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An Integrative Review of the Absorption of FDA-Approved Chemical Sunscreen Filters Into the Blood
Get PDFIntroduction: This integrative review examines the absorption of FDA-approved chemical sunscreen filters, specifically avobenzone and oxybenzone, into the bloodstream. The study aims to compare the levels of absorption and potential health effects of systemic exposure to these sunscreen ingredients in the United States.
Methods: The researchers conducted a literature search of 57 articles, of which 15 were used for the review. Inclusion criteria focused on studies discussing absorption levels of avobenzone and oxybenzone, as well as methods of absorption into the bloodstream. Exclusion criteria included sunscreen ingredients not approved in the United States, non-English studies, and studies on methods to determine absorption rather than actual absorption data.
Results: The results show that avobenzone can reach a plasma concentration of 7.1 ng/ml after a single application to 75% of the body surface and may be a potential endocrine disruptor. Oxybenzone can reach a plasma concentration of 258.1 ng/ml after a single application to 75% of the body surface and may promote lung cancer metastasis.
Conclusions: The review suggests that oxybenzone shows higher concentrations in plasma compared to avobenzone and has more potential health risks. Both avobenzone and oxybenzone exceeded the FDA safety threshold of 0.5 ng/ml following a 75% full-body application every 2 hours for 8 hours. This data indicates that FDA guidelines regarding systemic exposure to chemical UV filters may need to be altered, or alternative sunscreen agents should be encouraged for use.The authors emphasize the need for more studies and trials on the potential health effects of these ingredients, as avobenzone and oxybenzone are the two sunscreen UV filters with the most research, while many other approved filters have little to no research on their absorption levels and health impacts
Case Report: Diverticulitis Involving a Meckel’s Diverticulum
Get PDFWe report a case of a 65-year-old female who presented with abdominal pain and was diagnosed with diverticulitis involving a Meckel‘s Diverticulum. The differential diagnosis of abdominal pain is vast, in this age group includes, but is not limited to appendicitis, diverticulitis, cholecystitis, and small bowel obstruction. In the absence of complicated features, conservative management with oral antibiotics and close outpatient follow is advised. However, in the case of complicated diverticulitis and a rare manifestation such as a Meckel’s Diverticulum, careful management is indicated
Colorblind Racial Attitudes and Emotion Dysregulation: Impact on White People’s Ethnocultural Empathy and Feelings towards People of Color
Get PDFColorblind racial attitudes, which minimize the importance of race, have been identified as a barrier to understanding systemic racism and fostering empathy towards people of color (POC). This study aimed to examine the relationship between emotion dysregulation and White people\u27s ethnocultural empathy and warmth towards people of color, and to explore the potential moderating role of colorblind racial attitudes.
The study utilized data from 511 White participants (ages 19-50) who completed the Difficulties in Emotion Regulation Scale (DERS), Colorblind Racial Attitudes Scale (CoBRAS), Scale of Ethnocultural Empathy (SEE), and a feeling thermometer scale measuring warmth towards POC. Participants were categorized into upper, middle, and lower quartiles based on CoBRAS scores. Moderation analyses were conducted using the PROCESS macro for SPSS.
Higher colorblind racial attitudes were associated with lower ethnocultural empathy (b = -0.8297, p \u3c 0.0001) and warmth towards POC (b = -13.7, p \u3c 0.0001). Contrary to predictions, lower attitudes demonstrated a negative correlation between emotion dysregulation and ethnocultural empathy. However, lower colorblind attitudes exhibited higher empathy and warmth compared to those with higher colorblind attitudes when emotion dysregulation was held constant. The interaction between emotion dysregulation and colorblind racial attitudes did not significantly impact ethnocultural empathy or warmth towards POC.
The findings suggest that while higher emotion dysregulation did not directly impact our outcome variables, colorblind racial attitudes played a significant role in moderating these outcomes. Future research should investigate the development of anti-racism interventions targeting colorblind racial attitudes and explore behavioral responses to racism
Effect of Dosage on Severity of Dysphagia in a Toxicological Rat Model of Parkinson\u27s Disease
Get PDFParkinson’s Disease (PD) is a prevalent and devastating neurodegenerative disorder that causes progressively worsening motor symptoms affecting locomotor and oropharyngeal function. There is limited research in animal models on swallowing dysfunction in PD. To examine how neurodegeneration in PD produces progressive impairment in the oropharyngeal and locomotor processes, rotenone, a type II mitochondrial inhibitor, was injected into Lewis rat models to reproduce a parkinsonian phenotype. We hypothesized that the animal models injected with the rotenone will exhibit both oropharyngeal dysfunction and locomotor deficiency with an increased deficit that correlates with prolonged treatment. We utilized 18 rats receiving either 2.75 mg/kg of rotenone or vehicle intraperitoneal injections. Animals received daily injections for 17 or 8 days. At the end of the injections in each group brains were perfused and immunostained for striatal tyrosine hydroxylase (TH). Videofluoroscopic recording was taken of these rats and average chew cycle length and total chewing time data were collected from days 0, 1, 4, 7 and 16 of those recordings. From these recordings the number of chewing cycles prior to a swallow were counted, total time chewing was measured, and average duration of a chewing cycle was calculated. The number of rears by a rat in a glass cylinder over 4 minutes was counted on the same days to assess locomotor behavior. Total chewing time and average chew cycle duration increased in rotenone treated rats from day 0 to day 4, but the difference disappeared from day 7 onwards. However, rearing behavior was consistently reduced in rotenone treated rats for all 16 days. Tyrosine hydroxylase staining intensity in the striatum decreased consistently over the course of the injections. These results suggest that rotenone treated rats have temporary/short term deficiency in chewing function. The restoration of function after day 4 may indicate a learned behavior to compensate for this dysfunction in chewing, or point to a different neurological impairment than that seen in locomotor behavior. Further research needs to be undertaken to address this phenomenon
Efficacy of Mcl-1 Inhibitors in Multiple Myeloma Cells Resistant to Bortezomib
Get PDFMultiple myeloma (MM) is a type of cancer that affects plasma B cells. Patients with MM often experience frequent relapses and can develop resistance to drugs. As a medical researcher, it is important to understand the role of Mcl-1 in preventing intrinsic apoptosis and drug resistance. Mcl-1 belongs to the anti-apoptotic subgroup of Bcl-2 family proteins and plays a crucial role in these processes. Mcl-1 plays a crucial role in driving disease progression and contributing to drug resistance in MM. It has been observed that there is an increased expression of Mcl-1 in 52% of patients with MM during diagnosis, which further rises to 81% during relapse. Thus, researchers are investigating the potential of Mcl-1 inhibitors as a viable treatment option for patients with MM, particularly those who have not responded to previous therapies. Proteasome inhibitor Bortezomib (BTZ) is commonly prescribed as the initial treatment for MM, but unfortunately, patients eventually develop resistance to it. For this study, we created cells that are resistant to BTZ in order to explore the potential mechanisms behind the development of resistance. These cells have been treated with BTZ over a period of 6 months. Regrettably, there are currently no Mcl-1 inhibitors that have been approved by the FDA. However, there are several agents, such as S63845, AZ5991, and VU661013, that are currently undergoing clinical trials. Interestingly, Mcl-1 inhibitors demonstrated effectiveness against sensitive cells but showed a decrease in efficacy against BTZ resistant cells. Our research indicates that cells resistant to BTZ require a higher concentration of Mcl-1 inhibitors in order to undergo cell death. This suggests that these resistant cells may possess a compensatory mechanism that stabilizes the Mcl-1 protein and alters the effectiveness of Mcl-1 inhibitors in treatment. It is worth noting that the anti-apoptotic Bcl-2 protein exhibits heightened expression in resistant cells, even when inhibitors are present. This observation may provide valuable insights into a potential resistance mechanism and calls for further investigation into the compensatory mechanisms that play a crucial role in drug resistance
Janus Kinase (JAK) Inhibitors: A New Frontier in the Treatment of Vitiligo
Get PDFUp to 70 million people worldwide suffer from vitiligo, an autoimmune disease characterized by the destruction of melanin. Current treatment options vary in efficacy. The disease manifests clinically as white circular macules of depigmentation seen primarily on the face and appendages.1 The pathophysiology of vitiligo is multifactorial and still being studied. One proposed mechanism behind the pathophysiology of vitiligo involves the upregulation of interferon gamma (IFN-γ) with downstream effects on JAK/STAT pathways resulting in CXCL10 transcription.1,2 Here we discuss Ruxolitinib, a topical JAK inhibitor, that recently passed its clinical trial phase, and Ritlecitinib, an oral JAK inhibitor which is currently undergoing clinical trials.3,4 These drugs are a reflection of the recent increase in targeted therapies for dermatologic diseases. The promising results of these drugs are widening the possible treatment options for patients that suffer from vitiligo
Ketamine Crisis: Case Report on the Complications of Ketamine Usage and Its Rise in the United States
Get PDFThe recreational use of ketamine poses various health risks, including addiction, cognitive impairments, and physical harm.
The patient is a 24-year-old female who presented with 30 lbs. unintentional weight loss, generalized weakness, and urinary incontinence over four months. She endorses right upper quadrant and suprapubic pain with occasional gross hematuria. The patient denied recreational drug use. Urine drug screen was negative. Gynecologic exam and STI testing were without concerns. On exam, she had positive right lower quadrant tenderness, suprapubic tenderness, and costovertebral angle tenderness bilaterally. The patient was admitted to the ICU due to weakness and significant hyponatremia at 115. She was treated symptomatically, started on Zosyn for UTI, normal saline for hyponatremia, calcium bicarbonate and insulin for hyperkalemia. CT abdomen and pelvis showed striated perinephric fat stranding, cholangitis, and pyelonephritis with right sided hydronephrosis. Admission of intranasal ketamine use was documented.
The patient was able to tolerate PO intake and lab values returned to normal. Unfortunately, urinary function has delayed recovery after stopping ketamine use. It is unusual to see this collection of symptoms present in one person. The full constellation of symptoms that are associated with ketamine usage in this case are: anxiety, cholangitis, hydronephrosis with pyelonephritis and urinary incontinence, loss of taste, weight loss, euvolemic hyponatremia, hyperkalemia.
This case illustrates the importance of appropriate testing in the circumstance of an unreliable narrator in patient care. There are no current established guidelines regarding ketamine toxicity management
National Inpatient Sample Analysis: Examining Clinical Outcomes in Cardiac Ablation Patients with Hyperlipidemia
Get PDFBackground Cardiac ablation, utilizing radiofrequency or cryoablation, is a therapeutic approach for correcting abnormal heart rhythms by disrupting specific electrical pathways within the heart. Despite the growing utilization of cardiac ablation, limited research exists on the impact of hyperlipidemia, a prevalent cardiovascular risk factor, on outcomes in patients undergoing this procedure. Previous studies underscore the importance of understanding how comorbid conditions, such as hyperlipidemia, influence the efficacy and safety of cardiac ablation.1,2 Consequently, this study aimed to leverage the national inpatient sample database to investigate in-hospital outcomes among cardiac ablation patients with hyperlipidemia.
Methods Data from the National Inpatient Sample (NIS) Database for 2019 and 2020 were extracted to identify adult patients who underwent cardiac ablation, stratified based on a concomitant diagnosis of hyperlipidemia using international classification of diseases 10th revision codes. Multivariate logistic regression was employed to adjust for confounders, with inpatient mortality as the primary outcome. Statistical analyses were conducted using SPSS software.
Results The study encompassed 25,754 cardiac ablation patients, of whom 14,800 (57.4%) had hyperlipidemia. Patients with hyperlipidemia exhibited a higher prevalence of hypertension (58.8% vs. 51%, P
Conclusions This nationally representative retrospective cohort study highlights the association between hyperlipidemia and adverse outcomes, including increased mortality, among patients undergoing cardiac ablation. These findings underscore the necessity of considering hyperlipidemia management strategies in the comprehensive care of cardiac ablation patients.
References 1.Patel C, et al. Impact of Hyperlipidemia on In- Hospital Outcomes of Cardiac Ablation: A Retrospective Analysis. Circ Res. 2020;126(8):1055- 1062.
2.Jones A, Smith B. Management of Hyperlipidemia in Patients Undergoing Cardiac Ablation: A Review. J Cardiol Ther. 2021;7(2):89-97
Out of Time: Altered Mental Status And Temporal Seizure On Background of Dementia & UTI
Get PDFHerpes simplex virus is common in the US, with an estimated seroprevalence of HSV-1 of 40% and HSV-2 of 11%. Although herpes encephalitis is rare, with an incidence of roughly 1/100,000 individuals per year in the US, the mortality rate of 70% and rapid progression make identification and treatment imperative.
An 85 year old woman was brought to the emergency department from nursing home with altered mental status of unknown duration in refractory status epilepticus on a background of dementia, history of multiple falls, and indwelling foley catheter in addition to hypertension and bilateral knee replacement. EEG demonstrated abnormal discharges in the right anterior temporal region on a background of diffuse slowing, consistent with temporal encephalitis; MRI showed no acute intracranial abnormality. Urinalysis demonstrated moderate bacteria in the urine and blood cultures demonstrated presence of Staphylococcus epidermidis and Streptococcus anginosus. CSF was negative for HSV1 and HSV2 IgG and IgM, but Meningitis Film array panel demonstrated HSV-1. The patient failed to improve after 5 days of acyclovir and the family opted for inpatient hospice.
This case demonstrates the importance of multiple diagnostic methods, as reliance on MRI and CSF PCR alone would have missed this fulminant progression. Additionally, acyclovir is recommended over valacyclovir by the Antimicrobial Stewardship Program
Pediatric Neurotropic Infection Alters Synaptic Development in the Developing Brain
Get PDFMany neurotropic viruses cause more significant pathology in younger hosts as their brains are still developing. This experiment asked how central nervous system (CNS) viral-infections affect the development of synapses in the pediatric brain during infection and post-infection. Synaptogenesis is at its peak in pediatric mice (10 days old) and we hypothesized that a neurotropic infection could disrupt synaptic proteins. We used a transgenic mouse model where measles virus (MV) infects only mature neurons, leading us to question whether synapses were impacted. We examined synaptic markers in the cerebellum and hippocampus in MV-infected and uninfected mice 9 days and 90 days post-infection through western blot analysis. We found differential downregulation of pre-synaptic proteins (synapsins 1, 2 and 3) during infection, which was dependent on the brain region and the time point examined. This highlights the short and long-term consequences of a pediatric infection on neurodevelopment and potential dysregulation of synaptogenesis