Reallocating just 10 min to moderate-to-vigorous physical activity from other components of 24-hour movement behaviors improves cardiovascular health in adults.

BACKGROUND: As components of a 24-hour day, sedentary behavior (SB), physical activity (PA), and sleep are all independently linked to cardiovascular health (CVH). However, insufficient understanding of components' mutual exclusion limits the exploration of the associations between all movement behaviors and health outcomes. The aim of this study was to employ compositional data analysis (CoDA) approach to investigate the associations between 24-hour movement behaviors and overall CVH. METHODS: Data from 581 participants, including 230 women, were collected from the 2005-2006 wave of the US National Health and Nutrition Examination Survey (NHANES). This dataset included information on the duration of SB and PA, derived from ActiGraph accelerometers, as well as self-reported sleep duration. The assessment of CVH was conducted in accordance with the criteria outlined in Life's Simple 7, encompassing the evaluation of both health behaviors and health factors. Compositional linear regression was utilized to examine the cross-sectional associations of 24-hour movement behaviors and each component with CVH score. Furthermore, the study predicted the potential differences in CVH score that would occur by reallocating 10 to 60 min among different movement behaviors. RESULTS: A significant association was observed between 24-hour movement behaviors and overall CVH (p < 0.001) after adjusting for potential confounders. Substituting moderate-to-vigorous physical activity (MVPA) for other components was strongly associated with favorable differences in CVH score (p < 0.05), whether in one-for-one reallocations or one-for-remaining reallocations. Allocating time away from MVPA consistently resulted in larger negative differences in CVH score (p < 0.05). For instance, replacing 10 min of light physical activity (LPA) with MVPA was related to an increase of 0.21 in CVH score (95% confidence interval (95% CI) 0.11 to 0.31). Conversely, when the same duration of MVPA was replaced with LPA, CVH score decreased by 0.67 (95% CI -0.99 to -0.35). No such significance was discovered for all duration reallocations involving only LPA, SB, and sleep (p > 0.05). CONCLUSIONS: MVPA seems to be as a pivotal determinant for enhancing CVH among general adult population, relative to other movement behaviors. Consequently, optimization of MVPA duration is an essential element in promoting overall health and well-being.

Highlighting the Effect of Pro-inflammatory Mediators in the Pathogenesis of Periodontal Diseases and Alzheimer's Disease.

Alzheimer's disease (AD) is a neurological condition that is much more common as people get older. It may start out early or late. Increased levels of pro-inflammatory cytokines and microglial activation, both of which contribute to the central nervous system's inflammatory state, are characteristics of AD. As opposed to this, periodontitis is a widespread oral infection brought on by Gram-negative anaerobic bacteria. By releasing pro-inflammatory cytokines into the systemic circulation, periodontitis can be classified as a "low-grade systemic disease." Periodontitis and AD are linked by inflammation, which is recognized to play a crucial part in both the disease processes. The current review sought to highlight the effects of pro-inflammatory cytokines, which are released during periodontal and Alzheimer's diseases in the pathophysiology of both conditions. It also addresses the puzzling relationship between AD and periodontitis, highlighting the etiology and potential ramifications.

Effect of a high dose atorvastatin as added-on therapy on symptoms and serum AMPK/NLRP3 inflammasome and IL-6/STAT3 axes in patients with major depressive disorder: randomized controlled clinical study.

Background: Neuroinflammation pathways have been associated with the development of major depressive disorders (MDD). The anti-inflammatory characteristics of statins have been demonstrated to have significance in the pathophysiology of depression. Aim: To investigate the mechanistic pathways of high dose atorvastatin in MDD. Patients and methods: This trial included 60 patients with MDD who met the eligibility requirements. Two groups of patients (n = 30) were recruited by selecting patients from the Psychiatry Department. Group 1 received 20 mg of fluoxetine plus a placebo once daily. Group 2 received fluoxetine and atorvastatin (80 mg) once daily. All patients were assessed by a psychiatrist using the Hamilton Depression Rating Scale (HDRS). A HDRS score of ≤7 indicates remission or partial remission [HDRS<17 and>7]. Response was defined as ≥ 50% drop in the HDRS score. The serum concentrations of nucleotide-binding domain, leucine-rich-containing family, pyrin domain-containing-3 (NLRP-3), interleukin-6 (IL-6), adenosine monophosphate activated protein kinase (AMPK), and signal transducer and activator of transcription factor-3 (STAT-3) were measured. Results: The atorvastatin group showed a significant reduction in the levels of all measured markers along with a statistical increase in the levels of AMPK when compared to the fluoxetine group. The atorvastatin group displayed a significant decrease in HDRS when compared to its baseline and the fluoxetine group. The response rate and partial remission were higher in the atorvastatin group than fluoxetine (p = 0.03, and p = 0.005), respectively. Conclusion: These results imply that atorvastatin at high doses may be a promising adjuvant therapy for MDD patients by altering the signaling pathways for AMPK/NLRP3 and IL-6/STAT-3. Clinical Trial Registration: clinicaltrials.gov, identifier NCT05792540.

Correlation between depression scores and serum NF-ĸB/NLRP3 axis, biotinidase, and HMGB1 after treatment with isotretinoin in patients with acne vulgaris.

BACKGROUND: Acne vulgaris (AV) is an inflammatory skin disorder leading to scars and discomfort, its intensity has major psychological consequences such as depression. AIM: To investigate the effect of isotretinoin (ISO) on NF-κB/NLRP3, biotinidase, and HMGB and correlation with depression. PATIENTS AND METHODS: This was a case-control study that involved two groups. Group 1 is 20 healthy control, and group 2 is 20 patients diagnosed with AV according to Global Acne Grading System (GAGS) and received 20 mg ISO for 2 months. Before and after therapy, the Hamilton Depression Rating Scale (HDRS) was applied to assess each participant's level of depression. Nuclear factor kappa B (NF-ĸB), biotinidase, high mobility group box protein (HMGB1), nucleotide-binding domain, leucine-rich-containing family, and pyrin domain-containing-3 (NLRP-3) were measured in serum samples. RESULTS: There was no significant difference in all measured markers of healthy group before and after 2 months. Regarding group 2, there was a statistically significant decrease in all measured markers after 2 months of treatment and significant correlations between GAGS, NF-ĸB, HMGB1, NLRP3, biotinidase, and depression score. CONCLUSION: Increased GAGS, HMGB1, NLRP3, and biotinidase were associated with depression severity in AV patients and ISO treatment significantly reduced these parameters and reduced depressive symptoms.

Acute Pilates and plyometric exercise in school-based settings improve attention and mathematics performance in high school students.

The aim of this study was to examine the effects of acute Pilates and plyometric exercise in a school-based setting on attention and mathematics test performance in high school students. Forty 10th-grade students (21 females and 19 males; age: [15.0 ± 0.5] years, body mass index: [21.4 ± 2.8] kg/m2) participated in this crossover and quasi-experimental study. In week 1, students were familiarized with the d2 test of attention and Pilates and plyometric exercises activities, and body composition measurements were taken. In both weeks 2 and 3, students completed the d2 test of attention and mathematics test with 20 questions following a single session of low-to-moderate-intensity exercise and a classroom-based non-exercise activity, in a non-randomized order. The exercise sessions included 30 mins of plyometric exercises for male students and Pilates exercise for female students, with intensities corresponding to 10-14 on the Borg rating of perceived exertion scale6-20. Compared to the non-exercise activity, a 30-min of Pilates and plyometric exercise resulted in significant improvements in attention score (mean difference [Δ] â€‹= â€‹54.5 score; p â€‹< 0.001; Cohen's effect sizes [d] â€‹= â€‹1.26) and concentration performance (Δ â€‹= â€‹20.7 score; p â€‹= â€‹0.003; d â€‹= â€‹0.51). The students scored significantly higher on the mathematics test after participating in the exercise sessions compared to the non-exercise condition (Δ% â€‹= â€‹11.7; p â€‹< â€‹0.001; d â€‹= â€‹0.76). There were no significant differences between genders (p â€‹> â€‹0.05). These findings demonstrate the effectiveness of acute light-to-moderate-intensity Pilates and plyometric exercises in school-based settings for improving attention and mathematics performance in adolescents.

Progressive Arm Cycling Ergometry With 3- And 5-Minute Stage Durations Yields Similar Estimates of Substrate Oxidation in Healthy Adults.

Arm cycling ergometry (ACE) leads to a lower maximal oxygen uptake (VO2max) than cycling which is related to a smaller active muscle mass. This study compared estimates of fat and carbohydrate oxidation (FOx and CHOOx) between progressive exercise protocols varying in stage duration in an attempt to create a standard exercise protocol for determining substrate metabolism using ACE. Four men and seven women (age = 24 ± 9 yr) unfamiliar with ACE completed incremental exercise to determine peak power output and VO2peak. During two subsequent sessions completed after an overnight fast, they completed progressive ACE using 3- or 5-min stages during which FOx, CHOOx, and blood lactate concentration (BLa) were measured. Results showed no difference (p > 0.05) in FOx, CHOOx, or BLa across stage duration, and there was no difference in maximal fat oxidation (0.16 ± 0.08 vs. 0.13 ± 0.07 g/min, p = 0.07). However, respiratory exchange ratio in response to the 3 min stage duration was significantly lower than the 5 min duration (0.83 ± 0.05 vs. 0.86 ± 0.03, p = 0.04, Cohen's d = 0.76). Results suggest that a 3 min stage duration is preferred to assess substrate metabolism during upper-body exercise in healthy adults.

Knowledge of Hepatitis B Vaccine and Vaccination Status of Theatre Personnel at ATBUTH, Bauchi.

BACKGROUND: Hepatitis B virus infection affects millions of people worldwide and is transmitted vertically and through contact with infected blood or body fluids. Frontline Healthcare workers are at increased risk of contracting HBV infection and the HBV vaccine is a crucial preventive measure recommended by WHO to safeguard healthcare workers. OBJECTIVES: To investigate the awareness and knowledge of hepatitis B virus infection, to evaluate current vaccination status among theatre personnel, and to identify factors influencing vaccine uptake. METHODOLOGY: This is a cross-sectional study conducted among 85 theatre personnel of ATBUTH Bauchi. Convenience sampling method was used to select participants, each participant gave consent to participate in this study. A structured questionnaire was used to collect data, which was analysed using SPSS version 25. RESULT: Hepatitis B virus vaccine is safe according to 85% of respondents, 92% agreed that they would recommend the vaccine to other surgical staff and that it should be given as part of workplace safety. However, only 33% of respondents had completed their vaccination, while 31% had not started. The main reasons given for not being vaccinated were because they had no time to attend and did not know about the vaccine or did not have enough information regarding it. CONCLUSION: The majority of study respondents were aware of and had a good knowledge of HBV and its' vaccine. However, vaccination status is very low among theatre personnel of ATBUTH Bauchi. Healthcare workers should be enlightened about the benefits of the HBV vaccine.

CONTEXTE: L'infection par le virus de l'hépatite B affecte des millions de personnes dans le monde et est transmise verticalement et par contact avec du sang infecté ou des liquides biologiques infectés. Les travailleurs de la santé de première ligne sont plus susceptibles de contracter une infection par le VHB et le vaccin contre le VHB est une mesure préventive cruciale recommandée par l'OMS pour protéger les travailleurs de la santé. OBJECTIFS: Enquêter sur la sensibilisation et les connaissances de l'infection par le virus de l'hépatite B, évaluer le statut de vaccination actuel parmi le personnel du théâtre, et identifier les facteurs influençant l'acceptation du vaccin. MÉTHODOLOGIE: Il s'agit d'une étude transversale menée auprès de 85 membres du personnel du théâtre de l'ATBUTH Bauchi. La méthode d'échantillonnage de convenance a été utilisée pour sélectionner les participants, chaque participant ayant donné son consentement pour participer à cette étude. Un questionnaire structuré a été utilisé pour collecter les données, qui ont été analysées à l'aide du logiciel SPSS version 25. RÉSULTAT: Selon 85 % des répondants, le vaccin contre le virus de l'hépatite B est sûr, 92 % ont convenu qu'ils recommanderaient le vaccin à d'autres membres du personnel chirurgical et qu'il devrait être administré dans le cadre de la sécurité au travail. Cependant, seuls 33 % des répondants avaient terminé leur vaccination, tandis que 31 % n'avaient pas commencé. Les principales raisons données pour ne pas être vaccinées étaient qu'elles n'avaient pas le temps d'assister et ne connaissaient pas le vaccin ou n'avaient pas suffisamment d'informations à ce sujet. CONCLUSION: La majorité des répondants de l'étude étaient conscients et avaient une bonne connaissance du VHB et de son vaccin. Cependant, le statut de vaccination est très faible parmi le personnel du théâtre de l'ATBUTH Bauchi. Les travailleurs de la santé devraient être informés des avantages du vaccin contre le VHB. MOTS-CLÉS: Hépatite B, Statut de vaccination, Personnel du théâtre, Bauchi.

EFFECT OF INSULIN HORMONE ON THYROID HORMONE FUNCTION IN PATIENTS WITH DIABETIC TYPE 2 DISEASE.

The thyroid hormones play a crucial role in regulating various physiological processes in the human body. They have a wide range of effects that impact metabolism, growth, development, and overall homeostasis. The current study aimed to investigate the levels of HbA1c and various biomarkers in different patient groups. Two groups of patients were included in the study, each consisting of 30 patients, encompassing both genders. One group comprised patients with type 2 diabetes mellitus (T2DM) who were receiving insulin treatment, while the other group comprised patients with T2DM who were not receiving insulin treatment. These patient groups were compared to a control group of participants from both genders. The research employed the colourimetric method to measure HbA1c levels in all groups. Additionally, they utilized the Enzyme-Linked Immunosorbent Assay (ELISA) method to measure the levels of insulin, and T4 in all groups. The study also involved comparing these biomarkers between groups and examining the effect of insulin levels on thyroid hormones. The mean±SD values were 4.4867±1.02 µg/dl and 3.2367± 0.78 µg/dl for the T2DM groups with and without insulin treatment, respectively, while it was 7.9033±0.29 µg/dl in the control group. These findings provide valuable insights into the relationship between insulin levels and thyroid hormones, shedding light on the complex interplay between these two physiological systems. Overall, the impact of insulin on thyroid hormone regulation underscores the intricate interplay between endocrine systems and highlights the need for a comprehensive understanding of these interactions to optimize patient care and improve health outcomes.

Typhoid Fever Presenting with Ileal Perforation and Gastric Perforation.

Typhoid fever is caused by Salmonella typhi and Salmonella paratyphi. It is a disease of developing countries and is seen among people of low socio-economic status. Patients can develop complications like typhoid intestinal perforation which is associated with higher mortality. A 15-year-old female presented to the emergency pediatric unit with fever, abdominal pain and abdominal distension. She was septic, in respiratory distress, and had marked generalized abdominal tenderness with guarding. An assessment of generalized peritonitis secondary to typhoid intestinal perforation was made. She had exploratory laparotomy with intra-operative findings of ileal perforation and gastric perforation. She had repair of the intestinal and gastric perforations. Our patient presented late with concurrent use of NSAIDs and overwhelming sepsis which likely contributed to the gastric perforation as this is not a usual finding in patients with typhoid intestinal perforation. Gastric perforation is an unusual finding in patients with typhoid intestinal perforation. Typhoid fever and its complications can be easily prevented by the provision of safe water, proper facilities for sanitation, and practicing good hygiene.

La fièvre typhoïde est causée par Salmonella typhi et Salmonella paratyphi. C'est une maladie des pays en développement et elle est observée chez les personnes de bas niveau socio-économique. Les patients peuvent développer des complications telles que la perforation intestinale typhoïdique, associée à une mortalité plus élevée. Une adolescente de 15 ans s'est présentée à l'unité de pédiatrie d'urgence avec de la fièvre, des douleurs abdominales et une distension abdominale. Elle était septique, en détresse respiratoire, et présentait une sensibilité abdominale généralisée marquée avec une défense. Une évaluation d'une péritonite généralisée secondaire à une perforation intestinale typhoïdique a été réalisée. Elle a subi une laparotomie exploratrice révélant une perforation iléale et une perforation gastrique. Des réparations ont été effectuées sur les perforations intestinales et gastriques. Notre patiente s'est présentée tardivement avec une utilisation concomitante d'AINS et une septicémie sévère, ce qui a probablement contribué à la perforation gastrique, car cela n'est pas une découverte habituelle chez les patients atteints de perforation intestinale typhoïdique. La perforation gastrique est une découverte inhabituelle chez les patients atteints de perforation intestinale typhoïdique. La fièvre typhoïde et ses complications peuvent être facilement prévenues par la fourniture d'eau potable, d'installations sanitaires adéquates et en pratiquant une bonne hygiène MOTS-CLÉS: fièvre typhoïde, perforation intestinale, perforation gastrique.

Effect of Pre-exercise Sodium Citrate Ingestion on Repeated Sprint Performance in Soccer Players.

ABSTRACT: Kuru, D, Aktitiz, S, Atakan, MM, Köse, MG, Turnagöl, HH, and Kosar, SN. Effect of pre-exercise sodium citrate ingestion on repeated sprint performance in soccer players. J Strength Cond Res 38(3): 556-562, 2024-This study aimed to test the hypothesis that sodium citrate (CIT) administered 180 minutes before exercise improves repeated sprint performance in athletes within a field-based setting. Twenty male soccer players (mean ± SD : age = 20.9 ± 2.3 years; body mass [BM] = 73.8 ± 5.9 kg) performed a running-based anaerobic sprint test (RAST) with 0.5 g·kg -1 BM of CIT or with placebo (PLC; NaCl) ingestion 180 minutes before exercise in a randomized, crossover, and double-blind design, with at least 6 days between the trials. Blood samples were collected before exercise and at first, third, fifth, and seventh minutes after exercise to analyze blood pH, bicarbonate, and lactate levels. Gastrointestinal symptoms were also monitored at 30-minute intervals for 180 minutes after CIT and PLC ingestion. Pre-exercise blood pH (CIT = 7.49 ± 0.03 vs. PLC = 7.41 ± 0.02) and bicarbonate (CIT = 30.57 ± 1.33 vs. PLC = 25.25 ± 1.52) increased with CIT compared with PLC ( p < 0.001). Blood pH, bicarbonate, and lactate at the first, third, fifth, and seventh minutes after RAST with CIT were higher than PLC ( p < 0.05), except for lactate at first minute ( p > 0.05). Compared with PLC, CIT ingestion significantly improved minimum power output ( p = 0.024) and percentage decrement score ( p = 0.023). Gastrointestinal symptoms were significantly higher after CIT ingestion vs. PLC at 30th ( p = 0.003) and 60th minutes ( p = 0.010). However, there were no significant differences at 90th, 120th, 150th, or 180th minutes ( p > 0.05). The ingestion of 0.5 g·kg -1 BM of CIT 180 minutes before exercise is an effective ergogenic aid for improving repeated sprint ability as evidenced by improvements in minimum power output and percentage decrement score.

Small peptides: could they have a big role in metabolism and the response to exercise?

Exercise is a powerful non-pharmacological intervention for the treatment and prevention of numerous chronic diseases. Contracting skeletal muscles provoke widespread perturbations in numerous cells, tissues and organs, which stimulate multiple integrated adaptations that ultimately contribute to the many health benefits associated with regular exercise. Despite much research, the molecular mechanisms driving such changes are not completely resolved. Technological advancements beginning in the early 1960s have opened new avenues to explore the mechanisms responsible for the many beneficial adaptations to exercise. This has led to increased research into the role of small peptides (<100 amino acids) and mitochondrially derived peptides in metabolism and disease, including those coded within small open reading frames (sORFs; coding sequences that encode small peptides). Recently, it has been hypothesized that sORF-encoded mitochondrially derived peptides and other small peptides play significant roles as exercise-sensitive peptides in exercise-induced physiological adaptation. In this review, we highlight the discovery of mitochondrially derived peptides and newly discovered small peptides involved in metabolism, with a specific emphasis on their functions in exercise-induced adaptations and the prevention of metabolic diseases. In light of the few studies available, we also present data on how both single exercise sessions and exercise training affect expression of sORF-encoded mitochondrially derived peptides. Finally, we outline numerous research questions that await investigation regarding the roles of mitochondrially derived peptides in metabolism and prevention of various diseases, in addition to their roles in exercise-induced physiological adaptations, for future studies.

Effects of 4-Week Low-Load Resistance Training with Blood Flow Restriction on Muscle Strength and Left Ventricular Function in Young Swimmers: A Pilot Randomized Trial.

Low-load resistance training combined with blood flow restriction (BFR) is known to result in muscle hypertrophy and strength similar to that observed with higher loads. However, the effects of resistance training with BFR on cardiac structure and cardiac function remain largely unknown. Therefore, the purpose of this randomized study was to compare the effects of conventional high-load resistance training (HL-RT) with the effects of low-load resistance training with BFR (LL-BFR) on muscle strength and left ventricular function. Sixteen young swimmers (mean ± standard deviation: age = 19.7 ± 1.6 years, body mass = 78.9 ± 9.7 kg, body height = 180.8 ± 5.8 cm) were randomly allocated to a conventional HL-RT group (n = 8) or a LL-BFR group (n = 8) with a pressure band (200 mmHg) placed on both thighs of participants for 4 weeks (3 days•week-1). Outcome measures were taken at baseline and after 4 weeks of training, and included body composition, one-repetition maximum (1RM) back squat, and echocardiography measures. The 1RM back squat significantly improved (partial eta squared (È 2) = 0.365; p = 0.013) in HL-RT (mean difference (Δ) = 6.6 kg; [95% confidence interval (CI) -7.09 to 20.27]) and LL-BFR groups (Δ = 14.7 kg; [95% CI 3.39 to 26.10]), with no main effect of group or group × time interaction (p > 0.05). Interventricular septum end-systolic thickness showed a slight but statistically significant increase in LL-BFR and HL-RT groups (È 2 = 0.253; p = 0.047), yet there was no main effect of group or group × time interaction (p > 0.05). There were no statistically significant changes (p > 0.05) in other cardiac structure or function parameters (e.g., left ventricular (LV) mass, LV cardiac output, LV ejection fraction, LV stroke volume) after the training programs. Results suggest that 4 weeks of HL-RT and LL-BFR improve muscle strength similarly with limited effects on left ventricular function in young swimmers.

Perceived Usefulness of Smartphone Medical Apps As Theoretical and Clinical Learning Aids Among Medical Students in Pakistan: A Cross-Sectional Study.

Background Smartphone applications have become popular tools in clinical educational environments, particularly because they enhance learning in any setting through their accessibility. Despite students utilizing these apps in their daily learning, Pakistan's medical education system has yet to strongly endorse them. Given the rising usage of medical applications among clinical year medical students and the wide range of apps accessible on contemporary devices aimed specifically at the student population, there is a lack of literature addressing the use of these apps on clinical learning in low- and middle-income countries (LMIC) such as Pakistan. Objectives Our study aims to (1) assess the level of awareness among clinical-year medical students in Pakistan, of smartphone applications for academic purposes, (2) determine the usefulness of medical apps as educational tools for clinical-year medical students, in terms of enhancing overall patient-care skills and (3) identify barriers to the usage of apps among students who do not have them installed. Methods This online questionnaire-based study includes clinical year medical students across four medical colleges (two private and two public sectors) in Pakistan. Participant identity was kept anonymous and informed consent was required to participate. A sample size of 360 was used based on previous studies in the UK and student estimates from chosen medical colleges. The questionnaire tool used consists of three sections; demographics and medical school information, perceived usefulness of medical smartphone apps on a Likert Scale and barriers to usage among students who do not have them installed. Results 97.9% of the total study population chose to participate in the study. There was roughly an equal percentage of responses from each clinical year and 72% of students reported active use of medical apps of which the vast majority (48%) have one to two apps on their phones. Only 39% of students felt that their medical colleges encourage the use of smartphone apps for academic purposes. 54% of students use apps to look up medical criteria for disease processes and almost 42% use them to search medications. On a Likert scale of 1-5, improvement of clinical performance received highest average score among users (3.92, SD 1.1), followed by quick access to medical guidelines (3.83, SD 1.0). The most common reasons for nonuse of medical apps were medical colleges not offering subscriptions and not knowing how to utilize apps. Conclusion Smartphone apps are widely used by clinical year medical students for academic purposes in our study. Despite lack of endorsement from their respective medical colleges, these apps are still popularly utilized for revision and research on disease criteria during clinics and rounds. Encouragement from the university has been identified as a significant barrier, however. Students who use smartphone apps reported an improvement in clinical performance overall; they were able to retrieve information quicker during rounds and noticed enhancements in formulating diagnoses and reading radiological images. In contrast, those not using these apps faced challenges with interpreting imaging results, recalling pharmacological properties of medications and developing differential diagnoses. Through these findings, we highlight the benefits of incorporating technological media into the undergraduate curriculum and hope medical universities from Pakistan can take inspiration.

Does red blood cell distribution width predict prognosis in metastatic renal cell carcinoma patients using first-line vascular endothelial growth factor receptor tyrosine kinase inhibitor therapy?

Aim: It is red cell distribution width (RDW) that has been reported to show an inflammatory response which has been studied recently. The aim of this study is to investigate whether the pre-treatment RDW in patients using first-line vascular endothelial growth factor tyrosine kinase inhibitor (VEGFR TKI) with the diagnosis of metastatic renal cell carcinoma (mRCC) predicts treatment response and is a prognostic factor or not. Methods: About 92 patients diagnosed with mRCC who were being treated with sunitinib or pazopanib in the first line between January 2015 and June 2021 were included in the study. The patients were divided into 2 groups, as being ≤15.3 and >15.3, according to the RDW cut-off value calculated by ROC analysis. Results: The mOS of patients with a RDW of ≤15.3% was 45.0 (30.0-59.9) months, and of 21.3 (10.4-32.2) in those with a RDW of >15.3%. This difference was statistically significant (p < 0.001). In the group of patients with a RDW of ≤15.3, median progression free survival (mPFS) (38.04 [16.3-59.7] months) was found to be significantly higher than those with a RDW of >15.3 (17.1 [11.8-22.5] months) (p = 0.04). In multivariate analysis, RDW level (≤15.3, >15.3), was determined to be prognostic markers (p = 0.022). Conclusion: In mRCC patients, the RDW value measured before first-line VEGFR TKI therapy is an independent prognostic marker.

Atypical Teratoid/Rhabdoid Tumor of the Sellar Region in an Adult Male: A Case Report.

Atypical teratoid/rhabdoid tumor (AT/RT) is a rare, fast-growing, aggressive tumor that is almost exclusively seen in the pediatric population; it has a poor prognosis despite aggressive treatment. Adult cases were thought to be exclusively of women, with a total of 23 cases reported worldwide. We herein report a case of a 35-year-old male who posed a unique clinical and diagnostic challenge. To the best of our knowledge, this is the third case of a male patient with sellar AT/RT in the world.

Gut Dysbiosis in Experimental Kidney Disease: A Meta-Analysis of Rodent Repository Data.

SIGNIFICANCE STATEMENT: Alterations in gut microbiota contribute to the pathophysiology of a diverse range of diseases, leading to suggestions that chronic uremia may cause intestinal dysbiosis that contributes to the pathophysiology of CKD. Various small, single-cohort rodent studies have supported this hypothesis. In this meta-analysis of publicly available repository data from studies of models of kidney disease in rodents, cohort variation far outweighed any effect of experimental kidney disease on the gut microbiota. No reproducible changes in animals with kidney disease were seen across all cohorts, although a few trends observed in most experiments may be attributable to kidney disease. The findings suggest that rodent studies do not provide evidence for the existence of "uremic dysbiosis" and that single-cohort studies are unsuitable for producing generalizable results in microbiome research. BACKGROUND: Rodent studies have popularized the notion that uremia may induce pathological changes in the gut microbiota that contribute to kidney disease progression. Although single-cohort rodent studies have yielded insights into host-microbiota relationships in various disease processes, their relevance is limited by cohort and other effects. We previously reported finding metabolomic evidence that batch-to-batch variations in the microbiome of experimental animals are significant confounders in an experimental study. METHODS: To attempt to identify common microbial signatures that transcend batch variability and that may be attributed to the effect of kidney disease, we downloaded all data describing the molecular characterization of the gut microbiota in rodents with and without experimental kidney disease from two online repositories comprising 127 rodents across ten experimental cohorts. We reanalyzed these data using the DADA2 and Phyloseq packages in R, a statistical computing and graphics system, and analyzed data both in a combined dataset of all samples and at the level of individual experimental cohorts. RESULTS: Cohort effects accounted for 69% of total sample variance ( P <0.001), substantially outweighing the effect of kidney disease (1.9% of variance, P =0.026). We found no universal trends in microbial population dynamics in animals with kidney disease, but observed some differences (increased alpha diversity, a measure of within-sample bacterial diversity; relative decreases in Lachnospiraceae and Lactobacillus ; and increases in some Clostridia and opportunistic taxa) in many cohorts that might represent effects of kidney disease on the gut microbiota . CONCLUSIONS: These findings suggest that current evidence that kidney disease causes reproducible patterns of dysbiosis is inadequate. We advocate meta-analysis of repository data as a way of identifying broad themes that transcend experimental variation.

Impact of Naples Prognostic Score at Admission on In-Hospital and Follow-Up Outcomes Among Patients with ST-Segment Elevation Myocardial Infarction.

The Naples prognostic score (NPS) consists of cholesterol level, albumin concentration, lymphocyte-to-monocyte and neutrophil-to-lymphocyte ratios and reflects systemic inflammation, malnutrition, and survival for various conditions. We investigated the relationship of NPS at admission with in-hospital and follow-up outcomes among ST-segment elevation myocardial infarction (STEMI) patients. This retrospective study included 1887 consecutive patients diagnosed with STEMI and who underwent primary percutaneous coronary intervention between March 2020 and May 2022. The study population was divided by NPS into 2; low (0-1-2) and high (3-4). In-hospital adverse events and all-cause mortality rates during follow-up were extracted from the registry. The Median follow-up time was 15 months. The overall mortality rate was 14.6%. The proportions of in-hospital events that included acute respiratory failure, acute kidney injury, malignant arrhythmia, and mortality were significantly higher in the high NPS group than in the low NPS group. Compared with the baseline model, in the full model of Cox regression analysis; NPS was an independent predictor of all-cause mortality (adjusted hazard ratio (aHR): 2.49, 95%CI, 1.75-3.50, P < .001), with a significant improvement in model performance (likelihood ratio χ2, P < .001) and better calibration. In conclusion, we found an association between NPS and in-hospital and follow-up outcomes in STEMI patients.

Analysis of Microvasculature in Children Recovered from COVID-19 Using Swept-Source OCT/OCTA Technology.

PURPOSE: To analyze structural and vascular changes of the retina and choroid in pediatric patients with coronavirus disease 2019 (COVID-19) using optical coherence tomography (OCT)/OCT angiography (OCTA). METHODS: This comparative cross-sectional study consists of the COVID-19 group including pediatric COVID-19 patients and the control group including healthy children. Vessel density (VD), central macular thickness,, and choroidal thickness (ChT) measurements were performed using swept-source OCT/OCTA 12 weeks after the recovery from COVID-19. RESULTS: The mean VD measurements in the central fovea and nasal quadrants of all three retinal layers and choriocapillaris showed insignificantly lower values in the COVID-19 group when compared to the control group (0:002 < p < 0:05 for all). Similar to VD measurements, insignificant lower ChT measurements were obtained in the central fovea and nasal points in the COVID-19 group. CONCLUSION: OCTA can be used as a non-invasive and valid biomarker in the assessment of early microvascular dysfunction associated with COVID-19.

High rates of anxiety detected in mothers of children with inconclusive cystic fibrosis screening results.

OBJECTIVE: The purpose was to assess postpartum depression, anxiety, and depression in mothers of children with an inconclusive diagnosis after a positive cystic fibrosis (CF) newborn screening (NBS), known as cystic fibrosis transmembrane conductance regulator (CFTR)-related metabolic syndrome (CRMS) or CF screen positive, inconclusive diagnosis (CFSPID). There is limited information on the prognosis and on the impact of this designation on maternal mental health. METHODS: Mothers of children with CRMS/CFSPID and CF identified by NBS were recruited from two centers in California. Maternal mental health was assessed using measures of depression, anxiety, and a scripted interview. Descriptive statistics and multivariate logistic regression were applied for data reporting. RESULTS: A total of 109 mothers were recruited: CF: 51, CRMS/CFSPID: 58. Mothers from both groups showed higher rates of depression and anxiety symptoms than women in the general population. CRMS/CFSPID and CF mothers had no significant difference on their self-reported symptoms of anxiety and depression after adjusting for potential confounders. Mothers equally reported that their child's diagnosis had a negative impact, and that genetic counseling had a positive impact on their emotional health. CONCLUSIONS: CF and CRMS/CFSPID diagnoses impact maternal mental health similarly. Uncertain prognosis of CRMS/CFSPID likely contributed to the negative mental health impact. Providers should consider conducting mental health screening for every mother of a child with CRMS/CFSPID, in addition to the recommended mental health screening for mothers of children with CF. Genetic counseling has potential to mitigate emotional stress on these families.