European review for medical and pharmacological sciences最新文献

OBJECTIVE: Tendon tears cause significant disability, especially in the elderly. Lipid metabolism was shown to play a role in tendon tear pathogenesis. Statins, which lower cholesterol levels, have been associated with tendinopathies and tendon tears as possible adverse events. This systematic review evaluates the association between statin use and tendon rupture risk, as well as statins' influence on tendon healing after repair. MATERIALS AND METHODS: A literature search was conducted on PubMed, Embase, and Google Scholar databases using specific search strings related to statins and tendons. The inclusion criteria included randomized controlled trials (RCTs), retrospective or prospective studies on humans, articles written in English, papers published in indexed journals, and articles evaluating the relationship between statins and tendons. The quality of RCTs was assessed through the Cochrane Risk of Bias tool, while the risk of bias for non-randomized studies was evaluated according to the modified ROBINS-I tool. RESULTS: Twelve studies were included; eight studies investigated statin effects on native tendons, and four evaluated outcomes after tendon repair. Across over 1 million patients, a large cohort study found no significant increase in the risk of native tendon rupture among statin users (HR 0.95, 95% CI 0.84-1.08). Conversely, a retrospective study found that hyperlipidemic patients treated with statins had a significantly higher retear rate after rotator cuff repair compared to the control group (OR 6.5, p < 0.001). Furthermore, statin use was associated with an increased risk of tendinopathies, including trigger finger (HR 1.435), radial styloid tenosynovitis (HR 1.365), and Achilles tendinitis (HR 1.516) (p < 0.0001 for all). However, protective effects were observed for rotator cuff disease with rosuvastatin (HR 0.41, p < 0.0001). CONCLUSIONS: The effect of statins on tendons may be modulated by variables such as sex, tendon type, statin formulation, and comorbidities. Hence, statin therapy does not universally increase tendon rupture risk but may influence tendon integrity and healing in a patient-specific manner. Further high-quality studies are needed to define these relationships better and optimize clinical recommendations.

Graphical abstract: https://www.europeanreview.org/wp/wp-content/uploads/Graphical-Abstract-22-scaled.jpg.

OBJECTIVE: Oropharyngeal cancer and its treatment often lead to sarcopenia, which is linked to increased toxicity, reduced response to therapy, and worse survival. Traditional weight-based metrics may fail to detect this muscle loss. This study investigates the feasibility of using cone-beam computed tomography (CBCT) to monitor sarcopenia longitudinally in patients undergoing radiochemotherapy. MATERIALS AND METHODS: A retrospective analysis was conducted on 15 patients with locally advanced, inoperable oropharyngeal cancer who maintained stable body weight during treatment. All patients received intensity-modulated radiotherapy (IMRT) or volumetric arc therapy (VMAT), with daily cone-beam computed tomography (CBCT) for image guidance. Skeletal muscle area and density at the C3 vertebral level were measured weekly. A calibration phantom corrected CBCT Hounsfield Unit (HU) values. Longitudinal changes were assessed using linear mixed-effects models (LMMs), and correlations between skeletal muscle index (SMI) and body mass index (BMI) were evaluate. RESULTS: A significant weekly decline in SMI (p = 0.037) was observed, particularly after week 3, despite stable BMI. The muscle area decreased progressively while the HU values remained stable. A moderate inverse correlation was found between SMI and BMI (r = -0.39, p < 0.001), indicating that BMI is an inadequate measure for reflecting muscle loss. CONCLUSIONS: CBCT allows non-invasive, real-time monitoring of sarcopenia during treatment. Integrating CBCT-based body composition analysis into clinical practice could enable earlier detection and intervention, potentially improving treatment tolerance and outcomes. Larger studies and improved segmentation techniques are needed to validate and optimize this approach.

Graphical abstract: https://www.europeanreview.org/wp/wp-content/uploads/Graphical-Abstract-23.jpg.

OBJECTIVE: Programmed intermittent epidural bolus (PIEB) is an effective analgesic method owing to the redistribution of the drug solution, which leads to a gradual improvement in postoperative pain over time. This study aimed to compare the postoperative analgesic effects of patient-controlled epidural analgesia (PCEA) with those of tapering PIEB (t-PIEB), in which the drug dosage is decreased over time, and continuous epidural infusion (CEI). MATERIALS AND METHODS: Patients undergoing video-assisted thoracoscopic surgery (VATS) with general and epidural anesthesia were randomized in a 1:1 ratio into the t-PIEB and CEI groups. Patients in the t-PIEB group received 3 mL of 0.2% ropivacaine from the pump every hour, whereas those patients in the CEI group received the same drug solution continuously at a rate of 3 mL/h. In both groups, a 2-mL bolus of 0.2% ropivacaine was administered postoperatively, with additional PCEA as needed. In the t-PIEB group, the dosage was gradually decreased to 2 mL/dose after 25 h and to 1 mL/dose after 49 h. The primary endpoint was the number of times the patient pressed the PCA button at 24, 48, and 72 h. RESULTS: No significant difference was observed in the frequency of PCA button pressing between the two groups during the observation period. The t-PIEB group had a significantly lower usage of ropivacaine. CONCLUSIONS: Nt-PIEB could have analgesic effects comparable to those of CEI for postoperative pain following VATS with less medication use.

Graphical abstract: https://www.europeanreview.org/wp/wp-content/uploads/Graphical-Abstract-20-scaled.jpg.

BACKGROUND: Foodborne botulism is a rare but potentially serious and lethal disease that is considered a threat to public health systems across the globe. Botulism is a paralytic disorder caused by the neurotoxin, produced by Clostridium botulinum, which acts upon peripheral cholinergic nerve terminals by inhibiting acetylcholine release, subsequently causing denervation to muscle fibers. CASE SERIES: In April 2024, an outbreak of foodborne botulism was reported in Riyadh, Saudi Arabia, following consumption of contaminated fast food. Four patients were affected: two females and two males, aged 14 to 21 years. All patients developed neurological symptoms, including cranial nerve involvement, dysphagia, and generalized weakness. Three patients progressed to severe hypercapnic respiratory failure requiring prolonged mechanical ventilation. Electrophysiological studies demonstrated characteristic findings of presynaptic neuromuscular junction dysfunction. CONCLUSIONS: This case series adds to existing knowledge by providing detailed descriptions of the clinical course, neurological examination findings, and electrodiagnostic features of foodborne botulism cases in Saudi Arabia. Our findings highlight that, despite early antitoxin administration, patients can develop prolonged neuromuscular weakness requiring extended mechanical ventilation. This underscores the importance of considering botulism in the differential diagnosis of acute flaccid paralysis and the need for timely electrophysiological evaluation to guide management and prognosis.

Graphical abstract: https://www.europeanreview.org/wp/wp-content/uploads/Graphical-ABSTRACT-19.jpg.

Parkinson's disease (PD) is a progressive neurodegenerative disorder characterized by the loss of nigrostriatal dopaminergic neurons and pathological aggregation of a-synuclein. Despite advancements in symptomatic treatment, there is a critical unmet need for disease-modifying therapies capable of halting or slowing disease progression. Drug repurposing offers an efficient, cost-effective strategy to identify new treatments by leveraging the established safety and pharmacokinetic profiles of existing compounds. Dimethyl fumarate (DMF), an FDA-approved drug for multiple sclerosis and psoriasis, has recently emerged as a promising neuroprotective agent in PD research. Preclinical studies consistently demonstrate that DMF exerts beneficial effects in both in vitro and in vivo PD models, primarily via activation of the nuclear factor erythroid 2-related factor 2 (Nrf2) pathway. Through this mechanism, DMF counters oxidative stress, reduces neuroinflammation, promotes mitochondrial quality control, and impedes pathological protein aggregation. These biological effects translate into the preservation of dopaminergic neurons and improvements in motor behavior in animal models. Although direct clinical evidence of DMF's efficacy in PD patients is currently very limited, early mechanistic human studies provide indirect support for the targeting of the Nrf2 pathway in PD. Furthermore, DMF's neuroprotective properties extend to other neurodegenerative diseases, underscoring its broader therapeutic potential. In conclusion, the strong preclinical foundation, combined with an established clinical safety record, makes DMF an attractive candidate for repurposing as a disease-modifying therapy for PD. Future clinical trials will be essential to validate these preclinical promises and define DMF's role in the management of PD.

Graphical abstract: https://www.europeanreview.org/wp/wp-content/uploads/Graphical-abstract-21.jpg.

OBJECTIVE: The astrocyte-neuron lactate shuttle is the mechanism by which astrocytic lactate is transferred to neurons to maintain brain function and is modulated by astrocytic glycogen content. The aims of this study were to determine whether mulberry leaf extracts promote astrocytic glycogen accumulation and to explore the active compounds of mulberry leaf extracts. MATERIALS AND METHODS: Glycogen content was determined in human-induced pluripotent stem cell-derived astrocytes treated with mulberry leaf extracts or their active compounds. To determine the involvement of active compounds in glycogen synthesis and degradation, human-induced pluripotent stem cell-derived astrocytes were treated with glucose-free medium containing 13C-glucose, and the amounts of 12C- and 13C-glucose in glycogen were quantified. RESULTS: Mulberry leaf extracts promoted astrocytic glycogen accumulation. Iminosugars in mulberry leaf extracts did not significantly increase the glycogen content of astrocytes. In contrast, several quercetin glycosides exhibited some of the activities of the mulberry leaf extracts. Quercetin aglycone, the basic backbone structure without glycosides, increased astrocytic glycogen content. Additionally, quercetin aglycone increased both 12C- and 13C-glucose contents, meaning it promoted glycogen synthesis and inhibited glycogen breakdown. CONCLUSIONS: In this study, quercetin glycosides were identified as active compounds present in mulberry leaf extracts. The principal compound responsible for the activity was identified as quercetin aglycone. Mulberry leaf extracts and quercetin analogs may induce astrocyte-neuron lactate shuttling by promoting the accumulation of glycogen in astrocytes.

Graphical abstract: https://www.europeanreview.org/wp/wp-content/uploads/Graphical-Abstract-2.png.

BACKGROUND: Spinal and bulbar muscular atrophy (SBMA) is a rare X-linked neuromuscular disorder characterized by progressive muscle weakness and endocrine abnormalities. Beyond its classic neurological presentation, SBMA is increasingly associated with metabolic and cardiovascular comorbidities, including dyslipidemia and insulin resistance.   CASE REPORT: We present the case of a 54-year-old male with genetically confirmed SBMA and high cardiovascular risk, in whom statins and ezetimibe were contraindicated due to persistently elevated creatine kinase levels and underlying muscle involvement. Coronary CT angiography revealed subclinical atherosclerosis. Alirocumab, a PCSK9 inhibitor, was initiated at a dose of 150 mg every 2 weeks. After six months, LDL cholesterol was reduced by 54.9% without adverse effects or functional decline, and CK levels remained stable.   CONCLUSIONS: This case highlights the potential role of PCSK9 inhibitors as a safe and effective lipid-lowering option in patients with neuromuscular disorders at high cardiovascular risk, for whom traditional therapies are not feasible. It also highlights the importance of integrated cardiovascular care in managing multisystem diseases, such as SBMA.

Graphical abstract: https://www.europeanreview.org/wp/wp-content/uploads/Graphical-Abstract-2-1.jpg.

The article "Long noncoding RNA MNX1-AS1 overexpression promotes the invasion and metastasis of gastric cancer through repressing CDKN1A" by J.-X. Ma, Y.-L. Yang, X.-Y. He, X.-M. Pan, Z. Wang, Y.-W. Qian, published in Eur Rev Med Pharmacol Sci 2019; 23 (11): 4756-4762 DOI: 10.26355/eurrev_201906_18057-PMID: 31210302 has been retracted by in accordance with the Publisher and the Editor in Chief. Following some concerns on PubPeer, the authors were informed of the ongoing investigation and were asked to provide original data and clarify several other issues but remained unresponsive. The journal's investigation confirmed the duplication detected in Figure 3C and D and therefore the manuscript is retracted for Figure duplication. This article has been retracted. The Publisher apologizes for any inconvenience this may cause. https://www.europeanreview.org/article/18057.

BACKGROUND: Subungual splinter hemorrhages may represent an expression of infective endocarditis as well as autoimmune diseases or neoplasms. Anti-SAE1 autoantibody is directed against a small ubiquitin-like modifier-activating enzyme that plays a role in regulating transcription, cell cycle, and apoptosis. It is specific for dermatomyositis with skin rash and mild muscle involvement, and it can be associated with cancer.  CASE REPORT: We describe the case of a patient who developed subungual splinter hemorrhages and acrocyanosis. Infections were excluded, and autoimmunity resulted in anti-SAE1 autoantibodies. A cancer screening found a high-grade urothelial carcinoma. The splinter hemorrhages disappeared after the carcinoma enucleation.  CONCLUSIONS: Our case describes an atypical onset of anti-SAE1 dermatomyositis with splinter hemorrhages, potentially linked to urothelial cancer. This highlights the importance of comprehensive cancer screening in patients with unusual dermatomyositis presentations.

Graphical abstract: https://www.europeanreview.org/wp/wp-content/uploads/Graphical-Abstract-rev.jpg.