Search

Introduction Methods Results Conclusion Currently, there are two approved single chamber leadless pacemakers (LP) in the United States (US), Micra VR™; approved since 2016 and AVEIR VR™; approved in 2022. A potential complication of LPs is dislodgement and/or embolization (D/E) during or after implant. According to the IDE trials, there appears to be a significant difference in D/E rates between the two LPs that have different fixation mechanisms; Micra uses nitinol tines, while AVEIR uses an active screw helix. The aim of this study was to determine if the AVEIR VR LP has continued to exhibit D/E in the United States since it was approved by the Food and Drug Administration (FDA) in April 2022.The FDA Manufacturer and User Facility Device Experience (MAUDE) database was searched for US D/E reports communicated by the manufacturers of both LP devices. For AVEIR VR we reviewed reports from approval till December 2023, and for Micra VR we looked at reports from approval to April 2024. Excluded were reports based on information indirectly obtained from registries, journals, social media, or volunteers. Total number of US implants was acquired from the manufacturers' product performance reports.During a period of 21 months, 5990 AVEIR VR implants had been registered in the United States, of which 53 (0.88%) encountered D/E both during and after the procedure. More D/E (32; 60.4%) occurred during the implantation procedure, with device release problems being the most prominent procedural issue involved with these events. Within a 8‐year period, 72 237 Micra VR implants have been registered in the United States, of which 211 (0.29%) showed D/E. The rate of D/E since the US approval of both devices was significantly higher for AVEIR VR compared to Micra VR (0.88% vs 0.29%; p < .0001).AVEIR VR implants may be complicated by dislodgement with or without embolization. Currently, the estimated incidence is about 0.9%, which is significantly higher than Micra VR. Fixation issues and separation problems of the device from the delivery catheter appear to be responsible for most of these D/E events. [ABSTRACT FROM AUTHOR]

Introduction Methods Results Conclusions The Medtronic Micra VR and Abbott AVEIR VR are the leadless pacemakers (LPM) currently available in the United States (US). Micra VR employs fixation tines and the AVEIR VR uses an active fixation helix. Micra VR requires fixation before electrical measurements are obtained, while R‐waves may be mapped by AVEIR VR without fixation. Little comparative data is available for these LPMs. Accordingly, we compared the incidences of procedure‐related major adverse clinical events (MACE) and device problems in the US for Micra VR and AVEIR VR during 2022–2024.We searched the FDA's Manufacturer and User Facility Device Experience (MAUDE) database for US reports of MACE and device problems that were filed from April 2022 to December 2023 for AVEIR VR, and from June 2022 to April 2024 for Micra VR. Totals for US‐registered LPM implants were obtained from the manufacturers' product performance reports.During the study period, 5990 AVEIR VR and 10 940 Micra VR implants were registered in the US. We found 305 MAUDE reports for AVEIR VR (5.1%), versus 541 MAUDE reports for Micra VR (4.9%) (p = .702). The incidence of MACE was 0.72% (43/5990) for AVEIR VR versus 0.59% (65/10 940) for Micra VR, (p = .387). The incidences of procedure‐related death, cardiac perforation. cardiac arrest, emergency pericardial drainage or reparative surgery were similar for both LPMs (p > .05). Micra VR had more unacceptable thresholds requiring LPM replacement compared to AVEIR VR (95;0.9% vs. 24;0.4%; p = .001). AVEIR VR had a statistically higher incidence of device dislodgement during (32) and after (21) implant compared to Micra VR (53 (0.9%) vs. 46 (0.4%), p < .001).Micra VR and AVEIR VR have similar procedural safety profiles, including the incidences of death and perforation. However, device problems differed significantly, possibly related to their design differences. Compared to Micra VR, AVEIR VR appears to have an advantageous threshold measurement capability but is more prone to device dislodgement. [ABSTRACT FROM AUTHOR]

Background: Among various growth parameters, liver and spleen size is an important parameter used for the evaluation of patients with certain disorders and abnormalities in these organs. Aim: To determine the normal dimensions for the liver, spleen, and kidney in Egyptian infants, children, and adolescents from birth to 18 years. Methods: This cross-sectional randomized study was conducted on 1861 Egyptian infants, children, and adolescents from birth to 18 years for the establishment of Z score reference of liver, spleen, and kidney parameters. Results: Egyptian children of both sexes (51.5% boys and 48.5% girls) from birth to 18 years old were studied. Then Z scores reference for liver, spleen, and kidney parameters for both sexes were represented in detailed tables and graphs. There was no statistically significant difference between both sexes, so we used unisex tables and graphs (P > 0.05). Conclusions: Determination of pathologic changes in the size of the liver, spleen, and kidney necessitates knowing the normal range of dimensions for these organs. So, our study established a Z score chart for normal values of liver, spleen, and kidney size for children and adolescents from birth to 18 years. [ABSTRACT FROM AUTHOR]

Background: Mechanical thrombectomy (MT) is the standard treatment for acute large vessel occlusion (LVO). Recurrent LVO can still occur in patients who already underwent MT for the first LVO. This study aimed to evaluate the efficacy of repeating MT for recurrent LVO. Methods: This meta-analysis of the available literature was conducted to summarize the current evidence regarding repeated MT outcomes in patients with recurrent LVO. All studies with ≥ 1 outcomes of interest were included. The Newcastle-Ottawa Scale (NOS) was used for risk of bias assessment. Results: Twenty studies, 10 observational (n = 21,251 patients) and 10 case reports (n = 10 patients), were included. 266 patients (62.78% females) with recurrent LVO were identified, with an overall prevalence of 1.6% and a mean age of 65.67 ± 16.23 years. Cardio-embolism was the most common mechanism in both times, with a median of 15 days between the first and second LVOs. Compared with pre-intervention, the first and second MTs significantly reduced the National Institute of Health Stroke Scale (NIHSS) score, (mean difference (MD) = −8.91) and (MD = −5.97) respectively, with a significant difference (p = 0.001). The rate of favorable outcome (modified Rankin scale (mRS) score 0–3) was 82.6% and 59.2% after the first and second MTs respectively, with a significant difference (p < 0.001). Conclusion: In properly selected recurrent LVO patients, repeated MT is efficacious and safe. A prior MT procedure should not discourage aggressive treatment as many patients may achieve favorable outcomes. [ABSTRACT FROM AUTHOR]

Introduction: Since the start of the COVID‐19 pandemic, data published on the immunogenicity of the SARS‐CoV‐2 BNT 162B2 vaccine in pediatric patients receiving renal replacement therapy are scant. Our primary objective is to study this population's humoral immune response to the COVID‐19 vaccine. Methods: Pediatric kidney transplant recipients (PKTRs) and hemodialysis recipients (HR) at our center who received two doses of the SARS‐CoV‐2 BNT 162B2 vaccine were included. Transplant and HR who had PCR‐positive COVID‐19 infections during the study, regardless of their vaccine status, were also included. SARS‐CoV‐2 anti‐spike protein (S1/S2) IgG was measured after the second dose of the vaccine and after any PCR‐positive COVID‐19 infection as routine clinical practice. Data on demographics, induction, maintenance immunosuppressants, type of transplant, and posttransplant or dialysis duration were included. Results: Of the 61 patients included, 19 were dialysis recipients who received two doses of vaccine without subsequent infection (HV), and 42 were kidney transplant recipients. All dialysis patients and 33 (78.6%) transplant recipients received two doses of the SARS‐CoV‐2 BNT 162b2 vaccine. A total of 33.3% (11/33) of the transplant recipients who received vaccination developed COVID‐19 infection (KTH) at a median time of 13 days after the second dose of vaccine. Nine transplant patients had pure COVID‐19 infection without vaccination (KTI). The seroconversion rate in the HV group was 94.7% (18/19) compared to 50% (11/22) in the kidney transplant vaccine recipients who did not develop subsequent COVID‐19 infection (KTV) (p <.001). The median S1/S2 IgG titers for the HV group were 400 AU/mL versus 15 AU/mL in the KTV group (p <.0001). There was no significant difference in the duration of the test from the second dose of the vaccine between HV and KTV (55 vs. 33.5 days, p =.095). The KTH had higher titers than KTV group (370 vs. 15 p <.0001). The median duration of the test after vaccination in the vaccine group and those with hybrid immunity was similar (35 vs. 33.5 days, p =.2).There were no clear predictors for seroconversion in the PKTRs. Natural infection alone was as good as the vaccine in eliciting humoral immune response. Conclusion: The humoral immune response to two doses of the SARS‐CoV‐2 BNT 162B2 vaccine in PKTRs without subsequent COVID‐19 infection is suboptimal compared to that in hemodialysis recipients and in PKTRs with hybrid immunity from both infection and vaccination. [ABSTRACT FROM AUTHOR]

Subglacial lakes form beneath ice sheets and ice caps if water is available and if bedrock and surface topography are able to retain the water. On a regional scale, the lakes modulate the timing and rate of freshwater flow through the subglacial system to the ocean by acting as reservoirs. More than 100 hydrologically active subglacial lakes that drain and recharge periodically have been documented under the Antarctic Ice Sheet, while only approximately 20 active lakes have been identified in Greenland. Active lakes may be identified by local changes in ice topography caused by the drainage or recharge of the lake beneath the ice. The small size of the Greenlandic subglacial lakes puts additional demands on mapping capabilities to resolve the evolving surface topography in sufficient detail to record their temporal behaviour. Here, we explore the potential for using CryoSat-2 swath-processed data, together with TanDEM-X digital elevation models, to improve the monitoring capabilities of active subglacial lakes in Greenland. We focus on four subglacial lakes previously described in the literature and combine the data with ArcticDEMs to obtain improved measurements of the evolution of these four lakes. We find that with careful tuning of the swath processor and filtering of the output data, the inclusion of these data, together with the TanDEM-X data, provides important information on lake activity, documenting, for example, that the ice surface collapse basin on Flade Isblink Ice Cap was 50 % (30 m) deeper than previously recorded. We also present evidence of a new, active subglacial lake in southwestern Greenland, which is located close to an already known lake. Both lakes probably drained within 1 month in the summer of 2012, which suggests either that they are hydrologically connected or that the drainages were independently triggered by extensive surface melt. If the hydrological connection is confirmed, this would to our knowledge be the first indication of hydrologically connected subglacial lakes in Greenland. [ABSTRACT FROM AUTHOR]

The most frequent PROMs in allergen immunotherapy trials include total nasal symptom score (TNSS), total ocular symptom score (TOSS), total symptom score (TSS) and visual analogue scales (VASs). The TOSS was less well correlated with RQLQ and VAS-RS.[5] Although ocular symptoms are bothersome and affect RQLQ, RQLQ may not be optimal at reflecting ocular symptoms. Patient-reported outcome measures in birch pollen allergic patients treated with sublingual immunotherapy reflect real life. [Extracted from the article]

Background: Tissue Doppler Imaging (TDI) modality is frequently utilized to evaluate cardiac function. TDI velocities and timings vary with age and growth. Data about normal TDI values in the first two years of life is limited. Also, reference values of TDI differ according to racial and environmental factors. Objective: This research aimed to identify the normal values and introduce Z scores for left ventricular pulsed TDI timings and velocities in Egyptian children as well as investigate the impact of age, heart rate (HR), body surface area (BSA), and gender on TDI timings and velocities. Methods: For 208 healthy children with an age range between two months and two years, a pulsed TDI examination was applied using the apical four chamber view at the septal and lateral mitral annuli during ventricular systole and early and late diastole. We measured systolic, early and late diastolic velocities, isovolumic contraction, isovolumic relaxation and ejection times (ETs). Also, mitral closure to opening time (MCOT) and Tie index were obtained. The association between TDI velocities and timings and different demographic variables were analyzed using linear regression model. Results: Normal values and Z score graphs for most of left ventricular TDI velocities and time intervals were demonstrated. TDI velocities and timings were positively correlated with age and BSA while negatively correlated with HR and not affected by sex. Conclusion: We present reference values of left ventricular TDI parameters in pediatric Egyptian children from two months to two years of age and demonstrate the effect of growth on TDI velocities. [ABSTRACT FROM AUTHOR]

Cardiovascular diseases (CVDs) are the most common cause of mortality worldwide. In acute cardiovascular conditions, time is a crucial player in the outcomes of disease management. Given the ease and noninvasiveness of obtaining saliva, salivary biomarkers may provide a rapid and efficient diagnosis of CVD. Here, we reviewed the published data on the value of salivary molecules for diagnosis of CVD, especially in acute care settings. In this review, we show that some biomarkers such as salivary creatinine kinase myocardial band, C‐reactive protein, troponin‐1, and myoglobin exhibited promising diagnostic values that were comparable to their serum counterparts. Other molecules were also investigated and showed controversial results, including myeloperoxidase, brain natriuretic peptide, and some oxidative stress markers. Based on our review, we concluded that the clinical use of salivary biomarkers to diagnose CVD is promising; however, it is still in the early stage of development. Further studies are needed to validate these findings, determine cutoff values for diagnosis, and compare them to other established biomarkers currently in clinical use. [ABSTRACT FROM AUTHOR]

Objectives Evaluation of the predictive value of serial estimations of serum presepsin (PSP), C-reactive protein (CRP), and procalcitonin (PCT) for the development of infective complications and/or anastomotic leakage (AL) after elective colorectal resection with anastomosis for N0M0 colorectal cancers. Patients and methods During 7-year study period, 113 patients underwent colorectal resection; postoperative (PO) morbidities were graded according to the comprehensive complication index (CCI). Five venous blood samples (T1–5) were collected at the time of induction of anesthesia, immediate, 1 day, 3 days, and 5 days after surgery for blood leukocytic count, and calculation of neutrophil-to-lymphocyte ratio and estimation of serum levels of the studied cytokines. Study outcome is the ability of serum cytokines' levels estimated in T2 sample to predict the possibility for the development of AL. Results Incidence of PO infective morbidities was 31%, incidence of AL was 8.85%, and PO mortality rate was 2.65%. Operative time was significantly longer; the total score of the CCI was significantly higher and PO hospital stay was significantly longer for patients who had AL. Patients who developed AL had significantly higher neutrophil-to-lymphocyte ratio in T3–5 samples than in the T1 sample. Mean serum levels of the studied cytokines were significantly higher in T2–5 samples than in T1 sample with significantly higher levels in patients who developed AL. Regression analysis defined high serum levels of PSP and PCT in the T3 sample and CRP levels in T5 sample as predictors of AL and high levels of the three biomarkers in the T3 sample could predict mortality. Automatic linear regression defined high serum PSP levels in the T3 sample and long operative time as significant predictors for high CCI and bad outcome with accuracy rates of 61 and 39%, respectively. Conclusion The level of serum biomarkers could predict AL, but PSP was superior to CRP and PCT. High serum PSP levels in T2 sample can accurately predict high CCI for PO complications. [ABSTRACT FROM AUTHOR]

Introduction Pilonidal sinus (PNS) disease is distributed in young adults who are supposed to be healthy with maximum productivity. Wide local excision creates a tissue gap, while the concept of minimal excision preserves healthy tissues with minimal tissue gap. Objectives The aim of the study was to evaluate the efficiency of minimal excision technique after 9 years of experience. Patients and methods This retrospective study involved 205 consecutive patients with sacrococcygeal PNS. All patients were treated surgically with minimal excision and primary closure. Follow-up included wound seroma, infection, or disruption, in addition to sick leave and PNS recurrence. Results PNS minimal excision was performed on 205 patients. The mean operative time was 33 min. The hospital stay ranged from 7 to 12 h. Healing time was 12–22 days. Time to remove the drain 4–7 days. Seroma developed in 4.39%, simple wound infection 6.8%, significant wound infection 2.9%, and recurrence in 1.46%. Patients with recurrence shared the criteria of being obese with deep clefts and poor hygiene. Conclusion Minimal excision and primary closure is a safe and easy operative procedure, applicable to primary, recurrent, and complex branched cases with good results in wound healing and low recurrence rate. [ABSTRACT FROM AUTHOR]

Introduction: Parkinson's disease (PD) is a chronic neurodegenerative disorder that presents with motor and non‐motor manifestations. Amongst the non‐motor features, various forms of sleep disturbances can occur, and obstructive sleep apnea (OSA) is considered to be a common comorbidity. We conducted this systematic review and meta‐analysis to assess the impact of OSA on cognitive and motor functions in PD. Methods: The information sources of for this systematic review and meta‐analysis were PubMed, SCOPUS, Web of Science, and ScienceDirect. Studies meeting the following criteria were included: (1) studies including idiopathic PD patients, (2) studies using polysomnography to categorize PD patients into PD with OSA and PD without OSA, and (3) studies with observational designs (case–control, cohort, or cross‐sectional). Data analysis was performed using RevMan. Results: Our meta‐analysis showed that OSA was associated with significantly lower scores of Montreal Cognitive Assessments (MoCA) (mean difference (MD) = −0.70, 95% confidence interval (CI) [−1.28, −0.13], P = 0.01) and Mini‐Mental State Examination (MMSE) (MD = −0.69, 95% CI [−1.17, −0.21], P = 0.005). Moreover, the score of the motor part of the Unified Parkinson's Disease Rating Scale (UPDRS III) was significantly higher in PD patients with OSA as compared with those without OSA (MD = 1.63, 95% CI [0.03, 3.23], P = 0.049). Conclusions: OSA is associated with increased severity of PD‐associated cognitive dysfunction and motor symptoms. However, further studies are needed to corroborate these findings, assess the underlying mechanisms by which OSA influences the motor and cognitive functions in PD, and investigate whether OSA can accelerate the neurodegenerative process of PD. © 2020 International Parkinson and Movement Disorder Society [ABSTRACT FROM AUTHOR]

Giant cell tumors (GCT) of the bone are uncommon primary bone neoplasms that occur mainly in the epiphyses of long bones. Their incidence in craniofacial skeleton is rare, particularly in the maxilla. We report a case of a 12-year-old patient with a GCT of the left maxilla, who underwent a surgical excision of whole mass, and showed no recurrence one year after intervention. [ABSTRACT FROM AUTHOR]

Objective The aim was to investigate cases of postlaparoscopic cholecystectomy (LC) bile leakage and aim to check if endoscopic retrograde cholangiopancreatography (ERCP) is mandatory for every patient or only for selected cases. Patients and methods The present study includes 35 patients who had a bile leak following LC and subjected to conservative (nonoperative) management and had a patent biliary tree and normal anatomy in the magnetic resonance cholangiopancreatography (MRCP) study. Patients were distributed into two groups. Group A included 20 patients who did not undergo an ERCP, while the second group included 15 patients who underwent an ERCP from the start. The efficacy and outcomes of both lines of management and the time needed to fistula closure were studied. Data were collected, recorded, and statistically analyzed. The results In group A, conservative management succeeded in 18/20 of patients, while the remaining two patients were sent to undergo ERCP due to a distressing bile leakage after a time of conservative management. In group B, the first ERCP failed to help in the cessation of bile leak in 2/15 patients (13%), so they underwent a second ERCP. The mean hospital stay was higher (but not significant) in the non-ERCP group, 5.19±4.72 vs 4.88±3.41 days in the ERCP group. The pain scores, fever, and many other morbidities were higher in the ERCP group. Conclusion In post-LC bile leak, ERCP is not mandatory for patients who have a patent biliary tree with normal anatomy in MRCP study. In these patients, ERCP is better to be avoided as an initial step and should be restricted to the resistant cases. [ABSTRACT FROM AUTHOR]

Alzheimer's disease (AD) is the most common neurodegenerative disease in the world. Several pathological pathways and genetic alterations have been linked to AD; however, the definitive cause of the disease remains unknown. Recently, an increasing body of evidence suggests that neurodegenerative diseases, including AD, might be triggered by microbial infections. Herpes simplex virus type 1 (HSV1) has been found in brain samples from dead AD patients. At some point of in their lifetime, every person comes into contact with HSV1, but when this enters the brain, it remains latent. However, it was observed that when a person becomes old, and there is a decline in their immunity, the latent HSV1 virus becomes reactivated. The reactivated virus then causes damage to the neural cell DNA and disrupts the DNA repair system, leading to AD. The present review would provide a clear understanding of how HSV1 influences DNA damage, and causes plaque formation and phosphorylation of tau protein, which in turn leads to AD, by inducing the production of interferons that would facilitate the production of specific humoral immunity, which could lead to neurodegeneration. [ABSTRACT FROM AUTHOR]

Interpolation operators are important for many applications in scientific computing. During numerical simulations and especially in the context of anisotropic mesh adaptation, with highly stretched elements, the interpolation step is crucial. However, it reduces conservation of important physical quantities and leads to errors that spoil the solution accuracy. In this paper we present a globally conservative method suitable for both interpolations on unstructured fixed and adaptive anisotropic meshes. It consists in combining an a posteriori error estimator that minimizes the interpolation error of the finite element solution followed by an interpolation with restrictions method that conserves physical properties of the field being interpolated. Several numerical examples, in 2D and 3D, are presented and validated to illustrate the efficiency of the approach. [ABSTRACT FROM AUTHOR]

Supernumerary teeth are extra teeth or tooth-like structures. Single, double, or multiple teeth that occur in one or both jaws may be erupted or unerupted and unilateral or bilateral. Supernumeraries are less common in primary dentition than in permanent dentition. The etiology of ST is still unknown. A number of theories have been postulated to try to explain their presence, including atavism (evolutionary throwback), tooth germ dichotomy, genetic and environmental factors, and hyperactivity of the dental lamina. However, all theories are hypothetical due to the inability to obtain sufficient embryologic material on their origin. The aim of this paper is two present two case reports of non syndromic supernumerary teeth in female patients and their management. [ABSTRACT FROM AUTHOR]

The goal of this work is to exploit the statistical signatures for discrimination between biological tissues and contrast microbubbles in order to develop new strategies for contrast imaging and tissue characterization. For this purpose, the efficiency of the Nakagami statistical model, for describing the ultrasonic echoes of both contrast microbubbles and tissues, was investigated. Experimental measurements have been performed using a linear array probe connected to an open research platform. A commercially available in vitro phantom was used to mimic biological tissue in which SonoVue contrast microbubbles were flowing. Experimental ultrasound echoes have been filtered around the transmitted frequency (fundamental at 2.5 MHz) and around twice the transmitted frequency (at 5 MHz) for 2nd harmonic analysis, and a logarithmic compression was applied. The signals have been analyzed in order to evaluate the Nakagami parameter m , the scaling parameter Ω and the probability density function at both frequencies. Parametric images based on the Nakagami parameters map (Nakagami-mode images) were reconstructed and compared to B-mode images. Contrary to the B-mode image which is influenced by the system settings and user operations, the Nakagami parametric image is only based on the backscattered statistics of the ultrasonic signals in a local phantom. Such an imaging principle allows the Nakagami image to quantify the local scatterer concentrations in the phantom and to extract the backscattering information from the regions of the weakest echoes that may be lost in the conventional B-mode image. Results show that the tissue and microbubbles characterization is more sensitive in the 2nd harmonic mode when a logarithmic transform is used. These results would be useful for improving the ultrasound image quality and contrast detection in nonlinear mode. [ABSTRACT FROM AUTHOR]

Abstract: Using a picosecond pump and probe time-resolved technique we evidence a single pump pulse photo-induced magnetic ordering in a Mn-doped semiconductor magneto-photonic microcavity operating in the strong coupling regime at room temperature. This nanosecond duration magnetization is attributed to a magnetic ordering of the Mn-impurities mediated through photo-generated holes and enhanced through the confinement. It is distinct from the preceding short lived photo-induced spin orientation of carriers also evidenced by our technique for circularly polarized pump beams. The photo-generated magnetic flux density amounts to a 1kG for beam fluences of few tens μJcm−2 and effective Mn concentrations of 5nm−3; large photo-induced magneto-optic Kerr rotations are also evidenced. [Copyright &y& Elsevier]

Alzheimer's disease (AD) is a chronic neurodegenerative disorder affecting millions of people, and its prevalence is expected to continue to grow in the older age population. It is characterized by cognitive impairment and dementia on the long term leading to a wide spectrum of social and financial burdens. Due to these burdens, there is a need to have a better understanding of the disease pathophysiology as well as to come up with more readily available and cost-effective screening tools to provide an acceptable estimate of the disease risk/diagnosis in the early years of the disease before dementia develops as it is in these early years that lifestyle modifications can be more effective in protecting against and delaying the frank cognitive impairment associated with AD. Recently, there has been a more detailed, yet incomplete, comprehension of the inflammatory component of the AD pathophysiology. The inflammatory response in AD entails hyperactivation of neutrophils with noticeable changes in their subsets and increased migration of lymphocytes into the central nervous system (CNS) across the compromised blood-brain barrier (BBB). These changes in the counts of the different immune cells in AD allowed for pursuing a new cost-effective, and more widely accessible diagnostic tool, which is the neutrophil-to-lymphocyte ratio (NLR). In this review, we aimed to discuss the inflammatory response in AD, and how this response is reflected in the counts of different immune cells, mainly neutrophils and lymphocytes which can be implemented in the utility of NLR as a diagnostic tool in AD patients. • Inflammation in Alzheimer involves hyperactivation of neutrophils and migration of lymphocytes • How peripheral inflammatory cells can affect the Alzheimer's brain is not well-known • Neutrophil-to-lymphocyte ratio might be considered as possible diagnosis tool to identify Alzheimer onset [ABSTRACT FROM AUTHOR]

We aimed to synthesize evidence from published clinical trials on the efficacy and safety of tranexamic acid (TXA) administration in patients with aneurysmal subarachnoid hemorrhage (aSAH). We followed the standard methods of the Cochrane Handbook of Systematic Reviews for interventions and the PRISMA statement guidelines 2020 when conducting and reporting this study. A computer literature search of PubMed, Scopus, Web of Science, and Cochrane Central Register of Controlled Trials was conducted from inception until 1 January 2022. We selected observational studies and clinical trials comparing TXA versus no TXA in aSAH patients. Data of all outcomes were pooled as the risk ratio (RR) with the corresponding 95% confidence intervals in the meta-analysis models. Thirteen studies with a total of 2991 patients were included in the analysis. TXA could significantly cut the risk of rebleeding (RR 0.56, 95% CI 0.44 to 0.72) and mortality from rebleeding (RR 0.60, 95% CI 0.39 to 0.92, p = 0.02). However, TXA did not significantly improve the overall mortality, neurological outcome, delayed cerebral ischemia, or hydrocephalus (all p > 0.05). In terms of safety, no significant adverse events were reported. No statistical heterogeneity or publication bias was found in all outcomes. In patients with aSAH, TXA significantly reduces the incidence of rebleeding and mortality from rebleeding. However, current evidence does not support any benefits in overall mortality, neurological outcome, delayed cerebral ischemia, or hydrocephalus. [ABSTRACT FROM AUTHOR]

Objectives: We conducted the present multicenter, retrospective study to assess the epidemiological, clinical, laboratory, and radiological characteristics associated with critical illness among patients with COVID-19 from Egypt. Methods: The present study was a multicenter, retrospective study that retrieved the data of all Egyptian cases with confirmed COVID-19 admitted to hospitals affiliated to the General Organization for Teaching Hospitals and Institutes (GOTHI) through the period from March to July 2020. The diagnosis of COVID-19 was based on a positive reverse transcription-polymerase chain reaction (RT-PCR) laboratory test. Results: This retrospective study included 2724 COVID-19 patients, of whom 423 (15.52%) were critically ill. Approximately 45.86% of the critical group aged above 60 years, compared to 39.59% in the non-critical group (p = 0.016). Multivariate analysis showed that many factors were predictors of critically illness, including age >60 years (OR = 1.30, 95% CI [1.05, 1.61], p = 0.014), low oxygen saturation (OR = 0.93, 95% CI [0.91, 0.95], p<0.001), low Glasgow coma scale (OR = 0.75, 95% CI [0.67, 0.84], p<0.001), diabetes (OR = 1.62, 95% CI [1.26, 2.08], p<0.001), cancer (OR = 2.47, 95% CI [1.41, 4.35], p = 0.002), and serum ferritin (OR = 1.004, 95% CI [1.0003, 1.008], p = 0.031). Conclusion: In the present report, we demonstrated that many factors are associated with COVID-19 critical illness, including older age groups, fatigue, elevated temperature, increased pulse, lower oxygen saturation, the preexistence of diabetes, malignancies, cardiovascular disease, renal diseases, and pulmonary disease. Moreover, elevated serum levels of ALT, AST, and ferritin are associated with worse outcomes. Further studies are required to identify independent predictors of mortality for patients with COVID-19. [ABSTRACT FROM AUTHOR]

Background: The most frequent cause of vision loss from diabetic retinopathy is diabetic macular edema (DME). Earlier clinical trials tried to examine the role of intravitreal triamcinolone (IVT) and intravitreal bevacizumab (IVB) in DME; they either qualified IVT over IVB or IVB over IVT or did not exhibit a significant difference. Objective: This paper aims to compare the efficacy and safety of IVB versus IVT alone or combined IVB+IVT in the treatment of DME. Methods: We systematically searched PubMed, CENTRAL, Scopus, Embase, Science Direct, OVID, and Web of Science for randomized controlled trials of IVB versus IVT alone or combined IVB+IVT and IVT versus the combined IVB+IVT in DME patients. Results: A total of 1243 eyes of 17 trials were included in our meta-analysis and regression. Repeated injections of IVB were superior at improving VA comparing with those of IVT at 12, 24, 48-weeks, and IVB+IVT at 12, 24, 48-weeks. Single injections were comparable across the three arms regarding BCVA improvement. CMT reductions were also comparable across the three arms. Meanwhile, the overall safety regarding intraocular pressure and intraocular hypertension significantly favored the IVB group. Improvement in VA was best modified with CMT reduction from 480 um to 320um. This association was significant at 12-weeks in the three arms and persisted till 24-weeks and 48-weeks exclusively in the IVB group. Conclusions and relevance: Our analysis reveals that repeated successive injections associate with better BCVA compared to single injection. Current evidence affirms that IVB is superior to IVT and IVB+IVT at improving BCVA, comparable at reducing CMT, and presents a better safety profile in the treatment of DME. [ABSTRACT FROM AUTHOR]

Background: Current guidelines advocate for colorectal cancer (CRC) screening in adults who are at risk by using direct visualization methods such as colonoscopy. However, in Egypt, there is a paucity of data regarding the current practice of colonoscopy screening. Moreover, more information is needed about the knowledge and attitudes of potential participants regarding the procedure and possible barriers that can limit their participation. Methods: We conducted a nationwide cross-sectional study using an interview-based survey of patients aged 45 years or above who presented to outpatient clinics of nine university hospitals throughout Egypt. Participants were surveyed to assess their compliance with CRC colonoscopy screening guidelines, their knowledge of and attitude towards colonoscopy screening, and their perspective on potential barriers to colonoscopy screening. Results: A total of 1,453 participants responded to our survey in the nine study centers. Only a minority of participants (2.3%) were referred for CRC screening. Referral rates were higher among those who knew someone with a history of CRC (5.3% vs 1.5%, p < 0.001) or had a discussion with their physician about CRC (25.8% vs 0.7%, p < 0.001). Few responders (3.2%) had good knowledge regarding CRC screening. After introducing the concept of CRC screening to all participants, most patients (66.7%) showed a positive attitude towards having the procedure. Financial burden and fear of results were the two most frequently cited barriers to undergoing CRC screening (81.1%; and 60.1%, respecteively). Conclusions: Despite the positive attitude, there is insufficient knowledge about CRC screening among eligible participants in Egypt. This has probably contributed to low compliance with current CRC screening guidelines and needs to be addressed at the national level. [ABSTRACT FROM AUTHOR]

Background: There is considerable interest in improving the scoring methods for evaluating the efficacy of allergen immunotherapy (AIT) and to show if this is associated with clinically meaningful results from the patient's perspective. We aimed to assess the efficacy and clinical relevance of a 300 index of reactivity (IR) 5‐grass pollen sublingual immunotherapy (SLIT) tablet in children, adolescents and adults with moderate to severe grass‐induced allergic rhinoconjunctivitis (ARC) with or without controlled asthma using the combined symptom and medication score CSMS0‐36. Methods: The data of the European population that participated in 3 Phase III, international, randomized double‐blind placebo‐controlled clinical trials were analyzed post hoc. Results: A total of 864 patients randomized to 300 IR 5‐grass tablet or placebo were analyzed. Over the primary evaluation period, the difference in CSMS0‐36 between the 300 IR and placebo groups was statistically significant (point estimates: −2.51, CI95% [−3.88; −1.14], p < 0.0001 in clinical trial1; −2.31, CI95% [−3.39; −1.23], p < 0.0001 in CT2; and −2.31, CI95% [−3.58; −1.03], p = 0.0004 in CT3). The relative differences between the 300 IR 5‐grass tablet and placebo were −29.7%, −33.8%, and −26.3%, respectively. The results based on CSMS0‐36 were consistent with those obtained with the primary endpoints of the trials and support the consideration of the 2‐point threshold of the CSMS0‐36 for clinical relevance of AIT. Conclusion: Post hoc analysis of 3 CTs with the 300 IR 5‐grass SLIT tablet confirmed its significant and clinically relevant effect in the European population with grass pollen‐induced ARC with or without controlled asthma. [ABSTRACT FROM AUTHOR]

Several Mediterranean fisheries are experiencing flaws in the application of the management system based on input control, including Algeria, where the state of fisheries and stocks remain unclear. This paper focused on the characterization of the catches from bottom trawling by professional fishing vessels in the Mostaganem fishery (West of Algeria). Catch data were collected on board between 2017 and 2020 in two different fishing areas between isobaths 30 and 100 meters in depth. Out of a total of 87 species caught, discards represented a greater variety of species (74) than landings (57). Quantitatively, the landing weights were estimated at 7.8 tons, while the discard weights were lower, accounting for 1.8 tons. Between the two fishing areas, a significant difference was detected in the composition of discards and landings, while for the weights, the two areas were similar. Generally, the Mostaganem fishery is similar to other bottom trawl Mediterranean fisheries both for target and discard species. Otherwise, this research highlighted the existence of an uncontrolled black market, which sustains the practice of illegal, unregulated and unreported fishing, and potentially increases the rate of overexploitation. [ABSTRACT FROM AUTHOR]

Purpose: This systematic review and meta-analysis sought to assess the diagnostic accuracy of magnetic resonance imaging (MRI) in distinguishing fibrotic from inflammatory strictures in Crohn's disease (CD) patients. Methods: A rigorous and systematic exploration of five key databases yielded studies that met predefined criteria. Data were extracted for a comprehensive meta-analysis using MetaDiSC and MetaDTA software, providing diagnostic accuracy measures. The Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool was utilized for evaluating the methodological quality and potential bias within the studies. Results: The systematic review involved the evaluation of 7437 records, culminating in the inclusion of 22 studies. In detecting fibrotic strictures in CD patients, MRI exhibited a pooled sensitivity of 85.20% (95% CI: 76.10–91.20%) and specificity of 96.00% (95% CI: 87.80–98.70%). For differentiating fibrotic strictures from inflammatory stenosis, the sensitivity was 81.5% (95% CI: 70.2–89.20%), and the specificity was 97.2% (95% CI: 90.0–99.3%). In terms of assessing the severity of strictures, sensitivity stood at 90.4% (95% CI: 78.1–96.1%) and specificity at 89.4% (95% CI: 57.4–98.2%). The consistency of the diagnostic accuracy was observed across different geographical locations and the various reference tests applied in the studies. Conclusions: The results of this meta-analysis underscore the robust diagnostic accuracy of MRI in detecting fibrotic strictures, distinguishing between fibrotic and inflammatory strictures, and evaluating stricture severity in CD patients. These findings support the integration of MRI into standard diagnostic protocols for patients with CD. Further large-scale, multicenter trials are warranted to confirm these results and to identify any potential limitations associated with the application of MRI in this clinical setting. [ABSTRACT FROM AUTHOR]

Heart failure (HF) is a common clinical syndrome that affects more than 23 million individuals worldwide. Despite the marked advances in its management, the mortality rates in HF patients have remained unacceptably high. Peroxisome proliferator-activated receptors (PPARs) are nuclear transcription regulators, involved in the regulation of fatty acid and glucose metabolism. PPAR agonists are currently used for the treatment of type II diabetes mellitus and hyperlipidemia; however, their role as therapeutic agents for HF remains under investigation. Preclinical studies have shown that pharmacological modulation of PPARs can upregulate the expression of fatty acid oxidation genes in cardiomyocytes. Moreover, PPAR agonists were proven able to improve ventricular contractility and reduce cardiac remodelling in animal models through their anti-inflammatory, anti-oxidant, anti-fibrotic, and anti-apoptotic activities. Whether these effects can be replicated in humans is yet to be proven. This article reviews the interactions of PPARs with the pathophysiological mechanisms of HF and how the pharmacological modulation of these receptors can be of benefit for HF patients. [ABSTRACT FROM AUTHOR]

Background: There have been varying reports on the potential occurrence and severity of changes to menstruation including the median cycle length, days of bleeding, bleeding heaviness, and menstrual pain, following receipt of COVID‐19 vaccinations. We aimed to assess potential postvaccination menstrual changes in women residing in the Middle East. Methods: We implemented a cross‐sectional online survey‐based study. Data about the participants' demographic characteristics, menstruation experience, and vaccination status were collected and analyzed among six Arab countries. Results: Among 4942 menstruating females included in this study, females who had received one or more doses of COVID‐19 vaccination reported a higher frequency of back pain, nausea, tiredness, pelvic pain with periods, unprescribed analgesics use, and passage of loose stools. They also reported higher scores describing average and worst menstrual pain. Fully vaccinated females reported heavier flow and more days of bleeding. Conclusion: Our findings indicate that COVID‐19 vaccine may have an effect on menstruation in terms of menstrual pain and bleeding heaviness. The evidence needs to be further investigated in longitudinal studies. [ABSTRACT FROM AUTHOR]

Stroke, whether ischemic or haemorrhagic, is one of the main causes of mortality and disability all over the world, which entails huge burdens in both healthcare environments as well as social and economic aspects of life. Therefore, there is a continuous search for novel reliable biomarkers that can enhance the recognition of stroke events in a timely manner and predict the clinical outcomes following a stroke event. Galectins are a group of proteins expressed by many types of cells and tissues including vasculature, certain immune cells, fibroblasts, and gastrointestinal epithelial cells. These proteins vary in their structure and configuration according to their type and have a diversity of functions according to the type of tissue they are expressed in. Among these proteins, a few studies investigated mainly the roles played by galectin-1 (Gal-1) and galectin-3 (Gal-3) in the molecular mechanisms of atherosclerosis and in brain tissue remodeling after a stroke event. In this review, we present an updated overview of the current understanding of Gal-3's functions and implications in stroke occurrence and the response of the brain tissue to stroke events, which may be a key to its utility as a predictor of stroke incidence and clinical prognosis in the future. [ABSTRACT FROM AUTHOR]

Stroke, whether ischemic or haemorrhagic, is one of the main causes of mortality and disability all over the world, which entails huge burdens in both healthcare environments as well as social and economic aspects of life. Therefore, there is a continuous search for novel reliable biomarkers that can enhance the recognition of stroke events in a timely manner and predict the clinical outcomes following a stroke event. Galectins are a group of proteins expressed by many types of cells and tissues including vasculature, certain immune cells, fibroblasts, and gastrointestinal epithelial cells. These proteins vary in their structure and configuration according to their type and have a diversity of functions according to the type of tissue they are expressed in. Among these proteins, a few studies investigated mainly the roles played by galectin-1 (Gal-1) and galectin-3 (Gal-3) in the molecular mechanisms of atherosclerosis and in brain tissue remodeling after a stroke event. In this review, we present an updated overview of the current understanding of Gal-3's functions and implications in stroke occurrence and the response of the brain tissue to stroke events, which may be a key to its utility as a predictor of stroke incidence and clinical prognosis in the future. [ABSTRACT FROM AUTHOR]

We aimed to assess the epidemiological, clinical, and laboratory characteristics associated with mortality among hospitalized Egyptian patients with COVID-19. A multicenter, retrospective study was conducted on all polymerase chain reaction (PCR)-confirmed COVID-19 cases admitted through the period from April to July 2020. A generalized linear model was reconstructed with covariates based on predictor's statistical significance and clinically relevance. The odds ratio (OR) was calculated by using stepwise logistic regression modeling. A total of 3712 hospitalized patients were included; of them, 900 deaths were recorded (24.2%). Compared to survived patients, non-survived patients were more likely to be older than 60 years (65.7%), males (53.6%) diabetic (37.6%), hypertensive (37.2%), and had chronic renal insufficiency (9%). Non-survived patients were less likely to receive azithromycin (p <0.001), anticoagulants (p <0.001), and steroids (p <0.001). We found that age ≥ 60 years old (OR = 2.82, 95% CI 2.05–3.86; p <0.0001), diabetes mellitus (OR = 1.58, 95% CI 1.14–2.19; p = 0.006), hypertension (OR = 1.69, 95% CI 1.22–2.36; p = 0.002), chronic renal insufficiency (OR = 3.15, 95% CI 1.84–5.38; p <0.0001), tachycardia (OR = 1.65, 95% CI 1.22–2.23; p <0.001), hypoxemia (OR = 5.69, 95% CI 4.05–7.98; p <0.0001), GCS <13 (OR 515.2, 95% CI 148.5–1786.9; p <0.0001), the use of therapeutic dose of anticoagulation (OR = 0.4, 95% CI 0.22–0.74, p = 0.003) and azithromycin (OR = 0.16, 95% CI 0.09–0.26; p <0.0001) were independent negative predictors of mortality. In conclusion, age >60 years, comorbidities, tachycardia, hypoxemia, and altered consciousness level are independent predictors of mortality among Egyptian hospitalized patients with COVID-19. On the other hand, the use of anticoagulants and azithromycin is associated with reduced mortality. [ABSTRACT FROM AUTHOR]

Background: Mavoglurant (AFQ056), a selective metabotropic glutamate receptor 5 (mGluR5) inhibitor, was tested for t levodopa-induced dyskinesia (LID) in patients with Parkinson's Disease (PD). However, clinical trials showed inconsistent results regarding the efficacy of mavoglurant in treating LID in patients with Parkinson's disease (PD). Methods: A computer literature search of PubMed, Scopus, Web of science, and Cochrane CENTRAL was conducted until March 2021. We selected relevant randomized controlled trials comparing mavoglurant to placebo. Study data were extracted and pooled as mean difference (MD) in the meta-analysis model. Results: Six RCTs were included in this meta-analysis with a total of 485 patients. Mavoglurant was not significantly superior to placebo in terms of the "off-time" (MD −0.27 h, 95% CI −0.65 to 0.11), "on time" (MD 0.29 h, 95% CI −0.09 to 0.66), Lang-Fahn activities of daily living dyskinesia scale (MD −0.95, 95% CI −1.98 to 0.07), UPDRS-III (MD −0.51, 95% CI −1.66 to 0.65), or UPDRS-IV (MD −0.41, 95% CI −0.85 to 0.03). However, the pooled modified abnormal involuntary movement scale favored the mavoglurant group than the placebo group (MD −2.53, 95% CI −4.23 to −0.82). Conclusions: This meta-analysis provides level one evidence that mavoglurant is not effective in treating the LID in patients with PD. [ABSTRACT FROM AUTHOR]

Background: Little consensus is available regarding the standard treatment for recurrent anterior instability of the shoulder. Typically, treatment selection has been based on training and tradition rather than the available evidence. Purpose: This study aimed to compare the clinical outcomes between arthroscopic Bankart procedure and the Latarjet procedure in the treatment of recurrent anterior shoulder instability with emphasis on follow-up time. Study Design: Systematic review and meta-analysis. Methods: We searched PubMed, Cochrane Central Register of Controlled Trials, Scopus, Ovid, and Web of Science up to January 2018 and included studies that compared arthroscopic Bankart versus Latarjet for treatment of anterior shoulder instability. Continuous data, such as operative time and patient-reported outcomes, were pooled as mean differences (MDs), whereas dichotomous data, such as recurrence, revision, redislocation, arthropathy, infection, and hematoma, were pooled as risk ratios (RRs), with 95% CIs. Results: Pooling data from 7 cohort studies (3275 patients) showed that arthroscopic Bankart was associated with a higher risk of redislocation (RR, 2.74; 95% CI, 1.48-5.06; P =.03), a higher risk of recurrence (RR, 2.87; 95% CI, 1.91-4.30; P <.0001), and a lower risk of infection (RR, 0.16; 95% CI, 0.06-0.43; P =.0002) compared with Latarjet, while the effect size did not favor arthroscopic Bankart or Latarjet in terms of Rowe score (MD, 0.22; 95% CI, –5.64 to 6.08; P =.94), revision (RR, 0.34; 95% CI, 0.08-1.39; P =.13), and hematoma (RR, 0.20; 95% CI, 0.03-1.19; P =.07). The effect estimate showed a pronounced advantage for Latarjet from 6 to 10 years postoperatively in terms of recurrence and redislocation (RR, 3.00; 95% CI, 1.98-4.56 and RR, 2.85; 95% CI, 1.51-5.38, respectively). Conclusion: Our results showed that Latarjet had less risk of recurrence and redislocation with longer follow-up time. Both procedures were comparable in terms of Rowe score, the need for revision, and postoperative hematoma formation, whereas Bankart repair was associated with a lower risk of infection. [ABSTRACT FROM AUTHOR]

Objectives: To compare non-motor symptoms (NMSs) among patients with essential tremor (ET), Parkinson's disease (PD) subtypes (akinetic-rigid type (ART) and tremor-dominant type (TDT)), and healthy controls. Patients and methods: This retrospective study included 129 participants, 72 PD (33 PD-ART, 33 PD-TDT, and 6 Mixed), 29 ET patients, and 28 controls. PD patients were assessed by the unified Parkinson's disease rating scale (UPDRS), Hoehn, and Yahr scale (H&Y), while ET patients were evaluated by the Fahn Tolosa Marin Tremor Rating Scale. All subjects were evaluated by non-motor symptoms scale (NMSS) for NMSs and Beck depression inventory (BDI) for depression. Results: PD subtypes groups, ET, and controls were age and gender-matched. Compared to controls, all PD, PD subtypes, and ET showed significantly worse most of NMSs (p<0.001) and depression. Compared to ET, all PD and PD-ART had significantly worse gastrointestinal (p = 0.002), urinary symptoms (p = 0.001, p = 0.003) and depression (p = 0.002) and PD-TDT worse depression, while ET patients showed worse memory/attention than PD subtypes. Total NMSS of ET is highly correlated to depression and moderately to tremor severity and age of onset, while total of NMSS is highly correlated to depression, disease severity, and disability. Conclusion: The current study demonstrated several comparable domains of NMSs of PD subtypes and ET, except worse gastrointestinal and urinary symptoms among PD-ART. Identifying different NMSs profiles is important for predicting, better assessing, and tailoring management of ET and PD subtypes. [ABSTRACT FROM AUTHOR]

Background: Under nutrition and overweight typically occur during nutritional transition periods in developing countries including Egypt. Short stature and anemia are public health concern due to its strong link with malnutrition which is a preventable risk factor. Objectives: to estimate the prevalence of overweight, obesity, underweight and short stature and its concurrence with anemia, also to determine the etiological profile of short stature among primary school children in Egypt. Methods: A cross-sectional study was carried out on 33,150 Egyptian children aged 6–11 years old from January 2018 to January 2020, allocated in 59 primary schools from diverse geographical districts in Egypt. Complete anthropometric measurements were conducted and applied according to WHO growth charts. Hemoglobin level was measured. Systematic approach to detect the etiology of short stature was applied randomly to a sample of 380 stunted children. Results: The prevalence of underweight was 8.2%, while obesity and overweight represented 21.8% (9.6 and 12.2% respectively). Overall short stature constituted 17%. The main etiologies of short stature were familial (40.8%) and constitutional (24.2%). Anemia was diagnosed in 26% of children; while concurrent anemia and stunting was reported in 9.9%. Regarding anemia and anemia with stunting were more common among girls (30.0% (OR = 1.50, CI95%: 1.43–1.58) and 11.4% (OR = 1.39, CI95%:1.29–1.49) respectively), who were living in rural areas (33.4% (OR = 1.96, CI 95%:1.87–2.06) &12.7% (OR = 1.72, CI 95%:1.60–1.85)) and those who had low socioeconomic status)34.6% (OR = 2.54, CI 95%:2.29–2.82) & 17.2% (OR = 3.32, CI 95%:2.85–3.88() respectively. Anemia with stunting was significantly higher among children aged ≥9 years old representing 12% (OR = 1.40, CI 95%:1.30–1.51). Conclusion: Prevalence of short stature, obesity and anemia was high among primary school children in Egypt with a strong concurrence between anemia and stunting. Intensive parental health education and in-depth nutritional assessment are required. [ABSTRACT FROM AUTHOR]

The diet of the greater forkbeard Phycis blennoides (Brünnich, 1768) of the Algerian coast was studied between December 2013 and June 2015, providing information on its ecology for a better understanding of the feeding strategy. A total of 956 individuals, whose total length (TL) varied between 9.7 and 54.5 cm and weight (W) between 2.80 and 1334.11 g, were examined. The index of relative importance (%IRI), combining the three main descriptors of the presence of different ingested prey (%F, %N, %W), was used to characterize the relative importance of different food taxa. Qualitative and quantitative variations in diet were studied according to sex, size and seasons. The average annual digestive vacuity index (%V) was 5.51. It did not vary between seasons (X² cal = 5.43, X² th = 7.82, α = 5%) and size (X² cal = 2.08, X² th = 5.99, α = 5%), but was different between male (%V = 4.94) and female (%V= 12.78). Qualitative analysis of stomach contents reveals a fairly diverse range of predation with 1342 preys counted for a total weight of 462.84 g, which corresponds to an average number (AN) and weight (AW) of 3.03 and 1.04 g, respectively. This species feeds on benthic preys, composed mainly of natantia crustaceans (%IRI = 44.84) and teleost fish (%IRI = 2.61) with intraspecific preys (%IRI = 6.15). This cannibalism was frequent in specimens with a TL that exceeds 20 cm; it was even more frequent in females as well as in winter. Significant differences in feeding habits of P. blennoides occurred according to sex, fish size and between seasons. The trophic level (TROPH) was high (3.66 < TROPH < 3.97), corresponding to carnivorous character. [ABSTRACT FROM AUTHOR]

The Global burden of disease study ranked migraine as the sixth most common disorder worldwide in 2016, with significant social and economic sequelae. In this study, we assessed the efficacy of different Calcitonin gene-related peptide (CGRP) receptor blockers as potential pharmacological approaches and compare them to placebo using the systematic review (SR) and network meta-analysis (NMA) approach. We performed a computerized search of SCOPUS, PubMed, Cochrane central, and Embase databases through January 2019 and included randomized controlled trials (RCTs), which were performed on episodic and chronic migraine patients who used Erenumab, Eptinezumab, Fremanezumab, or Galcanezumab. The combined analysis revealed that after six, eight, and twelve weeks of intervention, the medications with the most potent effects in comparison to placebo were Fremanezumab 900 mg, (SMD = −0.55, 95% CI [−0.97, −0.12]); Erenumab 140 mg, (SMD = −0.51, 95% CI [−0.61, 0.41]); and Erenumab 140 mg, (SMD = −0.48, 95% CI [−0.571, 0.39]), respectively. For chronic migraine patients, Fremanezumab 900 mg, Erenumab 140 mg, in addition to Erenumab 70 mg, were associated with the highest efficacy after 6, 8, and 12 weeks, correspondingly. The analysis of combined groups data (Chronic and Episodic) showed that Fremanezumab was the most effective drug after six weeks, where Erenumab was the most effective after 8 and 12 weeks. The current evidence retrieved from this NMA suggests that Fremanezumab was the most effective anti-migraine medication in decreasing MHDs per month after six weeks in both chronic and episodic patients. • Fremanezumab was the most effective anti-migraine medication from the family of the CGRP receptor blockers in decreasing migraines. • Erenumab was the most potent medication in the chronic migraine group. • The drug dose that had the most favorable outcomes was Fremanezumab 900mg. [ABSTRACT FROM AUTHOR]

Gliomas, which account for nearly a quarter of all primary CNS tumors, present significant contemporary therapeutic challenges, particularly the highest-grade variant (glioblastoma multiforme), which has an especially poor prognosis. These difficulties are due to the tumor's aggressiveness and the adverse effects of radio/chemotherapy on the brain. Stem cell therapy is an exciting area of research being explored for several medical issues. Neural stem cells, normally present in the subventricular zone and the hippocampus, preferentially migrate to tumor masses. Thus, they have two main advantages: They can minimize the side effects associated with systemic radio/chemotherapy while simultaneously maximizing drug delivery to the tumor site. Another feature of stem cell therapy is the variety of treatment approaches it allows. Stem cells can be genetically engineered into expressing a wide variety of immunomodulatory substances that can inhibit tumor growth. They can also be used as delivery vehicles for oncolytic viral vectors, which can then be used to combat the tumorous mass. An alternative approach would be to combine stem cells with prodrugs, which can subsequently convert them into the active form upon migration to the tumor mass. As with any therapeutic modality still in its infancy, much of the research regarding their use is primarily based upon knowledge gained from animal studies, and a number of ongoing clinical trials are currently investigating their effectiveness in humans. The aim of this review is to highlight the current state of stem cell therapy in the treatment of gliomas, exploring the different mechanistic approaches, clinical applicability, and the existing limitations. [ABSTRACT FROM AUTHOR]