Archives of Medical Research最新文献

Air pollution is a critical global issue with extensive implications beyond respiratory health, significantly affecting neurological and psychiatric disorders. Emerging evidence establishes a link between exposure to fine particulate matter (PM < 2.5 µm), sulfur dioxide (SO₂), and nitrogen dioxide (NO₂) and heightened risks of dementia, Alzheimer's disease, schizophrenia, ADHD, stroke, Parkinson's disease, and multiple sclerosis. Mechanistic pathways include neuroinflammation, oxidative stress, microglial activation, cerebrovascular dysfunction, and blood-brain barrier disruption. Epidemiological studies indicate increased susceptibility among urban residents, particularly men, middle-aged individuals, and married persons, to the mental health impacts of air pollution. Additionally, socioeconomic factors, such as GDP per capita, access to health resources, green spaces, and sports facilities, modulate these health outcomes. Addressing this public health challenge necessitates stricter industrial emission controls, sustainable agricultural practices, promotion of cleaner energy sources, and incorporation of pollution exposure history into clinical assessments. Enhanced public awareness and interdisciplinary research are vital for mitigating the detrimental effects of air pollution on neurological and psychiatric health, ultimately striving for a cleaner and healthier environment for future generations.

Background

Nearly 58% of very low birth weight (VLBW) infants receive at least one red blood cell transfusion, which is not without risk. Reticulocyte fluorescence (RF) indicates the degree of cell maturation. The greater the fluorescence, the greater the immaturity of the reticulocytes.

Aim

To evaluate RF as a marker of reticulocyte maturity and to investigate its predictive value for transfusion requirement in VLBW infants.

Methods

Complete blood count was performed at 1, 7, 14, 21, and 28 d of age in 104 VLBW infants at the University Hospital of Parma. Iron supplementation was started at 15 d of life. The infants were divided into two groups: those who required transfusion after 28 d of life. (Tr) and those who did not (NTr).

Results

Twenty-seven of 104 newborns required a red blood cell transfusion after 28 d of life (Tr group). At 14 d of life, the percentage of high fluorescence reticulocyte (HFR) was significantly higher in the r group than in infants who did not receive any transfusion (NTr groups): 18.5 vs. 5%, p = 0.002. The ROC curve (AUC 74%) revealed an HFR cut-off value of 16.5% as a predictor of the need for red blood cell (RBC) transfusion.

Conclusions

Reticulocyte maturation at 14 d of life is clinically useful for estimating the qualitative impairment of erythropoiesis and predicts the risk of RBC transfusion in VLBW infants. The data suggest the need for tailored iron integration in VLBW infants to improve the quality of hematopoiesis and reduce the risk of blood transfusion.

Background/Aim

The balance between atherogenic and antiatherogenic lipid particles significantly influences coronary artery disease (CAD), as an imbalance may contribute to the development and progression of atherosclerosis, which affects the risk and severity of CAD. This study aims to introduce and validate the atherogenic combined index (ACI) as a novel lipid biomarker that, comprehensively assesses the balance between atherogenic and antiatherogenic particles in the blood to effectively reflect the cumulative atherogenic effect and its association with the presence and severity of CAD.

Material and Methods

In this cross-sectional study, 1,830 patients diagnosed with CAD and a total of 650 patients without CAD were included in the study cohort for comprehensive analysis and comparison. Based on the tertiles of the SYNTAX score (SS), three subgroups of patients with CAD were identified. ACI and other atherogenic indices were compared to predict the presence and severity of CAD.

Results

The levels of ACI and other non-traditional lipid markers levels were higher in the CAD group compared to the non-CAD group (p <0.05, for all). ACI showed a good linear association with the SYNTAX score (r = 0.527; p <0.001). The multivariate logistic regression model showed that ACI was an independent predictor of the presence (OR: 1.602, 95% CI: 1.509–1.701, p <0.001) and severity (OR: 1.296, 95% CI: 1.243–1.351, p <0.001) of CAD after adjustment for various confounders.

Conclusion

The results suggest that ACI may serve as a promising and stronger tool for predicting the presence and severity of CAD.

Background and aim

Several microRNAs (miRNAs) are differentially expressed and serve as tumor suppressors in glioblastoma (GBM). The present study aimed to elucidate the function of exosomal microRNA‐4731-5p (miR-4731-5p) from adipose tissue-derived mesenchymal stem cells (AD-MSCs) in the activity of human GBM cell lines.

Method

First, GBM-related miRNAs, their expression, and potential target genes and cytokines of miR-4731-5p were identified using bioinformatic datasets. Subsequently, purified AD-MSCs were transfected with a miRNA-4731‐5p expression plasmid, and exosomes were isolated and characterized. Next, the transfection process was confirmed and the 50% inhibitory concentration (IC50) of the overexpressed exosomal miRNA-4731‐5p was inhibited for cancer cells. The probable anticancer action of exosomal miRNA-4731‐5p on U‐87 and U‐251 GBM cell lines was verified by flow cytometry, DAPI staining, cell cycle, real-time PCR, and wound healing assays.

Results

A concentration of 50 ng/mL of miRNA-4731-5p-transfected exosomes was the safe dose for anticancer settings. The results showed that the exosomal miR-4731-5p exerted an inhibitory effect on the cell cycle and migration and induced apoptosis in GBM cell lines by regulating the phosphoinositide-3-kinase-AKT (PI3K-AKT) and nuclear factor-kB (NF-kB) signaling pathways.

Conclusion

This study reveals that the expression of exosomal miRNA-4731-5p has favorable antitumor properties for the treatment of GBM cell lines and may be a fundamental therapeutic option for this type of brain tumor.

Background

Nonalcoholic fatty liver disease (NAFLD) is a global health challenge, with a rising rate in line with other metabolic diseases. We aimed to assess the global prevalence of NAFLD in adult and pediatric populations.

Methods

PubMed, Scopus and Web of Science databases were systematically searched up to May 2023. Heterogeneity was assessed using Cochran's Q test and I² statistics, and random-effects model was used for meta-analysis. Analyses were performed using STATA version 18.

Results

A total of 479 studies with 78,001,755 participants from 38 countries were finally included. The global prevalence of NAFLD was estimated to be 30.2% (95% CI: 28.7–31.7%). Regionally, the prevalence of NAFLD was as follows: Asia 30.9% (95% CI: 29.2–32.6%), Australia 16.1% (95% CI: 9.0–24.8%), Europe 30.2% (95% CI: 25.6–35.0%), North America 29% (95% CI: 25.8–32.3%), and South America 34% (95% CI: 16.9–53.5%). Countries with a higher human development index (HDI) had significantly lower prevalence of NAFLD (coefficient = –0.523, p = 0.005). Globally, the prevalence of NAFLD in men and women was 36.6% (95% CI: 34.7–38.4%) and 25.5% (95% CI: 23.9–27.1%), respectively. The prevalence of NAFLD in adults, adults with obesity, children, and children with obesity was 30.2% (95% CI: 28.8–31.7%), 57.5% (95% CI: 43.6–70.9%), 14.3% (95% CI: 10.3–18.8%), and 38.0% (95% CI: 31.5–44.7%), respectively.

Conclusion

The prevalence of NAFLD is remarkably high, particularly in countries with lower HDI. This substantial prevalence in both adults and children underscores the need for disease management protocols to reduce the burden.

Aims

Growth differentiation factor 15 (GDF15) plays an important role in multiple inflammatory disorders. We aimed to analyze serum GDF15 levels in adult patients with idiopathic inflammatory myopathies (IIMs).

Methods

Serum GDF15 levels were measured in 179 adult patients with IIMs and 76 healthy controls (HCs). The association between GDF15 levels and disease variables was analyzed using Spearman's rank correlation. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the discriminatory ability of GDF15 and the GDF15-to-lymphocyte ratio (GLR). Machine learning methods were applied to build predictive models.

Results

GDF15 levels and GLR were significantly elevated in patients with adult IIMs than in HCs. Compared with patients in remission, both GDF15 and GLR were significantly higher in myositis patients in an active phase. GDF15 levels correlated positively with myositis disease activity indices and negatively correlated with lymphocyte and platelet counts. ROC curve analysis revealed that GDF15 levels and GLR outperformed muscle enzymes and distinguished well between patients with active disease and those in remission. Furthermore, even in the normal muscle enzyme group, GDF15 levels and GLR were also well-distinguished between patients with active disease and those in remission. Using machine learning, a logistic regression model of GDF15 combined with creatine kinase and lymphocyte count was constructed and had a reliable predictive value for disease activity.

Conclusions

GDF15, particularly GLR, was significantly correlated with disease activity in adult patients with IIMs. They could serve as useful biochemical markers for evaluating disease activity, monitoring disease progression, and guiding treatment in adult patients with IIMs.

Background

The study of dietary patterns in older adults (OA) and their association with geriatric syndromes (GS) is scarce in Latin America.

Objective

To describe the association of dietary patterns with GS in the Mexican older adult population, using data from the 2018-19 National Health and Nutrition Survey.

Methods

Dietary data were collected from 3,511 adults (≥60 years of age, both sexes) using a semi-quantitative food frequency questionnaire. Dietary patterns were derived by principal component analysis based on the consumption of 162 foods from 24 food groups. The GS studied were: frailty, depressive symptoms (DS), low appendicular skeletal muscle mass (ASMM); additionally, we studied inflammation (serum CRP>5 mg/L). Logistic regression models were used.

Results

Four major dietary patterns were identified: a) “Western”, b) “Prudent”, c) “Soups”, and d) “Traditional”. The middle and higher tertiles of the “Prudent” pattern were associated with lower odds of DS (OR 0.71, p = 0.04; and OR 0.61, p = 0.008), respectively. The second tertile of the “Soups” pattern was associated with lower odds of low ASMM (OR 0.68, p = 0031) and inflammation (OR 0.58, p = 0.022). The highest tertile of the “Traditional” pattern was associated with low ASMM (OR 1.55, p = 0.008) and lower odds of inflammation (OR 0.69, p = 0.044). No association was found between the “Western” dietary pattern and GS.

Conclusions

Three of four major dietary patterns were associated with GS in older Mexican adults. Further studies are needed to address strategies to improve diet quality in this age group and its association with health and functional outcomes.

Background

The optimal dose of rabbit anti-thymocyte globulin (r-ATG) in renal transplantation is still under debate. We previously reported that a low-dose r-ATG induction of 3 mg/kg can be used safely and effectively in low-risk kidney transplants with good results in the first year after transplantation compared to basiliximab induction.

Aims

The purpose of this study is to evaluate the long-term impact of this trial of low-dose r-ATG versus basiliximab on post-transplant outcomes (patient and graft survival, biopsy-proven acute rejection incidence [BPAR], infectious complications, and side effects).

Methods

Observational study (three-year follow-up) of a 12-month single-center, open-label RCT in de novo kidney allograft recipients assigned to receive either thymoglobulin or basiliximab before transplantation.

Results

Patients in the basiliximab group (BG) underwent more kidney transplant biopsies than patients in the low-dose r-ATG group (TG) (50 vs. 31.8%, p = 0.07). Although the 12-month cumulative incidence of BPAR was lower in BG, by the end of the three-year follow-up period this incidence was higher (22%) than in the low-dose TG (15%) (p = ns). Steroids were withdrawn more frequently in the TG group and sirolimus was most frequently indicated. Graft function and graft survival were higher in the low-dose TG than in the BG at three-year follow-up but not statistically significant. Patient survival was similar between groups (>90%).

Conclusions

These three-year follow-up data confirm the efficacy and favorable safety aspects of the low-dose r-ATG (3 mg/kg) in low-risk kidney transplantation.

Background

Elder abuse (EA), depressive symptoms, and loneliness represent a growing risk to the health, well-being, and premature mortality of older adults. However, the role of loneliness in the relationship between EA and depressive symptoms has not yet been examined.

Aims

To investigate the associations between these constructs and to explore the possible mediating role of loneliness in the relationship between EA and depressive symptoms in a representative sample of older Mexican people.

Methods

A representative community-dwelling survey of older adults aged 60 and older was conducted in two cities in Mexico (Mexico City and Xalapa) in 2018–2019. Measurements of EA, loneliness, depressive symptoms, health, and sociodemographic data were collected. Regression and mediation models were tested to analyze the associations between these variables.

Results

The prevalence of EA was 16.3%, loneliness was 50%, and depressive symptoms were 25.5%. The odds ratio (OR) for the occurrence of depressive symptoms was 2.7 when the combined effects of EA and loneliness were considered. The proportion of the effect that could explain the mediating role of loneliness was 31%.

Conclusion

To effectively reduce depressive symptoms in older individuals affected by emotional or psychological abuse and neglect, it is crucial to address both the mediating influence of loneliness and EA itself in therapeutic and preventive interventions.