15 research outputs found
Isotretinoin-induced spondyloarthropathy-related symptoms: A prospective study
Objective. Acne vulgaris is a chronic inflammatory disease involving the pilosebaceous unit of the skin. Isotretinoin is a systemic retinoid that is often used as an effective treatment option for severe and treatment-resistant acne. Isotretinoin may also cause rheumatologic symptoms. The aim of this prospective observational study was to present followup results regarding the rheumatologic symptoms of patients who received systemic therapy for the treatment of acne (isotretinoin and tetracycline). Methods. For inclusion in the study, all consecutive patients with acne who were aged > 18 years were evaluated by the same dermatologist. The first 42 consecutive patients were included in the isotretinoin group, and after matching for age and sex, 32 consecutive patients were included in the tetracycline group. Isotretinoin treatment was planned as an average dose of 30 mg daily and a total dose of 120-150 mg/kg for 4-6 months. The patients were administered a dose of 1 g/day of tetracycline as 2 equal doses for 3 months. Results. Forty-two patients diagnosed with acne vulgaris were treated with isotretinoin 20.6 ± 4.4 (male/female: 17/22), and 32 patients were treated with tetracycline 20.6 ± 2.7 (male/female: 8/24). There was no significant difference between the 2 groups with respect to age and sex. Unilateral Achilles enthesopathy developed in 3 patients, whereas both Achilles enthesopathy and unilateral sacroiliitis developed in 1 patient. Inflammatory back pain developed in 6 patients in the isotretinoin group. Conclusion. To our knowledge, this was the first prospective observational study that assessed the rheumatologic symptoms of isotretinoin treatment. The spondyloarthropathy findings were identified in 23.1% of the patients who used isotretinoin
Hepcidin, Serum Iron, and Transferrin Saturation in Full-Term and Premature Infants during the First Month of Life: A State-of-the-Art Review of Existing Evidence in Humans.
Neonates regulate iron at birth and in early postnatal life. We reviewed literature from PubMed and Ovid Medline containing data on umbilical cord and venous blood concentrations of hepcidin and iron, and transferrin saturation (TSAT), in human neonates from 0 to 1 mo of age. Data from 59 studies were used to create reference ranges for hepcidin, iron, and TSAT for full-term-birth (FTB) neonates over the first month of life. In FTB neonates, venous hepcidin increases 100% over the first month of life (to reach 61.1 ng/mL; 95% CI: 20.1, 102.0 ng/mL) compared with umbilical cord blood (29.7 ng/mL; 95% CI: 21.1, 38.3 ng/mL). Cord blood has a high concentration of serum iron (28.4 μmol/L; 95% CI: 26.0, 31.1 μmol/L) and levels of TSAT (51.7%; 95% CI: 46.5%, 56.9%). After a short-lived immediate postnatal hypoferremia, iron and TSAT rebounded to approximately half the levels in the cord by the end of the first month. There were insufficient data to formulate reference ranges for preterm neonates
Non-invasive diagnostic tests for Helicobacter pylori infection
BACKGROUND: Helicobacter pylori (H pylori) infection has been implicated in a number of malignancies and non-malignant conditions including peptic ulcers, non-ulcer dyspepsia, recurrent peptic ulcer bleeding, unexplained iron deficiency anaemia, idiopathic thrombocytopaenia purpura, and colorectal adenomas. The confirmatory diagnosis of H pylori is by endoscopic biopsy, followed by histopathological examination using haemotoxylin and eosin (H & E) stain or special stains such as Giemsa stain and Warthin-Starry stain. Special stains are more accurate than H & E stain. There is significant uncertainty about the diagnostic accuracy of non-invasive tests for diagnosis of H pylori. OBJECTIVES: To compare the diagnostic accuracy of urea breath test, serology, and stool antigen test, used alone or in combination, for diagnosis of H pylori infection in symptomatic and asymptomatic people, so that eradication therapy for H pylori can be started. SEARCH METHODS: We searched MEDLINE, Embase, the Science Citation Index and the National Institute for Health Research Health Technology Assessment Database on 4 March 2016. We screened references in the included studies to identify additional studies. We also conducted citation searches of relevant studies, most recently on 4 December 2016. We did not restrict studies by language or publication status, or whether data were collected prospectively or retrospectively. SELECTION CRITERIA: We included diagnostic accuracy studies that evaluated at least one of the index tests (urea breath test using isotopes such as13C or14C, serology and stool antigen test) against the reference standard (histopathological examination using H & E stain, special stains or immunohistochemical stain) in people suspected of having H pylori infection. DATA COLLECTION AND ANALYSIS: Two review authors independently screened the references to identify relevant studies and independently extracted data. We assessed the methodological quality of studies using the QUADAS-2 tool. We performed meta-analysis by using the hierarchical summary receiver operating characteristic (HSROC) model to estimate and compare SROC curves. Where appropriate, we used bivariate or univariate logistic regression models to estimate summary sensitivities and specificities. MAIN RESULTS: We included 101 studies involving 11,003 participants, of which 5839 participants (53.1%) had H pylori infection. The prevalence of H pylori infection in the studies ranged from 15.2% to 94.7%, with a median prevalence of 53.7% (interquartile range 42.0% to 66.5%). Most of the studies (57%) included participants with dyspepsia and 53 studies excluded participants who recently had proton pump inhibitors or antibiotics.There was at least an unclear risk of bias or unclear applicability concern for each study.Of the 101 studies, 15 compared the accuracy of two index tests and two studies compared the accuracy of three index tests. Thirty-four studies (4242 participants) evaluated serology; 29 studies (2988 participants) evaluated stool antigen test; 34 studies (3139 participants) evaluated urea breath test-13C; 21 studies (1810 participants) evaluated urea breath test-14C; and two studies (127 participants) evaluated urea breath test but did not report the isotope used. The thresholds used to define test positivity and the staining techniques used for histopathological examination (reference standard) varied between studies. Due to sparse data for each threshold reported, it was not possible to identify the best threshold for each test.Using data from 99 studies in an indirect test comparison, there was statistical evidence of a difference in diagnostic accuracy between urea breath test-13C, urea breath test-14C, serology and stool antigen test (P = 0.024). The diagnostic odds ratios for urea breath test-13C, urea breath test-14C, serology, and stool antigen test were 153 (95% confidence interval (CI) 73.7 to 316), 105 (95% CI 74.0 to 150), 47.4 (95% CI 25.5 to 88.1) and 45.1 (95% CI 24.2 to 84.1). The sensitivity (95% CI) estimated at a fixed specificity of 0.90 (median from studies across the four tests), was 0.94 (95% CI 0.89 to 0.97) for urea breath test-13C, 0.92 (95% CI 0.89 to 0.94) for urea breath test-14C, 0.84 (95% CI 0.74 to 0.91) for serology, and 0.83 (95% CI 0.73 to 0.90) for stool antigen test. This implies that on average, given a specificity of 0.90 and prevalence of 53.7% (median specificity and prevalence in the studies), out of 1000 people tested for H pylori infection, there will be 46 false positives (people without H pylori infection who will be diagnosed as having H pylori infection). In this hypothetical cohort, urea breath test-13C, urea breath test-14C, serology, and stool antigen test will give 30 (95% CI 15 to 58), 42 (95% CI 30 to 58), 86 (95% CI 50 to 140), and 89 (95% CI 52 to 146) false negatives respectively (people with H pylori infection for whom the diagnosis of H pylori will be missed).Direct comparisons were based on few head-to-head studies. The ratios of diagnostic odds ratios (DORs) were 0.68 (95% CI 0.12 to 3.70; P = 0.56) for urea breath test-13C versus serology (seven studies), and 0.88 (95% CI 0.14 to 5.56; P = 0.84) for urea breath test-13C versus stool antigen test (seven studies). The 95% CIs of these estimates overlap with those of the ratios of DORs from the indirect comparison. Data were limited or unavailable for meta-analysis of other direct comparisons. AUTHORS' CONCLUSIONS: In people without a history of gastrectomy and those who have not recently had antibiotics or proton ,pump inhibitors, urea breath tests had high diagnostic accuracy while serology and stool antigen tests were less accurate for diagnosis of Helicobacter pylori infection.This is based on an indirect test comparison (with potential for bias due to confounding), as evidence from direct comparisons was limited or unavailable. The thresholds used for these tests were highly variable and we were unable to identify specific thresholds that might be useful in clinical practice.We need further comparative studies of high methodological quality to obtain more reliable evidence of relative accuracy between the tests. Such studies should be conducted prospectively in a representative spectrum of participants and clearly reported to ensure low risk of bias. Most importantly, studies should prespecify and clearly report thresholds used, and should avoid inappropriate exclusions
Processing of anode slime with deep eutectic solvents as a green leachant
WOS:000703942500005This paper describes an efficient process of recovering valuable metals from a copper anode slime sample using green chemicals such as choline chloride (ChCl) based deep eutectic solvents (DESs). The leaching agents include ChCl-urea, ChCl-ethylene glycol, ChCl-urea-ethylene glycol and ChCl/urea-deionized water in a 1:2, 1:2, 1:0.5:1.5, and 1:1 ratio, respectively. Prior to leaching experiments, chemical and mineralogical characterization of copper anode slime was performed. Considerable amount of precious metals was detected in the copper anode slime by chemical analysis. The main phases of copper anode slime detected by XRD and SEM/EDX analysis were namely Cu2O, SnO2, and, PbSO4. After leaching experiments, 97% of copper was recovered from the copper anode slime using ChCl-urea under an optimum condition at 95 °C of reaction temperature, 4 h reaction duration and, 1/25 g/mL solid/liquid ratio. The results showed that 91% of silver was extracted from the anode slime under the optimum condition with ChCl-urea DES composition, 95 °C reaction temperature, 48 h reaction duration, and 1/10 solid/liquid ratio. Gold was not leachable in the experiment using ChCl based DES with hydrogen bonding reagents such as urea and ethylene glycol. Moreover, the results revealed that PbSO4 was very soluble in DES prepared by ChCl and urea
Investigation of use of deep eutectic solvent on copper leaching from copper anode slime
Bu çalışmada, pirometalurjik yöntemle metalik bakır üretiminin elektrokazanım aşamasında ortaya çıkan anot çamurundan bakır geri kazanımı üzerine çevre ve insan sağlığına duyarlı düşük ötektik noktalı çözücü (DES) kullanımı araştırılmıştır. Taguchi optimizasyon yöntemi kullanılarak liç sıcaklığı, liç süresi ve katı/sıvı oranı deneysel parametrelerin bakır geri kazanımı üzerine etkisi incelenmiştir. Kolin klorür (ChCl) ve ürenin 1:2 molar oranda karıştırılmasıyla hazırlanan DES çözücüsü ile yapılan liç işlemleri sonunda optimum şartlar; 95 oC’liç sıcaklığı, 2 saat liç süresi ve 1/20 katı/sıvı oranı olarak belirlenmiş ve bu şartlarda %98 bakır geri kazanımı elde edilmiştir. Yapılan bu çalışma ile ChCl-üre karışımıyla hazırlanan DES çözücüsünün anot çamurundan bakır geri kazanımı için çevreci bir çözücü adayı olabileceği ortaya konulmuştur.In this study, use of environmentally and human health sensitive solvent, called deep eutectic solvent (DES), was investigated for copper recovery from anode slime which was produced during electrorefining stage of the metallic copper production by pyrometallurgical method. The effect of experimental parameters was investigated using the Taguchi optimization method. At the end of the leaching process with DES solvent prepared by mixing ChCl and urea in 1:2 molar ratio, optimum conditions were determined as; 95 oC leaching temperature, 2 hours leaching time and 1/20 solid/liquid ratio and 98% copper recovery was obtained under this condition. With this study, it has been revealed that DES prepared by ChCl-urea mixture can be an environmentally friendly solvent candidate for copper recovery from anode slime
Calcium antagonists, digoxin, calcaemia and anaemia in heart failure.
WOS: 000412521200040Objective: To reveal that Calcium Antagonist (CA) use is associated with lower haemoglobin (Hb) and digoxin use is associated with higher Hb in Heart Failure (HF). Method: 223 chronic HF patients in acute decompensation phase were included in the study. Patients with comorbidities leading to anemia and those receiving blood transfusion or antianaemic treatment were excluded. Patients were classified into two groups as anemic and non-anemic groups. Two groups were compared retrospectively with demographics, clinical findings, medication use, echocardiography findings, complete blood count and biochemistry. Different independent variables between two groups were subjected to Multivariate Binary Logistic Regression Analysis (MBLRA) under the dependent variable anemia. Multivariable linear Regression Analysis (RA) was also performed with the dependent variable of Hb. Results: MBLRA results showed that anemia was seen less frequently in digoxin users, whereas it was more frequent in the following conditions: CA use, chronic renal failure, lower AST, lower LDL cholesterol, lower triglyceride, lower Transferring Saturation Rate (TSR). RA results also showed that lower LDL cholesterol, lower eGFR, lower transferrin saturation rate, lower corrected calcium, female gender and CA use were associated with lower Hb; whereas, digoxin use was associated with higher Hb. Conclusions: Haemoglobin levels were found higher in digoxin users. CA use, lower corrected calcium and lower AST were associated with lower Hb in heart failure. These findings have not been reported so far
Gold Leaching from Copper Anode Slime with 1-Butly-3-Methyl Imidazolium Chloride
WOS:000771321300001The aim of this study was to realize gold leaching from copper anode slime (CAS) with ionic liquid treatment. A novel medium, 1-butyl -3-methyl-imidazolium chloride (BmimCl), was used as the leaching reagent. The effects of ionic liquid concentration, temperature, time ,and solid/liquid ratio (S/L) on the leaching efficiency were investigated by Taguchi optimization and ANOVA methods. The results showed that 61.20% of gold leaching efficiency was achieved from CAS, under the optimum leaching conditions which were determined as %80 ionic liquid concentration, 50°C temperature, 1 h time and 1/20 g/mL solid/liquid ratio. The statistical results of the experiments revealed that the effects of each parameter on the gold leaching with BmimCl were in the following order: temperature > time > solid/liquid ratio > ionic liquid concentration
Calcium antagonists, digoxin, calcaemia and anaemia in heart failure
WOS: 000401775600042
Cortical excitability in Duchenne muscular dystrophy
Objective: To investigate the probable cortical excitability changes in DMD by electrophysiological means