Bilateral abducens and facial nerve palsies following fourth ventriculoperitoneal shunt with laparoscopic-assisted abdominal catheter placement.

Introduction: Hydrocephalus, altering cerebrospinal fluid (CSF) dynamics, affects 175 per 100,000 adults worldwide. Ventriculoperitoneal shunts (VPS) manage symptomatic hydrocephalus, with 125,000 cases annually. Despite efficacy, VPS face complications, necessitating interventions. Research question: "What are the mechanisms and risk factors for bilateral VIth and VIIth lower motor neuron palsies in hydrocephalus patients with a fourth ventriculoperitoneal shunt?" Material and methods: This study details a 36-year-old female with a neonatal meningitis history, multiple shunt replacements, admitted for abdominal pain secondary to pelvic inflammatory disease. An abdominal shunt catheter removal and external ventricular drain placement occurred after consultation with a general surgeon. A cardiac atrial approach and subsequent laparoscopic abdominal approach were performed without complications. Results: After one month, the patient showed neurological complications, including decreased facial expression, gait instability, and bilateral VIth and VIIth lower motor neuron palsies, specifically upgazed and convergence restriction. Discussion: The complication's pathophysiology is discussed, attributing it to potential brainstem herniation from over-drainage of CSF. Literature suggests flexible endoscopic treatments like aqueductoplasty/transaqueductal approaches into the fourth ventricle. Conclusions: This study underscores the need for increased awareness in monitoring neurological outcomes after the fourth ventriculoperitoneal shunt, particularly in cases with laparoscopic-assisted abdominal catheter placement. The rarity of bilateral abducens and facial nerve palsies emphasizes the importance of ongoing research to understand pathophysiology and develop preventive and therapeutic strategies for this unique complication.

Cogan syndrome: a case report and review of the literature.

Cogan syndrome is a rare disease whose etiology is still undetermined. It typically affects men and women between the second and fourth decade of life. We report a case of Cogan syndrome with ocular and audio-vestibular involvement as a systemic manifestation in a 31-year-old woman.

Edible Coatings as a Natural Packaging System to Improve Fruit and Vegetable Shelf Life and Quality.

In the past years, consumers have increased their interest in buying healthier food products, rejecting those products with more additives and giving preference to the fresh ones. Moreover, the current environmental situation has made society more aware of the importance of reducing the production of plastic and food waste. In this way and considering the food industry's need to reduce food spoilage along the food chain, edible coatings have been considered eco-friendly food packaging that can replace traditional plastic packaging, providing an improvement in the product's shelf life. Edible coatings are thin layers applied straight onto the food material's surface that are made of biopolymers that usually incorporate other elements, such as nanoparticles or essential oils, to improve their physicochemical properties. These materials must provide a barrier that can prevent the passage of water vapor and other gasses, microbial growth, moisture loss, and oxidation so shelf life can be extended. The aim of this review was to compile the current data available to give a global vision of the formulation process and the different ways to improve the characteristics of the coats applied to both fruits and vegetables. In this way, the suitability of compounds in by-products produced in the food industry chain were also considered for edible coating production.

Pressurized Liquid Extraction for the Recovery of Bioactive Compounds from Seaweeds for Food Industry Application: A Review.

Seaweeds are an underutilized food in the Western world, but they are widely consumed in Asia, with China being the world's larger producer. Seaweeds have gained attention in the food industry in recent years because of their composition, which includes polysaccharides, lipids, proteins, dietary fiber, and various bioactive compounds such as vitamins, essential minerals, phenolic compounds, and pigments. Extraction techniques, ranging from more traditional techniques such as maceration to novel technologies, are required to obtain these components. Pressurized liquid extraction (PLE) is a green technique that uses high temperatures and pressure applied in conjunction with a solvent to extract components from a solid matrix. To improve the efficiency of this technique, different parameters such as the solvent, temperature, pressure, extraction time and number of cycles should be carefully optimized. It is important to note that PLE conditions allow for the extraction of target analytes in a short-time period while using less solvent and maintaining a high yield. Moreover, the combination of PLE with other techniques has been already applied to extract compounds from different matrices, including seaweeds. In this way, the combination of PLE-SFE-CO2 seems to be the best option considering both the higher yields obtained and the economic feasibility of a scaling-up approximation. In addition, the food industry is interested in incorporating the compounds extracted from edible seaweeds into food packaging (including edible coating, bioplastics and bio-nanocomposites incorporated into bioplastics), food products and animal feed to improve their nutritional profile and technological properties. This review attempts to compile and analyze the current data available regarding the application of PLE in seaweeds to determine the use of this extraction technique as a method to obtain active compounds of interest for food industry application.

Bioactive Compounds of Verbascum sinuatum L.: Health Benefits and Potential as New Ingredients for Industrial Applications.

Verbascum sinuatum (V. sinuatum) is a plant belonging to the Scrophulariaceae family that has been used as an ingredient in traditional medicine infusions for the treatment of many diseases. The aerial part of this plant is a source of bioactive compounds, especially polyphenols and iridoids. Moreover, antioxidant activity studies have shown that V. sinuatum phenolic and flavonoid composition is higher than those in other plants of the same genus. V. sinuatum bioactive compound composition could vary according to the harvesting location, growing conditions of the plants, sample preparation methods, type and concentration of the extraction solvent, and the extraction methods. The obtention of these compounds can be achieved by different extraction techniques, most commonly, maceration, heat assisted extraction, and infusion. Nevertheless, since conventional extraction techniques have several drawbacks such as long times of extraction or use of large amounts of solvents, the use of green extraction techniques is suggested, without affecting the efficiency of the extraction. Moreover, V. sinuatum bioactive compounds have several biological activities, such as antioxidant, anticancer, cardiovascular, antimicrobial, antidiabetic, and neuroprotective activities, that may be increased by encapsulation. Since the bioactive compounds extracted from V. sinuatum present good potential as functional food ingredients and in the development of drugs or cosmetics, this review gives an approach of the possible incorporation of these compounds in the food and pharmacological industries.

Safety and efficacy of pilocarpine, cevimeline, and diquafosol compared to artificial tears for the treatment of dry eye: protocol for a systematic review.

BACKGROUND: Dry eye disease (DED) is a condition that compromises the ocular surface and affects millions of people around the world. In recent years, a scheme has been proposed for the treatment of DED, with the use of artificial tear being the mainstay of treatment. In this scheme, the use of secretagogues is suggested as part of the treatment for patients with moderate to severe affectation. With this systematic review, we aim to evaluate the effectiveness and safety of secretagogues for DED. METHODS: Electronic databases will be searched; we will include randomized controlled trials that compare secretagogues and artificial tears. Study inclusion will not be restricted on the basis of language or publication status. We will use Google Translate to assess studies written in languages other than English and Spanish. Identification, evaluation, data extraction, and assessment of risk of bias will be conducted by two authors of the review, a third review author will resolve any disagreement. The outcomes will be the ocular surface disease index score, tear film break-up time, Schirmer test score, VRQoL Score, and tear film osmolarity. We will use the Cochrane Collaboration Risk of Bias 2 (RoB 2) tool for assessing the risk of bias of the included studies. Based on the heterogeneity of the included studies, we will combine the findings in a meta-analysis using a fixed effect model if heterogeneity ≤ 50% or a random effect model if heterogeneity > 50%. If we deem meta-analysis as inappropriate, we will document the reasons and report findings from the individual studies narratively. DISCUSSION: Based on the evidence obtained, we will evaluate the effect of pilocarpine, cevimeline, and diquafosol and compare it to artificial tears on multiple outcome measures. This systematic review aims to determine the efficacy and safety of the secretagogues pilocarpine, cevimeline, and diquafosol to help clinicians in the decision-making process. TRIAL REGISTRATION: PROSPERO CRD42020218407 .

Quality of life and erectile dysfunction in patients with benign prostatic hyperplasia.

ANTECEDENTES: La patología de la próstata más frecuente es la hiperplasia prostática benigna. A los 50 años, el 50% de los hombres son diagnosticados y a los 80 años aumenta hasta al 90%. La prevalencia de disfunción eréctil en conjunto con hiperplasia prostática benigna es del 5.2-40%, y los pacientes con hiperplasia prostática benigna es 1.33-6.24 veces más frecuente que tengan disfunción eréctil que aquellos sin hiperplasia prostática benigna. Ambas afecciones repercuten en la calidad de vida. OBJETIVO: Identificar la calidad de vida y el grado de disfunción eréctil en pacientes con hiperplasia prostática benigna. MÉTODO: Estudio transversal, descriptivo, en pacientes con crecimiento prostático benigno a los cuales se les aplicaron dos cuestionarios: SF-12 para calidad de vida e Índice Internacional de Función Eréctil versión 5 para disfunción eréctil. RESULTADOS: Fueron 101 pacientes, edad media de 66.5 ± 8.5 años, promedio físico de 38.68, promedio mental de 43.35, 14 de ellos sin disfunción eréctil y 38 con disfunción eréctil leve, 33 leve a moderada, 15 moderada y 1 grave. CONCLUSIONES: Los pacientes con hiperplasia prostática benigna tienen una salud física mala y una salud mental buena. El 70.3% de los pacientes muestran grado leve o leve-moderado de disfunción eréctil. BACKGROUND: The most frequent prostatic pathology is benign prostatic hyperplasia. By the age of 50, 50% are diagnosed with it and by the age of 80, it increases to 90%. The erectile dysfunction prevalence along benign prostatic hyperplasia is 5.2%-40%. Patients with benign prostatic hyperplasia are 1.33-6.24 times more likely to have erectile dysfunction tan without benign prostatic hyperplasia. OBJECTIVE: To identify quality of life and to grade erectile dysfunction in patients with benign prostatic hyperplasia. METHOD: A transversal, descriptive study was conducted in patients with benign prostatic hyperplasia. Two questionnaires were applied: SF-12 for quality of life and IIEF-5 for erectile dysfunction. RESULTS: 101 patients, mean age 66.5 ± 8.5 years, mean physical aspect 38.68, mean mental aspect 43.35, 14 without erectile dysfunction, 38 mild grade, 33 mild to moderate, 15 moderate and 1 severe. CONCLUSIONS: Benign prostatic hyperplasia patients have poor physical health and good mental health. 70.3% of patients have a grade of erectile dysfunction between mild and mild-moderate.

Relationship between lower urinary tract symptoms and prostatic anatomic characteristics in patients with obesity and severe obesity.

OBJECTIVE: The objective of the study was to compare lower urinary tract symptoms and prostatic anatomic characteristic with prostatic enlargement in obese patients. MATERIALS AND METHODS: A comparative and cross-sectional study was conducted from October 2018 to November 2018. Lower urinary tract symptoms were compared in patients with body mass index (BMI) 30-34.9 and BMI 35-39. To evaluate these symptoms, the International Prostatic Symptom Score (IPSS) was used on 537 patients. The variables were age, weight and size, BMI, prostatic volume measurement by ultrasound, prostate-specific antigen (PSA), and finasteride treatment. Descriptive statistic was used, Cronbach's alpha, Fisher's exact test, and Chi-square. RESULTS: One hundred fulfilled inclusion criteria. Mean values were age 68.73 years, weight 84.98 kg, size 1.61 m, BMI 32.62, ultrasonographic prostatic size was 69.09 cm3, and PSA 1.94 ng/dl. The IPSS was severe in 3.6% (Group 1), 17.6% (Group 2); moderate 72% (Group 1), 70.5% (Group 2); and mild 33.3% (Group 1), 11.7% (Group 2), with significant differences between both groups (p = 0.05). Differences between values of prostatic volume and BMI did not show statistical significance (p ≥ 0.05). CONCLUSION: Statistical association between obesity and severe obesity and lower urinary tract symptoms is positive.

OBJETIVO: Comparar los síntomas del tracto urinario bajo y las características anatómicas de la próstata en pacientes con crecimiento prostático y obesidad. MÉTODO: Estudio comparativo, transversal, realizado de octubre a noviembre de 2018. Se compararon los síntomas del tracto urinario bajo y las características anatómicas de la próstata presentados por pacientes con obesidad y obesidad grave. Se aplicó el Índice Específico de Síntomas Prostáticos (IPSS) para evaluar los síntomas del tracto urinario bajo. Variables: edad, peso, talla, índice de masa corporal (IMC), volumen prostático por ultrasonido, antígeno prostático específico (PSA) y finasterida. Estadística: descriptiva, alfa de Cronbach, pruebas exacta de Fisher y ji al cuadrado. RESULTADOS: De 537 pacientes, 100 cumplieron los criterios de inclusión. Edad media: 68.73 años; peso medio: 84.98 kg; talla media: 1.61 m; IMC medio: 32.62; tamaño prostático ultrasonográfico medio: 69.09 cm3; cuantificación media de PSA: 1.94 ng/dl. El 72% tuvieron un IPSS moderado en ambos grupos. La diferencia entre IMC y síntomas del tracto urinario bajo tuvo una p = 0.05; no así el volumen prostático y el IMC en ambos grupos (p > 0.05). CONCLUSIÓN: Existe asociación entre la obesidad y la obesidad grave con los síntomas del tracto urinario bajo.