Journal of Medicine and Life最新文献

Brucellosis, a chronic zoonotic disease with a significant global burden, particularly in endemic areas, can also present as neurobrucellosis, a rare complication. We report a case of polyradiculoneuropathy in a pediatric patient resulting from this uncommon presentation. A 5-year-old girl presented with progressive asymmetric lower limb weakness for two weeks that progressed to a loss of ambulation in four weeks. She also had flu-like symptoms and persistent high-grade fever. Her history was notable for ingesting raw milk before the onset of fever. Initial examination revealed meningismus signs and fever. She had bilateral weak hip flexion graded 4/5 on the Medical Research Council (MRC) scale, weak right and left knee flexion (3/5 and 4/5, respectively), and weak right ankle dorsiflexion (4/5). She also had diminished reflexes throughout. The patient exhibited a clinical picture resembling Guillain-Barré Syndrome (GBS) after admission as her weakness progressed. Cerebrospinal fluid (CSF) analysis revealed no cell counts, elevated protein levels (1545 mg/dL), and normal glucose levels (3.34 mmol/L). Blood and CSF cultures were negative, but the serum antibody titer was elevated at 1:1280 against Brucella melitensis and Brucella abortus species. Lumbosacral MRI showed diffuse enhancement of the lower nerve roots. A nerve conduction study (NCS) demonstrated axonal and demyelinating polyradiculoneuropathy. The patient regained her strength three months after presentation, following a course of antibiotics. When evaluating patients with atypical manifestations resembling GBS, brucellosis should be considered an important differential diagnosis in endemic areas.

Ulcerative colitis (UC) is a chronic inflammatory bowel disease characterized by recurring periods of inflammation and remission, primarily affecting the colon. The concept of medication-related burden, which refers to the adverse effects experienced by patients due to conventional medical treatments, is relatively new in the field. This study aimed to measure medication-related burden among patients with ulcerative colitis in Iraq. The study was conducted at the Gastroenterology and Hepatology Teaching Hospital, Medical City, Baghdad, Iraq, from December 2022 to May 2023. We used the Arabic version of the Living with Medicines Questionnaire version 3 (LMQ-3) to explore medication-related burdens experienced by patients with UC. Eighty-six patients with ulcerative colitis were included. The mean of the total medication-related burden score was 107.5 ± 20.7. The findings showed that 45.3% of patients with UC had a moderate degree of medication-related burden, followed by minimum burden (44.2%), high burden (5.8%), and no burden (4.7%). The lowest median burden scores emerged in five domains: interactions with healthcare professionals, practical difficulties with medication use, medication side effects, medication effectiveness, and the impact on daily life. Conversely, the highest-burden scores were noted in the cost, concerns about medication use, and autonomy to vary the regimen domains. In multivariate analysis, none of the patient-related variables was independently correlated with the total medication-related burden score. A large proportion of the patients with UC who participated in the current study reported varying degrees of medication-related burden, with the majority having a minimum to moderate medication-related burden.

The liver is a critical organ in the human body and is frequently exposed to numerous exogenous toxic substances, including silver nanoparticles (AgNPs). This study aimed to examine the anti-inflammatory, anti-angiogenic, and hepatoprotective effects of Withania somnifera (W. somnifera) extract on AgNP-induced liver toxicity in Swiss mice. Fifty mice were divided into five groups. Group I (negative control) consisted of ten mice. Group II received oral W. somnifera extracts (80 mg/kg/bw) for 14 days. Group III was injected intraperitoneally (i.p.) with AgNPs at a daily dose of 35 mg/kg/bw for 3 days. Group IV received i.p. AgNPs for 3 days, followed by saline for 14 days. Group V received i.p. AgNPs for 3 days, followed by oral W. somnifera (80 mg/kg/bw) for 14 days. Liver function tests, pro and anti-inflammatory cytokines, antioxidant activities, protein carbonyl (PC) levels, liver histopathological analysis, immunohistochemical expressions of transcription factor (NF-κB), and vascular endothelial growth factor (VEGF) were examined. Group III had elevated levels of liver function, a significant increase of pro and anti-inflammatory cytokines, antioxidant activity, and PC levels. Histological observations revealed congested sinusoids filled with red blood cells (RBCs) and hepatocyte necrosis. Also, positive expressions of NF-κB and VEGF were detected compared with Group I. However, the administration of W. somnifera to Group V revealed significant changes with evident improvements in liver function biomarkers, pro and anti-inflammatory cytokines, antioxidant activities, oxidative stress markers (PC), and histopathological and immunohistochemical parameters compared to Group III. The results revealed that W. somnifera has promising and potential hepatoprotective, anti-inflammatory, and anti-angiogenic effects against liver toxicity. Further detailed studies are recommended to explore the potential of W. somnifera as a treatment for human liver ailments.

Influenza affects millions globally each year, often causing severe complications, hospitalizations, and deaths, particularly among the elderly. As the global population ages, infections will pose a growing health risk. Annual vaccination remains the most effective way to prevent influenza and its complications. After the age of 65, people suffering from chronic diseases become the majority of this population category. All the data support that most of the population over 65 years old, whose immune system goes through immunosenescence, presents multimorbidity, requiring age-appropriate anti-influenza protection. The immune response to the traditional influenza vaccine has been proven to be lower in the elderly, highlighting the need for a more immunogenic vaccine specifically tailored to the elderly population group. Therefore, high-dose (HD) influenza vaccines have demonstrated their safety and are more effective in preventing influenza and its associated complications compared to standard-dose (SD) vaccines in the elderly in the context of immunosenescence. These recommendations focus on the safety, effectiveness, and efficacy of HD influenza vaccines, adapted to the elderly and available on the Romanian market, to increase the vaccination rate and, thus, protect against influenza infection and its complications. Therefore, strategies such as increased accessibility and free immunizations, as well as ensuring that flu vaccines for the elderly are prescribed without restrictions based on the number of comorbidities, should be used.

The World Health Organization (WHO) Central Nervous System (CNS) Tumors Classification 5^th edition (2021) integrates both molecular and histopathological criteria for diagnosing glial tumors. This updated classification highlights significant differences between pediatric and adult gliomas in terms of molecular characteristics and prognostic implications. The 5^th edition comprises a new category of pediatric-type diffuse low-grade glioma (PDLGG) and pediatric-type diffuse high-grade glioma (PDHGG), classified mainly based on genetic alterations and histopathological features. We reviewed the microscopy, diagnostic molecular pathology, and prognosis of various tumors under the categories PDLGG and PDHGG. The review also addresses the need for clarification concerning overlapping diagnostic features. PDLGG are characterized by diffuse growth, low-grade morphology, and MYB/MYBL1(MYB Proto-Oncogene Like 1) gene fusion or mitogen-activated protein kinase (MAPK) pathway alterations. In contrast, PDHGG is described by diffuse growth, high-grade morphology, and increased mitosis and often shows alterations of histone gene resulting in epigenetic alterations, which contrasts with common isocitrate dehydrogenase (IDH) mutation and epidermal growth factor receptor (EGFR) amplification seen in adult-type high-grade glioma.

Sarcopenia, first introduced as a concept by I. Rosenberg in 1989, has since been extensively studied, particularly in its correlation with chronic diseases. In recent years, sarcopenia has been increasingly associated with advanced chronic liver disease, leading to a lower quality of life and poor outcomes for these patients. Studies have shown that sarcopenia has a prevalence of 33% in individuals with advanced chronic liver disease, impacting not only the patient's health but also contributing to increased healthcare costs. The prevalence of frailty in patients with advanced chronic liver disease is 27%. Given the high prevalence of sarcopenia and frailty in this population, early diagnosis and treatment are crucial to improving patient quality of life outcomes and reducing the strain on healthcare systems globally.

Bullying in schools is a serious global health issue that jeopardizes youth and future adult health and negatively impacts academic outcomes. This cross-sectional study investigated the prevalence, forms, and associated factors of bullying among students aged 7-17 in public schools in Shaqra City, Saudi Arabia, where no prior data existed. A total of 372 students participated, with a median age of 11 years (interquartile range 9-14), of whom 187 were girls. 27 students (12.6%) reported being bullied in the past month, primarily through verbal abuse (89.4%), followed by physical bullying (10.6%). Cyberbullying was prevalent, with all students bullied experiencing it through social media, and some through texting (6 students, 1.6%) or email (3 students, 0.8%). Factors like student and parent age, student sex, school level, class level, nationality, chronic diseases, polygamy, and smartphone ownership were not associated with bullying. Cyberbullying and bullying affected 12.6% of students. Verbal bullying, the most common, occurred in restrooms and halls. Victims were hesitant to discuss their worries with anyone. Bullying incidents both within and outside of schools were more likely to result in positive adult intervention. Bullying among adolescents was attributed to factors such as physical strength and size. The possible reactions of bystander peers to a bullying incident include alerting the school administration and directly intervening independently.

Cardiovascular disease remains a leading cause of morbidity and mortality worldwide. Understanding and detecting risk factors are crucial for early diagnosis and prevention strategies. Obesity, dyslipidemia, hypertension, and insulin resistance, among others, have been described as modifiable risk factors. Among these, the triglycerides-to-HDL cholesterol (TG/HDL) ratio has been described as a marker of insulin resistance and a predictor of cardiovascular disease. Our objective was to investigate the association between the TG/HDL ratio and various cardiometabolic risk factors. A total of 239 young adults aged 18-24 years were recruited. We assessed anthropometric measurements, lipid profiles, glucose levels, insulin, the HOMA index, and the TG/HDL ratio. Participants were stratified based on their BMI and TG/HDL ratio. Our findings revealed that individuals with an elevated TG/HDL ratio had higher blood pressure, BMI, waist circumference, cholesterol, and triglyceride levels compared to those with a normal ratio. Specifically, the TG/HDL ratio was associated with an odds ratio (OR) of 9.3 for overweight, 27.5 for obesity, and 4.41 for abdominal obesity. Additionally, the HOMA index, which measures insulin resistance, was higher in those with an elevated TG/HDL ratio, with a prevalence of 45.6%. In conclusion, the TG/HDL ratio is a predictive marker of insulin resistance in young individuals and is associated with modifiable risk factors for cardiometabolic disease.