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Liu T, Zhao Z, Liu M, An S, Nie M, Liu X, Qian Y, Tian Y, Zhang J, Jiang R. The pharmacological landscape of chronic subdural hematoma: a systematic review and network meta-analysis of randomized and non-randomized controlled studies. BURNS & TRAUMA 2024; 12:tkae034. [PMID: 39328367 PMCID: PMC11427070 DOI: 10.1093/burnst/tkae034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 05/21/2024] [Accepted: 05/22/2024] [Indexed: 09/28/2024]
Abstract
Background There are various treatment modalities for chronic subdural hematoma (CSDH) and there is extensive debate surrounding pharmaceutical interventions. There is no consensus regarding the relative efficacy and safety of multiple treatment modalities. This study aims to investigate this issue and offer potential clinical recommendations. Methods We searched PubMed, Web of Science, Embase and the Cochrane Library from January 2000 to May 2023 to identify randomized and nonrandomized controlled studies reporting one or more outcomes associated with the pharmacologic management of CSDH. The primary outcomes of interest included recurrence, favorable prognosis and adverse events, while the secondary outcomes included a reduction in hematoma volume and mortality. Pooled estimates, credible intervals and odds ratios were calculated for all outcomes using a fixed effects model. Confidence in network meta-analysis judgments were employed to stratify the evidential quality. This study was registered with PROSPERO: CRD42023406599. Results The search strategy yielded 656 references; ultimately, 36 studies involving 8082 patients fulfilled our predefined inclusion criteria. The findings suggested that statins + glucocorticoids (GCs) ranked highest for preventing recurrence, improving prognosis and facilitating hematoma absorption. Tranexamic acid ranked second highest for preventing recurrence. Statins were found to be the preferred drug intervention for decreasing mortality and preventing adverse events. Antithrombotic agents ranked lowest in terms of decreasing mortality and improving prognosis. Conclusions Our findings indicate that statins + GCs may be the most effective treatment modality for preventing recurrence, improving patient prognosis and facilitating hematoma absorption. In terms of reducing mortality and preventing adverse events, statins may be superior to other pharmacological interventions. Routine use of GCs is not suggested for patients with CSDH. Further prospective research is needed to directly compare the efficacy and superiority of various pharmaceutical interventions targeting CSDH to reinforce and validate our findings.
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Affiliation(s)
- Tao Liu
- Department of Neurosurgery, Tianjin Neurological Institute, State Key Laboratory of Experimental Hematology, Key Laboratory of Post‐Neuroinjury Neurorepair and Regeneration in Central Nervous System Tianjin & Ministry of Education , Tianjin Medical University General Hospital, 154 Anshan Road, Tianjin 300052, China
| | - Zhihao Zhao
- Department of Neurosurgery, Tianjin Neurological Institute, State Key Laboratory of Experimental Hematology, Key Laboratory of Post‐Neuroinjury Neurorepair and Regeneration in Central Nervous System Tianjin & Ministry of Education , Tianjin Medical University General Hospital, 154 Anshan Road, Tianjin 300052, China
| | - Mingqi Liu
- Department of Neurosurgery, Tianjin Neurological Institute, State Key Laboratory of Experimental Hematology, Key Laboratory of Post‐Neuroinjury Neurorepair and Regeneration in Central Nervous System Tianjin & Ministry of Education , Tianjin Medical University General Hospital, 154 Anshan Road, Tianjin 300052, China
| | - Shuo An
- Department of Neurosurgery, Tianjin Neurological Institute, State Key Laboratory of Experimental Hematology, Key Laboratory of Post‐Neuroinjury Neurorepair and Regeneration in Central Nervous System Tianjin & Ministry of Education , Tianjin Medical University General Hospital, 154 Anshan Road, Tianjin 300052, China
| | - Meng Nie
- Department of Neurosurgery, Tianjin Neurological Institute, State Key Laboratory of Experimental Hematology, Key Laboratory of Post‐Neuroinjury Neurorepair and Regeneration in Central Nervous System Tianjin & Ministry of Education , Tianjin Medical University General Hospital, 154 Anshan Road, Tianjin 300052, China
| | - Xuanhui Liu
- Department of Neurosurgery, Tianjin Neurological Institute, State Key Laboratory of Experimental Hematology, Key Laboratory of Post‐Neuroinjury Neurorepair and Regeneration in Central Nervous System Tianjin & Ministry of Education , Tianjin Medical University General Hospital, 154 Anshan Road, Tianjin 300052, China
| | - Yu Qian
- Department of Neurosurgery, Tianjin Neurological Institute, State Key Laboratory of Experimental Hematology, Key Laboratory of Post‐Neuroinjury Neurorepair and Regeneration in Central Nervous System Tianjin & Ministry of Education , Tianjin Medical University General Hospital, 154 Anshan Road, Tianjin 300052, China
| | - Ye Tian
- Department of Neurosurgery, Tianjin Neurological Institute, State Key Laboratory of Experimental Hematology, Key Laboratory of Post‐Neuroinjury Neurorepair and Regeneration in Central Nervous System Tianjin & Ministry of Education , Tianjin Medical University General Hospital, 154 Anshan Road, Tianjin 300052, China
| | - Jianning Zhang
- Department of Neurosurgery, Tianjin Neurological Institute, State Key Laboratory of Experimental Hematology, Key Laboratory of Post‐Neuroinjury Neurorepair and Regeneration in Central Nervous System Tianjin & Ministry of Education , Tianjin Medical University General Hospital, 154 Anshan Road, Tianjin 300052, China
| | - Rongcai Jiang
- Department of Neurosurgery, Tianjin Neurological Institute, State Key Laboratory of Experimental Hematology, Key Laboratory of Post‐Neuroinjury Neurorepair and Regeneration in Central Nervous System Tianjin & Ministry of Education , Tianjin Medical University General Hospital, 154 Anshan Road, Tianjin 300052, China
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Brunyé TT, Goring SA, Cantelon JA, Eddy MD, Elkin-Frankston S, Elmore WR, Giles GE, Hancock CL, Masud SB, McIntyre J, McKenzie KL, Mitchell KB, O’Donovan MP, Racicot K, Ramsay JW. Trait-level predictors of human performance outcomes in personnel engaged in stressful laboratory and field tasks. Front Psychol 2024; 15:1449200. [PMID: 39315045 PMCID: PMC11418282 DOI: 10.3389/fpsyg.2024.1449200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2024] [Accepted: 08/20/2024] [Indexed: 09/25/2024] Open
Abstract
Introduction Personnel performance under stress hinges on various factors, including individual traits, training, context, mental and physiological states, and task demands. This study explored the link between the traits of military personnel and their performance outcomes in five domains: move, shoot, communicate, navigate, and sustain. Methods A total of 387 U.S. Army soldiers participated in this study, undergoing trait assessments covering physical, cognitive, social-emotional, demographic/lifestyle, and health domains. Performance was measured through lab and field events assessing a broad range of individual and team-level skills under conditions demanding resilience to acute cognitive and physical stress exposure. Analysis used feature selection and elastic net regression. Results Analyses revealed complex associations between traits and performance, with physical, cognitive, health-related, social-emotional, and lifestyle traits playing roles in guiding and constraining performance. Measures of resilience, emotion regulation, grit, and mindfulness were identified as relevant predictors of several performance-related outcomes. Discussion Results carry implications for the selection, training, and operational effectiveness of personnel in high-stakes occupations including military and first response. Further research is necessary to explore the mechanisms underlying these associations and inform targeted interventions to boost personnel effectiveness.
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Affiliation(s)
- Tad T. Brunyé
- U.S. Army DEVCOM Soldier Center, Natick, MA, United States
- Center for Applied Brain and Cognitive Sciences, Tufts University, Medford, MA, United States
| | - Sara Anne Goring
- Center for Applied Brain and Cognitive Sciences, Tufts University, Medford, MA, United States
| | - Julie A. Cantelon
- U.S. Army DEVCOM Soldier Center, Natick, MA, United States
- Center for Applied Brain and Cognitive Sciences, Tufts University, Medford, MA, United States
| | - Marianna D. Eddy
- U.S. Army DEVCOM Soldier Center, Natick, MA, United States
- Center for Applied Brain and Cognitive Sciences, Tufts University, Medford, MA, United States
| | - Seth Elkin-Frankston
- U.S. Army DEVCOM Soldier Center, Natick, MA, United States
- Center for Applied Brain and Cognitive Sciences, Tufts University, Medford, MA, United States
| | - Wade R. Elmore
- U.S. Army DEVCOM Soldier Center, Natick, MA, United States
| | - Grace E. Giles
- U.S. Army DEVCOM Soldier Center, Natick, MA, United States
- Center for Applied Brain and Cognitive Sciences, Tufts University, Medford, MA, United States
| | | | - Shoaib Bin Masud
- Center for Applied Brain and Cognitive Sciences, Tufts University, Medford, MA, United States
- Department of Electrical and Computer Engineering, Tufts University, Medford, MA, United States
| | - James McIntyre
- Center for Applied Brain and Cognitive Sciences, Tufts University, Medford, MA, United States
| | | | | | | | | | - John W. Ramsay
- U.S. Army DEVCOM Soldier Center, Natick, MA, United States
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103
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Liu L, Xie J, Chang J, Liu Z, Sun T, Qiao H, Liang G, Guo W. H-Net: Heterogeneous Neural Network for Multi-Classification of Neuropsychiatric Disorders. IEEE J Biomed Health Inform 2024; 28:5509-5518. [PMID: 38829757 DOI: 10.1109/jbhi.2024.3405941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2024]
Abstract
Clinical studies have proved that both structural magnetic resonance imaging (sMRI) and functional magnetic resonance imaging (fMRI) are implicitly associated with neuropsychiatric disorders (NDs), and integrating multi-modal to the binary classification of NDs has been thoroughly explored. However, accurately classifying multiple classes of NDs remains a challenge due to the complexity of disease subclass. In our study, we develop a heterogeneous neural network (H-Net) that integrates sMRI and fMRI modes for classifying multi-class NDs. To account for the differences between the two modes, H-Net adopts a heterogeneous neural network strategy to extract information from each mode. Specifically, H-Net includes an multi-layer perceptron based (MLP-based) encoder, a graph attention network based (GAT-based) encoder, and a cross-modality transformer block. The MLP-based and GAT-based encoders extract semantic features from sMRI and features from fMRI, respectively, while the cross-modality transformer block models the attention of two types of features. In H-Net, the proposed MLP-mixer block and cross-modality alignment are powerful tools for improving the multi-classification performance of NDs. H-Net is validate on the public dataset (CNP), where H-Net achieves 90% classification accuracy in diagnosing multi-class NDs. Furthermore, we demonstrate the complementarity of the two MRI modalities in improving the identification of multi-class NDs. Both visual and statistical analyses show the differences between ND subclasses.
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104
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Silverstein JW, D'Amico RS, Mehta SH, Gluski J, Ber R, Sciubba DM, Lo SFL. The diagnostic accuracy of neuromonitoring for detecting postoperative bowel and bladder dysfunction in spinal oncology surgery: a case series. J Neurooncol 2024; 169:409-422. [PMID: 38884662 DOI: 10.1007/s11060-024-04742-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Accepted: 06/10/2024] [Indexed: 06/18/2024]
Abstract
PURPOSE Postoperative bowel and bladder dysfunction (BBD) poses a significant risk following surgery of the sacral spinal segments and sacral nerve roots, particularly in neuro-oncology cases. The need for more reliable neuromonitoring techniques to enhance the safety of spine surgery is evident. METHODS We conducted a case series comprising 60 procedures involving 56 patients, spanning from September 2022 to January 2024. We assessed the diagnostic accuracy of sacral reflexes (bulbocavernosus and external urethral sphincter reflexes) and compared them with transcranial motor evoked potentials (TCMEP) incorporating anal sphincter (AS) and external urethral sphincter (EUS) recordings, as well as spontaneous electromyography (s-EMG) with AS and EUS recordings. RESULTS Sacral reflexes demonstrated a specificity of 100% in predicting postoperative BBD, with a sensitivity of 73.33%. While sensitivity slightly decreased to 64.71% at the 1-month follow-up, it remained consistently high overall. TCMEP with AS/EUS recordings did not identify any instances of postoperative BBD, whereas s-EMG with AS/EUS recordings showed a sensitivity of 14.29% and a specificity of 97.14%. CONCLUSION Sacral reflex monitoring emerges as a robust adjunct to routine neuromonitoring, offering surgeons valuable predictive insights to potentially mitigate the occurrence of postoperative BBD.
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Affiliation(s)
- Justin W Silverstein
- Department of Neurology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, NY, USA.
- Department of Clinical Neurophysiology, Neuro Protective Solutions, New York, NY, USA.
| | - Randy S D'Amico
- Department of Neurological Surgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, NY, USA
| | - Shyle H Mehta
- Department of Neurological Surgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, NY, USA
| | - Jacob Gluski
- Department of Neurological Surgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, NY, USA
| | - Roee Ber
- Department of Neurological Surgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, NY, USA
| | - Daniel M Sciubba
- Department of Neurological Surgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, NY, USA
| | - Sheng-Fu Larry Lo
- Department of Neurological Surgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, NY, USA
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Clarke AJ, Brodtmann A, Irish M, Mowszowski L, Radford K, Naismith SL, Mok VC, Kiernan MC, Halliday GM, Ahmed RM. Risk factors for the neurodegenerative dementias in the Western Pacific region. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2024; 50:101051. [PMID: 39399869 PMCID: PMC11471060 DOI: 10.1016/j.lanwpc.2024.101051] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 02/04/2024] [Accepted: 03/12/2024] [Indexed: 10/15/2024]
Abstract
The Western Pacific Region (WPR) is characterized by a group of socioeconomically, culturally, and geopolitically heterogenous countries and represents a microcosm of the global endemic of neurodegeneration. This review will chart the known risk factors for dementia across the WPR. We explore the intersection between the established risk factors for dementia including the biomedical and lifestyle (cardiovascular and metabolic disease, sleep, hearing loss, depression, alcohol, smoking, traumatic brain injury, genetics) and social determinants (social disadvantage, limited education, systemic racism) as well as incorporate neuroimaging data, where available, to predict disease progression in the WPR. In doing so, we highlight core risk factors for dementia in the WPR, as well as geographical epicentres at heightened risk for dementia, to orient future research towards addressing these disparities.
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Affiliation(s)
- Antonia J. Clarke
- Department of Neurosciences, Monash University, Melbourne, VIC 3004 Australia
| | - Amy Brodtmann
- Department of Neurosciences, Monash University, Melbourne, VIC 3004 Australia
| | - Muireann Irish
- Brain and Mind Centre, The University of Sydney, Sydney, NSW 2050 Australia
| | - Loren Mowszowski
- Brain and Mind Centre, The University of Sydney, Sydney, NSW 2050 Australia
- Department of Neurology, Royal Prince Alfred Hospital, Sydney, Australia
| | - Kylie Radford
- Department of Neurology, Royal Prince Alfred Hospital, Sydney, Australia
- The University of New South Wales, Sydney, NSW 2031 Australia
| | - Sharon L. Naismith
- Brain and Mind Centre, The University of Sydney, Sydney, NSW 2050 Australia
| | | | - Matthew C. Kiernan
- Brain and Mind Centre, The University of Sydney, Sydney, NSW 2050 Australia
- Department of Neurology, Royal Prince Alfred Hospital, Sydney, Australia
| | - Glenda M. Halliday
- Brain and Mind Centre, The University of Sydney, Sydney, NSW 2050 Australia
- Faculty of Medicine and Health, School of Medical Sciences, The University of Sydney, Sydney, NSW 2050 Australia
| | - Rebekah M. Ahmed
- Brain and Mind Centre, The University of Sydney, Sydney, NSW 2050 Australia
- Department of Neurology, Royal Prince Alfred Hospital, Sydney, Australia
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Perazella MA. Proton Pump Inhibitors and Kidney Disease: What Gives? KIDNEY360 2024; 5:1374-1376. [PMID: 39325592 PMCID: PMC11441802 DOI: 10.34067/kid.0000000000000521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/28/2024]
Affiliation(s)
- Mark A Perazella
- Section of Nephrology, Yale School of Medicine, New Haven, Connecticut
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Yan H, Wu H, Yang J, Jiang J, Yang F, Yang H. Advantages of disposable portable endoscope in removing thalamic hematoma via the superior parietal lobule. ZHONG NAN DA XUE XUE BAO. YI XUE BAN = JOURNAL OF CENTRAL SOUTH UNIVERSITY. MEDICAL SCIENCES 2024; 49:1261-1270. [PMID: 39788514 PMCID: PMC11628224 DOI: 10.11817/j.issn.1672-7347.2024.240234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Indexed: 01/05/2025]
Abstract
OBJECTIVES Thalamic hematoma patients present with diverse clinical conditions, and treatment approaches vary widely. Currently, the use of disposable portable endoscope surgery has been rapidly adopted in many hospitals, but outcomes can vary significantly. Surgical approaches and techniques for thalamic hematoma often reference those used for basal ganglia hemorrhage, but their effectiveness remains uncertain. This study aims to explore the advantages of using disposable portable endoscopes in removing thalamic hematoma via the superior parietal lobule, providing guidelines for clinicians to manage thalamic bleeding effectively. METHODS Clinical data of patients with thalamic hematoma who underwent either disposable portable endoscope or microscope surgery at the Third Xiangya Hospital, Central South University, were retrospectively analyzed. Surgical duration, hematoma clearance rate, length of hospital stay, improvement rate in Glasgow Coma Scale (GCS) score at 24 hours post-operation, and incidence of pulmonary infection were compared between the 2 groups. RESULTS Compared with the microscope group, the disposable portable endoscope group had shorter operation time, higher hematoma clearance rate, shorter hospital stay, and lower incidence of pulmonary infection (all P<0.05). However, there was no significant difference in the improvement rate of GCS score at 24 hours post-operation between the 2 groups (P>0.05). CONCLUSIONS In the surgical removal of thalamic hematoma via the superior parietal lobule, the disposable portable endoscope offers advantages such as shorter surgical duration, better visualization, higher hematoma clearance rate, improved surgical efficiency, shorter hospital stay, and lower incidence of pulmonary infection. Therefore, it can be considered as a preferred surgical treatment option for patients with thalamic hematoma.
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Affiliation(s)
- Hui Yan
- Department of Neurosurgery, Third Xiangya Hospital, Central South University, Changsha 410013.
| | - Hao Wu
- Department of Neurosurgery, Third Xiangya Hospital, Central South University, Changsha 410013
| | - Jinfu Yang
- Department of Neurosurgery, Third Xiangya Hospital, Central South University, Changsha 410013
| | - Jiaode Jiang
- Department of Neurosurgery, Third Xiangya Hospital, Central South University, Changsha 410013
| | - Fan Yang
- Department of Neurosurgery, Third Xiangya Hospital, Central South University, Changsha 410013
| | - Hui Yang
- Department of Anesthesiology, Third Xiangya Hospital, Central South University, Changsha 410013, China.
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Swinckels L, Bennis FC, Ziesemer KA, Scheerman JFM, Bijwaard H, de Keijzer A, Bruers JJ. The Use of Deep Learning and Machine Learning on Longitudinal Electronic Health Records for the Early Detection and Prevention of Diseases: Scoping Review. J Med Internet Res 2024; 26:e48320. [PMID: 39163096 PMCID: PMC11372333 DOI: 10.2196/48320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 09/29/2023] [Accepted: 04/29/2024] [Indexed: 08/21/2024] Open
Abstract
BACKGROUND Electronic health records (EHRs) contain patients' health information over time, including possible early indicators of disease. However, the increasing amount of data hinders clinicians from using them. There is accumulating evidence suggesting that machine learning (ML) and deep learning (DL) can assist clinicians in analyzing these large-scale EHRs, as algorithms thrive on high volumes of data. Although ML has become well developed, studies mainly focus on engineering but lack medical outcomes. OBJECTIVE This study aims for a scoping review of the evidence on how the use of ML on longitudinal EHRs can support the early detection and prevention of disease. The medical insights and clinical benefits that have been generated were investigated by reviewing applications in a variety of diseases. METHODS This study was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A literature search was performed in 2022 in collaboration with a medical information specialist in the following databases: PubMed, Embase, Web of Science Core Collection (Clarivate Analytics), and IEEE Xplore Digital Library and computer science bibliography. Studies were eligible when longitudinal EHRs were used that aimed for the early detection of disease via ML in a prevention context. Studies with a technical focus or using imaging or hospital admission data were beyond the scope of this review. Study screening and selection and data extraction were performed independently by 2 researchers. RESULTS In total, 20 studies were included, mainly published between 2018 and 2022. They showed that a variety of diseases could be detected or predicted, particularly diabetes; kidney diseases; diseases of the circulatory system; and mental, behavioral, and neurodevelopmental disorders. Demographics, symptoms, procedures, laboratory test results, diagnoses, medications, and BMI were frequently used EHR data in basic recurrent neural network or long short-term memory techniques. By developing and comparing ML and DL models, medical insights such as a high diagnostic performance, an earlier detection, the most important predictors, and additional health indicators were obtained. A clinical benefit that has been evaluated positively was preliminary screening. If these models are applied in practice, patients might also benefit from personalized health care and prevention, with practical benefits such as workload reduction and policy insights. CONCLUSIONS Longitudinal EHRs proved to be helpful for support in health care. Current ML models on EHRs can support the detection of diseases in terms of accuracy and offer preliminary screening benefits. Regarding the prevention of diseases, ML and specifically DL models can accurately predict or detect diseases earlier than current clinical diagnoses. Adding personally responsible factors allows targeted prevention interventions. While ML models based on textual EHRs are still in the developmental stage, they have high potential to support clinicians and the health care system and improve patient outcomes.
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Affiliation(s)
- Laura Swinckels
- Department of Oral Public Health, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit, Amsterdam, Netherlands
- Department Oral Hygiene, Cluster Health, Sports and Welfare, Inholland University of Applied Sciences, Amsterdam, Netherlands
- Medical Technology Research Group, Cluster Health, Sport and Welfare, Inholland University of Applied Sciences, Haarlem, Netherlands
- Data Driven Smart Society Research Group, Faculty of Engineering, Design & Computing, Inholland University of Applied Sciences, Alkmaar, Netherlands
| | - Frank C Bennis
- Quantitative Data Analytics Group, Department of Computer Science, Vrije Universiteit, Amsterdam, Netherlands
- Department of Pediatrics, Emma Neuroscience Group, Emma Children's Hospital, Amsterdam UMC, Amsterdam, Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam, Netherlands
| | - Kirsten A Ziesemer
- Medical Library, University Library, Vrije Universiteit, Amsterdam, Netherlands
| | - Janneke F M Scheerman
- Department Oral Hygiene, Cluster Health, Sports and Welfare, Inholland University of Applied Sciences, Amsterdam, Netherlands
- Medical Technology Research Group, Cluster Health, Sport and Welfare, Inholland University of Applied Sciences, Haarlem, Netherlands
| | - Harmen Bijwaard
- Medical Technology Research Group, Cluster Health, Sport and Welfare, Inholland University of Applied Sciences, Haarlem, Netherlands
| | - Ander de Keijzer
- Data Driven Smart Society Research Group, Faculty of Engineering, Design & Computing, Inholland University of Applied Sciences, Alkmaar, Netherlands
- Applied Responsible Artificial Intelligence, Avans University of Applied Sciences, Breda, Netherlands
| | - Josef Jan Bruers
- Department of Oral Public Health, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit, Amsterdam, Netherlands
- Royal Dutch Dental Association (KNMT), Utrecht, Netherlands
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Habib HEAE, Elnoamany H, Elnaggar AG. Subgaleal drain versus dissection of subgaleal space and closure without drain after burr-hole drainage of chronic subdural hematoma. Surg Neurol Int 2024; 15:288. [PMID: 39246800 PMCID: PMC11380829 DOI: 10.25259/sni_363_2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2024] [Accepted: 07/26/2024] [Indexed: 09/10/2024] Open
Abstract
Background Chronic subdural hematoma (CSDH) is a collection of blood, blood degradation products, and fluid that accumulate on the surface of the brain between its arachnoid and dural coverings. This study is to evaluate the efficacy of subgaleal drain (SGD) versus subgaleal dissection without drainage as adjuncts to burr-hole evacuation of CSDH. Methods A retrospective study was conducted utilizing the data of 60 patients operated for symptomatic CSDH. Patients were divided into two groups, each thirty consecutive patients: Group I, in which a SGD was inserted after CSDH evacuation through a burr-hole; and Group II, the hematoma was evacuated as in the Group I, but with no SGD insertion but instead a subgaleal pocket was created for drainage. Results The neurological improvement at 24 h, discharge, 2 weeks, and 6 months after surgery was comparable in both groups. The overall recurrence was 4 cases (4/60, 6.7%). The rate of recurrence and surgical infection rate were comparable in both groups. Both groups showed similar incidences of postoperative seizures, bleeding, rates of medical complications, and neurological deficits. The overall postoperative mortality was five cases (5/60, 8.3%) with no significant difference between groups. Conclusion Blunt dissection to open the subgaleal space and closure without a drain is a safe and efficient alternative to the insertion of a drain after the burr-hole evacuation of CSDH.
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Affiliation(s)
| | - Hossam Elnoamany
- Department of Neurosurgery, Faculty of Medicine, Menoufia University, Shebin Elkom, Egypt
| | - Ahmed Gabry Elnaggar
- Department of Neurosurgery, Faculty of Medicine, Menoufia University, Shebin Elkom, Egypt
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Chappell AG, Spinner RJ, Bishop AT, Shin AY. Hirayama Disease: Surgical Restoration of Hand Function. J Hand Surg Am 2024:S0363-5023(24)00306-X. [PMID: 39127956 DOI: 10.1016/j.jhsa.2024.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 04/03/2024] [Accepted: 06/27/2024] [Indexed: 08/12/2024]
Abstract
PURPOSE Hirayama disease (HD) is a rare, nonfamilial, self-limiting, progressive lower cervical myelopathy, resulting in debilitating distal upper-extremity motor deficits, mimicking high ulnar neuropathy, lower trunk brachial plexopathy, or C8-T1 radiculopathy. Although most literature focuses on pathophysiology and prevention of disease progression, there remains limited discussion regarding treatment to improve upper-extremity function in patients with stable disease. The upper-extremity manifestations of HD are reviewed along with surgical options for restoring hand function. METHODS A retrospective review of patients with HD who underwent reconstruction to improve hand function was undertaken. Demographic data, preoperative electrodiagnostic and electromyographic, and physical examination findings were collected. Outcome data involved postoperative grip, pinch, and functional assessment documented on clinical visits. Qualitative descriptions of the surgical techniques are described. RESULTS Among six patients identified, four met the inclusion criteria and underwent tendon transfers and selected joint arthrodeses. All patients were diagnosed as teenagers, were right hand-dominant, and three were male. Unilateral symptoms were present in one patient and were bilateral in the rest. All patients were treated with tendon transfers for thumb opposition, grasp, anticlaw, and thumb interphalangeal joint arthrodesis. All patients had postoperative grip strength improvement. The average follow-up was 3.2 years. CONCLUSIONS Hirayama disease is a rare disease often managed by spine surgeons and neurologists who may be unaware of options for restoring hand function deficits. Technical strategies and outcomes of improving hand function in HD have not been adequately described. Surgical options to improve hand function are tailored to the deficits and include tendon transfers, select joint arthrodeses, and/or tenodeses. Risk of disease progression and expectations following hand reconstruction must be managed carefully. TYPE OF STUDY LEVEL OF EVIDENCE Therapeutic V.
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Affiliation(s)
- Ava G Chappell
- Division of Hand Surgery, Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
| | | | - Allen T Bishop
- Division of Hand Surgery, Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
| | - Alexander Y Shin
- Division of Hand Surgery, Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA.
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Qi W, Zhu X, He D, Wang B, Cao S, Dong C, Li Y, Chen Y, Wang B, Shi Y, Jiang G, Liu F, Boots LMM, Li J, Lou X, Yao J, Lu X, Kang J. Mapping Knowledge Landscapes and Emerging Trends in AI for Dementia Biomarkers: Bibliometric and Visualization Analysis. J Med Internet Res 2024; 26:e57830. [PMID: 39116438 PMCID: PMC11342017 DOI: 10.2196/57830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 05/04/2024] [Accepted: 06/25/2024] [Indexed: 08/10/2024] Open
Abstract
BACKGROUND With the rise of artificial intelligence (AI) in the field of dementia biomarker research, exploring its current developmental trends and research focuses has become increasingly important. This study, using literature data mining, analyzes and assesses the key contributions and development scale of AI in dementia biomarker research. OBJECTIVE The aim of this study was to comprehensively evaluate the current state, hot topics, and future trends of AI in dementia biomarker research globally. METHODS This study thoroughly analyzed the literature in the application of AI to dementia biomarkers across various dimensions, such as publication volume, authors, institutions, journals, and countries, based on the Web of Science Core Collection. In addition, scales, trends, and potential connections between AI and biomarkers were extracted and deeply analyzed through multiple expert panels. RESULTS To date, the field includes 1070 publications across 362 journals, involving 74 countries and 1793 major research institutions, with a total of 6455 researchers. Notably, 69.41% (994/1432) of the researchers ceased their studies before 2019. The most prevalent algorithms used are support vector machines, random forests, and neural networks. Current research frequently focuses on biomarkers such as imaging biomarkers, cerebrospinal fluid biomarkers, genetic biomarkers, and blood biomarkers. Recent advances have highlighted significant discoveries in biomarkers related to imaging, genetics, and blood, with growth in studies on digital and ophthalmic biomarkers. CONCLUSIONS The field is currently in a phase of stable development, receiving widespread attention from numerous countries, institutions, and researchers worldwide. Despite this, stable clusters of collaborative research have yet to be established, and there is a pressing need to enhance interdisciplinary collaboration. Algorithm development has shown prominence, especially the application of support vector machines and neural networks in imaging studies. Looking forward, newly discovered biomarkers are expected to undergo further validation, and new types, such as digital biomarkers, will garner increased research interest and attention.
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Affiliation(s)
- Wenhao Qi
- School of Nursing, Hangzhou Normal University, Hangzhou, China
| | - Xiaohong Zhu
- School of Nursing, Hangzhou Normal University, Hangzhou, China
| | - Danni He
- School of Nursing, Hangzhou Normal University, Hangzhou, China
- Nursing Department, Zhejiang Provincial People's Hospital, Hangzhou, China
| | - Bin Wang
- School of Nursing, Hangzhou Normal University, Hangzhou, China
| | - Shihua Cao
- School of Nursing, Hangzhou Normal University, Hangzhou, China
| | - Chaoqun Dong
- School of Nursing, Hangzhou Normal University, Hangzhou, China
| | - Yunhua Li
- College of Education, Chengdu College of Arts and Sciences, Sichuan, China
| | - Yanfei Chen
- School of Nursing, Hangzhou Normal University, Hangzhou, China
- Nursing Department, Affiliated Hospital of Hangzhou Normal University, Hangzhou, China
| | - Bingsheng Wang
- School of Nursing, Hangzhou Normal University, Hangzhou, China
| | - Yankai Shi
- School of Nursing, Hangzhou Normal University, Hangzhou, China
| | - Guowei Jiang
- Department of Psychiatry and Neuropsychology and Alzheimer Center Limburg, School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, Netherlands
| | - Fang Liu
- College of Electronics and Information Engineering, Shenzhen University, Shenzhen, China
| | - Lizzy M M Boots
- Department of Psychiatry and Neuropsychology and Alzheimer Center Limburg, School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, Netherlands
| | - Jiaqi Li
- School of Nursing, Hangzhou Normal University, Hangzhou, China
| | - Xiajing Lou
- School of Nursing, Hangzhou Normal University, Hangzhou, China
| | - Jiani Yao
- School of Nursing, Hangzhou Normal University, Hangzhou, China
| | - Xiaodong Lu
- Department of Neurology, Affiliated Hospital of Hangzhou Normal University, Hangzhou, China
| | - Junling Kang
- Department of Neurology, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
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Thapa L, Katwal S, Thapa BR. Association between gallstone disease and carotid intima-media thickness: a prospective observational cross-sectional study in a tertiary care center. Ann Med Surg (Lond) 2024; 86:4410-4415. [PMID: 39118692 PMCID: PMC11305746 DOI: 10.1097/ms9.0000000000002269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Accepted: 06/03/2024] [Indexed: 08/10/2024] Open
Abstract
Background and objectives Gallstone disease (GD) is a prevalent health issue globally, particularly in developed nations, and has notable associations with cardiovascular disease (CVD). This prospective observational cross-sectional study aimed to investigate the association between gallstone disease and carotid intima-media thickness (CIMT), a marker of carotid atherosclerosis, in a tertiary care setting. Method Conducted at a tertiary care center, the study included 96 participants (48 with gallstone disease and 48 age and sex-matched controls). Data collection involved demographic information, BMI calculation, abdominal ultrasonography for gallstone detection, and carotid ultrasonography for CIMT measurement. Statistical analysis was performed using SPSS version 26. Results The study revealed higher CIMT values in GD patients compared to controls (P<0.001). Additionally, a positive correlation was observed between CIMT and age (r=0.450, P<0.001) and BMI (r=0.550, P<0.001). The Cohen's d-test indicated a clinically significant difference in CIMT between GD patients and controls (d=1.47). Conclusion This study revealed a significant association between gallstone disease and elevated CIMT, correlating with higher BMI indicating a potential link between gallstone disease and increased risk of carotid atherosclerosis. These findings highlight the importance of assessing cardiovascular risk in patients with gallstone disease, highlighting the potential utility of carotid ultrasonography as a non-invasive screening tool. Early intervention strategies may be warranted to mitigate cardiovascular risks associated with gallstone disease.
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Affiliation(s)
- Lokendra Thapa
- Department of Radiology, National Academy of Medical Sciences, Kathmandu
| | - Shailendra Katwal
- Department of Radiology, Dadeldhura Subregional Hospital, Dadeldhura, Nepal
| | - Bikash Raj Thapa
- Department of Radiology, National Academy of Medical Sciences, Kathmandu
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Lyakhova UA, Lyakhov PA. Systematic review of approaches to detection and classification of skin cancer using artificial intelligence: Development and prospects. Comput Biol Med 2024; 178:108742. [PMID: 38875908 DOI: 10.1016/j.compbiomed.2024.108742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 06/03/2024] [Accepted: 06/08/2024] [Indexed: 06/16/2024]
Abstract
In recent years, there has been a significant improvement in the accuracy of the classification of pigmented skin lesions using artificial intelligence algorithms. Intelligent analysis and classification systems are significantly superior to visual diagnostic methods used by dermatologists and oncologists. However, the application of such systems in clinical practice is severely limited due to a lack of generalizability and risks of potential misclassification. Successful implementation of artificial intelligence-based tools into clinicopathological practice requires a comprehensive study of the effectiveness and performance of existing models, as well as further promising areas for potential research development. The purpose of this systematic review is to investigate and evaluate the accuracy of artificial intelligence technologies for detecting malignant forms of pigmented skin lesions. For the study, 10,589 scientific research and review articles were selected from electronic scientific publishers, of which 171 articles were included in the presented systematic review. All selected scientific articles are distributed according to the proposed neural network algorithms from machine learning to multimodal intelligent architectures and are described in the corresponding sections of the manuscript. This research aims to explore automated skin cancer recognition systems, from simple machine learning algorithms to multimodal ensemble systems based on advanced encoder-decoder models, visual transformers (ViT), and generative and spiking neural networks. In addition, as a result of the analysis, future directions of research, prospects, and potential for further development of automated neural network systems for classifying pigmented skin lesions are discussed.
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Affiliation(s)
- U A Lyakhova
- Department of Mathematical Modeling, North-Caucasus Federal University, 355017, Stavropol, Russia.
| | - P A Lyakhov
- Department of Mathematical Modeling, North-Caucasus Federal University, 355017, Stavropol, Russia; North-Caucasus Center for Mathematical Research, North-Caucasus Federal University, 355017, Stavropol, Russia.
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Wang X, Yu W, Jiang G, Li H, Li S, Xie L, Bai X, Cui P, Chen Q, Lou Y, Zou L, Li S, Zhou Z, Zhang C, Sun P, Mao M. Global Epidemiology of Gallstones in the 21st Century: A Systematic Review and Meta-Analysis. Clin Gastroenterol Hepatol 2024; 22:1586-1595. [PMID: 38382725 DOI: 10.1016/j.cgh.2024.01.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 01/21/2024] [Accepted: 01/23/2024] [Indexed: 02/23/2024]
Abstract
BACKGROUND & AIMS Gallstones are common and associated with substantial health and economic burden. We aimed to comprehensively evaluate the prevalence and incidence of gallstones in the 21st century. METHODS We systematically searched PubMed and Embase to identify studies reporting the prevalence and/or incidence of gallstones between January 1, 2000, and November 18, 2023. Pooled prevalence and incidence were calculated using DerSimonian and Laird's random-effects model. We performed subgroup analyses and meta-regression based on age, sex, geographic location, population setting, and modality of detection to examine sources of heterogeneity. RESULTS Based on 115 studies with 32,610,568 participants, the pooled prevalence of gallstones was 6.1% (95% CI, 5.6-6.5). Prevalence was higher in females vs males (7.6% vs 5.4%), in South America vs Asia (11.2% vs 5.1%), in upper-middle-income countries vs high-income countries (8.9% vs 4.0%), and with advancing age. On sensitivity analysis of population-based studies, the prevalence of gallstones was 5.5% (95% CI, 4.1-7.4; n = 44 studies), and when limiting subgroup analysis to imaging-based detection modalities, the prevalence was 6.7% (95% CI, 6.1-7.3; n = 101 studies). Prevalence has been stable over the past 20 years. Based on 12 studies, the incidence of gallstones was 0.47 per 100 person-years (95% CI, 0.37-0.51), without differences between males and females, and with increasing incidence in more recent studies. CONCLUSIONS Globally, 6% of the population have gallstones, with higher rates in females and in South America. The incidence of gallstones may be increasing. Our findings call for prioritizing research on the prevention of gallstones.
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Affiliation(s)
- Xin Wang
- Department of Epidemiology and Biostatistics, West China School of Public Health, West China Fourth Hospital, Sichuan University, Wuhou District, Chengdu, China; West China-PUMC C.C. Chen Institute of Health, West China School of Public Health, West China Fourth Hospital, Sichuan University, Wuhou District, Chengdu, China
| | - Wenqian Yu
- Department of Epidemiology and Biostatistics, West China School of Public Health, West China Fourth Hospital, Sichuan University, Wuhou District, Chengdu, China; West China-PUMC C.C. Chen Institute of Health, West China School of Public Health, West China Fourth Hospital, Sichuan University, Wuhou District, Chengdu, China
| | - Guoheng Jiang
- Department of Epidemiology and Biostatistics, West China School of Public Health, West China Fourth Hospital, Sichuan University, Wuhou District, Chengdu, China; West China-PUMC C.C. Chen Institute of Health, West China School of Public Health, West China Fourth Hospital, Sichuan University, Wuhou District, Chengdu, China
| | - Hongyu Li
- Department of Epidemiology and Biostatistics, West China School of Public Health, West China Fourth Hospital, Sichuan University, Wuhou District, Chengdu, China; West China-PUMC C.C. Chen Institute of Health, West China School of Public Health, West China Fourth Hospital, Sichuan University, Wuhou District, Chengdu, China
| | - Shiyi Li
- Department of Epidemiology and Biostatistics, West China School of Public Health, West China Fourth Hospital, Sichuan University, Wuhou District, Chengdu, China; West China-PUMC C.C. Chen Institute of Health, West China School of Public Health, West China Fourth Hospital, Sichuan University, Wuhou District, Chengdu, China
| | - Linjun Xie
- Department of Epidemiology and Biostatistics, West China School of Public Health, West China Fourth Hospital, Sichuan University, Wuhou District, Chengdu, China; West China-PUMC C.C. Chen Institute of Health, West China School of Public Health, West China Fourth Hospital, Sichuan University, Wuhou District, Chengdu, China
| | - Xuan Bai
- Department of Epidemiology and Biostatistics, West China School of Public Health, West China Fourth Hospital, Sichuan University, Wuhou District, Chengdu, China; West China-PUMC C.C. Chen Institute of Health, West China School of Public Health, West China Fourth Hospital, Sichuan University, Wuhou District, Chengdu, China
| | - Ping Cui
- Department of Public Health, Jining Medical University, Jining, China
| | - Qi Chen
- Department of Endocrinology and Metabolism, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Yanmei Lou
- Department of Health Management, Beijing Xiaotangshan Hospital, Beijing, China
| | - Li Zou
- Department of Nursing, Luzhou People's Hospital, Luzhou, China
| | - Sulian Li
- Department of Nursing, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, China
| | - Zhongfang Zhou
- Preventive Medical of TCM & Physical Examination Center of The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, China
| | - Chi Zhang
- Department of Prevention, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Peng Sun
- Department of Gastrointestinal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Shenzhen Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Shenzhen, China
| | - Min Mao
- The Joint Laboratory for Lung Development and Related Diseases of West China Second University Hospital, Sichuan University, School of Life Sciences of Fudan University, West China Institute of Women and Children's Health, West China Second University Hospital, Sichuan University, Chengdu, China.
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Yang Y, Shi M, Liu X, Zhu Q, Xu Z, Liu G, Feng T, Stewart T, Zhang J. Calcium influx: An essential process by which α-Synuclein regulates morphology of erythrocytes. J Adv Res 2024; 62:187-198. [PMID: 37714326 PMCID: PMC11331169 DOI: 10.1016/j.jare.2023.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 09/06/2023] [Accepted: 09/11/2023] [Indexed: 09/17/2023] Open
Abstract
INTRODUCTION Morphological abnormalities of erythrocytes/red blood cells (RBCs), e.g., increased acanthocytes, in Parkinson's disease (PD) have been reported previously, although the underlying mechanisms remain to be characterized. In this study, the potential roles of α-synuclein (α-syn), a protein critically involved in PD and highly abundant in RBCs, were studied in PD patients as well as in a PD mouse model. METHODS Transgenic [PAC-Tg (SNCAA53T), A53T] mice overexpressing A53T mutant α-syn and SNCA knockout mice were employed to characterize the effect of α-syn on RBC morphology. In addition to A53T and SNCA knockout mice, the morphology of RBCs of PD patients was also examined using scanning electron microscopy. The potential roles of α-syn were further investigated in cultured RBCs and mice. RESULTS Morphological abnormalities of RBCs and increased accumulation of aggregated α-syn on the RBC membrane were observed in PD patients. A similar phenomenon was also observed in A53T mice. Furthermore, while mice lacking α-syn expression showed a lower proportion of acanthocytes, treating RBCs derived from SNCA knockout mice with aggregated α-syn resulted in a higher percentage of acanthocytes. In a follow-up proteomic investigation, several major classes of proteins were identified as α-syn-associated proteins on the RBC membrane, seven of which were calcium-binding proteins. Applying aggregated α-syn to the RBC membrane directly induced extracellular calcium influx along with morphological changes; both observations were adequately reversed by blocking calcium influx. CONCLUSIONS This study demonstrated that α-syn plays a critical role in PD-associated morphological abnormalities of RBCs, at least partially via a process mediated by extracellular calcium influx.
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Affiliation(s)
- Ying Yang
- Department of Pathology, Zhejiang University First Affiliated Hospital and School of Medicine, Hangzhou, Zhejiang 310002, China; Department of Pathology, School of Basic Medical Sciences, Peking University Third Hospital, Peking University Health Science Center, Beijing 100191, China
| | - Min Shi
- Department of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, WA 98104, USA
| | - Xiaodan Liu
- Department of Pathology, School of Basic Medical Sciences, Peking University Third Hospital, Peking University Health Science Center, Beijing 100191, China
| | - Qiaoyun Zhu
- Central Laboratory, Zhejiang University First Affiliated Hospital and School of Medicine, Hangzhou, Zhejiang 310002, China
| | - Zhi Xu
- Department of Pathology, Zhejiang University First Affiliated Hospital and School of Medicine, Hangzhou, Zhejiang 310002, China
| | - Genliang Liu
- Center for Movement Disorders, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China; China National Clinical Research Center for Neurological Diseases, Beijing 100070, China
| | - Tao Feng
- Center for Movement Disorders, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China; China National Clinical Research Center for Neurological Diseases, Beijing 100070, China.
| | - Tessandra Stewart
- Department of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, WA 98104, USA.
| | - Jing Zhang
- Department of Pathology, Zhejiang University First Affiliated Hospital and School of Medicine, Hangzhou, Zhejiang 310002, China; National Human Brain Bank for Health and Disease, Zhejiang University, Zhejiang, Hangzhou, China.
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Kang X, Gao X, Chen G. A rare case of atypical tumoral presentation of calcium pyrophosphate dihydrate crystal deposition disease. Quant Imaging Med Surg 2024; 14:6189-6194. [PMID: 39143993 PMCID: PMC11320512 DOI: 10.21037/qims-24-328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 06/17/2024] [Indexed: 08/16/2024]
Affiliation(s)
- Xuefeng Kang
- Department of Radiology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Xiaomin Gao
- Department of Radiology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Guangxiang Chen
- Department of Radiology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
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Shi JY, Li TT, Yang HT, Zhang S, An R, Mao L, Li Y, Li Q, Luan GY, Shen Y, Wang EL, Liu GH. Acupoints for Headache with Blood Stasis Syndrome: a Literature Study Based on Data Mining Technology. J Pain Res 2024; 17:2455-2471. [PMID: 39081327 PMCID: PMC11288322 DOI: 10.2147/jpr.s471441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2024] [Accepted: 07/06/2024] [Indexed: 08/02/2024] Open
Abstract
Objective This study aimed to investigate the features and underlying principles of acupuncture points used in the treatment of headaches associated with blood stasis syndrome. Methods Literature on the treatment of blood stasis headache with acupuncture and moxibustion was searched across three Chinese databases and one English database from January 1st, 2000, to January 1st, 2024. Relevant data including titles, journals, authors, keywords, interventions, main acupoints, and outcomes were extracted for further analysis. Results A total of 112 papers with 102 complete prescriptions were analyzed. Of the 77 acupoints examined, 72 were meridian points, and 5 were extraordinary points, used 699 times in total. The top ten acupoints by frequency were Fengchi (GB20), Taiyang (EX-HN5), Baihui (GV20), Hegu (LI4), Shuaigu (GB8), Taichong (LR3), Xuehai (SP10), Touwei (ST8), Geshu (BL17), and Waiguan (TE5). Yang meridian points were used more frequently than Yin meridian points (82.8% vs 17.2%), with the Gallbladder Meridian of Foot Shaoyang being the most common. Nearly half of the acupoints (49.9%) were on the head and neck, and 23.1% on the lower limbs. Specific acupoints accounted for 53.5% of the total frequency. Fengchi (GB20) and Taiyang (EX-HN5) showed the highest correlation. Association rule mining highlighted combinations like Fengchi (GB20) with Taiyang (EX-HN5) and Baihui (GV20). Cluster analysis yielded five clusters. Conclusion The study provides insights into selecting effective acupoints and combinations for clinical acupuncture practice and experimental studies in treating blood stasis headaches. Acupoints like Fengchi (GB20), Taiyang (EX-HN5), and Baihui (GV20) may be effective for clinical treatment, but further studies are needed to validate their efficacy.
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Affiliation(s)
- Jin-yu Shi
- First Clinical Medical College, Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning, 110847, People’s Republic of China
| | - Ting-ting Li
- First Clinical Medical College, Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning, 110847, People’s Republic of China
- Department of Neurology, Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning, 110032, People’s Republic of China
| | - Hui-ting Yang
- First Clinical Medical College, Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning, 110847, People’s Republic of China
| | - Shi Zhang
- Department of Neurology, Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning, 110032, People’s Republic of China
| | - Ran An
- Department of Neurology, Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning, 110032, People’s Republic of China
| | - Liang Mao
- Department of Neurology, Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning, 110032, People’s Republic of China
| | - Yang Li
- Department of Neurology, Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning, 110032, People’s Republic of China
| | - Qian Li
- Department of Neurology, Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning, 110032, People’s Republic of China
| | - Guang-yi Luan
- Department of Neurology, Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning, 110032, People’s Republic of China
| | - Yan Shen
- Department of Neurology, Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning, 110032, People’s Republic of China
| | - En-long Wang
- Department of Neurology, Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning, 110032, People’s Republic of China
| | - Guang-hui Liu
- First Clinical Medical College, Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning, 110847, People’s Republic of China
- Department of Neurology, Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning, 110032, People’s Republic of China
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Choi BC, Lee SJ, Choi E, Lee S, Lee J. The Effect of Oral Diet Training in Indwelling Nasogastric Tube Patients with Prolonged Dysphagia. Nutrients 2024; 16:2424. [PMID: 39125305 PMCID: PMC11314472 DOI: 10.3390/nu16152424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Revised: 07/17/2024] [Accepted: 07/23/2024] [Indexed: 08/12/2024] Open
Abstract
Background: Patients with severe dysphagia are usually fed using a nasogastric tube (NGT). Many patients who receive long-term NGT feeding are unable to obtain sufficient nutrients orally immediately after NGT removal. Thus, a transitional period involving oral diet training is required to transition from NGT feeding to exclusive oral feeding. We aimed to investigate the therapeutic effect of oral diet training in indwelling NGT patients with prolonged dysphagia. Methods: A total of 175 patients who were fed using an NGT for more than 4 weeks were enrolled. Their swallowing function was evaluated by a videofluoroscopic swallowing study (VFSS). During the VFSS, patients received thick and thin barium while the NGT was inserted. Then, the patients underwent a VFSS without an NGT thirty minutes after NGT removal. If a patient had no aspiration with NGT inserted during the VFSS, oral diet training combined with NGT feeding was recommended. Results: Of the 49 indwelling NGT patients who were recommended to receive oral diet training, 39 (79.6%) transitioned to exclusive oral feeding. A transition period of 2-8 weeks was required for them to achieve full oral feeding. Patients who were eligible for oral feeding trials showed no significant aspiration during the VFSS with an NGT inserted and had sufficient cough function. Patients who required prolonged NGT feeding and who could not complete oral trials showed significant aspiration during the VFSS when an NGT was inserted. Conclusions: This study demonstrated that oral diet training combined with NGT feeding is safe in patients with prolonged dysphagia who have sufficient cough function and no aspiration during VFSS. We suggest that if the patient is a proper candidate for NGT removal, direct oral feeding training with an NGT inserted could be a useful therapeutic strategy during the transitional period from long-term NGT feeding to successful oral feeding.
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Affiliation(s)
| | - Sook Joung Lee
- Department of Physical Medicine and Rehabilitation, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea; (B.-c.C.); (E.C.); (S.L.); (J.L.)
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Tognetti L, Miracapillo C, Leonardelli S, Luschi A, Iadanza E, Cevenini G, Rubegni P, Cartocci A. Deep Learning Techniques for the Dermoscopic Differential Diagnosis of Benign/Malignant Melanocytic Skin Lesions: From the Past to the Present. Bioengineering (Basel) 2024; 11:758. [PMID: 39199716 PMCID: PMC11351129 DOI: 10.3390/bioengineering11080758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2024] [Revised: 07/15/2024] [Accepted: 07/17/2024] [Indexed: 09/01/2024] Open
Abstract
There has been growing scientific interest in the research field of deep learning techniques applied to skin cancer diagnosis in the last decade. Though encouraging data have been globally reported, several discrepancies have been observed in terms of study methodology, result presentations and validation in clinical settings. The present review aimed to screen the scientific literature on the application of DL techniques to dermoscopic melanoma/nevi differential diagnosis and extrapolate those original studies adequately by reporting on a DL model, comparing them among clinicians and/or another DL architecture. The second aim was to examine those studies together according to a standard set of statistical measures, and the third was to provide dermatologists with a comprehensive explanation and definition of the most used artificial intelligence (AI) terms to better/further understand the scientific literature on this topic and, in parallel, to be updated on the newest applications in the medical dermatologic field, along with a historical perspective. After screening nearly 2000 records, a subset of 54 was selected. Comparing the 20 studies reporting on convolutional neural network (CNN)/deep convolutional neural network (DCNN) models, we have a scenario of highly performant DL algorithms, especially in terms of low false positive results, with average values of accuracy (83.99%), sensitivity (77.74%), and specificity (80.61%). Looking at the comparison with diagnoses by clinicians (13 studies), the main difference relies on the specificity values, with a +15.63% increase for the CNN/DCNN models (average specificity of 84.87%) compared to humans (average specificity of 64.24%) with a 14,85% gap in average accuracy; the sensitivity values were comparable (79.77% for DL and 79.78% for humans). To obtain higher diagnostic accuracy and feasibility in clinical practice, rather than in experimental retrospective settings, future DL models should be based on a large dataset integrating dermoscopic images with relevant clinical and anamnestic data that is prospectively tested and adequately compared with physicians.
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Affiliation(s)
- Linda Tognetti
- Dermatology Unit, Deparment of Medical, Surgical and Neurosciences, University of Siena, Viale Bracci 16, 53100 Siena, Italy (P.R.)
| | - Chiara Miracapillo
- Dermatology Unit, Deparment of Medical, Surgical and Neurosciences, University of Siena, Viale Bracci 16, 53100 Siena, Italy (P.R.)
| | - Simone Leonardelli
- Dermatology Unit, Deparment of Medical, Surgical and Neurosciences, University of Siena, Viale Bracci 16, 53100 Siena, Italy (P.R.)
| | - Alessio Luschi
- Bioengineering and Biomedical Data Science Lab, Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy (E.I.)
| | - Ernesto Iadanza
- Bioengineering and Biomedical Data Science Lab, Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy (E.I.)
| | - Gabriele Cevenini
- Bioengineering and Biomedical Data Science Lab, Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy (E.I.)
| | - Pietro Rubegni
- Dermatology Unit, Deparment of Medical, Surgical and Neurosciences, University of Siena, Viale Bracci 16, 53100 Siena, Italy (P.R.)
| | - Alessandra Cartocci
- Dermatology Unit, Deparment of Medical, Surgical and Neurosciences, University of Siena, Viale Bracci 16, 53100 Siena, Italy (P.R.)
- Bioengineering and Biomedical Data Science Lab, Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy (E.I.)
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Soe NN, Yu Z, Latt PM, Lee D, Ong JJ, Ge Z, Fairley CK, Zhang L. Evaluation of artificial intelligence-powered screening for sexually transmitted infections-related skin lesions using clinical images and metadata. BMC Med 2024; 22:296. [PMID: 39020355 PMCID: PMC11256573 DOI: 10.1186/s12916-024-03512-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 07/02/2024] [Indexed: 07/19/2024] Open
Abstract
BACKGROUND Sexually transmitted infections (STIs) pose a significant global public health challenge. Early diagnosis and treatment reduce STI transmission, but rely on recognising symptoms and care-seeking behaviour of the individual. Digital health software that distinguishes STI skin conditions could improve health-seeking behaviour. We developed and evaluated a deep learning model to differentiate STIs from non-STIs based on clinical images and symptoms. METHODS We used 4913 clinical images of genital lesions and metadata from the Melbourne Sexual Health Centre collected during 2010-2023. We developed two binary classification models to distinguish STIs from non-STIs: (1) a convolutional neural network (CNN) using images only and (2) an integrated model combining both CNN and fully connected neural network (FCN) using images and metadata. We evaluated the model performance by the area under the ROC curve (AUC) and assessed metadata contributions to the Image-only model. RESULTS Our study included 1583 STI and 3330 non-STI images. Common STI diagnoses were syphilis (34.6%), genital warts (24.5%) and herpes (19.4%), while most non-STIs (80.3%) were conditions such as dermatitis, lichen sclerosis and balanitis. In both STI and non-STI groups, the most frequently observed groups were 25-34 years (48.6% and 38.2%, respectively) and heterosexual males (60.3% and 45.9%, respectively). The Image-only model showed a reasonable performance with an AUC of 0.859 (SD 0.013). The Image + Metadata model achieved a significantly higher AUC of 0.893 (SD 0.018) compared to the Image-only model (p < 0.01). Out of 21 metadata, the integration of demographic and dermatological metadata led to the most significant improvement in model performance, increasing AUC by 6.7% compared to the baseline Image-only model. CONCLUSIONS The Image + Metadata model outperformed the Image-only model in distinguishing STIs from other skin conditions. Using it as a screening tool in a clinical setting may require further development and evaluation with larger datasets.
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Affiliation(s)
- Nyi N Soe
- Melbourne Sexual Health Centre, Alfred Health, 580 Swanston Street, Carlton, Melbourne, VIC, 3053, Australia
- School of Translational Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Zhen Yu
- School of Translational Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Phyu M Latt
- Melbourne Sexual Health Centre, Alfred Health, 580 Swanston Street, Carlton, Melbourne, VIC, 3053, Australia
- School of Translational Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - David Lee
- Melbourne Sexual Health Centre, Alfred Health, 580 Swanston Street, Carlton, Melbourne, VIC, 3053, Australia
| | - Jason J Ong
- Melbourne Sexual Health Centre, Alfred Health, 580 Swanston Street, Carlton, Melbourne, VIC, 3053, Australia
- School of Translational Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Zongyuan Ge
- Augmented Intelligence and Multimodal analytics (AIM) for Health Lab, Faculty of Information Technology, Monash University, Melbourne, Australia
| | - Christopher K Fairley
- Melbourne Sexual Health Centre, Alfred Health, 580 Swanston Street, Carlton, Melbourne, VIC, 3053, Australia
- School of Translational Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Lei Zhang
- Melbourne Sexual Health Centre, Alfred Health, 580 Swanston Street, Carlton, Melbourne, VIC, 3053, Australia.
- School of Translational Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia.
- Clinical Medical Research Centre, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, 210008, China.
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Soni P, Ammal Kaidery N, Sharma SM, Gazaryan I, Nikulin SV, Hushpulian DM, Thomas B. A critical appraisal of ferroptosis in Alzheimer's and Parkinson's disease: new insights into emerging mechanisms and therapeutic targets. Front Pharmacol 2024; 15:1390798. [PMID: 39040474 PMCID: PMC11260649 DOI: 10.3389/fphar.2024.1390798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Accepted: 06/17/2024] [Indexed: 07/24/2024] Open
Abstract
Neurodegenerative diseases represent a pressing global health challenge, and the identification of novel mechanisms underlying their pathogenesis is of utmost importance. Ferroptosis, a non-apoptotic form of regulated cell death characterized by iron-dependent lipid peroxidation, has emerged as a pivotal player in the pathogenesis of neurodegenerative diseases. This review delves into the discovery of ferroptosis, the critical players involved, and their intricate role in the underlying mechanisms of neurodegeneration, with an emphasis on Alzheimer's and Parkinson's diseases. We critically appraise unsolved mechanistic links involved in the initiation and propagation of ferroptosis, such as a signaling cascade resulting in the de-repression of lipoxygenase translation and the role played by mitochondrial voltage-dependent anionic channels in iron homeostasis. Particular attention is given to the dual role of heme oxygenase in ferroptosis, which may be linked to the non-specific activity of P450 reductase in the endoplasmic reticulum. Despite the limited knowledge of ferroptosis initiation and progression in neurodegeneration, Nrf2/Bach1 target genes have emerged as crucial defenders in anti-ferroptotic pathways. The activation of Nrf2 and the inhibition of Bach1 can counteract ferroptosis and present a promising avenue for future therapeutic interventions targeting ferroptosis in neurodegenerative diseases.
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Affiliation(s)
- Priyanka Soni
- Darby Children’s Research Institute, Medical University of South Carolina, Charleston, SC, United States
- Department of Pediatrics, Medical University of South Carolina, Charleston, SC, United States
| | - Navneet Ammal Kaidery
- Darby Children’s Research Institute, Medical University of South Carolina, Charleston, SC, United States
- Department of Pediatrics, Medical University of South Carolina, Charleston, SC, United States
| | - Sudarshana M. Sharma
- Department of Biochemistry and Molecular Biology and Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, United States
| | - Irina Gazaryan
- Department of Chemical Enzymology, School of Chemistry, M.V. Lomonosov Moscow State University, Moscow, Russia
- Department of Chemistry and Physical Sciences, Dyson College of Arts and Sciences, Pace University, Pleasantville, NY, United States
| | - Sergey V. Nikulin
- Faculty of Biology and Biotechnologies, Higher School of Economics, Moscow, Russia
| | - Dmitry M. Hushpulian
- Faculty of Biology and Biotechnologies, Higher School of Economics, Moscow, Russia
- A.N.Bach Institute of Biochemistry, Federal Research Center “Fundamentals of Biotechnology” of the Russian Academy of Sciences, Moscow, Russia
| | - Bobby Thomas
- Darby Children’s Research Institute, Medical University of South Carolina, Charleston, SC, United States
- Department of Pediatrics, Medical University of South Carolina, Charleston, SC, United States
- Department of Neuroscience, Medical University of South Carolina, Charleston, SC, United States
- Department of Drug Discovery, Medical University of South Carolina, Charleston, SC, United States
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Sun S, Zhang T, Yu H, Xia T, Yao Y, Sun M, Liang H, Huang Q, Wang W, Yang H, Hong X. Time trends in Alzheimer's disease mortality attributable to metabolic risks and smoking in China from 1990 to 2019: an age-period-cohort analysis. Front Aging Neurosci 2024; 16:1425577. [PMID: 39026988 PMCID: PMC11256009 DOI: 10.3389/fnagi.2024.1425577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Accepted: 06/18/2024] [Indexed: 07/20/2024] Open
Abstract
Background With the increase in the aging population worldwide, Alzheimer's disease has become a rapidly increasing public health concern. In the Global Burden of Disease Study 2019, there are three risk factors judged to have evidence for a causal link to Alzheimer's disease and other dementias: smoking, high body-mass index (HBMI), and high fasting plasma glucose (HFPG). Objective This study aimed to analyze trends in AD mortality and the relevant burden across China from 1990 to 2019, as well as their correlation with age, period, and birth cohort. Methods The data were extracted from the GBD 2019. Trends in AD mortality attributable to metabolic risks (HFPG and HBMI) and smoking were analyzed using Joinpoint regression. The age-period-cohort (APC) model was used to evaluate cohort and period effects. Results From 1990 to 2019, the overall age-standardized mortality rate of AD increased, especially in women. There was an increase in AD mortality due to smoking in the net drift, and it was more significant in women (0.46, 95%CI = [0.09, 0.82]) than men (-0.03, 95%CI = [-0.11, 0.05]). For the cause of HFPG, the net drift values for men and women were 0.82% and 0.43%. For HBMI, the values were 3.14% and 2.76%, respectively, reflecting substantial increases in AD mortality. Conclusion Time trends in AD mortality caused by metabolic risks and smoking in China from 1990 to 2019 have consistently increased. Therefore, it is necessary to prevent excessive weight gain and obesity during the later stages of life, especially for females.
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Affiliation(s)
- Simeng Sun
- Nanjing Municipal Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Ting Zhang
- Nanjing Municipal Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Hao Yu
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Ting Xia
- Monash Addiction Research Centre, Monash University, Clayton, VIC, Australia
| | - Yunan Yao
- Nantong Center for Disease Control and Prevention, Nantong, Jiangsu, China
| | - Mengting Sun
- Nanjing Drum Tower Hospital, Nanjing, Jiangsu, China
| | - Hongmei Liang
- Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qiaoyu Huang
- Nanjing Municipal Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Weiwei Wang
- Nanjing Municipal Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Huafeng Yang
- Nanjing Municipal Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Xin Hong
- Nanjing Municipal Center for Disease Control and Prevention, Nanjing, Jiangsu, China
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Ito T, Ramos-Alvarez I, Jensen RT. Long-Term Proton Pump Inhibitor-Acid Suppressive Treatment Can Cause Vitamin B 12 Deficiency in Zollinger-Ellison Syndrome (ZES) Patients. Int J Mol Sci 2024; 25:7286. [PMID: 39000391 PMCID: PMC11242121 DOI: 10.3390/ijms25137286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2024] [Revised: 06/26/2024] [Accepted: 06/28/2024] [Indexed: 07/16/2024] Open
Abstract
Whether the long-term treatment of patients with proton pump inhibitors (PPIs) with different diseases [GERD, Zollinger-Ellison syndrome (ZES), etc.] can result in vitamin B12 (VB12) deficiency is controversial. In this study, in 175 patients undergoing long-term ZES treatment with anti-acid therapies, drug-induced control acid secretory rates were correlated with the presence/absence of VB12 deficiency, determined by assessing serum VB12 levels, measurements of VB12 body stores (blood methylmalonic acid (MMA) and total homocysteine[tHYC]), and other features of ZES. After a mean of 10.2 yrs. of any acid treatment (5.6 yrs. with PPIs), 21% had VB12 deficiency with significantly lower serum and body VB12 levels (p < 0.0001). The presence of VB12 deficiency did not correlate with any feature of ZES but was associated with a 12-fold lower acid control rate, a 2-fold higher acid control pH (6.4 vs. 3.7), and acid control secretory rates below those required for the activation of pepsin (pH > 3.5). Over a 5-yr period, the patients with VB12 deficiency had a higher rate of achlorhydria (73% vs. 24%) and a lower rate of normal acid secretion (0% vs. 49%). In conclusion, in ZES patients, chronic long-term PPI treatment results in marked acid hyposecretion, resulting in decreased serum VB12 levels and decreased VB12-body stores, which can result in VB12 deficiency.
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Affiliation(s)
- Tetsuhide Ito
- Neuroendocrine Tumor Centra, Fukuoka Sanno Hospital, International University of Health and Welfare, 3-6-45 Momochihama, Sawara-Ku, Fukuoka 814-0001, Japan
| | | | - Robert T Jensen
- Digestive Diseases Branch, NIDDK, NIH, Bethesda, MD 20892-1804, USA
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Pisano F, Bilotta F. The Predictive Value of the Verbal Glasgow Coma Scale in Traumatic Brain Injury: A Systematic Review. J Head Trauma Rehabil 2024; 39:273-283. [PMID: 38453630 DOI: 10.1097/htr.0000000000000938] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
BACKGROUND Traumatic brain injury (TBI) is a major global health concern, imposing significant burdens on individuals and healthcare systems. The Glasgow Coma Scale (GCS), a widely utilized instrument for evaluating neurological status, includes 3 variables: motor, verbal, and eye opening. The GCS plays a crucial role in TBI severity stratification. While extensive research has explored the predictive capabilities of the overall GCS score and its motor component, the Verbal Glasgow Coma Scale (V-GCS) has garnered less attention. OBJECTIVE To examine the predictive accuracy of the V-GCS in assessing outcomes in patients with TBI, with a particular focus on functional outcome and mortality. In addition, we intend to compare its predictive performance with other components of the GCS. METHODS A systematic review, based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, was conducted utilizing the PubMed, Scopus, and Web of Science databases. Inclusion criteria encompassed 10 clinical studies involving patients with TBI, wherein the level of consciousness was assessed using the verbal GCS score. Predominant statistical measures employed were odds ratios (ORs) and area under the curve (AUC). RESULTS Recorded findings consistently underscore that lower V-GCS scores are associated with adverse functional outcomes and mortality in patients with TBI. Despite the predictive accuracy of the V-GCS, the Motor Glasgow Coma Scale (M-GCS) emerges as a superior predictor. CONCLUSION In the context of TBI outcome prediction, the V-GCS demonstrates its efficacy as a prognostic tool. However, the M-GCS exhibits superior performance compared with the V-GCS. These insights underscore the multifaceted nature of TBI assessment and emphasize the necessity of considering distinct components of the Glasgow Coma Scale for comprehensive evaluation. Further research is warranted to refine and improve the application of these predictive measures in clinical practice.
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Affiliation(s)
- Francesca Pisano
- Department of Anesthesiology, Critical Care and Pain Medicine, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy
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Nair BR, Rajshekhar V. Quantitative Assessment of Brain Expansion After Evacuation of Chronic Subdural Hematoma as a Predictor of Recurrence. World Neurosurg 2024; 187:e1054-e1061. [PMID: 38740085 DOI: 10.1016/j.wneu.2024.05.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Accepted: 05/08/2024] [Indexed: 05/16/2024]
Abstract
BACKGROUND A lack of brain expansion is considered a risk factor for recurrence after evacuation of a chronic subdural hematoma (CSDH). To the best of our knowledge, no studies have reported on objective measurement of brain expansion after evacuation of a CSDH. METHODS We performed a retrospective analysis of prospectively collected data of patients undergoing 2 burr hole evacuation of a CSDH. We measured the depth of the brain surface from the frontal burr hole dural opening after hematoma evacuation using a specially devised measuring tool. Other predictors analyzed for recurrence of hematoma were age, gender, a history of hypertension, the use of anticoagulant and/or antiplatelet agents, Glasgow coma scale score at presentation, unilateral or bilateral hematoma, computed tomography appearance, and hematoma thickness. RESULTS Among 88 patients who underwent hematoma evacuation, 3 (3.4%) underwent surgery for recurrence. The significant factors associated with recurrence were the presence of bilateral hematoma (P = 0.001), hematoma width >2.3 cm (P = 0.04), gradation type of hematoma on the computed tomography scan (P = 0.03), and the depth of the brain after hematoma evacuation (P = 0.02). The brain expanded less in those with recurrence, with a mean depth of the brain of 18 ± 6 mm versus 7.27 ± 7.8 mm in those without recurrence. CONCLUSIONS Evacuation of a CSDH through 2 burr holes, along with copious irrigation and bed rest for 3 days, resulted in a very low recurrence rate without the use of a drain. A lack of brain expansion might be a predictor of recurrence. To the best of our knowledge, this is the first study to quantitatively measure the depth of the brain at surgery in patients undergoing surgery for CSDH.
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Affiliation(s)
- Bijesh Ravindran Nair
- Department of Neurological Sciences, Christian Medical College Vellore, Ranipet Campus, Vellore, India
| | - Vedantam Rajshekhar
- Department of Neurological Sciences, Christian Medical College Vellore, Ranipet Campus, Vellore, India.
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Sun S, Huang X, Fei X, Gong K, Ye F, Gao H. Neuroendoscopic Surgery Versus Stereotactic Aspiration in the Treatment of Supratentorial Intracerebral Hemorrhage: A Meta-Analysis. World Neurosurg 2024; 187:e585-e597. [PMID: 38679374 DOI: 10.1016/j.wneu.2024.04.132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Accepted: 04/21/2024] [Indexed: 05/01/2024]
Abstract
BACKGROUND Debate persists over the relative merits of neuroendoscopic surgery (NS) compared to stereotactic aspiration (SA) for treating supratentorial intracerebral hemorrhage (ICH). Consequently, we undertook this meta-analysis to assess the efficacy and safety of NS versus SA. METHODS We searched for the all-relevant studies systematically from English databases including PubMed, Embase, Web of Science, and the Cochrane Library. Three independent researchers identified and selected these literatures that met the inclusion criteria. Then we evaluated the quality of these studies according to the Cochrane Collaboration's risk of bias tool and the Newcastle-Ottawa Scale. RevMan 5.4 statistical software was used to conduct this meta-analysis. RESULTS Sixteen studies, including 2722 supratentorial ICH patients, were included in our meta-analysis. The pooled results showed that NS could effectively improve the functional prognosis (P = 0.002), reduce the postoperative mortality (P < 0.00001), and increase the hematoma evacuation rate (P < 0.00001). In addition, SA had more advantages in shortening operation time (P < 0.00001) and reducing intraoperative blood loss (P < 0.0001). However, there was no obvious statistical difference in intensive care unit stays (P = 0.23) between NS and SA. Besides, no sufficient evidence could support a significant difference in hospital stays. In the aspect of complications, NS was discovered to have a positive effect on preventing rebleeding (P = 0.005) and intracranial infection (P = 0.003). However, no significant differences between the 2 groups in digestive tract ulcer (P = 0.34), epilepsy (P = 0.99), and pneumonia (P = 0.58) were discovered. In the subgroup analysis, factors including publication time, Glasgow Coma Scale score, age, and follow-up, all significantly influenced the good functional outcome and mortality. Meanwhile, NS behaved more advantageous in improving functional prognosis for patients with hematoma located in the basal ganglia. CONCLUSIONS NS may hold more advantages over SA in the treatment of supratentorial ICH. However, SA is also an effective and suitable alternative for elderly patients, especially those with multiple comorbidities intolerant to extended surgical procedures. Further high-quality studies are warranted to substantiate our findings in the future.
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Affiliation(s)
- Shuwen Sun
- Department of Neurosurgery, The Affiliated Jiangyin hospital of Nantong University, Jiangyin, China.
| | - Xin Huang
- Department of Neurosurgery, The Affiliated Jiangyin hospital of Nantong University, Jiangyin, China
| | - Xiaobin Fei
- Department of Neurosurgery, The Affiliated Jiangyin hospital of Nantong University, Jiangyin, China
| | - Kai Gong
- Department of Neurosurgery, The Affiliated Jiangyin hospital of Nantong University, Jiangyin, China
| | - Fuhua Ye
- Department of Neurosurgery, The Affiliated Jiangyin hospital of Nantong University, Jiangyin, China
| | - Heng Gao
- Department of Neurosurgery, The Affiliated Jiangyin hospital of Nantong University, Jiangyin, China
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Kaaber IA, Lesbo M, Wichmann TO, Olsen DA, Rasmussen MM, Brink O, Borris LC, Hviid CVB. Admission levels of serum biomarkers have additive and cumulative prognostic value in traumatic brain injury. Sci Rep 2024; 14:14139. [PMID: 38898030 PMCID: PMC11187066 DOI: 10.1038/s41598-024-64125-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 06/05/2024] [Indexed: 06/21/2024] Open
Abstract
Elevated levels of CNS-derived serum proteins are associated with poor outcome in traumatic brain injury (TBI), but the value of adding acute serum biomarker levels to common clinical outcome predictors lacks evaluation. We analyzed admission serum samples for Total-Tau (T-Tau), Neurofilament light chain (Nfl), Glial fibrillary acidic protein (GFAP), and Ubiquitin C-terminal hydrolase L1 (UCHL1) in a cohort of 396 trauma patients including 240 patients with TBI. We assessed the independent association of biomarkers with 1-year mortality and 6-12 months Glasgow Outcome Scale Extended (GOSE) score, as well as the additive and cumulative value of biomarkers on Glasgow Coma Scale (GCS) and Marshall Score for outcome prediction. Nfl and T-Tau levels were independently associated with outcome (OR: Nfl = 1.65, p = 0.01; T-Tau = 1.99, p < 0.01). Nfl or T-Tau improved outcome prediction by GCS (Wald Chi, Nfl = 6.8-8.8, p < 0.01; T-Tau 7.2-11.3, p < 0.01) and the Marshall score (Wald Chi, Nfl = 16.2-17.5, p < 0.01; T-Tau 8.7-12.4, p < 0.01). Adding T-Tau atop Nfl further improved outcome prediction in majority of tested models (Wald Chi range 3.8-9.4, p ≤ 0.05). Our data suggest that acute levels of serum biomarkers are independently associated with outcome after TBI and add outcome predictive value to commonly used clinical scores.
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Affiliation(s)
- Ida A Kaaber
- Department of Clinical Biochemistry, Aarhus University Hospital, 8200, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Maj Lesbo
- Department of Ortopedic Surgery, Viborg Regional Hospital, Viborg, Denmark
| | - Thea O Wichmann
- Department of Neurosurgery, Aarhus University Hospital, Aarhus, Denmark
| | - Dorte Aa Olsen
- Department of Biochemistry and Immunology, Lillebaelt Hospital, University Hospital of Southern Denmark, Vejle, Denmark
| | - Mikkel M Rasmussen
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Neurosurgery, Aarhus University Hospital, Aarhus, Denmark
| | - Ole Brink
- Department of Ortopedic Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Lars C Borris
- Department of Ortopedic Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Claus V B Hviid
- Department of Clinical Biochemistry, Aarhus University Hospital, 8200, Aarhus, Denmark.
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
- Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark.
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Dahshan A, Youssef AH, Al Subhi A, Darweesh WS, Al Fahdi Z, Al Yahyaai M. The hidden threat: subdural empyema strikes a healthy teen. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2024; 60:74. [DOI: 10.1186/s41983-024-00849-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 05/30/2024] [Indexed: 01/05/2025] Open
Abstract
Abstract
Background
The incidence estimates for intracranial subdural empyema are 0.1 per 100,000 individuals, making it a rare clinical condition. It is a highly morbid and fatal illness that is most commonly the result of a primary infection somewhere else.
Case presentation
The authors present a young male patient 15 years presented with 1 week history of headache, fever, confusion and seizure attack with initial negative CT head and nearly negative CSF analysis. With few days he developed left sided weakness. MRI brain showed right temporoparietal subdural fluid collection with midline shift. Urgent neurosurgical evacuation was made and revealed subdural empyema. The boy received combination therapy of vancomycin, ceftriaxone, and metronidazole. The culture of the pus was negative but 16S rRNA gene sequencing (bacterial) revealed streptococcus intermedius. He made a good recovery with no recollection or neurological deficit on follow up.
Conclusion
This case highlights the possibility of occurrence of this rare infection in otherwise healthy individuals without obvious precipitating factor. It also indicates the superiority of MRI brain over CT head in detection of subdural collection. The rapid diagnosis and intervention improve the outcome of the patient.
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Hwang SC. Surgical treatment and recurrence of chronic subdural hematoma. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2024; 67:389-395. [DOI: 10.5124/jkma.2024.67.6.389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 04/01/2024] [Indexed: 01/05/2025] Open
Abstract
Background: The incidence of chronic subdural hematoma (CSDH) is increasing owing to the rapid growth of the elderly population. CSDH causes various neurological symptoms such as cognitive impairment and motor dysfunction, which can improve with appropriate surgical management.Current Concepts: CSDH usually comprises a hemorrhagic fluid that accumulates within the subdural space and compresses the brain. Surgery is indicated if CSDH is associated with neurological symptoms and is aimed at safe and sufficient drainage of the hematoma. Currently, the recommended primary surgical method involves insertion of a draining catheter after burr hole or twist-drill trephination to facilitate drainage of the hematoma over a couple of days. Craniotomy is limited to cases of organized or calcified hematoma. The postoperative recurrence rate is approximately 10% to 20%. The same treatment method is attempted in cases of recurrence.Discussion and Conclusion: Surgical methods aim for rapid symptom relief and minimal invasiveness. Trephination and indwelling subdural catheter placement can enable immediate drainage of the hematoma and can be performed under local anesthesia. Preoperatively, it is necessary to obtain an accurate medical and medication history of elderly patients. Except in cases of emergencies, it is preferable to select the timing of the surgery only after reversal of the effects of drugs to prevent surgical complications in patients who receive anticoagulants or antiplatelet agents. Close postoperative follow-up is necessary in elderly patients because insufficient brain expansion leads to maintenance of the subdural space and is associated with a high risk of recurrence.
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Kim HS, Choi YK, Oh M, Cho YS, Ghim JL. Enhancing drug administration flexibility: evaluation of pharmacokinetic properties of tegoprazan orally disintegrating tablet (ODT) administered via nasogastric tube or oral dosing. Transl Clin Pharmacol 2024; 32:98-106. [PMID: 38974342 PMCID: PMC11224899 DOI: 10.12793/tcp.2024.32.e9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Revised: 05/26/2024] [Accepted: 06/13/2024] [Indexed: 07/09/2024] Open
Abstract
Tegoprazan orally disintegrating tablet (ODT) formulation is a novel formulation to improve a convenience in comparison to taking the conventional tablet of tegoprazan, a potassium-competitive acid blocker. The purpose of this study was to evaluate the pharmacokinetic and safety profiles of tegoprazan ODT when administered via two routes: nasogastric tube or oral dosing. This study is expected to expand the administration route of tegoprazan ODT. The study was conducted in an open-label, randomized, single-dose, two-way crossover design with a 1-week washout period. Healthy subjects aged 19 to 45 years were administered 50 mg of tegoprazan ODT orally or dissolved in water via nasogastric tube. Tegoprazan, the active ingredient, was quantified using a ultra-high performance liquid chromatography tandem mass spectroscopy (UPLC-MS/MS), and pharmacokinetic parameters were determined through non-compartmental analysis. Safety was monitored throughout the study. A total of 48 subjects, successfully completed the trial. The geometric mean ratios for log-transformed Cmax and AUCt, representing the ratio of nasogastric tube group to oral dosing group, along with 90% confidence intervals, were 1.1087 (1.0243-1.2000) and 1.0023 (0.9620-1.0442), respectively. All adverse events were unrelated to tegoprazan and mild in intensity. The pharmacokinetic profiles of tegoprazan ODT were equivalent between the nasogastric tube and oral administration. Considering the demonstrated linear pharmacokinetics and concentration-dependent pharmacodynamics of tegoprazan, the administration via nasogastric tube is expected to yield effects equivalent to those of oral administration. This approach offers a viable alternative, especially beneficial for patients with oral intake difficulties.
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Affiliation(s)
- Ho-Sook Kim
- Department of Pharmacology and Pharmacogenomics Research Center, Inje University College of Medicine, Busan 47392, Korea
| | - Young-Kyung Choi
- Department of Pharmacology and Pharmacogenomics Research Center, Inje University College of Medicine, Busan 47392, Korea
| | - Minkyung Oh
- Department of Pharmacology and Pharmacogenomics Research Center, Inje University College of Medicine, Busan 47392, Korea
| | - Yong-Soon Cho
- Department of Pharmacology and Pharmacogenomics Research Center, Inje University College of Medicine, Busan 47392, Korea
| | - Jong-Lyul Ghim
- Department of Clinical Pharmacology, Inje University Busan Paik Hospital, Busan 47392, Korea
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131
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Jiang Y, Cai Y, Lu Y, Wu G, Zhang XY. Relationship between anemia and its correlates and cognitive function in Chinese patients with chronic schizophrenia: A large cross-sectional study. Schizophr Res Cogn 2024; 36:100300. [PMID: 38288371 PMCID: PMC10823126 DOI: 10.1016/j.scog.2024.100300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 01/12/2024] [Accepted: 01/12/2024] [Indexed: 01/31/2024]
Abstract
Background Although both anemia and schizophrenia (SCZ) can cause cognitive decline, it is unclear whether anemia worsens cognitive decline in patients with SCZ. The primary objective of this study was to investigate the prevalence of anemia and the relationship between anemia, SCZ symptom severity, and cognitive function in patients with SCZ. Methods We obtained demographic and clinical data from 1690 inpatients with SCZ. All psychiatric symptoms and cognitive functioning were assessed by the Positive and Negative Syndrome Scale (PANSS), the Mini-Mental State Examination (MMSE), and the Repeated Battery for the Assessment of Neuropsychological Status (RBANS). Hemoglobin (HGB) values as well as red blood cell (RBC) counts were collected by routine blood tests. Results The proportion of anemia in patients with SCZ was 26.36 % (383/1453). Compared to SCZ patients without anemia, SCZ patients with anemia were older, had a lower bodyweight, a smaller waist circumference and lower apolipoprotein B levels, but longer QT intervals. Further logistic regression analysis revealed that anemia was associated with age, gender, and weight. In addition, there was no difference in cognitive function between SCZ patients with and without anemia. Conclusion Our findings suggest a high proportion of anemia in patients with chronic SCZ in the Han Chinese population. Several demographic and clinical variables are associated with anemia in SCZ patients.
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Affiliation(s)
- Yang Jiang
- Guangxi Brain Disease Prevention & Treatment Research Center, Brain Hospital of Guangxi Zhuang Autonomous Region, Liuzhou, Guangxi, China
| | - Yi Cai
- Shenzhen Mental Health Center/Shenzhen KangNing Hospital, Department of Psychosomatic Disorders, Shenzhen, Guangdong, China
| | - Yaoyao Lu
- Guangxi Brain Disease Prevention & Treatment Research Center, Brain Hospital of Guangxi Zhuang Autonomous Region, Liuzhou, Guangxi, China
| | - Guanghui Wu
- Guangxi Brain Disease Prevention & Treatment Research Center, Brain Hospital of Guangxi Zhuang Autonomous Region, Liuzhou, Guangxi, China
| | - Xiang-Yang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
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Huang ST, Wang TG, Peng MC, Chen WM, Jao AT, Tang FT, Hsieh YT, Ho CS, Yeh SM. Predictors for Failed Removal of Nasogastric Tube in Patients With Brain Insult. Ann Rehabil Med 2024; 48:220-227. [PMID: 38830633 PMCID: PMC11217763 DOI: 10.5535/arm.230011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 03/25/2024] [Accepted: 05/02/2024] [Indexed: 06/05/2024] Open
Abstract
OBJECTIVE To construct a prognostic model for unsuccessful removal of nasogastric tube (NGT) was the aim of our study. METHODS This study examined patients with swallowing disorders receiving NGT feeding due to stroke or traumatic brain injury in a regional hospital. Clinical data was collected, such as age, sex, body mass index (BMI), level of activities of daily living (ADLs) dependence. Additionally, gather information regarding the enhancement in Functional Oral Intake Scale (FOIS) levels and the increase in food types according to the International Dysphagia Diet Standardization Initiative (IDDSI) after one month of swallowing training. A stepwise logistic regression analysis model was employed to predict NGT removal failure using these parameters. RESULTS Out of 203 patients, 53 patients (26.1%) had experienced a failed removal of NGT after six months of follow-up. The strongest predictors for failed removal were age over 60 years, underweight BMI, total dependence in ADLs, and ischemic stroke. The admission prediction model categorized patients into high, moderate, and low-risk groups for removal failure. The failure rate of NGT removal was high not only in the high-risk group but also in the moderate-risk groups when there was no improvement in FOIS levels and IDDSI food types. CONCLUSION Our predictive model categorizes patients with brain insults into risk groups for swallowing disorders, enabling advanced interventions such as percutaneous endoscopic gastrostomy for high-risk patients struggling with NGT removal, while follow-up assessments using FOIS and IDDSI aid in guiding rehabilitation decisions for those at moderate risk.
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Affiliation(s)
- Shih-Ting Huang
- Department of Physical Medicine and Rehabilitation, Lotung Poh-Ai Hospital, Lo-Hsu Foundation, Yilan County, Taiwan (R.O.C.)
| | - Tyng-Guey Wang
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, School of Medicine, National Taiwan University, Taipei City, Taiwan (R.O.C.)
| | - Mei-Chih Peng
- Department of Physical Medicine and Rehabilitation, Lotung Poh-Ai Hospital, Lo-Hsu Foundation, Yilan County, Taiwan (R.O.C.)
| | - Wan-Ming Chen
- Big Data Center, Lotung Poh-Ai Hospital, Lo-Hsu Foundation, Yilan County, Taiwan (R.O.C.)
| | - An-Tzu Jao
- Big Data Center, Lotung Poh-Ai Hospital, Lo-Hsu Foundation, Yilan County, Taiwan (R.O.C.)
| | - Fuk Tan Tang
- Department of Physical Medicine and Rehabilitation, Lotung Poh-Ai Hospital, Lo-Hsu Foundation, Yilan County, Taiwan (R.O.C.)
| | - Yu-Ting Hsieh
- Department of Physical Medicine and Rehabilitation, Lotung Poh-Ai Hospital, Lo-Hsu Foundation, Yilan County, Taiwan (R.O.C.)
| | - Chun Sheng Ho
- Department of Physical Medicine and Rehabilitation, Lotung Poh-Ai Hospital, Lo-Hsu Foundation, Yilan County, Taiwan (R.O.C.)
| | - Shu-Ming Yeh
- Department of Physical Medicine and Rehabilitation, Lotung Poh-Ai Hospital, Lo-Hsu Foundation, Yilan County, Taiwan (R.O.C.)
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Alp A, Yıldız Mİ, Eroğlu EÖ, Işıkay Aİ, Ayhan Y, Ertuğrul A. Recurrent Psychotic Depression Associated with Chronic Subdural Haematoma: A Case Report. Noro Psikiyatr Ars 2024; 61:180-183. [PMID: 38868841 PMCID: PMC11165614 DOI: 10.29399/npa.28519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 08/29/2023] [Indexed: 06/14/2024] Open
Abstract
Chronic subdural hematomas (CSDH) with isolated psychiatric presentation are rare. In this paper, we report a case of 77-year-old-female patient who had psychotic depression after repetitive head trauma without any neurological symptoms. The brain magnetic resonance imaging revealed an 20 mm subdural hematoma in the right frontoparietal region and a 7 mm subdural hematoma in the left frontal region. The psychiatric symptoms improved within the first week after evacuation but relapsed with the occurrence of right sided pneumocephalus. In the follow up, with the disappearance of the pneumocephalus, the psychiatric symptoms improved. It should be kept in mind that isolated psychiatric symptoms can be seen due to subdural hematoma and evacuation of the hematoma has an important role in improving the psychiatric symptoms.
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Affiliation(s)
- Anıl Alp
- Hacettepe University Faculty of Medicine, Department of Psychiatry, Ankara, Turkey
| | - M. İrem Yıldız
- Hacettepe University Faculty of Medicine, Department of Psychiatry, Ankara, Turkey
| | - Elçin Özçelik Eroğlu
- Hacettepe University Faculty of Medicine, Department of Psychiatry, Ankara, Turkey
| | - A. İlkay Işıkay
- Hacettepe University Faculty of Medicine, Department of Brain and Nerve Surgery, Ankara, Turkey
| | - Yavuz Ayhan
- Hacettepe University Faculty of Medicine, Department of Psychiatry, Ankara, Turkey
| | - Aygün Ertuğrul
- Hacettepe University Faculty of Medicine, Department of Psychiatry, Ankara, Turkey
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Feng CK, Chen WJ, Kung WM, Sun YY, Lin MS. CDGSH iron-sulfur domain 2 as a therapeutic target for stroke: an opinion article. Front Mol Neurosci 2024; 17:1386118. [PMID: 38864028 PMCID: PMC11165110 DOI: 10.3389/fnmol.2024.1386118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 04/23/2024] [Indexed: 06/13/2024] Open
Affiliation(s)
- Chao-Kang Feng
- Department of Nursing, College of Nursing, Hung Kuang University, Taichung, Taiwan
| | - Wei-Jung Chen
- Department of Biotechnology and Animal Science, College of Bioresources, National Ilan University, Yilan, Taiwan
| | - Woon-Man Kung
- Division of Neurosurgery, Department of Surgery, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
- Department of Exercise and Health Promotion, College of Kinesiology and Health, Chinese Culture University, Taipei, Taiwan
| | - Yu-Yo Sun
- Institute of Biopharmaceutical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan
- Department of Neuroscience, Center for Brain Immunology and Glia (BIG), University of Virginia School of Medicine, Charlottesville, VA, United States
| | - Muh-Shi Lin
- Department of Biotechnology and Animal Science, College of Bioresources, National Ilan University, Yilan, Taiwan
- Department of Health Business Administration, College of Medical and Health Care, Hung Kuang University, Taichung, Taiwan
- Division of Neurosurgery, Department of Surgery, Kuang Tien General Hospital, Taichung, Taiwan
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135
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Qin H, Suo S, Yang F, Hao P, Zhang X. The role of digestive system diseases in cerebrovascular disease: a comprehensive Mendelian randomization study. Front Neurol 2024; 15:1389352. [PMID: 38854966 PMCID: PMC11157012 DOI: 10.3389/fneur.2024.1389352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 05/13/2024] [Indexed: 06/11/2024] Open
Abstract
Background Cerebrovascular disease, among the most prevalent neurological disorders, poses a substantial threat to human health with its elevated mortality and disability rates, placing considerable strain on healthcare systems. Although several studies in recent years have suggested a potential association between digestive system diseases and cerebrovascular diseases, the findings remain inconsistent. Methods Genome-wide association study (GWAS) summary data for 12 digestive diseases and cerebrovascular diseases were used to conduct Mendelian randomization (MR) analysis. In this investigation, we endeavored to elucidate the causal relationship between digestive system diseases and cerebrovascular diseases. Employing a comprehensive approach, including two-sample MR (TSMR), multivariate MR (MVMR), and two-step MR analysis, we leveraged summary statistics data obtained from published GWAS. The primary analysis method employed was inverse variance weighted (IVW), with MR-Egger and weighted median (WM) as secondary methods. Sensitivity analysis included heterogeneity testing, horizontal multivariate testing, MR-PRESSO, and a "leave-one-out" method. Additionally, the F-statistic was utilized to assess the strength of instrumental variables, ensuring robust results. Results In the TSMR analysis, this study found a significant causal relationship between genetically predicted gastroesophageal reflux disease (GERD) and any stroke (AS), any ischemic stroke (AIS), large-artery atherosclerotic stroke (LAS), intracranial aneurysm (IA), and subarachnoid hemorrhage (SAH). In MVMR analysis, this study found that even after adjusting for systolic blood pressure (SBP), body mass index (BMI) and type 2 diabetes (T2D), the causal relationship remains exist. In the two-step MR mediation analysis, it was found that BMI, SBP and T2D play mediating role in the causal relationship between GERD and cerebrovascular diseases. Conclusion This study indicates a clear positive causal relationship between GERD and cerebrovascular diseases, and this causal association remains significant even after adjusting for BMI, SBP and T2D. The mediation MR analysis suggests that BMI, SBP and T2D may mediate the causal relationship between GERD and the risk of cerebrovascular diseases.
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Affiliation(s)
- Hao Qin
- Department of Neurosurgery, The First Hospital of Jilin University, Changchun, China
| | - Shihuan Suo
- Department of Neurosurgery, The First Hospital of Jilin University, Changchun, China
| | - Fan Yang
- Department of Anesthesiology, The First Hospital of Jilin University, Changchun, China
| | - Pengfei Hao
- Department of Neurosurgery, Tongji Shanxi Hospital, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Third Hospital of Shanxi Medical University, Taiyuan, China
| | - Xianfeng Zhang
- Department of Neurosurgery, The First Hospital of Jilin University, Changchun, China
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136
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Qi W, Cao S, Wang B, Zhu X, Dong C, He D, Chen Y, Shi Y, Wang B. The Rise of Large Language Models in the Medical Field: A Bibliometric Analysis. 2024 IEEE INTERNATIONAL WORKSHOP ON FOUNDATION MODELS FOR CYBER-PHYSICAL SYSTEMS & INTERNET OF THINGS (FMSYS) 2024:56-62. [DOI: 10.1109/fmsys62467.2024.00014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2025]
Affiliation(s)
- Wenhao Qi
- School of Nursing, Hangzhou Normal University,Hangzhou,Zhejiang,China
| | - Shihua Cao
- School of Nursing, Hangzhou Normal University,Hangzhou,Zhejiang,China
| | - Bin Wang
- School of Nursing, Hangzhou Normal University,Hangzhou,Zhejiang,China
| | - Xiaohong Zhu
- School of Nursing, Hangzhou Normal University,Hangzhou,Zhejiang,China
| | - Chaoqun Dong
- School of Nursing, Hangzhou Normal University,Hangzhou,Zhejiang,China
| | - Danni He
- School of Nursing, Hangzhou Normal University,Hangzhou,Zhejiang,China
| | - Yanfei Chen
- School of Nursing, Hangzhou Normal University,Hangzhou,Zhejiang,China
| | - Yankai Shi
- School of Nursing, Hangzhou Normal University,Hangzhou,Zhejiang,China
| | - BingSheng Wang
- School of Nursing, Hangzhou Normal University,Hangzhou,Zhejiang,China
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137
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Pholngam N, Jamrus P, Viwatpinyo K, Kiatpakdee B, Vadolas J, Chaichompoo P, Ngampramuan S, Svasti S. Cognitive impairment and hippocampal neuronal damage in β-thalassaemia mice. Sci Rep 2024; 14:10054. [PMID: 38698053 PMCID: PMC11066061 DOI: 10.1038/s41598-024-60459-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 04/23/2024] [Indexed: 05/05/2024] Open
Abstract
β-Thalassaemia is one of the most common genetic diseases worldwide. During the past few decades, life expectancy of patients has increased significantly owing to advance in medical treatments. Cognitive impairment, once has been neglected, has gradually become more documented. Cognitive impairment in β-thalassaemia patients is associated with natural history of the disease and socioeconomic factors. Herein, to determined effect of β-thalassaemia intrinsic factors, 22-month-old β-thalassaemia mouse was used as a model to assess cognitive impairment and to investigate any aberrant brain pathology in β-thalassaemia. Open field test showed that β-thalassaemia mice had decreased motor function. However, no difference of neuronal degeneration in primary motor cortex, layer 2/3 area was found. Interestingly, impaired learning and memory function accessed by a Morris water maze test was observed and correlated with a reduced number of living pyramidal neurons in hippocampus at the CA3 region in β-thalassaemia mice. Cognitive impairment in β-thalassaemia mice was significantly correlated with several intrinsic β-thalassaemic factors including iron overload, anaemia, damaged red blood cells (RBCs), phosphatidylserine (PS)-exposed RBC large extracellular vesicles (EVs) and PS-exposed medium EVs. This highlights the importance of blood transfusion and iron chelation in β-thalassaemia patients. In addition, to improve patients' quality of life, assessment of cognitive functions should become part of routine follow-up.
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Affiliation(s)
- Nuttanan Pholngam
- Graduate Program in Molecular Medicine, Faculty of Science, Mahidol University, Bangkok, Thailand
- Thalassemia Research Center, Institute of Molecular Biosciences, Mahidol University, Nakhon Pathom, 73170, Thailand
| | - Parinda Jamrus
- Thalassemia Research Center, Institute of Molecular Biosciences, Mahidol University, Nakhon Pathom, 73170, Thailand
- Department of Pathobiology, Faculty of Science, Mahidol University, Bangkok, Thailand
| | - Kittikun Viwatpinyo
- Research Center for Neuroscience, Institute of Molecular Biosciences, Mahidol University, Nakhon Pathom, 73170, Thailand
- Department of Medical Science, School of Medicine, Walailak University, Nakhonsithammarat, Thailand
| | - Benjaporn Kiatpakdee
- Thalassemia Research Center, Institute of Molecular Biosciences, Mahidol University, Nakhon Pathom, 73170, Thailand
| | - Jim Vadolas
- Centre for Cancer Research, Hudson Institute of Medical Research, Melbourne, Australia
- Department of Molecular and Translational Science, Monash University, Melbourne, Australia
| | - Pornthip Chaichompoo
- Department of Pathobiology, Faculty of Science, Mahidol University, Bangkok, Thailand
| | - Sukonthar Ngampramuan
- Research Center for Neuroscience, Institute of Molecular Biosciences, Mahidol University, Nakhon Pathom, 73170, Thailand.
| | - Saovaros Svasti
- Thalassemia Research Center, Institute of Molecular Biosciences, Mahidol University, Nakhon Pathom, 73170, Thailand.
- Department of Biochemistry, Faculty of Science, Mahidol University, Bangkok, Thailand.
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138
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Prablek M, Reyes G, Kannan V, Gay CT, Lotze TE, Donoho DA, Bauer DF. Anterior cervical discectomy and fusion for the treatment of pediatric Hirayama disease. Childs Nerv Syst 2024; 40:1427-1434. [PMID: 38231402 DOI: 10.1007/s00381-024-06281-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 01/03/2024] [Indexed: 01/18/2024]
Abstract
PURPOSE Hirayama disease, a rare cervical myelopathy in children and young adults, leads to progressive upper limb weakness and muscle loss. Non-invasive external cervical orthosis has been shown to prevent further neurologic decline; however, this treatment modality has not been successful at restoring neurologic and motor function, especially in long standing cases with significant weakness. The pathophysiology remains not entirely understood, complicating standardized operative guidelines; however, some studies report favorable outcomes with internal fixation. We report a successful surgically treated case of pediatric Hirayama disease, supplemented by a systematic review and collation of reported cases in the literature. METHODS A review of the literature was performed by searching PubMed, Embase, and Web of Science. Full-length articles were included if they reported clinical data regarding the treatment of at least one patient with Hirayama disease and the neurologic outcome of that treatment. Articles were excluded if they did not provide information on treatment outcomes, were abstract-only publications, or were published in languages other than English. RESULTS Of the fifteen articles reviewed, 63 patients were described, with 59 undergoing surgery. This encompassed both anterior and posterior spinal procedures and 1 hand tendon transfer. Fifty-five patients, including one from our institution, showed improvement post-treatment. Eleven of these patients were under 18 years old. CONCLUSION Hirayama disease is an infrequent yet impactful cervical myelopathy with limited high-quality evidence available for optimal treatment. The current literature supports surgical decompression and stabilization as promising interventions. However, comprehensive research is crucial for evolving diagnosis and treatment paradigms.
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Affiliation(s)
- Marc Prablek
- Department of Neurosurgery, Baylor College of Medicine at Texas Children's Hospital, Houston, TX, 77030, USA.
| | - Gabriel Reyes
- Department of Neurosurgery, Baylor College of Medicine at Texas Children's Hospital, Houston, TX, 77030, USA
| | - Varun Kannan
- Department of Pediatrics, Division of Pediatric Neurology, Emory School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia
| | - Charles T Gay
- Department of Pediatrics, Section of Neurology and Developmental Neuroscience, Baylor College of Medicine at Texas Children's Hospital, Houston, TX, USA
| | - Timothy E Lotze
- Department of Pediatrics, Section of Neurology and Developmental Neuroscience, Baylor College of Medicine at Texas Children's Hospital, Houston, TX, USA
| | - Daniel A Donoho
- Division of Neurosurgery, Center for Neuroscience at Children's National Hospital, Department of Neurosurgery, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - David F Bauer
- Department of Neurosurgery, Baylor College of Medicine at Texas Children's Hospital, Houston, TX, 77030, USA
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139
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Koneru M, Paul U, Upadhyay U, Tanamala S, Golla S, Shaikh HA, Thomas AJ, Mossop CM, Tonetti DA. Correlating Age and Hematoma Volume with Extent of Midline Shift in Acute Subdural Hematoma Patients: Validation of an Artificial Intelligence Tool for Volumetric Analysis. World Neurosurg 2024; 185:e1250-e1256. [PMID: 38519018 DOI: 10.1016/j.wneu.2024.03.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 03/13/2024] [Indexed: 03/24/2024]
Abstract
OBJECTIVE Decision for intervention in acute subdural hematoma patients is based on a combination of clinical and radiographic factors. Age has been suggested as a factor to be strongly considered when interpreting midline shift (MLS) and hematoma volume data for assessing critical clinical severity during operative intervention decisions for acute subdural hematoma patients. The objective of this study was to demonstrate the use of an automated volumetric analysis tool to measure hematoma volume and MLS and quantify their relationship with age. METHODS A total of 1789 acute subdural hematoma patients were analyzed using qER-Quant software (Qure.ai, Mumbai, India) for MLS and hematoma volume measurements. Univariable and multivariable regressions analyzed association between MLS, hematoma volume, age, and MLS:hematoma volume ratio. RESULTS In comparison to young patients (≤ 70 years), old patients (>70 years) had significantly higher average hematoma volume (old: 62.2 mL vs. young 46.8 mL, P < 0.0001), lower average MLS (old: 6.6 mm vs. young: 7.4 mm, P = 0.025), and lower average MLS:hematoma volume ratio (old: 0.11 mm/mL vs. young 0.15 mm/mL, P < 0.0001). Young patients had an average of 1.5 mm greater MLS for a given hematoma volume in comparison to old patients. With increasing age, the ratio between MLS and hematoma volume significantly decreases (P = 0.0002). CONCLUSIONS Commercially available, automated, artificial intelligence (AI)-based tools may be used for obtaining quantitative radiographic measurement data in patients with acute subdural hematoma. Our quantitative results are consistent with the qualitative relationship previously established between age, hematoma volume, and MLS, which supports the validity of using AI-based tools for acute subdural hematoma volume estimation.
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Affiliation(s)
- Manisha Koneru
- Cooper Medical School of Rowan University, Camden, New Jersey, USA
| | - Umika Paul
- UMass Chan Medical School, Worcester, Massachusetts, USA
| | | | | | | | - Hamza A Shaikh
- Cooper Medical School of Rowan University, Camden, New Jersey, USA; Division of the Cooper Neurological Institute, Department of Neurosurgery, Cooper University Health Care, Camden, New Jersey, USA
| | - Ajith J Thomas
- Cooper Medical School of Rowan University, Camden, New Jersey, USA; Division of the Cooper Neurological Institute, Department of Neurosurgery, Cooper University Health Care, Camden, New Jersey, USA
| | - Corey M Mossop
- Cooper Medical School of Rowan University, Camden, New Jersey, USA; Division of the Cooper Neurological Institute, Department of Neurosurgery, Cooper University Health Care, Camden, New Jersey, USA
| | - Daniel A Tonetti
- Cooper Medical School of Rowan University, Camden, New Jersey, USA; Division of the Cooper Neurological Institute, Department of Neurosurgery, Cooper University Health Care, Camden, New Jersey, USA.
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140
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Cenci GI, Rocha RB, Ferreira Bomtempo F, Nager GB, Silva GD, Figueiredo EG, Telles JPM. Efficacy of transcranial direct current stimulation in patients with dysphagia after stroke: a systematic review. Neurol Sci 2024; 45:2119-2125. [PMID: 38044393 DOI: 10.1007/s10072-023-07216-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 11/20/2023] [Indexed: 12/05/2023]
Abstract
BACKGROUND Swallowing is a complex function that can be disrupted after stroke. Transcranial Direct Current Stimulation (tDCS) is a non-invasive brain stimulation therapy that recently has been tested to treat stroke-related dysphagia. METHODS The authors performed a search in the literature to review the described evidence of the use of tDCS in dysphagia after stroke. Three electronic databases were searched. The risk of bias evaluation was carried out through the RoB-2 tool. The Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) framework was also implemented. RESULTS Of 265 articles, only nine studies were included in this review. The most common location of the tDCS stimulation was the unaffected hemisphere (44%). Regarding the outcome measure, the Dysphagia Outcome and Severity Scale (DOSS) was the most commonly used (55%). However, due to the high heterogeneity of the protocols, and considering the differences between the types of stroke, the authors opted not to perform a metanalysis. Instead, a systematic review with a thorough analysis of each individual study and the impact of the differences to the outcomes was preferred. CONCLUSIONS The final considerations are that even though the majority of studies described benefits from tDCS in post-stroke dysphagia, as they present too many methodological differences, it is not possible to compare them. In addition, many articles included patients with less than 6 months after stroke, which is an important bias as the swallowing function can be recovered spontaneously within this period, turning the certainty of the evidence really low.
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Affiliation(s)
| | | | | | - Gabriela Borges Nager
- School of Medicine, Federal University of the State of Rio de Janeiro, Rio de Janeiro, Brazil
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Albayrak H, Atli E, Aydin S, Ozyemisci-Taskiran O. Successful outcome following a multimodal pelvic rehabilitation program in a woman with neurogenic bladder and bowel dysfunction: A case report. Physiother Theory Pract 2024; 40:1083-1090. [PMID: 36369853 DOI: 10.1080/09593985.2022.2144561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 10/29/2022] [Accepted: 10/30/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND Neurogenic bladder and bowel dysfunctions lead to physical, social, and emotional disability and affects one's quality of life. Initial treatment is conservative including several rehabilitation techniques such as pelvic floor muscle training, biofeedback, electrical stimulation, and posterior tibial nerve stimulation. OBJECTIVE In this case report, a 45-year-old woman with neurogenic bladder and bowel dysfunction was presented. CASE DESCRIPTION Her urinary and fecal incontinence symptoms began twenty years before this episode of care, after an incomplete spinal cord injury secondary to spinal ependymoma and syringomyelia. She discontinued medical treatments due to side effects and ceased intermittent catheterization. A multimodal pelvic rehabilitation program was administered consisting of posterior tibial nerve stimulation, active pelvic floor muscle training accompanied by biofeedback, and electrical stimulation of pelvic floor muscles. OUTCOMES There were clinically important favorable differences in the scores of King's health questionnaire (reductions in symptom severity from 25 to 18 and in each of the impact of incontinence, physical and social limitations, personal relationships, sleep/energy, and severity measures from 100 to 67), pelvic floor distress inventory (decreased from 257 to 146) and female sexual function index (increased from 15.1 to 25.1) after 12 weeks of a multimodal pelvic rehabilitation program. Manual muscle tests demonstrated improvements in pelvic floor muscle strength and endurance. CONCLUSION A 12-week multimodal pelvic rehabilitation program reduced urinary and fecal incontinence symptoms, together with improvements in her sexual life and alleviation of neuropathic pain.
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Affiliation(s)
- Havvanur Albayrak
- Department of Physical Medicine and Rehabilitation, Koç University Hospital, Topkapi, Turkey
| | - Ecenur Atli
- Department of Physical Medicine and Rehabilitation, Koç University Hospital, Topkapi, Turkey
| | - Serdar Aydin
- Department of Obstetric and Gynecology, Koç University School of Medicine, Topkapi, Turkey
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Chavhan R, Wanjari A, Kumar S, Acharya S, Rathod N, Reddy H, Gemnani R. A Comprehensive Review on Navigating the Neurological Landscape of COVID-19: Insights Into Etiopathogenesis and Clinical Management. Cureus 2024; 16:e60079. [PMID: 38860093 PMCID: PMC11163389 DOI: 10.7759/cureus.60079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Accepted: 05/10/2024] [Indexed: 06/12/2024] Open
Abstract
The coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has emerged as a global health crisis with significant neurological implications. While initially characterized by respiratory symptoms, COVID-19 has been increasingly recognized for its diverse neurological manifestations, including encephalopathy, stroke, peripheral neuropathies, and neuropsychiatric disorders. Understanding the neurological landscape of COVID-19 is essential for elucidating its pathophysiology, optimizing clinical management, and improving patient outcomes. This comprehensive review provides insights into the etiopathogenesis, clinical manifestations, diagnostic approaches, management strategies, and prognostic implications of neurological involvement in COVID-19. Mechanistic insights highlight the multifactorial nature of neurological complications involving direct viral invasion, immune-mediated mechanisms, and thrombotic events. Diagnostic challenges underscore the importance of a multidisciplinary approach to patient care, while management strategies emphasize early recognition and appropriate intervention. Long-term neurological sequelae and prognostic factors are also examined, emphasizing the need for comprehensive follow-up and rehabilitation services. Finally, recommendations for future research prioritize efforts to elucidate underlying mechanisms, identify biomarkers, and evaluate rehabilitative interventions. By addressing these challenges, we can better understand and mitigate the neurological consequences of the ongoing COVID-19 pandemic.
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Affiliation(s)
- Roma Chavhan
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institiute of Higher Education and Research, Wardha, IND
| | - Anil Wanjari
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institiute of Higher Education and Research, Wardha, IND
| | - Sunil Kumar
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institiute of Higher Education and Research, Wardha, IND
| | - Sourya Acharya
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institiute of Higher Education and Research, Wardha, IND
| | - Nishant Rathod
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institiute of Higher Education and Research, Wardha, IND
| | - Harshitha Reddy
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institiute of Higher Education and Research, Wardha, IND
| | - Rinkle Gemnani
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institiute of Higher Education and Research, Wardha, IND
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Nasser R, Abouelseoud Y, Mikhail M. Robust watermark based on Schur decomposition and dynamic weighting factors. THE VISUAL COMPUTER 2024; 40:3249-3269. [DOI: 10.1007/s00371-023-03028-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/06/2023] [Indexed: 01/05/2025]
Abstract
AbstractSince multimedia data are now more widely distributed in digital form and easier to copy and change, copyright protection has become an essential need. One of the most common copyright protection techniques is watermarking. Invisibility and robustness are crucial aspects of watermarking; however, many of the currently used techniques simply focus more on invisibility than how robust they are. Moreover, the trade-off between invisibility and robustness is challenging. To this end, this paper proposes a novel watermark technique that efficiently overcomes the idea of a trade-off between robustness and invisibility, thereby increasing both under most attacks. Schur decomposition and a dynamic weighting factors matrix are added to the embedding process to improve the robustness of the proposed technique. Besides that, the embedding function is improved to simultaneously maximize imperceptibility and robustness. Another key contribution of the proposed approach is its use of a trajectory-based optimization algorithm rather than the more prevalent population-based algorithms to determine the optimal scaling factors. Consequently, the proposed technique rapidly identifies the best scaling factors for the embedding function. Statistical analysis is performed using the Friedman test. Experimental results show that the proposed technique outperforms other existing techniques for different sizes, shapes, and types of watermarks.
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Seifi S, Nazari SE, Avan A, Khalili-tanha N, Babaei F, Soleimanpour S, Asgharzadeh F, Hajzadeh MAR, Khazaei M, Marjani A. The therapeutic potential of Wild Bitter Melon to ameliorate muscle atrophy in a murine model. AVICENNA JOURNAL OF PHYTOMEDICINE 2024; 14:388-401. [PMID: 39086863 PMCID: PMC11287028 DOI: 10.22038/ajp.2024.24011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 12/30/2023] [Indexed: 08/02/2024]
Abstract
Objective Muscle atrophy due to immobility is a common complication of many diseases and a consequence of therapeutic processes. Immobility and inactivity have been shown to be associated with increased inflammation. The aim of this study was to investigate the therapeutic potential of Wild Bitter Melon (WBM) (Momordica charantia Linn) on muscle atrophy due to immobility in a mouse model. Materials and Methods This study was performed in two phases of atrophy and recovery on male BALB/c mice which were divided into 3 groups: control, immobilized, and experimental. The treatment period with WBM at a dose of 400 mg/kg daily by gavage was 17 days, including 7 days of being immobilized and 10 days of recovery. At the end of each phase, half of the mice from each group were examined regarding the four limb grip strength, and then histological and biochemical analyses were done. Results The tissue level of malondialdehyde (MDA) oxidative stress index in the atrophy phase in the atrophy group (5.4567±0.522) nmol/g compared to the control group (3.455±0.065) nmol significantly (p 0.001) <) increased. Also, the tissue level of MDA in the WBM group (3.87±0.035) showed a significant decrease compared to the atrophy group (p<0.01). The strength percentage of four limbs in the mice of the treatment group (-23.46±2.45) was significantly higher than that of the atrophy group (-30.60±3.15) at the end of the atrophy phase. Conclusion The results suggest that the use of WBM reduces the degree of inflammation, oxidative stress and muscle damage, as well as muscle atrophy, which may improve the muscle atrophy in mice.
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Affiliation(s)
- Sima Seifi
- Metabolic Disorders Research Center, Department of Biochemistry and Biophysics, Golestan University of Medical Sciences Gorgan, Golestan, Iran
- Metabolic syndrome Research center, Mashhad University of Medical Sciences, Mashhad, Iran
- Equal first author
| | - Seyedeh Elnaz Nazari
- Metabolic syndrome Research center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Medical Physiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Equal first author
| | - Amir Avan
- Metabolic syndrome Research center, Mashhad University of Medical Sciences, Mashhad, Iran
- Basic Sciences Research Institute, Mashhad University of Medical Sciences, Mashhad, Iran
- Medical Genetics Research center, Mashhad University of Medical Sciences, Mashhad, Iran
- Equal first author
| | - Nima Khalili-tanha
- Metabolic syndrome Research center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Fatemeh Babaei
- Metabolic syndrome Research center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Saman Soleimanpour
- Metabolic syndrome Research center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Fereshteh Asgharzadeh
- Metabolic syndrome Research center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mousa-al-reza Hajzadeh
- Department of Medical Physiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Majid Khazaei
- Metabolic syndrome Research center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Medical Physiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Basic Sciences Research Institute, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Abdoljalal Marjani
- Metabolic Disorders Research Center, Department of Biochemistry and Biophysics, Golestan University of Medical Sciences Gorgan, Golestan, Iran
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Zeidan RS, Martenson M, Tamargo JA, McLaren C, Ezzati A, Lin Y, Yang JJ, Yoon HS, McElroy T, Collins JF, Leeuwenburgh C, Mankowski RT, Anton S. Iron homeostasis in older adults: balancing nutritional requirements and health risks. J Nutr Health Aging 2024; 28:100212. [PMID: 38489995 DOI: 10.1016/j.jnha.2024.100212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 03/05/2024] [Accepted: 03/06/2024] [Indexed: 03/17/2024]
Abstract
Iron plays a crucial role in many physiological processes, including oxygen transport, bioenergetics, and immune function. Iron is assimilated from food and also recycled from senescent red blood cells. Iron exists in two dietary forms: heme (animal based) and non-heme (mostly plant based). The body uses iron for metabolic purposes, and stores the excess mainly in splenic and hepatic macrophages. Physiologically, iron excretion in humans is inefficient and not highly regulated, so regulation of intestinal absorption maintains iron homeostasis. Iron losses occur at a steady rate via turnover of the intestinal epithelium, blood loss, and exfoliation of dead skin cells, but overall iron homeostasis is tightly controlled at cellular and systemic levels. Aging can have a profound impact on iron homeostasis and induce a dyshomeostasis where iron deficiency or overload (sometimes both simultaneously) can occur, potentially leading to several disorders and pathologies. To maintain physiologically balanced iron levels, reduce risk of disease, and promote healthy aging, it is advisable for older adults to follow recommended daily intake guidelines and periodically assess iron levels. Clinicians can evaluate body iron status using different techniques but selecting an assessment method primarily depends on the condition being examined. This review provides a comprehensive overview of the forms, sources, and metabolism of dietary iron, associated disorders of iron dyshomeostasis, assessment of iron levels in older adults, and nutritional guidelines and strategies to maintain iron balance in older adults.
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Affiliation(s)
- Rola S Zeidan
- Department of Physiology and Aging, College of Medicine, University of Florida, Gainesville, FL, USA; Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Matthew Martenson
- Department of Physiology and Aging, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Javier A Tamargo
- Department of Physiology and Aging, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Christian McLaren
- Department of Clinical and Health Psychology, College of Health and Health Professions, University of Florida, Gainesville, Florida, USA
| | - Armin Ezzati
- Department of Physiology and Aging, College of Medicine, University of Florida, Gainesville, FL, USA; Department of Food, Nutrition, Dietetics and Health, Kansas State University, Manhattan, KS, USA
| | - Yi Lin
- Department of Physiology and Aging, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Jae Jeong Yang
- UF Health Cancer Center, Gainesville, FL, USA; Department of Surgery, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Hyung-Suk Yoon
- UF Health Cancer Center, Gainesville, FL, USA; Department of Surgery, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Taylor McElroy
- Department of Physiology and Aging, College of Medicine, University of Florida, Gainesville, FL, USA; Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - James F Collins
- Department of Food Science & Human Nutrition, Institute of Food and Agricultural Sciences, University of Florida, Gainesville, FL, USA
| | - Christiaan Leeuwenburgh
- Department of Physiology and Aging, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Robert T Mankowski
- Department of Physiology and Aging, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Stephen Anton
- Department of Physiology and Aging, College of Medicine, University of Florida, Gainesville, FL, USA; Department of Clinical and Health Psychology, College of Health and Health Professions, University of Florida, Gainesville, Florida, USA.
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146
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Xia B, He Q, Smith FG, Gkoutos VG, Nirantharakumar K, Kuo ZC, Wang D, Feng Q, Cheung EC, Dai L, Huang J, Yu Y, Meng W, Qin X, Yuan J. Individualized prevention of proton pump inhibitor related adverse events by risk stratification. Nat Commun 2024; 15:3591. [PMID: 38678022 PMCID: PMC11055952 DOI: 10.1038/s41467-024-48007-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 04/17/2024] [Indexed: 04/29/2024] Open
Abstract
Proton pump inhibitors (PPIs) are commonly used for gastric acid-related disorders, but their safety profile and risk stratification for high-burden diseases need further investigation. Analyzing over 2 million participants from five prospective cohorts from the US, the UK, and China, we found that PPI use correlated with increased risk of 15 leading global diseases, such as ischemic heart disease, diabetes, respiratory infections, and chronic kidney disease. These associations showed dose-response relationships and consistency across different PPI types. PPI-related absolute risks increased with baseline risks, with approximately 82% of cases occurring in those at the upper 40% of the baseline predicted risk, and only 11.5% of cases occurring in individuals at the lower 50% of the baseline risk. While statistical association does not necessarily imply causation, its potential safety concerns suggest that personalized use of PPIs through risk stratification might guide appropriate decision-making for patients, clinicians, and the public.
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Affiliation(s)
- Bin Xia
- Department of Epidemiology and Biostatistics, Clinical Big Data Research Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China
- Chinese Health RIsk MAnagement Collaboration (CHRIMAC), Shenzhen, Guangdong, China
| | - Qiangsheng He
- Department of Epidemiology and Biostatistics, Clinical Big Data Research Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China
- Chinese Health RIsk MAnagement Collaboration (CHRIMAC), Shenzhen, Guangdong, China
| | - Fang Gao Smith
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - V Georgios Gkoutos
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
- College of Medical and Dental Sciences, Centre for Health Data Science, University of Birmingham, Edgbaston, Birmingham, UK
| | - Krishnarajah Nirantharakumar
- College of Medical and Dental Sciences, Centre for Health Data Science, University of Birmingham, Edgbaston, Birmingham, UK
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Zi Chong Kuo
- Guangdong Provincial Key Laboratory of Gastroenterology, Center for Digestive Disease, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China
| | - Danni Wang
- Department of Epidemiology and Biostatistics, Clinical Big Data Research Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China
- Chinese Health RIsk MAnagement Collaboration (CHRIMAC), Shenzhen, Guangdong, China
| | - Qi Feng
- Oxford Population Health, University of Oxford, Oxford, Oxfordshire, UK
| | - Eddie C Cheung
- Guangdong Provincial Key Laboratory of Gastroenterology, Center for Digestive Disease, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China
- Division of Gastroenterology, Davis School of Medicine, University of California, Oakland, CA, USA
| | - Lunzhi Dai
- National Clinical Research Center for Geriatrics and Department of General Practice, West China Hospital, Sichuan University, Chengdu, China
| | - Junjie Huang
- J.C. School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, Hong Kong, China
| | - Yuanyuan Yu
- Department of Surgery, The Chinese University of Hong Kong, Sha Tin, Hong Kong, China
| | - Wenbo Meng
- Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou, Gansu, China.
| | - Xiwen Qin
- School of Population and Global Health, Faculty of Medicine, Density and Health Sciences, University of Western Australia, Perth, AU-WA, Australia.
- Laboratory of Data Discovery for Health (D24H), Hong Kong Science Technology Park, Sha Tin, Hong Kong, China.
| | - Jinqiu Yuan
- Department of Epidemiology and Biostatistics, Clinical Big Data Research Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China.
- Chinese Health RIsk MAnagement Collaboration (CHRIMAC), Shenzhen, Guangdong, China.
- Guangdong Provincial Key Laboratory of Gastroenterology, Center for Digestive Disease, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China.
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Chen WJ, Kung WM, Lin MS. Editorial: The legacy of Dr. Rita Levi-Montalcini: advances in neurotrophic factors in brain disease development and treatment. Front Mol Neurosci 2024; 17:1387026. [PMID: 38736481 PMCID: PMC11084665 DOI: 10.3389/fnmol.2024.1387026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Accepted: 04/09/2024] [Indexed: 05/14/2024] Open
Affiliation(s)
- Wei-Jung Chen
- Department of Biotechnology and Animal Science, College of Bioresources, National Ilan University, Yilan, Taiwan
| | - Woon-Man Kung
- Division of Neurosurgery, Department of Surgery, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
- Department of Exercise and Health Promotion, College of Kinesiology and Health, Chinese Culture University, Taipei, Taiwan
| | - Muh-Shi Lin
- Department of Biotechnology and Animal Science, College of Bioresources, National Ilan University, Yilan, Taiwan
- Department of Health Business Administration, College of Medical and Health Care, Hung Kuang University, Taichung, Taiwan
- Division of Neurosurgery, Department of Surgery, Kuang Tien General Hospital, Taichung, Taiwan
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Pozdnyakov DI, Kozlova VV, Reps VF. Serum markers of neuroinflammation and oxidative stress in modeling spinal injury of various genesis. SECHENOV MEDICAL JOURNAL 2024; 15:36-46. [DOI: 10.47093/2218-7332.2024.15.1.36-46] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2025]
Abstract
Aim. To evaluate changes in the concentration of molecules that mark the neurodegenerative process, experimental spinal cord injuries (SCI) of various origins were studied.Materials and methods. SCI was modeled in six-month-old male Wistar rats by exposing the T10 vertebra to: carbon dioxide under a pressure of 2 N/cm2 (pneumocontusion); free-falling load of three weights of 1.12 N/cm2, 1.68 N/cm2, 1.96 N/cm2 (contusion injury); compression with forceps (compression injury); partial hemisection of the spinal cord; mechanical laminectomy using a mechanical drill. There were 6 rats in each group, including the intact control group. On the 28th day after a single application of SCI in rats, the concentrations of tumor necrosis factor-alpha (TNF-α), interleukin 6 (IL-6), albumin, thiobarbituric acid reactive substances (TBA-RS) and superoxide dismutase activity were assessed in the blood serum.Results. When modeling SCI of various origins in rats, the serum concentration of TNF-α increased (from 115.5% (p < 0.05) in mild contusion to 234.5% (p < 0.05) in compression trauma compared to intact control) as well as IL-6 (from 49.2% (p < 0.05) in mechanical laminectomy to 89.8% (p < 0.05) in hemisection compared with intact control), suggesting activation of inflammatory reactions. The concentration of albumin in the blood serum of rats with SCI was lower than that of intact animals, especially in the hemisection group – by 41.9% (p < 0.05). Animals with SCI had an increase in TBA-RS concentration ranging from 103.2% (p < 0.05) in mild contusion and compression to 135.5% (p < 0.05) in pneumocontusion, and a decrease in superoxide dismutase activity ranging from 26.3% (p < 0.05) in laminectomy to 31.7% (p < 0.05) in hemisection. At the same time, injuries caused by spinal compression and hemisection led to a more pronounced activation of the inflammatory process, as evidenced by the increased TNF-α content compared to other variants of SCI modeling.Conclusion. All SCI simulations resulted in equivalent activation of oxidative stress, while inflammation is more pronounced when reproducing compression injury and injury caused by spinal hemisection.
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Affiliation(s)
- D. I. Pozdnyakov
- Pyatigorsk Medical and Pharmaceutical Institute; Pyatigorsk State Research Institute of Balneology, branch of the Federal Scientifi c and Clinical Center of Medical Rehabilitation and Balneology of the Federal Medical and Biological Agency of Russia
| | - V. V. Kozlova
- Pyatigorsk Medical and Pharmaceutical Institute; Pyatigorsk State Research Institute of Balneology, branch of the Federal Scientifi c and Clinical Center of Medical Rehabilitation and Balneology of the Federal Medical and Biological Agency of Russia
| | - V. F. Reps
- Pyatigorsk Medical and Pharmaceutical Institute; Pyatigorsk State Research Institute of Balneology, branch of the Federal Scientifi c and Clinical Center of Medical Rehabilitation and Balneology of the Federal Medical and Biological Agency of Russia
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Doskas T, Vadikolias K, Ntoskas K, Vavougios GD, Tsiptsios D, Stamati P, Liampas I, Siokas V, Messinis L, Nasios G, Dardiotis E. Neurocognitive Impairment and Social Cognition in Parkinson's Disease Patients. Neurol Int 2024; 16:432-449. [PMID: 38668129 PMCID: PMC11054167 DOI: 10.3390/neurolint16020032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 04/06/2024] [Accepted: 04/11/2024] [Indexed: 04/29/2024] Open
Abstract
In addition to motor symptoms, neurocognitive impairment (NCI) affects patients with prodromal Parkinson's disease (PD). NCI in PD ranges from subjective cognitive complaints to dementia. The purpose of this review is to present the available evidence of NCI in PD and highlight the heterogeneity of NCI phenotypes as well as the range of factors that contribute to NCI onset and progression. A review of publications related to NCI in PD up to March 2023 was performed using PubMed/Medline. There is an interconnection between the neurocognitive and motor symptoms of the disease, suggesting a common underlying pathophysiology as well as an interconnection between NCI and non-motor symptoms, such as mood disorders, which may contribute to confounding NCI. Motor and non-motor symptom evaluation could be used prognostically for NCI onset and progression in combination with imaging, laboratory, and genetic data. Additionally, the implications of NCI on the social cognition of afflicted patients warrant its prompt management. The etiology of NCI onset and its progression in PD is multifactorial and its effects are equally grave as the motor effects. This review highlights the importance of the prompt identification of subjective cognitive complaints in PD patients and NCI management.
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Affiliation(s)
- Triantafyllos Doskas
- Department of Neurology, Athens Naval Hospital, 11521 Athens, Greece;
- Department of Neurology, General University Hospital of Alexandroupoli, 68100 Alexandroupoli, Greece; (K.V.); (D.T.)
| | - Konstantinos Vadikolias
- Department of Neurology, General University Hospital of Alexandroupoli, 68100 Alexandroupoli, Greece; (K.V.); (D.T.)
| | | | - George D. Vavougios
- Department of Neurology, Athens Naval Hospital, 11521 Athens, Greece;
- Department of Neurology, Faculty of Medicine, University of Cyprus, 1678 Lefkosia, Cyprus
- Department of Respiratory Medicine, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41500 Larissa, Greece
| | - Dimitrios Tsiptsios
- Department of Neurology, General University Hospital of Alexandroupoli, 68100 Alexandroupoli, Greece; (K.V.); (D.T.)
| | - Polyxeni Stamati
- Department of Neurology, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41110 Larissa, Greece; (P.S.); (I.L.); (V.S.); (E.D.)
| | - Ioannis Liampas
- Department of Neurology, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41110 Larissa, Greece; (P.S.); (I.L.); (V.S.); (E.D.)
| | - Vasileios Siokas
- Department of Neurology, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41110 Larissa, Greece; (P.S.); (I.L.); (V.S.); (E.D.)
| | - Lambros Messinis
- School of Psychology, Laboratory of Neuropsychology and Behavioural Neuroscience, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| | - Grigorios Nasios
- Department of Speech and Language Therapy, School of Health Sciences, University of Ioannina, 45500 Ioannina, Greece;
| | - Efthimios Dardiotis
- Department of Neurology, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41110 Larissa, Greece; (P.S.); (I.L.); (V.S.); (E.D.)
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Wu M, Islam MM, Poly TN, Lin MC. Application of AI in Sepsis: Citation Network Analysis and Evidence Synthesis. Interact J Med Res 2024; 13:e54490. [PMID: 38621231 PMCID: PMC11058558 DOI: 10.2196/54490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 01/27/2024] [Accepted: 03/04/2024] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND Artificial intelligence (AI) has garnered considerable attention in the context of sepsis research, particularly in personalized diagnosis and treatment. Conducting a bibliometric analysis of existing publications can offer a broad overview of the field and identify current research trends and future research directions. OBJECTIVE The objective of this study is to leverage bibliometric data to provide a comprehensive overview of the application of AI in sepsis. METHODS We conducted a search in the Web of Science Core Collection database to identify relevant articles published in English until August 31, 2023. A predefined search strategy was used, evaluating titles, abstracts, and full texts as needed. We used the Bibliometrix and VOSviewer tools to visualize networks showcasing the co-occurrence of authors, research institutions, countries, citations, and keywords. RESULTS A total of 259 relevant articles published between 2014 and 2023 (until August) were identified. Over the past decade, the annual publication count has consistently risen. Leading journals in this domain include Critical Care Medicine (17/259, 6.6%), Frontiers in Medicine (17/259, 6.6%), and Scientific Reports (11/259, 4.2%). The United States (103/259, 39.8%), China (83/259, 32%), United Kingdom (14/259, 5.4%), and Taiwan (12/259, 4.6%) emerged as the most prolific countries in terms of publications. Notable institutions in this field include the University of California System, Emory University, and Harvard University. The key researchers working in this area include Ritankar Das, Chris Barton, and Rishikesan Kamaleswaran. Although the initial period witnessed a relatively low number of articles focused on AI applications for sepsis, there has been a significant surge in research within this area in recent years (2014-2023). CONCLUSIONS This comprehensive analysis provides valuable insights into AI-related research conducted in the field of sepsis, aiding health care policy makers and researchers in understanding the potential of AI and formulating effective research plans. Such analysis serves as a valuable resource for determining the advantages, sustainability, scope, and potential impact of AI models in sepsis.
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Affiliation(s)
- MeiJung Wu
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
- Department of Nursing, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Md Mohaimenul Islam
- Department of Outcomes and Translational Sciences, College of Pharmacy, The Ohio State University, Columbus, OH, United States
| | - Tahmina Nasrin Poly
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
| | - Ming-Chin Lin
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
- Taipei Neuroscience Institute, Taipei Medical University, Taipei, Taiwan
- Department of Neurosurgery, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
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