ADIPONECTIN LEVELS IN GRAVES' DISEASE - SYSTEMATIC REVIEW AND META-ANALYSIS.

Context: Graves' disease is the most prevalent cause of hyperthyroidism worldwide. Adiponectin, the most abundant adipokine, plays a significant role in a cluster of prevalent diseases connected to metabolic disorders. Objective: Although the association between adiponectin and Graves' disease has been studied, the existing data is inconsistent. Therefore, we conducted this systematic review and meta-analysis to evaluate the relationship between adiponectin levels and Graves' disease. Methods: We performed a systematic electronic search on PubMed, EMBASE, Scopus and Cochrane Library using predefined keywords. We used the NHLBI quality assessment tools to assess the included studies. Results: There were 11 studies involving 781 subjects included in our qualitative synthesis, while 6 studies were included in our quantitative synthesis. We observed significantly increased adiponectin levels in Graves' disease patients compared to controls (MD 2.983 [95% CI 0.138-5.828]) and hypothyroidism patients (MD 3.389 [95% CI 1.332-5.446]). Nevertheless, no significant MD was observed when comparing Graves' disease patients with and without Graves' ophthalmopathy (MD -27.124 [95% CI -88.893 - 34.645]). Conclusions: Adiponectin levels were significantly higher in patients with Graves' disease compared to controls and hypothyroidism patients. However, patients with and without Graves' ophthalmopathy did not present a significant mean difference in adiponectin levels.

Gene transcription and antioxidants production in Arthrospira (Spirulina) platensis grown under temperature variation.

AIM: To investigate the transcription of selected antioxidants and relevant genes under varying temperature conditions, and to identify the optimum temperature for antioxidants production by Arthrospira platensis. METHODS AND RESULTS: The dry weight (DW), pigment production, antioxidants production and gene transcription were examined in A. platensis growing under three temperatures of 23, 30 and 37°C. The cyanobacterial DW was highest in the high temperatures (30 and 37°C), while the pigments, such as Chl a, carotenoids, C-phycocyanin and total phycobiliprotein contents, showed their maximum value at 30°C. The total soluble protein and carbohydrate contents were highest at 30°C. Lipid peroxidation, as a marker for thermal stress, was high at 23°C, while higher temperatures remarkably reduced lipid peroxidation levels. Antioxidants activity was increased by 1·5-fold at 30°C and temperature fluctuations induced the antioxidant enzyme activities. The transcriptional abundance of heat shock protein (HSP90), glutamate synthase (GOGAT), delta-9 desaturase (desC), iron-superoxide dismutase (FeSOD) and the large subunit of Rubisco (rbcL) genes was measured under the same temperatures. CONCLUSION: The optimal temperature for growth, biochemical constituents and antioxidants of A. platensis is 30°C while some antioxidant enzyme activity increased at lower and higher temperatures. SIGNIFICANCE AND IMPACT OF THE STUDY: The study showed the significance of temperature for growth, enzymatic and non-enzymatic antioxidants and gene expression in A. platensis. This contributes to the knowledge of culturing A. platensis to harvest specific antioxidants or as an antioxidant-rich food source.

Urgency of caesarean section, grading, alarm chain and intrauterine resuscitation - a survey of Scandinavian practice.

BACKGROUND: About 40,000 women have caesarean section in Scandinavia each year. Organizational factors for emergency caesarean section (CS), classification, anaesthetic practice, alarm chain, intrauterine resuscitation has all been investigated in the United Kingdom, but no information from the Scandinavian countries exists. METHODS: Using publicly available data from the National Board of Health, obstetric anaesthetic departments were identified. The heads of the departments provided e-mail contact details of two anaesthesiologists regularly practicing obstetric anaesthesia who were then surveyed. RESULTS: One hundred and forty-five specialists from 82 departments in Scandinavia replied to our survey. Ninety-five percent of Danish specialists reported a three-grade classification system for urgency CS. Where classification in Denmark was enumerative classification, Norwegians equally reported enumerative and verbal descriptors, whereas Swedish specialists mostly reported verbal descriptors. Local guidelines describing decision-to-delivery interval for emergency CS was reported by 100% of Danish specialists vs. 47% from Norway and 85% from Sweden. Mean benchmark decision-to-delivery interval for emergency CS was 12.7 min. General anaesthesia for emergency CS was highly favoured in Norway (95%) and Sweden (97%), compared to Denmark (49%). Twenty specialists reported existence of local guidelines for intrauterine resuscitation. CONCLUSION: Our survey of Scandinavian specialists indicate emergency CS practise differs from United Kingdom practices in several aspects; general anaesthesia is by the majority of Scandinavian specialists reported as the default choice for emergency CS and benchmark for decision-to-delivery interval is < 20 min. Nomenclature used for classification showed considerable variance in Norway and Sweden compared to Denmark. No joint Scandinavian guidelines exist.

Outcomes of elective and emergency surgical repair of incisional hernia: a comparative observational study.

PURPOSE: Incisional hernia (IH) is a common complication following abdominal surgery. Surgical repair of IH is associated with the alleviation of symptoms and improvement of quality of life. Operative intervention can pose a significant burden to the patient and healthcare facilities. This study aims to describe and compare outcomes of elective and emergency surgical repair of IH. METHODS: This study is a single-centre comparative retrospective study including patients who had repair of IH. Patients were divided into Group I (Emergency) and Group II (Elective), and a comparison was conducted between them. RESULTS: Two hundred sixty-two patients were identified with a mean age of 61.8 ± 14.2 years, of which 152 (58%) were females. The mean BMI was 31.6 ± 7.2 kg/m2. More than 58% had at least one comorbidity. 169 (64.5%) patients had an elective repair, and 93 (35.5%) had an emergency repair. Patients undergoing emergency repair were significantly older and had higher BMI, p = 0.031 and p = 0.002, respectively. The significant complication rate (Clavien-Dindo III and IV) was 9.54%. 30 and 90-day mortality rates were 2.3% (n = 6) and 2.68% (n = 7), respectively. In the emergency group, the overall complications, 30-day and 90-day mortality rates were significantly higher than in the elective group, p ≤ 0.001, 0.002 and 0.001, respectively. Overall, 42 (16.1%) developed wound complications, 25 (9.6%) experienced a recurrence, and 41 (15.71%) were readmitted within 90 days, without significant differences between the two groups. CONCLUSION: Patients who underwent emergency repair were significantly older and had a higher BMI than the elective cases. Emergency IH repair is associated with higher complication rates and mortality than elective repair.

Histopathological, immunohistochemical, and molecular investigation of atrazine toxic effect on some organs of adult male albino rats with a screening of Acacia nilotica as a protective trial.

Atrazine (ATZ) is a widely used herbicide; however, it has deleterious effects. The current study aimed to investigate the potential toxic effect of ATZ as a neuroendocrine disruptor on the cerebellum and thyroid gland and on the liver as a detoxifying organ. We examined the ability of ATZ to induce oxidative stress and subsequent apoptosis in these organs. Moreover, we investigated the potential protective effect of Acacia nilotica, because of its potent antioxidant activity. Thus, our study was carried out on 40 adult male albino rats that were divided equally into 4 groups (10 rats/each group). The first group received distilled water, while the second group received ATZ dissolved in corn oil at 200 mg/kg body weight/day by stomach gavage. The third group was treated orally by ATZ (200 mg/kg body weight/day) plus Acacia nilotica (400 mg/kg/day). Group IV received Acacia nilotica only at a dose (400 mg/kg/day). After successive 30 days of the experiment, blood and tissue samples were collected from all groups. Our findings revealed the ability of ATZ to induce toxic effects was observed microscopically in the form of degenerated neurons and vacuolated neuropil of the cerebellum, degenerated hepatocytes, and vacuolation of the follicular cells of the thyroid gland. Furthermore, ATZ significantly elevated AST, ALT, and ALP serum levels and TB concentration, while decreased GSH. DNA fragmentation% and activated caspase-3 expression significantly increased after ATZ exposure. Interestingly, Acacia nilotica administration was able to partially protect the examined organs against the toxic effect of ATZ exposure.

An environmental magnetic record of heavy metal pollution in Vembanad lagoon, southwest coast of India.

Magnetic signature of the iron-bearing minerals archived in sediments is sensitive to change in environment and therefore, studied to reconstruct the signals linked with environmental processes. In the present work, we have analyzed 11 sediment cores from Vembanad lagoon, southwest coast of India, to estimate the magnetic fluctuations associated with environmental processes. Down-core variation in magnetic susceptibility and anhysteretic, isothermal and saturation isothermal remnant magnetization and S and H-ratios have been interpreted to map the degree and spatial distribution of anthropogenic pollution in and around the lagoon. Downcore variation of magnetic susceptibility of Vembanad lagoon sediments varies from 10 to 100 × 10-8 m3/ kg. The top layers of sediment samples from river mouth regions (Periyar and Muvattupuzha rivers) show higher susceptibility values and incidentally these samples are of coarse sized. The subtle variations in SIRM/χlf ratios suggest that there are magnetic grain size differences in the samples. The SIRM and χlf relation suggests that dominant magnetic grain size in sediments. The low ARM/χlf ratios suggest a relatively higher ferrimagnetic contribution and coarser magnetite grain size. Rock magnetism data reveal that the coarse magnetic grain size is affecting the pollution of Vembanad lagoon. We also analyzed downcore variability of metal concentrations such as Fe, Mn, Cu, Zn, Ni and Cr, and all these metals exhibit higher concentrations in the top layers of the cores. Our study suggests that higher values of magnetic parameters and metal concentrations are due to various anthropogenic sources.

Non-invasive index of liver fibrosis induced by alcohol, thioacetamide and Schistosomal infection in mice.

BACKGROUND: Non invasive approaches will likely be increasing utilized to assess liver fibrosis. This work provides a new non invasive index to predict liver fibrosis induced in mice. METHODS: Fibrosis was generated by thioacetamide (TAA), chronic intake of ethanol, or infection with S. mansoni in 240 mice. Both progression and regression of fibrosis (after treatment with silymarin and/or praziquantel) were monitored. The following methods were employed: (i) The METAVIR system was utilized to grade and stage liver inflammation and fibosis; (ii) Determination of hepatic hydroxyproline and collagen; and (iii) Derivation of a new hepatic fibrosis index from the induced changes, and its prospective validation in a group of 70 mice. RESULTS: The index is composed of 4 serum variable including total proteins, gamma-GT, bilirubin and reduced glutathione (GSH), measured in diseased, treated and normal mice. These parameters were highly correlated with both the histological stage and the grade. They were combined in a logarithmic formula, which non-invasively scores the severity of liver fibrosis through a range (0 to 2), starting with healthy liver (corresponding to stage 0) to advanced fibrosis (corresponding stage 3).Receiver operating characteristic curves (ROC) for the accuracy of the index to predict the histological stages demonstrated that the areas under the curve (AUC) were 0.954, 0.979 and 0.99 for index values corresponding to histological stages 1, 2 and 3, respectively. Also, the index was correlated with stage and grade, (0.947 and 0.859, respectively). The cut off values that cover the range between stages 0-1, 1-2 and 2-3 are 0.4, 1.12 and 1.79, respectively. The results in the validation group confirmed the accuracy of the test. The AUROC was 0.869 and there was good correlation with the stage of fibrosis and grade of inflammation. CONCLUSION: The index fulfils the basic criteria of non-invasive marker of liver fibrosis since it is liver-specific, easy to implement, reliable, and inexpensive. It proved to be accurate in discriminating precirrhotic stages.

The extension of epidural blockade for emergency caesarean section: a survey of Scandinavian practice.

BACKGROUND: Little is known about drugs and safety precautions used during epidural top-ups for emergency caesarean section in Scandinavia. We surveyed Scandinavian practice of epidural top-up regimens for emergency caesarean sections. METHODS: Anaesthetic departments in Denmark, Norway and Sweden were identified via National Boards of Health. An electronic questionnaire was sent to Scandinavian specialist anaesthesiologists performing obstetric anaesthesia asking for information on anaesthetic practice for emergency caesarean section. RESULTS: The response rate was 80% (n=145). One hundred and twenty (83%) specialists reported the existence of local guidelines for epidural top-ups. Fourteen (9.7%) specialists gave a full-dose top-up in the delivery room, 34 (23.4%) initiated the top-up with a test-dose, and 87 (60%) only administered local anaesthetics in the operating theatre. Twenty-five different drug combinations for epidural top-ups were reported. Lidocaine was used by 67 (47.9%) and ropivacaine was used by 53 (37.9%). Seventy (50%) specialists added opioid to the top-up, 15 (10.7%) added bicarbonate and 53 (37.9%) supplemented with adrenaline. Median top-up volume ranged from 16 to 19mL for lidocaine, ropivacaine and chloroprocaine. One-hundred-and-eighteen (81%) specialists recommended trainees use the same regimen. Forty (83%) of 48 specialists topping-up in the labour unit had ephedrine readily available. During transport, pulse oximetry was used by nine (19%) and non-invasive blood pressure monitoring by eight (17%). CONCLUSIONS: Epidural top-ups for emergency caesarean section in Scandinavia are used frequently but normally performed in the operating theatre. Drugs used differ greatly between countries and departments although top-up volumes appear similar. During transport, available equipment and drugs were limited. Best practice guidelines and national guidelines present little information on epidural top-ups that could explain the variation found.

Periodontitis in sheep: a model for human periodontal disease.

The use of sheep as a suitable animal model of destructive forms of human periodontal disease has been assessed from comparative radiological, histological, and serological investigations of sheep with and without periodontal disease. The results showed that, in sheep with periodontitis, bone resorption, collagen breakdown, degradation of blood capillary vessel walls, cellular infiltration of plasma cells, lymphocytes, and epithelial infiltration were significantly greater than in sheep without periodontitis, and the features are similar to those in rapidly destructive forms of periodontal disease in man. The levels of serum IgG antibody reactive against B. gingivalis antigens (measured by ELISA) were significantly higher in sheep with periodontitis than those without, similar to the association reported in some types of human periodontal diseases. These findings suggest that periodontitis in sheep could represent a suitable animal experimental model for certain types of rapidly destructive human periodontal diseases.

Modified lingual split technique versus conventional buccal technique in odontectomy of impacted mandibular third molars.

This study was conducted to compare two different techniques used in odontectomy of impacted mandibular third molar; the modified lingual split technique and the conventional buccal technique as regarding the duration of surgery as well as the incidence of postoperative sequelae such as pain, edema, and trismus. This study was carried out on thirty adult male patients having class II, position B mesioangular impacted mandibular third molar scheduled for removal, the cases were divided into two equal groups. Group one using the conventional buccal technique and group two using the modified lingual split technique. Pain was categorized into a three grade scale according to the dose of the analgesic taken by the patients postoperatively. The degree of trismus was calculated by measuring the interincisal distance when the mouth was opened at a maximum using a graduated caliper both preoperatively and postoperatively. Edema was measured linearly using a tape between different predetermined facial anatomical landmarks in different planes. All measurements were carried out immediately before surgery and after one, two and seven days postoperatively. The collected data were tabulated and were statistically analyzed. There was a significant difference between the two techniques as regarding the duration of surgery in favour of the modified lingual split technique, with a mean of 36.3 minutes, in group two against a mean of 54.3 minutes in group I. As regarding pain there was no significant difference in the first and the second postoperative days, while there was a significant difference in favour of the modified lingual split bone technique in the seventh postoperative day. Trismus and edema were comparable in both groups.