Blood Of Patients Research Articles

Correlation between facial vascularized composite allotransplantation rejection and laboratory markers: Insights from a retrospective study of eight patients

The field of facial vascularized composite allotransplantation (fVCA) is still new and a limited number of patients have undergone the procedure. This has led to a lack of understanding about the impact of fVCA rejection on standard laboratory markers (e.g., CBC, BMP, CRP) for the acute management of these patients. It is not clear if rejection elicits a systemic inflammatory response that influences common inflammatory markers such as WBC and CRP. A comprehensive understanding of changes in these markers could help in the management of fVCA patients in the acute setting. The medical records of 8 fVCA patients with a total of 9 transplants were reviewed retrospectively, and data on standard laboratory values (CBC, BMP, LFTs, CRP) and vital signs were extracted. To examine the relationship between laboratory values and rejection status, linear mixed models were used to analyze the data, taking into account their longitudinal nature (repeated measures). A statistically significant relationship was found between the Banff grade of rejection and the relative number of basophils in the patient's blood during rejection (p=0.005). In addition, in patients with clinical signs of rejection (e.g., facial erythema, edema) and skin biopsy showing Banff ≥II, CRP was found to be significantly elevated (p=0.03). The WBC count remained stable during rejection, and the relative number of neutrophils was lower at the time of rejection, indicating possible consumption at the site of rejection. During fVCA rejection, most standard laboratory parameters and vital signs appear to be stable. However, the levels of CRP and basophils were elevated during rejection, while the neutrophil count was lower. Leukocytosis can likely be used as a marker of microbial infection in fVCA patients, as WBC does not seem to increase at the time of allograft rejection.

Pregnancy complicated by juxtaglomerular cell tumor of the kidney: A case report

Juxtaglomerular cell tumor (JGCT) of the kidney, also known as reninoma, is a rare renal tumor that typically clinically manifests as hypertension, hypokalemia, high renin, and high aldosterone. It is a cause of secondary hypertension. Pregnancy with JGCT is rarer and easily misdiagnosed as pregnancy-induced hypertension, thus affecting treatment. A 28-year-old woman presented in early pregnancy with hypertension (blood pressure of 229/159 mmHg), nausea, and occasional dizziness and headache. The patient was diagnosed with pregnancy-induced hypertension, and no relief was found after symptomatic treatment; hence, the pregnancy was terminated by artificial abortion. Her blood pressure remained high following termination of pregnancy. Blood tests suggested hypokalemia (2.997 mmol/L), blood aldosterone measured 613 ng/L, and computed tomography urography showed a tumor in the right kidney. Therefore, laparoscopic partial nephrectomy was performed. After surgery, the patient's blood pressure returned to normal, and blood potassium, aldosterone, and renin normalized. Postoperative pathological examination revealed JGCT. After long-term follow-up, the patient became pregnant again 6 mo after surgery. No hypertension occurred during pregnancy, and the patient delivered a healthy female neonate. Patients with pregnancy complicated by JGCT are difficult to diagnose. Herein, we advise surgeons on proper handling of such situations.

Pilot study of gene mutations associated with Lynch syndrome in Slovak patients with breast cancer.

Lynch syndrome (LS) is an autosomal dominant inherited disorder which causes an increased risk of cancer, especially colorectal and endometrial carcinomas. Recent studies have shown an association between LS and breast cancer as well. The aim of our study is to highlight the possible presence of mutations in genes associated with LS in patients with breast cancer and the need to include the examination of Lynch-associated genes in patients with a family history of breast cancer as well as in patients with recurrent breast cancer, as well as with the occurrence of other Lynch-associated cancer. We analyzed tumor tissue samples from 78 patients with primary breast cancer. Our samples were tested with a gene panel associated with the risk of developing breast cancer, while in our study we focused primarily on the occurrence of mutations in mismatch-repair genes. DNA isolated from tumor tissue was sequenced using next generation sequencing (NGS) and analyzed using the Ingenuity Variant Analysis tool. To confirm the germline mutation, we examined the patient's blood sample using NGS sequencing. As a result of our analysis, we managed to identify a mutation in the PMS2 gene in one patient's breast tumor tissue. The presence of this mutation indicates that the resulting cancer may be a consequence of LS. As for pathogenicity, this was probably a pathogenic variant, as we detected deletions in the exon region, which led to frameshift mutation. Moreover, we also identified single-nucleotide pathogenic variants in the TP53 and PIK3CA genes. To definitively establish the diagnosis of LS in the patient, we examined a blood sample, where we also identified a mutation of the PMS2 gene. LS is underdiagnosed in many Lynch-associated cancers. However, in the case of a familial occurrence of breast cancer and other Lynch-associated genes, it is important to think about a possible diagnosis of LS and, if the patient meets the diagnostic criteria, to carry out a genetic examination of Lynch-associated genes.

Analyses of single extracellular vesicles from non-small lung cancer cells to reveal effects of epidermal growth factor receptor inhibitor treatments

Precision cancer medicine has changed the treatment landscape of non-small cell lung cancer (NSCLC) as illustrated by the introduction of tyrosine kinase inhibitors (TKIs) towards mutated epidermal growth factor receptor (EGFR). However, as responses to EGFR-TKIs are heterogenous among NSCLC patients, there is a need for ways to early monitor changes in treatment response in a non-invasive way e.g., in patient's blood samples. Recently, extracellular vesicles (EVs) have been identified as a source of tumor biomarkers which could improve on non-invasive liquid biopsy-based diagnosis of cancer. However, the heterogeneity in EVs is high. Putative biomarker candidates may be hidden in the differential expression of membrane proteins in a subset of EVs hard to identify using bulk techniques. Using a fluorescence-based approach, we demonstrate that a single-EV technique can detect alterations in EV surface protein profiles. We analyzed EVs isolated from an EGFR-mutant NSCLC cell line, which is refractory to EGFR-TKIs erlotinib and responsive to osimertinib, before and after treatment with these drugs and after cisplatin chemotherapy. We studied expression level of five proteins; two tetraspanins (CD9, CD81), and three markers of interest in lung cancer (EGFR, programmed death-ligand 1 (PD-L1), human epidermal growth factor receptor 2 (HER2)). The data reveal alterations induced by the osimertinib treatment compared to the other two treatments. These include the growth of the PD-L1/HER2-positive EV population, with the largest increase in vesicles exclusively expressing one of the two proteins. The expression level per EV decreased for these markers. On the other hand, both the TKIs had a similar effect on the EGFR-positive EV population.

Frequency analysis of subgroup blood typing and Cis-AB type

The purpose of this study is to prevent side effects of transfusion by analyzing the frequency of subtype blood types in blood type tests. Of the 19,800 cases, 128 (0.59%) cases were classified as subtypes. The distribution of subtype detection in K University Hospital was classified as Cis-AB (39 cases, 30.5%), A₂ (25 cases, 21.6%), A₂B (24 cases, 20.7%), A₁B (13 cases, 11.2%), A₃ (11 cases, 9.5 cases) %), B₃(9 cases, 7.8%), Ag(3 cases, 2.6%), Ax(1 case, 0.95%), Ay(1 case, 0.9%), Bx(1 case, 0.9%), Bel(1 case, 0.9%). Am, Az, and Bm were not detected at all. These subtype blood types are caused by quantitative and qualitative variants of antigenicity on the surface of red blood cells. Finally, the examiner should select blood that matches the patient's blood type and select blood that is not abnormal in the examination and transfuse it to prevent side effects of transfusion in advance.

Recent Advances in Nanomaterials‐Based FETs for SARS‐CoV‐2 (COVID‐19 Virus) Diagnosis

The emergence of infectious diseases that are quickly spreading, like the coronavirus (COVID‐19), necessitates the development of efficient biosensors that can quickly detect and identify pathogens. It is essential to create sensitive virus detection methods in order to stop a virus from spreading throughout the world. It is determined that field‐effect transistors (FETs) made of nanomaterials are potential candidates for rapid virus identification due to how easily the electronic transport characteristics of such an atomically thin nanomaterial can be affected by perturbations. Various FETs in this review article are investigated that are based on nanoparticles, carbon nanotubes (CNT), graphene, graphene‐oxide, and semiconducting transition metal dichalcogenides (TMDs) WSe2 in order to show that they are promising biosensors in regards to quickly and precisely detect COVID‐19. The conjugation of nanomaterials with proteins enables the direct delivery of antiviral agents to the host cells. This method also minimizes the off‐target effects and enables the targeted interactions. This mechanism has produced encouraging results in regards to sensing or treating COVID‐19. The high surface area and extremely small size of nanomaterials make them crucial in regards to the development of new detection methods. The point‐of‐care test method of detection is quick, simple, and user‐friendly, and it only requires a small amount of a patient's blood. It does not require a laboratory or trained professionals. This overview of the current research that is conducted on nanomaterials will prove to be useful in the process of formulating strategies for the diagnosis, treatment, and vaccination of viruses in opinion. Finally, the conclusion of this review provides a summary of the current challenges and the future prospects.

Three Klebsiella species as potential pathobionts generating endogenous ethanol in a clinical cohort of patients with auto-brewery syndrome: a case control study

Patients with auto-brewery syndrome (ABS) become inebriated after the ingestion of an alcohol-free, high-carbohydrate diet. Our previous work has shown that high-alcohol-producing (HiAlc) Klebsiella pneumoniae can generate excessive endogenous ethanol and cause non-alcoholic fatty liver disease (NAFLD). Therefore, it is reasonable to speculate that such bacteria might play an important role in the pathogenesis of ABS. The characteristics and metabolites of the intestinal flora from a clinical cohort of patients with ABS were analysed during different stages of disease and compared to a group of healthy controls. An invitro culture system of relevant samples was used for screening drug sensitivity and ABS-inducing factors. Rabbit intestinal and murine models were established to verify if the isolated strains could induce ABS invivo. We observed intestinal dysbiosis with decreased abundance of Firmicutes and increased of Proteobacteria in patients with ABS compared with healthy controls. The abundance of the genus Klebsiella in Enterobacteriaceae was strongly associated with fluctuations of patient's blood alcohol concentration. We isolated three species of HiAlc Klebsiella from ABS patients, which were able to induce ABS in mice. Monosaccharide content was identified as a potential food-related inducing factor for alcohol production. Treatments with antibiotics, a complex probiotic preparation and a low-carbohydrate diet not only alleviated ABS, but also erased ABS relapse during the follow-up observation of one of the patients. Excessive endogenous alcohol produced by HiAlc Klebsiella species was an underlying cause of bacterial ABS. Combined prescription of appropriate antibiotics, complex probiotic preparation and a controlled diet could be sufficient for treatment of bacteria-caused ABS. The funders are listed in the acknowledgement.

The Effect of Respira Inhalation on the Oxygen Saturation of a Patient's Blood (SPO2): A Case Report

Infection and the accompanying inflammation of the upper and lower respiratory tract, influenza and Covid-19, are among the deadliest diseases in human life of the world. Due to the high emergence of bacterial resistance to antibiotics, we strive to find alternatives to contribute to the treatment by using new formulation of a mixture of six essential oils in the form of a drop called it Respira drops for therapeutic approach of the upper or lower parts of the respiratory system infection, either by inhalation or sniffing, or by touching it with the body in the form of a skin patch on the head, neck, or chest. The present study suggested that natural essential oils may act as prophylactic and therapeutic agent in respiratory tract hypoxia, inflammation and bacterial and viral infection (influenza and COVID-19).

Quantification of Blood Viscoelasticity under Microcapillary Blood Flow.

Blood elasticity is quantified using a single compliance model by analyzing pulsatile blood flow. However, one compliance coefficient is influenced substantially by the microfluidic system (i.e., soft microfluidic channels and flexible tubing). The novelty of the present method comes from the assessment of two distinct compliance coefficients, one for the sample and one for the microfluidic system. With two compliance coefficients, the viscoelasticity measurement can be disentangled from the influence of the measurement device. In this study, a coflowing microfluidic channel was used to estimate blood viscoelasticity. Two compliance coefficients were suggested to denote the effects of the polydimethylsiloxane (PDMS) channel and flexible tubing (C1), as well as those of the RBC (red blood cell) elasticity (C2), in a microfluidic system. On the basis of the fluidic circuit modeling technique, a governing equation for the interface in the coflowing was derived, and its analytical solution was obtained by solving the second-order differential equation. Using the analytic solution, two compliance coefficients were obtained via a nonlinear curve fitting technique. According to the experimental results, C2/C1 is estimated to be approximately 10.9-20.4 with respect to channel depth (h = 4, 10, and 20 µm). The PDMS channel depth contributed simultaneously to the increase in the two compliance coefficients, whereas the outlet tubing caused a decrease in C1. The two compliance coefficients and blood viscosity varied substantially with respect to homogeneous hardened RBCs or heterogeneous hardened RBCs. In conclusion, the proposed method can be used to effectively detect changes in blood or microfluidic systems. In future studies, the present method can contribute to the detection of subpopulations of RBCs in the patient's blood.

Breast cancer cell secretome analysis to decipher miRNA regulating the tumor microenvironment and discover potential biomarkers

MicroRNA (miRNA/miR) 526 b- and miR655-overexpressed tumor cell-free secretions regulate the breast cancer tumor microenvironment (TME) by promoting tumor-associated angiogenesis, oxidative stress, and hypoxic responses. Additionally, premature miRNA (pri-miR526b and pri-miR655) are established breast cancer blood biomarkers. However, the mechanisms of how these miRNAs regulate the TME has yet to be investigated. Mass spectrometry analysis of miRNA-overexpressed cell lines MCF7-miR526b, MCF7-miR655, and miRNA-low MCF7-Mock cell-free secretomes identified 34 differentially expressed proteins coded by eight genes. In both miRNA-high cell secretomes, four markers are upregulated: YWHAB, SFN, TXNDC12, and MYL6B, and four are downregulated: PEA15, PRDX4, PSMB6, and FN1. All upregulated marker transcripts are significantly high in both total cellular RNA pool and cell-free secretions of miRNA-high cell lines, validated with quantitative RT-PCR. Bioinformatics tools were used to investigate these markers' roles in breast cancer. These markers' top gene ontology functions are related to apoptosis, oxidative stress, membrane transport, and motility supporting oncogenic miR526b- and miR655-induced functions. Gene transcription factor analysis tools were used to show how these miRNAs regulate the expression of each secretory marker. Data extracted from the Human Protein Atlas showed that YWHAB, SFN, and TXNDC12 expression could distinguish early and late-stage breast cancer in various breast cancer subtypes and are associated with poor patient survival. Additionally, immunohistochemistry analysis showed the expression of each marker in breast tumors. A stronger correlation between miRNA clusters and upregulated secretory markers gene expression was found in the luminal A tumor subtype. YWHAB, SFN, and MYL6B are upregulated in breast cancer patient's blood, showing biomarker potential. Of these identified novel miRNA secretory markers, SFN and YWHAB successfully passed all validations and are the best candidates to further investigate their roles in miRNA associated TME regulation. Also, these markers show the potential to serve as blood-based breast cancer biomarkers, especially for luminal-A subtypes.

Blood Pressure Challenge Reduces Hematomas in Gender-Affirming Mastectomy: A Retrospective Chart Review of 92 Consecutive Patients.

Gender-affirming mastectomy is a common surgery for the treatment of gender incongruence and gender dysphoria and improves quality of life. Hematoma rates for gender-affirming double incision mastectomies are between 2.8% and 8.1%. This study aims to investigate the utility of a blood pressure challenge, whereby the patient's blood pressure is medically increased intraoperatively to reveal bleeding vessels that can be addressed with additional hemostasis before skin closure, to reduce postoperative hematoma. A retrospective chart review of patients who underwent gender-affirming double incision mastectomies over a 6-year period by a single surgeon was conducted. Surgeries were separated into a blood pressure challenge experimental group and a non-blood pressure challenge control group. Demographics, surgical characteristics, and postoperative complications were compared between the 2 cohorts using Pearson χ2, Fisher exact, t tests, univariate logistic regression, and multivariable logistical regression. Significance was established at P < 0.05. A total of 92 patients (184 breasts) were included with 32 patients (64 breasts) in the control group and 60 (120 breasts) in the blood pressure challenge group. In the control group, there were 5 hematomas (7.81%) compared with 1 (0.83%) in the blood pressure challenge group (P = 0.02). On univariate logistical regression analysis, blood pressure challenge was the only variable significantly associated with hematoma (odds ratio, 0.1; 95% confidence interval, 0.01-0.63; P = 0.04). On multivariable logistical regression, after controlling for age, body mass index, smoking status, and mass of excised breast tissue, patients who underwent blood pressure challenge demonstrated lower hematoma rates (odds ratio, 0.08; 95% CI, 0.004-0.59; P = 0.04). Using an intraoperative blood pressure challenge was associated with reduced hematoma rates. Guidelines for blood pressure challenge goals should be established to standardize care and reduce complications in gender-affirming mastectomies.

Arterial Stiffness as A Predictor of Future Cardiovascular Events: Methods of Measurement and Clinical Implications

Arterial stiffness has recently emerged as strong predictor of cardiovascular events, including coronary heart disease. The cardio-ankle vascular index (CAVI) is a novel index that measures the overall stiffness of the artery all the way from the point where it branches off from the aorta to the ankle. CAVI's ability to provide accurate results regardless of the patient's blood pressure at the moment of measurement is without a doubt its most valuable characteristic. CAVI is related to many cardiovascular risk factors, including hypertension, diabetes mellitus, dyslipidemia, and smoking. It also increases with age and in many arteriosclerotic diseases, such as coronary artery disease, carotid arteriosclerosis, chronic kidney disease, and cerebrovascular disease. CAVI also increases in patients who have cerebrovascular disease. Controlling conditions such as diabetes mellitus and hypertension, in addition to quitting smoking, may also reduce the risk of CAVI. This indicates that CAVI is a physiological surrogate measure of atherosclerosis, and it also implies that it might be a signal of lifestyle change. Recent research has shown that CAVI and numerous functions of the left ventricle are linked to one another, which points to a linkage between the heart muscle and vascular function. This study discusses the fundamentals of CAVI as well as our present understanding of the measurement, with a particular emphasis on its functions and potential future use.

A rare form of systemic amyloidosis with kidney damage — AFIB-amyloidosis

Within the framework of this publication, the first description of the AFib-form of amyloidosis with kidney damage in the Russian Federation is presented. Detection of a rare form of amyloidosis became possible after morphological examination of the kidneys and typing of amyloid into AA and AL forms, as well as mass spectrometric examination of the patient's blood and urine.

Thiamine deficiency in exclusive breastfed infants with encephalopathy attending Govind Ballabh Panth children hospital, Srinagar

Background: Thiamine deficiency (TD) has historically affected countries and populations consuming milled white rice. TD in infants can have an acute presentation of encephalopathy with shock with severe metabolic acidosis and death sometimes, if not promptly treated with an intravenous dose of thiamine. Aim was to study the biochemical deficiency of thiamine in exclusively breastfed infants presenting with encephalopathy and compare them with age-matched controls and to study their clinical course and short-term outcome (till discharge). Methods: After dividing infants into four groups based on age in days: (31-60 days; 13 in cases and 8 in controls; 61-90; 4 in cases and 3 in controls; 91-120 days; 2 in cases and none in controls; and &gt;120 days 4 each in cases and controls. This study primarily included the selection of case/control subjects. Two case-control analyses were conducted. In the first one, blood thiamine levels were compared between infants with encephalopathy and without encephalopathy. In the second one, breast milk thiamine levels were compared between infants with encephalopathy and without encephalopathy. Student's independent t test was used for statistical analysis. Results: Out of 38 infants, 23 had presented with encephalopathy, and 15 were healthy taken as controls. The mean blood levels of thiamine in infants with encephalopathy in cases were 17.29 nmol/l with a standard deviation of 8.86: the levels ranged between 13.47 and 21.13. The mean value of controls was 51.31, with a standard deviation of 25.52 ranging between 23.25 and 124.7. The p&lt;0.001 and was considered statistically significant. The ROC analysis of the data obtained from thiamine levels obtained in the study 'patient's blood compared with the control group. Conclusions: TD can be clinically and biochemically attributed to presentation of infants with acute encephalopathy.

Versatile Dynamic Bioactive Lubricant-Infused Surface for Effective Isolation of Circulating Tumor Cells.

The rarity of circulating tumor cells (CTCs) and the complexity of blood components present major challenges for the efficient isolation of CTCs in blood. The coexisting matters could interfere with the detection of CTCs by adhering to the binding sites on the material surface, leading to the reduced accuracy of biomarker capture in blood. Herein, we developed dynamic bioactive lubricant-infused slippery surfaces by grafting the 1H,1H,2H,2H-heptadecafluorodecyl acrylate polymer and 3-acrylamidophenylboronic acid polymer brushes on quartz plates by UV light-initiated and then grafted cancer cell-binding peptides via reversible catechol-boronate chemistry between phenylboronic acid groups and 3,4-dihydroxy-l-phenylalanine groups of peptides for high-efficient capture of CTCs and nondestructive release of the desired cells in sugar response. Patterned dynamic bioactive lubricant-infused surfaces (PDBLISs) further exhibited the improved capture efficiency of CTCs and more effective antifouling properties for nonspecific cells and blood components. Moreover, the PDBLIS can efficiently capture rare cancer cells from the mimic of cancer patient's blood samples. We anticipate that the strategy we proposed would be used in further clinical diagnosis of complicated biofluids related to a variety of tumors and exhibit good prospects and potential in future liquid biopsies.

Thiamine Deficiency in Exclusive Breastfed Infants with Encephalopathy Attending Govind Ballabh Panth Children Hospital Srinagar, India

Introduction: Thiamine deficiency has historically affected countries and populations consuming milled white rice. Thiamine deficiency in infants can have an acute presentation of encephalopathy with shock with severe metabolic acidosis and death sometimes, if not promptly treated with an intravenous dose of thiamine.&#x0D; Aims: To study the biochemical deficiency of thiamine in exclusively breastfed infants presenting with encephalopathy and compare them with age-matched controls and to study their clinical course and short-term outcome (till discharge).&#x0D; Materials and Methods: After dividing infants into four groups based on age in days: (31-60 days; 13 in cases and 8 in controls; 61-90; 4 in cases and 3 in controls; 91-120 days; 2 in cases and none in controls; and &gt;120 days 4 each in cases and controls. This study primarily included the selection of case/control subjects. Two case-control analyses were conducted. In the first one, blood thiamine levels were compared between infants with encephalopathy and without encephalopathy. In the second one, breast milk thiamine levels were compared between infants with encephalopathy and without encephalopathy. Student's independent t-test was used for statistical analysis.&#x0D; Results: Out of 38 infants, 23 had presented with encephalopathy, and 15 were healthy taken as controls. The mean blood levels of thiamine in infants with encephalopathy in cases were 17.29nmol/l with a Standard deviation of 8.86: the levels ranged between 13.47 and 21.13. The mean value of controls was 51.31, with a Standard deviation of 25.52 ranging between 23.25 and 124.7. The P value was &lt;0.001 and was considered statistically significant. The ROC analysis of the data obtained from thiamine levels obtained in the study 'patient's blood compared with the control group.&#x0D; Conclusion: Thiamine deficiency can be clinically and biochemically attributed to the presentation of infants with acute encephalopathy.

Correlation of hyperprolactinemia, Subclinical hypothyroidism with Polycystic Ovary Syndrome and infertility

Background: Polycystic ovarian syndrome (PCOS) is a hyperandrogenic condition characterized by polycystic ovarian morphology and chronic oligo-anovulation. When it is combines with hypothyroidism and hyperprolactinemia, this condition can have severe consequences, may even lead to infertility.&#x0D; Case Presentation: This case study illustrates the complexity of PCOS and the significance of a multidisciplinary approach to its diagnosis and therapy. The patient is a 24-year-old non diabetic nonsmoker female with PCOS who has been attempting to conceive for seven years. The patient presented to the hospital with irregular menstrual cycles and a desire to become pregnant. The patient had previously been unsuccessfully treated with Clomid and letrozole. The patient's BMI was determined to be 23. 3 and a pelvic scan indicated PCO ovaries. Laboratory results revealed hyperprolactinemia (53 ng/ml) and subclinical hypothyroidism (TSH 12.6 uIU/ml, T4 0.54 ng/dL- TPO antibodies:187 IU/mL, Anti thyroglobulin antibodies 235 IU/mL), but a pituitary gland MRI was normal. Thyroid US features going with Hashimoto thyroiditis. The patient's PCOS symptoms were initially managed with metformin and Duphaston, and then Cabergoline was introduced to address hyperprolactinemia. The patient became pregnant shortly following hyperprolactinemia medication. Prenatal screenings revealed elevated fasting glucose levels and gestational diabetes. The patient's blood sugar was initially controlled by Metformin, but she later required multiple insulin doses to maintain control. The patient was scheduled for induction of labor at 38 weeks, but a lower segment emergency cesarean surgery was performed due to fetal distress.&#x0D; Conclusion: Regular monitoring and management of both PCOS and related conditions such as hypothyroidism and hyperprolactinemia are crucial to ensure the best outcome for the patient. Additionally, we suggest Metformin, Duphaston, Cabergoline to treat PCOS patient having subclinical hypothyroidism and hyperprolactinemia.&#x0D; Keywords: Polycystic ovarian syndrome, subclinical hypothyroidism, hyperprolactinemia, gestational diabetes.

Active specific immunotherapy: mechanisms of action and clinical applications in bioregenerative and anti-aging medicine, autoimmune conditions and cancers

Autologous Active Specific Immunotherapy (AASI) is a type of immunotherapy that targets complementary autoantibodies which suppress the specific immune response using anti-idiotypic antibodies. AASI entails removing immune cells (dendritic cells) from the patient's blood and subjecting them in a lab setting to a particular tumour antigen (proteins detected on the surface of cancer cells). AASI is a personalized treatment approach that has been used to treat various types of cancer, including melanoma, osteosarcoma and breast cancer. Clinical trials have shown promising results, with some patients experiencing complete remission or long-term disease control. Although AASI has shown potential as a cancer treatment, further research is needed to optimize its effectiveness and safety. AASI is a complex and expensive therapy, and its use is currently limited to specialized cancer treatment centres.

Hubungan Tingkat Pengetahuan Diabetes Mellitus Terhadap Kadar Gula Darah Pasien Diabetes Mellitus di Puskesmas X

Diabetic Mellitus is a chronic disease caused a limited or inneffective insulin produced by pancreas. Diabetes is a big health problems that has reached an worry level and is a global threat. A knowledge has an important role for behavior. This research is used to look a correlation between level of knowledge with of blood sugar levels in patients of diabetic mellitus at the X Health Center. This research used an analytic survey design with a cross-sectional program. The samples was 93 patients with inclusion criteria in the form in patient of diabetic mellitus at the X Health Center and willing to be respondents. This research was held in December 2022 until January 2023. The research used instrument a questionnaire sheet by DKQ 24. The results of the univariate research were obtained by 64,5% of patient had a good levels knowledge and 35,5% had a not good level of knowledge, 60,2% of patient had a normal blood sugar levels and 39,8% of patient had abnormal blood sugar levels. The bivariate with a Chi-Square statistical test found that there a correlation between the level of knowledge with of blood sugar levels in diabetic mellitus patients at the X Health Center in Kediri City with a P value of 0.014. From this research it can be conclude that there a significant correlation between the level knowledge with of blood sugar levels patients of diabetic mellitus at the X Health Center. Hoped the results this research will give information to the X Health Center to continue providing education about diabetes mellitus to patients as a support the stability of the patient's blood sugar levels with a better life.

Combining CAR T-cell and immune checkpoint inhibitor therapy, a promising, yet unproven immuno-oncology approach

Chimeric antigen receptor (CAR) T-cell therapy is a method that extracts T cells from the patient's blood and virally introduces a genetically engineered T cell receptor targeting a specific cancer antigen and subsequently readministering these genetically engineered CAR T cells to the patient. These T cells are then better at identifying the tumors and attaching to these tumor cells resulting in a stronger cytotoxic immune response. The development of CAR T cells has been a huge success as an immunotherapy, especially for the targeting of non-solid tumors. Since their original inception in 1987, there are now six independent FDA approved CAR T cell therapies targeting a variety of blood cancers, with the first being approved in 2017. As a relatively new treatment, there is a continuous effort in improving the safety and efficacy of CAR T cell therapies. As mentioned previously, CAR T cells have undoubtedly been successful in the treatment of non-solid tumors, however their efficacy towards treatment of solid tumors has been limited. Additionally, the safety and long-term effects of CAR T cell treatments is still a concern. Combination therapy utilizing CAR-T cells and immune checkpoint inhibitors is being explored to potentially mitigate some of the limitations associated with CAR-T cells.