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Objective Methodology Results Conclusions The objective of this study was to compare, evaluate and manage abdominal trauma using two distinct surgical techniques: laparoscopy and laparotomy. The aim was to assess the effectiveness and safety of laparoscopic procedures compared with laparotomy for treating penetrating or blunt abdominal trauma.In this prospective comparative study, we recruited 60 patients clinically diagnosed with abdominal trauma. The research was conducted at the Emergency Unit of the Department of General Surgery, Faculty of Medicine, Aswan University Hospital. All participants provided signed informed consent before their inclusion in the study.There was a significant statistical difference between the two groups in terms of the operation duration, length of stay in the intensive care unit post‐operatively, occurrence of gas passage and duration of hospitalisation.Laparoscopic surgical procedures present a viable and practical alternative to laparotomy in appropriate cases for patients. The decision to choose laparoscopy as a surgical approach should depend on the surgeon's proficiency and the availability of required resources. [ABSTRACT FROM AUTHOR]

Nowadays, functionalized cucurbit[n]urils are considered one of the most important examples of macromolecules and have attracted a lot of attention due to their potential applications in several sectors. In the present work monomethyl‐cucurbit[7]uril (3) was synthesized for the first time through facile synthetic route with high purity form by the reaction of monomethylglycoluril (3a‐methyltetrahydroimidazo[4,5‐d]imidazole‐2,5(1H,3H)‐dione) with glycoluril (tetrahydroimidazo[4,5‐d]imidazole‐2,5(1H,3H)‐dione) in the ratio of 1:6, respectively, and formaldehyde in the presence of hydrochloric acid as a catalyst for 24 h at 95°C through Mannich reaction. Moreover, dimethyl‐cucurbit[7]uril (5) was successfully synthesized through the reaction of dimethylglycoluril (3a,6a‐dimethyltetrahydroimidazo[4,5‐d]imidazole‐2,5(1H,3H)‐dione) with glycoluril (tetrahydroimidazo[4,5‐d]imidazole‐2,5(1H,3H)‐dione), following the same procedure as for the monomethyl‐cucurbit[7]uril. The chemical structures of the obtained compounds were established by mass spectrometry, NMR spectroscopy, and quantum‐chemical calculations. [ABSTRACT FROM AUTHOR]

Successful endodontic treatment requires advanced materials to eliminate biofilm This study aims to assess the penetration depth and the effectiveness of Boswellia sacra as a novel intracanal medicament compared with calcium hydroxide against Enterococcus faecalis biofilm. 60 single‐rooted teeth were decoronated, prepared and sterilised. Fifty teeth were contaminated with a culture of E. faecalis (ATCC 19433) for 21 days. Two teeth were used to confirm the biofilm using scanning electron microscope. For colony‐forming unit (CFU), 40 samples were divided into one control group (calcium hydroxide) and the other experimental group (B. sacra). Each group was divided into two subgroups to be tested at 3 and 7 days. The minimum inhibitory concentration (MIC) of B. sacra was determined, and the B. sacra's ethanolic extract medicament was prepared. Eight discs divided into groups similar to CFU were used to evaluate live/dead bacteria using confocal laser scanning microscopy (CLSM). Ten teeth were selected for penetration depth using CLSM. The intracanal medicaments were mixed with 0.1% rhodamine B. were inserted into the root canals 0.2 slices were dissected and viewed under CLSM. The MIC of B. sacra was 1.25 mg/ml. The CFU evaluation proved that B. sacra are more effective than calcium hydroxide in the 3 days groups. However, it was statistically insignificant compared with calcium hydroxide after 7 days. The depth of penetration of B. sacra exceeds that of calcium hydroxide. B. sacra is an effective intracanal medicament. [ABSTRACT FROM AUTHOR]

In dengue‐endemic regions, the co‐infection with SARS‐CoV‐2 and dengue is a significant health concern. Therefore, we performed a literature search for relevant papers in seven databases on 26 Spetember 2021. Out of 24 articles, the mortality rate and intensive care unit (ICU) admission were 19.1% and 7.8%, respectively. The mean hospital stay was 11.4 days. In addition, we identified two pregnancies with dengue and COVID‐19 co‐infection; one ended with premature rupture of membrane and intrauterine growth restriction fetus, while the other one ended with maternal mortality and intrauterine fetal death. COVID‐19 and dengue co‐infection had worse outcomes regarding mortality rates, ICU admission, and prolonged hospital stay. Thus, wise‐decision management approaches should be adequately offered to these patients to enhance their outcomes. Establishing an early diagnosis might be the answer to reducing the estimated significant burden of these conditions. [ABSTRACT FROM AUTHOR]

Summary: Parkinson's disease (PD) patients who contracted Coronavirus disease 2019 (Covid‐19) had a decline in motor functions; nevertheless, there is limited evidence on whether PD patients have a higher risk for contracting Covid‐19 or have worse outcomes. This is the first systematic review and meta‐analysis to review the impact of PD on the prognosis of Covid‐19 patients. We performed a systematic search through seven electronic databases under the recommendations of the Preferred Reporting Items for Systematic Review and Meta‐analyses statement (PRISMA) guidelines. The R software version 4.0.2 was used to calculate pooled sample sizes and their associated confidence intervals (95%CI). Finally, we included 13 papers in this study. The pooled prevalence rate of Covid‐19 was 2.12% (95%CI: 0.75–5.98). Fever, cough, fatigue and anorexia were the most common symptoms with a rate of 72.72% (95% CI: 57.3 ‐ 92.29), 66.99% (95% CI: 49.08–91.42), 61.58% (95% CI: 46.69–81.21) and 52.55% (95% CI: 35.09–78.68), respectively. The pooled rates were 39.89% (95% CI: 27.09–58.73) for hospitalisation, 4.7% (95% CI: 1.56–14.16) for ICU admission and 25.1% (95%CI: 16.37–38.49) for mortality. On further comparison of hospitalisation and mortality rates among Covid‐19 patients with and without PD, there were no significant differences. In conclusion, the prevalence and prognosis of Covid‐19 patients seem comparable in patients with PD and those without it. The increased hospitalisation and mortality may be attributed to old age and co‐morbidities. [ABSTRACT FROM AUTHOR]

Background: It remains unknown whether the cutaneous microvascular responses are different between patients with scleroderma‐associated pulmonary arterial hypertension (SSc‐PAH) and SSc without pulmonary hypertension (PH). Methods: We included 59 patients with SSc between March 2013 and September 2019. We divided patients into 4 groups: (a) no PH by right heart catheterization (RHC) (n = 8), (b) no PH by noninvasive screening tests (n = 16), (c) treatment naïve PAH (n = 16), and (d) PAH under treatment (n = 19). Microvascular studies using laser Doppler flowmetry (LDF) were done immediately after RHC or at the time of an outpatient clinic visit (group b). Results: The median (IQR) age was 59 (54–68) years, and 90% were females. The responses to local thermal stimulation and postocclusive reactive hyperemia, acetylcholine, and sodium nitroprusside iontophoresis were similar among groups. The microvascular response to treprostinil was more pronounced in SSc patients without PH by screening tests (% change: 340 (214–781)) compared with SSc‐PAH (naïve + treatment) (Perfusion Units (PU) % change: 153 (94–255) % [p =.01]). The response to A‐350619 (a soluble guanylate cyclase (sGC) activator) was significantly higher in patients with SSc without PH by screening tests (PU % change: 168 (46–1,296)) than those with SSc‐PAH (PU % change: 22 (15–57) % [p =.006]). The % change in PU with A350619 was directly associated with cardiac index and stroke volume index (R: 0.36, p =.03 and 0.39, p =.02, respectively). Conclusions: Patients with SSc‐PAH have a lower cutaneous microvascular response to a prostacyclin analog treprostinil and the sGC activator A‐350619 when compared with patients with SSc and no evidence of PH on screening tests, presumably due to a peripheral reduction in prostacyclin receptor expression and nitric oxide bioavailability. [ABSTRACT FROM AUTHOR]

Melatonin is known to protect sperm against freezing‐inflicted damage in different domestic species. The aim of the study was to evaluate the effect of supplementation of semen extender with melatonin on the quality and DNA integrity of cooled and frozen/thawed rabbit spermatozoa. We also investigated whether the addition of melatonin to the semen extender could improve the fertility of rabbit does artificially inseminated with frozen/thawed semen. Semen samples collected from eight rabbit bucks were pooled and then diluted in INRA‐82 supplemented either with (0.5, 1.0 or 1.5 mM) or without (0.0 mM) melatonin. Diluted semen was cooled at 5°C for 24 hr. For cryopreservation and based on the first experiment's best result, semen samples were diluted in INRA‐82 in the presence or absence of 1.0 mM melatonin and then frozen in 0.25 ml straws. Following cooling or thawing, sperm quality and DNA integrity were evaluated. Furthermore, the fertility of frozen/thawed semen was investigated after artificial insemination. Supplementation of semen extender with 1.0 mM melatonin improved (p <.05) motility, viability, membrane and acrosome integrities in cooled semen compared with other groups. Sperm quality and DNA integrity were higher (p <.05) in frozen/thawed semen diluted in 1.0 mM melatonin‐supplemented extender than in the control group. Conception and birth rates were higher in does inseminated with 1.0 mM melatonin treated semen compared with the controls. In conclusion, supplementation of semen extender with 1.0 mM melatonin improved the quality of cooled and frozen/thawed rabbit spermatozoa. Melatonin can preserve DNA integrity and enhance the fertility of frozen/thawed rabbit spermatozoa. [ABSTRACT FROM AUTHOR]

Pyrimidine and thienopyrimidine derivatives play a very important role in organic chemistry because of their wide applications as bioactive compounds with multiple biological activities. However, a literature survey revealed that the merger of different groups in the thieno[2,3‐d]pyrimidine heterocyclic ring enhances its antibacterial, antifungal and anti‐inflammatory activities. This encouraged us to prepare a new series of thieno[2,3‐d]pyrimidine heterocyclic compounds and to test them as antimicrobial and anti‐inflammatory agents. These compounds have shown remarkable activity toward fungi, bacteria, and inflammation. Thus, these compounds have been prepared by the chloroacylation of 5‐amino‐4‐phenyl‐2‐(p‐tolylamino)thieno[2,3‐d] pyrimidine‐6‐carboxamide (4) using chloroacetyl chloride under neat condition to afford the target compound (6), which was used as precursor for the synthesis of a number of bioactive compounds. Thus reaction of the chloromethylpyrimidine derivative (6) with triphenylphosphine in dry benzene gave the corresponding ((4‐oxo‐9‐phenyl‐7‐(p‐tolylamino)‐3,4‐dihydropyrimido[4′,5′:4,5]thieno[2,3‐d]pyrimidin‐2‐yl)methyl) triphenylphosphonium chloride (7). Compounds 8a–8c and 9a–9c were obtained by the reaction of 7 with some selected aromatic aldehydes and ketones in methanol and sodium methoxide under Wittig reaction condition. The structures of the all new synthesized compounds were established on the basis of their analytical and spectral data (IR, 1H NMR, 13C NMR, and MS). [ABSTRACT FROM AUTHOR]

Pyrimidines and pyrimidine bearing indole derivatives are very important species in organic chemistry due to their wide use as bioactive compounds with a broad range of good biological activities. Due to the wide spread of different species of bacteria and fungi nowadays, in the present work, a novel series of indolyl‐pyrimidines (2–13) were synthesized starting from 3‐chloro‐1H‐indole‐2‐carbaldehyde (1). Elemental analysis, IR, 1H‐NMR, 13C‐NMR, and mass spectral data elucidated the structure of newly synthesized compounds. All compounds were screened for their in vitro antibacterial and antifungal activity, and they demonstrated promising results; all the new compounds synthesized from compound (1), which allowed reactions with thiourea and ethyl cyanoacetate, gave the target compound (2), which was used as a precursor for the synthesis of indolylthiazolopyrimidine derivatives (3–8) by reactions with halocarbonyl compounds such as chloroacetone, phancyl bromide, and chloroacetic acid through alkylation of the mercapto group followed by cyclization through a nucleophilic attack. When compound (2) subjected to react with hydrazine hydrate gave 4‐indolyl‐2‐hydrazinopyrimidine (5), the latter compound, when allowed to react with ethyl chloroacetate or diethyloxalate, gave indolylpyrimidotriazine derivatives (10,11); in contrast, when the compound reacted with acetic anhydride or formic acid, it gave triazolopyrimidine derivatives (12, 13). This work discuss the different synthetic routes for the synthesis of different pyrimdine Indole hybrids. Where indolylthioxoyrimidine compound is used ad precursor for synthesis of different fused pyrimidine systems as following indolylthiazolopyrimidine by the reaction with different halocarbonyl compounds. Then the starting compound react with hydrazine hydrate to give hydrazino compound which under ring closure reaction with different reagent give other two fused systems indolylpyrmidotriazine and indolylthiazolopyrimidine. [ABSTRACT FROM AUTHOR]

Because of the great biological importance of substituted indole derivatives, in the present study, a series of pyrazolylindole, thiazolylindole, and pyrimidinylindole derivatives have been synthesized with good yield. The precursor indolyl chalcone 2a–d was prepared by reaction of 3‐chloro‐1H‐indole‐2‐carbaldehyde 1 with different ketones. Then, compounds 3b–d, 4, and 5a–d have been synthesized by the reaction of chalcones 2a–d with hydrazine, phenylhydrazine, and thiosemicarbazide. When the chalcone derivative 2b subjected to react with hydroxylamine hydrochloride gave isoxazolylindole derivative 6b. N‐thiazolidine pyrazolyl indole 7 was obtained by reacting compound 5a with ethyl chloroacetate. On the other hand, when chalcone derivative 2b allowed to react with urea and thiourea gave the corresponding pyrimidinylindole derivatives 8 and 9. Finally, when chalcone derivative 2b reacted with ethyl cyanoacetate or malononitrile gave pyridinylindole derivatives 10 and 11. The structures of the all synthesized compounds were elucidated on the basis of spectral analysis infrared, NMR, and mass spectroscopy. Some of the synthesized compounds were screened for their antimicrobial and anti‐inflammatory activity. Compound 4b was the highest antibacterial activity against all strains of bacteria with values higher than those of the corresponding reference antibiotics (ciprofloxacin and levofoxacin, respectively) and almost the same as (gemifloxacin, moxifloxacin, clindamycin, gentamycin, and streptomycin). Compounds 4, 5, 6, and 7 showed high anti‐inflammatory activity compared with the standard drug indomethacin. [ABSTRACT FROM AUTHOR]

5‐Amino‐2‐(p‐tolylamino)‐4‐phenylthieno[2,3‐d]pyrimidine‐6‐carbonitrile 9, which was synthesized by an innovative method, was used as a versatile precursor for synthesizing pyrimido‐thienopyrimidine, triazolopyrimidothienopyrimidine, and pyrimidothienotriazine compounds. Thus, reaction of aminothienopyrimidinecarbonitrile 9 with chloroacetylchloride in dioxane afforded the chloroacetylaminocarbonitrile derivative 10, which underwent nucleophilic substitution reactions with various primary and secondary amines gave the corresponding N‐alkyl‐(aryl)amino acetamides 11a,b. On the other hand, the reaction of aminocarbonitrile 9 with triethyl orthoformate followed by cyclization with hydrazine yielded an aminoiminopyrimidine derivative 13. The latter was used as versatile precursor for synthesis of new heterocyclic compounds. The structures of all the new compounds have been established on the basis of their analytical and spectral data (IR, 1H NMR, 13C NMR, and MS). Some of the synthesized compounds were evaluated in vitro for their anti‐inflammatory activity. All the tested compounds exhibited remarkable anti‐inflammatory activity. [ABSTRACT FROM AUTHOR]

The excitability of the central nervous system depends largely on the surface density of neurotransmitter receptors. The endocannabinoid receptor 1 (CB1R) and the metabotropic glutamate receptor mGlu8R are expressed pre-synaptically where they reduce glutamate release into the synaptic cleft. Recently, the CB1R interacting protein cannabinoid receptor interacting protein 1a (CRIP1a) was identified and characterized to regulate CB1R activity in neurons. However, underlying molecular mechanisms are largely unknown. Here, we identified a common mechanism used by CRIP1a to regulate the cell surface density of two different types of G-protein coupled receptors, CB1R and mGlu8aR. Five amino acids within the CB1R C-terminus were required and sufficient to reduce constitutive CB1R endocytosis by about 72% in the presence of CRIP1a. Interestingly, a similar sequence is present in mGlu8aR and consistently, endocytosis of mGlu8aR depended on CRIP1a, as well. Docking analysis and molecular dynamics simulations identified a conserved serine in CB1R (S468) and mGlu8aR (S894) that forms a hydrogen bond with the peptide backbone of CRIP1a at position R82. In contrast to mGlu8aR, the closely related mGlu8bR splice-variant carries a lysine (K894) at this position, and indeed, mGlu8bR endocytosis was not affected by CRIP1a. Chimeric constructs between CB1R, mGlu8aR, and mGlu8bR underline the role of the identified five CRIP1a sensitive amino acids. In summary, we suggest that CRIP1a negatively regulates endocytosis of two different G-protein coupled receptor types, CB1R and mGlu8aR. [ABSTRACT FROM AUTHOR]

Objectives: Perform a follow-up study to investigate the histologic impact of high-dose intralaryngeal cidofovir injections in porcine vocal cords, either alone or in combination with bevacizumab, and compared to saline controls.Study Design: This was an in vivo study involving 24 pigs with blinded pathologist review of specimens. Six groups were created, with four subjects in each group. Each subject received 10 or 20 mg of either cidofovir or bevacizumab alone, or in combination, injected into the right vocal cord. The left vocal fold was used as a saline control. Three separate injections were made at 2-week intervals. Larynges were harvested at 8 and 12 weeks, stained with hematoxylin and eosin and trichrome stain, and reviewed for histologic changes by two blinded pathologists.Results: Minimal inflammation, edema, and atypia were noted with all treatments. Increased glandular inflammation was noted with 10 mg bevacizumab (P < 0.05), which decreased when combined with 10 mg cidofovir (P < 0.05). No lamina propria or muscle fibrosis was observed. Drug duration had no statistically significant histologic impact.Conclusion: High-dose cidofovir and bevacizumab do not induce detrimental vocal fold changes. Combination cidofovir and bevacizumab do not cause vocal fold scarring. Further work is needed to assess systemic concentration with this high-dose combination in humans.Level Of Evidence: N/A. Laryngoscope, 127:671-675, 2017. [ABSTRACT FROM AUTHOR]

One partial and three complete moles were studied using the HDliveFlow silhouette mode with HDlive silhouette mode (Voluson E10, GE Healthcare Japan, Tokyo, Japan). The case of typical complete mole was reported previously by our group, using different rendering techniques for 3D examinations of the molar pregnancy [1]. This article is protected by copyright. All rights reserved. [ABSTRACT FROM AUTHOR]

We present our experience of using new 3‐dimensional color/power Doppler sonography (HDliveFlow; GE Healthcare Japan, Tokyo, Japan) with the HD live silhouette mode for diagnosing complete molar pregnancy in the first trimester and differentiating it from missed abortion with hydropic degeneration. In the case of a complete mole, color Doppler sonography showed numerous vesicles without blood vessels, whereas HDliveFlow with the HD live silhouette mode clearly depicted these vesicles forming a mass with the clear demarcation of its edges and showed no blood flow inside the mass. In contrast to the hydropic abortion, which appeared as some vesicles with many blood vessels around them on color Doppler sonography, HDliveFlow with the HD live silhouette mode showed some vesicles embedded within the abundant blood vessels. The spatial relationship between the vesicles and surrounding highly vascularized uterus could be shown on HDliveFlow with the HD live silhouette mode. This technique might be beneficial as an additional diagnostic tool along with conventional color/power Doppler sonography, and it facilitates the early discrimination of these cases in the first trimester of pregnancy. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this article is to present our experience with normal and abnormal fetal cardiac structures reconstructed in the HDlive silhouette mode (GE Healthcare Japan, Tokyo, Japan) with spatiotemporal image correlation (STIC). Methods: Twenty‐two fetuses with normal hearts and 1 fetus with a congenital heart anomaly (Ebstein anomaly) at 20 to 36 weeks' gestation were studied in the HDlive silhouette mode with STIC. Results: In normal fetal hearts, 4 cardiac chambers and crisscross arrangements of the pulmonary artery and aorta were clearly identified. This modality facilitated visualization of the relationships and course of the outflow and inflow tracts, thus helping the operators more effectively understand the spatial relationships among the cardiac chambers and vessels. The opening and closing of mitral, tricuspid, pulmonary, and aortic valves were ascertained in the en face view of both atrioventricular valves and great vessels. In the fetus with Ebstein anomaly, a low attachment of the tricuspid valve and an enlarged right atrium were evident. Conclusions: The HDlive silhouette mode with STIC provides new visual experiences for physicians, owing to the anatomically clear depiction of fetal cardiac structures, and it may be an easier way to depict the spatial relationships among fetal cardiac chambers, great arteries, and veins. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effect of TeamSTEPPS (Team Strategies and Tools to Enhance Performance and Patient Safety) on operating room efficiency for the otolaryngology service at a tertiary care medical center.Study Design: Retrospective database review.Setting: Otolaryngology department at tertiary care medical center.Subjects and Methods: To assess the impact of implementing an evidence-based patient safety initiative, TeamSTEPPS, on operating room efficiency in the otolaryngology department, the operative times, time lost to delayed starts, and turnover times during the year following the implementation of TeamSTEPPS were compared with the values from the prior year.Results: The study compared 1322 cases and 644 turnovers in the year prior to TeamSTEPPS implementation with 1609 cases and 769 turnovers in the following year. There were no statistically significant decreases in operating room efficiency in the year after the TeamSTEPPS rollout.Conclusion: Operating room efficiency was preserved after the rollout of a rigorous evidence-based patient safety initiative that requires active participation from all operating room team members. [ABSTRACT FROM AUTHOR]

ABSTRACT Sidechain rotamer libraries are obtained through exhaustive statistical analysis of existing crystallographic structures of proteins and have been applied in multiple aspects of structural biology, for example, crystallography of relatively low-resolution structures, in homology model building and in biomolecular NMR. Little is known, however, about the driving forces that lead to the preference or suitability of one rotamer over another. Construction of 3D hydropathic interaction maps for nearly 30,000 tyrosines reveals the environment around each, in terms of hydrophobic (π-π stacking, etc.) and polar (hydrogen bonding, etc.) interactions. After partitioning the tyrosines into backbone-dependent ( ϕ, ψ) bins, a map similarity metric based on the correlation coefficient was applied to each map-map pair to build matrices suitable for clustering with k-means. The first bin (−200° ≤ ϕ < -155°; −205° ≤ ψ < -160°), representing 631 tyrosines, reduced to 14 unique hydropathic environments, with most diversity arising from favorable hydrophobic interactions with many different residue partner types. Polar interactions for tyrosine include surprisingly ubiquitous hydrogen bonding with the phenolic OH and a handful of unique environments surrounding the tyrosine backbone. The memberships of all but one of the 14 environments are dominated (>50%) by a single χ1/ χ2 rotamer. The last environment has weak or no interactions with the tyrosine ring and its χ1/ χ2 rotamer is indeterminate, which is consistent with it being composed of mostly surface residues. Each tyrosine residue attempts to fulfill its hydropathic valence and thus, structural water molecules are seen in a variety of roles throughout protein structure. Proteins 2015; 83:1118-1136. © 2015 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Background We hypothesized that transcutaneous gas determinations of O2 and CO2 (TcPO2 and TcPCO2) are associated with the severity of PAH. Methods In this cross-sectional study, we included consecutive patients with PAH (group 1 PH; n = 34). Transcutaneous gas determinations were compared to those of age- and gender-matched healthy controls ( n = 14), nongroup 1 PH ( n = 19) or patients with high estimated RVSP on echocardiography but without hemodynamic evidence of PH ( n = 12). Results In patients with PAH, TcPO2, and TcPCO2 were significantly associated with PaO2 ( R = 0.44, p = 0.03) and PaCO2 ( R = 0.77, p < 0.001), respectively. TcPO2/FiO2 (mean difference: −65.0 [95% CI: −121.3, −8.7]) and TcPCO2 (mean difference: −7.4 [95% CI: −11.6, −3.1]) were significantly lower in patients with PAH than healthy controls. TcPCO2 was useful in discriminating PAH patients from other individuals ( AUC: 0.74 [95% CI: 0.62, 0.83]). TcPO2/FiO2 ratio was significantly associated with mean PAP, TPG, PVR, CI, SVI, DLCO, six-minute walk distance and components of the CAMPHOR questionnaire. Conclusions Transcutaneous pressure of CO2 was lower in patients with PAH. Transcutaneous pressure of O2 over inspired fraction of O2 ratio was inversely associated with severity of disease in patients with PAH. [ABSTRACT FROM AUTHOR]

We present our experience of using the HDLive silhouette inversion mode to assess complete hydatidiform mole early in pregnancy. The HDLive silhouette inversion mode clearly depicted the number, size, and spatial position of molar vesicles, compared with conventional two ‐ dimensional sonography or the HDLive inversion mode. Moreover, spatial relationships among molar vesicles, intrauterine anechoic fluid collection, and the uterine wall enabled the clear localization of the lesion. This technique provides new insights, and has the potential to supplement conventional two ‐ dimensional sonography in the diagnosis of complete hydatidiform mole. [ABSTRACT FROM AUTHOR]

Background Cleft palate anesthesia is challenging due to difficult airway. Left paraglossal intubation moves resting point of laryngoscope laterally but associated with narrower laryngoscopic view and possible trauma, and we invented the use of hard gum shield as a bridge over defective palate to facilitate intubation with possible wider window and defective tissue protection. Methods Eighty bilateral cleft palate children, ASA physical status I- II aged 9 months to 6 years scheduled for plastic surgery had general anesthesia, were involved in prospective, controlled, randomized study, and were randomly divided by closed envelope method into two groups: group I (40 patients): intubated by hard gum shield-aided intubation and group II (40 patients): intubated by left paraglossal intubation. Both techniques compared as regards (i) intubation time; (ii) Cormack and Lehane score; (iii) need for external laryngeal manipulation; (iv) easiness of intubation: easy, modest, or difficult intubation; and (v) complications: desaturation and failed intubation. Results Intubation time was shorter in group I (28.47 ± 3.78 vs. 37.63 ± 6.64 s, P = 0.001). Cormack and Lehane score was better in group I ( P = 0.003). Need for external laryngeal manipulation was less in group I ( P = 0.015). Easiness of intubation was better in group I ( P = 0.022). No difference was found in complications between groups. Conclusion Hard gum shield-aided intubation facilitated intubation more than left paraglossal in bilateral cleft palate children with shorter intubation time, better glottic view, easier intubation, less need for laryngeal manipulation than left paraglossal intubation with no difference in complications. [ABSTRACT FROM AUTHOR]

Neuropathic pain is a common problem following spinal cord injury (SCI). Effective analgesic therapy has been hampered by the lack of knowledge about the mechanisms underlying post-SCI neuropathic pain. Current evidence suggests GABAergic spinal nociceptive processing is a critical functional node in this complex phenotype, representing a potential target for therapeutic intervention. Normal GABA neurotransmission is dependent on precise regulation of the level of intracellular chloride, which is determined by the coordinated activities of two cation/chloride cotransporters (CCCs) in the SLC12 family: the inwardly directed Na+-K+-Cl− cotransporter isoform 1 (NKCC1) and outwardly directed K+-Cl− cotransporter isoform 2 (KCC2). Inhibition of NKCC1 with its potent antagonist bumetanide reduces pain behavior in rats following SCI. Moreover, the injured spinal cord tissues exhibit a significant transient upregulation of NKCC1 protein and a concurrent downregulation of KCC2 protein. Thus, imbalanced function of NKCC1 and KCC2 may contribute to the induction and maintenance of the chronic neuropathic pain following SCI. [ABSTRACT FROM AUTHOR]

Purpose: Evaluation of the strain transmitted to the abutments and residual ridge by polyetherketoneketone material compared to the cobalt-chromium one in distal extension removable partial dentures (RPDs) to fulfill the objective of preservation of the supporting structures., Materials and Methods: A virtual model simulating a Kennedy class I partially edentulous mandibular arch was designed. Two models, one for each group, were printed. Five RPDs were made in each group. In group CR, the framework was milled from a cobalt-chromium alloy. While in group PK, it was milled from a polyetherketoneketone blank. Strain gauge rosettes were bonded distal to the last abutment and posteriorly in the distal end of the residual ridge. Unilateral vertical and oblique loadings were applied. Mann-Whitney U test was used for inter-group comparisons while the Friedman test was used for intra-group comparisons and corrected by Wilcoxon Signed-Rank Sum. The significance level was set at p ≤ 0.05., Results: During unilateral vertical load application, a statistically significant difference was found between both groups distal to the abutment in the loaded and unloaded sides as well as the residual ridge on the unloaded side. During oblique load application, a statistically significant difference was found between both groups in all slots., Conclusion: Polyetherketoneketone material induces less stress on the abutments and more stress on the residual ridges compared to the cobalt-chromium ones. Therefore, it may be recommended for weak abutments supporting RPDs., (© 2024 by the American College of Prosthodontists.)

Background: It remains unknown whether the cutaneous microvascular responses are different between patients with scleroderma-associated pulmonary arterial hypertension (SSc-PAH) and SSc without pulmonary hypertension (PH)., Methods: We included 59 patients with SSc between March 2013 and September 2019. We divided patients into 4 groups: (a) no PH by right heart catheterization (RHC) (n = 8), (b) no PH by noninvasive screening tests (n = 16), (c) treatment naïve PAH (n = 16), and (d) PAH under treatment (n = 19). Microvascular studies using laser Doppler flowmetry (LDF) were done immediately after RHC or at the time of an outpatient clinic visit (group b)., Results: The median (IQR) age was 59 (54-68) years, and 90% were females. The responses to local thermal stimulation and postocclusive reactive hyperemia, acetylcholine, and sodium nitroprusside iontophoresis were similar among groups. The microvascular response to treprostinil was more pronounced in SSc patients without PH by screening tests (% change: 340 (214-781)) compared with SSc-PAH (naïve + treatment) (Perfusion Units (PU) % change: 153 (94-255) % [p = .01]). The response to A-350619 (a soluble guanylate cyclase (sGC) activator) was significantly higher in patients with SSc without PH by screening tests (PU % change: 168 (46-1,296)) than those with SSc-PAH (PU % change: 22 (15-57) % [p = .006]). The % change in PU with A350619 was directly associated with cardiac index and stroke volume index (R: 0.36, p = .03 and 0.39, p = .02, respectively)., Conclusions: Patients with SSc-PAH have a lower cutaneous microvascular response to a prostacyclin analog treprostinil and the sGC activator A-350619 when compared with patients with SSc and no evidence of PH on screening tests, presumably due to a peripheral reduction in prostacyclin receptor expression and nitric oxide bioavailability., (© 2021 John Wiley & Sons Ltd.)