Isolated Deep Infiltrating Endometriosis of the Sciatic Nerve: A Case Report and Overview of the Literature.

Isolated deep infiltrating endometriosis (DIE) of sacral nerve roots or major pelvic nerves, including the sciatic nerve, is considered to be extremely rare. Due to the overlap with sciatica symptoms, the diagnosis of sciatica DIE is difficult yet crucial, as it results in permanent neural damage if left untreated. We report a case of a 45-year-old woman who experienced a three-year-long and recently exacerbating pain in her right leg, accompanied by a tingling sensation and weakness in her right leg and foot, with difficulty walking. In between regular menstrual bleedings, when her aforementioned symptoms worsened, she had been experiencing mild 10-day extra-cyclical bleeding. Her neurologist's, orthopedist's, and gynecological examinations were unremarkable. Magnetic resonance imaging (MRI) showed an infiltrative lesion on the right sciatic nerve that was immunohistochemically confirmed to be endometriosis. The patient was treated with gonadotropin-releasing hormone analogues (GnRHa), which led to a significantly diminished size of the lesion on the control MRI, and endometriosis remission was obtained. For persistent mild, but cyclical, pain and muscle weakness, continuous progestagnes were administered, with advice for physical therapy provided for her neuro-muscle rehabilitation and a scheduled check-up in 6 months.

Methanol extracts of Teucrium arduini L. and Teucrium flavum L. induce protective effect against mitomycin C in human lymphocytes in vitro.

The study was designed to evaluate antigenotoxic effect of methanol Teucrium arduini and Teucrium flavum extracts against mitomycin C (MMC)-induced chromosome and DNA damage in vitro. Cytokinesis-block micronucleus (CBMN) and comet assays were used to investigate effect of plant extracts in different concentrations (125, 250, 500 and 1000 µg/mL) on human peripheral blood lymphocytes (PBLs). The obtained results showed that the all tested concentrations of T. arduini and the highest concentration of T. flavum significantly reduced the MMC-induced micronucleus (MN) frequency in comparison to positive control (only MMC). There were significantly negative correlations between the extracts concentrations and MN frequencies (Pearson, r = -0.905, p = 0.0001 for T. arduini; r = -0.861, p = 0.0001 for T. flavum). The extracts of both plants further lowered the MMC-decreased nuclear division index (NDI) in a dose dependent-manner (Pearson, r = -0.837, p = 0.001 for T. arduini; r = -0.598, p = 0.040 for T. flavum), but significantly only in the highest concentration (1000 µg/mL). Comet assay showed that extracts reduced MMC-increased genetic damage index (GDI), significantly in the concentrations of 500 and 1000 µg/mL, in comparison with positive control. Based on our results, it can be concluded that methanol T. arduini and T. flavum extracts possess protective proapoptotic and antigenotoxic effect which is indication of their medicinal relevance and use in treatment.

Data Analysis of Impaired Renal and Cardiac Function Using a Combination of Standard Classifiers.

We examine the significance of the predictive potential of EPI cystatin C (EPI CysC) in combination with NTproBNP, sodium, and potassium in the evaluation of renal function in patients with cardiorenal syndrome using standard mathematical classification models from the domain of artificial intelligence. The criterion for the inclusion of subjects with combined impairment of heart and kidney function in the study was the presence of newly discovered or previously diagnosed clinically manifest cardiovascular disease and acute or chronic kidney disease in different stages of evolution. In this paper, five standard classifiers from the field of machine learning were used for the analysis of the obtained data: ensemble of neural networks (MLP), ensemble of k-nearest neighbors (k-NN) and naive Bayes classifier, decision tree, and a classifier based on logistic regression. The results showed that in MLP, k-NN, and naive Bayes, EPI CysC had the highest predictive potential. Thus, our approach with utility classifiers recognizes the essence of the disorder in patients with cardiorenal syndrome and facilitates the planning of further treatment.

Predictors of Non-Adherence to Medications in Hypertensive Patients.

Background: Elevated blood pressure (BP) is one of the leading causes for developing major cardiovascular events and still represents a major public health challenge worldwide. We aimed to provide data on predictors of poor adherence to medication in hypertensive patients in Serbia. Methods: Observational, analytical study was undertaken at a group of 388 patients who refilled their medications in the Pharmacy Institution, "Apoteka Kragujevac", Kragujevac, Serbia between Jan and Mar 2019. Afterward, we conducted a case-control study to evaluate the influence of the variables associated with the adherence. We used a self-developed questionnaire and SF-36 to assess the influence of the quality of life on medication adherence. Results: Results revealed four independent predictors of non-adherence: increased number of medications, living in a city, forgetfulness of the dosing regimen and low energy. The odds of non-adherence were the highest among the participants living in the city and the low energy was the only factor inversely associated with the level of non-adherence. Conclusion: Many factors were associated with the non-adherence to medication. Further studies are needed to find the most appropriate protocol to promote adherence. The four risk factors (increased number of medications, living in a city, forgetfulness of the dosing regimen and low energy) are associated with non-adherence in adult hypertensive patients.

Photoacoustic Characterization of TiO2 Thin-Films Deposited on Silicon Substrate Using Neural Networks.

In this paper, the possibility of determining the thermal, elastic and geometric characteristics of a thin TiO2 film deposited on a silicon substrate, with a thickness of 30 µm, in the frequency range of 20 to 20 kHz with neural networks were analysed. For this purpose, the geometric (thickness), thermal (thermal diffusivity, coefficient of linear expansion) and electronic parameters of substrates were known and constant in the two-layer model, while the following nano-layer thin-film parameters were changed: thickness, expansion and thermal diffusivity. Predictions of these three parameters of the thin-film were analysed separately with three neural networks. All of them together were joined by a fourth neural network. It was shown that the neural network, which analysed all three parameters at the same time, achieved the highest accuracy, so the use of networks that provide predictions for only one parameter is less reliable. The obtained results showed that the application of neural networks in determining the thermoelastic properties of a thin film on a supporting substrate enables the estimation of its characteristics with great accuracy.

Oxidative Stress Mediated Therapy in Patients with Rheumatoid Arthritis: A Systematic Review and Meta-Analysis.

OBJECTIVE: The aim of this meta-analysis is to explore all the available literature to obtain updated data about the potential use of antioxidants in the treatment of rheumatoid arthritis (RA) and its ability to reduce disease progression and cardiovascular risk. METHODS: This systematic review and meta-analysis was performed strictly in accordance with the PRISMA guidelines. English and Chinese databases were searched with a retrieval time up to March 2023. These databases included the PubMed, Embase, Medline Complete, Web of Sciences and Cochrane Collaboration, Wanfang, China National Knowledge Infrastructure, and VIP databases. This literature search was formulated by the two researchers independently. The search strategy consists of reading, collecting the literature, and conducting the preliminary screening. After that, they provide the final selection of the literature according to the inclusion criteria and data extraction. Also, for all studies, the risk bias was assessed to evaluate the quality of the included references. The content of the risk assessment of bias included the following criteria: random allocation method, allocation plan hiding, blind method, completeness of result data, and selectivity of reporting of results, as well as other biases. The main outcomes were clinical efficiency of antioxidant therapy (C-reactive protein, DAS28 score, HAQ, Number of tender joints, etc.) and oxidative stress indicators (catalase, superoxide dismutase, or total antioxidant capacity). RESULTS: We observed, in most of the studies, the small or moderate effects of antioxidant treatment. The mean effect size is 0.525, and that means that moderate effects were observed in 30 selected RCTs. Also, this effect is confirmed in the 1652 patients with RA with the mean confidence interval of 0.276 (lower limit) and 0.983 (upper limit). Cohen coefficient was calculated at 0.05. CONCLUSION: The existing evidence is that antioxidants can reduce systemic and local oxidative stress and can reduce damage as the main agent involved in autoimmune diseases such as rheumatoid arthritis.

Examining the Effects of Hyperbaric Oxygen Therapy on the Cardiovascular System and Oxidative Stress in Insulin-Treated and Non-Treated Diabetic Rats.

BACKGROUND: This study explored the effects of hyperbaric oxygen therapy (HBOT) on the cardiovascular system and oxidative stress in streptozotocin-induced diabetic rats. Wistar albino rats were divided into four groups: DM group (diabetic rats), DM+HBOT group (diabetic rats exposed to HBOT for 1 h daily, five days a week, at 2.8 atmosphere absolute (ATA) with 100% oxygen for two weeks), DM+INS group (diabetic rats treated with neutral protamine hagedorn (NPH) insulin at a dosage of 3-5 U/day), and DM+HBOT+INS group (diabetic rats treated with both NPH insulin and HBOT for two weeks). METHODS: Evaluations included glycemic control, oxidative stress parameters, and cardiac function measurements. RESULTS: NPH insulin treatment reduced blood glucose levels, although normoglycemia was not achieved. The DM+HBOT+INS group demonstrated the lowest pro-oxidative marker levels. NPH insulin treatment improved cardiac function, and combination therapy effectively restored cardiac function in diabetic animals. CONCLUSIONS: NPH insulin treatment reduced hyperglycemia and improved cardiac function in diabetic rats. The combined approach of NPH insulin and HBOT resulted in decreased pro-oxidative markers. These findings provide valuable insights for managing cardiovascular complications and oxidative stress in diabetes.

Evidence for the Neuronal Expression and Secretion of Adiponectin.

Peripheral adiponectin acts on the hypothalamus to inhibit energy expenditure and increase food intake through its receptors AdipoR1 and adipoR2. The hypothalamic expression of adiponectin is poorly documented. We hypothesize that whether hypothalamic adiponectin is confirmed, its expression and secretion could be regulated as peripheral adiponectin. Thus, in the present work, we aim to determine whether adiponectin is expressed in the hypothalamus and in two neuronal cell lines and investigate the potential mechanisms regulating its neuronal expression. Using immunohistochemistry, we show that adiponectin is expressed in the mediobasal hypothalamic neurons of mice. Adiponectin expression is also evidenced in two neuronal cell lines mHypo POMC (an adult mouse hypothalamic cell line) and SH-SY5Y (human neuroblastoma). The neuronal expression of adiponectin is increased in response to rosiglitazone treatment (a PPARγ agonist) and FGF21 and is decreased in insulin-resistant neurons. Furthermore, we show that adiponectin expressed by mHypo POMC neurons is secreted in a culture medium. Adiponectin also diminished the resistin-induced IL6 expression in SIMA9 cells, a microglia cell line. In conclusion, we evidenced the hypothalamic expression of adiponectin and its regulation at the neuronal level.

Genotoxic and cytotoxic properties of two medical plants (Teucrium arduini L.and Teucrium flavum L.) in relation to their polyphenolic contents.

A large number of species belonging to the genus Teucrium are used in pharmacy and traditional medicine for the treatment of different diseases. This study aimed to evaluate the polyphenolic composition as well as genotoxic and cytotoxic effects of methanolic extracts from T. arduini and T. flavum, two native species found in Montenegro. We determined the total phenolic and flavonoid contents of these plants using spectrophotometric methods; the qualitative content of polyphenolic compounds was investigated by high-performance liquid chromatography (HPLC). Genotoxicity in cultured human lymphocytes was measured in the cytokinesis-block micronucleus assay (CBMN) and comet assay in the range between 125 and 1000 µg/mL. Cytotoxicity was assessed by the MTT viability assay in normal human MRC-5 fibroblasts and MDA-MB-231 breast carcinoma cells. The content of total phenolics and flavonoids in T. arduini extract was higher than in T. flavum (200.35 mg GA/g vs. 171.08 mg GA/g; 96.32 mg RU/g vs. 78.14 mg RU/g). The polyphenolic composition of both extracts was qualitatively similar and eight phenol compounds were identified. The most commonly present phenol was caffeic acid and among four flavonoids, the most common was quercetin. Both plant extracts were genotoxic in both the CBMN and comet assays at concentrations of 250, 500 and 1000 µg/mL. After 72 h of exposure, the extracts of T. arduini and T. flavum were found to induce cytotoxicity in MRC-5 fibroblasts but not in MDA-MB-231 breast cancer cells. The results suggest that the constituents of both plant species are genotoxic and cytotoxic, therefore these extracts warrant additional evaluation to be safely applied in humans.