Standard Markers Research Articles

Lactate Dehydrogenase Levels after Aortic Valve Replacement: What Do They Tell Us?

Lactate dehydrogenase (LDH) is a standard postoperative marker for hemolysis in the presence of paravalvular leakage (PVL) after replacement of the aortic valve (AVR). LDH is elevated in certain valves by a fluttering phenomenon. Previous studies suggested a correlation between microparticles (MPs) and LDH elevation after AVR. Thus, we analyze the postoperative relevance of LDH after AVR with transapical transcatheter aortic valves (TA-TAVs) or rapid deployment valves (RDVs). We retrospectively analyzed the data from patients who received an AVR with the RDV and TA-TAV groups between 2015 and 2018. We compared PVL and LDH levels before and after surgery, transvalvular gradients, heart block that required pacemaker implantation, and 30-day mortality. In total, 138 consecutive patients were selected for the study: 79 patients in the RDV group (37 Sorin Perceval valve, 42 Edwards Intuity valve) and 59 in the TA-TAV group (Edwards Sapien valve). TA-TAV group was older (median 10 years) and had a higher incidence of PVL (odds ratio 11, 95% confidence interval [CI] 2.5-73.2, p = 0.04)). Interestingly, the TA-TAV group showed lower levels of LDH despite higher rates of PVL. Of note, the Perceval valve trended toward higher LDH values. Additionally, the RDV group showed an increased arrhythmia profile (p = 0.0041); however, the results show lower incidence in pacemaker implantation (95% CI 0.05-1.65, p = 0.635). The 30-day mortality was similar between groups. Our data do not support the association between hemolysis and PVL despite elevated LDH in suture-free valves. Our results suggest that LDH could be a marker of extreme heart muscle output or fluttering phenomenon and not a marker of hemolysis after sutureless AVR.

Forget-me-not phylogenomics: Improving the resolution and taxonomy of a rapid island and mountain radiation in Aotearoa New Zealand (Myosotis; Boraginaceae)

Island and mountain systems represent natural laboratories for studies of species radiations, but they often present several challenges for phylogenetic inference and species delimitation. The southern hemisphere forget-me-nots (Myosotis, Boraginaceae) comprise a geologically recent radiation centred in Aotearoa New Zealand, a mountainous archipelago, with about 50 species that are morphologically and ecologically divergent but lack genetic variation sufficient to resolve phylogenetic relationships and species boundaries using standard DNA Sanger sequencing markers, AFLPs, or microsatellites. Many of these Myosotis species are geographically restricted in alpine areas, uncommon or threatened, have polyploid and dysploid genomes, and are of high taxonomic and conservation priority. Here we present phylogenomic analyses using target-capture of Angiosperms353 baits, and genome skimming of whole plastomes and nrDNA, to improve resolution of the radiation, explore biogeographic and morphological patterns within it, and address specific taxonomic questions for each species. Our comprehensive sampling includes over 300 individuals representing nearly all species from New Zealand and Australia, which is ∼ 2–3 × more taxon sampling and ∼ 80–120 × more molecular data than previously published for Myosotis. Exploration of different data filtering, curation and analyses (coalescent vs. concatenation) improved the resolution of the Angiosperms353 tree, which despite short backbone branches with low support values, showed taxonomic and geographic patterns, including multiple switches between ebracteate and bracteate inflorescences and multiple expansions within New Zealand from Te Waipounamu South Island to Te Ika-a-Māui North Island, Rakiura Stewart Island, subantarctic islands, and Australia. Some of these patterns were also seen in the genome skimming datasets, and comparison of the three datasets was useful for improving our understanding of the taxonomy and resolution of this radiation. Although this phylogenomic study does not fully overcome all of the challenges regarding species delimitation of this rapid island and mountain species radiation, it nevertheless makes an important contribution to an integrative taxonomic revision of the southern hemisphere species of Myosotis.

Evaluation of Feulgen Reaction for Quantitative DNA Analysis in Oral Leukoplakia: Insights into Malignant Transformation Risk

ABSTRACT Background: Oral leukoplakia is a potentially malignant disorder with a significant risk of transformation into oral squamous cell carcinoma. The Feulgen reaction, a DNA-specific staining technique, has been widely used for the quantitative analysis of DNA content in various tissues. Materials and Methods: A total of 50 patients diagnosed with oral leukoplakia were selected for the study. Biopsy samples were obtained from the lesions, and the Feulgen reaction was performed to stain the DNA. Quantitative DNA analysis was conducted using image cytometry, measuring the integrated optical density (IOD) of Feulgen-stained nuclei. The samples were categorized based on their DNA content into diploid, aneuploid, and tetraploid groups. Statistical analysis was performed to assess the correlation between DNA content and the histopathological grading of the lesions. Results: Out of the 50 samples, 30% (n = 15) exhibited diploid DNA content, 50% (n = 25) were aneuploid, and 20% (n = 10) were tetraploid. A significant correlation was found between aneuploid DNA content and higher grades of dysplasia (P < 0.05). The mean IOD values for diploid, aneuploid, and tetraploid samples were 1.2, 2.8, and 3.5, respectively. Patients with aneuploid DNA content demonstrated a higher risk of malignant transformation compared to those with diploid DNA content. Conclusion: The Feulgen reaction, combined with quantitative DNA analysis, is a valuable tool in assessing the malignant transformation risk in oral leukoplakia. The presence of aneuploidy in these lesions is significantly associated with higher dysplastic changes and an increased risk of progression to oral cancer. Further studies with larger sample sizes are recommended to validate these findings and to establish the Feulgen reaction as a standard predictive marker in clinical practice.

Determining how the gestational changes, including low hemoglobin influence the hba1c and estimated average glucose relationship

ABSTRACT Background: Gestational Diabetes Mellitus (GDM) affects up to 14% of pregnancies globally, with accurate glycemic control critical for preventing adverse outcomes. While HbA1c is a standard marker for long-term glucose control, its reliability in pregnant women with anemia is debated. This study explores the association between anemia and glycemic indicators (Glycosylated hemoglobin HbA1c, Random plasma glucose (rPG), and Estimated average glucose (eAG) in pregnant women with GDM. Additionally, it examined the correlation between average glucose levels or eAG, measured by random plasma glucose rPG, and HbA1C. Methods: A prospective case-control study was carried out over eight months at the Departments of Chemical Pathology and Obstetrics and Gynecology, Dow University of Health Sciences (DUHS). Pregnant women in their second trimester after being diagnosed for GDM through oral glucose tolerance test were classified into anemic (hemoglobin < 10.5 g/dL) and non-anemic groups. Blood samples were collected and analyzed for HbA1c, hemoglobin, and random plasma glucose levels. Data were processed using SPSS (version-26) different variables compared by using independent t-test and correlation analyses at a significance level of p < 0.05. Results: Mean values for eAG, HbA1C, and rPG were 174.22 ± 24.489 mg/dl, 8.342 ± 1.6152%, and 166.21 ± 21.478 mg/dl, respectively. Anemia was associated with significantly higher HbA1C (p < 0.001), eAG (p < 0.001), and rPG (p = 0.004). A strong positive correlation was observed between eAG and rPG (r = 0.958, p < 0.01), while eAG showed a moderate correlation with HbA1C (r = 0.501, p < 0.01). In contrast, the correlation between HbA1C and rPG was weaker (r = 0.331, p < 0.01). Conclusion: eAG proved to be a good indicator for assessing glycemic control in pregnant non-anemic women with GDM. Anemia significantly affected glycemic metrics, leading to higher HbA1C and glucose levels.

Epitope Analysis of Hypothetical Proteins in Leptospira interrogans Serovar Lai Reveals Potential Diagnostic Markers

Leptospirosis is a neglected zoonosis caused by a pathogenic spirochete, Leptospira interrogans. The mode of infection in humans is through an abrasion in human skin or the conjunctiva and mucous membrane. Infected patients usually show different symptoms resembling bacterial or viral infections such as the flu. Hence, diagnosing leptospirosis in the early stage is complex, and can be easily confused with other infections. A strategical pathway was developed to analyze the hypothetical proteins in L. interrogans and unveil their potential as diagnostic markers. Subcellular localization tools such as PSORTb, CELLO, SOSUI-GramN, and ProtCompB were used to segregate the outer membrane and surface proteins from the overall pool of hypothetical proteins. The shortlisted proteins were checked for their virulency, and antigenicity through tools such as VirulentPred, and VaxiJen, respectively. Proteins with the highest scores were fed into ElliPro which predicted both linear and discontinuous epitopes in each protein. Proteins with many epitopes were further analyzed with BepiPred 3.0, which provided the epitope probability for each protein’s amino acid. Epitope probability of the potential proteins was compared with the standard diagnostic marker, LipL32. The comparison revealed that a protein (UniProt ID D4YW28) has better immunogenic potential than the gold standard marker, LipL32. In conclusion, this protein can be used as a diagnostic marker for the detection of leptospirosis and it will also serve as a better vaccine candidate.

Assessment of Glecaprevir/Pibrentasvir Treatment’s Influence on Biochemical and Metabolic Markers in Patients with Chronic Hepatitis

Background/Objectives: Liver function tests (LFT) are essential for diagnosing and monitoring liver status in patients with chronic hepatitis. In addition, tracking the systemic implications reflected in the changes in metabolic parameters is essential for correctly managing the cases. This study addresses the critical gap in the literature by evaluating the effects of glecaprevir/pibrentasvir on key liver function markers (AST, ALT, GGT, TB) and metabolic parameters (TC, TG, HbA1c) in patients with chronic hepatitis C (CHC). Moreover, this study will evaluate the impact of glecaprevir/pibrentasvir on A2MG, which provides insights into its effects on liver fibrosis. Awareness of these effects is critical for the optimal management of patients during and following antiviral therapy to ensure that therapeutic success does not come at the expense of overall liver and metabolic health. These parameters should be monitored as they supply clinicians with essential data, informing treatment more accurately and ensuring a holistic approach in CH patients. Methods: This study consists of 104 patients with chronic hepatitis C treated with glecaprevir/pibrentasvir and monitored from January to June 2024. Assessments comprised standard liver markers, lipid profiles, glycated hemoglobin, and alpha-2-macroglobulin, as well as specific non-invasive tests of liver injury. Results: 95.2% of the patients experienced a sustained virologic response. Biochemical markers and total cholesterol values were significantly decreased with glecaprevir/pibrentasvir therapy. Non-significant elevations in total bilirubin and glycated hemoglobin support the drug’s favorable tolerability profile. Conclusions: In the treatment of chronic hepatitis C patients, glecaprevir/pibrentasvir therapy leads to normalization in biochemical markers (AST, ALT, and GGT), as well as in total cholesterol.

Sensitive Detection of Gynecological Cancer Recurrence Using Circulating Tumor DNA and Digital PCR: A Comparative Study with Serum Biochemical Markers.

Early detection of recurrences in gynecological cancers is crucial for women's health. Circulating tumor DNA (ctDNA) analysis through liquid biopsy offers a promising approach for monitoring disease progression and identifying relapses. This study investigated the utility of digital Polymerase Chain Reaction (dPCR) for ctDNA detection in three gynecological cancer patients with clinically confirmed relapses during a two-year post-surgical follow-up. Patient-specific tumor mutations were identified through whole-exome sequencing (WES) and confirmed via Sanger sequencing. dPCR probes targeting these mutations were used to quantify the ctDNA levels in plasma samples collected throughout the follow-up period, and the findings were compared with standard serum biochemical markers. In two patients, persistent positive dPCR signals for the selected mutations were detected after tumor removal, with ctDNA levels progressively increasing even after post-surgical chemotherapy. Notably, dPCR identified elevated ctDNA levels before an increase in the cancer antigen 125 (CA125) biochemical marker was observed. In the third patient, no ctDNA signals from the two selected mutations were detected despite clinical evidence of recurrence, suggesting the emergence of new mutations. While this study highlights the promise of dPCR for early recurrence detection in gynecological cancers, it also underscores the critical need for comprehensive mutation panels to overcome the inherent challenges posed by tumor heterogeneity and the emergence of new mutations during disease progression.

Novel Gene Biomarkers Specific to Human Mesenchymal Stem Cells Isolated from Bone Marrow.

In this paper, we present a comparative analysis of the transcriptomic profile of three different human cell types: hematopoietic stem cells (HSCs), bone marrow-derived mesenchymal stem cells (MSCs) and fibroblasts (FIBs). The work aims to identify unique genes that are differentially expressed as specific markers of bone marrow-derived MSCs, and to achieve this undertakes a detailed analysis of three independent datasets that include quantification of the global gene expression profiles of three primary cell types: HSCs, MSCs and FIBs. A robust bioinformatics method, called GlobalTest, is used to assess the specific association between one or more genes expressed in a sample and the outcome variable, that is, the 'cell type' provided as a single univariate response. This outcome variable is predicted for each sample tested, based on the expression profile of the specific genes that are used as input to the test. The precision of the tests is calculated along with the statistical sensitivity and specificity for each gene in each dataset, yielding four genes that mark MSCs with high accuracy. Among these, the best performer is the protein-coding gene Transgelin (TAGLN, Gene ID: 6876) (with a Positive Predictive Value > 0.96 and FDR < 0.001), which identifies MSCs better than any of the currently used standard markers: ENG (CD105), THY1 (CD90) or NT5E (CD73). The results are validated by RT-qPCR, providing novel gene biomarkers specific for human MSCs.

Determination of Dried Root Extract of Rheum emodi and its Commercial Products Using Rhein and Chrysophanol as Standard Markers by HPTLC Densitometric Analysis

Determination of Dried Root Extract of Rheum emodi and its Commercial Products Using Rhein and Chrysophanol as Standard Markers by HPTLC Densitometric Analysis

Static histomorphometry parameters can identify bone turnover status in children and adults with chronic kidney disease

IntroductionTetracycline labeling for bone biopsy facilitates quantification of the pace of new bone production. As tetracycline labeling needs to be done prior to biopsy, it cannot be used to assess bone turnover in patients presenting with fractures, yet knowing turnover rate in patients experiencing fractures - especially in those with chronic kidney disease (CKD) - may guide appropriate medical therapy after surgical repair. Therefore, we sought to determine the diagnostic accuracy of static markers of bone turnover relative to tetracycline labeling in a pediatric and adult cohort of patients with chronic kidney disease (CKD) undergoing iliac crest biopsy with histomorphometry. MethodsWe evaluated two cohorts, one of 147 children and young adults ages 18±10 and another of 151 adults ages 49±13 who had undergone iliac crest biopsy with tetracycline labeling for clinical indications of CKD-mineral and bone disorders. We used bone formation rate relative to bone surface (BFR/BS) based on double tetracycline labeling as our gold standard marker of bone turnover. A blinded investigator used light microscopy without fluorescence to measure static bone turnover parameters. We compared the area under the ROC curve (AUC), sensitivity, and specificity of each static parameter with low and high bone turnover based on BFR/BS. ResultsIn the pediatric and adult cohorts, 35 (24 %) and 70 (46 %) had low bone turnover, respectively, and 18 (12 %) and 30 (20 %) had high bone turnover, respectively. The static parameters with the greatest AUCs for low and high turnover were osteoblasts surface/bone surface (Ob.S/BS), osteoclasts surface/bone surface (Oc.S/BS), eroded surface/bone surface (ES/BS), osteoid surface/bone surface (OS/BS), osteoid volume/bone volume (OV/BV), and osteoid thickness (O.Th.) in both cohorts. Ob.S/BS had the highest AUC for low and high turnover in the pediatric cohort (0.8204 and 0.8678, respectively) whereas Oc.S/BS had the highest AUC for low turnover (0.8325) and ES/BS had the highest AUC for high turnover (0.7360) in the adult cohort. DiscussionStatic measures of histomorphometry that do not rely on tetracycline bone labeling can identify low and high bone turnover in children and adults with CKD with moderate to high accuracy. This approach may allow assessment of bone turnover in the setting of clinical fractures where clinicians may have access to bone tissue but where tetracycline labeling is not possible.

Comparison of the Performance of Commercially Available Quantitative Viral Load Assays Using Clinical Samples from Patients from Regions Where Distinct HIV-1 Subtypes Co-Circulate: Potential Implications for Patient Management.

HIV RNA plasma viral load (VL) is the standard surrogate marker to monitor response to antiretroviral treatment (ART). We compared the linearity, repeatability, and concordance of six commercially available HIV RNA VL platforms using clinical samples from patients from Brazilian sites where different HIV-1 subtypes co-circulate. A total of 150 plasma samples from each city were collected in Curitiba, Southern Brazil (subtype C), São Paulo (subtype B), and Santos (BF recombinants), Southeast Brazil. Platforms were VERSANT® Siemens HIV RNA 1.0 (kPCR); VERSANT® Siemens HIV-1 RNA 3.0 (bDNA); Abbott Real-Time HIV-1; NucliSens EasyQ® HIV-1 v2.0 Biomerieux; COBAS® TaqMan®, Roche; and artus HIV Virus-1 RT-PCR, QIAGEN. OptiQuant HIV-1 RNA quantification panel was used to compare VL linearity, using samples containing 50, 500,5,000, 50,000, 500,000, and 5,000,000 HIV copies/mL. HIV RNA panels with subtypes A, B, C, D, F, G, H, circulating recombinant form (CRF)1, and CRF2 were utilized. A high degree of linearity and repeatability was demonstrated for all platforms. When compared with a subtype B reference sample, 17 of 54 (31.48%) samples diverged by more than 0.5 log10 copies/mL. Except for the Roche platform, all platforms underestimated subtype C VLs. A total of 743 (82.6%) valid results were obtained with samples from São Paulo, 707 (78.6%) from Santos, and 673 (74.8%) from Curitiba (São Paulo vs. Santos, p = .03; São Paulo vs. Curitiba, p = .00006; Santos vs. Curitiba, p = .06). The number of discordant samples between different methodologies when VL was undetectable in one method and detectable in the other ranged from 1.25% (Abbot vs. Siemens) to 44.8% (Abbott vs. Biomerieux). Finding samples with undetectable VL in one method and a high VL in another might have important individual and public health consequences. Standardization of VL measurements, particularly for non-B subtypes infections, especially subtype C, is necessary to maximize the individual and public health benefits of ART globally.

Evaluation of Blood–Brain Barrier Disruption Using Low- and High-Molecular-Weight Complexes in a Single Brain Sample in a Rat Traumatic Brain Injury Model: Comparison to an Established Magnetic Resonance Imaging Technique

Traumatic brain injury (TBI), a major cause of death and disability among young people, leads to significant public health and economic challenges. Despite its frequency, treatment options remain largely unsuitable. However, examination of the blood–brain barrier (BBB) can assist with understanding the mechanisms and dynamics of brain dysfunction, which affects TBI sufferers secondarily to the injury. Here, we present a rat model of TBI focused on two standard BBB assessment markers, high- and low-molecular-weight complexes, in order to understand BBB disruption. In addition, we tested a new technique to evaluate BBB disruption on a single brain set, comparing the new technique with neuroimaging. A total of 100 Sprague–Dawley rats were separated into the following five groups: naive rats (n = 20 rats), control rats with administration (n = 20 rats), and TBI rats (n = 60 rats). Rats were assessed at different time points after the injury to measure BBB disruption using low- and high-molecular-weight complexes. Neurological severity score was evaluated at baseline and at 24 h following TBI. During the neurological exam after TBI, the rats were scanned with magnetic resonance imaging and euthanized for assessment of the BBB permeability. We found that the two markers displayed different examples of BBB disruption in the same set of brain tissues over the period of a week. Our innovative protocol for assessing BBB permeability using high- and low-molecular-weight complexes markers in a single brain set showed appropriate results. Additionally, we determined the lower limit of sensitivity, therefore demonstrating the accuracy of this method.

Association of PD-L1 immunoexpression with tumor grade in colorectal adenocarcinoma

Globally, colorectal cancer (CRC) is the primary cause of cancer-related deaths, and in emerging countries, its prevalence is continuously increasing. With all the advancements in surgery and treatment, the outlook for CRC patients is still not good. Even with the use of standard prognostic markers, there are presently no effective prognostic techniques for colorectal cancer. The long-term survival of many malignancies has been significantly enhanced by immune checkpoint blockades (ICB), suggesting that the immune checkpoint mechanism is crucial in inhibiting tumor-specific immune responses in the tumor microenvironment. By inhibiting T effector cell activity, the "PD-1 (programmed cell death-1)"/PD-L1 (programmed cell death-ligand 1) axis contributes significantly to immune suppression control and allows tumor cells to evade the host's anti-tumor immune surveillance. While early study suggested that immunotherapy was not relevant for patients with colorectal cancer, more recent studies have demonstrated that immunotherapy was beneficial for a certain subset of patients. This suggests that the prognosis prediction of colorectal cancer may benefit from a thorough evaluation of the local immune response. This study set out to assess the association between PD-L1 immunoexpression and tumor grade in CRC. : This was a cross-sectional observational study. Paraffin blocks of total 64 cases were selected from the patients who were diagnosed as adenocarcinoma from resected samples received in the department of pathology at BSMMU from July 2021 to June 2023. Immuno-histochemical staining for PD-L1 was performed using 28-8 clone along with appropriate positive control. In this study, PD-L1 immuno-expression was found in 14(21.9%) out of 64 cases. However, no expression was found in rest of the 50 (78.1%) cases. This study showed association of PD-L1 expression with high grade (Grade-3) tumors. : Evaluation of expression of PD-L1 may emerge as a new marker and target for the immunotherapy of colorectal cancer.

Hsa_circ_0002473 inhibits GH3 cell proliferation and GH secretion as a competitive endogenous RNA for has-miR-4645-3p.

Growth hormone deficiency (GHD) diagnosis still lacks a gold standard or ideal diagnostic marker. Unlike other epigenetic mechanisms, non-coding RNAs regulate post-transcriptional levels. The information on non-coding RNAs in the field of GHD is limited. Therefore, this study aimed to explore the role of hsa_circ_0002473 as a competitive endogenous RNA for has-miR-4645-3p in attenuating the inhibitory effect of has-miR-4645-3p on SSTR2. In this study, we screened three significantly expressed circular RNAs (circRNAs) in five children with GHD, and selected the highest expressed hsa_circ_0002473 as the study object, and screened has-miR-4645-3p, which is the most likely to bind to hsa_circ_0002473, according to the microRNA (miRNA)-circRNA regulatory network, to study the role and mechanism of has-miR-4645-3p as a competitive endogenous RNA of has-miR-4645-3p on GH3 cells. Somatostatin receptor 2 (SSTR2) inhibits GH3 cell proliferation, and miRNA binding to SSTR2 inhibits the latter expression. Both bioinformatics and dual-luciferase reporter analyses showed targeting relationships between hsa_circ_0002473 and has-miR-4645-3p and between has-miR-4645-3p and SSTR2. We constructed the hsa_circ_0002473/has-miR-4645-3p axis and transfected it into GH3 cells and found that overexpression of hsa_circ_0002473 inhibited the proliferation and growth hormone (GH) secretion of GH3 cells, and that hsa-miR-4645-3p promoted the proliferation and GH secretion of GH3 cells by targeting SSTR2. Co-culture revealed that the inhibitory effect of hsa_circ_0002473 was reversed by has-miR-4645-3p. In conclusion, our findings suggest that hsa_circ_0002473 can act as a competitive endogenous RNA for has-miR-4645-3p to regulate GH3 cell proliferation and secretion by targeting SSTR2.

Identifiable Information Value of Standard Autosomal STR in Indigenous Populations of Russia for Determination of First-Degree Relatedness

The effects of the demographic history of mankind have led to the fact that the indigenous peoples of Dagestan and Siberia are inferior in terms of genetic diversity to the populations of Europe, which affects the level of identification informativeness of standard forensic autosomal markers in these populations. In our study, we evaluated the effectiveness of two standard sets of autosomal STRs (13 CODIS, 20 CODIS, Combined DNA Index System) for the genetic testing of parent-child relatedness in four highly inbred populations of the Russian Federation and the Russian population, using two types of reference frequencies. The results of the study confirmed the assumption that the level of identification informativity of standard autosomal markers in highly inbred populations of Siberia and Dagestan is lower than in the Russian population. The total information content of markers of the new CODIS standard exceeds the threshold values required in the order of the Ministry of Health and Social Development of the Russian Federation (No. 346n). At the same time, the probability of a false positive result increases with an increase in the inbreeding coefficient in the population.

6744 Clinical Profile And Outcomes Of Medically And Surgically Managed Patient With Primary Hyperaldosteronism In A Third-World World Setting

Abstract Disclosure: A.A. Apa-ap: None. E.P. Pacheco: None. Background: Assessing therapeutic response in Primary hyperaldosteronism (PA) has previously been significantly hampered by a lack of standardized outcome markers. Although most participants in observational studies benefit from both medical and surgical therapy, comparative analyses have been limited. To date, no available Filipino data comparing therapeutic responses have been published. This paper aims to answer the clinical profile and outcomes of patients with PA in a third-world setting. Method: This is a retrospective cohort study that includes adult patients diagnosed with PA in the Philippine General Hospital seen at the outpatient department and admitted from January 1, 2013, until December 31, 2022. Result: 57 patients with PA were identified on chart review. A total of 40 (70%) patients were included in the study. 17 patients were excluded due to missing data. All patients had a unilateral adrenal mass. 23 patients underwent adrenalectomy and grouped under surgical management. 17 patients were treated with antihypertensive including MRA and grouped under medical management. Out of the 40 patients included: 83% were women, mean age was 40, hypertension averaged 6 years and 92.5% had hypokalemia. Radiologic profile showed mean tumor size 1.7cm and and mean tumor density 11.7 HU, mean absolute washout of 68.8 HU, and mean relative washout 54.8 HU. Comparing the post-treatment clinical outcome between surgical and medical management showed that patients who underwent surgical treatment had significantly lower systolic (difference=-11.12, p=0.0012) and diastolic blood pressure (difference= -6.03, p=0.0264), mean number of antihypertensive medication (difference= -2.30, p&amp;lt;0.001), mean daily dose of antihypertensive(difference= -3.43, p&amp;lt;0.001). Both groups had normal serum K post-treatment, but patients who underwent surgical treatment had significantly higher mean serum K (difference= 0.41, p=0.0025) and none had required MRA post-op. There was a lower number of patients with left ventricular hypertrophy and a significantly higher ejection fraction (difference= 5.81, p=0.0038) post-op compared to patients who underwent medical management. In terms of biochemical profile, there was a significantly lower mean plasma aldosterone concentration (difference= -31.95, p&amp;lt;0.001), and mean aldosterone/renin activity (difference= -211.51, p=0.0013) and significantly higher mean plasma renin activity (difference= 0.43, p&amp;lt;0.001) after surgery compared to those who underwent medical management. All surgical patients had a histopathologic diagnosis of adrenocortical adenoma. 9 patients complete clinical success and 14 had partial clinical success post-op; 22 had complete biochemical success and 1 had partial biochemical success based on PASO consensus. Conclusion: This study showed better clinical outcomes in patients with PA who underwent surgical management. Presentation: 6/1/2024

Comparing qualitative and quantitative echocardiographic markers to assess cardiac contractility in newborn infants: protocol for a prospective cohort study

IntroductionNeonatologist-performed echocardiography (NPE) is increasingly used in the neonatal intensive care unit, aiding clinicians in enhancing diagnostic precision and guiding treatment decisions based on underlying pathophysiology. Experienced NPE operators typically...

Glymphatic System and Psychiatric Disorders: A Rapid Comprehensive Scoping Review.

Since discovering the glymphatic system, there has been a looming interest in exploring its relationship with psychiatric disorders. Recently, increasing evidence suggests an involvement of the glymphatic system in the pathophysiology of psychiatric disorders. However, clear data are still lacking. In this context, this rapid comprehensive PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) scoping review aims to identify and analyze current evidence about the relation between the glymphatic system and psychiatric disorders. We conducted a comprehensive review of the literature and then proceeded to discuss the findings narratively. Tables were then constructed and articles were sorted according to authors, year, title, location of study, sample size, psychiatric disorder, the aim of the study, principal findings, implications. Twenty papers were identified as eligible, among which 2 articles on Schizophrenia, 1 on Autism Spectrum Disorders, 2 on Depression, 1 on Depression and Trauma-related Disorders, 1 on Depression and Anxiety, 2 on Anxiety and Sleep Disorders, 8 on Sleep Disorders, 2 on Alcohol use disorder and 1 on Cocaine Use Disorder. This review suggests a correlation between the glymphatic system and several psychiatric disorders: Schizophrenia, Depression, Anxiety Disorders, Sleep Disorders, Alcohol Use Disorder, Cocaine Use Disorder, Trauma-Related Disorders, and Autism Spectrum Disorders. Impairment of the glymphatic system could play a role in Trauma-Related Disorders, Alcohol Use Disorders, Cocaine Use Disorders, Sleep Disorders, Depression, and Autism Spectrum Disorders. It is important to implement research on this topic and adopt standardized markers and radio diagnostic tools.

Molecular detection of Rickettsia aeschlimannii, Candidatus Rickettsia shennongii, Rickettsia sp. and Coxiella burnetii in ticks collected from camels

Tick-borne bacteria of the genera Rickettsia and Coxiella cause several emerging veterinary and human infectious diseases. Ticks of the genus Hyalomma are medically important vectors due to their potential role in the transmission of pathogens to vertebrate hosts. There is an inadequate knowledge on tick-borne Rickettsia spp. and Coxiella spp. in ticks infesting transhumant camels in Pakistan. In this study, we conducted a molecular survey for screening of Rickettsia spp. and Coxiella spp. in ticks infesting camels. Seven hard tick species including Hyalomma dromedarii, Hyalomma anatolicum, Hyalomma scupense, Hyalomma isaaci, Hyalomma turanicum, Hyalomma asiaticum, and Rhipicephalus sanguineus s.l were confirmed on camels in three distinct physiographic regions of Khyber Pakhtunkhwa, Pakistan. A subset of morphologically identified ticks were subjected to molecular assays for the genetic characterization of ticks and the detection and genetic characterization of Rickettsia and Coxiella species using standard genetic markers. Ticks screened for pathogens resulted in the detection of Rickettsia aeschlimannii and Candidatus Rickettsia shennongii and Coxiella burnetii. The molecular analysis further reveals the presences of an undetermined Rickettsia aeschlimannii-like species, that is making a distinct phylogenetic clade with R. aeschlimannii. The detection of pathogens in camel ticks poses potential health hazards as these ticks frequently bites humans. Molecular screening of Rickettsia spp. and Coxiella spp. associated with camel ticks is a preliminary step toward the surveillance of evaluating their zoonotic threats in the region.

Species delimitation under allopatry: genomic insights within and across continents in Lepidoptera

Abstract Delimitation of allopatric populations into species remains subjective and largely arbitrary. Many cold-adapted species from the sub-Arctic and Central and Southern European Mountain systems provide excellent models to study allopatry problem due to their patchy distributions. The same concerns many Holarctic species, which frequently show varying degrees of differentiation between continents. In this study, we analyze high-throughput target enrichment data for 10 groups of Arctic-alpine and Holarctic lepidopteran species sampled from different regions across the Holarctic realm, i.e., Fennoscandia, European Alps, Altai Mountains, and North America. We first aimed to assess whether the genetic differences in the nuclear genome reflected observed DNA barcode divergences and, secondly, whether the gap between population and species-level differences can be reliably dissected using genomic data. We compared the phylogenetic trees and uncorrected pairwise genetic distances obtained from target enrichment and mitochondrial COI barcodes and performed a suite of population genetic and species delimitation analyses to further explore patterns of intraspecific variation in our study species. We observed that in about one-half of the cases, DNA barcodes showed phylogenetic relationships similar to the target enrichment markers. Nuclear genetic differentiation varied among the populations analyzed, from low differentiation of geographically separated populations to the deeper separation of some Nearctic populations and Arctic-alpine disjunction in the populations from Fennoscandia and Southern European mountains. Our results highlight the need for consistent delimitation of allopatric populations, especially given the prevalence of distributional discontinuities across species. Large sets of standard genetic markers provide a very promising avenue towards this goal.