SAGE Open Medicine最新文献

Background: The potential association between new antineoplastic drugs and an increased risk of suicide-related adverse drug reactions remains unclear. This study aims to utilize the FAERS public database to analyze suicide-related adverse drug reactions associated with common antitumor drugs and to investigate potential risk signals for such adverse drug reactions.

Methods: This study was a retrospective analysis utilizing the FAERS database. The FAERS database was examined for reports of suicide-related adverse events associated with antitumor drugs, spanning from 2004 to 2023. To identify and verify adverse event signals, we employed reporting odds ratios, proportional reporting ratios, and Bayesian methods (Bayesian Confidence Propagation Neural Network). Additionally, logistic regression analysis was performed to assess outcomes in tumor patients.

Results: A total of 223,781 suicide-related adverse event reports were screened, of which 3790 involved common antitumor drugs. The top five drugs reported were tretinoin (n = 1220), methotrexate (n = 664), celecoxib (n = 505), rituximab (n = 107), and imatinib (n = 105). Risk signal analysis indicated that, with the exception of tretinoin (ROR = 6.317), the reporting odds ratio values for the other drugs were below 2. Among cancer patients, the most frequently reported adverse events included suicidal ideation (n = 233), completed suicide (n = 131), and suicide attempts (n = 97). Regression analysis revealed that risk factors for patient death included indication (OR = 0.967, p < 0.01), gender (OR = 0.57, p < 0.01), and type of adverse event (OR = 4.644, p < 0.01).

Conclusion: The findings suggest that antineoplastic drugs may not statistically increase the risk of suicide-related adverse events. However, specific tumor types and suicide-related adverse events may contribute to increased mortality in cancer patients. Further research is warranted to elucidate the risk of suicide-related adverse events in oncology patients.

Background: Staphylococcus species are widely distributed in nature and found in various human body sites.

Objectives: To determine the antibiotic susceptibility pattern of Staphylococcus species isolated from different clinical samples.

Methods: This cross-sectional study was conducted on 400 clinical specimens from conveniently sampled patients seeking healthcare at two health facilities in sulaimani / Iraq. Bacterial isolation and identification were done using conventional techniques, after which the antibiotic susceptibility profile of Staphylococcus species commonly prescribed antibiotics used in treating infections at the facilities was done using the disc diffusion method. Finally, MecA, methicillin-resistant Staphylococcus aureus and macrolides-lincosamide and streptogramin genes with mupirocin-resistant, beta-lactamase and vancomycin-resistance phenotypes were identified.

Results: Staphylococcus aureus was the prevalent isolated species (n = 197, 49.3%), followed by Staphylococcus hemolyticus (n = 115, 28.8%), Staphylococcus epidermidis (n = 49, 12.3%), Staphylococcus hominis (n = 9.0, 2.3%), Staphylococcus sciuri (n = 8.0, 2.0%) and Staphylococcus lentus (n = 4.0, 1.0%). All isolated species resisted Penicillin G, Ampicillin, Cefotaxime and Cefoxitin. Most of the isolates, 89.5% (n = 358) had the beta-lactamase phenotype, 18.0% (n = 72) had the MecA gene, 2.8% (n = 11) the Mupirocin-resistant phenotype, and 2.0% (n = 8.0) the vancomycin-resistance phenotype. Additionally, 12 isolates had both methicillin-resistant Staphylococcus aureus (66.7%) and macrolides-lincosamide and streptogramin (65.2%) genes. The majority of the patients, 43% (n = 172) were >50 years old and 52.25% (n = 209) males. Also, most samples were from patients with urinary tract infection (n = 73), wound (n = 71), blood (n = 35), sputum (n = 29), pus (n = 28), seminal fluid (n = 27), cerebrospinal fluid (n = 1.0) and stool (n = 1.0). Most isolates that had the MSLb gene were highly significantly resistant to both Clindamycin (94.6%) and Erythromycin (84.7%) (p < 0.001).

Conclusions: Staphylococcus aureus was the predominant Staphylococcus species isolated from the clinical samples, most of which were resistant to most commonly prescribed antibiotics and had developed resistant genes and phenotypes.

Aim: Diabetic Charcot neuro-osteoarthropathy carries a significant worldwide disease burden including diabetic foot infection, ulceration and amputation. The current accepted standard of treatment during the active phase of Charcot neuro-osteoarthropathy is offloading with total contact casting; however, controversy remains regarding weight-bearing status during this period.

Methods: A systematic review was performed following PRISMA guidelines of Pubmed, EMBASE, MEDLINE and the Cochrane central register of controlled trials for clinical studies from inception until June 2024 investigating weight-bearing and non-weight-bearing total contact casting for active Charcot neuro-osteoarthropathy.

Results: Four hundred ninety-three studies were identified in the search strategy of which 5 studies met the inclusion criteria comprising 158 patients. These studies found that allowing patients to weight-bear during total contact casting does not have a negative impact on the healing process. There were no comparative studies between weight-bearing and non-weight-bearing total contact casting.

Conclusions: There is limited evidence to support current practice of non-weight bearing in a total contact casting for active Charcot neuro-osteoarthropathy. Allowing patients to weight bear carries advantages to patient independence and quality of life. Further investigation with randomised control trial should be considered to investigate if weight bearing is associated with negative outcomes.

Introduction: Breast cancer is the second most common cancer and a leading cause of cancer death in U.S. women. The tumor microenvironment, especially nearby adipocytes, plays a crucial role in its progression. Therefore, this study aimed to investigate the effects of human adipose mesenchymal stem cells-derived conditioned medium (SUP) and extract (CE) from on breast cancer cells.

Methods: Human adipose-derived mesenchymal stem cells were isolated and characterized by flow cytometry using Cluster of Differentiation (CD) markers (CD34, CD45, CD90, and CD105). The differentiation potential was confirmed via adipogenic and osteogenic induction. MCF-7 and MDA-MB-231 cells were treated with SUP and CE, and cell viability was assessed using the 3-(4,5-Dimethylthiazol-2-Yl)-2,5-Diphenyltetrazolium Bromide (MTT) assay at 24, 48, and 72 h. Doubling time, colony formation, wound healing, and gene expression for key cancer-related genes (TIMP1, TIMP2, MMP2, PDL1, IDO, Bax, caspase 3, and caspase 9) were also evaluated.

Results: Both SUP and CE significantly inhibited the viability of MCF-7 and MDA-MB-231 cells, reduced their doubling time, and suppressed colony formation. In wound healing assays, cell migration was notably impaired in MDA-MB-231 cells but less so in MCF-7 cells. Real-time polymerase chain reaction revealed downregulation of TIMP1, MMP2, PDL1, and IDO in MDA-MB-231 cells after treatment, while CE increased certain gene expressions in MCF-7 cells. Bax, caspase 3, and caspase 9 expressions were significantly upregulated in MDA-MB-231 cells but not in MCF-7 cells after treatment.

Conclusion: Human adipose-derived mesenchymal stem cells-derived SUP and CE exhibit antitumor effects on breast cancer cells, suggesting a potential therapeutic strategy to suppress tumor progression. Mesenchymal stem cells-SUP and CE could be a safe and novel regenerative approach for breast reconstruction postmastectomy without tumor recurrence risk.

The estimation of surgical blood loss is routinely performed during and after surgical procedures and has morbidity and mortality implications related to the risk of under- and over-resuscitation. The strategies for estimating surgical blood loss include visual estimation, the gravimetric method, the colorimetric method, formula-based methods, and other techniques (e.g., cell salvage). Currently, visual estimation continues to be the most widely used technique. In addition, unique considerations exist when these techniques are applied to various clinical settings such as massive transfusion, cardiac surgery, and obstetrics. Ultimately, when using estimated surgical blood loss to guide perioperative fluid management and transfusion thresholds, it is also important to mitigate the risks associated with resuscitation by targeting a goal-directed fluid therapy approach by utilizing markers of fluid-responsiveness to optimize stroke volume (cardiac output) and delivery of oxygen.

Tracheal tube infections pose significant challenges in the management of mechanically ventilated patients in intensive care units. These infections contribute to prolonged intensive care unit stays, increased healthcare costs, the spread of antibiotic resistance, and poor patient outcomes. This study aims to elucidate the complex relationship between environmental factors, hospital practices, and the incidence of tracheal tube infections. Our comprehensive review explores the impact of factors such as air quality, water sources, equipment contamination, ventilation strategies, infection control protocols, and microbial reservoirs within hospital settings on tracheal tube infection rates. Additionally, it investigates global variations in tracheal tube infection prevalence, which are influenced by differences in healthcare infrastructure, infection control adherence, antibiotic resistance profiles, and patient demographics. Our findings highlight the importance of targeted interventions and collaborative approaches to reduce the burden of tracheal tube infections and improve patient care in intensive care units. By fully understanding the interplay between environmental conditions and hospital practices, effective prevention and management strategies can be developed to reduce the impact of tracheal tube infections on patient outcomes and healthcare resources, ultimately enhancing the quality of care in critical care settings.

Background: To demonstrate the safety and performance of the Arrow EZ-IO Intraosseous Vascular Access System, particularly in the pediatric patient population, a retrospective observational study was conducted in 2021 and 2022.

Methods: Following study design, IRB approval, and investigator selection, data were collected for all patients needing intraosseous access-adult and pediatric. The primary endpoint was the success rate for achieving intraosseous access; the secondary endpoint was the rate of adverse events. Following initial data collection, additional data were collected and a sub-set analysis was conducted to demonstrate the same in pediatric patients only, which is the focus of this report.

Results: Data for 106 pediatric cases were collected. The success rate for achieving intraosseous access and infusion was 96.2%. There were three adverse events in two patients (1.9%); none serious or previously unreported. The mean duration of device use was 60 h (SD = 46). For 46 patients, the device was used for up to 48 h, and for another 45 patients, the device was used for a longer duration.

Conclusions: This report is the first characterization of the safety and performance of the Arrow EZ-IO Intraosseous Vascular Access System when used in the pediatric population for longer dwell times (>24 h), with no serious complications reported. Performance and safety objectives were met. The results of this real-world evidence study are in alignment with findings from the clinical literature concluding that, for pediatric patients, the Arrow EZ-IO Intraosseous Vascular Access System is safe and effective for providing vascular access in urgent, emergent, and medically necessary situations, in which intravenous access is difficult or impossible to obtain. In addition, this study supports the use of intraosseous access for dwell times greater than 24 h.

Background: LncRNAs play diverse roles and participate in various biological processes within the human body. It has been frequently reported that they are involved in the occurrence and development of recurrent spontaneous miscarriage. PRNCR1, a crucial player in several types of cancers, may also have implications for recurrent spontaneous miscarriage risk. However, the correlation between PRNCR1 rs13252298 A > G polymorphism and this risk remains unclear. In summary, we conducted the following experiments to investigate the association between the PRNCR1 polymorphic site rs13252298 and susceptibility to recurrent spontaneous miscarriage.

Method: Our research included 695 healthy controls and 413 patients with recurrent spontaneous miscarriage from southern China. Genotyping was performed using the TaqMan method.

Result: Our findings revealed that there is a relationship between PRNCR1 rs13252298 A > G polymorphism and lower susceptibility to recurrent spontaneous miscarriage (AG and AA: adjusted OR = 0.794, 95% CI = 0.527-1.196, p = 0.2696; GG and AA: adjusted OR = 0.705, 95% CI = 0.542-0.917, p = 0.0092; dominant model: adjusted OR = 0.722, 95% CI = 0.563-0.926, p = 0.0104; recessive model: adjusted OR = 0.949, 95% CI = 0.644-1.398, p = 0.7912).

Conclusion: The results of our study demonstrate that the PRNCR1 rs13252298 A > G allele may contribute to a decreased risk of recurrent spontaneous miscarriage. The rs13252298 polymorphism could potentially serve as a biomarker for detecting recurrent spontaneous miscarriage risk and aiding prevention efforts.

Objective: We studied the prognosis of olfactory and gustatory dysfunctions in patients with long COVID (Coronavirus Disease 2019) after treatment with oral zinc and steroids.

Methods: We measured olfactory and gustatory functions of long COVID patients at their first visits, and after 2-4 months of treatment with oral zinc and steroids using the traditional Chinese version of the University of Pennsylvania Smell Identification Test and the Waterless Empirical Taste Test. We also assessed by phone the recovery of olfactory and gustatory functions at a mean of about 10 months of follow-up.

Results: Among our 71 long COVID patients, 34 complained of loss of smell and taste. Their objective test results showed 88.2% hyposmic, 23.5% hypogeusic at the first visit. After treatment, 77.8% of the patients were hyposmic, and 16.7% were hypogeusic. After a mean follow-up of 10.35 months, 91.2% of the patients reported improvement in their olfactory function. Among the 36 patients who had complained only of smell loss, the objective test results showed 75% hyposmic at their first visit. After treatment, 71.4% of the patients were hyposmic. After a mean of 10.42 months of follow-up, 77.8% of the patients reported improvement in their olfactory function. Only one patient complained of taste loss.

Conclusions: We found that olfactory dysfunction in most long COVID patients persisted for more than 10 months.

Introduction: Living kidney donation is currently low in Colombia, and this is associated with the lack of knowledge of the risks and renal function outcomes of potential donors; there are no studies that evaluate these outcomes. The objective of this study is to evaluate the outcomes of renal function, the incidence of metabolic diseases, arterial hypertension, as well as the finding of albuminuria and/or proteinuria in living kidney donors with a 2-year follow-up post donation.

Methods: Observational study in living kidney donor patients, in which renal function outcomes were evaluated between the predonation period and up to 24 months postdonation.

Results: Ninety-one patients were included, with a median predonation glomerular filtration rate of 98 ml/min/1.73 m², interquartile range (90.5-109), and 24-month postdonation of 66.3 ml/min/1.73 m² interquartile range (57.9-75). A total of 60.26% of the population was in stage 2 at the end of follow-up and no patient had a glomerular filtration rate less than 30 ml/min/1.73 m² or required renal support therapy.

Conclusion: A living donor evaluation process based on risk factor stratification and adequate assessment of renal function was found to generate safe renal function outcomes both in the perioperative period and in medium- and long-term follow-up.