Tag: nevin manimala

Int J Stroke. 2023 Nov 10:17474930231215660. doi: 10.1177/17474930231215660. Online ahead of print.

ABSTRACT

BACKGROUND: Adverse non-motor outcomes are common after acute stroke and likely to substantially affect quality of life, yet few studies have comprehensively assessed their prevalence, patterns, and predictors across multiple health domains.

AIMS: We aim to identify the prevalence, patterns and the factors associated with non-motor outcomes 30 days after stroke.

METHODS: This prospective observational hospital cohort study (Stroke Investigation in North and Central London (SIGNAL) identified patients with acute ischaemic stroke or intracerebral haemorrhage (ICH) admitted to the Hyperacute Stroke Unit (HASU) University College Hospital (UCH), London, between August 1st 2018 and August 31st 2019. We assessed non-motor outcomes (anxiety, depression, fatigue, sleep, participation in social roles and activities, pain, bowel, and bladder function) at 30-day follow-up using the Patient Reported Outcome Measurement Information System-Version 29 (PROMIS-29) scale and Barthel Index scale.

RESULTS: We obtained follow-up data for 605/719 (84.1%) eligible patients (mean age 72.0 years; 48.3% female; 521 with ischaemic stroke, 84 with ICH). Anxiety (57.0%), fatigue (52.7%), bladder dysfunction (50.2%), reduced social participation (49.2%), and pain (47.9%) were the commonest adverse non-motor outcomes. The rates of adverse non-motor outcomes in ≥1, ≥2 and ≥3 domains were 89%, 66.3% and 45.8%, respectively; in adjusted analyses, stroke due to ICH (compared to ischaemic stroke) and admission stroke severity were the strongest and most consistent predictors. There were significant correlations between; bowel dysfunction and bladder dysfunction (κ= 0.908); reduced social participation and bladder dysfunction (κ= 0.844); and anxiety and fatigue (κ= 0.613). We did not identify correlation for other pairs of non-motor domains.

CONCLUSIONS: Adverse non-motor outcomes are very common at one month after stroke, affecting nearly 90% of evaluated patients in at least one health domain, about two-thirds in two or more domains, and almost 50% in three or more domains. Stroke due to ICH and admission stroke severity were the strongest and most consistent predictors. Adverse outcomes occur in pairs of domains such as with anxiety and fatigue.Our findings emphasise the importance of a multi-domain approach to effectively identify adverse non-motor outcomes after stroke to inform the development of more holistic patient recovery programs.

PMID:37950351 | DOI:10.1177/17474930231215660

J Pharm Biomed Anal. 2023 Oct 31;238:115838. doi: 10.1016/j.jpba.2023.115838. Online ahead of print.

ABSTRACT

Euphorbia pekinensis (EP), known for its diuretic properties, is clinically utilized for treating conditions such as edema and malignant tumors. However, in its raw form, Euphorbia pekinensis is toxic, and oral administration of this crude medicine can lead to gastrointestinal stimulation, resulting in abdominal pain and diarrhea. In Mongolian medicine’s ethnomedicinal system, a distinctive processing method called “Chebulae Fructus processing” is employed. Chebulae Fructus is used to mitigate the toxicity of EP and alleviate its purgative effects. Nevertheless, the detoxification mechanism associated with this processing method remains unexplored. It is hypothesized that processing with Chebulae Fructus may alter the chemical composition of EP, and the residual components of Chebulae Fructus within processed Chinese medicine might exhibit pharmacological antagonistic effects, thereby achieving the purpose of processing and reducing toxicity. To investigate this further, a combination of UPLC-QTOF-MS-based metabolomics technology and multivariate statistical analysis was employed to analyze and compare the chemical composition of raw and processed EP. Differential variables contributing to group separation were identified based on specific criteria, including VIP (Variable Importance in Projection) values of ≥ 1 in PLS-DA models, p-values < 0.05, and fold changes (FC) > 1.2 or < 0.8. The resulting differentially expressed features were then identified through database matching, literature review, or manual annotation. In total, 47 components were identified from the PEP samples in both positive and negative ionization modes, primarily belonging to flavonoids, terpenoids, organic acids, glycosides, and fatty acids. Among the raw EP group and PEP S4 group, 10 differential compounds were identified. Notably, one toxic terpene and one phenylpropanoid from EP were downregulated, while two bioactive components from Chebulae Fructus were upregulated in the processed group. The possible conversion reactions of these two processing Q-markers were also elucidated. The characteristic processing with Chebulae Fructus resulted in a change in the composition of this Mongolian medicine EP. Furthermore, this study provides a scientific foundation for optimizing the processing technology of EP and offers insights into the processing of other ethnomedicines with toxic properties.

PMID:37948776 | DOI:10.1016/j.jpba.2023.115838

Biomed Phys Eng Express. 2023 Nov 10. doi: 10.1088/2057-1976/ad0bb2. Online ahead of print.

ABSTRACT

Precise monitoring of the position and dwell time of iridium-192 (Ir-192) during high-dose-rate (HDR) brachytherapy is crucial to avoid serious damage to normal tissues. Source imaging using a compact gamma camera is a potential approach for monitoring. However, images from the gamma camera are affected by blurring and statistical noise, which impact the accuracy of source position monitoring. This study aimed to develop a deep-learning approach for estimating ideal source images that reduce the effect of blurring and statistical noise from experimental images captured using a compact gamma camera.&#xD;Approach: A double pix2pix model was trained using the simulated gamma camera images of an Ir-192 source. The first model was responsible for denoising the Ir-192 images, whereas the second model performed super resolution. Trained models were then applied to the experimental images to estimate the ideal images. &#xD;Main results: At a distance of 100 mm between the compact gamma camera and the Ir-192 source, the difference in full width at half maximum (FWHM) between the estimated and actual source sizes was approximately 0.5 mm for a measurement time of 1.5 s. This difference has been improved from approximately 2.7 mm without the use of DL. Even with a measurement time of 0.1 s, the ideal images could be estimated as accurately as in the 1.5 s measurements. This method consistently achieved accurate estimations of the source images at any position within the field of view; however, the difference increased with the distance between the Ir-192 source and the compact gamma camera.&#xD;Significance: The proposed method successfully provided estimated images from the experimental images within errors smaller than 0.5 mm at 100 mm. This method is promising for reducing blurring and statistical noise from the experimental images, enabling precise real-time monitoring of Ir-192 sources during HDR brachytherapy.

PMID:37948761 | DOI:10.1088/2057-1976/ad0bb2

J Infect Dis. 2023 Nov 9:jiad446. doi: 10.1093/infdis/jiad446. Online ahead of print.

ABSTRACT

BACKGROUND: Neutralizing monoclonal antibodies (nmAbs) failed to show clear benefit for hospitalized patients with coronavirus disease 2019 (COVID-19). Dynamics of virologic and immunologic biomarkers remain poorly understood.

METHODS: Participants enrolled in the Therapeutics for Inpatients with COVID-19 trials were randomized to nmAb versus placebo. Longitudinal differences between treatment and placebo groups in levels of plasma nucleocapsid antigen (N-Ag), anti-nucleocapsid antibody, C-reactive protein, interleukin-6, and d-dimer at enrollment, day 1, 3, and 5 were estimated using linear mixed models. A 7-point pulmonary ordinal scale assessed at day 5 was compared using proportional odds models.

RESULTS: Analysis included 2149 participants enrolled between August 2020 and September 2021. Treatment resulted in 20% lower levels of plasma N-Ag compared with placebo (95% confidence interval, 12%-27%; P < .001), and a steeper rate of decline through the first 5 days (P < .001). The treatment difference did not vary between subgroups, and no difference was observed in trajectories of other biomarkers or the day 5 pulmonary ordinal scale.

CONCLUSIONS: Our study suggests that nmAb has an antiviral effect assessed by plasma N-Ag among hospitalized patients with COVID-19, with no blunting of the endogenous anti-nucleocapsid antibody response. No effect on systemic inflammation or day 5 clinical status was observed.

CLINICAL TRIALS REGISTRATION: NCT04501978.

PMID:37948759 | DOI:10.1093/infdis/jiad446

Retina. 2023 Nov 7. doi: 10.1097/IAE.0000000000003987. Online ahead of print.

ABSTRACT

PURPOSE: The primary aim was to describe patterns of para macular involvement, not yet reported but that OCT-A can now detect in SCD patients. The secondary aim was to search arguments concerning the physio pathogeny of para macular involvement.

METHODS: This institutional cohort retrospective study was conducted in a Referral Center for Ophthalmological Rare Diseases. Follow-up included an ophthalmological examination with optical coherent tomography and optical coherent tomography angiography.

RESULTS: Hundred and thirty-two sickle cell patients were included. Typical sickle cell maculopathy was observed in temporal area in 84 eyes (40.0 %) of SS patients and 8 eyes (14.8 %) of SC patients (p < 0.001). Enlargement of the foveal avascular zone was observed in 10 eyes whom 8 of SS patients. Two atypical parafoveal abnormalities were found in SS patients only. The first one consisted in macular thinning with normal vascularization in 15 eyes of 11 patients. The second atypical maculopathy was large areas of loss of vascularization without retina thinning 10 eyes of six patients. Multivariate analysis did not show a statistically significant relation between the PSR stage and the different type of sickle cell maculopathy (p = 0.21).

CONCLUSION: Those atypical sickle cell maculopathy may correspond to early forms preceding a typical SCM. This would point towards several physiopathogenic mechanisms. The first one included the existence of ischemia which can be related to anemia. Presence of retinal thinning without vascular involvement point out to a neurogenic mechanism.

PMID:37948742 | DOI:10.1097/IAE.0000000000003987

Retina. 2023 Nov 6. doi: 10.1097/IAE.0000000000003990. Online ahead of print.

ABSTRACT

PURPOSE: Manual extraction of spectral domain optical coherence tomography (SD-OCT) reports is time- and resource-intensive. This study aimed to develop an optical character recognition (OCR) algorithm for automated data extraction from Cirrus SD-OCT macular cube reports.

METHODS: SD-OCT monocular macular cube reports (n=675) were randomly selected from a single-center database of patients from 2020-2023. Image processing and bounding box operations were performed, and Tesseract (an OCR library) was used to develop the algorithm, OCTess. The algorithm was validated using a separate test dataset.

RESULTS: The long short-term memory (LSTM) deep learning version of Tesseract achieved the best performance. After re-verifying all discrepancies between human and algorithmic data extractions, OCTess achieved accuracies of 100.00% and 99.98% in the training (n=125) and testing (n=550) datasets, while the human error rate was 1.11% (98.89% accuracy) and 0.49% (99.51% accuracy) in each, respectively. OCTess extracted data in 3.1 seconds, compared to 94.3 seconds for human evaluators.

CONCLUSION: We developed an OCR and machine learning algorithm that extracts SD-OCT data with near-perfect accuracy, which is more accurate and efficient compared to a human. This algorithm can be used for efficient construction of large-scale SD-OCT datasets for researchers and clinicians.

PMID:37948741 | DOI:10.1097/IAE.0000000000003990

Wiad Lek. 2023;76(10):2295-2301. doi: 10.36740/WLek202310125.

ABSTRACT

OBJECTIVE: The aim: To substantiate the use of data on patients’ lifestyle, parameters of blood glucose, heart rate, blood pressure and bread units to build a mathematical model for predicting fasting blood glucose level in diabetes mellitus patients to improve existing measures for diabetes prevention.

PATIENTS AND METHODS: Materials and methods: An open database consisting of the studied parameters of 359 people was used in the research. The linear regression method was used to predict fasting blood glucose level in diabetes mellitus patients. The statistical software IBM SPSS Statistics Version 23 was chosen for calculations.

RESULTS: Results: To calculate the coefficients of the linear regression equation, stepwise elimination of parameters was chosen. The analysis of the coefficients of influence of independent variables on dependent showed that the greatest effect on the change in glucose level had value of consumed bread units. The model for women diagnosed with type 2 diabetes showed the highest accuracy.

CONCLUSION: Conclusions: Mathematical modeling made it clear that any malnutrition or health disorders can lead to a significant change in glucose levels. The obtained models consist of a number of parameters, some of which might depend on the presence of concomitant diseases. Further studies should focus on the optimal combination of various parameters taking into account methods of treating comorbidities.

PMID:37948729 | DOI:10.36740/WLek202310125

Wiad Lek. 2023;76(10):2258-2262. doi: 10.36740/WLek202310119.

ABSTRACT

OBJECTIVE: The aim: To study the quality of life of patients with periodontal disease.

PATIENTS AND METHODS: Materials and methods: The study was conducted among 189 patients, including 87 men and 102 women. Research methods – clinical method, question¬naire survey (study of the quality of life related to oral health (oral health-related quality of life – OHRQoL, ОНІР-14), medical and statistical analysis using an application package Statistica 10.0 (StatSoft, Inc., USA) and Microsoft Office Excel 2010.

RESULTS: Results: According to the results of periodontal examination, it was found that 29,1% of patients suffer from acute gingivitis, acute periodontitis – 48,1%, chronic periodontitis – 21,7%. According to the results of patients’ self-assessment of the quality of life associated with oral health, a good lifestyle can be stated. Almost 50% of patients said that the most tangible problems associated with the health of their oral cavity are functional disorders (31,7%), oral pain, and difficulty eating (16,6%). Psychological problems were reported by 16,3% of respondents, among whom one-third noted a feeling of irritability and tension, dissatisfaction with eating, and also noted limitations in communication with people, and the need to interrupt food intake during its intake due to oral problems.

CONCLUSION: Conclusions: Periodontal tissue diseases reduce the quality of life of patients. Assessing the quality of life related to oral health is essential to determine the effectiveness of measures aimed at improving and preserving public health.

PMID:37948723 | DOI:10.36740/WLek202310119

Wiad Lek. 2023;76(10):2239-2244. doi: 10.36740/WLek202310116.

ABSTRACT

OBJECTIVE: The aim: The study of cytomorphological and cytogenetic features of the buccal epithelium of residents of apartments who complained of unpleasant odors in their homes.

PATIENTS AND METHODS: Materials and methods: The state of buccal epithelium in residents of multi-story buildings was studied. A total of 237 individuals were examined, 117 males and 120 females, aged from 6 to 81 years. Buccal cells were collected using a sterile spatula and stained with a 2.5% solutionofaceto-orcein and 1% light green. The preparations were examined using a light microscope OPTON Axioskop (Germany) with oil immersion at a magnification of x1000. Statistical processing of the data was performed using IBMSPSS Statistics 29.0.0.0 (t-Student criterion; Mann-Whitney; ANOVA: Tukey; T3-Dunnett), with p≤0.05.

RESULTS: Results: Cytomorphological and cytogenetic abnormalities, compared to physiological limits, were mainly manifested as karyorrhexis, nuclear doubling, the appearance of epitheliocytes with perinuclear vacuoles, or nuclear vacuolization. The frequency of micronuclei was observed in the range of (0.3-2.8 ‰). The highest micronucleus index (per 1000 cells, ‰) was observed among males aged 15-39 years and females over 65 years old. In both sexes, the lowest micronucleus indices were found in the age group of 6-14 years.

CONCLUSION: Conclusions: in the «sick building» an increase in the frequency of micronucleus occurrence among males and females was observed simultaneously with increasing age.

PMID:37948720 | DOI:10.36740/WLek202310116

Wiad Lek. 2023;76(10):2195-2199. doi: 10.36740/WLek202310110.

ABSTRACT

OBJECTIVE: The aim: To investigate clinical and pathohistological manifestations of acute kidney injury among patients with drug poisoning (overdose).

PATIENTS AND METHODS: Materials and methods: A cohort retrospective analysis of medical data of 86 patients treated in 2017-2021 with a diagnosis of “acute drug poisoning” com¬plicated by the development of acute kidney injury syndrome was conducted. A forensic medical examination of deceased patients (7 persons) was carried out. Histological samples were examined using an microscope OPTON Axioskop (Germany) in transmitted light, at magnifications of 100 and 400 times. Statistical analysis of the obtained data was carried out using the IBM SPSS Statistics 29.0.0.0 program, Pearson’s correlation analysis was used, p≤0.05.

RESULTS: Results: Acute renal failure in drug poisoning occurs under the influence of prerenal (hypoxia, r=0,66, р=0,0021; hypovolemia, r=0,61, р=0,0333) and renal factors (toxic effect of chemical components of the drug and rhabdomyolysis, r=0,743, р=0,0034). In the tissue samples, erythrocyte stasis in the capillaries, general fullness of blood vessels, signs of the sludge effect and small diapedesis hemorrhages were found; vasculitis and perivascular sclerosis are noted; foci of mononuclear infiltration of the stroma, focal edema, necrosis and interstitial fibrosis; desquamation, degenerative-dystrophic changes of the nephrothelium, tubular atrophy were found; hyaline casts in separate tubules; focal glomerular changes with segmental increase of the mesangial matrix and proliferation of endothelial cells, atrophy and hyalinosis of individual glomeruli were noted.

CONCLUSION: Conclusions: The multifactorial effect of opioids is confirmed by microcirculation disorders, vascular, interstitial, tubular and glomerular changes in the kidneys.

PMID:37948714 | DOI:10.36740/WLek202310110