Trophic restructuring (Wieser 1953) of free-living nematode in marine sediment experimentally enriched to increasing doses of pharmaceutical penicillin G

Trophic structure of free living nematode from Bizerte lagoon was tested by a microcosmic study after 30 days of exposure with 5 increasing doses of pharmaceutical penicillin G (D1: 3 mg L^?1, D2: 30 mg L^?1, D3: 300 mg L^?1, D4: 600 mg L^?1, D5: 700 mg L^?1). Results showed significant differences between nematode assemblages from undisturbed controls and those from penicillin G treatments. Selective deposit-feeders (1A) or nonselective deposit-feeders (1B), very abundant in the control microcosm, were significantly affected and their dominance declined significantly. Epistrate feeders (2A) were significantly gradual increase for all microcosms treated with penicillin G, appeared to be more tolerant to the antibiotic and to take advantage of the growing scarcity of other trophic groups. Compared to the control microcosms, omnivorous-carnivorous (2B) was found to be higher in all treated microcosms, with the exception of those treated with D5. Trophic index (Σθ²) was significantly reduced in all microcosms treated whereas trophic ratio 1B/2A appears to be insignificant.     

Could hydroxyethyl starch be a therapeutic option in management of acute aluminum phosphide toxicity?

Acute aluminum phosphide poisoning is a serious toxicity and results in high mortality rate despite the progress of critical care. After ingestion, phosphine gas is released and absorbed quickly, causing systemic poisoning and cell hypoxia. Excessive thirst, severe hypotension, arrhythmias, tachypnea, and severe metabolic acidosis are the common clinical manifestations. We think acute metabolic response which characteristically occurs in severe injury also happens in aluminum phosphide poisoning. Necropsy examinations indicate congestion in almost all vital organs because of leakage of fluids from intravascular to extravascular space. The most favorable type of fluid for intravascular volume resuscitation persists and is disputed. Colloids remain in the intravascular space rather than crystalloids, and provide more rapid hemodynamic stabilization. Furthermore, hydroxyethyl starch solution may have other benefits e.g. it can reduce the extra vascular leak of albumin and fluids from an endothelial injury site. As refractory hypotension and cardiovascular collapse, because leakage of fluids from intravascular to extravascular space are common cause of death in this toxicity, we propose that hydroxyethyl starch can dominate this refractory hypotension and consequently acute metabolic response.     

Endoplasmic Reticulum Stress and Autophagy Markers in Soleus Muscle Disuse-Induced Atrophy of Rats Treated with Fish Oil

Endoplasmic reticulum stress (ERS) and autophagy pathways are implicated in disuse muscle atrophy. The effects of high eicosapentaenoic (EPA) or high docosahexaenoic (DHA) fish oils on soleus muscle ERS and autophagy markers were investigated in a rat hindlimb suspension (HS) atrophy model. Adult Wistar male rats received daily by gavage supplementation (0.3 mL per 100 g b.w.) of mineral oil or high EPA or high DHA fish oils (FOs) for two weeks. Afterward, the rats were subjected to HS and the respective treatments concomitantly for an additional two-week period. After four weeks, we evaluated ERS and autophagy markers in the soleus muscle. Results were analyzed using two-way analysis of variance (ANOVA) and Bonferroni post hoc test. Gastrocnemius muscle ω-6/ω-3 fatty acids (FAs) ratio was decreased by both FOs indicating the tissue incorporation of omega-3 fatty acids. HS altered (p < 0.05) the protein content (decreasing total p38 and BiP and increasing p-JNK2/total JNK2 ratio, and caspase 3) and gene expressions (decreasing BiP and increasing IRE1 and PERK) of ERS and autophagy (decreasing Beclin and increasing LC3 and ATG14) markers in soleus. Both FOs attenuated (p < 0.05) the increase in PERK and ATG14 expressions induced by HS. Thus, both FOs could potentially attenuate ERS and autophagy in skeletal muscles undergoing atrophy.     

The relationship between serum LDL-cholesterol, HDL-cholesterol and systolic blood pressure in patients with type 2 diabetes

BACKGROUND: The prevalence of hypertension and lipid disorders is increased in patients with diabetes. The relationship between cholesterol and blood pressure values has not yet been well established in this group of patients. AIM: To assess the correlation between lipid levels and blood pressure values in patients with type 2 diabetes. METHODS: The study group consisted of 122 patients (82 females, 40 males, mean age 63+/-10 years) with type 2 diabetes. The mean duration of diabetes was 7.4+/-5.8 years, and hypertension 3.2+/-4.6 years. In all patients glycosylated haemoglobin (HbA1c) and lipid serum concentrations were assessed. RESULTS: The mean serum LDL-cholesterol was 112+/-37 mg/dl (median: 112 mg/dl) and HDL-cholesterol - 47+/-18 mg/dl (median: 44 mg/dl). A significant inverse correlation between HDL-cholesterol and systolic blood pressure (r=-0.177, p=0.05) as well as a positive correlation between LDL-cholesterol and systolic blood pressure values (r=0.196, p=0.031) were found. CONCLUSION: In patients with type 2 diabetes there is a significant relationship between lipid levels and blood pressure values, which suggests an increased susceptibility to vascular disease associated with LDL-cholesterol in these patients.     

Impact of Residents on Safety Outcomes in Laparoscopic Cholecystectomy

New training programs face quality concern by faculty who believe resident involvement in operative management may lead to poorer outcomes. This study aims to understand the impact of resident surgeons on outcomes in a specific common surgical procedure. We obtained a retrospective review of 1216 laparoscopic cholecystectomy cases between June 2012 and June 2017 at a community teaching hospital. Data reviewed included patient demographics, operative time, length of stay, 30-day outcomes. An initial analysis comparing outcomes with/without resident participation was undertaken. A subset analysis comparing junior (PGY 1–2) and senior (PGY 3–5) groups was also performed. We found the resident group participated in higher-risk patient (ASA > 3, 47.5% vs 39.8%, p = 0.04 more acute disease (59.8% vs 37.5%, p < 0.0001) and emergent surgery (59.7% vs 37.5%, p < 0.0001). Resident involvement in severe cases was not a significant factor in the odds of morbidity, mortality, conversion rate or length of stay. Resident participation did increase the odds of having longer OR time (OR 12.54, 95% CI 7.74–17.34, p < 0.0001). Resident participation is associated with increased operative times but not complications. This study confirms resident participation in the operating room in difficult and challenging cases is safe.