Thrombus Research Articles

Determination of some NSAIDs content in meat by liquid chromatography with tandem mass spectrometry (LC-MS/MS)

Nonsteroidal anti-inflammatory drugs (NSAIDs) are the most widely used group of drugs worldwide for pain relief, anti-inflammation, blood clot prevention, and fever reduction, but they can cause some side effects bad for health if used incorrectly. NSAIDs are on the list of drugs that must be monitored according to Council Directive 96/23/EC. The fact that NSAIDs are also used in animals for anti-inflammation, fever reduction, and pain relief raises concerns that animal products such as meat, eggs, and milk may be contaminated with NSAIDs, affecting human health if consumed like eating right. Therefore, developing a method to analyze NSAIDs in meat products is necessary, contributing to assessing the quality of meat products currently circulating on the market. In this study, 4 common substances in the NSAIDs group were studied and identified by liquid chromatography with tandem mass spectrometry (LC-MS/MS) using a Symmetry C18 chromatographic column with an ESI (+) positive electron spray ionization source and multiple reaction monitoring (MRM) mode. The validity of the method was confirmed according to the guidelines of the Association of Official Analytical Chemists (AOAC). The results showed that the method has good specificity, the linearity range from 5.0 to 100 µg/kg, the detection limit of 1.5 µg/kg, the quantification limit of 5.0 µg/kg; precision and accuracy with relative standard deviation (RSD) less than 11% and recoveries ranging from 81.1 to 111%, meeting AOAC requirements. The method was used to analyze the content of NSAIDs in 15 meat samples in Hanoi. The results showed that 7 samples showed tolfenamic acid exceeding the quantitative limit of the method.

Hypoxia Pathways in Parkinson’s Disease: From Pathogenesis to Therapeutic Targets

The human brain is highly dependent on oxygen, utilizing approximately 20% of the body’s oxygen at rest. Oxygen deprivation to the brain can lead to loss of consciousness within seconds and death within minutes. Recent studies have identified regions of the brain with spontaneous episodic hypoxia, referred to as “hypoxic pockets”. Hypoxia can also result from impaired blood flow due to conditions such as heart disease, blood clots, stroke, or hemorrhage, as well as from reduced oxygen intake or excessive oxygen consumption caused by factors like low ambient oxygen, pulmonary diseases, infections, inflammation, and cancer. Severe hypoxia in the brain can manifest symptoms similar to Parkinson’s disease (PD), including cerebral edema, mood disturbances, and cognitive impairments. Additionally, the development of PD appears to be closely associated with hypoxia and hypoxic pathways. This review seeks to investigate the molecular interactions between hypoxia and PD, emphasizing the pathological role of hypoxic pathways in PD and exploring their potential as therapeutic targets.

A novel method for the degradation of human blood clot by immobilised bromelain using multi-walled carbon nanotube and polyphenol oxidase

Pathological blood clot in blood vessels, which often leads to cardiovascular diseases, are one of the most common causes of death in humans. Therefore, enzymatic therapy to degrade blood clots is vital. To achieve this goal, bromelain was immobilized and used for the biodegradation of blood clots. Bromelain was extracted from the pineapple fruit pulp (Ananas comosus) and purified by ion exchange chromatography after precipitation with ammonium sulphate (0-80 %), resulting in a yield of 70%, purification fold of 1.42, and a specific activity of 1175 U/mg. Bromelain was covalently immobilized on functionalized multi-walled carbon nanotubes (MWCNT), with an enzyme loading of 71.35%. The results of the characterization of free and immobilized bromelain demonstrated that the optimum pH for free and immobilized bromelain activity was 7.0, while the pH range of stability was from 5.0 to 8.5 and 4.0 to 9.0, respectively. The optimum temperature for free and immobilized bromelain activity was 45ºC, whereas the stability was 15 to 50°C and 15 to 55°C, respectively. The immobilized bromelain activity was decreased after the fifth reuse, and the storage period of the free and immobilized bromelain was decreased after 6 and 123 days, respectively. Casein was the best substrate-free bromelain, and fibrin was the best substrate for immobilized bromelain. The results of the purification of polyphenol oxidases (PPO) from potatoes by ion exchange chromatography gave a yield of about 54 %, a purification fold of 1.27, and a specific activity of 2804 U/mg. The current study showed that the immobilized bromelain can significantly biodegrade human blood clots in vitro, while the PPO enzyme has no significant effect on blood clots.

Nivel de Conocimiento de los Estudiantes de Enfermería acerca del Riesgo de Tromboembolismo Venoso en Pacientes Quirúrgicos

Deep vein thrombosis is defined as the formation of blood clots that originate in the lower extremities. In Ecuador it ranks third in morbidity due to cardiovascular causes and constitutes 10-15% of preventable in-hospital morbidity. The objective of the research was to determine the level of knowledge of nursing students at the Technical University of Ambato about the risk of venous thromboembolism in surgical patients. The research presented a descriptive, quantitative, cross-sectional cohort study, the instrument was applied physically explaining the informed consent and the categories contained in the instrument, it was established between 10 to 15 minutes for the students to answer the questionnaire, once obtained The responses were entered into an Excel database and the data was subsequently transferred to SPSS to make descriptive tables. The population for the study was estimated at 87 students. According to the inclusion and exclusion criteria, we worked with a total population of 82. students. Of the total population of 82 respondents, 26.8% have a good level of knowledge, while 65.9% are average and 7.3% are poor. In conclusion, it was determined that students have a regular level of knowledge that corresponds to 65.9% about the risk of venous thromboembolism in surgical patients, this could have a negative impact on the development of students in the hospital environment.

Effects of Dezocine and Propofol Combination on Plasma 5-HT and ET Levels in Stroke Patients Undergoing Thrombolysis

Objective: To investigate the effect of dezocine combined with propofol on brain metabolism in patients undergoing cerebral thrombosis thrombolysis. Methods: A total of 86 stroke patients admitted between July 2022 and December 2023 were randomly divided into two groups: Group A (study group) and Group B (control group), with 43 patients in each group. Both groups underwent intra-arterial thrombolysis therapy. Group B received dezocine for anesthesia, while Group A received a combination of dezocine and propofol. Plasma concentrations of 5-hydroxytryptamine and endothelin, as well as brain metabolic indicators, were compared between the two groups immediately after anesthesia, at 1 hour post-reperfusion, and 3 hours post-reperfusion. Results: There were no significant differences in the levels of 5-hydroxytryptamine and endothelin between the two groups immediately after anesthesia and at 1 hour post-reperfusion (P > 0.05). However, at 3 hours post-reperfusion, the levels of 5-hydroxytryptamine and endothelin in Group A were significantly lower than those in Group B. Furthermore, in Group A, the levels of 5-hydroxytryptamine and endothelin at 3 hours post-reperfusion were lower compared to the levels at 1 hour post-reperfusion (P < 0.05). Conclusion: Dezocine combined with propofol can effectively improve the quality of anesthesia and has a minimal effect on brain metabolic indices, suggesting reduced damage to brain metabolism.

Sudden death due to aortic rupture in New Zealand sheep

ABSTRACT Case history Over a period of 2 months in the spring and early summer of 2021, 13 cases of sudden death in cull ewes due to aortic rupture were diagnosed at a small number of New Zealand abattoirs. Clinical findings In 12/13 (92%) cases, a large blood clot was present in the thorax, and in one case the blood clot was seen in the tissues dorsal to the heart. There were no obvious signs of external trauma. The pluck (heart and lungs) or fixed aorta was submitted for histological examination in seven cases and in all of these, a tear in the aorta was found. Comparing the microscopic appearance of the proximal aorta in these seven cases to three clinically normal ewes from unaffected farms, the aortic wall thickness appeared thinner in the case ewes than the unaffected ewes. Subjectively, there was increased collagen in the tunica media in 3/7 and decreased elastin fibres in 5/7 case ewes compared to the control ewes. Further investigations on the index farm (where the first cases originated), found that the mean liver and serum Cu concentrations in 10 similarly aged, clinically normal ewes were within the normal reference range for New Zealand sheep. Similarly, the liver Cu concentrations of the seven case ewes were within the normal reference range. Diagnosis Aortic rupture due to an unknown aetiology. Clinical relevance Clinicians should be aware of this condition as a differential diagnosis for sudden death in older sheep and to assist the Ministry for Primary Industries in establishing the extent of this problem in New Zealand.

Neutrophil-Lymphocyte Ratio as a Predictor of Persistent Type 2 Endoleak after Endovascular Aneurysm Repair.

Objectives: One of the important postoperative complications of endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA) is type 2 endoleak (T2EL). However, there is no well-established biomarker. We aimed to evaluate the validity of the neutrophil-lymphocyte ratio (NLR) as a predictor of T2EL. Methods: Data were retrospectively collected from 146 patients who underwent EVAR for AAA at our institution between April 1, 2008 and March 31, 2021. Within 90 days before surgery, preoperative NLR was calculated from the same blood sample. The receiver operating characteristic curve (ROC) was used to determine the cutoff NLR values for persistent T2EL. Univariate and multivariate analyses were performed. Results: Compared with patients without persistent T2EL, those who had persistent T2EL had lower preoperative NLR (P = 0.041), based on a cutoff value of 1.918, and the entire group was then divided into two groups based on these values for comparison. Univariate analysis showed significant differences in NLR, the white blood cell (WBC) count, the percentage of mural thrombus of aneurysm, history of the hypertension, follow-up term, and aneurysm diameter at final follow-up. Multivariate analysis showed that NLR and AAA diameter on the last follow-up were significantly associated with T2EL persistence. Conclusions: Preoperative low NLR can be a useful predictor of postoperative persistent T2EL.

Results of assessing cerebral vasospasm following subarachnoid hemorrhage using transcranial doppler ultrasound

SUMMARY Objective: Review the results of assessing cerebral vasospasm after subarachnoid hemorrhage using transcranial doppler ultrasound. Subjects and methods: A retrospective, cross-sectional descriptive study was performed on 39 patients with subarachnoid hemorrhage treated at the Neurology Center, Bach Mai Hospital from January 2020 to September 2023. Results: The mean age of the study group was 55.12 ± 14.33. The age group distribution with the highest incidence is 41-50 years old with a rate of 35.9%. The male/female ratio is 20/19. The most common symptoms were headache (97.4%), nausea and vomiting (92.3%), The least common symptoms were convulsions and hemiplegia in 5.1% of subjects. The most common clinical severity assessed by the Hunt and Hess scale is level 2 (59%), followed by level 3 (23.1%), level 4 (10.2%), and level 1 (5.1%). Evaluation of Fisher scale found that the most common fisher level is level 4 with a rate of 33.6%, followed by level 3 (28.2%), level 1 (25.6%), the least common is grade 2 with 2.6%. The results of the second transcranial Doppler ultrasound performed on the sixth to eighth day of the disease is the time with the highest rate of vasospasm, showing the most vasospasm cerebral artery is the middle cerebral artery: right middle cerebral artery. 35.9%, left middle cerebral artery 12.8%. Next is anterior cerebral artery spasm: right anterior cerebral artery 23.1%, left anterior cerebral artery 2.6%. Right posterior cerebral artery 10.3%, left posterior cerebral artery 5.1%. Compared to the gold standard for diagnosing vasospasm, which is 128-slices MSCT, transcranial Doppler ultrasound has a sensitivity of 0.91, a specificity of 0.88, a positive predictive value of 0.91, and a negative predictive value of 0.88. The appropriateness of transcranial Doppler ultrasound and 128-slices computed tomography scan in diagnosing cerebral vasospasm after subarachnoid hemorrhage is very high, Kappa coefficient = 0.791, statistically significant with p < 0.05. Conclusion: Clinical symptoms of the disease are very diverse and non-specific, the most common symptom being headache is 97.4%. The most common Hunt and Hess scale to assess clinical severity is 2, however the most common Fisher scale is 4. Middle cerebral artery thrombosis has the highest rate of spasm, followed by the anterior cerebral artery. Compared to the gold standard for diagnosing vasospasm, which is 128-slices MSCT, transcranial Doppler ultrasound has a sensitivity of 0.91, a specificity of 0.88, a positive predictive value of 0.91, and a negative predictive value of 0.88

Thermal analysis in unsteady oscillatory Darcy blood flow through stenosed artery

This study aims to provide an extensive overview of the consequences of heat source and thermal radiation on blood flow in stenosed arteries through Casson fluid. We examine the behaviour of an unsteady non-Newtonian fluid under oscillatory Darcy flow. This analysis explores the impact of blood flow in the stenosed arteries on the momentum and energy profiles of the Casson fluid. In addition, this study examines a parametric analysis to illustrate the impact of the Nusselt number and Casson parameter. Higher values of the thermal radiation and Casson-Viscous parameters result in enhanced velocity fields. The Brinkman model accurately represents the resistance to flow caused by the porous material, known as Darcy resistance. The inner space of the coronary artery generates cholesterol-rich fatty plaques and blood clots that block the artery, simulating the diseased condition of blood circulation in this study. We employ a set of non-dimensional variables to convert the governing equations of the current flow into dimensionless partial differential equations. Analytical methods have derived a solution for the studied problem. The discovery is pertinent to the natural circulation of blood through coronary arteries, which are highly porous. A particular artery pathology creates a permeable structure within the arterial lumen. The current study demonstrates that blood flow may be manipulated by adjusting the intensity of the external magnetic field, while the temperature of the blood can be managed by either increasing or decreasing its thermal conductivity. The graphical representation demonstrates the impact of different physical parameters on velocity, temperature, and concentration profiles. The significant results of the current studies are that, the fluid velocity diminishes with rising magnetic and Biot numbers but exhibits an increase when considering the Darcy number and Hall parameter. There is a gentle increase in the wall shear stress as the Casson parameter (β) increases from 0.1 to 0.3. For β= 0.3, the percentage change along the axial direction (x) is more pronounced. This is because the wall shear stress is proportional to the number of Casson parameters.

Catastrophic Antiphospholipid Syndrome: A Review of Current Evidence and Future Management Practices.

Antiphospholipid syndrome (APS) is an autoimmune disorder characterized by blood clots and pregnancy complications due to antiphospholipid antibodies. Catastrophic APS (CAPS), a severe variant, leads to multiorgan failure and is often fatal. Pathogenesis involves antiphospholipid antibodies, particularly anti-beta-2-glycoprotein I (aβ2GPI), which trigger endothelial cell (EC) activation, cytokine release, and a prothrombotic state. Infections, surgeries, and other triggers can precipitate CAPS, leading to widespread microthromboses and systemic inflammatory responses. CAPS predominantly affects younger patients and those with systemic lupus erythematosus (SLE), with a high mortality rate, though recent treatment advances have improved survival. Diagnosing CAPS involves identifying clinical manifestations, including rapid organ involvement and small vessel occlusions, confirmed by histopathology and high antiphospholipid antibody levels. The CAPS registry data indicate that commonly affected organs include kidneys, lungs, central nervous system, and the heart, with a high prevalence of lupus anticoagulant and anticardiolipin antibodies (aCL). Current management strategies focus on therapeutic anticoagulation, immunosuppressive therapies like corticosteroids, and adjunct treatments such as plasmapheresis and intravenous immunoglobulin (IVIG). Early use of glucocorticoids and combination therapy has significantly improved outcomes. In life-threatening cases, especially with microangiopathy, experts recommend performing plasma exchange (PE). Patients with associated autoimmune conditions or refractory cases may receive cyclophosphamide (CY) and rituximab while considering PE for treatment. Maintenance of anticoagulation with an appropriate international normalized ratio (INR) is crucial to prevent recurrence.This article reviews the pathogenesis and epidemiology of CAPS. It also examines the current management strategies, and discusses the challenges and controversies associated with these strategies. It hereafter offers recommendations for future management and outlines directions for further research.

Evaluating the Effectiveness of Enoxaparin in Treating Pediatric Arterial Thrombosis in Saudi Arabia.

Thrombosis is the abnormal formation of blood clots within blood vessels; it results from an imbalance between fibrinolytic, pro-coagulant, and anticoagulant systems. Pediatric arterial thrombosis, especially related to catheter usage, is an emerging issue with limited evidence. This study evaluates the efficacy of enoxaparin in treating arterial thrombosis in pediatric patients at a single center. A retrospective single-center study included children under 14 years old diagnosed with catheter-related arterial thrombosis (CAT) and treated with low-molecular-weight heparin (LMWH) at King Abdulaziz Medical City between 2016 and 2021. Patients without follow-up at our institution or those using other anticoagulants were excluded. Data collected included age, sex, weight, catheter type, location and degree of thrombosis, ultrasonographic results, treatment duration, hemoglobin and platelet levels, and missed refills. Radiologic confirmation of CAT was required for inclusion. This study included 111 children treated with enoxaparin for non-cerebral arterial thrombosis. The median age at diagnosis was 3 months, with 58% being male patients. Most cases (87%) involved cardiac catheterization, and all were confirmed using ultrasonography. Complete thrombus resolution was achieved in 90% of patients, partial resolution in 8.1%, and 1.8% had no resolution. The median duration of enoxaparin therapy was 20 days. Multivariate analysis indicated that higher age and lower body weight were associated with a higher risk of non-resolution. Indwelling catheters also posed a greater risk of non-resolution compared to cardiac catheters. Enoxaparin proved effective in treating catheter-related arterial thrombosis in children, with high resolution rates and few side effects. This study helps inform treatment strategies in pediatric thrombosis management and highlights the need for further research to refine treatment durations and address patient risk factors.

The Use of Platelet-Rich Fibrin (PRF) in the Management of Dry Socket: A Systematic Review.

Dry socket or alveolar osteitis is a common postoperative complication following tooth extraction, characterized by severe pain due to the disintegration of the blood clot within the socket. Various factors contribute to its development, such as traumatic extraction, patient age and sex, smoking, and anesthetic use. To mitigate this condition, socket preservation techniques, including the use of bone substitute materials, have been employed. Platelet-rich fibrin (PRF) has emerged as a promising biomaterial, enhancing healing and reducing the incidence of dry socket. Materials and Methods: This systematic review, adhering to the PRISMA guidelines and registered with PROSPERO (ID: CRD 578018), examines the efficacy of PRF in managing dry socket by analyzing studies from PubMed, Scopus, and Web of Science published between January 2013 and May 2024. Boolean keywords have been used in the search strategy: ("Treatment") AND ("Dry Socket") AND ("Platelet Rich Fibrin" OR "PRF"). A total of 738 publications were found using the electronic database search. After the screening phase, 13 records were chosen for qualitative analysis. The results from multiple clinical trials and comparative studies indicate that PRF significantly reduces postoperative pain, expedites healing, and lowers the incidence of Alveolar Osteitis. Despite promising results, further large-scale, randomized studies are needed to validate PRF as a standard treatment for dry socket.

Pulsed focused ultrasound ablation assisted by a surface modified catheter for thrombolysis: a feasibility study

Interventional procedures for the recanalization of blood vessels to treat deep vein thrombosis carry a high risk of vessel wall injuries or hemorrhaging. Focused ultrasound (FUS) has been used to non-invasively break down blood clots that occlude the vessels in both in vitro and in vivo studies. Previous studies have either used thrombolytic drugs or ultrasound contrast agents (e.g., microbubbles) in combination with FUS. Several studies have applied very high peak-negative-pressures (PNP) during FUS treatment to achieve successful thrombolysis without the use of contrast agents. In the current study, we demonstrated that cavitation activity could be significantly enhanced by placing a nitinol wire, whose surface was roughed by laser etching, in the focal region of a FUS field. We demonstrated in vitro in a mock thrombosis that the thrombolysis efficacy of a 500 kHz FUS transducer was significantly enhanced using a surface-etched nitinol wire as compared to an unetched nitinol wire, whereas FUS-alone at the same pressure level did not result in any thrombolysis. These results suggest that a surface modified nitinol catheter exposed to FUS can result in intense cavitation activities leading to enhanced thrombolysis without the use of additional pharmacological or contrast agents.

Pathomorphological Changes of the Placenta in Antenatal Asphyxia of the Fetus Associated with the Coronavirus Disease (COVID-19) in Pregnant Women

Сoronavirus disease (COVID 19) in a pregnant woman remains a risk factor for perinatal losses despite the barrier function of the placenta. This prompted us to do some research. Objective — to determine the pathomorphological changes of the placenta and fetus during antenatal asphyxia in the acute period of COVID-19 in a pregnant woman. Materials and methods. We studied placentas and fetuses in case of antenatal asphyxia (n = 16) in the acute period of the COVID-19 in a pregnant woman, confirmed by a positive PCR test (determination of SARS-CoV-2 RNA). The duration of the post-COVID interval (time from the diagnosis of COVID-19 to delivery) was 1—3 weeks. Results and discussion. Intrauterine death of the fetus occurred at different gestational period: from 26 to 38 weeks (median 33). At the same time, the woman fell ill with COVID-19 between 18 and 35 weeks of gestation (median 31). Hemorrhages in the right atrium and auricle of the heart were observed in fetuses — 93.8 % (95 % CI: 75.4—100); dark blood clots in the chambers of the heart; hemorrhages under the periosteum of the bones of the skull, stasis in the veins of the brain — 81.3 % (95 % CI: 57.1—96.7), hemorrhages in the scrotum, spermatic cord — 6.3 % (95 % CI: 0.0—24.6) and kidney hemorrhages — 62.5 % (95 % CI: 36.2—85.4). When examined macroscopically, the placenta was characterized by a flabby or dense consistency; diffuse hemorrhages or local blood clots in numerous cysts; areas of abruption, thrombosis of umbilical cord vessels. Microscopic examination of the placenta revealed chorioamnionitis — 81.3 % (95 % CI: 57.1—96.7 %), intervillositis — 93.8 % (95 % CI: 75.4—100), acute villitis — 56.3 % (95 % CI: 30.2—80.6). Basal deciduitis was detected in all observations in 100 % (95 % CI: 88.8—100). Disorders of blood circulation were found in the placentas: stasis, thrombosis, hemorrhages; and necrosis of the arteriole endothelium — 100 % (95 % CI: 88.8—100 %). Conclusions. COVID-19 in a pregnant woman from 18 to 35 weeks of gestation (median 31) is a risk factor for perinatal losses. No significant differences were found between the severity of the course of COVID-19 in the mother and the morphological changes of the placenta. Pathognomonic changes in the fetus with COVID-19 in the mother in the acute period: «porphyry lung», hemorrhages in the right atrium, under the periosteum of the bones of the skull, spermatic cord, kidneys, blood clots in the chambers of the heart. The cause of antenatal death of the fetus in the acute period of COVID-19 in a pregnant woman is acute placental insufficiency associated with disorder of placental-fetal blood circulation, due to manifestations of the exudative phase of inflammation: placentitis (focal chorioamnionitis, acute villitis, intervilositis, basal deciduitis) and disorder of blood rheology, which was manifested by thrombosis, hemorrhages in the intervillous space, detachment of the placenta.

A self-gelling alginate/chitosan based powder containing bioactive nanoparticles for non-compressible bleeding control and promoting wound healing

The challenge remains in developing hemostatic dressings that can fulfill both hemostatic and repair functions to meet clinical demands worldwide. Herein, the biodegradable powders composed of benzeneboronic acid-modified sodium alginate/catechol-modified quaternized chitosan hydrogel (SBQCC) networks and bioactive cerium oxide nanoparticles (CNPs), were prepared for hemostasis and promoting wound healing. The SBQCC/CNPs powders had good self-gelation ability, water absorption ratio, tissue adhesiveness and biocompatibility. The SBQCC/CNPs powders could not only rapidly absorb a large amount of blood to concentrate coagulation factors when applied on bleeding wounds, but also formed an adhesive hydrogel physical barrier to control bleeding in situ. Meanwhile, the aggregation and activation of red blood cells and platelets induced by the SBQCC/CNPs powders can initiate the forming of internal blood clot with fibrin to further enhance the hemostatic effect. The SBQCC/CNPs powders demonstrated excellent hemostatic performance in non-compressible rat tail vein bleeding and rabbit liver bleeding models. In addition, SBQCC/CNPs powder-derived hydrogels had antibacterial activity and multiple biological activities, including antioxidant, anti-inflammatory and promoting angiogenesis for accelerating wound healing. Therefore, the SBQCC/CNPs powders can accelerate wound healing while achieving effective hemostasis, which will be a promising hemostatic dressing.

Current Patient Management for Bacterial Meningitis Simultaneously Affected by Stroke.

Bacterial meningitis (BM) is a critical central nervous system infection characterized by increased risks of complications and potentially fatal outcomes. The chances of full recovery are significantly reduced in the presence of concomitant neurovascular complications such as ischemic and hemorrhagic strokes, intracerebral hemorrhage, and cerebral sinus thrombosis. Effective treatment of BM requires a targeted approach that simultaneously addresses the causative pathogen and manages the neurologically related complications. However, clinicians continue to face challenges in determining optimal pharmacotherapy for these patients.The presence of neurological complications is pivotal in determining patient outcomes, contributing to high disability and mortality rates. Early medical management is crucial and begins with essential stabilization followed by rapid diagnostic testing and the administration of empirical broad-spectrum antimicrobial therapy. The use of targeted antibiotics based on culture results is standard, with adjunct therapies such as dexamethasone and, in some cases, anticoagulants playing supportive roles. Despite the deployment of such comprehensive therapeutic strategies, the variability in treatment response and the high incidence of adverse outcomes necessitate ongoing research. This includes exploring novel therapeutic approaches and enhancing current clinical practices through retrospective studies and clinical trials to mitigate the high morbidity and mortality rates associated with BM and its complications. Strategic management is crucial for patient recovery, considering the substantial risk, a broad spectrum of complications, and fatal outcomes from this meningeal infection and stroke. The use of antimicrobial therapy with intravenous adjunct dexamethasone isthe current standard of care for patients with cerebrovascular complications and acute BM. In addition, other options that can provide benefits in complicated cases include anticoagulants and neurosurgery. Further investigation into treatment algorithms for patients with meningeal infection complicated by stroke and/or increased intracranial pressure is still needed.

Foam Cells: The Origin of Formation and Target for Plant-derived Bioactive Compounds.

Foam cells play a crucial role in the initiation and progression of atherosclerosis, a condition marked by the development and growth of plaques that narrow blood vessel lumens. This narrowing can prevent normal blood flow and, in severe cases, lead to plaque rupture and blood clot formation, which can cause stroke or myocardial infarction. The origin of foam cells is diverse, arising from monocytes, vascular smooth muscle cells, stem/progenitor cells, and dendritic and endothelial cells. In their attempt to eliminate excess lipoproteins and cholesterol, foam cells inadvertently contribute to plaque development and rupture. Cholesterol uptake, efflux, and esterification are the major processes regulating foam cell formation. Advances in technology, such as the identification of cell-surface markers for lineage tracing and single-cell RNA sequencing, have unveiled diverse molecular mechanisms involved in the formation of foam cells from different origins, offering new insights into plaque formation and potential targets for anti-foam cell therapies. In this review, we focus on recent studies exploringthe inhibitory effects of medicinal plants and their bioactive components on foam cell formation. Various mechanisms are explored, including the inhibition of cholesterol uptake and the up-regulation of cholesterol efflux, as well as the suppression of inflammatory and adhesion activities. Emphasizing a cellular target-based therapeutic approach, this review envisions the development of innovative plant-based medications for atherosclerosis treatment.

Small leucine zipper protein negatively regulates liver fibrosis by suppressing the expression of plasminogen activator inhibitor-1

Liver fibrosis, which is caused by viral infection, toxic exposure, and autoimmune diseases, is a chronic liver disease. Plasminogen activator inhibitor-1 (PAI-1) is a serine protease inhibitor of tissue-type plasminogen activator (tPA) and urokinase plasminogen activator, which convert plasminogen into plasmin. Therefore, PAI-1 suppresses fibrinolysis by blocking plasmin synthesis and is involved in liver fibrosis via extracellular matrix deposition. Small leucine zipper protein (sLZIP) acts as a transcription factor and plays critical roles in many cellular processes. However, the role of sLZIP in liver fibrosis remains unclear. In this study, we investigated the role of sLZIP in regulating PAI-1 transcription and liver fibrosis. sLZIP knockdown enhanced the expression of PAI-1 at the mRNA and protein levels. sLZIP knockdown also increased PAI-1 secretion and suppressed blood clot lysis by blocking tPA activity. Moreover, conditioned medium derived from sLZIP knockdown cells downregulated the expression of matrix metalloprotease (MMP)-2 and MMP-9 in the presence of tPA in hepatic stellate cells (HSCs). Liver-specific sLZIP knockout mice showed deteriorated liver fibrosis compared to control mice in a bile duct ligation-induced fibrosis model. These findings demonstrate that sLZIP functions as a negative regulator of liver fibrosis by suppressing PAI-1 transcription and HSC activation.

Head injury management in road accident patients: a case report

Objective: To examine recovery outcomes for patients with head injuries from road traffic accidents (RTAs), focusing on neurosurgical care. Methodology: We studied patients admitted to our hospital with head injuries from RTAs. This included a case study of a 55-year-old man severely injured in a road accident, highlighting neuropsychological assessments and treatment outcomes. Results: The case report presents the successful recovery of a 55-year-old patient who sustained severe head injuries from a road traffic accident. Following neurosurgical intervention to remove blood clots and comprehensive neuropsychological therapy, the patient showed significant improvement in memory and cognitive functions. The outcomes demonstrate a positive response to the integrated treatment approach, with the patient regaining substantial normalcy in life over the course of three months. Conclusion: The case of a 55-year-old patient highlights the challenges and outcomes of treating severe head injuries resulting from RTAs. Key findings include the importance of immediate and appropriate neurosurgical care and neuropsychological support.

FREQUÊNCIA DA HOSPITALIZAÇÃO DOS CASOS DE EMBOLIA E TROMBOSE ARTERIAL EM MONTES CLAROS

Arterial thrombosis occurs when the formation of a blood clot completely blocks or impairs the flow of blood from an artery, which are the medium and large caliber vessels in our body responsible for transporting oxygen- and nutrient-rich blood to the tissues. This is a quantitative descriptive study whose data were collected in the Ministry of Health's online program TABNET-DATASUS, related to the municipality of Montes Claros, Minas Gerais. The selected variables were hospitalization by year of processing, age group, sex, color/race, and deaths during the period from 2017 to 2021. It is noted that with the analysis of the results obtained and the literature, that with advancing age, changes occur in normal aging, making individuals more prone to develop diseases, added to unhealthy habits and/or decompensated chronic diseases throughout life becomes even more predisposed.