Protection from the Pathogenesis of Neurodegenerative Disorders, including Alzheimer’s Disease, Amyotrophic Lateral Sclerosis, Huntington’s Disease, and Parkinson’s Diseases, through the Mitigation of Reactive Oxygen Species
Published on: 4th November, 2019
OCLC Number/Unique Identifier: 8302209826
The biological changes caused by oxidative stress (OS) are known to be involved in the etiology of neurodegenerative disorders, including Alzheimer’s disease, amyotrophic lateral sclerosis, Huntington’s disease, and Parkinson’s disease. The brain is particularly vulnerable to OS due to its high lipid content and extensive consumption of oxygen. OS processes, particularly the excessive production of reactive oxygen species (ROS), play a critical role in how neurodegenerative disorders develop. This is evidenced by in vivo studies investigating various biomolecules related to OS, such as products of lipid and DNA oxidation. Accordingly, ROS can also cause oxidative-related damage in neurodegenerative disorders, including dopamine auto-oxidation, mitochondrial dysfunction, glial cell activation, α-synuclein aggregation, excessive free iron, and changes in calcium signaling. Furthermore, excessive levels of cellular oxidants reduce antioxidant defenses, which in turn propagate the cycle of OS. As such, it is increasingly important to determine the linkage between a high intake of antioxidants through dietary interventions and a lower risk of developing neurodegenerative diseases. Indeed, in addition to modulating the immune system, optimal nutritional status is capable of changing various processes of neuroinflammation known to be involved in the pathogenesis of neurodegeneration. Accordingly, a better understanding of the role ROS plays in the etiology of neurodegeneration is needed, along with the identification of dietary interventions that may lead to improved therapeutic strategies for both the treatment and prevention of neurodegenerative disorders. Therefore, this review presents a comprehensive summary of the role of ROS in the pathogenesis of neurodegenerative disorders. In addition, nutrients believed to be useful for mitigating and counteracting ROS are discussed.
Immunohistochemical expression of Nestin as Cancer Stem Cell Marker in gliomas
Published on: 11th November, 2019
OCLC Number/Unique Identifier: 8457474432
Background: Gliomas represent the most frequent primary tumors of central nervous system (CNS), contributing to more than half of the incidence of brain tumors. Cancer stem cell markers (CSC) identify a group of patients at high risk for progression. Nestin is an intermediate filament (IF) protein was first described as a neural stem cell/progenitor cell marker. Nestin-positive neuroepithelial stem cells are detected in the subventricular zone of the human adult brain and they remain mitotically active throughout adulthood. The expression of Nestin in gliomas has been suggested to be related to dedifferentiation, improved cell motility, invasive potential and increased malignancy. This study aims to investigate Nestin immunohistochemical expression in different types of glioma and its correlation with different clinicopathological parameters.
Materials and Methods: Nestin immunostaining was studied in 60 specimens of glioma using avidin-biotin peroxidase method.
Results: Nestin was strongly expressed in 11/60 (18.33%), moderately expressed in 29/60 (48.33%) and weekly expressed in 15/60 (25%) of studied gliomas. A significant positive correlation was found between Nestin expression and histologic type (p < 0.001) and increasing grade of gliomas (p < 0.001).
Conclusion: Increased Nestin expression is correlated with tumor progression, increasing grade and poor prognostic parameter of glioma. Nestin is a useful marker for detection of CSC in high-grade glioma which is responsible for resistance to chemo-radiotherapy and may serve as a predictor for patient outcomes.
Impact of mandibular advancement device in quantitative electroencephalogram and sleep quality in mild to severe obstructive sleep apnea
Published on: 30th December, 2020
OCLC Number/Unique Identifier: 8899350400
Sleep related breathing disorders (SRBD) are among seven well-established major categories of sleep disorders defined in the third edition of The International Classification of Sleep Disorders (ICSD-3), and Obstructive Sleep Apnea (OSA) is the most common SRBD [1,2]. Several studies have demonstrated that obstructive sleep apnea treatment increases the quality of life in OSA patients [3-8]. Indeed, excessive daytime sleepiness (EDS), cognitive impairment (e.g., deficits in attention-concentration, memory, dexterity, and creativity), traffic accidents, and deterioration of social activities are frequently reported in untreated patients [9-11]. Furthermore, an increase in cardiovascular morbidities and mortality (systemic hypertension, stroke, cardiac arrhythmias, pulmonary arterial hypertension, heart failure) [12], metabolic dysfunction, cerebrovascular ischemic events and chemical/structural central nervous system cellular injuries (gray/white matter) has been reported in OSA patients [13-17].
Continuous positive airway pressure (CPAP) therapy is considered the gold standard for treatment of moderate-severe OSA, nevertheless there is an increasing body of evidence supporting the usefulness of mandibular advancement devices (MADs) for improving quality of life and respiratory parameters even among patients with a high severity of OSA burden [5,10,18,19]. According to the standard of care of the American Academy of Sleep Medicine (AASM), MADs are indicated for mild to moderate OSA particularly in the context of CPAP intolerance or refusal, surgical contraindication, or the need for a short-term substitute therapy [9,15,20-22]. In Cuba, CPAP machines are not readily available; they are expensive and the majority of OSA patients cannot obtain this mode of therapy. Taking into account this problem, our hypothesis was based in the scientific evidences of MAD effectiveness, considering that low cost MADs could offer a reasonable alternative treatment for patients with OSA where CPAP technology are not handy. In this way our purpose was to assess the efficacy of one of the most simple, low cost, manufactured monoblock MAD models (SAS de Zúrich) in terms of improvements in cerebral function, sleep quality and drowsiness reports in a group of Cuban OSA patients with mild to severe disease. Outcome measures included changes in the brain electrical activity, sleep quality, and respiratory parameters, measured by EEG recording with qEEG analysis and polysomnographic studies correspondingly, which were recorded before and during treatment with an MAD, as well as subjective/objective improvements in daytime alertness.
Granulomatosis with polyangiitis (GPA) in a 76-year old woman presenting with pulmonary nodule and accelerating acute kidney injury
Published on: 20th January, 2020
OCLC Number/Unique Identifier: 8516756417
Granulomatosis with polyangiitis (GPA), a form of ANCA-associated vasculitis (AAV), is a rare disease with an often-occult presentation. It is more common in 4th and 5th decades of life but can be seen in all ages.
This case report details a 76-year-old female presenting with abdominal pain, generalized weakness, and malaise, who was found to have pulmonary nodules on chest imaging. Biopsy of the lung nodule showed organizing pneumonia. Initially, antibiotics were used to treat the patient. However, she developed acute renal failure a few days after presentation and found to have positive serum C-ANCA as well as elevated ANCA-PR3 serologies. A subsequent kidney biopsy demonstrated pauci-immune necrotizing and crescentic glomerulonephritis that was consistent with GPA and the patient was started immediately on combination immunosuppressive therapy, plasmapheresis, and hemodialysis.
GPA’s clinical and radiological presentation can mimic other common conditions such as pneumonia, malignancy, bacterial sinusitis, pulmonary tuberculosis, sarcoidosis, and urinary tract infection. Because of this, a high level of suspicion is required for early diagnosis and treatment to alter the high mortality rate in this disease entity. All forms of ANCA-associated vasculitis (AAV) should be in the differential diagnosis for all patients presenting with multiorgan system involvement particularly in individuals with pulmonary and renal manifesations.
Correlation between interdialytic weight gain, left ventricular hypertrophy and FGF- 23 in prevalent hemodialysis patients
Published on: 28th July, 2020
OCLC Number/Unique Identifier: 8648999984
Background:Patients with end-stage renal disease are suspected to have significant volume shifts and thereby cardiovascular strain as a result to interdialytic weight gain, chronic fluid overload and fluid removal during dialysis. In long-term hemodialysis patients, higher IDWG (interdialytic weight gain) could be associated with poor survival. Patients with the lowest interdialytic weight gain have the greatest survival. Certain laboratory and imaging modalities could help to assess and monitor the appropriate fluid balance for hemodialysis patients.
FGF -23 might be associated with cardiovascular morbidity in ESRD patients.
Objective: To evaluate correlation between hypervolemia and left ventricular hypertrophy and FGF-23 in hemodialysis patients.
Patients and Methods: This cross sectional study was conducted on 60 prevalent hemodialysis patients. Patients were divided into two groups according to interdialytic weight gain (IDWG): Group I (low IDWG): Patients with absolute weight gain < 3 kg. Group II (high IDWG): patients with weight gain ≥ 3 kg. FGF 23, routine laboratory tests and echocardiography were done for both groups.
Results: high IDWG group has higher systolic blood pressure and LVMI than low IDWG group. In all patients group, FGF-23 had a positive correlation with (weight gain, Na, PO4, PTH, systolic, diastolic blood pressure, LV wall septal and posterior wall thickness and left ventricular mass index) and had a negative correlation with Hb level.
Conclusion: FGF-23 could be a marker of volume overload and LVH in ESRD patients, which affect morbidity and mortality in these patients.
FGF- 23 might be a marker of anemia in ESRD as it has a negative correlation with HB.
Influence of Histidine on the contractility and adrenaline inotropic effect in the experiments with myocardium of right ventricular of Non pregnant and Pregnant Rats
Published on: 19th November, 2018
OCLC Number/Unique Identifier: 7929237612
It was investigated contractility and adrenoreactivity of intact myocardium strips of right ventricular in experiment with 60 rats. They were assessed by the force of induce contraction and its changes under the influence of adrenaline (10-9 or 10-5 g / ml). Found that these indicators do not depend on the phases of the estrous cycle and the presence of pregnancy. Histidine (10-10-10-4 g / ml) did not increase the response to adrenalin (10-9 g / ml), but increased the force of the contractions in rats in progesterone dominance (trend) and pregnancy (statistically significant). Against the background of propranolol (10-8 g / mL) or atenolol (10-8, 10-6 g / mL), adrenaline (10-5 g / mL) instead of increasing the force of contraction reduced it (probably due to activation of beta3-, alpha1 - and alpha1 a2- adrenergic receptors), and histidine (10-4 g / mL) prevented this reduction, but does not restore full ability of adrenaline to exert a positive inotropic effect. On the background of nicergoline (10-8 g / mL or nicergoline and propranolol (10-8 g / mL), adrenaline (10-5 g / mL) did not alter the force of contraction, and histidine (10-4 g/mL) restore ability of adrenaline to exert a positive inotropic effect but only in the experiments with nicergoline. Concluded that histidine increases the efficiency of the activation of all three (beta1-, beta2- and beta3-) populations of myocardial beta-adrenoceptoprs, including at lower by adrenergic blockers. Therefore, histidine proposed as an antagonist of beta-adrenergic blockers and as resensitizator of these receptors.
Core Tip: In the experiments with strips of the right ventricle of 40 nonpregnant and 20 pregnant rats histidine (10-10-10-4 g /mL) did not increase the response to adrenaline (10-9 g / ml), but increased the force of contractions in pregnant rats. On the background of propranolol (10-8 g / mL) or atenolol (10-8, 10-6 g / mL), adrenaline (10-5g/mL) showed a negative inotropic effect, and histidine (10-4 g / mL) prevented it, but does not restore the ability of adrenaline to show positive inotropic effect,. i.e histidine exhibits the properties of the antagonist of beta-blockers and of resensitizator of beta-adrenoceptors
Factors associated with mortality after decompressive craniectomy in large basal ganglia bleeds
Published on: 11th May, 2021
OCLC Number/Unique Identifier: 9272362372
Aim: To assess the efficacy of decompressive craniectomy in patients with large basal ganglia (BG) bleed. To establish predictive criteria of mortality after surgery in patients with BG bleed.
Materials: This prospective study includes all patients of large spontaneous BG bleed operated by decompressive craniectomy without hematoma evacuation from October 2012 to September 2015. Data was collected on patient age, gender, distribution of bleed, affected hemisphere dominancy, preexisting medical conditions, admission Glasgow Coma Score (GCS), midline shift on CT or MRI Brain, hematoma volume and anisocoria, duration (hours) between the onset of stroke and operation, post-operative complications, and the duration of hospital stay. This data was correlated with one month mortality of the patients.
Results: Total number of patients were 27. Mean age was 51 years and mean GCS was 7.55(range 5-11). The mean volume of the bleed was 68.51 ml. Mortality was noted in 17 out of 27 patients (63%) in 30 days. Thirteen of the 16 patients with intraventricular extension of BG bleed had mortality. The factors that showed statistically significant correlation with one month mortality were age, GCS at admission, volume of the bleed and the intraventricular extension.
Conclusion: Large BG bleed was associated with high mortality and morbidity. Age of 50 years or more and GCS ≤ 8 at presentation were poor prognostic factors for decompressive craniectomy in patients with BG bleed. Patients with large BG bleed of volume > 60 ml and intraventricular extension had poor prognosis.
Endovascular management of tandem occlusions in stroke: Treatment strategies in a real-world scenario
Published on: 29th June, 2021
OCLC Number/Unique Identifier: 9272368208
The association between intracranial large vessel occlusion (LVO) and concurrent steno-occlusive lesion of an ipsilateral extracranial internal carotid artery (ICA) is considered a tandem occlusion (TO) [1]. In approximately half of TO, the first clinical manifestation are acute occlusions of the extracranial ICA associated with occlusion of the middle cerebral artery (MCA), with additional occlusion of the intracranial ICA in up to 25% of these cases.[2] This particular lesion subset is technically challenging for endovascular treatment (EVT) and is also characterized by lower success rates of intravenous thrombolysis [3], worse prognosis compared to intracranial occlusions alone, and higher rates of symptomatic intracranial hemorrhage [4]. The optimal approach regarding EVT of TO remains controversial, and reports in this regard are scarce. There are two proposed strategies according to the selection of the first lesion to be treated. The proximal approach comprises stenting of the proximal cervical ICA followed by mechanical thrombectomy (MT) of the intracranial vessel, whereas the distal approach involves MT followed by stenting of the cervical ICA [3–14].
Besides, there other clinically relevant unresolved aspects regarding the treatment of these patients, such as concomitant use of intravenous thrombolysis, the need for stenting compared to angioplasty alone, as well as the most adequate antiplatelet strategy after treatment. Accordingly, we aimed to report the procedural and clinical outcomes of a real-world experience in a comprehensive stroke center regarding EVT of anterior circulation acute ischemic stroke (AIS) associated with a TO.
Role of neuron specific enolase as a biomarker in Parkinson’s disease
Published on: 6th July, 2021
OCLC Number/Unique Identifier: 9137583301
Parkinson’s disease (PD) is thought to be the most common neurodegenerative disease with movement disorder. The key motor symptoms are rigidity, tremor, akinesis/hypokinesia/bradykinesia, and postural instability. However, in our day-to-day clinical practice we tend to see several other symptoms which may be motor or non-motor. Non-motor symptoms (NMS) are quite common and debilitating. The pathological hallmarks of PD are loss of dopaminergic neurons in the substantia nigra pars compacta (SNPc) and accumulation of unfolded or misfolded alpha-synuclein. Diagnosis of PD is difficult in the pre-motor stage. Late diagnosis renders a substantial loss of dopaminergic neurons in SNPc and spread of disease in other parts of the brain. This may manifest as either full blown symptoms requiring multiple medications or may even lead to life threatening condition due to lack of early diagnostic tools and techniques. Biomarkers are required to diagnose PD at a very early stage when prevention is possible. Hence, we see a lot of interest among researchers involved in finding a biomarker specific to the disease. Biomarkers may be clinical, image based, genetic, and biochemical. Cerebrospinal fluid (CSF) and serum markers which may correlate with disease pathophysiology are of great significance. One such molecule which recently gained a lot of attention is neuron-specific enolase (NSE). The main aim of this paper is to highlight the role of NSE in predicting neurodegeneration and neuroinflammation ultimately reflecting damage of brain cells in PD.
Facial-onset sensory-motor neuronopathy, a rare variant of Huntington’s disease or chance association?
Published on: 15th July, 2021
OCLC Number/Unique Identifier: 9136190397
Objectives: To describe a patient with facial-onset sensory-motor neuronopathy (FOSMN) that later developed Huntington’s disease (HD).
Case report: A 62-year-old woman complained of progressive dysphagia 8 years before referral. At initial evaluation, there was excessive salivation, dysphagia, and sensory-motor trigeminal impairment. Denervation was noted on the upper limbs and the tongue. Blink reflexes were abolished. Genetic study of amyotrophic lateral sclerosis (ALS)-related genes was normal. She was diagnosed with FOSMN syndrome. Her clinical state progressively worsened with corneal anesthesia, severe denutrition, right arm and axial weakness. Seven years after referral, she was unable walk and developed generalized chorea. Abnormal huntingtin gene repeat expansion confirmed the diagnosis of HD. She died 16 years after onset of dysphagia.
Conclusion: Cases with both HD and ALS have already been reported but not FOSMN and HD, to our knowledge. Some FOSMN cases have been linked to ALS-related gene mutations and HD phenocopies have been associated with C9ORF72 repeat expansions. Recently, huntingtin repeat expansions were described in the ALS population. Although a chance association cannot be excluded, data from the literature are in favor of a pathogenic relationship between FOSMN and HD in this particular case. We suggest that huntingtin gene be more systematically studied in patients with FOSMN.
An educational strategy for the implementation of a delirium assessment tool
Published on: 10th August, 2021
OCLC Number/Unique Identifier: 9198828639
Background: Delirium is an acute syndrome of organ dysfunction with long-term consequences which commonly occurs in the Intensive Care Unit (ICU). The incidence of delirium ranges from 30% - 50% in low severity ICU patients and up to 80% in mechanically ventilated patients. This condition is frequently under-recognized and daily routine screening is a key strategy to early intervention. The Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) and the Intensive Care Delirium Screening Checklist (ICDSC) are the most recommended assessment tools for detecting delirium in the critical ill patient.
Objective: The main objective of this study is to educate ICU staff about delirium. In addition, nurses were trained to use the CAM-ICU as a standard screening tool. The intervention was evaluated through a survey aimed at ICU staff.
Methods: An educational intervention was started in 2014 in our ICU. An educational package for ICU staff consisted of a didactic brochure and explanatory videos. One-on-one teaching, case based scenarios and didactic teaching were strategies used in the implementation process. The entire intervention was evaluated by means of a survey directed to the professionals.
Results: The structure of the didactic brochure was simple in order to have an easy understanding of the CAM-ICU tool. We also created 10-minute videos. According to the results of the satisfaction survey (N=62), disorganized thinking was the most difficult feature of CAM-ICU to interpret. When in doubt, consultation between co-workers was the primary resource selected by unit staff.
Conclusion: This initiative achieved the objective of training health care professionals in the application of the CAM-ICU tool with a good level of satisfaction from them. Therefore, ICU staff consider delirium management in the broader picture of critically ill patient care as a major activity of daily practice.
Immunocompromised patients with SARS-CoV-2 infection in intensive care units, outcome and mortality
Published on: 17th August, 2021
OCLC Number/Unique Identifier: 9272368819
Background: The new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak severely hit Northeastern France from March to May 2020. The massive arrival of SARS-CoV-2 positive patients in the intensive care units (ICU) raised the question of how immunocompromised patients would be affected. Therefore, we analyzed the clinical, biological and radiological features of 24 immunocompromised ICU patients with severe SAR-CoV-2 infection.
Results: The mortality rate was significantly higher for immunocompromised patients compared with other patients (41.7% versus 27.3%, respectively, p = 0.021). Mortality occurred in the first 2 weeks of intensive care, highlighting the possible interest in prolonged full-code managnement of these patients. Finally, patients with lymphoid malignancies appeared to be particularly affected, mostly with monoclonal gamma-pathology.
Conclusion: Mortality rate of SARS-CoV-2 acute respiratory syndrome in immuno-compromised patient is high. No treatment was associated with survival improvement. Prolonged full-code management is required for these patients.
Case report: Perioperative management of a patient with familial dysautonomia
Published on: 8th September, 2021
OCLC Number/Unique Identifier: 9244749562
Familial dysautonomia is a rare autosomal recessive neurodegenerative disease affecting cells of the autonomic nervous system. Patients with this disease are insensitive to pain but their autonomic nervous system is still activated with noxious stimuli. This report details a case of a patient with familial dysautonomia who underwent right ankle open reduction and internal fixation for a bimalleolar right ankle fracture. The patients preoperative and intraoperative course were uneventful but shortly after handoff to the intensive care unit, the patient experienced an autonomic crisis. Management of these patients is complex, requiring maintenance of physiologic homeostasis as well as preventing hemodynamic instability caused by noxious stimuli. Any deviations from baseline may cause an autonomic crisis, as happened in our patient. Herein, we detail the perioperative management of a patient with familial dysautonomia in further detail.
Behavior evaluation of freundlich and langmuir isotherms in cadmium preconcentration using solid phase extraction method for linear and nonlinear numerical computational patterns
Published on: 8th September, 2021
OCLC Number/Unique Identifier: 9244773069
Cadmium is naturally present in the mineral cadmium sulfide which is a rare form of this element and the highest amount of cadmium is obtained from the extraction process of other minerals such as lead, copper and zinc. The release of this metal into the environment leads to widespread epidemiological effects. Therefore, measuring small amounts of this metal is also of particular importance. Small amount measuring methods of this metal are such as,preconcentration using solid phase extraction system using adsorbents. The main part of the preconcentration process is achieved by adsorption processes. In this study, the behavior of Freundlich and Langmuir adsorption isotherms for the capacity of TMON and IMNM adsorbents in cadmium adsorption has been evaluated by Power and Rational statistical distributions. At the end of the study, the constant coefficients of the Freundlich and Langmuir models were compared in both linear and non-linear modes. The results showed; the linearization method for the Kf coefficient of the Freundlich isotherm can cause errors equal to 41.6% in TMON adsorbent and 39.3% in IMNM adsorbent. Also, in parameter b, errors of 66.66% are obtained in TMON adsorbent and 32.45% in IMNM adsorbent.
The dermatologic manifestations of COVID-19: a mini-review
Published on: 27th August, 2021
OCLC Number/Unique Identifier: 9244773760
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was identified in Wuhan, China, and caused coronavirus disease-19 (COVID-19), which is still a global pandemic. Dermatologic manifestations have increasingly been identified as significant extrapulmonary manifestations of COVID-19. The dermatologic manifestations associated with COVID-19 infection reported to date include maculopapular rash, vesicular lesions, urticaria-like lesions, and chilblain-like lesions. Knowledge of dermatologic manifestations of COVID-19 may be essential for early diagnosis and a better prognosis in COVID-19 patients. This review summarizes the current understanding of common COVID-19-associated dermatologic manifestations.
Flow cytometry potential applications in characterizing solid tumors main phenotype, heterogeneity and circulating cells
Published on: 24th August, 2021
OCLC Number/Unique Identifier: 9213084224
Flow cytometry (FCM) is a unique technique that allows rapid quantitative measurement of multiple parameters on a large number of cells at the individual level. FCM is based on immunolabelling with fluorochrome-conjugated antibodies, leading to high sensitivity and precision while time effective sample preparation. FCM can be performed on tissue following enzymatic or mechanical dissociation. The expression of epithelial antigens and cytokeratin isoforms help in distinguishing tumor cells from adjacent epithelial cells and from tumor infiltrating leukocytes. Tumor phenotypes can be characterized on expression intensity, aberrancies and presence of tumor-associated antigens as well as their cell proliferation rate and eventual heteroploidy. FCM can measure quantitative expression of hormone or growth factor receptors, immunoregulatory proteins to guide adjuvant therapy. Expression of adhesion molecules tells on tumor’s capacity for tissue invasion and metastasis seeding. Tumor heterogeneity can be explored quantitatively and rare, potentially emerging, clones with poor prognosis can be detected. FCM is easily applicable on fine needle aspiration and in any tumor related biological fluids. FCM can also be used to detect circulating tumor cells (CTC) to assess metastatic potential at diagnosis or during treatment. Detecting CTC could allow early detection of tumors before they are clinically expressed although some difficulties still need to be solved. It thus appears that FCM should be in the pathologist tool box to improve cancer diagnosis, classification and prognosis evaluation as well as in orientating personalized adjuvant therapy and immunotherapy. More developments are still required to better known tumor phenotypes and their potential invasiveness
A rare presentation of orbital dermoid: A case study
Published on: 10th August, 2021
OCLC Number/Unique Identifier: 9168714793
Introduction: A dermoid cyst is a developmental choristoma lined with epithelium and filled with keratinized material arising from ectodermal rests pinched off at suture lines. These are the most common orbital tumors in childhood. They are categorized into superficial and deep. Superficial orbital dermoid tumors usually occur in the area of the lateral brow adjacent to the frontozygomatic suture. Infrequently a tumor may be encountered in the medial canthal area [1], which is the second most common site of orbital dermoids. We report a case where a swelling presented in the medial canthal area without involving the lacrimal system.
Case report: A 43 year old lady presented with complaint of swelling near the (RE; Right eye) since 2 years duration. She presented with a solitary 1.5 cm x 1 cm ovoid, non-tender, non-pulsatile, firm, non-compressible mobile swelling with smooth surface over the medial canthus of right eye. (MRI; Magnetic Resonance Imaging) brain and orbit showed right periorbital extraconal lesion and the (FNAC; Fine Needle Aspiration Cytology) suggested of Dermoid Cyst. RE canthal dermoid cyst excision was done under Local Anasthesia.
Conclusion: Complete surgical excision in to be treatment of choice for dermoids. Since medial canthal mass can involve the lacrimal system, it becomes necessary to perform preoperative assessments using (CT; Computed Tomography), MRI or dacryocystography while planning the surgical approach. Silicone intubation at the beginning of the surgery is an easy and effective way of identifying canaliculi and of preventing canalicular laceration during dermoid excision if the lacrimal system is found to be involved.
Effect of chitosan and silicon oxide treatments on postharvest Valencia Late (Citrus × sinensis) fruits
Published on: 6th October, 2021
OCLC Number/Unique Identifier: 9305369016
The efficacy of chitosan and silicon oxide to prevent postharvest weight loss and fungi infection in 'Valencia Late' oranges was tested. Three silicon oxide concentrations (0.1%, 0.2%, 1%) were applied as preharvest treatments. Chitosan treatments were performed at the same concentrations in postharvest fruit. Preharvest applications were carried out by tractor spraying, while fruit were submerged for 30 seconds in baths with the chitosan concentrations in the postharvest applications. In both cases, a positive control (water treatment) and negative control (fungicide) were included. Treated fruit were stored in a chamber to simulate commercial storage conditions (4 ºC, 90% RH) for 9 weeks. After this time, the weight loss and damage caused by fungi due to natural infection were evaluated. Both silicon oxide and chitosan applications were effective in controlling natural infection by Penicillium species but had no positive effect on weight loss.
Membranous nephropathy complicating relapsing polychondritis: A case report
Published on: 7th October, 2021
OCLC Number/Unique Identifier: 9305467462
Background: Relapsing polychondritis is a rare systemic disease characterized by recurrent inflammation, and often destruction, of cartilaginous tissues. Renal manifestations are rare. Membranous nephropathy complicating relapsing polychondritis has been reported only once previously, and there is no standardized treatment for membranous nephropathy associated with relapsing polychondritis.Case presentation: A 67-year-old Caucasian man with a history of chronic renal disease presented with 9 months of progressive dyspnea on exertion and 5 months of erythema, pain, and collapse of auricular cartilage. Imaging studies confirmed active inflammation of laryngeal, auricular, and costal cartilage and he was diagnosed with relapsing polychondritis. Patient had longstanding proteinuria and renal biopsy demonstrated membranous nephropathy. Patient initially showed renal and respiratory improvement with etanercept, a tumor necrosis factor alpha inhibitor, treatment. However, subsequent disease and treatment-related complications led to a progressive overall clinical decline and patient died approximately 1 year following relapsing polychondritis diagnosis.Conclusion: Membranous nephropathy may rarely complicate relapsing polychondritis. In our case, both the cartilaginous inflammation and the renal disease improved after treatment with tumor necrosis factor alpha blockade, however complications of existing airway disease led to recurrent hospitalizations and eventually death.
Non-alcoholic fatty liver disease: Update on treatment options and translational implications of sleep disruption
Published on: 17th August, 2021
OCLC Number/Unique Identifier: 9206109721
Non-alcoholic fatty liver disease (NAFLD) is a condition that is associated with cirrhosis and hepatocellular carcinoma, and is increasing in prevalence worldwide. Sleep disruptions are commonly seen in NAFLD, and the disease process is associated with sleep disorders, including obstructive sleep apnea, circadian rhythm disorders, and insufficient sleep. The intermittent hypoxia seen in obstructive sleep apnea may contribute to fibrotic changes in the liver.A major component of this linkage may be related to gut microbiome changes. One notable change is increase in Bacteroidetes/Firmicutes ratio, and decrease in flora that ferment fiber into anti-inflammatory short-chain fatty acids. Several therapeutic options exist for NAFLD that target both sleep and NAFLD, including non-pharmacological factors, such as lifestyle modification (mainly diet and exercise). Pharmacological options include melatonin, Vitamin E, thiazolidinediones, and fecal microbiota transplantation.Core tipThe pathogenesis of non-alcoholic fatty liver disease is closely tied to sleep and circadian rhythm abnormalities, through shared inflammatory pathways and altered metabolism. This review explores the pathogenesis of NAFLD in the context of sleep and circadian abnormalities. The associated inflammatory response is linked to changes in gut-microbiome interactions that contribute to the disease process. Understanding of this linkage has implications for various therapies for disease mitigation.
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