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A retrospective observational study to evaluate the association between self-reported binge alcohol drinkers and asthma. 一项回顾性观察性研究,评估自我报告的酗酒者与哮喘之间的关系。
Q3 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2025-12-24 eCollection Date: 2026-01-01 DOI: 10.1515/jbcpp-2025-0057
Yashaswi Guntupalli, Bharath Sai Vejandla, Shruti Suresh Suvarna, Shrishti Prakash Khetan, Jesheen Mann, Rhea Sibal, Deepthi Enumula

Objectives: To assess the association between binge drinking and asthma risk across demographic and socioeconomic groups.

Methods: A retrospective analysis using the 2022 Behavioral Risk Factor Surveillance System (BRFSS) database. Binge drinking status was the exposure variable, and asthma diagnosis was the outcome. Socioeconomic and demographic characteristics were included as covariates. Cross-tabulations, chi-squared tests, and Fisher's exact tests were conducted, results reported as odds ratios (ORs) and 95 % confidence intervals (CIs).

Results: Binge drinkers had a 5.2 % lower asthma risk (OR: 0.948, 95 % CI: 0.9245-0.9722). The greatest risk reduction was in ages 45-64 (26.8 %), while ages 18-24 had a 14.3 % increased risk (OR: 1.143). Men had 4.4 % higher asthma risk, while women had 1.1 % lower risk. Black and Hispanic binge drinkers had 8.1 and 2.3 % higher risk, while white binge drinkers had 8.4 % lower risk. Higher-income and education were linked to lower asthma risk.

Conclusions: Binge drinking is associated with lower asthma risk in older adults and women but higher risk in young adults and men. Further research is needed to explore mechanisms.

目的:评估不同人口统计学和社会经济群体中酗酒与哮喘风险之间的关系。方法:采用2022年行为风险因素监测系统(BRFSS)数据库进行回顾性分析。酗酒状态是暴露变量,哮喘诊断是结果。包括社会经济和人口统计学特征作为协变量。进行交叉表、卡方检验和Fisher精确检验,结果报告为优势比(ORs)和95% %置信区间(ci)。结果:酗酒者哮喘风险降低5.2 % (OR: 0.948, 95 % CI: 0.9245-0.9722)。风险降低最大的是45-64岁(26.8% %),而18-24岁的风险增加14.3% % (OR: 1.143)。男性患哮喘的风险高4.4 %,而女性低1.1 %。黑人和西班牙裔酗酒者的风险增加了8.1和2.3 %,而白人酗酒者的风险降低了8.4 %。较高的收入和教育水平与较低的哮喘风险有关。结论:酗酒与老年人和女性较低的哮喘风险相关,但与年轻人和男性较高的风险相关。需要进一步的研究来探索其机制。
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引用次数: 0
A prospective study to assess the prognosis of patients with necrotizing fasciitis using laboratory risk indicator for necrotizing fasciitis (LRINEC) scoring system in a tertiary care hospital. 应用实验室坏死性筋膜炎风险指标(LRINEC)评分系统评估某三级医院坏死性筋膜炎患者预后的前瞻性研究。
Q3 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2025-12-17 DOI: 10.1515/jbcpp-2025-0117
Rekha Walwekar, Vignesh Ramalingam, Arun Walwekar

Introduction: Necrotizing fasciitis (NF) is a rare but potentially fatal infection, involving the subcutaneous tissue and fascia. The incidence of NF worldwide ranges from 0.30 to 15 cases per 100,000 populations and mortality remains high at 25 %.

Objectives: To classify severity of necrotizing fasciitis and assess the prognosis of necrotizing fasciitis using the LRINEC Scoring system.

Methods: A thorough history and detailed clinical examination was done. Patient underwent necessary investigations like hemoglobulin, total leukocyte count, serum sodium, serum creatinine, random blood sugar, and C-reactive protein. Based on the investigations, two groups were formulated, LRINEC score <6 (low risk) and ≥6 (high risk). Then prognosis was assessed. The results were compared between the two groups.

Results: In our study, a total of 124 patients were included with 62 of them with LRINEC score of <6 and 62 patients with LRINEC score ≥6. The sensitivity and specificity for predicting the septic shock and mortality with LRINEC score is 94 % and 70 % and 94 % and 71 %, respectively.

Conclusions: LRINEC score is a simple clinical tool for predicting the prognostic outcomes in patients with necrotizing fasciitis. LRINEC score of ≥6 have poorer prognosis in the form septic shock and eventual mortality.

坏死性筋膜炎(NF)是一种罕见但可能致命的感染,累及皮下组织和筋膜。NF在世界范围内的发病率为每10万人0.30至15例,死亡率仍然很高,为25% %。目的:应用LRINEC评分系统对坏死性筋膜炎的严重程度进行分级,并评价坏死性筋膜炎的预后。方法:对患者进行详细的病史和临床检查。对患者进行必要的检查,如血红蛋白、白细胞总数、血清钠、血清肌酐、随机血糖和c反应蛋白。结果:本研究共纳入124例患者,其中LRINEC评分为62例。结论:LRINEC评分是预测坏死性筋膜炎患者预后的简单临床工具。LRINEC评分≥6的患者脓毒性休克的预后较差,最终死亡。
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引用次数: 0
Efficacy and safety of Mirikizumab in the treatment of moderate to severe active ulcerative colitis: a systematic review. Mirikizumab治疗中重度活动性溃疡性结肠炎的疗效和安全性:一项系统综述。
Q3 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2025-12-15 DOI: 10.1515/jbcpp-2025-0172
Ajay Kumar Shukla, Saurav Misra, Ravi Kant Narayan, Shahnawaz Ahmed

Introduction: Ulcerative colitis in the second or third decade is characterised by haematochezia, stomach pain, faecal urgency, and tenesmus. On October 26, 2023, the US-FDA approved Mirikizumab for the treatment of moderate-to-severe ulcerative colitis in adults.

Content: This systematic review evaluated the safety and effectiveness of Mirikizumab for the treatment of ulcerative colitis by analysing data from available clinical trials. We performed a thorough search across databases such as PubMed, Cochrane, Embase, Scopus, Google Scholar, and ClinicalTrials.gov, covering records from their inception up to June 30, 2025, in accordance with PRISMA guidelines. Thorough investigation identified five relevant studies: four randomised controlled trials and one observational study. All Mirikizumab doses achieved complete healing of the inflamed lumen. Except for the 50 mg dose, they also showed superior histological remission compared to placebo. Most adverse effects likely stem from the condition itself rather than the drug, supported by a higher dropout rate among placebo patients. Additionally, in patients with prior treatment failures, Mirikizumab demonstrated improved outcomes by week 40.

Summary and outcome: Mirikizumab improves clinical, endoscopic, and histological results in ulcerative colitis. This study highlights the clinical importance of Mirikizumab and its potential to change treatment standards for ulcerative colitis.

简介:溃疡性结肠炎在第二个或第三个十年的特点是血便病,胃痛,大便急症,和尿急。2023年10月26日,美国fda批准Mirikizumab用于成人中重度溃疡性结肠炎的治疗。内容:本系统综述通过分析现有临床试验数据,评估了Mirikizumab治疗溃疡性结肠炎的安全性和有效性。我们在PubMed、Cochrane、Embase、Scopus、谷歌Scholar和ClinicalTrials.gov等数据库中进行了彻底的搜索,根据PRISMA指南,涵盖了从它们成立到2025年6月30日的记录。彻底调查确定了五项相关研究:四项随机对照试验和一项观察性研究。所有剂量的Mirikizumab均实现了炎症腔的完全愈合。除了50mg剂量外,与安慰剂相比,他们也表现出更好的组织学缓解。大多数不良反应可能源于病情本身,而不是药物,安慰剂患者的辍学率更高。此外,在先前治疗失败的患者中,Mirikizumab在第40周显示出改善的结果。总结和结果:Mirikizumab改善溃疡性结肠炎的临床、内窥镜和组织学结果。这项研究强调了Mirikizumab的临床重要性及其改变溃疡性结肠炎治疗标准的潜力。
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引用次数: 0
An overview and comparison of haemovigilance reporting forms across six countries relative to the WHO template. 与世卫组织模板相比,六个国家血液警戒报告表格的概述和比较。
Q3 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2025-12-11 DOI: 10.1515/jbcpp-2025-0120
Manmeet Kaur, Saurav Misra, Jayant Kumar Kairi

Objectives: Haemovigilance monitors, identifies, reports, investigates, and analyses adverse event near-misses and reactions related to transfusion and blood product manufacture.

Methods: This was an observational study in which we analyzed and compared the WHO haemovigilance template form for hospital and blood establishment haemovigilance reporting forms from Australia, Canada, India, New Zealand, South Africa, and the United States. All data from these reporting systems/forms was tabulated. The study analyzed data elements from each form, scoring them based on their presence in the WHO template and country forms. Higher scores indicated greater comparability and more comprehensive data collection.

Results: We identified 57 data fields in haemovigilance reporting forms from six countries and the WHO template, essential for collecting information on suspected transfusion products and reactions. The US FDA form has the most fields at 40 (70 %), followed by Canada with 33 (58 %) and India with 27 (47 %). New Zealand's form has the fewest at 16 (28 %), followed by South Africa with 17 (30 %).

Conclusions: Effective haemovigilance systems require time and commitment to develop, often starting small and growing with stakeholder involvement. A straightforward reporting form, accessible to all, is crucial for success.

目的:血液警戒监测、识别、报告、调查和分析与输血和血液制品生产有关的不良事件、未遂事件和反应。方法:这是一项观察性研究,我们分析和比较了来自澳大利亚、加拿大、印度、新西兰、南非和美国的医院和血液机构血液警戒报告表格的WHO血液警戒模板表。来自这些报告系统/表格的所有数据都被制成表格。该研究分析了每个表格中的数据元素,并根据它们在世卫组织模板和国家表格中的存在情况对它们进行评分。得分越高,表明可比性越强,数据收集越全面。结果:我们在来自6个国家的血液警戒报告表格和世卫组织模板中确定了57个数据字段,这对于收集可疑输血产品和反应的信息至关重要。美国FDA表格拥有最多的领域,为40个(70 %),其次是加拿大33个(58 %)和印度27个(47 %)。新西兰最少,16人(28 %),其次是南非,17人(30 %)。结论:有效的血液警戒系统需要时间和承诺来开发,通常从小规模开始,并随着利益相关者的参与而发展。一份简单易懂的报告表格对成功至关重要。
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引用次数: 0
Interleukin-23 (IL-23) inhibitor, mirikizumab in the treatment of ulcerative colitis (UC): a promising therapy? 白细胞介素-23 (IL-23)抑制剂米利珠单抗治疗溃疡性结肠炎(UC):一个有希望的治疗方法?
Q3 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2025-11-27 eCollection Date: 2026-01-01 DOI: 10.1515/jbcpp-2024-0102
Saurav Misra, Manmeet Kaur, Ashish Kumar Saranjhna

Mirikizumab is a monoclonal antibody that targets the human IL-23p19 and has been humanized with IgG4. It is currently under development for treating Crohn's disease and ulcerative colitis. The FDA approved mirikizumab on October 26, 2023 as a highly effective treatment for ulcerative colitis, providing patients with a new option for this chronic and debilitating inflammatory bowel disease. Millions of people worldwide suffer from ulcerative colitis, and it is crucial to induce and maintain remission. However, existing therapies may not suffice in terms of efficacy or patient tolerability. Mirikizumab demonstrated a favorable safety profile during trials, with reported adverse events aligning with anticipated outcomes in the patient group. These safety results underscore the viability of mirikizumab as a well-tolerated therapeutic option for extended use. The trials data indicated that the treatment not only swiftly alleviated symptoms but also exhibited potential for sustaining remission over an extended period. This article seeks to offer a condensed overview of the noteworthy clinical trial outcomes that contributed to the development of mirikizumab, ultimately leading to its initial approval for the treatment of ulcerative colitis.

Mirikizumab是一种靶向人IL-23p19的单克隆抗体,已经用IgG4人源化。目前正在开发用于治疗克罗恩病和溃疡性结肠炎的药物。FDA于2023年10月26日批准mirikizumab作为溃疡性结肠炎的高效治疗药物,为这种慢性和衰弱性炎症性肠病患者提供了新的选择。全世界有数百万人患有溃疡性结肠炎,诱导和维持缓解是至关重要的。然而,现有的治疗方法在疗效或患者耐受性方面可能还不够。Mirikizumab在试验中显示出良好的安全性,报告的不良事件与患者组的预期结果一致。这些安全性结果强调了mirikizumab作为长期使用的耐受性良好的治疗选择的可行性。试验数据表明,治疗不仅迅速缓解症状,而且表现出在较长时间内维持缓解的潜力。本文旨在提供一个值得注意的临床试验结果的简要概述,这些结果促进了mirikizumab的发展,最终导致其最初被批准用于治疗溃疡性结肠炎。
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引用次数: 0
The role of the urinary microbiome in diabetes-associated UTIs: current understanding and future directions. 尿微生物组在糖尿病相关尿路感染中的作用:目前的认识和未来的方向。
Q3 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2025-11-19 eCollection Date: 2026-01-01 DOI: 10.1515/jbcpp-2025-0116
Meenakshi Reddy Yathindra, Rithvika Badugu, Shaurya Kumar Singh, Sowthrisha Paluri, Hrudai Poudala, Naraginti Leninbabu Swathi

This review explores the interplay between type 2 diabetes mellitus (T2DM) and urinary microbiome dysbiosis, focusing on its role in urinary tract infections (UTIs). Once considered sterile, the urinary tract hosts a diverse microbiota that supports mucosal immunity and pathogen resistance. In T2DM, chronic hyperglycemia and glycosuria disrupt microbial balance, impair immune responses, and increase UTI susceptibility. Glycosuria promotes pathogenic colonization, biofilm formation, and microbial shifts, with studies reporting a threefold rise in Escherichia coli and a 56 % reduction in Lactobacillus spp. in diabetic women with recurrent UTIs. Diabetic urine shows reduced diversity, higher abundance of Klebsiella, Pseudomonas, and Enterococcus, and elevated IL-8. Microbiota-targeted interventions, including probiotics (Lactobacillus crispatus, Lactobacillus rhamnosus GR-1), prebiotics (astaxanthin), and phytotherapeutics (cranberry), demonstrate potential via lactic acid, hydrogen peroxide production, competitive exclusion, and NF-κB modulation. A 12-month RCT showed significant UTI recurrence reduction with probiotics. Advances in 16 S rRNA sequencing and metagenomics reveal microbial signatures associated with diabetic UTIs, though methodological heterogeneity limits comparability. A review of 1,200 publications (2000-2024) highlights the need for longitudinal studies and precision microbiota therapeutics to translate findings into clinical practice.

本文综述了2型糖尿病(T2DM)与尿微生物群失调之间的相互作用,重点讨论了其在尿路感染(uti)中的作用。一旦被认为是无菌的,泌尿道拥有多种微生物群,支持粘膜免疫和病原体抵抗。在T2DM中,慢性高血糖和糖尿会破坏微生物平衡,损害免疫反应,增加尿路感染的易感性。糖尿促进致病性定植、生物膜形成和微生物转移,研究报告在复发性尿路感染的糖尿病妇女中,大肠杆菌增加三倍,乳酸杆菌减少56% %。糖尿病患者尿液多样性降低,克雷伯氏菌、假单胞菌和肠球菌丰度增高,白细胞介素-8升高。以微生物群为目标的干预措施,包括益生菌(crispatus乳杆菌、鼠李糖乳杆菌GR-1)、益生元(虾青素)和植物疗法(蔓越莓),通过乳酸、过氧化氢生产、竞争排斥和NF-κB调节显示出潜力。一项为期12个月的随机对照试验显示,益生菌显著减少了尿路感染的复发。16 S rRNA测序和宏基因组学的进展揭示了与糖尿病尿路感染相关的微生物特征,尽管方法异质性限制了可比性。对1200份出版物(2000-2024)的回顾强调了纵向研究和精确微生物群治疗的必要性,以将研究结果转化为临床实践。
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引用次数: 0
Thyroid hormone imbalance, malnutrition, and sarcopenia: a triad of muscle health challenges. 甲状腺激素失衡,营养不良和肌肉减少症:肌肉健康的三重挑战。
Q3 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2025-11-17 eCollection Date: 2025-11-01 DOI: 10.1515/jbcpp-2025-0160
Annarita Nappi, Serena Sagliocchi, Annunziata Gaetana Cicatiello, Caterina Miro

Sarcopenia and malnutrition are increasingly recognized as major determinants of morbidity and functional decline in aging and chronically ill populations. Thyroid hormones (THs), particularly triiodothyronine (T3), play a critical role in regulating skeletal muscle homeostasis, influencing myogenesis, mitochondrial function, metabolic rate, and fibre-type specification. Alterations in thyroid function, both hypo- and hyperthyroidism, negatively impact muscle protein turnover, leading to impaired strength and muscle wasting. Notably, nutritional status modulates TH metabolism at multiple levels: malnutrition impairs deiodinase activity, alters TH transport, and reduces peripheral T3 availability, thereby contributing to the low T3 syndrome frequently observed in frail or undernourished individuals. Conversely, excessive T3 levels, as seen in hyperthyroid states or during inappropriate replacement therapy, exacerbate catabolism and accelerate muscle loss. This review synthesizes current evidence on the bidirectional interactions among thyroid dysfunction, nutritional deficiencies, and sarcopenia, proposing an integrative pathophysiological model. We discuss the clinical implications of TH replacement in sarcopenic and malnourished patients, highlighting the need for personalised, multimodal interventions that include hormonal, nutritional, and physical strategies to prevent or mitigate muscle deterioration in endocrine and geriatric contexts.

肌少症和营养不良日益被认为是老年和慢性病人群发病率和功能下降的主要决定因素。甲状腺激素(THs),特别是三碘甲状腺原氨酸(T3),在调节骨骼肌稳态、影响肌肉生成、线粒体功能、代谢率和纤维类型规范方面发挥着关键作用。甲状腺功能的改变,无论是甲状腺功能减退还是甲状腺功能亢进,都会对肌肉蛋白的转换产生负面影响,导致力量受损和肌肉萎缩。值得注意的是,营养状况在多个层面上调节TH代谢:营养不良会损害脱碘酶活性,改变TH转运,降低外周T3可用性,从而导致体弱多病或营养不良人群中常见的低T3综合征。相反,在甲状腺功能亢进状态或不适当的替代治疗期间,过量的T3水平会加剧分解代谢并加速肌肉损失。这篇综述综合了目前关于甲状腺功能障碍、营养缺乏和肌肉减少症之间双向相互作用的证据,提出了一个综合的病理生理模型。我们讨论了在肌肉减少症和营养不良患者中进行TH替代的临床意义,强调了个性化、多模式干预的必要性,包括激素、营养和身体策略,以预防或减轻内分泌和老年环境下的肌肉退化。
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引用次数: 0
Menopause, estrogen, and GERD: an exploration of symptoms and endoscopic correlations. 更年期,雌激素和胃反流:症状和内镜相关性的探索。
Q3 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2025-10-16 eCollection Date: 2026-01-01 DOI: 10.1515/jbcpp-2025-0097
Praveena Meyyazhagan, Pavitra Vyshnavi Yogisparan, Thendral Anandaraj

Objectives: To define the pattern of symptoms and severity of GERD among premenopausal and postmenopausal women in relation to estrogen levels and endoscopy findings.

Methods: The research was carried out in the Laboratory of Gastrointestinal Motility inside the Gastroenterology Department at PSGIMS&R, Coimbatore and the following approval from Institutional Human Ethics Committee (IHEC).

Results: The findings reveal significant variations in estrogen levels between premenopausal and postmenopausal women with gastroesophageal reflux disease (GERD), with premenopausal women having higher levels (82.80 ± 27.91 to 150.43 ± 40.80 pg/mL) compared to postmenopausal women (6.05 ± 2.75 to 17.30 ± 5.43 pg/mL, p < 0.001). This decline in estrogen post-menopause is associated with increased GERD symptoms and endoscopic abnormalities.

Conclusion: The study concludes that reduced estrogen levels in postmenopausal women are linked to a higher prevalence of GERD symptoms, including heartburn and dysphagia, compared to premenopausal women. Endoscopic findings further support the correlation between hormonal changes and GERD severity, highlighting the necessity for careful evaluation of GERD risk factors.

目的:确定绝经前和绝经后妇女胃食管反流的症状和严重程度与雌激素水平和内窥镜检查结果的关系。方法:本研究在哥印拜陀PSGIMS&R消化内科胃肠运动实验室进行,并经机构人类伦理委员会(IHEC)批准。结果:研究结果显示,绝经前和绝经后胃食管反流病(GERD)妇女雌激素水平存在显著差异,绝经前妇女雌激素水平(82.80±27.91 ~ 150.43±40.80 pg/mL)高于绝经后妇女(6.05±2.75 ~ 17.30±5.43 pg/mL, p < 0.001)。绝经后雌激素的下降与胃反流症状和内窥镜异常的增加有关。结论:该研究得出结论,与绝经前妇女相比,绝经后妇女雌激素水平降低与胃反流症状(包括胃灼热和吞咽困难)的患病率较高有关。内镜检查结果进一步支持激素变化与胃食管反流严重程度之间的相关性,强调了仔细评估胃食管反流危险因素的必要性。
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引用次数: 0
Association of adiponectin and nutritional indices with sarcopenia in elderly diabetic patients. 脂联素和营养指标与老年糖尿病患者肌肉减少症的关系。
Q3 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2025-10-16 eCollection Date: 2025-11-01 DOI: 10.1515/jbcpp-2025-0128
Aruna Raju, Jean Fredrick, Asmita Hazra, Boudhayan Das Munshi, Debarati Guha Roy

Objectives: To assess the relationship between adiponectin levels, nutritional indices, and sarcopenia in elderly diabetic patients, and to identify metabolic and nutritional biomarkers that distinguish sarcopenic from non-sarcopenic elderly diabetic individuals.

Methods: This cross-sectional study included 80 diabetic patients aged >60 years, sarcopenic (n=40) and non-sarcopenic (n=40) groups based on Asian Working Group for Sarcopenia criteria. Serum adiponectin, glucose metabolism markers, lipid profiles, and nutritional indices including prognostic nutritional index (PNI), geriatric nutritional risk index (GNRI), and controlling nutritional status (CONUT) score were assessed.

Results: Sarcopenic patients demonstrated significantly higher adiponectin levels (12.8 ± 3.4 vs. 8.4 ± 2.1 μg/mL, p<0.001), representing a 52% increase compared to non-sarcopenic individuals. The sarcopenic group showed impaired insulin sensitivity (QUICKI: 0.31 ± 0.05 vs. 0.36 ± 0.04, p=0.003), elevated atherogenic indices, and reduced nutritional status. All nutritional indices were significantly impaired in the sarcopenic group: PNI (45.2 ± 5.4 vs. 52.4 ± 6.8, p<0.001), GNRI, and CONUT score. Multiple logistic regression identified adiponectin (OR=1.264, 95% CI: 1.062-1.504, p=0.009), age, insulin resistance, and nutritional indices as independent predictors of sarcopenia.

Conclusions: Elevated adiponectin levels paradoxically associate with sarcopenia in elderly diabetes, suggesting a potential biomarker for muscle wasting. The association between nutritional indices and sarcopenia emphasizes the importance of comprehensive nutritional assessment in elderly diabetic patients.

目的:评估老年糖尿病患者脂联素水平、营养指标与肌肉减少症之间的关系,并确定区分老年糖尿病患者肌肉减少症和非肌肉减少症的代谢和营养生物标志物。方法:本横断面研究纳入80例年龄在bb0 ~ 60岁的糖尿病患者,根据亚洲肌少症工作组的标准,分为肌少症组(n=40)和非肌少症组(n=40)。评估血清脂联素、葡萄糖代谢标志物、脂质谱和营养指标,包括预后营养指数(PNI)、老年营养风险指数(GNRI)和控制营养状态(CONUT)评分。结论:脂联素水平升高与老年糖尿病患者肌肉减少症存在矛盾关系,提示其可能是肌肉萎缩的生物标志物。营养指标与肌肉减少症的相关性强调了对老年糖尿病患者进行综合营养评估的重要性。
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引用次数: 0
Atrioventricular block and myastenia gravis. A case report and review of the literature. 房室传导阻滞与重症肌无力。病例报告及文献回顾。
Q3 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2025-10-01 eCollection Date: 2025-11-01 DOI: 10.1515/jbcpp-2025-0155
Anna Lombardi, Francesco Murru, Luigi Giuseppe Atripaldi, Carmine D'Argenzio, Rita Verdoliva, Giordana G Iannibelli, Claudia Canitano, Mariarosaria De Luca, Giuseppe Cudemo, Rosa Lucci, Andrea Salzano, Alberto M Marra, Michele Arcopinto, Antonio Cittadini

Objectives: Myasthenia gravis (MG) is a chronic autoimmune disease primarily affecting skeletal muscles, though cardiac involvement, particularly arrhythmias, may occur, especially in severe cases or in patients with thymoma.

Case presentation: We report the case of a 62-year-old male with AchR-Ab-positive MG, without thymoma, who developed an advanced atrioventricular block requiring pacemaker implantation. Cardiac manifestations in MG can result from either the disease itself - through myocarditis, autoantibodies and autonomic dysfunction - or as a side effect of treatments such as pyridostigmine and immunosuppressants. Management strategies include considering discontinuation of pyridostigmine or using hyoscyamine to assess potential drug-induced bradyarrhythmias before proceeding with permanent pacing.

Conclusions: This case highlights the diagnostic challenges in distinguishing iatrogenic from autoimmune cardiac complications and emphasizes the importance of cardiovascular monitoring in MG patients, especially those presenting with cardiac symptoms or EKG abnormalities. Early recognition and appropriate intervention are crucial to improve outcomes and quality of life.

目的:重症肌无力(MG)是一种慢性自身免疫性疾病,主要影响骨骼肌,但可累及心脏,特别是心律失常,特别是在重症或胸腺瘤患者中。病例介绍:我们报告一名62岁男性,患有achr - ab阳性MG,无胸腺瘤,发展为晚期房室传导阻滞,需要植入起搏器。MG的心脏表现可能是由疾病本身引起的——通过心肌炎、自身抗体和自主神经功能障碍——或者是吡哆斯的明和免疫抑制剂等治疗的副作用。管理策略包括在进行永久性起搏前考虑停用吡哆斯的明或使用山莨菪碱来评估潜在的药物引起的慢性心律失常。结论:本病例强调了在区分医源性和自身免疫性心脏并发症方面的诊断挑战,并强调了对MG患者进行心血管监测的重要性,特别是那些有心脏症状或心电图异常的患者。早期识别和适当干预对改善预后和生活质量至关重要。
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引用次数: 0
期刊
Journal of Basic and Clinical Physiology and Pharmacology
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