Health Science Reports最新文献

Background

The treatment and prevention of bronchial asthma continue to present significant challenges. Mendelian randomization (MR) has been extensively employed to identify novel therapeutic targets. Consequently, we conducted a systematic MR analysis across the druggable genome to identify potential therapeutic targets for asthma.

Aims

Exploring new potential therapeutic targets for the treatment of asthma.

Methods

We obtained data on druggable genes and screened genes within lung expression quantitative trait loci (eQTL) and blood eQTL. Then, MR analysis and colocalization analysis were performed to identify genes highly associated with asthma. In addition, phenome-wide analysis, enrichment analysis and protein–protein interaction network construction (PPI) have been carried out, providing valuable guidance for the development of more effective therapeutic targets.

Results

Druggable genes were sourced from the Drug-Gene Interaction Database (DGIdb) and supplemented by a compilation of druggable genes outlined in a review by Finan et al. The eQTL data sets are derived from eQTLGene and GTEx v8. We obtained asthma GWAS data sets from two large-scale genotypic data sets, FinnGen, and UK Biobank. Finally, we identified six druggable genes significantly associated with asthma. Five druggable genes in whole blood (IRF1, OXER1, PSMA4, UNC13D and HLA-DRB1) and one in lung tissue (CD226). These positive gene interactions were shown to be associated with asthma pathways by enrichment analysis. In the end, phenome-wide analysis showed that most had no side effects.

Conclusion

This study identified six potential drug targets for the treatment of asthma. This discovery provides promising insights for more effective treatments for asthma, with the potential to reduce drug development costs.

Background and Aims

In classical Hodgkin lymphoma liver involvement occurs in 5%–8%, ranging from mild dysfunction to acute liver failure. Recognition and treatment of advanced cases are challenging due to rapid progression and limited use of therapies.

Methods

We analyzed the data of 250 Hodgkin lymphoma patients; 9 had liver involvement, one in the form of acute liver failure.

Results

Laboratory findings showed elevations of cholestatic enzymes, lactate dehydrogenase and haemostatic changes. PET/CT showed solo or multiple active areas in the liver and diffuse elevated standard uptake value in the patient with acute liver failure. In six cases ABVD/EBVD, in two brentuximab vedotin+AVD were used. Four patients achieved complete remission, four were relapsed or refractory, three of them died later. Brentuximab vedotin was started for the patient with acute liver failure, but she died in 2 days. Autopsy confirmed a Hodgkin-infiltrated liver structure.

Conclusion

Liver involvement has a negative impact on prognosis; however, early diagnosis and immediate initiation of therapy improve liver function. PET/CT can be a practical tool to support diagnosis and monitor response to therapy in patients where liver biopsy is not possible or does not contribute significantly to clinical management. With preserved liver function, ABVD is an effective treatment option, while with worsening liver function, brentuximab vedotin can be a safe alternative.

Background and Aims

Hair-Focused Repetitive Behavior Disorders (HFRBDs), commonly associated with trichotillomania (TTM), including hair pulling, manipulation, or ingestion, can cause significant emotional, physical, and social distress. This study aimed to (1) identify hair care-related behaviors among individuals with HFRBDs; (2) explore how these practices relate to hair-pulling behaviors; and (3) examine the potential role of hair professionals in supporting affected individuals.

Methods

An online survey was conducted with adult participants (n = 195) who self-identified as having HFRBDs involving scalp hair. The survey assessed hair-pulling behavior, personal and professional hair care routines, and perceived effects of these practices. Both quantitative and qualitative data were collected and analyzed.

Results

Findings showed that constructive hair care practices often coexisted with hair-pulling behaviors. Participants reported that washing (54.1%) and haircutting (34.1%) helped reduce pulling urges, while styling (8.7%) and combing/brushing (15.4%) had minimal effect. Notably, 27.7% stated that their own touch increased urges, while 9.8% found that another person's touch reduced them. Thematic analysis of 501 open responses revealed categories such as pre-pulling routines, sensory responses to hair texture, and varied experiences with hair salons.

Conclusion

The study highlights the complex relationship between hair care and HFRBDs. Tailored hair care strategies may offer meaningful support for individuals with HFRBDs and could be integrated into guidance provided by clinicians, dermatologists, and hair professionals. Personalized interventions may improve overall management of the condition.

Background and Aims

Although the global plan aimed to eliminate mother-to-child transmission of HIV by 2015, an estimated 130,000 children were newly infected, and 84,000 children died from HIV related causes in 2022. In Ethiopia, 3200 children became newly infected and 1,900 children died from HIV related causes in 2022. A new target has now been set for 2030. Vertical transmission remains the predominant route of pediatric HIV infection. This study aimed to assess HIV vertical transmission and its predictors among HIV-exposed infants in Northwest Ethiopia.

Methods

A retrospective cohort study was conducted among 480 mother–infant pairs enrolled in the PMTCT program. Data were analyzed using R version 4.3.2. To account for missing values, multiple imputations were performed prior to bivariate and multivariable logistic regression analyses. Associations with a p-value < 0.05 were considered statistically significant.

Results

The rate of vertical transmission of HIV was 3.6%. Mothers residing outside the catchment area (AOR = 4.74; 95% CI: 1.17–20.63) and those not receiving antiretroviral therapy (AOR = 6.82; 95% CI: 1.33–38.73) had significantly higher odds of vertical HIV transmission. Conversely, maternal HIV diagnosis prior to pregnancy (AOR = 0.08; 95% CI: 0.009–0.84), receiving Nevirapine prophylaxis (AOR = 0.14; 95% CI: 0.03–0.65), and delivery at a health facility (AOR = 0.08; 95% CI: 0.01–0.66) were significantly protective against mother-to-child transmission.

Conclusion

The rate of vertical HIV transmission was found to be high. Therefore, we recommend further PMTCT service expansion; focus on maternal HIV diagnosis in the preconception period; improve provision of infant Nevirapine prophylaxis and maternal ART help to minimize HIV vertical transmission. Reduce home delivery also helps to decrease HIV vertical transmission.

Background and Aims

The “My eDrug Manager” app provides Hong Kong patients with detailed medication guidance and reminders, but its impact on medication adherence and blood pressure control among older adults with hypertension is not well-studied. This study aims to assess the impact of the “My eDrug Manager” mobile app on medication adherence and blood pressure control in hypertensive older adults in Hong Kong.

Methods

This randomized controlled trial included 569 older adults who were on antihypertensive medication, possessed a smartphone, but demonstrated poor medication adherence. Participants were randomly assigned to either the intervention group, which used the “My eDrug Manager” app and received baseline instructions and adherence pamphlets, or the control group, which received standard care instructions and the same pamphlet. Adherence was measured using the Morisky Medication Adherence Scale (MMAS-8), with data collected at 3, 6, and 12 months. Statistical comparisons between groups were conducted using t-tests and chi-square tests.

Results

At 12 months, the intervention group had a significantly higher mean MMAS-8 score (7.06 ± 1.40) compared to the control group (6.56 ± 1.44, p < 0.001). The proportion of participants with optimal adherence was also higher in the intervention group (68.6% vs. 57.6%, p =0.007). However, no significant differences in blood pressure control were observed between the groups.

Conclusion

The application demonstrates the potential to improve medication adherence among older adults with hypertension, highlighting the need for integrating digital tools into care programs while also pursuing additional strategies for better blood pressure control.

Background and Aims

The COVID-19 pandemic impacted daily life and healthcare. This study investigated how this affected the outcome in children and adolescents living with HIV/AIDS.

Methods

This study investigated medical visits and outcomes (viral load, immunological parameters) in participants in the German Pediatric and Adolescent HIV cohort for 30 months, covering a period before and during the COVID-19 pandemic.

Results

Fifty-two participants receiving antiretroviral therapy (27 females, 25 males; median age: 18 years, IQR: 15.0, 22.0) were analysed. Fifty percent of patients had fewer medical visits, 21% had an unchanged number of visits, and 29% had more medical visits when comparing the pandemic period with the prior period. (p = 0.016). This decline is primarily attributed to the first phase of the pandemic, where the incidence ratio of medical controls was 0.66 (95% CI 0.42–0.97) compared to the previous period (p = 0.05).

In male patients, there was a significant reduction in medical visits which was not seen in females. Among male patients, 60% experienced a decrease in control visits, while 20% remained unchanged (p = 0.015). Age of the patients was significantly negatively associated with number of visits (rho = −0.39; 95% CI [−0.63 to −0.15]; p = 0.004) before and during the pandemic (rho = −0.37; 95% CI [−0.58 to −0.12]; p = 0.007).

Half of the participants did not present with positive viral loads (≥ 20 cps/mL) in any of the two periods. Borderline cases of viral load measurements increased during the pandemic from 38% to 62% cases (p = 0.03), with the largest difference during the first wave.

Conclusion

Overall, the study shows a negative impact during the COVID-19 pandemic on the outcome in children and adolescents living with HIV in Germany and indicates the fragile nature of virological control in this population. Appropriate measures including virtual consultations should be implemented to improve outcome in future pandemic situations.

Background and Aims

Evidence demonstrates unhealthy dietary patterns in early life may contribute to obesity and increased risk of chronic diseases in later life. The COVID-19 pandemic has the potential to impact the dietary habits of schoolchildren due to movement restrictions. Therefore, this study aims to investigate the prevalence of unhealthy dietary habits among primary and secondary school students in Hong Kong during COVID-19, along with associated factors.

Methods

A cross-sectional study was conducted among the primary and secondary school students in Hong Kong from September 2021 to November 2021. Data on sociodemographic information, dietary habits, and lifestyle were collected using self-administered questionnaires. Multivariate logistic regression was conducted to investigate the association between variables and unhealthy dietary habits.

Results

A total of 1541 participants were included, with 762 primary school students (mean age: 10.0) and 779 secondary school students (mean age: 13.6). Approximately 81.5% of primary school students and 89.5% of secondary school students reported inadequate intake of vegetables and fruits. 18.6% of primary students and 42.8% of secondary students reported skipping breakfast, while 46.4% of primary students and 49.2% of secondary students consumed unhealthy foods. Analysis indicates that inadequate vegetable and fruit intake was positively associated with physical inactivity in both groups (aORs = 3.26–3.39). Students who engage in excessive screen time on games or social media had higher odds of skipping breakfast and consuming unhealthy foods (aOR = 1.47–2.24). Secondary school students who perceived themselves as underweight had higher odds of consuming unhealthy foods (aOR = 1.81), while those who reported being overweight had higher odds of skipping breakfast (aOR = 1.51).

Conclusion

Findings highlighted the high prevalence of unhealthy dietary habits among school children in Hong Kong and identified physical inactivity and excessive screen time as key contributing factors. Future research should develop and validate interventions to improve dietary habits.

Introduction

Extracorporeal membrane oxygenation (ECMO) is a life-saving intervention for refractory cardiopulmonary failure. Despite advancements reducing complications, ECMO remains associated with acute kidney injury (AKI), often requiring kidney replacement therapy (KRT). Studies report up to 45% of ECMO patients needing KRT, significantly increasing mortality. A prior meta-analysis suggested a declining mortality trend in recent years.

Methodology

Following PRISMA guidelines, PubMed, MEDLINE, EMBASE, and Cochrane Library were searched (2000–2024) for randomized and observational studies on adult ECMO patients requiring KRT. Data extraction covered study characteristics, patient demographics, ECMO type, KRT timing, and clinical outcomes. Quality was assessed using the Newcastle–Ottawa Scale. Statistical analyses were performed using RevMan 5.4.1 under a random-effects model, with mortality as the primary outcome.

Result

A total of 24 studies (6347 patients) met the inclusion criteria, including 23 observational studies and one RCT. The mean age of ECMO + KRT patients was 51 years in observational studies and 61.2 years in the RCT, with cardiogenic shock as the most common ECMO indication. Meta-analysis showed a significantly higher mortality in ECMO + KRT patients (RR: 1.86, 95% CI: 1.63–2.12, p < 0.001), with infections and bleeding as key contributors. Subgroup analysis revealed no significant survival difference based on KRT timing, while Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) was associated with worse outcomes than Veno-venous extracorporeal membrane oxygenation (VV-ECMO). The RCT reported 61.9% mortality at 30 days in ECMO + KRT patients.

Conclusion

KRT during ECMO is associated with increased mortality, likely due to the severity of illness and complications like infections and bleeding. The optimal timing of KRT initiation remains unclear, and no significant survival benefit was found for early KRT. Further large-scale RCTs are needed to optimize management strategies.

Background & Aim

Diabetic nephropathy is a common complication in patients with type 2 diabetes, and insomnia may exacerbate renal dysfunction. This study aimed to evaluate the effects of magnesium and potassium supplementation on diabetic nephropathy markers in diabetic patients with insomnia.

Methods

A single-blinded randomized controlled trial was conducted on 320 diabetic patients. However, only 290 diabetic patients continued the trial after 60 days follow up. Insomnia was defined by using Insomnia Severity Index (ISI). Supplements dosages were prepared in the form of tablets, characterized as T1; placebo, T2; magnesium (Mg), T3; potassium (K), and T4; as magnesium along with potassium. Serum urea level, serum ALT, serum AST, serum creatinine and HbA1c were quantified in blood (serum) employing a quantitative and highly sensitive enzyme-labelled immunosorbent assay (ELISA), pre-and post-trial.

Results

The total of 290 participants; 93 male and 197 female, were having mean HbA1c and BMI as 7.77 ± 2.10 and 31.00 ± 23.68 respectively. A significant association was revealed by analysis among pre- and post-trial serum urea level, serum creatinine, serum ALT level and magnesium supplementation, p = 0.000, p = 0.000, p = 0.003. Moreover, there was significant association between pre and post-trial serum ALT, AST level, RA factor level and magnesium in combination of potassium supplementation, p = 0.000, p = 0.004. 0.000.

Conclusions

Study concluded that magnesium, and in combination with potassium supplementation had significant reducing effects on diabetic nephropathy markers and suppression in the RA factor level.