European review for medical and pharmacological sciences最新文献

Objective: Standard treatment for adults with acute myeloid leukemia (AML) involves anthracycline and cytarabine, while alternative regimens are necessary for elderly and frail patients. This study aims to compare the effectiveness and safety of various induction regimens in AML patients.

Patients and methods: The retrospective study included 130 adult AML patients treated at a tertiary care center from January 2014 to December 2022. Patients received one of the following induction regimens: anthracycline and cytarabine (n = 82), azacitidine and venetoclax (n = 11), etoposide and cytarabine (n = 22), or reduced-dose anthracycline and cytarabine (n = 15). Data on demographics, clinical characteristics, treatment-related toxicities, and infectious complications were collected. Outcomes included overall survival and remission rates.

Results: The anthracycline and cytarabine regimen demonstrated the highest overall survival rate, although remission rates did not significantly differ among the treatment groups. Patients receiving azacitidine and venetoclax experienced a significantly longer duration of neutropenia. The use of antiviral prophylaxis increased over the study period, reflecting improved management strategies. Infection remained the leading cause of mortality.

Conclusions: Effective management of prolonged neutropenia and infections is crucial for improving patient outcomes. Future research should focus on optimizing prophylactic and infection treatment strategies to further enhance survival in AML.

Objective: End-stage renal disease (ESRD) commonly manifests with disrupted calcium balance, leading to renal osteodystrophy. We posited that variations in the genetic makeup of vitamin D and calcium-sensing receptors, specifically single nucleotide polymorphisms (SNPs), could affect calcium homeostasis. This study aimed to identify the genetic predictors related to vitamin D and calcium-sensing receptors on calcium metabolism using machine learning algorithm analysis in ESRD.

Patients and methods: We conducted a cross-sectional analysis on adults with ESRD. We gathered comprehensive demographic data and medical history. Blood samples were collected to measure SNPs, and a panel of calcium metabolism biomarkers associated with the calcium-sensing receptor and vitamin D receptor. The biomarkers included calcium, phosphate, vitamin D, parathyroid hormone (PTH), sclerostin, procollagen type 1 alpha 1, osteocalcin, and bone-specific alkaline phosphatase. We utilized machine learning algorithms to pinpoint genetic markers predictive of vitamin D deficiency.

Results: We found a notable decrease in serum procollagen type 1 alpha 1 levels among individuals with the CC of rs10190 (related to the calcium-sensing receptor) compared to those with the TT genotype and in those with the TT of rs739837 (pertaining to the vitamin D receptor) compared to the GG genotype. Similarly, the TT genotype of rs10190 was associated with significantly lower serum phosphate levels compared to CC and CT genotypes. Additionally, a lower serum PTH level was noted in individuals with the CT of rs1802757 (calcium-sensing receptor) compared to those with the CC genotype. Our machine learning analysis identified rs2221266 and rs1042636 as the most significant SNPs linked to vitamin D deficiency, demonstrating considerable predictive accuracy.

Conclusions: Our findings indicate that specific single nucleotide polymorphisms in the vitamin D and calcium-sensing receptors significantly influence calcium metabolism biomarkers in ESRD patients. Assessing the clinical implications of these genetic variations is crucial for advancing personalized medicine in renal care.

The article "MiR-299-3p inhibits proliferation and invasion of cervical cancer cell via targeting TCF4" by Y. Yu, J.-D. Zhao, H. Yang published in Eur Rev Med Pharmacol Sci 2019; 23 (13): 5621-5627-DOI: 10.26355/eurrev_201907_18296-PMID: 31298314 has been retracted by the Editor in Chief. Following some concerns raised on PubPeer (link: https://pubpeer.com/publications/4275612B2FA-7C9A9CD7255B791D3A6), 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 data fabrication and several figure manipulations. Specifically, duplications were found within Figures 2C, 2F, 3C, 4A, and 4E. Moreover, Figure 2 (C, D, E), Figure 3C, and Figure 4 (C-D) contained duplications from previously published articles. 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 decided to retract the article. This article has been retracted. The Publisher apologizes for any inconvenience this may cause. https://www.europeanreview.org/article/18296.

Objective:   Acute respiratory distress syndrome (ARDS) is a systemic disease with high morbidity and mortality. Dead space fraction (Vd/Vt) represents the volume of air that does not participate in gas exchange and accurately depicts the pathophysiology of ARDS due to ventilation and perfusion mismatch. In this study, we aim to conduct a systematic review and meta-analysis regarding its usefulness for predicting mortality.

Materials and methods: We performed a systematic literature search identifying comparative studies meeting the above criteria from four databases: MEDLINE, clinicaltrials.gov, CENTRAL, and Google Scholar. A statistical meta-analysis was conducted utilizing the "meta" package in R software, with the included studies assessed based on the Newcastle-Ottawa scale.

Results: A total of twelve studies were included and data from over 1,700 patients was collected. Patients with higher levels of Vd/Vt were more likely to not survive with an OR=1.27 [95% CI (1.09, 1.48), I2=93%, p<0.01]. In addition, non-survivors of ARDS had higher mean value levels of Vd/Vt than survivors with an MD=0.07 [95% CI (0.02, 0.11), I2=82%, p<0.01]. Furthermore, a leave-one-out meta-analysis was performed in order to assess the effect of each individual study on the overall outcome, which led to the lowering of heterogeneity to 0.

Conclusions: The Vd/Vt ratio is an accurate index for determining the mortality of ARDS, reflecting the severity of the disease.

Objective: The recently discovered protein adropin is a highly conserved polypeptide that plays critical functions in energy homeostasis, metabolic processes, fat metabolism, and insulin resistance. On the other hand, non-alcoholic fatty liver disease (NAFLD) is a medical condition that causes the buildup of fat in the liver cells in individuals who consume little or no alcohol. The frequency of NAFLD is rising globally, and it is frequently linked to obesity, insulin resistance, type 2 diabetes, and metabolic syndrome. Therefore, this study evaluates the association between adropin levels and insulin resistance in individuals with and without NAFLD.

Materials and methods: Data from Scopus, Science Direct, and PubMed were searched between January 1, 2012, and February 18, 2024, using precise terms and stated criteria. Comprehensive Meta-Analysis V. 2 (Biostat, Englewood, NJ, USA) was used for data analysis, and Random-effect models were used to estimate the pooled mean differences with 95% CIs of adropin level, insulin level, and homeostatic model assessment for insulin resistance (HOMA-IR) associated with the exposures of interest.

Results: Our results revealed that adropin blood levels are significantly reduced in NAFLD patients compared to control individuals. The mean difference in adropin blood levels was 2.391 ng/ml with a 95% CI of 1.127 to 3.656 with I2 99.6. on the other hand, insulin resistance was significantly higher in NAFLD compared to controls (MD: -1.668, 95% CI: -2.333 to -1.002, I2=86%).

Conclusions: Our findings reveal that adropin levels are significantly greater in healthy controls than in NAFLD patients, suggesting that adropin may have a preventative effect on NAFLD. This meta-analysis highlights how closely adropin and insulin resistance interact in non-alcoholic fatty liver disease. Also, it may open the door to new diagnostic tools and therapeutic modalities.

Objective: Nasopharyngeal carcinoma (NPC) is a prevalent malignancy in Southeast Asia and Southern China, with a notable incidence in Indonesia. This study aimed to characterize the expression and correlation of Yes-associated protein (YAP1) and miR-340-5p in NPC metastasis tissues.

Materials and methods: This study utilized clinical samples from primary tumors of NPC patients to investigate the expression of YAP1 and miR-340-5p. The Cancer Genome Atlas (TCGA) Head and Neck Cancer dataset was analyzed to assess YAP1 and miR-340-5p expression in broader head and neck cancer samples. Protein-protein interaction (PPI) and functional enrichment analyses were performed to understand the putative regulatory mechanisms of YAP1 and miR-340-5p head and neck cancer. YAP1 mRNA and miR-340-5p level expression were measured by reverse transcription-quantitative polymerase chain reaction (RT-qPCR), and statistical analyses were performed to compare the expression of these markers in NPC samples.

Results: Analysis of clinical samples revealed lower expression levels of YAP1 and miR-340-5p in metastasis NPC cases compared to non-metastatic cases (p<0.0001). YAP1 and miR-340-5p revealed a negative correlation in metastasis and non-metastasis samples but were statistically insignificant. Additionally, both genes showed significantly lower expression in stage IVB compared to stage II, III, and IVA NPC tissues (p<0.0001). The TCGA dataset showed consistent decreases in YAP1 and miR-340-5p expression in head and neck cancer tumors as opposed to normal tissues. Functional enrichment and PPI analysis suggested the involvement of the Hippo signaling pathway and other cancer-related pathways in NPC progression.

Conclusions: The study highlights the under-expressed YAP1 and miR-340-5p in metastasis tumor cases, suggesting their potential role as a tumor suppressor in NPC.

Objective: Cardiovascular events prognosis based on CYP2C19 gene polymorphisms had many applications in clinical practice. Assessed characteristics and predictive performance of cardiovascular events in acute coronary syndrome patients with CYP2C19 gene polymorphisms.

Patients and methods: The patients were analyzed for CYP2C19 gene polymorphisms by real-time polymerase chain reaction (PCR). The PCR worked with primers around the mutant, as well as two fluorescent probes, one specific for the normal allele and the other for the mutant allele, and cardiovascular events were followed at 3 months and 6 months.

Results: Patients with CYP2C19 gene polymorphism accounted for 48.6% of which CYP2C19 *1/*2 genotype had the highest proportion (31.7%). The normal metabolizer phenotype was the majority (51.4%), and the *1 allele proportion accounted for the most (72.2%). Patients with type 2 diabetes (HR: 3.082, 95% CI: 1.652-5.747, p < 0.001) and ST-segment elevation myocardial infarction (HR: 2.874, 95% CI: 1.528-5.404, p = 0.001) were independent prognostic factors for cardiovascular events at 90 days. Type 2 diabetes was an independent prognostic factor for cardiovascular events at 180 days (HR: 3.714, 95% CI: 1.557-8.862, p = 0.003). The CYP2C19 gene polymorphism was an independent prognostic factor of cardiovascular events at 90 days (HR: 1.965, 95% CI: 1.012-3.814, p = 0.046). However, at 180 days of analysis, the association between the CYP2C19 gene polymorphism was not significant (HR: 2.234, 95% CI: 0.862-5.789, p = 0.098).

Conclusions: CYP2C19 gene polymorphism was an independent prognostic factor of cardiovascular events 90 days after acute coronary syndrome.

Objective: Pregnancy is a natural physiological process, but certain conditions can increase the risk, leading to high-risk pregnancy. Several risk factors may cause high-risk pregnancy. The leading ones are chronic diseases, anemia, multiple pregnancies, premature rupture of membrane, preeclampsia, obesity, frequent pregnancy, and advanced maternal age.

Patients and methods: A total of 7,230 women with high-risk pregnancies followed up by the Unit of Women's and Reproductive Health of the Directorate of Public Health Services, Kayseri Provincial Directorate of Health between 2016 and 2020 were included in the study. Demographic data, pregnancy outcomes, and risk factors were recorded. The mean age was 27.62±6.55 years. The mean number of pregnancy follow-ups was 3.69±1.36. The mean number of follow-ups for Turkish pregnant women was 3.73±1.34 while it was 1.93±1.1 for foreign pregnant women. Binary logistic regression analysis was used to investigate the effect of risk factors on pregnancy outcomes.

Results: Pregnancies that did not result in live birth were associated with preeclampsia (OR=12.677), hypertension (HT) (OR=2.079), and cardiovascular disorders (OR=2.277). It was revealed that the number of follow-ups for high-risk pregnancies was low.

Conclusions: In conclusion, we believe that increasing monitoring of high-risk pregnancies and developing follow-up models by health authorities will improve the quality of monitoring for high-risk pregnancies.

Objective: The immune system of the body mistakenly targets its own joints in rheumatoid arthritis (RA), a chronic autoimmune disease that causes pain, inflammation, and damage. The complexity of RA often requires the simultaneous use of several different management strategies. This study examines the potential enhancement of conventional RA treatments, specifically conventional Disease-Modifying Anti-Rheumatic Drugs (cDMARDs), by the addition of formic acid, a naturally occurring substance that may possess anti-inflammatory properties.

Patients and methods: A total of 90 children diagnosed with rheumatoid arthritis were examined at our hospital from 2020 to 2022. We segregated them into two cohorts, each consisting of 45 children. One cohort was administered conventional rheumatoid arthritis (RA) treatments, referred to as cDMARDs, which specifically included methotrexate and leflunomide. The other group was administered the standard treatments in addition to a low dosage of a specialized medication known as all-trans retinoic acid. We conducted follow-up assessments on the children at 6 months and 1-year post-treatment. We sought to evaluate the efficacy of the treatments by assessing the subjective reports of the children and their physicians, analyzing the outcomes of medical examinations, and examining diagnostic images, such as X-rays. Furthermore, we took measures to ensure the safety of the treatments.

Results: Among the cohort exclusively administered cDMARDs, approximately 26.7% exhibited significant improvement, 24.4% demonstrated moderate improvement, and 6.7% displayed minor improvement after a duration of 6 months. Approximately 57.8% of the children in this group experienced positive outcomes as a result of the treatment. The group that received retinoic acid also demonstrated superior outcomes. Approximately one-third (33.3%) of the participants demonstrated significant improvement, while another one-third showed moderate improvement. Additionally, 11.1% of the participants displayed minor improvement after a period of six months. Upon comparing the two groups, it was observed that the group receiving retinoic acid demonstrated a significantly superior outcome (p<0.05).

Conclusions: Overall, the incorporation of all-trans retinoic acid alongside conventional treatments for children with RA appears to enhance their efficacy.

Background: According to the literature, the brachial plexus presents a high rate of anatomical variations in the human neural system. The musculocutaneous nerve, a vital component of the brachial plexus, exhibits significant anatomical variations that hold clinical relevance across multiple medical disciplines. This case report, with a comprehensive review, explores the different variations in the course, branching patterns, and clinical implications of the musculocutaneous nerve. Understanding these variations is essential for surgeons, radiologists, and clinicians to enhance surgical precision, improve diagnostic accuracy, and reduce the risk of iatrogenic complications.

Case report: During an anatomical dissection we observed a very rare anatomical variation of the musculocutaneous nerve. Based on this discovery, we performed research in the literature with the aim of finding if this variation has been previously described. Firstly, we identified various classifications of anatomical variations of communicating branches between the musculocutaneous and median nerves, and then we observed that these variations corresponded to various rates of frequency. Our finding is a rare undescribed anatomical variant within the variants classified as Type II according to Le Minor, which is observed in 6.8-10.7% of cases.

Conclusions: The peculiar position of anatomical variations and anastomosis has clinical and functional relevance. Healthcare professionals must be aware of these variations to minimize surgical complications, accurately diagnose neurovascular pathologies, and optimize patient management. Further research into the genetic and embryological underpinnings of these variations may provide additional insights into this intriguing aspect of human anatomy.