Molecular binding mechanism and novel antidiabetic and anti-hypertensive bioactive peptides from fermented camel milk with anti-inflammatory activity in raw macrophages cell lines.

The investigation was to determine the effect of camel milk fermented with Limosilactobacillus fermentum KGL4 (MTCC 25515) on ACE-inhibiting, anti-inflammatory, and diabetes-preventing properties and also to release the novel peptides with antidiabetic and anti-hypertensive attributes with molecular interaction studies. Growth conditions were optimised on the basis of total peptide production by inoculating the culture in camel milk at different rates (1.5, 2.0, and 2.5%) along with different incubation periods (12, 24, 36, and 48 h). However, after 48 h of fermentation with a 2.5% rate of inoculum, the highest proteolytic activity was obtained. Reverse phase high-pressure liquid chromatography (RP-HPLC) was used to calculate the % Rpa from permeates of 3 kDa and 10 kDa fractions. Molecular weight distributions of fermented and unfermented camel milk protein fractions were compared using SDS-PAGE. Spots obtained from 2D gel electrophoresis were separated on the basis of pH and molecular weight. Spots obtained from 2D gel were digested with trypsin, and the digested samples were subjected to RP-LC/MS for the generation of peptide sequences. The inhibition of tumour necrosis factor alpha, interleukin-6, and interleukin-1 during fermentation was studied using RAW 264.7 macrophages. In the study, fermented camel milk with KGL4 (CMKGL4) inhibited LPS-induced nitric oxide (NO) production and pro-inflammatory cytokine production (TNF-α, IL-6, and IL-1ß) by the murine macrophages. The results showed that the peptide structures (YLEELHRLNK and YLQELYPHSSLKVRPILK) exhibited considerable binding affinity against hPAM and hMGA during molecular interaction studies.

Perioperative Blood Loss after Preoperative Prostatic Artery Embolization in Patients Undergoing Simple Prostatectomy: A Propensity Score‒Matched Study.

PURPOSE: To assess perioperative blood loss following prostatic artery embolization (PAE) before surgery in patients undergoing simple prostatectomy. METHODS: A retrospective chart review was used to identify 63 patients (mean age, 65.3 ± 8.0 years) with prostatic hypertrophy and severe lower urinary tract symptoms who underwent prostatectomy from September 2014 to December 2019, 18 (28.5%) of whom underwent PAE before surgery. Demographic data, pertinent laboratory results, procedural or operative information, hospital course details, and pathology reports were obtained. A 2:1 propensity score‒matching analysis was performed to compare intraoperative blood loss in patients who underwent prostatectomy alone with intraoperative blood loss in those who first underwent bilateral PAE before surgery. RESULTS: Sixteen (89%) of the 18 patients underwent bilateral PAE before surgery. Thirty-two patients who underwent prostatectomy without embolization before surgery were selected for the 2:1 propensity score‒matched analysis based on age, race, surgery type, prostate gland size, and comorbidities. The mean estimated blood loss (EBL) for prostatectomy alone was 545 ± 380 mL (mean ± standard deviation). There was a statistically significant reduction in the EBL for patients who underwent bilateral PAE (303 ± 227 mL, P < .01). The operative time was also significantly decreased for patients who underwent PAE before surgery (P < .05). For patients who underwent PAE, there were no complications related to the procedure. CONCLUSIONS: Bilateral PAE before surgery appears to be safe and may be effective in reducing perioperative bleeding and operative time.

Trauma CT evaluation prior to selective angiography in patients with traumatic injuries: negative predictive power and factors affecting its utility.

PURPOSE: To evaluate the predictive power of arterial injury detected on contrast-enhanced CT (trauma CT (tCT)) imaging obtained prior to selective angiography for treatment of patients with traumatic abdominal and pelvic injuries. MATERIALS AND METHODS: A retrospective chart review was performed of all patients who underwent angiography after undergoing contrast-enhanced CT imaging for the evaluation/treatment of traumatic injuries to the abdomen and pelvis between March 2014 and September 2018. Data collection included demographics, pertinent history and physical findings, CT and angiography findings, treatment information, and outcomes. RESULTS: Eighty-nine (63 males, mean age = 45.8 ± 20.5 years) patients that were found to have 102 traumatic injuries on tCT and subsequently underwent angiography met inclusion criteria for this study. Sixty-four injuries demonstrated evidence of traumatic vascular injury on initial tCT. A negative tCT was able to predict subsequent negative angiography in 83% of cases (negative predictive power = 83%). The ability of tCT to rule out a positive finding on subsequent angiography was also 83% (sensitivity = 83%). The average systolic blood pressure and hemoglobin concentration at the time of tCT were higher in patients who had positive tCT than in patients with negative tCT (p < 0.05 and p < 0.01, respectively). The average time to angiography was greater in patients whom had subsequent negative angiography than the patients who had subsequent positive angiography (p < 0.05). CONCLUSION: Contrast-enhanced CT imaging may be able to help stratify patients who may have subsequent negative angiograms. Hemodynamic factors may affect sensitivity of tCT. Shorter time to angiography may increase the chance of identifying the injury on subsequent angiography.

Safety and Efficacy of Sacroplasty for Sacral Fractures: A Systematic Review and Meta-Analysis.

PURPOSE: To evaluate the safety and efficacy of sacroplasty for the treatment of osteoporotic and malignant sacral fractures by performing a systematic review and meta-analysis of existing literature. MATERIALS AND METHODS: PubMed, Web of Science, and SCOPUS databases were searched from their inception until February 2018 for articles describing sacroplasty. Inclusion criteria were as follows: studies reporting > 5 patients, and pain assessment before and after the procedure recorded with visual analog scale (VAS). Demographic data, procedural details, technical success rates, VAS scores before and after the procedure, and procedural complications were recorded. A random-effects meta-analyses of the VAS pain score before the procedure, at 24-48 hours, at 6 months, and at 12 months were calculated. RESULTS: Nineteen studies (18 case series and 1 cohort study) were identified consisting of 861 total patients (682 women and 167 men; mean age 73.89 ± 9.73 years). Patients underwent sacroplasty for the following indications: sacral insufficiency fractures secondary to osteoporosis (n = 664), malignancy (n = 167), and nonspecified sacral insufficiency fractures (n = 30). Technical and clinical successes were achieved in 98.9% (852/861) and 95.7% (623/651) of patients undergoing sacroplasty, respectively. The pooled major complication rate was 0.3%, with 3 patients requiring surgical decompression for cement leakage. Random-effects meta-analyses demonstrated statistically significant differences in the VAS pain level at preprocedure, 24-48 hours, 6 months, and 12 months, with cumulative pain scores of 8.32 ± 0.01, 3.55 ± 0.01, 1.48 ± 0.01, and 0.923 ± 0.01, respectively. CONCLUSIONS: Sacroplasty appears safe and effective for pain relief in patients with osteoporotic or malignant sacral fractures, with statistically significant sustained improvement in VAS pain scores up to 12 months.

Endovascular Therapy for Vasculogenic Erectile Dysfunction: A Systematic Review and Meta-Analysis of Arterial and Venous Therapies.

PURPOSE: To systematically review and perform a meta-analysis on the safety and efficacy of endovascular therapy in the treatment of the two most common etiologies of vasculogenic erectile dysfunction (ED): veno-occlusive dysfunction (VOD) and arterial insufficiency (AI). MATERIALS AND METHODS: PubMed, Web of Science, ScienceDirect, and Scopus databases were searched for published English literature regarding endovascular ED treatments. Case series (n ≥ 3) were included. Multiple data points were obtained, including demographic data, etiology, diagnosis method, imaging studies, treatment approach, technical success, clinical success, complications, and follow-up. RESULTS: Sixteen relevant articles were obtained and a total of 212 patients with VOD and 162 with AI were identified. The VOD cohort were treated either percutaneously (60.4%; n = 128) or after surgical exposure of the deep dorsal vein (33.5%, n = 71), or it was unspecified (6.1%; n = 13). The most common embolic used was n-butyl cyanoacrylate (51.9%; n = 109). Meta-analysis found an overall clinical success rate of 59.8% in VOD patients. Complications occurred in 5.2% of patients (n = 11), with 9 considered to be mild and 2 considered to be severe. The AI cohort contained 162 patients most commonly treated via stenting of the internal pudendal artery (40.1%; n = 65). Meta-analysis found an overall clinical success rate of 63.2% in AI patients. Complications occurred in 4.9% of patients (n = 8), with 4 considered to be mild and 4 considered to be severe. CONCLUSIONS: Endovascular therapy for medically refractory ED is safe and may provide a treatment alternative to more invasive surgical management; however, conclusions are limited by the heterogeneity of clinical success definitions among the included studies.

Ethylene vinyl alcohol copolymer (onyx) embolization for acute hemorrhage: a systematic review of peripheral applications.

PURPOSE: To evaluate the endovascular use of ethylene vinyl alcohol (EVOH) copolymer (Onyx; ev3 Endovascular, Inc, Plymouth, Minnesota) for the treatment of acute peripheral nonneurologic hemorrhage. MATERIALS AND METHODS: MEDLINE and PubMed databases were searched for articles published in English from 1946 to August 2014 describing patients treated for hemorrhage with EVOH copolymer outside of its usual neurovascular applications. Additional cases were collected from the bibliographies of relevant articles. Full-text articles were obtained. Demographic data, clinical presentation, underlying etiology, culprit vessel, endovascular treatment, outcomes, and follow-up times were obtained. RESULTS: The literature search yielded 19 relevant articles. Cases of 131 patients (87 men, 44 women; mean age, 61 y ± 19.2) describing the treatment of 151 lesions were reviewed. The most common categories of arterial lesions were gastrointestinal (n = 53) and bronchial (n = 40) in origin. In 14 cases, EVOH copolymer was employed after failure or rebleeding following the use of a different embolic agent. Average follow-up time was 12.0 months. EVOH copolymer was the sole embolic agent used in 105 patients. Rebleeding after treatment with EVOH copolymer occurred in 10 patients. There were 2 technical failures. One patient died of multiorgan failure in the setting of persistent hemoptysis. Complications included 2 nerve injuries and 2 minor strokes. CONCLUSIONS: Embolization of acute hemorrhage in the peripheral vasculature was safe and effective with EVOH copolymer.

Association of Scholarly Impact to Industrial Contributions Among Academic Interventional Radiologists.

OBJECTIVE: The Physician Sunshine Act of 2010 aimed to increase public awareness of physician-industry relationships. Our objective was to evaluate whether there is an association between scholarly impact and industry funding among academic interventional radiologists. METHODS: A database from a prior study with our group was used in which we had investigated H-indices among US interventional radiologists; academic rank, gender, institution, and geographic location were obtained. The Scopus database was queried to determine all physicians' H-index. The CMS Open Payments database was used to determine industry payments from 2015 to 2021 for each interventional radiologist. RESULTS: H-index and professor rank positively and significantly correlated with industrial funding (H-index coefficient = $6,977, P < .001 and professor rank coefficient = $183,902, P = .003). Industry funding was found to be significantly different between all ranks. Among 830 academic interventional radiologists, the mean industrial funding of male physicians was $130,034, which was significantly higher than female physicians' $28,166 (P = .00013). By academic rank, male primary investigators of associate professor and unranked position had higher industrial funding than female primary investigators (Wilcoxon test, P = .029 and P= .039, respectively). Professor and assistant professor ranks had no significant difference in industrial funding between male and female physicians (Wilcoxon's test, P = .080 and P = .053, respectively). CONCLUSION: Scholarly activity as defined by the H-index and academic rank seem to have a positive association with industry funding of academic interventional radiologists.

Readability assessment of internet-based patient education materials related to uterine artery embolization.

PURPOSE: To determine the readability of Internet-based patient education materials (IPEMs) created by United States hospitals and universities and clinical practices and miscellaneous health care-associated Web sites regarding uterine artery embolization (UAE) as a marker for IPEMs in general. METHODS AND METHODS: Two hundred unique Web sites were evaluated for patient-related articles on UAE. Web sites produced by US hospitals and universities and clinical practices, as well as miscellaneous health care-associated Web sites meeting the Health on the Net Foundation Code of Conduct criteria were included in the database. By using mathematical regression algorithms based on word and sentence length to quantitatively analyze reading materials for language intricacy, readability of 40 UAE-related IPEMs was assessed with four indices: Flesch-Kincaid Grade Level (FKGL), Flesch Reading Ease Score (FRES), Simple Measure of Gobbledygook (SMOG), and Gunning Frequency of Gobbledygook (GFOG). Scores were evaluated against national recommendations, and intergroup analysis was performed. RESULTS: None of the IPEMs were written at or below the sixth-grade reading level, based on FKGL. The mean readability scores were as follows: FRES, 43.98; FKGL, 10.76; SMOG, 13.63; and GFOG, 14.55. These scores indicate that the readability of UAE IPEMs is written at an advanced level, significantly above the recommended 6th grade reading level (P<.05) determined by the United States Department of Health and Human Services. CONCLUSIONS: IPEMs related to UAE generated by hospitals, clinical practices, and miscellaneous health care-associated Web sites are written above the recommended sixth grade level. IPEMs for other disease entities may also reflect similar results.

In-Office Jones tube exchange using the Seldinger technique.

Conjunctivodacryocystorhinostomy (CDCR) with Jones tube placement is usually performed as a primary procedure for severe stenosis or obstruction of both upper and lower canaliculi of the lacrimal drainage pathway, or occasionally, after unsuccessful dacryocystorhinostomy (DCR). Jones tube obstruction is quite common, and often requires removal of the obstructed tube and replacement or exchange of the tube in the operating room. This procedure is typically performed under general anesthesia, and is associated with the risks of general anesthesia, a significant investment of time, and the cost of the operating suite. Recently, there has been a movement toward in-office procedures in otolaryngology and ophthalmology due to greater patient satisfaction and savings in time and money for patients and physicians. In this report, we describe a novel in-office method to exchange an obstructed Jones tube that provides the aforementioned benefits while preserving patient comfort. No similar case has been previously reported in the literature.

Early harvesting of the vascularized pedicled nasoseptal flap during endoscopic skull base surgery.

PURPOSE: The vascularized pedicled nasoseptal flap (PNSF) represents a successful option for reconstruction of large skull base defects after expanded endoscopic endonasal approaches (EEA). This vascularized flap can be harvested early or late in the operation depending on the anticipation of high-flow CSF leaks. Each harvesting technique (early vs. late) is associated with different advantages and disadvantages. In this study, we evaluate our experience with early harvesting of the PNSF for repair of large skull base defects after EEA. METHODS: A retrospective review was performed at a tertiary care medical center on patients who underwent early PNSF harvesting during reconstruction of intraoperative high-flow CSF leaks after EEA between December 2008 and March 2012. Demographic data, repair materials, surgical approach, and incidence of PNSF usage were collected. RESULTS: Eighty-seven patients meeting the inclusion criteria were identified. In 86 procedures (98.9%), the PNSF harvested at the beginning of the operation was used. In 1 case (1.1%), the PNSF was not used because a high-flow intraoperative CSF leak was not encountered. This patient had recurrence of intradural disease 8months later, and the previously elevated PNSF was subsequent used after tumor resection. CONCLUSION: Based on our data, a high-flow CSF leak and need for a PNSF can be accurately anticipated in patients undergoing EEA for skull base lesions. Because of the advantages of early harvesting of the PNSF and the high preoperative predictive value of CSF leak anticipations, this technique represents a feasible harvesting practice for EEA surgeries.

Inferior vena cava filter retrievals using advanced techniques: a systematic review.

This study aimed to assess the safety of complex inferior vena cava (IVC) filter retrieval techniques through a systematic review of published literature. Using PubMed, a systematic review was conducted in line with the 2020 Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines to identify articles published through April 2020 that reported on complex IVC filter retrieval techniques in >5 patients. Case reports, review papers, and studies that did not report on primary outcomes or variables of interest were excluded. Risk of bias was assessed using a modified Newcastle-Ottawa Quality Assessment scale. Pooled success and complication rates were calculated for the overall number of complex retrieval attempts as well as for each filter type and each complex retrieval method. Sixteen fair-quality and three good-quality studies met the inclusion criteria, with 758 patients (428 female) who had undergone 770 advanced retrieval attempts. The mean age of the patients was 46.5 ± 7.1 years (range: 14.1-90), and the mean dwell time was 602.5 ± 388.6 days (range: 5-7336). Regarding filters, 92.6% (702/758) were retrievable and 7.4% (56/758) were permanent. Indications for complex retrieval included the failure of standard retrieval (89.2%; 676/758) and tilting or embedding in the caval wall (53.8%; 408/758); 92.6% (713/770) of the advanced retrieval attempts were successful. The pooled success rate was 92.0% (602/654) for retrievable filters and 96.4% (53/55) for permanent filters (P = 0.422). Only 2.8% (21/758) of patients experienced major complications, and the major complication rate was not significantly associated with filter type (P = 0.183). Advanced techniques for IVC filter retrieval appear safe for the retrieval of retrievable filters and certain permanent filters, with a low short-term major complication rate. Further studies on complex retrieval techniques used to remove permanent filters should be conducted to clarify their safety with respect to filter type.

Evaluation of h-index in Academic Interventional Radiology.

RATIONALE AND OBJECTIVE: This study evaluates the association of h-index, a widely used bibliometric factor used to determine promotions and grant allocations, with academic ranking, sex, and geographic distribution in the interventional radiology community. MATERIALS AND METHODS: A database of all academic interventional radiologists in the US was created; academic rank, sex, institution, and geographic location were obtained. The Scopus database was used to determine the physicians' h-index. RESULTS: Our query identified 832 board-certified interventional radiologists. The mean h-index amongst all interventional radiologists was 10.81 ± 13.17 (median, 7; range, 0-167). H-indices were significantly different amongst assistant professors, associate professors, and professors (p < 0.0001). Our query identified 724 male interventional radiologists and 108 female interventional radiologists. The mean h-index amongst male interventional radiologists was 11.27 ± 13.69 (median, 7; range, 0-167) and amongst female interventional radiologists was 7.72 ± 8.33 (median, 5; range, 0-47). When stratified by rank, there was no statistically significant difference in h-index between male and female interventional radiologists. Multiple regression analysis identified sex is not significantly associated with h-index, but academic rank and region are. CONCLUSION: H-index in academic interventional radiology correlates significantly with faculty position and may be a factor in determining academic promotion. The sex-based differences in h-index seem to be due to the greater number of male faculty in senior academic positions who have been in the field for longer.

Surgical nuances for nasoseptal flap reconstruction of cranial base defects with high-flow cerebrospinal fluid leaks after endoscopic skull base surgery.

Extended endoscopic endonasal approaches have allowed for a minimally invasive solution for removal of a variety of ventral skull base lesions, including intradural tumors. Depending on the location of the pathological entity, various types of surgical corridors are used, such as transcribriform, transplanum transtuberculum, transsellar, transclival, and transodontoid approaches. Often, a large skull base dural defect with a high-flow CSF leak is created after endoscopic skull base surgery. Successful reconstruction of the cranial base defect is paramount to separate the intracranial contents from the paranasal sinus contents and to prevent postoperative CSF leakage. The vascularized pedicled nasoseptal flap (PNSF) has become the workhorse for cranial base reconstruction after endoscopic skull base surgery, dramatically reducing the rate of postoperative CSF leakage since its implementation. In this report, the authors review the surgical technique and describe the operative nuances and lessons learned for successful multilayered PNSF reconstruction of cranial base defects with high-flow CSF leaks created after endoscopic skull base surgery. The authors specifically highlight important surgical pearls that are critical for successful PNSF reconstruction, including target-specific flap design and harvesting, pedicle preservation, preparation of bony defect and graft site to optimize flap adherence, multilayered closure technique, maximization of the reach of the flap, final flap positioning, and proper bolstering and buttressing of the PNSF to prevent flap dehiscence. Using this technique in 93 patients, the authors' overall postoperative CSF leak rate was 3.2%. An illustrative intraoperative video demonstrating the reconstruction technique is also presented.

Current Trends and Applications of Food-derived Antihypertensive Peptides for the Management of Cardiovascular Disease.

Food-derived antihypertensive peptides are considered a natural supplement for controlling hypertension. Food protein serves as a macronutrient and acts as a raw material for the biosynthesis of physiologically active peptides. Food sources, like milk and milk products, animal proteins such as meat, chicken, fish, eggs, and plant-derived proteins from food products like soy, rice, wheat, mushroom, and pumpkins contain higher quantities of antihypertensive peptides. The food-derived antihypertensive peptides can suppress the action of renin and the angiotensinconverting enzyme (ACE), which are mainly involved in the regulation of blood pressure by RAS. ACE inhibitory peptides enhance endothelial nitric oxide's biosynthesis, which increases nitric oxide production in vascular walls and encourages vasodilation. The peptides also inhibit the interaction between angiotensin II and its receptor, which helps reduce hypertension. This review explores the novel sources and applications of food-derived peptides for the management of hypertension.

Quality and Reliability of YouTube Videos on Uterine Fibroid Embolization.

PURPOSE: To evaluate the quality of information available in YouTube videos on the treatment of uterine fibroids. MATERIALS AND METHODS: The DISCERN Scale Criterion was used to quantify the quality of YouTube videos on uterine fibroid embolization. The Video Power Index was used to quantify the popularity of videos on uterine fibroid embolization. RESULTS: Among the 31 videos identified in the study, the average total DISCERN score was 48.82 ± 14.48, indicative of average to poor quality. There was no correlation between a video's popularity and its quality. Popularity, as measured by Video Power Index, was not significantly different between videos containing a board-certified physician and those that did not. Videos with a board-certified interventional radiologist had a significantly lower Video Power Index than those without a board-certified physician. CONCLUSION: YouTube is not currently a high-quality source of information for uterine fibroid treatment options. Physicians should be aware of highly viewed material on YouTube to have informed discussions with patients about their treatment options and address misperceptions.

Biological and mechanical response of laser shock peening orthopaedic titanium alloy (Ti-6Al-7Nb).

This paper focuses on the evaluation of mechanical and biological properties of laser shock peening (LSP) orthopaedic grade Ti-6Al-7Nb alloy. LSP surface treatment was conducted at laser energy of 3 to 7 J with overlaps of 33%-67%, and with a 3 mm laser spot size. Cell viability on laser shock peened surface was evaluated through in-vitro MTT assay, using osteoblast-like MG63 cells for the first-time. Residual stresses, microhardness, microstructure, sliding wear and wetting properties were investigated. Compressive residual stresses were found at various depths due to controlling the LSP parameters, compared to the as-received surface. The laser shock peened surfaces were hardened from 365HV0.05 to 405HV0.05, while the as-received surface was 320HV0.05. The average sub-grain size was refined from 14% to 36% after LSP. The wear resistance was also controllable by altering LSP parameters. The MTT results show that the cell viability on the laser shock peened surfaces was comparatively lower than that of the untreated surface after 24 h. However, after 72 h, the cell viability on modified surfaces were significantly improved. This work indicated that laser shock peened surfaces have a strong potential to decrease the pain from orthopaedic implant failures and promote the cytocompatibility between the bone and implant.

High incidence of large bore temporary hemodialysis catheter malfunction in patients with COVID-19 related kidney injury.

PURPOSE: To evaluate the incidence of large bore hemodialysis catheter malfunction in the setting of COVID-19. MATERIALS AND METHODS: A retrospective review was performed of all patients who underwent placement of a temporary hemodialysis catheter after developing kidney injury after COVID-19 infection at our institution. Data collected included demographic information, procedure related information, and incidence of replacement due to lumen thrombosis. Groups were compared using students t-test for continuous variables and Fisher's exact test for nominal variables. RESULTS: Sixty-four patients (43M, mean age 63.2 ± 13.3) underwent placement of temporary hemodialysis catheter placement for kidney injury related to COVID 19 infection. Thirty-one (48.4%) of catheters were placed via an internal jugular vein (IJV) access and 33 (52.6%) of catheters were placed via a common femoral vein (CFV) access. Overall, 15 (23.4%) catheters required replacement due to catheter dysfunction. There were no differences in demographics in patients who required replacement to those who did not (p > 0.05). Of the replacements, 5/31 (16%) were placed via an IJV access and 10/33 (30.3%) were placed via a CFV access (p = 0.18). The average time to malfunction/replacement was 7.8 ± 4.8 days for catheters placed via an IJ access versus 3.4 ± 3.3 days for catheters placed via a CFV access (p = 0.055). CONCLUSION: A high incidence of temporary dialysis catheter lumen dysfunction was present in patients with COVID-19 infection. Catheters placed via a femoral vein access had more frequent dysfunction with shorter indwelling time.

Exploring the potential of Lacticaseibacillus paracasei M11 on antidiabetic, anti-inflammatory, and ACE inhibitory effects of fermented dromedary camel milk (Camelus dromedaries) and the release of antidiabetic and anti-hypertensive peptides.

The goal of this investigation was to find antidiabetic peptides and inhibit angiotensin converting enzyme (ACE) in Lacticaseibacillus paracasei (M11) fermented dromedary camel milk (Camelus dromedaries). According to the findings, the rate of antidiabetic activity increased along with the incubation periods and reached its peak after 48 hr of fermentation. The inhibitions of α-amylase, α-glucosidase, and lipase were 80.75, 59.62, and 65.46%, respectively. The inhibitory activity of ACE was 78.33%, and the proteolytic activity was 8.90 mg/mL. M11 at 0.25 mg/mL effectively suppressed LPS-induced pro-inflammatory cytokines and their mediators such as NO, TNF-α, IL-6, and IL-1ß in RAW 264.7 cells. The rate of inoculum in the optimization phase was 1.5-2.5%, and the greatest proteolytic activity was observed after 48 hr of fermentation. The investigation of the above property in the ultrafiltered fermented milk exhibited the highest antidiabetic and ACE inhibition activities in the 3 kDa than 10 kDa fractions. The molecular weight was determined employing SDS-PAGE, and the six-peptide sequences were identified using 2D gel electrophoresis. Due to its high proteolytic activity, the L. paracasei strain has been reported to be useful in the production of ACE-inhibitory and antidiabetic peptides. Amino acid sequences such from ɑ1, ɑ2, and ß-caseins have been identified within fermented camel milk by searching on online databases, including BIOPEP (for antidiabetic peptides) and AHTPDB (for hypertension peptides) to validate the antidiabetic and ACE-inhibitory actions of several peptides. PRACTICAL APPLICATIONS: The study aims to identify antidiabetic peptides and inhibit ACE in dromedary camel milk fermented with Lacticaseibacillus paracasei M11. Maximum antidiabetic and ACE-inhibitory actions of the fermented camel milk were observed in 3 kDa permeate fractions. Fermented camel milk significantly reduced the excessive TNF-α, IL-6, and IL-1ß production in LPS-activated RAW 264.7 cells. RP-LC/MS was used to identify 6 bioactive peptides from dromedary fermented camel milk. This fermented camel milk could be used for the management of hypertension and diabetic related problems.

Inferior vena cava filter fracture with strut migration on CT with volume rendering.

We present the computed tomography findings in a patient with a fractured IVC filter and migration of a broken strut to the right lower quadrant. The filter morphology and strut fragment are well demonstrated on volume rendered images confirming the value of volumetric 3D computed tomography imaging to evaluate IVC filter integrity and identify migrated filter fragments.