Female Patients Research Articles

The Dispensing Error Rate in an App-Based, Semaglutide-Supported Weight-Loss Service: A Retrospective Cohort Study

Digital weight-loss services (DWLSs) combining pharmacotherapy and health coaching have the potential to make a major contribution to the global struggle against obesity. However, the degree to which DWLSs compromise patient safety through the dispensation of Glucagon-like peptide-1 receptor agonist (GLP-1 RA) medications is unknown. This study retrospectively analysed the rate at which patients reported GLP-1 RA dispensing errors from patient-selected and partner pharmacies of Australia’s largest DWLS provider over a six-month period. The analysis found that 99 (0.35%) of the 28,165 dispensed semaglutide orders contained an error. Incorrect dose (58.6%) and unreasonable medication expiry window (21.2%) were the two most common error types. Most errors (84.9%) were deemed to have been of medium urgency, with 11.1% being considered high-urgency errors. Incorrect doses (45.5%) and supplies of the wrong medication (36.3%) comprised most errors reported in high-urgency cases. Female patients reported more dispensing errors than male patients (0.41% vs. 0.12%, p < 0.001). Similarly, reported dispensing error rates were highest among patients aged 18 to 29 years (0.6%) and 30 to 39 years (0.5%). This research provides preliminary evidence that GLP-1 RA dispensing errors within comprehensive Australian DWLSs are relatively low.

Incidence of and predictive factors for lung cancer in patients with rheumatoid arthritis: A retrospective long-term follow-up study.

To determine the incidence and predictive factors of lung cancer in rheumatoid arthritis (RA). We conducted a retrospective follow-up study of patients who were diagnosed with RA at our institution between April 2001 and December 2022. Pulmonary complications were evaluated using high-resolution computed tomography at RA diagnosis. Patients were followed until the diagnosis of lung cancer, diagnosis of other malignancies, death, loss to follow-up, or the end of the study. Among 771 RA patients, 3.5% were diagnosed with combined pulmonary fibrosis and emphysema (CPFE), 4.9% with interstitial lung disease (ILD) alone, and 6.0% with emphysema alone. During follow-up (mean of 9.3 years), the crude incidence rates of lung cancer per 1,000 patient-years were 2.9 in all patients, 47.8 in CPFE patients, 10.5 in ILD patients, 11.9 in emphysema patients, and 0.8 in patients without these complications. The standardized incidence ratios (95% confidence intervals [CI]) compared with the general population were 2.53 (1.29-3.77) for male patients and 0.89 (0.57-1.16) for female patients. In Fine-Gray regression analysis, adjusted hazard ratios (95% CI) of lung cancer were 13.48 (3.14-57.85) for CPFE, 6.42 (1.42-29.09) for ILD alone, and 4.65 (1.18-18.30) for emphysema alone versus without these complications, and 1.02 (1.01-1.04) per additional 1 pack-year for smoking history. These factors were not associated with the risk of other malignancies. Close monitoring of lung cancer is needed for RA patients with smoking history and pulmonary complications, especially CPFE.

A large vertebral artery fenestration involving the distal segments associated with bilateral duplication of the superior cerebellar artery: a case report.

The aim of our study is to report a case of a large fenestrated vertebral artery (FVA) and bilateral duplication of the superior cerebellar artery (SCA) incidentally diagnosed using Computed Tomography Angiography (CTA) and Digital Subtraction Angiography (DSA). A 63-year-old female patient presenting to the neurology clinic with complaints of dizziness and balance disorder. CTA and DSA revealed a large FVA involving the V3 and V4 segments. Additionally, we observed bilateral duplicated SCAs originating from the distal basilar artery. FVA is a rare anomaly resulting from fusion failure during the embryological period, with a reported incidence of 0.1%. FVA is often (70%) detected in the extracranial region, but it can also occur intracranially at a frequency of approximately 30%. Although various nomenclatures are used in the literature, we identified only two reports of a single fenestration encompassing the V3 and V4 segments, i.e., involving both the extracranial and intracranial regions. While duplication of the SCA is relatively common, bilateral duplication of SCA occurs at a rate of 0.9-5%. This case report describes an unusual case of VA fenestration involving both extracranial and intracranial segments, along with bilateral duplication of the SCAs. While rare, these findings highlight the importance of recognizing such vascular anomalies, which could be relevant for planning surgical or endovascular procedures in the posterior circulation.

Suprasellar teratoma to germinoma recurrence: implications for diagnosis and follow-up.

Mature teratoma is a subtype of intracranial germ cell tumors (GCTs), distinguished from malignant GCTs by its benign nature and excellent prognosis. Typically, no adjuvant therapy is recommended following gross total resection (GTR). We report a case of a prepubertal girl with a suprasellar mature teratoma that recurred as a germinoma 6 months post-GTR. A 7-year-old girl presented with headache and polydipsia. Imaging revealed a suprasellar mass. The patient underwent GTR, and pathological diagnosis confirmed a mature teratoma without other GCT components. Six months later, MRI identified a newly developed suprasellar mass adjacent to the optic chiasm. A second surgery confirmed the mass as a germinoma. The patient subsequently underwent adjuvant chemotherapy combined with proton therapy, resulting in complete remission. The diagnosis of mature teratoma must be approached with caution, and thorough follow-up is imperative, particularly in cases involving female patients, prepubertal age, or non-pineal locations.

Sex differences in the association between chest computed tomography-defined sarcopenia and cardiovascular risk factors among inpatients.

While sarcopenia has been found to be associated with increased risks of cardiovascular diseases (CVDs), evidence exploring sex-related differences remains insufficient. This study aimed to investigate the differences in how often sarcopenia occurs in each sex, as determined by skeletal muscle area (SMA) in chest CT images, and its association with CVD common risk factors. This cross-sectional study involved 1,340 inpatients from the Department of Geriatrics of Renji Hospital, affiliated to Shanghai Jiaotong University School of Medicine. Data on age, sex, body mass index (BMI), smoking status, disease history, and clinical parameters were collected. Sarcopenia was defined using chest CT images with a cut-off value of T12-SMA/height2 <25.75 cm2/m2 in male patients and <20.16 cm2/m2 in female patients. Cardiovascular risk was assessed using the Framingham risk score (FRS). The association between T12-SMA/height2-defined sarcopenia and CVD risk factors by sex was evaluated using a multivariate logistic regression analysis. The overall prevalence of T12-SMA/height2-defined sarcopenia (<25.75 cm2/m2 for male patients, <20.16 cm2/m2 for female patients) was 54.03%, with 48.09% in male patients and 63.19% in female patients. The proportion of male patients with high CVD risk was greater than that of female patients. The multivariate analysis revealed that T12-SMA/height2-defined sarcopenia was independently associated with age (in male patients only), systolic blood pressure (SBP), cholesterol, and high-density lipoprotein cholesterol (HDL-C) among the six FRS cardiovascular risk indices. Our results suggest that T12-SMA/height2-defined sarcopenia was more prevalent in male patients than in female patients. Sarcopenia was associated with higher levels of SBP and HDL-C and lower levels of cholesterol. Increasing age had a more significant effect on CVD risk in male patients.

Evaluation of contraception methods in chronic myeloid leukemia patients: A Turkish multicenter study.

Chronic myeloid leukemia (CML) incidence has recently increased in younger individuals. With time, given the nature of the disease and available therapies, as well as the existing paucity and inconsistency of advice, worries about fertility have surfaced. With all these clear unknowns, we designed this study to raise awareness among both physicians and CML patients about whether male and female patients of childbearing age were using contraception at the time of diagnosis, and if so, which methods they were using. In this context, this study aimed to evaluate the contraception methods in patients with CML. Eighteen centres from Turkey participated in the study. Male and female patients of childbearing age diagnosed with chronic and accelerated phase CML between the years 2000 and 2024 were evaluated retrospectively. Of the two hundred and thirty-two patients included, one hundred and twenty-five (53.9%) of these patients were female and 107 (46.1%) were male. At diagnosis, all female patients were in the childbearing age, and male patients were sexually active. The median age at diagnosis of the patients was 38 (range, 18-77) years. Eighty-six (68.8%) female patients were using any contraception method, while this was 53.2% (n = 57) among male patients. In conclusion, since CML patients are diagnosed at an earlier age and the desire of these patients to have children, adequate information and evaluation should be provided regarding fertility and contraception issues, especially in female patients, from the moment of diagnosis.

The association of sex differences in ambulatory blood pressure with cardiovascular events and mortality in dialysis patients.

Male patients with pre-dialysis chronickidneydisease(CKD) have worse ambulatory blood pressure(BP) control than females; this is associated with higher mortality. Male hemodialysis patients have higher ambulatoryBP levels than females. This analysis aimed to investigate the association of sex differences in ambulatory BP with cardiovascular events and mortality in hemodialysis individuals. 129 male and 91 female hemodialysis patients with valid 48-h BP monitoring were followed for 53.4 ± 31.1 months. The primary endpoint was cardiovascular mortality; the secondary endpointwas a composite of cardiovascular death, non-fatal myocardialinfarction, non-fatal stroke, resuscitation after cardiacarrest, heartfailure-hospitalization, coronary or peripheral revascularization. Cumulativefreedom from the primary endpoint was lower for women (logrank-p = 0.032), while cumulative-freedom from the secondary endpoint did not differ significantly between-groups (logrank-p = 0.644). The crude risk for cardiovascular mortality was significantly higher in women (HR = 1.613, 95% CI[1.037, 2.509]). The crude risk for the combined endpoint was not different between the two groups (HR = 0.918, 95% CI[0.638, 1.320]). After adjusting for major risk factors (age, diabetes, dialysis vintage, coronary disease and hemoglobin) no significant differences in the risk for both the primary and the secondary endpoint were observed between women and men (primary: HR = 1.295 (95% CI[0.808, 2.078]), secondary: HR = 0.763 (95% CI[0.521, 1.118])). After additional adjustment for 44-h systolicBP the above relationships did not alter (primary: HR = 1.329 (95% CI [0.826, 2.137]), secondary: HR = 0.808 (95% CI [0.551, 1.184])). In conclusion, female hemodialysis patients have higher crude but similar adjusted cardiovascular mortality rates compared to male counterparts. In contrast to pre-dialysis CKD, the neutral relationship between gender and adverse cardiovascular outcomes in hemodialysis is not further affected by ambulatory BP.

Generalized Seizure Masquerading the Cause of Coma

Background: Diagnosis is traditionally made by taking a medical history and performing a medical examination. These have become less useful in contemporary emergency and critical care medicine.  Objective: The objective was to show the importance of obtaining the medical history and re-evaluating it in medical emergencies for diagnosis and management.  Methods and Materials: In our instance, a female patient, age 22, was taken to the emergency room by her parents when she was unconscious and exhibiting tonic posture in all limbs. Due to our insufficient medical history, we ended up doing unnecessary and expensive investigations. The re- evaluation of the patient played a crucial role in diagnosis and management.  Results: The patient's re-evaluation to obtain a proper medical history revealed the actual cause of unconsciousness in our case, which led to proper management.  Conclusion: Our case showed the importance of obtaining a medical history in a medical emergency.  Key message: In cases of unconsciousness or other medical emergencies, taking a proper medical history and conducting a clinical examination are crucial. A re- evaluation of the patient helps in taking a proper medical history. It helps in proper diagnosis and management.

Perception and Role of Indirect and Post-Discharge Surveillance in Predicting Surgical Site Infection in Surgical Patients: An Institutional Experience

Abstract Background: Surgical site infection (SSI) surveillance is a process of observing and reporting of infections following surgery. SSI surveillance studies are few in our country. Objectives: Present study was conducted to know the perception and role of SSI surveillance. Incidence of surgical site infection, identification of risk factors and bacterial spectrum of surgical wounds during surveillance were also studied. Methods: Patients who underwent a surgical procedure between July 2022 and June 2023 at our hospital were included. A prospective incidence surveillance for SSI was done to look for any signs of infection and record them in the surveillance form. Wound swabs or pus aspirates were sent for microbiological culture. Results: A total of 2312 patients underwent surgery during the study period, of whom 61 patients were diagnosed with SSI. The incidence of SSI was 2.6%. SSI was encountered more in female patients (57.3%). Age distribution had a significant association with SSI (P = 0.025). Most operative wounds were clean-contaminated (45.9%). Most SSIs were superficial (91.8%), followed by deep (8.2%). Most patients who developed SSI had a National Nosocomial Infection Surveillance (NNIS) patient risk index of 2 (45.9%). Bacterial growth was observed in 45.9% of cases. Multidrug resistance (MDR) among these isolates was 42.6%. Conclusion: This study helped to determine predictors of SSI like duration of surgery, type of wound, duration of hospital stays, and NNIS risk index. MDR isolates are now contributing to SSI. The perception of healthcare workers about SSI surveillance was that it was feasible to use and practice. Surveillance helped clinicians to strengthen the existing infection prevention and control practices for the future.

High-Output Heart Failure Secondary to Post-Traumatic Arteriovenous Fistula

Introduction: Arteriovenous fistulas are abnormal connections between the arterial and venous systems that bypass normal anatomical capillary beds. Any device, implement, or projectile that passes through an artery and vein has the potential to lead to one, thereby preventing normal blood flow through the capillary bed. Late complications of untreated arteriovenous fistulas include proximal arterial dilation, venous congestion, congestive heart failure, and distal ischemia. Objective: Describe the clinical manifestations, diagnostic, therapeutic, prognostic complexities and complications present in post-traumatic arteriovenous fistula and its association with heart failure. Material and methods: Retrospective study presentation of a clinical case. Results: The case of a 55-year-old female patient is presented, with a 2-year history of ischemic heart disease and a gunshot wound 20 years ago. Who was admitted for bypass and coronary angiography + cardiac angiography in whom no etiology of his dilated ischemic heart disease was found until Doppler ultrasound and tomography angiography was performed due to recurrence of pain in the lower limbs and changes in skin color, which revealed presence of arteriovenous fistula. The same one that was resolved with distal ligation of the popliteal vein + exclusion of aneurysm. Conclusions: Risk factors for the development of this pathology are difficult to establish. Therefore, the shotgun trauma to the left leg 20 years ago, in addition to her obesity and female sex, led to the formation of an arteriovenous fistula that would gradually produce high-grade heart failure. Endovascular AVF repair is a treatment alternative for those patients considered high risk from anesthesia, those who have a hostile groin due to excessive scar tissue, or who cannot tolerate the consequences of bleeding that can occur with surgical control. of the FAV.

Unmasking the Face of a Rare Disease – Progressive Nodular Histiocytosis

Abstract Non-Langerhans cell histiocytoses (NLCHs) are a complex group of disorders which can be difficult to diagnose due to their confounding clinical and microscopic features. Progressive nodular histiocytosis (PNH) is a rare subtype of NLCH characterized by benign, xanthogranulomatous lesions on the skin and mucous membranes. Clinical features of PNH involve the gradual emergence of multiple yellow-brown papules and nodules, with histological examination demonstrating the presence of foamy tissue macrophages, spindle-shaped cells within a fibrocollagenous matrix, and Touton cells. We present a rare case of a 55-year-old female patient with progressively increasing facial nodules, where clinical, histopathological, and immunohistochemical findings clinched the diagnosis of PNH.

Stevens-Johnson Syndrome/Toxic epidermal necrolysis complicated with fulminant type 1 diabetes mellitus: a case report and literature review

BackgroundStevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare but life-threatening skin lesion triggered by hypersensitive drug reaction. They are characterized by extensive epidermal necrosis and skin exfoliation. Fulminant type 1 diabetes mellitus (FT1DM) is featured by a rapid-onset of hyperglycemia with ketoacidosis due to severely destroyed β-cell function. Fulminant type 1 diabetes mellitus as a sequela of SJS/TEN has rarely been reported.Case presentationWe present a 73-year-old female patient who developed SJS/TEN skin allergic reaction after taking carbamazepine and phenytoin for 35 days. Then, hyperglycemia and diabetic ketoacidosis occurred 20 days after discontinuation of antiepileptic drugs. A very low serum C-peptide level (8.79 pmol/l) and a near-normal glycosylated hemoglobin level met the diagnostic criteria for fulminant T1DM. Intravenous immunoglobulin (IVIG) and insulin were promptly administered, and the patient recovered finally.ConclusionsThis rare case indicates that monitoring blood glucose is necessary in SJS/TEN drug reaction, and comprehensive therapy with rehydration, insulin, antibiotics, and IVIG may improve the prognosis.

Successful Management of Waja’al-Rukba (Knee Osteoarthritis) with Unani Pharmacopeial Poultice: A Case Study

Knee osteoarthritis (Knee OA) is the most common Musculoskeletal disorder, which causes functional disability thus, increasing the economic burden in society. In Unani medicine knee Osteoarthritis is treated with various regimens and drugs. Among these regimens, Dimād (Poultice) is prepared with several single Unani pharmacopeial drugs that exert anti-inflammatory, analgesic and anti-arthritic actions. Keeping this in mind a case study was conducted to assess the efficacy of Dimād-i-jalinus a pharmacopeial Unani formulation in the management of Knee OA. A 63-year-old female patient with chief complaints of pain and swelling in the left knee joint, joint stiffness and mild tenderness feeling severe pain while performing daily activity for the last 6 months was treated at OPD of Hakim Syed Ziaul Hasan Govt. (Auto) Unani Medical College &amp; Hospital, Bhopal. Dimād-i-jalinus was given to the patient, in paste form and the patient was explained to use this paste over the anterior surface of the Left knee joint and the bandage was wrapped to keep the medicines in place overnight every day for 14 days. The patient was assessed at baseline, 7th day and 14th day based on changes in subjective and objective parameters with the help of Visual Analogue Scale (VAS) and Western Ontario and McMaster Universities Arthritis Index (WOMAC). The present study reveals that Dimād-i-jalinus is safe and effective in treating Knee OA without any side effects. Therefore, further randomized clinical studies need to be carried out to validate the effectiveness of Dimād-i-jalinus in the management of Knee OA.

Investigating the Relationship Between Serum Thyroid Hormone and Vitamin D Levels in Women with Melasma

Patches and macules of hyperpigmentation characterize melasma, a prevalent condition of skin pigmentation. Known risk factors for melasma include a genetic predisposition, sun exposure, and pregnancy. Melasma may have a connection to thyroid issues, according to previous research. Considering that vitamin D influences and promotes melanocytes' melanin formation, this study sought to examine the correlation between thyroid problems, blood vitamin D levels, and melasma in female patients seen at Al-Mahmoudiya Hospital. Both Wood's light investigation and clinical evaluation by seasoned dermatologists verified the melasma diagnosis. There were 80 participants in total, with 40 assigned to the melasma group and 40 to the control group. Their ages and sexes were matched. In all groups, blood samples were taken to assess levels of TSH, Anti-TPO, T3, T4, and vitamin D. Melasma patients' clinical pigmentation severity was assessed using the standard mMASI score. I used SPSS (IBM Statistical Package for the Social Sciences) version 21 to conduct the statistical analysis. Melasma patients were more likely to have thyroid problems (50%) and lower vitamin D serum levels (47.5%), compared to the control group (27.5%) and healthy individuals (40%). The levels of thyroid hormone (T3) and vitamin D were found to be considerably higher in the case group as compared to the control group (P&lt;0.05). A relationship was found between Anti-TPO and mMASI Score (P&lt; 0.05) when the relationship between age, thyroid hormones, vitamin D, and mMASI Score was investigated. Melasma and pigmentation intensity are linked to thyroid autoimmune diseases. The most prevalent clinical form of melasma is the centro facial variant as well.

Mosaic chromosomal alterations in hematopoietic cells and clinical outcomes in patients with multiple myeloma.

Mosaic chromosomal alterations (mCAs) in hematopoietic cells increase mortality and risk of hematological cancers and infections. We investigated the landscape of mCAs and their clinical consequences in 976 patients with multiple myeloma undergoing high-dose chemotherapy and autologous stem cell support (ASCT) with median 6.4 years of follow-up. mCAs were detected in the stem cell harvest product of 158 patients (16.2%). Autosomal aberrations were found in 60 patients (6.1%) and affected all chromosomes. Loss of chromosome X was found in 51 females (12.7%) and loss of chromosome Y in 55 males (9.6%). Overall survival and progression were similar between carriers of autosomal mCAs and non-carriers. In contrast, female patients with loss of the X chromosome had longer overall survival (age-adjusted[a.a.] HR 0.54, 95% CI 0.32-0.93, p = 0.02), lower risk of progression (a.a. HR 0.55, 95% CI 0.35-0.87; p = 0.01), and better post-transplant response (higher degree of complete response (CR) or very good partial response (VGPR)). The reason for this substantial effect is unknown. Additionally, myeloma clones in the stem cell product was confirmed by mCA analysis in the few patients with multiple mCAs (n = 12 patients). Multiple mCAs conferred inferior overall survival (a.a. HR 2.0, 95% CI 1.02-3.84; p = 0.04) and higher risk of myeloma progression (a.a. HR 3.36, 95% CI 1.67-6.81; p < 0.001), which is presumed to be driven by suspected myeloma contaminants.

Evaluation of whether commonly used risk assessment tools are applicable to women in forensic psychiatric institutions

ObjectiveBy providing a structured assessment of specific risk factors, risk assessment tools allow statements to be made about the likelihood of future recidivism in people who have committed a crime. These tools were originally developed for and primarily tested in men and are mainly based on the usual criminological background of men. Despite significant progress in the last decade, there is still a lack of empirical research on female offenders, especially female forensic psychiatric inpatients. To improve prognosis in female offenders, we performed a retrospective study to compare the predictive quality of the following risk assessment tools: PCL-R, LSI-R, HCR-20 v3, FAM, and VRAG-R. MethodData were collected from the information available in the medical files of 525 female patients who had been discharged between 2001 and 2017. We examined the ability of the tools to predict general and violent recidivism by comparing the predictions with information from the Federal Central Criminal Register. ResultsOverall, the prediction instruments had moderate to good predictive performance, and the study confirmed their general applicability to female forensic psychiatric patients. ConclusionThe LSI-R proved to be particularly valid for general recidivism, and both, LSI-R and HCR-20 v3, for violent recidivism.

A nomogram model for early recurrence of HBV-related hepatocellular carcinomas after radical hepatectomy.

To identify the risk factors and construct a predictive model for early recurrence of hepatitis B virus(HBV-)- related hepatocellular carcinomas(HCCs) after radical resection. A total of 465 HBV-related HCC patients underwent radical resections between January 1, 2012 and August 31, 2018.Their data were collected through the inpatient information management system of the First Affiliated Hospital of University of Science and Technology of China. Survival and subgroup analyses of early recurrence among male and female patients were performed using Kaplan-Meier curves. The independent risk factors associated with early postoperative tumor recurrence were analyzed using multivariate Cox proportional hazards regression model. Based on these independent risk factors, a risk function model for early recurrence was fitted, and a column chart for the prediction model was drawn for internal and external validation. A total of 181 patients developed early recurrences, including 156 males and 25 females. There was no difference in the early recurrence rates between males and females. Tumor diameters>5cm, microvascular invasion and albumin level<35 g/L were independent risk factors for early recurrence. A nomogram for the early recurrence prediction model was drawn; the areas under the curve for the model and for external verification were 0.638 and 0.655, respectively. Tumor diameter>5 cm, microvascular invasion, and albumin level<35 g/L were independent risk factors for early recurrence. The prediction model based on three clinical indicators could predict early recurrence, with good discrimination, calibration, and extrapolation.

Chest CT Airway and Vascular Measurements in Females with COPD or Long-COVID

Chest CT provides a way to quantify pulmonary airway and vascular tree measurements. In patients with COPD, CT airway measurement differences in females are concomitant with worse quality-of-life and other outcomes. CT total airway count (TAC), airway lumen area (LA), and wall thickness (WT) also differ in females with long-COVID. Our objective was to evaluate CT airway and pulmonary vascular and quality-of-life measurements in females with COPD as compared to ex-smokers and patients with long-COVID. Chest CT was acquired 3-months post-COVID-19 infection in females with long-COVID for comparison with the same inspiratory CT in female ex-smokers and COPD patients. TAC, LA, WT, and pulmonary vascular measurements were quantified. Linear regression models were adjusted for confounders including age, height, body-mass-index, lung volume, pack-years and asthma diagnosis. Twenty-one females (53 ± 14 years) with long-COVID, 17 female ex-smokers (69 ± 9 years) and 13 female COPD (67 ± 6 years) patients were evaluated. In the absence of differences in quality-of-life scores, females with long-COVID reported significantly different LA (p = 0.006) compared to ex-smokers but not COPD (p = 0.7); WT% was also different compared to COPD (p = 0.009) but not ex-smokers (p = 0.5). In addition, there was significantly greater pulmonary small vessel volume (BV5) in long-COVID as compared to female ex-smokers (p = 0.045) and COPD (p = 0.003) patients and different large (BV10) vessel volume as compared to COPD (p = 0.03). In females with long-COVID and highly abnormal quality-of-life scores, there was CT evidence of airway remodelling, similar to ex-smokers and patients with COPD, but there was no evidence of pulmonary vascular remodelling.Clinical Trial Registration: www.clinicaltrials.gov NCT05014516 and NCT02279329

Renin and CYP P450 gene variations significantly associated with essential hypertension: A prospective pharmacogenomics study

ObjectiveThis study aims to investigate the association between Renin-angiotensin aldosterone system (RAAS) and Cytochrome P450 gene polymorphisms in hypertension patients of the South Indian population using pharmacogenomics profile. MethodsHypertension cases (N = 147) and control subjects (n = 150) were collected from Tamil Nadu, India. A case-control association study was conducted to assess the involvement of RAAS gene polymorphisms (REN rs397514691, REN rs544315427, REN rs567667202) and CYP gene polymorphisms (CYP2D6 rs754164689, CYP2D6 rs1058172, CYP3A4 rs765598920) in essential hypertensive patients. Genotyping was performed using the PCR-RFLP method, and significant results were validated through RT-PCR analysis. ResultsThe genotype and allele distribution of REN rs397514691 and rs544315427 variants significantly associated with hypertensive patients (Variant Allele Frequency (VAF) = 0.11; VAF = 0.27, respectively). CYP2D6 polymorphisms rs754164689 and rs1058172 variant alleles were significantly associated with female hypertensive patients, suggesting a potential risk allele for essential hypertension in the South Indian population. REN and CYP3A4 variants, highly connected in pharmacology action, were validated through RT-PCR amplification studies, providing new insights into their role in the development of hypertension. Association confirmation was achieved through multifactor dimensionality reduction analysis. ConclusionThe genes associated with specific variants, particularly REN and CYP2D6, may serve as potential markers for the early diagnosis of hypertension and as new drug targets, particularly in the female population.

Inflammation and Vitamin D Receptor Polymorphism: Impact on All-Cause and Cardiovascular Mortality in Mexican Women on Dialysis

Mineral bone disease (MBD) is common in dialysis patients. Genetics and the hormonal environment influence the clinical picture and outcomes of women. This study aimed to determine how these factors affect mortality. In 234 female dialysis patients on Continuous Ambulatory (48%) or Automated (29%) Peritoneal Dialysis or Hemodialysis (23%), MBD biochemical variables, as well as bone density and genetic Bsm1 polymorphism of vitamin D receptor (VDR) were performed at baseline. The cohort was followed-up by 17 (IQ range 15–31) months. According to VDR polymorphism, the distribution of patients was bb: 64% and BB+Bb: 36%. Fifty-five patients died from all-cause mortality; the hs-C-reactive protein level was the most significant risk in multivariate Cox analysis. Nineteen died from cardiovascular mortality. None of the variables were significant for cardiovascular mortality. Patients with bb plus inflammation had the highest risk in the analysis; the significance persisted after adjustment for age, diabetes, and parathyroid hormone levels HR 2.33 (95% CI, 1.01–8.33) and after further adjustment for time on dialysis, albumin, and Osteoprotegerin levels HR 3.49 (95% CI, 1.20–10.9). The presence of the bb genotype from VDR and inflammation had the highest risk of death from all-cause mortality in females on CAPD, APD, and HD patient.