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Pharyngoesophageal defects can cause exposure to various bacterial flora and severe inflammation. We fabricated a biodegradable polycaprolactone (PCL) patch composed of both thin film and three-dimensional (3D) printed lattice, and then investigated the efficacy of pharyngoesophageal reconstruction by using 3D printed antibiotic-releasing PCL patches that inhibited early inflammation by sustained tetracycline (TCN) release from both thin PCL films and printed rods implanted in esophageal partial defects. PCL was 3D printed in lattice form on a presolution casted PCL thin film at ∼100 μm resolution. TCN was loaded onto the PCL-printed patches by 3D printing a mixture of TCN and PCL particles melted at 100°C. TCN exhibited sustained release

Yao Lin, Yaqi Li, Jingjing Ma, Aijie Li, Yang Liu, Lin Shi Department of Cardiology, Children’s Hospital, Capital Institute of Pediatrics, Beijing, People’s Republic of ChinaCorrespondence: Lin ShiDepartment of Cardiology, Children’s Hospital, Capital Institute of Pediatrics, No. 2 Yabao Road, Chaoyang District, Beijing, 100020, People’s Republic of ChinaTel +86-13621096102Email shilinpediatric@outlook.comBackground: Aspirin remains a key component of the standard therapy for Kawasaki disease (KD) in children. Although it is well known that aspirin can cause hypersensitivity such as aspirin-induced urticaria (AIU), AIU in children with KD has not been described.Methods: A retrospective case-control study was conducted to investigate AIU clinical features, biochemical parameters, treatment and outcomes in children with KD. Furthermore, biomarkers for predicting AIU were explored using the receiver operating characteristic (ROC) curve analysis.Results: We identified 46 AIU cases with 22 boys and 24 girls during April 2015–May 2019. Eighty-nine age-matched KD patients without AIU were randomly chosen as controls. The proportions of children with allergy history and aspirin doses administered in the 2 groups were found not to be significantly different. AIU group had substantially higher baseline C-reactive protein and NT-proBNP levels, and increased neutrophil percent. AIU appeared 6.0 (4.0, 8.0) days after aspirin treatment. Aspirin withdrawal and anti-allergic treatment were applied for AIU, and AIU disappeared in 1– 3 days. Baseline NT-proBNP predicted AIU with an AUC of 0.70 (95% CI [0.60 to 0.79]) for sensitivity and specificity of 72.1% and 62.5%, respectively, for a cut-off value of 612.9 mg/L. The length of hospital stay for AIU patients was significantly greater compared with controls.Conclusion: AIU in KD children is not related to gender or aspirin dose, and those with AIU have more severe inflammation at admission. Aspirin should be withdrawn for AIU management. Baseline NT-proBNP may serve as a valuable biomarker to predict AIU.Keywords: Kawasaki disease, aspirin, aspirin-induced urticaria, case-control study

In this article, we present a case of apixaban elimination prolonged by 450% in a patient with coronavirus disease 2019 because of multiple conditions, including drug–drug interaction, severe inflammation, and acute kidney injury. Therapeutic drug monitoring was used to explain unusual routine coagulation assays. This grand round highlights the importance of dialog between the clinician and a therapeutic drug monitoring consultant for optimal patient care.

The high load of protozoan parasites in marine bivalves often leads to mass mortalities of the hosts. On the west coast of Korea in the Yellow Sea, the protozoan parasite Perkinsus olseni has been identified as the agent causing mass mortality of Manila clam Ruditapes philippinarum. During August and September 2004, mass mortality of clam occurred at Hwangdo (HD) tidal flat in Anmyeondo Island on the west coast, resulting in a 50% reduction in the clam landings. Shortly after the mortality event, we examined pathology, and the fitness of the survived clams from HD to elucidate the impacts of P. olseni infection. Histology revealed that clams collected from HD in October 2004 were infected by P. olseni. In histology, P. olseni could be observed from all types of tissues of clams from HD, and severe inflammation was observed in the gills. Ray's fluid thioglycollate medium assay (RFTM) indicated that the infection intensity in clams from HD (1.738 × 106 cells/g gills in October and 1.476 × 106 cells/g gills in December) was significantly higher than the levels in clams from the neighboring tidal flats (0.001 to 0.622 × 106 cells/g gills, P

This study was conducted to assess the clinical spectrum, management, and outcome of SARS-CoV-2-related multisystem inflammatory syndrome in children (MIS-C). We reviewed medical records of children with MIS-C diagnosis seen at the Children's Hospital of Michigan in Detroit between April and June 2020. Thirty-three children were identified including 22 who required critical care (group 1) and 11 with less intense inflammation (group 2). Children in group 1 were older (median 7.0 years) than those in group 2 (median 2.0 years). Abdominal pain was present in 68% of patients in group 1. Hypotension or shock was present in 17/22 patients in group 1. Thirteen (39.4%) had Kawasaki disease (KD)-like manifestations. Five developed coronary artery dilatation; All resolved on follow-up. Intravenous immunoglobulin (IVIG) was given to all patients in group 1 and 7/11 in group 2. Second-line therapy was needed in 13/22 (group 1) for persisting inflammation or myocardial dysfunction; 12 received infliximab. All patients recovered.Conclusion: MIS-C clinical manifestations may overlap with KD; however, MIS-C is likely a distinct inflammatory process characterized by reversible myocardial dysfunction and rarely coronary artery dilatation. Supportive care, IVIG, and second-line therapy with infliximab were associated with a favorable outcome. What is Known: • Multisystem inflammatory syndrome in children (MIS-C) manifestations include fever, gastrointestinal symptoms, shock, and occasional features of Kawasaki disease (KD). • Treatment includes immunomodulatory agents, most commonly IVIG and corticosteroids. What is New: • Spectrum of MIS-C varies from mild to severe inflammation and coronary artery dilatation occurred in 5/22 (23%) critically ill patients. • IVIG and infliximab therapy were associated with a favorable outcome including resolution of coronary dilatation; only 2/33 received corticosteroids.

This study compared clinical, histologic, and inflammatory outcomes of Biodentine and Bioactive glass (70S30C-BAG) as pulpotomy agents in primary teeth. A randomised, clinical trial was performed recruiting 70 children, 5–9 years old, having ≥ 1 tooth indicated for vital pulpotomy. Participants were randomised to Biodentine or 70S30C-BAG groups. Clinical evaluation was scheduled at 1, 3, 6, 9, and 12 months. Additional 16 teeth were extracted after 6 weeks to assess histologic and inflammatory response (IL-8/IL-10 ratio) using ELISA. Fisher exact, Mann Whitney U test, and t test were used to compare clinical, histologic outcomes and IL-8/IL-10 ratio. After 3 months, 10 teeth treated with Biodentine were clinically successful, while 9 teeth treated with 70S30C-BAG failed (P

Background Subtotal cholecystectomy is a “damage control” or “bailout procedure” that is used in difficult gallbladder cases when severe inflammation distorts the local anatomy resulting in increased risk in damage to surrounding structures. Subtotal cholecystectomy rates increased nationally over the past decade. We aimed to determine provider experience and patient factors associated with the performance of subtotal cholecystectomies. Methods All cholecystectomies from 2016 to 2019 were reviewed. Patient demographics, laboratory values, imaging, preoperative diagnosis, surgical technique (fenestrating vs. reconstituting), and years of attending and resident experience were collected. Multivariable regression analysis was performed to evaluate for factors that increase the likelihood of subtotal cholecystectomy. Results Of 916 cholecystectomies, 86 were subtotal. The likelihood of subtotal cholecystectomy did not increase based on attending experience of ≤5 vs. > 5 years (odds ratio (OR) .66, P = .09). Older age (adjusted odds ratio (aOR) 1.23, P = .03), male sex (aOR 2.59, P < .01), white blood cells (WBC) above 10.3 (aOR 2.02, P = .02), and preoperative diagnosis of acute on chronic cholecystitis (aOR 5.47, P < .01) were associated with increased likelihood of subtotal cholecystectomy. Discussion Older age, male sex, WBC above 10.3, and preoperative diagnosis of acute on chronic cholecystitis were associated with the increased likelihood of subtotal cholecystectomies. The performance of subtotal cholecystectomy was not impacted by attending years of experience. In cases of severe gallbladder pathology, this technique is being used as an operative strategy among all surgeon levels.

Background and study aims Circular ESD (CESD) is a treatment option for patients with extensive early esophageal cancer. Its major drawback is the development of a stricture. Stenting may represent an attractive prevention strategy. We designed an experimental study to assess the effect of stents covered with acellular biomatrix (AB) and a drug-eluting stent. Materials and methods Thirty-five 35 pigs underwent CESD and were randomized into six groups: G1 (control), G2 (SEMS), G3 (SEMS + AB), G4 (SEMS + AB + steroid-eluting layer), G5 (biodegradable stent [BD]), G6 (BD + AB). SEMS were placed alongside the post-CESD defect, fixed and removed after 21 days. The main outcomes were stricture development, severity, and histopathology. Results Pigs with BD stents (G5, 6) experienced severe inflammation and hypergranulation without biodegradation, therefore, these groups were closed prematurely. Significant strictures developed in 29 of 30 pigs (96.7 %). The most severe stricture developed in G2 and G4 (narrowest diameter (mm) 8.5 ± 3, 3 (G2) and 8.6 ± 2.1 (G4) vs. 17 ± 7.3 (G1) and 13.5 ± 8.3 (G3); P Conclusions Stenting did not effectively prevent development of post-CESD esophageal stricture. SEMS with AB resulted in improved re-epithelization and decreased stricture severity. Steroid-eluting SEMS suppressed inflammation. BD stents seem inappropriate for this indication.

This study was conducted to determine the effects of a co-infection with Moritella viscosa at different exposure levels of sea lice Lepeophtheirus salmonis in Atlantic salmon (Salmo salar). M. viscosa (1.14 × 106 cfu/ml) was introduced to all experimental tanks at 10 days post-lice infection (dpLs). Mean lice counts decreased over time in both the medium lice co-infection (31.5 ± 19.0 at 7 dpLs; 16.9 ± 9.3 at 46 dpLs) and high lice co-infection (62.0 ± 10.8 at 7 dpLs; 37.6 ± 11.3 at 46 dpLs). There were significantly higher mortalities and more severe skin lesions in the high lice co-infected group compared to medium lice co-infected group or M. viscosa-only infection. Quantitative gene expression analysis detected a significant upregulation of genes in skin from the high lice co-infection group consistent with severe inflammation (il-8, mmp-9, hep, saa). Skin lesions retrieved throughout the study were positive for M. viscosa growth, but these were rarely located in regions associated with lice. These results suggest that while M. viscosa infection itself may induce skin lesion development in salmon, co-infection with high numbers of lice can enhance this impact and significantly reduce the ability of these lesions to resolve, resulting in increased mortality.

Mammalian group 2 innate lymphoid cells (ILC2s) are responsible for the early production of type 2 cytokines at mucosal barriers upon exposure to allergen. Inflammatory tissue environmental cues can influence ILC2 activity, and this cellular population can be further categorized into subtypes with additional or alternative functions. Subtypes can include trained (or 'memory-like') ILC2s, which recall previous allergic inflammation, inflammatory ILC2s, which acquire the ability to produce IL-17, and ex-ILC2s, which produce ILC1 cytokines. However, the functional states of ILC2s at sites of chronic or severe inflammation are not well characterized. Here, we discuss the emergence of ILC2s with 'exhausted'-like signatures, and argue that their hyporesponsiveness to stimulation and expression of inhibitory receptors is relevant in mammalian chronic allergic inflammation.

The systemic autoinflammatory diseases are disorders of the innate immune system distinguished by severe inflammation resulting from dysregulation of the innate immune system. Hereditary fever syndromes, such as FMF, TNF receptor-associated periodic syndrome, cryopyrin-associated periodic syndromes and mevalonate kinase deficiency, were the first group of systemic autoinflammatory diseases for which a genetic basis was established, between 1999 and 2001. Currently according to the latest report of the international union of immunological societies, 37 separate monogenic disorders were classified as autoinflammatory. In addition to the abovementioned monogenic conditions, we describe Schnitzler’s syndrome, a well-defined, acquired autoinflammatory condition without a clear genetic basis. For the purposes of this review, we discuss several conditions defined by the latest consensus process as systemic autoinflammatory diseases. We focus on those disorders where recent studies have contributed to further phenotypic characterization or had an impact on clinical management.

Introduction and importance Tubo-ovarian abscesses (TOA) is presented with multiple clinical manifestations including gastrointestinal findings. Case presentation Herein, we present a case of complicated diverticulitis that was misdiagnosed as TOA, owing to overlapping genital involvement. Clinical discussion Imaging could be misleading in these patients as a result of severe inflammation of intestines and surrounding organs. Conclusion Patients who do not respond to antibiotic treatment should be suspected of other gastrointestinal pathologies such as diverticulitis and should be evaluated accordingly., Highlights • Concomitant presentation of diverticulitis and Tubo-ovarian abscesses (TOA) has been rarely reported. • Diverticulitis can also be complicated, indicated by the involvement of other organs such as ovaries and fallopian tube. • In such cases, pathological evaluation, following the surgical intervention can indicate the exact disease.

In this study, we comprehensively explored graphene oxide (GO)-induced systemic immune responses and interference with hematopoiesis in mice upon GO intravenous injection. In the liver and spleen, GO led to alterations in immune components at different time points. GO exposure showed an effect on the populations of different types of hepatic macrophages. In the liver, the populations of macrophages mainly affected by GO including Kupffer cells and monocyte-derived macrophages. Stimulated hepatic inflammation led to the infiltration of platelets from the circulation into the liver and decreased peripheral platelets population at day 1. Interestingly, a decreased platelet population was observed on day 7 in the spleen. GO also led to accelerated hematopoiesis in the spleen. Therefore, the possible forced generation of more platelets and the release of mature platelets from the spleen contributed to the increased circulating platelet count on day 7. Therefore, although GO showed a low potential to induce severe inflammation in the liver and spleen, it disrupted hematopoiesis in the spleen, which contributed to fluctuations in circulating platelet counts. The interaction of GO with the immune system warrants comprehensive study for gaining better understanding.

In Japan, a 51-year-old man had minimally symptomatic severe acute respiratory syndrome coronavirus 2 infection. Multisystem inflammatory syndrome was diagnosed ≈5 weeks later; characteristics included severe inflammation, cardiac dysfunction, and IgG positivity. Clinicians should obtain detailed history and examine IgG levels for cases of inflammatory disease with unexplained cardiac decompensation.

Anti-myeloperoxidase vasculitis (MPO-AAV) is a life-threatening autoimmune disease which causes severe inflammation of small blood vessels, mainly in the kidney. As for many other autoimmune diseases, current treatments, which consist of general immunosuppressants, are partially effective, toxic and broadly immunosuppressive, causing significant and serious adverse effects in many patients. Therefore, there is an urgent need for more targeted and less harmful therapies. Tolerogenic dendritic cells, regulatory T cells and stem cells have emerged as attractive, new and safer options for the treatment for various autoimmune diseases due to their unique and selective immunosuppressive capacity. In this review, we will discuss how these cellular therapies offer potential to become novel and safer treatments for MPO-AAV.

Summary Type I and III interferons (IFNs) drive effective antiviral functions but differentially affect tissue homeostasis. Using mouse models of severe inflammation, Broggi et al. and Major et al. report in Science that type III IFNs disrupt epithelial cell proliferation and differentiation in the lung., Type I and III interferons (IFNs) drive effective antiviral function but differentially affect tissue homeostasis. Using mouse models of severe inflammation, Broggi et al. and Major et al. report in Science that type III IFNs disrupt epithelial cell proliferation and differentiation in the lung.

Purpose To describe vision-threatening complications after micropulse diode transscleral cyclophotocoagulation (MP-TSCPC). Methods Retrospective case series. Medical charts of patients who underwent MP-TSCPC and developed visually significant inflammation and hyphema after the procedure were reviewed. Patients were seen at the Upstate Medical University Ophthalmology clinic between 2017 and 2019. Results Out of 64 patients who underwent MP-TSCPC in the defined time period, 2 patients with postprocedure severe inflammation and hyphema were identified. One patient had severe-stage primary open-angle glaucoma (POAG). After MP-TSCPC, the patient was noted to have a large visually significant anterior chamber reaction and hyphema that occupied 80% of the anterior chamber on postprocedure day 1. The patient was treated with topical and oral corticosteroids, and topical atropine. The second patient had uncontrolled severe-stage POAG. The patient underwent MP-TSCPC. After the procedure, the patient was noted to have significant inflammation with fibrin and hyphema that filled 80% of the anterior chamber. The patient was treated with topical steroids. Conclusions As with any intervention, complications are inevitable. Recognition of complications and its possible associations allow for better and more individualized risk versus benefit analysis of an intervention. In this case series, exuberant anterior segment inflammation and hyphema occurred in 2 patients who underwent MP-TSCPC. The authors' goal is to raise awareness of severe anterior chamber inflammation and hyphema as complications occurring after laser treatment with a reputation of minimal or no side-effect profile and to better understand this relatively new laser advancement in the treatment of glaucoma.

Objective: Osteomyelitis (OM) is an acute or chronic inflammatory process, characterized by severe inflammation and progressive bone destruction. Limited efforts have been made to explore the genetic basis of OM. Method: The genome-wide association study data set of OM was obtained from the UK Biobank. A transcriptome-wide association study (TWAS) of OM was conducted by the FUSION tool using the gene expression reference weights of lymphocytes and blood. The OM-associated genes identified by TWAS were subjected to gene ontology (GO) enrichment analysis to explore OM-related gene sets. The TWAS results of OM were finally compared with a genome-wide mRNA expression profiling of OM to detect common genes and gene sets. Results: TWAS of OM detected 86 genes for lymphocytes and 387 genes for blood. Comparing the genes identified by TWAS and mRNA expression profiling detected eight common genes for OM, including VWF (pTWAS = 0.0030, pmRNA = 3.44 × 10−9), CCDC50 (pTWAS = 0.0130, pmRNA = 0.0003), and TPD52 (pTWAS = 0.0180, pmRNA = 1 × 10−6). GO analysis of the genes identified by TWAS detected multiple OM-associated GO terms, e.g. peroxisomal matrix (pTWAS = 0.0082), extracellular exosome (pTWAS = 0.0248), and monooxygenase activity (pTWAS = 0.0040). Further comparing the GO results of TWAS and mRNA expression profiling detected one common GO term, named extracellular exosome (pTWAS = 0.0248, pmRNA = 0.0027). Conclusion: This integrative study of TWAS and mRNA expression profiling detected multiple candidate genes and GO terms for OM. Our results provide novel clues for understanding the pathogenesis of OM.

We evaluated the effects of incision placement (midline vs. lateral), closure method (absorbable monofilament suture vs. n‐butyl‐ester cyanoacrylate adhesive, Vetbond®, 3 M), and tag burden (PIT-tag only vs. PIT-tag and acoustic transmitter) on survival, post-operative complications (i.e., viscera expulsion, necrosis), incision dehiscence, incision apposition, transmitter retention, incision healing, inflammation, and growth for intracoelomic transmitter implantation in age-0 lake sturgeon (Acipenser fulvescens). The risk of death was 5.17 times higher and the risk of viscera expulsion was 6.21 times higher for sturgeon that had midline incisions closed with Vetbond compared to all other treatments. Incision dehiscence probabilities were low for all treatments, except for midline incisions closed with Vetbond. Time to complete incision apposition occurred most quickly in the lateral suture treatment followed closely by the midline suture and lateral vetbond treatment groups. Tissue strength was notably weaker in the midline region. Transmitter retention was 100% for all treatments except for midline incisions closed with Vetbond. Inflammation was low and slightly decreased over time for incisions closed with Vetbond, while incisions closed with suture exhibited significant increases in inflammation levels over time. Incisions closed with suture achieved better healing outcomes initially, but the healing process was 2–3 times more likely to relapse because of severe inflammation compared to lateral incisions closed with Vetbond. Sturgeon with midline incisions closed with Vetbond gained less weight compared to the other treatments, while sturgeon with lateral incisions closed with Vetbond gained similar amounts of weight relative to both suture treatments and the control group. Collectively, results suggest that Vetbond can be effectively used to close small lateral incisions (≤ 8 mm), with a lower risk of severe inflammation compared with sutures. For transmitter implantation, we recommend using a lateral incision through the hypaxial musculature and either closing the incision with suture or Vetbond.

Aim of the work: To investigate the relation of hyponatremia to disease activity and fatigue in systemic lupus erythematosus (SLE) patients. Patients and methods: The present study included 30 SLE patients with hyponatremia and 70 with normal serum sodium (Na) level. SLE disease activity index and the Functional Assessment of Chronic Illness Therapy (FACIT)-Fatigue score were assessed. Results: The gender, age and disease duration of SLE patients with hyponatremia (26 females and 4 males; mean age 37.8 ± 9.3 years, 10.9 ± 5.1 years) were comparable with those without (60 females and 10 males; 36.9 ± 11.8 years, 11.1 ± 6.02; p = 0.71 and p = 0.9 respectively). SLE patients with hyponatremia showed significantly increased SLEDAI (14.2 ± 3.85 vs 3.86 ± 3.59; p

To describe a case of inflammatory neovascularization of the lens after open globe injury.Case report.A 57-year-old man presented with severe inflammation, posterior synechiae with traumatic cataract, and thick neovascularization of the intralenticular and anterior lens capsule after open globe injury in the left eye. We administered an intravitreal bevacizumab injection and performed cataract surgery with synechiolysis 1 month later.Inflammation after open globe injury may present as intralenticular neovascularization. Before cataract surgery for traumatic cataract with intralenticular neovascularization, the use of intravitreal bevacizumab injection was ineffective.

El síndrome respiratorio agudo severo coronavirus 2 (SARS-COV-2) descrito en Wuhan, China a finales del 2019, ha causado más de 9 millones de infecciones en el mundo, y más de 480 mil muertes. En Panamá se han reportado más de 28 mil casos, y más de 500 muertes por COVID-19. Se ha observado un alto riesgo de complicaciones trombóticas, probablemente como consecuencia del daño vascular asociado con la infección viral y la inflamación severa, con la contribución patógena de las plaquetas que interactúan con la pared vascular y los leucocitos. Describimos 3 casos de pacientes hospitalizados en un hospital general en la provincia de Panamá, República de Panamá. Dos hombres y una mujer, edad promedio 40.6 años, estadía hospitalaria promedio de 35.3 días; ingresados con diagnóstico de neumonía por SARS-COV-2, niveles elevados de dimero D (> 5 ug/mL), riesgo bajo calculado para embolia pulmonar. Encontrando embolia pulmonar aguda en las ANGIO tomografía y en un caso acompañado de trombosis venosa profunda. Todos recibían dosis profiláctica de heparina de bajo peso molecular. Se necesitan algoritmos para identificar a aquellos susceptibles de desarrollar complicaciones trombóticas y enfermedades graves, determinar el papel de los biomarcadores y sistemas de puntuación para estratificar el riesgo.AbstractThe severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) described in Wuhan, China in late 2019, has caused more than 9 million infections worldwide, and more than 480 thousand deaths. In Panama, more than 28 thousand cases have been reported, and more than 500 deaths from COVID-19. A high risk of thrombotic complications has been observed, probably as a consequence of vascular damage associated with viral infection and severe inflammation, with the pathogenic contribution of platelets that interact with the vascular wall and leukocytes. We describe 3 cases of patients hospitalized in a general hospital in the province of Panama, Republic of Panama. Two men and one woman, average age 40.6 years, average hospital stay of 35.3 days; admitted with a diagnosis of SARS-VOC-2 pneumonia, elevated levels of dimer D (> 5 ug / mL), calculated low risk for pulmonary embolism. Finding acute pulmonary embolism on ANGIO tomography and in one case accompanied by deep vein thrombosis. All received prophylactic doses of low molecular weight heparin. Algorithms are needed to identify those susceptible to developing thrombotic complications and serious diseases, determine the role of biomarkers and scoring systems to stratify risk.

In the past, a severe inflammation was a difficulty to complete a laparoscopic cholecystectomy for the increased risk of vasculo-biliary injuries. Today, if in laparoscopy a “critical view of safety” (CVS) is not possible, to avoid damages, several laparoscopic rescue procedures have been proposed. The first one and the most safe is to change technique abandoning the research of CVS to perform a laparoscopic subtotal cholecystectomy. Mandatory is that the decision of changing the surgical strategy should be made before doing vascular or biliary injuries. In this chapter, all the tricks to complete the usual cholecystectomy are reported. But when the safety of the patient is in danger, we report all the alternative laparoscopic techniques to finish the procedure safely. Finally, all the outcomes conclude the chapter.

This review examines the stress hormone cortisol which plays an important role in regulating and supporting different bodily functions. Disruption in cortisol production has an impact on health and this review looks at a wide range of papers where cortisol has been indicated as a factor in numerous chronic conditions—especially those which are classed as “noncommunicable diseases” (NCDs). Timely detection, screening, and treatment for NCDs are vital to address the growing problem of NCDs worldwide—this would have health and socioeconomic benefits. Interestingly, many of the papers highlight the pro‐inflammatory consequences of cortisol dysregulation and its deleterious effects on the body. This is particularly relevant given the recent findings concerning COVID‐19 where pro‐inflammatory cytokines have been implicated in severe inflammation., This review examines the stress hormone cortisol which plays an important role in regulating and supporting different bodily functions. Disruption in cortisol production has an impact on health and this review looks at a wide range of papers where cortisol has been indicated as a factor in numerous chronic conditions—especially those which are classed as “noncommunicable diseases” (NCDs).

Inflammation generally leads to recruitment of monocyte-derived macrophages. What regulates the fate of these cells and to what extent they can assume the identity and function of resident macrophages is unclear. Here, we show that macrophages elicited into the peritoneal cavity during mild inflammation persist long-term but are retained in an immature transitory state of differentiation due to the presence of enduring resident macrophages. By contrast, severe inflammation results in ablation of resident macrophages and a protracted phase wherein the cavity is incapable of sustaining a resident phenotype, yet ultimately elicited cells acquire a mature resident identity. These macrophages also have transcriptionally and functionally divergent features that result from inflammation-driven alterations to the peritoneal cavity micro-environment and, to a lesser extent, effects of origin and time-of-residency. Hence, rather than being predetermined, the fate of inflammation-elicited peritoneal macrophages seems to be regulated by the environment., The peritoneal cavity is a complicated myeloid niche containing a mixed population of resident macrophages and infiltrating cells that are responsive to inflammatory cues. Here the authors trace the fate of these infiltrating macrophages, their conversion to resident cells and how this is altered by the local inflammatory state over time.

Tissue adhesives have been widely used in surgery to treat pulmonary air leaks. However, conventional adhesives have poor interfacial strength under wet conditions. To overcome this clinical problem, we modified Alaska pollock-derived gelatin to include decanyl (C10) groups (C10-ApGltn) and used electrospinning to create a tissue-adhesive fiber sheet (AdFS). C10-AdFS showed higher burst strength when adhering to porcine pleura compared with a sheet of original ApGltn (Org-ApGltn). Hematoxylin-eosin-stained sections after burst experiments reveal that a dense C10-AdFS layer remained on the surface of the porcine pleura. The effect of the degree of C10 modification of ApGltn on the burst strength was evaluated. ApGltn with a C10 modification ratio of 13 mol% amino groups (13C10-AdFS) exhibited the highest burst strength. Furthermore, from ex vivo experiments with extracted rat lung, 13C10-AdFS exhibited a higher burst strength (41 cm H2O) than Org-AdFS. The decanyl groups in 13C10-AdFS interacted with the hydrophobic proteins and the lipid bilayers of the cells, resulting in the high interfacial strength between 13C10-AdFS and the pleura. Moreover, 13C10-AdFS samples implanted subcutaneously in the backs of rats were completely degraded within 21 days without any severe inflammation. These results show that 13C10-AdFS is a promising adhesive material for the treatment of pulmonary air leaks.

© 2020 by the authors. Licensee MDPI, Basel, Switzerland. Fumaric acid esters (FAEs) are small molecules with anti‐oxidative, anti‐inflammatory and immune‐modulating effects. Dimethyl fumarate (DMF) is the best characterised FAE and is approved and registered for the treatment of psoriasis and Relapsing‐Remitting Multiple Sclerosis (RRMS). Psoriasis and RRMS share an immune‐mediated aetiology, driven by severe inflammation and oxidative stress. DMF, as well as monomethyl fumarate and diroximel fumarate, are commonly prescribed first‐line agents with favourable safety and efficacy profiles. The potential benefits of FAEs against other diseases that appear pathogenically different but share the pathologies of oxidative stress and inflammation are currently investigated.

In healthcare practice, the sedimentation rate of red blood cells (erythrocytes) is a widely used clinical parameter for screening of several ailments such as stroke, infectious diseases, and malignancy. In a traditional pathological setting, the total time taken for evaluating this parameter varies typically from 1 to 2 h. Furthermore, the volume of human blood to be drawn for each test, following a gold standard laboratory technique (alternatively known as the Westergren method), varies from 4 to 5 ml. Circumventing the above constraints, here we propose a rapid (∼1 min) and highly energy efficient method for the simultaneous determination of hematocrit and erythrocyte sedimentation rate (ESR) on a microfluidic chip, deploying electrically driven spreading of a tiny drop of blood sample (∼8 μl). Our unique approach estimates these parameters by correlating the same with the time taken by the droplet to spread over a given radius, reproducing the results from more elaborate laboratory settings to a satisfactory extent. Our novel methodology is equally applicable for determining higher ranges of ESR such as high concentration of bilirubin and samples corresponding to patients with anemia and patients with some severe inflammation. Furthermore, the minimal fabrication steps involved in the process, along with the rapidity and inexpensiveness of the test, render the suitability of the strategy in extreme point-of-care settings.

Objective. To determine a peculiarities of morphological changes in pancreatic gland after resectional operations, using the high-energy electric surgical instruments (HEESI) and standard surgical procedure. Маterials and methods. In conditions of experiment a pancreatic resection was performed in white laboratory rats, using a standard surgical procedure and a high-energy electro-surgical instruments (HEESI) in a welding regime (DA2), bipolar and monopolar regimes. Histological investigation of pancreatic gland was done immediately postoperatively and in 3, 7 and 21 days, using a light-optical microscope Leica DМ500. Results. In early terms after application of a standard surgical procedure a more severe inflammation have had occur and more rapidly the newly created connective tissue volume enhanced, than after application of electro-surgical methods. After all kinds of electro-resection performed in a newly created tissue the ducts have been formatted, what was not observed after application of a standard procedure. After bipolar welding the surface resected have had lesser hematomas, than after application of surgical scissors. After resection, performed, using monopolar welding, a less dense coagulation layer have been created, than after resection, performed with application of a bipolar welding, in 21 days in the resection zone a significantly more volume of connective tissue was created and more significant signs of inflammation persisted, than after application of a bipolar method. Conclusion. While applying of all kinds of electro-resection the operative intervention duration shortens, the hemorrhage occurrence risk reduces, hermetic joints on the surface resected are created, and the restoration processes do not complicate.

PurposeTo prove the feasibility and measure the diagnostic accuracy of contrast-enhanced ultra-low-dose CT (ULD-CT) for the depiction of inflammatory soft-tissue changes (synovitis, tenosynovitis and peritendonitis) in patients with arthritis of the hand.Materials and methodsIn this institutional review board–approved study, 36 consecutive patients over the age of 50 with suspected rheumatoid arthritis underwent ULD-CT (estimated radiation exposure ResultsAll 36 patients showed synovitis in MRI. ULD-CT had 69% sensitivity on the patient level and 65% on the joint level with 87% specificity. Sensitivity was higher in patients with more severe inflammation (80% for MRI RAMRIS >1). There was almost perfect correlation between the modified RAMRIS sum scores of ULD-CT and MRI (Pearson’s r=0.94). Regarding preferences for future examinations, 85% preferred ULD-CT over MRI. ULD-CT detected more differential diagnoses than MRI (8 vs 2/12).Conclusion Contrast-enhanced ULD-CT of the hand allows for depiction of soft-tissue inflammation at the hand and can be achieved using very low radiation exposure (

Etiologies of human pathophysiology have been associated with states of severe inflammation. The endothelium defender P53 supports cellular functions, by orchestrating anti-inflammatory responses. The purpose of the present article is to provide an update on the mechanisms enforcing the protective actions of P53 in human homeostasis, and to discuss current efforts on the development of new therapies against inflammatory abnormalities.

WOS: 000456712300018 PubMed: 29744721 ObjectiveThis study examined the effects of MTA and Biodentine on the clinical and radiographic success rates of pulpotomies performed on primary teeth with carious pulp exposures.Materials and methodsThis study was conducted with 44 mandibular primary molars requiring vital pulpotomy. Carious dentin surrounding the exposure site was used as the inclusion criteria for all teeth, which were randomly divided into two groups according to pulpotomy material [MTA group (n=24), Biodentine group (n=20)]. Treatment was followed up clinically and radiologically for 24months. Pulp canal obliteration was not regarded as a failure.ResultsClinical and radiographic success rates at the end of 24months were 100% for the MTA group and 89.4% for the Biodentine group. Success rates did not vary significantly between the groups (p=0.646). Pulp canal obliteration was observed in two teeth (8.3%) in the MTA group at 6months, but the teeth were found to be stabilized by 24months.ConclusionThe long-term clinical and radiographic success rates obtained in this study indicate that both MTA and Biodentine are appropriate options for pulpotomy treatment of primary teeth with carious exposure in patients whose teeth should be retained for long periods of time.Clinical relevanceThe etiology of exposure determines pulpal response, making it crucial to distinguish between mechanical and carious exposures. The carious exposure is presumed to be accompanied by severe inflammation, which makes the prognosis of treatment unpredictable. Biomaterials can be used especially in cases with carious pulp exposures.

The clinical associations and correlations with other virulence factors such as cag pathogenicity island (PAI) of the Integrating Conjugative Elements Helicobacter pylori TFSS (ICEHptfs), a new type IV secretion system (TFSS) in H. pylori has not been described. Among 103 studied strains from Indonesia, almost all strains (99.0%) contained cag PAI with more than half (55.8%) were intact cag PAI. Patients infected with intact cag PAI strains showed significantly higher antral activity, inflammation and atrophy as well as corporal inflammation than those with non-intact cag PAI strains, confirming the virulence of cag PAI. Over half of strains (53.8%) contained ICEHptfs, predominantly consisted of ICEHptfs3-tfs4a (42.8%) and ICEHptfs3 (16.3%). Although patients infected with ICEHptfs-positive strains had lower H. pylori density, those with the complete ICEHptfs4b strains tended to have higher antral activity than the negative one. In combination, patients infected with combination of intact cag PAI-ICEHptfs-positive strains had more severe inflammation than those with non-intact cag PAI-ICEHptfs-negative, suggesting a possibility of a mutual correlation between these TFSS(s).

The complex cascades of pathophysiological events in the patients suffering from AP lead to the initial elevation of IAP. The ACS is a result of a vicious circle of the severe inflammation and impaired perfusion of abdominal organs, especially gut. The understanding of the development of ACS in the course of AP may help in its prevention and timely administration of the best possible treatment.

Smears of a fine needle aspirate of an abdominal, intestine-associated mass in a domestic rabbit revealed abundant polymorphous cocci and rod-shaped bacteria, as well as plant material in one location. Cell structures were largely necrotic; however, some cells were consistent with mainly degenerated heterophils. Cytopathological differential diagnosis included a small intestinal pseudodiverticulum with secondary inflammation and an intestine-associated abscess. Histopathological examination confirmed an ileal pseudodiverticulum with severe inflammation.

Purpose: To report severe immunologic and toxic reaction due to corneal wasp sting that may cause catastrophic sight-threatening outcomes. Methods: A 45-year-old man referred to the emergency room with corneal wasp sting of Vespa Orientalis. The authors review previous Medline literature about this topic. Results: In our case, the response to frequent topical corticosteroid was dramatic, and at the seventh day after injury, all inflammatory responses in the anterior segment of the eye had been resolved. Conclusion: Corneal wasp injury with Vespa Orientalis can cause severe inflammation of the cornea and the anterior segment. Topical corticosteroids are the mainstay of treatment. Keywords: Wasp, Sting, Cornea

To describe the use of equine pericardium as an off-label temporary emergency treatment of scleral and corneal perforations. Three eyes of two male patients aged 34 and 38 years were included, i.e. a case with a history of severe bilateral thermal burn undergoing phacoemulsification complicated by tearing of the main port causing iris exposure and a patient with bilateral corneal perforation secondary to non-infectious corneal melt due to presumed ocular non-steroid anti-inflammatory drug abuse. The equine pericardium patch was soaked in balanced salt solution, trimmed and sutured over the perforated area with interrupted nylon 10-0 sutures. Slit-lamp photographs were taken before and immediately after surgery as well as at 2 and 5 months postoperatively. A watertight closure of the perforation was achieved in both cases. No evidence of infection, severe inflammation, leakage or hypotony was detected throughout the observation period. The first patient developed a pseudopterygium over the pericardium patch 5 months after surgery. The second patient showed at 2 months a bilateral melt of the pericardium and loosening of the sutures. After removal of the latter, a tectonically stable scar was evident in both eyes. Equine pericardium offered an effective primary treatment in cases of non-infectious globe perforation and may be considered when other materials, e.g. amniotic membrane, corneal or scleral allografts, are not readily available. Further studies may further elucidate the safety and efficacy profile of this biomaterial in ophthalmic surgery.

Background/purpose: Langerhans cells (LCs) are antigen-presenting cells. This study assessed the LC counts in 80 dentigerous cysts (DCs). Materials and methods: The S100-positive LC numbers in the lining epithelia and subepithelial connective tissues were counted at 80 DC sites without inflammation, 33 DC sites with mild/moderate inflammation, and 9 DC sites with severe inflammation from 80 DC specimens. Results: The mean S100-positive LC counts in the lining epithelia and subepithelial connective tissues increased significantly from no inflammation (0.6 ± 0.6 and 0.7 ± 0.6 cell/high-power field or HPF, respectively) through mild/moderate inflammation (8.1 ± 2.0 and 4.5 ± 2.3 cells/HPF, respectively) to severe inflammation DC sites (21.0 ± 7.0 and 11.1 ± 6.5 cells/HPF, respectively; P-value 50 μm) group (8.6 ± 7.1 and 4.8 ± 4.5 cells/HPF, respectively) than in the thinner lining epithelium (â¦50 μm) group (0.6 ± 0.6 and 0.6 ± 0.6 cells/HPF, respectively; both P-valuesÂ