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Gastrointestinal bleeding is a common clinical problem in patients using low-dose acetylsalicylic acid (ASA). It is uncertain whether aspirin should continue to be used in patients who develop acute gastrointestinal bleeding during low-dose ASA therapy. To assess whether ASA should be continued in patients who develop GI bleeding during low-dose ASA. All patients admitted to an academic hospital for acute gastrointestinal bleeding between 2009 and 2011 were reviewed retrospectively. Clinical characteristics, comorbidities, medications and treatments were recorded from the patient records. Patients were divided into two groups based on continuing or discontinuing ASA after discharge. A total of 548 patients were included. ASA was continued in 282 (51.5%) (ASAc group) and discontinued in 266 (48.5%) patients (ASAd group). ASAc patients had more often coronary artery disease (57.8% vs. 42.5%, p <.001) and peripheral artery disease (17.4% vs. 9.0%, p =.004) than ASAd patients, whereas no differences were found in other comorbidities. There was no difference in 30-day all-cause mortality between ASAd and ASAc groups. However, after adjustment for age, gender and comorbidities, one-year all-cause mortality was double in the ASAd group (hazard ratio 2.16, 95% confidence interval 1.39–3.35). ASAd and ASAc groups did not differ with respect to cardiovascular mortality (4.9% vs. 5.3%, p =.811, respectively) or re-bleeding (10.2% vs. 9.2%, p =.713, respectively). Continuing low-dose ASA after gastrointestinal bleeding was associated with lower all-cause mortality during the first year without increasing the risk of re-bleeding. [ABSTRACT FROM AUTHOR]

Acute upper gastrointestinal bleeding is a well-recognized complication of peptic ulcers and erosions. The aim of this study was to assess the incidence rate and identify risk factors for this complication in southeastern Norway. Between March 2015 and December 2017, a prospective observational study was conducted at two Norwegian hospitals with a total catchment area of approximately 800,000 inhabitants. Information regarding patient characteristics, comorbidities, drug use, H. pylori status and 30-day mortality was recorded. A total of 543 adult patients were included. The incidence was 30/100,000 inhabitants per year. Altogether, 434 (80%) of the study patients used risk medication. Only 46 patients (8.5%) used proton pump inhibitors (PPIs) for more than 2 weeks before the bleeding episode. H. pylori testing was performed in 527 (97%) patients, of whom 195 (37%) were H. pylori-positive. The main comorbidity was cardiovascular disease. Gastric and duodenal ulcers were found in 183 (34%) and 275 (51%) patients, respectively. Simultaneous ulcerations at both locations were present in 58 (10%) patients, and 27 (5%) had only erosions. Overall, the 30-day mortality rate was 7.6%. The incidence of upper gastrointestinal bleeding due to peptic ulcers and erosions was found to be lower than previously demonstrated in comparable studies, but the overall mortality rate was unchanged. The consumption of risk medication was high, and only a few patients had used prophylactic PPIs. Concurrent H. pylori infection was present in only one-third of the patients. Bleeding Ulcer and Erosions Study 'BLUE Study', ClinicalTrials.gov Identifier. NCT03367897. [ABSTRACT FROM AUTHOR]

This article evaluates regulatory responses to stereotypical gender portrayals in advertising in the UK before and after the 2019 changes in the Advertising Standards Authority's (ASA) harm and offensiveness framework. It systematises for the first time the ASA's rulings in this territory and brings a new perspective in its modern practice by examining it within Deaux and Lewis' theoretical framework on the multicomponent structure of gender stereotypes. We argue that the ASA's new rule and guidelines represent a missed opportunity to take bolder steps against ads that objectify or inappropriately sexualise individuals and are not sufficiently attentive to the multi-faceted nature and fluidity of modern gender identities. We conclude by making recommendations for improving the effectiveness and implementation of the ASA's guidance on the depiction of gender stereotypes. [ABSTRACT FROM AUTHOR]

The aim of the present study was to investigate the use and attitudes toward standardized assessment tools among clinicians in a public mental health service in Norway. A total of 606 clinicians provided feedback on their use and attitudes regarding psychometric qualities of such tools, their practicality, and their benefit over clinical judgment alone using the Attitudes toward Standardized Assessment (ASA) Scales. Clinicians working in the adult mental health field scored significantly higher on use of diagnostic interviews, pre–post evaluations, and ongoing evaluations, whereas clinicians working in the child/adolescent mental health field scored significantly higher on use of screening instruments and held more positive attitudes towards using standardized assessment tools. Attitudes toward standardized assessment tools predicted use of such tools, and results were found to be similar to a study on US clinicians. Whereas the US study only found attitudes regarding the practicality of using such instrument as an independent predictor of assessment use, the current study found that attitudes regarding psychometric qualities of such tools, their practicality, and their benefit over clinical judgment alone were independent predictors of use. [ABSTRACT FROM AUTHOR]

Here, the L-ascorbic acid (AsA) content as well as activities of enzymes and genes in AsA biosynthesis were investigated in bagged and unbagged fruit of Pyrus pyrifolia 'Cuiguan' during on-tree development. The contents of AsA/dehydroascorbate (DHA) and glutathione (γ-glutamyl-L-cysteinylglycine, GSH)/oxidised glutathione (GSSG) couples, the enzyme activities of L-galactono-1,4-lactone dehydrogenase (GLDH; EC 1.3.2.3), L-galactose dehydrogenase (GalDH; EC 1.1.1.117), ascorbate peroxidase (APX; EC 1.11.1.11), monodehydroascorbate reductase (MDHAR; EC 1.6.5.4), glutathione-dependent dehydroascorbate reductase (DHAR; EC 1.8.5.1) and glutathione reductase (GR; EC 1.6.4.2), and the relative expression levels of GLDH and DHAR genes were highest at 20 days after full bloom (DAFB) and then decreased to their minimum at harvest. When the fruit were grown in the dark induced by bagging, the ascorbate contents, enzyme activities and gene expression amounts had a statistical decline compared to the control in the most sampling dates. However, although L-AsA metabolism was affected and the use of light transmitting fruit bags may be preferable, the drop in vitamin C was not really significant in a dietary sense. [ABSTRACT FROM AUTHOR]

Chitosan (CS)-acetylsalicylic acid (ASA) nanoparticles, which are well dispersed and stable in aqueous solution, have been prepared by interpolymer complexation of ASA in CS solution. The physicochemical properties of nanoparticles were investigated by using FT-IR, 1H NMR, scanning electron microscope（SEM）, dynamic light scattering, and UV spectrophotometer. It was found that the carboxyl group of the ASA had firmly integrated on the amino group of CS and the ASA-CS nanoparticles were almost spherical in shape with an average diameter of less than (79.3 ± 24.6) nm in high reproducibility and showed high chemical stability against environmental changes. It was also found that the prepared nanoparticles carried a positive charge and showed the size in the range from 700 to 150 nm. The surface structure and zeta potential of nanoparticles can be controlled by different preparation processes. The factor experiment results indicated that the ASA-CS nanoparticles had satisfactory loading capacity (LC) and encapsulation efficiency (EE), 27.27% and 46.88% (data not shown), respectively. The experiments of in vitro ASA release showed that these nanoparticles provided a sustained and pH-dependent drug release manner, and the release behavior was influenced by the pH value of the medium. Preliminary pharmacology experiment exhibited prolonged circulation and higher bioavailability than that of ASA. All the results indicated that ASA/CS nanoparticles may have promising pharmaceutical application, and further pharmacological research is needed to confirm these beneficial effects. [ABSTRACT FROM AUTHOR]

Purpose: Coffee is a widely consumed beverage. While recent studies have linked its intake to a reduced risk of cataracts, caffeine is believed to be the key factor for its effect. To know how roasting beans affects the effect of coffee on cataract formation, we investigated the impact roasting using a selenite-induced cataract rat model. Materials and Methods: Sprague Dawley rats were given a single injection of sodium selenite, which induced formation of nuclear cataracts by day 6, with or without coffee intake (100% coffee, 0.2 mL/day) for following 3 days. Results: The concentrations of glutathione (GSH) and ascorbic acid (AsA) in selenite-induced cataract lenses declined to half that of controls. However, 3 days of coffee intake ameliorated the reduction of GSH and AsA so that concentrations remained at 70–80% that of controls. Roasting enhanced the preventive effect of coffee by further reducing cataract formation and ameliorating selenite-induced reduction of antioxidants. High-performance liquid chromatography analysis revealed degradation of chlorogenic acid and generation of pyrocatechol during the coffee roasting process. We discovered that pyrocatechol, at doses equivalent to that found in dark-roasted coffee, was equally effective as caffeine at reducing cataract formation and ameliorating the reduction of antioxidants. Conclusion: Our results indicate that pyrocatechol, generated during the roasting process, acts as an antioxidant together with caffeine to prevent cataract formation. [ABSTRACT FROM PUBLISHER]

In this article I critically examine the hypothesis that the early edition of the Book of Kings was written during the time of Hezekiah. I first analyze the histories of the kings of Judah from Ahaz to Josiah and the way their accounts helped to shape the histories of five earlier Judahite kings (Asa, Jehoshaphat, Jehoash, Amaziah, and Uzziah). This analysis demonstrates that the same author wrote the histories of the pre-Hezekian and post-Hezekian Judahite king—an author who operated not earlier than the time of Josiah. Hence, the early edition of Kings was written in either the late monarchic or the early exilic period; thus, the hypothesis that an early edition of Kings was written during the time of Hezekiah can no longer be upheld. [ABSTRACT FROM PUBLISHER]

Aim:We aimed to investigate the protective effect of caffeic acid phenethyl ester (CAPE) on acetylsalicylic acid (ASA)-induced lung damage in rats in the present study.Methods: A total of 40 rats were randomly divided into five groups, with eight rats in each group—group 1: control, not receiving any medication; group 2: ASA (50 mg/kg/day); group 3: ASA (50 mg/kg/day) plus CAPE (20 μg/kg/day); group 4: ASA (100 mg/kg/day); and group 5: ASA (100 mg/kg/day) plus CAPE (20 μg/kg/day). ASA and CAPE were given via orogastric gavage for 5 days. The total oxidant status (TOS), total antioxidant capacity (TAC), oxidant stress index (OSI), and paraoxonase-1 (PON-1) activity of the blood samples and lung tissues were determined. Histopathological examinations of the lung tissues were performed by using light microscopic methods.Results:CAPE treatment significantly increased antioxidant PON-1 level both in the lung tissue and plasma (p< .05). Plasma antioxidant marker (TAC, PON-1) levels significantly increased and oxidant marker (TOS, OSI) levels significantly decreased in CAPE-treated rats (groups 3,5) compared to ASA given no-CAPE groups (group 2,4) (p< .05). Treatment with CAPE improved pulmonary interstitial inflammation and eosinophil accumulation due to ASA histopathologically.Conclusion:Eosinophil-rich inflammation and oxidative stress play important roles in ASA-induced lung toxicity, and CAPE may protect against ASA-induced lung toxicity by reduction of oxidative damage and inflammation in rats. [ABSTRACT FROM PUBLISHER]

Background:Salicylate absorption following overdose of aspirin (ASA) tablet formulations can be prolonged for greater than 24 h. Accordingly, serial serum concentrations are typically recommended to guide treatment. However, there are little published data on absorption following ingestion of powder ASA formulations, and it is not known if delayed ASA absorption occurs following overdose of powder formulations. The objective of this study is to compare the absorption characteristics of powder and tablet formulations of ASA in patients reported to a single poison center. Methods:Electronic records from an accredited poison center were searched for single substance acute or acute on chronic ingestions of ASA in powder form between 1 January 2002 and 31 January 2014. An identical search for ingestions of ASA tablet products between 1 January 2012 and 31 December 2013 was undertaken as the comparator group. Other inclusion criteria were age >12 years, documented time of ingestion, treatment in a health care facility within nine hours of ingestion and at least two detectable serum salicylate concentrations. Results:16 of 25 powder and 22 of 49 tablet cases met inclusion criteria for analysis. Repeat serum salicylate concentrations following ingestion of tablets increased or insignificantly changed in 11 of 22 (50%) cases, and median serum salicylate concentrations in followed cases remained elevated for up to 12 h in some cases. In comparison, serum salicylate concentrations following powder ingestions declined in 15 of 16 (94%) cases. One patient, who ingested a powder product, underwent hemodialysis pursuant to an initial serum salicylate concentration of 96 mg/dL. Conclusions:In contrast to persistent concentrations following overdose of tablets, the majority of serum salicylate concentrations declined following ingestion of powder formulations. In this small study population, these findings suggest that prolonged absorption is unlikely following ingestions of ASA powders. [ABSTRACT FROM PUBLISHER]

Radical cystectomy (RC) with pelvic lymph node dissection constitutes the gold standard treatment for muscle-invasive urothelial carcinoma of the bladder and high-risk nonmuscle-invasive disease refractory to instillation therapy. Although RC is performed with curative intent, the overall 5-year survival has been reported to be as low as 62% in the current literature. Various clinicopathological parameters determine post-RC outcome, but besides these, the role of comorbidity has gained increasing attention. In the current clinical practice, comorbidity information is quantified using various evaluated comorbidity indices. In this paper, we discuss the most recent data on comorbidity and performance indices assessed in patients undergoing RC and highlight their clinical implications. [ABSTRACT FROM AUTHOR]

The influence of storage conditions on the sizing degree of AKD and ASA sized pilot papers was evaluated. A number of pilot papers sized with AKD or ASA were prepared from ECF bleached pulp fibers, unfilled and filled with 20% PCC, respectively and investigated in terms of sizing degree over a period of several months. The papers were stored at 23°C and 50% RH either wrapped in aluminium foil or as separate sheets exposed to open atmosphere. The unfilled papers stored protected from ambient atmosphere after papermaking showed only a marginal reduction in sizing during prolonged storage. Only the paper having the lowest AKD-dosage suffered from reduced water-resistance, the Cobb60-value changed from 34 to 79 g/m2. The PCC filled papers stored in the same conditions lost some of their sizing, to a higher extent in the case of AKD than for ASA sized papers. This was attributed to the further hydrolysis of the size catalyzed by PCC. In comparison, the sizing of the papers stored as separate sheets dropped significantly even after a few weeks in storage. In the end of the storage the AKD papers, particularly the unfilled ones had lost their sizing efficiency to a clearly higher extent than the ASA papers. The reduction in the sizing level occurred mainly during the first five weeks for the unfilled ASA and AKD papers, after which the process continued at a slower rate. The ToF-SIMS analysis revealed that both AKD and hydrolyzed AKD, the latter being the major portion, were present at the outermost surface of the unfilled AKD sized papers, but in significantly lower levels than in the case of the corresponding protected papers. In other words, a significant loss of AKD mass had occurred for the papers exposed to an open atmosphere. This was attributed to migration of AKD. The results demonstrated that ASA sized papers also suffered from size loss. The ToF-SIMS results showed no signal for active, nonbonded ASA and instead clear signals were observed for hydrolyzed ASA and for calcium and aluminium. As in the papers wrapped in aluminium foil, ASA was mainly in its hydrolyzed form. Although to a markedly lower extent, the reason for sizing loss in the case of ASA was the same as for AKD. [ABSTRACT FROM AUTHOR]

Objective. Traditional non-steroidal anti-inflammatory drugs (NSAIDs) including ASA for thrombosis prophylaxis (ASA-TP), for pain medication (ASA-P) or non-ASA NSAIDs (NANSAIDs), Helicobacter pylori infection, CagA strains of H. pylori and smoking are reported risk factors for peptic ulcer bleeding (PUB), but the combined and the dose effects of these factors are controversial. The aim of this study was to estimate the significance of these risk factors and their combinations in PUB. Material and methods. PUB patients (n=94) were compared with an age- (±5 years) and gender-matched control group of non-ulcer patients (n=94) attending elective endoscopy. A questionnaire on the possible risk factors (previous gastric and duodenal ulcer, use of ASA-TP, ASA-P, NANSAIDs, warfarin, alcohol and smoking) was completed. H. pylori infection was determined as positive if histology and/or urease tests were positive. CagA antibodies of IgG class were determined using an immunoblot method. Results. H. pylori infection (odds ratio (OR) 8.8), the use of ASA-P (OR 3.5), ASA-TP (OR 4.07), NANSAIDs with ≥1 defined daily dose (OR 6.56), smoking ≥20 cigarettes daily (OR 6.43) and previous duodenal ulcer (DU) (OR 8.96) were independent risk factors for PUB. At least two risk factors were present in 65% of PUB patients. CagA strains were detected in 97% of the H. pylori-positive cases and in 96% of the respective controls. ASA, ibuprofen, ketoprofen and smoking were dose-dependent risk factors for PUB. Conclusions. Previous DU, H. pylori, the use of any ASA and smoking explained the majority of the PUB episodes. CagA strains of H. pylori were not associated with PUB. Two-thirds of the PUB patients had at least two risk factors, but their combination did not potentiate the risk. [ABSTRACT FROM AUTHOR]

A procedure based on a spot test for salicylate is presented. The method is simple, rugged and is based on the salycilate native fluorescence measurement on the surface of a filter paper by using optical fibers for light conduction. The fluorescence was linear at concentration range of 0.01–0.4 mmol l-1. The relative standard deviation of 5% (n=10) was observed. Detection and quantification limits were 4 and 14 µmol l-1, respectively. The results obtained in pharmaceutical salicylate determinations showed that practically no statistical difference existed with the pharmacopeical method (95% confidence level). The recovery studies in biological samples spiked with salicylic acid at overdose concentration levels showed that the matrix sample did not interfere in the method. [ABSTRACT FROM AUTHOR]

Appropriate experimental conditions for the estimation of hydroxyl radical generation by salicylate hydroxylation were determined for multiple organs of X-irradiated mice in vivo. The in vitro experiments showed that there were significant correlations between the salicylic acid (SA) concentration, the amount of 2,3-dihydroxy benzoic acid (2,3-DHBA) and the X-ray exposure dose, and we obtained two linear-regression equations to calculate the amounts of hydroxyl radicals generated by the X-irradiation. The optimum dosage of SA and the appropriate sampling time for in vivo experiments was determined, and significant increases in the ratio of 2,3-DHBA to SA were detected in several organs of mice after X-irradiation. The hydroxyl radical equivalents of the 2,3-DHBA increases were also calculated. Our results clearly demonstrated the usefulness of the salicylate hydroxylation method in estimating hydroxyl radical generation in multiple organs in vivo. [ABSTRACT FROM AUTHOR]

NGOs in Bangladesh have been recognized as effective change agents in the socioeconomic arena throughout the world. Their contributions in micro credit, non-formal education and primary health care are widely known. NGOs play a significant role in society. NGO accountability, as a result, has become a critical issue. NGO accountability in Bangladesh has been examined here in relation to patrons, clients and themselves. Of the three relationships only accountability to patrons is in a near satisfactory state. Accountability to clients is handicapped by lack of opportunities of beneficiaries to participate meaningfully in NGO policy making. Accountability to themselves is adversely affected due to the adherence to a strictly hierarchical system and the influence of founding and charismatic NGO leaders. [ABSTRACT FROM AUTHOR]