Post-treatment Values Research Articles

Abstract 4139198: A Systematic Approach to Prompting Large Language Models for Automated Feature Extraction from Cardiovascular Imaging Reports

Introduction: Cardiovascular radiology reports contain valuable diagnostic information linked to images, but the unstructured text format makes feature extraction difficult on a large scale. Large language models (LLMs) allow for feature extraction where string parsing alone is insufficient, but require careful prompting for accurate results. Hypothesis: We hypothesize that a systematic prompting approach using LLMs can expedite the extraction of features from unstructured text in transesophageal echocardiography (TEE) reports. Methods: The data consisted of 7106 intraoperative TEE reports, 600 of which were manually reviewed to obtain pre- and post-intervention ground truth values for left ventricular ejection fraction (LVEF), right ventricular systolic function (RVSF), and tricuspid regurgitation (TR). Reports are paired with an imaging study consisting of 50-200 clips. For each feature considered, 100 of the 600 labeled reports were used to engineer a prompt in Llama-2 that maximized feature extraction accuracy. Results: We found that using multiple, shorter prompts yielded higher accuracy than did fewer, longer prompts. Additionally, when imposing semantic information onto a numerical scale, prompt engineering in combination with string parsing (Figure 1) gave the best results. When evaluated on the 500 labeled reports withheld for testing, the finalized prompts had accuracies of 94.1%, 94.8%, and 91.3% for LVEF, RVSF, and TR, respectively. Using this strategy, 5000 intraoperative TEE reports were analyzed and used to train and evaluate a regression model for LVEF estimation from TEE clips (Figure 2). Conclusion: We have shown that performing prompt engineering on Llama-2 can be used to extract features from unstructured TEE reports in an accurate manner. As an extension of these methods, automated feature prediction from echocardiograms can be used to create rapid, low-cost, and accessible cardiac assessments.

Isotretinoin increases non-insulin-based surrogate markers of insulin resistance in acne vulgaris patients

Background Lipid indices, particularly the triglyceride-glucose index (TyG index) and the triglyceride/high-density lipoprotein cholesterol (TG/HDL-C) ratio, are simple, reliable, non-insulin-based surrogate markers of insulin resistance that have recently gained prominence. The aim of this study was to evaluate the effect of isotretinoin treatment on surrogate markers of insulin resistance, in particular the TyG index, in patients with acne vulgaris (AV). Materials and methods This retrospective study reviewed the records of 200 patients who received isotretinoin treatment for acne vulgaris at the Department of Dermatology and Venereology between September 2023 and March 2024. Serum fasting glucose, fasting lipid profile [triglyceride (TG), total cholesterol (TC), very low-density lipoprotein cholesterol (VLDL-C), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C)] and other biochemical parameters were recorded. Triglyceride-glucose (TyG) index value was calculated with the formula Ln [fasting triglyceride (mg/dL) × fasting plasma glucose (mg/dL)/2]. Pre-treatment values were compared with values after 5 months of treatment. Results TyG index and TG/HDL, TC/HDL, and LDL/HDL ratios all increased statistically significantly (p < 0.001). In addition, a positive correlation was found between pre- and post-treatment TyG index values and pre- and post-treatment TC/HDL, LDL/HDL and TG/HDL ratio values (p < 0.001). Among lipid measurements, triglycerides, total cholesterol, VLDL-C, LDL-C increased statistically significantly (p < 0.001), while HDL-C decreased statistically significantly (p < 0.05). Conclusion The results of this study suggest that isotretinoin treatment may increase insulin resistance in AV patients by increasing surrogate biomarkers of insulin resistance. We also suggest that the TyG index and other lipid indices can be used in treatment follow-up.

Short-term results of steroid treatment in patients with non-arteritic ischemic optic neuropathy

Aims: To evaluate the effects of steroid treatment on the best-corrected visual acuity (BCVA) and retinal nerve fiber layer (RNFL) in patients with non-arteritic ischemic optic neuropathy (NAION). Methods: The retrospective study included 24 eyes of 24 patients who received 1 gram/day pulse steroid treatment for 3 days with a diagnosis of NAION. The patient's comorbidities, demographic information, intraocular pressure, BCVA, and RNFL measured by optical coherence tomography (OCT) were recorded before and after treatment at one month. Results: The mean age of the patients was 64.35±14.6 (22-86). Diabetes mellitus was present in 14 patients (58.3%), hypertension in 13 (54.2%), and coronary artery disease in 5 (27.8%). The pre-treatment BCVA was 0.33±0.37, and post-treatment BCVA was 0.37±0.36 (p=0.345). The pre-treatment RNFL value was 208.0±57.9, and the post-treatment RNFL value was 113.6±32.6 (p&lt;0.000). No additional complications related to treatment were observed. Conclusion: While there was no significant difference in BCVA values one month after steroid treatment, a significant anatomical improvement was observed in RNFL thickness.

Evaluating the Impact of Age and G8 Assessment on Definitive Treatment Strategies in Elderly Patients with Local Advanced Esophageal Carcinoma

Introduction: While chemoradiotherapy (CRT) is commonly employed as a curative approach for esophageal cancer, administering standard CRT to elderly patients often presents challenges in practical settings. The objective of this study was to compare treatment tolerance and survival outcomes between younger and elderly patients (aged ≥65 years) diagnosed with locally advanced esophageal cancer receiving curative-intent treatment. Additionally, it aimed to assess the impact of the Geriatric-8 Health Status Screening Tool (G8 score) on treatment decisions in elderly patients. Methods: Ninety-seven patients treated with neoadjuvant or definitive CRT for locally advanced esophageal cancer were retrospectively evaluated at two centers from 2013 to 2023. We divided the patients by age (<65 and ≥65 years) and assessed their demographic, clinical, and treatment data, including pre- and post-treatment G8 scores. Radiotherapy (RT) was administered at a median dose of 50.4 Gy (45–66 Gy). Planned concurrent chemotherapy was completed in 73 (75.3%) of the patients. Results: In the comparative study of 97 esophageal cancer patients, 48 geriatric (aged ≥65 years) and 49 younger individuals were followed up for a median of 20 and 21 months, respectively. No significant statistical differences were noted between the groups concerning baseline and treatment characteristics. Surgical intervention rates were comparable, with 22.9% of geriatric and 36.7% of young patients undergoing surgery (p = 0.184). There were no significant differences in pathological complete response, local recurrence, distant metastasis, progression, or death rates. The median progression-free survival (PFS) for geriatric and younger patients was 31 months (95% CI, 13.6–48.4) and 19 months (95% CI, 0–39.4), respectively (p = 0.832). The median overall survival (OS) was 38 months (95% CI, 23.8–52.2) in geriatric patients, while it was not reached in younger patients (p = 0.745). There was no significant difference between the two groups. The pretreatment and post-treatment G8 values of the geriatric patients were 9.25 (6–13.5) and 9.5 (6–14), respectively. Patients with increased G8 scores were found to have significantly higher PFS (median 85 months vs. 11 months, p = 0.001) and OS (median 85 months vs. 14 months, p = 0.001) compared to those with unchanged or decreased G8 scores. Conclusion: Age alone should not be the determining factor in the treatment decision of elderly patients diagnosed with locally advanced esophageal cancer. Moreover, CRT could be safely performed even in patients with low G8 scores, and although the G8 score may not directly influence treatment decision, its enhancement during the treatment process holds significant prognostic value.

Regulated Medical Waste Reduction in the Dermatology Clinic.

The disposal of regulated medical waste (RMW) in the healthcare setting can be both costly and environmentally harmful. Prior studies have found large amounts of waste disposed of in RMW containers are inappropriately placed. Few studies to date have investigated the efficacy of waste reduction practices in the dermatology setting. This study aims to evaluate the effectiveness of a practice-wide intervention in reducing RMW in the outpatient dermatology setting. By performing daily waste audits and two concurrent educational interventions, the amount of RMW produced and percent of appropriately placed RMW will be measured. Further analysis will occur by comparing pre-intervention values to post-intervention values. The percentage of waste properly placed in RMW containers prior to any intervention was 11%. Following both educational interventions, the percentage of waste properly placed in RMW containers increased by 56.1% (CI 43.7-68.5%) and the percentage of total waste produced that was identified and disposed of as RMW decreased by 6.0% (95% CI 1.2-10.8%). Our study provides practical data for dermatology providers to make small changes which can result in significant reductions of regulated medical waste, potentially providing benefits to the environment and cost-savings.

Transdermal Carboxytherapy for Treating Vulvovaginal Atrophy: A Pilot Study

Objective: Genitourinary syndrome of menopause (GSM) is a prevalent disorder that can negatively impact the overall health, sexual function, and quality of life of affected women; however, available data do not support specific treatment protocols. A novel product enables the noninvasive transdermal administration of carboxytherapy with a topical gel (CO2Lift®, Lumisque, Inc.; Weston, FL). The following randomized, placebo-controlled pilot study assessed the safety and efficacy of the transdermal carboxytherapy gel for treating GSM-related vulvovaginal changes. Methods: Menopausal or postmenopausal women 40 to 70 years old with signs or symptoms of vulvovaginal atrophy and Female Sexual Dysfunction were randomized to receive topical carboxytherapy gel (n=40) or placebo gel (n=10) in a randomized, double-blind fashion. The assigned treatments were placed into the vagina and on the vulva for 45 minutes before removal. Treatment was applied daily for 5 days, stopped for 2 days, then continued for 5 additional days. Subjects completed four validated pre- and posttreatment questionnaires to assess female sexual function, sexual health, and genital self-image. Additionally, control (n=10) and treatment subjects (n=10) were randomized to undergo 3 mm pre- and posttreatment punch biopsies of vulva and vaginal tissue. Results: Overall, carboxytherapy-treated subjects achieved significant improvements in Female Sexual Function Index scores with strong positive correlations between sexual desire and arousal, arousal and sexual satisfaction, and sexual satisfaction and desire. The Day-to-Day Impact of Vaginal Aging Questionnaire results demonstrated a significant difference in mean pre- and posttreatment values for each assessment among subjects receiving topical carboxytherapy. Biopsy improvements included hyperplasia of the keratinized squamous epithelium, discrete hyperplasia of the basal layer and neovascularization, and increased thickness of mucous squamous epithelium. There were no adverse events. Conclusion: Transdermal carboxytherapy represents a safe, noninvasive means of treating the genitourinary syndrome of menopause symptoms and is suitable for home use. Additional research on this treatment is warranted.

Effect of the PROFIT-BR exercise program on physical fitness of children: a protocol study

BackgroundConsidering that school environments are important and have the potential to promote an active lifestyle with direct impacts on physical, motor, cognitive, affective, and psychological aspects, the objective of this study was to evaluate the effect of a physical exercise program in the school context.MethodsA parallel, two-arm experimental research project carried out over 19 weeks, with two non-consecutive weekly classes of 60 min, with the inclusion of PROFIT-BR in the initial 15 min of the class followed by 40 min based on specific physical education skills on indicators of physical fitness in children. Estimates of excess weight and visceral fat will be measured and assessed by body mass index and waist-to-height ratio, respectively, and cardiorespiratory fitness by performance in the six-minute run/walk test. Flexibility will be assessed by the sit and reach test; and muscle strength measured by the number of sit-ups in one minute. The 2 kg medicine ball throw and the horizontal jump will be used to measure upper and lower limb power, respectively, the square test used as a measure of agility, and the 20-meter run test used to measure speed. To analyze the differences between baseline and post-intervention values, repeated measures ANOVA adjusted for somatic maturation will be used. The magnitude of the effect size will be estimated by “partial eta squared”. Statistical analyses will be carried out using SPSS version 24.0 software and a 5% probability of error in the analyses will be accepted.DiscussionThe main theoretical assumption of the proposal is the cause-and-effect relationship between the regular practice of physical exercise in childhood and adolescence and several parameters of health and motor performance. The elaborated program has a lot of applicability because it was wondering from the perspective of the school, in terms of materials, space, and objectives of physical education.

Impact of virtual reality and mirror therapy on balance, muscle strength and quality of life in children with unilateral cerebral palsy: a double blinded randomized comparative study

Background and Purpose This study aimed to compare between the impact of virtual reality and mirror therapy on balance, muscle strength and quality of life in unilateral cerebral palsy children. Materials and methods This study involved 36 children of both sexes with unilateral cerebral palsy. Their ages ranged between 6 to 10 years and their motor function ability fell between levels I and II on Growth Motor Functional Classification System (GMFCS). Their grade of spasticity on Modified Ashworth scale was from 1+ to 2. They were allocated to one of two study groups (A and B). A designated physical rehabilitation program was given to both groups. furthermore, group A received a wii fit virtual reality-based program while, group B received mirror therapy. Children in both groups received treatment for three consecutive months, three days per week, 60 minutes per day. Balance, muscle strength and quality of life were assessed using biodex balance system, lafayette hand-held dynamometer and pediatric quality of life inventory cerebral palsy Module respectively for each child in two groups pre and post treatment program. Results Children in the two groups demonstrated a noticeable improvement in the post-treatment average scores of all evaluated outcomes (p 0.001) when compared to pre-treatment average scores. By comparing posttreatment values of both groups, group A showed a noticeably greater improvement than group B (p 0.05). Conclusions Both virtual reality and mirror therapy may be recommended to enhance balance, muscle strength and quality of life in children with unilateral cerebral palsy. Virtual reality is more beneficial in enhancing balance, muscular strength and quality of life among those children.

Diabetes Mellitus Type 2, Dyslipidemia and Blood Pressure: Common Pathway to Development of Metabolic Syndrome

Type of this study was single blind, placebo controlled and was approved by ethics committee of the hospital. Okra was used to see hypolipidemic, hyopoglycemic and hypotensive effects in primary and secondary hyperlipidemic patients. Separate folder was made to keep record of Pre and post treatment values of the parameters like blood pressure, total cholesterol, LDL cholesterol, HDL cholesterol, and blood sugar. Pre and post treatment values were compared after therapy, which proved that as compared to placebo, total cholesterol, triglycerides, LDL cholesterol and fasting blood sugar was reduced significantly with p-value &lt;0.001. HDL cholesterol was increased with p-value &lt;0.01 which was significant change. Results of study concluded that okra can reduce lipid profile and fasting blood sugar in primary and secondary hyperlipidemic patients and can be used to prevent metabolic syndrome leading to other health related consequences like heart diseases and central nervous system illnesses.

Subthreshold Cannabidiol Potentiates Levetiracetam in the Kainic Acid Model of Temporal Lobe Epilepsy: A Pilot Study.

Refractoriness to antiseizure medications is still a major concern in the pharmacotherapy of epilepsy. For this reason, we decided to evaluate the combination of levetiracetam and cannabidiol, administered at a subthreshold dose, to limit the possible adverse effects of this phytocannabinoid. We administered levetiracetam (300 mg/kg/day, via osmotic minipumps), cannabidiol (120 mg/kg/day, injected once a day subcutaneously), or their combination for one week in epileptic rats. Saline-treated epileptic rats were the control group. Animals were monitored with video electroencephalography the week before and after the treatment. No changes were found in the controls. Levetiracetam did not significantly reduce the total seizure number or the overall seizure duration. Still, the overall number of seizures (p < 0.001, Duncan's new multiple range test) and their total duration (p < 0.01) increased in the week following treatment withdrawal. Cannabidiol did not change seizures when administered as a single drug. Instead, levetiracetam combined with cannabidiol resulted in a significant reduction in the overall number and duration of seizures (p < 0.05), when comparing values measured during treatment with both pre- and post-treatment values. These findings depended on changes in convulsive seizures, while non-convulsive seizures were stable. These results suggest that cannabidiol determined a remarkable potentiation of levetiracetam antiseizure effects at a subthreshold dose.

Brolucizumab in patients with neovascular age-related macular degeneration: Real-life outcomes from a tertiary care eye hospital.

To report real-world clinical evidence of brolucizumab in treating neovascular age-related macular degeneration (nAMD). This study included 37 eyes with nAMD treated with intravitreal injections of brolucizumab. The main outcomes were best corrected visual acuity (BCVA) changes, central retinal thickness (CRT), and serious ocular adverse events. Intraretinal fluid (IRF) and subretinal fluid (SRF), subretinal hyperreflective material (SHRM), pigment epithelial detachments (PEDs), hyperreflective foci, macular atrophy, and retinal pigment epithelial tears were evaluated. The mean BCVA of all patients showed a post-treatment value of 0.47 ± 0.33 log of minimum angle of resolution (LogMAR), compared to a baseline measure of 0.50 ± 0.28 LogMAR (P = 0.372). For treatment-naïve patients, a non-statistically significant improvement in BCVA was observed (P = 0.116). Both treatment-naive patients and the entire patient cohort exhibited a statistically significant improvement in the mean CRT after injections. Majority of patients exhibited improvements in optical coherence tomography findings, specifically in the resolution of IRF, SRF, SHRM, and PEDs. Four eyes experienced ocular adverse events in the form of intraocular inflammation. Brolucizumab did not yield a substantial improvement in BCVA, but it exhibited efficacy in reducing CRT in the entire study population and treatment-naive patients with nAMD. Our study identified intraocular inflammation as a significant adverse event with brolucizumab. Thus, precise patient selection, education, and vigilant inflammation monitoring are crucial for patients undergoing this treatment.

The Influence of Treatment With Sofosbuvir/Velpatasvir on Children's Growth-Results of the PANDAA-PED Study.

The aim of this study was to evaluate the influence of treatment of hepatitis C with sofosbuvir and velpatasvir (SOF/VEL) on children's growth. Fifty children 6-18 years of age were successfully treated for hepatitis C with a 12-week course of SOF/VEL fixed dose adjusted to the body weight in the PANDAA-PED (Treatment of chronic hepatitis C in children aged 6-18 years of age using a pangenotypic direct-acting antiviral sofosbuvir/velpatasvir) project. Growth parameters were compared at 1 year after treatment with baseline (at the start of treatment) and 12-week-posttreatment values. Body mass index (BMI), weight and height Z scores adjusted to sex and age were calculated according to the World Health Organization reference data. Forty-nine participants (23 boys and 26 girls) completed all the visits. The mean age at 1 year after treatment was 10.9 ± 2.5 years, and all children had undetectable hepatitis C virus RNA at this point. Significant weight and height gains were observed after treatment irrespective of the patients' age and sex. Height Z scores did not vary significantly both at 12 weeks and 1 year after treatment, confirming a normal increase in participants' height. Weight Z scores for 16 children below 10 years of age decreased at 1 year after treatment. BMI Z score values decreased at 12 weeks after treatment compared to the baseline in boys, but no difference was found between 1-year posttreatment and baseline BMI Z scores in both girls and boys. Results of the PANDAA-PED study showed normal growth up to 1 year after successful treatment with SOF/VEL in children 6-18 years of age. Despite the decrease in BMI Z score in boys observed at 12 weeks after treatment, no differences were found between baseline and 1-year posttreatment values. Our observations confirm the long-term safety of the SOF/VEL treatment in children 6-18 years of age.

Impact of PNF and MET technique on hamstring flexibility among university students with hamstring tightness

Background. Hamstring tightness affects pelvic posture, contributing to symptoms such as low back discomfort and improper lumbar-pelvic area motions. The purpose of this study is to determine the immediate effectiveness of both Proprioceptive Neuromuscular Facilitation (PNF) and Muscle Energy Technique (MET) interventions on hamstring tightness. A paucity of literature has left a research gap on this topic. Thus, my study aims to compare the effects of these two interventions on improving hamstring flexibility among university students with hamstring tightness. Methods. Group I, consisting of 20 subjects, received PNF for 30 minutes. Group II, also consisting of 20 subjects, received MET for 30 minutes. The study was conducted for 4 weeks. Results. The ROM variables were examined using an independent ‘t’ test with a significance level of 0.05. The mean ± SD of the difference in hamstring ROM for the PNF group was 9.77 ± 4.01° and 10.7 ± 5.21° for the MET group. This indicates that a marked difference was obtained between Group I and Group II, as well as a substantial variation between both the pre-intervention and post-intervention values. Conclusion. The findings demonstrated that both PNF and MET significantly improved (p = 0.000) ROM. Meanwhile, no significant difference (p &gt; 0.05) was found between these two interventions.

The Effects of Different Treatment Methods on Blood Hematological Parameters İn COVID 19: A Retrospective Look at Patients in Pandemic İntensive Care Unit During The First Wave of the Pandemic

Introduction: In this study, we compared the pre- and post-treatment values of basic hematological parameters in severe COVID 19 patients, whose were received favipiravir, tocilizumab, methylprednisolone and convalescent plasma therapy. Methods: Hematological parameters such as eosinophyl, neutrophil, lymphocyte, platelet count and, neutrophil / lymphocyte, platelet/ lymphocyte ratio were investigated pre and post treatment of favipiravir, tocilizumab convalescent plasma and methylprednisolone in severe COVID 19 patients in ICU. Results: Lymphocyt values were increased after convelescent plasma theraphy and i.v. methyl prednisolon group. Eosinophil count improvement was only in the favipiravir group . We found that favipiravir, convalescent plasma andmethyl prednisolon treatment, were statistically significant increased both NLR and PLR. Conclusion : Hematologic parameters and their contribution of the respond of the treatment and clinical improvement should be taken into account.

Effects of Defatted Rice Bran-Fortified Bread on the Gut Microbiota Composition of Healthy Adults With Low Dietary Fiber Intake: Protocol for a Crossover Randomized Controlled Trial.

Inadequate dietary fiber (DF) intake is associated with several human diseases. Bread is commonly consumed, and its DF content can be increased by incorporating defatted rice bran (DRB). This first human study on DRB-fortified bread primarily aims to assess the effect of DRB-fortified bread on the relative abundance of a composite of key microbial genera and species in fecal samples. Secondary outcomes include clinical (cardiovascular risk profile), patient-reported (daily bread consumption and bowel movement, gut comfort, general well-being, and total DF intake), biological (fecal microbiota gene abundances, and fecal and plasma metabolites), and physiome (whole-gut and regional transit time and gas fermentation profiles) outcomes in healthy adults with low DF intake. This is a 2-armed, placebo-controlled, double-blinded, crossover randomized controlled trial. The study duration is 14 weeks: 2 weeks of lead-in, 4 weeks of intervention per phase, 2 weeks of washout, and 2 weeks of follow-up. Overall, 60 healthy adults with low DF intake (<18 g [female individuals] or <22 g [male individuals] per day) were recruited in Christchurch, New Zealand, between June and December 2022. Randomly assigned participants consumed 3 (female individuals) or 4 (male individuals) slices of DRB-fortified bread per day and then placebo bread, and vice versa. The DRB-fortified bread provided 8 g (female individuals) or 10.6 g (male individuals) of total DF, whereas the placebo (a matched commercial white toast bread) provided 2.7 g (female individuals) or 3.6 g (male individuals) of total DF. Before and after each intervention phase, participants provided fecal and blood samples to assess biological responses; completed a 3-day food diary to assess usual intakes and web-based questionnaires to assess gut comfort, general and mental well-being, daily bread intake, and bowel movement via an app; underwent anthropometry and blood pressure measurements; and drank blue food dye to assess whole-gut transit time. Additionally, 25% (15/60) of the participants ingested Atmo gas-sensing capsules to assess colonic gas fermentation profile and whole-gut and regional transit time. Mean differences from baseline will be compared between the DRB and placebo groups, as well as within groups (after the intervention vs baseline). For metabolome analyses, comparisons will be made within and between groups using postintervention values. Preliminary analysis included 56 participants (n=33, 59% female; n=23, 41% male). Due to the large dataset, data analysis was planned to be fully completed by the last quarter of 2024, with full results expected to be published in peer-reviewed journals by the end of 2024. This first human study offers insights into the prospect of consuming DRB-fortified bread to effectively modulate health-promoting gut microbes, their metabolism, and DF intake in healthy adults with low DF intake. Australian New Zealand Clinical Trials Registry ACTRN12622000884707; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=383814. DERR1-10.2196/59227.

Efficacy of Static Stretching Versus Proprioceptive Neuromuscular Facilitation (PNF) Stretching on Hip Adductor Flexibility in Recreational Football Players

Adductor strain is most commonly seen in football players. To help ease groin pain and improve the flexibility of muscles, stretching techniques like ballistic stretching, static stretching, etc can be used. Static hip adductor stretching and Proprioceptive Neuromuscular Facilitation (PNF) stretching, which is relatively new, are two effective techniques to increase muscle flexibility. This study examines the effects of these two stretching techniques on tight hip adductors. Method: Fifty people were chosen based on the inclusion criteria. There were two groups of subjects. PNF and static adductor stretching were administered to Group A. Group B received adductor stretching. These methods were used for three different days. Using a goniometer, the abduction range of motion was measured before the start of the first session and at the conclusion of the last one. Flexibility was measured before the first session and at the end of the previous treatment session by groin flexibility test. The inter-group analysis for Range of Motion (ROM) between Group A versus Group B showed a statistically significant difference by using an unpaired ‘t’ test. Results: Group A’s post-intervention flexibility values were 17.23, whereas group B’s were 13.5. There was a sizeable difference between Group A and Group B in the intergroup analysis of flexibility. The unpaired “t” test was used for this purpose. Conclusion: It is concluded that PNF stretching exercises had a statistically significant effect on the abduction range of motion and groin flexibility scores.

The Impact of Modern Bone Markers in Multiple Myeloma: Prospective Analyses Pre and Post-First Line Treatment.

Multiple myeloma, the disease characterized by the malignant proliferation of plasma cells that invades the bone marrow, produces osteolytic lesions and secretes monoclonal proteins. Several biomarkers have been shown to represent important tools in the pathogenesis of myeloma and offer insights into bone degradation and formation. The objectives of this current study were to assess the associations of modern biomarkers (TNF-α: tumor necrosis factor; IFN: Interferon; FreeRANKL: Free Receptor Activator for Nuclear Factor kappa B Ligand; RANKL: Receptor Activator for Nuclear Factor kappa B Ligand, Beta crosslaps, IL-6: Interleukin 6) with osteolytic lesions status after first-line treatment and to evaluate the correlations between modern and classical biomarkers (LDH: Lactate Dehydrogenase; VSH: Erythrocyte Sedimentation Rate; Hgb: Hemoglobin, Calcium, Albumin, B2microglobulin) stratified by osteolytic lesions status. A total of 35 patients diagnosed with multiple myeloma divided into two groups according to the osteolytic bone lesions, were studied: (1) unchanged status of osteolytic lesions and (2) changed status of osteolytic lesions. After fist-line treatment, we found a significant difference in Albumin (p = 0.0029) and Calcium levels (p = 0.0304), patients with a changed status in osteolytic lesions having higher values of Albumin and Calcium compared to those without changes in status of osteolytic lesions. After first-line treatment, decreased IL-6 values were significantly correlated with elevated values of Albumin (ρ = -0.96, p = 0.0005) in the patients with changed status of osteolytic lesions. Post-treatment values of IFN showed a significant positive correlation with Hemoglobin (ρ = 0.47, p = 0.0124), IL-6 (ρ = 0.55, p = 0.0026) and TNF-alpha values (ρ = 0.54, p = 0.0029). The results obtained from patients with unmodified lytic lesions identified a significant correlation between the biomarkers IL-6, Free RANKL, and IFN-beta with the classical marker LDH. This association highlights the involvement of these markers in promoting bone destruction and the development of osteolytic lesions.

Effects of Strawberry Tree Water Leaf Extract and Arbutin on Biochemical Markers and DNA Integrity in Brain Cells of Lewis Rats.

There is growing evidence that arbutin and plant extracts rich in arbutin, such as extracts of the strawberry tree (Arbutus unedo L.), exert a range of beneficial effects, including cyto- and genoprotective properties. This study evaluated the effects of strawberry tree water leaf extract (STE) and arbutin in the brain tissue of Lewis rats. STE or arbutin were administered per os to male and female rats at a dose of 200 mg/kg body weight/day for 14 or 28 days. Treatment outcomes were evaluated using biochemical markers (lipid peroxidation and the activities of the antioxidative enzymes catalase and superoxide dismutase). The effects of the tested substances on DNA integrity in brain cells were evaluated using the alkaline comet assay. The results suggest a high biocompatibility of both tested substances with rat brain tissue. No significant harmful disturbances were observed in the oxidative/antioxidative status or impairments of DNA integrity in the rat brain cells. Nearly all post-treatment values were within tolerable limits as compared to the matched control rats. Such encouraging findings support further research using other subtle biomarkers to clarify the safety aspects of arbutin and STE prior to the development of specific nutraceutical products.

The effect of an educational video about healthy diet on metabolic control of patients on hemodialysis: an interventional study with a one-year follow-up

BackgroundAdherence to diet is effective for metabolic control in patients on hemodialysis. There are educational pamphlets or booklets to improve patients’ knowledge about healthy diets. As video presentation is more desirable than the presentation of readable materials, we designed an educational video on healthy diets in renal failure patients who was played during several sessions of hemodialysis. We compared the effect of this modality on the knowledge, attitudes and metabolic control of the patients before and after the intervention.MethodsIn this interventional study, all the patients who were referred to the hemodialysis ward at Ashrafi-Esfahani Medical Center (Tehran, Iran) between May 2018 and March 2019 were enrolled (N = 190). Totally, 130 patients had inclusion criteria. An educational video about a healthy diet was shown seven times (once a week in the first month, once every two weeks in the second month, and once in the third month) during hemodialysis for the patients. The nephrologist prepared a video in the form of a lecture with graphic images for 20 min based on the healthy nutrition of the Kidney Federation of Iran’s Guide for hemodialysis patients. The questionnaire was completed in terms of awareness and attitudes, and blood and urine tests were performed at the 1st, 3rd, and 12th months. Serum parameters, including electrolytes, lipid profile, CBC-diff, dialysis efficacy (Kt/V), and the URR (urine filtration rate) were examined. Pre and post intervention values were compared via the statistical analysis performed using IBM SPSS. P-Value < 0.05 was significant.ResultsThe data of 128 people were analyzed at the end of the study. 55% of patients were 10–40 years old and 60% were male. 56% of patients were illiterate or had an elementary school education. The most common underlying diseases were hypertension and diabetes mellitus. Ten to 19% of participants had enough knowledge about the various components of a healthy diet for patients on hemodialysis. Approximately 25%, 14%, and 45% of the participants consumed a healthy diet for breakfast, lunch and dinner, respectively. A comparison of the mean values of the serum parameters before and after the intervention revealed significant changes in phosphorus, blood urea nitrogen, and hemoglobin with mean differences of -118.41 ± 22.84, 21.51 ± 10.38 (both P < 0.001), and 0.29 ± 1.18 (P = 0.044), respectively. The mean Kt/V was similar at all phases.ConclusionThe use of an educational video was effective for normalizing the metabolic parameters in patients under hemodialysis and can be an appropriate option, especially for illiterate patients.Trial registrationIRCT2016082229481N1.

The effects of laser acupuncture on metabolic syndrome in obese postmenopausal women: a randomized controlled study

To study the laser acupuncture (LA) effects on postmenopausal obese women’s metabolic syndrome. Randomized controlled trial. Benha university hospital. Thirty postmenopausal women were randomized into two equal groups. Group A received a diet regimen and Group B received LA treatment for 30 min three times a week for two months beside the diet regimen. Included weight (W), body mass index (BMI), waist (WC), hip (HC), waist-hip ratio (WHR), systolic blood pressure (SBP), diastolic blood pressure (DBP), serum level of total cholesterol (TC), triglycerides (TG), high density lipoprotein (HDL), low density lipoprotein (LDL), fasting blood glucose (FBG), fasting blood insulin (FBI), homeostatic model assessment-insulin resistance (HOMA-IR) before and after the end of treatment. The study’s findings showed that both groups experienced a highly statistically significant decrease in the post-testing mean value of W, BMI, WC, HC, WHR, SBP, DBP, TC, TG, LDL, FBG, FBI, and HOMA-IR, while both groups experienced a significant increase in the post-treatment mean value of HDL (p 0.0001). The posttreatment SBP, DBP, TC, TG, LDL, FBS, FBI and insulin resistance were significantly lower while HDL was significantly higher in women who received combined LA and diet regimen compared to those who received dietary regimen only. LA beside the nutritional intervention is a physical therapy technique that may be used safely, easily, and effectively to minimize metabolic syndrome features during menopause.