on indium halide and aminophosphine precusors, that allow for the economic, up-scaled production of InP quantum dots (QDs). The reactions attain a close to full yield conversion with respect to the indium precursor and we demonstrate that size tuning at full chemical yield is possible by changing the nature of the indium halide salt. In addition, we present ZnS and ZnSe shell growth procedures that lead to InP/ZnS and InP/ZnSe core/shell QDs that emit from 510 to 630 nm with an emission line width between 46 and 63 nm. This synthetic method is an important step toward performing Cd-free QDs, and it could help the transfer of colloidal QDs from the academic field to product applications.

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Chemical solution deposition of functional ceramic coatings using ink-jet printing

This paper discusses the development of environmentally-friendly precursor inks suited for ink-jet printing of functional ceramic coatings. We synthesized superconducting materials, SrTiO3 thin films for coated conductor applications and transparent TiO2 photocatalytic coatings. Here, we discuss all aspects of ink formulation, including the stabilization of metal ions, nanoparticle inks or combination of both. This demands the investigation and determination of the inks rheological parameters. Ceramic nanoparticles are often incorporated in our inks to decrease thermal processing temperatures (e.g., TiO2 or YSZ coatings...) or enhance the properties of the functional ceramic coating (e.g., pinning centres in superconducting coatings). These ceramic nanoparticles (ZrO2, HfO2, TiO2...) are synthesized through methods based on microwave heating from aqueous and/or organic solutions. With that, we aim at developing smart and environmentally friendly processes that require lower energy input.

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The MITOS system predicts long-term survival in amyotrophic lateral sclerosis.

http:--highwire.stanford.edu-icons-exter Related Articles

The MITOS system predicts long-term survival in amyotrophic lateral sclerosis.

J Neurol Neurosurg Psychiatry. 2015 Nov;86(11):1180-5

Authors: Tramacere I, Dalla Bella E, Chiò A, Mora G, Filippini G, Lauria G, EPOS Trial Study Group

Abstract
OBJECTIVE: The choice of adequate proxy for long-term survival, the ultimate outcome in randomised clinical trials (RCT) assessing disease-modifying treatments for amyotrophic lateral sclerosis (ALS), is a key issue. The intrinsic limitations of the ALS Functional Rating Scale-Revised (ALSFRS-R), including non-linearity, multidimensionality and floor-effect, have emerged and its usefulness argued. The ALS Milano-Torino staging (ALS-MITOS) system was proposed as a novel tool to measure the progression of ALS and overcome these limitations. This study was performed to validate the ALS-MITOS as a 6-month proxy of survival in 200 ALS patients followed up to 18 months.
METHODS: Analyses were performed on data from the recombinant human erythropoietin RCT that failed to demonstrate differences between groups for both primary and secondary outcomes. The ALS-MITOS system is composed of four key domains included in the ALSFRS-R scale (walking/self-care, swallowing, communicating and breathing), each with a threshold reflecting the loss of function in the specific ALSFRS-R subscores. Sensitivity, specificity and the area under the curve of the receiver operating characteristic curves of the ALS-MITOS system stages and ALSFRS-R decline at 6 months were calculated and compared with the primary outcome (survival, tracheotomy or >23-hour non-invasive ventilation) at 12 and 18 months Predicted probabilities of the ALS-MITO system at 6 months for any event at 12 and 18 months were computed through logistic regression models.
RESULTS: Disease progression from baseline to 6 months as defined by the ALS-MITOS system predicted death, tracheotomy or >23-hour non-invasive ventilation at 12 months with 82% sensitivity (95% CI 71% to 93%, n=37/45) and 63% specificity (95% CI 55% to 71%, n=92/146), and at 18 months with 71% sensitivity (95% CI 61% to 82%, n=50/70) and 68% specificity (95% CI 60% to 77%, n=76/111). The analysis of ALS-MITOS and ALSFRS-R progression at 6-month follow-up showed that the best cut-off to predict survival at 12 and 18 months was 1 for the ALS-MITOS (ie, loss of at least one function) and a decline ranging from 6 to 9 points for the ALSFRS-R.
CONCLUSIONS: The ALS-MITOS system can reliably predict the course of ALS up to 18 months and can be considered a novel and valid outcome measure in RCTs.

PMID: 25886781 [PubMed - indexed for MEDLINE]



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Abdominal Mondor disease mimicking acute appendicitis.

Abdominal Mondor disease mimicking acute appendicitis.

Int J Surg Case Rep. 2016 Jan 13;20:37-40

Authors: Schuppisser M, Khallouf J, Abbassi Z, Erne M, Vettorel D, Paroz A, Naiken SP

Abstract
INTRODUCTION: Mondor disease (MD), a superficial thrombophlebitis of the thoraco-epigastric veins and their confluents is rarely reported in the literature. The superior epigastric vein is the most affected vessel but involvement of the inferior epigastric vessels or their branches have also been described. There is no universal consensus on treatment in the literature but most authors suggest symptomatic treatment with non-steroid anti-inflammatory drugs (NSAIDs).
CASE REPORT: We report the case of a marathon runner who presented with right iliac fossa pain mimicking the clinical symptomatology of an acute appendicitis. The history and the calculated Alvarado score were not in favor of an acute appendicitis. This situation motivated multiple investigations and we finally arrived at the diagnosis of MD.
DISCUSSION: Acute appendicitis (AA) is the most common cause of surgical emergencies and one of the most frequent indications for an urgent abdominal surgical procedure around the world. In some cases, right lower quadrant pain remains unclear in spite of US, CT scan, and exclusion of urological and gynecological causes, thus we need to think of some rare pathologies like MD.
CONCLUSION: MD is often mentioned in the differential diagnosis of breast pathologies but rarely in abdominal pain assessment. It should be mentioned in the differential diagnosis of the right lower quadrant pain when the clinical presentation is unclear and when acute appendicitis has been excluded. Awareness of MD can avoid misdiagnosis and decrease extra costs by sparing unnecessary imaging.

PMID: 26803533 [PubMed - as supplied by publisher]



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Effects of expiratory muscle strength training on oropharyngeal dysphagia in subacute stroke patients: a randomised controlled trial.

Effects of expiratory muscle strength training on oropharyngeal dysphagia in subacute stroke patients: a randomised controlled trial.

J Oral Rehabil. 2016 Jan 24;

Authors: Park JS, Oh DH, Chang MY, Kim KM

Abstract
Expiratory muscle strength training (EMST) involves forcible blowing as a means of generating high expiratory pressure, against adjustable resistance. EMST has recently been introduced as a potential treatment for dysphagia. This study was performed to investigate the effects of EMST on the activity of suprahyoid muscles, aspiration and dietary stages in stroke patients with dysphagia. Twenty-seven stroke patients with dysphagia were randomly divided into two groups. The experimental group performed EMST with a 70% threshold value of maximal expiratory pressure, using an EMST device, 5 days a week for 4 weeks. The placebo group trained with a sham device. The EMST regime involved 5 sets of 5 breaths through the EMST device for a total of 25 breaths per day. Activity in the suprahyoid muscle group was measured using surface electromyography (sEMG). Further, the penetration-aspiration scale (PAS) was used to assess the results of the videofluoroscopic swallowing study (VFSS). In addition, dietary stages were evaluated using the Functional Oral Intake Scale (FOIS). The experimental group exhibited improved suprahyoid muscle group activity and PAS results, when compared to the placebo group. Following intervention, statistical analysis indicated significant differences in measured suprahyoid muscle activity (P = 0·01), liquid PAS outcomes (P = 0·03) and FOIS results (P = 0·06), but not semisolid type PAS outcomes (P = 0·32), between the groups. This study confirms EMST as an effective treatment for the development of suprahyoid muscle activity in stroke patients with dysphagia. Additionally, improvements in aspiration and penetration outcomes were observed.

PMID: 26803525 [PubMed - as supplied by publisher]



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Nanoparticles Based on Quantum Dots and a Luminol Derivative: Implications for in vivo Imaging of Hydrogen Peroxide by Chemiluminescence Resonance Energy Transfer

CrossMark.jpg

Chem. Commun., 2016, Accepted Manuscript
DOI: 10.1039/C5CC09850E, Communication
Eun Sook Lee, Deepagan veerasikku gopal, Dong Gil You, Jueun Jeon, Gi-Ra Yi, Jun Young Lee, Doo Sung Lee, Yung Doug Suh, Jae Hyung Park
Overproduction of hydrogen peroxide, keeps homeostasis in normal condition, is involved in the pathogenesis of inflammatory diseases such as cancer and arthritis. To image hydrogen peroxide via chemiluminescence energy transfer...
The content of this RSS Feed (c) The Royal Society of Chemistry


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Synthesis and antimicrobial activity of 4-chloro-3-nitrophenylthiourea derivatives targeting bacterial type II topoisomerases

Abstract

A series of novel 4-chloro-3-nitrophenylthiourea derivatives were synthesized and evaluated for their antimicrobial, antibiofilm and tuberculostatic activities. Most of compounds exhibited high antibacterial activity against both standard and hospital strains (MIC values 0.5-2 μg/ml), as compared to Ciprofloxacin. Derivatives with 3,4-dichlorophenyl (11) and 3-chloro-4-methylphenyl (13) substituents were the most promising towards Gram-positive pathogens. Both of them exhibited antibiofilm potency and effectively inhibited the formation of biofilms of methicillin-resistant and standard strains of Staphylococcus epidermidis. Two N-alkylthioureas (20, 21) showed 2-4-fold increase in in vitro potency against isolates of Mycobacterium tuberculosis, as compared to Isoniazid. An action of 7, 10, 11, 13, 20 and 21 against activity of topoisomerases isolated from Staphylococcus aureus was studied. Synthesized compounds were found as non-genotoxic.

This article is protected by copyright. All rights reserved.

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A series of nongenotoxic thiourea derivatives were synthesized and evaluated for their antimicrobial, antibiofilm and tuberculostatic activities. Most of them exhibited high antibacterial activity against both standard and hospital Gram-positive strains (MIC values 0.5-2 μg/ml). An action of 7, 10, 11, 13, 20 and 21 against activity of topoisomerases isolated from Staphylococcus aureus was studied.



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Synthesis of novel oxazolo[4,5-b]pyridine-2-one based 1,2,3-triazoles as Glycogen Synthase Kinase-3β inhibitors with anti-inflammatory potential

Abstract

A novel series of oxazolo[4,5-b]pyridine-2-one based 1,2,3-triazoles has been synthesized by click chemistry approach and evaluated for in vitro GSK-3β inhibitory activity. Compound 4g showed maximum inhibition with IC50 value of 0.19 μM. Keeping in view the effect of GSK-3β inhibition on inflammation, compounds 4g, 4d, 4f, 4i, 4n and 4q exhibiting significant GSK-3β inhibition were examined for in vivo anti-inflammatory activity in rat-paw edema model. The compounds 4g, 4d, 4f and 4i showed pronounced in vivo anti-inflammatory activity (76.36, 74.54, 72.72 and 70.90% respectively after 5 h post-carrageenan administration) and were further found to inhibit the pro-inflammatory mediators viz., NO, TNF-α, IL-1β and IL-6 substantially in comparison to indomethacin, an anti-inflammatory drug as well as SB216763, a GSK-3β inhibitor, reported to exert a similar effect. Histopathology studies confirmed the tolerance of gastric mucosa to these compounds.

This article is protected by copyright. All rights reserved.

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We synthesized series of novel oxazolo[4,5-b]pyridine-2-one based 1,2,3-triazoles.

Compounds were assessed for in vitro GSK-3β inhibition and in vivo anti-inflammatory activity.

Compounds 4g, 4d, 4f and 4i were most active against both GSK-3β and inflammation and also suppressed concentrations of NO, TNF-α, IL-1β and IL-6 ex vivo.

4g, 4d, 4f and 4i also didn't cause any gastric ulceration and could be promising for GSK-3β inhibition with potential for treatment of anti-inflammatory disorders.



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Shikonin derivative DMAKO-05 inhibits Akt signal activation and melanoma proliferation

Abstract

DMAKO-05((S)-1-((5E,8E)-5,8-bis(hydroxyimino)-1,4-dimethoxy-5,8-dihydronaphthalen-2-yl)-4-methylpent-3-enyl 3-methylbutanoate) is a novel oxime derivative of shikonin, the major component extracted from Chinese herb Lithospermun erythrorhizon. Here, we report that DMAKO-05 had an anti-tumor activity against mouse melanoma cell line B16F0. Our studies indicated that DMAKO-05 not only inhibited B16F0 proliferation and migration but also led to cell cycle arrest at G1 phase and cell apoptosis, in which DMAKO-05 triggered mitochondrial-mediated apoptosis signal including caspase-9/3 and PARP. In response to DMAKO-05 treatment, the Akt-mediated survival signals were remarkably attenuated in B16F0 cells. Collectively, DMAKO-05 has a strong cytotoxicity in B16F0 cells via inhibiting Akt activation, inducing G1 arrest and promoting B16F0 cell apoptosis. DMAKO-05 might serve as a potential candidate lead compound for melanoma.

This article is protected by copyright. All rights reserved.

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The novel oxime derivative of shikonin DMAKO-05 was found toxic to melanoma cell B16F0. DMAKO-05 remarkably inhibited the phosphorylation of Akt, induced G1 cell cycle arrest and promoted B16F0 melanoma cell apoptosis. DMAKO-05 might serve as a potential inhibitor for melanoma.



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Comparison of clinical and radiographic status around dental implants placed in patients with and without prediabetes: 1-year follow-up outcomes

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Abstract

Objective

We hypothesized that peri-implant soft tissue inflammation is worse and peri-implant marginal bone loss (MBL) is higher around dental implants placed in patients with prediabetes compared to healthy subjects. The aim of the present 12-month follow-up study was to compare the clinical and radiographic status around dental implants placed in patients with and without prediabetes.

Material and methods

Twelve patients with medically diagnosed prediabetes (Group-1) and 12 controls (Group-2) were included. All patients were indicated for single tooth maxillary or mandibular premolar replacement with the adjacent teeth intact. Success of the restored implants was assessed by comparing clinical (peri-implant bleeding on probing [BOP], and probing pocket depth [PPD]) and radiographic (peri-implant MBL) parameters at baseline and at 12-months follow-up. Statistical analysis was performed using one-way analysis of variance, and P-values <0.05 were considered statistically significant.

Results

At 12 months of follow-up, there was no clinical evidence for the presence of plaque, BOP and peri-implant pockets with PPD ≥ 4 mm in both groups. At 12-month follow-up, the mean MBL among implants placed in groups 1 and 2 were 0.2 ± 0.1 mm and 0.1 ± 0.01 mm, respectively. Overall, the periodontal status (PI, BOP and PPD ≥ 4 mm) at 12-month follow-up was comparable among patients in both groups.

Conclusion

Within the limitations of this study, it is concluded that dental implants inserted in prediabetic and healthy patients have similar success rates and remain clinically and radiographically stable after 1-year follow-up.



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Highlights ICS 2015



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Ultra-wideband cork substrate-integrated-waveguide cavity-backed slot antenna



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Testosteron: de richtlijnen en verder



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Relation between TKA kinematics and patient reported outcomes: a fluoroscopic analysis



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Testostérone: les directives et bien plus encore



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Efficient full-wave modeling of electromagnetic interference in the presence of multiple non-collocated noise sources



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Investigation of faecal volatile organic metabolites as novel diagnostic biomarkers in inflammatory bowel disease

Summary

Background

The aetiology of inflammatory bowel disease (IBD) remains poorly understood. Recent evidence suggests an important role of gut microbial dysbiosis in IBD, and this may be associated with changes in faecal volatile organic metabolites (VOMs).

Aim

To describe the changes in the faecal VOMs of patients with IBD and establish their diagnostic potential as non-invasive biomarkers.

Methods

Faecal samples were obtained from 117 people with Crohn's disease (CD), 100 with ulcerative colitis (UC), and 109 healthy controls. Faecal VOMs were extracted using solid-phase micro-extraction and analysed by gas chromatography mass spectrometry. Data analysis was carried out using partial least squares-discriminate analysis (PLS-DA) to determine class membership based on distinct metabolomic profiles.

Results

The PLS-DA model showed clear separation of active CD from inactive disease and healthy controls (P < 0.001). Heptanal, 1-octen-3-ol, 2-piperidinone and 6-methyl-2-heptanone were up-regulated in the active CD group [variable important in projection (VIP) score 2.8, 2.7, 2.6 and 2.4, respectively], while methanethiol, 3-methyl-phenol, short-chain fatty acids and ester derivatives were found to be less abundant (VIP score of 3.5, 2.6, 1.5 and 1.2, respectively). The PLS-DA model also separated patients with small bowel CD from healthy controls and those with colonic CD from UC (P < 0.001). In contrast, less distinct separation was observed between active UC, inactive UC and healthy controls.

Conclusions

Analysis of faecal volatile organic metabolites can provide an understanding of gut metabolomic changes in IBD. It has the potential to provide a non-invasive means of diagnosing IBD, and can differentiate between UC and CD.



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Systematic review with meta-analysis: coffee consumption and the risk of cirrhosis

Summary

Background

Liver cirrhosis is a large burden on global health, causing over one million deaths per year. Observational studies have reported an inverse association between coffee and cirrhosis.

Aims

To perform a systematic review and meta-analysis to characterise the relationship between coffee consumption and cirrhosis.

Methods

We searched for studies published until July 2015 that reported odds ratios, relative risks (RR) or hazard ratios for cirrhosis stratified by coffee consumption. We calculated RRs of cirrhosis for an increase in daily coffee consumption of two cups for each study and overall. We performed analyses by study design, type of cirrhosis and mortality. We assessed the risk of bias in each study and the overall quality of evidence for the effect of coffee on cirrhosis.

Results

We identified five cohort studies and four case–control studies involving 1990 cases and 432 133 participants. We observed a dose–response in most studies and overall. The pooled RR of cirrhosis for a daily increase in coffee consumption of two cups was 0.56 (95% CI 0.44–0.68; I2 83.3%). The RR pooled from cohort studies for a daily increase of two cups was 0.58 (95% CI 0.41–0.76; I2 91.1%) and from case–control studies it was 0.52 (95% CI 0.40–0.63; I2 0.0%). The pooled RR of alcoholic cirrhosis for a daily increase of two cups was 0.62 (95% CI 0.51–0.73; I2 0%) and of death from cirrhosis it was 0.55 (95% CI 0.35–0.74; I2 90.3%).

Conclusion

This meta-analysis suggests that increasing coffee consumption may substantially reduce the risk of cirrhosis.



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Intracerebral hemorrhage due to developmental venous anomalies.

Intracerebral hemorrhage due to developmental venous anomalies.

J Clin Neurosci. 2016 Jan 20;

Authors: Li X, Wang Y, Chen W, Wang W, Chen K, Liao H, Lu J, Li Z

Abstract
Developmental venous anomalies (DVA) and cavernous malformations (CM) are a common form of mixed vascular malformation. The relationship between DVA, CM and hemorrhage is complicated. It is important to differentiate hemorrhagic CM and hemorrhagic DVA. A retrospective review of all patients with acute spontaneous intracerebral hemorrhages (ICH) between 1 May 2008 and 1 May 2013 was performed. ICH due to DVA or CM were identified and compared for demographic features, clinical symptoms, neurological deficits, and radiological findings. A total of 1706 patients with acute spontaneous ICH were admitted to our hospital during the study period. Among these, 10 (0.59%) were caused by DVA and 42 (2.47%) were caused by CM. No significant differences were found in age (p=0.252) or sex ratio (p=1.000) between the two groups. Compared with CM-induced ICH, DVA-induced ICH were characterized by cerebellar predominance (p=0.000) and less severe neurological deficits (p=0.008). Infratentorial hemorrhagic DVA are characterized by cerebellar predominance and benign clinical course. Infratentorial hemorrhagic CM are mainly located in the brainstem. DVA should be given suspected rather than CM when considering the etiology of a cerebellar hemorrhage, especially in young adults.

PMID: 26803466 [PubMed - as supplied by publisher]



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Effect of Nano-HA/Collagen Composite Hydrogels on Osteogenic Behavior of Mesenchymal Stromal Cells.

Effect of Nano-HA/Collagen Composite Hydrogels on Osteogenic Behavior of Mesenchymal Stromal Cells.

Stem Cell Rev. 2016 Jan 23;

Authors: Hayrapetyan A, Bongio M, Leeuwenburgh SC, Jansen JA, van den Beucken JJ

Abstract
This study aimed to comparatively evaluate the in vitro effect of nanosized hydroxyapatite and collagen (nHA/COL) based composite hydrogels (with different ratios of nHA and COL) on the behavior of human mesenchymal stromal cells (MSCs), isolated from either adipose tissue (AT-MSCs) or bone marrow (BM-MSCs). We hypothesized that (i) nHA/COL composite hydrogels would promote the osteogenic differentiation of MSCs in an nHA concentration dependent manner, and that (ii) AT-MSCs would show higher osteogenic potential compared to BM-MSCs, due to their earlier observed higher proliferation and osteogenic differentiation potential in 2D in vitro cultures [1]. The obtained results indicated that AT-MSCs show indeed high proliferation, differentiation and mineralization capacities in nHA/COL constructs compared to BM-MSCs, but this effect was irrespective of nHA concentration. Based on the results of alkaline phosphatase (ALP) activity and osteocalcin (OCN) protein level, the osteogenic differentiation of BM-MSCs started in the beginning of the culture period and for AT-MSCs at the end of the culture period. At a molecular level, both cell types showed high expression of osteogenic markers (bone morphogenic protein 2 [BMP2], runt-related transcription factor 2 [RUNX2], OCN or COL1) in both an nHA concentration and time dependent manner. In conclusion, AT-MSCs demonstrated higher osteogenic potential in nHA/COL based 3D micro-environments compared to BM-MSCs, in which proliferation and osteogenic differentiation were highly promoted in a time dependent manner, irrespective of nHA amount in the constructs. The fact that AT-MSCs showed high proliferation and mineralization potential is appealing for their application in future pre-clinical research as an alternative cell source for BM-MSCs.

PMID: 26803618 [PubMed - as supplied by publisher]



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Simulation-Based Dysphagia Training: Teaching Interprofessional Clinical Reasoning in a Hospital Environment.

Simulation-Based Dysphagia Training: Teaching Interprofessional Clinical Reasoning in a Hospital Environment.

Dysphagia. 2016 Jan 23;

Authors: Miles A, Friary P, Jackson B, Sekula J, Braakhuis A

Abstract
This study evaluated hospital readiness and interprofessional clinical reasoning in speech-language pathology and dietetics students following a simulation-based teaching package. Thirty-one students participated in two half-day simulation workshops. The training included orientation to the hospital setting, part-task skill learning and immersive simulated cases. Students completed workshop evaluation forms. They filled in a 10-question survey regarding confidence, knowledge and preparedness for working in a hospital environment before and immediately after the workshops. Students completed written 15-min clinical vignettes at 1 month prior to training, immediately prior to training and immediately after training. A marking rubric was devised to evaluate the responses to the clinical vignettes within a framework of interprofessional education. The simulation workshops were well received by all students. There was a significant increase in students' self-ratings of confidence, preparedness and knowledge following the study day (p < .001). There was a significant increase in student overall scores in clinical vignettes after training with the greatest increase in clinical reasoning (p < .001). Interprofessional simulation-based training has benefits in developing hospital readiness and clinical reasoning in allied health students.

PMID: 26803776 [PubMed - as supplied by publisher]



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Validation of the Spanish Version of the Eating Assessment Tool-10 (EAT-10spa) in Colombia. A Blinded Prospective Cohort Study.

Validation of the Spanish Version of the Eating Assessment Tool-10 (EAT-10spa) in Colombia. A Blinded Prospective Cohort Study.

Dysphagia. 2016 Jan 23;

Authors: Giraldo-Cadavid LF, Gutiérrez-Achury AM, Ruales-Suárez K, Rengifo-Varona ML, Barros C, Posada A, Romero C, Galvis AM

Abstract
Dysphagia might affect 12 % of the general population, and its complications include pneumonia, malnutrition, social isolation, and death. No validated Spanish symptom survey exists to quantify dysphagia symptoms among Latin Americans. Therefore, we performed a prospective cohort study in a tertiary care university hospital to validate the Spanish version of the 10-Item Eating-Assessment-Tool (EAT-10spa) for use in Colombia. After an interdisciplinary committee of five bilingual specialists evaluated the EAT-10spa (translated and validated in Spain) and deemed it appropriate for the Colombian culture, its feasibility, reliability, validity, sensitivity to change, and diagnostic capacity were evaluated. As a reference standard, we used the flexible endoscopic evaluation of swallowing with sensory testing and a standardized clinical evaluation. All assessments were blinded. In total, 133 subjects were included (52 % women, mean age 55 years) and completed the EAT-10spa (median completion time: 2 min [IQR 1-3 min]), 39 % of whom had an elementary-level education. Cronbach's α coefficient: 0.91; test-retest intra-class correlation coefficient: 0.94. The Spearman's correlation coefficient of the EAT-10spa with the 8-point penetration-aspiration scale was 0.54 (P < 0.001). The area under the receiver-operating-characteristic-curve (AUC-ROC) for dysphagia and aspiration were 0.79 (P < 0.001) and 0.81 (P < 0.001), respectively. The best cut-off points for dysphagia and aspiration were EAT-10spa ≥2 (sensitivity 93.6 %, specificity 36.4 %) and EAT-10spa ≥4 (sensitivity 94.3 %, specificity 49.5 %), respectively. A reduction in the EAT-10 ≥3 was the best cut-off point for a clinically significant improvement (AUC-ROC 0.83; P < 0.0001). The EAT-10spa showed excellent psychometric properties and discriminatory capacity for use in Colombia.

PMID: 26803775 [PubMed - as supplied by publisher]



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Validation of Clinical Observations of Mastication in Persons with ALS.

Validation of Clinical Observations of Mastication in Persons with ALS.

Dysphagia. 2016 Jan 23;

Authors: Simione M, Wilson EM, Yunusova Y, Green JR

Abstract
Amyotrophic lateral sclerosis (ALS) is a progressive neurological disease that can result in difficulties with mastication leading to malnutrition, choking or aspiration, and reduced quality of life. When evaluating mastication, clinicians primarily observe spatial and temporal aspects of jaw motion. The reliability and validity of clinical observations for detecting jaw movement abnormalities is unknown. The purpose of this study is to determine the reliability and validity of clinician-based ratings of chewing performance in neuro-typical controls and persons with varying degrees of chewing impairments due to ALS. Adults chewed a solid food consistency while full-face video were recorded along with jaw kinematic data using a 3D optical motion capture system. Five experienced speech-language pathologists watched the videos and rated the spatial and temporal aspects of chewing performance. The jaw kinematic data served as the gold-standard for validating the clinicians' ratings. Results showed that the clinician-based rating of temporal aspects of chewing performance had strong inter-rater reliability and correlated well with comparable kinematic measures. In contrast, the reliability of rating the spatial and spatiotemporal aspects of chewing (i.e., range of motion of the jaw, consistency of the chewing pattern) was mixed. Specifically, ratings of range of motion were at best only moderately reliable. Ratings of chewing movement consistency were reliable but only weakly correlated with comparable measures of jaw kinematics. These findings suggest that clinician ratings of temporal aspects of chewing are appropriate for clinical use, whereas ratings of the spatial and spatiotemporal aspects of chewing may not be reliable or valid.

PMID: 26803773 [PubMed - as supplied by publisher]



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Voluntary Cough Airflow Differentiates Safe Versus Unsafe Swallowing in Amyotrophic Lateral Sclerosis.

Voluntary Cough Airflow Differentiates Safe Versus Unsafe Swallowing in Amyotrophic Lateral Sclerosis.

Dysphagia. 2016 Jan 23;

Authors: Plowman EK, Watts SA, Robison R, Tabor L, Dion C, Gaziano J, Vu T, Gooch C

Abstract
Dysphagia and aspiration are prevalent in amyotrophic lateral sclerosis (ALS) and contribute to malnutrition, aspiration pneumonia, and death. Early detection of at risk individuals is critical to ensure maintenance of safe oral intake and optimal pulmonary function. We therefore aimed to determine the discriminant ability of voluntary cough airflow measures in detecting penetration/aspiration status in ALS patients. Seventy individuals with ALS (El-Escorial criteria) completed voluntary cough spirometry testing and underwent a standardized videofluoroscopic swallowing evaluation (VFSE). A rater blinded to aspiration status derived six objective measures of voluntary cough airflow and evaluated airway safety using the penetration-aspiration scale (PAS). A between groups ANOVA (safe vs. unsafe swallowers) was conducted and sensitivity, specificity, area under the curve (AUC) and likelihood ratios were calculated. VFSE analysis revealed 24 penetrator/aspirators (PAS ≥3) and 46 non-penetrator/aspirators (PAS ≤2). Cough volume acceleration (CVA), peak expiratory flow rise time (PEFRT), and peak expiratory flow rate (PEFR) were significantly different between airway safety groups (p < 0.05) and demonstrated significant discriminant ability to detect the presence of penetration/aspiration with AUC values of: 0.85, 0.81, and 0.78, respectively. CVA <45.28 L/s/s, PEFR <3.97 L/s, and PEFRT >76 ms had sensitivities of 91.3, 82.6, and 73.9 %, respectively, and specificities of 82.2, 73.9, and 78.3 % for identifying ALS penetrator/aspirators. Voluntary cough airflow measures identified ALS patients at risk for penetration/aspiration and may be a valuable screening tool with high clinical utility.

PMID: 26803772 [PubMed - as supplied by publisher]



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At the Beach: To Jump or Not to Jump?

Pediatric Emergency Care

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Microvascular dysfunction as opposed to conduit artery disease explains sex-specific chest pain in emergency department patients with low to moderate cardiac risk

Clinical Therapeutics

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Researchers may hold key to developing a single treatment against several types of Ebola

University of Texas Medical Branch at Galveston

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Decreased movement path tortuosity is associated with improved functional status in patients with traumatic brain injury

Journal of Head Trauma Rehabilitation

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Young people after Obamacare: some ER visits down, others way up

American College of Emergency Physicians News

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The effect of early intensive care on recovery from whiplash associated disorders - Results of a population based cohort study

Archives of Physical Medicine and Rehabilitation

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Compensatory neural tract from contralesional fornical body to ipsilesional medial temporal lobe in a patient with mild traumatic brain injury: a case report

American Journal of Physical Medicine & Rehabilitation

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Independent association of vitamin D with physical function in people with chronic spinal cord injury

Archives of Physical Medicine and Rehabilitation

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An oxygen mask to prevent sequelae from stroke?

Inserm (Institut national de la santé et de la recherche médicale)

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Out-of-hospital cardiac arrest: the prospect of E-CPR in the Maastricht region

Netherlands Heart Journal

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A research confirms that melatonin could be of use for preventing sepsis, first cause of death in hospital ICUs

University of Granada Health Science and Technology News

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An evidence-based approach to minimizing acute procedural pain in the emergency department and beyond

Pediatric Emergency Care

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Clinical utility and psychometric properties of the Traumatic Brain Injury Quality of Life scale (TBI-QOL) in US military service members

Journal of Head Trauma Rehabilitation

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Combined approaches for the relief of spinal cord injury-induced neuropathic pain

Complementary Therapies in Medicine

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