Introduction: Western lifestyle characterized by increased consumption of red meat, fat, processed food, smoking, alcohol drinking, lower consumption of vegetables and physical inactivity has been associated with a higher gastrointestinal cancer risk. Digestive system cancers are diagnosed at late stages when they show poor response to treatment and are associated with a high mortality rate. Colorectal, gastric, esophageal and pancreatic cancers are among the most common cancers worldwide. Studies show that more than 50% of gastrointestinal cancers develop as a result of inappropriate lifestyle. An inverse association between physical activity and many chronic diseases has been proved so far. However, the association between physical activity and some gastrointestinal cancers is still controversial. This study was aimed to determine the association between physical activity and gastrointestinal cancers risk.
Methods: We conducted a comprehensive search of English and Persian databases from February 2007 till December 2017, for studies investigating the association of physical activity and risk of gastrointestinal cancers. Finally, after reading full text of articles, 123 studies were included.
Results: Physical activity can be helpful in reducing the risk of gastrointestinal cancer, especially colon and pancreatic cancers. The risk reduction is not similar for different types of gastrointestinal cancers and also among males and females.
Conclusion: Different types of physical activity are associated with a lower risk of gastrointestinal cancer. However, it is unknown which type and intensity of physical activity are associated with a protective effect against gastro-intestinal cancer.
Objective. The aim of the study was to evaluate vimentin expression in inflamed nasal mucosa of patients with chronic rhinosinusitis without nasal polyps (CRSsNP) and serum levels of matrix metalloproteinase-9 (MMP-9).
Material and Methods. We measured concentrations of MMP-9 in blood serum of twenty patients with CRSsNP using ELISA and compared them with the control group composed of twenty healthy subjects. Vimentin expression in nasal mucosa was studied by an immunohistochemical method.
Results. Blood serum levels of MMP-9 were found to be elevated in patients with CRSsNP. The disease was also associated with the upregulation of vimentin expression both in the lamina propria and nasal epithelial layer.
Conclusion. CRSsNP is accompanied by a higher number of vimentin-expressing cells in the nasal epithelium, which may indicate their epithelial-to-mesenchymal transition (EMT). We speculate that MMP-9 may contribute to the increased rate of EMT of nasal epithelial cells in CRSsNP.
Dehydration and electrolyte imbalance as a result of prolonged strenuous exercise leads to poor thermoregulation and impaired muscle performance. Thus, appropriate rehydration during and after exercise with a solution that has a balanced combination of nutrients including electrolytes, carbohydrates and proteins is crucial in preventing the side effects of dehydration. Yogurt drink as a traditional drink with an appropriate nutritious content could be used as an alternative to expensive commercially available drinks for rehydrating athletes after long exercises in warm and humid environments and in developing countries. In this cross-over trial we examined the rehydration potential of yogurt drink in comparison to water and a commercial drink after a strenuous exercise (cycling) session in a hot and humid environment. Blood measurements included blood osmolality, serum glucose, hematocrit and serum electrolytes. Urine measurements included urine volume, osmolality and electrolyte concentrations. The results showed that early after rehydration Yogurt drink compared to water significantly increased urine sodium (mmol/L) (138.8 ± 93.4 vs. 90.0 ± 50.7, P < 0.01), urine potassium (mmol/L) (105.6 ± 55.1 vs. 35.8 ± 22.0, P < 0.05) and urine chloride (mmol/L) (113.2 ± 28.4 vs. 35.8 ± 25.1 P < 0.01). This degree of improvement was the same as with the commercial drink for urine sodium, potassium, and chloride. Yogurt drink prevented dehydration-induced changes in the blood as it stabilized the hematocrit and serum sodium, potassium and osmolality within the normal range after exercise. Finally, our results indicated that yogurt drink, as a natural and affordable rehydration option, can be considered to restore fluid and electrolyte losses after strenuous exercises in hot and humid environments.
Hairline is a crucial landmark in facial aesthetics. Its restoration in terms of position, continuity and hair growth is of a paramount importance in facial plastic aesthetic and reconstructive surgery. The purpose of the paper is to demonstrate the effectiveness of using local tissue only in the restoration of skin and soft tissue defects affecting the hair-line. A brief retrospective analysis of clinical cases with defects engaging the hairline was made. The majority of the patients (20 out of 22) were operated because of skin lesions of different entities. In 7 of the cases the direct closure technique was applied as a surgical tool for hairline restoration and in 15 of them rotational flaps were the best reconstructive option. A special emphasis is put on the defect size in regards of choosing the right surgical technique for defect closure in order to achieve the best aesthetic outcome in the hairline restoration.
Urinary neutrophil gelatinase-associated lipocalin (uNGAL), urinary N-acetyl-bd-glucosaminidase (NAG), urinary α1-microglobulin/creatinine ratio and cystatin C have been suggested as potential early markers of delayed graft function (DGF) following kidney transplantation. We conducted a prospective study in 50 consecutive kidney transplant recipients to evaluate serial changes of these biomarkers within the first week after transplantation and assess their performance in predicting DGF (dialysis requirement during initial post-transplant week) and graft function throughout the first year. Urine samples were collected on post-transplantation days 0, 1, 2, 4, and 7. Statistical analysis: Linear mixed and multivariable regression models, receiver-operating characteristic (ROC), and areas under ROC curves were used. At all-time points, mean urinary NGAL levels were significantly higher in patients developing DGF. Shortly after transplantation (3-6 h), uNGAL and uNAG values were higher in DGF recipients (on average +242 ng/mL; NAG – 6.8 U/mmol creatinine, considering mean dialysis time of 4.1 years) and rose further in the following days, contrasting with prompt function recipients. On Day-1 uNGAL levels accurately predicted DGF (AUC-ROC = 0.93), with a performance higher than serum creatinine (AUC-ROC = 0.76), and similar to cystatin C (AUC-ROC = 0.95). Multivariable analyses revealed that uNGAL levels at days 4 and 7 were strongly associated with one-year serum creatinine level. Urinary NGAL, serum cystatin C is an early marker of graft injury and is independently associated with dialysis requirement within one week after transplantation and one-year graft function.
The objective of this study was to perform a comprehensive evaluation of major indices of pain syndrome in patients with mandibular fractures accompanied by damage of inferior alveolar nerve using conventional therapeutic regimen supplemented by the administration of drug product Nucleo CMP Forte. Operative and postoperative treatment of 50 patients with angular fractures of the mandible, accompanied by clinical manifestations of inferior alveolar nerve damage, was performed. The severity of pain syndrome and neuropathy symptoms was evaluated using the LANSS pain scale, DN4 questionnaire, the Visual Analogue Scale (VAS) and Neuropathy Total Symptom Scores (NTSS-9). Decrease of pain syndrome was revealed in both groups but with different dynamic pattern. In the treatment group pain syndrome manifestations and neuropathy symptoms decreased quicker than in the comparison group. As LANSS, DN4, VAS and NTSS-9 scales characterize pain syndrome from various perspectives, the results were different but similar tendency was shown. At the beginning of the study LANSS scale indices were nearly identical in both groups, while on the 7th and 14th day they were 1.35 and 2.03 times lower, respectively, in the treatment group compared to the control group. On the first day NTSS-9 scale values did not practically differ in between the studied patients, being somewhat higher in the treatment group. On the 7th and 14th day the values increased 1.24 and 3.82 times, in the treatment group and in the group of comparison, respectively. Thus, the patients in the treatment group showed significantly greater pain relief than those in the comparison group. The analysis of dynamic pattern of complaints as well as the objective findings in angular fractures of the mandible, accompanied by the damage of inferior alveolar nerve, demonstrated that the administration of drug product Nucleo CMP Forte led to a more pronounced improvement of pain syndrome in the course of treatment. Because of the fact that neuropathic pain can develop in orthodontic treatment, as well as when partial and complete removable dentures are used, the administration of drug product Nucleo CMP Forte is warranted in combined therapy of both mandibular fractures followed by the clinical manifestations of inferior alveolar nerve damage, and neuropathic pain management in orthodontics and orthopedic stomatology.
Congenital lacrimal fistula is a developmental abnormality. This is a case of a patient with an external congenital lacrimal sac fistula. Surgical treatment was used to correct the condition. Immediate postoperative results were seen. To present a case of a patient with an external congenital lacrimal sac fistula, in which surgical treatment was applied and immediate postoperative results with a good outcome were seen. A 3-year-old boy with an external congenital lacrimal sac fistula presented to our clinic. The skin orifice was observed on the left eye in a typical place – located in the inferomedial aspect of the medial canthal angle. The patient was treated in the at the Eye clinic, at university hospital “Dr. Georgi Stranski” – Pleven, Bulgaria. He underwent a surgical procedure – simple fistula excision (closed fistula excision). The surgical technique was a successful closed fistula excision. In the immediate postoperative period there were no complications such as infection, recurrence or worsening of the epiphora, poor cosmetic results, bleeding or damage to the lid structures or nose. The prognosis for patients with congenital lacrimal fistulas is quite good. Many are asymptomatic and those who have symptomatic epiphora or mucoid discharge can be successfully treated by surgery. Several surgical options exist – closed fistula excision, dacryocystorhinostomy (DCR) with fistula excision and fistula excision with nasolacrimal intubation. Symptomatic congenital lacrimal sac fistulas can be treated successfully with excision alone.
The endodontic treatment of immature permanent teeth with necrotic pulp is a serious clinical challenge. The chemical agents, used in regenerative procedures, should be selected not only based on their bactericidal/bacteriostatic properties, but also on their ability to ensure the survival of the patient’s stem cells. The aim of this study was to evaluate the effect of citric acid on the vitality of SCAP in a model of an immature tooth root. Models of immature roots were created from 12 freshly extracted teeth. The models were gas sterilized with ethylene oxide and they were separated into three groups, based on the used combinations of irrigants: 1) 1.5% sodium hypochlorite / 17% EDTA; 2) 1.5% sodium hypochlorite / 10% citric acid; 3) saline. SCAPs in a hyaluronic acid–based scaffold were seeded into the canals and cultured for 7 days. Viable cells were quantified using a colorimetric assay. There was no statistically significant difference between the groups, irrigated with NaOCl/EDTA and NaOCl/citric acid. The results from our experiment show that 10% citric acid can be used in combination with 1.5% NaOCl in a regenerative endodontic procedure.
We describe the case of a 74-year-old Bulgarian woman with a long history of chronic urticaria with severe burning sensation, arthralgia and fever. Additional symptoms of Schnitzler such as monoclonal immunoglobulin – kappa component, elevated erythrocyte sedimentation rate and enlarged lymph nodes were detected six years after the onset of the symptoms. The first diagnoses hypersensitive vasculitis and dermatitis were established in 2009. Schnitzler syndrome was recognized and the diagnosis was established 2 years later after some examination tests. The time course of the values of IgM, C-reactive protein, erythrocyte sedimentation rate and neutrophils were presented. The mean value of IgM is 13.8 ± 2.19 g/l, the mean value of erythrocyte sedimentation rate is 48.6 ± 14.46 mm/h and the mean value of C-reactive protein – 29.8 ± 7.34 mg/l. The use of nonsteroid anti-inflammatory drugs throughout the period and corticosteroids prescribed parenterally and orally resulted in the relief of arthralgia and fever.
Provision of quality health services to population of the rural areas with limited access to dental treatment and educating dental students in high standard of professional conduct when delivering health services to the population, represents the main reason for the foundation of a dental college in an area like Mangalore. The purpose of this study was to assess the satisfaction of patients visiting the dental college clinics. A cross-sectional study was conducted between May 1 and July 31, 2017. A questionnaire, covering 4 items: patient-dentist relationship; efficiency of the general clinic; patients perception of dental care quality; college healthcare opinion, was distributed to 400 patients visiting the dental clinic. Data were treated statistically using overall percentage distributions and Fisher exact test. The mean percentage of agreement for the 4 items was 85.86 ± 24.51% denoting a high level of satisfaction. Fisher exact test showed (p < 0.01) statistically important difference between first time and multiple time visitors answers. Majority of the patients were satisfied with the clinical settings and the benefits of the fast delivered treatment. The quality of the services was appreciated by the majority of visitors. The attitude of the providers of healthcare was perceived as very friendly and gentle. The assessment of patients’ contentment and perception of healthcare services could be an efficient tool to evaluate the overall activity of an educational healthcare institution.