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Immunoadsorption therapy in refractory heart failure patients with dilated cardiomyopathy: a potential therapeutic option. 免疫吸附治疗难治性心力衰竭合并扩张型心肌病:一种潜在的治疗选择。
IF 1.4 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-01-01 DOI: 10.1590/1806-9282.20220784
Yuksel Cavusoglu, Senan Tahmazov, Selda Murat, Olga Meltem Akay
SUMMARY OBJECTIVE: Removal of cardiac autoantibodies by immunoadsorption might confer clinical improvement in dilated cardiomyopathy. In this pilot study, we investigated the efficacy and safety of immunoadsorption therapy in refractory heart failure patients with dilated cardiomyopathy. METHODS: This study consisted of 9 heart failure patients with dilated cardiomyopathy, NYHA III-IV, left ventricular ejection fraction <30%, unresponsive to heart failure therapy, and with cardiac autoantibodies. Patients underwent immunoadsorption therapy for five consecutive days using a tryptophan column. Changes in cardiac function (left ventricular ejection fraction, left ventricular end-diastolic diameter, left ventricular end-systolic diameter), exercise capacity (6-minute walk distance), neurohormonal (N-terminal pro-brain natriuretic peptide), proinflammatory (high-sensitive C-reactive protein), and myocardial (cardiac troponin-I), biochemical, and hematological variables were obtained at baseline and after 3 and 6 months of immunoadsorption therapy. RESULTS: Mean left ventricular ejection fraction and 6-minute walk distance significantly increased at 3 months (from 23.27±5.09 to 32.1±1.7%, p=0.01 for left ventricular ejection fraction and from 353±118 to 434±159 m, p=0.04 for 6-minute walk distance) and further increased at 6 months after immunoadsorption therapy (to 34.5±7.7%, p=0.02 for ejection fraction and to 441±136 m, p=0.04 for 6-minute walk distance). NT-proBNP level reduced from 1161(392.8–3034) to 385(116.1–656.5) ng/L (p=0.04), and high-sensitive C-reactive protein decreased from 9.74±0.96 to 4.3±5.8 mg/L (p=0.04) at 6 months. Left ventricular end-diastolic diameter (66.1±5.8 vs. 64.7±8.9 mm) and left ventricular end-systolic diameter (56.1±8.6 vs. 52.3±10.8 mm) tended to decrease but did not reach statistical significance. No significant worsening was observed in creatinine, cardiac troponin-I, and hemoglobin levels after the immunoadsorption procedure. CONCLUSION: In dilated cardiomyopathy patients with refractory heart failure, immunoadsorption may be considered a potentially useful therapeutic option to improve a patient's clinical status.
目的:免疫吸附法去除心脏自身抗体可能改善扩张型心肌病的临床疗效。在这项初步研究中,我们研究了免疫吸附治疗难治性心力衰竭合并扩张型心肌病患者的疗效和安全性。方法:9例心衰合并扩张型心肌病患者,NYHA III-IV,左心室射血分数。平均左室射血分数和6分钟步行距离在3个月时显著增加(左室射血分数从23.27±5.09增加到32.1±1.7%,p=0.01, 6分钟步行距离从353±118增加到434±159 m, p=0.04),并在免疫吸附治疗后6个月进一步增加(射血分数为34.5±7.7%,p=0.02, 6分钟步行距离为441±136 m, p=0.04)。6个月时NT-proBNP水平从1161(392.8-3034)降至385(116.1-656.5)ng/L (p=0.04),高敏c反应蛋白从9.74±0.96降至4.3±5.8 mg/L (p=0.04)。左室舒张末期内径(66.1±5.8比64.7±8.9 mm)和左室收缩末期内径(56.1±8.6比52.3±10.8 mm)有减小的趋势,但无统计学意义。免疫吸附手术后肌酐、心肌肌钙蛋白- 1和血红蛋白水平未见明显恶化。结论:在扩张型心肌病合并难治性心衰患者中,免疫吸附可能被认为是一种潜在有用的治疗选择,可以改善患者的临床状况。
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引用次数: 0
Evaluation of patients of vaccine side effects after the COVID-19 vaccine. COVID-19疫苗接种后疫苗副作用患者评价。
IF 1.4 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-01-01 DOI: 10.1590/1806-9282.20221035
Muhammed Semih Gedik, Ali İhsan Kilci, Hakan Hakkoymaz, Ömer Faruk Küçük, Yavuzalp Solak, Nuri Mehmet Basan, Yunus Emre Çıkrıkçı

Objective: Postvaccine side effects were evaluated in patients presenting to our emergency department with complaints of vaccine side effects after taking COVID-19 vaccine, and new unknown side effects ranging from mild complaints to life-threatening risks, and frequency of all side effects were investigated. This study aimed to establish a scientific resource to identify the potential side effects of the vaccine.

Methods: Patients' demographic information, clinical characteristics, epicrisis reports, COVID-19 disease and vaccination histories, vital values, and blood values were examined. The SPSS 20.0 package program was used for statistical evaluation. p<0.05 was considered statistically significant.

Results: Notably, 13.1% of patients presenting to the emergency department started to have complaints after taking Sinovac vaccine, whereas 86.9% of them had complaints after taking BioNTech vaccine. Also, 36.9% of patients stated that they had COVID-19. All patients had a Glasgow coma scale score of 15 during admission. No patient was hospitalized, ventilator was not needed, and all patients were discharged. While the most common presenting complaint to the emergency department after vaccination was fatigue in 29.7%, the most common diagnoses after examination in the emergency department were myalgia in 32.1% and upper respiratory tract infection in 28.6%.

Conclusion: Results and conclusions of our study will guide healthcare workers and patients on the side effects of COVID-19 vaccine.

目的:评估以新冠肺炎疫苗副反应为主诉就诊于急诊科的患者接种后疫苗副反应情况,以及新出现的未知副反应,从轻微主诉到危及生命的危险,并调查所有副反应发生的频率。本研究旨在建立科学资源,以确定疫苗的潜在副作用。方法:对患者的人口学资料、临床特征、疫情报告、COVID-19疾病及疫苗接种史、生命体征、血值进行统计。采用SPSS 20.0软件包程序进行统计评价。结果:值得注意的是,到急诊科就诊的患者中,有13.1%的人在接种了科兴疫苗后开始有投诉,而86.9%的人在接种了BioNTech疫苗后开始有投诉。36.9%的患者表示自己感染了新冠病毒。所有患者入院时格拉斯哥昏迷评分为15分。无患者住院,无需呼吸机,全部出院。接种疫苗后到急诊科最常见的主诉是疲劳(29.7%),急诊科检查后最常见的诊断是肌痛(32.1%)和上呼吸道感染(28.6%)。结论:我们的研究结果和结论将指导医护人员和患者了解COVID-19疫苗的副作用。
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引用次数: 3
Relationship between platelet indices and red cell distribution width and short-term mortality in traumatic brain injury with 30-day mortality. 外伤性脑损伤血小板指数、红细胞分布宽度与短期死亡率及30天死亡率的关系
IF 1.4 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-01-01 DOI: 10.1590/1806-9282.00210889
Onur Palabiyik, Yakup Tomak, Muberra Acar, Unal Erkorkmaz, Ayca Tas Tuna, Kezban Ozmen Suner, Davut Ceylan

Objective: This study aimed at investigating whether there is a relationship between 7- or 30-day mortality and mean platelet volume, platelet distribution width, platelet count-to-total lymphocyte count ratio, or red cell distribution width in patients with traumatic brain injury.

Methods: We retrospectively analyzed intensive care unit patients with traumatic brain injury. We recorded patients' ages; genders; diagnoses; Glasgow Coma Scale scores; length of intensive care unit stay (in days); mean platelet volume, platelet distribution width, platelet count-to-total lymphocyte count ratio, and red cell distribution width values upon hospital admission; and health on the 7th and 30th days of their stays.

Results: We analyzed data from 110 patients. Of these, 84 (76.4%) were male and 26 (23.6%) were female. On the 7- and 30-day mortality evaluations, compared to the living patients, the deceased patients had a significantly higher median age and a significantly lower median Glasgow Coma Scale. Thus, increased age and lower Glasgow Coma Scale scores were associated with increased 7- and 30-day mortality rates. mean platelet volume and platelet distribution width values were similar in living and deceased patients. platelet count-to-total lymphocyte count ratio values were lower in deceased patients, but this difference was not statistically significant. Within 30 days after traumatic brain injury, deceased patients' red cell distribution width values were significantly elevated in deceased patients compared to those of living patients.

Conclusion: Mean platelet volume, platelet distribution width, and platelet count-to-total lymphocyte count ratio values were not associated with 7- and 30-day mortality, whereas only elevated red cell distribution width was associated with 30-day mortality.

目的:本研究旨在探讨创伤性脑损伤患者7天或30天死亡率与平均血小板体积、血小板分布宽度、血小板计数与总淋巴细胞计数比、红细胞分布宽度之间的关系。方法:回顾性分析重症监护病房外伤性脑损伤患者。我们记录了患者的年龄;性别;诊断;格拉斯哥昏迷量表评分;重症监护病房住院时间(以天为单位);入院时平均血小板体积、血小板分布宽度、血小板计数与总淋巴细胞计数比、红细胞分布宽度值;在他们停留的第7天和第30天进行健康检查。结果:我们分析了110例患者的数据。其中男性84例(76.4%),女性26例(23.6%)。在7天和30天的死亡率评估中,与活着的患者相比,死亡患者的中位年龄明显较高,中位格拉斯哥昏迷评分明显较低。因此,年龄的增加和格拉斯哥昏迷评分的降低与7天和30天死亡率的增加有关。在世和死亡患者的平均血小板体积和血小板分布宽度值相似。死亡患者血小板计数与总淋巴细胞计数比值值较低,但差异无统计学意义。创伤性脑损伤后30天内,死亡患者红细胞分布宽度值明显高于活着的患者。结论:平均血小板体积、血小板分布宽度和血小板计数与总淋巴细胞计数比值值与7天和30天死亡率无关,而只有红细胞分布宽度升高与30天死亡率相关。
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引用次数: 1
Effect of dexmedetomidine on tourniquet-induced skeletal muscle injury. 右美托咪定对止血带所致骨骼肌损伤的影响。
IF 1.4 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-01-01 DOI: 10.1590/1806-9282.20220865
Wenjie Cheng, Zhe Wu, Jizheng Zhang, Wanlu Ren

Objective: The aim of this study was to investigate whether dexmedetomidine could reduce tourniquet-induced skeletal muscle injury.

Methods: C57BL6 male mice were randomly assigned to sham, ischemia/reperfusion, and dexmedetomidine groups. Mice in the ischemia/reperfusion and dexmedetomidine groups received normal saline solution and dexmedetomidine intraperitoneally, respectively. The sham group underwent the same procedure as the ischemia/reperfusion group, with the exception of tourniquet application. Subsequently, the ultrastructure of the gastrocnemius muscle was observed, and its contractile force was examined. In addition, Toll-like receptor 4 and nuclear factor-κB expression within muscles was detected by Western blot.

Results: Dexmedetomidine alleviated myocyte damage and increased the contractility of skeletal muscles. Moreover, dexmedetomidine significantly inhibited the expression of Toll-like receptor 4/nuclear factor-κB in the gastrocnemius muscle.

Conclusion: Taken together, these results demonstrate that dexmedetomidine administration attenuated tourniquet-induced structural and functional impairment of the skeletal muscle, partly through inactivation of the Toll-like receptor 4/nuclear factor-κB pathway.

目的:探讨右美托咪定是否能减轻止血带所致骨骼肌损伤。方法:C57BL6雄性小鼠随机分为假手术组、缺血再灌注组和右美托咪定组。缺血再灌注组和右美托咪定组小鼠分别腹腔注射生理盐水和右美托咪定。假手术组除止血带外,手术过程与缺血再灌注组相同。观察腓肠肌的超微结构,测定腓肠肌的收缩力。Western blot检测toll样受体4和核因子-κB在肌肉中的表达。结果:右美托咪定减轻了骨骼肌细胞的损伤,增加了骨骼肌的收缩力。右美托咪定显著抑制腓肠肌toll样受体4/核因子-κB的表达。结论:综上所述,这些结果表明右美托咪定减轻了止血带引起的骨骼肌结构和功能损伤,部分原因是toll样受体4/核因子-κB通路失活。
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引用次数: 1
Syndecan-1 as a marker to predict acute kidney injury after isolated coronary artery bypass graft operations. Syndecan-1作为预测离体冠状动脉搭桥术后急性肾损伤的标志物。
IF 1.4 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-01-01 DOI: 10.1590/1806-9282.20220839
Derih Ay, Mesut Engin, Sadık Ahmet Sünbül, Filiz Ata, Rahime Feyza Koloğlu, Yasemin Ustundag, Senol Yavuz, Ahmet Fatih Özyazıcıoğlu

Objective: Postoperative acute kidney injury is an important problem that can occur after coronary artery bypass graft operations, and it is important to identify risky patient groups preoperatively. This study aimed to investigate the importance of preoperative syndecan-1 levels in predicting acute kidney injury after elective coronary artery bypass graft operations accompanied by cardiopulmonary bypass.

Methods: Patients who underwent coronary artery bypass graft operation in our clinic between March 1 and May 10, 2022, were included in this prospective study. Patients who did not develop acute kidney injury in the postoperative period were recorded as group 1 and patients who developed it were recorded as group 2.

Results: A total of 79 patients undergoing coronary artery bypass graft surgery with cardiopulmonary bypass were included in the study. There were 55 patients in group 1 and 24 patients in group 2. There was no difference between the groups in terms of age, gender, diabetes mellitus, body mass index, smoking, and hyperlipidemia rates. In multivariate logistic regression analysis, increased blood product use (odds ratio 1.634; 95%CI 1.036-2.579; p=0.035), preoperative high creatinine (odds ratio 59.387; 95%CI 3.034-1162.496; p=0.007), and high syndecan-1 (odds ratio 1.015; 95%CI 1.002-1.028; p=0.025) were independent predictors of acute kidney injury.

Conclusion: This study revealed that elevated preoperative syndecan-1 is associated with acute kidney injury after isolated coronary artery bypass graft accompanied by cardiopulmonary bypass and has prognostic utility independent of other recognized risk factors.

目的:急性肾损伤是冠状动脉旁路移植术后可能出现的重要问题,术前识别高危患者群体十分重要。本研究旨在探讨术前syndecan-1水平在预测选择性冠状动脉旁路移植术合并体外循环术后急性肾损伤中的重要性。方法:前瞻性研究纳入于2022年3月1日至5月10日在我院行冠状动脉旁路移植术的患者。术后未发生急性肾损伤的患者为1组,发生急性肾损伤的患者为2组。结果:79例接受冠状动脉搭桥术合并体外循环的患者被纳入研究。1组55例,2组24例。两组在年龄、性别、糖尿病、体重指数、吸烟和高脂血症发生率方面没有差异。在多因素logistic回归分析中,血液制品使用增加(优势比1.634;95%可信区间1.036 - -2.579;P =0.035),术前高肌酐(优势比59.387;95%可信区间3.034 - -1162.496;P =0.007),高syndecan-1(比值比1.015;95%可信区间1.002 - -1.028;P =0.025)是急性肾损伤的独立预测因子。结论:本研究显示,术前syndecan-1升高与孤立冠状动脉搭桥术合并体外循环术后急性肾损伤有关,且具有独立于其他已知危险因素的预后价值。
{"title":"Syndecan-1 as a marker to predict acute kidney injury after isolated coronary artery bypass graft operations.","authors":"Derih Ay,&nbsp;Mesut Engin,&nbsp;Sadık Ahmet Sünbül,&nbsp;Filiz Ata,&nbsp;Rahime Feyza Koloğlu,&nbsp;Yasemin Ustundag,&nbsp;Senol Yavuz,&nbsp;Ahmet Fatih Özyazıcıoğlu","doi":"10.1590/1806-9282.20220839","DOIUrl":"https://doi.org/10.1590/1806-9282.20220839","url":null,"abstract":"<p><strong>Objective: </strong>Postoperative acute kidney injury is an important problem that can occur after coronary artery bypass graft operations, and it is important to identify risky patient groups preoperatively. This study aimed to investigate the importance of preoperative syndecan-1 levels in predicting acute kidney injury after elective coronary artery bypass graft operations accompanied by cardiopulmonary bypass.</p><p><strong>Methods: </strong>Patients who underwent coronary artery bypass graft operation in our clinic between March 1 and May 10, 2022, were included in this prospective study. Patients who did not develop acute kidney injury in the postoperative period were recorded as group 1 and patients who developed it were recorded as group 2.</p><p><strong>Results: </strong>A total of 79 patients undergoing coronary artery bypass graft surgery with cardiopulmonary bypass were included in the study. There were 55 patients in group 1 and 24 patients in group 2. There was no difference between the groups in terms of age, gender, diabetes mellitus, body mass index, smoking, and hyperlipidemia rates. In multivariate logistic regression analysis, increased blood product use (odds ratio 1.634; 95%CI 1.036-2.579; p=0.035), preoperative high creatinine (odds ratio 59.387; 95%CI 3.034-1162.496; p=0.007), and high syndecan-1 (odds ratio 1.015; 95%CI 1.002-1.028; p=0.025) were independent predictors of acute kidney injury.</p><p><strong>Conclusion: </strong>This study revealed that elevated preoperative syndecan-1 is associated with acute kidney injury after isolated coronary artery bypass graft accompanied by cardiopulmonary bypass and has prognostic utility independent of other recognized risk factors.</p>","PeriodicalId":21234,"journal":{"name":"Revista da Associacao Medica Brasileira","volume":"69 1","pages":"107-111"},"PeriodicalIF":1.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f0/ff/1806-9282-ramb-69-01-0107.PMC9937607.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10836371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Fetal thymus in growth-restricted fetuses due to placental insufficiency. 胎盘功能不全致生长受限胎儿的胸腺。
IF 1.4 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-01-01 DOI: 10.1590/1806-9282.20220975
Marisa Akemi Takeno, Roseli Mieko Yamamoto Nomura

Objective: The aim of this study was to assess fetal thymus size by ultrasound in growth-restricted fetuses due to placental insufficiency and compare to high-risk and low-risk pregnancy fetuses with normal placental function.

Methods: This is a nested case-control study of pregnant women followed up at a university hospital (July 2012 to July 2013). In all, 30 pregnant women presenting small fetuses for gestational age (estimated fetal weight p95) were compared to 30 high-risk and 30 low-risk pregnancies presenting normal Doppler indices. The thymus transverse diameter and perimeter were converted into zeta score according to the normal values for gestational age. Head circumference and femur length were used to calculate ratios.

Results: Fetal thymus were significantly lower in pregnancies with placental insufficiency when compared to high-risk and low-risk pregnancies presenting, respectively, transverse diameter zeta score (-0.69±0.83 vs. 0.49±1.13 vs. 0.83±0.85, p<0.001) and P zeta score (-0.73±0.68 vs. 0.45±0.96 vs. 0.26±0.89, p<0.001). There was also a significant difference (p<0.05) in the ratios among the groups: pregnancies with placental insufficiency (TD/HC=0.10, P/FL=1.32, and P/HC=0.26), high-risk pregnancies (TD/HC=0.11, P/FL=1.40, and P/HC=0.30), and control group (DT/HC=0.11, P/FL=1.45, and P/HC=0.31).

Conclusion: Fetal thymus size is reduced in growth-restricted fetuses due to placental insufficiency, suggesting fetal response as a consequence of the adverse environment.

目的:本研究旨在通过超声评估胎盘功能不全致生长受限胎儿胸腺大小,并与胎盘功能正常的高危和低危妊娠胎儿进行比较。方法:采用巢式病例对照研究,对2012年7月至2013年7月在某大学医院随访的孕妇进行随访。总的来说,30名胎龄较小的孕妇(估计胎儿体重p95)与30名多普勒指数正常的高危孕妇和30名低危孕妇进行了比较。按胎龄正常值将胸腺横径和胸腺周长换算成zeta评分。用头围和股骨长度计算比值。结果:胎盘功能不全妊娠的胎儿胸腺明显小于高危妊娠和低危妊娠,其横径zeta评分分别为(-0.69±0.83 vs. 0.49±1.13 vs. 0.83±0.85)。结论:胎盘功能不全导致生长受限胎儿胸腺大小减小,提示胎儿反应是不良环境的结果。
{"title":"Fetal thymus in growth-restricted fetuses due to placental insufficiency.","authors":"Marisa Akemi Takeno,&nbsp;Roseli Mieko Yamamoto Nomura","doi":"10.1590/1806-9282.20220975","DOIUrl":"https://doi.org/10.1590/1806-9282.20220975","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to assess fetal thymus size by ultrasound in growth-restricted fetuses due to placental insufficiency and compare to high-risk and low-risk pregnancy fetuses with normal placental function.</p><p><strong>Methods: </strong>This is a nested case-control study of pregnant women followed up at a university hospital (July 2012 to July 2013). In all, 30 pregnant women presenting small fetuses for gestational age (estimated fetal weight <p10) due to placental insufficiency (umbilical artery Doppler >p95) were compared to 30 high-risk and 30 low-risk pregnancies presenting normal Doppler indices. The thymus transverse diameter and perimeter were converted into zeta score according to the normal values for gestational age. Head circumference and femur length were used to calculate ratios.</p><p><strong>Results: </strong>Fetal thymus were significantly lower in pregnancies with placental insufficiency when compared to high-risk and low-risk pregnancies presenting, respectively, transverse diameter zeta score (-0.69±0.83 vs. 0.49±1.13 vs. 0.83±0.85, p<0.001) and P zeta score (-0.73±0.68 vs. 0.45±0.96 vs. 0.26±0.89, p<0.001). There was also a significant difference (p<0.05) in the ratios among the groups: pregnancies with placental insufficiency (TD/HC=0.10, P/FL=1.32, and P/HC=0.26), high-risk pregnancies (TD/HC=0.11, P/FL=1.40, and P/HC=0.30), and control group (DT/HC=0.11, P/FL=1.45, and P/HC=0.31).</p><p><strong>Conclusion: </strong>Fetal thymus size is reduced in growth-restricted fetuses due to placental insufficiency, suggesting fetal response as a consequence of the adverse environment.</p>","PeriodicalId":21234,"journal":{"name":"Revista da Associacao Medica Brasileira","volume":"69 1","pages":"136-141"},"PeriodicalIF":1.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/17/8e/1806-9282-ramb-69-01-0136.PMC9937593.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10834924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cardiovascular disease risk prediction in scleroderma. 硬皮病患者心血管疾病风险预测。
IF 1.4 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-01-01 DOI: 10.1590/1806-9282.20220936
Aliye Çelikkol, Rıdvan Mercan, Savaş Güzel, Ahsen Yılmaz

Objective: Cardiovascular disease risk prediction in scleroderma is important. In this study of scleroderma patients, the aim was to investigate the relationship between cardiac myosin-binding protein-C, sensitive troponin T, and trimethylamine N-oxide and cardiovascular disease risk with the Systematic COronary Risk Evaluation 2 model of the European Society of Cardiology.

Methods: Systematic COronary Risk Evaluation 2 risk groups of 38 healthy controls and 52 women with scleroderma were evaluated. Cardiac myosin-binding protein-C, sensitive troponin T, and trimethylamine N-oxide levels were analyzed with commercial ELISA kits.

Results: In scleroderma patients, cardiac myosin-binding protein-C and trimethylamine N-oxide levels were higher than healthy controls but sensitive troponin T was not (p<0.001, p<0.001, and p=0.274, respectively). Out of 52 patients, 36 (69.2%) were at low risk, and the other 16 (30.8%) patients were at high-moderate risk with the Systematic COronary Risk Evaluation 2 model. At the optimal cutoff values, trimethylamine N-oxide could discriminate high-moderate risk with sensitivity 76%, specificity 86% and cardiac myosin-binding protein-C with sensitivity 75%, specificity 83%. Patients with high trimethylamine N-oxide levels (≥10.28 ng/mL) could predict high-moderate- Systematic COronary Risk Evaluation 2 risk 15 times higher than those with low trimethylamine N-oxide (<10.28 ng/mL) levels (odds ratio [OR]: 15.00, 95%CI 3.585-62.765, p<0.001). Similarly, high cardiac myosin-binding protein-C (≥8.29 ng/mL) levels could predict significantly higher Systematic COronary Risk Evaluation 2 risk than low cardiac myosin-binding protein-C (<8.29 ng/mL) levels (OR: 11.00, 95%CI 2.786-43.430).

Conclusion: Noninvasive cardiovascular disease risk prediction indicators in scleroderma, cardiac myosin-binding protein-C, and trimethylamine N-oxide could be recommended to distinguish between high-moderate risk and low risk with the Systematic COronary Risk Evaluation 2 model.

目的:对硬皮病患者进行心血管疾病风险预测具有重要意义。本研究以硬皮病患者为研究对象,采用欧洲心脏病学会的系统性冠状动脉风险评估2模型,探讨心肌肌球蛋白结合蛋白- c、敏感肌钙蛋白T和三甲胺n-氧化物与心血管疾病风险的关系。方法:对38例健康对照者和52例硬皮病女性患者的2个危险组进行系统性冠状动脉危险评价。使用商用ELISA试剂盒分析心肌肌球蛋白结合蛋白c、敏感肌钙蛋白T和三甲胺n-氧化物水平。结果:硬皮病患者心肌肌球蛋白结合蛋白- c和三甲胺n-氧化物水平高于健康对照组,而敏感肌钙蛋白T水平低于健康对照组。结论:建议采用系统性冠状动脉风险评价2模型,将硬皮病无创心血管疾病风险预测指标、心肌肌球蛋白结合蛋白- c和三甲胺n-氧化物作为区分高、中危和低危的指标。
{"title":"Cardiovascular disease risk prediction in scleroderma.","authors":"Aliye Çelikkol,&nbsp;Rıdvan Mercan,&nbsp;Savaş Güzel,&nbsp;Ahsen Yılmaz","doi":"10.1590/1806-9282.20220936","DOIUrl":"https://doi.org/10.1590/1806-9282.20220936","url":null,"abstract":"<p><strong>Objective: </strong>Cardiovascular disease risk prediction in scleroderma is important. In this study of scleroderma patients, the aim was to investigate the relationship between cardiac myosin-binding protein-C, sensitive troponin T, and trimethylamine N-oxide and cardiovascular disease risk with the Systematic COronary Risk Evaluation 2 model of the European Society of Cardiology.</p><p><strong>Methods: </strong>Systematic COronary Risk Evaluation 2 risk groups of 38 healthy controls and 52 women with scleroderma were evaluated. Cardiac myosin-binding protein-C, sensitive troponin T, and trimethylamine N-oxide levels were analyzed with commercial ELISA kits.</p><p><strong>Results: </strong>In scleroderma patients, cardiac myosin-binding protein-C and trimethylamine N-oxide levels were higher than healthy controls but sensitive troponin T was not (p<0.001, p<0.001, and p=0.274, respectively). Out of 52 patients, 36 (69.2%) were at low risk, and the other 16 (30.8%) patients were at high-moderate risk with the Systematic COronary Risk Evaluation 2 model. At the optimal cutoff values, trimethylamine N-oxide could discriminate high-moderate risk with sensitivity 76%, specificity 86% and cardiac myosin-binding protein-C with sensitivity 75%, specificity 83%. Patients with high trimethylamine N-oxide levels (≥10.28 ng/mL) could predict high-moderate- Systematic COronary Risk Evaluation 2 risk 15 times higher than those with low trimethylamine N-oxide (<10.28 ng/mL) levels (odds ratio [OR]: 15.00, 95%CI 3.585-62.765, p<0.001). Similarly, high cardiac myosin-binding protein-C (≥8.29 ng/mL) levels could predict significantly higher Systematic COronary Risk Evaluation 2 risk than low cardiac myosin-binding protein-C (<8.29 ng/mL) levels (OR: 11.00, 95%CI 2.786-43.430).</p><p><strong>Conclusion: </strong>Noninvasive cardiovascular disease risk prediction indicators in scleroderma, cardiac myosin-binding protein-C, and trimethylamine N-oxide could be recommended to distinguish between high-moderate risk and low risk with the Systematic COronary Risk Evaluation 2 model.</p>","PeriodicalId":21234,"journal":{"name":"Revista da Associacao Medica Brasileira","volume":"69 2","pages":"246-251"},"PeriodicalIF":1.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a5/61/1806-9282-ramb-69-02-0246.PMC9983472.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9434175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Colic and sleep outcomes of nonpharmacological intervention in infants with infantile colic: systematic review and metaanalysis. 非药物干预对婴儿绞痛和睡眠结果的影响:系统回顾和荟萃分析。
IF 1.4 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-01-01 DOI: 10.1590/1806-9282.20230071
Doğan Çağrı Tanrıverdi, Aysu Yıldız Karaahmet, Fatma Şule Bilgiç

Objective: The aim of this study was to systematically review the colic and sleep outcomes of nonpharmacological intervention in infants with infantile colic and perform a meta-analysis of the available evidence.

Methods: The literature review for this systematic review was conducted between December 2022 and January 2023 using five electronic databases, namely PubMed, CINAHL, Scopus, Web of Science, and ULAKBİM. Published articles were scanned using MeSH-based keywords. Only randomized controlled trials conducted in the past 5 years were included. The data were analyzed using the Review Manager computer program.

Results: This meta-analysis included three studies involving a total of 386 infantile colic infants. After nonpharmacological treatment, it was found that infants with infantile colic reduced crying time (standardized mean difference: 0.61; 95%CI 0.29-0.92; Z=3.79; p=0.00002), improved sleep duration (standardized mean difference: 0.22; 95%CI -0.04 to 0.48; Z=1.64; p=0.10), and decreased crying intensity (mean difference: -17.24; 95%CI -20.11 to 14.37; Z=11.77; p<0.000001).

Conclusion: According to the meta-analysis findings, it was determined that the risk of bias was low in the studies included and that nonpharmacological chiropractic, craniosacral, and acupuncture treatments applied to infantile colic infants in the three included studies reduced crying time and intensity and increased sleep duration.

目的:本研究的目的是系统地回顾非药物干预对婴儿绞痛和睡眠的影响,并对现有证据进行荟萃分析。方法:本系统综述的文献检索时间为2022年12月至2023年1月,检索时间为PubMed、CINAHL、Scopus、Web of Science和ULAKBİM 5个电子数据库。使用基于mesh的关键词扫描已发表的文章。仅包括过去5年进行的随机对照试验。使用Review Manager计算机程序对数据进行分析。结果:本荟萃分析包括三项研究,共涉及386例婴儿绞痛。经非药物治疗后,发现婴儿绞痛的婴儿哭闹时间减少(标准化平均差值:0.61;95%可信区间0.29 - -0.92;Z = 3.79;P =0.00002),改善睡眠时间(标准化平均差:0.22;95%CI -0.04 ~ 0.48;Z = 1.64;P =0.10),哭泣强度降低(平均差异:-17.24;95%CI -20.11 ~ 14.37;Z = 11.77;结论:根据荟萃分析结果,确定纳入研究的偏倚风险较低,并且在纳入的三项研究中,对婴儿绞痛进行非药物捏脊、颅骶和针灸治疗可减少哭泣时间和强度,并增加睡眠时间。
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引用次数: 0
Effect of protection of enoxaparin against experimental ischemia/reperfusion injury in the rat ovary on in vitro fertilization outcomes. 依诺肝素对实验性卵巢缺血再灌注损伤的保护作用对体外受精结果的影响。
IF 1.4 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-01-01 DOI: 10.1590/1806-9282.20220385
Mehmet Suhha Bostancı, Ozcan Budak, Hüseyin Çakiroğlu, Osman Köse, Özkan Durmaz, Erdem Cokluk

Objective: The study aimed to investigate the protection of enoxaparin (E) against experimental ischemic (I) and ischemic-reperfusion (I/R) injury in rat ovaries on in vitro fertilization outcomes.

Methods: In total, 56 adult female Sprague-Dawley albino rats were randomly assigned to 6 groups of 8 animals each: Sham, Ischemia, I/R, Sham+E, I+E, and I/R+E. Ischemia groups were subjected to bilateral adnexal torsion for 3 h. In contrast, I/R and I/R+E groups received subsequent detorsion for 3 h. Enoxaparin (0.5 mg/kg s.c.) was administered 30 min prior to ischemia (I+platelet-rich plasma) or reperfusion (I/R+I+platelet-rich plasma). Ovaries were stimulated through intraperitoneal injection of 150-300 internal units IU/kg pregnant mare serum gonadotropin. Anti-Müllerian hormone levels were measured before and after surgery in all groups.

Results: When the number of metaphase II oocytes was evaluated, statistically significant differences were observed between the I and I+E (p=0.001) and I/R and I/R+E (p=0.000) groups. When both I and I+E groups and I/R and I/R+E groups were compared, it was found that E application increased the number of fertilized oocytes. The number of embryos on the second day was higher in the I/R+E group than that in the I/R group. Statistically significant differences were found in the number of grade 1 embryos between the I/R and I/R+E groups (p=0.003). In comparing anti-Müllerian hormone values within the group, the highest decrease was observed in the I and I/R groups.

Conclusion: Enoxaparin effectively minimizes ovarian damage and preserves ovarian reserve following ovarian torsion.

目的:探讨依诺肝素(E)对大鼠卵巢实验性缺血(I)和缺血再灌注(I/R)损伤的保护作用。方法:将56只成年雌性Sprague-Dawley白化病大鼠随机分为Sham、Ischemia、I/R、Sham+E、I+E、I/R+E 6组,每组8只。缺血组双侧附件扭转3小时,I/R组和I/R+E组继续扭转3小时。在缺血(I+富血小板血浆)或再灌注(I/R+I+富血小板血浆)前30分钟给予依诺肝素(0.5 mg/kg s.c)。通过腹腔注射150 ~ 300内单位IU/kg妊娠母马血清促性腺激素刺激卵巢。测定各组手术前后抗勒氏杆菌激素水平。结果:对中期II期卵母细胞数量进行评估时,I组与I+E组(p=0.001)、I/R组与I/R+E组(p=0.000)差异有统计学意义。对比I组和I+E组以及I/R组和I/R+E组,发现施E能增加受精卵数量。I/R+E组第2天胚数高于I/R组。I/R组和I/R+E组1级胚胎数差异有统计学意义(p=0.003)。在比较组内抗勒氏杆菌激素值时,I组和I/R组下降幅度最大。结论:依诺肝素能有效减少卵巢扭转后的卵巢损伤,保留卵巢储备。
{"title":"Effect of protection of enoxaparin against experimental ischemia/reperfusion injury in the rat ovary on in vitro fertilization outcomes.","authors":"Mehmet Suhha Bostancı,&nbsp;Ozcan Budak,&nbsp;Hüseyin Çakiroğlu,&nbsp;Osman Köse,&nbsp;Özkan Durmaz,&nbsp;Erdem Cokluk","doi":"10.1590/1806-9282.20220385","DOIUrl":"https://doi.org/10.1590/1806-9282.20220385","url":null,"abstract":"<p><strong>Objective: </strong>The study aimed to investigate the protection of enoxaparin (E) against experimental ischemic (I) and ischemic-reperfusion (I/R) injury in rat ovaries on in vitro fertilization outcomes.</p><p><strong>Methods: </strong>In total, 56 adult female Sprague-Dawley albino rats were randomly assigned to 6 groups of 8 animals each: Sham, Ischemia, I/R, Sham+E, I+E, and I/R+E. Ischemia groups were subjected to bilateral adnexal torsion for 3 h. In contrast, I/R and I/R+E groups received subsequent detorsion for 3 h. Enoxaparin (0.5 mg/kg s.c.) was administered 30 min prior to ischemia (I+platelet-rich plasma) or reperfusion (I/R+I+platelet-rich plasma). Ovaries were stimulated through intraperitoneal injection of 150-300 internal units IU/kg pregnant mare serum gonadotropin. Anti-Müllerian hormone levels were measured before and after surgery in all groups.</p><p><strong>Results: </strong>When the number of metaphase II oocytes was evaluated, statistically significant differences were observed between the I and I+E (p=0.001) and I/R and I/R+E (p=0.000) groups. When both I and I+E groups and I/R and I/R+E groups were compared, it was found that E application increased the number of fertilized oocytes. The number of embryos on the second day was higher in the I/R+E group than that in the I/R group. Statistically significant differences were found in the number of grade 1 embryos between the I/R and I/R+E groups (p=0.003). In comparing anti-Müllerian hormone values within the group, the highest decrease was observed in the I and I/R groups.</p><p><strong>Conclusion: </strong>Enoxaparin effectively minimizes ovarian damage and preserves ovarian reserve following ovarian torsion.</p>","PeriodicalId":21234,"journal":{"name":"Revista da Associacao Medica Brasileira","volume":"69 3","pages":"380-385"},"PeriodicalIF":1.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/93/06/1806-9282-ramb-69-03-0380.PMC10004281.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9192302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Impact of coronavirus disease pandemic on performance and satisfaction, physical activity, and quality of life of the elderly. 冠状病毒大流行对老年人工作表现和满意度、身体活动和生活质量的影响
IF 1.4 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-01-01 DOI: 10.1590/1806-9282.20221018
Elif Gur Kabul, Bilge Basakcı Calık

Objective: The aim of this study was to examine the effects of the coronavirus disease pandemic in the elderly.

Methods: A total of 140 elderly with a mean age of 71.30±6.00 years (69 females, 71 males) who spent the coronavirus disease pandemic period at home were included. Canadian Occupational Performance Measure, Visual Analog Scale (for pain intensity at rest and activity), International Physical Activity Questionnaire-Short Form, and EuroQol Five-Dimensional Questionnaire, Three-Level Version Health States were used in the evaluation. Two scores are obtained in Canadian Occupational Performance Measure: one for performance and one for satisfaction. EuroQol Five-Dimensional Questionnaire, Three-Level Version consists of two parts: EuroQol Five-Dimensional Questionnaire, Three-Level Version descriptive system and EuroQol Five-Dimensional Questionnaire, Three-Level Version Visual Analog Scale.

Results: While female gender (p=0.006, p=0.001), using walking assistant (p=0.001, p=0.001), being single/widow (p=0.031, p=0.007), and history of falling (p=0.004, p=0.001) made difference in Visual Analog Scale (rest, activity), female gender (p=0.013) and being single/widow (p=0.020) made difference in satisfaction scores of Canadian Occupational Performance Measure. Female gender (p=0.001), using walking assistant (p=0.001), and history of falling (p=0.010) made difference in EuroQol Five-Dimensional Questionnaire, Three-Level Version descriptive system. In addition, performance scores of Canadian Occupational Performance Measure had a low correlation with Visual Analog Scale (rest r=-0.198, p=0.019; activity r=-0.188, p=0.026) and had a moderate correlation with EuroQol Five-Dimensional Questionnaire, Three-Level Version descriptive system (r=0.327, p=0.001) and EuroQol Five-Dimensional Questionnaire, Three-Level Version Visual Analog Scale (r=0.307, p=0.001). Satisfaction scores of Canadian Occupational Performance Measure had a low correlation with Visual Analog Scale (rest r=-0.247, p=0.003; activity r=-0.223, p=0.008) and had a moderate correlation with EuroQol Five-Dimensional Questionnaire, Three-Level Version descriptive system (r=0.399, p=0.001) and EuroQol Five-Dimensional Questionnaire, Three-Level Version Visual Analog Scale (r=0.306, p=0.001).

Conclusion: The elderly who were women, single/widowed, using walking assistant, and having a history of falling were more affected during the coronavirus disease period.

目的:本研究旨在探讨冠状病毒病大流行对老年人的影响。方法:选取平均年龄71.30±6.00岁、在家中度过冠状病毒大流行期的老年人140例,其中女性69例,男性71例。采用加拿大职业表现量表、视觉模拟量表(用于休息和活动时的疼痛强度)、国际体育活动问卷-短表和EuroQol五维健康状态问卷,三级版本进行评估。在加拿大职业绩效测量中获得两个分数:一个是绩效,一个是满意度。EuroQol五维问卷,三级版本由两部分组成:EuroQol五维问卷,三级版本描述系统和EuroQol五维问卷,三级版本视觉模拟量表。结果:女性(p=0.006, p=0.001)、使用助行器(p=0.001, p=0.001)、单身/丧偶(p=0.031, p=0.007)和跌倒史(p=0.004, p=0.001)在视觉模拟量表(休息、活动)上存在差异,女性(p=0.013)和单身/丧偶(p=0.020)在加拿大职业绩效量表满意度得分上存在差异。女性(p=0.001)、使用助行器(p=0.001)和跌倒史(p=0.010)对EuroQol五维问卷、三级版本描述系统有影响。此外,加拿大职业绩效量表的绩效得分与视觉模拟量表的相关性较低(其余r=-0.198, p=0.019;活度r=-0.188, p=0.026),且与EuroQol五维问卷三级版本描述系统(r=0.327, p=0.001)和EuroQol五维问卷三级版本视觉模拟量表(r=0.307, p=0.001)有中度相关性。加拿大职业绩效量表满意度得分与视觉模拟量表相关性较低(其余r=-0.247, p=0.003;活性r=-0.223, p=0.008),且与EuroQol五维问卷三级版本描述系统(r=0.399, p=0.001)和EuroQol五维问卷三级版本视觉模拟量表(r=0.306, p=0.001)有中度相关性。结论:女性、单身/丧偶、使用助行器、有跌倒史的老年人在冠状病毒病期间易感。
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引用次数: 0
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Revista da Associacao Medica Brasileira
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