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1.
Klin Onkol ; 38(2): 95-101, 2024.
Article in English | MEDLINE | ID: mdl-38697817

ABSTRACT

BACKGROUND: The N-myc downstream-regulated gene 1 (NDRG1) has been discovered as a significant gene in the progression of cancers. However, the regulatory mechanism of NDRG1 remained obscure in prostate cancer (PCa). METHODS: The miR-96-5p and NDRG1 expression levels were evaluated in PCa cell lines, and prostate tissues, and validated in public databases by real-time polymerase chain reaction, western blot analysis, and immunohistochemistry. The function of miR-96-5p and NDRG1 were investigated by scratch assay and transwell assays in vitro, and mouse xenograft assay in vivo. The candidate pathway regulated by NDRG1 was conducted by the next-generation gene sequencing technique. Immunofluorescence and luciferase assays were used to detect the relation between miR-96-5p, NDRG1, and NF-kB pathway. RESULTS: Overexpressing NDRG1 suppresses the migration, invasion, and epithelial-mesenchymal transition (EMT) in vitro, and inhibits metastasis in vivo. Moreover, miR-96-5p contributes to NDRG1 deficiency and promotes PCa cell migration and invasion. Furthermore, NDRG1 loss activates the NF-kB pathway, which stimulates p65 and IKBa phosphorylation and induces EMT in PCa. CONCLUSIONS: MiR-96-5p promotes the migration and invasion of PCa by targeting NDRG1 and regulating the NF-kB pathway.


Subject(s)
Cell Cycle Proteins , Intracellular Signaling Peptides and Proteins , MicroRNAs , NF-kappa B , Neoplasm Invasiveness , Prostatic Neoplasms , MicroRNAs/genetics , Humans , Male , Prostatic Neoplasms/pathology , Prostatic Neoplasms/genetics , Prostatic Neoplasms/metabolism , Intracellular Signaling Peptides and Proteins/genetics , Intracellular Signaling Peptides and Proteins/metabolism , Cell Cycle Proteins/genetics , Cell Cycle Proteins/metabolism , NF-kappa B/metabolism , Animals , Cell Line, Tumor , Mice , Epithelial-Mesenchymal Transition , Cell Movement , Gene Expression Regulation, Neoplastic
2.
Explore (NY) ; 20(4): 535-543, 2024.
Article in English | MEDLINE | ID: mdl-38594113

ABSTRACT

BACKGROUND AND AIM: Oral health is a vital indicator of overall well-being, quality of life, and general health, with historical roots in Unani medicine (i.e. preventive measures, oral hygiene, and treatment). This study aims to assess the efficacy and safety of prepared herbal mouthwash in maintaining oral health among school children. EXPERIMENTAL PROCEDURE: 110 schoolchildren were randomly assigned to the test group (treated with herbal mouthwash -Anacyclus pyrenthrum DC, Punica granutum (pericarp), Capparis spinosa (root bark), and Quercus infectoria Oliv (galls)) and the control group (treated with 0.2 % Chlorhexidine Mouthwash) for 30-days. The response was assessed by DMFT, Salivary pH, Oral hygiene index-simplified (OHI-S), Plaque index (Loe & Silness) (PI), Plaque index simplified (O'Leary et al., 1972) (PI-S), Gingival Index (Löe-Silness) (GI), and Bleeding on probing (BOP) on baseline and 30th day GI and PI were further assessed on 60th, 90th and 120th days to determine the sustainable effect of the intervention. RESULTS: After treatment, Mean OHI-S, PI, PI-S, GI and BOP significantly reduced on the 30th day from baseline (p ≤ 0.001) in both groups. After discontinuing intervention, both groups showed significantly lower PI and GI scores on the 120th day from baseline. (p < 0.001). CONCLUSION: This study revealed that prepared mouthwash is safe and significantly effective in maintaining oral health, and it could be used as an adjunct to mechanical oral hygiene measures.


Subject(s)
Mouthwashes , Oral Health , Humans , Mouthwashes/therapeutic use , Child , Female , Male , Single-Blind Method , Chlorhexidine/therapeutic use , Periodontal Index , Oral Hygiene Index , Phytotherapy , Dental Plaque Index , Oral Hygiene/methods , Saliva , Quercus , Plant Preparations/therapeutic use , Adolescent
3.
Braz. j. biol ; 842024.
Article in English | LILACS-Express | LILACS, VETINDEX | ID: biblio-1469279

ABSTRACT

Abstract Maydis leaf blight, caused by Bipolaris maydis, is an important disease of maize crop in Khyber Pakhtunkhwa (KP) Pakistan. Fifteen isolates of the pathogen, collected across KP, were studied for variability based on phenotypic and molecular markers. Significant variability among the isolates was observed when assessed using phenotypic traits such as radial growth, spore concentration, fungicide sensitivity and virulence. The isolates were classified into six culture groups based on colour, texture and margins of the colony. Conidial morphology was also variable. These were either straight or slightly curved and light to dark brown in colour. Fungicide test showed significant variation in the degree of sensitivity against Carbendazim. Isolate Bm8 exhibited maximum radial growth on carbendazim spiked plates. Conversely, isolate Bm15 showed the lowest radial growth. Variations in virulence pattern of the isolates were evident when a susceptible maize variety Azam was inoculated with spores of B. maydis. Genetic variability amongst the isolates was also estimated by RAPD as well as sequencing of ITS region. The RAPD dendrogram grouped all the isolates into two major clusters. Average genetic distance ranged from 0.6% to 100%, indicating a diverse genetic gap among the isolates. Maximum genetic distance was found between isolates Bm9 and Bm10 as well as Bm2 and Bm8. Conversely, isolates Bm13 and Bm15 were at minimum genetic distance. Phylogenetic dendrogram based on sequencing of ITS region grouped all the isolates into a single major cluster. The clusters in both the dendrogram neither correlate to the geographical distribution nor to the morphological characteristics.


Resumo A ferrugem das folhas de maydis, causada por Bipolaris maydis, é uma doença importante da cultura do milho em Khyber Pakhtunkhwa (KP), Paquistão. Quinze isolados do patógeno, coletados em KP, foram estudados quanto à variabilidade com base em marcadores fenotípicos e moleculares. Variabilidade significativa entre os isolados foi observada quando avaliada por meio de características fenotípicas, como crescimento radial, concentração de esporos, sensibilidade a fungicida e virulência. Os isolados foram classificados em seis grupos de cultura com base na cor, textura e margens da colônia. A morfologia dos conídios também foi variável. Estes eram retos ou ligeiramente curvos e de cor marrom-claro a escuro. O teste de fungicida mostrou variação significativa no grau de sensibilidade ao carbendazim. O isolado Bm8 exibiu crescimento radial máximo em placas com adição de carbendazim. Por outro lado, o isolado Bm15 apresentou o menor crescimento radial. As variações no padrão de virulência dos isolados foram evidentes quando uma variedade de milho suscetível Azam foi inoculada com esporos de B. maydis. A variabilidade genética entre os isolados também foi estimada por RAPD, bem como sequenciamento da região ITS. O dendrograma RAPD agrupou todos os isolados em dois grupos principais. A distância genética média variou de 0,6% a 100%, indicando uma lacuna genética diversa entre os isolados. A distância genética máxima foi encontrada entre os isolados Bm9 e Bm10 e também entre Bm2 e Bm8. Por outro lado, os isolados Bm13 e Bm15 estavam a uma distância genética mínima. O dendrograma filogenético baseado no sequenciamento da região ITS agrupou todos os isolados em um único aglomerado principal. Os agrupamentos em ambos os dendrogramas não se correlacionam com a distribuição geográfica nem com as características morfológicas.

4.
Data Brief ; 51: 109772, 2023 Dec.
Article in English | MEDLINE | ID: mdl-38020434

ABSTRACT

Bangladesh's economy is primarily driven by the agriculture sector. Rice is one of the staple food of Bangladesh. The count of panicles per unit area serves as a widely used indicator for estimating rice yield, facilitating breeding efforts, and conducting phenotypic analysis. By calculating the number of panicles within a given area, researchers and farmers can assess crop density, plant health, and prospective production. The conventional method of estimating rice yields in Bangladesh is time-consuming, inaccurate, and inefficient. To address the challenge of detecting rice panicles, this article provides a comprehensive dataset of annotated rice panicle images from Bangladesh. Data collection was done by a drone equipped with a 4 K resolution camera, and it took place on April 25, 2023, in Bonkhoria Gazipur, Bangladesh. During the day, the drone captured the rice field from various heights and perspectives. After employing various image processing techniques for curation and annotation, the dataset was generated using images extracted from drone video clips, which were then annotated with information regarding rice panicles. The dataset is the largest publicly accessible collection of rice panicle images from Bangladesh, consisting of 2193 original images and 5701 augmented images.

5.
Int J Colorectal Dis ; 38(1): 9, 2023 Jan 11.
Article in English | MEDLINE | ID: mdl-36630001

ABSTRACT

PURPOSE: Evidence regarding the learning curve of robot-assisted total mesorectal excision is scarce and of low quality. Case-mix is mostly not taken into account, and learning curves are based on operative time, while preferably clinical outcomes and literature-based limits should be used. Therefore, this study aims to assess the learning curve of robot-assisted total mesorectal excision. METHODS: A retrospective study was performed in four Dutch centers. The primary aim was to assess the safety of the individual and institutional learning curves using a RA-CUSUM analysis based on intraoperative complications, major postoperative complications, and compound pathological outcome (positive circumferential margin or incomplete TME specimen). The learning curve for efficiency was assessed using a LC-CUSUM analysis for operative time. Outcomes of patients before and after the learning curve were compared. RESULTS: In this study, seven participating surgeons performed robot-assisted total mesorectal excisions in 531 patients. Learning curves for intraoperative complications, postoperative complications, and compound pathological outcome did not exceed predefined literature-based limits. The LC-CUSUM for operative time showed lengths of the learning curve ranging from 12 to 35 cases. Intraoperative, postoperative, and pathological outcomes did not differ between patients operated during and after the learning curve. CONCLUSION: The learning curve of robot-assisted total mesorectal excision based on intraoperative complications, postoperative complications, and compound pathological outcome did not exceed predefined limits and is therefore suggested to be safe. Using operative time as a surrogate for efficiency, the learning curve is estimated to be between 12 and 35 procedures.


Subject(s)
Laparoscopy , Rectal Neoplasms , Robotics , Humans , Rectum/surgery , Rectum/pathology , Learning Curve , Retrospective Studies , Rectal Neoplasms/surgery , Rectal Neoplasms/pathology , Postoperative Complications/etiology , Postoperative Complications/surgery , Intraoperative Complications/etiology , Margins of Excision , Treatment Outcome
6.
Int J Colorectal Dis ; 37(7): 1635-1645, 2022 Jul.
Article in English | MEDLINE | ID: mdl-35708836

ABSTRACT

PURPOSE: Evidence regarding local recurrence rates in the initial cases after implementation of robot-assisted total mesorectal excision is limited. This study aims to describe local recurrence rates in four large Dutch centres during their initial cases. METHODS: Four large Dutch centres started with the implementation of robot-assisted total mesorectal excision in respectively 2011, 2012, 2015, and 2016. Patients who underwent robot-assisted total mesorectal excision with curative intent in an elective setting for rectal carcinoma defined according to the sigmoid take-off were included. Overall survival, disease-free survival, systemic recurrence, and local recurrence were assessed at 3 years postoperatively. Subsequently, outcomes between the initial 10 cases, cases 11-40, and the subsequent cases per surgeon were compared using Cox regression analysis. RESULTS: In total, 531 patients were included. Median follow-up time was 32 months (IQR: 19-50]. During the initial 10 cases, overall survival was 89.5%, disease-free survival was 73.1%, and local recurrence was 4.9%. During cases 11-40, this was 87.7%, 74.1%, and 6.6% respectively. Multivariable Cox regression did not reveal differences in local recurrence between the different case groups. CONCLUSION: Local recurrence rate during the initial phases of implantation of robot-assisted total mesorectal procedures is low. Implementation of the robot-assisted technique can safely be performed, without additional cases of local recurrence during the initial cases, if performed by surgeons experienced in laparoscopic rectal cancer surgery.


Subject(s)
Laparoscopy , Rectal Neoplasms , Robotics , Cohort Studies , Disease-Free Survival , Humans , Neoplasm Recurrence, Local/pathology , Rectal Neoplasms/pathology , Treatment Outcome
7.
Radiol Case Rep ; 17(3): 852-855, 2022 Mar.
Article in English | MEDLINE | ID: mdl-35013689

ABSTRACT

COVID-19 related leukoencephalopathy can be multifactorial given the systemic effects of the viral disease. We present couple of cases with typical clinico-imaging stigmata of COVID-19 resulting in severe respiratory insufficiency. MR brain imaging revealed confluent diffuse supratentorial white matter T2 hyperintensity with restricted diffusion during the sub-acute course of the disease. The MR imaging pattern of leukoencephalopathy was non-specific but more comparable to delayed post-hypoxic leukoencephalopathy (DPHL) as also previously reported in COVID-19. Interestingly, T2 imaging showed unusual but peculiar finding of "accentuated medullary veins" in the superficial zones. No dural venous sinus thrombosis or micro-hemorrhages were present to explain "dots and stripes" due to dilated medullary veins. The patho-mechanism of this findings is not clear but may possibly be related to demyelination as DPHL has shown to be a demyelinating process. We present a review of COVID-related leukoencephalopathy with discussion on hypoxia-induced demyelinating process with accentuated medullary veins as possible associated marker.

8.
J Ethnopharmacol ; 286: 114839, 2022 Mar 25.
Article in English | MEDLINE | ID: mdl-34896208

ABSTRACT

ETHNOPHARMACOLOGICAL RELEVANCE: F.parviflora Lam. is a plant widely used in traditional medicine systems like Unani, Ayurveda, and folk medicines in Iraq and Turkey. It is known as Shahatraj in Arabic, which is derived from Shahatra and called Shajaratuddam. In the ancient Unani system, it is called Shajaratuddam. The term derived from Sajarat means tree, and Dam means blood since it has a potent blood purifier property. AIM OF THE STUDY: This review focused on comprehensive, updated information on the F.parviflora Lam. about the traditional uses, phytochemical and pharmacology and provided insights into potential opportunities for future research. MATERIALS AND METHODS: The classical literature of Shahatra for its temperament (Mizaj), medicinal properties and traditional therapeutic uses were gathered from nearly 15 classical Unani books, eight local and foreign books on ethnomedicines and ethnobotany in English. The information of pharmacognosy, phytochemical and pharmacological activities of F.parviflora Lam was collected by browsing the Internet (PubMed, ScienceDirect, Wiley online library, Google Scholar, ResearchGate). The relevant primary sources were probed, analysed, and included in this review. The keywords used to browse were F.parviflora Lam, shahatra, pitpapda, and fine fumitory. Relevant Sources were gathered up to April 2021, and the chemical structures were drawn using Chemsketch software. The species name was checked with http://www.theplantlist.org ("F.parviflora Lam. - The Plant List," n.d.). The materials published in both Urdu and English were included in the review. RESULTS: F.parviflora Lam was found to possess an excess of bioactive compounds and broad pharmacological properties, including antimicrobial activity, antioxidant activity, antiprotozoal activity, anthelmintic activity, antidiarrheal, antispasmodic and bronchodilator activities, antidiabetic activity, hepatoprotective activity, anticancer activity (cytotoxicity)of nanoparticle, antipruritic activity, dermatological effect, reproductive effect, anti-inflammatory and anti-nociceptive activity. CONCLUSION: In this review, the botany, traditional uses, phytochemistry and pharmacology of F.parviflora were reviewed. It showed a broad scope of application, and its benefits had been extended far beyond the initial conventional uses of its parts. It consists of numerous chemical constituents and reported various pharmacological activities such as antimicrobial activity, antioxidant activity, antidiabetic activity, hepatoprotective activity, anticancer activity etc. Though it is widely studied using several in-vitro and in-vivo models and tested clinically for skin diseases, several gaps and research priorities have been identified that need to be addressed in the future, such as active ingredients and their mechanism of action applications in immunomodulation and hepatic diseases.


Subject(s)
Fumaria/chemistry , Medicine, Traditional/methods , Plant Extracts/pharmacology , Animals , Ethnobotany , Ethnopharmacology , Humans , Phytochemicals/isolation & purification , Phytochemicals/pharmacology
9.
Obes Res Clin Pract ; 15(5): 473-484, 2021.
Article in English | MEDLINE | ID: mdl-34233859

ABSTRACT

BACKGROUND: Obesity is a barrier to kidney transplantation for patients with kidney failure. Consequently, bariatric surgery is often considered as a bridge to transplantation, even though its risks and benefits are poorly characterised in the dialysis population. METHODS: Systematic searches of observational studies indexed in Embase, MEDLINE and CENTRAL till April 2020 were performed to identify relevant studies. Risk of bias was assessed by the Newcastle Ottawa Scale and quality of evidence was summarised in accordance with GRADE methodology. Random effects meta-analyses were performed to obtain summary odds ratios for postoperative outcomes. RESULTS: Four cohort studies involving 4196 chronic dialysis and 732,204 non-dialysis patients undergoing bariatric surgery were included. Sleeve gastrectomy (61%), and Roux-en-Y gastric bypass (29%) were the most common procedures performed. Absolute rates of adverse events were low, but the odds of postoperative mortality (0.4-0.5% vs. 0.1%; odds ratio [OR] 4.7, 95%CI 2.2-9.9), and myocardial infarction (0.0-0.5% vs. 0.1%, OR 3.4, 95% CI 2.0-5.9) were higher in dialysis compared to non-dialysis patients. Patients on dialysis also had more than 2-fold increased odds of returning to theatre and having a readmission. Rates of kidney transplant wait-listing among dialysis patients was 59%, with 28% of all patients eventually receiving a kidney transplant. CONCLUSION: Patients receiving chronic dialysis have substantially increased odds of postoperative mortality and myocardial infarction following bariatric surgery compared with patient who do not have kidney failure. It is uncertain whether bariatric surgery improves the likelihood of kidney transplantation, with mid- to long-term outcomes being poorly described.


Subject(s)
Bariatric Surgery , Gastric Bypass , Obesity, Morbid , Bariatric Surgery/adverse effects , Gastrectomy , Humans , Obesity , Obesity, Morbid/surgery , Postoperative Complications/etiology , Renal Dialysis
10.
Eur J Surg Oncol ; 47(9): 2414-2420, 2021 09.
Article in English | MEDLINE | ID: mdl-34023165

ABSTRACT

INTRODUCTION: Bowel obstruction patients are at increased risk of emergency surgery and have poor nutritional and physical conditions. These patients could benefit from prehabilitation and prevention of emergency surgery. This study assessed the effect of a multimodal obstruction treatment for bowel obstruction patients in colorectal surgery on the risk of emergency surgery and postoperative morbidity and mortality. MATERIALS AND METHODS: This multicenter observational cohort study included all consecutive bowel obstruction patients who received obstruction treatment (obstruction protocol) in the period 2019-2020 in two Dutch hospitals. Benign and malignant causes of bowel obstruction were included. Treatment consisted of 1. dietary adjustments, 2. postponing surgery for three weeks, 3. laxatives, and 4. prehabilitation. We compared emergency surgery and postoperative morbidity and mortality rates to known rates from the literature. RESULTS: Eighty-nine patients were included: obstruction treatment was successful in 77 patients (87%) who underwent elective surgery and unsuccessful in 12 patients (13%) who underwent emergency surgery. Sixty-six (74%) had colorectal cancer, and 22 (25%) had benign disease. Thirty-day mortality of 0% in our study was significantly lower than the national average of 4% in colorectal cancer patients in the Netherlands (p = 0.049). Anastomotic leakage rate was 3%, severe complications (Clavien-Dindo ≥ III) 8%, and bowel perforation 0%. These rates did not differ significantly from rates reported in literature. CONCLUSION: The obstruction treatment prevented emergency surgery in most patients with bowel obstruction and reduced postoperative morbidity and mortality. The obstruction treatment seems to be a safe and efficient alternative to emergency surgery.


Subject(s)
Colorectal Neoplasms/complications , Colorectal Surgery/methods , Intestinal Obstruction/therapy , Intestinal Perforation/etiology , Postoperative Complications/etiology , Anastomosis, Surgical/adverse effects , Anastomotic Leak/etiology , Colorectal Surgery/adverse effects , Combined Modality Therapy , Crohn Disease/complications , Diet , Digestive System Surgical Procedures/adverse effects , Diverticulitis/complications , Elective Surgical Procedures , Emergencies , Humans , Intestinal Obstruction/diagnostic imaging , Intestinal Obstruction/etiology , Intestinal Obstruction/surgery , Laxatives/therapeutic use , Mortality , Netherlands , Nutritional Status , Preoperative Exercise , Preoperative Period , Prospective Studies , Time Factors , Treatment Outcome
11.
Colorectal Dis ; 22(12): 1941-1948, 2020 12.
Article in English | MEDLINE | ID: mdl-32627889

ABSTRACT

AIM: Emergency surgery is a known predictor for 30-day mortality. However, its relationship with long-term mortality is still a matter of debate. The aim of this study was to analyse the effect of emergency surgery compared with elective surgery on long-term survival. METHOD: Data from the Dutch Colorectal Audit and the Dutch Cancer Centre registry of a large nonacademic teaching hospital were used to analyse outcomes of patients who underwent surgery for colon cancer from 2009 until 2017. Univariable and multivariable Cox regression were used to assess the effect of emergency surgery on long-term mortality with adjustment for patient, tumour and treatment characteristics. RESULTS: A total of 1139 patients with a median follow-up of 40 months (interquartile range 23-65 months) were included. Emergency surgery was performed in 158 patients (14%). The 5-year survival after emergency surgery was 46% compared with 72% after elective surgery. After adjusting for baseline differences there was an independent and significant association between emergency surgery and increased long-term mortality (hazard ratio 1.79, 95% CI 1.28-2.51, P = 0.001). CONCLUSION: Emergency surgery for colon cancer seems to lead to a significantly increased risk of long-term mortality compared with elective surgery. Detection and treatment of early symptoms that can lead to emergency surgery might be the way forward.


Subject(s)
Colectomy , Colonic Neoplasms , Colonic Neoplasms/surgery , Elective Surgical Procedures , Emergencies , Humans
12.
Hum Exp Toxicol ; 39(11): 1463-1474, 2020 Nov.
Article in English | MEDLINE | ID: mdl-32495657

ABSTRACT

Cardiovascular disease and type 2 diabetes mellitus (T2DM) patients have low level of adiponectin, however, till now the role of adiponectin in progression of 'T2DM with cardiac dysfunction' in animal model has not been characterized. Therefore, the aim of the present study was to develop and characterize T2DM animal model with cardiac dysfunction and to study the role of cardiac adiponectin expression in cardiac dysfunction. For this, Wistar rats (M/F) were fed a high-fat diet for different time periods: 3, 4 and 5 weeks and given a single, low-dose streptozotocin (25mg/kg), intraperitoneal injection 1 week prior to the experiments. Rats in T2DM group (3 weeks) developed hyperglycaemia, hyperlipidaemia, oxidative stress with normoinsulinaemia and mild cardiac dysfunction suggesting onset of T2DM with cardiac dysfunction. Extended high-fat feeding, that is, 4 and 5 weeks induced insulin resistance accompanied with cardiac hypertrophy, cardiac dysfunction and reduced baroreflex sensitivity indicating development of T2DM with cardiac dysfunction. Cardiac adiponectin expression did not change in rats of T2DM group (3 weeks), however, it significantly decreased in rats of two T2DM groups (4 and 5 weeks) along with increased intracellular adhesion molecule-1 levels. Thus, the present study for the first time indicates that in the present T2DM animal model, as T2DM progresses cardiac adiponectin expression also decreases which might be the precipitating factor for cardiac hypertrophy and decrease in baroreflex sensitivity, which induces cardiac dysfunction.


Subject(s)
Adiponectin/metabolism , Diabetes Mellitus, Experimental/metabolism , Diabetes Mellitus, Type 2/metabolism , Heart Diseases/metabolism , Animals , Baroreflex , Diabetes Mellitus, Experimental/physiopathology , Diabetes Mellitus, Type 2/physiopathology , Female , Heart Diseases/physiopathology , Male , Myocardium/metabolism , Rats, Wistar , Ventricular Function, Left
13.
Eur J Surg Oncol ; 46(3): 326-332, 2020 03.
Article in English | MEDLINE | ID: mdl-31955993

ABSTRACT

Older studies reported high rates of postoperative morbidity and mortality in the senior population, which lead to a tendency to withhold curative surgery in the older population. However, more recent studies showed impressing developments in postoperative outcomes in seniors. Probably, these improvements are due to enhancements in both surgical and non-surgical aspects in the pre-, peri- and postoperative period, such as minimally invasive techniques and anesthesiological insights. The postoperative survival gap seen earlier between younger and older patients is fading. For optimal treatment in the older population, special awareness and care on several aspects is needed. As only a minority of the seniors are frail, a quick frailty assessment is crucial to distinguish the fit from the frail in the decision-making process. In addition, it could be valuable to improve the lacks in physical condition in the preoperative period with the use of prehabilitation programs. Furthermore, it is important to evolve an emergency to an elective setting by postponing emergency surgery to prevent any high-risk situation. In conclusion, based on modern insights, surgery is a valid option in the curative treatment of colorectal cancer in seniors, however individual attention and care is required.


Subject(s)
Colonic Neoplasms/surgery , Elective Surgical Procedures/methods , Geriatric Assessment/methods , Postoperative Complications/epidemiology , Aged , Global Health , Humans , Morbidity/trends , Risk Factors
14.
Eur J Surg Oncol ; 46(3): 415-419, 2020 03.
Article in English | MEDLINE | ID: mdl-31676200

ABSTRACT

INTRODUCTION: Bowel obstruction increases risk of emergency surgery and leads to suboptimal physical and nutritional condition. Preventing emergency surgery and prehabilitation might improve outcomes. This pilot study aimed to examine the effect of a multimodal obstruction protocol for bowel obstruction patients on the risk of emergency surgery and postoperative morbidity and mortality. MATERIALS AND METHODS: All bowel obstruction patients treated according to the obstruction protocol in the period 2013-2017 were included in this uncontrolled observational cohort study. Benign and malignant causes of bowel obstruction were included. The protocol consisted of: 1. specific dietary adjustments to reduce prestenotic dilatation, 2. oral laxatives and 3. prehabilitation. Emergency surgery and postoperative morbidity and mortality rates were compared to known rates from the literature. RESULTS: Sixty-one patients were included: 44 (72%) were treated for colorectal cancer and 17 (28%) for Crohn's disease or diverticulitis. Four patients (7%) underwent emergency surgery. Primary anastomosis was constructed in 49 out of 57 elective patients (86%). Severe complications (Clavien-Dindo ≥ III) occurred in four patients (7%). No bowel perforation, anastomotic leakages or 30-day mortality was observed. These rates were much lower than rates reported in the literature after surgery for colorectal cancer (3% bowel perforation, 8% anastomotic leakage, 4% 30-day mortality, 15% severe complications) and benign disease (30-day mortality 17%, severe complications 7%). CONCLUSION: Using the obstruction protocol in patients with bowel obstruction reduced emergency surgery and postoperative morbidity and mortality in this pilot study. This protocol seems to be a viable and efficient alternative to emergency surgery.


Subject(s)
Colorectal Neoplasms/surgery , Exercise Therapy/methods , Intestinal Obstruction/therapy , Nutritional Support/methods , Postoperative Complications/therapy , Aged , Digestive System Surgical Procedures/adverse effects , Elective Surgical Procedures/adverse effects , Female , Follow-Up Studies , Humans , Incidence , Intestinal Obstruction/epidemiology , Intestinal Obstruction/etiology , Male , Middle Aged , Netherlands/epidemiology , Pilot Projects , Postoperative Complications/epidemiology , Postoperative Complications/etiology , Retrospective Studies , Treatment Outcome
15.
Colorectal Dis ; 22(4): 408-415, 2020 04.
Article in English | MEDLINE | ID: mdl-31696590

ABSTRACT

AIM: Older colorectal cancer (CRC) patients are at increased risk of postoperative morbidity and mortality. Routine postoperative overnight intensive care unit (ICU) admission might reduce this risk. This study aimed to examine the effect of routine overnight ICU admission after CRC surgery on postoperative adverse outcomes and costs in patients aged 80 years or older. METHODS: Patients aged 80 years or older who underwent CRC surgery in our centre were included in this observational cohort study. All patients in the period 2014-2017 with routine overnight ICU admission were assigned to the ICU cohort; all patients in the period 2009-2013 were assigned to the non-ICU cohort. Multivariable logistic regression was performed to compare the primary composite end-point (30-day mortality, serious complications and readmission) between the groups. Cost data from the literature were used to perform a cost analysis. RESULTS: A total of 242 patients were included, 125 in the ICU cohort and 117 in the non-ICU cohort. Routine overnight ICU admission was associated with a reduced risk of the composite end-point (OR 0.44, 95% CI 0.22-0.87, P = 0.02) after adjusting for important confounders. In the ICU cohort 28% of patients experienced ICU events requiring intervention; this was not associated with postoperative morbidity or mortality. The 9% reduction in the incidence of serious complications in the ICU cohort is sufficient to offset the additional costs of routine overnight ICU admission. CONCLUSION: Routine overnight ICU admission after CRC surgery in patients aged 80 years and older is associated with reduced risk of postoperative mortality and morbidity and seems to be cost-effective.


Subject(s)
Colorectal Neoplasms , Patient Admission , Aged , Colorectal Neoplasms/surgery , Hospital Mortality , Humans , Incidence , Intensive Care Units , Postoperative Complications/epidemiology , Postoperative Complications/prevention & control , Retrospective Studies
16.
Rev Sci Tech ; 38(1): 261-270, 2019 May.
Article in English | MEDLINE | ID: mdl-31564724

ABSTRACT

The convergence of humans, animals and our shared environment results in a dynamic in which the health of each group is inextricably linked. Taking into account the fact that the majority of emerging pathogens (e.g. highly pathogenic avian influenza [HPAI], severe acute respiratory syndrome coronavirus, Nipah virus, Middle East respiratory syndrome coronavirus) are zoonotic diseases, Egypt has established a national One Health coordination mechanism. The primary purpose of this mechanism is to provide a comprehensive, strategic approach to concurrent and future health challenges that are facing public and animal heath, including environmental impacts. In this way, the public health, animal health and environment sectors can improve disease mitigation measures, develop stronger and more stable public and animal health services, promote effective national communication strategies and improve One Health collaboration among all relevant sectors. In Egypt, the Food and Agriculture Organization of the United Nations (FAO) and the World Health Organization (WHO) currently assist in hosting the country's Four-Way Linking Task Force with the participation of the convening Ministries (Ministry of Health and Population, Ministry of Environment, and Ministry of Agriculture and Land Reclamation [MOALR] - through the General Organisation for Veterinary Services and the MOALR's laboratories). In the context of the Emerging Pandemic Threats 2 Program, funded by the United States Agency for International Development (USAID), FAO plans to assist Egypt in establishing a robust, multidisciplinary and multisectoral One Health system. This system is based on the solid foundation of the Four-Way Linking Platform, which combines information from four functional streams - epidemiology, laboratories, and animal and human health. Egypt's platform will involve all sectors concerned with HPAI control and combine all stakeholders in an integrated, holistic approach to improve the detection of, response to and control of any threats at the human- animal-environment interface in Egypt.


La coexistence des humains, des animaux et d'un environnement partagé crée une dynamique au sein de laquelle la santé de chaque groupe est inextricablement liée à celle des autres. Confrontée au caractère zoonotique de la majorité des agents pathogènes émergents (par exemple le virus de l'influenza aviaire hautement pathogène [IAHP], le coronavirus responsable du syndrome respiratoire aigu sévère, le virus Nipah, le coronavirus responsable du syndrome respiratoire du Moyen-Orient), l'Égypte a mis en place un mécanisme de coordination Une seule santé. Les objectifs en sont les suivants : a) mieux comprendre l'interaction des facteurs intervenant à l'interface homme­animal­environnement, b) améliorer les mesures d'atténuation de l'impact des maladies, c) oeuvrer en faveur de services de santé publique et de santé animale performants et stables, d) promouvoir des stratégies nationales de communication efficaces et une collaboration multisectorielle Une seule santé entre toutes les entités concernées. En Égypte, l'Organisation des Nations Unies pour l'alimentation et l'agriculture (FAO) et l'Organisation mondiale de la santé (OMS) contribuent à cette démarche en accueillant le Groupe de travail quadri-directionnel (Four-Way Linking) qui réunit les ministères concernés (ministère de la Santé et de la population, ministère de l'Environnement et ministère de l'Agriculture et de la revalorisation des terres [MOALR], à travers l'Organisation générale des Services vétérinaires et les laboratoires du MOALR). La FAO prévoit de fournir à l'Égypte une assistance visant à mettre en place un système robuste, multisectoriel et multidisciplinaire Une seule santé, dans le cadre de la deuxième phase du Programme sur les menaces pandémiques émergentes financé par l'Agence des États-Unis pour le développement international (USAID). Ce système est basé sur les bases solides déjà posées par la plateforme quadri-directionnelle en place, qui fait converger les informations émanant de quatre circuits opérationnels : l'épidémiologie, les laboratoires, la santé animale et la santé publique. La Plateforme égyptienne fera participer tous les secteurs impliqués dans la lutte contre l'IAHP et réunira les parties prenantes dans une démarche intégrée et holistique visant à améliorer la détection des menaces à l'interface homme­animal­environnement en Égypte ainsi que la réponse qui leur est apportée et leur contrôle.


La confluencia de personas y animales en el medio común a todos nosotros da lugar a una dinámica en la que la salud de cada parte está inextricablemente ligada a la de las demás. Teniendo en cuenta que la mayoría de los patógenos emergentes (influenza aviar altamente patógena [IAAP], coronavirus del síndrome respiratorio agudo severo, virus Nipah, coronavirus del síndrome respiratorio de Oriente Medio, etc.) son zoonóticos, Egipto ha establecido un mecanismo nacional de coordinación en clave de Una sola salud con los siguientes objetivos: a) entender mejor la interrelación de distintos factores en la interfaz de personas, animales y medio ambiente; b) mejorar las medidas de mitigación de enfermedades; c) instituir servicios sólidos y estables de salud pública y sanidad animal; y d) promover dispositivos nacionales de comunicación eficaces y una colaboración multisectorial entre todas las entidades interesadas que se inscriba en los postulados de Una sola salud. En Egipto, la Organización de las Naciones Unidas para la Alimentación y la Agricultura (FAO) y la Organización Mundial de la Salud (OMS) prestan apoyo actualmente albergando al grupo de trabajo que en el país se dedica a la conexión cuatridimensional (Four-Way Linking) con participación de los ministerios convocantes (Ministerio de Salud y Población, Ministerio de Medio Ambiente y Ministerio de Agricultura y Recuperación de Tierras y por conducto de la Organización General de Servicios Veterinarios y los laboratorios del Ministerio de Agricultura). Como parte de la segunda fase del programa contra las amenazas pandémicas emergentes que financia la Agencia de los Estados Unidos para el Desarrollo Internacional (USAID), la FAO tiene previsto ayudar a Egipto a instituir un robusto sistema pluridisciplinar y multisectorial de Una sola salud partiendo de las sólidas bases que ha sentado el dispositivo de conexión cuatridimensional, que centraliza información procedente de cuatro grandes ámbitos de trabajo: epidemiología, laboratorios, sanidad animal y salud humana. El dispositivo egipcio federará a todos los sectores que intervienen en la lucha contra la IAAP y combinará, desde un planteamiento integrado y holístico, la labor de todos los interlocutores para detectar, controlar y combatir más eficazmente cuantas amenazas surjan en Egipto en la interfaz de personas, animales y medio ambiente.


Subject(s)
Communicable Disease Control , Intersectoral Collaboration , One Health , Animals , Communicable Disease Control/trends , Egypt , Humans , Interdisciplinary Communication , United Nations , Zoonoses/prevention & control
17.
Hum Exp Toxicol ; 38(10): 1183-1194, 2019 Oct.
Article in English | MEDLINE | ID: mdl-31256679

ABSTRACT

Heart failure (HF) is a leading cause of hospitalization across the world and is known to cause ill-health and heavy economic losses. In the present study, a rat model of isoproterenol (ISO, 85 mg/kg subcutaneously for two subsequent days) induced HF was developed. ISO induces HF by its direct effect, that is, rise in left ventricular end-diastolic pressure (mechanical) and indirectly by altering the baroreflex (neural), electrocardiography (electrical), and development of oxidative stress and hyperlipidemia (chemical). Fenofibrate, a hypolipidemic drug, which ameliorates myocardial energy metabolism was seen to improve the both ISO-induced oxidative stress and lipid profile and consequently improved Baroreflex Sensitivity (BRS), partial ventricular functions, and cardiac hypertrophy. Therefore, our result suggests that fenofibrate treatment protected the heart by alleviating the ISO-induced effects, that is, neural, mechanical, electrical, and chemical alterations.


Subject(s)
Baroreflex/drug effects , Energy Metabolism/drug effects , Fenofibrate/therapeutic use , Heart Failure/prevention & control , Hypolipidemic Agents/pharmacology , Ventricular Function, Left/drug effects , Animals , Blood Pressure/drug effects , Disease Models, Animal , Electrocardiography/drug effects , Heart Failure/metabolism , Heart Failure/physiopathology , Heart Rate/drug effects , Hypertrophy, Left Ventricular/metabolism , Hypertrophy, Left Ventricular/physiopathology , Hypertrophy, Left Ventricular/prevention & control , Lipid Peroxidation/drug effects , NADPH Oxidases/genetics , Rats, Wistar
18.
Lupus ; 28(8): 995-1002, 2019 Jul.
Article in English | MEDLINE | ID: mdl-31184250

ABSTRACT

BACKGROUND: Pediatric-onset SLE (pSLE) is a multisystem autoimmune disease. Recently, the ficolin-2 (FCN2) gene has emerged as a potential candidate gene for susceptibility to SLE. OBJECTIVES: The objective of this study was to evaluate the association of the FCN2 gene polymorphisms at positions -986 (G/A), -602 (G/A), -4 (A/G) and SNP C/T (rs3124954) located in intron 1, with susceptibility to pSLE in Egyptian children and adolescents. METHODS: This was a multicenter study of 280 patients diagnosed with pSLE, and 280 well-matched healthy controls. The FCN2 promoter polymorphisms at -986 G/A (rs3124952), -602 G/A (rs3124953), -4 A/G (rs17514136) and SNP C/T (rs3124954) located in intron 1 were genotyped by polymerase chain reaction, while serum ficolin-2 levels were assessed using enzyme-linked immunosorbent assay. RESULTS: The frequencies of the FCN2 GG genotype and G allele at -986 and -602 positions were significantly more represented in patients with pSLE than in controls (p < 0.001). Conversely, the FCN2 AA genotype and A allele at position -4 were more common in patients than in controls (p < 0.001). Moreover, patients carrying the FCN2 GG genotype in -986 position were more likely to develop lupus nephritis (odds ratio: 2.6 (95% confidence interval: 1.4-4.78); p = 0.006). The FCN2 AA genotype at position -4 was also identified as a possible risk factor for lupus nephritis (odds ratio: 3.12 (95% confidence interval: 1.25-7.84); p = 0.024). CONCLUSION: The FCN2 promoter polymorphisms may contribute to susceptibility to pSLE in Egyptian children and adolescents. Moreover, the FCN2 GG genotype at position -986 and AA genotype at position -4 were associated with low serum ficolin-2 levels and may constitute risk factors for lupus nephritis in pSLE.


Subject(s)
Genetic Predisposition to Disease , Lectins/genetics , Lupus Erythematosus, Systemic/genetics , Lupus Nephritis/genetics , Adolescent , Alleles , Case-Control Studies , Child , Egypt , Female , Humans , Logistic Models , Male , Polymorphism, Single Nucleotide , Prospective Studies , Risk Factors , Ficolins
20.
Int J Toxicol ; 34(4): 300-7, 2015.
Article in English | MEDLINE | ID: mdl-26060268

ABSTRACT

Vascular endothelium plays a vital role in the organization and function of the blood vessel and maintains homeostasis of the circulatory system and normal arterial function. Functional disruption of the endothelium is recognized as the beginning event that triggers the development of consequent cardiovascular disease (CVD) including atherosclerosis and coronary heart disease. There is a growing data associating mercury exposure with endothelial dysfunction and higher risk of CVD. This review explores and evaluates the impact of mercury exposure on CVD and endothelial function, highlighting the interplay of nitric oxide and oxidative stress.


Subject(s)
Cardiovascular Diseases/pathology , Endothelium, Vascular/drug effects , Mercury/toxicity , Nitric Oxide/metabolism , Oxidative Stress/drug effects , Animals , Cardiovascular Diseases/chemically induced , Disease Models, Animal , Endothelial Cells/drug effects , Endothelial Cells/metabolism , Endothelium, Vascular/physiopathology , Humans
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