D-dimers in omicron versus delta: A retrospective analysis.

Background: Infection with SARS-CoV-2 has shown to cause an increase in D-dimers, which correlate with severity and prognosis for in-hospital mortality. The B.1.617.2 (delta) variant is known to cause a raised D-dimer level, with data on D-dimers in the B.1.1.529 (omicron) variant being scarce. Objectives: To determine the effect of age, gender and SARS-CoV-2 variant on the D-dimer in South Africans admitted to tertiary medical centres from May 2021 to December 2021. Method: The study was performed retrospectively on 16 010 adult patients with a SARS-CoV-2 infection. Age, gender, SARS-CoV-2 PCR and D-dimer levels on admission were collected from two national laboratories. Admissions from 01 May 2021 to 31 October 2021 were classified as B.1.617.2, whereas admissions from 01 November 2021 to 23 December 2021 were classified as B.1.1.529 infections. Results: Omicron infections had a median D-dimer level of 0.54 µg/mL (95% CI: 0.32, 1.08, p < 0.001). Multivariable regression analysis showed that infection with omicron had a 34.30% (95% CI: 28.97, 39.23) reduction in D-dimer values, compared with delta infections. Middle aged, aged and aged over 80 years had D-dimer results greater than the adult baseline (42.6%, 95% CI: 38.0, 47.3, 124.6%, 95% CI: 116.0, 133.7 and 216.1%, 95% CI: 199.5, 233.3). Males on average had a 7.1% (95% CI: 4.6, 9.6) lower D-dimer level than females. Conclusion: Infection with the B.1.1.529 variant, compared with B.1.617.2 variant, had significantly lower D-dimer levels, with age being a more significant predictor of D-dimer levels, than gender and SARS-CoV-2 variant of infection. Contribution: This study provides novel insight into the hypercoagulable impact of various SARS-CoV-2 variants, which can guide the management of patients.

Continuous Periosteal Strapping Sutures for Stabilization of Osseous Grafts With Resorbable Membranes for Buccal Ridge Augmentation: A Technique Report.

Alveolar bone loss occurs after extraction with loss of a premolar or anterior tooth; the residual supporting alveolar bone loss averages 1.53 mm of crestal bone height and 3.87 mm of buccolingual width, with most of the bone loss occurring at the facial plate. Socket preservation does not completely preserve the original ridge contours but can be an effective means of reducing bone loss following extraction. Attempts to rebuild the alveolar ridge structure after tooth loss often employ the concept of guided bone regeneration, a technique-sensitive procedure that routinely involves placement of particulate bone with or without fixation screws and either a resorbable or a nonresorbable membrane. We present a novel technique for stabilizing a resorbable membrane and underlying particulate graft allowing for predictable bone grafting across multiple edentulous sites.

Roles of eosinophils in the modulation of angiogenesis.

Chronic allergic inflammatory diseases are characterized by tissue damage with consequent remodeling including fibrosis and angiogenesis. Eosinophils are usually recruited to sites of allergic inflammation infiltrating the tissues as fully differentiated cells. In the last two decades, these cells have been characterized as a proangiogenic. The inadequate blood supply together with a high consumption of oxygen by the infiltrated cells is the main cause of tissue hypoxia in inflammation. Infiltrated eosinophils respond to hypoxia by increasing their viability and proangiogenic potential and regulate the expression of receptors particularly CD300a.

O,O'-Diester methylenediphosphonotetrathioate: synthesis, characterization, and potential applications.

A new transformation of methylene-bis(phosphonic dichloride) into tetrathiobisphosphonate derivatives is reported. The reaction of methylene-bis(phosphonic dichloride) with 1,2-ethanedithiol in bromoform in the presence of AlCl(3) formed methylene-bis(1,3,2-dithiaphospholane-2-sulfide), which gave rise to O,O'-diester-methylenediphosphonotetrathioate analogues 1a-k upon reaction with phenols and alkyl alcohols in the presence of DBU. Reaction mechanisms are proposed, and all products were characterized by (31)P, (13)C, and (1)H NMR. An X-ray crystal structure was obtained for intermediate 2. The potential of the novel scaffold for selective coordination of metal-ions was examined by coordination of Hg(II) and Pb(II) by 1f, as determined by FT-IR, and chelation of Zn(II), but not Ca(II), by 1b, as determined by (31)P/(1)H NMR. UV-vis measurements of 1g-Ni(II) mixture revealed a 2:1 ligand:metal complex. These derivatives are potential antioxidants, and their ability to inhibit ·OH formation in Fenton reactions was quantified by ESR measurements. Analogue 1g proved to be a most potent antioxidant (IC(50) 53 µM), inhibiting the Cu(I)-catalyzed Fenton reaction at lower concentrations than GSH, ascorbic acid, and EDTA. Analogue 1c inhibited the Fe(II)-catalyzed Fenton reaction at about the same concentrations as ascorbic acid (IC(50) 83 vs 93 µM). In summary, the novel compounds, 1a-k, proved to chelate various borderline/soft Lewis acid metal-ions, and may be useful as antioxidants and metal extractors.

Nucleoside-5'-phosphorothioate analogues are biocompatible antioxidants dissolving efficiently amyloid beta-metal ion aggregates.

Amyloid beta (Aß) peptide is known to precipitate and form aggregates with zinc and copper ions in vitro and, in vivo in Alzheimer's disease (AD) patients. Metal-ion-chelation was suggested as therapy for the metal-ion-induced Aß aggregation, metal-ion overload, and oxidative stress. In a quest for biocompatible metal-ion chelators potentially useful for AD therapy, we tested a series of nucleoside 5'-phosphorothioate derivatives as re-solubilization agents of Cu(+)/Cu(2+)/Zn(2+)-induced Aß-aggregates, and inhibitors of Fenton reaction in Cu(+) or Fe(2+)/H(2)O(2) system. The most promising chelator in this series was found to be APCPP-γ-S. This nucleotide was found to be more efficient than EDTA in re-solubilization of Aß(40)-Cu(2+) aggregates as observed by the lower diameter, d(H), (86 vs. 64 nm, respectively) obtained in dynamic light scattering measurements. Likewise, APCPP-γ-S dissolved Aß(40)-Cu(+) and Aß(42)-Cu(2+)/Zn(2+) aggregates, as monitored by (1)H-NMR and turbidity assays, respectively. Furthermore, addition of APCPP-γ-S to nine-day old Aß(40)-Cu(2+)/Zn(2+) aggregates, resulted in size reduction as observed by transition electron microscopy (diameter reduction from 2.5 to 0.1 µm for Aß(40)-Cu(2+) aggregates). APCPP-γ-S proved to be more efficient than ascorbic acid and GSH in reducing OH radical production in Fe(2+)/H(2)O(2) system (IC(50) values 85, 216 and, 92 µM, respectively). Therefore, we propose APCPP-γ-S as a potential AD therapy capable of both reducing OH radical production and re-solubilization of Aß(40/42)-M(n+) aggregates.

Hypoxia modulates human eosinophil function.

BACKGROUND: Eosinophils are involved in various inflammatory processes including allergic inflammation during which angiogenesis has been documented. Angiogenesis is most likely connected to the hypoxia which characterizes inflamed tissues. Eosinophils produce VEGF and are pro-angiogenic. However, to the best of our knowledge no study has been performed to verify the existence of a direct link between eosinophils, hypoxia and angiogenesis in allergic inflammation. OBJECTIVE: To characterize eosinophil function and angiogenic potential under hypoxic conditions. METHODS: Human peripheral blood eosinophils were cultured in normoxic or hypoxic conditions with or without cytokines. Viability and apoptosis were assessed by Annexin V/PI staining. Anti- or pro-apoptotic protein levels, HIF-1alpha levels and MAPK phosphorylation were analyzed by immunoblot analysis. Angiogenic mediator release was evaluated by ELISA. RESULTS: Hypoxic eosinophils were more viable than normoxic ones after up to three days. In addition in hypoxia, anti-apoptotic Bcl-XL protein levels increased more than pro-apoptotic Bax levels. Hypoxia increased VEGF and IL-8 release. In hypoxic eosinophils high levels of HIF-1alpha were observed, particularly in the presence of GM-CSF. MAPK, particularly ERK1/2 inhibitors, decreased hypoxia-mediated VEGF release and HIF-1alpha expression. CONCLUSION: Eosinophils respond to hypoxia by up-regulation of survival and of some of their pro-angiogenic functions indicating a correlation between eosinophilic inflammation and angiogenesis.

Benign fibroepithelial polyps of the ureter and renal pelvis in childhood. Two case reports.

Benign fibroepithelial polyps of the ureter and renal pelvis are extremely rare in children. Two cases are presented and the clinical and surgical aspects of diagnosis and treatment are discussed.

Efficacy of intravesical mitomycin C in the treatment of superficial transitional cell carcinoma of the urinary bladder.

We treated 47 patients with recurrent transitional cell carcinoma of the bladder with intravesical chemotherapy. Twenty milligrams of mitomycin C per treatment was introduced 7 days after transurethral resection (TUR) or diagnostic cystoscopy, and was repeated at 2-week intervals for five times followed again by cystoscopy. Two more similar courses were administered for a total of 36 weeks. Clinical data revealed no toxicity-related symptoms. Cystoscopic follow-up showed a gradual decline in the presence of tumor to a complete response rate of 87.1% at 36 weeks. Thirteen patients who were previously treatment failures with other drugs responded to mitomycin C.

Pneumaturia: need for diagnostic alertness.

Pneumaturia, an air-filled urinary bladder with or without passage of gas in the urine, is a rare phenomenon in the general population, but is more frequent in defined high-risk subgroups. Relevant symptomatology may be hardly noticeable for a relatively long period; however, the outcome may be serious and sometimes fatal. We present three such cases and discuss diagnostic and therapeutic aspects.

Accessory urethral channel.

A case of accessory urethral channel with wide divergence of the pubes, suggesting a relationship to the exstrophy-epispadias complex, is described. The various embryogenic factors and possible modes of treatment are discussed.

Angiodysplasia as a cause of colonic bleeding in the elderly.

Angiodysplasia is being recognized as a major causal factor of colonic haemorrhage in the elderly. Superior mesenteric arteriography in an 86-year-old lady with recurrent haemorrhage revealed the lesion. Confirmation of the diagnosis was made possible by the injection of contrast material into the blood vessels of the removed intestine and subsequent histological examination.