Normal Limits Research Articles

Cardiovascular autonomic neuropathy in chronic kidney disease: a study of kidney biopsy cases

BackgroundThe interplay between cardiac and kidney functions is mediated by the autonomic nervous system. Cardiovascular autonomic neuropathy (CAN) is a well-documented dysfunction of this system, with heart rate variability (HRV) serving as the principal diagnostic tool. CAN is recognized as a prognostic marker for adverse kidney outcomes in diabetic kidney disease (DKD). However, the pathogenesis of CAN in patients with nondiabetic chronic kidney disease (CKD) remains underexplored. This study elucidated the prevalence of CAN and its clinicopathologic characteristics in patients with nondiabetic CKD.MethodsThis cross-sectional analysis evaluated 165 nondiabetic CKD patients who underwent kidney biopsy from 2020 to 2023. HRV was quantified using the coefficient of variation of the RR interval (CVRR). CAN was diagnosed based on the CVRR and defined using the CVRR reference value—derived by defining the age and sex-dependent lower normal limits as the 2.5 percentile point of the distribution of the CVRR values in healthy individuals.ResultsThe median patient age was 47.0 (34.0–57.0) years, and 50.9% were male. The median estimated glomerular filtration rate was 65.0 (42.0–85.0) mL/min/1.73m2, and the CVRR was 3.5 (2.4–4.7)% and 16 patients (9.7%) were diagnosed with CAN. CAN was frequently associated with kidney dysfunction, dyslipidemia, and advanced interstitial fibrosis/tubular atrophy (IF/TA). Multivariable analysis revealed that IF/TA was associated with CVRR, independent of established risk factors for CAN (P = 0.045).ConclusionsThe prevalence of CAN diagnosed using the CVRR in this nondiabetic CKD cohort was 9.7%, which is four times higher than that in healthy individuals. Nondiabetic CKD patients with CAN was associated with advanced IF/TA.

Analysis of blood calcium levels in calcium water consumers

Introduction: Water is a primary and basic human need. One of the chemical parameters that must be met for drinking water needs is mineral content, such as calcium and magnesium. Water hardness is a condition in which there is excessive calcium and magnesium content, which is commonly known as calcareous water. If consumed long-term, high-water hardness that exceeds normal limits can interfere with body health. Specifically, excess calcium in the body can cause hypercalcemia, hyperparathyroidism, kidney stones, and muscle tissue damage (muscle weakness). Objective: This study aims to determine blood calcium levels in individuals who consume calcareous healthy water. Methods: The type of research used is descriptive-analytical, with blood calcium level analysis carried out using the Ion Selective Electrode (ISE) method through the Electrolyte Analyzer (CBS400). Result: Based on the results of the study, it was obtained that blood calcium levels in 30 community respondents in Ranomeeto District (100%) were above the reference value, indicating high blood calcium levels. Conclusion: blood calcium levels in people who consume lime juice indicate high blood calcium levels. Consuming water with a high lime content can hurt health. Therefore, people need to consider the quality of the drinking water they drink, especially those that have a high lime content, to maintain heart and kidney health in the long term.

Distal median nerve dysfunction and carpal tunnel syndrome in people with multiple sclerosis treated with teriflunomide: an electrodiagnostic study.

Trials demonstrated an increased risk of distal median nerve dysfunction (DMND) and carpal tunnel syndrome (CTS) associated with teriflunomide in people with multiple (pwMS). To estimate the real-world prevalence of clinical CTS and electrodiagnostic DMND in teriflunomide-treated pwMS. Cross-sectional study on selected teriflunomide (WHOATC code: L04AK02)-treated, risk factor-free pwMS at the Isfahan MS clinic in 2022. CTS was diagnosed through history and physical examination, and DMND was diagnosed by nerve conduction studies (NCS). Outcome consisted of an ordinal scale of DMND as follows: no DMND, all values within normal limits; mild, sensory conduction velocity < 40m/s with motor onset latency < 4.5ms; moderate, motor onset latency between 4.5-6.5ms; severe, motor onset latency > 6.5ms with amplitude > 0.2mV; and very severe, motor amplitude < 0.2mV. 52 participants were included (median [range] duration of teriflunomide treatment: 3 [18] years); 5.8% were diagnosed with CTS, yet, 51.9% showed at least some evidence of DMND; of the 104 hands, 25% showed mild, 11.5% moderate, 2.9% severe, and none showed very severe DMND. Right hand side (aβ [SE]: 0.67 [0.26]; p = 0.01), duration of MS (aβ [SE]: -0.14 [0.05]; p = 0.01) and age (aβ [SE]: 0.06 [0.03]; p = 0.05) were associated with a worse grade of DMND, while the association of DMND grade with sex, EDSS score, duration of teriflunomide treatment, and prior DMT, were not confirmed (all p values > 0.05). A considerable proportion of teriflunomide-treated pwMS had DMND in at least one hand. The etiology, along its optimal management strategy, remains to be explored.

Efficacy of lycopene in reducing malondialdehyde (MDA) levels due to Lipopolysaccharide (LPS) exposure in Mice (Mus musculus)

Objective: Lipopolysaccharide (LPS) is a major component of the outer membrane of gram-negative bacteria and can trigger inflammatory and oxidative stress responses. This study aims to observe the efficacy of lycopene in reducing malondialdehyde (MDA) levels due to lipopolysaccharide (LPS) exposure in mice (Mus musculus). Method: This laboratory experimental study used 25 male mice aged 3 months with body weights of ± 25 g – 35 g, divided into five groups with five replicates each. K(-) was the control group: no LPS or lycopene was administered. K(+): received LPS 0.042 mg/kg without lycopene. P1: received LPS 0.042 mg/kg and lycopene 0.3 mg/kg. P2: received LPS 0.042 mg/kg and lycopene 0.6 mg/kg. P3: received LPS 0.042 mg/kg and lycopene 0.9 mg/kg. LPS was given on days 1 and 8 intraperitoneally, and lycopene was administered daily for 14 days. MDA levels were measured using the ELISA method, and data analysis was performed using ANOVA followed by Tukey's Test (p&lt;0.05). Result: LPS exposure significantly increased MDA levels (p&lt;0.05), and lycopene administration significantly reduced MDA levels (p&lt;0.05) to normal levels similar to the control (-). Conclusion: LPS exposure significantly increased MDA levels, and lycopene administration was able to reduce MDA levels to normal limits.

Can severe hypertriglyceridemia cause angina in the absence of significant coronary artery lesions?

Hyperlipidaemia is considered one of the most common risk factors for ischemic heart disease. Severely elevated triglyceride levels may lead to hyperviscosity which may contribute to endothelial dysfunction, tissue ischemia and chylomicronaemia. This case report features a 39-year-old, non-smoker male with a past medical history of hypertension and no family history of coronary artery disease, who presented to the clinic with angina. The electrocardiogram and echocardiogram were normal. Laboratory tests were normal except for severely elevated triglyceride levels. A dobutamine stress echocardiogram was positive, so the patient underwent coronary angiography which revealed normal coronary arteries with slow flow in all of the coronary arteries (TIMI 2 flow grade). The patient was then discharged on high-intensity statin, fenofibrate, isosorbide mononitrate, nebivolol, and was given lifestyle modification instructions. After 3 months the patient came back to the clinic for follow-up. He was in good general condition and symptom free. Laboratory tests (including lipid profile) were within normal limits.

Impact of longitudinal changes in serum uric acid levels and weight gain on new-onset atrial fibrillation—The Nishimura Health Survey: a retrospective cohort study

ObjectiveUric acid (UA) and obesity are significant risk factors for new-onset atrial fibrillation (AF). Based on the pathogenesis mechanisms of new-onset AF involving obesity and UA, it is possible that...

Renal Resistive Index as A Early Predictor of Renal Dysfunction in Patients with Type 2 Diabetes Mellitus

Background : Type 2 diabetes develops over a long period of time, represents 85–90 per cent of all cases of diabetes . Diabetic nephropathy is a relatively common form of chronic renal disease. It is the most constant microvascular complication in diabetic patients.Conventional ultrasound and colour Doppler provide easily available, affordable and non-invasive follow up method for evaluation of kidneys in diabetic nephropathy. Aim :The purpose of this study is to assess the intrarenal resistivity index by Doppler ultrasonography in a group of diabetics with normal renal function in comparison to non diabetic controls and correlating them with biochemical parameters. Materials And Methods :The study was done over a period of 2 years from October 2020 To October 2022. The study I a case control study we evaluated the intra-renal hemodynamic changes with Doppler sonography in diabetic patients in comparison to non-diabetic controls, All the data was expressed as mean + SD. Differences between the two groups was analysed by t test and chi-square test. Categorical data expressed as frequency and percentages. Results And Observations The mean age in the diabetic group was 58.84 years SD + 15.61 years and age - non diabetic group was 56.66 years SD + 14.09 years . there was a negative correlation between age and diabetes mellitus with nephropathy , p &gt; 0.0784 r -.026 A significant the correlation of the Mean resistivity index RI of the right kidney at the hilum was 0.63 the correlation was positive that is the resistance increased in diabetes mellitus as compared to non diabetic and this was significant with a p value 0 .049 significant . All the resistive indices were higher in the diabetic than the non diabetic individuals , the highest being in the midpole and it was statistically significant at all places in both kidneys with a p value &lt;0.05. Conclusion :The renal Doppler indices are good indices to evaluate the renal dysfunction in the early stages. In this study, the blood sugar levels of all cases were at least moderately controlled, yet the renal indices showed gross anomaly even though the creatinine clearance was well above normal limits.

Pancreaticoduodenal Artery Aneurysm in a Patient with Celiac Artery Atresia

Visceral artery aneurysms (VAA) have an array of presentations and management strategies. Pancreaticoduodenal artery aneurysms (PDAA) are rare, potentially lethal, and necessitate treatment. We present the case of a PDAA in a patient with a congenitally hypoplastic celiac artery treated by open surgical reconstruction. A 60-year-old female presented with an incidental 2 cm proximal inferior PDAA. Significantly, her celiac trunk was hypoplastic and all flow to hepatic, gastric, and splenic arteries stemmed from a dilated superior mesenteric artery (SMA). The PDAA was located 1 cm from the origin of the pancreaticoduodenal artery at the superior mesenteric artery (SMA) and was adhered to the fourth portion of the duodenum. Considering her anatomy, open repair with reconstruction of the pancreaticoduodenal artery was pursued via a midline laparotomy, resection of the PDAA, and primary end-to-side pancreaticoduodenal artery to SMA reconstruction. There was excellent flow into the PDA, GDA, and their emanating branches intra-operatively and on post-operative imaging. The patient progressed well and was discharged home on post-operative day five. Liver function tests were serially checked and were within normal limits upon discharge. We demonstrate a safe and successful surgical option for patients with PDAA who required preserved GDA flow.

Efficacy and intrarenal pressure analysis of flexible and navigable suction ureteral access sheaths with flexible ureteroscopy in modified surgical positions for 2-6 cm upper urinary tract stones: a multicenter retrospective study.

This multicenter retrospective study aimed to assess the efficacy, intrarenal pressure (IRP), and complications of retrograde intrarenal surgery (RIRS) using a flexible and navigable suction ureteral access sheaths (FANS-UAS) in the reverse Trendelenburg lithotomy position (RTLP) for treating kidney and upper ureteral stones measuring 2-6 cm. Conducted at six medical centers in Fujian Province from 2022 to 2024, the study included 231 patients with a median stone size of 26 mm. The immediate stone-free rate (ISFR) was 90.48%, while the SFR at postoperative day 30 was 95.67%. Only two patients developed postoperative fever, two patients had ureteral laceration and most experienced mild pain. Although surgical time increased with stone size, factors such as sex, infundibulopelvic angle (IPA), and stone density had little effect on duration, and there was no significant difference between ISFR and 30-day SFR. Importantly, all IRP measurements remained within normal limits. These findings suggest that RIRS with FANS-UAS in RTLP is a safe and effective approach for managing upper urinary tract stones of 2-6 cm, especially in 2-4 cm stones.

Quality aspects during pine resin storage: Appearance deterioration, turpentine chemical components change, kinetic model and insights into isomerization mechanisms

Pine resin is a promising natural resource with various industrial applications and economic value. However, the quality of pine resin deteriorates during storage, resulting in a decline in the quality of rosin and turpentine. This study compares the effects of deionized and surface water, as well as deionized and surface water containing 5 % impurities, on the quality of pine resin over a six-month storage period. The color of pine resin was evaluated using the CIE L*a*b* color space, and the softening point and acid value of rosin and the refractive index of turpentine obtained from the distillation of pine resin were examined. Furthermore, the alterations in the chemical constitution of turpentine were examined through GC-MS. The results demonstrated that the appearance of pine resin gradually deteriorated with increasing storage time. The acid value and softening point are within normal limits (159 ∼ 170 mg/g, approximately 75 °C), and the color of rosin begins to redden, yellow, and darken with time, with a maximum deterioration to grade 5 at 6 months. The refractive index of turpentine gradually increased with time, from 1.4661 to 1.4687, after 6 months of storage. The pinene content declined, with a maximum decrease of 51.88 % at 6 months. In addition, the network diagram was constructed, which delineates the reaction pathways of pinene during storage. The isomerization of α-pinene and β-pinene produces monocyclic terpenoids, primarily including p-cymene and isoterpinolene. A first-order kinetic model was constructed to describe the mechanism of the transformation of α-pinene and β-pinene. The results provided a scientific rationale for further endeavors to enhance the quality of pine resin and associated commodities during the storage.

The emerging field of non-invasive brain stimulation in Alzheimer's disease.

Treating cognitive impairment is a holy grail of modern clinical neuroscience. In the past few years, non-invasive brain stimulation is increasingly emerging as a therapeutic approach to ameliorate performance in patients with cognitive impairment and as an augmentation approach in persons whose cognitive performance is within normal limits. In patients with Alzheimer's disease, better understanding of brain connectivity and function has allowed for the development of different non-invasive brain stimulation protocols. Recent studies have shown that transcranial stimulation methods enhancing brain plasticity with several modalities have beneficial effects on cognitive functions. Amelioration has been shown in preclinical studies on behaviour of transgenic mouse models for Alzheimer's pathology and in clinical studies with variable severity of cognitive impairment. While the field is still grappling with issues related to the standardization of target population, frequency, intensity, treatment duration and stimulated region, positive outcomes have been reported on cognitive functions and on markers of brain pathology. Here we review the most encouraging protocols based on repetitive transcranial magnetic stimulation, transcranial direct current stimulation, transcranial alternating current stimulation, visual-auditory stimulation, photobiomodulation and transcranial focused ultrasound, which have demonstrated efficacy to enhance cognitive functions or slow cognitive decline in patients with Alzheimer's disease. Beneficial non-invasive brain stimulation effects on cognitive functions are associated with the modulation of specific brain networks. The most promising results have been obtained targeting key hubs of higher-level cognitive networks, such as the frontal-parietal network and the default mode network. The personalization of stimulation parameters according to individual brain features sheds new light on optimizing non-invasive brain stimulation protocols for future applications.

Do MMPI-3 Validity Scale Findings Generalize to Concurrently Administered Measures? Validation with a Forensic Disability Sample.

Research has demonstrated that over-reporting and under-reporting, when detected by the MMPI-2/-RF Validity Scales, generalize to responses to other self-report measures. The purpose of this study was to investigate whether the same is true for the Minnesota Multiphasic Personality Inventory-3 (MMPI-3) Validity Scales. We examined the generalizability of over-reporting and under-reporting detected by MMPI-3 Validity Scales to extra-test self-report, performance-based, and performance validity measures. The sample included 665 majority White, male disability claimants who, in addition to the MMPI-3, were administered several self-report measures, some with embedded symptom validity tests (SVTs), performance-based measures, and performance validity tests (PVTs). Three groups were identified based on MMPI-3 Validity Scale scores as over-reporting (n = 276), under-reporting (n = 100), or scoring within normal limits (WNL; n = 289). Over-reporting on the MMPI-3 generalized to symptom over-reporting on concurrently administered self-report measures of psychopathology and was associated with evidence of over-reporting from other embedded SVTs. It was also associated with poorer performance on concurrently administered measures of cognitive functioning and PVTs. Under-reporting on the MMPI-3 generalized to symptom minimization on collateral measures of psychopathology. On measures of cognitive functioning, we found no differences between the under-reporting and WNL groups, except for the Wisconsin Card Sorting Test-64 Card Version and Wide Range Achievement Test-Fifth Edition (each with negligible effect sizes). MMPI-3 Validity Scales can identify possible over- and under-reporting on concurrently administered measures. This can be of particular value when such measures lack validity indicators.

The effectiveness of liver transplantation in reducing lipid levels in Saudi children with homozygous familial hypercholesterolemia

IntroductionThe lipid profiles of patients aged &amp;lt;15 years who have been diagnosed with homozygous familial hypercholesterolemia (HoFH) at King Faisal Specialist Hospital &amp;amp; Research Center (Riyadh) were examined.MethodsThe total cholesterol and low-density lipoprotein cholesterol (LDL-C) levels of 17 patients were measured on initial presentation and compared with the levels measured after pharmacological treatment and then again after liver transplantation.ResultsAt the end of the pharmacological treatment, the total cholesterol levels decreased by an average of 3.79 mmol/L (reduced by 15.40%) (P &amp;lt; 0.001), and LDL-C levels decreased on average by 2.73 mmol/L (reduced by 13.46%) (P = 0.014). However, in two patients, LDL-C levels increased by 5.42% and 9.03% after pharmacological treatment. Conversely, the lipid values measured after liver transplantation decreased significantly nearly to within normal and borderline limits. The post-transplant total cholesterol and LDL-C levels declined by a mean of 19.96 mmol/L (reduced by 81.04%) and 17.47 mmol/L (reduced by 84.27%), respectively (P &amp;lt; 0.001 for both).DiscussionThese findings suggest that liver transplantation provides a more effective means to reduce elevated total cholesterol and LDL-C levels in patients with HoFH. Although liver transplantation is considered a better treatment for FHoH, risks, complications, and donor organ shortage may present problems.

Isatin-1,2,3-triazole derivatives: Synthesis, molecular docking and evaluation against acute experimental toxoplasmosis

Toxoplasmosis remains a challenge for both public health and animal husbandry which created a constant demand to develop novel compounds using innovative methods. To join this relentless quest for an ideal chemotherapeutic agent, herein, we developed newly synthesized isatin-1,2,3-triazole derivatives. Three compounds (5a, 5b and 5c) were synthesized, characterized, loaded on chitosan nanoparticles (CNPs) and then evaluated accordingly. Initially, a molecular docking study was carried out which revealed the effective interaction with the target enzymes; purine nucleoside phosphorylase (PNPase) and T. gondii calcium-dependent protein kinase-1 (TgCDPK1). This was further substantiated by in vivo evaluation of the three compounds (5a-c) and their nanoformulae (5a-CNPs, 5b-CNPs, and 5c-CNPs) against acute Toxoplasma gondii infection in murine model. It is worthy of note that all tested compounds and their nanoformulae produced a statistically significant reduction of parasite burden in both peritoneal fluid and liver impression smear and profound ultrastructural alterations, detected by scanning electron microscopy, compared to the infected non-treated control. The nanoformula 5c-CNPs yielded the most outstanding results with the highest tachyzoite reduction percentage in both peritoneal fluid (98.1%) and liver impression smear (95.3%). Furthermore, the serum levels of liver enzymes (aspartate transaminase (AST) and alanine transaminase (ALT), and renal function tests (urea and creatinine) in mice were within normal limits which makes them more appealing candidates with proven safety. To the best of our knowledge, the present work is the first in silico and in vivo study proving the anti-Toxoplasma effect of isatin-1,2,3- triazoles which paves the way for further development of isatin and triazole-based leads for the treatment of toxoplasmosis.

A Neurological Disease, Vathatvartma (Ptosis), Managed with Integrated Management of Modern Science and Ayurveda – A Case Report

ABSTRACT Introduction: Ptosis is when the upper eyelid droops downward. However, a droopy eyelid can cover the pupil and reduce vision in some cases. Causative factors may be congenital, injury or stretching of eyelid muscles or ligaments damage to the nerve controlling the eyelid muscles, aging, a complication of eye surgery, a complication of Botox injections. Aim and objectives: To study case of ptosis with integrated treatment of neurologist along with Ayurveda treatment. Methodology: Case Description - This is a 34year old female patient complaining that she is unable to open her right eye since11 days. She visited to local ophthalmologist, then they have consulted neurologist, MRI done, treatment started, at the same time patient wants to take Ayurveda treatment also. After 7th day visit to neurologist, she has stopped his medicine and told to continue alternative treatment So she consulted at MGACH&amp;RC Salod on 4/3/2022. Her V/A right eye after uplifting upper lid by doctors hand is 6/6 and lt eye v/A is 6/6. Fundus of both was within normal limit. No diplopia, Acute onset with fronto orbital pain, pupil NSRL, conjugate left downgaze movement restricted. Result and Discussion: treatment prescribedshirodhara with brahmi and til tail, netratarpan with triphalaghruta, Tab Palsineuron 2 bd, Tab Ekangvirras 2 bd. - vatashamak Chikitasa is done as ptosis is neurological disease.after 7th day visit to neurologist, he has stopped his medicine and told to continue alternative treatment. Conclusion: The results were enthusiastic photographic depiction were taken. This case may be fruitful for further research on Nimesh/ Ptosis.

Mental Health of Pediatric Patients with Cystic Fibrosis after 18 Months on Elexacaftor-Tezacaftor-Ivacaftor Therapy.

Research studies are conflicting regarding new highly effective modulators and the association with mental health symptoms for adults and adolescents with cystic fibrosis (CF). For younger children, small studies and case reports indicate a wide range of effects, ranging from improvement in mood to the development of neuropsychiatric symptoms. However, a large placebo-controlled study indicated no causal connection. This study evaluates the frequency and severity of mental health symptoms in children and adolescents while taking elexacaftor/tezacaftor/ivacaftor (ETI). The study includes 81 pediatric patients with CF followed at Nationwide Children's Hospital (NCH). Patient Reported Outcomes Measurement Information System (PROMIS)-Anxiety and Depression, Patient Health Questionnaire 8 (PHQ-8) and Generalized Anxiety Disorder Questionnaire (GAD-7) were used to screen for depression and anxiety. Age-appropriate questionnaires were completed over the first 18 months after initiating ETI. At baseline, majority of participants reported mental health symptoms within normal limits (WNL). For participants with elevated baseline measures, depressive and anxiety symptoms significantly decreased throughout the study period. Depending on the metric, patients experiencing depressive and anxiety symptoms dropped to 2-3% (n = 1, on each depressive measure) and 0% (n = 0, on either anxiety measures) respectively by 18 months. Most pediatric patients with CF did not endorse symptoms of depression or anxiety disorders at ETI initiation. Over the first 18 months of ETI usage, the percentage of patients with these symptoms decreased, suggesting that the percentage of patients experiencing severe symptoms of depression and anxiety may decrease with ongoing use of ETI.

HPB SO57 - Imaging in Acute Pancreatitis: Are We Getting It Right?

Abstract Background Guidelines indicate that routine use of imaging is unwarranted in patients with acute uncomplicated pancreatitis presenting with abdominal pain and increased serum amylase or lipase levels without signs of severe disease. Moreover, early CT scans may fail to accurately reflect disease severity and provide no diagnostic advantage. Method We performed a retrospective clinical audit at a district general hospital in the United Kingdom to find out the current practice regarding the use of imaging in patients presenting with acute pancreatitis. The patients were studied from January 2023 to March 2023 for the 1st cycle, and from April 2024 to May 2024 for the 2nd cycle. The list was identified by the clinical audit department – adult patients who presented to the A&amp;E with symptoms of acute pancreatitis were included. Results Between January - March 2023, 44 patients presented to A&amp;E with symptoms of acute pancreatitis. Of these, 25 (56%) had a CT-scan within 72-hours, with 80% showing evidence of acute pancreatitis —1 with pancreatic necrosis, 7 with intra-peritoneal fluid, &amp; 5 with peri-pancreatic fat-stranding. The study revealed poor compliance with standards, prompting efforts to raise awareness. Findings were shared at the departmental audit meeting, &amp; posters were displayed in A&amp;E and GeneralSurgery departments. In the 2nd-cycle (April-May 2024), 32 patients presented, with 14 (53%) having a CT-scan within 72-hours &amp; all had serum amylase levels checked, with 11 within normal limits. Conclusion This closed-loop clinical audit demonstrated that with appropriate measures and improved awareness of current guidelines, there can be increased compliance to the guidelines by the clinicians. This, in turn, reduces the risk of radiation exposure to patients and optimizes the use of CT scans.

Abstract 4118178: Echocardiographic Measure of Right Ventricular-Pulmonary Arterial Coupling Predicts Survival in Lung Cancer

Background: Echocardiographic indicators of pulmonary hypertension have been reported to predict decreased survival in lung cancer. We sought to test the hypothesis that this may be associated with impaired right ventricular (RV)-systolic pulmonary arterial pressure (sPAP) coupling, further enhancing the prognostic strength of echocardiography in lung cancer. Methods: This prospective observational study included 220 patients with non-small cell lung cancer (NSCLC) examined by Doppler, strain and 3D echocardiography before starting therapy. Prediction of overall survival was assessed by univariable analysis followed by multivariate Cox regression, receiver operating characteristic (ROC) curves and Kaplan-Meier analyses. Results: Echocardiographic examination was on average within normal limits, even though 30% of the patients had sPAP ≥35 mm Hg. In univariable analysis, overall survival was associated with measures of RV systolic function and probability of pulmonary hypertension. In multivariate Cox regression, only RV global longitudinal strain (GLS)/sPAP (HR: 5.766 [95% CI: 1.025–32.443]) and Eastern Cooperative Oncology Group performance status &lt;2 (HR: 0.332 [95% CI: 0.171–0.644]) independently predicted survival. The optimal ROC curve-derived RV GLS/sPAP cut-off to predict survival was −0.54%/mm Hg. Among patients in Union for International Cancer Control (UICC) stage 4, those with impaired RV-arterial coupling (RV GLS/sPAP &gt;−0.54%/mm Hg) had worse survival than those with maintained RV-arterial coupling (HR: 2.8 [95% CI: 1.5–5.3]); the latter subgroup had similar survival compared with patients in UICC stage 3 (HR: 0.57 [95% CI: 0.28–1.14]). Conclusion: RV GLS/sPAP as an echocardiographic measure of RV-arterial coupling adds to prognostication by the UICC status in NSCLC.

Short-term intraocular pressure changes after intravitreal aflibercept 2 mg, aflibercept 8 mg and faricimab: a prospective, comparative study

Background/aimsIntravitreal injection (IVT) of anti-vascular endothelial growth factor agents is the standard of care for several retinal diseases but can cause intraocular pressure (IOP) elevations. This study investigates short-term postinjection...

TUDY OF CHRONIC TOXICITY OF AN IMPROVED A-SILICONE IMPRESSION MATERIAL PRODUCED IN UKRAINE

The objective of this study is to evaluate the potential toxic effects of an improved A-silicone impression material with decorative properties on the organs and mucous membranes of laboratory animals. Materials and Methods The experiment was conducted on white laboratory rats aged 9 months and weighing 230–285 g. Findings indicate that prolonged contact (30 days) with the material does not result in significant changes in the function of major organ systems in these laboratory rats. Results. A single exposure of laboratory rats to A-silicone impression material with disinfectant properties did not cause significant changes in the physiological state of the animals. Weights of internal organs, including the liver, spleen, heart, and adrenal glands, remained within normal limits, indicating that the material had no toxic effects. The analysis of the peripheral blood composition did not reveal any abnormalities in the number of red blood cells, leukocytes, hemoglobin and other cellular components. The functional state of the liver and kidneys, including the activity of the enzymes AlаT and AсаT, levels of total protein, albumin, creatinine and urea, remained stable and did not change under the influence of the material. There was also no effect on carbohydrate metabolism. No abnormalities in protein synthesis and nitrogen excretion functions were detected, which confirms the safety of the material during the 30-day observation. Conclusion. It was established that this material in the tested dose does not affect the enzyme-synthetic function of the liver and does not exhibit cytolytic effects. The material was found to have no toxic impact on liver function with prolonged use, nor does it cause statistically significant deviations in the measured indicators between the control and experimental groups. The absence of sugar, ketones, and protein in the urine indicates no adverse effect on the renal nitrogen-excreting and saluretic functions, as well as on the vital organs of the rats.