Medical Science Monitor : International Medical Journal of Experimental and Clinical Research最新文献

Eclampsia is the most serious pregnancy complication and one of the main causes of death of pregnant and delivering women. The mortality rate of young mothers is 5-20%, emphasizing the severity of this pregnancy-related disorder. Today many centers have only rare opportunities to see and deal with eclampsia cases; therefore, it is very important to bring this emergency medical condition to the attention of attending physicians. All patients with eclampsia, and after eclamptic seizures, should be treated in an intensive care unit. However, taking into account clinical realities, especially in developing countries, this is not always possible. It is necessary for all gynecologists-obstetricians to be fully prepared for eclampsia, although its occurrence is very rare. Drug treatment aims to stop eclampsia seizures and prevent reoccurrence of convulsions and complications. Magnesium sulphate is the drug of first choice used in treatment of eclampsia seizure, whereas treatment with the use of antihypertensive drugs and proper blood pressure control is one of the most important factors effectively reducing the risk of deaths or acute complications and poor pregnancy outcomes. The most urgent part of the treatment is the lifesaving procedure involving airways patency assessment, maintenance of breathing and blood circulation of the mother, securing an adequate oxygen level of the mother and thereby of the fetus, and prevention of injuries. This review aims to present an overview of the current prevalence, diagnosis, and management of eclampsia and the need for improved maternal care.

BACKGROUND Thoracic paravertebral block (TPVB) and erector spinae plane block (ESPB) are widely used in video-assisted thoracic surgery (VATS). However, they have corresponding adverse effects, including hypotension for TPVB and unpredictable injectate spread in ESPB. An optimal perioperative analgesic strategy remains controversial. We investigated the effect of ultrasound-guided combined TPVB and ESPB (CTEB) for VATS. MATERIAL AND METHODS A total of 120 patients scheduled for thoracic surgery were randomized to receive either ultrasound-guided TPVB, ESPB, or CTEB preoperatively. Postoperative analgesia was achieved with sufentanil patient-controlled intravenous analgesia. The primary outcome was the static pain score at 2 h after surgery. RESULTS The static pain score 2 h postoperatively was significantly different among the 3 groups. This difference was statistically significant for Group ESPB vs Group TPVB (P=0.004), but not for Group ESPB vs Group CTEB (P=0.767), or Group TPVB vs Group CTEB (P=0.117). Group TPVB exhibited the highest incidence of hypotension among the 3 groups. More patients experienced a sensory loss in Groups TPVB and CTEB 30 min after the block performance. Patients receiving CTEB exhibited a lower incidence of chronic pain 6 months postoperatively than those in Group ESPB. CONCLUSIONS CTEB does not enhance the analgesic effect of ESPB in patients undergoing VATS; however, it may induce a faster sensory loss after nerve block and reduce the incidence of postoperative chronic pain compared with ESPB. CTEB may also help to reduce the incidence of intraoperative hypotension compared with TPVB.

BACKGROUND Qigong, an ancient health preservation technique forming part of Traditional Chinese Medicine, combines slow body movements, breathing, and meditation. While this meditative movement system has been reported to offer various physical and psychological benefits, studies on the Taoist school of qigong are sparse. This study, therefore, aimed to investigate the effects of Taoist qigong on white blood cells and other immune parameters in healthy individuals. MATERIAL AND METHODS Thirty-eight participants were recruited for the study, with 21 assigned to the experimental group and 17 to the control group. Participants in the experimental group engaged in a four-week Taoist qigong program. Blood samples for immune parameter quantification, including leukocyte count, neutrophil, eosinophil, basophil, lymphocyte, and large unstained cell (LUC) counts, as well as concentrations of IgG, IgA, IgM, C3, and C4, were collected one day before the experiment started and one day after it ended. RESULTS Post-program, the experimental group exhibited significantly lower total leukocyte counts, and reduced numbers of lymphocytes and LUCs. Additionally, a higher percentage of monocytes was noted in this group. CONCLUSIONS Taoist qigong practice induced a distinct immunomodulatory profile, characterized by decreased counts of several white blood cell parameters and increased percentages of certain agranulocytes. This outcome presents intriguing implications from a psychobiological perspective and highlights the need for further research into the immune effects of Taoist mind-body practice.

BACKGROUND Periapical lesions (PL) are a common complication of endodontically treated teeth (ETT), which can result from a missed canal (MC). This study aimed to assess the prevalence of PL and MC in the ETT of a Chinese subpopulation and investigate potential associations between them. MATERIAL AND METHODS A total of 561 cone-beam computed tomography images were selected and analyzed. A total of 1024 endodontically treated posterior teeth excluding third molars were evaluated for the presence of PL and MC. The chi-square test or Fisher's exact test, as well as the odds ratio test, were used to determine whether there was an association and risk relationship between the incidence of PL and the occurrence of MC. RESULTS The overall prevalence of PL and MC in ETT was 56.1% and 19.0%, respectively. In endodontically treated molars, the incidence of PL and MC was 64.1% and 27.6%, whereas in premolars, it was 42.1% and 4.27%. The maxillary first molar showed the highest frequency of PL (71.5%) and MC (65.7%), with the mesiobuccal second canal being the most missed (78.8%). Teeth with an MC were found to be 3.658 times (95% confidence interval=2.541-5.301, P<0.0001) more likely to be associated with a PL. CONCLUSIONS Endodontically treated teeth with missed canals are associated with higher risks of periapical lesions. The high prevalence of these complications in a Chinese subpopulation underscores the importance of implementing enhanced diagnostic and treatment methods for root canal treatment or retreatment.

BACKGROUND The treatment of distal radius diaphyseal metaphyseal junction (DMJ) fracture in children is a clinical problem; several treatments are available, but none are very effective. Therefore, this study aimed to report a novel method for treating this fracture using limited open reduction and transepiphyseal intramedullary fixation with Kirschner wire. MATERIAL AND METHODS From January 2018 to December 2019, a total of 15 children (13 boys and 2 girls) with distal radius DMJ fractures with a mean age of 10 years (range: 6-14 years) were included in the study. The operation time, incision length, and X-ray radiation exposure were precisely recorded. All children were followed up regularly. At the final follow-up, clinical outcomes were evaluated according to Price criteria, and complications were recorded. RESULTS The mean operation time of the 15 children was 21.4 min, and the mean incision length was 1.9 cm. The intraoperative X-ray was performed 3.7 times on average. The mean radiographic union of fracture was 4.7 weeks, and the mean time to remove the Kirschner wire was 4.8 weeks for radial instrumentation and 4.7 months for ulnar instrumentation. According to the Price grading evaluation system, clinical outcome was excellent in 14 cases and good in 1 case. Moreover, there were no major complications related to loss of reduction, malunion, nonunion, and physeal arrest of the distal radius. CONCLUSIONS Limited open reduction and transepiphyseal intramedullary fixation with Kirschner wire are effective for treating distal radius DMJ fracture in children, which has the advantages of simple surgical procedures, short operation time, small incision, and less radiation exposure, making it an excellent choice for treating this fracture.

Breast cancer (BC) is the most frequently diagnosed malignancy in women worldwide. Despite the wide variety of therapeutic methods for BC, their results are not satisfying, especially in triple-negative breast cancer (TNBC) patients. One of the main challenges in efficient oncology is achieving optimal conditions to evaluate a molecular genotype and phenotype of a tumor. Therefore, new therapeutic strategies are urgently needed. Animal models are an important tool for the molecular and functional characterization of BC, and for the development of targeted BC therapies. Zebrafish, as a promising screening model organism, has been widely applied in the development of patient-derived xenografts (PDX) for the discovery of novel potential antineoplastic drugs. Moreover, the generation of BC xenografts in zebrafish embryos/larvae allows for a description of the tumor growth, cell invasion, and systemic interaction between tumor and host in vivo without immunogenic rejection of transplanted cancer cells. Interestingly, zebrafish can be genetically manipulated and their genome has been fully sequenced. Genetic studies in zebrafish have described new genes and molecular pathways involved in BC carcinogenesis. Thus, the zebrafish in vivo model is becoming an exquisite alternative for metastatic research and for discovering new active agents for BC therapy. Herein, we systematically reviewed the recent cutting-edge advances in zebrafish BC models for carcinogenesis, metastasis, and drug screening. This article aims to review the current status of the role of the zebrafish (Danio reiro) in preclinical and clinical models of biomarker identification and drug targeting, and developments in personalized medicine in BC.

Most studies on the long-term effects of SARS-CoV-2 infection have been retrospective, have lacked an uninfected comparison group, and have focussed on the prevalence of individual symptoms, resulting in different estimates of prevalence. Recognizing the range and complex interactions between the many long-term effects of COVID-19 is essential before effective prevention or management strategies can be investigated and implemented. Therefore, the term, long COVID, is too simplistic, and there are reasons to replace it with the term, post-acute sequelae of SARS-CoV-2 infection (PASC). The National Institutes of Health (NIH) have established the Researching COVID to Enhance Recovery (RECOVER) Consortium, a prospective longitudinal cohort initiative to learn about the long-term effects of COVID-19. Analysis of the RECOVER data identified 37 symptoms involving multiple systems at 6 months. This Editorial aims to present the range and complex interactions between the many long-term effects of COVID-19 that support the updated terminology of PASC.

BACKGROUND The COVID-19 epidemic has caused a huge amount of occupational stress among emergency department (ED) nurses. They are not only at high risk of infection, but they are also more likely to experience mental health problems. This study aimed to investigate the factors associated with psychological distress and resilience among ED nurses. MATERIAL AND METHODS This was a multi-center, cross-sectional study using cluster sampling. The survey utilizing a general information questionnaire, Kessler Psychological Distress Scale (K10), and 10-item Connor-Davidson Resilience Scale (CD-RISC-10) was conducted with 374 ED nurses working in 3 women's and children's hospitals in Chengdu, Sichuan, China between November 20 and November 27, 2021. Descriptive analysis, single-factor analysis, and correlation analysis were performed on data. RESULTS The nurses' mean score for the K10 was 20.65±5.99. Three hundred (80.2%) nurses had K10 scores of 16 or above. The nurses' mean score for the CD-RISC-10 was 27.73±6.520. Work hours and work area were the factors associated with psychological distress (F=11.858, P<0.05; F=3.467, P<0.05). Age and work hours were the factors associated with resilience (F=3.231, P<0.05; t=11.937, P<0.05). The K10 score was negatively correlated with the CD-RISC-10 score (P<0.01, r=-0.453). CONCLUSIONS Of the 374 nurses, 80.2% had psychological distress. Nurse managers should consider the factors associated with psychological distress and resilience and take positive measures to relieve the nurses' psychological distress.

BACKGROUND This study aimed to compare a composite resin (Duo-Shade) shade guide with Vita ceramic shades before/after chemical and autoclave sterilization. MATERIAL AND METHODS Color values (L*a*b*) were recorded directly from shade tabs of prefabricated composite resin (Brilliant NG Universal Duo-Shade) and ceramic (Vita classic) shade guide with a calibrated spectrophotometer (Vita Easy Shade Advance 4.0). Seventy-two composite resin disk samples with 6 different shades (A1/B1, A2/B2, A3/D3, A3.5/B3, A4/C4, and C2/C3) (n=12 each) were divided into 2 groups (Gp) - Gp A (Autoclave) and Gp C (Chemical) (15 cycles) - to assess their influence on respective shades. Mean values calculated the color differences (ΔE) while differences in color values (L*a*b*) were graded on the National Bureau of Standards (NBS) 6-grade scale and assessed for Clinical Acceptance/Perceptible Threshold (CAT), (CPT). All differences were considered significant if the color difference ΔE was ≥3.3. RESULTS Only 2 out of 12 Shade tabs (C2C3, A4C4) of composite resin matched to Vita shade tab C2 and C4 (ΔE ≤3.3). Both groups showed notable color differences after respective sterilization protocols, with color differences in Gp A significantly higher than Gp C (DE ³3.3). Within groups, all shades in Gp A showed remarkably different color changes, with shade C2C3 and A1B1 being denoted as clinically unacceptable. CONCLUSIONS Manufacturer-provided shade guides do not match ceramic shades as claimed and chemical sterilization using 10% Deconex was associated with less color changes than with autoclave sterilization.

BACKGROUND This study, employing an online questionnaire, aimed to assess and contrast the awareness, knowledge, and perceptions of dentists in Saudi Arabia (SA) regarding endocrowns (EC) as post-endodontic restorations with those of dentists educated in various other countries. MATERIAL AND METHODS We conducted a cross-sectional survey among dental interns and practicing dentists in government facilities, private dental centers, and dental colleges in SA, including participants of diverse nationalities. We disseminated validated, closed-ended questionnaires through WhatsApp via Google Forms. The Chi-square test was applied to assess associations between categorical variables, with a P-value of ≤0.05 indicating statistical significance. RESULTS The majority of participants (61.2%) indicated that EC restorations are best suited for molar teeth. Furthermore, 69.6% asserted that the primary objective of employing EC is to accomplish minimally invasive preparations while preserving the existing tooth structure. Among the responses, 68.3% pinpointed debonding of ECs as a significant cause of failure. Notably, substantial differences were observed in responses concerning the knowledge or practice of EC across various factors such as gender, educational attainment, country of graduation, and workplace. CONCLUSIONS The findings reveal a comparatively low adoption of ECs among the participants, irrespective of experience or country of education. This underscores the need for incorporating ECs into dental curricula through theoretical and clinical discussions or considering them as a subject for post-graduate continuing education programs.