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Background: Volume contraction frequently contributes to the development of acute kidney injury. The rapid assessment of volume status in patients with acute kidney injury could improve decision making and outcomes. Methods: The maximum and minimum diameters and percent collapsibility of the inferior vena cava (IVC) were measured in 30 patients admitted to the medical intensive care unit with laboratory evidence of acute kidney injury. These measurements were made on the day of admission and 24 hours following admission. Information about age, gender, body mass index, serum creatinine levels, and fluid balances was recorded. Results: This study included 30 patients with a mean age is 62.4 ±16.0 years. The mean initial creatinine was 4.3 ± 4.2 mg/dL (range: 1.7 mg/dL to 22.1 mg/dL). The mean fractional excretion of sodium was 2.06 ± 2.65%. The mean maximum diameter of inferior vena cava was 1.8 ± 0.5 cm with the range is 0.4-2.65 cm. The mean percent collapse was 32 ± 20%. Five patients had evidence of hypovolemia using guidelines from the American Society of Echocardiology; 6 patients had evidence of hypervolemia. Nineteen patients had measurements between these 2 categories. There is no significant change in mean diameters following fluid administration for 24 hours. An initial IVC diameter of 0.94 cm predicted ≥ 30% collapsibility with an area under the curve is 0.748. Discussion: Patients with acute kidney injury based on laboratory measurements had evidence for hypovolemia, euvolemia, and hypervolemia based on IVC measurements. There was no consistent change in IVC dimensions following fluid administration, even though the creatinine fell in most patients. Simple bedside measurements of IVC dimensions can facilitate fluid administration decisions but must be used with clinical assessment.

Drugs, including those used during diagnostic procedures, can have adverse effects and potentially serious side-effects, especially in complicated patients with significant comorbidity. Benzocaine is frequently used as an oropharyngeal anesthetic agent during bronchoscopy, transesophageal echocardiography, and upper GI endoscopy and can cause methemoglobinemia, a potentially life-threatening event if not diagnosed and treated quickly. Co-oximetry is the gold standard for the diagnosis of methemoglobinemia and can quantitate blood levels, which in turn correlate with the clinical presentation and the urgency for treatment. Methylene blue is the treatment of choice for methemoglobinemia. In this case report we discuss the pathophysiology, the clinical presentation, the diagnosis, and the treatment of benzocaine-induced methemoglobinemia.

Cardiovascular disease is the leading cause of death in patients with chronic kidney disease. Heart failure may lead to acute kidney injury and vice versa. Chronic kidney disease may affect the clinical outcomes in patients with cardiovascular disorders. Renal impairment with any degree of albuminuria has been increasingly recognized as an independent risk factor for cardiovascular events and heart failure hospitalizations, while chronic heart failure may cause chronic kidney disease. The bidirectional nature of these disorders contributes to the complexity and the composite definitions of cardiorenal syndromes. However, the most important clinical trials in heart failure tend to exclude patients with significant renal dysfunction. The mechanisms whereby renal insufficiency worsens the outcome in heart failure are not known, and several pathways could contribute to the ‘‘vicious heart/kidney circle.’’ Traditionally, renal impairment has been attributed to the renal hypoperfusion due to reduced cardiac output and decreased systemic pressure. The hypovolemia leads to sympathetic activity, increased renin-angiotensin aldosterone pathway, and arginine-vasopressin release. These mechanisms cause fluid and sodium retention, peripheral vasoconstriction, and volume overload. Therapy to improve renal dysfunction, reduce neurohormonal activation and ameliorate renal blood flow could lead to a reduction in mortality and hospitalization in patients with cardiorenal syndrome.

We are reporting a case of familial thoracic aortic aneurysm and dissection in a 26-year-old man with no significant past medical history and a family history of dissecting aortic aneurysm in his mother at the age of 40. The patient presented with cough, shortness of breath, and chest pain. Chest X-ray showed bilateral pulmonary infiltrates. CT scan of the chest showed a dissection of the ascending aorta. The patient underwent aortic dissection repair and three months later he returned to our hospital with new complaints of back pain. CT angiography showed a new aortic dissection extending from the left carotid artery through the bifurcation and into the iliac arteries. The patient underwent replacement of the aortic root, ascending aorta, total aortic arch, and aortic valve. The patient recovered well postoperatively. Genetic studies of the patient and his children revealed no mutations in ACTA2, TGFBR1, TGFBR2, TGFB2, MYH11, MYLK, SMAD3, or FBN1. This case report focuses on a patient with familial TAAD and discusses the associated genetic loci and available screening methods. It is important to recognize potential cases of familial TAAD and understand the available screening methods since early diagnosis allows appropriate management of risk factors and treatment when necessary.

Breast cancer is the most common cancer type and a primary cause of cancer mortality among females worldwide. Here, we analyzed the anticancer efficacy of a novel bromochlorinated monoterpene, PPM1, a synthetic analogue of polyhalogenated monoterpenes from Plocamium red algae and structurally similar non-brominated monoterpenes. PPM1, but not the non-brominated monoterpenes, decreased selectively the viability of several triple-negative as well as triple-positive breast cancer cells with different p53 status without significantly affecting normal breast epithelial cells. PPM1 induced accumulation of triple-negative MDA-MB-231 cells with 4N DNA content characterized by decreased histone H3-S10/T3 phosphorylation indicating cell cycle arrest in the G2 phase. Western immunoblot analysis revealed that PPM1 treatment triggered an initial rapid activation of Aurora kinases A/B/C and p21Waf1/Cip1 accumulation, which was followed by accumulation of polyploid >4N cells. Flow cytometric analysis showed mitochondrial potential disruption, caspase 3/7 activation, phosphatidylserine externalization, reduction of the amount polyploid cells, and DNA fragmentation consistent with induction of apoptosis. Cell viability was partially restored by the pan-caspase inhibitor Z-VAD-FMK indicating caspase contribution. In vivo, PPM1 inhibited growth, proliferation, and induced apoptosis in MDA-MB-231 xenografted onto the chick chorioallantoic membrane. Hence, Plocamium polyhalogenated monoterpenes and synthetic analogues deserve further exploration as promising anticancer lead compounds.

The family of polyhalogenated monoterpenes from Plocamium counts over a hundred known members. Using glyceraldehyde acetonide as a chiral-pool precursor, an enantioselective and divergent strategy was developed that provides a blueprint for the synthesis of many of the small yet complex acyclic members of this family. The broad applicability of this approach is demonstrated with the short, eight-step synthesis of four natural products and three analogues. These syntheses are the first of any members of the acyclic polyhalogenated Plocamium monoterpenes and permitted the evaluation of their selectivity against a range of tumor cell lines.

This correction notice emphasizes that the experiments conducted in the original publication were done simultaneously with several plant species, and identical control groups were used for both articles. This decision was made to minimize animal usage and ensure reliable results. The authors apologize for not disclosing this similarity in the original submission. Additionally, there was a mistake in the legend for Figure 11 in the original publication. The authors state that the scientific conclusions are unaffected, and the original publication has been updated. [Extracted from the article]

Objectives : To determine the importance of bilateral neck dissections which is done as a routine procedure in patients with supraglottic carcinoma and N0 neck, in terms of detecting the incidence of positive lymph nodes on the contralateral side. Study Design : Prospective study including 50 patients with supraglottic carcinoma & N0 neck. Setting : 50 patients were admitted from Otolaryngology department, Kasr-Al Aini hospital, Cairo University during the period from January 2016 till August 2017. Subjects and Methods : All patients were diagnosed with supraglottic carcinoma with N0 lymph nodes. Bilateral neck dissections were done - in conjugation to laryngectomy - to detect the incidence of the positive contralateral lymph nodes in these cases. Those with the extensive tumor midline cross over, unfit ones, or who were refusing surgery were excluded. Results : In this study, 48% of the cases had positive lymph nodes on the ipsilateral side while 16% had positive lymph nodes on the contralateral side. Level II on both sides was the most affected with 67% on the ipsilateral side & 100% on the contralateral side. A correlation was detected between the T-stage of the primary lesion of the larynx and the incidence of positive lymph nodes for both sides of neck (p value <0.05). It was also revealed that the incidence of the contralateral positive neck nodes was increased as the incidence of the ipsilateral positive nodes increased in N0 cases (p value <0.05). Conclusions : It could be concluded that bilateral neck dissections should be routinely done in cases of supraglottic carcinoma N0 patients, especially with the higher T stages. [ABSTRACT FROM AUTHOR]

Background: Haplophyllum tuberculatum is a plant belongs to family rutacee. It is rich in volatile oils, fixed oils, alkaloids, and furanocoumarins. It is well known for the huge number of folkloric uses in middle east. Objective: The aim of this study is to establish the chemical composition of the essential oils of Libyan H. tuberculatum and to investigate their cytotoxic potentialities.Materials and Methods: The essential oils of the aerial parts and flowers of H. tuberculatum growing in Libya were prepared by hydrodistillation. GC/MS analyses were performed on a Shimaduz capillary gas chromatograph (GC 17A ver.3) instrument directly coupled to mass spectrometer-MS QP5050A. Oil A and F of H. tuberculatum at different concentrations (0-50 µg/ml) in DMSO were tested for cytotoxicity against human tumor cell lines. Results: Oil yield was found 0.4 and 1.5 (v/w %) on dry weight basis respectively. GC/MS analysis resulted in identification of total 35 compounds. 15 compounds were common to both oils. oil A of H. tuberculatum exhibited antitumor activities against. liver carcinoma cell line (HEPG2) and lung carcinoma cell line (H1299) 4.7 µg/ml and 4.1 µg/ml. Conclusion: Essential oil of the aerial parts of H. tuberculatum is potentially active against lung (H-1299), and liver (HEPG2) carcinoma cell lines. The observed cytotoxic, activities can be attributed to the dominance of α and γ-terpinene in this oil. [ABSTRACT FROM AUTHOR]

In rural and remote areas, solar photovoltaic energy (PV) water pumping systems (SPWPSs) are being favored over diesel-powered water pumping due to environmental and economic considerations. PV is a clean source of electric energy offering low operational and maintenance cost. However, the direct-coupled SPWPS requires inventive solutions to improve the system's efficiency under solar power variations while producing the required amount of pumped water concurrently. This paper introduces a new quadratic V/f (Q V/f) control method to drive an induction motor powered directly from a solar PV source using a two-stage power converter without storage batteries. Conventional controllers usually employ linear V/f control, where the reference motor speed is derived from the PV input power and the dc-link voltage error using a simple proportional–integral (PI) controller. The proposed Q V/f-based system is compared with the conventional linear V/f control using a simulation case study under different operating conditions. The proposed controller expectedly enhances the system output power and efficiency, particularly under low levels of solar irradiance. Some alternative controllers rather than the simple PI controller are also investigated in an attempt to improve the system dynamics as well as the water flow output. An experimental prototype system is used to validate the proposed Q V/f under diverse operating conditions. [ABSTRACT FROM AUTHOR]

Patients with neuropathic pain experience chronic painful tingling, burning, and prickling sensations accompanied with hyperalgesia and/or allodynia. In this study, 38 secondary metabolites of a methanol extract from Salix tetrasperma flowers were identified by liquid chromatography-mass spectrometry (HPLC-MS/MS). The extract showed substantial anti-inflammatory, central and peripheral anti-nociceptive, antipyretic, and antioxidant activities in vitro and in different animal models. In the chronic constriction injury (CCI) rat model, the extract was able to attenuate and significantly relieve hyperalgesia and allodynia responses in a dose dependent manner and restore the myelin sheath integrity and Schwann cells average number in the sciatic nerve. The enzyme-linked immunosorbent assay (ELISA) showed that the extract significantly reduced the expression of various pro-inflammatory biomarkers including nuclear factor kabba B (NF-κB), tumor necrosis factor alpha (TNF-α), prostaglandin E2 (PGE2), 5-lipoxygenase (5-LOX), cyclooxygenase-2 (COX-2), inducible nitric oxide synthase (iNOS), and the oxidative stress biomarker NADPH oxidase 1 (NOX1), in brain stem and sciatic nerve tissues. These findings were supported by in vitro enzyme inhibition assays (COX-1, COX-2 and 5-LOX). Moreover, the extract significantly reduced p53 expression in the brain stem tissue. These findings support the use of S. tetrasperma in folk medicine to alleviate pain. It could be a promising natural product for further clinical investigations to treat inflammation, nociceptive pain and chronic neuropathic pain. [ABSTRACT FROM AUTHOR]