RESUMEN

Background: Non-alcoholic steatohepatitis (NASH) is a severe medical illness that has few available therapeutic options. Resmetirom, a liver-targeting agonist of the thyroid hormone receptor (THR), has recently been licenced by the FDA. We assess the effectiveness and safety of resmetirom in patients with NASH. Methods: PubMed, SCOPUS and Cochrane Central were searched till March 2024 to find potential articles. Outcomes assessed included MRI-proton density fat fraction (MRI-PDFF), Fat Reduction, and NASH Resolution Without Fibrosis, changes in aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transpeptidase (GGT), low-density lipoprotein (LDL), and triglyceride (TG) levels, along with diarrhoea, nausea, urinary tract infection (UTI), and headache. Subgroup analysis was performed between outcomes before and after 6 months. Outcomes were analyzed with a random-effects model and results presented as mean difference (MD) for continuous outcomes and odds ratios (OR) for safety analysis, along with their 95% confidence intervals. A risk of bias assessment was performed using Cochrane Risk of Bias tool. Results: Four randomized controlled trials (RCTs) were included in our analysis. Resmetirom shown a substantial improvement in MRI-PDFF with a MD of -19.23 (P<0.00001). Additionally, it resulted in a 30% reduction in fat (OR: 3.54, P=0.004) and resolution of NASH without fibrosis (OR: 2.41, P=0.04). There was no notable enhancement observed in AST levels, with a mean difference of -0.87 and a P value of 0.73. The usage of resmetirom resulted in significant improvement in ALT levels (MD: -4.36, P value: 0.32), GGT levels (MD: -17.87, P value: <0.00001), TG levels (MD: -23.48, P value: <0.00001), LDL levels (mean difference: -12.80, P value: <0.00001), and rT3 levels (MD: -2.08, P value: <0.00001). The use of Resmetirom was associated with a higher likelihood of experiencing diarrhoea (OR: 2.07, P<0.0001) and nausea (OR: 1.81, P=0.0003). However, there was no significant difference observed in the occurrence of UTI (OR: 1.04, P=0.85) or headaches (OR: 0.79, P=0.48). Conclusion: Resmetirom demonstrates efficacy in enhancing MRI-PDFF score, diminishing adipose tissue, resolving NASH without fibrosis, reducing GGT, TG, LDL, reverse triiodothyronine (rT3) levels in NASH patients. Nevertheless, there is also an observed heightened susceptibility to experiencing diarrhoea and nausea. Additional trials are necessary to further examine the efficacy and safety of this medication.

RESUMEN

Background: The optimal treatment regimen for patients with Hughes syndrome remains unclear. Therefore, the authors sought to compare the outcomes of warfarin vs. factor Xa inhibitors in patients with Hughes syndrome. Methods: MEDLINE, Embase, and Cochrane Central databases were searched for randomized controlled trials (RCTs) comparing 8 efficacy and safety of warfarin and factor Xa inhibitors in patients with Hughes syndrome. Recurrent thrombosis, all-cause mortality, stroke, adverse reactions, and bleeding were among 10 outcomes of interest. Mantel-Haenszel weighted random-effects model was used to calculate 11 relative risks (RRs) with 95% CIs. Results: The analysis included 625 patients from four RCTs and one post-hoc analysis. Meta-analysis showed a statistically non-significant difference between factor Xa inhibitors and warfarin in the recurrent thrombosis risk (arterial or venous) [RR 2.77 (95%, CI 0.79, 9.65); P=0.11, I2=50%]. Consistent results were revealed among patients with a previous history of arterial thrombosis [RR 2.76 (95% CI 0.93, 8.16); P=0.75, I2=0%], venous thrombosis [RR 1.71 (95% CI 0.60, 4.84); P=0.31, I2=15%] and patients who were triple antiphospholipid antibodies (aPL) positive [RR 4.12 (95% CI 0.46, 37.10); 21 P=0.21, I2=58%]. Factor Xa inhibitors were significantly associated with an increased risk of stroke [RR 8.51 (95% CI 2.35, 13.82); P=0.47, I2=0%]. Conclusion: Factor Xa inhibitors exhibited an increased risk of stroke among patients with Hughes syndrome. In addition, although not significant, the higher RRs among patients on factor Xa inhibitors may indicate a higher risk of thrombotic events associated with factor Xa inhibitors.

RESUMEN

The resiliency of plastic products against microbial degradation in natural environment often creates devastating changes for humans, plants, and animals on the earth's surface. Biodegradation of plastics using indigenous bacteria may serve as a critical approach to overcome this resulting environmental stress. In the present work, a polyethylene degrading bacterium Alcaligenes faecalis strain ISJ128 (Accession No. MK968769) was isolated from partially degraded polyethylene film buried in the soil at plastic waste disposal site. The biodegradation studies were conducted by employing various methods such as hydrophobicity assessment of the strain ISJ128, measurement of viability and total protein content of bacterial biofilm attached to the polyethylene surface. The proliferation of bacterial cells on polyethylene film, as indicated by high growth response in terms of protein content (85.50 µg mL-1) and viability (1010 CFU mL-1), proposed reasonable suitability of our strain A. faecalis ISJ128 toward polyethylene degradation. The results of biodegradation assay revealed significant degradation (10.40%) of polyethylene film within a short period of time (i.e., 60 days), whereas no signs of degradation were seen in control PE film. A. faecalis strain ISJ128 also demonstrated a removal rate of 0.0018 day-1 along with half-life of 462 days. The scanning electron microscope (SEM) and Fourier transform infrared (FTIR) spectroscopy studies not only displayed changes on polyethylene surface but also altered level of intensity of functional groups and an increase in the carbonyl indexes justifying the degradation of polyethylene film due to bacterial activity. In addition, the secondary structure prediction (M fold software) of 16SrDNA proved the stable nature of the bacterial strain, thereby reflecting the profound scope of A. faecalis strain ISJ128 as a potential degrader for the eco-friendly disposal of polyethylene waste. Schematic representation of methodology.

Asunto(s)

Alcaligenes faecalis , Polietileno , Humanos , Animales , Polietileno/química , Polietileno/metabolismo , Alcaligenes faecalis/metabolismo , Biodegradación Ambiental , Bacterias/metabolismo , Biopelículas

RESUMEN

The accelerated population and industrial development have caused an extensive increase in the use of plastic products. Since polyethylene degrades slowly generating poisonous compounds, therefore, elimination of plastic from the environment is the prerequisite requirement today. Biodegradation of plastics seems to be a convenient and effective method to curb this problem. In view of this, the present study focuses on LDPE degradation capability of bacterial strain Pseudomonas aeruginosa ISJ14 (Accession No. MG554742) isolated from waste dump sites. Further, the stability of 16S rDNA of the isolate was determined by applying bioinformatics tools. For biodegradation studies, the polyethylene films were incubated with the culture of P. aeruginosa ISJ14 in two different growth medium namely Bushnell Hass broth (BHM) and Minimal Salt medium (MSM) for 60 days at 37 °C on 180 rpm. In addition, hydrophobicity and viability of bacterial isolate along with quantification of total protein content was also done. The microbial degradation was confirmed by surface modification and formation of fissures on polyethylene surface along with the variation in the intensity of functional groups as well as an increase in the carbonyl index using field emission scanning electron microscopy (Fe-SEM) and Fourier transform infrared spectrophotometry (FTIR). These results indicate that P. aeruginosa strain ISJ14 can prove to be a suitable candidate for LDPE waste treatment without causing any harm to our health or environment.