Rebamipide potentially mitigates methotrexate-induced nephrotoxicity via inhibition of oxidative stress and inflammation: A molecular and histochemical study

Methotrexate (MTX) is a widely used chemotherapeutic agent; nevertheless, the nephrotoxicity associated with its use has limited its clinical use. Rebamipide (REB) is a gastro-protective agent with diverse promising biological activities. Here, we investigated the renoprotective effects of REB against MTX-induced nephrotoxicity in rats. Male Wistar rats were allocated into four groups: the normal control group, the REB group (100 mg kg⁻¹ day⁻¹, PO, for 12 days), the MTX group (which received a single injection of 20 mg/kg, ip), and the REB + MTX group (which received 100 mg kg⁻¹ day⁻¹ REB for 7 days before and 5 days after being injected with 20 mg/kg MTX). Interestingly, MTX triggered kidney injury, characterized by renal dysfunction along with histopathological alterations. Moreover, increased reactive oxygen species level and inflammatory response were detected in the kidney of MTX-treated rats. However, REB prevented MTX-induced oxidative kidney injury and boosted an antioxidant balance. Mechanistically, REB markedly activated the NRF-2 protein and upregulated the expression of both SIRT-1 and FOXO-3 genes. Additionally, REB administration strongly inhibited the inflammatory response by downregulating both NF-κB-p65 and TLR-4. Finally, the coadministration of REB and MTX activated the mTOR/PI3K/AKT signaling pathway. Simultaneously, REB treatment attenuated the reduction in glomerular size, the widening of the capsular spaces, and the tubular cell damage due to MTX administration. Taken together, these results indicate the potential of REB as adjuvant therapy to prevent nephrotoxicity in patients receiving MTX treatment.     

Susceptibility of Acanthamoeba to multipurpose lens-cleaning solutions

The present study investigated the susceptibility of Acanthamoeba spp. trophozoites to two multipurpose systems for cleaning and maintenance of contact lenses. Three strains of trophozoites from the ATCC (A. castellani T4, A. castellani Neff, and A. polyphaga) and two Acanthamoeba isolates obtained from swimming pools (PT5 and PO1) were placed in monoxenic culture. To test their survival in cleaning solutions for contact lenses, the trophozoites were exposed for 4 and 24 h to two multipurpose solutions (A and B), and were then inoculated into a new monoxenic culture. Amoebic growth on the plates was observed after 72 h of incubation. Trophozoites from all three ATCC strains and one isolate from a swimming pool (PO1) grew in all plates after 4 h of exposure to solutions A and B. After 24 h, the ATCC strains and the PO1 isolate showed growth in most of the plates treated. Only the PT5 isolate showed susceptibility to both solutions over the time intervals tested. The two solutions were not completely effective against most strains and isolates over the time intervals tested. These results are important, since species of Acanthamoeba are widely distributed in the environment and are potential agents of eye pathologies.     

Clinical Presentation and Management of Severe Acute Renal Failure in McArdle Disease

McArdle disease, also known as glycogen storage disease type V, is an autosomal recessive disease due to the absence of myophosphorylase activity, leading to the complete disruption of glycogen breakdown in muscles. We present a rare case of a Caucasian male, aged 26 years, who developed rhabdomyolysis-induced acute renal failure and uremic encephalopathy. Neurological examination and histopathological studies supported the diagnosis of McArdle disease. The severity of his symptoms necessitated urgent hemodialysis, upon which the patient reported improvement in status. Acute renal failure in McArdle disease usually resolves with supportive treatment and maintenance of regular physical activity. Nevertheless, in more severe cases, intensive care with urgent hemodialysis may be needed. A multidisciplinary approach is necessary for the adequate management of similar cases.     

Use of nanohybrid nanomaterials in water treatment: highly efficient removal of ranitidine

Entire elimination of pharmaceutical drugs from waste- and domestic-waters has attracted great attention due to their potent adverse effects on human health, particularly the human immune system. Many risks have been related to the presence of different types of drugs at different concentrations in wastewater. These risks include antimicrobial resistance (AMR), endocrine action, hormonal activation of cancers, and photodegradation of drugs. In this study, new nanohybrid materials consisting of graphene oxide (GO) and oxidized carbon nanotubes (OCNTs) were developed to remove a well-known drug, namely, ranitidine that treats stomach ulcers and gastrointestinal (GI) reflux disease from aqueous solutions. The characterization of synthesized nanohybrid GO-OCNTs was performed using spectroscopic (FTIR, and XRD), thermogravimetric (TGA) and microscopic (SEM) techniques. Batch adsorption experiments were used to investigate the technical feasibility of using synthesized GO-OCNTs for the removal of ranitidine from aqueous solutions. The effects of different operating conditions such as contact time, nanohybrid mass, solution temperature, solution pH, % crosslinking agent, and GO-to-OCNT ratio on the entire elimination of ranitidine were investigated. The experimental results indicated that the removal of ranitidine was very efficient, where 98.3% removal of the drug from aqueous solutions was achieved with a drug uptake of 97.8 mg g⁻¹. Moreover, the results indicated the optimum conditions for the removal of ranitidine, which are as follows: contact time = 140 minutes, nanohybrid GO-OCNT mass = 10 mg, solution temperature = 290 K, solution pH = 6.4, % crosslinking agent = 0.5%, and GO to O-CNT ratio = 1 : 4. The equilibrium data were fitted to different adsorption isotherms and Langmuir was found to best describe our data. Dynamic studies demonstrated that ranitidine adsorption followed pseudo-second order, and the thermodynamic parameters confirmed exothermic drug adsorption as well as the physisorption process.

Entire elimination of pharmaceutical drugs from waste- and domestic-waters has attracted great attention due to their potent adverse effects on human health, particularly the human immune system.     

Should physicians have facial piercings?

OBJECTIVE: The objective of this study was to assess attitudes of patrons and medical school faculty about physicians with nontraditional facial piercings. We also examined whether a piercing affected the perceived competency and trustworthiness of physicians. DESIGN: Survey. SETTING: Teaching hospital in the southeastern United States. PARTICIPANTS: Emergency department patrons and medical school faculty physicians. INTERVENTIONS: First, patrons were shown photographs of models with a nontraditional piercing and asked about the appropriateness for a physician or medical student. In the second phase, patrons blinded to the purpose of the study were shown identical photographs of physician models with or without piercings and asked about competency and trustworthiness. The third phase was an assessment of attitudes of faculty regarding piercings. MEASUREMENTS AND MAIN RESULTS: Nose and lip piercings were felt to be appropriate for a physician by 24% and 22% of patrons, respectively. Perceived competency and trustworthiness of models with these types of piercings were also negatively affected. An earring in a male was felt to be appropriate by 35% of patrons, but an earring on male models did not negatively affect perceived competency or trustworthiness. Nose and eyebrow piercings were felt to be appropriate by only 7% and 5% of faculty physicians and working with a physician or student with a nose or eyebrow piercing would bother 58% and 59% of faculty, respectively. An ear piercing in a male was felt to be appropriate by 20% of faculty, and 25% stated it would bother them to work with a male physician or student with an ear piercing. CONCLUSIONS: Many patrons and physicians feel that some types of nontraditional piercings are inappropriate attire for physicians, and some piercings negatively affect perceived competency and trustworthiness. Health care providers should understand that attire may affect a patient's opinion about their abilities and possibly erode confidence in them as a clinician.