Edema Diameter Research Articles

Anti-inflammatory effects of thymol: an emphasis on the molecular interactions through in vivo approach and molecular dynamic simulations.

Thymol (THY), as the natural monoterpene phenol, acts against oxidative stress and inflammatory processes. This study aimed to evaluate the anti-inflammatory effects and possible molecular mechanisms of THY via formalin-induced mouse and egg albumin-induced chick models alongside molecular docking and molecular dynamic (MD) simulations. THY (7.5, 15, and 30mg/kg) was investigated, compared to celecoxib and ketoprofen (42mg/kg), as anti-inflammatory standards. THY dose-dependently and significantly (p < 0.05) decreased paw-licking and edema diameter parameters in formalin (phases I and II) and egg albumin-induced models. Moreover, THY (15mg/kg) exerted better anti-inflammatory effects in combination with the standard drug ketoprofen than alone and with celecoxib. In silico studies demonstrated elevated binding affinities of THY with cyclooxygenase-2 (COX-2) than the COX-1 enzyme, and the ligand binds at a similar location where ketoprofen and celecoxib interact. The results of MD simulations confirmed the stability of the test ligand. THY exerted anti-inflammatory effects on Swiss mice and young chicks, possibly by interacting with COX-2. As a conclusion, THY might be a hopeful drug candidate for the management of inflammatory disorders.

Delayed-onset seizures after subthalamic nucleus deep brain stimulation surgery for Parkinson’s disease

BackgroundDelayed-onset seizures after deep brain stimulation (DBS) surgery were seldom reported. This study summarized the clinical characteristics of delayed-onset seizures after subthalamic nucleus (STN) DBS surgery for Parkinson’s disease (PD) and analyzed risk factors. MethodsA single-center retrospective study containing consecutive STN-DBS PD patients from 2006 to 2021 was performed. Seizures occurred during the DBS surgery or within one month after DBS surgery were identified based on routine clinical records. Patients with postoperative magnetic resonance imaging (MRI) were included to further analyze the risk factors for postoperative seizures with univariate and multivariate statistical methods. Results341 consecutive PD patients treated with bilateral STN-DBS surgery wereidentified, and five patients experienced seizures after DBS surgery with an incidence of 1.47 %. All seizures of the five cases were characterized as delayed onset with average 12 days post-operatively. All seizures presented as generalized tonic-clonic seizures and didn’t recur after the first onset. In those seizures cases, peri-electrode edema was found in both hemispheres without hemorrhage and infarction. The average diameter of peri-electrode edema of patients with seizures was larger than those without seizures (3.15 ± 1.00 cm vs 1.57 ± 1.02 cm, p = 0.005). Multivariate risk factor analysis indicated that seizures were only associated with the diameter of peri-electrode edema (OR 4.144, 95 % CI 1.269–13.530, p = 0.019). ConclusionsDelayed-onset seizures after STN-DBS surgery in PD patients were uncommon with an incidence of 1.47 % in this study. The seizures were transient and self-limiting, with no developing into chronic epilepsy. Peri-electrode edema was a risk factor for delayed-onset seizures after DBS surgery. Patients with an average peri-electrode edema diameter > 2.70 cm had a higher risk to develop seizures.

Anti-inflammatory activity of d-pinitol possibly through inhibiting COX-2 enzyme: in vivo and in silico studies.

Introduction: D-pinitol, a naturally occurring inositol, has diverse biological activities like antioxidant, antimicrobial and anticancer activities. This study aimed to evaluate anti-inflammatory effect of d-pinitol in a chick model. Additionally, in silico studies were performed to evaluate the molecular interactions with cyclooxygenase-2 (COX-2). Methods: The tested groups received d-pinitol (12.5, 25, and 50mg/kg) and the standard drugs celecoxib and ketoprofen (42mg/kg) via oral gavage prior to formalin injection. Then, the number of licks was counted for the first 10min, and the paw edema diameter was measured at 60, 90, and 120min. Results and Discussion: The d-pinitol groups significantly (p < 0.05) reduced the number of paw licks and paw edema diameters, compared to negative control. When d-pinitol was combined with celecoxib, it reduced inflammatory parameters more effectively than the individual groups. The in silico study showed a promising binding capacity of d-pinitol with COX-2. Taken together, d-pinitol exerted anti-inflammatory effects in a dose-dependent manner, possibly through COX-2 interaction pathway.

Perilesional edema diameter associated with brain metastases as a predictive factor of response to radiotherapy in non-small cell lung cancer.

Different prognostic scales exist in patients with brain metastasis, particularly in lung cancer. The Graded Prognostic Assessment for lung cancer using molecular markers (Lung-molGPA index) for brain metastases is a powerful prognostic tool that effectively identifies patients at different risks. However, these scales do not include perilesional edema diameter (PED) associated with brain metastasis. Current evidence suggests that PED might compromise the delivery and efficacy of radiotherapy to treat BM. This study explored the association between radiotherapy efficacy, PED extent, and gross tumor diameter (GTD). The aim of this study was to evaluate the intracranial response (iORR), intracranial progression-free survival (iPFS), and overall survival (OS) according to the extent of PED and GT. Out of 114 patients with BM at baseline or throughout the disease, 65 were eligible for the response assessment. The GTD and PED sum were measured at BM diagnosis and after radiotherapy treatment. According to a receiver operating characteristic (ROC) curve analysis, cutoff values were set at 27mm and 17mm for PED and GT, respectively. Minor PED was independently associated with a better iORR [78.8% vs. 50%, OR 3.71 (95% CI 1.26-10.99); p = 0.018] to brain radiotherapy. Median iPFS was significantly shorter in patients with major PED [6.9 vs. 11.8 months, HR 2.9 (95% CI 1.7-4.4); p < 0.001] independently of other prognostic variables like the Lung-molGPA and GTD. A major PED also negatively impacted the median OS [18.4 vs. 7.9 months, HR 2.1 (95% CI 1.4-3.3); p = 0.001]. Higher PED was associated with an increased risk of intracranial progression and a lesser probability of responding to brain radiotherapy in patients with metastatic lung cancer. We encourage prospective studies to confirm our findings.

Delayed anaphylaxis due to Alpha-gal allergy: A modified desensitization protocol with red meat in an adult patient.

Alpha-gal allergy is the sensitization to Alpha-gal present in saliva when a tick bites and the development of an IgE-mediated reaction to Alpha-gal also present in red meat by cross-reactivity. In contrast to other food allergies, symptoms occur as late as 2-6 hours after a meal. Prick to prick testing with nonmammalian meat in combination with cooked mammalian meat is recommended for diagnosis. However, the main diagnostic test is Alpha-gal sIgE> 0.1 IU/mL. The primary recommendation in patients with Alpha-gal syndrome is to prevent new tick bites and avoid all mammalian meats. Since most of the dishes in our country's food culture contain red meat, elimination diet may adversely affect patients quality of life. In the management of these patients, the option of desensitization with red meat can be considered by evaluating the benefit-risk ratio together with the patient. Our patient with a history of tick bites and a reaction pattern ranging from urticaria to anaphylaxis two hours after meat consumption was evaluated for Alpha gal allergy. The patient was found to be positive by prick-to-prick with cooked red meat. In addition, the high level of Alpha-gal specific IgE (27.3 Ku/L) confirmed the Alpha-gal allergy, and the decision to apply desensitization with red meat was taken. There are only two literatures on this subject, one of which includes two adult cases and the other a single pediatric case. Since a reaction developed in the fifth step of the 27-step desensitization scheme (Ünal et al.), which we took as a reference, which led to a dose increase of more than 100 times, we modified the protocol by using an intermediate steps. We repeated the prick-to-prick test with red meat after desensitization in our case who successfully completed the modified desensitization protocol. Observation of more than half reduction in test edema diameter concretely supports the success of our modified desensitization protocol.

Comparative effect of laser therapy and Fufang xueshuantong capsules in patients with diabetic retinopathy and ocular hemodynamic characteristics

Purpose: To investigate the therapeutic effect of combined administration of laser and Fufang xueshuantong capsules in patients with diabetic retinopathy, and its influence on ocular hemodynamics.Methods: A total of 193 patients with diabetic retinopathy in the Ophthalmology Department of Hebei University Affiliated Hospital from October 2020 to April 2022 were retrospectively analyzed. The patients were divided into two groups: study group (127 patients) and control group (66 patients). Control group received laser therapy in the fundus while the study group was administered 3 capsules (i.e., 1.5 g) of Fufang xueshuantong thrice daily for 7 days. Changes in the fundus and visual acuity, hemodynamic indices of the ophthalmic artery, and changes in macular edema diameter, and adverse reactions in both groups were recorded.Results: In the study group, after treatment, eyeground changes were especially effective (67.37 %), effective (30.51 %), or ineffective (2.12 %). Visual acuity improved (58.90 %), (unchanged at 38.56 %), or decreased (2.54 %). In the control group, laser treatment was especially effective (42.61 %), effective (44.35 %), or ineffective (13.04 %); however, visual acuity increased (36.52 %), unchanged (47.83 %), or decreased (15.65 %). The changes were significant (p &lt; 0.05). There was no significant difference in ophthalmic artery hemodynamics between the two groups before treatment (p &gt; 0.05). After treatment, however, peak systolic velocity (Psv), end diastolic blood flow velocity (Edv), mean velocity (Vm), resistance index (RI), and pulsatile index (PI) in the study group were significantly different from those of the control group (p &lt; 0.05); There was also no significant difference between the two groups before and 1 day after the operation (p &gt; 0.05), neither was there a significant difference in adverse reactions between the two groups (p &lt; 0.05).Conclusion: Fufang xueshuantong capsule is effective in the treatment of diabetic retinopathy, and significantly improves ophthalmic artery hemodynamics. Further clinical trials, however, are required for the validation of the findings of this study.

Developing transdermal patch from Momordica charantia L. fruit using polyvinyl alcohol and ethyl cellulose potentially as anti-inflammatory dosage form

Introduction: Anti-inflammatory medication is currently sufficiently developed for the ease of application and effectiveness of therapy. Development of natural ingredients that are applied through the skin is needed to get a profitable product. This study aimed to develop bitter melon (Momordica charantia L.) fruit as an anti-inflammatory agent using transdermal patch preparations. Materials and Methods: Dried bitter melon powder was macerated using 96% ethanol, followed by evaporation until a viscous extract was obtained. Bitter melon fruit extract (BMFE) 30% was prepared into three patch transdermal preparations using combinations of polyvinyl alcohol (PVA) and ethyl cellulose (EC) as bases. A mixture of BMFE, propylene glycol, and glycerin was added to the bases and mixed until homogeneous. The entire mass was poured into a mold, coated with aluminum foil, allowed to stand for 24 h, and dried in an oven at 40 °C for 30 min. All preparations of the transdermal patch were evaluated for their physical and chemical characteristics as well as their anti-inflammatory effects Results: All transdermal patch preparations had solid form, visible brown, weight 0.424 -0.432 g, thickness 0.344 – 0.320 mm, folding endurance of more than 300, pH 4.84 – 4.87, and hygroscopicity 6.50 - 6.99 %. All preparations showed a decrease in the diameter of the edema, but this was not significant; after the 90th minute, the edema diameter was significantly reduced. Conclusion: This study showed that BMFE can be used for anti-inflammatory patch preparation and has the potential to be developed as a transdermal anti-inflammatory dosage form.

Efektivitas Latihan Kaki terhadap Diameter Edema

This study aims to determine the effectiveness of foot pump exercise on edema diameter in patients with leg edema. The research method used is a literature review. The results showed a significant decrease in pitting edema and edema diameter when doing leg exercises in patients with leg edema. In conclusion, leg exercises in flexion and extension in the edematous leg area combined with leg elevation decrease the edema diameter.&#x0D; Keywords: Fluid Overload, Leg Edema, Leg Pump Exercise

Acrocarpus fraxinifolius Wight and Arn. Bark; phenolics, toxicity studies, antioxidant and anti-inflammatory activities

The purpose of the survey was to determine acute & chronic toxicity; in vivo antioxidant and anti-inflammatory actions of the different extracts of A. fraxinifolius Wight and Arn bark; along with estimation of the phenolic, flavonoidal contents and investigation of phenolic metabolites that may attribute to the activities. LD50 of the total ethanol extract (TEE) was 7.1 g/kg b. wt, the radical scavenging activity of DPPH showed 60.31% inhibition, FRAP ability and ABTS+ activity showed 55.024 and 67.217 µmol Trolox/100 g dry weight, respectively. TEE followed by ethyl acetate extract (EAE) at 100 mg/kg b.w exhibited the highest in vivo antioxidant activity (94.51% and 91.08% potency, respectively) compared with Vit E (100%). The TEE & EAE exhibited the highest anti-inflammatory activity (3.81±0.08 & 3.79±.0.04) respectively in comparison with indomethacin 3.83±0.01 measured as edema diameter after 4 hours of extract administration. The total phenolic and total flavonoid contents in the total ethanol extract (TEE) estimated as gallic acid and catechin equivalents were 61.06± 0.08 μg eq GA/g, 40.33± 0.20 μg CE/g extract respectively. EAE revealed five phenolic acids and eight flavonoid compounds isolated for the first time from the plant.

Deficit in voluntary wheel running in chronic inflammatory and neuropathic pain models in mice: Impact of sex and genotype

Patients with chronic pain report decreased general activity and emotional distress. Therefore, the development of various animal models that encompass different aspects of pain are crucial for the discovery of genetic differences and the assessment of novel analgesics to improve quality of life. C57BL/6J and DBA/2J mice received unilateral intraplantar injections of 100 % CFA, paclitaxel, or CCI surgery to compare their distance traveled in a voluntary wheel running assay, paw edema diameter, and mechanical sensitivity. Mechanical withdrawal thresholds were lower in both strains of mice that received CFA when compared to their vehicle. However, a decrease in distance traveled was observed in CFA-treated C57BL/6J but not DBA/2J mice. In a separate group, chemotherapy agent paclitaxel 8 mg/kg, i.p. was administered to both strains of mice to induce CIPN which was confirmed by lower mechanical thresholds in paclitaxel-treated mice compared to vehicle-treated mice. Only female C57BL/6J mice showed attenuation of distance traveled following treatment, whereas male C57BL/6J and DBA/2J mice did not. Lastly, C57BL/6J mice underwent chronic constriction injury (CCI) or sham surgery to observe the impact of another chronic neuropathic pain model in wheel running assay. CCI mice showed a gradual decrease in mechanical withdrawal threshold and a decrease in distance traveled compared to sham 5 days following the procedure. Comparing these chronic inflammatory and neuropathic pain models in different mouse strains may help us better understand genetic differences underlying pain perception and its impact on reflexive and nonreflexive outcome measures.

Is radiofrequency ablation safe and effective in treating osteoid osteomas? A prospective single-center study with atypical cases.

Osteoid osteomas are benign and nonprogressive lesions. The clinical presentation of osteoid osteoma is typical with night pain responsive to nonsteroidal anti-inflammatory agents. The typical radiological appearance is lucent nidus and adjacent reactive sclerosis. The most traditional management of osteoid osteoma is surgical removal which is associated with significant morbidity. This article aims to demonstrate our single-center experience of 55 patients with osteoid osteoma treated with percutaneous radiofrequency ablation (RFA). Fifty-five symptomatic patients who were seen at our orthopedics outpatient clinics, diagnosed with osteoid osteoma, and referred to interventional radiology department between May 2015 and April 2019 were enrolled. The nidus size, pain numeric rating scale score, and intramedullary edema diameter before and after RFA were compared. Clinical and technical success, intervention-related complications, and need for subsequent ablation were recorded. Of the 55 patients, including 12 pediatric cases, 6 had atypical locations such as metatarsal, vertebra, and scapula, while 1 case had osteoid osteoma with multiple nidus. The mean age was 18.5 ± 9.6 years. Preintervention maximum nidus diameter, pain score, and edema diameter were significantly lower in postintervention measurements (p < 0.001). Technical success rate was 98.1%, and clinical success was 96.36%. Severe complication occurred in one patient with soft tissue burn and osteomyelitis. This is one of the largest series of osteoid osteoma treated with RFA done in a single center with atypical cases. In conclusion, RFA is safe and effective in both pediatric and adult patients with rare complications even in challenging cases with atypical locations.

Analgesic, anti-inflammatory, and central nervous system depressant activities of Monochoria hastate (L.) Solms. in animal models

Background: Monochoria hastate (L.) Solms. is extensively used as traditional medicine despite the fact that no scientific data has yet been published revealing its biological activity in vivo. Objectives: The objective of the study was to investigate the pharmacological effect of crude leaf extracts of M. hastate in mice model, justifying its medicinal use and evaluating its safety and efficacy as a crude drug. Materials and Methods: Crude extracts were prepared using methanol and ethyl acetate as solvent. Analgesic activity was evaluated by writhing and formalin-induced licking bioassay. Anti-inflammatory activity was examined by detecting its effect on carrageenan-induced edema. Effect on the central nervous system (CNS) was tested by monitoring movements of test animals by open-field and hole-cross assay. Results: Oral administration (400 mg/kg) of methanol and ethyl acetate extract resulted in 93% and 92% reduction of writhing (P < 0.001) compared to the 87% by diclofenac, whereas ethyl acetate extract caused maximum inhibition (91%) of licking response. Both the extracts manifested marked (P < 0.05) reduction in edema diameter, but the effects were less significant than the standard. Open-field and hole-cross test demonstrated significant (P < 0.001) suppression of motor activity in the treated group. The resulting movements 120 min after oral administration of methanol and ethyl acetate extract (400 mg/kg) and diazepam (1 mg/kg) were 205.8 ± 33, 1.4 ± 0.5, 217 ± 28, 1.0 ± 0.3, 191.2 ± 25, and 2.0 ± 0.7, respectively. Conclusion: These findings provide substantial evidence that leaf extracts of M. hastate possess analgesic, anti-inflammatory, and CNS depressant activity in mice explaining some of its use in traditional medicine.

Pre- and postoperative headache in patients with meningioma.

Meningiomas are generally slowly growing intracranial tumors. They are often incidentally diagnosed, given that symptoms may be absent even in cases of an enormous tumor size. Headache is a frequent but not consistent symptom. Therefore, we examined the association between structural, biochemical and histochemical tumor parameters with preoperative as well as postoperative occurrence of headache. In our study, we prospectively investigated 69 consecutive patients enrolled for meningioma neurosurgery. Anatomical, histological and biochemical parameters were acquired, and headache parameters were registered from the clinical report and from a questionnaire filled by the patients before neurosurgery. The headache was re-evaluated one year after neurosurgery. The study was designed to exploratively investigate whether there is an association of acquired clinical and biological parameters with the occurrence of preoperative and postoperative headache. Edema diameter and the proliferation marker MIB-1 were negatively associated with the incidence and intensity of preoperative headache, while the content of prostaglandin E2 in the tumor tissue was positively associated with preoperative headache intensity. Headache was more prevalent when the meningioma was located in the area supplied by the ophthalmic trigeminal branch. Compared to preoperative headache levels, an overall reduction was observed one year postoperative, and patients with a larger tumor had a higher headache remission. In parietal and occipital meningiomas and in those with a larger edema, the percentage of the headache remission rate was higher compared to other locations or smaller edema. Multivariable analyses showed an involvement of substance P and prostaglandin E2 in preoperative headache. The study demonstrates new associations between meningiomas and headache. The postoperative headache outcome in the presented patient sample is encouraging for the performed neurosurgical intervention. These results should be tested in a prospective study that incorporates all patients with meningiomas.

Magnetic resonance imaging evaluation of treatment efficacy and prognosis for brain metastases in lung cancer patients after radiotherapy: A preliminary study.

BackgroundThis study used magnetic resonance imaging (MRI) to monitor changes to brain metastases and investigate the imaging signs used to evaluate treatment efficacy and determine prognosis following radiotherapy for brain metastases from lung cancer.MethodsA total of 60 non‐small cell lung cancer patients with brain oligometastases were selected. MRI scans were conducted before and 3, 6, 9, 12, 18, 24, and 30 months after radiotherapy. The tumor and peritumoral edema diameters, Cho/Cr values, elevation of the Lip peak value, and whether the island (yu‐yuan) sign or high‐signal ring were present on T2 fluid‐attenuated inversion recovery (FLAIR) imaging were recorded for each metastasis.ResultsThe mortality risk was higher the earlier the maximum value of peritumoral edema diameter was reached, when there were fewer island signs, and when brain metastases did not present as tumor progression on imaging. There were significant differences in the average peritumoral edema diameter, apparent diffusion coefficient value, the number of elevated Lip peak values, and the number of T2 FLAIR imaging high‐signal rings in a year after radiotherapy in 14 patients with a survival period < 1 year compared to patients with a survival period > 2 years.ConclusionAfter radiotherapy for brain metastases, patients with the island sign had longer survival periods, high‐signal rings in T2 FLAIR, elevated Lip peaks, and reduced apparent diffusion coefficient values, indicating tumor necrosis. Increased diameter of metastases and Cho/Cr > 2 cannot serve as reliable indicators of brain metastasis progression.

Evaluation of the anti-arthritic activity of the hydroethanolic leaf extract of Alchornea cordifolia in rats.

Different decoctions of Alchornea cordifolia leaves are used by Yoruba herbalists (Southwest Nigeria) for the local treatment of ulcers, rheumatic pains, febrile convulsions, and for enhancing physical performance. In this study, the anti-arthritic effect of 100 - 400 mg/kg/day of the hydroethanolic leaf extract of Alchornea cordifolia (HEAC) was investigated in Complete Freund's Adjuvant (CFA)-induced arthritic rats as a way of evaluating its efficacy in the local management of arthritis. In addition, the effects of HEAC on liver and renal function parameters as well as its effect on the antioxidant enzyme system were investigated. Arthritis was induced using 0.1 ml of 10 mg/ml of Complete Freund's Adjuvant (CFA) following 1 h oral pretreatment and 8(th) day post-arthritic induction with 100, 200 and 400 mg/kg/day of HEAC and 3 mg/kg/day of celecoxib as the reference drug. The anti-arthritic activity of HEAC was assessed based on the ability of HEAC to alter the paw edema diameter, body weight, full blood count, renal and liver function markers, glycoprotein, lysosomal enzymes and possible antioxidant potential in the arthritic rats. Oral pretreatment with 100, 200, and 400 mg/kg/day of HEAC produced significant (p<0.001, p<0.05 and p<0.01) reductions in the paw edema diameter in a non-dose dependent fashion in ACF-induced arthritic rats with the 100 mg/kg/day of HEAC producing the most significant anti-arthritic effect. Similarly, HEAC increased hepatic GSH levels, CAT and SOD activities suggesting possible antioxidant mechanism for its anti-arthritic effect. Overall, results of this study lend credence to the folkloric use of water decoction of Alchornea cordifolia leaves against rheumatoid arthritis. However, further pharmacological investigations would be required at isolating and determining the active anti-arthritic molecule(s) in HEAC in the nearest future.