Progress Of Medical Science Research Articles

Geriatric failure to thrive: between illusory diagnosis and clinical reality

The geriatric failure to thrive, a controversial French concept not present in the international literature, was first characterized by Jean Carrié in 1956. It is described as a process of aging and physical and psychological decline associated with advanced age, manifesting as a pronounced overall deterioration. In this case report, we present the case of an 88-year-old patient, admitted to a general medicine service for geriatric failure to thrive, whose management eventually leads to the diagnosis of endocarditis with digestive cancer complicated by a characterized depressive episode. This case prompts us to consider the geriatric failure to thrive with extreme caution and challenges the legitimacy of such a diagnosis in the context of an aging population and the progress of medical sciences.

Brain death: from the transformation of medical concept to the change of medical practice

The implementation of death determination by clinicians usually involves three steps: learning the concept of death, mastering the skills of death determination, and recording the results of death determination. Each process needs to be changed with the progress of medical science. The transformation of brain death concept is the establishment and formation of the latest cognition of "irreversible brain function", which needs to be completed based on the theoretical learning of recognized standards. The transformation of brain death determination is the learning and mastering of the latest skills of brain death determination, which requires relearning and retraining based on special technologies. The transformation of brain death determination is the habit formation of standardized records of brain death judgement results, which needs to be completed based on the continuous improvement of case quality control. The gradual advancement of the three steps will accelerate the process of determining brain death in China.

Kappa-carrageenan and sodium alginate-based pH-responsive hydrogels for controlled release of methotrexate.

Despite remarkable progress in medical sciences, modern man is still fighting the battle against cancer. In 2022, only in the USA, 640 000 deaths and 2 370 000 patients were reported because of cancer. Chemotherapy is the most widely used for cancer treatments. However, chemotherapeutics have severe physicochemical side effects. Therefore, we have prepared poly(amididoamine) dendrimeric carrageenan (CG), sodium alginate (SA) and poly(vinyl alcohol) (PVA) hydrogels by using solution casting methodology. The constituents of hydrogels were cross-linked by mutable quantity of 3-aminopropyl(diethoxy)methyl silane (APDMS). Hydrogels were characterized by Fourier transform infrared spectroscopy, thermal gravimetric analysis, scanning electron microscope and atomic force microscopy. Hydrogels exhibited higher swelling volumes in 5-7 pH range. In vitro biodegradation in ribonuclease-A solution and cytocompatibility analysis against DF-1 fibroblasts established their biodegradable and non-toxic nature, which enables them as a suitable carrier for chemotherapeutic compounds. Hence, methotrexate (MTX) as a model drug was loaded on CAP-8 hydrogel and its release was detected by the UV-visible spectrophotometer in phosphate-buffered saline (PBS) solution. In 13.5 h, 81.25% and 77.23% of MTX were released at pH 7.4 (blood pH) and 5.3 (tumour pH) in PBS, respectively. MTX was released by super case II mechanism and best fitted to zero-order and Korsmeyer-Peppas model. The synthesized APDMS cross-linked CG/SA/PVA dendrimeric hydrogels could be an efficient model platform for the effective delivery of MTX in cancer treatments.

Analysis of the Development and Stability of the Plasma Supplier Team in Single-collection Plasma Stations

With the improvement of people s living standard and the progress of medical science, the application of blood products in clinical treatment and disease prevention and control has become more and more extensive and in greater demand. The most important raw material for the production of blood products is healthy human plasma, and the plasma must be collected by the single plasma collection station set up by blood product manufacturers to recruit healthy people (called plasma donors) to voluntarily donate plasma, due to the completely voluntary nature of plasma donors plasma donations, their individual behaviors are susceptible to the influence of a variety of factors, and the need for plasma donors team development and stabilization has posed a serious challenge to single plasma collection stations. This paper briefly dis- cusses the development and stability of the plasma donor team in the single plasma station, hoping to play a guiding role in the development of the blood source of the single plasma industry.

Neurogenic Bowel Management in Traumatic Spinal Cord Injury – A Narrative Review

Abstract Neurogenic bowel management in persons with spinal cord injury (SCI) is an important issue due to the associated morbidities causing a significant impact on the persons’ quality of life (QOL) and burden the caregiver and healthcare services. Complications such as constipation, diarrhoea, incontinence, social embarrassment and autonomic dysreflexia can be managed effectively and resourcefully to counter the ill effects. In India, the incidence of SCI is 15,000, with a prevalence of 0.15 million; most are educationally and economically underprivileged with substandard living conditions. Complications associated with neurogenic bowel tend to impede the implementation of vocational rehabilitation and community integration measures. The goals of management are to prevent complications and improve the QOL of persons with SCI. With the revolutionary progress in medical science, many pharmacological, non-pharmacological and surgical options have been formulated to satisfactorily and effectively manage the neurogenic bowel. In this narrative review, we have tried to compile some of the most popular and time-tested options for managing neurogenic bowel in persons with SCI.

The Faces of Deceptive Healers: A Scoping Review of Titles and Traits Associated with Quacks across Regions

Abstract: Background: The progress in medical science and the increased accessibility of digital resources have enhanced the convenience for individuals in accessing appropriate treatments. Despite these advancements, quackery continues to persist as a global concern. Throughout history, people have been intrigued by miraculous treatments rooted in faith and trust theories. In ancient times, distinguishing between scientifically approved and unapproved medical practices posed challenges. Ever since medical practices have been taking place, service providers took advantage of people’s unawareness, exploiting patients for personal gain. Over time, in certain cultures and societies, their intentions became apparent, and they earned a reputation as deceivers in the medical field. The current research seeks to uncover the various traits utilized by quacks across different times and locations worldwide, aiming to expose their fraudulent practices. Methodology: In this scoping review, the focus was on investigating various characteristics displayed by quacks during their practices. The study involved a comprehensive examination of 3740 published research articles and 400 pieces of gray literature such as websites of regulatory authorities, Acts, Laws. News items and reports which encompassed regulatory authority websites, news articles, and reports. From this extensive pool of sources, 45 articles and 4 excerpts were carefully chosen for in-depth analysis. Result: The current study highlighted 90 terms used for quacks to define their characteristics. The data was analyzed and developed five different themes defining various traits according to the near association. The main theme covered the moral values of these practitioners followed by Modern quackery under complementary and alternative healthcare services, sorcery and mystic, ignorant of science, and contract to law. Conclusion: Quackery, with its long-standing history, remains an ongoing health threat. Embracing modern technology, it utilizes the Internet and social media to propagate deceptive claims. Gaining insights into the traits of quacks is crucial for policymakers to address this issue effectively. Combating quackery necessitates heightened awareness, robust regulations, dissemination of authentic information and evidence-based healthcare involving all stakeholders.

Advances and Challenges in Cancer Stem Cells for Onco-Therapeutics

Six decades have passed since the foundational recognition of the primary properties of the stem cells. Research on stem cells has since remained at the forefront of efforts to combat a spectrum of diseases, most notably cancer. Despite remarkable progress in medical science, a definitive cure for cancer has remained elusive, spurring the pursuit of diverse therapeutic strategies, among which stem cell therapy is a particularly promising avenue. Moreover, the utilization of cancer stem cells as a therapeutic source holds immense potential for addressing intractable diseases. The strategy of targeting cancer stem cells is beset with challenges, including immune rejection and disease relapse. Additionally, the capacity to inadvertently generate cancer stem cells upon transplantation underscores the critical need to eliminate these cells to ensure the efficacy of cell-based therapies. This paper underscores the pivotal role of cancer stem cells in onco-therapeutics and their potential to aid in early cancer diagnosis. With the proliferation of tissue banks and their collection of malignant tissue types, a renewable source of medications to combat cancer is on the horizon. While cancer stem cell-based therapy presents sophisticated and significant challenges, it offers unprecedented opportunities to extend human life. Continued technological advancements in stem cell therapy promise to provide new insights and refine approaches for cancer treatment, ushering in a new era of hope and innovation in the fight against this formidable disease.

Current status of and future perspectives on care for cancer survivors in China.

Cancer is currently a major public health issue faced by countries around the world. With the progress of medical science and technology, the survival rate of cancer patients has increased significantly and the survival time has been effectively prolonged. How to provide quality and efficient care for the increasingly large group of cancer survivors with limited medical resources will be a key concern in the field of global public health in the future. Compared to developed countries, China's theoretical research and practical experience in care for cancer survivors are relatively limited and cannot meet the multi-faceted and diverse care needs of cancer patients. Based on the existing models of care worldwide, the current work reviews care for cancer survivors in China, it proposes considerations and suggestions for the creation of models of cancer care with Chinese characteristics in terms of optimizing top-level system design, enhancing institutional mechanisms, accelerating human resource development, and enhancing self-management and social support for patients.

Virtuoso of Pathophysiological Experiment: to the 100th Anniversary of Academician V. K. Kulagin

Aim. To analyze the contribution of V. K. Kulagin, Doctor of Medical Sciences, Professor of the Department of Pathological Physiology of the Military Medical Academy into development of scientific perspectives concerning the etiology, pathogenesis and therapy of traumatic shock, following thorough analysis of 1950–1980s series of featured publications. We analyzed the general theoretical views of the scientist, his methodological preferences in organizing laboratory experiments, the methodology for developing standard models for conducting experiments, choosing indicators and evaluation criteria. We brought to recollection the proposed by V. K. Kulagin approach to traumatic shock staging and phases relative to the leading pathogenetic factor; highlighted some of the key topics and results of his experimental research related to individual resistance to shock, prerequisites of shock irreversibility and factors complicating the course of traumatic shock.Conclusion. Theoretical and experimental inventions of V. K. Kulagin are relevant to the present day and are of great importance for further progress of medical science.

Electrochemical oxidation technique to pharmaceutical pollutants removal

Human progress in medical science and drug production has improved the growth process and increased human lifespan. Most of the drugs used are to control or prevent common human diseases. These drugs can be produced in different ways such as synthetic, chemical, biological, etc. On the other hand, pharmaceutical companies have a large volume of pharmaceutical effluents and wastewater that enters the environment and harms nature and human life. The main problems of entering the pharmaceutical effluent into the environmental cycle are the creation of drug resistance against the active substance of the drugs and the occurrence of abnormalities in the next generations. Therefore, the process of pharmaceutical wastewater treatment is used to reduce the level of pharmaceutical pollutants in order to enter the pharmaceutical wastewater into the environmental cycle. Until recently, filtration, passing through reverse osmosis and ion exchange resins, cleaning facilities, etc., have been various methods to remove pharmaceutical pollutants. Due to the low efficiency of the usual and old systems, the use of new methods has attracted more attention. In this article, the aim is to investigate the electrochemical oxidation method in order to remove the active ingredient of some commonly used drugs (aspirin, atorvastatin, metformin, metronidazole and ibuprofen) from the wastewater of pharmaceuticals. Therefore, in order to observe the initial conditions of the samples, a cyclic voltammetry diagram with a scanning rate of 100 mV/s has been performed. Next, by using the chronoamperometry process and applying a constant potential, the desired drugs were subjected to the electrochemical process of oxidation.As a result, the re-examined samples were subjected to cyclic voltammetry test to determine the conditions of sample oxidation peaks as well as the removal efficiency of the samples by examining the surface under the initial and final voltammetry graph. The results indicate that this method for removing selected drugs has a high removal efficiency of about 70% and 100% for atorvastatin samples. Therefore, this method is accurate, reproducible (RSD 2%), efficient, easy and economical and can be used in drug manufacturing industries. This method is used in a wide range of drug concentration. This means that by increasing the concentration of the drug, without the need to change the equipment used and the applied potential, by spending more time in the oxidation process, it is possible to remove very high amounts of the drug (more than 1000 ppm).

Prediction of Infectious Disease to Reduce the Computation Stress on Medical and Health Care Facilitators

Prediction of the infectious disease is a potential research area from the decades. With the progress in medical science, early anticipation of the disease spread becomes more meaningful when the resources are limited. Also spread prediction with limited data pose a deadly challenge to the practitioners. Hence, the paper presents a case study of the Corona virus (COVID-19). COVID-19 has hit the major parts of the world and implications of this virus, is life threatening. Research community has contributed significantly to understand the spread of virus with time, along with meteorological conditions and other parameters. Several forecasting techniques have already been deployed for this. Considering the fact, the paper presents a proposal of two Rolling horizon based Cubic Grey Models (RCGMs). First, the mathematical details of Cubic Polynomial based simple grey model is presented than two models based on time series rolling are proposed. The models are developed with the time series data of different locations, considering diverse overlap period and rolling values. It is observed that the proposed models yield satisfactory results as compared with the conventional and advanced grey models. The comparison of the performance has been carried out with calculation of standard error indices. At the end, some recommendations are also framed for the authorities, that can be helpful for decision making in tough time.

Klauzula sumienia – w poszukiwaniu równowagi między moralnością a prawem

Law and conscience are more and more often analyzed together. The mutual influence of law and ethics raises many questions, to which it is in vain to look for a clear answer in the acts of statutory law. Due to the imperfection and incompleteness of legislation, which does not contain a definition of conscience itself, researchers are forced to base their considerations on legal-ethical grounds. It is up to ethicists to define what conscience is, and the law should defend its freedom. The conscience clause, i.e. the doctor’s right to refrain from performing health services inconsistent with his conscience, has been defined in the Act on the Professions of Physician and Dentist. However, this is not the only act that refers to the possibility of refusing a service that is inconsistent with the ethical attitude of a physician. Both the Code of Medical Ethics as a deontological act, acts of international law or even the teaching of the Catholic Church can provide a background for the search for a solution to this important legal issue. However, not every doctor’s decision to invoke the conscience clause will be protected. A number of questions also arise in connection with the progress of medical science. This article is an attempt to answer the question about the legal nature of the conscience clause.

Investigation of the inverse piezoelectric effect of synchrotron light source imaging of electrical stimulation on the fate of nano stem cells and its role and application in regenerative medicine and cancer treatment

The presence of electrical activity in body organs such as the nervous system, heart and bones has caused one of the most widely used treatment methods called electrotherapy to be widely used, especially in the relief of underlying pain. On the other hand, the progress of medical science in the field of nano stem cells and regenerative medicine has created many promises in treatment. Also, recently, treatments based on electric field have been widely used in cancer treatment. The main issues in regenerative medicine are the proliferation of nano stem cells to the required extent and directing them towards the differentiation of the target tissue. Electric field (EF) stimulation can play an important role in creating appropriate nano stem cell responses and directing nano stem cell differentiation towards osteogenesis/neuronogenesis/cardiomyogenesis. The electric field with nanosecond pulse as well as the electric field for tumor therapy have attracted a lot of attention for the treatment of cancer. Major signaling pathways and cellular responses elicited by electrical stimulation include reactive oxygen species and heat shock proteins, fluctuations in intracellular calcium ion concentration, ATP production, clustering or reaggregation of cell surface receptors., reconstruction of the cytoskeleton that affect the fate of the nano stem cell. Also, the lack of pain, ease and reasonable price have made cancer treatment with electric field more and more popular. In this research, an attempt has been made to briefly review the effects of electrical signals on the behavior of nano stem cells, as well as examples of their therapeutic effects in the treatment of tissue lesions and cancer. Schematic of the inverse piezoelectric effect of synchrotron light source imaging of electrical stimulation on the fate of nano stem cells and its role and application in regenerative medicine and cancer treatment.

Long-term outcomes of non-metastatic breast cancer patients by molecular subtypes

BackgroundToday, with the progress of medical sciences, increasing the cure probability and survival time is an important goal of cancer treatment. This study compared long-term disease-free survival (DFS) of non-metastatic breast cancer patients based on different molecular subtypes.MethodsThis retrospective cohort study consisted of 1287 patients diagnosed with breast cancer and treated at Motamed Cancer Institute from 2000 to 2016 and followed up until 2018. Kaplan–Meier curve was fitted to data based on molecular subtypes. Then the semi-parametric mixture cure model was applied to determine the survival and cure probability of molecular subtypes by adjusting clinical and demographic factors.ResultsAmong 1287 breast cancer patients, 200 (15.5%) cases died. The mean age of patients was 47.00 ± 10.72 years. Women with the HR+/HER2-subtype had the best 5-year survival rate (84.2%), whereas other subtypes had a lower rate as follows: HR+/HER2+ (77.3%), triple-negative (76.5%), and HR−/HER2+ (62.3%). Kaplan–Meier curve calculated a cure rate of about 60% and patients who survived more than 150 months were intuitively considered cured. After adjustment for clinical and demographic variables, the cure probability of HR−/Her2+ patients was substantially lower than HR+/HER2– patients (OR = 0.22), though there were no significant variations in short-term DFS based on molecular subtypes (HR = 0.91).ConclusionsOur results confirm that the most prevalent breast cancer was HR+/HER2− tumor type which had the best prognosis. It is also concluded that HR−/HER2+ patients had the worst outcomes, with the highest rates of recurrence and metastasis and the lowest overall and disease-free survival rates.

Gender medicine as a tool for implementing the right to health.

The COVID-19 pandemic has increased the interest in the right to health, which represents a relatively new concept brought about by progress in medical science and the evolution of societies. The Italian Constitution, in article 32, states the right to health without specifications about the parameter of sex, assuming that this fundamental right is property of women and men indiscriminately. To assess whether the right to health has actually been achieved in an equal way from the standpoint of sex, and whether a hypothetically "neutral" approach is actually convincing and profitable in this context. This paper analyzes the topic of gender medicine from a scientific and legal perspective, based on current medical literature and its implementation in the Italian and European legal systems. Gender medicine is the only credible response to sex- and gender-based inequalities affecting the right to health, as it provides tools to address persisting inequalities in prevention and treatment, thus pursuing health for all: women and men. The importance of this path was underlined also by the Summit and the Rome Declaration of 21 May 2021, acknowledging that the topic of sex and gender can no longer be overlooked in focusing a correct and equal healthcare approach.

Comparative systematic review and meta-analysis of the therapeutic effects of coblation tonsillectomy versus electrocautery tonsillectomy.

Surgical removal of the primary lesion is a common treatment for chronic tonsillitis, recurrent tonsillitis, and tonsillar hypertrophy, and is the most widely performed surgery in otorhinolaryngology. With the development and progress of medical science and technology, the methods of tonsillectomy have gradually diversified, and it is of great significance to seek the best tonsillectomy method. This meta-analysis explored the advantages and disadvantages of coblation tonsillectomy (CT) and electrocautery tonsillectomy (ET). The keywords "coblation", "radiofrequency ablation", "electrocautery", and "tonsillectomy" were used to search the PubMed, Embase, Cochrane library, Clinicaltrials.gov, and Google Scholar databases, and randomized controlled trials (RCTs) of the 2 procedures since the establishment of the database were included. After screening and bias risk assessment, a meta-analysis was performed using Stata 16.0 software. A total of 10 articles met the inclusion criteria and entered the final meta-analysis. There were 1,056 participants, including 547 patients who underwent CT and 509 patients who underwent ET. There was no significant difference in the operation time between CT and ET [standard mean difference (SMD) =0.39, 95% CI: -0.35 to 1.13, Z=1.044, P=0.296]. CT resulted in less intraoperative blood loss than ET (SMD =-2.62, 95% CI: -4.83 to -0.41, Z=-2.322, P=0.020). The postoperative pain score of CT was less than ET, but the difference was not statistically significant (SMD =-0.28, 95% CI: -0.58 to 0.01, Z=-1.866, P=0.062). CT resulted in less time to return to normal diet after surgery than ET, and the difference was statistically significant (SMD =-0.36, 95% CI: -0.60 to -0.12, Z=-2.918, P=0.004). CT resulted in less intraoperative blood loss and faster postoperative recovery than ET, but there was no significant difference in operation time, postoperative pain, and the incidence rate of postoperative complications between the 2 groups.

Міжпрофесійна взаємодія для досягнення оптимального здоров’я порожнини рота

Нестримний прогрес у сфері медичної науки, розвиток інноваційних технологій обумовлюють необхідність безперервного професійного розвитку не лише лікарів-стоматологів, а й спеціалістів загальної практики. Асоціація стоматологів України разом з провідними лікарями загальних спеціальностей провела вже III Український конгрес, спрямований на вдосконалення професійної компетентності лікарів.

Digitalization of healthcare sector as a tool for implementation of competition policy

Competitiveness of modern states is increasingly dependent on the method and scope of using information-communications technologies (ICTs) in the economy and in the implementation of the states' care functions. The application of information-communications technologies (ICTs) in health care is of special importance due to observed dynamic changes taking place in social structures. The main factors contributing to the widespread use of information-communications technologies (ICTs) in health care include demographic changes, the increase in the duration of human life, the increase in health care expenditures, progress in medical science and the increase in patients' ability to use automated devices. The aim of this article is to characterize the main ideas forming the architecture of the Healthcare 4.0 concept and to place this concept in a broader perspective of the Industry 4.0 concept.

The new normal? Redaction bias in biomedical science.

A concerning amount of biomedical research is not reproducible. Unreliable results impede empirical progress in medical science, ultimately putting patients at risk. Many proximal causes of this irreproducibility have been identified, a major one being inappropriate statistical methods and analytical choices by investigators. Within this, we formally quantify the impact of inappropriate redaction beyond a threshold value in biomedical science. This is effectively truncation of a dataset by removing extreme data points, and we elucidate its potential to accidentally or deliberately engineer a spurious result in significance testing. We demonstrate that the removal of a surprisingly small number of data points can be used to dramatically alter a result. It is unknown how often redaction bias occurs in the broader literature, but given the risk of distortion to the literature involved, we suggest that it must be studiously avoided, and mitigated with approaches to counteract any potential malign effects to the research quality of medical science.

HUMAN BEING IN NORM AND PATHOLOGY: TOWARDS THE QUESTION OF EXPERTISE IN MEDICINE

Abstract. The article discusses a problem of a change in habitual paradigms of human being understanding in medicine within the progress of medical science and practice. The prevalence of natural scientific principles in medical expertise is becoming ineffective; medicine is losing its subject – a human being in norm and pathology. The awareness of the consequences of an object-oriented attitude contributed to the development of new notions about the subject of medicine, fixed in a socio-cultural and, later, person-oriented approaches in scientific understanding of human being in norm and pathology, as well as the development of practices aimed at protecting humans from interference. As a result, a new form of expertise is emerging in medicine – ethical expertise, aimed at protecting a human being. However, in the process of ethical expertise evolution, as the author shows, a shift has taken place towards bureaucratic management, oriented to proceduralism and efficiency. Moreover, ethical expertise continues to use socio-cultural approach as its methodological basis, which is not sufficient within the new situation of blurring boundary between norm and pathology. A human being himself as an object of expertise is disappearing.