Awake fibreoptic intubation (AFOI) is a technique used in patients with difficult airways. This study compares the suitability of remifentanil target-controlled infusion (TCI) to propofol TCI for ...conscious sedation during AFOI in patients with bona fide difficult airways.
We recruited 24, ASA I–III patients, who were undergoing sedation for elective AFOI. Patients were randomized to one of the two groups, Group P (n=10) received propofol TCI and Group R (n=14) received remifentanil TCI. Primary outcome measures were conditions achieved at endoscopy, intubation, and post-intubation, which were graded using scoring systems. Other parameters measured were the endoscopy time, intubation time, and number of attempts at intubation. A postoperative interview was conducted to determine recall of events and level of patient satisfaction.
Endoscopy scores (0–5) and intubation scores (0–5) were significantly different Group P 3 (1–4) vs Group R 1 (0–3) P<0.0001, Group P 3 (2–4) vs Group R 1 (0–3) P<0.0001, respectively; with much better conditions in Group R, endoscopy times and intubation times were also significantly different, being shorter in Group R (P<0.007 and P<0.023, respectively). Patient tolerance of the procedure, judged by the discomfort scores (P<0.004) and the post-intubation scores (P<0.08), was significantly better in Group R. The level of recall for events was higher in Group R. However, there were no significant differences in the patient satisfaction scores.
Remifentanil TCI appears to provide better conditions for AFOI when compared with propofol TCI. The disadvantage of remifentanil in this setting may be a higher incidence of recall.
The present work demonstrated a novel Cleome simplicifolia-mediated green fabrication of nickel oxide nanoparticles (NiO NPs) to explore in vitro toxicity in Bm-17 and Labeo rohita liver cells. ...As-fabricated bioinspired NiO NPs were characterized by several analytical techniques. X-ray diffraction (XRD) revealed a crystalline face-centered-cubic structure. Fourier transform infrared spectroscopy (FTIR), ultraviolet–visible diffuse reflectance spectroscopy (UV-DRS), Raman spectroscopy, and X-ray photoelectron spectroscopy (XPS) confirmed NiO formation. The chemical composition was confirmed by energy-dispersive X-ray spectroscopy (EDS) and X-ray photoelectron spectroscopy. Brunauer–Emmett–Teller (BET) revealed the mesoporous nature. Scanning electron microscopy (SEM) and transmission electron microscopy (TEM) revealed the formation of 97 nm diameter nanospheres formed due to the congregation of 10 nm size particles. Atomic force microscopy (AFM) revealed the nearly isotropic behavior of NiO NPs. Further, a molecular docking study was performed to explore their toxicity by binding with genetic molecules, and it was found that the docking energy was about −9.65284 kcal/mol. On evaluating the in vitro toxicity of NiO NPs for Bm-17 cells, the study showed that when cells were treated with a high concentration of NPs, cells were affected severely by toxicity, while at a lower concentration, cells were affected slightly. Further, on using 50 μg/mL, quick deaths of cells were observed due to the formation of more vacuoles in the cells. The DNA degradation study revealed that NiO NPs are significantly responsible for DNA degradation. For further confirmation, trypan blue assay was observed for cell viability, and morphological assessment was performed using inverted tissue culture microscopy. Further, the cytotoxicity of NiO NPs in L. rohita liver cells was studied. No toxicity was observed at 1 mg/L of NiO NPs; however, when the concentration was 30 and 90 mg/L, dark and shrank hepatic parenchyma was observed. Hence, the main cause of cell lysis is the increased vacuolization in the cells. Thus, the present study suggests that the cytotoxicity induced by NiO NPs could be used in anticancer drugs.
CONTEXT Hepatitis C virus (HCV) infection may resolve (viral clearance), persist
without complications, or cause end-stage liver disease (ESLD). The frequency
and determinants of these outcomes are ...poorly understood. OBJECTIVE To assess the incidence and determinants of viral clearance and ESLD
among persons who acquired HCV infection from injection drug use. DESIGN AND SETTING Community-based prospective cohort study with enrollment in 1988-1989
and a median follow-up of 8.8 years. SUBJECTS A total of 1667 persons aged 17 years or older with a history of injection
drug use and an HCV antibody–positive test result during follow-up. MAIN OUTCOME MEASURES Viral clearance was assessed in a subset of 919 patients and defined
as failure to detect HCV RNA in at least 2 consecutive samples collected 5
or more months apart. End-stage liver disease was assessed at semiannual visits
and by review of medical records and death certificates and defined by the
presence of ascites, esophageal varices, or hepatic encephalopathy, or when
ESLD was stated as a cause of death. RESULTS Viral clearance was observed in 90 persons who were compared with 722
with persistent viremia, while the viremia of 107 was not resolved. Viral
clearance occurred more often in nonblacks (adjusted odds ratio OR, 5.15;
95% confidence interval CI, 2.60-10.17) and those not infected with human
immunodeficiency virus (HIV) (adjusted OR, 2.19; 95% CI, 1.26-3.47). Forty
cases of ESLD were observed throughout follow-up (incidence, 3.1 per 1000
person-years). In a multivariate model, risk of ESLD was higher for persons
aged 38 years or older at enrollment (adjusted relative incidence, 3.67; 95%
CI, 1.96-6.88) and who reported ingestion of more than 260 g of alcohol per
week (adjusted relative incidence, 3.60; 95% CI, 1.73-7.52). Of 210 patients
without ESLD randomly selected for biopsy, only 2 had cirrhosis. CONCLUSIONS Our results indicate that although HCV infection can be self-limited
or associated with ESLD, the majority of adults have persistent viremia without
clinically demonstrable liver disease. Further research is needed to explain
the less frequent clearance of HCV infection among black persons and to improve
utilization of treatment for those infected in the context of injection drug
use.
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In the present study a series of O-substituted pyrazoles 7(a–f) and N-substituted pyrazoles 9(a–f) were synthesized via phase-transfer catalyzed reaction of ethyl ...5-(bromomethyl)-1,3-diphenyl-1H-pyrazole-4-carboxylate 5 with various oxygen and nitrogen containing compounds in presence of tetrabutylammonium bromide (TBAB) in THF. The compound 5 was obtained by the efficient bromination with N-bromosuccinimide (NBS) in presence of a catalytic amount of azoiso-bis-butyro nitrile (AIBN) in refluxing CCl4. The synthesized compounds were evaluated for their in vitro antimicrobial and antidiabetic activity and were compared with standard drugs. Among the synthesized compounds, compound 9b emerged as an excellent antimicrobial and antidiabetic agent. Newly synthesized compounds were characterized by analytical and spectral (IR, 1H NMR, 13C NMR and LC–MS) methods.
Aging and obesity contribute to the initiation and progression of osteoarthritis with little information on their relation to gene expression in joint tissues, particularly the meniscus. Here, we ...test the hypothesis that patient age and body mass index (BMI) correlate with the expression of osteoarthritis- and obesity-related gene signatures in the meniscus.
Meniscus was obtained from patients (N=68) undergoing arthroscopic partial meniscectomy. The mRNA expression of 24 osteoarthritis-related and 4 obesity-related genes in meniscus was assessed by quantitative real-time PCR. The relationship between gene expression and patient age and BMI was analyzed using Spearman's rank-order correlation. Hierarchical cluster dendrogram and heat map were generated to study inter-gene associations.
Age was negatively correlated (P<0.05) with the expression of MMP-1 (r=-0.447), NFκB2 (r=-0.361), NFκBIA (r=-0.312), IκBA (r=-0.308), IL-8 (r=-0.305), ADAMTS-4 (r=-0.294), APLN (apelin) (r=-0.250) and IL-6 (r=-0.244). Similarly, BMI was negatively correlated with the expression of APLN (r=-0.328), ACAN (r=-0.268) and MMP-1 (r=-0.261). After adjusting for the correlation between age and BMI (r=0.310; P=0.008), the only independent effect of BMI on gene expression was for APLN (r=-0.272). However, age had an independent effect on the expression on ADAMTS-4 (r=-0.253), MMP-1 (r=-0.399), IL-8 (r=-0.327), COL1A1 (r=-0.287), NFκBIA (r=-0.278), NFκB2 (r=-0.312) and IκBA (r=-0.299). The gene correlation analysis identified four clusters of potentially relevant genes: transcription factors, matrix-degrading enzymes, cytokines and chemokines, and obesity genes.
Age and BMI were negatively correlated with several osteoarthritis- and obesity-related genes. Although the bulk of these changes appeared to be driven by age, expression of APLN was related to BMI. Inter-gene correlation analysis implicated a common role for strongly correlated genes. Although age-related variations in gene expression appear to be more relevant than obesity-related differences for the role of the meniscus in osteoarthritis development, further investigation into the role of APLN in meniscus and joint health is warranted.
To investigate the transcriptomic differences in chondrocytes obtained from LG/J (large, healer) and SM/J (small, non-healer) murine strains in an attempt to discern the molecular pathways implicated ...in cartilage regeneration and susceptibility to osteoarthritis (OA).
We performed RNA-sequencing on chondrocytes derived from LG/J (n = 16) and SM/J (n = 16) mice. We validated the expression of candidate genes and compared single nucleotide polymorphisms (SNPs) between the two mouse strains. We also examined gene expression of positional candidates for ear pinna regeneration and long bone length quantitative trait loci (QTLs) that display differences in cartilaginous expression.
We observed a distinct genetic heterogeneity between cells derived from LG/J and SM/J mouse strains. We found that gene ontologies representing cell development, cartilage condensation, and regulation of cell differentiation were enriched in LG/J chondrocytes. In contrast, gene ontologies enriched in the SM/J chondrocytes were mainly related to inflammation and degeneration. Moreover, SNP analysis revealed that multiple validated genes vary in sequence between LG/J and SM/J in coding and highly conserved noncoding regions. Finally, we showed that most QTLs have 20–30% of their positional candidates displaying differential expression between the two mouse strains.
While the enrichment of pathways related to cell differentiation, cartilage development and cartilage condensation infers superior healing potential of LG/J strain, the enrichment of pathways related to cytokine production, immune cell activation and inflammation entails greater susceptibility of SM/J strain to OA. These data provide novel insights into chondrocyte transcriptome and aid in identification of the quantitative trait genes and molecular differences underlying the phenotypic differences associated with individual QTLs.
The current study is focused on using tannery waste called buffing dust to remove hexavalent chromium from an aqueous solution. The buffing dust was characterised by using different technique like ...FTIR, SEM, and BET analysis. The adsorption experiment was conducted in batch mode. The different operating factors including contact time, dose and initial Cr (VI) concentration were investigated. The optimum adsorption capacity was observed at contact time of 240 min and dose of 1g/100 mL. The adsorption isotherm such as Langmuir, Freundlich and Temkin were investigated at different initial concentration. It was observed that Langmuir isotherm model was best fitted for present study with maximum adsorption efficiency of 11.33 mg/g. The kinetic study was performed for pseudo first order and pseudo second order and it was found that pseudo second order model was provided the best match with regression coefficient (R2) of 0.9991.
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Hydroxypropyl methyl cellulose, HPMC, a hydrophilic polymer, is widely used for the development of extended release hydrophilic matrices and it is also considered as a good contender for the ...fabrication of 3D printing of matrix tablets. It is often combined with plasticisers to enable extrusion. The aim of the current project was to develop plasticizer-free 3D printed hydrophilic matrices using drug loaded filaments prepared via HME to achieve an in vitro (swelling, erosion and drug release) and in vivo (drug absorption) performance which is analogous to hydrophilic matrix tablets developed through conventional approaches. Additionally, the morphology of the printed tablets was studied using quantitative 3D surface texture studies and the porosity calculated. Filaments were produced successfully and used to produce matrix tablets with acceptable drug loading (95-105%), mechanical and surface texture properties regardless of the employed HPMC grade. The viscosity of HPMC had a discernible impact on the swelling, erosion, HPMC dissolution, drug release and pharmacokinetic findings. The highest viscosity grade (K100M) results in higher degree of swelling, decreased HPMC dissolution, low matrix erosion, decreased drug release and extended drug absorption profile. Overall, this study demonstrated that the drug loaded (glipizide) filaments and matrix tablets of medium to high viscosity grades of HPMC, without the aid of plasticisers, can be successfully prepared. Furthermore, the in vitro and in vivo studies have revealed the successful fabrication of extended release matrices.
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