Occurrence Of Syndrome Research Articles

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.

Analysis of Deep Vein Thrombosis: A Prospective Observational Study.

Objective This prospective observational study aimed to investigate the prevalence, acquired risk factors, and treatment outcomes of deep vein thrombosis (DVT) at a tertiary care center in India. Materials and methods Conducted from 2022 to 2024, the study included 100 patients diagnosed with lower extremity DVT. The study subjects included patients visiting the general surgery, vascular surgery, surgical gastroenterology, general medicine, emergency medicine, and obstetrics and gynecology departments with symptoms suggestive of DVT. The primary objectives were to evaluate the effectiveness of conventional anticoagulation and thrombolytic therapy as well as to assess the various acquired risk factors for DVT. Patients underwent comprehensive clinical and biochemical evaluations, including venous Doppler ultrasound, and were treated based on their clinical presentations. The study's primary end outcome was early recanalization rates on day 14 post-initiation of treatment and occurrence of post-thrombotic syndrome (PTS). Secondary outcome measures included duration of hospital stay, time taken to return to workand early complications. Results The highest incidence of DVT was in individuals in their forties, with a mean age of 44.84+/-11.71 years and a female preponderance of 58% (n=58). Key acquired risk factors identified included hypertension (25%; n=25), diabetes mellitus (20%; n=20), obesity (16%; n=16), and smoking (34%; n=34). Obesity (16%; n=16), a history of DVT (25%; n=25), trauma/immobilization (9%; n=9), pregnancy (10%; n=10), smoking (34%; n=34), and cancer (20%; n=20) were also identified as important acquired risk factors contributing to the occurrence of DVT. Amongst the study participants, 28% (n=28) had femoro-popliteal segment involvement, 36% (n=36) had calf vein thrombosis, and the remaining 36% (n=36) showed femoro-iliac segment thrombosis. Conventional anticoagulation was administered to 69% (n=69) of patients, while 31% (n=31) received thrombolytic therapy. Both treatments showed similar recanalization rates, but thrombolytic therapy was associated with a longer hospital stay (8.61+/-1.65 days; p=0.024; p<0.05) and return to work period (14.65+/-2.31 days; p=0.012; p<0.05). Post-thrombotic syndrome was less common in the thrombolytic therapy group (3%; n=3). Three patients died in the study, with the cause being pulmonary embolism. The descriptive statistics were computed to delineate the study sample. After completion of data collection, data analysis was achieved using SPSS for Windows, Version 16 (Released 2007; SPSS Inc., Chicago, United States), and the correlations sought after were achieved using the chi-square test of significance. Conclusion The study underscores the importance of recognizing and managing acquired risk factors for DVT, thereby facilitating early diagnosis and ultimately reducing morbidity and mortality. Understanding these factors and employing effective treatment strategies are crucial for better management and prevention of DVT, enhancing patient outcomes.

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.

Sickle Cell Disease Revealed by Simultaneous Occurrence of Acute Coronary Syndrome and Pulmonary Embolism: A Case Report

The simultaneous occurrence of acute coronary syndrome (ACS) and pulmonary embolism (PE) in patients with sickle cell disease (SCD) presents notable diagnostic and management challenges. This case report describes a 25-year-old woman with SCD who, after an uncomplicated laparoscopic cholecystectomy, developed acute retrosternal chest pain, severe dyspnea, and tachycardia. Diagnostic workup included several key methods: thoracic CT angiography was performed, revealing massive bilateral pulmonary embolism and a pulmonary infarct. Echocardiography demonstrated myocardial abnormalities, such as wall motion defects and a mildly reduced ejection fraction. Electrocardiography showed ST-segment depression and T-wave inversions in the anteroseptal leads. To confirm the presence of coronary artery disease, coronary angiography identified significant thrombotic stenosis in the proximal left anterior descending artery. Sickle cell disease was confirmed through a positive sickle cell test, which identified the characteristic hemoglobin S. Despite aggressive treatment, the patient’s condition rapidly deteriorated, leading to death within 24 hours. This case underscores the critical role of a comprehensive diagnostic approach, including specific tests for SCD, in managing severe cardiovascular complications and highlights the need for tailored treatment strategies to improve patient outcomes.

Inhibitors of NLRP3 Inflammasome Formation: A Cardioprotective Role for the Gasotransmitters Carbon Monoxide, Nitric Oxide, and Hydrogen Sulphide in Acute Myocardial Infarction.

Myocardial ischaemia reperfusion injury (IRI) occurring from acute coronary artery disease or cardiac surgical interventions such as bypass surgery can result in myocardial dysfunction, presenting as, myocardial "stunning", arrhythmias, infarction, and adverse cardiac remodelling, and may lead to both a systemic and a localised inflammatory response. This localised cardiac inflammatory response is regulated through the nucleotide-binding oligomerisation domain (NACHT), leucine-rich repeat (LRR)-containing protein family pyrin domain (PYD)-3 (NLRP3) inflammasome, a multimeric structure whose components are present within both cardiomyocytes and in cardiac fibroblasts. The NLRP3 inflammasome is activated via numerous danger signals produced by IRI and is central to the resultant innate immune response. Inhibition of this inherent inflammatory response has been shown to protect the myocardium and stop the occurrence of the systemic inflammatory response syndrome following the re-establishment of cardiac circulation. Therapies to prevent NLRP3 inflammasome formation in the clinic are currently lacking, and therefore, new pharmacotherapies are required. This review will highlight the role of the NLRP3 inflammasome within the myocardium during IRI and will examine the therapeutic value of inflammasome inhibition with particular attention to carbon monoxide, nitric oxide, and hydrogen sulphide as potential pharmacological inhibitors of NLRP3 inflammasome activation.

Periodontal management may reduce hospitalization for acute coronary syndrome and stroke in older individuals

BackgroundThis study aimed to examine the impact of periodontal management on the occurrence of acute coronary syndrome and stroke using retrospective analysis of Japanese health insurance claims data. MethodsThe analysis included health insurance claims data of individuals aged ≥ 75 years who had been diagnosed with periodontal disease and received treatment between September 2016 and February 2017. Hospitalizations related to acute coronary syndrome and stroke were observed as outcome events during the follow-up period from March 2017 to March 2019. Covariates such as sex, age, place of residence, and chronic diseases were adjusted for using a generalized linear mixed model. ResultsThe study involved 117,010 participants with a mean age of 80.0 ± 4.0 years, and 44.7 % were male. The analysis suggested that supportive periodontal therapy significantly reduced the risk of hospitalization for acute coronary syndrome (adjusted odds ratio: AOR 0.88, P = 0.017). Supportive periodontal therapy also showed a borderline significant 13 % reduction in stroke hospitalizations. ConclusionsPeriodontal treatment is associated with a decreased risk of acute hospitalization. Regular periodontal management, aimed at minimizing oral chronic inflammation, can potentially lower the risk of developing acute coronary syndrome and stroke.

Competence of Combined Low Dose of Human Chorionic Gonadotropin (HCG) and Clomiphene Citrate (CC) Versus Continued CC during Ovulation Induction in Women with CC-Resistant Polycystic Ovarian Syndrome: A Randomized Controlled Trial.

Background and Objectives: Polycystic ovarian syndrome (PCOS) is a widespread endocrine disorder affecting 5-18% of females in their childbearing age. The aim of this study is to assess the efficacy of combining a low dosage of human chorionic gonadotropin (HCG) along with clomiphene citrate (CC) for stimulating ovulation in infertile women diagnosed with CC-resistant PCOS. Materials and Methods: A randomized controlled trial was carried out on 300 infertile CC-resistant PCOS women. All participants were assigned to two groups: the CC-HCG group and the CC-Placebo group. Subjects in the CC-HCG group were given CC (150 mg/day for 5 days starting on the 2nd day of the cycle) and HCG (200 IU/day SC starting on the 7th day of the cycle). Subjects in the CC-Placebo group were given CC and a placebo. The number of ovarian follicles > 18 mm, cycle cancellation rate, endometrial thickness, ovulation rate, clinical pregnancy rate, and occurrence of early ovarian hyper-stimulation syndrome were all outcome variables in the primary research. Results: Data from 138 individuals in the CC-HCG group and 131 participants in the CC-Placebo group were subjected to final analysis. In comparison to the CC-Placebo group, the cycle cancellation rate in the CC-HCG group was considerably lower. The CC-HCG group exhibited a substantial increase in ovarian follicles reaching > 18 mm, endometrial thickness, and ovulation rate. The clinical pregnancy rate was higher in the CC-HCG group (7.2% vs. 2.3%; CC-HCG vs. CC-Placebo). Upon adjusting for BMI and age, the findings of our study revealed that individuals in the CC-HCG group who had serum prolactin levels below 20 (ng/mL), secondary infertility, infertility duration less than 4 years, baseline LH/FSH ratios below 1.5, and serum AMH levels more than 4 (ng/mL) had a higher likelihood of achieving pregnancy. In the CC-Placebo group, there was a greater prediction of clinical pregnancy for those with serum AMH (<4), primary infertility, serum prolactin ≤ 20 (ng/mL), baseline LH/FSH < 1.5, and infertility duration < 4 years. Conclusions: The use of a small dose of HCG along with CC appeared to be an effective treatment in reducing cycle cancelation, improving the clinical pregnancy rate and ovulation rate in CC-resistant PCOS patients. The trial was registered with Clinical Trials.gov, identifier NCT02436226.

A prediction model for hemolysis, elevated liver enzymes and low platelets syndrome in pre-eclampsia with severe features.

The aim of the present study was to determine the risk factors for patients with pre-eclampsia (PE) with severe features to develop hemolysis, elevated liver enzymes and low platelets (HELLP) syndrome and to design a prediction score model that incorporates these risk factors. A retrospective cohort study was conducted at a tertiary university-affiliated medical center between 2011 and 2019. The study population comprised patients diagnosed with PE with severe features, divided into two groups: those with HELLP syndrome (study group) and those without (control group). A logistic regression was employed to identify independent predictors of HELLP syndrome. A predictive model for the occurrence of HELLP syndrome in the context of PE with severe features was developed using a receiver operating characteristic curve analysis. Overall, 445 patients were included, of whom 69 patients were in the study group and 376 in the control group. A multivariate logistic analysis regression showed that maternal age <40 (OR = 2.28, 95% CI: 1.13-5.33, P = 0.045), nulliparity (OR = 2.22, 95% CI: 1.14-4.88, P = 0.042), mild hypertension (OR = 2.31, 95% CI: 1.54-4.82, P = 0.019), epigastric pain (OR = 3.41, 95% CI: 1.92-7.23, P < 0.001) and placental abruption (OR = 6.38, 95% CI: 1.29-35.61, P < 0.001) were independent risk factors for HELLP syndrome. A prediction score model reached a predictive performance with an area under the curve of 0.765 (95% CI: 0.709-0.821). This study identified several key risk factors for developing HELLP syndrome among patients with PE with severe features and determined that a prediction score model has the potential to aid clinicians in identifying high risk patients.

Giant unruptured middle cerebral artery aneurysm revealed by intracranial hypertension: is a systematic decompressive hemicraniotomy mandatory?

Our study aimed to evaluate the postoperative outcome of patients with unruptured giant middle cerebral artery (MCA) aneurysm revealed by intracranial hypertension associated to midline brain shift. From 2012 to 2022, among the 954 patients treated by a microsurgical procedure for an intracranial aneurysm, our study included 9 consecutive patients with giant MCA aneurysm associated to intracranial hypertension with a midline brain shift. Deep hypothermic circulatory flow reduction (DHCFR) with vascular reconstruction was performed in 4 patients and cerebral revascularization with aneurysm trapping was the therapeutic strategy in 5 patients. Early (< 7 days) and long term clinical and radiological monitoring was done. Good functional outcome was considered as mRS score ≤ 2 at 3 months. The mean age at treatment was 44 yo (ranged from 17 to 70 yo). The mean maximal diameter of the aneurysm was 49 mm (ranged from 33 to 70 mm). The mean midline brain shift was 8.6 mm (ranged from 5 to 13 mm). Distal MCA territory hypoperfusion was noted in 6 patients. Diffuse postoperative cerebral edema occurred in the 9 patients with a mean delay of 59 h and conducted to a postoperative neurological deterioration in 7 of them. Postoperative death was noted in 3 patients. Among the 6 survivors, early postoperative decompressive hemicraniotomy was required in 4 patients. Good functional outcome was noted in 4 patients. Complete aneurysm occlusion was noted in each patient at last follow-up. We suggest to discuss a systematic decompressive hemicraniotomy at the end of the surgical procedure and/or a partial temporal lobe resection at its beginning to reduce the consequences of the edema reaction and to improve the postoperative outcome of this specific subgroup of patients. A better intraoperative assessment of the blood flow might also reduce the occurrence of the reperfusion syndrome.

The effect of post-traumatic chondropathy on the functional state of knee joints in athletes during the basketball game.

The relevance of the study is conditioned upon the widespread occurrence of knee injuries in athletes when playing basketball, in particular, damage to the cartilage system of the knee joint. Such a feature of injury causes the fact that basketball players may develop post-traumatic chondropathy with a subsequent change in the functional state of knee joints, which is inextricably linked with a decrease in the quality of life, the occurrence of pain syndrome, shortening of career duration, an increased risk of surgical interventions, and possible disability in the long-term perspective. This paper is aimed at uncovering modern ideas about the impact of post-traumatic chondropathy on the functional state of knee joints in athletes during basketball games. The method for this paper was the search for relevant studies concerning the formulated problem, the collection of information and drawing conclusions. Given the character of the basketball game, knee injuries, both acute and chronic, are widespread among athletes of this sport, including cartilaginous defects of the knee joint, which often occur in athletes. The materials of the paper are of practical value for sports medicine doctors, physiotherapists, traumatologists since it presents the main mechanisms of knee injuries in athletes when playing basketball and the possible consequences of these injuries in the long term.

Investigating hemolysis, elevated liver enzymes and low platelet count in preeclampsia: A case-control study in Ghana.

Preeclampsia poses a heightened risk for women, particularly in the development of hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome, leading to adverse outcomes for both mothers and newborns. The incidence of HELLP syndrome tends to be notably higher among women with preeclampsia compared with those with normotensive pregnancies. However, there is a dearth of research on the frequency of HELLP syndrome within the context of preeclampsia specifically in Ghana. Furthermore, the potential predictive value of serum erythrocyte adenylate kinase (EAK), a marker of hemolysis, in anticipating the onset of preeclampsia remains largely unexplored. Conducted between May 2020 and April 2022, this research employed a case-control methodology at the War Memorial and Upper East Regional Hospitals. A total of 291 pregnant women participated, comprising 111 diagnosed with preeclampsia and 180 control subjects, aged between 18 and 43 years. Venous blood samples were collected and subjected to analysis for platelet count, aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LDH), and EAK, utilizing automated analyzers, alongside the ELISA technique. Diagnosis of HELLP syndrome was established using the Mississippi triple-class definition. The median serum ALT level (with interquartile range) was significantly elevated in the preeclampsia group compared with controls [20.0 (13.7-27.0) vs. 13.0 (9.4-18.6); p < 0.001]. Moreover, the frequency of Mississippi class 3 HELLP syndrome was notably higher among preeclampsia cases (2/111; 1.8%) compared with controls (1/180; 0.6%). Serum ALT emerged as the superior predictor of preeclampsia, outperforming LDH (with an area under the curve of 0.73 compared with 0.58). The sensitivity and specificity of ALT were measured at 47.8% and 87.2%, respectively. Although the occurrence of HELLP syndrome in preeclampsia cases appears relatively low, it may escalate as the prevalence of preeclampsia is anticipated to rise in low and middle-income nations.

Gender related incidence of frailty syndrome occurrence in patients with atrial fibrillation

Abstract Introduction Atrial fibrillation (AF) is one of the biggest challenges associated with the treatment of cardiovascular diseases in modern countries. On the other hand frailty syndrome is one of the main problems of modern gerontology and is also an indicator of a poor prognosis. The exact relationship between frailty syndrome and AF is still the subject of research. The aim of the study was to evaluate the relationship between the gender of patients with AF and the presence of frailty syndrome. Methods 132 consecutive patients over 60 years (58 women; 72,71 ± 6,73) of age with diagnosed atrial fibrillation were included. In all patients occurrence of frailty syndrome using the Tilburg Frailty Indicator scale (TFI) was analyzed. Having 5 or more points indicates that a patient has frailty syndrome. AF was also divided into types according to modified ESC guidelines: paroxysmal (first diagnosed AF + paroxysmal AF); persistent AF and permanent AF (long-standing persistent AF + permanent AF). Results Frailty syndrome was diagnosed in 59,85% of patients with atrial fibrillation, including 47,95% of men and 81,49% of women, p = 0,0002. The mean point value of the frailty syndrome was 5,31 ± 2,69. Women had a greater severity of frailty syndrome in general and in the physical and social domain – exact results are presented in the table below. Regardless of the type of atrial fibrillation, frailty syndrome was more common syndrome in women: persistent AF: 7,64 ± 2,53 vs 5,28 ± 2,39; p = 0,0226 paroxysmal AF: 6,18 ± 2,63 vs 3,88 ± 2,47; p = 0,0465, permanent AF: 5,52 ± 2,58 vs 3,86 ± 1,77; p = 0,0324. Conclusions Frailty syndrome is more common among women what can suggest worst prognosis. Existing of frailty syndrome was independently from the type of AF.

The uveitis–glaucoma–hyphema syndrome. Part 1. Pathogenesis, clinical features, diagnosis

BACKGROUND: The uveitis–glaucoma–hyphema (UGH) syndrome was first described in 1978 as a complication of anterior chamber polymethyl methacrylate intraocular lenses implantation. Introduction into practice of foldable intraocular lenses with intracapsular fixation has reduced the incidence of UGH. However, this complication still occurs today, especially with extracapsular intraocular lens fixation. AIM: The aim of this study is to describe “uveitis–glaucoma–hyphema” syndrome pathogenesis, clinical features, and diagnosis. MATERIAL AND METHODS: A retrospective analysis of medical data for 2017–2021 identified 100 patients (101 eyes) diagnosed with UGH syndrome, they made up the study group. Complaints, medical history, biomicroscopy, visual acuity and intraocular pressure were assessed. 37 patients underwent anterior segment ultrasound biomicroscopy using the Accutome UBM Plus (USA). RESULTS: The occurrence of UGH syndrome is at least 0.19%. The leading UGH syndrome risk factor was intraocular lens material. In 49% of cases these were AcrySof hydrophobic intraocular lenses. The second UGH risk factor was extracapsular (mixed and sulcus) intraocular lens fixation, occurring, according to ultrasound biomicroscopy, in 54 and 19% of cases, respectively. The most significant diagnostic UGH sign was hyphema (93%). Ocular hypertension was detected in 66%, and uveitis in 57% of cases. CONCLUSIONS: The main UGH syndrome manifestations are hyphema and iris transillumination after phacoemulsification complicated by posterior capsule rupture with extracapsular hydrophobic intraocular lens fixation. The most informative instrumental method to assess intraocular lens position is ultrasound biomicroscopy.

Pharmacomechanical Thrombectomy and Catheter-Directed Thrombolysis, with or without Iliac Vein Stenting, in the Treatment of Acute Iliofemoral Deep Vein Thrombosis.

This study aims to evaluate and compare the outcomes and clinical efficacy of pharmacomechanical thrombectomy (PMCT) plus catheter-directed thrombolysis (CDT) and PMCT combined with CDT and venous stenting in managing acute iliofemoral deep vein thrombosis (DVT), while also assessing the long-term safety and efficacy of these interventions. A retrospective case-control study spanning 3 years involved 112 patients presenting with acute symptomatic iliofemoral deep vein thrombosis (DVT), each with a symptom duration of less than 14 days. Patients were consecutively categorized into two groups based on individual clinical indications: PMCT + CDT vs. PMCT + CDT + venous stent. Statistical analyses were conducted to compare clinical features and outcomes between the two groups. Additionally, patients were followed up for 24 months post-treatment, during which quality of life (QoL) and severity of post-thrombotic syndrome (PTS) were analyzed. In this retrospective study, we analyzed a total of 112 consecutive patients, with 63 patients undergoing PMCT + CDT and 49 patients undergoing PMCT + CDT + venous stent. Between the two groups, regarding primary outcomes at 6 months, there was no difference in the observed cumulative patency rates, standing at 82.5% for PMCT + CDT and 81.6% for PMCT + CDT + stent. Survival analyses for primary, primary-assisted, and secondary patency yielded comparable results for PMCT + CDT, with p-values of 0.74, 0.58, and 0.72, respectively. The two-year patency rate was high in both groups (85.7% for PMCT + CDT vs. 83.7% for PMCT + CDT + stent). Additionally, during the follow-up period, there were no statistically significant differences observed in the incidence of PTS or the average Villalta score between the two groups. At 24 months post-intervention, the incidence of post-thrombotic syndrome (PTS) was 11.1% in the PMCT + CDT group and 22% in the PMCT + CDT + stent group (p = 0.381). Both treatment arms of the study groups experienced bleeding complications during the thrombolysis therapy; in the PMCT + CDT group, there were three cases of gastrointestinal bleeding, compared to two cases in the PMCT + CDT + stent group (p = 0.900). Additionally, there was one intracranial hemorrhage in the PMCT + CDT group and two in the PMCT + CDT + stent group. Pharmacomechanical thrombectomy (PMCT) combined with catheter-directed thrombolysis (CDT) therapy has shown significant efficacy in alleviating leg symptoms and reducing the occurrence of post-thrombotic syndrome (PTS), including the incidence of moderate-to-severe PTS. On the other hand, the utilization of PMCT + CDT + stent therapy, tailored to individual patients' clinical and venous conditions, may enhance long-term venous patency and lead to superior outcomes, including improved quality of life parameters.

Enhancing Awareness and Management of Carpal Tunnel Syndrome Among Medical Professionals and Athletes

Introduction and objective: The objective of this research is to enhance the awareness of carpal tunnel among medical professionals and individuals engaged in sports. The acquired knowledge will enable medical professionals to more effectively identify, treat, and prevent issues related to carpal tunnel. Additionally, individuals engaged in sports will be able to prevent the occurrence of carpal tunnel syndrome in themselves or their pupils, thereby allowing them to engage in long-term and safe physical activity. Review methods: Review and summary of research studies available in open-source format on Google Scholar, PubMed. Abbreviated description of the state of knowledge: Carpal tunnel syndrome is a disease belonging to the group of compression neuropathies. The symptoms of carpal tunnel syndrome typically manifest as an uncomfortable sensation in the thumb, index finger, and half of the ring finger. Such symptoms may include numbness and tingling. In some cases, weakness of the hand muscles may occur, and in rarer instances, atrophy of the hand muscles. The condition of carpal tunnel syndrome is primarily the result of repetitive movements of the fingers and wrist. Such activities include typing, using a mouse, riding a bicycle, or playing a musical instrument. Summary: Carpal tunnel syndrome is a prevalent condition among the general population. This condition may affect individuals who engage in regular physical activity, resulting in diminished efficiency and a notable reduction in the quality of life. The objective of this study is to examine the risk factors, symptoms, and diagnostic methods associated with carpal tunnel syndrome. In the context of sports, we will examine the mechanisms of disease development in athletes and focus on prevention. This encompasses the rehabilitation of individuals at risk of developing the disease and patient education, which will facilitate the minimisation of the appearance or recurrence of disease symptoms.

Exploring the Therapeutic Potential of Sodium Hydrosulfide in Alleviating Oxidative Stress and Ovarian Dysfunction in a Rat Model of Polycystic Ovary Syndrome.

Oxidative stress is known to play a key role in the occurrence of polycystic ovary syndrome (PCOS) as the most common cause of anovulatory infertility. The purpose of the current study was to investigate whether diminished activity of ovarian enzymes responsible for hydrogen sulfide (H2S) production, cystathionine β-synthase (CBS), and cystathionine γ-lyase (CSE) contributes to oxidative stress in PCOS. The study also explored whether administration of sodium hydrosulfide (NaSH), an H2S donor, could ameliorate PCOS symptoms by reducing oxidative stress. The total eighteen rats were randomly assigned into three groups (n=6): control, PCOS, and PCOS+NaSH. PCOS was induced by intramuscular injection of estradiol valerate to induce PCOS in the PCOS and PCOS+NaSH groups. The PCOS+NaSH group received 30 μmol/L of NaSH in drinking water for 27 days after PCOS induction. Ovarian tissue samples were analyzed for oxidative stress indices including malondialdehyde (MDA) levels and superoxide dismutase (SOD) activity. Additional analyses measured H2S levels, CBS, and CSE activity. PCOS induction led to a significant decrease in SOD activity, H2S levels, and CBS and CSE activity, accompanied by a significant increase in MDA levels (p<0.0001). Furthermore, PCOS caused severe histological alterations in the ovaries. However, administration of NaSH effectively restored all measured parameters to pre-PCOS induction levels (p<0.0001). This study showed that the decrease in the activity of H2S-producing enzymes and H2S levels may contribute to oxidative stress in PCOS. Therefore, administration of NaSH as a H2S donor can be considered as a potential therapeutic strategy for PCOS patients.

A Prospective Study of Dry Eye Syndrome among Patients with Type 2 Diabetes Mellitus

Introduction: Diabetes is one of the leading health related catastrophes the world has ever witnessed. It affects millions of people all over the world. The reduced corneal sensitivity favors the occurrence of dry eye syndrome (DES) by reducing the blink rate, by decreasing the reflex-induced lacrimal secretion and increasing evaporative tear loss. It affects millions of people all over the world. Objective: Assessment of incidence of dry eyes in type 2 diabetic patients. Methods: A prospective study was carried out to assess the presence of dry eyes and to investigate the relationship of retinopathy with dry eyes. After applying inclusion and exclusion criteria 50 diabetic patients who attended the out-patient department of the Department of Ophthalmology, Ad-din Akij Medical College, Khulna, Bangladesh from July to December 2023. After applying inclusion and exclusion criteria 50 diabetic patients who attended the out-patient department of the Department of Ophthalmology, were selected. Results: Out of 50 Diabetic patients, 29 had dry eyes. Mild form of dry eyes was most common (20%). Majority of the patients were between the ages of 40-60 years. There was no significant association of age, sex and duration of diabetes with incidence of dry eyes. Mild form of dry eyes was most common (20%). There was no significant association of age, sex and duration of diabetes with incidence of dry eyes. Abnormal tear break up time was abnormal in 32%. Abnormal Fluorescein staining was seen in 20% study subjects. Moderate non-proliferative diabetic retinopathy was significantly more common in diabetic patients with dry eyes. Conclusion: Examination of dry eyes should be an integral part of the assessment of diabetic eye disease so as to improve the patients comfort and to prevent or minimize further structural damage to the ocular surface.

Evaluating antiretroviral therapy–induced insulin resistance syndrome using the homeostasis model assessment method: an important global clarion call for concern among people living with HIV-disease

Abstract Background Antiretroviral treatment advances have been accompanied by a new spectrum of adverse drug reactions that affect metabolism and body composition. Purpose This review was principally designed to focus on how to comprehensively evaluate for the occurrence of antiretroviral therapy-induced insulin resistance syndrome with associated impaired glucose metabolism disorder(s) among people living with HIV disease. Data sources and materials During the course of this present study, original peer-reviewed articles reported in English language that investigated antiretroviral therapy-induced insulin resistance were identified by exploring the Medline-Entrez-PubMed search, Web of Science database, Google Scholar search, and Science Direct database online facilities. Also, information was sourced from printed textbooks and the reports documented by some recognized medically inclined and health professional bodies. These published materials containing documented reports relating to the subject matter of focus in this review were accessed and adequately referenced. This study spanned for 12-month duration from March 2023 to February 2024. Study selection and manuscript preparation with limitations A total number of 92 published articles were reviewed, out of which 55 referenced articles were found to contain information pertinent to this present study; while those parts of the referenced articles inapt to this study were neglected. Antiretroviral therapy-induced insulin resistance syndrome can be broadly classified into mild, moderate, and severe categories; based on the severity grading reviews of homeostasis model assessment-insulin resistance index values. Conclusion The clinical assessment of antiretroviral therapy-induced insulin resistance syndrome should be given utmost importance in HIV-disease individuals with considerably high-risk factor(s) for its occurrence.

The Immunotherapy of Acute Myeloid Leukemia: A Clinical Point of View.

The potential of the immune system to eradicate leukemic cells has been consistently demonstrated by the Graft vs. Leukemia effect occurring after allo-HSCT and in the context of donor leukocyte infusions. Various immunotherapeutic approaches, ranging from the use of antibodies, antibody-drug conjugates, bispecific T-cell engagers, chimeric antigen receptor (CAR) T-cells, and therapeutic infusions of NK cells, are thus currently being tested with promising, yet conflicting, results. This review will concentrate on various types of immunotherapies in preclinical and clinical development, from the point of view of a clinical hematologist. The most promising therapies for clinical translation are the use of bispecific T-cell engagers and CAR-T cells aimed at lineage-restricted antigens, where overall responses (ORR) ranging from 20 to 40% can be achieved in a small series of heavily pretreated patients affected by refractory or relapsing leukemia. Toxicity consists mainly in the occurrence of cytokine-release syndrome, which is mostly manageable with step-up dosing, the early use of cytokine-blocking agents and corticosteroids, and myelosuppression. Various cytokine-enhanced natural killer products are also being tested, mainly as allogeneic off-the-shelf therapies, with a good tolerability profile and promising results (ORR: 20-37.5% in small trials). The in vivo activation of T lymphocytes and NK cells via the inhibition of their immune checkpoints also yielded interesting, yet limited, results (ORR: 33-59%) but with an increased risk of severe Graft vs. Host disease in transplanted patients. Therefore, there are still several hurdles to overcome before the widespread clinical use of these novel compounds.