Evaluation of microalbuminuria in patients with systemic sclerosis as an indicator of early renal damage and increased morbidity

AbstractIntroductionRenal involvement and systemic vascular damage have been shown to be significantly affecting prognosis in systemic sclerosis.Aim of workMicroalbuminuria detection in SSc patients as an indicator of early renal involvement and its correlation with various SSc clinical, laboratory parameters and severity of organ systems’ damage assessed by Scleroderma Assessment Questionnaire.Patients and methodsForty SSc patients (33 females and 7 males) with mean age of 27.48±12.56years and mean disease duration of 6.2±4.14years were included. Twenty-four (60%) had lSSc; 13 (32.5%) had dSSc and 3 (7.5%) patients had SSc sine scleroderma.ResultsEight (20%) had microalbuminuria and 9 (22.5%) patients had decreased creatinine clearance. Albumin/creatinine ratio was significantly higher among dSSc patients compared to those with lSSc and SSc sine scleroderma (X2=9.077; p=0.01). Albumin/creatinine ratio showed significant positive correlations with telangiectasia (r=0.322; p=0.04) and mRodnan’s skin score (r=0.352; p=0.026) and negative correlations with inter-incisor distance (r=−0.525; p=0.001) and pleurisy (r=−0.446; p=0.004). Albumin/creatinine ratio correlated significantly and positively with IMSS and IDS indices of SAQ (r=0.378, 0.32; p=0.016, 0.044, respectively). SSc patients with microalbuminuria showed significantly higher mean IDS than those without (1.058 vs. 0.631, p=0.04). No statistically significant correlations were found between creatinine clearance and the different demographic, clinical features and the indices of SAQ.ConclusionMicroalbuminuria compared to creatinine clearance may be a more sensitive indicator of early renal affection and predictor of increased morbidity

Novel Green Synthesis and Characterization of Nanopolymer Porous Gold Oxide Nanoparticles

Purpose: To develop a novel approach to green synthesis of nano-polymer porous gold oxide nanoparticles, and examine the effects of the temperatures on their surface.Methods: Green synthesis of nano-polymer porous gold oxide nanoparticles (GONPs) using cetyle trimethylammonium bromide (CTAB) surfactant with a mixture of Olea europaea fruit and Acacia Nilotica extracts, was performed using sol-gel method. The nanoporous particles were characterized by UV (ultraviolet (UV) visible spectroscopy and dynamic light scattering (DLS) while a zetasizer was applied to determine their average particle size. Their surface morphology and shape were assessed by transmission electron microscopy (TEM) and scanning election microscopy (SEM) while surface area was measured using nitrogen gas adsorption method.Results: TEM and SEM images showed a smooth, cylindrical or spherical, and cluster shapes, and porous surface morphology. Increase in calcination temperature resulted in increase in surface area and pore volume of nanoparticles. This feature yielded GONPs that were unique with a high surface area of 146.706 m2/g.Conclusion: The approach used in this study constitutes a new and rapid green synthesis of porous nanoparticles of gold oxide under simple conditions. Furthermore, increase in GONPs surface area is enhanced by increase in calcination temperature.Keywords: Gold oxide, Nanoporous, Green synthesis, Olea europaea, Acacia Nilotica, Surface area, Nanopolymer, Surface morpholog

Analgesic effect of neohesperidin is mediated by TRPV1 antagonism

Context: Transient receptor potential vanilloid type 1 (TRPV1) is a non-specific cation channel. It is one of the most important targets in pain research. Aims: To evaluate new TRPV1 antagonists without altering body temperature. Methods: Docking simulation was performed, and one of the candidate compounds, neohesperidin, was tested using thermal and chemical pain models in BALB/c mice. Rectal body temperature was measured using a temperature meter with a thermocouple probe detector, and the capsaicin-evoked calcium response was determined in dorsal root ganglia (DRG) neurons. Results: Docking resulted in the identification of 30 compounds able to interact with the essential amino acids required for the antagonistic activity of TRPV1. Neohesperidin was chosen for further investigations because of its good binding energy (-6.63 kcal/mol) and because its TRPV1 antagonistic activity was not tested before. This study reported for the first time that neohesperidin exerted analgesic activity through TRPV1 antagonism without altering body temperature. Its activity was comparable to the known TRPV1 antagonist N-(4-tertiarybutylphenyl)-4-(3-chloropyridin-2-yl)tetrahydropyrazine-1(2H)-carbox-amide (BCTC). In the writhing test, acetic acid-induced abdominal cramps decreased by 66% using 30 mg/kg of neohesperidin. All tested doses of neohesperidin significantly decreased paw-licking time in the capsaicin-induced paw-licking test. A significant increase in the latency time in hot plate and tail flick tests was observed using 30 and 60 mg/kg of neohesperidin. In DRG neurons, neohesperidin reduced capsaicin-evoked calcium responses. Conclusions: Neohesperidin exerts a significant analgesic activity without altering body temperature, which could be due, at least partially, to its antagonistic activity against TRPV1

Tumor-Associated Macrophage (TAM) and Angiogenesis in Human Colon Carcinoma

AIM: This study aimed to clarify how macrophages affect prognosis in cancer colon and their association with tumor angiogenesis.MATERIAL AND METHODS: Forty four biopsies of colon carcinoma and 15 of benign adenomatous polyps were investigated for macrophages infiltration and microvessels density using immunohistochemistry and image morphometric analysis. Macrophages and blood vessels were stained immunohistochemically by CD68 and F-VIII markers respectively. The morphometric analysis was carried out on the immunohistochemically stained slides using the Leica Qwin 500 Image Analyzer. Both of macrophages infiltration and microvessels density were correlated with histological tumor grade, stage and lymph node metastases and were correlated with each others.RESULTS: Macrophage infiltration was significantly higher in malignant cases than in benign polyps. High macrophage infiltration and hypervascularity were significantly correlated with T-staging and lymph nodes metastasis. A significant correlation was found between macrophage infiltration and microvessels densitie in malignant tumors where hypervascularity was significantly correlated with high macrophages infiltration.CONCLUSION: The significant correlation between macrophage infiltration and tumor angiogenesis suggests an interaction between macrophages and cancer cells stimulating microvessels formation, tumor invasion and metastasis in colon cancer. We recommend that macrophages infiltration should be evaluated to investigate their clinical value in development of individualized therapeutic regimens for management of colon carcinoma

Green Synthesis, Characterization, and Antibacterial Activity of Silver/Polystyrene Nanocomposite

A novel, nontoxic, simple, cost-effective and ecofriendly technique was used to synthesize green silver nanoparticles (AgNPs). The AgNPs were synthesized using orange peel extract as a reducing agent for silver nitrate salt (AgNO3). The particle size distribution of AgNPs was determined by Dynamic Light Scattering (DLS). The average size of silver nanoparticles was 98.43 nm. The stable dispersion of silver nanoparticles was added slowly to polystyrene solution in toluene maintaining the temperature at 70°C. The AgNPs/polystyrene (PS) nanocomposite solution was cast in a petri dish. The silver nanoparticles encapsulated within polymer chains were characterized by X-ray diffraction (XRD) and Scanning Electron Microscopy (SEM) equipped with Energy Dispersive Spectroscopy (EDS) in addition to Transmission Electron Microscopy (TEM). The green AgNPs/PS nanocomposite film exhibited antimicrobial activity against Gram-negative bacteria Escherichia coli, Klebsiella pneumoniae and Salmonella, and Gram-positive bacteria Staphylococcus aureus. Thus, the key findings of the work include the use of a safe and simple AgNPs/PS nanocomposite which had a marked antibacterial activity which has a potential application in food packaging

Determination of α1-acid glycoprotein (AGP) concentration by HPLC in patients following local infiltration analgesia for primary total hip arthroplasty and its relation to ropivacaine (total and unbound)

Introduction: This study was performed to determine the levels of α1-acid glycoprotein (AGP) in old-age patients undergoing total hip arthroplasty. AGP is considered an acute phase protein produced during the acute phase reaction in the body to various stimuli; their proper monitoring is thus important.Methods: In order to study how AGP concentrations in old age patients change in response to surgical stress (total hip arthroplasty), a high-performance liquid chromatography assay was performed to measure AGP levels. AGP was isolated from the plasma by adding perchloric acid and was analyzed using PLRP-S 4000°A column. The mobile phase consisted of 1 mL TFA/L of water (Solvent A pH 2) and 1 mL TFA/L of acetonitrile (Solvent B). The gradient used was as follows: 0 min 18% B and 82% A, 15 min 60% B and 40% A, and 17 min 60% B and 40% A followed by column re-equilibration for 7 min before the next injection. AGP peak was obtained between 8.8 and 8.9 min. The method was fully optimised according to established guidelines.Results: The data obtained were analyzed on ChromQuest software. AGP concentrations were determined in all samples, including baseline and samples taken at different timed intervals. The peak for AGP was obtained between 8.8 and 8.9 min for both standard AGP and patient plasma. The graphs indicate that AGP concentration in almost all patient samples increased considerably, especially after 4 h and 24 h—for example, initial concentration in patient 1 was 10.36 mg/100 mL but, after 24 h, increased to 23.50 mg/100 mL. There was thus almost a 13 mg/100 mL increase in 24 h, which is confirmed by AGP concentration increasing after various conditions, including surgery. The increased plasma protein binding was comparatively associated with the unchanged free fraction of the drug.Conclusion: This surgically induced increase in AGP concentration resulted in increased plasma protein binding of the drug (ropivacaine), which in turn kept the free portion of ropivacaine stable during the postoperative period

Nephroprotective Activity of Green Microalgae, Chlorella sorokiniana Isolated from Jordanian Water

Nephropathy is a global health issue that affects more than 20% of the adult population. Nephropathy is expected to be the fifth leading cause of death worldwide over the coming two decades. The introduction of green microalgae in nutrition and therapeutics for their biological activities is increasing. The current study examined the effect of Chlorella sorokiniana on renal health after inducing nephrotoxicity in mice. Preliminary screening of the algal aqueous extract revealed the presence of soluble polyphenols and triterpenoids. Successive intraperitoneal doses of gentamicin were administered to mice to induce nephrotoxicity. Concurrent intraperitoneal doses of the algal extract were administered to the infected mice to evaluate their nephroprotective activity. Two different concentrations of the treatment agent were administered in successive doses to two groups of mice. The tested concentrations were 150 and 300 mg/kg of mouse weight, respectively. The other two groups were either left untreated (normal control) or treated only with antibiotics (negative control). Creatinine, urea, and uric acid levels were analyzed in both serum and urine samples to evaluate the renal health of each animal group. Histochemical examination of the renal tissues was performed to assess the damage and improvement status. In vivo studies revealed a promising and significant nephroprotective activity of C. sorokiniana

Evaluation of the effectiveness of sleep hygiene education and FITBIT devices on quality of sleep and psychological worry: a pilot quasi-experimental study among first-year college students

BackgroundCollege students report disturbed sleep patterns that can negatively impact their wellbeing and academic performance.ObjectivesThis study examined the effect of a 4-week sleep hygiene program that included sleep education and actigraph sleep trackers (FITBITs) on improving sleep quality and reducing psychological worry without control group.Design, settings, and participantsA pilot quasi-experimental design, participants were randomly selected medical and health sciences from a university students in the United-Arab-Emirates.MethodsStudents were asked to wear FITBITs and log their daily sleep data and completed the Pittsburgh Sleep Quality Index (PSQI) and Penn State Worry Questionnaire (PSWQ). Extensive sleep hygiene education was delivered via lectures, a WhatsApp group, and the Blackboard platform. In total, 50 students completed pre-and post-assessments and returned FITBIT data.ResultsThere was a significant difference in the prevalence of good sleep postintervention compared with pre-intervention (46% vs. 28%; p = 0.0126). The mean PSQI score was significantly lower post-intervention compared with pre-intervention (6.17 ± 3.16 vs. 7.12.87; p = 0.04, Cohen’s d 0.33). After the intervention, subjective sleep quality, sleep latency, and daytime dysfunction were significantly improved compared with pre-intervention (p < 0.05). In addition, FITBIT data showed total sleep time and the number of restless episodes per night were significantly improved postintervention compared with pre-intervention (p = 0.013). The mean PSWQ score significantly decreased from pre-intervention to p = 0.049, Cohen’ d = 0.25. The correlation between PSQI and PSWQ scores was significant post-intervention (β = 0.40, p = 0.02).ConclusionOur results may inform university educational policy and curricular reform to incorporate sleep hygiene awareness programs to empower students and improve their sleep habits

A global experiment on motivating social distancing during the COVID-19 pandemic

Finding communication strategies that effectively motivate social distancing continues to be a global public health priority during the COVID-19 pandemic. This cross-country, preregistered experiment (n = 25,718 from 89 countries) tested hypotheses concerning generalizable positive and negative outcomes of social distancing messages that promoted personal agency and reflective choices (i.e., an autonomy-supportive message) or were restrictive and shaming (i.e., a controlling message) compared with no message at all. Results partially supported experimental hypotheses in that the controlling message increased controlled motivation (a poorly internalized form of motivation relying on shame, guilt, and fear of social consequences) relative to no message. On the other hand, the autonomy-supportive message lowered feelings of defiance compared with the controlling message, but the controlling message did not differ from receiving no message at all. Unexpectedly, messages did not influence autonomous motivation (a highly internalized form of motivation relying on one’s core values) or behavioral intentions. Results supported hypothesized associations between people’s existing autonomous and controlled motivations and self-reported behavioral intentions to engage in social distancing. Controlled motivation was associated with more defiance and less long-term behavioral intention to engage in social distancing, whereas autonomous motivation was associated with less defiance and more short- and long-term intentions to social distance. Overall, this work highlights the potential harm of using shaming and pressuring language in public health communication, with implications for the current and future global health challenges

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely