European review for medical and pharmacological sciences最新文献

Objective: The study evaluated the lack of neurological improvement and the factors influencing it in patients with acute ischemic stroke (AIS) without major arterial occlusion.

Patients and methods: A cross-sectional study was conducted on patients diagnosed with acute ischemic stroke without significant occlusion of major arteries, with imaging evidence from 3-tesla magnetic resonance imaging (MRI) scans at the S.I.S Hospital in Can Tho, Vietnam, from 2019 to 2023. Eligible patients received treatment with low-dose alteplase (a single dose of 0.6 mg/kg).

Results: Among the 268 patients included in the study, a significant improvement in neurological function was observed in 195 patients (72.8%) [modified Rankin Scale (mRS): 0-1 points], while 73 patients (27.2%) demonstrated little or no improvement after 3 months of treatment. There were no recorded fatalities during the study period. Female patients accounted for 35.8% of the total sample. The average age of the participants was 62.9 years. The multivariate regression analysis identified several predictive factors associated with the risk of lack of improvement after 3 months, including advanced age, higher National Institute of Health Stroke Scale (NIHSS) scores, elevated blood glycemia levels (mmol/L), and elevated high-sensitive (hs) troponin I levels (ng/mL) (p < 0.05). Glycemia and hs troponin I levels were identified as biomarkers for predicting outcomes after ischemic stroke. No evidence was found linking sex, a history of chronic illness, and a lack of improvement.

Conclusions: Predicting prognostic factors for lack of neurological improvement will assist neurologists in developing personalized treatment plans for patients, reducing complications, and promoting patient recovery.

Objective: Monoamine oxidase (MAO) inhibitors reduce inflammation in a number of in vitro and in vivo models. This finding led to the development of a novel MAO-B selective inhibitor (RG0216) designed to reduce blood-brain barrier penetration. To elucidate RG0216's regulatory role in inflammation-relevant signaling pathways, we employed a transcriptome analytic approach to identify genes that are differentially regulated by RG0216 and then globally identified which inflammation-relevant biological signaling pathways were altered by this drug.

Material and methods: Primary human gingival keratinocyte (HGK) cells were treated with RG0216, and RNA was extracted (4 h). RNAseq transcriptome analysis was utilized to identify differentially expressed genes (DEGs), while Gene Ontology (GO), and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses were used to identify significantly enriched biological pathways. Relevant genes associated with these pathways and RG0216 regulation of Porphyromonnas gingivalis lipopolysaccharide (PgLPS)-induced cytokine/chemokine expression were evaluated using the real-time quantitative reverse-transcription polymerase chain reaction (RT-qPCR) approach.

Results: RG0216 significantly altered the expression of 50 DEGs in HGK cells. Using GO and KEGG analytic approaches, these genes were associated with the biological pathways relevant to mitogen-activated protein kinase (MAPK) and MAPK phosphatases. These phosphatases are part of the 10-member catalytically active dual-specificity phosphatase (DUSP) family. RG0216 induced the expression of DUSP10, reduced the expression of DUSP4 and DUSP6, and decreased IL-6 and IL-8 expression in control and PgLPS-stimulated cultures.

Conclusions: In HGK cells, a novel MAO-B inhibitor (RG0216) significantly altered DUSP4, DUSP6, and DUSP10 expression. DUSPs play a regulatory role in MAPK activity and, therefore, can alter cellular inflammatory responses. We found that RG0216 inhibited IL-6 and IL-8 expression. Further studies are planned to examine RG0216's regulatory role in DUSP expression and its impact on the regulation of cytokine/chemokine expression.

Objective: The detrimental effects of cigarette smoking on overall health are well-documented, with nicotine and carbon monoxide contributing to peripheral vasoconstriction and impaired oxygen delivery to tissues. This study reviews the impact of smoking on wound and bone healing, specifically in foot and ankle surgery, given its significant role as a modifiable risk factor for complications in orthopedic procedures.

Materials and methods: A systematic literature review was conducted in May 2024 following PRISMA guidelines. An electronic search of PubMed was performed using keywords related to smoking and wound complications in foot and ankle surgery. Inclusion criteria were studies published in English from 1993 to May 2024 focusing on orthopedic procedures. After screening 28 studies, six relevant articles were selected, comprising literature reviews, retrospective studies, and comparative series.

Results: The review highlights that smoking, including smokeless tobacco, significantly increases the risk of complications in foot and ankle surgeries. Smokers show markedly higher rates of non-union, wound infections, and delayed bone healing compared to non-smokers. For instance, smokers exhibit a 14.8% wound infection rate and higher rates of malunion and non-union, with 14.5% vs. 6.7% in non-smokers. Elective procedures such as total ankle replacement (TAR) also show worse outcomes for smokers, including increased infection rates and poorer functional scores. Conversely, smoking's impact on amputation procedures is less pronounced, although complications remain significant in patients with comorbid conditions.

Conclusions: This review underscores the severe impact of smoking on surgical outcomes in foot and ankle procedures. Smoking cessation before surgery has demonstrated substantial benefits, including reduced infection rates and improved healing. Preoperative counseling and smoking cessation programs are crucial for optimizing patient outcomes, and a multidisciplinary approach should be considered to enhance therapeutic strategies. Future studies should focus on refining smoking cessation guidelines and exploring new tobacco alternatives.

Objective: CYP2D6 plays a critical role in metabolizing tamoxifen into its active metabolite, endoxifen, which is crucial for its therapeutic effect in estrogen receptor-positive breast cancer. Single nucleotide polymorphisms (SNPs) in the CYP2D6 gene can affect enzyme activity and thus impact tamoxifen efficacy. This study aimed to use machine learning algorithms (MLAs) to identify significant predictors of Breast Cancer-Free Interval (BCFI) and to apply bioinformatics tools to investigate the structural and functional implications of CYP2D6 SNPs.

Patients and methods: The study utilized data from 4,974 breast cancer patients recruited by the International Tamoxifen Pharmacogenomics Consortium (ITPC), focusing on 898 patients with available BCFI data. Predictors included age, ethnicity, menopausal status, breast cancer grade, CYP2D6 genotype, and BCFI. An ensemble MLA model was developed, incorporating regression, CHAID, artificial neural networks (ANN), and classification and regression trees (CART). Bioinformatics tools, such as STRING-DB and GEPIA2, were used to analyze protein-protein interactions and survival data related to CYP2D6.

Results: The ensemble model identified age and CYP2D6 genotypes as significant predictors of BCFI. The mean prediction error for the training and testing cohorts was 13.8 and 40.2 days, respectively. Bioinformatics analysis revealed reduced CYP2D6 functional activity associated with decreased survival, and Kaplan-Meier analysis demonstrated that lower CYP2D6 expression significantly reduced survival rates.

Conclusions: This study highlights the utility of MLAs in identifying key predictors of tamoxifen response and the value of bioinformatics in understanding CYP2D6's role in breast cancer outcomes. Personalized treatment approaches based on CYP2D6 metabolizer status could enhance tamoxifen therapy effectiveness.

Objective: Time in therapeutic range (TTR) is a new approach to monitoring blood pressure (BP), providing a more accurate picture over time compared to the standard single BP measurement during a clinic visit. Currently, no study from Saudi Arabia has explored the use of TTR in assessing BP control and its related factors. Thus, we aimed to investigate them in this study.

Patients and methods: Participants aged ≥ 18 years with at least three BP measurements from January 2016 to December 2020 were enrolled. Patient data were collected, including the date of hypertension (HTN) diagnosis, comorbidities, medication history, and laboratory test results. TTR values were calculated, and descriptive statistical analysis was applied to assess the differences between patients with TTR ≥ 50% and those with TTR < 50%. The Poisson regression model was used to describe the associations between patient characteristics and TTR values.

Results: 30,694 patients were included, with 74% identified as having TTR < 50%. Female gender, concomitant diabetes mellitus, or cardiovascular diseases were significantly associated with TTR ≥ 50% (p < 0.02). Conversely, increasing age, body mass index, years with HTN, or hyperlipidemia were associated with TTR < 50% (p < 0.001).

Conclusions: According to the 2017 American College of Cardiology and the American Heart Association (ACC/AHA) guidelines, about three-quarters of the patients presented with TTR < 50% among the screened Saudi cohort. The results of this study may raise concerns about clinicians' adherence to the updated HTN management guidelines and patients' compliance with their treatment plans. This underscores the urgent need to improve HTN management and TTR attainment among Saudi patients.

The article "MiR-5692a promotes the invasion and metastasis of hepatocellular carcinoma via MMP9" by S.-J. Sun, N. Wang, Z.-W. Sun, J. Chen, H.-W. Cui, published Eur Rev Med Pharmacol Sci 2018; 22 (15): 4869-4878-DOI: 10.26355/eurrev_201808_15623-PMID: 30070322 has been retracted by the Editor in Chief. Due to concerns raised by online readers regarding a set of articles published by different publishers sharing similarities in Kaplan-Meier survival plots, correlation plots, and overlapping images from wound-healing and transwell assays, the Editor-in-Chief has initiated an investigation to evaluate the validity of the results and potential figure manipulation. The journal's investigation revealed duplications between panels A of Figure 4 and panel B of Figure 5. Also, splicing was detected in panel A of Figure 4. The authors have been informed about the journal's investigation but remained unresponsive and have not provided the study's raw data. Consequently, the Editor in Chief mistrusts the results presented and has decided to retract the article. This article has been retracted. The Publisher apologizes for any inconvenience this may cause. https://www.europeanreview.org/article/15623.

The article "Functional role of SIRT1-induced HMGB1 expression and acetylation in migration, invasion and angiogenesis of ovarian cancer" by W. Jiang, P. Jiang, R. Yang, D.-F. Liu, published in Eur Rev Med Pharmacol Sci 2018; 22 (14): 4431-4439-DOI: 10.26355/eurrev_201807_15494-PMID: 30058682 has been retracted by the Editor in Chief. Following some concerns raised on PubPeer (link: https://pubpeer.com/publications/B4079372E27EE32646DBD24D98E7DA), the Editor in Chief has started an investigation to assess the validity of the results as well as possible figure manipulation. The journal's investigation revealed duplications between panels A and B of Figure 1, between Figure 3 and a previously published article (link: https://doi.org/10.1371/journal.pone.0140918), and image duplication and rotation within panel Normal Control of Figure 6C. The authors have been informed about the journal's investigation but remained unresponsive and have not provided the study's raw data. Consequently, the Editor in Chief has decided to retract the manuscript. This article has been retracted. The Publisher apologizes for any inconvenience this may cause. https://www.europeanreview.org/article/15494.

Objective: We aimed to utilize artificial intelligence (AI) via machine learning (ML) to analyze the relationship between visual analogue scale foot and ankle (VASFA) and short-form 36 (SF-36) quality of life scores and determine AI's performance over the aforementioned analysis.

Materials and methods: We collected data from our registry of 819 data units or rows of datasets of foot and ankle patients with VASFA, SF-36 scores, and other demographic data. They were prepared and verified to be a proper input for building ML models using a web-based algorithm platform. After the first ML model was developed using random forest regression, the SF-36 percentage value was set as an endpoint. We developed a second ML model to evaluate it against the current algorithm. This new model employed a gradient-boosting regressor, where we omitted a key parameter, SF_Total, to correct the overfitting. We performed an external validation based on an unseen dataset from 42 data units of patients.

Results: Internal validity showed an excellent relationship among the VASFA, SF-36 total score, and overall SF-36 percent values at a correlation coefficient (R2 score) of 1.000 based on the random forest regression model of ML (first model: 28XJ). The VASFA percent value of the total score (0=worst; 100=best) demonstrated the dynamic changes in the three zones of the score levels; these were unsatisfactory: ≤ 57.25; borderline: 57.26-80.99; satisfactory: ≥ 81 and could impact the levels of overall SF-36 percent value. A second ML model (model FK13) showed an R2 score of 0.977, which was a great performance. External validation showed no significant difference between the predicted and actual values, with a two-tailed p-value of 0.2136.

Conclusions: Our ML models predicted excellent relationships among VASFA, with or without SF-36 total score and overall SF-36 percentage values, with evidence from external validation.

Benign prostatic hyperplasia (BPH) is highly prevalent and associated with a significant impact on individuals' well-being. Initial management involves various medications, but their benefits can be limited by side effects, particularly concerning young people. In this context, novel and better-tolerated therapeutic strategies have been proposed, thus including the modulation of the gut microbiome through probiotic ingestion. We aimed to examine the available evidence linking the urinary microbiome to lower urinary tract symptoms (LUTS) and to evaluate the possible usefulness of probiotic supplementation as a novel treatment option for LUTS/BPH. A narrative review design was preferred to fulfill our purpose. The search strategy included a range of terms, e.g., "microbiome," "microbiota," "urobiome," AND/OR "probiotics" AND "benign prostatic hyperplasia," "benign prostatic enlargement," "lower urinary tract symptoms." A range of studies aimed to investigate the possible impact of urinary microbiome on BPH. Gut and/or urinary dysbiosis can alter the gut permeability and initiate/maintain inflammatory and oxidative processes in the prostate, which may contribute to the cell-hyper-proliferation leading to BPH. The modulation of the urinary and/or gut microbiome through probiotic supplementation seems to provide levels of clinical effectiveness in the management of BPH. Although different probiotics have been tested, a combination of B. Longum and F. Psychaerophilum seems to be particularly promising due to their capability of modulating both the inflammatory pathway and the intestinal barrier permeability. Gut and/or urinary microbiome dysbiosis is most likely contributing to the BPH pathogenesis. Even though only scarce evidence on the potential usefulness of probiotic supplementation in the management of BPH is currently available, the available studies seem to provide encouraging results. Further prospective trials are warranted in order to confirm these findings and to clarify which probiotic strains are more suitable for supplementation in this setting.

Objective: Solanum sisymbriifolium Lam. is a native perennial plant with chemical characteristics of therapeutic importance. In Paraguayan traditional medicine, it is attributed to antihypertensive and diuretic activities. For this reason, the objective of the study was to evaluate the effect of acute oral administration of the ethanolic extract and fraction enriched in saponins obtained from the root of S. sisymbriifolium on the diuresis profile of rats.

Materials and methods: Male Wistar rats were used, randomly distributed in 6 groups to evaluate the diuretic activity. The control group received distilled water; the diuretic group was treated with 20 mg/kg of furosemide. Two groups were treated with 50 and 100 mg/kg of the ethanolic extract of S. sisymbriifolium, and two other groups were treated with 1 and 10 mg/kg with the fraction enriched in saponins. The animals were placed in individual metabolic cages for a period of 24 h. Urine volume was determined at 5 and 24 h, and urinary electrolytes, pH, and glomerular filtration rate at 24 h.

Results: The findings indicated that both doses of the ethanolic extract and the saponin-enriched fraction significantly increased diuresis after 24 hours of treatment. Urinary pH was not affected. A significant increase in the urinary excretion of Na+ and Cl- was observed without affecting the elimination of K+ with both doses of the extracts. In addition, a significant increase in GFR was evidenced.

Conclusions: Both ethanolic extract and saponins enriched fraction, presented natriuretic and saluretic effects with a possible mechanism of action mediated, at least partially, by the inhibition of carbonic anhydrase. Furthermore, it was possible to demonstrate the participation of the COX/PG pathway in the diuretic mechanism of the extracts in male rats.