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Pakistan Journal of Medical Sciences Jul 2024Several studies have investigated the effectiveness of preoperative or perioperative pulmonary rehabilitation in thoracic surgery patients, but the results are... (Review)
Review
Effectiveness of preoperative and perioperative pulmonary rehabilitation nursing program for the management of patients undergoing thoracic surgery: A systematic review and meta-analysis.
BACKGROUND & OBJECTIVE
Several studies have investigated the effectiveness of preoperative or perioperative pulmonary rehabilitation in thoracic surgery patients, but the results are inconsistent and inconclusive. This study attempts to summarize the existing data on the effect of the preoperative and perioperative pulmonary rehabilitation nursing program for the management of patients undergoing thoracic surgery.
METHODS
Systematic search was done in PubMed Central, SCOPUS, EMBASE, MEDLINE, Google Scholar, and ScienceDirect for papers published until December 2022 and reporting data of postoperative complications and pulmonary health status in patients undergoing thoracic surgery and receiving preoperative or perioperative pulmonary rehabilitation nursing intervention or standard care. Meta-analysis was done by random-effects model and pooled standardised mean differences (SMD) or odds ratios (OR) along with 95% confidence intervals (CIs) were reported.
RESULTS
Eighteen studies were included and analysed. Pooled SMD was 0.44 (95%CI: -0.21 to 1.08) for forced expiratory volume (FEV-1), -0.34 (95%CI: -0.94 to 0.26) for peak expiratory flow (PEF), 0.61 (95%CI: -0.60 to 1.81) for forced vital capacity (FVC), 0.42 (95%CI: -0.13 to 0.98) for diffusing capacity of carbon monoxide (DLCO). Pooled SMD for length of hospital stay was -0.64 (95%CI: -1.09 to -0.19). Pooled OR was 0.87 [95%CI: 0.32 to 2.37] for all-cause mortality, 0.35 [95%CI: 0.25 to 0.50] for postoperative pulmonary complications, 0.98 [95%CI: 0.45 to 2.12] for respiratory failure, 0.52 [95%CI: 0.38 to 0.78] for pneumonia and 0.50 [95%CI: 0.33 to 0.76] for atelectasis.
CONCLUSION
Perioperative pulmonary rehabilitation nursing program is effective in reducing the postoperative lung complications and shortening the length of hospital stay in patients undergoing thoracic surgery.
PubMed: 38952505
DOI: 10.12669/pjms.40.6.9259 -
Pakistan Journal of Medical Sciences Jul 2024Metallic copper alloys have gained attention recently as a cutting-edge antibacterial weapon for areas where surface hygiene is crucial. The present study aimed to...
OBJECTIVE
Metallic copper alloys have gained attention recently as a cutting-edge antibacterial weapon for areas where surface hygiene is crucial. The present study aimed to assess copper coupons (99% Cu) for their potential to decrease the viability of various strains from inanimate hospital surfaces.
METHODS
This in vitro-experimental study was conducted at the Microbiology Laboratory, Faculty of Natural and Life Sciences and Earth and Universe Sciences, University of Guelma, and Khodja Ahmed Public Hospital Establishment, Algeria, for a period of six months from January to May 2022. A total of 85 samples were collected from patient room door handles and bed rails at the government hospital in Guelma State, from which 12 enterobacterial isolates were obtained. These isolates were evaluated for susceptibility to copper and polyvinyl chloride (PVC) coupons using plate counts to determine bacterial viability after 72 hours of incubation at 37°C or room temperature (25°C). Antibiotic sensitivity testing was then carried out using a modified Kirby-Bauer disc diffusion method. Copper coupons' ability to either select for or create antibiotic resistance is also determined.
RESULTS
Copper showed a bactericidal effect after three hours for and six hours for . Whereas it was shown that within three days of selection, 83.33% of strains are capable of rapidly acquiring Cu resistance. Indeed, the increase in temperature reduced the effects of Cu (p<0.05; Student's t-test). Antimicrobial susceptibility testing revealed that the copper-resistant bacteria were less sensitive than their predecessors. strains showed the highest incidence of multidrug resistance. The most significant findings included widespread resistance to beta-lactams (100%-75%) and chloramphenicol (66.67%).
CONCLUSION
These results suggest that prolonged copper usage may contribute to the development of antibiotic resistance, which could have significant ramifications.
PubMed: 38952496
DOI: 10.12669/pjms.40.6.8435 -
Pakistan Journal of Medical Sciences Jul 2024Identification of MBL, AmpC and ESBLs in colistin intrinsic and acquired resistant uropathogenic gram negative bacteria.
OBJECTIVE
Identification of MBL, AmpC and ESBLs in colistin intrinsic and acquired resistant uropathogenic gram negative bacteria.
METHOD
Urine samples were collected from Hayatabad Medical Complex, Peshawar during 17 January to 30 June 2019. Collected urine samples were aseptically transported microbiology lab of Health Research Institution (HRI), National Institute of Health (NIH), Khyber Medical College, Peshawar and streaked on different media. Positive growth was identified by API-10s. Antibiotic sensitivity profile was done by Modified Kirby Bauer disc diffusion method. Detection of metallo βlactamases (MBL) production by Imipenem EDTA synergy test, Double Disc Synergy Test (DDST) for detection of ESBLs and D-test for the detection of inducible AmpC beta lactamases test was used. Colistin resistance was identified via broth micro dilution according to CLSI manual. Colistin resistant bacteria was divided in two categories; acquired and intrinsic resistant bacteria according to CLSI manual.
RESULTS
Out of 2000 urine samples, 281(14%) gram-negative bacteria were isolated. Among positive samples, acquired colistin resistant bacteria were 241 and intrinsic resistant bacteria were 40 isolates. MBL was produce by twenty one (11.7%) and seventeen (40.5 and were ESBLs producing bacteria. AmpC production was prevalent in fourteen (7.8%) and twelve (28.6. Fifty-five samples showed resistance to colistin out of 241 samples. In colistin resistant bacteria, two were MBL, ESBLs, while one was ESBLs, AmpC co-producing bacteria. The most prevalent extended drug resistant bacteria were 6.1%), While 155(86.6%) , 25 (59.5%) and 22 (95.7%) was multi drug resistant bacteria.
CONCLUSION
Current study concluded that ESBL, MBL AmpC enzymes and their co-expression was observed with colistin resistance in and .
PubMed: 38952491
DOI: 10.12669/pjms.40.6.8516 -
Molecular Imaging 2024To investigate the performance of diffusion-tensor imaging (DTI) and hydrogen proton magnetic resonance spectroscopy (H-MRS) parameters in predicting the...
OBJECTIVE
To investigate the performance of diffusion-tensor imaging (DTI) and hydrogen proton magnetic resonance spectroscopy (H-MRS) parameters in predicting the immunohistochemistry (IHC) biomarkers of glioma.
METHODS
Patients with glioma confirmed by pathology from March 2015 to September 2019 were analyzed, the preoperative DTI and H-MRS images were collected, apparent diffusion coefficient (ADC) and fractional anisotropy (FA), in the lesion area were measured, the relative values relative ADC (rADC) and relative FA (rFA) were obtained by the ratio of them in the lesion area to the contralateral normal area. The peak of each metabolite in the lesion area of H-MRS image: N-acetylaspartate (NAA), choline (Cho), and creatine (Cr), and metabolite ratio: NAA/Cho, NAA/(Cho + Cr) were selected and calculated. The preoperative IHC data were collected including CD34, Ki-67, p53, S-100, syn, vimentin, NeuN, Nestin, and glial fibrillary acidic protein.
RESULTS
One predicting parameter of DTI was screened, the rADC of the Ki-67 positive group was lower than that of the negative group. Two parameters of H-MRS were found to have significant reference values for glioma grades, the NAA and Cr decreased as the grade of glioma increased, moreover, Ki-67 Li was negatively correlated with NAA and Cr.
CONCLUSION
NAA and Cr have potential application value in predicting glioma grades and tumor proliferation activity. Only rADC has predictive value for Ki-67 expression among DTI parameters.
Topics: Humans; Glioma; Male; Female; Middle Aged; Adult; Immunohistochemistry; Brain Neoplasms; Diffusion Tensor Imaging; Magnetic Resonance Imaging; Aged; Proton Magnetic Resonance Spectroscopy; Young Adult
PubMed: 38952400
DOI: 10.1177/15353508241261583 -
Frontiers in Endocrinology 2024We present the case of a 36-year-old female who was diagnosed at birth with CHI that caused severe hypoglycaemia unresponsive to Diazoxide. Subtotal pancreatectomy was...
We present the case of a 36-year-old female who was diagnosed at birth with CHI that caused severe hypoglycaemia unresponsive to Diazoxide. Subtotal pancreatectomy was performed at the age of three weeks. Later, histological analysis of her pancreas in a research setting revealed a focal form of CHI. Genetic testing was not available at that time. The patient developed pancreatic exocrine deficiency and insulin-dependent diabetes at the age of 9 years. In 2016, a genetic test revealed a missense heterozygous variant in the ABCC8 gene inherited from her father and classified as having a recessive inheritance. The geneticist concluded that the risk of CHI for her offspring would be low (1/600), making pregnancy favourable. As there was no consanguinity in the family, testing the future father was deemed unnecessary (carrier frequency 1/150 in the general population). The pregnancy occurred spontaneously in 2020 and at a gestational age of 28 weeks, the mother went into premature labour. An emergency C-section was performed in April 2021 resulting in the birth of bichorial bi-amniotic male twins. Following birth, both newborns experienced persistent severe hypoglycaemia which required glucagon treatment and intravenous glucose infusion initially, followed by Diazoxide from day 51 after birth, without satisfactory response. Continuous intravenous Octreotide treatment was introduced on day 72. Due to the recurrence of hypoglycaemia episodes despite reaching maximum doses of Octreotide, from day 92 the treatment was switched to Pasireotide. Genetic tests revealed the same genotypes for both infants: the exon 39 missense variant (c.4716C>A; p.Ser1572Arg) inherited from their mother and a truncating variant in exon 28 (c.3550del; p.Val1184*), inherited from their asymptomatic father. As a result of inheriting two recessive variants of the ABCC8 gene, the children were diagnosed with a diffuse form of CHI, consistent with the diazoxide-unresponsive presentation. This situation is very rare outside consanguinity. This case emphasises the significance of genetic counselling for individuals with a history of rare diseases outside the context of consanguinity, as there is a potential risk of recurrence. Prenatal diagnosis can lead to better outcomes for affected neonates, as well as help families make informed decisions about future pregnancies.
Topics: Humans; Female; Congenital Hyperinsulinism; Pregnancy; Adult; Infant, Newborn; Sulfonylurea Receptors; Male; Twins, Dizygotic
PubMed: 38952388
DOI: 10.3389/fendo.2024.1408003 -
Heliyon Jun 2024The combination of solid oxide fuel cells (SOFCs) and wood gasification has the potential to significantly increase renewable electricity production and decrease...
The combination of solid oxide fuel cells (SOFCs) and wood gasification has the potential to significantly increase renewable electricity production and decrease emissions. Depending on the quality of the wood gas, degradation processes have a significant impact on the reliability and lifetime of the SOFC. Using electrochemical impedance spectroscopy (EIS) and subsequent distribution of relaxation times (DRT) analysis, the impact on the degradation of coupling wood gasification with a commercial SOFC stack is determined in this study. The thermal behavior of the SOFC stack under various operating conditions, as well as various synthetic wood gas mixtures classified by their hydrogen-to-carbon (H/C) ratio, was assessed. The decrease in the H/C ratio from 8 to 1, observed during syngas and real wood gas operation, leads to a rightward shift in the Nyquist plots, suggesting an increase in the SOFC stack's impedance. Correlations between variations in the H/C ratio and their effects on anodic electrooxidation, ionic conduction, gas transport, and diffusion were identified using DRT analysis to interpret the EIS results. By incorporating an upstream desulfurization system and ensuring an H/C ratio greater than 2, the coupling of biomass gasification with the SOFC stack was stable to degradation issues.
PubMed: 38952384
DOI: 10.1016/j.heliyon.2024.e32509 -
Dalton Transactions (Cambridge, England... Jul 2024The development of heteroatom dual-doped porous carbon frameworks with uniform doping is highly desirable for achieving highly efficient oxygen reduction reaction (ORR)...
The development of heteroatom dual-doped porous carbon frameworks with uniform doping is highly desirable for achieving highly efficient oxygen reduction reaction (ORR) activity, due to their tunable chemical and electronic structures. Herein, porous covalent triazine-based frameworks (CTFs) incorporating nitrogen/chorine dual-doped porous carbon networks were fabricated by selecting 1,3-bis(4-cyanophenyl) imidazolium chloride as a building block, in a facile and controllable way a bottom-up strategy. The resulting nitrogen/chorine dual-doped catalyst CCTF-700 exhibits excellent ORR performance with a more positive onset and half-wave potential (0.85 V RHE), higher diffusion-limited current density and significantly improved stability in comparison with the benchmark commercial 20 wt% Pt/C catalyst. It is worth mentioning that CCTF-700 shows one of the best ORR performances among all the reported metal-free electrocatalysts under alkaline conditions. This work paves the way for a controllable and reliable strategy to craft highly efficient heteroatom dual-doped carbon catalysts for energy conversion.
PubMed: 38952336
DOI: 10.1039/d4dt01519c -
Analytical Chemistry Jul 2024Carboxylesterase (CE), an enzyme widely present in organisms, is involved in various physiological and pathological processes. Changes in the levels of CEs in the liver...
Carboxylesterase (CE), an enzyme widely present in organisms, is involved in various physiological and pathological processes. Changes in the levels of CEs in the liver may predict the presence of type 2 diabetes mellitus (T2DM). Here, a novel dicyanoisophorone (DCI)-based proximity-labeled far-red fluorescent probe DCI2F-Ac with endoplasmic reticulum targeting was proposed for real-time monitoring and imaging of the CEs activity. DCI2F-Ac featured very low cytotoxicity and biotoxicity and was highly selective and sensitive for CEs. Compared with traditional CEs probes, DCI2F-Ac was covalently anchored directly to CEs, thus effectively reducing the loss of fluorescent signals due to diffusion. Through the "on-off" fluorescence signal readout, DCI2F-Ac was able to distinguish cell lines and screen for CEs inhibitors. In terms of endoplasmic reticulum (ER) stress, it was found that thapsigargin (Tg) induced upregulation of CEs levels but not tunicamycin (Tm), which was related to the calcium homeostasis of the ER. DCI2F-Ac could efficiently detect downregulated CEs in the livers of T2DM, and the therapeutic efficacy of metformin, acarbose, and a combination of these two drugs was assessed by tracking the fluctuation of CEs levels. The results showed that combining metformin and acarbose could restore CEs levels to near-normal levels with the best antidiabetic effect. Thus, the DCI2F-Ac probe provides a great opportunity to explore the untapped potential of CEs in liver metabolic disorders and drug efficacy assessment.
Topics: Fluorescent Dyes; Diabetes Mellitus, Type 2; Humans; Carboxylesterase; Endoplasmic Reticulum; Animals; Mice; Optical Imaging; Hep G2 Cells; Endoplasmic Reticulum Stress
PubMed: 38952276
DOI: 10.1021/acs.analchem.4c01721 -
Annals of Clinical and Translational... Jul 2024The dentato-thalamo-cortical tract (DTT) is the main cerebellar efferent pathway. Degeneration of the DTT is a core feature of Friedreich ataxia (FRDA). However, it...
OBJECTIVE
The dentato-thalamo-cortical tract (DTT) is the main cerebellar efferent pathway. Degeneration of the DTT is a core feature of Friedreich ataxia (FRDA). However, it remains unclear whether DTT disruption is spatially specific, with some segments being more impacted than others. This study aimed to investigate microstructural integrity along the DTT in FRDA using a profilometry diffusion MRI (dMRI) approach.
METHODS
MRI data from 45 individuals with FRDA (mean age: 33.2 ± 13.2, Male/Female: 26/19) and 37 healthy controls (mean age: 36.5 ± 12.7, Male/Female:18/19) were included in this cross-sectional multicenter study. A profilometry analysis was performed on dMRI data by first using tractography to define the DTT as the white matter pathway connecting the dentate nucleus to the contralateral motor cortex. The tract was then divided into 100 segments, and dMRI metrics of microstructural integrity (fractional anisotropy, mean diffusivity and radial diffusivity) at each segment were compared between groups. The process was replicated on the arcuate fasciculus for comparison.
RESULTS
Across all diffusion metrics, the region of the DTT connecting the dentate nucleus and thalamus was more impacted in FRDA than downstream cerebral sections from the thalamus to the cortex. The arcuate fasciculus was minimally impacted.
INTERPRETATION
Our study further expands the current knowledge about brain involvement in FRDA, showing that microstructural abnormalities within the DTT are weighted to early segments of the tract (i.e., the superior cerebellar peduncle). These findings are consistent with the hypothesis of DTT undergoing anterograde degeneration arising from the dentate nuclei and progressing to the primary motor cortex.
PubMed: 38952134
DOI: 10.1002/acn3.52048 -
Langmuir : the ACS Journal of Surfaces... Jul 2024Thermoresponsive microgels experience a volume phase transition triggered by temperature changes, a phenomenon often analyzed using dynamic light scattering to observe...
Thermoresponsive microgels experience a volume phase transition triggered by temperature changes, a phenomenon often analyzed using dynamic light scattering to observe overall size alterations via the diffusion coefficient. However, local structural changes are typically assessed using more intricate and expensive techniques like small-angle neutron or X-ray scattering. In our research, we investigate the volume phase transition of poly--isopropylacrylamide (PNIPAM)-based microgels by employing a combination of temperature-dependent dynamic light scattering and simpler, faster, and more efficient attenuation measurements. We utilize attenuation at a fixed wavelength as a direct measure of dispersion turbidity, linking the absolute changes in hydrodynamic radius to the absolute changes in turbidity. This approach allows us to compare "classical" PNIPAM microgels from precipitation polymerization, charged copolymer microgels from precipitation copolymerization, and core-shell microgels from seeded precipitation polymerization. Our study includes a systematic analysis and comparison of 30 different microgels. By directly comparing data from dynamic light scattering and attenuation spectroscopy, we gain insights into structural heterogeneity and deviations from the established fuzzy sphere morphology. Furthermore, we demonstrate how turbidity data can be converted to swelling curves.
PubMed: 38951962
DOI: 10.1021/acs.langmuir.4c01344