Showing papers in "Archives of Medical Science in 2022"
TL;DR: A joint position paper by the Polish Society of Hypertension, Polish Society for the Treatment of Obesity, Polish Lipid Association, Polish Association for Study of Liver, and Division of Prevention and Epidemiology.
Abstract: A joint position paper by the Polish Society of Hypertension, Polish Society for the Treatment of Obesity, Polish Lipid Association, Polish Association for Study of Liver, Polish Society of Family Medicine, Polish Society of Lifestyle Medicine, Division of Prevention and Epidemiology Polish Cardiac Society, “Club 30” Polish Cardiac Society, and Division of Metabolic and Bariatric Surgery Society of Polish Surgeons
18 citations
TL;DR: The fastest way to have inclisiran available for the polish patients, with the necessary changes of the existing drug program for PCSK9 inhibitors (B-101), is indicated, explaining why it is the optimal way, and why, taking into account available EBM data (the ORION program), inclisIRan should be added to this program.
Abstract: It is the statement of the Polish Experts on the group of patients that might benefit the most from inclisiran. We indicated the fastest way to have inclisiran available for the polish patients, with the necessary changes of the existing drug program for PCSK9 inhibitors (B-101), explaining why it is the optimal way, and why, taking into account available EBM data (the ORION program), inclisiran should be added to this program. We also present some perspective on the future necessary changes in the availability of the innovative therapies such us PCSK9 targeted therapy, what, taking into account the effectiveness of LDL-C goal achievement in Poland for very high CVD risk patients (only 17%), seems to be critically important. Obviously it needs to be combined with our continuous attempts to improve the effectiveness and therapy adherence to available cheap therapy with statins and ezetimibe.
9 citations
TL;DR: Empagliflozin may be a new safe treatment in GSD Ib patients with an advanced stage of the disease and improvement of clinical symptoms of inflammatory bowel disease and arthritis along with reduction in serum CRP levels and urinary albumin excretion was noted.
Abstract: Introduction Recently published case reports suggest the benefit of empagliflozin use in subjects with glycogen storage disease Ib (GSD Ib). Methods We present the clinical and laboratory data of 2 adult brothers with GSD Ib treated with empagliflozin for 12 months. Results There was no severe infection during administration of empagliflozin. The improvement of clinical symptoms of inflammatory bowel disease and arthritis along with reduction in serum CRP levels and urinary albumin excretion was noted. Neutrophil count increased, allowing for reduction or temporary withdrawal of G-CSF treatment. Conclusions Empagliflozin may be a new safe treatment in GSD Ib patients with an advanced stage of the disease.
5 citations
TL;DR: There was no significant effect of LLAs regardless of the achieved level of LDL-C on the risk of hemorrhagic stroke; however, TSA indicated that further studies are needed to settle the question and most of the effects were subject to high levels of heterogeneity.
Abstract: Introduction The impact of low-density lipoprotein cholesterol (LDL-C) on the risk of different types of strokes is unclear. Therefore, we systematically evaluated the impact of LDL-C levels (cohort studies) and lipid-lowering agents (LLAs) (randomized controlled trials) on the different types of stroke. Material and methods PubMed, SCOPUS, Web of Science and Google Scholar were searched up to 1st September 2019. The DerSimonian-Laird method and generic inverse variance methods were used for quantitative data synthesis. The leave-one-out method was performed as sensitivity analysis. Trial sequential analysis (TSA) was used to evaluate the optimal sample size to detect a 35% reduction in outcomes after administration of LLAs. Results Participants in the highest category of LDL-C had a lower risk of hemorrhagic stroke (RR = 0.91, 95% CI: 0.85–0.98, I2 = 0%) compared with the lowest category of LDL-C. Subjects with the highest category of LDL-C had a higher risk of ischemic stroke (RR = 1.11, 95% CI: 1.07–1.14, I2 = 0%) compared to the lowest LDL-C category. LLAs decreased the risk of all types of strokes for those who achieved LDL-C < 1.8 mmol/l (< 70 mg/dl; RR = 0.88, 95% CI: 0.80–0.96, absolute risk reduction (ARR): 0.7%, number needed to treat (NNT): 143, I2 = 53%, n = 13). Statin therapy decreased the risk of all strokes (RR = 0.88, 95% CI: 0.80–0.97, ARR = 0.6%, NNT = 167, I2 = 56%). With regard to ischemic stroke only, LLAs decreased the risk of ischemic stroke for those who achieved LDL-C < 1.8 mmol/l (< 70 mg/dl; RR = 0.75, 95% CI: 0.67–0.83, ARR = 1.3%, NNT = 77, I2 = 0%); the same was observed for statins (RR = 0.76, 95% CI: 0.69–0.84, ARR = 1.3%, NNT = 77, I2 = 32%). TSA indicated that both benefit boundaries and optimal sample size were reached. There was no significant effect of LLAs regardless of the achieved level of LDL-C on the risk of hemorrhagic stroke; however, TSA indicated that further studies are needed to settle the question and most of the effects were subject to high levels of heterogeneity. Conclusions Our study sheds light on the debatable association between low LDL-C and different type of strokes. This information can help determine the optimal LDL-C range for stroke prevention, and help plan future LLA studies.
4 citations
TL;DR: Machine learning techniques were applied in order to develop an accurate in-hospital mortality risk score for COVID-19 based on ten variables that has utility in clinical settings to guide the management and prognostication of CO VID-19 patients.
Abstract: Introduction Identifying SARS-CoV-2 patients at higher risk of mortality is crucial in the management of a pandemic. Artificial intelligence techniques allow one to analyze large amounts of data to find hidden patterns. We aimed to develop and validate a mortality score at admission for COVID-19 based on high-level machine learning. Material and methods We conducted a retrospective cohort study on hospitalized adult COVID-19 patients between March and December 2020. The primary outcome was in-hospital mortality. A machine learning approach based on vital parameters, laboratory values and demographic features was applied to develop different models. Then, a feature importance analysis was performed to reduce the number of variables included in the model, to develop a risk score with good overall performance, that was finally evaluated in terms of discrimination and calibration capabilities. All results underwent cross-validation. Results 1,135 consecutive patients (median age 70 years, 64% male) were enrolled, 48 patients were excluded, and the cohort was randomly divided into training (760) and test (327) groups. During hospitalization, 251 (22%) patients died. After feature selection, the best performing classifier was random forest (AUC 0.88 ±0.03). Based on the relative importance of each variable, a pragmatic score was developed, showing good performances (AUC 0.85 ±0.025), and three levels were defined that correlated well with in-hospital mortality. Conclusions Machine learning techniques were applied in order to develop an accurate in-hospital mortality risk score for COVID-19 based on ten variables. The application of the proposed score has utility in clinical settings to guide the management and prognostication of COVID-19 patients.
4 citations
TL;DR: The first data on the possible predictors of PIMS-TS risk in the Long-COVID period is presented, and these results need to be further validated to next create the PIMs SCORE algorithm, which might enable the effective prediction of children with the risk of Pims-TS occurrence after COVID-19 recovery.
Abstract: Introduction We aimed to characterize biochemical and cardiovascular predictors of the paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS) risk based on the data from the LATE-COVID-Kids study. Methods 148 consecutive COVID-19 convalescents hospitalized for the clinical evaluation after the acute phase of COVID-19 were classified into two groups related to symptoms: 33 children finally diagnosed with PIMS-TS and 115 children without PIMS-TS (control group). Results PIMS-TS children were significantly younger (6.79 ±4.57 vs. 9.10 ±4.94 years). After adjustment, in comparison to those without, PIMS-TS children had a higher level of antithrombin III (111 ±9.30 vs. 105 ±11.4), higher heart rate (HR)/min (100 (89.0–111) vs. 90 (79.7–100)) and sinus rhythm (p = 0.03) but lower PQ interval (p = 0.02) on admission to hospital. The lymphocytes (absolute count and percentage) were significantly higher in children with PIMS-TS, and the opposite results were obtained for IgA and neutrophils. Furthermore, children with PIMS-TS had a higher level of thyroid stimulating hormone (2.76 (2.16–4.18) vs. 2.36 (1.73–2.83)) and red cell distribution width (p < 0.005) compared to those without. Conclusions It is the first data on the possible predictors of PIMS-TS risk in the Long-COVID period. These results need to be further validated to next create the PIMS SCORE algorithm, which might enable the effective prediction of children with the risk of PIMS-TS occurrence after COVID-19 recovery.
4 citations
TL;DR: RBCT should be viewed as a treatment of last resort in anemic critically ill patients, and anemia management should instead be focused on causal anemia treatment and minimization of patient blood loss.
Abstract: Red blood cell (RBC) transfusion (RBCT) is one of the most frequently performed hospital procedures. Transfusion decision making (TDM) rep-resents a common challenge to critical care physicians [1]. On one hand RBCT may be associated with complications such as acute lung injury, circulatory overload, transmission of pathogen, immunosuppression, and increased mortality [1]. In this context RBCT should be viewed as a treatment of last resort in anemic critically ill patients. Anemia management should instead be focused on causal anemia treatment and minimization of patient blood loss, both important elements of patient blood management [2]. On the other hand, anemia in critically ill patients may lead to, among other consequences, prolonged weaning from the respirator, acute kidney injury, myocardial ischemia
3 citations
TL;DR: The typical epidemiological and clinical characteristics of HE in the Czech Republic are described and there is a possibility of severe health complications caused by the hepatitis E virus in thezech Republic.
Abstract: Introduction The majority of hepatitis E (HE) reports come from Western Europe. The aim of the study was to describe the typical epidemiological and clinical characteristics of HE in the Czech Republic. Methods A retrospective analysis of 173 patients with HE. Results At least 90% of cases were autochthonous (HEV-3 genotype). Seventeen patients were treated with ribavirin. Five underwent liver transplants because of fulminant HE. We noted neurological symptomatology in 9 cases. Six patients developed chronic HE. Conclusions There is a possibility of severe health complications caused by the hepatitis E virus in the Czech Republic.
3 citations
TL;DR: Investigation of miRNA microarray and quantitative PCR found that miR-17-5p was significantly increased and positively associated with biochemical indicators of GDM in 30 GDM plasma samples and 28 matched control plasma samples, which may serve as a promising biomarker and therapeutic target for GDM.
Abstract: Gestational diabetes mellitus (GDM) is a metabolic disease that endangers pregnant women and their offspring. Insights into biomarkers and GDM pathogenesis are crucial. Ectopic expression of microRNA-17-5p was found in GDM, but its the diagnostic value and role of miR-17-5p remain unclear.Detection of miRNA microarray and quantitative PCR (qPCR) found that miR-17-5p was significantly increased and positively associated with biochemical indicators of GDM in 30 GDM plasma samples and 28 matched control plasma samples.The area under the ROC curve was 0.827 (P < 0.01), which showed good diagnostic potential. Mitochondrial staining showed that compared with controls, trophoblasts exhibited more mitochondrial fusion and endothelial cells exhibited more mitochondrial fission in GDM than these in controls. Western blot and qPCR assays further revealed that expression of the mitofusin Mfn1/Mfn2 was lower in primary endothelial cells from GDM patients, whereas their expression was significantly higher in primary trophoblasts from GDM patients compared with those from controls. Conversely, miR-17-5p expression was higher in primary endothelial cells from GDM patients, whereas their expression was significantly lower in primary trophoblasts from GDM patients compared with those from controls. Bioinformatics and luciferase reporter assays confirmed that both Mfn1 and Mfn2 are targets of miR-17-5p. Last, decreased Mfn1/2 was observed not only to increase the apoptotic rate of primary endothelial cells from GDM, but also to reverse anti-apoptotic effects of miR-17-5p inhibitor.MiR-17-5p regulates Mfn1/Mfn2-mediated mitochondrial dynamics involved in GDM. MiR-17-5p may serve as a promising biomarker and therapeutic target for GDM.
3 citations
TL;DR: This paper aims to provide a history of rheumatology and immunology in China and its role in modern medicine and aims to clarify the role of modern medicine in the treatment of autoimmune diseases.
Abstract: Attribution-NonCommercial-ShareAlike 4.0 International (CC BY -NC -SA 4.0). License (http://creativecommons.org/licenses/by-nc-sa/4.0/). Corresponding author: Zhenhua Wen Department of Rheumatology and Immunology Zhuzhou Hospital Affiliated to Xiangya Medical College Central South University Zhuzhou Hunan, China E-mail: zhenhuawen2021@126.com 1 Department of Rheumatology and Immunology, Zhuzhou Hospital Affiliated to Xiangya Medical College, Central South University, Zhuzhou, Hunan, China 2 Department of Nephrology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
3 citations
TL;DR: This Expert Opinion aims to help clinicians with a practical guide underlying the proven strategies and the remaining gaps of evidence to optimize the management of coronary patients.
Abstract: Introduction Long-term follow-up after an acute coronary syndrome (ACS) presents a crucial challenge due to the high residual cardiovascular risk and the potential for major bleeding events. Although several treatment strategies are available, this article focuses on patients who have undergone percutaneous coronary intervention (PCI) for ACS, which is a frequent clinical situation. This position paper aims to support physicians in daily practice to improve the management of ACS patients. Material and methods A group of recognized international and French experts in the field provides an overview of current evidence-based recommendations – supplemented by expert opinion where such evidence is lacking – and a practical guide for the management of patients with ACS after hospital discharge. Results The International Collaborative Group underlines the need of a shared collaborative approach, and a care plan individualized to the patient’s risk profile for both ischaemia and bleeding. Each follow-up appointment should be viewed as an opportunity to optimize the personalized approach, to reduce adverse clinical outcomes and improve quality of life. As risks – both ischaemic and haemorrhagic – evolve over time, the risk–benefit balance should be assessed in an ongoing dynamic process to ensure that patients are given the most suitable treatment at each time point. Conclusions This Expert Opinion aims to help clinicians with a practical guide underlying the proven strategies and the remaining gaps of evidence to optimize the management of coronary patients.
TL;DR: The mammalian gastrointestinal tract is continuously vulnerable to numerous bacteria and food additives as well as to environmental tox-ins that damage the epithelia of the gut.
Abstract: The mammalian gastrointestinal tract is continuously vulnerable to numerous bacteria and food additives as well as to environmental tox-ins that damage the epithelia of the gut [1]. Disturbance in intestinal
TL;DR: Patients with liver metastases of NPC with recurrence or distant metastasis have a very short survival time, and different treatment regimens have different survival rates, so how to choose a treatment regimen to maximize the benefit of patients is an urgent problem to be solved.
Abstract: Nasopharyngeal carcinoma (NPC) is an ascending squamous cell carcinoma located in the retronasal cavity. Due to the occult site, many patients present with synchronous distant metastases at initial diagnosis, with the bone, lung, and liver being the most common sites. Studies have shown that liver metastases may be an independent negative prognostic factor compared with bone or lung metastases [1]. NPC patients with liver metastases have a very short survival time, with a median survival time of only about 18.0 months [2], and different treatment regimens have different survival rates [3]. Therefore, how to choose a treatment regimen to maximize the benefit of patients with liver metastases of NPC is an urgent problem to be solved. Systemic chemotherapy is an important treatment for advanced NPC with recurrence or distant metastasis, but its efficacy
TL;DR: In this article , the diagnostic usefulness of selected novel parameters as biomarkers of hypertension: miR-145-5p, miR 1-3p and miR 423 5p, PCSK9, MyBPC3, NOX1, and CYBb, and NCF2.
Abstract: Introduction The present study aimed to evaluate the diagnostic usefulness of selected novel parameters as biomarkers of hypertension: miR-145-5p, miR-1-3p, miR-423-5p, PCSK9, MyBPC3, NOX1, and CYBb, and NCF2, DNase 1, anti-MPO and anti-PR3 antibodies. Methods We present the data of men with normal blood pressure, diagnosed hypertension, confirmed hypertension, and hypertension and coexisting coronary artery disease. Results Elevated levels of miR-145-5p, miR-1-3p, and miR-423-5p and high levels of PCSK9, MyBPC3, and DNase 1 were observed in all groups of hypertensive men. We showed decreased levels of NOX1 and CYBb, and an elevated level of NCF2. Conclusions PCSK9 shows the greatest potential as an early biomarker of screening-detected hypertension.
TL;DR: Fleischmann et al. as discussed by the authors studied the safety and effectiveness of upadacitinib or adalimumab plus methotrexate in patients with rheumatoid arthritis over 48 weeks with switch to alternate therapy in patients having insufficient response.
Abstract: 1. Fleischmann RM, Genovese MC, Enejosa JV, et al. (2019). Safety and effectiveness of upadacitinib or adalimumab plus methotrexate in patients with rheumatoid arthritis over 48 weeks with switch to alternate therapy in patients with insufficient response Ann Rheum Dis. 78: 1454-62. Google Scholar
TL;DR: Sabouret et al. as mentioned in this paper investigated low levels of low-density lipoprotein cholesterol, intracerebral haemorrhage, and other safety issues: is there still a matter of debate?
Abstract: 1. Sabouret P, Angoulvant D, Cannon CP, Banach M. Low levels of low-density lipoprotein cholesterol, intracerebral haemorrhage, and other safety issues: is there still a matter of debate?Eur Heart J Open2022; 2: oeac038. Google Scholar
TL;DR: In this article , the authors reported a case of relapsed focal segmental glomerulosclerosis (FSGS) and severe acute kidney injury (AKI) supported by renal replacement therapy after receiving the COVID-19 vaccine.
Abstract: The Oxford-AstraZeneca (AZ) COVID-19 vaccine is a viral vector vaccine containing a modified, replication-deficient chimpanzee adenovirus ChAdOx1 [1]. The COVID-19 vaccine has been the most effective pub-lic health intervention in combating the current COVID-19 pandemic. Though the vaccine appears to be safe and is recommended even for patients with nephrotic syndrome, a few cases of relapsed nephrotic syndrome have been reported. Here we report a first case of relapsed focal segmental glomerulosclerosis (FSGS) and severe acute kidney injury (AKI) supported by renal replacement therapy after receiving the AZ COVID-19
TL;DR: A case of hemichorea-hemiballismus is described in which T1 imaging was normal throughout a severe and persistent hypoglycemic episode, but diffusion-weighted imaging (DWI) revealed a hyperintense lesion in the left lentiform and caudate.
Abstract: Hemichorea-hemiballismus can be caused by anatomical, neuro-chemical, or metabolic problems with the basal ganglia [1]. Hyperglyce-mia-induced hemiballismus is more common, while hypoglycemia-in-duced movement disorders have been recorded less frequently [1–3] . In movement disorders induced by hypoglycemia, the development of hyperintense lesions in the contralateral putamen and striatal areas on MRI-T1 imaging studies is the typical feature [4, 5]. We describe a case of hemichorea-hemiballismus in which T1 imaging was normal throughout a severe and persistent hypoglycemic episode, but diffusion-weighted imaging (DWI) revealed a hyperintense lesion in the left lentiform and caudate
TL;DR: As first-line steroid-sparing agent, rituximab is more effective and safer than cyclophosphamide and tacrolimus in FRSDNS, and improve QOL.
Abstract: Introduction Frequently-relapsing/steroid-dependent nephrotic syndrome (FRSDNS) leads to steroid toxicity impairing quality of life (QOL), thus prompting the use of steroid-sparing drugs. Methods 51 FRSDNS children not previously treated with steroid-sparing agents were randomized to receive rituximab, cyclophosphamide, or tacrolimus. Clinical findings and QOL were evaluated before and after treatment. Results The mean relapse rate in all groups declined six months after treatment, however, 1-year relapse-free survival rate, number of relapses, and cumulative prednisolone dosage were lower with rituximab than with tacrolimus and cyclophosphamide. Cyclophosphamide group had twice frequency of infections compared to the other groups. At 1 year after treatment, total scores showed greater improvement with rituximab. Conclusions As first-line steroid-sparing agent, rituximab is more effective and safer than cyclophosphamide and tacrolimus in FRSDNS, and improve QOL.
TL;DR: A reduced influenza prevalence and anincreased survivalfrom influenza infection was observed in patients on ongoing statin treatment and further research is needed to define the possible role of statins as adjunctive therapy in patients with influenza infection.
Abstract: Introduction Influenza virus infection is associated with high morbidity and mortality, and so additional therapeutic strategies to reduce the burden for healthcare systems are needed. Statins, by virtue of their anti-inflammatory and immunomodulatory effects, have been hypothesized as capable of influencing the host’s response against the influenza virus. The aim of this meta-analysis was to assess the effect of ongoing statin treatment on susceptibility to influenza virus infection and on influenza-associated mortality. Material and methods Studies investigating the impact of statin treatment on influenza prevalence and mortality were searched for in the PubMed-Medline, Scopus, ISI Web of Knowledge, Embase, Proquest, OVID, EBSCO, and CINAHL databases (up to 8 November 2021). Fixed- and random-effects models and the generic inverse variance method were used for quantitative data synthesis. Results In the meta-analysis of 14 arms of 2 eligible studies, including 14,997 flu-vaccinated and unvaccinated patients, treatment with statins was associated with a reduction of influenza virus prevalence (odds ratio (OR) = 0.85, 95% confidence interval (CI): 0.73–0.99; p = 0.040). No significant effect of statins on the susceptibility to influenza infection was observed in the distinct communities of either vaccinated or unvaccinated subjects. Among 9 arms of 6 eligible studies, including 87,204 patients, the use of statins among patients with influenza was associated with a reduced mortality (OR = 0.68, 95% CI: 0.56, 0.82; p < 0.001). This result was confirmed for both 30-day mortality since influenza infection diagnosis (OR = 0.61, 95% CI: 0.47, 0.80; p <0.001) and for up to 90-day mortality (OR = 0.74, 95% CI: 0.55, 1.00; p = 0.042). Conclusions Reduced influenza prevalence and increased survival from influenza infection was observed in patients on ongoing statin treatment. Further research is needed to define the possible role of statins as adjunctive therapy in patients with influenza infection.
TL;DR: The presence of cff-circRNA in the maternal circulation is demonstrated and this finding may shed new light on the development of non-invasive prenatal testing (NIPT).
Abstract: Introduction There is an urgent need to find novel stable cell-free fetal (cff-) RNA in the maternal circulation to facilitate the advance of non-invasive prenatal testing (NIPT) to more effectively avoid birth defects. Methods CircRNA microarray was used to detect the cff-circRNA in plasma. Results There were cff-circRNAs from the fetus in the peripheral blood of pregnant women and they persisted even until at least 24 h after delivery. In addition, we found that cff-circRNA might have a specific expression pattern in gestational disease. Conclusions We demonstrated the presence of cff-circRNA in the maternal circulation, which may shed new light on the development of NIPT.
TL;DR: The decrease of PCSK9 might be utilized as an independent surrogate marker of improvement of atherosclerotic cardiovascular disease risk after bariatric surgery.
Abstract: Introduction This systematic review and meta-analysis focuses on PCSK9 changes in obese patients following bariatric surgery. Methods A systematic literature search in four databases was performed. Comprehensive Meta-Analysis (CMA) V2 software used to conduct the meta-analysis. Studies were evaluated regarding heterogeneity in design, populations under investigation, and treatment duration using a random-effects model and the generic inverse variance weighting approach. A random-effect meta-regression approach was used to investigate the association with the estimated effect size. Results The results of the meta-analysis on 4 trials including 260 individuals demonstrated a remarkable decline of PCSK9 after bariatric surgery (WMD = –57.34 ng/ml, 95% CI: –87.97, –26.71, p < 0.001; I2 = 96.25%). Consistently, a significant decrease of LDL-C after bariatric surgery (WMD = –22.57 mg/dl, 95% CI: –27.5, –17.574, p < 0.001; I2 = 86.35%) was observed. Conclusions PCSK9 is reduced significantly after bariatric surgery. The decrease of PCSK9 might be utilized as an independent surrogate marker of improvement of atherosclerotic cardiovascular disease risk after bariatric surgery.
TL;DR: ET-1 and ETA gene polymorphisms are prevalent in the PH-MVD group suggesting that they may predispose to the development of PH.
Abstract: Introduction Endothelin-1 (ET-1) gene polymorphisms are implicated in pathogenesis of idiopathic pulmonary arterial hypertension. Methods We studied ET-1 (Lys198Asn and 3A/4A) and endothelin receptor A (ETA) gene (His323His) polymorphisms in 123 subjects with pulmonary hypertension associated with rheumatic mitral valve disease (PH-MVD) and 123 healthy controls. Results The mutant homozygous Asn/Asn genotype in Lys198Asn and T/T genotype in His323His polymorphism was more prevalent in the PH-MVD group. Presence of Asn/Asn genotype was significantly associated with an increased risk (odds ratio 3.9). Conclusions ET-1 and ETA gene polymorphisms are prevalent in the PH-MVD group suggesting that they may predispose to the development of PH.
TL;DR: In this article , a clinical trial tested the use of the TENA SmartCare Change Indicator in a home care environment, which led to a reduction in the number of manual checks and leakages.
Abstract: Introduction This clinical trial tested the use of the TENA SmartCare Change Indicator in a homecare environment. Methods The trial included 35 elderly subjects with urinary incontinence. The trial lasted for 3 weeks. The primary outcome was the reduction in manual absorbing product checks between the baseline (first) and the investigational (third) week. Results The numbers of checks and leakages were significantly reduced by 16% (p = 0.001) and 40% (p = 0.0051). Conclusions Use of the device led to a reduction in the numbers of manual checks and leakages. The device appears to be safe, well tolerated and easy to use.
TL;DR: In this paper , the authors evaluated antibiotic consumption and antibiotic use during the coronavirus disease 2019 (COVID-19) pre-pandemic period and pandemic period.
Abstract: Introduction The appropriate use of antibiotics is an important strategy in slowing the development of antimicrobial resistance. This study aimed to evaluate antibiotic consumption and antibiotic use during the coronavirus disease 2019 (COVID-19) pre-pandemic period and pandemic period. Methods Antibiotic consumption was evaluated with the antibiotic consumption index (ACI). Results Antibiotics with the largest increase in ACI value during the pandemic period compared to the previous year increased from 0.4 to 1.8 DDI/100 bed days in moxifloxacin. Teicoplanin, linezolid, and clindamycin were not affected in terms of consumption. Conclusions It was observed that the use of many intravenous antibiotics in our hospital increased during the pandemic period.
TL;DR: Evaluating the prevalence of the arterial ischaemic stroke in Polish children and the parameters related to AIS hospitalization, including age, gender, region, month and season of a year, proved that AIS occurs more often in boys than girls and is more common in adolescents (15–18 years) than younger children.
Abstract: The present study aimed to evaluate the prevalence of the arterial ischaemic stroke (AIS) in Polish children, as well as to analyse the parameters related to AIS hospitalization, including age, gender, region, month and season of a year at admission, duration and costs based on data from National Health Fund (NHF) registery in 2011–2020.Data from the NHF were analysed statistically. The disease was identified according to the codes I63 and I64 of the International Classification of Diseases, Tenth Revision (ICD-10), and patients included only individuals up to 18 years of age. Results We identified 622 hospitalisations due to paediatric AIS in Poland in the study period.The most frequent age subgroups were adolescents, followed by toddlers or pre-school children (34.73% and 24.12%, respectively), while the least frequent – neonates or infants (9.81%). ICD-10 procedures did significantly affect the duration and costs of hospitalisation (p<0.001). The highest costs of hospitalisations concerned the I63.1 procedure (cerebral infarction due to embolism of precerebral arteries), which included thrombectomy. Duration and costs of hospitalisation were positively correlated to each other (r=0.525, p<0.001). Age correlated negatively with duration of hospitalisation (r= -0.154, p<0.001) and positively with costs of hospitalisation (r =0.133, p=0.008).Data from the NHF registry proved that AIS occurs more often in boys than girls and is more common in adolescents (15–18 years) than younger children.
TL;DR: The receptor-binding domain (RBD) of S protein plays an important role in facilitating coronavirus entry and facilitates the binding of human angiotensin-converting enzyme 2 (hACE-2), forming a complex.
Abstract: The receptor-binding domain (RBD) of S protein plays an important role in facilitating coronavirus entry. These proteins facilitate the binding of human angiotensin-converting enzyme 2 (hACE-2), forming a complex. This RBD and ACE2 complex is a hot topic for researchers to investigate the viral mechanisms and to search for the possible intermediate host. CD26, CD147, and RBD have also been reported to facilitate virus entry.
TL;DR: This paper aims to provide a history of traditional Chinese Medicine in Hefei and its applications in modern medicine, as well as some of the aspects of modern emergency medicine, to present a contemporary view.
Abstract: Attribution-NonCommercial-ShareAlike 4.0 International (CC BY -NC -SA 4.0). License (http://creativecommons.org/licenses/by-nc-sa/4.0/). Corresponding author: Aihong Pan Nursing Department Hefei City First People’s Hospital Hefei, China E-mail: panaihonghong@163.com 1Nursing Department, The First People’s Hospital of Hefei, Hefei, China 2Neonatal Intensive Care Unit, The First People’s Hospital of Hefei, Hefei, China 3Spine Orthopedics, The First People’s Hospital of Hefei, Hefei, China 4Dean’s Office, The First People’s Hospital of Hefei, Hefei, China 5Intensive Care Unit, The First People’s Hospital of Hefei, Hefei, China 6Infection Department, The First People’s Hospital of Hefei, Hefei, China 7 Traditional Chinese Medicine Department, The First People’s Hospital of Hefei, Hefei, China 8Emergency Medicine Department, The First People’s Hospital of Hefei, Hefei, China
TL;DR: The simultaneous COVID-19 infection could probably provoke an exacerbation of a previously asymptomatic CADASIL patient and could lead to an acute ischemic multi-infarct encephalopathy.
Abstract: Encephalopathy and stroke in COVID-19 patients have been repeatedly reported. Previous reports indicate that SARS-CoV-2 infection is associated with a significantly escalated risk of ischemic stroke, especially with potentially cryptogenic stroke. Encephalopathy is also present in Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL). Definitive diagnosis of CADASIL is based on sequencing the NOTCH3 gene. Primary pathology is the accumulation of abnormal transmembrane deposits on vascular smooth muscle cells in the brain and other organs.Genome of the patient was sequenced with the average depth of coverage 32,7x and mapped to the reference genome GRCh38. The whole genome sequencing (WGS) approach identified heterozygous missense variant NOTCH3 in the exon 8. Targeted Sanger sequencing was done to confirm the presence of the variant, and to examine the closest relatives. Beside the patient, all family members were unaffected, the variant appeared de novo.Identified variant was not reported in the GnomAD v.3 and 1000 Genomes, nor in polymorphism database dbSNP. No clinical information was available in ClinVar. The only information regarding variants in the same amino acid position (Cs440Ser and Cys440Gly) from LOVD database were reported by Markus et al. They were found in 2 individuals affected with CADASIL and interpreted as pathogenic on the basis of symptoms and familial cosegregation.
Beside the patient, all family members were unaffected, the variant appeared de novo.The simultaneous COVID-19 infection could probably provoke an exacerbation of a previously asymptomatic CADASIL patient and could lead to an acute ischemic multi-infarct encephalopathy.
TL;DR: This review article discusses microRNA modulation with oxidative stress and inflammation in patients with type 2 diabetes mellitus and suggests novel potential therapeutic targets for treatment of diabetes and its complications is of utmost importance for public health.
Abstract: In parallel with the rapid growth of obesity, there is also an increase in the prevalence of type 2 diabetes mellitus (T2D) worldwide. Due to its complications, cardiovascular diseases are the leading cause of death in those patients. In the last two decades, special attention has been given to oxidative stress and inflammation, as the underlying mechanisms related to T2D occurrence and progression. Moreover, micro-ribonucleic acids (miRNAs) as new genetic biomarkers take an important place in the investigation of different metabolic pathways of insulin signaling. In this review article, we discuss microRNA modulation with oxidative stress and inflammation in patients with T2D. Better insight into the novel potential therapeutic targets for treatment of diabetes and its complications is of utmost importance for public health.