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Lin Chuang Er Bi Yan Hou Tou Jing Wai... Jan 2022To investigate the clinical characteristics of infantile subglottic hemangioma(SGH), and to observe the safety and efficacy of propranolol in the treatment of SGH....
To investigate the clinical characteristics of infantile subglottic hemangioma(SGH), and to observe the safety and efficacy of propranolol in the treatment of SGH. The data of 13 children diagnosed with SGH and treated with propranolol in Shanghai Children's Hospital from November 2015 to March 2020 were retrospectively analyzed and followed up. All 13 cases underwent laryngoscopy and 10 cases underwentcontrastenhanced CT. Laryngeal exploration under general anesthesia was performed in 2 cases. Propranolol was started at 1 mg/(kg·d) divided into 3 doses. Heart rate and blood pressure were monitored during treatment. If no side effects were observed, then the dose was increased to 1.5 mg/(kg·d) on the second day. It was suggested to maintain this starting dose at diagnosis(1.5 mg/kg body weight), and not increase the number of milligrams as the child gained weight. The age at therapy termination ranged from 9 months to 38 months, only 2 cases beyond 2 years old, with an average of (19.3±7.7) months. The treatmentduration ranged from 6 to 21.3 months, with an average of (13.3±4.9) months. The follow-up time ranged from 21 to 71 months, with an average of (46.8±14.9) months. All 13 cases were cured. Infants under 2 years old with stridor have poor effect or repeated condition after routine treatment, SGH should be considered at this moment. Laryngoscopy combined with contrastenhanced CT is recommended. Oral propranolol is safe and effective in the treatment of SGH. It is suggested to oral propranololbeyond 19 months old to reduce recurrence, furthermore, 2 years old may be the best time for therapy termination.
Topics: Administration, Oral; Child; Child, Preschool; China; Hemangioma; Humans; Infant; Laryngeal Neoplasms; Propranolol; Retrospective Studies; Treatment Outcome
PubMed: 34979621
DOI: 10.13201/j.issn.2096-7993.2022.01.012 -
ACS Sustainable Chemistry & Engineering Jun 2023The use of biocatalysis for classically synthetic transformations has seen an increase in recent years, driven by the sustainability credentials bio-based approaches can...
The use of biocatalysis for classically synthetic transformations has seen an increase in recent years, driven by the sustainability credentials bio-based approaches can offer the chemical industry. Despite this, the biocatalytic reduction of aromatic nitro compounds using nitroreductase biocatalysts has not received significant attention in the context of synthetic chemistry. Herein, a nitroreductase (NR-55) is demonstrated to complete aromatic nitro reduction in a continuous packed-bed reactor for the first time. Immobilization on an amino-functionalized resin with a glucose dehydrogenase (GDH-101) permits extended reuse of the immobilized system, all operating at room temperature and pressure in aqueous buffer. By transferring into flow, a continuous extraction module is incorporated, allowing the reaction and workup to be continuously undertaken in a single operation. This is extended to showcase a closed-loop aqueous phase, permitting reuse of the contained cofactors, with a productivity of >10 g g and milligram isolated yields >50% for the product anilines. This facile method removes the need for high-pressure hydrogen gas and precious-metal catalysts and proceeds with high chemoselectivity in the presence of hydrogenation-labile halides. Application of this continuous biocatalytic methodology to panels of aryl nitro compounds could offer a sustainable approach to its energy and resource-intensive precious-metal-catalyzed counterpart.
PubMed: 37323810
DOI: 10.1021/acssuschemeng.3c01204 -
Cureus Jan 2022Background Osteoarthritis (OA) can result in significant pain, requiring pain management with opioids. Medical cannabis (MC) has the potential to be an alternative to...
Background Osteoarthritis (OA) can result in significant pain, requiring pain management with opioids. Medical cannabis (MC) has the potential to be an alternative to opioids for chronic pain conditions. This study investigates whether MC used in the management of OA-related chronic pain can reduce opioid utilization. Methods Forty patients with chronic OA pain were certified for MC. Average morphine milligram equivalents (MME) per day of opioid prescriptions filled within the six months prior to MC certification was compared to that of the six months after. Visual analog scale (VAS) for pain and Global Health scores were measured at baseline, three, and six months post MC certification. Results Average MME/day decreased from 18.2 to 9.8 (n=40, p<0.05). The percentage of patients who dropped to 0 MME/day was 37.5%. VAS scores decreased significantly at three and six months, and Global Physical Health score increased significantly by three months. Conclusions MC reduces opioid prescription for patients with chronic OA pain and improves pain and quality of life.
PubMed: 35228923
DOI: 10.7759/cureus.21564 -
The Spine Journal : Official Journal of... Mar 2022The enhanced recovery after surgery (ERAS) protocol is a multidisciplinary, multimodal approach which has been shown to facilitate recovery of physiological function,...
BACKGROUND
The enhanced recovery after surgery (ERAS) protocol is a multidisciplinary, multimodal approach which has been shown to facilitate recovery of physiological function, and reduce postoperative pain, complication rates, and length of stay without adversely affecting readmission rates. Design and implementation of ERAS protocols in the recent spine surgery literature has primarily focused on patients undergoing minimally invasive lumbar surgery. However, conventional open transforaminal lumbar interbody fusion (TLIF) remains a common procedure and to date there are no studies assessing an ERAS protocol in this patient population.
PURPOSE
This study presents a single surgeon experience implementing an ERAS protocol in patients undergoing 1- or 2-level open TLIF.
STUDY DESIGN/SETTING
Retrospective consecutive patient cohort with controls propensity-matched for age, body mass index, sex, and smoking status.
PATIENT SAMPLE
Consecutive patients that underwent 1- or 2-level open TLIF for degenerative disease from 12/2018 - 02/2021 and controls from 12/2011-12/2017 by a single surgeon. ERAS was implemented in December 2018.
OUTCOME MEASURES
Primary: length of stay; Secondary: first day to ambulate, first day to bowel movement, first day to void, daily average and maximum pain scores, opioid use, discharge disposition, 30-day readmission rate, and re-operations.
METHODS
Demographic, perioperative, clinical, radiographic data were collected. Multivariate mixed-linear regression models were developed for length of stay, physiological function, pain scales, and opiate use.
RESULTS
There were 114 patients included with 57 in each cohort. After propensity matching, patient characteristics were similar between groups. Operative time decreased significantly after institution of ERAS (170±44 vs. 141±37 minutes, p <.0001) as did length of stay (4.6±1.7 vs. 3.6±1.6 days, p<.0001). First day of ambulation, bowel movement, and bladder voiding improved by 0.8 (p<.0001), 0.7 (p=.008), and 0.8 (p<.0001) days, respectively, in the ERAS cohort. Total daily intravenous morphine milligram equivalent (MME) (8±9 vs. 36±38, p<0.0001) and total 72-hour MME consumption (53±33 vs. 68±48, p<.0001) was significantly lower in the ERAS cohort; however, 72-hour MME consumption was not found to be significantly different in a sensitivity analysis controlling for preoperative MME. Average daily pain scores were similar between groups.
CONCLUSIONS
Consistent with other studies demonstrating benefit of an ERAS protocol for minimally invasive spine procedures, ERAS was associated with decreased operative time, reduced length of stay, decrease in IV opioid consumption, and improved physiological outcomes for open 1- and 2-level TLIF. ERAS can be a potentially effective strategy for improving patient outcome and efficiency of healthcare resources for common conventional spinal surgeries such as open TLIF.
Topics: Cohort Studies; Enhanced Recovery After Surgery; Humans; Lumbar Vertebrae; Minimally Invasive Surgical Procedures; Retrospective Studies; Spinal Fusion; Treatment Outcome
PubMed: 34687905
DOI: 10.1016/j.spinee.2021.10.007 -
Environmental Health Perspectives Mar 2023Nitrate and trihalomethanes (THMs) in drinking water are widespread and are potential human carcinogens.
BACKGROUND
Nitrate and trihalomethanes (THMs) in drinking water are widespread and are potential human carcinogens.
OBJECTIVE
We evaluated the association between drinking-water exposure to nitrate and THMs and prostate cancer.
METHODS
During the period 2008-2013, 697 hospital-based incident prostate cancer cases (97 aggressive tumors) and 927 population-based controls were recruited in Spain, providing information on residential histories and type of water consumed. Average nitrate and THMs levels in drinking water were linked with lifetime water consumption to calculate waterborne ingestion. Odds ratios (OR) and 95% confidence intervals (CI) were estimated using mixed models with recruitment area as random effect. Effect modification by tumor grade (Gleason score), age, education, lifestyle, and dietary factors was explored.
RESULTS
Mean () adult lifetime waterborne ingested nitrate (milligrams per day), brominated (Br)-THMs (micrograms per day), and chloroform (micrograms per day) were 11.5 (), 20.7 (), and 15.1 () in controls. Waterborne ingested nitrate vs. was associated with an OR of 1.74 (95% CI: 1.19, 2.54) overall, and 2.78 (95% CI: 1.23, 6.27) for tumors with Gleason scores . Associations were higher in the youngest and those with lower intakes of fiber, fruit/vegetables, and vitamin C. Waterborne ingested THMs were not associated with prostate cancer. Residential tap water levels of Br-THMs and chloroform showed, respectively, inverse and positive associations with prostate cancer.
CONCLUSIONS
Findings suggest long-term waterborne ingested nitrate could be a risk factor of prostate cancer, particularly for aggressive tumors. High intakes of fiber, fruit/vegetables and vitamin C may lower this risk. Association with residential levels but not ingested chloroform/Br-THM may suggest inhalation and dermal routes could be relevant for prostate cancer. https://doi.org/10.1289/EHP11391.
Topics: Adult; Male; Humans; Drinking Water; Nitrates; Environmental Exposure; Trihalomethanes; Chloroform; Spain; Prostatic Neoplasms; Water Pollutants, Chemical; Ascorbic Acid
PubMed: 36883836
DOI: 10.1289/EHP11391 -
Bio-protocol Jul 2023Toxin-antitoxin (TA) systems are widespread bacterial immune systems that confer protection against various environmental stresses. TA systems have been classified into...
Toxin-antitoxin (TA) systems are widespread bacterial immune systems that confer protection against various environmental stresses. TA systems have been classified into eight types (I-VIII) based on the nature and mechanism of action of the antitoxin. Type III TA systems consist of a noncoding RNA antitoxin and a protein toxin, forming a ribonucleoprotein (RNP) TA complex that plays crucial roles in phage defence in bacteria. Type III TA systems are present in the human gut microbiome and several pathogenic bacteria and, therefore, could be exploited for a novel antibacterial strategy. Due to the inherent toxicity of the toxin for E. coli, it is challenging to overexpress and purify free toxins from E. coli expression systems. Therefore, protein toxin is typically co-expressed and co-purified with antitoxin RNA as an RNP complex from E. coli for structural and biophysical studies. Here, we have optimized the co-expression and purification method for ToxIN type III TA complexes from E. coli that results in the purification of TA RNP complex and, often, free antitoxin RNA and free active toxin in quantities required for the biophysical and structural studies. This protocol can also be adapted to purify isotopically labelled (e.g., uniformly 15N- or 13C-labelled) free toxin proteins, free antitoxin RNAs, and TA RNPs, which can be studied using multidimensional nuclear magnetic resonance (NMR) spectroscopy methods. Key features Detailed protocol for the large-scale purification of ToxIN type III toxin-antitoxin complexes from . The optimized protocol results in obtaining milligrams of TA RNP complex, free toxin, and free antitoxin RNA. Commercially available plasmid vectors and chemicals are used to complete the protocol in five days after obtaining the required DNA clones. The purified TA complex, toxin protein, and antitoxin RNA are used for biophysical experiments such as NMR, ITC, and X-ray crystallography.
PubMed: 37456336
DOI: 10.21769/BioProtoc.4763 -
Tobacco Control May 2021Some jurisdictions have instituted limits on electronic cigarette (ECIG) liquid nicotine concentration, in an effort to control ECIG nicotine yield, and others are...
Some jurisdictions have instituted limits on electronic cigarette (ECIG) liquid nicotine concentration, in an effort to control ECIG nicotine yield, and others are considering following suit. Because ECIG nicotine yield is proportional to the product of liquid nicotine concentration (milligram per millilitre) and device power (watts) regulations that limit liquid nicotine concentration may drive users to adopt higher wattage devices to obtain a desired nicotine yield. In this study we investigated, under various hypothetical regulatory limits on ECIG liquid nicotine concentration, a scenario in which a user of a common ECIG device (SMOK TF-N2) seeks to obtain in 15 puffs the nicotine emissions equivalent to one combustible cigarette (ie, 1.8 mg). We measured total aerosol and carbonyl compound (CC) yields in 15 puffs as a function of power (15-80 W) while all else was held constant. The estimated nicotine concentration needed to achieve combustible cigarette-like nicotine yield at each power level was then computed based on the measured liquid consumption. We found that for a constant nicotine yield of 1.8 mg, reducing the liquid nicotine concentration resulted in greater amount of liquid aerosolised (p<0.01) and greater CC emissions (p<0.05). Thus, if users seek a given nicotine yield, regulatory limits on nicotine concentration may have the unintended consequence of increasing exposure to aerosol and respiratory toxicants. This outcome demonstrates that attempting to control ECIG nicotine yield by regulating one factor at a time may have unintended health effects and highlights the need to consider multiple factors and outcomes simultaneously when designing regulations.
Topics: Aerosols; Electronic Nicotine Delivery Systems; Hazardous Substances; Humans; Nicotine
PubMed: 32522818
DOI: 10.1136/tobaccocontrol-2019-055523 -
Cureus Jul 2022It has been suggested that regular physical activity has become a part of rehabilitation in controlling blood glucose levels in type 2 diabetes mellitus patients. In... (Review)
Review
It has been suggested that regular physical activity has become a part of rehabilitation in controlling blood glucose levels in type 2 diabetes mellitus patients. In type 2 diabetes mellitus the cells become resistant to insulin, which leads to elevated blood glucose over time and leads to prediabetes and type 2 diabetes mellitus (T2DM). The typical adult's blood contains about 5-10 grams of glucose when their blood glucose content is 100 milligrams per decilitre. About half a billion individuals are at risk for diabetes worldwide. Physical exercise has been proved to be better therapy for controlling blood glucose in persons at risk for diabetes, preventing further body complications. Three significant interests in exercising to delay the onset of T2DM. First, increased blood flow into the muscle is triggered by skeletal muscle activity, which promotes glucose absorption from the bloodstream. Second, it reduces abdominal adipose tissue, a well-known risk of metabolic disease. Third, physical exercise with moderate intensity has been proven to boost glucose uptake by 40 percent. Globally and in developing nations like India, the burden of diabetes is expanding, attributable to a rise in overweight/obesity and sedentary lifestyles. It is difficult to provide healthcare for diseases like diabetes since it requires a consistent commitment to the prescribed course of treatment. Based on the correlation between fasting plasma glucose (FPG) or hemoglobin A1c (HbA1c) and retinopathy, cut-off values for glucose and HbA1c are estimated.
PubMed: 36060389
DOI: 10.7759/cureus.27476 -
MAbs 2021Advances in antibody discovery technologies, especially with the availability of humanized mice and phage/yeast library approaches, enable the generation of a large...
Advances in antibody discovery technologies, especially with the availability of humanized mice and phage/yeast library approaches, enable the generation of a large diversity of antibodies against nearly any target of interest. As a result, there is an increasing demand for the production of larger numbers of purified antibodies at quantities (10s-100s of milligrams) sufficient for functional screening assays, drug-ability/develop-ability studies and immunogenicity assessments. To accommodate this need, new methods are required that bridge miniature high throughput/plate-based purification and conventional, one at a time, two-step purification at much larger scales. Thus, we developed a semi-automated, mid-scale (i.e., 1-75 mg) purification process that uses a combination of parallel affinity capture and automated sequential polishing to provide substantially improved throughput while delivering high purity. We optimized the affinity capture step to perform 24 monoclonal antibody purifications in parallel using a Protein Maker for 20-200 mL culture media. The eluant is transferred directly to an AKTA pure system equipped with an autosampler for sequential preparative size exclusion chromatography to remove aggregates and undesirable impurities, as well as exchange the antibody into a buffer suitable for most uses, including cell-based assays. This two-step purification procedure, together with plate-based protein analytical methods, can purify 24-48 monoclonal antibodies in <20 hours and generate up to 80 mg per sample. A stringent clean-in-place protocol for both systems and column maintenance was designed and established to minimize endotoxin contamination. This process has proven to be very reliable and robust, enabling the production of thousands of antibodies of sufficient quality and quantity that are suitable for cell-based assays, biochemical/biophysical characterization, and in vivo animal models.
Topics: Animals; Antibodies, Monoclonal; Chromatography, Affinity; Chromatography, Gel; Mice; Staphylococcal Protein A
PubMed: 34781834
DOI: 10.1080/19420862.2021.2000348 -
Revista Medica de Chile Oct 2022Mycophenolate mofetil (MMF) is a largely used immunosuppressive agent in the prevention of transplant rejection and lupus nephritis. Its use has been extended to other...
BACKGROUND
Mycophenolate mofetil (MMF) is a largely used immunosuppressive agent in the prevention of transplant rejection and lupus nephritis. Its use has been extended to other immune-mediated diseases (ID).
AIM
To assess the off-label use of MMF, its performance as a glucocorticoid sparing agent, the therapeutic response, and its adverse effects.
MATERIAL AND METHODS
A retrospective study was performed. One hundred-seven patients aged 58 ± 16 years (83% females) who received MMF for ID in off label uses between 2016 and 2018 were included. The study variables were cause of MMF indication, sex, age, use as a first- or second-line treatment and maintenance dosing. The cumulative doses of glucocorticoids six months before and after MMF indication were compared.
RESULTS
MMF was used as a second-line therapy in 66 patients (62%). The mean maintenance dose of MMF was 1,500 ± 540 mg/day. Prednisone cumulative doses were 3,908 ± 2,173 and 1,672 ± 1,083 milligrams six months before and six months after starting MMF, respectively (p < 0.01). Adverse effects were identified in 21 (20%) cases, none of them serious.
CONCLUSIONS
Mycophenolate has a favorable response profile as a second line immunosuppressive agent. It is effective as a glucocorticoid sparing drug. The safety profile is also favorable as adverse effects were scanty and mild.
Topics: Female; Humans; Male; Mycophenolic Acid; Glucocorticoids; Retrospective Studies; Off-Label Use; Immunosuppressive Agents; Drug-Related Side Effects and Adverse Reactions; Treatment Outcome
PubMed: 37358090
DOI: 10.4067/S0034-98872022001001317