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Fluoride (F-), the ion of the element fluorine, is one of the mineral elements present in nature that enters drinking water through underground aquifers and when present in high concentration it can lead to risks such as skeletal, dental, and nonskeletal fluorosis with morbidity such as decreased IQ and negative effects on brain development, tooth discolouration, and bone pain. The aim of the study, was to study the ability of activated carbon developed from almond shell (ACAS), to remove fluoride from an aqueous solution. We examined the effects on fluoride removal efficiency of contact time, initial F-concentration, pH, and ACAS mass. The equilibrium data were also examined with models including the Langmuir, Freundlich, and Temkin isotherms. The removal characteristics were validated through the use of different kinetic models for the estimation of the solute interaction and the nature of the biosorption. A contact time of 60 min, an adsorbent dosage of 0.6 g/L, and a pH of 3 were considered to be the optimal operational conditions. The biosorption of F-onto ACAS and the equilibrium data follow from the Langmuir adsorption isotherm with a maximum adsorption of 84.3 mg/g and a regression coefficient of R2=0.999. The kinetic studies showed that the system fitted the pseudo-second order kinetic model. Thus, this work gives new insights on the interaction of ACAS with F- in a reconstituted aqueous solution. [ABSTRACT FROM AUTHOR]

Background: Bilateral inferior petrosal sinus sampling (IPSS) is used to distinguish pituitary from ectopic adrenocorticotropin (ACTH) excess in patients with ACTH-dependent Cushing's syndrome. Our objective was to examine the utility of prolactin measurement during IPSS with desmopressin (DDAVP) stimulation in localization of the source of ACTH excess. Method: Retrospective review of 20 patients with ACTH-dependent Cushing's syndrome who underwent IPSS with DDAVP stimulation. Baseline, DDAVP-stimulated, and prolactin-normalized ACTH IPS:P (inferior petrosal sinus to peripheral) ratios were calculated. Cut-off values for each test were obtained from receiver-operating characteristic (ROC) curve analysis. Results: Fifteen patients had Cushing disease (CD), and five were diagnosed with ectopic ACTH syndrome (EAS). For the baseline ACTH IPS:P ratio of ≥2, the diagnostic sensitivity (80%), specificity (100%), positive predictive value (PPV) (100%) and negative predictive value (NPV) (62.5%) were calculated. These values for DDAVP-stimulated IPS:P ACTH ratio ≥ 3, were 86.7%, 100%, 100% and 71.4%, respectively. The corresponding value for the prolactin-normalized ACTH IPS:P ratio ≥ 0.8 were 86.6%, 80%, 92.8% and 66.7%. The cut-off value for the baseline, DDAVP-stimulated and prolactin-normalized ACTH IPS:P ratios were 1.76, 3.9, and 0.33, respectively. Conclusion: Prolactin-normalized ACTH IPS:P ratio measurement showed comparable sensitivity and less specificity than baseline/DDAVP-stimulated IPS/P ACTH ratios. Moreover, when baseline and stimulated IPS/P ACTH tests were discordant, prolactin-normalized ACTH IPS: P ratio correctly localized the source of ACTH excess. The sensitivity of the test increased, applying a prolactin-normalized ACTH IPS: P ratio ≥0.33. [ABSTRACT FROM AUTHOR]

The fluoride ion (F) is widely used in different industries, including the semi-conductor, power plant, and glass product industries, and is released into the environment through effluents. Accordingly, the effectiveness of chitosan in the adsorption of F from water was evaluated in this study. At different concentrations of F, the significance of contact duration, pH, and adsorbent dose was examined in laboratory conditions. To understand the mode of adsorption and its kinetics, the Langmuir, Freundlich, and Temkin isotherms and the pseudo-first-order, the pseudosecond order, and the intraparticle diffusion model equations for the equilibrium adsorption data were analyzed. The results for the adsorption of F onto chitosan were best described by the Langmuir isotherm and the pseudo-second order models with the correlation values for both being 0.997. A contact time of 180 min, an adsorbent dosage of 5 g/L, and a pH of 7 were considered to be the optimal operational conditions and gave a fluoride removal efficiency of 87%. We conclude that, fluoride adsorption by chitosan can effectively remove fluoride from water. [ABSTRACT FROM AUTHOR]

Objective: To compare clinical outcomes of large pituitary adenomas (≥3 cm in maximum diameter), operated on by Endoscopic Transsphenoidal Surgery (ETS), versus Microscopic Transsphenoidal Surgery (MTS). Methods: Medical records and MRI Scans of patients with a diagnosis of pituitary adenoma for whom transphenoidal surgery was done were reviewed. Complete pre and post-operative data were available for 121 patients. Thirty five patients had large pituitary adenoma and were enrolled in this study. ETS was done in 16 patients, and 19 underwent MTS. All patients were followed for at least six months. Clinical and imaging characteristics were reported in details. Post-operative clinical outcomes were defined as clinical outcomes persisted 6 months after surgery. Results: The average tumor size was 36.3 ± 4.4 mm in ETS group, and 34.0 ± 4.6 mm in MTS group, (p = .46). Six months after surgery, tumor size was 4.6 ± 6.6 mm in ETS and 17.7 ± 12.2 mm in MTS group, (p = .002). Gross total resection (GTR) was observed in the 81.2% of the patient in the ETS group. In the MTS group, GTR was observed in 15.8%. Post-operative clinical outcomes including new onset hypopituitarism, visual impairment, and permanent diabetes insipidus (DI) were comparable between the two groups. Conclusion: ETS is superior to MTS in treatment of large pituitary adenomas with comparable post-operative complications. [ABSTRACT FROM AUTHOR]

Three novel allyl-containing alkoxysilanes, allyl 3-(trimethoxysilyl) propyl ether (ATSE), allyl 3-(trimethoxysilyl) propyl thioether (ATST) and 4-(trimethoxysilyl) propyloxy-4-methacryloxydiphenyl sulfone (TSMS) were prepared by the condensation reaction of allyl alcohol with chloropropyltrimethoxysilane (CPTS), allyl chloride with (3-mercaptopropyl)-trimethoxysilane (MPTS) and methacrylic acid with bis (4-hydroxyphenyl) sulfone and also with CPTS, respectively. Also acrylic groups were hybrid with alkyds via free radical chemistry. The alkyd comprised soybean oil, glycerol and phthalic anhydride. To closely model acrylated-alkyds, a mixture of acrylic monomers were copolymerized with the alkyd including: methyl methacrylate (MMA), butyl acrylate (BA), methacrylic acid (MAA), and alkoxysilanes ATSE, ATST and/or MPTS. [ABSTRACT FROM AUTHOR]

Background: Primary macronodular adrenocortical hyperplasia (PMAH) is a rare form of adrenal Cushing's syndrome with incomplete penetrance which may be sporadic or autosomal dominant. The inactivation of the ARMC5 gene, a potential tumor suppressor gene, is one of the associated causes of PMAH. This study aimed to identify the variant responsible for Iranian familial PMAH. Methods: The proband, a 44-year-old woman, was directed to whole-exome sequencing (WES) of the blood sample to discover a germline variant. In addition, the identified causative variant was confirmed and segregated in other and available unaffected family members. Results: The novel germline heterozygous missense variant, c.2105C>A in the ARMC5 gene, was found, and the same germline variant as the proband was confirmed in two affected sisters. This variant was detected in the brother of the proband with an asymptomatic condition and this considered because of incomplete penetrance and age-dependent appearance. The function of the ARMC5 protein would be damaged by the identified variant, according to in silico and computer analyses that followed. Conclusion: The new germline ARMC5 variation (c.2105C>A, (p. Ala702Glu)) was interpreted as a likely pathogenic variant based on ACMG and Sherloc standards. PMAH may be diagnosed early using genetic testing that shows inherited autosomal dominant mutations in the ARMC5 gene. [ABSTRACT FROM AUTHOR]

Background: Pituitary adenomas impose a burden of morbidity on patients and characterizing the molecular mechanisms underlying its pathogenesis received remarkable attention. Despite the appealing role of necroptosis as an alternative cell death pathway in cancer pathogenesis, its relevance to pituitary adenoma pathogenesis has yet to be determined that is perused in the current study. Methods: The total number of 109 specimens including pituitary adenomas and cadaveric healthy pituitary tissues were enrolled in the current study. Tumor and healthy pituitary tissues were subjected to RNA extraction and gene analysis using Real-Time PCR. The expression levels of necroptosis markers (RIP1K, RIP3K and, MLKL) and their association with the patient's demographic features were evaluated, also the protein level of MLKL was assessed using immunohistochemistry in tissues. Results: Based on our data, the remarkable reduction in RIP3K and MLKL expression were detected in nonfunctional and GH-secreting pituitary tumors compared to pituitary normal tissues. Invasive tumors revealed lower expression of RIP3K and MLKL compared to non-invasive tumors, also the attenuated level of MLKL was associated with the tumor size in invasive NFPA. The simultaneous down-regulation of MLKL protein in pituitary adenoma tissues was observed which was in line with its gene expression. While, RIP1K over-expressed significantly in both types of pituitary tumors which showed no significant correlation with patient's age, gender and tumor size in GHPPA and NFPA group. Notably, MLKL and RIP3K gene expression was significantly correlated in the GHPPA group. Conclusions: According to our data, the reduced expression of necroptosis mediators (RIP3K, MLKL) in pituitary adenoma reinforces the hypothesis that the necroptosis pathway can be effective in regulating the proliferation and growth of pituitary tumor cells and tumor recurrence. [ABSTRACT FROM AUTHOR]

The aim of this study was to identify risk factors of in-hospital mortality among diabetic patients infected with COVID-19. This is a retrospective cohort study. Using logistic regression analysis, the independent association of potential prognostic factors and COVID-19 in-hospital mortality was investigated in three models. Model 1 included demographic data and patient history; model 2 consisted of model 1, plus vital signs and pulse oximetry measurements at hospital admission; and model 3 included model 2, plus laboratory test results at hospital admission. The odds ratios (ORs) and 95% confidence intervals (95% CIs) were reported for each predictor in the different models. Moreover, to examine the discriminatory powers of the models, a corrected area under the receiver-operating characteristic curve (AUC) was calculated. Among 560 patients with diabetes (men = 291) who were hospitalised for COVID-19, the mean age of the study population was 61.8 (standard deviation [SD] 13.4) years. During a median length of hospitalisation of 6 days, 165 deaths (men = 93) were recorded. In model 1, age and a history of cognitive impairment were associated with higher mortality; however, taking statins, oral antidiabetic drugs and beta-blockers was associated with a lower risk of mortality (AUC = 0.76). In model 2, adding the data for respiratory rate (OR 1.07 [95% CI 1.00–1.14]) and oxygen saturation (OR 0.95 [95% CI 0.92–0.98]) slightly increased the AUC to 0.80. In model 3, the data for platelet count (OR 0.99 [95% CI 0.99–1.00]), lactate dehydrogenase (OR 1.002 [95% CI 1.001–1.003]), potassium (OR 2.02 [95% CI 1.33–3.08]) and fasting plasma glucose (OR 1.04 [95% CI 1.02–1.07]) significantly improved the discriminatory power of the model to AUC 0.86 (95% CI 0.83–0.90). Among patients with type 2 diabetes, a combination of past medical and drug history and pulse oximetry data, with four non-expensive laboratory measures, was significantly associated with in-hospital COVID-19 mortality. [ABSTRACT FROM AUTHOR]

Background: Pituitary adenomas as multifactorial intracranial neoplasms impose a massive burden of morbidity on patients and characterizing the molecular mechanism underlying their pathogenesis has received considerable attention. Despite the appealing role of cyclooxygenase enzymes and their bioactive lipid products in cancer pathogenesis, their relevance to pituitary adenoma pathogenesis is debated and yet to be determined. Thus, the current study perused this relevance. Methods: The expression level of the isoforms of cyclooxygenase (COX-1 and COX-2) was evaluated in hormone-secreting and in-active pituitary adenoma tumors and normal pituitary tissues through Real-Time PCR. The level of PGE2, as the main product of enzymes, was assessed using enzyme immunoassay kits in patients and healthy subjects. Results: The results of the current study demonstrated that COX-1 and COX-2 expression levels were increased in pituitary tumors including non-functional pituitary adenoma (NFPA), acromegaly, Cushing's disease and prolactinoma compared with normal pituitary tissues. A significant expression level of COX-2 was observed in NFPA compared with the other pituitary tumors. Furthermore, the COX-2 expression level was significantly increased in macroadenoma and invasive tumors. The level of PGE2 was consistent with COX enzymes enhanced in pituitary adenoma tumors compared with healthy pituitary tissue. A significant elevation in the PGE2 level was detected in NFPA compared with hormone-secreting pituitary tumors. Additionally, the PGE2 level was increased in macroadenoma compared with microadenoma and in invasive compared with non-invasive pituitary tumors. The diagnostic values of cyclooxygenase isoforms and PGE2 were considerable between patients and healthy groups; however, COX-2 revealed more value in distinguishing endocrinologically active and non-active pituitary tumors. Conclusions: Data from the current study provides expression patterns of COX-1, COX-2 and PGE2 in prevalent pituitary tumors and their association with patients' clinical features which may open up new molecular targets for early diagnosis/follow up of pituitary tumor growth. [ABSTRACT FROM AUTHOR]

Abstract This systematic review and meta-analysis of randomized controlled trials (RCTs) was performed to evaluate the effect of probiotic and symbiotic supplementation on inflammatory markers among patients with diabetes. Clinical trials were searched using Cochrane Library, EMBASE, PubMed, and Web of Science online databases for relevant trials published until April 2018. Two independent investigators evaluated study eligibility, extracted data, and assessed risk of bias of included clinical trials. Cochran's Q test and I-square (I2) statistic were used to detect heterogeneity among the included. Data were pooled by using the random-effect model and standardized mean difference (SMD) was considered as the summary effect size. From 986 originally identified publications 18 clinical trials with a total of 1337 patients were included. Findings showed that probiotic and synbiotic supplementation among patients with diabetes significantly decreased tumor necrosis factor-α (TNF-α) (SMD = −2.99; 95% CI, −4.77, −1.20; P = 0.001; I2: 96.3), and C-reactive protein (CRP) (SMD = −0.87; 95% CI, −1.27, −0.48; P < 0.001; I2: 90.2); while significantly increased nitric oxide (NO) concentrations (SMD = 1.49; 95% CI, 0.81, 2.16; P < 0.001; I2: 92.1). There were no effects of probiotic and synbiotic supplementation on interleukin-6 (IL-6) levels (SMD = −0.65; 95% CI, −1.88, 0.59; P = 0.30; I2: 94.7). In summary, the current meta-analysis demonstrated probiotic and synbiotic supplementation among patients with diabetes significantly decreased CRP and TNF-α, and increased NO levels, but did not affect IL-6 levels. [ABSTRACT FROM AUTHOR]

Background: This study was designed to present initial results on clinical presentation, therapeutic modalities, and outcome information of patients with pituitary tumors registered in Iran Pituitary Tumor Registry (IPTR). Methods: We collected data from a web-based electronic medical records of patients with various pituitary tumors referred to four tertiary care centers in the country. Retrospective analysis was performed on demographic, clinical, and therapeutic information of 298 patients including 51 clinically nonfunctioning adenoma (CNFA), 85 acromegaly, 135 prolactinoma, and 27 Cushing's disease (CD). Results: From October 2014 to July 2016, 298 people with the diagnosis of pituitary tumor were registered. Prolactinoma was the most prevalent tumor (45.3%), followed by Acromegaly (28.6%), CNFPA (17.1%), and CD (9%). Female dominance was seen among patients with prolactinoma and CD, while the majority of patients with CNFPA were male and acromegaly was equally distributed between men and women. Hypogonadal symptoms were almost always seen in all types of pituitary groups. Surgery alone was the most common therapeutic modality used in cases of acromegaly, CNFPA, and CD. However, medical therapy alone was frequently applied for cases of prolactinoma. Finally, biochemical cure was achieved in most cases of prolactinoma and CD, but only in 36.5% of acromegalics. Moreover, 80% of patients suffering from CNFPA showed no residual tumor in their imaging. Conclusion: In conclusion, this comprehensive tumor registry enables early identification, selection of best therapeutic approaches, and evaluation of long-term treatment outcomes. Furthermore, this registry can be used to improve surveillance protocols. [ABSTRACT FROM AUTHOR]

The main aim of this study was to evaluate the efficiency of natural zeolite for Cr(VI) removal from aqueous solutions. Following simple modification of adsorbent, the effect of operational parameters including pH (2-10), adsorbent dosage (2-20 g/L), contact time (5-150 min) and Cr(VI) concentration (10-50 mg/L) were studied according to one-factor-at-a-time procedure. The maximum Cr(VI) removal of 99.53% was obtained at initial pH of 2, contact time of 30 min, adsorbent dosage of 8 g/L and initial chromium concentration of 10 mg/L. The Freundlich isotherm was best fitted with experimental data (R2 = 0.951). Also, type 1pseudo second order kinetic model showed the most correlation (R2 = 1) with the experimental data. According to obtained results, it can be concluded that the application of clay-like adsorbents such as natural clinoptilolite zeolite can be considered as an efficient alternative for final treatment of effluents containing Cr(VI). [ABSTRACT FROM AUTHOR]

Thermally activated persulfate efficiency for the treatment of a recalcitrant high TDS wastewater was investigated. The specific character of studied wastewater was high TDS content of around 23820 mg/L and BOD5/COD ratio of 0.07. Effective operational parameters including initial pH values of 3-9, reaction temperature of 40-80°C and persulfate concentrations of 0.5-5 g/L for COD removal were investigated in batch mode experiments. Removal efficiency was pH and temperature dependent. The COD and TOC removal of 94.3% and 82.8% were obtained at persulfate concentration of 4 g/L, initial pH value of 5 and temperature of 70°C after 180 min for initial COD concentration of 1410 mg/L. The pseudo first-order kinetic model was best fitted with COD removal (R2 = 0.94). [ABSTRACT FROM AUTHOR]

Abstract: Background: Restless legs syndrome (RLS) is a common disorder in hemodialysis patients that leads to insomnia and impaired quality of life. Because high oxidative stress has been implicated in the pathogenesis of RLS, we sought to evaluate the efficacy of vitamins C and E and their combination in reducing the severity of RLS symptoms in hemodialysis patients in this randomized, double-blind, placebo-controlled, four-arm parallel trial. Methods: Sixty stable hemodialysis patients who had all four diagnostic criteria for RLS developed by the International Restless Legs Syndrome Group with no acute illness or history of renal stone were randomly allocated to four fifteen-patient parallel groups to receive vitamin C (200mg) and vitamin E (400mg), vitamin C (200mg) and placebo, vitamin E (400mg) and placebo, and double placebo daily for eight weeks. International Restless Legs Scale (IRLS) scores were measured for all patients at baseline and at the end of treatment phase. The primary outcome was absolute change in IRLS sum score from baseline to the end of treatment phase. Results: Means of IRLS sum score decreased significantly in the vitamins C and E (10.3±5.3, 95%CI: 7.4–13.3), vitamin C and placebo (10±3.5, 95%CI: 8.1–11.9), and vitamin E and placebo groups (10.1±6, 95%CI: 6.8–13.5) compared with the double placebo group (3.1±3, 95%CI: 1.5–4.8), (P <0.001); however, no differences were observed between these treatment groups. Conclusions: Vitamins C and E and their combination are safe and effective treatments for reducing the severity of RLS in hemodialysis patients over the short-term. [Copyright &y& Elsevier]

Background: Pituitary adenoma accounts as a complex and multifactorial intracranial neoplasm with wide range of clinical symptoms which its underlying molecular mechanism has yet to be determined. The bioactive lipid mediators received attentions toward their contribution in cancer cell proliferation, progression and death. Amongst, 15-Lipoxygense (15-Lox) enzymes and products display appealing role in cancer pathogenesis which their possible effect in pituitary adenoma tumor genesis is perused in the current study. Methods: The 15-Lipoxygenses isoforms expression level was evaluated in tumor tissues of prevalent functional and non-functional pituitary adenomas and normal pituitary tissues via Real-Time PCR. The circulating levels of 15(S) HETE and 13(S) HODE as 15-Lox main products were assessed in serum of patients and healthy subjects using enzyme immunoassay kits. Results: Our results revealed that 15-Lox-1 and 15-Lox-2 expression levels were elevated in tumor tissues of pituitary adenomas comparing to normal pituitary tissues. The elevated levels of both isoforms were accompanied with 15(S) HETE and 13(S) HODE elevation in the serum of patients. The 15-Lox-1 expression and activity was higher in invasive tumors as well as tumors with bigger size indicating the possible pro-tumorigenic role of 15-Lox-1, more than 15-Lox-2 in pituitary adenomas. The diagnostic value of 15-Lipoxygense isoforms and products were considerable between patients and healthy groups. Conclusion: The possible involvement of 15-Lipoxygense pathway especially 15-Lox-1 in the regulation of pituitary tumor growth and progression may open up new molecular mechanism regarding pituitary adenoma pathogenesis and might shed light on its new therapeutic strategies. [ABSTRACT FROM AUTHOR]