Current health sciences journal最新文献

The most frequent primary brain malignancy is glioma. Alterations in several adhesion G-protein-coupled receptors (aGPCRs) are present in cancer as they regulate adhesion, migration, and guidance. Epidermal growth factor (EGF) module-containing mucin-like receptor 2 (EMR2) is included in group II GPCRs and functionally in a family of brain angiogenesis inhibitor molecules (BAIs). Recent studies have shown that BAIs regulate phagocytosis and synaptogenesis, and their extracellular domain inhibits angiogenesis and tumor growth. In neoplastic processes, EMR2 appears to play a role in disease aggressiveness, patient survival rates, and tumor grade. This review summarizes the EMR2 involvement in cellular mechanisms and pathologies, particularly in cancer. We searched the Pubmed Central, Google Scholar and Scopus databases for terms "EMR2" and "glioma". The initial search yielded a total of 92 results. After excluding studies not written in English, based on design, and excluding duplicates and non-relevant studies, we included 38 studies in the review. EMR2 was shown to be expressed in various histologic grades of gliomas and to be linked to the PI3K pathway, as both are upregulated in glioblastoma after bevacizumab therapy. The PI3K-Akt pathway is involved in tumorigenesis, and upregulation of EMR2 may in turn upregulate PI3K, leading to increased tumor invasiveness. Indeed, overexpression of EMR2 was associated with the mesenchymal glioblastoma subtype, tumor invasiveness, and poor survival. EMR2 also regulates neutrophil function by producing reactive oxygen species (ROS) and degranulation. Possible therapeutic approaches have been studied, such as the stimulation of microglia and monocytes to inhibit tumor-initiating cells by down-regulating the EMR2 gene or through an antibody against EMR2. The current review summarizes the knowledge about the EMR2 receptor that can serve as motivation for future studies on its role in the clinical evolution and tumor biology of gliomas in order to find new modulator therapeutic approaches.

Introduction: Microglia, one of the most important cells of the central nervous system, undergo specific changes depending on the pathology. It has been reported that both depressive disorders and liver diseases generate hippocampal changes and neuroinflammation. However, the combined effects of the two pathologies on microglia morphology in the hippocampus have not been sufficiently explored.

Material and methods: In this study, we analyzed the morphological changes of the hippocampal microglia using confocal microscopy and a semi-manual method of quantification. We focused on total branch length, the branch number and the mean branch length. C57BL/6N mice were used and subjected to a methionine and choline deficient diet (MCD) to induce liver damage, and a chronic unpredictable mild stress (CUMS) procedure for depressive-like behavior.

Results: We were able to show that CUMS protocol and MCD diet led to a reduction in total branch length, branch number and mean branch length. Also, CUMS alone was associated with a decrease in the number of secondary and terminal branches.

Conclusion: Our study showed that depressive-like behavior and liver damage influence microglial morphology in the hippocampus, and it may be considered in future research of these intricate pathologies.

Purpose: The fear of vascular access procedures reduces patient cooperation, often resulting in unsuccessful venipuncture attempts and prolonging the overall treatment process. Because people getting venipunctures in medical and surgical settings usually feel pain and anxiety, the goal of this study was to look at and compare how cryotherapy (CT) and music therapy (MT) affected the levels of pain and anxiety (P&Amp;A) these people felt.

Method: This research utilized a randomized controlled trial methodology. The target population consisted of patients hospitalized in the medical-surgical wards of Valiasr Hospital, Arak, Iran. One hundred twenty patients were purposively selected and then randomly assigned (using block randomization) to one of four groups: MT, CT, combination therapy (COBT), or control. P&Amp;A levels were assessed using the Visual Analogue Scale (VAS) and the Visual Anxiety Intensity Scale (VAIS). Data were analyzed utilizing version 21 of the Statistical Package for the Social Sciences (SPSS) software. Descriptive statistics, including mean, standard deviation, frequency, and percentage, along with inferential statistics, such as the analysis of variance test, paired t-test, and Chi-square, were employed for analysis.

Findings: The findings revealed a statistically significant disparity in pain levels among the four groups (P<0.001). The mean pain score in the COBT group (1.66±1.66) was lower than that of the MT group (2.03±1.84) and the CT group (2.43±2.16). However, the three intervention groups (MT, CT, and COBT) showed no notable difference from a statistical perspective (P>0.05). Additionally, a statistically substantial distinction in anxiety levels was observed among the four groups after the study (P<0.05). Both the COBT and MT therapies markedly diminished anxiety severity in comparison to the control group.

Conclusion: The study results demonstrated that MT, CT, and COBT are effective in alleviating P&Amp;A in patients having venipuncture procedures. These interventions may serve as valuable complementary or alternative approaches in clinical practice.

Background: This study was conducted to determine the clinical concordance of non-invasive blood pressure (NIBP) measurements from the upper arm and ankle and to determine whether there is a difference between them.

Methods: A prospective and cross-sectional research design was used in this study. The study population included 106 patients hospitalized in the surgical clinics of a training and research hospital. Non-invasive blood pressure measurements were performed from both upper arms and ankles in the supine position. In the data analysis, ANOVA and the Bland-Altman plot were employed.

Results: Based on the results of NIBP measurements from the arm and ankle, the differences between diastolic blood pressure (DBP) and mean blood pressure (MBP) were acceptable and within the limits of concordance. The difference between the mean systolic blood pressure (SBP) was found to be significantly different and outside the limits of concordance. The difference between the mean SBP measured from the ankle and the upper arm was determined to be 18 mmHg.

Conclusion: It was determined that the results of SBP measured from the ankle were significantly higher and outside the limits of concordance compared to the upper arm, while the results of DBP and MBP measurements were within acceptable limits.

Introduction: The present case describes one of the few reported occurrences of coinfection by EBV and SARS-CoV-2, initially treated as streptococcal pharyngitis.

Case description: An 18-year-old female was admitted with whitish plaques in the throat associated with pain, cough, hoarseness, asthenia, tonsillar exudate, hypertrophy, hyperemia, and adenomegaly on the cervical region. Based on suspicion of bacterial tonsillitis, the patient was already taking amoxicillin with clavulanate. A rapid test was negative for group A streptococci. Laboratory exams revealed elevated counts of Anti-VCA IgM and Anti-VCA IgG for EBV. The cytomegalovirus (IgM and IgG) result was negative, and the blood count was within normal limits. However, a COVID-19 infection was confirmed by qPCR. The management was supportive treatment for symptom relief and isolation for 14 days. The patient remained afebrile and clinically stable during this period, with saturation ranging from 98% to 100%. However, the patient evolved with anosmia and ageusia. Then, olfaction training therapy was initiated, as well as continuing asthenia. Five days later, she presented petechiae on the chest and upper limbs, associated with mild pruritus.

Conclusion: Epstein-Barr mononucleosis and COVID-19 are similar in some aspects, and their viruses may be associated with a coinfection, which could make the diagnoses difficult and aggravate the clinical condition. In addition, it is essential to emphasize the importance of laboratory tests to avoid erroneous treatments that may worsen the patient's condition and change his prognosis.

Objectives: The study has as main objective the evaluation of the potential roles of vitamin D, the neutrophil to lymphocyte ratio (NLR), and the systemic inflammation index (SII) as future biomarkers regarding the classification of flares in systemic lupus erythematosus (SLE).

Material and methods: Individuals diagnosed with SLE were encompassed in this observational study. The current applicable criteria, namely The European Alliance of Associations for Rheumatology (EULAR)/American College of Rheumatology (ACR) 2019 criteria had to be fulfilled. The participants underwent specific musculoskeletal examination, paraclinical investigations including complete blood count (CBC), determination of serum creatinine levels, as well as liver enzymes, and also the markers of inflammation. The fractions of the serum complement (C3 and C4) were also evaluated, together with serum vitamin D concentrations. Safety of Estrogens in Lupus National Assessment-Systemic Lupus Erythematosus Disease Activity Index (SELENA-SLEDAI) was required in order to analyze the research group's disease activity.

Results: NLR and SII demonstrated validity, having statistically significant correlations with SELENA-SLEDAI (p value less than 0.001). The ROC analysis proved a strong discriminative power for NLR (AUC=0.96) and SII (AUC=0.963) in predicting severe disease flares. Optimal cut-off values were 3.45 for NLR and 877,002.19 for SII. Serum vitamin D concentrations had a weak association with the SLEDAI score (p=0.048, r=0.213).

Conclusions: NLR and SII can be considered reliable biomarkers for discriminating between the levels of disease activity in SLE individuals. Low serum levels of vitamin D may also influence disease severity, but require further validation.

Objectives: to assess the impact of pulmonary hypertension (PH) on short and long-term respiratory and neurodevelopmental outcomes in extremely preterm infants, diagnosed with moderate to severe bronchopulmonary dysplasia (MSBPD).

Study design: cohort study, with retrospective analysis of the medical records of infants born at ≤32 weeks gestation admitted to a single neonatal tertiary centre from 2010 to 2020. Primary outcome was consistent with hospital re-admissions by 2 years post menstrual age. Neurodevelopment was assessed using Bayley's Scales of Infant and Toddler Development 3rd edition (Bayley-III) as a secondary outcome.

Results: 201 infants with no PH and 23 infants with PH were analysed. The PH group showed higher risk for respiratory and paediatric intensive care unit re-admission (65%) during the first 2 years of life (OR: 3.15; 95% CI: 1.28 to 7.78; p<0.5). In contrast to current published literature, our study showed that pulmonary hypertension complicating moderate to severe bronchopulmonary dysplasia had no negative impact on neurodevelopmental outcomes (OR: 1.87; 95% CI: 0.72 to 4.88; p value=0.19). However, in our population, ethnicity, chorioamnionitis and need for persistent ductus arteriosus treatment were all independently associated with poor neurodevelopmental outcomes (p values <0.5).

Conclusion: infants with MSBPD associated pulmonary hypertension (MSBPD-PH) are more likely to need intensive care and respiratory hospital re-admissions. Ethnicity, chorioamnionitis and need for ductus arteriosus treatment are independently associated with poor neurodevelopmental outcomes regardless of the pulmonary hypertension status.

Objectives: To quantify levels of two inflammation-related indexes, namely neutrophil-lymphocyte ratio (NLR) and systemic immune-inflammation index (SII) in systemic scleroderma patients and determine the association with clinical manifestations and features of heart ultrasound.

Methods: The study group consisted of 34 patients with diagnosis of systemic scleroderma which were admitted to the hospital during 2015-2019. Patient data included the presence and type of clinical manifestations of systemic scleroderma, chest imaging to screen for lung disease, heart ultrasound reports and the laboratory investigations needed to quantify inflammatory indexes. We analysed the levels of inflammatory indexes and compared results based on the prevalence of systemic manifestations.

Results: Higher serum levels of NLR and SII are associated with the presence of joint, lung and pericardial involvement. Statistical significance was observed only for NLR levels with regard to the presence of articular involvement and ILD. Low ejection fraction was also associated with higher levels of both inflammatory indexes, without statistical significance.

Conclusion: Inflammatory indexes are cost-effective markers that reflect active disease manifestations of systemic scleroderma and can thus be a useful tool to include in the regular follow-up of patients in order to better inform organ-specific assessments.

Hypopituitarism is a clinical syndrome that occurs when the anterior pituitary gland fails to secrete one or more hormones. Developmental delay is frequently seen in these patients. However, skeletal deformities and postural instability are unexceptional. We present a 17-year-old male patient with panhypopituitarism (PHP) with back and leg pain, postural malalignment, and skeletal deformities referred by the pediatric endocrinology clinic. According to the physical examination, laboratory tests, and radiographic assessments, the patient was considered as sequela spondyloarthropathy (SpA). Autoimmune and rheumatic diseases are frequently encountered in patients with hypogonadism. However, the association of PHP and ankylosing spondylitis (AS) has not yet been demonstrated. This case was presented to draw attention to the alignment of PHP and SpA and also to emphasize that skeletal deformities were not encountered in the absence of anterior hypophysis hormones.

Thyroid angiosarcoma is an extraordinarily sparse malignancy, often populating alpine regions. Clinically, thyroid angiosarcomas tend to be nonspecific in presentation, starkly dependent on site, size, extension, and metastases. Tumors are locally aggressive and can present with sudden onset pain due to intra-nodular hemorrhage and compressive symptoms from sudden expansion. Due to the disease being a scarcely reported entity, there is little scholarship regarding its management. We report an interesting case of a 63-year-old man presenting with a swelling in the neck, incidentally found to be a thyroid angiosarcoma with a first-time reported associated spinal metastasis. The patient has a uniquely presenting thyroid angiosarcoma and is the first patient to present as such within a non-alpine South Asian region.