Groundwater under threat from diffuse contaminants: improving on-site sanitation, agriculture and water supply practices

https://ift.tt/2RQ9Owr

The effectiveness of mouthwashes in alleviating radiation-induced oral mucositis in head and neck cancer patients: a systematic review

Abstract

Objective

The aim of the study was to perform a systematic literature search and meta-analysis to reveal the most effective mouthwash for head and neck cancer patients who are experiencing radiation therapy-induced mucositis.

Methods

Using two electronic databases, a literature search and data interpretation were systematically performed as follows: (i) problem specification, (ii) devising of a literature search plan, (iii) literature search and retrieval of publications, and (iv) meta-analysis and data interpretation. The main problem was specified as follows: what mouthwash is effective in alleviating oral mucositis for head and neck cancer patients who are undergoing radiotherapy?

Results

The literature search yielded 354 titles and abstracts. After reviewing the extracted literature, 25 publications met the inclusion criteria for this study and 17 of 25 were eventually evaluated in the meta-analysis.

Conclusion

The results of the meta-analysis indicated that the use of a mouthwash that includes anti-inflammatory properties contributes the most to alleviating oral mucositis in patients who are undergoing radiotherapy to treat head and neck cancer.

https://ift.tt/2SC6956

Pharmacokinetics and bioequivalence of generic and branded abiraterone acetate tablet: a single-dose, open-label, and replicate designed study in healthy Chinese male volunteers

Abstract

Purpose

Abiraterone acetate is a highly variable drug and has been approved for the treatment of patients with metastatic castration-resistant prostate cancer in many countries. This study was conducted to compare the pharmacokinetic profile between the test product (abiraterone acetate tablet) and reference product ZYTIGA® (250 mg) mainly.

Methods

To overcome the high intra-subject variability of abiraterone, a two-sequence and four-period crossover study was designed to assess bioequivalence between the two products in 32 healthy male Chinese subjects under fasting conditions. The plasma concentration of abiraterone was analyzed by a validated liquid chromatography tandem mass spectrometry (LC-MS/MS) assay and the reference-scaled procedure was used to determine bioequivalence for the pharmacokinetics parameters.

Results

The point estimate of geometric mean ratios with 90% confidence interval (CI) of maximum observed concentration (C_max) and the area under the concentration–time curve (AUC_0t) for abiraterone in the test and reference products were 100.19% (90% CI 87.05–115.32%) and 105.99% (90% CI 96.34–116.62%), respectively, and were both within the range of 80.00–125.00%. The 95% confidence upper limit bound for \({({\bar {Y}_{\text{T}}} - {\overline {Y} _{\text{R}}})^{\text{2}}}~ - ~\theta S_}}^}{\text{ }}\) was − 0.1079 for C_max and was − 0.0515 for AUC_0t.

Conclusions

Bioequivalence was demonstrated between the two abiraterone acetate products. The study also confirmed high intra-subject variability, for abiraterone: coefficient of variation (CV, %) of C_max values for the test and reference products were 40.33% and 46.58%, while for AUC_0t were 24.02% and 34.16%, respectively.

Trial registration

http://www.chinadrugtrials.org.cn/: CTR20170997.

https://ift.tt/2QkgQfY

Microneedling by dermapen and glycolic acid peel for the treatment of acne scars: Comparative study

Summary

Background

Many methods have been performed to achieve a satisfying outcome in acne scars but some of them were high cost and also were associated with low results and some complications.

Objectives

To evaluate and compare the efficacy and safety therapy of glycolic acid (GA) peel, microneedling with dermapen and a combination of both procedures in treatment of atrophic acne scars.

Patents and methods

This study was conducted on 30 patients suffering from acne scars. They were randomly assigned into three groups, each group included 10 patients; group I was treated with GA peel, group II treated was with microneedling. Group III received a combination of both procedures. All patients received six sessions with 2‐week intervals. The clinical assessment was based on the qualitative global scar grading system before and after treatment, quartile grading scale, and degree of patient satisfaction.

Results

There was a statistically significant decrease in acne scars grade after treatment among the studied groups (P = 0.04) but it was higher in group III. There was improvement in boxcar, ice pick, and rolling scars in all groups, respectively (P = 0.03, P = 0.04, P = 0.04). Patients' satisfaction was higher in group III (P = 0.04).

Conclusion

The combination of dermapen and GA peel is more effective than monotherapy.

https://ift.tt/2zRIDdn

Six years of experience using an advanced algorithm for botulinum toxin application

Summary

Background

Botulinum toxin (BTX) products continue to be widely used for facial rejuvenation. Variables to consider prior to BTX treatment include the anatomical area to be treated, gender, muscle mass, ethnicity, skin thickness, and the effects of aging.

Objective

To describe a treatment algorithm which has been developed for facial rejuvenation to help physicians to easily and systematically customize BTX treatment, and to describe its use in a large number of patients.

Methods and Materials

Prior to treatment, digital images of patients were obtained while relaxed and while forming different facial expressions. This information was used to plan the depth, dose, and location of BTX injections (onabotulinumtoxinA; Botox^®; Allergan, Inc). Dilution was 100 U of BTX to 1 mL 0.9% preserved saline. Injections were performed with 30 U insulin syringes and 30 gauge needles.

Results

The treatment algorithm described here has been used by the author for facial rejuvenation for more than 5 years. It was originally based on published guidelines; however, by carefully noting treatment outcomes, the number and location of injection points and the dose of BTX used have been modified to create the current treatment system.

Conclusion

Published guidelines for the use of BTX are an excellent starting point for clinicians with little experience; however, each practitioner is likely to develop their own algorithm for achieving good facial rejuvenation outcomes.

https://ift.tt/2PvN2YH

Evaluation of oral tranexamic acid in the treatment of melasma

Summary

Background

Melasma is an acquired, chronic, recurrent hypermelanosis that occurs exclusively in areas exposed to the sun. Its treatment can be very challenging. Tranexamic acid (TA) is an inhibitor of plasmin, and it is a synthetic derivative of the amino acid lysine that reversibly blocks binding sites on the plasminogen molecule, inhibiting the plasminogen activator from converting plasminogen to plasmin.

Aims

This study evaluated the efficacy of oral TA in the treatment of melasma in patients from a philanthropic dermatological clinic.

Patients/Methods

This was a monocentric, randomized, double‐blind, controlled clinical trial. Patients with facial melasma were randomly divided into the following two groups: A (TA 250 mg orally twice daily) or B (oral placebo twice daily). Evaluations were performed before and after 12 weeks of treatment with photographs, colorimetry, MELASQoL, and MASI. All patients were instructed to use tinted sunscreen (SPF 50).

Results

Of the 47 patients selected, 37 completed the study, with 20 in group A and 17 in group B; the patients consisted of one male and 36 females, and the mean age was 43.97 years old. Based on the four methods of evaluation, the melasma in 50% of patients in group A improved versus only 5.9% of patients in group B (P < 0.005). There was an improvement according to all evaluation methods in the treatment group. No patient had severe side effects.

Conclusions

We conclude that tranexamic acid was effective in 50% of patients according to four methods of evaluation when compared to the placebo.

https://ift.tt/2PvkVZt

Comparison of intraoral biofilm reduction on silver-coated and silver ion-implanted stainless steel bracket material

Abstract

Purpose

The objective of this in situ study was to quantify the intraoral biofilm reduction on bracket material as a result of different surface modifications using silver ions. In addition to galvanic silver coating and physical vapor deposition (PVD), the plasma immersion ion implantation and deposition (PIIID) procedure was investigated for the first time within an orthodontic application.

Materials and methods

An occlusal splint equipped with differently silver-modified test specimens based on stainless steel bracket material was prepared for a total of 12 periodontally healthy patients and was worn in the mouth for 48 h. The initially formed biofilm was fluorescently stained and a quantitative comparative analysis of biofilm volume, biofilm surface coverage and live/dead distribution of bacteria was performed by confocal laser scanning microscopy (CLSM).

Results

Compared to untreated stainless steel bracket material, the antibacterial effect of the PIIID silver-modified surface was just as significant with regard to reducing the biofilm volume and the surface coverage as the galvanically applied silver layer and the PVD silver coating. Regarding the live/dead distribution, however, the PIIID modification was the only surface that showed a significant increase in the proportion of dead cells compared to untreated bracket material and the galvanic coating.

Conclusions

Orthodontic stainless steel with a silver-modified surface by PIIID procedure showed an effective reduction in the intraoral biofilm formation compared to untreated bracket material, in a similar manner to PVD and galvanic silver coatings applied to the surface. Additionally, the PIIID silver-modified surface has an increased bactericidal effect.

https://ift.tt/2L8ahqZ

Comparison of intraoral biofilm reduction on silver-coated and silver ion-implanted stainless steel bracket material

Abstract

Purpose

The objective of this in situ study was to quantify the intraoral biofilm reduction on bracket material as a result of different surface modifications using silver ions. In addition to galvanic silver coating and physical vapor deposition (PVD), the plasma immersion ion implantation and deposition (PIIID) procedure was investigated for the first time within an orthodontic application.

Materials and methods

An occlusal splint equipped with differently silver-modified test specimens based on stainless steel bracket material was prepared for a total of 12 periodontally healthy patients and was worn in the mouth for 48 h. The initially formed biofilm was fluorescently stained and a quantitative comparative analysis of biofilm volume, biofilm surface coverage and live/dead distribution of bacteria was performed by confocal laser scanning microscopy (CLSM).

Results

Compared to untreated stainless steel bracket material, the antibacterial effect of the PIIID silver-modified surface was just as significant with regard to reducing the biofilm volume and the surface coverage as the galvanically applied silver layer and the PVD silver coating. Regarding the live/dead distribution, however, the PIIID modification was the only surface that showed a significant increase in the proportion of dead cells compared to untreated bracket material and the galvanic coating.

Conclusions

Orthodontic stainless steel with a silver-modified surface by PIIID procedure showed an effective reduction in the intraoral biofilm formation compared to untreated bracket material, in a similar manner to PVD and galvanic silver coatings applied to the surface. Additionally, the PIIID silver-modified surface has an increased bactericidal effect.

https://ift.tt/2L8ahqZ

A Trial to Evaluate the Efficacy of Poziotinib, Pan HER Inhibitor in Recurrent/Metastatic Esophageal Cancer (R/M ESCC)

Condition:   Inoperable or Recurrent or Metastatic Esophageal Squamous Carcinoma
Intervention:   Drug: Treatment with Poziotinib
Sponsor:   Yonsei University
Not yet recruiting

https://ift.tt/2EdtTJ6

Laparoscopic Appendectomy Performed by Junior SUrgeonS: Impact of 3D Visualization on Surgical Outcome

Conditions:   Appendicolith;   Appendicitis;   Appendicitis With Perforation;   Appendicitis Peritonitis;   Appendiceal Abscess;   Appendicitis Acute
Interventions:   Procedure: 3D Laparoscopic Appendectomy;   Procedure: 2D Laparoscopic Appendectomy
Sponsor:   Azienda Ospedaliera Spedali Civili di Brescia
Recruiting

https://ift.tt/2Enj4F2

Targeting neratinib-induced diarrhea with budesonide and colesevelam in a rat model

Abstract

Purpose

Neratinib is an irreversible pan-ErbB tyrosine kinase inhibitor used for the extended adjuvant treatment of early-stage HER2-positive breast cancer. Its use is associated with the development of severe diarrhea in up to 40% of patients in the absence of proactive management. We previously developed a rat model of neratinib-induced diarrhea and found inflammation and anatomical disruption in the ileum and colon. Here we tested whether anti-diarrheal interventions, budesonide and colesevelam, can reduce neratinib-induced diarrhea and intestinal pathology.

Methods

Rats were treated with 50 mg/kg neratinib via oral gavage for 14 or 28 days (total n = 64). Body weight and diarrhea severity were recorded daily. Apoptosis was measured using immunohistochemistry for caspase-3. Inflammation was measured via a multiplex cytokine/chemokine assay. ErbB levels were measured using PCR and Western Blot.

Results

Budesonide co-treatment caused rats to gain significantly less weight than neratinib alone from day 4 of treatment (P = 0.0418). Budesonide (P = 0.027) and colesevelam (P = 0.033) each reduced the amount of days with moderate diarrhea compared to neratinib alone. In the proximal colon, rats treated with neratinib had higher levels of apoptosis compared to controls (P = 0.0035). Budesonide reduced histopathological injury in the proximal (P = 0.0401) and distal colon (P = 0.027) and increased anti-inflammatory IL-4 tissue concentration (ileum; P = 0.0026, colon; P = 0.031) compared to rats treated with neratinib alone. In the distal ileum, while budesonide decreased ErbB1 mRNA expression compared to controls (P = 0.018) (PCR), an increase in total ErbB1 protein was detected (P = 0.0021) (Western Blot).

Conclusion

Both budesonide and colesevelam show potential as effective interventions against neratinib-induced diarrhea.

https://ift.tt/2Pu1boY

Sitagliptin vs. pioglitazone as add-on treatments in patients with uncontrolled type 2 diabetes on the maximal dose of metformin plus sulfonylurea

Abstract

Aims

To compare the efficacy of sitagliptin versus pioglitazone as add-on drugs in patients with poorly controlled diabetes with metformin and sulfonylureas.

Methods

This is a randomized, open-label, parallel assignment clinical trial. Patients who had inadequate glycemic control [7% (53 mmol/mol) ≤ A1C < 11% (97 mmol/mol)] despite a minimum 6-month period of active treatment with metformin 2000 mg/day plus gliclazide 240 mg/day were enrolled in the study. HbA1C, fasting blood glucose (FBG), fasting plasma lipid parameters [total cholesterol (TC0, low-density lipoprotein cholesterol (LDL-C), triglycerides (TG) and high-density lipoprotein cholesterol (HDL-C)], systolic and diastolic blood pressure (SBP, DBP), weight, waist circumference, and body mass index were measured at baseline and after 17, 34, and 52 weeks of treatment. Generalized estimating equation analysis was done to compare treatment groups for continuous efficacy parameters.

Results

No significant difference in HbA1C reduction was observed between the treatment groups during the study course. (P = 0.149, adjusted P = 0.434; coefficient − 0.11 ± 0.08). The FBG (P = 0.032; coefficient 7.44 ± 3.48), HDL-C (P = 0.001; coefficient − 2.69 ± 0.83), TG (P = 0.027; coefficient 12.63 ± 5.71) and SBP (P < 0.001; coefficient 5.43 ± 1.26) changes from baseline, and weight gain were greater in the pioglitazone group. The mean changes in LDL-C and TC from baseline to week 52 were greater in the sitagliptin group (P = 0.034; coefficient − 7.40 ± 3.50, P = 0.013; coefficient − 7.16 ± 2.88, respectively).

Conclusion

Sitagliptin and pioglitazone were equally effective in improvement of HbA1C. There were some differences in terms of lipid indices, weight gain, and SBP. The current study confirmed that both sitagliptin and pioglitazone are effective treatment options and the decision should be made for each individual based on the baseline characteristics.

https://ift.tt/2SCy2KA

Utility of anthropometric indicators to screen for clustered cardiometabolic risk factors in children and adolescents

Journal Name: Journal of Pediatric Endocrinology and Metabolism
Issue: Ahead of print


https://ift.tt/2C1V1ZU

Familial ROBO1 deletion associated with ectopic posterior pituitary, duplication of the pituitary stalk and anterior pituitary hypoplasia

Journal Name: Journal of Pediatric Endocrinology and Metabolism
Issue: Ahead of print


https://ift.tt/2L7lfwX

Correction to: Aromatase inhibitor-induced carpal tunnel syndrome: prevalence in daily practice

The original version of this article unfortunately contained a mistake. The given name and family name were swapped.

https://ift.tt/2L5ezzm