Pub Date : 2023-01-01DOI: 10.18103/mra.v11i10.4241
Sophie Laven, Daniek Meijs, Zenab Alsalhi, Esmée Vaes, Nick Wilmes, Eveline Luik, Maud Vesseur, Sander Haas, Chahinda Doha, Marc Spaanderman
Background: Hypertension is the leading risk factor for cardiovascular disease (CVD) in females. While treatment of high BP is essential in the global prevention strategies of CVD it is assumed that effectiveness of pharmacological treatment may be different across sexes. Objective: The aim of this systematic review and meta-analysis was to evaluate sex-stratified effects for angiotensin receptor blockers (ARBs) on blood pressure (BP), heart rate and cardiac function in female compared to male hypertensive individuals. Design and methods: We performed a series of systematic reviews and meta-analysis after we systematically searched PubMed and EMBASE for studies evaluating the effects of the five major groups of antihypertensive medication from 1945 to May 2020. We included randomized control trials and observational studies in humans (≥18 years) investigating Beta-blockers (BB), angiotensin converting enzyme inhibitors (ACE-I), angiotensin receptor blockers (ARB), calcium channel blockers (CCB), and diuretics. In this study we analysed data on ARB’s. Studies had to present both baseline and follow-up measurements of at least one of the outcome variables of interest and present their data in a sex-stratified manner. Data on BP, heart rate and cardiac function were retrieved from studies. Mean differences between baseline and follow-up were calculated using a random-effects model. Intervention effect was assessed for the acute (0-14 days), subacute (15-30 days) and chronic (>31 days) phase. Results: The search strategy resulted in 73,867 hits. After first screening based on title and abstract, 15,130 articles were suitable for full text screening. After excluding all studies that matched our exclusion criteria, 205 studies were eligible for analysis for the five antihypertensive drugs. Studies investigating ARB´s (n=17) were used in this review. ARB decreased BP significantly but comparably in both female and male; systolic BP -18.2 mmHg (95% CI, -24.8; -11.5) vs -20.1 mmHg (95% CI, -26.7; -13.6) and diastolic BP -11.6 mmHg (95% CI, -14.7; -8.4) vs -12.3 mmHg (95% CI, -16.4; -8.1). Left ventricular ejection fraction (LVEF) did not change significantly in either group. Left ventricle (LV) mass was only reported in males and did not change statistically significant -11.8 g (95% CI, -25.6; 1.9). Conclusion: ARB’s decreased BP in both female and male hypertensive patients substantially but comparably.
背景:高血压是女性心血管疾病(CVD)的主要危险因素。虽然治疗高血压在心血管疾病的全球预防策略中至关重要，但假设药物治疗的有效性可能因性别而异。目的:本系统综述和荟萃分析的目的是评价血管紧张素受体阻滞剂(ARBs)对女性高血压患者血压(BP)、心率和心功能的影响，并将其与男性高血压患者进行比较。设计和方法:我们系统地检索PubMed和EMBASE，以评估1945年至2020年5月期间五组主要抗高血压药物的疗效，随后进行了一系列系统评价和荟萃分析。我们纳入了随机对照试验和人类观察性研究(≥18岁)，研究了β受体阻滞剂(BB)、血管紧张素转换酶抑制剂(ACE-I)、血管紧张素受体阻滞剂(ARB)、钙通道阻滞剂(CCB)和利尿剂。在这项研究中，我们分析了ARB的数据。研究必须提供至少一个感兴趣的结果变量的基线和随访测量，并以性别分层的方式提供数据。从研究中检索血压、心率和心功能的数据。使用随机效应模型计算基线和随访之间的平均差异。在急性期(0-14天)、亚急性期(15-30天)和慢性期(31天)评估干预效果。结果:该搜索策略产生了73,867个点击。经过第一次基于标题和摘要的筛选，有15,130篇文章适合全文筛选。在排除了所有符合我们排除标准的研究后，205项研究有资格分析这5种抗高血压药物。本综述使用了调查ARB的研究(n=17)。ARB显著降低血压，但在女性和男性中具有可比性;收缩压-18.2 mmHg (95% CI， -24.8;-11.5) vs -20.1 mmHg (95% CI， -26.7;-13.6)，舒张压-11.6 mmHg (95% CI， -14.7;-8.4) vs -12.3 mmHg (95% CI， -16.4;-8.1)。两组左心室射血分数(LVEF)均无显著变化。左心室(LV)质量仅在男性中报道，没有统计学意义的变化-11.8 g (95% CI， -25.6;1.9)。结论:ARB对女性和男性高血压患者的降压作用明显，但具有可比性。
{"title":"Sex Differences in the Efficacy of Angiotensin Receptor Blockers in Blood Pressure Lowering and Cardiac Remodeling: A Systematic Review and Meta-Analysis","authors":"Sophie Laven, Daniek Meijs, Zenab Alsalhi, Esmée Vaes, Nick Wilmes, Eveline Luik, Maud Vesseur, Sander Haas, Chahinda Doha, Marc Spaanderman","doi":"10.18103/mra.v11i10.4241","DOIUrl":"https://doi.org/10.18103/mra.v11i10.4241","url":null,"abstract":"Background: Hypertension is the leading risk factor for cardiovascular disease (CVD) in females. While treatment of high BP is essential in the global prevention strategies of CVD it is assumed that effectiveness of pharmacological treatment may be different across sexes. Objective: The aim of this systematic review and meta-analysis was to evaluate sex-stratified effects for angiotensin receptor blockers (ARBs) on blood pressure (BP), heart rate and cardiac function in female compared to male hypertensive individuals. Design and methods: We performed a series of systematic reviews and meta-analysis after we systematically searched PubMed and EMBASE for studies evaluating the effects of the five major groups of antihypertensive medication from 1945 to May 2020. We included randomized control trials and observational studies in humans (≥18 years) investigating Beta-blockers (BB), angiotensin converting enzyme inhibitors (ACE-I), angiotensin receptor blockers (ARB), calcium channel blockers (CCB), and diuretics. In this study we analysed data on ARB’s. Studies had to present both baseline and follow-up measurements of at least one of the outcome variables of interest and present their data in a sex-stratified manner. Data on BP, heart rate and cardiac function were retrieved from studies. Mean differences between baseline and follow-up were calculated using a random-effects model. Intervention effect was assessed for the acute (0-14 days), subacute (15-30 days) and chronic (>31 days) phase. Results: The search strategy resulted in 73,867 hits. After first screening based on title and abstract, 15,130 articles were suitable for full text screening. After excluding all studies that matched our exclusion criteria, 205 studies were eligible for analysis for the five antihypertensive drugs. Studies investigating ARB´s (n=17) were used in this review. ARB decreased BP significantly but comparably in both female and male; systolic BP -18.2 mmHg (95% CI, -24.8; -11.5) vs -20.1 mmHg (95% CI, -26.7; -13.6) and diastolic BP -11.6 mmHg (95% CI, -14.7; -8.4) vs -12.3 mmHg (95% CI, -16.4; -8.1). Left ventricular ejection fraction (LVEF) did not change significantly in either group. Left ventricle (LV) mass was only reported in males and did not change statistically significant -11.8 g (95% CI, -25.6; 1.9). Conclusion: ARB’s decreased BP in both female and male hypertensive patients substantially but comparably.","PeriodicalId":18641,"journal":{"name":"Medical Research Archives","volume":"72 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135446935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Falls constitute a major public health problem among older persons worldwide. This study attempted to observe and identify the potential environmental hazards within and outside the houses that could have caused fall-related injuries of older persons. The modifications done to the house after the falls were also observed. Households of older persons who were hospitalised at a tertiary care centre in Thiruvananthapuram district of Kerala, India for complaints of fall related injuries (participants of a case-control study) were observed using a guide that was customized and adapted for the setting. The areas around the houses were slippery and had several tripping hazards. Marble, granite and tiled floors were found to be slippery. Door thresholds, door mats with no grip backing and plastic chairs were found to be potential tripping hazards. Steps/stairs were important in causation of falls. The bedrooms were often dark, small and cluttered with furniture. The bathrooms were frequently located outdoors and at a different level from the rest of the house. Lighting was a problem within the house, inside the toilet and bathrooms. Commonest alteration made to prevent falls was introduction of mats inside and outside the house. Changes that were needed for a safe environment for older persons are often challenged by the need to display status markers. Several potential hazards were identified within and around the house. They either precipitated the falls or modified the outcome of falls. Further research is necessary to work out a guideline for constructing safe and friendly houses for older persons.
{"title":"Assessment of Household Environmental Risk Factors for Falls Among Community Dwelling Older Persons in Thiruvananthapuram District of Kerala","authors":"Rekha Ravindran, V Kutty","doi":"10.18103/mra.v11i9.4385","DOIUrl":"https://doi.org/10.18103/mra.v11i9.4385","url":null,"abstract":"Falls constitute a major public health problem among older persons worldwide. This study attempted to observe and identify the potential environmental hazards within and outside the houses that could have caused fall-related injuries of older persons. The modifications done to the house after the falls were also observed. Households of older persons who were hospitalised at a tertiary care centre in Thiruvananthapuram district of Kerala, India for complaints of fall related injuries (participants of a case-control study) were observed using a guide that was customized and adapted for the setting. The areas around the houses were slippery and had several tripping hazards. Marble, granite and tiled floors were found to be slippery. Door thresholds, door mats with no grip backing and plastic chairs were found to be potential tripping hazards. Steps/stairs were important in causation of falls. The bedrooms were often dark, small and cluttered with furniture. The bathrooms were frequently located outdoors and at a different level from the rest of the house. Lighting was a problem within the house, inside the toilet and bathrooms. Commonest alteration made to prevent falls was introduction of mats inside and outside the house. Changes that were needed for a safe environment for older persons are often challenged by the need to display status markers. Several potential hazards were identified within and around the house. They either precipitated the falls or modified the outcome of falls. Further research is necessary to work out a guideline for constructing safe and friendly houses for older persons.","PeriodicalId":18641,"journal":{"name":"Medical Research Archives","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135914325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The management of non-Hodgkin lymphoma (NHL), including refractory and relapsed high grade and low-grade NHL has been significantly improved in recent years with the development of cellular therapies which harness the powerful anti-cancer effects of the immune system. These include the ground-breaking and now established technology of chimeric antigen receptor cell therapy as well as the promising new range of bispecific monoclonal antibody therapies. This article will give a summary of the currently available cellular and bi-specific antibody therapies for the treatment of NHL in licenced use and clinical trials, including an overview of their proven efficacy and characteristic side-effect profiles which distinguish them from conventional immunochemotherapy. The relative strengths and weaknesses of these comparable therapies will also be discussed together with consideration of where they may fit into the treatment sequence of NHL in the future. The article will also address the challenges of delivering these innovative technologies in different healthcare settings and how they may alter the future of therapy for patients with this form of cancer.
{"title":"An An Overview of the Treatment of Non-Hodgkin Lymphoma with The Novel Cellular Therapies: CAR-T and Bispecific Monoclonal Antibodies","authors":"David Tucker, Christine Thiebaud","doi":"10.18103/mra.v11i9.4494","DOIUrl":"https://doi.org/10.18103/mra.v11i9.4494","url":null,"abstract":"The management of non-Hodgkin lymphoma (NHL), including refractory and relapsed high grade and low-grade NHL has been significantly improved in recent years with the development of cellular therapies which harness the powerful anti-cancer effects of the immune system. These include the ground-breaking and now established technology of chimeric antigen receptor cell therapy as well as the promising new range of bispecific monoclonal antibody therapies. This article will give a summary of the currently available cellular and bi-specific antibody therapies for the treatment of NHL in licenced use and clinical trials, including an overview of their proven efficacy and characteristic side-effect profiles which distinguish them from conventional immunochemotherapy. The relative strengths and weaknesses of these comparable therapies will also be discussed together with consideration of where they may fit into the treatment sequence of NHL in the future. The article will also address the challenges of delivering these innovative technologies in different healthcare settings and how they may alter the future of therapy for patients with this form of cancer.","PeriodicalId":18641,"journal":{"name":"Medical Research Archives","volume":"2016 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135914653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Thyroid hormones play a crucial role in metabolism and the proliferation of blood cells. Therefore, thyroid hormones have a direct effect on blood parameters by stimulating erythrocyte precursors and indirect effect by enhancing erythropoietin production. Additionally, it affects red blood cells include mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, and red cell distribution width. In this study, we evaluated difference of complete blood count result between the healthy control, Hashimoto thyroiditis and Graves’ disease study groups. Methods and results: This is a cross-sectional study which included 158 subjects (male 9, female 149), categorized into three groups: control, hypothyroidism (patients with Hashimoto’s thyroiditis), and hyperthyroidism (patient with Graves’ disease). The analyses showed a significant difference the between the groups in term of mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, and red cell distribution width and monocyte (p values < 0.05). Conclusion: The functional abnormalities of the thyroid gland significantly impact blood cells, and the complete blood cell count results play a critical role in the diagnosis of the condition.
{"title":"Effect of Thyroid Dysfunction on Complete Blood Count","authors":"Bolormaa Ganbaatar, Davaasuren Damdindorj, Punsaldulam Tsogbadrakh, Anujin Rentsentavkhai, Maralmaa Khuder, Oyunbileg Bavuu","doi":"10.18103/mra.v11i9.4420","DOIUrl":"https://doi.org/10.18103/mra.v11i9.4420","url":null,"abstract":"Background: Thyroid hormones play a crucial role in metabolism and the proliferation of blood cells. Therefore, thyroid hormones have a direct effect on blood parameters by stimulating erythrocyte precursors and indirect effect by enhancing erythropoietin production. Additionally, it affects red blood cells include mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, and red cell distribution width. In this study, we evaluated difference of complete blood count result between the healthy control, Hashimoto thyroiditis and Graves’ disease study groups. Methods and results: This is a cross-sectional study which included 158 subjects (male 9, female 149), categorized into three groups: control, hypothyroidism (patients with Hashimoto’s thyroiditis), and hyperthyroidism (patient with Graves’ disease). The analyses showed a significant difference the between the groups in term of mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, and red cell distribution width and monocyte (p values < 0.05). Conclusion: The functional abnormalities of the thyroid gland significantly impact blood cells, and the complete blood cell count results play a critical role in the diagnosis of the condition.","PeriodicalId":18641,"journal":{"name":"Medical Research Archives","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135953285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In this narrative review, the scientific background of the use of collagen in osteoporosis is presented, drawing inspiration for a discussion on the food supplements use in medicine. The first part of the paper provides an overview on collagen and hydrolyzed collagen. The second part deals with collagen carential disease, comprising conditions ranging from nail fragility to osteoporosis. The third part focuses on osteoporosis and its treatment, the fourth on hydrolyzed collagen. The medical use of hydrolyzed collagen provides a typical example of “Green economy”, the new alliance between man and nature that is involving medicine too.
{"title":"Medical use of hydrolyzed collagen in osteoporosis","authors":"Bruno Silvestrini, Mauro Silvestrini","doi":"10.18103/mra.v11i9.4358","DOIUrl":"https://doi.org/10.18103/mra.v11i9.4358","url":null,"abstract":"In this narrative review, the scientific background of the use of collagen in osteoporosis is presented, drawing inspiration for a discussion on the food supplements use in medicine. The first part of the paper provides an overview on collagen and hydrolyzed collagen. The second part deals with collagen carential disease, comprising conditions ranging from nail fragility to osteoporosis. The third part focuses on osteoporosis and its treatment, the fourth on hydrolyzed collagen. The medical use of hydrolyzed collagen provides a typical example of “Green economy”, the new alliance between man and nature that is involving medicine too.","PeriodicalId":18641,"journal":{"name":"Medical Research Archives","volume":"40 43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135953299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alzheimer's disease is the most common neurodegenerative disease. It is believed that the number of people suffering from Alzheimer's disease worldwide is about 32 million, and the number of people with the preclinical stage of the disease can be up to 300 million. For a long time, it was believed that Alzheimer's disease arises as a result of disorders in the metabolism of amyloid beta and tau-protein in cerebral tissue. According to numerous recent studies, it has been established that the disease is accompanied by dyscirculatory angiopathy of Alzheimer's type. This is an Alzheimer's disease-specific complex lesion of the cerebral vascular system with arterial, microcirculatory, and venous bed disorders. One of the most promising directions in the field of brain revascularization, as well as the regeneration of cerebral tissue in Alzheimer's disease, is the use of laser with low output power. This direction was named laser “photobiomodulation therapy”. Currently, laser photobiomodulation therapy is divided into transcranial, intranasal, intravascular (intravenous) and transcatheter intracerebral methods of treatment. Laser energy has a complex effect on cerebral tissues. Photobiomodulation therapy stimulates angiogenesis, causes collateral and capillary revascularization, restores the exchange of adenosine triphosphate in neuronal mitochondria, improves cellular and tissue metabolism, stimulates neurogenesis, and causes regeneration of tissue structures. Various types of Photobiomodulation therapy are non-traumatic, physiological, pathogenetically substantiated, effective methods for the treatment of cerebral microcirculatory disorders in Alzheimer's disease. The choice of one or another method of laser photobiomodulation therapy is purely individual and depends on the specific clinical case.
{"title":"Various Methods of Laser Photobiomodulation Therapy for Alzheimer's Disease","authors":"Ivan Maksimovich","doi":"10.18103/mra.v11i9.4327","DOIUrl":"https://doi.org/10.18103/mra.v11i9.4327","url":null,"abstract":"Alzheimer's disease is the most common neurodegenerative disease. It is believed that the number of people suffering from Alzheimer's disease worldwide is about 32 million, and the number of people with the preclinical stage of the disease can be up to 300 million. For a long time, it was believed that Alzheimer's disease arises as a result of disorders in the metabolism of amyloid beta and tau-protein in cerebral tissue. According to numerous recent studies, it has been established that the disease is accompanied by dyscirculatory angiopathy of Alzheimer's type. This is an Alzheimer's disease-specific complex lesion of the cerebral vascular system with arterial, microcirculatory, and venous bed disorders. One of the most promising directions in the field of brain revascularization, as well as the regeneration of cerebral tissue in Alzheimer's disease, is the use of laser with low output power. This direction was named laser “photobiomodulation therapy”. Currently, laser photobiomodulation therapy is divided into transcranial, intranasal, intravascular (intravenous) and transcatheter intracerebral methods of treatment. Laser energy has a complex effect on cerebral tissues. Photobiomodulation therapy stimulates angiogenesis, causes collateral and capillary revascularization, restores the exchange of adenosine triphosphate in neuronal mitochondria, improves cellular and tissue metabolism, stimulates neurogenesis, and causes regeneration of tissue structures. Various types of Photobiomodulation therapy are non-traumatic, physiological, pathogenetically substantiated, effective methods for the treatment of cerebral microcirculatory disorders in Alzheimer's disease. The choice of one or another method of laser photobiomodulation therapy is purely individual and depends on the specific clinical case.","PeriodicalId":18641,"journal":{"name":"Medical Research Archives","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135953803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ulalume Arciga, Sofía Sánchez, Sara Ménde, Federico Martinez
Introduction: During pregnancy, P4 is essential to maintain the maternal-fetal relationship. Maternal cholesterol is the main source of P4 production, a process that takes place in the syncytiotrophoblast mitochondrion. The mechanism and proteins involved in the cholesterol transport for the steroidogenic process are still unknown in detail. The STARD3 protein could be the substitute for its STARD1 equivalent localized in all acute response tissues. However, mutation or null STARD3 mice maintain their reproductive capacity, suggesting other proteins are involved in this process. Previously, we reported that the HSP60 participates in steroidogenesis in mitochondria isolated from the placental syncytiotrophoblast, mitochondrial contact sites or JEG-3. Also, take relevance that non-steroidogenic cells, such as the HEK293, which are human kidney embryo cells, when are transformed into steroidogenic by transfection of the steroidogenic machinery, they synthesize progesterone. To understand better the mechanism through which HSP60 participates in placental steroidogenesis, mutation of cysteine 442, which is essential in the active site for its activity, and deletion of 146 amino acid residues of the N-terminal of HSP60 were performed. The first was implemented to determine whether the protein structure is essential to support steroidogenesis, and the second was done to elucidate whether its activity occurs outside or inside the mitochondrion. Methods: Two mutants were obtained: a) cysteine 442 was replaced by alanine (HSP60C442A) and b) the HSP60-mature (HSP60M) without the mitochondrial-leading sequence. Human kidney cells HEK293 were transformed into steroidogenic by transfection with pECE-P450scc, pCMV-3βHSD-I. The transfected cells were transfected with the HSP60wt, HSP60C442A, or HSP60M plasmids. The transfection was validated by western blot and P4 was determined by an enzyme immunoassay kit. HSP60 without mutations was used as control (HSP60wt). Results: The synthesis of P4 was stimulated by the wild type HSP60 (HSP60wt). However, with both mutants, steroidogenesis occurred as in the control, suggesting that mutants do not support P4 synthesis. Discussion: The mechanism to transport cholesterol to steroidogenic mitochondria requires the full HSP60 to support P4 synthesis, which is necessary to maintain pregnancy. Highlights HSP60 participates in the steroidogenesis of transformed HEK293 cells. Cys442 mutant of HSP60 loses its activity in steroidogenesis. N-terminal deletion of HSP60 is not involved in steroidogenesis. Native HSP60 is critical for steroidogenesis.
{"title":"Characterization of Mitochondrial Heat Shock Protein 60 variants in HEK293 Cells Transformed into Steroidogenic","authors":"Ulalume Arciga, Sofía Sánchez, Sara Ménde, Federico Martinez","doi":"10.18103/mra.v11i9.4274","DOIUrl":"https://doi.org/10.18103/mra.v11i9.4274","url":null,"abstract":"Introduction: During pregnancy, P4 is essential to maintain the maternal-fetal relationship. Maternal cholesterol is the main source of P4 production, a process that takes place in the syncytiotrophoblast mitochondrion. The mechanism and proteins involved in the cholesterol transport for the steroidogenic process are still unknown in detail. The STARD3 protein could be the substitute for its STARD1 equivalent localized in all acute response tissues. However, mutation or null STARD3 mice maintain their reproductive capacity, suggesting other proteins are involved in this process. Previously, we reported that the HSP60 participates in steroidogenesis in mitochondria isolated from the placental syncytiotrophoblast, mitochondrial contact sites or JEG-3. Also, take relevance that non-steroidogenic cells, such as the HEK293, which are human kidney embryo cells, when are transformed into steroidogenic by transfection of the steroidogenic machinery, they synthesize progesterone. To understand better the mechanism through which HSP60 participates in placental steroidogenesis, mutation of cysteine 442, which is essential in the active site for its activity, and deletion of 146 amino acid residues of the N-terminal of HSP60 were performed. The first was implemented to determine whether the protein structure is essential to support steroidogenesis, and the second was done to elucidate whether its activity occurs outside or inside the mitochondrion. Methods: Two mutants were obtained: a) cysteine 442 was replaced by alanine (HSP60C442A) and b) the HSP60-mature (HSP60M) without the mitochondrial-leading sequence. Human kidney cells HEK293 were transformed into steroidogenic by transfection with pECE-P450scc, pCMV-3βHSD-I. The transfected cells were transfected with the HSP60wt, HSP60C442A, or HSP60M plasmids. The transfection was validated by western blot and P4 was determined by an enzyme immunoassay kit. HSP60 without mutations was used as control (HSP60wt). Results: The synthesis of P4 was stimulated by the wild type HSP60 (HSP60wt). However, with both mutants, steroidogenesis occurred as in the control, suggesting that mutants do not support P4 synthesis. Discussion: The mechanism to transport cholesterol to steroidogenic mitochondria requires the full HSP60 to support P4 synthesis, which is necessary to maintain pregnancy. Highlights HSP60 participates in the steroidogenesis of transformed HEK293 cells. Cys442 mutant of HSP60 loses its activity in steroidogenesis. N-terminal deletion of HSP60 is not involved in steroidogenesis. Native HSP60 is critical for steroidogenesis.","PeriodicalId":18641,"journal":{"name":"Medical Research Archives","volume":"51 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135953977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
At Roseville Wellness Group, a Sydney holistic health care centre, 23 post-Covid patients who presented with persistent post infective symptomatology were identified. They all received primary treatment with auricular management using an Evo Premio Laser and secondary support treatment with body acupuncture dependent on the findings at the auricle at that time point. The vascular autonomic signal which is a physiological phenomenon locating dysfunction and distress for the brain and body was used at the auricle to locate vagal dysfunction and subsequent correction. Baseline Vagal Upload Times were measured in 23 post-COVID patients to assess the functional status of their Liver, Lungs, Kidneys and Spleen. Access was via the auricular branch of the vagus located at the concha. The patients were treated weekly and their Vagal Upload Times recorded. Recovery from COVID was associated with a reduction in upload time which decreased over the occasions of measurement for all participants and significant decreases were recorded from the start of treatment to the final session. Patients described improved ability to function, clearing of their brain fog, reduction in their chronic cough and also resolution of their vertigo or balance issues when the upload time reduced to less than 20 seconds per auricular point.
{"title":"Quantifying Vagal Upload Time to measure recovery from COVID","authors":"Im Smith","doi":"10.18103/mra.v11i9.4452","DOIUrl":"https://doi.org/10.18103/mra.v11i9.4452","url":null,"abstract":"At Roseville Wellness Group, a Sydney holistic health care centre, 23 post-Covid patients who presented with persistent post infective symptomatology were identified. They all received primary treatment with auricular management using an Evo Premio Laser and secondary support treatment with body acupuncture dependent on the findings at the auricle at that time point. The vascular autonomic signal which is a physiological phenomenon locating dysfunction and distress for the brain and body was used at the auricle to locate vagal dysfunction and subsequent correction. Baseline Vagal Upload Times were measured in 23 post-COVID patients to assess the functional status of their Liver, Lungs, Kidneys and Spleen. Access was via the auricular branch of the vagus located at the concha. The patients were treated weekly and their Vagal Upload Times recorded. Recovery from COVID was associated with a reduction in upload time which decreased over the occasions of measurement for all participants and significant decreases were recorded from the start of treatment to the final session. Patients described improved ability to function, clearing of their brain fog, reduction in their chronic cough and also resolution of their vertigo or balance issues when the upload time reduced to less than 20 seconds per auricular point.","PeriodicalId":18641,"journal":{"name":"Medical Research Archives","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135954313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.18103/mra.v11i10.4582
Christabel Cheung, Laundette Jones, Haelim Lee, Jordan Bridges, Reginald Seeley, Melissa Vyfhuis, Maria Gianelle, Bria Thomas, Gail Betz, Laurie Waldo, Alan Hirsch, Shana Ntiri
Background: Healthcare providers have an influential role in the experience of financial toxicity among their cancer patients, yet patients commonly report unmet needs and dissatisfaction regarding communication with their providers about financial concerns. Aims: The purpose of this study is to develop a novel financial navigation pathway that leverages existing patient financial services and resources with corresponding patient-centered, community-informed strategies, via study participants, that may be utilized in routine care to reduce financial hardship among cancer patients. Methods: We conducted in-depth interviews (n=50) with 34 cancer patients and 16 cancer care professionals at a National Cancer Institute designated comprehensive cancer center located in a dense urban area of the US between December 2022 to June 2023. Results: Content analyses resulted in emergent themes and representative quotations on experiences of financial hardship within the material, behavioral, and psychosocial domains. Investigators used emergent themes to develop financial strategies and construct a financial navigation pathway to screen patients for and intervene upon the financial toxicity of cancer in routine care. Conclusion: This study followed an innovative approach by constructing a financial navigation pathway tool that follows the oncological workflow at a National Cancer Institute designated comprehensive cancer center. Future research is needed to test the tool’s impact on financial toxicity, cancer outcomes, and other health-related outcomes, and to better understand how much patient navigation is needed to bring about meaningful change.
{"title":"Anticipatory Guidance: Developing a Patient Navigation Pathway to Reduce the Financial Toxicity of Cancer","authors":"Christabel Cheung, Laundette Jones, Haelim Lee, Jordan Bridges, Reginald Seeley, Melissa Vyfhuis, Maria Gianelle, Bria Thomas, Gail Betz, Laurie Waldo, Alan Hirsch, Shana Ntiri","doi":"10.18103/mra.v11i10.4582","DOIUrl":"https://doi.org/10.18103/mra.v11i10.4582","url":null,"abstract":"Background: Healthcare providers have an influential role in the experience of financial toxicity among their cancer patients, yet patients commonly report unmet needs and dissatisfaction regarding communication with their providers about financial concerns. Aims: The purpose of this study is to develop a novel financial navigation pathway that leverages existing patient financial services and resources with corresponding patient-centered, community-informed strategies, via study participants, that may be utilized in routine care to reduce financial hardship among cancer patients. Methods: We conducted in-depth interviews (n=50) with 34 cancer patients and 16 cancer care professionals at a National Cancer Institute designated comprehensive cancer center located in a dense urban area of the US between December 2022 to June 2023. Results: Content analyses resulted in emergent themes and representative quotations on experiences of financial hardship within the material, behavioral, and psychosocial domains. Investigators used emergent themes to develop financial strategies and construct a financial navigation pathway to screen patients for and intervene upon the financial toxicity of cancer in routine care. Conclusion: This study followed an innovative approach by constructing a financial navigation pathway tool that follows the oncological workflow at a National Cancer Institute designated comprehensive cancer center. Future research is needed to test the tool’s impact on financial toxicity, cancer outcomes, and other health-related outcomes, and to better understand how much patient navigation is needed to bring about meaningful change.","PeriodicalId":18641,"journal":{"name":"Medical Research Archives","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134889823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Seven decades ago, over 80% of Indian pregnant women were anaemic. About 3/4th of anaemia was due to nutritional deficiencies of: iron (most common), folic acid (second) and vitamin B12 (not as common). Anaemia in pregnancy was associated with higher maternal morbidity and mortality, low birth weight and high perinatal mortality. Detection and appropriate management of anaemia, including parenteral iron therapy and intensive care for severe anaemia were important components of antenatal care in India, but only about 10% of women had access to antenatal care. In 1970s the national programme for anaemia in pregnancy focussed on identifying all pregnant women and providing them iron and folic acid (IFA) supplementation. The coverage and compliance with supplementation were low. In 1990 when the primary health care infrastructure was established, the anaemia control programme embarked on testing and providing appropriate treatment to anaemic women. The tertiary care centres operationalised this “test and treat” strategy. In primary and secondary care settings, accurate test for diagnosis of anaemia was not available. In the absence of accurate Hb estimation at all levels of care, it was not possible to provide appropriate treatment based on Hb levels. So, all pregnant women continued to receive one tablet of IFA throughout pregnancy. Over the next two decades, coverage under antenatal care and IFA supplementation improved but compliance with supplementation was low because about a third of pregnant women had gastrointestinal side effects with IFA. Despite these problems, between 2002 and 2015, there had been a decline in the prevalence of severe and moderate anaemia. To accelerate the decline in anaemia in pregnancy the country is focusing on the ‘test and treat’ strategy in pregnant women using an accurate method for Hb estimation and providing appropriate treatment. Nutrition education to improve iron intake prior to and during pregnancy, is focussing on dietary diversification and use of iron fortified salt or cereals. Progress will be monitored through national surveys and locale specific appropriate mid-course modifications in the programme will be made.
{"title":"Prevention and management of Anaemia in Pregnancy in India: Challenges and Opportunities","authors":"Prema Ramachandran, K. Kalaivani","doi":"10.18103/mra.v11i9.4404","DOIUrl":"https://doi.org/10.18103/mra.v11i9.4404","url":null,"abstract":"Seven decades ago, over 80% of Indian pregnant women were anaemic. About 3/4th of anaemia was due to nutritional deficiencies of: iron (most common), folic acid (second) and vitamin B12 (not as common). Anaemia in pregnancy was associated with higher maternal morbidity and mortality, low birth weight and high perinatal mortality. Detection and appropriate management of anaemia, including parenteral iron therapy and intensive care for severe anaemia were important components of antenatal care in India, but only about 10% of women had access to antenatal care. In 1970s the national programme for anaemia in pregnancy focussed on identifying all pregnant women and providing them iron and folic acid (IFA) supplementation. The coverage and compliance with supplementation were low. In 1990 when the primary health care infrastructure was established, the anaemia control programme embarked on testing and providing appropriate treatment to anaemic women. The tertiary care centres operationalised this “test and treat” strategy. In primary and secondary care settings, accurate test for diagnosis of anaemia was not available. In the absence of accurate Hb estimation at all levels of care, it was not possible to provide appropriate treatment based on Hb levels. So, all pregnant women continued to receive one tablet of IFA throughout pregnancy. Over the next two decades, coverage under antenatal care and IFA supplementation improved but compliance with supplementation was low because about a third of pregnant women had gastrointestinal side effects with IFA. Despite these problems, between 2002 and 2015, there had been a decline in the prevalence of severe and moderate anaemia. To accelerate the decline in anaemia in pregnancy the country is focusing on the ‘test and treat’ strategy in pregnant women using an accurate method for Hb estimation and providing appropriate treatment. Nutrition education to improve iron intake prior to and during pregnancy, is focussing on dietary diversification and use of iron fortified salt or cereals. Progress will be monitored through national surveys and locale specific appropriate mid-course modifications in the programme will be made.","PeriodicalId":18641,"journal":{"name":"Medical Research Archives","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136258238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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