Pub Date : 2023-06-08DOI: 10.14218/erhm.2023.00024
A. Boukhmis, Mohammed El-Amin Nouar, K. Khacha, Yacine Djouaher
Patients with secondary mitral regurgitation (SMR), the majority of which is ischemic, often have atherosclerotic ascending aorta and left ventricular (LV) dysfunction. In these patients, restrictive mitral annuloplasty is associated with a high rate of MR recurrence, aortic cross-clamping increases the stroke rate, and cardioplegic arrest increases postoperative low cardiac output syndrome. To avoid these complications, beating heart mitral valve replacement without aortic cross-clamping has been proposed. Here, we describe two male patients, aged 71 and 54 years, with severe SMR and low left ventricle ejection fraction (LVEF) (24% and 30%, respectively). Beating-heart mitral valve replacement with total chordal sparing was performed without aortic cross-clamping through a full sternotomy. Weaning from cardiopulmonary bypass was easily achieved without use of inotropes. The duration of mechanical ventilation (3 and 6 hours, respectively) and intensive care (24 and 48 hours, respectively) was short. Neither patients presented with postoperative neurological disorders. After a mean follow-up of 66 months, both patients were asymptomatic, without prosthetic valve dysfunction, and their LVEF reached 42% and 51%, respectively. This cases study indicates that for patients with SMR with impaired LV function who are at high risk for cardioplegic arrest, clampless beating heart mitral valve replacement with total preservation of the subvalvular apparatus could reduce stroke incidence, preserve peri-operative LVEF, and allow reverse LV remodeling.
{"title":"Clampless Beating Heart Mitral Valve Replacement in Dilated Cardiomyopathy","authors":"A. Boukhmis, Mohammed El-Amin Nouar, K. Khacha, Yacine Djouaher","doi":"10.14218/erhm.2023.00024","DOIUrl":"https://doi.org/10.14218/erhm.2023.00024","url":null,"abstract":"Patients with secondary mitral regurgitation (SMR), the majority of which is ischemic, often have atherosclerotic ascending aorta and left ventricular (LV) dysfunction. In these patients, restrictive mitral annuloplasty is associated with a high rate of MR recurrence, aortic cross-clamping increases the stroke rate, and cardioplegic arrest increases postoperative low cardiac output syndrome. To avoid these complications, beating heart mitral valve replacement without aortic cross-clamping has been proposed. Here, we describe two male patients, aged 71 and 54 years, with severe SMR and low left ventricle ejection fraction (LVEF) (24% and 30%, respectively). Beating-heart mitral valve replacement with total chordal sparing was performed without aortic cross-clamping through a full sternotomy. Weaning from cardiopulmonary bypass was easily achieved without use of inotropes. The duration of mechanical ventilation (3 and 6 hours, respectively) and intensive care (24 and 48 hours, respectively) was short. Neither patients presented with postoperative neurological disorders. After a mean follow-up of 66 months, both patients were asymptomatic, without prosthetic valve dysfunction, and their LVEF reached 42% and 51%, respectively. This cases study indicates that for patients with SMR with impaired LV function who are at high risk for cardioplegic arrest, clampless beating heart mitral valve replacement with total preservation of the subvalvular apparatus could reduce stroke incidence, preserve peri-operative LVEF, and allow reverse LV remodeling.","PeriodicalId":12074,"journal":{"name":"Exploratory Research and Hypothesis in Medicine","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79299087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-19DOI: 10.14218/erhm.2023.00028
M. Balasubramanyam
{"title":"Type 2 Diabetes: Is it Time to Target β-cell Heterogeneity?","authors":"M. Balasubramanyam","doi":"10.14218/erhm.2023.00028","DOIUrl":"https://doi.org/10.14218/erhm.2023.00028","url":null,"abstract":"","PeriodicalId":12074,"journal":{"name":"Exploratory Research and Hypothesis in Medicine","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88894585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-11DOI: 10.14218/erhm.2022.00127
Dandan Shi, Luna Ge, Lei Yan, Yuang Zhang, Ting Wang, Yun Geng, H. Fan, Ruojia Zhang, Zhurui Shao, Longjie Hu, Jianli Zhao, Shufeng Li, Yi Li, Haojun Shi, Jihong Pan, G. Song, Lin Wang
{"title":"Qingfei Paidu Decoction Inhibits LPS-induced Acute Lung Injury by Targeting the Complement Pathway","authors":"Dandan Shi, Luna Ge, Lei Yan, Yuang Zhang, Ting Wang, Yun Geng, H. Fan, Ruojia Zhang, Zhurui Shao, Longjie Hu, Jianli Zhao, Shufeng Li, Yi Li, Haojun Shi, Jihong Pan, G. Song, Lin Wang","doi":"10.14218/erhm.2022.00127","DOIUrl":"https://doi.org/10.14218/erhm.2022.00127","url":null,"abstract":"","PeriodicalId":12074,"journal":{"name":"Exploratory Research and Hypothesis in Medicine","volume":"83 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75346451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-11DOI: 10.14218/erhm.2023.00013
R. Rastmanesh
Although anemia may cause angiogenesis and neovascularization, especially in ocular situations, neither published nonran-domized clinical trials nor registered clinical trials have reported the anemia status as inclusion or exclusion criteria in their design. Increases in the circulating levels of erythropoietin and vascular endothelial growth factor are proportional to the levels of tissue hypoxia, which are influenced by hematocrit. Erythropoietin is a potent retinal angiogenic factor that is independent of endothelial growth factor and is capable of stimulating ischemia-induced retinal angiogenesis. We suggest that clinical trials investigating anti-vascular endothelial growth factor treatment for retinal neovascularization should measure appropriate variables such as serum erythropoietin, vascular endothelial growth factor, hemoglobin, and hematocrit to yield preliminary data for future trials of angiogenesis inhibitors. Ignoring the anemia status, serum erythropoietin, and/or vascular endothelial growth factor levels could create clinical uncertainty and subtle statistical bias in both systematic reviews and nonrandomized clinical trials that aim to evaluate the efficiency of angiogenesis inhibitors in several medical situations, including but not limited to ocular alterations, rheumatoid arthritis, and many types of cancer, just to mention a few. Implications of this type of bias could be involved in other disease situations in which angiogenesis inhibitors are used for medication, such as different carcinomas as well as metastases. In this hypothesis paper, we suggest that clinical trials of angiogenesis inhibitors should measure appropriate variables such as serum erythropoietin, hemoglobin, and hematocrit and match their participants by anemia and its severity to avoid a game-changing bias in their data analysis.
{"title":"Anemia: A Potential Source of Bias in Clinical Trials of Angiogenesis Inhibitors: A Hypothesis","authors":"R. Rastmanesh","doi":"10.14218/erhm.2023.00013","DOIUrl":"https://doi.org/10.14218/erhm.2023.00013","url":null,"abstract":"Although anemia may cause angiogenesis and neovascularization, especially in ocular situations, neither published nonran-domized clinical trials nor registered clinical trials have reported the anemia status as inclusion or exclusion criteria in their design. Increases in the circulating levels of erythropoietin and vascular endothelial growth factor are proportional to the levels of tissue hypoxia, which are influenced by hematocrit. Erythropoietin is a potent retinal angiogenic factor that is independent of endothelial growth factor and is capable of stimulating ischemia-induced retinal angiogenesis. We suggest that clinical trials investigating anti-vascular endothelial growth factor treatment for retinal neovascularization should measure appropriate variables such as serum erythropoietin, vascular endothelial growth factor, hemoglobin, and hematocrit to yield preliminary data for future trials of angiogenesis inhibitors. Ignoring the anemia status, serum erythropoietin, and/or vascular endothelial growth factor levels could create clinical uncertainty and subtle statistical bias in both systematic reviews and nonrandomized clinical trials that aim to evaluate the efficiency of angiogenesis inhibitors in several medical situations, including but not limited to ocular alterations, rheumatoid arthritis, and many types of cancer, just to mention a few. Implications of this type of bias could be involved in other disease situations in which angiogenesis inhibitors are used for medication, such as different carcinomas as well as metastases. In this hypothesis paper, we suggest that clinical trials of angiogenesis inhibitors should measure appropriate variables such as serum erythropoietin, hemoglobin, and hematocrit and match their participants by anemia and its severity to avoid a game-changing bias in their data analysis.","PeriodicalId":12074,"journal":{"name":"Exploratory Research and Hypothesis in Medicine","volume":"114 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84011920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-11DOI: 10.14218/erhm.2023.00019
Subendu Sarkar
Non-alcoholic fatty liver disease (NAFLD) is one of the leading causes of chronic liver disease. The worldwide increasing prevalence of NAFLD has become a cause of concern for clinicians. Furthermore, the molecular mechanism of NAFLD pathogenesis remains poorly understood. Moreover, therapeutic interventions are presently limited. Balanced diet, physical exercise and lifestyle modifications have been recommended. Several studies have revealed that vitamin D deficiency is correlated with NAFLD, and it’s supplementation may play a vital role in this regard. Sufficient information was obtained from full articles written in the English language, and accessible in PubMed, Google Scholar, Web of Science, and Scopus. The increasing prevalence of vitamin D deficiency remains as a global health risk factor, and this is linked to NAFLD pathogenesis. In vitro and in vivo studies, and clinical trials have revealed the beneficial role of vitamin D supplementation to control NAFLD. Vitamin D potentially regulates the molecular pathways associated with NAFLD risk factors, such as obesity, insulin resistance, and diabetes. It acts on adipocytes to control free fatty acid (FFA) trafficking, lipogenesis, and inflammation. Similarly, vitamin D acts on hepatocytes to reduce de novo lipogenesis and cellular FFA trafficking. Furthermore, it acts on pancreatic β-cells to im - prove insulin secretion, cell survival, and cellular functions. Vitamin D supplementation improves glucose uptake and insulin sensitivity. In addition, it decreases inflammation and liver injury, and acts on mitochondria to control reactive oxygen species (ROS)-mediated cellular toxicity. Vitamin D deficiency is a major risk factor for NAFLD pathogenesis. Thus, there is an urgent need to conduct molecular level analysis for further discernments
非酒精性脂肪性肝病(NAFLD)是慢性肝病的主要原因之一。全球范围内NAFLD患病率的上升已经成为临床医生关注的一个原因。此外，NAFLD发病的分子机制尚不清楚。此外，治疗干预目前是有限的。建议均衡饮食、体育锻炼和改变生活方式。几项研究表明，维生素D缺乏与NAFLD有关，补充维生素D可能在这方面起着至关重要的作用。充分的信息是从用英语撰写的完整文章中获得的，并且可以在PubMed, Google Scholar, Web of Science和Scopus中访问。维生素D缺乏症的日益流行仍然是一个全球健康风险因素，这与NAFLD的发病机制有关。体外和体内研究以及临床试验显示，补充维生素D对控制NAFLD有有益作用。维生素D可能调节与NAFLD风险因素相关的分子途径，如肥胖、胰岛素抵抗和糖尿病。它作用于脂肪细胞，控制游离脂肪酸(FFA)的运输、脂肪生成和炎症。同样，维生素D作用于肝细胞，减少新生脂肪生成和细胞游离脂肪酸运输。此外，它还作用于胰腺β细胞，改善胰岛素分泌、细胞存活和细胞功能。补充维生素D可以改善葡萄糖摄取和胰岛素敏感性。此外，它还能减少炎症和肝损伤，并作用于线粒体来控制活性氧(ROS)介导的细胞毒性。维生素D缺乏是NAFLD发病的主要危险因素。因此，迫切需要进行分子水平分析以进一步鉴别
{"title":"Molecular Crosstalk Between Vitamin D and Non-alcoholic Fatty Liver Disease","authors":"Subendu Sarkar","doi":"10.14218/erhm.2023.00019","DOIUrl":"https://doi.org/10.14218/erhm.2023.00019","url":null,"abstract":"Non-alcoholic fatty liver disease (NAFLD) is one of the leading causes of chronic liver disease. The worldwide increasing prevalence of NAFLD has become a cause of concern for clinicians. Furthermore, the molecular mechanism of NAFLD pathogenesis remains poorly understood. Moreover, therapeutic interventions are presently limited. Balanced diet, physical exercise and lifestyle modifications have been recommended. Several studies have revealed that vitamin D deficiency is correlated with NAFLD, and it’s supplementation may play a vital role in this regard. Sufficient information was obtained from full articles written in the English language, and accessible in PubMed, Google Scholar, Web of Science, and Scopus. The increasing prevalence of vitamin D deficiency remains as a global health risk factor, and this is linked to NAFLD pathogenesis. In vitro and in vivo studies, and clinical trials have revealed the beneficial role of vitamin D supplementation to control NAFLD. Vitamin D potentially regulates the molecular pathways associated with NAFLD risk factors, such as obesity, insulin resistance, and diabetes. It acts on adipocytes to control free fatty acid (FFA) trafficking, lipogenesis, and inflammation. Similarly, vitamin D acts on hepatocytes to reduce de novo lipogenesis and cellular FFA trafficking. Furthermore, it acts on pancreatic β-cells to im - prove insulin secretion, cell survival, and cellular functions. Vitamin D supplementation improves glucose uptake and insulin sensitivity. In addition, it decreases inflammation and liver injury, and acts on mitochondria to control reactive oxygen species (ROS)-mediated cellular toxicity. Vitamin D deficiency is a major risk factor for NAFLD pathogenesis. Thus, there is an urgent need to conduct molecular level analysis for further discernments","PeriodicalId":12074,"journal":{"name":"Exploratory Research and Hypothesis in Medicine","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77246047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-24DOI: 10.14218/erhm.2023.00010
Gülseren Maraş, Y. Sürme
{"title":"Surgical Site Infections: Prevalence, Economic Burden, and New Preventive Recommendations","authors":"Gülseren Maraş, Y. Sürme","doi":"10.14218/erhm.2023.00010","DOIUrl":"https://doi.org/10.14218/erhm.2023.00010","url":null,"abstract":"","PeriodicalId":12074,"journal":{"name":"Exploratory Research and Hypothesis in Medicine","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75654516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-13DOI: 10.14218/erhm.2023.00011
R. Monteiro-Júnior, Iaggo Raphael David, Iara Heloísa Ramos Mendes, Luciana Aparecida Coutinho, Biancart José Monteiro Júnior, H. N. Oliva
{"title":"Cortical Brain Response to Acute Bouts of Exercise in Patients with Severe Psychiatric Disorders: Report of Three Cases","authors":"R. Monteiro-Júnior, Iaggo Raphael David, Iara Heloísa Ramos Mendes, Luciana Aparecida Coutinho, Biancart José Monteiro Júnior, H. N. Oliva","doi":"10.14218/erhm.2023.00011","DOIUrl":"https://doi.org/10.14218/erhm.2023.00011","url":null,"abstract":"","PeriodicalId":12074,"journal":{"name":"Exploratory Research and Hypothesis in Medicine","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76673126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-30DOI: 10.14218/erhm.2022.00120
Jake Sellers, Sarah Neal Secrest Horne, W. D. de Riese
{"title":"The Origin of BPH and Prostate Cancer in Different Prostate Zones and the Impact on the Incidence of Prostate Cancer: A Systematic Review and Update of the Literature for Urologists and Clinicians","authors":"Jake Sellers, Sarah Neal Secrest Horne, W. D. de Riese","doi":"10.14218/erhm.2022.00120","DOIUrl":"https://doi.org/10.14218/erhm.2022.00120","url":null,"abstract":"","PeriodicalId":12074,"journal":{"name":"Exploratory Research and Hypothesis in Medicine","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79738760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-07DOI: 10.14218/erhm.2022.00119
I. A. Rakityanskaya, T. Ryabova, Anastasiya A. Kalashnikova
{"title":"Effects of Alloferon versus Valaciclovir for Treating Chronic Epstein-Barr Virus Infection","authors":"I. A. Rakityanskaya, T. Ryabova, Anastasiya A. Kalashnikova","doi":"10.14218/erhm.2022.00119","DOIUrl":"https://doi.org/10.14218/erhm.2022.00119","url":null,"abstract":"","PeriodicalId":12074,"journal":{"name":"Exploratory Research and Hypothesis in Medicine","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84137504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-07DOI: 10.14218/erhm.2022.00118
A. Majid, Farah Naz, Shamim Bhatti, A. Phull
{"title":"Phenolic Profile and Antioxidant Activities of Three Date Seeds Varieties (Phoenix Dactylifera L.) of Pakistan","authors":"A. Majid, Farah Naz, Shamim Bhatti, A. Phull","doi":"10.14218/erhm.2022.00118","DOIUrl":"https://doi.org/10.14218/erhm.2022.00118","url":null,"abstract":"","PeriodicalId":12074,"journal":{"name":"Exploratory Research and Hypothesis in Medicine","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87270571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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