Paraquat has been recognized as a highly toxic agent for pest removal and is used worldwide. In adults, paraquat poisoning for suicidal attempts is much more common than accidental exposure poisoning. Approximately 20% of patients with paraquat poisoning develop pneumomediastonium as a complication with a mortality rate of approximately 100%. A 19-year-old man patient was admitted to the poisoning emergency department of Khorshid hospital, who had ingested paraquat. He had nausea and vomiting and had normal vital signs and examination in admission. Initial treatment for the patient was done. The patient signs got worsened on the 21 st day of hospitalization and had severe emphysema of the superficial and deep spaces of the neck, followed by bilateral pneumothorax, and severe pneumomediastinum. Unfortunately, the patient died on the 27 th day of hospitalization. Purpose of the current study is to raise awareness of rare paraquat toxicity complications, treatment, and especially its lethal complications, including pneumomomediastonium.
Background Human dental pulp-derived mesenchymal stem cells (hDP-MSCs), which include human dental pulp stem cells (hDPSCs) and stem cells from human exfoliated deciduous teeth (SHEDs), are promising cell sources for regenerative therapies. Nevertheless, a lack of knowledge relating to the mechanisms regulating their differentiation has limited their clinical application. microRNAs (miRNAs) are important regulatory molecules in cellular processes including cell differentiation. This systematic review aims to provide a panel of miRNAs that regulate the differentiation of hDP-MSCs including hDPSCs and SHEDs. Additionally, bioinformatic analyses were conducted to discover target genes, signaling pathways and gene ontologies associated with the identified miRNAs. Methods A literature search was performed in MEDLINE (via PubMed), Web of Science, Scopus, Embase and Cochrane Library. Experimental studies assessing the promotive/suppressive effect of miRNAs on the differentiation of hDP-MSCs and studies evaluating changes to the expression of miRNAs during the differentiation of hDP-MSCs were included. miRNAs involved in odontogenic/osteogenic differentiation were then included in a bioinformatic analysis. A miRNA-mRNA network was constructed, and Gene Ontology and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses were performed. A protein–protein interaction (PPI) network was also constructed. Results Of 766 initially identified records through database searching, 42 and 36 studies were included in qualitative synthesis and bioinformatic analyses, respectively. Thirteen miRNAs promoted and 17 suppressed odontogenic/osteogenic differentiation of hDP-MSCs. hsa-miR-140-5p, hsa-miR-218 and hsa-miR-143 were more frequently reported suppressing the odontogenic/osteogenic differentiation of hDP-MSCs. hsa-miR-221 and hsa-miR-124 promoted and hsa-miR-140-5p inhibited neuronal differentiation, hsa-miR-26a-5p promoted and hsa-miR-424 suppressed angiogenic differentiation, and hsa-miR-135 and hsa-miR-143 inhibited differentiation within myogenic lineages. A miRNA-mRNA network including 1890 nodes and 2171 edges was constructed. KEGG pathway analysis revealed MAPK, PI3K-Akt and FoxO as key signaling pathways involved in the odontogenic/osteogenic differentiation of hDP-MSCs. Conclusions The findings of this systematic review support the potential application of the specific miRNAs to regulate the directed differentiation of hDP-MSCs in the field of regenerative therapies.
Aims: Gastric cancer (GC) represents a global health-care challenge. In recent years, a large number of competing endogenous RNA (ceRNA) network studies have elucidated critical long non-coding RNAs (lncRNAs) as potential prognostic biomarkers in GC. Nevertheless, there is no systematic review and meta-analysis regarding them. Here, we propose a systematic review and meta-analysis for lncRNAs as prognostic biomarkers based on the ceRNA network studies in GC. Main methods: The Web of Science, Embase, PubMed, Scopus, ProQuest and Google Scholar databases were searched to collect eligible ceRNA network studies in which lncRNAs were reported as prognostic biomarkers until 27th June 2022. The pooled hazard ratios (HRs) were assessed to evaluate the prognostic effect of the lncRNAs. Prognostic values of highly reported lncRNAs were also examined. Furthermore, sensitivity analysis, and publication bias were evaluated. Key findings: Totally, 35 studies were included in the systematic review among which 13 studies were eligible for meta-analysis. Pooled examination of HRs based on the univariate and multivariate reports revealed that the expression changes of the lncRNAs correlate with overall survival (OS) of GC patients. Two lncRNAs including CCDC144NL-AS1 and LINC01094 were highly reported as potential prognostic biomarkers based on the ceRNA network studies. Prognostic value of these two lncRNAs was furthermore confirmed by meta-analysis. Significance: Our meta-analysis demonstrated potential application of lncRNAs introduced based on the ceRNA network studies as promising prognostic biomarkers in GC. Further functional studies are needed to elucidate the molecular mechanisms underlying these lncRNAs' functions in GC.
Introduction: Oral health is an important aspect of general health, which affects the wellbeing and quality of life of older adults. Residents in aged care facilities often suffer from overall dental neglect and insufficient oral healthcare, leading to moderate-to-high levels of oral diseases. Furthermore, physical or mental health concerns may result in difficulties in maintaining good oral health. Objectives: This implementation project aims to audit and improve the oral healthcare status of the elderly living in a residential care home in Isfahan, Iran using the JBI evidence summary. Methods: The methods are preimplementation and postimplementation design using audit and feedback with a situational analysis to guide implementation planning. Seven evidence-based quality indicators were used to measure preintervention compliance with the best practice. Situational analysis was used to identify and target barriers through locally developed practice change strategies following which a repeat audit was conducted at 4 months. Four nursing staff, 11 caregivers, and 38 residents were interviewed for both the baseline and the follow-up audit. Results: Compliance rates improved for all seven criteria except the use of a soft-bristled toothbrush (criterion 6). All eight categories of criterion 2 measuring assessment of oral health improved by at least 10%, with the largest improvements in saliva assessment and gingiva assessment. Criterion 1 (oral health training for caregivers) reached the greatest compliance rate (100%). Conclusion: The implemented strategies included improving knowledge and changing the attitudes of the caregivers through organizing educational sessions. These strategies were developed to address process and structural barriers to best practice and were helpful for staff uptake of evidence.
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