Synthesis of homologous series of surfactants from renewable resources, structure-properties relationship, surface active performance, evaluation of their antimicrobial and anticancer potentialities.

Sugar esters display surface-active properties, wetting, emulsifying, and other physicochemical phenomena following their amphipathic nature and recognize distinct biological activity. The development of nutritional pharmaceuticals and other applications remains of great interest. Herein, three novel homologous series of several N-mono-fatty acyl amino acid glucosyl esters were synthesized, and their physicochemical properties and biological activities were evaluated. The design and preparation of these esters were chemically performed via the reaction of glucose with different fatty acyl amino acids as renewable starting materials, with the suggestion that they would acquire functional characteristics superior and competitive to certain conventional surfactants. The synthesized products are characterized using FTIR, 1H-NMR, and 13C-NMR spectroscopy. Further, their physicochemical properties, such as HLB, CMC, Γmax, γCMC, and Amin, were determined. Additionally, their antimicrobial and anticancer efficiency were assessed. The results indicate that the esters' molecular structure, including the acyl chain length and the type of amino acid, significantly influences their properties. The measured HLB ranged from 8.84 to 12.27, suggesting their use as oil/water emulsifiers, wetting, and cleansing agents. All esters demonstrate promising surface-active characteristics, with moderate to high foam production with good stability. Notably, compounds 6-O-(N-dodecanoyl, tetradecanoyl cysteine)-glucopyranose (34, 35), respectively and 6-O-(N-12-hydroxy-9-octadecenoyl cysteine)-glucopyranose (38) display superior foamability. Wetting efficiency increased with decreasing the chain length of the acyl group. The storage results reveal that increasing the fatty acyl hydrophobe length enhances the derived emulsion's stability for up to 63 days. Particularly, including cysteine in these glucosyl esters improves wetting, foaming, and emulsifying potentialities. Furthermore, the esters exhibit antibacterial activity against several tested Gram-positive and Gram-negative bacteria and fungi. On the other hand, they show significant antiproliferative effects on some liver tumor cell lines. For instance, compounds 6-O-(N-12-hydroxy-9-octadecenoylglycine)-glucopyranose (28), 6-O-(N-dodecanoyl, hexadecanoyl, 9-octadecenoyl and 12-hydroxy-9-octadecenoylvaline)- glucopyranose (29, 31, 32 and 33), respectively in addition to the dodecanoyl, hexadecanoyl, 9-octadecenoyl and 12-hydroxy-9-octadecenoyl cysteine glucopyranose (34, 36, 37 and 38), respectively significantly inhibit the examined cancer cells.

Is the carotenoid production from Phaffia rhodozyma yeast genuinely sustainable? a comprehensive analysis of biocompatibility, environmental assessment, and techno-economic constraints.

Microorganisms, such as yeasts, filamentous fungi, bacteria, and microalgae, have gained significant attention due to their potential in producing commercially valuable natural carotenoids. In recent years, Phaffia rhodozyma yeasts have emerged as intriguing non-conventional sources of carotenoids, particularly astaxanthin and ß-carotene. However, the shift from academic exploration to effective industrial implementation has been challenging to achieve. This study aims to bridge this gap by assessing various scenarios for carotenoid production and recovery. It explores the use of ionic liquids (ILs) and bio-based solvents (ethanol) to ensure safe extraction. The evaluation includes a comprehensive analysis involving Life Cycle Assessment (LCA), biocompatibility assessment, and Techno-Economic Analysis (TEA) of two integrated technologies that utilize choline-based ILs and ethanol (EtOH) for astaxanthin (+ß-carotene) recovery from P. rhodozyma cells. This work evaluates the potential sustainability of integrating these alternative solvents within a yeast-based bioeconomy.

Engineering of Multifunctional Nanocomposite Membranes for Wastewater Treatment: Oil/Water Separation and Dye Degradation.

Multifunctional membrane technology has gained tremendous attention in wastewater treatment, including oil/water separation and photocatalytic activity. In the present study, a multifunctional composite nanofiber membrane is capable of removing dyes and separating oil from wastewater, as well as having antibacterial activity. The composite nanofiber membrane is composed of cellulose acetate (CA) filled with zinc oxide nanoparticles (ZnO NPs) in a polymer matrix and dipped into a solution of titanium dioxide nanoparticles (TiO2 NPs). Membrane characterization was performed using transmission electron microscopy (TEM), field emission scanning electron microscopy (FESEM), and Fourier transform infrared (FTIR), and water contact angle (WCA) studies were utilized to evaluate the introduced membranes. Results showed that membranes have adequate wettability for the separation process and antibacterial activity, which is beneficial for water disinfection from living organisms. A remarkable result of the membranes' analysis was that methylene blue (MB) dye removal occurred through the photocatalysis process with an efficiency of ~20%. Additionally, it exhibits a high separation efficiency of 45% for removing oil from a mixture of oil-water and water flux of 20.7 L.m-2 h-1 after 1 h. The developed membranes have multifunctional properties and are expected to provide numerous merits for treating complex wastewater.

Effect of Protective Layer on the Performance of Monocrystalline Silicon Cell for Indoor Light Harvesting.

The development of renewable energy sources has grown increasingly as the world shifts toward lowering carbon emissions and supporting sustainability. Solar energy is one of the most promising renewable energy sources, and its harvesting potential has gone beyond typical solar panels to small, portable devices. Also, the trend toward smart buildings is becoming more prevalent at the same time as sensors and small devices are becoming more integrated, and the demand for dependable, sustainable energy sources will increase. Our work aims to tackle the issue of identifying the most suitable protective layer for small optical devices that can efficiently utilize indoor light sources. To conduct our research, we designed and tested a model that allowed us to compare the performance of many small panels made of monocrystalline cells laminated with three different materials: epoxy resin, an ethylene-tetrafluoroethylene copolymer (ETFE), and polyethylene terephthalate (PET), under varying light intensities from LED and CFL sources. The methods employed encompass contact angle measurements of the protective layers, providing insights into their wettability and hydrophobicity, which indicates protective layer performance against humidity. Reflection spectroscopy was used to evaluate the panels' reflectance properties across different wavelengths, which affect the light amount arrived at the solar cell. Furthermore, we characterized the PV panels' electrical behavior by measuring short-circuit current (ISC), open-circuit voltage (VOC), maximum power output (Pmax), fill factor (FF), and load resistance (R). Our findings offer valuable insights into each PV panel's performance and the protective layer material's effect. Panels with ETFE layers exhibited remarkable hydrophobicity with a mean contact angle of 77.7°, indicating resistance against humidity-related effects. Also, panels with ETFE layers consistently outperformed others as they had the highest open circuit voltage (VOC) ranging between 1.63-4.08 V, fill factor (FF) between 35.9-67.3%, and lowest load resistance (R) ranging between 11,268-772 KΩ.cm-2 under diverse light intensities from various light sources, as determined by our results. This makes ETFE panels a promising option for indoor energy harvesting, especially for powering sensors with low power requirements. This information could influence future research in developing energy harvesting solutions, thereby making a valuable contribution to the progress of sustainable energy technology.

Role of pomegranate extract in restoring endometrial androgen receptor expression, proliferation, and pinopodes in a rat model of polycystic ovary syndrome.

BACKGROUND: Polycystic ovary syndrome (PCOS) is a multifactorial hormonal disorder accompanied by impairment of endometrial function and structure. Pomegranate is recognized for its role in normalizing the female sex hormones in PCOS with little known about its effect on the accompanying endometrial histological alterations. AIM OF THE WORK: To assess the possible ameliorative role of pomegranate juice extract (PJE) on endometrial injury in a rat model of PCOS. MATERIAL AND METHODS: Forty adult albino rats were equally divided into 4 groups; control, PJE-treated (400mg/kg/day for 3 weeks), letrozole-treated (PCOS) (1mg/kg/day for 3 weeks), and PJE & PCOS groups. Serum Follicle-stimulating hormone (FSH), Luteinizing hormone (LH), testosterone, estradiol, and tissue malondialdehyde (MDA) were assayed. Uterine samples were processed for histological staining with hematoxylin & eosin and Masson's trichrome stains, Ki67 and androgen receptor immunohistochemical staining, and scanning electron microscopy. RESULTS: PCOS group revealed a significant increase in serum FSH, LH, testosterone, estradiol, and tissue MDA. Uterine sections depicted various histological alterations in the endometrium with signs of inflammation. A significant increase in the endometrial collagen fiber content, as well as a significant upregulation in Ki67 and androgen receptor immunohistochemical expression were detected. Scanning electron microscopy showed a significant decrease in the mean number of pinopodes. Concomitant administration of PJE efficiently restored the studied biochemical, histological, and immunohistochemical parameters. CONCLUSION: PJE ameliorated PCOS accompanying endometrial histological alterations through its antioxidant, anti-inflammatory, anti-fibrotic, anti-proliferative, and anti-androgenic effects most probably due to its polyphenols content.

Graphene oxide-based nanocomposites (GO-chitosan and GO-EDTA) for outstanding antimicrobial potential against some Candida species and pathogenic bacteria.

To obtain the synergistic antimicrobial potential of nano-composites conjugated with graphene oxide (GO), an alternative approach was developed throughout the hybridization of chitosan (CS) or ethylene diamine tetraacetic acid (EDTA) with GO. The synthesized GO-nanocomposites were identified by XRD, HRTEM, SEM, FTIR, Zeta potential, and Raman spectroscopy. The antimicrobial activity of GO, GO-CS, and GO-EDTA was investigated against some pathogenic bacteria and Candida sp. Results showed that nano-composites looked flattened and clear, with some lines and folds on the exterior part. SEM images show the basic morphology of GO which owns remarkable holes, crevasses, and indeclinable internal structure. GO-EDTA and GO-CS possess a promising antimicrobial activity against all pathogenic microbes. In-vitro ZOI result verified that they exhibited activity against Escherichia coli (22.0 mm for GO-EDTA and 11.0 mm for GO-CS), Staphylococcus aureus (15.0 mm for GO-EDTA and 10.0 mm for GO-CS) and Candida albicans (22.0 mm for GO-EDTA and 16.0 mm for GO-CS). Microbial cells may be ultimately-damaged when they interact with GO-based nanocomposites due to different mechanisms such as oxidative and membrane stress and wrapping isolation. This work provides revolutionary GO-nanocomposites for increasing the antimicrobial activity against some pathogenic microbes with a cost-effective and eco-friendly approach.

Insuficiencia cardiaca la epidemia en el medio rural: características y manejo en un centro de salud rural de Albacete / Heart failure the epidemic in the rural area: characteristics andmanagement in a rural health center of Albacete

INTRODUCCIÓN Y OBJETIVO: El adecuado manejo en los pacientes con insuficiencia cardíaca crónica (ICC) reduce su morbimortalidad y por tanto el número de reingresos hospitalarios. Numerosos estudios informan sobre su manejo en el ámbito hospitalario, mientras que en atención primaria son escasos. El objetivo es evaluar el grado de adecuación a la guía clínica de la Sociedad Europea de Cardiología en la ICC en los pacientes de atención primaria. MÉTODOS: Diseño observacional descriptivo, de manejo, de utilización de medicamentos, tipo indicación-prescripción. Población y muestra: equipos de atención primaria de la zona básica de Casas Ibañez (Albacete). La población de estudio está formada por los pacientes con un diagnóstico de insuficiencia cardíaca crónica en grado II-IV de la New York Heart Association (NYHA), de un registro de 224 con insuficiencia cardíaca crónica, pertenecientes a 10 médicos de atención primaria. Se seleccionaron todos los pacientes diagnosticados de Insuficiencia Cardiaca Crónica 223 enfermos con afijación al estratos rural. Mediciones principales: se evalúa la adherencia a los fármacos recomendados en la guía clínica mediante 2 indicadores, uno global y otro para fármacos con mayor grado de evidencia (A1: inhibidores de la enzima conversora de angiotensina/antagonistas de los receptores de angiotensina II [IECA/ARA-II], beta-bloqueantes [BB] y espironolactona). RESULTADOS: Se estudian 223 enfermos, con una edad promedio de 78,4 años, de los cuales son mujeres el 53,1%. La hipertensión arterial (HTA) y la isquemia cardíaca causan el 64,7%. La comorbilidad promedio, excluyendo la ICC, fue de 2,9. El 40,4% están en grado III-IV de la NYHA. El Índice de Adherencia Global (diuréticos, IECA/ARA-II, beta-bloqueantes, espironolactona, digoxina y anticoagulantes orales) y el de Adherencia a la Evidencia A1 (IECA/ARA-II, BB y espironolactona) fueron del 55,2 y del 44,6%, respectivamente. El 39,5% tiene una baja adherencia, solo el 12,9% de los pacientes exhiben una perfecta adherencia a los medicamentos con el mejor grado de evidencia, mientras que tener menos de 70 años, los antecedentes de isquemia, HTA e ingreso hospitalario son variables asociadas a mejor adherencia. CONCLUSIÓN: Existe una infrautilización de medicamentos recomendados por la guía clínica para la insuficiencia cardíaca, sobre todo de aquellos con mejores evidencias para reducir la morbimortalidad

INTRODUCTION AND OBJECTIVE: Proper management in chronic heart failure (CHF) patients reduces their morbidity as well as the mortality and therefore the number of hospital readmissions. Numerous studies report about their management in the hospital setting, while in primary care they are scarce. The objective is to evaluate the application of European Society of Cardiology clinical guidelines in the chronic heart failure patients in primary care setting. METHODS: Observational descriptive design focusing on management, use of medications and indication-prescription. Population and sample: Primary care teams in the area of ​​Casas Ibañez (Albacete). The study population consists of patients with chronic heart failure diagnosis classes from II to V according to the New York Heart Association (NYHA). Data were collected from a registry of 224 patients with chronic heart failure belonging to 10 primary care physicians. All patients diagnosed with Chronic Heart Failure (223 patients) belonging to the rural strata were selected. MAIN MEASUREMENTS: adherence to the drugs recommended in the clinical guideline is evaluated using 2 indicators, one global and the other for drugs with a higher degree of evidence (A1: angiotensin converting enzyme inhibitors / angiotensin II receptor blockers [ACE Inhibitors/ ARBs], Beta-blockers [BB] and spironolactone). RESULTS: 223 patients are studied, with an average age of 78.4 years, of which 53.1% are women. Arterial hypertension (AHT) and cardiac ischemia cause 64.7%. The average comorbidity, excluding CHF, was 2.9. 40.4% were class III-IV of the NYHA. The Global Adherence Index (diuretics, ACE Inhibitors / ARBs, Beta-blockers, spironolactone, digoxin and oral anticoagulants) and the Adherence to Evidence A1 (ACE Inhibitors / ARBs, β-blockers and spironolactone) were 55.2 and of 44.6% respectively. Only 12.9% of patients showed perfect adherence to medications with the higher degree of evidence while 39.5% had low adherence. Having less than 70 years, the history of ischemic heart diseases, AHT and hospital admissions are variables associated with better adhesion. CONCLUSION: There is an underutilization of medications recommended by the clinical guideline for congestive heart failure management, especially those with better evidence to reduce morbidity and mortality

Riesgo de la obesidad en pacientes con Insuficiencia Cardiaca / Risk of obesity in patients with Heart Failure

OBJETIVO: Analizar la relación del Índice de Masa Corporal (IMC) con la Insuficiencia cardiaca en un área de salud. MÉTODO: Estudio descriptivo observacional de los 161 pacientes que habían sido diagnosticados en el Area de Salud entre Enero de 2014 y diciembre de 2016. Entre otros datos demográficos, clínicos, y analíticos, se analizó el IMC a partir del peso y la talla en la primera visita a la unidad, mediante la fórmula: peso (en kilogramos) / cuadrado de la talla (en metros). Una vez obtenido se evaluó la relación entre el IMC y la supervivencia a 2 años. Se analizó a 4 subgrupos de pacientes, en función de su IMC, a partir de los criterios definidos por la Organización Mundial de la Salud (OMS) en 1999 (Technical Report Series, n.o 854; Ginebra: 1999): bajo peso (IMC < 20,5), peso normal (IMC de 20,5 a < 25,5), sobrepeso (IMC de 25,5 a < 30) y obesidad (IMC ≥ 30). El análisis estadístico se realizó mediante el paquete estadístico SPSS® 24.0 para Windows. La asociación entre el IMC como variable continua y la mortalidad a 2 años. RESULTADOS: De los participantes 81 eran obesos (50,8%), siendo 33 hombres y 48 mujeres. La edad media de los obesos es de 80,32 +/-9,23 años. Las principales causas de Insuficiencia Cardiaca en un 62,2% tenían diagnosticado algún tipo de cardiopatía, siendo: 29,2% Cardiopatía Isquémica, 46,6% Arritmias cardiacas y 20,5% Valvulopatías. El IMC como variable continua se asoció de forma significativa con la mortalidad (p < 0,001), la edad (0,002), la enfermedad isquémica (0,001), sexo (0,004), HTA (0,002), Diabetes (0,003) y dislipemia (0,004). También se ha visto relación del IMC con el uso de tratamientos Digoxina, Diuréticos de Asa y Espironolactona a mayor IMC más utilización. EL IMC también está asociada con el número de ingresos, mayor número de enfermedades crónicas concomitantes y mortalidad. Las puntuaciones obtenidas en el cuestionario de calidad de vida MLWHFQ en la visita inicial; los pacientes con bajo peso fueron los que mayor puntuación obtuvieron, que corresponde a una peor calidad de vida. No hubo diferencias significativas entre las puntuaciones obtenidas por los pacientes de peso normal, con sobrepeso y obesos, si bien éstos mostraron cierta tendencia a obtener puntuación más alta. CONCLUSIONES: El IMC empeora la mortalidad, la enfermedad isquémica, el sexo, la HTA, diabetes y dislipemia en pacientes con insuficiencia cardiaca

OBJECTIVE: To analyze the relationship of the Body Mass Index (BMI) with heart failure in a health area. METHOD: Observational descriptive study of the 161 patients who had been diagnosed in the Health Area between January 2014 and December 2016. Among other demographic, clinical and analytical data, the BMI was analyzed based on weight and height at the first visit to the unit, using the formula: weight (in kilograms) / square of height (in meters). Once obtained, the relationship between BMI and 2-year survival was evaluated. Four subgroups of patients were analyzed, based on their BMI, based on the criteria defined by the World Health Organization (WHO) in 1999 (Technical Report Series, No. 854, Geneva: 1999): low weight (BMI < 20.5), normal weight (BMI of 20.5 to <25.5), overweight (BMI of 25.5 to <30) and obesity (BMI ≥ 30). Statistical analysis was carried out using the statistical package SPSS® 24.0 for Windows. The association between BMI as a continuous variable and 2-year mortality. RESULTS: Of the participants, 81 were obese (50.8%), being 33 men and 48 women. The average age of the obese is 80.32 +/- 9.23 years. The main causes of heart failure in 62.2% had diagnosed some type of heart disease, being: 29.2% Ischemic heart disease, 46.6% cardiac arrhythmias and 20.5% valvulopathies. BMI as a continuous variable was significantly associated with mortality (p <0.001), age (0.002), ischemic disease (0.001), gender (0.004), hypertension (0.002), diabetes (0.003) and dyslipidemia (0.004). ). The relation of BMI with the use of Digoxin, Asa Diuretics and Spironolactone treatments has also been seen with higher BMI plus utilization. BMI is also associated with the number of admissions, greater number of concomitant chronic diseases and mortality. The scores obtained in the MLWHFQ quality of life questionnaire at the initial visit; the patients with low weight were those who obtained the highest score, which corresponds to a worse quality of life. There were no significant differences between the scores obtained by patients of normal weight, overweight and obese, although these showed a tendency to obtain a higher score. CONCLUSIONS: BMI has been shown to be associated with mortality, ischemic disease, sex, hypertension, diabetes and dyslipidemia in patients with heart failure

Use of isotope hydrology in groundwater conceptualization for modeling flow and contaminant transport at northwestern Sinai, Egypt.

The study area extends along northwestern Sinai coastal plain, which is considered an integral part of the Mediterranean Sea. It depends mainly on the groundwater resource for different type of human activities such as agricultural and drinking. Many programs and policies should be implemented in this area to concurrently improve the sustainability of groundwater use and manage the risks of its degradation. Leakage from some factories in Bir El-Abd might be a contamination source that would threaten groundwater. In this paper, an attempt was made using an integrated approach of the hydrogeological setting and the conjugation of the hydrogeochemical data with the stable isotope hydrology for representation of the conceptual model of the study area. Those tools give more insights on the characterization of the groundwater system with all relevant boundaries and main recharge sources of the aquifer; which is considered to be the key components of a groundwater modeling. A particular focus is placed on modeling a hypothetical accident for contaminant transport in the groundwater system, using both lead and chromium as a typical contaminant component. Further predication of the concentration of those elements has been estimated, and the safety distances of their plume have been determined. This study would be helpful in dealing with water management issues related to contaminant hydrogeology. As well, it introduces some finding for reducing the environmental risk form the industrial development at the study area.

Predictors of stroke outcome: the role of hemorheology, natural anticoagulants, and serum albumin.

BACKGROUND: The early hours after an acute stroke are crucial; early accurate prediction of outcome in stroke patients can help health system providers and families to choose appropriate lines of management and plan for the future. The aim of this work is to assess the role of hemorheological parameters (such as blood viscosity, hematocrit, platelet aggregation, and leukocyte count), protein C, protein S, antithrombin III, and serum albumin as predictors of stroke outcome. METHODS: Thirty subjects, 20 patients with acute ischemic stroke within 24 h from the onset and 10 normal subjects, were included in this case control study. Clinical, functional, and radiological evaluation was done for the patients, and all patients and control were subjected to routine laboratory tests and assessment of blood viscosity, hematocrit level, platelet aggregation, protein C, protein S, and antithrombin III. RESULTS: Platelet aggregation was significantly higher and serum albumin was significantly lower in stroke patients compared to control (p value = 0.000 and 0.039) respectively. On comparing between patient with good and poor outcome, good outcome was associated with increased serum albumin level at admission (p value = 0.03) respectively. A significant negative correlation was found between total leukocyte count, hematocrit value, and stroke outcome (p value = 0.015 and 0.013) respectively. Only albumin was found to be a significant predictor for outcome by linear regression analysis. CONCLUSION: Serum albumin, hematocrit level, and total leukocyte count at the time of presentation of ischemic stroke are useful markers for stroke outcome.

Hydrochemical and multivariate analysis of groundwater quality in the northwest of Sinai, Egypt.

The northwestern coast of Sinai is home to many economic activities and development programs, thus evaluation of the potentiality and vulnerability of water resources is important. The present work has been conducted on the groundwater resources of this area for describing the major features of groundwater quality and the principal factors that control salinity evolution. The major ionic content of 39 groundwater samples collected from the Quaternary aquifer shows high coefficients of variation reflecting asymmetry of aquifer recharge. The groundwater samples have been classified into four clusters (using hierarchical cluster analysis), these match the variety of total dissolvable solids, water types and ionic orders. The principal component analysis combined the ionic parameters of the studied groundwater samples into two principal components. The first represents about 56% of the whole sample variance reflecting a salinization due to evaporation, leaching, dissolution of marine salts and/or seawater intrusion. The second represents about 15.8% reflecting dilution with rain water and the El-Salam Canal. Most groundwater samples were not suitable for human consumption and about 41% are suitable for irrigation. However, all groundwater samples are suitable for cattle, about 69% and 15% are suitable for horses and poultry, respectively.

Assessment of groundwater quality using geographical information system (GIS), at north-east Cairo, Egypt.

The present investigation has been conducted to delineate the hydrogeochemical and environmental factors that control the water quality of the groundwater resources in the north-east of Cairo. A complementary approach based on hydrogeochemistry and a geographical information system (GIS) based protectability index has been employed for conducting this work. The results from the chemical analysis revealed that the groundwater of the Quaternary aquifer is less saline than that of the Miocene aquifer and the main factors that control the groundwater salinity in the studied area are primarily related to the genesis of the original recharging water modified after by leaching, dissolution, cation exchange, and fertilizer leachate. The computed groundwater quality index (WQI) falls into two categories: fair for almost all the Miocene groundwater samples, while the Quaternary groundwater samples are all have a good quality. The retarded flow and non-replenishment of the Miocene aquifer compared to the renewable active recharge of the Quaternary aquifer can explain this variation of WQI. The index and overlay approach exemplified by the DUPIT index has been used to investigate the protectability of the study aquifers against diffuse pollutants. Three categories (highly protectable less vulnerable, moderately protectable moderately vulnerable and less protectable highly vulnerable) have been determined and areally mapped.

Complications of endovenous lasers.

Endovenous laser ablation (EVLA) and radiofrequencey ablation have become the procedures of choice for the treatment of superficial venous insufficiency. Their minimally invasive technique and safety profile when compared with operative saphenectomy have led to this change. As EVLA has replaced saphenectomy as the procedure of choice, the distribution of complications has changed. We evaluated the most common and most devastating complications in the literature including burns, nerve injury, arterio-venous fistula (AVF), endothermal heat-induced thrombosis and deep venous thrombosis. The following review will discuss the most frequently encountered complications of treatment of superficial venous insufficiency using EVLA. The majority of the complications described can be avoided with the use of good surgical technique and appropriate duplex ultrasound guidance. Overall, EVLA has an excellent safety profile and should be considered among the first line for treatment of superficial venous reflux.

The antimicrobial peptide LL-37 modulates the inflammatory and host defense response of human neutrophils.

The human cathelicidin antimicrobial peptide acts as an effector molecule of the innate immune system with direct antimicrobial and immunomodulatory effects. The aim of this study was to test whether the cathelicidin LL-37 modulates the response of neutrophils to microbial stimulation. Human neutrophils were exposed to LPS, Staphylococcus aureus and Pseudomonas aeruginosa subsequent to incubation with LL-37 and cytokine release was measured by ELISA. The incubation with LL-37 significantly decreased the release of proinflammatory cytokines from stimulated human neutrophils. ROS production of neutrophils was determined by a luminometric and a flow cytometry method. The peptide induced the production of ROS and the engulfment of bacteria into neutrophils. Peritoneal mouse neutrophils isolated from CRAMP-deficient and WT animals were treated with LPS and TNF-alpha in the supernatant was measured by ELISA. Antimicrobial activity of neutrophils was detected by incubating neutrophils isolated from CRAMP-knockout and WT mice with bacteria. Neutrophils from CRAMP-deficient mice released significantly more TNF-alpha after bacterial stimulation and showed decreased antimicrobial activity as compared to cells from WT animals. In conclusion, LL-37 modulates the response of neutrophils to bacterial activation. Cathelicidin controls the release of inflammatory mediators while increasing antimicrobial activity of neutrophils.

Acute renal failure in the State of Qatar: presentation and outcome.

Despite major improvements in health care, acute renal failure is still one of the main prognostic factors in terms of patient mortality and long-term morbidity. This cohort prospective study to evaluate the patterns and outcomes of renal failure in Qatar was performed between January and June 2005. Of the 213 patients followed prospectively from referral to the end of their hospitalization, 66.7% were males and 33.3% females. Their overall mean age was 60 years; the majority were referred from critical care units. Comorbidity was present in 87% of all patients. Volume depletion, hypotension, and sepsis were the main predisposing factors for renal failure. Eighty three patients (39%) needed renal replacement treatment and 130 (61%) were treated conservatively. The majority of critical care patients needed dialysis. Overall mortality was 23.9%, 7% needed chronic dialysis, and 69.1% were discharged with normal or mild renal impairment. This study showed that acute renal failure was a major factor affecting patient mortality in Qatar. Early treatment of predisposing factors may improve overall patient outcomes.

Early graft function and carboxyhemoglobin level in liver transplanted patients.

INTRODUCTION: Heme-Oxygenase-1 catalyzes hemoglobin into bilirubin, iron, and carbon monoxide, a well known vasodilator. Heme-Oxygenase-1 expression and carbon monoxide production as measured by blood carboxyhemoglobin levels, increase in end stage liver disease patients. We hypothesized that there may be a correlation between carboxyhemoglobin level and early graft function in patients undergoing liver transplant surgeries. METHODS: In a descriptive retrospective study, 39 patients who underwent liver transplantation between the year 2005 and 2006 at KFSH&RC, are included in the study. All patients received general anesthesia with isoflurane in 50% oxygen and air. Levels of oxyhemoglobin, carboxyhemoglobin and methemoglobin concentration in percentage were recorded at preoperative time, anhepatic phase, end of surgery, ICU admission and 24 hr after surgery. The level of lactic acid, prothrombin time (PT), partial thrombin time (PTT), serum total bilirubin and ammonia were also recorded at ICU admission and 24 hr after surgery. The numbers of blood units transfused were recorded. RESULTS: 39 patients were included in the study with 13/39 for living donor liver transplant (LDLT) compared to 26/39 patients scheduled for deceased donor liver transplant (DDLT). The mean age was 35.9 +/- 16.9 years while the mean body weight was 60.3 +/- 20.9 Kg. Female to male ratio was 21/18. The median packed red blood cell (PRBC) units was 4 (Rang 0-40). There was a significant increase in carboxyhemoglobin level during the anhepatic phase, end of surgery and on ICU admission compared with preoperative value (p<0.005). However, there was insignificant changes in methemoglobin level and significant decrease in oxyhemoglobin levels throughout the study period compared to the preoperative value (p<0.005). The changes in carboxyhemoglobin level on ICU admission and 24 hrs postoperatively were positively correlated with the changes in serum total bilirubin and prothrombin time (R = 0.35, 0.382, 0.325 and 0.31) respectively p<0.05) but not with the changes in serum lactic acid. The same strong correlation was found when analysing LDLT and DDLT patients separately between carboxyhemoglobin concentration and PT and total bilirubin while still the correlation with lactic acid was weak. There was no correlation between average perioperative carboxyhemoglobin concentration during different timing of measurements and average units of transfused blood (R = -0.02) p>0.05. CONCLUSION: The changes in carboxyhemoglobin level significantly correlate with the Changes in graft functions particularly prothrombin time and serum total bilirubin and may be used as an early, rapid and simple test for early evaluation of graft function.

Factor analysis of body measurements in Arabian horses.

Data of 13 body measurements have been analysed from 166 Arabian horses, 123 mares and 43 stallions, ranging from 49 to 298 months of age, belonging to Alzahraa stud, Cairo, Egypt. General linear model was used to study age and gender effects on these measures. Gender was a significant source of variation for most studied traits, but not for neck girth, cannon bone circumference of fore and hind legs, and pastern girth of fore and hind legs. Age significantly affected pastern girths of fore and hind legs and cannon bone circumference of fore legs, while there was no significant effect on the other measurements. Pearson correlations, adjusted for age effect, between measurements were estimated and ranged from 0.02 to 0.84 for mares and from -0.05 to 0.90 for stallions. Factor analysis with promax rotation for each gender was carried out to derive fewer independent common factors. Three factors were extracted which accounted for 66% and 67% of the total variance in mares and stallions respectively. The first, second and third factors in mares tended to describe body thickness, leg thickness and general size respectively; whereas in stallions they tended to differentiate among general size, leg thickness and body thickness respectively. The three extracted factors for each gender determine the main sources of shared variability that control body conformation in Arabian horses. These factors could be considered in selection programmes to acquire highly coordinated bodies in pure Arabian horses with fewer measurements.

Role of fexible ureterorenoscopy in the management of lateralizing essential haematuria

Objective: To evaluate the role of flexible ureterorenoscopy in diagnosis and treatment of lateralizing essential haematuria. Patients and Methods: Twenty-three patients suffering from unilateral haematuria were included in the study and underwent flexible ureterorenoscopy. Their age ranged from 17 to 68 years (mean age: 36 years). Unilateral gross haematuria was demonstrated cystoscopically. The patients were subjected to a careful history taking; full laboratory and radiological investigations. However; we failed to localize the cause of haematuria in the patients included in the study. This necessitated flexible ureterorenoscopy on the affected ureterorenal unit. Results: The collecting system was inspected in 21/23 patients. Discrete lesions were identified in 11 patients (haemangioma on a renal papilla in six; small vascular lesions in three; a small calculus in one and a small papillary growth in one). Non-specific abnormalities (erythema of the infundibulumor abnormal configuration in the renal papilla) were found in six patients. No lesion was detected in 4 patients. Patients with non-specific abnormalities were biopsied and coagulated. The remaining 11 patients with discrete lesions underwent laser fragmentation of the calculus; nephroureterectomy for the papillary transitional cell carcinoma (TCC) and 9 patients underwent fulguration with or without biopsies. The haematuria resolved in all patients with discrete lesions. Patients with non-specific abnormalities had a poor outcome in our series; since all had recurrent or persistent bleeding. Follow-up ranged from 6-18 months (mean 9 months). Conclusion: Flexible ureterorenoscopy can be of value in the diagnosis and treatment of lateralizing haematuria. Patients with discrete lesions respond well to endoscopic treatment (electrocoagulation)

Dynamic three-dimensional spiral computed tomographic cysto-urethrography: a novel technique for evaluating post-traumatic posterior urethral defects.

OBJECTIVE: To present a new method of identifying the anatomy of posterior urethral distraction defects (PUDDs) using three-dimensional spiral computed tomography/cysto-urethrography (CTCUG), as conventional two-dimensional CUG can give a false interpretation of the exact anatomy. PATIENTS AND METHODS: Twenty-one patients presenting with a PUDD were assessed between February 2001 and October 2002. All patients initially underwent combined ascending and micturating CUG (ACUG), followed by CTCUG analysed using special software. In this technique all soft-tissue densities were subtracted from the volume of interest leaving only high-density images, i.e. pelvic bony structure and the contrast medium-filled bladder and urethra. The images were taken over a sequence and 36 different images viewed by 'roll and spin' techniques, each of which had a different plane of vision. Images were supplied as static CT films and as a movie on a compact disk using a computer program. RESULTS: The technique allows one CT image to be viewed from 36 different angles both dynamically and statically, allowing the surgeon the unique opportunity to view the PUDD through several planes and precisely identify its anatomy. By comparing the data obtained with this technique to those obtained by conventional ACUG, and each in relation to the operative findings, the following aspects could be more thoroughly evaluated by CTCUG: the location of the distraction injury, the length of the distraction defect, the degree and direction of urethral end-alignment, the relation of the ectopic bony fragments and bone callus to the urethra, and the presence of various pathological defects, e.g. fistulae, false passages and diverticulae. CONCLUSION: With CTCUG, both static and dynamic images can be obtained, allowing the easier staging of a PUDD and thus better surgical planning and consequently better results from reconstruction.

Pre-exposure modulates attraction to sex pheromone in a moth.

In behavioural experiments we investigated the influence of previous short exposure to sex pheromone on subsequent response of male Spodoptera littoralis moths to sex pheromone. We found that pre-exposed males showed increased sensitivity to female sex pheromone after a single exposure to a pheromone plume compared to that found in naïve males. The increased responsiveness lasted for at least 27 h after the exposure, showing that it was not just a short-term sensitization of the males. Exposure to the odour source without upwind movement towards the source was enough to increase the responsiveness. Physical activation without exposure to odour did not affect responsiveness. The increase in responsiveness after exposure was higher when the males were pre-exposed to natural female pheromone gland extract than when they were exposed to a higher dose of the main component, even though both odour sources elicited similar upwind attraction in naïve males. Thus, the quality of the pheromone mixture to which males were exposed influenced the subsequent response.