Medical Science Monitor最新文献

BACKGROUND Assessment of labor progress via digital vaginal examination is subjective, while intrapartum transperineal ultrasonography is deemed more objective and effective. The angle of descent (AoD) is a reliable intrapartum transperineal ultrasound parameter with minimal inter-observer and intra-observer errors. This study compared intrapartum transperineal ultrasonography with digital vaginal examination in evaluating the angle of descent for vaginal delivery selection in 70 women. MATERIAL AND METHODS This cross-sectional study was conducted at Dr. Mohammad Hoesin Hospital Palembang in Indonesia, using a consecutive sampling method to measure AoD of 70 patients at admission and every 2 h during labor progression. Patients were monitored until childbirth, and outcomes of successful vaginal or cesarean delivery were reported. A diagnostic test determined the optimal AoD for predicting successful vaginal delivery and its predictive value. RESULTS The study included 70 patients with a mean age of 28.29±6.09 years and a body mass index of 30.59±3.49 kg/m². Among them, 29 (41%) had successful vaginal deliveries. Adequate contraction frequency at admission was strongly associated with successful vaginal delivery (P<0.001). The optimal AoD for predicting successful vaginal delivery was 94.5°, with an area under the curve of 0.567 (95% CI 0.425-0.710), sensitivity of 84.2%, specificity of 45.7%, and accuracy of 54.3%. CONCLUSIONS Intrapartum transperineal ultrasonography for measuring AoD can be a valuable adjunct in labor management. Further investigations are needed to validate the optimal AoD in Indonesian pregnant women.

BACKGROUND Recruitment maneuvers (RMs) are used to reduce pulmonary atelectasis in patients under general anesthesia, but they can lead to a decrease in cerebral hemodynamics. MATERIAL AND METHODS Thirty patients undergoing carotid endarterectomy were randomized to a manual sustained inflation (SI) group or a stepwise increase in PEEP (IP) group. During both RMs, the peak airway pressure (Ppeak) was maintained at 30 cmH₂O for 30 s. Electrical impedance tomography was used to evaluate pulmonary aeration changes. Mean velocity of blood flow in the middle cerebral artery (Vm) and cerebral oxygen saturation (rScO₂) was monitored intraoperatively. RESULTS IP improved lung aeration better at Ppeak=30 cmH₂O than SI (58.2±8.4% vs 46.0±8.3%, P=0.001) and this persisted until the end of surgery. Dorsal (dependent) ventilation 30 min after extubation in the SI group was lower than that before surgery (7.7±2.6% vs 9.9±3.8%, P=0.003). Vm and rScO₂ returned to baseline immediately after RM in the SI group, while it remained below baseline in the IP group (42.5±12.6 vs 50.9±18.8 cm/s, P<0.001 and 68.1±3.5% vs 70.6±3.7%, P=0.001). Heart rate declined significantly during RM only in the SI group (55.9±6.6 vs 52.2±6.9 bpm, P=0.008). CONCLUSIONS Compared with SI, IP performed better in improving lung aeration, with greater hemodynamic stability. IP resulted in slower recovery of cerebral blood flow and oxygenation.

The Editors of Medical Science Monitor wish to inform you that the above manuscript has been retracted from publication due to concerns with the credibility and originality of the study, the manuscript content, and the Figure images. Reference: Chunping Yao, Xiujuan Cao, Zheng Fu, Jing Tian, Wei Dong, Jin Xu, Kang An, Limin Zhai, Jinming Yu. Boschniakia rossica Polysaccharide Triggers Laryngeal Carcinoma Cell Apoptosis by Regulating Expression of Bcl-2, Caspase-3, and P53. Med Sci Monit, 2017; 23: 2059-2064. DOI: 10.12659/MSM.901381.

Lamotrigine belongs to the group of antiepileptic drugs and mood stabilizers, and its action is based on the selective blocking of voltage-deficient sodium channels. The effect of this mechanism is the stabilization of the presynaptic part of the neuronal membrane and subsequent inhibition of the secretion of the neurotransmitters glutamate and aspartate into the postsynaptic part of the neuron. Lamotrigine has been approved by the Food and Drug Administration for the maintenance treatment of adults with bipolar disorder since 1994. In the field of psychiatry, this medicine is also used off-label in the treatment of acute bipolar depression. Studies show promising effects of the use of lamotrigine in bipolar disorder type II with rapid phase change. Bipolar disorder is a common psychiatric problem that most often affects young adults. Lamotrigine is most effective in bipolar disorder in preventing depressive episodes, which dominate the clinical picture of this disease. The latest research focuses on extending its action, to include manic episodes. Lamotrigine, through an unexplained mechanism, can affect the immune system, causing Stevens-Johnson syndrome, hemophagocytic lymphohistiocytosis, and drug reaction with eosinophilia and systemic symptoms syndrome. These are rare, life-threatening adverse effects that require urgent intervention in the form of drug discontinuation and immunosuppressive treatment. Strict contraindications to the use of lamotrigine include sensitivity reactions accompanied by systemic symptoms. Phenotype testing enables screening of patients predisposed to serious hypersensitivity reactions. The aim of the article is to review the indications, contraindications, and adverse effects of lamotrigine in the treatment of bipolar disorder and depression.

BACKGROUND Anterior reduction disc displacement (ARDD) of the temporomandibular joint (TMJ) can present with pain and clicking of the jaw when chewing. This study aimed to evaluate the relationship between articular eminence cortication (AEC) and mandibular condyle cortication (MCC) in 81 patients with ARDD of the TMJ using cone beam computed tomography (CBCT) imaging. MATERIAL AND METHODS We examined images of 142 patients who applied to the outpatient clinic between 2022 and 2024 for various reasons and whose radiographic records included CBCT and MRI images. Sixty-one patients who did not meet the inclusion criteria were excluded from the study. MRI images of the remaining 81 patients were analyzed and evaluated for the presence of ARDD. Subsequently, all mandibular condylar processes and articular eminences included in the study were examined by CBCT and the degree of cortication was classified and noted. The relationship between MCC and AEC and ARDD was evaluated with the SPSS 23.0 program (SPSS, Chicago, IL, USA). RESULTS ARDD was observed in 46 (28.4%) of 162 condyles examined. Type 1 cortications were observed in 8 (17.4%), type 2 in 36 (78.3%), and type 3 in 2 (4.3%) of the condyles with disc displacement; 80.0% (8) of type 2 cortications were found in patients with ARDD (P<0.001), and 75.0% of type 3 cortication was observed in intact condyles (P<0.001). CONCLUSIONS This study shows that loss of AEC and MCC may be a significant factor in the diagnosis of ARDD, and decreased AEC and MCC may be a criterion for the diagnosis of ARDD.

BACKGROUND In patients with multiple sclerosis, depression and its associated symptoms are factors that reduce the health-related quality of life can affect the course of the disease and the patient's compliance with therapeutic recommendations, or may even increase the risk of suicide. This study aimed to determine the relationship between body composition, motor function of limbs, physical activity, and the occurrence of depressive symptoms in patients with multiple sclerosis. MATERIAL AND METHODS The study group included 110 patients - 84 women (76.4%) and 26 men (23.6%) - with multiple sclerosis and with or without depression. Disability status was assessed using the EDSS scale. Depressive symptoms were recognized based on the Beck Depression Inventory-II, while motor function was determined with the 9-Hole Peg Test and Timed 25-Foot Walk test. Accelerometers were used to evaluate physical activity of patients. Statistical analysis of collected data was performed using logistic regression. RESULTS Depressive symptoms (BDI-II score ≥14) were observed in 24.55% of the participants. MS patients with and without depression symptoms differed significantly in terms of fat mass, T25-FW, and 9-HPT-dominant hand. Multivariate regression analyses demonstrated that increased adiposity (OR=1.09; 95% CI=1.02-1.16; P=.008; and decreased motor ability of the upper limb, both dominant (OR=1.07; 95% CI=1.01-1.15; P=.043) and non-dominant one (OR=1.10 95% CI 1.01-1.18; P=.025) were associated with a higher risk of depression. The differences in physical activity and T25-FW between groups were statistically insignificant. CONCLUSIONS The severity of depression symptoms was related to higher body mass and decreased functional ability of the upper limbs in patients with MS. Thus, a detailed evaluation of the patient's upper-limb function should constitute an integral part of motor function assessment of patients with MS.

BACKGROUND The environmentally friendly production of silver nanoparticles (AgNPs) has gained significant attention as a sustainable alternative to traditional chemical methods. This study focused on synthesizing AgNPs using extract of Dracocephalum kotschyi (D. kotschyi), a medicinal plant. MATERIAL AND METHODS The biosynthesis of AgNPs was monitored using UV-visible spectrophotometry. The role of phytoconstituents from D. kotschyi in stabilizing AgNPs was analyzed using Fourier-transform infrared (FTIR) spectroscopy. Dynamic light scattering (DLS) spectroscopy was used to determine the size, charge, and polydispersity of the nanoparticles, while scanning electron microscopy (SEM) was employed to assess their morphology. We evaluated the antimicrobial efficacy of the synthesized AgNPs against various bacteria, their antioxidant properties via a 2,2-Diphenyl-1-picrylhydrazyl (DPPH) assay, and their cytotoxic activity against the HeLa cervical cancer cell line. RESULTS The formation of AgNPs was indicated by a color change and the emergence of a surface plasmon resonance peak at 418 nm. The nanoparticles demonstrated significant antimicrobial, antioxidant, cytotoxic, and anticancer activities. Morphology, size, and shape analysis revealed nearly spherical particles with an average size of 43 nm. FTIR confirmed the presence of phenolic compounds in the extract, serving as reducing and capping agents. X-ray diffraction (XRD) analysis confirmed the crystalline structure of the nanoparticles. Antimicrobial assessments showed effectiveness against Escherichia coli and Staphylococcus aureus. The DPPH scavenging assay demonstrated efficient antioxidant activity, and potent apoptotic anticancer effects were observed on cervical cancer cells. CONCLUSIONS The extract of D. kotschyi was effective as a reducing agent in the environmentally friendly synthesis of AgNPs, which exhibited noteworthy antimicrobial, antioxidant, and anticancer properties. These findings suggest potential biomedical applications for the synthesized AgNPs.

BACKGROUND Rates of self-medication among pregnant women are high, due to the promotion of herbal and dietary supplements and lack of awareness of possible adverse effects. This study evaluated self-medication in pregnant women attending an antenatal clinic at Soba Teaching Hospital, Sudan. MATERIAL AND METHODS A quantitative study was conducted using a pre-tested semi-structured interviewer-administered questionnaire, which consisted of 25 questions divided into 4 sections: demographic and obstetric; self-medication source, recommendations, and conditions; most commonly used medications and herbal medicine; reasons for self-medications. A total of 230 pregnant women were included in the study. The chi-square test was used to test associations between variables and the binary logistic regression model was used to evaluate the relationship between self-medication practice and explanatory variables. A P value of <0.05 was deemed significant in the final model. RESULTS Of the 230 pregnant women interviewed, 67% were multigravida, 184 (80%) practiced self-medication, 45.6% used pharmaceutical products, commonly analgesics (32.5%), and 21.9% used herbal remedies, including peppermint (19.4%) and citrus fruits (17.5%). Self-medication was used for nausea (49.5%) and heartburn (46.2%). Reasons for self-medication included belief in safety (40%) and the expense of physician fees (28.1%). Socio-demographic characteristics and the prevalence of self-medication in pregnant women showed no significant associations. CONCLUSIONS The findings from this study showed that the prevalence of self-medication reported by pregnant women attending antenatal clinics in Sudan was high and included approved drugs and herbal medicines, mainly from pharmacies, and was driven by the perception that all medications supplied by pharmacies were safe.

The Editors of Medical Science Monitor wish to inform you that the above manuscript has been retracted from publication due to concerns with the credibility and originality of the study, the manuscript content, and the Figure images. Reference: Na Li, Mei Han, Ning Zhou, Yong Tang, Xu-Shan Tang. MicroRNA-495 Confers Increased Sensitivity to Chemotherapeutic Agents in Gastric Cancer via the Mammalian Target of Rapamycin (mTOR) Signaling Pathway by Interacting with Human Epidermal Growth Factor Receptor 2 (ERBB2). Med Sci Monit, 2018; 24: CLR5990-5972. DOI: 10.12659/MSM.909458.

Rising levels of obesity in all age groups are associated with profound effects on health and economies in developed and developing countries. This year, the scientific research behind the development of glucagon-like peptide 1 (GLP-1) receptor agonists (GLP-1 analogs or incretin mimetics) has been recognized. On 19 September 2024, three scientists were presented with a Lasker Award for their basic clinical research on identifying and studying the roles of GLP-1. The research by Joel Habener, Svetlana Mojsov, and Lotte Bjerre Knudsen began three decades ago and has led to new anti-obesity drugs, which mimic GLP-1 to lower blood glucose levels and control appetite. The efficacy of GLP-1 receptor agonists in the management of obesity in adults, as well as in children and adolescents, has now been supported by several clinical trials. This editorial aims to describe the research behind developing GLP-1 receptor agonists and their potential and pitfalls in managing obesity in all age groups.