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Scientific Reports Feb 2024Over the past 15 years, there has been a noticeable uptick in incidents involving children ingesting multiple magnetic foreign bodies which can cause injuries and... (Observational Study)
Observational Study
Over the past 15 years, there has been a noticeable uptick in incidents involving children ingesting multiple magnetic foreign bodies which can cause injuries and gastrointestinal complications including death. The current study aimed to identify the prevalence, clinical presentation, and management of single or multiple magnet ingestions. A retrospective multi-central cross-sectional study was conducted to include all pediatric patients < 18 years presented to the emergency department with ingestion of single or multiple magnets and admitted across hospitals in Qatar, UAE, KSA, Tunisia, and Turkey between January 2011 and December 2021. Demographics, symptoms, management, and outcomes were analyzed. There were 189 magnet ingestions, of which 88 (46.6%) were multiple magnet ingestions. Most patients (55.6%) were male, and the median age was 3.9 (IQR 2-7) years. An abdominal X-ray was obtained in all cases. 119 (62%) patients were conservatively treated, 53 (28%) required surgical intervention and 17 (8.9%) underwent gastroscopy. None of the patients with single magnet ingestions experienced morbidity or severe outcomes. Multiple magnet ingestions led to significant morbidity including hospitalizations, perforations (44.3%), severe intestinal necrosis (19.3%), peritonitis (13.6%), severe abdominal infection (10.2%), and septic shock (4.5%). The rate of surgical intervention (59.1% vs. 1.0%) and gastroscopy (15.9% vs. 3.0%) was significantly higher in the multiple ingestion group compared to the single magnet ingestion group. No deaths were identified. A high risk of serious complications, including the need for surgery to remove the magnets and substantial morbidity may result from swallowing more than one magnet. Magnet safety requirements, public education, and improved legislation are urgently required.
Topics: Humans; Child; Male; Child, Preschool; Female; Magnets; Retrospective Studies; Cross-Sectional Studies; Foreign Bodies; Eating
PubMed: 38403623
DOI: 10.1038/s41598-024-55127-0 -
Journal of Pharmacological Sciences Mar 2024Imidazole derivatives are commonly used as antifungal agents. Here, we aimed to investigate the functions of imidazole derivatives on macrophage lineage cells. We...
Imidazole derivatives are commonly used as antifungal agents. Here, we aimed to investigate the functions of imidazole derivatives on macrophage lineage cells. We assessed the expression levels of inflammatory cytokines in mouse monocyte/macrophage lineage (RAW264.7) cells. All six imidazole derivatives examined, namely ketoconazole, sulconazole, isoconazole, luliconazole, clotrimazole, and bifonazole, reduced the expression levels of inflammatory cytokines, such as interleukin (IL)-6 and tumor necrosis factor-α, after induction by lipopolysaccharide (LPS) in RAW264.7 cells. These imidazole derivatives also induced cell death in RAW264.7 cells, regardless of the presence or absence of LPS. Since the cell death was characteristic in morphology, we investigated the mode of the cell death. An imidazole derivative, sulconazole, induced gasdermin D degradation together with caspase-11 activation, namely, pyroptosis in RAW264.7 cells and peritoneal macrophages. Furthermore, priming with interferon-γ promoted sulconazole-induced pyroptosis in RAW264.7 cells and macrophages and reduced the secretion of the inflammatory cytokine, IL-1β, from sulconazole-treated macrophages. Our results suggest that imidazole derivatives suppress inflammation by inducing macrophage pyroptosis, highlighting their modulatory potential for inflammatory diseases.
Topics: Mice; Animals; Pyroptosis; Interferon-gamma; Monocytes; Lipopolysaccharides; Macrophages; Imidazoles; Cytokines
PubMed: 38395517
DOI: 10.1016/j.jphs.2024.01.006 -
International Journal of Surgery Case... Mar 2024Necrotizing fasciitis (NF) is a rare and rapidly progressing soft tissue infection. The commonly involved body parts are the extremities and trunk. Necrotizing fasciitis...
INTRODUCTION
Necrotizing fasciitis (NF) is a rare and rapidly progressing soft tissue infection. The commonly involved body parts are the extremities and trunk. Necrotizing fasciitis (NF) involving the retroperitoneum is very uncommon but associated with higher morbidity and mortality. There are only a few patients survived according to the report.
PRESENTATION OF CASE
This is a 19-year-old male patient presented with abdominal pain, high-grade fever, vomiting and abdominal distension for 3 days. On physical examination, he was hypotensive, tachycardic and febrile. He had a distended, tender abdomen, and hypoactive bowel sound. There were no significant pertinent findings on the other systems. Laboratory tests showed leukocytosis, thrombocytopenia, and elevated liver enzymes. After optimizing with resuscitation and initiating antibiotics, a laparotomy was performed. The finding was 300 ml of hemorrhagic fluid, ischemic cecum and ascending colon, and retroperitoneal necrosis. Subsequently, multiple debridement and right hemicolectomy with stoma was performed. Despite the close monitoring in the ICU, the patient died of uncontrolled sepsis.
CLINICAL DISCUSSION
Necrotizing fasciitis (NF) is a rapidly progressing infectious condition that requires urgent intervention. While it is rare for the retroperitoneum to be affected by NF, it is associated with a high mortality rate. The symptoms of retroperitoneal NF are not specific, making it difficult to diagnose. Here, we present a case of retroperitoneal NF with signs and symptoms of generalized peritonitis, resembling perforated appendicitis.
CONCLUSION
When patients are presented with a case of generalized peritonitis, it is important to include retroperitoneal NF as a potential differential diagnosis.
PubMed: 38382145
DOI: 10.1016/j.ijscr.2024.109412 -
Idiopathic myointimal hyperplasia of mesenteric veins: radiological evaluation using CT angiography.BJR Case Reports Jan 2024A 44-year-old man presented with a chief complaint of constipation. Initial contrast-enhanced CT showed extensive bowel wall thickening, mainly in the left colon, with a...
A 44-year-old man presented with a chief complaint of constipation. Initial contrast-enhanced CT showed extensive bowel wall thickening, mainly in the left colon, with a thin cord-like inferior mesenteric vein (IMV), in contrast to ectatic mesenteric venous branches, suggesting bowel ischaemia owing to venous stasis. One month later, at the time of symptom exacerbation, CT angiography showed a cord-like IMV and ectatic mesenteric venous branches with early enhancement, suggesting the presence of an arteriovenous fistula (AVF). Owing to the progression of bowel ischaemia and necrosis with peritonitis, emergency surgery was performed. Surgical specimens showed focal myointimal hyperplasia of the proximal mesenteric veins in both ischaemic and non-ischaemic lesions of the resected colon, thus leading to the diagnosis of idiopathic myointimal hyperplasia of mesenteric veins (IMHMV) when combined with the clinical and imaging findings. IMHMV is a bowel ischaemic disease caused by non-thrombotic venous obstruction that requires bowel resection and has been suggested to be associated with AVF. Cord-like IMV and AVF in the mesentery are important CT findings that characterize IMHMV. CT angiography is useful in diagnosing IMHMV.
PubMed: 38352257
DOI: 10.1093/bjrcr/uaad009 -
Polski Przeglad Chirurgiczny Oct 2023<b><br>Introduction:</b> Acute appendicitis is one of the most frequent emergencies in hospitals around the world; it requires early surgical treatment... (Review)
Review
<b><br>Introduction:</b> Acute appendicitis is one of the most frequent emergencies in hospitals around the world; it requires early surgical treatment in complicated cases. One of the challenges that the surgeon faces during appendectomy is when the base of the appendix is compromised by either a perforation or gangrene. To show the surgical strategies that have been reported, as well as the complications associated with a compromised appendicular base in a complicated acute appendicitis.</br> <b><br>Methods:</b> A bibliographic search was carried out in the databases of Pubmed, Embase, Web of Science, and Google Scholar. The search expression ("appendiceal stump closure" OR "Closure of the appendiceal stump" OR "Management of appendiceal stump") was used to search for articles. The inclusion criteria were observational studies (case reports, case series, or cross-sectional, case-control, or cohort studies).</br> <b><br>Discussion:</b> Different techniques have been reported for the treatment of a compromised appendicular base. Among the most used are primary closure, partial resection of the cecum, cecostomy tube, ileocecectomy, and right hemicolectomy. The most frequent complications are surgical site infection, intra-abdominal abscess, postoperative ileus, intestinal obstruction, and others.</br> <b><br>Conclusions:</b> The appendicular base, compromised by necrosis or perforation, requires adequate treatment in order to prevent dehiscence of the appendicular stump sutures and fecal peritonitis. A number of surgical options have been reported.</br>.
Topics: Humans; Appendicitis; Cross-Sectional Studies; Laparoscopy; Appendix; Appendectomy; Postoperative Complications
PubMed: 38348988
DOI: 10.5604/01.3001.0053.6868 -
Clinical Case Reports Feb 2024Brucellosis, caused by gram-negative coccobacilli of the genus , is a zoonotic disease with bone and joint complications being common. However, acute abdomen with...
Brucellosis, caused by gram-negative coccobacilli of the genus , is a zoonotic disease with bone and joint complications being common. However, acute abdomen with intestinal perforation is rare. We present a case of a 69-year-old man diagnosed with acute diffuse peritonitis and intestinal perforation due to infection. Surgical intervention revealed ileocecal perforation with wheel spoke-like necrosis. The patient underwent partial resection, ileum closure, and ileostomy. Positive blood culture and agglutination confirmed the diagnosis. Targeted tetracycline and aminoglycoside treatment led to recovery.
PubMed: 38344359
DOI: 10.1002/ccr3.8496 -
Journal of Pharmacological Sciences Feb 2024In our previous study, we reported that 2, 5-dimethyl-celecoxib (DM-C), a derivative of celecoxib, prevents cardiac remodeling in different mouse models of heart...
2,5-Dimethyl-celecoxib induces early termination of inflammatory responses by transient macrophage accumulation and inhibits the progression of cardiac remodeling in a mouse model of cryoinjury-induced myocardial infarction.
In our previous study, we reported that 2, 5-dimethyl-celecoxib (DM-C), a derivative of celecoxib, prevents cardiac remodeling in different mouse models of heart failure, including myocardial infarction (MI). The inflammatory response after MI affects the progression of cardiac remodeling, wherein the immune cells, mainly macrophages, play crucial roles. Therefore, we evaluated the effect of DM-C on macrophages in a cryoinjury-induced myocardial infarction (CMI) mouse model. We observed that DM-C attenuated the deterioration of left ventricular ejection fraction and cardiac fibrosis 14 d after CMI. Gene expression of pro-inflammatory cytokines at the infarct site was reduced by DM-C treatment. Analysis of macrophage surface antigens revealed that DM-C induced transient accumulation of macrophages at the infarct site without affecting their polarization. In vitro experiments using peritoneal monocytes/macrophages revealed that DM-C did not directly increase the phagocytic ability of the macrophages but increased their number, thereby upregulating the clearance capacity. Moreover, DM-C rapidly excluded the cells expressing necrotic cell marker from the infarct site. These results suggested that DM-C enhanced the clearance capacity of macrophages by transiently increasing their number at the infarct site, and terminated the escape from the inflammatory phase earlier, thereby suppressing excessive cardiac remodeling and ameliorating cardiac dysfunction.
Topics: Animals; Mice; Celecoxib; Stroke Volume; Ventricular Remodeling; Ventricular Function, Left; Myocardial Infarction; Macrophages; Disease Models, Animal; Pyrazoles; Sulfonamides
PubMed: 38246733
DOI: 10.1016/j.jphs.2024.01.001 -
BMC Surgery Jan 2024Acute mesenteric ischemia is a rare but lethal disease. Acute occlusive mesenteric ischemia consists of mesenteric artery embolism, mesenteric artery thrombosis, and...
BACKGROUND
Acute mesenteric ischemia is a rare but lethal disease. Acute occlusive mesenteric ischemia consists of mesenteric artery embolism, mesenteric artery thrombosis, and mesenteric vein thrombosis. This study aimed to investigate the factors that may affect the outcome of acute occlusive mesenteric ischemia.
METHODS
Data from acute occlusive mesenteric ischemia patients admitted between May 2016 and May 2022 were reviewed retrospectively. Patients were divided into 2 groups according to whether complications(Clavien‒Dindo ≥ 2) occurred within 6 months of the first admission. Demographics, symptoms, signs, laboratory results, computed tomography angiography features, management and outcomes were analyzed.
RESULTS
59 patients were enrolled in this study. Complications(Clavien‒Dindo ≥ 2) occurred within 6 months of the first admission in 17 patients. Transmural intestinal necrosis, peritonitis, white blood cell count, percentage of neutrophils, percentage of lymphocytes, neutrophil-to-lymphocyte ratio, lactate dehydrogenase, creatine kinase isoenzyme, cardiac troponin I, laparoscopic exploration rate, open embolectomy rate, enterostomy rate, length of necrotic small bowel, length of healthy small bowel, surgical time and intraoperative blood loss differed significantly between groups. Creatine kinase isoenzyme (OR = 1.415, 95% CI: 1.060-1.888) and surgical time (OR = 1.014, 95% CI: 1.001-1.026) were independent risk factors associated with complications(Clavien‒Dindo ≥ 2).
CONCLUSIONS
Our analysis suggests that acute occlusive mesenteric ischemia patients with a creatine kinase isoenzyme level greater than 2.22 ng/mL or a surgical time longer than 156 min are more likely to experience complications'(Clavien‒Dindo ≥ 2) occurrence within 6 months of the first admission.
Topics: Humans; Mesenteric Ischemia; Retrospective Studies; Isoenzymes; Thrombosis; Acute Disease; Ischemia; Creatine Kinase; Mesenteric Vascular Occlusion
PubMed: 38218808
DOI: 10.1186/s12893-024-02310-9 -
International Journal of Nanomedicine 2024To explore the effect of calcium peroxide nanoparticles (CaO NPs) combined with programmed cell death protein 1 (PD-1) inhibitors in the treatment of liver cancer and...
PURPOSE
To explore the effect of calcium peroxide nanoparticles (CaO NPs) combined with programmed cell death protein 1 (PD-1) inhibitors in the treatment of liver cancer and its related mechanism.
METHODS
Hepa1-6 cells were cultured to construct the Hepa1-6 mouse liver cancer model. In vivo mechanism study, a unilateral tumor model was established. Eighteen tumor-bearing mice were randomly divided into the control group (intra-tumoral injection of PBS solution) and the experimental group (intra-tumoral injection of CaO NPs). A hypoxic probe, pH probe, and micro-CT were used to evaluate the effect of CaO NPs on improving hypoxia, neutralizing acidity, and inducing calcium overload within the tumor. To study the effect of CaO NPs combined with PD-1 inhibitors on proximal and distal tumors, the bilateral tumor model was established. Forty tumor-bearing mice were randomly divided into the control group (intra-tumoral/intra-peritoneal injection of PBS solution), CaO NPs group (intra-tumoral injection of CaO NPs), PD-1 group (intra-peritoneal injection of PD-1 inhibitor), and the combination group (intra-tumoral injection of CaO NPs and intra-peritoneal injection of PD-1 inhibitors). The administered side was recorded as the proximal tumor. Tumor volume and body weight were measured every 2 days after treatment. On day 8, serum and tumor samples were collected. The immune factors in serum (Interferon-γ (IFN-γ), Tumour necrosis factor-α (TNF-α), Interleukin-2 (IL-2), and Interleukin-10 (IL-10)) and tumor tissue (IFN-γ and TNF-α) were detected by ELISA. H&E staining was used to detect tumor necrosis. Immunohistochemical staining was used to detect the amount of CD4 and CD8 T cells within the tumor. By analyzing the tumor volume, pathological indexes, and immune-related indexes, the effects of CaO NPs combined with PD-1 inhibitors on proximal and distal tumors were evaluated, and they mediated immunomodulatory effects (including local and systemic immunity), and their effects on tumor burden were studied. In addition, a unilateral tumor model was established to study the effect of CaO NPs combined with PD-1 inhibitors on survival time.
RESULTS
The results of in vivo mechanism study showed that CaO NPs can improve hypoxia, neutralize acidity, and induce calcium overload within tumors. The results of the study on the effect of CaO NPs combined with PD-1 inhibitor on proximal and distal tumors showed that, compared with the other three groups, the bilateral tumor burden of the combination group was significantly reduced, the intra-tumoral infiltration of CD8 and CD4 T cells were significantly increased, the secretion of anti-tumor immune factors in tumor and serum was increased, and the secretion of pro-tumor immune factors was decreased. Mice in the combination group showed the longest survival compared with the other groups.
CONCLUSION
CaO NPs can improve hypoxia, neutralize acidity, and induce calcium overload within tumors, so as to reduce tumor burden and realize an immunosuppressive tumor transformation to a hot tumor, and play a synergistic role with PD-1 inhibitors in anti-liver cancer.
Topics: Mice; Animals; Carcinoma, Hepatocellular; Immune Checkpoint Inhibitors; Programmed Cell Death 1 Receptor; Calcium; CD8-Positive T-Lymphocytes; Tumor Necrosis Factor-alpha; Liver Neoplasms; Mice, Inbred Strains; Disease Models, Animal; Hypoxia; Immunologic Factors
PubMed: 38196507
DOI: 10.2147/IJN.S440387 -
Romanian Journal of Morphology and... 2023Currently, worldwide, the coronavirus disease 2019 (COVID-19) pandemic, which first appeared in Wuhan, China, in December 2019, is capsizing the medical system and...
Currently, worldwide, the coronavirus disease 2019 (COVID-19) pandemic, which first appeared in Wuhan, China, in December 2019, is capsizing the medical system and turning the attention of the entire healthcare system through the many aspects it presents, both from a pathophysiological and from a semiological view, insufficiently studied aspects. With a high rate of morbidity and mortality, the COVID-19 pandemic was initially observed as a pathology leading to a severe acute respiratory syndrome, but over time gastrointestinal and hepatic manifestations have been reported. The study includes an analysis of 21 patients in the stage of the clinical disease of COVID-19 or in the stage of recovery, hospitalized in the Departments of General Surgery II or Gastroenterology, Emergency Clinical County Hospital of Craiova, Romania, with predominantly digestive symptoms, with the clinical expression of infectious enterocolitis, although stool culture was negative for pathogenic bacteria. The evolution of patients was influenced by the appearance of peritonitis through colonic necrosis or remission of clinical symptoms under empirical therapy.
Topics: Humans; Abdomen, Acute; Pandemics; COVID-19; Liver Failure; Diarrhea; Enterocolitis
PubMed: 38184833
DOI: 10.47162/RJME.64.4.09