ResearchPad - other https://www.researchpad.co Default RSS Feed en-us © 2020 Newgen KnowledgeWorks <![CDATA[An Atypical Presentation of Formic Acid Poisoning]]> https://www.researchpad.co/article/elastic_article_11602 Although formic acid (FA) poisoning is rare, it is usually fatal. Many FA poisoning cases commonly involve rubber plantation workers in which these workers ingest FA accidentally or with suicidal intentions. This is a case presentation of FA poisoning by a 73-year-old man. Additionally, the patient’s old age likely contributed to his severe prognosis.

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<![CDATA[Therapeutic Drug Monitoring Characteristics in a Tertiary University Hospital in 2019]]> https://www.researchpad.co/article/elastic_article_9457 Introduction

Therapeutic drug monitoring (TDM) is defined as measuring drug concentration in a biological sample to optimize pharmacotherapy. This study aims to evaluate TDM requests in a tertiary university hospital retrospectively.

Materials and methods

TDM requests were evaluated retrospectively for lithium, valproic acid, carbamazepine, and digoxin in 2019. The age and gender of the patient, requesting department, and measurement results were evaluated. Lower levels than the reference values were considered as subtherapeutic, while levels higher than the reference were considered as toxic.

Results 

A total of 415 drug level measurement records were found. The pediatric age sample ratio was 13.7%, and the elderly age sample ratio was 11.8%. When all samples were evaluated according to the relevant laboratory cut-off values, 72.8% of samples were within the therapeutic level range, 21.9% of samples were subtherapeutic, and 5.3% were toxic. The pediatric age group had a higher ratio of toxic levels for the four drugs studied (54.5%).

Conclusions

Tests for lithium, valproic acid, carbamazepine, and digoxin would not be considered sufficient for TDM. Multidisciplinary teamwork might be appropriate for further implementation and interpretation of TDM.

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<![CDATA[A cross‐sectional study of patients referred for <i>HNF1B</i>‐MODY genetic testing due to cystic kidneys and diabetes]]> https://www.researchpad.co/article/elastic_article_7095 Patients referred for HNF1B testing present very heterogeneous phenotypes. Despite suggestive characteristics, many do not harbor mutations in HNF1B. Our objective was to evaluate the clinical characteristics of probands referred for HNF1B genetic testing through a nationwide monogenic diabetes screening program.MethodsProbands tested for HNF1B mutations in the 2005‐2018 period (N = 50) were identified in the Polish Monogenic Diabetes Registry, which prospectively recruits primarily pediatric patients and their families on a nationwide scale. Variants that had been reported pathogenic were reassessed using criteria of the American College of Medical Genetics and Genomics (ACMG). A structured medical interview was performed with all available individuals, their parents, and/or their physicians. For each patient, HNF1B score was calculated based on available clinical information.ResultsThe study group numbered 36 unrelated probands (28% lost to follow‐up): 14 with pathogenic or likely‐pathogenic variants in HNF1B, one with a variant of uncertain significance, and 21 negative for HNF1B mutations. Presence of cystic kidneys (OR = 9.17, 95% CI:1.87‐44.92), pancreatic abnormalities (OR = 15, 95% CI:1.55‐145.23), elevated liver enzymes (OR = 15, 95% CI:1.55‐145.23) best discriminated HNF1B‐positive cases from the negative ones. Presence of impaired glucose tolerance coupled with kidney disease in the proband and one parent was also highly predictive for HNF1B mutations (OR = 11.11, 95% CI:1.13‐109.36). HNF1B‐score with recommended cutoff distinguished patients with and without HNF1B findings with 100% sensitivity and 47.6% specificity. Addition of four clinical variables to select patients based on HNF1B score improved specificity to 71.4% (95% CI:47.8%‐88.7%) while retaining 100% sensitivity.ConclusionsDetailed medical interview may enable more accurate patient selection for targeted genetic testing. ]]> <![CDATA[A safe approach to surgery for pituitary and skull base lesions during the COVID-19 pandemic]]> https://www.researchpad.co/article/N5d068efd-7f18-442e-b6b6-454595b3fd79 <![CDATA[Recycling endosomes associate with Golgi stacks in sea urchin embryos]]> https://www.researchpad.co/article/Nd5908d6d-c6b6-42d0-92ba-7c063f1f7b48 The trans-Golgi network (TGN) and recycling endosome (RE) have been recognized as sorting centers, the former for newly synthesized and the latter for endocytosed proteins. However, recent findings have revealed that TGN also receives endocytosed materials and RE accepts newly synthesized proteins destined to the plasma membrane. Recently, we reported that in both Drosophila and microtubule-disrupted HeLa cells, REs are associated with the trans-side of Golgi stacks. REs are highly dynamic: their separation from and association with Golgi stacks are often observed. Importantly, a newly synthesized cargo, glycosylphosphatidylinositol-anchored-GFP was found to be concentrated in Golgi-associated REs (GA-REs), while another cargo VSVG-GFP was excluded from GA-REs before post-Golgi trafficking to the plasma membrane. This suggested that the sorting of cargos takes place at the interface of Golgi stacks and GA-REs. In this study, we demonstrated that REs could associate with Golgi stacks in sea urchin embryos, further indicating that the association of REs with Golgi stacks is a well-conserved phenomenon in the animal kingdom.

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<![CDATA[Using genomics to understand inter- and intra- outbreak diversity of <i>Pasteurella multocida</i> isolates associated with fowl cholera in meat chickens]]> https://www.researchpad.co/article/N223fe369-48eb-46de-bb92-0a45a338f1fc Fowl cholera, caused by Pasteurella multocida, continues to be a challenge in meat-chicken-breeder operations and has emerged as a problem for free-range meat chickens. Here, using whole-genome sequencing (WGS) and phylogenomic analysis, we investigate isolate relatedness during outbreaks of fowl cholera on a free-range meat chicken farm over a 5-year period. Our genomic analysis revealed that while all outbreak isolates were sequence type (ST) 20, they could be separated into two distinct clades (clade 1 and clade 2) consistent with difference in their lipopolysaccharide (LPS) type. The isolates from the earlier outbreaks (clade 1) were carrying LPS type L3 while those from the more recent outbreaks (clade 2) were LPS type L1. Additionally, WGS data indicated high inter- and intra-chicken genetic diversity during a single outbreak. Furthermore, we demonstrate that while a killed autogenous vaccine carrying LPS type L3 had been successful in protecting against challenge from L3 isolates it might have driven the emergence of the closely related clade 2, against which the vaccine was ineffective. The genomic results also revealed a 14 bp deletion in the galactosyltransferase gene gatG in LPS type L3 isolates, which would result in producing a semi-truncated LPS in those isolates. In conclusion, our study clearly demonstrates the advantages of genomic analysis over the conventional PCR-based approaches in providing clear insights in terms of linkage of isolate within and between outbreaks. More importantly, it provides more detailed information than the multiplex PCR on the possible structure of outer LPS, which is very important in the case of strain selection for killed autogenous vaccines.

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<![CDATA[Integrating Cupping Therapy in the Management of Sudden Sensorineural Hearing Loss: A Case Report]]> https://www.researchpad.co/article/N639c0ff9-cd2b-4087-812b-9f5c94c4730b

Sudden sensorineural hearing loss (SSNHL) is most often defined as a rapid hearing loss of ≥ 30 decibels across at least three contiguous audiometric frequencies over a time of ≤ 72 hours. Cupping therapy has been practiced across the world for thousands of years. Cupping therapy is practiced by creating suction inside cups that are placed on predefined skin areas. Our case is a 48-year-old female with a four-year history of Meniere’s disease, recurrent tinnitus, episodes of dizziness attacks, and fullness of the right ear. The patient developed sudden sensorineural hearing loss. She received conventional treatment and wet cupping therapy as a complementary integrative treatment. After the integrative management protocol was completed, pure tone audiometry tests revealed significant hearing improvement across almost all frequencies. To the best of our knowledge, this case presentation is the first reported case of this type. A positive effect of cupping was reported in our case as an integrative complementary treatment. Large, well-designed quality clinical trials to evaluate the efficacy and safety of wet cupping therapy (WCT) as a complementary treatment of SSNHL is highly recommended.

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<![CDATA[Cardioprotective Effect of Olive Oil Against Ischemia Reperfusion-induced Cardiac Arrhythmia in Isolated Diabetic Rat Heart]]> https://www.researchpad.co/article/Na5d96904-2d95-4c44-aabe-ee145d168aa8

Background

Olive oil is rich in monounsaturated fatty acids and has been reported for a variety of beneficial cardiovascular effects, including blood pressure lowering, anti-platelet, anti-diabetic, and anti-inflammatory effects. Diabetes is a major risk factor for cardiac dysfunctions, and olive oil prevents diabetes-induced adverse myocardial remodeling.

Objective

The study aimed to evaluate the effects of olive oil against streptozotocin-induced cardiac dysfunction in animal models of diabetes and ischemia and reperfusion (I/R)-induced cardiac arrhythmias.

Methods

Diabetes was induced in male rats with a single intraperitoneal injection of streptozotocin (60 mg/kg i.p), rats were treated for five, 15, or 56 days with olive oil (1 ml/kg p.o). Control animals received saline. Blood glucose and body weight were monitored every two weeks. At the end of the treatment, rats were sacrificed and hearts were isolated for mounting on Langedorff’s apparatus. The effect of olive oil on oxidative stress and histopathological changes in the cardiac tissues were studied.

Results

The initial blood glucose and body weight were not significantly different in the control and olive-treated animals. Streptozotocin (60 mg/kg i.p) caused a significant increase in the blood glucose of animals as compared to saline-treated animals. The control, saline-treated diabetic animals exhibited a 100% incidence of I/R-induced ventricular fibrillation, which was reduced to 0% with olive oil treatment. The protective effects of olive oil were evident after 15 and 56 days of treatment. Diltiazem, a calcium channel blocker (1 µm/L) showed similar results and protected the I/R-induced cardiac disorders. The cardiac tissues isolated from diabetic rats exhibited marked pathological changes in the cardiomyocytes, including decreased glutathione (GSH) and increased oxidative stress (malondialdehyde; MDA). Pretreatment of animals with olive oil (1 ml/kg p.o) increased GSH and decreased MDA levels. Olive oil also improved the diabetic-induced histopathological changes in the cardiomyocytes.

Conclusion

Olive oil possesses cardiac protective properties against I/R-induced cardiac arrhythmias in rats. It attenuated oxidative stress and diabetes-induced histopathological changes in cardiac tissues. The observed cardiac protectiveness of olive oil in the present investigation may be related to its antioxidant potential.

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<![CDATA[Efficacy and Tolerability of Ashwagandha Root Extract in the Elderly for Improvement of General Well-being and Sleep: A Prospective, Randomized, Double-blind, Placebo-controlled Study]]> https://www.researchpad.co/article/Nbe49d8a2-d159-48f2-8114-3733d98e0106

Background

Ashwagandha is an excellent adaptogen that is being used since ancient times in Ayurvedic medicine. Traditionally, it is used for various ailments and general well-being, including the treatment of geriatric patients. Managing quality of life (QoL) remains a challenge for the elderly population, especially joint pain management, sleep, and general well-being. With a growing global elderly population, QoL management with efficient medication and supplementation is the major healthcare requirement.

Objective

The objective of this study was to assess the safety, efficacy, and tolerability of Ashwagandha (Withania somnifera (L.) Dunal.) root extract on the improvement of general health and sleep in elderly people.

Methods

This 12-week, prospective, randomized, double-blind, placebo-controlled study was conducted on individuals of either gender aged between 65-80 years. Participants were randomized to receive Ashwagandha root extract at a dose of 600 mg/day (n = 25) orally, or identical placebo capsules with the same dose (n = 25) for 12 weeks. Efficacy was assessed using the WHOQOL-BREF questionnaire, sleep quality, mental alertness on rising, and Physician’s Global Assessment of Efficacy to Therapy (PGAET). The safety and tolerability were assessed using the clinical adverse events reporting and Patient's Global Assessment of Tolerability to Therapy (PGATT).

Results

Statistically significant (P<0.0001) improvement was observed in the Ashwagandha treatment group compared to the placebo. The mean (SD) total score of WHOQOL-BREF improved from 140.53 (8.25) at the baseline to 161.84(9.32) at the end of the study. The individual domain scores were also improved. At baseline, the sleep quality and the mental alertness on rising were comparatively low in both the groups. However, upon intervention, a significant increase in the quality of sleep (P<0.0001) and mental alertness (P<0.034) was observed in the Ashwagandha treatment group when compared to the placebo group. Overall improvement was observed for the general wellbeing, sleep quality, and mental alertness in the study population. The experimental group population displayed good tolerability to the test product and it was reported as safe and beneficial by the study participants. 

Conclusion

The study outcomes suggest that Ashwagandha root extract was efficient in improving the QoL, sleep quality, and mental alertness as self-assessed by the elderly participants. The recommended dose used in this study could be effective for the elderly population. 

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<![CDATA[Effects of Air Pollution and Other Environmental Exposures on Estimates of Severe Influenza Illness, Washington, USA]]> https://www.researchpad.co/article/N9c6ec5a1-e195-484f-aae7-aa4aa0f641b2

Ecologic models of influenza burden may be confounded by other exposures that share winter seasonality. We evaluated the effects of air pollution and other environmental exposures in ecologic models estimating influenza-associated hospitalizations. We linked hospitalization data, viral surveillance, and environmental data, including temperature, relative humidity, dew point, and fine particulate matter for 3 counties in Washington, USA, for 2001–2012. We used negative binomial regression models to estimate the incidence of influenza-associated respiratory and circulatory (RC) hospitalizations and to assess the effect of adjusting for environmental exposures on RC hospitalization estimates. The modeled overall incidence rate of influenza-associated RC hospitalizations was 31/100,000 person-years. The environmental parameters were statistically associated with RC hospitalizations but did not appreciably affect the event rate estimates. Modeled influenza-associated RC hospitalization rates were similar to published estimates, and inclusion of environmental covariates in the model did not have a clinically important effect on severe influenza estimates.

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<![CDATA[Risk for Transportation of Coronavirus Disease from Wuhan to Other Cities in China]]> https://www.researchpad.co/article/N00c6f358-68ee-40be-ba1e-812b37277a1d

On January 23, 2020, China quarantined Wuhan to contain coronavirus disease (COVID-19). We estimated the probability of transportation of COVID-19 from Wuhan to 369 other cities in China before the quarantine. Expected COVID-19 risk is >50% in 130 (95% CI 89–190) cities and >99% in the 4 largest metropolitan areas.

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<![CDATA[Clarification That Study Database Included Hospital Inpatients]]> https://www.researchpad.co/article/Na3a2f1ae-b60d-4d72-b82d-633508ea61d6 ]]> <![CDATA[Error in Trial Registration Number]]> https://www.researchpad.co/article/Ncc328491-3551-4e34-8277-1038379b39b5 ]]> <![CDATA[Error in Data in the Abstract]]> https://www.researchpad.co/article/Na0512b81-96aa-47df-82ff-a9e0588d9795 ]]> <![CDATA[Error in Methods]]> https://www.researchpad.co/article/Nc697507f-531c-47bd-b861-f036b1825503 ]]> <![CDATA[Error in Abstract]]> https://www.researchpad.co/article/N4d1fae2e-fd6a-42f3-b578-d21649762e3a ]]> <![CDATA[A Comprehensive Literature Review on the Clinical Presentation, and Management of the Pandemic Coronavirus Disease 2019 (COVID-19)]]> https://www.researchpad.co/article/Nb01bf2ae-0a1d-4d73-ab83-4e3a4f2d5389

Coronavirus disease 2019 (COVID-19) is a declared global pandemic. There are multiple parameters of the clinical course and management of the COVID-19 that need optimization. A hindrance to this development is the vast amount of misinformation present due to scarcely sourced manuscript preprints and social media. This literature review aims to presents accredited and the most current studies pertaining to the basic sciences of SARS-CoV-2, clinical presentation and disease course of COVID-19, public health interventions, and current epidemiological developments.

The review on basic sciences aims to clarify the jargon in virology, describe the virion structure of SARS-CoV-2 and present pertinent details relevant to clinical practice. Another component discussed is the brief history on the series of experiments used to explore the origins and evolution of the phylogeny of the viral genome of SARS-CoV-2. Additionally, the clinical and epidemiological differences between COVID-19 and other infections causing outbreaks (SARS, MERS, H1N1) are elucidated.

Emphasis is placed on evidence-based medicine to evaluate the frequency of presentation of various symptoms to create a stratification system of the most important epidemiological risk factors for COVID-19. These can be used to triage and expedite risk assessment. Furthermore, the limitations and statistical strength of the diagnostic tools currently in clinical practice are evaluated. Criteria on rapid screening, discharge from hospital and discontinuation of self-quarantine are clarified. Epidemiological factors influencing the rapid rate of spread of the SARS-CoV-2 virus are described. Accurate information pertinent to improving prevention strategies is also discussed.

The penultimate portion of the review aims to explain the involvement of micronutrients such as vitamin C and vitamin D in COVID19 treatment and prophylaxis. Furthermore, the biochemistry of the major candidates for novel therapies is briefly reviewed and a summary of their current status in the clinical trials is presented. Lastly, the current scientific data and status of governing bodies such as the Center of Disease Control (CDC) and the WHO on the usage of controversial therapies such as angiotensin-converting enzyme (ACE) inhibitors, nonsteroidal anti-inflammatory drugs (NSAIDs) (Ibuprofen), and corticosteroids usage in COVID-19 are discussed.

The composite collection of accredited studies on each of these subtopics of COVID-19 within this review will enable clarification and focus on the current status and direction in the planning of the management of this global pandemic.

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<![CDATA[Extensive multiplex PCR diagnostics reveal new insights into the epidemiology of viral respiratory infections]]> https://www.researchpad.co/article/N00934776-c980-44ad-be69-fd7ff9c62bad

SUMMARY

Viral respiratory infections continue to pose a major global healthcare burden. At the community level, the co-circulation of respiratory viruses is common and yet studies generally focus on single aetiologies. We conducted the first comprehensive epidemiological analysis to encompass all major respiratory viruses in a single population. Using extensive multiplex PCR diagnostic data generated by the largest NHS board in Scotland, we analysed 44230 patient episodes of respiratory illness that were simultaneously tested for 11 virus groups between 2005 and 2013, spanning the 2009 influenza A pandemic. We measured viral infection prevalence, described co-infections, and identified factors independently associated with viral infection using multivariable logistic regression. Our study provides baseline measures and reveals new insights that will direct future research into the epidemiological consequences of virus co-circulation. In particular, our study shows that (i) human coronavirus infections are more common during influenza seasons and in co-infections than previously recognized, (ii) factors associated with co-infection differ from those associated with viral infection overall, (iii) virus prevalence has increased over time especially in infants aged <1 year, and (iv) viral infection risk is greater in the post-2009 pandemic era, likely reflecting a widespread change in the viral population that warrants further investigation.

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<![CDATA[AORN Guidance Statement: Human and Avian Influenza and Severe Acute Respiratory Syndrome]]> https://www.researchpad.co/article/N91e45255-b250-4a64-8c56-4e8ba6235cd5 ]]> <![CDATA[The Impact of Adding Taxanes to Anthracyclines on Women with Breast Cancer Receiving Adjuvant Chemotherapy]]> https://www.researchpad.co/article/N25f3fe38-93ac-4bdc-b323-7a8a9443eae4

Introduction

This study aimed to analyze the impact of adding taxanes to anthracycline-based regimens on women diagnosed with breast cancer and treated with adjuvant chemotherapy.

Methods

This retrospective study included 559 female breast cancer patients who underwent adjuvant chemotherapy at the University Hospital Center “Mother Teresa” in Tirana, Albania from 2005 to 2011. Three hundred fifty-nine patients received an anthracycline-based regimen, and 200 received anthracycline-plus-taxane regimens. Common anthracycline-based regimens consisted of 5-fluorouracil 600 mg/m2, doxorubicin 60 mg/m2, cyclophosphamide 600 mg/m2 every three weeks for six cycles. Combined taxane-anthracycline regimens were anthracycline-based regimen in the first four cycles (doxorubicin 60 mg/m2, cyclophosphamide 600 mg/m2, docetaxel 80 mg/m2) followed by either weekly paclitaxel or thrice-weekly docetaxel for four cycles.

Results

Overall, after a 5-year follow-up, it was found that 148 women in the taxanes-based regimen group (74%) did not experience relapse compared with 264 women in the anthracycline-based regimen group (73.5%). The relapse status was affected by hormonal status (p: <0.001) in the taxane-based regimen. In the anthracycline-based regimen patients, the relapse status was affected by hormone status and nodal involvement (p: <0.001).

Conclusion

The taxanes-plus-anthracycline regimen was slightly more effective than the anthracycline-based regimen for breast cancer patients in terms of avoiding relapse, but the difference was not statistically significant. Therefore, adding taxanes to adjuvant chemotherapy for women diagnosed with breast cancer is not beneficial for every subgroup. Hence, the future of breast cancer therapy remains chemotherapy individualized for each patient for optimal outcomes.

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