Nevin Manimala

Int J Gynaecol Obstet. 2023 Sep 1. doi: 10.1002/ijgo.15077. Online ahead of print.

ABSTRACT

OBJECTIVE: The objective of this study was to evaluate the effects of maternal coronavirus disease 2019 (COVID-19) vaccination on preventing severe complications of COVID-19 in pregnant women.

METHODS: A retrospective study was conducted in pregnant women infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during pregnancy and/or for up to 6 weeks postpartum between September 1, 2021, to January 30, 2022. The data was retrieved from a national database. The pregnant women were divided into two groups of vaccinated and unvaccinated. The proposed outcomes (the need for hospitalization, intensive care unit admission, and mechanical ventilation and products of conception complications) were compared between the two groups.

RESULTS: Approximately 90 000 pregnant women infected with COVID-19 were included in the study. The data of the vaccinated (19 922) and unvaccinated (70 147) groups were analyzed and compared. Pregnant patients in the vaccinated group had a significantly lower rate of hospitalization (21.2% vs 29.4%) (odds ratio [OR], 0.648 [95% confidence interval (CI), 0.625-0.673], P = 0.0001) and intensive care unit admission (3.7% vs 7.8%) (OR, 0.453 [95% CI, 0.382-0.535], P = 0.0001). The need for mechanical ventilation was also lower, although not statistically significant, in the vaccinated group than in the unvaccinated group (30 of 155 [19.4%] vs 418 of 1597 [26.2%]) (OR, 0.677 [95% CI, 0.448-1.024], P = 0.063). Cesarean section (54.3% vs 58.1%) (OR, 0.856 [95% CI, 0.751-0.977], P = 0.021) and stillbirth (0.4% vs 3.6%) (OR, 0.097 [95% CI, 0.026-0.252], P = 0.0001) were also significantly lower in the vaccinated patients. Most pregnant women in the vaccinated group (18 484-96.14%) received Sinopharm BIBP COVID-19 inactivated vaccine. No significant differences were seen in the effect of different types of COVID-19 vaccines on reducing COVID-19 complications in infected pregnant patients.

CONCLUSION: Maternal COVID-19 immunization is effective in reducing COVID-19 complications in infected pregnant women.

PMID:37655467 | DOI:10.1002/ijgo.15077

Soft Matter. 2023 Sep 1. doi: 10.1039/d3sm00298e. Online ahead of print.

ABSTRACT

A suspension of dielectric particles rotating spontaneously when subjected to a DC electric field in two dimensions next to a no-slip electrode has proven to be an ideal model for active matter [Bricard et al., Nature, 2013, 503, 95-98]. In this system, an electrohydrodynamic (EHD) instability called Quincke rotation was exploited to create self-propelling particles which aligned with each other due to EHD interactions, giving rise to collective motion on large length scales. It is natural to question whether a suspension of such particles in three dimensions will also display collective motion and spontaneously flow like bacterial suspensions do. Using molecular dynamics type simulations, we show that dielectrophoretic forces responsible for chaining in the direction of the applied electric field in conventional electrorheological fluids and the counter-rotation of neighboring particles in these chains prevent collective motion in suspensions undergoing spontaneous particle rotations. Our simulations discover that the fundamental microstructural unit of a suspension under Quincke rotation is a pair of counter-rotating spheres aligned in the direction of the electric field. We perform a linear stability analysis that explains this observation.

PMID:37655464 | DOI:10.1039/d3sm00298e

J Eur Acad Dermatol Venereol. 2023 Sep 1. doi: 10.1111/jdv.19486. Online ahead of print.

ABSTRACT

BACKGROUND: Of all ultraviolet (UV) radiations reaching the earth, UVA1 rays have a higher potential of penetrating and producing clinically harmful consequences. While UV radiations up to 370 nm are well blocked by current sunscreens, a photoprotection gap remains for the UVA1 wavelengths between 370 and 400 nm.

OBJECTIVE: This study was to assess under outdoor summer conditions the impact on pigmentation and skin ageing signs of a protection against UVA1 using Methoxypropylamino Cyclohexenylidene Ethoxyethylcyanoacetate (MCE) filter added to a reference SPF50 sunscreen, in comparison with the same sunscreen without the MCE filter.

MATERIAL AND METHODS: This prospective randomized comparative intra-individual study was conducted in 113 women in Brazil and China. Subjects had their face and two forearms exposed twice-daily to a one-hour outdoor sunlight exposure over 8 weeks. Before exposure, the SPF50 sunscreen containing 3% MCE was applied on one half-face and one forearm and the same reference product without MCE on the other half-face and forearm. Primary study endpoint was skin colour changes (chromametry). Other endpoints included expert panel grading of pigmentation and facial skin ageing, and naïve panel assessment of facial skin radiance and homogeneity.

RESULTS: After 8 weeks, the skin was darker on both forearms, but the increase in sun-induced pigmentation was smaller with the SPF50/MCE sunscreen. Expert panel evaluations showed no change in severity scores for pigmentation and a decreased severity scores for facial skin ageing in areas protected with the SPF50/MCE product; severity scores in areas protected with the SPF50 alone were either increased (pigmentation) or unchanged (skin ageing). Naïve panel evaluations of skin radiance and homogeneity showed statistically significant superiority of the SPF50/MCE product.

CONCLUSION: Overall, this study demonstrates that a protection with the SPF50/MCE sunscreen significantly reduces pigmentation and ageing signs compared to the same SPF50 sunscreen.

PMID:37655436 | DOI:10.1111/jdv.19486

Zh Nevrol Psikhiatr Im S S Korsakova. 2023;123(8):98-106. doi: 10.17116/jnevro202312308198.

ABSTRACT

OBJECTIVE: Typological differentiation of periodic catatonia in schizophrenia and schizophrenia spectrum disorders (SSD), in particular, schizoaffective disorder.

MATERIAL AND METHODS: Seventy-four patients with the verified diagnosis of schizophrenia and SSD (ICD-10 items F20, F21) were studied. The clinical, psychometric (BFCRS, SANS) and statistical methods were used. Clinical and psychometric study of seizures of periodic catatonia was carried out at the following stages: 1) manifestation of a seizure; 2) the maximum severity of psychopathological disorders. Also, at the end of the seizure, an additional assessment of the severity of negative symptoms was carried out using the SANS.

RESULTS: Three forms of periodic catatonia have been identified: hypokinetic, parakinetic, multikinetic. Clinical distinguishing indicators of periodic catatonia seizurs have been established (protracted – two-stage – form of seizures; the phenomenon of «secondary catatonia»). The psychometric study revealed significant differences between the variants of periodic catatonia seizures in terms of the severity of motor phenomena (at both stages of the seizure) and negative disorders. BFCRS scores at the first stage of seizures were as follows: hypokinetic – 9.7±0.4; parakinetic – 12.8±0.9; multikinetic – 32.3±1.6 (the differences were found between 1 and 2 (p<0.05); between 1 and 3, as well as 2 and 3 (p<0.01)). BFCRS scores at the second stage of seizures were 12.1±0.8; 19.9±1.2 and 47.7±1.9, respectively,with the differences between 1 and 2 (p<0.05); between 1 and 3, and also 2 and 3 (p<0.01). The scores on the SANS anhedonia-asociality subscale were 1.9±0.2 for hypokinetic; 2.3±0.3 for parakinetic and 3.2±0.2 for multikinetic with the differences between 1 and 2, 1 and 3, 2 and 3 (p<0.01).

CONCLUSION: Periodic catatonia is the clinical entity that includes a complex of progressively worsening seizures, the psychopathological systematics of which takes into account the clinical structure of motor disorders, their affiliations with positive and negative dimensions, and functional activity.

PMID:37655417 | DOI:10.17116/jnevro202312308198

Zh Nevrol Psikhiatr Im S S Korsakova. 2023;123(8):90-97. doi: 10.17116/jnevro202312308190.

ABSTRACT

OBJECTIVE: To evaluate the long-term effects of annual course therapy with Cerebrolysin on cognitive functioning and the risk of transition to dementia in relatives of patients with Alzheimer’s disease (AD) with amnestic-type mild cognitive decline syndrome (aMCI) in comparison with the same group untreated relatives.

MATERIAL AND METHODS: The cohort included 88 first-degree relatives of BA patients with aMCI syndrome aged 50 to 82 years (mean age 65.0±9.9 years) of which 46 people received course therapy with Cerebrolysin and 42 people were not treated. Clinical, neuropsychological, statistical methods were used. Conducted annual course therapy with Cerebrolysin (a total of 3 courses of infusion therapy: for a course of 20 intravenous infusions of 20 ml of Cerebrolysin in 100 ml of isotonic saline) followed by a follow-up study after 3 months after the end of the therapeutic period. The dynamics of cognitive functioning in the therapeutic group was compared with the corresponding dynamics in the comparison group over the same period. The assessment was carried out on day 0, by the end of 1, 14, 27 and 30 months research.

RESULTS: In the therapeutic group, according to the CGI-I scale, by the end of the 3rd course of therapy, in 95.7% of cases, a pronounced or moderate improvement was achieved after each of the courses on all scales and tests. In this group, by the end of the therapeutic period, a significant improvement in the initial mean group scores was established. According to the all scales and tests, a significant improvement of the initial average group scores was found after each course of therapy (p<0.05). In the comparison group there was a significant deterioration (p<0.05) of the average group scores of most of the cognitive scales and test by the end of the observation. The annual conversion from aMCI to dementia due to probable AD was 9.5% only in the comparison group. The average group indicators of all scales and tests significantly worsened starting from the 14th month of observation in the comparison group.

CONCLUSION: The absence of cases of aMCI conversion to dementia in the treated patients for 2.5 years of observation can serve as confirmation of a disease-modifying effect in Cerebrolysin. These results indicate the need for more extensive clinical studies of the preventive effects of Cerebrolysin and to explore the possibility of including such therapy in drug prevention programs for AD in people at high risk for this disease.

PMID:37655416 | DOI:10.17116/jnevro202312308190

Zh Nevrol Psikhiatr Im S S Korsakova. 2023;123(8):82-89. doi: 10.17116/jnevro202312308182.

ABSTRACT

OBJECTIVE: To study the neurocognitive profile of patients with protracted and chronic endogenous manic and manic-delusional states (EMDS).

MATERIAL AND METHODS: Thirty-two female patients, aged 18 to 55 years (mean age 36.2±10.2 years), with protracted and chronic EMDS were studied. Based on the clinical typology of EMDS, patients were divided into 4 groups of 8 patients each: group 1 – «acute» subtype, group 2 – «chronified» subtype, group 3 – «developing» subtype and group 4 – subtype «double mania». Neuropsychological, clinical-psychopathological and statistical methods were used.

RESULTS: Disturbances of regulatory and executive functions and a decrease in neurodynamic indicators of mental activity in patients with EMDS are significantly more pronounced compared with the control group (p<0.05). The values of the index of severity of disturbances of regulatory and executive functions in patients with EMDS range from 0.95 points (group 1) to 1.14 points (group 4), without statistically significant differences between the groups. The highest severity of neurodynamic disorders is observed in group 1 (1.88 points), while in other groups the index values range from 0.88 points in group 2 to 1.09 in group 4 (p<0.05). Patients of group 1 have greater severity and wider spectrum of neurodynamic symptoms compared with group 2 (U=45.00; p<0.0021), group 3 (U=30.00; p<0.04), and group 4 (U=45.00; p<0.001). It should be noted that the cognitive impairments identified in patients with EMDS did not reach the level of dementia.

CONCLUSION: The most characteristic of EMBS are cognitive impairments associated with a decrease in the parameters of the neurodynamics of mental activity related to the first functional block, as well as with deficiency of executive functions, impaired planning and organization of cognitive activity, due to the weakness of the structures of the third functional block.

PMID:37655415 | DOI:10.17116/jnevro202312308182

Zh Nevrol Psikhiatr Im S S Korsakova. 2023;123(8):75-81. doi: 10.17116/jnevro202312308175.

ABSTRACT

OBJECTIVE: To study the efficacy and safety of Cytoflavin in combination with thrombolytic therapy.

MATERIAL AND METHODS: At the first preclinical stage, the effect of Cytoflavin, solution for intravenous administration, on the fibrinolytic activity of alteplase (Actilyse) was studied in vitro. At the second, clinical stage, the safety and efficacy of Cytoflavin treatment, initiated within in the first 24 hours from the stroke onset and continued for 10 days, was evaluated in patients with acute stroke who received reperfusion therapy. At the clinical stage of the study, 200 patients were examined: 100 subjects of the main group who received reperfusion therapy in combination with Cytoflavin; 100 control subjects who received reperfusion therapy in combination with other drugs from the neuroprotective group as part of routine clinical practice.

RESULTS: The preclinical study has demonstrated that alteplase in the studied concentrations debulks the mass of a thrombus by 2131%. There were no statistically significant differences in the reduction of thrombus weight with addition of Cytoflavin at various concentrations combined with alteplase to the incubation medium. The addition of Cytoflavin to the incubation medium with alteplase had no effect on the concentration of D-dimer in the rat’s plasma. In the clinical study, there were no statistically significant differences in the frequencies of intracranial hemorrhages of various types between the study groups. In the multivariable analysis, significant predictors of intracranial hemorrhage were baseline NIHSS score, systolic blood pressure, history of diabetes and anticoagulant use, baseline CT ASPECTS score, but not the treatment group.

CONCLUSION: The use of Cytoflavin in combination with thrombolytic therapy is safe. Up-to-date treatment of stroke which includes timely reperfusion and neurometabolic support of recovery leads to the rapid manifest regression of the neurological deficit and to the improvement in functioning and activity of patients with cerebral infarction.

PMID:37655414 | DOI:10.17116/jnevro202312308175

Zh Nevrol Psikhiatr Im S S Korsakova. 2023;123(8):68-74. doi: 10.17116/jnevro202312308168.

ABSTRACT

OBJECTIVE: Evaluation of the bioequivalence of the tested Relonova, tablets, 10 mg and Maxalt, tablets, 10 mg drugs on an empty stomach in healthy volunteers.

MATERIAL AND METHODS: The pharmacokinetic analysis population included 40 volunteers, the safety analysis population included 40 volunteers. The average age of randomized volunteers (men – 20, women – 20) was 29.3±8.9 years, height 1.71±0.09 m, body weight 70.86±11.66 kg, mean BMI 24.18±2.81 kg/m². The method used high performance liquid chromatography with tandem mass spectrometric detection. Statistical analysis of the obtained data was performed based on the assumption of a log-normal distribution of the parameters AUC0-72 and Cmax.

RESULTS: The ratio of geometric means for the key pharmacokinetic parameters (AUC0-t, AUC0-inf and Cmax) of rizatriptan is close to 90%, CI is within the acceptable range for bioequivalent drugs (80-125%). The intrasubject variability (CVintra) for rizatriptan was 23.74% (Cmax), 10.94% (AUC0-t). The average profiles of the pharmacokinetic curves of rizatriptan when taking the test and reference drugs have similar shapes. Relonova and reference Maxalt are bioequivalent.

CONCLUSION: The results of the study make it possible to recommend Relonova for further clinical study and wide practical application.

PMID:37655413 | DOI:10.17116/jnevro202312308168

Mov Disord. 2023 Sep 1. doi: 10.1002/mds.29581. Online ahead of print.

ABSTRACT

BACKGROUND: To date, studies on positron emission tomography (PET) with ¹⁸ F-fluorodeoxyglucose (FDG) in progressive supranuclear palsy (PSP) usually included PSP cohorts overrepresenting patients with Richardson’s syndrome (PSP-RS).

OBJECTIVES: To evaluate FDG-PET in a patient sample representing the broad phenotypic PSP spectrum typically encountered in routine clinical practice.

METHODS: This retrospective, multicenter study included 41 PSP patients, 21 (51%) with RS and 20 (49%) with non-RS variants of PSP (vPSP), and 46 age-matched healthy controls. Two state-of-the art methods for the interpretation of FDG-PET were compared: visual analysis supported by voxel-based statistical testing (five readers) and automatic covariance pattern analysis using a predefined PSP-related pattern.

RESULTS: Sensitivity and specificity of the majority visual read for the detection of PSP in the whole cohort were 74% and 72%, respectively. The percentage of false-negative cases was 10% in the PSP-RS subsample and 43% in the vPSP subsample. Automatic covariance pattern analysis provided sensitivity and specificity of 93% and 83% in the whole cohort. The percentage of false-negative cases was 0% in the PSP-RS subsample and 15% in the vPSP subsample.

CONCLUSIONS: Visual interpretation of FDG-PET supported by voxel-based testing provides good accuracy for the detection of PSP-RS, but only fair sensitivity for vPSP. Automatic covariance pattern analysis outperforms visual interpretation in the detection of PSP-RS, provides clinically useful sensitivity for vPSP, and reduces the rate of false-positive findings. Thus, pattern expression analysis is clinically useful to complement visual reading and voxel-based testing of FDG-PET in suspected PSP. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

PMID:37655363 | DOI:10.1002/mds.29581

SAGE Open Med. 2023 Aug 27;11:20503121231195602. doi: 10.1177/20503121231195602. eCollection 2023.

ABSTRACT

BACKGROUND: Hyperhomocysteinemia is an emerging risk factor causing early-onset cardiovascular events. The objective of the study was to assess serum homocysteine levels in newly diagnosed young persons (age < 30 years) with abnormal glucose tolerance.

METHODOLOGY: This cross-sectional study included 40 young participants with newly diagnosed abnormal glucose tolerance (including prediabetes and diabetes mellitus) and an equal number of young persons with normal glucose tolerance (normal glucose tolerance vs prediabetes vs. diabetes mellitus-age (years): 25.0 (22.0, 28.0) vs 25.50 (21.50, 27.0) vs 28.0 (25.0, 29.0), median (interquartile range)). Glycemic status was diagnosed by American Diabetes Association, 2021 criteria. After taking clinical information, fasting blood was collected to measure homocysteine by chemiluminescent immunoassay.

RESULTS: Homocysteine level was different across the spectrum of glycemic status (normal glucose tolerance vs. prediabetes vs. diabetes mellitus: 15.57 (13.89-20.71) vs 13.19 (11.40-18.11) vs 12.27 (9.97-14.42) µmol/L; median (interquartile range); p = 0.006). Serum homocysteine was significantly elevated in participants with normal glucose tolerance than diabetes mellitus (p = 0.006) but statistically similar in prediabetes in comparison to both normal glucose tolerance and diabetes mellitus (p = NS for both). Homocysteine level was above the normal level in 47.5% of participants with normal glucose tolerance and in 22.5% with abnormal glucose tolerance (p = 0.019).

CONCLUSIONS: Patients under 30 years with diabetes mellitus had lower homocysteine levels than those with normal glucose tolerance.

PMID:37655304 | PMC:PMC10467175 | DOI:10.1177/20503121231195602