Tag: pubmed

Front Neurol. 2024 Oct 30;15:1484661. doi: 10.3389/fneur.2024.1484661. eCollection 2024.

ABSTRACT

BACKGROUND: Guillain-Barré syndrome (GBS) is a rare autoimmune disease that affects the peripheral nervous system. It is characterized by the destruction of nerves involved in movement. This condition can lead to transient pain, changes in temperature and touch sensations, muscle weakness, loss of sensation in the legs and/or arms, and difficulty swallowing or breathing. Published data on the outcomes of critical care for patients with GBS are extremely scarce in Africa, particularly Ethiopia. Therefore, this study aimed to assess mortality and its predictors among patients with GBS in the intensive care unit (ICU) of specialized hospitals in Ethiopia, a low-income country.

MATERIALS AND METHODS: This retrospective cohort study was conducted at the Tibebe Ghion Specialized Hospital and the Felege Hiwot Comprehensive Specialized Hospital in Bahir Dar, Ethiopia, from 1 January 2019 to 30 December 2023. Data were collected in the medical record rooms. Cox regression analysis was performed to identify the predictors of mortality among GBS patients in the ICU. The crude and adjusted hazard ratios (AHRs) and 95% confidence intervals (CIs) were calculated using bivariable and multivariable Cox regression models. A p-value of <0.05 was considered statistically significant.

RESULTS: Of 124 GBS patients admitted to the ICU, 120 were included in the final analysis. During the follow-up, there were 23 (19.17%) deaths. The overall incidence rate of death was 1.96 (95% CI: 1.30, 2.95) per 100 person-days of observation. Traditional medicine (AHR = 3.11, 95%: 1.12, 16.70), COVID-19 infection (AHR = 5.44, 95% CI: 1.45, 73.33), pre-ICU cardiac arrest (AHR = 6.44, 95% CI: 2.04, 84.50), and ICU readmission (AHR = 4.24, 95% CI: 1.03, 69.84) were identified as the independent predictors of mortality.

CONCLUSION: The mortality rate among GBS patients admitted to the ICU was high. Traditional medicine, COVID-19 infection, pre-ICU cardiac arrest, and readmission to the ICU were the significant predictors of mortality. Conducting large-scale studies with a prospective design in the future would yield more robust evidence.

PMID:39559822 | PMC:PMC11571968 | DOI:10.3389/fneur.2024.1484661

Front Cardiovasc Med. 2024 Oct 30;11:1462730. doi: 10.3389/fcvm.2024.1462730. eCollection 2024.

ABSTRACT

OBJECTIVES: In this study, we assessed the clinical efficacy and safety of Danlou tablets in the treatment of stable angina pectoris (SAP) with intermingled phlegm and blood stasis (IPBS), to provide high-quality evidence-based medical evidence for the prevention and treatment of coronary heart disease.

METHODS: In this multicenter randomized controlled study, 304 patients diagnosed with stable angina pectoris with IPBS enrolled from 12 national traditional Chinese medicine (TCM) clinical research centers in China were randomly assigned to the treatment group and the control group at a ratio of 1:1. Each group was divided into four subgroups based on the results of TCM syndrome differentiation: IPBS, IPBS combined with qi deficiency, IPBS combined with qi stagnation, and IPBS combined with toxin accumulation. The control group was treated with routine Western medicine. In addition to routine Western medicine treatment, the treatment group (the IPBS group) was treated with Danlou tablets or Danlou tablets supplemented by interventional therapies based on the results of traditional Chinese medicine differentiation. The frequency of angina attacks per week was the main efficacy evaluation indicator and the secondary efficacy evaluation indicators included angina symptom score, Seattle Angina Questionnaire, an electrocardiogram (ECG) efficacy evaluation, a cardiac Doppler two-dimensional ultrasound, an electrocardiogram treadmill exercise test, blood lipids, blood glucose, a coagulation function test, hemorheology indicators, homocysteine, C-reactive protein (CRP) or high sensitivity-CRP, TCM syndromes (syndrome score, tongue, pulse), and long-term prognosis (endpoint outcome, cardiovascular events).

RESULTS: There were 300 cases in the full analysis set (FAS), 266 in the per-protocol set (PPS), and 300 in the safety set. Regarding the main efficacy indicator, after treatment, the reduction in the frequency of weekly angina attacks in the treatment group was significantly greater than that in the control group (P < 0.05). The results of the FAS and PPS were consistent. Regarding the secondary efficacy evaluation indicators, the angina symptom, TCM syndrome, ECG evaluation, Seattle Angina Pectoris Questionnaire, and 36-item Health Status Survey Summary Form scores of the treatment group were significantly higher than the control group (P < 0.05) and the homocysteine levels of the treatment group were significantly reduced (P < 0.05). The results of the FAS and PPS were consistent. In the PPS, the triglyceride levels in the treatment group were significantly lower than those in the control group after treatment (P < 0.05). The activated partial thromboplastin time in the treatment group decreased significantly (P < 0.05). There was no statistically significant difference in the safety indicators and incidence of adverse reactions between the two groups.

CONCLUSION: Treatment with Danlou tablets and the modified combination therapy based on Western medicine treatment could improve angina pectoris symptoms of patients with SAP and IPBS syndrome and its concurrent syndromes, and improve patients’ quality of life. Furthermore, the treatment is safe, has a long-term prognosis, and is worth further promotion and application in clinical practice.

CLINICAL TRIAL REGISTRATION: https://www.chictr.org.cn/showproj.html?proj=39724, ChiCTR registry, ChiCTR1900023708.

PMID:39559795 | PMC:PMC11571080 | DOI:10.3389/fcvm.2024.1462730

IEEE Open J Eng Med Biol. 2024 Mar 8;5:846-858. doi: 10.1109/OJEMB.2024.3374956. eCollection 2024.

ABSTRACT

Goal: The network representation is becoming increasingly popular for the description of cardiovascular interactions based on the analysis of multiple simultaneously collected variables. However, the traditional methods to assess network links based on pairwise interaction measures cannot reveal high-order effects involving more than two nodes, and are not appropriate to infer the underlying network topology. To address these limitations, here we introduce a framework which combines the assessment of high-order interactions with statistical inference for the characterization of the functional links sustaining physiological networks. Methods: The framework develops information-theoretic measures quantifying how two nodes interact in a redundant or synergistic way with the rest of the network, and employs these measures for reconstructing the functional structure of the network. The measures are implemented for both static and dynamic networks mapped respectively by random variables and random processes using plug-in and model-based entropy estimators. Results: The validation on theoretical and numerical simulated networks documents the ability of the framework to represent high-order interactions as networks and to detect statistical structures associated to cascade, common drive and common target effects. The application to cardiovascular networks mapped by the beat-to-beat variability of heart rate, respiration, arterial pressure, cardiac output and vascular resistance allowed noninvasive characterization of several mechanisms of cardiovascular control operating in resting state and during orthostatic stress. Conclusion: Our approach brings to new comprehensive assessment of physiological interactions and complements existing strategies for the classification of pathophysiological states.

PMID:39559780 | PMC:PMC11573414 | DOI:10.1109/OJEMB.2024.3374956

IEEE Open J Eng Med Biol. 2024 May 7;5:859-866. doi: 10.1109/OJEMB.2024.3397550. eCollection 2024.

ABSTRACT

Goal: REM Sleep Behavior Disorder (RBD) is a REM parasomnia that is associated to high risk of developing α-synucleinopathies, as Parkinson’s disease (PD) or dementia with Lewy bodies, over time. This study aims at investigating the presence of autonomic dysfunctions in RBD subjects, with and without PD, by assessing their sleep structure and autonomous nervous system activity along the different sleep stages. Methods: To this aim, an innovative framework combining a sleep transition model, by Markov chains, with an instantaneous assessment of autonomic state dynamics by statistical modeling of heart rate variability (HRV) dynamics through a point-process approach, was introduced. Results: In general, RBD groups showed lower HRV than controls across all sleep stages, as well as higher probabilities of transitioning towards lighter sleep stages. Subjects also affected by PD present an even lower HRV, but better sleep continuity. Conclusions: RBD patients suffer from sleep fragmentation and overall autonomic dysfunction, mainly due to lower autonomic activation across all sleep stages. Coexistence of PD seems to improve sleep quality, possibly due to a sleep-related relief of their symptoms.

PMID:39559778 | PMC:PMC11573400 | DOI:10.1109/OJEMB.2024.3397550

J Oral Biol Craniofac Res. 2024 Nov-Dec;14(6):815-824. doi: 10.1016/j.jobcr.2024.10.014. Epub 2024 Nov 4.

ABSTRACT

OBJECTIVES: The objective of the study was to determine the antimicrobial efficacy of Lavandula angustifolia (True Lavender extract) towards Candida albicans, Streptococcus mutans, Staphylococcus aureus pathogens. Varying proportions of the extract was incorporated into polymethyl methacrylate (PMMA) denture base resin and the anti-adherent effect was investigated.

METHODS: An in-vitro study was performed after pure extract was obtained from Lavandula angustifolia (LA) flowers using a solvent based hot extraction process. Chromatographic analysis and computational molecular docking were done to analyze its phytoconstituents with potential target-ligand bond. Tests of antimicrobial susceptibility, minimum inhibitory concentration, minimum bactericidal and fungicidal dosages and in-vitro cytotoxicity were performed. Different proportions of LA extract (0, .5, 1.0, 1.5, and 2.0 %) were added to PMMA resin to assess anti-adherence property. Obtained data were statistically analyzed with One-way ANOVA followed by Tukey post-hoc tests.

RESULTS: The reports revealed significant antimicrobial susceptibility against the test pathogens compared to control drugs (P > 0.05). A minimum concentration of .02 mg of lavender extract inhibited microbial growth with low cytotoxicity (P < 0.05). The highest anti-adherent activity was observed in the .5 % LA-incorporated PMMA resin group (P = 0.0001).

CONCLUSIONS: Incorporating lavender extract into denture base resin demonstrated promising antimicrobial properties. This investigation encourages further research to understand its effects on mechanical and physical properties of reinforced dental resins.

PMID:39559748 | PMC:PMC11570514 | DOI:10.1016/j.jobcr.2024.10.014

Vaccine X. 2024 Nov 1;21:100578. doi: 10.1016/j.jvacx.2024.100578. eCollection 2024 Dec.

ABSTRACT

BACKGROUND: Worldwide, vaccine-preventable diseases have been a significant cause of mortality in the under-5 age group. To reduce the disease burden, new vaccines are being introduced in every country’s immunization programmes. For this to happen, high vaccination coverage is necessary. However, rapidly identifying the areas that fail to reach the expected coverage becomes cumbersome. During recent years, lot quality assurance sampling (LQAS) has been widely used in evaluating immunization coverage across the globe. The present study aims to pilot this approach for field monitoring of a new vaccine against routine concurrent field monitoring in one of the North-Eastern states of India.

METHODOLOGY: For LQAS, a community-based cross-sectional study was undertaken among 55 children aged 0-23 months in all 5 Primary health centres (lots) of Medziphema block, Dimapur, Nagaland. The total sample size for LQAS was calculated based on α = 5, β = 90 using Lemeshow and Taber-LQAS table with a target level of immunization defined as 90 % and the lower limit set to 55 %. For the concurrent field monitoring, a sample of 30 children in the same age group was selected through random sampling. Pre-designed, pre-tested questionnaire for the caregivers, scripted on a digital tool was employed with verification of immunization card and caregiver’s recall. Data was analyzed using SPSS software version 25.0.

RESULTS: The study found a slight difference in the percentage of children age-appropriately vaccinated for PCV (as per the schedule) in concurrent field monitoring (93.3 %) and LQAS (90.9 %). However, no statistically significant difference was found in comparing the immunization coverage using both methodologies (p > 0.05).

CONCLUSION: The study findings encourage that LQAS can be considered for monitoring the immunization coverage of a newly introduced vaccine. It offers the added advantage of identifying poor/low-performing pockets that require focused attention.

PMID:39559738 | PMC:PMC11570966 | DOI:10.1016/j.jvacx.2024.100578

Onco Targets Ther. 2024 Nov 14;17:1017-1032. doi: 10.2147/OTT.S475644. eCollection 2024.

ABSTRACT

PURPOSE: Poor lung cancer patients’ outcomes and survival rates demand the discovery of new biomarkers for the specific, significant, and less invasive detection of non-small cell lung cancer (NSCLC) progression. The present study aimed to investigate the potential of miRNA expression as biomarkers in NSCLC utilizing a preclinical cell culture setup based on screening of miRNAs in NSCLC cells grown in 3D cell culture.

PATIENTS AND METHODS: The study was performed using lung cancer cell lines, varying in different levels of aggressiveness: NCI-H1299, A549, Calu-1, and NCI-H23, as well as noncancerous bronchial epithelial cell line HBEC3, which were grown in 3D cell culture. Total RNA from all cell lines was extracted and small RNA libraries were prepared and sequenced using the Illumina NGS platform. The expression of 8 differentially expressed miRNAs was further validated in 89 paired tissue specimens and plasma samples obtained from NSCLC patients. Statistical analysis was performed to determine whether miRNA expression and clinicopathological characteristics of NSCLC patients could be considered as independent factors significantly influencing PFS or OS.

RESULTS: Differentially expressed miRNAs, including let-7d-3p, miR-10a-3p, miR-28-3p, miR-28-5p, miR-100-3p, miR-182-5p, miR-190a-5p, and miR-340-5p, were identified through next-generation sequencing in NSCLC cell lines with varying levels of aggressiveness. Validation of patient samples, including tumor and plasma specimens, revealed that out of the 8 investigated miRNAs, only plasma miR-10a-3p showed a significant increase, which was associated with significantly extended progression-free survival (PFS) (p=0.009). Furthermore, miR-10a-3p in plasma emerged as a statistically significant prognostic variable for NSCLC patients’ PFS (HR: 0.5, 95% CI: 0.3-0.9, p=0.029).

CONCLUSION: Our findings of screening miRNA expression patterns in NSCLC cells grown in 3D cell culture indicated that the expression level of circulating miR-10a-3p has the potential as a novel non-invasive biomarker to reflect the short-term prognosis of NSCLC patients.

PMID:39559728 | PMC:PMC11572442 | DOI:10.2147/OTT.S475644

Curr Dev Nutr. 2024 Sep 29;8(11):104470. doi: 10.1016/j.cdnut.2024.104470. eCollection 2024 Nov.

ABSTRACT

BACKGROUND: Modest inverse associations have been found between dairy intake, particularly yogurt, and type 2 diabetes risk. Investigating associations of dairy intake with early onset of type 2 diabetes offers opportunities for effective prevention of this condition.

OBJECTIVES: This study aims to investigate the relationships between the intake of different dairy types, prediabetes risk, and continuous glycemic outcomes.

METHODS: Systematic literature searches across multiple databases were performed of studies published up to September 2023. Included were prospective cohort studies in healthy adults that examined the association between dairy intake and prediabetes risk according to diagnostic criteria, or continuous glycemic markers. A dose-response random-effects meta-analysis was used to derive incremental relative risks (RRs) for associations of total dairy, fermented dairy, milk, yogurt, cheese (all total, high-fat, and low-fat), cream, and ice cream with prediabetes risk adjusted for sociodemographic, health and cardiometabolic risk factors, and dietary characteristics.

RESULTS: The meta-analyses encompassed 6653 prediabetes cases among 95,844 individuals (age range 45.5-65.5 y) including 6 articles describing 9 cohorts. A quadratic inverse association was observed for total dairy intake and prediabetes risk, with the lowest risk at 3.4 servings/d (RR: 0.75; 95% confidence interval: 0.60, 0.93; I ² = 18%). Similarly, total, and high-fat cheese exhibited nonlinear inverse associations with prediabetes risk, showing the lowest risk at 2.1 servings/d (0.86; 0.78, 0.94; I ² = 0%, and 0.90; 0.81, 0.99; I ² = 12%), but a higher risk at intakes exceeding 4 servings/d. Ice cream intake was linearly associated with prediabetes risk (0.85; 0.73, 0.99; I ² = 0% at the highest median intake of 0.23 servings/d). Other dairy types showed no statistically significant associations. The systematic review on dairy intake and glycemic outcomes showed considerable variabilities in design and results.

CONCLUSIONS: The findings suggest an inverse association between moderate dairy and cheese intake in preventing prediabetes. The potential for reverse causation and residual confounding highlights the need for studies with comprehensive repeated measurements.

TRIAL REGISTRATION NUMBER: PROSPERO 2023 CRD42023431251.

PMID:39559723 | PMC:PMC11570412 | DOI:10.1016/j.cdnut.2024.104470

Glob Pediatr Health. 2024 Nov 17;11:2333794X241298811. doi: 10.1177/2333794X241298811. eCollection 2024.

ABSTRACT

Background. Rheumatic heart disease remains a significant health burden in resource-limited settings. This study investigated the clinical characteristics and valve lesion patterns of RHD in children from Eastern Ethiopia, comparing newly diagnosed and known RHD patients. Objective. This study aimed to characterize the clinical features and valve lesion patterns in children with Rheumatic heart disease and provide a comparative analysis between newly diagnosed and known cases. Methods. A hospital-based cross-sectional study was conducted at Hiwot Fana Comprehensive Specialized Hospital from January 1 to December 31, 2021. A total of 39 children with RHD were included, with data collected from medical records, clinical assessments, and echocardiographic evaluations. Descriptive statistics and chi-square tests were used for analysis. Results. Among the 39 children studied, 25 were newly diagnosed and 14 were known RHD cases. The majority were female (71.8%). The median age was 10 years. Shortness of breath (53.9%) and cough (38.5%) were the most common presenting complaints. Only 14.3% of known RHD patients were adherent to secondary prophylaxis. Severe acute malnutrition and severe anemia were the most common comorbidities. Class IV heart failure was present in 89.7% of the patients. Echocardiographic findings revealed that all patients had mitral valve involvement, with mitral regurgitation (94.9%) being the most frequent. Conclusion. This study revealed that rheumatic diseases in children in Eastern Ethiopia present at advanced stages. Low adherence to secondary prophylaxis and high rates of severe heart failure highlights the consequences of delayed diagnosis and management. These findings underscore the urgent need for better healthcare infrastructure, enhanced prevention programs, and improved strategies to increase prophylaxis adherence to prevent disease progression and improve outcomes for affected children.

PMID:39559717 | PMC:PMC11571246 | DOI:10.1177/2333794X241298811

J Diabetes Res. 2024 Nov 11;2024:9912907. doi: 10.1155/2024/9912907. eCollection 2024.

ABSTRACT

Background: Diabetic peripheral neuropathy (DPN) impacts approximately 50% of individuals with Type 2 diabetes mellitus (T2DM), leading to severe complications such as foot ulcers and amputations. Notably, visceral adiposity is increasingly recognized as a pivotal factor in augmenting the risk of DPN. We aim to evaluate the correlation between obesity-related body composition, particularly visceral fat, and DPN to facilitate early identification of high-risk patients with T2DM. Methods: This cross-sectional analysis encompassed 113 T2DM patients from the Department of Endocrinology and Metabolism at the Second Affiliated Hospital of Fujian Medical University, conducted between September 2020 and January 2021. Patients were categorized into two cohorts: those with DPN (DPN group) and those without (NDPN group). We utilized bioelectrical impedance analysis (BIA) to determine body measurements, such as weight and visceral fat area, in addition to collecting clinical and biochemical data. Logistic regression was employed to analyze the data. Results: The study uncovered a statistically significant difference in the visceral fat area between the DPN and NDPN groups (p = 0.048). Through multivariate logistic regression analysis, the visceral fat area was identified as an independent risk factor for DPN among T2DM patients (OR 1.027; 95% CI 1.004-1.051, p = 0.022). Other significant risk factors included the duration of diabetes and the presence of diabetic retinopathy. Conclusion: The visceral fat area serves as an independent risk factor for DPN in individuals with T2DM. Implementing measures to assess and manage visceral obesity could be vital in the prevention and management of DPN. This underscores the value of technologies such as BIA in clinical and community settings for early intervention.

PMID:39559714 | PMC:PMC11573447 | DOI:10.1155/2024/9912907