Hepatic Disorders and COVID-19: From Pathophysiology to Treatment Strategy.

Following the SARS-CoV-2 outbreak and the subsequent development of the COVID-19 pandemic, organs such as the lungs, kidneys, liver, heart, and brain have been identified as priority organs. Liver diseases are considered a risk factor for high mortality from the COVID-19 pandemic. Besides, liver damage has been demonstrated in a substantial proportion of patients with COVID-19, especially those with severe clinical symptoms. Furthermore, antiviral medications, immunosuppressive drugs after liver transplantation, pre-existing hepatic diseases, and chronic liver diseases such as cirrhosis have also been implicated in SARS-CoV-2-induced liver injury. As a result, some precautions have been taken to prevent, monitor the virus, and avoid immunocompromised and susceptible individuals, such as liver and kidney transplant recipients, from being infected with SARS-CoV-2, thereby avoiding an increase in mortality. The purpose of this review was to examine the impairment caused by SARS-CoV-2 infection and the impact of drugs used during the pandemic on the mortality range and therefore the possibility of preventive measures in patients with liver disease.

Monoclonal antibodies in cervical malignancy-related HPV.

Despite many efforts to treat HPV infection, cervical cancer survival is still poor for several reasons, including resistance to chemotherapy and relapse. Numerous treatments such as surgery, radiation therapy, immune cell-based therapies, siRNA combined with various drugs, and immunotherapy are being studied and performed to provide the best treatment. Depending on the stage and size of the tumor, methods such as radical hysterectomy, pelvic lymphadenectomy, or chemotherapy can be utilized to treat cervical cancer. While accepted, these treatments lead to interruptions in cellular pathways and immune system homeostasis. In addition to a low survival rate, cervical neoplasm incidence has been rising significantly. However, new strategies have been proposed to increase patient survival while reducing the toxicity of chemotherapy, including targeted therapy and monoclonal antibodies. In this article, we discuss the types and potential therapeutic roles of monoclonal antibodies in cervical cancer.

Quantitative and Qualitative Assessment of Medial Osteotomy of the Greater Palatine Foramen in Wide Cleft Palate Repair.

Background: Repairing of a wide cleft palate faces with several problems, e.g. medialization of palatal flaps, lack of tissue for repair, and fistula formation. We aimed at quantitative and qualitative evaluation of medial osteotomy of the greater palatine foramen for patients with wide cleft palate and its postoperative outcomes. Methods: Eight patients 4 males, 4 females with wide cleft palate and the median age of 1.5 year were operated using medial osteotomy of the greater palatine foramen from 2018-2020. In this technique, the osteotomy was carried in the outlet of vascular pedicle medially and posteriorly. This led to more degrees of freedom for the vascular pedicle and a palatoplasty without tension through mucoperiosteal flap movement toward the medial direction. Results: After osteotomy and repairing for 8 patients (16 flaps), the mean (SD) length of mucoperiosteal flap pedicle was significantly increased from 2.78 mm to 6.09 mm (P<0.001). All patients were successfully repaired with no major complications, and none of them required any secondary repair. Three weeks postoperatively, all patients showed normal feeding, normal nasal resonance of speech with normal palatal mobility. Conclusion: Osteotomy of the greater palatine foramen for the closure of wide palatal clefts showed a good efficiency, quantitatively and qualitatively. The mean length of mucoperiosteal pedicle increased by 3.22 mm (6.44 mm for bilateral) after repairing, which helps to more freely medial movement of the palatal flap and lesser tension across its closure. All patients were successfully improved without any major complications.

Prediction of Mechanical Properties of Artificially Weathered Wood by Color Change and Machine Learning.

Color parameters were used in this study to develop a machine learning model for predicting the mechanical properties of artificially weathered fir, alder, oak, and poplar wood. A CIELAB color measuring system was employed to study the color changes in wood samples. The color parameters were fed into a decision tree model for predicting the MOE and MOR values of the wood samples. The results indicated a reduction in the mechanical properties of the samples, where fir and alder were the most and least degraded wood under weathering conditions, respectively. The mechanical degradation was correlated with the color change, where the most resistant wood to color change exhibited less reduction in the mechanical properties. The predictive machine learning model estimated the MOE and MOR values with a maximum R2 of 0.87 and 0.88, respectively. Thus, variations in the color parameters of wood can be considered informative features linked to the mechanical properties of small-sized and clear wood. Further research could study the effectiveness of the model when analyzing large-sized timber.

Examining memory performance in body dysmorphic disorder (BDD): A comparison study with obsessive compulsive disorder (OCD).

The aim of this study is comparing directly the BDD and OCD disorders in terms of similarities and differences in memory function for the first time. 19 BDD patients, 15 OCD patients and 26 individuals in a healthy control group were recruited from three hospitals in Tehran. They were administered the following subtests of the Wechsler Memory Scale: logical memory (immediate and delayed), verbal paired association (immediate and delayed), digit span and spatial span as well as the Rey-Osterrieth complex figure test (RCFT). The results showed that BDD and OCD groups had lower performance in comparison to the control group across all measures, except for the immediate memory of the verbal paired associate task, which was similar across the three groups. Both the BDD and OCD groups showed poor performance on the auditory-verbal memory tasks. However, only the BDD group showed poor performance in the visual domain (i.e. spatial span and RCFT). This suggest that memory deficits are similar between BDD and OCD patients in the verbal domain. Furthermore, BDD patients demonstrated poorer visual working memory. The findings of this study reveal that BDD and OCD patients have more similarities than differences regarding neuropsychological features, in other words, the idea of the incorporation of BDD within the obsessive-compulsive and related disorders (OCRDs) spectrum in DSM-5 is supported, at least through the viewpoint of neuropsychology.

The Use of Pectoralis Major Musculocutaneus and Deltopectoral Flaps in Oromandibular Defects Reconstruction.

The main complication in patients with combined treatment of head, neck, mandibular and maxillary tumors is osteoradionecrosis, which appears after radiation therapy. Radiation therapy is widely used to treat cancer, but growing concern is related to the risk of osteoradionecrosis after treatment. This can occur after radiation therapy. Below, we would like to describe the treatment of osteoradionecrosis, which appeared 5 years after radiation therapy in a 54-year-old male patient. In 2012, a patient in Turkey was diagnosed with adenocystic carcinoma of the tongue base, and surgery was performed to remove the tumor after the patient underwent a course of radiotherapy. In 2016, the patient underwent again a surgery for tumor recurrence. In December 2017, the patient was admitted to our clinic with osteoradionecrosis. We performed segmental resection of the mandible, type I right-sided modified neck dissection, reconstruction of the mandible with a titanium plate and a pectoralis major muscle skin flap. The technique described in this case is the insertion of a well-vascularized tissue into the pre-irradiated and necrotic hypovascular region of the mandible with a skin-muscle flap of the pectoralis major muscle wrapped around the plate for reconstruction. As a result, a pectoralis major flap coverred the mouth floor on internal side and the outside skin defect was covered with a deltopectoral one. The viability of the skin-muscle flap of the pectoralis major muscle was assessed using clinical monitoring, checking the flap every four hours for the first 3 days. This study describes a successful outcome.

BMI1 and TWIST1 downregulated mRNA expression in basal cell carcinoma.

BACKGROUND: BMI1, TWIST1 and SNAI2/SLUG have been implicated in aggressive behavior of squamous cell carcinoma (SCC) and melanoma and BMI1 expression could identify subtypes of Merkel cell carcinoma (MCC). However, BMI1, TWIST1 and SNAI2 expression levels in basal cell carcinomas (BCCs) have not been elucidated. We hypothesized BCC could be a good model system to decipher mechanisms which inhibit processes that drive tumor metastasis. The aim of this study was to examine the mRNA expression level of BMI1, TWIST1, and SNAI2 in BCCs. MATERIALS AND METHODS: Thirty-five fresh non-metastatic BCC tissue samples and seven fresh normal skin tissue samples were evaluated by real-time RT-PCR. RESULTS: BMI1 and TWIST1 demonstrated marked down-regulation (p<0.00l, p=0.00l respectively), but SNAI2 showed no significant change (p=0.12). CONCLUSIONS: Previous literature has clearly demonstrated a positive association between BMI1 and TWIST1 expression and metastatic BCC, aggressive SCC and melanoma. Here, we demonstrated a negative association between BMI1 and TWIST1 mRNA expression level and BCC.

The Effects of Aloe Vera Cream on Split-thickness Skin Graft Donor Site Management: A Randomized, Blinded, Placebo-controlled Study .

UNLABELLED:  Purpose. Split-thickness skin graft donor site management is an important patient comfort issue. The present study examined the effects of aloe vera cream compared to placebo cream and gauze dressing on the rates of wound healing and infection at the donor site. METHODS: Forty-five patients were enrolled in this randomized clinical trial and divided into three groups: control (without topical agent), placebo (base cream without aloe vera), and aloe vera cream groups. All patients underwent split-thickness skin grafting for various reasons, and the skin graft donor site wounds were covered with single-layer gauze without any topical agent, with aloe vera, or with placebo cream. The donor sites were assessed daily postoperatively until complete healing was achieved. RESULTS: Mean time to complete re-epithelization was 17 ± 8.6, 9.7 ± 2.9, and 8.8 ± 2.8 days for control, aloe vera, and placebo groups, respectively. Mean wound healing time in the control group was significantly different from the aloe vera and placebo groups (P < 0.005). The healing rate was not statistically different between aloe vera and placebo groups. CONCLUSION: This study showed a significantly shorter wound care time for skin graft donor sites in patients who were treated with aloe vera and placebo creams. The moist maintenance effect of these creams may contribute to wound healing.

Preventive effect of botulinum toxin A in microanastomotic thrombosis: a rabbit model.

BACKGROUND: Microvascular free tissue transfers play an important role in the reconstruction of body defects. Various aetiologies lead to vascular thrombosis and free-flap failure. In this study, the effects of botulinum toxin A on vessel diameters and prevention of anastomotic thrombosis were studied in a blinded vasospasm model in rabbits. METHODS: One side of 16 adult rabbit ears was pre-treated with botulinum toxin type A, and normal saline injections were performed as control in the contralateral side. Seven days later, vessel diameters were measured in both the groups; the vessels were then cut and reanastomosed after vasospastic challenge and vessel patencies were evaluated. RESULTS: Both artery and vein diameters were significantly larger in the botulinum toxin A group (P=0.002 and < 0.001, respectively). The patency rate of arterial and venous anastomosis was significantly higher in the neurotoxin pre-treated group (P=0.038 and 0.003, respectively). CONCLUSION: This study shows that pre-treatment with botulinum toxin type A is associated with a lower rate of arterial and venous thrombosis in rabbit-model microanastomosis. Further studies are necessary to evaluate its ability to decrease vasospasm and thrombosis in free-flap survival of humans.