Tag: nevin manimala

Eur J Pain. 2024 Aug 31. doi: 10.1002/ejp.4719. Online ahead of print.

ABSTRACT

BACKGROUND: Sensory profiling in neuropathic pain using quantitative sensory testing (QST) has not been extended to central neuropathic pain due to spinal cord injury (SCI). This study aims to fill this gap by evaluating sensory profiles in patients with neuropathic SCI pain.

METHOD: We retrospectively analysed consecutive QST data from 62 patients with neuropathic spinal cord injury pain (SCIP), following the German Research Network on Neuropathic Pain protocol. The study included at-level and below-level SCIP due to a spinal cord lesion, and at-level SCIP following a cauda equina lesion. QST parameters were compared between diagnostic groups. QST profiles of below-level SCIP (central neuropathic pain) were manually assigned to sensory phenotypes based on literature and expert opinion.

RESULTS: No statistical difference in QST parameters between pain diagnoses was found. For central neuropathic pain (below-level SCIP), three phenotypes were descriptively observed: loss of function (59%), thermal and mechanical hyperalgesia combination (16%), and mechanical hyperalgesia (19%). The remaining 5% of patients did not fit a common pattern. There was no statistical difference in clinical and psychological variables between phenotypes. In a subgroup analysis, the loss of function phenotype weakly correlated with older age, longer time since injury, and longer pain duration.

CONCLUSIONS: Here, we capture sensory phenotypes of central neuropathic pain following SCI. The limited sample size, high rate of missing values, and the retrospective nature of the study mean that results should be seen as strictly exploratory. Further research should replicate these findings and explore the significance of phenotypes.

SIGNIFICANCE STATEMENT: The evaluation of sensory phenotypes by quantitative sensory testing in central neuropathic pain due to SCI adds a new perspective on sensory phenotypes in comparison to peripheral neuropathic pain. The described thermal and mechanical hyperalgesia combination might represent involvement of the spinothalamic tract. In addition, there was a trend towards older age and longer time since injury in patients with loss of function.

PMID:39215588 | DOI:10.1002/ejp.4719

J Sep Sci. 2024 Sep;47(17):e2400421. doi: 10.1002/jssc.202400421.

ABSTRACT

Shaoyao Gancao Decoction (SGD), a traditional Chinese medicine, has been proven to have a good liver protection effect, but the mechanism and pharmacodynamic substances of SGD in the treatment of acute liver injury are still unclear. In this study, an ultra-high-performance liquid chromatography-quadrupole-time-of-flight mass spectrometry (UHPLC-Q-TOF-MS) method was established to characterize 107 chemical components of SGD and 12 compounds absorbed in rat plasma samples after oral administration of SGD. Network pharmacology was applied to construct a component-target-pathway network to screen the possible effective components of SGD in acute liver injury. Using lipidomics based on UHPLC-Q-TOF-MS coupled with a variety of statistical analyses, 20 lipid biomarkers were screened and identified, suggesting that the improvement of acute liver injury by SGD was involved in cholesterol metabolism, glycerol-phospholipid metabolism, sphingolipid signaling pathways and fatty acid biosynthesis. In addition, the UHPLC-tandem MS method was established for pharmacokinetics analysis, and 10 potential active components were determined simultaneously within 12 min through the optimization of 0.1% formic acid water and acetonitrile as a mobile phase system. A Pharmacokinetics study showed that paeoniflorin, albiflorin, oxypaeoniflorin, liquiritigenin, isoliquiritigenin, liquiritin, ononin, formononetin, glycyrrhizic acid, and glycyrrhetinic acid as the potential active compounds of SGD curing acute liver injury.

PMID:39215583 | DOI:10.1002/jssc.202400421

Clin Exp Dermatol. 2024 Aug 31:llae363. doi: 10.1093/ced/llae363. Online ahead of print.

ABSTRACT

BACKGROUND: Acquired idiopathic generalized anhidrosis (AIGA) is a rare disorder primarily observed in Asian populations, particularly in Japan. Although pulse methylprednisolone therapy is an effective treatment for AIGA, predictors of therapeutic response remain poorly defined.

OBJECTIVES: This study sought to identify factors that predict the efficacy of pulse methylprednisolone therapy in patients with AIGA.

METHODS: Data obtained from 32 patients with AIGA were assessed based on clinical, histopathological, and serological examinations. Statistical analyses were conducted to explore predictors of response to pulse methylprednisolone therapy.

RESULTS: The average age of participants was 32.1 years (SD = 12.3), with a male predominance (66%). Response to pulse methylprednisolone therapy was closely associated with the time from the onset to start of therapy (Wilcoxson’s rank sum test, p = 0.016, n = 27), with earlier intervention resulting in better outcome. Notably, males and patients presenting with severe symptoms at diagnosis responded better to treatment. High serum carcinoembryonic antigen (CEA) levels and histological evidence of inflammation around sweat glands also correlated with a positive therapeutic response.

CONCLUSIONS: Earlier intervention, elevated serum CEA levels, and inflammation around sweat glands are potential indicators of successful response to pulse methylprednisolone therapy in patients with AIGA.

PMID:39215567 | DOI:10.1093/ced/llae363

Mov Disord Clin Pract. 2024 Aug 31. doi: 10.1002/mdc3.14200. Online ahead of print.

ABSTRACT

BACKGROUND: The Levodopa Equivalent Daily Dosage (LEDD) calculation algorithms help in capturing and harmonization of Parkinson’s Disease (PD) therapies. Analyzing these updates is essential for validating their effectiveness.

OBJECTIVE: To assess updated LEDD conversion factors in capturing the newer therapies in PD and therapy modules in different geographical cohorts.

METHODS: Data were sourced from 10 Centers from 6 countries representing 2 different continents. The study compared the LEDD conversion factors proposed by Tomlinson et al and Jost et al, alongside investigating demographic disparities.

RESULTS: The analysis involved 2943 subjects; 87% (n = 2577) met the UK Brain Bank criteria for PD. The LEDD differed significantly across methodologies (Tomlinson vs. Jost, 598 mg vs 610 mg, P < 0.0001). Geographical disparities highlighted variations in PD onset age (P < 0.0001). Jost and Tomlinson’s calculations demonstrated consistency within but significant differences across countries (P < 0.0001).Age at onset revealed statistically significant differences in LEDD requirements (P < 0.0001), which were particularly higher in 21-50 years (718 mg vs 566 mg). This subgroup also demonstrated increased usage of non-Levodopa therapies (P < 0.0001). Men exhibited higher total LEDD (P = 0.001). 34% reported dyskinesia, associated with higher LEDD (756 mg, P < 0.0001). Surgically treated patients also had higher LEDD (P < 0.0001) and a significant difference between Jost and Tomlinson dosages (761 mg vs716mg) reflecting the incorporation of newer therapeutic molecules.

CONCLUSION: This analysis delineates the importance of updated LEDD algorithms and intricacies in the landscape of PD treatment, underscored by geographical, age-related, and gender-specific variations, in real-life management scenarios.

PMID:39215556 | DOI:10.1002/mdc3.14200

Allergy. 2024 Aug 31. doi: 10.1111/all.16306. Online ahead of print.

NO ABSTRACT

PMID:39215541 | DOI:10.1111/all.16306

Anat Histol Embryol. 2024 Sep;53(5):e13105. doi: 10.1111/ahe.13105.

ABSTRACT

The skull is a complex, vital structure made up of many bones. It has been observed that studies on skulls help to determine species and sex. In recent years, craniometric studies have been frequently used to determine morphometric features in animals. In our study, 150 skulls were studied, 50 from the second trimester (25 males and 25 females), 50 from the third trimester (25 males and 25 females), and 50 from the third and fourth week after birth (25 males and 25 females). The skulls were sectioned by computerised tomography and stored in DICOM format. From the images, nine different measurements and five index calculations were made. The similarities and differences between species were determined by ignoring sex differences. Correlation analyses were performed to compare measurement parameters between animal species. In addition, the results of statistical analyses between sexes were evaluated without species distinction. SL, CW and ICI parameters were highly statistically significant between measurements in the second trimester, third trimester and postnatal group (p < 0.01). In the third trimester, the EHC measurement parameter was found to be highly significant between males and female (p < 0.01). In Table 5, the CL parameter was positively correlated with CW, IHC, EHC, ILC, ELC, FMW and FMH. There are very few studies on foetal development. It is predicted that the data obtained can be used in zoo-archaeology, anatomy, surgery and forensic medicine. In addition, radiographic determination of craniometric features will help in the treatment and prognosis of diseases.

PMID:39215528 | DOI:10.1111/ahe.13105

Nutr Health. 2024 Aug 31:2601060241273570. doi: 10.1177/02601060241273570. Online ahead of print.

ABSTRACT

STUDY PURPOSE: this study aims to analyze QOL and psychosocial impact on patients with blood disorders.

METHODS: A cross-sectional survey design is adopted in this study. The survey questionnaire included SF-36 form for measuring quality of life (QOL), along with psychosocial impact assessment scale. Adult patients with different types of blood disorders were recruited for the survey. Out of the 417 responses received, 389 were considered for data analysis and the remaining were avoided due to incomplete data.

RESULTS: In terms of psychosocial impact scales, the highest mean is observed for financial stress (4.09 ± 1.22), followed by social exclusion (3.76 ± 1.19) and relationship challenges (3.31 ± 1.18). Among the QOL scales, the highest mean was observed for pain (3.81 ± 1.17), followed by physical functioning (3.68 ± 1.12). Statistically significant differences (p < 0.05) were observed among the participants groups characterized by age and type of disorder. Strong positive correlations between social exclusion and general health (r = 0.513), as well as pain and relationship challenges (r = 0.735) were observed.

CONCLUSION: Given the existing challenges in social exclusion, poor awareness, and support there is a need to develop comprehensive and personalized treatment plans integrating physical and mental support, awareness creation, and financial support.

PMID:39215525 | DOI:10.1177/02601060241273570

Clin Appl Thromb Hemost. 2024 Jan-Dec;30:10760296241280624. doi: 10.1177/10760296241280624.

ABSTRACT

BACKGROUND: ICU patients have a high incidence of VTE. The American College of Chest Physicians antithrombotic practice guidelines recommend assessing the risk of VTE in all ICU patients. Although several VTE risk assessment tools exist to evaluate the risk factors among hospitalized patients, there is no validated tool specifically for assessing the risk of VTE in ICU patients.

METHODS: A retrospective corhort study was conducted between June 2018 and October 2022. We obtained data from the electronic medical records of patients with a variety of diagnoses admitted to a mixed ICU. Multivariable logistic regression analysis was used to evaluate the independent risk factors of VTE. Receiver operating characteristic (ROC) curves were used to analyse the predictive accuracy of different tools.

RESULTS: A total of 566 patients were included, and VTE occurred in 89 patients (15.7%), 62.9% was asymptomatic VTE. A prediction model (the ICU-VTE prediction model) was derived from the independent risk factors identified using multivariate analysis. The ICU-VTE prediction model included eight independent risk factors: history of VTE (3 points), immobilization ≥4 days (3 points), multiple trauma (3 points), age ≥70 years (2 points), platelet count >250 × 10³/μL (2 points), central venous catheterization (1 point), invasive mechanical ventilation (1 point), and respiratory failure or heart failure (1 point). Patients with a score of 0-4 points had a low (1.81%) risk of VTE. Patients were at intermediate risk, scoring 5-6 points, and the overall incidence of VTE in the intermediate-risk category was 17.1% (odds ratio [OR], 11.1; 95% confidence interval [CI], 4.2-29.4). Those with a score ≥7 points had a high (44.1%) risk of VTE (OR, 42.6; 95% CI, 16.4-110.3). The area under the curve (AUC) of the ICU-VTE prediction model was 0.838, and the differences in the AUCs were statistically significant between the ICU-VTE prediction model and the other three tools (ICU-VTE score, Z = 3.723, P < 0.001; Caprini risk assessment model, Z = 6.212, P < 0.001; Padua prediction score, Z = 7.120, P < 0.001).

CONCLUSIONS: We identified eight independent risk factors for acquired VTE among hospitalized patients in the ICU, deriving a new ICU-VTE risk assessment model. The model aims to predict asymptomatic VTE in ICU patients. The new model has higher predictive accuracy than the current tools. A prospective study is required for external validation of the tool and risk stratification in ICU patients.

PMID:39215514 | DOI:10.1177/10760296241280624

Clin Appl Thromb Hemost. 2024 Jan-Dec;30:10760296241271406. doi: 10.1177/10760296241271406.

ABSTRACT

BACKGROUND: Currently, no universally accepted standardized VTE risk assessment model (RAM) is specifically designed for critically ill patients. Although the ICU-venous thromboembolism (ICU-VTE) RAM was initially developed in 2020, it lacks prospective external validation.

OBJECTIVES: To evaluate the predictive performance of the ICU-VTE RAM in terms of VTE occurrence in mixed medical-surgical ICU patients.

METHODS: We prospectively enrolled adult patients in the ICU. The ICU-VTE score and Caprini or Padua score were calculated at admission, and the incidence of in-hospital VTE was investigated. The performance of the ICU-VTE RAM was evaluated and compared with that of Caprini or Padua RAM using the receiver operating curve.

RESULTS: We included 269 patients (median age: 70 years; 62.5% male). Eighty-three (30.9%) patients experienced inpatient VTE. The AUC of the ICU-VTE RAM was 0.743 (95% CI, 0.682-0.804, P < 0.001) for mixed medical-surgical ICU patients. Comparatively, the performance of the ICU-VTE RAM was superior to that of the Pauda RAM (AUC: 0.727 vs 0.583, P < 0.001) in critically ill medical patients and the Caprini RAM (AUC: 0.774 vs 0.617, P = 0.128) in critically ill surgical patients, although the latter comparison was not statistically significant.

CONCLUSIONS: The ICU-VTE RAM may be a practical and valuable tool for identifying and stratifying VTE risk in mixed medical-surgical critically ill patients, aiding in managing and preventing VTE complications.

PMID:39215513 | DOI:10.1177/10760296241271406

J Magn Reson Imaging. 2024 Aug 30. doi: 10.1002/jmri.29598. Online ahead of print.

ABSTRACT

BACKGROUND: Brown adipose tissue (BAT) is metabolically activatable and plays an important role in obesity and metabolic diseases. With reduced fat-water-fraction (FWF) compared with white adipose tissue (WAT), BAT mass and its functional activation may be quantified with Z-spectra MRI, with built-in FWF and the metabolic amide proton transfer (APT) contrasts.

PURPOSE: To investigate if Z-spectral MRI can quantify the mass and metabolic activity of adipose tissues.

STUDY TYPE: Prospective.

SUBJECTS: Seven groups of 8-week-old male rats, including two groups (n = 7 per group) for in vivo MRI study and five groups (n = 5 per group) for ex vivo validation; 12 young and healthy volunteers with 6 male and 6 female.

FIELD STRENGTH/SEQUENCE: The 7 T small animal and 3 T clinical systems, T₂-weighted imaging, Rapid Acquisition with Relaxation Enhancement (RARE) readout based chemical exchange saturation transfer (CEST) Z-spectral MRI sequence.

ASSESSMENT: Quantified FWF and APT from Z-spectra in rats before and after norepinephrine (NE) stimulation and in healthy human subjects; ex vivo measurements of total proteins in BAT from rats.

STATISTICAL TESTS: Two-tailed unpaired Student’s t-tests and repeated measures ANOVA. P-value <0.05 was considered significant.

RESULTS: Decreased FWF (from 39.6% ± 7.2% before NE injection to 16.4% ± 7.2% 120 minutes after NE injection, P < 0.0001) and elevated APT (from 1.1% ± 0.5% before NE injection to 2.9% ± 0.5% 120 minutes after NE injection, P < 0.0001) signals in BAT were observed with in vivo Z-spectral MRI in rats injected with NE at 7 T MRI. At clinical 3 T, Z-spectral MRI was used to quantify the FWF (58.5% ± 7.2% in BAT and 73.7% ± 6.5% in WAT with P < 0.0001) and APT (2.6% ± 0.8% in BAT and 0.9% ± 0.3% in WAT with P < 0.0001) signals in healthy volunteers. APT signals of BAT were negatively correlated with the BMI in humans (r = 0.71).

DATA CONCLUSION: Endogenous Z-spectral MRI was demonstrated to simultaneously quantify BAT mass and function based on its FWF and APT contrasts.

TECHNICAL EFFICACY STAGE: 1.

PMID:39215496 | DOI:10.1002/jmri.29598