Score Points Research Articles

Revealing distinct treatment mechanisms and outcome correlations in patients with interstitial cystitis/bladder pain syndrome after different bladder therapies through urinary biomarker analysis.

Urinary cytokine changes may serve as biomarkers to assess treatment outcomes for interstitial cystitis/bladder pain syndrome (IC/BPS). This study analyzed the changes in urinary cytokines following various bladder therapies and explored their clinical significance in therapeutic mechanisms. A total of 122 patients with IC/BPS treated with platelet-rich plasma (PRP), botulinum toxin-A (BoTN-A), hyaluronic acid (HA), or low-energy shock wave (LESW) were evaluated. Urinary inflammatory and oxidative stress biomarkers were measured at baseline and at 3months posttreatment. Treatment outcomes were assessed using the Global Response Assessment (GRA), a 10-point visual analog score for pain, and the O'Leary-Saint Symptom Score (OSS). A GRA ≥ 2 was considered indicative of effective treatment. Significant symptom improvement was observed in patients treated with PRP and BoNT-A but not with LESW or HA. At 3months post-treatment, PRP therapy led to decreased urinary 8-isoprostane and total antioxidant capacity levels, while BoNT-A therapy reduced monocyte chemotactic protein-1 and 8-hydroxy-2'-deoxyguanosine levels. HA therapy did not alter urinary biomarker levels, whereas LESW therapy increased macrophage inflammatory protein-1 beta and tumor necrosis factor-α levels. Patients with significant urinary biomarker reductions (GRA ≥ 2) demonstrated clinical improvement at 3months. PRP or BoNT-A exhibits anti-inflammatory effects, reflected by reductions in urinary cytokine levels, correlating with positive treatment outcomes. Urinary cytokine changes may play a role to evaluate the mechanisms of action of various treatments in patients with IC/BPS.

A comparative analysis of methods of preinduction cervical ripening and induction of labor in Poland and in Germany (Part II): maternal and neonatal outcomes

The benefits and risks of delivery should always be considered before initiating preinduction cervical ripening and labor induction. Understanding the benefits and potential complications is crucial for healthcare professionals to make informed decisions and provide optimal care. The research was conducted retrospectively between January 2019 and July 2022. It involved the analysis of the medical records of 154 pregnant women staying in the Clinic of Obstetrics and Gynecology in the city of Szczecin and 150 pregnant women hospitalized in the Clinic of Obstetrics and Gynecology in the town of Schwedt/Oder in Germany. Inclusion criteria were consent to participate and the implementation of internal written protocols in line with national guidelines for labor induction. The research concerned a group of pregnant women with postdate pregnancy, calculated according to the Naegele’s rule and confirmed by the USG examination conducted in the first trimester of the pregnancy, as well as an unfavorable cervix that received less than 6 points in the Bishop score. Moreover, the pregnant patients with a low biophysical profile and an abnormal record of CTG or comorbidities were also included, as these factors determined the classification of the group above. The study did not include patients who had undergone cesarean section. The average change in evaluation of the cervix marked on the Bishop Score was higher in Germany, and it was 2.7 points, whereas in Poland, it was 1.6 points. The largest percentage of the scores on the Apgar Scale in the first, third and fifth minutes after birth was in the norm and indicated a good health condition of infants. They reached 8 to 10 points in both countries. Significantly more infants in Germany received pH from the umbilical cord within the limits of the norm. And it marks the welfare of neonates (7.20–7.45). The duration of hospitalization in Poland was shorter than in Germany. It was 3.8 days in the case when the median equalled 3. The number of days of preinduction cervical ripening and induction was similar in both countries. The levels of haemoglobin were comparable in both countries. The most common postpartum complications in Poland and Germany were first-degree perineal tears, episiotomies and anemia. Among the postpartum complications, cervical tears, revision of the uterine cavity, and episiotomy were significantly more common in Poland. First- and second-degree perineal tears were more frequent in Germany.

Questionnaire and analysis of the standardized use of home self-monitoring portable blood glucose meters.

To evaluate the accuracy of home self-monitoring portable blood glucose meters, we analyzed the current problems of patients using portable blood glucose meters and put forward reasonable suggestions. A self-designed questionnaire was used to survey 142 patients and 132 healthcare professionals. The questionnaire consisted of 16 items with an overall score ranging from 1 to 13 (with a higher score indicating better experience). The study included adult patients with diabetes mellitus type 1 or type 2. The patients' awareness rate for standardized use of portable blood glucose meters at home was at 31.42%. Specifically, awareness of blood collection specifications was at 15.85%, standardized operation at 42.53%, and accuracy of results at 0%. A significant majority (81.69%) scored between 0 and 5 points in home blood glucose meter use, with knowledge and practice scores consistently below 3 points. Notably, no patients conducted a formal comparison of various meters. Despite this, their confidence level in the portable blood glucose meter results was as high as 71.1%. Urgent measures are needed to educate patients on proper usage and encourage regular instrument comparisons.

P1056 Effectiveness and Safety of Upadacitinib Induction Therapy in Real-World Setting for 234 Patients with Crohn’s Disease: A GETAID Multicentre Cohort Study

Abstract Background While upadacitinib has demonstrated its efficacy as an induction treatment for Crohn’s disease (CD) in two phase 3 randomized, placebo-controlled trials1, real-world data remain limited. Methods From September 2022 to September 2024, all consecutive patients with refractory CD treated with once-daily upadacitinib 45 mg in 30 French and Belgian GETAID centres were retrospectively included. The primary endpoint was steroid-free clinical remission (SFCR) at week 12, defined as a Harvey-Bradshaw Index (HBI) score of < 4. Secondary endpoints included clinical response (decrease of ≥ 3 points in the HBI score and/or an HBI score < 4), clinical remission, biological remission (calprotectin ≤ 250 µg/g, or CRP ≤ 5 if calprotectin was unavailable), endoscopic or radiological (IUS and/or MRI) response, and adverse events (AEs). Results 234 patients were included, all of whom had been previously exposed to at least one biologic (median 4, IQR[3-4]), and 125 (53.9%) had undergone prior intestinal resection (Table 1). At week 12, SFCR was observed in 107 patients (n=107/197, 54%), clinical response in 120 (n=120/190, 63%) and clinical remission in 111 (n=111/197, 56%). Ninety-two (n=92/179, 51%) achieved biological remission and endoscopic or radiological response was observed in 19 (n=19/40, 48%) patients (Figure 1). Respectively 28 (n=28/37, 76%) and 20 (n=20/37, 54%) of patients with articular EIMs achieved clinical response and remission. For cutaneous EIM, clinical response was achieved in 10 patients (n=10/11, 91%), and clinical remission was achieved in nine patients (n=9/11, 82%). In multivariate analysis, body mass index < 18.5 kg/m2 (OR=0.09, 95%CI: 0.01-0.33, p=0.002) and HBI > 7 (OR=0.24, 95%CI: 0.12-0.47, p<0.0001) were associated with lower rates of SFCR at W12 while the number of prior biologics did not influence SFCR (OR = 0.72, 95% CI: 0.35-1.48; p = 0.36). At week 12, 35 (15%) patients discontinued upadacitinib (lack of effectiveness, n=31; AEs, n=2 and other, n=2). CD-related hospitalization was needed in 18 (7.7%) patients, and 4 (1.7%) underwent intestinal resection. Sixty-eight AEs occurred in 61 patients (26%), including 19 serious AEs, corresponding to 18 cases of CD exacerbation and one case of colonic EBV-associated lymphoproliferative disorder. Acne was observed in 25 (10.7%), justifying treatment discontinuation in one (0.4%). Conclusion In this real-world cohort of highly refractory CD patients, upadacitinib induction resulted in a clinical response in about two-thirds of patients and SFCR in half of patients.

P0152 Distinct faecal metabolic profiles associated with endoscopic remission in ulcerative colitis patients following faecal microbiota transplantation

Abstract Background While FMT has shown promise in inducing remission in ulcerative colitis (UC) patients, there are still high rates of non-response (1). Identifying patterns associated with treatment response may help optimize FMT and improve the management of UC patients by identifying FMT's underlying mechanisms. This study aimed to examine the faecal metabolic profile of UC patients post-FMT to identify key metabolites and metabolic pathways linked to treatment response. Methods Faecal samples were collected from 18 treatment-naïve UC patients recruited from a single-centre, single-blinded randomised controlled trial (ISRCTN58082603). All patients received antibiotics and bowel lavage before randomisation into three groups: (1) a single FMT enema (n=7), (2) five consecutive FMT enemas over five days (n=7), and (3) a control group receiving only antibiotics and bowel lavage (n=4). Samples were collected at baseline (week 0) and at weeks 1, 4, 8, and 12 post-treatment. Treatment response was defined as endoscopic remission or a drop of ≥2 points in the partial Mayo score. Faecal samples were analysed using 1H-NMR spectroscopy. Univariate statistics analysis was performed on processed spectral data using Metaboanalyst 5.0. Results Among 18 patients (median age 42, range 18-70; 7 (39%) male), 3 of 14 in the FMT groups and 2 in the control group achieved endoscopic remission. Faecal metabolic profiles were available for 58 samples at week (W) 0, W4, W8 and W12, showing a total of 23 targeted metabolites. Although no individual metabolites were significantly changed across groups and all timepoints, pathway-specific analysis revealed distinct metabolic shifts in responders post-FMT. Responders showed a reduction in purine metabolism and alanine synthesis, whereas non-responders’ metabolic profile remained comparable to baseline (W0), suggesting these pathways may play a role in remission induction. Disturbances in purine metabolism have been linked to inflammatory conditions, including inflammatory bowel disease (IBD) and bacterial purine metabolism is a target of thiopurine drugs commonly used in IBD therapy (2, 3). Conclusion Alterations in purine and alanine metabolism are associated with clinical response in UC patients following FMT, underscoring their potential role in mediating treatment effects. Ongoing analysis, including taxonomic profiling, aims to further explore the relationship between these pathways and the gut microbiome may provide insights into the underlying mechanisms driving FMT-induced remission.

Quality of Life and Social Health in Patients After Pancreatic Surgery.

Clinicians lack robust data on quality of life and social functioning after pancreatectomy limiting their ability guide patient decision-making aligned with patients' goals of care. In this cross-sectional survey study, we administered the European Organization for Research and Treatment of Cancer Core Quality of Life questionnaire (EORTC QLQ-C30); pancreas-specific QLQ-PAN26; Patient-Reported Outcomes Measurement Information System (PROMIS™) Ability to Participate in Social Roles; and PROMIS™ Activities and social Isolation scales to all elective pancreatectomies (2021-2023). Results were compared to both normative data and between groups to determine factors predicting better QOL with a >10-12-point change considered clinically significant. 143 patients were included. 71 (49.6%) completed the distributed surveys. The average age of responders was 59.9±16.1 years with 56.3% men. Pancreaticoduodenectomy (54.9%) was performed for malignancy in 67.6% of cases. Compared to normative population controls, post-pancreatectomy patients reported lower role functioning scores (67.2±28.7 vs 81.7±28.2, 14.5 score difference) but less social isolation (40.6±5.7 vs 50.0±10.0, 9.4 score difference). Compared to patients with benign disease, those with malignancy reported clinically significant worse social functioning; more fatigue, pain, constipation, change in taste, weight loss, weakness, and altered bowel habits; worse body image; and increased worries about the future. Despite more symptoms they were more satisfied with the healthcare they received (all >10-point score difference). QOL and social health are impacted by pancreatic resection and outcomes differ whether surgery was performed for benign or malignant disease. These issues are largely unaddressed and are potential targets for intervention to improve QOL.

An Analysis of the Impact of Digital Therapeutic Interventions on Attention and Working Memory in Children with Attention-Deficit/Hyperactivity Disorder: A Randomized Controlled Trial

Previous research has investigated non-pharmacological digital therapeutic interventions to improve compliance and reduce side effects in attention-deficit/hyperactivity disorder (ADHD) medication treatments for children. This study focuses on validating the effects of game-based intervention content for enhancing working memory and concentration. It tracks quantitative changes to evaluate improvements in concentration and working memory when digital game-based content is used as adjunct therapy alongside medication for children with ADHD. Thirty children participated; one group received digital therapeutic intervention based on game content alongside medication (experimental) and the other group received conventional treatments (control). The study results show that children with ADHD in the experimental group, who use digital game-based content, exhibit a reduction of 8.13 ± 6.71 points in the K-ARS total score at the fourth week compared to baseline, while the control group shows a reduction of 7.14 ± 8.73 points. Inattention decreases by 36.84% in the experimental group and 28.56% in the control group, while hyperactivity–impulsivity decreases by 50.71% in the experimental group and 34.00% in the control group. All the results are analyzed using a paired t-test between baseline and the fourth week. Significant decreases in the K-CBCL total problem behavior score and internalizing and externalizing behaviors are consistently observed at 28 days compared with baseline. The FAIR attention–concentration test results show significant differences between the experimental and control groups in the Q-percentile and Q-standard scores, with repeated measures ANOVA results showing p = 0.006 and p = 0.007, respectively. Digital content was shown to influence digital therapeutic intervention—a non-pharmacological treatment for ADHD.

Content Validity of the Friedreich Ataxia Rating Scale in Patients with Spinocerebellar Ataxia.

The Friedreich Ataxia Rating Scale-Activities of Daily Living (FARS-ADL) is a validated and highly utilized measure for evaluating patients with Friedreich Ataxia. While construct validity of FARS-ADL has been shown for spinocerebellar ataxia (SCA), content validity has not been established. Individuals with SCA1 or SCA3 (n=7) and healthcare professionals (HCPs) with SCA expertise (n=8) participated in qualitative interviews evaluating the relevance, clarity, and clinical meaningfulness of FARS-ADL for assessment of individuals with SCA. Interviews were recorded, transcribed, coded, and analyzed by ATLAS.Ti v22 software. FARS-ADL concepts most frequently reported by individuals with SCA were difficulty walking (n=7/7), falls (n=6/7), speech difficulties (n=4/7), and swallowing (n=3/7). Individuals with SCA reported that all FARS-ADL items were relevant; Gait and Walking (n=7/7), Bladder Function (n=6/7), and Falling (n=6/7) were considered extremely relevant. All HCPs (n=8/8) reported that most FARS-ADL items were relevant to individuals with SCA; Quality of Sitting Position was considered least relevant. HCPs reported meaningful change as 1-2 point score change in individual FARS-ADL items (n=7/7), 1-3 point change in total score (n=6/6), and stability on any item and/or total score over≥1year, depending on SCA subtype (n=5/8). Cognitive debriefing supported clarity and comprehension of FARS-ADL. Suggested improvements included refining response options for Dressing, Falling, Walking, and Bladder Function items. The findings confirm the content validity of most FARS-ADL items for use in individuals with mild-to-moderate SCA1 and SCA3, and offer suggested improvements for response options.

Age-dependent differences in the association between blood interleukin-6 levels and mortality in patients with sepsis: a retrospective observational study

BackgroundInterleukin-6 (IL-6) is a cytokine that predicts clinical outcomes in critically ill patients, including those with sepsis. Elderly patients have blunted and easily dysregulated host responses to infection, which may influence IL-6 kinetics and alter the association between IL-6 levels and clinical outcomes.MethodsThis retrospective observational study included patients aged ≥ 16 years who were admitted to the intensive care unit at Chiba University Hospital. The patients were categorized into two groups: non-elderly (< 70 years) and elderly (≥ 70 years). Associations between log-transformed blood IL-6 levels and 28-day in-hospital mortality (primary outcome) and multiple organ dysfunction (MOD) on days 3 and 7 (secondary outcomes) were examined.ResultsThe non-elderly and elderly groups included 272 and 247 patients, respectively. There were no significant differences in the Sequential Organ Failure Assessment score, components of the APACHE II score (Acute physiology score and Chronic health points), MOD at baseline, or any of the outcome measures between the groups. In the non-elderly group, univariate Cox regression analysis showed a significant association between IL-6 levels and mortality (hazard ratio [HR] 1.71, 95% confidence interval [CI] 1.25–2.37, P < 0.001). This association remained significant after adjusting for sex, body mass index, steroid use prior to sepsis onset, and number of chronic organ dysfunctions (HR 1.66, 95% CI 1.20–2.32, P = 0.002). However, no significant association was observed in the elderly group in either the univariate (P = 0.69) or multivariable analyses (P = 0.77). Multivariable logistic regression analysis of MOD on days 3 and 7 revealed significant associations between MOD and IL-6 levels in both groups.ConclusionsBlood IL-6 levels were significantly associated with mortality in non-elderly patients with sepsis, but not in elderly patients. IL-6 levels were associated with MOD in both groups. Therefore, IL-6 levels should be interpreted with caution when predicting mortality in elderly patients with sepsis.Trial registration: Not applicable.

Efficacy of tamsulosin in patients with lower urinary tract symptoms due to benign prostate enlargement and having intravesical prostate protrusion.

Objective: To study the efficacy of Tamsulosin in patients with IPP due to BPE. Study Design: Descriptive study. Setting: Department of Urology, Madinah Teaching Hospital Faisalabad. Period: Oct 2020 to April 2021. Methods: After approval from ethical review comity and informed consent a total of 96 male patients between the ages 50-90 years who had LUTS due to benign prostate enlargement of ≥30g were included in the study. Patients with no IPP or having uncontrolled hypertension / diabetes were excluded from the study as well as those having LUTS due to any other etiology e.g. neurogenic bladder or bladder stone. IPSS was calculated for all the patients and entry was made in the research pro forma. All patients received Cap. Tamsulosin 0.4 mg at bedtime for 2 weeks. On follow up in outpatient department, IPSS was calculated again and any improvement of 3 points of the IPSS score was taken as significant and as an evidence of efficacy of Tamsulosin. All the data including any complication was collected and secured on the pro forma. Results: Pretreatment and post treatment mean IPSS was calculated to be 19.54 ± 5.87 and 17.27 ± 4.29 respectively. Frequency of efficacy of Tamsulosin in patients with Intravesical prostatic protrusion due to benign prostatic enlargement was recorded in 42.71% (n=41) whereas 57.29% (n=55) had no efficacy. Stratification with regards to grade of IPP shows that 12 of 25 cases of grade I, 19 of 40 cases in grade II and 10 of 31 cases in grade III had efficacy, p value was 0.23. Conclusion: We concluded that tamsulosin is effective in patients with intravesical prostatic protrusion due to benign prostatic enlargement, however, further trials are required to validate our results.

Exploring Quantitative MRI Biomarkers of Head and Neck Post-Radiation Lymphedema and Fibrosis: Post Hoc Analysis of a Prospective Trial.

Quantifying head and neck lymphedema and fibrosis (HN-LEF) is crucial in the investigation and management of treatment sequelae in head and neck cancer (HNC). The T1- and T2-weighted MRI signal intensity (SI) was examined in relation to HN-LEF categories per physical/tactile examination (No-LEF, A-B = edema, C = edema + fibrosis, D = fibrosis), and MRI structural volumes were examined in relation to a novel 10-point HN-LEF score in the intraoral and submental regions. We identified differences in ranks among HN-LEF categories in relation to the MRI SI (A-B and C are higher than D and No-LEF for T2 SI, and A-B is the highest for T1). Furthermore, six pairs of FOM volumes on MRI demonstrated a strong negative correlation (p < 0.05) with the HN-LEF score at adjacent palpable sites. Both MRI SI and structural volumes can potentially be imaging biomarkers of edematous soft tissue states in HNC patients.

Spatial Distribution Dynamics of Sensory Disturbances in the Treatment of Obesity-Related Meralgia Paresthetica Using Transcutaneous Electrical Nerve Stimulation.

Background: To date, there have been no studies on the dynamics of areas of pain, paraesthesia and hypoesthesia after the use of various transcutaneous electrical nerve stimulation in the treatment of meralgia paresthetica. Methods: In this pilot study, we observed 68 patients with obesity-related bilateral meralgia paresthetica. Pain syndrome, paraesthesia symptoms, and hypoesthesia were evaluated using 10-point scores. In addition, pain drawing (PD) was used to determine the area of the spatial distribution of pain syndrome and paraesthesia symptoms, and body drawing was used to determine the area of hypoesthesia. Sham TENS was performed in the control group, and effective TENS was performed in the treatment group. The treatment group consisted of two subgroups. One subgroup underwent HF-LA TENS, and the second subgroup underwent LF-HA TENS. Results: Despite the greatest analgesic effect observed from HF-LA TENS, which was assessed using scoring methods, during and after treatment, the reduction in the area of pain and paraesthesia symptoms and the area of hypoesthesia was moderate, short-term, and reversible. In contrast, LF-HA TENS had a pronounced analgesic and sustained anti-paraesthesia effect, manifested by a noticeable decrease in pain and paraesthesia symptoms area in PD, gradually increasing during the first 2 months of follow-up and accompanied by an irreversible prolonged decrease in the area of hypoesthesia. Conclusion: The areas of paraesthesia and hypoesthesia correlate with affective reactions to long-term chronic pain, which noticeably regress under the influence of LF-HA TENS compared to HF-LA TENS.

Nasal endoscopic treatment for nasal deformity secondary to unilateral cleft lip and palate using septal cartilage and bone

Objective: To explore the surgical methods and treatment outcomes of nasal endoscopic surgery for nasal deformity secondary to unilateral cleft lip and palate, combined with nasal septal deviation, using nasal septal cartilage and bone. Methods: Eleven patients who underwent surgical treatment for unilateral cleft lip and palate secondary to nasal deformity in the Department of Otorhinolaryngology, Head and Neck Surgery, Linyi People's Hospital, Shandong Second Medical University, from March 2021 to March 2023, were retrospectively analyzed. The cohort included 8 males and 3 females, aged (22.0±8.4) years (range: 17 to 35 years). Preoperatively, all of them underwent CT scanning and three-dimensional reconstruction of the nasal bones and sinuses to evaluate the size of the nasal septal cartilage and the design of the material to be taken, and to assess the degree of nasal deformity. During the operation, an open "V"-shaped incision was made through the nasal columella, and part of the septal bone and cartilage were removed under direct nasal endoscopic visualization. The septal cartilage and bony structures were used to correct the nasal deformity, and a nasal brace was used as an intraoperative support for the reconstruction of the nasal cartilage, which was then worn for 1 month after the operation to maintain a stable nasal shape. A visual analog scale (VAS) was used before and after surgery to assess the patient's satisfaction with the nasal shape and the degree of nasal ventilation. Corresponding data on both sides of the external nose were measured, including nasal tip height, nostril height, nostril width, nasal base width, and nasal columella inclination, to assess the symmetry of the external nose objectively. SPSS 22.0 software was used for statistical analysis to evaluate the surgical results. Results: The surgical incisions of all 11 patients healed at stage Ⅰ. At 6-24 months of postoperative follow-up, nasal symmetry was restored, and the nostrils were equal in size. The difference in symmetry indexes before and after the surgery was statistically significant. The t value for nasal tip height, the nostril height, the nostril width, the nasal base width, and the nasal columellar inclination were 4.21, 2.26, 3.38, 3.65, and 2.36, respectively (all P<0.05). Postoperative incision scarring was not obvious, and patients were satisfied with the nasal appearance [VAS score (9.14±0.48) points vs (3.45±1.23) points, t=14.29, P<0.001], and nasal ventilation was significantly improved [VAS score (9.32±1.24) points vs (4.61±0.85) points, t=10.39, P<0.001]. Conclusion: Nasal endoscopic surgery using septal cartilage and bone to treat nasal deformity secondary to unilateral cleft lip and palate, combined with deviated septum, can simultaneously improve the patients' nasal shape and nasal ventilation, yielding good clinical outcomes.

Serum neuritin as a predictive biomarker of early neurological deterioration and poor prognosis after spontaneous intracerebral hemorrhage: a prospective cohort study.

Intracerebral hemorrhage (ICH) is a common cerebrovascular disease characterized by high mortality and disability rates. Neuritin, significantly expressed in injured brain tissues, is implicated in the molecular mechanisms underlying acute brain injury. We aimed to explore the prognostic and predictive value of serum neuritin in ICH. In this prospective cohort study, serum neuritin levels were measured at admission in 202 patients, on post-ICH days 1, 3, 5, 7, and 10 in 54 of these patients, and at the time of enrollment in 100 healthy controls. The Glasgow Coma Scale (GCS) and hematoma volume were used as severity indicators. A poor prognosis was defined as a modified Rankin Scale (mRS) score of 3-6 at 90 days after ICH. END was defined as a decrease of ≥2 points in the GCS score within 24 h of admission. A multivariate logistic regression model was used to assess the independent relationships between serum neuritin levels, END, and poor prognosis. Serum neuritin levels were significantly increased at the time of patient admission, continued to rise on day 1, peaked on day 3, and then gradually diminished from day 5 until day 10. The levels remained substantially higher in patients compared to healthy controls throughout the 10-day period. The levels were independently related to GCS scores and hematoma volume. In subgroup analyses, the levels showed a linear relationship with the likelihood of experiencing END and poor prognosis at the 90-day mark after ICH. Additionally, the levels were independently associated with END, ordinal mRS scores, and poor prognosis. Under receiver operating characteristic (ROC) curve analysis, serum neuritin levels effectively predicted both END and poor prognosis. Two models incorporating GCS, hematoma volume, and serum neuritin levels were developed and represented using two nomograms separately to estimate END risks and poor prognosis. These models demonstrated clinical efficiency, stability, and validity in ROC, calibration, and decision curve analyses. Internal validation of the models was conducted using a randomly extracted subset of 101 patients. Furthermore, two specific weighted scoring systems were developed to optimize clinical prediction of poor prognosis and END after ICH. Elevated serum neuritin levels are strongly associated with disease severity, END, and 90-day poor neurological outcomes following ICH, establishing serum neuritin as a potential prognostic biomarker for ICH.

Sexual function after treatment with non-invasive radiofrequency device for improvement of the genitourinary syndrome of menopause: A multi-arm randomized clinical trial.

Several anatomical and functional changes occur during menopause and lead to female sexual dysfunction (FSD). The use of energy-based devices to improve women's sexual health brings an innovative scenario. To evaluate the effect of non-invasive radiofrequency (RF) treatment compared to vaginal estrogen therapy (E) and vaginal moisturizer (M) in postmenopausal women with FSD. Thirty-two sexually active postmenopausal women aged 45-75years were enrolled in a single center randomized controlled trial with three intervention arms: non-invasive RF, vaginal estrogen (E), or vaginal moisturizer (M) treatment. Assessments at baseline, and 4months were conducted using the Female Sexual Function Index (FSFI). The primary outcome of this RCT was an assessment of the effect of RF on FSD compared to that of E and M. According to the total FSFI score, 100% of participants in the RF and E arms and 90% in the M arm had sexual problems at the baseline. The mean age of the participants was 58+/-5.3, 57.9+/-6.3, and 59.6+/-6.0years in the RF, E, and M arms, respectively (p=0.741). After 4months of follow-up, FSD had ameliorated by 146.1% in the RF arm (improvement of 17.32 points in the total FSFI score), with no significant improvement in the other arms (p=0.009). We observed improvements in sexual desire (1.32 points in the partial FSFI score), arousal (2.37 points in the partial FSFI score), and orgasm (2.8 points in the partial FSFI score) only in the RF arm (p=0.004, p<0.001, and p<0.001, respectively). The use of an energy-based device independently of hormonal therapy to improve female SF is very promising. Our findings may contribute to treatment decisions when there is failure of vaginal estrogen therapy, a need for a combination of treatments, or a patient preference for the use of energy-based devices, in postmenopausal women with FSD. Non-invasive RF treatment for FSD showed superior efficacy compared to vaginal estrogen therapy and vaginal moisturizer after 4months of follow-up. Further studies with longer follow-up periods are needed to corroborate these findings and evaluate the long-term effects of non-invasive RF therapy on sexual function.

Application of efgartigimod in Chinese patients with myasthenia gravis: a single-center real-world prospective study.

China has a large number of myasthenia gravis (MG) patients, creating an urgent need for rapid and tolerable treatment options. As the first-approved Fc receptor antagonist, efgartigimod has bright prospects for treating MG. However, real-world evidence on its application within the Chinese MG population are limited. This study aims to evaluate the rapid efficacy and safety of efgartigimod in Chinese MG population. This single-center prospective study enrolled Chinese MG patients aged 18 and older who were treated with efgartigimod, classified as Myasthenia Gravis Foundation of America I-IV, with a baseline Myasthenia Gravis Activities of Daily Living (MG-ADL) score of at least 4. Patients received efgartigimod at a dose of 10 mg/kg infused once weekly for 4 weeks. During the treatment, the corticosteroids dosage could be adjusted as appropriate or the non-steroidal immunosuppressive therapies (NSISTs) added. Prior to each infusion, patients' MG-ADL scores, IgG levels, and routine laboratory tests were evaluated, while also recording the prednisone tapering and any adverse events occurring during the treatment. Twenty five Chinese MG patients were enrolled between November 2023 and June 2024, including 3 with ocular MG (OMG) and 22 with generalized MG (GMG). During the 8-week follow-up, in GMG patients, whether positive for acetylcholine receptor (AChR) or muscle-specific tyrosine kinase (MuSK) antibodies, the overall efficacy was significant. Within one treatment cycle, 18 (82%) patients showed a reduction of at least 2 points in MG-ADL scores and sustained for at least 4 weeks, and 6 (27%) attained minimal symptom expression (MSE) and sustained for at least 4 weeks. Only 1 patient experienced exacerbation. Among OMG patients, 1 achieved MSE within the treatment cycle, while 2 showed minor improvements. Patients who added tacrolimus concurrently with efgartigimod did not achieve better improvement in MG-ADL scores compared to others. The average reduction in prednisone dosage was 27.4%. Only one patient experienced transient vomiting and diarrhea, with no serious adverse reactions reported. This study confirmed the short-term efficacy and safety of efgartigimod in Chinese MG patients. However, in clinical practice, careful consideration is needed regarding its application in OMG and whether to add NSISTs regimen during the treatment. Efgartigimod could potentially serve as an alternative to long-term corticosteroids therapy.

Baseline characteristics and 2-year functional outcome data of patients undergoing an arthroscopic rotator cuff repair in Switzerland, results of the ARCR_Pred study.

The ARCR_Pred study was initiated to document and predict the safety and effectiveness of arthroscopic rotator cuff repair (ARCR) in a representative Swiss patient cohort. In the present manuscript, we aimed to describe the overall and baseline characteristics of the study, report on functional outcome data and explore case-mix adjustment and differences between public and private hospitals. Between June 2020 and November 2021, primary ARCR patients were prospectively enrolled in a multicenter cohort across 18 Swiss and one German orthopedic center. Baseline characteristics, including sociodemographic and diagnostic variables, were reported. Clinical scores and patient-reported outcome measures were assessed up to 24-month follow-up. After screening 2350 individuals, 973 patients with ARCR were included. Follow-up rates reached 99%, 95%, 89% and 88% at 6 weeks, 6, 12, and 24 months, respectively. While the proportion of massive tears was higher in the study population (44% vs. 20%, Std. Diff. = 0.56), there were no other major differences in key characteristics between enrolled and non-enrolled patients or in patients lost to follow-up. Functional scores improved over time, with positive changes rates ranging from 83% to 92% at 6-month, reaching 91% to 97% at 12- and 24-month follow-up. In linear mixed models, used to estimate the associations between baseline factors, hospital type and standardized 0-100 scores, marginal effects for time ranged from 20 to 30, 28 to 39 and 34 to 41 points at the 6-, 12- and 24-month follow-up, respectively. Except at the 12-month follow-up, where marginal effects for the interaction terms ranged from -5 to -4 points in the standardized scores, there were no consistent outcome differences between public and private hospitals. Increasing number of years of education was consistently associated with better scores, greater feelings of depression and anxiety, smoking and ASA group III-IV were consistently associated with worse scores. Tear severity showed a consistent negative association solely for the Constant-Score. The ARCR_Pred study shows high potential for generalizability to the population of patients undergoing an ARCR in Switzerland. Further analyses are needed to establish relevant clinimetrics for the Swiss population and to compare outcomes for surgical techniques, surgeon experiences profiles and post-operative management.

Knowledge, attitudes, and practices (KAP) of animal health staff and farmers towards brucellosis control in sheep and goat in China: A cross-sectional study.

In China, brucellosis has resurfaced recently with a discernible spatial distribution, particularly affecting dairy herds and small ruminant populations. However, limited dissemination of knowledge, attitudes, and practices (KAP) for brucellosis control exists among farmers and animal health staff. This study aimed to assess the KAP of brucellosis control and prevention in animal health staff and farmers, with the goal of educating the public regarding the application of efficient brucellosis control and prevention strategies. We conducted a cross-sectional survey involving 1,468 participants, comprising farmers (n = 1,067) and animal health staff (n = 401) based on their significant density of sheep and goat population. They completed a questionnaire targeting a specific group of farmers and animal health staff through face-to-face interviews. The KAP scores were then categorized as either satisfactory or unsatisfactory based on a cutoff set at ≥80% of the total score for satisfactory. Binary logistic regression was used to identify the association between KAP and geographical information. The results indicated satisfaction with KAP among farmers (57.7%, 75.8% and 87.0%) and animal health staff (80.5%, 84.5%, and 78.3%) at ≥ 80% cut-off point of total score. The primary concern of farmers is involved in the understanding of the route of transmission and handwashing practices after contacting animals. Predictors of higher knowledge and positive attitude included province of residence and age. The factors linked to satisfactory practice levels consist of province of residence, educational level, and a history of family members' infections (p < 0.05). Among animal health staff, the primary factor associated with KAP was province of residence, sex, level of education, and history of family members infection (p < 0.05). Additionally, brucellosis information primarily originated from traditional promotional materials and veterinarians. This study emphasized that the KAP scores for both animal health staff and farmers were satisfactory, except for a suboptimal knowledge score among farmers. To proactively control future brucellosis outbreaks, it is imperative to develop targeted educational resources aimed at enhancing the understanding of brucellosis, particularly among farmers. Ensuring the availability and accessibility of informative materials for the effective prevention and control of brucellosis in livestock animals.

Evaluating the prognostic value of DECAF score and procalcitonin in patients with COPD exacerbation.

Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) frequently result in emergency department (ED) visits, necessitating accurate risk stratification. The aim of this study was to evaluate and compare the prognostic utility of the DECAF score and serum procalcitonin levels in predicting clinical outcomes in patients with AECOPD. This retrospective cohort study encompassed AECOPD patients presenting to the ED over a three-year period who had serum procalcitonin levels measured. The primary outcome was one-month mortality, with secondary outcomes including ED re-admission, hospitalization, and intensive care unit (ICU) admission. Receiver operating characteristic (ROC) curve analysis was employed to assess the prognostic performance of DECAF score and procalcitonin, and differences between areas under the curve (AUC) were compared. A total of 130 patients were analyzed, comprising 105 survivors and 25 non-survivors. The median DECAF score was significantly higher in non-survivors [4 (IQR: 3-4)] compared to survivors [3 (IQR: 2-4)] (p<0.001). Similarly, median procalcitonin levels were elevated in non-survivors [0.26ng/mL (IQR: 0.11-2.77)] relative to survivors [0.08ng/mL (IQR: 0.04-0.21)] (p<0.001). The AUC for the DECAF score was 0.758 (95% CI: 0.673-0.842), while that for procalcitonin was 0.764 (95% CI: 0.668-0.860). The difference between AUCs was 0.006 (95% CI: -0.140 to 0.127), (p=0.927). The negative predictive value (NPV) was 90.6% for the 4-point DECAF score and 96.2% for a 0.075ng/mL procalcitonin cut-off. Notably, when used in combination, the NPV reached 100% (95% CI: 89.1-100). The DECAF score and serum procalcitonin levels both exhibit robust prognostic capabilities in excluding adverse outcomes in AECOPD patients, with their predictive accuracy enhanced when used in tandem.

Prognostic serum biomarkers of synaptic, neuronal and glial injury in patients with acute ischemic stroke of the anterior circulation.

We aimed to investigate the prognostic role of β-synuclein in comparison to that of neurofilament light chain (NfL) and glial fibrillary acidic protein (GFAP) for predicting functional outcome after acute ischemic stroke (AIS). We measured serum concentrations of β-synuclein, NfL and GFAP 24 h after hospital admission in 213 consecutive patients with moderate-to-severe AIS. We investigated the association between serum biomarkers and radiological/clinical characteristics, 3-months mortality and functional outcome on the modified Rankin Scale (mRS). In 213 patients with AIS [mean age: 76.1 (±12.5) years, 53.1% males, median NIHSS score on admission: 13 (IQR: 9-17)], higher levels of β-synuclein, NfL and GFAP were associated with higher NIHSS scores and with lower Alberta Stroke Program CT Score (ASPECTS) points on admission. Serum β-synuclein levels was significantly correlated with NfL (rho = 0.715, p < 0.001) and GFAP concentrations (rho = 0.684, p < 0.001). The inclusion of serum β-synuclein significantly improved the accuracy of prediction models without biomarkers for overall mortality (AUC: 0.836 vs. 0.752, p < 0.001) and mRS 3-6 vs. 0-2 (AUC: 0.812 vs. 0.624, p < 0.001). Combination models with NfL and/or GFAP showed a similar accuracy. Serum β-synuclein may be used to assess synaptic damage/dysfunction and to predict 3-months clinical outcomes in patients with AIS.