Long-term outcome of completion gastrectomy for nonmalignant disease

Between 1989 and 1995 we performed completion gastrectomy for non-malignant disease in 21 patients (11 men and 10 women, mean age 48.4 years). These patients had undergone a total of 48 prior gastric operations. Indications for completion gastrectomy in this group were anastomotic ulceration with stricture in eight patients, alkaline reflux gastritis and/or esophagitis in eight, postsurgical gastroparesis in two, gastroesophageal necrosis in two, and gastrocutaneous fistula in one. Major preoperative symptoms included nausea and vomiting in 16 cases, abdominal pain in 15, dysphagia in 14, heartburn in seven, and weight loss in five. Following completion gastrectomy, five patients (24%) had serious complications and there was one postoperative death (5%). Five patients were lost to follow-up. For the remaining 15 patients, mean follow-up has been 30 months with a range of 1 to 70 months. These patients were all interviewed and eight (53%) report significant improvement, two (13%) report moderate improvement, and four (27%) report no improvement; one patient (7%) has had worsening of symptoms since undergoing completion gastrectomy. The average body weight index was essentially unchanged after completion gastrectomy. We conclude that completion gastrectomy with Roux-en-Y esophagojejunostomy results in a favorable outcome in the majority of selected patients with diseases of the foregut who are unresponsive to less radical treatment. Presented at the Thirty-Seventh Annual Meeting of The Society for Surgery of the Alimentary Tract, San Francisco, Calif., May 19–22, 1996.     

Review of COVID-19 and male genital tract

COVID-19 pandemic leads to health challenges globally, and its diverse aspects need to be uncovered. Multi-organ injuries have been reported by describing potential SARS-CoV-2 entrance routes: ACE2 and TMPRSS2. Since these cell surface receptors’ expression has been disclosed within the male reproductive system, its susceptibility to being infected by SARS-CoV-2 has been summarised through this literature review. Expression of ACE2 and TMPRSS2 at RNA or protein level has been reported across various investigations indicates that the male genitalia potentially is vulnerable to SARS-CoV-2 infection. Presence of SARS-CoV-2 within semen samples and following direct viral damage, secondary inflammatory response causing orchitis or testicular discomfort and finally the amount of viral load leading testicular damage and immune response activation are among probable underlying mechanisms. Therefore, genital examination and laboratory tests should be considered to address the male reproductive tract complications and fertility issues.     

Pentraxin 3 is a marker of early joint inflammation in patients with juvenile idiopathic arthritis

Pentraxin 3 (PTX3) is an acute phase protein produced in different body tissues. The aims of this study were to characterize PTX3 secretion in synovial fluid (SF) of juvenile idiopathic arthritis (JIA) patients and to analyze the correlation of PTX3 levels in SF with clinical characteristics and the course of the disease. SF-PTX3 levels were measured in a cohort of 75 consecutive JIA patients followed in a single center. Patients’ clinical characteristics, disease course, and therapies were analyzed for their correlation with SF-PTX3 levels. A synovial cell line was used to study the kinetics of PTX3 secretion by synoviocytes. SF-PTX3 levels varied over a wide range. Elevated SF-PTX3 levels were detected in patients who subsequently required treatment with disease-modifying antirheumatic drugs during the follow-up period. SF-PTX3 levels were found to be inversely correlated with the length of time from onset of joint swelling. No correlation was found between synovial and serum PTX3 or C-reactive protein (CRP). Following in vitro stimulation of synovial cell line with TNFa or IL1, the secretion of PTX3 increases transiently in the first 48–72 h. A similar increase was obtained in patients’ synovial fluids but not with IL6. Higher SF-PTX3 levels were found when tested closer to arthritis exacerbation and 48–72 h after in vitro stimulation of cells from a synovial cell line, implying that PTX3 plays a role in early stages of inflammation. Higher SF-PTX3 levels were associated with several clinical features reflecting disease severity and prognostic data. Measuring SF-PTX3 levels may help in providing a more focused and patient-adjusted treatment.     

Osteoarticular complications of brucellosis in Hamedan, an endemic area in the west of Iran.

OBJECTIVE: To determine the frequency and clinical characteristics of osteoarticular complications of brucellosis in an endemic region in Iran. METHODS: In a prospective study we evaluated 245 patients with brucellosis diagnosed between January 2004 and December 2005. Patients included were those older than 8 years of age and who had clinical features suggestive of brucellosis and specific antibodies at significant titers, and/or positive blood or body fluid culture for Brucella species. A bone scan was performed in those with a clinical suspicion of osteoarticular involvement. RESULTS: Seventy patients (28.6%) had osteoarticular complications. Sacroiliitis was the most common complication (75.7%), followed by spondylitis (21.4%) and peripheral arthritis (8.6%). Spondylitis was the most common osteoarticular complication in the elderly. Relapses occurred in five (2%) patients, three of them with spondylitis. CONCLUSIONS: Osteoarticular disease is the most common complication of brucellosis in Western Iran. Sacroiliitis is the most common form of osteoarticular complication. With the use of a proper treatment regimen, the prospect for recovery is good.     

Investigating effects of hydroalcoholic extract of saffron on sex hormones in female rats undergoing chemotherapy with cyclophosphamide

Cyclophosphamide is an antineoplastic medicine that causes disorder in functions of the body systems. Thus, the purpose of this study is to investigate the effect of hydroalcoholic extract of saffron on improving the complications of cyclophosphamide on sex hormones. Fifty-six adult female Wistar rats were randomly divided into seven groups; control, sham (received distilled water, solvent extract, and drug), experimental groups 1, 2, and 3 (received cyclophosphamide (5 mg/kg/bw) + hydroalcoholic extract of saffron (2, 1, and 0.5 g/kg/bw), experimental group 4 (saffron 2 g/kg/bw), and experimental group 5 (cyclophosphamide 5 mg/kg/bw). Cyclophosphamide was given intraperitoneally, and extract by gavage was prescribed for 21 days. At the end of the experiment, after blood and preparation of serum, ELISA method was used for measuring the estrogen, progesterone, FSH, and LH hormones. Data and LSD test were analyzed with SPSS software (version 18). Results show that the concurrent use of low-dose cyclophosphamide and saffron extract can reduce toxic effect of cyclophosphamide on pituitary-gonadal axis and cause estrogen to be produced.     

Evaluation of the effect of static magnetic field in treatment of tendon injuries in dog

To assess the effect of magnetic field in experimental tendon injuries, ten clinically healthy adult indigenous dogs were divided into two equal groups (control and experimental). The left superficial digital flexor tendon was exposed and three windows of 6 mm thickness, 3 mm length, and 2 mm intervals were made under general anesthesia. In the experimental group, the dogs were subjected to a magnetic field of 6?×?800 G for 30 days. The tendon biopsy was collected from the site of operation on the postoperative day 30. Histomorphological changes indicated low rate of inflammatory cells, high rate of mature fibroblast, and increased normal collagen fibers, and these were better in the experimental group. The biomechanical test revealed that the tendons of the dogs in the experimental group were more resistant than tendons of the dogs in the control group. The result of this study indicated that magnetic field therapy reduced edema and local swelling, enhanced proliferation of fibroblasts, and regulated arrangement of collagen fibers, providing a good noninvasive physical therapy for tendinous injuries.