Egyptian propolis and selenium nanoparticles against murine trichinosis: a novel therapeutic insight.

Trichinosis is a serious zoonotic disease that causes human morbidity and mortality. New effective natural remedies with minimal side effects that are well tolerated are needed to treat both enteral and parenteral trichinosis. This study evaluated the efficacy of selenium (Se), Se nanoparticles (SeNPs) and Egyptian propolis compared with albendazole as antiparasitic, anti-inflammatory and anti-angiogenic agents for treating murine trichinosis. We used parasitological, histopathological and immunohistochemical assays, as well as scanning electron microscopy, to examine adult worms. Overall, 80 Swiss albino male mice were divided into eight groups, with ten mice in each group, as follows: negative control, positive control, albendazole, propolis, Se, combination of propolis and Se, SeNPs and combination of SeNPs and propolis. Mice were slaughtered seven and 35 days after infection to examine the intestinal and muscular phases, respectively. This study demonstrated the efficacy of the combination of SeNPs and propolis. As revealed by electron microscopy, this combination caused damage to the adult worm cuticle. Additionally, compared with albendazole, it resulted in a significant reduction in adult worm and total larval counts; moreover, it caused a decrease in the number of larvae deposited in muscles, with a highly significant decrease in the inflammatory cell infiltrate around the larvae and a considerable decrease in the expression of the angiogenic marker vascular endothelial growth factor in muscles. In conclusion, the combination of SeNPs and propolis had antiparasitic, anti-inflammatory and anti-angiogenic effects on trichinosis. Consequently, this combination could be used as a natural alternative therapy to albendazole for treating trichinosis.

Assessment of Biomechanical Behavior of Endodontically Treated Premolar Teeth Restored with Novel Endocrown System.

OBJECTIVE: Despite the increased popularity of endocrowns, there is no clear consensus considering their effectiveness to restore severely-destructed endodontically treated premolars. This study aimed to assess the biomechanical behavior of endodontically treated maxillary first premolars restored with a novel endocrown system compared to the conventional one. MATERIALS AND METHODS: Twenty sound human maxillary first premolars were collected. After endodontic treatment, they were divided into 2 groups (n=10) according to the system used for endocrown fabrication. Group C (Control): conventional monolithic IPS e.max CAD endocrowns. Group P: novel bi-layered endocrowns (Pekkton ivory coping veneered with cemented IPS e.max CAD). All specimens were subjected to 10000 thermal cycles followed by 240000 dynamic load cycles. Surviving specimens were subjected to fracture resistance test followed by qualitative analysis using Stereomicroscopy and Scanning Electron Microscopy. RESULTS: A significantly higher load was observed for Group P (1831.37 ± 240.69 N) than Group C (1433.47 ± 174.39 N) (p ⟨ 0.001). A statistically significant difference was observed considering the failure mode (p = 0.036), with more favorable fractures detected with Group P. CONCLUSIONS: The tested novel endocrown system improved the biomechanical behavior of the tooth/ restoration complex in the restored endodontically treated maxillary first premolars. CLINICAL SIGNIFICANCE: The tested novel endocrown system with a PEKK coping veneered with cemented IPS e.max CAD can be considered a promising option for restoration of severely-destructed endodontically treated premolar teeth. It can be considered as a conservative alternative option to the conventional treatment modalities.

Early vs delayed closure of loop defunctioning ileostomy in patients undergoing distal colorectal resections: an integrated systematic review and meta-analysis of published randomized controlled trials.

AIMS: The objective of this study was to evaluate the surgical outcomes and feasibility of early loop defunctioning ileostomy closure, within 2 weeks of index surgery, in patients undergoing distal colorectal resection. METHODS: A systematic review of the literature on published randomized controlled trials reporting the feasibility and outcomes on early vs delayed closure of loop defunctioning ileostomy in patients undergoing distal colorectal resection using the principles of meta-analysis on RevMan 5.4 statistical software was undertaken. RESULTS: Four randomized, controlled trials on 446 patients evaluating the feasibility and outcomes on early vs delayed closure of loop defunctioning ileostomy in patients undergoing low colorectal resection were analysed. There were 176 patients in the early closure group and 270 patients in the delayed closure group. The risk of anastomotic leak [risk ratio 0.37 (CI: 0.10-1.42), P = 0.15], anastomotic stenosis [risk ratio 4.79 (CI: 0.23-98.47), P = 0.31] and postoperative complications [risk ratio 0.75 (CI: 0.48-1.16), P = 0.19] was similar in both groups. In addition, there was no significant difference between the groups with regard to the duration of operation [standardized mean difference -0.49 (CI: -01.09, -0.12), P = 0.12] and length of hospitalization [standardized mean difference -0.04 (CI: -0.25, -0.18), P = 0.75]. CONCLUSIONS: Early closure of loop defunctioning ileostomy in patients undergoing distal colorectal resection is feasible with comparable outcomes to delayed closure.

Systematic review and meta-analysis of published trials comparing the effectiveness of transanal endoscopic microsurgery and radical resection in the management of early rectal cancer.

AIM: A systematic analysis was conducted of trials comparing the effectiveness of transanal endoscopic microsurgery (TEMS) with radical resection (RR) for T1 and T2 rectal cancer. METHOD: An electronic search was carried out of trials reporting the effectiveness of TEMS and RR in the treatment of T1 and T2 rectal cancers. RESULTS: Ten trials including 942 patients were retrieved. There was a trend toward a higher risk of local recurrence (odds ratio 2.78; 95% confidence interval 1.42, 5.44; z = 2.97; P < 0.003) and overall recurrence (P < 0.01) following TEMS compared with RR. The risk of distant recurrence, overall survival (odds ratio 0.90; 95% confidence interval 0.49, 1.66; z = 0.33; P = 0.74) and mortality was similar. TEMS was associated with a shorter operation time and hospital stay and a reduced risk of postoperative complications (P < 0.0001). The included studies, however, were significantly diverse in stage and grade of rectal cancer and the use of neoadjuvant chemoradiotherapy. CONCLUSION: Transanal endoscopic microsurgery appears to have clinically measurable advantages in patients with early rectal cancer. The studies included in this review do not allow firm conclusions as to whether TEMS is superior to RR in the management of early rectal cancer. Larger, better designed and executed prospective studies are needed to answer this question.

A systematic review of the current availability of mobile applications in eyecare practices.

BACKGROUND: There is an increasing shift towards non-communicable eye diseases (NCEDs) because of a demographic transition. Incorporation of telemedicine into everyday clinical practice is becoming increasingly popular. We sought to carry out a systematic review to look at which applications on portable devices are available for use in eyecare practices for patients with NCEDs, specifically refractive error, diabetic retinopathy, age-related macular degeneration (AMD) and glaucoma. METHODS: Pubmed, EMBASE, Medline, PsychInfo databases were systematically searched using keywords and MeSH terms. Eligible articles included peer-reviewed, original full text articles evaluating apps for use on portable devices aimed at patients with NCEDs. RESULTS: The initial search yielded 100 studies. Nine studies met the inclusion criteria, and an additional eight studies were identified through reference screening. Of the included studies, 29.4%% (n = 5) evaluated applications aimed for use to identify refractive errors, 35.3% (n = 6) aimed at patients with glaucoma, 23.5% (n = 4) for use by patients with AMD, 11.7% (n = 2) for the non-specific monitoring of visual acuity/fields. 76.5% (n = 13) of the studies showed that the application evaluated was an effective and reliable tool compared to clinical standards. CONCLUSIONS: Portable device applications in patients with NCED have been shown to be effective. The use of these apps for patients is limited to either diagnostic or monitoring use. There is scope for apps which encompass other aspects of patient care that have been used in other specialties that may be applied to ophthalmic patients, including those with an educational aim which have a role in increasing compliance.

Quantification of non-specific binding of magnetic micro- and nanoparticles using cell tracking velocimetry: Implication for magnetic cell separation and detection.

The maturation of magnetic cell separation technology places increasing demands on magnetic cell separation performance. While a number of factors can cause sub-optimal performance, one of the major challenges can be non-specific binding of magnetic nano- or microparticles to non-targeted cells. Depending on the type of separation, this non-specific binding can have a negative effect on the final purity, the recovery of the targeted cells, or both. In this work, we quantitatively demonstrate that non-specific binding of magnetic nanoparticles can impart a magnetization to cells such that these cells can be retained in a separation column and thus negatively impact the purity of the final product and the recovery of the desired cells. Through experimental data and theoretical arguments, we demonstrate that the number of MACS magnetic particles needed to impart a magnetization that is sufficient to cause non-targeted cells to be retained in the column to be on the order of 500-1,000 nanoparticles. This number of non-specifically bound particles was demonstrated experimentally with an instrument, cell tracking velocimeter, CTV, and it is demonstrated that the sensitivity of the CTV instrument for Fe atoms contained in magnetic nanoparticles on the order of 1 x 10(-15) g/mL of Fe.

Surgical and medical management of small bowel gastrointestinal stromal tumors: A report of the Dutch GIST registry.

BACKGROUND: A cohort of 201 patients with small bowel gastrointestinal stromal tumors (GIST) treated between January 1st, 2009 and December 31st, 2016 in five GIST expertise centers in the Netherlands was analyzed. Goal of this study was to describe the clinical, surgical and pathological characteristics of this rare subpopulation of GIST patients, registered in the Dutch GIST registry. METHODS: Clinical outcomes and risk factors of patients with small bowel GIST who underwent surgery or treated with systemic therapy were analyzed. A classification was made based on disease status at diagnosis (localized vs. metastasized). RESULTS: 201 patients with small bowel GIST were registered of which 138 patients (69%) were diagnosed with localized disease and 63 patients (31%) with metastatic disease. Approximately 19% of the patients had emergency surgery, and in 22% GIST was an accidental finding. In patients with high risk localized disease, recurrence occurred less often in patients who received adjuvant treatment (4/32) compared to patients who did not (20/31, p < 0.01). Disease progression during palliative imatinib treatment occurred in 23 patients (28%) after a median of 20.7 (range 1.8-47.1) months. Ongoing response was established in 52/82 patients on first line palliative treatment with imatinib after a median treatment time of 30.6 (range 2.5-155.3) months. CONCLUSION: Patients with small-bowel GIST more frequently present with metastatic disease when compared to patients with gastric GIST in literature. We advocate for Prospective registration of these patients and investigate the use of surgery in patients with limited metastatic disease.

Phase II clinical trial of arsenic trioxide with liposomal doxorubicin, vincristine, and dexamethasone in newly diagnosed multiple myeloma.

In patients with multiple myeloma, there is preclinical justification to combine arsenic trioxide (ATO and As(2)O(3)) with DVd (Doxiltrade mark, vincristine, and dexamethasone) for newly diagnosed patients. Eleven patients on this phase II trial received 0.15 mg/kg of ATO for five consecutive days followed by four cycles of DVd plus ATO with the ATO at 0.25mg/kg IV twice per week. The most common grade 3 toxicities were hyperglycemia, hyponatremia, and hypocalcemia. There were four partial and no complete responses. We could not demonstrate that the addition of ATO with this schedule improved the response rate of MM to DVd.

Remarkable effects of imatinib in a family with young onset gastrointestinal stromal tumors and cutaneous hyperpigmentation associated with a germline KIT-Trp557Arg mutation: case report and literature overview.

Gastrointestinal stromal tumors (GISTs) occur mostly sporadically. GISTs associated with a familial syndrome are very rare and are mostly wild type for KIT and platelet-derived growth factor alpha (PDGFRA). To date 35 kindreds and 8 individuals have been described with GISTs associated with germline KIT mutations. This is the third family described with a germline p.Trp557Arg mutation in exon 11 of the KIT gene. The effect of imatinib in patients harboring a germline KIT mutation has been rarely described. Moreover, in some studies imatinib treatment was withheld considering the lack of evidence for efficacy of this treatment in GIST patients harboring a germline KIT mutation. This paper describes a 52-year old patient with a de novo germline p.Trp557Arg mutation with multiple GISTs throughout the gastrointestinal tract and cutaneous hyperpigmentation. Imatinib treatment showed long-term regression of the GISTs and evident pathological response was seen after resection. Remarkably, the hyperpigmentation of the skin also diminished during imatinib treatment. Genetic screening of the family revealed the same mutation in two daughters, both with similar cutaneous hyperpigmentation. One daughter, aged 23, was diagnosed with multiple small intestine GISTs, which were resected. She was treated with adjuvant imatinib which prompted rapid regression of the cutaneous hyperpigmentation. Imatinib treatment in GIST patients harboring a germline KIT mutation shows favorable and long-term responses in both the tumor and the phenotypical hyperpigmentation.

Kiwifruit ameliorates gentamicin induced histological and histochemical alterations in the kidney of albino mice.

Gentamicin is an antibiotic used worldwide for treating Gram-negative bacterial infections. Gentamicin causes nephrotoxicity in up to 25% of therapeutic cases owing to increased production of free radicals. Kiwifruit are nutrient-dense fruits that have proven effective for ameliorating many pathological conditions caused by oxidative stress. We investigated the possible prophylactic and therapeutic effects of kiwifruit on the changes in renal histology and histochemistry caused by gentamicin. Intramuscular injection of mice with gentamicin for 10 consecutive days was nephrotoxic as indicated by epithelial vacuolization, glomerular atrophy and tubular necrosis. Necrotic tubule cells lost most of their polysaccharides and structural proteins. Co-administration of kiwifruit with gentamicin prevented nephrotoxic changes to a modest degree. When administered subsequent to gentamicin intoxication, kiwifruit ameliorated significantly the histological and histochemical alterations caused by gentamicin. Our findings support the use of kiwifruit in cases of acute renal injury due to gentamicin.

Preliminary efficacy of a brief family intervention to prevent declining quality of life secondary to parental bone marrow transplantation.

The primary purpose of this research was to develop and evaluate the efficacy and feasibility of a brief, cost-effective family-focused intervention to promote adaptive coping and quality of life throughout a parent's bone marrow transplantation (BMT). Targeted outcomes were cohesion, decreased use of avoidance coping, open communication and effective management of emotional distress. Participants included an intervention group of 31 families and 29 families in a control group who received usual care. Each family included the BMT recipient, a partner/caregiver and children 10-18 years old. The intervention included two dyadic sessions for the BMT recipient and the partner/caregiver, one individual session for the caregiver and two digital video discs (DVDs) for children. Statistical analyses indicated that the intervention had a positive impact on at least one aspect of the adaptation of each family member. Caregivers reported the most distress but benefitted least from the intervention, whereas recipients and children reported improvement in distress. Ratings of satisfaction/acceptability were high, with 97% responding that they would recommend the intervention to others. Plans for future research include increased intervention intensity for the caregiver, a larger more diverse sample and implementation over an extended period post BMT.

Advancement in conductive cotton fabrics through in situ polymerization of polypyrrole-nanocellulose composites.

Current research was undertaking with a view to innovate a new approach for development of conductive - coated textile materials through coating cotton fabrics with nanocellulose/polypyrrole composites. The study was designed in order to have a clear understanding of the role of nanocellulose as well as modified composite thereof under investigation. It is anticipated that incorporation of nanocellulose in the pyrrole/cotton fabrics/FeCl3/H2O system would form an integral part of the composites with mechanical, electrical or both properties. Three different nanocellulosic substrates are involved in the oxidation polymerization reaction of polypyrrole (Ppy) in presence of cotton fabrics. Polymerization was subsequently carried out by admixing at various ratios of FeCl3 and pyrrole viz. Ppy1, Ppy2 and pp3. The conductive, mechanical and thermal properties of cotton fabrics coated independently with different nanocellulose/polypyrrole were investigated. FTIR, TGA, XRD, SEM and EDX were also used for further characterization. Results signify that, the conductivity of cotton fabrics increases exponentially with increasing the dose of pyrrole and oxidant irrespective of nanocellulose substrate used. While, the mechanical properties of cotton fabrics are not significantly affected by the oxidant treatment.

ZIKA VIRUS STRATEGIC RESPONSE FRAMEWORK FOR THE GULF STATES-2016: AN URGENT NEED FOR COLLABORATION.

The Zika virus (ZIKV) became the latest threat to global health security when WHO declared on 1t February 2016, that recently reported clusters of microcephaly and other neurological disorders in Brazil constitute a Public Health Emergency of International Concern (PHEIC). These clusters were reported concurrently with an outbreak of ZIKV, which has been ongoing in Brazil and other countries in the America region since 2015. A growing body of clinical and epidemiological data possibly leans towards a causal role for ZIKV as the occurrence of the clusters of microcephaly and other neurological disorders principally the Guillain-Barre' syndrome are associated in time and place with the ongoing ZIKV transmission in the America region. So far, Zika viral transmission has been documented in a total of 69 countries and territories with autochthonous transmission from 20I7 to 10 August 2016. The geographical range of ZIKV has been increasing steadily. Consid'ring the presence of competent vectors that transmit ZIKV in, some parts of the Gulf countries, and the close relationship with Brazil, a local transmission of the virus is plausible once the virus is introduced through travel. This review suggests the integration of epidemiologicalind entomological surveillance for monitoring and control of the vectors of ZIKV. The risks associated with ZIKV infection and the possible threat to the Gulf States was described. A strategic Zika response framework (SRF) for the Gulf States has been developed to meet'their,urgent need for a collaborative and coordinated response for prevention and spread of ZIKV infection. A coordinated response of all partners in the Gulf States across sectors and services at national, as well as, regional levels is required.

High-dose busulfan, cyclophosphamide, and etoposide does not improve outcome of allogeneic stem cell transplantation compared to BuCy2 in patients with acute myeloid leukemia.

SUMMARY: To reduce relapse following allogeneic transplantation for AML, intensification of high-dose busulfan/cyclophosphamide using additional agents has been investigated but with few reported comparisons. We compared an intensified regimen of etoposide (60 mg/kg), busulphan (14 mg/kg), and cyclophosphamide (120 mg/kg) (BuCyVP) with BuCy2 in 237 AML patients. No significant difference in overall outcome was observed following BuCyVP (n=127) or BuCy2 (n=110). The 5-year survival was 27.3 and 30.1% following BuCyVP and BuCy2, respectively (P=0.48). Similarly, the 5-year cumulative incidence of relapse (CIR) was 28.3 and 34.8% with BuCyVP and BuCy2 (P=0.45), respectively. On multivariable analysis, patients transplanted in CR1 (P=0.002) and from related donors (P=0.013) had longer survival, while disease status at transplant was the only factor predicting CIR (P=0.002). In a separate analysis of CR1 patients (n=56), there was no significant difference in survival (P=0.37) or CIR (P=0.87) between the two regimens. However, for more advanced disease, there was a trend towards less relapse with BuCyVP (P=0.08), which was balanced by a higher cumulative incidence of transplant-related deaths (P=0.03) compared to BuCy2, resulting in similar survival. Overall, our results do not support the use of the more intensive BuCyVP regimen over BuCy2 in either early or more advanced disease AML patients.

Clonally rearranged antigen receptor gene DNA studies in evaluation of susceptibility of neoplastic lymphocytic and plasmacytic disorders to selective loss in long-term marrow culture.

Survival of neoplastic cells of disorders involving the lymphocytic lineage in relation to normal hemopoietic cells has been investigated in long-term culture of bone marrow (LTMC) infiltrated by conditions in which a clonally rearranged B- or T-cell antigen receptor gene provided an objective marker of the neoplastic cell population. Relative amounts of clonally rearranged and germline antigen receptor gene DNA were assessed by Southern analysis of bone marrow cell DNA, before and after LTMC in studies on ten cases of non-Hodgkin's lymphoma (NHL), four of myeloma (MM), and two of chronic lymphocytic leukemia (CLL). Clonally rearranged DNA became undetectable during LTMC in 12 studies (seven NHL, four MM, one CLL), and in seven of these studies the extent of the decrease determined by densitometric analysis of rearranged and germline bands on the autoradiograms was sufficient to demonstrate that preferential loss of neoplastic relative to other cell series had taken place. At the same time, there was a net increase in normal myeloid series, to indicate that a selective adverse effect similar to that reported to operate on leukemic cells in LTMC also applied to certain malignancies involving the lymphocytic lineage. In four of the 16 studies (three NHL, one CLL), the neoplastic cells possessing clonally rearranged DNA were maintained in LTMC, demonstrating that susceptibility to this selective adverse effect was not a uniform characteristic of neoplastic lymphocytic disorders.

Radically new cellulose nanocomposite hydrogels: Temperature and pH responsive characters.

Innovation produced for synthesis of radically new stimuli-responsive hydrogels were described. The innovation is based on inclusion of cellulose nanowhiskers (CNW)-polyacrylamide (PAAm) copolymer in poly N-isopropyl acrylamide (PNIPAm) semi interpenetrating network (IPN) hydrogel. After being prepared as per free radical polymerization of AAm onto CNW, the as prepared copolymer was incorporated in a polymerization system, which comprises NIPAm monomer, bismethylene acrylamide (BMA) crosslinker, K2S2O8 initiator and TEMED accelerator, to yield CNW-PAAm-PNIPAm nanocomposite hydrogels. The latter address pH-responsive hydrogel as well as temperature-responsive. Hydrogels exhibit the highest equilibrium swelling ratio (ESR) in acidic medium (pH 4). Meanwhile they perform good swelling behavior and hydrophilicity at a temperature of 32°C. These hydrogels carry the characteristic features of CNW-PAAm copolymer as conducted from FTIR and TGA. The hydrogels are homogenous and well-proportioned network structure with highly connected irregular pores with a large size ranging from 30 to 100nm as concluded from SEM.

Individual and competitive adsorption of phenol and nickel onto multiwalled carbon nanotubes.

Individual and competitive adsorption studies were carried out to investigate the removal of phenol and nickel ions by adsorption onto multiwalled carbon nanotubes (MWCNTs). The carbon nanotubes were characterized by different techniques such as X-ray diffraction, scanning electron microscopy, thermal analysis and Fourier transformation infrared spectroscopy. The different experimental conditions affecting the adsorption process were investigated. Kinetics and equilibrium models were tested for fitting the adsorption experimental data. The characterization experimental results proved that the studied adsorbent possess different surface functional groups as well as typical morphological features. The batch experiments revealed that 300 min of contact time was enough to achieve equilibrium for the adsorption of both phenol and nickel at an initial adsorbate concentration of 25 mg/l, an adsorbent dosage of 5 g/l, and a solution pH of 7. The adsorption of phenol and nickel by MWCNTs followed the pseudo-second order kinetic model and the intraparticle diffusion model was quite good in describing the adsorption mechanism. The Langmuir equilibrium model fitted well the experimental data indicating the homogeneity of the adsorbent surface sites. The maximum Langmuir adsorption capacities were found to be 32.23 and 6.09 mg/g, for phenol and Ni ions, respectively. The removal efficiency of MWCNTs for nickel ions or phenol in real wastewater samples at the optimum conditions reached up to 60% and 70%, respectively.

The natural history of atherosclerosis: an ecologic perspective.

Virologic findings reported in recent atherosclerosis literature may have profound implications. To assess them, we have viewed atherosclerosis in a broad biologic context and against a background of environmental, behavioral, and social change. Reasonable grounds exist, we believe, for regarding atherosclerosis as a chronic, low-grade infectious macroangiopathy which is aggravated by hypercholesterolemia and other recognized risk factors. There are probably multiple infective pathogens and transmission routes. The putative agents that initiate atherosclerosis might include ubiquitous viruses that produce clinically unapparent infections in many animal species. Pathways for their transmission to humans may include the food chain and contaminated water. Food-chain transmission may have been largely responsible for the parallel increases of meat consumption and mortality from coronary heart disease in the United States during the middle third of the century. It provides a hypothetical basis for considering thermal intervention as a heretofore unrecognized factor that may actually best account for the surprising reversal of climbing heart disease mortality rates. Improved sanitation and food hygiene as well as improvements in diet, lifestyle, and medical care may have shaped the downward mortality curve. The virus hypothesis may reconcile apparent epidemiologic conflicts and elucidate the natural history of atherosclerosis.