Nanophyto-gel against multi-drug resistant Pseudomonas aeruginosa burn wound infection

Burn wound is usually associated by antibiotic-resistant Pseudomonas aeruginosa infection that worsens and complicates its management. An effective approach is to use natural antibiotics such as cinnamon oil as a powerful alternative. This study aims to investigate topical nanostructured lipid carrier (NLC) gel loaded cinnamon oil for Pseudomonas aeruginosa wound infection. A 2⁴ full factorial design was performed to optimize the formulation with particle size 108.48 ± 6.35 nm, zeta potential −37.36 ± 4.01 mV, and EE% 95.39 ± 0.82%. FTIR analysis revealed no excipient interaction. Poloxamer 407 in a concentration 20% w/w NLC gel was prepared for topical application. Drug release exhibited an initial burst release in the first five hours, followed by a slow, sustained release of up to five days. NLC-cinnamon gel has a significant ability to control the drug release with the lowest minimum inhibitory concentration again P. aeruginosa compared to other formulations (p < .05). In vivo study also showed NLC-cinnamon gel effectively healed the infected burned wound after a six-day treatment course with better antibacterial efficacy in burned animal models. Histological examination ensured the tolerability of NLC-cinnamon gel. The results suggest that nanoparticle-based cinnamon oil gel is a promising natural product against antibiotic-resistant strains of P. aeruginosa in wound infection.     

Ethnopharmacological study of herbal remedies used for the management of thyroid disorders in Algeria

Traditional medicine is gaining an increasing importance in diseases management. Besides, thyroid disease is one of the common endocrine disorders spreading at high frequency worldwide. The present work is an ethnopharmacological study aiming to identify, document and analyze aromatic and medicinal plants used in Algerian traditional medicines for thyroid disorders management. Semi-structured interviews with 120 herbalists and traditional practitioners and rural dwellers were realized in eleven locations in Algeria throughout field studies achieved from June 2017 to July 2019. Results reveal the use of 63 medicinal plants belonging to 59 genera and 34 families. The most represented botanical families were Lamiaceae, Fabaceae, Apiaceae, Amaranthaceae and Asteraceae. However, the most cited plant species were Atriplex halimus L., Bunium incrassatum (Boiss.) Amo, Nigella sativa L., Aquilaria malaccensis Lam. and Saussurea costus (Falc.) Lipsch. These species are taken alone or in mixtures of two or more ingredients from different origins such as honey, olive oil, and goat milk. Our findings revealed new therapeutic uses of 60 medicinal plants that have not been previously reported for the treatment of thyroid in Algeria. This is the first study documenting the traditional uses based on herbal medicine for thyroid management in Algeria. Our findings are relevant in the search for novel drug discovery. Obviously, it is the time to increase effective scientific studies on mechanisms of action of these medicinal plants in order to validate their popular usages.     

Caffeine increased progressive motility of human spermatozoa in normozoospermic and asthenozoospermic semen samples and enhanced activity of seminal creatine kinase

Even though the effect of caffeine on humans' health has been revealed in various research studies, its effect on semen quality has yet to be well explained. Here, we measured the effect of caffeine at 1, 5, 10 and 20 mM on motility of human spermatozoa in normozoospermic and asthenozoospermic semen samples, level of seminal nitric oxide, chelation of seminal calcium ions and activity of seminal creatine kinase. Fifty-one normozoospermic and ten asthenozoospermic semen samples were recruited in this study. Sperm motility was evaluated by Makler counter, and seminal nitric oxide, seminal-free calcium and activity of seminal creatine kinase were measured spectrophotometrically. Caffeine at 10 mM significantly (p < .05) increased progressive motility of spermatozoa in both tested groups. Also, caffeine significantly increased (p < .05) activity of creatine kinase and insignificantly (p > .05) altered nitric oxide and free calcium levels in seminal plasma. In conclusion, progressive motility of human spermatozoa was found to be higher in the presence of caffeine at 10 mM in normozoospermic and asthenozoospermic semen samples; this increase, albeit partially, could be due to increased activity of seminal creatine kinase, but not to increased production of nitric oxide or chelation of free calcium ions.     

Caudally directed upper-instrumented vertebra pedicle screws associated with minimized risk of proximal junctional failure in patients with long posterior spinal fusion for adult spinal deformity

BACKGROUND CONTEXTIt is unknown whether upper instrumented vertebra (UIV) pedicle screw trajectory and UIV screw-rod angle are associated with development of proximal junctional kyphosis (PJK) and/or proximal junctional failure (PJF).PURPOSETo determine whether (1) the cranial-caudal trajectory of UIV pedicle screws and (2) UIV screw-vertebra angle are associated with PJK and/or PJF after long posterior spinal fusion in patients with adult spinal deformity (ASD).STUDY DESIGN/SETTINGRetrospective review.PATIENT SAMPLEWe included 96 patients with ASD who underwent fusion from T9–T12 to the pelvis (>5 vertebrae fused) between 2008 and 2015.OUTCOME MEASURESPedicle screw trajectory was measured as the UIV pedicle screw–vertebra angle (UIV-PVA), which is the mean of the two angles between the UIV superior endplate and both UIV pedicle screws. (Positive values indicate screws angled cranially; negative values indicate screws angled caudally.) We measured UIV rod-vertebra angle (UIV-RVA) between the rod at the point of screw attachment and the UIV superior endplate.METHODSDuring ≥2-year follow-up, 38 patients developed PJK, and 28 developed PJF. Mean (± standard deviation) UIV-PVA was ?0.9° ± 6.0°. Mean UIV-RVA was 87° ± 5.2°. We examined the development of PJK and PJF using a UIV-PVA/UIV-RVA cutoff of 3° identified by a receiver operating characteristic curve, while controlling for osteoporosis, age, sex, and preoperative thoracic kyphosis.RESULTSPatients with UIV-PVA ≥3° had significantly greater odds of developing PJK (odds ratio 2.7; 95% confidence interval: 1.0–7.1) and PJF (odds ratio 3.6; 95% confidence interval: 1.3–10) compared with patients with UIV-PVA <3°. UIV-RVA was not significantly associated with development of PJK or PJF.CONCLUSIONSIn long thoracic fusion to the pelvis for ASD, UIV-PVA ≥3° was associated with 2.7-fold greater odds of PJK and 3.6-fold greater odds of PJF compared with UIV-PVA <3°. UIV-RVA was not associated with PJK or PJF.LEVEL OF EVIDENCEIII     

Total pancreatectomy with islet cell autotransplantation in a 2-year-old child with hereditary pancreatitis due to a PRSS1 mutation

Acute recurrent and chronic pancreatitis in children carries high morbidity and burden. Compared to adults, ~75% of the cases of chronic pancreatitis in children are associated with underlying genetic mutations. The decision to intervene and the optimal timing poses unique challenges. Total pancreatectomy and islet cell autotransplantation (TPIAT) provides definitive therapy to relieve pain and improve quality of life while minimizing the risk of pancreatogenic diabetes. Substantial clinical data are available for adults; however, information on clinical outcomes in children remains scarce, particularly for very young children. Herein, we present an unusual, complex case of a 2-year-old child that underwent a successful TPIAT due to hereditary pancreatitis with an underlying mutation in PRSS1 gene, complicated by unremitting pancreatic ascites, hemorrhage, and sepsis. This is the youngest case to be reported in the literature. We provide a comprehensive report of the course and procedures implemented in this patient to guide other teams when considering these extraordinary measures in similar cases.     

Temporal Potential of Phragmites australis as a Phytoremediator to Remove Ni and Pb from Water and Sediment in Lake Burullus,Egypt

In the current work, we investigated the concentration of Ni and Pb in different organs of Phragmites australis to evaluate its potential application as a phytoremediator to remove these two metals from contaminated water and sediment in Lake Burullus (a Ramsar site in Egypt). Above- and below-ground biomass of P. australis, water and sediment were sampled monthly for 1 year at six sites of Lake Burullus (three sites represent each of the northern and southern parts of the lake) using six randomly distributed quadrats (each of 0.5 × 0.5 m) at each sampling site. Significant variation was detected for Ni and Pb concentrations in the sediments and waters between the northern and southern sites of the lake. The biomass of P. australis in the southern sites was greater than that in the northern sites; in addition, the above-ground biomass was higher than the below-ground biomass. The above-ground organs accumulated higher concentrations of Ni and Pb than the below-ground organs. The Ni and Pb standing stocks data indicated that the organs of P. australis extracted higher amounts of Ni and Pb per its area from the southern rather than the northern sites. In the current study, the Ni and Pb above-ground standing stocks increased from the early growing season (February) and reached its peak during August and then decreased. The highest monthly Ni and Pb standing stock (18.2 and 18.4 g m^− 2, respectively) was recorded in the above-ground organs of plants in the southern sites in August. The bioaccumulation factor of Ni was 157.6 and 153.4 in the northern and southern sites, respectively, whereas that of Pb was 175.3 and 158.3. The translocation factor of Ni and Pb from the below- to above-ground organs was generally > 1. Thus, this reed species is a potential candidate for Ni and Pb phytoextraction. Based on our results, P. australis could be used for the extraction of Ni and Pb to reduce the pollution in Lake Burullus, if the above-ground biomass is harvested at its maximum value in August, as was the case regarding the maximum standing stock of Ni and Pb.

     

Diagnostic performance of <Superscript>18</Superscript>F-FDG PET/CT and whole-body MRI before and early after treatment of multiple myeloma: a prospective comparative study

Objective

To determine the diagnostic accuracy of WB-MRI and ¹⁸F-FDG PET/CT in detecting infiltration pattern, disease activity, and response to treatment in patients with multiple myeloma (MM).

Materials and methods

Fifty-six patients with confirmed MM were included in the present study for pre-treatment evaluation. Among these individuals, 22 patients were available for the post-treatment evaluation of response to therapy. All patients were imaged with both WB-MRI and ¹⁸F-FDG PET/CT. All radiographic findings of infiltration pattern, disease activity, and response to therapy were compared. The diagnostic performance of both modalities was estimated using bone marrow aspirate and biopsy as the reference test.

Results

For detection of active myelomatous tissue at diagnosis, WB-MRI achieved higher sensitivity (94%) than ¹⁸F-FDG PET/CT (75%) (p?=?0.0039), whereas both modalities achieved the same specificity (80%). For detection of residual myelomatous tissue after treatment, ¹⁸F-FDG PET/CT achieved higher specificity (86%) than WB-MRI (43%) (p?=?0.0081), whereas both modalities achieved the same sensitivity (75%).

Conclusion

WB-MRI is more sensitive than ¹⁸F-FDG PET/CT in the diagnosis of MM before treatment; however, ¹⁸F-FDG PET/CT is more specific than WB-MRI in detecting residual involvement in treated patients.