Antioxidant and anti-inflammatory activities of different extracts from aerial parts of Zilla spinosa (L.) Prantl

Zilla spinosa L. is a medicinal plant widely used in traditional Algerian phytotherapy against urinary lithiasis. The present study aims to evaluate the antioxidant and anti-inflammatory effects of different extracts from the aerial part of this plant. The antioxidant activity of the extracts was examined by two different methods, 2,2-diphenyl-1-picrylhydrazyl (DPPH) and cupric reducing antioxidant capacity (CUPRAC). The anti-inflammatory activity of Z. spinosa was determined by the protein denaturation method. The qualitative phytochemical screening shows the presence of the majority of secondary metabolites in the aerial parts except anthraquinones and steroids, on the other hand, the root is characterized by the absence of several metabolites except tannins and coumarins.The ethyl acetate fraction displayed the highest antioxidant capacity (IC50 value: 10.47±0.18 μg/mL in DPPH assay, and A0.50 value: 40.89 ± 0.86 μg/mL in CUPRAC). The percentage of inhibition of BSA denaturation (0.2%) is proportional to the concentration of the different plant extracts, where the highest percentage was recorded in the concentrations of ethyl acetate 500; 250 μg/mL compared to Diclofenac (75 mg/3 mL), in contrast to the aqueous extract which gave non-significant results compared to the standards (p≥5℅). In comparison to the standards used in this study, the ethyl acetate extract demonstrated better DPPH inhibitory activity, while all organic extracts demonstrated lower CUPRAC inhibitory activity but higher anti-inflammatory activity

Trans-sinusal frontal approach for olfactory groove meningiomas

Background We report on our experience with the trans-sinusal frontal approach in removing olfactory groove meningiomas in the department of neurosurgery of Univesity Hospital Center of Annaba (Algeria).Methods Ten tumours were operated on by the trans-sinusal frontal approach, using a bicoronal incision, tree tumours developed on one side, and there were seven bilateral olfactosellar tumours. Our procedure : steotomy of the anterior wall of the frontal sinus was performed with an oscillating saw. The posterior wall of the sinus was resected and the tumour was removed through a real subfrontal route along the plane of the anterior skull base. Ethmoidal blood supply was early controlled at the initial stages of the operation, allowing avascular tumour debulking. Tumour extensions toward the sella and the optic canals were removed without brain retraction. Results Seven patients made a good neurologic recovery. Two was dead in the 24 hours after intervention and one four days after. Olfactory nets were preserved on the contralateral side in unilateral tumours. Conclusions The trans-sinusal frontal approach represents an excellent way for tumours developed in the central anterior skull base, especially for olfactory groove meningiomas, whatever their size

A prospective, randomised comparison of continuous paravertebral block and continuous intercostal nerve block for post-thoracotomy pain

Background: This study aimed to compare paravertebral block and continuous intercostal nerve block after thoracotomy.Methods: Forty-six adult patients undergoing elective posterolateral thoracotomy were randomised to receive either a continuous intercostal nerve blockade or a paravertebral block. Opioid consumption and postoperative pain were assessed for 48 hours .Pulmonary function was assessed by forced expiratory volume in 1 s (FEV1) recorded at 4 hours intervals.Results: With respect to the objective visual assessment (VAS), both techniques were effective for post thoracotomy pain. The average VAS score at rest was 29±10mm for paravertebral block and 31.5±11mm for continuous intercostal nerve block. The average VAS score on coughing was 36±14mm for the first one and 4 ±14mm for the second group. Pain at rest was similar in both groups. Pain scores on coughing were lower in paravertebral block group at 42 and 48 hours. Post-thoracotomy function was better preserved with paravertebral block. No difference was found among the two groups for side effects related to technique, major morbidity or duration of hospitalisation.Conclusion: We found that continuous intercostal nerve block and paravertebral block were effective and safe methods for post-thoracotomy pain.

The pregnane X receptor drives sexually dimorphic hepatic changes in lipid and xenobiotic metabolism in response to gut microbiota in mice.

The gut microbiota-intestine-liver relationship is emerging as an important factor in multiple hepatic pathologies, but the hepatic sensors and effectors of microbial signals are not well defined. By comparing publicly available liver transcriptomics data from conventional vs. germ-free mice, we identified pregnane X receptor (PXR, NR1I2) transcriptional activity as strongly affected by the absence of gut microbes. Microbiota depletion using antibiotics in Pxr <sup>+/+</sup> vs Pxr <sup>-/-</sup> C57BL/6J littermate mice followed by hepatic transcriptomics revealed that most microbiota-sensitive genes were PXR-dependent in the liver in males, but not in females. Pathway enrichment analysis suggested that microbiota-PXR interaction controlled fatty acid and xenobiotic metabolism. We confirmed that antibiotic treatment reduced liver triglyceride content and hampered xenobiotic metabolism in the liver from Pxr <sup>+/+</sup> but not Pxr <sup>-/-</sup> male mice. These findings identify PXR as a hepatic effector of microbiota-derived signals that regulate the host's sexually dimorphic lipid and xenobiotic metabolisms in the liver. Thus, our results reveal a potential new mechanism for unexpected drug-drug or food-drug interactions. Video abstract

French Endocrine Society Guidance on endocrine side-effects of immunotherapy

The management of cancer patients has changed due to the considerably more frequent use of immune checkpoint inhibitors (ICPI). However, the use of ICPI has a risk of side-effects, particularly endocrine toxicity. Since the indications for ICPI are constantly expanding due to their efficacy, it is important that endocrinologists and oncologists know how to look for this type of toxicity and how to treat it when it arises. In view of this, the French Endocrine Society initiated the formulation of a consensus document on ICPI-related endocrine toxicity. In this paper, we will introduce data on the general pathophysiology of endocrine toxicity, we will then outline expert opinion focusing primarily on methods for screening, management and monitoring for endocrine side-effects in patients treated by ICPI. We will then look in turn at endocrinopathies that are induced by ICPI including dysthyroidism, hypophysitis, primary adrenal insufficiency and fulminant diabetes. In each chapter, expert opinion will be given on the diagnosis, management and monitoring for each complication. These expert opinions will also discuss the methodology for categorizing these side-effects in oncology using \u27Common terminology criteria for adverse events\u27 (CTCAE) and the difficulties in applying this to endocrine side-effects in the case of these anti-cancer therapies. This is shown in particular by certain recommendations that are used for other side-effects (high-dose corticosteroids, contra-indicated in ICPI for example), and that cannot be considered as appropriate in the management of endocrine toxicity, as it usually does not require ICPI withdrawal or high dose glucocorticoid intake

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Modélisation de la disponibilité d'une chaîne de GNL sur la base d'une approche bayésienne d'estimation des indices de fiabilité

Les usines de gaz naturel liquéfié (GNL) se caractérisent par leur nombre relativement réduit dans le monde, la diversité des procédés technologiques utilisés ainsi que des coûts d'investissement et d'exploitation très élevés. L'autoconsommation de ce type d'unité est de l'ordre de 15 % et peut quasiment doubler dans le cas d'une fréquence importante des arrêts intempestifs ou volontaires dus aux pannes des équipements situés sur tout le parcours de la chaîne GNL. En conséquence, l'amélioration de la fiabilité de la chaîne dans sa globalité se traduirait objectivement par une réduction substantielle des coûts d'énergie. Pour le cas des systèmes réparables, on utilise le plus souvent la disponibilité comme indicateur de fiabilité. Dans cet article, la chaîne GNL est assimilée à un système complexe indissociable. Cependant, la modélisation des systèmes complexes, d'un point de vue fiabilité ou autre, est toujours délicate en raison principalement des dimensions astronomiques de l'espace de phase. Ainsi, une approche de type systémique est mise à profit pour ramener l'espace de phase à des dimensions gérables. Une représentation des sous-systèmes par diagrammes de fiabilité permet alors une estimation plus aisée des probabilités associées à chaque état. Enfin, une démarche bottom up autorise la reconstitution du modèle global de disponibilité de la chaîne GNL. En liaison avec la faiblesse manifeste caractérisant le retour d'expérience dans le domaine de la technologie du GNL, une approche d'estimation bayésienne des indices de fiabilité des différents équipements composant la chaîne est mise à profit. Un certain nombre de résultats de l'application de la méthodologie développée à la chaîne Hassi R'mel-Skikda sont fourni

Optimisation du réseau algérien de transport de brut et de condensat = optimization of the algerian crude and condensate network

Le diagnostic et l'extension optimale du réseau algérien de transport de brut et de condensat, en liaison avec l'intensification des rythmes de production, nécessitent la mise au point de procédures systémiques de modélisation. Dans ce contexte, le pompage par batch est représenté par des bi-flots. L'arsenal de la théorie des graphes et le problème du flot maximal, associé à un modèle de fiabilité, sont ensuite mis à contribution. Le modèle global peut alors être utilisé comme stand d'expérimentation où l'impact de chaque décision ou événement est dégagé par simulation. Cependant, en raison de la non-linéarité des coûts, l'extension optimale du réseau est soumise à la résolution d'un modèle de programmation non linéair