Impact of bariatric surgery on outcomes of patients with nonalcoholic fatty liver disease: a nationwide inpatient sample analysis, 2004–2012

Background

Bariatric surgery in eligible morbidly obese individuals may improve liver steatosis, inflammation, and fibrosis; however, population-based data on the clinical benefits of bariatric surgery in patients with nonalcoholic fatty liver disease (NAFLD) are lacking.

Simultaneous medullary and papillary thyroid carcinoma with lymph node metastasis in the same patient: case report and review of the literature

We report a rare case of simultaneous medullary thyroid carcinoma on the left thyroid lobe with lymph node metastasis and papillary thyroid cancer on the right thyroid lobe. The 55-year-old woman was diagnosed with medullary thyroid carcinoma after left hemithyroidectomy for goitre. Completion thyroidectomy, central neck dissection and left modified neck dissection revealed the presence of papillary carcinoma on the right side. The extreme rarity and interesting pathological features are discussed and we raise the question of whether the finding of another thyroid cancer on the opposite side was coincidental or from possible activation of a common tumorigenic pathway for both follicular and parafollicular thyroid cells.     

Feasibility of Real-Time Continuous Glucose Monitoring Telemetry System in an Inpatient Diabetes Unit: A Pilot Study

Background:Hospitalization of persons with diabetes in an inpatient diabetes unit is challenging, notably for patients having different profiles. We aimed to evaluate the feasibility and the benefit of a continuous glucose monitoring (CGM) telemetry system to control glucose excursions in hospitalized patients with diabetes, according to their diabetes type and the reasons for their hospitalization.Method:A prospective pilot study was conducted in 53 insulin-requiring diabetes patients hospitalized in the general ward. Glucose was monitored using Guardian Connect (GC, Medtronic) to adopt insulin therapy. The time in range (TIR, target 70-180 mg/dL), the time below range (TBR), and the time above range (TAR) were recorded by GC between the start of hospitalization (SH) and end of hospitalization (EH), and analyzed according to the diabetes type (type 1 diabetes n = 28, type 2 diabetes n = 25) and the reasons for hospitalization (acute complications n = 35, therapeutic education n = 18). Patient and caregiver satisfaction was also assessed.Results:In patients with type 2 diabetes and those hospitalized for acute complications, TIR significantly increased between the SH and EH, from 75.7% (95%CI 48.5-84.6) to 82.2% (95%CI 63.2-91.8) P = 0.043 and from 58.3% (95%CI 46.3-69.7) to 66.4% (95%CI 55.6-75.5) P = 0.031, respectively, and TAR significantly decreased, with no change in TBR. In patients with diabetes hospitalized for therapeutic education, TBR significantly decreased from 3.4% (95%CI 0-9.4) to 0% (95%CI 0-3.8) P = 0.037. Finally, 94% of patients and caregivers deemed the GC system useful.Conclusions:CGM telemetry system use is feasible and well accepted in patients hospitalized in diabetes care unit and could be useful to improve therapeutic education and metabolic control, especially for specific homogenous populations with diabetes.     

Histopathological changes induced by Hemiscorpius lepturus scorpion venom in mice

Envenomation by Hemiscorpius lepturus (H. lepturus) is associated with local necrosis, followed by systemic manifestations. In this work the LD₅₀ of H. lepturus venom were determined by subcutaneous (SC) injection in white Balb/c mice (5 mg/kg). Histopathological alterations in organs such as kidney, heart, liver, lungs, stomach and intestine were determined in 3, 6, 12 and 24 h following experimental (SC) envenoming injection of one LD₅₀ of the venom in Balb/c mice. Histological studies showed degenerative changes in the kidney with disorganized glomeruli and necrotic tubular in 3 h and reached to its climax in 6 h. Myocardium showed massive myocytolysis with interstitial necrosis in 3 h and reached to its peak after 6 h past envenoming. Bowels showed edema of lamina propria and slight villous necrosis. The enzymatic activities of creatine kinase (CK) and lactate dehydrogenase (LDH) were significantly increased in the serum in 9 h. No necrotic lesion observed in lungs and liver. The results indicate that the venom of H. lepturus is a highly cytotoxic, and induces massive tissue damages in specific organs, starting from the heart and kidney as the first target in 3 h and ends to the bowels in 6 h post envenomation.     

Development of new Alzheimer's disease drug candidates using donepezil as a key model

Alzheimer's disease (AD) is one of the most prevalent geriatric diseases and a significant cause of high mortality. This crippling disorder is becoming more prevalent at an unprecedented rate, which has led to an increase in the financial cost of caring. It is a pathologically complicated, multifactorial disease characterized by β-amyloid precipitation, β-amyloid oligomer production, decrease in cholinergic function, and dysregulation of other neurotransmitter systems. Due to the pathogenic complexity of AD, multitarget drugs that can simultaneously alternate multiple biological targets may enhance the therapeutic efficacy. Donepezil (DNP) is the most potent approved drug for the treatment of AD. It has a remarkable effect on a number of AD-related processes, including cholinesterase activity, anti-Aβ aggregation, oxidative stress, and more. DNP resembles an excellent scaffold to be hybridized with other pharmacophoric moieties having biological activity against AD pathological factors. There have been significant attempts made to modify the structure of DNP to create new bioactive chemical entities with novel structural patterns. In this review, we highlight recent advances in the development of multiple-target DNP-hybridized models for the treatment of AD that can be used in the future in the rational design of new potential AD therapeutics. The design and development of new drug candidates for the treatment of AD using DNP as a molecular scaffold have also been reviewed and summarized.     

Incidental finding of a bilateral complete ossification of stylo‐hyoid chain and thyro‐hyoid ligaments

Ossification of stylohyoid chain corresponds to the ossification of stylohyoid ligament that can vary from thin short to thick long ossification and can be associated with other calcifications. We report in this case a bilateral non painful complete ossification of the stylohyoid complex extended to the thyrohyoidien ligament.     

The rate of secondary genomic findings in the Saudi population

Secondary findings (SF) are defined as genetic conditions discovered unintentionally during an evaluation of raw data for another disease. We aimed to identify the rate of secondary genetic findings in the Saudi population in the 59 genes of the American College of Medical Genetics and Genomics (ACMG) list. In our study, the raw data of 1254 individuals, generated from exome sequencing for clinical purposes, were studied. Variants detected in the 59 genes on the ACMG list of secondary findings were investigated. Pathogenicity classifications were assigned to those variants based on the ACMG scoring system. We identified 2409 variants in the 59 gene list, 45 variants were classified as pathogenic/likely pathogenic variants according to the ACMG classification. The LDLR gene had the greatest number of pathogenic/likely pathogenic variants 12%. Cardiovascular genetic diseases had the highest frequency of disorders detected as secondary findings. In this study, the overall rate of positive cases identified with secondary findings in the Saudi population was 8%. The different in our current study and the previous studies in Saudi Arabia can be explained by the differences between the sequencing method, the criteria used for variant classification, the availability of newer evidence at the time of the publication, and the fact that we identified Saudi novel variants never reported in other populations.