Anti-apolipoprotein A-I antibodies and paraoxonase 1 activity in systemic lupus erythematosus

Systemic lupus erythematosus (SLE) patients have an increased risk of atherosclerosis. Identification of at-risk patients and the pathogenesis of atherosclerosis in SLE remain elusive. Paraoxonase 1 (PON1) and anti-apolipoprotein A-I antibody (anti-Apo A-I) appear to have a potential role in premature atherosclerosis in SLE. The aim of this work was to study PON1 activity and anti-Apo A-I antibody in SLE female patients and to demonstrate their relations to disease activity as well as disease related damage. Forty SLE female patients and 40 apparently healthy volunteers were included. Anti-Apo A-I antibodies levels and PON1 activity levels were assessed. Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) and systemic Lupus International Collaboration Clinics (SLICC)/American College of Rheumatology (ACR) damage index were preformed in all patients. Compared with controls, SLE patients showed significantly lower PON1 activity and significantly higher titers of anti-Apo A-I. Anti-Apo A-I antibody titers correlated inversely with PON1 activity. Elevated titers of anti-Apo A-I antibody and reduced PON activity were related to increased SLEDAI and (SLICC/ACR) damage index scores. We concluded that there is decreased PON1 activity and formation of anti-Apo A-I antibodies in female patients with SLE. SLE-disease activity assessed by SLEDAI and SLE disease related organ damage assessed by SLICC/ACR damage index are negatively correlated with PON1 activity and positively correlated with anti-Apo A-I antibodies. PON1 activity and anti-Apo A-I antibodies might be involved in the pathogenesis of atherosclerosis in SLE patients

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

Agathis robusta Bark Essential Oil Effectiveness against COVID-19: Chemical Composition, In Silico and In Vitro Approaches

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV2), the causative agent of Coronavirus Disease 2019 (COVID-19), has seriously threatened global health. Alongside the approved vaccines, the discovery of prospective anti-COVID-19 drugs has been progressively targeted. Essential oils (EOs) provide a rich source of compounds with valuable antiviral activities that may contribute as effective agents against COVID-19. In this study, the EO of Agathus robusta bark was investigated for its chemical composition and its antiviral activity against SARS-CoV2. Overall, 26 constituents were identified by gas chromatography-mass spectrometry (GC-MS) analysis. α-Pinene, tricyclene, α-terpineol, limonene, d-camphene, trans-pinocarveol, α-phellandren-8-ol, L-β-pinene and borneol were the major components. In silico docking of these constituents against viral key enzymes, spike receptor-binding domain (RBD), main protease (Mpro) and RNA-dependent RNA polymerase (RdRp), using Molecular Operating Environment (MOE) software revealed good binding affinities of the components to the active site of the selected targets, especially, the RBD. In Vitro antiviral MTT and cytopathic effect inhibition assays demonstrated a promising anti SARS-CoV2 for A. robusta bark EO, with a significant selectivity index of 17.5. The results suggested using this EO or its individual components for the protection against or treatment of COVID-19

Effectiveness of retinopathy preventive guidelines on patients' knowledge, attitude, and practices among type II diabetics

Background: Diabetic retinopathy is a serious complication of diabetes and is a major cause of visual impairment and blindness. Proper intervention and following preventive guidelines can prevent or halt the resulting vision loss. Aim: To evaluate the effectiveness of retinopathy preventive guidelines on patients' knowledge, attitude, and practices among type II diabetics. Design: A quasi-experimental design (pre-post and follow-up test) was applied to conduct this study. Setting: The study was conducted in diabetes clinics at the National Medical Institute Hospital in Damanhour. Subjects: A purposive sample of 200 patients with type 2 diabetes was collected. Tools: Two tools were used to collect the data; Tool (I) A structured interview questionnaire to evaluate the patient's demographic characteristics and clinical data. Tool (II) Patient’s knowledge, attitudes, and practices regarding diabetic retinopathy questionnaire. Results: The current study clarified a significant improvement in the overall levels of  Knowledge, Attitude, and Practices among diabetic patients post implementing preventive retinopathy guidelines and follow up phases compared to pre -preventive retinopathy guidelines implementation with p= (˂0.001). In addition, there was a significant positive association between diabetes knowledge, practice, and attitude scores regarding retinopathy preventive guidelines with p-value= (˂0.001)

<i>Cupressus arizonica</i> Greene: Phytochemical Profile and Cosmeceutical and Dermatological Properties of Its Leaf Extracts

For many decades, natural resources have traditionally been employed in skin care. Here, we explored the phytochemical profile of the aqueous and ethanolic leaf extracts of Cupressus arizonica Greene and assessed their antioxidant, antiaging and antibacterial activities in vitro. Liquid chromatography–mass spectrometry (LC-MS/MS) analysis led to the tentative identification of 67 compounds consisting mainly of phenolic and fatty acids, diterpene acids, proanthocyanidins and flavonoid and biflavonoid glycosides. The aqueous extract demonstrated substantial in vitro antioxidant potential at FRAP and DPPH assays and inhibited the four target enzymes (collagenase, elastase, tyrosinase, and hyaluronidase) engaged in skin remodeling and aging with IC50 values close to those of the standard drugs. Moreover, the aqueous extract at 25 mg/mL suppressed biofilm formation by Pseudomonas aeruginosa, a bacterial pathogen causing common skin manifestations, and decreased its swarming and swimming motilities. In conclusion, C. arizonica leaves can be considered a promising candidate for potential application in skin aging

Dermato-cosmeceutical properties of Pseudobombax ellipticum (Kunth) Dugand: Chemical profiling, in vitro and in silico studies

Plant extracts and their individual components have been used to manage skin aging for several decades. Recently, the discovery of new natural bioactive agents, that not only enhance the skin health but also offer protection against various deleterious factors, such as free radicals, ultraviolet radiation, and microbial infections, has been a potential target by many researchers. The aim of the current work was to investigate the phytochemical profile of an ethanol bark extract from Pseudobombax ellipticum, and to evaluate its antioxidant, antiaging and antibacterial activities in vitro. Molecular docking and molecular dynamics studies were adopted to estimate and confirm the binding affinity of several compounds and explain their binding pattern at the binding sites of four target enzymes associated with skin aging, namely collagenase, elastase, tyrosinase, and hyaluronidase. HPLC-MS/MS analysis led to the tentative identification of 35 compounds comprising phenolic acids, and their glycosides, procyanidins and flavonoid glycosides. The extract demonstrated a promising in vitro antioxidant activity in the DPPH and FRAP assays (IC50 56.45 and 15.34 μg/mL, respectively), and was able to inhibit the aforementioned key enzymes with comparable results to the reference drugs. In addition, the extract (6.25 mg/mL) inhibited the biofilm production of Pseudomonas aeruginosa and diminished the swimming and swarming motilities. The docked compounds revealed appreciable binding energy with the tested enzymes and were stable throughout the molecular dynamic simulations. In view of this data, P. ellipticum bark can be regarded as a good candidate for prospective application in derma-cosmeceutical preparations

Utilization of Active Edible Films (Chitosan, Chitosan Nanoparticle, and CaCl2) for Enhancing the Quality Properties and the Shelf Life of Date Palm Fruits (Barhi Cultivar) during Cold Storage

Interest in edible coatings applications has progressively developed towards improving the quality and shelf life of climacteric fruits. This study aimed to investigate the influence of pre-harvest treatments (chitosan, chitosan nanoparticle, and CaCl2) on the physicochemical and quality attributes of Barhi date palm fruits during storage periods. Different pre-harvest treatments (control, chitosan 1, 2, and 3 g/L, CaCl2 1, 2, and 3 g/L, nano-chitosan 1, 2, and 3 cm3 /L) were applied. The results showed that all treatments were effective for enhancing the fruit quality, with increasing total soluble solids and total sugars, decreasing weight loss, discarded total acidity, and total soluble tannins compared to the control treatment. Additionally, the results revealed that the highest percentage of TSS was obtained in control fruits (35.78%). Meanwhile, the lowest mean values were obtained from chitosan nanoparticle at 3 cm3/L (33.91%). Treatments with chitosan nanoparticle at 3 cm3/L and CaCl2 at 3 g/L gave the statistically highest values of total tannins (0.225 and 0.220, respectively). The optimal treatment involved spraying the fruit with 3 cm3/L of nano-chitosan or 3 g/L of CaCl2 to increase the fruit quality and the shelf life of Barhi dates. The results indicated that weight loss was negatively linked with the moisture content and firmness, while decay had a strong positive relationship with the Rutab index and a negative correlation with the moisture content. Furthermore, the Rutab index was negatively associated with the total tannins and total chlorophyll

Analysis of Outcomes in Ischemic vs Nonischemic Cardiomyopathy in Patients With Atrial Fibrillation A Report From the GARFIELD-AF Registry

IMPORTANCE Congestive heart failure (CHF) is commonly associated with nonvalvular atrial fibrillation (AF), and their combination may affect treatment strategies and outcomes