An optimization method for studying fractional-order tuberculosis disease model via generalized Laguerre polynomials

Tuberculosis (TB) is a deadly contagious disease that affects vital organs of the body, especially the lungs. Although the disease is preventable, there are still concerns about its continued spread. Without effective prevention or appropriate treatment, TB infection can be fatal to humans. This paper presents a fractional-order TB disease (FTBD) model to analyze TB dynamics and a new optimization method to solve it. The method is based on the basis functions of generalized Laguerre polynomials (GLPs) and some new operational matrices of derivatives in the Caputo sense. Finding the optimal solution to the FTBD model is reduced to solving a system of nonlinear algebraic equations with the aid of GLPs using the Lagrange multipliers method. A numerical simulation is also carried out to determine the impact of the presented method on the susceptible, exposed, infected without treatment, infected with treatment, and recovered cases in the population.

COVID-19 infection in children: A systematic review and meta-analysis of clinical features and laboratory findings

OBJECTIVE

We aimed to provide a meta-analysis of previously published papers on the COVID-19-related clinical features and laboratory findings in children.

METHOD

This meta-analysis was conducted by using Medline/PubMed, Scopus, Web of Sciences and Google Scholar. Finally, 32 articles were selected for full-text assessment.

RESULTS

The most frequent symptoms were fever, cough, vomiting, diarrhea, sore throat, and dyspnea. Regarding the combined results of the meta-analysis, fever (46%, 95% CI 40-53%), cough (37%, 95% CI 29-46%), diarrhea (19%, 95% CI 9-28%), and pharyngalgia (13%, 95% CI 5-20%) were the most widely reported symptom. Besides, positive RT-PCR test results (43%, 95% CI 33-53%), low oxygen saturation (38%, 95% CI 25-51%), and elevated D-dimer levels (36%, 95% CI 16-56%) were the most common laboratory findings.

CONCLUSION

This review found that clinical presentations were milder, the prognosis was better, and the mortality rate was lower in children with COVID-19 compared with adult patients; however, children are potential carriers, like adults, and can transmit the infection among the population. Therefore, early identification and intervention in pediatric patients with COVID-19 are essential in order to control the pandemic. Moreover, gastrointestinal symptoms were more common symptoms among children.

AB1313-HPR EFFECTS OF N-ACETYLCYSTEINE ON PULMONARY FUNCTIONS IN PATIENTS WITH SYSTEMIC SCLEROSIS: A DOUBLE BLIND, PLACEBO CONTROLLED STUDY

Background:

Systemic sclerosis (SSc) is a systematic and rare autoimmune disease that affects many organs. N-acetylcysteine (NAC), thiol containing compound, can act both as the precursor of reduced glutathione and direct scavenger of reactive oxygen species.

Objectives:

We assessed the clinical effect of NAC on pulmonary function test of patients with diffuse scleroderma.

Methods:

This study is a randomized double blind clinical trial that was done on 25 patients with diffuse SSc without lung involvement on primary chest high-resolution computed tomography. Placebo was administered for 13 patients and 1200 milligram NAC for 12 patients. Body plethysmography parameters were assessed at the beginning of the study and after 24 weeks.

Results:

Patients in the two groups were matched in the basic demographic data like age, duration of disease, and modified Rodnan skin score. The analysis showed no significant differences in parameters of plethysmography between the two groups. After importing the data of 2 patients in the placebo-treated group, who developed interstitial lung disease, DLCO in the placebo-treated group was 90.69 ± 21.29 milliliter at the end of the study, which significantly decreased compared with the beginning of the study (102.30 ± 13.83 ml). Also, changes of DLCO between the two groups were significantly different.

Conclusion:

In this trial, sensitivity of DLCO as the first marker in evaluation of pulmonary function in patients with SSc was confirmed. On the other hand, NAC had no effect versus placebo in a period of 24 weeks. We recommend that more studies with larger sample size and longer duration should conduct for further evaluation.

References:

No reference.

Acknowledgments:

The present article was extracted from the thesis written by Maryam Mazidi Moradi. The authors would like to thank Shiraz University of Medical Sciences, Shiraz, Iran and also Center for Development of Clinical Research of Nemazee Hospital and Dr. Nasrin Shokrpour for editorial assistance.

Disclosure of Interests:

None declared

Does intraperitoneal injection of propofol prior to detorsion improve testes weight and histopathological findings in a rat model?

Objectives

To determine the long-term preventive effects of intraperitoneal propofol on testicular ischemia–reperfusion injury in a rat model.

Materials and methods

Forty adult male albino Wistar rats were divided randomly into the following four groups according to the planned treatment (n=10 per group): group I, control; group II, sham-operated; group III, torsion/detorsion (T/D); and group IV, T/D plus propofol. Testicular ischemia was achieved by twisting the left testis 720° clockwise (ie, applying torsion) for 1 h. In the T/D plus propofol group (group IV), 50 mg/kg propofol was administered intraperitoneally 30 minutes before detorsion. Ipsilateral orchiectomy was performed under general anesthesia to determine the mean testicular weight and to enable histopathological examination of the testes using Johnsen’s mean testicular biopsy score 30 days after the surgical procedure in all groups.

Results

The testicular weights in groups I, II, III, and IV were 1.65±0.32, 1.59±0.33, 1.11±0.56, and 1.08±0.50 g (mean ± SD), respectively. Testicular weight was significantly lower in the T/D groups (III and IV) than in both the control and sham-operated groups (I and II), but there was no improvement in testicular weight as a result of propofol administration. Similarly, Johnsen’s mean testicular biopsy score was lower in groups III and IV than in groups I and II, but no positive effect was conferred by the administration of propofol in group IV.

Conclusion

The use of propofol in the treatment of testicular ischemia–reperfusion injury caused by testis torsion has no significant long-term therapeutic potential.

Stone scattering during percutaneous nephrolithotomy: role of renal anatomical characteristics

The purpose of this study was to evaluate how the upper calyx-lower calyx infundibular (ULI) angle influences intrarenal stone migration during percutaneous nephrolithotomy (PCNL) in patients with a solitary renal pelvis stone and significant hydronephrosis. 50 adult patients with a solitary renal pelvis stone larger than 20 mm were considered for PCNL with a pneumatic lithotriptor for stone fragmentation. Inclusion criteria were moderate to severe hydronephrosis and upper calyx infundibular width >10 mm, and access point was the lower calyx in all cases. The ULI angle as well as stone fragment migration from the renal pelvis toward the upper calyx was noted during the operation. To determine the "critical" angle above which the probability of stone migration would be increased significantly, receiver operating characteristic curve was used. Mean stone size was 33.8 ± 13.2 mm. In 23 patients (46 %) the stone migrated toward the upper calyx during stone fragmentation. Mean ULI angle was significantly wider in patients whose stone migrated (120.2 ± 20.5 versus 102.2 ± 21.4, P = 0.004, 99 % CI = 6.04-29.9). A ULI angle of 117.5° was the critical angle, above which the rate of stone migration rose significantly (P < 0.008). One-session stone-free rate was significantly higher in patients without stone migration (P = 0.03). In patients with a solitary renal pelvis stone and significant hydronephrosis, a wider ULI angle was associated with a greater likelihood of stone scattering which could potentially affect the outcome of PCNL with pneumatic lithotriptor. A cut-off angle of 117.5° was the critical angle, above which access via a calyx other than the lower calyx (example: middle or upper calyx) seems advisable.

Evolution of gas exchange abnormalities in patients with liver cirrhosis candidate for liver transplantation

BACKGROUND

Hypoxemia is common in patients with cirrhosis but the natural history of this syndrome is unknown. This study was conducted to evaluate the natural history of arterial oxygenation in patient with end stage liver cirrhosis.

METHODS

Sixty eight patients with liver cirrhosis were followed up for 6-12 months. Arterial blood gas (ABG) and pulse oximetry were obtained on day of presentation and follow up.

RESULTS

There were no significant changes in the oxygen saturation by pulse oximetry (SpO2), partial pressure of oxygen (PaO2) and alveolar arterial oxygen gradient (A-a O2) after 6-12 months. Mean arterial oxygen saturation (SaO2) in 46 patients was 95.42±1.92, and after follow up changed to 95.45±2.96. Thirty eight patients had SaO2 > 94% (mean 96.12±1.08 after 6-12 months changed to 95.66±2.58) ; 8 patients had SaO2 = 94 (mean 92.08±1.44 after 6-12 months changed to 94.46±4.47).

CONCLUSION

There were no significant changes in the SpO2, PaO2 and A-a O2 after 6-12 months.

Percutaneous nephrolithotomy complications in 671 consecutive patients: a single-center experience

PURPOSE

To evaluate major and minor complications of percutaneous nephrolithotomy (PCNL) and their management in our consecutive cases.

MATERIALS AND METHODS

We reviewed medical records of 671 patients who had undergone PCNL in our center from March 2000 to March 2006. The demographic data, stone parameters, PCNL complications, and stone-free rate were evaluated. Multiple parameters were evaluated for their association with PCNL complications using Chi-Square test.

RESULTS

Complications occurred in 203 (30.3%) patients; renal parenchymal injury in 103 (15.4%), peri-operative bleeding in 42 (6.3%), late bleeding in 6 (0.9%), renal collecting ducts injury in 35 (5.2%), fever in 7 (1.0%), colon perforation in 2 (0.3%), major vessels injury in 3 (0.4%), pneumothorax in 3 (0.4%), and hemothorax in 2 (0.3%) subjects. Mortality occurred in 1 patient with colon perforation (0.15%).

CONCLUSION

Percutaneous nephrolithotomy has low complication rate in experienced hands.

MR imaging and MR cholangiopancreatography of multifocal intraductal papillary mucinous neoplasms of the side branches: MR pattern and its evolution

PURPOSE

This paper describes the magnetic resonance imaging (MRI) and magnetic resonance cholangiopancreatography (MRCP) pattern of multifocal intraductal papillary mucinous tumours (IPMT) of the pancreatic side branches and its evolution during followup.

MATERIALS AND METHODS

Twenty-six patients with multifocal IPMT of the side branches were included in this retrospective study. Inclusion criteria were > or =2 ectasic side branches, presence of communication with the main pancreatic duct, and > or =2 MRI/MRCP examinations after > or = 6-12 months. Exclusion criteria were IPMT involving both the main pancreatic duct and its branch ducts, previous surgery and lack of follow-up MRI examinations. Median follow-up was 27 (range 6-59) months. Images were assessed qualitatively and quantitatively. Qualitative assessment considered: the number of cystic lesions of the branch ducts, morphology of the communication between the cystic lesion and the main duct (direct or neck), presence of intraluminal filling defects within the cystic lesions, presence of mural nodules and mural enhancement of the cystic lesion. quantitative assessment considered mean maximal diameter of the cystic lesions and mean length of the communication neck.

RESULTS

At diagnosis, the mean number of cystic lesions of the side branches was 7.5. a communication neck was detected in 16/26 patients (60%). Intraluminal filling defects in the side branches were present in 6/26 patients (23%). Mural nodules were seen in 1/26 patients (4%). The mean diameter of the cystic lesions was 18.8 mm. The mean length of the communication neck was 6.9 mm. At follow-up, the mean number of cystic lesions of the side branches was 8.4. A communication neck was detected in 20/26 patients (77%). Intraluminal filling defects in the side branches were detected in 7/26 patients (27%); mural nodules were seen in 2/26 patients (8%). Mural enhancement of the branch duct was detected in 2/26 patients (8%). The mean diameter of the cystic lesions increased to 22.3 mm (p < 0.05), and the mean length of the communication neck was 8.6 mm.

CONCLUSIONS

MultifocaL IPMT of the side branches shows a constant but very slow progression over time. In our series, only 2/26 patients showed mural nodules.

Left-Sided Inferior Vena Cava Found Incidentally During Laparoscopic Donor Nephrectomy: Report of Three Cases

Laparoscopic donor nephrectomy can be a challenging procedure in patients with abdominal great-vessel anomalies. We report our experience with three cases of laparoscopic donor nephrectomy with a rare incidentally found left-sided inferior vena cava.

Identification and characterization of Rhodopseudomonas spp., a purple, non-sulfur bacterium from microbial mats

A species of facultative photo-organotrophic, purple, non-sulfur bacterium was isolated from mixed-species microbial mats, characterized and examined for metal tolerance and bioremediation potential. Contributing mats were natural consortia of microbes, dominated by cyanobacteria and containing several species of bacteria arranged in a laminar structure, stabilized within a gel matrix. Constructed microbial mats were used for bioremediation of heavy metals and organic chemical pollutants. Purple, non-sulfur bacteria are characteristically found in lower strata of intact mats, but their contributing function in mats survival and function by mediating the chemical environment has not been explored. The gram-negative rod-shaped bacterium, reported here, produced a dark red culture under phototrophic conditions, reproduced by budding and formed a lamellar intracytoplasmic membrane (ICM) system parallel to cytoplasmic membrane, which contained bacteriochlorophyll a and carotenoids. This strain was found to have multiple metal resistances and to be effective in the reductive removal of Cr(VI) and the degradation of 2,4,6-trichlorophenol. Based on the results obtained from morphology, nutrient requirements, major bacteriochlorophyll content, GC content, random amplified polymorphic DNA-polymerase chain reaction (RAPD-PCR) profile and 16S-rDNA phylogenetic analysis, this member of the microbial mats may be identified as a new strain of the genus Rhodopseudomonas.