Mitomycin C application in resistant caustic esophageal stricture

Background/purpose Caustic esophageal strictures still represent a catastrophic problem in children of our country. Management protocol is usually started by regular esophageal dilatation in which multiple sessions may be needed until the resolution of dysphagia; however, in many cases endoscopic dilatation fails and therefore esophageal replacement is eventually required. Our aim is to assess the role of mitomycin C application in the management of caustic esophageal stricture refractory to regular endoscopic dilatation.Patients and methods Patients with resistant caustic esophageal stricture were subjected to topical mitomycin C application on stricture site after endoscopic dilatation. Patients were followed up clinically using validated dysphagia score to assess the improvement of dysphagia, radiologically by contrast esophagogram and endoscopically to confirm resolution of the stricture. Results were analyzed and compared with results of a control group managed at the institution by a regular dilatation protocol.Results During the period January 2008 to June 2010, 12 patients with resistant caustic esophageal stricture were followed at our unit of whom six had a short esophageal stricture (< 3 cm) and six had a long stricture ( >3 cm). Topical mitomycin C application resulted in clinical and radiological resolution of dysphagia and strictures in 83% and 66% respectively, compared with 44 (eight out of 18 patients with short stricture) and 25% (two out of eight patients with long stricture) in the control group.Conclusion Mitomycin C application can markedly improve the outcome of patients with caustic esophageal stricture, reducing the number of required sessions for endoscopic dilatation. However, double-blinded randomized controlled trial is needed to prove its effectiveness.Keywords: caustic esophageal stricture, esophageal dilatation, mitomycin

Utilization of extracorporeal membrane oxygenation during the COVID-19 pandemic.

The ongoing outbreak of severe acute respiratory syndrome coronavirus-2 [SARS-CoV-2, or coronavirus disease 2019 (COVID-19)] was declared a pandemic by the World Health Organization on March 11, 2020. Worldwide, more than 65 million people have been infected with this SARS-CoV-2 virus, and over 1.5 million people have died due to the viral illness. Although a tremendous amount of medical progress has been made since its inception, there continues to be ongoing research regarding the pathophysiology, treatments, and vaccines. While a vast majority of those infected develop only mild to moderate symptoms, about 5% of people have severe forms of infection resulting in respiratory failure, myocarditis, septic shock, or multi-organ failure. Despite maximal cardiopulmonary support and invasive mechanical ventilation, mortality remains high. Extracorporeal membrane oxygenation (ECMO) remains a valid treatment option when maximal conventional strategies fail. Utilization of ECMO in the pandemic is challenging from both resource allocation and ethical standpoints. This article reviews the rationale behind its use, current status of utilization, and future considerations for ECMO in critically ill COVID-19 patients

BIOPROCESIRANJE PRIRODNE FOSFATNE RUDE BAKTERIJOM STAPHYLOCOCCUS AUREUS

Phosphate ores are in high demand around the world because they are the primary raw materials used in the manufacturing of phosphatic fertilizers and other chemicals. Since the grade of the ore is gradually declining, it is becoming economically viable to mine and beneficiate numerous lower-grade deposits, and a significant number of precious minerals are discarded due to the inadequacy of new technological advances. Thus, biological processes are becoming more appealing in mineral processing due to their lower operating costs and potential applications to beneficiate low-grade complex ores through the interaction of bacteria and mineral surfaces, resulting in surface modification and mineral separation via bio-flotation. Staphylococcus aureus was supplied by the mineral bioprocessing lab, CMRDI. Bacterial adhesion measurements revealed a higher affinity for apatite than quartz. A binary mixture containing 12.5% P2O5 and 42.5% SiO2 yielded a concentrate containing 20.15% P2O5 and 33.5% SiO2. Using the bio-flotation process with Staphylococcus aureus and the optimal conditions on natural phosphate ore, a concentrate with 30.25% P2O5 was obtained from a feed containing 21.89% P2O5.Diljem svijeta velika je potražnja za fosfatnom rudom s obzirom na to da je riječ o primarnoj sirovini koja se koristi u proizvodnji fosfatnih gnojiva i drugih kemikalija. Budući da se koncentracija rude postupno smanjuje, ekonomski je sve isplativije eksploatirati i oplemenjivati brojna ležišta niže koncentracije s obzirom na to da se znatne količine korisne mineralne sirovine nedovoljno iskorištavaju zbog neadekvatnosti novih tehnologija. Stoga biološki procesi postaju sve zanimljiviji u oplemenjivanju SiO2 mineralnih sirovina zbog nižih operativnih troškova i potencijalne primjene za obogaćivanje kompleksnih ruda niskoga stupnja koncentracije, i to interakcijom bakterija i površine minerala, što rezultira površinskom modifikacijom i odvajanjem minerala putem bioflotacije. Bakteriju Staphylococcus aureus isporučio je laboratorij za bioprocesiranje minerala, CMRDI. Mjerenja bakterijske adhezije pokazala su veći afinitet za apatit nego za kvarc. Binarna smjesa koja je sadržavala 12,5 % P2O5 i 42,5 % SiO2 dala je koncentrat koji je sadržavao 20,15 % P2O5 i 33,5 % SiO2. Postupkom bioflotacije bakterijom Staphylococcus aureus pri optimalnim uvjetima na prirodnoj fosfatnoj rudi dobiven je koncentrat s 30,25 % P2O5 iz sirovine koja je sadržavala 21,89 % P2O5

A Challenging Combination: Anomalous Left Anterior Descending Coronary Artery, Myocardial Bridging, and Endothelial Dysfunction

50 years old female patient with a medical history of hypertension presented to the clinic with chest pain, palpitations, and dyspnea on exertion of 2 years duration. Extensive workup in search of the culprit etiology of her chest pain revealed a challenging combination of an anomalous left anterior descending artery with myocardial bridging and endothelial dysfunction. She was treated medically with long acting nitrates, L-arginine and calcium channel blockers, and remains asymptomatic after 12 months of follow up

Prevalence of Intestinal Protozoa among Saudi Patients with Chronic Renal Failure: A Case-Control Study

It has been hypothesized that chronic renal failure (CRF) predisposes patients to infection with intestinal protozoa. We tested this hypothesis with a matched case-control study to determine the prevalence of these protozoa and their diarrhea associated symptoms among 50 patients with CRF (cases) from Taif, western Saudi Arabia. Fifty diarrheal patients without CRF were recruited in the study as controls. Participants were interviewed by a structured questionnaire and stool samples were collected. Samples were thoroughly examined with microscopy and three coproantigens detection kits. Enteric protozoa were detected in 21 cases and 14 controls. Blastocystis spp. were the most predominant parasite (16% in cases versus 8% in controls), followed by Giardia duodenalis (10% in cases versus 12% in controls) and Cryptosporidium spp. (10% in cases versus 6% in controls). Cyclospora cayetanensis was identified in two cases, while Entamoeba histolytica was described in one case and one control. Intestinal parasitism was positively associated with the male gender, urban residence, and travel history. Clinical symptoms of nausea/vomiting and abdominal pain were significantly varied between the parasitized cases and controls (P value ≤ 0.05). Given the results, we recommend screening all diarrheal feces for intestinal protozoa in the study's population, particularly those with CRF

Fasciola gigantica Fatty Acid Binding Protein (FABP) as a Prophylactic Agent against Schistosoma mansoni Infection in CD1 Mice

Although schistosomicidal drugs and other control measures exist, the advent of an efficacious vaccine remains the most potentially powerful means for controlling this disease. In this study, native fatty acid binding protein (FABP) from Fasciola gigantica was purified from the adult worm's crude extract by saturation with ammonium sulphate followed by separation on DEAE-Sephadex A-50 anion exchange chromatography and gel filtration using Sephacryl HR-100, respectively. CD1 mice were immunized with the purified, native F. gigantica FABP in Freund's adjuvant and challenged subcutaneously with 120 Schistosoma mansoni cercariae. Immunization of CD1 mice with F. gigantica FABP has induced heterologous protection against S. mansoni, evidenced by the significant reduction in mean worm burden (72.3%), liver and intestinal egg counts (81.3% and 80.8%, respectively), and hepatic granuloma counts (42%). Also, it elicited mixed IgG1/IgG2b immune responses with predominant IgG1 isotype, suggesting that native F. gigantica FABP is mediated by a mixed Th1/Th2 response. However, it failed to induce any significant differences in the oogram pattern or in the mean granuloma diameter. This indicated that native F. gigantica FABP could be a promising vaccine candidate against S. mansoni infection

Evaluating the Feasibility of Pro-Neurotensin and 25-Hydroxyvitamin D3 as Possible Indicators for Type 2 Diabetes Mellitus and Its Complications

(1) Background: Type 2 diabetes mellitus (T2DM) and metabolic syndrome are associated with decreased vitamin D. In contrast, high pro-neurotensin (pro-NT) levels are linked with an increased risk of T2DM and cardiovascular disease. We aimed to determine the validity of pro-NT and 25-dihydroxy vitamin D3 levels as predictors for T2DM complications; (2) Methods: One hundred T2DM, and one hundred healthy volunteers participated in this case-control study. Their Pro-NT and 25-hydroxyvitamin D3 levels were evaluated using the ELISA technique; (3) Results: Pro-NT and 25 (OH) vitamin D3 have significant validity and accuracy in T2DM prediction, 84.5%, and 90.5%, respectively (p = 0.001). At a value of \u3c29.5, 25-Hydroxy vitamin D3 showed 88% sensitivity and 93% specificity in predicting T2DM. At a value of \u3e124 Pmol/L, Pro-NT showed 81% sensitivity and 88% specificity in predicting T2DM. At a value of 16.5, 25-Hydroxy vitamin D3 had 78.4% sensitivity and 68.3% specificity in predicting T2DM complications. At a value of \u3e158 pmol/L, Pro-NT predicted T2DM complications with 67.6% sensitivity and 56.0% specificity; (4) Conclusions: 25 (OH) Vit D3 and Pro-NT could identify T2DM patients and predict T2DM complications. More extensive research is required to adequately validate this novel perspective with a large population study

Finite time corrections in KPZ growth models

We consider some models in the Kardar-Parisi-Zhang universality class, namely the polynuclear growth model and the totally/partially asymmetric simple exclusion process. For these models, in the limit of large time t, universality of fluctuations has been previously obtained. In this paper we consider the convergence to the limiting distributions and determine the (non-universal) first order corrections, which turn out to be a non-random shift of order t^{-1/3} (of order 1 in microscopic units). Subtracting this deterministic correction, the convergence is then of order t^{-2/3}. We also determine the strength of asymmetry in the exclusion process for which the shift is zero. Finally, we discuss to what extend the discreteness of the model has an effect on the fitting functions.Comment: 34 pages, 5 figures, LaTeX; Improved version including shift of PASEP height functio

Effects of alginates on the growth, haematological, immunity, antioxidant and pro-inflammatory responses of rabbits under high temperature

Heat stress (HS) is one of the most severe hurdles impacting rabbit growth, immunity, homeostasis, and productivity. Alginate oligosaccharides (AOS) have considerable beneficial effects due to their plausible antioxidant and immune-stimulatory properties. This work was planned to explore the preventive function of AOS as a new bio-feed additive against the harmful effects caused by environmental HS on growing rabbits. Rabbits were allotted in four experimental groups (25 animals in each group) and fed on a basal diet supplemented with 0.0 (AOS0), 50 (AOS50), 100 (AOS100), and 150 (AOS150) mg AOS/kg diet reared under summer conditions. Dietary AOS supplementation improved significantly (P ≤ 0.001) feed conversion rate, while both AOS100 and AOS150 significantly (P ≤ 0.001) enhanced the final body weight and body weight gain. All AOS addition significantly increased nitric oxide and lysosome activity and significantly reduced interferon-gamma (IFNγ) compared with those in the control group. Tumor necrosis factor α (TNFα), interleukin1β (IL-1β), myeloperoxidase and protein carbonyl levels were significantly reduced in rabbits fed diets containing AOS (100 and 150 mg/kg) compared with those in the control group under heat stress conditions. In addition, glutathione (GSH) and catalase (CAT) were significantly (P ≤ 0.001) improved with increasing AOS dietary levels compared with the control group. Still, total antioxidant capacity (TAC), malondialdehyde (MDA), hematocrit, mean corpuscular volume (MCV), eosinophils, and lymphocytes did not change. Erythrocyte's indices improved significantly (P ≤ 0.001), while neutrophils and white blood cell counts were decreased by dietary AOS inclusion. Immunological (IgM and IgG) were markedly reduced in AOS-treated groups compared with the control group. The current investigation exemplified that AOS as a novel bio-feed additive that could be an effective strategy to extenuate prejudicial effects in heat-stressed rabbits via enhancing immunity, and antioxidant defence system, further regulating the inflammation cytokines.Universidad King Saud, Riad, Arabia Saudita | Ref. RSP2023R439Universidade de Vigo/CISU