Life-Basel最新文献

Background: The aim of this study was to evaluate the performance and the impact of contrast-enhanced intraoperative ultrasound (CE-IOUS) on intraoperative decision-making, as there is still no standardized protocol for its use. Therefore, we retrospectively analyzed multiple CE-IOUS performed in hepato-pancreatic-biliary surgery with respect to pre- and postoperative imaging and histopathological findings.

Methods: Data of 50 patients who underwent hepato-pancreatic-biliary surgery between 03/2022 and 03/2024 were retrospectively collected. CE-IOUS was performed with a linear 6-9 MHz multifrequency probe connected to a high-resolution device. The ultrasound contrast agent used was a stabilized aqueous suspension of sulphur hexafluoride microbubbles.

Results: In total, all 50 lesions indicated for surgery were correctly identified. In 30 cases, CE-IOUS was used to localize the primary lesion and to define the resection margins. In the remaining 20 cases, CE-IOUS identified an additional lesion. Fifteen of these findings were identified as malignant. In eight of these cases, the additional malignant lesion was subsequently resected. In the remaining seven cases, CE-IOUS again revealed an inoperable situation. In summary, CE-IOUS diagnostics resulted in a high correct classification rate of 95.7%, with positive and negative predictive values of 95.2% and 100.0%, respectively.

Conclusions: CE-IOUS shows excellent performance in describing intraoperative findings in hepato-pancreatic-biliary surgery, leading to a substantial impact on intraoperative decision-making.

Background: Autism spectrum disorder (ASD) has seen a rise in prevalence, and the immune system's role in brain development is increasingly recognized. This study investigates the relationship between immune dysregulation and ASD by examining serum concentrations of interleukin 6 (IL-6), interleukin 8 (CXCL8), and tumor necrosis factor alpha (TNF-alpha) in children.

Methods: Serum samples from 45 children with ASD and 30 controls, aged 2 to 12 years, were analyzed using electrochemiluminescence, chemiluminescent microparticle immunoassay, and chemiluminescent immunoassay. ASD symptoms were assessed using the Autism Spectrum Rating Scale (ASRS) and Social Communication Questionnaire (SCQ).

Results: No significant correlation was observed between CXCL8 levels and ASD. IL-6 levels showed a trend toward elevation in boys with ASD. TNF-alpha levels were significantly higher in children with ASD under 5 years compared to older children and controls, though no correlation with symptom severity was found.

Conclusions: TNF-alpha may be a potential biomarker for early ASD detection, especially in younger children. Further research on larger cohorts is needed to understand the role of immune dysregulation in ASD.

Previous studies on the mountain plant Ranunculus kuepferi concluded that apomictic self-compatible tetraploids have experienced a niche shift toward a colder climate during the Holocene, which suggests a fitness advantage over the sexual, self-sterile diploid parents under cold and stressful high-mountain conditions. However, there is still a lack of information on whether reproductive development would be advantageous for tetraploids. Here, we report on microsporogenesis, megagametogenesis, the dynamics of flower and seed development, and the consequences for reproductive success in a common garden experiment along a 1000 m climatic elevation gradient and in natural populations. Flower buds were initiated in the year preceding anthesis and passed winter in a pre-meiotic stage. Flower morphology differed in the known cytotype-specific way in that tetraploid flowers produced about twice as many carpels and fewer petals, stamens, and pollen grains than diploid flowers. Tetraploids developed precociously aposporous embryo sacs and showed a high rate of developmental disturbances. Sexual seed formation prevailed in diploids and pseudogamous apomixis in tetraploids. Along the elevation gradient, stigma pollen load, pollen performance, and seed output decreased. Combinations of reproductive traits, namely, bypass of meiosis irregularities and uniparental reproduction, might have promoted the vast expansion of apomictic R. kuepferi lines across the European Alps.

Type 2 diabetes, prediabetes, and insulin resistance (IR) are widespread yet often undetected in their early stages, contributing to a silent epidemic. Metabolic Syndrome (MetS) is also highly prevalent, increasing the chronic disease burden. Annual check-ups are inadequate for early detection due to conventional result formats that lack specific markers and comprehensive visualization. The aim of this study was to evaluate low-budget biochemical and hematological parameters, with data visualization, for identifying IR and MetS in a community-based laboratory. In a cross-sectional study with 1870 participants in Patras, Greece, blood samples were analyzed for key cardiovascular and inflammatory markers. IR diagnostic markers (TyG-Index, TyG-BMI, Triglycerides/HDL ratio, NLR) were compared with HOMA-IR. Innovative data visualization techniques were used to present metabolic profiles. Notable differences in parameters of cardiovascular risk and inflammation were observed between normal-weight and obese people, highlighting BMI as a significant risk factor. Also, the inflammation marker NHR (Neutrophils to HDL-Cholesterol Ratio) Index was successful at distinguishing the obese individuals and those with MetS from normal individuals. Additionally, a new diagnostic index of IR, combining BMI (Body Mass Index) and NHR Index, demonstrated better performance than other well-known indices. Lastly, data visualization significantly helped individuals understand their metabolic health patterns more clearly. BMI and NHR Index could play an essential role in assessing metabolic health patterns. Integrating specific markers and data visualization in routine check-ups enhances the early detection of IR and MetS, aiding in better patient awareness and adherence.

This study aims to develop and apply multistate models to estimate, forecast, and manage hospital length of stay during the COVID-19 epidemic without using any external packages. Data from Bellvitge University Hospital in Barcelona, Spain, were analyzed, involving 2285 hospitalized COVID-19 patients with moderate to severe conditions. The implemented multistate model includes transition probabilities and risk rates calculated from transitions between defined states, such as admission, ICU transfer, discharge, and death. In addition to examining key factors like age and gender, diabetes, lymphocyte count, comorbidity burden, symptom duration, and different COVID-19 waves were analyzed. Based on the model, patients hospitalized stay an average of 11.90 days before discharge, 2.84 days before moving to the ICU, or 34.21 days before death. ICU patients remain for about 24.08 days, with subsequent stays of 124.30 days before discharge and 35.44 days before death. These results highlight hospital stays' varying durations and trajectories, providing critical insights into patient flow and healthcare resource utilization. Additionally, it can predict ICU peak loads for specific subgroups, aiding in preparedness. Future work will integrate the developed code into the hospital's Health Information System (HIS) following ISO 13606 EHR standards and implement recursive methods to enhance the model's efficiency and accuracy.

The presence of Demodex spp. mites on the skin is a common phenomenon in the human population. In most people, it is an asymptomatic infestation, but in some patients, it can contribute to the occurrence of diseases such as demodicosis, rosacea, or blepharitis, as well as non-specific symptoms. In this study, the results of tests assessing the presence of Demodex spp. by direct microscopic examination (DME) in 2508 patients from northern Poland with the suspicion of demodicosis were retrospectively analyzed. A total of 3684 tests were performed. Among them, only 1585 (43.02%) revealed the presence of Demodex spp., while 2099 (56.98%) were negative. It was shown that in the analyzed population of patients with clinical suspicion of demodicosis, the degree of confirmation of the presence of Demodex spp. positively correlated with the patient's age (p = 0.001) and the mite was mainly found on the edges of eyelids and on the facial skin. Additionally, in men, the presence of Demodex was more often confirmed than in women (p = 0.004). In conclusion, the proper diagnosis of demodicosis still constitutes an important clinical problem due to the non-specificity of symptoms and the low confirmation of clinical suspicions of infestation by DME, especially in lower age groups.

Skeletal muscle secretome, through its paracrine and endocrine functions, contributes to the maintenance and regulation of overall physiological health. We conducted a narrative review on the role of skeletal muscle and exercise in maintaining glucose homeostasis, driving insulin resistance (IR), and preventing type 2 diabetes in pediatric populations, especially in the context of overweight and obesity. Myokines such as interleukin (IL)-6, IL-8, and IL-15, as well as irisin, myonectin, and myostatin, appear to play a crucial role in IR. Skeletal muscle can also become a target of obesity-induced and IR-induced inflammation. In the correlation between muscle, IR, and inflammation, the role of infiltration of the immune cells and the microvasculature may also be considered. It remains unclear which exercise approach is the best; however, combining aerobic exercise with resistance training seems to be the most effective strategy for managing IR, with high-intensity activities offering superior metabolic benefits and long-term adherence. Encouraging daily participation in enjoyable and engaging exercise is key for long-term commitment and effective glucose metabolism management. Promoting physical activity in children and adolescents must be a top priority for public health, not only in terms of individual quality of life and well-being but also for community health.

Objectives: Our aim was to investigate the diagnostic challenges and management of relapsing polychondritis (RP) with airway involvement, highlighting the need for accurate diagnosis and effective intervention to prevent severe complications.

Methods: In this retrospective study, medical records from January 2011 through June 2024 at a single tertiary-care institution were reviewed. This study was approved by the institutional review board. A total of 34 patients were diagnosed with RP, among whom 4 presented with significant airway complications. This study focused on these four patients, detailing their clinical presentations, diagnostic processes, and outcomes following various interventions.

Results: All patients were initially misdiagnosed with asthma and later developed severe airway issues necessitating interventions such as tracheotomy and endotracheal intubation. Diagnostic imaging, microlaryngoscopy and bronchoscopy (MLB) were crucial for identifying subglottic stenosis and other airway alterations. Treatments included high-dose steroids, rituximab, and surgical interventions such as balloon dilation and tracheostomy. Only one patient could be decannulated; the other three remained dependent on tracheostomy and experienced significant complications due to emergency medical interventions.

Conclusions: RP can manifest with nonspecific respiratory symptoms similar to asthma, which may delay correct diagnosis and appropriate treatment, leading to critical airway complications. The early, precise identification of RP, particularly with airway involvement, is vital. MLB and dynamic expiratory CT scans play significant roles in clinical diagnosis and management. A multidisciplinary approach involving otolaryngologists, rheumatologists, and pulmonologists is essential for optimizing patient outcomes and minimizing complications.

Cirsium vulgare (Savi) Ten. is a plant from the Asteraceae family that is commonly used in traditional medicine. The purpose of this work was to investigate the antioxidant and antimicrobial characteristics of phenolic compounds found in ethanol and dry extracts of C. vulgare leaves, inflorescence, and roots during various phenological stages. Apigenin-7-O-glucoside and chlorogenic acid were identified in practically all C. vulgare extracts. Extracts from leaves collected at the end of the phenological dormancy period and in the first growing year had the highest antioxidant (cupric ion-reducing antioxidant capacity of 12,938 Trolox equivalents/g dry weight) and antimicrobial activity (against Staphylococcus aureus, Staphylococcus epidermidis, Pseudomonas aeruginosa, Proteus vulgaris, and Candida albicans) with MIC values of ethanol extract from 16.7 mg/mL to 8.35 mg/mL. These extracts included a high concentration of chlorogenic acid and apigenin-7-O-glucoside. Also, dry extracts from C. vulgare roots and inflorescences showed a higher antimicrobial effect compared to ethanolic extracts with MIC values from 5.57 mg/mL to 3 mg/mL. The study emphasizes the critical role of phenological stages and raw material composition in the accumulation of phenolic compounds and their biological activity in C. vulgare. The findings suggest that extracts from C. vulgare leaves, especially those collected at the end of the phonological dormancy period, are promising candidates for further research into bioactive compounds with potential medicinal applications. The strong antioxidant and antibacterial properties of these extracts highlight their potential for development into natural pharmaceutical products.

Age-related macular degeneration (AMD) is both a poorly understood and devastating disease. Here, we analyze the physico-chemical forces at stake, including osmolarity, redox shift, and pressure due to inflammation. Hyperosmolarity plays a key role in diseases of the anterior segment of the eye such as glaucoma, cataracts or dry eyes, and corneal ulceration. However, its role in macular degeneration has been largely overlooked. Hyperosmolarity is responsible for metabolic shifts such as aerobic glycolysis which increases lactate secretion by Muller cells. Increased osmolarity will also cause neoangiogenesis and cell death. Because of its unique energetic demands, the macula is very sensitive to metabolic shifts. As a proof of concept, subretinal injection of drugs increasing hyperosmolarity such as polyethylene glycol causes neoangiogenesis and drusen-like structures in rodents. The link between AMD and hyperosmolarity is reinforced by the fact that treatments aiming to restore mitochondrial activity, such as lipoic acid and/or methylene blue, have been experimentally shown to be effective. We suggest that metabolic shift, inflammation, and hyperosmolarity are hallmarks in the pathogenesis and treatment of AMD.