Differential Expression of Human Peripheral Mononuclear Cells Phenotype Markers in Type 2 Diabetic Patients and Type 2 Diabetic Patients on Metformin

Background: Although peripheral blood mononuclear cells (PBMC) have been demonstrated to be in a pro-inflammatory state in obesity and type 2 Diabetes Mellitus (T2DM), characterization of circulating PBMC phenotypes in the obese and T2DM and the effect of Metformin on these phenotypes in humans is still ill-defined and remains to be determined.Methods: Thirty normal healthy adult volunteers of normal weight, 30 obese subjects, 20 obese newly diagnosed diabetics and 30 obese diabetics on Metformin were recruited for the study. Fasting blood samples were collected and PBMC were isolated from whole blood. Polarization markers (CD86, IL-6, TNFα, iNOS, CD36, CD11c, CD169, CD206, CD163, CD68, CD11b, CD16, and CD14) were measured by RT-qPCR. Gene expression fold changes were calculated using the 2−ΔΔCT method for RT-qPCR.Results: Obesity and T2DM are associated an increased CD68 marker in PBMC. mRNA expression of CD11b, CD11c, CD169, and CD163 were significantly reduced in PBMC from T2DM subjects whereas CD11c was significantly inhibited in PBMC from obese subjects. On the other hand, macrophage M1-like phenotype was observed in T2DM circulation as demonstrated by increased mRNA expression of CD16, IL-6, iNOS, TNFα, and CD36. There were no significant changes in CD14 and CD86 in the obese and T2DM when compared to the lean subjects. Metformin treatment in T2DM reverted CD11c, CD169, IL-6, iNOS, TNFα, and CD36 to levels comparable to lean subjects. CD206 mRNA expression was significantly upregulated in PBMC of T2DM while Metformin treatment inhibited CD206 expression levels.Conclusions: These data support the notion that PBMC in circulation in T2DM express different pattern of phenotypic markers than the patterns typically present in M1 and M2 like cells. These phenotypic markers could be representative of metabolically activated macrophages (MMe)-like cells. Metformin, on the other hand, reduces MMe-like cells in circulation

Global overview of the management of acute cholecystitis during the COVID-19 pandemic (CHOLECOVID study)

Background: This study provides a global overview of the management of patients with acute cholecystitis during the initial phase of the COVID-19 pandemic. Methods: CHOLECOVID is an international, multicentre, observational comparative study of patients admitted to hospital with acute cholecystitis during the COVID-19 pandemic. Data on management were collected for a 2-month study interval coincident with the WHO declaration of the SARS-CoV-2 pandemic and compared with an equivalent pre-pandemic time interval. Mediation analysis examined the influence of SARS-COV-2 infection on 30-day mortality. Results: This study collected data on 9783 patients with acute cholecystitis admitted to 247 hospitals across the world. The pandemic was associated with reduced availability of surgical workforce and operating facilities globally, a significant shift to worse severity of disease, and increased use of conservative management. There was a reduction (both absolute and proportionate) in the number of patients undergoing cholecystectomy from 3095 patients (56.2 per cent) pre-pandemic to 1998 patients (46.2 per cent) during the pandemic but there was no difference in 30-day all-cause mortality after cholecystectomy comparing the pre-pandemic interval with the pandemic (13 patients (0.4 per cent) pre-pandemic to 13 patients (0.6 per cent) pandemic; P = 0.355). In mediation analysis, an admission with acute cholecystitis during the pandemic was associated with a non-significant increased risk of death (OR 1.29, 95 per cent c.i. 0.93 to 1.79, P = 0.121). Conclusion: CHOLECOVID provides a unique overview of the treatment of patients with cholecystitis across the globe during the first months of the SARS-CoV-2 pandemic. The study highlights the need for system resilience in retention of elective surgical activity. Cholecystectomy was associated with a low risk of mortality and deferral of treatment results in an increase in avoidable morbidity that represents the non-COVID cost of this pandemic

CHARACTERISTICS OF PATIENTS HOSPITALIZED WITH 2009 H1N1 INFLUENZA IN A TERTIARY CARE HOSPITAL IN SOUTHERN SAUDI ARABIA

<p><strong>Background</strong></p> <p>Pandemic influenza A (H1N1) virus emerged and spread globally in the spring of 2009.  We describe the clinical features of the patients who were hospitalized with 2009 H1N1 influenza July 2009 to June 2010 in a tertiary care hospital in Khamis Mushyt, Saudi Arabia.  We analyzed the clinical and laboratory variables in order to determine predictors of poor outcome</p> <p><strong>Methods</strong></p> <p>We performed a prospective study in all patients who were hospitalized for at least 48 hours  and with a positive test for 2009 H1N1 virus through RT-PCR(real time polymerase chain reaction).  Their epidemiological, clinical, biochemical characteristics were collected and the hospital course of the patients with eventual outcome (discharge or death) was observed. We applied a logistic regression analysis to determine the best predictor of death.</p&gt

Investigation of Antibacterial Activity of Carob-Mediated Calcium Hydroxide Nanoparticles against Different Aerobic and Anaerobic Bacteria

Carob-mediated calcium hydroxide nanoparticles (C-CaOH2 NPs) are a type of NPs, newly developed via a green synthesis method, that have demonstrated good in vitro biocompatibility. However, their antibacterial potential has not yet been explored. Both calcium hydroxide and carob are known for their antibacterial potency as bulk materials; thus, we hypothesized that C-CaOH2 NPs may exhibit promising antibacterial efficacy. This study aimed to examine the antibacterial activity of C-CaOH2 NPs against aerobic and anaerobic strains using zone of inhibition (ZOI), minimum inhibitory concentration (MIC), and minimum bactericidal concentration (MBC) tests. The results showed that the Gram-negative aerobic strains are more susceptible than the Gram-positive stains. The most susceptible bacteria were P. aeruginosa, E. coli, and S. aureus, in that order. Conversely, P. micra and E. faecalis were the least susceptible strains. The best recorded ZOIs were at 100 and 150 mg/mL concentrations in all bacteria, with the greatest diameter (11.7 ± 0.6 mm) exhibited in P. aeruginosa. Moreover, the MICs for aerobes were 3.12 mg/mL, except for E. faecalis (0.78 mg/mL) and K. pneumoniae (1.56 mg/mL). MBCs were 12.5 mg/mL for all except P. aeruginosa (3.12 mg/mL) and K. pneumoniae (6.25 mg/mL). The anaerobic strain P. micra exhibited the highest values for both MIC (15.62 mg/mL) and MBC (31.25 mg/mL). The current investigation revealed that C-CaOH2 NPs have intermediate and dose-dependent antibacterial activity that may have variable biomedical applications

Investigation of Antibacterial Activity of Carob-Mediated Calcium Hydroxide Nanoparticles against Different Aerobic and Anaerobic Bacteria

Carob-mediated calcium hydroxide nanoparticles (C-CaOH2 NPs) are a type of NPs, newly developed via a green synthesis method, that have demonstrated good in vitro biocompatibility. However, their antibacterial potential has not yet been explored. Both calcium hydroxide and carob are known for their antibacterial potency as bulk materials; thus, we hypothesized that C-CaOH2 NPs may exhibit promising antibacterial efficacy. This study aimed to examine the antibacterial activity of C-CaOH2 NPs against aerobic and anaerobic strains using zone of inhibition (ZOI), minimum inhibitory concentration (MIC), and minimum bactericidal concentration (MBC) tests. The results showed that the Gram-negative aerobic strains are more susceptible than the Gram-positive stains. The most susceptible bacteria were P. aeruginosa, E. coli, and S. aureus, in that order. Conversely, P. micra and E. faecalis were the least susceptible strains. The best recorded ZOIs were at 100 and 150 mg/mL concentrations in all bacteria, with the greatest diameter (11.7 ± 0.6 mm) exhibited in P. aeruginosa. Moreover, the MICs for aerobes were 3.12 mg/mL, except for E. faecalis (0.78 mg/mL) and K. pneumoniae (1.56 mg/mL). MBCs were 12.5 mg/mL for all except P. aeruginosa (3.12 mg/mL) and K. pneumoniae (6.25 mg/mL). The anaerobic strain P. micra exhibited the highest values for both MIC (15.62 mg/mL) and MBC (31.25 mg/mL). The current investigation revealed that C-CaOH2 NPs have intermediate and dose-dependent antibacterial activity that may have variable biomedical applications

Global overview of the management of acute cholecystitis during the COVID-19 pandemic (CHOLECOVID study)

Background: This study provides a global overview of the management of patients with acute cholecystitis during the initial phase of the COVID-19 pandemic. Methods: CHOLECOVID is an international, multicentre, observational comparative study of patients admitted to hospital with acute cholecystitis during the COVID-19 pandemic. Data on management were collected for a 2-month study interval coincident with the WHO declaration of the SARS-CoV-2 pandemic and compared with an equivalent pre-pandemic time interval. Mediation analysis examined the influence of SARS-COV-2 infection on 30-day mortality. Results: This study collected data on 9783 patients with acute cholecystitis admitted to 247 hospitals across the world. The pandemic was associated with reduced availability of surgical workforce and operating facilities globally, a significant shift to worse severity of disease, and increased use of conservative management. There was a reduction (both absolute and proportionate) in the number of patients undergoing cholecystectomy from 3095 patients (56.2 per cent) pre-pandemic to 1998 patients (46.2 per cent) during the pandemic but there was no difference in 30-day all-cause mortality after cholecystectomy comparing the pre-pandemic interval with the pandemic (13 patients (0.4 per cent) pre-pandemic to 13 patients (0.6 per cent) pandemic; P = 0.355). In mediation analysis, an admission with acute cholecystitis during the pandemic was associated with a non-significant increased risk of death (OR 1.29, 95 per cent c.i. 0.93 to 1.79, P = 0.121). Conclusion: CHOLECOVID provides a unique overview of the treatment of patients with cholecystitis across the globe during the first months of the SARS-CoV-2 pandemic. The study highlights the need for system resilience in retention of elective surgical activity. Cholecystectomy was associated with a low risk of mortality and deferral of treatment results in an increase in avoidable morbidity that represents the non-COVID cost of this pandemic

SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study

Background: Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods: The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18-49, 50-69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results: NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year. Conclusion: As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population