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It was reported that inhaled corticosteroids (ICS) treatment may affect local immunity and microbial community of the airway. However, whether ICS treatment increases the risk of influenza in patients with asthma remains unclear. This meta-analysis aimed to compare the risk of influenza between ICS and non-ICS treatment in patients with asthma.

PubMed, Embase, Cochrane Library and Clinical Trials.gov were searched from inception until November 2019. Randomized controlled trials (RCTs) were included that compared ICS treatment with non-ICS treatment on the risk of influenza in patients with asthma. Meta-analyses were conducted by the Peto approach and Mantel-Haenszel approach with corresponding 95% CIs.

Nine trials involving 6486 patients were included in this meta-analysis. The risk of influenza was not different between ICS treatment and the control groups (Peto OR 1.01, 95% CI 0.74-1.37, P = 0.95). The results of subgroup analyses based on durations (long-term and short-term treatment), doses (high-, medium- and low-dose treatment) and types (fluticasone and budesonide treatment) of ICS were consistent with the above pooled results. Moreover, subgroup analysis based on patients' age also revealed that use of ICS did not increase the risk of influenza. Results of the two meta-analysis approaches were similar.

Use of ICS does not increase the risk of influenza in patients with asthma. This study adds to safety evidence of ICS as a regular controller treatment for patients with asthma.

Use of ICS does not increase the risk of influenza in patients with asthma. This study adds to safety evidence of ICS as a regular controller treatment for patients with asthma.

To determine whether topical tacrolimus can lessen steroid-induced intraocular pressure (IOP) elevation.

Open cohort post hoc analysis study.

Five hundred eleven patients with vernal keratoconjunctivitis or atopic keratoconjunctivitis (mean age 17.0 ± 9.2years) were studied. All 511 patients were treated with topical tacrolimus with or without topical steroids, and the changes in IOP were measured monthly for 3months. The elevation in IOP induced by use of topical steroids was calculated using mixed linear regression analyses. The relationship between the elevation in IOP within 4weeks and the use or nonuse of tacrolimus reported in published data was analyzed using metaregression analysis to estimate the effects of tacrolimus on the IOP in eyes treated with topical steroids.

The mean topical steroid-induced IOP elevation in tacrolimus-treated eyes was lower, by 5.2mmHg (P = 0.04), than that in earlier published data without tacrolimus as the control. In the tacrolimus-treated eyes, the mean betamethasone-induced IOP elevation was 1.3mmHg without discontinuation of the steroid. Metaregression analysis indicated that glaucoma history and younger age had significant effects on topical steroid-induced IOP elevation, by 4.0mmHg (P = 0.002) and 3.9mmHg (P = 0.01), respectively. In tacrolimus-treated eyes, the most significant effect on the IOP was associated with glaucoma history or medication; however, its effect on the IOP was limited to 1.7mmHg elevation (P = 0.006).

Topical tacrolimus may lessen the steroid-induced elevation in IOP in younger individuals and may be a good adjunctive therapy to avoid IOP elevation in refractory cases.

Topical tacrolimus may lessen the steroid-induced elevation in IOP in younger individuals and may be a good adjunctive therapy to avoid IOP elevation in refractory cases.This study was aimed at evaluating the protective effect of sodium selenite (SS) on DNA integrity, antioxidant/oxidant status, and histological changes on 4-nonylphenol (4-NP)-induced toxicity in liver and kidney tissues of rats. Twenty-four adult male Sprague Dawley rats were divided into 4 groups as control, SS, 4-NP, and SS+4-NP group. Control group was untreated. The SS group was supplemented with SS (0.5 mg/kg/day) and the 4-NP group was given 4-NP (125 mg/kg/day). The rats in the SS+4-NP group received SS followed by 4-NP 1 h later at the abovementioned doses. The treatments were administered by oral gavage for 48 days. DNA damage was analyzed by comet assay in lymphocytes. Oxidative stress parameters were measured, and histological evaluation was performed in liver and kidney tissues. Results showed that SS administration significantly decreased % Tail DNA and Mean Tail Moment in SS+4-NP group as compared with 4-NP group. Catalase activity in liver was significantly lower in 4-NP group only. SS treatment significantly increased the glutathione level and decreased high malondialdehyde level in tissues of the SS+4-NP group as compared with 4-NP group. Dilation of central vein, ballooning degeneration, vacuolar degeneration, and deterioration in the structure of remark cords in 4-NP-administered were alleviated in rats that received SS supplementation before administration of 4-NP. Moreover, glycogen intensity in hepatocytes and the wall of central vein increased in the SS+4-NP group. In addition, the SS supplementation in the SS+4-NP group decreased glomerular degeneration as well as the width of cavum glomeruli and congestion intensity in the kidney. These results indicate that SS may have a protective effect against 4-NP-induced hepato-nephrotoxicity in rats.

Oncogenic K-Ras mutations in colorectal cancer (CRC) combined with APC mutations worsen CRC prognosis and lower drug effectiveness. Thus, inhibition of both Wnt/β-catenin and Ras-MAPK signaling may be a rational strategy to improve the treatment of this cancer.

To identify a novel compound inhibiting both Wnt/β-catenin and Ras-MAPK signaling in CRC.

We developed a two-part screening system consisting of analysis of TOP flash reporter cells and then potential toxicity effects on primary neural stem cells (NSCs). We then screened 2000 chemical compounds and tested efficacy of candidates against isogenic colon cancer cells harboring wild-type or mutant K-Ras. We employed immunohistochemistry and immunocytochemistry to determine marker signatures associated with development of disease phenotypes.

We identified CPD0857, a compound that inactivates Wnt/β-catenin signaling and promotes ubiquitin-dependent proteasomal degradation of β-catenin and Ras proteins. CPD0857 effectively decreased proliferation and increased apoptosis of CRC cell lines, and overcame resistance of CRC harboring APC and K-Ras mutations to treatment with an EGFR monoclonal antibody (mAb). Moreover, CPD0857 attenuated invasiveness of highly migratory CRC cells in vitro. Accordingly, xenograft mice treated with CPD0857 showed slower tumor growth and significant decreases in both β-catenin and Ras protein expression.

CPD0857 may be a potential drug for treating aggressive CRC carrying mutations that aberrantly activate Wnt/β-catenin and Ras-ERK pathways.

CPD0857 may be a potential drug for treating aggressive CRC carrying mutations that aberrantly activate Wnt/β-catenin and Ras-ERK pathways.Digital subtraction angiography (DSA) is a powerful technique for visualizing blood vessels from X-ray images. However, the subtraction images obtained with this technique suffer from artifacts caused by patient motion. To avoid these artifacts, a new method called "Virtual DSA" is proposed, which generates DSA images directly from a single live image without using a mask image. The proposed Virtual DSA method was developed using the U-Net deep learning architecture. In the proposed method, a virtual DSA image only containing the extracted blood vessels was generated by inputting a single live image into U-Net. To extract the blood vessels more accurately, U-Net operates on each small area via a patch-based process. In addition, a different network was used for each zone to use the local information. The evaluation of the live images of the head confirmed accurate blood vessel extraction without artifacts in the virtual DSA image generated with the proposed method. In this study, the NMSE, PSNR, and SSIM indices were 8.58%, 33.86 dB, and 0.829, respectively. These results indicate that the proposed method can visualize blood vessels without motion artifacts from a single live image.

In patients with obesity, micronutrient deficiencies have been reported both before and after bariatric surgery (BS). Obesity is a chronic pro-inflammatory status, and inflammation increases the risk of micronutrient malnutrition. Our objective was to assess in pre-BS patients the prevalence of micronutrient deficiencies and their correlation with blood values of C-reactive protein (CRP).

Anthropometric data, instrumental examinations, and blood variables were centrally measured in the first 200 patients undergoing a pre-BS evaluation at the "Città della Salute e della Scienza" Hospital of Torino, starting from January 2018.

At least one micronutrient deficiency was present in 85.5% of pre-BS patients. Vitamin D deficiency was the most prevalent (74.5%), followed by folate (33.5%), iron (32%), calcium (13%), vitamin B12 (10%), and albumin (5.5%) deficiency. CRP values were high (> 5mg/L) in 65% of the patients. These individuals showed increased rate of iron, folate, vitamin B12 deficiency, and a higher number of micronutrient deficiencies. In a multiple logistic regression model, increased CRP levels were significantly associated with deficiencies of vitamin B12 (OR = 5.84; 95% CI 1.25-27.2; p = 0.024), folate (OR = 4.02; 1.87-8.66; p < 0.001), and with the presence of ≥ 2 micronutrient deficiencies (OR = 2.31; 1.21-4.42; p = 0.01).

Micronutrient deficiencies are common in patients with severe obesity undergoing BS, especially when inflammation is present. learn more In the presence of increased CRP values before surgery, it might be advisable to search for possible multiple micronutrient deficiencies.

Micronutrient deficiencies are common in patients with severe obesity undergoing BS, especially when inflammation is present. In the presence of increased CRP values before surgery, it might be advisable to search for possible multiple micronutrient deficiencies.Background Adherence to type 2 diabetes management is defined as the extent to which the behaviour of a person matches the one recommended by health care professionals. Control of this disease depends on adherence to diabetes management, which includes monitoring blood glucose levels, adopting a healthy diet, exercising, taking medication, quitting smoking, and undergoing psychosocial care and periodic check-ups. This can also prevent health complications and reduce medical costs. Objective The objective of this study is to validate a culturally appropriate instrument directed towards the Mexican population that measures a patient's level of adherence to their type 2 diabetes mellitus management. Method The study design was cross-sectional. The instrument was applied individually (face to face researcher-assisted survey) by a member of the team. The study sample included 200 participants, which were attended at an outpatient clinic. To evaluate the psychometric validity of the scale we calculated response frelidity index (I-CVI) of 0.9. Conclusion The proposed instrument, which includes factors that measure adherence in type 2 diabetes mellitus patient's management, using the transtheoretical model of behaviour change to simultaneously identify patient motivation to change their lifestyle, is valid and reliable.