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Management of aspirated foreign body in children is challenging. In situations when the incidence is not witnessed, the diagnosis is delayed which results in later complications. When neglected, the diagnosis becomes eluding as the presentation mimics other chest pathologies. Overlooked foreign bodies result in serious complications such as lung abscess and pyothorax. Migration of aspirated foreign bodies is reported. Empyema complicating a neglected foreign body was reported once in adults but not in pediatric population. We present a case of a child with pyothorax. Intraoperatively, an intrathoracic leaf was found to be the cause. • Aspiration of foreign bodies is common in children and a leading cause of accidental death in children below 6 years of age. • The diagnosis becomes quite challenging particularly if the event was unwitnessed by the caregiver. • Retained foreign bodies might become overlooked which later on result in serious complications. • These cases warrant a high degree of suspicion to explore the possibility of a neglected aspirated foreign body. [ABSTRACT FROM AUTHOR]

The fact that physical activity besides central cholinergic enhancement contributes in improving neuronal function and spastic plasticity, recommends the use of the anticholinesterase and cholinergic drug galantamine with/without exercise in the management of the experimental autoimmune encephalomyelitis (EAE) model of multiple sclerosis (MS). Sedentary and 14 days exercised male Sprague Dawley rats were subjected to EAE. Hereafter, exercised rats continued on rotarod for 30 min for 17 consecutive days. At the onset of symptoms (day 13), EAE sedentary/exercised groups were subdivided into untreated and post-treated with galantamine. The disease progression was assessed by EAE score, motor performance, and biochemically using cerebrospinal fluid (CSF). Cerebellum and brain stem samples were used for histopathology and immunohistochemistry analysis. Galantamine decreased EAE score of sedentary/exercised rats and enhanced their motor performance. Galantamine with/without exercise inhibited CSF levels of tumor necrosis factor (TNF)-α, interleukin (IL)-6), and Bcl-2-associated X protein (Bax), besides caspase-3 and forkhead box P3 (Foxp3) expression in the brain stem. Contrariwise, it has elevated CSF levels of brain derived neurotrophic factor (BDNF) and B-cell lymphoma (Bcl-2) and enhanced remyelination of cerebral neurons. Noteworthy, exercise boosted the drug effect on Bcl-2 and Bax. The neuroprotective effect of galantamine against EAE was associated with anti-inflammatory and anti-apoptotic potentials, along with increasing BDNF and remyelination. It also normalized regulatory T-cells levels in the brain stem. The impact of the add-on of exercise was markedly manifested in reducing neuronal apoptosis. [Display omitted] • Neuroprotective role of galantamine via anti-inflammatory/anti-apoptotic characters • Galantamine attenuates EAE severity and reverses demyelination. • Galantamine can govern the immune response in MS through its action on T-cells. • Exercise training proves a potential therapeutic role in MS. • Exercise training could augment the beneficial effects of galantamine. [ABSTRACT FROM AUTHOR]

Several microbial toll-like receptor (TLR) ligands, bacterial DNA and bacterial cell wall fragments have been identified in the synovium of rheumatoid arthritis (RA) patients, proving bacterial involvement in the pathogenesis of RA. The current study aimed to verify that low dose polymyxin B could prevent the development of chronic inflammatory arthritis. Twelve days post adjuvant injection, Sprague-Dawley rats were treated twice weekly with methotrexate (0.5 mg/kg) or daily with polymyxin B (1 mg/kg) or with combination of both for 1 or 2 weeks. Arthritis progression was assessed by hind paw swelling, serum levels of tumor growth factor-1β (TGF-1β), tumor necrosis factor-alpha (TNF-α), high sensitivity C-reactive protein (HS-CRP) and nuclear factor kappa B (NF-κB) were measured using ELISA. Cyclooxygenase-1 (Cox-1) and Cox-2 activities, as well as mRNA expression of TLR-2 and TLR-4 were determined. Histopathological examination of the ankle joint was performed as well as immunohistochemistry for anti-TLR-4. Histopathological assessment of toxic effects on the kidney was performed. Adjuvant arthritis led to a significant swelling of the hind paw and alteration in all serum parameters, TLR-2 and TLR-4 expression, as well as Cox-2 activity. These alterations were associated with histopathological changes of the joints. Polymyxin B reduced significantly all biomarkers of inflammation, showing better effect of the combination in most of the studied parameters, with minimal signs of nephrotoxicity. In conclusion, results showed that polymyxin B possesses significant anti-arthritic activity which may be attributed to inhibition of the TLR-4, NF-κB and Cox-2 signaling pathway. Unlabelled Image • Polymyxin B possesses significant anti-arthritic activity. • Combination therapy with polymyxin B is promising in RA. • Low dose of polymyxin B is deprived of acute kidney injury risk. • Polymyxin B inhibit the TLR-4, NF-κB, Cox-2 signaling pathway. [ABSTRACT FROM AUTHOR]

[Display omitted] Genistein (Gen) is one of the most potent soy isoflavones used for hepatocellular carcinoma (HCC) treatment. Low aqueous solubility and first-pass metabolism are the main obstacles resulting in low Gen oral bioavailability. The current study aims to introduce phytosomes as an approach to improve Gen solubility, protect it from metabolism by complexation with phospholipids (PL), and get used to PL in Gen lymphatic delivery. Different forms of PL namely: Lipiod® S100, Phosal® 53 MCT, and Phosal®75 SA were used in phytosomes preparation GP, GPM, and GPL respectively. The effect of formulation components on Gen absorption, metabolism, and liver accumulation was evaluated following oral administration to rats. Cytotoxicity and cellular uptake studies were applied on HepG2 cells and in-vivo anti-tumor studies were applied to the DEN-mice model. Results revealed that GP and GPL remarkably accumulated Gen aglycone in hepatic cells and minimized the metabolic effect on Gen. They significantly increased the intracellular accumulation of Gen in its complex form in HepG2 cells. Their cytotoxicity is time-dependent according to the complex stability. The enhanced in-vivo anti-tumor effect was observed for GP and GPL compared to Gen suspension on DEN-induced HCC in mice. In conclusion, Gen-phytosomes can represent a promising approach for liver cancer treatment. [ABSTRACT FROM AUTHOR]