Asian Biomedicine最新文献

Background: The prefrontal cortex (PFC) is vital for cognitive and emotional functions and is vulnerable to disruptions in preterm infants. Reliable volume estimation methods are needed to study its development.

Objective: To develop and validate a novel method for estimating the volume of PFC subfields in very preterm infants using magnetic resonance imaging (MRI) combined with stereological techniques. The method was designed to achieve a coefficient of error (CE) below 5%.

Methods: Five preterm infants born before 28 weeks of gestation were scanned using a 1.5-Tesla MRI scanner. The points of intersection between the grid and structure boundaries, in addition to the points in each slice, were counted using in-house software (Easy Measure).

Results: The shape coefficient for each subfield of the prefrontal cortex was calculated, which yielded coefficients of 4.5, 6.1, 6.4, and 6.5 for dorsolateral, dorsomedial, orbitolateral, and orbitomedial PFC regions, respectively. For the dorsolateral prefrontal cortex, a grid size of 4 × 4 pixels and a 0.2 cm slice gap for the dorsomedial prefrontal cortex (DMPFC), a grid size of 5 × 5 pixels and a 0.1 cm slice gap for the orbitolateral PFC, a grid size of 5 × 5 pixels and a 0.3 cm slice gap, and a grid size of 5 × 5 pixels and 0.1 cm slice gap for the DMPFC resulted in <5% CE.

Conclusion: This methodology offers new insights into the neurodevelopmental effects of preterm birth and has potential applications in the early detection of neurodevelopmental disorders. Its precision, reliability, and non-invasive nature make it suitable for longitudinal studies and contribute to neonatal neuroimaging and neurodevelopmental research.

Neurogenetics investigates the genetic basis of neurological disorders. It encompasses conditions ranging from neurodegenerative diseases with predominantly polygenic risk genes, such as Alzheimer's and Parkinson's, to monogenic diseases and repeated expansion disorders within movement and neuromuscular disorders, such as Friedreich ataxia and muscular dystrophies. Significant advances in recent years that have revolutionized our understanding of disease mechanisms and paved the way for personalized medicine approaches are due to the field of neurogenetics, with its intricate relationship both with clinical and genetic research. Therefore, all neurologists, even in resource-limited settings, are aware of the critical genetic basis; standard molecular diagnostic techniques such as next-generation sequencing, whole exome, and whole genome sequencing; and possible therapeutic modalities of their field. This review will also touch on elements of the neurogenetic clinic in tertiary care, ethical considerations, and insight into ongoing research that would help improve patient care and enhance clinical outcomes.

Background: The prevailing approach for the acute-phase treatment of autoimmune encephalitis (AIE) is currently the administration of intravenous immunoglobulin (IVIG) or plasma exchange (PLEX), in conjunction with high-dose corticosteroids. Despite this, there is still no definitive evidence on the risks and benefits of IVIG vs. PLEX in terms of treatment-related complications.

Objectives: The primary objective of this study was to determine the differences in the cumulative incidence of hospital-acquired infections (HAIs) in patients diagnosed with AIE, who received either IVIG or PLEX. The secondary objectives were to explore the differences in the duration of hospitalization and levels of disability.

Methods: Patients who were hospitalized at the King Chulalongkorn Memorial Hospital, Thailand, due to AIE, were aged ≥15 years, and had received either IVIG or PLEX during their hospitalization from January 2015 to December 2020 were included in the study. The modified Rankin scale (mRS) was utilized to evaluate the degree of disability at admission and discharge.

Results: Among the 44 patients included in the study, 10 (22.7%) received PLEX and 34 (77.3%) received IVIG. Those who received IVIG were significantly less likely to have HAIs (14.7% vs. 50.0%, P = 0.03) and had a significantly shorter duration of hospitalization (median [IQR] 12.0 [6.0 - 23.0] vs. 25.0 [21.0 - 49.0] d, P = 0.01) compared to those who received PLEX. Primary septicemia was the most commonly observed cause of infection in both groups. There were no significant differences in mRS at discharge, changes in mRS between admission and discharge, and the total direct cost of hospitalization between the two groups.

Conclusions: The utilization of IVIG is associated with a diminished occurrence of nosocomial infections, leading to shorter hospitalization and potential cost benefits. Our findings propose that IVIG may represent a more beneficial therapeutic alternative for AIE patients compared with PLEX.

Respiratory syncytial virus (RSV) is a major respiratory pathogen that particularly affects infants under 6 months, premature infants, and those with congenital heart disease (CHD) or chronic lung disease. In 2019, there was estimated 3.6 million hospital admissions among children under 5 years of age due to RSV-related lower respiratory tract infection (RSV-LRTI), with more than 26,000 deaths. For decades, monthly palivizumab injection has provided passive immunization for high-risk infants and has demonstrated efficacy in reducing RSV-related hospitalizations, while breastfeeding has been known to protect against severe RSV-LRTI. Recent advances aiming to reduce severe RSV-LRTI, that is, bronchiolitis and pneumonia, include maternal RSV immunization and long-acting monoclonal antibodies for infants. Bivalent non-adjuvanted RSV vaccine (Abrysvo®), RSVPreF, administered during pregnancy (gestational age 24-36 weeks) transfers protective RSV IgG antibodies across the placenta with high cord-to-maternal ratio at ~1.5. Studies have shown that maternal immunization significantly reduced medically attended severe RSV-associated LRTI in infants, with an efficacy of 81.8% at 90 days and 69.4% at 180 days after birth, respectively. For medically attended RSV-associated LRTI, the efficacy was 57.1% at 90 days and 51.3% at 180 days. Additionally, long-acting RSV monoclonal antibodies (Nirsevimab) provide season-long protection with a single dose for infants during the first RSV season, reducing both medically attended RSV-LRTI and hospitalizations by approximately 70%-80% in infants during their first RSV season. Consequently, in 2024, the Strategic Advisory Group of Experts (SAGE) recommended that countries introduce maternal RSVPreF vaccination and/or RSV monoclonal antibodies for infant RSV prevention. Many countries have already adopted these interventions, demonstrating cost-effectiveness of monoclonal antibodies.

Background: Anesthesia has been linked to neuroapoptosis and prolonged neurocognitive disorders in the neonatal rat brain, but the full extent of damage induced by anesthesia on the central nervous system is still unknown.

Objectives: We aim to investigate whether sevoflurane anesthesia affects the spinal cord.

Methods: After the approval of the ethics committee, 24 Wistar albino rat pups, weighing between 9 g and 11 g, on the postnatal 7th day were included in the study. In the sevoflurane groups, rats breathed 2.5% sevoflurane in oxygen. The tail flick tests were performed on postnatal 8th, 15th, and 30th days to evaluate motor functions. At the end of the experiments, rats were sacrificed by decapitation, and their spinal cords were taken for histopathological evaluation.

Results: There was a significant difference between the tail pulling times on the 8th and 30th days in both groups (P = 0.036). No significant difference was found between the control and sevoflurane groups (P = 0.053). In histopathological assessments, the chronic sevoflurane group showed a significant increase in apoptotic cell count (P < 0.001).

Conclusions: This study showed that although there was a significant increase in apoptotic cells in the chronic sevoflurane group, motor function of the spinal cord was not affected. Further studies can be conducted to investigate the possible mechanisms.

Background: Garlic extracts have been demonstrated to be effective supplements for reducing blood pressure in hypertensive subjects. However, contradictory observations on the efficacy of garlic extracts have been reported in different studies.

Objectives: To explore the efficacy of garlic, this study aimed to perform a meta-analysis of previously published controlled placebo trials and drew firm conclusions.

Methods: We searched online databases, including Scopus, PubMed, and Science Direct, to obtain relevant articles on the role of garlic in reducing blood pressure in patients with hypertension. The literature search, data extraction, and analysis were performed independently by two researchers. Comprehensive Meta-Analysis Software v4 was used for all the analyses.

Results: Twelve reports, comprising 405 patients treated with garlic derivatives and 333 receiving placebo, were included in this investigation. The results of the meta-analysis revealed a significant decrease in systolic blood pressure (mean difference: -8.121, 95% confidence interval [CI]: -10.95 to -5.28, P < 0.0001) and diastolic blood pressure (mean difference: -4.256, 95% CI: -5.99 to -2.52, P < 0.0001) in subjects treated with garlic extracts compared to those treated with placebo. Interestingly, trial sequential analysis also supports the observations of the meta-analysis and indicates that a sufficient number of trials have already been performed to reach a consensus conclusion, and further trials are not required. In addition, the GRADEing of evidence also supports the robustness of the observations.

Conclusions: Garlic extracts significantly lower blood pressure and may be prescribed by clinicians for patients with hypertension.

Background: Albinism is a rare genetic condition characterized by hypopigmentation of the skin, hair, and eyes, as well as visual impairments. Oculocutaneous albinism type 2 (OCA2) is commonly associated with variants in the OCA2 gene, which encodes a protein critical for melanosomal pH regulation and melanin biosynthesis. Exome sequencing, validated by Sanger sequencing, was employed to investigate the genetic basis of albinism in a consanguineous Iranian family. Bioinformatics analyses and structural modeling were conducted to assess the pathogenicity and impact of the detected variant.

Case presentation: A 27-year-old male from a consanguineous Iranian family presented with features of oculocutaneous albinism, including white hair, blue eyes, strabismus, sun-sensitive skin, reduced visual acuity, and significant photophobia, resulting in functional limitations in bright environments. Genetic analysis identified a novel homozygous missense variant in the OCA2 gene, NM_000275.3:c.1274T>G (p.Met425Arg), located in exon 13. The genomic coordinates of the variant are chr15:g.27985154A>C (GRCh38/hg38). In silico tools classified the variant as likely pathogenic based on its evolutionary conservation, absence in population databases, and structural modeling predictions. Segregation analysis confirmed autosomal recessive inheritance, with both parents being heterozygous carriers.

Conclusion: The identified OCA2 variant, c.1274T>G; p.Met425Arg, disrupts protein function, impairing melanosomal activity and melanin biosynthesis. This study underscores the importance of genetic analysis in characterizing OCA2 variants and highlights the need for further exploration of molecular mechanisms and phenotypic variability in OCA2-related albinism to improve diagnosis and counseling.