Publications by authors named "Salman Ahmed"

154 Publications

Low type I interferon response in COVID-19 patients: Interferon response may be a potential treatment for COVID-19.

Biomed Rep 2021 May 9;14(5):43. Epub 2021 Mar 9.

Genetic Engineering Laboratory, Biology Department, College of Science, Basrah University, Basrah, Iraq.

Interferons (IFN) are antiviral cytokines that mitigate the effects of invading viruses early on during the infection process. SARS-CoV and MERS induce weak IFN responses; hence, the clinical trials which included recombinant IFN accompanied with other antiviral drugs exhibited improved results in terms of shortening the duration of illness. The aim of the present study was to evaluate the type I IFN response in COVID-19 patients to determine whether it is sufficient to eliminate or reduce the severity of the infection, and whether it can be recommended as a potential therapy. Total RNA samples were converted to cDNA and used as templates to evaluate the gene expression levels of IFN regulatory factor (IRF)3 and IFN-β in COVID-19 patients or control. The results showed that IRF3 gene expression was upregulated ~250-fold compared with the negative samples. In contrast, IFN-β expression increased slightly in COVID-19 patients. Consistent with other coronaviruses, such as SARS-CoV and MERS, COVID-19 infection does not induce an efficient IFN response to reduce the severity of the virus. This may be attributed to an incomplete response of IRF3 in activating the IFN-β promoter in the infected patients. The results suggest IFN-β or α may be used as potential treatments.
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http://dx.doi.org/10.3892/br.2021.1419DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7995242PMC
May 2021

Changes of Urinary Cytokines in Non-Diabetic Obese Patients After Laparoscopic Sleeve Gastrectomy.

Int J Gen Med 2021 10;14:825-831. Epub 2021 Mar 10.

Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt.

Introduction: Adipose tissues synthesize and secrete various proinflammatory and anti-inflammatory mediators, termed cytokines. This work aims to assess different serum and urinary cytokine levels before and 12 months after laparoscopic sleeve gastrectomy (LSG).

Patients: This prospective study was performed on 61 obese non-diabetic patients who underwent LSG. All patients were followed up postoperatively at 12 months with the assessment of arterial blood pressure, microalbuminuria, urinary and serum levels of inflammatory cytokines (macrophage migration inhibitory factor "MIF," monocyte chemotactic protein "MCP"-1, chemokine (C-C motif) ligand 15 (CCL-15), and CCL-18), in addition to serum creatinine, total cholesterol, and C-reactive protein (CRP).

Results: Mean BMI showed decreased substantially from 44.78 ± 3.59 Kg/m to 34.56 ± 2.45. Systolic blood pressure decreased from 147.03 ± 16.89 mmHg to 128.82 ± 12.52 and diastolic blood pressure decreased from 90.51 ± 12.71 mmHg to 79.69 ± 10.39. At one-year of follow-up, there was statistically significant decrease of mean serum creatinine, total cholesterol, CRP, CCL-15, CCL-18, MIF/creatinine ratio, MCP-1/creatinine ratio, CCL-15/creatinine ratio, and CCL-18/creatinine ratio (P value <0.001).

Conclusion: Improvement of systemic and renal inflammatory states after LSG may positively affect obesity-related renal disease by steering the adipokine levels towards anti-inflammatory profiles.
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http://dx.doi.org/10.2147/IJGM.S302418DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7956865PMC
March 2021

Factors associated with resolution of type-2 diabetes mellitus after sleeve gastrectomy in obese adults.

Sci Rep 2021 Mar 16;11(1):6002. Epub 2021 Mar 16.

General Surgery Department, Faculty of Medicine, Cairo University, Cairo, Egypt.

Many bariatric procedures are more effective for improving type-2 diabetes mellitus (T2DM) than conventional pharmacotherapy. The current research evaluated factors linked to complete and partial remission or improvement of T2DM after laparoscopic sleeve gastrectomy (LSG). The current prospective study included all diabetic patients who were submitted LSG between January 2015 and June 2018 and completed a 2-year follow-up period. Patients were assessed at baseline and 2 years after LSG. This work comprised of 226 diabetic cases. Two years after LSG, 86 patients (38.1%) achieved complete remission of DM, and 24 (10.6%) reached partial remission. Only 14 patients (6.2%) showed no change in their diabetic status. On univariate analysis, age ≤ 45 years, duration of diabetes ≤ 5 years, use of a single oral antidiabetic, HbA1c ≤ 6.5%, HOMA-IR ≤ 4.6, C-peptide > 2.72 ng/mL, and BMI ≤ 40 kg/m predicted complete remission. The independent predictors of complete remission were age ≤ 45 years, duration of diabetes ≤ 5 years, use of a single oral antidiabetic, HOMA-IR ≤ 4.6, and C-peptide > 2.72 ng/mL. A combined marker of young age, short duration of DM, and low HOMA-IR predicted complete remission with sensitivity 93% and specificity 82%. Independent predictors of complete remission of T2DM after LSG were younger age, shorter duration, single oral antidiabetic, lower HOMA-IR, and higher C-peptide.
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http://dx.doi.org/10.1038/s41598-021-85450-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7966796PMC
March 2021

COVID-19 vaccines: Global challenges and prospects forum recommendations.

Int J Infect Dis 2021 Feb 27;105:448-451. Epub 2021 Feb 27.

King Abdullah International Medical Research Centre, King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia.

The 11th KAIMRC Annual Research Forum Themed "COVID-19 Vaccine: Global Challenges and Prospects Forum" discussed COVID19 Vaccines. The Forum was a vital event as it provided a hub for leading COVID-19 vaccine scientists, regulators, developers, and distributors to learn about COVID-19 vaccines in development, make decisions about the best vaccines to use, and develop appropriate plans for global distribution and pricing. The COVID-19: Global Efforts for Development, Clinical Trials and Distribution Symposium brought together leading scientists, clinicians, pharma, decision makers, academic institutions and businesses to present and discuss the vaccines that are being currently developed for the COVID19. This event was held to shed light on these vaccines as many are at the late stage of Phase III clinical trials and ready to be marketed. This follows the confusion that few vaccines were produced and pushed into phase III without sharing all the necessary data preventing the scientific and clinical community to judge its efficacy and safety. This event allowed a discussion into the challenges in the distribution, pricing and accessibility of the vaccines. Moreover, the symposium discussed the importance to invest in Biotech-Pharma to combat and overcome any future health crisis. The discussion focused on Saudi Arabia leading initiatives as front runner in the field among G20 members.
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http://dx.doi.org/10.1016/j.ijid.2021.02.093DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7912554PMC
February 2021

PMNet: A probability map based scaled network for breast cancer diagnosis.

Comput Med Imaging Graph 2021 Jan 30;89:101863. Epub 2021 Jan 30.

Computational Biology Research Lab, Department of Computer Science, NUCES-FAST, Islamabad, Pakistan.

The mortality rate of Breast Cancer in women has increased, both in west and east. Early detection is important to improve the survival rate of cancer patients. The manual detection and identification of cancer in whole slide images are critical and difficult tasks for pathologists. In this work, we introduce PMNet, a pipeline to detect regions with invasive characteristics in whole slide images. Our method employs scaled networks for detecting breast cancer in whole slide images. It classifies whole slide images on patch level into normal, benign, in situ and invasive tumors. Our approach yielded f1-score of 88.9(±1.7)% that outperforms the benchmark f1-score of 81.2(±1.3)% on patch level and achieved an average dice coefficient of 69.8% on 10 whole slide images compared to the benchmark average dice coefficient of 61.5% on BACH dataset. Similarly, on the dryad test dataset that comprises of 173 whole slide images, we achieved an average dice coefficient of 82.7% as compared to the previous state-of-art of 76% without fine-tuning on this dataset. We further proposed a method to generate patch level annotations for the image level TCGA breast cancer database that will be useful for future deep learning methods.
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http://dx.doi.org/10.1016/j.compmedimag.2021.101863DOI Listing
January 2021

Study of Early Postoperative Doppler Changes Post Living Donor Liver Transplantation and Their Impact on Early Mortality and Small-for-Size Syndrome: A Retrospective Study.

Int J Gen Med 2021 28;14:309-317. Epub 2021 Jan 28.

Internal Medicine Department, Faculty of Medicine, Minia University, Minia, Egypt.

Background: Adult-to-adult living donor liver transplantation (LDLT) has been a common practice because of the deficiency of deceased donor liver transplants. Liver hemodynamics differ substantially between cases with end-stage liver disease undergoing LT because of various degrees of hepatic affection, nature of implicated causative factors, and pathogenesis of the hepatic disorder. The present retrospective study primarily aimed to study the early postoperative doppler changes after adult to adult LDLT. The secondary aim was to assess these hemodynamics' impact on early in-hospital deaths and small for size syndrome (SFSS) development.

Methods: This retrospective work was done on 123 adult cases with end-stage liver disease for whom adult LDLT was performed after exclusion of pediatric patients and those with vascular complications.

Results: Postoperative (PO) mean portal vein velocity (PVV), hepatic artery (HA) peak systolic velocity (PSV), and HA resistivity index (RI) declined gradually but significantly post adult LDLT. Phasicity of hepatic veins changes towards the triphasic waveform gradually in the early PO period. There is a notable negative relationship between PO mean PVV with PO mean HA PSV. Higher PO HA RI affected PO mortality, while higher PO PVV and lower HA PSV increased the incidence of SFSS.

Conclusion: Early postoperative Doppler changes post-LDLT (PO PVV, HA RI, and HA PSV) can affect both mortality and SFSS development.
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http://dx.doi.org/10.2147/IJGM.S280456DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7850574PMC
January 2021

Utilization of radiation therapy in multiple myeloma: trends and changes in practice.

Ann Hematol 2021 Mar 12;100(3):735-741. Epub 2021 Jan 12.

Division of Hematology-Oncology, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA.

Plasma cell disorders including plasmacytomas and multiple myeloma (MM) are exquisitely radiosensitive, and thus, radiation therapy (XRT) is used effectively in their management. The role of XRT in the setting of novel MM therapeutics has not been explored. The 2016 National Cancer Database (NCDB) for MM with patients diagnosed between 2004 and 2013 was studied. Association between utilization of XRT as part of initial therapy and patient, disease, or treating facility characteristics was studied. A total of 111,281 cases with 91.6% MM, 7% osseous plasmacytoma (PLA-O), and 1.4% extramedullary plasmacytoma (PLA-E) were identified. XRT was utilized as part of initial therapy in 25.4% cases, including 69.3% of PLA-O, 60% of PLA-E, and 21.5% of MM patients. Patients with PLA-E and MM were significantly less likely to receive XRT as compared to PLA-O (p < 0.001). A significantly decreased use of XRT was noted over time (p < 0.001), and for advancing patient age (p < 0.001), women (p < 0.001), and blacks (p < 0.001), and with increasing income (p = 0.015). Patients with Medicare were less likely to receive XRT (OR 0.86, 95% CI 0.78, 0.94) as compared to uninsured as were those with initial treatment at academic or high-volume facilities and facilities performing stem cell transplant. There was overall decreased utilization of XRT in recent years, possibly due to advent of efficacious systemic agents for MM therapy, with a higher XRT utilization for plasmacytomas. Patterns of XRT use need to be explored prospectively, so that uniform standards of healthcare delivery can be maintained and treatment heterogeneity can be minimized.
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http://dx.doi.org/10.1007/s00277-020-04371-1DOI Listing
March 2021

High frequency of simultaneous presence of ESBL and carbapenemase producers among nosocomial coliform isolates in Faisalabad, Pakistan.

Pak J Med Sci 2021 Jan-Feb;37(1):34-39

Abdul Haque, PhD. Department of Health Biotechnology, Akhuwat FIRST, Faisalabad, Pakistan.

Objectives: The objective of the current study was to find prevalence of relevant ESBL and carbapenemase producing genes in nosocomial and isolates and to check phenotypic susceptibility of all ESBL positive isolates to carbapenems.

Methods: Forty ESBL producing clinical isolates of (n=33) and (n=7) were examined for the presence of β-lactamase genes (CTX-M, CTX-M-1, 2, 3, 4 and TEM). Carbapenem resistance was checked phenotypically and by presence of gene.

Results: Nine (27%) were positive for CTX-M genes, and 10 (30%) for TEM among isolates. Importantly, six isolates showed co-existence of CTX-M and TEM genes. In , two (28%) isolates were positive for CTX-M and one (14%) for TEM genes. Eight (24%) and one (14%) isolates were positive for CTX-M-1. Respective figures for CTX-M-4 were three (10%) and one (14%). CTX-M-2 and CTX-M-3 groups were not represented. Twenty (50%) isolates were resistant to both imipenem and meropenem out of which only four isolates expressed gene.

Conclusions: The significant presence of both ESBL and carbapenemase producers and co-existence of ESBL and carbapenemases in the same isolates is worrisome.
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http://dx.doi.org/10.12669/pjms.37.1.3192DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7794153PMC
January 2021

One Anastomosis Gastric Bypass in Patients with Gastrooesophageal Reflux Disease and/or Hiatus Hernia.

Obes Surg 2021 Apr 6;31(4):1449-1454. Epub 2021 Jan 6.

Bariatric Unit, Sunderland Royal Hospital, Sunderland, SR4 7TP, UK.

Introduction: One anastomosis gastric bypass (OAGB) offers favourable weight loss outcomes and is associated with reduced morbidity and mortality when compared to other mainstream bariatric procedures. However, a randomised trial reported a conversion rate to roux-en-Y configuration (RYC) of 3.1%, and some surgeons consider the procedure unsuitable for patients with a preoperative hiatus hernia (HH) or symptoms of gastrooesophageal reflux disease (GORD).

Methods: We carried out a retrospective review of patients undergoing OAGB in our institution. Included were all patients on PPI for symptoms of GORD preoperatively, as well as patients with HH or oesophagitis on preoperative endoscopy. We recorded GORD outcomes as well as rates of conversion to RYC in patients.

Results: Medium term follow up data at 23-28 months was available for 89 patients. Of these, 63 had HH, 34 had preoperative GORD requiring PPI and 9 had confirmed oesophagitis. The conversion rate to RYC was nil (0/63) in patients with HH. At the same time, 14.7% (5/34) of patients with preop GORD on PPI required conversion to RYC at a median time interval of 16 months. In patients already on PPI preoperatively, 16/34 (47.1%) needed to continue on PPI long term. In patients with HH, 20.6% (13/63) suffered de novo GORD symptoms.

Conclusion: OAGB can be offered to patients with HH with acceptable GORD outcomes but caution is advised in patients with preoperative GORD symptoms. Larger prospective and randomised studies are required to further assess this subgroup.
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http://dx.doi.org/10.1007/s11695-020-05149-0DOI Listing
April 2021

Generation of a Genetically Modified Chimeric Parasite Expressing Circumsporozoite Protein for Malaria Vaccine Development.

Front Cell Infect Microbiol 2020 17;10:591046. Epub 2020 Dec 17.

Department of Parasitology, Leiden University Medical Center, Leiden, Netherlands.

Chimeric rodent malaria parasites with the endogenous circumsporozoite protein () gene replaced with from the human parasites () and () are used in preclinical evaluation of CSP vaccines. Chimeric rodent parasites expressing CSP have also been assessed as whole sporozoite (WSP) vaccines. Comparable chimeric parasites expressing CSP of could be used both for clinical evaluation of vaccines targeting CSP in controlled human infections and in WSP vaccines targeting and . We generated chimeric parasites expressing both CSP and CSP. These -CSP parasites produced sporozoite comparable to wild type parasites and expressed CSP and CSP on the sporozoite surface. -CSP sporozoites infected human hepatocytes and induced antibodies to the repeats of both CSP and CSP after immunization of mice. These results support the use of -CSP sporozoites in studies optimizing vaccines targeting CSP.
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http://dx.doi.org/10.3389/fcimb.2020.591046DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7773900PMC
December 2020

Influence of bifurcation angle in left coronary artery with stenosis: A CFD analysis.

Biomed Mater Eng 2020 ;31(6):339-349

Department of Mechanical and Industrial Engineering, Sultan Qaboos University, Muscat, Oman.

Background: The left coronary artery commonly known as LCA gets divided into two branches, such as the left circumflex (LCX) and left anterior descending (LAD) at a particular angle. This angle is varies from person to person. The present computational study contributes remarkable expertise about the influence of this angle variation on the hemodynamic parameters in the presence of 80% area stenosis at the LAD branch.

Objective: This study aimed to compare the effect of the bifurcation angle on hemodynamic parameters in the left coronary artery with 80% stenosis.

Method: Computational models of left coronary bifurcation angles of 30°, 60°, 90°, 120° were developed to understand the flow behavior of left coronary artery branches. The 80% area stenosis (AS) is considered at the LAD branch immediate to bifurcation.

Results: Measurements of pressure, velocity and wall shear stress were carried out corresponding to various bifurcation angles. It was found that the drop-in pressure increases as the angle increases from narrow to wider. A slight elevation in the velocity at the stenosis was observed. In addition, the obtained results further reveal a recirculation region immediately after the plaque, which leads to more deposition of plaque in the flow obstructed area. It is known that the shear stress at the arterial wall across the stenosis increases as the angle of bifurcation increases from narrow to wider.

Conclusions: The bifurcation of the left coronary artery and size of the stenosis have a notable impact on the pressure and wall shear stress. These two factors should be given due consideration by cardiologists to assess the complexity of stenosis in the LCA branches.
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http://dx.doi.org/10.3233/BME-201107DOI Listing
January 2020

Study of factors affecting Small for Size Syndrome Post-Adult living donor liver transplantation.

Asian J Surg 2021 Feb 12;44(2):452-458. Epub 2020 Nov 12.

General Surgery Department, Faculty of Medicine, Al-Azhar University, Egypt. Electronic address:

Aim: Recently, increasing evidence showed that small-for-size syndrome (SFSS) is a multifactorial disease which is precipitated by various perioperative factors other than graft size. We conducted the current work to evaluate perioperative effectors, which can increase the risk of SFSS following adult living-donor liver transplantation (LDLT).

Methods: This is a retrospective study on 110 adult cirrhotic cases (mean age of 48.4 ± 6.9 years old) who underwent adult LDLT. Most cases were males (89%). Cases were categorized into two groups based on the occurrence of SFSS. The groups were compared regarding preoperative (gender, age, comorbidities, baseline investigations), intraoperative (mean blood pressure and glucose; mean operation time; number of packed red cells, plasma, platelets, and cryoprecipitate units; time of cold and warm ischemia, and anhepatic phase; preclamping and post-reperfusion portal pressures), and postoperative factors (relevant investigations, hospital stay).

Results: Postoperatively, 23 patients developed SFSS (20.9%). SFSS group had significantly lower preoperative graft recipient weight ratio (GRWR) (0.76 ± 0.1% versus 1.03 ± 0.15, respectively; p < 0.001), and elevated MELD scores (19 ± 2.1 versus 17.9 ± 4; p = 0.024). Preclamping and post-reperfusion portal pressures of ≥22.5 and 17.5 mmHg, exhibited a sensitivity of 95.7% and 91.3% and specificity of 87.4% and 88.9% respectively, for SFSS prediction.

Conclusion: SFSS risk is significantly linked to GRWR, MELD score, and intraoperative portal haemodynamics. Intraoperative portal haemodynamics exhibited good diagnostic accuracy for SFSS prediction and represented promising indicators for the prediction of SFSS.
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http://dx.doi.org/10.1016/j.asjsur.2020.10.016DOI Listing
February 2021

213 nm laser written waveguides in Ge-doped planar silica without hydrogen loading.

Opt Express 2020 Oct;28(21):32165-32172

In this paper we present the first example of waveguides fabricated by UV writing in non-hydrogen loaded Ge-doped planar silica with 213 nm light. Single mode waveguides were fabricated and the numerical apertures and mode field diameters were measured for a range of writing fluences. A peak index change of 5.3 x 10 was inferred for the waveguide written with 70 kJ cm. The refractive index change is sufficient to match the index structure of standard optical fiber. Uniformity of the written structures was measured and a propagation loss of 0.39 ± 0.03 dB cm was determined through cutback measurements.
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http://dx.doi.org/10.1364/OE.402762DOI Listing
October 2020

Discovery of four new B-cell protective epitopes for malaria using Q beta virus-like particle as platform.

NPJ Vaccines 2020 8;5:92. Epub 2020 Oct 8.

The Jenner Institute, University of Oxford, Oxford, UK.

Malaria remains one of the world's most urgent global health problems, with almost half a million deaths and hundreds of millions of clinical cases each year. Existing interventions by themselves will not be enough to tackle infection in high-transmission areas. The best new intervention would be an effective vaccine; but the leading and vaccine candidates, RTS,S and VMP001, show only modest to low field efficacy. New antigens and improved ways for screening antigens for protective efficacy will be required. This study exploits the potential of Virus-Like Particles (VLP) to enhance immune responses to antigens, the ease of coupling peptides to the Q beta (Qβ) VLP and the existing murine malaria challenge to screen B-cell epitopes for protective efficacy. We screened TRAP (PvTRAP) immune sera against individual 20-mer PvTRAP peptides. The most immunogenic peptides associated with protection were loaded onto Qβ VLPs to assess protective efficacy in a malaria sporozoite challenge. A second approach focused on identifying conserved regions within known sporozoite invasion proteins and assessing them as part of the Qβ. Using this VLP as a peptide scaffold, four new protective B-cell epitopes were discovered: three from the disordered region of PvTRAP and one from Thrombospondin-related sporozoite protein (TRSP). Antigenic interference between these and other B-cell epitopes was also explored using the virus-like particle/peptide platform. This approach demonstrates the utility of VLPs to help identifying new B-cell epitopes for inclusion in next-generation malaria vaccines.
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http://dx.doi.org/10.1038/s41541-020-00242-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7546618PMC
October 2020

Effect of laparoscopic sleeve gastrectomy on vasoactive mediators in obese hypertensive patients: A prospective study.

Clin Endocrinol (Oxf) 2021 Feb 26;94(2):193-203. Epub 2020 Nov 26.

Internal Medicine Department, Faculty of medicine, Cairo University, Cairo, Egypt.

Introduction: The causal relationship between obesity and high blood pressure is established; however, the detailed pathways for such association are still under research. This work aims to assess the changes in neprilysin, vasoconstrictor and vasodilatory molecules in obese hypertensive patients undergoing laparoscopic sleeve gastrectomy (LSG).

Patients: The present prospective study was done on 59 hypertensive obese patients in whom LGS was performed. Blood pressure, as well as blood samples for neprilysin, angiotensinogen, angiotensin II, renin, endothelin-1 "ET-1", aldosterone, atrial natriuretic peptide "ANP" and B-type natriuretic peptide "BNP", were assessed before and 15 months after surgery. Patients were divided into two groups according to the remission of hypertension (HTN).

Results: After 15 months, remission of hypertension was seen in 42 patients (71%). The declines in the following measurements were significantly higher in patients with remission than those with persistent HTN: aldosterone (p = .029567), angiotensin II (p < .000001), angiotensinogen (p = .000021), neprilysin (p = .000601), renin (p = .000454) and endothelin-1(p = .000030). There was a significantly higher increment in ANP (p = .000002) and a non-significant increment in BNP (p = .081740). Angiotensin II 15 months after LSG and Δ ANP % were significant independent predictors of persistent HTN.

Conclusion: In the setting of LSG, aldosterone, angiotensinogen, angiotensin II, renin and neprilysin were significantly lower in patients with remission of HTN after 15 months than those with persistent HTN, and natriuretic peptides were significantly higher. A lower postoperative level of angiotensin II and a larger percentage increment of ANP are independently associated with hypertension remission after LSG.
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http://dx.doi.org/10.1111/cen.14352DOI Listing
February 2021

Examining the Potential Impact of Race Multiplier Utilization in Estimated Glomerular Filtration Rate Calculation on African-American Care Outcomes.

J Gen Intern Med 2021 Feb 15;36(2):464-471. Epub 2020 Oct 15.

Division of Renal Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.

Background: Advancing health equity entails reducing disparities in care. African-American patients with chronic kidney disease (CKD) have poorer outcomes, including dialysis access placement and transplantation. Estimated glomerular filtration rate (eGFR) equations, which assign higher eGFR values to African-American patients, may be a mechanism for inequitable outcomes. Electronic health record-based registries enable population-based examination of care across racial groups.

Objective: To examine the impact of the race multiplier for African-Americans in the CKD-EPI eGFR equation on CKD classification and care delivery.

Design: Cross-sectional study SETTING: Two large academic medical centers and affiliated community primary care and specialty practices.

Participants: A total of 56,845 patients in the Partners HealthCare System CKD registry in June 2019, among whom 2225 (3.9%) were African-American.

Measurements: Exposures included race, age, sex, comorbidities, and eGFR. Outcomes were transplant referral and dialysis access placement.

Results: Of 2225 African-American patients, 743 (33.4%) would hypothetically be reclassified to a more severe CKD stage if the race multiplier were removed from the CKD-EPI equation. Similarly, 167 of 687 (24.3%) would be reclassified from stage 3B to stage 4. Finally, 64 of 2069 patients (3.1%) would be reassigned from eGFR > 20 ml/min/1.73 m to eGFR ≤ 20 ml/min/1.73 m, meeting the criterion for accumulating kidney transplant priority. Zero of 64 African-American patients with an eGFR ≤ 20 ml/min/1.73 m after the race multiplier was removed were referred, evaluated, or waitlisted for kidney transplant, compared to 19.2% of African-American patients with eGFR ≤ 20 ml/min/1.73 m with the default CKD-EPI equation.

Limitations: Single healthcare system in the Northeastern United States and relatively small African-American patient cohort may limit generalizability.

Conclusions: Our study reveals a meaningful impact of race-adjusted eGFR on the care provided to the African-American CKD patient population.
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http://dx.doi.org/10.1007/s11606-020-06280-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7878608PMC
February 2021

Herbal drug interaction: Mechanistic details through the pharmacokinetic portfolio.

CNS Neurol Disord Drug Targets 2020 Oct 8. Epub 2020 Oct 8.

Department. of Pharmacy, University of Naples Federico II Via Domenico Montesano 49, 80131 Naples. Italy.

Background: A huge number of individuals today use herbs as drug alongside medicine and non-physician recommended medications, thought about natural and safe, huge numbers of these herbs can potentially interact with other drugs, causing hazardous adverse effects and /or diminished advantages of prescription.

Objective: It ought to be comprehended that herbal drugs contain multiple active compounds in different percentages which can change the enzymatic frameworks, transporters and additionally the physiologic processes.

Methods: Different search engines such as Googlescholar, Scopus, ScienceDirect, were used for the search of the data on the subject; pharmacokinetic drug interactions with the herbal products.

Results: This worldwide increment in herbal drug popularity has risen with respect to HDIs. These interactions PD or PK are particularly significant for medications. Assessment of herbal drug interaction is difficult because of inconsistency in herbal drug composition, and frequently meager information of active constituent pharmacokinetic. These restrictions are bewildered further by the differing points of view concerning herbal product regulation.

Conclusion: It is concluded that a basic assessment of certain pharmacokinetic HDI is needed to settle on educated choices in regard to patient safety. The expanding comprehension of HDPKI will make more attention to the potential interactions.
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http://dx.doi.org/10.2174/1871527319666201008151710DOI Listing
October 2020

Characterization of the Frmd7 Knock-Out Mice Generated by the EUCOMM/COMP Repository as a Model for Idiopathic Infantile Nystagmus (IIN).

Genes (Basel) 2020 Sep 30;11(10). Epub 2020 Sep 30.

Clinical and Experimental Neurosciences, University of Southampton, Southampton SO16 6YD, UK.

In this study, we seek to exclude other pathophysiological mechanisms by which knock-down may cause Idiopathic Infantile Nystagmus (IIN) using the and murine models. We used a combination of genetic, histological and visual function techniques to characterize the role of gene in IIN using a novel murine model for the disease. We demonstrate that the allele represents a more robust model of knock-out at the mRNA level. The expression of was investigated using both antibody staining and X-gal staining confirming previous reports that expression in the retina is restricted to starburst amacrine cells and demonstrating that X-gal staining recapitulates the expression pattern in this model. Thus, it offers a useful tool for further expression studies. We also show that gross retinal morphology and electrophysiology are unchanged in these mutant models when compared with wild-type mice. High-speed eye-tracking recordings of mutant mice confirm a specific horizontal optokinetic reflex defect. In summary, our study confirms the likely role for in the optokinetic reflex in mice mediated by starburst amacrine cells. We show that the model provides a more robust knock-out than the model at the mRNA level, although the functional consequence is unchanged. Finally, we establish a robust eye-tracking technique in mice that can be used in a variety of future studies using this model and others. Although our data highlight a deficit in the optiokinetic reflex as a result of the starburst amacrine cells in the retina, this does not rule out the involvement of other cells, in the brain or the retina where is expressed, in the pathophysiology of IIN.
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http://dx.doi.org/10.3390/genes11101157DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7601595PMC
September 2020

Therapeutic potentials of crocin in medication of neurological disorders.

Food Chem Toxicol 2020 Nov 9;145:111739. Epub 2020 Sep 9.

Bionanotechnology Research Group, Ton Duc Thang University, Ho Chi Minh City, Viet Nam; Faculty of Pharmacy, Ton Duc Thang University, Ho Chi Minh City, Viet Nam. Electronic address:

Neurological sicknesses are serious, multifactorial, debilitating disorders that may cause neurodegeneration. Neuroprotection is the protection of the structure and capacity of neurons from affronts emerging from cell injuries instigated by an assortment of specialists or neurodegenerative diseases. Various neurodegenerative diseases, including Alzheimer's, Parkinson's, and epilepsy, afflict many people worldwide, with increasing age representing the leading risk factor. Crocin is a natural carotenoid compound which was found to have therapeutic potentials in the management of the neurological disease. In this review, we focused on the restorative capabilities of Crocin as a neuroprotective agent. The general neuroprotective impact and the various conceivable basic components identified with Crocin have been examined. In light of the substantial proof indicating the neuro-pharmacological viability of Crocin to different exploratory standards, it is concluded that Crocin exerts direct antioxidant, antiapoptotic and anti-inflammatory activities by multiple signaling pathways. Besides, Crocin was found to elevate dopamine level in the brain during the experimental model of Parkinson's disease. Thus, this compound has been demonstrated to be a promising option for the treatment of neurodegenerative diseases, with few adverse effects. It ought to be further considered as a potential contender for neuro-therapeutics, concentrating on the mechanistic and clinical evidence for its effects.
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http://dx.doi.org/10.1016/j.fct.2020.111739DOI Listing
November 2020

Acute kidney injury in renal transplant recipients undergoing cardiac surgery.

Nephrol Dial Transplant 2021 01;36(1):185-196

Division of Renal Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.

Background: Acute kidney injury (AKI) is a key risk factor for chronic kidney disease in the general population, but has not been investigated in detail among renal transplant recipients (RTRs). We investigated the incidence, severity and risk factors for AKI following cardiac surgery among RTRs compared with non-RTRs with otherwise similar clinical characteristics.

Methods: We conducted a retrospective cohort study of RTRs (n = 83) and non-RTRs (n = 83) who underwent cardiac surgery at two major academic medical centers. Non-RTRs were matched 1:1 to RTRs by age, preoperative (preop) estimated glomerular filtration rate and type of cardiac surgery. We defined AKI according to Kidney Disease: Improving Global Outcomes criteria.

Results: RTRs had a higher rate of AKI following cardiac surgery compared with non-RTRs [46% versus 28%; adjusted odds ratio 2.77 (95% confidence interval 1.36-5.64)]. Among RTRs, deceased donor (DD) versus living donor (LD) status, as well as higher versus lower preop calcineurin inhibitor (CNI) trough levels, were associated with higher rates of AKI (57% versus 33% among DD-RTRs versus LD-RTRs; P = 0.047; 73% versus 36% among RTRs with higher versus lower CNI trough levels, P = 0.02). The combination of both risk factors (DD status and higher CNI trough level) had an additive effect (88% AKI incidence among patients with both risk factors versus 25% incidence among RTRs with neither risk factor, P = 0.004).

Conclusions: RTRs have a higher risk of AKI following cardiac surgery compared with non-RTRs with otherwise similar characteristics. Among RTRs, DD-RTRs and those with higher preop CNI trough levels are at the highest risk.
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http://dx.doi.org/10.1093/ndt/gfaa063DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7771983PMC
January 2021

Anticancer Potential of Furanocoumarins: Mechanistic and Therapeutic Aspects.

Int J Mol Sci 2020 Aug 6;21(16). Epub 2020 Aug 6.

Department of Agricultural Sciences, University of Naples Federico II, Via Università 100, 80055 Portici, Italy.

Cancer is one of the most extreme medical conditions in both developing and developed countries around the world, causing millions of deaths each year. Chemotherapy and/or radiotherapy are key for treatment approaches, but both have numerous adverse health effects. Furthermore, the resistance of cancerous cells to anticancer medication leads to treatment failure. The rising burden of cancer overall requires novel efficacious treatment modalities. Natural medications offer feasible alternative options against malignancy in contrast to western medication. Furanocoumarins' defensive and restorative impacts have been observed in leukemia, glioma, breast, lung, renal, liver, colon, cervical, ovarian, and prostate malignancies. Experimental findings have shown that furanocoumarins activate multiple signaling pathways, leading to apoptosis, autophagy, antioxidant, antimetastatic, and cell cycle arrest in malignant cells. Additionally, furanocoumarins have been shown to have chemo preventive and chemotherapeutic synergistic potential when used in combination with other anticancer drugs. Here, we address different pathways which are activated by furanocoumarins and their therapeutic efficacy in various tumors. Ideally, this review will trigger interest in furanocoumarins and their potential efficacy and safety as a cancer lessening agents.
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http://dx.doi.org/10.3390/ijms21165622DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7460698PMC
August 2020

Assessment of antioxidant traits and protective action of Egyptian acacia pods extracts against paracetamol-induced liver toxicity in rats.

J Food Biochem 2020 09 21;44(9):e13392. Epub 2020 Jul 21.

Biochemistry Department, Faculty of Agriculture, Benha University, Benha, Egypt.

This study investigates the protective effect of Egyptian acacia pod extracts against overdose of paracetamol-induced liver damage. Egyptian acacia green and brown pods were extracted by mixture of ethanol 80%: HCl (6 M) (99:1 v/v). In extracts of green and brown pods, total phenolic content in hydrolyzed ethyl acetate fraction (HEF) at pH 4, was 649.89 and 712.14 mg GAE/g while antioxidant activity was 95.55% and 97.35%, both being the highest than any fraction. HEF (pH 4) in brown pods was analyzed by HPLC, there were 22 phenolic compounds rich in ethyl vanillin about 227 mg/g and 11 flavonoids rich in catechin 48.70 mg/g. A biological experiment was conducted using HEF (pH4) in brown pods against overdose of paracetamol in albino rats induced to hepatotoxicity. Thirty rats were divided into five groups; a control group, a paracetamol group, and the other three received paracetamol plus silymarin or two doses of HEF. Animals were received paracetamol and treated with either silymarin or HEF showed reduced levels of liver (ALT, AST, and ALP) and kidney (urea, creatinine, and uric acid) markers compared with the control group as well as reduction of oxidative stress and increment antioxidant enzyme activity in liver tissue when compared with the paracetamol group. It could be concluded that both HEF and silymarin are considerably high hepatoprotector against paracetamol-induced hepatotoxicity in rats due to their strong antioxidant activity. PRACTICAL APPLICATIONS: Both HEF and silymarin improved liver functions and exerted strong antioxidant activities. This antioxidant activity would have a positive effect against oxidative liver damage caused by parcetamol. Thus, it may be concluded that the liver plasma membranes were protected and the regenerative and reparative capacity of liver by phenolic compound in HEF treatment. The study demonstrated the HEF hepatoprotective activity and recommends using Egyptian acacia pods for treatment of liver disorders.
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http://dx.doi.org/10.1111/jfbc.13392DOI Listing
September 2020

Effect of Bariatric Surgery on the Cardiovascular System in Obese Cases with Pulmonary Hypertension.

Obes Surg 2021 Feb 16;31(2):523-530. Epub 2020 Jul 16.

General Surgery Department, Faculty of medicine, Cairo University, Giza, Egypt.

Introduction And Aim: Recently, the incidence of obesity has been rising exponentially. Clinical studies have demonstrated that different subtypes of pulmonary hypertension (PH) are linked to obesity. The current work mainly aims to assess the impact of laparoscopic sleeve gastrectomy (LSG) on PH in a cohort of obese cases.

Patients And Methods: The present prospective work included 37 obese cases with PH for whom LSG was done. Only cases with PH and presurgical right ventricular systolic pressure (RVSP) ≥ 35 mmHg using Doppler echocardiogram were enrolled. Fifteen months later, patients were reassessed regarding new weight and BMI in addition to changes in RVSP.

Results: At the end of follow-up, the average BMI improved from 45.8 + 3.9 to 33.8 + 2.5 Kg/m (p value < 0.001). Improved right ventricular (RV) size compared to baseline echo was observed in 20 patients. RV size decreased from 2.68 + 0.44 cm to 2.34 + 0.36 cm (p value < 0.001). Notable decrease of PH to less than 30 mmHg occurred in 33 patients. Mean RVSP decreased from 39.62 + 2.1 to 31.81 + 3.1 mmHg (p value < 0.001). LSG significantly decreased the requirements for PH drugs and supplemental oxygen therapy.

Conclusion: The current work suggests that LSG-induced weight loss may result in a considerable decrease in pulmonary pressures as well as RV size with a concurrent resolution of other metabolic comorbidities.
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http://dx.doi.org/10.1007/s11695-020-04852-2DOI Listing
February 2021

Generation of Novel NF135 and NF54 Lines Expressing Fluorescent Reporter Proteins Under the Control of Strong and Constitutive Promoters.

Front Cell Infect Microbiol 2020 10;10:270. Epub 2020 Jun 10.

Department of Parasitology, Leiden University Medical Center, Leiden, Netherlands.

Transgenic reporter lines of malaria parasites that express fluorescent or luminescent proteins are valuable tools for drug and vaccine screening assays as well as to interrogate parasite gene function. Different ( ) reporter lines exist, however nearly all have been created in the African NF54/3D7 laboratory strain. Here we describe the generation of novel reporter lines, using CRISPR/Cas9 gene modification, both in the standard NF54 background and in a recently described Cambodian NF135.C10 line. Sporozoites of this line show more effective hepatocyte invasion and enhanced liver merozoite development compared to NF54. We first generated NF54 reporter parasites to analyze two novel promoters for constitutive and high expression of mCherry-luciferase and GFP in blood and mosquito stages. The promoter sequences were selected based on available transcriptome data and are derived from two housekeeping genes, i.e., translation initiation factor SUI1, putative (, PF3D7_1243600) and 40S ribosomal protein S30 (, PF3D7_0219200). We then generated and characterized reporter lines in the NF135.C10 line which express GFP driven by the and promoters as well as by the previously used α promoter (α, ). The reporter line showed strongest GFP expression in liver stages as compared to the other two lines. The strength of reporter expression by the promoter throughout the complete life cycle, including liver stages, makes transgenic lines expressing reporters by the promoter valuable novel tools for analyses of .
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http://dx.doi.org/10.3389/fcimb.2020.00270DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7298075PMC
June 2020

Long-term effects of one-anastomosis gastric bypass on liver histopathology in NAFLD cases: a prospective study.

Surg Endosc 2021 Apr 16;35(4):1889-1894. Epub 2020 Jun 16.

General Surgery Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.

Purpose: Weight reduction can effectively improve nonalcoholic fatty liver disease (NAFLD), which is a constant companion of severe obesity. This study aimed to determine the effect of one-anastomosis gastric bypass (OAGB) on pathological liver changes in severely obese cases with NAFLD.

Methods: The present prospective research comprised 67 subjects with morbid obesity scheduled for OAGB during the period from February 2015 to August 2018. Clinical, biological, and histologic data were evaluated pre and 15 months postoperatively.

Results: Fifteen months after surgery, a considerable reduction was noted in the grades of fat deposition, liver cell ballooning, and lobular inflammatory changes, in addition to the total NAS score. Fifteen months after surgery, nonalcoholic steatohepatitis (NASH) disappeared in 42% of the patients. A significant regression of fibrosis stage occurred after surgery in 79.1% of patients (p < 0.001). After surgery, patients had substantial reductions in aspartate aminotransferase, alanine aminotransferase, γ-glutamyltransferase, HbA1c, total cholesterol, and Low-density lipoprotein (p < 0.001, for all comparisons). Diabetes mellitus, hypertension, and dyslipidemia resolved in 54%, 59%, and 69% of the patients, respectively.

Conclusion: OAGB resolved NASH from nearly 42% of patients and reduced the histological features of NAFLD 15 months after surgery. Bariatric procedures might be adopted as a therapeutic modality in severely obese cases with NAFLD after the failure of lifestyle modifications.
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http://dx.doi.org/10.1007/s00464-020-07725-yDOI Listing
April 2021

Role and Outcome of Laparoscopic/Minimally Invasive Surgery for Variety of Colorectal Emergencies.

Surg Laparosc Endosc Percutan Tech 2020 Oct;30(5):451-453

Department of Colorectal Surgery, James Cook University Hospital, Middlesbrough, UK.

Background: Recently, the laparoscopic or minimally invasive approach has become common practice for planned colorectal malignancies. Its use in the emergency setting is limited by various factors, including resource availability and surgical expertise. However, more recent evidence suggests a laparoscopic approach to colorectal emergencies, which is comparable with laparoscopic routine work, and often promising. In this study, authors have investigated the outcome of the laparoscopic approach in both benign and malignant colorectal emergencies.

Method: Retrospective analysis of prospectively collected data (theater records, histology database, and discharge records) over the course of 9 years. The standard surgical approach included conventional laparoscopic and single-port technique (single-incision laparoscopic surgery). The outcome variables included in the final analysis were: success of the minimally invasive approach, conversion rate, postoperative complications, return to theater, and mortality.

Results: A total of 202 (males, 110 and females, 92) emergency patients with a median age of 59 years underwent surgery between December 2009 and 2019. The mean operating time was 169 minutes and median American Society of Anesthesiology grade III. Single-incision laparoscopic surgery was used in 19 patients (9.4%). The conversion to open surgery was 12.3% (n=25). The majority of them had primary anastomosis (n= 132, 65.3%).The complications from most to least frequent were: CONCLUSION:: The favorable results obtained in this study underline the theme that with the availability of resources and expertise, it is possible to offer minimal invasive approach to emergency colonic pathology.
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http://dx.doi.org/10.1097/SLE.0000000000000812DOI Listing
October 2020

Impact of Depression and Anxiety on Opioid Use in Hospitalized Hematopoietic Cell Transplantation Recipients.

Psychosomatics 2020 Jul - Aug;61(4):363-370. Epub 2020 Mar 26.

Division of Hematology-Oncology and Blood and Marrow Transplantation Program, Mayo Clinic, Jacksonville, FL. Electronic address:

Background: Hematopoietic cell recipients are reported to have a high prevalence of depression and anxiety. The impact of depression and anxiety on opioid use has not been well characterized. This is of significance as the opioid epidemic continues, and over 60% of deaths secondary to drug overdose involve the use of opioids.

Objective: In this retrospective, single-center study of 275 patients who underwent hematopoietic cell transplantation (HCT) (allogeneic and autologous) for hematological malignancies, we explore the impact of depression and anxiety on opioid use.

Results: Patients who were both anxious and depressed at admission for HCT had increased odds of receiving an opioid (odds ratio of 4.50 [95% confidence interval: 1.75, 11.56]) compared with patients who were neither depressed nor anxious. However, patients who were either depressed or anxious did not have different odds of receiving an opioid compared with those who were neither depressed nor anxious. Autologous HCT recipients had reduced odds of receiving an opioid (odds ratio of 0.17 [95% confidence interval: 0.08, 0.38]) compared with patients undergoing allogeneic HCT. Patients with lower Karnofsky performance status (<90 on a scale of 1-100) had an increased incidence of receiving a higher Morphine milligram equivalent daily dosage (incidence rate ratio of 2.59 [95% confidence interval: 1.18, 5.67]) when modeled by zero truncated negative binomial regression.

Conclusion: Presence of depression and anxiety impacts opioid use in patients undergoing HCT.
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http://dx.doi.org/10.1016/j.psym.2020.03.003DOI Listing
March 2020

Walkability and its association with walking/cycling and body mass index among adults in different regions of Germany: a cross-sectional analysis of pooled data from five German cohorts.

BMJ Open 2020 04 28;10(4):e033941. Epub 2020 Apr 28.

Institute of Applied Health Research, University of Birmingham, Birmingham, UK.

Objectives: To examine three walkability measures (points of interest (POI), transit stations and impedance (restrictions to walking) within 640 m of participant's addresses) in different regions in Germany and assess the relationships between walkability, walking/cycling and body mass index (BMI) using generalised additive models.

Setting: Five different regions and cities of Germany using data from five cohort studies.

Participants: For analysing walking/cycling behaviour, there were 6269 participants of a pooled sample from three cohorts with a mean age of 59.2 years (SD: 14.3) and of them 48.9% were male. For analysing BMI, there were 9441 participants of a pooled sample of five cohorts with a mean age of 62.3 years (SD: 12.8) and of them 48.5% were male.

Outcomes: (1) Self-reported walking/cycling (dichotomised into more than 30 min and 30 min and less per day; (2) BMI calculated with anthropological measures from weight and height.

Results: Higher impedance was associated with lower prevalence of walking/cycling more than 30 min/day (prevalence ratio (PR): 0.95; 95% CI 0.93 to 0.97), while higher number of POI and transit stations were associated with higher prevalence (PR 1.03; 95% CI 1.02 to 1.05 for both measures). Higher impedance was associated with higher BMI (ß: 0.15; 95% CI 0.04 to 0.25) and a higher number of POI with lower BMI (ß: -0.14; 95% CI -0.24 to 0.04). No association was found between transit stations and BMI (ß: 0.005, 95% CI -0.11 to 0.12). Stratified by cohort we observed heterogeneous associations between BMI and transit stations and impedance.

Conclusion: We found evidence for associations of walking/cycling with walkability measures. Associations for BMI differed across cohorts.
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http://dx.doi.org/10.1136/bmjopen-2019-033941DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7213856PMC
April 2020

Atomoxetine improves hippocampal cell proliferation but not memory in Doxorubicin-treated adult male rats.

Vet Med Sci 2020 11 27;6(4):1017-1024. Epub 2020 Apr 27.

Faculty of Medicine, Ain Shams University, Cairo, Egypt.

Atomoxetine (ATX) is a noradrenaline reuptake inhibitor used to treat Attention deficit hyperactive disorder (ADHD), or improve cognition in normal subjects. Cancer patients treated with systemic adjuvant chemotherapy have described experiencing deterioration in cognition. Doxorubicin (DOX, Adriamycin) is one of the anthracycline families used in chemotherapy, which has a deteriorating effect on both cognition and proliferation. The cognitive effects of ATX require inputs from the hippocampus. The aim of this study was to examine spatial memory and proliferation in the subgranular zone (SGZ) of the DG in adult Lister Hooded rats treated either alone or with a combination of Atomoxetine (30 mg kg  day , six i.p. doses, one injection every other day) and Doxorubicin (DOX) ( 2 mg kg  day , six i.p. doses, one injection every other day). Spatial memory was tested using the Novel location recognition (NLR) test, and proliferation of hippocampal cells was quantified using immunohistochemistry for the proliferative marker Ki67. Results showed that ATX treatment has improved the NLR task and increased cell proliferation in the SGZ of the DG, compared with saline-treated controls. Animals treated with DOX only showed deficits in NLR task, and co-administration of ATX along with DOX did not improve their performance. DOX chemotherapy caused a significant reduction in the number of proliferating cells in the SGZ of the DG compared with saline-treated controls. This reduction was reversed by co-administration of ATX. The above findings suggest that DOX can negatively affect both cell proliferation and memory and ATX co-administration improves proliferation, but not memory in the adult male rat hippocampus.
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http://dx.doi.org/10.1002/vms3.276DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7738722PMC
November 2020

Antiurolithiatic effects of pentacyclic triterpenes: The distance traveled from therapeutic aspects.

Drug Dev Res 2020 09 20;81(6):671-684. Epub 2020 Apr 20.

Department of Health Sciences, Faculty of Science, University of Mauritius, Réduit, Mauritius.

Globally, approximately 12% of the population is inflicted by various types of urolithiasis. Standard treatments are available both to avert and treat urolithiasis, but with significant adverse side effects. Pentacyclic triterpenes represent a group of naturally occurring compounds which holds immense potential as therapeutic for treating kidney stone. This review aims to provide an integrative description on how pentacyclic triterpenes can effectively treat calcium oxalate urolithiasis through various mechanisms such as antioxidant, anti-inflammatory, diuretic, and angiotensin-converting enzyme inhibition. Some of the pentacylic triterpenes which shows promising activities include lupeol, oleanolic acid, betulin, and taraxasterol. Moreover, future perspectives in the development of pentacyclic triterpenes in formulations/drugs for urinary stone prevention are highlighted. It is anticipated that compiled information would serve as a scientific baseline to advocate further investigations on the potential of pentacyclic triterpenes in urolithiasis remediation.
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http://dx.doi.org/10.1002/ddr.21670DOI Listing
September 2020