Sedimentation Rate Research Articles

Clinical and computed tomography angiography characteristics of infected vs. non-infected abdominal aortic aneurysm: a comparative study.

The aim of this study was to investigate the clinical and multi-slice spiral computed tomography angiography (MSCTA) characteristics for the diagnosis of infected AAA. This retrospective comparative study included patients who were diagnosed with AAA at our hospital between January 2014 and May 2023. A total of 40 patients were included, comprising 20 with infected AAA and 20 with non-infected AAA. Patients with infected AAA were more likely to be younger (62.9 ± 10.1 vs. 70.0 ± 4.4 years, P = 0.007) and to present with fever [7 (35%) vs. 1 (5%), P = 0.026], pain [15 (75%) vs. 2 (10%), P < 0.001], higher C-reactive protein levels (60.4 ± 57.0 vs. 4.1 ± 2.9mg/l, P = 0.005), and higher erythrocyte sedimentation rates (47.7 ± 23.4 vs. 15.2 ± 8.3mm/h, P < 0.001) compared to those with non-infected AAA. Moreover, those with infected AAA exhibited significantly more eccentric saccular morphology [17 (85%) vs. 1 (5%), P = 0.002], a smaller longitudinal-transverse ratio (1.12 ± 0.33 vs. 2.33 ± 0.54, P = 0.001), thicker peri-aneurysmal soft tissue (2.29 ± 1.48 vs. 0.73 ± 0.55cm, P < 0.001), more lobulated margins [18 (90%) vs. 1 (5%), P = 0.001], lower aortic calcification scores (49 vs. 56, P < 0.001), more pneumatosis [6 (30%) vs. 0 (0%), P = 0.014], more ruptures [15 (75%) vs. 5 (20%), P = 0.002], more blurred peri-abdominal aortic fat spaces [16 (80%) vs. 2 (10%), P = 0.001], more adjacent bone destruction [5 (25%) vs. 0 (0%), P = 0.025], more involvement of the psoas major muscle [8 (40%) vs. 1 (5%), P = 0.005], more lymphadenectasis [8 (40%) vs. 1 (5%), P = 0.020], and less tortuous aortas [2 (10%) vs. 9 (45%), P = 0.034] compared with those with non-infected AAA. The clinical manifestations and MSCTA characteristics may differ between infected and non-infected AAA.

Correlation Between ABO Blood Grouping and Erythrocyte Sedimentation Rate (ESR) in Periodontal Diseases.

This study investigates the relationship between erythrocyte sedimentation rate (ESR) and ABO blood grouping in the context of periodontal disorders. Periodontal diseases, chronic inflammatory conditions that damage the tissues supporting teeth, can lead to tooth loss if left untreated. ESR, a common hematological test indicating systemic inflammation, has been linked to the severity of periodontal disease. ABO blood grouping, a hereditary trait, is linked to a higher risk of various oral and systemic diseases. By synthesizing existing research, this study explores the potential of the connection between blood type ABO and ESR levels in individuals with periodontal disorders, examining studies that assess the distribution of ABO blood types and corresponding ESR values among periodontal patients.

Value of proprotein convertase subtilisin/kexin type 9 and inflammatory markers in the diagnosis of carotid atherosclerosis in hypertensive men

Proprotein convertase subtilisin/kexin type 9 (PCSK9) is involved in lipid metabolism, has local and systemic effects in immunoregulation and atherogenesis in hypertensive patients.Aim. To personalize cardiovascular risk (CVR) stratification taking into account the diagnostic value of PCSK9 and inflammatory markers in men with hypertension and carotid atherosclerosis.Material and methods. The study included 162 males with stage I-III hypertension of various CVR. All patients underwent collection of complaints and medical history, physical examination with anthropometry. The following laboratory test were performed: complete blood count with white blood cell differential and erythrocyte sedimentation rate, assessment of fibrinogen, C-reactive protein (CRP), total cholesterol, low-density lipoprotein cholesterol, triglycerides, blood glucose, serum creatinine level. Glomerular filtration rate and microalbuminuria were also evaluated. Serum PCSK9, interleukins-8, 10 (IL-8, 10) were determined by enzyme immunoassay. In addition, 24-hour blood pressure monitoring, extracranial artery ultrasound with determination of intima-media thickness and carotid stenosis severity were performed. Patients were divided into 3 groups according to PCSK9 level.Results. Analysis of conventional cardiovascular factors and cytokine status (IL-8 and IL-10) in patients showed an inverse relationship between age and IL-8 (r=-0,230; p=0,036), IL-8/IL-10 (r=-0,309; p=0,005); heredity and IL-8/IL-10 (r=-0,423; p=0,001). There were following relationships between CVR factors and PCSK9: direct relationship between men's age (r=0,220, p=0,032), systolic and diastolic blood pressure (r=0,230, p=0,033; r=0,260, p=0,015) and PCSK9; inverse relationship between PCSK9 and heredity (r=-0,286, p=0,011). C-reactive protein and erythrocyte sedimentation rate were associated with IL-10 levels, which are associated with anti-inflammatory activity (r=0,78; p=0,02; r=0,78; p=0,02, respectively). The IL-8/IL-10 cytokine imbalance was most pronounced in patients with a night-peaker 24-hour systolic blood pressure profile (p=0,02). Patients with intima-media thickening and plaques had a highest level of PCSK9 (p=0,006). IL-8 levels were significantly higher with unchanged intima-media thickness (p=0,01).Conclusion. In patients with high levels of PCSK9, there is a close relationship between risk factors for hypertension and cytokine imbalance. The severity of extra­cranial artery atherosclerosis significantly depends on the increase in the levels of PCSK9 (p=0,006) and inflammatory markers (IL-10) (p=0,044).

Prognostic value of hematological indicators in preeclampsia

The objective: to evaluate the changes in hematological indicators as early predictors of the development of preeclampsia.Materials and methods. A retrospective cohort study was conducted with the participation of 49 pregnant women in the period from March 2020 to January 2022. All women were observed in the women’s consultation of the private medical center “Leleka”.Pregnant women were divided into two groups: the main group – women who were diagnosed with preeclampsia at &gt;20 weeks of pregnancy, n=20), and the control group (n=29) – women without preeclampsia during pregnancy.Each woman underwent a general blood test, the systemic inflammatory response index (SIRI), allergy index (AI), immunoreactivity index (II), adaptation index (А) in I (up to 12 weeks), II (13–27 weeks) and III (from 28 weeks) trimesters of pregnancy, respectively, were calculated.Results. Pregnant women, in whom subsequently preeclampsia developed, had statistically significant differences in white blood cell count and erythrocyte sedimentation rate (ESR) compared to controls.The AI index decreased statistically significantly in the control group in the II trimester compared to the I trimester (р=0.05), while the changes in the main group were statistically insignificant. The median AI indicator in the main group decreases by 22.7% in the II trimester, and increases by 8.9% in the III trimester; in the control group the median AI decreases by 12.3% and 7.5%, respectively.The median adaptation index in the main group statistically significantly decreases by 25.7% in the II trimester and increases by 19.2% in the III trimester. In the control group, this index does not increase in the III trimester.Conclusions. The dynamics of the main hematological indicators and calculated indices can be useful for predicting of preeclampsia development. Carrying out a general blood test as a widely available method is possible in order to stratify the individual risk of preeclampsia development in combination with other generally accepted factors of this complication.High values of leukocytes and ESR in the early terms of pregnancy in women who subsequently developed preeclampsia confirm the role of inflammation as an etiopathogenetic factor. A change in the integral hematological indices of allergy and adaptation can be an early predictor of preeclampsia.The results of this study predict the presence of preeclampsia clusters, the determination of the mechanisms of which will allow to expand the possibilities of preventive measures, which needs to be confirmed in large-scale randomized studies in the future.

Application of Constant Rate of Supply Model for the Determination of Sediment Accumulation Rates and Chronology of Bukit Merah Reservoir Perak, Malaysia

The Constant Rate of Supply (CRS) model is used to measure the continuous influx of unsupported 210Pb into the sediment, allowing for the assessment of changes in the rate of sediment accumulation due to anthropogenic impacts over time. Thus, the CRS model was used to analyze a 25 cm bottom sediment core extracted from Bukit Merah Reservoir. Results revealed a high sedimentation rate in the reservoir, which ranged from 0.14 to 0.37 gcm-2 yr-1, with a mean sedimentation rate of 0.31 cm yr-1. The presence of 137Cs was not observed in the core, while the activity of 241Am was detected in two isolated samples but was insufficient for use as a marker. The constant rate of 210Pb supply (CRS) model dated the oldest sediments (22.5-24.5 cm) to AD 1985 ± 34 years of human influences. Overall, the sedimentation rate in the reservoir experienced a rapid increase from the 1980s to the 2000s and fluctuated to the top of the core indicating continuous anthropogenic impacts on the reservoir. The study identified continuous increases in agricultural activities, expansion in the tourism industry, population growth, and changes in land use, as the main cause of heightened sedimentation and sediment particles delivery into the reservoir. Therefore, urgent measures are needed to address the current siltation state of the reservoir.

Joint Damage and Low Lean Body Mass in a Cohort of Peruvian Patients With Rheumatoid Arthritis.

To determine the association between radiologic joint damage (JD) and a lower lean body mass (LBM) in rheumatoid arthritis (RA) patients. A cross-sectional study from a single center established RA cohort. JD and appendicular LBM (arms and legs) were measured with the Sharp/van der Heijde (SvdH) score and dual x-ray absorptiometry expressed as kg/m 2 , respectively. A univariable analysis was used to determine the association between JD an LBM; then, a multivariable regression model was performed to evaluate the persistence of this association, adjusted by age, gender, disease duration, socioeconomic status (by the Graffar method), tobacco use, anticitrullinated protein antibody levels, Disease Activity Score in 28 joints for RA with erythrocyte sedimentation rate, glucocorticoid use (as prednisone equivalent), disease-modifying antirheumatic drug use, body mass index, and disability (by the multidimensional Health Assessment Questionnaire). Two hundred forty-seven patients were included; the average (SD) age was 63.0 (12.8) years, disease duration 20 (15.00) years, the total SvdH was 66 (86.75), and the aLBM was 13.6 (3.82) kg/m 2 . In the univariable analysis, a lower appendicular LBM was associated with higher SvdH score on the female population, in terms of the total ( B = -8.6, p < 0.01), bone erosion (-4.4, p < 0.01), and joint space narrowing (-4.2, p < 0.01) scores; this correlation remained in the multivariable analysis in terms of total SvdH ( B = -9.5, p < 0.01), bone erosion (-5.2, p < 0.01), and joint space narrowing (-4.3, p < 0.01). A lower LBM in female patients was associated with more severe JD independently of other variables examined. Strategies aimed at preserving LBM could have a favorable impact on the course of disease.

Biochemical Markers in the Prediction of Pregnancy Outcome in Gestational Diabetes Mellitus.

Background and Objectives: Gestational diabetes mellitus (GDM) may impact both maternal and fetal/neonatal health. The identification of prognostic indicators for GDM may improve risk assessment and selection of patient for intensive monitoring. The aim of this study was to find potential predictors of adverse pregnancy outcome in GDM and normoglycemic patients by comparing the levels of different biochemical parameters and the values of blood cell count (BCC) between GDM and normoglycemic patients and between patients with adverse and good outcome. Materials and Methods: Prospective clinical study included 49 patients with GDM (study group) and 44 healthy pregnant women (control group) who underwent oral glucose tolerance test (OGTT) at gestational age of 24-28 weeks. At the time of OGTT peripheral blood was taken for the determination of glucose levels, insulin, glycated hemoglobin, lipid status, homeostatic model assessment, BCC, iron and zinc metabolism, liver function, kidney function and inflammatory status. Each group was divided into two subgroups-normal and poor pregnancy outcome. Results: Higher RBC, hemoglobin concentration, hematocrit value, fasting glucose, uric acid and fibrinogen were found in GDM patients compared to control group. In GDM patients with poor pregnancy outcome values of fibrinogen, ALT, sedimentation rate, granulocyte and total leukocyte counts were elevated, while the serum level of zinc was significantly lower. Higher level of fibrinogen was found in normoglycemic patients with adverse pregnancy outcomes. ROC curve was constructed in order to assess fibrinogen's biomarker potential. The established AUC value for diagnostic ROC was 0.816 (p < 0.001, 95% CI 0.691-0.941), while the AUC value for assessing fibrinogen's potential to predict poor pregnancy outcome in GDM was 0.751 (p = 0.0096, 95% CI 0.561-0.941). Conclusions: The results of our study demonstrated that the best prognostic potential in GDM showed inflammation related parameters, identifying fibrinogen as a parameter with both diagnostic and prognostic ability.

The erythrocyte sedimentation rate and other markers of inflammation in cats tested for Leishmania infantum and feline immunodeficiency virus antibodies

BackgroundIn endemic areas, Leishmania infantum and feline immunodeficiency virus (FIV) co-infection occurs in cats, and may favour a progressive course of feline leishmaniosis. Abnormalities in serum protein fractions have been reported, but inflammation markers have scarcely been studied. Erythrocyte sediment rate (ESR) is a marker of inflammation that is poorly used in veterinary medicine, but it has been evaluated in EDTA blood using a recently introduced automatic device. We studied ESR and a pool of feline markers of inflammation (MoI) in cats L. infantum (Li+) and/or FIV antibody-positive (Li+FIV+/FIV+) with the aims (a) to evaluate ESR as MoI in cats with the infectious and clinical conditions considered and (b) to provide data about a pool of MoI never investigated in the feline infections studied and in other cat diseases before.MethodsThis prospective controlled study included 35 study group cats (Li+, n = 20; FIV +, n = 8; Li+FIV+, n = 7) and ten healthy antibody-negative control cats. Clinical findings at physical examination and selected clinical pathological abnormalities related to inflammation were statistically analysed in relation to the infectious status and ESR values.ResultsESR values were higher in Li+, FIV+, and Li+FIV+ cats compared with control cats, and 40% of the study group cats had ESR values above the reference interval (RI). ESR positively correlated with some positive MoI and negatively with some negative MoI studied. Additionally, a higher prevalence of ESR values above the RI has been detected in cats with hypoalbuminemia or hypergammaglobulinemia and higher ESR values were measured in cats with serum protein electrophoresis (SPE) fraction abnormalities. Correlations were also found with erythrocytes, hemoglobin, hematocrit and some erythrocyte indices. FIV+ and Li+FIV+ cats had a higher prevalence of increased ESR values, and almost all had SPE abnormalities and more severe clinical presentations compared with Li+ cats.ConclusionsAbnormal levels of MoI were found in almost all parameters studied, particularly in FIV+ and Li+FIV+ cats. Also, ESR can be used as a marker of inflammation in cats with L. infantum and/or FIV infection.Graphical

Development of Autoimmune Diseases Among Children With Pediatric Acute-Onset Neuropsychiatric Syndrome

Epidemiologic studies indicate a high rate of autoimmune conditions among patients with obsessive-complusive disorder and other psychiatric conditions. Furthering the understanding of the inflammatory diatheses of psychiatric conditions may open doors to new treatment paradigms for psychiatric disorders. To evaluate whether pediatric acute-onset neuropsychiatric syndrome (PANS) is associated with an inflammatory diathesis by assessing signs of immune activation and vasculopathy during a psychiatric symptom exacerbation (flare), estimating the risk of developing arthritis and other autoimmune diseases, and characterizing subtypes of arthritis. This retrospective cohort study used longitudinal clinical data on 193 consecutive patients with PANS followed up within the Stanford Immune Behavioral Health Clinic from September 1, 2012, to December 31, 2021. Medical records were reviewed, and a predefined set of immune markers that were measured during a flare and the features and imaging findings of arthritis and other autoimmune diseases were collected. Immune activation markers included (1) autoimmunity signs (antinuclear antibody, antihistone antibody, antithyroglobulin antibody, C1q binding assay, and complement levels [C3 and C4]); (2) immune dysregulation or inflammation signs (leukopenia, thrombocytosis, C-reactive protein, and erythrocyte sedimentation rate); and (3) vasculopathy signs (livedo reticularis, periungual redness and swelling, abnormally prominent onychodermal band, palatal petechiae, high von Willebrand factor antigen, and high d-dimer). Last, the cumulative risk of developing arthritis and autoimmune diseases was estimated using product limit (Kaplan-Meier) survival probability. The study included data from 193 children (112 boys [58.0%]) who had PANS at a mean (SD) age of 7.5 (3.5) years. They were followed up for a mean (SD) of 4.0 (2.1) years. Among those tested for immune activation markers, 54.2% (97 of 179) had nonspecific markers of autoimmunity, 12.0% (22 of 184) had nonspecific signs of immune dysregulation or inflammation, and 35.8% (69 of 193) had signs of vasculopathy. By 14 years of age, the estimated cumulative incidence of arthritis was 28.3% (95% CI, 20.8%-36.3%), and the estimated cumulative incidence of another autoimmune disease was 7.5% (95% CI, 4.0%-12.4%). Novel findings in the subgroup with arthritis include joint capsule thickening (55.0% [22 of 40]), distal interphalangeal joint tenderness (81.8% [45 of 55]), and spinous process tenderness (80.0% [44 of 55]). Among the 55 patients with arthritis, the most common subtypes of arthritis included enthesitis-related arthritis (37 [67.3%]), spondyloarthritis (27 [49.1%]), and psoriatic arthritis (10 [18.2%]). This study found that patients with PANS show signs of immune activation and vasculopathy during psychiatric symptom flares and have an increased risk of developing arthritis and other autoimmune diseases compared with the general pediatric population. The most common arthritis subtype was enthesitis-related arthritis. These findings suggest that PANS may be part of a multisystem inflammatory condition rather than an isolated psychiatric or neuroinflammatory disorder.

Up-Regulation of microRNA-34a in Women with Systemic Lupus Erythematosus

Systemic Lupus Erythematosus (SLE) is a chronic systemic autoimmune disease with multiple contributing factors. It is characterized by the immune system's inability to tolerate autoantigens such as nuclear antigens. The objective of this study is to evaluate the expression of microRNA-34a in relation to the incidence and occurrence of SLE in Iraqi women using quantitative real-time PCR and to determine its potential relationship with various demographic and laboratory parameters and disease activity. This investigation enrolled 100 healthy controls with a mean age of 31.68 years and 100 SLE patients, all of whom were women with a mean age of 32.85 years and a disease duration of 9.00 (6.75) years. The mean of the Systemic Lupus Erythematosus disease activity index (SLEDAI-2k) score was 10.860±3.275. Erythrocyte sedimentation rate, C-reactive protein, urea, and creatinine were significantly higher (50.00 vs. 10.00 mm/h, 16.70 vs. 0.650 mg/dl, 58.00 vs. 33.00 mg/l, and 1.550 vs. 0.700 mg/l, respectively), while hemoglobin, white blood cells, and Complement 3 and Complement 4 were significantly lower (8.40 vs. 13.00 g/dl, 3.500 vs. 6.800 x 109 /L, 74.00 vs. 130.00 mg/dl, and 10.00 vs. 13.50 mg/dl, respectively) in patients with SLE compared with controls (P≤ 0.001). The analysis of anti-nuclear antibodies (ANA) in patients showed that 89% have ANA and 95% have anti-double-stranded DNA (anti-dsDNA). Also, the findings revealed a significant increase in microRNA-34a expression with fold change (5.19 ±0.48) when compared to the fold change mean in controls (1.00 ±0.00). There is no evidence for any correlation between microRNA-34a fold change and any laboratory or demographic examination of the illness in the present study except for age and BMI. In addition, receiver operating characteristic (ROC) analysis was performed on SLE patients to establish the diagnostic accuracy of microRNA-34a in differentiating SLE patients from controls. The specificity and sensitivity of microRNA-34a were 98% and 100%, respectively. The area under the curve (AUC) was 0.990, and the cutoff point was 1.050. This indicates that the identified microRNA-34a may represent strong biomarkers for SLE disorders.

Efficacy and safety of levilimab in the treatment of patients with rheumatoid arthritis

Evaluation in real clinical practice of the effectiveness and safety of levilimab therapy in patients with highly and moderately active rheumatoid arthritis (RA). A prospective observational study (6 months) involving 35 patients with RA (29 women and 6 men, mean age 53.17±13.2 years) who were treated at the Ochapovsky Regional Clinic Hospital of Krasnodar Region. All patients included in the study were prescribed the drug levilimab (Ilsira). After 1 month of observation, there was a decrease in the clinical and laboratory activity of the process in the form of a decrease in the number of painful joints - 17.0 (14.0; 20.0) vs 8.0 (6.0; 10.0); p=0.000001, number of swollen joints - 3.0 (2.0; 4.0) vs 0.0 (0.0; 0.0); p=0.000002, reduction in pain intensity according to visual analog scale - 60.0 (60.0; 70.0) mm vs 30.0 (20.0; 40.0) mm (p=0.000001). Also, by the end of the first month of therapy, there was a decrease in clinical activity indices DAS28-ESR by 43%, SDAI by 60%, CDAI by 55%. Positive dynamics of laboratory parameters were noted - a decrease in erythrocyte sedimentation rate by 76%, a decrease in C-reactive protein level by 98%. By the 6th month of therapy, a decrease in RF by 36% and ACCP by 11% was recorded, but the dynamics of these indicators did not reach statistical significance. By the end of 4 weeks of treatment, 24 (68.6%) patients showed an increase in the level of total blood cholesterol - 5.1 (3.91; 6.0) mmol/L vs 6.1 (4.99; 7.07) mmol/L (p=0.000006), while 11 (45.8%) patients from this group had initially elevated cholesterol levels (6.4±0.6 mmol/L). In 5 (14.3%) patients, an increase in alanine aminotransferase (ALT) was recorded in the 4th week - 17.0 (11.0; 25.0) U/L vs 32.0 (22.0; 43.0) U/L (p=0.000062) and aspartate aminotransferase (AST) - 19.0 (14.0; 24.0) U/L vs 25.0 (18.0; 36.0) U/L (p=0.000171), in 1 (2.85%) of the patient, an increase in ALT and AST above normal was noted (ALT 144 U/L, AST 52 U/L), which required discontinuation of levilimab. In 2 (5.7%) patients, by the end of the 4th week a decrease in the absolute number of neutrophils was registered - 3.2 (2.6; 4.0)×10E9/L vs 2.3 (2.0; 2.5)×10E9/L (p=0.002), which did not require discontinuation of treatment, since the number of cells remained more than 1×10E9/L. During treatment with levilimab 162 mg subcutaneously once a week, the proportion of patients taking prednisolone decreased from 46% at the start of therapy to 11% at the end of 6 months of therapy. Levilimab is a highly effective drug for the treatment of patients with highly and moderately active RA and has a favorable tolerability and safety profile.

A Multimodal Fuzzy Approach in Evaluating Pediatric Chronic Kidney Disease Using Kidney Biomarkers.

Chronic kidney disease (CKD) is one of the most important causes of chronic pediatric morbidity and mortality and places an important burden on the medical system. Current diagnosis and progression monitoring techniques have numerous sensitivity and specificity limitations. New biomarkers for monitoring CKD progression have been assessed. Neutrophil gelatinase-associated lipocalin (NGAL) has had some promising results in adults, but in pediatric patients, due to the small number of patients included in the studies, cutoff values are not agreed upon. The small sample size also makes the statistical approach limited. The aim of our study was to develop a fuzzy logic approach to assess the probability of pediatric CKD progression using both NGAL (urinary and plasmatic) and routine blood test parameters (creatinine and erythrocyte sedimentation rate) as input data. In our study, we describe in detail how to configure a fuzzy model that can simulate the correlations between the input variables ESR, NGAL-P, NGAL-U, creatinine, and the output variable Prob regarding the prognosis of the patient's evolution. The results of the simulations on the model, i.e., the correlations between the input and output variables (3D graphic presentations) are explained in detail. We propose this model as a tool for physicians which will allow them to improve diagnosis, follow-up, and interventional decisions relative to the CKD stage. We believe this innovative approach can be a great tool for the clinician and validates the feasibility of using a fuzzy logic approach in interpreting NGAL biomarker results for CKD progression.

Reviving ancient therapeutics in modern medicine: an immunological and biological narrative review of wet cupping in the management of Hashimoto's thyroiditis.

The interwoven immunological, biological, and genetic complexity of thyroid diseases makes suitable targeted therapies particularly challenging to develop. Stemming from ancient practices, al-hijamah, or wet cupping, has achieved notable popularity in recent years, leading to unique applications in modern medicine. By grappling with the current literature that links the effects of wet cupping with the immune system in patients with Hashimoto's thyroiditis (HT), this narrative review aims to compose a comprehensive assessment of this adjunctive treatment based on evidence of its integration into practice. Between upregulating critical players of the innate immune system, such as immunostimulatory cytokines, white blood cells (WBCs) and natural killer (NK) cells, and downregulating essential thyroid antibodies (anti-thyroid peroxidase and anti-thyroglobulin) and inflammatory markers (C-reactive protein and erythrocyte sedimentation rate), wet cupping practices provide promising complementary therapy for hypothyroidism. Wet cupping manipulates in vivo molecular mechanisms, as outlined in hemodynamic and microparticle clearance theories, to slow disease progression and even development in disease-free populations. Given the established utilization of wet cupping in the context of autoimmune diseases and inflammatory conditions, the emerging utility of wet cupping continues to gain credibility. This literature review illuminates the documented improvements in immune and biological function due to cupping therapeutic practices and sheds light on its appropriate application in the clinical setting for patients with HT. Furthermore, this review proposes a clear need for implementing future clinical trials, which may effectively bridge pathophysiological causes of hypothyroidism with underrated techniques for enhanced thyroid health.

Unmasking Subacute Thyroiditis in a Young Male with PUO: A Case Report

Pyrexia of unknown origin (PUO) poses a diagnostic challenge, defined as persistent fever exceeding 38.3°C (100°F) without an identified cause after extensive investigation. Subacute thyroiditis (SAT), an uncommon inflammatory condition of the thyroid gland, typically presents with neck pain, thyrotoxic symptoms, and elevated inflammatory markers. However, it rarely manifests as PUO without typical symptoms. We report a case of a 32-year-old Indian male presenting with a 20-day history of persistent fever without localized symptoms, initially treated empirically with antibiotics without improvement. Clinical examination revealed a firm, non-tender goiter, and laboratory investigations showed elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). Subsequent thyroid function tests indicated elevated free T4 levels with low TSH, suggestive of thyroiditis, after negative thyroid autoantibodies ruling out Graves' disease. Further investigations including imaging and tests for PUO were negative, prompting an empirical trial of steroid therapy which resulted in rapid clinical improvement. Subsequent thyroid function tests revealed transient hypothyroidism, resolving without intervention. Retrospectively, a diagnosis of subacute thyroiditis was established, highlighting its atypical presentation as PUO. Our case sheds light on the importance of considering uncommon thyroid pathologies in the differential diagnosis of PUO, especially when typical symptoms are absent.

Forward numerical modelling of pleistocene marine strata, North-West of Morocco

Numerical stratigraphic forward modelling is useful to understand and reconstruct the relative sea-level and sediment supply history responsible for particular strata. This analysis uses BARSIM, a simple 2D forward stratigraphic process-response model that simulates wave and storm processes, applied with an inverse modelling optimisation method to better understand the history of Pleistocene strata in the Achakkar basin of the Tangier region, Morocco. Observations of grain size and bed thickness in four outcrop vertical sections are matched with BARSIM model output to estimate the lowest-error best-fit relative sea level and sediment supply histories that may have controlled deposition of the observed strata assuming deposition over a 10 ky period, consistent with available dating from outcrop sections. The best-fit relative sea level history drops from 4.88 to −2.82 m with two lower-amplitude highstands in between, most likely representing interglacial eustatic and tectonic event. The best-fit sediment supply is variable through time and different for each vertical section, with greatest variation from 11.7 to 2.11 m2y-1 over the 10 ky interval in the north-east vertical section. The spatial and temporal variation of sediment supply in the four vertical sections represents typically dynamic depositional conditions in shallow marine nearshore areas. On the other hand, it can indicate high stratigraphic incompleteness caused by periods of non-deposition or erosion with temporal variations in sediment supply. The optimum way for the simple model to reproduce short intervals of high sedimentation rate separated by longer periods of hiatus and deposition followed by erosion results in a discontinuous stratigraphic record.

Suspension stability of passion fruit nectar formulated with carboxymethyl cellulose: Analysis of sedimentation kinetics

This study evaluated the suspension stability of passion fruit nectar formulated with different concentrations of carboxymethyl cellulose (CMC). Passion fruit nectars with 0, 0.02, 0.1 and 0.2% (w/v) CMC were placed at rest in test tubes at room temperature (~25 °C) to measure the phase separation height for 87 h. Passion fruit nectars with 0 and 0.02% (w/v) CMC showed notable phase separation, while those with 0.1 and 0.2% (w/v) CMC were relatively stable suspensions. The analysis of sedimentation kinetics revealed that passion fruit nectars with 0 and 0.02% (w/v) CMC presented respectively: maximum sedimentation velocity of 0.426 m/s and 0.260 m/s, equilibrium sedimentation index of 46.494% and 20.434%, and sedimentation rate speed of 0.0362 and 0.0556%/s. A concentration of 0.2% (w/v) CMC is recommended in passion fruit nectar to maintain the appearance of a stable suspension, which is a characteristic desired by the consumer.

Human herpesvirus 6 as the underestimated causative agent of seizure disorders in febrile children

Introduction and objective: The aim of the study was to analyse the clinical symptoms and laboratory abnormalities of seizure disorders in febrile children infected with pathogens from the Herpesviridae family – human herpesvirus 6 (HHV-6), human cytomegalovirus (HCMV), and Epstein–Barr virus (EBV). Materials and methods: A total of 75 children were included in the study, including 64 patients after a febrile seizure and 11 patients after an epileptic seizure triggered by infection. The control group consisted of 36 children with developmental delay. Routine inflammatory markers were analysed including C-reactive protein (CRP), procalcitonin (PCT), erythrocyte sedimentation rate (ESR), and white blood count (WBC). Pathogens were detected using standard diagnostic methods. Results: Compared to control group, median CRP and PCT were significantly higher in children with all types of febrile seizures, and ESR was significantly higher in children with simple and complex seizures. Most children with WBC below and above the normal range were children with simple febrile seizures plus and those with complex seizures, respectively. HHV-6 was detected in 33% of children. HCMV was found in 5%, and EBV in 4% of children. There was no significant correlation between children with and without primary HHV-6 infection regarding age, gender, febrile seizures type and first-time seizures, nor significant differences in inflammatory markers except for WBC. The difference between the number of children with three-day fever and those without rash was borderline significant (p = 0.06); children with primary HHV-6 infection without rash had more frequent first-time seizures (p = 0.04). Conclusions: The clinical course of seizure disorders and the intensity of the inflammatory reaction in children were mild. HHV-6 was the most common causative agent of fever and seizure disorders.

Effect of surfactant and PAM on the settlement of kaolinite particles and its mechanism analysis

High concentrations of fine-grained clay minerals in tailings water are highly detrimental to environmental protection and water recycling. Using kaolinite as the study subject, this research investigates the effects of various cationic surfactants (DDA, DTAB, TTAB, CTAB) and flocculants (APAM, NPAM, CPAM) on the sedimentation of kaolinite particles. The study explores the impact of single agents, combined agents, and the sequence of their addition on kaolinite particle sedimentation. The results indicate that when using individual agents at low concentrations, CTAB outperforms TTAB, DTAB, and DDA, while APAM is more effective than NPAM and CPAM. The optimal performance is achieved with a CTAB concentration of 2×10&lt;sup&gt;-4&lt;/sup&gt; mol/L and an APAM dosage of 20 mg/L. When combining agents, the best results are observed when CTAB is added before APAM. By fixing the APAM dosage at 20 mg/L and varying the CTAB concentration, the highest sedimentation rate and lowest turbidity are obtained at a CTAB concentration of 1.5×10&lt;sup&gt;-4&lt;/sup&gt; mol/L. Mechanistic insights were obtained through aggregate imaging, area measurement, zeta potential testing, and contact angle testing. Cationic surfactants alter the surface properties of particles, reducing surface electronegativity and increasing hydrophobicity, which diminishes inter-particle repulsion and promotes aggregation, thereby reducing turbidity. Flocculants form larger flocs through adsorption and bridging, accelerating the sedimentation process. When flocculants and cationic surfactants are used together, the resulting flocs are more stable and larger, with an average floc area reaching 5017.6079 µm&lt;sup&gt;2&lt;/sup&gt;, indicating a significant reduction in fine particles within the solution.

Clinical outcomes of two-stage revision arthroplasty using a spiked tibial cement spacer in infected total knee arthroplasty.

A tibial cement spacer (TCS) with spikes offers better initial stability than a conventional TCS and reduces spacer-related problems in two-stage revision total knee arthroplasty (R-TKA) for infection. We compared the clinical outcomes of two-stage revision arthroplasty for infected TKA using spiked TCS with that of conventional TCS. This retrospective cohort study included 29 patients who underwent two-stage revision arthroplasty using an articulating cement spacer and who could be followed up for at least one year. Group S comprised 14 patients using spiked TCS, whereas Group C comprised 15 patients using conventional TCS. Demographic data, the interval from first to second stage revision, motion arc, numerical rating scale (NRS), Knee Society (KS) score, serum levels of erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), and frequency of repeating the first-stage and infection recurrence after R-TKA between the groups were analyzed. No significant differences were observed in the female ratio and mean age between both groups. The mean interval between the first and second stage revision was significantly shorter in Group S than in Group C. The mean motion arc was significantly larger in Group S than in Group C. The mean NRS was significantly lower in Group S than in Group C. The mean KS score in Group S was significantly higher than that in Group C. Serum ESR and CRP levels did not differ between the groups. The frequency of repeating the first stage was lower in Group S than in Group C. However, the recurrence rate after R-TKA was higher in Group S than in Group C. Compared with conventional TCS, spiked TCS shortened the period until R-TKA and improved pain and function levels. However, no significant difference existed in the rate of infection recurrence after R-TKA.

Sedimentation record of a complete glacial-interglacial cycle: Down-slope deposits, contourites and plumites of the North Sea trough mouth fan

Trough mouth fans (TMFs) are major submarine depocentres that form in front of ice streams advancing onto the continental shelf, and they provide extensive records of past glaciations and ice-sheet dynamics. However, early research about TMFs was conducted using primarily 2D seismic data, which limits the insights on the deposit's geometries and internal structures and more recent studies using 3D data have focused on the general depositional history of TMFs. Here, we assess the spatial and temporal changes of the glacio-marine landforms and deposits throughout the last glacial-interglacial cycle (Marine Isotope Stage (MIS) 6 to 1, ∼130 ka to present) recorded in a >550 m thick progradational sequence. We use 3D reflection seismic data with significant vertical resolution (up to 2 m) imaging over 14000 km2 from the uppermost North Sea Fan (NSF) to document the seismic stratigraphy and sedimentary processes, by combining horizon picking and geomorphological analyses. The studied interval comprises five mappable units, four on the slope and one on the shelf, spanning from the modern seabed down to the top of the Tampen Slide (∼130 ka). Five different channel types (here included slide scars), as well as contourite and plumite packages are described based on their seismic facies, morphology, geometry, and stratigraphical position. We propose that contour currents are responsible for sediment delivery after the Tampen Slide deposition during the interglacial period before the onset of the Last Glacial Maximum, when high meltwater influx from the shelf produced turbidites. Sedimentation became debris-flow-dominated towards the end of the period of shelf-edge glaciation. The deglacial interval is characterized by the deposition of plumites on the slope. On the shelf, subglacial tills are deposited during both glacial and deglacial periods. We calculate an average sedimentation rate of <1 m/kyr during the interglacial (MIS 5-3), and around 50–65 m/kyr during the glacial and deglacial periods (MIS2-early MIS1). Thus, we document a change of two orders of magnitude in sedimentation rate during a glacial cycle on the slope of a glaciated margin.