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HIV Medicine May 2022Comorbidities are associated with a high burden of disease in people living with HIV (PLWH). The objective was to investigate the prevalence of chronic comorbidities and...
OBJECTIVES
Comorbidities are associated with a high burden of disease in people living with HIV (PLWH). The objective was to investigate the prevalence of chronic comorbidities and use of co-medications in PLWH in Japan.
METHODS
This study retrospectively analysed clinical information from PLWH receiving antiretroviral therapy (ART) between April 2009 and March 2019. Demographic characteristics, numbers and types of chronic comorbidities, and numbers and types of non-ART co-medications, were described by age groups. The source of data was the National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB).
RESULTS
Overall, 28 089 PLWH (male 91.9%) who used ART were identified. Out of 28 089 PLWH, 81.5% had at least one chronic comorbidity. The numbers of AIDS-defining cancers and non-AIDS-defining cancers in this Japanese cohort were 2432 (8.7%) and 2485 (8.8%), respectively. The cumulative burden of comorbidities including non-AIDS-defining cancer increased with age. Changes in trend between 2009 and 2019 were observed, including a higher proportion of PLWH diagnosed at ≥ 70 years old [2019 (4.7%) vs. 2009 (2.4%)] and a decreasing percentage of patients with AIDS-defining cancers (down from 6.3% to 4.8% between 2009 and 2019). The most common co-medications during the most recent 3-month period were lipid-regulating/anti-atheroma preparations (11.3%), antacids, antiflatulents and anti-ulcerants (9.6%), and agents acting on the renin-angiotensin system (8.1%). The three most common therapeutic categories of co-medications during the study period were antacids, antiflatulents and anti-ulcerants (35.0%), systemic antihistamines (33.7%) and psycholeptics (27.1%). More than 30% of PLWH aged > 40 years used at least one co-medication in a 3-month period, while more than half of PLWH aged > 30 years had at least one co-medication prescribed concomitantly for a total of ≥ 90 days during the study period, and the numbers of co-medications used were greater in the older age groups.
CONCLUSIONS
The burden of chronic comorbidities and co-medication were found to be greater in older, as compared to younger patients, among 28 089 PLWH in a nationwide study in Japan. This finding suggests the need to identify elderly PLWH and to appropriately manage their HIV and comorbidities.
Topics: Acquired Immunodeficiency Syndrome; Aged; Antacids; Antifoaming Agents; Cohort Studies; Comorbidity; HIV Infections; Humans; Japan; Male; Neoplasms; Retrospective Studies
PubMed: 34821006
DOI: 10.1111/hiv.13206 -
Nutrients Nov 2021To explore the relationship between citrus fruit juices (oranges, grapefruits, and lemonades) and kidney stone disease (KSD). (Review)
Review
UNLABELLED
To explore the relationship between citrus fruit juices (oranges, grapefruits, and lemonades) and kidney stone disease (KSD).
METHODS
A systematic review was performed using the Medline, EMBASE, and Scopus databases, in concordance with the PRISMA checklist for all English, French, and Spanish language studies regarding the consumption of citrus fruit juices and the relationship to urinary stone disease. The main outcome of interest was the association of citrus fruit juices with KSD.
RESULTS
Thirteen articles met the criteria for inclusion in the final review. Three large epidemiological studies found that grapefruit juice was a risk factor for stone formation, while orange juice did not increase the risk for KSD. Ten small prospective clinical studies found that orange, grapefruit, and lemon juices all increased urinary citrate levels. Only orange and grapefruit juices had an alkalinizing effect and while lemon juice has a protective effect by raising urinary citrate levels, it lacked a significant alkalinizing effect on urine pH. Orange juice and grapefruit juices significantly increased urinary oxalate levels, while orange juice also had a high carbohydrate content.
CONCLUSION
While orange juice seems to play a protective role against stone formation, grapefruit was found to raise the risk of KSD in epidemiological studies but had a protective role in smaller clinical studies. Lemon juice had a smaller protective role than orange juice. Larger amounts of, as well as more accurate, data is needed before recommendations can be made and a high carbohydrate content in these juices needs to be taken into consideration.
Topics: Antacids; Citric Acid; Citrus; Citrus paradisi; Citrus sinensis; Fruit; Fruit and Vegetable Juices; Humans; Kidney Calculi; Plant Preparations; Urolithiasis
PubMed: 34836376
DOI: 10.3390/nu13114117 -
Pediatric Quality & Safety 2020Gastroesophageal reflux is a physiologic occurrence in infants. Clinicians caring for neonates use histamine-2 receptor antagonists (H2As) or proton pump inhibitors...
INTRODUCTION
Gastroesophageal reflux is a physiologic occurrence in infants. Clinicians caring for neonates use histamine-2 receptor antagonists (H2As) or proton pump inhibitors (PPIs) for symptomatic reflux, apnea/bradycardia/desaturations, or irritability. Recent studies have shown that there is an increased incidence of infection, fracture, and mortality in neonates who receive antacids.
METHODS
A multidisciplinary team aimed to decrease nonindicated antacid use in the NICU by 50% by April 2019. Outcome measures include the median number of inappropriate antacid prescriptions and patient-days on acid-suppressants. Interventions include education regarding use and risks of antacids, development of a list of indications deemed "appropriate" for starting an H2A or PPI, mandatory discussion on rounds when considering antacids, documentation of treatment goal, and indication, and an automatic drop-off in the electronic medical record.
RESULTS
Baseline data (June-December 2017) showed 19 prescriptions of H2As or PPIs. Of those, 10 orders were deemed "inappropriate," according to our indicated uses. There were 407 total patient-days of medication-use (median: 51 patient-days). After the implementation of the interventions (October 2018-May 2019), there were 11 prescriptions of antacid medications, 3 of which were deemed "inappropriate." There were 206 total days of medication-use (median: 18.5 patient-days).
CONCLUSIONS
A multidisciplinary agreement on indications for antacid use in neonates stimulates discussion and creates more purposeful use. Overall, we successfully decreased nonindicated antacid prescriptions in the NICU. For the next steps, we hope to educate physicians on the risks of antacid use and reduce prescriptions in other areas of the hospital and the outpatient setting.
PubMed: 32607459
DOI: 10.1097/pq9.0000000000000303 -
Cureus Mar 2024As the global incidence of idiopathic pulmonary fibrosis (IPF) is on the rise, there is a need for better diagnostic criteria, better treatment options, early and... (Review)
Review
As the global incidence of idiopathic pulmonary fibrosis (IPF) is on the rise, there is a need for better diagnostic criteria, better treatment options, early and appropriate diagnosis, adequate care, and a multidisciplinary approach to the management of patients. This systematic review explores the role of proton pump inhibitors (PPIs) in IPF and answers the question, "Does proton pump inhibitor improve only the prognosis of gastroesophageal associated idiopathic pulmonary fibrosis or for other types of idiopathic pulmonary fibrosis too?" We used PubMed (PMC) and Google Scholar for data collection for this systematic review and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for conducting this review. After in-depth literature screening and quality appraisal, 12 articles were selected for this systematic review. On the one hand, the efficacy of PPI therapy is supported by research such as the CAPACITY and ASCEND trials, a pilot randomized control trial (RCT) investigating the role of omeprazole in IPF and a bidirectional two-sample Mendelian randomization (MR) study, respectively. On the other hand, a systematic review and meta-analysis on antacid and antireflux surgery in IPF negate these results and show no statistical significance. Questions regarding the efficacy of PPI therapy must be dealt with in an adequately powered multicenter and double-blinded randomized control trial. The anti-inflammatory properties of antacids can serve as the cornerstone for future trials. In the following systematic review, antacid, antireflux therapy, omeprazole, and proton pump therapy are synonymous with stomach acid suppression therapy.
PubMed: 38606271
DOI: 10.7759/cureus.55980 -
PloS One 2022In nature, biomineralization is a common phenomenon, which can be further divided into authigenic and artificially induced mineralization. In recent years, artificially...
In nature, biomineralization is a common phenomenon, which can be further divided into authigenic and artificially induced mineralization. In recent years, artificially induced mineralization technology has been gradually extended to major engineering fields. Therefore, by elaborating the reaction mechanism and bacteria of mineralization process, and summarized various molecular dynamics equations involved in the mineralization process, including microbial and nutrient transport equations, microbial adsorption equations, growth equations, urea hydrolysis equations, and precipitation equations. Because of the environmental adaptation stage of microorganisms in sandy soil, their reaction rate in sandy soil environment is slower than that in solution environment, the influencing factors are more different, in general, including substrate concentration, temperature, pH, particle size and grouting method. Based on the characteristics of microbial mineralization such as strong cementation ability, fast, efficient, and easy to control, there are good prospects for application in sandy soil curing, building improvement, heavy metal fixation, oil reservoir dissection, and CO2 capture. Finally, it is discussed and summarized the problems and future development directions on the road of commercialization of microbial induced calcium carbonate precipitation technology from laboratory to field application.
Topics: Bacteria; Biomineralization; Calcium Carbonate; Soil; Technology
PubMed: 35867666
DOI: 10.1371/journal.pone.0271761 -
Scientific Reports Oct 2022The California Current System experiences seasonal ocean acidification and hypoxia (OAH) owing to wind-driven upwelling, but little is known about the intensity,...
The California Current System experiences seasonal ocean acidification and hypoxia (OAH) owing to wind-driven upwelling, but little is known about the intensity, frequency, and depth distribution of OAH in the shallow nearshore environment. Here we present observations of OAH and dissolved inorganic carbon and nutrient parameters based on monthly transects from March 2017 to September 2018 extending from the surf zone to the ~ 40 m depth contour in La Jolla, California. Biologically concerning OAH conditions were observed at depths as shallow as 10 m and as close as 700 m to the shoreline. Below 20 m depth, 8% of observations were undersaturated with respect to aragonite, 28% of observations had a pH less than 7.85, and 19% of observations were below the sublethal oxygen threshold of 157 µmol kg. These observations raise important questions about the impacts of OAH on coastal organisms and ecosystems and how future intensified upwelling may exacerbate these conditions.
Topics: Ecosystem; Seawater; Seasons; Hydrogen-Ion Concentration; Calcium Carbonate; Carbon; Oxygen; Oceans and Seas; California
PubMed: 36289268
DOI: 10.1038/s41598-022-21831-y -
Microbial Cell Factories Nov 2021Microbially induced calcite precipitation (MICP) is an ancient property of bacteria, which has recently gained considerable attention for biotechnological applications....
BACKGROUND
Microbially induced calcite precipitation (MICP) is an ancient property of bacteria, which has recently gained considerable attention for biotechnological applications. It occurs as a by-product of bacterial metabolism and involves a combination of chemical changes in the extracellular environment, e.g. pH increase, and presence of nucleation sites on the cell surface or extracellular substances produced by the bacteria. However, the molecular mechanisms underpinning MICP and the interplay between the contributing factors remain poorly understood, thus placing barriers to the full biotechnological and synthetic biology exploitation of bacterial biomineralisation.
RESULTS
In this study, we adopted a bottom-up approach of systematically engineering Bacillus subtilis, which has no detectable intrinsic MICP activity, for biomineralisation. We showed that heterologous production of urease can induce MICP by local increases in extracellular pH, and this can be enhanced by co-expression of urease accessory genes for urea and nickel uptake, depending on environmental conditions. MICP can be strongly enhanced by biofilm-promoting conditions, which appeared to be mainly driven by production of exopolysaccharide, while the protein component of the biofilm matrix was dispensable. Attempts to modulate the cell surface charge of B. subtilis had surprisingly minor effects, and our results suggest this organism may intrinsically have a very negative cell surface, potentially predisposing it for MICP activity.
CONCLUSIONS
Our findings give insights into the molecular mechanisms driving MICP in an application-relevant chassis organism and the genetic elements that can be used to engineer de novo or enhanced biomineralisation. This study also highlights mutual influences between the genetic drivers and the chemical composition of the surrounding environment in determining the speed, spatial distribution and resulting mineral crystals of MICP. Taken together, these data pave the way for future rational design of synthetic precipitator strains optimised for specific applications.
Topics: Bacillus subtilis; Biofilms; Biomineralization; Calcium Carbonate; Chemical Precipitation; DNA, Bacterial; Genetic Engineering; Hydrogen-Ion Concentration; Industrial Microbiology; Nickel; Polysaccharides, Bacterial; Sequence Deletion; Urea; Urease
PubMed: 34794448
DOI: 10.1186/s12934-021-01704-1 -
Vaccine Oct 2023The development of safe and effective second-generation COVID-19 vaccines to improve affordability and storage stability requirements remains a high priority to expand... (Comparative Study)
Comparative Study
Formulation development and comparability studies with an aluminum-salt adjuvanted SARS-CoV-2 spike ferritin nanoparticle vaccine antigen produced from two different cell lines.
The development of safe and effective second-generation COVID-19 vaccines to improve affordability and storage stability requirements remains a high priority to expand global coverage. In this report, we describe formulation development and comparability studies with a self-assembled SARS-CoV-2 spike ferritin nanoparticle vaccine antigen (called DCFHP), when produced in two different cell lines and formulated with an aluminum-salt adjuvant (Alhydrogel, AH). Varying levels of phosphate buffer altered the extent and strength of antigen-adjuvant interactions, and these formulations were evaluated for their (1) in vivo performance in mice and (2) in vitro stability profiles. Unadjuvanted DCFHP produced minimal immune responses while AH-adjuvanted formulations elicited greatly enhanced pseudovirus neutralization titers independent of ∼100%, ∼40% or ∼10% of the DCFHP antigen adsorbed to AH. These formulations differed, however, in their in vitro stability properties as determined by biophysical studies and a competitive ELISA for measuring ACE2 receptor binding of AH-bound antigen. Interestingly, after one month of 4°C storage, small increases in antigenicity with concomitant decreases in the ability to desorb the antigen from the AH were observed. Finally, we performed a comparability assessment of DCFHP antigen produced in Expi293 and CHO cells, which displayed expected differences in their N-linked oligosaccharide profiles. Despite consisting of different DCFHP glycoforms, these two preparations were highly similar in their key quality attributes including molecular size, structural integrity, conformational stability, binding to ACE2 receptor and mouse immunogenicity profiles. Taken together, these studies support future preclinical and clinical development of an AH-adjuvanted DCFHP vaccine candidate produced in CHO cells.
Topics: Animals; Spike Glycoprotein, Coronavirus; COVID-19 Vaccines; Adjuvants, Immunologic; Mice; Ferritins; SARS-CoV-2; COVID-19; Nanoparticles; Humans; Antibodies, Neutralizing; Female; Antibodies, Viral; Cell Line; Cricetulus; CHO Cells; Mice, Inbred BALB C; Aluminum Hydroxide; Immunogenicity, Vaccine; Nanovaccines
PubMed: 37620203
DOI: 10.1016/j.vaccine.2023.08.037 -
Water Research Oct 2022Reservoirs are active reactors for the biogeochemical cycling of carbon (C) and nutrients (nitrogen: N, phosphorus: P, and silica: Si), however, our in-depth...
Reservoirs are active reactors for the biogeochemical cycling of carbon (C) and nutrients (nitrogen: N, phosphorus: P, and silica: Si), however, our in-depth understanding of C and nutrient cycling in reservoirs is still limited by the fact that it involves a variety of closely linked and coupled biogeochemical and hydrological processes. In this study, the updated process-based Barman model was applied to three reservoirs of the Seine Basin during 2019-2020, considering the variations of carbon dioxide (CO) concentrations and key water quality variables. The model simulations captured well the observed seasonal variations of water quality variables, although discrepancies remained for some variables. According to the model, we found that: (1) the three reservoirs are autotrophic ecosystems and showed high removal efficiency of dissolved inorganic carbon and nutrients during 2019-2020; (2) phytoplankton assimilation, benthic denitrification, precipitation and dissolution of calcium carbonate, and gas exchange at the water-air interface are the dominant processes for water quality variations in reservoirs; (3) based on scenarios results, trophic state and mean water depth of reservoir would impact the biogeochemical processes and the retention efficiency of nitrate and dissolved silicate. Finally, we expect that the successful application of Barman model in the reservoirs of the Seine Basin could provide a useful tool for simulating reservoir water quality changes and thus evaluating the impacts of reservoirs on downstream water quality.
Topics: Carbon Dioxide; Ecosystem; Nitrates; Phosphorus; Nitrogen; Nutrients; Calcium Carbonate; Silicon Dioxide; Environmental Monitoring; China
PubMed: 36155003
DOI: 10.1016/j.watres.2022.119135 -
Journal of Investigative Medicine High... 2020Acute pancreatitis is caused by alcohol, gall stone disease, drugs, trauma, infections, and metabolic causes such as hypercalcemia and hyperlipidemia....
Acute pancreatitis is caused by alcohol, gall stone disease, drugs, trauma, infections, and metabolic causes such as hypercalcemia and hyperlipidemia. Hypercalcemia-induced acute pancreatitis has been well documented but only rarely occurs due to over-the-counter calcium carbonate. In this article, we present a case of over-the-counter calcium carbonate-induced acute pancreatitis.
Topics: Acute Disease; Adult; Calcium Carbonate; Humans; Hypercalcemia; Male; Nonprescription Drugs; Pancreatitis
PubMed: 32434384
DOI: 10.1177/2324709620922724