Influence of zinc on onset and progression of oral carcinogenesis in rats.

Three-week-old female rats were fed 0.09 (zinc-deficient), 0.77 (zinc-adequate) or 3.98 (zinc-supplemented) mmol zinc/kg diet in three experimental groups and the palatal mucosa was painted with the water-soluble carcinogen 4-nitroquinoline N-oxide (4NQO) three times a week for 20 weeks. The zinc-supplemented diet seemed to retard the induction of carcinogenesis, whereas a low-zinc diet had the opposite effect. Once initial cellular changes had been induced the supplementary zinc seemed to accelerate their further advancement. Zinc-deficiency in animals fed a copper/zinc low-zinc diet was reflected in the plasma and liver zinc levels as well as in the copper/zinc ratio. The development of cancer was accompanied by a decrease in plasma zinc and an increase in the plasma copper/zinc ratio as well as in the liver zinc. These changes were most remarkable in the zinc-supplemented group.     

The investigation of a recurrence of an AHC virus epidemic at Lucknow: a serosurvey for AHC virus antibodies before and after the epidemic.

An epidemic of acute haemorrhagic conjunctivitis (AHC) recurred at Lucknow during July to September 1975, after a gap of 4 years. Out of the 35 cases investigated thoroughly, 20 Entero-70-like cytopathogenic agents were isolated from the conjunctiva which were neutralized by antisera against AHC virus J670/71 of Japan. Seroconversion was seen in 7 out of 11 paired sera from patients. Serological study was also done on 100 sera collected before the AHC epidemic of 1971, 100 sera after 1971 and 100 sera after 1975 epidemic. There were no neutralizing antibodies in the pre-epidemic period, while 18% of sera after the first epidemic and 32% after the second epidemic showed antibodies. The incidence of antibodies was highest (43%) in children aged below 10 years. Of the children born after the first epidemic, 44% had antibodies. Thus our findings show that the AHC virus appeared for the firt time at Lucknow in 1971 and the almost complete absence of disease in children, and its mildness during second epidemic, may be due to immunity.     

Incidence and risk factors for post-penetrating keratoplasty glaucoma

Purpose:To carry out a prospective study to analyze the incidence and various preoperative, intraoperative, and postoperative risk factors for the development of PPKG.Methods:A total of 207 patients were analyzed prospectively, who were operated for penetrating keratoplasty (PK) in a tertiary eye care hospital between the time period of August 1, 2017 and February 28, 2018 and were followed up till the sixth month. Each patient was analyzed at every visit to determine the factors responsible for post-keratoplasty glaucoma.Results:Out of 207 eyes, post-PK glaucoma developed in 84 cases, which yielded an incidence of 41%. Incidence of PPKG (Post PK glaucoma) in various conditions was as follows: in repeat PK 62%, in perforated corneal ulcer 33%, in nonperforated corneal ulcer 29%, in corneal scar including adherent leukoma 37.2%, and in pseudophakic bullous keratopathy and aphakic bullous keratopathy, 14% and 80%, respectively. In age- and sex-adjusted multivariate analysis, the significant risk factors were age (P-value- 0.006), presence of PAS (P-value 0.001), and fellow eye glaucoma (P-value 0.04). Aphakia and combined surgery were not found to be significantConclusion:Our study recommends a meticulous examination of the fellow eye to assess the presence of glaucoma as it can increase the suspicion of glaucoma in the eye to be operated. The presence of PAS and age are important risk factors for developing PPKG. The risk of developing PPKG increases exponentially as the number of risk factors increases, but the presence of more than three risk factors does not add to the development of PPKG.     

Abdominal compartment syndrome: focus on the children

This article is a concise summary of intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) with an emphasis on factors relevant to their occurrence in children. It discusses the limitations in the direct application of the current World Society of Abdominal Compartment Syndrome consensus definitions and extrapolation of management practices derived from studying adult patients to the pediatric age group. Techniques that may be used for measuring intra-abdominal pressure (IAP) in children, normal IAP ranges, risk factors for developing ACS as well as current medical and surgical management options in children are discussed.     

Ziltivekimab for Treatment of Anemia of Inflammation in Patients on Hemodialysis: Results from a Phase 1/2 Multicenter,Randomized, Double-Blind,Placebo-Controlled Trial

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Massive immature mediastinal teratoma extending into the left pleural cavity

We report a case of a massive mediastinal teratoma in an 18-year-old woman who presented with a short history of exertional dyspnoea. The tumor arose from the left lobe of the thymus and extended into the left pleural cavity, completely compressing the left lung and extensively shifting the mediastinum to the right. Measuring 23 cm x 17 cm x 9 cm and weighing 2005 g it is one of the largest anterior mediastinal teratomas reported. It was successfully treated by surgical resection, with a final pathological diagnosis of a grades 1-2 immature teratoma.     

Effect of dietary cholesterol on biliary cholesterol content and bile flow in the hypothyroid rat

The hypothyroid rat model was used to investigate the effect of dietary-induced hypercholesterolemia on biliary cholesterol content and bile flow. Rats were divided into four dietary groups--diet A: Rat Chow; diet B: Rat Chow plus 0.1% propylthiouracil; diet C: Rat Chow plus 0.1% propylthiouracil, 0.3% taurocholate, 5% lard; diet D: Rat Chow plus 0.1% propylthiouracil, 0.3% taurocholate, 5% lard, and 1% cholesterol. After 6 wk, bile was collected and livers were excised for the preparation of membranes. In cholesterol-fed animals, biliary cholesterol content was increased. However, because of a significant decrease in the rate of bile flow that occurred in these animals, biliary cholesterol output was unchanged from the cholesterol output observed in control animals. Dietary cholesterol also caused a threefold increase in liver membrane cholesterol content and a 64% decrease in the activity of sodium-potassium-stimulated adenosine triphosphatase (Na+,K+-ATPase). In a separate group of animals, microsomes prepared from livers of control rats were incubated with phosphatidylserine liposomes, liposomes containing cholesterol, or buffer. The activity of Na+,K+-ATPase was increased in microsomes incubated with phosphatidylserine liposomes. However, when the cholesterol content of the microsomes was increased twofold by incubating the membranes with liposomes containing cholesterol, the stimulation of Na+,K+-ATPase activity was significantly decreased. The data suggest that in the cholesterol-fed hypothyroid rat, biliary cholesterol content is significantly increased; however, because of a decrease in the rate of bile flow, biliary cholesterol output is not changed. The decrease in bile flow is associated with an accumulation of cholesterol and a decrease in the activity of Na+,K+-ATPase in hepatic membranes.     

Frailty assessment and impact of frailty on outcomes after transcatheter aortic valve replacement

Introduction: Certain frail patients fail to achieve adequate functional or mortality benefit despite successful transcatheter aortic valve replacement (TAVR). Therefore, frailty assessment methods are becoming an important tool to identify and intervene on this high-risk patient subset for improving clinical outcomes.

Areas covered: The authors provide an overview of frailty and frailty assessment tools being used in clinical practice and discuss the impact of frailty on the cardiac patients, particularly among the TAVR population.

Expert commentary: Available evidence suggests that frailty assessment is critical for identifying patients at high risk of morbidity and mortality after TAVR procedures. However, there is lack of consensus for the best methodology to determine frailty and its optimal management in TAVR populations. Although, physical exercise is a commonly employed intervention to reduce frailty, a greater attention towards improving nutrition may convey more benefit than either intervention alone. Ongoing studies are investigating the benefits of a multicomponent approach to improve clinical outcomes in frail patients undergoing TAVR.