Biocompatible PAMAM-PLGA-PCL Nanocarrier for Efficient Curcumin Delivery to Lung Cancer Cells: In Vitro Studies.

We developed a novel polylactic-co-glycolic acid (PLGA)-polyamidoamine G4 (PAMAM G4)-polycaprolactone (PCL) nanocarrier for efficient delivery of curcumin (Cur) to A549 lung cancer cells. The synthesized nanocarrier was characterized by applying analytical techniques, FT-IR, DLS, TEM, and TGA. Successful synthesis, nano-size diameter (40 to 80 nm), near neutral surface charge (8.0 mV), and high drug entrapment (11.5%) were measured for the nanocarrier. Controlled (about 5 folds within first 2 h) and pH-sensitive (2 to 3 folds faster within first hours) Cur release observed for PLGA-PAMAM-PCL-Cur. Cell viability test (MTT assay) indicated the high capability of nanocarrier in suppression of A549 cancer cells (21% viability after 24 h of treatment with 200 nM) while did not result in toxicity on MSC normal cells. The IC50 observed for 50 nM at 24 h of post-treatment in A549 cells. The qRT-PCR technique indicated inducing the expression of apoptotic genes (Caspase9 and Bax) by 6-8 folds and suppressing anti-apoptotic gene (Bcl2) by 7 folds. ROS considerably increased in cancer cells as well. This nanocarrier would be a promising drug delivery system against lung cancer.

Sarcoidosis as a cause of chronic back pain: a case report.

While sarcoidosis is typically a multisystem disease, it can, in some instances, exclusively affect the vertebrae, leading to back pain. Additionally, sarcoidosis may manifest with inflammation of the sacroiliac joints, not meeting the criteria for spondyloarthritis, yet contributing to back pain. In this report, we present a case involving a previously healthy 55-year-old woman who sought medical attention due to chronic back pain. She was subsequently diagnosed with spinal sarcoidosis, based on MRI, PET scan, and biopsy results. Furthermore, treatment with prednisolone monotherapy demonstrated substantial improvement in her symptoms.

Unveiling the complexity of right middle lobe syndrome: a case series highlighting the association with asthma.

Introduction and importance: Right middle lobe syndrome (MLS) is a rare lung disorder primarily affecting children with a history of asthma or atopy. It encompasses a range of pathological and clinical conditions, from recurrent collapses of the middle lobe to bronchiectasis. In this study, the authors present a case series featuring four individuals with MLS associated with asthma, aiming to deepen our understanding of this uncommon condition. Case presentation: Four paediatric patients with right MLS exhibited symptoms of persistent cough, dyspnoea, and recurrent asthma exacerbations. Radiographic evaluations confirmed features consistent with right MLS, and bronchoscopy revealed mucus plugs and oedematous airways obstructing the right middle lobe bronchus. Treatment with bronchodilators, antibiotics, and corticosteroids led to symptom improvement and resolution of atelectasis. Clinical discussion: MLS is a rare condition characterized by chronic collapse of the right middle lobe and bronchiectasis. It is challenging to diagnose MLS, but computed tomography (CT) scans provide detailed lung images for confirmation. Treatment focuses on addressing the underlying cause, such as infections or mucus obstruction. Lobectomy may be considered in severe cases. This case series emphasizes the need for further research on MLS, as its rarity and characteristics remain unclear. Conclusion: These cases exhibited obstructive MLS with and without asthma. Accurate diagnosis is challenging, requiring imaging techniques. MLS has clinical implications, particularly in asthma patients. Future studies should focus on understanding the aetiology of non-obstructive MLS.

A novel chitosan-alginate@Fe/Mn mixed oxide nanocomposite for highly efficient removal of Cr (VI) from wastewater: Experiment and adsorption mechanism.

In this study, the synthesis and experimental theoretical evaluation of a new chitosan/alginate/hydrozyapatite nanocomposite doped with Mn2 and Fe2O3 for Cr removal was reported. The physicochemical properties of the obtained materials were analyzed using the following methods: SEM-EDX, XRD, FTIR, XPS, pH drift measurements, and thermal analysis. The adsorption properties were estimated based on equilibrium and adsorption kinetics measurements. The Langmuir, Freundlich and Temkin isotherms were applied to analyze the equilibrium data. The thermodynamic analysis of adsorption isotherms was performed. A number of equations and kinetic models were used to describe the adsorption rate data, including pseudo-first (PFOE) and pseudo-second (PSOE) order kinetic equations. The obtained test results show that the synthesized biomaterial, compared to pure chitosan, is characterized by greater resistance to high temperatures. Moreover, this biomaterial had excellent adsorption properties. For the adsorption of Cr (VI), the equilibrium state was reached after 120 min, and the sorption capacity was 455.9 mg/g. In addition, DFT calculations and NCI analyses were performed to get more light on the adsorption mechanism of Cr (VI) on the prepared biocomposite.

Biomagnetic chitosan-ethylene glycol diglycidyl ether/organo-nanoclay nanocomposite for azo dye removal: A statistical modeling by response surface methodology.

Herein, a quadruple biomagnetic nanocomposite of cross-linked chitosan-ethylene glycol diglycidyl ether/organo-nanoclay (MCH-EGDE/ORNC) was designed for the uptake of remazol brilliant blue R (RBBR) dye from aqueous environment. The adsorption process was systematically improved via the Box-Behnken design (BBD) to determine the influence of key uptake parameters, including MCH-EGDE/ORNC dosage, pH, and time, on the RBBR removal. The highest RBBR removal of 87.5 % was achieved at the following conditions: MCH-EGDE/ORNC dosage: 0.1 g/100 mL; pH: 4.0; contact time: 25 min. The findings of the kinetics and equilibrium studies revealed an excellent fit to the pseudo-second order and the Freundlich models, respectively. The adsorption capacity of the MCH-EGDE/ORNC for RBBR was found to be 168.4 mg/g, showcasing its remarkable adsorption capability. The present work highlights the potential of MCH-EGDE/ORNC biomaterial as an advanced adsorbent and lays the foundation for future applications in water purification and environmental remediation.

Bisphenol-A-diglycidyl ether modified chitosan/nano-SiO2 via hydrothermal process: A statistical modeling and adsorption mechanism for reactive orange 16 dye removal.

In this study, chitosan/nano SiO2 (CTS/NS) was chemically modified with bisphenol A diglycidyl ether (BADGE) cross-linker-assisted hydrothermal process to create an effective adsorbent, CTS-BADGE/NS, for the removal of reactive orange 16 (RO16) dye from aquatic systems. Box-Behnken design (BBD) was used to optimize the adsorption process by varying the adsorbent dose (0.02-0.1 g/100 mL), pH (4-10), and time (20-360 min). The adsorption isotherm results indicated that the Langmuir model fits the experimental data well, suggesting that the adsorption process involves a monolayer formation of RO16 on the surface of CTS-BADGE/NS. The kinetic modeling of RO16 adsorption by CTS-BADGE/NS demonstrated that the pseudo-first-order model fits the adsorption data. CTS-BADGE/NS achieved an adsorption capacity of 97.8 mg/g for RO16 dye at optimum desirability functions of dosage 0.099 g/100 mL, solution pH of 4.44, and temperature of 25 °C. Overall, the π-π electron donor-acceptor system significantly improved the adsorption performance of the CTS-BADGE/NS. The results of the regeneration investigation demonstrate that the CTS-BADGE/NS exhibits effective adsorption of RO16, even after undergoing five consecutive cycles. The results of this study suggest that the developed CTS-BADGE/NS composite can be a promising adsorbent for water purification applications.

Enhancing cationic dye removal via biocomposite formation between chitosan and food grade algae: Optimization of algae loading and adsorption parameters.

Herein, a natural material including chitosan (CTS) and algae (food-grade algae, FGA) was exploited to attain a bio-adsorbent (CTS/FGA) for enhanced methyl violet 2B dye removal. A study of the FGA loading into CTS matrix showed that the best mixing ratio between CTS and FGA to be used for the MV 2B removal was 50 %:50 % (CTS/FGA; 50:50 w/w). The present study employed the Box-Behnken design (RSM-BBD) to investigate the impact of three processing factors, namely CTS/FGA-(50:50) dose (0.02-0.1 g/100 mL), pH of solution (4-10), and contact time (5-15 min) on the decolorization rate of MV 2B dye. The results obtained from the equilibrium and kinetic experiments indicate that the adsorption of MV 2B dye on CTS/FGA-(50:50) follows the Langmuir and pseudo-second-order models, respectively. The CTS/FGA exhibits an adsorption capacity of 179.8 mg/g. The characterization of CTS/FGA-(50:50) involves the proposed mechanism of MV 2B adsorption, which primarily encompasses various interactions such as electrostatic forces, n-π stacking, and H-bonding. The present study demonstrates that CTS/FGA-(50:50) synthesized material exhibits a distinctive structure and excellent adsorption properties, thereby providing a viable option for the elimination of toxic cationic dyes from polluted water.

Solitary atrial Rhabdomyoma in an infant with tuberous sclerosis: a case report and review of the literature.

BACKGROUND: Despite its rare incidence of 1/40,000, fetal cardiac rhabdomyoma (CR) represents the prevailing type of benign cardiac fetal tumors, which commonly affects the ventricles. Fetal CRs rarely occur in the right atrium. Thus, the presentation of atrial fibrillation and premature atrial contractions (PAC) due to a solitary cardiac rhabdomyoma is an extremely rare scenario. Our literature review found that only 2% (1 out of 61) of rhabdomyoma cases were found in the right atrium. The majority of fetal cardiac rhabdomyomas are associated with tuberous sclerosis complex (TSC). CASE PRESENTATION: A 7-day-old male neonate presented with arrhythmias and an atrial mass for further evaluation. Echocardiography revealed a hyperechoic, round, uniform right atrial mass (25 mm). An abdominal and testicular ultrasound showed multiple thin-walled cortical cysts in both kidneys and a scrotal hydrocele, respectively. His laboratory workup was insignificant except for hypomagnesemia. Electrocardiography revealed junctional rhythm and PACs with wave distortions. A brain magnetic resonance imaging scan revealed multiple subependymal lesions on the frontal and occipital horns of the lateral ventricles. These findings (Fig. 1), along with a family history of TSC, confirmed the diagnosis of TSC with associated CR. The patient was treated symptomatically with an anti-convulsant and monitored with regular follow-ups. Surgical resection was not required. CONCLUSION: Despite CR's predominance in the ventricles, a diagnosis of rhabdomyoma should be kept in mind in the presence of a solitary atrial mass and PACs. Physicians should evaluate systemic findings related to TSC and provide appropriate follow-up and family screening. Surgical resection is not always required, and symptom management can be achieved through medical treatment alone.

Vacuolar Interface Dermatitis as a Histologic Reaction Pattern of Sjögren's Syndrome: A Case Report.

Sjögren's syndrome (SS) has been widely known for its dry mouth and dry eyes presentation. Extraglandular disease manifestations may be protean and pose a challenge for clinicians, especially when the typical known manifestations are absent. Skin involvement of SS is variable, and cutaneous signs and symptoms may be the initial presentation of this syndrome. Vacuolar interface dermatitis has been linked to dermatomyositis and systemic lupus erythematosus, but rarely to SS. Herein, we present the case of an 87-year-old man who presented for widespread itchy erythematous scaly plaques that were refractory to topical corticosteroids as well as discontinuation of possible offending medications. A biopsy demonstrated vacuolar interface dermatitis in the setting of strongly positive anti-SSA. Hydroxychloroquine treatment was effective in resolving the plaques.

Rare giant renal artery aneurysm in neurofibromatosis type 1 patient: a case report.

Introduction and importance: Neurofibromatosis type 1 (NF1) is a genetic disorder characterised by multiple neurofibromas, café-au-lait spots, and iris hamartomas. The variety of vasculopathies that can occur in NF1 make it difficult for clinicians to accurately follow-up patients. Most cases of vasculopathies are stenotic, and, in few cases, aneurysms may form. Case presentation: A 35-year-old male presented with extreme left flank pain for the past 2 days. His physical examination revealed whole-body several café-au-lait skin macules, a subcutaneous lesion, and a palpable abdominal mass in the left flank. His laboratory workup was within normal ranges. A multi-slice computed tomography and computed tomography angiogram with contrast outlined a giant left renal artery aneurysm (RAA). A kidney salvage surgery was planned. However, due to ectatic dilatation and large extension of the aneurysm, the affected renal artery branches and renal vein were found unfit for auto-transplantation during the surgical procedure and a total nephrectomy was necessary. Symptoms improved significantly postoperatively and no complications developed. Clinical discussion: RAA is an uncommon finding in NF1 patients. Diagnosis is often dependent on computed tomography angiogram. Management techniques are conservative, endovascular, or surgical. In few surgical cases, a total nephrectomy may be necessary if auto-transplantation is not feasible. Conclusion: Despite its rarity, the diagnosis of RAA should be considered in patients with NF1 presenting with flank pain. Moreover, early screening for renal vasculopathies can evade critical surgical outcomes including a total nephrectomy. Hence, the authors recommend a total vascular workup for these patients, consisting of doppler ultrasound and, if necessary, a multi-slice computed tomography with contrast.

Bladder stone formation due to neglected double J stent: a case report.

Introduction and importance: Double J (DJ) stents are commonly used in genitourinary procedures, but they can lead to complications including infection, hematuria, encrustation, and stone formation. The longer the duration of encrustation, the greater the risk of complications and renal dysfunction. Forgotten stents pose challenges for patients and can require endourological or open surgical procedures. Case presentation: A 40-year-old man with hypertension and coronary artery disease had a forgotten DJ stent for 3 years, causing suprapubic pain and dysuria. Kidney, ureter, and bladder (KUB) revealed a coiled DJ stent with a large bladder stone and encrustation, and an open cystolithotomy was successfully performed. Recovery was uneventful, and the patient was discharged without complication. Clinical discussion: Ureteral stents, including the DJ stent, are commonly used for urological conditions but can cause complications if retained beyond the intended timeframe. Optimal timing for stent removal is crucial, and patients' healthcare knowledge and adherence are critical to preventing retention. KUB X-ray can evaluate stent encrustation and bladder stones. Cystoscopy is the typical approach for stent removal, but supplementary interventions may be necessary. Open surgery was recommended for removing a large bladder stone and encrusted stent in this case. Conclusion: Timely removal of DJ stents is crucial to avoid complications. Extended retention can cause problems such as encrustation and stone formation. Patient education and adherence are essential to prevent retention and forgetfulness. This case report highlights the importance of careful management of patients with DJ stents for optimal outcomes and prevention of complications.

Thyroid Carcinoma Arising From Struma Ovarii at Adolescence: A Challenging Case With Favorable Outcome.

Malignant struma ovarii (MSO) is a rare and aggressive ovarian tumor that mostly affects adults but can occur in adolescents. Prompt recognition, accurate diagnosis, and multidisciplinary management are essential for favorable outcomes. Herein, we report the youngest case of an 11-year-old girl with a large MSO. First, conventional imaging revealed a large left ovarian mass, leading to a left oophorectomy. Subsequently, histopathological examination confirmed papillary thyroid carcinoma within MSO. Thyroid and fertility-preserving surgery were chosen after multidisciplinary consultation. Despite challenges, the patient had a positive outcome with no recurrence after 36 months. Therefore, the adoption of less invasive surgical approaches and vigilant follow-up can achieve remission, but more research is needed to further enhance our understanding of the disease's risk stratification and optimal treatment strategies.

Identification of Aggregation Mechanism of Acetylated PHF6* and PHF6 Tau Peptides Based on Molecular Dynamics Simulations and Markov State Modeling.

The microtubule-associated protein tau (MAPT) has a critical role in the development and preservation of the nervous system. However, tau's dysfunction and accumulation in the human brain can lead to several neurodegenerative diseases, such as Alzheimer's disease, Down's syndrome, and frontotemporal dementia. The microtubule binding (MTB) domain plays a significant, important role in determining the tau's pathophysiology, as the core of paired helical filaments PHF6* (275VQIINK280) and PHF6 (306VQIVYK311) of R2 and R3 repeat units, respectively, are formed in this region, which promotes tau aggregation. Post-translational modifications, and in particular lysine acetylation at K280 of PHF6* and K311 of PHF6, have been previously established to promote tau misfolding and aggregation. However, the exact aggregation mechanism is not known. In this study, we established an atomic-level nucleation-extension mechanism of the separated aggregation of acetylated PHF6* and PHF6 hexapeptides, respectively, of tau. We show that the acetylation of the lysine residues promotes the formation of ß-sheet enriched high-ordered oligomers. The Markov state model analysis of ac-PHF6* and ac-PHF6 aggregation revealed the formation of an antiparallel dimer nucleus which could be extended from both sides in a parallel manner to form mixed-oriented and high-ordered oligomers. Our study describes the detailed mechanism for acetylation-driven tau aggregation, which provides valuable insights into the effect of post-translation modification in altering the pathophysiology of tau hexapeptides.

Physicochemical fabrication of chitosan and algae with crosslinking glyoxal for cationic dye removal: Insight into optimization, kinetics, isotherms, and adsorption mechanism.

Herein, a highly efficient and sustainable adsorbent of cross-linked chitosan-glyoxal/algae biocomposite (CHT-GLX/ALG) adsorbent was developed through an innovative hydrothermal cross-linking method. The CHT-GLX/ALG biocomposite was characterized using several complementary analytical methods that include CHN-O, XRD, FTIR, SEM-EDX, and pHpzc. This new adsorbent, named CHT-GLX/ALG, was utilized for the adsorption of a cationic dye (methyl violet 2B; MV 2B), from synthetic wastewater. The optimization of the dye adsorption process involved key parameters is listed: CHT-GLX/ALG dosage (from 0.02 to 0.1 g/100 mL), pH (from 4 to 10), and contact time (from 20 to 180 min) that was conducted using the Box-Behnken design (BBD). The optimal adsorption conditions for the highest decolorization efficiency of MV 2B (97.02 %) were estimated using the statistical model of the Box-Behnken design. These conditions include a fixed adsorbent dosage of 0.099 g/100 mL, pH 9.9, and a 179.9 min contact time. The empirical data of MV 2B adsorption by CHT-GLX/ALG exhibited favorable agreement with the Freundlich isotherm model. The kinetic adsorption profile of MV 2B by CHT-GLX/ALG revealed a good fit with the pseudo-second-order model. The maximum adsorption capacity (qmax) for MV 2B by CHT-GLX/ALG was estimated at 110.8 mg/g. The adsorption of MV 2B onto the adsorbent can be attributed to several factors, including electrostatic interactions between the negatively charged surface of CHT-GLX/ALG and the MV 2B cation, as well as n-π and H-bonding. These interactions play a crucial role in facilitating the effective adsorption of MV 2B onto the biocomposite adsorbent. Generally, this study highlights the potential of CHT-GLX/ALG as an efficient and sustainable adsorbent for the effective removal of organic dyes.

Development of a chitosan/nanosilica biocomposite with arene functionalization via hydrothermal synthesis for acid red 88 dye removal.

Herein, the polymer nanomatrix of chitosan/SiO2 (CHI/n-SiO2) was enriched with a π-π electron donor-acceptor system using diaromatic rings of benzil (BEZ) assisted via a hydrothermal process to obtain an effective adsorbent of chitosan-benzil/SiO2 (CHI-BEZ/n-SiO2). The polymer nanomatrix (CHI/n-SiO2) and the resulting adsorbent (CHI-BEZ/n-SiO2) were applied to remove the anionic acid red 88 (AR88) dye from aqueous media in a comparative mode. Box-Behnken design (BBD) was adopted to optimize AR88 adsorption onto CHI/n-SiO2 and CHI-BEZ/n-SiO2 with respect to variables that influence AR88 adsorption (adsorbent dose: 0.02-0.1 g/100 mL; pH: 4-10; and time: 10-90). The adsorption studies at equilibrium were conducted with a variety of initial AR88 dye concentrations (20-200 mg/L). The adsorption isotherm results reveal that the AR88 adsorption by CHI/n-SiO2 and CHI-BEZ/n-SiO2 are described by the Langmuir model. The kinetic adsorption profiles of AR88 with CHI/n-SiO2 and CHI-BEZ/n-SiO2 reveal that the pseudo-first-order model provides the best fit results. Interestingly, CHI-BEZ/n-SiO2 has a high adsorption capacity (261.2 mg/g), which exceeds the adsorption capacity of CHI/n-SiO2 (215.1 mg/g) that relates to the surface effects of SiO2 and the functionalization of chitosan with BEZ. These findings show that CHI-BEZ/n-SiO2 represents a highly efficient adsorbent for the removal of harmful pollutants from water, which outperforming the CHI/n-SiO2 system.

Severity of SARS-CoV-2 infection in children with inborn errors of immunity (primary immunodeficiencies): a systematic review.

BACKGROUND: Inborn errors of immunity (IEIs) are considered significant challenges for children with IEIs, their families, and their medical providers. Infections are the most common complication of IEIs and children can acquire coronavirus disease 2019 (COVID-19) even when protective measures are taken. OBJECTIVES: To estimate the incidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in children with IEIs and analyse the demographic parameters, clinical characteristics and treatment outcomes in children with IEIs with COVID-19 illness. METHODS: For this systematic review, we searched ProQuest, Medline, Embase, PubMed, CINAHL, Wiley online library, Scopus and Nature through the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) guideline for studies on the development of COVID-19 in children with IEIs, published from December 1, 2019 to February 28, 2023, with English language restriction. RESULTS: Of the 1095 papers that were identified, 116 articles were included in the systematic review (73 case report, 38 cohort 4 case-series and 1 case-control studies). Studies involving 710 children with IEIs with confirmed COVID-19 were analyzed. Among all 710 IEIs pediatric cases who acquired SARS-CoV-2, some children were documented to be admitted to the intensive care unit (ICU) (n = 119, 16.8%), intubated and placed on mechanical ventilation (n = 87, 12.2%), suffered acute respiratory distress syndrome (n = 98, 13.8%) or died (n = 60, 8.4%). Overall, COVID-19 in children with different IEIs patents resulted in no or low severity of disease in more than 76% of all included cases (COVID-19 severity: asymptomatic = 105, mild = 351, or moderate = 88). The majority of children with IEIs received treatment for COVID-19 (n = 579, 81.5%). Multisystem inflammatory syndrome in children (MIS-C) due to COVID-19 in children with IEIs occurred in 103 (14.5%). Fatality in children with IEIs with COVID-19 was reported in any of the included IEIs categories for cellular and humoral immunodeficiencies (n = 19, 18.6%), immune dysregulatory diseases (n = 17, 17.9%), innate immunodeficiencies (n = 5, 10%), bone marrow failure (n = 1, 14.3%), complement deficiencies (n = 1, 9.1%), combined immunodeficiencies with associated or syndromic features (n = 7, 5.5%), phagocytic diseases (n = 3, 5.5%), autoinflammatory diseases (n = 2, 3%) and predominantly antibody deficiencies (n = 5, 2.5%). Mortality was COVID-19-related in a considerable number of children with IEIs (29/60, 48.3%). The highest ICU admission and fatality rates were observed in cases belonging to cellular and humoral immunodeficiencies (26.5% and 18.6%) and immune dysregulatory diseases (35.8% and 17.9%) groups, especially in children infected with SARS-CoV-2 who suffered severe combined immunodeficiency (28.6% and 23.8%), combined immunodeficiency (25% and 15%), familial hemophagocytic lymphohistiocytosis (40% and 20%), X-linked lymphoproliferative diseases-1 (75% and 75%) and X-linked lymphoproliferative diseases-2 (50% and 50%) compared to the other IEIs cases. CONCLUSION: Children with IEIs infected with SARS-CoV-2 may experience higher rates of ICU admission and mortality in comparison with the immunocompetent pediatric populations. Underlying immune defects does seem to be independent risk factors for severe SARS-CoV-2 infection in children with IEIs, a number of children with SCID and CID were reported to have prolonged infections-though the number of patients is small-but especially immune dysregulation diseases (XLP1 and XLP2) and innate immunodeficiencies impairing type I interferon signalling (IFNAR1, IFNAR2 and TBK1).

A Retrospective Analysis of Pinnaplasty Outcomes: The Welsh Experience.

Prominent ears (PEs) are the most frequent congenital external ear deformity, occurring in ∼5% of the population. Although the deformity does not usually cause functional difficulties, it can significantly affect the patient's psychological and social health. The authors aim to present the Welsh experience of pinnaplasty, reviewing our outcomes and complications. A retrospective cross-sectional study was performed of all patients undergoing pinnaplasty in Morriston Hospital, Swansea, Wales. We represent the tertiary plastic surgery referral unit across Wales. We included all patients undergoing pinnaplasty between 2015 and 2022 inclusive. We excluded patients undergoing revision procedures or those who had no follow-up. Over the 7-year period, 236 pinnaplasties were performed and 203 were included in the analysis. Ninety-six percent of cases were performed using a cartilage-sparing approach, which represents the mainstay in our unit. The mean follow-up length for our cases was 12 months. Revision procedures were required in 4% of cases. Three hematomas (1.5%) and one (0.5%) wound dehiscence due to infection were recorded and required a return to the operating room. Suture extrusion was noted in 5% of cases (10 patients); 4.5% (9) cases were affected by either hypertrophic or keloid scarring. Across the United Kingdom, cosmetic procedures have come under scrutiny, namely, because of a difficult economic climate. In the era of tight fiscal control in health care, it is pertinent to analyze the outcomes and performance metrics of our operations regularly, thus aiding in the development of an established evidence base to advocate for our respective patients.

Immune Response and Histological Changes in Broilers Chickens Vaccinated with Mycoplasma gallisepticum Vaccines.

Mycoplasma is unique among prokaryotes because of its small size, small genomes, and complete lack of cell walls, which makes them cell wall-less prokaryotes. This study aimed to evaluate the effect of vaccinating one-day-old chicks with inactivated and live vaccines (CRDF) of Mycoplasma gallisepticum (MG) on their humoral immune response and immune organs. The Enzyme-Linked Immunosorbent Assay was used to measure Ab titers and investigate histopathological changes. A total of 130 one-day-old broiler chicks were randomly divided into four groups of 30. The groups were treated as follows: G1 included the chicks vaccinated with live F-strain MG vaccine (on eye drop of 0.03ml/dose), G2 included the chicks vaccinated with inactivated MG (0.3 ml s.c) vaccine, G3 included the chicks vaccinated with inactivated and live MG vaccines, and G4 was considered the control group, in which the chicks were not vaccinated. Blood samples were collected on days 21 and 35 of the chick's life to measure the titers of specific antibodies. On day 35, the chicks were dissected, and the bursa of Fabricius, as well as the spleen, were removed for histological evaluations. On day 21, the results showed a significant difference (P≤0.05) between all vaccinated groups in Ab titers, compared to G4, with the highest mean in G3, followed by G2 and G1, in descending order. On day 35, there was a significant difference (P≤0.05) between G3 and other vaccinated groups (G2 and G1), as well as G4. In addition, there was a significant increase in all vaccinated groups on day 35, compared to day 21. In G1, histopathological examination results showed a moderate lymphocytic hyperplasia bursal follicle. In G2, varying degrees of lymphoproliferative were observed in the major bursal follicle, and in G3, a marked lymphocytic hyperplasia bursal follicle was observed. In G4, on the other hand, no obvious histopathological findings were recorded. The results of the spleen histopathological evaluation showed various degrees of lymphoproliferative and moderate neutrophilic infiltrate in the red pulp in G1, and mild sinus congestion with scattered lymphocytes was recorded in the lumen in G2. In the spleen of the chicks in G3, reactive lymphoid hyperplasia was observed. In contrast to the groups mentioned above, in G4, the spleen structure showed a typical structure. It was concluded that the chicks vaccinated with inactivated and live MG vaccines experienced increased production of Ab titers and the immune stimulation of immune organs.

Primary neuroendocrine tumor in the retroperitoneal cavity: A rare case report.

INTRODUCTION AND IMPORTANCE: Neuroendocrine tumors (NETs) are rare malignancies, accounting for a small percentage of gastrointestinal and bronchopulmonary cancers. Retroperitoneal NETs are infrequent and can be primary or metastatic. They are commonly metastatic rather than primary tumors, with primary retroperitoneal NETs being exceptionally rare. CASE PRESENTATION: A 38-year-old woman presented with left flank pain persisting for one year, which had progressively worsened. Imaging revealed a large retroperitoneal mass exerting pressure on the stomach, spleen, liver, and upper pole of the left kidney. A biopsy of the tumor was done and the results were consistent with NET. The tumor, which measured approximately 19 × 12.5 × 11 cm, was surgically removed, and the pathological findings were consistent with the results of the biopsy prior to the surgery. CLINICAL DISCUSSION: Neuroendocrine tumors are rare and exhibit diverse characteristics based on location, size, hormone secretion, and metastasis. Retroperitoneal neuroendocrine tumors are typically metastatic and rarely primary. The extremely large size of the tumor in this case highlights the surgical challenges associated with retroperitoneal NETs. Imaging, such as CT and MRI, plays a crucial role in diagnosis. CONCLUSION: The study emphasizes the need to consider primary NETs as a possible cause of large retroperitoneal masses, especially if the tumor size is significant. Surgical resection is the primary treatment option with generally favorable outcomes. However, the size of the tumor can complicate treatment, and further research is needed to evaluate the effectiveness of postoperative adjuvant therapy and develop therapeutic approaches for recurrent NETs.