1
|
Aldhahi MI, Baattaiah BA, Alharbi MD, Alotaibi M, Nazer R, Albarrati A. Multifaceted associations between walking performance, physical fitness, extremity function, health status, and depression in individuals with COPD. Ann Med 2024; 56:2338248. [PMID: 38590164 PMCID: PMC11005873 DOI: 10.1080/07853890.2024.2338248] [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: 10/18/2023] [Accepted: 03/06/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND/OBJECTIVE(S) Chronic obstructive pulmonary disease (COPD) can precipitate a deterioration of an individual's physical performance and overall health. Evidence suggests that, along with pulmonary functions, several other factors are related to the significant impairment of walking performance in individuals with COPD. This study compared the depressive symptoms, health status, upper and lower extremity functions, and peak oxygen uptake (VO2peak) in a group of individuals with COPD based on walking performance using a cutoff distance of 350 m in the six-minute walking test (6MWT). The study also investigated the associations between these factors and walking performance. MATERIALS AND METHODS Participants performed the 6MWT according to the guidelines and were classified into high (>350 m; n = 40) or low (<350 m; n = 30) walking performance groups according to distance. The forced expiratory volume (FEV1), forced vital capacity (FVC), and FEV1/FVC ratio were recorded. Participants completed the Patient Health Questionnaire-9 (PHQ-9), St. George's Respiratory Questionnaire (SGRQ), and the Upper and Lower Extremity Functional Index (UEFI/LEFI). Predicted VO2peak was measured using the Duke Activity Status Index (DASI). RESULTS Seventy participants with a mean age of 63 ± 11 years (20% female) were enrolled in this study. Patients with high walking performance demonstrated significantly better health status than those with low walking performance (SGRQ: 49 ± 25 vs. 56 ± 21, p = 0.03). Participants with low walking performance had lower predicted VO2peak compared to their higher performing counterparts (p = 0.002). The overall model was significant (F(8, 61) = 7.48, p = 0.0006), with PHQ-9, SGRQ, UEFI/LEFI, VO2peak, and FEV1/FVC explaining approximately 49.5% of the variance in the 6MWT distance. CONCLUSION This study shed light on the association of depressive symptoms, health status, extremity function, and VO2peak with walking performance, providing valuable insights that may impact the management and care of individuals with COPD.
Collapse
Affiliation(s)
- Monira I. Aldhahi
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Baian A. Baattaiah
- Department of Physical Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mutasim D. Alharbi
- Department of Physical Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mansour Alotaibi
- Department of Rehabilitation, Faculty of Applied Medical Sciences, Northern Border University, Arar, Saudi Arabia
| | - Rakan Nazer
- Cardiac Sciences Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Ali Albarrati
- Rehabilitation Sciences Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| |
Collapse
|
2
|
Marko M, Singh N, Ospel JM, Uchida K, Almekhlafi MA, Demchuk AM, Nogueira RG, McTaggart RA, Poppe AY, Rempel JL, Tymianski M, Hill MD, Goyal M, Menon BK. Symptomatic Non-stenotic Carotid Disease in Embolic Stroke of Undetermined Source : Analysis of the ESCAPE-NA1 Trial. Clin Neuroradiol 2024; 34:333-339. [PMID: 38108829 PMCID: PMC11130033 DOI: 10.1007/s00062-023-01365-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 11/09/2023] [Indexed: 12/19/2023]
Abstract
PURPOSE Non-stenotic (< 50%) carotid disease may play an important etiological role in ischemic stroke classified as embolic stroke of undetermined source (ESUS). We aimed to assess the prevalence of non-stenotic carotid disease and its association with ipsilateral ischemic stroke. METHODS Data are from ESCAPE-NA1, a randomized controlled trial investigating the neuroprotectant nerinetide in patients with acute ischemic stroke and large vessel occlusion (LVO). The degree of stenosis of the extracranial internal carotid artery (ICA) and high-risk plaque features were assessed on baseline computed tomography (CT) angiography. We evaluated the association of non-stenotic carotid disease and ipsilateral stroke by age-adjusted and sex-adjusted logistic regression and calculated the attributable risk of ipsilateral stroke caused by non-stenotic carotid disease. RESULTS After excluding patients with non-assessable imaging, symptomatic > 50% carotid stenosis and extracranial dissection, 799/1105 (72.1%) patients enrolled in ESCAPE-NA1 remained for this analysis. Of these, 127 (15.9%) were classified as ESUS. Non-stenotic carotid disease occurred in 34/127 ESUS patients (26.8%) and was associated with the presence of ipsilateral ischemic stroke (odds ratio, OR 1.6, 95% confidence interval, CI 1.0-2.6, p = 0.049). The risk of ipsilateral ischemic stroke attributable to non-stenotic carotid disease in ESUS was estimated to be 19.7% (95% CI -5.7% to 39%), the population attributable risk was calculated as 4.3%. Imaging features such as plaque thickness, plaque irregularity or plaque ulceration were not different between non-stenotic carotids with vs. without ipsilateral stroke. CONCLUSION Non-stenotic carotid disease frequently occurs in patients classified as ESUS and is associated with ipsilateral ischemic stroke. Our findings support the role of non-stenotic carotid disease as stroke etiology in ESUS, but further prospective research is needed to prove a causal relationship.
Collapse
Affiliation(s)
- Martha Marko
- Department of Neurology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
| | - Nishita Singh
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Johanna M Ospel
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Diagnostic Imaging, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Kazutaka Uchida
- Department of Neurosurgery, Hyogo Medical University, Nishinomiya, Japan
| | - Mohammed A Almekhlafi
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Diagnostic Imaging, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Andrew M Demchuk
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Diagnostic Imaging, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Raul G Nogueira
- Emory University School of Medicine, Grady Memorial Hospital, Atlanta, USA
| | - Ryan A McTaggart
- Warren Alpert School of Medicine, Brown University, Providence, RI, USA
| | - Alexandre Y Poppe
- Department of Medicine (Neurology), Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | | | | | - Michael D Hill
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Diagnostic Imaging, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Mayank Goyal
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Diagnostic Imaging, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Bijoy K Menon
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Diagnostic Imaging, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| |
Collapse
|
3
|
Schuchardt FF, Krafft AJ, Miguel Telega L, Küchlin S, Lagrèze WA, Demerath T, Arnold P, Fung C, Kraus LM, Hennemuth A, Beck J, Urbach H, Weiller C, Harloff A. Interrelation Between Cerebrospinal Fluid Pressure, Intracranial Morphology and Venous Hemodynamics Studied by 4D Flow MRI. Clin Neuroradiol 2024; 34:391-401. [PMID: 38277058 PMCID: PMC11130051 DOI: 10.1007/s00062-023-01381-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 12/26/2023] [Indexed: 01/27/2024]
Abstract
PURPOSE To quantify the effects of CSF pressure alterations on intracranial venous morphology and hemodynamics in idiopathic intracranial hypertension (IIH) and spontaneous intracranial hypotension (SIH) and assess reversibility when the underlying cause is resolved. METHODS We prospectively examined venous volume, intracranial venous blood flow and velocity, including optic nerve sheath diameter (ONSD) as a noninvasive surrogate of CSF pressure changes in 11 patients with IIH, 11 age-matched and sex-matched healthy controls and 9 SIH patients, before and after neurosurgical closure of spinal dural leaks. We applied multiparametric MRI including 4D flow MRI, time-of-flight (TOF) and T2-weighted half-Fourier acquisition single-shot turbo-spin echo (HASTE). RESULTS Sinus volume overlapped between groups at baseline but decreased after treatment of intracranial hypotension (p = 0.067) along with a significant increase of ONSD (p = 0.003). Blood flow in the middle and dorsal superior sagittal sinus was remarkably lower in patients with higher CSF pressure (i.e., IIH versus controls and SIH after CSF leak closure) but blood flow velocity was comparable cross-sectionally between groups and longitudinally in SIH. CONCLUSION We were able to demonstrate the interaction of CSF pressure, venous volumetry, venous hemodynamics and ONSD using multiparametric brain MRI. Closure of CSF leaks in SIH patients resulted in symptoms suggestive of increased intracranial pressure and caused a subsequent decrease of intracranial venous volume and of blood flow within the superior sagittal sinus while ONSD increased. In contrast, blood flow parameters from 4D flow MRI did not discriminate IIH, SIH and controls as hemodynamics at baseline overlapped at most vessel cross-sections.
Collapse
Affiliation(s)
- Florian F Schuchardt
- Department of Neurology and Neurophysiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
- Department of Neurology and Neurophysiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Breisacher Str. 64, 79106, Freiburg, Germany.
| | - Axel J Krafft
- Medical Physics, Department of Radiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Lidia Miguel Telega
- Department of Neurology and Neurophysiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Department of Neurosurgery, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Sebastian Küchlin
- Department of Neuro-ophthalmology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Wolf A Lagrèze
- Department of Neuro-ophthalmology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Theo Demerath
- Department of Neuroradiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg , Freiburg, Germany
| | - Philipp Arnold
- Department of Neuroradiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg , Freiburg, Germany
| | - Christian Fung
- Department of Neurosurgery, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Luisa M Kraus
- Department of Neurosurgery, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Anja Hennemuth
- Institute for Cardiovascular Computer-assisted Medicine, Charité, Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Germany
| | - Jürgen Beck
- Department of Neurosurgery, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Horst Urbach
- Department of Neuroradiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg , Freiburg, Germany
| | - Cornelius Weiller
- Department of Neurology and Neurophysiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Andreas Harloff
- Department of Neurology and Neurophysiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| |
Collapse
|
4
|
Sun D, Nguyen TN, Pan Y, Wang M, Abdalkader M, Masoud HE, Ma A, Tong X, Ma G, Sun X, Song L, Ma N, Gao F, Mo D, Miao Z, Huo X. Unsuccessful Recanalization versus Medical Management of Patients with Large Ischemic Core : Analysis of the ANGEL-ASPECT Randomized Trial. Clin Neuroradiol 2024; 34:441-450. [PMID: 38319347 DOI: 10.1007/s00062-024-01384-5] [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: 10/17/2023] [Accepted: 01/05/2024] [Indexed: 02/07/2024]
Abstract
PURPOSE The outcomes of patients with large ischemic core who fail to recanalize with endovascular therapy (EVT) compared to medical management (MM) are uncertain. The objective was to evaluate the clinical and safety outcomes of patients who underwent EVT in patients with large ischemic core and unsuccessful recanalization. METHODS This was a post hoc analysis of the ANGEL-ASPECT randomized trial. Unsuccessful recanalization was defined as patients who underwent EVT with eTICI 0-2a. The primary endpoint was 90-day very poor outcome (mRS 5-6). Multivariable logistic regression was conducted controlling for ASPECTS, occlusion location, intravenous thrombolysis, and time to treatment. RESULTS Of 455 patients 225 were treated with MM. Of 230 treated with EVT, 43 (19%) patients had unsuccessful recanalization. There was no difference in 90-day very poor outcomes (39.5% vs. 40%, aOR 0.93, 95% confidence interval, CI 0.47-1.85, p = 0.95), sICH (7.0% vs. 2.7%, aOR 2.81, 95% CI 0.6-13.29, p = 0.19), or mortality (30% vs. 20%, aOR 1.65, 95% CI 0.89-3.06, p = 0.11) between the unsuccessful EVT and MM groups, respectively. There were higher rates of ICH (55.8% vs. 17.3%, p < 0.001), infarct core volume growth (142.7 ml vs. 90.5 ml, β = 47.77, 95% CI 20.97-74.57 ml, p < 0.001), and decompressive craniectomy (18.6% vs. 3.6%, p < 0.001) in the unsuccessful EVT versus MM groups. CONCLUSION In a randomized trial of patients with large ischemic core undergoing EVT with unsuccessful recanalization, there was no difference in very poor outcomes, sICH or death versus medically managed patients. In the unsuccessful EVT group, there were higher rates of any ICH, volume of infarct core growth, and decompressive craniectomy.
Collapse
Affiliation(s)
- Dapeng Sun
- Interventional Neuroradiology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119, South 4th Ring West Road, Fengtai District, 100070, Beijing, China
| | - Thanh N Nguyen
- Neurology, Radiology, Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, Boston, USA
| | - Yuesong Pan
- Interventional Neuroradiology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119, South 4th Ring West Road, Fengtai District, 100070, Beijing, China
- China National Clinical Research Centre for Neurological Diseases, Beijing, China
| | - Mengxing Wang
- China National Clinical Research Centre for Neurological Diseases, Beijing, China
| | - Mohamad Abdalkader
- Neurology, Radiology, Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, Boston, USA
| | - Hesham E Masoud
- Neurology, SUNY Upstate Medical University Hospital, Syracuse, NY, USA
| | - Alice Ma
- Neurosurgery, Royal North Shore Hospital, Sydney, Australia
| | - Xu Tong
- Interventional Neuroradiology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119, South 4th Ring West Road, Fengtai District, 100070, Beijing, China
| | - Gaoting Ma
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Xuan Sun
- Interventional Neuroradiology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119, South 4th Ring West Road, Fengtai District, 100070, Beijing, China
| | - Ligang Song
- Interventional Neuroradiology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119, South 4th Ring West Road, Fengtai District, 100070, Beijing, China
| | - Ning Ma
- Interventional Neuroradiology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119, South 4th Ring West Road, Fengtai District, 100070, Beijing, China
| | - Feng Gao
- Interventional Neuroradiology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119, South 4th Ring West Road, Fengtai District, 100070, Beijing, China
| | - Dapeng Mo
- Interventional Neuroradiology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119, South 4th Ring West Road, Fengtai District, 100070, Beijing, China
| | - Zhongrong Miao
- Interventional Neuroradiology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119, South 4th Ring West Road, Fengtai District, 100070, Beijing, China.
| | - Xiaochuan Huo
- Interventional Neuroradiology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119, South 4th Ring West Road, Fengtai District, 100070, Beijing, China.
- Cerebrovascular Disease Department, Neurological Disease Center, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
| |
Collapse
|
5
|
Welsch D, Iturralde P. Emotions and cognition; a promising crossroad for brain tumor diagnosis and prevention. Int J Neurosci 2024:1-6. [PMID: 38709678 DOI: 10.1080/00207454.2024.2352783] [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: 10/30/2023] [Accepted: 05/03/2024] [Indexed: 05/08/2024]
Abstract
Cognitive and behavioral neuroscience is essential for understanding brain tumors and their effects. Researchers have realized that an important step is to start looking for cognitive impairment at the time of diagnosis to see what deficits the brain tumor has left the patient with. Then cognitive assessment should be made after the tumor has been removed to see how it changes. The aim of this study was to assess the current research on tumor diagnosis and prevention through a filter of emotion and cognition; and then look at what future steps need to be taken. This review reports what research has already been done and what research still needs to be accomplished, including addressing the need for more data on cognitive impairment while the brain tumor is active, in the literature.
Collapse
Affiliation(s)
- Devon Welsch
- Earl L. Vandermeulen High School, Port Jefferson, New York, USA
| | | |
Collapse
|
6
|
Pinto FPJ, Dutra RDM, Almeida LC, Craveiro MMS, Baima JP, Saad-Hossne R, Sassaki LY. Vedolizumab Safety During Pregnancy and Lactation in a Patient with Ulcerative Colitis: A Case Report. Clin Exp Gastroenterol 2024; 17:165-171. [PMID: 38799766 PMCID: PMC11122291 DOI: 10.2147/ceg.s457256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Accepted: 05/07/2024] [Indexed: 05/29/2024] Open
Abstract
Background Inflammatory bowel disease (IBD) affects young adults of reproductive age, and questions related to pregnancy and breastfeeding are common in clinical practice. Most medications used to treat IBD are considered safe during pregnancy, except methotrexate and small molecules such as tofacitinib. Despite few studies regarding vedolizumab (VDZ) safety, it appears to be safe during pregnancy. Therefore, this study aimed to report the management of ulcerative colitis in pregnant patient refractory to anti-tumor necrosis factor (TNF) agents using VDZ. Case Report A female, 38 years old, with ulcerative colitis was refractory to conventional treatment with mesalazine, sulfasalazine, and azathioprine. She was hospitalized at six weeks of gestation with severe acute colitis requiring the use of infliximab (IFX) to induce remission. She had a spontaneous abortion at nine weeks of gestation after the second dose of IFX. Since there was no endoscopic improvement after six months of IFX treatment, VDZ treatment was initiated. During the VDZ infusion period, the patient discovered that she was pregnant with twins, leading to the discussion of the risks and benefits of continuing the VDZ. The patient presented with disease clinical remission with the use of VDZ, and the babies were born at 34 weeks of gestation without complications. Breastfeeding was also performed without complications. Conclusion Continued VDZ medication is safe during pregnancy and breastfeeding, with adverse events similar to anti-TNF therapy.
Collapse
Affiliation(s)
| | - Renata de Medeiros Dutra
- Department of Internal Medicine, São Paulo State University (Unesp), Medical School, Botucatu, São Paulo State, Brazil
| | - Livia Cafundo Almeida
- Department of Internal Medicine, São Paulo State University (Unesp), Medical School, Botucatu, São Paulo State, Brazil
| | | | - Julio Pinheiro Baima
- Department of Internal Medicine, São Paulo State University (Unesp), Medical School, Botucatu, São Paulo State, Brazil
| | - Rogerio Saad-Hossne
- Department of Surgery, São Paulo State University (Unesp), Medical School, Botucatu, São Paulo State, Brazil
| | - Ligia Yukie Sassaki
- Department of Internal Medicine, São Paulo State University (Unesp), Medical School, Botucatu, São Paulo State, Brazil
| |
Collapse
|
7
|
Rahman FF. Indonesia's healthcare landscape: embracing innovation in the new health regime. Curr Med Res Opin 2024:1-5. [PMID: 38683759 DOI: 10.1080/03007995.2024.2349732] [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: 01/09/2024] [Accepted: 04/26/2024] [Indexed: 05/02/2024]
Abstract
The comment highlights the intricate health issues in Indonesia, emphasizing urban-rural gaps, healthcare financing challenges, and the government's dedication to Universal Health Coverage (UHC). The country's geographical layout amplifies the struggle of providing healthcare to rural areas, resulting in substantial health concerns like high tuberculosis rates and financial vulnerability for the impoverished. The concern raised underscores the paradox of low state healthcare spending despite high household expenditures, leading to individual payment reliance and underutilization of insurance. The analysis advocates a comprehensive healthcare approach, emphasizing prevention and curative actions. It also stresses the importance of decentralizing decision-making power to local governments for optimizing healthcare funds. The comment concludes by emphasizing the need for innovative solutions in Indonesia's healthcare landscape. It envisions a future where transformative approaches reshape the system, ensuring better health outcomes. Innovation, especially in medical technology, digital health, and healthcare delivery models, is identified as a central theme. The recommendation underscores the importance of creative solutions to address healthcare service limitations and advocates for leveraging advancements in preventive measures, education, and tackling lifestyle issues. The overall aim is to navigate Indonesia through its current healthcare challenges towards a more sustainable and effective system for the benefit of its population.
Collapse
Affiliation(s)
- Ferry Fadzlul Rahman
- Department of Public Health, Universitas Muhammadiyah Kalimantan Timur, Indonesia
| |
Collapse
|
8
|
Halema AA, El-Beltagi HS, Al-Dossary O, Alsubaie B, Henawy AR, Rezk AA, Almutairi HH, Mohamed AA, Elarabi NI, Abdelhadi AA. Omics technology draws a comprehensive heavy metal resistance strategy in bacteria. World J Microbiol Biotechnol 2024; 40:193. [PMID: 38709343 DOI: 10.1007/s11274-024-04005-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 04/24/2024] [Indexed: 05/07/2024]
Abstract
The rapid industrial revolution significantly increased heavy metal pollution, becoming a major global environmental concern. This pollution is considered as one of the most harmful and toxic threats to all environmental components (air, soil, water, animals, and plants until reaching to human). Therefore, scientists try to find a promising and eco-friendly technique to solve this problem i.e., bacterial bioremediation. Various heavy metal resistance mechanisms were reported. Omics technologies can significantly improve our understanding of heavy metal resistant bacteria and their communities. They are a potent tool for investigating the adaptation processes of microbes in severe conditions. These omics methods provide unique benefits for investigating metabolic alterations, microbial diversity, and mechanisms of resistance of individual strains or communities to harsh conditions. Starting with genome sequencing which provides us with complete and comprehensive insight into the resistance mechanism of heavy metal resistant bacteria. Moreover, genome sequencing facilitates the opportunities to identify specific metal resistance genes, operons, and regulatory elements in the genomes of individual bacteria, understand the genetic mechanisms and variations responsible for heavy metal resistance within and between bacterial species in addition to the transcriptome, proteome that obtain the real expressed genes. Moreover, at the community level, metagenome, meta transcriptome and meta proteome participate in understanding the microbial interactive network potentially novel metabolic pathways, enzymes and gene species can all be found using these methods. This review presents the state of the art and anticipated developments in the use of omics technologies in the investigation of microbes used for heavy metal bioremediation.
Collapse
Affiliation(s)
- Asmaa A Halema
- Genetics Department, Faculty of Agriculture, Cairo University, Giza, 12613, Egypt
| | - Hossam S El-Beltagi
- Agricultural Biotechnology Department, College of Agriculture and Food Sciences, King Faisal University, Al-Ahsa, 31982, Saudi Arabia.
- Biochemistry Department, Faculty of Agriculture, Cairo University, Giza, 12613, Egypt.
| | - Othman Al-Dossary
- Agricultural Biotechnology Department, College of Agriculture and Food Sciences, King Faisal University, Al-Ahsa, 31982, Saudi Arabia
| | - Bader Alsubaie
- Agricultural Biotechnology Department, College of Agriculture and Food Sciences, King Faisal University, Al-Ahsa, 31982, Saudi Arabia
| | - Ahmed R Henawy
- Microbiology Department, Faculty of Agriculture, Cairo University, Giza, 12613, Egypt
| | - Adel A Rezk
- Agricultural Biotechnology Department, College of Agriculture and Food Sciences, King Faisal University, Al-Ahsa, 31982, Saudi Arabia
- Plant Virology Department, Plant Pathology Research Institute, Agriculture Research Center, Giza, 12619, Egypt
| | - Hayfa Habes Almutairi
- Chemistry Department, College of Science, King Faisal University, Al-Ahsa, 31982, Saudi Arabia
| | - Amal A Mohamed
- Chemistry Dept, Al-Leith University College, Umm Al-Qura University, P.O. Box 6725- 21955, Makkah, Saudi Arabia
| | - Nagwa I Elarabi
- Genetics Department, Faculty of Agriculture, Cairo University, Giza, 12613, Egypt
| | | |
Collapse
|
9
|
Gao W, Peng C, Wang Z, Li Y, Liu M. Genetic association and causal relationship between multiple modifiable risk factors and autoimmune liver disease: a two-sample mendelian randomization study. J Transl Med 2024; 22:425. [PMID: 38704596 PMCID: PMC11070123 DOI: 10.1186/s12967-024-05247-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 04/28/2024] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND The intricate etiology of autoimmune liver disease (AILD) involves genetic, environmental, and other factors that yet to be completely elucidated. This study comprehensively assessed the causal association between genetically predicted modifiable risk factors and AILD by employing Mendelian randomization. METHODS Genetic variants associated with 29 exposure factors were obtained from genome-wide association studies (GWAS). Genetic association data with autoimmune hepatitis (AIH), primary biliary cholangitis (PBC) and primary sclerosing cholangitis (PSC) were also obtained from publicly available GWAS. Univariate and multivariate Mendelian randomization analyses were performed to identify potential risk factors for AILD. RESULTS Genetically predicted rheumatoid arthritis (RA) (OR = 1.620, 95%CI 1.423-1.843, P = 2.506 × 10- 13) was significantly associated with an increased risk of AIH. Genetically predicted smoking initiation (OR = 1.637, 95%CI 1.055-2.540, P = 0.028), lower coffee intake (OR = 0.359, 95%CI 0.131-0.985, P = 0.047), cholelithiasis (OR = 1.134, 95%CI 1.023-1.257, P = 0.017) and higher C-reactive protein (CRP) (OR = 1.397, 95%CI 1.094-1.784, P = 0.007) were suggestively associated with an increased risk of AIH. Genetically predicted inflammatory bowel disease (IBD) (OR = 1.212, 95%CI 1.127-1.303, P = 2.015 × 10- 7) and RA (OR = 1.417, 95%CI 1.193-1.683, P = 7.193 × 10- 5) were significantly associated with increased risk of PBC. Genetically predicted smoking initiation (OR = 1.167, 95%CI 1.005-1.355, P = 0.043), systemic lupus erythematosus (SLE) (OR = 1.086, 95%CI 1.017-1.160, P = 0.014) and higher CRP (OR = 1.199, 95%CI 1.019-1.410, P = 0.028) were suggestively associated with an increased risk of PBC. Higher vitamin D3 (OR = 0.741, 95%CI 0.560-0.980, P = 0.036) and calcium (OR = 0.834, 95%CI 0.699-0.995, P = 0.044) levels were suggestive protective factors for PBC. Genetically predicted smoking initiation (OR = 0.630, 95%CI 0.462-0.860, P = 0.004) was suggestively associated with a decreased risk of PSC. Genetically predicted IBD (OR = 1.252, 95%CI 1.164-1.346, P = 1.394 × 10- 9), RA (OR = 1.543, 95%CI 1.279-1.861, P = 5.728 × 10- 6) and lower glycosylated hemoglobin (HbA1c) (OR = 0.268, 95%CI 0.141-0.510, P = 6.172 × 10- 5) were positively associated with an increased risk of PSC. CONCLUSIONS Evidence on the causal relationship between 29 genetically predicted modifiable risk factors and the risk of AIH, PBC, and PSC is provided by this study. These findings provide fresh perspectives on the management and prevention strategies for AILD.
Collapse
Affiliation(s)
- Weize Gao
- Department of Clinical Laboratory, Key Laboratory of Laboratory Medicine, The Affiliated Hospital of Qingdao University, Qingdao, 266003, China
| | - Chong Peng
- Department of Clinical Laboratory, Key Laboratory of Laboratory Medicine, The Affiliated Hospital of Qingdao University, Qingdao, 266003, China
| | - Zhan Wang
- Department of Clinical Laboratory, Key Laboratory of Laboratory Medicine, The Affiliated Hospital of Qingdao University, Qingdao, 266003, China
| | - Yongxin Li
- Department of Clinical Laboratory, Key Laboratory of Laboratory Medicine, The Affiliated Hospital of Qingdao University, Qingdao, 266003, China
| | - Mingjun Liu
- Department of Clinical Laboratory, Key Laboratory of Laboratory Medicine, The Affiliated Hospital of Qingdao University, Qingdao, 266003, China.
| |
Collapse
|
10
|
Bothe E, Bennett RJ, Ferguson MA. Consumer and audiologist perspectives on hearables: a qualitative study. Int J Audiol 2024:1-10. [PMID: 38690770 DOI: 10.1080/14992027.2024.2341973] [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: 12/12/2023] [Accepted: 04/02/2024] [Indexed: 05/03/2024]
Abstract
OBJECTIVE We aimed to explore (i) what adults with hearing difficulties want and need from hearables, which we defined as any non-medical personal sound amplification product, and (ii) what hearing care professionals think about hearables. DESIGN This was an exploratory, qualitative study conducted using separate focus groups with adults with hearing difficulties and audiologists. Data were analysed inductively using reflexive thematic analysis. STUDY SAMPLE Participants were 12 adults with hearing difficulties and 6 audiologists. RESULTS Adults with hearing difficulties expressed desire for trustworthy information and support, described evaluating hearables and other devices according to diverse personal criteria, and expressed willingness to vary their budget according to product quality. Audiologists expressed views that hearables are an inferior product but useful tool, that it is not necessarily their role to assist with hearables, that hearables are a source of uncertainty, and that the provision of hearables by audiologists is not currently practical. CONCLUSION Adults with hearing difficulties may have complex reasons for considering hearables and may desire a high level of clinical support in this area. Ongoing research into the efficacy and effectiveness of hearables is needed together with research into effective strategies to incorporate hearables into clinical practice.
Collapse
Affiliation(s)
- Ellen Bothe
- Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia
- Curtin enAble Institute, Curtin University, Perth, Australia
| | - Rebecca J Bennett
- Curtin enAble Institute, Curtin University, Perth, Australia
- National Acoustic Laboratories, Sydney, Australia
- Ear Science Institute Australia, Perth, Australia
| | - Melanie A Ferguson
- Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia
- Curtin enAble Institute, Curtin University, Perth, Australia
| |
Collapse
|
11
|
Ye X, Xu T, Yang L, Hu X, Xie X, Lan G, Lu X, Huang Z, Wang T, Wu J, Lan J, Zhang Q, Zhan Z, Guo Y, Xie X. Association between plasma metal exposure and health span in very elderly adults: a prospective cohort study with mixture statistical approach. BMC Geriatr 2024; 24:388. [PMID: 38693478 PMCID: PMC11064295 DOI: 10.1186/s12877-024-05001-5] [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: 10/31/2023] [Accepted: 04/22/2024] [Indexed: 05/03/2024] Open
Abstract
BACKGROUND Metals have been linked to a diverse spectrum of age-related diseases; however, the effects of metal exposure on health span remains largely unknown. This cohort study aims to determine the association between plasma metal and health span in elder adults aged ≥ 90 years. METHODS The plasma concentrations of seven metals were measured at baseline in 300 elder adults. The end of the health span (EHS) was identified as the occurrence of one of eight major morbidities or mortality events. We used Cox regression to assess hazard ratios (HR). The combined effects of multiple metal mixtures were estimated using grouped-weighted quantile sum (GWQS), quantile g-computation (Q-gcomp), and Bayesian kernel machine regression (BKMR) methods. RESULTS The estimated HR for EHS with an inter-quartile range (IQR) increment for selenium (Se) was 0.826 (95% confidence interval [CI]: 0.737-0.926); magnesium (Mg), 0.806 (95% CI: 0.691-0.941); iron (Fe), 0.756 (95% CI: 0.623-0.917), and copper (Cu), 0.856 (95% CI: 0.750-0.976). The P for trend of Se, Mg, and Fe were all < 0.05. In the mixture analyses, Q-gcomp showed a negative correlation with EHS (P = 0.904), with the sum of the negative coefficients being -0.211. CONCLUSION Higher plasma Se, Mg, and Fe reduced the risk of premature end of health span, suggesting that essential metal elements played a role in health maintenance in elder adults.
Collapse
Affiliation(s)
- Xiaoying Ye
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Tingting Xu
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Le Yang
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Xiangju Hu
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
- Department for Chronic and Noncommunicable Disease Control and Prevention, Fujian Provincial Center for Disease Control and Prevention, Fuzhou, China
| | - Xiaowei Xie
- The First Clinical Medical School, Shanxi Medical University, Taiyuan, China
| | - Guohui Lan
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Xiaoli Lu
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Zelin Huang
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Tinggui Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Jieyu Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Jieli Lan
- Clinical Research Unit, The Second Affiliated Hospital, Fujian Medical University, Quanzhou, China
| | - Qian Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Zhiying Zhan
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Yansong Guo
- Department of Cardiology, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou, China.
- Fujian Provincial Key Laboratory of Cardiovascular Disease, Fujian Provincial Center for Geriatrics, Fujian Provincial Clinical Research Center for Severe Acute Cardiovascular Diseases, Fuzhou, China.
- Fujian Heart Failure Center Alliance, Fuzhou, China.
| | - Xiaoxu Xie
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China.
- Clinical Research Unit, The Second Affiliated Hospital, Fujian Medical University, Quanzhou, China.
| |
Collapse
|
12
|
Li Z, Wang Y. Evolution of neoadjuvant therapy for breast cancer regimens over 12 years and pathologic response rates according to tumor subtypes and clinical stage: A single-center retrospective study. J Cancer Res Ther 2024; 20:608-614. [PMID: 38687931 DOI: 10.4103/jcrt.jcrt_1693_23] [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: 07/26/2023] [Accepted: 10/17/2023] [Indexed: 05/02/2024]
Abstract
BACKGROUND AND PURPOSE Given the evolution of neoadjuvant therapy (NAT) for breast cancer, this study aimed to analyze trends in NAT regimens over time and patients' pathological responses, tumor stages, and subtypes. MATERIALS AND METHODS Data were analyzed for 548 patients with cT1-4N0-3M0 breast cancer who received NAT at Shandong Cancer Hospital between 2011 and 2022. The 12-year study period was divided into six 2-year periods termed P1 to P6. RESULTS From P1 to P6, the proportion of stage II patients treated with NAT increased from 6.4% to 33.8% compared with same-stage operable breast cancer (r = 0.228, P < 0.001), while the proportion of the full-course group increased from 50.0% to 99.0% (r = 0.354, P < 0.001). The pathologic complete remission (pCR) rate in the full-course group increased from 30.8% to 54.6% (r = 0.248, P < 0.001). In the full-course human epidermal growth factor receptor-2 positive (HER2+) group, the proportion of chemotherapy combined with inhibition therapy increased from 33.3% to 100% (r = 0.530, P < 0.001). Furthermore, dual inhibition therapy increased from 0 to 98.9%. The proportion of the nonanthracycline group (dual inhibition) increased from 56.0% at P5 to 76.6% at P6 (r = 0.190, P = 0.042). In the full-course Triple-Negative Breast Cancer (TNBC) group, the proportion of platinum therapy increased from 0 to 41.9% (r = 0.324, P < 0.001) and immune drugs increased from 0 to 53.2% (r = 0.500, P < 0.001). CONCLUSION Overall, the results indicate an increasing proportion of patients receiving NAT therapy over time. Furthermore, there were increases in HER2 + patients receiving inhibition therapy (especially dual inhibition) and TNBC patients receiving platinum and immune therapy as part of NAT. Notably, these changes were associated with improved outcomes.
Collapse
Affiliation(s)
- Zhedong Li
- Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China
- Breast Cancer Center, Shandong Cancer Hospital and Institute, Jinan, Shandong, China
| | - Yongsheng Wang
- Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China
- Breast Cancer Center, Shandong Cancer Hospital and Institute, Jinan, Shandong, China
| |
Collapse
|
13
|
Yamba K, Mudenda S, Mpabalwani E, Mainda G, Mukuma M, Samutela MT, Lukwesa C, Chizimu J, Kaluba CK, Mutalange M, Chilengi R, Muma JB. Antibiotic prescribing patterns and carriage of antibiotic-resistant Escherichia coli and Enterococcus species in healthy individuals from selected communities in Lusaka and Ndola districts, Zambia. JAC Antimicrob Resist 2024; 6:dlae027. [PMID: 38449515 PMCID: PMC10914442 DOI: 10.1093/jacamr/dlae027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 02/06/2024] [Indexed: 03/08/2024] Open
Abstract
Objectives This study assessed antibiotic prescribing patterns in primary healthcare facilities and antimicrobial resistance (AMR) profiles of commensal Escherichia coli and enterococci isolated from pregnant women and children under 5 years of age. Materials and methods This cross-sectional study was conducted in Lusaka and Ndola districts of Zambia. Prescription pattern data were obtained from hospital pharmacies. Identification and antimicrobial susceptibility profiles of E. coli and enterococci were determined by conventional methods, while confirmation of both pathogens and AMR genes were determined by PCR. Data were analysed using WHONET and SPSS version 25.0. Results Most prescribed antibiotics at the primary healthcare facilities belonged to the Access group of the WHO Access, Watch and Reserve (AWaRe) classification. All the primary healthcare facilities adhered to the AWaRe framework of ≥60% prescribed antibiotics belonging to the Access group. However, resistance was highest in the Access group of antibiotics. E. coli resistance to ampicillin ranged from 71% to 77% and to co-trimoxazole from 74% to 80%, while enterococcal resistance to tetracycline was 59%-64%. MDR was highest in E. coli (75%) isolates, while XDR was highest in enterococcal isolates (97%). The identified AMR genes in E. coli included blaCTX-M, sul2 and qnrA, while those of enterococci included erm(B), erm(C) and erm(A). Conclusions Resistance was highest in the prescribed WHO Access group of antibiotics. These findings highlight the need to use local susceptibility data to formulate country-specific treatment guidelines in line with WHO AWaRe classification and enforce regulations that prohibit easy access to antibiotics.
Collapse
Affiliation(s)
- Kaunda Yamba
- Department of Pathology & Microbiology, University Teaching Hospitals, Lusaka, Zambia
- Department of Disease Control University of Zambia, School of Veterinary Medicine, University of Zambia, Lusaka, Zambia
- Antimicrobial Resistance Cluster, Zambia National Public Health Institute, Lusaka, Zambia
| | - Steward Mudenda
- Department of Disease Control University of Zambia, School of Veterinary Medicine, University of Zambia, Lusaka, Zambia
- Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka, Zambia
| | - Evans Mpabalwani
- Department of Paediatrics & Child Health, School of Medicine, University of Zambia, Lusaka, Zambia
| | - Geoffrey Mainda
- Food and Agriculture Organization (FAO) of the United Nations, House No. 5, Chaholi, Off Addis Ababa Drive, Lusaka, Zambia
- Department of Veterinary Services Central Veterinary Research Institute (CVRI), Ministry of Fisheries and Livestock, Lusaka, Zambia
| | - Mercy Mukuma
- Department of Food Science, School of Agricultural Sciences and Nutrition, University of Zambia, Lusaka, Zambia
| | - Mulemba Tillika Samutela
- Department of Biomedical Sciences, School of Health Sciences, University of Zambia, Lusaka, Zambia
| | - Chileshe Lukwesa
- Department of Pathology & Microbiology, University Teaching Hospitals, Lusaka, Zambia
| | - Joseph Chizimu
- Antimicrobial Resistance Cluster, Zambia National Public Health Institute, Lusaka, Zambia
| | - Ciluvya Kavimba Kaluba
- Department of Disease Control University of Zambia, School of Veterinary Medicine, University of Zambia, Lusaka, Zambia
| | - Matenge Mutalange
- Department of Disease Control University of Zambia, School of Veterinary Medicine, University of Zambia, Lusaka, Zambia
- Department of Pathology and Microbiology, School of Medicine and Health Sciences, Mulungushi University, Livingstone, Zambia
| | - Roma Chilengi
- Zambia National Public Health Institute, Ministry of Health, Lusaka, Zambia
| | - John Bwalya Muma
- Department of Disease Control University of Zambia, School of Veterinary Medicine, University of Zambia, Lusaka, Zambia
| |
Collapse
|
14
|
Castelletti C, Dolz Del Castellar B, Miret M, Mercier H, Lara E. Loneliness and Subjective Wellbeing During the Covid-19 Pandemic: A Systematic Review. THE JOURNAL OF PSYCHOLOGY 2024:1-25. [PMID: 38466316 DOI: 10.1080/00223980.2024.2319172] [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: 02/11/2023] [Accepted: 02/11/2024] [Indexed: 03/12/2024] Open
Abstract
To prevent the transmission of COVID-19, unprecedented measures were implemented, such as community lockdowns. With limited social interactions, the problem of loneliness might have worsened. As loneliness is thought to have a detrimental effect on subjective wellbeing (SWB), the present systematic review aims to better investigate and summarize the existing evidence about the association of loneliness and SWB during the COVID-19 pandemic. A total of 18 articles were included. In all studies, independently of the component of wellbeing assessed or of the instrument used, a negative association between loneliness and SWB was found. The results show an increase in loneliness during times of restrictions on social contacts, with a subsequent association with lower SWB, and underscore the need for developing specific interventions to tackle loneliness and for promoting alternative forms of social interaction if further physical distancing measures are needed. However, the literature had several limitations, since most of the studies followed cross-sectional and descriptive methodologies.
Collapse
Affiliation(s)
- Chiara Castelletti
- Universidad Autónoma de Madrid
- Instituto de Investigación Sanitaria Princesa (IIS-Princesa)
| | | | - Marta Miret
- Universidad Autónoma de Madrid
- Centro de Investigación Biomédica en Red de Salud Mental
| | | | - Elvira Lara
- Centro de Investigación Biomédica en Red de Salud Mental
- Universidad Complutense de Madrid
| |
Collapse
|
15
|
Valente HB, Gervazoni NDL, Laurino MJL, Stoco-Oliveira MC, Ribeiro F, de Carvalho AC, Vanderlei LCM, Garner DM. Monitoring autonomic responses in Parkinson's disease individuals: non-linear and chaotic global metrics of heart rate variability. Int J Neurosci 2024:1-11. [PMID: 38433652 DOI: 10.1080/00207454.2024.2325020] [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: 08/07/2023] [Accepted: 02/25/2024] [Indexed: 03/05/2024]
Abstract
AIM To examine and compare the autonomic responses, as assessed through the non-linear and chaotic global metrics of heart rate variability in two groups: the Parkinson's Disease Group (PDG) and the Control Group (CG), both at rest and during an active tilt test. METHODS The study encompassed 46 participants (PDG: n = 23; 73.73 ± 7.28 years old; CG: n = 23; 70.17 ± 8.20 years old). Initial data collection involved the acquisition of participant's characteristics. The autonomic modulation was estimated both at rest and during the active tilt test. For this assessment, we computed non-linear indices derived from five entropies (Approximate, Sample, Shannon, Renyi, Tsallis), Detrended Fluctuation Analysis and the seven chaotic global metrics (hsCFP1-hsCFP7). RESULTS At rest, the PDG exhibited lower values of hsCFP3 (0.818 ± 0.116 vs. 0.904 ± 0.065; p < 0.05) and Sample Entropy (0.720 ± 0.149 vs. 0.799 ± 0.171; p < 0.05). During the test, the PDG demonstrated lower values of ApEn, while the CG presented lower values of SampEn, hsCFP1, hsCFP3, hsCFP7, and higher values of hsCFP5. An interaction was observed, indicating that hsCFP1 and hsCFP3 exhibit differential behavior for the CG and PDG in response to the test. CONCLUSION subjects with PD exhibited reduced complexity of the RR interval series at rest, and a diminished autonomic response to the active tilt test when compared with the CG. The test, together with non-linear indices, may serve for assessing the Autonomic Nervous System in individuals with PD in a clinical setting. The interpretation of these data should be approached with caution, given the possible influences of pharmacotherapies and the inclusion of diabetic participants.
Collapse
Affiliation(s)
- Heloisa Balotari Valente
- Faculdade de Ciências e Tecnologia, Departamento de Fisioterapia, Universidade Estadual Paulista "Júlio de Mesquita Filho", Presidente Prudente, Brazil
| | - Natacha de Lima Gervazoni
- Faculdade de Ciências e Tecnologia, Departamento de Fisioterapia, Universidade Estadual Paulista "Júlio de Mesquita Filho", Presidente Prudente, Brazil
| | - Maria Júlia Lopez Laurino
- Faculdade de Ciências e Tecnologia, Departamento de Fisioterapia, Universidade Estadual Paulista "Júlio de Mesquita Filho", Presidente Prudente, Brazil
| | - Mileide Cristina Stoco-Oliveira
- Faculdade de Ciências e Tecnologia, Departamento de Fisioterapia, Universidade Estadual Paulista "Júlio de Mesquita Filho", Presidente Prudente, Brazil
| | - Felipe Ribeiro
- Faculdade de Ciências e Tecnologia, Departamento de Fisioterapia, Universidade Estadual Paulista "Júlio de Mesquita Filho", Presidente Prudente, Brazil
| | - Augusto Cesinando de Carvalho
- Faculdade de Ciências e Tecnologia, Departamento de Fisioterapia, Universidade Estadual Paulista "Júlio de Mesquita Filho", Presidente Prudente, Brazil
| | - Luiz Carlos Marques Vanderlei
- Faculdade de Ciências e Tecnologia, Departamento de Fisioterapia, Universidade Estadual Paulista "Júlio de Mesquita Filho", Presidente Prudente, Brazil
| | - David M Garner
- Cardiorespiratory Research Group, Department of Biological and Medical Sciences, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| |
Collapse
|
16
|
Lemmers GPG, Melis RJF, Pagen S, Hak R, Snoo EKD, Westert GP, van der Wees PJ, Staal JB. The association of the STarT Back Screening Tool and type of leg pain with low back pain disability trajectories: a prospective cohort study. BMC Musculoskelet Disord 2024; 25:193. [PMID: 38439000 PMCID: PMC10910701 DOI: 10.1186/s12891-024-07301-8] [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: 10/05/2023] [Accepted: 02/22/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND Multiple factors influence the recovery process of low back pain (LBP). The identification and increased knowledge of prognostic factors might contribute to a better understanding of the course of LBP. The purpose of this study is to investigate the association of the STarT Back Screening Tool (SBST) risk score and the type of leg pain (non-radiating LBP, referred non-radicular, and radicular radiating leg pain) with the disability trajectory (at baseline, the slope, and recovery at one year) in adults with low back pain. METHODS This is a prospective cohort study in 347 patients with low back pain who sought physiotherapy care at three primary care practices in the Netherlands. Linear mixed models were estimated to describe the association of the SBST risk score and the type of leg pain with disability at baseline, the slope in the disability trajectory, and at twelve months follow-up. RESULTS A medium/high risk score on the SBST is associated with higher baseline disability scores on the Oswestry Disability Index (ODI), faster initial recovery, and still a higher disability ODI score at 12 months follow-up. Non-radicular referred and radicular radiating leg pain were associated with worse baseline disability ODI scores in LBP. This association was not present for the initial recovery or at the 12 months follow-up. CONCLUSION The SBST is associated with the LBP recovery trajectory. The SBST might be a useful tool to predict the disability trajectory in a heterogeneous group of people with low back pain in primary care and might, therefore, be recommended in future clinical practice guidelines. The type of leg pain was not associated with the recovery trajectory of LBP. Future research might focus on evaluating different types of leg pain. TRIAL REGISTRATION Clinicaltrials.gov: 109,643.
Collapse
Affiliation(s)
- Gijs P G Lemmers
- Radboud University Medical Center, IQ Health, Kapittelweg 54, Nijmegen, 6525 EP, The Netherlands.
- Dutch Healthcare Authority, Utrecht, The Netherlands.
| | - René J F Melis
- Department of Geriatric Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Robin Hak
- Fysius Back Experts, Nijverdal, The Netherlands
| | | | - Gert P Westert
- Radboud University Medical Center, IQ Health, Kapittelweg 54, Nijmegen, 6525 EP, The Netherlands
| | - Philip J van der Wees
- Radboud University Medical Center, IQ Health, Kapittelweg 54, Nijmegen, 6525 EP, The Netherlands
| | - J Bart Staal
- Radboud University Medical Center, IQ Health, Kapittelweg 54, Nijmegen, 6525 EP, The Netherlands
- Musculoskeletal Rehabilitation Research Group, HAN University of Applied Sciences, Nijmegen, The Netherlands
| |
Collapse
|
17
|
Boulton KA, Hodge A, Levu K, Ong N, Silove N, Guastella AJ. Access and barriers to supports for children and caregivers attending public child developmental assessment services: Findings from the Sydney child neurodevelopment research registry. Autism Res 2024; 17:555-567. [PMID: 38009266 DOI: 10.1002/aur.3064] [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: 07/24/2023] [Accepted: 10/30/2023] [Indexed: 11/28/2023]
Abstract
Families can spend years waiting for a developmental assessment. We sought to understand supports caregivers had accessed by the time of their child's first multi-disciplinary developmental assessment, the supports caregivers wanted, and the barriers caregivers reported to accessing these supports. We also sought to understand how government funding schemes (the National Disability Insurance Scheme) and sociodemographic factors influenced access to supports. Caregivers were emailed questionnaires on sociodemographic background and intervention history prior to their child's developmental assessment at a tertiary diagnostic and assessment service. Results from 202 caregivers showed most children were receiving less than 2 hours of support each week at assessment. The most common accessed supports were from general practitioners and pediatricians. Caregivers reported behavioral therapists (41%) and psychologists (29%) as the most desired but inaccessible child supports. Half of caregivers nominated a need for parenting interventions. The most frequent barriers to accessing child supports were wait lists, finance, and knowledge. Government funding improved access to the total number of services received (from 2.7 to 5.2 different services), but for disability specific services only (e.g., speech and occupational therapy). Results highlighted disparities for families without government funding, impacting certain groups (e.g., children over 7 years) and services (e.g., mental health). Socioeconomic disadvantage, parental separation, and, surprisingly, being from a non-culturally/linguistically diverse background were associated with fewer services and more barriers. Results highlight the need to facilitate access to supports for families to align with existing recommendations.
Collapse
Affiliation(s)
- Kelsie A Boulton
- Clinic for Autism and Neurodevelopment (CAN) research, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
- Child Neurodevelopment and Mental Health Team, Brain and Mind Centre, University of Sydney, Camperdown, Australia
| | - Antoinette Hodge
- Child Neurodevelopment and Mental Health Team, Brain and Mind Centre, University of Sydney, Camperdown, Australia
- Child Development Unit, The Children's Hospital at Westmead, Westmead, Australia
| | - Kelera Levu
- Clinic for Autism and Neurodevelopment (CAN) research, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
| | - Natalie Ong
- Child Development Unit, The Children's Hospital at Westmead, Westmead, Australia
| | - Natalie Silove
- Child Neurodevelopment and Mental Health Team, Brain and Mind Centre, University of Sydney, Camperdown, Australia
- Child Development Unit, The Children's Hospital at Westmead, Westmead, Australia
| | - Adam J Guastella
- Clinic for Autism and Neurodevelopment (CAN) research, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
- Child Neurodevelopment and Mental Health Team, Brain and Mind Centre, University of Sydney, Camperdown, Australia
| |
Collapse
|
18
|
Wijeratne D, Gibson JFE, Fiander A, Rafii-Tabar E, Thakar R. The global burden of disease due to benign gynecological conditions: A call to action. Int J Gynaecol Obstet 2024; 164:1151-1159. [PMID: 37987165 DOI: 10.1002/ijgo.15211] [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: 04/06/2023] [Revised: 10/04/2023] [Accepted: 10/08/2023] [Indexed: 11/22/2023]
Abstract
OBJECTIVE Focusing on low- and middle-income countries (LMICs), this article uses data from the Global Burden of Disease (GBD) database to highlight the burden of morbidity due to benign gynecological conditions (BGCs). METHODS We analyzed 2019 morbidity data for all BGCs, measured as years lost to disability (YLDs). Disease burden was calculated for individual conditions, BGCs overall, and percentages of overall disease burden from all conditions. The same data extraction was performed for malaria, tuberculosis, and HIV/AIDS for comparison. The data were subcategorized by age and World Bank income level. RESULTS BGCs are major causes of disease morbidity worldwide. For women aged 15 years and over in high-income countries (HICs), 3 588 157 YLDs (3.94% of all YLDs) were due to BGC. In LMICs, 18 242 989 YLDs (5.35% of all YLDs) were due to BGCs. The highest burden of BGCs is seen during the reproductive years where conditions driven or exacerbated by reproductive hormones are the major causes of morbidity. In LMICs, for women aged 15-49, 14 574 100 YLDs (7.75% of all YLDs) were due to BGCs, declining to 3 152 313 YLDs (3.04%) in women aged 50-69 and 529 399 YLDs (1.06%) in women age 70+. CONCLUSION These data demonstrate a huge burden of morbidity due to BGCs. There is an urgent need for international stakeholders to prioritize the treatment and prevention of BGCs.
Collapse
Affiliation(s)
- Dileep Wijeratne
- Department of Obstetrics and Gynaecology, Leeds Teaching Hospitals, Leeds, UK
| | - Joanna F E Gibson
- Department of Obstetrics and Gynaecology, Leeds Teaching Hospitals, Leeds, UK
| | | | - Elizabeth Rafii-Tabar
- Centre for Women's Global Health, Royal College of Obstetricians and Gynaecologists, London, UK
| | - Ranee Thakar
- Royal College of Obstetricians and Gynaecologists, London, UK
| |
Collapse
|
19
|
Li M, Wang M, Zhao Y, Zhong R, Chen W, Lei X, Wu X, Han J, Lei L, Wang Q, Luo G, Wei M. Effects of elevated remnant cholesterol on outcomes of acute ischemic stroke patients receiving mechanical thrombectomy. J Thromb Thrombolysis 2024; 57:390-401. [PMID: 38180591 DOI: 10.1007/s11239-023-02939-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/16/2023] [Indexed: 01/06/2024]
Abstract
OBJECTIVE Large cohort studies provided evidence that elevated remnant cholesterol (RC) was an important risk factor for ischemic stroke. However, the association between high RC and clinical outcomes in acute ischemic stroke (AIS) individuals was still undetermined. METHODS This retrospective study enrolled 165 AIS patients undergoing mechanical thrombectomy in one tertiary stroke center. We divided patients into two groups based on the median of their RC levels (0.49 mmol/L). The modified Rankin Scale (mRS) was used to evaluate the primary outcome 90 days after the onset of symptoms. The mRS scores ≤ 2 and ≤ 1 at 90 days were deemed as favorable and excellent outcomes, respectively. RESULTS In the overall AIS patients undergoing mechanical thrombectomy, there was no obvious distinction between the high and low RC group at 90-day favorable outcome (41.0% vs. 47.1%, P = 0.431) or excellent outcome (23.1% vs. 31.0%, P = 0.252). In the subgroup analysis stratified by stroke etiology, non-large artery atherosclerosis (non-LAA) stroke patients yielded with less favorable or excellent prognosis in the high RC group (26.8% vs. 46.8%, adjusted OR = 0.31, 95%CI: 0.11-0.85, P = 0.023; or 12.2% vs. 29.0%, adjusted OR = 0.18, 95%CI: 0.04-0.80, P = 0.024, respectively.). Post hoc power analyses indicated that the power was sufficient for favorable outcome (80.38%) and excellent outcome (88.72%) in non-LAA stroke patients. Additionally, RC can enhance the risk prediction value of a poor outcome (mRS scores 3-6) based on traditional risk indicators (including age, initial NIHSS score, operative duration, and neutrophil-to-lymphocyte ratio) for non-LAA stroke patients (AUC = 0.86, 95%CI: 0.79-0.94, P < 0.001). CONCLUSION In AIS patients undergoing mechanical thrombectomy, elevated RC was independently related to poor outcome for non-LAA stroke patients, but not to short-term prognosis of LAA stroke patients.
Collapse
Affiliation(s)
- Mengmeng Li
- Stroke Centre, Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Meng Wang
- Department of Neurology, Xi'an Children's Hospital, Xi'an, China
| | - Yixin Zhao
- Stroke Centre, Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Rui Zhong
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Wanying Chen
- Stroke Centre, Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Xiangyu Lei
- Stroke Centre, Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Xiaoyu Wu
- Stroke Centre, Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Jiaxin Han
- Stroke Centre, Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Lei Lei
- Stroke Centre, Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Qingfan Wang
- Stroke Centre, Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Guogang Luo
- Stroke Centre, Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
| | - Meng Wei
- Stroke Centre, Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
| |
Collapse
|
20
|
Soluk Özdemir Y, Paker N, Şişmanoğlu Ataç N, Buğdaycı D, Öneş K. COVID-19-related anxiety and obsession levels in stroke patients and family caregivers and their effects on caregiver burden. NEUROPSYCHIATRIE : KLINIK, DIAGNOSTIK, THERAPIE UND REHABILITATION : ORGAN DER GESELLSCHAFT OSTERREICHISCHER NERVENARZTE UND PSYCHIATER 2024; 38:24-31. [PMID: 38315321 DOI: 10.1007/s40211-024-00490-7] [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: 09/03/2023] [Accepted: 12/29/2023] [Indexed: 02/07/2024]
Abstract
PURPOSE The aim of this study is to describe coronavirus disease 2019 (COVID-19)-related dysfunctional anxiety and thinking in patients with stroke and caregivers who are family members and their effects on caregiver burden. METHODS This cross-sectional study included 79 stroke patients and their primary caregivers who were hospitalised in a tertiary rehabilitation hospital. Coronavirus Anxiety Scale (CAS) and Obsession with COVID-19 Scale (OCS) were used to assess the levels of COVID-19-related dysfunctional anxiety and obsession of the patients and their caregivers. Caregiver burden was assessed via the Zarit Burden Interview (ZBI). RESULTS In the patients with stroke, COVID-19-related anxiety and COVID-19-related obsession rates were 13.9% (n = 11) and 7.6% (n = 6), respectively, while 17.7% (n = 14) of caregiver family members had COVID-19-related anxiety and 11.4% (n = 9) had COVID-19-related obsession. The CAS score of caregivers showed a significant positive correlation with the CAS and OCS scores of patients (p = 0.000, r = 0.423; p = 0.007, r = 0.300, respectively). The OCS score of caregivers showed a significant positive correlation with the OCS scores of the patients (p = 0.000, r = 0.476). The mean ZBI score of caregiver family members was 31.9 ± 13.5. A significant positive correlation was observed between the caregiver's OCS and CAS scores and ZBI scores (p = 0.002, r = -0.349; p = 0.004, r = 0.323, respectively). CONCLUSION In this study, a significant relationship between caregiver burden and COVID-19-related anxiety and obsession in the caregivers of stroke patients was identified. Therefore, caregivers of stroke patients should not be forgotten during pandemics and should receive physical and psychological support.
Collapse
Affiliation(s)
- Yelda Soluk Özdemir
- Istanbul Physical Medicine and Rehabilitation Training and Research Hospital, Istanbul, Turkey.
| | - Nurdan Paker
- Istanbul Physical Medicine and Rehabilitation Training and Research Hospital, Istanbul, Turkey
| | - Nazlı Şişmanoğlu Ataç
- Istanbul Physical Medicine and Rehabilitation Training and Research Hospital, Istanbul, Turkey
| | - Derya Buğdaycı
- Istanbul Physical Medicine and Rehabilitation Training and Research Hospital, Istanbul, Turkey
| | - Kadriye Öneş
- Istanbul Physical Medicine and Rehabilitation Training and Research Hospital, Istanbul, Turkey
| |
Collapse
|
21
|
Berchtold J, Winkler C, Karner J, Groher M, Gaisberger C, Sedlmayer F, Wolf F. Noninvasive inter- and intrafractional motion control in ultrahypofractionated radiation therapy of prostate cancer using RayPilot HypoCath™-a substitute for gold fiducial-based IGRT? Strahlenther Onkol 2024; 200:195-201. [PMID: 37626226 PMCID: PMC10876743 DOI: 10.1007/s00066-023-02125-2] [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: 04/18/2023] [Accepted: 07/11/2023] [Indexed: 08/27/2023]
Abstract
PURPOSE In ultrahypofractionated radiation concepts, managing of intrafractional motion is mandatory because tighter margins are used and random errors resulting from prostate movement are not averaged out over a large number of fractions. Noninvasive live monitoring of prostate movement is a desirable asset for LINAC-based prostate stereotactic body radiation therapy (SBRT). METHODS We prospectively analyzed a novel live tracking device (RayPilot HypoCath™; Micropos Medical AB, Gothenburg, Sweden) where a transmitter is noninvasively positioned in the prostatic urethra using a Foley catheter in 12 patients undergoing ultrahypofractionated intensity-modulated radiation therapy (IMRT) of the prostate. Gold fiducials (Innovative Technology Völp, Innsbruck, Austria) were implanted to allow comparison of accuracy and positional stability of the HypoCath system and its ability to be used as a standalone IGRT method. Spatial stability of the transponder was assessed by analyzing transmitter movement in relation to gold markers (GM) in superimposed kV image pairs. Inter- and intrafractional prostate movement and the impact of its correction were analyzed. RESULTS A total of 64 fractions were analyzed. The average resulting deviation vector compared to the GM-based position was 1.2 mm and 0.7 mm for inter- and intrafractional motion, respectively. The mean intrafractional displacement vector of the prostate was 1.9 mm. Table readjustment due to exceeding the threshold of 3 mm was required in 18.8% of fractions. Repositioning reduced the time spent outside the 3‑mm margin from 7.9% to 3.8% of beam-on time. However, for individual patients, the time spent outside the 3‑mm margin was reduced from to 49% to 19%. CONCLUSION the HypoCath system allows highly accurate and robust intrafractional motion monitoring. In conjunction with cone beam CT (CBCT) for initial patient setup, it could be used as a standalone image-guided radiation therapy (IGRT) system.
Collapse
Affiliation(s)
- Johannes Berchtold
- Dpt. of Radiation Oncology, Paracelsus Medical University of Salzburg, Müllner Hauptstraße 48, 5020, Salzburg, Austria
| | - Carmen Winkler
- Paracelsus Medical University of Salzburg, Stubergasse 21, 5020, Salzburg, Austria
| | - Josef Karner
- Dpt. of Radiation Oncology, Paracelsus Medical University of Salzburg, Müllner Hauptstraße 48, 5020, Salzburg, Austria
| | - Michael Groher
- Dpt. of Radiation Oncology, Paracelsus Medical University of Salzburg, Müllner Hauptstraße 48, 5020, Salzburg, Austria
| | - Christoph Gaisberger
- Dpt. of Radiation Oncology, Paracelsus Medical University of Salzburg, Müllner Hauptstraße 48, 5020, Salzburg, Austria
| | - Felix Sedlmayer
- Dpt. of Radiation Oncology, Paracelsus Medical University of Salzburg, Müllner Hauptstraße 48, 5020, Salzburg, Austria
| | - Frank Wolf
- Dpt. of Radiation Oncology, Paracelsus Medical University of Salzburg, Müllner Hauptstraße 48, 5020, Salzburg, Austria.
| |
Collapse
|
22
|
Goerdt L, Holz FG, Finger RP. [Retinal optical coherence tomography biomarkers in dementia]. DIE OPHTHALMOLOGIE 2024; 121:84-92. [PMID: 37847375 DOI: 10.1007/s00347-023-01947-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/25/2023] [Indexed: 10/18/2023]
Abstract
BACKGROUND Due to the general aging of society, the prevalence and incidence of dementia are expected to increase considerably. In order to timely identify patients and assess their need for treatment and/or supportive measures, comprehensive and easy access screening methods are required, which, however, are yet to be developed. To date, several biomarkers for the presence of dementia on high-resolution spectral domain optical coherence tomography (OCT) and OCT angiography (OCT-A) images were identified. AIM To summarize previously identified OCT biomarkers in dementia and to assess their suitability for comprehensive screening examinations. MATERIAL AND METHODS A literature search was conducted on PubMed until March 2023 for the keywords "dementia", "mild cognitive impairment", "OCT", "OCT angiography" and "retinal biomarkers". Relevant publications were identified and summarized. RESULTS Numerous unspecific alterations on OCT imaging and OCT‑A were identified in patients with (predementia) dementia according to many population and clinical studies. These include a reduced thickness of the peripapillary retinal nerve fiber layer, the ganglion cell complex and the central retinal region. Additionally, a reduced vascular density and an enlarged foveal avascular zone (FAZ) were identified on OCT‑A imaging. CONCLUSION The currently known OCT biomarkers are too unspecific, and there is to date no OCT or OCT-A-based signature distinguishing between different types of dementia. Further longitudinal studies with larger sample sizes are warranted to develop and evaluate such distinct OCT signatures for different types of dementia and their respective early disease stages and to assess their prognostic value. Only then is the inclusion in comprehensive screening investigations feasible.
Collapse
Affiliation(s)
- L Goerdt
- Universitäts-Augenklinik Bonn, Ernst-Abbe-Str. 2, 53127, Bonn, Deutschland.
| | - F G Holz
- Universitäts-Augenklinik Bonn, Ernst-Abbe-Str. 2, 53127, Bonn, Deutschland
| | - R P Finger
- Universitäts-Augenklinik Mannheim, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Deutschland
| |
Collapse
|
23
|
Seidel C, Nicolay NH. [Vorasidenib for low-grade gliomas-new treatment option with unanswered questions regarding long-term outcomes]. Strahlenther Onkol 2024; 200:178-180. [PMID: 37982841 PMCID: PMC10805806 DOI: 10.1007/s00066-023-02179-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2023] [Indexed: 11/21/2023]
Affiliation(s)
- Clemens Seidel
- Klinik und Poliklinik für Strahlentherapie, Universitätsklinikum Leipzig, Stephanstraße 9a, 04103, Leipzig, Deutschland.
| | - Nils H Nicolay
- Klinik und Poliklinik für Strahlentherapie, Universitätsklinikum Leipzig, Stephanstraße 9a, 04103, Leipzig, Deutschland
| |
Collapse
|
24
|
Zheng R, Wang S, Wang J, Zhou M, Shi Q, Liu B. Neuromedin U regulates the anti-tumor activity of CD8 + T cells and glycolysis of tumor cells in the tumor microenvironment of pancreatic ductal adenocarcinoma in an NMUR1-dependent manner. Cancer Sci 2024; 115:334-346. [PMID: 38071753 PMCID: PMC10859610 DOI: 10.1111/cas.16024] [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: 06/03/2023] [Revised: 11/01/2023] [Accepted: 11/07/2023] [Indexed: 02/13/2024] Open
Abstract
Pancreatic ductal adenocarcinoma (PDAC) is an aggressive cancer with a poor prognosis, which is lethal in approximately 90% of cases despite advanced standard therapies. A typical feature of PDAC is the immunosuppressive tumor microenvironment with multiple immunosuppressive factors including neurotransmitters. Recently, neuromedin U (NMU), a highly conserved neuropeptide with many physiological functions, has attracted attention for its roles in tumorigenesis and metastasis in several types of cancers. However, whether NMU affects PDAC progression remains unclear. In this study, using an orthotopic mouse model of PDAC in combination with bioinformatics analysis, we found that NMU was upregulated in tumor tissues from the patients with PDAC and positively correlated with a poor prognosis of the disease. Interestingly, knockout of the Nmu gene in mice enhanced the anti-tumor functions of tumor-infiltrating CD8+ T cells in an NMU receptor 1-dependent manner. Additionally, NMU promoted the glycolytic metabolism of mouse PDAC tumors. The activities of pyruvate kinase (PK) and lactate dehydrogenase (LDH), pivotal enzymes involved in the regulation of lactate production, were markedly reduced in tumor tissues from NMU-knockout mice. In vitro the presence of LDHA inhibitor can reduce the production of lactic acid stimulated by NMU, which can increase the anti-tumor activity of CD8+ T cells. Moreover, treatment of the pancreatic cancer cells with a phosphoinositide 3-kinase (PI3K) inhibitor diminished NMU-induced lactate production and the activities of PK and LDH, suggesting that NMU might regulate glycolysis via the PI3K/AKT pathway.
Collapse
Affiliation(s)
- Rui Zheng
- Department of Pathogenic Microbiology, School of Basic Medical ScienceChina Medical UniversityShenyangChina
- Department of Physiology, School of Basic Medical ScienceShenyang Medical CollegeShenyangChina
| | - Si Wang
- Department of Pathogenic Microbiology, School of Basic Medical ScienceChina Medical UniversityShenyangChina
| | - Jia Wang
- Department of Pathogenic Microbiology, School of Basic Medical ScienceChina Medical UniversityShenyangChina
| | - Mengnan Zhou
- Department of Pathogenic Microbiology, School of Basic Medical ScienceChina Medical UniversityShenyangChina
| | - Qi Shi
- Department of Pathogenic Microbiology, School of Basic Medical ScienceChina Medical UniversityShenyangChina
| | - Beixing Liu
- Department of Pathogenic Microbiology, School of Basic Medical ScienceChina Medical UniversityShenyangChina
| |
Collapse
|
25
|
Wang S, Li G, Du H, Feng J. Low-dose radiation from CT examination induces DNA double-strand breaks and detectable changes of DNA methylation in peripheral blood cells. Int J Radiat Biol 2024; 100:197-208. [PMID: 37812067 DOI: 10.1080/09553002.2023.2267667] [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: 07/07/2023] [Accepted: 09/25/2023] [Indexed: 10/10/2023]
Abstract
BACKGROUND Radiation burden from CT examinations increases rapidly with the increased clinical use frequency. Previous studies have disclosed the association between radiation exposure and increased double-strand breaks (DSBs) and changes in DNA methylation. However, whether the induced DSBs by CT examination recover within 24h and whether a CT examination induces detectable gene-specific methylation changes are still unclear. The aim of the present study was to analyze γ-H2AX in the peripheral blood lymphocyte (PBL) of healthy adults before and after CT examination and to discover the differentially methylated positions (DMPs) along with an analysis of DNA methylation changes caused by CT examination. MATERIALS AND METHODS Peripheral blood samples of 4 ml were drawn from 20 healthy volunteers at three time points: before CT examination, after CT examination 1h, and after CT examination 24h. γ-H2AX immunofluorescence and Illumina Infinium Human Methylation EPIC BeadChip (850k BeadChip) were used respectively for the test of DSBs and the epigenome-wide DNA methylation analysis. Linear mixed-effect (LME) models were used to evaluate the impacts of doses represented by different parameters and foci on genome-wide DNA methylation. RESULTS The number of γ-H2AX foci per cell at 1h showed linear dose-responses for the radiation doses represented by CT index volume (CTDIvol), dose length product (DLP), and blood absorbed dose, respectively. Residual γ-H2AX foci was observed after CT examination at 24h (p < .001). DMPs and γ-H2AX foci changes could be found within 1h. One CpG site related to PAX5 was significantly changed by using most of the parameters in LME models and did not recover till 24h. CONCLUSIONS Residual γ-H2AX foci exist after CT examination at 24h. The DNA methylation changes induced by CT examination may not recover within 24h. The DNA methylation had been changed as early as at 1h. The PAX5-related CpG site may be a potential biomarker of low-dose radiation. CLINICAL RELEVANCE The biological effects and the cancer risks of CT examination are still unclear. The present study is an effort to document the CT scan-induced events in 24h in vivo. The CT scanning area should be strictly limited, and non-essential repeated operations shouldn't be performed within 24h.
Collapse
Affiliation(s)
- Shuo Wang
- Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology and National Engineering Laboratory for Digital and Material Technology of Stomatology and Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Gang Li
- Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology and National Engineering Laboratory for Digital and Material Technology of Stomatology and Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Han Du
- Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology and National Engineering Laboratory for Digital and Material Technology of Stomatology and Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Jiling Feng
- Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology and National Engineering Laboratory for Digital and Material Technology of Stomatology and Beijing Key Laboratory of Digital Stomatology, Beijing, China
| |
Collapse
|
26
|
Esparza-Reig J, Julián M. Association between suicidal ideation and burnout: A meta-analysis. DEATH STUDIES 2024:1-12. [PMID: 38180020 DOI: 10.1080/07481187.2023.2300064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2024]
Abstract
Approximately 700,000 people die by suicide annually worldwide. Researchers have explored a spectrum of experiences that involve stress in academic or work environments and potentially intensify suicidal thoughts or behaviors. However, no meta-analysis has examined the relationship between suicidal ideation (SI) and burnout. This study consisted of a meta-analysis to examine the association between SI and burnout syndrome, utilizing the WoS Core Collection, Scopus, PubMed, PsycINFO, DIALNET, and Google Scholar databases. Twenty-one samples met the study's eligibility criteria for inclusion in the analysis. The results revealed a significant relationship between SI and burnout, with the type of burnout (occupational, academic, and parental) emerging as the most significant moderating variable. Occupational burnout exhibited the lowest correlation, followed by academic and parental burnout. These findings suggest the importance of developing tools to assess SI within the context of the work environment, parenting and academics, and psychoeducational programs for managing stress.
Collapse
Affiliation(s)
| | - Martín Julián
- Department of Psychology, Universidad Europea de Valencia, Valencia, Spain
| |
Collapse
|
27
|
Yu J, Petersen C, Reid S, Rosenbloom ST, Warner JL. Telehealth and Technology: New Directions in Cancer Care. Cancer J 2024; 30:40-45. [PMID: 38265926 DOI: 10.1097/ppo.0000000000000692] [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: 01/26/2024]
Abstract
ABSTRACT Telehealth is a broad concept that refers to any delivery of health care in real time using technologies to connect people or information that are not in the same physical location. Until fairly recently, telehealth was more aspiration than reality. This situation changed radically due in part to the COVID-19 pandemic, which led to a near-overnight inability for patients to be seen for routine management of chronic health conditions, including those with cancer. The purpose of this brief narrative review is to outline some areas where emerging and future technology may allow for innovations with specific implications for people with a current or past diagnosis of cancer, including underserved and/or historically excluded populations. Specific topics of telehealth are broadly covered in other areas of the special issue.
Collapse
Affiliation(s)
| | - Carolyn Petersen
- Department of Artificial Intelligence and Informatics, Mayo Clinic, Rochester, MN
| | - Sonya Reid
- Division of Hematology/Oncology, Department of Medicine
| | - S Trent Rosenbloom
- Department of Biomedical Informatics, Vanderbilt University, Nashville, TN
| | | |
Collapse
|
28
|
Karius A, Strnad V, Lotter M, Kreppner S, Fietkau R, Bert C. Investigating the impact of breast positioning control on physical treatment parameters in multi-catheter breast brachytherapy. Strahlenther Onkol 2024; 200:49-59. [PMID: 37676482 PMCID: PMC10784386 DOI: 10.1007/s00066-023-02127-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 07/16/2023] [Indexed: 09/08/2023]
Abstract
PURPOSE To assess the effects of a workflow for reproducible patient and breast positioning on implant stability during high-dose-rate multi-catheter breast brachytherapy. METHODS Thirty patients were treated with our new positioning control workflow. Implant stability was evaluated based on a comparison of planning-CTs to control-CTs acquired halfway through the treatment. To assess geometric stability, button-button distance variations as well as Euclidean dwell position deviations were evaluated. The latter were also quantified within various separated regions within the breast to investigate the location-dependency of implant alterations. Furthermore, dosimetric variations to target volume and organs at risk (ribs, skin) as well as isodose volume changes were analyzed. Results were compared to a previously treated cohort of 100 patients. RESULTS With the introduced workflow, the patient fraction affected by button-button distance variations > 5 mm and by dwell position deviations > 7 mm were reduced from 37% to 10% and from 30% to 6.6%, respectively. Implant stability improved the most in the lateral to medial breast regions. Only small stability enhancements were observed regarding target volume dosimetry, but the stability of organ at risk exposure became substantially higher. D0.2ccm skin dose variations > 12.4% and D0.1ccm rib dose variations > 6.7% were reduced from 11% to 0% and from 16% to 3.3% of all patients, respectively. CONCLUSION Breast positioning control improved geometric and dosimetric implant stability for individual patients, and thus enhanced physical plan validity in these cases.
Collapse
Affiliation(s)
- Andre Karius
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Universitätsstr. 27, 91054, Erlangen, Germany.
- Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany.
| | - Vratislav Strnad
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Universitätsstr. 27, 91054, Erlangen, Germany
- Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany
| | - Michael Lotter
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Universitätsstr. 27, 91054, Erlangen, Germany
- Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany
| | - Stephan Kreppner
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Universitätsstr. 27, 91054, Erlangen, Germany
- Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany
| | - Rainer Fietkau
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Universitätsstr. 27, 91054, Erlangen, Germany
- Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany
| | - Christoph Bert
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Universitätsstr. 27, 91054, Erlangen, Germany
- Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany
| |
Collapse
|
29
|
Liu M, Fan G, Liu H. Integrated bioinformatics and network pharmacology identifying the mechanisms and molecular targets of Guipi Decoction for treatment of comorbidity with depression and gastrointestinal disorders. Metab Brain Dis 2024; 39:183-197. [PMID: 37847347 DOI: 10.1007/s11011-023-01308-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 10/04/2023] [Indexed: 10/18/2023]
Abstract
BACKGROUND Guipi decoction (GPD) not only improves gastrointestinal (GI) function, but also depressive mood. The bioinformatics study aimed to reveal potential crosstalk genes and related pathways between depression and GI disorders. A network pharmacology approach was used to explore the molecular mechanisms and potential targets of GPD for the simultaneous treatment of depression comorbid GI disorders. METHODS Differentially expressed genes (DEGs) of major depressive disorder (MDD) were identified based on GSE98793 and GSE19738, and GI disorders-related genes were screened from the GeneCards database. Overlapping genes between MDD and GI disorders were obtained to identify potential crosstalk genes. Protein-protein interaction (PPI) network was constructed to screen for hub genes, signature genes were identified by LASSO regression analysis, and single sample gene set enrichment analysis (ssGSEA) was performed to analyze immune cell infiltration. In addition, based on the Traditional Chinese Medicine Systems Pharmacology (TCMSP) database, we screened the active ingredients and targets of GPD and identified the intersection targets of GPD with MDD and GI disorder-related genes, respectively. A "component-target" network was constructed using Cytoscape, the Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses were performed. RESULTS The MDD-corrected dataset contained 2619 DEGs, and a total of 109 crosstalk genes were obtained. 14 hub genes were screened, namely SOX2, CRP, ACE, LEP, SHH, CDH2, CD34, TNF, EGF, BDNF, FN1, IL10, PPARG, and KIT. These genes were identified by LASSO regression analysis for 3 signature genes, including TNF, EGF, and IL10. Gamma.delta.T.cell was significantly positively correlated with all three signature genes, while Central.memory.CD4.T.cell and Central.memory.CD8.T.cell were significantly negatively correlated with EGF and TNF. GPD contained 134 active ingredients and 248 targets, with 41 and 87 relevant targets for the treatment of depression and GI disorders, respectively. EGF, PPARG, IL10 and CRP overlap with the hub genes of the disease. CONCLUSION We found that GPD may regulate inflammatory and oxidative stress responses through EGF, PPARG, IL10 and CRP targets, and then be involved in the treatment of both depression and GI disorders.
Collapse
Affiliation(s)
- Menglin Liu
- Tianjin University of Chinese Medicine, Tianjin, China
| | - Genhao Fan
- Tianjin University of Chinese Medicine, Tianjin, China
| | - Huayi Liu
- Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital, Tianjin, China.
| |
Collapse
|
30
|
Gnerucci A, Esposito M, Ghirelli A, Pini S, Paoletti L, Barca R, Fondelli S, Alpi P, Grilli B, Rossi F, Scoccianti S, Russo S. Robustness analysis of surface-guided DIBH left breast radiotherapy: personalized dosimetric effect of real intrafractional motion within the beam gating thresholds. Strahlenther Onkol 2024; 200:71-82. [PMID: 37380796 DOI: 10.1007/s00066-023-02102-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 05/16/2023] [Indexed: 06/30/2023]
Abstract
PURPOSE The robustness of surface-guided (SG) deep-inspiration breath-hold (DIBH) radiotherapy (RT) for left breast cancer was evaluated by investigating any potential dosimetric effects due to the residual intrafractional motion allowed by the selected beam gating thresholds. The potential reduction of DIBH benefits in terms of organs at risk (OARs) sparing and target coverage was evaluated for conformational (3DCRT) and intensity-modulated radiation therapy (IMRT) techniques. METHODS A total of 192 fractions of SGRT DIBH left breast 3DCRT treatment for 12 patients were analyzed. For each fraction, the average of the real-time displacement between the isocenter on the daily reference surface and on the live surface ("SGRT shift") during beam-on was evaluated and applied to the original plan isocenter. The dose distribution for the treatment beams with the new isocenter point was then calculated and the total plan dose distribution was obtained by summing the estimated perturbed dose for each fraction. Then, for each patient, the original plan and the perturbed one were compared by means of Wilcoxon test for target coverage and OAR dose-volume histogram (DVH) metrics. A global plan quality score was calculated to assess the overall plan robustness against intrafractional motion of both 3DCRT and IMRT techniques. RESULTS Target coverage and OAR DVH metrics did not show significant variations between the original and the perturbed plan for the IMRT techniques. 3DCRT plans showed significant variations for the left descending coronary artery (LAD) and the humerus only. However, none of the dose metrics exceeded the mandatory dose constraints for any of the analyzed plans. The global plan quality analysis indicated that both 3DCRT and IMRT techniques were affected by the isocenter shifts in the same way and, generally, the residual isocenter shifts more likely tend to worsen the plan in all cases. CONCLUSION The DIBH technique proved to be robust against residual intrafractional isocenter shifts allowed by the selected SGRT beam-hold thresholds. Small-volume OARs located near high dose gradients showed significant marginal deteriorations in the perturbed plans with the 3DCRT technique only. Global plan quality was mainly influenced by patient anatomy and treatment beam geometry rather than the technique adopted.
Collapse
Affiliation(s)
- A Gnerucci
- Department of Physics and Astronomy, University of Florence, Florence, Italy.
| | - M Esposito
- Medical Physics Unit, Azienda USL Toscana Centro, Florence, Italy
| | - A Ghirelli
- Medical Physics Unit, Azienda USL Toscana Centro, Florence, Italy
| | - S Pini
- Medical Physics Unit, Azienda USL Toscana Centro, Florence, Italy
| | - L Paoletti
- Radiotherapy Unit, Azienda USL Toscana Centro, Florence, Italy
| | - R Barca
- Radiotherapy Unit, Azienda USL Toscana Centro, Florence, Italy
| | - S Fondelli
- Radiotherapy Unit, Azienda USL Toscana Centro, Florence, Italy
| | - P Alpi
- Radiotherapy Unit, Azienda USL Toscana Centro, Florence, Italy
| | - B Grilli
- Radiotherapy Unit, Azienda USL Toscana Centro, Florence, Italy
| | - F Rossi
- Radiotherapy Unit, Azienda USL Toscana Sud Est, Grosseto, Italy
| | - S Scoccianti
- Radiotherapy Unit, Azienda USL Toscana Centro, Florence, Italy
| | - S Russo
- Medical Physics Unit, Azienda USL Toscana Centro, Florence, Italy
| |
Collapse
|
31
|
Jeong YJ, Kim HS, Kang HG. Development and Evaluation of a Mobile Application to Prevent Recurrent Stroke by Enhancing Self-management on Health Outcomes for Stroke Survivors. Comput Inform Nurs 2024; 42:53-62. [PMID: 37580022 DOI: 10.1097/cin.0000000000001050] [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: 08/16/2023]
Abstract
This study aimed to develop a Mobile Application to Prevent Recurrent Stroke to prevent recurrent stroke by enhancing self-management and to evaluate its effects on stroke survivors' health outcomes. The Mobile Application to Prevent Recurrent Stroke was developed based on social cognitive theory and the model in order of analysis, design, development, implementation, and evaluation process. The Mobile Application to Prevent Recurrent Stroke consisted of health management contents such as information about stroke, its associated risk factors, and required skills to conduct self-management with tailored support and counseling. A quasi-experimental preintervention and postintervention design was used involving a total of 54 stroke survivors. The experimental group (n = 27) was provided the Mobile Application to Prevent Recurrent Stroke for 8 weeks, whereas the control group (n = 27) received an education booklet. The result revealed that medication adherence ( P = .002), healthy eating habit ( P < .001), physical activity ( P < .001), and affected-side grip strength ( P = .002) in the experimental group were significantly better than those in the control group. The systolic blood pressure ( P = .020), diastolic blood pressure ( P < .001), body mass index ( P < .001), and waist circumference ( P < .001) in the experimental group were significantly lower than those in the control group. Stroke survivors can easily use this Mobile Application to Prevent Recurrent Stroke to improve self-management. Nurses can provide tailored care based on the lifelogging data of stroke survivors to prevent recurrent stroke.
Collapse
Affiliation(s)
- Young Ju Jeong
- Author Affiliations: Department of Nursing, Wonkwang Health Science University, Iksan (Dr Jeong); and College of Nursing, Research Institute of Nursing Science, Jeonbuk National University (Dr Kim), and Department of Neurology, Research Institute of Clinical Medicine (Dr Kang), Jeonbuk National University and Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea
| | | | | |
Collapse
|
32
|
Zheng H, Du H, Liu J. Primary Bladder Non-Hodgkin Lymphoma: A Case Report. Cureus 2024; 16:e52688. [PMID: 38384624 PMCID: PMC10879654 DOI: 10.7759/cureus.52688] [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] [Accepted: 01/21/2024] [Indexed: 02/23/2024] Open
Abstract
Primary bladder lymphoma, a rare form of non-Hodgkin's lymphoma, is diagnosed through histopathology and immunostaining. Most bladder lymphomas are of the B-cell type, with a higher incidence in women and often presenting with hematuria. This report details an exceptionally rare case of primary bladder T-cell lymphoma. A 50-year-old male, without hematuria or other symptoms, was diagnosed during a routine ultrasound. A computed tomography scan showed a tumor located in the anterior, right, and posterior walls. The patient underwent transurethral resection of the bladder lesion. Pathological examination of the tumor showed that it was composed of lymphoid tissue, in accordance with peripheral T-cell lymphoma of non-Hodgkin subtype.
Collapse
Affiliation(s)
- Haobo Zheng
- Urology, Hebei General Hospital, Shijiazhuang City, CHN
| | - Hao Du
- Urology, Hebei General Hospital, Shijiazhuang City, CHN
| | - Junjiang Liu
- Urology, Hebei General Hospital, Shijiazhuang City, CHN
| |
Collapse
|
33
|
Christl J, Supprian T. [Lithium treatment for affective disorders in old age]. DER NERVENARZT 2024; 95:41-45. [PMID: 38189940 DOI: 10.1007/s00115-023-01601-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/13/2023] [Indexed: 01/09/2024]
Abstract
BACKGROUND Lithium is considered the gold standard for the treatment of bipolar affective disorder for the prevention of recurrence of manic and depressive episodes and for augmentation treatment in unipolar severe depressive episodes. The indications for treatment with lithium do not differ for older or younger patients. Nevertheless, there are a number of aspects to be considered with respect to drug safety in the group of old patients. OBJECTIVE The aim was to give an overview of the current literature on lithium treatment in old age and from this to derive recommendations for action. MATERIAL AND METHODS A selective literature review on lithium treatment in old age was conducted to answer questions on drug safety, monitoring (particularly with respect to comorbidities) and potential alternatives to lithium. RESULTS AND DISCUSSION Lithium is an effective and, if used correctly, safe drug also in old people; however, with respect to somatic comorbidities that increase with age, special caution is required when using lithium in order to prevent nephropathy and intoxication.
Collapse
Affiliation(s)
- Julia Christl
- Abteilung Gerontopsychiatrie, LVR-Klinikum Düsseldorf, Kliniken der Heinrich-Heine-Universität Düsseldorf, Bergische Landstr. 2, 40629, Düsseldorf, Deutschland.
| | - Tillmann Supprian
- Abteilung Gerontopsychiatrie, LVR-Klinikum Düsseldorf, Kliniken der Heinrich-Heine-Universität Düsseldorf, Bergische Landstr. 2, 40629, Düsseldorf, Deutschland
| |
Collapse
|
34
|
Lin Y, Wang Y, Lai T, Teng J, Lin C, Ke C, Yu I, Lee H, Chan C, Tung C, Conrad DF, O'Bryan MK, Lin Y. Deleterious genetic changes in AGTPBP1 result in teratozoospermia with sperm head and flagella defects. J Cell Mol Med 2024; 28:e18031. [PMID: 37937809 PMCID: PMC10826451 DOI: 10.1111/jcmm.18031] [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: 04/20/2023] [Revised: 10/23/2023] [Accepted: 10/28/2023] [Indexed: 11/09/2023] Open
Abstract
Approximately 10%-15% of couples worldwide are infertile, and male factors account for approximately half of these cases. Teratozoospermia is a major cause of male infertility. Although various mutations have been identified in teratozoospermia, these can vary among ethnic groups. In this study, we performed whole-exome sequencing to identify genetic changes potentially causative of teratozoospermia. Out of seven genes identified, one, ATP/GTP Binding Protein 1 (AGTPBP1), was characterized, and three missense changes were identified in two patients (Affected A: p.Glu423Asp and p.Pro631Leu; Affected B: p.Arg811His). In those two cases, severe sperm head and tail defects were observed. Moreover, AGTPBP1 localization showed a fragmented pattern compared to control participants, with specific localization in the neck and annulus regions. Using murine models, we found that AGTPBP1 is localized in the manchette structure, which is essential for sperm structure formation. Additionally, in Agtpbp1-null mice, we observed sperm head and tail defects similar to those in sperm from AGTPBP1-mutated cases, along with abnormal polyglutamylation tubulin and decreasing △-2 tubulin levels. In this study, we established a link between genetic changes in AGTPBP1 and human teratozoospermia for the first time and identified the role of AGTPBP1 in deglutamination, which is crucial for sperm formation.
Collapse
Affiliation(s)
- Yu‐Hua Lin
- Division of Urology, Department of SurgeryCardinal Tien HospitalNew TaipeiTaiwan
- Department of ChemistryFu Jen Catholic UniversityNew Taipei CityTaiwan
| | - Ya‐Yun Wang
- Graduate Institute of Biomedical and Pharmaceutical Science, Fu Jen Catholic UniversityNew Taipei CityTaiwan
| | - Tsung‐Hsuan Lai
- Department of Obstetrics and GynecologyCathay General HospitalTaipeiTaiwan
- School of Medicine, Fu Jen Catholic UniversityNew Taipei CityTaiwan
| | - Jih‐Lung Teng
- Graduate Institute of Biomedical and Pharmaceutical Science, Fu Jen Catholic UniversityNew Taipei CityTaiwan
| | - Chi‐Wei Lin
- Graduate Institute of Biomedical and Pharmaceutical Science, Fu Jen Catholic UniversityNew Taipei CityTaiwan
| | - Chih‐Chun Ke
- Department of UrologyEn Chu Kong HospitalNew Taipei CityTaiwan
| | - I‐Shing Yu
- Laboratory Animal CenterCollege of Medicine, National Taiwan UniversityTaipeiTaiwan
| | - Hui‐Ling Lee
- Department of ChemistryFu Jen Catholic UniversityNew Taipei CityTaiwan
| | - Chying‐Chyuan Chan
- Department of Obstetrics and GynecologyTaipei City Hospital, Zhongxing Branch and Branch for Women and ChildrenTaipeiTaiwan
| | - Chi‐Hua Tung
- Program of Artificial Intelligence & Information SecurityFu Jen Catholic UniversityNew Taipei CityTaiwan
| | - Donald F. Conrad
- Division of Genetics, Oregon National Primate Research CenterBeavertonOregonUSA
| | - Moira K. O'Bryan
- School of BioSciences and Bio21 Institute, The University of MelbourneParkvilleVictoriaAustralia
| | - Ying‐Hung Lin
- Graduate Institute of Biomedical and Pharmaceutical Science, Fu Jen Catholic UniversityNew Taipei CityTaiwan
| |
Collapse
|
35
|
Anisimova EN, Anisimova NY, Orekhova IV, Sedyakina YV. [Improving the effectiveness of local anesthesia in patients with arterial hypertension in the provision of emergency dental care]. STOMATOLOGIIA 2024; 103:32-35. [PMID: 38741532 DOI: 10.17116/stomat202410302132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
THE AIM OF THE STUDY Was to evaluate the use of Ketorol Express as a preventive analgesia to increase the effectiveness of local anesthesia in providing emergency dental care to patients with arterial hypertension. MATERIALS AND METHODS The study was conducted on the basis of the state autonomous healthcare institution of the Moscow region «Royal Dental Clinic» with the participation of 83 people. The patients were divided into two groups. In group 1, Ketorol Express was prescribed as a preventive analgesia in a dosage of 20 mg before local anesthesia. Patients of group 2 underwent dental interventions without the use of preventive analgesia. A 3% solution of mepivacaine was used as a local analgesic solution. For a subjective assessment of the effectiveness of anesthesia, use a visual analog scale. All patients had their blood pressure and heart rate measured before and after the interventions and hemodynamic parameters were continuously monitored during emergency dental care. RESULTS In group 1, the effectiveness of combined anesthesia with the infiltration method of local anesthetic administration was 93±1.17%, according to the patient, 94±1.47%, according to the doctor, with the conductive method of anesthesia at the mandibular orifice - according to the patient it was 91±1.01%, according to the doctor 92± 1.36%. In group 2, when providing emergency dental care with the infiltration method of administration of 3% mepivacaine the anesthesia was effective in 80±1.97% of cases according to the patient and in 80±1.17% of cases according to the doctor, with the conductive method of anesthesia at the mandibular orifice, the effectiveness of anesthesia according to the patient was 82±1.11%, according to the doctor 85±1.23%. CONCLUSION The results of the study demonstrated a statistically significant increase in the effectiveness of local anesthesia performed with a 3% solution of mepivacaine in patients with arterial hypertension due to the use of preventive analgesia with Ketorol Express at a dosage of 20 mg (2 tablets of 10 mg) in emergency dental care with registration and analysis of changes in hemodynamic parameters.
Collapse
Affiliation(s)
| | - N Yu Anisimova
- Russian university of medicine of the Ministry of Healthcare of the Russian Federation, Moscow, Russia
| | - I V Orekhova
- Russian Biotechnological University, Moscow, Russia
| | - Yu V Sedyakina
- Russian university of medicine of the Ministry of Healthcare of the Russian Federation, Moscow, Russia
| |
Collapse
|
36
|
Miething A, Juárez SP. Income mortality paradox by immigrants' duration of residence in Sweden: a population register-based study. J Epidemiol Community Health 2023; 78:11-17. [PMID: 37669849 PMCID: PMC10715552 DOI: 10.1136/jech-2023-220500] [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: 02/22/2023] [Accepted: 08/25/2023] [Indexed: 09/07/2023]
Abstract
BACKGROUND Studies have shown that, compared with the general native population, immigrants display weaker or absent income gradients in mortality. The aim of this study is to examine the extent to which the income gradient is modified by immigrants' duration of residence in Sweden. METHODS Swedish register data from 2004 to 2016 were used to study the association between individual income and all-cause mortality among foreign-born and Swedish-born individuals at ages 25-64 years. Based on relative indices of inequality (RIIs) and slope indices of inequality (SIIs) derived from Poisson regressions, we measured relative and absolute mortality differentials between the least and most advantaged income ranks. The analyses were stratified by sex, immigrants' European or non-European origin, and immigrants' duration of residence in Sweden. RESULTS The relative income inequality in mortality among immigrant men was less than half (RII: 2.32; 95% CI: 2.15 to 2.50) than that of Swedish-born men (RII: 6.25; 95% CI: 6.06 to 6.44). The corresponding RII among immigrant women was 1.23 (95% CI: 1.13 to 1.34) compared with an RII of 2.75 (95% CI: 2.65 to 2.86) among Swedish-born women. Inequalities in mortality were lowest among immigrants who resided for less than 10 years in Sweden, and most pronounced among immigrants who resided for more than 20 years in the country. Corresponding analyses of absolute income inequalities in mortality based on the SII were largely consistent with the observed relative inequalities in mortality. CONCLUSIONS Income inequalities in mortality among immigrants differ by duration of residence in Sweden, suggesting that health inequalities develop in the receiving context.
Collapse
Affiliation(s)
- Alexander Miething
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
| | - Sol P Juárez
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
| |
Collapse
|
37
|
Yang Z, Yao X, Wang M, Li H, Li R. Updates in psoriasis diagnosis and treatment status in China: results from the National Psoriasis Center Registry. Chin Med J (Engl) 2023; 136:2874-2876. [PMID: 37022938 PMCID: PMC10686595 DOI: 10.1097/cm9.0000000000002563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Indexed: 04/07/2023] Open
Affiliation(s)
- Zhihui Yang
- Department of Dermatology and Venereology, Peking University First Hospital, Beijing 100034, China
- Beijing Key Laboratory of Molecular Diagnosis of Dermatoses, Peking University First Hospital, Beijing 100034, China
- National Clinical Research Center for Skin and Immune Diseases, Beijing 100034, China
- NMPA Key Laboratory for Quality Control and Evaluation of Cosmetics, Peking University First Hospital, Beijing 100034, China
| | - Xinyu Yao
- Department of Dermatology and Venereology, Peking University First Hospital, Beijing 100034, China
- Beijing Key Laboratory of Molecular Diagnosis of Dermatoses, Peking University First Hospital, Beijing 100034, China
- National Clinical Research Center for Skin and Immune Diseases, Beijing 100034, China
- NMPA Key Laboratory for Quality Control and Evaluation of Cosmetics, Peking University First Hospital, Beijing 100034, China
| | - Mingyue Wang
- Department of Dermatology and Venereology, Peking University First Hospital, Beijing 100034, China
- Beijing Key Laboratory of Molecular Diagnosis of Dermatoses, Peking University First Hospital, Beijing 100034, China
- National Clinical Research Center for Skin and Immune Diseases, Beijing 100034, China
- NMPA Key Laboratory for Quality Control and Evaluation of Cosmetics, Peking University First Hospital, Beijing 100034, China
| | - Hang Li
- Department of Dermatology and Venereology, Peking University First Hospital, Beijing 100034, China
- Beijing Key Laboratory of Molecular Diagnosis of Dermatoses, Peking University First Hospital, Beijing 100034, China
- National Clinical Research Center for Skin and Immune Diseases, Beijing 100034, China
- NMPA Key Laboratory for Quality Control and Evaluation of Cosmetics, Peking University First Hospital, Beijing 100034, China
| | - Ruoyu Li
- Department of Dermatology and Venereology, Peking University First Hospital, Beijing 100034, China
- Beijing Key Laboratory of Molecular Diagnosis of Dermatoses, Peking University First Hospital, Beijing 100034, China
- National Clinical Research Center for Skin and Immune Diseases, Beijing 100034, China
- NMPA Key Laboratory for Quality Control and Evaluation of Cosmetics, Peking University First Hospital, Beijing 100034, China
| |
Collapse
|
38
|
Banu A, Naqvi S, Qashqoosh MTA, Manea YK. Multispectroscopic and computational study of interaction of the bovine serum albumin with atropine and atropine-loaded chitosan nanoparticles (synthesized and characterized). J Biomol Struct Dyn 2023; 41:11137-11147. [PMID: 37211826 DOI: 10.1080/07391102.2023.2212802] [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: 09/22/2022] [Accepted: 12/12/2022] [Indexed: 05/23/2023]
Abstract
Two different systems of bovine serum albumin (BSA) were used for multiple spectroscopic and computational studies to determine interaction of BSA and atropine (Atrop), that is, BSA-Atrop system and Atrop-loaded chitosan nanoparticles (Atrop@CS NPs), that is, BSA-Atrop@CS NPs system. The study suggests that BSA-Atrop system and BSA-Atrop@CS NPs system involve non-fluorescent complexes of Ksv = 3.2 × 103 Lmol-1 and 3.1 × 104 Lmol-1, kq = 3.2 × 1011 Lmol-1 s-1 and 3.1 × 1012 Lmol-1 s-1, the binding constant Kb = 1.4 × 103 Lmol-1, 2.0 × 102 Lmol-1, respectively, and number of binding sites n ∼ 1 for both the systems. The negligible conformational changes induced in BSA were also observed. Synchronous fluorescence spectroscopic study revealed that more quenching occurred in intrinsic fluorescence of tryptophan (Trp, W) than that in tyrosine residue (Tyr, Y). UV-vis spectroscopic study verified the presence of static quenching from the presence of BSA-Atrop and BSA-Atrop@CS NPs complexes. CD spectra confirmed the conformational changes induced in BSA upon increment of concentrations of Atrop and Atrop@CS NPs separately into the constant concentration of BSA. The coherent observations from various spectroscopic studies were in agreement with those of computational study, showing BSA-Atrop complex formation and other related details. The hydrogen bonds (H-bonds), van der Walls (vdW) interactions and π -type of interactions were mainly involved in stabilization of the formed BSA-Atrop complex.Communicated by Ramaswamy H. Sarma.
Collapse
Affiliation(s)
- Afreen Banu
- Chemistry Section, Women's College, Aligarh Muslim University, Aligarh, India
| | - Saeeda Naqvi
- Chemistry Section, Women's College, Aligarh Muslim University, Aligarh, India
| | | | | |
Collapse
|
39
|
Kumar M, Chauhan M, Verma SK, Biswas A, Ansari A, Mishra A, Sanap SN, Bisen AC, Sashidhara KV, Bhatta RS. Preclinical pharmacokinetic exploration of a novel osteoporotic quinazolinone-benzopyran-indole hybrid (S019-0385) using LC-MS/MS. Xenobiotica 2023; 53:484-497. [PMID: 37787761 DOI: 10.1080/00498254.2023.2265475] [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: 08/10/2023] [Accepted: 09/27/2023] [Indexed: 10/04/2023]
Abstract
1. The current investigation was to develop and validate the LC-MS/MS method in order to analyse the various pharmacokinetic parameters of S019-0385. A sensitive, selective, and robust LC-MS/MS approach was established and validated for measuring S019-0385 in female mice plasma and tissue, using optimal multiple reaction monitoring (MRM) transition m/z 488.25/329.12 on positive mode. On a Waters Symmetry Shield C18 column, the analyte was separated using acetonitrile and deionised water with formic acid within 6 min at 0.7 mL/min. Linearity (R2 ≥ 0.99) was observed across 0.195-100 ng/mL concentration range using linear least-squares regression.2. Blood-to-plasma ratio and plasma protein drug binding (%) in mice and human was assessed and found to be less than 1 and >83%, respectively. Absolute bioavailability (%F) of S019-0385 in female Swiss mice was exhibited to be 6.90%. Percent dose excreted S019-0385 in unchanged form through urine and faecal was found to be less than 2% and 0.5%, respectively.3. Following oral administration at 5 mg/kg, the concentration of S019-0385 in tissue distribution was found to be in the order of C small intestine > C bone > C lung > C spleen > C kidney > C liver > C heart > C brain.
Collapse
Affiliation(s)
- Mukesh Kumar
- Pharmaceutics and Pharmacokinetic Division, CSIR-Central Drug Research Institute, Lucknow, India
- Jawaharlal Nehru University, New Delhi, India
| | - Mridula Chauhan
- Pharmaceutics and Pharmacokinetic Division, CSIR-Central Drug Research Institute, Lucknow, India
| | - Sarvesh Kumar Verma
- Pharmaceutics and Pharmacokinetic Division, CSIR-Central Drug Research Institute, Lucknow, India
- Jawaharlal Nehru University, New Delhi, India
| | - Arpon Biswas
- Pharmaceutics and Pharmacokinetic Division, CSIR-Central Drug Research Institute, Lucknow, India
- Jawaharlal Nehru University, New Delhi, India
| | - Alisha Ansari
- Academy of Scientific and Innovative Research, Ghaziabad, India
- Division of medicinal and process chemistry, CSIR-Central Drug Research Institute, Lucknow, India
| | - Anjali Mishra
- Pharmaceutics and Pharmacokinetic Division, CSIR-Central Drug Research Institute, Lucknow, India
- Academy of Scientific and Innovative Research, Ghaziabad, India
| | - Sachin Nashik Sanap
- Pharmaceutics and Pharmacokinetic Division, CSIR-Central Drug Research Institute, Lucknow, India
- Academy of Scientific and Innovative Research, Ghaziabad, India
| | - Amol Chhatrapati Bisen
- Pharmaceutics and Pharmacokinetic Division, CSIR-Central Drug Research Institute, Lucknow, India
- Academy of Scientific and Innovative Research, Ghaziabad, India
| | - Koneni V Sashidhara
- Division of medicinal and process chemistry, CSIR-Central Drug Research Institute, Lucknow, India
| | - Rabi Sankar Bhatta
- Pharmaceutics and Pharmacokinetic Division, CSIR-Central Drug Research Institute, Lucknow, India
| |
Collapse
|
40
|
Rodríguez-Nogales C, Meeus J, Thonus G, Corveleyn S, Allémann E, Jordan O. Spray-dried nanocrystal-loaded polymer microparticles for long-term release local therapies: an opportunity for poorly soluble drugs. Drug Deliv 2023; 30:2284683. [PMID: 37994039 PMCID: PMC10987046 DOI: 10.1080/10717544.2023.2284683] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 11/12/2023] [Indexed: 11/24/2023] Open
Abstract
Nano- and micro-technologies can salvage drugs with very low solubility that were doomed to pre-clinical and clinical failure. A unique design approach to develop drug nanocrystals (NCs) loaded in extended release polymeric microparticles (MPs) for local treatments is presented here through the case of a potential osteoarthritis (OA) drug candidate for intra-articular (IA) administration. Optimizing a low-shear wet milling process allowed the production of NCs that can be subsequently freeze-dried (FD) and redispersed in a hydrophobic polymer-organic solvent solution to form spray-dried MPs. Results demonstrated a successful development of a ready-to-upscale formulation containing PLGA MPs with high drug NC encapsulation rates that showed a continuous and controlled drug release profile over four months. The screenings and procedures described allowed for identifying and overcoming common difficulties and challenges raised along the drug reduction to nano-size and spray-drying process. Above all, the technical knowledge acquired is intended for formulation scientists aiming to improve the therapeutic perspectives of poorly soluble drugs.
Collapse
Affiliation(s)
- Carlos Rodríguez-Nogales
- School of Pharmaceutical Sciences, University of Geneva, Geneva, Switzerland
- Institute of Pharmaceutical Sciences of Western Switzerland, Geneva, Switzerland
| | - Joke Meeus
- CMC Analytical Development, Galapagos NV, Mechelen, Belgium
| | - Gaby Thonus
- CMC Analytical Development, Galapagos NV, Mechelen, Belgium
| | - Sam Corveleyn
- CMC Analytical Development, Galapagos NV, Mechelen, Belgium
| | - Eric Allémann
- School of Pharmaceutical Sciences, University of Geneva, Geneva, Switzerland
- Institute of Pharmaceutical Sciences of Western Switzerland, Geneva, Switzerland
| | - Olivier Jordan
- School of Pharmaceutical Sciences, University of Geneva, Geneva, Switzerland
- Institute of Pharmaceutical Sciences of Western Switzerland, Geneva, Switzerland
| |
Collapse
|
41
|
Houldcroft CJ, Underdown S. Infectious disease in the Pleistocene: Old friends or old foes? AMERICAN JOURNAL OF BIOLOGICAL ANTHROPOLOGY 2023; 182:513-531. [PMID: 38006200 DOI: 10.1002/ajpa.24737] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 03/01/2023] [Accepted: 03/14/2023] [Indexed: 11/26/2023]
Abstract
The impact of endemic and epidemic disease on humans has traditionally been seen as a comparatively recent historical phenomenon associated with the Neolithisation of human groups, an increase in population size led by sedentarism, and increasing contact with domesticated animals as well as species occupying opportunistic symbiotic and ectosymbiotic relationships with humans. The orthodox approach is that Neolithisation created the conditions for increasing population size able to support a reservoir of infectious disease sufficient to act as selective pressure. This orthodoxy is the result of an overly simplistic reliance on skeletal data assuming that no skeletal lesions equated to a healthy individual, underpinned by the assumption that hunter-gatherer groups were inherently healthy while agricultural groups acted as infectious disease reservoirs. The work of van Blerkom, Am. J. Phys. Anthropol., vol. suppl 37 (2003), Wolfe et al., Nature, vol. 447 (2007) and Houldcroft and Underdown, Am. J. Phys. Anthropol., vol. 160, (2016) has changed this landscape by arguing that humans and pathogens have long been fellow travelers. The package of infectious diseases experienced by our ancient ancestors may not be as dissimilar to modern infectious diseases as was once believed. The importance of DNA, from ancient and modern sources, to the study of the antiquity of infectious disease, and its role as a selective pressure cannot be overstated. Here we consider evidence of ancient epidemic and endemic infectious diseases with inferences from modern and ancient human and hominin DNA, and from circulating and extinct pathogen genomes. We argue that the pandemics of the past are a vital tool to unlock the weapons needed to fight pandemics of the future.
Collapse
Affiliation(s)
| | - Simon Underdown
- Human Origins and Palaeoenvironmental Research Group, School of Social Sciences, Oxford Brookes University, Oxford, UK
- Center for Microbial Ecology and Genomics, Department of Biochemistry, Genetics and Microbiology, University of Pretoria, Pretoria, South Africa
| |
Collapse
|
42
|
Layer JP, Fischer P, Dejonckheere CS, Sarria GR, Mispelbaum R, Hattenhauer T, Wiegreffe S, Glasmacher AR, Layer K, Nour Y, Caglayan L, Grau F, Müdder T, Köksal M, Scafa D, Giordano FA, Lopez-Pastorini A, Stoelben E, Schmeel LC, Leitzen C. Safety and efficacy of helical tomotherapy following lung-sparing surgery in locally advanced malignant pleural mesothelioma. Strahlenther Onkol 2023:10.1007/s00066-023-02174-7. [PMID: 37993554 DOI: 10.1007/s00066-023-02174-7] [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: 08/14/2023] [Accepted: 10/22/2023] [Indexed: 11/24/2023]
Abstract
PURPOSE To assess the value of radiation therapy (RT) with helical tomotherapy (HT) in the management of locally advanced malignant pleural mesothelioma (MPM) receiving no or lung-sparing surgery. METHODS Consecutive MPM cases not undergoing extrapleural pneumonectomy and receiving intensity-modulated (IM) HT were retrospectively evaluated for local control, distant control, progression-free survival (PFS), and overall survival (OS). Impact of age, systemic treatment, RT dose, and recurrence patterns was analyzed by univariate and multivariate analysis. As a secondary endpoint, reported toxicity was assessed. RESULTS A total of 34 localized MPM cases undergoing IMHT were identified, of which follow-up data were available for 31 patients. Grade 3 side effects were experienced by 26.7% of patients and there were no grade 4 or 5 events observed. Median PFS was 19 months. Median OS was 20 months and the rates for 1‑ and 2‑year OS were 86.2 and 41.4%, respectively. OS was significantly superior for patients receiving adjuvant chemotherapy (p = 0.008). CONCLUSION IMHT of locally advanced MPM after lung-sparing surgery is safe and feasible, resulting in satisfactory local control and survival. Adjuvant chemotherapy significantly improves OS. Randomized clinical trials incorporating modern RT techniques as a component of trimodal treatment are warranted to establish an evidence-based standard of care pattern for locally advanced MPM.
Collapse
Affiliation(s)
- Julian P Layer
- Department of Radiation Oncology, University Hospital Bonn/Venusberg-Campus 1, 53127, Bonn, Germany.
- Institute of Experimental Oncology, University Hospital Bonn, Bonn, Germany.
| | - Pascal Fischer
- Department of Thoracic Surgery, St. Hildegardis Hospital, Augustinerinnen Krankenhäuser gGmbH, Cologne, Germany
| | - Cas S Dejonckheere
- Department of Radiation Oncology, University Hospital Bonn/Venusberg-Campus 1, 53127, Bonn, Germany
| | - Gustavo R Sarria
- Department of Radiation Oncology, University Hospital Bonn/Venusberg-Campus 1, 53127, Bonn, Germany
| | - Rebekka Mispelbaum
- Department of Oncology, Hematology, Rheumatology and Immune-Oncology, University Hospital Bonn, Bonn, Germany
| | - Tessa Hattenhauer
- Department of Oncology, Hematology, Rheumatology and Immune-Oncology, University Hospital Bonn, Bonn, Germany
| | - Shari Wiegreffe
- Department of Radiation Oncology, University Hospital Bonn/Venusberg-Campus 1, 53127, Bonn, Germany
| | - Andrea R Glasmacher
- Department of Radiation Oncology, University Hospital Bonn/Venusberg-Campus 1, 53127, Bonn, Germany
| | - Katharina Layer
- Department of Radiation Oncology, University Hospital Bonn/Venusberg-Campus 1, 53127, Bonn, Germany
| | - Youness Nour
- Department of Radiation Oncology, University Hospital Bonn/Venusberg-Campus 1, 53127, Bonn, Germany
| | - Lara Caglayan
- Department of Radiation Oncology, University Hospital Bonn/Venusberg-Campus 1, 53127, Bonn, Germany
| | - Franziska Grau
- Department of Radiation Oncology, University Hospital Bonn/Venusberg-Campus 1, 53127, Bonn, Germany
| | - Thomas Müdder
- Department of Radiation Oncology, University Hospital Bonn/Venusberg-Campus 1, 53127, Bonn, Germany
| | - Mümtaz Köksal
- Department of Radiation Oncology, University Hospital Bonn/Venusberg-Campus 1, 53127, Bonn, Germany
| | - Davide Scafa
- Department of Radiation Oncology, University Hospital Bonn/Venusberg-Campus 1, 53127, Bonn, Germany
| | - Frank A Giordano
- Department of Radiation Oncology, University Medical Center Mannheim, Mannheim, Germany
- DKFZ-Hector Cancer Institute of the University Medical Center Mannheim, Mannheim, Germany
| | - Alberto Lopez-Pastorini
- Department of Thoracic Surgery, St. Hildegardis Hospital, Augustinerinnen Krankenhäuser gGmbH, Cologne, Germany
| | - Erich Stoelben
- Department of Thoracic Surgery, St. Hildegardis Hospital, Augustinerinnen Krankenhäuser gGmbH, Cologne, Germany
| | | | - Christina Leitzen
- Department of Radiation Oncology, University Hospital Bonn/Venusberg-Campus 1, 53127, Bonn, Germany
| |
Collapse
|
43
|
Ikoona EN, Toure MA, Njenga A, Namulemo L, Kaluya R, Kamara K, Oyat FWD, Aloyo J, Matovu JB, Kitara DL. Double burden of malnutrition among women in reproductive Age (15-49 years) in Sierra Leone: a secondary data analysis of the demographic health survey 2019 (SLDHS-2019). BMC Nutr 2023; 9:133. [PMID: 37986123 PMCID: PMC10662572 DOI: 10.1186/s40795-023-00795-w] [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: 02/09/2023] [Accepted: 11/14/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND The double burden of malnutrition (DBM) is rising globally, particularly in sub-Saharan Africa. In Sierra Leone, the incidence of overweight, obesity (OWOB), and overnutrition among women has sharply increased. This finding accompanies the high incidence of undernutrition, which has been prevalent for decades. This study aimed to determine the prevalence of different malnutrition categories (underweight, overweight, obesity, and overnutrition) and associated factors among women of reproductive age (15-49 years) in Sierra Leone using secondary data analysis of the Sierra Leone Demographic Health Survey of 2019 (SLDHS-2019). METHODS We conducted secondary data analysis of the SLDHS-2019 of 7,514 women aged 15-49 years. We excluded pregnant, post-natal, lactating, and post-menopausal women. Data was collected using validated questionnaires, and respondents were selected through a multistage stratified sampling approach. A multivariable logistic regression analysis was used to determine factors associated with malnutrition among 15-49-year-old women in Sierra Leone. RESULTS Among 15-49-year-old women in Sierra Leone, the prevalence of underweight was 6.7% (95%CI: 4.5-8.9%); overweight at 19.7% (95%CI: 17.7-21.7%); obesity was 7.4% (95% CI: 5.2-9.6%); and overnutrition, 27.1% (95%CI: 25.2-29.0%). Women aged 25-34 years were more likely to be underweight (adjusted Odds Ratios, aOR = 1.670, 95%CI: 1.254-2.224; p < 0.001) than those aged 15-24 years; women who were not married were less likely to be underweight (aOR = 0.594, 95%CI: 0.467-0.755; p < 0.001) than married women. Women from the North were less likely to be underweight (aOR = 0.734, 95%CI: 0.559-0.963; p = 0.026) than the East, and those who did not listen to the radio were less likely to be underweight (aOR = 0.673; 95%CI: 0.549-0.826; p < 0.001) than those who did. Overweight was less likely among 25-34 years (aOR = 0.609, 95%CI: 0.514-0.722; p < 0.001) and 35-49 years (aOR = 0.480, 95%CI: 0.403-0.571; p < 0.001) age-groups than 15-24 years; more likely among not married women (aOR = 1.470, 95%CI:1.249-1.730; p < 0.001) than married; less likely among working-class (aOR = 0.840, 95%CI: 0.720-0.980; p = 0.026) than not working-class; most likely in women from the North (aOR = 1.325, 95%CI:1.096-1.602; p = 0.004), and less likely among women from the South (aOR = 0.755, 95%CI: 0.631-0.903; p = 0.002) than the East; less likely among women of middle-wealth-index (aOR = 0.656, 95%CI: 0.535-0.804; p < 0.001), richer-wealth-index (aOR = 0.400, 95%CI: 0.309-0.517; p < 0.001), and richest-wealth-index (aOR = 0.317, 95%CI: 0.234-0.431; p < 0.001) than the poorest-wealth-index; and more likely among women who did not listen to radios (aOR = 1.149; 95%CI:1.002-1.317; p = 0.047) than those who did. The predictors of overweight among women 15-49 years are the same as obesity and overnutrition, except overnutrition and obesity were less likely in female-headed households (aOR = 0.717,95%CI: 0.578-0.889; p < 0.001). CONCLUSION The prevalence of all categories of malnutrition among women of reproductive age in Sierra Leone is high, affirming a double burden of malnutrition in this study population. Underweight was more likely among the 25-34-year age group than 15-24-year. The predictors of overweight, obesity, and overnutrition were being unmarried/single, residing in the North, and not listening to the radio. There is an urgent need for policymakers in Sierra Leone to design comprehensive educational programs for women of reproductive age on healthy lifestyles and the dangers of being underweight or over-nourished.
Collapse
Affiliation(s)
| | | | - Amon Njenga
- ICAP at Columbia University, Freetown, Sierra Leone
| | - Lucy Namulemo
- Foothills Community Based interventions, Monticello, Columbia, KY, USA
- Lindsey Wilson College, School of Professional Counseling, Columbia, KY, USA
- Uganda Counseling and Support Services, Kampala, Uganda
| | - Ronald Kaluya
- Uganda Counseling and Support Services, Kampala, Uganda
| | - Kassim Kamara
- Directorate of Health Security and Emergencies, Ministry of Health and Sanitation, Freetown, Sierra Leone
| | | | - Judith Aloyo
- Uganda Medical Association (UMA), UMA-Acholi Branch, Gulu City, Uganda
- Rhites-N, Acholi, Gulu City, Uganda
| | | | - David Lagoro Kitara
- Uganda Medical Association (UMA), UMA-Acholi Branch, Gulu City, Uganda.
- Gulu Centre for Advanced Medical Diagnostics, Research, Trainings, and Innovations (GRUDI BIONTECH INITIATIVE), Gulu, Uganda.
- Faculty of Medicine, Department of Surgery, Gulu University, P.0. Box 166, Gulu City, Uganda.
| |
Collapse
|
44
|
Silva TV, Borovac-Pinheiro A, Pacagnella RC. Estimates of avoided costs attributed to a short cervix screening program to prevent preterm birth from the perspective of the Unified Health System (SUS). Rev Saude Publica 2023; 57:87. [PMID: 37971181 PMCID: PMC10653101 DOI: 10.11606/s1518-8787.2023057004376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 08/19/2022] [Indexed: 11/19/2023] Open
Abstract
OBJECTIVE To perform an economic cost analysis of the implementation of a short cervix screening program to reduce preterm birth in singleton pregnancies in a short-term time horizon. METHODS We performed a cost-benefit economic analysis using the P5 trial database, a randomized multicenter clinical trial for prevention of preterm birth. Data collection was conducted from July 2015 to March 2019 in 17 different Brazilian hospitals. We conducted a cost analysis for universal cervical screening in singleton pregnancies between 18 weeks and 22 weeks plus 6 days. In subjects with a cervical length ≤ 25 mm, the analysis incorporated the costs of administering 200 mg/day of vaginal progesterone prophylactically until 36 weeks gestation. These findings were subsequently compared with the economic implications of forgoing cervical screening. The time horizon comprised from birth to 10 weeks postpartum. The outcome was measured monetarily in Brazilian real (R$) from the perspective of the Unified Health System. RESULTS Among 7,844 women, 6.67% (523) had a cervix ≤ 25 mm. The cost of screening with transvaginal ultrasound and vaginal progesterone for prevention of births with < 34 weeks was estimated at R$ 383,711.36, while non-screening generated an estimated additional cost of R$ 446,501.69 (related to the 29 non-screened preterm deliveries). Thus, screening and prophylaxis would generate a final cost reduction of R$ 62,790.33, constituting a possible cost-benefit strategy. CONCLUSION Universal short cervix screening for preterm birth has lower costs compared to non-screening within a short-term time horizon, which suggests an interesting benefit-cost ratio. Future studies should consider the cost-effectiveness of prophylactic treatment using sensitivity analyses in different scenarios within the Brazilian health system, as well as analyses that consider the long-term costs associated with preterm births, to robustly justify the implementation of a short cervix screening program.
Collapse
Affiliation(s)
- Thais V Silva
- Universidade Estadual de Campinas . Faculdade de Ciências Médicas . Departamento de Tocoginecologia . Campinas , SP , Brasil
- Universidade de Pernambuco . Centro Universitário Integrado de Saúde Amaury de Medeiros . Recife , PE , Brasil
| | - Anderson Borovac-Pinheiro
- Universidade Estadual de Campinas . Faculdade de Ciências Médicas . Departamento de Tocoginecologia . Campinas , SP , Brasil
| | - Rodolfo C Pacagnella
- Universidade Estadual de Campinas . Faculdade de Ciências Médicas . Departamento de Tocoginecologia . Campinas , SP , Brasil
| |
Collapse
|
45
|
Pingping Z, Yanyu Z, Xuri S, Qiming H, Yi W, Guoliang T. Comparison between original SARS-CoV-2 strain and omicron variant on thin-section chest CT imaging of COVID-19 pneumonia. RADIOLOGIE (HEIDELBERG, GERMANY) 2023; 63:55-63. [PMID: 37280418 PMCID: PMC10243278 DOI: 10.1007/s00117-023-01147-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/23/2023] [Indexed: 06/08/2023]
Abstract
OBJECTIVES We investigated different computed tomography (CT) features between Omicron-variant and original-strain SARS-CoV‑2 pneumonia to facilitate the clinical management. MATERIALS AND METHODS Medical records were retrospectively reviewed to select patients with original-strain SARS-CoV‑2 pneumonia from February 22 to April 22, 2020, or Omicron-variant SARS-CoV‑2 pneumonia from March 26 to May 31, 2022. Data on the demographics, comorbidities, symptoms, clinical types, and CT features were compared between the two groups. RESULTS There were 62 and 78 patients with original-strain or Omicron-variant SARS-CoV‑2 pneumonia, respectively. There were no differences between the two groups in terms of age, sex, clinical types, symptoms, and comorbidities. The main CT features differed between the two groups (p = 0.003). There were 37 (59.7%) and 20 (25.6%) patients with ground-glass opacities (GGO) in the original-strain and Omicron-variant pneumonia, respectively. A consolidation pattern was more frequently observed in the Omicron-variant than original-strain pneumonia (62.8% vs. 24.2%). There was no difference in crazy-paving pattern between the original-strain and Omicron-variant pneumonia (16.1% vs. 11.6%). Pleural effusion was observed more often in Omicron-variant pneumonia, while subpleural lesions were more common in the original-strain pneumonia. The CT score in the Omicron-variant group was higher than that in the original-strain group for critical-type (17.00, 16.00-18.00 vs. 16.00, 14.00-17.00, p = 0.031) and for severe-type (13.00, 12.00-14.00 vs 12.00, 10.75-13.00, p = 0.027) pneumonia. CONCLUSION The main CT finding of the Omicron-variant SARS-CoV‑2 pneumonia included consolidations and pleural effusion. By contrast, CT findings of original-strain SARS-CoV‑2 pneumonia showed frequent GGO and subpleural lesions, but without pleural effusion. The CT scores were also higher in the critical and severe types of Omicron-variant than original-strain pneumonia.
Collapse
Affiliation(s)
- Zeng Pingping
- Department ICU of the Second Affiliated Hospital, Fujian Medical University, No. 34, Zhongshan North Road, Licheng District, Quanzhou City, Fujian, China
| | - Zhou Yanyu
- Department ICU of the Second Affiliated Hospital, Fujian Medical University, No. 34, Zhongshan North Road, Licheng District, Quanzhou City, Fujian, China
| | - Sun Xuri
- Department ICU of the Second Affiliated Hospital, Fujian Medical University, No. 34, Zhongshan North Road, Licheng District, Quanzhou City, Fujian, China
| | - Huang Qiming
- Department of Medical Imaging of the Second Affiliated Hospital, Fujian Medical University, No. 34, Zhongshan North Road, Licheng District, Quanzhou City, Fujian, China
| | - Wang Yi
- Department of Medical Imaging of the Second Affiliated Hospital, Fujian Medical University, No. 34, Zhongshan North Road, Licheng District, Quanzhou City, Fujian, China
| | - Tan Guoliang
- Department ICU of the Second Affiliated Hospital, Fujian Medical University, No. 34, Zhongshan North Road, Licheng District, Quanzhou City, Fujian, China.
- Wuhan Jinyintan Hospital, Wuhan City, China.
- The Fourth People's Hospital of Shanghai, Shanghai City, China.
| |
Collapse
|
46
|
Keven A, Yetim EE, Elmalı A, Arslan AG, Çubuk SM. The role of diffusion magnetic resonance imaging in determining tumor aggressiveness during preoperative surgical planning in early-stage endometrial cancer. RADIOLOGIE (HEIDELBERG, GERMANY) 2023; 63:41-48. [PMID: 37014376 DOI: 10.1007/s00117-023-01134-7] [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: 11/15/2022] [Accepted: 02/14/2023] [Indexed: 04/05/2023]
Abstract
PURPOSE The present study aimed to evaluate the relationship between tumor volume and apparent diffusion coefficient (ADC) in preoperative magnetic resonance imaging and deep myometrial invasion, tumor grade, and lymphovascular space invasion (LVSI) in patients with early-stage endometrial cancer. METHODS The study included 73 patients diagnosed with early-stage endometrial cancer based on histopathological examination between May 2014 and July 2019. Receiver operating characteristic (ROC) curve analysis was used to estimate the accuracy of ADC and tumor volume in predicting the LVSI, the depth of myometrial invasion (DMI), and the histopathological tumor grade in these patients. RESULTS The areas under the ROC curves (AUCs) of ADC and tumor volume in predicting LVI, DMI, and high tumor grade were significantly greater than those for superficial myometrial invasion and low-grade tumors. The ROC analysis revealed that higher tumor volume was significantly associated with the prediction of DMI and tumor grade (p = 0.002 and p = 0.015). The corresponding cut-off values of tumor volume were > 7.12 and > 9.38 mL. The sensitivity of ADC in predicting DMI was higher than its sensitivity in predicting LVSI and grade 1 tumors. Furthermore, tumor volume was significantly associated with the prediction of DMI and tumor grade. CONCLUSION In the absence of pathological pelvic lymph nodes in early-stage endometrial cancer, tumor volume in DWI sequences determines the active tumor load and tumor aggressiveness. Furthermore, a low ADC indicates deep myometrial invasion and helps differentiate stage IA and stage IB tumors.
Collapse
Affiliation(s)
- Ayşe Keven
- Department of Radiology, Akdeniz University School of Medicine, Dumlupınar bulvarı, 07059, Arapsuyu, Antalya, Turkey.
| | - Emel Emir Yetim
- Department of Radiology, Akdeniz University School of Medicine, Dumlupınar bulvarı, 07059, Arapsuyu, Antalya, Turkey
| | - Aygül Elmalı
- Department of Radiology, Akdeniz University School of Medicine, Dumlupınar bulvarı, 07059, Arapsuyu, Antalya, Turkey
| | - Ahmet Gökhan Arslan
- Department of Radiology, Akdeniz University School of Medicine, Dumlupınar bulvarı, 07059, Arapsuyu, Antalya, Turkey
| | - Süleyman Metin Çubuk
- Department of Radiology, Akdeniz University School of Medicine, Dumlupınar bulvarı, 07059, Arapsuyu, Antalya, Turkey
| |
Collapse
|
47
|
Jin Y, Liu H, Zhao B, Pan W. ChatGPT and mycosis- a new weapon in the knowledge battlefield. BMC Infect Dis 2023; 23:731. [PMID: 37891532 PMCID: PMC10605453 DOI: 10.1186/s12879-023-08724-9] [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: 08/27/2023] [Accepted: 10/17/2023] [Indexed: 10/29/2023] Open
Abstract
As current trend for physician tools, ChatGPT can sift through massive amounts of information and solve problems through easy-to-understand conversations, ultimately improving efficiency. Mycosis is currently facing great challenges, including high fungal burdens, high mortality, limited choice of antifungal drugs and increasing drug resistance. To address these challenges, We asked ChatGPT for fungal infection scenario-based questions and assessed its appropriateness, consistency, and potential pitfalls. We concluded ChatGPT can provide compelling responses to most prompts, including diagnosis, recommendations for examination, treatment and rational drug use. Moreover, we summarized exciting future applications in mycosis, such as clinical work, scientific research, education and healthcare. However, the largest barriers to implementation are deficits in indiviudal advice, timely literature updates, consistency, accuracy and data safety. To fully embrace the opportunity, we need to address these barriers and manage the risks. We expect that ChatGPT will become a new weapon in in the battlefield of mycosis.
Collapse
Affiliation(s)
- Yi Jin
- Department of Dermatology, Shanghai Key Laboratory of Medical Mycology, Second Affiliated Hospital of Naval Medical University, Shanghai, 200003, P.R. China
| | - Hua Liu
- Department of Anesthesiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Bin Zhao
- Department of Anesthesiology and SICU, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200092, P.R. China.
| | - Weihua Pan
- Department of Dermatology, Shanghai Key Laboratory of Medical Mycology, Second Affiliated Hospital of Naval Medical University, Shanghai, 200003, P.R. China.
| |
Collapse
|
48
|
Ebenbichler GR, Murakoezy G, Kohlmann J, Habenicht R, Kienbacher T, Jaksch P, Mair P, Hoetzenecker K. Reproducibility of the 6-minute walk test in lung transplant recipients. Wien Klin Wochenschr 2023; 135:517-527. [PMID: 36576557 PMCID: PMC10558359 DOI: 10.1007/s00508-022-02132-w] [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: 06/10/2022] [Accepted: 11/19/2022] [Indexed: 12/29/2022]
Abstract
PURPOSE There is reason to believe that the favorable measurement properties of the 6‑minute walk test (6MWT) reported for retest reliability and its capability to detect a true change in healthy individuals or persons with chronic respiratory disease may not apply to lung transplant recipients (LuTXr). We therefore investigated retest reliability of the 6MWT and, in addition, made an attempt to explore whether the 6MWT was sensitive enough to detect important changes that occur with postacute rehabilitation in LuTXr after first time LuTX. METHODS Immediately before postacute rehabilitation, 50 LuTXr completed 6MWT testing twice, separated by 1-2 workdays (retest reliability), and were reassessed after completion of rehabilitation 2 months later (sensitivity to changes). Body function measures and health-related quality of life (HRQoL) assessments were collected at baseline. RESULTS Baseline retest 6‑minute walk distance (6MWD) and the age-related predicted walking distance (6MWD%pred) scores significantly increased before postacute rehabilitation. The intraclass coefficient of correlation ICC of the 6MWD was 0.93 (95% confidence interval, CI: 0.88-0.96) and its smallest real difference (SRD) 79 m (95% CI: 52;107). Receiver operating curve analyses revealed the rehabilitation associated changes in 6MWD/6MWD%pred to exceed the SRD/SRD% values in a highly accurate way. CONCLUSION The 6MWT overall represents a reliable functional performance tool in LuTXr that is sensitive to detect changes in physical performance as a result of medical postacute rehabilitation.
Collapse
Affiliation(s)
- Gerold R Ebenbichler
- Department of Physical Medicine, Rehabilitation & Occupational Medicine, Medical University of Vienna, General Hospital of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
| | - Gabriella Murakoezy
- Department of Thoracic Surgery, Medical University of Vienna, General Hospital of Vienna, Vienna, Austria
| | - Julia Kohlmann
- Department of Physical Medicine, Rehabilitation & Occupational Medicine, Medical University of Vienna, General Hospital of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Richard Habenicht
- Karl-Landsteiner-Institute for Outpatient Rehabilitation Research, Vienna, Austria
| | - Thomas Kienbacher
- Karl-Landsteiner-Institute for Outpatient Rehabilitation Research, Vienna, Austria
| | - Peter Jaksch
- Department of Thoracic Surgery, Medical University of Vienna, General Hospital of Vienna, Vienna, Austria
| | - Patrick Mair
- Department of Psychology, Harvard University, Cambridge, MA, USA
| | - Konrad Hoetzenecker
- Department of Thoracic Surgery, Medical University of Vienna, General Hospital of Vienna, Vienna, Austria
| |
Collapse
|
49
|
De Carvalho DE, Callaghan JP. Effect of office chair design features on lumbar spine posture, muscle activity and perceived pain during prolonged sitting. ERGONOMICS 2023; 66:1465-1476. [PMID: 36437777 DOI: 10.1080/00140139.2022.2152113] [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: 08/22/2022] [Accepted: 11/18/2022] [Indexed: 06/16/2023]
Abstract
Chair design features are typically compared using multiple seats, which can lead to confounding effects. Using a single chair, configurable to four designs (control, lumbar support, seat pan tilt and scapular relief), we investigated the effect of chair design on spine posture and movement, muscle activity and perceived pain in a sample of 31 asymptomatic adults. A total of 39% of the population were classified as pain developers, having significantly higher peak pain levels across most body regions. The lumbar support and seat pan tilt condition resulted in more neutral spine and pelvic postures. Greater muscle activity was found in the seat pan condition and non-pain developers displayed lower spine muscle activation levels overall. Despite some improvements in spine posture, sitting-induced pain was present in the study sample at similar proportions to those reported previously. Future studies may consider investigating interventions targeted to sitting-induced pain developers as opposed to the general population. Practitioner summary: Four office chair configurations were tested. The lumbar support and seat pan tilt conditions resulted in the most neutral back posture but did not mitigate the clinically significant levels of sitting-induced pain experienced by a large portion of the tested sample. Future work should target interventions to these individuals.
Collapse
Affiliation(s)
- D E De Carvalho
- Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada
| | - J P Callaghan
- Department of Kinesiology & Health Sciences, Faculty of Health, University of Waterloo, Waterloo, ON, Canada
| |
Collapse
|
50
|
Jiang H, Makelike K, Chen B, Xi M, Li Q, Hu Y, Zhu Y. Definitive concurrent chemoradiotherapy with docetaxel plus cisplatin versus 5-fluorouracil plus cisplatin in patients with esophageal squamous cell carcinoma: long-term follow-up results of a phase II randomized controlled trial. Radiat Oncol 2023; 18:150. [PMID: 37700348 PMCID: PMC10498519 DOI: 10.1186/s13014-023-02339-9] [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: 02/12/2023] [Accepted: 08/24/2023] [Indexed: 09/14/2023] Open
Abstract
BACKGROUND Definitive radiotherapy plus concurrent chemotherapy has been a standard treatment for esophagus patients who are unfit to undergo surgery. However, there are a variety of concurrent chemotherapy regimens with varying efficacy. In this phase II prospective study, we compared the efficacy and toxicity of DP (docetaxel and cisplatin) and PF (cisplatin and 5-fluorouracil) regimens with concurrent chemoradiotherapy (CCRT) in patients with esophageal squamous cell carcinoma (ESCC) and analyzed the 5-year overall survival (OS) and progression free survival (PFS). We also summarized the salvage treatments and late toxicities. METHODS We enrolled 86 patients with clinical stage II-IVA from the Sun Yat-sen University Cancer Center. The patients were divided into two groups: PF group (41) and DP group (45). Statistics were analyzed using SPSS version 19.0. RESULTS The 5-year OS rates were 62.9% ± 7.6% in PF group, and 52.7% ± 7.5% in DP group (P = 0.131), respectively. The 5-year PFS rates were 43.9% ± 7.8% for PF group, and 40.0% ± 7.3% for DP group (P = 0.398), respectively. Sixteen patients in the DP group and thirteen in the PF group received salvage treatment. For those patients with local residual or local recurrent disease, the median survival time after salvage treatment was 13.5 months and the 1, 2, and 3-year survival rates were 79.0%, 50.3%, and 43.1%, respectively. For all patients, thirteen (15.1%) had Grade 2 late cardiac toxicities. One patient had Grade 2 pleural effusion and required diuretic. Most patients with pneumonia are mild, and only one patient in PF group had Grade 2 pneumonia. One patient in the DP group developed tracheoesophageal fistula. CONCLUSIONS The 5-year follow-up confirmed that definitive CCRT with the DP regimen did not improve the treatment response, OS, or PFS in patients with ESCC compared to the PF regimen. The PF regimen remains the standard regimen for definitive CCRT for patients with locally advanced ESCC. Long-term follow-up also suggested that appropriate and active salvage treatment has a survival benefit for some patients, and late cardiopulmonary toxicities should be noticed during follow-up. TRIAL REGISTRATION The trial was registered at https://clinicaltrials.gov (ClinicalTrials.gov Identifier: NCT02969473, October 2010).
Collapse
Affiliation(s)
- Hui Jiang
- Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, 651 Dongfeng East Road, Guangzhou, 510060, Guangdong, P.R. China
| | - Kanjiebubi Makelike
- Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, 651 Dongfeng East Road, Guangzhou, 510060, Guangdong, P.R. China
| | - Baoqing Chen
- Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, 651 Dongfeng East Road, Guangzhou, 510060, Guangdong, P.R. China
| | - Mian Xi
- Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, 651 Dongfeng East Road, Guangzhou, 510060, Guangdong, P.R. China
| | - Qiaoqiao Li
- Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, 651 Dongfeng East Road, Guangzhou, 510060, Guangdong, P.R. China
| | - Yonghong Hu
- Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, 651 Dongfeng East Road, Guangzhou, 510060, Guangdong, P.R. China
| | - Yujia Zhu
- Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, 651 Dongfeng East Road, Guangzhou, 510060, Guangdong, P.R. China.
| |
Collapse
|