Study Group Research Articles

The impact of brain MRI screening on stage IV NSCLC patients: A real world look at guidelines based care.

The impact of brain MRI screening on stage IV NSCLC patients: A real world look at guidelines based care.

Flow-cytometric MRD detection in pediatric T-ALL: a multicenter AIEOP-BFM consensus-based guided standardized approach.

Risk-based stratification approaches using measurable residual disease (MRD) successfully help to identify T-acute lymphoblastic leukemia (T-ALL) patients at risk of relapse, whose treatment outcomes are very poor. Because of T-ALL heterogeneity and rarity, a reliable and standardized approach for flow cytometry (FC)-based MRD measurement and analysis is often missing. Within the international AIEOP-BFM-ALL-FLOW study group we made a consensus on markers and a standard operating procedure for common 8- and 12-color T-ALL MRD panels. Custom manufactured tubes with dried backbone antibodies were tested in parallel to local FC standards. Altogether, 66 diagnostic and 67day 15 samples were analyzed. We designed two guided MRD gating strategies to identify blast cells in parallel to expert-based evaluation. We proved that the optimized tubes allowed the correct identification of blast cells in all diagnostic samples. Both, expert and guided analysis of day 15 samples correlated to local standard (Spearman R=0.98 and R=0.94, respectively). Only in 2 (3 %) and 4 (6 %) patients expert gating and guided analysis results were substantially discordant from local standard, respectively. The cases that require an individualized approach may be partially identified at diagnosis through a rare immunophenotype or mixed phenotype acute leukemia status. Our work shows that standardized operating procedures together with guided analysis are applicable in a great majority of T-ALL cases. Further improvement of MRD detection is needed, as in some cases an individualized analytical approach is still required due to the challenging nature of the T-ALL phenotype.

The Aging Substantia Nigra is Characterized by ROS Accumulation Potentially Resulting in Increased Neuroinflammation and Cytoskeletal Remodeling.

Aging is a progressive and irreversible process, serving as the primary risk factor for neurodegenerative disorders. This study aims to identify the molecular mechanisms underlying physiological aging within the substantia nigra, which is primarily affected by Parkinson's disease, and to draw potential conclusions on the earliest events leading to neurodegeneration in this specific brain region. The characterization of essential stages in aging progress can enhance knowledge of the mechanisms that promote the development of Parkinson's disease. To gain a comprehensive overview three study groups are utilized: young individuals (mean age: 28.7 years), middle-aged (mean age: 62.3 years), and elderly individuals (mean age: 83.9 years). Using the proteomic approach, crucial features of physiological aging are able to be identified. These include heightened oxidative stress, enhanced lysosomal degradation, autophagy, remodeling of the cytoskeleton, changes in the structure of the mitochondria, alterations in vesicle transportation, and synaptic plasticity.

Effects of Guarana and Green Tea Consumption on Students’ Intellectual Performances

Background: guarana and green tea are known as compounds that may improve cognitive performance due to their high content of caffeine and other neurostimulants, such as theobromine in the case of guarana and ECGC (apigalocatechin-3-galate) in that of green tea. Methods: this study investigates the effects of Paullinia cupana (guarana) and Camellia sinensis consumption on students’ intellectual performance. The study group consisted of 33 students, mostly women, from various faculties. During the studied period, they consumed 2 g guarana per day for ten days and 1.5 g green tea per day for ten days. The students completed three cognitive tests before and after administration of the products, measuring reaction speed, memory, and attention. They also completed questionnaires regarding health status, product information, product quality, purchase intention, consumer confidence in the product, and perception of effects and preferences. Results and discussion: the results showed that both guarana and green tea fostered significant improvements in cognitive performance. However, more people felt the effect of guarana than the effect of green tea. The study found a strong correlation between cognitive effects and guarana administration, including improvements in energy and retention of information. For green tea, a calming effect and state of well-being were the most relevant responses. Conclusions: the findings suggest that guarana and green tea may constitute a useful strategy for improving academic performance. However, further research is needed to determine optimal doses, frequency of consumption, and potential long-term effects on cognitive function.

Comparison of Skeletal, Dental, and Soft Tissue Changes Before and After Orthodontic Treatment in Patients with Congenitally Missing Bilateral Maxillary Lateral Incisors

(1) Background and Objectives: Congenitally missing bilateral maxillary lateral incisors (CMBMLIs) present significant aesthetic, functional, and psychosocial challenges that require an orthodontic approach based on multidisciplinary consensus. The aim of this study was to evaluate the skeletal, dental, and soft tissue changes in patients with CMBMLIs treated with space opening and closure methods and to compare these changes with those in untreated individuals. (2) Materials and Methods: A total of 53 patients (mean age 16 ± 3.5 years) were included, and three groups were formed: the study groups, consisting of the space opening group (n = 18) and the space closure group (n = 17), and the control group (n = 18), which had ideal occlusion. A total of 14 angular and 13 linear measurements were performed on lateral cephalograms before (T0) and after (T1) treatment. Statistical significance was set at p < 0.05. (3) Results: Compared to the control group, significant post-treatment changes were more evident in dental measurements and less evident in skeletal and soft tissue measurements. A statistically significant increase in the U1/SN angle was observed in the space opening group compared to the space closure group. The U1/NA angle increased significantly in both study groups, with a greater increase in the space opening group. However, although the change in U1/NA angle was not significantly different between groups, the increase was greater in the space opening group. No significant differences were found between the control and study groups in the nasolabial angle, upper lip length and thickness, and the distance from the upper and lower lips to the E-line. (4) Conclusions: While space opening and closure methods had minimal effects on most skeletal and soft tissue parameters, the space opening method significantly altered the maxillary incisor position. Considering the waiting period for prosthetic restoration after space opening and potential alveolar bone limitations, space closure is recommended for CMBMLIs when feasible because it ensures a more predictable planned maxillary incisor position.

Carbetocin Is More Effective in Stabilizing Hemodynamic Parameters Compared to Oxytocin During Cesarean Section

Background/Objectives: First-line uterotonics include carbetocin and oxytocin, which act on the oxytocin receptor with varying potencies. Methods: In 70 pregnant Caucasian women who delivered by cesarean section, the effects of oxytocin and carbetocin on heart rate and blood pressure were compared. The pregnant women were divided into two groups: the OXY group, which received intravenous oxytocin 5 IU on an even day of the month, and the CARBE group, which received intravenous carbetocin 100 µg on an odd day of the month. Blood pressure and heart rate were measured noninvasively every 3 min from the beginning of cesarean section until the lower uterine incision, and then at 1, 2, and 3 min after the fetus and placenta were removed and the uterotonic drugs were discontinued. Subsequent measurements were taken at 3 min intervals until the end of the cesarean procedure. Results: After the administration of uterotonic drugs, a significant decrease in systolic blood pressure was observed only in the group receiving oxytocin at the first (p < 0.0001) and second minute after drug administration (p < 0.0001). Diastolic arterial pressure was significantly different in the study groups at the sixth minute after oxytocin and carbetocin administration (p = 0.004). Mean arterial pressure values were significantly different in the two study groups at the first and sixth minute after drug administration (p = 0.006; p = 0.014). With regard to heart rate, significant differences between the groups were found at 6 min after uterotonic drug administration (p = 0.019). Conclusions: Blood pressure and heart rate variability are significantly higher after oxytocin than after carbetocin administration in women delivering by cesarean section.

To drain or not to drain in minimal invasive ventral hernia surgery

PurposeDespite the high prevalence of ventral hernias worldwide, intraoperative drain placement remains a controversial topic. The benefit in reducing postoperative complications has not yet been clearly demonstrated. This study investigates whether a drain prevents postoperative complications after minimally invasive ventral hernia repair using the extended-totally-extraperitoneal-(eTEP)-technique.MethodsThis monocentric, retrospective cohort study included all patients who underwent eTEP between 2019 and 2024. Two comparison groups were formed (54 patients with drain,106 patients without) and analysed for potential differences.ResultsThere were no significant sociodemographic or clinical differences between the study groups. The defect size was larger in the drain group (drain: 13 cm2 (64,5) †, no-drain: 6,5 cm2 (21) †, p = 0,025). There were no significant differences regarding frequency of postoperative complications (drain: 13%, no-drain: 8,5%, p = 0,373), surgical site infections (SSI) (drain: 0%, no-Drain: 1,9%, p = 0,550), and surgical site occurrences (SSO) (drain: 13%, no-Drain: 4,7%, p = 0,108). A subgroup analysis showed that robotically operated patients were more frequently provided with drains (rob: 30 (47,6%), lap: 24 (24,7%), p = 0,003), had larger defect sizes (rob: 28 cm2 (72)†, lap: 6 cm2 (9,87)†, p < 0,001), and received Transversus-abdominis-releases (TAR) more often (rob: 14 (22,2%), lap: 5 (5,2%), p = 0,001).ConclusionWe found no significant differences between patients with and without drains after eTEP regarding the frequency of postoperative complications, SSOs and SSIs. Our findings do not suggest nor refute that wound drains prevent postoperative complications.

A new era in early childhood education (ECE): Teachers’ opinions on the application of artificial intelligence

Abstract This study aimed to evaluate the role of AI in preschool from the perspective of preschool teachers. The research group consisted of 101 preschool teachers. The study group was selected according to the easily accessible case sampling method, one of the purposeful sampling methods. The study was a phenomenology, which is a qualitative research design. Qualitative data were collected using a semi-structured interview form. Data were analyzed using inductive content analysis. As a result of the analyses, the participants stated they did not feel sufficient regarding Al literacy and competencies. The participants also emphasized that using AI in preschool was appropriate and would improve children’s skills, such as AI literacy and computational thinking. Moreover, they stated that using AI in preschool would cause privacy and security concerns for different reasons, such as not protecting personal data, using children’s pictures, and providing false and misleading information. The participants stated that they were worried about the implementation process of Al due to lack of content knowledge, lack of infrastructure, physical structure of the classroom, and lack of materials. In addition, participants emphasized that if the existing concerns were eliminated, AI could be easily integrated into the preschool period. In addition, it was determined that most participants had problems in modeling and drawing a model related to AI.

In-Hospital Proximal Femoral Fracture Mortality and Anesthesia: Do the First Postoperative 72 h Matter?

Background/Objectives: Proximal femoral fractures (PFFs) are a common worldwide ailment, causing high morbidity and mortality among the elderly, with one-year mortality estimated at 15–30%. This study aimed to identify factors influencing in-hospital patient survival after proximal femoral fracture surgery. Methods: A retrospective cohort study of patients over 65 admitted to an orthopedic surgery department due to a PFF over five years was carried out. Medical records, surgery reports, anesthesia and post-anesthesia care unit sheets, and laboratory archives were reviewed. Results: The study group consisted of 48 patients who died during the first postoperative week, while the control group consisted of 69 patients who were discharged for rehabilitation after a week. The study group was older, less active, and had higher rates of comorbidities. Anesthetic factors, such as the type of anesthesia and admixture of drugs, did not have a significant association with mortality. However, a binary logistic regression showed that age (OR = 1.15, p &lt; 0.001), intraoperative lactate levels (OR = 5.86, p &lt; 0.001), and post-anesthesia care unit (PACU) overnight stays (OR = 17.54, p &lt; 0.001) were significantly associated with early mortality. Conclusions: The study highlights the challenge of identifying PFF patients at risk of early mortality and the need to better understand the decision-making algorithm to create a reliable scale that can predict mortality and adjust treatment. In our study, solid mortality parameters were age and intraoperative lactate levels. The most significant parameter was PACU overnight stay, which represents the anesthesiologist’s soft-skill-based decision that is challenging to scale and reproduce.

Influence of SARS-CoV-2 Infection on the Perioperative Period of Functional Endoscopic Sinus Surgery.

This study was aimed at exploring the safety and timing of functional endoscopic sinus surgery (FESS) in patients after mild-to-moderate SARS-CoV-2 infection. The study group comprised 63 adult inpatients who underwent FESS in our department after mild-to-moderate SARS-CoV-2 infection between December 2022 and February 2023. Sixty adult patients without prior SARS-CoV-2 infection were randomly selected as the control group. The surgical time, intraoperative bleeding, postoperative epithelialization time and postoperative complications in each group were recorded, and statistical analysis was conducted with independent sample t-tests. Statistical analysis of the surgical time, intraoperative bleeding and postoperative epithelialization time showed no statistically significant differences between the study group and control group (p > 0.05). No postoperative complications were observed in either group. FESS is safe and effective for patients after mild-to-moderate SARS-CoV-2 infection if the symptoms have essentially resolved at least 15 days before surgery.

Safety and efficacy of proton pump inhibitors in preterm infants with gastroesophageal reflux disease.

Although physiological reflux is seen in nearly all newborns to varying degrees, symptoms can be severe and cause gastroesophageal reflux disease (GERD). In preterm infants, one symptom that is often attributed to GERD is apnea and associated cardiorespiratory events, such as bradycardia and oxygen desaturation. Although the relationship between GERD and apnea, bradycardia, and desaturation events remains a subject of ongoing investigation, trials of agents that reduce gastric acidity, such as proton pump inhibitors (PPI), have been conducted to assess the effect of these agents on GERD. To assess the benefits and harms of PPIs for the treatment of preterm infants with diagnosed or suspected GERD. We searched CENTRAL, MEDLINE, Embase, two trial registries, and Epistemonikos in October 2023. We checked reference lists of included studies, and studies and systematic reviews in which the subject matter was related to the intervention or population examined in this review. We included randomized controlled trials, quasi-randomized controlled trials, cross-over trials, and cluster-randomized trials that assessed the use of PPIs (including esomeprazole, lansoprazole, omeprazole, pantoprazole, or rabeprazole) alone or in combination. Infants had to receive treatment for a minimum of three days. We considered the following comparisons: (1) PPIs versus no treatment, (2) PPI versus positioning changes (elevated head of bed or prone positioning), (3) PPI versus dietary changes (thickened feeds). We excluded studies examining alginates and histamine receptor blockers. Studies including other non-pharmacological interventions for GERD were included if these interventions were available to infants in all study groups. Two review authors independently identified eligible trials, reviewed the methodological quality of each trial, and extracted data on prespecified outcomes. Data were compared and differences resolved. We used standard methods of Cochrane Neonatal to synthesize data using relative risk (RR), risk difference (RD), and mean difference (MD). After screening 1217 articles, only two studies, enrolling a total of 62 infants, met our criteria. Both studies compared the use of PPIs to no treatment (placebo). One study included ten infants with a mean gestational age of 36.1 ± 0.7 weeks, who were treated with seven days of PPI or placebo, and then crossed over to the other study arm for seven days, with gastric pH monitoring performed at the end of each week. The other study included 52 infants with a mean gestational age of 31 weeks, who were randomized to a PPI or placebo for 14 days, with various outcomes measured at baseline and after 14 days. Both studies were judged to be at low risk of bias. Only one study (N = 52) reported the primary outcome, cardiorespiratory events. The evidence is very uncertain about the effect of PPIs on cardiorespiratory events (MD 6.14 lower, 95% CI 44.51 lower to 32.23 higher). The evidence is very uncertain for the reported secondary outcome measures, including apnea at the end of treatment (MD 0.30 lower, 95% CI 0.93 lower to 0.33 higher), bradycardia at the end of treatment (MD 1.89 higher, 95% CI 1.11 lower to 4.89 higher), desaturation at the end of treatment (MD 7.72 lower, 95% CI 45.86 lower to 30.42 higher), choking at the end of the treatment (MD 0.96 higher, 95% CI 1.88 lower to 3.80 higher), irritability at the end of treatment (MD 0.02 higher, 95% CI 11 lower to 10.96 higher), and vomiting at the end of treatment (MD 0.34 higher, 95% CI 3.15 lower to 3.83 higher). The study was prematurely discontinued due to poor enrollment. One study (N = 10) reported a marked reduction in the percentage of time spent with esophageal acid exposure, with pH < 4. However, there was no effect on the frequency of symptoms. The study sample precludes the ability to extrapolate any significant data. Neither study reported data on length of stay or parental satisfaction. There were insufficient data to perform a meta-analysis. No trials addressed the issue of PPI versus positioning changes, or PPI versus dietary changes (thickened feeds). Although widely used, there are insufficient data regarding the benefits and harms of proton pump inhibitors in preterm infants with gastroesophageal reflux disease. The most limiting factor was the paucity of studies on preterm infants. Even the studies that were included in this review were not limited to preterm infants. Hence, further studies are needed to address the safety and efficacy of proton pump inhibitors for the treatment of diagnosed or suspected gastroesophageal reflux disease in preterm neonates.

Assessment of the Quality of Life of Patients with Diabetes and Prediabetes in Poland: A Cross-Sectional Study

Background: Diabetes mellitus is one of the greatest public health challenges worldwide and one of the major conditions contributing to a poorer quality of life. The main factors that may deteriorate quality of life among patients with diabetes include age, financial status, educational background, quality of healthcare services and presence of disease complications. This study aimed to assess the quality of life among patients with type 1 and type 2 diabetes and prediabetes in Poland using the example of the Podlaskie Province, taking into account selected sociodemographic variables. Methods: A total of 874 patients participated in the study, including 448 women (55.8%) and 386 men (44.2%). The study was conducted from July 2022 to July 2023 among participants of the “Zatrzymaj cukrzycę! Polski Rejestr Diabetologiczny PolReD” (“Stop Diabetes! Polish Diabetes Registry (PolRed)”) project or those hospitalised in the Department of Endocrinology, Diabetology and Internal Medicine at the University Clinical Hospital in Bialystok. The study used a diagnostic survey method using a survey questionnaire developed by the authors and the 36-Item Short Form Survey (SF-36). Results: The overall study group had the highest level of quality of life assessment in the domains of social functioning (M = 69.48; SD ± 28.07), physical functioning (M = 64.54; SD ± 31.57) and role limitations due to emotional problems (M = 62.40; SD ± 45.21), and the lowest level of quality of life in the domain of general health perceptions (M = 42.21; SD ± 12.77). Age was found to be negatively correlated in all quality of life domains analysed (r = −0.438; p &lt; 0.001)—quality of life decreased with age in all investigated domains. Men had a statistically significantly (p &lt; 0.05) higher quality of life in each analysed domain (M = 43.52–74.08; SD ± 12.68–44.09) compared to women (M = 41.18–65.88; SD ± 12.76–46.08). Place of residence also exhibited a statistically significant (p &lt; 0.05) differentiated quality of life in terms of physical functioning. Conclusions: The assessment of quality of life among patients with type 1 and type 2 diabetes and those diagnosed with prediabetes from the Podlaskie Province depends on the type of hyperglycaemic disorder. The assessment of quality of life among patients with type 1 and type 2 diabetes and prediabetes is determined by specific socio-demographic factors, including, above all, age and gender. Respondents with type 1 diabetes have a higher quality of life in terms of role limitations due to physical health, role limitations due to emotional problems, pain (bodily pain) and general health compared to respondents with type 2 diabetes.

A Study on Correlation of Depression among Diabetic Population in a Tertiary Care Hospital in Eastern India

Background of the study : Diabetes Mellitus is a chronic disease which affects almost every organ in the human system. Depression is found to bequiet common among diabetic population, and it can be associated with bad prognosis. This study was taken up to find out the correlation of different components of depression with diabetes . Methodology: 200 diagnosed cases of diabetes were selected according to the inclusion criteria attending the OPD, Department of Medicine of a tertiary care hospital in eastern India.. Then, they were assessed for any risk of depression in the Department of Psychiatry and relevant investigations were done. Results &amp; Conclusion : The analysis showed that certain factors related to diabetes can subsequently cause depression. More studies are required to establish the findings with a larger group of study and time frame.

Can prosocial behavior buffer symptom severity and impairment in children and adolescents with ADHD symptoms in a clinical setting?

BackgroundMost research in children with ADHD has focused on risk factors and their outcomes, such as symptom severity as a risk factor for functional impairment. Yet, a small group of studies show that some children function well despite their symptom severity. Preliminary evidence suggests that social protective factors may protect children with ADHD against its negative impact across different domains. The purpose of this study was to evaluate whether prosocial behavior, as a protective factor, buffers the effects of symptoms on impairment in children and adolescents with ADHD symptoms.MethodsIn this cross-sectional study, we used routinely collected data from the Development and Well-Being Assessment (DAWBA). Reports were included from 822 mothers, 581 fathers, and 1109 teachers, who provided information on the children’s symptoms, impairment and prosocial behavior (aged 5–18). To examine the effects of prosocial behavior on the relationship between symptoms and functional impairment, multiple regression analyses were conducted using data from these three perspectives.ResultsAlthough we did not find buffering effects, regression analyses revealed that parent- and teacher-reported prosocial behavior demonstrated promotive effects on functional impairment, indicating that prosocial behavior may be beneficial in reducing impairment on daily life of children with ADHD. These results were consistent across raters and age-groups, except the mother-rated model for adolescents. Additionally, when investigating these effects by gender, we found that higher prosocial behavior, as observed by fathers, was related to lower impairment for girls.ConclusionOur results suggest that prosocial behavior should be considered in clinical practice when evaluating impairment scores for ADHD. Finally, our findings plead for more in-depth measures of social protective factors and across different levels, including individual, family, and community levels. This approach will help identify factors that, independently of risks, may positively impact the functioning of these children.

Experience of the surgeon affects the success rate of the placement of orthodontic miniplates.

Skeletal Class III patients can be treated with bone anchored maxillary protraction (BAMP) treatment. The placement of miniplates is an invasive operation and needs to be carried out under general anesthesia. The aim of this retrospective study was to determine the failure rate of miniplates. All the patients who had miniplates placed for BAMP treatment between January 2010 and April 2020 in Department of Oral and Maxillofacial Diseases, Helsinki University Hospital, Finland were included in this study. The patient records were retrospectively screened. The success rate of the placement of orthodontic miniplates was evaluated between surgical residents (Group 1) and consultant surgeons (Group 2). The study group consisted of 164 miniplates in 42 patients. The miniplates were divided into two groups, depending on the placement operator. Group 1 consisted of 86 miniplates placed by surgical residents. Group 2 consisted of 78 miniplates placed by consultant surgeons. In Group 1 (11 females, 14 males) and Group 2 (16 females, 9 males). The overall failure rate of miniplates was 23.8% (n = 39). The failure rate for surgical residents (Group 1) was 31.4% (n = 27) and for consultant surgeons (Group 2), 15.3% (n = 12) (p < 0.05). Out of all the failed miniplates 69.2% (n = 27) were placed by residents and 30.8% (n = 12) by consultants. This retrospective study consisted of a limited number of patients. The failure rate of miniplates placed by consultant surgeons was lower compared to surgical residents (p < 0.05).

Endoplasmic Reticulum-Dependent Apoptotic Response to Cellular Stress in Patients with Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a chronic, common autoimmune disease. It is characterized by inflammatory polyarthritis, which can lead to permanent disability in patients. Current treatment is mainly symptom-related, aiming to reduce pain and inflammation, but does not lead to a full recovery. This treatment includes non-steroidal anti-inflammatory drugs (NSAIDs) and disease-modifying anti-rheumatic drugs (DMARDs). It has been shown that, due to chronic inflammation, reduced glucose levels and hypoxia, endoplasmic reticulum (ER) stress is induced in RA patients, leading to the activation of multiple signaling pathways, including the ER-dependent adaptation of the unfolded protein response (UPR) pathway. The aim of this study was to assess the level of apoptosis in patients diagnosed with RA. The study sought to investigate whether UPR response correlated with apoptosis induction could serve as a potential diagnostic marker or therapeutic target. In vitro studies have shown that UPR pathway activity can be observed in patients diagnosed with RA. The study group consisted of PBMC cells from 61 individuals, including a total of 31 rheumatoid arthritis patients and 30 healthy controls. In order to validate UPR activation, we estimated molecular markers of ER stress via RT-qPCR expression analysis. GAPDH expression was used as a standard control. Elevated levels of mRNA for the eIF2α (p-value = 0.001903), the BBC3 (PUMA) (p-value = 0.007457 × 10−7) and the TP53 (p-value = 0.002212) were confirmed in a group of RA patients. Further analysis showed that after the induction of apoptosis the percentage of DNA contained in the tail was 37.78% higher in RA patients than in the control group (p-value = 0.0003) measured by comet assay. The exogenous damage caused by hydrogen peroxide was found to be statistically elevated in RA patients and the caspase-3 level was calculated of 40.17% higher than in controls (p-value = 0.0028). It was also found that PBMC cells from RA patients were more sensitive to apoptotic induction. Our results were confirmed by flow cytometry. The most important finding from our data was the confirmation of elevated sensitivity to apoptosis induction in RA patients; the results showed a 40.23% higher percentage of cells in early apoptosis than in the control group (p-value = 0.0105). Our results may help to assess the feasibility of the application of early diagnosis and targeted therapy in the treatment of RA patients, including the ER signaling pathway via selected UPR-dependent molecular inhibitors.

Prevention and Nursing Experience of Complications in Advanced Lung Cancer

Objective: To study the measures and effects of advanced lung cancer patients in terms of complication prevention and care. Methods: 50 cases of advanced lung cancer patients were selected for data study during January–December 2023, where the patients were divided into two groups. The study group used complication prevention and nursing care, while the control group used conventional care. The differences between the groups were compared. Results: Compared with the control group, the study group had significantly fewer complications, significantly lower psychological state scores, significantly higher quality of life scores, and significantly lower pain scores (P &lt; 0.05). Comparing the psychological state scores, quality of life scores, and pain scores before care, both groups showed insignificant differences (P &gt; 0.05). Conclusion: The results of patients with advanced lung cancer are ideal after the application of measures in the area of complication prevention and care.

Efficacy and safety of medroxyprogesterone acetate on noninvasive ventilation -treated exacerbated COPD patients: a double-blind randomized clinical trial

BackgroundIn acute exacerbation periods of chronic obstructive pulmonary disease (COPD), patients may experience hypoxemia or hypercapnia. Noninvasive ventilation (NIV) and respiratory stimulant drugs are used to treat this condition. Medroxyprogesterone acetate (MPA) can cross the blood-brain barrier and cause breathing stimulation and hyperventilation. This study was conducted to investigate the effectiveness of MPA in hypercapnic exacerbated COPD patients and the possibility of faster weaning of patients from NIV.Materials and methodsThis double-blind clinical trial was conducted on consecutive exacerbated COD patients referred to Shahid Rahnemoun Hospital, Yazd, Iran, from February 2022 to August 2022. Through a block randomized sampling method with a 1:1 allocation ratio, 58 eligible patients with hypercapnic exacerbated COPD on NIV were divided into two study groups: the intervention (treated with MPA 10 mg every 8 h) and the control (treated with placebo). The clinical and arterial blood gas (ABG) parameters were investigated in both groups.ResultsOut of 50 patients, 27 and 23 intervention and control arms cases were analyzed. Although there was a significant difference in the amount of ABG parameters during the study in each group, there was no statistically significant difference between the two groups. Also, There was no significant difference in the total weaning rate of the patients in the two groups. Despite the higher number of early weaning in the MPA group, no significant difference was reported between the two groups in this regard. In addition, there was no difference between the two groups in the rate of ICU hospitalization, the length of stay of hospitalization and ICU, and the mortality rate.ConclusionThe administration of MPA has not improved clinical and laboratory results, and MPA is not superior to placebo in the weaning process of patients undergoing NIV.Trial registrationIRCT20190810044500N21 (01/02/2022), (https//irct.behdasht.gov.ir/user/trial/59402/view)

Prevalence of Rheumatic Heart Disease in First-degree Relatives of Index-cases: A Systematic Review and Meta-Analysis

Background: Rheumatic heart disease (RHD) is the leading cause of cardiac death in children, with over 300,000 annual fatalities. Immunological, genetic, and environmental factors contribute to an increased risk of RHD. It remains unclear whether first-degree relatives have a higher RHD prevalence than the regional average. Methods: We performed a systematic review and meta-analysis of echocardiographic screening studies reporting the prevalence of RHD in family members of individuals with RHD or acute rheumatic fever. PubMed, Embase, Cochrane, and Lilacs databases were searched. Finding Forrester RHD was classified as per the 2012 World Heart Federation criteria. Random-effects models assessed definite RHD prevalence in study groups. Results: Four of the 1160 studies were included, with 776 first-degree relatives screened. Two studies were from Africa, one from South America, and one from Oceania. In the first-degree relatives of index cases, the prevalence of RHD was 7% (95% confidence interval [CI] 3.7-13). The control group, individuals screened with no known RHD cases in their family, had a lower prevalence than first-degree relatives (risk ratio [RR] 0.44, 95% CI 0.26-0.75). There was no difference in the prevalence of RHD among siblings and parents of cases. Conclusion: RHD prevalence in first-degree relatives of index cases was more significant than the There is an overall prevalence of non-relatives from the respective region, which suggests that genetic predisposition may play a role. In future studies of RHD, the systematic screening of first-degree relatives should be considered with a better control group—socioeconomic, region, age, and sex-matched.

Efficacy of milrinone plus sildenafil in the treatment of neonates with persistent pulmonary hypertension: A single center, randomized controlled trial from a resource limited setting.

Objective: To compare the outcomes of milrinone plus sildenafil versus sildenafil alone in the treatment of persistent pulmonary hypertension (PPH) in neonates. Study Design: Randomized Controlled Trial. Setting: Department of Neonatology, The Children’s Hospital and Institute of Child Health, Multan, Pakistan. Period: December 2023 to May 2024. Methods: A total of 42 neonates, diagnosed to have PPH were enrolled. Neonates were randomized to either oral sildenafil monotherapy (n=21) or oral sildenafil and intravenous (IV) milrinone (n=21). Primary outcome was decrease in pulmonary artery systolic pressure (PASP). Secondary outcomes were improvement in oxygen saturation, duration of hospitalization, treatment related side effects, and mortality. Results: In a total of 42 neonates, 25 (59.5%) were boys. The mean age at the time of enrollment was 9.63±3.51 days. The mean PASP at the time of enrollment was 55.73±7.91 mmHg. PASP was statistically similar at baseline (p=0.5512), and day-3 (p=0.2163). At day-7, PASP was significantly reduced in sildenafil plus milrinone group was reported in comparison sildenafil group (37.62±8.04 mmHg vs. 42.92±8.25 mmHg, p=0.0413). SPO2, mortality, and post-treatment complications were statistically similar among neonates of both study groups. The duration of hospitalization was significantly less among neonates of sildenafil plus milrinone group vs. sildenafil group (13.58±2.93 days vs. 16.82±4.24 days, p=0.0063). Conclusion: Combined oral sildenafil and IV milrinone was more efficacious than sildenafil alone in reducing pulmonary arterial pressure.