Variation in postoperative outcomes of patients with intracranial tumors: insights from a prospective international cohort study during the COVID-19 pandemic

Background: This study assessed the international variation in surgical neuro-oncology practice and 30-day outcomes of patients who had surgery for an intracranial tumor during the COVID-19 pandemic. Methods: We prospectively included adults aged ≥18 years who underwent surgery for a malignant or benign intracranial tumor across 55 international hospitals from 26 countries. Each participating hospital recorded cases for 3 consecutive months from the start of the pandemic. We categorized patients’ location by World Bank income groups (high [HIC], upper-middle [UMIC], and low- and lower-middle [LLMIC]). Main outcomes were a change from routine management, SARS-CoV-2 infection, and 30-day mortality. We used a Bayesian multilevel logistic regression stratified by hospitals and adjusted for key confounders to estimate the association between income groups and mortality. Results: Among 1016 patients, the number of patients in each income group was 765 (75.3%) in HIC, 142 (14.0%) in UMIC, and 109 (10.7%) in LLMIC. The management of 200 (19.8%) patients changed from usual care, most commonly delayed surgery. Within 30 days after surgery, 14 (1.4%) patients had a COVID-19 diagnosis and 39 (3.8%) patients died. In the multivariable model, LLMIC was associated with increased mortality (odds ratio 2.83, 95% credible interval 1.37–5.74) compared to HIC. Conclusions: The first wave of the pandemic had a significant impact on surgical decision-making. While the incidence of SARS-CoV-2 infection within 30 days after surgery was low, there was a disparity in mortality between countries and this warrants further examination to identify any modifiable factors

Treatment of oily water using hydrophobic nano-silica

In view of serious water contamination threats posed by the ever-increasing usage of automobile fuels, the present study explores the potential of a commercially available hydrophobic nano-silica (Aersosil R 812) for the treatment of water contaminated with the gasoline and diesel using the process of adsorption. Owing to its nanometeic dimension, nano-silica Aerosil R 812 offers large surface area (260 m2/g) that translates into a higher uptake of gasoline and diesel as compared to other adsorbents reported in the literature with a removal efficiency found to be high as 99% and 97%, respectively, at pH 7. Both kinetic as well as equilibrium studies are carried out here, and the data thus obtained are processed in conjunction with appropriate models to obtain relevant parameters. Moreover, unlike porous-matrix based adsorbents, the nano-silica does not suffer from the pore filling and blockage problem, and therefore shows great promise towards the development of cost-effective water-treatment technology

Influence de la maladie rénale chronique terminale sur la disposition et le métabolisme extra rénal des médicaments : exemple des inhibiteurs du récepteur P2Y12 à l'ADP

La maladie coronarienne est l'une des principales causes de morbi-mortalité parmi les patients atteints d'une insuffisance rénale terminale (IRT). Le rôle de l'urémie comme facteur de risque indépendant de morbimortalité cardiovasculaire est incomplètement compris et pourrait impliquer une calcification des vaisseaux plus importante. Il semble également que les antiagrégants plaquettaires inhibant le récepteur P2Y12 à l'ADP comme le clopidogrel ou le prasugrel soient moins efficaces dans leur capacité à inhiber l'agrégation plaquettaire selon le degré d'insuffisance rénale chronique. Le cas d'un patient dialysé avec maladie coronarienne ayant présenté deux resténoses sur stent malgré un traitement de clopidogrel nous a conduit à une réflexion sur son efficacité dans ces conditions et à une revue de la littérature sur le niveau de preuve dans la prescription des antiagrégants plaquettaires lors de l'IRT. Les propriétés pharmacocinétiques de ces traitements sont potentiellement perturbées à différents niveaux (absorption, distribution, et métabolisme) pouvant conduire à une efficacité moindre qui a été décrite dans la littérature pour le clopidogrel et le prasugrel. Le ticagrélor semble donc être le traitement de choix dans cette indication chez le patient en IRT et sa prescription pourrait, à l'avenir, être quantifiée grâce au profil métabolomique des cytochromes P450 avant de débuter le traitement

The concentration (µg flask⁻¹) of different fatty acid and fatty acid groups in the cells or the culture medium of FaO after 3 days of supplementation with 100µM of ALA.

<p>Different letters above bars from the same fatty acid indicate significant (<i>P</i><0.05) differences.</p

Experimental design for a: the effect of time of incubation, and b: effect of ALA substrate concentration.

<p>Experimental design for the flasks used in FAMB computation is also explained in the subfigure b.</p

FA changes in the phospholipid and the non-esterified fatty acid classes, fractionated by TLC, in FaO cells, culture medium and the cells with their culture medium after 3 days of incubation.

<p>A 50 µM ALA was supplemented initially to the medium.</p><p>Values from the same source (cells, medium or the cells+medium) in the same row with different letters are significantly different (<i>P</i><0.05; ANOVA and Tukey’s post hoc test).</p

18∶3n-3 (ALA) bioconversion in FaO hepatocytes at: a; different time-points, b; at 3 days with different concentrations added into the culture medium (0, 25, 50, 75, 100 and 125 µM).

<p>SDA: 18∶4n-3, ETA: 20∶4n-3, EPA: 20∶5n-3, DPA: 22∶5n-3, DHA: 22∶6n-3.</p

Apparent activity (µmol g^–1 of cell protein hour of incubation⁻¹) of enzymes on different available substrates (mmol g⁻¹ of cell protein) in FaO hepatocytes deduced by the fatty acid mass balance.

<p>a: Michaelis-Menten nonlinear regression for Fads2 on 18∶3n-3: <i>Y</i> = 3654 <i>X</i>÷(310+<i>X</i>), <i>R</i>² = 0.93, normality of residual = 0.45; b: linear regression for Elovl5 on 18∶4n-3: <i>Y</i> = 3.479+14.19 <i>X</i>, <i>R</i>² = 0.93, <i>P</i> of deviation from zero <0.05; c: Michaelis-Menten nonlinear regression for Fads1 on 20∶4n-3: <i>Y</i> = 6052<i> X÷</i>(374.6+<i>X</i>), <i>R</i>² = 0.89, normality of residuals <i>P</i> = 0.26; d: Michaelis-Menten nonlinear regression for Elovl2 and Elovl5 on 20∶5n-3: <i>Y</i> = 357.3 <i>X</i>÷(27.5+<i>X</i>), <i>R</i>² = 0.46, normality of residuals <i>P</i> = 0.11; and e: Elovl2, Fads2 and β-oxidation on 22∶5n-3 which is not correlated with the substrate availability. (Note: the <i>Y</i> axis of the e subfigure is different from all the others).</p

Acute Effects of Vitamin C Exposure On Colonic Crypts: Direct Modulation of pH Regulation

Background/Aim: Colorectal cancer is still considered a leading cause of death in the United States and worldwide. One potential way to improve survival besides detection is to look to new therapeutic agents that can be taken prophylactically to reduce the risk of tumor formation. For cancer cells to grow and invade, a higher (more alkaline) intracellular pH must occur. We chose to examine a specific nutraceutical agent, which is Vitamin C. The acute effect of Vitamin C exposure on normal colonic crypts has been studied, providing some insight into how Vitamin C achieve its effect. Methods: Distal colon was excised from rats. Following enzymatic digestion single colonic crypts were isolated. Colonic crypts were loaded with pH sensitive dye to measure the intracellular pH changes. Crypts were exposed to solutions +/- Vitamin C. Results: 10 mM Vitamin C decreased Na+-dependent intracellular pH recovery. Vitamin C modulates SVCT leading to changes in proton extrusion. Vitamin C entry occurs via either SVCT2 on the basolateral membrane or by transcellular passive diffusion through tight junctions to the apical membrane and then active transport via SVCT1. Conclusion: Acute addition of Vitamin C to the basolateral membrane maintains low intracellular pH for a longer period which could halt and/or prevent tumor formation