European review for medical and pharmacological sciences最新文献

Eur Rev Med Pharmacol Sci 2024; 28 (3): 1213-1226-DOI: 10.26355/eurrev_202402_35360-PMID: 38375726, published online on February 16, 2024. This erratum corrects the references 1, 2, and 3, which have been mistakenly inserted in the text during the authors' drafting with the following: - Reference 1 has been substituted with the following: 1) Umakanthan S, Sahu P, Ranade AV, Bukelo MM, Rao JS, Abrahao-Machado LF, Dahal S, Kumar H, Kv D. Origin, transmission, diagnosis and management of coronavirus disease 2019 (COVID-19). Postgrad Med J 2020; 96: 753-758. - Reference 2 has been substituted with the following: 2) Stokes EK, Zambrano LD, Anderson KN, Marder EP, Raz KM, El Burai Felix S, Tie Y, Fullerton KE. Coronavirus Disease 2019 Case Surveillance - United States, January 22-May 30, 2020. MMWR Morb Mortal Wkly Rep 2020; 69: 759-765. - Reference 3 has been substituted with the following: 3) Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, Zhang L, Fan G, Xu J, Gu X, Cheng Z, Yu T, Xia J, Wei Y, Wu W, Xie X, Yin W, Li H, Liu M, Xiao Y, Gao H, Guo L, Xie J, Wang G, Jiang R, Gao Z, Jin Q, Wang J, Cao B. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020; 395: 497-506. There are amendments to this paper. The Publisher apologizes for any inconvenience this may cause. https://www.europeanreview.org/article/35360.

The article "MiR-1294 acts as a tumor suppressor in clear cell renal cell carcinoma through targeting HOXA6", by W. Pan, L.-J. Pang, H.-L. Cai, Y. Wu, W. Zhang, J.-C. Fang, published in Eur Rev Med Pharmacol Sci 2019; 23 (9): 3719-3725-DOI: 10.26355/eurrev_201905_17797-PMID: 31114997 has been retracted by the Editor in Chief. Following some concerns raised on PubPeer regarding a possible manipulation in Figures 2 and 3, the Editor in Chief has started an investigation to assess the validity of the results as well as possible figure manipulation. The authors have been informed about the journal's investigation but remained unresponsive. The journal investigation revealed duplications in panels miR-1294 mimic - Caki01 and Caki01 of Figure 2D and in the Western blots of Figure 3 with previously published articles. 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 This article has been retracted.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/17797.

Objective: Frozen shoulder is a prevalent condition among individuals in their middle and later years. Invasive therapy has shown promising results in the treatment of frozen shoulders, but its widespread adoption has been hampered by high costs and the need for advanced medical technology. As a result, patients with frozen shoulders often turn to non-steroidal anti-inflammatory drugs (NSAIDs) for symptomatic relief. However, the oral administration of NSAIDs can lead to troublesome adverse effects on the gastrointestinal, cardiovascular, and urinary systems. In contrast, topical NSAIDs have gained attention for their excellent efficacy and lower adverse effects in various chronic pain conditions. Therefore, our study aimed to investigate the efficacy and safety of topical NSAIDs in improving pain and mobility among patients with frozen shoulders.

Patients and methods: A total of 108 patients experiencing moderate to severe pain and mobility impairment due to frozen shoulder were enrolled in this study. The participants were randomly assigned to either the experimental group (n=72) or the control group (n=36). The experimental group received daily treatment with the loxoprofen hydrogel patch (LOX-P) in addition to basic rehabilitation physiotherapy. The control group was treated with flurbiprofen cataplasm (FLU-C) twice a day, along with rehabilitation physiotherapy. The primary endpoint for evaluating the efficacy of the two patches was the Constant-Murley score (CMS). Clinical symptom data, adverse events, and patient satisfaction were also recorded.

Results: After 14 days of treatment, the effective rate was 66.67% (n=48) in the experimental group and 41.67% (n=15) in the control group. The overall difference in the effective rates was 25.00% (95% CI=5.20-42.52; p=0.013). The safety profiles of the two topical agents were similar, with only a few adverse events reported.

Conclusions: The loxoprofen hydrogel patch demonstrates a significant ability to alleviate shoulder pain and restore shoulder function in the treatment of frozen shoulder, with minimal adverse reactions. Chictr.org.cn ID: ChiCTR2100052375.

Objective: Intravenous (IV) fluid therapy is a known source of iatrogenic complications. Guideline implementation can be used to educate and guide physicians on adequate fluid management. In the emergency department (ED), a complex and interruption-driven environment, workload is high and active documentation is required to facilitate audits of fluid management quality.

Patients and methods: Fluid management was evaluated in the ED records of adult non-critically ill patients admitted to a tertiary care center before (PRE: 1/12/2016-31/3/2017) and after (POST: 1/12/2018-31/3/2019) implementation of an educational intervention aiming to optimize IV fluid therapy in November 2018. First, the appropriateness of the 24-hour IV maintenance fluid prescription was evaluated, as prescribed by the emergency physician. Second, factors associated with appropriate prescribing were assessed, as well as the quality of fluid management documentation practice. Prescription appropriateness and documentation quality were evaluated retrospectively using a structured audit instrument and additional review by experts.

Results: A total of 237 patients (2.3%) were included in the PRE-intervention group and 253 patients (2.4%) in the POST-intervention group. The expert panel evaluated 214 prescriptions in 82.3% of patients (PRE: 99, POST: 115), and appropriateness increased significantly (19.2% vs. 61.2%, p=0.002). A higher odds of an appropriate IV maintenance fluid prescription was determined, attributed to the intervention (adjOR=2.580; 95% CI 1.363-4.884) and in patients having a prehospital intervention (adjOR=1.914, 95% CI 1.022-3.586). Appropriateness of fluid management documentation did not significantly improve after the implementation of the intervention (15.6% vs. 16.2%, p=0.858).

Conclusions: The IV fluid prescriptions' appropriateness was significantly higher after guideline implementation. However, documentation quality of fluid management was poor in the studied ED records. Active stewardship programs are warranted to further monitor fluid management quality in the ED.

Objective: Crush injuries and open fractures are often accompanied by extensive tissue loss, rendering clinical and surgical management quite challenging, particularly in the upper extremities. The primary goal in these cases is to obtain a functional and cosmetically acceptable limb. However, the management of complex crush injuries (involving extensive tissue loss and open fractures) is associated with a variety of complications, ranging from infection to amputation. In this study, we aimed to analyze the clinical outcomes of reconstruction for managing complex upper extremity crush injuries.

Patients and methods: We reviewed the clinical and surgical data of patients with complex upper extremity crush injuries who were treated at five Level III trauma centers between July 2012 and December 2022. Patients with an injury that could not be replanted at the time of trauma, those who succumbed to the injuries before reconstruction, and patients with a postoperative follow-up time of < 1-year, missing data, or lost to follow-up were excluded. Data regarding demographic characteristics, clinical examination, radiological images, mechanism of injury, orthopedic or non-orthopedic injuries, comorbidities, tissue loss size, surgical procedures, number of debridement and first debridement time, complications, number of days of hospitalization and, if any, intensive care unit stay, were recorded.

Results: Twenty-one patients were included in the study (mean age = 37.4 ± 7.25; range = 16-62 years; 17 males, 4 females). Road traffic accidents were the most frequently documented cause of injury. The mean time to the first reconstruction was 4.2 ± 1.2 days. Tissue defect sizes ranged from 6 × 4 cm to 18 × 12 cm. Anterolateral thigh flaps, latissimus dorsi flaps, radial forearm, and lateral arm flaps, with sizes ranging from 3 × 6 cm to 18 × 26 cm, were used in the patients.

Conclusions: Simple reconstruction techniques, such as skin grafts or island flaps, can provide satisfactory results in terms of both appearance and function in upper extremity crush injuries with significant bone exposure and large soft tissue defects.

Objective: The non-invasive detection of Helicobacter pylori (H. pylori) and its resistance to clarithromycin and levofloxacin significantly improves the management of infected patients by enabling tailored eradication treatments without the need for endoscopic procedures. This study aimed to assess the effectiveness of real-time PCR (RT-PCR) assays in identifying H. pylori infection and antibiotic resistance in stool and gastric biopsy specimens.

Patients and methods: Stool and gastric biopsy samples were collected from patients within three days of post-hospitalization. A total of 115 samples were analyzed for H. pylori infection, and an additional 115 samples were evaluated for resistance to clarithromycin and levofloxacin using an RT-PCR-based molecular test. Statistical analyses were performed using (SPSS 26.0 IBM Corp., Armonk, NY, USA).

Results: Among 115 patients (53 males, average age 50.8±13.2 years), H. pylori was detected in 93.1% of stool samples and 93.9% of gastric biopsies. The RT-PCR assay demonstrated a sensitivity of 99.1% and a specificity of 100%, with an overall diagnostic accuracy of 99.1%. Clarithromycin resistance was found in 37.3% of stool and 46.9% of gastric biopsy specimens, with the assay showing 79.6% sensitivity and 98.4% specificity. Levofloxacin resistance was identified in 32.1% of stool samples and 31.3% of gastric biopsies, with 86.3% sensitivity and 91.1% specificity of the molecular test.

Conclusions: The RT-PCR-based detection of H. pylori and its resistance to clarithromycin and levofloxacin in stool samples represents a promising approach to enhance eradication therapy outcomes, potentially improving treatment efficacy. Chictr.org.cn: ChiCTR2300070267.

Eur Rev Med Pharmacol Sci 2024; 28 (2): 477-501-DOI: 10.26355/eurrev_202401_35047-PMID: 38305595, published online on January 31, 2024. After publication, the authors have found a mistake in the affiliation No. 1. Affiliation No. 1 has been corrected as follows: The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China There are amendments to this paper. The Publisher apologizes for any inconvenience this may cause. https://www.europeanreview.org/article/35047.

Objective: Laparoscopic sleeve gastrectomy (LSG) is a widely recognized effective bariatric surgery. However, variable weight loss outcomes post-surgery remained a clinical challenge. Currently, there is no established consensus on the factors influencing weight loss failure following LSG. This study aimed to explore the association between preoperative cortisol secretion autonomy and postoperative weight loss in obese patients undergoing LSG.

Patients and methods: A cohort of 181 patients with simple obesity (BMI ≥ 28 kg/m2) who underwent LSG and were followed up for one year was analyzed. Weight loss was measured by the percentage of excess weight loss (%EWL), and cortisol secretion autonomy was evaluated using a 1 mg dexamethasone suppression test (DST). Regression models were used to analyze the correlation between preoperative 1 mg DST results and %EWL one year after laparoscopic sleeve gastrectomy (LSG).

Results: Cortisol secretion autonomy was significantly lower in the %EWL ≥ 75% group and higher in the %EWL < 75% group, showing a negative correlation with %EWL (R = -0.336, p = 0.001). Logistic regression analysis indicated that high cortisol secretion autonomy was significantly correlated with %EWL < 75% after LSG. The likelihood of %EWL being < 75% was 10.47 times greater in patients with high cortisol secretion autonomy compared to those with low cortisol secretion autonomy (odds ratio 10.472, confidence interval: 1.660-66.048, p = 0.012).

Conclusions: Cortisol secretion autonomy emerges as an independent predictor of weight loss outcomes in Asian patients undergoing LSG. This finding suggests the potential for cortisol secretion autonomy to inform preoperative assessments and personalized treatment strategies in bariatric surgery.

Objective: Burns are among the most common injuries in children. In burns of more than 20% of the total body surface area, a systemic inflammatory response involving several chemical mediators occurs. Among them, nerve growth factor (NGF) regulates the inflammatory response related to wound healing and promotes keratinocyte proliferation and angiogenesis. The aim of our study was to investigate the physiological response to injury in children with moderate-severe burns, assaying proNGF, mature NGF (mNGF), interleukins (IL)-1β, and Il-10 serum levels.

Patients and methods: This is a prospective observational study, including twelve children hospitalized for moderate-severe burns at the Gemelli Hospital (Rome). Their laboratory features were compared to those of patients with obstructive hydrocephalus who underwent surgery.

Results: Our results showed an increase in proNGF and mNGF serum levels. In burn patients, proNGF levels increased before mNGF, and serum concentrations of both were not correlated with burn extension and depth. The most significant levels of mNGF and proNGF were reported in scalds involving the face. Serum IL-1β and IL-10 peak levels were reached with a time-course pattern similar to proNGF.

Conclusions: Our preliminary results validate the hypothesis that serum levels of proNGF and mNGF may represent inflammatory biomarkers useful for monitoring burn patients and defining new strategies for their treatment.

Objective: Monitoring Jackson Pratt and Hemovac drains plays a crucial role in assessing a patient's recovery and identifying potential postoperative complications. Accurate and regular monitoring of the blood volume in the drain is essential for making decisions about patient care. However, transferring blood to a measuring cup and recording it is a challenging task for both patients and doctors, exposing them to bloodborne pathogens such as the human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV). To automate the recording process with a non-contact approach, we propose an innovative approach that utilizes deep learning techniques to detect a drain in a photograph, compute the blood level in the drain, estimate the blood volume, and display the results on both web and mobile interfaces.

Materials and methods: Our system employs semantic segmentation on images taken with mobile phones to effectively isolate the blood-filled portion of the drain from the rest of the image and compute the blood volume. These results are then sent to mobile and web applications for convenient access. To validate the accuracy and effectiveness of our system, we collected the Drain Dataset, which consists of 1,004 images taken under various background and lighting conditions.

Results: With an average error rate of less than 5% in milliliters, our proposed approach achieves highly accurate blood level detection and estimation, as demonstrated by our trials on this dataset. The system also exhibits robustness to variations in lighting conditions and drain shapes, ensuring its applicability in different clinical scenarios.

Conclusions: The proposed automated blood volume estimation system can significantly reduce the time and effort required for manual measurements, enabling healthcare professionals to focus on other critical tasks. The dataset and annotations are available at: https://www.kaggle.com/datasets/ayenahin/liquid-volume-detection-from-drain-images and the code for the web application is available at https://github.com/itsjustaplant/AwesomeProject.git.