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Carla Bonifacino

and 3 more

Rice (Oryza sativa) is one of the most frequently produced cereals in the world. Rice bran (RB) is obtained as a by-product in the rice milling process. A part of the RB is used for oil extraction, obtaining defatted rice bran (DRB) as a second by-product. The aim of this work was to analyze the emulsifying properties of soluble proteins fraction present in defatted rice bran concentrate (DRBC) in acidic and neutral conditions. Fine emulsions (prepared by high-speed and ultrasound homogenization) stabilized with soluble proteins obtained from DRBC showed a mean particle size lower than coarse emulsions (prepared by only high-speed homogenization) and a significantly lower degree of overall destabilization. Coarse emulsions showed sigmoidal destabilization profiles at pH 4.5 and 7.0, related to the existence of two populations with different particle sizes. In fine emulsions, both pH provided lower particle sizes and greater stability. After 24 h of quiescent storage, the coarse emulsions showed an increase of particle size that was not observed in fine emulsions. Both types of emulsions showed a Newtonian-type behavior. Fine emulsions showed higher viscosity values and higher lightness than coarse emulsions, consistent with the reduction of particle size and increase in the number of particles. The soluble proteins obtained from a waste of the rice industry can be used to obtain stable fine oil-in-water emulsions in acidic and neutral conditions. This result is of interest since it could be used as a food ingredient, increasing the added value of this important by-product.

Pamela Ny

and 7 more

Background: Patients who survived hospitalization for COVID-19 experienced varying durations of illness but the factors associated with prompt recovery are unknown. This study identifies factors differentiating hospitalized patients who recovered promptly vs. survived a prolonged course of illness due to COVID-19. Methods: This was a retrospective study from March-August 2020 of hospitalized adults with COVID-19 which were grouped based on time to recovery: short (≤ 3 days), intermediate (4-10 days), and prolonged (>10 days). Recovery was defined as resolution of fever, tachypnea, hypotension, extubation and return of mental status at baseline. Multivariate analysis was used to evaluate factors associated with prompt recovery. Results: Among 508 patients hospitalized for COVID-19, 401 (79%) survived. Of those, prompt recovery (within 3 days) was achieved in 43% (174/401) whereas 23% (92/401) recovered after a prolonged period of > 10 days. Overall, median age was 64 y with 73% admitted from home and 25% from a skilled nursing facility. Predictors for prompt recovery upon admission included female sex (OR, 1.8; 95% CI, 1.1-2.7; p = 0.01), no fever (OR, 1.6; 95% CI, 1.1-2.6; p = 0.03), longer time from symptom onset to hospitalization (OR, 1.1; 95% CI, 1.0-1.1; p = 0.001), no supplemental oxygen (OR, 1.9; 95% CI, 1.2-3.0; p = 0.004), no direct ICU admission (OR, 41.7; 95% CI, 2.4-740.4; p = 0.01) and absence of bacterial co-infections (OR, 2.5; 95% CI, 1.5-4.0, p = 0.0003). Conclusions: Our study provides relevant data that could help clinicians triage competing resources in health systems that are challenged by the ebb and flow of COVID-19 cases by identifying clinical features of COVID-19 patients who may require less intensive management including avoidance of unnecessary antibacterial therapy.

Mike Millar

and 2 more

Proposals for SARS-CoV-2 virus vaccination priorities in the UK and in many other countries are heavily influenced by epidemiological models, which use outcome measures such as deaths or hospitalisation. Limiting the values under consideration to those attributable to the direct effects of infection has the advantage of simplifying the models and the process of decision-making. However, the consequences of the pandemic extend beyond outcomes directly attributable to SARS-CoV-2 infection. The alternative to vaccination (in addition the threat of illness and death) is restrictions on educational and work opportunities, access to services, recreational activities, affiliations and relationships with others, freedom of movement (including escaping abusive relationships), and other determinants of human experience. Capability theory gives emphasis to the freedoms that individuals have to express themselves (in doings and beings). Restrictions on freedoms restrict our capabilities. Capability theory has been used to provide a framework for the evaluation and comparison of international development approaches and in the evaluation of public health policy. There is a clustering of disadvantages associated with this pandemic that adds to pre-existing inequalities. Much of the disadvantage engendered in the SARS-CoV-2 pandemic is left out when public health policy is based on a limited range of metrics. Acknowledging the impact of policy across the range of human freedoms at both a national and international level has the potential to improve policy, facilitate the mitigation of direct and indirect adverse consequences, and improve public confidence in vaccine deployment strategies.

Yeşim Ayazöz

and 1 more

Background: Human papilloma virus (HPV) infection is the most common sexually transmitted viral disease. It was aimed to evaluate the knowledge levels and attitudes of medical faculty students about HPV infection and vaccine. Methods: Our descriptive cross-sectional study; was made with the medical faculty students studying at the Harran University Faculty of Medicine in the 2019-2020 academic year. A total of 645 students were reached, excluding those who refused to participate in the study and those who were not at the faculty or hospital for any reason. Data were collected using a questionnaire method. NCSS 2007 program was used for statistical analysis. Results: 645 students were included in this study ( 52.9% (n = 341) is male, 47.1% (n = 304) is female, and average age of them is 21.46 ± 2.39 years). 75.3% of the students stated that they have information about HPV infection. The HPV infection knowledge level scores of the married were higher than the singles (p = 0.005; p <0.01). 51.2% of the students stated that they had knowledge about the HPV vaccine. HPV vaccine knowledge level scores of women were compared to men (p = 0.019; p <0.05); and the scores of married people were also higher than singles (p = 0.016; p <0.05). Only 1.9% of the students had the HPV vaccine. Conclusion: In our study, it was seen that the medical faculty students’ knowledge about HPV infection and vaccine was not sufficient, and the methods that should be used to provide more effective education should be determined. We believe that it will be beneficial to add the HPV vaccine to the national vaccine program in our country.

Müslüm Toptan

and 2 more

Aim: Red eye, a frequent cause of presentations to ophthalmology clinics, is an important indicator of ocular inflammation. Although the prognosis is generally good and self-limiting, it is possible to distinguish possible serious conditions and prevent important situations such as blindness, with detailed examination and correct treatment approach. The purpose of this study was to evaluate patients with red eye presenting to the eye diseases clinic in terms of clinical and sociodemographic characteristics. Material-method: The records of patients presenting to the Şanlıurfa Harran University Hospital Ophthalmology Clinic with red eye were investigated retrospectively. Diseases causing red eye were classified according to the International Classification of Diseases (ICD 10) coding system. Demographic characteristics such as age and sex and clinical findings were examined. Results: A total of 2625 patients, 1775 males (67.61%) and 850 females (32.38%), who presented with red eyes, were evaluated. The incidence of viral conjunctivitis, the most frequently observed condition in patients presenting due to red eye, was 15.08% (n=396). The most common cause of red eye resulting in decreased vision and increased intraocular pressure (IOP) was acute angle closure glaucoma (AACG). The most common symptom was stinging-burning (70.36%), and the most frequent finding was follicular hyperplasia (74.17%). Five hundred and seventy-one (21.75%) patients who applied to the clinic with red eye had previously applied to a family physician and 289 patients (11.0%) to an emergency physician. Conclusion: Although prognosis is usually good in red eye, and the condition is self-limiting, the detection of serious conditions through a detailed history, examination, and therapeutic approach can be enhanced with early and appropriate intervention. In addition to family physicians and emergency physicians, the first to examine patients with red eye, important morbidities such as blindness can also be prevented by increasing the awareness of ophthalmologists and cooperation between these.

Andrew Hughey

and 15 more

Introduction The reuse of cardiac implantable electronic devices may help increase access to these therapies in low- and middle-income countries (LMICs). No published data exist regarding the views of patients and family members in LMICs regarding this practice. Methods and Results A paper questionnaire eliciting attitudes regarding pacemaker reuse was administered to ambulatory adult patients and patients’ family members at outpatient clinics at Centro Nacional Cardiologia in Managua, Nicaragua, Indus Hospital in Karachi, Pakistan, Hospital Carlos Andrade Marín and Hospital Eugenio Espejo in Quito, Ecuador, and American University of Beirut Medical Center in Beirut, Lebanon. There were 945 responses (Nicaragua – 100; Pakistan – 493; Ecuador – 252; Lebanon – 100). A majority of respondents agreed or strongly agreed that they would be willing to accept a reused pacemaker if risks were similar to a new device (707, 75%), if there were a higher risk of device failure compared to a new device (584, 70%), or if there were a higher risk of infection compared to a new device (458, 56%). A large majority would be willing to donate their own pacemaker at the time of their death (884, 96%) or the device of a family member (805, 93%). Respondents who were unable to afford a new device were more likely to be willing to accept a reused device (79% vs. 63%, P<0.001). Conclusions Patients and their family members support the concept of pacemaker reuse for patients who cannot afford new devices.

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Gunter Sturm

and 38 more

Background: There is controversy whether taking β-blockers or ACE inhibitors (ACEI) is a risk factor for more severe systemic insect sting reactions (SSR) and whether it increases the number or severity of adverse events (AE) during venom immunotherapy (VIT). Methods: In this open, prospective, observational, multicenter trial, we recruited patients with a history of a SSR and indication for VIT. The primary objective of this study was to evaluate whether patients taking β-blockers or ACEI show more systemic AE during VIT compared to patients without such treatment. Results: In total, 1,425 patients were enrolled and VIT was performed in 1,342 patients. Of all patients included, 388 (27.2%) took antihypertensive (AHT) drugs (10.4% took β-blockers, 11.9% ACEI, 5.0% β-blockers and ACEI). Only 5.6% of patients under AHT treatment experienced systemic AE during VIT as compared with 7.4% of patients without these drugs (OR: 0.74, 95% CI: 0.43–1.22, p=0.25). The severity of the initial sting reaction was not affected by the intake of β-blockers or ACEI (OR: 1.14, 95% CI: 0.89–1.46, p=0.29). In total, 210 (17.7%) patients were re-stung during VIT and 191 (91.0%) tolerated the sting without systemic symptoms. Of the 19 patients with VIT treatment failure, 4 took β-blockers, none an ACEI. Conclusions: This trial provides robust evidence that taking β-blockers or ACEI does neither increase the frequency of systemic AE during VIT nor aggravate SSR. Moreover, results suggest that these drugs do not impair effectiveness of VIT. (Funded by Medical University of Graz, Austria; Clinicaltrials.gov number, NCT04269629)

Nazanin Kermani

and 12 more

Background. Patients with severe asthma may have a greater risk of dying from COVID-19 disease. Angiotensin converting enzyme-2 (ACE2) and the enzyme proteases, transmembrane protease serine 2 (TMPRSS2) and FURIN, are needed for viral attachment and invasion into host cells. Methods. We examined microarray mRNA expression of ACE2, TMPRSS2 and FURIN in sputum, bronchial brushing and bronchial biopsies of the European U-BIOPRED cohort. Clinical parameters and molecular phenotypes, including asthma severity, sputum inflammatory cells, lung functions, oral corticosteroid (OCS) use, and transcriptomic-associated clusters, were examined in relation to gene expression levels. Results. ACE2 levels were significantly increased in sputum of severe asthma compared to mild-moderate asthma. In multivariate analyses, sputum ACE2 levels were positively associated with OCS use and male gender. Sputum FURIN levels were significantly related to neutrophils (%) and the presence of severe asthma. In bronchial brushing samples, TMPRSS2 levels were positively associated with male gender and body mass index, whereas FURIN levels with male gender and blood neutrophils. In bronchial biopsies, TMPRSS2 levels were positively related to blood neutrophils. The neutrophilic molecular phenotype characterised by high inflammasome activation expressed significantly higher FURIN levels in sputum than the eosinophilic Type 2-high or the pauci-granulocytic oxidative phosphorylation phenotypes. Conclusion. Levels of ACE2 and FURIN may differ by clinical or molecular phenotypes of asthma. Sputum FURIN expression levels were strongly associated with neutrophilic inflammation and with inflammasome activation. This might indicate the potential for a greater morbidity and mortality outcome from SARS-CoV-2 infection in neutrophilic severe asthma.

Xinyi Guan

and 4 more

Fabio Ramponi

and 6 more

Coronary artery and cerebrovascular disease represent a major cause of cardiovascular morbidity and mortality worldwide. Despite technological advancements in percutaneous interventions, surgical revascularization remains the preferred strategy in patients with left main or multivessel disease and in those with complex lesions with high SYNTAX score. As a result, an increasing number of older patients with diffuse atherosclerotic extracoronary disease are referred for coronary artery bypass grafting (CABG). Cerebrovascular complications after isolated coronary surgery occurs in 1-5% of patients; the magnitude of injury ranges from overt neurologic lesions with varying degree of permanent disability to “asymptomatic” cerebral events detected by dedicated neuro-imaging, nevertheless associated with significant long term cognitive and functional decline. Thromboembolic events due to manipulation of an atherosclerotic aorta are universally recognized as the leading etiology of early postoperative stroke following CABG. Coronary bypass surgery performed on an arrested heart relies on considerable aortic instrumentation associated with significant atheroembolic risk especially in older patients presenting with diffuse aortic calcifications. Surgical techniques to deal with a calcified ascending aorta during isolated coronary surgery have evolved over the last forty years. Moving away from aggressive aortic debridement or replacement, surgeons have developed strategies aimed to minimize aortic manipulation: from pump-assisted beating heart surgery with the use of composite grafts to complete avoidance of aortic manipulation with “anaortic” off-pump coronary artery bypass grafting, a safe and effective approach in significantly reducing the risk of intraoperative stroke.

Oktay Ucer

and 3 more

Nada A. Saad

and 3 more

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