Antimicrobial Effect of Silk and Catgut Suture Threads Coated with Biogenic Silver Nanoparticles

Two bionanocomposites based on suture threads, silk-silver nanoparticles (Ag NPs) and catgut-Ag NPs, were prepared through a green chemistry methodology using Chenopodium ambrosioides (Mexican Epazote) as reducing agent. UV-Vis spectrophotometry (UV-Vis), Scanning Electron Microscopy (SEM) and Transmission Electron Microscopy (TEM), were used for their characterization. UV-Vis confirmed the synthesis of silver nanoparticles. Micrographs showed polydisperse, mostly spherical, Ag NPs attached to both suture threads. The bionanocomposites antimicrobial properties were evaluated through cultures and inhibition zones tests. The Chenopodium ambrosioides-assisted synthesized bionanocomposites have proved antibacterial effect against S. aureus and E. coli in both sutures (silk and catgut) and could be potentially useful for oral or periodontal surgery. There was no significant difference statistically in inhibition of Staphylococcus aureus versus Escherichia coli

Revisiting a Common Measure of Child Postoperative Recovery: Development of the Post Hospitalization Behavior Questionnaire for Ambulatory Surgery (PHBQ-AS)

Background The Post Hospitalization Behavior Questionnaire (PHBQ) was designed for assessing children\u27s posthospitalization and postoperative new‐onset behavioral changes. However, the psychometric properties of the scale have not been re‐evaluated in the past five decades despite substantial changes in the practice of surgery and anesthesia. In this investigation, we examined the psychometric properties of the PHBQ to potentially increase the efficacy and relevance of the instrument in current perioperative settings. Method This study used principal components analysis, a panel of experts, Cronbach\u27s alpha, and correlations to examine the current subscale structure of the PHBQ and eliminate items to create the Post Hospitalization Behavior Questionnaire for Ambulatory Surgery (PHBQ‐AS). Data from previous investigations (N = 1064, Mage = 5.88) which utilized the PHBQ were combined for the purposes of this paper. Results A principal components analysis revealed that the original subscale structure of the PHBQ could not be replicated. Subsequently, a battery reduction, which utilized principal components analysis and a panel of experts, was used to eliminate the subscale structure of the scale and reduce the number of items from 27 to 11, creating the PHBQ‐AS. The PHBQ‐AS demonstrated good internal consistency reliability and concurrent validity with another measure of children\u27s psychosocial and physical functioning. Conclusion Revising the former subscale structure and reducing the number of items in the PHBQ to create the PHBQ‐AS may provide a means for reducing the burden of postoperative behavioral assessment through decreasing time of administration and eliminating redundancy of items and allow for more accurate measurement of child postoperative behavioral changes

Healthcare resource use associated with the diagnosis of transthyretin amyloidosis cardiomyopathy

Objectives Our primary aim was to evaluate the healthcare resource use associated with the diagnosis of transthyretin amyloidosis cardiomyopathy. Second, we aim to assess the effect of the number of diagnostic tests and clinical contact points on the total time and costs between symptom onset and diagnosis defining a quantitative hypothetical optimized diagnostic pathway. Setting Clinical and cost data were collected from patients presenting between 2010 and 2018 in a tertiary referral institution in South London involving two participating hospitals. Participants Thirty-eight adult patients with a definite diagnosis of transthyretin amyloidosis cardiomyopathy were included, mostly male (n = 28, 74%) and of African-Caribbean descent (n = 23, 64%). We excluded patients without a confirmed transthyretin amyloidosis cardiomyopathy or those on inotersen, patisiran, or diflunisal at point of referral. Primary and secondary outcome measures The average time between first presentation and final diagnosis, and the cost per patient per month. By comparing to a more optimal clinical pathway towards diagnosis, we considered what could be the theoretical gain in terms of time to diagnosis and financial savings. Results The average time between first presentation and final diagnosis was 2.74 years. The average cost per patient per month was higher with progressive heart failure symptoms. A hypothetical optimal pathway reduces time to diagnosis of 1.65 to 1.74 years per patient. The potential financial savings are estimated within the range of £3000 to £4800 per patient. Conclusions Patients diagnosed with transthyretin amyloidosis cardiomyopathy have substantial healthcare resource utilization and costs starting from symptom onset. Higher costs were observed with progression in symptoms and appear linked to a delayed diagnosis. The number of additional diagnostic tests and clinical contact points may contribute to this and could represent a path to explore further for important health and cost savings, with more efficient pathways for these patients to be managed

Green Synthesis of Silver Nanoparticles Using <em>Heterotheca inuloides</em> and Its Antimicrobial Activity in Catgut Suture Threads

Silver nanoparticles were synthesized through a green method, using Heterotheca inuloides as a bioreducing agent. Moreover, catgut suture threads were decorated with those biogenic silver nanoparticles, and their antibacterial activity versus highly resistant pathogenic microorganisms was evaluated. The principles of green chemistry and nanotechnology allow us to obtain advanced materials, such as suture threads, which can reduce or avoid the prevalence of infectious processes in the medical field. Mexican medicinal plants, such as H. inuloides, represent an adequate alternative for biosynthesis; this plant species is known for its medicinal benefits and its antibacterial activity, and for that reason, it is being used in folk medicine

Adaptación basada en Ecosistemas en pequeñas fincas de granos básicos en Guatemala y Honduras

En Centroamérica, el maíz y el frijol son usualmente cultivados por agricultores que tienen pequeñas áreas de tierra y viven en situación de vulnerabilidad. El cambio climático representa una importante amenaza para estos pequeños agricultores de granos básicos, poniendo en peligro sus sistemas de producción y medios de vida. El uso de Adaptación basada en Ecosistemas (AbE) puede ayudarlos a enfrentar el cambio climático, pero existe poca información sobre el tema. El objetivo de este trabajo fue caracterizar las estrategias de AbE que los pequeños agricultores de granos básicos de cuatro paisajes de Guatemala y Honduras utilizan para aumentar su resiliencia frente al cambio climático. A través de entrevistas y mediciones en campo en 160 fincas, entre julio 2014 y junio 2015, 1) se exploró qué tan común es el uso de las diferentes prácticas de AbE, 2) se documentaron las características biofísicas de estas prácticas, y 3) se determinó si la implementación y características de las prácticas difieren entre paisajes. Los resultados indican que muchos de los pequeños agricultores de granos básicos usan prácticas de AbE, aun cuando cultivan áreas pequeñas (parcelas de maíz de ~0,68 ha), tienen un bajo nivel de educación y bajo acceso a capacitaciones o consejos técnicos. Las prácticas más comunes fueron el uso de árboles dispersos, huertos caseros y cercas vivas. Resultados de un análisis de ANDEVA indican que hubo diferencias significativas en el uso de diferentes prácticas entre agricultores, que sugiere que las adoptan en respuesta a sus medios de vida y condiciones biofísicas. El estudio sugiere que los pequeños agricultores de granos básicos tienen la experiencia y el conocimiento para utilizar prácticas de AbE, y que ven beneficios derivados de su implementación; sin embargo, para ampliar el uso de estas prácticas, se necesita más apoyo técnico, financiero y político

On the Bohr inequality

The Bohr inequality, first introduced by Harald Bohr in 1914, deals with finding the largest radius $r$, $0<r<1$, such that $\sum_{n=0}^\infty |a_n|r^n \leq 1$ holds whenever $|\sum_{n=0}^\infty a_nz^n|\leq 1$ in the unit disk $\mathbb{D}$ of the complex plane. The exact value of this largest radius, known as the \emph{Bohr radius}, has been established to be $1/3.$ This paper surveys recent advances and generalizations on the Bohr inequality. It discusses the Bohr radius for certain power series in $\mathbb{D},$ as well as for analytic functions from $\mathbb{D}$ into particular domains. These domains include the punctured unit disk, the exterior of the closed unit disk, and concave wedge-domains. The analogous Bohr radius is also studied for harmonic and starlike logharmonic mappings in $\mathbb{D}.$ The Bohr phenomenon which is described in terms of the Euclidean distance is further investigated using the spherical chordal metric and the hyperbolic metric. The exposition concludes with a discussion on the $n$-dimensional Bohr radius

Efficacy and safety of preoperative preparation with Lugol''s iodine solution in euthyroid patients with Graves’ disease (LIGRADIS Trial): Study protocol for a multicenter randomized trial

Background: Currently, both the American Thyroid Association and the European Thyroid Association recommend preoperative preparation with Lugol''s Solution (LS) for patients undergoing thyroidectomy for Graves’ Disease (GD), but their recommendations are based on low-quality evidence. The LIGRADIS trial aims to provide evidence either to support or refute the systematic use of LS in euthyroid patients undergoing thyroidectomy for GD. Methods: A multicenter randomized controlled trial will be performed. Patients =18 years of age, diagnosed with GD, treated with antithyroid drugs, euthyroid and proposed for total thyroidectomy will be eligible for inclusion. Exclusion criteria will be prior thyroid or parathyroid surgery, hyperparathyroidism that requires associated parathyroidectomy, thyroid cancer that requires adding a lymph node dissection, iodine allergy, consumption of lithium or amiodarone, medically unfit patients (ASA-IV), breastfeeding women, preoperative vocal cord palsy and planned endoscopic, video-assisted or remote access surgery. Between January 2020 and January 2022, 270 patients will be randomized for either receiving or not preoperative preparation with LS. Researchers will be blinded to treatment assignment. The primary outcome will be the rate of postoperative complications: hypoparathyroidism, recurrent laryngeal nerve injury, hematoma, surgical site infection or death. Secondary outcomes will be intraoperative events (Thyroidectomy Difficulty Scale score, blood loss, recurrent laryngeal nerve neuromonitoring signal loss), operative time, postoperative length of stay, hospital readmissions, permanent complications and adverse events associated to LS. Conclusions: There is no conclusive evidence supporting the benefits of preoperative treatment with LS in this setting. This trial aims to provide new insights into future Clinical Practice Guidelines recommendations. Trial registration: ClinicalTrials.gov identifier: NCT03980132. © 202