Effectiveness of Limberg and Karydakis flap in recurrent pilonidal sinus disease

OBJECTIVE: Sacrococcygeal pilonidal sinus is common in young men and may recur over time after surgery. We investigated whether a factor exists that can aid in the determination of the preferred technique between the early Limberg flap and Karydakis flap techniques for treating recurrent pilonidal sinus. MATERIALS AND METHODS: This prospective and randomized study enrolled 71 patients with recurrent pilonidal sinus in whom the Limberg flap or Karydakis flap techniques were applied for reconstruction after excision. Patients were divided into two groups as follows: 37 patients were treated with the Limberg flap technique and 34 patients were treated with the Karydakis flap technique. Fluid collection, wound infection, flap edema, hematoma, partial wound separation, return to daily activities, pain score, complete healing time, painless seating and patient satisfaction were compared between the groups. ClinicalTrial.gov: NCT02287935. RESULTS: The development rates of total fluid collection, wound infection, flap edema, hematoma, and partial wound separation were 9.8%, 16%, 7%, 15% and 4.2%, respectively; total flap necrosis was not observed in any patient (p<0.001). During the average follow-up of 28 months, no patients (0%) developed recurrent disease. The two groups differed with respect to early surgical complications (p<0.001). CONCLUSION: In this study, use of the Limberg flap was associated with lower complication rates, shorter length of hospital stay, early return to work, low pain score, high patient satisfaction and better complete healing duration. Therefore, we recommend the Limberg flap for treatment of recurrent pilonidal sinus. .

The reduction of serum aminotransferase levels is proportional to the decline of the glomerular filtration rate in patients with chronic kidney disease

OBJECTIVE: This study sought to determine the serum aminotransferase levels of patients with predialysis chronic kidney disease and establish their relationships with serum creatinine levels and glomerular filtration rate. METHODS: Patients with chronic kidney disease were evaluated between September 2011 and May 2012. Aminotransferase and creatinine serum levels were measured using an automated kinetic method, and glomerular filtration rates were estimated using the Cockroft-Gault and Modification of Diet in Renal Disease formulas to classify patients into chronic kidney disease stages. RESULTS: Exactly 142 patients were evaluated (mean age: 64±16 years). The mean creatinine serum level and glomerular filtration rate were 3.3±1.2 mg/dL and 29.1±13 mL/min/1.73 m2, respectively. Patients were distributed according to their chronic kidney disease stages as follows: 3 (2.1%) patients were Stage 2; 54 (38%) were Stage 3; 70 (49.3%) were Stage 4; and 15 (10.5%) were Stage 5. The mean aspartate aminotransferase and alanine aminotransferase serum levels showed a reduction in proportion to the increase in creatinine levels (p=0.001 and p=0.05, respectively) and the decrease in glomerular filtration rate (p=0.007 and p=0.028, respectively). Alanine aminotransferase and aspartate aminotransferase serum levels tended to be higher among patients classified as stage 2 or 3 compared with those classified as stage 4 or 5 (p=0.08 and p=0.06, respectively). CONCLUSIONS: The aspartate aminotransferase and alanine aminotransferase serum levels of patients with predialysis chronic kidney disease decreased in proportion to the progression of the disease; they were negatively correlated with creatinine levels and directly correlated with glomerular filtration rate. .

Tóxicos ambientales y su efecto sobre el neurodesarrollo / [Environmental toxic and its effect on neurodevelopment].

Neurodevelopmental disorders are the result of a disturbance of brain function. They are frequent, with varied symptomatology, manifest themselves at different times of life and tend to be persistent with impact at the individual, family and social level. The association of these disorders with genetic entities is low. Although the research supports a mode of genetic inheritance, epigenetic factors and environmental factors can play an important role. In recent years there was a striking increase of these disorders especially attention deficit hyperactivity disorders and pervasive development disorder. Environmental factors such as the intoxication of the fetus by especially heavy metals lead and mercury are to blame in some children, of these disorders. Other substances of wide use, little degradation and maintenance in the food chain as pesticides, polychlorinated biphenyls and now the recycling of electronic waste put especially infants and children at risk, and even more so in the developing countries.

Possible aggravating impact of gene polymorphism in women with endometriosis.

Background & objectives: Endometriosis is one of the most commonly encountered benign problems in gynaecology. It is frequently associated with chronic pelvic pain, dysmenorrhoea, menorrhagia and dyspareunia, which lead to infertility. To determine the possible association between polychlorinated biphenyls (PCBs) and GSTM1 null (*0/*0) mutation and their possible impact in the pathogenesis of endometriosis. Methods: Ninety seven women with endometriosis mean age (28.5 ± 6.5 yr) diagnosed by laparoscopy and 102 women without endometriosis (28.4 ± 4.8 yr) were included. Heparinised blood samples were collected from all for DNA isolation and estimation of PCBs. GSTM1 genotyping was done by PCR and PCBs were estimated by gas chromatography. Results: Women with endometriosis showed significantly higher concentrations of PCBs compared with control group. Twenty six (26.8%) women with endometriosis and 15 (14.7%) of the controls had the GSTM1 null (*0/*0) genotype [odds ratio (OR = 2.12, 95% confidence interval (CI) = 1.045-4.314], which showed significant association (P=0.03) with endometriosis. The association between the concentrations of PCBs, GSTM1 null genotype and different severity of endometriosis was significant (P<0.05) for all four compounds and GSTM1 (PCB1: r = +0.5388, P<0.0001; PCB5: r = +0.6753, P<0.0001; PCB29: r = +0.6471, P<0.0001; and PCB98: r = +0.4357, P<0.0001; GSTM1: r = +0.9439, P=0.05). Interpretation & conclusions: The study results suggested that women having higher concentration of PCBs and GSTM1 null (*0/*0) polymorphism might have an increased susceptibility of endometriosis. The findings need to be confirmed in a larger sample.

In vivo alternative testing with zebrafish in ecotoxicology

Although rodents have previously been used in ecotoxicological studies, they are expensive, time-consuming, and are limited by strict legal restrictions. The present study used a zebrafish (Danio rerio) model and generated data that was useful for extrapolating toxicant effects in this system to that of humans. Here we treated embryos of the naive-type as well as a transiently transfected zebrafish liver cell line carrying a plasmid (phAhREEGFP), for comparing toxicity levels with the well-known aryl hydrocarbon receptor (AhR)-binding toxicants: 3,3',4,4',5-pentachlorobiphenyl (PCB126), 2,3,7,8-tetrachlorodibenzo-p-dioxin, and 3-methylcholanthrene. These toxicants induced a concentration-dependent increase in morphological disruption, indicating toxicity at early life-stages. The transient transgenic zebrafish liver cell line was sensitive enough to these toxicants to express the CYP1A1 regulated enhanced green fluorescent protein. The findings of this study demonstrated that the zebrafish in vivo model might allow for extremely rapid and reproducible toxicological profiling of early life-stage embryo development. We have also shown that the transient transgenic zebrafish liver cell line can be used for research on AhR mechanism studies.

Toxicity of PCB 1232 on mitochondria of fish Arius caelatus (Valenciennes).

Mitochondrial proteins and phospholipids were estimated and SDH, Na(+)-K(+)-ATPase and Mg(2+)-ATPase activities were analysed in the gill, liver and heart tissues of PCB 1232 (sublethal doses) treated fish A. caelatus. Protein and phospholipids were found to be decreased significantly and SDH, Na(+)-K(+)-ATPase, Mg(2+)-ATPase and other enzyme systems displayed an inverse relationship with PCB dosage. Statistical analysis was carried out to indicate the relationship between sublethal doses of varying concentration and the activities of the enzyme systems involved in energy metabolism. The studies indicated impairment in mitochondrial functions.

Effect of polychlorinated biphenyl (Aroclor 1260) on histology of kidney and thyroid of rats.

Gross histological alteration in kidney and thyroid structures were observed in male Wistar rats fed polychlorinated biphenyls (PCBs; Aroclor 1260) at 50 and 100 ppm level in normal commercial diet for 120 days. While the kidney showed glomerulonephritis, degenerative changes in the proximal and distal tubules and increased cellularity of glomeruli, thyroid showed degeneration of follicles, fibrosis of follicles and lymphocytic infiltration followed by thyroiditis.

Effect of feeding polychlorinated biphenyl (Aroclor 1260) on hepatic enzymes of rats.

Significant increase in the activity of liver succinate dehydrogenase (SDH) was observed in male Wistar rats, fed Aroclor 1260 (PCB; polychlorinated biphenyl) at 50 and 100 ppm level for 120 days. Lactate dehydrogenase (LDH) activity increased in 50 ppm PCB fed animals and decreased in 100 ppm PCB fed rats. On the other hand, enzymes like alanine and aspartate aminotransferase, alkaline and acid phosphatase showed remarkable decrease in activity in PCB fed animals. Slab gel electrophoresis of LDH isozymes showed remarkable increase in LDH2 and LDH3 and to some extent increase in LDH1 isozymes of livers of 50 ppm PCB fed animals but not in 100 ppm PCB fed groups as compared to controls. In both the PCB fed groups, liver showed centrilobular hypertrophy, hepatocellular damage, hyperplasia, karyolysis and karyorrhexis.

Policloretos de bifenila: um grave problema ocupacional e ambiental / Polychlorinated biphenyls: an important occupational and environmental problem

É feita uma revisäo bibliográfica atualizada dos problemas tanto de natureza ambiental como de natureza ocupacional causados pelos policloretos de bifenila, destacando-se os estudos experimentais em animais e os estudos epidemiológicos que permitem um amplo conhecimento dos efeitos potencialmente nocivos desses agentes químicos

Algunas consideraciones sobre el riesgo de la contaminación de los peces, crustáceos y moluscos con bifenilos policlorados: revisión bibliográfica / Some considerations on contamination risk of fishes, crustacea and mollusca with polychlorinated biphenyls: bibliographic review

Se presenta una breve revisión bibliográfica, donde se aborda la problemática de los bifenilos policlorados en relación con su toxicidad, carcinogenicidad y contaminación de los animales de agua dulce y salada, los que resultan de importancia como indicadores de la contaminación de las aguas y del riesgo de su ingestión a través de sus fuentes principales, los productos pesqueros