Síndrome de Kartagener y artritis reumatoide. Reporte de caso / Kartagener Syndrome and Rheumatoid Arthritis. Case Report

Presentación del caso. Se trata de una mujer de 26 años de edad, en seguimiento por la especialidad de reumatología desde los 17 años, cuando consultó con historia de un año de evolución de síndrome poliarticular de grandes y pequeñas articulaciones, aditivo, simétrico acompañado de fatiga, rigidez matutina mayor de una hora. Se reportó además factor reumatoide positivo. La radiografía de ambas manos presentó erosiones, que confirmó el diagnóstico de artritis reumatoide. Adicionalmente, la paciente tenía el antecedente de procesos sinobronquiales a repetición desde su infancia. En la evaluación médica se identificó dolor en los senos paranasales, dextrocardia y bronquiectasias, confirmados por los estudios de imágenes, que permitió concluir en el diagnóstico de síndrome de Kartagener. Intervención terapéutica. La paciente presentaba actividad clínica severa de la artritis reumatoide, se inició el tratamiento con metotrexato 10 mg vía oral un día a la semana, prednisona 5 mg al día y ácido fólico 5 mg a la semana y citas periódicas, controlando los datos de actividad y efectos adversos de los medicamentos, con pruebas hepáticas, hemograma y transaminasas. La especialidad de neumología recomendó la inclusión de la paciente en un programa de rehabilitación respiratoria, así como el uso de azitromicina 500 mg cada día por tres días en los períodos de agudización. Evolución clínica. El tratamiento logró mantener una actividad leve de la artritis reumatoide y sin exacerbación de los síntomas respiratorios

Case presentation. A 26-year-old woman, under follow-up by the rheumatology specialty since she was 17 years old, when she consulted with a history of one year of evolution of polyarticular disease of large and small joints, additive, symmetrical, accompanied by fatigue and morning stiffness for more than one hour. Positive rheumatoid factor was also reported. Additionally, the patient had a history of repeated sinobronchial processes since childhood. Medical examination revealed sinus pain in the paranasal sinuses, dextrocardia, and bronchiectasis, confirmed by imaging studies, which led to the diagnosis of Kartagener's syndrome. Treatment. The patient presented the severe clinical activity of rheumatoid arthritis. The treatment was started with methotrexate 10 mg orally one day a week, prednisone 5 mg a day, and folic acid 5 mg a week and periodic appointments, controlling the activity data and adverse effects of the drugs, with liver tests, hemogram, and transaminases. The pneumology department recommended the inclusion of the patient in a respiratory rehabilitation program as well as the use of azithromycin 500 mg every day for three days during periods of exacerbation. Outcome. The treatment was successful in maintaining a mild activity of the rheumatoid arthritis and without exacerbation of respiratory symptoms

Mechanism of Aurantii Fructus and Its Active Components in Regulating Gastrointestinal Motility： A Review / 中国实验方剂学杂志

Gastrointestinal motility disorder is an important cause of digestive system diseases. Patients often suffer from nausea， vomiting， gastric retention， gastroparesis， constipation， and many other symptoms， and their quality of life is seriously reduced. Prokinetic agents are routinely used in clinical practice， but their long-term use is prone to problems such as reduced efficacy and increased adverse reactions. Since the incidence of gastrointestinal diseases has continued to rise globally in recent years， there is an urgent need for clinical development of safe and effective treatment strategies. Aurantii Fructus， a traditional Chinese medicine， has the effect of smoothing Qi and eliminating distention， and it has been used to treat gastrointestinal diseases for thousands of years. In modern clinical practice， it is mainly used for the treatment and auxiliary treatment of various gastrointestinal diseases such as functional dyspepsia， functional constipation， and irritable bowel syndrome. The efficacy is remarkable， and no adverse reactions have been reported at conventional doses. Therefore， it can greatly improve the symptoms of patients with gastrointestinal diseases and improve their quality of life. Modern research has revealed that there are many active components in Aurantii Fructus， among which flavonoids have the highest content and the most types. Flavonoids are the main active components in Aurantii Fructus to regulate gastrointestinal motility. Aurantii Fructus and its active components can affect gastrointestinal hormones， neural pathways， Cajal mesenchymal cells， and other multiple mechanisms. They can adjust gastrointestinal motility and correct gastrointestinal motility disorders， showing potential application value in the treatment of gastrointestinal motility disorders. However， a comprehensive analysis of Aurantii Fructus in this aspect is still lacking. This study summarized the pharmacological activities of active components of Aurantii Fructus extract and its flavonoids， volatile oils， alkaloids， and coumarin on the regulation of gastrointestinal motility and explored the latest research progress on its mechanism. Finally， the adverse reactions of Aurantii Fructus were summarized. It aims to provide a scientific basis for the research and clinical application of Aurantii Fructus and its active components in the regulation of gastrointestinal motility.

Effects of esketamine for multimodal analgesia on opioid consumption and gastric motility in mechanically ventilated non-surgical ICU patients / 中国药房

OBJECTIVE To investigate the effects of esketamine for multimodal analgesia on opioid consumption and gastric motility in mechanically ventilated non-surgical intensive care unit （ICU） patients. METHODS Forty cases of mechanically ventilated non-surgical patients in the ICU of our hospital from February 1st， 2023 to July 31st， 2023 were selected and randomly divided into control group and esketamine （S-K） group using grouping method with opaque envelopes， with 20 cases in each group. Control group was given sufentanil， and S-K group was infused with Esketamine hydrochloride injection at a constant rate of 0.2 mg/（kg·h）+ sufentanil. The treatment period length， analgesic compliance rate， sedation level， analgesic and sedative consumption， and gastric motility indexes were compared between the two groups. RESULTS There was no statistically significant difference in the treatment period length， analgesic compliance rate， sedation level， or the consumption of propofol and midazolam between the two groups （P＞0.05）. The consumption of sufentanil in the S-K group was significantly less than control group （P＜ 0.05）. Compared with 1 h after randomization， the antral contraction frequency， antral contraction amplitude and antral motility index of patients in the S-K group were significantly higher at 72 h after randomization and were significantly higher than control group （P＜0.05）. CONCLUSIONS Esketamine may reduce opioid consumption and improve gastric motility in mechanically ventilated non-surgical ICU patients while ensuring a level of analgesic sedation.

Aspectos gerais do retículo peritonite traumática em bovinos / General aspects of traumatic reticulum peritonitis in cattle / Aspectos generales de la peritonitis del retículo traumático en ganado

A Retículo Peritonite Traumática está diretamente ligada à ingestão de objetos metálicos perfuro cortantes, como pregos e pedaços de arame, que podem penetrar ou perfurar a parede do retículo. Embora a ocorrência de corpos estranhos de alumínio seja rara, outros elementos, como fios de pneus usados para fixar lonas em silagens e até cerdas de arame de escovas utilizadas em pequenos aeroportos, têm sido registrados como causas dessa afecção. A ingestão desses objetos pode resultar em lesões no retículo, desencadeando episódios de retículo peritonite traumática e suas sequelas, como pericardite traumática, inflamação do fígado, abscessos no baço e muito mais. Os sinais clínicos podem variar, mas incluem comportamento anormal, motilidade reduzida do rúmen, fezes mal digeridas, febre e sinais de dor. O diagnóstico baseia-se na avaliação dos sinais clínicos do animal, juntamente com exames complementares, como hemograma, bioquímico, ultrassom e radiografia. É importante considerar as alterações hematológicas, como leucocitose e hiperfibrinogenemia, como indicadores-chave desta afecção. O diagnóstico também envolve testes de dor ao corpo estranho. O tratamento pode ser conservativo ou cirúrgico. A abordagem conservativa envolve a administração de antibióticos, anti-inflamatórios e soluções intravenosas, além do tratamento de deficiências nutricionais subjacentes. A opção cirúrgica exige a remoção do corpo estranho do retículo, seguida de cuidados pós-operatórios.

Traumatic Reticulum Peritonitis this directly linked to the ingestion of sharp metallic objects, such as nails and pieces of wire, which can penetrate or pierce the wall of the reticulum. Although the occurrence of aluminum foreign bodies is rare, other elements, such as tire wires used to attach tarpaulins to silage and even wire bristles from brushes used in small airports, have been recorded as causes of this condition. Ingestion of these objects can result in damage to the reticulum, triggering episodes of traumatic reticulum peritonitis and its sequelae, such as traumatic pericarditis, liver inflammation, spleen abscesses and more. Clinical signs may vary but include abnormal behavior, reduced rumen motility, poorly digested feces, fever and signs of pain. The diagnosis is based on the evaluation of the animal's clinical signs, together with complementary tests, such as blood count, biochemistry, ultrasound and radiography. It is important to consider hematological changes, such as leukocytosis and hyperfibrinogenemia, as key indicators of this condition. Diagnosis also involves foreign body pain testing. Treatment can be conservative or surgical. The conservative approach involves administering antibiotics, anti-inflammatories and intravenous solutions, in addition to treating underlying nutritional deficiencies. The surgical option requires removal of the foreign body from the reticulum, followed by post-operative care.

La peritonitis traumática del retículo esto directamente ligada a la ingestión de objetos metálicos punzantes, como clavos y trozos de alambre, que pueden penetrar o perforar la pared del retículo. Aunque la aparición de cuerpos extraños de aluminio es rara, se han registrado como causas de esta afección otros elementos, como los alambres de neumáticos utilizados para fijar las lonas al ensilaje e incluso las cerdas de alambre de los cepillos utilizados en los aeropuertos pequeños. La ingestión de estos objetos puede provocar daños en el retículo, desencadenando episodios de peritonitis traumática del retículo y sus secuelas, como pericarditis traumática, inflamación del hígado, abscesos del bazo y más. Los signos clínicos pueden variar, pero incluyen comportamiento anormal, motilidad ruminal reducida, heces mal digeridas, fiebre y signos de dolor. El diagnóstico se basa en la evaluación de los signos clínicos del animal, junto con pruebas complementarias, como hemograma, bioquímica, ecografía y radiografía. Es importante considerar los cambios hematológicos, como la leucocitosis y la hiperfibrinogenemia, como indicadores clave de esta afección. El diagnóstico también implica la prueba del dolor por cuerpo extraño. El tratamiento puede ser conservador o quirúrgico. El enfoque conservador implica la administración de antibióticos, antiinflamatorios y soluciones intravenosas, además de tratar las deficiencias nutricionales subyacentes. La opción quirúrgica requiere la extracción del cuerpo extraño del retículo, seguida de cuidados postoperatorios.

Assessing the validity of flap motility sign in predicting the extent of anterior capsular tears in phacoemulsification

Capsulorhexis is an integral step of cataract surgery, and continuous curvilinear capsulorhexis is crucial during phacoemulsification to prevent intraoperative complications. However, sometimes during phacoemulsification in complicated and hard cataract cases, rhexis extension may occur, resulting in posterior capsular rent, nucleus drop, cortex drop, and aphakia. It may not always be possible to continue with phacoemulsification in all cases. In this perspective, the authors describe a novel flap motility sign (FMS) to predict the extent of anterior capsular tear during phacoemulsification. A total of 21,678 patients underwent phacoemulsification for three years, from July 2016 to June 2019. One hundred and twenty-one patients had an anterior capsular tear. There were 102 cases (84.3%) with pre-equatorial tears and 19 cases (15.70%) with postequatorial tears. All pre-equatorial flaps were everted and fluttering, and all postequatorial flaps were inverted and nonfluttering. Posterior capsule rupture (PCR) was observed in all 19 cases of postequatorial flaps (100%). No PCR was observed in patients with fluttering and everted flaps (0%). In-the-bag and scleral-fixated intraocular lens implantations succeeded in pre-equatorial and postequatorial tears, respectively. There was no case of a nucleus drop. This study validates FMS as a predictor for identifying the extent of anterior capsular tears, thereby determining the endpoint of safe phacoemulsification and the site for intraocular lens implantation. Pre-equatorial tears allow for the continuation of safe phacoemulsification and in-the-bag intraocular implantation. Postequatorial tears necessitate timely conversion to small-incision cataract surgery or extracapsular cataract extraction.

Postnatal Exposure to Exogenous progesterone Exacerbates the Prenatally-Induced Abnormal Sperms Production and Function in Rats / La exposición Posnatal a la Progesterona Exógena Exacerba la Producción y Función Anormales de Espermatozoides Inducidas Prenatalmente en Ratas

SUMMARY: This study aimed at clarifying the impact of long-term prenatal and postnatal exposure to exogenous progesterone on sperm production and function, relative sex organs weights, and the levels of the relevant hormones in rats. Sixty male Wistar rats were included and classified into three groups (n=20 in each). A test I group had mature rats born to dams treated with progesterone prenatally. A test II group included rats exposed to progesterone during prenatal as well as postnatal periods, and a control group had rats treated with a placebo (olive oil). The test groups revealed a significant reduction in sperm count, motility, and viability with higher abnormal forms than the control group (P< 0.05). Similarly, the test groups revealed significantly lower serum testosterone and higher FSH and LH levels (P< 0.001). Interestingly, the test II group showed pronounced sperm abnormalities, an alarming decrease in sperm viability and motility, and a significant accretion in the relative testicular weight compared to the test I group (p <0.001). Long-term (prenatal and early postnatal) treatment with synthetic progesterone hurts sperm quantity and quality, adversely affecting future male fertility.

Este estudio tuvo como objetivo aclarar el impacto de la exposición prenatal y posnatal a largo plazo a la progesterona exógena en la producción y función de los espermatozoides, el peso relativo de los órganos sexuales y los niveles de las hormonas relevantes en ratas. Sesenta ratas macho Wistar fueron incluidas y clasificadas en tres grupos (n=20 en cada uno). Un grupo de prueba I tenía ratas maduras nacidas de madres tratadas con progesterona prenatalmente. Un grupo de prueba II incluyó ratas expuestas a progesterona durante los períodos prenatal y posnatal, y un grupo de control tenía ratas tratadas con un placebo (aceite de oliva). Los grupos de prueba revelaron una reducción significativa en el recuento, la motilidad y la viabilidad de los espermatozoides con formas anormales más altas que el grupo de control (P < 0,05). De manera similar, los grupos de prueba revelaron niveles significativamente más bajos de testosterona sérica y niveles más altos de FSH y LH (P < 0.001). Curiosamente, el grupo de prueba II mostró anormalidades espermáticas pronunciadas, una disminución alarmante en la viabilidad y motilidad de los espermatozoides y una acumulación significativa en el peso testicular relativo en comparación con el grupo de prueba I (p <0.001). El tratamiento a largo plazo (prenatal y posnatal temprano) con progesterona sintética daña la cantidad y la calidad del esperma, lo que afecta negativamente la futura fertilidad masculina.

Characterization of Achalasia Subtypes Based on High-Resolution Manometry in Patients at a Reference Hospital in Colombia

Introduction: Limited information is available regarding the clinical and manometric characteristics of different subtypes of achalasia. This study aims to describe these characteristics in patients treated at a prominent hospital in Colombia. Methods: This descriptive observational study included patients diagnosed with achalasia using high-resolution esophageal manometry at Hospital Universitario San Ignacio in Bogotá, Colombia, between 2016 and 2020. We documented the clinical manifestations, manometric findings, treatment approaches, and response to treatment based on the subtype of achalasia. Results: A total of 87 patients were enrolled, with a median age of 51 years, and 56.4% of them were female. The majority had type II achalasia (78.1%), followed by type I (16%) and type III (5.7%). All patients presented with dysphagia, 40.2% experienced chest pain, and 27.6% had gastroesophageal reflux. The clinical parameters, including integrated relaxation pressure value (IRP; median: 24 mmHg, interquartile range [IQR]: 19-33), upper esophageal sphincter pressure (UES; median: 63 mmHg, IQR: 46-98), and lower esophageal sphincter pressure (LES; median: 34 mm Hg, IQR: 26-45), were similar across the different subtypes. Esophageal clearance was incomplete in all patients. Among the 35 patients who received intervention, Heller's myotomy was the most commonly employed procedure (68.5%), followed by esophageal dilation (28.6%). All patients experienced symptomatic improvement, with a median pre-treatment Eckardt score of 5 (IQR: 5-6) and a post-treatment score of 1 (IQR: 1-2). Conclusions: Type II achalasia is the most prevalent subtype. The clinical and manometric findings, as well as treatment response, exhibit similarities among the different subtypes of achalasia. In Colombia, the outcomes of this condition align with those reported in other parts of the world.

Introducción: existe información limitada sobre las características clínicas y manométricas de los diferentes subtipos de acalasia. Este estudio describe dichas características en pacientes manejados en un hospital de referencia en Colombia. Método: estudio descriptivo observacional que incluye a pacientes con diagnóstico de acalasia por manometría esofágica de alta resolución manejados en el Hospital Universitario San Ignacio de Bogotá, Colombia, entre 2016 y 2020. Se describen las manifestaciones clínicas, hallazgos manométricos, tratamiento utilizado y respuesta al mismo según el subtipo de acalasia. Resultados: se incluyeron a 87 pacientes (mediana de edad: 51 años, 56,4% mujeres). La mayoría de tipo II (78,1%), seguido por tipo I (16%) y tipo III (5,7%). Todos presentaron disfagia, 40,2% dolor torácico y 27,6% reflujo gastroesofágico. La clínica y los valores del integral de presión de relajación (IRP; mediana: 24 mm Hg, rango intercuartílico [RIC]: 19-33), presión del esfínter esofágico superior (EES; mediana: 63 mm Hg, RIC: 46-98) y presión del esfínter esofágico inferior (EEI; mediana: 34 mm Hg, RIC: 26-45) fueron similares en los diferentes subtipos. El aclaramiento esofágico fue incompleto en todos los pacientes. Entre 35 pacientes que recibieron manejo intervencionista, la miotomía de Heller fue la intervención más utilizada (68,5%), seguido por la dilatación esofágica (28,6%). La totalidad de estos pacientes presentó una mejoría sintomática con la mediana de Eckardt pretratamiento de 5 (RIC: 5-6) y postratamiento de 1 (RIC: 1-2). Conclusiones: la acalasia tipo II es la más común. La clínica y los hallazgos manométricos y respuesta a tratamiento son similares entre los subtipos de acalasia. En Colombia, esta entidad se comporta de forma similar a lo reportado en otras partes del mundo.

Integridad Del ADN Espermático Y La Toxicidad Reproductiva Del Nitrato De Plomo En Ratones Machos Adultos

Introducción: La toxicidad del plomo se ha relacionado a diferentes patologías en humanos y varias evidencias sugieren una fuerte relación con el daño observado sobre la función reproductiva en humanos y roedores. Método: Se proporcionó a ratones una dosis única de nitrato de plomo (NP) (50mg/kg/pc), los cuales fueron eutanizados siete días postinyección con el objetivo de evaluar los espermatozoides que han salido de los túbulos seminíferos y están en tránsito por el epidídimo; además, se evaluó la fragmentación del ADN espermático mediante el ensayo tunel. Resultados: La disminución del peso corporal en ratones, tratados con NP (p 0,05); de igual manera, los valores fisiológicos como conteo y movilidad espermática no disminuyeron con el tratamiento (p > 0.05). El tránsito y maduración de los espermatozoides en el epidídimo no sería afectado por el NP, y al no observar aumento en la fragmentación del ADN espermático en el grupo tratado (p > 0,05), la protaminación espermática estaría cumpliendo su rol protector sobre el material genético murino, por lo que no hubo daños genotóxicos por el NP. Conclusión: La administración intraperitoneal de 50mg/kg/pc de NP, por siete días, no causa toxicidad sistémica ni efecto en la espermatogénesis en ratón.

Introduction: Lead toxicity has been linked to different diseases in humans and several evidences suggest a strong relationship with the observed damage on reproductive function in humans and rodents. Methods: Mice were given a single dose of lead nitrate (NP) (50mg/kg/bw), which were euthanized seven days post-injection with the aim of evaluating sperm to come out from the seminiferous tubules and are in transit through the epididymis. Also, the Tunel test was done to evaluate the sperm DNA fragmentation. Results: The decrease in body weight in mice treated with ln (p 0.05), in the same way physiological values such as sperm concentration and motility didn´t decrease with the treatment (p > 0.05). Transit and sperm maturation in the epididymis would not be affected by the ln, and because we did not observe increased sperm DNA fragmentation in the treated group (p > 0.05), sperm protamination would be fulfilling its protective role on murine genetic material avoiding genotoxic damage by ln. Conclusion: The intraperitoneal administration of 50mg/kg/pc of ln for seven days does not cause systemic toxicity or effect on spermatogenesis in mice.

Juvenile Allergic Urethritis with Urethro-vasal Reflex Masquerading Cauda Equina Syndrome

We report a case of severe Juvenile Allergic Urethritis secondary to double concentrate orange squash of a famous brand in a 3-year-old boy who presented with urethral and perineal pain resulting in an abnormal gait and urinary symptoms suggestive of Cauda Equina Syndrome. Ultrasound of the Urinary Tract was normal as was the Magnetic Resonance Imaging (MRI) of the Spine. Withdrawal of the allergen produced complete recovery. Symptoms recurred on food challenge. There are several learning points and take-home messages in this case such as (1) Allergic Urethritis can have a dramatic presentation, mimicking serious conditions such as Cauda Equina Syndrome. (2) Food challenge provided the definitive diagnosis: this is the first report of double concentrate orange squash induced urethritis. (3) Complete avoidance has resulted in an enduring cure. (4) Appropriate timely referral by general Practitioner and cohesive and well-coordinated multidisciplinary team management at the University Teaching Hospital is required to successfully manage such rare and challenging case

Unraveling congenital ptosis with the aid of the pediatric perimeter device

Background: Ocular morbidity with an early onset can have a significant impact on the long-term development of an individual. Hence, careful assessment of visual functions early on is very important. However, testing infants always poses a challenge. Standard tools to assess infants’ visual acuity, ocular motility, and so on rely on the clinician’s quick subjective judgments of an infant’s looking behavior. Eye movements are usually observed from head rotations or spontaneous eye movements in infants. Judging eye movements in the presence of strabismus is even more challenging. Purpose: This video shows a 4-month-old infant’s viewing behavior captured during a visual field screening study. The recorded video aided in the examination of this infant that was referred to a tertiary eye care clinic. The additional information captured through the perimeter testing is discussed. Synopsis: The Pediatric Perimeter device was developed to address visual field extent and gaze reaction time assessment in the pediatric population. As a part of a large-scale screening study, infants’ visual fields were tested. During this screening, a 4-month-old infant presented with a ptosis in the left eye. The infant was consistently missing the light stimuli presented in the left upper quadrant in the binocular visual field testing. The infant was referred to a tertiary eye care center to a pediatric ophthalmologist for further examination. During clinical examination, the infant was suspected to either have congenital ptosis or monocular elevation deficit. But the diagnosis of the eye condition was unsure owing to the poor cooperation of the infant. With the aid of Pediatric Perimeter, the ocular motility was consistent with limitation of elevation in abduction, indicating a possible monocular elevation deficit with congenital ptosis. The infant was also noted to have Marcus Gunn jaw-winking phenomenon. The parents were assured and asked for a review in 3 months. In the subsequent follow-up, the Pediatric Perimeter testing was performed, and the recording showed a full extraocular motility in both eyes. Hence, the diagnosis was changed to only congenital ptosis. The probable explanation for missing the target in the left upper quadrant in the first visit is postulated further. The left upper quadrant is the superotemporal visual field of the left eye and the superonasal visual field of the right eye. As the left eye had ptosis, the superotemporal visual field could have been obstructed and hence the stimuli missed. The normative extent for the nasal and superior visual field is just about 30° for a 4-month-old infant. Hence, the right eye also perhaps missed the stimuli in its superonasal visual field extent. This video highlights the utility of the Pediatric Perimeter device in providing a magnified view of the infant’s face along with greater visibility of ocular features from the infrared video imaging. This can potentially help the clinician to easily observe different ocular/facial abnormalities such as extraocular motility disorders, lid functions, and in identifying unequal pupil size, media opacities, and nystagmus. Highlights: The presence of congenital ptosis in younger infants might predispose as superior visual field defect and could also masquerade as a limitation in elevation.

Antifertility activity of Oroxylum indicum (L.) Kurz:In vitro and in vivo study on human sperm and male wistar rats

Oroxylum indicum (L.) Kurz, commonly called as Broken bones tree or Indian trumpet flower, belonging to Fam. Bignoniaceae, is traditionally used as a contraceptive by ethnic people of Tripura, North-East India. Here, we investigated the scientific basis for use of O. indicum as male antifertility agent by folklore healers. In vitro spermicidal activity of aqueous (AEOI) and methanolic (MEOI) extracts of O. indicum stem bark were studied on human sperm. The in vivo activity was experimented on male albino rats. The treated animals were allowed to mate and the pups delivered by female rat partners were counted. Phytochemical estimation of test samples was done using HPLC. The AEOI and MEOI treatments significantly decreased human sperm motility and viability. Test extracts have increased the hypo-osmotic swelling of sperm. Both the extracts were significantly declined the weight of reproductive organ. The MEOI treated rats have shown significant decrease in sperm motility and sperm counts. AEOI and MEOI treatment significantly reduced level of testosterone, but sharply raised dihydrotestosterone and prostaglandin in rats. Results testified the traditional claim for use of O. indicum as a male contraceptive agent, where MEOI have shown reversible action on male reproductive system leading to contraception without harming the libido.

ABCA1 transporter promotes the motility of human melanoma cells by modulating their plasma membrane organization

BACKGROUND: Melanoma is one of the most aggressive and deadliest skin tumor. Cholesterol content in melanoma cells is elevated, and a portion of it accumulates into lipid rafts. Therefore, the plasma membrane cholesterol and its lateral organization might be directly linked with tumor development. ATP Binding Cassette A1 (ABCA1) transporter modulates physico-chemical properties of the plasma membrane by modifying cholesterol distribution. Several studies linked the activity of the transporter with a different outcome of tumor progression depending on which type. However, no direct link between human melanoma progression and ABCA1 activity has been reported yet. METHODS: An immunohistochemical study on the ABCA1 level in 110 patients-derived melanoma tumors was performed to investigate the potential association of the transporter with melanoma stage of progression and prognosis. Furthermore, proliferation, migration and invasion assays, extracellular-matrix degradation assay, immunochemistry on proteins involved in migration processes and a combination of biophysical microscopy analysis of the plasma membrane organization of Hs294T human melanoma wild type, control (scrambled), ABCA1 Knockout ( ABCA1 KO) and ABCA1 chemically inactivated cells were used to study the impact of ABCA1 activity on human melanoma metastasis processes. RESULTS: The immunohistochemical analysis of clinical samples showed that high level of ABCA1 transporter in human melanoma is associated with a poor prognosis. Depletion or inhibition ofABCA1 impacts invasion capacities of aggressive melanoma cells. Loss of ABCA1 activity partially prevented cellular motility by affecting active focal adhesions formation via blocking clustering of phosphorylated focal adhesion kinases and active integrin ß3. Moreover, ABCA1 activity regulated the lateral organization of the plasma membrane in melanoma cells. Disrupting this organization, by increasing the content of cholesterol, also blocked active focal adhesion formation. CONCLUSION: Human melanoma cells reorganize their plasma membrane cholesterol content and organization via ABCA1 activity to promote motility processes and aggressiveness potential. Therefore, ABCA1 may contribute to tumor progression and poor prognosis, suggesting ABCA1 to be a potential metastatic marker in melanoma.

Management of symptoms recurrence after myotomy for achalasia. a practical approach / Manejo da recidiva de sintomas após miotomia para acalasia. uma abordagem prática

ABSTRACT BACKGROUND: Achalasia is an esophageal motility disorder, and myotomy is one of the most used treatment techniques. However, symptom persistence or recurrence occurs in 9 to 20% of cases. AIMS: This study aims to provide a practical approach for managing the recurrence or persistence of achalasia symptoms after myotomy. METHODS: A critical review was performed to gather evidence for a rational approach for managing the recurrence or persistence of achalasia symptoms after myotomy. RESULTS: To properly manage an achalasia patient with significant symptoms after myotomy, such as dysphagia, regurgitation, thoracic pain, and weight loss, it is necessary to classify symptoms, stratify severity, perform appropriate tests, and define a treatment strategy. A systematic differential diagnosis workup is essential to cover the main etiologies of symptoms recurrence or persistence after myotomy. Upper digestive endoscopy and dynamic digital radiography are the main tests that can be applied for investigation. The treatment options include endoscopic dilation, peroral endoscopic myotomy, redo surgery, and esophagectomy, and the decision should be based on the patient's individual characteristics. CONCLUSIONS: A good clinical evaluation and the use of proper tests jointly with a rational assessment, are essential for the management of symptoms recurrence or persistence after achalasia myotomy.

RESUMO RACIONAL: A acalasia é um distúrbio da motilidade esofágica e a miotomia é uma das técnicas de tratamento mais utilizadas. No entanto, a persistência ou recorrência dos sintomas ocorre em 9 a 20%. OBJETIVOS: Este estudo visa fornecer uma abordagem prática para o manejo da recorrência ou persistência dos sintomas de acalasia após miotomia. MÉTODOS: Foi realizada uma revisão crítica para reunir evidências para uma abordagem racional no manejo da recorrência ou persistência dos sintomas de acalasia após miotomia. RESULTADOS: Para o manejo adequado de um paciente com acalásia com sintomas significativos após miotomia, como disfagia, regurgitação, dor torácica e perda de peso, é necessário classificar os sintomas, estratificar a gravidade, realizar exames adequados e definir uma estratégia de tratamento. Uma investigação diagnóstica diferencial sistemática é essencial para cobrir as principais etiologias de recorrência ou persistência dos sintomas após a miotomia. A endoscopia digestiva alta e a radiografia digital dinâmica são os principais exames que podem ser aplicados para investigação. As opções de tratamento incluem dilatação endoscópica, POEM (miotomia endoscópica oral), remiotomia e esofagectomia, e a decisão deve ser baseada nas características individuais do paciente. CONCLUSÕES: Uma boa avaliação clínica e a utilização de exames adequados, juntamente com uma avaliação racional, são essenciais para o manejo da recorrência ou persistência dos sintomas após miotomia por acalasia.

BALB/c and C57BL/6 mouse strains influence gastric function outcomes with administration of cisplatin and dexamethasone

Abstract Our aim was to evaluate the effects of cisplatin and dexamethasone alone and combined on gastric contractility and histomorphometry of BALB/c and C57BL/6 mice. BALB/c and C57BL/6 male mice (8-week-old) were randomly separated into: Control; Cisplatin (7.5 mg/Kg); Dexamethasone (2.0 mg/Kg); and Dexamethasone plus Cisplatin (2.0 mg/Kg of dexamethasone 1-hour prior to 7.5 mg/Kg of cisplatin). Drugs were administered intraperitoneally for three days. Body weight and food intake were evaluated on 2nd day. Alternating Current Biosusceptometry technique was employed to measure gastric contractions on 3rd day. Afterward, mice were killed for gastric histomorphometric analysis. Cisplatin decreased food intake and caused bradygastria in BALB/c mice; however, the amplitude of gastric contractions decreased in both BALB/c and C57BL/6. Dexamethasone and cisplatin combined restored the gastric frequency and food intake only in BALB/c, but drug combination reduced the gastric amplitude of contractions in both strains. Dexamethasone alone increased gastric mucosa thickness in C57BL/6 and decreased muscular thickness in BALB/c. In conclusion, the mouse strains presented differences in acute effects of cisplatin and dexamethasone alone and combined on gastric function. This reinforces the importance of choosing the appropriate mouse strain for studying the acute effects of drugs on the gastrointestinal tract.

Characterization of bacterial swarming motility: a review / 生物工程学报

Swarming motility is a typical synergistic motion, in which bacteria use flagella and Type Ⅳ Pili together to move collectively on semi-solid surfaces. Swarming motility is a hot topic of research in the field of microbiology because of its close relationship with biofilm formation, fruiting bodies formation, pathogen invasion and microbial dispersal and symbiosis. A large number of studies have been conducted on bacterial swarming motility, including changes in the expression of key proteins, changes in chemical communications between bacteria as well as mechanical changes. The expression of flagellin and the level of intracellular c-di-GMP complicatedly regulates the collective behavior of bacteria in colonies, which consequently impacts the swarming motility. The unique physical properties of swarmer cells are conducive to the expansion of the whole colony. Factors such as nutrient and water content in the surrounding growth environment of bacteria also affect the ability of bacteria to swarm to different degrees. It is challenging to construct a universal model of swarming motility based on the molecular mechanisms of swarming in the future.

The influence of Mycoplasma species on human and canine semen quality: a review / 亚洲男科学杂志(英文版)

Mycoplasma species (spp.) are bacteria that are difficult to detect. Currently, the polymerase chain reaction (PCR) is considered the most effective diagnostic tool to detect these microorganisms in both human and veterinary medicine. There are 13 known species of human Mycoplasma and 15 species of canine Mycoplasma. Owing to the difficulties in identifying the individual species of Mycoplasma, there is a lack of information regarding which species are saprophytic and which are pathogenic. The prevalence of the individual species is also unknown. In addition, in both humans and dogs, the results of some studies on the impact of Mycoplasma are conflicting. The presence of Mycoplasma spp. on the epithelium of reproductive tract is often associated with infertility, although they are also detected in healthy individuals. The occurrence of Mycoplasma spp. is more common in dogs (even 89%) than in humans (1.3%-4%). This is probably because the pH of a dog's genital is more conducive to the growth of Mycoplasma spp. than that of humans. Phylogenetically, human and canine Mycoplasma are related, and majority of them belong to the same taxonomic group. Furthermore, 40% of canine Mycoplasma spp. are placed in common clusters with those of human. This suggests that species from the same cluster can play a similar role in the canine and human reproductive tracts. This review summarizes the current state of knowledge about the impact of Mycoplasma on canine and human male fertility as well as the prospects of further development in this field.

Evaluation of anti-quorum sensing potential of Averrhoa bilimbi (Kamias) against Pseudomonas aeruginosa ATCC 27853

BACKGROUND AND OBJECTIVE@#Many opportunistic and nosocomial pathogens like Pseudomonas aeruginosa are very reliant on a bacterium-to-bacterium communication system called quorum sensing (QS). Without the aforementioned process, gene expressions associated with virulence factors will not be produced. In this study, the sub-inhibitory concentrations (sub-MICs) of methanolic leaf extract and obtained fractions from Averrhoa bilimbi (kamias) were screened for ability to inhibit quorum sensing-controlled phenotypes of P. aeruginosa ATCC 27853.@*METHODOLOGY@#A. bilimbi crude extract was fractionated through liquid-liquid extraction, producing four (4) fractions: hexane fraction, dichloromethane (DCM) fraction, ethyl acetate (EtOAc) fraction, and water (H2O) fraction. Among the sub-MICs obtained from resazurin-based fluorimetric microtiter assay, only 50 μg/mL was utilized in evaluating the anti-QS properties of crude extract and fr@*RESULTS@# In the swarming motility assay, hexane fraction (9.39 mm ± 0.67) and DCM fraction (10.82 mm ± 0.95) displayed restriction in the treated P. aeruginosa ATCC 27853 swarms against the control (16.20 mm ± 2.55). In the anti-pyocyanin production assay, hexane fraction exhibited an inhibition of 42.66 % ± 12.94. TLC analysis and phytochemical screening revealed that hexane fraction contains steroids, terpenes, triterpenes, and glycolipids; and DCM fraction contains cardiac glycosides, triterpenoids, terpenes, triterpenes, steroids, alkaloids, and glycolipids.@*CONCLUSION@#Hexane and DCM fractions obtained from A. bilimbi significantly inhibited swarming of P. aeruginosa ATCC 27853 while none of the extracts were able to significantly inhibit pyocyanin formation of P. aeruginosa ATCC 27853.

Electroacupuncture Alleviates Functional Constipation in Mice by Activating Enteric Glial Cell Autophagy via PI3K/AKT/mTOR Signaling / 中国结合医学杂志

OBJECTIVE@#To investigate autophagy-related mechanisms of electroacupuncture (EA) action in improving gastrointestinal motility in mice with functional constipation (FC).@*METHODS@#According to a random number table, the Kunming mice were divided into the normal control, FC and EA groups in Experiment I. The autophagy inhibitor 3-methyladenine (3-MA) was used to observe whether it antagonized the effects of EA in Experiment II. An FC model was established by diphenoxylate gavage. Then the mice were treated with EA stimulation at Tianshu (ST 25) and Shangjuxu (ST 37) acupoints. The first black stool defecation time, the number, weight, and water content of 8-h feces, and intestinal transit rate were used to assess intestinal transit. Colonic tissues underwent histopathological assessment, and the expressions of autophagy markers microtubule-associated protein 1 light chain 3 (LC3) and Beclin-1 were detected by immunohistochemical staining. The expressions of phosphoinositide 3-kinases (PI3K)-protein kinase B (AKT)-mammalian target of rapamycin (mTOR) signaling pathway members were investigated by Western blot and quantitative reverse transcription-polymerase chain reaction, respectively. The relationship between enteric glial cells (EGCs) and autophagy was observed by confocal immunofluorescence microscopy, localization analysis, and electron microscopy.@*RESULTS@#EA treatment shortened the first black stool defecation time, increased the number, weight, and water content of 8-h feces, and improved the intestinal transit rate in FC mice (P<0.01). In terms of a putative autophagy mechanism, EA treatment promoted the expressions of LC3 and Beclin-1 proteins in the colonic tissue of FC mice (P<0.05), with glial fibrillary acidic protein (GFAP) and LC3 significantly colocalized. Furthermore, EA promoted colonic autophagy in FC mice by inhibiting PI3K/AKT/mTOR signaling (P<0.05 or P<0.01). The positive effect of EA on intestinal motility in FC mice was blocked by 3-MA.@*CONCLUSION@#EA treatment can inhibit PI3K/AKT/mTOR signaling in the colonic tissues of FC mice, thereby promoting EGCs autophagy to improve intestinal motility.

Alterações oculares em escolares e adolescentes após início da pandemia por COVID-19 / Acute eye symptoms in schoolchildren and adolescents after the onset of COVID-19 pandemic

RESUMO Objetivo Identificar as alterações oculares em crianças e adolescentes secundárias ao fator do isolamento social e ao consequente aumento do uso de telas. Métodos Estudo observacional, descritivo e analítico, do tipo transversal realizado no período de julho a agosto de 2021, por meio da aplicação de questionários. Resultados Apresentaram cefaleia associada ao uso excessivo de tela 26,51% dos estudantes e 38,8% relataram suspeita de insuficiência de convergência. Em relação ao questionário de olho seco, 18,8% foram sintomáticos e 7,5% sintomáticos de difícil manejo. O computador foi o dispositivo mais utilizado em atividades escolares (71,5%), e, em segundo lugar, esteve o celular (66,3%). Casos sintomáticos de olho seco foram mais relatados em participantes que não faziam uso de computador (36,4%). Não foi possível identificar relação entre insuficiência de convergência e tempo de uso de dispositivos. Em relação ao olho seco, aqueles que passaram mais tempo em frente a tela relataram maior porcentagem de sintomas de difícil manejo (42,9%). Conclusão Foram mais prevalentes olho seco e sintomas de insuficiência de convergência na população estudada.

ABSTRACT Objective To identify eye conditions associated to social distancing and related increase in screen time exposure on children and teenagers. Methods Observational, descriptive and analytical study, with a cross-section design, carried out between July and August 2021, by questionnaire survey. Results Headaches related to excessive screen time exposure were reported by 26.51% of the students surveyed, while 38.8% reported suspect convergence insufficiency. Regarding the questionnaire about dry eye, 18.8% were symptomatic and 7.5% reported hard-to-manage symptoms. Computers were the devices most used for schoolwork (71.5%), followed by cellphones on second place (66.3%). Symptomatic cases of dry eye were mostly reported by participants that did not make use of computers (36.4%). It was not possible to establish a connection between convergence insufficiency and device usage time. Those participants that reported more screen time exposure also reported an increased percentage of hard-to-manage symptoms (42.9%), regarding dry eye. Conclusion Dry eye and convergence insufficiency symptoms were more prevalent in the surveyed population.

Cross-sectional evaluation of the saccharin transit time test for primary ciliary dyskinesia: did we discard this tool too soon?

ABSTRACT BACKGROUND: Primary ciliary dyskinesia (PCD) is a rare and heterogeneous disease that is difficult to diagnose and requires complex and expensive diagnostic tools. The saccharin transit time test is a simple and inexpensive tool that may assist in screening patients with PCD. OBJECTIVES: This study aimed to compare changes in the electron microscopy findings with clinical variables and saccharin tests in individuals diagnosed with clinical PCD (cPCD) and a control group. DESIGN AND SETTING: An observational cross-sectional study was conducted in an otorhinolaryngology outpatient clinic from August 2012 to April 2021. METHOD: Patients with cPCD underwent clinical screening questionnaires, nasal endoscopy, the saccharin transit time test, and nasal biopsy for transmission electron microscopy. RESULTS: Thirty-four patients with cPCD were evaluated. The most prevalent clinical comorbidities in the cPCD group were recurrent pneumonia, bronchiectasis, and chronic rhinosinusitis. Electron microscopy confirmed the clinical diagnosis of PCD in 16 of the 34 (47.1%) patients. CONCLUSION: The saccharin test could assist in screening patients with PCD due to its association with clinical alterations related to PCD.