The potential liver injury induced by metronidazole-provoked disturbance of gut microbiota: modulatory effect of turmeric supplementation.

It has been reported that the gut-liver axis and intestinal microbiome contribute crucially to different liver diseases. So, targeting this hepato-intestinal connection may provide a novel treatment modality for hepatic disorders such as drug-induced liver injury (DILI). The present study thought to investigate the protective effect of turmeric (TUR) on metronidazole (MNZ)-induced liver damage and the possible association of the gut-liver axis and gut microbiota as a suggested underlying mechanism. In the first experiment, a MNZ-induced liver injury rat model was reproduced after 130 mg/kg oral MNZ administration for 30 days. Meanwhile, the treatment group was orally treated with 100 mg/kg turmeric daily. In the second experiment, fecal microbiome transplantation (FMT) was conducted, in which the fecal microbiome of each group in the first experiment was transplanted to a healthy corresponding group in the second experiment. The liver enzymes (aminotransferase (ALT) and aspartate aminotransferase (AST)) and histopathological examination were estimated to assess liver function. Inflammatory cytokines and oxidative markers were evaluated in the liver tissues. Histological analysis, intestinal barrier markers, and expression of tight junction proteins were measured for assessment of the intestinal injury. Changes in the gut microbial community and possible hepatic bacterial transmission were analyzed using 16S rRNA sequencing. MNZ induced intestinal and liver injuries which were significantly improved by turmeric. Increased firmicutes/bacteroidetes ratio and bacterial transmission due to gut barrier disruption were suggested. Moreover, TUR has maintained the gut microbial community by rebalancing and restoring bacterial proportions and abundance, thereby repairing the gut mucosal barrier and suppressing bacterial translocation. TUR protected against MNZ-induced gut barrier disruption. Reshaping of the intestinal bacterial composition and prohibition of the hepatic microbial translocation were suggested turmeric effects, potentially mitigating MNZ-related liver toxicity.

Photobiomodulation therapy upregulates the growth kinetics and multilineage differentiation potential of human dental pulp stem cells-an in vitro Study.

This study aims to evaluate the impact of red LED irradiation on the viability, proliferation, colonogenic potential, markers expression along with osteogenic and chondrogenic differentiation of dental pulp stem cells. DPSCs were isolated from sound human permanent teeth using enzymatic digestion method and seeded with regular culture media. Cells at P4 were irradiated using red LED Light (627 nm, 2 J/cm2) and examined for growth kinetics, and multilineage differentiation using the appropriate differentiation media. The irradiated groups showed an increase in cellular growth rates, cell viability, clonogenic potential, and decrease in population doubling time compared to the control group. Cells of the irradiated groups showed enhanced differentiation towards osteogenic and chondrogenic lineages as revealed by histochemical staining using alizarin red and alcian blue stains. Photobiomodulation is an emerging promising element of tissue engineering triad besides stem cells, scaffolds, and growth factors.

A first evaluation of the usefulness of Kudzu starch in cultural heritage restoration.

In recent times, the use of natural and harmless products for the environment and restorer is taking place in the field of Cultural Heritage restoration. In this sense, wheat, rice and corn starches as adhesives, have suitable characteristics without toxicity risks. A new starch in this field, is the Kudzu, an almost pure compound (99.5% starch) that is processed by a natural way from a plant called Pueraria lobata. This is a preliminary study of the potential use of Kudzu starch for the restoration of Cultural Heritage, focusing, firstly, in its capacity as adhesive through a comparative evaluation with common starches. The accelerated aging process carried out proved that Kudzu ensures optimal chromatic behaviour. On the other hand, the main problem in starch paste is the biological colonization. The daidzein, a natural antimicrobial compound implicit in Kudzu starch, confirmed the resistance to microorganism in this preliminary approach. The evaluation of the adhesive capacity, and the reversibility of the starches, suggest that Kudzu starch is a valid adhesive in the field of paper restoration. Thus, the potential of this starch in the conservation of Cultural Heritage is evidenced and its use as cleaner, resistance to biological colonization and consolidant is promising.

Parents` knowledge and attitudes toward children with epilepsy.

OBJECTIVE: To study parents` knowledge and attitude towards children with epilepsy, and to identify contributing factors to negative attitudes. METHODS: A prospective cross-sectional study including consecutive parents attending the pediatric neurology clinics of King Abdulaziz University Hospital, Jeddah, Saudi Arabia from February to August 2012. A structured 40-item questionnaire was designed to examine their demographics, knowledge, and attitudes. RESULTS: A total of 117 parents were interviewed, 57% were mothers. The ages of their epileptic children ranged from 1-16 years (median 6.6), mostly boys (65%). Although most parents (70%) felt informed and recognized various treatment modalities, many believed that epilepsy is a mental disorder (48%), correlates with evil (44%), or affects the child`s intelligence (38%). Up to 53% admitted to treating their child differently and avoiding upsetting or punishing him/her. This behavior was less likely if they achieved college education (p=0.01). Some parents (29%) admitted to using non-medical treatments, usually traditional or religious practices. Those parents were more likely to believe that epilepsy is a mental disease (p=0.002), or correlates with evil (p=0.015). CONCLUSION: The level of knowledge among parents of epileptic children needs improvement. Many have significant misconceptions, negative attitudes, and poor parenting practices. Increased awareness and educational programs are needed to improve the quality of life of these families.

Stimulation of postprandial in vivo glycogenesis and lipogenesis of rats fed high fructose diet with varied phosphate content.

It has been reported that increased fructose intake is associated with the development of the metabolic syndrome. The phosphate (P) sequestering capacity of fructose is likely to affect the phosphorylation capacity of different metabolites, and this, in turn, may be the basis for several metabolic derangements, especially in the P requiring reactions, for example, glycogenesis and lipogenesis. We hypothesized that P enrichment of the diet can balance P status and, consequently, affect glycogenesis and lipogenesis. An animal experiment was executed in which adult male Sprague-Dawley rats were maintained for 4 days on high-fructose diets with different P content (0.15%, 0.165%, 0.30%, and 1.65%). At the end of the feeding period, overnight fasted rats were tube fed a test meal, injected with (3)H(2)O and euthanized 1 hour later. Final plasma glucose, insulin, uric acid, and triacylglycerol concentrations, as well as in vivo rates of glycogen and lipid synthesis and hepatic glycogen content, were measured. Results showed that increased P content of the diet was associated with an increase in postprandial epididymal fat pad (P = .007) and hepatic lipogenesis (P = .029), as well as glycogenesis (P = .024). In conclusion, P content of the diet was found to stimulate both glycogenesis and lipogenesis. These alterations in carbohydrate and fat metabolism point to the potential of P in influencing nutritional status.

Cervical spine involvement in rheumatoid arthritis: correlation between neurological manifestations and magnetic resonance imaging findings.

OBJECTIVE: To evaluate the correlation between neurological deficits indicative of compressive myelopathy and MRI findings in a series of patients with RA and symptomatic involvement of the cervical spine. METHODS: Forty-one consecutive patients with RA were studied using cervical spine MRI. Unconditional logistic regression analysis was used to identify MRI parameters of cervical spine involvement associated with the development of neurological dysfunction. RESULTS: The mean age of the 41 patients (33 women and 8 men) was 59 yrs (range 23-82 yrs), while the median disease duration was 18 +/- 9 yrs (range 4-40 yrs). According to Ranawat's classification, 17 (42%) patients were in Class I, 21 (51%) in Class II and 3 (7%) in Class III. Thus, patients with clinical manifestations of compressive myelopathy (Ranawat's Class II + III) represented 58% (24/41) of all cases. Among the different MRI parameters of cervical spine involvement analysed, only the presence of atlantoaxial spinal canal stenosis [odds ratio (OR) 4.55; 95% CI 1.14-18.15], atlantoaxial cervical cord compression (OR 9.6; 95% CI 1.08-85.16) and subaxial myelopathy changes (OR 11.43; 95% CI 1.3-100.81) were associated with a significantly increased risk for neurological dysfunction (Ranawat's Class II or III). CONCLUSION: In RA patients with symptomatic cervical spine involvement, there is a strong correlation between the development of neurological dysfunction and MRI identification of atlantoaxial spinal canal stenosis, especially in those cases with evidence of upper cervical cord or brainstem compression and subaxial myelopathy changes.

Subperiosteal leiomyosarcoma of the tibia.

Primary leiomyosarcoma of bone is a rare malignant tumor of smooth muscle. We report a case of low-grade subperiosteal primary bone leiomyosarcoma in the tibial diaphysis, which radiologically appeared to be osteoid osteoma. A 35-year-old man presented with a several-year history of a palpable hard nodule in the distal left leg, which had enlarged and become painful over the previous 2 years. Radiographs showed solid periosteal reaction with a well-defined lytic lesion in the posteromedial cortical border of the left tibial diaphysis. Computed tomography demonstrated a small, well-defined lytic lesion, not calcified, in a subperiosteal location, surrounded by solid periosteal bone formation. The lesion was excised en bloc and the histological diagnosis of a low-grade leiomyosarcoma was made. To the best of our knowledge, the surface location of primary bone leiomyosarcoma has not been previously described in the literature.

Spontaneous osteonecrosis of the knee associated with tibial plateau and femoral condyle insufficiency stress fracture.

The purpose of this article is to describe the association between spontaneous osteonecrosis and insufficiency stress fractures of the knee. To determine whether insufficiency stress fracture is associated with spontaneous osteonecrosis of the knee, we retrospectively reviewed the medical charts and imaging studies of all patients with spontaneous osteonecrosis of the knee, studied by MR imaging, seen in a tertiary hospital over an 8-year period. Four women (age range 66-84 years) presented spontaneous osteonecrosis of the knee associated with insufficiency stress fracture of the medial tibial plateau. One of these patients also presented a concomitant insufficiency stress fracture of the medial femoral condyle. Radiographs were diagnostic of spontaneous osteonecrosis of the medial femoral condyle in three cases, and insufficiency stress fracture of the medial tibial plateau was detected in one case. Magnetic resonance imaging allows the diagnosis of both conditions in all four cases. Spontaneous osteonecrosis of the knee may be associated with insufficiency stress fracture of the medial femoral condyle and the medial tibial plateau. This association provides additional arguments in favor of the traumatic etiology of spontaneous osteonecrosis of knee.

Tratamiento laparoscópico de la hernia de spiegel / Laparoscopic treatment of Spigelian hernias

Las hernias de Spiegel continúan atrayendo el interés de los cirujanos a pesar de ser poco frecuentes. Sin embargo, al menos en nuestro medio, no se ha prestado suficiente atención a las posibilidades de su abordaje laparoscópico. Presentamos los casos de tres pacientes con hernia de Spiegel tratados con éxito mediante la colocación on lay de una placa de PTFE por laparoscopia. Uno de ellos se intervino de urgencia (AU)

MR imaging of synovial tumors and tumor-like lesions.

The clinical diagnosis of synovial tumors and tumorlike lesions is difficult, and radiographic findings may establish a confident diagnosis only in some cases. MR imaging has become the modality of choice in evaluating these lesions, because with it a presumptive diagnosis can be made in most cases. Our goal is to review the MR features of pigmented villonodular synovitis, giant-cell tumor of the tendon sheath, synovial chondromatosis, synovial hemangioma, lipoma arborescens, synovial cysts and synovial sarcoma, emphasizing those findings that suggest a specific diagnosis.

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Morbidly obese patients with pulmonary disease--a retrospective study of four cases: a brief report.

Morbid obesity is a common chronic condition that predisposes affected individuals to a decrease in functional status. The purpose of this case series is to highlight the benefit of institutional rehabilitation for this subgroup of patients. A 6-mo retrospective review of 117 consecutive admissions to the rehabilitation unit of a municipal hospital center was conducted. A total of four patients (3.4%) met the criteria for morbid obesity. We present the brief case histories of these four subjects. All showed significant functional improvement and were able to return home after a mean length of stay of 61 days. They each required specialized rehabilitation intervention and specialized equipment such as extra large beds and oversize walkers. All four subjects had obstructive pulmonary disease, accounting for their initial hospital admission. This study demonstrates that inpatient rehabilitation improves functional status in morbidly obese patients. Further research regarding physiatric intervention in the morbidly obese patient is needed.

Enterovirus persistence and myocardial damage detected by 111In-monoclonal antimyosin antibodies in patients with dilated cardiomyopathy.

BACKGROUND: Patients with dilated cardiomyopathy in whom enteroviruses in the myocardium are detected are more likely to die than those in whom no viruses have been demonstrated. The presence of enterovirus RNA in the myocardium at endomyocardial biopsy has been shown to be the strongest predictor of reduced survival. These results raise the question as to whether persistent virus might be responsible for continuing myocardial damage. Detection of myocardial cell damage is assessed using 111Indium-labelled monoclonal antimyosin antibodies. The present study was undertaken to address the question of whether the presence of myocardial cell damage by such antibodies in patients with dilated cardiomyopathy can be correlated with enterovirus persistence. PATIENTS AND METHODS: A series of 19 consecutive patients diagnosed as having chronic dilated cardiomyopathy who were referred for evaluation for heart transplantation were studied with 111Indium labelled monoclonal antimyosin antibodies. These patients and 10 controls were screened for enterovirus RNA sequences in endomyocardial biopsy tissue by hybridization with an enterovirus group-specific cDNA probe. RESULTS: Antimyosin uptake, indicative of myocardial cell damage, was observed in 16 of 19 patients (84%), with dilated cardiomyopathy, and enterovirus RNA sequences were detected in endomyocardial biopsies from four of these 16 patients (25%), but not in myocardium from the remaining three patients with a negative antimyosin scan, nor from any of 10 controls. CONCLUSIONS: Although these data do not establish a causal relationship between virus persistence in the myocardium and myocardial damage, the results obtained in the preliminary study support the hypothesis that enterovirus persistence is associated with continuing myocardial damage in patients with dilated cardiomyopathy.

[An aortobronchial fistula 11 years after the resection of a posttraumatic aortic aneurysm]. / Fístula aortobronquial a los 11 años de la resección de un aneurisma postraumático de aorta.

A case of a 47-year-old white male who developed an aortobronchial fistula eleven years after resection of a posttraumatic aneurysm of the descending aorta is presented. The clinical picture, the diagnostic problems as well as the treatment are presented and commented.