Haemorrhagic ulcerative duodenitis in a patient with COVID-19 infection: clinical improvement following treatment with budesonide

We present a case of a male patient in his mid-30s with COVID-19-induced lung failure requiring extracorporeal membrane oxygenation, who needed an emergency oesophagogastroduodenoscopy due to major upper gastrointestinal bleeding. Endoscopy exposed severe ulcerative duodenitis with diffuse mucosal bleeding. While CT angiography did not show any signs of ischaemia, histopathology revealed duodenitis with substantial inflammatory cell infiltrates consisting of neutrophils and CD3(+) T lymphocytes with equal CD4(+)/CD8(+) distribution. Since the composition of cell infiltrates coincides with changes in inflammatory patterns of the respiratory mucosa from patients with COVID-19 and in COVID-19-associated enterocolitis, and systemic dexamethasone treatment became standard of care in ventilated intensive care unit patients with COVID-19 infection, we initiated an individualised therapeutic attempt to treat the duodenitis with topical enteral budesonide. Follow-up oesophagogastroduodenoscopies within 4 weeks of enteral budesonide administration revealed a full clinical and histological healing of the duodenal mucosa with marked reduction of neutrophilic and lymphocytic infiltrates. To our knowledge, the current report is the first description of enteral budesonide treatment of duodenitis in a patient with COVID-19 infection and warrants further investigation, whether budesonide might constitute a novel therapeutic strategy for the management of COVID-19-related intestinal mucosal damage

Sarcopenia Is a Negative Prognostic Factor in Patients Undergoing Transarterial Chemoembolization (TACE) for Hepatic Malignancies

Background and Aims: While transarterial chemoembolization (TACE) represents a standard of therapy for intermediate-stage hepatocellular carcinoma (HCC) and is also routinely performed in patients with liver metastases, it is still debated which patients represent the ideal candidates for TACE therapy in terms of overall survival. Sarcopenia, the degenerative loss of skeletal muscle mass and strength, has been associated with an adverse outcome for various malignancies, but its role in the context of TACE has largely remained unknown. Here, we evaluated the role of sarcopenia on the outcome of patients undergoing TACE for primary and secondary liver cancer. Methods: The patients’ psoas muscle size was measured on axial computed tomography (CT) scans and normalized for the patients’ height squared. This value was referred to as the psoas muscle index (PMI). The PMI was correlated with clinical and laboratory markers. Results: While pre-interventional sarcopenia had no impact on the direct tumor response to TACE, sarcopenic patients with a pre-interventional PMI below our ideal cut-o value of 13.39 mm/m2 had a significantly impaired long-term outcome with a median overall survival of 491 days compared to 1291 days for patients with a high PMI. This finding was confirmed by uni- and multivariate Cox-regression analyses. Moreover, a progressive rapid decline in muscle mass after TACE was a predictor for an unfavorable prognosis. Conclusion: Our data suggest that sarcopenia represents a previously unrecognized prognostic factor for patients undergoing TACE therapy which might yield important information on the patients’ post-interventional outcome and should therefore be implemented into clinical stratification algorithms

Исследование влияния противотурбулентных присадок на гидравлическое сопротивление потока нефти в добывающих скважинах и трубопроводах

При растворении полимера происходит увеличение вязкости жидкости, а также одновременно происходит и увеличение скорости турбулентного течения полимерного раствора по сравнению со скоростью течения маловязкого растворителя. Это явление получило название эффекта Томса или эффекта снижения гидродинамического сопротивления. Уже 20 лет в трубопроводном транспорте для снижения энергетических затрат и для увеличения скорости течения нефти используют противотурбулентные добавки Возможность использования присадок для уменьшения сопротивления турбулентности в трубопроводах сжиженного газа и, таким образом, снижения затрат энергии на транспортировку газа в трубопроводах.Liquefied natural gas has become one of the main players in the energy industry in recent years. Pipelines are the main means of transporting natural gas. This study is an analysis of the effect of drag reduction agents on the flow of liquefied natural gas. The feasibility of applying drag reduction agents implies a reduction in the energy requirement in pumping liquefied gas from the production site to the required market

Age-dependent alterations of monocyte subsets and monocyte-related chemokine pathways in healthy adults

<p>Abstract</p> <p>Background</p> <p>Recent experimental approaches have unraveled essential migratory and functional differences of monocyte subpopulations in mice. In order to possibly translate these findings into human physiology and pathophysiology, human monocyte subsets need to be carefully revisited in health and disease. In analogy to murine studies, we hypothesized that human monocyte subsets dynamically change during ageing, potentially influencing their functionality and contributing to immunosenescence.</p> <p>Results</p> <p>Circulating monocyte subsets, surface marker and chemokine receptor expression were analyzed in 181 healthy volunteers (median age 42, range 18-88). Unlike the unaffected total leukocyte or total monocyte counts, non-classical CD14⁺CD16⁺monocytes significantly increased with age, but displayed reduced HLA-DR and CX₃CR1 surface expression in the elderly. Classical CD14⁺⁺CD16^-monocyte counts did not vary dependent on age. Serum MCP-1 (CCL2), but not MIP1α (CCL3), MIP1β (CCL4) or fractalkine (CX₃CL1) concentrations increased with age. Monocyte-derived macrophages from old or young individuals did not differ with respect to cytokine release <it>in vitro </it>at steady state or upon LPS stimulation.</p> <p>Conclusions</p> <p>Our study demonstrates dynamic changes of circulating monocytes during ageing in humans. The expansion of the non-classical CD14⁺CD16⁺subtype, alterations of surface protein and chemokine receptor expression as well as circulating monocyte-related chemokines possibly contribute to the preserved functionality of the monocyte pool throughout adulthood.</p