Open Medicine最新文献

Objectives: This study sought to identify the risk factors associated with venous thrombosis for spontaneous intracerebral hemorrhage (ICH) in a long term.

Methods: A retrospective analysis was performed on the ICH patients between January 2021 and December 2022.

Results: A total of 737 patients were examined with 86 patients (11.7 %) of venous thrombosis. The risk factors linked to venous thrombosis were the length of hospital stay (p<0.001), admission NIH Stroke Scale (p=0.008), and D-dimer levels (p=0.041). No significant differences in mortality rates existed at any timepoint in this study between patients with and without venous thrombosis after correction analysis (p>0.05). However, patients who developed a venous thrombosis exhibited a higher rate of poor outcomes compared to patients who did not develop a venous thrombosis (p<0.05) at the time of hospital discharge (90.7 % vs. 59.6 %), 90 days post-onset (73.2 % vs. 41.6 %), and 1-year post-onset (73.2 % vs. 41.0 %).

Conclusions: The identified risk factors for venous thrombosis among ICH patients include extended hospitalization, elevated NIH Stroke Scale score and D-dimer level. The occurrence of a venous thrombosis correlated with inferior functional outcomes at the time of hospital discharge, at 90 days and 1 year after onset.

Objectives: Our research aimed to explore the potential indicators in discriminating mycoplasma pneumoniae pneumonia (MPP) from viral pneumonia (VP) in children.

Methods: TaqMan PCR testing was used to detect respiratory pathogens in all pneumonia patients. The serum levels of IL-37 and YKL-40 were measured by ELISA. While the expression levels of YKL-40 and IL37 mRNA in PBMCs were detected by qRT-PCR. We calculated the neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) values from blood routine test results. This study had been registered in the Chinese Clinical Trials Registry System (MR-32-24-025608).

Results: 170 patients were selected, including 85 MPP patients and 85 VP patients. In addition, 85 healthy control children were selected for comparison. The levels of serum YKL-40, IL-37 and their mRNA expressions in MPP patients were significantly higher than in VP patients and healthy control. Similarly, MPP patients had the highest levels of NLR and PLR. According to the ROC curve result, the combination of two indicators (YKL-40 and NLR) was the strongest predictor of MP vs. VP.

Conclusions: These results indicate that YKL-40 and NLR constitute the critical combination of biomarkers useful for differentiating between MPP and VP in children.

Objectives: This study provides the first comprehensive assessment of the global thyroid cancer burden from 1990 to 2021, focusing on incidence, mortality, and DALYs trends across 204 countries.

Methods: Using Global Burden of Disease (GBD) 2021 data, age-standardized rates (ASRs) and estimated annual percentage changes (EAPCs) were calculated. Associations with the Socio-demographic Index (SDI) were analyzed via linear regression.

Results: Globally, the age-standardized incidence rate increased from 2.06 to 2.91 per 100,000 (EAPC=1.25), with women accounting for 67 % of cases. Mortality showed a modest decline (EAPC=-0.23), but DALYs remained high (14.57 million in 2021). High-SDI regions, such as North America, accounted for 72 % of cases, reflecting intensive screening, whereas low-SDI regions, particularly Sub-Saharan Africa, contributed 68 % of deaths due to delayed diagnosis. High BMI contributed 1.68 % of DALYs, peaking at 4.26 % in Andean Latin America. Incidence varied significantly across countries, from 7.13 per 100,000 in Saudi Arabia (linked to iodine excess) to 0.014 per 100,000 in Tajikistan (iodine deficiency). Mortality was highest among elderly males, reaching 12.57 per 100,000 in those aged ≥90 years.

Conclusions: The rising global burden of thyroid cancer highlights pronounced gender and regional disparities. High-SDI regions should prioritize risk-stratified strategies to reduce overdiagnosis, while low-SDI regions require improved access to healthcare. Targeted efforts in early detection and metabolic risk reduction are critical to mitigate disease burden.

Objectives: To investigate the relationship between serum miR-342, miR-148a, and acute lung injury (ALI) in sepsis patients.

Methods: A total of 177 sepsis patients were divided into ALI and non-ALI groups; ALI patients were further classified as mild, moderate, or severe. 162 pneumonia patients served as controls. Serum miR-342 and miR-148a levels were measured using RT-qPCR.

Results: Sepsis patients had lower miR-342 and higher miR-148a than controls (p<0.05). Compared with non-ALI patients, the ALI group showed higher miR-148a, PaCO2, APACHE II scores, and RI, but lower miR-342 and OI (p<0.05). miR-342 decreased and miR-148a increased with ALI severity. Correlation analysis revealed that miR-342 was negatively correlated with PaCO2, APACHE II, and RI, and positively with OI, while miR-148a showed opposite trends. The AUC for predicting ALI using miR-342, miR-148a, and their combination was 0.818, 0.775, and 0.896, respectively.

Conclusions: Sepsis patients with ALI exhibit low serum miR-342 and high miR-148a, and their combination can effectively predict ALI occurrence.

Objectives: This study aimed to evaluate the significance of integrating hearing screening with genetic testing for hereditary deafness.

Methods: A retrospective analysis was performed on the hearing screening and genetic testing outcomes of 10,754 newborns delivered at Hangzhou Women's Hospital from June 2020 to December 2022. Hearing evaluations were conducted using transiently evoked otoacoustic emissions (TEOAE) and automated auditory brainstem response (AABR). For genetic testing, dried blood spots were collected, and 15 variants across four genes (GJB2, GJB3, SLC26A4, and mtDNA 12S rRNA) were examined using a DNA microarray platform.

Results: Among the 10,754 infants, the most commonly detected mutations were GJB2c.235delC (47.26 %) and SLC26A4 IVS7-2 A>G (21.17 %). A total of 62 infants (0.58 %) were referred for additional hearing assessments, while 529 (4.92 %) tested positive for genetic mutations (including heterozygous, homozygous, or compound heterozygous variants, as well as mtDNA 12S rRNA homoplasmy), with 522 (4.85 %) passing the hearing screening. Three infants (0.028 %) had two variants in GJB2 (either homozygous or compound heterozygous), and one of these infants passed the newborn hearing test. Additionally, 33 infants (0.307 %) had the MT-RNR1 variant (m.1555A>G or m.1494C>T), all of whom passed the hearing screening.

Conclusions: The most prevalent mutations associated with deafness were identified as GJB2 c.235delC, SLC26A4 IVS7-2 A>G, and m.1555A>G. The combination of hearing screening and genetic testing for deafness effectively identifies high-risk children with hereditary deafness for further intervention.

Pancreatic ductal adenocarcinoma (PDAC) is a highly aggressive malignancy associated with a poor prognosis and considerable resistance to conventional therapies. While radical surgery may offer benefit for a subset of patients with early-stage disease, recent decades have witnessed notable progress in immunotherapy, yielding encouraging outcomes across both hematologic cancers and solid tumors in preclinical and clinical settings. Despite these advances, PDAC remains largely refractory to current immunotherapeutic strategies, owing largely to its unique tumor microenvironment (TME). The TME plays a pivotal role in modulating tumor progression, metastatic dissemination, and treatment response. It is commonly marked by a profoundly immunosuppressive milieu that attenuates effective anti-tumor immunity and complicates therapeutic intervention. The complex cellular and molecular composition of the TME poses significant challenges for the development of novel treatment modalities. Consequently, there is a growing imperative to therapeutically "reprogram" various components and functions within the TME to improve clinical outcomes in PDAC patients. This review seeks to elucidate how the PDAC TME and its key immunosuppressive constituents influence disease progression and response to immunotherapy. A deeper understanding of these interactions may open avenues for innovative treatment approaches capable of overcoming the barriers imposed by the TME in pancreatic cancer.

Objectives: Neonatal infections, which continue to be a major cause of morbidity and mortality globally, can be avoided with proper umbilical cord care. There is still no widely recognized standard for cord care despite numerous antiseptic techniques, and the hunt for safe, natural, and efficient substitutes is becoming necessary. In this regard, OZOILE, a formulation based on stable ozonides with wound-healing and antibacterial qualities, may be a viable choice. The purpose of this study was to retrospectively assess the impact of topical OZOILE on the timing of umbilical cord detachment and the avoidance or reduction of infection-related problems in newborns.

Methods: The study was conducted in the Complex Operational Unit of Neonatology and Neonatal Intensive Care of the "Annunziata" Hospital-Cosenza (Italy) and included healthy newborns with a gestational age from the 35th to the 41st weeks of gestation, born to mothers with age ranging from 18 to 40 years.

Results: Daily application of OZOILE spray oil, directly to the umbilical cord 3 times a day was able the stump fell off in a short time from 5 to 7 days and without any complications. OZOILE reduces secondary alterations of falling umbilical stump.

Conclusions: In conclusion, OZOILE intervention could be a good candidate for umbilical cord care.

Objectives: Delirium is a frequent complication in elderly and critically ill patients, associated with significant morbidity and mortality, prolonged hospitalization, increased healthcare costs, and long-term cognitive impairment, emphasizing the need for early identification and prevention strategies. In this study, we aimed to assess the association between pregabalin use and the risk of delirium in elderly intensive care unit (ICU) patients.

Methods: This retrospective cohort study analyzed data from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. Propensity score matching (PSM) was applied to control for baseline confounders. Multivariate logistic regression, inverse probability of treatment weighting (IPTW), and subgroup analyses were conducted to validate the findings.

Results: Out of 12,327 patients, 309 pregabalin users were matched with 1,236 non-users through 1:4 PSM. Pregabalin use was significantly associated with increased delirium risk in patients aged 60 and older, with odds ratios (ORs) of 1.72 (1.31-2.25), 1.90 (1.44-2.49), 1.89 (1.37-2.58), and 1.91 (1.58-2.31) across models. Subgroup analyses confirmed this association across most variables. Notably, the risk was significantly higher among patients not receiving analgesia (p for interaction <0.05).

Conclusions: Pregabalin use is associated with an elevated risk of delirium in critically ill patients aged 60 and above. These findings have important implications for medication management and delirium prevention in the ICU.

Objectives: Infective endocarditis (IE) is a life-threatening infection of the inner lining of the heart resulting in severe complications such as valvular destruction and systemic embolism. Surgical intervention is often required to manage advanced cases. This study describes the clinical, paraclinical, and microbiological characteristics of patients with IE undergoing valve surgery at a tertiary cardiovascular centre in a developing country.

Methods: This retrospective study analysed 176 patients with IE who underwent valve surgery at a single centre in Vietnam between January 2019 and December 2023.

Results: The mean age of the cohort was 43.6 ± 15.9 years, with 62.5 % male patients and 13.5 % having a history of cardiac surgery. Mitral valve involvement was the most common lesion (94.9 %), predominantly presenting as regurgitation (96.4 %). The mean white blood cell count was 10.3 ± 8.6 K/μL, indicating an inflammatory response. Blood cultures were positive in 67.5 % of cases, with Viridans streptococci (34.6 %) and Streptococcus spp. (34.6 %) being the most frequently identified pathogens.

Conclusions: This study provides comprehensive data on patients with IE undergoing surgery in Vietnam, highlighting the importance of early diagnosis, microbiological identification, and surgical intervention for improving patient outcomes in resource-limited settings.

Objectives: To evaluate the long-term regulatory effects of high-fiber low-fat (HFLF) diet on gut microbiota diversity and inflammation/barrier-related markers in DSS-induced recurrent colitis mice.

Methods: A recurrent DSS model was established through multiple cycles of DSS administration. Mice were randomly assigned to HFLF diet vs. control/standard chow ± positive control groups. Multi-timepoint sampling was conducted throughout the study. 16S rRNA sequencing, SCFA quantification, and qPCR/ELISA/immunohistochemistry/Western blot analyses were performed.

Results: HFLF diet significantly improved clinical phenotype, increased gut microbiota diversity, promoted beneficial bacterial genera, enhanced SCFA production, and modulated inflammation/barrier indicators throughout the recurrence-remission cycles.

Conclusions: HFLF diet provides sustained protection during recurrence-remission processes through microbiota-SCFA-inflammation axis modulation, offering potential translational applications for IBD management.