Transdermal hormone replacement therapy with nanostructured medicines

Objectives: Due to hormonal changes during the menopause, women experience a variety of perimenopause and postmenopause symptoms. This review examines the various aspects of nanostructured hormone therapy and its application in the treatments of menopausal symptoms. Material and methods: Excerpta Medica DataBase, Medical Literature Analysis and Retrieval System Online, Web of Science, and Google Scholar were searched basing on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Seven eligible studies out of 51 related papers, which satisfied the initial search criteria, were extracted and carefully reviewed to clarify the role of nanomedicine in maintaining postmenopausal women’s health. Results: Review of the seven eligible studies confirmed nanostructured hormone therapy as a safe and effective method for the alleviation of menopausal symptoms. According to the existing studies, nanostructured hormone therapy decreased the mean daily frequency and severity of menopausal symptoms. Conclusion: The use of transdermal nanoformulations in hormone therapy can relieve climacteric symptoms and prevent other postmenopausal symptoms

Investigating the Association between Gender and Age Distribution with Severity of COVID-19: A Single-Center Study from Southern Iran

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused a highly contagious disease, which led to a pandemic health emergency. However, age distribution and sex, regarding factors affecting the severity of COVID-19, are controversial. Therefore, this study is designed to investigate the effect of gender difference on the severity of COVID-19 infection in the studied age groups.Methods: Patients with COVID-19 of Valiasr Hospital (Khorrambid, Fars, Iran) from February 20, 2020, to February 20, 2021, are included in this retrospective study. The inclusion criteria were the age of above 15 years old and being residents of Khorrambid. COVID‐19 severity was classified as mild and moderate/severe according to the WHO standards. The obtained demographical and clinical data from the patient registry forms were analyzed using SPSS-24; P value <0.05 was considered as the level of significance. Chi-square and independent t-test were used to assess the variables.Results: Herein, 218 patients were recruited with a mean age of 45.6±17.2 and a relatively equal distribution of men and women population. Out of this population, 23.8% had comorbid diseases, 48.2% had mild, and 51.8% had moderate/severe infections. Our results indicated that male gender and the age range of 25-64 years in men are the most important risk factors associated with the disease severity (P<0.0001).Conclusions: The current study revealed that the leading risk factor of the disease severity was higher age (≥65 years) in the studied women. Meanwhile, in the men group, this factor was the age range of 25-64 years. These results suggest that further research is required to identify the possible impacts of gender and age on various aspects of the ongoing epidemic

One Side Ovarian Rejuvenation: A Quasi-Experimental Study of the Effect of the Autologous Platelet Rich Plasma in Poor Ovarian Responders in IVF

BACKGROUND: The poor ovarian response is the most important limiting factor in the success of in vitro fertilization (IVF). The aim of this study was to evaluate the outcome of intraovarian injection of autologous platelet-rich plasma (aPRP) on the oocyte number and IVF outcomes in poor ovarian responders (POR). METHODS: This quasi-experimental study was performed from August 2021 to December 2021, in Vali-e-Asr Infertility Clinic affiliated with Tehran University of Medical Sciences, Tehran, Iran. There were 12 POR patients selected based on the criteria of Bologna group 4 who underwent two IVF cycles with similar antagonist regimens in a 70-day-interval. Immediately after the Oocytes Pick-Up (OPU), there was a 4cc of autologous PRP multifocal intramedullary injection done into their right ovaries in the first IVF cycle (case group). On the other hand, their left ovaries were considered as the control group. The patients underwent the second IVF cycle after 70 days. RESULTS: Those who had undergone aPRP experienced a significant increase of the mean of antral follicular count (AFC) (from 1.91±0.79 to 2.50±0.90, p=0.043). There was a significant increase in the number of embryos from the right ovary (intervention group) compared to the left ovary (control group) after PRP, but there was no significant difference in the number of embryos in the right ovary before and after the intervention (from 0.25 ±0.45 to 1.08±0.79, p=0.705). There was no significant change in the number of oocytes, AMH, and FSH in the case and control groups before and after the intervention (p&gt;0.05). CONCLUSION: According to the results of this study, it seems that in females with POR, intraovarian aPRP had no effect on the outcomes (embryos number, number of oocytes, FSH and AMH level), except for an increase in AFC

Case report: A case of renal arcuate vein thrombosis successfully treated with direct oral anticoagulants

A rare case of a 35 years old woman presented with renal arcuate vein thrombosis (RAVT) and acute kidney injury (AKI) following upper respiratory tract symptoms and toxic substance ingestion. Histopathological evaluation of the patient's kidney tissue indicated a rare venous thrombosis in the renal arcuate veins. Anticoagulation with Apixaban, a direct oral anticoagulant (DOAC), was commenced, and the patient's symptoms resolved during the hospital stay. Hitherto, a limited number of studies have shown the concurrent presentation of RAVT and overt AKI in patients following ingestion of nephrotoxic agents. Further studies are necessary to elucidate the etiology, clinical presentation, and treatment of RAVT. We suggest that Apixaban be studied as a suitable alternative to conventionally used anti-coagulants such as Warfarin in patients who lack access to optimal health care facilities

Prediction of overall survival for patients with metastatic castration-resistant prostate cancer : development of a prognostic model through a crowdsourced challenge with open clinical trial data

Background Improvements to prognostic models in metastatic castration-resistant prostate cancer have the potential to augment clinical trial design and guide treatment strategies. In partnership with Project Data Sphere, a not-for-profit initiative allowing data from cancer clinical trials to be shared broadly with researchers, we designed an open-data, crowdsourced, DREAM (Dialogue for Reverse Engineering Assessments and Methods) challenge to not only identify a better prognostic model for prediction of survival in patients with metastatic castration-resistant prostate cancer but also engage a community of international data scientists to study this disease. Methods Data from the comparator arms of four phase 3 clinical trials in first-line metastatic castration-resistant prostate cancer were obtained from Project Data Sphere, comprising 476 patients treated with docetaxel and prednisone from the ASCENT2 trial, 526 patients treated with docetaxel, prednisone, and placebo in the MAINSAIL trial, 598 patients treated with docetaxel, prednisone or prednisolone, and placebo in the VENICE trial, and 470 patients treated with docetaxel and placebo in the ENTHUSE 33 trial. Datasets consisting of more than 150 clinical variables were curated centrally, including demographics, laboratory values, medical history, lesion sites, and previous treatments. Data from ASCENT2, MAINSAIL, and VENICE were released publicly to be used as training data to predict the outcome of interest-namely, overall survival. Clinical data were also released for ENTHUSE 33, but data for outcome variables (overall survival and event status) were hidden from the challenge participants so that ENTHUSE 33 could be used for independent validation. Methods were evaluated using the integrated time-dependent area under the curve (iAUC). The reference model, based on eight clinical variables and a penalised Cox proportional-hazards model, was used to compare method performance. Further validation was done using data from a fifth trial-ENTHUSE M1-in which 266 patients with metastatic castration-resistant prostate cancer were treated with placebo alone. Findings 50 independent methods were developed to predict overall survival and were evaluated through the DREAM challenge. The top performer was based on an ensemble of penalised Cox regression models (ePCR), which uniquely identified predictive interaction effects with immune biomarkers and markers of hepatic and renal function. Overall, ePCR outperformed all other methods (iAUC 0.791; Bayes factor >5) and surpassed the reference model (iAUC 0.743; Bayes factor >20). Both the ePCR model and reference models stratified patients in the ENTHUSE 33 trial into high-risk and low-risk groups with significantly different overall survival (ePCR: hazard ratio 3.32, 95% CI 2.39-4.62, p Interpretation Novel prognostic factors were delineated, and the assessment of 50 methods developed by independent international teams establishes a benchmark for development of methods in the future. The results of this effort show that data-sharing, when combined with a crowdsourced challenge, is a robust and powerful framework to develop new prognostic models in advanced prostate cancer.Peer reviewe

IFI27 transcription is an early predictor for COVID-19 outcomes, a multi-cohort observational study

PurposeRobust biomarkers that predict disease outcomes amongst COVID-19 patients are necessary for both patient triage and resource prioritisation. Numerous candidate biomarkers have been proposed for COVID-19. However, at present, there is no consensus on the best diagnostic approach to predict outcomes in infected patients. Moreover, it is not clear whether such tools would apply to other potentially pandemic pathogens and therefore of use as stockpile for future pandemic preparedness.MethodsWe conducted a multi-cohort observational study to investigate the biology and the prognostic role of interferon alpha-inducible protein 27 (IFI27) in COVID-19 patients.ResultsWe show that IFI27 is expressed in the respiratory tract of COVID-19 patients and elevated IFI27 expression in the lower respiratory tract is associated with the presence of a high viral load. We further demonstrate that the systemic host response, as measured by blood IFI27 expression, is associated with COVID-19 infection. For clinical outcome prediction (e.g., respiratory failure), IFI27 expression displays a high sensitivity (0.95) and specificity (0.83), outperforming other known predictors of COVID-19 outcomes. Furthermore, IFI27 is upregulated in the blood of infected patients in response to other respiratory viruses. For example, in the pandemic H1N1/09 influenza virus infection, IFI27-like genes were highly upregulated in the blood samples of severely infected patients.ConclusionThese data suggest that prognostic biomarkers targeting the family of IFI27 genes could potentially supplement conventional diagnostic tools in future virus pandemics, independent of whether such pandemics are caused by a coronavirus, an influenza virus or another as yet-to-be discovered respiratory virus

Estimation of actual evapotranspiration : A novel hybrid method based on remote sensing and artificial intelligence

Actual evapotranspiration (AET) is one of the decisive factors controlling the water balance at the catchment level, particularly in arid and semi-arid regions, but measured data for which are generally unavailable. In this study, performance of a base artificial intelligence (AI) model, adaptive neuro-fuzzy inference system (ANFIS), and its hybrids with two bio-inspired optimization algorithms, namely shuffled frog leaping algorithm (SFLA) and grey wolf optimization (GWO), in estimating monthly AET was evaluated over 2001–2010 across Neishaboor watershed in Iran. The inputs of these models were categorized into three groups including meteorological, remotely sensed, and hybrid-based predictors, and defined in the form of 8 different scenarios. Net radiation (Rn), land surface temperature (LST), normalized difference vegetation index (NDVI), soil adjusted vegetation index (SAVI), and soil wetness deficit index (SWDI) were the remotely sensed predictors, computed using MODIS satellite images on the monthly scale for the study area. The results showed that the SWDI predictor has played a significant role in improving the accuracy of AET estimation, with the highest error reduction (12.5, 17 and 26.5% for ANFIS, ANFIS-SFLA, and ANFIS-GWO, respectively) obtained under scenarios including SWDI compared to corresponding scenarios excluding this predictor. In testing set, the three aforementioned models exhibited their best performance under Scenario 8 (RMSE = 11.93, NSE = 0.69, RRMSE = 0.37), Scenario 4 (RMSE = 11.06, NSE = 0.74, RRMSE = 0.37) and Scenario 4 (RMSE = 10.9, NSE = 0.76, RRMSE = 0.36), respectively. Coupling the SFLA and GWO optimization algorithms to the base model improved the accuracy of AET estimation, with the maximum error reduction for the two algorithms being about 12% (Scenarios 2 and 4) and 14% (Scenario 4), respectively. Examining the performance of the best scenarios of the three models in three intervals including the first, middle, and last third of measured AET values showed that all models were the most accurate in the first third interval. The results also indicated that all models have had higher accuracies in the first and middle third intervals of under-estimation set and the last interval of over-estimation set

Hypoglycemic effects of Acacia nilotica in type II diabetes: a research proposal

Abstract Objective Diabetes mellitus is a common metabolic disorder throughout the world which can negatively affect the function of various body organs. Due to their availability and few side effects, herbal medicines have been proposed as suitable alternatives in the management of diabetes. Previous studies have confirmed the anti diabetic properties of Acacia nilotica. The hypoglycemic effects of this plant have been attributed to its role in stimulating the islets of Langerhans to produce more insulin. The present paper describes a systematic review protocol for the assessment of the hypoglycemic effects of A. nilotica. Main texts Randomized and non-randomized placebo-controlled clinical trials, performed during 1999–2016 will be included. The outcomes will be measured through FBS, GCT, GTT, and OGTT in all of studies and in addition to these tests, will be measured 2HPP and HbA1c level in human study. Well-known databases will be searched for selected key terms A. nilotica, type II diabetes and hypoglycemia. The quality assessment of the selected papers will be evaluated based on SYRCLE and Cochrane Risk of Bias Tool. We believe that our findings will provide details about difficulties researchers face during the design of protocols or implementation of scientific studies. Ultimately, the publication of our findings will facilitate the development of effective treatment strategies to promote the health of people with type II DM. PROSPERO registration CRD4201605314