Morphometric Characteristics and Time to Hatch as Efficacious Indicators for Potential Nanotoxicity Assay in Zebrafish

Although the effects of nano-sized titania (nTiO2) on hatching events (change in hatching time and total hatching) in zebrafish have been reported, additional consequences of nTiO2 exposure (i.e., the effects of nTiO2-induced changes in hatching events and morphometric parameters on embryo-larvae development and survivability) have not been reported. To address this knowledge gap, embryos 4 h postfertilization were exposed to nTiO2 (0, 0.01, 10, and 1000 μg/mL) for 220 h. Hatching rate (58, 82, and 106 h postexposure [hpe]), survival rate (8 times from 34 to 202 hpe), and 21 morphometric characteristics (8 times from 34 to 202 hpe) were recorded. Total hatching (rate at 106 hpe) was significantly and positively correlated to survival rate, but there was no direct association between nTiO2-induced change in hatching time (hatching rate at 58 and 82 hpe) and survival rate. At 58, 82, and 106 hpe, morphometric characteristics were significantly correlated to hatching rate, suggesting that the nTiO2-induced change in hatching time can affect larval development. The morphometric characteristics that were associated with change in hatching time were also significantly correlated to survival rate, suggesting an indirect significant influence of the nTiO2-induced change in hatching time on survivability. These results show a significant influence of nTiO2-induced change in hatching events on zebrafish embryo-larvae development and survivability. They also show that morphometric maldevelopments can predict later-in-life consequences (survivability) of an embryonic exposure to nTiO2. This suggests that zebrafish can be sensitive biological predictors of nTiO2 acute toxicity

Comparison of adrenalectomy with conservative treatment on mild autonomous cortisol secretion: a systematic review and meta-analysis

ObjectiveThis systematic review and meta-analysis was conducted to compare the benefits of adrenalectomy and conservative treatment for comorbidities associated with mild autonomous cortisol secretion (MACS) in patients diagnosed with MACS.BackgroundMACS is the most common benign hormone-secreting functional adrenal incidentaloma. Overproduction of cortisol is observed in MACS patients, resulting in a variety of long-term health issues, including arterial hypertension (HTN), diabetes mellitus (DM), dyslipidemia, obesity, and osteoporosis; however, the classic clinical manifestations of Cushing’s syndrome (CS) are not present.MethodsA systematic search was conducted using MEDLINE, Embase, Web of Sciences, and Scopus databases on December, 2023. Two reviewers independently extracted data and assessed the quality of the included articles. A meta-analysis was performed to compare the beneficial effects of adrenalectomy versus conservative management for MACS-related comorbidities.ResultsFifteen articles were included in this study, which evaluated 933 MACS patients (384 Adrenalectomy and 501 Conservative treatment, and 48 excluded due to incomplete follow-up duration). MACS diagnosis criteria were different among the included articles. All studies, however, stated that there must be no overt CS symptoms. Meta-analysis demonstrates the overall advantage of adrenalectomy over conservative treatment for MACS-related comorbidities (Cohen’s d = -0.49, 95% CI [-0.64, -0.34], p = 0.00). Subgroup analysis indicated that the systolic blood pressure (pooled effect size = -0.81, 95% CI [-1.19, -0.42], p = 0.03), diastolic blood pressure (pooled effect size = -0.63, 95% CI [-1.05, -0.21], p = 0.01), and BMD (pooled effect size = -0.40, 95% CI [-0.73, -0.07], p = 0.02) were significantly in favor of adrenalectomy group rather than conservative treatment but no significant differences between the two treatment groups in other MACS-related comorbidities were reported.ConclusionDespite the limited and diverse data, this study demonstrates the advantage of adrenalectomy over conservative treatment for MACS-related comorbidities

The discriminative value of various biochemical parameters in detecting varying degrees of vitamin D deficiency in the Iranian population

Background: The present study was designed to assess the status and the discriminatory ability of serum Alk-Ph, Ca, P, and PTH in detecting hypovitaminosis D in some selected Iranian populations. Methods: Using a random cluster sample of apparently healthy men and women, this multi-centric cross-sectional study was carried out among the Iranian urban population of five large cities (Tehran, Tabriz, Mashhad, Shiraz, and Booshehr). Serum levels of 25(OH)D, PTH, Alk-Ph, Ca, and P levels were analyzed. Analysis of variance (ANOVA) was used to estimate the main effects by comparing the mean values of serum PTH, Alk-Ph, Ca, and P at different 25(OH)D levels. The discriminative value of the studied biochemical markers in detecting hypovitaminosis D was assessed by ROC curve analysis. Results: From among the studied subjects, 2164 (57.5 %) had moderate to severe vitamin D deficiency. The areas under the ROC curves showed the low accuracy of PTH (0.579), Alk-Ph (0.478), Ca (0.496), and P (0.406) in detecting subjects with a vitamin D concentration <20 ng / mL. Conclusions: Abnormalities in routine markers of bone profile such as PTH, Alk-Ph, Ca, and P are not adequate enough to discriminate patients with hypovitaminosis D. (Clin. Lab. 2011;57:163-170

Retrograde Trans-Femoral Approach for Successful Per- cutaneous Angioplasty in a Diabetic Patient with Ischemic Hand Ulcer: A Case Report

Hand ischemia is a rare complication of diabetes and some other chronic vascular diseases. Critical hand ischemia causes painful limbs and disability and requires urgent revascularization. There have been a few reports of successful trans-brachial percutaneous angioplasty in the upper extremity in the radial or ulnar artery. Herein, we report the results of the endovascular treatment of a 68-year-old diabetic patient with an ischemic hand ulcer due to the severe stenotic lesions of the infra-brachial arteries. The patient underwent successful angioplasty via the retrograde trans-femoral technique to avoid the drawbacks. At the first week of post-procedural follow-up, the patient’s finger was warm with a well–healing wound and reduced pain. In the next two months, he had no complaint of pain or active ulceration; the ulcer was well healed, and the hand was warm. The present case shows that history taking and physical examination should be followed by upper-extremity arteriography for the evaluation of hand ischemia. The trans-femoral approach enabled us to perform percutaneous catheterization for both diagnostic and interventional purposes. Not only is this strategy useful even for the severe stenotic disease of the distal parts of below-the-elbow arteries but also it avoids the unpleasant complications of antegrade brachial cannulation

Cold atmospheric plasma as an effective method to treat diabetic foot ulcers: A randomized clinical trial

Cold atmospheric plasma (CAP) was shown to decrease bacterial load in chronic wounds. It was also presented as a novel approach to healing wounds in both in vitro and in vivo experiments. We aimed to examine the first randomized clinical trial for the use of CAP in diabetic foot ulcers. Patients (n = 44) were randomly double-blinded, and assigned to receive standard care (SC, n = 22) without or with CAP, to be applied three times a week for three consecutive weeks (SC + CAP, n = 22), using block randomization with mixing block sizes of four. The trial was conducted at the Diabetes Research Center in Tehran, Iran. CAP was generated from ionized helium gas in ambient air, and driven by a high voltage (10 kV) and high frequency (6 kHz) power supply. Primary outcomes were wound size, number of cases reaching wound size of <0.5, and a bacterial load after over three weeks of treatment. CAP treatment effectively reduced the fraction of wound size (p = 0.02). After three weeks, the wounds to reach fraction wound size of ≤0.5 was significantly greater in the SC + CAP group (77.3%) compared to the SC group (36.4%) (p = 0.006). The mean fraction of bacterial load counted in each session ‘after CAP exposure’ was significantly less than ‘before exposure’ measures. CAP can be an efficient method to accelerate wound healing in diabetic foot ulcers, with immediate antiseptic effects that do not seem to last long

Antimicrobial effects of silver nanoparticles coated leather on diabetic foot ulcer

Background: Lower limb infection is among significant causes of mortality, morbidity, and prolonged treatment in diabetic patients. Lately, silver nanoparticles, found in various medical applications such as silver coated medical devices, have been introduced as an effective antimicrobial agent. Considering the fact that the antibacterial activity of silver nanoparticles has been established, the aim of study was to determines the efficacy of these particles in reducing the number of microorganisms which grow on diabetic foot ulcer and subsequently prevent diabetic foot infections. Methods: In this case-control study aerobic and anaerobic microorganism were taken from diabetic foot infections of patients visiting the outpatient diabetes clinic by micro debridement. Microorganisms were recognized through standard microbiological methods using kits such as tio glycolat, blood Agar, MacConkeys and chocolate Agar. The natural leather and nanoparticle-coated leather were then inserted in culture media. After 24 hours, samples were count by Muller. Results: Two hundred twenty two strains of 24 different types of bacteria were isolated from 95 diabetic foot ulcers, from among which 94 [42.3%] and 128 [57.7%] strains were respectively gram negative and gram positive. The number of bacteria that grew on the nanoparticle-coated leather was significantly lower. Conclusion: Considering the reduced number of aerobic, anaerobic, gram positive and negative bacteria that grew in diabetic foot ulcers when using nanoparticle-coated leather culture, it could be concluded that the use of such silver coats leather in diabetic foot shoes may prevent diabetic foot infections considerably

Empty sella in somatotropic pituitary adenomas; a series of 23 cases

PurposeWe aimed to investigate empty sella syndrome in somatotrophic pituitary adenoma for possible etiology, complications, and treatment options.MethodAmong over 2,000 skull base masses that have been managed in our center since 2013, we searched for growth hormone-producing adenomas. Clinical, surgical, and imaging data were retrospectively collected from hospital records to check for sella that lacked pituitary tissue on routine imaging.ResultIn 220 somatotrophic adenomas, 23 patients had an empty sella with surgical and follow-up data. The mean age of the sample was 46 years with the same male-to-female ratio. Five cases had partial empty sella and the rest were complete empty sellas. The most common simultaneous hormonal disturbance was high prolactin levels. Six had adenoma invasion into the clivus or sphenoid sinus and 10 had cavernous sinus intrusion. Peri-operative low-flow and high-flow cerebrospinal fluid (CSF) leaks were encountered in one and two patients, respectively, which were successfully sealed by abdominal fat. The majority of cases required growth hormone replacement therapy while it was controlled without any replacement therapy in nine patients. No pituitary hormonal disturbance occurred after transsphenoidal surgery except for hypothyroidism in one patient.ConclusionAn empty sella filled with fluid can be detected frequently in pituitary adenomas, especially in the setting of acromegaly. The pituitary gland may be pushed to the roof of the sella and might be visible as a narrow rim on imaging or may be detected in unusual places out of the sella. The pathophysiology behind such finding originates from soft and hard tissue changes and CSF pressure alternations during abundant growth hormone production