Background
Wound is an anatomical and functional disruption of the skin following an injury. In response to the injury, wound healing is a complex process of tissue repair or remodeling. ...Historically, plants and plant-based constituents have been extensively used for the treatment and management of different types of wounds. In the current times, different types of biopolymers are being researched for developing economical, sustainable, stable, and effective delivery system for the treatment of wounds.
Main text
The present review article attempts to enlist medicinal plants which have been reported to be effective in the treatment of wounds. Plant constituent-based wound dressings have also been discussed systematically including patented formulations reported by different inventors.
Conclusion
The compiled data aims to update the researchers/scientists which will be helpful in providing them a directional view in understanding the role and importance of plant-based components for the treatment and management of wounds.
The intestinal microbiota in allogeneic bone marrow transplant (allo-BMT) recipients modulates graft-versus-host disease (GVHD), a systemic inflammatory state initiated by donor T cells that leads to ...colitis, a key determinant of GVHD severity. Indole or indole derivatives produced by tryptophan metabolism in the intestinal microbiota limit intestinal inflammation caused by diverse stressors, so we tested their capacity to protect against GVHD in murine major histocompatibility complex–mismatched models of allo-BMT. Indole effects were assessed by colonization of allo-BMT recipient mice with tryptophanase positive or negative strains of Escherichia coli, or, alternatively, by exogenous administration of indole-3-carboxaldehyde (ICA), an indole derivative. Treatment with ICA limited gut epithelial damage, reduced transepithelial bacterial translocation, and decreased inflammatory cytokine production, reducing GVHD pathology and GVHD mortality, but did not compromise donor T-cell-mediated graft-versus-leukemia responses. ICA treatment also led to recipient-strain-specific tolerance of engrafted T cells. Transcriptional profiling and gene ontology analysis indicated that ICA administration upregulated genes associated with the type I interferon (IFN1) response, which has been shown to protect against radiation-induced intestinal damage and reduce subsequent GVHD pathology. Accordingly, protective effects of ICA following radiation exposure were abrogated in mice lacking IFN1 signaling. Taken together, these data indicate that indole metabolites produced by the intestinal microbiota act via type I IFNs to limit intestinal inflammation and damage associated with myeloablative chemotherapy or radiation exposure and acute GVHD, but preserve antitumor responses, and may provide a therapeutic option for BMT patients at risk for GVHD.
•Microbiota-derived or orally administered indoles limit GVHD but not graft-versus-leukemia.•Indoles act via IFN1 signaling to protect and repair the mucosal barrier from damage.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Haematopoietic stem-cell transplantation (HSCT) recipients are considered at high risk of poor outcomes after COVID-19 on the basis of their immunosuppressed status, but data from large studies in ...HSCT recipients are lacking. This study describes the characteristics and outcomes of HSCT recipients after developing COVID-19.
In response to the pandemic, the Center for International Blood and Marrow Transplant Research (CIBMTR) implemented a special form for COVID-19-related data capture on March 27, 2020. All patients-irrespective of age, diagnosis, donor type, graft source, or conditioning regimens-were included in the analysis with data cutoff of Aug 12, 2020. The main outcome was overall survival 30 days after a COVID-19 diagnosis. Overall survival probabilities were calculated using Kaplan-Meier estimator. Factors associated with mortality after COVID-19 diagnosis were examined using Cox proportional hazard models.
318 HSCT recipients diagnosed with COVID-19 were reported to the CIBMTR. The median time from HSCT to COVID-19 diagnosis was 17 months (IQR 8-46) for allogeneic HSCT recipients and 23 months (8-51) for autologous HSCT recipients. The median follow-up of survivors was 21 days (IQR 8-41) for allogeneic HSCT recipients and 25 days (12-35) for autologous HSCT recipients. 34 (18%) of 184 allogeneic HSCT recipients were receiving immunosuppression within 6 months of COVID-19 diagnosis. Disease severity was mild in 155 (49%) of 318 patients, while severe disease requiring mechanical ventilation occurred in 45 (14%) of 318 patients-ie, 28 (15%) of 184 allogeneic HSCT recipients and 17 (13%) of 134 autologous HSCT recipients. At 30 days after the diagnosis of COVID-19, overall survival was 68% (95% CI 58-77) for recipients of allogeneic HSCT and 67% (55-78) for recipients of autologous HSCT. Age 50 years or older (hazard ratio 2·53, 95% CI 1·16-5·52; p=0·020); male sex (3·53; 1·44-8·67; p=0·006), and development of COVID-19 within 12 months of transplantation (2·67, 1·33-5·36; p=0·005) were associated with a higher risk of mortality among allogeneic HSCT recipients, and a disease indication of lymphoma was associated with a higher risk of mortality compared with plasma cell disorder or myeloma (2·41, 1·08-5·38; p=0·033) in autologous HSCT recipients.
Recipients of autologous and allogeneic HSCT who develop COVID-19 have poor overall survival. These data emphasise the need for stringent surveillance and aggressive treatment measures in HSCT recipients who develop COVID-19.
American Society of Hematology; Leukemia and Lymphoma Society; National Cancer Institute; National Heart, Lung and Blood Institute; National Institute of Allergy and Infectious Diseases; National Institutes of Health; National Cancer Institute; Health Resources and Services Administration; Office of Naval Research.
By 2030, the US will not have enough neurosurgeons to meet the clinical needs of its citizens. Replacement of neurosurgeons due to attrition can take more than a decade, given the time-intensive ...training process. To identify potential workforce retention targets, the authors sought to identify factors that might impact neurosurgeons' retirement considerations.
The Council of State Neurosurgical Societies surveyed practicing AANS-registered neurosurgeons via email link to an online form with 25 factors that were ranked using a Likert scale of importance regarding retirement from the field (ranging from 1 for not important to 3 for very important). All participants were asked: "If you could afford it, would you retire today?"
A total of 447 of 3200 neurosurgeons (14%) responded; 6% had been in practice for less than 5 years, 19% for 6-15 years, 57% for 16-30 years, and 18% for more than 30 years. Practice types included academic (18%), hospital employed (31%), independent with academic appointment (9%), and full independent practice (39%). The most common practice size was between 2 and 5 physicians (46%), with groups of 10 or more being the next most common (20%). Career satisfaction, income, and the needs of patients were rated as the most important factors keeping neurosurgeons in the workforce. Increasing regulatory burden, decreasing clinical autonomy, and the burden of insurance companies were the highest rated for factors important in considering retirement. Subgroup analysis by career stage, practice size, practice type, and geographic region revealed no significant difference in responses. When considering if they would retire now, 45% of respondents answered "yes." Subgroup analysis revealed that midcareer neurosurgeons (16-25 years in practice) were more likely to respond "yes" than those just entering their careers or in practice for more than 25 years (p = 0.03). This effect was confirmed in multivariate logistic regression (p = 0.04). These surgeons found professional satisfaction (p = 0.001), recertification requirements (p < 0.001), and maintaining high levels of income (p = 0.008) important to maintaining employment within the neurosurgical workforce.
This study demonstrates that midcareer neurosurgeons may benefit from targeted retention efforts. This effort should focus on maximizing professional satisfaction and financial independence, while decreasing the regulatory burden associated with certification and insurance authorization. End-of-career surgeons should be surveyed to determine factors contributing to resilience and persistence within the neurosurgical workforce.
Abstract Background Context Cervical arthroplasty is an increasingly popular alternative for the treatment of cervical radiculopathy and myelopathy. This technique preserves motion at the index and ...adjacent disc levels, avoiding the restraints of fusion and potentially minimizing adjacent segment pathology onset during the postoperative period. Purpose This study aimed to identify all prospective studies reporting adjacent segment pathology rates for cervical arthroplasty. Study Design/Setting Systematic review and meta-analysis were carried out. Patient Sample Studies reporting adjacent segment degeneration (ASDegeneration) and adjacent segment disease (ASDisease) rates in patients who underwent cervical arthroplasty comprised the patient sample. Outcome Measures Outcomes of interest included reported ASDegeneration and ASDisease events after cervical arthroplasty. Methods We conducted a MEDLINE, SCOPUS, and Web of Science search for studies reporting ASDegeneration or ASDisease following cervical arthroplasty. A meta-analysis was performed to calculate effect summary values, 95% confidence intervals (CIs), Q values, and I2 values. Forest plots were constructed for each analysis group. Results Of the 1,891 retrieved articles, 32 met inclusion criteria. The patient incidence of ASDegeneration and ASDisease was 8.3% (95% CI 3.8%–12.7%) and 0.9% (95% CI 0.1%–1.7%), respectively. The rate of ASDegeneration and ASDisease at individual levels was 10.5% (95% CI 6.1%–14.9%) and 0.2% (95% CI −0.1% to 0.5%), respectively. Studies following patients for 12–24 months reported a 5.1% (95% CI 2.1%–8.1%) incidence of ASDegeneration and 0.2% (95% CI 0.1%–0.2%) incidence of ASDisease. Conversely, studies following patients for greater than 24 months reported a 16.6% (5.8%–27.4%) incidence of ASDegeneration and 2.6% (95% CI 1.0%–4.2%) of ASDisease. This identified a statistically significant increase in ASDisease diagnosis with lengthier follow-up. Additionally, 1- and 2-level procedures resulted in a 7.4% (95% CI 3.3%–11.4%) and15.6% (95 CI−9.2% to 40.4%) incidence of ASDegeneration, respectively. Although there was an 8.2% increase in ASDegeneration following 2-level operations (relative to 1-level), it did not reach statistical significance. We were unable to analyze ASDisease incidence following 2-level arthroplasty (too few cases), but 1-level operations resulted in an ASDisease incidence of 0.8% (95% CI 0.1%–1.5%). Conclusions This review represents a comprehensive estimation of the actual incidence of ASDegeneration and ASDisease across a heterogeneous group of surgeons, patients, and arthroplasty techniques. Our investigation should serve as a framework for individual surgeons to understand the impact of various cervical arthroplasty techniques, follow-up duration, and surgical levels on the incidence of ASDegeneration and ASDisease during the postoperative period.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
South Asian gay, bisexual, and other men who have sex with men (GBMSM) in the United States are subsumed under the broad, heterogeneous category of Asian GBMSM in national surveillance systems. ...Disaggregated data on their rates of HIV and sexually transmitted infection (STI) testing are not publicly reported. This is problematic as the diversity of ancestries, cultures, and customs across subgroups of Asian GBMSM may contribute to differential HIV and STI testing experiences. To address this deficit in knowledge, 115 South Asian GBMSM recruited through social media advertising and peer referral were surveyed about their patterns of HIV and STI testing. In the past 6 months, almost two-thirds (n = 72, 62.61%) had two or more male sex partners, and more than a quarter (n = 33, 28.70%) had condomless anal sex with two or more male partners. In the past year, more than one in four (n = 32, 27.83%) had not been tested for HIV, and more than two in five (n = 47, 40.87%) had not been tested for STIs. The prevalence of past-year HIV and STI testing was lower among participants aged ≥35 years and those who had never used pre-exposure prophylaxis. Participants who were partnered were less likely to have been tested for HIV, and those who were born outside the United States were less likely to have been tested for STIs in the past year. Findings highlight gaps in domestic HIV- and STI-prevention efforts with respect to adequately engaging South Asian GBMSM and suggest that some segments of this subgroup may benefit from targeted outreach.
The objective of this study was to assess the applicability of trans-rectal color Doppler ultrasonography for quantification of uterine blood flow in 30 healthy lactating Jersey cows on a weekly ...interval from days 0 to 56 after parturition (day 0). Significantly higher time average mean velocity (TAMEAN), time average maximum velocity (TAMAX) and blood flow volume (BFV-TAMEAN and BFV-TAMAX) in artery ipsilateral to previous gravid uterine horn (PGUH) was found as compared to contralateral middle uterine artery (MUA) on day 0 to 14 postpartum. Similarly, transverse diameter (D) of ipsilateral MUA was significantly higher as compared to contralateral MUA during first two weeks after parturition. Clinical uterine involution completed on day 32.47±0.85 postpartum as demonstrated by B-mode ultrasonography and a significant correlation (r= 0.31–0.44 from day 7–28) between size of PGUH and BFV-TAMAX was found. Also, significant correlation between transverse diameter of ipsilateral (r=0.56–0.80) and contralateral (r=0.51–0.79) MUA-D and BFV-TAMAX was found on different examination days. In conclusion, trans-rectal Doppler ultrasonography was a useful tool to investigate haemodynamic changes whereas PI, RI, Doppler pulse duration and systolic upstroke time were found unsuitable to indagate alterations in uterine perfusion during post-partum period.
The present study was designed for investigation on etiologies of genital prolapse in cattle of Himachal Pradesh. A total of 111 cattle were part of study, 39 were suffering with genital prolapse in ...pregnant, post-partum and non-pregnant stages of gestation while the remaining 72 cows were in normal pregnancy, post-partum and non-pregnant stage. Blood samples were collected for hormonal (cortisol, estrogen and progesterone), minerals (calcium, phosphorus and magnesium) and biochemical (glucose, total protein, triglycerides, urea, cholesterol, SGPT, SGOT) estimations. Mean plasma estradiol-17β elevation was significant (P<0.01) in affected cattle in all three stages (pregnant, postpartum and non-pregnant). Progesterone concentration was significantly (P<0.01) lower in affected cattle in pregnant and post-partum group. Also, significant elevation (P<0.01) was observed in cortisol plasma concentration among affected cattle in non-pregnant and post-partum groups. Calcium and phosphorus concentrations were significantly (P<0.01) lower in affected cattle with genital prolapse as compare to non-affected cattle in non-pregnant, pregnant and post-partum group. Similarly in the category of biochemical in affected pregnant group significant elevations were observed for triglyceride (P<0.01), urea (P<0.01) and SGOT (P<0.05). Post-partum group showed significant (P<0.05) decline in total protein, SGPT and SGOT. Whereas, in non-pregnant group, significant (P<0.05) increase and decrease was observed for urea and cholesterol concentration, respectively for prolapse showing cows. It is concluded that the serum hormones (estradiol and progesterone) and minerals (calcium and phosphorus) concentrations differ significantly between the genital prolapse affected and healthy cattle.
Sickle cell disease (SCD) decreases the oxygen-carrying capacity of red blood cells. Children with SCD have reduced/restricted cerebral blood flow, resulting in neurocognitive deficits. Hydroxyurea ...is the standard treatment for SCD; however, whether hydroxyurea influences such effects is unclear. A key area of SCD-associated neurocognitive impairment is working memory, which is implicated in other cognitive and academic skills. The neural correlates of working memory can be tested using n-back tasks. We analyzed functional magnetic resonance imaging (fMRI) data of patients with SCD (20 hydroxyurea-treated patients and 11 controls, aged 7–18 years) while they performed n-back tasks. Blood-oxygenation level–dependent (BOLD) signals were assessed during working memory processing at 2 time points: before hydroxyurea treatment and ~1 year after treatment was initiated. Neurocognitive measures were also assessed at both time points. Our results suggested that working memory was stable in the treated group. We observed a treatment-by-time interaction in the right cuneus and angular gyrus for the 2- >0-back contrast. Searchlight-pattern classification of the 2 time points of the 2-back tasks identified greater changes in the pattern and magnitude of BOLD signals, especially in the posterior regions of the brain, in the control group than in the treated group. In the control group at 1-year follow-up, 2-back BOLD signals increased across time points in several clusters (e.g., right inferior temporal lobe, right angular gyrus). We hypothesize that these changes resulted from increased cognitive effort during working memory processing in the absence of hydroxyurea. In the treated group, 0- to 2-back BOLD signals in the right angular gyrus and left cuneus increased continuously with increasing working memory load, potentially related to a broader dynamic range in response to task difficulty and cognitive effort. These findings suggest that hydroxyurea treatment helps maintain working memory function in SCD.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Diamond-Blackfan anemia (DBA) is one of the most common inherited causes of bone marrow failure in children. DBA typically presents with isolated erythroid hypoplasia and anemia in infants. ...Congenital anomalies are seen in 50% of the patients. Over time, many patients experience panhematopoietic defects resulting in immunodeficiency and multilineage hematopoietic cytopenias. Additionally, DBA is associated with increased risk of myelodysplastic syndrome, acute myeloid leukemia and solid organ cancers. As a prototypical ribosomopathy, DBA is caused by heterozygous loss-of-function mutations or deletions in over 20 ribosomal protein genes, with
RPS19
being involved in 25% of patients. Corticosteroids are the only effective initial pharmacotherapy offered to transfusion-dependent patients aged 1 year or older. However, despite good initial response, only ~20-30% remain steroid-responsive while the majority of the remaining patients will require life-long red blood cell transfusions. Despite continuous chelation, iron overload and related toxicities pose a significant morbidity problem. Allogeneic hematopoietic cell transplantation (HCT) performed to completely replace the dysfunctional hematopoietic stem and progenitor cells is a curative option associated with potentially uncontrollable risks. Advances in HLA-typing, conditioning regimens, infection management, and graft-versus-host-disease prophylaxis have led to improved transplant outcomes in DBA patients, though survival is suboptimal for adolescents and adults with long transfusion-history and patients lacking well-matched donors. Additionally, many patients lack a suitable donor. To address this gap and to mitigate the risk of graft-versus-host disease, several groups are working towards developing autologous genetic therapies to provide another curative option for DBA patients across the whole age spectrum. In this review, we summarize the results of HCT studies and review advances and potential future directions in hematopoietic stem cell-based therapies for DBA.
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