Pub Date : 2024-01-01DOI: 10.1016/j.clinsp.2024.100407
Hao Li
Background
NSCLC is one of the most common causes of death. The hypoxia microenvironment contributes to cancer progression. The purpose was to explore the effects and mechanism of melittin on NSCLC cells in the hypoxic microenvironment.
Methods
NSCLC cell lines (A549 and H1299) were cultured in normoxia or hypoxia conditions with or without melittin treatment. The viability of the cells was detected via MTT assay and the proliferation ability was evaluated by EdU assay. QRT-PCR was performed to evaluate GLUT1, LDHA, HK2, VEGF and LATS2 mRNA levels. Glucose transport was assessed by the 2-NBDG uptake assay. The angiogenesis was determined by the tubule formation assay. The protein expressions of GLUT1, LDHA, HK2, VEGF, LATS2, YAP, p-YAP and HIF-1α were detected via western blotting assay. The tumor formation assay was conducted to examine the roles of melittin and LATS2 in vivo.
Results
Melittin inhibited hypoxia-induced cell viability, proliferation, glycolysis and angiogenesis as well as suppressed YAP binding to HIF-1α in NSCLC. Melittin inactivated the YAP/HIF-1α pathway via up-regulation of LATS2, ultimately inhibiting cancer progression of NSCLC. Moreover, melittin suppressed tumor growth via up-regulation of LATS2 in vivo.
Conclusion
Melittin inactivated the YAP/HIF-1α pathway via up-regulation of LATS2 to contribute to the development of NSCLC. Therefore, melittin is expected to become a potential prognostic drug for the therapy of NSCLC.
{"title":"Melittin inactivates YAP/HIF-1α pathway via up-regulation of LATS2 to inhibit hypoxia-induced proliferation, glycolysis and angiogenesis in NSCLC","authors":"Hao Li","doi":"10.1016/j.clinsp.2024.100407","DOIUrl":"10.1016/j.clinsp.2024.100407","url":null,"abstract":"<div><h3>Background</h3><p>NSCLC is one of the most common causes of death. The hypoxia microenvironment contributes to cancer progression. The purpose was to explore the effects and mechanism of melittin on NSCLC cells in the hypoxic microenvironment.</p></div><div><h3>Methods</h3><p>NSCLC cell lines (A549 and H1299) were cultured in normoxia or hypoxia conditions with or without melittin treatment. The viability of the cells was detected via MTT assay and the proliferation ability was evaluated by EdU assay. QRT-PCR was performed to evaluate GLUT1, LDHA, HK2, VEGF and LATS2 mRNA levels. Glucose transport was assessed by the 2-NBDG uptake assay. The angiogenesis was determined by the tubule formation assay. The protein expressions of GLUT1, LDHA, HK2, VEGF, LATS2, YAP, p-YAP and HIF-1α were detected via western blotting assay. The tumor formation assay was conducted to examine the roles of melittin and LATS2 <em>in vivo</em>.</p></div><div><h3>Results</h3><p>Melittin inhibited hypoxia-induced cell viability, proliferation, glycolysis and angiogenesis as well as suppressed YAP binding to HIF-1α in NSCLC. Melittin inactivated the YAP/HIF-1α pathway via up-regulation of LATS2, ultimately inhibiting cancer progression of NSCLC. Moreover, melittin suppressed tumor growth via up-regulation of LATS2 <em>in vivo</em>.</p></div><div><h3>Conclusion</h3><p>Melittin inactivated the YAP/HIF-1α pathway via up-regulation of LATS2 to contribute to the development of NSCLC. Therefore, melittin is expected to become a potential prognostic drug for the therapy of NSCLC.</p></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S180759322400084X/pdfft?md5=3af4cd7e13811d82b575ae2cd2a47a03&pid=1-s2.0-S180759322400084X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141418126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.1016/j.clinsp.2024.100427
Anne C. Gomes , George B. Coura Filho , Luiz A. Gil Junior , Renato A. Caires , Emmanuel A. Burdmann , Carlos A. Buchpiguel , Veronica T. Costa e Silva , Marcelo T. Sapienza
Objectives
[51Cr]CrEDTA is used to measure the Glomerular Filtration Rate (GFR) in different clinical conditions. However, there is no consensus on the ideal number of blood samples to be taken and at what time points to measure its clearance. This study aimed to compare Slope Intercept (SI) and Single-Sample (SS) methods for measuring GFR in patients with solid tumors, stratified by age, GFR, and Body Mass Index (BMI).
Methods
1,174 patients with cancer were enrolled in this prospective study. GFR was calculated by the SI method using blood samples drawn 2-, 4-, and 6-hours after [51Cr]CrEDTA injection (246-GFR). GFR was also measured using the SI method with samples at 2 and 4 hours (24-GFR) and at 4 and 6 hours (46-GFR), and SS methods according to Groth (4Gr-GFR) and Fleming (4Fl-GFR). Statistical analysis was performed to assess the accuracy, precision, and bias of the methods.
Results
Mean 246-GFR was 79.2 ± 21.9 mL/min/1.73 m2. ANOVA indicated a significant difference between 4Gr-GFR and the reference 246-GFR. Bias was lower than 5 mL/min/1.73 m2 for all methods, except for SS methods in subgroups BMI > 40 kg/m2; GFR > 105 or < 45. Precision was adequate and accuracy of 30 % was above 98% for all methods, except for SS methods in subgroup GFR < 45.
Conclusion
46-GFR and 246-GFR have high agreement and may be used to evaluate kidney function in patients with solid tumors. Single-sample methods can be adopted in specific situations, for non-obese patients with expected normal GFR.
目的:[51Cr]CrEDTA 可用于测量不同临床情况下的肾小球滤过率(GFR)。然而,对于测量其清除率所需的理想血液样本数量和时间点,目前还没有达成共识。本研究旨在比较测量实体瘤患者 GFR 的斜率截距法(SI)和单样本法(SS),并根据年龄、GFR 和体重指数(BMI)进行分层。在注射[51Cr]CrEDTA(246-GFR)后 2、4 和 6 小时抽取血样,采用 SI 法计算 GFR。此外,还使用 SI 法测量了 2 小时和 4 小时(24-GFR)以及 4 小时和 6 小时(46-GFR)的样本,并根据 Groth 法(4Gr-GFR)和 Fleming 法(4Fl-GFR)测量了 SS 法。对这些方法的准确性、精确性和偏差进行了统计分析:结果:246-GFR 平均值为 79.2 ± 21.9 mL/min/1.73 m2。方差分析表明,4Gr-GFR 与参考 246-GFR 之间存在明显差异。所有方法的偏差均低于 5 mL/min/1.73 m2,但在 BMI > 40 kg/m2; GFR > 105 或 < 45 的亚组中,SS 方法除外。除 GFR < 45 亚组的 SS 方法外,所有方法的精确度都足够高,30% 的准确度高于 98%:46-GFR和246-GFR的一致性很高,可用于评估实体瘤患者的肾功能。在特殊情况下,对于预期 GFR 正常的非肥胖患者,可采用单样本方法。
{"title":"Comparison of plasma clearance of [51Cr]CrEDTA based on three, two and single samples to measure the glomerular filtration rate in patients with solid tumors: a prospective cross-sectional analysis","authors":"Anne C. Gomes , George B. Coura Filho , Luiz A. Gil Junior , Renato A. Caires , Emmanuel A. Burdmann , Carlos A. Buchpiguel , Veronica T. Costa e Silva , Marcelo T. Sapienza","doi":"10.1016/j.clinsp.2024.100427","DOIUrl":"10.1016/j.clinsp.2024.100427","url":null,"abstract":"<div><h3>Objectives</h3><p>[<sup>51</sup>Cr]CrEDTA is used to measure the Glomerular Filtration Rate (GFR) in different clinical conditions. However, there is no consensus on the ideal number of blood samples to be taken and at what time points to measure its clearance. This study aimed to compare Slope Intercept (SI) and Single-Sample (SS) methods for measuring GFR in patients with solid tumors, stratified by age, GFR, and Body Mass Index (BMI).</p></div><div><h3>Methods</h3><p>1,174 patients with cancer were enrolled in this prospective study. GFR was calculated by the SI method using blood samples drawn 2-, 4-, and 6-hours after [<sup>51</sup>Cr]CrEDTA injection (246-GFR). GFR was also measured using the SI method with samples at 2 and 4 hours (24-GFR) and at 4 and 6 hours (46-GFR), and SS methods according to Groth (4Gr-GFR) and Fleming (4Fl-GFR). Statistical analysis was performed to assess the accuracy, precision, and bias of the methods.</p></div><div><h3>Results</h3><p>Mean 246-GFR was 79.2 ± 21.9 mL/min/1.73 m<sup>2</sup>. ANOVA indicated a significant difference between 4Gr-GFR and the reference 246-GFR. Bias was lower than 5 mL/min/1.73 m<sup>2</sup> for all methods, except for SS methods in subgroups BMI > 40 kg/m<sup>2</sup>; GFR > 105 or < 45. Precision was adequate and accuracy of 30 % was above 98% for all methods, except for SS methods in subgroup GFR < 45.</p></div><div><h3>Conclusion</h3><p>46-GFR and 246-GFR have high agreement and may be used to evaluate kidney function in patients with solid tumors. Single-sample methods can be adopted in specific situations, for non-obese patients with expected normal GFR.</p></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1807593224001042/pdfft?md5=b0dc14970dc906a28748994c3cd941e0&pid=1-s2.0-S1807593224001042-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141466650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.1016/j.clinsp.2024.100482
{"title":"Resource management strategies for prioritizing non-scheduled surgical procedures in a tertiary public hospital","authors":"","doi":"10.1016/j.clinsp.2024.100482","DOIUrl":"10.1016/j.clinsp.2024.100482","url":null,"abstract":"","PeriodicalId":10472,"journal":{"name":"Clinics","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1807593224001595/pdfft?md5=a3822d665fe323dad9780354684bbe16&pid=1-s2.0-S1807593224001595-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142097429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.1016/j.clinsp.2024.100340
Lindson Mühlmann, Franklin Fernandes Pimentel, Daniel Guimarães Tiezzi, Hélio Humberto Angotti Carrara, Jurandyr Moreira de Andrade, Francisco José Candido dos Reis
Objectives
The COVID-19 pandemic has had a significant global impact since its declaration in March 2020. The COVID-19 pandemic has disproportionately impacted cancer patients, particularly those with breast cancer. This study aims to analyze the effects of the pandemic on women diagnosed with breast cancer recurrence.
Methods
A cohort study was conducted at a tertiary public hospital in São Paulo State, Brazil. Data were collected from electronic records. Patients diagnosed with breast cancer and experiencing recurrence between January 2011 and March 2022 were included. Survival analysis was performed using the Kaplan-Meier estimator and Cox regression.
Results
The study included 187 patients, 45 in the pandemic group (recurrence after March 23, 2020) and 142 in the pre-pandemic group. Distant recurrences were more frequent in both groups (pre-pandemic: 62.7 %, pandemic: 75.5 %). Compared to the pre-pandemic group (1.8 years), the pandemic group experienced a longer mean time to recurrence detection (2.9 years) and significantly decreased median survival (9 months vs. 22 months). The Cox regression analysis confirmed an increased risk of death for women diagnosed with breast cancer recurrence during the pandemic period (HR = 1.92, 95 % CI 1.19‒3.12).
Conclusion
The present study is among the first to investigate the pandemic's specific effects on breast cancer recurrence, revealing concerning delays in detection and a decrease in survival rates. Prompt diagnosis, timely treatment initiation, and comprehensive support are crucial during public health crises. These findings urge healthcare systems to prioritize tailored care for breast cancer patients during pandemics.
{"title":"Delayed diagnosis and increased mortality risk: Assessing the effects of the COVID-19 pandemic on breast cancer recurrence","authors":"Lindson Mühlmann, Franklin Fernandes Pimentel, Daniel Guimarães Tiezzi, Hélio Humberto Angotti Carrara, Jurandyr Moreira de Andrade, Francisco José Candido dos Reis","doi":"10.1016/j.clinsp.2024.100340","DOIUrl":"https://doi.org/10.1016/j.clinsp.2024.100340","url":null,"abstract":"<div><h3>Objectives</h3><p>The COVID-19 pandemic has had a significant global impact since its declaration in March 2020. The COVID-19 pandemic has disproportionately impacted cancer patients, particularly those with breast cancer. This study aims to analyze the effects of the pandemic on women diagnosed with breast cancer recurrence.</p></div><div><h3>Methods</h3><p>A cohort study was conducted at a tertiary public hospital in São Paulo State, Brazil. Data were collected from electronic records. Patients diagnosed with breast cancer and experiencing recurrence between January 2011 and March 2022 were included. Survival analysis was performed using the Kaplan-Meier estimator and Cox regression.</p></div><div><h3>Results</h3><p>The study included 187 patients, 45 in the pandemic group (recurrence after March 23, 2020) and 142 in the pre-pandemic group. Distant recurrences were more frequent in both groups (pre-pandemic: 62.7 %, pandemic: 75.5 %). Compared to the pre-pandemic group (1.8 years), the pandemic group experienced a longer mean time to recurrence detection (2.9 years) and significantly decreased median survival (9 months vs. 22 months). The Cox regression analysis confirmed an increased risk of death for women diagnosed with breast cancer recurrence during the pandemic period (HR = 1.92, 95 % CI 1.19‒3.12).</p></div><div><h3>Conclusion</h3><p>The present study is among the first to investigate the pandemic's specific effects on breast cancer recurrence, revealing concerning delays in detection and a decrease in survival rates. Prompt diagnosis, timely treatment initiation, and comprehensive support are crucial during public health crises. These findings urge healthcare systems to prioritize tailored care for breast cancer patients during pandemics.</p></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1807593224000176/pdfft?md5=ced412690f70a794895aff67023e78e2&pid=1-s2.0-S1807593224000176-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140014204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.1016/j.clinsp.2024.100351
Bruno Henrique Alvarenga , Izabel Cristina Rios , Francisco de Salles Collet e Silva , Edivaldo Massazo Utiyama
Objective
To evaluate whether the rate of surgical complications is higher during the first semester of the General Surgery residency in the largest hospital complex in Latin America. During this period, students are expected to have less experience in carrying out procedures.
Methods
During a period of two years, all General Surgery resident doctors at the Hospital das Clínicas of the Faculty of Medicine of the University of São Paulo, made a notification of all the procedures they performed (n = 14.063), containing information such as name of the procedure, date, who participated, complications, among others. These data were analyzed with the purpose of evaluating the variation in the rate of complications throughout the year.
Results
There was a 52 % increase in the rate of complications in the first academic semester when compared to the second semester. This phenomenon was observed in resident doctors in the first and second years of residency. Furthermore, it was observed that second-year residents remain with high rates of complications, in some procedures, for a longer time than first-year residents. Furthermore, the first three months (March, April and May) seem to have the highest complication rates of the entire year.
Conclusion
The impact of these complications can affect several health services and the increase in surgical complications in the first half of the year must be monitored by institutions, in order to control this phenomenon.
目的评估拉丁美洲最大综合医院的普通外科住院医生在第一学期的手术并发症发生率是否较高。方法在两年时间里,圣保罗大学医学院附属医院(Hospital das Clínicas of the Faculty of Medicine)的所有普外科住院医生都将他们实施的所有手术(n = 14.063)记录在案,其中包括手术名称、日期、参与人员、并发症等信息。对这些数据进行了分析,目的是评估全年并发症发生率的变化情况。结果第一学期的并发症发生率比第二学期增加了 52%。这一现象在第一年和第二年的住院医生中均有观察到。此外,还观察到二年级住院医生在某些手术中并发症发生率较高的时间比一年级住院医生长。此外,前三个月(3 月、4 月和 5 月)的并发症发生率似乎是全年最高的。
{"title":"Surgical complications in the first and second semesters of the general surgery medical residence. A study of 14063 cases","authors":"Bruno Henrique Alvarenga , Izabel Cristina Rios , Francisco de Salles Collet e Silva , Edivaldo Massazo Utiyama","doi":"10.1016/j.clinsp.2024.100351","DOIUrl":"https://doi.org/10.1016/j.clinsp.2024.100351","url":null,"abstract":"<div><h3>Objective</h3><p>To evaluate whether the rate of surgical complications is higher during the first semester of the General Surgery residency in the largest hospital complex in Latin America. During this period, students are expected to have less experience in carrying out procedures.</p></div><div><h3>Methods</h3><p>During a period of two years, all General Surgery resident doctors at the Hospital das Clínicas of the Faculty of Medicine of the University of São Paulo, made a notification of all the procedures they performed (<em>n</em> = 14.063), containing information such as name of the procedure, date, who participated, complications, among others. These data were analyzed with the purpose of evaluating the variation in the rate of complications throughout the year.</p></div><div><h3>Results</h3><p>There was a 52 % increase in the rate of complications in the first academic semester when compared to the second semester. This phenomenon was observed in resident doctors in the first and second years of residency. Furthermore, it was observed that second-year residents remain with high rates of complications, in some procedures, for a longer time than first-year residents. Furthermore, the first three months (March, April and May) seem to have the highest complication rates of the entire year.</p></div><div><h3>Conclusion</h3><p>The impact of these complications can affect several health services and the increase in surgical complications in the first half of the year must be monitored by institutions, in order to control this phenomenon.</p></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1807593224000280/pdfft?md5=20f4c9d435c4ebd0a5f74306894cc243&pid=1-s2.0-S1807593224000280-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140344805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.1016/j.clinsp.2024.100349
Ze-Ming Zhang, Na Zhang, Xiao-Fei Wang
Background
This study aimed to identify prognostic factors for pregnancy outcomes and construct a prognostic model for pregnancy outcomes in women with Recurrent Spontaneous Abortions (RSA) treated with cyclosporin A.
Methods
A total of 154 RSA patients treated with cyclosporin A between October 2016 and October 2018 were retrospectively recruited. Multivariate logistic regression was applied to identify the prognostic factors for pregnancy success in RSA women treated with cyclosporin A. The Receiver Operating Characteristic (ROC) curve was applied to construct prognostic value, and the prognostic performance was assessed using area under the ROC.
Results
After adjusting potential confounding factors, the authors noted increased age (OR = 0.771; 95 % CI 0.693‒0.858; p < 0.001) and positive antinuclear antibodies (OR = 0.204; 95 % CI 0.079‒0.526; p = 0.001) were associated with a reduced incidence of pregnancy success, while positive anti-β2 glycoprotein-I-antibody (OR = 21.941; 95 % CI 1.176‒409.281; p = 0.039) was associated with an increased incidence of pregnancy success after treated with cyclosporin A. The AUC of combining these variables for predicting pregnancy failure was 0.809 (95 % CI 0.735‒0.880).
Conclusions
This study systematically identified the prognostic factors for pregnancy success in women treated with cyclosporin A, and the constructed prognostic model based on these factors with relatively higher prognostic value. Further large-scale prospective studies should be performed to validate the prognostic value of the constructed model.
背景本研究旨在确定接受环孢素A治疗的复发性自发性流产(RSA)妇女的妊娠结局预后因素,并构建妊娠结局预后模型。方法回顾性招募2016年10月至2018年10月期间接受环孢素A治疗的154例RSA患者。应用多变量逻辑回归确定接受环孢素A治疗的RSA女性妊娠成功的预后因素,应用接收者操作特征曲线(ROC)构建预后值,并使用ROC下面积评估预后性能。结果在调整了潜在的混杂因素后,作者发现年龄增加(OR = 0.771; 95 % CI 0.693-0.858; p < 0.001)和抗核抗体阳性(OR = 0.204; 95 % CI 0.079-0.526; p = 0.001)与妊娠成功率降低有关,而抗β2糖蛋白-I-抗体阳性(OR = 21.941; 95 % CI 1.176-409.281; p = 0.039)与环孢素A治疗后妊娠成功率增加有关。结论 该研究系统地确定了环孢素 A 治疗妇女妊娠成功的预后因素,并根据这些因素构建了具有相对较高预后价值的预后模型。应进一步开展大规模前瞻性研究,以验证所构建模型的预后价值。
{"title":"Prognostic model on pregnancy outcomes for women with recurrent spontaneous abortions treated with cyclosporin A: A single-institution experience","authors":"Ze-Ming Zhang, Na Zhang, Xiao-Fei Wang","doi":"10.1016/j.clinsp.2024.100349","DOIUrl":"https://doi.org/10.1016/j.clinsp.2024.100349","url":null,"abstract":"<div><h3>Background</h3><p>This study aimed to identify prognostic factors for pregnancy outcomes and construct a prognostic model for pregnancy outcomes in women with Recurrent Spontaneous Abortions (RSA) treated with cyclosporin A.</p></div><div><h3>Methods</h3><p>A total of 154 RSA patients treated with cyclosporin A between October 2016 and October 2018 were retrospectively recruited. Multivariate logistic regression was applied to identify the prognostic factors for pregnancy success in RSA women treated with cyclosporin A. The Receiver Operating Characteristic (ROC) curve was applied to construct prognostic value, and the prognostic performance was assessed using area under the ROC.</p></div><div><h3>Results</h3><p>After adjusting potential confounding factors, the authors noted increased age (OR = 0.771; 95 % CI 0.693‒0.858; <em>p</em> < 0.001) and positive antinuclear antibodies (OR = 0.204; 95 % CI 0.079‒0.526; <em>p</em> = 0.001) were associated with a reduced incidence of pregnancy success, while positive anti-β2 glycoprotein-I-antibody (OR = 21.941; 95 % CI 1.176‒409.281; <em>p =</em> 0.039) was associated with an increased incidence of pregnancy success after treated with cyclosporin A. The AUC of combining these variables for predicting pregnancy failure was 0.809 (95 % CI 0.735‒0.880).</p></div><div><h3>Conclusions</h3><p>This study systematically identified the prognostic factors for pregnancy success in women treated with cyclosporin A, and the constructed prognostic model based on these factors with relatively higher prognostic value. Further large-scale prospective studies should be performed to validate the prognostic value of the constructed model.</p></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1807593224000267/pdfft?md5=2a622b7dd91612194c805cf1d57a1907&pid=1-s2.0-S1807593224000267-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140548829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.1016/j.clinsp.2024.100325
Patricia Andrade Batista , Cláudia de Oliveira , Rafaela Alkmin da Costa , Rossana Pulcineli Vieira Francisco , Fabio Roberto Cabar
Introduction
Pregnancy and diabetes mellitus promote several musculoskeletal changes predisposing this population to complaints of Lower Back (LB) and Pelvic Pain (PP).
Objective
To assess the frequency of LB and PP and associated factors in type 1 Diabetic (DM1) pregnant women. Method: An observational analytical cross-sectional study. Thirty-six pregnant women with DM1 were evaluated through a postural assessment with a focus on pelvic positioning and what patients reported. The associated factors were assessed using the State-Trait Anxiety Inventory (STAI), the International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF), and the Female Sexual Function Index (FSFI).
Results
The frequency of LB and PP was 55.6 % and 30.6 %, respectively. The presence of anxiety was not associated with a higher prevalence of pain. The incidence of sexual dysfunctions was higher in the GD. DM1 duration had a mean of 14.9 years (± 8.2 SD) in the GD and 9.0 years (± 6.9 SD) in the GSD, which was statistically significant (p ≤ 0.050). In the multiple binary regression analysis for the occurrence of pain, the independent factor was DM1 duration ≥ 17 years (OR = 11.2; 95 % CI = 1.02‒124.75). The association between DM1 duration ≥ 17 years and being overweight showed a probability of 95 % for the studied population in the analysis of the probabilities of occurrence of the pain event.
Conclusion
There was a high frequency of LB and PP related to pregnancy in DM1 pregnant women in the second trimester of pregnancy. The incidence of sexual dysfunction and DM1 duration ≥ 17 years increases the chance that DM1 pregnant women will experience pain. There was no association between anxiety. urinary incontinence and pain in DM1 pregnant women.
{"title":"Low back pain, pelvic pain, and associated factors in type 1 diabetic pregnant women","authors":"Patricia Andrade Batista , Cláudia de Oliveira , Rafaela Alkmin da Costa , Rossana Pulcineli Vieira Francisco , Fabio Roberto Cabar","doi":"10.1016/j.clinsp.2024.100325","DOIUrl":"https://doi.org/10.1016/j.clinsp.2024.100325","url":null,"abstract":"<div><h3>Introduction</h3><p>Pregnancy and diabetes mellitus promote several musculoskeletal changes predisposing this population to complaints of Lower Back (LB) and Pelvic Pain (PP).</p></div><div><h3>Objective</h3><p>To assess the frequency of LB and PP and associated factors in type 1 Diabetic (DM1) pregnant women. Method: An observational analytical cross-sectional study. Thirty-six pregnant women with DM1 were evaluated through a postural assessment with a focus on pelvic positioning and what patients reported. The associated factors were assessed using the State-Trait Anxiety Inventory (STAI), the International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF), and the Female Sexual Function Index (FSFI).</p></div><div><h3>Results</h3><p>The frequency of LB and PP was 55.6 % and 30.6 %, respectively. The presence of anxiety was not associated with a higher prevalence of pain. The incidence of sexual dysfunctions was higher in the GD. DM1 duration had a mean of 14.9 years (± 8.2 SD) in the GD and 9.0 years (± 6.9 SD) in the GSD, which was statistically significant (<em>p</em> ≤ 0.050). In the multiple binary regression analysis for the occurrence of pain, the independent factor was DM1 duration ≥ 17 years (OR = 11.2; 95 % CI = 1.02‒124.75). The association between DM1 duration ≥ 17 years and being overweight showed a probability of 95 % for the studied population in the analysis of the probabilities of occurrence of the pain event.</p></div><div><h3>Conclusion</h3><p>There was a high frequency of LB and PP related to pregnancy in DM1 pregnant women in the second trimester of pregnancy. The incidence of sexual dysfunction and DM1 duration ≥ 17 years increases the chance that DM1 pregnant women will experience pain. There was no association between anxiety. urinary incontinence and pain in DM1 pregnant women.</p></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1807593224000024/pdfft?md5=9a1908f193f70ed3831eef74dfbcba9e&pid=1-s2.0-S1807593224000024-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139700210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.1016/j.clinsp.2024.100339
Lei Liu, WenJie Huang, KeBing Luo, YiZhou Zeng, YunHao Shao, ZongMin Long
Background
Varicocele is an abnormal expansion of the pampininias venous plexus in the scrotum, resulting in impaired sperm production and reduced sperm quality. The exact pathophysiological mechanism leading to varicocele-related infertility has not been fully elucidated. Although treatable, varicocele may lead to male infertility.
Objective
To investigate the relationship between semen parameters, serum InhB and INSL-3 levels, and the degree of varicocele in male patients.
Methods
Serum InhB and INSL-3 were detected. To evaluate the relationship between semen parameters and serum InhB and INSL-3 levels. To evaluate the value of semen parameters and serum InhB and INSL-3 levels in distinguishing disease severity in patients with varicocele.
Results
Serum INSL-3 in patients with varicocele decreased with the severity of the disease. Serum INSL-3 was positively correlated with total sperm count and frequency of normal sperm morphology. There was a weak correlation between serum InhB and semen volume, concentration, and total sperm. Patients with different disease severity were similar within the groups, with partial overlap or similarity between varicocele Grade I and Grade II, and significant differences between Grade III and Grade I and II. Semen volume, concentration, total sperm, normal sperm morphology, and serum InhB and INSL-3 levels could distinguish the degree of varicocele.
Conclusion
Semen parameters and the combination of serum InhB and INSL-3 levels in patients with varicocele are closely related to the severity of the disease. Serum INSL-3 is expected to be a potential biomarker for early clinical intervention.
背景:精索静脉曲张是阴囊内潘品尼亚静脉丛的异常扩张,导致精子生成障碍和精子质量下降。导致精索静脉曲张相关不育症的确切病理生理机制尚未完全阐明。精索静脉曲张虽然可以治疗,但可能导致男性不育:研究男性患者精液参数、血清 InhB 和 INSL-3 水平与精索静脉曲张程度之间的关系:方法:检测血清 InhB 和 INSL-3。评估精液参数与血清 InhB 和 INSL-3 水平之间的关系。评估精液参数、血清 InhB 和 INSL-3 水平在区分精索静脉曲张患者疾病严重程度方面的价值:结果:精索静脉曲张患者的血清 INSL-3 随病情严重程度而下降。血清 INSL-3 与精子总数和精子形态正常的频率呈正相关。血清 InhB 与精液量、浓度和精子总数之间的相关性较弱。不同疾病严重程度的患者在组内相似,精索静脉曲张 I 级和 II 级之间有部分重叠或相似,III 级与 I 级和 II 级之间有显著差异。精液量、浓度、总精子数、正常精子形态以及血清 InhB 和 INSL-3 水平可区分精索静脉曲张的程度:结论:精索静脉曲张患者的精液参数以及血清 InhB 和 INSL-3 水平与疾病的严重程度密切相关。血清INSL-3有望成为早期临床干预的潜在生物标志物。
{"title":"Relationship between semen parameters, serum InhB, and INSL-3 levels, and the degree of varicocele","authors":"Lei Liu, WenJie Huang, KeBing Luo, YiZhou Zeng, YunHao Shao, ZongMin Long","doi":"10.1016/j.clinsp.2024.100339","DOIUrl":"10.1016/j.clinsp.2024.100339","url":null,"abstract":"<div><h3>Background</h3><p>Varicocele is an abnormal expansion of the pampininias venous plexus in the scrotum, resulting in impaired sperm production and reduced sperm quality. The exact pathophysiological mechanism leading to varicocele-related infertility has not been fully elucidated. Although treatable, varicocele may lead to male infertility.</p></div><div><h3>Objective</h3><p>To investigate the relationship between semen parameters, serum InhB and INSL-3 levels, and the degree of varicocele in male patients.</p></div><div><h3>Methods</h3><p>Serum InhB and INSL-3 were detected. To evaluate the relationship between semen parameters and serum InhB and INSL-3 levels. To evaluate the value of semen parameters and serum InhB and INSL-3 levels in distinguishing disease severity in patients with varicocele.</p></div><div><h3>Results</h3><p>Serum INSL-3 in patients with varicocele decreased with the severity of the disease. Serum INSL-3 was positively correlated with total sperm count and frequency of normal sperm morphology. There was a weak correlation between serum InhB and semen volume, concentration, and total sperm. Patients with different disease severity were similar within the groups, with partial overlap or similarity between varicocele Grade I and Grade II, and significant differences between Grade III and Grade I and II. Semen volume, concentration, total sperm, normal sperm morphology, and serum InhB and INSL-3 levels could distinguish the degree of varicocele.</p></div><div><h3>Conclusion</h3><p>Semen parameters and the combination of serum InhB and INSL-3 levels in patients with varicocele are closely related to the severity of the disease. Serum INSL-3 is expected to be a potential biomarker for early clinical intervention.</p></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1807593224000164/pdfft?md5=58521e6470568dcb08da139f88c66123&pid=1-s2.0-S1807593224000164-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139706239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.1016/j.clinsp.2024.100413
Objective
Atherosclerosis (AS) is a common pathogenesis of cardiovascular diseases. Puerarin (Pue) is a Chinese herbal remedy used to prevent and treat AS. Here, this research investigated the effect of Pue on AS progression.
Methods
ApoE−/− mice were induced with acrolein. Body weight, blood lipid index, inflammatory factors, mitochondrial oxidative stress, and lipid deposition were detected. IL-6 and TNF-α were detected by ELISA. Oil red staining and H&E staining were used to observe the aortic sinus plaque lesions. Serum expressions of inflammatory factors IL-6, TNF-a, SOD, GSH and MDA were detected by ELISA, the mRNA expression levels of HDAC1 in the aorta were detected by RT-qPCR, and IL-6 and TNF-α in the aorta were detected by immunohistochemistry. JNK, p-JNK, OPA-1, and HDAC1 were detected by Western blotting.
Results
Pue administration can effectively reduce lipid accumulation in AS mice induced by acrolein. Pue promoted the activity of SOD, GSH and MDA, and inhibited the formation of atherosclerotic plaques and the process of aortic histological changes. Pue reduced IL-6 and TNF-α. HDAC1 expression was down-regulated and p-JNK-1 and JNK protein expression was up-regulated.
Conclusion
Pue reduces inflammation and alleviates AS induced by acrolein by mediating the JNK pathway to inhibit HDAC1-mediated oxidative stress disorder.
{"title":"Puerarin inhibits HDAC1-induced oxidative stress disorder by activating JNK pathway and alleviates acrolein-induced atherosclerosis","authors":"","doi":"10.1016/j.clinsp.2024.100413","DOIUrl":"10.1016/j.clinsp.2024.100413","url":null,"abstract":"<div><h3>Objective</h3><p>Atherosclerosis (AS) is a common pathogenesis of cardiovascular diseases. Puerarin (Pue) is a Chinese herbal remedy used to prevent and treat AS. Here, this research investigated the effect of Pue on AS progression.</p></div><div><h3>Methods</h3><p>ApoE<sup>−/−</sup> mice were induced with acrolein. Body weight, blood lipid index, inflammatory factors, mitochondrial oxidative stress, and lipid deposition were detected. IL-6 and TNF-α were detected by ELISA. Oil red staining and H&E staining were used to observe the aortic sinus plaque lesions. Serum expressions of inflammatory factors IL-6, TNF-a, SOD, GSH and MDA were detected by ELISA, the mRNA expression levels of HDAC1 in the aorta were detected by RT-qPCR, and IL-6 and TNF-α in the aorta were detected by immunohistochemistry. JNK, p-JNK, OPA-1, and HDAC1 were detected by Western blotting.</p></div><div><h3>Results</h3><p>Pue administration can effectively reduce lipid accumulation in AS mice induced by acrolein. Pue promoted the activity of SOD, GSH and MDA, and inhibited the formation of atherosclerotic plaques and the process of aortic histological changes. Pue reduced IL-6 and TNF-α. HDAC1 expression was down-regulated and p-JNK-1 and JNK protein expression was up-regulated.</p></div><div><h3>Conclusion</h3><p>Pue reduces inflammation and alleviates AS induced by acrolein by mediating the JNK pathway to inhibit HDAC1-mediated oxidative stress disorder.</p></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1807593224000905/pdfft?md5=fc9811f3915ac6acfdfdf996686046d4&pid=1-s2.0-S1807593224000905-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141723262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.1016/j.clinsp.2024.100389
José Luiz Amuratti Gonçalves, José Jukemura, Carolina Bortolozzo Graciolli Facanali, Carlos Frederico Sparapan Marques, Rodrigo Ambar Filho, Carlos Walter Sobrado, Sergio Carlos Nahas
The authors aim to study Religiosity/Spirituality (R/S) and Quality of Life (QoL) in patients with Crohn's disease and their correlation with the disease phenotypes.
Methods
Prospective cross-sectional cohort study with 151 consecutive patients enrolled from March 2021 to October 2021 at the Colorectal IBD Outpatient of Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP). Sociodemographic, Religiosity/Spirituality (Duke University Religion Index – Durel) questionnaires and QoL (Inflammatory Bowel Disease Questionnaire – Short IBDQ-S) were applied. When necessary, qualitative variables were evaluated using the chi-square or Fisher's exact test. The Mann-Whitney and Kruskall-Wallis tests were used to analyze quantitative variables and compare more than two groups, both non-parametric statistical techniques.
Results
The most frequent location was Ileocolonic followed by Ileal and colonic (41.1 %, 27.2 %, and 25.2 %); only 6.6 % of subjects had a perianal presentation. Inflammatory, stenosing, and penetrating behaviors showed 36.4 %, 19.1 %, and 44.4 % respectively. The majority of the population is Catholic, Evangelical, or Spiritualist (92.4 %). QoL score showed no significant difference in the phenotypes. The scores for DUREL domains were 61.4 % for organizational religiosity, 75 % for non-organizational religiosity, 98.6 %, 93.6 % and 89.3 % for intrinsic spirituality, with high results in all disease phenotypes.
Conclusions
The studied population presented homogeneous sociodemographic results and high religious and spiritual activity. R/S in a positive context were not associated with better QoL or phenotype. R/S is present in the patients’ lives and could be seen as an important tool for adherence to treatment and the professional relationship between doctor and patient. The homogeneity of the sample difficult for an appropriate evaluation, which leads us to suggest new studies with more heterogeneous groups.
{"title":"Is religiosity/spirituality in patients with Crohn's disease important to their quality of life?","authors":"José Luiz Amuratti Gonçalves, José Jukemura, Carolina Bortolozzo Graciolli Facanali, Carlos Frederico Sparapan Marques, Rodrigo Ambar Filho, Carlos Walter Sobrado, Sergio Carlos Nahas","doi":"10.1016/j.clinsp.2024.100389","DOIUrl":"https://doi.org/10.1016/j.clinsp.2024.100389","url":null,"abstract":"<div><p>The authors aim to study Religiosity/Spirituality (R/S) and Quality of Life (QoL) in patients with Crohn's disease and their correlation with the disease phenotypes.</p></div><div><h3>Methods</h3><p>Prospective cross-sectional cohort study with 151 consecutive patients enrolled from March 2021 to October 2021 at the Colorectal IBD Outpatient of Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP). Sociodemographic, Religiosity/Spirituality (Duke University Religion Index – Durel) questionnaires and QoL (Inflammatory Bowel Disease Questionnaire – Short IBDQ-S) were applied. When necessary, qualitative variables were evaluated using the chi-square or Fisher's exact test. The Mann-Whitney and Kruskall-Wallis tests were used to analyze quantitative variables and compare more than two groups, both non-parametric statistical techniques.</p></div><div><h3>Results</h3><p>The most frequent location was Ileocolonic followed by Ileal and colonic (41.1 %, 27.2 %, and 25.2 %); only 6.6 % of subjects had a perianal presentation. Inflammatory, stenosing, and penetrating behaviors showed 36.4 %, 19.1 %, and 44.4 % respectively. The majority of the population is Catholic, Evangelical, or Spiritualist (92.4 %). QoL score showed no significant difference in the phenotypes. The scores for DUREL domains were 61.4 % for organizational religiosity, 75 % for non-organizational religiosity, 98.6 %, 93.6 % and 89.3 % for intrinsic spirituality, with high results in all disease phenotypes.</p></div><div><h3>Conclusions</h3><p>The studied population presented homogeneous sociodemographic results and high religious and spiritual activity. R/S in a positive context were not associated with better QoL or phenotype. R/S is present in the patients’ lives and could be seen as an important tool for adherence to treatment and the professional relationship between doctor and patient. The homogeneity of the sample difficult for an appropriate evaluation, which leads us to suggest new studies with more heterogeneous groups.</p></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1807593224000668/pdfft?md5=4d870dafe2784e74f553a36259b4d3c8&pid=1-s2.0-S1807593224000668-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141096069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}