Prevalence and risk factors of complication of endotracheal extubation in teaching hospitals affiliated with Jahrom University of medical science

Endotracheal intubation is to maintain a safe open airway to prevent pulmonary aspiration by administrating general anesthesia. Endotracheal tube, as a foreign body, can stimulate the patients’ airway during the emergence from general anesthesia and cause various reactions and complications immediately or within a multi-day delay.The present study intended to determine the prevalence and associated risk factors of the complications of endotracheal extubation (removal of endotracheal tube / ETT) within 24 hrs. since the surgery. To this end, a descriptive research was conducted on 200 adult candidates for elective and emergency surgery of endotracheal intubation by administrating general anesthesia. Data about the intended associated risk factors and complications were respectively collected in operating room (OR) and within 24 hrs. since surgery and were recorded in the questionnaire. The results indicated that the prevalent complications were sore throat (%21), cough (%12.5) and hoarseness (%15.5). There was not any case of dysphagia and bloody sputum (blood-streaked expectorant). Also, there was a significant relationship between sore throat and the type of surgery (P˂0.001). On the other hand, there was not any statistically significant relationship between sore throat and other associated risk factors (sex, age, weight, type of surgery and size of endotracheal tube). Likewise, not any significant relationship was observed between cough, hoarseness and the intended risk factors. To conclude, the present study found that the type of surgery has a significant effect on the incidence of sore throat within 24 hrs. since the surgical operation; thus, raising awareness of these risk factors and taking proper actions, particularly during intubation, can reduce the incidence of complications, in particular sore throat, and improve patients’ satisfaction.Keywords: General Anesthesia; Intubation; Complication

Systemic neutralization of IL-17A significantly reduces breast cancer associated metastasis in arthritic mice by reducing CXCL12/SDF-1 expression in the metastatic niches

BACKGROUND: IL-17A is a pro-inflammatory cytokine that is normally associated with autoimmune arthritis and other pro-inflammatory conditions. Recently, IL-17A has emerged as a critical factor in enhancing breast cancer (BC)-associated metastases. We generated immune competent arthritic mouse models that develop spontaneous BC-associated bone and lung metastasis. Using these models, we have previously shown that neutralization of IL-17A resulted in significant reduction in metastasis. However, the underlying mechanism/s remains unknown. METHODS: We have utilized two previously published mouse models for this study: 1) the pro-arthritic mouse model (designated SKG) injected with metastatic BC cell line (4T1) in the mammary fat pad, and 2) the PyV MT mice that develop spontaneous mammary gland tumors injected with type II collagen to induce autoimmune arthritis. Mice were treated with anti-IL-17A neutralizing antibody and monitored for metastasis and assessed for pro-inflammatory cytokines and chemokines associated with BC-associated metastasis. RESULTS: We first corroborate our previous finding that in vivo neutralization of IL-17A significantly reduced metastasis to the bones and lungs in both models. Next, we report that treatment with anti-IL17A antibody significantly reduced the expression of a key chemokine, CXCL12 (also known as stromal derived factor-1 (SDF - 1)) in the bones and lungs of treated mice. CXCL12 is a ligand for CXCR4 (expressed on BC cells) and their interaction is known to be critical for metastasis. Interestingly, levels of CXCR4 in the tumor remained unchanged with treatment. Consequently, protein lysates derived from the bones and lungs of treated mice were significantly less chemotactic for the BC cells than lysates from untreated mice; and addition of exogenous SDF-1 to the lysates from treated mice completely restored BC cell migration. In addition, cytokines such as IL-6 and M-CSF were significantly reduced in the lung and bone lysates following treatment. The data presented suggests that systemic neutralization of IL-17A can block the CXCR4/SDF-1 signaling pathway by reducing the expression of SDF-1 in the metastatic niches and significantly reducing metastasis in both mouse models. CONCLUSION: In our model, neutralization of IL-17A regulates SDF-1 expression in the metastatic niches either directly or indirectly via reducing levels of IL-6 and M-CSF

On thermodynamics second law in the modified Gauss Bonnet gravity

The second law and the generalized second law of thermodynamics in cosmology in the framework of the modified Gauss-Bonnet theory of gravity are investigated. The conditions upon which these laws hold are derived and discussed.Comment: 9pages, typos corrected, references adde

Inactivation of the nucl. Accumbens Core Exerts No Effect on Nicotine-Induced Conditioned Place Preference

Effects of transient inhibition of the core part of the nucl. accumbens (NAcC) by lidocaine on nicotine-induced conditioned place preference in male Wistar rats were examined. Lidocaine (2%) was injected into the NAcC of nicotine-conditioned animals before each nicotine i.p. injection. On the test day, behavior of the animals in a two-compartment apparatus was recorded during 10 min. Results revealed that i.p. injections of nicotine (1.0 or 1.5 mg/kg) induced place preference. Transient lidocaine-induced inhibition of one or both sides of the NAcC did not change place preference but changed the numbers of compartment crossings, rearings, and sniffings. Inhibition of the left part and both parts of the structure reduced sniffing and increased place preference; inhibition of the right part of the nucleus increased the intensity of this phenomena.Вивчали впливи тимчасової інактивації серцевинної частини nucl. accumbens (NAcC) за допомогою лідокаїну на індуковану нікотином умовнорефлекторну преференцію місця у самців щурів. Лідокаїн (2 %) ін’єкували в NAcC кондиційованих уведеннями нікотину тварин за 5 хв перед кожною тест-ін’єкцією нікотину. У день тестування поведінка тварин у двокомпартментному пристрої реєструвалася протягом 10 хв. Внутрішньоочеревинні ін’єкції нікотину (1.0 або 1.5 мг/кг) індукували виражену преференцію місця. Унілатеральна або білатеральна тимчасова інактивація NAcC не призводила до змін преференції, але зменшувала кількість стійок та перетинів межі компартментів. Гальмування лівої половини або обох частин NAcC зменшувало кількість епізодів принюхування та збільшувало інтенсивність преференції місця, тоді як гальмування тільки правої частини ядра посилювало принюхування та зменшувало рівень преференції. Отже, наші результати підтвердили, що як ліва, так і права частини NAcC залучені у формування нікотинової преференції місця, але їх ролі можуть бути відмінними

Suppressing miR-21 activity in tumor-associated macrophages promotes an antitumor immune response

microRNA-21 (miR-21) is the most commonly upregulated miRNA in solid tumors. This cancer-associated microRNA (oncomiR) regulates various downstream effectors associated with tumor pathogenesis during all stages of carcinogenesis. In this study, we analyzed the function of miR-21 in noncancer cells of the tumor microenvironment to further evaluate its contribution to tumor progression. We report that the expression of miR-21 in cells of the tumor immune infiltrate, and in particular in macrophages, was responsible for promoting tumor growth. Absence of miR-21 expression in tumor- associated macrophages (TAMs), caused a global rewiring of their transcriptional regulatory network that was skewed toward a proinflammatory angiostatic phenotype. This promoted an antitumoral immune response characterized by a macrophage-mediated improvement of cytotoxic T-cell responses through the induction of cytokines and chemokines, including IL-12 and C-X-C motif chemokine 10. These effects translated to a reduction in tumor neovascularization and an induction of tumor cell death that led to decreased tumor growth. Additionally, using the carrier peptide pH (low) insertion peptide, we were able to target miR-21 in TAMs, which decreased tumor growth even under conditions where miR-21 expression was deficient in cancer cells. Consequently, miR-21 inhibition in TAMs induced an angiostatic and immunostimulatory activation with potential therapeutic implications

Inhibition of profibrotic microRNA-21 affects platelets and their releasate.

Fibrosis is a major contributor to organ disease for which no specific therapy is available. MicroRNA-21 (miR-21) has been implicated in the fibrogenetic response, and inhibitors of miR-21 are currently undergoing clinical trials. Here, we explore how miR-21 inhibition may attenuate fibrosis using a proteomics approach. Transfection of miR-21 mimic or inhibitor in murine cardiac fibroblasts revealed limited effects on extracellular matrix (ECM) protein secretion. Similarly, miR-21-null mouse hearts showed an unaltered ECM composition. Thus, we searched for additional explanations as to how miR-21 might regulate fibrosis. In plasma samples from the community-based Bruneck Study, we found a marked correlation of miR-21 levels with several platelet-derived profibrotic factors, including TGF-β1. Pharmacological miR-21 inhibition with an antagomiR reduced the platelet release of TGF-β1 in mice. Mechanistically, Wiskott-Aldrich syndrome protein, a negative regulator of platelet TGF-β1 secretion, was identified as a direct target of miR-21. miR-21-null mice had lower platelet and leukocyte counts compared with littermate controls but higher megakaryocyte numbers in the bone marrow. Thus, to our knowledge this study reports a previously unrecognized effect of miR-21 inhibition on platelets. The effect of antagomiR-21 treatment on platelet TGF-β1 release, in particular, may contribute to the antifibrotic effects of miR-21 inhibitors

Effects of feed restriction on metabolic disorders in broiler chickens: A review

Continuous genetic selection and improvement in nutrition have led to a very fast growth rate in modern strains of broiler chickens. Metabolic disorders such as ascits, sudden death syndrome and leg problems are related to a rapid early growth rate in poultry, especially in broilers, and their incidence can be decreased by slowing early growth. The use of management tools to reduce metabolic disorders that rely primarily on decreasing feed consumption, The feed restriction programs is on of the main techniques in growth curve manipulation for increasing production efficiency in broiler chicken in alleviate the incidence of some metabolic disorders and can be used to reduction the unfavorable effects of fast growth rate in broiler chicken production industry, and could be profitable in broiler chickens production efficiency. This article implicated on new findings in about different feed restriction programs effects on these problems in broiler chickens

The effect of Descurainia sophia oil on methamphetamine-induced cell cytotoxicity and cell death in PC12

Methamphetamine causes cytotoxicity and apoptosis in different cell lines. It seems that Descurainia sophia oil, as an East Asian folk herbal drug, can suppress the methamphetamine-induced cell death. In this study, protective effects of Descurainia sophia oil were followed up in methamphetamine-induced cell cytotoxicity in a neuron-like PC12 cell line. The viability, proliferation, and cytotoxicity of the cells were assessed by Trypan blue, MTT test, and lactate dehydrogenase (LDH) assay, respectively. Terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) test was performed to detect DNA fragmentation and apoptosis. Nitric oxide (NO) level was detected by Griese method. Interleukin-1β (IL-1β), IL-6, interferon gamma (INF-γ), and tumor necrosis factor alpha (TNF-α) pro-inflammatory cytokines were measured by Rat Kit V-Plex, and finally, caspase-3 activity was determined by spectrophotometry. Results showed that Descurainia sophia oil has cell death–suppressing effects on PC12 cells. It enhanced the cell viability and proliferation and also increased the cell cytotoxicity and cell death index in methamphetamine-treated PC12 cells. Also, it suppressed NO production, inflammatory cytokine production by flow cytometry, mitochondrial membrane depolarization, and caspase-3 activity in a dose-dependent manner. We concluded that Descurainia sophia oil suppresses the methamphetamine-induced cell death in PC12 cell due to reduction of NO production, inflammation, and inhibition of apoptosis cascade. © 2019, Springer-Verlag London Ltd., part of Springer Nature

Erythema Multiforme Associated with Misoprostol: A Case Report

A 33-year-old healthy woman at 6 weeks of gestation without any underlying disease developed erythema multiforme (EM) after misoprostol. She had no history of herpes simplex virus infection and drug allergy to nonsteroidal anti-inflammatory drugs and antibiotic agents. Medical abortion was performed at 6 weeks' gestation. Later day, the patient developed oral lesions as several white bullae lesions in her buccal mucosa and hyperkeratotic lip plaques with mild pain. Then, lesions resolved within approximately 3 weeks. Microscopic finding of oral biopsy from beneath the tongue and lesions was performed. The result was consistent with erosive mucosa with granulation tissue formation and acute inflammation in favor of EM. This is the case report of probable misoprostol-induced EM. Because EM may produce in skin as a Stevens-Johnson syndrome in subsequent attack, monitoring of this adverse drug reaction should be considered for proper management and follow-up. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved