Medical sciences (Basel, Switzerland)最新文献

(1) Background: General nutrition knowledge is a fundamental pillar of well-being and healthy lifestyles. This study aimed to measure the general nutrition knowledge questionnaire (GNKQ) scores of overweight and obese participants who joined a pilot randomized controlled trial (RCT) and the association between changes in GNKQ scores and changes in anthropometric measures. (2) Methods: A total of 30 and 25 participants had completed the trial at the 3- and 6-month visits, respectively. All participants enrolled in a randomized controlled trial (RCT) and received a hypocaloric-tailored diet and three online nutrition education sessions over 6 months. The participants were randomly divided into two groups: an intervention group supported with weekly telemonitoring and monthly telehealth coaching vs. a control group. The Arabic-validated GNKQ was used, covering four sections: dietary recommendations; food groups and nutrient sources; healthy food choices; and associations between the diet-disease relationship and weight. (3) Results: The findings show that both the intervention and control groups showed improvements in GNKQ scores over time, with the intervention group demonstrating significant increases in overall nutrition knowledge and specific areas, such as the diet-disease relationship and weight management, at 3 months. In addition, changes in GNKQ scores had a significant negative association with BMI and visceral fat percentage. The findings underline the benefits of supporting dietary weight loss interventions with telemonitoring and telehealth coaching, suggesting that an increase in nutrition knowledge may relate to lower body fat metrics. Nevertheless, the small sample size and high attrition rate of participants were the main limitations of this study, such that large populations are required to confirm the reliability of the obtained findings.

Quantum computing (QC) represents a paradigm shift in computational power, offering unique capabilities for addressing complex problems that are infeasible for classical computers. This review paper provides a detailed account of the current state of QC, with a particular focus on its applications within medicine. It explores fundamental concepts such as qubits, superposition, and entanglement, as well as the evolution of QC from theoretical foundations to practical advancements. The paper covers significant milestones where QC has intersected with medical research, including breakthroughs in drug discovery, molecular modeling, genomics, and medical diagnostics. Additionally, key quantum techniques such as quantum algorithms, quantum machine learning (QML), and quantum-enhanced imaging are explained, highlighting their relevance in healthcare. The paper also addresses challenges in the field, including hardware limitations, scalability, and integration within clinical environments. Looking forward, the paper discusses the potential for quantum-classical hybrid systems and emerging innovations in quantum hardware, suggesting how these advancements may accelerate the adoption of QC in medical research and clinical practice. By synthesizing reliable knowledge and presenting it through a comprehensive lens, this paper serves as a valuable reference for researchers interested in the transformative potential of QC in medicine.

Background/objectives: Due to concerns about drug resistance and side effects, the discovery of improved drugs for lung cancer has attracted studies to find an effective and safe treatment. Aminolevulinic acid-mediated photodynamic therapy (ALA-PDT) is a cancer treatment with minimal side effects. However, ALA-PDT effectiveness can be hindered by ABCG2 and ABCB1 transporters impeding PpIX accumulation. Combining ALA with other substances can enhance PpIX accumulation. Hemin is a potential substance due to its antitumor properties and may be involved in regulating the ABCG2 and ABCB1 expressions.

Methods: The objective of this report is to analyze the effects of administering a combination of hemin and ALA after 48 h on A549 lung cancer cells by quantifying cell viability, intracellular PpIX, and ROS accumulation, completed by ABCG2 and ABCB1 expressions.

Results: Our data indicate that the combination of hemin and ALA followed by photoirradiation decreased the viability of A549 cells, which was due to increased intracellular PpIX and ROS. The expression of ABCG2 mRNA was significantly decreased after ALA-hemin treatment, while the ABCB1 mRNA expression increased. This result might suggest that ABCG2 plays a greater role than ABCB1 in regulating the PpIX accumulation in A549 lung cancer cells.

Conclusions: The combination of ALA and hemin followed by photoirradiation offers a promising novel treatment for lung cancer, and further evaluations of this therapy are required.

Purpose: To assess (I) whether, in autopsy-proven lethal intoxications with opiates/opioids, a dilatation of the common bile duct (CBD) is still visible in postmortem computed tomography (PMCT) and (II) if a dilatation of the CBD might also be measurable for other substance groups (e.g., stimulants, hypnotics, antipsychotics, etc.).

Methods: We retrospectively measured the CBD using PMCT in cases with lethal intoxication (n = 125) and as a control group in cases with a negative toxicological analysis (n = 88). Intoxicating substances were classified into the subgroups (opiates, opioids, stimulants, hypnotics, antipsychotics, gasses, and others). Significance between the study and control groups was tested with the Mann-Whitney U test, and correlations were examined by using crosstables.

Results: There was a statistically significant difference between the CBD diameters in the intoxication group overall, when compared to the CBD diameter in the control group (p < 0.001). For both subgroups of "opiates" and "opioids", there was a strong statistically significant difference between the CBD diameter (being wider) in those groups compared to the control group (both p = 0.001). For the three subgroups "hypnotics", "stimulants", and "psychotropic drugs", there was no statistically significant difference between the CBD diameters in the intoxication subgroups when compared with the control group. The other subgroups were too small for statistical analysis.

Conclusion: A dilated common bile duct in postmortem computed tomography might be used as an indication for a lethal opioid or opiate intoxication only in regard to the specific case circumstances or together with other indicative findings in a postmortem investigation.

Background: The use of beta-blockers in the perioperative period has been widely investigated due to their potential to reduce the risk of major adverse cardiovascular and cerebrovascular events (MACCE) and mortality; yet their overall impact on various postoperative outcomes remains debated. This study constitutes a systematic review and meta-analysis of the impact of beta-blockers on mortality, MI, stroke, and other adverse effects such as hypotension and bradycardia in patients undergoing non-cardiac surgery.

Methods: A comprehensive systematic review and meta-analysis were conducted according to PRISMA 2020 guidelines. Searches were performed across PubMed, Cochrane, Web of Science, Scopus, EMBASE, and CINAHL databases; we included randomized controlled trials and cohort and case-control studies published from 1999 to 2024.

Results: This meta-analysis included data from 28 studies encompassing 1,342,430 patients. Perioperative beta-blockers were associated with a significant increase in stroke risk (RR 1.42, 95% CI: 1.03 to 1.97, p = 0.03, I² = 62%). However, no statistically significant association was found between beta-blocker use and mortality (RR 0.62, 95% CI: 0.38 to 1.01, p = 0.05, I² = 100%). Subgroup analyses revealed a protective effect on mortality for patients with high risks, such as patients with a history of atrial fibrillation, chronic heart failure, and other arrhythmias. For myocardial infarction (RR 0.82, 95% CI: 0.53 to 1.28, p = 0.36, I² = 86%), a reduction in events was observed in the subgroup of randomized controlled trials. Beta-blockers significantly increased the risk of hypotension (RR 1.46, 95% CI: 1.26 to 1.70, p < 0.01, I² = 25%) and bradycardia (RR 2.26, 95% CI: 1.37 to 3.74, p < 0.01, I² = 64%).

Conclusions: Perioperative beta-blockers show increasing rates of stroke events following non-cardiac surgery but do not significantly impact the incidence of MI or mortality. The increased risks of hypotension and bradycardia necessitate careful patient selection and monitoring. Future research should aim to refine patient selection criteria and optimize perioperative management to balance the benefits and risks of beta-blocker use in surgical settings.

Background: The reddening of the face and neck following alcohol consumption is known as Asian flush. Although genetic factors related to Asian flush have been reported to be inversely associated with duration of sleep, no study has reported an association between Asian flush and sleep satisfaction.

Methods: A cross-sectional study of 3823 Japanese people, aged 20 to 64 years was conducted. The target population comprised general public resident monitors of Osaka Prefecture who were registered with an internet research company.

Results: A significant inverse association was observed between Asian flush and satisfaction of sleep. The potential confounder-adjusted odds ratio (OR) and 95% confidence interval (CI) of satisfied sleep was 0.81 (0.69-0.96). The alcohol consumption status-specific analysis revealed essentially the same associations between consumers and non-consumers of alcohol. The adjusted ORs (95% CIs) were 0.81 (0.65-0.997) for non-consumers and 0.80 (0.61-1.05) for consumers of alcohol.

Conclusion: The genetic characteristics of physical reactions to alcohol exposure may influence sleep quality. One's alcohol consumption status may not influence the effects of having a lower tolerance to alcohol on sleep quality.

Background: Thrombophilia, characterized by an increased risk of thrombosis, can result from genetic polymorphisms in clotting factors. This study aims to investigate the prevalence of factor V Leiden (G1691A), factor II prothrombin (G20210A), and MTHFR (C677T and A1298C) polymorphisms in a Greek population, evaluating not only their association with thrombophilia, but also broader health implications.

Methods: We conducted a cross-sectional study involving one hundred apparently healthy adults from Thessaloniki, Greece. After obtaining informed consent, DNA was isolated and analyzed using real-time PCR to detect the frequencies of the aforementioned polymorphisms.

Results: The genetic distribution of the examined polymorphisms aligns closely with that observed in Northern Europe. Factor V Leiden (FVL) and prothrombin G20210A mutations were predominantly wild types, with a small percentage showing heterozygous mutations. The MTHFR C677T and A1298C polymorphisms showed a higher variation in allele frequency. Certain lifestyle factors such as smoking and high body mass index were significantly associated with the occurrence of combined MTHFR genotypes, suggesting an interaction between genetic and environmental risk factors. Family cancer and cardiovascular history was significantly associated with combined FVL and prothrombin G20210A and MTHFR polymorphism heterozygous carriers.

Conclusions: Our findings indicate that these genetic polymorphisms are not only pivotal in understanding thrombophilia but also have broader implications for cardiovascular disease and cancer. This study highlights the need for further research into the combined effects of genetic and epigenetic factors on health, which could lead to improved screening and personalized preventive healthcare strategies.

Background: Chronic Myelomonocytic Leukemia (CMML) is a rare and aggressive form of leukemia with characteristics of both myeloproliferative neoplasms (MPNs) and myelodysplastic syndromes (MDSs). This study aims to explore the clinical features, survival outcomes, and prognostic factors in CMML patients over the past 20 years using a large sample. Methods: The study data from 4124 patients diagnosed with CMML between 2000 and 2017 were sourced from the SEER database. Demographic and clinical characteristics, along with overall and cancer-specific mortality, were examined. Factors with a p-value < 0.01 in univariate Cox regression were included in the multivariate Cox model to identify independent prognostic factors, with hazard ratios (HRs) greater than one indicating adverse outcomes. Results: The majority of the cohort were male (61.57%), and most diagnoses occurred between ages 60-79 (55.16%), with a small percentage under 40 (1.41%). Non-Hispanic whites represented the largest racial group (79.03%). Multivariate analysis showed higher mortality in males, those aged 80+, residents in metropolitan areas with populations between 250,000 and 1 million, single or widowed individuals, and those who underwent chemotherapy. Conversely, lower mortality was associated with an annual income of $75,000+. Conclusions: CMML remains a rare and highly aggressive hematologic disorder. This U.S.-based retrospective cohort study identified male gender, advanced age, single or widowed status, and chemotherapy as independent poor prognostic factors. While it is expected that older patients and those requiring chemotherapy would have a poorer prognosis, the higher mortality risk in single or widowed patients, as well as males, warrants further investigation. The early involvement of family and community support may help reduce mortality in these groups, suggesting a need for larger prospective studies to explore these associations further.

Objective: This study evaluates the suitability of cerebral oximetry using near-infrared spectroscopy (NIRS) compared to traditional pulse oximetry (SpO2) for measuring cerebral oxygen saturation during hypoxia testing, aiming to enhance safety during flight operations and training. Material and Methods: The study included 106 participants aged 18-60 years at the Aerospace Medicine Training Center in Königsbrück. Cerebral oxygen saturation (rSO2) and peripheral oxygen saturation (SpO2) were measured using the INVOS™ 5100C cerebral oximeter and Masimo™ MS5 pulse oximeter, respectively. Measurements were taken at baseline, during hypoxia at 25,000 feet, and post recovery. Data analysis included regression analysis, Bland-Altman plots, and concordance correlation coefficients (CCC). Ethical approval was obtained from the Hannover Medical School. Data from 100 participants were analyzed. Results: Baseline SpO2 was 97.5 ± 1.5%, and baseline rSO2 was 77.25 ± 6.4%. During hypoxia, SpO2 dropped significantly, while rSO2 showed higher values. SpO2 recovered faster than rSO2. Deviations in rSO2 between the right and left sides during hypoxia were minimal. Lin's CCC indicated moderate to substantial concordance. NIRS measurements were more stable and less prone to disturbances, with 95 disruptions in pulse oximetry, 25 of which were potentially critical. Conclusions: NIRS is a reliable method for detecting cerebral oxygen saturation, offering significant advantages over traditional pulse oximetry in stability and reliability during hypoxia testing. NIRS is less error-prone, supporting its use for continuous monitoring in aviation settings and enhancing flight safety by providing more accurate hypoxia detection.