Total Body Research Articles

Insufficient Bone Mineralization to Sustain Mechanical Load of Weight in Obese Boys: A Cross-Sectional Study.

The increase in bone mineral content (BMC) and density (BMD) measured by dual-energy x-ray absorptiometry (DXA) in obese children may not sustain the mechanical load associated with weight, and the factors influencing bone mineralization are not well known. We described bone mineralization in boys with overweight/obesity and leanness in relation to body composition. Cross-sectional study in the Pediatric Endocrinology Unit of Angers University Hospital with 249 overweight/obese boys aged 8-18 who underwent DXA and insulin, testosterone, and IGF-1 measurements. Bone mineralization was compared with data from 301 lean boys of similar age and height from NHANES 2011-2015, using the same DXA model. Path analyses were performed to evaluate factors associated with total body less head (TBLH) BMC. The mean age- and height-adjusted difference in TBLH BMC between obese and lean boys was 241 ± 20 g/cm2. Each 1 kg/m2 increase in BMI was associated with +39 ± 6 g of TBLH BMC in lean subjects vs + 25 ± 3 g in obese subjects (P < .05). Each 1 kg/m2 increase in lean BMI (LBMI) was associated with +78 ± 5 g of TBLH BMC in lean and obese boys, and each 1 kg/m2 increase in fat mass index (FMI) was associated with a decrease of 9 ± 3 g of TBLH BMC. The TBLH BMC was directly positively influenced by LBMI and indirectly and positively influenced by IGF-1, testosterone, and insulin (mediated through height and LBMI). FMI indirectly influenced TBLH BMC, both positively through LBMI and negatively through its negative impact on IGF-1 and testosterone. The increase in bone mineralization in obese children does not adapt to the increase in body mass.

Comparison of fludarabine-based conditioning regimens in adult cord blood transplantation for myeloid malignancy: A retrospective, registry-based study.

Fludarabine/busulfan and fludarabine/melphalan are viable options as conditioning regimens. However, the optimal fludarabine-based conditioning in cord blood transplantation (CBT) remains unclear. Therefore, this retrospective, registry-based study aimed to analyze the impact of five fludarabine-containing conditioning regimens on 1395 adult patients (median age, 61 years) with acute myeloid leukemia, myelodysplastic syndrome, and chronic myeloid leukemia who underwent their first CBT. Treatment outcomes of fludarabine combined with melphalan (100-140 mg/m2 ) and low-dose total body irradiation (TBI; FM140T); melphalan (80-99 mg/m2 ) and TBI (FM80T); busulfan (12.8 mg/kg) and melphalan (FB4M); busulfan (12.8 mg/kg) and TBI (FB4T); and busulfan (6.4 mg/kg) and TBI (FB2T) were compared. The 3-year survival rate was 67%, 53%, 44%, 36%, and 39%, respectively (p < .0001). The FM140T survival rate was the most favorable after adjusting for confounders, and the hazard ratios (vs. FM140T) for overall mortality were as follows: FM80T, 1.6 (95% confidence interval [CI], 1.2-2.2); FB4M, 2.1 (95% CI, 1.6-2.8); FB4T, 2.7 (95% CI, 2.0-3.7); and FB2T, 2.2 (95% CI, 1.6-3.1). The better survival observed with FM140T, regardless of the disease, disease risk, age, or transplant year, was attributed to the lower relapse rate and lower non-relapse mortality (NRM) associated with fewer infectious deaths. Conversely, FB4T was associated with a higher relapse rate and higher NRM. The findings indicate that the outcomes of CBT in myeloid malignancies were highly dependent on both the alkylating agent and its dose in combination with fludarabine. Therefore, compared with fludarabine/busulfan-based conditioning, FM140T may be the preferred regimen.

A new species of gracile blind snake in the genus Letheobia (Squamata: Scolecophidia: Typhlopidae) from Sagalla Hill, south-eastern Kenya

ABSTRACT The members of the typhlopid Letheobia pallida group are characterised by having a divided or split ocular scale. Letheobia wrayi sp. nov., differs from all other members of this group by having a low mid-dorsal scale count of 355 (other taxa 376–670). It also has a rostral which is rounded, not truncated posteriorly, and its nasal suture arises from the base of the first (not second) labial. In the new species the number of middorsal scales is similar to that of L. swahilica, but it is larger in total body length (245 mm compared to 190 mm). Letheobia wrayi sp. nov., differs from L. toritensis and L. pallida that have > 400 mid-dorsals. The new species can be distinguished from L. mbeerensis (mid-dorsals > 600, long tail 2.9% vs 1.2% short tail). It is known only from the holotype collected on the Sagalla Hill–Taita Hills at an elevation of about 1 100 m within a dry deciduous forest zone.

Potential Effects of an Exoskeleton-Assisted Overground Walking Program for Individuals With Spinal Cord Injury Who Uses a Wheelchair on Imaging and Serum Markers of Bone Strength: Pre-Post Study.

As many as 60% of individuals use a wheelchair long term after a spinal cord injury (SCI). This mode of locomotion leads to chronic decline in lower-extremity weight-bearing activities and contributes to the development of severe sublesional osteoporosis and high rates of fragility fracture. Overground exoskeleton-assisted walking programs provide a novel opportunity to increase lower-extremity weight bearing, with the potential to improve bone health. The aim of the study is to measure the potential effects of an exoskeleton-assisted walking program on lower-extremity bone strength and bone remodeling biomarkers in individuals with chronic (≥18 months) SCI who use a wheelchair. In total, 10 participants completed a 16-week exoskeleton-assisted walking program (34 individualized 1-hour sessions, progressing from 1 to 3 per week). Bone mineral density and bone strength markers (dual-energy x-ray absorptiometry: total body, left arm, leg, total hip, and femoral neck and peripheral quantitative computed tomography: 25% of left femur and 66% of left tibia) as well as bone remodeling biomarkers (formation=osteocalcin and resorption=C-telopeptide) were measured before and after intervention and compared using nonparametric tests. Changes were considered significant and meaningful if the following criteria were met: P<0.1, effect size ≥0.5, and relative variation >5%. Significant and meaningful increases were observed at the femur (femoral neck bone mineral content, bone strength index, and stress-strain index) and tibia (cortical cross-sectional area and polar moment of inertia) after the intervention (all P<.10). We also noted a decrease in estimated femoral cortical thickness. However, no changes in bone remodeling biomarkers were found. These initial results suggest promising improvements in bone strength markers after a 16-week exoskeleton-assisted walking program in individuals with chronic SCI. Additional research with larger sample sizes, longer interventions (possibly of greater loading intensity), and combined modalities (eg, pharmacotherapy or functional electrical stimulation) are warranted to strengthen current evidence. ClinicalTrials.gov NCT03989752; https://clinicaltrials.gov/ct2/show/NCT03989752. RR2-10.2196/19251.

Amino Acid Profile, Total Protein and Histological Changes in Female Wistar Rats After Administration of Dichloromethane Extract of Heterotis Rotundifolia Leaves on Dermal Wound.

The study investigated the amino acid and wound healing potentials of the leaves of Heterotis rotundifolia. Amino acid analysis was performed using HPLC. Total protein level, body weight and histology were studied. Excision wound(2cm) was induced on the dorsal skin of 75 wistar rats (176-308g) divided into five groups of fifteen animals: control, 0.1g Vaseline, 0.1g gentamicin (reference drug), 0.1g extract+0.1g Vaseline (HRE1) and 0.2g extract+0.1g Vaseline (HRE2). At the end of days 1, 7, 14 and 21, rats were sacrificed and blood was collected for wound healing parameters while wound surface was taken for histology. The result revealed a higher total protein level of HRE1 with a significant difference (p&lt;0.05) on day 21 compared to control and days 1-7 compared to gentamicin. Body weight in HRE2 significantly increased from days 1-21 with a significant difference (p&lt;0.05) on days 1-7 compared to control and 1-14 compared to gentamicin. Histological examination revealed faster collagen deposition and angiogenesis on day 14 in HRE1 compared to control and gentamicin. Eighteen amino acids were detected with aspartate, methionine and arginine, (12.94, 9.38 and 8.74mg/100g respectively) having the highest concentrations. Heterotis rotundifolia leaves contains essential amiono acids and has wound healing potentials.

Effects of Introducing Different Levels of Groundnut Hay Treated with Urea and Molasses on Performance of Desert Lambs (Hammari Ecotype)

Non-traditional agricultural by-products are a potentially valuable alternative source of animal feed which may decrease dependence on traditional feed products and decrease overall feeding costs. This experiment was conducted to evaluate the effect of using groundnut hay in lambs fattening. Groundnut hay was used at three levels (0, 20 and 30%) in three iso-energetic and iso-nitrogenous diets (A, B and C). Twenty seven male lambs of Sudanese Desert sheep (Hamari ecotype) were selected according to their age (4-5months) and average live body weight (20.5Kg) and they were kept in Rural Development and Extension Center (R.D.E.C). The experimental feed includes three different levels of groundnut hay treated with urea and molasses (0, 20 and 30 %). Experimental animals were fed for 60 days included two weeks as adaptation periods. All the data was collected and statistically analyzed by using statistical package for Social Studies (SPSS version 17.0). an A Completely Randomized Design (CRD). One way analysis of variance (ANOVA) and Duncans multiple range were used to test for difference among the treatments means. The study showed a significant differences (P&gt;0.05) among different treatments for average values of final live body weight gain(FLBWG), total live body weight gain(TLBWG), daily live body weight gain(DLBWG), feed conversion rate(FCR), feed conversion rate as % of live body weight gain, cost of one kg feed and cost of one kg live weight per (SG). While initial live body weight (ILBW) and daily feed intake (DFI) showed no significant differences (P&gt;0.05) among different treatments. Treatment A (control) reported the highest and best values of final live body weight, daily weight gain, cost of one kg feed, and cost of one kg live weight followed by treatment B (%20) while treatment C (30%) reported the lowest values so, we recommend to use groundnut hay up to 20% for finishing desert lamb.

Clinical, histopathological and immunohistochemical evaluation of ultraviolet A1 treatment in early-stage mycosis fungoides.

Mycosis fungoides (MF) is the most common variant of cutaneous T-cell lymphomas primarily involving the skin. Early-stage MF is characterised by non-specific skin lesions and non-diagnostic biopsies. While skin-focused treatments, such as PUVA and narrowband UVB (nbUVB), are the most frequently recommended treatments, the UVA1 efficacy has been researched in recent years. The purpose of this study was to evaluate the clinical, histopathological and immunohistochemical aspects of UVA1 treatment in patients with early-stage MF. The modified severity weighted assessment scale (mSWAT) was used for total skin body scoring before and after treatment. Skin punch biopsies were taken from the patients before and after treatment. UVA1 therapy was performed five times each week. This study included 26 patients with early-stage MF. The total number of UVA1 sessions varied between 15 and 34. Complete response was observed in 8 (30.8%) of 26 patients (30.8%). The median mSWAT score decreased statistically significantly from 7.1 to 2.0 after treatment (p < .001). Histopathological complete response was observed in 2 (9.5%) of 21 patients. A statistically significant decrease in dermal interstitial infiltrate was observed on histopathological examination after treatment (p = .039). Epidermal CD4/CD8 levels decreased statistically significantly higher from a median of 2.5-1.2 in the complete clinical response group after treatment (p = .043). According to our results, UVA1 treatment has an effect on early-stage MF in terms of clinical, histopathological and immunohistochemistry.

An update review: several extraction methods for collagen isolation in vertebrate fish

Fish are vertebrate animals with a backbone that live in marine environments, presenting a potential source of collagen due to their high protein content. Collagen is a structural protein in the body's connective tissue, contributing 25 to 30% of the total body protein. Collagen sources in fish can be found in the skin, scales, and bones. The isolation of collagen from fish involves several stages, including separation and cleaning, size reduction, removal of non-collagenous components, collagen extraction, and precipitation. The extraction method utilized in collagen isolation impacts the quantity of collagen produced. The aim of this literature review is to identify extraction methods applicable for collagen isolation in vertebrate fish, serving as a reference for selecting extraction methods in future research. The updated review method involved collecting journal data from various literature sources, obtained from national and international journals discussing collagen extraction methods in vertebrate fish. Based on the update review, the isolation of collagen from vertebrate fish is carried out using several extraction methods, including acid soluble collagen extraction, pepsin soluble collagen, water soluble collagen, organic acid ultrasound-assisted, extrusion hydro extraction, deep eutectic solvent, and supercritical fluid extraction.

Severe Burn Injuries - The Day the Sodium Starts Rising.

The current study was designed to evaluate the etiologies of hypernatremic episodes in patients with severe burn injuries in comparison to critically ill non-burn patients. The retrospective data acquisition was limited to the first 14 days and to patients with at least 20% total body surface area (TBSA) 2nd degree burn injuries or more than 10% TBSA when including areas of 3rd degree burn injuries. The results were compared to the results of a previously published study that analyzed the risk factors for hypernatremia in 390 non-burn intensive care unit patients. In total, 120 patients with a total of 50 hypernatremic episodes were included. Compared to non-burn injury patients, no significant differences were detectable except for a lower rate of hypokalemia and a higher rate of mechanical ventilation. The main trigger for hypernatremic episodes was the loss of free water, while 24% of the hypernatremic episodes seemed to be at least partly triggered by a surplus sodium influx. Patients with hypernatremic episodes had a significantly higher mortality rate. However, in none of the cases was hypernatremia the decisive cause of death. Besides the unique phenomenon of high volume internal and external volume shifts, the overall risk factors and etiologies of hypernatremia in patients with severe burn injury do not seem to significantly differ from other ICU patient collectives. Remarkably, a surplus of sodium influx and therefore a modifiable factor besides the specific burn injury volume resuscitation had an impact on the hypernatremic episodes in 24% of cases.

Characteristics and trends of pediatric firepit burns: insights for prevention and safety

IntroductionAs fire pits grow in popularity, so do the associated burn injuries. Our study examines pediatric fire pit burns characteristics to raise awareness and promote safety precautions.MethodsWe conducted a retrospective...

Measurement of body composition in postpartum South African women living with and without HIV infection.

While several methodologies are available to measure adiposity, few have been validated in sub-Saharan African (SSA) and none in postpartum African women living with HIV (WLHIV). We compared bioelectrical impendence analysis (BIA) and air displacement plethysmography (ADP) against dual x-ray absorptiometry (DXA) in South African women and examined differences by HIV and body mass index (BMI) status. Lin's concordance correlation coefficient (CCC) test was used to examine fat mass (FM), fat free mass (FFM), and total body fat percent (%BF) difference between BIA vs. DXA, and ADP vs. DXA in women living with HIV (n = 57) and without HIV (n = 25). The Bland Altman test was used to assess mean differences and the direction of bias. The median age was 31 years (IQR, 26-35) and months postpartum were 11 (IQR, 7-16), 44% of the women had obesity. Lin's CCC for BIA and ADP vs. DXA were both 0.80 for %BF and 0.97 for FM, and 0.86 and 0.80 for FFM, respectively. Mean differences (DXA-BIA and ADP estimates) were 0.22 ± 4.54% (p = 0.54) and 3.35 ± 3.27% (p < 0.01) for %BF, -0.82 ± 3.56 kg (p = 0.06) and 1.43 ± 2.68 kg (p = 0.01) for FM, -1.38 ± 3.61 kg (p = 0.01) and - 3.34 ± 2.37 kg (p < 0.01) for FFM, respectively. BIA overestimated %BF in WLHIV and underestimated it in women with obesity. Body composition measurements using BIA and ADP correlated well with DXA, thereby providing alternative, safe tools for measuring postpartum FM and FFM in SSA women, including WLHIV.

General and central obesity in adult pre-diabetics: A metabolic derangement to consider

Background: Obesity is a well-established risk factor for the development of type 2 diabetes mellitus (T2DM) and its precursor. Aims and Objectives: This study aimed to investigate the comparative overall obesity and central obesity in pre-diabetic and healthy control. Materials and Methods: A cross-sectional study was conducted on 86 pre-diabetics and 86 age and sex-matched control. Fasting blood glucose of &lt;100 was considered normal and 100–125 were considered to be pre-diabetics. General obesity was assessed using total body fat percentage and central obesity as visceral fat as measured by OMRON Body Fat Monitor-Karada Scan. We used a t-test to compare the parameters between two groups of population. Results: A total of 86 pre-diabetes patients and normal patients participated in the study. Total body fat in pre-diabetes was 28.84 ± 6.18 versus normal was 24.87 ± 5.38, P &lt; 0.0001. The visceral fat also showed a higher level in pre-diabetes patients (14.6 ± 1.72 vs. 10.13 ± 2.54, P &lt; 0.0001). Conclusion: General and central obesity are prominent risk factors for metabolic derangements in adult diabetics and pre-diabetics. This study highlights the importance of addressing both forms of obesity in the management and prevention of T2DM and underscores the need for tailored strategies for individuals at different stages of glucose dysregulation.

Treatment robustness of total body irradiation with volumetric modulated arc therapy

This study evaluated the robustness of multi-isocenter Volumetric Modulated Arc Therapy Total Body Irradiation dose distribution in the overlapping region between the head-first and feet-first computed tomography scans, considering the longitudinal isocenter shifts recorded during treatment delivery. For 15 out of 22 patients, the dose distribution in the overlapping region fulfilled all three the robustness criteria. The overlapping region dose distribution of the remaining 7 cases fulfilled two robustness criteria. The dose distribution was found to be robust against daily recorded longitudinal isocenter shifts, as a consequence of the patient position verification procedure, of up to 16 mm.

Effects of replacement of dietary fish oil with plant oil on growth performance and fatty acid composition of spinefoot rabbitfish, Siganus rivulatus.

A 95-day feeding study was carried out to evaluate the impact of complete replacement of fish oil by plant oils in the growth performance, feed consumption fatty acid and body composition of juvenile rabbitfish, Siganus rivulatus. There were four treatments i.e., A (fish oil diet), (linseed oil diet), C (soybean meal oil diet) and D (sunflower oil diet). The experimental trial was conducted in twelve 1.5-m3 fiber glass tanks (n=3). Spinefoot rabbitfish juveniles had an average initial weight of 0.948 g ± 0.124 g and they were stocked at 50 fish per tank. Fish fed diet A showed significantly better growth rate, final body weight, and total body weight than fish fed on the other diets. Moreover, the best FCR was observed for diet A followed by diet C and diets B and D had the worst FCR. Fish body composition for crude protein, dry matter, ashes and gross energy at the end of the trial had not differed between the treatments. The highest polyunsaturated fatty acids (PUFA) was found in fish fed diet A followed in decreasing order by diets D, B, and C. Fish oil is a better dietary lipid source for Spinefoot rabbitfish juveniles, Siganus rivulatus, than plant oils. Among plant oils, soybean oil was better than linseed oil and sunflower oil as the main dietary fat source.

Effects of Time-Restricted Eating on Aerobic Capacity, Body Composition, and Markers of Metabolic Health in Healthy Male Recreational Runners: A Randomized Crossover Trial

BackgroundOptimal nutrition is highly valuable for athletes aiming at maintaining or improving body composition and sports performance. When combined with structured exercise, time-restricted energy intake may represent an effective nonpharmacological approach to achieving these results. ObjectiveThe aim of this study was to investigate the effects of 4 weeks of time-restricted eating (TRE) vs 4 weeks of habitual diet on aerobic capacity, body composition, and metabolic health in 18- to 30-year-old men accustomed to endurance running. DesignThis trial used a randomized-crossover study design. Participants completed graded exercise tests, body composition scans, and fasting blood samples before and after each intervention condition. Participants/settingSixteen male physical education students were recruited and enrolled in the study from the Faculty of Human Kinetics—University of Lisbon in September 2020, in Lisbon, Portugal. One participant was excluded after 1 week because of a lack of adherence to the study protocol. Therefore, 15 participants completed the study and were involved in the final analysis. InterventionDuring the TRE condition, participants consumed two to three meals within an 8-hour eating window (between 1:00 and 9:00 pm). Only water, tea, and coffee (without caloric additives) were permitted to be consumed in the remaining 16 hours per 24-hour period. During the non-TRE condition, participants consumed their habitual diet without any timing restrictions. The order of the TRE intervention and the habitual diet condition was randomized and counterbalanced, and participants served as their own controls. The participants followed a structured training routine during each dietary condition. Main outcome measuresBody composition variables, indices of running aerobic capacity, and markers of metabolic health were assessed. Statistical analyses performedOne-way repeated-measures analysis of variance and covariance were performed to analyze differences between conditions and time with each intervention. ResultsNeither condition elicited observed changes in total body mass, fat mass, or fat-free mass between time points. Moreover, no significant changes were observed for markers of metabolic health. Significant improvements were obtained with both conditions for the first ventilatory threshold, maximum oxygen uptake (VO2max), and velocity at VO2max (P < 0.05). ConclusionsFour weeks of endurance running and TRE, compared with 4 weeks of endurance running and a habitual diet, in healthy trained 18- to 30-year-old male recreational runners did not result in observed differences in total body mass, fat mass, or fat-free mass. In addition, TRE did not offer any additional benefit for improving submaximal or peak exercise capacity in this population.

Acute Toxicity of Total Body Irradiation Using Volumetric Arc Therapy With a Focus on the Effect of Lung Dose Rate

Purpose/ObjectivesTo report adverse effects of high dose TBI delivered using a VMAT technique and to assess pulmonary toxicity at dose rates of 40 and 100 monitor units per minute (MU/min). Materials/MethodsThis retrospective study included patients >18 years old who received ≥8 Gy TBI using a VMAT technique. The TBI dose was prescribed to a planning target volume (PTV) consisting of a 0.5cm retraction of the body with the lungs subtracted. The objective function specified PTV coverage goals of D100%≥90% and Dmax<130%. A lung dose control structure consisting of a 1 cm retraction of the lung volume was limited to Dmean<75%. Treatments were initially delivered with a dose rate of 40 MU/min for the thoracic isocenters and 100 MU/min for the other isocenters. Beginning in January 2021, a dose rate of 100 MU/min was used for all isocenters. All treatments were administered in 2 Gy fractions delivered twice-daily. Acute toxicity was assessed for 30 days following TBI. ResultsA total of 29 patients were included in this analysis who received TBI between January 2019 and October 2021. Prescription dose ranged from 8 – 12 Gy. Mean lung dose was 7.9 Gy (SD: 1.4 Gy) for patients treated at 40 MU/min and for patients treated at 100 MU/min 7.1 Gy (SD: 1.3 Gy). Mucositis was the most common grade 3 toxicity and occurred in 10 (34%) patients. Only 1 instance of pneumonitis was observed and occurred in a patient who received a mean lung dose of 10.1 Gy delivered at 40 MU/min. ConclusionsIn this cohort of patients who received high dose TBI using a VMAT technique, the composite rate of acute toxicity was not unexpectedly high. We did not observe an increase in lung toxicity after increasing the dose rate of the thoracic isocenters from 40 MU/min to 100 MU/min.

Prevalence of Delirium and Its Related Factors in Burn Patients; a Systematic Review and Meta-Analysis.

Considering the importance of delirium disorder in burn patients and its complications, the present systematic review and meta-analysis aimed to determine the prevalence of delirium and its related factors in burn patients. A comprehensive, systematic search was performed in different international electronic databases, such as Scopus, PubMed, and Web of Science, as well as Persian electronic databases such as Iranmedex, and Scientific Information Database (SID) using keywords extracted from Medical Subject Headings such as "Prevalence", "Delirium", and "Burns" from the earliest to the 17th of July, 2023. In total, 2,710 burn patients participated in ten original studies. Among the participants, 64.6% were male. In the ten studies, the reported pooled prevalence of delirium among burn patients was 20.5% (95% CI: 10.9% to 35.0%; I2=96.889%; P<0.001). Also, factors such as total body surface area, duration of hospitalization, mortality, days on ventilator, alcoholism, benzodiazepine dose, methadone dose, age, male gender, ICU days, operation days, wound care under anesthesia, and opioid dose had a significant correlation with the prevalence of delirium in burn patients. Health managers and policymakers can reduce the prevalence of delirium in burn patients by eliminating or reducing factors associated with it.

Effect of Vitamin D on Retinoblastoma Protein in Prediabetic Individuals.

About 50.8 million people were diagnosed with diabetes in 2011; the count has increased by 10 million in the last five years. Type-1 diabetes could occur at any age, but predominantly in children and young adults. The risk of developing type II diabetes mellitus in the offspring of parents with DM II is 40% if one parent has DM II and approaches 70% if both parents have DM II. The process of developing diabetes from normal glucose tolerance is continuous, with insulin resistance being the first stage. As prediabetes progresses slowly to DM II, it may take approximately 15-20 years for an individual to become diabetic. This progression can be prevented or delayed by taking some precautions and making some lifestyle amendments, e.g., reducing weight by 5-7% of total body weight if obese, etc. Retinoblastoma protein is one of the pocket proteins that act as crucial gatekeepers during the G1/S transition in the cell cycle. A loss or defect in single- cell cycle activators (especially CDK4 and CDK6) leads to cell failure. In diabetic or stress conditions, p53 becomes a transcription factor, resulting in the transactivation of CKIs, which leads to cell cycle arrest, cell senescence, or cell apoptosis. Vitamin D affects insulin sensitivity by increasing insulin receptors or the sensitivity of insulin receptors to insulin. It also affects peroxisome proliferator-activated receptors (PPAR) and extracellular calcium. These influence both insulin resistance and secretion mechanisms, undertaking the pathogenesis of type II diabetes. The study confines a marked decrement in the levels of random and fasting blood glucose levels upon regular vitamin D intake, along with a significant elevation of retinoblastoma protein levels in the circulatory system. The most critical risk factor for the occurrence of the condition came out to be family history, showing that patients with first-degree relatives with diabetes are more susceptible. Factors such as physical inactivity or comorbid conditions further aggravate the risk of developing the disease. The increase in pRB levels caused by vitamin D therapy in prediabetic patients directly influences blood glucose levels. pRB is supposed to play a role in maintaining blood sugar levels. The results of this study could be used for further studies to evaluate the role of vitamin D and pRB in regeneration therapy for beta cells in prediabetics.

Transdermal exposure to Chrome-III oxide resulting in intoxicaitons and morbidity in two tanning workers—a case report

Here, we report two cases of chrome-III oxide intoxications following transdermal exposure in tanning workers. A 58-year-old man (case 1) and his 41-year-old co-worker (case 2) were brought to our ED with unconsciousness six hours after accidental transdermal exposure to chrome-III oxide crystals (Tankrom® AB, Chrome-III oxide 25.5% and Schorlemmer Basicity 33%). Upon arrival, both patients presented with agitation and chemical burns affecting 11% (case 1) and 3% (case 2) of their total body surface area, respectively. Chemical burns were mainly distributed on injured skin. Initial arterial blood gas analysis revealed moderate (case 1, pH: 7.268) to mild acidosis (case 2, pH: 7.352). One of our patients (case 1) had significant respiratory depression. Laboratory results of case 1 and case 2 showed increased white blood cell counts, (16,630 mm3 and 19,950 mm3) and elevated blood glucose (178 mg/dL and 193 mg/dL), creatinine (1.33 mg/dL and 1.52 mg/dL), liver enzyme (aspartate aminotransferase/alanine aminotransferase of 416/322 U/L and 141/118 U/L) and creatine phosphokinase level (474 U/L and 566 U/L), respectively. Radiologic examinations revealed an orbital wall fracture and L2 compression fracture in case 1, while case 2 had a subdural hematoma, subarachnoid hemorrhage and scapular fracture and had to undergo an operation for external ventricular drainage. Both patients became alert on day three (case 1) and day six (case 2) and were discharged on day 27. We serially measured their serum and urinary chromium concentrations after hospital arrival. The calculated serum half-lives were 35.7 hours and 25.1 hours, and urinary half-lives were 2.3 hours and 2.5 hours in case 1 and case 2, respectively. We suggest that transdermal exposure to chrome-III oxide, especially to injured skin, may result in significant toxicity and morbidity. Therefore, it is essential to take necessary precautions and preventive measures to avoid transdermal exposure to chromium.

Craniospinal irradiation for CNS leukemia: rates of response and durability of CNS control.

Management of CNS involvement in leukemia may include craniospinal irradiation (CSI), though data on CSI efficacy are limited. We retrospectively reviewed leukemia patients who underwent CSI at our institution between 2009 and 2021 for CNS involvement. CNS local recurrence (CNS-LR), any recurrence, progression-free survival (PFS), CNS PFS, and overall survival (OS) were estimated. Of thirty-nine eligible patients treated with CSI, most were male (59%) and treated as young adults (median 31 years). The median dose was 18Gy to the brain and 12Gy to the spine. Twenty-five (64%) patients received CSI immediately prior to allogeneic hematopoietic cell transplant, of which 21 (84%) underwent total body irradiation conditioning (median 12Gy). Among 15 patients with CSF-positive disease immediately prior to CSI, all 14 assessed patients had pathologic clearance of blasts (CNS-response rate 100%) at a median of 23 days from CSI start. With a median follow-up of 48 months among survivors, 2-year PFS and OS were 32% (95% CI 18-48%) and 43% (95% CI 27-58%), respectively. Only 5 CNS relapses were noted (2-year CNS-LR 14% (95% CI 5-28%)), which occurred either concurrently or after a systemic relapse. Only systemic relapse after CSI was associated with higher risk of CNS-LR on univariate analysis. No grade 3 or higher acute toxicity was seen during CSI. CSI is a well-tolerated and effective treatment option for patients with CNS leukemia. Control of systemic disease after CSI may be important for CNS local control. CNS recurrence may reflect reseeding from the systemic space.