Designing and synthesis of injectable hydrogel based on carboxymethyl cellulose/carboxymethyl chitosan containing QK peptide for femoral head osteonecrosis healing

Femoral head necrosis is a debilitating disorder that typically caused by impaired blood supply to the hip joint. In this study, a novel injectable hydrogel based on Oxidized Carboxymethyl Cellulose (OCMC)-Carboxymethyl Chitosan (CMCS) polymers containing an angiogenesis stimulator peptide (QK) with a non-toxic crosslinking interaction (Schiff based reaction) was synthesized to enhance angiogenesis following femoral head necrosis in an animal model. The physicochemical features of fabricated injectable hydrogel were analyzed by FTIR, swelling and degradation rate, rheometry, and peptide release. Also, the safety and efficacy were evaluated following an in vitro hydrogel injection study and an avascular necrosis (AVN) animal model. According to the results, the hydrogel exhibited an appropriate swelling ratio and water uptake (>90 %, 24 h) as well as a suitable degradation rate over 21 days accompanied by a continuous peptide release. Also, data showed that hydrogels containing QK peptide boosted the proliferation, differentiation, angiogenesis, and osteogenic potential of both Bone Marrow mesenchymal Stem Cells (BM-MSCs) and human umbilical vein endothelial cells (HUVECs) (****p < 0.0001 and ***p < 0.001, respectively). Furthermore, molecular and histological evaluations significantly demonstrated the overexpression of Runx2, Osteocalcin, Collagen I, VEGF and CD34 genes (**p < 0.01 and ***p < 0.001, respectively), and also femoral head necrosis was effectively prohibited, and more blood vessels were detected in defect area by OCMC-CMCS hydrogel containing QK peptide (bone trabeculae >9000, ***p < 0.001). In conclusion, the findings demonstrate that OCMC-CMCS-QK injectable hydrogel could be considered as an impressive therapeutic construct for femoral head AVN healing.

A narrative review on adverse drug reactions of COVID-19 treatments on the kidney

Studies showed that the respiratory is not the only system affected by coronavirus 2, while cardiovascular, digestive, and nervous systems, as well as essential organs such as the kidneys, can be affected by this virus. In this review, we have studied the epidemiology, clinical, and laboratory findings on COVID-19 infection renal involvement, mortality, physiopathology, remaining renal sequels after recovery, underlying renal disease, and renal injury due to its treatment. Also, protective measures for kidney injury are explained in three levels. Evidence of viral particles and genome in the urine and renal tubular cells and signs of damage such as microangiopathy, hypercoagulopathy, and fibrosis are found in COVID-19 patients. The result of this study showed, in hospitalized COVID-19 patients, that the rate of acute kidney injury (AKI) was up to 46%, with a mortality ranging from 11 to 96%. A considerable proportion of patients with AKI would remain on renal replacement therapy. Proteinuria and hematuria are observed in 87 and 75% patients, and increased Cr and glomerular filtration rate (GFR) <60 ml/min per 1.73 m2 are observed in 29.6 and 35.3% of the patients, respectively. Remedsivir is considered to have adverse effects on GFR. COVID-19 patients need special attention to prevent AKI. Those with underlying chronic kidney disease or AKI need proper and explicit evaluation and treatment to improve their prognosis and decrease mortality, which should not be limited to the hospitalization period.

Management of Iatrogenic Medial Collateral Ligament Injury in Primary Total Knee Arthroplasty: A Systematic Review

Objectives

The medial collateral ligament (MCL) injury is one of the possible complications of primary total knee arthroplasty (TKA), which can lead to coronal-plane instability that requires surgical revision. Injured MCL can result in joint instability and polyethylene wear. Different strategies have been proposed for MCL reconstruction based on the location of the injury. However, there is a lack of clarity regarding the optimal method for handling an iatrogenic MCL injury throughout a TKA.

Methods

A PRISMA flow diagram was used to guide the systematic literature review. An extensive search was conducted in PubMed, Embase, Scopus, Web of Science, and Google Scholar. Newcastle Ottawa scale checklist was used to assess the methodological quality of the articles.

Results

A total of 19 qualitative studies, including non-cadaveric patients with MCL injury during TKA, were identified after analyzing the full text of the articles. All included studies were either retrospective, observational cohort or case series. A total of 486 patients were studied to gather information on the methods used to repair the MCL and their results. Most injuries arose in the tibial attachment, which surgeons mostly realized during the final stages of surgery. Used techniques can be categorized into three main groups: Primary repair, Repair with augmentation, and changing prosthesis characteristics.

Conclusion

This systematic review demonstrated that the most popular management of iatrogenic MCL injury was using suture anchors, staples, screws and washers, and more constrained prostheses. The proper method should be decided considering the site of the MCL injury.

Neuromonitoring in pre-post and intraoperative total hip replacement surgery in type 4 high-riding developmental dysplasia of the hip

OBJECTIVE

The choice approach to treating congenital dislocation of the hip joint is total hip replacement (THR). One of the severe but uncommon complications of THR is nerve damage. The most common nerve injury associated with total hip arthroplasty (THA) is sciatic nerve palsy, and the second typical nerve damage with THA is femoral nerve paralysis.

PATIENTS AND METHODS

In this prospective cohort study, 35 patients with type 4 high riding developmental dysplasia of the hip (DDH) who were candidates for THA were enrolled. The somatosensory evoked potential (SSEP), motor evoked potential (MEP), and electromyography (EMG) were measured pre-post and intraoperatively to check the status of the sciatic and femoral nerves. After collecting the mentioned information, the data was analyzed by SPSS V. 26 software.

RESULTS

Out of 35 patients with DDH type 4 who were candidates for THR, nine patients showed a 50 percent decrease in SSEP amplitude, and six patients showed a 10 percent decrease in SSEP latency. One patient during and two patients after the surgery showed more than an 80 percent decrease in MEP amplitude. Meanwhile, 14 patients showed abnormal spikes during and two patients after surgery regarding EMG. All patients with disturbed neurophysiological findings reverted to normal in the further investigation during follow-up. No correlation was found between increasing limb shortness and these modalities.

CONCLUSIONS

Using neuromonitoring techniques during Total Hip Arthroplasty (THA) can help identify potential early nerve damage, prevent post-surgical complications, and improve high-riding DDH patient outcomes.

Digital monitoring of weight-bearing improves success rates and reduces complications in lower extremity surgeries

The aim of this study is to develop a digital monitoring system to track weight and evaluate its impact on postoperative outcomes after lower extremity surgeries (LES). This parallel randomized controlled trial enrolled 266 patients who underwent LES (fracture or joint replacement) at our medical center between March 11, 2022, and January 10, 2023. Patients were randomly assigned to the intervention and control groups in a 1:1 ratio. The intervention group (n=116) used a cane and shoes equipped with a weight-bearing system after lower limb surgery, while the control group (n=116) used a simple cane and shoes without a weight-bearing system. The primary outcomes included callus formation, duration of union, and success rate of union in the two groups. The intervention group had a significantly higher rate of complete surgical success than the control group (93.9% vs. 79.3%, p=0.001). The intervention group also had a significantly lower risk of non-union than the control group (OR: 2.33, 95% CI: 1.14, 3.48, p=0.001). The mean duration of surgery until the time of union and the meantime of callus formation was significantly lower in the intervention group (p=0.01). The use of a digital monitoring system for weighing in LES significantly increased the success rate and reduced post-operative complications. Therefore, incorporating this system can enhance the rehabilitation process and prevent revision surgeries in patients with LES.

Cross‑cultural adaptation and validation of the Persian version of the new Knee Society Knee Scoring System (KSS)

BACKGROUND

The new Knee Society Knee Scoring System (KSS) has been widely used to assess the symptoms, satisfaction, expectations, and physical activities of patients who undergo total knee arthroplasty (TKA). KSS has been translated and validated into many languages but not Persian. The aim of this study was to translate and evaluate the validity and reliability of the Persian version of the new KSS.

METHODS

The Persian version of the new KSS was translated and culturally adapted according to international guidelines, including translation, back-translation, pre-testing, and expert committee review. A total of 142 patients scheduled to undergo TKA were included in this study and were asked to complete the Persian-KSS, Oxford Knee Score (OKS), and the Visual Analogue Scale (VAS) index both two weeks before the surgery and 6 months after the surgery. Face, content, and construct validity were evaluated to assess the validity of Persian-KSS.

RESULTS

The Persian-KSS was comprehensive, indicating that the Persian version of KSS was clear and easy to understand for Persian-speaking patients undergoing TKA. The reliability of the Persian-KSS, assessed by Cronbach's alpha, was 0.894 and 0.800 for the pre- and post-operative stages, respectively. The intraclass correlation coefficient (ICC) assessed the test-retest reliability, which was 0.766 and 0.796 for the pre- and post-operative stages, respectively. The construct validity analysis of Persian-KSS demonstrated a statistically significant correlation between Persian-KSS and the OKS (r = - 0.935, p-value = 0.000 for the pre-operative stage, and r = - 0.809, p-value = 0.000 for the post-operative stage) and VAS index (r = - 0.401, p-value = 0.001 for the pre-operative stage and r = - 0.259, p-value = 0.029 for the post-operative stage).

CONCLUSION

The Persian-KSS, developed after the translation and cross-cultural adaptation process, was proven to be a reliable and valid assessment measure for those who undergo TKA.

Analysis of reproduction success, growth and milk trajectories and response to nutritional challenge in two Alpine goat lines selected on divergent longevity

This study aims to investigate whether the variation in reproduction success, growth, and milk trajectories is associated with different adaptive strategies in the short term (response to an acute nutritional challenge), using two Alpine goat lines. A total of 382 Alpine goats (179 low longevity (low_LGV) and 203 high longevity (high_LGV)), selected for divergent functional longevity from a commercial population, were monitored for 4 years and recorded for BW, reproduction and milking performance. Every year, an average of fifty primiparous goats were exposed to a 2-d nutritional challenge in early lactation. A polynomial model was used to analyse the lifetime trajectory of lactation and BW. A piecewise model was used to analyse the individual milk yield and responses of milk components to the nutritional challenges. The statistical analysis revealed that the two lines had a similar performance for total milk yield in the first lactation, BW at birth and at first kidding, litter size and weight, kidding interval and interval from the first insemination to conception. BW trajectories revealed that low_LGV goats had a greater BW in pregnancy but then lost more weight in early lactation compared to high_LGV goats, which showed a greater BW after kidding. Milk trajectories showed that the high_LGV goats had a higher initial milk yield, an earlier but less marked lactation peak and more persistency in milk production in late lactation than low_LGV goats. Except for milk protein content, quite similar response and recovery profiles of milk yield and milk fat content were observed during the challenge for both lines. The response to the challenge was positively correlated to the initial level of milk production in early lactation but negatively correlated with milk production decline after the peak. This finding suggests that the low_LGV goats were more adapted to allocate resources to meet an expected physiological change such as gestation and lactation. However, high_LGV goats allocate more than low_LGV goats for structural mass and may better cope with an unexpected environmental change such as nutritional deficit.

Core decompression combined with local DFO administration loaded on polylactic glycolic acid scaffolds for the treatment of osteonecrosis of the femoral head: a pilot study

BACKGROUND

Deferoxamine (DFO) angiogenesis induction potential has been demonstrated in earlier studies, but not in the osteonecrosis of the femoral head (ONFH). In this study, we evaluated the outcome of ONFH treated with combined core decompression and local DFO administration loaded on Polylactic Glycolic Acid (PLGA).

PATIENTS AND METHODS

In a pilot experimental study, six patients (10 hips) with early-stage non-traumatic ONFH were treated by core decompression, and concurrent injection of local DFO loaded on PLGA scaffold into the subchondral femoral head. Outcome measures were evaluated before the surgery and 12 and 24 months after the surgery and included visual analog scale (VAS) for pain, modified Merle d'Aubigné-Postel (MAP) score for hip function by MRI, and rate of osteonecrosis assessed by the modified.

RESULTS

The mean MPA score was 14.7 ± 1.16 before the surgery and 16.7 ± 1.41 one year after the surgery (P = 0.004). The mean VAS for pain was 4.7 ± 1.25 before the surgery and 1.8 ± 1.03 one year after the surgery (P = 0.005). The mean Kerboul angle was 219 ± 58.64 before the operation and 164.6 ± 41.82 one year after the operation (P < 0.001). Osteonecrosis progression or collapse was not seen in any of the patients at the final follow-up. No postoperative side effect attributed to the DFO was noticed, as well.

CONCLUSION

In short-term follow-up, combined core decompression and local DFO administration not only prevent the progression of ONFH but also reduces the rate of osteonecrosis significantly. However, future controlled studies are required to confirm the present results.

TRIAL REGISTRATION

IRCT20161121031003N3, 16/04/2019.

Natural psychedelics in the treatment of depression; a review focusing on neurotransmitters

Natural psychedelic compounds are emerging as potential novel therapeutics in psychiatry. This review will discuss how natural psychedelics exert their neurobiological therapeutic effects, and how different neurotransmission systems mediate the effects of these compounds. Further, current therapeutic strategies for depression, and novel mechanism of action of natural psychedelics in the treatment of depression will be discussed. In this review, our focus will be on N, N-dimethyltryptamine (DMT), reversible type A monoamine oxidase inhibitors, mescaline-containing cacti, psilocybin/psilocin-containing mushrooms, ibogaine, muscimol extracted from Amanita spp. mushrooms and ibotenic acid.

Trunnionosis in metal-on-polyethylene total hip arthroplasties: Report two cases

INTRODUCTION AND IMPORTANCE

Several studies have discussed trunnionosis in metal-on-metal total hip arthroplasties. However, trunnionosis in metal-on-polyethylene total hip arthroplasties has been less frequently discussed.

CASE PRESENTATION

In this study, trunnionosis in two male patients undergoing metal-on-polyethylene total hip arthroplasty, which was done to treat femoral head osteonecrosis were reported and discussed adequately.

CLINICAL DISCUSSION

Total hip arthroplasties (THA) were done for the treatment of femoral head osteonecrosis in these cases. In the first case, trunnionosis occurred one year after the revision of the primary THA, and in the second case occurred ten years after the primary THA. Both of these cases were presented with reduced range of motion. After surgery, the symptoms were resolved, and the patients remained complication-free until the last follow-up.

CONCLUSION

This report raises awareness regarding the importance of trunnionosis as a serious complication of modular total hip arthroplasty.

Bicondylar Hoffa fracture with concurrent medial and lateral collateral ligament avulsion: A case report

Hoffa fractures are rare fractures of the femoral condyle that occur in the coronal plane of the bone. In most cases, high-energy trauma leads to isolated coronal fractures of one of the femoral condyles, medial or lateral. Even with a typical unicondylar Hoffa fracture, our patient sustained a bicondylar Hoffa fracture in his right knee after falling from high and suffering direct trauma as well. The fracture was approached from both the medial and lateral sides of the distal femur. Three-month follow-up showed excellent functional scores, no laxity, and no pain.

Spinopelvic Parameters as Risk Factors of Nonspecific Low Back Pain: A Case-Control Study

Background

The effect of spinopelvic alignment on low back pain (LBP) incidence has been studied in many investigations. However, the interrelation between spinopelvic parameters and LBP is poorly understood. In particular, it is unknown whether particular patterns of spinopelvic parameters render nonspecific LBP. In this study, we aimed to evaluate the role of spinopelvic parameters as risk factors of nonspecific LBP.

Methods

In this case-control study, spinopelvic parameters, including lumbar lordosis (LL), sacral slope (SS), pelvic tilt (PT), and pelvic incidence (PI), were compared between 148 patients with nonspecific LBP and 148 healthy controls. Demographic characteristics of the patients, such as age, gender, occupation, smoking, diabetes mellitus, and body mass index (BMI), were recorded as confounders. Spinopelvic parameters were assessed using radiographic findings in 2 groups. The analysis was done once as univariate (Kolmogorov-Smirnov test) and once as multivariate (multivariate logistic regression) analysis.

Results

Univariate analysis showed that female gender, higher BMI, smoking, and blue-collar jobs were associated with a higher risk of nonspecific LBP. LL, SS, and PI, but not PT, were all greater in LPB patients in the univariate analysis regarding the spinopelvic parameters. Multivariate analysis showed female gender (odds ratio adjusted (ORAdj) = 4.26 [95% CI, 2.11-9.58]; P = 0.001) and LL (ORAdj = 1.58; [95% CI, 1.18-3.22]; P = 0.026) were predictable risk factors for Nonspecific LBP.

Conclusion

Spinopelvic parameters, particularly LL, could be considered as risk factors of nonspecific LBP so that a more significant LL might indicate a greater risk of LBP. However, the role of other parameters in this association could not be neglected.

Short-term Complications of Open Latarjet Procedure for Recurrent Anterior Shoulder Dislocation

Background

Anterior dislocation is the most common type of shoulder dislocation, and even after appropriate treatment, recurrence after a primary traumatic anterior dislocation is highly frequent. Surgical options for treating recurrent anterior dislocations mainly include Bankart arthroscopic and Latarjet open surgery. We aimed to evaluate the outcomes and complication rates of the open Latarjet procedure in a series of patients with recurrent anterior shoulder dislocation.

Methods

A total of 55 patients with recurrent anterior shoulder dislocation who underwent an open Latarjet procedure were included in this retrospective cohort study. Shoulder range of motion and postoperative complications, including neurapraxia, re-dislocation, hematoma, infection, dehiscence, implant failure, and pain, were evaluated.

Results

The mean age of the patients was 27.7 ± 6.5 years . The mean time interval after the first dislocation was 3.4 ± 2.7 years . The mean preoperative and postoperative forward flexion (P = 0.200), abduction (P = 0.200), external rotation (P = 0.066), and internal rotation (P = 0.310) were not significantly different. Postoperative complications included 1 case of postoperative musculocutaneous nerve neurapraxia, 1 case of re- dislocation, 1 case of wound dehiscence, and 2 cases of screw breakage. Postoperative pain was also recorded in 11 (20%) patients that were either in the form of occasional night pain (n = 6) or activity-dependent pain (n = 5).

Conclusion

Open Latarjet procedure is an efficient procedure for the treatment of recurrent anterior shoulder dislocation. However, its rate of complications remains relatively high, and surgeons must consider this drawback in their decision-making and address patients' expectations.

A Study of Characteristic Features and Diagnostic Roles of X-ray and MRI in Calcifying Tendinitis of the Shoulder

Background: Calcifying tendinitis (CT) is an enigmatic lesion with several obscure aspects and it is a common disorder of the upper extremity characterized by the presence of calcifications in rotator cuff tendons and synovial tissues. In this study, we aimed to review the demographic and clinical characteristics, as well as radiologic and treatment history in CT patients who were referred with shoulder pain.

Methods: In this cross-sectional study, a total of 146 patients who were referred with a shoulder CT were included. The definitive diagnosis was based on a combination of plain radiograph and magnetic resonance imaging (MRI). A predesigned independent t test was used to capture demographic and clinical data, as well as radiologic and treatment histories, and a chi-square test was utilized to assess the statistical correlation between qualitative variables.

Results: The median age of the patients was 42.5 years. The female to male ratio was 2.3 to 1. The complaint of restricted shoulder movement was recorded in 107 (73.3%) patients and more frequently in women (p = 0.042). Night pain was present in 109 (74.7%) patients. The current and previous diagnoses matched in 36.1% (13 out of 36) of patients who only had MRI and in 63.6% (35 out of 55) patients who had both MRI and plain radiograph with them. Supraspinatus tendon was the main site of calcified deposition 65% (95 out of 146).

Conclusion: CT is frequent at the age of around 40 and in the female gender. The diagnosis should be based on a combination of radiography and MRI and not based on MRI alone. The efficacy of different conservative treatments remains to be unwrapped.

Cell-Matrix Elastocapillary Interactions Drive Pressure-based Wetting of Cell Aggregates

Cell-matrix interfacial energies and the energies of matrix deformations may be comparable on cellular length-scales, yet how capillary effects influence tis sue shape and motion are unknown. In this work, we induce wetting (spreading and migration) of cell aggregates, as models of active droplets onto adhesive substrates of varying elasticity and correlate the dynamics of wetting to the balance of interfacial tensions. Upon wetting rigid substrates, cell-substrate tension drives outward expansion of the monolayer. By contrast, upon wetting compliant substrates, cell substrate tension is attenuated and aggregate capillary forces contribute to internal pressures that drive expansion. Thus, we show by experiments, data-driven modeling and computational simulations that myosin-driven 'active elasto-capillary' effects enable adaptation of wetting mechanisms to substrate rigidity and introduce a novel, pressure-based mechanism for guiding collective cell motion.

Characteristic Features and Outcomes of Open Gunshot Fractures of Long-bones with Gustilo Grade 3: A Retrospective Study

BACKGROUND

The incidence of gunshot injuries is growing, and civilian orthopedics should be more aware of the treatment and consequences of these injuries. This study aimed to describe the characteristic features and complications of gunshot injuries to long-bones.

METHODS

A total of 50 patients who presented with an open gunshot fracture of the tibia, humerus, and femur in the emergency room of our hospital were included in this study. Primary irrigation and debridement, as well as prophylactic antibiotics, were administered in the emergency room. The treatment was performed either conservatively (n=4) or surgically (n=46). The external fixator, nailing, or plating was used for surgical fixation.

RESULTS

The mean age and follow-up duration of the patients were 32.3±9.9 years and 13.1±5.6 months, respectively. The most common injured long bone was the femur (32 of 50). Regarding the Gustilo grade, IIIa, IIIb, and IIIc were observed in 37, 7, and 5 patients, respectively. The Masquelet technique was used for 7 (14%) patients, and 12 (24%) cases had skin flaps. Furthermore, the vascular injury was present in 5 (10%) patients, and Malunion of the fracture site was observed in 5 (10%) cases. Nonunion of the fractured bone occurred in 13 (26%) patients that was significantly associated with the presence of vascular injuries (P=0.02). Postoperative infection occurred in 9 (18%) patients and was significantly associated with the presence of skin flap (P=0.014).

CONCLUSION

Gunshot injuries of long bones are associated with a high incidence of post-treatment complications, such as infection and nonunion, and therefore, more intensive care should be taken to avoid these complications.

Intra-articular osteoid osteoma of the capitulum: A diagnostic challenge

Here, we describe the first case of intra-articular osteoid osteoma of the capitulum, which is presented as elbow pain, extension lack, and sensation of click in joint flexion. Surgical treatment either arthroscopic or open is more in use in this location of the tumor than cortical osteoid osteoma.

Active Regulation of Pressure and Volume Defines an Energetic Constraint on the Size of Cell Aggregates

We explore the relationship between the nonequilibrium generation of myosin-induced active stress within the F-actin cytoskeleton and the pressure-volume relationship of cellular aggregates as models of simple tissues. We find that due to active stress, aggregate surface tension depends upon its size. As a result, both pressure and cell number density depend on size and violate equilibrium assumptions. However, the relationship between them resembles an equilibrium equation of state with an effective temperature. This suggests that bulk and surface properties of aggregates balance to yield a constant average work performed by each cell on their environment in regulating tissue size. These results describe basic physical principles that govern the size of cell aggregates.

Multiple Schwannomas in Sciatic Nerve: A Rare Case Report

Schwannomas are the most common nerve sheath tumors which are usually solitary enucleated lesions. Multiple schwannomas are a rare circumstance which may occur with or without other manifestations of neurofibromatosis. In this study, we report the case of a 45-year-old man presenting with pain and swelling in the thigh and popliteal space without any manifestation of neurofibromatosis or neurologic problems. Surgery was performed and revealed four separated tumors in the sciatic nerve which was characteristic of schwannoma and confirmed by pathologic findings. Although multiple schwannomas are frequently associated with neurofibromatosis, the current case demonstrated a patient with multiple schwannomas without any manifestation of neurofibromatosis.

Friction on incommensurate substrates: Role of anharmonicity and defects

We present molecular dynamics simulations of one- and two-dimensional bead-spring models sliding on incommensurate substrates after an initial kick, in the case where the coupling to the underlying substrate is weak, i.e., energy can dissipate only into the internal degrees of freedom of the sliding object, but not into the substrate below. We investigate how sliding friction is affected by structural defects and interaction anharmonicity. In their absence, we confirm earlier findings, namely, that at special resonance sliding velocities, friction is maximal. When sliding off-resonance, partially thermalized states are possible, whereby only a small number of vibrational modes becomes excited, but whose kinetic energies are already Maxwell-Boltzmann distributed. Anharmonicity and defects typically destroy partial thermalization and instead lead to full thermalization, implying much higher friction. For sliders with periodic boundaries, thermalization begins with vibrational modes whose spatial modulation is compatible with the incommensurate lattice. For a disk-shaped slider, modes corresponding to modulations compatible with the slider radius are initially the most dominant. By tuning the mechanical properties of the slider's edge, this effect can be controlled, resulting in significant changes in the sliding distance covered.

Detection of Fasciola Hepatica in Lori Sheep Using Polymerase Chain Reaction and Conventional Diagnostic Methods in Western Iran

Fascioliasis is an emerging and important food and water-borne disease in human communities which has become one of the most important health challenges in countries, like Iran. It causes weight loss, a decrease in feed conversion ratio as well as milk and meat production, and also reduces fertility in animals the prevalence of fasciolosis is increasing in some regions of the world due to various factors. Different methods have been used for the detection of Fasciola hepatica in animals. This study is the first to detect F. hepatica in Lori sheep using polymerase chain reaction (PCR) and conventional diagnostic methods in Western Iran. During three months, 195 fecal samples were collected from sheep in Lorestan province, Iran, using the stratified random sampling method. The conventional diagnostic methods, including wet mount microscopic examination and concentration assays, as well as the PCR technique targeting the intergenic spacer gene of F. hepatica, were used for the detection of the parasite in sheep. In total, 4 (2.1%) out of 195 examined stool samples were positive for F. hepatica based on the conventional assays. The PCR test was positive for F. hepatica in7 (3.6%) samples of 195 studied specimens. Statistical analyses of the data revealed that there is a significant difference between the results of diagnostic methods for F. hepatica detection (P=0.0421). Finally, the results showed that PCR has more diagnostic sensitivity, compared to conventional diagnostic methods, including the concentration techniques and microscopic examination. Hence, it can be advised to use PCR for the detection of F. hepatica in sheep.

Environmental Effects of Temperature and Water Potential on Mycelial Growth of Neocosmospora solani and Fusarium spp. Causing Dry Root Rot of Citrus

This study aimed at evaluating the effect of environmental factors temperature and water potential (Ψw) on the growth of Neocosmospora (Fusarium) solani and three Fusarium species (F. oxysporum, F. equiseti and F. brachygibbosum) associated with citrus dry root rot and to determine the optimum and marginal rate for their growth. The effects of incubation temperature (5-40 °C), water potentials (Ψw) (- 15.54; - 0.67 MPa) (0.89-0.995 a_w) and their interaction (5-30 °C) was evaluated on the in vitro radial growth rates of Fusarium spp. and on their lag phase. Secondary models were used to model the combined effect of these factors on radial growth rate. The results underlined a highly significant effects (P < 0.001) of Ψw and temperature and their interactions on radial growth rates and lag phases (λ). The Four studied species were shown tolerant to a temperature of 35 °C with an optimum mycelial growth at 30 for N. solani and F. oxysporum and at 25 °C for F. equiseti and F. brachygibbosum. However, no growth was observed at both temperatures 5 and 40 °C and at Ψw of - 9.68 MPa (0.93 a_w). The optimum water potential for growth was ≥- 2.69 MPA (>0.98 a_w). The results from the polynomial model and response surface showing good agreement between observed and predicted values. The external validation on citrus fruit indicated slight differences between predicted and observed values of radial growth. The results of this study will be beneficial for understanding the ecological knowledge of these species and thereby limited preventively their occurrence.

Missed Hip Fractures in Pediatrics

The article's abstract is not available.

Clozapine attenuates mitochondrial dysfunction, inflammatory gene expression, and behavioral abnormalities in an animal model of schizophrenia

Beyond abnormalities in the neurotransmitter hypothesis, recent evidence suggests that mitochondrial dysfunction and immune-inflammatory responses contribute to the pathophysiology of schizophrenia. The prefrontal cortex (PFC) undergoes maturation and development during adolescence, which is a critical time window in life that is vulnerable to environmental adversities and the development of psychiatric disorders such as schizophrenia. Applying eight weeks of post-weaning social isolation stress (PWSI) to rats, as an animal model of schizophrenia, we decided to investigate the effects of PWSI on the mitochondrial function and expression of immune-inflammatory genes in the PFC of normal and stressed rats. To do this, control and PWSI rats were divided into treatment (clozapine; CLZ, 2.5 mg/kg/day for 28 days) and non-treatment sub-groups. Our results showed PWSI caused schizophrenic-like behaviors in rats and induced mitochondrial dysfunction as well as upregulation of genes associated with innate immunity in the PFC. Chronic treatment with CLZ attenuated the effects of PWSI on behavioral abnormalities, mitochondrial dysfunction, and immune-inflammatory responses in the PFC of rats. These results may advance our understanding about the mechanism of action of CLZ that targets mitochondrial dysfunction and immune-inflammatory responses as factors involved in the pathophysiology of schizophrenia.

Simvastatin and Ezetimibe-Loaded Nanofibers Administered Locally to Augment Bone Healing

The article's abstract is not available.  

Pleiotropic effects of statins: A focus on cancer

The statin drugs ('statins') potently inhibit hydroxymethylglutaryl-coenzyme A (HMG-CoA) reductase by competitively blocking the active site of the enzyme. Statins decrease de novo cholesterol biosynthesis and thereby reduce plasma cholesterol levels. Statins exhibit "pleiotropic" properties that are independent of their lipid-lowering effects. For example, preclinical evidence suggests that statins inhibit tumor growth and induce apoptosis in specific cancer cell types. Furthermore, statins show chemo-sensitizing effects by impairing Ras family GTPase signaling. However, whether statins have clinically meaningful anti-cancer effects remains an area of active investigation. Both preclinical and clinical studies on the potential mechanisms of action of statins in several cancers have been reviewed in the literature. Considering the contradictory data on their efficacy, we present an up-to-date summary of the pleiotropic effects of statins in cancer therapy and review their impact on different malignancies. We also discuss the synergistic anti-cancer effects of statins when combined with other more conventional anti-cancer drugs to highlight areas of potential therapeutic development.

Smoking and disability pension: a systematic review and meta-analysis

OBJECTIVES

Smoking has negative consequences on occupational health. The current meta-analysis was conducted with the aim to pool the studies about smoking and increased disability pension.

STUDY DESIGN

Systematic review and meta-analysis.

METHODS

Articles were found in the scientific literature using keywords, and searching was limited to prospective cohort studies that had been published before August 2018. Based on the inclusion and exclusion criteria, 23 prospective cohort studies were selected. The analyses were carried out on the basis of the random-effects method. Subgroup analysis was also carried out. Finally, the bias of publication was examined using Begg's test, the Egger test, the trim-and-fill method, and the funnel plot.

RESULTS

Twenty-three studies were included. The results showed a positive association between smoking and disability pension, with a risk ratio (RR) of 1.41 and 95% confidence interval (95% CI) of 1.30-1.53 (P < 0.001). In men, the RR was equal to 1.48 and 95% CI was equal to 1.30-1.68 (P < 0.001). In women, the RR was equal to 1.23 and 95% CI was equal to 1.09-1.37 (P = 0.001). In current smokers, the RR was equal to 1.41 and 95% CI was equal to 1.26-1.57 (P < 0.001). In former smokers, the RR was equal to 1.16 and 95% CI was equal to 1.05-1.29 (P = 0.003). Qualitative evaluation showed that the studies had a low level of selection bias, data collection bias, and withdrawal and dropout bias.

CONCLUSIONS

Smoking is a risk factor for increasing disability pension, and men are at higher risk of disability pension. In addition, both current and former smokers are in high risk of disability pension. Overall, it can be concluded that smoking is a risk factor for occupational health.

22 Whole-brain functional connectivity based on the graph theory analysiisn Psychogenic Non-Epileptic Seizures (PNES)

Objective

Despite being the subject of many studies over the past two decades, mechanisms underlying psychogenic non-epileptic seizures (PNES) are still poorly understood. We tried to address this issue by utilizing brain functional connectivity analysis to identify brain regions with abnormal activities in patients with PNES. In a case-control study, we performed graph based network analysis, a robust technique that determines the organization of brain connectivity and characterizes topological properties of the brain networks.

Methods

Twelve individuals with PNES and twenty-one healthy control subjects were examined. Resting state functional magnetic resonance imaging (rsfMRI) was acquired. All subjects were asked to keep their eyes open during the scanning process. The rsfMRI analysis consisted of pre-processing, extracting the functional connectivity matrix (FCM) based on the AAL atlas, threshold for binary FCM, constructing a graph network from FCM and extracting graph features, and finally statistical analysis. For all cortical and subcortical regions of the AAL atlas, we calculated measures of ‘degree,’ which is one of the features of the graph theory. Results: Our results revealed that, as compared to the healthy control subjects, patients with PNES had a significantly lower degree in some brain regions including their left and right insula (INS), right Putamen (PUT), left and right Supramarginal gyrus (SMG), right Middle occipital gyrus (MOG), and left and right Rolandic operculum (ROL). In contrast, degree was significantly greater in two regions [i.e., right Caudate (CAU) and left Inferior frontal gyrus orbital part (ORBinf)] in patients with PNES compared to that in controls.

Conclusion

Our findings suggest that functional connectivity of several major brain regions are different in patients with PNES compared with that in healthy individuals. While there is hypoactivity in regions important in perception, motor control, self- awareness, and cognitive functioning (e.g., insula) and also movement regulation (e.g., putamen), there is hyperactivity in areas involved in feedback processing (i.e., using information from past experiences to influence future actions and decisions) (e.g., caudate) in patients with PNES. The observation that individuals with PNES suffer from a wide range of abnormal activities in functional connectivity of their brain networks is consistent with the fact that PNES occur in a heterogeneous patient population; no single mechanism or contributing factor could explain PNES in all patients.

Mutations in the Reelin pathway are associated with abnormal expression of microglial IgG FC receptors in the cerebellar cortex

Microglia are the immune cells of the central nervous system involved in a variety of developmental processes, such as regulation of cell death and survival, spatial patterning, and contribute to the development of Purkinje cells (PCs) during migration. Microglia express immunoglobulin G Fc receptors (FcgRs). In this report, we describe microglial FcgR expression and its relation to abnormal PC migration in the cerebellum during development. To detect microglial FcgR, the direct anti-IgG (secondary antisera) and high concentrations of Triton X-100 were applied as a method for labeling microglial cells without the use of any specific primary antiserum. By using Acp2^-/- mice, which show an excessive PC migration into the molecular layer (ml), and 3 different types of mice with a null to alter the Reelin pathway (Reeler-, Dab1 (SCM)-, and Apoer mutant mice), we studied the location of PCs and the expression of FcgRs. Wild type littermates were used as controls in all studies. We show that the expression of microglial FcgRs was absent and PCs were ectopically located in the white matter in the cerebella of all mutant mice, except for the Acp2^-/- mice (PCs were located in the ml). These results suggest a role for FcgRs in the Reelin signaling pathway, not in regulating PC migration, but rather in the adaptation to an environment with a relatively large number of ectopically located PCs. However, the exact correlation between the ectopic location of PCs and lack of FcgRs in Reeler, SCM, and Apoer^-/- mice and the presence of FcgRs and directed PC location in the ml in Acp2^-/- mice are yet to be determined.

Chronic Ethanol Exposure Alters DNA Methylation in Neural Stem Cells: Role of Mouse Strain and Sex

Prenatal alcohol exposure (PAE) is considered as a risk factor for the development of fetal alcohol spectrum disorders (FASD). Evidence indicates that PAE affects epigenetic mechanisms (such as DNA methylation) and alters the normal differentiation and development of neural stem cells (NSC) in the fetal brain. However, PAE effects depend on several factors such as sex and strain of the studied subjects. Here, we investigated whether murine sex and strain contribute to the effects of chronic ethanol exposure on DNA methylation machinery of differentiating NSC. Further, the effects of PAE on glial lineage (including both astrocytes and oligodendrocytes) in a sex- and strain-dependent manner have not been studied yet. To examine the effects of chronic ethanol exposure on gliogenesis, we exposed differentiating NSC to glio-inductive culture conditions. Applying a standard in vitro model system, we treated male and female differentiating NSC (obtained from the forebrain of CD1 and C57BL/6 embryos at embryonic day 14.5) with chronic ethanol exposure (70 mM) for 8 days. We show that ethanol induces global DNA hypomethylation, while altering the expression of DNA methylation-related genes in a sex- and strain-specific manner. The observed change in cellular DNA methylation levels was associated with altered expression of glial markers CNPASE, GFAP, and OLIG2 in CD1 (but not C57BL/6) cells. We conclude that the impact of ethanol effect on DNA methylation is dependent on cellular sex and strain. Also, ethanol impact on neural stem cell fate commitment was only detected in cells isolated from CD1 mouse strain, but not in C57BL/6 cells. The results of the current study provide evidence that sex and strain of rodents (C57BL/6 and CD1) during gestation are important factors, which affect alcohol effects on NSC differentiation and DNA methylation. Results of this study may also help in interpreting data on the developmental toxicity of many compounds during the gestational period.

Resting-State Functional Connectivity in Popular Targets for Deep Brain Stimulation in the Treatment of Major Depression: An Application of a Graph Theory

We examined the functional connectivity of subcallosal cingulate gyrus (SCG), nucleus accumbens (NAc), and ventral caudate (VCa), the main target areas for the treatment of major depression disorder (MDD), using deep brain stimulation (DBS). MDD is one of the most common diseases in the world, and approximately 30% of MDD patients do not respond to common therapies, including psychotherapy and antidepressant medications. Alternatively, DBS has been recently used to treat MDD. Resting state fMRI was obtained from seventeen healthy subjects and seven MDD patients. The functional connectivity network of the brain was constructed for all subjects and measured by the `degree' value for each SCG, NAc, and VCa regions using the graph theory analysis. The results show that the degree values of VCa and the left SCG are higher in the MDD group than the healthy group. Furthermore, the patterns of the degree values were different for the right and left hemispheres in MDD patients. Our findings suggest that degree values and their patterns have a potential to be used as diagnosis tools to detect the brain areas with abnormal functional connectivity.

Pelargonidin exhibits restoring effects against amyloid β-induced deficits in the hippocampus of male rats

Background: Alzheimer's disease (AD) is characterized by amyloid-beta plaques, neuronal loss, and cognitive dysfunction. Oxidative stress plays a key role in the pathophysiology of AD, and it has been suggested that antioxidants may slow the progress of the disease. In this study, the possible protective effects of pelargonidin (a natural flavonoid) against amyloid β (Aβ)-induced behavioral deficits was investigated in rats.

Methods: Adult Wistar male rats were treated with intrahippocampal injections of the Aβ (aa 25-35) and intraperitoneal injection of pelargonidin. Learning and spatial memory were tested using the Morris water maze (MWM) task. The antioxidant activity was evaluated using the ferric reducing/antioxidant power assay (FRAP assay). Data were analyzed using SPSS 20, and value of p≤0.05 was considered significant.

Results: The results of this study showed that Aβ significantly increased escape latency and the distance traveled in the MWM, and pelargonidin attenuated these behavioral changes. Aβ induced a significant decrease in the total thiol content of hippocampus, and pelargonidin restored the hippocampal antioxidant capacity.

Conclusion: The results of this study suggest that pelargonidin can improve Aβ-induced behavioral changes in rats.

Betulin and its derivatives as novel compounds with different pharmacological effects

Betulin (B) and Betulinic acid (BA) are natural pentacyclic lupane-structure triterpenoids which possess a wide range of pharmacological activities. Recent evidence indicates that B and BA have several properties useful for the treatment of metabolic disorders, infectious diseases, cardiovascular disorders, and neurological disorders. In the current review, we discuss B and BA structures and derivatives and then comprehensively explain their pharmacological effects in relation to various diseases. We also explain antiviral, antibacterial and anti-cancer effects of B and BA. Finally, we discuss the delivery methods, in which these compounds most effectively target different systems.

Genome-Wide Transcriptome Landscape of Embryonic Brain-Derived Neural Stem Cells Exposed to Alcohol with Strain-Specific Cross-Examination in BL6 and CD1 Mice

We have previously reported the deregulatory impact of ethanol on global DNA methylation of brain-derived neural stem cells (NSC). Here, we conducted a genome-wide RNA-seq analysis in differentiating NSC exposed to different modes of ethanol exposure. RNA-seq results showed distinct gene expression patterns and canonical pathways induced by ethanol exposure and withdrawal. Short-term ethanol exposure caused abnormal up-regulation of synaptic pathways, while continuous ethanol treatment profoundly affected brain cells’ morphology. Ethanol withdrawal restored the gene expression profile of differentiating NSC without rescuing impaired expression of epigenetics factors. Ingenuity Pathway Analysis (IPA) analysis predicated that ethanol may impact synaptic functions via GABA receptor signalling pathway and affects neural system and brain morphology. We identified Sptbn2, Dcc, and Scn3a as candidate genes which may link alcohol-induced neuronal morphology to brain structural abnormalities, predicted by IPA analysis. Cross-examination of Scn3a and As3mt in differentiated NSC from two different mouse strains (BL6 and CD1) showed a consistent pattern of induction and reduction, respectively. Collectively, our study identifies genetic networks, which may contribute to alcohol-mediated cellular and brain structural dysmorphology, contributing to our knowledge of alcohol-mediated damage to central nervous system, paving the path for better understanding of FASD pathobiology.

Acute foot-shock stress decreased seizure susceptibility against pentylenetetrazole-induced seizures in mice: Interaction between endogenous opioids and cannabinoids

BACKGROUND

Stressful conditions affect the brain's neurotransmission and neural pathways that are involved in seizure susceptibility. Stress alters the intensity and/or frequency of seizures. Although evidence indicates that chronic stress exerts proconvulsant effects and acute stress has anticonvulsant properties, the underlying mechanisms which mediate these effects are not well understood. In the present study, we assessed the role of endogenous opioids, endocannabinoids, as well as functional interaction between opioid and cannabinoid systems in the anticonvulsant effects of acute foot-shock stress (FSS) against pentylenetetrazole (PTZ)-induced seizures in mice.

METHODS

Prolonged intermittent FSS was chosen as an acute stress model. Seizure threshold was determined after 30 min of stress induction in male Naval Medical Research Institute (NMRI) mice (20-30 g). Opioid and cannabinoid receptor antagonists were administered before animal placement in the FSS apparatus.

RESULTS

Acute FSS significantly decreased seizure susceptibility in animals. The administration of the cannabinoid receptor 1 (CB₁) antagonist, AM251, completely blocked the anticonvulsant effect of acute FSS at the doses of 1 pg/kg-100 μg/kg but not at 1 fg/kg. Pretreatment with the nonspecific opioid receptor antagonist, naltrexone (NTX), significantly inhibited the anticonvulsant effects of acute FSS at 1 and 2 mg/kg but not at 0.3 mg/kg. However, coadministration of the subeffective doses of AM251 (1 fg/kg) and NTX (0.3 mg/kg) reversed the anticonvulsant effects of acute FSS.

CONCLUSIONS

Opioid and cannabinoid systems are involved in the anticonvulsant effects of acute FSS, and these neurotransmission systems interact functionally in response to acute FSS.

Anticonvulsant effect of minocycline on pentylenetetrazole-induced seizure in mice: involvement of nitric oxide and N-methyl-d-aspartate receptor

Anticonvulsant effects of minocycline have been explored recently. This study was designed to examine the anticonvulsant effect of acute administration of minocycline on pentylenetetrazole-induced seizures in mouse considering the possible role of the nitric oxide/N-methyl-d-aspartate (NMDA) pathway. We induced seizure using intravenous administration of pentylenetetrazole. Our results showed that acute administration of minocycline increased the seizure threshold. Furthermore, co-administration of subeffective doses of the nonselective nitric oxide synthase (NOS) inhibitor NG-l-arginine methyl ester (10 mg/kg) and the neuronal NOS inhibitor 7-nitroindazole (40 mg/kg) enhanced the anticonvulsant effect of subeffective doses of minocycline (40 mg/kg). We found that inducible NOS inhibitor aminoguanidine (100 mg/kg) had no effect on the antiseizure effect of minocycline. Moreover, l-arginine (60 mg/kg), as a NOS substrate, reduced the anticonvulsant effect of minocycline. We also demonstrated that pretreatment with the NMDA receptor antagonists ketamine (0.5 mg/kg) and MK-801 (0.05 mg/kg) increased the anticonvulsant effect of subeffective doses of minocycline. Results showed that minocycline significantly decreased the hippocampal nitrite level. Furthermore, co-administration of a neuronal NOS inhibitor like NMDA receptor antagonists augmented the effect of minocycline on the hippocampal nitrite level. In conclusion, we revealed that anticonvulsant effect of minocycline might be, at least in part, due to a decline in constitutive hippocampal nitric oxide activity as well as inhibition of NMDA receptors.

Maternal exposure to silver nanoparticles are associated with behavioral abnormalities in adulthood: Role of mitochondria and innate immunity in developmental toxicity

Silver nanoparticles (Ag-NPs) are currently used in a wide range of consumer products. Considering the small size of Ag-NPs, they are able to pass through variety of biological barriers and exert their effects. In this regard, the unique physicochemical properties of Ag-NPs along with its high application in the industry have raised concerns about their negative effects on human health. Therefore, it investigated whether prenatal exposure to low doses of Ag-NPs is able to induce any abnormality in the cognitive and behavioral performance of adult offspring. We gavaged pregnant NMRI mice with, 1) Deionized water as vehicle, 2) Ag-NPs 10 nm (0.26 mg/kg/day), 3) Ag-NPs 30 nm (0.26 mg/kg/day), and 4) AgNO₃ (0.26 mg/kg/day) from gestational day (GD) 0 until delivery day. At the postnatal day (PD) 1, our results showed that high concentration of silver is present in the brain of pups. Further, we observed mitochondrial dysfunction and upregulation of the genes relevant to innate immune system in the brain. At PD 60, results revealed that prenatal exposure to Ag-NPs provoked severe cognitive and behavioral abnormalities in male offspring. In addition, we found that prenatal exposure to Ag-NPs was associated with abnormal mitochondrial function and significant up-regulation of the genes relevant to innate immunity in the brain. Although the Ag-NPs have been considered as safe compounds at low doses, our results indicate that prenatal exposure to low doses of Ag-NPs is able to induce behavioral and cognitive abnormalities in adulthood. Also, we found that these effects are at least partly associated with hippocampal mitochondrial dysfunction and the activation of sterile inflammation during early stages of life.

Opioid Receptors Gene Polymorphism and Heroin Dependence in Iran

Introduction:

Genes often have multiple polymorphisms that interact with each other and the environment in different individuals. Variability in the opioid receptors can influence opiate withdrawal and dependence. In humans, A118G Single Nucleotide Polymorphisms (SNP) on μ-Opioid Receptor (MOR), 36 G>T in κ-Opioid Receptor (KOR), and T921C in the δ-Opioid Receptor (DOR) have been found to associate with substance dependence.

Methods:

To investigate the association between opioid receptors gene polymorphism and heroin addiction, 100 control subjects with no history of opioid use, and 100 heroin addicts (50% males and 50% females) in Tehran (capital of Iran), were evaluated. A118G, 36 G>T, and T921C SNPs on the MOR, KOR, DOR genes, respectively, were genotyped by sequencing.

Results:

We found no differences in either allele or genotype frequency for MOR, KOR and DOR genes SNPs between controls and subjects addicted to heroin.

Conclusion:

The relationships among polymorphisms may be important in determining the risk profile for complex diseases such as addiction, but opioid addiction is a multifactorial syndrome which is partially hereditary and partially affected by the environment.