The roles of angiotensin-converting enzyme 2 inhibitor, melatonin and its agonist on angiotensin II reactivity in intact and denuded rat aortic rings.

BACKGROUND: The pineal product melatonin (MEL) modulates blood vessels through G protein-coupled receptors (GPCRs) called melatonin type 1 receptor (MT1R) and melatonin type 2 receptor (MT2R), in that order. The renin-angiotensin system (RAS), which breaks down angiotensin II (Ang II) to create Ang 1-7, is thought to be mostly controlled by angiotensin-converting enzyme-2 (ACE2). AIM: The current work examines the involvement of ACE2 inhibitor, MEL, and ramelteon (RAM) in the vascular response to Ang II activities in the endothelial denuded (E-) and intact (E+) rat isolated thoracic aortic rings. METHOD: The isometric tension was measured to evaluate the vascular Ang II contractility using dose response curve (DRC). RESULTS: MEL and RAM caused a rightward shift of Ang II in endothelium E + and endothelium E- aorta. CONCLUSION: According to the current study, the distribution of MEL receptors and the endothelium's condition are related to the vasomodulatory effect of MEL and ACE2 on Ang II attenuation. These physiological interactions can control vascular tone and increase Ang II reactivity denude endothelial layaer.

The Protective Potential of Aronia melanocarpa L. Berry Extract against Cadmium-Induced Kidney Damage: A Study in an Animal Model of Human Environmental Exposure to This Toxic Element.

The impact of cadmium (Cd) on the function and structure of the kidney and the potential protective effect of an extract from Aronia melanocarpa L. berries were investigated in a rat model of low- and moderate-level environmental exposure to this heavy metal (1 and 5 mg Cd/kg feed for up to 24 months). The sensitive biomarkers of Cd-induced damage to the kidney tubules (N-acetyl-ß-D-glucosaminidase (NAG), alkaline phosphatase (ALP), ß2-microglobulin (ß2-MG), and kidney injury molecule-1 (KIM-1) in the urine), clinically relevant early markers of glomerular damage (albumin in the urine and creatinine clearance), and other markers of the general functional status of this organ (urea, uric acid, and total protein in the serum and/or urine) and Cd concentration in the urine, were evaluated. The morphological structure of the kidney and inflammatory markers (chemerin, macrophage inflammatory protein 1 alpha (MIP1a), and Bcl2-associated X protein (Bax)) were also estimated. Low-level and moderate exposure to Cd led to damage to the function and structure of the kidney tubules and glomeruli. The co-administration of A. melanocarpa berry extract significantly protected against the injurious impact of this toxic element. In conclusion, even low-level, long-term exposure to Cd poses a risk of kidney damage, whereas an intake of Aronia berry products may effectively protect from this outcome.

Association of Arterial Stiffness and Atherosclerotic Burden With Brain Structural Changes Among Japanese Men.

Background Little is known regarding whether arterial stiffness and atherosclerotic burden are each independently associated with brain structural changes. Simultaneous assessments of both arterial stiffness and atherosclerotic burden in associations with brain could provide insights into the mechanisms of brain structural changes. Methods and Results Using data from the SESSA (Shiga Epidemiological Study of Subclinical Atherosclerosis), we analyzed data among 686 Japanese men (mean [SD] age, 67.9 [8.4] years; range, 46-83 years) free from history of stroke and myocardial infarction. Brachial-ankle pulse wave velocity and coronary artery calcification on computed tomography scans were measured between March 2010 and August 2014. Brain volumes (total brain volume, gray matter, Alzheimer disease signature and prefrontal) and brain vascular damage (white matter hyperintensities) were quantified using brain magnetic resonance imaging from January 2012 through February 2015. In multivariable adjustment models including mean arterial pressure, when brachial-ankle pulse wave velocity and coronary artery calcification were entered into the same models, the ß (95% CI) for Alzheimer disease signature volume for each 1-SD increase in brachial-ankle pulse wave velocity was -0.33 (-0.64 to -0.02), and the unstandardized ß (95% CI) for white matter hyperintensities for each 1-unit increase in coronary artery calcification was 0.68 (0.05-1.32). Brachial-ankle pulse wave velocity and coronary artery calcification were not statistically significantly associated with total brain and gray matter volumes. Conclusions Among Japanese men, higher arterial stiffness was associated with lower Alzheimer disease signature volumes, whereas higher atherosclerotic burden was associated with brain vascular damage. Arterial stiffness and atherosclerotic burden may be independently associated with brain structural changes via different pathways.

Current Levels of Environmental Exposure to Cadmium in Industrialized Countries as a Risk Factor for Kidney Damage in the General Population: A Comprehensive Review of Available Data.

The growing number of reports indicating unfavorable outcomes for human health upon environmental exposure to cadmium (Cd) have focused attention on the threat to the general population posed by this heavy metal. The kidney is a target organ during chronic Cd intoxication. The aim of this article was to critically review the available literature on the impact of the current levels of environmental exposure to this xenobiotic in industrialized countries on the kidney, and to evaluate the associated risk of organ damage, including chronic kidney disease (CKD). Based on a comprehensive review of the available data, we recognized that the observed adverse effect levels (NOAELs) of Cd concentration in the blood and urine for clinically relevant kidney damage (glomerular dysfunction) are 0.18 µg/L and 0.27 µg/g creatinine, respectively, whereas the lowest observed adverse effect levels (LOAELs) are >0.18 µg/L and >0.27 µg/g creatinine, respectively, which are within the lower range of concentrations noted in inhabitants of industrialized countries. In conclusion, the current levels of environmental exposure to Cd may increase the risk of clinically relevant kidney damage, resulting in, or at least contributing to, the development of CKD.

The Body Status of Manganese and Activity of This Element-Dependent Mitochondrial Superoxide Dismutase in a Rat Model of Human Exposure to Cadmium and Co-Administration of Aronia melanocarpa L. Extract.

The impact of a polyphenol-rich 0.1% aqueous extract from Aronia melanocarpa L. berries (AE) on the body status of manganese (Mn) and the activity of this essential element-dependent mitochondrial superoxide dismutase (MnSOD) during treatment with cadmium (Cd) was investigated in a rat model of low-level and moderate environmental human exposure to this xenobiotic (1 and 5 mg Cd/kg diet, respectively, for 3-24 months). The exposure to Cd, dose- and duration-dependently, affected the body status of Mn (apparent absorption, body retention, serum and tissue concentrations, content in some organs and total Mn body burden, and urinary and faecal excretion) and the activity of MnSOD in the mitochondria of the liver, kidney, and brain. The administration of AE during the exposure to Cd prevented or at least partially protected the animals from the perturbation of the metabolism of Mn, as well as ameliorated changes in the activity of MnSOD and the concentration of Mn and protected from Cd accumulation in the mitochondria. In conclusion, AE may protect from disorders in the body status of Mn and influence the antioxidative capacity of cells under chronic exposure to Cd. The findings confirm the protective impact of aronia berries products against Cd toxicity.

Impact of Whole Body Vibration and Zoledronic Acid on Femoral Structure after Ovariectomy: Morphological Evaluation.

Our study aimed to evaluate the effect of whole body vibration (WBV) treatment as an non-pharmacological method of treatment for early osteopenia in ovariectomized female rats. In total, 48 female Wistar rats were assigned to two groups: sham-operated control (SHAM, n = 12) and ovariectomized (n = 36). Four weeks after ovariectomy, the animals were divided into three experimental groups (n = 12 each): ovariectomized (OVX), ovariectomized subjected to whole body vibration with acceleration level of 0.3 g (OVX + WBV), or ovariectomized subjected to i.m. injection of Zoledronic acid at a dose of 0.025 mg/kg (OVX + ZOL). After the 8th and 16th week of treatment n = 6 rats from each group were euthanized and isolated femora were subjected to histological examination of trabecular bone and analysis of the expression of collagen 1 (Col1), osteoprotegerin (OPG), and receptor activator of nuclear factor kappa-Β ligand (RANKL) involved in bone turnover. The obtained results indicated that widespread vibration therapy can provide negative outcomes such as deterioration of trabecular bone histomorphometry.

Effect of Mechanical Stimuli and Zoledronic Acid on the Femoral Bone Morphology in Rats with Obesity and Limited Mobility.

Our study aimed to compare the impact of zoledronic acid and whole-body vibration (WBV) as a non-pharmacological method of treatment for early obesity/immobility-related osteoporosis in male rat models. In total, 36 male Wistar rats were assigned to the following groups: obese control with immobility (Control, n = 12) and two experimental groups (n = 12 each), including obese and immobile rats subjected to whole-body vibration with an acceleration level of 3 m/s2 g (obesity and immobility + WBV) and obese and immobile rats that received an intramuscular injection of zoledronic acid at a dose of 0.025 mg/kg (obesity and immobility + ZOL). After the 8th and 16th week of treatment, n = 6 rats from each group were euthanized and isolated femora were subjected to a histological examination of bone, and analysis of the expression of osteoprotegerin (OPG) and the receptor activator of nuclear factor kappa-B ligand (RANKL) involved in bone turnover and the amount of thin collagen fibers (PSR stain). The obtained results showed that short-term vibrotherapy (up to 8 weeks) can lead to improvement in bone remodeling in rat models with obesity and limited mobility.

Effect of zoledronic acid on bone nanocomposites organization and prevention of bone mineral density loss in ovariectomized rats.

OBJECTIVES: Osteoporosis often occurs in individuals of different age groups, frequently during menopause and after ovariectomy. It increases the risk of pathological fractures almost twice. The aim of our research was to assess bone metabolism, nanocomposite structure of the tibia under conditions of ovariectomy and zoledronic acid treatment. METHODS: X-ray diffraction has been performed for nanostructure analysis of mineral crystallites and crystal lattice of hydroxyapatite in the tibia samples of ovariectomized rats with additional application of bisphosphonate zoledronic acid (0.025 mg/kg). Markers of remodeling - osteocalcin, alkaline phosphatase, tartrate resistant acid phosphatase 5b - were determined. Quantitative amount of calcium in the bones was detected by atomic absorption method. RESULTS: Zoledronic acid prevented loss of mineral mass after ovariectomy. Rats after ovariectomy, treated with zoledronic acid, showed statistically higher (р<0.05) values of crystalline phase and calcium content compared with the SHAM-surgery and ovariectomy groups (р<0.05). Zoledronic acid inhibited bone remodeling, which is proved by tartrate resistant acid phosphatase 5b reduction and inhibition of osteoclasts during the experiment. CONCLUSIONS: These results enable to suggest that zoledronic acid can improve mineral mass of the bone during menopause in individuals of different age groups.

Effects of mechanical stimuli on structure and organization of bone nanocomposites in rats with glucocorticoid-induced osteoporosis.

Objective. Clinical use of glucocorticoids is a frequent cause of secondary osteoporosis, which reduces the mineral density of bones and results in pathological fractures. Mechanical stimulation as non-physiological high-frequency vibration with low acceleration prevents the loss of a crystalline component and stimulates the anabolic remodeling of the bone. The aim of the present research was to assess the impact of mechanical vibration on the bone structure in rats, which received glucocorticoids.Methods. Wistar rats were randomized into three groups: Vehicle control (Veh), Methylprednisolone sodium succinate (Mps), and Mps combined with whole-body vibration (WBV). Rats of Mps+WBV and Mps groups received 3 mg/kg/day of methylprednisolone every other day for 24 weeks and rats of Veh group received 0.9% saline (sodium chloride). The group of rats Mps+WBV was subjected to WBV for 30 minutes per day for five days a week with parameters 0.3 g and frequency 50 Hz. Relative amount of crystalline component and collagen in the bones was determined by X-ray diffraction (XRD) and calcium level - by atomic absorption spectroscopy. Bone tissue metabolism was assessed by determining the concentration of markers, in particular osteocalcin and Tartrate-resistant acid phosphatase (TRAP5b).Results. Glucocorticoids induced a considerable increase in the rats body mass (+13%) and decreased the content of mineral component in the femoral neck (-17%) in Mps group compared with Veh. The process of the bone metabolism was significantly accelerated, which is proven by an increased level of remodeling markers. It should be mentioned that WBV did not allow significant decrease in mineral component of the bone to 16th week of the experiment compared with Mps group, although these parameters did not achieve the indices in the Vehicle control group (-10%). Our investigation allows to suggest that mechanical high-frequency vibration of low intensity can partially inhibit the harmful consequences of glucocorticoids on bone structure in rats. Despite the positive impact of vibration on the bone tissue after Mps introduction in the 8th-16th week, this influence was not statistically reliable in the 24th week of the experiment.Conclusions. The results of our investigation on animal model indicate that non-physiological vertical mechanical vibrations are an effective means to prevent loss of a mineral bone component during treatment with glucocorticoids.

Enhanced Zinc Intake Protects against Oxidative Stress and Its Consequences in the Brain: A Study in an In Vivo Rat Model of Cadmium Exposure.

We examined, in a rat model of moderate environmental human exposure to cadmium (Cd), whether the enhanced intake of zinc (Zn) may protect against Cd-caused destroying the oxidative/antioxidative balance and its consequences in the brain. The intoxication with Cd (5 mg/L, 6 months) weakened the enzymatic (superoxide dismutase, glutathione peroxidase, catalase) and non-enzymatic (total thiol groups, reduced glutathione) antioxidative barrier decreasing the total antioxidative status and increased the concentrations of pro-oxidants (hydrogen peroxide, myeloperoxidase) in this organ and its total oxidative status. These resulted in the development of oxidative stress and oxidative modifications of lipids and proteins. The co-administration of Zn (30 and 60 mg/L enhancing this element intake by 79% and 151%, respectively) importantly protected against Cd accumulation in the brain tissue and this xenobiotic-induced development of oxidative stress and oxidative damage to lipids and proteins. Moreover, this bioelement also prevented Cd-mediated oxidative stress evaluated in the serum. The favorable effect of Zn was caused by its independent action and interaction with Cd. Concluding, the enhancement of Zn intake under oral exposure to Cd may prevent the oxidative/antioxidative imbalance and oxidative stress in the brain and thus protect against injury of cellular macromolecules in the nervous system.

Effects of various epiphytic microbiota inoculation on the fermentation quality and microbial community dynamics during the ensiling of sterile Napier grass.

AIM: To investigate epiphytic microbiota transformation of forages, their adaptation and contributions to fermentation quality of silage. METHODS AND RESULTS: Gamma-irradiated chopped Napier grass were ensiled with distilled water (STR), extracted epiphytic microbiota of Napier grass (NAP), sudan grass (SUD), whole crop corn (WCC) and forage sorghum (FS). Inoculating Napier grass with WCC significantly increased lactic acid (LA) concentrations during the initial ensiling period followed by a decline after 30 days. Relative to other silages (except STR) inoculation with NAP resulted in lower LA and greater pH, ammonia-N and dry matter (DM) losses. Silage inoculated with FS and SUD maintained lower pH as well as higher (P < 0·05) LA concentrations after 60 days of storage. During day 3 of ensilage, WCC, NAP and SUD inoculated silage were dominated by bacterial genera of Lactobacillus, while Lactococcus dominated the FS silage. Final silages were dominated by Lactobacillus in all treatment silages, however Enterobacter (16·3%) in NAP and Acetobacter (25·7%) in WCC silage were also prominent during the final ensiling. CONCLUSION: The inoculation of epiphytic microbiota of forage sorghum and sudan grass positively influenced the microbial community and fermentability of sterile Napier grass silage. SIGNIFICANCE AND IMPACT OF THE STUDY: This is the first time to investigate the effects of various epiphytic microbiota as silage inoculants which can be used as alternative source of environmental friendly and economically feasible silage additives.

What explains socioeconomic inequalities in dental flossing? Cross-sectional results from the RaNCD cohort study.

INTRODUCTION: The magnitude and underlying determinants of socioeconomic inequality in dental flossing are poorly understood in Iran. This study aimed to measure and decompose socioeconomic inequalities in dental flossing in Ravansar, Iran. METHODS: Data of 10,002 individuals aged 35-65 years who participated in the Ravansar Non- communicable Diseases (RaNCD) cohort study in Kermanshah province, western Iran, were analyzed. Based on an asset-based method, socioeconomic status (SES) was measured using principal component analysis (PCA). The concentration index and curve were employed to measure socioeconomic inequality in dental flossing. Decomposition analysis was used to estimate the contribution of each determinant to the overall inequality. RESULTS: Of 10,002 participants, 11.74% were found to practice dental floss. The normalized CI for dental flossing was 0.327 in the entire population, 0.323 in females and 0.329 in males, indicating that the use of dental floss is more concentrated among high-SES individuals. The decomposition analysis indicated that SES (50.58%) and level of education (44.90%) respectively contributed the most to this inequality. Place of residence (10.55%) and age group (2.7%) were the next main contributors, respectively. CONCLUSIONS: We found a low prevalence of dental flossing among participants in RaNCD study. We also observed a relatively high degree of pro-rich inequality in dental flossing. The observed inequality was mainly explained by socioeconomic status, level of education and place of residence. Policy interventions should consider these factors to reduce inequalities in dental flossing.

Clinical and immunologic assessment of a complex of therapeutic-preventive measures concerning chronic catarrhal gingivitis in children with comorbid diabetes mellitus.

OBJECTIVE: The aim of our study is to increase the efficacy of treatment of chronic catarrhal gingivitis in children suffering from type 1 diabetes mellitus by means of improvement of themethods of pharmacological correction on the basis of investigation of clinical-immunologic peculiarities of the disease. PATIENTS AND METHODS: Materials and methods: 2 groups of the study were formed. Children received basic insulin therapy. The treatment of chronic catarrhal gingivitis in children from the main group were suggested the antiseptic solution "Decasan"; pill of a probiotic action "BioGaia ProDentis" and the immune modulator "Imupret". Children from the comparative group were treated according to the common scheme. RESULTS: Results: The state of the oral hygiene in all the children after treatment improved considerably. According to PMA index inflammatory process was completely eliminated in children from the main group. A similar tendency was observed concerning sextants with gingival bleeding. In children dental calculus was lacking after treatment. Lysozyme activity in the oral fluid of children after treatment increased approximately 37.50% in the main group, and 16,67 % - in the comparison group. A similar tendency was found concerning sIgА level. CONCLUSION: Conclusions: Therefore, conducted course of the treatment concerning chronic catarrhal gingivitis promoted considerable improvement of the periodontal tissue in children.

Age and sex-related structural and functional changes of bone remodeling during simultate abdomen ct-scanning.

OBJECTIVE: The aim of investigation was to study the structural and functional conditions of cortical and trabecular layers of lumbar vertebrae L1-L5 in different age groups. PATIENTS AND METHODS: Materials and methods: In order to assess BMD of the lumbar vertebrae 102 people18 to 75 years old was examined. Study of bone mineral density cortical and trabecular layer of lumbar vertebrae (L1-L5) performed by computed tomography in Hounsfield Units (HU) in terms of standard deviation (SD). RESULTS: Results: The results of computed tomography showed a direct relationship of bone mineral density of lumbar vertebrae with age of examined persons. Osteoporosis and osteopenia was registered in 15% of men and 30% women in middle adulthood, in late adulthood - 35% and 50% respectively. During early old age osteopenia and osteoporosis are observed in 37,5% and 25% of men and 26% and 64% women. Osteoporosis in the middle old age has been reported in 50% of men and 75% of women. CONCLUSION: Conclusions: Results of the study showed a direct link between mineral density, age and gender. The middle adulthood age period was characterized by the highest mineral mass compared with the other age periods. Then there is a loss of bone mass throughout life, and with the onset of aging osteopenia and osteoporosis are recorded. It was investigated that in the early old age, loss of bone mass is mainly observed in female.

Thoracoscopic cryoanalgesia: A new strategy for postoperative pain control in minimally invasive pectus excavatum repair. / Crioanalgesia toracoscópica: nueva estrategia para el control del dolor postoperatorio en cirugía del pectus excavatum.

OBJECTIVE: Recent publications report early discharge and low opioid requirements after minimally invasive pectus excavatum repair treated with bilateral intercostal nerve cryoablation. Our aim is to report our initial experience with this technique. MATERIAL AND METHODS: Retrospective analysis of medical records of patients undergoing bilateral thoracoscopic cryoanalgesia during minimally invasive pectus excavatum repair within our institution from September 2018 to March 2019. TECHNIQUE: A cryoprobe was applied at -70 ºC for 2 minutes each from the 3rd to the 7th intercostal nerves bilaterally under thoracoscopic control. Postoperative pain was assessed using a visual analogue scale (VAS). RESULTS: Twenty-one patients were included. Ninety percent were male, the mean age being 15.2 ± 4.29 years, and the mean weight being 53.6 ± 15.33 kg. The average Haller index was 5.1 ± 2.97, and the mean repair index was 37.6 ± 13.77%. The mean number of implants introduced was 2.55 ± 0.74. The mean duration of cryoanalgesia was 39.9 ± 21.1. No patients received epidural anesthesia. Mean postoperative stay was 1.64 ± 0.73 days. Seventy-one percent of the patients required 1 dose of opioids at the most for postoperative pain control. According to the VAS, the average pain score on postoperative days 1, 3, 7, and 21 was 2.55, 2.01, 0.5, and 0.06, respectively. CONCLUSIONS: Bilateral thoracoscopic cryoanalgesia during minimally invasive pectus excavatum repair leads to early discharge and good postoperative pain control in all cases. Cryoanalgesia has become our treatment of choice for pain control in the thoracoscopic repair of pectus excavatum.

INTRODUCCION: Publicaciones recientes reportaron el alta temprana y bajos requerimientos de opioides para el control del dolor postoperatorio en la reparación mínimamente invasiva del pectus excavatum tras crioablación bilateral de nervios intercostales. Nuestro objetivo es describir nuestra experiencia inicial con esta técnica. MATERIAL Y METODOS: Análisis retrospectivo de historias clínicas de pacientes sometidos a crioanalgesia toracoscópica bilateral durante la reparación mínimamente invasiva del pectus excavatum en nuestra institución desde septiembre de 2018 a marzo de 2019. TECNICA: Se aplicó una criosonda a -70°C bajo visión toracoscópica durante 2 minutos del 3º al 7º espacio intercostal, de manera bilateral. El dolor postoperatorio fue evaluado con una Escala Visual Analógica. RESULTADOS: Se incluyeron 21 pacientes, de los cuales el 90% era de sexo masculino con una edad media de 15,2 ± 4,29 años y un peso de 53,6 ± 15,33 kg. El índice de Haller promedio fue de 5,1 ± 2,97 y el índice de corrección de 37,6 ± 13,77%. El número promedio de implantes fue de 2,55 ± 0,74. La duración media de la crioanalgesia fue de 39,9 ± 21,1 minutos. Ninguno recibió anestesia peridural. El tiempo de internación postquirúrgico fue de 1,64 ± 0,73. La necesidad de rescate con opiáceos fue menor a 1 dosis en el 71,3%. La puntuación de dolor en los días postoperatorios 1, 3, 7 y 21 fue, en promedio, de 2,55; 2,01; 0,5 y 0,06, respectivamente. CONCLUSIONES: El empleo de la crioanalgesia toracoscópica bilateral permitió el alta hospitalaria temprana y buen control del dolor postoperatorio en todos los casos, convirtiéndose en el método analgésico de elección en nuestra práctica clínica.

Assessment of inoculating various epiphytic microbiota on fermentative profile and microbial community dynamics in sterile Italian ryegrass.

AIMS: To evaluate the effects of various epiphytic microbiota from Italian ryegrass (IR), maize (MZ) and sorghum (SG) on fermentative profile and microbial community dynamics in sterile IR. METHODS AND RESULTS: Using microbiota transplantation, the irradiated IR was treated with the following: (i) sterile water; (ii) epiphytic microbiota on IR (IRIR); (iii) epiphytic microbiota on MZ (IRMZ); (iv) epiphytic microbiota on SG (IRSG). After 60 days of ensiling, MZ and SG microbiota significantly (P < 0·05) decreased lactic acid (LA) and acetic acid (AA) concentrations compared to IR microbiota, while SG microbiota notably (P < 0·05) reduced the ratio of LA to AA than MZ and IR microbiota. Apparently (P < 0·01) higher amounts of Lactobacillus genus were observed in IRIR and IRMZ groups on 60 day compared to IRSG group, and the dominant Lactococcus genus on 3 day was eventually replaced by Enterobacteriaceae and Lactobacillus in IRSG group. CONCLUSIONS: Exogenous microbiota could evidently affect the fermentative profile and microbial community dynamics of IR silage. The numbers of Enterobacteriaceae and Lactobacillus were mainly responsible for this. SIGNIFICANCE AND IMPACT OF THE STUDY: Identifying the role of microbe during ensiling is of great significance to manipulate the fermentation products and improve the preservation of silage.

Crioanalgesia toracoscópica: nueva estrategia para el control del dolor postoperatorio en cirugía del pectus excavatum / Thoracoscopic cryoanalgesia: A new strategy for postoperative pain control in minimally invasive pectus excavatum repair

Introducción: Publicaciones recientes reportaron el alta temprana y bajos requerimientos de opioides para el control del dolor postope-ratorio en la reparación mínimamente invasiva del pectus excavatumtras crioablación bilateral de nervios intercostales. Nuestro objetivo es describir nuestra experiencia inicial con esta técnica. Material y métodos: Análisis retrospectivo de historias clínicas de pacientes sometidos a crioanalgesia toracoscópica bilateral durante la reparación mínimamente invasiva del pectus excavatum en nuestra institución desde septiembre de 2018 a marzo de 2019. Técnica: Se aplicó una criosonda a -70°C bajo visión toracoscópica durante 2 minutos del 3º al 7º espacio intercostal, de manera bilateral. El dolor postoperatorio fue evaluado con una Escala Visual Analógica. Resultados: Se incluyeron 21 pacientes, de los cuales el 90% era de sexo masculino con una edad media de 15,2 ± 4,29 años y un peso de 53,6 ± 15,33 kg. El índice de Haller promedio fue de 5,1 ± 2,97 y el índice de corrección de 37,6 ± 13,77%. El número promedio de implantes fue de 2,55 ± 0,74. La duración media de la crioanalgesia fue de 39,9 ± 21,1 minutos. Ninguno recibió anestesia peridural. El tiempo de internación postquirúrgico fue de 1,64 ± 0,73. La necesidad de rescate con opiáceos fue menor a 1 dosis en el 71,3%. La puntuación de dolor en los días postoperatorios 1, 3, 7 y 21 fue, en promedio, de 2,55; 2,01; 0,5 y 0,06, respectivamente. Conclusiones: El empleo de la crioanalgesia toracoscópica bilateral permitió el alta hospitalaria temprana y buen control del dolor postoperatorio en todos los casos, convirtiéndose en el método analgésico de elección en nuestra práctica clínica

Objective: Recent publications report early discharge and low opioid requirements after minimally invasive pectus excavatum repair treated with bilateral intercostal nerve cryoablation. Our aim is to report our initial experience with this technique. Materials and methods: Retrospective analysis of medical records of patients undergoing bilateral thoracoscopic cryoanalgesia during minimally invasive pectus excavatum repair within our institution from September 2018 to March 2019. Technique: A cryoprobe was applied at -70 ºC for 2 minutes each from the 3rd to the 7th intercostal nerves bilaterally under thoracoscopic control. Postoperative pain was assessed using a visual analogue scale (VAS). Results: Twenty-one patients were included. Ninety percent were male, the mean age being 15.2 ± 4.29 years, and the mean weight being 53.6 ± 15.33 kg. The average Haller index was 5.1 ± 2.97, and the mean repair index was 37.6 ± 13.77%. The mean number of implants intro-duced was 2.55 ± 0.74. The mean duration of cryoanalgesia was 39.9 ± 21.1. No patients received epidural anesthesia. Mean postoperative stay was 1.64 ± 0.73 days. Seventy-one percent of the patients required 1 dose of opioids at the most for postoperative pain control. According to the VAS, the average pain score on postoperative days 1, 3, 7, and 21 was 2.55, 2.01, 0.5, and 0.06, respectively. Conclusions: Bilateral thoracoscopic cryoanalgesia during minimally invasive pectus excavatum repair leads to early discharge and good postoperative pain control in all cases. Cryoanalgesia has become our treatment of choice for pain control in the thoracoscopic repair of pectus excavatum

The Peculiarities of Remodelling Muscle Tissue of Rats Under the Vibration Influence.

Study of the influence of vibration oscillations of different frequency, amplitude and vibration acceleration on the structural and functional state and mechanisms of muscle tissue remodelling. An experimental study was conducted on sexually mature male rats. The rats of the four experimental groups were subjected to vertical vibration oscillations of 15, 25, 50 and 75 Hz, respectively. It has been established that pathological changes in muscle tissue in the form of different variants of damage and remodelling tend to increase, which correlates with the frequency of vibration, amplitude and vibration acceleration level, as in the 2nd group, where the maximum permissible vibration levels did not exceed the established allowable norms, and in other groups of animals, where the permissible levels of total vibration were exceeded. By increasing vibration acceleration for more than 1.25 m/s2 (0.13 g, frequency more than 25 Hz and amplitude of 2 mm), severe damages are observed in the form of alterative changes of muscle fibres with the disappearance of transverse strain, homogenization of sarcoplasm, fragmentation with dissociation fibres on separate beams, partial and subtotal myocytolysis, and necrosis of separate fibres. Inflammation is rapidly increasing with the increase in the frequency of vibration and the level of vibration acceleration for more than 5.0 m/s2 (0.51 g).

Características clínicas de los pacientes con apneas obstructivas del sueño: diferencias según género / Clinical features in patients with obstructive sleep apnea syndrome: differences by gender

INTRODUCCIÓN: El síndrome de apnea obstructiva del sueño (SAHOS) es más prevalente en hombres, los estudios poblacionales muestran una relación de 2:1, sin embargo, en los estudios clínicos la frecuencia llega a ser de hasta de 6:1. Estas diferencias en el ambiente clínico puede ser consecuencia de variaciones en el reporte de síntomas en hombres comparados con mujeres. OBJETIVO: Evaluar las diferencias de género en la presentación clínica de apnea obstructiva de sueño. Pacientes: Estudio transversal de pacientes sometidos a una poligrafía respiratoria (PR) con sospecha clínica de SAHOS. Se recolectaron datos demográficos, antropométricos, comorbilidades y las variables de la PR. Se realizó estudio t de student, Mann-Whitney y chi-cuadrado según correspondiera. RESULTADOS: Se incluyeron 1.044 pacientes: edad promedio 53,2 ± 14 años, 76% hombres. Las mujeres con SAHOS poseen mayor IMC (32,2 ± 6,1 vs 30,8 ± 5,0; p=0,002) y edad (61,4 ± 12,2 vs 52,6 ± 13,9; p < 0,001), pero menor circunferencia de cuello (CC) (38,1 ± 3,6 vs 43,2 ± 3,3; p < 0,001), además, presentan menor IA/H y menor duración de las apneas. No hubo diferencias en los síntomas clásicos de apneas presenciada y somnolencia diurna, sin embargo, describen más frecuentemente insomnio, cefalea matinal, depresión y uso de fármacos hipnóticos. CONCLUSIONES: Las mujeres al momento del diagnóstico son de mayor edad y más obesas, aunque presentan una CC menor, presentan una enfermedad más leve, pero refieren más fatiga, cansancio, cefalea e insomnio. Debemos estar alerta en la presentación clínica diferente de las mujeres para mejorar la sospecha diagnóstica.

INTRODUCTION: Obstructive sleep apnea (OSA) is more prevalent in men, population studies show a ratio of 2:1, however in clinical studies the frequency is as high as 6:1. These differences in the clinical setting may be a consequence of variations in the reporting of symptoms in men compared to women. OBJECTIVE: To evaluate gender differences between women and men with recent diagnosis of OSA. Patients: A cross-sectional, study of patients undergoing home sleep apnea testing (HSAT) with clinical suspicion of OSA. Demographic, anthropometric, comorbidities and HSAT variables were collected. We performed t student analysis, Mann-Whitney test or chi square test as appropriate. RESULTS: 1,044 patients were included: mean age 53.2 ± 14 years, 76% men. Women with OSA have a higher BMI (32.2 ± 6.1 vs 30.8 ± 5.0, p = 0.002), were older (61.4 ± 12.2 vs 52.6 ± 13.9, p <0.001), but have a lower neck circumference (NC) (38.1 ± 3.6 vs. 43.2 ± 3.3, p <0.001). The women presented lower AHI and shorter duration of apneas. Although the classic symptoms of apnea and daytime sleepiness showed no differences, women reported more frequently insomnia, morning headache, depression and use of hypnotic drugs. CONCLUSIONS:: Clinical differences between gender are present at time of diagnosis. Woman are older and more obese, although they have a lower NC. They have a milder disease, but they refer to be more tired, headache, insomnia and depression. We must be alert in the different clinical presentation of women to improve the diagnostic suspicion.

Demographical and population dynamics impact on public health of cutaneous Leishmaniasis in Al-Madinah Almonawra, Saudi Arabia.

BACKGROUND: A cross-sectional study conducted in Al-Madinah Almonawra in KSA held during the period from March 2014-March 2015. AIM OF THE STUDY: This study aimed at analyzing the effect of population dynamics on the current situation of cutaneous leishmaniasis in Al-Madinah Almonawarah area, a holy city that attracts millions of muslims annually. METHODOLOGY: Epidemiological and clinical data were collected by especial questionnaire and laboratory specimens were collected using skin scraping and needle aspiration. Staining and direct microscopy were done. LST was conducted. Analysis was done using SPSS program. RESULTS: The study included 164 patients, all of them were men. Saudi nationality comprised around 20% of the study group, the majority were Egyptians, 26.2%, followed by Pakistani, 21.3%. CONCLUSION: The presence of non-Saudi nationality as foreign workers, immigrants and refugees has worsened the current situation of the disease.