Anterior skull base meningiomas: surgery related hypothalamic sequalae. How to avoid?

Introduction: Surgical: morbidities related to anterior skull base meningiomas are widely addressed in the literature and mostly related to tumor relations to cranial nerves and vascular structures in this challenging area. However; there is infrequent complications related to hypothalamic insult either from direct affection or via manipulation of vascular supply of this area.The aim of this study: is to address hypothalamic complications occurred after surgery for anterior skull base meningiomas, pitfalls in our surgical technique and the way to minimize such morbidities.Patients and methods: Retrospective study was conducted on all patients who did surgery for anterior skull base meningiomas in the neurosurgery department, Mansoura University during the period from 2011 to 2016. All the patients clinical and radiological data before and after surgery were analyzed. All patients who developed transient or permeant hypothalamic manifestation were included in this study and data regarding their tumor morphology, surgical technique and post-operative early and late imaging were assessed.Results: Among 93 patients who did surgery for anterior skull base meningiomas; 12 patients developed post-operative sequalae related to hypothalamic function. In 7 patients; tumor was recurrent and in 4 patients; conformal radiotherapy was given after the initial surgery. Complication was transient in 3 patients and permeant in 9 patients. 8 patients died from their hypothalamic sequalae. Early post-operative imaging showed hypothalamic infarction in 8 patients.Conclusion: Through reviewing these cases we can address the importance of many factors in the tumours especially size, morphology, recurrence who increase hypothalamic insults. Factors in surgery include preservation of arachnoid plain, perforators, meticulous dissection for minimize this complication

Comparative study of the chemical composition and anti-proliferative activities of the aerial parts and roots of Apium graveolens L. (celery) and their biogenic nanoparticles

Apiaceae plants are multipurpose folk remedies and bioactive foods that show a remarkable ability to biosynthesize a large number of secondary metabolites with antitumor and chemopreventive potential. Among the various members of the Apiaceae, celery (Apium graveolens L.) has long been used as a popular edible and medicinal plant owing to its plentiful health benefits and nutraceutical properties; however, the anticancer potential of this important species has been seldom studied, mostly focusing on its seeds. Therefore, this work was designed to delve into the chemical composition and anti-proliferative potential of the total ethanolic extracts of the aerial parts (TEEAGA) and roots (TEEAGR) of A. graveolens var. dulce (Mill.) Pers. as well as their green synthesized silver nanoparticles (AgNPs). In general, both TEEAGA and TEEAGR exhibited moderate to potent inhibitory activities against human liver (HepG-2), colon (Caco-2), and breast (MCF-7) cancer cell lines, with interesting IC50 profiles [(41.37 ± 0.12, 27.65 ± 0.27, and 9.48 ± 0.04 μg/mL) and (11.58 ± 0.02, 7.13 ± 0.03, and 6.58 ± 0.02 μg/mL), respectively] as compared with doxorubicin, while more pronounced anti-proliferative effects were observed for their biogenic AgNPs, which showed IC50 values ranging between 25.41 ± 0.16 and 1.37 ± 0.03 μg/mL. Moreover, HPLC‒HESI‒HRMS-based metabolomics analysis of both extracts showed the presence of a varied group of secondary metabolites, including flavonoids, phenylpropanoids, phthalides, coumarins, and sesquiterpenes that further displayed moderate to promising binding affinities to the active site of cyclin G-associated kinase (GAK), particularly graveobioside A, graveobioside B, and celeroside C, suggesting their possible contribution as GAK modulators to the anti-proliferative potential of celery. These findings can help broaden future research on the utilization of different parts of celery and their NPs as functional foods and medicines in cancer chemoprevention and therapy

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

Antifungal potential of marine natural products

Highlights: • Fungal infections represent an increasing threat to human health. • Fungal infections in plants are a worldwide problem to the agricultural industry. • Diverse antifungal compounds were isolated from different marine organisms. • The number of new antifungal marine natural products is rapidly developing. • Marine sponges and bacteria are the predominant sources for antifungal compounds. Abstract: Fungal diseases represent an increasing threat to human health worldwide which in some cases might be associated with substantial morbidity and mortality. However, only few antifungal drugs are currently available for the treatment of life-threatening fungal infections. Furthermore, plant diseases caused by fungal pathogens represent a worldwide economic problem for the agriculture industry. The marine environment continues to provide structurally diverse and biologically active secondary metabolites, several of which have inspired the development of new classes of therapeutic agents. Among these secondary metabolites, several compounds with noteworthy antifungal activities have been isolated from marine microorganisms, invertebrates, and algae. During the last fifteen years, around 65% of marine natural products possessing antifungal activities have been isolated from sponges and bacteria. This review gives an overview of natural products from diverse marine organisms that have shown in vitro and/or in vivo potential as antifungal agents, with their mechanism of action whenever applicable. The natural products literature is covered from January 2000 until June 2015, and we are reporting the chemical structures together with their biological activities, as well as the isolation source

A new bioactive sesquiterpenoid quinone from the mediterranean sea marine sponge Dysidea avara

Investigation of the marine sponge Dysidea avara, family Dysideidae, afforded a new sesquiterpene (-)-N-methylmelemeleone-A (5), in addition to four known sesquiterpenes (+)-avarol (1), (+)-avarone (2), (-)-3′- methylaminoavarone (3) and (-)-4′-methylaminoavarone (4). The structure elucidation of compound 5 was based on 1D and 2D NMR spectroscopic, and HR-MS studies, as well as by comparison with the literature. Cytotoxicity, protein kinase inhibition, inhibition of NFκB-activity and insecticidal activity were evaluated for the isolated compounds

Officinalioside, a new lignan glucoside from <i>Borago officinalis</i> L.

<p>A new lignan glucoside, officinalioside <b>(1)</b>, was isolated from <i>n</i>-BuOH fraction of the aerial parts of <i>Borago officinalis</i> L., together with four known compounds: actinidioionoside (<b>2</b>), roseoside (<b>3</b>), crotalionoside C (<b>4</b>) and kaempferol 3-<i>O</i>-β-D-galactopyranoside (<b>5</b>). The structure of the new compound was established by means of spectroscopic and chemical analyses. Compounds <b>1</b> and <b>2</b> showed a moderate DPPH radical scavenging activity (IC₅₀: 52.6 ± 1.70 and 41.3 ± 0.25 μM, respectively) comparable with that of the standard trolox (16.6 ± 2.2 μM) without any significant cytotoxicity towards human cell line A549 (IC₅₀ > 100 μM).</p

Aqueous Fraction of <i>Beta vulgaris</i> Ameliorates Hyperglycemia in Diabetic Mice due to Enhanced Glucose Stimulated Insulin Secretion, Mediated by Acetylcholine and GLP-1, and Elevated Glucose Uptake via Increased Membrane Bound GLUT4 Transporters

<div><p>Background</p><p>The study was designed to investigate the probable mechanisms of anti-hyperglycemic activity of <i>B. Vulgaris</i>.</p><p>Methodology/Principal Findings</p><p>Aqueous fraction of <i>B. Vulgaris</i> extract was the only active fraction (50mg/kg). Plasma insulin level was found to be the highest at 30 mins after <i>B. Vulgaris</i> administration at a dose of 200mg/kg. <i>B. Vulgaris</i> treated mice were also assayed for plasma Acetylcholine, Glucagon Like Peptide-1 (GLP-1), Gastric Inhibitory Peptide (GIP), Vasoactive Intestinal Peptide, Pituitary Adenylate Cyclase-Activating Peptide (PACAP), Insulin Like Growth Factor-1 (IGF-1), Pancreatic Polypeptides (PP), and Somatostatin, along with the corresponding insulin levels. Plasma Acetylcholine and GLP-1 significantly increased in <i>B. Vulgaris</i> treated animals and were further studied. Pharmacological enhancers, inhibitors, and antagonists of Acetylcholine and GLP-1 were also administered to the test animals, and corresponding insulin levels were measured. These studies confirmed the role of acetylcholine and GLP-1 in enhanced insulin secretion (p<0.05). Principal signaling molecules were quantified in isolated mice islets for the respective pathways to elucidate their activities. Elevated concentrations of Acetylcholine and GLP-1 in <i>B. Vulgaris</i> treated mice were found to be sufficient to activate the respective pathways for insulin secretion (p<0.05). The amount of membrane bound GLUT1 and GLUT4 transporters were quantified and the subsequent glucose uptake and glycogen synthesis were assayed. We showed that levels of membrane bound GLUT4 transporters, glucose-6-phosphate in skeletal myocytes, activity of glycogen synthase, and level of glycogen deposited in the skeletal muscles all increased (p<0.05).</p><p>Conclusion</p><p>Findings of the present study clearly prove the role of Acetylcholine and GLP-1 in the Insulin secreting activity of <i>B. Vulgaris</i>. Increased glucose uptake in the skeletal muscles and subsequent glycogen synthesis may also play a part in the anti-hyperglycemic activity of <i>B. Vulgaris</i>.</p></div

Antiproliferative potential of Dypsis decaryi seeds supported by metabolic profiling and molecular docking

IntroductionDypsis decaryi seeds need more phytochemical and biological attention specially on one of the most important life-threatening problems (cancer).MethodsTotal ethanol extract of D. decaryi seeds (TEEDDS, Arecaceae) and its fixed oil fraction (FOF) were subjected to UPLC-HR-ESI-MS metabolic profiling and gas chromatography-mass spectrometry, respectively. Also, TEEDDS, FOF, and FOF silver nanoparticles (FOF-SNPs) were screened using 4 cell lines. FOF effects on expression of Bcl-2, Bax, P53, and epidermal growth factor receptor (EGFR) in human prostate carcinoma cell line (PC-3) were evaluated and supported by docking study.ResultsMetabolic profiling of TEEDDS resulted in identification of 18 compounds. While GC-MS of FOF displayed the presence of 12 fatty acids methyl esters. TEEDDS, staurosporine, FOF, and FOF-SNPs showed IC50= 3.55, 9.81, 16.88, and 0.01 µg/mL, respectively, against PC-3 (human prostate carcinoma cell line). FOF effects on the expression of Bcl-2, Bax, P53, and EGFR in PC-3 cell lines displayed IC50= 1.09, 220.6, 619.8, and 399.64 ng/mL, respectively. The FOF major constituent (E-13-octadecenoic acid) exhibited significant affinity and binding interactions that were comparable with that of the cocrystalized inhibitor.Discussion/ConclusionsFor the first time, in vitro antiproliferative activity against PC-3, HepG-2, HCT-116, and MCF-7 cells, and chemical profiles of TEEDDS and its FOF have been noteworthy studied. FOF and FOF-SNPs displayed the highest activities particularly on PC-3. Additionally, FOF showed significant activities on Bcl-2, Bax, P53, and EGFR, which was also supported by docking study. These results highlight that FOF and FOF-SNPs could have potent antiproliferative activity against PC-3 cell lines and may play an important role in antiproliferative drug development

Effects of aqueous fraction of <i>Beta vulgaris</i> (BV) on A) cAMP content, B) Protein Kinase A (PKA) activity, and C) Insulin secretion from isolated mouse islets after a 30mins incubation period.

<p>Values are means and standard deviation (SD) represented by vertical bars (n = 4). Groups of 25–30 islets were isolated from db/db diabetic mice after collagenase digestion. The mice were fed with <i>B. Vulgaris</i> (200 mg/kg) for 8weeks before the isolation procedure. Isolated islets were exposed to 5.6mM glucose for 60minsto adapt to a baseline glucose concentration. Then they were exposed to 16.7mM glucose alone (untreated group) or to <i>B. Vulgaris</i> (50 μg/ml) or to <i>B. Vulgaris</i> (50 μg/ml)+Ext9 (Extendin 9–39) (2μmol/l) for 30mins. At the same time, the groups were also exposed to GLP-1 14.7pmol/l (untreated group), 21.4 pmol/l (<i>B. Vulgaris</i> treated group), and 21.5pmol/l (<i>B. Vulgaris</i>+Extending 9–39 treated group) (concentrations of GLP-1 found during in vivo test in response to different treatments at 30mins). After the incubation period, samples were collected or islets were sonicated, where required, and equivalent amount of islet protein was analyzed. Values marked with an asterisk (*) or two (**) were significantly higher from the control group value with p<0.05 or p<0.01 respectively (Derived from One-way ANOVA followed by post hoc Dunnett’s test).</p