Correction to: Two years later: Is the SARS-CoV-2 pandemic still having an impact on emergency surgery? An international cross-sectional survey among WSES members

Background: The SARS-CoV-2 pandemic is still ongoing and a major challenge for health care services worldwide. In the first WSES COVID-19 emergency surgery survey, a strong negative impact on emergency surgery (ES) had been described already early in the pandemic situation. However, the knowledge is limited about current effects of the pandemic on patient flow through emergency rooms, daily routine and decision making in ES as well as their changes over time during the last two pandemic years. This second WSES COVID-19 emergency surgery survey investigates the impact of the SARS-CoV-2 pandemic on ES during the course of the pandemic. Methods: A web survey had been distributed to medical specialists in ES during a four-week period from January 2022, investigating the impact of the pandemic on patients and septic diseases both requiring ES, structural problems due to the pandemic and time-to-intervention in ES routine. Results: 367 collaborators from 59 countries responded to the survey. The majority indicated that the pandemic still significantly impacts on treatment and outcome of surgical emergency patients (83.1% and 78.5%, respectively). As reasons, the collaborators reported decreased case load in ES (44.7%), but patients presenting with more prolonged and severe diseases, especially concerning perforated appendicitis (62.1%) and diverticulitis (57.5%). Otherwise, approximately 50% of the participants still observe a delay in time-to-intervention in ES compared with the situation before the pandemic. Relevant causes leading to enlarged time-to-intervention in ES during the pandemic are persistent problems with in-hospital logistics, lacks in medical staff as well as operating room and intensive care capacities during the pandemic. This leads not only to the need for triage or transferring of ES patients to other hospitals, reported by 64.0% and 48.8% of the collaborators, respectively, but also to paradigm shifts in treatment modalities to non-operative approaches reported by 67.3% of the participants, especially in uncomplicated appendicitis, cholecystitis and multiple-recurrent diverticulitis. Conclusions: The SARS-CoV-2 pandemic still significantly impacts on care and outcome of patients in ES. Well-known problems with in-hospital logistics are not sufficiently resolved by now; however, medical staff shortages and reduced capacities have been dramatically aggravated over last two pandemic years

Phytochemical Screening of Cinnamon Cassia and Its Protective Effects Against Hepatotoxicity Induced By Difenoconazole in Male Albino Rats.

Abstract The objective of the present study has focused on the phytochemical analysis of Cinnamon cassia bark for determination of bioactive components, which have been associated with antioxidative stress induced by difenoconazole treatment in hepatic tissue of male albino rats. Ninety rats were assigned randomly to 9 groups, each group comprised of 10 animals. The first group served as control animals were administrated distilled water and the rest served as the experimental groups. Groups II and III animals were orally administrated with difenoconazole at doses of 58.9 and 117.8 mg/kg BW (represent of 1/20 and 1/10 of oral LD 50 , respectively) while the groups IV and V animals were received aqueous extract of cinnamon (AEC) at doses of 200 and 400 mg/kg BW , respectively . In addition groups VI and VII, animals were received AEC prior to 2h of administration with difenoconazole at low dose as well as groups VIII and IX, rats were received with AEC before treatments with high dose of difenoconazole for 28 days. Results of the present study indicated the presence of total phenolic, flavinoids and tannins as the main bioactive components in the AEC. Furthermore, the final body weight and liver index were increased markedly in difenoconazole-treated rats and these parameters values were comparable to control group following co-administration with AEC. However, difenoconazole-treatment induced a significant elevation in the level of (LPO) associated with adepletion of GSH level and an elevation in the activities of serum liver enzyme markers (i.e., AST ,ALT,ALP and GGT) was observed. These results confirmed with histopatlogical findings . In contrast, treatment with AEC in difenoconazole-treated rats elevated the level of endogenous hepatic antioxidant system (SOD, CAT and GSH) along with reducing the activities of serum liver enzymes. However, the hepatic protective property of AEC was further confirmed by histopathological findings. These findings may be attributed to the presence of total phenolic , flavoniods and tannins , which have anti-oxidative effect against oxidative injury- induced by tested fungicide.</jats:p

Sub-channel thermal-hydraulic analysis for VVER- 1000 generation III PWR

Abstract The sub-channel thermal-hydraulic analysis of a nuclear reactor is essential for assessing of its safety aspects. In this paper, the VVER-1000 has been selected as an example of the third generation reactors since it meets most of the international safety standards and because it has been taken as a base for designing the VVER-1200 which is belonging to the III+ generation. A steady state mathematical model has been proposed and solved to validate and assure that the hottest channel temperature limits are satisfied. The various temperature distributions, the critical heat flux and the departure from nucleate boiling ratio (DNBR) for the hottest channel were evaluated. Also, a transient state model has also been presented and solved using the finite difference method with the aid of MATLAB algorithm. An exponential loss of flow rate of the reactor core coolant was triggered from the steady state conditions. We assumed that the neutron flux and the generated power were unchanged during the postulated event. The average core coolant flow time constant was treated as a single parameter expressing the rapidity of the event. A value of 250 seconds time constant was assumed for slow transient, whereas 10 seconds was assumed for fast one. The reactor core was assumed to be protected through the reactor control system and mitigated according to the regular emergency operating procedures. The time dependent temperature distributions were calculated for the cladding of the hottest coolant channel. For each value of the temperature, the response time required for reaching unsafe conditions was evaluated, discussed and presented.</jats:p

Through-bolts to control ovalization of CHS T-joints under brace member compressive loads

[abstract not available]https://fount.aucegypt.edu/faculty_book_chapters/1452/thumbnail.jp

Caudal epidural steroid injection ultrasound-guided versus fluoroscopy-guided in treatment of refractory lumbar disc prolapse with radiculopathy

AbstractBackgroundLumbar disc prolapse is a localized herniation of disc beyond intervertebral disc space and is the most common cause of sciatica; the aim of this study is to investigate the efficacy of ultrasound (US)-guided caudal epidural steroid injection (CESI) compared with fluoroscopy (FL)-guided CESI in treatment of patients with refractory lumbar disc prolapse (LDP) with radiculopathy.ResultsAt the beginning of the study, there was no significant difference between both groups in all parameters. (a) Group 1 had significantly improved the straight leg raising and modified Schober tests, VAS, and ODI at 1-month and 3-month post-injection evaluation in comparison to baseline recordings (p&lt; 0.001); (b) Group 2 had significantly improved the straight leg raising and modified Schober tests, VAS, and ODI at 1-month and 3-month post-injection evaluation in comparison to baseline recordings (p&lt; 0.001); and (c) US-guided CESI was not statistically different from the FL-guided CESI in the improvement of the straight leg raising (p= 0.87, 0.82) and modified Schober tests (p= 0.87, 0.82) as well as VAS (p= 0.40, 0.43) and ODI (p= 0.7, 0.2) at 1-month and 3-month post-injection evaluation. In a multivariate analysis using CI = 95%, the significant predictors for a successful outcome were duration&lt;6 months (p= 0.03, OR = 2.25), target level not L2-3/L3-4 (p&lt; 0.001, OR = 4.13), and LDP other than foraminal type (p= 0.002, OR = 3.78). However, age &lt; 40 years was found to be non-significant in predicting a successful outcome (p= 0.38, OR = 0.98).ConclusionUS is excellent in guiding CESI with similar treatment outcomes as compared with FL-guided CESI.Trial registrationClinicalTrials.gov Identifier:NCT03933150.</jats:sec

The significance of α-defensins 1-3 in Behcet’s disease: a case-control study among Egyptian patients

Abstract Background Behcet’s disease (BD) is associated with uveitis, oral ulcers, genital ulcers and arthritis. Enhanced activity of innate immunity components, such as neutrophils, natural killer (NK) cells and endothelial cells, is a prominent feature of BD. The aim of this study was to clarify the significance of α-defensins 1-3 in BD and detect their correlation with disease activity, severity and oral ulcer activity. Results Significant differences were found between Behcet’s patients and controls as regards serum α-defensins 1-3 (median 10.1, IQR 4–45 μg/ml versus median 7.4, IQR 0.6–13.2 μg/ml, p = 0.001) and salivary α-defensins 1-3 (median 17.4, IQR 5.7–44 μg/ml versus median 8.6, IQR 3.3–11 μg/ml, p &lt; 0.001). Receiver operating characteristic (ROC) showed a fair area under curve (AUC) (AUC = 0.743), with sensitivity of 40% and specificity 100% at cutoff value of 17.3 μg/ml for serum α-defensins 1-3, while salivary α-defensins 1-3 showed excellent AUC (AUC = 0.936), with sensitivity of 93.3% and specificity of 86.7% at cutoff value of 9.8 μg/ml. The levels of serum and salivary α-defensins 1-3 &gt; cutoff value were significantly higher in active severe Behcet’s patients with active oral ulcers (p &lt; 0.001). Conclusion α-Defensins 1-3 may be involved in the pathogenesis of BD and could be valuable markers in the determination of disease activity, severity and oral ulcer activity. </jats:sec

The significance of α-defensins 1-3 in Behcet’s disease: a case-control study among Egyptian patients

Abstract Background Behcet’s disease (BD) is associated with uveitis, oral ulcers, genital ulcers and arthritis. Enhanced activity of innate immunity components, such as neutrophils, natural killer (NK) cells and endothelial cells, is a prominent feature of BD. The aim of this study was to clarify the significance of α-defensins 1-3 in BD and detect their correlation with disease activity, severity and oral ulcer activity. Results Significant differences were found between Behcet’s patients and controls as regards serum α-defensins 1-3 (median 10.1, IQR 4–45 μg/ml versus median 7.4, IQR 0.6–13.2 μg/ml, p = 0.001) and salivary α-defensins 1-3 (median 17.4, IQR 5.7–44 μg/ml versus median 8.6, IQR 3.3–11 μg/ml, p cutoff value were significantly higher in active severe Behcet’s patients with active oral ulcers (p < 0.001). Conclusion α-Defensins 1-3 may be involved in the pathogenesis of BD and could be valuable markers in the determination of disease activity, severity and oral ulcer activity