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Becerra-Bolaños Á, Ramos-Ahumada DF, Herrera-Rodríguez L, Valencia-Sola L, Ojeda-Betancor N, Rodríguez-Pérez A. Withdrawal/Withholding of Life-Sustaining Therapies: Limitation of Therapeutic Effort in the Intensive Care Unit. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:1461. [PMID: 39336502 PMCID: PMC11434306 DOI: 10.3390/medicina60091461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2024] [Revised: 08/29/2024] [Accepted: 09/02/2024] [Indexed: 09/30/2024]
Abstract
Background/Objectives: The change in critically ill patients makes limitation of therapeutic effort (LTE) a widespread practice when therapeutic goals cannot be achieved. We aimed to describe the application of LTE in a post-surgical Intensive Care Unit (ICU), analyze the measures used, the characteristics of the patients, and their evolution. Methods: Retrospective observational study, including all patients to whom LTE was applied in a postsurgical ICU between January 2021 and December 2022. The LTE defined were brain death, withdrawal of measures, and withholding. Withholding limitations included orders for no cardiopulmonary resuscitation, no orotracheal intubation, no reintubation, no tracheostomy, no renal replacement therapies, and no vasoactive support. Patient and ICU admission data were related to the applied LTE. Results: Of the 2056 admitted, LTE protocols were applied to 106 patients. The prevalence of LTE in the ICU was 5.1%. Data were analyzed in 80 patients. A total of 91.2% of patients had been admitted in an emergency situation, and 56.2% had been admitted after surgery. The most widespread limitation was treatment withholding (83.8%) compared to withdrawal (13.8%). No differences were found regarding who made the decision and the type of limitation employed. However, patients with the limitation of no intubation had a longer stay (p = 0.025). Additionally, the order of not starting or increasing vasopressor support resulted in a longer hospital stay (p = 0.007) and a significantly longer stay until death (p = 0.044). Conclusions: LTE is a frequent measure in critically ill patient management and is less common in the postoperative setting. The most widespread measure was withholding, with the do-not-resuscitate order being the most common. The decision was made mainly by the medical team and the family, respecting the wishes of the patients. A joint patient-centered approach should be made in these decisions to avoid futile treatment and ensure end-of-life comfort.
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Affiliation(s)
- Ángel Becerra-Bolaños
- Department of Anesthesiology, Intensive Care and Pain Medicine, Hospital Universitario de Gran Canaria Doctor Negrín, 35010 Las Palmas de Gran Canaria, Spain; (L.H.-R.); (L.V.-S.); (N.O.-B.); (A.R.-P.)
- Department of Medical and Surgical Sciences, Universidad de Las Palmas de Gran Canaria, 35001 Las Palmas de Gran Canaria, Spain;
| | - Daniela F. Ramos-Ahumada
- Department of Medical and Surgical Sciences, Universidad de Las Palmas de Gran Canaria, 35001 Las Palmas de Gran Canaria, Spain;
| | - Lorena Herrera-Rodríguez
- Department of Anesthesiology, Intensive Care and Pain Medicine, Hospital Universitario de Gran Canaria Doctor Negrín, 35010 Las Palmas de Gran Canaria, Spain; (L.H.-R.); (L.V.-S.); (N.O.-B.); (A.R.-P.)
| | - Lucía Valencia-Sola
- Department of Anesthesiology, Intensive Care and Pain Medicine, Hospital Universitario de Gran Canaria Doctor Negrín, 35010 Las Palmas de Gran Canaria, Spain; (L.H.-R.); (L.V.-S.); (N.O.-B.); (A.R.-P.)
| | - Nazario Ojeda-Betancor
- Department of Anesthesiology, Intensive Care and Pain Medicine, Hospital Universitario de Gran Canaria Doctor Negrín, 35010 Las Palmas de Gran Canaria, Spain; (L.H.-R.); (L.V.-S.); (N.O.-B.); (A.R.-P.)
| | - Aurelio Rodríguez-Pérez
- Department of Anesthesiology, Intensive Care and Pain Medicine, Hospital Universitario de Gran Canaria Doctor Negrín, 35010 Las Palmas de Gran Canaria, Spain; (L.H.-R.); (L.V.-S.); (N.O.-B.); (A.R.-P.)
- Department of Medical and Surgical Sciences, Universidad de Las Palmas de Gran Canaria, 35001 Las Palmas de Gran Canaria, Spain;
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da Cunha JA, Marques Dos Santos M, Costa de Lima K. Acquired syphilis in older people in Brazil from 2010-2020. PLoS One 2024; 19:e0296481. [PMID: 39240879 PMCID: PMC11379233 DOI: 10.1371/journal.pone.0296481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 12/14/2023] [Indexed: 09/08/2024] Open
Abstract
BACKGROUND The infection caused by Treponema pallidum remains a severe public health problem, with a high prevalence in individuals over 60 years. However, research into infections such as syphilis continues to be neglected in geriatrics. This study aims to evaluate data on the detection rate of syphilis in Brazil, in individuals between 60 and 120 years, by characterizing the epidemiological profile and respective factors associated with it, in addition to performing a temporal trend analysis, from 2010 to 2020. METHODOLOGY Ecological, time-series study, which started with the collection of notifications from the database of the Information System on Compulsory Notification of Diseases. The epidemiological profile was characterized based on sociodemographic variables. The Statistical Package for the Social Sciences program, version 19.0, was used for incidence and prevalence analysis. The 2010 census by the Brazilian Institute of Geography and Statistics and projections for older people were considered. In the trend analysis, the Joinpoint regression model was used. MAIN FINDINGS There was an upward variation in the detection of syphilis in older people from 2010 to 2018, with a peak in 2018. In 2019, there was a slight reduction in the notification of cases, which was accentuated in 2020. The prevalence of the infection was equivalent to 12.84 cases for each 100,000 Brazilians, with a mean age of 68.04 years (±7.15) for those between 60 and 120 years, being higher in white and black males. The highest proportion of older people with syphilis occurred in the South and Southeast regions. However, the trend analysis showed a significant and homogeneous increase in all regions of Brazil, for both sexes and all age groups. CONCLUSIONS There is a tendency for an increase in cases of syphilis in older people, which reinforces the need to plan health actions to combat the disease in this population.
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Affiliation(s)
- Josiane Araújo da Cunha
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
- Laboratory of Technological Innovation in Health, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Marquiony Marques Dos Santos
- Laboratory of Technological Innovation in Health, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Kenio Costa de Lima
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
- Graduate Program in Collective Health, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
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Gryguc A, Maciulaitis J, Mickevicius L, Laurinavicius A, Sutkeviciene N, Grigaleviciute R, Zigmantaite V, Maciulaitis R, Bumblyte IA. Prevention of Transition from Acute Kidney Injury to Chronic Kidney Disease Using Clinical-Grade Perinatal Stem Cells in Non-Clinical Study. Int J Mol Sci 2024; 25:9647. [PMID: 39273595 PMCID: PMC11394957 DOI: 10.3390/ijms25179647] [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: 06/24/2024] [Revised: 07/30/2024] [Accepted: 09/02/2024] [Indexed: 09/15/2024] Open
Abstract
Acute kidney injury (AKI) is widely recognized as a precursor to the onset or rapid progression of chronic kidney disease (CKD). However, there is currently no effective treatment available for AKI, underscoring the urgent need for the development of new strategies to improve kidney function. Human placental mesenchymal stromal cells (hpMSCs) were isolated from donor placentas, cultured, and characterized with regard to yield, viability, flow cytometry, and potency. To mimic AKI and its progression to CKD in a rat model, a dedicated sensitive non-clinical bilateral kidney ischemia-reperfusion injury (IRI) model was utilized. The experimental group received 3 × 105 hpMSCs into each kidney, while the control group received IRI and saline and the untreated group received IRI only. Urine, serum, and kidney tissue samples were collected over a period of 28 days. The hpMSCs exhibited consistent yields, viability, and expression of mesenchymal lineage markers, and were also shown to suppress T cell proliferation in a dose-dependent manner. To ensure optimal donor selection, manufacturing optimization, and rigorous quality control, the rigorous Good Manufacturing Practice (GMP) conditions were utilized. The results indicated that hpMSCs increased rat survival rates and improved kidney function by decreasing serum creatinine, urea, potassium, and fractionated potassium levels. Furthermore, the study demonstrated that hpMSCs can prevent the initial stages of kidney structural fibrosis and improve kidney function in the early stages by mitigating late interstitial fibrosis and tubular atrophy. Additionally, a robust manufacturing process with consistent technical parameters was established.
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Affiliation(s)
- Agne Gryguc
- Department of Nephrology, Medical Academy, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania
- Hospital of Lithuanian University of Health Science, 50161 Kaunas, Lithuania
| | - Justinas Maciulaitis
- Institute of Cardiology, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania
- Institute of Physiology and Pharmacology, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania
| | - Lukas Mickevicius
- Department of Urology, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania
| | - Arvydas Laurinavicius
- National Center of Pathology, Affiliate of Vilnius University Hospital Santaros Klinikos, 08661 Vilnius, Lithuania
| | - Neringa Sutkeviciene
- Large Animal Clinic, Veterinary Academy, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania
| | - Ramune Grigaleviciute
- Biological Research Center, Veterinary Academy, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania
| | - Vilma Zigmantaite
- Biological Research Center, Veterinary Academy, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania
| | - Romaldas Maciulaitis
- Department of Nephrology, Medical Academy, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania
- Institute of Physiology and Pharmacology, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania
- Faculty of Medicine, Medical Academy, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania
| | - Inga Arune Bumblyte
- Department of Nephrology, Medical Academy, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania
- Hospital of Lithuanian University of Health Science, 50161 Kaunas, Lithuania
- Faculty of Medicine, Medical Academy, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania
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Shen Z, Liu Z, Shen C, Mo Z, Chen Y, Guo Y, Wu F, Gao J. Long-term outcome of robotic-guided closed reduction internal fixation for Delbet II femoral neck fractures in children. J Orthop Surg Res 2024; 19:543. [PMID: 39237987 PMCID: PMC11378569 DOI: 10.1186/s13018-024-05035-w] [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: 07/28/2024] [Accepted: 08/27/2024] [Indexed: 09/07/2024] Open
Abstract
OBJECTIVE To retrospectively analyze and assess the long-term effectiveness of robotic navigation and traditional closed reduction internal fixation in the treatment of Delbet type II femoral neck fracture in children. METHODS A total of fifty-five patients diagnosed with pediatric Delbet type II femoral neck fracture, who were admitted to Foshan Hospital of Traditional Chinese Medicine between January 2018 and June 2022, were included in this study. Among them, 22 cases of nailing under robotic navigation were set as the observation group, and 33 cases of nailing under fluoroscopy of the C-arm machine were set as the control group. All patients had their femoral neck fractures closed and repositioned first. After confirming the satisfactory fracture repositioning under the fluoroscopic view of the C-arm machine, internal fixation was performed by inserting hollow compression screws in the corresponding surgical way.A comparative analysis was conducted between the two groups to assess the disparity in the amount of X-ray exposure during surgery, the number of guide pins inserted, and the duration of the surgical procedure. The quality of comparative fracture reduction was assessed according to the Haidukewych criteria on the first postoperative hip X-ray, and the parallelism and distribution of the comparative screws were measured. The incidence of hip function and postoperative complications according to the Ratliff criteria were evaluated between each of the subgroups at the final follow-up. RESULTS Comparison of general information, operation duration, and quality of fracture reduction between the two groups failed to reveal statistically significant results (P > 0.05). The observation group had a lower number of X-ray exposures and guide pin placements compared to the control group, and this difference was statistically significant (P < 0.05).At the last follow-up, the observation group exhibited superior screw parallelism and distribution, as well as hip joint function, compared to the control group, and this difference was statistically significant (P < 0.05). The incidence of complications in the observation group was lower than that in the control group; however, the difference was not statistically significant (P > 0.05). CONCLUSION Closed reduction and internal fixation under orthopedic robot navigation can achieve better long-term efficacy in treating Delbet type II femoral neck fracture in children.
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Affiliation(s)
- Zhaoxiong Shen
- The Eighth Clinical Medical College, Guangzhou University of Chinese Medicine, 6 QinRen Road, ZuMiao Street, Foshan, 528000, Guangdong, China
- Department of Orthopedics, Foshan Hospital of Traditional Chinese Medicine, 6 QinRen Road, ZuMiao Street, Foshan, 528000, Guangdong, China
| | - Zhenjiang Liu
- The Eighth Clinical Medical College, Guangzhou University of Chinese Medicine, 6 QinRen Road, ZuMiao Street, Foshan, 528000, Guangdong, China
- Department of Orthopedics, Foshan Hospital of Traditional Chinese Medicine, 6 QinRen Road, ZuMiao Street, Foshan, 528000, Guangdong, China
| | - Chulong Shen
- Department of Orthopedics, Foshan Hospital of Traditional Chinese Medicine, 6 QinRen Road, ZuMiao Street, Foshan, 528000, Guangdong, China
| | - Zhihong Mo
- The Eighth Clinical Medical College, Guangzhou University of Chinese Medicine, 6 QinRen Road, ZuMiao Street, Foshan, 528000, Guangdong, China
| | - Yongge Chen
- Department of Orthopedics, Foshan Hospital of Traditional Chinese Medicine, 6 QinRen Road, ZuMiao Street, Foshan, 528000, Guangdong, China
| | - Yueming Guo
- Department of Orthopedics, Foshan Hospital of Traditional Chinese Medicine, 6 QinRen Road, ZuMiao Street, Foshan, 528000, Guangdong, China
| | - Feng Wu
- Department of Orthopedics, Foshan Hospital of Traditional Chinese Medicine, 6 QinRen Road, ZuMiao Street, Foshan, 528000, Guangdong, China
| | - Junqing Gao
- Department of Orthopedics, Foshan Hospital of Traditional Chinese Medicine, 6 QinRen Road, ZuMiao Street, Foshan, 528000, Guangdong, China.
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Stopar Pintarič T, Pavlica M, Druškovič M, Kavšek G, Verdenik I, Pečlin P. Relationship between labour analgesia modalities and types of anaesthetic techniques in categories 2 and 3 intrapartum caesarean deliveries. BIOMOLECULES & BIOMEDICINE 2024; 24:1301-1309. [PMID: 38488674 PMCID: PMC11378996 DOI: 10.17305/bb.2024.10186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 03/04/2024] [Accepted: 03/04/2024] [Indexed: 04/20/2024]
Abstract
General anesthesia (GA) is typically recommended for category 1 emergency cesarean delivery (CD). For categories 2-4 emergencies, either regional or GA can be used. The factors influencing the choice of anesthetic technique in these categories remain poorly understood. We analyzed the association between the type of labor analgesia and subsequent anesthetic techniques employed for intrapartum categories 2 and 3 CD. In a prospective longitudinal cohort study, 300 women were consequently enrolled and categorized according to Lucas's classification of CD urgency. The techniques of anesthesia (GA, spinal, and epidural anesthesia [EA]) employed for CD were analyzed with respect to labor analgesia methods (remifentanil patient-controlled analgesia [remifentanil-PCA], EA, and nitrous oxide [N2O]). EA was the most frequent analgesic option (43.8%), followed by remifentanil-PCA (20.7%) and N2O (5.1%), while 30.4% of parturient women received no analgesia. All anesthetic methods showed a significant relationship with analgesic modalities (P < 0.001). Remifentanil-PCA was associated with a higher incidence of GA. Contraindication to EA was the primary factor related to the transition from remifentanil-PCA to GA. Most parturients who received EA were successfully converted to EA. Spinal anesthesia was the most common technique in women using N2O and those without labor analgesia. GA was associated with lower 5-min Apgar scores. The method of labor analgesia was associated with the anesthesia technique employed for categories 2 and 3 CD. This finding may guide patient counseling and intrapartum anesthetic planning. However, the analysis should be cautiously interpreted as the selection of anesthesia is a complex decision influenced by several clinical considerations.
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Affiliation(s)
- Tatjana Stopar Pintarič
- Department of Anaesthesiology and Intensive Therapy, University Medical Centre Ljubljana, Ljubljana, Slovenia; Institute of Anatomy, Medical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Maja Pavlica
- Department of Perinatology, Division of Obstetrics and Gynaecology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Mirjam Druškovič
- Department of Perinatology, Division of Obstetrics and Gynaecology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Gorazd Kavšek
- Department of Perinatology, Division of Obstetrics and Gynaecology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Ivan Verdenik
- Department of Perinatology, Division of Obstetrics and Gynaecology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Polona Pečlin
- Department of Perinatology, Division of Obstetrics and Gynaecology, University Medical Centre Ljubljana, Ljubljana, Slovenia
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Katiyarangsan W, Charoenphun P, Chuamsaamarkkee K, Musikarat S, Kiranantawat K, Sakulpisuti C, Thamnirat K, Kositwattanarerk A, Sritara C, Chamroonrat W. Characterizing Normal Upper Extremity Lymphatic Flow with 99mTc In-House Dextran: A Retrospective Study. Diagnostics (Basel) 2024; 14:1960. [PMID: 39272744 PMCID: PMC11393990 DOI: 10.3390/diagnostics14171960] [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: 07/27/2024] [Revised: 08/14/2024] [Accepted: 08/23/2024] [Indexed: 09/15/2024] Open
Abstract
Lymphoscintigraphy evaluates the lymphatic system using radiocolloid compounds like 99mTc-sulfur colloid and 99mTc-nanocolloid, which vary in particle size and distribution timing. A local in-house Dextran kit (15-40 nm) was developed in 2005 and began clinical use in 2008 to localize sentinel lymph nodes; diagnose lymphedema; and detect lymphatic leakage. The normal drainage pattern remains unexplored. We retrospectively analyzed 84 upper extremity lymphoscintigraphies from 2008 to 2021. 99mTc in-house Dextran was intradermally injected into both hands, followed by whole-body imaging at specified intervals (≤15 min; 16-30 min; 31-45 min; 46-60 min), with some receiving delayed imaging. Visual and quantitative analyses recorded axillary and forearm lymph nodes and liver, kidney, and urinary bladder activity. Results showed 92% (77/84) upper extremity lymphatic tract visualization within 45 min. Axillary node detection rates increased from 46% (≤15 min) to 86% (46-60 min). Delayed imaging further revealed nodes. Epitrochlear or brachial node visualization was rare (4%, 3/84). Hepatic, renal, and urinary bladder activity was noted in 54%, 71%, and 93% at 1 h, respectively. The axillary node uptake ratio was minimal (<2.5% of injection site activity; median 0.33%). This study characterizes normal upper extremity lymphatic drainage using 99mTc in-house Dextran, offering insights into its clinical application.
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Affiliation(s)
- Wiroj Katiyarangsan
- Division of Nuclear Medicine, Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
- Division of Nuclear Medicine, Department of Radiology, Maha Vajiralongkorn Thanyaburi Hospital, Pathum Thani 12110, Thailand
| | - Putthiporn Charoenphun
- Division of Nuclear Medicine, Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
- Master of Science Program in Medical Physics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
| | - Krisanat Chuamsaamarkkee
- Division of Nuclear Medicine, Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
- Master of Science Program in Medical Physics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
| | - Suchawadee Musikarat
- Division of Nuclear Medicine, Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
| | - Kidakorn Kiranantawat
- Division of Plastic and Maxillofacial Surgery, Department Surgery, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
| | - Chaninart Sakulpisuti
- Division of Nuclear Medicine, Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
| | - Kanungnij Thamnirat
- Division of Nuclear Medicine, Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
| | - Arpakorn Kositwattanarerk
- Division of Nuclear Medicine, Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
| | - Chanika Sritara
- Division of Nuclear Medicine, Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
| | - Wichana Chamroonrat
- Division of Nuclear Medicine, Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
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Soleimanian M, Bijani M, Nikrouz L, Naghizadeh MM, Ranjbar K, Heidari G. A timeliness analysis of emergency services and cardiovascular outcomes in cardiac patients referred through prehospital emergency services between 2020 and 2023: a cross-sectional study in Iran. BMC Res Notes 2024; 17:250. [PMID: 39237991 PMCID: PMC11378617 DOI: 10.1186/s13104-024-06922-5] [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: 03/29/2024] [Accepted: 08/28/2024] [Indexed: 09/07/2024] Open
Abstract
OBJECTIVE Effective time management is crucial for the survival of all patients, particularly those with cardiovascular conditions. This is especially true in the context of pre-hospital emergency services, where prompt intervention can significantly impact outcomes. This study delves into the timeliness of emergency services and the subsequent outcomes for hospitalized cardiovascular patients in EMS center in Fasa University of Medical Sciences, southern Iran. RESULTS A total of 4972 emergency calls related to cardiac diagnoses were received between 2020 and 2023. The transport time was significantly correlated with age, location of the mission, and type of mission. Of the total, 86 underwent angioplasty within the standard time of less than 90 min, of which 81 were discharged and 5 died. 51 patients underwent angioplasty after more than 90 min, of which 47 were discharged and 4 died. In addition, 124 of these patients experienced cardiopulmonary resuscitation, of which 63 were successful and 61 were unsuccessful.
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Affiliation(s)
- Mohammad Soleimanian
- Student Research Committee, School of Nursing, Fasa University of Medical Sciences, Fasa, Iran
| | - Mostafa Bijani
- Department of Medical Surgical Nursing, School of Nursing, Fasa University of Medical Sciences, Fasa, Iran.
| | - Leila Nikrouz
- Department of Medical Surgical Nursing, School of Nursing, Fasa University of Medical Sciences, Fasa, Iran.
| | | | - Kamran Ranjbar
- Department of Medical Surgical Nursing, School of Nursing, Fasa University of Medical Sciences, Fasa, Iran
| | - Gholamali Heidari
- Department of Medical Surgical Nursing, School of Nursing, Fasa University of Medical Sciences, Fasa, Iran
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108
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Asenova A, Hristova H, Ivanova S, Miteva V, Zhivkova I, Stefanova K, Moncheva P, Nedeva T, Urshev Z, Marinova-Yordanova V, Georgieva T, Tzenova M, Russinova M, Borisova T, Donchev D, Hristova P, Rasheva I. Identification and Characterization of Human Breast Milk and Infant Fecal Cultivable Lactobacilli Isolated in Bulgaria: A Pilot Study. Microorganisms 2024; 12:1839. [PMID: 39338513 PMCID: PMC11433867 DOI: 10.3390/microorganisms12091839] [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: 07/31/2024] [Revised: 09/02/2024] [Accepted: 09/04/2024] [Indexed: 09/30/2024] Open
Abstract
During the last few decades, the main focus of numerous studies has been on the human breast milk microbiota and its influence on the infant intestinal microbiota and overall health. The presence of lactic acid bacteria in breast milk affects both the quantitative and qualitative composition of the infant gut microbiota. The aim of this study was to assess the most frequently detected cultivable rod-shaped lactobacilli, specific for breast milk of healthy Bulgarian women and fecal samples of their infants over the first month of life, in 14 mother-infant tandem pairs. Additionally, we evaluated the strain diversity among the most common isolated species. A total of 68 Gram-positive and catalase-negative strains were subjected to identification using the MALDI-TOF technique. Predominant cultivable populations belonging to the rod-shaped lactic acid bacteria have been identified as Lacticaseibacillus rhamnosus, Limosilactobacillus fermentum, Lacticaseibacillus paracasei, and Limosilactobacillus reuteri. Also, we confirmed the presence of Lactiplantibacillus plantarum and Lactobacillus gasseri. Up to 26 isolates were selected as representatives and analyzed by 16S rRNA sequencing for strain identity confirmation and a phylogenetic tree based on 16S rRNA gene sequence was constructed. Comparative analysis by four RAPD primers revealed genetic differences between newly isolated predominant L. rhamnosus strains. This pilot study provides data for the current first report concerning the investigation of the characteristic cultivable lactobacilli isolated from human breast milk and infant feces in Bulgaria.
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Affiliation(s)
- Asya Asenova
- Department of General and Industrial Microbiology, Faculty of Biology, Sofia University St. Kliment Ohridski, Dragan Tsankov Blvd 8, 1164 Sofia, Bulgaria; (A.A.); (T.N.); (P.H.)
| | - Hristiyana Hristova
- Department of General and Industrial Microbiology, Faculty of Biology, Sofia University St. Kliment Ohridski, Dragan Tsankov Blvd 8, 1164 Sofia, Bulgaria; (A.A.); (T.N.); (P.H.)
| | - Stanimira Ivanova
- Department of General and Industrial Microbiology, Faculty of Biology, Sofia University St. Kliment Ohridski, Dragan Tsankov Blvd 8, 1164 Sofia, Bulgaria; (A.A.); (T.N.); (P.H.)
| | - Viliana Miteva
- Department of General and Industrial Microbiology, Faculty of Biology, Sofia University St. Kliment Ohridski, Dragan Tsankov Blvd 8, 1164 Sofia, Bulgaria; (A.A.); (T.N.); (P.H.)
| | - Ivelina Zhivkova
- Department of Clinical Microbiology, National Center of Infectious and Parasitic Disease, Yanko Sakuzov Blvd 26, 1504 Sofia, Bulgaria (D.D.)
| | - Katerina Stefanova
- Agrobioinstitute Bulgarian Agriculture Academy, Dragan Tsankov Blvd 8, 1164 Sofia, Bulgaria;
| | - Penka Moncheva
- Department of General and Industrial Microbiology, Faculty of Biology, Sofia University St. Kliment Ohridski, Dragan Tsankov Blvd 8, 1164 Sofia, Bulgaria; (A.A.); (T.N.); (P.H.)
| | - Trayana Nedeva
- Department of General and Industrial Microbiology, Faculty of Biology, Sofia University St. Kliment Ohridski, Dragan Tsankov Blvd 8, 1164 Sofia, Bulgaria; (A.A.); (T.N.); (P.H.)
| | - Zoltan Urshev
- LB Bulgaricum PLC, Malashevska Str. 14, 1113 Sofia, Bulgaria
| | - Victoria Marinova-Yordanova
- Department of General and Industrial Microbiology, Faculty of Biology, Sofia University St. Kliment Ohridski, Dragan Tsankov Blvd 8, 1164 Sofia, Bulgaria; (A.A.); (T.N.); (P.H.)
- Department of Bioactivity of Compouds, Centre of Competence “Sustainable Utilization of Bio Resources and Waste of Medicinal and Aromatic Plants for Innovative Bioactive Products”, Dragan Tsankov Blvd 8, 1164 Sofia, Bulgaria
| | - Tzveta Georgieva
- Department of Applied Genomics and GMO, National Center of Public Health and Analyses, Academic Ivan Geshov Blvd 15, 1431 Sofia, Bulgaria;
| | - Margarita Tzenova
- Department of General and Industrial Microbiology, Faculty of Biology, Sofia University St. Kliment Ohridski, Dragan Tsankov Blvd 8, 1164 Sofia, Bulgaria; (A.A.); (T.N.); (P.H.)
| | - Maria Russinova
- Human Milk Bank, Sava Mihailov Str. 57, 1309 Sofia, Bulgaria (T.B.)
| | | | - Deyan Donchev
- Department of Clinical Microbiology, National Center of Infectious and Parasitic Disease, Yanko Sakuzov Blvd 26, 1504 Sofia, Bulgaria (D.D.)
- Centre of Competence “Fundamental Translational and Clinical Research in Infection and Immunity”, Yanko Sakuzov Blvd 26, 1504 Sofia, Bulgaria
| | - Petya Hristova
- Department of General and Industrial Microbiology, Faculty of Biology, Sofia University St. Kliment Ohridski, Dragan Tsankov Blvd 8, 1164 Sofia, Bulgaria; (A.A.); (T.N.); (P.H.)
| | - Iliyana Rasheva
- Department of General and Industrial Microbiology, Faculty of Biology, Sofia University St. Kliment Ohridski, Dragan Tsankov Blvd 8, 1164 Sofia, Bulgaria; (A.A.); (T.N.); (P.H.)
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Zhou JQ, Liu ZX, Zhong HF, Liu GQ, Ding MC, Zhang Y, Yu B, Jiang N. Single nucleotide polymorphisms in the development of osteomyelitis and prosthetic joint infection: a narrative review. Front Immunol 2024; 15:1444469. [PMID: 39301021 PMCID: PMC11410582 DOI: 10.3389/fimmu.2024.1444469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Accepted: 08/08/2024] [Indexed: 09/22/2024] Open
Abstract
Currently, despite advancements in diagnostic and therapeutic modalities, osteomyelitis and prosthetic joint infection (PJI) continue to pose significant challenges for orthopaedic surgeons. These challenges are primarily attributed to the high degree of heterogeneity exhibited by these disorders, which are influenced by a combination of environmental and host factors. Recent research efforts have delved into the pathogenesis of osteomyelitis and PJI by investigating single nucleotide polymorphisms (SNPs). This review comprehensively summarizes the current evidence regarding the associations between SNPs and the predisposition to osteomyelitis and PJI across diverse populations. The findings suggest potential linkages between SNPs in genes such as IL-1, IL-6, IFN-γ, TNF-α, VDR, tPA, CTSG, COX-2, MMP1, SLC11A1, Bax, NOS2, and NLRP3 with the development of osteomyelitis. Furthermore, SNPs in genes like IL-1, IL-6, TNF-α, MBL, OPG, RANK, and GCSFR are implicated in susceptibility to PJI. However, it is noted that most of these studies are single-center reports, lacking in-depth mechanistic research. To gain a more profound understanding of the roles played by various SNPs in the development of osteomyelitis and PJI, future multi-center studies and fundamental investigations are deemed necessary.
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Affiliation(s)
- Jia-Qi Zhou
- Division of Orthopaedics & Traumatology, Department of Orthopaedics, Nanfang Hospital, Southern Medical University, Guangzhou, China
- Department of Orthopaedics, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China
- Guangdong Engineering Technology Research Center of Functional Repair of Bone Defects and Biomaterials, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China
| | - Zi-Xian Liu
- The Second Hospital & Clinical Medical School, Lanzhou University, Lanzhou, China
- Department of Orthopedics, Lanzhou University Second Hospital, Lanzhou, China
| | - Hong-Fa Zhong
- Department of Trauma Emergency Center, Ganzhou Hospital-Nanfang Hospital, Southern Medical University, Ganzhou, China
| | - Guan-Qiao Liu
- Division of Orthopaedics & Traumatology, Department of Orthopaedics, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Ming-Cong Ding
- The Second Hospital & Clinical Medical School, Lanzhou University, Lanzhou, China
- Department of Orthopedics, Lanzhou University Second Hospital, Lanzhou, China
| | - Yu Zhang
- Department of Orthopaedics, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China
- Guangdong Engineering Technology Research Center of Functional Repair of Bone Defects and Biomaterials, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China
| | - Bin Yu
- Division of Orthopaedics & Traumatology, Department of Orthopaedics, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Nan Jiang
- Division of Orthopaedics & Traumatology, Department of Orthopaedics, Nanfang Hospital, Southern Medical University, Guangzhou, China
- Department of Trauma Emergency Center, Ganzhou Hospital-Nanfang Hospital, Southern Medical University, Ganzhou, China
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Ducloux-Lebon B, Lebon D, Tesson JR, Fumery M, Marolleau JP, Chatelain D. [Recto-colic graft-versus-host disease (GVH). Diagnostic and prognostic criteria in a cohort of patients from Amiens university hospital]. Ann Pathol 2024:S0242-6498(24)00161-5. [PMID: 39242243 DOI: 10.1016/j.annpat.2024.08.003] [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: 09/01/2023] [Revised: 08/11/2024] [Accepted: 08/12/2024] [Indexed: 09/09/2024]
Abstract
INTRODUCTION Recto-colic graft-versus-host disease (GVHD) is a frequent and serious complication of hematopoietic stem cell allogeneic transplantation, which is sometimes difficult to diagnose. The aim of our study was to identify histological diagnostic and prognostic criteria for recto-colic GVH. MATERIAL AND METHOD Patients allografted at Amiens university hospital from 2012 to 2017 were retrieved. Those who had a recto-colic biopsy were included and divided into two groups (final diagnosis of GVH and non-GVH), then biopsies were reviewed by 2 pathologists. RESULTS One hundred and nineteen patients were included. Sixty-seven were allocated to the GVH group and 52 to the non-GVH group. In the GVH group, we observed a significantly greater number of apoptotic bodies (AB) on standard HES staining and with the anti-Caspase 3 immunohistochemistry, cryptolytic AB abscesses, atrophy, regenerative glands and glands lined with eosinophilic cells (P<0.001). Anti-Caspase 3 immunohistochemistry revealed more AB than standard HES staining (P<0.005). But to differentiate GVH cases from non-GVH cases, we obtained a threshold value of 3.5 AB per 10 contiguous crypts on standard HE staining and with the anti-Caspase 3 immunohistochemistry. From 4 AB per 10 contiguous crypts, on HES staining and anti-Caspase 3 immunostaining, the diagnosis of GVH became consistent. No non-GVH case had more than 6 AB per 10 contiguous crypts. GVH patients with more than 8 AB per 10 contiguous crypts had a worse prognosis (P<0.001). CONCLUSION We confirm the value of AB and their counting in the diagnosis of GVH, with a diagnostic threshold of 4 AB and a prognostic threshold of 8 AB. Glands lined with eosinophilic cells could be an additional diagnostic criterion in favor of GVH to be confirmed by further studies.
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Affiliation(s)
- Benjamin Ducloux-Lebon
- Service d'anatomie et cytologie pathologiques, CHU Amiens Nord, place Victor-Pauchet, 80000 Amiens, France.
| | - Delphine Lebon
- Service d'hématologie clinique et thérapie cellulaire, CHU Amiens Sud, 1, Rond-Point du Professeur-Christian-Cabrol, 80054 Amiens cedex, France
| | - Jean-René Tesson
- Service d'anatomie et cytologie pathologiques, CHU Amiens Nord, place Victor-Pauchet, 80000 Amiens, France
| | - Mathurin Fumery
- Service d'hépato gastro-entérologie, CHU Amiens Sud, 1, Rond-Point du Professeur-Christian-Cabrol, 80054 Amiens cedex, France
| | - Jean-Pierre Marolleau
- Service d'hématologie clinique et thérapie cellulaire, CHU Amiens Sud, 1, Rond-Point du Professeur-Christian-Cabrol, 80054 Amiens cedex, France
| | - Denis Chatelain
- Service d'anatomie et cytologie pathologiques, CHU Amiens Nord, place Victor-Pauchet, 80000 Amiens, France
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111
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Kim DY, Liu Y, Kim G, An SB, Han I. Innovative Strategies in 3D Bioprinting for Spinal Cord Injury Repair. Int J Mol Sci 2024; 25:9592. [PMID: 39273538 PMCID: PMC11395085 DOI: 10.3390/ijms25179592] [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: 07/06/2024] [Revised: 09/01/2024] [Accepted: 09/03/2024] [Indexed: 09/15/2024] Open
Abstract
Spinal cord injury (SCI) is a catastrophic condition that disrupts neurons within the spinal cord, leading to severe motor and sensory deficits. While current treatments can alleviate pain, they do not promote neural regeneration or functional recovery. Three-dimensional (3D) bioprinting offers promising solutions for SCI repair by enabling the creation of complex neural tissue constructs. This review provides a comprehensive overview of 3D bioprinting techniques, bioinks, and stem cell applications in SCI repair. Additionally, it highlights recent advancements in 3D bioprinted scaffolds, including the integration of conductive materials, the incorporation of bioactive molecules like neurotrophic factors, drugs, and exosomes, and the design of innovative structures such as multi-channel and axial scaffolds. These innovative strategies in 3D bioprinting can offer a comprehensive approach to optimizing the spinal cord microenvironment, advancing SCI repair. This review highlights a comprehensive understanding of the current state of 3D bioprinting in SCI repair, offering insights into future directions in the field of regenerative medicine.
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Affiliation(s)
- Daniel Youngsuk Kim
- Research Competency Milestones Program (RECOMP), School of Medicine, CHA University, Seongnam-si 13488, Republic of Korea
- Department of Medicine, School of Medicine, CHA University, Seongnam-si 13496, Republic of Korea
| | - Yanting Liu
- Department of Neurosurgery, CHA Bundang Medical Center, CHA University, Seongnam-si 13496, Republic of Korea
| | - Gyubin Kim
- Department of Neurosurgery, CHA Bundang Medical Center, CHA University, Seongnam-si 13496, Republic of Korea
| | - Seong Bae An
- Department of Neurosurgery, CHA Bundang Medical Center, CHA University, Seongnam-si 13496, Republic of Korea
| | - Inbo Han
- Department of Neurosurgery, CHA Bundang Medical Center, CHA University, Seongnam-si 13496, Republic of Korea
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Sciurti A, Baccolini V, Ceparano M, Isonne C, Migliara G, Iera J, Alessandri F, Ceccarelli G, Marzuillo C, Tellan G, De Giusti M, Pugliese F, Villari P, The Collaborating Group. Incidence and Predictors of Healthcare-Associated Infections in Patients Admitted to a Temporary Intensive Care Unit during the COVID-19 Pandemic Waves: A Two-Year (2021-2023) Retrospective Cohort Study in Rome, Italy. Antibiotics (Basel) 2024; 13:842. [PMID: 39335015 PMCID: PMC11428387 DOI: 10.3390/antibiotics13090842] [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: 07/31/2024] [Revised: 08/20/2024] [Accepted: 08/30/2024] [Indexed: 09/30/2024] Open
Abstract
To manage the number of critical COVID-19 patients, Umberto I Teaching Hospital in Rome established a temporary ICU on March 1, 2021. This study investigated the incidence and risk factors of healthcare-associated infections (HAIs) among these patients during various COVID-19 waves. Patients were grouped by admission date according to the dominant SARS-CoV-2 variant prevalent at the time (Alpha, Delta, Omicron BA.1, Omicron BA.2, Omicron BA.5, and Omicron XBB). First-HAI and mortality rates were calculated per 1000 patient-days. Predictors of first-HAI occurrence were investigated using a multivariable Fine-Gray regression model considering death as a competing event. Among 355 admitted patients, 27.3% experienced at least one HAI, and 49.6% died. Patient characteristics varied over time, with older and more complex cases in the later phases, while HAI and mortality rates were higher in the first year. Pathogens responsible for HAIs varied over time, with first Acinetobacter baumannii and then Klebsiella pneumoniae being progressively predominant. Multivariable analysis confirmed that, compared to Alpha, admission during the Omicron BA.1, BA.2, BA.5, and XBB periods was associated with lower hazards of HAI. Despite worsening COVID-19 patient conditions, late-phase HAI rates decreased, likely due to evolving pathogen characteristics, improved immunity, but also better clinical management, and adherence to infection prevention practices. Enhanced HAI prevention in emergency situations is crucial.
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Affiliation(s)
- Antonio Sciurti
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Valentina Baccolini
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Mariateresa Ceparano
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Claudia Isonne
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Giuseppe Migliara
- Department of Life Sciences, Health, and Health Professions, Link Campus University, 00165 Rome, Italy
| | - Jessica Iera
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
- Management and Health Laboratory, Institute of Management, Department EMbeDS, Sant'Anna School of Advanced Studies, 56127 Pisa, Italy
| | - Francesco Alessandri
- Department of Anaesthesia and Intensive Care Medicine, Umberto I Teaching Hospital, Sapienza University of Rome, 00185 Rome, Italy
| | - Giancarlo Ceccarelli
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Carolina Marzuillo
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Guglielmo Tellan
- Department of Anaesthesia and Intensive Care Medicine, Umberto I Teaching Hospital, Sapienza University of Rome, 00185 Rome, Italy
| | - Maria De Giusti
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Francesco Pugliese
- Department of Anaesthesia and Intensive Care Medicine, Umberto I Teaching Hospital, Sapienza University of Rome, 00185 Rome, Italy
- Department of General and Specialist Surgery "P. Stefanini", Sapienza University of Rome, 00185 Rome, Italy
| | - Paolo Villari
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - The Collaborating Group
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
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113
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Puighermanal E, Luna-Sánchez M, Gella A, van der Walt G, Urpi A, Royo M, Tena-Morraja P, Appiah I, de Donato MH, Menardy F, Bianchi P, Esteve-Codina A, Rodríguez-Pascau L, Vergara C, Gómez-Pallarès M, Marsicano G, Bellocchio L, Martinell M, Sanz E, Jurado S, Soriano FX, Pizcueta P, Quintana A. Cannabidiol ameliorates mitochondrial disease via PPARγ activation in preclinical models. Nat Commun 2024; 15:7730. [PMID: 39231983 PMCID: PMC11375224 DOI: 10.1038/s41467-024-51884-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 08/16/2024] [Indexed: 09/06/2024] Open
Abstract
Mutations in mitochondrial energy-producing genes lead to a heterogeneous group of untreatable disorders known as primary mitochondrial diseases (MD). Leigh syndrome (LS) is the most common pediatric MD and is characterized by progressive neuromuscular affectation and premature death. Here, we show that daily cannabidiol (CBD) administration significantly extends lifespan and ameliorates pathology in two LS mouse models, and improves cellular function in fibroblasts from LS patients. CBD delays motor decline and neurodegenerative signs, improves social deficits and breathing abnormalities, decreases thermally induced seizures, and improves neuropathology in affected brain regions. Mechanistically, we identify peroxisome proliferator-activated receptor gamma (PPARγ) as a key nuclear receptor mediating CBD's beneficial effects, while also providing proof of dysregulated PPARγ expression and activity as a common feature in both mouse neurons and fibroblasts from LS patients. Taken together, our results provide the first evidence for CBD as a potential treatment for LS.
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Affiliation(s)
- Emma Puighermanal
- Institut de Neurociències, Universitat Autònoma de Barcelona, Bellaterra, Spain.
| | - Marta Luna-Sánchez
- Institut de Neurociències, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Departament de Biologia Cel·lular, Fisiologia i Immunologia, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Alejandro Gella
- Institut de Neurociències, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Departament de Biologia Cel·lular, Fisiologia i Immunologia, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Gunter van der Walt
- Institut de Neurociències, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Andrea Urpi
- Institut de Neurociències, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - María Royo
- Institute of Neuroscience, CSIC-UMH, San Juan de Alicante, Spain
| | - Paula Tena-Morraja
- Celltec-UB, Departament de Biologia Cel·lular, Fisiologia i Immunologia, Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain
| | - Isabella Appiah
- Institut de Neurociències, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | | | - Fabien Menardy
- Institut de Neurociències, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Patrizia Bianchi
- Institut de Neurociències, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Anna Esteve-Codina
- Centro Nacional de Análisis Genómico (CNAG), Barcelona, Spain
- Universitat de Barcelona (UB), Barcelona, Spain
| | | | | | | | - Giovanni Marsicano
- Inserm Université de Bordeaux, U1215 Neurocentre Magendie, Bordeaux, France
| | - Luigi Bellocchio
- Inserm Université de Bordeaux, U1215 Neurocentre Magendie, Bordeaux, France
| | | | - Elisenda Sanz
- Institut de Neurociències, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Departament de Biologia Cel·lular, Fisiologia i Immunologia, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Sandra Jurado
- Institute of Neuroscience, CSIC-UMH, San Juan de Alicante, Spain
| | - Francesc Xavier Soriano
- Celltec-UB, Departament de Biologia Cel·lular, Fisiologia i Immunologia, Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain
| | | | - Albert Quintana
- Institut de Neurociències, Universitat Autònoma de Barcelona, Bellaterra, Spain.
- Departament de Biologia Cel·lular, Fisiologia i Immunologia, Universitat Autònoma de Barcelona, Barcelona, Spain.
- Human Metabolomics, Faculty of Natural and Agricultural Sciences, North-West University, Potchefstroom, South Africa.
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114
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Jiang X, Wang H, Nie K, Gao Y, Chen S, Tang Y, Wang Z, Su H, Dong H. Targeting lipid droplets and lipid droplet-associated proteins: a new perspective on natural compounds against metabolic diseases. Chin Med 2024; 19:120. [PMID: 39232826 PMCID: PMC11373146 DOI: 10.1186/s13020-024-00988-w] [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: 06/17/2024] [Accepted: 08/22/2024] [Indexed: 09/06/2024] Open
Abstract
BACKGROUND Lipid droplet (LD) is a metabolically active organelle, which changes dynamically with the metabolic state and energy requirements of cells. Proteins that either insert into the LD phospholipid monolayer or are present in the cytoplasm, playing a crucial role in lipid homeostasis and signaling regulation, are known as LD-associated proteins. METHODS The keywords "lipid droplets" and "metabolic diseases" were used to obtain literature on LD metabolism and pathological mechanism. After searching databases including Scopus, OVID, Web of Science, and PubMed from 2013 to 2024 using terms like "lipid droplets", "lipid droplet-associated proteins", "fatty liver disease", "diabetes", "diabetic kidney disease", "obesity", "atherosclerosis", "hyperlipidemia", "natural drug monomers" and "natural compounds", the most common natural compounds were identified in about 954 articles. Eventually, a total of 91 studies of 10 natural compounds reporting in vitro or in vivo studies were refined and summarized. RESULTS The most frequently used natural compounds include Berberine, Mangostin, Capsaicin, Caffeine, Genistein, Epigallocatechin-3-gallate, Chlorogenic acid, Betaine, Ginsenoside, Resveratrol. These natural compounds interact with LD-associated proteins and help ameliorate abnormal LDs in various metabolic diseases. CONCLUSION Natural compounds involved in the regulation of LDs and LD-associated proteins hold promise for treating metabolic diseases. Further research into these interactions may lead to new therapeutic applications.
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Affiliation(s)
- Xinyue Jiang
- Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hongzhan Wang
- Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Kexin Nie
- Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yang Gao
- Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shen Chen
- Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yueheng Tang
- Department of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhi Wang
- Department of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hao Su
- Department of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hui Dong
- Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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Vadhanavikkit P, Srifuengfung M, Wiwattarangkul T, Wiwattanaworaset P, Oon-Arom A, Chiddaycha M, Piyavhatkul N, Wainipitapong S. Prevalence of Depression and Generalized Anxiety Among LGBTQ+ Medical Students in Thailand. JOURNAL OF HOMOSEXUALITY 2024:1-21. [PMID: 39230396 DOI: 10.1080/00918369.2024.2389905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/05/2024]
Abstract
This study evaluated the prevalence and associated factors of depression and generalized anxiety among LGBTQ+ in five medical schools in Thailand. The Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) were used to assess major depressive disorder (MDD) and generalized anxiety disorder (GAD), respectively, and multivariable logistic regression was employed to identify associated factors. Of 1,322 students, 412 (31.16%) identified as LGBTQ+. The prevalence for MDD and GAD among LGBTQ+ students were 32.77% and 17.23%, respectively. Significant associated factors for both MDD and GAD were a history of psychiatric illness (AOR for MDD = 2.32, p = .020; AOR for GAD = 3.67, p < .001), educational problems (AOR for MDD = 6.62, p < .001; AOR for GAD = 5.12, p < .001), and dissatisfaction with gender identity or sexual orientation (AOR for MDD = 1.92, p = .019; AOR for GAD = 2.47, p = .005). Additional factors associated with MDD were preclinical years (AOR = 2.30, p = .023), financial struggles (AOR = 2.05, p = .021), and inadequate peer support (AOR = 2.57, p = .044). In conclusion, nearly one-third and one-fifth of Thai LGBTQ+ medical students suffer from MDD and GAD, respectively. Our findings suggest that Thai medical schools should promote LGBTQ+ inclusivity to enhance students' identity satisfaction. Peer support groups should be encouraged, especially for preclinical LGBTQ+ students who face educational and financial challenges.
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Affiliation(s)
- Papan Vadhanavikkit
- Department of Psychiatry, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Maytinee Srifuengfung
- Department of Psychiatry, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Teeravut Wiwattarangkul
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | | | - Awirut Oon-Arom
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Mayteewat Chiddaycha
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Nawanant Piyavhatkul
- Department of Psychiatry, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Sorawit Wainipitapong
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Faculty of Medicine, Center of Excellence in Transgender Health, Chulalongkorn University, Bangkok, Thailand
- Department of Global Health and Social Medicine, King's College London, UK
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116
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Yeung WCG, Toussaint ND, Lioufas N, Hawley CM, Pascoe EM, Elder GJ, Valks A, Badve SV. Vitamin D status and intermediate vascular and bone outcomes in chronic kidney disease: a secondary post hoc analysis of IMPROVE-CKD. Intern Med J 2024. [PMID: 39225105 DOI: 10.1111/imj.16516] [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: 02/08/2024] [Accepted: 08/12/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND AND AIMS Cardiovascular disease is the leading cause of death in patients with chronic kidney disease (CKD) and has been associated with abnormalities of mineral metabolism and vascular calcification. Vitamin D influences parathyroid hormone values and calcium and phosphate metabolism, and may play a role in vascular function and bone health. We aimed to test our hypothesis that vitamin D deficiency is associated with arterial stiffness, aortic calcification and lower bone mineral density (BMD) in patients with CKD. METHODS A cross-sectional analysis was performed using baseline data from the IMpact of Phosphate Reduction On Vascular Endpoints in CKD (IMPROVE-CKD) study cohort. Clinical and laboratory parameters were compared between those with and without vitamin D deficiency, defined as 25-hydroxyvitamin D (25(OH)D) <50 nmol/L. Univariable and multivariable linear regression analyses were performed to assess associations between serum 25(OH)D levels and pulse wave velocity (PWV), augmentation index (AIx), abdominal aortic calcification (measured by the Agatston score) and lumbar spine BMD. RESULTS Baseline 25(OHD) values were available in 208 out of 278 IMPROVE-CKD study participants, with a mean value of 70.1 ± 30.7 nmol/L. Of these, 57 (27%) patients had vitamin D deficiency. Those with 25(OH)D deficiency were more likely to have diabetes (56% vs 38%), cardiovascular disease (54% vs 36%) and lower serum calcium (2.29 ± 0.13 vs 2.34 ± 0.13 mmol/L). On univariable and multivariable regression analyses, baseline 25(OH)D values were not associated with PWV, the AIx, Agatston score or BMD. CONCLUSION Baseline 25(OH)D levels were not associated with intermediate markers of vascular function and BMD in patients with CKD stages 3b and 4.
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Affiliation(s)
- Wing-Chi G Yeung
- Department of Nephrology, Wollongong Hospital, Wollongong, New South Wales, Australia
- Renal and Metabolic Division, The George Institute for Global Health, Sydney, New South Wales, Australia
- Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Nigel D Toussaint
- Department of Nephrology, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
- Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
| | - Nicole Lioufas
- Department of Nephrology, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
- Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
| | - Carmel M Hawley
- Translational Research Institute, Brisbane, Queensland, Australia
- Department of Nephrology, Princess Alexandra Hospital, Brisbane, Queensland, Australia
- Australasian Kidney Trials Network, The University of Queensland, Brisbane, Queensland, Australia
| | - Elaine M Pascoe
- Centre for Health Services Research, The University of Queensland, Brisbane, Queensland, Australia
| | - Grahame J Elder
- School of Medicine, University of Notre Dame, Sydney, New South Wales, Australia
- Skeletal Biology Program, Garvan Institute of Medical Research, Sydney, New South Wales, Australia
- Department of Nephrology, Westmead Hospital, Sydney, New South Wales, Australia
| | - Andrea Valks
- Australasian Kidney Trials Network, The University of Queensland, Brisbane, Queensland, Australia
| | - Sunil V Badve
- Renal and Metabolic Division, The George Institute for Global Health, Sydney, New South Wales, Australia
- Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
- Department of Nephrology, St George Hospital, Sydney, New South Wales, Australia
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Diniz L, Carneiro M, Fonseca A, Shirahige L, Brito R, Melo L, Melo D, Austregésilo M, Piscitelli D, Monte-Silva K. Can electroencephalography (EEG) identify the different dimensions of pain in fibromyalgia? A pilot study. BMC Musculoskelet Disord 2024; 25:705. [PMID: 39227893 PMCID: PMC11370227 DOI: 10.1186/s12891-024-07824-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2024] [Accepted: 08/27/2024] [Indexed: 09/05/2024] Open
Abstract
BACKGROUND Electroencephalography (EEG) is a promising tool for identifying the physiological biomarkers of fibromyalgia (FM). Evidence suggests differences in power band and density between individuals with FM and healthy controls. EEG changes appear to be associated with pain intensity; however, their relationship with the quality of pain has not been examined. We aimed to investigate whether abnormal EEG in the frontal and central points of the 10-20 EEG system in individuals with FM is associated with pain's sensory-discriminative and affective-motivational dimensions. The association between EEG and the two dimensions of emotional disorders (depression and anxiety) was also investigated. METHODS In this cross-sectional pilot study, pain experience (pain rating index [PRI]) and two dimensions of emotional disorders (depression and anxiety) were assessed using the McGill Pain Questionnaire (PRI-sensory and PRI-affective) and Hospital Anxiety and Depression Scale (HADS), respectively. In quantitative EEG analysis, the relative spectral power of each frequency band (delta, theta, alpha, and beta) was identified in the frontal and central points during rest. RESULTS A negative correlation was found between the relative spectral power for the delta bands in the frontal (r= -0.656; p = 0.028) and central points (r= -0.624; p = 0.040) and the PRI-affective scores. A positive correlation was found between the alpha bands in the frontal (r = 0.642; p = 0.033) and central points (r = 0.642; p = 0.033) and the PRI-affective scores. A negative correlation between the delta bands in the central points and the anxiety subscale of the HADS (r = -0.648; p = 0.031) was detected. CONCLUSION The affective-motivational dimension of pain and mood disorders may be related to abnormal patterns of electrical activity in patients with FM. TRIAL REGISTRATION Retrospectively registered on ClinicalTrials.gov (NCT05962658).
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Affiliation(s)
- Luam Diniz
- Applied Neuroscience Laboratory, Department of Physical Therapy, Universidade Federal de Pernambuco, Recife, PE, 50670-901, Brazil
| | - Maíra Carneiro
- Applied Neuroscience Laboratory, Department of Physical Therapy, Universidade Federal de Pernambuco, Recife, PE, 50670-901, Brazil
| | - André Fonseca
- Center of Mathematics, Computation and Cognition, Universidade Federal do ABC, São Paulo, São Paulo, Brazil
| | - Lívia Shirahige
- Applied Neuroscience Laboratory, Department of Physical Therapy, Universidade Federal de Pernambuco, Recife, PE, 50670-901, Brazil
| | - Rodrigo Brito
- Applied Neuroscience Laboratory, Department of Physical Therapy, Universidade Federal de Pernambuco, Recife, PE, 50670-901, Brazil
| | - Lorena Melo
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany
| | - Daniel Melo
- Applied Neuroscience Laboratory, Department of Physical Therapy, Universidade Federal de Pernambuco, Recife, PE, 50670-901, Brazil
| | - Marília Austregésilo
- Applied Neuroscience Laboratory, Department of Physical Therapy, Universidade Federal de Pernambuco, Recife, PE, 50670-901, Brazil
| | - Daniele Piscitelli
- Doctor of Physical Therapy Program, Department of Kinesiology, University of Connecticut, 3107 Horsebarn Hill Road, U-4137, Storrs, CT, 06269-1101, USA.
| | - Katia Monte-Silva
- Applied Neuroscience Laboratory, Department of Physical Therapy, Universidade Federal de Pernambuco, Recife, PE, 50670-901, Brazil
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Shang L, Zheng M, Wang Z, Zhu Y. The learning curve for modified hand-assisted retroperitoneoscopic living donor nephrectomy. BMC Urol 2024; 24:191. [PMID: 39227858 PMCID: PMC11370098 DOI: 10.1186/s12894-024-01581-x] [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: 06/12/2023] [Accepted: 08/23/2024] [Indexed: 09/05/2024] Open
Abstract
BACKGROUND We aimed to introduce our modified hand-assisted retroperitoneoscopic living donor nephrectomy (HARPLDN) technique and define the learning curve. METHODS One hundred thirty-eight kidney donors who underwent modified HARPLDN by the same surgeon between May 2015 and March 2022 were included. A cumulative sum (CUSUM) learning curve analysis was performed with the total operation time as the study outcome. RESULTS In total, the mean operative time was 138.2 ± 32.1 min. The median warm ischemic time (WIT) and estimated blood loss were 90 s and 50 ml, respectively. The learning curve for the total operative time was best modeled as a second-order polynomial with the following equation: CUSUMOT (min) = (-0.09 case number2) + (12.88 case number) - 67.77 (R2 = 0.7875; p<0.05). The CUSUM learning curve included the following three unique phases: phase 1 (the initial 41 cases), representing the initial learning curve; phase 2 (the middle 43 cases), representing expert competence; and phase 3 (the final 54 cases), representing mastery. The overall 6-month graft survival rate was 99.3%, with 94.9% immediate onset of graft function without delayed graft function and 0.7% ureteral complications. CONCLUSIONS Our modified method is safe and effective for living donor nephrectomy and has the advantages of a shorter operating time and optimized WIT. The surgeon can become familiar with the modified HARPLDN after 41 cases and effectively perform the next 97 cases.
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Affiliation(s)
- Limin Shang
- Department of Urology, Beijing Friendship hospital, Capital Medical University, Beijing, China
- Institute of Urology, Beijing Municipal Health Commission, Beijing, China
| | - Mengmeng Zheng
- Department of Urology, Beijing Friendship hospital, Capital Medical University, Beijing, China
- Institute of Urology, Beijing Municipal Health Commission, Beijing, China
| | - Zhipeng Wang
- Department of Urology, Beijing Friendship hospital, Capital Medical University, Beijing, China
- Institute of Urology, Beijing Municipal Health Commission, Beijing, China
| | - Yichen Zhu
- Department of Urology, Beijing Friendship hospital, Capital Medical University, Beijing, China.
- Institute of Urology, Beijing Municipal Health Commission, Beijing, China.
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Zaman SU, Mehdi MS. Dialysis treatment, in vitro, and anticoagulation activity of polysulfone-polyacrylamide based-blend membranes: an experimental study. JOURNAL OF BIOMATERIALS SCIENCE. POLYMER EDITION 2024:1-22. [PMID: 39228062 DOI: 10.1080/09205063.2024.2398325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2024] [Accepted: 08/23/2024] [Indexed: 09/05/2024]
Abstract
The majority of treatments are performed with polysulfone (PSf) membranes. The main issue of the PSf membrane is its lack of endothelial function, leading to various processes like platelet adhesion, protein adsorption, and thrombus formation when comes in contact with blood. The crucial aspect in the development of hemodialysis (HD) membrane materials is a biocompatibility factor. This study aims to improve the performance and biocompatibility of PSf membranes by utilizing polyethylene glycol (PEG) as a pore-forming agent and polyacrylamide (PAA) as a multifunctional modifying additive owing to its non-toxic, and biocompatible nature. The formulated HD membranes were characterized using Fourier Transform Infrared (FTIR) spectroscopy, Scanning Electron Microscopy (SEM), and Water Contact Angle (WCA) measurements. The biocompatibility results showed that PSf-PAA membranes reduced the adsorption of bovine serum albumin (BSA) protein, hemolysis process, thrombus formation, and platelets adhesion with improved in vitro cytotoxicity results as well as anticoagulation performance. The protein separation results showed that PSf-PAA membranes were able to reject 90.1% and 92.8% of BSA protein. The membranes also showed better uremic waste clearance for urea (76.56% and 78.24%) and creatinine (73.71% and 79.13%) solutes, respectively. It is conceivable that these modern-age membranes may surpass conventional HD membranes regarding both efficiency and effectiveness.
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Affiliation(s)
- Shafiq Uz Zaman
- Department of Chemical Engineering, Ghulam Ishaq Khan Institute of Engineering Sciences and Technology, Topi, Pakistan
| | - Muhammad Shozab Mehdi
- Department of Chemical Engineering, Ghulam Ishaq Khan Institute of Engineering Sciences and Technology, Topi, Pakistan
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Lima EOVD, Tasima LJ, Grego KF, Tanaka-Azevedo AM. Fibrinogenolytic potential of venoms of medically important Brazilian snakes. Comp Biochem Physiol C Toxicol Pharmacol 2024; 287:110019. [PMID: 39233288 DOI: 10.1016/j.cbpc.2024.110019] [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: 07/01/2024] [Revised: 08/20/2024] [Accepted: 08/29/2024] [Indexed: 09/06/2024]
Abstract
One of the main clinical manifestations presented by victims of snake bite envenoming are coagulation disorders. Considering that fibrinogen is a key molecule for crosslinked fibrin clot formation, the objective of this work was the quantitative analysis of the fibrinogenolytic activity of snakes of medical importance in Brazil and neutralization by specific antivenom. For this, pools of three genera of medical importance (Bothrops, Crotalus and Lachesis) that are used for the production of antivenom were used, and three pools of species of the genus Bothrops that are not part of the pool for the production of antivenom. The Lachesis pool had the highest fibrinogenolytic activity, even demonstrating partial cleavage (42.9 % consumption) of the fibrinogen gamma chain. The Bothrops genus venom pools have shown subtle variations between them. The Crotalus pool, despite not showing total cleavage of any fibrinogen chain, began cleavage of fibrinogen by the beta chain. The specific antivenoms used were able to delay the cleavage of fibrinogen in all the venoms used, which could be the first step towards implementing previous in vitro tests to analyze the quality of the batches of antivenoms produced, thus potentially reducing the use of animals used in this process.
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Affiliation(s)
- Eduardo Oliveira Venancio de Lima
- Laboratory of Herpetology, Instituto Butantan, São Paulo 05503-900, SP, Brazil; Interunidades em Biotecnologia, Instituto de Ciências Biomédicas-Instituto de Pesquisas Tecnológicas-Instituto Butantan, Universidade de São Paulo, São Paulo 05508-900, SP, Brazil
| | - Lídia Jorge Tasima
- Laboratory of Herpetology, Instituto Butantan, São Paulo 05503-900, SP, Brazil; Interunidades em Biotecnologia, Instituto de Ciências Biomédicas-Instituto de Pesquisas Tecnológicas-Instituto Butantan, Universidade de São Paulo, São Paulo 05508-900, SP, Brazil
| | | | - Anita Mitico Tanaka-Azevedo
- Laboratory of Herpetology, Instituto Butantan, São Paulo 05503-900, SP, Brazil; Interunidades em Biotecnologia, Instituto de Ciências Biomédicas-Instituto de Pesquisas Tecnológicas-Instituto Butantan, Universidade de São Paulo, São Paulo 05508-900, SP, Brazil.
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Bailey K, Allemang B, Vandermorris A, Munce S, Cleverley K, Chisholm C, Cohen E, Davidson C, El Galad A, Leibovich D, Lowthian T, Pillainayagam J, Ramesh H, Samson A, Senthilnathan V, Siska P, Snider M, Toulany A. Benefits, barriers and recommendations for youth engagement in health research: combining evidence-based and youth perspectives. RESEARCH INVOLVEMENT AND ENGAGEMENT 2024; 10:92. [PMID: 39223602 PMCID: PMC11370084 DOI: 10.1186/s40900-024-00607-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 07/05/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND Youth engagement refers to the collaboration between researchers and youth to produce research. Youth engagement in health research has been shown to inform effective interventions aimed at improving health outcomes. However, limited evidence has identified promising practices to meaningfully engage youth. This synthesis aims to describe youth engagement approaches, frameworks, and barriers, as well as provide both evidence-based and youth-generated recommendations for meaningful engagement. MAIN BODY This review occurred in two stages: 1) a narrative review of existing literature on youth engagement and 2) a Youth Advisory Council (YAC) to review and supplement findings with their perspectives, experiences, and recommendations. The terms 'youth engagement' and 'health research' were searched in Google Scholar, PubMed, Web of Science, Scopus, and PsycINFO. Articles and non-peer reviewed research works related to youth engagement in health research were included, reviewed, and summarized. The YAC met with research team members and in separate youth-only forums to complement the narrative review with their perspectives. Types of youth engagement include participation as research participants, advisors, partners, and co-investigators. Barriers to youth engagement were organized into youth- (e.g., time commitments), researcher- (e.g., attitudes towards youth engagement), organizational- (e.g., inadequate infrastructure to support youth engagement), and system-level (e.g., systemic discrimination and exclusion from research). To enhance youth engagement, recommendations focus on preparing and supporting youth by offering flexible communication approaches, mentorship opportunities, diverse and inclusive recruitment, and ensuring youth understand the commitment and benefits involved. CONCLUSIONS To harness the potential of youth engagement, researchers need to establish an inclusive and enabling environment that fosters collaboration, trust, and valuable contributions from youth. Future research endeavors should prioritize investigating the dynamics of power-sharing between researchers and youth, assessing the impact of youth engagement on young participants, and youth-specific evaluation frameworks.
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Affiliation(s)
- Katherine Bailey
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Brooke Allemang
- Child Health Evaluative Sciences, SickKids Research Institute, Toronto, ON, Canada
| | - Ashley Vandermorris
- Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Division of Adolescent Medicine, The Hospital for Sick Children, 555 University Ave, Toronto, ON, M5G 1X8, Canada
| | - Sarah Munce
- KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada
| | - Kristin Cleverley
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Lawrence S. Bloomberg School of Nursing, University of Toronto, Toronto, ON, Canada
- Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Cassandra Chisholm
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Eva Cohen
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
| | - Cedar Davidson
- Neurosciences and Mental Health, SickKids Research Institute, Toronto, ON, Canada
| | - Asil El Galad
- Michael De Groote School of Medicine, McMaster University, Hamilton, ON, Canada
| | | | - Trinity Lowthian
- Department of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | | | | | - Anna Samson
- Patient Partner, Canadian Arthritis Patient Alliance, Toronto, ON, Canada
| | - Vjura Senthilnathan
- KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
| | | | | | - Alene Toulany
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
- Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
- Division of Adolescent Medicine, The Hospital for Sick Children, 555 University Ave, Toronto, ON, M5G 1X8, Canada.
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Yavuz NC, Seker D, Sengul D, Sengul I, Cinar E, Soares JM. Anti-thyroid peroxidase antibody in stroke localization: exordium doorway of preliminary findings in thyroidology? REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2024; 70:e20240447. [PMID: 39230146 PMCID: PMC11370745 DOI: 10.1590/1806-9282.20240447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Accepted: 05/20/2024] [Indexed: 09/05/2024]
Abstract
OBJECTIVE Stroke is a chronic health problem that affects all areas of life. The presence of thyroid autoantibodies can augment the severity of stroke. The aim of this work is to investigate whether there is a relationship between the site of stroke involvement and the anti-thyroid peroxidase antibody (anti-TPO) or not. This is the first study in the English-language literature. METHODS A total of 39 patients with a diagnosis of acute ischemic stroke were included, and the cases under 18 years of age with an infection and the ones with autoimmune diseases other than Hashimoto's thyroiditis were excluded from the study design. The patients' age, gender, smoking status, comorbid conditions, and stroke localization in brain imaging were recorded. The region involving the anterior circulation area originating from the internal carotid artery was evaluated as anterior, and the region possessing the vertebrobasilar circulation area from the vertebral arteries was considered posterior involvement. Thyroid-stimulating hormone (TSH), triiodothyronine (T3), thyroxine (T4), triglyceride, high-density lipoprotein (HDL), low-density lipoprotein (LDL), C-reactive protein (CRP), sedimentation, and anti-TPO were retrospectively analyzed. RESULTS As a consequence, gender distribution, smoking, comorbid conditions, TSH, T3, T4, triglyceride, HDL, LDL, CRP, and sedimentation did not differ significantly, while the age of the posterior-located stroke was lower than that of the cases with the anterior. The anti-TPO value was significantly lower in posterior-located strokes than in the anterior system. CONCLUSION In summary, the anti-TPO value was recognized as higher in the anterior stroke localization. Thyroiditis and accompanying anti-TPO autoantibody positivity are conditions that should not be ignored by thyroidologists and thyroid-health providers.
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Affiliation(s)
- Nurce Cilesizoglu Yavuz
- Giresun University, Faculty of Medicine, Department of Physical Medicine and Rehabilitation – Giresun, Turkey
| | - Demet Seker
- Giresun University, Faculty of Medicine, Department of Neurology – Giresun, Turkey
| | - Demet Sengul
- Giresun University, Faculty of Medicine, Department of Pathology – Giresun, Turkey
| | - Ilker Sengul
- Giresun University, Faculty of Medicine, Division of Endocrine Surgery – Giresun, Turkey
- Giresun University, Faculty of Medicine, Department of General Surgery – Giresun, Turkey
| | - Esma Cinar
- Giresun University, Faculty of Medicine, Department of Pathology – Giresun, Turkey
| | - José Maria Soares
- Universidade de São Paulo, Hospital das Clínicas, Faculdade de Medicina, Departamento de Obstetrícia e Ginecologia, Disciplina de Ginecologia, Laboratório de Ginecologia Estrutural e Molecular – São Paulo (SP), Brazil
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123
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Mohammad M, Hartmann JP, Andersen AB, Hartmeyer HL, Iepsen UW, Berg RMG. Test-retest reliability of Doppler ultrasound-based leg blood flow assessments during exercise in patients with chronic obstructive pulmonary disease. Exp Physiol 2024. [PMID: 39223728 DOI: 10.1113/ep092100] [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: 06/07/2024] [Accepted: 08/01/2024] [Indexed: 09/04/2024]
Abstract
Doppler ultrasound may be used to assess leg blood flow (Q ̇ leg ${{\dot{Q}}_{{\mathrm{leg}}}}$ ), but the reliability of this method remains unexplored in patients with chronic obstructive pulmonary disease (COPD), where between-subject variability may be larger than healthy due to peripheral vascular changes. This study aimed to investigate the reliability of Doppler ultrasound in quantifyingQ ̇ leg ${{\dot{Q}}_{{\mathrm{leg}}}}$ during single-leg knee-extensor exercise (KEE) in COPD patients compared with those obtained from healthy matched controls. In this case-control study, 16 participants with COPD were matched based on sex and age with 16 healthy controls. All participants underwent measurement ofQ ̇ leg ${{\dot{Q}}_{{\mathrm{leg}}}}$ using Doppler ultrasound in a KEE set-up at various intensities on two separate visits. Confounding factors onQ ̇ leg ${{\dot{Q}}_{{\mathrm{leg}}}}$ were controlled for, and the ultrasound scans were consistently performed by the same sonographer. During exercise, smallest real difference (SRD) ranged from 367 mL to 583 mL in COPD and 438 mL to 667 mL in the control group. The coefficient of variation (CV) ranged from 7.9% to 14.3% in COPD and 9.4% to 10.4% in the control group. The intraclass correlation coefficient ranged from 0.75 to 0.92 in COPD and 0.67 to 0.84 in the control group. CV was lower in the control group during exercise at 0 W, but apart from that, reliability was not different between groups during exercise. Doppler ultrasound showed nearly equal reliability when evaluatingQ ̇ leg ${{\dot{Q}}_{{\mathrm{leg}}}}$ in COPD patients and healthy individuals with a CV below 15% during exercise for both groups. HIGHLIGHTS: What is the central question of this study? What is the between-day reliability of Doppler ultrasound when quantifying leg blood flow during single-leg knee-extensor exercise in COPD patients compared to healthy matched controls? What is the main finding and its importance? This study demonstrates a coefficient of variation ranging from 7.9 to 14.3% during single-leg knee-extensor exercise for between-day reliability when applying Doppler ultrasound to assess leg blood flow in patients with COPD. Furthermore, it offers insights into the peripheral circulatory constraints in COPD, as evidenced by diminished leg blood flow. This study is the first of its kind to evaluate the reliability of Doppler ultrasound in the assessment of the peripheral circulation during exercise in COPD.
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Affiliation(s)
- Milan Mohammad
- Centre for Physical Activity Research, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Jacob P Hartmann
- Centre for Physical Activity Research, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Amalie B Andersen
- Centre for Physical Activity Research, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Helene L Hartmeyer
- Centre for Physical Activity Research, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Ulrik W Iepsen
- Centre for Physical Activity Research, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Department of Anesthesiology and Intensive Care, Copenhagen University Hospital, Hvidovre Hospital, Copenhagen, Denmark
| | - Ronan M G Berg
- Centre for Physical Activity Research, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Neurovascular Research Laboratory, Faculty of Life Sciences and Education, University of South Wales, Pontypridd, UK
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Silveira ACSL, Zazzetta MS, Orlandi FDS, Pavarini SCI, Santos AAD, Say KG, Jesus ITMD, Gomes GADO, Gratão ACM, Costa-Guarisco LP. Association between participation restriction due to hearing loss and self-perception of health, social support, and quality of life in elderly people: a cross-sectional study. Codas 2024; 36:e20230299. [PMID: 39230181 PMCID: PMC11404837 DOI: 10.1590/2317-1782/20242023299pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 02/19/2024] [Indexed: 09/05/2024] Open
Abstract
PURPOSE To verify the association between participation restriction due to hearing loss and self-perception of health, social support, and quality of life in elderly people. METHODS This is a cross-sectional, observational, and descriptive study with a quantitative data approach. A database with information collected in a medium-sized Brazilian municipality was used. The study was conducted with 235 elderly people registered in five Family Health Strategy Units. Sociodemographic and health information and the results of the following questionnaires were used: Hearing Handicap Inventory for the Elderly - Screening Version (HHIE-S), Medical Outcomes Study (MOS) Social Support Survey, Subjective Health Assessment, and Short-Form 6-Dimension (SF-6D) Health and Quality of Life Index. Groups with and without participation restriction were compared according to sociodemographic, health, social support, and quality of life variables. A multivariate binary logistic regression method was employed to evaluate the associations between the independent variables and participation restriction. RESULTS The group with participation restriction is composed of older individuals with lower quality of life and poorer self-perception of health. Poorer self-perception of health was the only predictor of participation restriction related to hearing loss. CONCLUSION Participation restriction is associated with poorer self-perception of health. The study highlights the importance of assessing individuals' self-perception regarding biopsychosocial issues, in addition to considering the environmental context to understand the social and emotional impacts caused by hearing loss.
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Affiliation(s)
| | - Marisa Silvana Zazzetta
- Departamento de Gerontologia, Universidade Federal de São Carlos - UFSCar - São Carlos (SP), Brasil
| | - Fabiana de Souza Orlandi
- Departamento de Gerontologia, Universidade Federal de São Carlos - UFSCar - São Carlos (SP), Brasil
| | | | | | - Karina Gramani Say
- Departamento de Gerontologia, Universidade Federal de São Carlos - UFSCar - São Carlos (SP), Brasil
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Batista C, Cruz JVR, Stipursky J, de Almeida Mendes F, Pesquero JB. Kinin B 1 receptor and TLR4 interaction in inflammatory response. Inflamm Res 2024; 73:1459-1476. [PMID: 38965133 DOI: 10.1007/s00011-024-01909-1] [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: 03/13/2024] [Revised: 05/27/2024] [Accepted: 06/19/2024] [Indexed: 07/06/2024] Open
Abstract
OBJECTIVE We aimed to broaden our understanding of a potential interaction between B1R and TLR4, considering earlier studies suggesting that lipopolysaccharide (LPS) may trigger B1R stimulation. METHODS We assessed the impact of DBK and LPS on the membrane potential of thoracic aortas from C57BL/6, B1R, or TLR4 knockout mice. Additionally, we examined the staining patterns of these receptors in the thoracic aortas of C57BL/6 and in endothelial cells (HBMEC). RESULTS DBK does not affect the resting membrane potential of aortic rings in C57BL/6 mice, but it hyperpolarizes preparations in B1KO and TLR4KO mice. The hyperpolarization mechanism in B1KO mice involves B2R, and the TLR4KO response is independent of cytoplasmic calcium influx but relies on potassium channels. Conversely, LPS hyperpolarizes thoracic aorta rings in both C57BL/6 and B1KO mice, with the response unaffected by a B1R antagonist. Interestingly, the absence of B1R alters the LPS response to potassium channels. These activities are independent of nitric oxide synthase (NOS). While exposure to DBK and LPS does not alter B1R and TLR4 mRNA expression, treatment with these agonists increases B1R staining in endothelial cells of thoracic aortic rings and modifies the staining pattern of B1R and TLR4 in endothelial cells. Proximity ligation assay suggests a interaction between the receptors. CONCLUSION Our findings provide additional support for a putative connection between B1R and TLR4 signaling. Given the involvement of these receptors and their agonists in inflammation, it suggests that drugs and therapies targeting their effects could be promising therapeutic avenues worth exploring.
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Affiliation(s)
- Carolina Batista
- Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rua César Pernetta, S/N, Prédio do ICB (Anexo ao Bloco F do CCS), 3º andar, sala LJ.03.01, Cidade Universitária, Rio de Janeiro, RJ, CEP: 21941-902, Brazil
- Departamento de Biofísica, Universidade Federal de São Paulo, R. Pedro de Toledo, 669, 9° andar, São Paulo, SP, CEP: 04039-032, Brazil
| | - João Victor Roza Cruz
- Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rua César Pernetta, S/N, Prédio do ICB (Anexo ao Bloco F do CCS), 3º andar, sala LJ.03.01, Cidade Universitária, Rio de Janeiro, RJ, CEP: 21941-902, Brazil
| | - Joice Stipursky
- Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rua César Pernetta, S/N, Prédio do ICB (Anexo ao Bloco F do CCS), 3º andar, sala LJ.03.01, Cidade Universitária, Rio de Janeiro, RJ, CEP: 21941-902, Brazil
| | - Fabio de Almeida Mendes
- Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rua César Pernetta, S/N, Prédio do ICB (Anexo ao Bloco F do CCS), 3º andar, sala LJ.03.01, Cidade Universitária, Rio de Janeiro, RJ, CEP: 21941-902, Brazil.
| | - João Bosco Pesquero
- Departamento de Biofísica, Universidade Federal de São Paulo, R. Pedro de Toledo, 669, 9° andar, São Paulo, SP, CEP: 04039-032, Brazil.
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Heinig S, Aigner T, Bloß HG, Grabenbauer GG. Spinal and cervical nodal metastases in a patient with glioblastoma. Strahlenther Onkol 2024; 200:838-843. [PMID: 38488900 DOI: 10.1007/s00066-024-02214-w] [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: 11/13/2023] [Accepted: 02/04/2024] [Indexed: 03/17/2024]
Abstract
This article presents the rare case of a 54-year-old gentleman with primary glioblastoma developing multiple extracranial metastases 7 months after diagnosis. Initially, the patient complained of progressive headaches, confusion, and weakness of the left arm. Magnetic resonance imaging of the brain showed a right temporoparietal tumor with substantial surrounding subcortical edema and midline shift to the left. Two consecutive craniotomies resulted in complete microsurgical resection of the lesion. Histology was consistent with a World Health Organization grade IV, IDH-wildtype glioblastoma. Further treatment was standard chemoradiation including intensity-modulated radiotherapy with oral temozolomide chemotherapy. Seven months after diagnosis, the cranial lesion progressed, and the patient developed painful metastases in multiple bones and suspicious right-sided cervical lymph nodes. Immunohistochemistry and molecular signature supported the case of a metastatic glioblastoma. Further treatment was palliative radiotherapy of the spinal lesions along with symptomatic pain management. Extracranial metastasis of glioblastoma is a rare complication of which only a few cases have been reported in the literature. Little is known about the precise mechanisms of tumor dissemination and the appropriate treatment.
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Affiliation(s)
- Silvio Heinig
- Department of Radiation Oncology, Coburg Cancer Center, Coburg, Germany
- University of Split School of Medicine, Split, Croatia
| | - Thomas Aigner
- Department of Molecular Pathology, Coburg Cancer Center, Coburg, Germany
| | - Heinz-Georg Bloß
- Department of Neurosurgery, Coburg Cancer Center, Lichtenfels, Germany
| | - Gerhard G Grabenbauer
- Department of Radiation Oncology, Coburg Cancer Center, Coburg, Germany.
- University of Split School of Medicine, Split, Croatia.
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Loh L, Prem-Senthil M, Constable PA. Visual acuity and reading print size requirements in children with vision impairment. Clin Exp Optom 2024; 107:709-715. [PMID: 37952256 DOI: 10.1080/08164622.2023.2279190] [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: 12/19/2022] [Revised: 08/07/2023] [Accepted: 10/30/2023] [Indexed: 11/14/2023] Open
Abstract
CLINICAL RELEVANCE The support of students with a vision impairment throughout education could be enhanced by assessing the functional reading ability of the individual. This visual assessment could inform educators of individualised student needs and potentially improve the academic achievement for these students. BACKGROUND Support for children with a vision impairment within a classroom is typically based on clinical findings of distance visual acuity and visual fields. Therefore, determining optimal print size for reading is essential to ensure best academic outcomes. Secondary aims were to investigate the possible impact of underlying pathology on reading ability. METHODS Forty-seven participants were recruited from a state-wide support service for children with a vision impairment in South Australia. Three visual acuity groups were formed based on World Health Organisation definitions of mild, moderate, and severe vision impairment. Correlation between clinical measures of distance visual acuity using the Freiburg Visual Acuity Test, were compared with reading acuity and critical print size (smallest font before reading speed reduced) using Minnesota low vision reading chart (MNREAD). RESULTS No significant correlations were found for mild (0.20-0.49 logMAR) and severe (1.00-1.52 logMAR) vision impairment groups between distance visual acuity and reading acuity read (p = .64, CI [-.585, .395]/p = .82, CI [-.48, .58]) or critical print size (p = .78, CI [-.57, .45]/p = .43, CI [-.34, .68]. A significant correlation was found for the moderate vision impairment group: 0.50-0.99 logMAR for minimum reading acuity (p < .001, CI [.44, .91]) and critical print size (p = .03, CI [.05, .80]). CONCLUSIONS Standard clinical measures of distance visual acuity are an unpredictable estimate of reading ability in children with mild and severe vision impairment. Additional measures of functional near reading ability could provide a more meaningful indicator of reading ability and help provide optimum support to students through education.
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Affiliation(s)
| | | | - Paul A Constable
- College of Nursing and Health Sciences, Caring Futures Institute, Flinders University, Bedford Park, South Australia, Australia
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128
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Applebaum J, Kim EK, Ewy J, Humphries LA, Shah DK. Operative Time and Accrual of Postoperative Complications in Minimally Invasive Versus Open Myomectomy. J Minim Invasive Gynecol 2024; 31:747-755. [PMID: 38740130 DOI: 10.1016/j.jmig.2024.05.010] [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: 12/09/2023] [Revised: 04/13/2024] [Accepted: 05/08/2024] [Indexed: 05/16/2024]
Abstract
STUDY OBJECTIVE To compare the prevalence and accrual of 30-day postoperative complications by operative time for open myomectomy (OM) and minimally invasive myomectomy (MIM). DESIGN Retrospective cohort study SETTING: Hospitals participating in the National Surgical Quality Improvement Program database from January 2015 to December 2021. PATIENTS Female patients aged ≥18 years undergoing OM or MIM. INTERVENTIONS Patients were categorized into OM and MIM cohorts. Covariates associated with operative time and composite complications were identified using general linear model and chi-square or Fisher's exact test as appropriate. Adjusted spline regression was performed as a test of linearity between operative time and composite complications. Adjusted risk ratios of 30-day postoperative individual, minor, major, and composite complications by 60-minute operative time increments were estimated using Poisson regression with robust error variance. MEASUREMENTS AND MAIN RESULTS Of 27 728 patients, 11 071 underwent MIM and 16 657 underwent OM. Mean operative times (SD) were 164.6 (82.0) for MIM and 129.2 (67.0) for OM. Raw composite complication rates were 5.5% for MIM and 15.8% for OM. Adjusted spline regression demonstrated linearity between operative time and relative risk of composite postoperative complications for both MIM and OM. MIM had higher adjusted relative risk (aRR, 95% CI) compared to OM of blood transfusion (1.55, 1.45-1.64 versus 1.29, 1.25-1.34), overall minor complications (1.13, 1.03-1.23 versus 1.01, 0.92-1.10), and overall major complications (1.43, 1.35-1.51 versus 1.27, 1.12-1.32). Operative time had greater impact on risk of composite complications for MIM than OM, reaching aRR 2.0 at 296 minutes versus 461 minutes for OM. CONCLUSION OM has a higher overall rate of composite, minor, and major complications compared to MIM. While operative time is independently and linearly associated with postoperative complications with myomectomy regardless of approach, optimizing surgical efficiency for MIM may be more critical than for OM.
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Affiliation(s)
- Jeremy Applebaum
- Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania (Drs. Applebaum and Ewy), Philadelphia, Pennsylvania.
| | - Edward K Kim
- Division of Urogynecology, Department of Obstetrics and Gynecology, Brigham and Women's Hospital (Dr. Kim), Boston, Massachusetts
| | - Joshua Ewy
- Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania (Drs. Applebaum and Ewy), Philadelphia, Pennsylvania
| | - Leigh A Humphries
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania (Drs. Humphries and Shah), Philadelphia, Pennsylvania
| | - Divya K Shah
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania (Drs. Humphries and Shah), Philadelphia, Pennsylvania
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De Filippo O, Di Pietro G, Nebiolo M, Ribaldone DG, Gatti M, Bruno F, Gallone G, Armandi A, Birtolo LI, Zullino V, Mennini G, Corradini SG, Mancone M, Bugianesi E, Iannaccone M, De Ferrari GM, D'Ascenzo F. Increased prevalence of high-risk coronary plaques in metabolic dysfunction associated steatotic liver disease patients: A meta-analysis. Eur J Clin Invest 2024; 54:e14188. [PMID: 38396359 DOI: 10.1111/eci.14188] [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: 12/07/2023] [Accepted: 02/15/2024] [Indexed: 02/25/2024]
Abstract
BACKGROUND Metabolic dysfunction associated steatotic liver disease (MASLD) is associated with an increased risk of coronary artery disease. Computed Tomography Coronary Angiography (CTCA) can assess both the extent and the features of coronary plaques. We aimed to gather evidence about the prevalence and features of coronary plaques among MASLD patients. METHODS PubMed, Scopus, and Google Scholar databases were searched for randomized controlled trials and adjusted observational studies assessing the prevalence and features of coronary plaques by means of CTCA in MASLD patients as compared with a control group. The prevalence of coronary stenosis (defined as >30% and >50% diameter of stenosis), of increasing coronary artery calcium (CAC) score and of high-risk features (namely low-attenuation plaques, napkin ring sign, spotty calcification and positive remodelling) in MASLD patients were the endpoints of interest. RESULTS Twenty-four observational studies were included. MASLD was associated with an increased prevalence of critical coronary stenosis compared with controls (odds ratio [OR] 1.54, 95%CI 1.23-1.93). Increased values of CAC score were observed in MASLD patients (OR 1.35, 95%CI 1.02-1.78 and OR 2.26, 95%CI 1.57-3.23 for CAC score 0-100 and >100, respectively). An increased risk of 'high-risk' coronary plaques was observed in MASLD patients (OR 2.13, 95%CI 1.42-3.19). As high-risk features plaques, a higher prevalence of positive remodelling and spotty calcification characterize MASLD patients (OR 2.92, 95%CI 1.79-4.77 and OR 2.96, 95%CI 1.22-7.20). CONCLUSIONS Patients with MASLD are at increased risk of developing critical coronary stenosis and coronary plaques characterized by high-risk features as detected by CTCA.
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Affiliation(s)
- Ovidio De Filippo
- Division of Cardiology, Cardiovascular and Thoracic Department, Città della Salute e della Scienza Hospital, Turin, Italy
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - Gianluca Di Pietro
- Division of Cardiology, Cardiovascular and Thoracic Department, Città della Salute e della Scienza Hospital, Turin, Italy
- Department of Clinical Internal, Anaesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Marco Nebiolo
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - Davide Giuseppe Ribaldone
- Department of Medical Sciences, University of Turin, Turin, Italy
- Division of Gastroenterology and Hepatology, Città della Salute e della Scienza di Torino, Turin, Italy
| | - Marco Gatti
- Radiology Unit, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Francesco Bruno
- Division of Cardiology, Cardiovascular and Thoracic Department, Città della Salute e della Scienza Hospital, Turin, Italy
- Department of Medical Sciences, University of Turin, Turin, Italy
| | | | - Angelo Armandi
- Department of Medical Sciences, University of Turin, Turin, Italy
- Metabolic Liver Disease Research Program, University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Lucia Ilaria Birtolo
- Department of Clinical Internal, Anaesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Veronica Zullino
- Department of General Surgery, Surgical Specialties and Organ Transplantation "Paride Stefanini" Sapienza University of Rome, Rome, Italy
| | - Gianluca Mennini
- Department of General Surgery, Surgical Specialties and Organ Transplantation "Paride Stefanini" Sapienza University of Rome, Rome, Italy
| | | | - Massimo Mancone
- Department of Clinical Internal, Anaesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Elisabetta Bugianesi
- Department of Medical Sciences, University of Turin, Turin, Italy
- Division of Gastroenterology and Hepatology, Città della Salute e della Scienza di Torino, Turin, Italy
| | | | - Gaetano Maria De Ferrari
- Division of Cardiology, Cardiovascular and Thoracic Department, Città della Salute e della Scienza Hospital, Turin, Italy
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - Fabrizio D'Ascenzo
- Division of Cardiology, Cardiovascular and Thoracic Department, Città della Salute e della Scienza Hospital, Turin, Italy
- Department of Medical Sciences, University of Turin, Turin, Italy
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Thanapluetiwong S, Chattaris T, Shi SM, Park CM, Sison SDM, Kim DH. Association between Drug Therapy and Risk of Incident Frailty: A Systematic Review. Ann Geriatr Med Res 2024; 28:247-256. [PMID: 38757259 DOI: 10.4235/agmr.24.0034] [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: 02/07/2024] [Accepted: 05/09/2024] [Indexed: 05/18/2024] Open
Abstract
Medication is a potential factor influencing frailty. However, the relationship between pharmaceutical treatments and frailty remains unclear. Therefore, we conducted the present systematic review to summarize the association between drug therapy and the risk of incident frailty in older adults. We systematically searched the MEDLINE electronic database for articles indexed between January 1, 2000, and December 31, 2021, for randomized controlled trials (RCTs) and cohort studies reporting frailty changes associated with drug therapy. A total of six RCTs and 13 cohort studies involving 211,948 participants were identified, and their treatments were categorized into six medication classes: analgesics, cardiometabolic medication, chemotherapy, central nervous system (CNS)-active medication, hormonal therapy, and nutritional supplements. While the analysis revealed that only CNS-active medications were associated with an elevated risk of frailty, other medication classes also affected frailty; however, this is not conclusively attributable to a class-wide effect.
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Affiliation(s)
- Saran Thanapluetiwong
- Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA, USA
| | - Tanchanok Chattaris
- Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA, USA
| | - Sandra Miao Shi
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA, USA
- Division of Gerontology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Chan Mi Park
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Stephanie Denise M Sison
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA, USA
- Department of Medicine, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Dae Hyun Kim
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA, USA
- Division of Gerontology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
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Spineli-Silva S, Monlleó IL, Félix TM, Gil-da-Silva-Lopes VL, Vieira TP. Overlapping Spectrum of Craniofacial Microsomia Phenotype in Cat-Eye Syndrome. Cleft Palate Craniofac J 2024; 61:1578-1585. [PMID: 37183441 DOI: 10.1177/10556656231174435] [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] [Indexed: 05/16/2023] Open
Abstract
This study reports three patients with Cat-eye Syndrome (CES), two of which present a previous clinical diagnosis of Craniofacial microsomia (CFM). Chromosomal microarray analysis (CMA) revealed a tetrasomy of 1,7 Mb at the 22q11.2q11.21 region, which is the typical region triplicated in the CES, in all patients. The most frequent craniofacial features found in individuals with CFM and CES are preauricular tags and/or pits and mandibular hypoplasia. We reinforce that the candidate genes for CFM features, particularly ear malformation, preauricular tags/pits, and facial asymmetry, can be in the proximal region of the 22q11.2 region.
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Affiliation(s)
- Samira Spineli-Silva
- Laboratory of Human Cytogenetics and Cytogenomics, Department of Translational Medicine, School of Medical Sciences, State University of Campinas (Unicamp), Campinas, São Paulo, Brazil
| | - Isabella L Monlleó
- Faculty of Medicine, Federal University of Alagoas (UFAL), Maceió, Alagoas, Brazil
- Clinical Genetics Service, University Hospital, Federal University of Alagoas (UFAL), Maceió, Alagoas, Brazil
| | - Têmis M Félix
- Medical Genetics Service, Clinical Hospital of Porto Alegre (HCPA), Porto Alegre, Rio Grande do Sul, Brazil
| | - Vera L Gil-da-Silva-Lopes
- Laboratory of Human Cytogenetics and Cytogenomics, Department of Translational Medicine, School of Medical Sciences, State University of Campinas (Unicamp), Campinas, São Paulo, Brazil
| | - Társis P Vieira
- Laboratory of Human Cytogenetics and Cytogenomics, Department of Translational Medicine, School of Medical Sciences, State University of Campinas (Unicamp), Campinas, São Paulo, Brazil
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Mounisha E, Talwar V, Mudgal P. Comparative Efficacy of Intracuff 1% and 2% Alkalinized Lignocaine with Saline on Endotracheal Tube-Induced Hemodynamic Changes and Emergence Phenomena in Neurosurgical Patients. Asian J Neurosurg 2024; 19:354-361. [PMID: 39205904 PMCID: PMC11349405 DOI: 10.1055/s-0043-1760856] [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] [Indexed: 09/04/2024] Open
Abstract
Introduction Extubation is associated with hemodynamic changes and emergence phenomena leading to cough, sore throat, dysphonia, and dysphagia in the postoperative period. The aim of our study was to compare intracuff 2% alkalinized lignocaine with 1% alkalinized lignocaine and saline in reducing endotracheal tube induced emergence phenomena and haemodynamic changes at extubation in neurosurgical patients. Materials and Methods In this randomized controlled study, 90 adult patients of either sex, scheduled to undergo neurosurgical procedures were randomly divided into three groups of 30 each to receive either 1% alkalinized lignocaine (AL1), 2% alkalinized lignocaine (AL2), or saline as cuff inflation media. Intracuff pressures and haemodynamic variables were noted intraoperatively and during emergence. The presence of postextubation cough, sore throat, dysphonia, and dysphagia were monitored until 24 hours postoperatively. Data were analyzed using Chi-square test and ANOVA. A p -value of less than 0.05 was considered significant. Results The intracuff pressures were significantly less with alkalinized lignocaine as compared to saline, after 3 hours of induction. Post extubation, hemodynamic parameters and incidence of coughing and bucking at extubation were significantly less in Groups AL1 ( p = 0.024) and AL2 ( p = 0.02) as compared to saline. On assessment of laryngotracheal morbidity, the incidence of coughing was found to be significantly less with 2% alkalinized lignocaine as compared to saline ( p = 0.021) at 1 hour after extubation. Sore throat was significantly less in Groups AL1 and AL2 as compared with saline at 1 hour ( p = 0.008, 0.002 respectively) and 8 hours ( p = 0.01 in both groups), and in Group AL2 versus saline at 24 hours ( p = 0.044) after extubation. The incidence of dysphonia was significantly less in Groups AL1 and AL2 as compared with saline at 1 hour ( p = 0.016, p = 0.002) and 24 hours ( p = 0.012 in both groups) and in Group AL2 versus saline at 8 hours (p = 0.03) postoperatively. No significant differences were noted between 1% alkalinized lignocaine and 2% alkalinized lignocaine. Conclusion Intracuff alkalinized lignocaine 1% and 2% were significantly better than saline in reducing coughing and bucking at extubation, post extubation haemodynamic changes and incidence of postoperative cough, sore throat, and dysphonia.
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Affiliation(s)
- Elugoti Mounisha
- Department of Anesthesiology and Critical care, Vardhaman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
- Department of Transplant Anesthesia, KIMS Hospitals, Secunderabad, India
| | - Vandana Talwar
- Department of Anesthesiology and Critical care, Vardhaman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Pratibha Mudgal
- Department of Anesthesiology and Critical care, Vardhaman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
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Burke BI, Ismaeel A, McCarthy JJ. The utility of the rodent synergist ablation model in identifying molecular and cellular mechanisms of skeletal muscle hypertrophy. Am J Physiol Cell Physiol 2024; 327:C601-C606. [PMID: 39069822 PMCID: PMC11427019 DOI: 10.1152/ajpcell.00362.2024] [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: 05/29/2024] [Revised: 06/16/2024] [Accepted: 06/17/2024] [Indexed: 07/30/2024]
Abstract
Skeletal muscle exhibits remarkable plasticity to adapt to stimuli such as mechanical loading. The mechanisms that regulate skeletal muscle hypertrophy due to mechanical overload have been thoroughly studied. Remarkably, our understanding of many of the molecular and cellular mechanisms that regulate hypertrophic growth were first identified using the rodent synergist ablation (SA) model and subsequently corroborated in human resistance exercise training studies. To demonstrate the utility of the SA model, we briefly summarize the hypertrophic mechanisms identified using the model and the following translation of these mechanism to human skeletal muscle hypertrophy induced by resistance exercise training.
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Affiliation(s)
- Benjamin I Burke
- Department of Physiology, College of Medicine, University of Kentucky, Lexington, Kentucky, United States
- Center for Muscle Biology, University of Kentucky, Lexington, Kentucky, United States
| | - Ahmed Ismaeel
- Department of Physiology, College of Medicine, University of Kentucky, Lexington, Kentucky, United States
- Center for Muscle Biology, University of Kentucky, Lexington, Kentucky, United States
| | - John J McCarthy
- Department of Physiology, College of Medicine, University of Kentucky, Lexington, Kentucky, United States
- Center for Muscle Biology, University of Kentucky, Lexington, Kentucky, United States
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Venturini E, Ugolini A, Bianchi L, Di Bari M, Paci M. Prevalence of burnout among physiotherapists: a systematic review and meta-analysis. Physiotherapy 2024; 124:164-179. [PMID: 38943718 DOI: 10.1016/j.physio.2024.01.007] [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: 12/29/2022] [Revised: 01/15/2024] [Accepted: 01/23/2024] [Indexed: 07/01/2024]
Abstract
BACKGROUND Work-related burnout is a significant concern amongst healthcare professionals, including physiotherapists. It can negatively impact on both staff well-being and the quality of care delivered to patients. OBJECTIVES To estimate the prevalence of burnout among physiotherapists. DATA SOURCES PubMed, CINAHL, Web of Science, Embase, Scopus and PsycINFO, from inception to February 1st, 2022. STUDY SELECTION OR ELIGIBILITY CRITERIA Studies reporting burnout prevalence among physiotherapists. DATA EXTRACTION AND DATA SYNTHESIS Prevalence of burnout. Sub-analyses were performed grouping studies based on countries where surveys were conducted, classified as developed or developing countries. The risk of bias was assessed using a modified version of the Newcastle-Ottawa Scale. RESULTS 32 studies were included in the systematic review and 31 in the meta-analysis, enrolling a total of 5984 physiotherapists from 17 countries. Pooled prevalence (95% confidence interval) of burnout was 8% (4-15). Prevalence figures for Maslach Burnout Inventory dimensions were: (i) emotional exhaustion, 27% (21-34) (ii) depersonalization, 23% (15-32) (iii) low personal accomplishment, 25% (15-40). Both overall and single components prevalence was higher, although not significantly, in studies from developing than in developed countries. LIMITATIONS Tools used to assess burnout and cut-off scores chosen to identify the burnout prevalence differed across studies. CONCLUSION AND IMPLICATIONS OF KEY FINDINGS Prevalence of burnout reported by physiotherapists appears high worldwide, in particular in developing countries, and compares with that reported by nurses and physicians. Substantial heterogeneity in the prevalence of burnout, in its definition and assessment methods across studies, and limited quality of most studies precludes drawing definitive conclusions. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO CRD42022307876 CONTRIBUTION OF THE PAPER.
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Affiliation(s)
- Enrico Venturini
- Servizio di Assistenza Infermieristico Tecnico e Riabilitativo, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136 Bologna, Italy.
| | | | - Lapo Bianchi
- Unit of Functional Rehabilitation, Azienda USL Toscana Centro, Piazza Martin Luther King 1, Borgo, San Lorenzo, 50032 Florence, Italy.
| | - Mauro Di Bari
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy; Department of Medicine and Geriatrics, Unit of Geriatrics, Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla, 3, 50134 Florence, Italy.
| | - Matteo Paci
- Department of Allied Health Professions, Azienda USL Toscana Centro, via di San Salvi 12, 50135 Florence, Italy.
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Danaei Mehrabad S, Panahi S, Sedghi S, Aryankhesal A. Information and health literacy policies during pandemics: A narrative review. Health Info Libr J 2024; 41:216-234. [PMID: 39101635 DOI: 10.1111/hir.12544] [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: 07/29/2023] [Revised: 06/26/2024] [Accepted: 07/08/2024] [Indexed: 08/06/2024]
Abstract
BACKGROUND The COVID-19 pandemic has compelled governments globally to formulate policies addressing the unique needs of their populations. These policies are critical in disseminating accurate information and enhancing health literacy during crises. OBJECTIVE This narrative review aims to identify and assess effective information and health literacy policies implemented during pandemics. METHODS A comprehensive literature search was performed across five electronic information sources (PubMed, Science Direct, ProQuest, Emerald Insight, Scopus), supplemented by Google Scholar. The analysis employed Walt and Gilson's health policy triangle framework to categorize and evaluate the findings. RESULTS The review revealed that the policies could be grouped into several key categories: educational programs, laws and regulations, knowledge sharing, national programs, and different information sources. The development of these policies involved multifaceted processes influenced by political, scientific, economic, cultural and social factors, as well as the involvement of multiple stakeholders. CONCLUSIONS This review offers significant insights and actionable recommendations for policymakers and stakeholders. By understanding the dimensions and components of effective information and health literacy policies, stakeholders can better prepare for and respond to future pandemics and similar health crises.
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Affiliation(s)
- Shabnam Danaei Mehrabad
- Department of Medical Library and Information Science, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Sirous Panahi
- Department of Medical Library and Information Science, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Shahram Sedghi
- Department of Medical Library and Information Science, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Aidin Aryankhesal
- Department of Health Services Management, School of Health and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
- School of Health Sciences, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK
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Dimli BO, Mutlu EK, Altac DS, Taskiran H. Comparison of the effects of pelvic floor muscle training and modified pilates exercises in elderly women with stress urinary incontinence: A randomized clinical trial. Eur J Obstet Gynecol Reprod Biol 2024; 300:327-336. [PMID: 39084033 DOI: 10.1016/j.ejogrb.2024.07.033] [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: 03/06/2024] [Revised: 05/13/2024] [Accepted: 07/14/2024] [Indexed: 08/02/2024]
Abstract
OBJECTIVE The aim of this study was to compare the effects of pelvic floor muscle training (PFMT) and modified pilates exercises (MPE) in elderly women with stress urinary incontinence (SUI). STUDY DESIGN Both randomized groups [Group 1: PFMT (n = 17), Group 2: MPE (n = 17)] performed their exercises twice a week for 12 weeks. Incontinence Severity Index (ISI), Urogenital Distress Inventory-Short Form (UDI-6) and Incontinence Impact Questionnaire-Short Form (IIQ-7) were used to assess SUI frequency and level of exposure from symptoms, electromyography (EMG) device was used to assess PFM activation response and a stabilizer was used to assess transversus abdominis (TrA) muscle strength. The assessments were performed at baseline and at week 12. RESULTS While in-group assessment there were statistically significant differences in ISI, UDI-6, IIQ-7 in both groups at week 12 (p < 0.05); in the assessment between groups, there were statistically significant difference for EMG-work avarage (U = 60.00, P = 0.02), EMG-work peak (U = 62,50, P = 0.03) and EMG-rest peak (U = 61,50, P = 0.03) in favor of Group 1 and TrA muscle strength (U = 61.00, P = 0.02) in favor of Group 2 from baseline to week 12 (p < 0.05). CONCLUSION In summary, MPE can be considered alternative and safe exercise in clinic for elderly women with SUI who do not want to receive PFMT for various reasons.
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Affiliation(s)
- Berna Okdemir Dimli
- Istanbul Aydin University, Institute of Graduate Education, Division of Physiotherapy and Rehabilitation, Istanbul, Turkey
| | - Ebru Kaya Mutlu
- Bandirma Onyedi Eylul University, Faculty of Health Science, Division of Physiotherapy and Rehabilitation, Bandirma, Turkey
| | - Duygu Sahin Altac
- Halic University, Faculty of Health Science, Division of Physiotherapy and Rehabilitation, Istanbul, Turkey.
| | - Hanifegul Taskiran
- Istanbul Aydin University, Division of Physiotherapy and Rehabilitation, Istanbul, Turkey
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Meng L, Zhao X, Sun Y, Cheng S, Bao L, Fang K, Yu Q, Zheng Y, Wang J, Luo M, Gunderman D, Vuckovic N, Sidhu AS, Li J, Li G, Wolfe JW, Liu Z, Adams DC. Characteristics associated with effectiveness in postoperative delirium research: a systematic review of randomised controlled trials with meta-regression and meta-analysis. Br J Anaesth 2024; 133:565-583. [PMID: 38969535 DOI: 10.1016/j.bja.2024.05.033] [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: 09/15/2023] [Revised: 05/28/2024] [Accepted: 05/30/2024] [Indexed: 07/07/2024] Open
Abstract
BACKGROUND Postoperative delirium remains prevalent despite extensive research through randomised trials aimed at reducing its incidence. Understanding trial characteristics associated with interventions' effectiveness facilitates data interpretation. METHODS Trial characteristics were extracted from eligible trials identified through two systematic literature searches. Multivariable meta-regression was used to investigate trial characteristics associated with effectiveness estimated using odds ratios. Meta-analysis was used to investigate pooled effectiveness. RESULTS We identified 201 eligible trials. Compared with China, trials from the USA/Canada (ratio of odds ratio, 1.89; 95% confidence interval, 1.45-2.45) and Europe/Australia/New Zealand (1.67; 1.29-2.18) had an 89% and 67% higher odds ratio, respectively, suggesting reduced effectiveness. The effectiveness was enhanced when the incidence of postoperative delirium increased (0.85; 0.79-0.92, per 10% increase). Trials with concerns related to deviations from intended interventions reported increased effectiveness compared with those at low risk (0.69; 0.53-0.90). Compared with usual care, certain interventions appeared to have reduced the incidence of postoperative delirium in low-risk trials with low-to-moderate certainty of evidence. However, these findings should be considered inconclusive because of challenges in grouping heterogeneous interventions, the limited number of eligible trials, the prevalence of small-scale studies, and potential publication bias. CONCLUSIONS The effectiveness of postoperative delirium trials varied based on the region of trial origin, the incidence of delirium, and the risk of bias. The limitations caution against drawing definitive conclusions from different bodies of evidence. These findings highlight the imperative need to improve the quality of research on a global scale. SYSTEMATIC REVIEW PROTOCOL PROSPERO (CRD42023413984).
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Affiliation(s)
- Lingzhong Meng
- Department of Anesthesia, Indiana University School of Medicine, Indianapolis, IN, USA.
| | - Xu Zhao
- Department of Anesthesiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yanhua Sun
- Department of Anesthesiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Shufen Cheng
- Department of Anesthesiology, The Fourth Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Lin Bao
- Department of Anesthesiology, Peking University Third Hospital, Beijing, China
| | - Kaiyun Fang
- Department of Anesthesiology, Guizhou Provincial People's Hospital, Guiyang, Guizhou, China
| | - Qiong Yu
- Department of Anesthesiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Yueying Zheng
- Department of Anesthesiology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Jin Wang
- Department of Anesthesiology, The Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Mengqiang Luo
- Department of Anesthesiology, Huashan Hospital, Fudan University, Shanghai, China
| | - David Gunderman
- Indiana University School of Medicine, Indiana University, Indianapolis, IN, USA
| | - Nikola Vuckovic
- Indiana University School of Medicine, Indiana University, Indianapolis, IN, USA
| | - Angad S Sidhu
- Indiana University School of Medicine, Indiana University, Indianapolis, IN, USA
| | - Jian Li
- Department of Anesthesiology, The Fourth Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Gang Li
- Department of Anesthesiology, Peking University Third Hospital, Beijing, China
| | - John W Wolfe
- Department of Anesthesia, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Ziyue Liu
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, IN, USA
| | - David C Adams
- Department of Anesthesia, Indiana University School of Medicine, Indianapolis, IN, USA
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Bozdag A, Gundogan Bozdag P. Evaluation of systemic inflammation markers in patients with Hashimoto's thyroiditis. J Int Med Res 2024; 52:3000605241280049. [PMID: 39301788 PMCID: PMC11418427 DOI: 10.1177/03000605241280049] [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: 05/15/2024] [Accepted: 08/12/2024] [Indexed: 09/22/2024] Open
Abstract
OBJECTIVE To investigate markers of systemic inflammation and the effect of thyroid dysfunction on these parameters in patients with Hashimoto's thyroiditis (HT). METHODS Patients with HT and volunteer healthy individuals admitted to the general surgery outpatient clinic between January 2020 and June 2023 were enrolled into the study. Patients with HT were divided into euthyroid, hypothyroid, and hyperthyroid subgroups. All participant data were retrospectively extracted from the hospital database. RESULTS A total of 268 patients (euthyroid, n = 131; hypothyroid, n = 83; and hyperthyroid, n = 54) and 124 controls were included. The platelet-to-lymphocyte ratio was lower in the euthyroid group versus control group, and the neutrophil-to-lymphocyte ratio was lower in controls than the three patient subgroups. Euthyroid and hypothyroid patients with HT exhibited a higher systemic inflammation index than the control group. The pan-immune inflammation index was lower in controls than in euthyroid, hypothyroid, and hyperthyroid patients with HT. In patients with HT, inflammation markers did not significantly differ between subgroups. CONCLUSIONS Markers of systemic inflammation provide meaningful and reliable information in patients with HT, but do not differentiate between euthyroid, hypothyroid, or hyperthyroid patients.
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Affiliation(s)
- Ahmet Bozdag
- Firat University School of Medicine, Department of General Surgery, Elazig, Turkey
| | - Pinar Gundogan Bozdag
- Health Sciences University, Elazig Fethi Sekin City Hospital, Department of Radiology, Elazig, Turkey
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Rodrigues AR, Oliveira A, Vieira T, Assis R, Lume C, Gonçalves-Pereira J, Fernandes SM. A prolonged intensive care unit stay defines a worse long-term prognosis - Insights from the critically ill mortality by age (Cimba) study. Aust Crit Care 2024; 37:734-739. [PMID: 38649316 DOI: 10.1016/j.aucc.2024.03.001] [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: 07/27/2023] [Revised: 01/11/2024] [Accepted: 03/02/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Patients with critical illness often survive the intensive care unit (ICU) at a cost of prolonged length of stay (LOS) and slow recovery. This chronic critically ill disease may lead to long-term poor outcomes, especially in older or frail patients. OBJECTIVES The main goal of this study was to address the characteristics and outcomes of patients with prolonged ICU LOS. Mainly, short- and long-term admissions were compared to identify risk factors for persistent critical illness and to characterise the impact on ICU, hospital, and long-term mortality. METHODS Subanalysis of a retrospective, multicentric, observational study addressing the 2-year outcome of patients admitted to Portuguese ICUs (the Cimba study). Patients were segregated according to an ICU LOS of ≥14 days. RESULTS Data from 37 118 patients were analysed, featuring a median ICU LOS of 4 days (percentile: 25-75 2-9), and a mortality of 16.1% in the ICU, 24.0% in the hospital, and 38.7% after 2 years. A total of 5334 patients (14.4%) had an ICU LOS of ≥14 days (corresponding to 48.9% of all ICU patients/days). Patients with prolonged LOS were more often younger (52.8% vs 46.4%, were ≤65 years of age , p < 0.001), although more severe (Simplified Acute Physiology Score II: 49.1 ± 16.9 vs 41.8 ± 19.5, p < 0.001), and had higher ICU and hospital mortality (18.3% vs 15.7%, and 31.2 vs 22.8%, respectively). Prolonged ICU LOS was linked to an increased risk of dying during the 2-year follow-up (adjusted Cox proportional hazard: 1.65, p < 0.001). CONCLUSION Prolonged LOS is associated with a long-term impact on patient prognosis. More careful planning of care should incorporate these data.
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Affiliation(s)
- Ana Rita Rodrigues
- Clinica Universitária de Medicina Intensiva, FMUL, Lisbon, Portugal; Intensive Care Department, Hospital St(a) Maria, Lisbon, Portugal
| | - André Oliveira
- Intensive Care Unit, Hospital de Vila Franca Xira, EPE, Portugal
| | - Tatiana Vieira
- Intensive Care Department, Hospital de São João, Porto, Portugal
| | - Rui Assis
- Intensive Care Unit, Centro Hospitalar Médio Tejo, Abrantes, Portugal
| | - Catarina Lume
- Intensive Care Unit, Hospital Nélio Mendonça, Funchal, Portugal
| | - João Gonçalves-Pereira
- Clinica Universitária de Medicina Intensiva, FMUL, Lisbon, Portugal; Intensive Care Unit, Hospital de Vila Franca Xira, EPE, Portugal; Grupo Infeção e Desenvolvimento em Sépsis (GIS-ID), Porto, Portugal
| | - Susana M Fernandes
- Clinica Universitária de Medicina Intensiva, FMUL, Lisbon, Portugal; Intensive Care Department, Hospital St(a) Maria, Lisbon, Portugal; Grupo Infeção e Desenvolvimento em Sépsis (GIS-ID), Porto, Portugal.
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Florido JVB, Caetano MJD, Janducci AL, Sossai MI, Dias ALO, Gramani-Say K, Ansai JH. Effects of a case management-based intervention on non-motor risk factors for falls in older people with history of falls: a randomised clinical trial. Psychogeriatrics 2024; 24:1111-1119. [PMID: 39039430 DOI: 10.1111/psyg.13167] [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: 03/06/2024] [Revised: 06/05/2024] [Accepted: 07/08/2024] [Indexed: 07/24/2024]
Abstract
BACKGROUND Falls are directly related to morbidity and mortality of older people. Multifactorial approaches that are individualised and based on fall risk factors are necessary. This study aims to verify the effects of a case management-based intervention on non-motor risk factors for falls in community-dwelling older people with a history of falls. METHODS The intervention applied a multidimensional assessment of risk factors for falls, a discussion about the identified risk factors, the preparation of an individualised plan with the participant, and the application, monitoring and review of the plan. RESULTS There was a significant interaction between groups and assessments only in the visuospatial domain (P = 0.031). After simple main effects analysis, differences between groups and assessments were not significant, although there was a tendency of worse visuospatial performance in the control group in the follow-up assessment (P = 0.099). There were no significant differences between groups or between assessments in other variables. CONCLUSION The intervention has the potential to maintain non-motor risk factors for falls in community-dwelling older people with a history of falls. However, more clinical trials are needed to prove its effects.
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141
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Al Mawaali Z, Abdelrahman H, Al Qadire M, Ballad CAC, Al Busafi S, Al Busaidi B, Al Mahari F, Al Balushi M, Al Rawahi I, Al Omari O, Almaawali M, Khalaf A. Prevalence of Anxiety, Depression, and Sleep Disturbance Among Emergency Nurses in Oman. J Emerg Nurs 2024; 50:635-643. [PMID: 38483424 DOI: 10.1016/j.jen.2024.02.004] [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: 09/17/2023] [Revised: 02/04/2024] [Accepted: 02/09/2024] [Indexed: 08/24/2024]
Abstract
INTRODUCTION Anxiety, depression, and sleep disturbances among accident and emergency nurses not only harm their well-being but also affect patient care and organizational outcomes. This study examines anxiety, depression, and sleep prevalence and associations among accident and emergency nurses. METHODS We conducted a cross-sectional correlational survey with 331 accident and emergency nurses in 12 Omani governmental hospitals. RESULTS Results showed that 28.7% of accident and emergency nurses reported symptoms indicative of anxiety, with 13.6% experiencing symptoms of depression, 16.6% reporting mild sleep disturbances, and 1.5% experiencing moderate disturbance. Those with symptoms of anxiety (r = 0.183, P = .001) or depression (r = 0.152, P = .005) were more likely to experience sleep disturbances. Being single (t [170.7] = 2.5, P = .015), childless (t [169.7] = -2.807, P = .008), Omani (t [215] = 7.201, P < .001), younger (r = -0.375, P < .001) and having less clinical experience (t [329] = 4.6, P < .001) were associated with a higher anxiety score. For depression, being of Omani nationality (t [215] = 7.201, P < .001), having less than 10 years of experience (t [329] = 3.2, P = .002), and being of younger age (r = -0.285, P < .001) were associated with a higher score. DISCUSSION Accident and emergency nurses commonly experience anxiety, depression, and sleep disturbances. Implementing interventions to promote their mental well-being or manage these issues is crucial. Organizational support is vital for ensuring their mental health, and individual-level interventions may also prove beneficial.
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Martín-Miguel MV, Delgado-Martín MV, Barreiro-Arceiz C, Goicoechea-Castaño A, Rodríguez-Pastoriza S, González-Formoso C, Fernández-Pérez M, García-Cendón C, Roca J, Clavería A. BODYFAT: a new calculator to determine the risk of being overweight validated in Spanish children between 11 and 17 years of age. Eur J Pediatr 2024; 183:3885-3895. [PMID: 38896274 PMCID: PMC11322224 DOI: 10.1007/s00431-024-05596-2] [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: 02/03/2024] [Revised: 04/27/2024] [Accepted: 05/02/2024] [Indexed: 06/21/2024]
Abstract
The assessment of body fat of children in primary care requires consideration of the dynamic changes in height, weight, lean mass, and fat mass during childhood growth. To achieve this, we aim to develop a predictive equation based on anthropometric values, with optimal diagnostic utility. This is a cross-sectional observational study, involving schoolgoers aged 11-17 years in the Vigo metropolitan area. Out of 10,747 individuals, 577 were randomly recruited. VARIABLES age, sex, ethnicity/country of origin, weight, height, 8 skinfolds, 3 diameters, 7 perimeters, and 85% percentile of body fat mass as the gold standard. Generalized additive regression was selected by cross-validation and compared using receiver operating characteristic curves (ROC curves). Sensitivity, specificity, positive and negative predictive values, true positive and true negative values, false positive and false negative values, accuracy, and positive and negative likelihood ratios were calculated. Two models were identified. The optimal model includes sex, weight, height, leg perimeter, and arm perimeter, with sensitivity of 0.93 (0.83-1.00), specificity of 0.91 (0.83-0.96), accuracy of 0.91 (0.84-0.96), and area under the curve (AUC) of 0.957 (0.928-0.986). The second model includes sex, age, and body mass index, with sensitivity of 0.93 (0.81-1.00), specificity of 0.90 (0.80-0.97), accuracy of 0.90 (0.82-0.96), and an AUC of 0.944 (0.903-0.984). CONCLUSION Two predictive models, with the 85th percentile of fat mass as the gold standard, built with basic anthropometric measures, show very high diagnostic utility parameters. Their calculation is facilitated by a complementary online calculator. WHAT IS KNOWN • In routine clinical practice, mainly in primary care, BMI is used to determine overweight and obesity. This index has its weaknesses in the assessment of children. WHAT IS NEW • We provide a calculator whose validated algorithm, through the determination of fat mass by impedanciometry, makes it possible to determine the risk of overweight and obesity in the community setting, through anthropometric measurements, providing a new practical, accessible and reliable model that improves the classification of overweight and obesity in children with respect to that obtained by determining BMI.
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Affiliation(s)
- María Victoria Martín-Miguel
- Vigo Family and Community Medicine and Nursing Teaching Unit, Health Area of Vigo, SERGAS, Vigo, Spain
- I-Saúde Group, South Galicia Health Research Institute (Instituto de Investigación Sanitaria Galicia Sur), SERGAS-UVIGO, Vigo, Spain
- Research Netwpork in Chronicity, Primary Care and Health Promotion (Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud/RICAPPS), Vigo, Spain
| | - María Victoria Delgado-Martín
- Moaña Health Center, SERGAS, Vigo Area, Vigo, Spain.
- I-Saúde Group, South Galicia Health Research Institute (Instituto de Investigación Sanitaria Galicia Sur), SERGAS-UVIGO, Vigo, Spain.
- Research Netwpork in Chronicity, Primary Care and Health Promotion (Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud/RICAPPS), Vigo, Spain.
| | | | - Ana Goicoechea-Castaño
- Sárdoma Health Center, SERGAS, Vigo Area, Vigo, Spain
- I-Saúde Group, South Galicia Health Research Institute (Instituto de Investigación Sanitaria Galicia Sur), SERGAS-UVIGO, Vigo, Spain
| | - Sara Rodríguez-Pastoriza
- I-Saúde Group, South Galicia Health Research Institute (Instituto de Investigación Sanitaria Galicia Sur), SERGAS-UVIGO, Vigo, Spain
| | - Clara González-Formoso
- I-Saúde Group, South Galicia Health Research Institute (Instituto de Investigación Sanitaria Galicia Sur), SERGAS-UVIGO, Vigo, Spain
- Ponteareas Health Center, SERGAS, Vigo Area, Vigo, Spain
- Research Netwpork in Chronicity, Primary Care and Health Promotion (Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud/RICAPPS), Vigo, Spain
| | - Martín Fernández-Pérez
- I-Saúde Group, South Galicia Health Research Institute (Instituto de Investigación Sanitaria Galicia Sur), SERGAS-UVIGO, Vigo, Spain
| | - Clara García-Cendón
- I-Saúde Group, South Galicia Health Research Institute (Instituto de Investigación Sanitaria Galicia Sur), SERGAS-UVIGO, Vigo, Spain
- Val Miñor Health Center, SERGAS, Vigo Area, Vigo, Spain
| | - Javier Roca
- Galician Research and Mathematical Technology Center (Centro de Investigación e Tecnoloxía Matemática de Galicia/CITMAga) & Department of Statistics and Operations Research, University of Vigo, Vigo, Spain
- Research Netwpork in Chronicity, Primary Care and Health Promotion (Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud/RICAPPS), Vigo, Spain
| | - Ana Clavería
- I-Saúde Group, South Galicia Health Research Institute (Instituto de Investigación Sanitaria Galicia Sur), SERGAS-UVIGO, Vigo, Spain
- Research Netwpork in Chronicity, Primary Care and Health Promotion (Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud/RICAPPS), Vigo, Spain
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Oliveira MRE, Modolo NSP, Nascimento P, Lima RM, Stirling D, Mizubuti GB, Silva LMD, Navarro LH. Effectiveness of intracuff alkalinized lidocaine associated with intravenous dexamethasone in reducing laryngotracheal morbidity in children undergoing general anesthesia for tonsillectomy: a randomized controlled trial. BRAZILIAN JOURNAL OF ANESTHESIOLOGY (ELSEVIER) 2024; 74:844548. [PMID: 39103017 PMCID: PMC11364003 DOI: 10.1016/j.bjane.2024.844548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 07/25/2024] [Accepted: 07/27/2024] [Indexed: 08/07/2024]
Abstract
BACKGROUND Postoperative sore throat is one of the main postoperative complaints in patients undergoing tonsillectomy. As the primary outcome, we aimed to determine whether endotracheal tube cuffs filled with alkalinized lidocaine are associated with a lower incidence of postoperative sore throat and anesthesia emergence phenomena in children undergoing tonsillectomy or adenotonsillectomy. We also assessed the potential additional benefits of IV dexamethasone in reducing postoperative laryngotracheal morbidity. METHODS This is a clinical prospective, randomized, controlled trial. Patients were randomly allocated to one of four groups, as follows: air - endotracheal tube cuff filled with air; air/dex - endotracheal tube cuff filled with air and intravenous dexamethasone; lido - endotracheal tube cuff filled with alkalinized lidocaine; and lido/dex - endotracheal tube cuff filled with alkalinized lidocaine and intravenous dexamethasone. Perioperative hemodynamic parameters and the incidence of postoperative nausea and vomiting, coughing and hoarseness were recorded. Postoperative sore throat was assessed in the postanesthetic care unit and 24 hours post tracheal extubation. RESULTS In total, 154 children aged 4-12 years, ASA physical status I or II, undergoing general anesthesia for elective tonsillectomy and adenotonsillectomy, were assessed for postoperative sore throat in this study. The incidence of postoperative sore throat 24 hours after tracheal extubation was significantly lower in the lido/dex group compared to groups air and air/dex (p = 0.01). However, no additional reduction in these symptoms was observed from the intravenous administration of dexamethasone when comparing the lido and lido/dex groups. Similarly, there were no differences among groups regarding perioperative hemodynamic variables or postoperative nausea and vomiting, coughing, and hoarseness during the study period. CONCLUSION Intracuff alkalinized lidocaine, associated with intravenous dexamethasone, might be effective in reducing sore throat 24 hours post-tonsillectomy or adenotonsillectomy in children when compared to the use of air as the cuff insufflation media.
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Affiliation(s)
- Morenna Ramos E Oliveira
- Universidade Estadual Paulista (UNESP), Faculdade de Medicina de Botucatu, Departamento de Anestesiologia, São Paulo, SP, Brazil.
| | - Norma S P Modolo
- Universidade Estadual Paulista (UNESP), Faculdade de Medicina de Botucatu, Departamento de Anestesiologia, São Paulo, SP, Brazil
| | - Paulo Nascimento
- Universidade Estadual Paulista (UNESP), Faculdade de Medicina de Botucatu, Departamento de Anestesiologia, São Paulo, SP, Brazil
| | - Rodrigo M Lima
- University of Manitoba, Department of Anesthesiology, Perioperative and Pain Medicine, Winnipeg, MB, Canada
| | - Devin Stirling
- Queen's University, Department of Anesthesiology and Perioperative Medicine, Kingston, ON, Canada
| | - Glenio B Mizubuti
- Queen's University, Department of Anesthesiology and Perioperative Medicine, Kingston, ON, Canada
| | - Leopoldo Muniz da Silva
- Hospital São Luiz, Departamento de Anestesiologia, Equipe de Anestesia do CMA, São Paulo, SP, Brazil
| | - Lais H Navarro
- Universidade Estadual Paulista (UNESP), Faculdade de Medicina de Botucatu, Departamento de Anestesiologia, São Paulo, SP, Brazil; University of Manitoba, Department of Anesthesiology, Perioperative and Pain Medicine, Winnipeg, MB, Canada
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Roberts MD, Hornberger TA, Phillips SM. The utility-and limitations-of the rodent synergist ablation model in examining mechanisms of skeletal muscle hypertrophy. Am J Physiol Cell Physiol 2024; 327:C607-C613. [PMID: 39069828 PMCID: PMC11427104 DOI: 10.1152/ajpcell.00405.2024] [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: 06/14/2024] [Accepted: 06/27/2024] [Indexed: 07/30/2024]
Abstract
In this issue, Burke et al. discuss the utility of the rodent synergist ablation (SA) model for examining mechanisms associated with skeletal muscle hypertrophy. In this invited perspective, we aim to complement their original perspective by discussing limitations to the model along with alternative mechanical overload models that have strengths and limitations.
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Affiliation(s)
- Michael D Roberts
- School of Kinesiology, Auburn University, Auburn, Alabama, United States
| | - Troy A Hornberger
- Department of Comparative Biosciences, University of Wisconsin-Madison, Madison, Wisconsin, United States
| | - Stuart M Phillips
- Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
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Carrillo MN, Garribia M, Armando L, Adeoye AO, Garcia NH, Muñoz SE. Adherence to Dietary Patterns and Cardiovascular Disease Risk: A Cross-Sectional Study of Total Carotid Plaque Area in Argentina. J Lipid Atheroscler 2024; 13:338-347. [PMID: 39355400 PMCID: PMC11439755 DOI: 10.12997/jla.2024.13.3.338] [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: 12/13/2023] [Revised: 01/27/2024] [Accepted: 06/22/2024] [Indexed: 10/03/2024] Open
Abstract
Objective Assessing subclinical atherosclerosis (sAT) is crucial for preventing cardiovascular disease. The Mediterranean diet is considered the gold standard for cardiovascular protection, but cultural and economic barriers can hinder adherence to it. The prudent dietary pattern (DP) has been associated with protective effects against chronic diseases. However, its impact on primary cardiovascular prevention remains uncertain. This study examined adherence to various DPs and their effect on sAT, measured by total carotid plaque area (TPA). Methods This cross-sectional study included 116 adults enrolled in a cardiovascular prevention program. Demographic, clinical, laboratory, and TPA data were collected. Adherence to DPs was assessed using a food frequency questionnaire. Participants were categorized according to their adherence to 4 mutually exclusive DPs: prudent, traditional, sweet, and mixed. Generalized linear models were used to assess the effect of DPs on TPA, adjusting for relevant cardiovascular variables. Results The traditional, sweet, and mixed DPs were associated with higher TPA values than the prudent DP, with medians (interquartile range) of 27 (99), 39 (49), 27.5 (58), and 0 (36) mm2, respectively. Gamma regression analysis found that the beta exponents for the traditional, sweet, and mixed DPs versus the prudent DP were 3.78 (p=0.046); 3.73 (p=0.013), and 2.20 (p=0.072), respectively. Systolic blood pressure values were higher for the sweet and mixed DPs than for the prudent DP (133.9±11.7; 132.5±13.9 and 122.7±8.8 mmHg, respectively; p<0.05). Conclusion These findings underscore the importance of additional research and targeted interventions to promote healthier DPs to promote improvements in cardiovascular health.
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Affiliation(s)
- Mariana N Carrillo
- Instituto de Investigaciones en Ciencias de la Salud (INICSA) CONICET-UNC, Universidad Nacional de Córdoba, Córdoba, Argentina
| | | | | | - Akinwunmi Oluwaseun Adeoye
- Instituto de Investigaciones en Ciencias de la Salud (INICSA) CONICET-UNC, Universidad Nacional de Córdoba, Córdoba, Argentina
- Department of Biochemistry, Federal University Oye-Ekiti, Oye-Ekiti, Nigeria
| | - Nestor H Garcia
- Instituto de Investigaciones en Ciencias de la Salud (INICSA) CONICET-UNC, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Sonia E Muñoz
- Instituto de Investigaciones en Ciencias de la Salud (INICSA) CONICET-UNC, Universidad Nacional de Córdoba, Córdoba, Argentina
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146
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Zvrko E, Popović N, Radunović M, Nikolić G. Motivational Factors Influencing the Choice of Medical Studies and Future Career Plans among Montenegrin Students. Zdr Varst 2024; 63:132-141. [PMID: 38881636 PMCID: PMC11178028 DOI: 10.2478/sjph-2024-0018] [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: 03/05/2024] [Accepted: 05/13/2024] [Indexed: 06/18/2024] Open
Abstract
Introduction There is a concerning trend of emigration among highly educated individuals in Montenegro. This includes medical professionals who seek better job opportunities abroad. The aim of the present study was to identify the primary motivational factors driving Montenegrin medical students to pursue a career in medicine, and whether these factors undergo changes over the course of their studies. Methods A cross-sectional study included 210 medical students in Montenegro, 27.62% were males, and 72.38% were females. The mean age of the students was 21.90 years (SD=3.05) (range 19-39). Their academic motivation was analysed using the Academic Motivation Scale, previously validated in various cultural contexts. Results The results showed that autonomous motivation levels were higher than controlled motivation levels (p<0.001) among students in Montenegro, which has been previously associated with better learning outcomes. Students with medical doctors among their family members had higher extrinsic motivation related to rewards and punishments (extrinsic motivation with external regulation p=0.018). Amotivation showed a trend of increasing as the students got closer to graduation (p=0.057). Only 8.1% of students planned a career in primary healthcare, and 1% wished to specialize in family medicine. Conclusions This study's findings, which indicate high levels of autonomous motivation among medical students, are of significant importance. They contribute to a comprehensive understanding of the motivation factors among medical students and young healthcare professionals in Montenegro. Moreover, they provide a basis for the implementation of strategic interventions to retain highly skilled medical professionals within the country's workforce, thereby addressing the concerning trend of emigration among this group.
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Affiliation(s)
- Elvir Zvrko
- Department of Otorhinolaryngology, Clinical Center of Montenegro, Ljubljanska bb, 81000 Podgorica, Montenegro
- Faculty of Medicine, University of Montenegro, Kruševac bb, 81000 Podgorica, Montenegro
| | - Nataša Popović
- Faculty of Medicine, University of Montenegro, Kruševac bb, 81000 Podgorica, Montenegro
| | - Miodrag Radunović
- Faculty of Medicine, University of Montenegro, Kruševac bb, 81000 Podgorica, Montenegro
| | - Goran Nikolić
- Montenegrin Academy of Science and Arts, Rista Stijovića 5, 81000 Podgorica, Montenegro
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147
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Pournajaf S, Damiani C, Agostini F, Morone G, Proietti S, Casale R, Franceschini M, Goffredo M. Identifying discriminant factors between phantom limb pain, residual limb pain, and both in people with lower limb amputations: a cross-sectional study. Int J Rehabil Res 2024; 47:214-220. [PMID: 38995163 PMCID: PMC11424063 DOI: 10.1097/mrr.0000000000000634] [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: 07/13/2024]
Abstract
Postamputation pain is a common condition in patients with lower limb amputation (LLA), which compromises amputees' rehabilitation, use of the prosthesis, and quality of life. The aim of our study was to investigate the prevalence of phantom limb pain (PLP), residual limb pain (RLP), or both types of pain among individuals with LLA, and to identify the factors associated with the presence of one type of pain versus the other. Patients who underwent amputation for traumatic or vascular reasons and who reported on RLP or PLP were analyzed and divided into three groups: PLP, RLP, or a group of subjects that presented both pains. We searched for factors that affect the occurrence of limb pain using univariate analyses, followed by multinomial logistic regression. Among the 282 participants with transtibial and transfemoral amputations, 192 participants (150 male and 42 female) presented PLP, RLP, or both types of pain, while 90 participants declared to perceive no pain. The estimated prevalence of any type of pain after transfemoral and transtibial amputation was therefore 68% (27% PLP, 10% RLP, and 31% both). Among the studied characteristics, only amputation level was associated with the type of pain ( P = 0.001). Multinomial logistic regression identified transfemoral amputation as the only statistically significant predictor for PLP (odds ratio = 2.8; P = 0.002). Hence, it was estimated that individuals with transfemoral amputation have nearly three times higher odds of experiencing PLP compared with those with transtibial amputation.
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Affiliation(s)
- Sanaz Pournajaf
- Research Area in Neuromotor Rehabilitation and Rehabilitation Robotics, Department of Neurosciences, IRCCS San Raffaele
| | - Carlo Damiani
- Research Area in Neuromotor Rehabilitation and Rehabilitation Robotics, Department of Neurosciences, IRCCS San Raffaele
| | - Francesco Agostini
- Research Area in Neuromotor Rehabilitation and Rehabilitation Robotics, Department of Neurosciences, IRCCS San Raffaele
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University of Rome, Rome
| | - Giovanni Morone
- Department of Life, Health and Environmental Sciences, University of L'Aquila, Aquila
- San Raffaele Institute of Sulmona, Sulmona
| | - Stefania Proietti
- Research Area in Neuromotor Rehabilitation and Rehabilitation Robotics, Department of Neurosciences, IRCCS San Raffaele
| | | | - Marco Franceschini
- Research Area in Neuromotor Rehabilitation and Rehabilitation Robotics, Department of Neurosciences, IRCCS San Raffaele
| | - Michela Goffredo
- Research Area in Neuromotor Rehabilitation and Rehabilitation Robotics, Department of Neurosciences, IRCCS San Raffaele
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Open University, Rome, Italy
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148
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Vafaeipour Z, Imenshahidi M, Mohammadpour AH, Taghdisi SM, Danesh NM, Moshiri M, Jafarian AH, Abnous K. Evaluation of the Protective Effects of Lugol's Solution in Rats Poisoned with Aluminum Phosphide (Rice Tablets). Cardiovasc Toxicol 2024; 24:955-967. [PMID: 38990500 DOI: 10.1007/s12012-024-09890-1] [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: 11/02/2023] [Accepted: 07/01/2024] [Indexed: 07/12/2024]
Abstract
Aluminum phosphide (AlP) is the main component of rice tablets (a pesticide), which produces phosphine gas (PH3) when exposed to stomach acid. The most important symptoms of PH3 toxicity include, lethargy, tachycardia, hypotension, and cardiac shock. It was shown that Iodine can chemically react with PH3, and the purpose of this study is to investigate the protective effects of Lugol solution in poisoning with rice tablets. Five doses (12, 15, 21, 23, and 25 mg/kg) of AlP were selected, for calculating its lethal dose (LD50). Then, the rats were divided into 4 groups: AlP, Lugol, AlP + Lugol, and Almond oil (as a control). After 4 h, the blood pressure and electrocardiogram (ECG) were recorded, and blood samples were obtained for biochemical tests, then liver, lung, kidney, heart, and brain tissues were removed for histopathological examination. The results of the blood pressure showed no significant changes (P > 0.05). In ECG, the PR interval showed a significant decrease in the AlP + Lugol group (P < 0.05). In biochemical tests, LDH, Ca2+, Creatinine, ALP, Mg2+, and K+ represented significant decreases in AlP + Lugol compared to the AlP group (P < 0.05). Also, the administration of Lugol's solution to AlP-poisoned rats resulted in a significant decrease in malondialdehyde levels and a significant increase in catalase activity (P < 0.05). Histopathological evaluation indicates that Lugol improves changes in the lungs, kidneys, brain, and heart. Our results showed that the Lugol solution could reduce tissue damage and oxidative stress in AlP-poisoned rats. We assume that the positive effects of Lugol on pulmonary and cardiac tissues are due to its ability to react directly with PH3.
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Affiliation(s)
- Zeinab Vafaeipour
- Department of Pharmacodynamics and Toxicology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, 9177948954, Iran
| | - Mohsen Imenshahidi
- Department of Pharmacodynamics and Toxicology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, 9177948954, Iran
- Pharmaceutical Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amir Hooshang Mohammadpour
- Department of Clinical Pharmacy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyed Mohammad Taghdisi
- Targeted Drug Delivery Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Pharmaceutical Biotechnology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Mohammad Moshiri
- Medical Toxicology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amir Hossein Jafarian
- Cancer and Molecular Research Center, Department of Pathology, Ghaem Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Khalil Abnous
- Pharmaceutical Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran.
- Department of Medicinal Chemistry, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.
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149
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Serra M, Simola N, Pollack AE, Costa G. Brain dysfunctions and neurotoxicity induced by psychostimulants in experimental models and humans: an overview of recent findings. Neural Regen Res 2024; 19:1908-1918. [PMID: 38227515 DOI: 10.4103/1673-5374.390971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 11/10/2023] [Indexed: 01/17/2024] Open
Abstract
Preclinical and clinical studies indicate that psychostimulants, in addition to having abuse potential, may elicit brain dysfunctions and/or neurotoxic effects. Central toxicity induced by psychostimulants may pose serious health risks since the recreational use of these substances is on the rise among young people and adults. The present review provides an overview of recent research, conducted between 2018 and 2023, focusing on brain dysfunctions and neurotoxic effects elicited in experimental models and humans by amphetamine, cocaine, methamphetamine, 3,4-methylenedioxymethamphetamine, methylphenidate, caffeine, and nicotine. Detailed elucidation of factors and mechanisms that underlie psychostimulant-induced brain dysfunction and neurotoxicity is crucial for understanding the acute and enduring noxious brain effects that may occur in individuals who use psychostimulants for recreational and/or therapeutic purposes.
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Affiliation(s)
- Marcello Serra
- Department of Biomedical Sciences, Section of Neuroscience, University of Cagliari, Cagliari, Italy
| | - Nicola Simola
- Department of Biomedical Sciences, Section of Neuroscience, University of Cagliari, Cagliari, Italy
| | - Alexia E Pollack
- Department of Biology, University of Massachusetts-Boston, Boston, MA, USA
| | - Giulia Costa
- Department of Biomedical Sciences, Section of Neuroscience, University of Cagliari, Cagliari, Italy
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150
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Liu C, Zhu Q, Zhang H, Wang Z. Gastrointestinal bleeding caused by splenic artery pseudoaneurysm in chronic pancreatitis: a case report and literature review. J Surg Case Rep 2024; 2024:rjae574. [PMID: 39280021 PMCID: PMC11393571 DOI: 10.1093/jscr/rjae574] [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: 07/11/2024] [Accepted: 08/24/2024] [Indexed: 09/18/2024] Open
Abstract
Pseudoaneurysm of the splenic artery is a rare vascular complication of chronic pancreatitis, with a high mortality rate. Haemorrhage and abdominal pain are the most common manifestations, and so far there are no literature reviews on the rare complication of splenic artery pseudoaneurysm due to chronic pancreatitis. Therefore, we describe a male patient with worsening haemochezia and upper abdominal pain, who had been hospitalized repeatedly for 'pancreatitis' 1 year ago, and relevant investigations confirmed a pseudoaneurysm of the splenic artery, which was successfully treated by transarterial embolization, and a literature review is also presented.
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Affiliation(s)
- Chenyao Liu
- Department of Gastroenterology, Southwest Medical University, Luzhou, Sichuan Province 646000, China
| | - Qingliang Zhu
- Department of Gastroenterology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan Province 646000, China
| | - Hailong Zhang
- Department of Gastroenterology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan Province 646000, China
| | - Zhongqiong Wang
- Department of Gastroenterology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan Province 646000, China
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