Significant Reduction In Scores Research Articles

Multicomponent Dietary Supplementation: Impact on Tear Secretion and Ocular Surface Inflammation in Dry Eye Syndrome Patients

Dry eye syndrome (DES) is a prevalent ocular condition characterized by tear film instability, inflammation, and discomfort, affecting millions worldwide. DES is related to oxidative stress imbalance and ocular surface inflammation, which are important factors in the development of the condition. Recent studies have demonstrated that fish oil, lutein, and zeaxanthin possess anti-inflammatory and antioxidant properties. This study investigated the efficacy of a multicomponent dietary supplement in improving tear secretion and mitigating ocular surface inflammation in patients with DES. It was an open-label intervention trial. In total, 52 participants were randomly assigned to control (n = 23) and supplement (45 mg/day eicosapentaenoic acid, 30 mg/day docosahexaenoic acid, 30 mg/day lutein, and 1.8 mg/day zeaxanthin; n = 29) groups for 12 weeks. The participants were evaluated using Schirmer’s test and the ocular surface disease index (OSDI) as ocular surface parameters. Moreover, blood or tear oxidative stress, antioxidant capacities, and tear inflammatory indicators were measured at weeks 0 and 12. The results indicated a significant increase in tear secretion and a significant reduction in OSDI scores in the supplement group. Additionally, inflammatory markers, such as interleukin (IL)-6 and IL-8, significantly decreased after the intervention. However, the OSDI of the supplement group significantly improved by 6.60 points (β = −6.60, p = 0.01). These findings support the potential of targeted nutritional supplementation as a safe and effective strategy for alleviating DES symptoms, offering an alternative to conventional treatments that exclusively focus on symptom management. This study highlights the role of specific nutrients in modulating tear production and inflammation, thereby providing a foundation for dietary approaches to DES treatment. Future research should explore the long-term benefits of such interventions and their impact on overall ocular health.

Longitudinal Improvement of Quality of Life in Children With Legg-Calve-Perthes Disease Treated With Proximal Femoral Varus Osteotomy.

Proximal femoral varus osteotomy (PFVO) is commonly performed to improve femoral head containment and decrease deformity in Legg-Calve-Perthes disease (LCPD). Little is known about how PFVO impacts the quality of life after surgery. The purpose of this study was to determine the longitudinal changes to patient-reported physical, mental, and social health measures after PFVO. This is a retrospective review of prospectively collected Patient-Reported Outcomes Measurement Information System (PROMIS) data from 20 patients with unilateral LCPD treated with a PFVO. We collected seven PROMIS measures (mobility, anxiety, fatigue, depressive symptoms, pain interference, anger, and peer relationships) before and approximately 1, 3, 8, 12, and 18 months after surgery. We compared PROMIS scores across different time points using repeated measures ANOVA and multiple pairwise comparisons with Tukey adjustment. The relationship between presurgery and postsurgery mental health scores was analyzed using a Spearman correlation. The mean age at PFVO was 8.2 ± 1.6 years. The mean length of follow-up was 17.0 ± 2.1 months. There was a significant improvement in the mobility score between preoperation and 12 months (P=0.0031) and 18 months postoperation (P<0.0001). Anxiety scores significantly improved from preoperation and 18 months postoperation (P=0.0014). A significant reduction in the pain interference score between preoperation and 12 and 18 months postoperation (P<0.0001) was observed. Peer relationships significantly improved from one month postoperatively to 18 months postoperation (P=0.0355). Individual variations were also observed with some patients having elevated depressive symptoms and anxiety scores. Moderate correlations between preoperative and postoperative anxiety and depressive symptoms scores were observed. PROMIS mobility, anxiety, pain interference, and peer relationship scores improved significantly after PFVO. While the mean anxiety, depressive symptoms, peer relationships, and anger scores were in normal ranges at each visit, individual variations with elevated anxiety and depressive symptom scores were observed. This new longitudinal PROMIS data will better inform patients and families about the quality of life and recovery experience after PFVO. Level IV-therapeutic study.

Comparative analysis of warm needle moxibustion and gua sha nursing care on sleep quality and psychological stress in insomnia patients undergoing eszopiclone tablet treatment: A retrospective study.

This retrospective study aims to assess the adjunctive efficacy of warm needle moxibustion and gua sha care in the treatment of eszopiclone tablets on sleep quality and psychological stress in insomnia patients. Data of 138 insomnia patients from Gansu Baoshihua hospital between January and December 2022 were collected. Patients were bifurcated into 2 groups: those solely treated with eszopiclone (n = 71) and those administered a combined regimen of eszopiclone, warm needle moxibustion, and gua sha (n = 67). Sleep quality, psychological stress, and daytime drowsiness were assessed using the Pittsburgh Sleep Quality Index (PSQI), Perceived Stress Scale-10 (PSS-10), and Epworth Sleepiness Scale (ESS), respectively. Adverse effects were also monitored. Baseline demographics and clinical characteristics were comparable between the 2 groups. Post-intervention, the intervention group exhibited significant reductions in PSQI and ESS scores (P < .05), whereas the control group showed no significant changes. The PSS-10 scores remained unchanged in both groups post-intervention. The intervention group reported a significant decrease in the prevalence of nausea and dizziness posttreatment (P < .05), with a notably lower post-intervention nausea prevalence compared to the control group (P < .05). Incorporating warm needle moxibustion and gua sha nursing care into the eszopiclone treatment regimen potentially amplify sleep quality while reducing side effects in patients with insomnia.

Efficacy of vidian neurectomy in treating chronic rhinosinusitis with nasal polyps combined with allergic rhinitis: A systematic review and meta-analysis.

To evaluate the impact of additional vidian neurectomy or posterior nasal neurectomy in patients with chronic rhinosinusitis with nasal polyps (CRSwNP) and allergic rhinitis (AR), compared to the outcomes of conventional endoscopic sinus surgery alone. Up to May 2024, six databases were systematically searched. We evaluated studies that compared the clinical improvement of chronic sinusitis-related symptoms and endoscopic findings between the neurectomy group (endoscopic sinus surgery plus vidian neurectomy or posterior nasal neurectomy) and the control group (endoscopic sinus surgery only). The neurectomy group showed a significant reduction in the Lund-Kennedy endoscopic score (SMD = -1.3163 [-1.6519; -0.9807]; I² = 53.3 %). However, this treatment did not have a significant effect on the Quality-of-life score (SMD = -0.1222 [-0.3427; 0.0983]; I² = 27.5 %) or patient-reported nasal symptom-related VAS scores (SMD = -1.6690 [-3.7062; 0.3682]; I² = 96.3 %). In the subgroup analyses of these results according to time points of measurement, the Lund-Kennedy endoscopic score was statistically lower in the treatment group during treatment periods (postop 6months, 12months, and 24months). However, there were no statistically significant differences in Quality-of-life score and VAS between the treatment and control groups during all treatment periods. There was no significant difference in the recurrent rate of CRS during the following up periods (odds ratio=0.5263 [0.1518; 1.8254], I2 = NA) between two groups. Regarding the adverse effect of neurectomy, this additional procedure did not induce the postoperative bleeding (odds ratio=0.8886 [0.3411; 2.3150]; I2 = 0.0 %) and dry eye related discomfort (odds ratio=65.3560 [0.1044; 40,908.1619]; I2 = 88.9 %) significantly compared to control group. Additional neurectomy shows better efficacy in improving endoscopic findings and is safer in patients with CRSwNP combined with AR; however, more clinical studies are needed to evaluate its long-term symptomatic effects and disease recurrence.

Aggression in crime and sports: a study on prisoners and amateur combat athletes in Türkiye

BackgroundThis research focuses on examining and comparing the aggression levels of prisoners incarcerated for intentional injury and amateur combat athletes. The study aims to explore the differences in aggression levels among these groups to understand the impact of incarceration and sports participation on aggression.MethodsThe participants included in the analysis consist of prisoners (n = 363) housed in Marmara No. 7 and No. 3 Type L Closed Penal Institutions, who have been incarcerated for intentional injury, with an average age of 36.64 ± 10.30 years and an average custody period of 980.47 ± 1335.27 days. Amateur combat athletes (n = 203) with an average age of 25.17 ± 10.09 years have been actively engaged in sports for an average of 11.83 ± 9.53 years. The control group (n = 329) has an average age of 32.65 ± 7.56 years. Data collection instruments included a personal information form and the Buss-Perry Aggression Questionnaire. The data were analyzed using IBM SPSS Statistics 23.0, with a significance level set at p < 0.05.ResultsAnalysis of the Buss-Perry Aggression Questionnaire scores revealed that the aggression levels of prisoners incarcerated for intentional injury were statistically significantly lower than those of both amateur combat athletes and control group participants (p < 0.001). Additionally, a significant reduction in overall aggression scores was observed among prisoners as the number of days in custody increased (p = 0.045). No significant differences were found among amateur combat athletes concerning the discipline variable, and no meaningful relationship was identified between years of active sports participation and aggression scores.ConclusionThe findings indicate that educational, social, and sports activities organized in correctional facilities can be effective in reducing aggression levels among inmates. Systematic planning, professional implementation, and continuous evaluation of such programs can make significant contributions to the rehabilitation of prisoners and their successful reintegration into society.

The Significance of Psychological Support in Managing Depression in Parkinson's Disease: Combining Venlafaxine with Pramipexole and Psychological Care.

Depression is a common comorbidity in patients with Parkinson's disease (PD) and can significantly impact their overall well-being. The combination of venlafaxine and pramipexole is a standard treatment approach for depression in PD. However, the effects of incorporating psychological care into the treatment regimen remain unclear. This study aimed to investigate the impact of psychological intervention in the treatment of depression in Parkinson's disease, using a combination of venlafaxine and pramipexole. The clinical data of 151 patients with both Parkinson's disease (PD) and depression, treated in Geriatric Hospital of Hainan from May 2021 to May 2023, were analyzed retrospectively. Among the 151 patients, 71 received routine nursing care and were allocated to the control group, while the remaining 80 patients received psychological nursing care based on routine nursing care and were assigned to the study group. The Hamilton Depression Rating Scale (HAMD) and the Hamilton Anxiety Scale (HAMA) were used to evaluate the degree of depression and anxiety in both groups before and after care. The MOS 36-Item Short-Form Health Survey (SF-36) was employed to assess the quality of life of both groups before and after care. The efficacy and adverse reactions in both groups were also analyzed. Before care, the HAMD and HAMA scores did not significantly differ between the two groups (p > 0.05). However, after care, both groups exhibited a significant reduction in HAMD and HAMA scores (p < 0.0001), with a more pronounced decrease observed in the study group (p < 0.0001). Prior to care, there was no significant difference in SF-36 scores between the two groups (p > 0.05). However, following care, the SF-36 scores markedly increased in both groups (p < 0.0001), with a more pronounced increase in the study group (p < 0.0001). Additionally, a significantly lower overall response rate was noted in the control group compared to the study group (p = 0.013), while no significant difference was observed in the total incidence of adverse reactions between the two groups (p = 0.273). Utilizing venlafaxine combined with pramipexole in the treatment of depression in PD, supplemented by psychological nursing care, significantly enhances therapeutic efficacy. This combined approach effectively alleviates symptoms of depression and anxiety in patients without introducing additional side effects. Hence, it emerges as a valuable clinical treatment option.

A modified technique for radial artery access: how interventional radiologists can optimise the cardiologists’ technique to suite their procedures

BackgroundThis is a single-centre prospective observational study examining radial access in 62 Prostatic Artery Embolisation (PAE) procedures. Evaluation of left radial artery diameter using high frequency ultrasound before and after administration of sublingual glycerl trinitrate (GTN). Pre-procedure questionnaires calculating symptom severity score compared with post-procedure.ResultsSublingual GTN resulted in a statistically significant increase in radial artery diameter (p < .00001). There was a statistically significant reduction in both average International Prostate Symptom Score (IPSS) and Quality of Life (QoL) from pre-procedure to post-PAE. The radial sheath was successfully inserted in 100% of cases. Crossover rate to femoral access was low (4%). Radial artery access had a low complication rate (2%). Radial artery variant anatomy was reasonably common (7%).ConclusionsSublingual GTN significantly increase radial artery diameter. PAE from radial access is associated with a symptomatic improvement at 2-month follow-up.

Alternate nostril breathing (Nadi-Shodhana Pranayama) and its impact on perceived stress and hearing threshold among medical students; a prospective study

Background: Medical students often experience significant psychological stress, which can negatively impact their academic performance, cognitive functions, and overall well-being. Psychological/emotional stress can also affect hearing if severe or if it lasts long enough. Amongst stress reduction strategies, meditation techniques are found to be helpful. Aims and Objectives: This study aimed to assess the effect of alternate nostril breathing (Nadi-Shodhana Pranayama) on perceived stress and auditory thresholds (AT) among medical students. Materials and Methods: Following institutional ethics committee approval, a sample of 60 consenting students aged 18–26 years participated in a 3-month intervention, where they practiced pranayama for 15–20 min, 5 days a week. Baseline and post-intervention data were collected using the perceived stress scale (PSS) and pure tone audiometry. Results: The results demonstrated a statistically significant reduction in PSS scores (P&lt;0.001), indicating decreased stress levels. In addition, ATs in both ears improved, with a more pronounced change observed in the left ear (P&lt;0.001). These findings suggest that pranayama not only reduces psychological stress but also enhances auditory perception, possibly through the regulation of stress hormones and improved inner ear functioning. Conclusion: The study supports the use of pranayama as a simple, non-invasive intervention to reduce stress which tends to improve cognitive performance in medical students, contributing to better academic outcomes and overall well-being. Further research is warranted to explore long-term benefits and potential mechanisms behind the observed improvements in auditory function and stress resilience.

Molecular insights into the therapeutic mechanisms of Bushen-Qiangdu-Zhilv decoction for ankylosing spondylitis.

Ankylosing spondylitis (AS) is a chronic rheumatic immune disease characterized by high disability rates, significantly affecting patients' quality of life. BuShen-QiangDu-ZhiLv Decoction (BQZD), developed by the renowned traditional Chinese medicine practitioner Jiao Shude, has been traditionally used for AS treatment. However, the bioactive components and the precise mechanisms underlying BQZD's therapeutic effects remain largely unexplored. To investigate the protective effects and elucidate the molecular mechanisms of BQZD in treating ankylosing spondylitis. Ultra Performance Liquid Chromatography coupled with tandem mass spectrometry (UPLC-MS/MS) was used to identify active compounds in BQZD. Bulk RNA-seq and Gene Set Variation Analysis (GSVA) were conducted to assess changes in pathway activity in AS patients before and after three months of BQZD treatment. We also utilized network pharmacology and molecular docking analyses to predict potential mechanisms, identifying key target genes such as IL-6, NFATc1, and c-FOS. Animal experiments were performed to validate these findings. UPLC-MS/MS identified 28 active compounds in BQZD capable of entering the bloodstream, with potential anti-inflammatory, immunomodulatory, and bone metabolism-regulating effects. BQZD treatment led to a significant reduction in ESR, CRP, and ASDAS-CRP scores, indicating clinical improvement in AS patients. RNA-seq analysis showed decreased GSVA scores for the ossification pathway, with moderate reductions in inflammatory response and RANKL signaling pathways. Positive correlations were found between pathway activity and clinical indicators. Network pharmacology and transcriptomic analysis identified IL-6, NFATc1, and c-FOS as key targets. In vivo experiments confirmed that BQZD reduced TNF-α and IL-1β levels, inhibited ectopic ossification, and modulated the expression of DKK-1, MMP-9, and OPN in the CAIA model. BQZD exerts therapeutic effects in AS by regulating inflammation and abnormal ossification through multi-pathway, multi-target mechanisms. The identification of key target genes such as IL-6, NFATc1, and c-FOS provides a solid foundation for future research and clinical applications of BQZD in AS management.

Peripheral blood complement factors C2 and C3 as biomarkers of clinical efficacy in patients with first-episode schizophrenia after aripiprazole treatment

ObjectiveThe objective of this study was to identify serum complement factor-based biomarkers indicative of clinical efficacy in patients with first-episode schizophrenia (SCZ) following treatment with aripiprazole.MethodsThe retrospective study cohort comprised 40 patients diagnosed with first-episode SCZ (SCZ group) and 40 healthy individuals (control group). Quantitative analyses were conducted on five complement factors, namely complement component 1 (C1), C2, C3, C4, and the 50% hemolytic complement (CH50). Baseline serum complement factor levels were compared between the SCZ and control groups. Patients diagnosed with SCZ underwent a 4-week treatment regimen with aripiprazole. The severity of psychiatric symptoms in these patients was assessed using the Positive and Negative Symptom Scale (PANSS) and the Brief Psychiatric Rating Scale-18 Item Version (BPRS). Comparative analyses were conducted on PANSS and BPRS scores, as well as serum complement factor levels, both prior to (pre-treatment group) and following aripiprazole administration (post-treatment group). Pearson’s correlation test was employed to evaluate the relationships between changes in serum complement factor levels and the reduction rates of PANSS/BPRS scores.ResultsAt baseline, patients with SCZ exhibited significantly elevated levels of C1, C2, C3, C4, and CH50 compared to the control group (P < 0.05). Moreover, following treatment, there was a significant reduction in the PANSS total score, positive symptom score, negative symptom score, and BPRS score in the post-treatment group compared to the pre-treatment group (P < 0.05). Furthermore, patients in the post-treatment group exhibited a significant reduction in serum levels of C2, C3, and C4, alongside a significant increase in the serum level of CH50 compared to those in the pre-treatment group (P < 0.05). Additionally, the baseline serum C2 levels and the variations in serum C2 levels pre- and post-treatment exhibited a negative correlation with the reduction rate of PANSS/BPRS scores (P < 0.05). Similarly, both the baseline serum C3 levels and the changes in serum C3 levels pre- and post-treatment were negatively correlated with the reduction rate of PANSS/BPRS scores (P < 0.05).ConclusionBaseline serum levels of C2 and C3, as well as their variations pre- and post-treatment, may serve as biomarkers for predicting clinical efficacy in patients with first-episode SCZ undergoing treatment with aripiprazole.

Efficiency of laparoscopic retroperitoneal pancreatic necrosectomy for treating infected pancreatic necrosis with duodenal fistula: a single-center retrospective cohort study

BackgroundOpen surgical debridement was the main treatment option for infected pancreatic necrosis (IPN). However, it was associated with significant trauma, leading to a higher mortality rate. With the development of minimally invasive surgery, the step-up treatment principle centered around minimally invasive intervention, significantly reducing the incidence of complications and mortality rates among IPN patients. However, few studies have reported the efficacy of laparoscopic retroperitoneal pancreatic necrosectomy (LRPN), a new minimally invasive debridement technique, in IPN patients with duodenal fistula (DF)—a severe complication of IPN. Therefore, we analyzed the effectiveness and safety of LRPN for treating IPN with DF and discussed the impact of DF on patient prognosis.MethodsWe retrospectively examined patients diagnosed with IPN between 2018 and 2023. The patients were divided into two groups based on the presence or absence of DF. Clinical characteristics, treatment strategies, clinical outcomes, and follow-up information were analyzed. A 1:1 propensity score-matching (PSM) method was used to assess differences in outcome indicators more accurately.ResultsA total of 197 patients were examined. After PSM, no significant differences were observed between the two groups in in-hospital mortality rate, incidence of single organ failure, rate of postoperative severe complications (Clavien–Dindo Classification ≥ 3), and intensive care unit stay (P > 0.05). However, the incidence of multiorgan failure, gastrointestinal bleeding, number of percutaneous catheter drainage (PCD) procedures, surgery cases, hospital stay, and hospitalization costs were higher in the DF group (P < 0.05). Of these patients, 71.6% (n = 141) were treated with PCD + LRPN, with a conversion rate of 6.38% to open surgery. A higher proportion of patients in the non-DF group showed improved clinical outcomes solely with PCD (22.6% vs. 2.4%, P < 0.05), whereas a higher proportion of patients in the DF group underwent PCD + LRPN (88.1% vs. 67.1%, P < 0.05). Both groups showed a significant reduction in the Sequential Organ Failure Assessment score 72 h postoperatively.ConclusionsFor patients with IPN and DF, the LRPN-centered step-up strategy was safe and effective. DF prolongs hospital stay and increases hospitalization costs for patients.

Reduction of the Douleur Neuropathique 4 (DN4) Score in the Supraclavicular Nerve Separation and Disability of the Arm Shoulder and Hand (DASH) Score Third Month and Sixth Month Post Open Reduction Internal Fixation of Clavicular Fracture

Introduction: Clavicle fractures are common injuries to the scapular girdle, with fractures in the middle third of the clavicle being the most prevalent. Non-operative treatment is often used but can lead to unsatisfactory outcomes, including pain, malunion, and thoracic outlet syndrome. As a result, operative fixation using Open Reduction and Internal Fixation (ORIF) Plate and Screw (ORIF PS) has gained popularity. Postoperative complications such as numbness around the surgical incision are frequently observed. This study aims to evaluate the differences in functional outcomes in patients with clavicle fractures post ORIF PS using the preserved supraclavicular nerve and non-preserved supraclavicular nerve methods, assessed by the Disability of the Arm Shoulder and Hand (DASH) score and Douleur Neuropathique 4 (DN4) score at 3 and 6 months post-operation. Methods: This cohort study used medical records data from patients with middle third clavicle fractures at RSUP Prof. Dr. IGNG Ngoerah. Patients were divided into two groups: preserved supraclavicular nerve and non-preserved supraclavicular nerve. Data were collected at 3 and 6 months post-operation to evaluate DASH and DN4 scores. Statistical analysis was performed using SPSS version 25.0, with the Kolmogorov-Smirnov test for normality and appropriate hypothesis tests based on data distribution. Results: This study involved 51 patients with clavicle fractures undergoing ORIF PS surgery. There were no significant differences in baseline characteristics between the two groups. At three months, the difference in DN4 scores between the preserved and non-preserved groups was not statistically significant (p=0.347). However, at six months, the preserved group showed significantly lower DN4 scores (p=0.012). The DASH scores at three months showed a significant difference between the two groups (p&lt;0.001), with the preserved group showing better scores. At six months, the difference in DASH scores was not significant (p=0.210). Longitudinal analysis showed significant reductions in DASH and DN4 scores between three and six months in both groups. Discussion: This study demonstrates that preserving the supraclavicular nerve during ORIF clavicle surgery provides significant benefits in reducing neuropathic pain and improving arm function in the long term. These findings support the importance of this approach in clavicle fracture surgeries to reduce complications and enhance functional outcomes. Conclusion: Preserving the supraclavicular nerve during ORIF clavicle surgery can significantly reduce neuropathic pain and improve arm function in the long term. These findings emphasize the importance of this approach in clinical practice to improve patient outcomes following clavicle fracture surgery. Keywords: Clavicular fracture, Douleur Neuropathique 4 score, supraclavicular nerve separation, DN4 score, DASH score, ORIF.

The effect of psychoeducation-based on transtheoretical model on depression in patients with coronary heart disease

Background: Depression is the most common psychological condition among patients with coronary heart disease (CHD). Although psychoeducational programs (PEPs) based on the Transtheoretical Model (TTM) have shown promise for psychiatric patients, their application among individuals with medical conditions, particularly cardiovascular disease, remains limited—especially in Indonesia. Purpose: This study aimed to assess the effectiveness of a TTM-based PEP intervention in reducing depression among CHD patients. Methods: A quasi-experimental design was employed, involving 80 CHD patients hospitalized in the coronary care unit (CCU) of a private hospital in West Java, Indonesia, in 2022. Participants in the intervention group attended seven sessions, each lasting 60 to 90 minutes. Depression symptoms were measured using the Hamilton Depression Rating Scale (HDRS). An ANOVA was performed to compare pre- and post-intervention mean HDRS scores and subscale scores between the two groups. After accounting for attrition, the final analysis included data from 76 patients. Results: The participants had a mean age of 59.39 years (SD = 11.10) and a mean disease duration of 4.05 years (SD = 1.69). A paired t-test showed a significant reduction in the mean HDRS score of the intervention group, from 13.79 ± 2.84 pre-intervention to 10.16 ± 2.16 post-intervention (p &lt; 0.0001). Most HDRS subscale scores also decreased significantly, except for insomnia, somatic/genital symptoms, and weight loss. ANCOVA confirmed significant differences between the two groups in overall HDRS scores. Conclusions: The findings suggest that TTM-based PEP is effective in reducing depression among CHD patients. Incorporating such programs alongside standard treatments is recommended for enhanced patient outcomes.

Extracellular vesicles of ADSCs inhibit ischemic stroke-induced pyroptosis through Gbp3 regulation: A role for the NLRP3/GSDMD signaling pathway.

Mounting data indicates that extracellular vesicles (EVs) have the potential to improve the injury after a stroke. Pyroptosis is a recently identified kind of programmed cell death that initiates an inflammatory reaction. We aimed to ascertain the therapeutic implications and possible molecular processes of EVs obtained from adipose-derived stem cells (ADSCs) in inhibiting pyroptosis in ischemic stroke. The investigation employed transient middle cerebral artery occlusion (tMCAO) rat model and a BV2 of oxygen-glucose deprivation/reoxygenation (OGD/R) to ascertain ADSCs-EVs implications on inflammation and pyroptosis as assessed by neurological deficit scores, TTC staining, IHC, HE, CCK8, WB, ELISA, and immunofluorescence. RNA-Seq was performed on BV2 cells in the control, OGD/R, and OGD/R + ADSCs-EVs groups. Using sequencing data analysis, in the OGD/R group, we screened the upregulated genes regulated by EVs, overlapped with 74 pyroptosis-related genes, and identified Guanylate-binding protein 2 (Gbp2) and Guanylate-binding protein 3 (Gbp3) as key genes. Following the validation of the sequencing results in vivo and in vitro, Gbp3 was selected for further study. To test its regulatory effects on inflammation and pyroptosis, Gbp3 was knocked down and overexpressed in vitro. The administration of ADSCs-EVs resulted in a significant reduction in neurological involvement scores and reduced infarct volume in rats with tMCAO. They were also protective against BV-2 cells after OGD/R. In vivo and in vitro, ADSCs-EVs inhibited inflammatory response and pyroptosis after stroke. The outcomes of the RNA-Seq data analysis manifested that the protective implications of EVs after stroke are mediated by the modulation of inflammation-related mechanisms. Moreover, treatment with EVs led to a significant reduction in Gbp3 expression in post-ischemic brain tissue and cells. When Gbp3 was knocked down, the expression of inflammatory molecules and proteins linked to pyroptosis had a significant decline. When Gbp3 was overexpressed, the opposite results were obtained. ADSCs-EVs modulate the NLRP3/GSDMD signaling pathway via Gbp3 to attenuate the inflammatory response and reduce pyroptosis that occurs after stroke.

Effect of toys made from medical materials on anxiety among hospitalized children: A randomized controlled trial.

This study was conducted as a randomized controlled trial to examine the effect of toys made from medical materials on anxiety among hospitalized children. This study was conducted with pediatric patients aged 4-6years who were hospitalized in the pediatrics department of a teaching and research hospital in the Southeastern Anatolia Region. The study was completed with 90 children, allocated to the toys made of medical materials group (45) and the control group (45). Children, in the toys made of medical materials group, were given medical materials and asked to make toys. The anxiety levels of children in both the toys made of medical materials and control groups were assessed using the Children's State Anxiety (CSA) scale. Analysis based on children's self-reports revealed a significant reduction in the post-test anxiety scores of children in the toys made of medical materials group. No significant difference was observed in the anxiety scores of children in the control group. In the comparison between groups based on mothers' reports, it was found that the post-test anxiety scores of children in the toys made of medical materials group were significantly lower than those of children in the control group. Our study found that toys made from medical materials were effective in reducing children's anxiety. Healthcare workers can relieve children's anxieties by making toys using medical materials that are easily accessible in the clinic.

Pulmonary involvement in newly diagnosed and untreated rheumatoid arthritis and psoriatic arthritis: a prospective longitudinal study

ObjectivesTo longitudinally assesses pulmonary involvement in newly diagnosed rheumatoid arthritis (RA) and psoriatic arthritis (PsA) patients over a 12-months follow-up. To identify biomarkers and establish a diagnostic algorithm for monitoring pulmonary changes.MethodsNewly diagnosed RA and PsA patients were examined with clinical and laboratory assessments, pulmonary function tests (PFT), and chest radiography (CXR) at three-months intervals for one year.ResultsThe study enrolled 50 patients (26 RA, 24 PsA) and 26 controls. At baseline, 37.0% of arthritis patients (50.0% RA, 22.7% PsA) exhibited radiographic pulmonary involvement, with 64.7% being asymptomatic. No association was observed between CXR and PFTs. Reduced pathological breathing width was noted in 64.0% of patients (RA 69.2%, PsA 58.3%) and 23.1% of controls (p < .001). Thoracic excursion and lung auscultation showed no differences. During follow-up, PFT and physical examination findings remained stable. Mean CRP levels significantly decreased in RA patients from 23.5 mg/l (± 33.6; 95% CI: 9.9–37.1) to 2.7 mg/L (± 3.4; 95% CI: 1.0-4.3), and in PsA patients from 13.3 mg/L (± 18.0; 95% CI: 5.7–20.9) to 8.1 mg/L (± 16.2; 95% CI: 0.1–16.2) (p < .001). Additionally, significant reductions in disease activity scores and improvements in six-minute walking distance were observed (p < .001). No associations were identified between PFT outcomes, disease activity, or rheumatological medications throughout the disease course.ConclusionOur study underscores the prevalence of significant, predominantly asymptomatic pulmonary involvement in newly diagnosed RA and PsA patients. The lack of correlation between pulmonary function, disease activity, and medication during disease progression suggests that reducing arthritic disease activity does not necessarily mitigate the risk or severity of pulmonary involvement. Finally, our finding underscore the need for more sensitive biomarkers and optimized monitoring strategies.

Therapeutic potential of SGLT-2 inhibitors and DDP4 inhibitors in elderly patients with type 2 diabetes mellitus and benign prostatic hyperplasia

Background. Benign prostatic hyperplasia (BPH) has recently been linked to diabetes mellitus and insulin resistance. This study aims to explore whether the use of either sodium-glucose co-transporter-2 (SGLT-2) inhibitors or dipeptidyl peptidase-4 (DPP-4) inhibitors is associated with favorable outcomes in prostate volume and symptoms. Methods. This is a before-and-after study involving 57 elderly male patients with type 2 diabetes mellitus and BPH, who were recruited and followed up for one year. Twenty-seven patients were prescribed SGLT-2 inhibitors (Dapagliflozin 10 mg), and thirty patients were prescribed DPP-4 inhibitors (Sitagliptin 100 mg). Prostate volume, International Prostate Symptom Score (IPSS), and Pittsburgh Sleep Quality Index (PSQI) were assessed in all patients. Results. The use of either SGLT-2 inhibitors or DPP-4 inhibitors was associated with a statistically significant decrease in prostate volume after one year of treatment (p = 0.04 for SGLT-2 inhibitors and p = 0.02 for DPP-4 inhibitors). Statistically significant reductions were found in both groups regarding post-voiding urine volume after one year of treatment compared to baseline levels (p = 0.014 for SGLT-2 inhibitors and p = 0.017 for DPP-4 inhibitors). At the end of the follow-up period, there was a statistically significant reduction in IPSS scores (p = 0.02 for SGLT-2 inhibitors and p = 0.03 for DPP-4 inhibitors). Similarly, the use of either DPP-4 inhibitors or SGLT-2 inhibitors was associated with a statistically significant improvement in nocturia and sleep quality (PSQI score) (p = 0.012 for SGLT-2 inhibitors and p = 0.01 for DPP-4 inhibitors). Post-hoc analysis showed that DPP-4 inhibitors were superior to SGLT-2 inhibitors in reducing prostate volume and symptoms (p &lt; 0.05). Conclusion. Both SGLT-2 inhibitors and DPP-4 inhibitors improve prostate volume and symptoms in patients with diabetes mellitus and BPH. Notably, DPP-4 inhibitors exhibited superiority over SGLT-2 inhibitors in terms of reducing prostate volume and alleviating symptoms. Larger-scale studies are required to confirm these favorable effects.

Comparison of the analgesic efficacy of intra-articular steroid injections and its combination with suprascapular nerve block for adhesive capsulitis of the shoulder joint: a randomized clinical trial

BackgroundAdhesive capsulitis is a distressing ailment that progressively limits the active and passive mobility of the shoulder joint. Physical therapy (PT) combined with intra-articular steroid (IAS) injection and suprascapular nerve...

Assessing the Feasibility and Acceptability of the Daybreak Drink Tracker: Prospective Observational Study.

Excessive alcohol use is associated with significant harms, with wide-ranging social and economic impacts. Efforts to prevent and reduce the harmful use of alcohol are a public health priority. Smartphone apps have the potential to provide accessible and cost-effective support to those seeking to reduce alcohol consumption; however, the evidence base regarding which components are effective is lacking. Self-monitoring is considered as one of the most effective components for behavior change across multiple health domains, yet there is mixed evidence for its role in the alcohol use space. An improved understanding of the use, acceptability, and outcomes of smartphone apps and their inherent components is required to determine their potential role in alcohol behavior change. We investigated the feasibility and acceptability of the Drink Tracker, a novel feature of the commercially available Daybreak (Hello Sunday Morning) app. The Daybreak app is accessible worldwide via major app stores and is offered free of charge to Australian residents. Individuals (aged over 18 years) registering for Daybreak were invited to access the Drink Tracker to monitor their alcohol consumption as part of an uncontrolled observational prospective study. Feasibility was assessed via uptake and frequency of use of the Drink Tracker. Acceptability was measured via participant feedback to determine overall satisfaction, perceived helpfulness, and likelihood of recommending the Drink Tracker to others. Self-reported changes in alcohol consumption (Alcohol Use Disorders Identification Test score) and psychological distress (Kessler Psychological Distress Scale score) at 3-month follow-up were also measured. Preliminary data collected for the first 4 months (October 2023 to February 2024) of the study were reported, including 3-month follow-up outcomes. Feasibility was demonstrated, with almost 70% (2847/4119) of those registering for Daybreak going on to access the Drink Tracker. Of those accessing the Drink Tracker, 71.1% (n=2024) consented to research, comprising the final participant sample. Frequency of use was high, with over half of participants (1112/2024, 54.9%) using the Drink Tracker more than once, and more than one-third (757/2024, 37.4%) using the Drink Tracker more than 5 times. Of the 30 participants completing a 3-month follow-up, acceptability was high, with 73% (n=22) reporting high satisfaction levels with the Drink Tracker overall, 87% (n=26) indicating it was easy to use and rating a mean score of 7.7 (SD 2.8) out of 10 in terms of likelihood of recommending to others. Significant reductions in alcohol consumption (P<.001) and psychological distress scores (P<.001) were observed at the 3-month follow-up. Our results suggest that the Daybreak Drink Tracker is highly feasible and acceptable in supporting individuals accessing commercially available smartphone apps to change their relationship with alcohol. While positive clinical outcomes were observed, the absence of a control group disallows any conclusions with regard to the efficacy of the Drink Tracker. Further testing via a randomized controlled trial is required.

Assessment of Nasal Breathing Function and Tip Definition after the Implementation of the Cephalic Lateral Crural Advancement Flap Technique.

Cephalic trimming of the lower lateral cartilage (LLC) can result in the collapse of the internal and external nasal valves, pinched nose, and alar retraction. The cephalic lateral crural advancement flap (CLCAF) technique is introduced as a method to prevent these complications by avoiding grafts in the LLC. A retrospective study was conducted on 126 open-approach rhinoplasties (82 female and 44 male) employing the CLCAF technique between January 2021 and March 2022. Preoperatively, 20 patients exhibited collapse of the internal nasal valve. CLCAF was performed in all patients following cephalic incision, leaving 7 to 8 mm horizontally and caudally of LLC, and preserving the scroll ligament. The CLCAF was advanced onto the lateral crura to reinforce it and tension the scroll ligament. The Nasal Obstruction Symptom Evaluation (NOSE) scale was used to assess the technique. The average postoperative follow-up period was 14 months. Overall, 114 patients (90.5%) experienced improved nasal breathing on the NOSE scale, and the overall NOSE score significantly decreased from a mean of 30.4 to 14.0 (p < 0.001). A statistically significant reduction in NOSE scores was observed in groups with moderate, severe, and extreme obstruction (p < 0.001), with greater improvement seen in the patients with more severe preoperative nasal breathing obstruction. Postintervention, no patient exhibited collapse of the internal valve, and all patients with preoperative collapse of the internal nasal valve showed an increase of at least 40 points in the NOSE scale. Two patients required revision due to tip asymmetry related to CLCAF. Pinched nose or alar retraction was not observed postoperatively in any patient. The implementation of CLCAF, combined with other techniques, enhances nasal breathing function, prevents the collapse of the internal nasal valve, and leads to optimal nasal tip definition, resulting in a better-shaped and functioning nose.