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Anal cancer - impact of interstitial brachytherapy

Published on: 1st February, 2021

OCLC Number/Unique Identifier: 9039880199

We evaluated a total of 115 patients diagnosed with anal cancer, who were treated at our clinic from 1995 to 2012. Their average age was 61 years, most often were diagnosed in stages II and III, in most cases it was a squamous cell carcinoma located in the anal canal. The mean follow-up was 83 months (minimum 1 month and maximum 240 months). We combined external radiotherapy with boost of brachytherapy or boost of external radiotherapy and possibly a combination of both boosts. Half of the patients received concomitant chemotherapy. We specifically evaluated local tumor regression, overall survival and the impact to therapeutic effect of the chosen irradiation technique. Complete regression was achieved in 92 patients, partial regression in 21 patients. Overall survival, regardless of stage, was 80% 3-year, 74% 5-year and 67% 10-year. The age of patients, the size of their own primary tumor and the therapeutic method used had a statistically significant effect on survival - especially the importance of brachytherapy was irreplaceable.
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Can the Wondfo® SARS-CoV-2 IgM/IgG antibodies be used as a rapid diagnostic test?

Published on: 21st October, 2020

OCLC Number/Unique Identifier: 8689018987

Background: An outbreak of novel coronavirus (SARS-CoV-2) disease (COVID-19) has rapidly spread worldwide. The aim of this study was to evaluate and validate the performance of the Wondfo® lateral-flow immunochromatographic assay that detect SARS-CoV-2- IgG, IgM antibodies (Wondfo® IC), using the results obtained by the fluorescence immunoassay test as reference diagnostic. Material and methods: 97 serum specimens collected and analyzed by four independent laboratories of Sergipe/Brazil was used for validated the Wondfo® SARS-CoV-2 IgM/IgG antibodies test. The COVID-19 positive serum specimens were determined by fluorescence immunoassay technique, used as reference standard. Results: An overall of 97 serum specimens show 39 (39/97) SARS-CoV-2 IgG positive specimens, 33 (33/97) SARS-CoV-2 IgM positive specimen and 25 non-reagent specimens (25/97). However, the Wondfo® IC assay detected only 9 (9/97) IgM/IgG positive specimen and 25 (25/97) no-reagent specimen. A weak correlation was found between the outcomes of the Wondfo® IC assay and fluorescence test. The accuracy between the two tests was 32.08%. The sensitivity, specificity, positive predictive value, and negative predictive value of Wondfo® IC assay were of 11.12%, 100%, 100% and 25.27%, respectively. Moreover, no false positive sample was determinate, whereas 88.89% of false negative results were found. Conclusion: The Wondfo® IC test failed in providing a quick, valid, and reliable results and appears not to be a good alternative for clinical use in detecting pandemic coronavirus. However, if the limitations of the rapid test are known, some correction factors can be used in order to adjust the epidemiological data.
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Evaluation of the antibacterial and anticancer activities of marine Bacillus subtilis ESRAA3010 against different multidrug resistant Enterococci (MDRE) and cancer cell lines

Published on: 28th October, 2020

OCLC Number/Unique Identifier: 8872659898

Fifty nine isolates belonging to six species of Enterococci namely, Enterococcus faecalis, Enterococcus faecium, Enterococcus raffinosus, Enterococcus durans, Enterococcus mundtiiand Enterococcus avium (n = 35, 15, 4, 3, 1 and 1 isolates, respectively) were obtained from different clinical specimens including urine, pus, blood, wound, sputum and synovial fluid. The highest numbers of Enterococci were recorded from the pus (20 isolates, 33.90%) followed by urine (12 isolates, 20.34%) while the lowest frequency was observed with synovial fluid samples (2 isolates, 3.39%). These isolates showed different multidrug resistant patterns with the lowest resistant for linezolid (n = 5, 8.48%), followed by teicoplanin (n = 14, 23.73%) and vancomycin (n = 20, 33.90%) while they exhibited the highest resistant against penicillin (n = 53, 89.83%), oxacillin (n = 50, 84.75%), erythromycin (n = 49, 83.05%) and streptomycin (n = 47, 79.66 %). On the other hand, a free living marine bacterium under isolation code ESRAA3010 was isolated from seawater samples obtained from the fishing area Masturah, Red Sea, Jeddah, Saudi Arabia. The phenotypic, chemotaxonomic, 16S rRNA gene analyses and phylogenetic data proved that isolate ESRAA3010 is very close to Bacillus subtilis and then it was designated as Bacillus subtilis ESRAA3010. It gave the highest antagonistic activity against all clinical Enterococcus faecalis, Enterococcus faecium, Enterococcus raffinosus, Enterococcus durans, Enterococcus mundtiiand Enterococcus avium isolates under study with minimum inhibitory concentration (MIC) ranged from 4 to 56 µg/mL, 4 to 12 µg/mL, 4 to 8 µg/mL, 4 to 8 µg/mL, 8 µg/mL and 4 µg/mL, respectively as well as minimum bactericidal concentration (MBC) (8 to 64 µg/mL, 4 to 16 µg/mL, 4 to 12 µg/mL, 4 to 16 µg/mL, 12 µg/mL and 8 µg/mL, respectively). Moreover it showed anti-proliferative activity against colon (HCT-116), liver (HepG-2), breast (MCF-7) and lung (A-549) carcinomas with IC50 equal to 39, 50, 75 and 19 µg/mL, respectively which indicates its prospective usage in the upcoming decades.
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Treatment of perianal fistulae in crohn's disease with mesenchymal stem cells

Published on: 4th May, 2022

Crohn's disease is a chronic syndrome of the gastrointestinal tract that produces idiopathic inflammation. Approximately half of the patients develop abscesses and/or fistulas throughout their history that are located, mainly, in the perianal region. Current treatments are based on individualized plans that generally use combined pharmacology for symptomatic relief based on glucocorticoids, immunosuppressants or immunomodulators, antibiotics, anti-inflammatories, probiotics, and antibodies, or surgical therapies such as intestinal resections or ostomizations (colostomy and ileostomy) that tend to cause notable side effects in a considerable percentage of patients and a significant decrease in their quality of life.Perianal fistulas consist of abnormal tracts, inflammatory tunnels, or chronic tracts of granular tissue that connect two surfaces lined with epithelium, have an external hole in the skin that borders the anus, and an internal hole located inside it around the anal canal, rectus and sphincters. Treatment is a complex process that requires a multidisciplinary approach and the combination of several treatments. In the short term, the goal is to drain abscesses, reduce inflammatory and infectious processes, guard the fistulous tract with seton or lax lines, facilitate patency, and hinder new formations. In the long term, a total cure and the avoidance of complications that require surgery or the creation of intestinal stomas are pursued.For this reason, new effective remedies with fewer adverse effects continue to be investigated, one of the most promising being the use of mesenchymal stem cells for the regeneration and cure of perianal fistulas and the remission of symptoms. The present bibliographic review delves into this new therapy and analyzes the current state of the situation regarding its efficacy and safety.
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Magnets, Gradients, and RF Coils of MR Scanners

Published on: 25th July, 2023

The topic of this paper is the parts of modern MR devices, which contain magnet coils. MR scanner magnets are made of four types of electromagnetic coils: 1) Main magnet, made of superconducting material. The main magnet of an MR (Magnetic Resonance Imaging) scanner creates a strong and uniform magnetic field around the patient being scanned. This magnetic field is typically in the range of 0.5 to 3 Tesla and is used to align the magnetic moments of the hydrogen atoms in the patient's body. The superconductors, which create the main magnetic field, should be cooled with liquid helium and liquid nitrogen. The main magnets made of superconductors should use a cryostat, with cooling vessels with liquid helium and liquid nitrogen, thermal insulation, and other protective elements of the magnet system. 2) The gradient magnetic field is made of three types of coils: x-coils, y-coils, and z-coils.  The X coil, made of resistive material, creates a variable magnetic field, horizontally, from left to right, across the scanning tube; 3) The Y coil creates a variable magnetic field, vertically, from bottom to top; 4) The Z coil creates a variable magnetic field, longitudinally, from head to toe, inside the scanning tube. RF coils are used to generate RF pulses to excite the hydrogen protons (spins) in the patient's body and detect the signals emitted by the protons when they return to their equilibrium state after the RF excitation is turned off.  The resulting interaction between the magnetic field and the aligned hydrogen atoms produces a signal that is used to generate the images seen in an MRI scan. The main magnetic field is what allows MR imaging to produce detailed anatomical and functional information non-invasively. The structure of the MR scanner magnet is complex. The resonant frequency changes at each point of the field in a controlled manner. Inside the copper core are embedded the windings of the main magnet made of superconducting material in the form of microfibers. A non-linear gradient field is created by coils of conductive material. It adds to the main magnetic field. Thus the resulting magnetic field is obtained. The types of magnets that exist in the basic configurations of MR scanners are analyzed. Scanners in the form of a closed cylindrical cavity generate their magnetic fields by passing current through a solenoid, which is maintained at the temperature of a superconductor. Exclusively used superconductors are niobium-titanium (NbTi), niobium-tin (Nb3Sn), vanadium-gallium (V3Ga), and magnesium-diboride (MgB2). Only magnesium diboride is a high-temperature superconductor, with a critical temperature Tc = 390K. The three remaining superconductors are low temperatures. New high-temperature superconductors have been discovered, as well as superconductors at room temperature. Newly discovered superconducting materials are not used in MR scanners.
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Timely initiation of breastfeeding and associated factors among mothers who have infants less than six months of age in Gunchire Town, Southern Ethiopia 2019

Published on: 9th April, 2020

OCLC Number/Unique Identifier: 8582297046

Background: Timely starting of breastfeeding is defined as the starting of breastfeeding within one hour after childbirth. Globally mothers who practiced breastfeeding within one hour were less than half in percent. In least developed countries like Eastern and Southern Africa including Ethiopia infant breastfeeding practice within one hour were low. The aim of this study was to assess timely initiation of breastfeeding and associated factors among mothers who have an infant less than six months of age in Gunchire town, Southern Ethiopia. Methods: The study was conducted from May 1 to 28, 2019 in Gunchire town. Data were collected by using a structured face to face interview questionnaire. The community based cross-sectional study was employed on 333 women. The study participants were selected by Simple random sampling techniques. The data were coded, entered, cleaned and analyzed by SPSS with windows version 21.0. Binary and multivariable logistic regression statistical model was used. Adjusted odds ratio with 95% CI was computed to see the strength of association. Results: In this study the magnitude of timely initiation of breastfeeding was 80.5%. Governmental employed mothers (AOR=2.914, 95% CI: 1.139, 7.46), Antenatal care follow up (AOR=5.99, 95% CI: 1.29, 27.81), Baby skin to skin contact (AOR=2.4, 95% CI: 1.092, 5.34), Vaginal delivery (AOR=5.82 95% CI: 1.68, 20.14) Institutional delivery (AOR=5.5, 95 CI%: 1.66, 18.3), Good knowledge of breastfeeding (AOR=4.02, 95% CI: 1.04, 15.59) and Breast disease (AOR=0.24, 95% CI: 0.08, 0.73) were significantly associated with timely starting of breastfeeding. Conclusion: More than two third of the mothers timely initiated breastfeeding within one hour after birth. Being governmentally employed, having Antenatal care follows up, skin to skin contact, mode of delivery, knowledge of mothers about breastfeeding and place of delivery were positively and significantly associated with timely initiation of breast feeding, whereas, breast disease was protective against timely starting of breastfeeding. Therefore, we would like to recommend Enamore woreda health office and Gunchire primary Hospital staffs work at MCH clinic to provide appropriate services and stimulate the mothers to initiate breastfeeding, skin to skin contact enhancing within the first hour of birth.
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Hygiene and Care Protocols for Implant-supported Dental Prostheses in Patients with Diabetes

Published on: 21st February, 2024

Background: Prophylactic dental procedures following implant placement are critical to the long-term success of implants and are also dependent on the patient maintaining effective home care.Purpose: Evaluation of the effectiveness of preventive measures in patients with diabetes during long periods after prosthetic treatment with implants.Materials and methods: The study included 62 patients with diabetes with edentulism using 146 dental implants. Patients underwent constant monitoring, including regular occupational hygiene during follow-up examinations. Their frequency was set individually from 2 to 4 times A clinical index including Bleeding on Probing (BOP), Probing Depth (PD), and Marginal Bone Loss (MBL). Results: In patients included in the preventive protocol after 12 months, the mean BOP was 1.4 ± 0.15, and PPD was 2.46 ± 0.42. After 12 months in patients mean MBL was 0.72 ± 0.6 mm, after 3 years MBL was 1.24 ± 0.25 mm. For patients who were excluded from preventive services after 12 months, the mean BOP 1.9 ± 0.25, and the mean PPD was 3.56 ± 0.28). After 12 months in patients mean MBL was 0.87 ± 0.7 mm, after 3 years MBL was 1.52 ± 0.32 mm (p > 05). Compared to persons enrolled in the preventive protocol, those in the group without services were more likely to develop peri-implantitis (42.4% vs. 12,6%). The survival rate of implants after 3 years was 98.4%. The survival rate of implants in those patients who were excluded from preventive services after 3 years was 95.4%.Conclusion: For patients with diabetes, regular medical examinations, accompanied by professional oral hygiene procedures, prevent the development of negative reactions of the soft tissues surrounding the implant.
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COVID-19 in pregnancy: Our experience at a tertiary maternity unit in France

Published on: 24th June, 2020

OCLC Number/Unique Identifier: 8625644678

Objectives: Our main objectives are to reveal the pregnancy and neonatal impacts of COVID-19 infection and to compare it to the results that are reported in the literature. Methods and materials: The characteristics of the admitted pregnant patients COVID-19 positive with their initial presentation, course at the hospital, and short term follow-up are exposed. Correlation of the age and gestational age with the severity of the disease was calculated. Results: Thirty five COVID-19 positive pregnant patients presented between the beginning of March and the end of April 2020. From 5 weeks till 41 weeks of gestation, all trimesters were included. The mean of age is 32 and the BMI equal 28.2. Associated comorbidities included not only diabetes and hypertension but also PCOS. The symptomatology was considered mild in most of the cases. The distribution of the symptoms included cough in 86%. 10 out of 35 delivered and cesarean was performed in 50% of the cases. The mean length of stay is 6 days. Neither maternal nor neonatal deaths occurred. There is a significant correlation between the age of the patient and the severity of the disease but this is not the case with gestational age. Conclusion: Our results were comparable to the literature in terms of initial presentation, associated comorbidities and the length of stay. Despite the fact that the cesarean rate was high, it was far below that of the literature. More data is still needed about COVID-19 in pregnancy.
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Prostate cancer-associated thrombotic microangiopathy: A case report and review of the literature

Published on: 8th March, 2021

OCLC Number/Unique Identifier: 8980361223

Background: Thrombotic microangiopathy (TMA) is a rare and life-threatening complication of prostate carcinoma. Whether plasma exchange has a role in treatment remains a subject of debate. Here we present a case followed by a systematic review of the literature on this subject. Case report: We describe a 69-year old patient presenting with TMA, which was associated with an underlying metastatic prostate carcinoma. We conducted a search of similar cases in literature. Results: Our patient was treated and responded well on plasma exchange. Systematic review of the literature showed 17 additional cases of TMA associated with prostate carcinoma of which eleven were treated with plasma exchange with mostly good response. Conclusion: Based on current data we cannot exclude a potential role for plasma exchange in prostate cancer associated TMA.
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The role of cognitive distraction in sexual dysfunction in female medical resident doctors

Published on: 31st May, 2022

Introduction: Studies have shown a high prevalence of sexual dysfunction in Medical residents. Psychological, interpersonal, and sociocultural factors play an important role in sexual vulnerability. In addition, distraction or interference in the cognitive process of the erotic stimulus plays an important role in the development of sexual dysfunction. The aim of our study was to determine the prevalence of sexual dysfunctions among a sample of married female medical resident doctors and to explore its relation with cognitive distraction during sex.Subjects and methods: This was a cross-sectional study, which was carried out in October 2017 with 70 married female medical resident doctors. We used the Female Sexual Function Index (FSFI) for sexual functioning assessment and the cognitive distraction during sex scale. Results: The mean age of women was 30.52 years. They had been married for 6.04 years on the mean. The majority (74%) had children. According to the FSFI, 40% of resident doctors had sexual dysfunction. The mean cognitive distraction during sex score was 4.37.In our study, women with female sexual dysfunction reported significantly lower sexual desire score = 3.2 vs. 4.1 and p = 0.03) and arousal (score = 3.è vs. 4.7 and p = 10-3), decreased lubrication (score = 3.8 vs. 5.1; p = 10-3), less sexual satisfaction (score = 3.9 vs. 5.8; p = 10-3)and higher orgasm difficulties (score = 3.4 vs. 5.1; p = 10-3). Yet, our results highlighted that women with female sexual dysfunction presented significantly more cognitive distraction during sex (score = 3.9 vs. 4.6; p = 0.03). Conclusion: According to our study, it appears that the prevalence of FSD in medical resident doctors is considerable. Besides, intrusive thoughts and cognitive distraction during sexual intercourse are importantly associated with sexual functioning. Therefore, several measures should be implemented in this population to prevent or act on these factors.
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