uti

Bilateral trigeminal neuralgia refractory to medical therapy is a rare occurrence and it is mandatory to choose therapeutic procedures minimizing possible bilateral sensitive deficit due to the employment of bilateral mininvasive ablative techniques.  A patient affected by bilateral trigeminal neuralgia refractory to medical therapy secondary to multiple sclerosis is presented. Multiple therapeutic tools were employed in this challenging pathology. The second and third left trigeminal divisions were involved by the neuralgia, while the third division was involved in the right facial side. Controlled radiofrequency thermocoagulation was employed for the isolated right third division, then radiosurgery was conducted for the left hemifacial side.  After one month, because of the persistence of pain attacks of the left second trigeminal division, peripheral authorizations were performed. Control of pain, with the withdrawal of medical therapy (BNI scale class I), was achieved in this patient with a multi-therapeutic approach. Radiofrequency thermorizotomy was performed for the right third division because neuralgia was very acute, and immediate pain relief was achieved. Pain in the left third trigeminal division regressed after radiosurgery, while pain in the left second division continued after radiosurgery, then peripheral alcoholization was performed with pain control.Bilateral trigeminal neuralgia refractory to medical therapy should be treated by the dedicated neurosurgeon, avoiding bilateral ablative techniques for the same division and using neurosurgical techniques according to the trigeminal division interested by the neuralgia and according to the intensity of pain.

Background: Outcomes of chemotherapy in adults with ALL in resource-poor countries are reportedly worse compared with outcomes in resource-rich countries. There are few comparative data on transplants in these settings.Methods: Retrospective analysis of 102 consecutive subjects > 18 years with ALL receiving an allotransplant from Jan 2007 to Sept 2022 in Jordan.Results: Median follow-up is 38 mo ([IQR] 16-80 mo). 81 subjects were men. The median age was 29 y(IQR 22-36 y). 63 were B-cell and 38, were T-cell lineage. 31 had the Ph-chromosome. 68 were in 1st and 34, ≥ 2nd histological complete remission. 97 received intensive conditioning. Donors were an HLA-identical sibling (N = 88) or an HLA-mis-matched relative (N = 14). Grafts were blood cells. Subjects received conventional GvHD prophylaxis, cyclophosphamide (N = 11) or ATG (N = 3). All subjects recovered bone marrow function with complete donor chimerism. 5-year leukemia-free survival (LFS), 58% (47, 69%) and survival, 45% (34, 56%). 45 subjects developed acute and 44, cGvHD. 3-year cumulative incidence of cGvHD was 28% (15, 42%). 5-year CIR was 32% (18, 45%) and 3-year NRM, 25% (15, 35%).Conclusion: Allotransplant outcomes in adults with ALL in Jordan, a resource-poor country, seem comparable to those reported in resource-rich countries.

This document has been translated from Spanish into English using ChatGPT. While efforts have been made to ensure accuracy and maintain the original meaning, some nuances or interpretations may differ from the source text. For any clarification, please refer to the original document or contact the author.This brief article addresses the concern arising from the accelerated whirlwind of changes of all kinds experienced by our social systems, some of which have a significant evolutionary impact, largely driven by advances in science and technology. Particular interest has emerged in connecting certain properties inherent to the behavior of complex systems far from equilibrium—such as social systems—under the framework of properties currently studied in Complexity Sciences. The article outlines this concern, which is, for now, merely the beginning of what could develop into a groundbreaking investigation. It references laboratory simulation work aimed at understanding the evolutionary horizons of Chile’s social system. The text includes an example of some graphs that illustrate a potential method for detecting and anticipating possible evolutionary horizons of the social system, based on the role played by certain “attractor variables” within the system. However, the research is still exploratory, and this article serves merely as a general description of the initial concern.

This study investigates the impact of socio-political disruptions on air quality in Khartoum, Sudan, focusing on key pollutants: Aerosol Optical Depth (AOD), Carbon Monoxide (CO), Nitrogen Dioxide (NO₂), and Sulfur Dioxide (SO₂). Using Sentinel-5P satellite data (2020–2024) processed in Google Earth Engine (GEE), spatial and temporal variations in pollutant levels were analyzed before and after a significant war event in April 2023. The methodology included data acquisition, preprocessing (e.g., cloud masking, spatial filtering), monthly averages computation, visualization, and statistical analysis using Google Earth Engine (GEE), ArcGIS Pro, and Microsoft Excel. Results showed a marked post-war increase in AOD levels, attributed to infrastructure destruction, fires, and diminished industrial oversight, alongside spatially consistent pollution patterns in some regions. CO concentrations exhibited an overall decline due to reduced industrial activities and transportation, though localized anomalies were linked to concentrated emissions. Similarly, NO₂ levels dropped significantly, reflecting reduced vehicular and industrial activities, while sporadic increases suggested localized emissions like generator use. SO₂ demonstrated mixed trends, with reduced mean levels but increased variability, indicating sporadic high-emission events linked to emergency fuel use or conflict-related disruptions. This study uniquely combines high-resolution satellite data with advanced spatial and temporal analysis techniques to reveal the nuanced and multi-pollutant impact of socio-political conflicts on air quality in Khartoum, providing novel insights into the environmental repercussions of armed conflicts. These findings highlight the profound impact of socio-political events on atmospheric pollution dynamics, underscoring the need for robust urban planning, targeted environmental monitoring, and policies to mitigate air quality deterioration and address public health concerns in conflict-prone regions. The study emphasizes the importance of satellite-based monitoring to provide critical insights into the environmental repercussions of socio-political upheavals.

Double-Positive Patients (DPPs), characterized by the simultaneous presence of Anti-Neutrophil Cytoplasmic Antibody (ANCA) and anti-Glomerular Basement Membrane (anti-GBM) antibodies, represent a rare subset in systemic vasculitis. We present two cases of DPPs with renal involvement and review the existing literature to elucidate the clinical characteristics, histopathological findings, management strategies, and prognostic outcomes associated with this condition. Both cases exhibited renal involvement with rapidly progressive glomerulonephritis, requiring renal replacement therapy. Renal biopsies confirmed crescentic glomerulonephritis with features of both anti-GBM disease and ANCA-associated vasculitis. Management included high-dose glucocorticoids, cyclophosphamide, and consideration of plasma exchanges. Double-positive ANCA and anti-GBM vasculitis pose challenges in management and prognosis. Further research is essential to improve therapeutic strategies for this rare and heterogeneous condition.

Kalanchoe pinnata is a widely recognized medicinal plant known for its antioxidant and anti-inflammatory properties. This study explores its in vitro antioxidant and anti-inflammatory activities, highlighting its potential for pharmaceutical and biomedical applications. The research innovatively assesses its bioactive components using DPPH radical scavenging, nitric oxide inhibition assays, and phenolic content analysis. Results demonstrated significant antioxidant activity with IC50 values comparable to ascorbic acid, along with notable anti-inflammatory effects via nitric oxide inhibition. These findings emphasize Kalanchoe pinnata’s potential as a source for developing antioxidant and anti-inflammatory therapeutics. Further investigation into bioactive compound isolation and mechanistic pathways is recommended to clarify its pharmacological efficacy.

Alginate, a naturally occurring biopolymer extracted from brown algae, presents a promising avenue for developing sustainable and efficient membranes for wastewater treatment. This review comprehensively examines recent advancements in the fabrication, modification, and application of alginate-based membranes for effective water purification. The paper delves into various fabrication techniques, including casting, electrospinning, and 3D printing, which influence the structural and functional properties of the resulting alginate membranes. To enhance performance, strategies such as crosslinking, incorporation of porogens, and surface functionalization are employed. These modifications optimize crucial properties like mechanical strength, porosity, selectivity, and antifouling resistance. Furthermore, Response Surface Methodology (RSM) has emerged as a valuable tool for systematically optimizing fabrication parameters, enabling researchers to identify optimal conditions for achieving desired membrane characteristics. The integration of alginate membranes with biological treatment processes, such as phycoremediation (utilizing microalgae) and mycoremediation (employing fungi), offers a synergistic approach to enhance wastewater treatment efficiency. By immobilizing these microorganisms within the alginate matrix, their bioremediation capabilities are amplified, leading to improved pollutant degradation and nutrient removal. In conclusion, alginate-based membranes demonstrate significant potential as a sustainable and effective technology for wastewater treatment. Continued research and development, focusing on optimizing fabrication processes and exploring innovative integration strategies with biological systems, will further advance the application of alginate membranes in addressing the pressing global challenge of water pollution.

Retracing the evolution of Mineralocorticoid Receptors (MR) obliges us to take an instructive as well as fascinating leap back in time. This journey teaches us that the relationship between MRs and what we consider their natural ligand, aldosterone, has not always been an exclusive one. MRs operated for a very long time in the oceans and, in any case, in an aquatic environment, stimulated by ligands other than aldosterone, and exercising functions that we still do not know well but which were certainly different from those they currently perform in terrestrial vertebrates, where they maintain normal sodium and body fluids. The history of MRs was initially intertwined with that of female sexual hormones, in particular with progesterone, which was one of the first agonists for MRs, before becoming, with the transition to the terrestrial environment, an important antagonist. This initial intertwining could be the cause of the sexual dimorphism that can be glimpsed when these receptors are overstimulated, as emerges from many experimental studies and some clinical data and/or when antagonistic drugs for these receptors are studied. This must be taken into account in the planning of clinical studies, especially randomized controlled trials, in which the presence of the two sexes must always be well balanced and in the interpretation of the results which must always be performed being well aware of the gender of participants. This does not always happen, however.

Introduction: Behçet’s disease is a rare, systemic, inflammatory condition that primarily affects young adults. It is characterized by a variety of clinical manifestations. However, neurological and cardiac presentations remain uncommon and often delayed in diagnosis. This disease can lead to severe complications, such as ischemic strokes and myocarditis, highlighting the systemic and complex nature of the condition.Case presentation: A 27-year-old patient was hospitalized after experiencing an ischemic stroke and myocarditis, which revealed Behçet’s disease. He had a history of oral and cutaneous ulcers, without a prior diagnosis of Behçet. Upon admission, brain imaging confirmed an ischemic stroke, and echocardiography and cardiac MRI showed acute myocarditis. Biological tests confirmed elevated systemic inflammation, which guided the treatment plan. The initial treatment included corticosteroids, immunosuppressors (azathioprine), and cardioprotective therapy. The patient showed significant clinical improvements, although mild deficits persist.Discussion: Myocarditis in Behçet’s disease is a rare but severe manifestation resulting from inflammation of the heart walls, often associated with other systemic vascular involvement. Although less common than oral or cutaneous ulcers, myocarditis can lead to acute heart dysfunction and even heart failure if not treated promptly. It is generally caused by an excessive inflammatory response, often associated with immune system activation, which affects the coronary circulation and damages the cardiac muscle. Treatment for myocarditis in this context relies on high-dose corticosteroids to control inflammation, followed by long-term immunosuppressive medications like azathioprine. While the initial treatment often leads to a rapid improvement in cardiac function, the risk of long-term complications, such as dilated cardiomyopathy or heart failure, remains high. Close follow-up is therefore essential to prevent these complications and optimize the long-term cardiac prognosis of patients with this rare disease.Conclusion: The progression of myocarditis in Behçet’s disease can be favorable if diagnosed and treated early, with significant improvement in cardiac function achieved through the use of corticosteroids and immunosuppressive therapy. However, the long-term prognosis remains uncertain due to the risk of chronic cardiac complications, such as dilated cardiomyopathy or heart failure.

This review underscores the transformative impact of Computer-Aided Engineering (CAE) on modern engineering, emphasizing its role in advancing sustainable and efficient technological solutions. The CAE industry is further analyzed, focusing on market trends and future directions. The CAE market is projected to grow significantly in the next five years in industries like automotive, aerospace, and energy, especially with the rapid advancements in High-Performance Computing (HPC), Artificial Intelligence (AI), Internet of Things (IoT), and Digital Twin technologies that enhance real-time optimization and predictive capabilities, thus fostering innovation in sustainable product design and performance. Lastly, this review presents KYAMOS Software and its state-of-the-art CAE solutions for tackling high-demand engineering problems, mainly concerning green technologies.

Introduction: Membranoproliferative glomerulonephritis (MPGN) is a significant cause of glomerulopathy and chronic kidney disease (CKD) or end-stage renal disease (ESRD) in children. The deposition of circulating immune complexes in the glomerulus and abnormal activation of the alternative complement pathway is believed to trigger the disease. However, there is limited knowledge regarding the optimal treatment and prognosis for children with immune complex-associated MPGN (IC-MPGN) and C3 glomerulopathy (C3G).Case report: We report the case of a 14-year-old child admitted for rapidly progressive glomerulonephritis with anuria managed on haemodialysis. The kidney biopsy showed an appearance compatible with MPGN on light microscopy, with immunoglobulin and complement C3 deposits on direct immunofluorescence. The prognosis was poor, with rapid progression to ESRD despite treatment combining corticosteroid therapy and immunosuppressants.Discussion and conclusion: Evaluating the effectiveness of different therapeutic approaches for MPGN in children is challenging due to the small sample sizes and the short duration of the published controlled studies. As a result, it is crucial to conduct more comprehensive trials that focus on both prognosis and treatment options.

Severe fever with thrombocytopenia syndrome (SFTS) is caused by a virus that induces acute infections. Despite its expansion beyond China, where it first appeared in 2009, no specific drug exists to treat the disease. The discovery that antibodies targeting the SFTS virus surface glycoprotein (Glycoprotein N, GN) significantly enhance patient survival has driven the development of antibodies, particularly nanobodies. Nanobodies targeting the GN protein are a promising therapeutic approach. This paper presents a systematic study of the purification process for a recombinant nanobody-Fc fusion designed to treat the SFTS virus HB29. The study evaluated a sequential purification approach using affinity (AFF), ion exchange (IEC), and hydrophobic interaction chromatography (HIC) techniques to gradually remove impurities. The results demonstrate that this approach achieves an overall yield of more than 50% and a total purity of 95%. Efficient nanobody purification methods, as outlined here, can pave the way for novel treatments to manage this disease.

Mitochondria are essential intracellular organelles that significantly influence various cellular processes, including metabolism, stress response, and cell fate. Their precise regulation is crucial for maintaining both organelle and cellular homeostasis. Wound healing is a complex, multifactorial process that relies on the coordinated actions of multiple cell types and numerous cellular mechanisms. Dysregulation in this process can lead to chronic wounds, which pose substantial challenges for healthcare systems and present limited treatment options due to their intricate pathogenesis. Recent research has increasingly focused on the role of mitochondria in wound healing, revealing their involvement in critical processes such as metabolism, apoptosis, and redox signaling. Mitochondrial dynamics play a vital role in wound healing by adapting to cellular demands and environmental cues. Moreover, mitophagy, the selective degradation of damaged mitochondria, is crucial for maintaining mitochondrial integrity and function during the healing process. Mitochondria are not only pivotal in energy production but also in calcium homeostasis and the generation of mitochondrial reactive oxygen species, which are essential for signaling during wound repair. As wound healing progresses through distinct yet overlapping stages mitochondria facilitate the energy demands of repair and contribute to cytoskeletal remodeling necessary for wound closure. Understanding the multifaceted roles of mitochondria in wound healing could lead to novel therapeutic approaches for chronic wounds. Future research should prioritize investigating mitochondrial dynamics and functions in human tissues to develop targeted strategies for enhancing wound healing outcomes.

Blood cell production through hematopoiesis within the bone marrow serves both to maintain blood equilibrium and to respond to tissue injury and infectious demands. Hematopoietic stem cell (HSC) therapy developments have revolutionized medical treatment approaches for anemia leukemia and bone marrow failure caused by chemotherapy or radiation exposure. The therapeutic compounds present in medicinal plants have traditionally supported blood health and researchers now understand these plants could help regenerate bone marrow tissue. The analysis investigates how phytochemicals affect HSC proliferation and differentiation while supporting HSC survival. The medicinal plants Panax ginseng, Astragalus membranaceus, and Curcuma longa receive special attention for their documented ability to enhance hematopoiesis in preclinical and clinical settings. This review examines the challenges that include standardization issues, toxicity concerns, and regulatory barriers alongside future perspectives about combining plant-based therapies with traditional treatments to improve bone marrow recovery and health results. 

Public-Private Partnership (PPP) road projects are being promoted worldwide to encourage road investments; however, research on the appropriate rate of return for these projects is insufficient. This is likely because the return on investment for PPP road projects is determined through negotiations between the government and the private sector, a process that remains confidential. The rate of return for PPP road projects is not only a key indicator for evaluating project performance but also a potential driver for future government financial subsidies. Therefore, research on the appropriate rate of return for PPP road projects is necessary for the sustainability of these projects.This study, based on the concept that both the government and the private sector share the anticipated risks of the project, quantifies six types of risks and proposes a model for predicting the appropriate rate of return. The model is able to explain approximately 68% of the cases in South Korea’s PPP road projects. The risk with the greatest influence on the rate of return was found to be an economic risk, while the least influential was regulation change risk.Due to the confidentiality of data related to PPP road projects, this study only utilized 54 cases from South Korea. It is hoped that a wider range of data will be collected and further research on the appropriate rate of return will continue to enhance the sustainability of PPP road projects.

Quantum fluctuations, usually arising from the inherent uncertainty in the quantum fields, are pivotal in understanding the universe at both the small and large scales. Even though fluctuations are usually unobservable and rather small, they give significant observable effects during specific epochs under specific conditions. During the early epochs of the universe, the fluctuations were scaled, resulting in the primordial density perturbations that gave rise to the large-scale structure of the universe and the observed inhomogenities. In this paper, we study the basic origin, structure, evolution, and imprints of fluctuations during the inflationary period resulting in large-scale structure formation. We use the Mukhanov-sasaki formalism to model scalar perturbations, embedding the theoretical results into observations. Theoretical predictions show an almost scale-invariant power spectrum with stringent constraints on the inflationary parameters. It further states that in the very early universe, the inflatons that are quanta of the primordial field were highly filled in the degenerate quantum state. This carries large potential energy that results in an exponential expansion of the universe. During post post-inflationary period the inflaton dominated the Universe’s energy density; they interact among themselves and due to non-linear effects, these inhomogeneities grow which amalgamate into spatially distinguishable patches in our observable universe. Our understanding projects us towards the fact that fluctuations play a pivotal role in understanding the structure formation at micro, macro, and far-macro scales. This study also addresses the significance of quantum fluctuations in cosmic evolution and manifests the enduring relevance in addressing some of the profound mysteries of our universe.

Immune Checkpoint Inhibitors (ICPIs), while revolutionizing cancer therapy through potentiation of anti-tumour responses via targeted blockade of T-lymphocyte inhibitory receptors, are associated with immune-related adverse events (irAEs), including diverse renal manifestations. This report presents a case of a 69-year-old male with urothelial carcinoma who developed Acute Kidney Injury (AKI) and nephrotic-range proteinuria following initiation of nivolumab, an anti-PD1 antibody, necessitating renal biopsy to clarify the aetiology. The biopsy revealed Focal Segmental Glomerulosclerosis (FSGS) with endotheliopathy, suggesting a direct ICPI-induced glomerular injury. This case underscores the need for heightened awareness of ICPI-associated glomerular disease, alongside more common renal adverse events such as Acute Interstitial Nephritis (AIN), and for the need for renal biopsy in such cases. While the incidence of ICPI-associated AKI is approximately 17%, and AIN is a more frequent finding, FSGS and other glomerular pathologies should also be considered. Current treatment for such renal events involves discontinuation of the ICPI agent and initiation of immunosuppression with glucocorticoids. The management of these cases requires prompt detection, timely diagnosis, and often interdisciplinary collaboration, thus highlighting the need for more case reports, research, and better treatment strategies.

This work aims to describe the chemical-physical properties of various GELS used as galenic forms in hospital pharmacy practice. After an overview of the excipients and method used three preparations are reported. LAT GEL is used as an anesthetic in an emergency (pediatry ) in treating little Traumatic lacerations of the skin and scalp, calcium gel is used as an antidote for fluoride acid burns, and Lidocaine viscose 2% oral gel is used in some pathological conditions like severe esophagitis in onco - hematological patients after radiotherapy or chemotherapy. The galenic role in the situation of some drug shortages was also analyzed.

Plant extracts and their constituents have a long history as antifungal agents, but their use in biotechnology as preservatives, due to the increasing resistance of fungi to fungicides, has been rarely reported in Libya. The aim of this study is to evaluate the antifungal activity of ethanol extract and water extract of the wild native plant Artemisia herba-alba against two genera of mold fungi Aspergillus sp. and Rhizopus sp. This mold fungal causes significant damage to crops in the field or during storage. In this study, a hot ethanol extract was prepared using a device Soxhlet, and water extract hot as well as a cold ethanol extract and cold-water extract aqueous extract three concentrations (25% - 50% - 75%) of plant extracts were used on the tested fungi. All extracts showed an effect on the tested fungi. The concentrations of (75% - 50%) of the extracts had an effect on the tested fungi, while most concentrations of 25% of the extracts did not record any effect on the tested fungi. The hot ethanol extract of the Artemisia herba-alba plant was more effective than the other extracts. Aspergillus sp. was recorded with the highest inhibitory zone (0.73 mm).  

Background: CT-guided lung biopsy is routinely performed minimally invasive procedure. Imaging findings in the lung can have a broad differential diagnosis; therefore, it is indicated for definitive determination of pulmonary nodules or masses. Post-biopsy complications are common with most of them manageable in daycare. As pneumothorax is the most common complication, frequency and severity of pneumothorax with assessment of risk factors and follow-up for resolution is necessary.Methods: A prospective evaluation of 123 biopsies with automated coaxial biopsy of 18 gauge was done. Post-biopsy pneumothorax was evaluated for its incidence and resolution. The studied risk factors were; patient age, sex, lesion location, lesion size, shortest pleural lesion depth, traversed lung parenchymal distance, presence of emphysema, fissure penetration, needle thoracic wall angle, and lesion characteristics.Results: Reported immediate post-procedural pneumothorax was 22% with 19% of mild, 4% of moderate and 2.4% of severe cases. 51.9% of cases showed resolution within 24 hours. The intervention was required in only 4.8% of biopsy cases. A significant p - value of pneumothorax with the nodule depth increased traversed lung parenchymal distance, acute needle angle, fissure puncture, and presence of emphysema was seen. Emphysema was an independent variable in pneumothorax in multivariate analysis.Conclusion: Pneumothorax is an unamenable consequence of CT-guided lung biopsy and a cautious approach should be kept in view of the variables that are associated with it to reduce its incidence and severity in patients.