Tag: pubmed

Georgian Med News. 2023 Jul-Aug;(340-341):159-164.

ABSTRACT

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that affects almost all internal organs, among which circulatory system organs (CSO) lesions are not only among the most common but also at the top of the list of causes of mortality. The tactics of treatment of patients with SLE without and in combination with CSO lesions are fundamentally different, and therefore, improving diagnostic methods will help to enhance the effectiveness of the management of this category of patients. The aim of the study – to determine the diagnostic value of laboratory markers of syntropic lesions of the circulatory system organs in patients with systemic lupus erythematosus. The research included 125 patients with SLE with CSO lesions, among whom the vast majority were young women. Patients were stratified according to syntropy. Syntropic lesions were those whose frequency significantly increased with increasing severity of SLE: retinal angiopathy, capillaritis, Raynaud’s syndrome, livedo reticularis, atherosclerosis, mitral valve insufficiency, mitral valve thickening, pericardial effusion, pulmonary hypertension, myocarditis, endocarditis, symptomatic arterial hypertension, and vein thrombosis. During the study, the diagnostic value of individual laboratory markers and their constellations in terms of sensitivity, specificity, and accuracy in patients with SLE with syntropic lesions of CSO was determined step by step, and the one with the highest diagnostic value for the diagnosis of these lesions was chosen. The difference was considered statistically significant if p<0.050. The association coefficient and the contingent coefficient were used to determine the closeness of the relationship between the marker and the syntropic lesion. The relationship was considered confirmed if the association coefficient was ≥ 0.50 or the contingent coefficient was ≥ 0.30. We studied the diagnostic value of individual laboratory markers and their constellations in terms of sensitivity, specificity, and accuracy in patients with SLE with syntropic CSO lesions. It was found that the best diagnostic value for the diagnosis of retinal angiopathy is the constellation of ↑ LDL + ↑ IA + ↑ anti-ds DNA + ↑ ANA; capillaritis – ↑ β-globulins + ↑ IA + ↑ anti-ds DNA + ↑ antiphospholipid antibodies Ig M + ↑ anti-Sm + ↓ C4; Raynaud’s syndrome – a separate marker ↓ C3; livedo reticularis – ↑ ESR + ↑ small CIC + ↑ anti-ds DNA + ↑ anti-Sm; atherosclerosis – ↓ hemoglobin + ↑ LDL + ↑ ANA + ↓ C4; mitral valve insufficiency – ↑ ESR + ↑ anti-ds DNA + ↑ ANA + ↑ antiphospholipid antibodies Ig M; mitral valve stenosis – ↑ ESR+↑ LDL + ↑ small CK + ↑ ANA; pericardial effusion – erythropenia + ↑ C-RP + ↑ lupus anticoagulant; pulmonary hypertension – hypercholesterolemia + ↑ LDL + ↑ anti-ds DNA + ↑ ANA; myocarditis – an individual marker ↓ C4; endocarditis – ↑ ESR + ↑ total fibrinogen + ↑ γ-globulins + hypercholesterolemia + ↑ anti-Sm; symptomatic arterial hypertension – ↑ LDL + ↑ anti-ds DNA + ↑ ANA + ↑ anti-SSA (Ro); vein thrombosis – erythropenia + ↓ hemoglobin + ↑ LDL + ↑ ANA. For each syntropic lesion in patients with systemic lupus erythematosus, an individual laboratory marker or constellations have been identified that having the best diagnostic value for the diagnosis of these lesions.

PMID:37805891

Georgian Med News. 2023 Jul-Aug;(340-341):131-135.

ABSTRACT

Aim – improving the effectiveness of complex treatment of patients with maxillomandibular anomalies and disorders of the architectonics of the vestibule of the mouth. We conducted clinical, X-ray methods and cytomorphometric, rheographic examination of the oral mucosa of 30 patients 15-17-years old with acquired maxillomandibular anomalies and disorders of the architectonics of the vestibule of the mouth (buccal frenum) and 15 relatively healthy children – norm group. The patients of I group had surgical correction of buccal frenum, where the surgical wound was healing by secondary tension. The patients of II group had proposed surgical correction of buccal frenum, where the surgical wound was healing by primary tension Patients were prescribed chlorhexidine-denta and a preparation based on hyaluronic acid (Gengigel, Italy) in the postoperative period. Statistical processing of the results was performed using a personal computer using the software package Statistica 12.0. Data distribution was assessed using the Kolmogorov-Smirnov test of normality. Mean values and standard errors were calculated for continuous variables. Correlation between parameters was analyzed using Spearman’s correlation coefficient and tested for significance. Significance was set at p<0.05. Clinical studies have shown that all patients have anomalies of buccal frenum fixationin the area of the canines and premolars. The results of cytomorphometric and rheographic studies indicated a deficiency of blood supply in these areas. The results of clinical and laboratory examination showed the advantage of the proposed treatment plan. Long-term results indicate the formation of a normorthophic scar, the absence of recurrences and recessions of the gums in the area of projections of the buccal frenum, the normalization of clinical and laboratory parameters. The obtained data in ІІ group significantly differ from those in І group (p <0.05). Surgical correction of disorders of the architectonics of the vestibule of the mouth is an important and necessary stage of complex treatment of patients with maxillomandibular anomalies and disorders of the architectonics of the vestibule of the mouth. We can achieve the desired therapeutic effect in the treatment of such patients and prevent relapses only by eliminating the etiological factor. The use of preparations based on hyaluronic acid in the postoperative period stimulates reparative processes in the operated area and contributes to the formation of a normotrophic scar. Plastic of buccal frenulum is a prevention of abnormal position of premolars and gum recession in the area of canines and premolars. It is important for preventive dentistry.

PMID:37805886

Georgian Med News. 2023 Jul-Aug;(340-341):107-112.

ABSTRACT

Remineralizing agents such as fluoride and hydroxyapatite (HA) (Ca5 (po4)3OH) are well-known treatment choices for incipient enamel lesions. Hydroxyapatite has been newly presented to return the color of such enamel lesions. The purpose of this prospective in vitro study was to compare commercial sodium fluoride paste to hydroxyapatite paste (HA) made from chicken eggshells powder (CESP) in terms of how it affected the microhardness and color of the enamel surface of artificially demineralized permanent teeth. Fifty healthy maxillary premolars were gathered, decoronated, and the crowns were placed in acrylic moulds with the buccal enamel surfaces exposed. Baseline microhardness evaluation was done for the baseline group, while the colour assessment was done at baseline to three treatment groups. Then specimens were randomly divided into the following five groups (n = 10) based on the treatment of enamel surface: Group 1: Baseline group; Group 2: Acid group demineralized only; Group 3: demineralized followed by the application of hydroxyapatite paste (HA); Group 4: demineralized followed by the application of sodium fluoride toothpaste (Naf); and Group 5: demineralized followed by application of combination treatments (HA paste at morning and Naf paste at evening. The specimens were stored in deionized water at room temperature during treatments, after one week they were subjected to a Vickers microhardness test, and colour assessment to three treatment groups after treatment. One‑way ANOVA and Tukey’s post hoc multiple comparison tests were used for statistical analysis (P < 0.05). After artificial demineralization, the enamel’s surface microhardness was greatly reduced, and after management, it dramatically increased. The combination group had the greatest mean microhardness value when compared to the HA paste group and the Naf paste group. Statistically, there was no significant variance in microhardness values among the Naf paste and HA paste groups. Hydroxyapatite sourced from chicken eggshell was as effective as Naf paste in remineralizing and restoring the lost microhardness of artificially demineralized enamel, hydroxyapatite paste changed tooth color, while sodium fluoride paste, a combination group neither changed nor masked color of early caries lesion.

PMID:37805883

Georgian Med News. 2023 Jul-Aug;(340-341):76-80.

ABSTRACT

The study aimed to analyse the adverse drug reactions report form data received by the State Expert Center of the Ministry of Health of Ukraine from healthcare professionals in the Lviv region in 2022. Regarding specific types of medicines, the ones with proven cause-and-effect relationships that caused the highest frequency of adverse drug reactions incidents were chemotherapeutic agents (35.5%), medicines affecting the cardiovascular system (20.3%), and non-steroidal anti-inflammatory drugs (8%). Within the penicillin class, amoxicillin potentiated by clavulanate (67%) and amoxicillin (29%) were the dominant drugs showing the highest incidence rate of adverse reactions. Among cephalosporins, ceftriaxone (46%) and cefixime (15%) were found to take the lead in terms of adverse reaction frequency. The highest proportion among all adverse drug reactions caused by penicillins and cephalosporins was attributed to allergic reactions. To confirm or rule out immediate or delayed type allergies in patients, as well as in patients with a history of immediate-type allergic reactions to β-lactams and planned administration of another β-lactam, it is necessary to conduct skin testing (skin prick test, or, in the case of parenteral administration, intradermal test) with the planned β-lactam antibiotic. The second highest proportion of induced adverse drug reactions was attributed to drugs affecting the cardiovascular system (20.3%). The leading medications in the angiotensin-converting enzyme inhibitors category were enalapril (47%) and the combination of lisinopril with hydrochlorothiazide (24%). In the angiotensin II receptor blockers category of medications, valsartan (30%) and telmisartan-hydrochlorothiazide combination (20%) ranked highest. In the category of CCB drugs, amlodipine (66%) and nifedipine (20%) held the leading positions. among angiotensin-converting enzyme inhibitors, enalapril caused the most prevalent and predicted adverse reaction, that of cough, affecting 10.5% of patients, whereas, with the combination therapy of lisinopril and hydrochlorothiazide, the cough was observed in only 5.2% of patients. Angiotensin II receptor blockers have a better safety profile, particularly concerning cough. Analysis of adverse drug reactions reports for angiotensin II receptor blockers showed no cases of cough with valsartan and telmisartan-hydrochlorothiazide combination. Among calcium channel blocker medications, amlodipine emerged to rank highest, causing one of the predicted adverse drug reactions, that of lower extremity oedema in 64% of patients. The second position was taken by the combination of amlodipine with valsartan, which showed a statistically significant reduction of 14.3% (p≤0.05) in the incidence of oedema. Using amlodipine at a dose of 5 mg in combination with sartan medicines as angiotensin receptor blockers is an effective therapeutic alternative not only for enhancing blood pressure control in hypertensive patients but also for improving the safety profile of amlodipine. Among all the non-steroidal anti-inflammatory drugs prescribed to patients in the Lviv region in 2022, the highest number of adverse reactions was associated with the administration of diclofenac, ibuprofen, paracetamol, and nimesulide, causing adverse drug reactions in 22%, 19%, 17%, and 10% of cases, respectively. The most common systemic manifestations of adverse reactions with these non-steroidal anti-inflammatory drugs were allergic reactions (63.4%) and gastrointestinal disorders (26.8%). From an evidence-based medicine perspective, the most justified approach for primary and secondary prevention of gastrointestinal complications is the use of proton pump inhibitors.

PMID:37805878

Georgian Med News. 2023 Jul-Aug;(340-341):25-29.

ABSTRACT

Acute myeloid leukemia (AML) is a myeloid malignancy in which hematopoietic progenitor cells are blocked early in development, causing the development of abnormal cells. The most common type of adult leukemia is AML. The most significant developments in the treatment of cancer over the past ten years have been made possible by programmed death protein 1 and anti-programmed ligand 1 (PD-L1) which are examples of immune checkpoint (IC) inhibitors. This study involved two groups: the patient group, consisting of 80 samples, and the control group, consisting of 40 samples. The participants’ age range was 18-85 years, and the samples were obtained from at Baghdad Teaching Hospital – Medical City in Baghdad, Iraq. Patients were categorized into the FAB according to AML Subtype including the FAB (M3), FAB (non- M3). The age group did not show a significant difference (P≥0.05) in patients with AML compared to the control group. Furthermore, The mean age of patients was 42.83 years, and control age mean 40.4 years. The aim of this study was to evaluate the effect of Acute myeloid leukemia on the levels of certain immunological parameters. The results of the QRT-PCR technique for immunological tests showed the PD-1 expression in patients with AML statistically has high significant difference (P≤0.0001). and the PD-L1 expression also had a highly significant difference (P<0.0001) in PD-1, PD-L1 genes, compared to the control group. These findings suggest that AML infection may influence immunological responses.

PMID:37805869

Sheng Wu Gong Cheng Xue Bao. 2023 Sep 25;39(9):3579-3593. doi: 10.13345/j.cjb.230079.

ABSTRACT

Data-independent acquisition (DIA) is a high-throughput, unbiased mass spectrometry data acquisition method which has good quantitative reproducibility and is friendly to low-abundance proteins. It becomes the preferred choice for clinical proteomic studies especially for large cohort studies in recent years. The mass-spectrometry (MS)/MS spectra generated by DIA is usually heavily mixed with fragment ion information of multiple peptides, which makes the protein identification and quantification more difficult. Currently, DIA data analysis methods fall into two main categories, namely peptide-centric and spectrum-centric. The peptide-centric strategy is more sensitive for identification and more accurate for quantification. Thus, it has become the mainstream strategy for DIA data analysis, which includes four key steps: building a spectral library, extracting ion chromatogram, feature scoring and statistical quality control. This work reviews the peptide-centric DIA data analysis procedure, introduces the corresponding algorithms and software tools, and summarizes the improvements for the existing algorithms. Finally, the future development directions are discussed.

PMID:37805839 | DOI:10.13345/j.cjb.230079

Ann Saudi Med. 2023 Sep-Oct;43(5):329-338. doi: 10.5144/0256-4947.2023.329. Epub 2023 Oct 5.

ABSTRACT

BACKGROUND: Abdominal pain is a common and non-specific symptom in children. It is important to be able to distinguish the source of abdominal pain before surgery.

OBJECTIVES: Assess importance of the systemic immune inflammation index (SII), systemic inflammation response index (SIRI), and other systemic inflammatory response blood cell indices in predicting the diagnosis and prognosis of acute appendicitis in children.

DESIGN: Retrospective cohort SETTING: Single center in Turkey PATIENTS AND METHODS: The files of patients with abdominal pain aged 0-18 years who underwent surgery for appendicitis in our clinic between January 2011 and January 2022 were reviewed. According to the pathology results, patients were divided into two groups, those with pathologic findings of appendicitis (positive for appendicitis) and those without appendicitis. Systemic inflammation markers were statistically compared between the groups.

MAIN OUTCOME MEASURES: Systemic inflammation markers.

SAMPLE SIZE: 1265 patients RESULTS: Of the 1265 patients, 784 (62%) were male and 481 were female (38%). According to the pathologic examinations, 256 (20.2%) patients did not have appendicitis, and 1009 (79.8%) patients had acute appendicitis. The SIRI level was significantly higher in patients with acute appendicitis compared with patients without acute appendicitis (P<.001). Levels of SII were significantly higher in patients with acute appendicitis (P<.001).

CONCLUSION: In children presenting with abdominal pain, high SIRI and SII values alone support the diagnosis of acute appendicitis at a rate of 95%. When physical examination findings, duration of pain, and imaging test results are added, the diagnosis becomes clear at a rate of 98%.

LIMITATIONS: Single-center study and retrospective.

PMID:37805819 | DOI:10.5144/0256-4947.2023.329

Ann Saudi Med. 2023 Sep-Oct;43(5):308-314. doi: 10.5144/0256-4947.2023.308. Epub 2023 Oct 5.

ABSTRACT

BACKGROUND: Hepatitis C virus (HCV) can cause chronic liver disease, hepatic cirrhosis, hepatocellular carcinoma, liver transplantation, and death. Early diagnosis and treatment are thus vital.

OBJECTIVES: We aimed to investigate the sustained virological response (SVR) rates in chronic hepatitis C patients infected with different genotypes, receiving different direct-acting antiviral treatments (DAAs).

DESIGN: Retrospective, observational SETTING: Clinic for infectious diseases and clinical microbiology PATIENTS AND METHODS: Patients diagnosed with chronic hepatitis C who applied to our outpatient clinic between January 2016 and November 2022 and were treated with a DAA were included in the study. Treatment responses were evaluated after each patient was treated with either ledipasvir plus sofosbuvir (LDV/SOF), LDV/SOF + ribavirin (RBV), SOF+RBV, ombitasvir/paritaprevir/ritonavir plus dasabuvir (OBV/PTV/r±DSV) ±RBV, or glecaprevir plus pibrentasvir (GLE/PIB).

MAIN OUTCOME MEASURES: Sustained virological response (SVR) rates at 12 weeks (SVR12) post-treatment.

SAMPLE SIZE: 360 patients.

RESULTS: Of 360 patients who met the inclusion criteria, 218 (60.6%) were male and 142 (39.4%) were female with no statistically significant differences in SVR between sexes (P=.252). Nearly all had a SVR (n=353, 98.1%). The median (IQR) age of the patients was 56 (30.3) years. There were 42 (11.7%), 199 (55.3%), 4 (1.1%), 106 (29.4%), 8 (2.2%) and 1 (0.3%) patient with genotypes 1a, 1b, 2, 3, 4 and 5, respectively, and SVR12 did not differ significantly between genotypes (P=.066). SVR12 response was higher in 246 (68.3%) non-injecting drug users compared to 114 (31.7%) injecting drug users (P=.005). The SVR12 response was achieved in 100% of patients with genotypes 1a, 2, 4, and 5. SVR12 response could not be obtained in 1 of 199 genotype 1b patients and 6 of 106 genotype 3 patients. The common feature of 6 reinfection patients with genotype 3 was that they were using intravenous drugs. These 6 patients were reinfected due to their continued intravenous drug use.

CONCLUSION: In conclusion, DAAs provide high SVR12 rates in cirrhotic/non-cirrhotic, pegylated interferon-naive/experienced patient groups and in patients infected with all genotypes. DAAs have a high SVR12 rate in patients with chronic hepatitis C.

LIMITATIONS: Retrospective, single-center.

PMID:37805816 | DOI:10.5144/0256-4947.2023.308

Ann Saudi Med. 2023 Sep-Oct;43(5):263-276. doi: 10.5144/0256-4947.2023.263. Epub 2023 Oct 5.

ABSTRACT

BACKGROUND: Cutaneous leishmaniasis (CL) is a vector-borne disease prevalent in Algeria since 2000. The disease has significant impacts on affected communities, including morbidity and social stigma.

OBJECTIVE: Investigate the association between environmental factors and the incidence of CL in the province of Ghardaïa and assess the predictive capacity of these factors for disease occurrence.

DESIGN: Retrospective SETTING: The study area included both urban and rural communities.

METHODS: We analyzed a dataset on CL in the province of Ghardaïa, Algeria, spanning from 2000 to 2020. The dataset included climatic variables such as temperature, average humidity, wind speed, rainfall, and the normalized difference vegetation index (NDVI). Using generalized additive models, we examined the relationships and interactions between these variables to predict the emergence of CL in the study area.

MAIN OUTCOME MEASURES: The identification of the most significant environmental factors associated with the incidence and the predicted incidence rates of CL in the province of Ghardaïa, Algeria.

SAMPLE SIZE AND CHARACTERISTICS: 252 monthly observations of both climatic and epidemiological variables.

RESULTS: Relative humidity and wind speed were the primary climatic factors influencing the occurrence of CL epidemics in Ghardaïa, Algeria. Additionally, NDVI was a significant environmental factor associated with CL incidence. Surprisingly, temperature did not show a strong effect on CL occurrence, while rainfall was not statistically significant. The final fitted model predictions were highly correlated with real cases.

CONCLUSION: This study provides a better understanding of the long-term trend in how environmental and climatic factors contribute to the emergence of CL. Our results can inform the development of effective early warning systems for preventing the transmission and emergence of vector-borne diseases.

LIMITATIONS: Incorporating additional reservoir statistics such as rodent density and a human development index in the region could improve our understanding of disease transmission.

PMID:37805813 | DOI:10.5144/0256-4947.2023.263

Zhonghua Shao Shang Za Zhi. 2023 Sep 20;39(9):874-881. doi: 10.3760/cma.j.cn501225-20220522-00198.

ABSTRACT

Objective: To investigate the status of knowledge, attitude, and behavior of enteral nutrition implemented by nurses in burn intensive care unit (BICU) and analyze its influencing factors. Methods: A multi-center cross-sectional survey research method was used. On May 8^th, 2022, 107 BICU nurses who met the inclusion criteria were selected from the burn departments of the First Affiliated Hospital of Army Medical University (the Third Military Medical University), Guangdong Provincial People’s Hospital, the First Affiliated Hospital of Guangxi Medical University, the Affiliated Hospital of Qinghai University, the Second Affiliated Hospital of Air Force Medical University, the Affiliated Hospital of Nantong University, Guiyang Steel Factory Staff Hospital, and the Second Affiliated Hospital of Kunming Medical University. The self-made nurses’ enteral nutrition nursing knowledge-attitude-behavior questionnaire for severely burned patients was used to investigate the nurses’ gender, age, working years, professional title, position, highest educational background, and whether they received systematic training in knowledge of enteral nutrition, the scores of each factor, and the total scores of knowledge, attitude, and behavior dimensions of enteral nutrition in nurses. The nurses were classified according to the general data, and the total scores of their knowledge, attitude, and behavior of enteral nutrition were calculated. Data were statistically analyzed with independent sample t test, one-way analysis of variance, Mann-Whitney U test, and Kruskal-Wallis H test. According to the results of univariate analysis and combined with clinical experience and significance, the generalized linear model analysis was carried out to screen the independent influencing factors of the total scores of knowledge, attitude, and behavior of enteral nutrition in BICU nurses. Results: A total of 107 nurses were surveyed, and 107 valid questionnaires were collected, with an effective recovery rate of 100%. In the BICU nurses’ enteral nutrition knowledge-attitude-behavior questionnaire, the total scores of knowledge, attitude, and behavior were 44±13, 87±15, and 70±19, respectively. Most of the BICU nurses in this survey were female, aged 22-48 (31±6) years, and the number of nurses worked for 1-5, 6-10, and ≥11 years was evenly distributed. The majority of the professional titles of nurses were nurses, positions were responsible nurses, and the highest educational background was undergraduate. Forty-four nurses received systematic training in knowledge of enteral nutrition. There were statistically significant differences in the total scores of knowledge of enteral nutrition among BICU nurses with different ages, working years, professional titles, positions, highest educational background, and whether they received systematic training in knowledge of enteral nutrition (with H values of 27.36, 15.27, and 10.19, respectively, Z values of -3.33, -2.59, and -6.46, respectively, P<0.05). There were no statistically significant differences in the total scores of attitude and behavior of enteral nutrition among BICU nurses with different gender, ages, working years, professional titles, positions, highest educational background, and whether they received systematic training in knowledge of enteral nutrition (P>0.05). Age (26-30, 31-35, and ≥36 years old), highest educational background (undergraduate), and the systematic training received in enteral nutrition knowledge were the independent influencing factors for the total score of knowledge of enteral nutrition in BICU nurses (with 95% confidence intervals of 0.12-0.36, 0-0.30, 0.03-0.31, 0.01-0.32, and 0.19-0.40, respectively, standardized regression coefficients of 0.24, 0.15, 0.17, 0.17, and 0.29, respectively, P<0.05). There were no independent influencing factors for the total scores of enteral nutrition attitude and behavior of BICU nurses in different characteristics (P>0.05). Conclusions: The BICU nurses have low cognitive level in the implementation of enteral nutrition, their concept needs to be updated in time, and their behavior needs to be further standardized. Age (26-30, 31-35, and ≥36 years old), highest educational background (undergraduate), and the systematic training received in enteral nutrition knowledge were the independent influencing factors for the knowledge of enteral nutrition in BICU nurses.

PMID:37805804 | DOI:10.3760/cma.j.cn501225-20220522-00198