Preparation of novel shell-ionotropically crosslinked micelles based on hexadecylamine and tripolyphosphate for cancer drug delivery.

AIMS: Micellar systems have the advantage of being easily prepared, cheap, and readily loadable with bioactive molecular cargo. However, their fundamental pitfall is poor stability, particularly under dilution conditions. We propose to use simple quaternary ammonium surfactants, namely, hexadecylamine (HDA) and hexadecylpyridinium (HDAP), together with tripolyphosphate (TPP) anion, to generate ionotropically stabilized micelles capable of drug delivery into cancer cells. METHODS: optimized mixed HDA/HDAP micelles were prepared and stabilized with TPP. Curcumin was used as a loaded model drug. The prepared nanoparticles were characterized by dynamic light scattering, infrared spectroscopy, transmission electron microscopy, and differential scanning calorimetry. Moreover, their cellular uptake was assessed using flow cytometry and confocal fluorescence microscopy. RESULTS: The prepared nanoparticles were found to be stable under dilution and at high temperatures and to have a size range from 139 nm to 580 nm, depending on pH (4.6-7.4), dilution (up to 100 times), and temperature (25 - 80 °C). They were effective at delivering their load into cancer cells. Additionally, flow cytometry indicated the resulting stabilized micellar nanoparticles to be non-cytotoxic. CONCLUSIONS: The described novel stabilized micelles are simple to prepare and viable for cancer delivery.

Functional and morphological study of the effects of carvacrol on smooth muscle of the thoracic aorta in the rat.

Background: The leaves of Origanum are widely used in herbal medicine hence of having many beneficial ingredients, one of these important compounds is Carvacrol. The inhibitory effect of Carvacrol was the core of this study by applying different kinds of stimulants to smooth muscles in the wall of thoracic aorta in rats. Aim: To investigate the pharmacological effects of Carvacrol, the main active ingredient present in the medicinal plant Origanum, on the contractile activity and morphology of the smooth muscle of the rat thoracic aorta. Materials and Methods: After the thoracic aorta arteries were isolated and prepared for the experiments, each thoracic aorta was cut into 5-mm ring segments; different stimulants were used (Potassium Chloride, Norepinephrine, U46619, and α,ß-methylene ATP) in the presence and absence of Carvacrol on four groups of rats. The isolated rings were placed and connected to a force transducer which in turn linked to a data acquisition system via an amplifier to record the effect of each stimulant. GraphPad Prism version 5.02 for Windows, one-way analysis of variance followed by Dunnett's multiple comparison test. Results: It was found out that Carvacrol obstructs the contractile responses elicited by exogenous NA, KCl, U46619, and α,ß-methylene ATP in a concentration dependent manner. Conclusion: The addition of Carvacrol in the experimental rats showed an increase in the thickness of tunica media as evident by the number of smooth muscle layers and laminae of elastic fibers. It was found that Carvacrol reduced the vascular smooth muscle contractility in the rat thoracic aorta. The mechanism of action is presumed to be achieved through interfering with the mobilization of both intracellular and extracellular Ca2+ through different receptors. Furthermore, it might be suggested that Carvacrol in high doses stimulates smooth muscles in the wall of aorta leading to an increase in the thickness of tunica media layer.

Feasibility and impact of laparoscopic sleeve gastrectomy after renal transplantation on comorbidities, graft function and quality of life.

BACKGROUND: The aim of this study is to clarify the feasibility and effect of laparoscopic sleeve gastrectomy (LSG) on comorbidities, graft function and quality of life in patients who underwent renal transplantation (RT). METHODS: This is a retrospective review of five patients who underwent LSG after RT. Demographic data, anthropometric parameters, the effect on comorbidities, postoperative course, immunosuppressive medications, causes of RT, renal function, the survival of graft, and quality of life after SG in obese patients with a history of RT were assessed using BAROS-Moorhead-Ardelt survey RESULTS: From September 2015 to September 2019, 5 renal transplant patients underwent LSG; three female, and two male. Median body mass index (BMI) decreased from 42.17 kg/m2 (range 36-55) before surgery to 28.16 kg/m2 (range 25-42) after surgery. Improvement in blood pressure, triglyceride, and cholesterol levels was observed, and all cases were able to decrease their medications. Insulin was stopped and replaced with linagliptin in all diabetic patients. Graft function improved, and proteinuria level decreased in all cases. All patients reported to have an excellent quality of life. CONCLUSION: LSG showed excellent outcomes in this high-risk group of patients regarding comorbidities, graft function and quality of life.

Effects of different levels of dietary lipids on growth performance, liver histology and cold tolerance of Nile tilapia (Oreochromis niloticus).

This study evaluated the effects of different levels of dietary lipids on the growth performance, feed utilization, body composition and cold tolerance of Nile tilapia (Oreochromis niloticus) fingerlings (7.33 ± 0.12 g fish-1). Four isonitrogenous (275 g kg-1 crude protein), isocaloric (18.5 MJ kg-1) diets containing a mixture of fish oil and corn oil (1:1 ratio) at different levels (70, 85, 110 and 130 g kg-1) were prepared and fed to Nile tilapia reared at a fixed water temperature 25 ± 1 °C for two months. After the feeding trial, the fish were exposed to a cold challenge. The best growth rates and feed utilization were achieved at 70 and 85 g kg-1 dietary lipid, whereas the lowest results were recorded at higher lipid levels (110 and 130 g kg-1). The ability of Nile tilapia to survive the acute cold stress was significantly improved as the lipid level increased from 70 to 110 g kg-1 and decreased with further increase in lipid levels. During the cold stress, saturated fatty acids (SFA) significantly decreased, while unsaturated fatty acids (UFA) tended to increase. Thus, this study demonstrates, to a certain level, that high dietary lipid levels have a positive effect on the cold tolerance of Nile tilapia fingerlings.

Incidence of Silent Deep Venous Thrombosis after Laparoscopic Bariatric Surgery in Patients Who Received Combined Mechanical and Chemical Thromboprophylaxis Compared to Patients Who Received Mechanical Thromboprophylaxis Only.

Background. This prospective randomized study compares the incidence of silent deep venous thrombosis (DVT) among 2 groups of patients who underwent laparoscopic bariatric surgery. The first group received mechanical thromboprophylaxis only, while the second group received a combination of mechanical and chemical thromboprophylaxis. Methods. This study included 150 morbidly obese patients who underwent primary one-stage laparoscopic bariatric surgery (sleeve gastrectomy and mini-gastric bypass) over a 6-month period. Patients were randomly assigned to 2 groups: group A (n = 75) was subjected to mechanical thromboprophylaxis in the form of perioperative elastic stockings on both lower limbs and early postoperative ambulation, and group B (n = 75) was subjected to combined mechanical thromboprophylaxis and chemical thromboprophylaxis in the form of 40 mg subcutaneous enoxaparin 12 hours before surgery and postoperative enoxaparin (40 mg subcutaneous every 24 hours) for 2 weeks. Bilateral lower limb venous duplex was done for all patients before discharge, on the second and fourth weeks postoperatively, to detect silent DVT. Results. Nine patients out of 150 patients developed silent DVT (6%). All patients among group A were subjected to mechanical thromboprophylaxis only (12%) [P = .247, relative risk: .45, 95% confidence interval; .37-.62]. There was no silent DVT among group B who received combined mechanical and chemical thromboprophylaxis. No bleeding complications were reported in both groups. Conclusion. Combined mechanical and mechanical thromboprophylaxis is effective and safe in the prevention of silent DVT after laparoscopic bariatric surgery. Trial registration: The trial was registered in the Thai Clinical Trials Registry (TCTR20200127002) on January 20, 2020 retrospectively.

Percutaneous cannulated screw fixation in the treatment for diabetic ankle fractures.

BACKGROUND: Diabetic ankle fractures were usually treated by open reduction and internal fixation (ORIF) which may lead to Charcot joint, or conservative which may lead to pressure sores. For better results, minimally invasive procedures have been developed, which decrease complications and enable early mobilization and rapid rehabilitation. MATERIALS AND METHODS: This is a retrospective study of a total of 26 uncontrolled diabetic patients: 8 males [30.8%] and 18 females [69.2%]. The mean age of the patients was 67.4 (range 60 to 75) years. We include only Weber A and B where 10 patients suffered from lateral malleolus only (38.5%), 11 patients with bi-malleolar ankle fracture (42.3%) and 5 patients with tri-malleolar fracture (19.2%). RESULTS: The mean time to union was 6.92 weeks (range of 6 to 12 weeks). Weight-bearing has begun from the first day in 19 patients (73.1%), while 7 patients began weight-bearing 4 weeks after the operation (26.9%). Mean follow-up ranged from 2 to 5 years. Mean AOFAS was 96.12 (range of 60 to 99). Only 3 patients suffered from complication: One patient suffered from Charcot joint, one suffered from fracture displacement and needed revision, and one suffered from mal-reduction. Thus, the complication rate was 11.5%. CONCLUSION: We believe that percutaneous cannulated screws technique is a simple and effective method that can be applied safely in uncontrolled DM patients with ankle fractures.

Two-Color Analysis of Leukocytes Labeled by Modified RBCs and Their Fragments.

Red blood cells (RBCs) are attractive tools for surface modification to adhere specifically to molecules, cellular fragments (e.g., microvesicles), or whole cells for potential use in bioanalytical assays or as a delivery vehicle in targeted therapy. Within this study, we have loaded RBCs with fluorochrome-conjugated antibodies (Ab) against CD45 and CD22 leukocyte markers and evaluated the conjugation process by microscopy. We have assessed the potential application of RBCs fragments generated from conjugated RBCs for targeting Cyto-Trol control cells by flow cytometric (FCM) approaches. Based on their scattering and fluorescence characteristics (FITC and PE expression), modified RBCs and their fragments, Cyto-Trol cells, and clusters of both were distinguished by two color FCM analysis. Fragments with anti-human Kallestad Ab as a nonspecific FITC conjugate had less than 20% binding to Cyto-Trol controls compared to CD45-FITC Ab conjugate with nearly 100% binding capacity. Cyto-Trol-microvesicle-clusters were more than 45% positive for either FITC or PE. Anti-CD22-PE modified RBCs fragments were also useful in staining and showing about 19.5% positively stained events in the Cyto-Trol region. The proof-of-concept shows, that specific antibody can be attached to RBCs, and generated fragments can be useful to stain target cells for FCM analysis. © 2018 International Society for Advancement of Cytometry.

Dietary lipid sources affect cold tolerance of Nile tilapia (Oreochromis niloticus).

This study was carried out to evaluate the effects of dietary lipid sources on growth performance, fatty acids composition and cold tolerance of Nile tilapia (Oreochromis niloticus) fingerlings (7.00 ±â€¯0.50 g/fish). The fish were fed four isonitrogenous (28% crude protein), isocaloric (500 kcal/100 g) diets containing four lipid sources; fish oil (FO), corn oil (CO), coconut oil (COCO) or fish oil/ corn oil mixture (1:1 ratio) (oil mix). The diets were offered to the fish at a daily rate of 3% of their body weights (BW), twice a day for two months. After the feeding trial, the fish were exposed to decreasing water temperature from 25 °C until the appearance of death symptoms. The results revealed that FO-based diets (FO and oil mix) produced the best growth rates and feed efficiency, followed by corn oil diet, while COCO resulted in the lowest performance. Fish fed on CO and oil mix showed higher body unsaturated fatty acids (UFA) and lower lethal temperature than those fed on FO- or COCO-based diets. These results indicate that cold shock can modify the lipid metabolism in Nile tilapia by lowering total body saturated fatty acids and raising n-6 and n-3 UFA. This finding suggests that the inclusion of high levels of plant oils in Nile tilapia feeds can enhance their cold tolerance.

Fast RBC loading by fluorescent antibodies and nuclei staining dye and their potential bioanalytical applications.

This study was designed to load different antibodies (Abs) and a fluorescent dye onto the red blood cell (RBC) surface. We have used fluorescein isothiocyanate (FITC)-conjugate anti-human Ab, CD22-PE (B-cell marker-phycoerythrin Ab), and 4',6-diamidino-2-phenylindole (DAPI) for insertion over the RBC surface. In a first step, conjugation experiments were performed: in dimethyl sulfoxide (DMSO), RBCs were conserved and modified by succinic anhydride to create an additional -COOH group, and then activated with 3-(3-dimethylaminopropyl)carbodiimide-N-hydroxysuccinimide (EDC-NHS) in 2-(N-morpholino) ethanesulfonic acid hydrate buffer for insertion of labeled Abs or DAPI. In a second step, fluorescence signals were evaluated by microscopy and the mean fluorescence intensities of cell lysates were measured by spectrofluorometry. The results showed clear evidence for adsorption of FITC- and PE-labeled Abs to activated conserved RBCs. DAPI was adsorbed well also to DMSO-conserved RBCs without the need for an activation step. The DMSO conservation step was enough to create reactive RBCs for insertion of specific Abs and fluorescent dyes. The additional modification by succinic anhydride and activation with EDC-NHS resulted in two- to seven-fold increase in fluorescence signals, indicating a much higher RBC loading capacity. These Ab- and fluorescent dye-functionalized RBCs have potentially high application in developing new biomedical diagnostic and in vitro assay techniques.

Water quality observations in the marine aquaculture complex of the Deeba Triangle, Lake Manzala, Egyptian Mediterranean coast.

Coastal aquaculture is faced with extreme variation in water quality. The Deeba Triangle on Lake Manzala is the largest marine coastal aquaculture-producing area on the Egyptian Mediterranean. Samples from 16 ponds were taken during four seasons (2014-2015), to investigate the variation of 12 water quality parameters at that region. We tested the hypothesis that there is no spatial or temporal variation in water quality of the fish ponds. Fish ponds were statistically clustered into three groups (p = 0.0005) coincident with their geographical location. Hypersaline and transparent waters characterized the western ponds; higher dissolved oxygen and higher nutrients characterized the central region. These spatial differences were principally due to variations in salinity and nutrients of the water sources used for irrigation of the ponds and to differences in the aeration management styles. Strong seasonality was seen in water temperature (following air temperature), nutrients, and turbidity (following the seasonal cycles of various water sources from the Lake Manzala and the seasonality of the petrochemical plants effluents close to these ponds). We conclude that municipal effluents significantly affected, spatially and temporally, the quality of the irrigation water used for coastal aquaculture purposes, which consequently might affect fish yield.

Perception of Periodontitis Patients about Treatment Outcomes: A Cross-Sectional Study in Saudi Arabia.

Patient compliance following periodontal therapy is extremely important in predicting the prognosis of the disease and maintaining treatment outcomes. Therefore, this study aimed to investigate the perception of periodontitis patients about treatment outcomes. A cross-sectional study was conducted among periodontitis patients in a single dental center through a pre-validated questionnaire that was distributed to each participant in the waiting area of periodontal clinics by utilizing a convenience sampling technique. Median and interquartile ranges were used in addition to frequency and percentages. Bivariate analyses were performed using the Mann-Whitney U and Kruskal-Wallis test. Among the 300 male and female participants, the median score (interquartile range) of the current level of pain revealed that males experienced more pain than females, with a median score of 5 (0-7) for males and 4 (0-6) for women. However, the median (interquartile range) for desired and expected pain levels in both genders was 0 (0-1), 0 (0-4). There were significant differences in median score ratings between males and females for expected, distress, success, and importance levels (p-value < 0.05). Patients with periodontitis provided valuable insights into the experiences of individuals undergoing treatment for periodontal disease, indicating overall patient satisfaction with the expected levels of periodontal outcomes.

Lower limb coronal malalignment correction by percutaneous osteotomy and schanz screws fixation.

Pediatric knee deformities are common, and the classic treatment is corrective osteotomy. The aim of this study to assess the safety and efficacy of percutaneous low-energy osteotomy and casting with shanz screws fixation in treatment of Genu varum in children equal or younger than 7 years. This is a prospective nonrandomized case series study was conducted. A total of 38 patients (total of 60 limbs: 36 varus and 24 valgus) were treated by percutaneous low-energy osteotomy and casting with shanz screws fixation and observed over 2-5 years. Clinical and radiological outcomes were evaluated at the end of follow-up period by standing scanogram which enabled tibiofemoral angles and the mechanical axis to be measured and the rate of complications. There was a statistically significant improvement of the radiographic parameters in the form of tibiofemoral angle and MAD. Clinically, all the cases were completely corrected just one patient (two limbs) complicated by over-correction but statically non-significant and. pin tract infection in shanz screws fixation was noticed in one Patient. Percutaneous low-energy osteotomy and casting with shanz screws fixation is a simple, safe, and effective method in dealing with 7 years and younger children with pathological knee deformities. Level of evidence: Therapeutic level IV.

An Extremely Rare and Aggressive Case of Undifferentiated Carcinoma With Osteoclast-Like Giant Cells of the Pancreas Presenting as a Paraneoplastic Syndrome: A Case Report and Literature Review.

Undifferentiated carcinoma with osteoclast-like giant cells (UC-OGC) is a rare tumor type of pancreatic cancer. Paraneoplastic syndromes, an idiopathic inflammatory myositis characterized by various skin manifestations (such as dermatomyositis (DM)), cannot be attributed to the primary tumor itself. Here, we report an unusual case of UC-OGC presenting as a paraneoplastic syndrome, the first reported from Saudi Arabia and the Arabian Gulf states. A 49-year-old Eritrean woman with known DM was referred to our hospital with a left-sided pleural effusion. Computed tomography of the abdomen revealed a large necrotic splenic mass (~17 × 12.9 × 18.2 cm). The patient underwent exploratory laparotomy with en bloc resection of the mass (splenectomy, distal pancreatectomy, and partial excision of the left hemidiaphragm). Following a histopathological examination of the mass, UG-OGC of the pancreas, presenting as a paraneoplastic syndrome, was diagnosed. To our knowledge, this case is the first to present a paraneoplastic syndrome associated with UC-OGC. The identification of an exceedingly rare tumor presenting atypically as a paraneoplastic syndrome shows the importance of conducting comprehensive examinations of patients with malignancies, emphasizing the need for more reports of similar cases.

Proteolysis Assays With Conserved or Aminofluorescein-Labeled Red Blood Cells.

Backgrounds: Various physiological functions and reaction cascades, as well as disease progression in the living systems, are controlled by the activity of specific proteolytic enzymes. We conducted the study to evaluate protease activity by assessing peptide fragments from either conserved or labeled red blood cells (RBCs) with aminofluorescein (AF) in the reaction media. Methods: RBCs were incubated in media containing trypsin. Subsequently, the concentration of peptide fragments in the reaction media, resulted by the digestion with trypsin from conserved cells, was estimated by 3-(4-carboxybenzoyl)quinoline-2-carboxaldehyde (CBQCA) as an amine-reactive fluorogenic reagent. In a second approach, we conjugated AF to the conserved RBCs and then exposed AF-labeled RBCs to trypsin. This was followed by directly measuring the fluorescence intensity (FI) in the reaction media to estimate the concentration of AF-labeled peptide fragments resulting from the enzyme's activity. Results: Show a concentration- and time-dependent increase in FIs, reflecting the activity of trypsin as a proteolytic enzyme. The FIs increased significantly by 4 to 5 folds in samples treated with different enzyme concentrations, and by over 11 folds after 2 h incubation in media containing a 50 µL trypsin, as evidenced by CBQCA assays. Conclusion: These fast and affordable approaches could be applied with high reliability for the general estimation of protease activity in samples and customized for diagnostic purposes and prognostic evaluation in various diseases.

A huge benign gastric schwannomas presented with upper and lower gastrointestinal bleeding: a case report and literature review.

Gastric schwannomas (GS) are rare mesenchymal tumors from Schwann cells in the gastrointestinal (GI) tract, representing 2-6% of such tumors. We report a 52-year-old woman who experienced abdominal pain, hematemesis, and melena, initially suspected of having a GI stromal tumor through ultrasound and computed tomography abdomen. Despite no active bleeding found during an upper endoscopy, she underwent a successful open subtotal gastrectomy, with histopathology confirming GS. The diagnosis of GS, which may mimic other GI conditions, relies heavily on imaging and histopathological analysis due to its nonspecific symptomatology, including the potential for both upper and lower GI bleeding. This case underscores the diagnostic challenges of GS and highlights surgical resection as the preferred treatment, generally leading to a favorable prognosis.

Acrylamide detection and reduction in meat products using organic acids, fruit extracts, and probiotics.

Grilled foods are an important source of acrylamide, which has neurotoxic, genotoxic, and carcinogenic properties. The current study aims to evaluate the level of acrylamide in beef, chicken, and fish products, especially those requiring high cooking temperatures, using High Performance Liquid Chromatography (HPLC). Reduction of acrylamide by organic acids i.e., (citric acid, malic acid, tartaric acid, and lactic acid) and fruit extracts of lemon, apple, and grape has also been investigated. The results revealed that the highest mean acrylamide concentration was found in chicken products (grilled chicken) which recorded 8.32 µg/100 g, followed by beef products (beef grilled) with a concentration of 7.91 µg/100 g, and fish products (pan-fried fish burgers) which recorded 6.77 µg/100 g). Furthermore, the mixture of organic acid has the highest effect on reducing the level of acrylamide in a chemical model system. Moreover, the fruit extract mixture was more effective in reducing the percentage of acrylamide in the grilled chicken than organic acids mixture. Finally, the addition of fruit extract improved the sensory properties of grilled chickens. In sum, this study offers novel and promising natural strategies to decrease acrylamide in meat products toward further future application in meat industry to deliver safe food to consumers.

Cycle-level traffic conflict prediction at signalized intersections with LiDAR data and Bayesian deep learning.

Real-time safety prediction models are vital in proactive road safety management strategies. This study develops models to predict traffic conflicts at signalized intersections at the signal cycle level, using advanced Bayesian deep learning techniques and efficient LiDAR points. The modeling framework contains three phases, which are data preprocessing, base deep learning model development, and Bayesian deep learning model development. The core of the framework is the long short-term memory (LSTM) employed to predict the conflict frequency of a cycle by using traffic features of the previous five cycles (e.g., dynamic traffic parameters, traffic conflict frequency). Four Bayesian deep learning models were developed, including Bayesian-Standard LSTM, Bayesian-Hybrid-LSTM, Bayesian-Stacked-LSTM Encoder-Decoder, and Bayesian-Multi-head Stacked-LSTM Encoder-Decoder. The developed models were applied to traffic conflicts extracted from LiDAR points that were collected from a signalized intersection in Harbin, China with a total duration of seven days. Traffic conflicts, measured by the modified time-to-collision conflict indicator, were identified using the peak over threshold approach. The models were thoroughly evaluated from the aspects of reliability, transferability, sensitivity, and robustness. The results show that the developed four models can predict traffic conflict frequency per cycle per lane simultaneously with its uncertainty. Moreover, the two Bayesian encoder-decoder models perform better than Bayesian-Standard LSTM and Bayesian-Hybrid-LSTM in the four tests. Bayesian-Multi-head Stacked-LSTM Encoder-Decoder is suggested as the optimal model for its high reliability under uncertainty, good transferability in three scenarios, low sensitivity to different parameters, and sound robustness against small noise. The proposed framework could benefit studies on the state-of-the-art data-driven approach for real-time safety prediction.

Comparative Study Between Silver Nanoparticles Dressing (SilvrSTAT Gel) and Conventional Dressing in Diabetic Foot Ulcer Healing: A Prospective Randomized Study.

BACKGROUND: We are trying to evaluate silver nanoparticles' effectiveness (SilvrSTAT Gel) in accelerating healing rate of nonischemic diabetic foot ulcers (DFUs). METHODS: This prospective, double-blind, randomized, controlled study includes 80 patients with nonischemic DFUs classified into 2 groups. Group A was subjected to SilvrSTAT Gel dressing, and group B was subjected to conventional dressing (wet-to-moist dressing with or without povidone-iodine). All cases had minimal debridement before treatment. In both groups, all cases were nonischemic after successful revascularization either by bypass surgery or endovascular therapy. RESULTS: The healing rate of the SilvrSTAT group was significantly higher than that of the conventional group. The healing rate per week of the SilvrSTAT group was considerably higher than that of the conventional group (P < .0001). The rate of complete healing for ulcers in group A was achieved in 22 patients (55%) by the 6th week, while 29 (72.5%), 34 (85%), and 36 (90%) patients were healed entirely by the 8th, 10th, and 12th weeks, respectively. In group B: 20 (50%), 27 (67.5%), and 30 (75%) patients were completeley healed by the 8th, 10th, and 12th weeks, respectively. CONCLUSIONS: SilvrSTATGel is effective in the treatment of DFU.

Hybrid and open repair for patients with acute limb ischemia of the lower extremities.

BACKGROUND: Hybrid revascularization procedures for acute limb ischemia (ALI) are becoming increasingly common, bibliographic data on outcomes is however sparse. METHODS: Single-center, retrospective study of consecutive patients with ALI that underwent either surgical treatment (ST) or hybrid treatment (HT) between January 2015 and December 2021. The composite outcome of amputation-free survival (AFS) was the primary endpoint. Technical success, overall survival, amputation, and re-intervention rates were the secondary endpoints. RESULTS: During the study period 266 patients (mean age 70.2±14.5 years; 49.6% males) were treated for ALI, 67.3% undergoing ST and 32.7% HT. HT was more frequently used in patients with a previous vascular intervention in the index limb (38/87; 43.7% HT vs. 40/179; 22.3% ST, P=0.001), a stent- or stent graft-occlusion (16/87; 18.4% HT vs. 10/179; 5.6% ST, P=0.002) and/or a bypass occlusion (16/87; 18.4% HT vs. 16/179; 8.9% ST, P=0.043). Technical success was higher in the OR group (75/87; 86.2% HT vs. 173/179; 96.6% ST, P=0.003). Amputation-free survival rate during follow-up (43/87; 49.4% HT vs. 94/179; 52.5% ST, HR 0.76, 95% CI: 0.49 to 1.18, P=0.22) and overall survival (32/87; 36.8% HT vs. 84/179; 46.9% ST, HR 0.81, 95% CI: 0.49 to 1.34, P=0.41) were comparable between the two groups. No statistical differences were observed between the groups regarding major amputation (19/87; 21.8% HT vs. 15/179; 8.4% ST, HR 0.85, 95% CI: 0.33 to 2.23, P=0.74) or reintervention during follow-up (45/87; 51.7% HT vs. 65/179; 36.3% ST, HR 0.92, 95% CI: 0.56 to 1.51, P=0.73). CONCLUSIONS: Hybrid and open surgical treatments showed comparable results in our cohort, even though significantly more patients undergoing HT presented with stent and bypass occlusions rather than de-novo lesions.

Sensorineural hearing loss imprint on postural control: A pediatric and adolescent innovative study.

BACKGROUND: Sensorineural hearing loss is the most common type of permanent hearing impairment and results in postural control and motor deficits in children that may affect or delay all developmental indicators. OBJECTIVE: The purpose of the study was to objectively investigate the consequences of sensorineural hearing loss concerning postural control in pediatrics. METHODS: Forty students of both genders, ages ranging from 10 to 16 years, diagnosed with severe to profound sensorineural hearing loss, were selected from the Public School for the Deaf and Hard of Hearing in El-Minia district, Egypt. The outcome was assessed by HUMAC Balance System and Bruininks-Oseretsky Test (BOT-2) subtest (5) for balance. RESULTS: Regarding HUMAC Balance System and subtest (5) of BOT-2, there was a statistically significant difference between the scores of study subgroups and the counterpart normal subgroups of the same age and gender where p-value equal 0.0035 or less. CONCLUSION: The findings of this study suggest that children with sensorineural hearing loss have a defect in their postural control skills compared to normal children of the same gender and age groups according to HUMAC Balance System and Bruininks-Oseretsky scale.