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Tidsskrift For Den Norske Laegeforening... Apr 2021Acute abdomen in pregnancy is challenging. The presentation of symptoms and available diagnostic tools are directed and complicated by the pregnancy. A rare cause of...
BACKGROUND
Acute abdomen in pregnancy is challenging. The presentation of symptoms and available diagnostic tools are directed and complicated by the pregnancy. A rare cause of acute abdomen in pregnancy requiring immediate intervention is presented.
CASE PRESENTATION
A primiparous woman with 34 weeks of uncomplicated pregnancy presented with acute onset of abdominal pain, no signs of labour or vaginal bleeding, blood pressure 127/100, and pulse 90. No fetal distress was indicated by cardiotocography or abdominal ultrasound, while large amounts of intra-abdominal free fluid were identified. The clinical examination revealed free intra-abdominal fluid, which combined with the intense pain prompted an emergency caesarean section on vital indication with removal of intra-abdominal blood, immediate delivery, and manual compression of the aorta. No signs of placental abruption or rupture of the uterine wall were identified. The bleeding, originating from a spontaneous rupture of the left uterine vein, was halted by vessel ligation. Although haemodynamically stable, the woman's estimated blood loss was 4700 millilitres. The child remained for ten days in the NICU owing to prematurity.
INTERPRETATION
A total of 100 case reports of acute spontaneous haemoperitoneum during pregnancy have been published. The underlying pathophysiology is undetermined, but possible risk factors include nulliparity, endometriosis causing extrauterine bleeding, and varicose veins. The condition requires immediate intervention, as morbidity and mortality rates for mother and fetus are high.
Topics: Abdomen, Acute; Cesarean Section; Child; Female; Humans; Placenta; Pregnancy; Pregnant Women; Rupture, Spontaneous
PubMed: 33876611
DOI: 10.4045/tidsskr.20.0551 -
International Journal of Ophthalmology 2022To evaluate the association of complement factor H () and microtubule-associated protein 1 light chain 3 beta () gene polymorphisms with the risk of age-related macular...
AIM
To evaluate the association of complement factor H () and microtubule-associated protein 1 light chain 3 beta () gene polymorphisms with the risk of age-related macular degeneration (AMD) in a high-altitude population.
METHODS
The study group consisted of 172 participants with symptoms of AMD who were examined and diagnosed between January 2019 and June 2020. The control group was composed of 120 healthy individuals. Each participant was required to provide two milliliters of peripheral blood for DNA extraction. Two single nucleotide polymorphisms (SNPs) of (rs1061170 and rs800292) and two SNPs of (rs8044820 and rs9903) were genotyped. The genotypes and allele frequencies of the SNPs in the study and control groups were further compared using Chi-square and Fisher's exact tests.
RESULTS
In a high-altitude population, the nominally significant differences of rs800292 and rs9903's genotype AG frequencies were observed in the AMD group (=0.034 and 0.004, respectively). The frequencies of allele G of rs800292 and allele A of rs9903 were also significantly different in the AMD group compared to the control [(=0.034, OR=0.70, 95%CI: 0.50-0.98) and (=0.004, OR=1.60, 95%CI: 1.15-2.22), respectively]. No significant differences in the genotype distributions (=0.16 and 0.40, respectively) and allele frequencies (>0.05) of rs1061170 and rs8044820 were observed in the AMD group.
CONCLUSION
Genotype AG of rs800292 may be a protective factor for AMD. Conversely, rs9903 seems to be a risk factor for AMD. Therefore, allele G of rs800292 may be a protective factor, and allele A of rs9903, a risk factor for AMD in Qinghai high-altitude population.
PubMed: 36404982
DOI: 10.18240/ijo.2022.11.04 -
Biophysical Journal Aug 2021The crowdedness of living cells, hundreds of milligrams per milliliter of macromolecules, may affect protein folding, function, and misfolding. Still, such processes are...
The crowdedness of living cells, hundreds of milligrams per milliliter of macromolecules, may affect protein folding, function, and misfolding. Still, such processes are most often studied in dilute solutions in vitro. To assess consequences of the in vivo milieu, we here investigated the effects of macromolecular crowding on the amyloid fiber formation reaction of α-synuclein, the amyloidogenic protein in Parkinson's disease. For this, we performed spectroscopic experiments probing individual steps of the reaction as a function of the macromolecular crowding agent Ficoll70, which is an inert sucrose-based polymer that provides excluded-volume effects. The experiments were performed at neutral pH at quiescent conditions to avoid artifacts due to shaking and glass beads (typical conditions for α-synuclein), using amyloid fiber seeds to initiate reactions. We find that both primary nucleation and fiber elongation steps during α-synuclein amyloid formation are accelerated by the presence of 140 and 280 mg/mL Ficoll70. Moreover, in the presence of Ficoll70 at neutral pH, secondary nucleation appears favored, resulting in faster overall α-synuclein amyloid formation. In contrast, sucrose, a small-molecule osmolyte and building block of Ficoll70, slowed down α-synuclein amyloid formation. The ability of cell environments to modulate reaction kinetics to a large extent, such as severalfold faster individual steps in α-synuclein amyloid formation, is an important consideration for biochemical reactions in living systems.
Topics: Amyloid; Humans; Kinetics; Parkinson Disease; Protein Folding; alpha-Synuclein
PubMed: 34242594
DOI: 10.1016/j.bpj.2021.06.032 -
Cureus Feb 2023Introduction Personal skincare leave-on products increase the risk of food allergies. Parents must be imparted with an elevated degree of cognizance regarding the...
Introduction Personal skincare leave-on products increase the risk of food allergies. Parents must be imparted with an elevated degree of cognizance regarding the allergenic nature of pediatric skincare products. Material and methods We aimed to examine the data inferred from the promotional material on labeling these products about their proclivity to elicit skin sensitization. This study investigated the relationship between food allergens and essential oil ingredients and highlighted marketing terms, product prices, and ratings of moisturizers for children that are sold on Amazon, Japan. We searched and recorded the product labels and website marketing terms, price (per gram or milliliter), the number of reviews, and allergens and investigated the relationship between the percentage of food allergens in those products and marketing terms, price, and the number of Amazon reviews. Results Among the 164 pediatric skincare products we included, 144 (87.8%) that were manufactured in Japan were the most common; 7 (4.3%), 15 (9.1%), 23 (14.0%), 24 (14.6%), and 54 (32.9%) contained the eight regulated food allergens, grain, nut, fruit, and essential oils, respectively. Marketing terms emphasizing "natural/organic" were more likely to contain grain allergens and essential oils and were more expensive with and without "organic" labeling, respectively, whereas those labeled with marketing terms emphasizing "hypoallergenic" were less likely to contain fruit allergens or essential oils. Products with fewer Amazon reviews were more likely to use the marketing term "natural/organic" and had a higher grain allergen content. Conclusion In Japan, 4.3% of children's skincare products sold on Amazon contain eight food allergens that should obligatorily be labeled when included in food products. In addition, more than 10% of these children's skin care products contain ingredients derived from nuts, while more than 30% contain fruit extracts or essential oils.
PubMed: 36938271
DOI: 10.7759/cureus.34918 -
Frontiers in Oncology 2023Aggressive angiomyxoma (AAM) is a rare, locally aggressive soft tissue neoplasm with a marked tendency for local recurrence after surgery. Although hormone therapy,... (Review)
Review
OBJECTIVE
Aggressive angiomyxoma (AAM) is a rare, locally aggressive soft tissue neoplasm with a marked tendency for local recurrence after surgery. Although hormone therapy, radiation therapy, and vascular embolization can be performed, we investigated the safety and efficacy of a new chemical ablation protocol for AAM.
METHODS
This study included two female AAM patients from 2012 to 2016. The patients' clinical and imaging data were collected. The amount of anhydrous ethanol and glacial acetic acid used for chemical ablation was documented, and the management of any complications was detailed.
RESULTS
The maximum dimensions of the residual tumor were 12.6 cm and 14.0 cm. In one case, the lesion was in the pelvis and protruded into the vulva. Eighty milliliters of liquid with a mixture of glacial acetic acid, anhydrous ethanol, and iohexol (10:9:1) was used for chemical ablation therapy multipoint injections with a single needle. However, a pelvic fistula developed 1 month later. In another case, the lesion was located in the abdominal wall. The ablation procedure was improved by performing chemical ablation therapy with multiple needles for multi-point injections of smaller than 30 ml injections for each procedure. To date, no recurrence or metastasis has been observed in the two cases.
CONCLUSION
The preferred treatment for AAM is complete resection. Chemical ablation therapy is a novel adjuvant therapy for AMM. Nonetheless, more research is needed to confirm these findings.
PubMed: 37007152
DOI: 10.3389/fonc.2023.1154283 -
Life (Basel, Switzerland) Oct 2022Oral candidiasis is the most common opportunistic fungal infection caused by commensal species. Since there are various local and systemic predisposing factors for the... (Review)
Review
Oral candidiasis is the most common opportunistic fungal infection caused by commensal species. Since there are various local and systemic predisposing factors for the disease, the treatment also varies from topical to systemic antifungal agents. Nystatin is a common antifungal agent used topically. The aim of this systematic review was to evaluate and compare the efficacy of different antifungal agents and the safety of nystatin in the treatment of oral candidiasis. Three electronic databases were searched for randomized controlled trials comparing nystatin with other anti-fungal therapies or placebo. Clinical and/or mycological cure was the outcome evaluation. A meta-analysis and descriptive study on the efficacy, treatment protocols, and safety of nystatin was also conducted. The meta-analysis included five studies, which compared the efficacy of nystatin suspensions with photodynamic therapy. A significant difference in the colony-forming units per milliliters (CFU/mL) of species was observed at 60 days intervals for both palatal mucosa and denture surfaces, with both groups favoring nystatin with low heterogeneity at a 95% confidence interval. Nystatin and photodynamic therapy were found to be equally effective for the clinical remission of denture stomatitis as well as a significant reduction of CFU/mL of species from dentures and palatal surfaces of the patients.
PubMed: 36362833
DOI: 10.3390/life12111677 -
Marine Drugs Jan 2024Marine fungi, such as species from the and genera, are prolific producers of a diversity of natural products with cytotoxic properties. These fungi have been... (Review)
Review
Marine fungi, such as species from the and genera, are prolific producers of a diversity of natural products with cytotoxic properties. These fungi have been successfully isolated and identified from various marine sources, including sponges, coral, algae, mangroves, sediment, and seawater. The cytotoxic compounds derived from marine fungi can be categorized into five distinct classes: polyketides, peptides, terpenoids and sterols, hybrids, and other miscellaneous compounds. Notably, the pre-eminent group among these compounds comprises polyketides, accounting for 307 out of 642 identified compounds. Particularly, within this collection, 23 out of the 642 compounds exhibit remarkable cytotoxic potency, with IC values measured at the nanomolar (nM) or nanogram per milliliter (ng/mL) levels. This review elucidates the originating fungal strains, the sources of isolation, chemical structures, and the noteworthy antitumor activity of the 642 novel natural products isolated from marine fungi. The scope of this review encompasses the period from 1991 to 2023.
Topics: Fungi; Aspergillus; Antineoplastic Agents; Biological Products; Polyketides
PubMed: 38393041
DOI: 10.3390/md22020070 -
Saudi Pharmaceutical Journal : SPJ :... Nov 2020Atorvastatin (ATO) is of the statin class and is used as an orally administered lipid-lowering drug. ATO is a reversible synthetic competitive inhibitor of... (Review)
Review
Atorvastatin (ATO) is of the statin class and is used as an orally administered lipid-lowering drug. ATO is a reversible synthetic competitive inhibitor of 3-hydroxy-3-methyl-glutaryl-CoA (HMG-CoA) reductase thus leading to a reduction in cholesterol synthesis. It has recently been demonstrated that ATO has different pharmacological actions, which are unrelated to its lipid-lowering effects and has the ability to treat chronic airway diseases. This paper reviews the potential of ATO as an anti-inflammatory, antioxidant, and anti-proliferative agent after oral or inhaled administration. This paper discusses the advantages and disadvantages of using ATO under conditions associated with those found in the airways. This treatment could potentially be used to support the formulating of ATO as an inhaler for the treatment of chronic respiratory diseases.
PubMed: 33250642
DOI: 10.1016/j.jsps.2020.08.025 -
Extracellular Vesicles and Circulating... 2021Extracellular vesicles (EVs) have been recognized as an evolving biomarker within the liquid biopsy family. While carrying both host cell proteins and different types of...
Extracellular vesicles (EVs) have been recognized as an evolving biomarker within the liquid biopsy family. While carrying both host cell proteins and different types of RNAs, EVs are also present in sufficient quantities in biological samples to be tested using many molecular analysis platforms to interrogate their content. However, because EVs in biological samples are comprised of both disease and non-disease related EVs, enrichment is often required to remove potential interferences from the downstream molecular assay. Most benchtop isolation/enrichment methods require > milliliter levels of sample and can cause varying degrees of damage to the EVs. In addition, some of the common EV benchtop isolation methods do not sort the diseased from the non-diseased related EVs. Simultaneously, the detection of the overall concentration and size distribution of the EVs is highly dependent on techniques such as electron microscopy and Nanoparticle Tracking Analysis, which can include unexpected variations and biases as well as complexity in the analysis. This review discusses the importance of EVs as a biomarker secured from a liquid biopsy and covers some of the traditional and non-traditional, including microfluidics and resistive pulse sensing, technologies for EV isolation and detection, respectively.
PubMed: 34414401
DOI: 10.20517/evcna.2021.07 -
Clinical Practice and Cases in... Feb 2022Aripiprazole is an atypical antipsychotic with unique receptor-binding properties that has a favorable safety profile in therapeutic doses compared to other...
INTRODUCTION
Aripiprazole is an atypical antipsychotic with unique receptor-binding properties that has a favorable safety profile in therapeutic doses compared to other antipsychotics. Massive aripiprazole overdose in children, however, presents with profound lethargy and may have neurologic, hemodynamic, and cardiac effects, often requiring admission to a high level of care.
CASE REPORT
We describe a case of a 21-month-old male with a reported 52-milligram aripiprazole ingestion. Initial vital signs were remarkable for tachycardia and hypertension, which rapidly resolved. The patient did not develop hypotension throughout hospitalization. He experienced 60 hours of lethargy. Irritability associated with upper extremity spasms and tremors occurred from 36-72 hours post ingestion, which resolved without intervention. The initial electrocardiogram demonstrated ST-segment depressions in the anteroseptal leads; further cardiac workup was normal. Concurrent medical workup was unrevealing. Aripiprazole and dehydro-aripiprazole serum concentrations sent 46 hours after reported exposure were 266.5 nanograms per milliliter (ng/mL) and 138.6 ng/mL, respectively. He returned to neurologic baseline and was discharged 72 hours after ingestion.
CONCLUSION
Antipsychotics, including aripiprazole, should be considered as a potential toxicological cause of persistent central nervous system depression; ingestion of a single dose has the potential to cause significant toxicity.
PubMed: 35226844
DOI: 10.5811/cpcem.2021.10.54520