Assessing the performance of ChatGPT in answering questions regarding cirrhosis and hepatocellular carcinoma

Background/Aims@#Patients with cirrhosis and hepatocellular carcinoma (HCC) require extensive and personalized care to improve outcomes. ChatGPT (Generative Pre-trained Transformer), a large language model, holds the potential to provide professional yet patient-friendly support. We aimed to examine the accuracy and reproducibility of ChatGPT in answering questions regarding knowledge, management, and emotional support for cirrhosis and HCC. @*Methods@#ChatGPT’s responses to 164 questions were independently graded by two transplant hepatologists and resolved by a third reviewer. The performance of ChatGPT was also assessed using two published questionnaires and 26 questions formulated from the quality measures of cirrhosis management. Finally, its emotional support capacity was tested. @*Results@#We showed that ChatGPT regurgitated extensive knowledge of cirrhosis (79.1% correct) and HCC (74.0% correct), but only small proportions (47.3% in cirrhosis, 41.1% in HCC) were labeled as comprehensive. The performance was better in basic knowledge, lifestyle, and treatment than in the domains of diagnosis and preventive medicine. For the quality measures, the model answered 76.9% of questions correctly but failed to specify decision-making cut-offs and treatment durations. ChatGPT lacked knowledge of regional guidelines variations, such as HCC screening criteria. However, it provided practical and multifaceted advice to patients and caregivers regarding the next steps and adjusting to a new diagnosis. @*Conclusions@#We analyzed the areas of robustness and limitations of ChatGPT’s responses on the management of cirrhosis and HCC and relevant emotional support. ChatGPT may have a role as an adjunct informational tool for patients and physicians to improve outcomes.

Age-related outcomes in patients with cardiogenic shock stratified by etiology / 老年心脏病学杂志（英文版）

BACKGROUND@#As a result of improved and novel treatment strategies, the spectrum of patients with cardiovascular disease is consistently changing. Overall, those patients are typically older and characterized by increased burden with comorbidities. Limited data on the prognostic impact of age in cardiogenic shock (CS) is available. Therefore, this study investigates the prognostic impact of age in patients with CS.@*METHODS@#From 2019 to 2021, consecutive patients with CS of any cause were included. The prognostic value of age (i.e., 60-80 years and > 80 years) was investigated for 30-day all-cause mortality. Spearman's correlations, Kaplan-Meier analyses, as well as multivariable Cox proportional regression analyses were performed for statistics. Subsequent risk assessment was performed based on the presence or absence of CS related to acute myocardial infarction (AMI).@*RESULTS@#223 CS patients were included with a median age of 77 years (interquartile range: 69-82 years). No significant difference in 30-day all-cause mortality was observed for both age-groups (54.6% vs. 63.4%, log-rank P = 0.169; HR = 1.273, 95% CI: 0.886-1.831, P = 0.192). In contrast, when analyzing subgroups stratified by CS-etiology, AMI-related CS patients of the group > 80 years showed an increased risk of 30-day all-cause mortality (78.1% vs. 60.0%, log-rank P = 0.032; HR = 1.635, 95% CI: 1.000-2.673, P = 0.050), which was still evident after multivariable adjustment (HR = 2.072, 95% CI: 1.174-3.656, P = 0.012).@*CONCLUSIONS@#Age was not associated with 30-day all-cause mortality in patients with CS of mixed etiology. However, increasing age was shown to be a significant predictor of increased mortality-risk in the subgroup of patients presenting with AMI-CS.

Mitochondrial oxidative damage by co-exposure to bisphenol A and acetaminophen in rat testes and its amelioration by melatonin / 대한생식의학회지

Objective@#Human exposure to multiple xenobiotics, over various developmental windows, results in adverse health effects arising from these concomitant exposures. Humans are widely exposed to bisphenol A, and acetaminophen is the most commonly used over-the-counter drug worldwide. Bisphenol A is a well-recognized male reproductive toxicant, and increasing evidence suggests that acetaminophen is also detrimental to the male reproductive system. The recent recognition of male reproductive system dysfunction in conditions of suboptimal reproductive outcomes makes it crucial to investigate the contributions of toxicant exposures to infertility and sub-fertility. We aimed to identify toxicity in the male reproductive system at the mitochondrial level in response to co-exposure to bisphenol A and acetaminophen, and we investigated whether melatonin ameliorated this toxicity. @*Methods@#Male Wistar rats were divided into six groups (n=10 each): a control group and groups that received melatonin, bisphenol A, acetaminophen, bisphenol A and acetaminophen, and bisphenol A and acetaminophen with melatonin treatment. @*Results@#Significantly higher lipid peroxidation was observed in the testicular mitochondria and sperm in the treatment groups than in the control group. Levels of glutathione and the activities of catalase, glutathione peroxidase, glutathione reductase, and manganese superoxide dismutase decreased significantly in response to the toxicant treatments. Likewise, the toxicant treatments significantly decreased the sperm count and motility, while significantly increasing sperm mortality. Melatonin mitigated the adverse effects of bisphenol A and acetaminophen. @*Conclusion@#Co-exposure to bisphenol A and acetaminophen elevated oxidative stress in the testicular mitochondria, and this effect was alleviated by melatonin.

Pulmonary and neurological profile of vasculitis patients at tertiary care hospital

Background: The vasculitis are a heterogenous group of conditions characterized by blood vessel inflammation and necrosis. Vasculitis are relatively uncommon conditions whose etiology is still poorly understood. Treating vasculitis is as regarding as establishing diagnosis. In the absence of treatment, most of patients will suffer or die. With treatment most of patients improve, many will achieve remission and a few will be cured. Disease classification is the process of categorizing illnesses in a larger framework of medical conditions. Objectives: To study the pulmonary and neurological profile of vasculitis patients at a tertiary care centre. Materials and methods: The present hospital based observational study was conducted in the Department of Internal Medicine, SKIMS Srinagar. The study had two parts; retrospective and prospective. Retrospective part: All patients of vasculitis who were admitted or evaluated in OPD from March 2012 to Sept. 2018, were enrolled for the analysis. Prospective part: All Patients of vasculitis admitted or evaluated in OPD from Oct. 2018 to May 2020 were enrolled for study. Patients were classified as vasculitis if they fulfil ACR / EULAR / EMA / Chapell Hill consensus classification criteria for vasculitis and biopsy. Results: Our study was an observational study of 77 patients. Majority of patients i.e. 5 (33.33%) each in LVV group belonged to age groups of <30 and 31-40 years. In SVV group, majority of patients i.e. 11 (27.5%) belonged to age group of <30 years followed by 9 (22.5%) patients each who aged between 31-40 years and 41-50 years. In group LVV there were 12 (80%) males compared to 3 (20%) females. In group SVV, there were 8 (20%) males compared to 32 (80%) females while as 13 (59%) males and 9 (41%) females constituted others group. Chest x-ray was normal was normal in majority of patients in all three groups. CT Chest was done in 23 patients in which nodules were seen in 7 (35%) patients, 4 (20%) patients each had consolidation, DAH and 2 (10%) patients had ILD. CT head were suggestive of encephalomalacia in 1, ischemic stroke in 1 and normal findings in 1 (33.3%) patients. CT Chest and Head findings were compared in three study groups with SVV group showing abnormal findings as compared to other two groups. Tuberculosis profile was negative in 26 (96.3%) of 27 patients. TB profile was positive in only 1 (11.1%) patient in others group. On NCV, peripheral neuropathy was observed in 11 (68.8%) of the 16 patients. On NCV, peripheral neuropathy was observed in 9 (75%) patients in SVV group and 2 (50%) patients in others group. Conclusion: Most of abnormalities on CT Chest, Head, and NCV were present in SVV group. They mostly presented with ILD, DAH, encephalomalacia, ischemic stroke, peripheral neuropathy.

Metabolites in Conocarpus erectus leaves attenuate α-amylase activity by modulating amino acid residues of α-amylase: an in vitro and docking study / Los metabolitos en las hojas de Conocarpus erectus atenúan la actividad de la α-amilasa al modular los residuos de aminoácidos de la α-amilasa: un estudio in vitro y de acoplamiento

The antioxidant activity and the inhibitory potential of α-amylase of lyophilized hydroethanolic extracts of Conocarpus erectus leaves obtained by ultrasonication were determined. The most potent extract was subjected to ultra-high performance liquid chromatography system equipped with mass spectrometer for metabolite identification. The identified metabolites were docked in α-glucosidase to assess their binding mode. The results revealed that 60% ethanolic extract exhibited highest ferric reducing antioxidant power (4.08 ± 0.187 mg TE/g DE) and α-amylase inhibition (IC50 58.20 ± 1.25 µg/mL. The metabolites like ellagic acid, 3-O-methyl ellagic acid, ferujol, 5, 2 ́-dihydroxy-6,7,8-trimethyl flavone and kaempferol glucoside were identified in the extract and subjected to molecular docking studies regarding α-amylase inhibition. The comparison of binding affinities revealed 3-O-methyl ellagic acid as most effective inhibitor of α-amylase with binding energy of -14.5911 kcal/mol comparable to that of acarbose (-15.7815 kcal/mol). The secondary metabolites identified in the study may be extended further for functional food development with antidiabetic properties.

Se determinó la actividad antioxidante y el potencial inhibidor de la α-amilasa de extractos hidroetanólicos liofilizados de hojas de Conocarpus erectus obtenidos por ultrasónicación. El extracto más potente se sometió a un sistema de cromatografía líquida de ultra alto rendimiento equipado con un espectrómetro de masas para la identificación de metabolitos. Los metabolitos identificados se acoplaron en α-glucosidasa para evaluar su modo de unión. Los resultados revelaron que el extracto etanólico al 60% exhibió el mayor poder antioxidante reductor férrico (4.08 ± 0.187 mg TE/g DE) e inhibición de la α-amilasa (IC50 58.20 ± 1.25 µg/mL. Los metabolitos como el ácido elágico, 3-O-metil elágico ácido, ferujol, 5, 2 ́-dihidroxi-6,7,8-trimetil flavona y kaempferol glucósido se identificaron en el extracto y se sometieron a estudios de acoplamiento molecular con respecto a la inhibición de la α-amilasa. La comparación de las afinidades de unión reveló 3-O-metil El ácido elágico como inhibidor más eficaz de la α-amilasa con una energía de unión de -14,5911 kcal/mol comparable a la de la acarbosa (-15,7815 kcal/mol). Los metabolitos secundarios identificados en el estudio pueden ampliarse aún más para el desarrollo funcional de alimentos con propiedades antidiabéticas.

Vedolizumab for perianal fistulizing Crohn’s disease: systematic review and meta-analysis

Background/Aims@#Perianal fistulas are a debilitating manifestation of Crohn’s disease (CD). Despite the advent of anti-tumor necrosis factor (anti-TNF) therapy, the medical management of fistulizing CD continues to be challenged by unmet needs. We conducted a systematic review and meta-analysis of the effectiveness of vedolizumab for the management of perianal fistulizing CD. @*Methods@#A search of PubMed, EMBASE and the Cochrane Library was performed from inception to June 2020 for studies reporting rates of perianal fistula healing in CD patients treated with vedolizumab. The primary outcome of interest was complete healing of perianal fistulas and the secondary outcome was partial healing. The pooled fistula healing rates with 95% confidence intervals (CI) were calculated utilizing a random effects model. @*Results@#A total of 74 studies were initially identified, 4 of which met the inclusion criteria. A total of 198 patients with active perianal fistulas were included, 87% of whom had failed previous anti-TNF therapy. The pooled complete healing rate was 27.6% (95% CI, 18.9%–37.3%) with moderate heterogeneity (I2=49.4%) and the pooled partial healing rate was 34.9% (95% CI, 23.2%–47.7%) with high heterogeneity (I2=67.1%). @*Conclusions@#In a meta-analysis of 4 studies that included 198 patients with perianal fistulizing CD, the majority of whom had failed previous anti-TNF therapy, vedolizumab treatment led to healing of perianal fistulas in nearly one-third of the patients. The lack of high-quality data and significant study heterogeneity underscores the need for future prospective studies of fistula healing in patients receiving anti-integrin therapy.

COVID-19 pandemic and mental health of a sample of Brazilian caregivers of people with dementia / Pandemia de COVID-19 e saúde mental de uma amostra de cuidadores brasileiros de pessoas com demência

ABSTRACT Social distancing policies adopted in the COVID-19 pandemic generated a negative psychological impact on the general population and can affect caregivers of people with dementia more severely. Objective: This study screened for indications of mental health problems among informal caregivers of people with dementia. Main changes in the people's routine and behavior resulting from the social isolation measures adopted due to the pandemic were also investigated. Method: Thirty-five informal caregivers of people with dementia from a medium-sized Brazilian city responded to a telephone interview. Results: Risks for mental health problems were found in 31.4% of the sample. These participants stated that they found it very difficult to deal with routine care changes during the pandemic. The variables related to the caregiver's characteristics and those related to changes in routine significantly affected the caregiver's mental health scores. Discussion: Indices of mental disorders in the studied sample did not differ from the prevalence of mental health problems in the general population during COVID-19 pandemic; however, participants reported worsening symptoms such as nervousness, sadness, and sleep during quarantine. Conclusions: Results show the complexity of this topic and the need for individual care for this group, especially in situations like the COVID-19 pandemic.

RESUMO As medidas de isolamento social adotadas na pandemia de COVID-19 geraram um impacto psicológico negativo na população em geral e podem afetar mais duramente cuidadores de pessoas com demência. Objetivos: Esta pesquisa rastreou indicativos de problemas de saúde mental entre cuidadores informais de pacientes com demência. As principais modificações de rotina e comportamento dos pacientes decorrentes das medidas de isolamento social adotadas em função da pandemia também foram investigadas. Métodos: Trinta e cinco cuidadoras informais de pessoas com demência de uma cidade brasileira de médio porte responderam a uma entrevista por telefone. Resultados: Riscos de problemas de saúde mental foram encontrados em 31,4% da amostra. Esses participantes afirmaram encontrar muitas dificuldades para lidar com as mudanças de rotina de cuidados durante a pandemia. As variáveis relativas às características do cuidador e as relativas às alterações de rotina afetaram significativamente os escores de saúde mental do cuidador. Discussão: Os índices de indicadores de risco para problemas mentais na amostra não diferiram da população em geral durante a pandemia de COVID-19, mas os participantes relataram piora de sintomas como nervosismo, tristeza e sono durante a quarentena. Conclusões: Os resultados apresentados mostram a complexidade do tema e a necessidade de cuidados especiais para cuidadores de pessoas com demência, especialmente em situações como a pandemia de COVID-19.

In vitro pharmacological attributes and metabolite's fingerprinting of Conocarpus lancifolius / Atributos farmacológicos in vitro y huellas dactilares de metabolitos de Conocarpus lancifolius

Search for safe antioxidants and novel nutraceuticals urged to evaluate the antioxidant, anti-acetylcholine esterase and anti-lipoxygenase activity of various leaf extracts of Conocarpus lancifolius. Extraction was optimized from freeze dried plant extracts quenched with liquid nitrogen using water, ethanol, methanol, hexane, ethyl acetate and chloroform. Maximum extract yield, total phenolic contents and total flavonoid contents were obtained in case of ethanolic extraction. The highest 2,2-diphenyl-1-picrylhydrazylradical scavenging in terms of IC50 value of 55.26 µg/mL was observed for ethanolic leaf extract. The acetylcholine esterase and lipoxygenase inhibitory activities (IC50) were also observed for ethanolic extract. These findings for ethanolic extract were statistically significant when compared with other extracts (ρ<0.05). The haemolytic % values indicated that all extracts were associated with very low or negligible toxicity. The epicatechin, isorhamnetin, rutin, scopoleptin, skimmianine, quercetin-3-O-α-rhamnoside, quercetin-3-O-ß-glucoside, cornoside, creatinine, choline, pyruvic acid, α-hydroxybutyric acid, phyllanthin and hypophyllanthin were identified as major functional metabolites in ethanolic leaf extract of C. lancifoliusby 1H-NMR. The identified metabolites were probably responsible for the pharmacological properties of C.lancifolius. The findings may be utilized as pharmacological leads for drug development and food fortification.

Se insta a la búsqueda de antioxidantes seguros y nuevos nutracéuticos para evaluar la actividad antioxidante, anti-acetilcolina esterasa y anti-lipoxigenasa de varios extractos de hojas de Conocarpus lancifolius. La extracción se optimizó a partir de extractos de plantas liofilizados enfriados con nitrógeno líquido usando agua, etanol, metanol, hexano, acetato de etilo y cloroformo. En el caso de extracción etanólica se obtuvo el rendimiento máximo de extracto, el contenido de fenoles totales y el contenido de flavonoides totales. La mayor eliminación de radicales 2,2-difenil-1-picrilhidrazilo en términos de valor de CI50 de 55,26 µg/mL se observó para el extracto de hoja etanólico. También se observaron las actividades inhibidoras de la acetilcolina esterasa y lipoxigenasa (CI50) para el extracto etanólico. Estos hallazgos para el extracto etanólico fueron estadísticamente significativos en comparación con otros extractos (ρ<0.05). Los valores del % hemolítico indicaron que todos los extractos estaban asociados con una toxicidad muy baja o insignificante. Se identificaron la epicatequina, isorhamnetina, rutina, escopoleptina, skimmianina, quercetina-3-O-α-ramnosido, quercetina-3-O-ß-glucósido, cornosido, creatinina, colina, ácido pirúvico, ácido α-hidroxibutírico, filantrina e hipofillantina. como metabolitos funcionales principales en el extracto etanólico de hojas de C. lancifoliuspor 1H-NMR. Los metabolitos identificados probablemente fueron responsables de las propiedades farmacológicas de C. lancifolius. Los hallazgos pueden utilizarse como pistas farmacológicas para el desarrollo de fármacos y la fortificación de alimentos.

Effect of Vitamin K2 Alone or in Combination on Various Bone Turnover Markers Amongst Postmenopausal Females

Background@#Osteoporosis is common in postmenopausal women. Some studies have demonstrated the usefulness of vitamin K through the action of bone-specific proteins and osteoblast and osteoclast activities. However, no systematic review had explored this aspect in postmenopausal women. Hence, this systematic review aimed to explore the effect of vitamin K2 alone or in combination with other agents (vitamin D3 or calcium) on various bone turnover markers (BTMs) and bone mineral density (BMD) in postmenopausal women. @*Methods@#MEDLINE, ScienceDirect, PubMed, and Google Scholar were searched to identify relevant studies using specific inclusion criteria. Data extraction and quality assessment were carried out using standardized tests, and the results were narratively synthesized and presented in the form of tables. @*Results@#Vitamin K2 was beneficial in inducing an improvement or preventing deterioration, as evidenced by the BMD and osteocalcin (OC), undercarboxylated OC (ucOC), carboxylated OC (cOC), and γ-carboxylated OC levels. However, its effect was not conclusive when procollagen type 1 N-terminal propeptide, carboxyterminal propeptide of type I procollagen, C-terminal telopeptide of type I collagen, bone alkaline phosphatase, deoxypyridinoline, and N-terminal telopeptide levels (NTX) and ucOC:cOC or cOC:ucOC, and NTX:creatinine ratios were examined. @*Conclusions@#Vitamin K2 supplementation combined with vitamin D and calcium was found to be advantageous. However, vitamin K2 supplementation cannot replace the existing treatment options. In addition, vitamin K2 should be used with caution, considering its interactions with food and other drugs.

Implications for clinical practice from a multicenter survey of heart failure management centers

OBJECTIVES: This observational, cross-sectional study based aimed to test whether heart failure (HF)-disease management program (DMP) components are influencing care and clinical decision-making in Brazil. METHODS: The survey respondents were cardiologists recommended by experts in the field and invited to participate in the survey via printed form or email. The survey consisted of 29 questions addressing site demographics, public versus private infrastructure, HF baseline data of patients, clinical management of HF, performance indicators, and perceptions about HF treatment. RESULTS: Data were obtained from 98 centers (58% public and 42% private practice) distributed across Brazil. Public HF-DMPs compared to private HF-DMP were associated with a higher percentage of HF-DMP-dedicated services (79% vs 24%; OR: 12, 95% CI: 94-34), multidisciplinary HF (MHF)-DMP [84% vs 65%; OR: 3; 95% CI: 1-8), HF educational programs (49% vs 18%; OR: 4; 95% CI: 1-2), written instructions before hospital discharge (83% vs 76%; OR: 1; 95% CI: 0-5), rehabilitation (69% vs 39%; OR: 3; 95% CI: 1-9), monitoring (44% vs 29%; OR: 2; 95% CI: 1-5), guideline-directed medical therapy-HF use (94% vs 85%; OR: 3; 95% CI: 0-15), and less B-type natriuretic peptide (BNP) dosage (73% vs 88%; OR: 3; 95% CI: 1-9), and key performance indicators (37% vs 60%; OR: 3; 95% CI: 1-7). In comparison to non- MHF-DMP, MHF-DMP was associated with more educational initiatives (42% vs 6%; OR: 12; 95% CI: 1-97), written instructions (83% vs 68%; OR: 2: 95% CI: 1-7), rehabilitation (69% vs 17%; OR: 11; 95% CI: 3-44), monitoring (47% vs 6%; OR: 14; 95% CI: 2-115), GDMT-HF (92% vs 83%; OR: 3; 95% CI: 0-15). In addition, there were less use of BNP as a biomarker (70% vs 84%; OR: 2; 95% CI: 1-8) and key performance indicators (35% vs 51%; OR: 2; 95% CI: 91,6) in the non-MHF group. Physicians considered changing or introducing new medications mostly when patients were hospitalized or when observing worsening disease and/or symptoms. Adherence to drug treatment and non-drug treatment factors were the greatest medical problems associated with HF treatment. CONCLUSION: HF-DMPs are highly heterogeneous. New strategies for HF care should consider the present study highlights and clinical decision-making processes to improve HF patient care.

Knowledge level of Iranian dental practitioners towards digital radiography and cone-beam computed tomography / Nível de conhecimento de dentistas Iranianos sobre Radiografia Digital e Tomografia Computadorizada de Feixe Cônico

Objective: TThis study aimed to assess the knowledge level of Iranian dental practitioners about digital radiography (DR) and cone-beam computed tomography (CBCT). Material and Methods: In this cross-sectional study, a researcher-designed questionnaire was administered among 180 general dentists and specialists. The questionnaire had three main domains of demographic information, fifteen questions about knowledge of DR (advantages, disadvantages, physical properties) and twenty six questions about knowledge of CBCT (indications, applications, advantages, route of knowledge acquisition). Data were analyzed using descriptive statistics, t-test and Pearson's correlation coefficient. Results: Of 180 participants, 76 (42.2%) were females. The minimum, maximum and mean± standard deviation scores obtained in DR were 4, 14, and 9.031 ± 1.85 and in CBCT were 0,26 and 18.56 ± 4.81, respectively. In the CBCT domain, the participants had maximum knowledge about "low radiation dose" (72.8%) and minimum knowledge about the "role of CBCT in determination of bone density" (45%). In DR domain, the participants had maximum knowledge about "no need for radiographic films" (75.6%) and minimum knowledge about "not requiring manual processing" (15.6%). Overall, participants had higher level of knowledge about CBCT than DR. An inverse correlation was noted between age and work experience with the number of correct answers. However, no significant difference was noted in the knowledge level of males and females regarding CBCT or DR (p = 0.233 and p = 0.227, respectively). Conclusions: further education seem imperative for dentists in this respect for more efficient diagnosis and treatment planning, minimize patient radiation dose and save time and cost. (AU)

Objetivos: Avaliar o nível de conhecimento de dentistas iranianos sobre radiografia digital (RD) e tomografia computadorizada de feixe cônico (TCFC). Materiais e métodos: Neste estudo transversal, um questionário, elaborado por pesquisadores, foi aplicado a 180 dentistas clínicos geral e especialistas. O questionário tinha três domínios principais de informação demográfica, quinze questões sobre conhecimento de RD (vantagens, desvantagens, propriedades físicas) e vinte e seis questões sobre conhecimento de CBCT (indicações, aplicações, vantagens, protocolo de aquisição). Os dados foram analisados por meio de estatística descritiva, teste t e coeficiente de correlação de Pearson. Resultados: Dos 180 participantes, 76 (42,2%) eram do sexo feminino. Os escores mínimo, máximo e média ± desvio padrão obtidos na RD foram 4, 14 e 9,031 ± 1,85 e na CBCT foram 0, 26 e 18,56 ± 4,81, respectivamente. No domínio CBCT, os participantes tinham conhecimento máximo sobre "baixa dose de radiação" (72,8%) e conhecimento mínimo sobre o "papel da CBCT na determinação da densidade óssea" (45%). No domínio RD, os participantes possuíam conhecimento máximo sobre "não há necessidade de filmes radiográficos" (75,6%) e conhecimento mínimo sobre "não requer processamento manual" (15,6%). No geral, os participantes tinham maior nível de conhecimento sobre CBCT do que RD. Foi observado correlação inversa entre idade e experiência de trabalho com o número de acertos. No entanto, nenhuma diferença significativa foi observada no nível de conhecimento de homens e mulheres sobre TCFC ou RD (p = 0,233 e p = 0,227 respectivamente). Conclusão: Parece imperativo para os dentistas iranianos, mais educação nesse aspecto para diagnóstico e planejamento de tratamento mais eficientes, minimizar a dose de radiação para paciente, economizar tempo e custos. (AU)

In-vitro model of scardovia wiggsiae biofilm formation and effect of nicotine

Abstract Recently, Scardovia wiggsiae has been reported to be strongly associated with caries formation. This study aimed to establish an in vitro model of S. wiggsiae biofilm and to investigate the effect of nicotine on S. wiggsiae colony-forming units (CFUs) growth. S. wiggsiae biofilm was grown overnight using brain-heart infusion (BHI) broth supplemented with 5 g of yeast extract/L (BHI-YE). The overnight culture was used as an inoculum to grow S. wiggsiae biofilm on standardized enamel and dentin samples. Samples were incubated with different nicotine concentrations (0, 0.5, 1, 2, 4, 8, 16 and 32 mg/mL) for 3 days. The dissociated biofilms were diluted, spiral plated on blood agar plates, and incubated for 24 h. CFUs/mL were quantified using an automated colony counter. A two-way ANOVA was used to compare the effect of different nicotine concentrations on S. wiggsiae CFUs. This study demonstrated that S. wiggsiae biofilm could be initiated and formed in vitro. Increased CFUs was observed through 0.5-4 mg/mL and 0.5-8 mg/mL of nicotine using enamel and dentin substrates, respectively. 16 and 32 mg/mL of nicotine were determined as the minimum inhibitory concentration (MIC) and the minimum bactericidal concentration (MBC), respectively. S. wiggsiae formed greater biofilm on enamel than dentin specimens in response to the nicotine stimulus. This study demonstrated the negative effect of smoking on increasing S. wiggsiae biofilm. Establishing S. wiggsiae biofilm in vitro may allow researchers in the future to have a better understanding of caries pathogenesis and bacterial interaction.

Resumo Recentemente, foi relatado que Scardovia wiggsiae está fortemente associado à formação de cáries. Este estudo teve como objetivo estabelecer um modelo in vitro de biofilme de S. wiggsiae e investigar o efeito da nicotina no crescimento de unidades formadoras de colônias (UFC) de S. wiggsiae. O biofilme de S. wiggsiae foi cultivado durante a noite usando caldo de infusão de cérebro-coração (BHI) suplementado com 5 g de extrato de levedura / L (BHI-YE). A cultura noturna foi usada como um inóculo para cultivar biofilme de S. wiggsiae em amostras padronizadas de esmalte e dentina. As amostras foram incubadas com diferentes concentrações de nicotina (0, 0,5, 1, 2, 4, 8, 16 e 32 mg/mL) por 3 dias. Os biofilmes dissociados foram diluídos, semeados em espiral em placas de ágar sangue e incubados por 24 h. UFC/mL foram quantificados usando um contador de colônias automatizado. Uma ANOVA de duas vias foi usada para comparar o efeito de diferentes concentrações de nicotina em UFCs de S. wiggsiae. Este estudo demonstrou que o biofilme de S. wiggsiae pode ser iniciado e formado in vitro. UFCs aumentadas foram observadas com 0,5-4 mg/mL e 0,5-8 mg/mL de nicotina usando substratos de esmalte e dentina, respectivamente. A concentração inibitória mínima (CIM) e a concentração bactericida mínima (CBM) de nicotina foram determinadas, respectivamente, como 16 e 32 mg/mL. S. wiggsiae formou maior biofilme no esmalte do que espécimes de dentina em resposta ao estímulo de nicotina. Este estudo demonstrou o efeito negativo do tabagismo no aumento do biofilme de S. wiggsiae. O estabelecimento do biofilme de S. wiggsiae in vitro pode permitir que os pesquisadores no futuro tenham uma melhor compreensão da patogênese da cárie e da interação bacteriana.

In Vitro And In Vivo Anticancer Efficacy Of Adiantum Capillus-Veneris L. Against Some Selected Human Cancer Cell Lines And On Eac Mouse Model

Adiantum capillus-veneris, commonly known as maidenhair fern belongs to family Pteridaceae, has traditionally been used in various medicinal preparations as demulcent, expectorant, emmenagogue, diuretic etc. in the form of oil, paste, decoction and powder. It has also prominent role in hair growing and has anti-microbial, anti-inflammatory, anti-diabetic, anti-nociceptive and antioxidant properties of therapeutic interest. This study aimed to investigate the in vitro cytotoxic activity of fractions of ethanolic extract isolated from the aerial part of A. capillus-veneris against some human cancer cell lines such as colon (HCT-116), lung (A549), breast (MCF-7) and pancreatic (MIA PaCa-2) and tumor cell proliferation/inhibition was assessed using MTT assay. The in vivo anticancer activity of hexane fraction was also evaluated against murine Ehrlich ascites carcinoma (EAC) model. The results confirmed that all the fractions of ethanolic extract exhibited promising in vitro inhibition of tumor cell proliferation when tested against different human cancer cell lines. Among all, hexane fraction proved to be more effective having IC50 values 21.72, 22.67, 26.25 μg/mL, for HCT- 116, A-549, MCF-7, respectively, but chloroform fraction revealed to be more cytotoxic against Mia-PACA-2 having IC50 value 14.72 μg/mL. Higher cytotoxic activity is found to be associated with lower IC50 values. The findings showed that all five fractions exhibited dose-dependent killing capabilities in various human derived cancer cell lines at 48 h of treatment. Hexane fraction was found to inhibit tumour growth development by 16.95%, 41.12% and 82.07% at 50, 100 and 200 mg/kg body weight, respectively. Additionally, this fraction was predicted to be non-toxic at the tested doses. The findings indicate that A. capillus-veneris herb is an antineoplastic agent and suggest that further studies evaluating the isolation of active antitumor compounds from A. capillus-veneris and their mechanism(s) of action are necessary.

Evaluation the role of laparoscopic management of complicated appendicitis

Background: A laparoscopic appendectomy (LA) was performed mostly on uncomplicated appendicitis due to opinions about its safety when it was first introduced. Nevertheless, there are still concerns about surgical difficulties in managing complicated appendicitis with laparoscopy, possible post-op complications and conversion to an open appendectomy (OA) during the surgery.Methods: The study consists of 30 patients who underwent laparoscopic appendectomy in department of General Surgery at Assiut University hospitals. The study population was enrolled after fulfilling the selection criteria from department of General Surgery. Informed consent was taken from all the patients who are involved in this study. Patients diagnosis was based on clinical findings, complete blood counts, and abdominal sonography.Results: Thirty patients underwent laparoscopic appendectomy for complicated appendicitis. Of the 30 patients, perforated appendix cases are 27, gangrenous appendix are 1, appendicular abscess only one case. Post operation wound infection, conversion rate and hospital stay rate very less.Conclusions: The present study proved that laparoscopic appendectomy is the best approach in complicated appendicitis.

The Effects Of Dietary Sodoium Nitrite Supplementation On Jejunal Mucosa And Possible Protective Effect Of Vitamin A In Albino Rats

Nitrate (NO3-) and nitrite (NO2-) are naturally-occurring oxidation products of nitrogen which widely used in thefood industry. The goal of this study was to illustrate the histopathological effects of sub-lethal dose of sodiumnitrite on jejunal mucosa and the possible protective effect of vitamin A. Thirty adult male Albino rats weredivided into 3 groups as follows: Group I (control) received distilled water, Group II (Nitrite-treated) whichreceived intra-gastric daily dose of 50 mg/kg NaNO2 and Group III (Nitrite & vit-A treated group) which receivedintra-gastric daily dose of 50 mg/kg NaNO2 +10,000 I.U/ rat vitamin A. Animals were sacrificed 8 weeks aftertreatment. Blood samples were collected and examined. Specimens from jejunal mucosa of rats were collectedfor the optical and electron microscope study. The blood samples showed significant reduction in all blood cellscounting and albumin level with elevated methemoglobin level in the nitrite treated group. Light microscopicexamination revealed that; Sodium nitrite cause jejunal mucosa damage represented by abnormal shape andlength of jejunal mucosa villi, necrosis with marked loss of covering epithelium and excessive cellular infiltrationin its core of lamina. PAS stained sections exhibited weak or negative PAS reaction of goblet cells of brush borderof villi and crypts. The entrocytes and goblet cells showed ultrastructural changes. Vitamin A administrationresulted in marked regression of the previously mentioned jejunal mucosal effects. Results of the current studyrevealed that diatry supplemtation of nitrite cause multible jejunal mucosal injury but the co-administration ofVitamin A greatly reduce the toxic effects of nitrite supplementation on jejunal mucosa

In vitro efficacy of new synthetic benzimidazole-related compounds against Schistosoma mansoni adult worms

Objective: To evaluate the in vitro antischistosomal activity of two new synthetic benzimidazole-related compounds: NBTP-OH and NBTP-F. Methods: Schistosoma adult worms were recovered from mice infected with Schistosoma mansoni cercaria, washed and then incubated in the culture media with different concentrations of compounds NBTP-OH and NBTP-F up to 72 h. Scanning electron microscopy was conducted to report morphological changes. Results: Incubation of adult Schistosoma mansoni with 10 µg/mL of NBTP-OH for 48 h killed 81.25% of worms. The calculated LC50 and LC90 72 h post-incubation were 6.8 µg/mL and 9.8 µg/ mL, respectively. Exposure of worms to 10 µg/mL of NBTP-F killed 89.5% of worms after 48 h, mostly males (83.3%), the LC50 and LC90 after 72 h of incubation were 4.8 µg/mL and 6.9 µg/mL, respectively. Worms incubated for 72 h with these compounds revealed swelling and deformity of oral sucker, disorganization and erosion of the tegument when examined with scanning electron microscopy. Conclusions: NBTP-OH and NBTP-F possess in vitro antischistosomal activities; however, in vivo studies should be conducted to examine their antischistosomal effects.

Metabolite profiling and antidiabetic attributes of ultrasonicated leaf extracts of Conocarpus lancifolius

Objective: To profile the secondary metabolites and to evaluate the antidiabetic potential of hydroethanolic leaf extracts of Conocarpus lancifolius. Methods: The various hydroethanolic extracts of Conocarpus lancifolius leaf were prepared by ultrasonication assisted freeze-drying. Total phenolic contents, flavonoid contents, antioxidant activity, α-glucosidase and α-amylase inhibitions of leaf extracts were determined. The metabolite profiling was accomplished by UHPLC-Q-TOF-MS/MS analysis. The antidiabetic assessment of the most potent extract was carried out by measuring the hypoglycemic and hypolipidemic effect in the high fat diet-fed diabetic albino mice. The blood glucose level, haemoglobin, total cholesterol, high-density lipoproteins (HDL) and low-density lipoproteins (LDL) were determined. Results: The 60% ethanolic extract exhibited the highest phenolic and flavonoid contents of (349.39 ± 2.13) mg GAE/g dry extract and (116.95 ± 2.34) mg RE/g dry extracts, respectively, and the highest DPPH scavenging activity with an IC50 value of (32.87 ± 1.11) μg/mL. The IC50 values for α-glucosidase and α-amylase inhibitions were (38.64 ± 0.93) μg/mL and (44.80 ± 1.57) μg/mL, respectively. UHPLC-Q-TOF-MS/MS analysis confirmed the presence of gallic acid, ellagic acid, corilagin, kaempherol-3-O-rutinoside, caffeic acid derivative, isorhamnetin and galloyl derivatives in the 60% ethanolic extract. Plant extract at a dose of 450 mg/kg body weight reduced blood glucose level, total cholesterol, LDL and HDL, and increased haemoglobin in alloxan-induced diabetic mice, Conclusions: Conocarpus lancifolius leaves are proved as a good source of biologically functional metabolites and possess antidiabetic activity which may be further explored to treat diabetes.

Metabolite profiling and antidiabetic attributes of ultrasonicated leaf extracts of Conocarpus lancifolius

Objective: To profile the secondary metabolites and to evaluate the antidiabetic potential of hydroethanolic leaf extracts of Conocarpus lancifolius.Methods: The various hydroethanolic extracts o f Conocarpus lancifolius leaf were prepared by ultrasonication assisted freeze-drying. Total phenolic contents, flavonoid contents, antioxidant activity, α-glucosidase and α-amylase inhibitions of leaf extracts were determined. The metabolite profiling was accomplished by UHPLC-Q-TOF-MS/MS analysis. The antidiabetic assessment of the most potent extract was carried out by measuring the hypoglycemic and hypolipidemic effect in the high fat diet-fed diabetic albino mice. The blood glucose level, haemoglobin, total cholesterol, high-density lipoproteins (HDL) and low-density lipoproteins (LDL) were determined. Results: The 60％ ethanolic extract exhibited the highest phenolic and flavonoid contents of (349.39 ± 2.13) mg GAE/g dry extract and (116.95 ± 2.34) mg RE/g dry extracts, respectively, and the highest DPPH scavenging activity with an IC50 value of (32.87 ± 1.11) μg/mL. The IC50 values for α-glucosidase and α-amylase inhibitions were (38.64 ± 0.93) μg/mL and (44.80 ± 1.57) μg/mL, respectively. UHPLC-Q-TOF-MS/MS analysis confirmed the presence of gallic acid, ellagic acid, corilagin, kaempherol-3-O-rutinoside, caffeic acid derivative, isorhamnetin and galloyl derivatives in the 60％ ethanolic extract. Plant extract at a dose of 450 mg/kg body weight reduced blood glucose level, total cholesterol, LDL and HDL, and increased haemoglobin in alloxan-induced diabetic mice, Conclusions: Conocarpus lancifolius leaves are proved as a good source of biologically functional metabolites and possess antidiabetic activity which may be further explored to treat diabetes.

Influence of salivary conditioning and sucrose concentration on biofilm-mediated enamel demineralization

Abstract The acquired pellicle formation is the first step in dental biofilm formation. It distinguishes dental biofilms from other biofilm types. Objective To explore the influence of salivary pellicle formation before biofilm formation on enamel demineralization. Methodology Saliva collection was approved by Indiana University IRB. Three donors provided wax-stimulated saliva as the microcosm bacterial inoculum source. Acquired pellicle was formed on bovine enamel samples. Two groups (0.5% and 1% sucrose-supplemented growth media) with three subgroups (surface conditioning using filtered/pasteurized saliva; filtered saliva; and deionized water (DIW)) were included (n=9/subgroup). Biofilm was then allowed to grow for 48 h using Brain Heart Infusion media supplemented with 5 g/l yeast extract, 1 mM CaCl2.2H2O, 5% vitamin K and hemin (v/v), and sucrose. Enamel samples were analyzed for Vickers surface microhardness change (VHNchange), and transverse microradiography measuring lesion depth (L) and mineral loss (∆Z). Data were analyzed using two-way ANOVA. Results The two-way interaction of sucrose concentration × surface conditioning was not significant for VHNchange (p=0.872), ∆Z (p=0.662) or L (p=0.436). Surface conditioning affected VHNchange (p=0.0079), while sucrose concentration impacted ∆Z (p<0.0001) and L (p<0.0001). Surface conditioning with filtered/pasteurized saliva resulted in the lowest VHNchange values for both sucrose concentrations. The differences between filtered/pasteurized subgroups and the two other surface conditionings were significant (filtered saliva p=0.006; DIW p=0.0075). Growing the biofilm in 1% sucrose resulted in lesions with higher ∆Z and L values when compared with 0.5% sucrose. The differences in ∆Z and L between sucrose concentration subgroups was significant, regardless of surface conditioning (both p<0.0001). Conclusion Within the study limitations, surface conditioning using human saliva does not influence biofilm-mediated enamel caries lesion formation as measured by transverse microradiography, while differences were observed using surface microhardness, indicating a complex interaction between pellicle proteins and biofilm-mediated demineralization of the enamel surface.