Cardiac Dysfunction and Exercise Tolerance in Patients after Complex Treatment for Cranial and Craniospinal Tumors in Childhood.

State-of-the-art therapy improves the five-year survival rate of patients under the age of 20 with cranial and craniospinal tumors by up to 74%. The urgency of dealing effectively with late treatment-associated cardiovascular complications is rising. Objective: We aimed to assess echocardiographic parameters and exercise performance in subjects with a history of complex treatment for cranial and craniospinal tumors in childhood. Methods: the study of 48 subjects who underwent cranial and craniospinal irradiation for CNS tumors in childhood and 20 healthy age- and sex-matched volunteers was conducted. The examination included hormone studies, cardiopulmonary exercise testing, and, in the main group, echocardiography (ECHO). Results: In five (10.4%) patients, ECHO changes were detected after complex anti-cancer treatment: thickening and calcification of the aortic valve leaflets (2%), and reduction in the systolic LV and RV function (8% and 6%, respectively). Irradiation of various areas was a significant predictor for reduced exercise tolerance, hyperventilation at rest and upon exertion, and an increased ventilatory equivalent for carbon dioxide. Low exercise tolerance was associated with a younger age at the time of treatment initiation. Significant differences were noted between the control group and the childhood cancer survivors with endocrine disorders. Conclusions: The obtained data confirm the importance of regular cardiovascular and endocrine monitoring of this group of cancer survivors.

A single-lead ECG based cardiotoxicity detection in patients on polychemotherapy.

Background: Anti-cancer treatment can be fraught with cardiovascular complications, which is the most common cause of death among oncological survivors. Without appropriate cardiomonitoring during anti-cancer treatment, it becomes challenging to detect early signs of cardiovascular complications. In order to achieve higher survival rates, it is necessary to monitor oncological patients outpatiently after anti-cancer treatment administration. In this regard, we aim to evaluate the efficacy of single-lead ECG remote monitoring to detect cardiotoxicity in cancer patients with minimal cardiovascular diseases after the first cycle of polychemotherapy. Materials and methods: The study included patients 162 patients over 18 years old with first diagnosed different types of solid tumors, planed for adjuvant (within 8 weeks after surgery) or neoadjuvant polychemotherapy. All patients were monitored, outpatiently, during 14-21 days (depending on the regimen of polychemotherapy) after polychemotherapy administration using single-lead ECG. Results: QTc > 500 mc prolongation was detected in 8 patients (6.6 %), first-diagnosed arial fibrillation was detected in 11 patients (9 %) in period after chemotherapy administration. Moreover, left ventricular diastolic dysfunction using single-lead ECG after polychemotherapy was detected in 49 (40.1 %) patients with sensitivity 80 %, specificity 95 %, AUC 0.88 (95 % CI, 0.82-0.93). Conclusions: The side effects of cancer treatment may cause life-threatening risks. Early identification of cardiotoxicity plays a vital role in the solution of this problem. Using portable devices to detect early cardiotoxicity is a simple, convenient and affordable screening method, that can be used for promptly observation of patients.

Impact of Dietary Administration of Seaweed Polysaccharide on Growth, Microbial Abundance, and Growth and Immune-Related Genes Expression of The Pacific Whiteleg Shrimp (Litopenaeus vannamei).

This work aims to determine the impact of dietary supplementation of polysaccharide, extracted from brown seaweeds Sargassum dentifolium on growth indices, feed utilization, biochemical compositions, microbial abundance, expressions of growth and immunity-related genes, and stress genes of the Pacific Whiteleg shrimp Litopenaeus vannamei. A total of 360 post-larvae of L. vannamei were randomly distributed into a 12-glass aquarium (40 L of each) at a stocking density of 30 shrimp with an initial weight of (0.0017 ± 0.001 g). During the 90-day experiment trial, all shrimp larvae were fed their respective diets at 10% of total body weight, three times a day. Three experimental diets were prepared with different seaweed polysaccharide (SWP) levels. The basal control diet had no polysaccharide level (SWP0), while SWP1, SWP2, and SWP3 contained polysaccharides at concentrations of 1, 2, and 3 g kg-1 diet, respectively. Diets supplemented with polysaccharide levels showed significant improvements in weight gain and survival rate, compared to the control diet. Whole-body biochemical composition and the microbial abundance (the total count of heterotrophic bacteria and Vibrio spp.) of L. vannamei showed significant differences among polysaccharide-treated diets compared to the control. At the end of the feeding experiment, the dietary supplementation of polysaccharide levels enhanced the expression of growth-related genes (Insulin-like growth factors (IGF-I, IGF-II), immune-related genes (ß -Glucan-binding protein (ß-Bgp), Prophenoloxidase (ProPO), Lysozyme (Lys), and Crustin), and stress genes (Superoxide dismutase (SOD) and Glutathione peroxidase (GPx) in the muscle tissue of L. vannamei. However, the current study concluded that the inclusion rate of 2 g kg-1 of polysaccharide as a dietary additive administration enhanced both weight gain and survival rate of L. vannamei, while the incorporation level of 3 g kg-1 reduces the abundance of pathogenic microbes and enhances the growth-, immunity- and stress-related gene expressions of L. vannamei.

Growth Performance, Immune-Related and Antioxidant Genes Expression, and Gut Bacterial Abundance of Pacific White Leg Shrimp, Litopenaeus vannamei, Dietary Supplemented With Natural Astaxanthin.

The current study examines the effect of dietary supplementation of ethanolic extract of Arthrospira platensis NIOF17/003, which is mainly natural astaxanthins (97.50%), on the growth performance, feed utilization, bacterial abundance, and immune-related and antioxidant gene expressions of the Pacific white leg shrimp, Litopenaeus vannamei. A total of 360 healthy L. vannamei postlarvae (0.19 ± 0.003 g) were divided into four groups (0, 2, 4, and 6 g natural astaxanthins/kg diet) each in three replicates, at an initial density of 30 PLs per tank (40 L capacity). The shrimp were fed the tested diets three times a day at a rate of 10% of their total body weight for 90 days. Diets supplemented with different astaxanthin levels significantly improved shrimp growth performance and feed conversion ratio compared to the control diet. No significant differences were observed in survival rates among all experimental groups. The immune-related genes (prophenoloxidase, lysozyme, beta-glucan binding protein, transglutaminase, and crustin) mRNA levels were significantly upregulated in groups fed with different concentrations of the natural astaxanthins in a dose-dependent manner. The prophenoloxidase gene is the highest immune-upregulated gene (14.71-fold change) in response to astaxanthin supplementation. The superoxide dismutase mRNA level was significantly increased with increasing dietary astaxanthin supplementation. In addition, increasing astaxanthin supplementation levels significantly reduced the count of heterotrophic bacteria and Vibrio spp. in the culture water and shrimp intestine. Overall, the current results concluded that diet supplementation with natural astaxanthin, extracted from Arthrospira platensis, enhanced the growth performance, immune response, and antioxidant status of L. vannamei.

Prevalence of Entamoeba histolytica and Giardia Lamblia Associated with Diarrhea in Children referring to lbn Al-Atheer Hospital in Mosul, Iraq.

Amebiasis and giardiasis are major health problems caused by Entamoeba histolytica and Giardia Lamblia which are the two most common intestinal protozoan parasites with worldwide distribution, especially in developing countries. Both protozoa are spread by the fecal-oral route; that is to say, by eating or drinking contaminated food or water. The present study aimed to assess the prevalence of E. histolytica and G.lamblia in children with clinical signs of diarrhea referring to Ibn Al-Atheer Hospital in Mosul, Iraq, from January 2019 to December 2020. A total of 2,296 samples were examined by the direct swab of stool method. The patients were within the age range of less than 1 year and above 12 years. The results demonstrated that in 2019 and 2020, the prevalence rates of E. histolytica infections were (152, 13.2%) and (181, 15.7%); moreover, the prevalence rates of G.lamblia were obtained at (10, 0.86%) and (12, 1.04%) (P<0.01). The prevalence of intestinal parasite infections was significantly associated with age and gender, and the prevalence of both E. histolytica and G.lamblia infections were higher in males. Furthermore, the highest and lowest prevalence rates of E. histolytica and G.lamblia infections were reported in the age groups of under 1 year and above 12 years (P<0.05). The high prevalence of protozoan infection in the age group of under 1 year can be attributed to their lack of developed immunity system and resistance. Due to disease transmission, the enhancement of health conditions is of utmost importance in controlling the prevalence of intestinal protozoan parasites.

The Optimization of Dietary Protein Level and Carbon Sources on Biofloc Nutritive Values, Bacterial Abundance, and Growth Performances of Whiteleg Shrimp (Litopenaeusvannamei) Juveniles.

A biofloc technology-based 75-day indoor growth trial in an 80 L glass aquaria was conducted to evaluate the effects of two different carbon sources (sugarcane bagasse, SB, and wheat flour, WF) on the biofloc composition, bacterial abundance, and growth of whiteleg shrimp (Litopenaeus vannamei) juveniles (0.23 ± 0.04 g). Three different levels of dietary protein content (250, 300, and 350 g protein kg−1 diet) and two carbon sources (SB and WF) were applied (SB250, WF250, SB300, WF300, SB350, and WF350, respectively), comparing to a controlled diet without biofloc and fed on a 450 g protein kg−1 diet (C450). With the addition of SB and WF, water quality was in the ideal recommended ranges for L. vannamei culture. At the end of the experiment, the biofloc volume increased with increasing dietary protein levels. The nutritional value of biofloc in different treatments was influenced by dietary protein and added SB and WF. Increasing dietary protein significantly increased the protein and lipid contents of the produced biofloc. The use of WF as a carbon source significantly increased lipids and nitrogen-free extract in the biofloc. The total heterotrophic bacterial (THB) count was significantly higher (p < 0.05) in WF300 and WF350 than in the other treatments. The mean effect of the protein levels and carbon source was significantly reported, whereas the highest significant THB count was recorded with 300 dietary protein and using WF as a carbon source. The growth performances of L. vannamei fed with biofloc treatments were significantly (p < 0.05) higher than the C450 group. The highest final weight and weight gain were recorded in SB350 treatment. The feed conversion ratio was not affected by reducing dietary protein levels; meanwhile, the protein efficiency ratio increased significantly in biofloc treatments than in the control. Overall, the results demonstrate that, compared to the control treatment of 450 dietary protein, the biofloc treatments using WF as a carbon source could compensate for the reduction in the dietary protein levels in the diet of L. vannamei and maintain higher zootechnical performance.

Visible-light responsive ZnSe-anchored mesoporous TiO2heterostructures for boosted photocatalytic reduction of Cr(VI).

The accumulation of Cr(VI) ions in water can cause serious influences on the environment and human health. This work reports a humble synthesis of ZnSe nanoparticles anchored to the sol-gel prepared TiO2for visible-light-driven photocatalytic reduction of Cr(VI) ions. The 7.9 nm ZnSe nanoparticles were attached to TiO2surfaces at a content of 1.0-4.0 wt% as experiential by TEM investigation. The designed nanocomposite unveiled mesostructured surfaces exhibiting surface areas of 176-210 m2g-1. The impregnation of ZnSe amended the visible-light absorption of TiO2due to the bandgap decrease from 3.14 to 2.90 eV. The photocatalytic reduction of Cr(VI) applying the optimized portion of 3.0 wt% ZnSe/TiO2was achieved at 177µmol min-1. This photocatalytic activity is higher than the common Degussa P25 and pristine TiO2by 20 and 30 times, respectively. The improved performance is signified by the efficient interfacial separation of charge carriers by the introduction of ZnSe. This innovative ZnSe/TiO2has also shown photocatalytic stability for five consecutive runs.

Potential Applications of Arthrospira platensis Lipid-Free Biomass in Bioremediation of Organic Dye from Industrial Textile Effluents and Its Influence on Marine Rotifer (Brachionus plicatilis).

Arthrospira platensis is one of the most important cultured microalgal species in the world. Arthrospira complete dry biomass (ACDB) has been reported as an interesting feedstock for many industries, including biodiesel production. The A. platensis by-product of biodiesel production (lipid-free biomass; LFB) is a source of proteins, functional molecules, and carbohydrates, and can also be reused in several applications. The current study investigated the efficiency of ACDB and LFB in bioremediation of dye (Ismate violet 2R, IV2R) from textile effluents. In addition, the potential of ACDB and LFB loaded by IV2R as a feed for Rotifer, Brachionus plicatilis, was examined. The surface of the adsorbents was characterized by SEM, FTIR, and Raman analysis to understand the adsorption mechanism. The batch sorption method was examined as a function of adsorbent dose (0.02-0.01 g L-1), solution initial concentration (10-100 mg L-1), pH (2-10), and contact time (15-180 min). The kinetic studies and adsorption isotherm models (Freundlich, Langmuir, Tempkin, and Halsey) were used to describe the interaction between dye and adsorbents. The results concluded that the adsorption process increased with increasing ACDB and LFB dose, contact time (120 min), initial IV2R concentration (10 mg L-1), and acidity pH (2 and 6, respectively). For the elimination of industrial textile wastewater, the ACDB and LFB sorbents have good elimination ability of a dye solution by 75.7% and 61.11%, respectively. The kinetic interaction between dye and adsorbents fitted well to Langmuir, Freundlish, and Halsey models for LFB, and Langmuir for ACDB at optimum conditions with R2 > 0.9. In addition, based on the bioassay study, the ACDB and LFB loaded by IV2R up to 0.02 g L-1 may be used as feed for the marine Rotifer B. plicatilis.

Genetic profiling of CAH Egyptian children: rapid guide to clinical interpretation of common mutations.

OBJECTIVES: The prevalence of CAH in Egypt is reported to be ten times more than that of the worldwide prevalence. The study aimed at genetic screening of children diagnosed with 21-alpha hydroxylase deficiency congenital adrenal hyperplasia (21OHD-CAH). In addition, the study offers a rapid and easy guide for clinical reporting of common mutations for endocrinologists. METHODS: A cohort of 174 unrelated Egyptian children with 21OHD-CAH were screened for 11 common CYP21A2 gene mutations using a strip hybridization assay, and then, bioinformatics analysis was done to report the pathogenicity of the common mutations for clinical classification. RESULTS: The most common mutations were I2 splice and p.Q318X. Deletions/conversions comprised 45.9% of the cohort, whereas 7.4% of the cases were negative for all mutations. The least positively detected point mutations were p.P453S, cluster E6, p.R483P, and p.L307FS, which were detected in fewer than 5% of cases. CONCLUSION: Strip hybridization assay is a rapid screening tool for the diagnosis of CAH. The authors hypothesized an easy and rapid scheme for clinical interpretation of the strip results to gain the highest value of the strip in diagnosis.

[Desmoid infantile mandibular fibromatosis]. / Fibromatose desmoïde infantile de la mandibule.

INTRODUCTION: A desmoid tumor, or aggressive fibromatosis, is a benign fibrous tumor with a high potential for locoregional extension. This tumor is very rarely located in the mandible. OBSERVATION: A 2-year-old boy presented with an extensive mandibular desmoid tumor. The diagnosis was proved on histological examination. Two years after surgery, there was no recurrence. DISCUSSION: Aggressive fibromatosis is rarely located in the mandible. The differential diagnosis with malignant tumors is difficult. Surgery is the first-line treatment. However, alternative therapies should be considered, especially in children, to avoid mutilating operations.

Impact of operating history on mixed culture fermentation microbial ecology and product mixture.

Mixed culture fermentation is an alternative to pure culture fermentation for production of biofuels and valuable products. A glucose-fed, continuous reactor was operated cyclically to a central pH of 5.5 from a number of precedent pHs, from 4.5 to 7.5. At each pH, stable chemical production was reached after 2 retention times and was held for least 2 further retention times prior to the next change. Bacterial groups were identified by phylogenetic analysis of 16S rRNA gene clones. Bacterial community dynamics were monitored by terminal-restriction fragment length polymorphism. More ethanol was produced at high pH, and more butyrate at lower pH. At pH 5.5, the product spectrum was not measurably influenced by precedent pH but showed seemingly random changes. The impact of precedent pH on community structure was more systematic, with clear indications that when the pH was returned to 5.5, the bacterial group that was dominant at the precedent pH remained at high abundance. This result is important, since it indicates a decoupling between microbial function (as indicated by product spectrum), and community structure. More work is needed to determine the longevity of this hysteresis effect. There was evidence that groups retained their ability to re-emerge even after times of low abundance.

[Mucoepidermoid carcinoma of the parotid gland in young children]. / Carcinome mucoépidermoïde de la glande parotide chez le petit enfant.

INTRODUCTION: Mucoepidermoid carcinoma of the parotid gland is a rare malignant tumor mostly affecting adults. It accounts for 1 to 3 % of head and neck malignant tumors. It is very rarely observed in children under 10 years of age. OBSERVATION: A four-and-half-year-old boy was brought to consultation in our department, in June 2006, for a left cervical swelling having progressively increased over the previous two years. Cervical US confirmed the presence of a 2.3cm long tumor of the left parotid area, hyperechogenic and heterogenic, associated to a homolateral lymphadenopathy in the jugular and carotid region (zone II), 2cm in diameter. A total parotidectomy preserving the facial nerve was performed. The biopsy extemporaneous histological examination suggested a low-grade mucoepidermoid carcinoma. Surgery was completed by functional neck dissection. DISCUSSION: Our four-and-half-year-old patient was one of the youngest cases ever reported. Malignant parotid gland tumors are very rarely observed in children: less than 19 cases have been published worldwide. Its occurrence in a young child under ten years of age is very rare. Mucoepidermoid carcinoma accounts for one third of all malignant parotid gland tumors.

[Exophthalmos arising from paranasal sinuses]. / Exophtalmie d'origine naso-sinusienne en ORL.

INTRODUCTION: Proptosis due to intraorbital process is frequent and secondary to various aetiologies. Its findings in ENT practice is the sign of a serious complication. The purpose of this study is to review a series of patients who presented an exophtalmy. MATERIAL AND METHODS: We conducted a retrospective analysis of 15 patients with exophthalmos complicating a rhinosinusal benign disease, diagnosed and treated in our department between January 2003 and December 2010. As their management is different, we excluded all cases of orbital cellulitis. RESULTS: Average age of presentation was 38 years, without sex predominance. Exophthalmos was unilateral, non axial and irreductible in all cases. The average duration of symptoms installation was 18 months. The most common aetiology was fronto-ethmoidal osteomas (9 cases), followed by fronto-ethmoidal mucoceles (5 cases) and spheno-orbito-frontal fibrous dysplasia (1 case). The functional prognosis of the affected eye depended on the aetiology and the degree of ocular injury. CONCLUSION: In our experience, sinusal causes of exophthalmos comprise osteomas and ethmoidal mucoceles. Medical history, clinical and radiological data as provide the diagnostic. In case of benign tumours, surgery is the curative treatment.

[Chondrosarcoma of the nasal septum]. / Chondrosarcome de la cloison nasale.

INTRODUCTION: A chondrosarcoma is rarely located in the nasal septum with only fifty cases reported in the literature. CASE REPORT: We report a new case of a seventy years old woman presenting with a large facial midline mass extending to the nasal cavity, having evolved for six months. Subsequent computed tomography revealed a mass destroying the nasal septum and extending to the endocrane. Intranasal biopsy revealed a chondrosarcoma. The extended work up revealed pulmonary metastasis. The course was not favourable and the patient died after one year. DISCUSSION: The bones of the pelvis and of the lower extremities are the most common localizations for chondrosarcoma. It is rarely located in the nasal septum. Histological analysis is required for the diagnosis. It is characterized clinically by local aggressiveness, frequent metastatic evolution, and poor prognosis. Surgical resection is reserved to operable cases. Chemotherapy and radiotherapy used as adjuvant treatment and palliation are not effective.

[Far-advanced otosclerosis]. / Surdités mixtes profondes par otospongiose.

OBJECTIVES: The aim of this study was to report a series of patients with far-advanced otosclerosis who were unable to benefit from hearing aids. Among patients with profound hearing loss, it is particularly useful to diagnose far-advanced otosclerosis even if relatively rare, because stapes surgery can improve hearing to a level allowing conventional hearing aid use (sometime the only choice before cochlear implant). MATERIAL AND METHODS: We retrospectively reviewed the charts of 7 patients (9 operated ears) in order to highlight diagnostic criteria, surgical indications and results of stapes surgery (stapedectomy or stapedotomy). RESULTS: Diagnosis of far-advanced otosclerosis was based on clinical presentation, course of hearing loss, positive family history of otosclerosis, and results of CT scan which was helpful in all the cases. Obliterative otosclerosis was found in 55% of the cases. Success of stapes surgery was observed in 89%, with no significant difference between stapedectomy or stapedotomy. CONCLUSION: Although rare, far-advanced otosclerosis must be diagnosed because patients can benefit from stapes surgery (and subsequently fitting of appropriate hearing aids).

[Thyroid tuberculosis]. / Tuberculose thyroïdienne.

OBJECTIVES: The aims of this study were to emphasize the difficulties of diagnosing thyroid tuberculosis because of its non specific symptoms and to encourage physicians to seek it more frequently. MATERIAL AND METHODS: Six cases of thyroid tuberculosis diagnosed within a 3-year period were included in a retrospective study. RESULTS: There were two men and four women, mean age 45 years. Four patients underwent lobo-isthmectomy with frozen section analysis which enabled us to rectify the diagnosis. Medical treatment was based on a 6-month course of bactericidal chemotherapy. Outcome was favorable in all the cases with 17 months average follow up. CONCLUSION: Symptoms of thyroid tuberculosis are misleading, pathologic findings are of increasing importance for diagnosis, which with the new serology techniques may improve further.

[Benign cementoblastoma. Apropos of a case and review of the literature]. / Le cémentoblastome bénin. A propos d'un cas et revue de la littérature.

The cementoblastoma is a rare benign tumor of odontogen origin that interests the roots of the teeth especially the lower molars. The evolution is often silent, the radiological exam is not specific, the diagnosis of certainty is histological. The surgical treatment assures the recovery without aftermath. The authors report a case of cementoblastoma at a patient of 37 years for which he has benefited of a resection by vestibular way and debate diagnosis and therapeutic modes of this affection.

Induction of labour using low and high dose regimens of prostaglandin E2 vaginal tablets.

OBJECTIVE: To compare the efficacy of low dose prostaglandin E2 vaginal tablets with that of high dose in induction of labour. DESIGN: A retrospective study. SETTING: Abha Maternity Hospital, a teaching hospital in the southern region of Saudia Arabia. PATIENTS: The outcome of induction of labour in 73 women induced with 1.5 mg prostaglandin E2 vaginal tablets was compared with those in 168 women induced with 3 mg vaginal tablets. RESULTS: There were no statistical significant differences in the success rate, induction-delivery interval, caesarean section rate and Apgar scores between the two groups. There were two incidences of uterine hyperstimulation and two of uterine rupture in the high dose group. These were not statistically significant. Logistic regression analysis showed that the success rate of induction of labour was dependent only on maternal age (P=0.0025) and Bishop score (P=-0.0403) and not on parity, gestational age, birthweight or dose of prostaglandin. CONCLUSION: The low dose regimen of 1.5 mg is as efficacious as the high dose regimen of 3 mg prostaglandin E2 vaginal tablets in inducing labour. This implies that using the low dose regimen reduces the cost of induction of labour effectively. Larger prospective randomized studies are needed to confirm this finding.