Sodium polystyrene sulfonate (Kayexalate) or its analog calcium polystyrene sulfonate (Kalimate) has long been used to treat hyperkalemia in patients with chronic kidney disease (CKD). Although the side effect was rare, there were many case reports in the literature. Its etiology remains unclear. Lillemoe et al., on five uremic patients who developed catastrophic colonic necrosis that was temporally associated with the use of Kayexalate in sorbitol, contributed to death in four of their patients. They further provided experimental evidence implicating sorbitol as the agent responsible for colonic necrosis in a rat model. In contrast to the results of aforementioned animal study, Ayoub et al., published another experimental study in rats, they demonstrated that sodium polystyrene sulfonate (SPS), not sorbitol, was the main culprit for colonic necrosis. Recently, we encountered three patients who had hyperkalemia and were on Kalimate in water. They underwent colonic and gastric biopsy because of developing gastrointestinal symptoms. Kalimate crystals were found in all biopsy specimen, admixed with inflammatory exudate, or standing along on the mucosa surface, without provoking inflammatory reaction. We reviewed the photographs in the published case reports, they were similar to ours. Therefore, we felt that those crystals were bystanders, not the culprits. We fell that SPS ion-exchange resins, if given in water, appears to be clinically effective and reasonably safe to treat hyperkalemia in patients with CKD.
Gallic acid produces hepatoprotection by modulating EGFR expression and phosphorylation in induced preneoplastic liver foci in rats
The purpose of this study was to analyze the role of gallic acid as liver protector and identify its role in the regulation of EGFR expression and phosphorylation in induced preneoplastic liver lesions in rats. Male Wistar rats were randomly divided into four groups. (1) Control; (2) animals receiving gallic acid (AG) 50 mg/kg v.o. for 8 weeks; (3) animals with preneoplasia (P) induced by a single dose of diethylnitrosamine 200 mg/kg i.p. (DEN) and two weeks after a single dose of carbon tetrachloride 2 mL/kg i.p. (CCl4); and (4) animals with preneoplasia treated with GA during 8 weeks. In order to evaluate GA hepatoprotection on preneoplastic lesions, we performed histological examination of liver tissue using H&E staining as well as an immunohistochemical analysis for PCNA. To evaluate the effect of GA on EGFR expression and phosphorylation, we performed an immunohistochemical and western blot analysis. The results indicated that GA significantly decreased EGFR expression and pY1068 EGFR phosphorylation in animals with preneoplastic lesions. GA significantly decreased PCNA expression in animals with preneoplastic lesions, suggesting it may work as an antiproliferative agent. Additionally, GA improved the architecture and organization of liver tissue and significantly decreased serum AST, ALT and FA, which are indicators of hepatocellular damage. By histopathological and immunohistochemical analysis we demonstrated an improvement in liver morphology, a reduction of preneoplastic liver foci and a reduction of cell proliferation, as well as an improvement on liver functionality. In conclusion, GA produces hepatoprotection by modulating EGFR expression and phosphorylation in preneoplastic lesions.
Effectiveness and safety of glecaprevir and pibrentasvir for hemodialysis patients with hepatitis C virus infection at a single center
Background/Aims: Glecaprevir/pibrentasvir (GLE/PIB) is a pan-genotypic regimen for the treatment of hepatitis B virus (HCV) infection. GLE and PIB are direct acting antiviral (DAA) agents that can be used for patients with chronic renal failure who are on hemodialysis (HD) and those with HCV genotype 2 infections. Here, we report the usefulness and safety of GLE/PIB in 13 hemodialysis (HD) patients with HCV infection. Material and Methods: The subjects comprised patients with genotype 1 and 2 (six each) and one unknown genotype patient in whom GLE/PIB therapy was introduced by December 2018. The mean age was 69.2 (59-78) years (seven men and six women). The mean HCV RNA amount prior to treatment initiation was 4.81 (2.1-6.5). The administration periods were 8 and 12 weeks (n = 9 and 4, respectively). Results: Twelve patients received all the doses orally while an increase in total bilirubin (T-BIL) caused administration to be discontinued in one patient. HCV RNA at week 4 after treatment initiation became undetectable in 11 (91.6%) of the 12 patients. All patients achieved rapid viral response (RVR). Concerning adverse effects, although itching occurred in three (25%) patients, the symptom improved following administration of oral medication and the treatment was able to be continued. Conclusion: The results suggest that GLE/PIB can also be safely administered to HD patients. However, the usefulness and safety need to be further studied by examining more cases.
FORMULATION AND EVALUATION OF WOUND HEALING ACTIVITY OF ALOE VERA LEAF EXTRACT ALONG WITH CURCUMA LONGA EXTRACT-BASED GEL
Wounds result in functional disruption of living tissues. Herbs and their extracts have potential to regenerate damage skin. Purpose of this study was to evaluate the wound healing activity of aloe vera leaf extract in combination with curcuma longa extract. Both herbs possess anti-inflammatory and antibacterial properties. Gel-I and Gel-II were formulated using Carbopol 940, 3%w/w aloe vera leaf extract, 1 and 3%w/w curcuma longa extracts respectively and were applied on excision and incision wounds created on albino rabbits. Animals were divided into four groups having six animals, group-I was control, group-II received standard gel (Nitrofurazone), group-III received Gel-I, group-IV received Gel-II. Gels were evaluated for color, pH, clarity, viscosity, consistency, spreadability, extrudability, skin irritation test and stability studies. Gels were applied on excision wound once a day for 12 days. Wound treated with Gel-II showed better healing activity and greater percentage of wound contraction (p
Peptic ulcer disease (PUD) is one of the most common gastroduodenal disorders. Its prevalence has been decreasing over recent years. It has multiple complications, one of which is the life-threatening perforation. The latter usually present in a dramatic clinical picture and often necessitate an emergent surgical approach. A silent gastric perforation, however, is one of the rare conditions in the clinical practice which makes the diagnosis more challenging. We describe a case of silent perforated peptic ulcer complicated with septic shock and treated by surgery. This report highlights the wide spectrum of the clinical presentations of the peptic ulcer disease.
Archives information resources are the first-hand data and original records for recording and responding to emergencies. They play an important role in the emergency decision-making of emergencies. Strengthening the development of emergency archives information resources is an important way to improve emergency decision-making ability. The article takes the development of archives information resources for earthquake disasters in Sichuan Province as an example, conducts research on the development of archives information resources, and conducts case analysis to point out the current problems and optimization ideas.
Objective: to report the process of implementation of educational actions in the subject of human communication health and speech therapy for professionals working in the Hospital Network of Pernambuco. Methods: This is an experience report developed after approval of the ethics committee in partnership with the State Nucleus of Telehealth of the Health Secretariat of Pernambuco. The methodological route for implantation consisted of four stages namely: 1- Technical analysis of the videoconference points 2-videoconferencing offer; 3- Evaluation of satisfaction by the target audience. Results: To date, two videoconferences have been carried out out of a total of four planned. Four State Hospital Hospitals participated in the sessions. At the events, 23 professionals participated, with an average training time of 17.86 years and who had been following up for approximately five years. The vast majority (95%) reported being satisfied with the proposal, 100% reported satisfaction with the topic addressed, with the material made available and with the technical quality and infrastructure. All said that the topics covered were important in their work process and that they would use the knowledge in their daily work. Unanimously, professionals said that the proposal should continue and that they participated in other projects in the same format. Conclusion: It is verified that the actions of permanent education mediated by information and communication technologies contribute in the professional qualification process of speech-language pathologists assisting in the clinical decision-making and in the support to integral health care of human communication.
Introduction. Kabuki syndrome is a rare congenital anomaly characterized by defects craniofacial, intellectual and cardiac. It has a clinical diagnosis and its main phenotypic characteristic observed is the facial dysmorphia, very similar to the makeup used by the Japanese theater actors Kabuki. This review aims to describe the characteristics of Kabuki Syndrome and its main implications. Methodology. A literature review was conducted with research on the following databases: PubMED, BVS and SCIELO. Five scientific papers and two dissertations were selected. Results. It is believed that the disease is related to a mutation of the MLL2 gene, which is responsible for coding the group of Tritorax proteins, which have as their main regular function and genetic expression. Conclusion. This disease is still poorly understood in the health not having a clarity about their phenotypic / genotypic relationship needing further studies on the subject.
Objective: To apply a health education action on the empty nest syndrome (SNV), verify its applicability in the quilombola community, as well as its peculiarities. Methodology: Conversation wheels were held in a quilombola community in the state of Alagoas, with a simplified approach taking into account the community’s lack and social inequality, using theatrical presentations, with the purpose of informing about the pathology, considering its signs and manifestations. Results: This action demonstrated in a population that is located in a quilombola community, distant from the city, making education, health and assistance very limited, so that it can lead to health education, it was very rewarding, where it was possible to pass the scientific knowledge and be able to enrich us with the knowledge of this community. Conclusion: It was notorious that the community understood and was told to identify themselves with the information about SNV. Considering the observations after the activities were carried out, the importance of health education in this community became evident, since, because it is a community far from society, with the media very limited, they are not aware of the news outside the community. It is evident that the Empty Nest Syndrome is a psychic and social problem. It is then the emergence of new strategies of care that can provide psychic and social support to this community, making it possible to avoid the loss of functionality and social isolation, factors prone to triggering suffering.
Introduction: Aase-Smith syndrome is a rare genetic disease characterized by anemia and skeletal deformities. The age at the start of symptoms is since birth and it´s commom in both sexes. * Show the syndrome problem in individuals, their clinical and behavioral characteristics. Contribute to a better understanding of the Aase Syndrome with syndromes that lead to similar symptoms. Methodology: This literature review on the syndrome was performed with research of information in published scientific articles. Result: Analyzed some common and rare symptoms, reports of observed cases of Aase-Smith syndrome, jointly with their respective symptoms and other syndromes, in addition whit the authors’ arguments in their articles that interpose, for example, about the genetic inheritance of the syndrome is dominant or recessive. Conclusion: The relationship between Aase syndrome and congenital hypoplasia anemia is not fully understood by the scientists and the syndrome represents a challenge in the approach to treatment, since this syndrome has no cure and does not present a standard treatment approach.