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Archives of Endocrinology and Metabolism Mar 2023Hypercalcemia is a frequent condition in clinical practice and when the most frequent causes are excluded, etiological diagnosis can be challenging. A rare cause of...
Hypercalcemia is a frequent condition in clinical practice and when the most frequent causes are excluded, etiological diagnosis can be challenging. A rare cause of PTH-independent hypercalcemia is described in the present case report. A male adult with a history of androgenic-anabolic steroids abuse, and injection of mineral oil and oily veterinary compound containing vitamins A, D and E into muscles for local hypertrophy presented with hypercalcemia, nephrocalcinosis, and end-stage renal disease. On physical examination, the presence of calcified subcutaneous nodules and calcification of musculature previously infused with oily substances drew attention. Laboratory tests confirmed hypercalcemia of 12.62 mg/L, low levels of PTH (10 pg/mL), hyperphosphatemia (6.0 mg/dL), 25(OH)D of 23.3 ng/mL, and elevated 1,25(OH)2D (138 pg/mL). Imaging exams showed diffuse calcification of muscle tissue, subcutaneous tissue, and organs such as the heart, lung, and kidneys. The patient was diagnosed with PTH-independent hypercalcemia secondary to foreign body reaction in areas of oil injection. The patient underwent treatment with hydrocortisone for 10 days, single dose zoledronic acid and hemodialysis. He evolved with serum calcium levels of 10.4 mg/dL and phosphorus of 7.1 mg/dL. In addition, sertraline and quetiapine were prescribed to control body dysmorphic disorder. The medical community should become aware of new causes of hypercalcemia as secondary to oil injection since this should become increasingly frequent due to the regularity with which such procedures have been performed.
Topics: Adult; Male; Humans; Hypercalcemia; Mineral Oil; Vitamins; Vitamin A; Parathyroid Hormone; Calcium
PubMed: 37011375
DOI: 10.20945/2359-3997000000591 -
JAMA Jan 2020Staphylococcus aureus is a leading cause of health care-associated infections in the neonatal intensive care unit (NICU). Parents may expose neonates to S aureus... (Randomized Controlled Trial)
Randomized Controlled Trial
IMPORTANCE
Staphylococcus aureus is a leading cause of health care-associated infections in the neonatal intensive care unit (NICU). Parents may expose neonates to S aureus colonization, a well-established predisposing factor to invasive S aureus disease.
OBJECTIVE
To test whether treating parents with intranasal mupirocin and topical chlorhexidine compared with placebo would reduce transmission of S aureus from parents to neonates.
DESIGN, SETTING, AND PARTICIPANTS
Double-blinded randomized clinical trial in 2 tertiary NICUs in Baltimore, Maryland. Neonates (n = 236) with S aureus-colonized parent(s) were enrolled. The study period was November 7, 2014, through December 13, 2018.
INTERVENTIONS
Parents were assigned to intranasal mupirocin and 2% chlorhexidine-impregnated cloths (active treatment, n = 117) or petrolatum intranasal ointment and nonmedicated soap cloths (placebo, n = 119) for 5 days.
MAIN OUTCOMES AND MEASURES
The primary end point was concordant S aureus colonization by 90 days, defined as neonatal acquisition of an S aureus strain that was the same strain as a parental strain at time of screening. Secondary outcomes included neonatal acquisition of any S aureus strain and neonatal S aureus infections.
RESULTS
Among 236 randomized neonates, 208 were included in the analytic sample (55% male; 76% singleton births; mean birth weight, 1985 g [SD, 958 g]; 76% vaginal birth; mean parent age, 31 [SD, 7] years), of whom 18 were lost to follow-up. Among 190 neonates included in the analysis, 74 (38.9%) acquired S aureus colonization by 90 days, of which 42 (56.8%) had a strain concordant with a parental baseline strain. In the intervention and placebo groups, 13 of 89 neonates (14.6%) and 29 of 101 neonates (28.7%), respectively, acquired concordant S aureus colonization (risk difference, -14.1% [95% CI, -30.8% to -3.9%]; hazard ratio [HR], 0.43 [95.2% CI, 0.16 to 0.79]). A total of 28 of 89 neonates (31.4%) in the intervention group and 46 of 101 (45.5%) in the control group acquired any S aureus strain (HR, 0.57 [95% CI, 0.31 to 0.88]), and 1 neonate (1.1%) in the intervention group and 1 neonate (1.0%) in the control group developed an S aureus infection before colonization. Skin reactions in parents were common (4.8% intervention, 6.2% placebo).
CONCLUSIONS AND RELEVANCE
In this preliminary trial of parents colonized with S aureus, treatment with intranasal mupirocin and chlorhexidine-impregnated cloths compared with placebo significantly reduced neonatal colonization with an S aureus strain concordant with a parental baseline strain. However, further research is needed to replicate these findings and to assess their generalizability.
TRIAL REGISTRATION
ClinicalTrials.gov Identifier: NCT02223520.
Topics: Administration, Intranasal; Adult; Anti-Bacterial Agents; Anti-Infective Agents, Local; Chlorhexidine; Disease Reservoirs; Disease Transmission, Infectious; Disinfection; Double-Blind Method; Female; Hospitalization; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intensive Care Units, Neonatal; Male; Mupirocin; Parents; Staphylococcal Infections; Staphylococcus aureus
PubMed: 31886828
DOI: 10.1001/jama.2019.20785 -
Cirugia Y Cirujanos 2023To compare the protective effect of nitroglycerin ointment 2% and Dimethylsulfoxide (DMSO) in dorsal flaps of the rat.
OBJECTIVE
To compare the protective effect of nitroglycerin ointment 2% and Dimethylsulfoxide (DMSO) in dorsal flaps of the rat.
METHODS
A blind, experimental study was conducted in 24 male Wistar rats, with a mean weight of 320 (286-376) grams. Group 1: Control. Petrolatum jelly (Vaseline), n = 8, Group 2: Nitroglycerin (NTG) ointment 2% (Nitro-Bid, Altana Co.) n = 8, and Group 3: DMSO gel 90% (Neogen corp. Lexington KY, 40611), n = 8.
RESULTS
A total of 24 rats were operated on in the 6-month period of this study. Using a non-parametric Mann-Whitney U-test analysis, a statistically significant p was obtained between the control group and 2% NTG ointment, both in the area of necrosis and in the healthy area (p = 0.026). In contrast, the comparison between DMSO [CH3) 2SO] and the control group (p = 0.180) and between both study groups, with a p = 0.18, was not significant.
CONCLUSIONS
Our study concluded that there is a protective effect of 2% NTG ointment for flap survival in relation to the control group (petrolatum). DMSO administered topically did not show a protective effect, compared to the control group.
Topics: Rats; Male; Animals; Nitroglycerin; Dimethyl Sulfoxide; Ointments; Rats, Wistar; Necrosis; Petrolatum
PubMed: 37844881
DOI: 10.24875/CIRU.22000203 -
PloS One 2022Multiepitope vaccines could induce multiantigenic immunity against large complex pathogens with different strain variants. Herein, the in silico, in vitro and in vivo...
Multiepitope vaccines could induce multiantigenic immunity against large complex pathogens with different strain variants. Herein, the in silico, in vitro and in vivo studies were used to design and develop a novel candidate antigenic multiepitope vaccine against SARS-CoV-2 pathogen. The designed multiepitope construct targets the spike glycoprotein (S), membrane protein (M), and nucleocapsid phosphoprotein (N) of SARS-CoV-2 (i.e., the S-N-M construct). This construct contains the cytotoxic T lymphocyte (CTL)-, helper T lymphocyte (HTL)-, and linear B lymphocyte (LBL)-inducing epitopes. The multiepitope s-n-m fusion gene was subcloned in prokaryotic (pET24a) and eukaryotic (pcDNA3.1) expression vectors. Its expression was evaluated in mammalian cell line using LL37 cell penetrating peptide. Moreover, the recombinant multiepitope S-N-M peptide was produced in E. coli strain. Finally, mice were immunized using homologous and heterologous regimens for evaluation of immune responses. Our data indicated that the multiepitope S-N-M peptide construct combined with Montanide 720 in homologous regimen significantly stimulated total IgG, IgG2a, IFN-γ, TNF-α, IL-15, IL-21 and IL-6, and Granzyme B secretion as compared to other groups. Moreover, the pcDNA-s-n-m/ LL37 nanoparticles significantly induced higher immune responses than the naked DNA in both homologous and heterologous regimens. In general, our designed multiepitope vaccine construct can be considered as a vaccine candidate in SARS-CoV-2 infection model.
Topics: Animals; COVID-19; COVID-19 Vaccines; Epitopes, B-Lymphocyte; Epitopes, T-Lymphocyte; Escherichia coli; Humans; Mammals; Mice; Mineral Oil; SARS-CoV-2; Spike Glycoprotein, Coronavirus; Vaccines, Subunit
PubMed: 35679246
DOI: 10.1371/journal.pone.0268251 -
International Journal of Environmental... Oct 2022An excess of body fat is one of the biggest public health concerns in the world, due to its relationship with the emergence of other health problems. Evidence suggests... (Randomized Controlled Trial)
Randomized Controlled Trial
Krill Oil Supplementation Does Not Change Waist Circumference and Sagittal Abdominal Diameter in Overweight Women: A Pilot Balanced, Double-Blind, and Placebo-Controlled Clinical Trial.
An excess of body fat is one of the biggest public health concerns in the world, due to its relationship with the emergence of other health problems. Evidence suggests that supplementation with long-chain polyunsaturated fatty acids (omega-3) promotes increased lipolysis and the reduction of body mass. Likewise, this clinical trial aimed to evaluate the effects of supplementation with krill oil on waist circumference and sagittal abdominal diameter in overweight women. This pilot, balanced, double-blind, and placebo-controlled study was carried out with 26 women between 20 and 59 years old, with a body mass index >25 kg/m. The participants were divided into the control (CG) ( = 15, 3 g/daily of mineral oil) and krill oil (GK) ( = 16, 3 g/daily of krill oil) groups, and received the supplementation for eight weeks. Food intake variables were obtained using a 24 h food recall. Anthropometric measurements (body mass, body mass index, waist circumference, and sagittal abdominal diameter) and handgrip strength were obtained. After the intervention, no changes were found for the anthropometric and handgrip strength variables ( > 0.05). Regarding food intake, differences were found for carbohydrate ( = 0.040) and polyunsaturated ( = 0.006) fatty acids, with a reduction in the control group and an increase in krill oil. In conclusion, supplementation with krill oil did not reduce the waist circumference and sagittal abdominal diameter. Therefore, more long-term studies with a larger sample size are necessary to evaluate the possible benefits of krill oil supplementation in overweight women.
Topics: Animals; Humans; Female; Young Adult; Adult; Middle Aged; Overweight; Waist Circumference; Euphausiacea; Sagittal Abdominal Diameter; Hand Strength; Mineral Oil; Dietary Supplements; Fatty Acids, Omega-3; Double-Blind Method; Carbohydrates
PubMed: 36294155
DOI: 10.3390/ijerph192013574 -
European Review For Medical and... Dec 2022Dexpanthenol is an ingredient in multiple topical pharmaceutical preparations thanks to its high penetration and localized concentration. It is included in many...
OBJECTIVE
Dexpanthenol is an ingredient in multiple topical pharmaceutical preparations thanks to its high penetration and localized concentration. It is included in many ointments or lotions for dermatological use, assisting in healing and reducing pruritus. Vaseline is a synthetic product obtained by distilling crude oil. It is commercially available in several grades. The study presented here examined how topically applied agents (dexpanthenol or vaseline) affect nasal epithelial cells in culture. In particular, the study aimed to identify any alterations to epithelial cells which might indicate toxicity.
MATERIALS AND METHODS
The nasal epithelial cells used were sourced from mucosal tissue fragments left over the following septorhinoplasty on five patients not suffering from rhinosinusitis. The first step was to dissect the mucosal fragments into smaller pieces on a sterilized Petri dish. These fragments were then placed into the DMEM-F12 cell culture medium, which had been freshly prepared. The dexpanthenol and vaseline were diluted in dimethylsulfoxide (DMSO) to a concentration of 5 mg/mL. The cells in the wells were exposed to varying concentrations of dexpanthenol or vaseline. The actual concentration of the test reagent to which the epithelial cells were exposed ranged from 0.15 mg/mL to 5 mg/mL. The exposure period was 24 hours. The cells were finally examined using a Leica SP5II confocal microscope. The features sought were DNA fragmentation, condensation of the nuclei, changes in the outer membrane, or cytoskeletal abnormality. These features, if present, indicate cytotoxicity.
RESULTS
The viability of the cultured nasal epithelial cells was unaltered by a 24-hour exposure to dexpanthenol, nor was the cellular proliferation rate affected at the level of statistical significance. There was evidence of a cytotoxic effect from exposing nasal epithelial cells to vaseline in liquid form for 24 hours. There was a reduction in cellular viability in the plates where the highest dose of vaseline (5 mg/mL) was used. Cellular viability was not affected significantly at any of the doses below 5 mg/mL.
CONCLUSIONS
The absence of cytotoxic effects from the application of dexpanthenol to the nasal mucosa indicates that this agent may be safely used within the nose. The cytotoxic effects of liquid vaseline observed in this trial (condensed nuclear chromatin, loss of cellular volume) indicate that this agent may be harmful when used intranasally. For patients who require nasal packing due to nose bleeds or following endoscopic sinus surgical procedures, dexpanthenol should be preferred to vaseline from the point of view of maximizing healing of a nasal injury.
Topics: Humans; Excipients; Petrolatum; Sinusitis; Pantothenic Acid
PubMed: 36524920
DOI: 10.26355/eurrev_202212_30496 -
Skin Research and Technology : Official... May 2022Dry skin can trigger eczema that affects >10% of the US population. Dressing films have been developed to improve diseased skin, but there is limited knowledge about...
BACKGROUND
Dry skin can trigger eczema that affects >10% of the US population. Dressing films have been developed to improve diseased skin, but there is limited knowledge about their effects, especially for dry skin-related symptoms. We developed an electrospinning method that creates a coating film, called a fine fiber (FF) film, characterized by the production of a transparent, thin, flexible, and adherent membrane on the skin surface.
OBJECTIVE
The aim of this pilot study was to examine the effects of the FF film on dry skin.
METHODS
Three treatments (lotion only, lotion with the FF film, and lotion with an alternative film) were designed to treat subjects with rough skin on their lower legs. Twenty-four females were enrolled and used either a water-based lotion U or a petrolatum-based lotion P and the FF film for 2 weeks followed by a regression phase for 1 week. Skin hydration and roughness scores were assessed as were the subjects' perceptions of the effects.
RESULTS
When the FF film was applied with lotion U, skin hydration was significantly improved even after 1 week, accompanied by a significant improvement of skin roughness and an increase in skin hydration by the end of the regression phase. An evaluation of moisture permeability suggested that the FF film, especially with lotion U, performed as a semipermeable membrane with optimal moisture healing effects on dry skin.
CONCLUSION
The FF film together with a water-based lotion is a promising treatment to quickly improve dry skin conditions.
Topics: Double-Blind Method; Emollients; Female; Humans; Pilot Projects; Skin; Skin Cream; Skin Diseases; Treatment Outcome; Water
PubMed: 35411972
DOI: 10.1111/srt.13149 -
Aesthetic Plastic Surgery Oct 2022The constricted ear is an auricular deformity produced by a deficiency in the circumference of the helical rim. The classification and corrective methods for constricted...
BACKGROUND
The constricted ear is an auricular deformity produced by a deficiency in the circumference of the helical rim. The classification and corrective methods for constricted ears continue to be controversial. In order to identify them, the authors have reviewed and analyzed cases operated in a Chinese specialty clinic.
METHODS
Correction of constricted ears from January of 2017 to June of 2021 was retrospect through medical records. Data of patients' variables (including sex, age, laterality, type of constricted ear, presence of other ear anomalies), surgical techniques, esthetic outcomes, and postoperative complications have been collected.
RESULTS
The deformed ears were classified into four graded types by three criteria including deficiency of auricle cartilage, vertical height in dorsal view, and surgical outcome. A total of 68 constricted ears of 57 patients (type I, n = 6; type IIA, n = 41; type IIB, n = 19, and type III, n = 2) were enrolled in the study. Of the 66 constricted ears undergoing surgical correction, most of them were performed with helical expansion through auricular/costal cartilage graft, Mustardé-type mattress sutures, and tumbling cartilage flap. External molding using Vaseline gauze rolls was implemented on every case to assist reshaping the scapha. A triangular superficial temporal fascial flap was elevated to prevent the reoccurrence of lidding in some cases. Corrective techniques and esthetic outcomes for deformed cases of each graded type were described. Based on a four-point Likert scale, the average esthetic outcome score was 3.7.
CONCLUSIONS
The classification was practical and the constricted ears were effectively corrected by simple surgical procedures without removal of deformed auricular cartilage. All corrections were performed in one stage.
LEVEL OF EVIDENCE IV
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
Topics: Humans; Ear, External; Retrospective Studies; Plastic Surgery Procedures; Treatment Outcome; Ear Cartilage; Ear Auricle; Petrolatum; China
PubMed: 35094132
DOI: 10.1007/s00266-021-02699-1 -
Plastic Surgery (Oakville, Ont.) Feb 2023Patients presenting with total body surface area (TBSA) >40% burns require significant surgical treatment. Two substantial challenges during these surgeries are...
Patients presenting with total body surface area (TBSA) >40% burns require significant surgical treatment. Two substantial challenges during these surgeries are limiting blood loss and maintaining core temperatures. To overcome these challenges, several techniques have been developed, ranging from the Pitkin syringe method to the pneumatic tourniquet strategy for large-volume hyperthermic insufflation. Here, we compare the pneumatic tourniquet method to a roller pump method for maintenance of intraoperative normothermia and control of bleeding. We conducted a retrospective chart review of 20 patients presenting with TBSA >40% burns, 10 of whom were treated with the rapid infusion roller pump and 10 of whom were treated with the pneumatic tourniquet technique. Patients from each group were controlled for % TBSA, presence of inhalation injury, age, and date of admission. We reviewed transfusion requirement and the intraoperative temperatures, as well as the average intraoperative drop in temperature. We observed improvement in the infusion volume, operative time, intraoperative temperature drop, minimum intraoperative temperature, estimated blood loss, and amount of required transfusion. Our study suggests that the rapid infusion roller pump technique is capable of achieving superior intraoperative bleeding control and temperature maintenance compared to the pneumatic tourniquet technique, resulting in decreased transfusion requirement.
PubMed: 36755828
DOI: 10.1177/22925503211024744 -
Heliyon Jan 2021Five different galenics were analyzed and compared concerning tissue breathability and gas exchange with the environment after an application period of 6 h on pig ear...
PURPOSE
Five different galenics were analyzed and compared concerning tissue breathability and gas exchange with the environment after an application period of 6 h on pig ear skin. Aim was to find the most suitable galenics for efficient moist treatment for everyday injuries (abrasions, lacerations and cuts) without influencing the transepidermal water loss.
METHODS
A quantity of 0.1 g of the different test preparations was applied once topically to an area of 2 cm. The analysis of the breathability was performed by TEWL (transepidermal water loss) measurements in the first hour after product application. The moisture retention effect was assessed by corneometry in the first 5 h after product application.
RESULTS
The hydrogel preparations showed a higher breathability in contrast to a semi-occlusive ointment and petrolatum. The same applies to the moisture penetration of the skin. Here, all hydrogel formulations showed the highest tissue hydration. After 3 h an additional increase in moisture was observed for the areas treated with Tyrosur® CareExpert Wound Gel and the ointment.
CONCLUSION
In contrast to petrolatum and the semi-occlusive ointment, treatment with the hydrogels led to a preservation of the breathability and good moistening of the tissue, which is due to the galenics of the gels consisting of water, carbomer and propylene glycol. The increase in moisture after 3 h in areas treated with Tyrosur® CareExpert Wound Gel and the semi-occlusive ointment indicates a sustained moisturizing effect mediated by dexpanthenol.
PubMed: 33553748
DOI: 10.1016/j.heliyon.2021.e06071