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Abstract Introduction Non-response to palatal surgery for OSA is a problem. Residual lateral wall hypopharyngeal collapse is the proposed mechanism of failure. Objective This study aims to evaluate the role of transpalatal advancement pharyngoplasty in non-responders to primary palatal surgery with residual lateral wall hypopharyngeal collapse. Methods This is a retrospective study that was conducted on patients who underwent transpalatal advancement pharyngoplasty for residual lateral wall hypopharyngeal. Inclusion criteria were age greater than 18-years, OSA proved by the polysomnography with apnea hypopnea index >15, lateral wall collapse at the level of hypopharynx as proved by drug-induced sleep endoscopy and had a previous tonsillectomy or previous palatal surgery for OSA. Exclusion criteria were those with no history of tonsillectomy or any other surgery for OSA and those with a missed followup. Data of included patients were collected and included gender, age, polysomnographic data like the apnea hypopnea index, oxygen desaturation and the calculated preoperative Epworth sleepiness scale. The early outcome included symptom improvement as measured by Epworth sleepiness scale score and lateral pharyngeal wall evaluation by nasopharyngoscopic examination in the first postoperative month. Late outcome measurement was performed by the 6-month postoperative polysomnography. Data were analyzed using SPSS program. Results The study included 37 patients with a mean age of (40.43 ± 6.51). The study included 26 men and 11 women. There was a statistically significant improvement of apnea hypopnea index from 37.8 ± 9.93 to 9.9 ± 2.55. In addition, a statistically significant improvement of lowest oxygen saturation from 78.9 ± 3.39 to 83.3 ± 3.31 was encountered. The patients improved clinically, and this improvement was measured by statistically significant improvement of Epworth sleepiness scale score and snoring visual analogue scale. Conclusion Transpalatal advancement pharyngoplasty widens the retropalatal airway and has a great role in the management of the vertical palate phenotype. In addition, it can have a role in the management of lateral walls, especially lateral wall hypopharyngeal collapse.
Resumo Introdução A ausência de resposta à cirurgia palatina para AOS é um problema. O colapso residual da parede lateral da hipofaringe é um mecanismo de falha proposto. Objetivo Avaliar o papel da faringoplastia com avanço transpalatino em pacientes que não responderam à cirurgia palatina primária com colapso residual da parede lateral da hipofaringe. Método Estudo retrospectivo que será feito em casos que receberam faringoplastia com avanço transpalatino para parede lateral da hipofaringe residual. Os critérios de inclusão foram idade maior que 18 anos, AOS comprovada por polissonografia com índice de apneia e hipopneia > 15, colapso da parede lateral ao nível da hipofaringe comprovado por endoscopia do sono induzido por drogas e submetidos a amigdalectomia ou cirurgia palatina anterior para AOS. Os critérios de exclusão foram pacientes sem histórico de amigdalectomia ou qualquer outra cirurgia para AOS e aqueles com perda de seguimento. Os dados dos pacientes incluídos foram coletados e incluíram sexo, idade, dados polissonográficos, como índice de apneia e hipopneia, dessaturação de oxigênio e a escala de sonolência de Epworth calculada no pré‐operatório. O desfecho inicial incluiu melhoria dos sintomas medida pelo escore da escala de sonolência de Epworth e avaliação da parede lateral da faringe por exame nasofaringoscópico no primeiro mês do pós‐operatório. A medida do desfecho tardio foi feita pela polissonografia pós‐operatória de 6 meses. Os dados foram analisados no programa SPSS. Resultados O estudo incluiu 37 pacientes com média de 40,43 ± 6,51 anos. O estudo incluiu 26 homens e 11 mulheres. Houve uma melhoria estatisticamente significante do índice de apneia e hiponeia de 37,8 ± 9,93 para 9,9 ± 2,55. Além disso, foi encontrada uma melhoria estatisticamente significante da menor saturação de oxigênio de 78,9 ± 3,39 para 83,3 ± 3,31. Os pacientes melhoraram clinicamente e essa melhoria foi medida pela melhoria estatisticamente significante no escore da escala de sonolência de Epworth e na escala escala visual analógica do ronco. Conclusão A faringoplastia com avanço transpalatino alarga a via aérea retropalatina e tem um papel importante no manejo do fenótipo do palato vertical. Além disso, ela pode ter um papel no manejo das paredes laterais, especialmente no colapso da parede lateral da hipofaringe.
ABSTRACT
L'expansion planétaire du covid19 représente une crise sans précèdent ; cette pandémie a fait plus d'un million de mort en une année. En plus de l'atteinte pulmonaire, le virus a des implications majeures sur le système cardiovasculaire : les maladies cardiovasculaires pré existantes représentent un facteur de risque d'infection sévère avec augmentation de la mortalité, d'autre part l'infection entraine des complications cardiovasculaires qui aggravent le pronostic. Le lien entre le Covid19 et le système cardiovasculaire découle principalement de la voie d'entrée cellulaire du virus qui est assurée par sa liaison à une protéine membranaire l'enzyme de conversion de l'angiotensine (ECA), qui joue un rôle clé dans la régulation neurohumorale ; cette protéine est très présente au niveau du cÅur et du poumon, d'où le tropisme du virus qui entraine la dysrégulation de cette voie cellulaire avec des répercussion sur la fonction cardiaque et respiratoire. Une polémique a déferlé concernant les traitements anti hypertenseurs et notamment les inhibiteurs du système rénine angiotensine aldostérone mais après évaluation des données actuelles, il est de consensus de ne pas arrêter ou changer les traitements anti hypertenseurs. L'augmentation des troponines cardiaques est un facteur de mauvais pronostic qui aggrave le tableau. La myocardite est définie par une inflammation myocardique, Les tableaux cliniques sont variables de la forme légère à la forme grave ; les biomarqueurs myocardiques restent un test incontournable en cas de suspicion clinique, le pronostic est incertain avec des formes fulminantes qui peuvent régresser et enfin pour le traitement les corticoïdes semblent être efficaces. Une autre complication du virus sont les accidents thrombo-emboliques et le dilemme occasionné par le risque accru aux thromboses et la thrombopénie induite par l'utilisation de l'héparine (TIH). On note une augmentation de l'incidence des syndromes coronaires aigus chez les sujets atteints du covid19.
The global expansion of covid19 represents a global crisis; this pandemic killed more than a million people in one year. In addition to pulmonary involvement, the virus has major implications on the cardiovascular system: pre-existing cardiovascular diseases represent a risk factor for severe infection with increased mortality, on the other hand the infection causes cardiovascular complications which worsen the prognosis. The link between the Covid19 and the cardiovascular system stems primarily from the virus's cellular entry pathway, which is provided by its binding to a membrane protein, the angiotensin converting enzyme (ACE) wich plays a key role in neurohumoral regulation; this protein is very present in the heart and lungs, hence the tropism of the virus which causes the dysregulation of this cellular pathway with repercussions on cardiac and respiratory function. A controversy broke out concerning the antihypertensive treatments and in particular the inhibitors of the renin angiotensin aldosterone system but after evaluation of the current data, there is a consensus not to withhold or change the treatments. The increase in cardiac troponins is a factor of poor prognosis which worsens the picture. Myocarditis is defined by myocardial inflammation, its clinical form ranges from the mild form to the severe one; the myocardial biomarkers remain an essential when the clinical suspicion rise, the prognosis is uncertain with fulminant forms which can regress; for treatment corticosteroids seem to be effective. Another complication of the virus are thromboembolic events and the dilemma caused by the increased risk of thrombosis and thrombocytopenia induced by the use of heparin (TIH), and there is an increase in the incidence of acute coronary syndromes in patients affected by covid19.
Subject(s)
COVID-19 , Thrombosis , Cardiovascular System , Algeria , COVID-19 Nucleic Acid Testing , MyocarditisABSTRACT
Back Ground: Heparin induced thrombocytopenia (HIT) isthrombocytopenia or thrombosis with one or more positivetests for HIT antibodies. To diagnose HIT, platelet countmonitoring; at least every other day until hospital discharge forday 14 (whichever occurs sooner). A platelet count fall of 50%or greater from baseline or any thrombosis occurs 5 to 10 daysafter heparin starting with exclusion or other causes ofthrombocytopenia are highly suggestive of HIT. Laboratoryconfirming assays are helpful as platelet activations assay.Management of HIT includes discontinuing of any type ofheparin and using an alternative anticoagulant as DTIs(liperudin, argatropan, bivalerudin). Warfarin should be delayedpending substantial recovery of the platelet account.Methods: This study was conducted to 100 patients receivingheparin in a variety of clinical settings to assess the prevalenceof HIT trying to identify clinical predictors of such complication.To all these patients platelet count every other day from baseline to day 14 was done then the 4T score system was appliedto all patients.Results: Only 6 patients developed HIT; 4 of them developedthrombosis and 3 patients died in hospital due to thesethromboembolic events. UFH, surgical treatment and firstheparin exposure were the clinical predictors of HIT.Conclusion: HIT is a serious and life threatening complicationof heparin therapy that should be early diagnosed and properlymanaged to prevent its thromboembolic complications.
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A high-fat diet can cause obesity and type 2 diabetes mellitus. This study aimed to observe the antioxidant compounds ofCordyline terminalis’s leaf extract which have the ability to be in vitro antioxidant and antidiabetic. Phytochemical tests andIC 50 to dpph were carried out in vitro. The study was conducted in vivo using 24 female wistar rats, which were dividedinto 4 groups: control of normal rats, high fat diet in obese rats, extract 100 mg / kg bw and extract 200 mg / kg bw. After30 days of research, blood samples were taken for examination of triglycerides, glucose, and free fatty acids. The resultsshowed that methanol extract contained saponins, steroids, flavonoids, alkaloids and polyphenols. The methanol extract canreduce free radicals with IC50 88.25 ppm. In vivo test results showed that there was a significant differences (p <0.05) in thelevels of TG, glucose and free fatty acids with the treatment of methanol extract (100 mg / kg bw and 200 mg / kg bw)compared to the high fat group. Based on the results of the study, it can be concluded that the methanol extract of andongleaves contained antioxidant compounds that act as antidiabetic in obese wistar rats.
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Schistosomiasis is the third most devastating tropical disease worldwide caused by blood flukes of the genus Schistosoma. Praziquantel (PZQ) is the drug of choice for treating all species of schistosomes. However, PZQ kills only adult Schistosoma worms, not immature stages. The inability of PZQ to abort early infection or prevent re-infection, and the lack of prophylactic effect prompt the need for novel drugs and strategies for the prevention of schistosomiasis. Tumor burden can be developed in Schistosoma-infected patients. The present study aimed to determine the host responses to mutual interaction between cancer, represented by Ehrlich ascites, and infection, represented by Schistosomiasis. Mice infected with Schistosoma and challenged with tumor 4-5 weeks later showed the same anti-schistosomal (worm and egg burden) and antitumor (total tumor cell count and mouse survival) parameters when compared to mice infected with Schistosoma alone or challenged with tumor cells alone. As expected, combinatorial treatment with PZQ and cisplatin of Schistosoma-infected mice that were challenged with tumor cell line decreased the tumor burden as well as the worm and egg burden after treatment as compared to the non-treated controls; while the worm burden and egg counts were significantly decreased (P <0.001) in treated group (VI) treated with cisplatin (0.5 mg/kg), group (VII) treated with cisplatin (2 mg/kg), group (VIII) treated with PZQ/ cisplatin (0.5 mg/kg) and group (IX) treated with PZQ / cisplatin (2 mg/kg) by 44.55% , 74%, 100% and 97.8% in worm burden, and by 47%, 78.7%, 96% and 97% in liver egg count , respectively than that of group (II) non treated S. mansoni infected alone and (IV) non treated S. mansoni/EAC alone. Also, Group IX caused a significant reduction (P <0.05) in worm burden than that of group VI. Also, total ascetic volume and the tumor cell counts in Ehrlich's ascites carcinoma (EAC)-cells were significantly decreased (P <0.001) in groups VIII and IX than that of the group (III) non-treated (EAC) inoculated alone. There was no mutual interaction between schistosomiasis infection and tumor burden. Also, whereas, PZQ did not affect on the antitumor parameters, cisplatin even at low doses had anti-schistosomal effects.
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Background: Patients with liver cirrhosis seem to be at increased risk of complications during fasting. This study aimed to assess the effect of Ramadan fasting on liver functions and portal hemodynamics among patients with liver cirrhosis in comparison with healthy subjects
Materials and Methods: Participants were divided into three groups. Group I: patients with liver cirrhosis who fasted during Ramadan [n = 34], group II: patients with cirrhosis who did not fast [n = 8], and group III: healthy volunteers who fasted [n = 30]. This study was done from May 2017 to July 2017 and the month of Ramadan began on May 27th to June 26th, 2017. Portal hemodynamics were evaluated by portal vein diameter, congestion index [CI], and portal flow velocity. Laboratory investigations were determined before, during, and after Ramadan as an indicator of the changes in the liver functions
Results: There were no dropouts during the study. Among the three groups, portal vein parameters showed statistically non-significant differences. Model for End-Stage Liver Disease [MELD] score and serum albumin levels showed a significant difference when the group I and II compared separately to group III [P = 0.000], while there were no differences between group I and group II [P = 0.6 and 0.57, respectively]. For portal vein CI, there was a significant difference between the patients with cirrhosis [fasting; group I and non-fasting; group II] and healthy subjects [group III] [p = 0.000], while the CI did not change significantly between the groups I and II [p = 0.54]
Conclusions: Patients with cirrhosis showed changes in their liver functions and portal hemodynamics irrespective of their fasting status and these differences were more pronounced in portal vein CI, MELD score, and serum albumin when compared with healthy subjects
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Aim: The objective of this work is to find out whether there is a relation between the expression of TLR4 and fibrosis progression in chronic HCV patients
Background: Toll-like Receptor 4 [TLR4] is a pattern recognition receptor whose activation results in the production of several pro-inflammatory cytokines
Methods: Fifty patients with chronic HCV were included. They were divided into group A: 40 patients [F1-F4] and group B [control group] which included ten patients [F0] based on fibroscan value. All patients were exposed to clinical and laboratory evaluations preliminary to antiviral therapy, assessment of TLR4 mRNA by Real Time- PCR
Results: Twenty-eight males and 22 females with a mean age 28.9 +/- 6.1 years. The mean TLR4 expression is 11.2 +/- 7.4 folds, TLR4 expression in F0 group is 2.8 +/- 1.9, in F1 group 4.8 +/- 1.5, F2 group 10.2 +/- 2.5, F3 group 16.8 +/- 1.5 and in F4 21.3 +/- 3.6 folds [p<0.001]. TLR4 showed a positive correlation with age, fibrosis stage, HCV RNA, serum transaminases, total bilirubin and prothrombin time, a negative correlation with platelet count and serum albumin. Fibrosis progression was independently associated with TLR4 expression [beta=0. 648, P<0.0001], RNA [beta= 0.160, P =0.001] and platelet count [beta= -0.248, P = 0.004]
Conclusion: The expression of TLR4 is highly correlated with the fibrosis progression; TLR4 may be a potential target for drugs to limit the progression of fibrosis
ABSTRACT
This study examined eight hundred ninety six marine fishes belonging to nine different fish species; Synodus saurus; Merluccius merluccius; Trachurus mediterraneus; Serranus cabrilla; Mullus surmuletus; Diplodus annularis; Spicara maena; Siganus rirulatus and Liza ramada. The fishes were bought from fish markets at five different sites on Libyan coast, from January to December 2013, for study the anisakids larvae among them. The results showed that 344/896 fishes [38.4%] were infected with Anisakids larvae. S. saurus was the highly infected [80.9%], followed by T. mediterraneus [77.5%] but, S. cabrilla, S. maena, M. merluccius, M. surmuletus, and D. annularis were least anisakid infected showed rates of 58.2%, 53.8%, 43.7%, 36.7% and 3.6%, respectively. No parasites were in S. rirulatus and L, ramada. Ten species of Anisakids larvae was detected during the present study. Two Pseudoterranova sp. Larvae, two types of Anisakis larvae, Anisakis simplex larva and Anisakis sp. Larva, two types of Contracaecum sp. Larvae and four Hysterothylacium larvae. Females showed higher prevalence than males. The number of anisakid larvae varied according to body length and weight of infected fish, without significant difference between prevalence and seasons, but, a significant difference was between prevalence and regions
Subject(s)
Animals , Aquatic Organisms , Prevalence , FishesABSTRACT
The present work was undertaken in order to investigate the effects of static magnetic field (SMF) on growth rates, hematopoiesis, plasmatic proteins levels, glucose concentration, lactate dehydrogenase (LDH) and transaminases activities in male rats. Sub-acute exposure of rats during 5 consecutive days to SMF (1h/day at 128mT) induced an increase of plasma LDH activity (+38 percent, p<0.05), and glucose concentration (+31 percent, p<0.05), whereas haematological parameters, protein levels, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) activities remained unchanged. SMF exposure of rats during 30 consecutive days (1hour/day at 128mT) decreased significantly growth rates by the second week and increased significantly the plasmatic total protein levels (+62 percent, p<0.05), hemoglobin (+10 percent, p<0.05), red blood cells (+7 percent, p<0.05), white blood cells (+17 percent, p<0.05), and platelet number (+10 percent, p<0.05). Sub-chronic exposure to SMF increased also LDH (+43 percent, p<0.05), AST (+ 41 percent, p<0.05) and ALT activities (+95 percent, p<0.05). In contrast, the glucose concentration was unaffected. These changes suggested that exposure to SMF had a possible effect on the proliferation of blood cells and enzymes release within blood indicating tissue alterations.
Este estudo foi realizado com o obejtivo de investigar os efeitos do campo magnético estático (CMS) nas taxas de crescimento, hematopoiese, concentrações de proteínas plasmáticas, glicemia, da desidrogenase lática (DHL) e transaminases (alanina aminotransferase-ALT e aspartato aminotransferase-AST) em ratos machos. Após exposição de modo sub-agudo durante 5 dias consecutivos ao CMS (1 hora/dia, a 128mT), houve aumento em 38 por cento na concentração de DHL (p<0.05), porém não houve mudanças nos índices hematimétricos, nas proteínas plasmáticas e nas transaminases. Duas semans após exposição ao CMS durante 30 dias consecutivos (CMS (1 hora/dia, a 128mT) houve diminuição significativa das taxas de crescimento e aumento significativo das concetrações de proteínas (+62 por cento, p<0.05), da hemoglobina (+10 por cento, p<0.05), eritrócitos (+7 por cento, p<0.05), leucócitos (+17 por cento, p<0.05) e plaquetas (+10 por cento, p<0.05). A exposição sub-crônica ao CMS induziu aumento da DHL (+43 por cento, p<0.05), AST (+ 41 por cento, p<0.05) e ALT (+95 por cento, p<0.05). Em contraste não houve aumento da glicemia. Estas alterações sugerem que a exposição ao CMS possivelmente influencia a proliferação de células do sistema hematopoiético e a produção enzimática, indicando alterações teciduais.
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The aim of this study was to investigate the correlation between ABO blood groups, secretory status and chronic cholecystitis with or without peptic ulceration. This study was conducted on 30 patients [18 males and 12 females] proved by abdominal ultrasound to have chronic cholecystitis either calcular or non-calcular. Our results showed that there was a significant correlation between blood group A with positive secretory status and chronic cholecystitis either calcular or non-calcular. Also, chronic non-calcular cholecystitis was frequent in patients with blood group 0 with negative secretory status. Duodenal ulcer was significantly present in patients with blood group A with positive secretory status and blood group 0 with negative secretory status when compared with other blood groups. From the above results we suggest that both chronic cholecystitis and duodenal ulcer might have the same genetic predisposition