Navigating Asymptomatic Idiopathic Pneumoperitoneum: A Case Report and a Literature Review.

Pneumoperitoneum refers to the presence of free air in the abdominal cavity, typically indicating viscus perforation requiring urgent surgical intervention. Occasionally, pneumoperitoneum occurs without organ perforation, termed 'spontaneous' or 'non-surgical' pneumoperitoneum. We present the case of a 65-year-old male referred to the emergency department after a seizure episode. The patient reported no abdominal pain or fever, and examination revealed no other signs of peritonitis. An erect chest X-ray showed air under the diaphragm, and a subsequent computed tomography (CT) scan confirmed free intraperitoneal air in the abdomen. The patient underwent a prompt exploratory laparotomy to assess for abdominal perforation, but the findings were negative. He had an uneventful post-operative hospital course and was discharged nine days after admission. This case underlines the importance of considering spontaneous idiopathic pneumoperitoneum (SIP) in asymptomatic patients and discusses management options.

Utility of the Paris System in Urine Cytology for Improved Screening of High-Grade Urothelial Carcinoma in Bahrain.

BACKGROUND: Urothelial carcinoma, a prevalent and aggressive urological malignancy, necessitates early detection for improved prognosis. Urine cytology serves as a cost-effective screening tool, but inconsistencies in reporting due to the lack of standardized criteria limit its efficacy. The Paris System for reporting urinary cytology (TPS) was introduced to address this issue, aiming to improve diagnostic accuracy. This retrospective study investigates the effectiveness of urine cytology in detecting high-grade urothelial carcinoma (HGUC) using TPS classification, specifically focusing on atypical urothelial cells (AUC) categorized as TPS-III and suspicious for high-grade urothelial carcinoma (SHGUC) categorized as TPS-IV. METHODS: We reviewed 470 urine cytology samples collected over two years at a tertiary healthcare center in Bahrain. All samples were re-evaluated using TPS classification by two independent consultant cytopathologists blinded to the original cytology report. The analysis included only samples categorized as TPS-III or TPS-IV with corresponding histopathology reports from confirmatory biopsies performed within four months of urine collection. Biopsy results were categorized as either benign/low-grade urothelial carcinoma (non-HGUC) or malignant (HGUC). The positive predictive value (PPV) of urine cytology for HGUC detection was calculated for both TPS-III and TPS-IV categories. Statistical significance was assessed using Fisher's exact test. RESULTS: Among the 470 urine cytology samples, 40 (8.5%) were classified as TPS-III or TPS-IV. Within this subset, 16 patients underwent confirmatory biopsies. Histopathological analysis revealed HGUC in 12 (75%) patients and non-HGUC (benign or low-grade) in 4 (25%) patients. The PPV of TPS-III for HGUC was 50%, while TPS-IV demonstrated a higher PPV of 90%. However, the difference between these values was not statistically significant (p = 0.25). This study explored the utility of TPS classification in urine cytology for HGUC detection. While SHGUC (TPS-IV) exhibited a numerically higher PPV compared to AUC (TPS-III), the lack of statistical significance necessitates further investigation. Our findings highlight the potential of TPS to improve the accuracy of urine cytology. TPS implementation has been shown to reduce the number of inconclusive "atypical" diagnoses, leading to more targeted investigations. CONCLUSION: Our study suggests that SHGUC (TPS-IV) within TPS classification framework might hold promise as a more specific indicator for HGUC compared to AUC (TPS-III). However, further research with larger cohorts is necessary to definitively establish the clinical significance of this observation. This investigation paves the way for future studies exploring the potential of TPS, particularly the SHGUC category, as a reliable screening tool for HGUC, potentially leading to earlier diagnoses and improved patient outcomes.

Avascular Necrosis of the Femoral Head Following Intramedullary Nailing of a Femoral Shaft Fracture in a Skeletally Mature Adult: A Case Report.

Avascular necrosis (AVN) of the femoral head is a well-documented complication that occurs following femoral neck fractures in both adults and pediatrics. Incidence of AVN following intramedullary nailing (IMN) for femoral shaft fractures is relatively rare. We are reporting an exceptional case of a 28-year-old skeletally mature adult, with no risk factors, who developed stage 3 AVN following trochanteric entry-point IMN for a traumatic femur shaft fracture. Our case contributes to the existing literature by adding to the limited number of reported cases available. In addition, it emphasizes the importance of observation and anticipation for such complications and shows the need for further studies to understand the relationship between this modality of treatment and the development of AVN of the femoral head.

BotCl, the First Chlorotoxin-like Peptide Inhibiting Newcastle Disease Virus: The Emergence of a New Scorpion Venom AMPs Family.

Newcastle disease virus (NDV) is one of the most serious contagions affecting domestic poultry and other avian species. It causes high morbidity and mortality, resulting in huge economic losses to the poultry industry worldwide. Despite vaccination, NDV outbreaks increase the need for alternative prevention and control means. In this study, we have screened fractions of Buthus occitanus tunetanus (Bot) scorpion venom and isolated the first scorpion peptide inhibiting the NDV multiplication. It showed a dose dependent effect on NDV growth in vitro, with an IC50 of 0.69 µM, and a low cytotoxicity on cultured Vero cells (CC50 > 55 µM). Furthermore, tests carried out in specific pathogen-free embryonated chicken eggs demonstrated that the isolated peptide has a protective effect on chicken embryos against NDV, and reduced by 73% the virus titer in allantoic fluid. The N-terminal sequence, as well as the number of cysteine residues of the isolated peptide, showed that it belongs to the scorpion venom Chlorotoxin-like peptides family, which led us to designate it "BotCl". Interestingly, at 10 µg/mL, BotCl showed an inhibiting effect three times higher than its analogue AaCtx, from Androctonus australis (Aa) scorpion venom, on NDV development. Altogether, our results highlight the chlorotoxin-like peptides as a new scorpion venom AMPs family.

Q-Rank: Reinforcement Learning for Recommending Algorithms to Predict Drug Sensitivity to Cancer Therapy.

In personalized medicine, a challenging task is to identify the most effective treatment for a patient. In oncology, several computational models have been developed to predict the response of drugs to therapy. However, the performance of these models depends on multiple factors. This paper presents a new approach, called Q-Rank, to predict the sensitivity of cell lines to anti-cancer drugs. Q-Rank integrates different prediction algorithms and identifies a suitable algorithm for a given application. Q-Rank is based on reinforcement learning methods to rank prediction algorithms on the basis of relevant features (e.g., omics characterization). The best-ranked algorithm is recommended and used to predict the response of drugs to therapy. Our experimental results indicate that Q-Rank outperforms the integrated models in predicting the sensitivity of cell lines to different drugs.

Effect of clones, year of harvest and geographical origin of fruits on quality and chemical composition of Argan oil.

Argan oil is precious oil with food and cosmetic uses. In recent years, this oil has been subject to an increasing national and international demand. The present work aims at studying the effect of clones and age, year of harvest and geographical origin on Argan oil quality and chemical composition. The results indicate that age does not affect Argan oil quality and fatty acids content. However, clones had a significant effect on fatty acids and tocopherol levels. Saturated and unsaturated fatty acids were highly influenced by the year of harvest and geographical origin, presumably due to climatic conditions. Unsaturated fatty acids varied from 78.28% to 81.77%. Depending on clones, total tocopherols varied from 687.40 mg/kg to 1068 mg/kg. This study is useful for the choice of clones with the aim of developing Argan trees orchards destined to oil production.

Lebectin, a Macrovipera lebetina venom-derived C-type lectin, inhibits angiogenesis both in vitro and in vivo.

Integrins play an essential role in endothelial cell motility processes during angiogenesis and thus present interesting targets for the development of new anti-angiogenic agents. Snake venoms naturally contain a variety of proteins that can affect integrin-ligand interactions. Recently, the C-type lectin proteins (CLPs) have been characterized as efficient modulators of integrin functions. In this study, we investigated the anti-angiogenic activity of lebectin, a newly discovered CLP from Macrovipera lebetina venom. Human brain microvascular endothelial cells (HBMEC), used as an in vitro model, express alphavbeta3, alphavbeta5, and alpha5beta1 integrins, as well as the alpha2, alpha3, alpha6, and beta4 subunits. Our data show that lebectin acts as a very potent inhibitor (IC(50) approximately 0.5 nM) of HBMEC adhesion and migration on fibronectin by blocking the adhesive functions of both the alpha5beta1 and alphaV integrins. In addition, lebectin strongly inhibits both HBMEC in vitro tubulogenesis on Matrigel trade mark (IC(50) = 0.4 nM) and proliferation. Finally, using both a chicken CAM assay and a Matrigel trade mark Plug assay in nude mice, our results show that lebectin displays potent anti-angiogenic activity in vivo. Lebectin thus represents a new C-type lectin with anti-angiogenic properties with great potential for the treatment of angiogenesis-related diseases.