Frequency Of Attacks Research Articles

The effectiveness of intratympanic injections with methylPREDnisolon versus placebo in the treatment of vertigo attacks in MENière’s disease (PREDMEN trial): a study protocol for a phase-3 multicentre, double-blinded, randomised, placebo-controlled trial

IntroductionIntratympanic corticosteroids are commonly used in the treatment of Menière’s disease (MD). However, few and small randomised controlled trials (RCT) on the effectiveness of intratympanic corticosteroids have been performed. A...

Hyperechoic Spots in the Renal Medulla as a Potential Indicator of Early Gouty Nephropathy

Introduction: The aim of the study was to explore the causes and clinical significance of hyperechoic renal medulla observed by ultrasonography in patients with primary gout. Methods: This study included 2,107 patients with primary gout treated in the Gout Clinic of our hospital from 2016 to 2022. The clinical data and biochemical data of these patients were collected and analyzed. According to the presence or absence of punctate hyperechogenicity in the renal medulla on ultrasound examination, the patients were divided into the hyperechoic medulla (HM) and the normal hypoechoic medulla (NM) groups, and the HM group was further divided into the partial HM (P-HM) and fulfilled HM (F-HM) subgroups according to the distribution range of hyperechogenicity. Results: Among the 2,107 patients with primary gout, 380 had hyperechoic renal medulla on renal ultrasound, including 106 patients with F-HM and 274 with P-HM. There were significant differences in the gout duration, urate arthropathy number, serum urate (SU) level, clinical tophi number, blood urea nitrogen, serum creatinine (sCr), and estimated glomerular filtration rate between the HM and NM groups or between the F-HM and P-HM subgroups (p < 0.05). Multivariate regression analysis showed that the presence of HM was positively correlated with gout duration, urate arthropathy number, gout attack frequency, SU, and sCr. The number of clinical tophi and sCr were closely related to F-HM. Conclusion: Ultrasound examination showed that a high medulla echo in patients with gout was often related to renal function damage. P-HM may be a transitory condition between NM and F-HM in patients with gout.

Research on Personal Information Security and Privacy Issues in the Network Environment

In today s digital age, we face the grave challenges of personal information security. Frequent hacker attacks, data breaches, social engineering, and illegal information trading pose serious threats to user privacy. By comprehensively applying encryption technology, access control, data desensitization, combined with improved laws and regulations and enhanced user security awareness, these challenges can be effectively addressed, which means, personal privacy can be protected, and a secure and trustworthy network environment can be built.

Occipital nerve stimulation for cluster headache: lessons to learn from the ‘voltage tuners’

BackgroundCluster headache (CH) is a significant health concern due to its major socioeconomic consequences and most patients being refractory to conventional strategies. For treatment resistant CH, occipital nerve stimulation (ONS) is considered an effective treatment option. Whereas most patients do not adjust the amplitude of the ONS system, a subset changes the amplitude on a regular basis using their remote control, and are therefore referred to as ‘voltage tuners’. Anxiety and self-control are thought to be central themes to this behavior. Research on this voltage tuning behavior could provide new insights in the use of ONS as acute attack treatment. To date, voltage tuning has not been assessed for CH. Hence this is a unique study aiming to investigate the occurrence and efficacy of voltage tuning in patients with CH and ONS.MethodsFor this analysis, patients with CH who received ONS from 2020–2024, at our university medical center, were included. All patients underwent bilateral ONS implantation. Data on attack frequency, intensity and duration were collected retrospectively. Outcomes on the response, frequency, moment during the day, duration, rationale, sensation, average increase in amplitude, and efficacy of voltage tuning were collected with prospective interviews.ResultsThirty-three patients (M = 20) (42 ± 12.7 years) were included in the current analysis. At 1y follow-up, an overall response rate of 70% (23/33) was found for ONS. In total, 48% (18/33) of patients were defined as voltage tuners. Voltage tuning was performed with an average increase in amplitude of 92 (20–360)%, a frequency of 1–20 times/month and duration of 20 minutes-48 hours. Sensations of voltage tuning were described as “tingling” and/or “pinching”. The rationale for voltage tuning in patients varied from prevention and ceasing to lowering the intensity and enhance control of CH attack.ConclusionsOutcomes show that voltage tuning may cease and/or terminate CH attacks and therefore raise interests in the use of ONS as acute attack treatment for patients with resistant CH treated with ONS. Future research on the occurrence and potential of voltage tuning will provide valuable insights for achieving optimal efficacy of ONS and quality of life in patients with CH.

Treating severe paediatric asthma with mepolizumab or omalizumab: a protocol for the TREAT randomised non-inferiority trial

IntroductionA minority of school-aged children with asthma have persistent poor control and experience frequent asthma attacks despite maximal prescribed maintenance therapy. These children have higher morbidity and risk of death....

Large-scale IoT attack detection scheme based on LightGBM and feature selection using an improved salp swarm algorithm

Due to the swift advancement of the Internet of Things (IoT), there has been a significant surge in the quantity of interconnected IoT devices that send and exchange vital data across the network. Nevertheless, the frequency of attacks on the Internet of Things is steadily rising, posing a persistent risk to the security and privacy of IoT data. Therefore, it is crucial to develop a highly efficient method for detecting cyber threats on the Internet of Things. Nevertheless, several current network attack detection schemes encounter issues such as insufficient detection accuracy, the curse of dimensionality due to excessively high data dimensions, and the sluggish efficiency of complex models. Employing metaheuristic algorithms for feature selection in network data represents an effective strategy among the myriad of solutions. This study introduces a more comprehensive metaheuristic algorithm called GQBWSSA, which is an enhanced version of the Salp Swarm Algorithm with several strategy improvements. Utilizing this algorithm, a threshold voting-based feature selection framework is designed to obtain an optimized set of features. This procedure efficiently decreases the number of dimensions in the data, hence preventing the negative effects of having a high number of dimensions and effectively extracting the most significant and crucial information. Subsequently, the extracted feature data is combined with the LightGBM algorithm to form a lightweight and efficient ensemble learning scheme for IoT attack detection. The proposed enhanced metaheuristic algorithm has superior performance in feature selection compared to the recent metaheuristic algorithms, as evidenced by the experimental evaluation conducted using the NSLKDD and CICIoT2023 datasets. Compared to current popular ensemble learning solutions, the proposed overall solution exhibits excellent performance on multiple key indicators, including accuracy, precision, as well as training and detection time. Especially on the large-scale dataset CICIoT2023, the proposed scheme achieves an accuracy rate of 99.70% in binary classification and 99.41% in multi classification.

Acute intermittent porphyria: a disease with low penetrance and high heterogeneity.

Acute intermittent porphyria (AIP) is caused by mutations in the gene encoding hydroxymethylbilane synthase (HMBS), a key enzyme in the heme biosynthesis pathway. AIP is an autosomal dominant disorder characterized by low penetrance and a highly heterogenous clinical presentation. The estimated prevalence of AIP is 5-10 cases per 100,000 persons, with acute attacks manifesting in less than 1% of the at-risk population. This low frequency of attacks suggests significant roles for oligogenic inheritance and environmental factors in the pathogenesis of the disease. In recent years, identification of several modifier genes has advanced our understanding of the factors influencing AIP penetrance and disease severity. This review summarizes these factors including the impact of specific HMBS mutations, oligogenic inheritance, mitochondrial DNA copy number, age, sex, the influence of sex hormones, and the role of environmental factors. Further studies into the etiology of AIP disease penetrance should inform pathogenesis, potentially allowing for the development of more precise diagnostic and therapeutic approaches.

Altered functional connectivity of parietal opercular 2 in patients with vestibular migraine: a resting-state fMRI study

Objective: To investigate the differences in resting-state functional connectivity (FC) between patients with vestibular migraine (VM) and migraine without aura (MwoA) in order to infer the possible neuroimaging mechanisms of VM. Methods: Thirty VM patients admitted to the Department of Neurology of the Second Affiliated Hospital of Xuzhou Medical University from December 2019 to December 2022 were selected as the experimental group (EG) (6 males and 24 females, with mean age of 38.3 years) and 26 MwoA patients as the control group (7 males and 19 females, mean age 35.5 years). General demographic and clinical data such as gender, age, year of education, course of disease and frequency of attacks were collected for all the patients, as well as data of Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD), Montreal Cognitive Assessment (MoCA), headache Visual Arialogue Scale (VAS), Headache Impact Test 6 (HIT-6) and Migraine Disability Assessment Questionnaire (MIDAS). VM patients were also assessed by Dizziness Handicap Inventory (DHI), dizziness VAS and Vestibular Disorders Activities of Daily Living (VADL) scales. All patients underwent resting-sate functional Magnetic Resonance Imaging (fMRI) scans. Bilateral parietal opercular cortex 2 (OP2) and primary visual cortex (V1) were used as regions of interests (ROIs). Differences in FC between ROIs and other brain regions were calculated between the two groups. In view of the brain regions with significant differences, z-values of FC were extracted for each subject in the EG, and Pearson partial correlation analysis was conducted between z-values of FC and clinical characteristics of patients, P<0.05 was considered to have significant correlation. SPSS 22.0 was used for statistical analysis. Results: There was no significant difference in gender, age, years of education, course of disease, frequency of attack and scores of MoCA, HAMA and HAMD between the two groups (P>0.05). Headache VAS, HIT-6 and MIDAS scores in VM patients were significantly lower than those in MwoA patients (P<0.05). Compared with MwoA patients, the FC between left OP2 and bilateral precuneus and left thalamus was significantly increased in VM patients, and the FC between right OP2 and left thalamus and right anterior cingulate gyrus were significantly increased (P<0.05, False Discovery Rate correction). Correlation analysis showed that the FC between left OP2 and left precuneus was positively correlated with DHI score in VM patients (P=0.007, r=0.480), and the FC between right OP2 and left thalamus was positively correlated with the disease course in VM patients (P=0.015, r=0.439). Conclusions: The pathogenesis of VM may be related to the altered FC of vestibular, pain and visual-motor networks, abnormalities of these neural pathways may be important imaging biomarkers of VM pathogenesis.

The Quality of Life in Patients with Familial Mediterranean Fever and Their Parents Perception.

Familial Mediterranean fever (FMF) is a chronic disease characterized by recurrent episodes of fever and polyserositis. This study aimed to assess children's quality of life (QoL), as reported by children and their parents, and to compare the results according to clinical variables. The study examined 107 children with FMF, evaluating their demographic and genetic data, utilizing the Pediatric Quality of Life Inventory (PedsQL) to assess QoL, and comparing scores based on disease severity. The severity of FMF is inversely correlated with QoL scores, with mild cases having the highest scores (97±4), followed by moderate (76±11) and severe cases (52±10.3) (p<0,001). Disease severity, treatment adherence, healthcare utilization, genetic mutations, family income, and maternal age at birth all significantly impact perceived quality of life in FMF patients (p<0,001). Additionally, parents reported lower QoL for children with FMF who experienced various adverse factors such as low family income, household smoking, frequent attacks, hospitalizations, irregular medication use, and low maternal education levels (p<0,001). Children's daily activities, academic performance, and family functioning are all significantly impacted by FMF. Physicians caring for patients with FMF should be aware of the QoL changes in the management of these patients. As a result, medical therapy, patient education, and indicators of psychological and social support can all be offered more effectively.

CLINICAL APPLICATION STUDY OF 3D-ASL PERFUSION IMAGING AND MAGNETIC RESONANCE DIFFUSION IMAGING IN TRANSIENT ISCHEMIC ATTACK.

Objective: This study aimed to explore the clinical application of three-dimensional arterial spin labeling (3D-ASL) and diffusion-weighted magnetic resonance imaging (DWI) in transient ischemic attacks. Methods: Forty patients with transient cerebral ischemia in our hospital were selected and included from July 2020 to March 2022. All subjects were detected by DWI and 3D-ASL technology. The positive rate, relative cerebral blood flow (rCBF), and the receiver operating characteristic curve of the two methods in the diagnosis of transient cerebral ischemia were compared; the objective was to compare the relationship between the frequency of transient ischemic attack and hypoperfusion, and vascular stenosis. Results: The 3D-ASL examination showed two cases of hypoperfusion in the healthy control group (5.00), and the magnetic resonance imaging examination showed four cases of vascular stenosis in the healthy control group (10.00). The rCBF ratio in the cerebral ischemia group was significantly lower than that in the cerebral ischemia group, which was significantly lower than that in the healthy control group ( P < 0.05). The area under the curve (AUC) of 3D-ASL in the diagnosis of transient cerebral ischemia was 0.800, and the AUC of DWI in the diagnosis of transient cerebral ischemia was 0.725. The AUC of the combination of the two methods in transient cerebral ischemia was 0.850. There was a significant difference in the attack frequency of patients with transient cerebral ischemia with different perfusion ( P < 0.05). There was a significant difference in attack frequency between patients with transient ischemic attack and patients without vascular stenosis ( P < 0.05). Conclusion: 3D-ASL and DWI technology have higher diagnostic efficiency for transient cerebral ischemia.

Flibanserin conquers murine depressive pseudodementia by amending HPA axis, maladaptive inflammation and AKT/GSK/STAT/BDNF trajectory: Center-staging of the serotonergic/adrenergic circuitry

Depressive pseudodementia (DPD) is a debilitating cognitive dysfunction that accompanies major and/or frequent depressive attacks. DPD has gained significant research attention owing to its negative effects on the patients' quality of life and productivity. This study tested the procognitive potential of Flibanserin (FBN), the serotonin (5HT) receptor modulator, against propranolol (PRP), as β/5HT1A receptors blocker. Serving this purpose, female Wistar Albino rats were subjected to chronic unpredictable stress (CUS) and subsequently treated with FBN only (3 mg/kg/day, p.o), PRP only (10 mg/kg/day, p.o), or PRP followed by FBN, using the same doses. FBN ameliorated the behavioral/cognitive alterations and calmed the hypothalamic-pituitary-adrenal (HPA) axis storm by reducing the levels of stress-related hormones, viz, corticotropin-releasing hormone (CRH), adrenocorticotropic hormone (ACTH), corticosterone (CORT) parallel to epinephrine (EPI) hyperstimulation. The maladaptive inflammatory response, comprising of interleukin (IL)-1β/6, and tumor necrosis factor (TNF)-α, was consequently blunted. This was contemporaneous to the partial restoration of the protein kinase-B (AKT)/glycogen synthase kinase (GSK)3β/signal transducer and activator of transcription (STAT)-3 survival trajectory and the reinstatement of the levels of brain derived neurotrophic factor (BDNF). Microscopically, FBN repaired the hippocampal architecture and lessened CD68/GFAP immunoreactivity. Pre-administration of PRP partially abolished FBN effect along the estimated parameters, except for 5HT2A receptor expression and epinephrine level, to prove 5HT1A receptor as a fulcrum initiator of the investigated pathway, while its sole administration worsened the underlying condition. Ultimately, these findings highlight the immense procognitive potential of FBN, offering a new paradigm for halting DPD advancement via synchronizing adrenergic/serotonergic circuitry.

Disability in cluster headache is more than attack frequency - results from and validation of the English version of the Cluster Headache Impact Questionnaire (CHIQ)

BackgroundCluster headache (CH) is associated with high disability. The Cluster Headache Impact Questionnaire (CHIQ) is a short, disease-specific disability questionnaire first developed and validated in German. Here, we validated the English version of this questionnaire.MethodsThe CHIQ was assessed together with nonspecific headache-related disability questionnaires in CH patients from a tertiary headache center and an American self-help group. Results155 active episodic and chronic CH patients were included. The CHIQ showed good internal consistency (Cronbach’s α = 0.91) and test-retest reliability (ICC = 0.93, n = 44). Factor analysis identified a single factor. Convergent validity was shown by significant correlations with the Headache Impact Test™ (HIT-6™, ρ = 0.72, p < 0.001), the Hospital Anxiety and Depression Scale (HADS depression: ρ = 0.53, HADS anxiety: ρ = 0.61, both p< 0.001), the Perceived Stress Scale (PSS-10, ρ = 0.61, p < 0.001) and with CH attack frequency (ρ = 0.29, p < 0.001). Chronic CH patients showed the highest CHIQ scores (25.4 ± 7.9, n = 76), followed by active episodic CH and episodic CH patients in remission (active eCH: 22.2 ± 8.7, n = 79; eCH in remission: 14.1 ± 13.1, n = 127; p < 0.001). Furthermore, the CHIQ was graded into 5 levels from “no to low impact” to “extreme impact” based on the patients’ perception. Higher CHIQ grading was associated with higher attack and acute medication frequency, HIT-6™, HADS and PSS scores.ConclusionThe English version of the CHIQ is a reliable, valid, and disease-specific patient-reported outcome measure to assess the impact of headaches on CH patients.

Use of rimegepant as an alternative to triptans in migraine treatment

Introduction and aim of study: Migraine is a chronic neurological disorder that is considered one of the leading causes of disability worldwide. Increasing evidence indicates that the calcitonin gene-related peptide (CGRP), a neuropeptide released during trigeminal nerve activation, plays a major role in pathophysiology and serves as an important therapeutic target. Rimegepant is an antagonist for the receptor of this peptide and an alternative to the commonly used triptans. Materials and Methods: Two databases, Pubmed and Medline, were searched using the terms "rimegepant" and "migraine." Results: By reducing the severity and frequency of migraine attacks, rimegepant significantly improves patients' daily functioning and quality of life. A single 75 mg dose of rimegepant provided better efficacy than placebo in the acute treatment of migraine. Two hours after dosing, significantly more patients in the rimegepant group than in the placebo group reported pain relief (59.3% vs. 43.3%). Rimegepant was also effective in the long term when taken every other day for preventive treatment of migraine and/or as needed for acute migraine treatment. When used, rimegepant was well tolerated in both acute and preventive migraine treatment. The most common adverse events included nasopharyngitis, nausea, urinary tract infection, and upper respiratory tract infection. Conclusions: Rimegepant is an effective drug for treating migraine attacks, offering quick and long-lasting pain relief with a favorable safety profile, especially for patients with contraindications to triptans. Therefore, rimegepant represents a valuable alternative for patients who do not respond adequately to other available migraine therapies.

Effectiveness of greater occipital nerve blockade in chronic cluster headache.

Greater occipital nerve (GON) blockade injections can be used to prevent episodic and chronic cluster headaches. In recent studies, prophylactic treatment has been used in addition to the GON blockade. In this study, we aimed to elucidate the effect of GON blockade on the attack frequency, pain intensity, and duration in patients diagnosed with chronic cluster headaches. The demographic characteristics of 30 patients who received GON blockade along with acute attack treatment, short- and long-term prophylactic treatment for cluster headache, and 24 patients who received only acute attack treatment, short- and long-term prophylactic treatment, before blockade treatment, in the 1st week and 1st month after blockade were investigated. Attack frequency, attack duration, and visual analog scale (VAS) variables were compared. We evaluated the VAS score, daily attack frequency, and duration of pain attacks after repeated GON blockade and found a statistically significant difference in the VAS score, daily attack frequency, duration of pain attacks, average values of the treatment, and time interaction of pain intensity in the group in which GON blockade was applied in the 1st week and 1st month compared to the pre-treatment period (p<0.01), (p<0.01), (p=0.044). Regarding the outcomes of this research, GON blockade provided significant improvement in pain frequency, attack duration, and VAS score in the period from attack treatment to the start of long-term prophylaxis treatment and one month after treatment, without the need to switch to different prophylaxis treatments. Therefore, GON blockade may be a preferable and reliable treatment option.

Stabilization of Networked Switched Systems Under DoS Attacks.

This article studies the stability issue of networked switched systems (NSSs) under denial-of-service (DoS) attacks. To address this issue, the derived limitations imposed on both the frequency of DoS attacks on each subsystem and the upper limit of attack duration that each subsystem can tolerate are mode-dependent, which is more efficient and flexible than the current results for NSSs. Moreover, we reveal the relationship between the upper bound of the average maximum tolerable attack duration associated with the corresponding subsystem and the actual mode-dependent average dwell time. Furthermore, we identify that the total tolerable DoS attack duration as a percentage of the system runtime in this article can be higher than existing results. Finally, an example is given to demonstrate the effectiveness of our work.

Open label experience of repeated OnabotulinumtoxinA injections towards the sphenopalatine ganglion in patients with chronic cluster headache and chronic migraine.

A novel technique for injection of OnabotulinumtoxinA (BTA) towards the sphenopalatine ganglion (SPG) has shown promise in refractory chronic migraine (CM) and chronic cluster headache (CCH). Open label safety and efficacy data are presented here. Patients with refractory CM or CCH who had received at least one injection and completed headache diaries were included. Efficacy was defined as ≥50% reduction in moderate-to-severe headache days for CM, or ≥50% reduction in attack frequency for CCH, at weeks five to eight. Over 261 injections, there were 123 adverse events (AE), of which one was serious. Most (93%) AEs were mild and all were transient. The 50% response to one injection was 81% for CM and 69% for CCH. The response gradually reduced over subsequent months for CM but stayed between 55% and 67% for CCH. Repeated injections were beneficial. Injections resulted in improvement for both groups and was maintained with repeated injections. Repeat injection after three months may be beneficial in CM. Adverse events were not uncommon, but universally transient, presumably as a result of the mechanism of action of BTA. Repeated BTA injection towards the SPG could be an effective treatment for refractory CM and CCH. Larger, randomised, placebo-controlled trials are required.

Exploring factors for predicting colchicine responsiveness in children with PFAPA

Periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis syndrome (PFAPA) are the most common autoinflammatory syndromes in children. This study aimed to evaluate the clinical and laboratory parameters that may predict colchicine responsiveness.This retrospective, multicenter, cross-sectional study involved nine pediatric rheumatology centers from our country., The patients diagnosed with PFAPA were compared on the basis of their responses to colchicine. In the 806 (42.3% female 57.7% male) patients, the most common clinical findings were fever (100%), exudative tonsillitis (86.5%), pharyngitis (80.9%), and aphthous stomatitis (50.5%). The mean attack frequency was 13.5 ± 6.8 attacks per year lasting for a mean of 3.9 ± 1.1 days. Colchicine treatment was attempted in 519 (64.4%) patients, with 419 (80.7%) showing a favorable response. In patients who underwent MEFV gene analysis (70.8%), the most common variant was M694V heterozygous (16.8%). The presence of pharyngitis (p = 0.03, 95% CI 0.885 to 0.994), the presence of arthralgia (p = 0.04, 95% CI 0.169 to 0.958), and having more frequent attacks (p = 0.001, 95% CI 0.028 to 0.748) were found to be associated with colchicine unresponsiveness, whereas the carriage of the M694V variant (p = 0.001, 95% CI 0.065 to 0.242) was associated with colchicine responsiveness.Conclusion: This study identified the presence of pharyngitis, arthralgia, and increased attack frequency in patients with PFAPA as factors predicting colchicine unresponsiveness, whereas the carriage of the M694V variant emerged as a predictor of colchicine responsiveness. Predicting colchicine response at disease onset may facilitate a more effective management of PFAPA.What is Known:• Colchicine treatment can be used in the prophylaxis of PFAPA disease.• Having the MEFV variant is the most commonly known factor in predicting response to colchicine.What is New:• The presence of pharyngitis or arthralgia, and more frequent attacks in PFAPA disease were found to be independently associated with colchicine unresponsiveness. • Carrying the M694V variant was identified as the sole factor predicting colchicine responsiveness.

An Essential Problem in Patients with Hereditary Angioedema: Irritable Bowel Syndrome

Objective: Hereditary angioedema (HAE) is characterized by attacks of subcutaneous and mucosal edema. HAE usually affects the skin or mucosal tissues of the upper respiratory and gastrointestinal tract. Irritable bowel syndrome (IBS) is one of the diseases in which the abdominal symptoms of HAE may be confused. In this study, we aimed to clarify the role of IBS in clinical presentation and diagnostic delay in HAE. Material and Method: 50 patients with HAE followed in our clinic between January 2013 and April 2023 were included in this study, and hospital records were retrospectively reviewed. Patients with HAE were divided into two groups, those with and without IBS, and evaluated according to Rome IV criteria for diagnosing IBS. Results: The mean age of the study group was 40 ± 13 years, and 60% (n=30) were female. IBS was observed in 30% (n=15) of the patients, and 60% (n=9) had IBS before diagnosing HAE. The frequency of attacks and history of gastrointestinal tract medical/surgical history were more frequent in HAE patients with IBS (p

The clinical application and experience of acupuncture in the treatment of asthma assisted by intelligent technology

Asthma, a prevalent chronic respiratory disease, impacts patients' quality of life. Traditional acupuncture therapy is effective but lacks personalization. This paper introduces AI technology into acupuncture treatment, proposing an intelligent assistance system. The system uses patients' physiological and imaging data to construct an intelligent diagnostic model, accurately identifying conditions and symptom types. Through reinforcement learning optimization algorithms, personalized acupuncture plans are tailored for each patient. Clinical trials show that AI-assisted acupuncture significantly improves symptom scores, lung function, and reduces attack frequency, enhancing clinical efficacy and serving as a valuable tool for traditional Chinese medicine acupuncture training.

Are there any benefits from prescribing a cardiac cytoprotector to enhance the quality of life in patients with coronary heart disease and chronic heart failure?

Introduction. Type 2 diabetes (T2D) increases the risk of developing cardiovascular diseases, which leads to a high mortality in this category of patients. Issues regarding the prevention of the onset and progression of coronary heart disease (CHD) and chronic heart failure (CHF) in patients with T2D and/or metabolic syndrome (MS) are still not fully understood. The use of metabolic drugs with cardioprotective effects, in particular Mildronate®, is one of the possibilities to improve the effectiveness of combination treatment of CHD and CHF.Aim. To study the effect of Mildronate® on the quality of life (QoL) of patients with CHD and CHF, suffering from T2D and/or MS.Materials and methods. A total of 2.084 patients with co-occurring two (or more) disorders: obesity, type 2 diabetes, angina pectoris, CHT, and CHF were included in the INDICOR observational study conducted in real-life clinical practice settings. Group 1 received therapy with disease-modifying agents prescribed due to CHD and T2D; Group 2 received Mildronate® at a dose of 1000 mg per day in addition to the same therapy. The studied lab test results were assessed at baseline and 42 days of therapy.Results. A 42-day course of therapy in patients receiving Mildronate® at a dose of 1000 mg per day in addition to disease-modifying therapy (DMT) contributed to a percentage increase in the number of patients with CHD, FC (functional class) I angina pectoris (Δ,% + 63%, p &lt; 0.001 ) as compared to the control group with no significant changes (Δ,% + 7%, p &gt; 0.5). A significant increase in the number of patients with FC I CHF was recorded in Group 2 (from 23.5 to 42.1%, Δ,% + 79%) as compared to Group 1, where no significant changes were detected (22.7 to 23.7%, Δ,% + 4%). The QoL in patients with CHF based on data collected using the Minnesota Questionnaire and QoL in patients with CHD based on data collected using the Seattle Questionnaire significantly improved in the groups that received Mildronate® in addition to DMT, as compared with the group of patients who were only on DMT.Conclusion. Results from the Seattle and Minnesota questionnaires showed that the use of Mildronate® as part of combination therapy in patients with CHD and CHF, suffering from T2D and/or MS, contributed to a significant reduction in the frequency of angina attacks and lowering angina FC, CHF FC, and also enhanced the quality of life in this category of patients.