Evaluation of the effects of Albizia lebbeck bark extracts on the cariogenic properties of Streptococcus mutans

Introduction: Oral diseases continue to be a major and common health problem worldwide and affect the quality of life by causing considerable pain and discomfort. While the mechanistic methods of caries prevention and treatment are in vogue, the concern about adverse effects of the constituents of these methods persists. Thus, there has always existed a need to develop effective and safe strategies to combat oral pathogens such as Streptococcus mutans (S. mutans). Aim: To examine the action of Albizia lebbeck (A. lebbeck) bark extracts on the growth and virulence factors of S. mutans such as- biofilm formation, surface adherence, cell surface hydrophobicity and acid production. Materials and Methods: Ethyl acetate, hexane, and chloroform extracts of the bark of A. lebbeck was prepared and tested for their activity against the ATCC 25175 S. mutans. The phytochemical constituents of the extracts were determined by biochemical assays and the MIC (Minimum Inhibitory Concentration) and MBC (Minimum Bactericidal Concentration) were obtained using the well diffusion assay. The effect of the sub-MIC concentrations of extracts on biofilm formation & eradication, microbial growth, adherence of the strain to glass surfaces, cell surface hydrophobicity and acid production were also determined. Results: All extracts inhibited the organism’s growth, and MIC was determined as 25 mg/ml. the sub-MIC concentrations of the extracts were found to- inhibit the formation of biofilms, eradicate formed biofilms and interfere with the adherence and acid production of S. mutans. Conclusion: The ethyl acetate and ethanolic extracts were found to be active at low concentrations (0.02mg/ml) and demonstrate a potential to be used in the formulation of anti-caries preparations.

Main and moderated effects of multimorbidity and depressive symptoms on cognition

Objective: Multimorbidity, or the occurrence of two or more chronic conditions, is a global challenge, with implications for mortality, morbidity, disability, and life quality. Psychiatric disorders are common among the chronic diseases that affect patients with multimorbidity. It is still not well understood whether psychiatric symptoms, especially depressive symptoms, moderate the effect of multimorbidity on cognition. Methods: We used a large (n=2,681) dataset to assess whether depressive symptomatology moderates the effect of multimorbidity on cognition using structural equation modelling. Results: It was found that the more depressive symptoms and chronic conditions, the worse the cognitive performance, and the higher the educational level, the better the cognitive performance. We found a significant but weak (0.009; p = 0.04) moderating effect. Conclusion: We have provided the first estimate of the moderating effect of depression on the relation between multimorbidity and cognition, which was small. Although this moderation has been implied by many previous studies, it was never previously estimated.

Early- and Long-Term Outcomes of Mitral Valve Repair in a Low-Volume Centre in the Caribbean

Abstract Introduction: This study examines early- and long-term outcomes of mitral valve repairs in a low-volume cardiac surgery centre in the Caribbean. Methods: Ninety-six consecutive patients underwent mitral valve repair from April 2009 to December 2018. Patients were divided into two groups: functional mitral regurgitation requiring simple mitral annuloplasty (FMR, n=63) or structural degenerative mitral regurgitation requiring more complex repair (DMR, n=33). Data collected prospectively were retrospectively analysed from the unit-maintained cardiac surgery database. Results: Thirty-day mortality in the whole series was 2.1%, with 3% in the FMR group and 0% in the DMR group. Early post-operative echocardiography in the FMR group demonstrated 51 patients (83.6%) without mitral regurgitation, 8 patients (13.1%) with trivial to mild regurgitation, and 2 patients (3.3%) with moderate regurgitation. However, at a mean follow-up of 98.2±50.8, only 21 patients (42.8%) were in NYHA class I, with 7 (14.2%) in class II, 16 (32.6%) in class III, and 5 (10.2%) in class IV. There were 9 cardiac-related deaths at final follow-up, with freedom from re-operation and survival of 98% and 75.6%, respectively. In the DMR group, early post-operative echocardiography demonstrated 29 patients (87.9%) without mitral regurgitation, 3 patients (9.1%) with trivial regurgitation and 1 patient (3.0%) with mild regurgitation. At a mean follow-up of 114.1±25.4 months, there was a good functional post-operative status in this group with 93.3% in NYHA class I, and 6.7% in class II. No patient required reintervention, 96.3% of patients had mild or no mitral regurgitation and survival was 90.9%. Conclusion: Despite challenges of maintaining skills in a low-volume centre, mitral valve repair can be performed safely with good early- and long-term results.

Contamination Rates in Duodenoscopes Reprocessed Using Enhanced Surveillance and Reprocessing Techniques: A Systematic Review and Meta-Analysis

Background/Aims@#Multiple outbreaks of multidrug-resistant organisms have been reported worldwide due to contaminated duodenoscopes. In 2015, the United States Food and Drug Administration recommended the following supplemental enhanced surveillance and reprocessing techniques (ESRT) to improve duodenoscope disinfection: 1. microbiological culture, 2. ethylene oxide sterilization, 3. liquid chemical sterilant processing system, and 4. double high-level disinfection. A systematic review and metaanalysis was performed to assess the impact of ESRT on the contamination rates. @*Methods@#A thorough and systematic search was performed across several databases and conference proceedings from inception until January 2021, and all studies reporting the effectiveness of various ESRTs were identified. The pooled contamination rates of post-ESRT duodenoscopes were estimated using the random effects model. @*Results@#A total of seven studies using various ESRTs were incorporated in the analysis, which included a total of 9,084 post-ESRT duodenoscope cultures. The pooled contamination rate of the post-ESRT duodenoscope was 5% (95% confidence interval [CI]: 2.3%–10.8%, inconsistency index [I2]=97.97%). Pooled contamination rates for high-risk organisms were 0.8% (95% CI: 0.2%–2.7%, I2=94.96). @*Conclusions@#While ESRT may improve the disinfection process, a post-ESRT contamination rate of 5% is not negligible. Ongoing efforts to mitigate the rate of contamination by improving disinfection techniques and innovations in duodenoscope design to improve safety are warranted.

Guía basada en la evidencia. Diagnóstico y manejo del síndrome de Guillain-Barré en diez pasos / Evidence based guidelines. Diagnosis and management of Guillain-Barré syndrome in ten steps

Resumen El síndrome de Guillain-Barré (SGB) es una enfermedad inmunológica del nervio periférico y las raíces nerviosas, poco frecuente, potencialmente mortal y que suele desencadenarse por infecciones. La incidencia del SGB puede aumentar durante el brote de enfermedades infecciosas, tal como se observó en las epidemias del virus Zika en la Polinesia Francesa en 2013 y en América Latina en 2015. El diagnóstico y el manejo clínico del SGB pueden ser complicados ya que su presentación y el curso de la enfermedad son heterogéneos, y actualmente no se cuenta con guías clínicas internacionales. Para respaldar a los médicos, especialmente en el contexto de un brote de una enfermedad infecciosa, hemos desarrollado una guía clínica aplicable en todo el mundo para el diagnóstico y el tratamiento del SGB. La guía se basa en literatura actualizada y el consenso de expertos, y tiene una estructura de diez pasos para facilitar su uso en la práctica clínica. Inicialmente, brindamos una introducción a los criterios de diagnóstico, variantes clínicas y diagnósticos diferenciales del SGB. Los diez pasos luego abordan el reconocimiento y el diagnóstico temprano del SGB, la admisión a la unidad de cuidados intensivos, indicación y selección de tratamiento, seguimiento y tratamiento de la progresión de la enfermedad, predicción del curso clínico, resultados y tratamiento de complicaciones y secuelas.

Abstract Guillain-Barré syndrome (GBS) is a rare, but potentially fatal, immune-mediated disease of the peripheral nerves and nerve roots that is usually triggered by infections. The incidence of GBS can therefore increase during outbreaks of infectious diseases, as was seen during the Zika virus epidemics in 2013 in French Polynesia and in 2015 in Latin America. Diagnosis and management of GBS can be complicated as its clinical presentation and disease course are heterogeneous, and no international clinical guidelines are currently available. To support clinicians, especially in the context of an outbreak, we have developed a globally applicable guideline for the diagnosis and management of GBS. The guideline is based on current literature and expert consensus, and has a ten-step structure to facilitate its use in clinical practice. We first provide an introduction to the diag nostic criteria, clinical variants and differential diagnoses of GBS. The ten steps then cover early recognition and diagnosis of GBS, admission to the intensive care unit, treatment indication and selection, monitoring and treatment of disease progression, prediction of clinical course and outcome, and management of complications and sequelae.

Vaginoplasty tips and tricks

ABSTRACT Vaginoplasty is a commonly performed surgery for the transfeminine patient. In this review, we discuss how to achieve satisfactory surgical outcomes, and highlight solutions to common complications involved with the surgery, including: wound separation, vaginal stenosis, hematoma, and rectovaginal fistula. Pre-operative evaluation and standard technique are outlined. Goal outcomes regarding aesthetics, creation of a neocavity, urethral management, labial appearance, vaginal packing and clitoral sizing are all described. Peritoneal vaginoplasty technique and visceral interposition technique are detailed as alternatives to the penile inversion technique in case they are needed to be used. Post-operative patient satisfaction, patient care plans, and solutions to common complications are reviewed.

Incidence and Significance of Biliary Stricture in Chronic Pancreatitis Patients Undergoing Extracorporeal Shock Wave Lithotripsy for Obstructing Pancreatic Duct Stones

Background/Aims@#This study assessed the significance of biliary stricture in symptomatic chronic pancreatitis patients requiring extracorporeal shock wave lithotripsy (ESWL) and endoscopic retrograde cholangiopancreatography (ERCP) to remove obstructing pancreatic calculi. @*Methods@#A total of 97 patients underwent ESWL followed by ERCP to remove pancreatic calculi between October 2014 and October 2017 at Virginia Mason Medical Center. Significant biliary stricture (SBS) was defined as a stricture with upstream dilation on computed tomography scan or magnetic resonance cholangiopancreatography scans accompanied by cholestasis and/or cholangitis. SBS was initially managed by either a plastic stent or fully covered self-expandable metallic stent (fcSEMS). If the stricture did not resolve, the stent was replaced with either multiple plastic stents or another fcSEMS. Data were collected by retrospectively reviewing the medical records. @*Results@#Biliary strictures were noted in approximately one-third of patients (34/97, 35%) undergoing ESWL for pancreatic calculi. Approximately one-third of the biliary strictures (11/34, 32%) were SBS. Pseudocysts were more frequently found in those with SBS (36% vs 8%, p=0.02), and all pseudocysts in the SBS group were located in the pancreatic head. The initial stricture resolution rates with fcSEMSs and plastic prostheses were 75% and 29%, respectively. The overall success rate for stricture resolution was 73% (8/11), and the recurrence rate after initial stricture resolution was 25% (2/8). @*Conclusions@#Although periductal fibrosis is the main mechanism underlying biliary stricture development in chronic pancreatitis, inflammation induced by obstructing pancreatic calculi, including pseudocysts, is an important contributing factor to SBS formation during the acute phase.

Posture-reading by men's football goalkeepers and other factors in saving penalty kicks / Leitura pelo goleiro da postura do cobrador de pênaltis no futebol masculino e outros fatores na defesa / Lectura por el golero de la postura del ejecutante de penales en el fútbol masculino y otros factores en la atajada

ABSTRACT Penalty kicks are often decisive in football matches. Therefore, any technique that yields an advantage either in scoring or saving them is of great importance. Here we show the influence of a training programme for goalkeepers on the probability of defending penalties in men's football. Virtual training was used through an app that shows the shooter at the moment of setting the support foot on the ground and requiring the answer of which side (right or left) the ball will be directed at. Complemented with physical training, four sub 21 professional goalkeepers from Santarém, Brazil, developed the ability to correctly choose the side (left or right) at which the ball will be aimed. Sets of 800 penalties were kicked before (acting as control group) and after the training programme and it was found that, after training, the chances of saving penalty kicks or, at least, choosing the correct side, increase dramatically. It is concluded that the training programme improved the goalkeeper's ability to choose the correct side. Other factors (laterality and height) were not found to be statistically significant.

RESUMO Os pênaltis são frequentemente decisivos em partidas de futebol. Portanto, qualquer técnica que produza uma vantagem tanto para marcar como para salvá-los é de grande importância. Aqui mostramos a influência de um programa de treinamento de goleiros na probabilidade de defesa de pênaltis no futebol masculino. O treinamento virtual foi utilizado por meio de um aplicativo que mostra o chutador no momento de colocar o pé de apoio no solo e exigir a resposta de qual lado (direito ou esquerdo) a bola será direcionada. Complementado com treinamento físico, quatro goleiros profissionais sub 21 de Santarém, Brasil, desenvolveram a habilidade de escolher corretamente o lado (esquerdo ou direito) para o qual a bola seria direcionada. Conjuntos de 800 pênaltis foram chutados antes (agindo como um grupo de controle) e depois do programa de treinamento e verificou-se que, após o treino, as chances de salvar pênaltis ou, pelo menos, de escolher o lado correto aumentam drasticamente. Conclui-se que o programa de treinamento melhorou a habilidade do goleiro em escolher o lado correto. Outros fatores (lateralidade e estatura) não mostraram ser estadísticamente significativos.

RESUMEN Los tiros penales suelen ser decisivos en los partidos de fútbol. Por lo tanto, cualquier técnica que proporcione una ventaja, ya sea para anotar o para atajarlos, es de gran importancia. Aquí mostramos la influencia de un programa de entrenamiento para goleros sobre la probabilidad de atajar los penaltis en el fútbol masculino. Se utilizó entrenamiento virtual a través de una aplicación que muestra al tirador en el momento de poner el pie de apoyo en el suelo y que requiere la respuesta de hacia qué lado (derecho o izquierdo) se dirigirá el balón. Complementado con entrenamiento físico, cuatro goleros profesionales sub 21 de Santarém, Brasil, desarrollaron la capacidad de elegir correctamente el lado (izquierdo o derecho) al que se dirigiría el balón. Se lanzaron series de 800 penales antes (actuando como un grupo de control) y después del programa de entrenamiento y se encontró que, después del entrenamiento, las posibilidades de atajarlos o, al menos, elegir el lado correcto, aumentan drásticamente. Se concluye que el programa de entrenamiento mejoró la capacidad del golero para elegir el lado correcto. Otros factores (lateralidad y estatura) no mostraron ser estadísticamente significativos.

The incidence and pattern of geriatric limb fractures in Ibadan, Nigeria

Background: Individuals within the geriatric age group sustained different types of fractures as such the need to determine the incidence and pattern of limb fractures among patients 65 years and above admitted through the accident and emergency department of the University College Hospital Ibadan.Methods: A retrospective hospital-based study in which patients 65 years and above admitted through the accident and emergency department of the University College Hospital Ibadan over a 42-month period were involved in the study. Using a proformal completed from the electronically stored data that captures the patient’s history, examination findings, X-ray film and treatment offered which was collected on a weekly basis.Results: 12.58% of the patients reviewed within the study period were geriatric patients. A total of 98 geriatric patients were reviewed. There were 59 female and 39 male with a ratio 1.5:1. The fractures were mostly secondary to a trivial fall within their homes (68.37%) while traumatic injury from motor vehicle and motor bike crashes accounted for 11.22% and 16.33% respectively. The most commonly fractured bone is the femur and the proximal third is the most affected part. Comminuted fracture is the most common pattern observed.Conclusions: More than 10% of the reviewed population was in the geriatric age group and the proximal femur was the most commonly fractured bone in this age group. They usually follow trivial falls.

Outcome of clubfoot treatment in the pre-ponseti period in a Nigerian teaching hospital: a 14 year review

Background: Congenital Talipes Equinovarus (CTEV) is a common musculoskeletal congenital disorder. Historically, surgical treatment of various types was popular; however, currently the gold standard of treatment is non-operative care using the Ponseti method. This work evaluates the outcome of this former method of managing CTEV before author adopted the Ponseti Method and compares it with the reported outcomes of the Ponseti method in published literature.Methods: A retrospective review of this data from January 1990 to December 2003 was done, the patients demographics, treatment given, duration and outcome of care were analysed using descriptive statistics. This finding was then compared with outcomes of Ponseti method in literature.Results: Here, 145 patients had initial non operative care; eighteen of those patients (12.4%), eventually require either a posteromedial release, a combined posteromedial and posterolateral releases or a triple arthrodesis.Conclusions: The study shows that the success rate of this method of manipulation preceding the adoption of the Ponseti method is 87.6%. This outcome is inferior when compared to the outcome of Ponseti method in published literature. Also, the extensive nature of eventual surgical intervention required to achieve correction is in contrast to the minimal surgeries needed achieve correction of residual deformities following the use of the Ponseti method.

Reducing Dislocations of Antibiotic Hip Spacers via Hybrid Cement-screw Constrained Liner Fixation: A Case Series / 대한고관절학회지

Purpose@#Infection following total hip arthroplasty is a challenging and devastating complication. In two-stage revision arthroplasty, antibiotic spacers, although efficacious, can be associated with an unacceptable rate of mechanical complications (e.g., fracture, dislocation). This series describes 15 patients with infected total hip prostheses treated with hybrid cement-screw fixation constrained liner antibiotic spacers to enhance stability and minimize mechanical complications. @*Materials and Methods@#All patients with an infected hip prosthesis undergoing two-stage revision arthroplasty at a single academic medical center were identified and screened for inclusion. Clinical and radiographic data including patient demographics and outcome measures were collected and retrospectively analyzed. @*Results@#Two patients died of unrelated causes at an average of 6-week postoperatively. Infections in the remaining thirteen patients (100%) were successfully eradicated; all underwent uncomplicated revision arthroplasty at a mean duration of 99.5 days after the placement of the antibiotic spacer. No dislocations, fractures, or other mechanical failures of any spacer were observed in this series. @*Conclusion@#The hybrid cement-screw fixation technique for constrained liner antibiotic spacers is a reliable and effective treatment method for eradicating prosthetic joint infections without mechanical complications.

Reducing Dislocations of Antibiotic Hip Spacers via Hybrid Cement-screw Constrained Liner Fixation: A Case Series / 대한고관절학회지

Purpose@#Infection following total hip arthroplasty is a challenging and devastating complication. In two-stage revision arthroplasty, antibiotic spacers, although efficacious, can be associated with an unacceptable rate of mechanical complications (e.g., fracture, dislocation). This series describes 15 patients with infected total hip prostheses treated with hybrid cement-screw fixation constrained liner antibiotic spacers to enhance stability and minimize mechanical complications. @*Materials and Methods@#All patients with an infected hip prosthesis undergoing two-stage revision arthroplasty at a single academic medical center were identified and screened for inclusion. Clinical and radiographic data including patient demographics and outcome measures were collected and retrospectively analyzed. @*Results@#Two patients died of unrelated causes at an average of 6-week postoperatively. Infections in the remaining thirteen patients (100%) were successfully eradicated; all underwent uncomplicated revision arthroplasty at a mean duration of 99.5 days after the placement of the antibiotic spacer. No dislocations, fractures, or other mechanical failures of any spacer were observed in this series. @*Conclusion@#The hybrid cement-screw fixation technique for constrained liner antibiotic spacers is a reliable and effective treatment method for eradicating prosthetic joint infections without mechanical complications.

The world database for pediatric and congenital heart surgery: A collaboration with the Registro Nacional de Cirugía Cardiaca Pediátrica / La base de datos mundial de cirugía cardíaca pediátrica y congénita: una colaboración con el Registro Nacional de Cirugía Cardiaca Pediátrica (RENACCAPE)

Abstract Objective: Following the notable work accomplished by the Mexican Association of Specialists in Congenital Heart Disease (Asociación Mexicana de Especialistas en Cardiopatías Congénitas) with the development of a national registry for congenital cardiac surgery, the World Society for Pediatric and Congenital Heart Surgery has implemented an international platform to collect data and analyze outcomes of children with congenital heart disease. Methodology: This manuscript proposes a possible collaboration between Mexico's national congenital cardiac database (Registro Nacional de Cirugía Cardíaca Pediátrica) and the World Database for Pediatric and Congenital Heart Surgery. Conclusion: Such a partnership would advance the countries' desire for the ongoing development of quality improvement processes and improve the overall treatment of children with congenital heart disease.

Resumen Objetivo: Siguiendo el notable trabajo realizado por la Asociación Mexicana de Especialistas en Cardiopatías Congénitas (Asociación Mexicana de Especialistas en Cardiopatías Congénitas: AMECC) con el desarrollo de un registro nacional para la cirugía cardíaca congénita, la Sociedad Mundial de Pediatría y Cirugía Cardíaca Congénita ha implementado una plataforma internacional para recopilar datos y analizar los resultados de los niños con cardiopatía congénita. Metodología: Este manuscrito propone una posible colaboración entre la base nacional de datos cardiacos congénitos de México (RENACCAPE) y la Base de Datos Mundial para la Cirugía Cardíaca Pediátrica y Congénita (WDPCHS). Conclusión: Esta asociación promovería el deseo de los países de seguir desarrollando procesos de mejora de la calidad y mejorar el tratamiento general de los niños con cardiopatía congénita.

Testing a low-cost approach to giving eRIG for rabies PEP: Ethical issues

Ethical concerns in using a lower dose of equine rabies immune globulin (eRIG) to irrigate wounds from dog bites to prevent rabies are discussed. A lower dose of eRIG was used because of a general shortage of eRIG and the high market cost in the Himachal Pradesh state of India. The cost and availability of drugs in low- and middle-income countries (LMIC) often necessitates testing a lower dose of a vaccine or treatment than that recommended by international organizations (eg WHO). It raises the issue that recommendations may be designed for higher income countries without taking into consideration issues of supply and cost. Secondly a case-control design to compare dosages or delivery systems is usually not an option so investigators must often use historical data for comparison or other study designs. The ethical issues in the testing of drugs and vaccines in LMIC must be continuously reviewed by the international community

Outcomes of Infected versus Symptomatic Sterile Walled-Off Pancreatic Necrosis Treated with a Minimally Invasive Therapy

BACKGROUND/AIMS: Acute pancreatitis complicated by walled-off necrosis (WON) is associated with high morbidity and mortality, and if infected, typically necessitates intervention. Clinical outcomes of infected WON have been described as poorer than those of symptomatic sterile WON. With the evolution of minimally invasive therapy, we sought to compare outcomes of infected to symptomatic sterile WON. METHODS: We performed a retrospective cohort study examining patients who were undergoing dual-modality drainage as minimally invasive therapy for WON at a high-volume tertiary pancreatic center. The main outcome measures included mortality with a drain in place, length of hospital stay, admission to intensive care unit, and development of pancreatic fistulae. RESULTS: Of the 211 patients in our analysis, 98 had infected WON. The overall mortality rate was 2.4%. Patients with infected WON trended toward higher mortality although not statistically significant (4.1% vs 0.9%, p=0.19). Patients with infected WON had longer length of hospitalization (29.8 days vs 17.3 days, p<0.01), and developed more spontaneous pancreatic fistulae (23.5% vs 7.8%, p<0.01). Multivariate analysis showed that infected WON was associated with higher odds of spontaneous pancreatic fistula formation (odds ratio, 2.65; 95% confidence interval, 1.20 to 5.85). CONCLUSIONS: This study confirms that infected WON has worse outcomes than sterile WON but also demonstrates that WON, once considered a significant cause of death, can be treated with good outcomes using minimally invasive therapy.

Advising a woman with suspected Zika virus infection

The Zika virus (ZIKV) epidemic is spreading: 67 countries are now reporting transmission, and over 2,000 cases of congenital Zika syndrome (CZS) have been confirmed. The heaviest burden has been borne by those living where poverty, poor infrastructure, and lack of access to health services are common and the penetration of Aedes aegypti is high. Because most cases are asymptomatic, the most dramatic signs of the disease appear through the CZS cases. In spite of the need for disaggregated epidemiological data to understand transmission patterns and evaluate interventions in vulnerable populations, there is no reliable count of ZIKV cases by sex and ethnicity (1).

The World Database for Pediatric and Congenital Heart Surgery: Use of an International Congenital Database in South Korea / 대한흉부외과학회지

No abstract available.

Morphological Studies of Developmental Stages of Oculotrema hippopotami (Monogenea: Polystomatidae) Infecting the Eye of Hippopotamus amphibius (Mammalia: Hippopotamidae) Using SEM and EDXA with Notes on Histopathology

The present study was performed to observe histopathological effects of Oculotrema hippopotami Stunkard, 1924 infection in the eye of Hippopotamus amphibius, as well as to reveal new details of morphology and structural features of this monogenean and its comparison between 2 age stages of the parasite. This was done using both light and scanning electron microscopy, energy dispersive X-ray analysis (EDXA) and histopathology. The presence of a mixture of different generations (adult and sub-adult) in one host individual is common for Oculotrema Stunkard, 1924 in contrast to Polystoma Zeder, 1800. New metrical and graphical information obtained for adults and sub-adults compared with the previous studies. Here we show the presence of genital papillae in adults, metrical data on the distal part of the vas deferens. SEM micrographs of sperm ejaculatory structures and information about the flattened dorsal side of the body provided for the first time. Histopathological changes, such as necrosis and hemorrhage in host tissues as a result of O. hippopotami attachment structures are described. Structural analysis of different body parts of O. hippopotami of both age groups are also included. We show qualitative differences in the presence of hardening ions (S, P, Ca) in attachment structures (oral and haptor suckers) that increase with the age of the worm. The presence of sub-adults and adults on the same host, together with high levels of infection without high pathogenicity may account for Oculotrema being one of the most successful parasites among the Monogenea.

RNA mA modification and its function in diseases / 医学前沿

N-methyladenosine (mA) is the most common post-transcriptional RNA modification throughout the transcriptome, affecting fundamental aspects of RNA metabolism. mA modification could be installed by mA "writers" composed of core catalytic components (METTL3/METTL14/WTAP) and newly defined regulators and removed by mA "erasers" (FTO and ALKBH5). The function of mA is executed by mA "readers" that bind to mA directly (YTH domain-containing proteins, eIF3 and IGF2BPs) or indirectly (HNRNPA2B1). In the past few years, advances in mA modulators ("writers," "erasers," and "readers") have remarkably renewed our understanding of the function and regulation of mA in different cells under normal or disease conditions. However, the mechanism and the regulatory network of mA are still largely unknown. Moreover, investigations of the mA physiological roles in human diseases are limited. In this review, we summarize the recent advances in mA research and highlight the functional relevance and importance of mA modification in in vitro cell lines, in physiological contexts, and in cancers.

Kaempferia parviflora ethanol extract improves self-assessed sexual health in men: a pilot study / 中西医结合学报

<p><b>BACKGROUND</b>Sexual health positively correlates with overall wellbeing. Existing therapeutics to enhance male sexual health are limited by factors that include responsiveness, adherence and adverse effects. As the population ages, safe and effective interventions that preserve male sexual function are needed. Published research suggests that various preparations of Kaempferia parviflora, a plant in the Zingiberaceae (ginger) family, support cardiovascular health and may ameliorate erectile function.</p><p><b>OBJECTIVE</b>The aim of this study was to examine the effects of KaempMax™, an ethanol extract of the K. parviflora rhizome, on erectile function in healthy middle-aged and older men.</p><p><b>DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS</b>We conducted an open-label, one-arm study on 14 generally healthy males aged 50-68 years with self-reported mild erectile dysfunction, who were not using prescription treatments. Participants took 100 mg KaempMax™ daily for 30 days.</p><p><b>MAIN OUTCOME MEASURES</b>Evaluations were conducted at baseline and on the final study assessment. Primary efficacy analyses included the International Index of Erectile Function (IIEF); secondary efficacy analyses included the Global Assessment Question about erectile function.</p><p><b>RESULTS</b>Thirteen participants completed the 30-day study. Supplementation with KaempMax™ resulted in statistically significant improvements in erectile function, intercourse satisfaction and total scores on the IIEF questionnaire. KaempMax™ was well tolerated and exhibited an excellent safety profile.</p><p><b>CONCLUSION</b>Our results suggest that KaempMax™ may improve erectile function in healthy middle-aged and older men. While the effects were not as pronounced as what might be seen with prescription medication, most participants found them satisfactory. Additional, longer and placebo-controlled clinical trials will be needed.</p><p><b>TRIAL REGISTRATION</b>Clinicaltrials.gov identifier NCT03389867.</p>