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Predictors of Treatment Outcome and Clinical Profile among Guillain- Barre Syndrome Patients in South India. 南印度格林-巴利综合征患者治疗结果和临床特征的预测因素。
IF 1.4 Q4 PHARMACOLOGY & PHARMACY Pub Date : 2023-01-01 DOI: 10.2174/0115748871254419231019053136
Nitin Joseph, Soumya Shrigiri

Background: Guillain-Barre syndrome (GBS) is one of the principal causes of acute neuromuscular weakness and paralysis worldwide. Its clinic-epidemiological profile and factors influencing its treatment outcomes in developing countries are very minimally studied.

Objective: The study aimed to find out the risk factors, clinical presentation, management, and predictors of treatment outcomes among GBS patients admitted in two tertiary care hospitals.

Materials and methods: Medical records of 121 inpatients with GBS confirmed based on the Brighton criteria over the recent five-year period from June 2017 to May 2022 were examined. Assessment of the severity of GBS was done using the Hughes functional grading scale.

Results: The mean age at onset was 36.8 ± 18.9 years. The majority of the patients [82 (67.8%)] were males. Antecedent illnesses within 1 month of onset of GBS were present among 34 (28.1%) patients. The majority of them developed respiratory tract illnesses [13 (38.2%)]. Recurrent history of GBS was observed among 4 (3.3%) patients. The median time gap between the onset of antecedent illnesses and the onset of GBS was 5 days (IQR 3, 10). The most common symptom among GBS patients was the weakness of the muscles of the extremities [117 (96.7%)]. The pattern of progression of weakness among 53 (45.3%) of these patients was from the lower to upper limbs. The most common sign noted was hypotonia [64(52.9%)]. Complications due to GBS were observed among 12 (9.9%) patients. The most common complication among them was respiratory distress in 11 (91.7%) patients, followed by autonomic dysfunctions in 8 (66.7%). Albuminocytological dissociation in cerebrospinal fluid was noted among 48 (39.7%) patients. The majority of patients in nerve conduction studies had acute inflammatory demyelinating polyneuropathy [61(50.4%)]. The majority of the GBS patients [68 (56.2%)] were treated using intravenous immunoglobulin (IVIG). 95 (78.5%) patients improved with treatment at the time of discharge. In multivariable analysis, the absence of antecedent illnesses (p =0.029), Brighton's diagnostic certainty levels 1 and 2 of GBS (p =0.024), and being on IVIG treatment (p =0.05) were associated with improvement in disease condition among the patients.

Conclusion: Appropriate diagnosis of GBS using both clinical and laboratory evidence and providing appropriate treatment along with more supervision among GBS patients with a history of antecedent illnesses will help improve their prognosis at the time of discharge.

背景:格林-巴利综合征(GBS)是世界范围内急性神经肌肉无力和瘫痪的主要原因之一。对其在发展中国家的临床流行病学概况和影响其治疗结果的因素的研究很少。目的:本研究旨在研究两所三级护理医院收治的GBS患者的危险因素、临床表现、管理和治疗结果的预测因素。材料和方法:在2017年6月至2022年5月的近五年时间里,检查了121名根据布莱顿标准确诊的GBS住院患者的医疗记录。使用Hughes功能分级量表对GBS的严重程度进行评估。结果:平均发病年龄为36.8±18.9岁。大多数患者[82(67.8%)]为男性。34名(28.1%)患者在GBS发作后1个月内出现既往疾病。大多数患者出现呼吸道疾病[13例(38.2%)]。4例(3.3%)患者有GBS复发史。既往疾病发作和GBS发作之间的中位时间间隔为5天(IQR 3,10)。GBS患者最常见的症状是四肢肌肉无力[117(96.7%)]。其中53(45.3%)患者的无力发展模式是从下肢到上肢。最常见的体征是64例(52.9%)患者的肌张力减退。在12名(9.9%)患者中观察到由于GBS引起的并发症。最常见的并发症是11例(91.7%)患者的呼吸窘迫,其次是8例(66.7%)的自主神经功能障碍。48例(39.7%)患者出现脑脊液白蛋白细胞学分离。神经传导研究中的大多数患者患有急性炎症性脱髓鞘性多发性神经病[61(50.4%)]。大多数GBS患者[68(56.2%)]使用静脉注射免疫球蛋白(IVIG)进行治疗。95名(78.5%)患者在出院时通过治疗得到改善。在多变量分析中,既往疾病的缺失(p=0.029)、GBS的Brighton诊断确定性水平1和2(p=0.024)以及继续接受IVIG治疗(p=0.05)与患者病情的改善有关。结论:利用临床和实验室证据对GBS进行适当的诊断,并在有既往病史的GBS患者中提供适当的治疗和更多的监督,将有助于改善他们出院时的预后。
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引用次数: 0
Effect of Scapula Focused Interventions on Pain and Disability in Neck Pain with Mobility Deficits- Protocol for a Single Blinded Randomized Controlled Trial. 肩胛骨集中干预对伴有活动障碍的颈部疼痛和残疾的影响--单盲随机对照试验方案。
IF 1.4 Q4 PHARMACOLOGY & PHARMACY Pub Date : 2023-01-01 DOI: 10.2174/1574887118666230519155631
Nithin Prakash, Joshua Cleland, Karvannan Harikesavan

Background: Neck pain with mobility deficits is a common non-specific disorder often observed in younger individuals. The abnormal position of the scapula has also been identified as a risk factor in individuals with neck pain and mobility deficits. Though literature exists regarding the effects of scapular strengthening exercises, there is a lack of studies that have examined the effects of scapular strengthening exercises in individuals with neck pain and mobility deficits. This randomized controlled trial aims to examine the effects of scapula-focused exercises on pain and disability in individuals with neck pain and mobility deficits.

Methods: A single-blind (assessor-blinded) randomized controlled trial will be performed. One hundred and eight participants will be recruited and randomly assigned into two groups. The intervention group will receive scapula-focused exercises, and the control group will receive neckspecific exercises. Both groups will receive supervised sessions 3 days per week for 6 weeks and unsupervised sessions for the remaining weeks. Disability, pain, range of motion, pain pressure threshold, muscle strength, EMG activity, and sensory-motor functions will be assessed at the baseline, the 6th week, and the 12th week.

Results: This study aims to provide the effectiveness of scapular-focused exercises and its effect on neck pain with mobility deficits.

Conclusion: Analyzing the results can provide insight into how effective scapular-focused exercises are when compared to neck exercises.

背景:颈部疼痛伴有活动障碍是一种常见的非特异性疾病,通常发生在年轻人身上。肩胛骨的异常位置也被认为是颈部疼痛和活动障碍患者的一个危险因素。虽然已有文献介绍了肩胛骨强化训练的效果,但缺乏对肩胛骨强化训练对颈部疼痛和活动障碍患者效果的研究。本随机对照试验旨在研究肩胛骨强化训练对颈部疼痛和活动障碍患者的疼痛和残疾的影响:方法:将进行单盲(评估者盲)随机对照试验。将招募 108 名参与者并随机分配到两组。干预组将接受以肩胛骨为重点的锻炼,对照组将接受针对颈部的锻炼。两组都将在每周 3 天的指导下进行为期 6 周的训练,其余几周则在无人指导的情况下进行。将在基线、第 6 周和第 12 周对残疾、疼痛、活动范围、疼痛压力阈值、肌肉力量、肌电图活动和感觉运动功能进行评估:本研究旨在提供以肩胛骨为重点的锻炼的有效性及其对伴有活动障碍的颈部疼痛的影响:结论:通过分析结果,我们可以深入了解肩胛运动与颈部运动相比的有效性。
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引用次数: 0
Invasive Mechanical Ventilation in Traumatic Brain Injured Patients with Acute Respiratory Failure. 创伤性脑损伤并发急性呼吸衰竭患者的有创机械通气。
IF 1.9 Q4 PHARMACOLOGY & PHARMACY Pub Date : 2023-01-01 DOI: 10.2174/1574887117666220826164723
Fabrizio Racca, Cristina Geraci, Luca Cremascoli, Domenico Ruvolo, Fabio Piccolella, Tatsiana Romenskaya, Yaroslava Longhitano, Ermelinda Martuscelli, Angela Saviano, Gabriele Savioli, Christian Zanza

Patients with severe traumatic brain injury (TBI) need to be admitted to intensive care (ICU) because they require invasive mechanical ventilation (IMV) due to reduced consciousness resulting in loss of protective airway reflexes, reduced ability to cough and altered breathing control. In addition, these patients can be complicated by pneumonia and acute distress syndrome (ARDS). IMV allows these patients to be sedated, decreasing intracranial pressure and ensuring an adequate oxygen delivery and tight control of arterial carbon dioxide tension. However, IMV can also cause dangerous effects on the brain due to its interaction with intrathoracic and intracranial compartments. Moreover, when TBI is complicated by ARDS, the setting of mechanical ventilation can be very difficult as ventilator goals are often different and in conflict with each other. Consequently, close brain and respiratory monitoring is essential to reduce morbidity and mortality in mechanically ventilated patients with severe TBI and ARDS. Recently, recommendations for the setting of mechanical ventilation in patients with acute brain injury (ABI) were issued by the European Society of Intensive Care Medicine (ESICM). However, there is insufficient evidence regarding ventilation strategies for patients with ARDS associated with ABI. The purpose of this paper is to analyze in detail respiratory strategies and targets in patients with TBI associated with ARDS.

严重创伤性脑损伤(TBI)患者需要入住重症监护(ICU),因为由于意识下降导致保护性气道反射丧失、咳嗽能力下降和呼吸控制改变,他们需要有创机械通气(IMV)。此外,这些患者可能并发肺炎和急性窘迫综合征(ARDS)。IMV可以使这些患者镇静,降低颅内压,确保足够的氧气输送和严格控制动脉二氧化碳张力。然而,由于IMV与胸内和颅内隔室的相互作用,它也会对大脑造成危险的影响。此外,当TBI合并ARDS时,机械通气的设置可能非常困难,因为呼吸机的目标通常不同且相互冲突。因此,密切的脑和呼吸监测对于降低重型TBI和ARDS机械通气患者的发病率和死亡率至关重要。最近,欧洲重症医学会(ESICM)发布了急性脑损伤(ABI)患者机械通气设置的建议。然而,关于急性呼吸窘迫综合征合并ABI患者的通气策略的证据不足。本文的目的是详细分析TBI合并ARDS患者的呼吸策略和目标。
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引用次数: 2
Investigating the Efficacy of HPV Vaccines in Preventing Cervical Cancer from 2006 to 2018 in the US: A SEER Data Set Analysis. 2006年至2018年美国HPV疫苗预防癌症的有效性调查:SEER数据集分析。
IF 1.9 Q4 PHARMACOLOGY & PHARMACY Pub Date : 2023-01-01 DOI: 10.2174/1574887118666230410093715
Alexander Mattis, Hind Beydoun, Yuliya Dobrydneva, Rohini Ganjoo

Background: Human papillomavirus (HPV) is the most common sexually transmitted infection in the US.The first HPV vaccine was introduced in 2006. There are three different HPV vaccines that commonly target high-risk HPV types.

Objective: This study compares HPV vaccine efficacy based on alternative endpoints with the most recently available cervical cancer incidence data from the Surveillance, Epidemiology and End Results (SEER) program and SEER*Stat statistical software.

Methods: The incidence of cervical cancer, mined from the most recent April 2021 SEER data set, was stratified according to age and racial groups. Trend analysis reporting cervical cancer incidence percentage change (PC) and annual percentage change (APC) was calculated by SEER*Stat statistical software.

Results: A total of 46,583 cases of cervical cancer were reported, with an average of about 3,580 incidents of cervical cancer per year, with an overall decrement of about 60 cases over the period of 12 years. The percentage change according to age and race groups varied between -15.9 among 40- 44 years old (yo) and +13.8 among 30-34 yo, and from -12 among non-Hispanic White women to +13 among Hispanic women. Statistically significant APC was observed for five of the nine age groups and four of the five racial groups.

Conclusion: There seems to be little if any, correlation between cervical cancer incidence and the HPV vaccine program in the US. HPV vaccine efficacy based on alternative endpoints, such as nucleic acid testing and cytological, surgical, and seropositivity endpoints, is fair. Therefore, it is important to emphasize such alternative testing and surrogate endpoints.

背景:人乳头瘤病毒(HPV)是美国最常见的性传播感染。第一种HPV疫苗于2006年问世。有三种不同的HPV疫苗通常针对高危型HPV。目的:本研究将基于替代终点的HPV疫苗效力与来自监测、流行病学和最终结果(SEER)计划和SEER*Stat统计软件的最新可用宫颈癌症发病率数据进行比较。方法:根据最新的2021年4月SEER数据集,根据年龄和种族群体对癌症的发病率进行分层。采用SEER*Stat统计软件计算报告宫颈癌症发病率百分比变化(PC)和年百分比变化(APC)的趋势分析。结果:共报告46583例宫颈癌症病例,平均每年约3580例宫颈癌症事件,12年来总体减少约60例。根据年龄和种族组的百分比变化在40-44岁(约)人群中为-15.9,在30-34岁人群中为+13.8,在非西班牙裔白人女性中为-12,在西班牙族女性中为+13。在九个年龄组中的五个年龄组和五个种族组中的四个种族组观察到具有统计学意义的APC。结论:在美国,宫颈癌症发病率与HPV疫苗计划之间的相关性似乎很小(如果有的话)。基于替代终点(如核酸检测和细胞学、手术和血清阳性终点)的HPV疫苗效力是公平的。因此,重要的是要强调这种替代测试和代理端点。
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引用次数: 0
The Burden of Irritable Bowel Syndrome in Medical and Nurse Italian University Student Population: The VANVITELLI-IBS Survey. 意大利医科和护士大学生肠易激综合征负担:VANVITELLI-IBS调查。
IF 1.9 Q4 PHARMACOLOGY & PHARMACY Pub Date : 2023-01-01 DOI: 10.2174/1574887118666230508154027
Antonietta Gerarda Gravina, Raffaele Pellegrino, Mario Romeo, Giovanna Palladino, Marina Cipullo, Giorgia Iadanza, Simone Olivieri, Giuseppe Zagaria, Chiara Mazzarella, Tommaso Durante, Alessandro Federico

Background: The increased prevalence of irritable bowel syndrome (IBS) among medical and nursing students is a global challenge. Unfortunately, data on the Italian medical and nurse student population are scarce. Therefore, this study was designed to assess the prevalence of IBS in this setting and to evaluate the demographic, university, Mediterranean diet adherence, and anxiety factors associated with its increased presence.

Objective: To assess the prevalence of IBS, anxiety levels, and adherence to the Mediterranean diet in medical and nursing university students.

Methods: An anonymous online questionnaire was sent to participants. Several demographic and educational variables were assayed, and the presence of symptoms associated with the definition of IBS (according to Rome IV criteria). In addition, anxiety levels and adherence to the Mediterranean diet were also assessed.

Results: Of 161 students, 21.11% met the Rome IV criteria for IBS. Some subgroups, the out-ofcourse students or no scholarship recipients, were found to have a higher percentage of IBS (p < 0.05). Being out-of-course was shown to be associated with an increased and unreported risk of presenting IBS (OR: 8.403, p < 0.001). Levels of anxiety and adherence to the Mediterranean diet were significantly worse in the IBS group (p < 0.01). Adherence to the Mediterranean diet was associated with a reduced risk of presenting IBS in our setting (OR 0.258, p = 0.002).

Conclusion: Our sample of Italian medical and nursing students recorded a non-negligible percentage of IBS. Therefore, screening and awareness campaigns could be suggested.

背景:肠易激综合征(IBS)在医学和护理专业学生中的患病率上升是一个全球性的挑战。不幸的是,关于意大利医学和护士学生的数据很少。因此,本研究旨在评估该地区肠易激综合征的患病率,并评估人口统计学、大学、地中海饮食依从性和与肠易激综合征增加相关的焦虑因素。目的:评估医学和护理专业大学生肠易激综合征患病率、焦虑水平和地中海饮食依从性。方法:向参与者发送匿名在线问卷。分析了一些人口统计学和教育变量,以及与肠易激综合征定义相关的症状的存在(根据Rome IV标准)。此外,还评估了焦虑水平和对地中海饮食的坚持程度。结果:161名学生中,21.11%符合IBS的Rome IV标准。在一些亚组中,校外学生或没有奖学金获得者,发现IBS的百分比更高(p < 0.05)。病程外被证明与IBS发病风险增加和未报告的风险相关(OR: 8.403, p < 0.001)。肠易激综合征组的焦虑水平和地中海饮食依从性明显较差(p < 0.01)。在我们的研究中,坚持地中海饮食与IBS发病风险降低相关(OR 0.258, p = 0.002)。结论:我们的意大利医学和护理专业学生的样本记录了一个不可忽略的IBS百分比。因此,可以建议进行筛查和提高认识运动。
{"title":"The Burden of Irritable Bowel Syndrome in Medical and Nurse Italian University Student Population: The VANVITELLI-IBS Survey.","authors":"Antonietta Gerarda Gravina,&nbsp;Raffaele Pellegrino,&nbsp;Mario Romeo,&nbsp;Giovanna Palladino,&nbsp;Marina Cipullo,&nbsp;Giorgia Iadanza,&nbsp;Simone Olivieri,&nbsp;Giuseppe Zagaria,&nbsp;Chiara Mazzarella,&nbsp;Tommaso Durante,&nbsp;Alessandro Federico","doi":"10.2174/1574887118666230508154027","DOIUrl":"https://doi.org/10.2174/1574887118666230508154027","url":null,"abstract":"<p><strong>Background: </strong>The increased prevalence of irritable bowel syndrome (IBS) among medical and nursing students is a global challenge. Unfortunately, data on the Italian medical and nurse student population are scarce. Therefore, this study was designed to assess the prevalence of IBS in this setting and to evaluate the demographic, university, Mediterranean diet adherence, and anxiety factors associated with its increased presence.</p><p><strong>Objective: </strong>To assess the prevalence of IBS, anxiety levels, and adherence to the Mediterranean diet in medical and nursing university students.</p><p><strong>Methods: </strong>An anonymous online questionnaire was sent to participants. Several demographic and educational variables were assayed, and the presence of symptoms associated with the definition of IBS (according to Rome IV criteria). In addition, anxiety levels and adherence to the Mediterranean diet were also assessed.</p><p><strong>Results: </strong>Of 161 students, 21.11% met the Rome IV criteria for IBS. Some subgroups, the out-ofcourse students or no scholarship recipients, were found to have a higher percentage of IBS (p < 0.05). Being out-of-course was shown to be associated with an increased and unreported risk of presenting IBS (OR: 8.403, p < 0.001). Levels of anxiety and adherence to the Mediterranean diet were significantly worse in the IBS group (p < 0.01). Adherence to the Mediterranean diet was associated with a reduced risk of presenting IBS in our setting (OR 0.258, p = 0.002).</p><p><strong>Conclusion: </strong>Our sample of Italian medical and nursing students recorded a non-negligible percentage of IBS. Therefore, screening and awareness campaigns could be suggested.</p>","PeriodicalId":21174,"journal":{"name":"Reviews on recent clinical trials","volume":"18 3","pages":"206-213"},"PeriodicalIF":1.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10203705","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}
引用次数: 0
Development and Implementation of the Hdc.DrApp.la and SIMDA Programs to Reduce Polypharmacy and Drug-drug Interactions in Patients Hospitalized in Internal Medicine. 开发和实施Hdc.DrApp.la和SIMDA计划以减少内科住院患者的多药和药物相互作用。
IF 1.9 Q4 PHARMACOLOGY & PHARMACY Pub Date : 2023-01-01 DOI: 10.2174/1574887118666230208124744
Ricardo E Barcia, Guillermo Alberto Keller, Francisco Azzato, Roberto A Diez, Mathias Sielecki, Ricardo Klaine Samson, Juan Alberto Lescano, Guido Giunti

Objectives: We evaluated polypharmacy and possible drug-drug interactions (p-DDIs) in hospitalized patients before and after using the SIMDA Computerized Medical Decision Support System (CMDSS).

Materials and methods: We included the prescriptions of ≥ 18 years hospitalized patients in the internal medicine department. We developed and implemented the Hdc.DrApp Physician Order Entry System and the CMDSS SIMDA, which detects p-DDIs and signals dosage adjustment based on renal function. To evaluate the impact of the CMDSS, we made a comparison Before (Survey) / After (Intervention): Survey between Oct/22/2019, and Mar/21/2020, and Intervention between Apr/4/2020 and Sep/3/2020. We analyze prescriptions from the first day and after the first day. We compared the number of drugs, polypharmacy (≥ 5 drugs), excessive polypharmacy (≥ 10 drugs), and p-DDIs. We evaluated differences with the X2 test, Yates correction, Fisher's exact test, ANOVA, and post hoc tests according to their characteristics.

Results: We evaluated 2,834 admissions: Survey 1,211 and Intervention 1,623. The number of drugs per patient was 6.02 (± 3.20) in Survey and 5.17 (± 3.22) in Intervention (p < 0.001) on the first day and 9.68 (± 5.60) in Survey and 7.22 (± 4.93) in Intervention (p < 0.001) throughout the hospitalization. Polypharmacy was present in 64% of the Survey and 53% of Interventions (RR: 0.83 (0.78-0.88); and excessive polypharmacy in 14% of the Survey and 10% of Intervention (RR: 0.73, 0.60-0.90). The frequency of total p-DDIs was 1.91/patient (± 4.11) in Survey and 0.35 (± 0.81) in the Intervention (p < 0.001).

Conclusions: We developed and implemented the Hdc.DrApp and SIMDA systems that were easy to use and allowed us to quantify and reduce polypharmacy and p-DDIs.

目的:我们评估住院患者在使用SIMDA计算机化医疗决策支持系统(CMDSS)前后的多重用药和可能的药物-药物相互作用(p- ddi)。材料与方法:纳入内科住院≥18年患者的处方。我们开发并实现了Hdc。DrApp医嘱录入系统和CMDSS SIMDA,检测p- ddi并根据肾功能发出剂量调整信号。为了评估CMDSS的影响,我们比较了调查前(调查)和干预后(干预):2019年10月22日至2020年3月21日的调查和2020年4月4日至2020年9月3日的干预。我们分析第一天和第一天之后的处方。比较药物数量、多药(≥5种药物)、过度多药(≥10种药物)和p- ddi。我们根据其特点,采用X2检验、Yates校正、Fisher精确检验、方差分析和事后检验来评估差异。结果:我们评估了2834例入院患者:调查1211例,干预1623例。在整个住院期间,调查组患者人均用药数量为6.02(±3.20)个,干预组为5.17(±3.22)个(p < 0.001),调查组为9.68(±5.60)个,干预组为7.22(±4.93)个(p < 0.001)。64%的调查和53%的干预措施存在多重用药(RR: 0.83 (0.78-0.88);14%的调查对象和10%的干预对象过度使用多种药物(RR: 0.73, 0.60-0.90)。调查组总p- ddi频率为1.91例/例(±4.11例),干预组为0.35例(±0.81例)(p < 0.001)。结论:我们开发并实现了Hdc。DrApp和SIMDA系统易于使用,使我们能够量化和减少多药和p- ddi。
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引用次数: 1
Characteristics of Products of Fibrinogen Origin in the Presence of Anti- SARS-CoV-2 IgG in the Bloodstream. 血液中抗SARS-CoV-2 IgG存在时纤维蛋白原产物的特征
IF 1.9 Q4 PHARMACOLOGY & PHARMACY Pub Date : 2023-01-01 DOI: 10.2174/1574887118666221219115856
Antonina Rachkovska, Daryna Krenytska, Vitalii Karbovskyy, Tetiana Halenova, Nataliia Raksha, Tetiana Vovk, Olexii Savchuk, Dmytro Liubenko, Tetyana Falalyeyeva, Liudmyla Ostapchenko, Ludovico Abenavoli

Background: The hemostasis system has been extensively investigated in patients in the acute phase of coronavirus disease 2019 (COVID-19). In contrast, the post-COVID syndrome is a poorly known entity, and there is a lack of information on the mechanisms underlying the hemostasis abnormalities in the post-COVID period.

Aim: To analyze the potential changes in the parameters of the hemostasis system in the post- COVID period in the plasma of donors with different titers of anti-SARS-CoV-2 IgG.

Methods: The plasma from 160 donors who had recovered from COVID infection was used in the study. Based on the results of the Abbott SARS-CoV-2 IgG serological assay, all donors were divided into several groups: 5 ± 3 (n = 20); 55 ± 5 (n = 20); 65 ± 5 (n = 20); 75 ± 5 (n = 20); 85 ± 5 (n = 20); 95 ± 5 (n = 20); 125 ± 5 (n = 20); 175 ± 5 (n = 20) Index (S/C). A total of 20 healthy individuals without anti-SARS-CoV-2 IgG constituted the control group. Key laboratory parameters, such as fibrinogen concentrations, soluble fibrin monomer complex (SFMCs), and Ddimer, were investigated. In addition, the qualitative composition of the fraction of SFMCs was analyzed.

Results: The slight increase in the concentration of fibrinogen, SFMCs, and D-dimers in some donor groups have been found, which could cause the development of hemostasis disorders. In the fraction of SFMCs, the increase in the number of protein fragments with a molecular weight of less than 250 kDa and an increase in the level of proteins with a molecular weight of more than 270 kDa was revealed.

Conclusion: The obtained results indicated the relationship between the changes in the parameters of the hemostasis system and the titers of anti-SARS-CoV-2 IgG in donors in the post-COVID period. It can be assumed that donors with higher titers of anti-SARS-CoV-2 IgG (>55 ± 5 Index (S/C)) are more prone to hemostasis abnormalities in the post-COVID period since a pronounced imbalance in the levels of SFMCs and D-dimer characterizes them. The appearance of protein fragments of different molecular weights in the fraction of SFMC points to uncontrolled activation of biochemical processes involving molecules of fibrinogenic origin. Additional studies are required to elucidate the role of anti-SARS-CoV-2 IgG in the post-COVID period.

背景:对2019冠状病毒病(COVID-19)急性期患者的止血系统进行了广泛的研究。相比之下,covid后综合征是一个鲜为人知的实体,并且缺乏关于covid后时期止血异常的机制的信息。目的:分析不同抗- cov -2 IgG滴度献血者血浆中新冠病毒感染后止血系统参数的潜在变化。方法:采用160例新冠肺炎康复献血者的血浆。根据雅培SARS-CoV-2 IgG血清学检测结果,将所有献血者分为5±3组(n = 20);55±5 (n = 20);65±5 (n = 20);75±5 (n = 20);85±5 (n = 20);95±5 (n = 20);125±5 (n = 20);175±5 (n = 20)指数(S/C)。无抗sars - cov -2 IgG的健康个体20例作为对照组。关键的实验室参数,如纤维蛋白原浓度,可溶性纤维蛋白单体复合物(SFMCs)和二聚体,进行了研究。此外,还对SFMCs组分的定性组成进行了分析。结果:部分供血组纤维蛋白原、SFMCs、d -二聚体浓度轻微升高,可引起止血障碍的发生。在SFMCs片段中,分子量小于250 kDa的蛋白质片段数量增加,分子量大于270 kDa的蛋白质片段水平增加。结论:所得结果提示献血者术后止血系统参数变化与抗sars - cov -2 IgG滴度之间存在相关性。可以认为,抗- cov -2 IgG抗体滴度(>55±5指数(S/C))较高的献血者在covid - 19后更容易出现止血异常,因为他们的SFMCs和d -二聚体水平明显失衡。SFMC部分中不同分子量的蛋白质片段的出现表明涉及纤维蛋白原分子的生化过程的不受控制的激活。需要进一步的研究来阐明抗sars - cov -2 IgG在covid后时期的作用。
{"title":"Characteristics of Products of Fibrinogen Origin in the Presence of Anti- SARS-CoV-2 IgG in the Bloodstream.","authors":"Antonina Rachkovska,&nbsp;Daryna Krenytska,&nbsp;Vitalii Karbovskyy,&nbsp;Tetiana Halenova,&nbsp;Nataliia Raksha,&nbsp;Tetiana Vovk,&nbsp;Olexii Savchuk,&nbsp;Dmytro Liubenko,&nbsp;Tetyana Falalyeyeva,&nbsp;Liudmyla Ostapchenko,&nbsp;Ludovico Abenavoli","doi":"10.2174/1574887118666221219115856","DOIUrl":"https://doi.org/10.2174/1574887118666221219115856","url":null,"abstract":"<p><strong>Background: </strong>The hemostasis system has been extensively investigated in patients in the acute phase of coronavirus disease 2019 (COVID-19). In contrast, the post-COVID syndrome is a poorly known entity, and there is a lack of information on the mechanisms underlying the hemostasis abnormalities in the post-COVID period.</p><p><strong>Aim: </strong>To analyze the potential changes in the parameters of the hemostasis system in the post- COVID period in the plasma of donors with different titers of anti-SARS-CoV-2 IgG.</p><p><strong>Methods: </strong>The plasma from 160 donors who had recovered from COVID infection was used in the study. Based on the results of the Abbott SARS-CoV-2 IgG serological assay, all donors were divided into several groups: 5 ± 3 (n = 20); 55 ± 5 (n = 20); 65 ± 5 (n = 20); 75 ± 5 (n = 20); 85 ± 5 (n = 20); 95 ± 5 (n = 20); 125 ± 5 (n = 20); 175 ± 5 (n = 20) Index (S/C). A total of 20 healthy individuals without anti-SARS-CoV-2 IgG constituted the control group. Key laboratory parameters, such as fibrinogen concentrations, soluble fibrin monomer complex (SFMCs), and Ddimer, were investigated. In addition, the qualitative composition of the fraction of SFMCs was analyzed.</p><p><strong>Results: </strong>The slight increase in the concentration of fibrinogen, SFMCs, and D-dimers in some donor groups have been found, which could cause the development of hemostasis disorders. In the fraction of SFMCs, the increase in the number of protein fragments with a molecular weight of less than 250 kDa and an increase in the level of proteins with a molecular weight of more than 270 kDa was revealed.</p><p><strong>Conclusion: </strong>The obtained results indicated the relationship between the changes in the parameters of the hemostasis system and the titers of anti-SARS-CoV-2 IgG in donors in the post-COVID period. It can be assumed that donors with higher titers of anti-SARS-CoV-2 IgG (>55 ± 5 Index (S/C)) are more prone to hemostasis abnormalities in the post-COVID period since a pronounced imbalance in the levels of SFMCs and D-dimer characterizes them. The appearance of protein fragments of different molecular weights in the fraction of SFMC points to uncontrolled activation of biochemical processes involving molecules of fibrinogenic origin. Additional studies are required to elucidate the role of anti-SARS-CoV-2 IgG in the post-COVID period.</p>","PeriodicalId":21174,"journal":{"name":"Reviews on recent clinical trials","volume":"18 1","pages":"69-75"},"PeriodicalIF":1.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9260306","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}
引用次数: 2
The Principal Components of Autonomic Dysfunction in Fibromyalgia Assessed by the Refined and Abbreviated Composite Autonomic Symptom Score. 纤维肌痛症自主神经功能障碍的主要成分用精炼和简化的复合自主神经症状评分评估。
IF 1.9 Q4 PHARMACOLOGY & PHARMACY Pub Date : 2023-01-01 DOI: 10.2174/1574887118666230315120413
Basant K Puri, Gary S Lee

Background: We have recently confirmed that non-pain autonomic dysfunction symptoms occur in fibromyalgia and can be assessed with the 31-item Composite Autonomic Symptom Score (COMPASS 31) instrument. Fibromyalgia patients have been found to have higher scores than matched controls across all six domains of this instrument.

Objectives: To analyse the principal components of the autonomic COMPASS 31 domain scores in fibromyalgia patients to understand better the fundamental dimensions of dysautonomia in this disorder.

Methods: A principal component analysis of fibromyalgia autonomic domain scores was carried out using a varimax orthogonal rotation with decomposition being based on the correlation matrix and setting a threshold of greater than one for the eigenvalues.

Results: Three mutually orthogonal principal components, accounting for over 80% of the total variance, were identified. The first was a function of the secretomotor, orthostatic intolerance and pupillomotor domains; the second was a function of the vasomotor and urinary bladder domains; and the third was a function of the gastrointestinal and orthostatic intolerance domains. There was a positive correlation between symptom domain scores of the Revised Fibromyalgia Impact Questionnaire and the first principal component scores (rs = 0.536, p = 0.006).

Conclusion: This analysis has reduced the dimensionality of autonomic dysfunction in fibromyalgia patients from six to three. The internal structure of the fibromyalgia dysautonomia data reflected by these results may help in the elucidation of the aetiology of this complex and difficult-to-treat disorder.

背景:我们最近证实,纤维肌痛患者出现非疼痛性自主神经功能障碍症状,可以用31项复合自主神经症状评分(COMPASS 31)工具进行评估。纤维肌痛患者已被发现在该仪器的所有六个领域中得分高于匹配的对照组。目的:分析纤维肌痛患者自主神经COMPASS 31结构域评分的主要成分,以更好地了解纤维肌痛患者自主神经异常的基本特征。方法:采用方差正交旋转法对纤维肌痛自主神经域评分进行主成分分析,根据相关矩阵进行分解,并为特征值设置大于1的阈值。结果:确定了3个相互正交的主成分,占总方差的80%以上。第一个是分泌运动、直立不耐受和瞳孔运动域的功能;第二个是血管舒缩和膀胱域的功能;第三个是胃肠道和直立性不耐受域的功能。修正纤维肌痛影响问卷的症状域得分与第一主成分得分呈正相关(rs = 0.536, p = 0.006)。结论:该分析将纤维肌痛患者的自主神经功能障碍从6个维度减少到3个维度。这些结果反映的纤维肌痛自主神经异常的内部结构数据可能有助于阐明这种复杂和难以治疗的疾病的病因。
{"title":"The Principal Components of Autonomic Dysfunction in Fibromyalgia Assessed by the Refined and Abbreviated Composite Autonomic Symptom Score.","authors":"Basant K Puri,&nbsp;Gary S Lee","doi":"10.2174/1574887118666230315120413","DOIUrl":"https://doi.org/10.2174/1574887118666230315120413","url":null,"abstract":"<p><strong>Background: </strong>We have recently confirmed that non-pain autonomic dysfunction symptoms occur in fibromyalgia and can be assessed with the 31-item Composite Autonomic Symptom Score (COMPASS 31) instrument. Fibromyalgia patients have been found to have higher scores than matched controls across all six domains of this instrument.</p><p><strong>Objectives: </strong>To analyse the principal components of the autonomic COMPASS 31 domain scores in fibromyalgia patients to understand better the fundamental dimensions of dysautonomia in this disorder.</p><p><strong>Methods: </strong>A principal component analysis of fibromyalgia autonomic domain scores was carried out using a varimax orthogonal rotation with decomposition being based on the correlation matrix and setting a threshold of greater than one for the eigenvalues.</p><p><strong>Results: </strong>Three mutually orthogonal principal components, accounting for over 80% of the total variance, were identified. The first was a function of the secretomotor, orthostatic intolerance and pupillomotor domains; the second was a function of the vasomotor and urinary bladder domains; and the third was a function of the gastrointestinal and orthostatic intolerance domains. There was a positive correlation between symptom domain scores of the Revised Fibromyalgia Impact Questionnaire and the first principal component scores (r<sub>s</sub> = 0.536, p = 0.006).</p><p><strong>Conclusion: </strong>This analysis has reduced the dimensionality of autonomic dysfunction in fibromyalgia patients from six to three. The internal structure of the fibromyalgia dysautonomia data reflected by these results may help in the elucidation of the aetiology of this complex and difficult-to-treat disorder.</p>","PeriodicalId":21174,"journal":{"name":"Reviews on recent clinical trials","volume":"18 2","pages":"140-145"},"PeriodicalIF":1.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9558810","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}
引用次数: 0
Plasma Levels of MMPs and TIMP-1 in Patients with Osteoarthritis After Recovery from COVID-19. COVID-19骨性关节炎患者康复后血浆MMPs和TIMP-1水平的变化
IF 1.9 Q4 PHARMACOLOGY & PHARMACY Pub Date : 2023-01-01 DOI: 10.2174/1574887118666230131141608
Yuriy Tuharov, Daryna Krenytska, Tetiana Halenova, Larysa Kot, Nataliia Raksha, Olexii Savchuk, Larisa Prysiazhniuk, Ruzhena Matkivska, Tetyana Falalyeyeva, Liudmyla Ostapchenko

Background: Matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPS) play a key role in the pathogenesis of osteoarthritis (OA). Recent research showed the involvement of some MMPs in COVID-19, but the results are limited and contradictory.

Objective: In this study, we investigated the levels of MMPs (MMP-1, MMP-2, MMP-3, MMP-8, MMP-9, MMP-10) and TIMP-1 in the plasma of patients with OA after recovery from COVID- 19.

Methods: The experiment involved patients aged 39 to 80 diagnosed with knee OA. All study participants were divided into three research groups: the control group included healthy individuals, the group OA included patients with enrolled cases of OA, and the third group of OA and COVID-19 included patients with OA who recovered from COVID-19 6-9 months ago. The levels of MMPs and TIMP-1 were measured in plasma by enzyme-linked immunosorbent assay.

Results: The study showed a change in the levels of MMPs in patients with OA who had COVID- 19 and those who did not have a history of SARS-CoV-2 infection. Particularly, patients with OA who were infected with coronavirus established an increase in MMP-2, MMP-3, MMP-8, and MMP-9, compared to healthy controls. Compared to normal subjects, a significant decrease in MMP-10 and TIMP-1 was established in both groups of patients with OA and convalescent COVID-19.

Conclusion: Thus, the results suggest that COVID-19 can affect the proteolysis-antiproteolysis system even after a long postinfectious state and may cause complications of existing musculoskeletal pathologies.

背景:基质金属蛋白酶(MMPs)及其组织抑制剂(TIMPS)在骨关节炎(OA)的发病机制中起关键作用。最近的研究表明,一些MMPs与COVID-19有关,但结果有限且相互矛盾。目的:研究新冠肺炎康复后OA患者血浆中MMPs (MMP-1、MMP-2、MMP-3、MMP-8、MMP-9、MMP-10)和TIMP-1水平的变化。方法:实验对象为39 ~ 80岁的膝关节OA患者。所有研究参与者被分为三个研究组:对照组包括健康个体,OA组包括入组的OA患者,OA和COVID-19第三组包括6-9个月前从COVID-19恢复的OA患者。采用酶联免疫吸附法测定血浆中MMPs和TIMP-1的水平。结果:研究显示,患有COVID- 19的OA患者和没有SARS-CoV-2感染史的OA患者的MMPs水平发生了变化。特别是,与健康对照组相比,感染冠状病毒的OA患者的MMP-2、MMP-3、MMP-8和MMP-9水平均有所增加。与正常受试者相比,两组OA患者和恢复期COVID-19患者的MMP-10和TIMP-1均显著降低。结论:由此可见,即使在感染后很长一段时间内,COVID-19仍可影响蛋白水解-抗蛋白水解系统,并可能导致现有肌肉骨骼病变的并发症。
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引用次数: 0
Bilateral Superficial Trigeminal Nerve Blocks are not More Effective than a Placebo in Abolishing Post-operative Headache Pain in Pituitary Transsphenoidal Neurosurgery: A Prospective, Randomized, Doubleblinded Clinical Trial. 双侧三叉浅神经阻滞在消除垂体-蝶窦神经外科术后头痛方面并不比安慰剂更有效:一项前瞻性、随机、双盲临床试验。
IF 1.9 Q4 PHARMACOLOGY & PHARMACY Pub Date : 2023-01-01 DOI: 10.2174/1574887118666230227113217
Una Srejic, Erik Litonius, Seema Gandhi, Pekka Talke, Oana Maties, Claas Siegmueller, Avic Magsaysay, Daniel Hasen, Sandeep Kunwar, Rahul Seth, Lizbeth Gibson, Philip Bickler

Background: Pituitary neurosurgery executed via the transsphenoidal endonasal approach is commonly performed for pituitary adenomas. Reasons for prolonged hospital stay include postoperative headache and protracted nausea with or without vomiting. Bilateral superficial trigeminal nerve blocks of the supra-orbital V1 and infra-orbital V2 (SION) nerves performed intra-operatively as a regional anesthetic adjunct to general anesthesia were hypothesized to decrease 6 hours postoperative morphine PCA (patient-controlled analgesia) use by patients.

Methods: Forty-nine patients, following induction of general anesthesia for their transsphenoidal surgery, were prospectively randomized in a double-blinded fashion to receive additional regional anesthesia as either a block (0.5% ropivacaine with epi 1:200,000) or placebo/sham (0.9% normal saline). The primary endpoint of the study was systemic morphine PCA opioid consumption by the two groups in the first 6-hours postoperatively. The secondary endpoints included (1) pain exposure experienced postoperatively, (2) incidence of postoperative nausea and vomiting, and (3) time to eligibility for PACU discharge.

Results: Of the 49 patients that were enrolled, 3 patients were excluded due to protocol violations. Ultimately, there was no statistically significant difference between morphine PCA use in the 6 hours postoperatively between the block and placebo/sham groups. There was, however, a slight visual tendency in the block group for higher pain scores, morphine use p=0.046, and delayed PACU discharge. False discovery rate corrected comparisons at each time point and then revealed no statistically significant difference between the two groups. There were no differences between the two groups for secondary endpoints.

Conclusion: It was found that a 6-hour postoperative headache after endoscopic trans-sphenoidal pituitary surgery likely has a more complicated mechanism involving more than the superficial trigeminovascular system and perhaps is neuro-modulated by other brain nuclei.

背景:经蝶窦鼻内入路垂体神经外科手术是垂体腺瘤的常见手术方式。住院时间过长的原因包括术后头痛和伴有或不伴有呕吐的长期恶心。假设术中作为全身麻醉的辅助区域麻醉进行的眶上V1和眶下V2(SION)神经的双侧三叉浅神经阻滞可减少患者术后6小时吗啡PCA(患者控制镇痛)的使用。方法:49名患者在进行经蝶手术全身麻醉诱导后,前瞻性地以双盲方式随机接受额外的区域麻醉,作为阻滞(0.5%罗哌卡因和epi 1:200000)或安慰剂/假手术(0.9%生理盐水)。该研究的主要终点是两组在术后前6小时的全身吗啡PCA阿片类药物消耗量。次要终点包括(1)术后疼痛暴露,(2)术后恶心和呕吐的发生率,以及(3)符合PACU出院条件的时间。结果:在入选的49名患者中,有3名患者因违反方案而被排除在外。最终,阻断组和安慰剂/假手术组在术后6小时内吗啡PCA的使用之间没有统计学上的显著差异。然而,阻滞组有轻微的视觉倾向,疼痛评分较高,吗啡使用p=0.046,PACU出院延迟。错误发现率纠正了每个时间点的比较,然后显示两组之间没有统计学上的显著差异。两组在次要终点方面没有差异。结论:经蝶窦垂体内窥镜手术后6小时的头痛可能比浅表三叉神经血管系统有更复杂的机制,并且可能受到其他脑细胞核的神经调节。
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引用次数: 1
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Reviews on recent clinical trials
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