Efficacy and safety of Elagolix in the treatment of endometriosis associated pain: a systematic review and network meta-analysis

Background: Endometriosis commonly presents with dysmenorrhea, non-menstrual pelvic pain, and infertility. Elagolix is an oral, short-acting, gonadotropin-releasing hormone antagonist acting through complete estrogen suppression. Objective: To evaluate the evidence from published randomized controlled trials (RCTs) about the efficacy and safety of Elagolix in the treatment of endometriosis associated pain. Search strategy: Electronic databases containing articles published between January 2000 and February 2020 were searched using the MeSH terms (Elagolix OR gonadotropin-releasing hormone antagonist OR GnRH antagonist OR antigonadotropin) AND (endometriosis) AND (pelvic pain). Selection criteria: All RCTs assessing the efficacy of Elagolix in the treatment of pain associated with endometriosis were considered for this network meta-analysis, where five studies were deemed eligible for this review. Data collection and analysis: The mean difference (MD) and confidence intervals (95% CI) for continuous outcomes including analgesic use, dysmenorrhea, non-menstrual pelvic pain, and quality of life were calculated. Main results: Elagolix 250 mg reduced dysmenorrhea significantly, as compared to placebo, (MD = -0.41, 95% CI [-0.7, -0.13]) at 12 weeks, while Elagolix 200 mg reduced dysmenorrhea significantly (MD= -1.2, 95% CI [-1.9, -0.57]) compared to placebo after 24 weeks of treatment. Conclusions: Elagolix 200 mg seems to be an effective drug with fewer side effects when used to reduce dysmenorrhea and non-menstrual pelvic pain after 24 weeks of treatment in patients with endometriosis

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

A Review on MoS2 Energy Applications: Recent Developments and Challenges

Molybdenum disulfide (MoS2) is a promising transition metal dichalcogenide (TMD) that has exceptional electronic, magnetic, optical, and mechanical properties. It can be semiconducting, superconducting, or an insulator according to its polymorph. Its bandgap structure changes from indirect to direct when moving towards its nanostructures, which opens a door to bandgap engineering for MoS2. Its supercapacitive and catalytic activity was recently noticed and studied, in order to include this material in a wide range of energy applications. In this work, we present MoS2 as a future material for energy storage and generation applications, especially solar cells, which are a cornerstone for a clean and abundant source of energy. Its role in water splitting reactions can be utilized for energy generation (hydrogen evolution) and water treatment at the same time. Although MoS2 seems to be a breakthrough in the energy field, it still faces some challenges regarding its structure stability, production scalability, and manufacturing costs

A graphene-based THz selective absorber with absorptivity 95 % and wide-range electrical tunability

A growing adoption of Terahertz (THz) frequency across various applications is witnessed in the recent years. This specific frequency range is said to yield a breakthrough in high-speed electronics and communications, besides its significant role in the medical field regarding scanning and treatment. As frequency absorbers are one of the common blocks in the mentioned applications, they were the focus of many research work. In this paper, we present a theoretical model for a selective THz frequency absorber that has more than 90 % absorptivity and can reach 95 % and near unity absorptivity at some frequencies. The structure is based on monolayers of nanoribbons of graphene, MoS2, and phosphorene. The utilization of the surface plasmon oscillations of these two-dimensional (2D) materials, in addition to the impedance matching, is employed to achieve maximum absorptivity. The structure has an electrically tunable selective frequency from 1.3 THz to 10 THz that nearly covers the whole THz range, and a bandwidth ranging from 0.9 THz to 1.3 THz. Electrical tunability is done through varying the applied voltage on the MoS2/graphene heterostructure (0.2 V ∼ 5 V) based on the tunable conductivity of graphene. In addition to the voltage tunability of the design, the absorption frequency is also swept by varying the nanoribbons widths (20 nm ∼ 160 nm). The proposed design surpasses previous ones by its simple structure and high absorption through the entire THz range, besides its low cost of fabrication. The structure is ultrathin (∼10 nm) that it can fit in ultrathin electronics. It has a relatively small bandwidth compared to previous work, that represents the basis for narrowband absorbers. The structure is simulated using the finite element method (FEM) and verified using the transmission line circuit theory which demonstrated the validity of the structure for higher frequency ranges. The possibility of future synthesis is also discussed

A review on MoS₂ properties, synthesis, sensing applications and challenges

Molybdenum disulfide (MoS₂) is one of the compounds discussed nowadays due to its outstanding properties that allowed its usage in different applications. Its band gap and its distinctive structure make it a promising material to substitute graphene and other semiconductor devices. It has different applications in electronics especially sensors like optical sensors, biosensors, electrochemical biosensors that play an important role in the detection of various diseases’ like cancer and Alzheimer. It has a wide range of energy applications in batteries, solar cells, microwave, and Terahertz applications. It is a promising material on a nanoscale level, with favorable characteristics in spintronics and magnetoresistance. In this review, we will discuss MoS₂ properties, structure and synthesis techniques with a focus on its applications and future challenges.Published versionThis research was funded by United Arab Emirates University UPAR project, grant number 31N393

Association of NOS3 (rs 2070744) and SOD2Val16Ala (rs4880) gene polymorphisms with increased risk of ESRD among Egyptian patients

Abstract Background Chronic kidney Failure (CKD), particularly End-Stage Renal Disease (ESRD), may be serious ill-health related to a high death rate. Uremic syndrome leads to increased oxidative stress, inflammation, and dyslipidemia. Our study aimed at identifying the association of NOS3 (rs 2070744) and SOD2 Val16Ala (rs4880) gene polymorphisms within ESRD Egyptian patients. Methods This work was conducted on 100 ESRD and 16 CKD Egyptian patients who were compared to 100 healthy controls. DNA was genotyped for these variants using the (T-ARMS-PCR) technique. Results ESRD patients showed a significant association of the genotype of NOS3 gene polymorphism compared with healthy controls (P = 0.032). In the contrast, the present study revealed that no statistically significant differences were found among the CKD, ESRD, and control groups as regards the SOD2 genotypes (P = 0.064). Conclusions Our findings indicated a significant association between NOS3 (rs 2070744) gene polymorphism and increased risk of ESRD and CKD among Egyptian patients

Metabolomic profiling and biological evaluations of <i>Spongia irregularis</i>-associated actinomycetes supported by multivariate statistical analysis

AimMetabolomic analysis using LC–HRESIMS of 12 extracts of Spongia irregularis-associated actinomycetes for dereplication purposes in addition to evaluation of cytotoxic and antiviral activities of the extracts.Methods and resultsIn this study, three actinomycetes belonging to the genera Micromonospora, Streptomyces, and Rhodococcus were recovered from the marine sponge Spongia irregularis. Applying the OSMAC approach, each strain was fermented on four different media, resulting in 12 extracts. All extracts were subjected to metabolomic analysis using LC–HRESIMS for dereplication purposes. Multivariate data statistical analysis was carried out for the differentiation between extracts. Additionally, the cytotoxic and anti-hepatitis C virus (anti-HCV) potentials of extracts were evaluated. Most of extracts showed strong to moderate cytotoxicity effects against HepG-2, CACO-2, and MCF-7 cell lines with a general IC50 range of 2.8–8.9 µg/ml. Moreover, the extracts of Micromonospora sp. UR44 using ISP2 and OLIGO media and Streptomyces sp. UR32 using ISP2 medium exhibited anti-HCV activity with IC50 of 4.5 ± 0.22, 3.8 ± 0.18, and 5.7 ± 0.15 µM, respectively.ConclusionMetabolomic analysis of 12 extracts of S. irregularis-associated actinomycetes led to the identification of a large number of secondary metabolites. Morever, investigation of cytotoxic and antiviral activities of the extracts revealed that only three extracts exhibited antiviral activity and seven extracts exhibited cytotoxic activity

sj-docx-1-ppj-10.1177_17504589231221642 – Supplemental material for The impact of ketamine on delayed neurocognitive recovery in elderly patients undergoing spinal anaesthesia for orthopaedic procedures, a pilot study

Supplemental material, sj-docx-1-ppj-10.1177_17504589231221642 for The impact of ketamine on delayed neurocognitive recovery in elderly patients undergoing spinal anaesthesia for orthopaedic procedures, a pilot study by Mostafa Samy Abbas, Mohamed Gamal Abo-Zeid, Fatma Gad-Elrab Askar and Omnia Ahmed Askar in Journal of Perioperative Practice</p

Whole-food phytochemicals antioxidative potential in alloxan-diabetic rats

Background: The importance of whole-food antioxidants in terms of promoting antioxidant recycling in the body in complex human diseases is not fully understood. We aim to discuss the benefits of whole-food antioxidants in ameliorating the diabetic complications in vivo and to address the effect of germination versus heat processing or drying on the potential therapeutic effect of whole grains and legumes. We studied the antioxidant status of alloxan-diabetic (AD) male Spargue Dawley rats, injected intraperitoneally with alloxan dose of 150 mg/kg body weight, and fed on experimental diets based on the flour of soybean, broadbean and whole-wheat for five weeks. Results: Diabetes-induced oxidative stress in liver was manifested by significant increase in hepatic malondialdehyde (MDA), erythrocytes superoxide dismutase (eSOD) and plasma alpha-tocopherol (α-T) levels, reduction in hepatic glutathione (GSH) levels and catalase (CAT) activity. Consumption of soybean and whole-wheat both had beneficial effects on the oxidative status of AD rats more than broadbean. Feeding dried wheat was effective in improving MDA, GSH and α-T levels. Soybeans and wheat lowered triacylglycerols (TAGs) and tended to lower total cholesterol. Germination enhanced the effect of soybeans on TAGs and in the case of soy and wheat enhanced the effect on total cholesterol. Conclusion: Whole foods containing naturally occurring phytochemicals and antioxidant vitamins such as legumes and whole grains are recommended, alongside medication, for controlling hyperglycaemia, blood lipids and oxidative status in diabetes. Keywords: Isoflavones, Lignans, Germination, Reactive oxygen species, Alloxan, Rat