The potential association between metabolic syndrome and risk of post-surgical adhesion.

payth.elady61 shared this article with you from Inoreader The potential association between metabolic syndrome and risk of post-surgical adhesion. Via pubmed: "arch physiol bioche... The potential association between metabolic syndrome and risk of post-surgical adhesion. Arch Physiol Biochem. 2020 Dec 08;:1-6 Authors: Ferns GA, Shahini Shams Abadi M, Arjmand MH Abstract Metabolic syndrome (MetS) is defined by the clustering of several associated with a group of disorders that include: obesity, dyslipidemia, hypertension, and insulin resistance. The incidence of MetS is increasing globally around the world. Indeed the rates of different types of surgery in older or younger patients with Mets are increasing and they are exposed to a wide range of operations including abdominal, pelvic, urologic, or any invasive procedures. Post-surgical adhesion is a common problem and is a challenge for the surgeon. Despite many studies on its pathogenesis, there remain many un-answered questions about it, for example why certain tissues and patients are more at higher risk of post-surgical adhesions. Many studies have suggested that MetS is associated with up-regulating molecular mechanisms leading to chronic inflammation and hypercoagulability. In this review, we discuss some of the molecular mechanisms by MetS may enhance post-surgical adhesion, and partic ularly regarding those involved in coagulation and inflammation. PMID: 33290664 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Emergency Orthopaedic surgery in the pandemic era: A case series at a national tertiary hospital in Jakarta, Indonesia.

payth.elady61 shared this article with you from Inoreader Emergency Orthopaedic surgery in the pandemic era: A case series at a national tertiary hospital in Jakarta, Indonesia. Via pubmed: "int j surg case rep... Emergency Orthopaedic surgery in the pandemic era: A case series at a national tertiary hospital in Jakarta, Indonesia. Int J Surg Case Rep. 2020 Dec 02;: Authors: Kamal AF, Widodo W, Kuncor MW, Karda IWAM, Prabowo Y, Habib H, Liastuti LD, Trimartani, Hutagalung EU, Saleh I, Tobing SDAL, Gunawan B, Dilogo IH, Lubis AM, Kurniawan A, Rahyussalim AJ, Oesman I, Ifran NN, Latief W, Wijaya MT, Ivansyah MD, Primaputra MRA, Reksoprodjo AY, Hendriarto A, Novriandi KMA, Alaztha Z, Canintika AF, Sitanggang AHR Abstract Introduction: Every emergency surgery performed is aimed at saving lives; however, during COVID-19 pandemic, surgeries are often postponed. Many existing recommendations take into account postponing surgery during a pandemic. How these surgeries can lead to increasing infection rates has not been widely published. This study aims to investigate the relationship of emergency orthopaedic surgery and the incidence rate of COVID-19. Presentation of case: : This was a case series of 14 patients. The study was performed at the emergency department unit at a national tertiary hospital in Jakarta, Indonesia. A total of 14 patients underwent orthopaedic surgery in the emergency room of our institution. The mean age of the subjects was 40.07 ± 20.5 years. Twelve (85.7%) were male patients and 2 (14.3%) were female patients. The average duration of surgery was 125 minutes. The most used type of anaesthesia was general anaesthesia for 6 operations (50%). Patients were hospitalized for an average length of 4 days. Three patients had infiltrates found on plain x-ray examination, which required further examination to determine whether the cause was COVID-19 infection or not. There was no ground glass appearance (GGO) in the three patients in further follow-up examination. Conclusions: We found that emergency orthopaedic surgery was not associated with increasing number of COVID-19 cases. Factors including duration of surgery, length of stay, types of anaesthesia and comorbidities were also not associated with COVID-19 cases in this study. PMID: 33288992 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Alimentary System is Directly Attacked by SARS-COV-2 and Further Prevents Immune Dysregulation Caused by COVID-19.

payth.elady61 shared this article with you from Inoreader Alimentary System is Directly Attacked by SARS-COV-2 and Further Prevents Immune Dysregulation Caused by COVID-19. Via pubmed: frontiers immunology Alimentary System is Directly Attacked by SARS-COV-2 and Further Prevents Immune Dysregulation Caused by COVID-19. Int J Clin Pract. 2020 Dec 07;:e13893 Authors: Chen S, Zhou J, Ou X, Cheng W, Qin Y, Guo Y, Jiang Y Abstract BACKGROUND: SARS-COV-2 causes digestive system symptom, the effect of which remains equivocal. METHODS: Patients with COVID-19 were classified into 4 groups according to symptom. The study traced the onset and duration of symptoms, compared laboratory examinations and conducted bioinformatic analysis. Immune indices were further analyzed. RESULTS: By March 16, 25 patients with COVID-19 and 13 with suspect COVID-19 were admitted to West China Hospital, Sichuan University. Digestive system symptom group had the highest level of ESR (mm/h, P＜0.0001), serum ferritin (ng/ml, P＜0.0001), hepatic enzymes (P＜0.05), and retentive lymphocyte count/percentage (P＜0.05) and its subsets (P＜0.05). Combined group (respiratory combined with subsequent digestive system symptom) had the highest level of IL-6 (pg/ml, P=0.0046), CRP (mg/L, P=0.0004) and moderate lymphocyte depletion. Respiratory system symptom and asymptomatic groups suffered the most from lymphocyte depletion (P＜0.05). Bioinformatic analysis indicated co-expression of binding related proteins of SARS-COV-2 (ACE2, TMPRSS2 and Furin) in small intestine. CD147 was extensively expressed in alimentary tract. CTSL, PIKfyve, TPC2 and CTSB could be detected with ≥moderate expressions in a variety of organs including alimentary system. CONCLUSIONS: Alimentary system is possibly attacked by SARS-COV-2 other than hyperinflammation or immune dysregulation caused by it. Involvement of alimentary system might further protect mild and moderate cases from lymphocyte depletion caused by COVID-19. PMID: 33289233 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Development and evaluation of puerarin-loaded controlled release nanostructured lipid carries by central composite design.

payth.elady61 shared this article with you from Inoreader Development and evaluation of puerarin-loaded controlled release nanostructured lipid carries by central composite design. Via pubmed: "drug dev ind pharm"... Development and evaluation of puerarin-loaded controlled release nanostructured lipid carries by central composite design. Drug Dev Ind Pharm. 2020 Dec 08;:1-37 Authors: Ye Q, Li J, Li T, Ruan J, Wang H, Wang F, Zhang X Abstract The present work was aimed at developing optimized puerarin-loaded nanostructured lipid carrier (PA-NLC) on base of phospholipid complex. The puerarin phospholipid complex (PA-PC) was prepared by a solvent evaporation method and the formulation was confirmed according to the encapsulation efficiency (EE %). The hepatoprotective effect of PA-NLC on BRL 3A cell stimulated by ethanol was carried out using MTT assay, and cell imaging was done using aninverted phase contrast tissue culture microscope. The NLCs were produced by nanoemulsion method using glyceryl monostearate (GMS), olive oil and Poloxamer 188 as the solid, liquid lipids and surfactant. A single factor analysis determined the optimal ratio of solid lipid to liquid lipid. A 3-factor, 5-level central composite design (CCD) was used to predict responses variables and construct 3D-response contour plots. The independent variables, which were the concentrations of PA-PC, total lipid, and surfactant affected particle size , surface charge of the nanoparticles and the EE. An optimized NLC composition consisted of 31.25% PA-PC, 46.87% GMS, 9.38% olive oil, and 18.75% Poloxamer 188. The NLC had an average particle size of 159 ± 1.1 nm, zeta potential of -28.3 mV, EE % of 92.16%, and drug loading (DL %) of 5.75%. Differential scanning calorimetry (DSC), X-ray diffraction (XRD), and Fourier transform infrared spectroscopy (FTIR) studies showed that the formation of NLC was accompanied by changes in crystallinity and intermolecular interaction. The PA-NLC system showed enhanced therapeutic effect on alcohol-induced cell injury of BRL-3A. PMID: 33289579 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Monoolein-based nanoparticles containing indinavir: a taste-masked drug delivery system.

payth.elady61 shared this article with you from Inoreader Monoolein-based nanoparticles containing indinavir: a taste-masked drug delivery system. Via pubmed: "drug dev ind pharm"... Monoolein-based nanoparticles containing indinavir: a taste-masked drug delivery system. Drug Dev Ind Pharm. 2020 Dec 08;:1-32 Authors: Bianchin MD, Prebianca G, Immich MF, Teixeira ML, Colombo M, Koester LS, Araújo BV, Poletto F, Külkamp-Guerreiro IC Abstract OBJECTIVE: This study developed a novel child-friendly drug delivery system for pediatric HIV treatment: a liquid, taste-masked, and solvent-free monoolein-based nanoparticles formulation containing indinavir (0.1%). Significance: Adherence to antiretroviral therapy by pediatric patients is difficult because of the lack of dosage forms adequate for children. Methods: Monoolein-based nanoparticles were developed. The particle size, zeta potential, pH, drug content, small angle X-ray scattering, stability, in vitro drug release profile, biocompatibility, toxicity, and taste masking properties were evaluated. Results: Monoolein-based formulations containing indinavir had nanosized particles with 155 ± 7 nm, unimodal particle size distribution and polydispersity index of 0.16 ± 0.03. The zeta potential was negative (-31.3 ± 0.3 mV) and pH was neutral (7.78 ± 0.01). A 96% drug incorporation efficiency was achieved, and the indinavir concentration remained c onstant for 30 days. Polarized light microscopy revealed isotropic characteristics. Transmission electron microscopy images showed spherical shaped morphology. Small angle X-ray scattering displayed a form factor broad peak. Indinavir had a sustained release from the nanoparticles. The system was non-irritant and was able to mask drug bitter taste. Conclusions: Monoolein-based nanoparticles represent a suitable therapeutic strategy for antiretroviral treatment with potential to reduce the frequency of drug administration and promote pediatric adherence. PMID: 33289591 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Design and optimiZation of A probiotic tablet for gastrointestinal tolerance by a simplex-centroid mixture.

payth.elady61 shared this article with you from Inoreader Design and optimiZation of A probiotic tablet for gastrointestinal tolerance by a simplex-centroid mixture. Via pubmed: "drug dev ind pharm"... Design and optimiZation of A probiotic tablet for gastrointestinal tolerance by a simplex-centroid mixture. Drug Dev Ind Pharm. 2020 Dec 08;:1-27 Authors: Azhar MA, Abdul Munaim MS Abstract In this study, a simplex-centroid mixture design using design of experiment (DOE) software was implemented to evaluate the effect of biopolymers as excipients, which are hydroxypropyl methylcellulose, and alginate, on the gastrointestinal tolerance of probiotic tablet containing Saccharomyces boulardii. Microbial viability and dissolution time were used to evaluate the ideal formulation made using 39.01% carboxymethylcellulose and 60.99% alginate as excipients, which protected the probiotics from the acidic condition in the stomach with good dissolution time. The formulated probiotic tablet is more stable in terms of viability when stored at 4 °C compared to room temperature. However, the viability remains above 106 CFU/tablet after six months of storage at room temperature. This study shows that the simplex-centroid mixture design is valid and can be used to formulate probiotic tablets that possess gastrointestinal tolerance. This study can lead to the development of comm ercial production of probiotic yeast tablets with gastrointestinal tolerance. PMID: 33290104 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Psychometric properties of Patient-Specific Functional Scale in patients with upper extremity disorders. A systematic review.

payth.elady61 shared this article with you from Inoreader Psychometric properties of Patient-Specific Functional Scale in patients with upper extremity disorders. A systematic review. Via pubmed: disability and rehab... Psychometric properties of Patient-Specific Functional Scale in patients with upper extremity disorders. A systematic review. Disabil Rehabil. 2020 Dec 08;:1-10 Authors: Nazari G, Bobos P, Lu Z, Reischl S, MacDermid JC Abstract PURPOSE: To identify, critically appraise, and synthesise the measurement properties of Patient-Specific Functional Scale (PSFS) in patients with upper extremity musculoskeletal disorders. METHODS: Medline, Embase, PubMed, and Google Scholar databases from January 1999 to November 2020 were searched. Prospective measurement studies that included patients with upper extremity musculoskeletal disorders, that reported on the psychometric properties of PSFS were included. We used the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) 2018 guideline for systematic reviews to appraise the studies. RESULTS: Fourteen eligible studies were included. Three studies with adequate-very good quality and sufficient properties indicated excellent intra-class correlation coefficients (ICC) (≥0.75) in patients with shoulder pain (mean age 48 ± 11 years), multiple shoulder disorders (mean age 55 ± 16 years), and hand osteoarthritis (mean age 64 ± 9 years). The construct validity estimates of PSFS were moderate, when compared with Upper Extremity Functional Index (UEFI) (r = 0.50) and Numeric Pain Rating Scale (NPRS) (r = 0.51) in patients with combined upper extremity musculoskeletal disorders (shoulder/upper arm, wrist/hand and elbow/forearm). CONCLUSIONS: The patient-specific functional scale can be considered as a reliable, valid, and responsive tool in assessing functional change in patients with shoulder disorders/pain. Implications for rehabilitation The Patient-Specific Functional Scale (PSFS) can be considered as: • a reliable outcome measure in assessing functional change in patients with shoulder pain and hand osteoarthritis; • a valid measure in assessing functional limitation in patients with upper extremity disorders; • a measure that is sensitive to change (displays longitudinal validity) in assessing functional change in patients with upper extremity disorders and in patients with shoulder pain; and • a responsive outcome measure in assessing functional change in patients with upper extremity disorders. PMID: 33290102 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A multidisciplinary advanced approach in central pontine myelinolysis recovery: considerations about a case report.

payth.elady61 shared this article with you from Inoreader A multidisciplinary advanced approach in central pontine myelinolysis recovery: considerations about a case report. Via pubmed: disability and rehab... A multidisciplinary advanced approach in central pontine myelinolysis recovery: considerations about a case report. Disabil Rehabil Assist Technol. 2020 Dec 08;:1-12 Authors: Raciti L, Pizzurro R, Occhipinti F, Manuli A, Corallo F, Calabrò RS Abstract BACKGROUND AND PURPOSE: Central pontine myelinolysis (CPM) is a solitary, symmetric, demyelination in the central pons. This case study aimed to report the effects of an intensive robotic gait training with Lokomat-Pro on mobility and quality of life in a case of CPM. CASE DESCRIPTION AND INTERVENTION: A 33-year-old female patient with tetraparesis and gait disturbance due to CPM was hospitalized to undergo intensive rehabilitation training for about 2 months. Daily session of Lokomat-Pro and psychotherapy by telemedicine were performed, besides nursing care and occupational and physical therapy. Motor evaluation and quality of life were assessed by using standardized scales. OUTCOMES: The multidisciplinary therapy led to significant improvements both in functional motor outcomes (as per 10-Meter Walk Test, Berg Balance and Tinetti scale) and quality of life. DISCUSSION: Innovation technology, including robotics and telemedicine, may be a valuable tool to improve functional outcomes in patients with severe motor impairment due to chronic CPM. IMPLICATIONS FOR REHABILITATION A multidisciplinary approach involving robotics plus virtual reality is mandatory to reduce medical and bedridden complications in patients affected by CPM. PMID: 33290136 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Parent-Reported Outcome Questionnaire for Swallowing Dysfunction in Healthy Infants and Toddlers: Construction and Content Validation.

payth.elady61 shared this article with you from Inoreader Parent-Reported Outcome Questionnaire for Swallowing Dysfunction in Healthy Infants and Toddlers: Construction and Content Validation. Via pubmed: dysphagia Parent-Reported Outcome Questionnaire for Swallowing Dysfunction in Healthy Infants and Toddlers: Construction and Content Validation. Otolaryngol Head Neck Surg. 2020 Dec 08;:194599820970950 Authors: Baqays A, Johannsen W, Rashid M, Jaffal H, Hicks A, Jeffery C, Seikaly H, El-Hakim H Abstract OBJECTIVES: There is limited epidemiological information on swallowing dysfunction (SwD) in otherwise healthy infants and toddlers (OHITs). Cost, invasiveness, expertise, and resources constrain the repeatability and utility of instrumental diagnostic tests. A parent-reported outcomes (PRO) tool has the potential to mitigate these disadvantages. Hence, we set out to develop and validate a novel PRO tool to assess SwD in OHITs. STUDY DESIGN: A mixed-method study. SETTING: Tertiary pediatric center. METHODS: We recruited parents of OHITs with SwD and excluded those with a confounding diagnosis (syndromes or neurological impairment). Interviews were conducted and thematically analyzed to extract the relevant domains and items. A similar analytical method was performed on the reports from a systematic review and literature search. Four verification sessions of parents and experts were conducted to maintain rigor. A panel of experts assessed and established the content validity of the items using a modified Delphi technique. RESULTS: We achieved information saturation after interviewing 10 parents and generated 7 domains with 72 items. Over the course of 3 rounds of modified Delphi content validation, the domains were reduced to 3 (swallowing, breathing, and illness) containing 21 items; a content validity index of 82.1% was achieved. CONCLUSION: We validated the content of a new PRO instrument to assess SwD in OHITs. The instrument is composed of 3 primary domains representing 21 items. This tool has the potential to screen for swallowing dysfunction and can assess management outcomes specifically for this population at a community level. PMID: 33287657 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Single-session endoscopic fundoplication after peroral endoscopic myotomy (POEM+F) for prevention of post gastroesophageal reflux - 1-year follow-up study.

payth.elady61 shared this article with you from Inoreader Single-session endoscopic fundoplication after peroral endoscopic myotomy (POEM+F) for prevention of post gastroesophageal reflux - 1-year follow-up study. Via pubmed: dysphagia Single-session endoscopic fundoplication after peroral endoscopic myotomy (POEM+F) for prevention of post gastroesophageal reflux - 1-year follow-up study. Endoscopy. 2020 Dec 08;: Authors: Bapaye A, Dashatwar P, Dharamsi S, Pujari R, Gadhikar HP Abstract Background and Aim Peroral endoscopic myotomy (POEM) is an established treatment for achalasia cardia (AC), however post-POEM gastroesophageal reflux (GER) remains a significant problem. Concomitant endoscopic fundoplication following POEM (POEM+F) was recently described to reduce post-POEM GER. This single-center study reports medium-term outcomes of POEM+F. Patients and Methods Retrospective analysis of prospectively maintained database of patients undergoing POEM+F. Abstracted data - demographics, achalasia type, pre-POEM Eckardt score (ES), prior therapy, follow-up. Follow-up was 3-monthly for one-year. Follow-up assessments included post-POEM ES, GerdQ score, EGD - wrap integrity and esophagitis, and pH studies. GER was defined according to Lyon consensus. Data was recorded as mean (SD) or median (IQR), P-value < 0.05 was considered statistically significant. Results 25 patients underwent POEM+F, mean age (SD) - 40.13 (13.66) years, 12 females. POEM+F was technically successful in 23/25 (92%). Significant dysphagia improvement was seen in all 25 (mean [SD] pre- and post-POEM ES 8.21 [1.08] and 0.1 [0.3] respectively, p < 0.05). Mean total procedure and fundoplication time (SD) - 115.6 (27.2) and 46.7 (12.4) minutes respectively. Time reduced significantly after initial 5 cases. Median follow-up was 12-months (IQR 9 - 13). Intact wrap was seen in 19/23 (82.6%). GER (abnormal EAET) was seen in 2/18 (11.1%); one reported GerdQ > 8. Borderline GER (asymptomatic grade A esophagitis, normal EAET) was identified in 4/22 (18.1%). Two (8%) minor delayed adverse events required no intervention. Conclusions POEM+F is safe and reproducible. At 12-months follow-up, incidence of post-POEM+F GER was low and acceptable. PMID: 33291157 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Characteristics and Burden of Diagnostic Error-Related Malpractice Claims in Neurosurgery.

payth.elady61 shared this article with you from Inoreader Characteristics and Burden of Diagnostic Error-Related Malpractice Claims in Neurosurgery. Via pubmed: "world neurosurg"[jo... Characteristics and Burden of Diagnostic Error-Related Malpractice Claims in Neurosurgery. World Neurosurg. 2020 Dec 05;: Authors: Otsuki K, Watari T Abstract BACKGROUND: Neurosurgery is a specialty at high risk for malpractice claims, which can be influenced by the quality and safety of care. Diagnostic errors have gained increasing attention as a potentially preventable problem. Despite the burden of diagnostic errors, few studies have analyzed diagnostic errors in the field of neurosurgery. Here we delineate the effect of diagnostic errors on malpractice claims involving a neurosurgeon. METHODS: This is a retrospective study, using the national Japanese malpractice claims database, and includes cases closed between 1961 and 2017. To examine the effect of diagnostic errors in neurosurgery, we compared diagnostic error-related claims (DERCs) with non-DERCs in indemnity, clinical outcomes, and factors relating to neurosurgeons. RESULTS: There were 95 closed malpractice claims involving neurosurgeons during the study period. Of these claims, 36 (37.9%, 95% confidence interval [CI]: 28.7%-47.9%) were DERCs. Death was the most common outcome in patients associated with DERCs. Wrong, delayed, and missed diagnosis occurred in 25 (69.4%; 95% CI: 53.1%-82.0%), 4 (11.1%; 95% CI: 4.4%-25.3%), and 7 (19.4%; 95% CI: 9.8%-35.0%) cases, respectively. The most common presenting medical condition in DERCs was stroke. Subarachnoid hemorrhage, accounting for 85.7% of stroke cases, led to 27.8% of the total indemnity paid in DERCs. CONCLUSION: DERCs are associated with higher numbers of accepted claims and worse outcomes. Identifying diagnostic errors is important in neurosurgery, and countermeasures are required to reduce the burden on neurosurgeons and improve quality. This is the first study to focus on diagnostic errors in malpractice claims arising from neurosurgery. PMID: 33290895 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.