RESUMEN
INTRODUCTION: Evidence is emerging that paracetamol is a safe and effective alternative therapy for haemodynamically significant patent ductus arteriosus (hsPDA). Although there is no consensus opinion on its routine use for PDA in preterm infants, paracetamol is being used increasingly in many centres to treat hsPDA. OBJECTIVE: We conducted a national survey to review the current practice in the UK and the prevalence of paracetamol use for hsPDA closure in preterm infants. METHOD: A web-based and telephone survey on the use of paracetamol for hsPDA closure in preterm infants was conducted. All neonatal intensive care and local neonatal units across the UK were contacted between May and August 2018. RESULTS: 98% (143/146) neonatal units responded. The first-line medication for hsPDA closure was ibuprofen in 92% (131/143) units. 33% (47/143) of units used paracetamol; three units used it as first-line. The dose and duration of paracetamol varied greatly among the units with a dose of 15 mg/kg 6 hourly in 62% (29/47) units and a duration of 3 and 5 days in 33% (14/42) and 31% (13/42) of units, respectively. 44% (19/43) of units did routine blood investigations using paracetamol for monitoring patients on treatment and 21% (9/43) took paracetamol level in addition to other tests. CONCLUSION: 33% of the neonatal units across the UK offered paracetamol to treat hsPDA in preterm infants. Currently, there is a variation in practice regarding the dose, duration of paracetamol and monitoring of infants during its use for hsPDA closure. One strategy would be to develop national guidance once strong evidence is established to support its routine use for hsPDA in preterm infants.
Asunto(s)
Acetaminofén , Conducto Arterioso Permeable , Acetaminofén/uso terapéutico , Conducto Arterioso Permeable/tratamiento farmacológico , Humanos , Ibuprofeno/uso terapéutico , Lactante , Recién Nacido , Recien Nacido Prematuro , Reino UnidoRESUMEN
BACKGROUND: Obesity is a chronic non-communicable disease that affects a lot of people worldwide. Current management strategies for obesity include dietary management, physical exercises and pharmacological agents but sustenance of weight loss is still a problem. Perilipin 1 is a lipid droplet protein that is involved in lipolysis in adipose tissue. Perilipin 1 degradation or knock-out is associated with leanness. AIM: The aim of this study is to use computational servers and software to predict the 3D structure of perilipin 1 and predict potential inhibitors to be used as treatment of obesity. MATERIALS AND METHODS: The 3D structure of perilipin 1 was predicted by I-TASSER server. ZINC database was used to obtain potential inhibitors for perilipin 1. Docking of potential inhibitors was done using Molegro Virtual Docker. RESULTS: The predicted 3D structure of perilipin 1 had a high confidence score reflecting the reliability of the obtained structure. 4-Nitrophenyl 2,3,4-Tri-O-levulinoyl-α-D-mannopyranoside showed a high reliable docking score suggesting its potential action as perilipin 1 inhibitor. CONCLUSIONS: This study shows that 4-Nitrophenyl 2,3,4-Tri-O-levulinoyl-α-D-mannopyranoside can be used as an inhibitor for perilipin 1 and a potential treatment for obesity.