Incidence Of Syndrome Research Articles

Molecular study of CYP21 gene polymorphism rs13405728 and CYP11A1 gene polymorphism rs4077582 in polycystic ovarian syndrome patients

BackgroundPCOS is a serious endocrine-metabolic condition characterized by hyperandrogenemia, anovulation, or oligo-ovulation, and links to obesity, insulin resistance, and an elevated risk of type 2 diabetes mellitus. The pathophysiology of PCOS is thought to involve both environmental and genetic factors. PCOS etiology has been linked to genetic factors, with the CYP21 and CYP11A1 genes identified as possible candidate genes. Previous research has linked the rs13405728 polymorphism in the CYP21 gene and the rs4077582 polymorphism in the CYP11A1 gene to PCOS. However, more research is needed to confirm these connections in specific populations. The purpose of this study was to look at the role of single gene polymorphisms in PCOS, specifically the rs13405728 polymorphism in the CYP21 (LHCGR) gene and the rs4077582 polymorphism in the CYP11A1 gene. Blood was drawn from 150 PCOS patients and 150 age- and gender-matched healthy people. The phenol–chloroform procedure was used to extract DNA, and gel electrophoresis was used to quantify it. To analyze polymorphisms, researchers used polymerase chain reaction (PCR) with the allele-specific amplification refractory mutation system (ARMS-PCR) to amplify specific areas of DNA. ARMS-PCR was used to detect mutations in the CYP21 and CYP11A1 genes, followed by sequencing to examine the rs13405728 polymorphism and rs4077582 polymorphism, respectively, in 150 PCOS patients and 150 control people. ARMS-PCR polymorphism study of the CYP21 (LHCGR) and CYP11A1 genes indicated significant correlations.ResultsFor the CYP21 gene, heterozygous (CT) carriers of the rs13405728 polymorphism had a fourfold greater incidence of PCOS (OR 4.10; CI 2.47–6.80; p = 0.0001), whereas homozygous mutant (TT) carriers had a significant connection with PCOS (OR 0.27; CI 0.16–0.45; p = 0.0001). These data imply that the CYP21 (LHCGR) gene polymorphism rs13405728 has a substantial impact on the development of polycystic ovarian syndrome. The data for the CYP11A1 gene show the SNP (rs4077582) heterozygous (CT) was associated with PCOS (OR 1.72; 95% CI 1.02–2.88; p = 0.0392). The identical SNP heterozygous (CT) raised the incidence of PCOS by up to onefold. The homozygous mutant SNP (TT) had no connection with illness onset (OR 1.377; 95% CI 0.85–2.2; p = 0.1855), while the mutant (TT) of the SNP nearly doubled the incidence of polycystic ovarian syndrome. The combined model of the same SNP (CT + TT) revealed a significant correlation with PCOS (OR 2.1905; 95% CI 1.355–3.53; p = 0.0014). The combination model (CT + TT) of the same SNP more than doubled the risk of polycystic ovarian syndrome. All the risk factors investigated had a substantial connection with PCOS.ConclusionIn conclusion, this study supports the role of the CYP21 (LHCGR) and CYP11A1 gene polymorphism in PCOS. More studies are needed to investigate the functional significance of this polymorphism as well as its possible clinical impact on the diagnosis and treatment of PCOS.

Prevalence, incidence, and recovery of metabolic syndrome after the fukushima nuclear power plant disaster: A 10-year longitudinal study

After the 2011 Fukushima nuclear power plant accident, the prevalence of metabolic syndrome sharply increased in municipalities near the nuclear power plant, where a massive evacuation of community residents occurred (the evacuation area). However, after the initial increase, the rate of increase in metabolic syndrome in the evacuation area was slower than that in the surrounding area (non-evacuation area). In this study, we compared the incidence of and recovery from metabolic syndrome as well as its prevalence between evacuation and non-evacuation areas during the 10 years after the accident to explore whether the slower increase in metabolic syndrome after the initial increase in the evacuation area stemmed from suppressed incidence or from fast recovery. We analyzed specific health check-up data of community residents aged 40–74 in Fukushima Prefecture from fiscal year (FY) 2012 to FY 2021 (N = 710,201). To explore the prevalence of metabolic syndrome, we examined the associations of time, residential area, and their interaction with metabolic syndrome using mixed-model repeated measures. We used data from those without metabolic syndrome in FY 2012 to investigate the incidence. We similarly examined the associations of time, residential area, and their interaction with metabolic syndrome using FY 2013 to FY 2021 data. To explore recovery, we used the data of those with metabolic syndrome in FY 2012 and repeated the same procedure. The rate of increase in the prevalence and incidence of metabolic syndrome was slower in the evacuation area than in the non-evacuation area. On the other hand, as for the recovery, the time trend of metabolic syndrome did not differ between the two areas. The slower increase in metabolic syndrome in the evacuation area was partly explained by the slower incidence in the evacuation area but not by recovery.

Disease burden of AIDS in last 30-year period and its predicted level in next 25-years based on the global burden disease 2019

BackgroundThis study examines global trends in acquired immune deficiency syndrome (AIDS) incidence, mortality, and disability-adjusted life years (DALYs) from 1990 to 2019, focusing on regional disparities in AIDS incidence, mortality, and DALYs across various levels of socio-demographic index (SDI). It also investigates variations in AIDS incidence, mortality, and DALYs across different age groups, and projects specific trends for the next 25 years.MethodsComprehensive data on AIDS from 1990 to 2019 in 204 countries and territories was obtained from a GBD study. This included information on AIDS incidence, mortality, DALYs, and age-standardized rates (ASRs). Projections for AIDS incidence and mortality over the next 25 years were generated using the Bayesian age-period-cohort model.ResultsFrom 1990 to 2019, the global incidence of HIV cases increased from 1,989,282 to 2,057,710, while the age-standardized incidence rate (ASIR) decreased from 37.59 to 25.24 with an estimated annual percentage change (EAPC) of -2.38. The ASIR exhibited an upward trend in high SDI and high-middle SDI regions, a stable trend in middle SDI regions, and a downward trend in low-middle SDI and low SDI regions. In regions with higher SDI, the ASIR was higher in males than in females, while the opposite was observed in lower SDI regions. Throughout 1990 to 2019, the age-standardized death rate (ASDR) and age-standardized DALY rate remained stable, with EAPCs of 0.24 and 0.08 respectively. Countries with the highest HIV burden affecting women and children under five years of age are primarily situated in lower SDI regions, particularly in sub-Saharan Africa. Projections indicate a significant continued decline in the age-standardized incidence and mortality rates of AIDS over the next 25 years, for both overall and by gender.ConclusionsThe global ASIR decreased from 1990 to 2019. Higher incidence and death rates were observed in the lower SDI region, indicating a greater susceptibility to AIDS among women and < 15 years old. This underscores the urgent need for increased resources to combat AIDS in this region, with focused attention on protecting women and < 15 years old as priority groups. The AIDS epidemic remained severe in sub-Saharan Africa. Projections for the next 25 years indicate a substantial and ongoing decline in both age-standardized incidence and mortality rates.

Study on the clinical effect of initiating continuous blood purification at different times for severe acute pancreatitis

To observe the clinical effect of initiating continuous blood purification (CBP) treatment at different times for patients with severe acute pancreatitis (SAP), and to explore the optimal timing for starting CBP treatment for SAP, so as to provide evidence for clinicians to start CBP treatment. A retrospective cohort study was used to select patients with SAP who received CBP treatment in People's Hospital of Hunan Province from January 2020 to December 2023. According to the timing of CBP initiation, the patients were divided into early initiation group (diagnosis of SAP to the first CBP treatment time < 24 hours) and late initiation group (diagnosis of SAP to the first CBP treatment time of 24-48 hours). The general data, acute physiology and chronic health evaluation II (APACHE II), bedside index for severity in acute pancreatitis (BISAP) score and laboratory indicators, local complications and systemic complications, intensive care unit (ICU) treatment time, hospital stay, treatment cost, and clinical outcome of the two groups were collected and compared. A total of 130 patients with SAP who received CBP treatment were enrolled, including 90 patients in the early initiation group and 40 patients in the late initiation group. Before treatment, there were no significant differences in gender, age, APACHE II score, BISAP score, etiology and laboratory examination indexes between the early initiation group and late initiation group. At 48, 72, 96 hours after treatment, the blood calcium level of the two groups was significantly higher than that before treatment, and the levels of white blood cell count (WBC), C-reactive protein (CRP), lactic acid, interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), APACHE II score and BISAP score were significantly lower than those before treatment. The WBC level, APACHE II score and BISAP score of the late initiation group were significantly lower than those of the early initiation group at 72 hours and 96 hours after treatment [WBC (×109/L): 10.96 (8.68, 13.04) vs. 12.45 (8.93, 16.30) at 72 hours after treatment, and 10.18 (8.68, 12.42) vs. 11.96 (8.81, 16.87) at 96 hours after treatment; APACHE II score: 9.50 (5.75, 12.00) vs. 11.00 (6.25, 14.00) at 72 hours after treatment, and 10.00 (4.00, 12.00) vs. 12.00 (7.00, 14.75) at 96 hours after treatment; BISAP score: 2.35±1.03 vs. 2.76±1.10 at 72 hours after treatment, and 2.08±1.21 vs. 2.70±1.11 at 96 hours after treatment], the differences were statistically significant (all P < 0.05). In terms of complications, the incidence of pancreatic abscess in the late initiation group was significantly lower than that in the early initiation group [5.00% (2/40) vs. 20.00% (18/90)], but the incidence of abdominal compartment syndrome was significantly higher than that in the early initiation group [42.50% (17/40) vs. 13.33% (12/90)], the differences were statistically significant (all P < 0.05). In addition, the ICU treatment time in the early initiation group was significantly shorter than that in the late initiation group [days: 11.00 (6.00, 20.00) vs. 15.00 (9.75, 25.00), P < 0.05], and there were no statistically significant differences in hospitalization costs, length of stay and mortality between the two groups. CBP can effectively increase the level of blood calcium and decrease the level of lactic acid and inflammatory factors. Starting CBP within 24-48 hours after diagnosis of SAP can reduce WBC level and disease severity score faster, and reduce the occurrence of pancreatic abscess. Initiation of CBP within 24 hours after diagnosis of SAP can reduce the incidence of abdominal compartment syndrome and shorten the duration of ICU treatment.

Incidence and predictors of acute coronary syndrome after transcatheter mitral valve repair

ABSTRACT Background Acute coronary syndrome (ACS) post-transcatheter mitral valve repair (TMVR) carries high mortality. We aim to study the incidence and predictors of ACS in patients who underwent TMVR. Research design and methods We queried the U.S. National Readmission Database to identify all cases of TMVR from 2016 to 2019. We further evaluated the incidence of ACS and used multivariable logistic regression to determine independent predictors of ACS in this population. Results Among 3,742 patients who underwent TMVR, 264 (7.05%) developed ACS. Among ACS patients, 204 (77%) had non-ST-segment elevation ACS and 66 (25%) had ST-segment elevation ACS. Independent predictors of ACS were acute limb ischemia, cardiogenic shock, history of coronary artery disease (CAD), smoking, cardiac arrest, respiratory failure requiring mechanical ventilation, and acute kidney injury. In-hospital mortality among ACS was three times higher in ACS patients than without ACS (16.76% vs. 5.45%, p-value < 0.01). Conclusions ACS is not an uncommon complication after TMVR. The occurrence of ACS after TMVR is associated with high in-hospital mortality, longer length of stay, and higher hospital charges. The strongest predictors of ACS in these patients are the development of acute limb ischemia, cardiogenic shock, and a history of CAD.

Effect of a subanesthetic dose of esketamine combined with propofol on postoperative fatigue syndrome in patients undergoing gastroenterological endoscopy under anaesthesia: A retrospective study.

To assess the effect of subanesthetic dose of esketamine in combination with propofol on the incidence of postoperative fatigue syndrome (POFS) in patients who underwent gastroenterological endoscopy under anaesthesia. Clinical data of 160 patients who underwent gastroenterological endoscopy under anaesthesia in Huzhou Maternity & Child Health Care Hospital from January to December 2022, ASA Grade- I and II, were retrospectively selected. According to the records, patients were grouped based on the administered anesthetic. Patients who received 0.2 mg/kg of esketamine and 2~2.5mg/kg of propofol comprised Group-E, and patients who were administered one μg/kg of fentanyl and 2 - 2.5mg/kg of propofol comprised Group-F. Mean arterial pressure (MAP), oxygen saturation (SpO2) and heart rate (HR) were recorded before the operation (T0), after anesthesia (T1), three minutes after the gastroscope was inserted (T2), five minutes after the colonoscope was inserted (T3) and at the end of the operation (T4). Operating time, recovery time, propofol dosage and incidence of adverse reactions in the two groups were recorded. The Christensen scores and the incidence of POFS of all patients on Day-I before operation and 1st, 3rd, and 5th days after the operation were recorded. Compared with T0, MAP, SpO2 and HR in both groups of patients decreased at T1, T2, T3 and T4 (P<0.05). MAP, SpO2 and HR of patients in Group-E were significantly higher compared to Group-F at T1, T2, T3 and T4 (P<0.05). Compared with Group-F, the recovery time, intraoperative bradycardia and respiratory depression in Group-E were significantly lower (P<0.05), and Christensen scores and the incidence of POFS decreased significantly on the 1st, 3rd, and 5th day after the operation (P<0.05). Subanesthetic dose of esketamine combined with propofol can reduce POFS and postoperative adverse reactions in patients undergoing gastroenterological endoscopy.

Prevalence of Persistent Post-Concussion Syndrome in Adults After Mild Traumatic Brain Injury

Background: The incidence of post-concussion syndrome (PCS) in post-traumatic brain injury patients continues to increase every year. Although mild Traumatic Brain Injury (mTBI) is one of the primary causes of death and disability worldwide, research on the prevalence of PCS after mTBI is still extremely limited. Previous studies have shown that approximately 10-15% of mTBI patients experience PCS, but these studies often have different methodologies and sample sizes.Purpose: This study aimed to determine and compare the prevalence of persistent post-concussion syndrome (PCS; &gt;1 month post-injury) in patients with mTBI and those without PCS.Methods: This study employed a retrospective cohort design and analyzed patient data from hospital records between July and December 2022, yielding a sample of 112 participants with persistent post-concussion syndrome (PCS) following mTBI and 204 participants without PCS. Patients with complete medical record data and active health checks for one month after being treated were taken as research subjects. PCS measurement was conducted using the Rivermead Post Concussion Symptoms Questionnaire (RPQ).Results: The total number of mTBI patients was 112 patients with PCS (35.4%) with p&lt;0.000. The occurrence of PCS was found to be most prevalent in the second month, with 49 patients (43.7%). Problems concentrating (37.5%), headache (30.3%), and memory problems (16.9%).Conclusions: The study found that 35.4% of patients with mTBI experienced persistent post-concussion syndrome (PCS) after one month. The occurrence of PCS was most prevalent in the second month, with 43.7% of patients experiencing it. The symptoms most commonly indicating PCS were problems concentrating, headache, and memory problems. These findings warrant better screening guidelines, and practices that patients adopt after mTBI.

Fatal Bladder Carcinoma in Woman with Human Immunodeficiency Virus: A Case Report

Background: Chronic human immunodeficiency virus (HIV) infection is associated with an increased incidence of Non-Acquired Immunodeficiency Syndrome (non-AIDS) defining cancers. To date, only a limited number of cases of bladder cancer have been linked with HIV infection in women. We sought to describe the clinical characteristics of HIV-associated bladder cancer. Methods: A 54-year-old female patient presented with symptoms of an occlusive syndrome. Medical examination was followed by a CT scan. The imaging revealed a significant finding. There was a noticeable process within the bladder. Further evaluation and management were recommended. Results: Spontaneous urinary cytology revealed the presence of malignant cells. An endoscopy was performed under spinal anesthesia, uncovering a large sessile tumor with necrotic areas located on the ventral aspect and dome of the bladder. Due to the severity of the condition, a palliative resection was carried out. Subsequent histological examination identified the tumor as a high-grade urothelial carcinoma, with evidence of muscle invasion. This diagnosis confirmed the aggressive nature of the disease, highlighting the necessity for further medical management and intervention. Conclusion: Bladder cancers in HIV-infected patients are rare but can occur in relatively young individuals with a low nadir CD4 cell count. These cancers often exhibit aggressive pathological features and can be fatal.

Asymptomatic Cholecystitis Presents a New Challenge for Correcting Treatment Tactics in Patients with Gallstone Disease Rather Than Being an Unsolvable Problem of Biliary Surgery

Gallbladder stones, or cholelithiasis, represent a significant public health concern, particularly in Russia, with an incidence of 5-6 per 1,000 people annually. Western countries report a prevalence of 10%-20%, which has nearly tripled in the last three decades due to advancements in diagnostic techniques. Notably, the condition disproportionately affects women and the elderly, with a marked increase in prevalence after the age of 70. Approximately 80% of cases are asymptomatic, and the clinical manifestations develop in only 1-4% of patients annually. Despite the rising identification of asymptomatic cases through enhanced imaging, management strategies remain unclear, leading to hesitancy among surgeons regarding surgical intervention. Current guidelines from various national and international bodies, including NICE and ESGE, advocate for a watch-and-wait approach for asymptomatic patients, citing spontaneous stone clearance. However, the treatment of asymptomatic choledocholithiasis remains contentious, with some guidelines supporting intervention. This ambiguity is compounded by the recognition that complications can arise from unnecessary cholecystectomy, with 10-40% of patients experiencing ongoing symptoms post-surgery. The article emphasizes the need for a comprehensive understanding of asymptomatic cholecystitis, advocating for a meticulous diagnostic approach that considers the potential underlying causes of gallstone formation. The lack of consensus in current literature regarding management strategies highlights the necessity for further research into the natural history of asymptomatic gallstones and the implications of various treatment options. By addressing these complexities, clinicians can enhance patient outcomes and reduce the incidence of post-cholecystectomy syndrome, ultimately leading to more individualized and effective management strategies for patients with asymptomatic cholecystitis.

Association between Exclusive Breastfeeding and the Incidence of Childhood Nephrotic Syndrome

ObjectiveTo assess the relationship between breastfeeding and the risk of developing nephrotic syndrome using a population-based nationwide birth cohort in Korea. Study designThis nationwide cohort study utilized data from the Korean National Health Information Database and the Korean National Health Screening Program for Infants and Children. The study included all children born between January 1, 2010, and December 31, 2018, who underwent their first health screening, which included a specific questionnaire on breastfeeding between 4 and 6 months of age. Associations between nephrotic syndrome and exclusive breastfeeding were estimated using adjusted hazard ratios (aHR) derived from Cox proportional hazards models, adjusted for sociodemographic variables, with follow-up until the occurrence of nephrotic syndrome, eight years post-index date, death, or December 31, 2022, whichever was first. ResultsThe study population comprised 1,787,774 children (median follow-up: 7.96 years; IQR: 6.31–8.00 years), including 612,556 exclusively breastfed and 1,175,218 formula-fed children. Exclusive breastfeeding was associated with a decreased risk of developing nephrotic syndrome (aHR: 0.80; 95% CI: 0.69 – 0.93). Subgroup analysis stratified by sex mirrored the overall findings, although statistical significance was not observed in girls (boys: aHR, 0.75; 95% CI, 0.62–0.92; girls: aHR, 0.87; 95% CI, 0.70 – 1.09). Sensitivity analysis confirmed these results. ConclusionExclusive breastfeeding was associated with a 20% reduced risk of developing nephrotic syndrome up to 8 years of age.

Biomarkers and metal content in white seabream (Diplodus sargus) and its relationship with the occurrence of the Abnormal Tough Syndrome

There is still controversy on the cause of the incidence of abnormal tough syndrome (ATS) in some fish species, mainly the white seabream (Diplodus sargus). This work analyses the incidence of the ATS in white seabream in areas with a different extent of heavy metal pollution and its possible relationship with fish health. Muscular cholinesterase (ChE) activities were selected to assess their potential as biomarkers of ATS occurrence. Among the trace elements Zn, Cu, Pb, and As in muscle and Cu in liver were significantly higher in the fish from the most polluted marina location. ATS incidence (33 %) was also recorded in this site with individuals showing a significantly lower body condition but ChE activities did not reflect any neurotoxic impact on the fish, neither did detoxification and oxidative stress damage. However, a significant negative association was seen between AChE activity and muscle body burden of Hg, Cu, and Se in fish from the less impacted sites, which suggests a certain neurotoxic modulation by these metals. It also alerts for the consumption of fish from recreational activities that do not follow any regulatory measures.

Association Between Clubfoot and Neonatal Abstinence Syndrome in the United States, 2018-2022.

The United States has seen an increase in opioid use and misuse over the last 2 decades. Infants have been impacted by the opioid epidemic, with a reported 5-fold increase in the incidence of neonatal abstinence syndrome (NAS) over the last 2 decades. There are many conditions associated with NAS, and thus, the current study sought to examine the association between NAS and clubfoot. The study was retrospective, utilizing patient data from the Pediatric Hospital Information System (PHIS) database. Neonates presenting to any PHIS hospital between 2018 and 2022 were identified and included in the study. Patients with NAS and clubfoot were identified utilizing the International Classification of Diseases (ICD)-9 and 10 codes. Univariable and multivariable analyses were performed to investigate associations between clubfoot, race, ethnicity, insurance type, gestational age, length of stay, NAS, and comorbidity burden. A total of 458,274 patients were identified, of whom 2337 (0.5%) had a clubfoot diagnosis and 5431 (1.2%) had a diagnosis of NAS. Multivariable logistic regression revealed higher independent odds of clubfoot among patients with a diagnosis of NAS [odds ratio (OR): 1.49], patients with a greater number of comorbidities (OR: 4.75 for 1 comorbidity vs. none, and 21.19 for 2+ comorbidities, vs. none), patients with a greater gestational age (OR: 1.01 per week increase), and those with an increased length of stay (OR: 1.00 per day increase). A lower independent odds of clubfoot was observed among patients of Asian race (OR: 0.66), Hispanic/Latino ethnicity (OR: 0.80), non-Hispanic Black (OR: 0.75), and multiracial (OR: 0.80) ethnicity/race relative to non-Hispanic/Latino White patients (P<0.05 for all). Patients with a diagnosis of NAS demonstrated higher odds of clubfoot, in addition to sociodemographic factors, as well as comorbidity burden.

Case Report : Nephrotic Syndrome

Nephrotic syndrome (NS) is characterized by persistent heavy proteinuria (mainly albuminuria) (&gt;2 g/m2/24 hours); hypoproteinemia (serum albumin 250 mg/dL); and edema. Small amounts of protein are found in the urine of healthy children. Nephrotic syndrome is an important chronic disease in children. The estimated annual incidence of nephrotic syndrome in healthy children is two to seven new cases per 100,000 children under 18 years of age. A case has been reported of a boy aged 9 years 5 months who was brought by his parents to the emergency room at Tengku Rafi'an Siak District Hospital with complaints of swelling since 2 days ago before being admitted to the hospital. Complaints accompanied by puffy eyes when waking up, urinating a little, stomach and legs feeling like they are getting bigger. History of the same complaint (+), diagnosed with nephrotic syndrome in February 2024. Children with first clinical manifestations of SN should be hospitalized in order to accelerate examination and evaluation of dietary management, edema management, initiation of steroid treatment, and parental education.

The occurrence of cytokine release syndrome and its impact on the prognosis of patients with relapsed and refractory multiple myeloma following chimeric antigen receptor T-cell therapy

Objective: To analyze the incidence of cytokine release syndrome (CRS) and its impact on the prognosis of patients with relapsed and refractory multiple myeloma (RRMM) following treatment with chimeric antigen receptor T-cell (CAR-T) therapy. Methods: A retrospective collection was conducted of the clinical data of 91 patients with RRMM who underwent CAR-T therapy at the Affiliated Hospital of Xuzhou Medical University from January 2020 to October 2022. Before CAR-T cell infusion, the patient underwent pretreatment with the fludarabine plus cyclophosphamide (FC) regimen. On day 0 (d0), the patient received a dose of 1×106 cells/kg of CAR-T. The occurrence of CRS was recorded post-treatment and graded accordingly, with grades 1 to 2 indicating mild CRS and grade≥3 indicating severe CRS. The follow-up cut-off date was February 14, 2023, with a median follow-up time [M (Q1, Q3)] of 14.1 (3.1, 37.7) months. Kaplan-Meier survival curve analysis assessed the progression-free survival (PFS) and overall survival (OS) of Grade 1 and Grade 2 CRS patients. Furthermore, univariate logistic regression analysis was conducted to identify factors associated with the development of severe CRS. Results: In a cohort of 91 patients diagnosed with RRMM, there were 51 male and 40 female individuals, with a median age [M (Q1,Q3)] of 57 (31, 73) years. All 91 cases (100%) experienced CRS, with 82 cases (90%) classified as mild (grades 1-2) CRS and 9 cases (10%) classified as severe (grades 3-5) CRS. In a study involving 9 patients with severe CRS, 8 cases resulted in mortality. The Kaplan-Meier survival curve analysis revealed that among grade 1 CRS patients, neither the median PFS nor the median OS was achieved. For grade 2 CRS patients, the median PFS was 12 months (95%CI: 4-not achieved), and the median OS was 21 months (95%CI: 4-not achieved). The progression-free survival and overall survival rates of grade 2 CRS patients were both lower than those of grade 1 CRS patients (both P<0.05). Single-factor logistic regression analysis revealed that a high tumor burden (OR=1.025, 95%CI: 1.002-1.049, P=0.031), a prolonged duration of CRS onset (OR=0.809, 95%CI: 0.646-0.971, P=0.037) and persistence (OR=1.758, 95%CI: 1.349-2.481, P=0.001) were identified as significant factors associated with severe CRS in patients with RRMM. Conclusions: Patients with RRMM who undergoes CAR-T therapy have a high incidence of CRS, with a higher mortality rate among those experiencing severe CRS. Furthermore, patients with grade 2 CRS exhibit lower rates of progression-free survival and overall survival compared to those with grade 1 CRS. Factors associated with the development of severe CRS in RRMM patients include high tumor burden and prolonged duration and onset of CRS.

Association of Handgrip Strength Weakness and Asymmetry With Incidence of Motoric Cognitive Risk Syndrome in the China Health and Retirement Longitudinal Study.

Association of Handgrip Strength Weakness and Asymmetry With Incidence of Motoric Cognitive Risk Syndrome in the China Health and Retirement Longitudinal Study.

Comparative Outcomes of Monopolar and Bipolar Transurethral Resection of the Prostate: An Institutional Perspective.

Objective This prospective comparative study aimed to highlight and compare two types of transurethral resection of the prostate (TURP), namely M-TURP (monopolar) and B-TURP (bipolar), in the endoscopic management of benign prostatic hyperplasia (BPH). Methods and materials This research was conducted between 2022 and 2023 at a tertiary care health center. Included in the investigation were 100 consenting study participants undergoing M-TURP and B-TURP at our center. All referred patients presenting with clinical, ultrasound, or uroflowmetry features of BPH and those with failed attempts at medical management were included in the study. Patients with carcinoma of the prostate were excluded from the study. Post-operatively, the endpoints for comparison included maximal urinary flow rate (Qmax), prostate volume, duration of hospital stay, duration of catheterization, drop in serum sodium concentration, and drop in hemoglobin levels. Descriptive statistics were computed to delineate the study sample. After the completion of data collection, data analysis was performed using SPSS for Windows, Version 16.0 (Released 2007; SPSS Inc., Chicago, IL, USA), and the correlations sought were achieved using the Chi-square test of significance. Results The peak incidence of BPH was seen in the sixth decade of life: the M-TURP group was 65.16 ± 7.07 years (mean ± standard deviation), while that in the B-TURP group was 62.32 ± 8.16 years (mean ± standard deviation). Nine percent of the study participants did not show any comorbidities. The most frequent symptom of BPH at presentation was a poor urinary stream (78%, n = 100), followed by nocturia (67%, n = 100). In our study, patients undergoing M-TURP had a mean serum prostate-specific antigen (PSA) level of 4.31 ± 1.03 ng/mL, while patients undergoing B-TURP had a mean serum PSA of 4.24 ± 0.99 ng/mL (p = 0.820; p > 0.05). The study found that patients undergoing M-TURP had a mean prostate size of 35.04 ± 3.57 cc, while those undergoing B-TURP had a mean prostate size of 35.72 ± 3.22 cc (p = 0.765). For the B-TURP group, the mean decrease in postoperative serum sodium concentration was 4.3 mEq/L, while for the M-TURP group, it was 6.4 mEq/L (p = 0.903). In the M-TURP group, there were three cases of transurethral resection (TUR) syndrome, while the B-TURP group had only one case. Conclusion BPH is a common problem affecting the quality of life of several male patients. Both M-TURP and B-TURP are comparable in their efficacy in treating BPH, with the exception of a higher incidence of hyponatremia and TUR syndrome in the M-TURP group.

Smoking Behaviors, Dietary Patterns, and Dyspepsia among Indonesian Adults in 2022

Background: The global prevalence of dyspeptic syndrome among adults was estimated to be 1.8–57% in 2014, with an average of 20.8%. In a pilot survey involving 30 respondents, we found 21 acute respiratory infections, 16 dyspeptic syndromes, and 6 hypertension cases. Smoking was observed in 70% of the total respondents. This was the basis for conducting additional research in 2022 to examine the relationship between dyspepsia, smoking behaviors, and dietary patterns among adults in Krajan Hamlet, Malang, Indonesia. Methods: This quantitative study used an analytical observational design with a cross-sectional approach. The sample consisted of 70 adults aged 18–65, selected by random sampling. The collected data were analyzed using the Chi-squared test (p&lt;0.05). Results: The prevalence rate for dyspepsia was 44.3%. Among them, 67.1% were smokers (both frequent and non-frequent), and 32.9% were non-smokers (including former and passive). The active smokers had a smoking duration of &gt;2 years and smoked &gt;10 cigarettes daily. A total of 11.4% of subjects exhibited eating habits of consuming trigger foods that put them at a high risk for dyspepsia. Specifically, 42.0% of subjects had an eating interval of &gt;6 hours, while 87.1% had a meal frequency that led to a high risk of developing dyspepsia. There was a significant relationship between a high-risk diet and dyspeptic syndrome (p=0.037). Conclusion: High-risk diets exhibited a relationship with the prevalence of dyspeptic syndrome. Early detection is crucial in an effort to prevent and reduce the incidence and complications of dyspeptic syndrome. Highlights: This study investigated the relationship between dyspepsia, smoking behaviors, and dietary patterns, which are often overlooked, particularly among those living in rural areas. The findings of this study are anticipated to raise awareness regarding the detrimental impacts of smoking and unhealthy diets on dyspepsia.

The Relationship of Stress Level With Premenstrual Syndrome on Midwifery Students at Akbid Bandung

The prevalence of STDs in several regions in Indonesia shows different results. In South Jakarta, it shows that 45% of vocational school students experience PMS. In Kudus, the prevalence of PMS in Midwifery Academy students was found to be 45.8%. In Padang, 51.8% of high school students experienced PMS, while in Purworejo, the prevalence of PMS was 24.6% (Pratita &amp; Margawati, 2013). Differences in the incidence of premenstrual syndrome (PMS) between women are usually caused by several factors including: stress, increasing age, poor eating patterns and nutritional status (Sukarni and Wahyu, 2013). To find out the relationship between stress levels and premenstrual syndrome in midwifery students at AKBID Bandung. This type of research is analytical research using a cross sectional design. The sample in this study were all female students of AKBID Bandung, Level II Regular Bachelor of Applied Midwifery Study Program, namely 48 female students. The sampling technique in this study was total sampling with a total sample of 48 female students. Data analysis used the chi-square test with a 95% confidence level (?=0.05). There was no association between stress levels and premenstrual syndrome (PMS) (?value = 0.733). The other factors of premenstrual syndrome include family history, age, lack of exercise, lack of vitamins and minerals, too much salt consumption, drinking a lot of coffee (Nugroho &amp;; Utama, 2014). There was no significant association between stress levels and the incidence of premenstrual syndrome (PMS). This is because individuals who experience premenstrual syndrome are not only caused by stress factors, but also there are other supporting factors.

Exploring the Relationship between Acute Coronary Syndrome, Lower Respiratory Tract Infections, and Atmospheric Pollution.

Background: Respiratory infections were found to be connected with the incidence of acute coronary syndrome (ACS). The proposed pathway of this connection includes inflammation, oxidative stress, pro-coagulation, and atherosclerotic plaque destabilization. This can cause rapture and thrombus formation, leading to ACS. Our study aimed to assess the risk factors for coronary artery thrombosis as a manifestation of ACS and for lower respiratory tract infections (LRTIs) in patients with ACS. Methods: The study included 876 patients with ACS from January 2014 to December 2018. Both the clinical data and air pollution data were analyzed. Statistical tests used for analysis included Student's t-test, the Mann-Whitney U-test, the Chi-squared test, and the odds ratio Altman calculation. Results: LRTIs were found in 9.13% patients with ACS. The patients with LRTI had a higher risk of coronary artery thrombosis (OR: 2.4903; CI: 1.3483 to 4.5996). Moreover, they had increased values of inflammatory markers, were older, had a lower BMI, and a higher rate of atrial fibrillation. The average atmospheric aerosols with a maximum diameter of 2.5 μm (PM2.5 concentration) from three consecutive days before hospitalization for ACS were higher in patients with LRTI. Conclusions: The occurrence of coronary artery thrombosis was higher among the patients with LRTI during ACS. PM2.5 exposition was higher in the three consecutive days before hospitalization in patients with LRTI during ACS.

Lipid profile is significantly associated with sarcopenia status in elderly patients with metabolic syndrome

Background: Sarcopenia is a degenerative condition closely associated with the elderly, especially those with metabolic syndrome. Patients with sarcopenia often experience a decrease in muscle mass which is replaced by fat mass. Dyslipidemia through insulin resistance mechanisms can cause muscle dysfunction in the elderly. Additionally, low albumin levels can decrease muscle mass, worsening sarcopenia. Uric acid can also influence the development of sarcopenia. Sarcopenia sufferers tend to experience an increase in TNF-α levels due to insulin resistance. The incidence of metabolic syndrome with increased morbidity and mortality is more common among older individuals. The study aims to determine the relationship between lipid profile, albumin, TNF-α, and uric acid levels with sarcopenia status in elderly individuals with metabolic syndrome. Methods: An observational analytic study using a cross-sectional design. The subjects were 42 elderly individuals with metabolic syndrome. Plasma samples were used to measure lipid profile, albumin, TNF-α, and uric acid levels. Sarcopenia status was assessed through physical performance tests, hand grip strength, and BIA. Results: Total cholesterol, triglycerides, HDL, and LDL levels were significantly associated with sarcopenia status in elderly individuals with metabolic syndrome, while albumin, TNF-α, and uric acid levels were not. Conclusion: Lipid profile is significantly associated with sarcopenia status in elderly patients with metabolic syndrome.