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Helicobacter Aug 2023Potassium-competitive acid blockers (P-CAB) are recommended for the treatment of Helicobacter pylori infections, but dual therapy of P-CAB with amoxicillin has been... (Randomized Controlled Trial)
Randomized Controlled Trial
Eradication rates of Helicobacter pylori in treatment-naive patients following 14-day vonoprazan-amoxicillin dual therapy: A multicenter randomized controlled trial in China.
BACKGROUND
Potassium-competitive acid blockers (P-CAB) are recommended for the treatment of Helicobacter pylori infections, but dual therapy of P-CAB with amoxicillin has been poorly studied. The current study compared the efficacy, adverse reactions, compliance, and effects on gut microbiota of 14-day vonoprazan-amoxicillin (VA) dual therapy with esomeprazole, bismuth potassium citrate, amoxicillin, and metronidazole (EBAM) quadruple therapy in treatment-naive patients with H. pylori.
MATERIALS AND METHODS
This was a multicenter, open-label, randomized, and controlled, non-inferiority study. Patients (n = 194) enrolled from six centers were randomly divided into either the VA or EBAM group. H. pylori eradication was determined using C urea breath tests (UBT) 4-6 weeks post-treatment. Fecal samples were collected, and gut microbial populations were analyzed by 16S rDNA and metagenomic sequencing technology.
RESULTS
Eradication rates of H. pylori in the VA and EBAM groups were 88.7% and 91.8%, respectively, according to intention-to-treat (ITT) analysis; 95.6% and 96.7% with per-protocol (PP) analysis; and 94.5% and 96.7% with modified ITT (mITT) analysis (all p > 0.05). The incidence of adverse reactions in the VA group was significantly lower compared to the EBAM group, and compliance within both groups was good. There was no difference in α-diversity or microbial composition in the VA and EBAM groups at one-month post-treatment compared to baseline, except for a markedly reduced abundance of Bacteroides in the EBAM group.
CONCLUSION
VA therapy achieved excellent eradication rates with low adverse reactions, good compliance, and little impact on gut microbiota. VA therapy should be recommended as a first-line treatment against H. pylori.
Topics: Humans; Amoxicillin; Helicobacter Infections; Helicobacter pylori; Anti-Bacterial Agents; Drug Therapy, Combination; Bismuth; Treatment Outcome; Proton Pump Inhibitors; Clarithromycin
PubMed: 37160689
DOI: 10.1111/hel.12970 -
Journal of Nephrology Jul 2023Globally, urolithiasis is becoming more and more common among children. We aimed to determine the etiology, and the diagnostic and therapeutic approaches in patients...
BACKGROUND
Globally, urolithiasis is becoming more and more common among children. We aimed to determine the etiology, and the diagnostic and therapeutic approaches in patients with urolithiasis.
METHODS
This was a retrospective study which included all patients (aged 1 month-18 years) admitted to the pediatric nephrology clinic in Elazığ Fethi Sekin City Hospital with urolithiasis between November 2019 and 2021. Only patients whose diagnosis of urolithiasis was confirmed by urinary ultrasonography were included in the study, while patients with chronic diseases (neurological diseases such as epilepsy, cerebral palsy, chronic bowel diseases, etc.) predisposing to kidney stone formation were not. Demographic characteristics, serum and urine biochemical parameters, urine metabolic and kidney stone metabolic and chemical analyses, urinary tract ultrasonography findings and treatment modalities were collected.
RESULTS
One hundred ninety-seven patients (91 female and 106 male) were included in the study. Hypervitaminosis D was detected in 4 (2%) patients, suppressed parathyroid hormone in 12 (6%) and hypercalcemia in 27 (14%) patients. Metabolic screening showed hypercalciuria in 69 (35%) patients, hypocitraturia in 39 (20%), hyperoxaluria in 15 (8%) and cystinuria in 6 (3%) patients. Eighty three (42%) patients had a positive family history for kidney stones. One hundred eighteen (60%) patients received potassium citrate treatment, 71 (36%) were given hydration and diet recommendations without medical treatment, 6 (3%) received tiopronin treatment, and 2 (1%) patients were treated surgically.
CONCLUSIONS
Our study suggests that Vitamin D supplementation at doses higher than 400 IU/day may be a risk factor for kidney stones in children. We observed that mothers tend not to give water to infants who are breastfed or formula-fed in the first year of life. K-citrate treatment can be a good option for prevention and dissolution of stones by alkalinization.
Topics: Infant; Child; Humans; Male; Female; Retrospective Studies; Urolithiasis; Cystinuria; Kidney Calculi; Risk Factors
PubMed: 37160650
DOI: 10.1007/s40620-023-01638-4 -
Conservation Physiology 2023Climate change is causing large declines in many Pacific salmon populations. In particular, warm rivers are associated with high levels of premature mortality in...
Climate change is causing large declines in many Pacific salmon populations. In particular, warm rivers are associated with high levels of premature mortality in migrating adults. The Fraser River watershed in British Columbia, Canada, supports some of the largest Chinook salmon () runs in the world. However, the Fraser River is warming at a rate that threatens these populations at critical freshwater life stages. A growing body of literature suggests salmonids are locally adapted to their thermal migratory experience, and thus, population-specific thermal performance information can aid in management decisions. We compared the thermal performance of pre-spawning adult Chinook salmon from two populations, a coastal fall-run from the Chilliwack River (125 km cooler migration) and an interior summer-run from the Shuswap River (565 km warmer migration). We acutely exposed fish to temperatures reflecting current (12°C, 18°C) and future projected temperatures (21°C, 24°C) in the Fraser River and assessed survival, aerobic capacity (resting and maximum metabolic rates, absolute aerobic scope (AAS), muscle and ventricle citrate synthase), anaerobic capacity (muscle and ventricle lactate dehydrogenase) and recovery capacity (post-exercise metabolism, blood physiology, tissue lactate). Chilliwack Chinook salmon performed worse at high temperatures, indicated by elevated mortality, reduced breadth in AAS, enhanced plasma lactate and potassium levels and elevated tissue lactate concentrations compared with Shuswap Chinook salmon. At water temperatures exceeding the upper pejus temperatures (T, defined here as 80% of maximum AAS) of Chilliwack (18.7°C) and Shuswap (20.2°C) Chinook salmon populations, physiological performance will decline and affect migration and survival to spawn. Our results reveal population differences in pre-spawning Chinook salmon performance across scales of biological organization at ecologically relevant temperatures. Given the rapid warming of rivers, we show that it is critical to consider the intra-specific variation in thermal physiology to assist in the conservation and management of Pacific salmon.
PubMed: 37152448
DOI: 10.1093/conphys/coad022 -
Urology Practice May 2022Potassium citrate has been shown to significantly reduce kidney stone recurrence by alkalinizing urine and increasing citrate excretion. However, the cost of potassium...
INTRODUCTION
Potassium citrate has been shown to significantly reduce kidney stone recurrence by alkalinizing urine and increasing citrate excretion. However, the cost of potassium citrate can be prohibitive. Thus, over-the-counter use of potassium citrate supplements has gained interest from patients and providers due to reported decreased cost. Prior studies show that fluids such as orange juice, Crystal Light and certain sodas are reasonable sources of alkali citrate; however, the true alkali citrate content among leading over-the-counter supplements is unknown. We investigate popular supplements and compare them to pharmaceutical potassium citrate.
METHODS
The top 6 potassium citrate supplements were purchased from Amazon.com in October 2020 and April 2021. These supplements and Urocit®-K were dissolved in deionized water and diluted before measurement with a colorimetric citrate assay kit. A pH electrode was used to measure the pH of each sample and the alkali citrate content of each supplement was calculated.
RESULTS
Urocit-K and Thorne® had the highest percentage of alkali citrate per gram. NOW® supplements and Nutricost® offered the cheapest alkali citrate at less than 1 cent per mEq.
CONCLUSIONS
Citrate supplements vary widely in their cost and citrate content. Patients and providers may find this information useful depending on their individual preferences for cost and pill size. Pharmaceutical Urocit-K was not the most cost-effective option; however, it may be the more convenient option as it requires fewer pills.
PubMed: 37145541
DOI: 10.1097/UPJ.0000000000000300 -
Langmuir : the ACS Journal of Surfaces... May 2023In this study, a strategy for the rapid and simple preparation of porous carbon (PC) using the microwave method was proposed. Oxygen-rich PC was synthesized by microwave...
In this study, a strategy for the rapid and simple preparation of porous carbon (PC) using the microwave method was proposed. Oxygen-rich PC was synthesized by microwave irradiation in air, where potassium citrate and ZnCl served as the carbon source and microwave absorber, respectively. ZnCl achieves microwave absorption through dipole rotation, which uses ion conduction to convert heat energy in the reaction system. In addition, potassium salt etching improved the porosity of PCs. The PC prepared under optimal conditions had a large specific surface area (902 m·g) and exhibited a significant specific capacitance (380 F·g) in the three-electrode system at 1 A·g. The energy and power densities of the assembled symmetrical supercapacitor device based on PC-375W-0.4 were 32.7 W·h·kg and 0.65 kW·kg, respectively, at a current density of 1 A·g. Even after 5000 cycles at 5 A·g current density, the excellent cycle life retained 94% of its initial capacitance.
PubMed: 37141530
DOI: 10.1021/acs.langmuir.3c00596 -
Acta Cirurgica Brasileira 2023To explore the role and mechanism of curcumin (Cur) in reducing oxidative stress damage in rats with nephrolithiasis induced by ethylene glycol (EG).
PURPOSE
To explore the role and mechanism of curcumin (Cur) in reducing oxidative stress damage in rats with nephrolithiasis induced by ethylene glycol (EG).
METHODS
Thirty male rats were divided into normal control, model, positive (10% potassium citrate), Cur-10 (10 mg/kg curcumin) and Cur-20 (20 mg/kg curcumin) groups.
RESULTS
The results of kidney tissue section stained by hematoxylin-eosin and von Kossa showed that curcumin treatment can inhibit the formation of kidney stones. The biochemical test results showed that the urea (Ur), creatinine (Cr), uric acid (UA), inorganic phosphorus and Ca2+ concentrations in urine decreased after being treated with curcumin. There were significant differences between different doses of curcumin (P < 0.05). Compared with the Cur-10 group, Cur-20 had a more significant inhibitory effect on malondialdehyde (MDA) (P < 0.05). In addition, reverse transcription polymerase chain reaction (PCR) detection and immunohistochemical results indicated that the osteopontin (OPN) in the kidney was significantly reduced after curcumin treatment.
CONCLUSIONS
Curcumin could reduce the oxidative stress damage caused by EG-induced kidney stones.
Topics: Animals; Male; Rats; Antioxidants; Curcumin; Kidney; Kidney Calculi; Osteopontin; Oxidative Stress
PubMed: 37132752
DOI: 10.1590/acb380223 -
Alternative Therapies in Health and... Jul 2023The prevalence of antimicrobial resistance in Helicobacter pylori (HP) infection has increased globally. This study aimed to compare the efficacy of Biling Weitong...
OBJECTIVE
The prevalence of antimicrobial resistance in Helicobacter pylori (HP) infection has increased globally. This study aimed to compare the efficacy of Biling Weitong granules (BLWTG) combined with quadruple therapy in patients with refractory HP infection who had previously failed eradication therapy.
METHODS
This single-center prospective study enrolled patients with two or more consecutive failed HP treatments. A total of 122 patients with previously failed HP treatment from our hospital were recruited as participants and randomly (1:1) allocated to two eradication groups: patients treated with bismuth-containing quadruple therapy (esomeprazole 40 mg, amoxicillin 1.0 g, bismuth potassium citrate 220 mg, and clarithromycin 500 mg, twice daily [EACB group]) for 14 days. And those treated with BLWTG (5 g three times daily) combined with the EACB group for 14 days (BLWTG+EACB group). The therapeutic effects of the two treatment programs were comprehensively evaluated.
RESULTS
The study group had a significantly higher improvement rate in symptoms (dull stomach pain, nausea, gastric distension, loss of appetite, and belching) compared to the control group (P < .05). Eight weeks after drug withdrawal, the eradication rates in the control and study groups were 49.18% and 73.77%, respectively. The levels of interleukin-6, C-reactive protein, and tumor necrosis factor-α were significantly lower in both groups after treatment but were significantly lower in the study group than in the control group (P < .05).
CONCLUSIONS
The combination of BLWTG and standard four-drug therapy had a high eradication rate and low recurrence rate in patients with refractory HP infection. Additionally, this combined therapy could regulate inflammatory reactions and reduce drug-related adverse reactions.
Topics: Humans; Helicobacter Infections; Bismuth; Anti-Bacterial Agents; Helicobacter pylori; Prospective Studies; Drug Therapy, Combination; Treatment Outcome; Amoxicillin
PubMed: 37083648
DOI: No ID Found -
Current Urology Reports Aug 2023We wanted to analyse the outcomes of surgical (SWL, URS, PCNL) and medical management of cystine stones in the paediatric population in terms of stone-free status and... (Review)
Review
PURPOSE OF REVIEW
We wanted to analyse the outcomes of surgical (SWL, URS, PCNL) and medical management of cystine stones in the paediatric population in terms of stone-free status and complication rates, based on all the available literature evidence.
RECENT FINDINGS
A systematic review of literature was performed for all studies with paediatric cystine stone management. Twelve studies met the eligibility criteria, of which 4 analysed outcomes of SWL, 2 of URS and 3 of PCNL and 3 focused on the effect of either alkalising agents (potassium citrate, citric acid) or cysteine-binding thiol (CBT) agents (tiopronin, penicillamine). The reported SFR in studies ranged from 50 to 83%, 59 to 100% and 63 to 80.6%, with a complication rate of 2.8-51%, 14-27% and 12.9-15.4% with SWL, URS and PCNL, respectively. Paediatric cystine stones treatment should aim at complete stone clearance, preservation of renal function and prevention of further recurrences. SWL achieves inferior results in case of cystine stones. URS and PCNL are safe and effective procedures in the paediatric population, with a low rate of major complications. Adherence to medical prevention therapies may prolong recurrence-free periods.
Topics: Humans; Child; Kidney Calculi; Cystine; Lithotripsy; Ureteroscopy; Ureteral Calculi; Treatment Outcome
PubMed: 37079195
DOI: 10.1007/s11934-023-01162-9 -
Sexual Medicine Reviews Jun 2023Erectile dysfunction (ED) is one of the most common urologic problems in men worldwide, with an approximately high incidence rate, significantly affecting patients'... (Review)
Review
INTRODUCTION
Erectile dysfunction (ED) is one of the most common urologic problems in men worldwide, with an approximately high incidence rate, significantly affecting patients' quality of life and their sexual partners.
OBJECTIVES
Due to the association of this disorder with essential diseases such as cardiovascular disease and diabetes, its prevention and treatment are vital for overall human physiologic and psychological health. Along with reviewing the history of treatment and current methods, we seek new approaches to curb this issue in the future.
METHODS
In this review, investigations were based on the focus of each section's content or conducted on an ad hoc basis. Searches were performed in Scopus and PubMed.
RESULTS
In recent years, many treatments for ED have been reported besides oral administration of phosphodiesterase 5 inhibitors such as sildenafil and tadalafil (approved by the Food and Drug Administration). Common oral medications, intracavernous injections, herbal therapies (eg, herbal phosphodiesterase 5 inhibitors), and topical/transdermal medications are routine ED treatment approaches. Moreover, some novel medications are innovative candidates for completing ED's treatment protocols: stem cell injection, low-intensity extracorporeal shock wave therapy, platelet-rich plasma injection, gene therapy, amniotic fluid matrices, rho-kinase inhibitors, melanocortin receptor antagonists, maxi-K channel activators (ie, large-conductance calcium-activated potassium channels), guanylate cyclase activators, and nitric oxide donors.
CONCLUSION
Due to the importance of this complicated problem in men's society, a faster course of treatment trends toward new methods is needed to increase efficiency. Combining the mentioned treatments and attentively examining their efficacy through programmed clinical trials can be a big step toward solving this global problem.
Topics: United States; Male; Humans; Erectile Dysfunction; Phosphodiesterase 5 Inhibitors; Quality of Life; Sildenafil Citrate; Tadalafil
PubMed: 37076171
DOI: 10.1093/sxmrev/qead014 -
Small (Weinheim An Der Bergstrasse,... Jul 2023Direct removal of carbon dioxide (CO ) from the atmosphere, known as direct air capture (DAC) is attracting worldwide attention as a negative emission technology to...
Direct removal of carbon dioxide (CO ) from the atmosphere, known as direct air capture (DAC) is attracting worldwide attention as a negative emission technology to control atmospheric CO concentrations. However, the energy-intensive nature of CO absorption-desorption processes has restricted deployment of DAC operations. Catalytic solvent regeneration is an effective solution to tackle this issue by accelerating CO desorption at lower regeneration temperatures. This work reports a one-step synthesis methodology to prepare monodispersed carbon nanospheres (MCSs) using trisodium citrate as a structure-directing agent with acidic sites. The assembly of citrate groups on the surface of MCSs enables consistent spherical growth morphology, reduces agglomeration and enhances water dispersibility. The functionalization-assisted synthesis produces uniform, hydrophilic nanospheres of 100-600 nm range. This work also demonstrates that the prepared MCSs can be further functionalized with strong Brønsted acid sites, providing high proton donation ability. Furthermore, the materials can be effectively used in a wide range of amino acid solutions to substantially accelerate CO desorption (25.6% for potassium glycinate and 41.1% for potassium lysinate) in the DAC process. Considering the facile synthesis of acidic MCSs and their superior catalytic efficiency, these findings are expected to pave a new path for energy-efficient DAC.
PubMed: 37058083
DOI: 10.1002/smll.202300150