Abstract Background We conducted this updated systematic review to assess the effects of corticosteroids vs. placebo or no treatment for improving patient-relevant outcomes in hemolysis, elevated ...liver enzymes and low platelets (HELLP) syndrome. Methods CENTRAL, MEDLINE/PubMed, Web of Science, and Scopus, from the date of inception of the databases to February 3, 2024 were searched. Reference lists of included studies and systematic reviews were thoroughly searched. We included RCTs that enrolled women with HELLP syndrome, whether antepartum or postpartum, to receive any corticosteroid versus placebo or no treatment. No language or publication date restrictions were made. We used a dual independent approach for screening titles and abstracts, full text screening, and data extraction. Risk of bias was assessed in the included studies using Cochrane’s RoB 2 tool. Pairwise meta-analyses were conducted, where two or more studies met methodological criteria for inclusion. GRADE approach was used to assess certainty of evidence for the pre-specified outcomes. Results Fifteen trials (821 women) compared corticosteroids with placebo or no treatment. The effect of corticosteroids is uncertain for the primary outcome i.e., maternal death (risk ratio RR 0.77, 95% confidence interval CI 0.25 to 2.38, very low certainty evidence). Out of 6 studies reporting maternal death, 5 were judged overall to have “low risk” of bias. The effect of corticosteroids is also uncertain for other important outcomes including pulmonary edema (RR 0.70, 95% CI 0.23 to 2.09), dialysis (RR 3, 95% CI 0.13 to 70.78), liver morbidity (hematoma, rupture, and failure; RR 0.22, 95% CI 0.03 to 1.83), or perinatal death (0.64, 95% CI 0.21 to 1.97) because of very low certainty evidence. Low certainty evidence suggests that corticosteroids have little or no effect on the need for platelet transfusion (RR 0.98, 95% CI 0.60 to 1.60) and may result in a slight reduction in acute renal failure (RR 0.67, 95% CI 0.40 to 1.12). Subgroup and sensitivity analyses showed results that were similar to the primary synthesis. Conclusions In women with HELLP syndrome, the effect of corticosteroids vs. placebo or no treatment is uncertain for patient-relevant outcomes including maternal death, maternal morbidity, and perinatal death. These uncertainties regarding this critical question should be addressed by adequately powered rigorous trials. Systematic review registration Center for Open Science, osf.io/yzku5.
A role for human cytomegalovirus (HCMV) in the pathogenesis of glioblastoma multiforme (GBM) was proposed more than a decade ago and has since generated a considerable debate as a possible ...therapeutic target. We investigate the presence of HCMV in the specimens of patients with GBM treated in our centre. This is a retrospective cohort study to investigate the presence of HCMV by routine immunohistochemical stains and polymerase chain reaction (PCR)-based molecular analysis on formalin-fixed-paraffin-embedded tissue of all patients with GBM treated in our hospital in 2009-2013 (5 years). The evaluation of positivity by immunohistochemistry (IHC) was semi-quantitative. The molecular analysis was performed by extracting the tumour DNA from representative paraffin-embedded tissue blocks and amplified for detection by a sensitive real time PCR (RT-PCR) CMV assay. During the study period, we treated 45 patients with GBM; however, adequate pathology tissue materials were available only for 32 patients. All the pathology material was reviewed and the diagnosis was confirmed. All the cases were found to be negative for CMV expression by our IHC and RT-PCR CMV assay. Our study has shown no expression of CMV in GBM. Our results were similar to other recent reports that concluded insufficient evidence to recommend routine testing for CMV in GBM or treatment as an add-on therapy.
Celotno besedilo
Dostopno za:
DOBA, IJS, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Background Data: Posterior C1-C2 fusion techniques are the commonly used treatment for odontoid fracture. This procedure is usually associated with limitation in the cervical spine range of motion ...(ROM) especially the rotational motion. Posterior C1-C2 temporary fixation technique can spare the range of motion of the atlantoaxial joint after odontoid fracture healing is complete. Purpose: To assess the clinical and radiological outcome of the posterior C1-C2 temporary fixation technique in the treatment of a new odontoid fracture. Study Design: It is a retrospective study with clinical and radiological evaluation before and after instrumentation removal. Patients and Methods: Twelve consecutive patients, suffering from type-II odontoid fracture, were retrospectively recruited for this study. The age ranged between 15 and 43 years with a mean age being 24±11.6 years. Eight patients were males and four were females. All cases suffered from acute posttraumatic type-II dens fracture. Eight patients suffered from reducible subluxation and four cases were in place. Only two patients were suffering from partial neurologic deficit preoperatively (grade 4). All patients were submitted to Harms’ atlantoaxial fixation procedure. Surgical removal of the implants was done after a mean of 15.5 (range, 12–20 weeks) weeks from the first surgery. All patients had MSCT scan to assess healing and then dynamic MSCT scan after removal to assess C1-C2 ROM. Results: All of our twelve patients completed the two procedures without significant events. Two patients with preoperative neurological illness had improved gradually with physiotherapy. All patients had complete healing of their factures. Postoperative dynamic CT scan showed partial restoration of the rotation after removal of instrumentations with a mean total rotation restoration of 30±8°. Significantly better functional outcomes were observed after the temporary fixation removal using Visual Analog Scale (VAS) score for neck pain (P=0.0033), neck stiffness, and the patient satisfaction. Conclusion: Posterior atlantoaxial temporary fixation is a good salvage approach in dealing with odontoid fracture, especially when anterior odontoid screw is contraindicated. By regaining partial ROM, the functional outcome of the patients improved. (2019ESJ187)
Many pathogens that cause chronic diseases in birds use the respiratory tract as a primary route of infection, and respiratory disorders are the main leading source of financial losses in the poultry ...business. Respiratory infections are a serious problem facing the poultry sector, causing severe economic losses. Avian influenza virus, Newcastle disease virus, infectious bronchitis virus, and avian pneumovirus are particularly serious viral respiratory pathogens. Mycoplasma gallisepticum, Staphylococcus, Bordetella avium, Pasteurella multocida, Riemerella anatipestifer, Chlamydophila psittaci, and Escherichia coli have been identified as the most serious bacterial respiratory pathogens in poultry. This review gives an updated summary, incorporating the latest data, about the evidence for the circulation of widespread, economically important poultry respiratory pathogens, with special reference to possible methods for the control and prevention of these pathogens.
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This study was designed to investigate the potential effects and underlying mechanism of adipose tissue-derived mesenchymal stem cells (MSCs) on allergic inflammation compared to Montelukast as an ...antileukotriene drug in a rat model of allergic rhinitis (AR). The effect of MSCs was evaluated in albino rats that were randomly divided into four (control, AR, AR + Montelukast, and AR + MSCs) groups. Rats of AR group were sensitized by ovalbumin (OVA) and then challenged with daily nasal drops of OVA diluted in sterile physiological saline (50 μL/nostril, 100 mg/mL, 10% OVA) from day 15 to day 21 of treatment with/without Montelukast (1 h before each challenge) or MSCs I/P injection (1 × 10⁶ MCSs; weekly for three constitutive weeks). Both Montelukast and MSCs treatment started from day 15 of the experiment. At the end of the 5th week, blood samples were collected from all rats for immunological assays, histological, and molecular biology examinations. Both oral Montelukast and intraperitoneal injection of MSCs significantly reduced allergic symptoms and OVA-specific immunoglobulin E (IgE), IgG1, IgG2a and histamine as well as increasing prostaglandin E2 (PGE2). Further analysis revealed that induction of nasal innate cytokines, such as interleukin (IL)-4 and TNF-α; and chemokines, such as CCL11 and vascular cell adhesion molecule-1 (VCAM-1), were suppressed; and transforming growth factor-β (TGF-β) was up-regulated in Montelukast and MSCs-treated groups with superior effect to MSCs, which explained their underlying mechanism. In addition, the adipose tissue-derived MSCs-treated group had more restoring effects on nasal mucosa structure demonstrated by electron microscopical examination.
In this paper, heat transfer performance was experimentally tested in a helically coiled pipe using three types of nanofluids, TiO2, ZnO and Ag water-based nanofluids. TiO2, ZnO and Ag nanoparticles ...were characterized by X-ray powder diffraction (XRD), scanning electron microscopy (SEM), and transmission electron microscope (TEM). The XRD results showed that the purity of ZnO and TiO2 were obtained. TEM and SEM results showed that the mean particles size of TiO2, ZnO and Ag are 14, 20 and 16 nm respectively. The three types of nanofluids, TiO2/water, ZnO/water and Ag/water were prepared with a volume concentration of 0.25%. To ensure a good mixture and measure particles distribution in each nanofluid, Zetsizer test was performed and showed a good distribution of nanoparticles in all tested nanofluids. The three different nanofluids have been thermally tested in helical coil with a flow rate from 1 to 3.5 L/s with different inlet temperatures in the range of 30 °C and 60 °C. The experimental results showed an enhancement in Nusselt number up to 27.31%, 16.03%, and 10.38% with augmentation in the heat transfer coefficient up to 32%, 21% and 16% utilizing TiO2, ZnO and Ag nanoparticles respectively.
In the current paper, a numerical model was designed using COMSOL Multiphysics software based on experimental results to predict Nusselt number of TiO2, ZnO and Ag water-based nanofluids in helical ...coil under isothermal boundary conditions. All Nusselt number data extracted from the model were compared with experimental data to validate the model and the results showed that the model gives good accuracy and the model could be used to predict non-experimental data. Root Mean Square Error (RMSE) was calculated to evaluate model accuracy and the results were 4.35, 2.40 and 2.53 for TiO2/water, Ag/water and ZnO/water respectively. The model was used to predict non-experimental data and the results were logically predicted compared with experimental data and the model was proven to be sufficient for predicting non-experimental data. Model results were compared with two types of artificial neural networks predicting Nusselt number Feed Forward Neural Network (FFNN) and Generalized Regression Neural Network (GRNN). The deviation between predicted data and experimental data was calculated and the results indicated that GRNN network has the highest accuracy with maximum deviations of +0.02% & −0.3% while the COMSOL model has a maximum deviation of +4.5% & −5.9% and finally FFNN network +8.9% & −5.7%.
The present study is conducted to evaluate the neuroprotective effect of curcumin nanoparticles (CUR NP) against the neurotoxicity induced by cisplatin (CP) in rat. Rats were divided into control ...group that received saline solution, CP-treated rats that received a single i.p. injection of CP (12 mg/kg body wt), and CP-treated rats that received a single i.p injection of CP (12 mg/kg body wt) followed by a daily oral administration of CUR NP (50 mg/kg body wt) for 14 days. At the end of the experiment, the motor activity of rats was evaluated by open field test. The neurochemical and histopathological changes were investigated in the cerebral cortex. A significant decrease in motor activity was observed in CP-treated rats. This was associated with a significant increase in the cortical levels of lipid peroxidation, nitric oxide, tumor necrosis factor-α, caspase-3, and acetylcholinesterase activity. However, CP induced a significant decrease in reduced glutathione levels and Na
+
, K
+
-ATPase activity. In rats treated with CP and CUR NP, no significant changes were recorded in the parameters of the open field test as compared to control. In addition, treatment with CUR NP prevented all the neurochemical changes induced by CP except the increased value of nitric oxide. CUR NP also reduced the histopathological changes induced by CP. It is clear from the present data that CUR NP could ameliorate the neurotoxic effect induced by cisplatin.
Celotno besedilo
Dostopno za:
DOBA, IJS, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
•Three types of nanofluids TiO2/water, ZnO/water and Ag/water through helical coils are experimentally investigated. .•Increasing the coil pitch reduces both Nusselt number and pressure drop.•Nusselt ...number enhancement up to 28.7 %, 17.8 % and 11.8 % was achieved for TiO2/water, ZnO/water and Ag/water respectively.•Pressure drop increasing up to 28.5%, 23.5% and 25.4% was observed for TiO2/water, ZnO/water and Ag/water respectively.•Novel correlations are introduced for Nusselt number and pressure drop.
Nanofluids are an innovative attractive challenging field suitable for many heat transfer applications. The helical coil is preferred due to compactness and additional curvature flow disturbance.
Heat transfer and pressure drop characteristics of Ag, ZnO and TiO2 water based nanofluids through helical coil tubes under isothermal boundary conditions are experimentally investigated with 0.25% nanoparticles volume concentration Ag/water, ZnO/water and TiO2/water nanofluids. Five coils are constructed with different coil pitches of 2, 4, 6, 8 and 10 cm. The flow rate of the nanofluid varies between 1 to 3.5 L/min with inlet temperature from 30 °C to 60 °C.
The results showed that increasing the coil pitch reduces Nusselt number and pressure drop. The nanofluids have a positive impact on the enhancement of heat transfer but with a pressure drop penalty. Average Nusselt number enhancement up to 11.8 %, 17.8 % and 28.7 % was achieved at Ag/water, ZnO/water and TiO2/water with average pressure drop increasing up to 25.4%, 23.5% and 28.5% respectively. The results showed that an increase in coil pitch decreases hydrothermal performance index (HTPI) and utilizing nanofluids increases HTPI for all types of nanofluids Ag/water, ZnO/water and TiO2/water. Novel correlations were developed to predict Nusselt number and pressure drop.
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