Manejo histeroscópico de los restos ovulares con energía mecánica / Hysteroscopic management of products of conception with mechanical energy

Objetivo: Evaluar e identificar aquellas variables relacionadas con la tasa de éxito en el manejo con el histeroscopio de energía mecánica Truclear System 5.0(R) de los restos ovulares retenidos. Material y métodos: Estudio descriptivo prospectivo realizado en el Hospital de Igualada con periodo de inclusión de enero del 2015 a diciembre del 2016. Incluye a todas aquellas pacientes con diagnóstico de restos ovulares a las que se les realizó en el quirófano una histeroscopia diagnóstico-terapéutica con el histeroscopio de energía mecánica Truclear System 5.0(R). Resultados: Se incluyeron un total de 42 pacientes de las cuales se excluyeron 12 por no cumplir los criterios de inclusión. De las 30 pacientes analizadas, 21 (70%) presentaban pérdidas discontinuas en el momento del diagnóstico, mientras que 9 (30%) permanecían asintomáticas. La morcelación completa de los restos se consiguió en el 77% de las pacientes (23). No hubo ninguna complicación evidente intraoperatoria ni en el postoperatorio inmediato. Conclusiones: La resección selectiva histeroscópica con energía mecánica parece ser un buen método terapéutico para la retención de los restos ovulares, con unos porcentajes de éxito del 77%. Esta técnica nos ofrece una alternativa al tradicional legrado uterino evacuador que minimiza los riesgos y complicaciones que supone un acto quirúrgico invasivo para la paciente. Se plantea, como futura hipótesis de trabajo, la seguridad y el beneficio en la realización de la histeroscopia ambulatoria en todas aquellas pacientes con restos ovulares que cumplan unos criterios específicos

Objective: To evaluate and identify the variables related to the success rate in managing patients diagnosed with retained products of conception, by using the Truclear System 5.0(R) Hysteroscopic Morcellator, which is powered by mechanical energy. Materials and methods: A descriptive prospective study was performed at Hospital de Igualada, with the inclusion period lasting from January 2015 to December 2016. The study included all patients diagnosed with retained products of conception who underwent diagnostic and therapeutic hysteroscopy with the Truclear System 5.0(R) Hysteroscopic Morcellator, which uses mechanical energy. Results: A total of 42 patients were included, of whom 12 were excluded because they did not meet the inclusion criteria. Of the 30 patients analysed, 21 (70%) had low abnormal uterine bleeding at the time of diagnosis and 9 (30%) remained asymptomatic. The complete removal of the remains was achieved in 77% of the patients (23). There were no evident complications either during or immediately after surgery. Conclusions: Hysteroscopic selective resection with mechanical energy seems to be a good therapeutic method for retained products of conception, achieving a success rate of 77%. This technique offers an alternative to traditional dilatation and legrado, minimising the risks and complications involved in invasive surgical procedures for patients. Further studies are needed to evaluate the safety of and benefit in performing hysteroscopy on an outpatient basis in all patients with retained products of conception who meet specific criteria

Protein efficiency ratio of pigeon pea (Cajanus cajan) and lima bean (Phaseolus lunatus): A sprague-dawley rat growth assay

@#<p style="text-align: justify;"><strong>OBJECTIVE:</strong> This study has been conducted to determine the protein efficiency ratio (PER) of selected indigenous legumes, namely pigeon pea (Cajanus cajan) and lima bean (Phaseolus lunatus), as alternative protein sources.</p><p style="text-align: justify;"><strong>METHODS:</strong> Experimental diets (pigeon pea-based and lima bean-based) and control diet (casein-based) were formulated and standardized using proximate analysis to have 10% protein basal diet based on the Association of Official Analytical Chemists (AOAC) guidelines. Diets were given to corresponding groups (2 experimental, 1 control) using 30 albino Sprague-Dawley weanling rats aged 21 days old, over a 28-day growth assay.</p><p style="text-align: justify;"><strong>RESULTS:</strong> Results showed that the mean final weight and weight gain were significantly higher in rats fed with casein-based diet (p0.05). The PER of the casein (3.37 ± 2.71) is higher than that of the pigeon pea (1.87) and lima bean (1.32). These results can be attributed to the presence of anti-nutritional factors (ANFs) in the seeds of pigeon pea and lima bean. Reduced protein intake (due to bitter taste), toxicity, and interference with protein digestibility (through interaction with digestive enzymes) imparted by these ANFs can explain the weight loss among the experimental groups and consequently the low PER. Heat treatment done in the study were not adequate to remove the ANFs.</p><p style="text-align: justify;"><strong>CONCLUSION:</strong> The study shows that pigeon pea and lima bean as protein sources alone are not as adequate and efficient in providing necessary protein requirements for weanling rats. Proper processing and treatment should be done to remove inhibitors of protein digestibility and quality.</p>

Interest of an auto-adjustable nighttime compression sleeve (MOBIDERM® Autofit) in maintenance phase of upper limb lymphedema: the MARILYN pilot RCT.

PURPOSE: Breast cancer-related lymphedema (BCRL) is a debilitating condition. The recommended treatment is based on decongestive lymphedema therapy (DLT) with two separate phases: a short-term intensive phase to reduce lymphedema volume and a long-term maintenance phase to stabilize it. Optimizing compression therapy and compliance during maintenance phase are key factors for long-term control of lymphedema. The primary objective of this pilot prospective open-label randomized study was to assess the benefit of a new auto-adjustable nighttime arm sleeve (MOBIDERM® Autofit) on lymphedema volume during the maintenance phase after the intensive phase. METHODS: Forty women with BRCL were consecutively enrolled and randomized (D0) for 1 month in 1:1 ratio either in night-use group: with MOBIDERM® Autofit (on top of a daytime compression hosiery), or in no night-use group: without MOBIDERM® Autofit (daytime hosiery alone). From Day 31 to Day 90, all patients were fitted with MOBIDERM® Autofit. Primary endpoint was lymphedema volume variation between Day 0 and Day 30. Secondary endpoints were compliance, quality of life (LYMQOL arm questionnaire), functional symptoms (heaviness, limb use limitation, pain), sleep quality, and safety. RESULTS: In ITT population, between Day 0 and Day 30, mean lymphedema volume increase was higher in no night-use group with 92.9 mL (i.e., 3.2%) than in night-use group with 46.7 mL (i.e., 1.80%), p = 0.757. Between Day 30 and Day 90, all patients fitted with MOBIDERM® Autofit, lymphedema volume remained stable in both groups. The device improved functional symptoms and function domain of the LYMQOL arm questionnaire. MOBIDERM® Autofit was worn overnight almost 85% of the nights. It was well accepted by the patients and no adverse reaction leading to permanent device discontinuation occurred. CONCLUSIONS: Our results suggest that MOBIDERM® Autofit offers clinical benefits during maintenance phase of lymphedema treatment and enhances patient's self-management.

[Schizophrenia and culture: reality and perspectives based on the Tunisian experience]. / Schizophrénie et culture: réalités et perspectives à partir de l'expérience tunisienne.

UNLABELLED: Despite notable advances in the field, schizophrenia is still considered a major public health problem on international level. The combination of frequency, chronicity and severity make it, for some authors, the "cancer of mental disorders". However, according to the many cross-cultural studies, in particular, the two mammoth research projects of the WHO (IPSS and DOSMED, it is now irrefutable that the course and outcome of schizophrenia are better in patients from developing countries. The reasons for better outcome and more favorable course of schizophrenia in developing countries are still far from clear and remain speculative. AIM OF THE STUDY: We have carried out a study among a population of schizophrenic patients admitted to our hospital during the past year, to question the issues of outcome, course and prognosis in Tunisia, which is an emerging country, ranking half-way between the most and the least developed countries. RESULTS: It appears that the outcome of schizophrenia is similar to that of developed countries. A community survey reported an annual prevalence of 5.7 and an incidence of 3. 266 patients with schizophrenia were admitted between August 2003 and 2004, representing 40% of the whole hospitalized population; 80% were former patients who had been hospitalized an average of 8 times. One patient out of five will be readmitted at least once within the same year. Only 16.5% were married, and 10% had a regular job, in spite of a high level of education. A chronic course without remission is not unusual and long stay patients now account for a fourth of the hospital population. COMMENTS: It seems clearly and paradoxically that the course and outcome of schizophrenia is deteriorating and getting closer to what is observed in the industrialized societies. The same trend was observed in the western countries during the last centuries, leading some authors to claim that schizophrenia is a modern disease, which appeared in the XIX(e) century and spread in the XX(e). Besides, other than the controversy regarding the recent evolution of its incidence, it seems that we are not witnessing the anticipated decrease in incidence that comes with the therapeutic progress and the decline in fertility among individuals with schizophrenia. DISCUSSION: We shall discuss three hypotheses to try to explain the aggravation of schizophrenia along with the economic development: the heterogeneity of the disease with two clinical presentations: a benign form (good prognosis), more frequent in developing countries, and a severe form, observed mainly in developed societies. The progress in medicine and gynecology-obstetrics, which contributes to the survival of patients with serious schizophrenia and the vulnerable newborn exposed to multiple assaults and risk factors related to birth. The progress in psychiatry that is selecting the more serious subtypes of schizophrenia, which are overrepresented today. Research issues pertaining to course and outcome of schizophrenia are still unresolved. It is likely that prognosis of schizophrenia varies according to the economic development rather than to the culture. This observation could open new research and prevention perspectives.

The catabolite inactivation of Aspergillus nidulans isocitrate lyase occurs by specific autophagy of peroxisomes.

In Aspergillus nidulans, activity of the glyoxylate cycle enzyme isocitrate lyase is finely regulated. Isocitrate lyase is induced by growth on C2 compounds and long-chain fatty acids and repressed by glucose. In addition, activity of isocitrate lyase is subject to a second mechanism of catabolite control, glucose-induced inactivation. Here, we demonstrate that the catabolite inactivation of A. nidulans isocitrate lyase, a process that takes place during glucose adaptation of cells grown under gluconeogenic conditions, occurs by proteolysis of the enzyme. Ultrastructural analyses were carried out in order to investigate the cellular processes that govern the catabolite inactivation of this peroxisomal enzyme. Addition of glucose to oleate-induced cells triggered the specific engulfment and sequestration of peroxisomes by the vacuoles. Sequestration of various peroxisomes by a single vacuole was a frequently observed phenomenon. Results obtained by immunoelectron microscopy using antibodies against A. nidulans isocitrate lyase showed that degradation of this peroxisomal enzyme occurred inside the vacuole. In addition, ultrastructural studies demonstrated that microautophagy was the autophagic pathway involved in degradation of redundant peroxisomes during glucose adaptation of oleate-induced cells of A. nidulans.