Profile Of Patients Research Articles

Personality, Aging, and Alzheimer's Disease: Implications for Psychoneuroimmunology and Personalized Medicine.

Psychoneuroimmunology (PNI) advancements may revolutionize personalized medicine by identifying systemic biomarkers that enhance diagnosis and treatment. Inflammatory pathways connect personality traits with cognitive performance, aging-related disorders, and mortality risks. Studies have demonstrated the critical interactions between personality and various biological systems like the hypothalamic-pituitary-adrenal (HPA) axis. The gut-brain axis also affects behaviors and psychological states in older adults, with specific gut microbiota influencing cognition, mood, and personality. These findings underscore the practical implications of understanding personality-biology interactions. They can support preventive and personalized medicine for aging-associated disorders. Specifically, personality changes are prevalent in Alzheimer's disease (AD) patients, impacting clinical management and caregiver stress. Non-cognitive factors, such as personality traits and psychiatric symptoms, may serve as early markers of AD. Traits like high Neuroticism and low Openness can predict initial AD stages, often before a formal diagnosis. Personality alterations in AD are also linked to cerebrospinal fluid (CSF) and vascular imaging biomarkers, which can track AD pathology and serve as predictors. Dynamic personality assessment can aid in timely diagnosis, monitoring progression, and evaluating treatmentsof AD. Understanding personality traits is crucial for predicting burnout, lifespan, and intervention success. Integrating personality and PNI biomarkers into patient profiles will support the development of personalized and systems medicine.

Turkish validity and reliability of the Aging Simulation Experience Scale for undergraduate students of nursing: A methodological study

ABSTRACT The older adult population is growing gradually. The demographic structure is changing with the increasing elderly population. Changing demographic structure may lead to changes in the patient profile that nurses will provide care for. Nurses need to adapt to changing environments, and the quality of care they provide must reflect this. Simulating situations experienced by older adults allows future nurses to gain experience that may help raise awareness without having to face the changing patient profile. There is a need for valid and reliable measurement tools intended to evaluate simulation experiences about aging. The purpose of this study was to adapt the Aging Simulation Experience Scale into Turkish and determine its validity and reliability. A methodological and cross-sectional design was employed. Data were collected between May and June 2023. The validity of the scale was determined using language, content, and construct validity. Cronbach’s alpha coefficient and item analysis were used to determine the reliability of the scale. The content validity index of the scale items ranged from 0.80 to 0.95. Item-total correlations of the items ranged from 0.413 to 0.713. Cronbach's alpha reliability coefficient was 0.91 for the perception toward older adults dimension and 0.83 for the simulation experiences dimension. In conclusion, the Turkish form of the Aging Simulation Experience Scale was found valid and reliable.

Neurometabolic Profile in Obese Patients: A Cerebral Multi-Voxel Magnetic Resonance Spectroscopy Study.

Background and Objectives: Obesity-related chronic inflammation may lead to neuroinflammation and neurodegeneration. This study aimed to evaluate the neurometabolic profile of obese patients using cerebral multivoxel magnetic resonance spectroscopy (mvMRS) and assess correlations between brain metabolites and obesity markers, including body mass index (BMI), waist circumference, waist-hip ratio, body fat percentage, and indicators of metabolic syndrome (e.g., triglycerides, HDL cholesterol, fasting blood glucose, insulin, and insulin resistance index (HOMA-IR)). Materials and Methods: This prospective study involved 100 participants, stratified into two groups: 50 obese individuals (BMI ≥ 30 kg/m2) and 50 controls (18.5 ≤ BMI < 25 kg/m2). Anthropometric measurements, body fat percentage, and biochemical markers were evaluated. All subjects underwent long- and short-echo mvMRS analysis of the frontal and parietal supracallosal subcortical and deep white matter, as well as the cingulate gyrus, analyzing NAA/Cr, Cho/Cr, and mI/Cr ratios, along with absolute concentrations of NAA and Cho. Results: Obese participants exhibited significantly decreased NAA/Cr and Cho/Cr ratios in the deep white matter of the right cerebral hemisphere (p < 0.001), while absolute concentrations of NAA and Cho did not differ significantly between groups (p > 0.05). NAA levels showed negative correlations with more reliable obesity parameters (waist circumference and waist-to-hip ratio) but not with BMI, particularly in the deep frontal white matter and dorsal anterior cingulate gyrus of the left cerebral hemisphere. Notably, insulin demonstrated a significant negative impact on NAA (ρ = -0.409 and ρ = -0.410; p < 0.01) and Cho levels (ρ = -0.403 and ρ = -0.392; p < 0.01) at these locations in obese individuals. Conclusions: Central obesity and hyperinsulinemia negatively affect specific brain regions associated with cognitive and emotional processing, while BMI is not a reliable parameter for assessing brain metabolism.

Intestinal Insights: The Gut Microbiome's Role in Atherosclerotic Disease: A Narrative Review.

Recent advances have highlighted the gut microbiota as a significant contributor to the development and progression of atherosclerosis, which is an inflammatory cardiovascular disease (CVD) characterized by plaque buildup within arterial walls. The gut microbiota, consisting of a diverse collection of microorganisms, impacts the host's metabolism, immune responses, and lipid processing, all of which contribute to atherosclerosis. This review explores the complex mechanisms through which gut dysbiosis promotes atherogenesis. We emphasize the potential of integrating microbiota modulation with traditional cardiovascular care, offering a holistic approach to managing atherosclerosis. Important pathways involve the translocation of inflammatory microbial components, modulation of lipid metabolism through metabolites such as trimethylamine-N-oxide (TMAO), and the production of short-chain fatty acids (SCFAs) that influence vascular health. Studies reveal distinct microbial profiles in atherosclerosis patients, with increased pathogenic bacteria (Megamonas, Veillonella, Streptococcus) and reduced anti-inflammatory genera (Bifidobacterium, Roseburia), highlighting the potential of these profiles as biomarkers and therapeutic targets. Probiotics are live microorganisms that have health benefits on the host. Prebiotics are non-digestible dietary fibers that stimulate the growth and activity of beneficial gut bacteria. Interventions targeting microbiota, such as probiotics, prebiotics, dietary modifications, and faecal microbiota transplantation (FMT), present effective approaches for restoring microbial equilibrium and justifying cardiovascular risk. Future research should focus on longitudinal, multi-omics studies to clarify causal links and refine therapeutic applications.

Impact of adalimumab on erectile dysfunction, sperm parameters and hormonal profile in male psoriasis patients: a six-month observational study.

Psoriasis, a chronic inflammatory skin disease, is associated with systemic complications that extend beyond cutaneous lesions, including cardiovascular risks and sexual dysfunction. Erectile dysfunction (ED) is notably more prevalent in male psoriasis patients, likely driven by both systemic inflammation and psychological stress. Adalimumab (ADA), a tumor necrosis factor-alpha (TNF-α) inhibitor, has been shown to effectively reduce psoriasis severity, but its effects on sexual and reproductive health remain underexplored. This study investigates the impact of ADA on erectile function, sperm parameters, and hormonal profiles in male psoriasis patients. This six-month prospective observational study included 33 biologic-naïve male patients aged 18-50 years with moderate-to-severe plaque psoriasis (Psoriasis Area and Severity Index [PASI] > 10). Patients received ADA according to standard clinical protocols. Erectile function was assessed using the International Index of Erectile Function (IIEF-5). Sperm parameters, including ejaculate volume, sperm concentration, total sperm count, motility, vitality, and morphology, were analyzed following World Health Organization (WHO) 2010 criteria. Hormonal profiles (testosterone, luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol, and prolactin) were measured via standardized assays. Statistical analyses were performed using paired t-tests or Wilcoxon signed-rank tests, with p-values < 0.05 considered significant. ADA significantly improved erectile function, as the mean IIEF-5 score increased from 21.3 ± 2.2 to 22.2 ± 1.9 (p = 0.03). The percentage of patients with ED decreased from 51.5% at baseline to 36.4% post-treatment (p < 0.001). Progressive sperm motility and vitality showed statistically significant improvement post-treatment (p = 0.02 and p = 0.04, respectively), while other sperm parameters remained unchanged. Total testosterone levels significantly increased from 3.4 ± 0.4 ng/ml to 3.5 ± 0.4 ng/ml (p = 0.02), while LH, FSH, estradiol, and prolactin levels showed no significant changes. The anti-inflammatory properties of adalimumab, through the inhibition of TNF-α, not only reduce psoriasis severity but also appear to exert positive effects on male sexual and reproductive health. Our study demonstrated significant improvements in erectile function, sperm motility, vitality, and testosterone levels in male psoriasis patients after adalimumab therapy. These findings suggest that beyond its role in controlling psoriatic skin lesions, adalimumab may help mitigate the systemic inflammatory burden that contributes to sexual dysfunction and impaired spermatogenesis. Future long-term studies are essential to further explore the sustained impact of TNF-α inhibition on male fertility and reproductive outcomes.

Untargeted metabolomics to detect and identify plasma metabolic signatures associated with intracranial aneurysm and its rupture.

The biological basis for metabolic differences between unruptured and ruptured intracranial aneurysm (UIA and RIA) populations and their potential role in triggering IA rupture remain unclear. The aim of this study was to analyze the plasma metabolic profiles of patients with UIA and RIA using an untargeted metabolomic approach and to develop a model for early rupture classification. Plasma samples were analyzed using an ultra-high-performance liquid chromatography high-resolution tandem mass spectrometry-based platform. Least absolute shrinkage and selection operator regression and random forest machine learning methods were employed for metabolite feature selection and predictive model construction. Among 49 differential plasma metabolites identified, 31 were increased and 18 were decreased in the plasma of RIA patients. Five key metabolites-canrenone, piperine, 1-methyladenosine, betaine, and trigonelline-were identified as having strong potential to discriminate between UIA and RIA patients. This combination of metabolites demonstrated high diagnostic accuracy, with an area under the curve exceeding 0.95 in both the training and validation datasets. Our finding highlights the significance of plasma metabolites as potential biomarkers for early detection of IA rupture risk, offering new insights for clinical practice and future research on IA management.

Personality and Psychoneuroimmunology: A Systems Biology Perspective.

Research in psychoneuroimmunology (PNI) underscores the intricate connections within the "whole mind-body system." Personality plays a pivotal role, with specific traits linked to stress influencing neural behavior and psychophysiological disorders. Gene expression networks associated with personality affect neuronal plasticity, epigenetic processes, and adaptive behaviors, highlighting the importance of systems biology mechanisms. Systemic inflammation correlates with key personality traits. Understanding the roles of inflammatory and oxidative biomarkers in personality traits and disorders can help identify diagnostic and therapeutic targets for various diseases. Neurobiological features contribute to our understanding of personality disorders and related conditions. Personality traits are linked to distributed neuroendocrine networks, particularly the hypothalamic-pituitary-adrenal (HPA) axis, rather than localized brain areas. Correlations have also been identified between personality traits and thyroid hormones. Disrupted hypothalamic-pituitary-thyroid (HPT) axis functions may be associated with disease severity, depression, and distress, highlighting the need for comprehensive endocrinological and psychopathological evaluations. The gut-brain axis influences personality traits, emotions, stress, and social behaviors. Altered gut microbiota is common in psychiatric conditions, suggesting potential treatments targeting the microbiota. Chronic stress impacts cognitive functions and correlates with personality and mental health, emphasizing the need for comprehensive, multi-dimensional patient profiles for effective prevention and therapy. A biopsychosocial model integrating personality traits will advance personalized and systems medicine.

CORRELATION OF LEPTIN AND ADIPONECTIN LEVELS WITH METABOLIC AND HORMONAL PROFILES IN PCOS PATIENTS: A COMPARATIVE STUDY WITH NORMAL CONTROLS

Objective: Polycystic Ovary Syndrome (PCOS) is a common endocrine disorder characterized by metabolic and reproductive abnormalities, including insulin resistance and hyperandrogenism. Leptin and adiponectin, two adipokines involved in metabolic regulation, are known to be dysregulated in PCOS. This study aims to investigate the correlation between leptin and adiponectin levels and their association with metabolic and hormonal profiles in PCOS patients compared to healthy controls. Methods: A prospective, observational study was conducted involving 120 women diagnosed with PCOS and 50 healthy controls. Leptin and adiponectin levels were measured using enzyme-linked immunosorbent assay (ELISA). The adiponectin-to-leptin ratio (ALR) was calculated, and correlations with BMI, LH/FSH ratio, and other metabolic parameters were analyzed. Data were analyzed using appropriate statistical methods. Results: Leptin levels were significantly higher in the PCOS group compared to controls (25.34 ng/ml vs. 11.16 ng/ml, p&lt;0.0001), while adiponectin levels were significantly lower (2.93 mcg/ml vs. 21.44 mcg/ml, p&lt;0.0001). The adiponectin-to-leptin ratio was markedly reduced in PCOS patients (0.13 vs. 2.05, p&lt;0.0001). A significant correlation was observed between the adiponectin/leptin ratio and the LH/FSH ratio (r = 0.2138, p = 0.019). Conclusion: This study highlights the dysregulation of leptin and adiponectin in PCOS, suggesting their potential role in metabolic and reproductive dysfunction. The adiponectin-to-leptin ratio emerges as a promising biomarker for insulin resistance and metabolic risk in PCOS patients.

JAK inhibitor adverse event profiles in dermatology patients: the experience of two academic medical centers.

JAK inhibitors (JAKi) are increasingly being utilized for both FDA-approved and off-label treatments in dermatology. However, JAKi carry a black box warning concerning major side effects, including serious infections, cardiovascular events, thrombosis, malignancy, and mortality. Given that there is an absence of large-scale studies examining the adverse event (AE) profile of multiple JAKi for dermatologic conditions in real-world settings, our study aimed to bridge this gap by evaluating AEs of dermatology patients on oral JAKi at two academic medical centers.

Safety and Effectiveness of Elotuzumab in Japanese Patients with Relapsed/Refractory Multiple Myeloma: A Post-marketing Surveillance Study.

Objective Elotuzumab plus lenalidomide and dexamethasone (ELd) was approved in Japan in 2016 for the treatment of relapsed/refractory multiple myeloma (RRMM). This post-marketing surveillance study evaluated the safety and effectiveness of ELd in RRMM patients during routine clinical practice in Japan. Methods Elotuzumab safety was assessed by evaluating adverse drug reactions (ADRs), and effectiveness was assessed primarily by the best overall response. Patients The study enrolled patients with RRMM who received ELd therapy between November 18, 2016, and June 18, 2017. The safety and effectiveness analysis sets included 831 and 755 patients, respectively. Results In the safety analysis set, patients received a median (range) of 12 (1-40) elotuzumab administrations over 108 (1-728) days of treatment. The relative dose intensity of elotuzumab was ≥90% in 74.1% of patients. ADRs and serious ADRs were reported in 41.2% and 15.2% of the patients, respectively. The most common ADR was infection (12.0%), followed by lymphocytopenia (10.1%), infusion reactions (7.5%), secondary malignancies (e.g. gastric cancer and pancreatic carcinoma), cataracts, and interstitial lung disease (0.2% each). While most patients with ADRs recovered, 71 discontinued treatment, and 14 deaths were reported. The presence of comorbidities, particularly cardiovascular disorders, significantly affected the safety. The overall response rate was 41.1%. Conclusion This all-case post-marketing surveillance study showed that ELd had an acceptable tolerability profile and promising clinical activity in Japanese patients with RRMM.

The evaluation of myocarditis in patients with Still's disease; clinical findings from the multicentre international AIDA Network Still's Disease Registry.

To evaluate the cardiac involvement in patients with Still's disease with a focus on myocarditis included in the multicenter AIDA (AutoInflammatory Disease Alliance) network Still's disease registry. To exploit the predictive factors for myocarditis in deriving a clinical risk patient profile for this severe manifestation. A multicenter observational study was built up assessing consecutive patients with Still's disease characterized by the cardiac involvement among those included in the AIDA Network Still's Disease Registry. The cardiac involvement was defined according to the presence of pericarditis, tamponade, myocarditis, and/or aseptic endocarditis. In total, 73 patients with Still's disease and cardiac involvement were assessed (mean age 36.3±19.9 years, 42.5% male sex); out of them, 21.9% were children. The most common cardiac manifestation was the pericarditis in 90.4% of patients, 26.0% presented with myocarditis, and less frequently endocarditis (2.7%) and tamponade (1.4%). Comparing clinical features of patients with myocarditis than others, significantly increased frequencies of skin rash, and pleuritis as well as higher values of systemic score were recognised. Furthermore, an enhanced mortality rate was registered in patients with myocarditis. In regression models, the skin rash and the systemic score independently predicted the myocarditis. The characteristics of patients with Still's disease and cardiac involvement were assessed in the AIDA network. The most common feature was the pericarditis but also a more severe clinical picture was reported in patients with myocarditis. The latter was associated with increased mortality rate and with higher systemic score, identifying patients to be carefully managed.

When Would Minimally Invasive Spinal Surgery Not Be Preferable for Metastatic Spine Disease?

Metastatic spine tumor surgery (MSTS) is an important treatment modality of metastatic spinal disease (MSD). Open spine surgery (OSS) was previously the gold standard of treatment till the early 2010s. However, advancements in MSTS in recent years have led to the advent of minimally invasive spinal surgery (MISS) techniques for the treatment of MSD. The clear benefits of MISS have resulted in a current paradigm shift toward today's gold standard of MISS and early adjuvant radiotherapy in treating MSD patients. Nonetheless, despite improvements in surgical techniques and the rise of literature supporting MISS for MSD, there are still certain situations whereby MISS is not desirable or even suitable. There has also yet to be any literature describing the considerations of not using MISS in MSD in today's clinical context. A narrative review was conducted for this manuscript. All studies related to OSS and MISS in MSTS were included. A total of 54 studies were included in this review. These studies discussed various advantages of MISS for MSD in today's clinical context, including the patient profile, location of vertebrae involved with metastasis requiring treatment, tumor characteristics, as well as equipment availability. This study establishes situations in which MISS can be less applicable despite the advantages it may confer over traditional OSS. MSTS should be individualized, depending on the experience of the surgeon. OSS is a time-tested approach that still holds weight in MSTS and should be readily utilized depending on the clinical situation.

Mandibular pitching in management of severe open bite– A case report

This case report outlines the management of severe skeletal open bite with SFOA. Different treatment modalities are available to treat Class III Skeletal open bite. But the best treatment outcome can be achieved only when the treatment plan is individualized for every patient. A 18-year-old male patient with an Open bite and a class III skeletal base. Treated by Surgery first approach followed by Orthodontic treatment to transform the patient profile and smile.SFOA can be considered as a good option in patients with mandibular prognathism. Mandibular anterior pitch-up surgery offers an immediate solution in patients with severe skeletal open bite.

Understanding dermatological health challenges in rural communities - An epidemiological study

Skin diseases contribute to significant morbidity to the patients which have geographical variation. There are many hospital-based studies describing the distribution of dermatoses but social and preventive health camps conducted in rural areas often give the real portrait of the dermatological burden in entire population. To provide a detailed overview of the prevalence of skin diseases in a rural area. This is cross sectional study conducted in people attending preventive health camps in Pudukottai district over a period of 3months. Patients with various dermatological complaints are diagnosed clinically and details recorded using a proforma tailored for recording dermatology conditions. Statistical analysis was made according to patient profile, final diagnosis and appropriate treatment suggested. Awareness about the preventive measures were educated.In our study, among the 5870 patients attending the dermatology campy, 1468 had dermatological complaints. Males outnumbered females and the most common age group is 40-60years. Non-infectious dermatoses were predominant, some of them include eczema, appendageal and pigmentary disorders. Infectious dermatoses are the second common, among them the fungal infections top the list followed by bacterial and arthropod infections. Planning of the health programmes should be tailored to the individual needs of a community. This study provides valuable insights into the epidemiology of dermatological conditions in the studied rural population. Further researches are warranted to enhance diagnostic, therapeutic and preventive strategies for these conditions.

Pharmacologic Treatment of Pulmonary Hypertension Due to Heart Failure with Preserved Ejection Fraction: Are There More Arrows on Our Bow?

Pulmonary hypertension (PH) associated with heart failure with preserved ejection fraction (PH-HFpEF) represents a frequent form of PH related to left ventricular dysfunction. The pathophysiology of PH-HFpEF is intricate, and varied and includes vascular, cardiac, and pulmonary factors that contribute synergistically to developing this clinical syndrome. Improved knowledge of the pathophysiology of PH-HFpEF has paved the way for the use of new drugs such as angiotensin receptor neprilysin inhibitors (ARNIs), non-steroidal mineral corticoid receptor antagonist (nsMRA), sodium-glucose cotransporter inhibitors (SGLT2is), levosimendan, and glucagon-like peptide 1 (GLP-1) agonists. ARNIs are a widely used drug for the treatment of PH associated with heart failure with reduced ejection fraction. They have also recently been used in PH-HFpEF patients with hemodynamic benefits that need to be confirmed in future research. Finerenone is an innovative non-steroidal mineralocorticoid receptor antagonist that exhibits notable cardioprotective and renoprotective properties in individuals suffering from chronic diabetic kidney disease. It also enhances outcomes for patients with heart failure, whether they have mildly reduced or preserved ejection fraction. Moreover, in experimental studies, finerenone has been found to lower pulmonary artery pressure, reduce muscularization, and decrease the wall thickness of pulmonary arteries. SGLT2i have revolutionized the treatment of patients with heart failure irrespective of left ventricular ejection fraction, and their treatment is also associated with an improvement in the hemodynamics profile in patients with PH-HFpEF. Levosimendan is a widely used inodilator in the treatment of acute and advanced heart failure. In addition, its use in patients with PH-HFpEF (supported by the positive effects on pulmonary hemodynamics that levosimendan exerts) has recently demonstrated hemodynamic benefit in a small phase 2 study that paved the way for phase 3 studies and the creation of an oral formulation of levosimendan. Finally, GLP1 agonists are a class of drugs that, in preliminary evidence, have shown a positive effect on cardiac hemodynamics, mainly by facilitating left ventricular unloading. These effects, along with the reduction in insulin resistance and weight loss, likely lead to beneficial outcomes for PH-HFpEF patients, especially those with obesity as a comorbidity.

Depigmented, polymerized cat epithelium extract is safe and improves rhinitis and asthma symptoms in cat allergic patients: A real-world retrospective study.

Cat allergy is often difficult to avoid. Here, we evaluated the safety and effectiveness of a depigmented, polymerized cat epithelium extract (Dpg-pol-cat) for the treatment of allergic rhinoconjunctivitis and asthma. Real-world, retrospective study of patients ≥12 years with cat allergy and moderate to severe allergic rhinitis/rhinoconjunctivitis, with or without asthma, who started allergen immunotherapy (AIT) with Dpg-pol-cat extract during routine visits to the Allergy Department. Safety and effectiveness (improvement in FEV1) of AIT were evaluated. The use of rescue medication and patient perceptions were also assessed. A total of 62 patients were included, of which 34 (54.8%) received at least 12 months of AIT. There were 15 adverse reactions, 8 local and 7 systemic, of which 3 led to AIT discontinuation. Patients with moderate to severe rhinitis decreased from 88.2% at baseline to 29.4% at 12 months (p <0.0001), and patients with moderate asthma decreased from 76.5% to 38.2% (p = 0.0004). FEV1 improved from a mean (SD) of 3188.9 (771.4) ml to 3419.6 (878.4) ml (p = 0.0023). The use of rescue medications for rhinitis decreased from 94.1% to 23.5% (p <0.0001), all patients requiring rescue medications for conjunctivitis (20.6%) were medication free at 12 months, and 97.1% and 92.6% of patients reported improvement in rhinitis and asthma symptoms, respectively. AIT with Dpg-pol-cat extract shows a favorable safety and effectiveness profile in patients with allergic rhinitis/rhinoconjunctivitis, with or without allergic asthma, due to cat allergy, representing a valuable treatment option for these patients.

The Demographic Profile of Colorectal Cancer Patients in Indonesia: Insights from a Single Center Experience and Exploration of Immune Response and Survival Outcomes

The Demographic Profile of Colorectal Cancer Patients in Indonesia: Insights from a Single Center Experience and Exploration of Immune Response and Survival Outcomes

Potential Prognostic Protein Biomarkers in Tears From Noninfectious Uveitis Patients Under Biologic Treatment as a Prelude to Personalized Medicine.

Adalimumab (ADA) is a systemic biological treatment option approved for the treatment of noninfectious uveitis (NIU); however, up to 40% of patients do not respond to the drug, either in a primary or secondary manner. Here, we evaluated the proteomic profile of patients with NIU who fail to ADA to identify proteins implicated in intraocular inflammation, as well as potential biomarkers for treatment response and novel therapeutic targets. Cross-sectional observational study of patients with NIU under ADA treatment for six or more months. Tears were collected with microcapillary tubes and protein analyzed by data-independent acquisition/sequential window acquisition of all theoretical mass spectra. Differentially expressed proteins (DEPs) were defined based on the fold change between their expression in nonresponders (NR) and responders (R). Protein network and gene ontology analysis were performed. The χ2 test for trend and receiver operating characteristic (ROC) curves were used to evaluate potential biomarkers of treatment response. Twenty-nine DEPs, 14 upregulated and 15 downregulated, were detected in NR. These proteins were mainly related to enhanced neutrophil effector functions and redox imbalance. ROC analysis identified defensin-1,3 (DEF-1,3), biotinidase, and ATP-binding cassette transporter A1 as potential biomarkers for treatment response. This is the first study on a clinical cohort of patients with noninfectious uveitis that identifies tear proteins related to neutrophil hyperactivation as drivers of the persistent intraocular inflammation observed in NR to ADA and provides evidence that targeting interleukin 6, Janus kinases, or the complement cascade could be potential alternative therapeutic strategies in these patients. Our results indicate the potential of high-throughput proteomics to provide insights into the underlying pathological mechanisms of persistent intraocular inflammation observed in patients who do not adequately respond to anti-TNF treatment and the value of tear proteomics as a tool for personalized medicine.

Analysis of six consecutive waves of ICU-admitted COVID-19 patients: key findings and insights from a Portuguese population.

Identifying high-risk patients, particularly in intensive care units (ICUs), enhances treatment and reduces severe outcomes. Since the pandemic, numerous studies have examined COVID-19 patient profiles and factors linked to increased mortality. Despite six pandemic waves, to the best of our knowledge, there is no extensive comparative analysis of patients' characteristics across these waves in Portugal. Thus, we aimed to analyze the demographic and clinical features of 1041 COVID-19 patients admitted to an ICU and their relationship with the different SARS-Cov-2 variants in Portugal. Additionally, we conducted an in-depth examination of factors contributing to early and late mortality by analyzing clinical data and laboratory results from the first 72h of ICU admission. Our findings revealed a notable decline in ICU admissions due to COVID-19, with the highest mortality rates observed during the second and third waves. Furthermore, immunization could have significantly contributed to the reduction in the median age of ICU-admitted patients and the severity of their conditions. The factors contributing to early and late mortality differed. Age, wave number, D-dimers, and procalcitonin were independently associated with the risk of early death. As a measure of discriminative power for the derived multivariable model, an AUC of 0.825 (p < 0.001; 95% CI, 0.719-0.931) was obtained. For late mortality, amodel incorporating age, wave number, hematologic cancer, C-reactive protein, lactate dehydrogenase, and platelet counts resulted in an AUC of 0.795 (p < 0.001; 95% CI, 0.759-0.831). These findings underscore the importance of conducting comprehensive analyses across pandemic waves to better understand the dynamics of COVID-19.

Strength profiles in patients with knee osteoarthritis with and without unilateral transfemoral amputation

Background: Individuals with lower limb amputation have increased risk of developing knee osteoarthritis (KOA) in the intact limb, however there is little information regarding strength profiles in individuals with KOA with and without amputation. Objective: To compare lower extremity strength in individuals with KOA with and without unilateral transfemoral (TF) amputation. Study Design: Descriptive laboratory study. Methods: Seven participants with unilateral TF amputation (3F/4M, 58.0 ± 11.0 years, 172.7 ± 12.8 cm, 90.8 ± 19.1 kg, 38.8 ± 14.4 years after amputation) and symptomatic KOA in the intact limb and 9 participants with unilateral KOA (control (CON)) without leg amputation (4F/5M, 66.0 ± 9.9 years, 170.5 ± 10.7 cm, 86.8 ± 18.1 kg) participated in this study. Both groups completed strength testing on the involved limb with KOA and the Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire to meaure subjective function. Strength variables were mass-normalized. Results: There were no significant differences between groups in age, mass, or height. The CON group reported significantly reduced subjective function on the KOOS total score (P = 0.049; d = 1.03) and KOOS symptoms scores (P = 0.047, d = 0.95) compared with the TF amputation group. A lower subjective function score indicates worse function. There were no other significant differences between groups on KOOS subcategories. The TF amputation group had significantly greater average isokinetic quadriceps torque (P = 0.05; d = 1.10), peak isokinetic quadriceps torque (P = 0.02; d = 1.36), and average isokinetic quadriceps power (P = 0.02; d = 1.38) compared with the CON group. There were no differences between groups in isometric knee extensor strength or any differences in knee flexor isokinetic or isometric strength. Conclusions: The TF amputation group demonstrated greater isokinetic knee extensor strength in their intact limb with KOA compared with the CON group osteoarthritic limb; however, there were no differences in isometric strength. Furthermore, the differences in isokinetic strength may suggest that those with a history of leg amputation may require more strength and power in the intact limb to maintain daily activity and, therefore, may require greater thresholds of strength to protect the knee joint from cartilage degradation.