Journal of Medicine and Life最新文献

Acyclovir is an established antiviral agent. The global emergence of the coronavirus disease 2019 (COVID-19) pandemic brought forth the necessity to investigate potential therapeutic attributes of existing drugs, including acyclovir, to combat this novel virus. The primary focus of this research was to assess the theoretical bioactivities of acyclovir derivatives and to evaluate their molecular docking capacities, thereby determining their prospective application in treating COVID-19. A set of 22 ligand molecules derived from acyclovir were carefully selected for this study. Using the one-click docking technique, these derivatives underwent molecular interactions with specific proteins sourced from the Protein Data Bank, identified by IDs 1R4L, 1S49, 1AJ6, and 1PVG. The molecular docking analysis revealed that acyclovir derivatives no. 3, 5, 8, and 14 displayed the highest docking scores and could be potential candidates as therapeutic agents against COVID-19 based on these scores. Further experimental validations are essential to establish their efficacy in clinical settings.

Palliative care for children with neurological conditions is essential to improve their quality of life and that of their family, given their uncontrollable symptoms and associated disabilities. These conditions include genetic diseases, congenital brain malformations, neurodegenerative disorders, and acquired brain injury. Enteral feeding, given directly into the gastrointestinal tract, is often necessary. A retrospective study conducted between 2018 and 2023 at the Lumina Association - Bacau Palliative Care Center analyzed data from 604 children with progressive neurological disorders out of 952 patients. These children, with an average age of 9.03 years, required enteral feeding due to swallowing disorders (48%), congenital malformations (29%), and malnutrition (23%). Feeding was performed mainly through a nasogastric tube (97.52%) and in 2.48% of cases through a gastrostomy. During this period, 4.14% of patients died from the underlying disease. The study highlights the benefits and complications of enteral feeding in these children. Although enteral feeding has been shown to be effective in maintaining nutritional status and avoiding dehydration, challenges have been identified, including digestive complications and the risk of infections in the context of palliative care.

This study evaluated the protective effects of silica nanoparticles (SiNPs) derived from melon seed husk ash against the neurotoxic effects of common environmental pollutants, aluminum (Al), nickel (Ni), and their combination in Wistar rats. Ninety-one male Sprague Dawley rats (220-250 g; 6-8 weeks old) were divided into 13 experimental groups. Key findings revealed that exposure to nickel, aluminum, or their combination significantly impaired spatial learning and memory, as evidenced by prolonged latency periods in treated rats. Treatment with SiNPs from melon seed husks reduced these latency periods. Increased Ni and Al levels in the frontal cortex after Ni/Al mixture exposure were mitigated by SiNPs. SiNPs also countered the reduction in iron levels caused by exposure to nickel, aluminum, and the mixture of nickel and aluminum. Moreover, SiNPs ameliorated oxidative stress by reducing MDA levels and increasing antioxidant enzyme activities. SiNPs treatment caused improved nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF) levels and reversed elevated Aβ-42 and cyclooxygenase-2 levels, highlighting their potential neuroprotective effects. Our results demonstrated the neuroprotective effects of SiNPs from melon seed husks by attenuating metal-induced oxidative stress and inflammation, though they did not enhance cortical cholinergic activity in rats.

Coagulation dysfunction has emerged as a significant aspect of COVID-19 pathophysiology, with abnormal coagulation parameters observed in severe cases. This study aimed to investigate the predictive value of coagulation parameters, including prothrombin time (PT), activated partial thromboplastin time (PTT), and international normalized ratio (INR) for mortality in patients with COVID-19. A retrospective analysis was conducted on a cohort of patients diagnosed with COVID-19. Coagulation parameters, including PT, PTT, and INR, were measured upon admission. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the predictive performance of these parameters. Sensitivity and specificity were calculated, and the area under the curve (AUC) values were determined. The analysis included 156 patients diagnosed with COVID-19. The t-test revealed a significant difference (P < 0.05) in PTT, PT, and INR. PTT demonstrated the highest predictive performance, with an AUC value of 0.68, indicating superior discrimination compared with PT and INR. PTT exhibited a sensitivity of 83% and a specificity of 46% for identifying deceased patients. These findings suggest that PTT may serve as a valuable prognostic marker of mortality risk in patients with COVID-19. Coagulation indicators, particularly PTT, predicted COVID-19 mortality. Monitoring coagulation markers may help stratify the risk and guide treatment. Further research and validation studies are needed to corroborate these findings and to establish the clinical importance of coagulation markers in COVID-19 therapy. COVID-19 coagulation dysfunction mechanisms must be understood in order to design targeted therapies to reduce thrombotic consequences.

It is unclear whether fever suppression in the elderly provides long-term benefits or poses risks due to their distinct immune profiles and body temperature regulation compared to younger individuals. This study aimed to assess the long-term health effects of antipyretic treatment during infections in the elderly. A systematic review was conducted, including studies that compared antipyretic treatment with other drugs, therapies, placebo, or no treatment. PubMed, Embase and Cochrane CENTRAL databases were searched. Primary and secondary outcomes were the onset or worsening of chronic inflammatory diseases, fever reduction, length of hospital stay, patient satisfaction, mortality, laboratory indicators of morbidity, and progression to complications, respectively. Out of 11,481 studies screened, 17 were included (two randomized controlled trials [RCTs], seven observational studies, one case series, and seven case reports). None investigated the primary outcome or patient-reported outcomes. The risk of bias in the included studies ranged from unclear to high. Due to the heterogeneity of the studies, a narrative synthesis was conducted, as meta-analysis was not feasible. Antipyretics showed a significant reduction of fever in RCTs. Five studies reported a significant drop in blood pressure, and one showed significant mortality from antipyretics. Morbidity indicators and length of stay were available only in the studies that reported adverse events. The certainty of evidence, assessed using GRADE, was low to very low for all outcomes. Evidence regarding the long-term benefit or harm from fever suppression with antipyretics during infections in the elderly is insufficient.

Autosomal recessive dystrophic epidermolysis bullosa (RDEB) is a severe form of an inherited skin disorder. RDEB segregates both in an autosomal dominant as well as in an autosomal recessive pattern. It has been shown that both forms of dystrophic epidermolysis bullosa (DEB) are caused by mutations in the COL7A1 gene. In this study, we investigated a consanguineous four-generation family with two individuals displaying the RDEB phenotype. Both patients showed multiple skin erosions, atrophic scares, crusted scaling, and pseudosyndactyly. Whole exome sequencing (WES) was performed to identify the underlying genetic defect, revealing a homozygous nonsense mutation, c.409C>T (p.Arg137*) in COL7A1 in both patients. This variant was validated through Sanger sequencing and confirmed to segregate within the family. This report describes a recurrent nonsense mutation in COL7A1 that leads to a severe form of autosomal recessive dystrophic epidermolysis bullosa. Moreover, this study demonstrates that whole exome sequencing analysis is imperative in resolving clinically and genetically heterogeneous diseases like RDEB. Furthermore, this study expands the mutation spectrum of the COL7A1 gene in distinct populations.

Akkermansia muciniphila (AM), one of the many microbial species residing in the human gut, has been particularly highlighted for its potential beneficial impacts on host metabolism and gut barrier function. This study evaluated the association between AM concentration and metabolic markers among patients diagnosed with metabolic dysfunction-associated steatotic liver disease (MASL). The study included a cohort of 122 patients with MASLD, monitored between January 1 and June 30, 2024, at the Venus Vascular Center in Oradea, Romania. Enterotype 2 was predominant in the study population, accounting for over 60% of participants. Correlation analysis revealed no statistically significant association between alanine aminotransferase (ALT) or aspartate aminotransferase (AST) levels and AM concentration (ALT: r = -0.147, P = 0.105; AST: r = -0.090, P = 0.325). However, a significant negative linear correlation was determined between gamma-glutamyl transferase (GGT) values and AM concentrations (r = -0.314, P < 0.001) and a moderate, positive correlation between high-density lipoprotein (HDL) values and AM concentration (r = 0.307, P < 0.001). Glycemia showed a weak negative correlation with AM concentration (r = -0.262, P = 0.003). The improvement of liver markers (AST, ALT), even in the absence of correlation with AM concentration, and the negative correlation of GGT, a marker for hepatobiliary diseases and metabolic syndrome, suggest the reduction of oxidative stress in MASLD.

Impostor syndrome is prevalent among undergraduate nursing and medical students. Resilience is the ability to adapt and rebound from challenges, which is crucial for student well-being and academic success. Exploring the connection between impostor syndrome and resilience is essential to support students effectively. This cross-sectional study investigated the relationship between resilience and impostor syndrome among undergraduate nursing and medical students at King Saud Bin Abdulaziz University for Health Sciences. A total of 300 students were recruited using a convenience sample and completed self-reported questionnaires assessing resilience and impostor syndrome between September 2022 and March 2023. Various bias mitigation strategies were employed to ensure data accuracy and reliability, such as anonymous data collection and validated scales. The results indicated that less than half of the participants experienced impostor syndrome. Among nursing students, 41.7% were classified as severe, 37.7% as moderate, and 13.0% as intense impostors. For medical students, 4.6% were mild, 4.6% moderate, 4.5% severe, and 4.5% intense impostors. Mean resilience scores were 24.3 ± 7.15 for nursing students and 25.6 ± 7.22 for medical students. A significant negative correlation was found between resilience and impostor syndrome scores (r = -0.220, P < .001). Regression analysis indicated that resilience significantly predicted impostor syndrome, with higher resilience associated with lower levels of impostor syndrome. These findings highlight the importance of resilience in mitigating impostor syndrome among nursing and medical students. Building resilience through interventions may be beneficial in promoting student well-being and academic success. Future research should explore the effectiveness of such interventions and identify other factors contributing to impostor syndrome among healthcare students.

The postmortem interval (PMI) is one of the primary objectives and challenging tasks proposed for determining the time of death. This study aimed to estimate the PMI using serum levels of high mobility group box 1 (HMGB1), a biomarker of pyroptotic cell death, along with desmin immunohistochemical and histological analyses of the gastrocnemius muscle in rats at various time intervals. Serum and gastrocnemius muscle samples were collected at zero, 24-, 48-, 72-, and 96 hours postmortem from 50 rats maintained at 22 ± 2°C. The results revealed that the HMGB1 level peaked at 48 hours and dropped in a time-dependent manner afterward. Immunohistochemical analysis revealed a progressive decrease in desmin expression, with severe immunoreactivity (38.19%) at 0 hours, dropping to a minimal level (1.09%) 96 hours after death. Histological analysis of the gastrocnemius muscle at 96 hours revealed significant vacuolation, loss of normal architecture, reduced nuclear visibility, and complete autolysis of all myocytes. In conclusion, HMGB1 levels, desmin immunoreactivity, and histopathological alterations seen in the gastrocnemius muscle could be helpful, valuable, and potential markers for accurately determining PMIs in humans in future studies.