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    Improvement of the Deterioration of the Gut Microbiota Due to High-fat, High-sucrose Diet Acylated Steryl-β-glycosides Intake

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    Daily high-fat diet (HFD) intake is generally associated with an increased risk of metabolic diseases, cancer, and neurological disorders, which represent a major global health burden with significant social and economic consequences. In the present study, mice were treated with HFD containing 40% lipids. Furthermore, HFD was supplemented with 0.5% or 1.0% acylated sterol-β-glucoside (ASG).After 55 days of rearing, body weight, epididymal fat weight, weight, and pH of cecum contents and intestinal microflora were compared with mice fed HFD or a low-fat diet (LFD) containing lipid at 7%. The results showed that body weight and epididymis fat weight on the last day of feeding were significantly higher in HFD, 0.5% ASG, and 1.0% ASG compared to LFD, but significantly lower in 0.5% ASG and 1.0% ASG compared to HFD. Cecum content weight was lower with HFD compared to LFD but increased to LFD levels with the addition of ASG. Cecum pH was significantly lower on the 1.0% ASG compared to the other groups.The gut microbiota was significantly elevated in the HFD compared to the LFD, with Bacilliota specific to obese mice. However, the addition of ASG to the HFD decreased the Bacilliota and increased the Bacteroidota. Clostridium cluster XI and Clostridium subcluster XIVa, intestinal bacteria involved in the production of carcinogenic secondary bile acids, were markedly increased by consumption of the HFD but were markedly decreased by ASG.Daily intake of ASG may inhibit the deterioration of gut bacteria caused by HFD and reduce the disease risk posed by HFD

    The Impacts of Angiotensin Receptor Blockers (ARBs) or Angiotensin-Converting Enzyme Inhibitors (ACEIs) on Patients with Stereotactic Body Radiation Therapy (SBRT) for Early-Stage NSCLC

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    Purpose: Stereotactic body radiation therapy (SBRT) has emerged as an alternative to surgery for patients with inoperable early-stage non-small cell lung cancer (NSCLC). The majority of inoperable NSCLC patients are elderly and frequently have comorbidities including cardiovascular diseases for which they frequently receive angiotensin receptor blockers (ARBs) or angiotensin-converting enzyme inhibitors (ACEIs). The interactions of these medications with SBRT are not clear. The objective of the current study is to investigate the interaction of ARBs and ACEIs with SBRT for the outcomes of early-stage NSCLC. Methods and Materials: A retrospective chart review of patients treated with SBRT for Stage I and II NSCLC (AJCC 7th edition) at a single institution between 2006 and 2017 was conducted. Information on the use of ARBs, ACEIs, demographics, and tumor-related factors was collected. Kaplan-Meier and Cox proportional hazard analyses were performed to assess the impact of ARBs and ACEIs combined with SBRT respectively on the treatment outcomes of these patients. Results: In total, 116 patients were included in the study, among whom 38/116 (32.76%) received ACEIs, and 20/116 (17.24%) received ARBs. In the multivariable analysis, the use of ARBs, but not ACEIs, with SBRT, was significantly associated with the increased risk of dissemination (Hazard Ratio (HR): 2.97; CI: 1.40-6.27; p < 0.004) compared to SBRT without ARBs. The tumor size of > = 3 cm was associated with significantly decreased time to local failure and OS compared to tumor size <3cm. Conclusion: In the current retrospective study, the use of ARBs, in combination with SBRT, was associated with a significantly increased risk of disease dissemination in early-stage NSCLC compared to SBRT alone. The findings warrant further investigations on the concurrent use of ARBs, ACEIs, and other medicines used for chronic diseases with SBRT for early-stage NSCLC

    Diagnostic Challenge of Gitelman Syndrome: A Rare but Significant Cause of Electrolyte Imbalance

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    Objective: This case study presents a young female patient diagnosed with symptomatic electrolyte disturbances, later confirmed as Gitelman syndrome (GS). It highlights the underlying pathophysiology and emphasizes the importance of its proper management. Background: GS is a rare genetic disorder affecting kidney electrolyte reabsorption, leading to symptoms like weakness, muscle cramps, fatigue, nausea, and vomiting. Diagnosis involves lab tests and genetic confirmation, with treatment comprising electrolyte supplementation and medications. Ongoing management is vital to prevent complications. Case presentation: A 23-year-old Caucasian female presented to the ED with sudden weakness in all extremities, thirst, and lightheadedness. Lab results showed hyperglycemia 166 (70-100 mg/dL),severe hypokalemia 1.1 (3.6-5.1 mmol/L), mild hypercalcemia 11 (8.9-10.4 mg/dL), and severe hypophosphatemia 0.6 (2.3-7.0 mg/dL). Incidentally, she had prior hypokalemia history from a motor accident hospitalization and managed it with KCl for a year but stopped when symptoms improved. She was treated with electrolyte replacement and discharged with oral potassium. Five days later, she returned with severe hypokalemia 1.3, mild hypercalcemia 10.7, and severe hypophosphatemia 0.6. A 24-hour urinary test showed distal convoluted tubulopathy indicative of GS. She was treated with replacement therapy and spironolactone, with instructions for ongoing supplementation and follow-up with a nephrologist. Discussion: GS is mostly caused by mutations in the SLC12A3 gene, affecting the kidneys’ sodium chloride cotransporter function, as confirmed in our patient. Conclusion: While GS has no cure, appropriate treatment with medication and dietary adjustments can enhance patients’ quality of life by maintaining electrolyte balance. Healthcare providers’ awareness is crucial for effective care and complication prevention

    A case of true hermaphroditism: presenting as congenital bilateral inguinal hernia

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    True hermaphroditism (TH) is a cause of intersexuality in which both ovarian and testicular tissue is present in the same individual [1]. The gonadal distribution in cases of true hermaphroditism varies from [2

    Non-variant phenomena in heterogeneous systems. New type of solubility diagrams points

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    The article gives a general classification of non-invariant points in phase equilibrium diagrams of all possible types. The complete topological isomorphism of the diagrams of fusibility, solubility, and liquid-vapor equilibria in various sets of variables is demonstrated. The stability of mono-variant equilibria near the non-variant points is investigated. Recurrent formulas for calculating the number of topological elements of phase diagrams are given. A previously undescribed type of non-invariant points and phase processes in the solubility diagrams is described and characterized. The last ones have no topological analogs in other types of diagrams. Thus, we have carried out, as far as is available to the authors, a complete classification of invariant points and invariant processes in phase equilibrium diagrams of an arbitrary type and with an arbitrary number of components

    Association of HLA-DRB1 Alleles with Rheumatic Fever Among Senegalese Patients

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    Background: Acute rheumatic fever (ARF) is a systemic inflammatory disease resulting from an abnormal immune response to group A β-hemolytic streptococci. ARF is a major public health problem in developing countries, particularly in Senegal. The aim of this study was to evaluate the mutation penetrance and genetic diversity of exon 2 of the HLA-DRB1 gene in Senegalese patients with ARF. Results: DNA was extracted from the blood of patients with ARF. Exon 2 of the HLA-DRB1 gene was amplified by polymerase chain reaction and sequenced using the Sanger method. Bioinformatics software and databases (polyphen-2, SIFT and ProVean) were used to assess the pathogenicity of missense mutations. The results revealed a high level of polymorphism in exon 2 of the HLA-DRB1 gene, with 73 non-synonymous mutations between codons 21 and 89, which lie in the hypervariable region encoded by exon 2. Of the 73 variants tested, 44% were pathogenic, indicating their potential involvement in ARF onset. Conclusion: Our results indicate that the HLA-DRB1 mutations involvement in the onset of rheumatic fever

    The Stability and Behaviour of the Superposition of Non-Linear Waves in Space

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    The superposition of non-linear waves in space refers to the phenomenon where two or more waves overlap and combine to form a new wave pattern. Non-linear waves are characterized by their ability to interact with each other, leading to complex behaviors that are not observed in linear wave systems. Understanding the stability and behavior of the superposition of non-linear waves in space is crucial in various fields such as physics, engineering, and oceanography.When non-linear waves superpose, their interactions can lead to a range of behaviors, including wave breaking, formation of solitons (localized wave packets), and the generation of harmonics. The stability of the superposition is determined by the balance between the non-linear effects and dispersive effects, which can either stabilize or destabilize the wave pattern. In addition, the behavior of non-linear waves in space is influenced by external factors such as boundaries, dissipation, and external forcing.In this paper, we study the behavior and characteristics of waves when they interact with each other. Superposition refers to the phenomenon where multiple waves combine to form a resultant wave. In the case of linear waves, this superposition occurs according to the principles of linear superposition, which states that the displacement or amplitude at any point is the algebraic sum of the displacements or amplitudes of the individual waves.Understanding the superposition of linear waves in space has various applications in fields such as physics, engineering, acoustics, optics, and signal processing. By studying how waves interact and combine, researchers can gain insights into wave propagation, interference patterns, wave reflections, diffraction, and other phenomena that occur when waves meet

    Update on the Clinical Applications of Mesenchymal Stem Cells

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    Mesenchymal stem cells are heterogenous adult multipotent stromal cells that can be isolated from various sources including bone marrow, peripheral blood, umbilical cord blood, dental pulp, and adipose tissue. They have certain regenerative, anti-inflammatory, immunomodulatory, immunosuppressive, antimicrobial, and other properties that enable them to have several therapeutic and clinical applications including treatment of various autoimmune disorders; role in hematopoietic stem cell transplantation and regenerative medicine; treatment of skin, pulmonary and cardiovascular disorders; treatment of neurological and eye diseases; as well as treatment of various infections and their complications. Different factors including donor age, biological source, route of administration, and signaling pathways have an impact on the functions and consequently the clinical applications of mesenchymal stromal cells. The products of mesenchymal stem cells such as extracellular vesicles and exosomes reproduce the biological effects and most of the therapeutic actions of the parent stem cells. Genetic engineering and the use of specific mesenchymal stromal cell products have improved their clinical efficacy and decreased their adverse effects. However, despite the recent progress in the use of mesenchymal stem cells, the clinical application of these cells in the treatment of several diseases still faces real challenges that need to be resolved. The current status of mesenchymal stem cells and the controversies related to their clinical utilization in various disease conditions will be thoroughly discussed in this review

    Bleeding from Varices: Still a Heavy Burden in Patients with Cirrhosis

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    Introduction: Bleeding from varices is a severe complication in patients with cirrhosis. Despite its treatment has been well established in the last three decades the mortality can be still high. This study compares the epidemiological features and the bleeding-related outcomes of a group of patients published about ten years ago with a more recent group of 168 consecutive patients. Methods: The diagnosis, the treatment, and the main outcomes (5-day failure, 5-day and 6-week rebleeding, 5-day and 6-week mortality) of variceal bleeding were evaluated according to the current guidelines.Results: The number of patients with cirrhosis admitted for variceal bleeding every year has progressively decreased in the last ten years. The age sex and severity of liver disease, evaluated with Child Pugh and MELD scores, were comparable in the two series. In the more recent series, there were significantly fewer patients with HCV infection and more patients with alcohol-related cirrhosis. The main outcomes of bleeding were comparable too. Overall, at 6 weeks 36.4% of patients did not overcome the bleeding episode. Conclusion: The decreasing incidence of bleeding from varices is likely attributable to antiviral treatment of HCV and HBV and the larger diffusion of beta-blockers in primary prophylaxis. Despite the larger application of the gold standard therapy, the mortality of variceal bleeding remains high in patients with cirrhosis

    Biologic Medications for the Treatment of Psoriasis - Main Groups and Dosing System

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    This review explores the evolving landscape of psoriasis treatment with a focus on the transformative impact of biologic drugs. Psoriasis, a prevalent and persistent skin condition characterized by red and scaly patches, historically relied on topical, phototherapeutic, and systemic treatments, each with limitations. The advent of biologics represents a significant advancement, offering targeted interventions by addressing specific immunologic mechanisms underlying the disease. Biologics are now considered the preferred systemic therapy for chronic moderate-to-severe plaque psoriasis, particularly when conventional treatments prove ineffective or present disadvantages.The review delineates the mechanisms of action for biologics targeting tumour necrosis factor-alpha (TNF-α), interleukin-17 (IL-17) and interleukin-23 (IL-23). Specific drugs under each category, including etanercept, infliximab, adalimumab, secukinumab, ustekinumab, and others, are detailed with recommended dosages. Biologics have demonstrated substantial effectiveness, with clinical trials and real-world studies showcasing significant improvements in disease severity and patient’s quality of life. Notably, these drugs exhibit rapid action, often yielding noticeable changes within weeks.While biologics have revolutionized psoriasis treatment, the review emphasizes the importance of judicious use due to potential side effects such as injection-site reactions and respiratory infections. Serious adverse events, including infections and autoimmune reactions, necessitate careful patient selection and monitoring for safety. In conclusion, biologics offer a precise and effective approach to psoriasis treatment, promising marked symptom improvement and enhanced quality of life. The review underscores the need for responsible utilization, considering patient-specific factors, and anticipates ongoing advancements in biologics for improved control over this chronic dermatitis

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