Yttrium-90 Radioembolization of Hepatic Metastases from Colorectal Cancer

Liver metastases from colorectal cancer (CRC) result in substantial morbidity and mortality. The primary treatment is systemic chemotherapy, and in selected patients, surgical resection; however, for patients who are not surgical candidates and/or fail systemic chemotherapy, liver-directed therapies are increasingly being utilized. Yttrium-90 (Y-90) microsphere therapy, also known as selective internal radiation therapy (SIRT) or radioembolization, has proven to be effective in terms of extending time to progression of disease and also providing survival benefit. This review focuses on the use of Y-90 microsphere therapy in the treatment of liver metastases from CRC, including a comprehensive review of published clinical trials and prospective studies conducted thus far. We review the methodology, outcomes, and side effects of Y-90 microsphere therapy for metastatic CRC

Report of Xanthid crab Lophozozymous incisus (H. Mille Edwards, 1834) from the gut of Humpback red snapper Lutjanus gibbus

Two specimens of Lophozozymous incisus were collected from the gut of Humpback red snapper Lutjanus gibbus caught in hooks and lines off Cochin. L. incisus belongs to Family Xanthidae, the largest family of brachyuran crabs. The crab has only been reported from Angrias Bank, Maharashtra and Orissa coast. This is the first report from the southern waters

Trace Metal Concentrations in Zooplankton from the Eastern Arabian Sea and Western Bay of Bengal

Trace metal contents in zooplankton samples were estimated as a part of the Marine Research–Living Resource program at 24 stations in the Bay of Bengal (November, 2002) and 29 stations in the Arabian Sea (September–October, 2003) during the Cruises 209 and 217 of the Fishery and Oceanographic Research Vessel Sagar Sampada. The average metal concentrations in the Bay of Bengal zooplankton (Fe, 14,073 µg g−1; Co, 24.2 µg g−1; Ni, 29.5 µg g−1; Cu, 46.2 µg g−1; Zn, 2000 µg g−1; Cd, 18.7 µg g−1; and Pb, 6.55 µg g−1) were found to be higher of comparable magnitudes than the Arabian Sea zooplankton (Fe, 1786 µg g−1; Co, 14.2 µg g−1; Ni, 18.6 µg g−1; Cu, 21.5 µg g−1; Zn, 374 µg g−1; Cd, 16.5 µg g−1; and Pb, 4.0 µg g−1). The spatial variability of metal contents in zooplankton from both basins indicates that it is markedly enriched in coastal samples than offshore samples. The metal enrichment in zooplankton from the coastal areas of the eastern Arabian Sea occurs due to a combined effect of upwelling, riverine, and anthropogenic sources, whereas the latter two are only dominating in the coastal Bay of Bengal zooplankton. A comparison of average trace metal concentrations in the zooplankton from the Arabian Sea and Bay of Bengal showed that the enrichment of Fe, Zn, Cd, Ni, Cu, and Pb in the Bay of Bengal zooplankton may be due to high bioaccumulation factor of these elements, whereas the slight Co enrichment may be due to the bioavailability of this metal in the seawater

Endocrine Autoimmunity in Association with Female Infertility

Infertility is the inability to conceive after a year of regular unprotected sexual intercourse, affecting 10-15% of couples. Advanced age, obesity, and certain medications can hinder fertility. Endocrine autoimmunity is increasingly recognized as a significant contributor to female infertility, often complicating various gynecological conditions. Autoimmune issues involving the hypothalamus, pituitary gland, thyroid, adrenal glands, and ovaries can impact fertility. A multidisciplinary approach is essential for diagnosing infertility, with a crucial focus on identifying potential endocrine disorders. Here we discuss how to identify endocrine autoimmune patients with ovulatory dysfunction. Women must be advised about limiting factors to be avoided, to protect their fertility. A comprehensive understanding of the underlying mechanisms, coupled with appropriate diagnostic and therapeutic approaches, is crucial for effectively managing this complex condition and helping women achieve their reproductive goals

Directional Secretory Response of Double Stranded RNA-Induced Thymic Stromal Lymphopoetin (TSLP) and CCL11/Eotaxin-1 in Human Asthmatic Airways

Background Thymic stromal lymphoproetin (TSLP) is a cytokine secreted by the airway epithelium in response to respiratory viruses and it is known to promote allergic Th2 responses in asthma. This study investigated whether virally-induced secretion of TSLP is directional in nature (apical vs. basolateral) and/or if there are TSLP-mediated effects occurring at both sides of the bronchial epithelial barrier in the asthmatic state. Methods Primary human bronchial epithelial cells (HBEC) from control (n = 3) and asthmatic (n = 3) donors were differentiated into polarized respiratory tract epithelium under air-liquid interface (ALI) conditions and treated apically with dsRNA (viral surrogate) or TSLP. Sub-epithelial effects of TSLP were examined in human airway smooth muscle cells (HASMC) from normal (n = 3) and asthmatic (n = 3) donors. Clinical experiments examined nasal airway secretions obtained from asthmatic children during naturally occurring rhinovirus-induced exacerbations (n = 20) vs. non-asthmatic uninfected controls (n = 20). Protein levels of TSLP, CCL11/eotaxin-1, CCL17/TARC, CCL22/MDC, TNF-α and CXCL8 were determined with a multiplex magnetic bead assay. Results Our data demonstrate that: 1) Asthmatic HBEC exhibit an exaggerated apical, but not basal, secretion of TSLP after dsRNA exposure; 2) TSLP exposure induces unidirectional (apical) secretion of CCL11/eotaxin-1 in asthmatic HBEC and enhanced CCL11/eotaxin-1 secretion in asthmatic HASMC; 3) Rhinovirus-induced asthma exacerbations in children are associated with in vivo airway secretion of TSLP and CCL11/eotaxin-1. Conclusions There are virally-induced TSLP-driven secretory immune responses at both sides of the bronchial epithelial barrier characterized by enhanced CCL11/eotaxin-1 secretion in asthmatic airways. These results suggest a new model of TSLP-mediated eosinophilic responses in the asthmatic airway during viral-induced exacerbations

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Mixed immune response in Pediatric severe asthma

Rationale: Severe asthma account for 5-10% of all patients but \u3e70% of healthcare cost. While the majority of asthma is thought to be driven by a Th2 immune response, recent data suggests Th1 and Th17 responses may play a role in severe asthma. Few studies have evaluated Broncho alveolar lavage (BAL) cytokines in pediatric severe asthma. In this pilot study, we hypothesize that children with severe asthma exhibit a mixed Th2 and Th1/Th17 response based on BAL cytokine profiling. Method: BAL samples and data were collected from children undergoing bronchoscopy for severe refractory asthma symptoms or chronic cough. MSD multiplex kits were used to measure Th1 (IFN-Y, IL-1β, TNF-α), Th2 (IL-5, IL-13, TSLP) and Th17 (IL-17A, IL21, IL-23, and IL-33) cytokines in BAL. Data collected included demographics, asthma history, serum IgE and eosinophils, BAL neutrophil and eosinophil count. Asthma severity was defined based on NAEPP criteria. BAL results and clinical characteristics were analyzed comparing severe asthma to non-severe asthma subjects. Results: A total of 22 children were included in this study of which 17 BAL samples were analyzed (77.2% male, median age 6.0 yrs (SED ±1.1), 72.7% African American). Overall, median FEV1 was 86% predicted (SED ±3.2), serum IgE 80IU/ml (SED ±145.8) and serum eosinophilia 0.34K/mcl. Children with severe asthma were older [10.0 vs. 2.0 years (p \u3c0.001)], received a higher number of systemic steroid courses in the past year [3 vs. 2 (p= 0.05), and had a higher median BAL eosinophil (14 vs. 0% (p\u3c0.001)]. After correcting for age, there was no increase in any BAL cytokine in severe vs. non-severe asthma. Unlike findings in non-severe asthma, there was a significant positive correlation in the severe asthma cohort between IL-13 and TNF-α (p= 0.003), IL-5 with Th17 (IL-23, IL-33) (p= 0.001 for both), and IL-13 with Th17 (IL-23, IL-33) (p=0.017, 0.023 respectively). Conclusion: In pediatric patients with severe asthma, BAL samples showed multiple correlations between Th1, Th2, and Th17 cytokines. This reflects a mixed immune response of different T-helper cells unique to severe asthma in children. This may help explain inadequate responses to current treatment measures, including steroids. Further studies are needed to evaluate mechanisms for this mixed response in epithelium, smooth muscle and sub-epithelial structures, which may lead to other therapeutic targets for severe, therapy resistant asthma

Not Available

Not AvailableTwo specimens of Lophozozymous incisus were collected from the gut of Humpback red snapper Lutjanus gibbus caught in hooks and lines off Cochin. L. incisus belongs to Family Xanthidae, the largest family of brachyuran crabs. The crab has only been reported from Angrias Bank, Maharashtra and Orissa coast. This is the first report from the southern waters.Not Availabl

Not Available

Not AvailableTwo specimens of Lophozozymous incisus were collected from the gut of Humpback red snapper Lutjanus gibbus caught in hooks and lines off Cochin. L. incisus belongs to Family Xanthidae, the largest family of brachyuran crabs. The crab has only been reported from Angrias Bank, Maharashtra and Orissa coast. This is the first report from the southern waters.Not Availabl