Journal of Basic and Clinical Physiology and Pharmacology最新文献

Introduction: Esophageal achalasia is a rare motility disorder characterized by impaired lower esophageal sphincter relaxation and absent peristalsis. Diagnostic tools such as high-resolution manometry (HRM) and functional lumen imaging probe (FLIP) have improved disease recognition; however, interpretation remains complex and highly operator dependent. Artificial intelligence (AI) has emerged as a promising approach to automate data analysis and enhance diagnostic accuracy, but its specific role in achalasia is not yet clearly defined.

Content: A narrative review was conducted using PubMed, Scopus, and Web of Science, searching for studies published up to June 2025 that investigated AI applications in esophageal motility disorders, with particular attention to achalasia. Search terms included "artificial intelligence," "machine learning," "achalasia," "esophageal motility," and "high-resolution manometry." Although no prospective or interventional studies directly evaluating AI in achalasia were identified, several retrospective proof-of-concept studies applied AI algorithms to HRM and FLIP data. These studies demonstrated the feasibility of automated classification of esophageal motility disorders, with high accuracy in differentiating motility subtypes potentially applicable to achalasia. Exploratory research on AI-assisted imaging and outcome prediction also showed encouraging results.

Summary: Current evidence suggests that AI-based models can accurately analyze complex esophageal motility data and reduce interobserver variability. While direct clinical evidence in achalasia remains limited, existing studies provide a solid methodological foundation for AI-assisted diagnosis, classification, and clinical decision support in this condition.

Outlook: Future research should focus on prospective validation, multicenter data collection, and multimodal integration of clinical, physiologic, and imaging data. With targeted development and ethical governance, AI has the potential to enhance diagnostic precision, support personalized treatment strategies, and advance precision motility care in patients with achalasia.

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.

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.

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.

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.

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.

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.

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.

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.

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.