Esomeprazole vs pantoprazole effects on cyclosporine levels in kidney transplantation: A randomized clinical trial

Renal allograft survival requires multiple immunosuppressive drugs. This strategy may lead to gastric complications that necessitate gastro‐protective medications, notably, proton pump inhibitors (PPI). This study aimed to compare the influence of pantoprazole and esomeprazole on serum cyclosporine trough levels (C₀) in renal transplant recipients (RTR). A prospective, parallel, open‐label trial was conducted on 47 adult RTR receiving cyclosporine doses adjusted to attain trough concentrations of 100 to 150 μg/L, mycophenolate mofetil (MMF) 750 mg q12 hour and prednisolone at 5 mg daily at Nasser Institute, Cairo, Egypt from January to September 2016. Patients were randomized into the esomeprazole group (25) or pantoprazole group (22) receiving the same dose (40 mg once daily). The study outcomes included clinical signs of rejection and renal function decline, assessed by elevations in serum creatinine, caused by cyclosporine level variations in either of the two study groups. Renal function, C₀ and CBC measurements were measured at baseline and monthly for 6 months. The mean C₀ values were higher in the pantoprazole group than in the esomeprazole group in the sixth month only (P = .007). Serum creatinine level was lower in the sixth month than at baseline in the esomeprazole group (P = .004). There were no signs of rejection biochemical or clinical in any of the study groups. In conclusion, PPIs should be used with caution and doses should be titrated to reach the C₀ targets in RTR, which is of more importance in pantoprazole than esomeprazole to avoid C₀ level elevation or decline affecting the allograft function.     

Breastfeeding and Helicobacter pylori Infection in Early Childhood: a Continuing Dilemma

Objective:

Helicobacter pylori (H. pylori) is the most common chronic bacterial infection in humans. Chronic colonization increases the risk of duodenal ulcer and gastric cancer. The risk factors for acquiring the infection have been extensively studied. However, there are conflicting results on the role of breastfeeding in the prevention of H. pylori infection. We conducted a study to evaluate the effects of breastfeeding on the H. Pylori infection in Kurdish children in Sanandaj, IR Iran.

Methods:

A historical cohort study was carried out from January 2011 through December 2012. Totally 221 children who were going to attain 2 years old during the study period were randomly enrolled. They were divided into two groups, i.e. breastfed and non-breastfed. We used H. pylori stool antigen test to detect infection in the selected group of children after age of 2 years and cessation of breastfeeding. Each group was subdivided into two subgroups, infected and non-infected. The associations of breastfeeding with H. pylori infection was assessed using statistical software.

Findings:

We found no difference in the odds of infection between breastfed and non-breastfed groups (OR=0.809, 95% CI [0.453–1.444]). An association between age and the prevalence of infection was found (P=0.008). There was an increase in the odds of infection as the family size grew (OR=1.93, 95% CI [1.04–3.6]) as well as increasing housing density (OR=2.12, 95% CI [1.10–4.10]).

Conclusion:

The data suggests that breastfeeding in infancy does not protect against H. pylori infection for long duration among studied children in Iran. The protective effects of breastfeeding, if any, are at most transient.     

The β-cyclodextrin-modified nanosized ZSM-5 zeolite as a carrier for curcumin

Herein, the nanosized ZSM-5 zeolite was synthesized based on a fractional factorial experimental design by a hydrothermal method to study the optimum conditions for the synthesis and formation of the ZSM-5 zeolite by employing different conditions. The samples were synthesized without any organic template, and different conditions, such as the molar composition of the synthesis gel and reaction time, were applied in a wide range. Then, the samples were analysed by X-ray diffraction to investigate the formation of the zeolite ZSM-5, and the results were compared to obtain the optimum conditions for its synthesis. The obtained samples were characterized by SEM, FTIR spectroscopy and TGA. Then, the functionalization of nano zeolite ZSM-5 crystals with β-cyclodextrin (β-CD) was investigated. The zeolite surface was first functionalized with amino groups using an amino alkoxysilane. Then, toluene diisocyanate was reacted with the amino-terminated ZSM-5 zeolite crystals and used for the incorporation of β-CD via its remaining isocyanate groups. After this, a drug delivery system (DDS) was prepared based on the cyclodextrin-modified zeolite with the curcumin anticancer drug, and its formation was studied under experimental conditions. The results of in vitro studies show that this drug delivery system has better characteristics than free curcumin in terms of stability and anti-proliferative and anti-inflammatory effects.

Herein, the nanosized ZSM-5 zeolite was synthesized based on a fractional factorial experimental design by a hydrothermal method to study the optimum conditions for the synthesis and formation of the ZSM-5 zeolite by employing different conditions.     

Nanocomposite Electrospun Nanofiber Membranes for Environmental Remediation

Rapid worldwide industrialization and population growth is going to lead to an extensive environmental pollution. Therefore, so many people are currently suffering from the water shortage induced by the respective pollution, as well as poor air quality and a huge fund is wasted in the world each year due to the relevant problems. Environmental remediation necessitates implementation of novel materials and technologies, which are cost and energy efficient. Nanomaterials, with their unique chemical and physical properties, are an optimum solution. Accordingly, there is a strong motivation in seeking nano-based approaches for alleviation of environmental problems in an energy efficient, thereby, inexpensive manner. Thanks to a high porosity and surface area presenting an extraordinary permeability (thereby an energy efficiency) and selectivity, respectively, nanofibrous membranes are a desirable candidate. Their functionality and applicability is even promoted when adopting a nanocomposite strategy. In this case, specific nanofillers, such as metal oxides, carbon nanotubes, precious metals, and smart biological agents, are incorporated either during electrospinning or in the post-processing. Moreover, to meet operational requirements, e.g., to enhance mechanical stability, decrease of pressure drop, etc., nanofibrous membranes are backed by a microfibrous non-woven forming a hybrid membrane. The novel generation of nanocomposite/hybrid nanofibrous membranes can perform extraordinarily well in environmental remediation and control. This reality justifies authoring of this review paper.     

Putty Index for Tripoding

Precise orientation and transfer of the selected path of insertion and removal is a critical step in cast removable partial denture prosthesis design. An easy technique for registering the same is described using addition silicon putty and a used diamond disk.     

Mitochondrial serine protease HTRA2 p.G399S in a kindred with essential tremor and Parkinson disease

Essential tremor is one of the most frequent movement disorders of humans and can be associated with substantial disability. Some but not all persons with essential tremor develop signs of Parkinson disease, and the relationship between the conditions has not been clear. In a six-generation consanguineous Turkish kindred with both essential tremor and Parkinson disease, we carried out whole exome sequencing and pedigree analysis, identifying HTRA2 p.G399S as the allele likely responsible for both conditions. Essential tremor was present in persons either heterozygous or homozygous for this allele. Homozygosity was associated with earlier age at onset of tremor (P < 0.0001), more severe postural tremor (P < 0.0001), and more severe kinetic tremor (P = 0.0019). Homozygotes, but not heterozygotes, developed Parkinson signs in the middle age. Among population controls from the same Anatolian region as the family, frequency of HTRA2 p.G399S was 0.0027, slightly lower than other populations. HTRA2 encodes a mitochondrial serine protease. Loss of function of HtrA2 was previously shown to lead to parkinsonian features in motor neuron degeneration (mnd2) mice. HTRA2 p.G399S was previously shown to lead to mitochondrial dysfunction, altered mitochondrial morphology, and decreased protease activity, but epidemiologic studies of an association between HTRA2 and Parkinson disease yielded conflicting results. Our results suggest that in some families, HTRA2 p.G399S is responsible for hereditary essential tremor and that homozygotes for this allele develop Parkinson disease. This hypothesis has implications for understanding the pathogenesis of essential tremor and its relationship to Parkinson disease.Essential tremor is one of the most frequent movement disorders in humans (1). It is characterized primarily by postural or kinetic tremor of the arms and hands, but head, legs, voice, and other regions of the body may also be affected (2). The worldwide prevalence is 0.9%, increasing to more than 4% in elderly populations (1). Familial essential tremor is genetically heterogeneous. Genetic linkage studies of multiply affected families revealed three genomic regions segregating with the condition, on chromosomes 3q13 [ETM1; Online Mendelian Inheritance in Man (OMIM) 190300], 2p22-24 (ETM2; OMIM 602134), and 6p23 (ETM3; OMIM 611456) (3–5). No clearly causal mutations have been identified in these regions, although the common variant DRD3 p.S9G in the ETM1 region has been proposed as a risk factor and HS1BP3 p.A265G in the ETM2 region appeared in two multiply affected families (6, 7). Genomewide association studies of essential tremor reported associations with common variants in an intron of LINGO1 and in an intron of SLC1A2 (8–10). Recently, DNAJC13 p.N855S, which had been identified in Parkinson disease patients, was also found in two unrelated patients with essential tremor (11). Nonsense mutation p.Q290X in the RNA-binding protein FUS was identified by whole exome sequencing in a large family with essential tremor (ETM4; OMIM 614782) (12). Screening other subjects with essential tremor for FUS revealed two rare missense variants, suggesting that mutations in FUS explain a subset of cases with the condition (13, 14).In this study, we examined a six-generation family segregating essential tremor, and in multiple relatives, essential tremor as a feature of Parkinson disease. We carried out whole exome sequencing of genomic DNA from three severely affected family members and subsequent pedigree analysis to identify the genetic basis of essential tremor and Parkinson disease in the family.