Pub Date : 2023-01-12DOI: 10.1101/2023.01.10.23284415
C. Balaguera, M. Osorio, M. Echavarría, M. Garzón
Global efforts regarding the COVID-19 pandemic have been focused on preventive activities, such as vaccination, since the disease is expected to become endemic. Adolescents were among the last population groups to be included in the vaccination program in Colombia, and adequate coverage has not yet been achieved in this group and in infants. It is important to understand their motivations to improve the willingness of this population to be vaccinated. A cross-sectional study was designed via an online survey in adolescents aged 14-19 years in Villavicencio Meta after validation of the survey and informed consent. The following options were provided for the question on vaccine disposition: willing, undecided, and unwilling. We described the disposition toward receiving COVID-19 vaccine using graphs and absolute and relative frequencies based on age group. A multinomial regression model was used to assess the relationship between our predictor variables and vaccine disposition in adolescents. In this study, 288 adolescents were surveyed. The risk variables for unwillingness to be vaccinated were being male (odds ratio [OR] 2.18, 95% confidence interval [CI] 0.8-5.7, p = 0.62), belonging to low social stratum (OR 2.29, 95% CI 0.9-5.88, p = 0.19), having a monthly family income of less than 1 million Colombian pesos (250 USD) (OR 2.01, 95% CI 0.8-5.16, p = 0.19), and having basic education (OR 2.59, 95% CI 0.33-20.14, p = 0.18). Unproven myths and beliefs exert a profound influence on adolescents, which results in an unwillingness to be vaccinated. Hence, innovative public health strategies should be designed to improve the disposition to be vaccinated in this population group.
COVID-19大流行的全球努力一直侧重于疫苗接种等预防活动，因为预计该疾病将成为地方性疾病。在哥伦比亚，青少年是最后一批被纳入疫苗接种规划的人口群体之一，但这一群体和婴儿的疫苗接种覆盖率尚未达到足够的水平。重要的是要了解他们的动机，以提高这一人群接种疫苗的意愿。通过在线调查设计了一项横断面研究，调查对象为Villavicencio Meta地区14-19岁的青少年，经调查验证并获得知情同意。关于疫苗处置的问题提供了以下选项:愿意、未决定和不愿意。我们使用图表以及基于年龄组的绝对频率和相对频率描述了接受COVID-19疫苗的倾向。使用多项回归模型来评估我们的预测变量与青少年疫苗倾向之间的关系。本研究对288名青少年进行了调查。不愿接种疫苗的风险变量为男性(比值比[OR] 2.18, 95%可信区间[CI] 0.8 ~ 5.7, p = 0.62)、社会底层(比值比2.29,95% CI 0.9 ~ 5.88, p = 0.19)、家庭月收入低于100万哥伦比亚比索(250美元)(比值比2.01,95% CI 0.8 ~ 5.16, p = 0.19)、接受过基础教育(比值比2.59,95% CI 0.33 ~ 20.14, p = 0.18)。未经证实的神话和信仰对青少年产生了深远的影响，导致他们不愿接种疫苗。因此，应设计创新的公共卫生战略，以改善这一人群接种疫苗的倾向。
{"title":"DISPOSITION OF ADOLESCENTS TOWARD RECEIVING COVID-19 VACCINATIONS IN VILLAVICENCIO: MYTHS AND BELIEFS","authors":"C. Balaguera, M. Osorio, M. Echavarría, M. Garzón","doi":"10.1101/2023.01.10.23284415","DOIUrl":"https://doi.org/10.1101/2023.01.10.23284415","url":null,"abstract":"Global efforts regarding the COVID-19 pandemic have been focused on preventive activities, such as vaccination, since the disease is expected to become endemic. Adolescents were among the last population groups to be included in the vaccination program in Colombia, and adequate coverage has not yet been achieved in this group and in infants. It is important to understand their motivations to improve the willingness of this population to be vaccinated. A cross-sectional study was designed via an online survey in adolescents aged 14-19 years in Villavicencio Meta after validation of the survey and informed consent. The following options were provided for the question on vaccine disposition: willing, undecided, and unwilling. We described the disposition toward receiving COVID-19 vaccine using graphs and absolute and relative frequencies based on age group. A multinomial regression model was used to assess the relationship between our predictor variables and vaccine disposition in adolescents. In this study, 288 adolescents were surveyed. The risk variables for unwillingness to be vaccinated were being male (odds ratio [OR] 2.18, 95% confidence interval [CI] 0.8-5.7, p = 0.62), belonging to low social stratum (OR 2.29, 95% CI 0.9-5.88, p = 0.19), having a monthly family income of less than 1 million Colombian pesos (250 USD) (OR 2.01, 95% CI 0.8-5.16, p = 0.19), and having basic education (OR 2.59, 95% CI 0.33-20.14, p = 0.18). Unproven myths and beliefs exert a profound influence on adolescents, which results in an unwillingness to be vaccinated. Hence, innovative public health strategies should be designed to improve the disposition to be vaccinated in this population group.","PeriodicalId":94137,"journal":{"name":"Medical research archives","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78289204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objetive: to analyze whether ultrasonography with fine-needle aspiration cytology of an axillary suspicious node, in patients with breast cancer, could help to differentiate between patients with low involvement of the axilla (up to 2 nodes with macrometastasis) of those with high involvement of the axilla (more than 2 lymph nodes with macrometastasis). Material and methods: A total of 115 consecutive patients with breast cancer (up to 5 cm in diameter), with clinically negative axilla and pathologically positive axilla. All patients underwent preoperative axillary ultrasound and ultrasound-guided fine-needle aspiration cytology was performed in patients with suspicious nodes. In all patients with positive cytology, lymphadenectomy was performed. In all patients with negative ultrasound and cytology, sentinel lymph node biopsy was performed, and when it was positive, lymphadenectomy was performed. The number of pathological lymph nodes was evaluated after lymphadenectomy. Results: A total of 61 patients had positive axillary ultrasound and cytology. In 42 of them (69%), there were more than 2 pathological lymph nodes. There were 54 patients with negative axillary ultrasound and cytology. In 49 of them (90%), there were only 1 or 2 pathological lymph nodes. Axillary ultrasound and fine-needle aspiration cytology were able to identify 42 of the 47 patients (89%) with more than 2 pathological lymph nodes. Conclusion: ultrasound and ultrasound-guided fine-needle aspiration citology was able to identify, in a preoperative stage, those patients with high axillary involvement (more than 2 lymph nodes with macrometastasis). The latter are the patients who would benefit from lymphadenectomy of the axilla, ignoring the sentinel lymph node biopsy stage.
{"title":"The Current Status of Ultrasonography and Fine-Needle Aspiration Citology for the Management of the Axilla in Breast Cancer","authors":"G. de León, Andrés Dell´Acqua, A. Cristiani","doi":"10.18103/mra.v11i5.3851","DOIUrl":"https://doi.org/10.18103/mra.v11i5.3851","url":null,"abstract":"Objetive: to analyze whether ultrasonography with fine-needle aspiration cytology of an axillary suspicious node, in patients with breast cancer, could help to differentiate between patients with low involvement of the axilla (up to 2 nodes with macrometastasis) of those with high involvement of the axilla (more than 2 lymph nodes with macrometastasis). Material and methods: A total of 115 consecutive patients with breast cancer (up to 5 cm in diameter), with clinically negative axilla and pathologically positive axilla. All patients underwent preoperative axillary ultrasound and ultrasound-guided fine-needle aspiration cytology was performed in patients with suspicious nodes. In all patients with positive cytology, lymphadenectomy was performed. In all patients with negative ultrasound and cytology, sentinel lymph node biopsy was performed, and when it was positive, lymphadenectomy was performed. The number of pathological lymph nodes was evaluated after lymphadenectomy. Results: A total of 61 patients had positive axillary ultrasound and cytology. In 42 of them (69%), there were more than 2 pathological lymph nodes. There were 54 patients with negative axillary ultrasound and cytology. In 49 of them (90%), there were only 1 or 2 pathological lymph nodes. Axillary ultrasound and fine-needle aspiration cytology were able to identify 42 of the 47 patients (89%) with more than 2 pathological lymph nodes. Conclusion: ultrasound and ultrasound-guided fine-needle aspiration citology was able to identify, in a preoperative stage, those patients with high axillary involvement (more than 2 lymph nodes with macrometastasis). The latter are the patients who would benefit from lymphadenectomy of the axilla, ignoring the sentinel lymph node biopsy stage.","PeriodicalId":94137,"journal":{"name":"Medical research archives","volume":"70 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73659774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
F. Vangroenweghe, Sarah Goethals, Delphine Zele, Anne Bruijn
β-Mannans are strongly anti-nutritive polysaccharide fibers found in most vegetable feed ingredients. The estimated content of soluble β-mannans in common swine diets range from 0.15 to 0.40%. In vitro studies have demonstrated that as little as 0.05% soluble β-mannan content in feed can elicit a strong innate immune response. Hemicell HT (Elanco Animal Health) is a β-mannanase enzyme for animal feed that breaks down β-mannans, thereby preventing economic losses from the wasteful immune response to β-mannans. The present study aimed to compare pig performance on a control diet and a reformulated diet with a lower energy content – 45 kcal/kg NE reduction – and the inclusion of a β-mannanase enzyme. A six-week feeding trial was conducted on a commercial post-weaning facility with DanBred x Belgian Piétrain pigs starting at 21 days of age. Standard three-phase control diets were compared to reformulated diets with an energy reduction of 45 kcal NE/kg and inclusion of a β-mannanase enzyme (Hemicell HT; Elanco) at 300 g/tonne. Standard production data were collected. The data were analyzed using JMP 15.0 statistical program. Overall, performance data did not differ significantly between trial groups in both Phase 1 and Phase 2, and overall, during the entire post-weaning period. Mortality was only numerically, but not significantly higher in the Control as compared to the Hemicell HT group. Hemicell HT had an overall benefit of € 1.69 per piglet and € 15.18 per tonne of feed due to the 45 kcal/kg NE reduction. The current trial demonstrated that the inclusion of Hemicell HT in reformulated diets with a lower energy content (45 kcal NE/kg) was able to retain production performance in post-weaned piglets with an economic benefit.
{"title":"Application of a β-mannanase enzyme in diets with a reduced net energy content in post-weaning piglets resulted in equal performance and an additional economic benefit","authors":"F. Vangroenweghe, Sarah Goethals, Delphine Zele, Anne Bruijn","doi":"10.18103/mra.v11i6.3954","DOIUrl":"https://doi.org/10.18103/mra.v11i6.3954","url":null,"abstract":"β-Mannans are strongly anti-nutritive polysaccharide fibers found in most vegetable feed ingredients. The estimated content of soluble β-mannans in common swine diets range from 0.15 to 0.40%. In vitro studies have demonstrated that as little as 0.05% soluble β-mannan content in feed can elicit a strong innate immune response. Hemicell HT (Elanco Animal Health) is a β-mannanase enzyme for animal feed that breaks down β-mannans, thereby preventing economic losses from the wasteful immune response to β-mannans. The present study aimed to compare pig performance on a control diet and a reformulated diet with a lower energy content – 45 kcal/kg NE reduction – and the inclusion of a β-mannanase enzyme. A six-week feeding trial was conducted on a commercial post-weaning facility with DanBred x Belgian Piétrain pigs starting at 21 days of age. Standard three-phase control diets were compared to reformulated diets with an energy reduction of 45 kcal NE/kg and inclusion of a β-mannanase enzyme (Hemicell HT; Elanco) at 300 g/tonne. Standard production data were collected. The data were analyzed using JMP 15.0 statistical program. Overall, performance data did not differ significantly between trial groups in both Phase 1 and Phase 2, and overall, during the entire post-weaning period. Mortality was only numerically, but not significantly higher in the Control as compared to the Hemicell HT group. Hemicell HT had an overall benefit of € 1.69 per piglet and € 15.18 per tonne of feed due to the 45 kcal/kg NE reduction. The current trial demonstrated that the inclusion of Hemicell HT in reformulated diets with a lower energy content (45 kcal NE/kg) was able to retain production performance in post-weaned piglets with an economic benefit.","PeriodicalId":94137,"journal":{"name":"Medical research archives","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74071905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Effective prevention and treatment of atherosclerosis and cardiovascular disease (CVD), the commonest cause of death in most countries, is still lacking. For many years we have studied the cholesterol hypothesis and found that there are many contradictions to this hypothesis. For instance, no trial has shown exposure response; the lipid values are not associated with degree of atherosclerosis, and people with high LDL-C live just as long or longer than people with low LDL-C. These facts together with the observation that inflammation is a common finding in atherosclerotic arteries have probably contributed to the hypothesis that CVD may be caused by inflammation. However, several trials with anti-inflammatory drugs have shown that such treatment increases the risk of CVD. Therefore, a relevant hypothesis is whether it is infections which cause the inflammation and whether CVD may be caused by infections because many human observations and animal experiments are in accordance with this idea. As cholesterol-lowering treatment is ineffective and may cause serious side effects, we believe that future research should elucidate the importance of infections in the etiology of CVD. A relevant method would be to perform a blood culture on all patients with an acute AMI and if it is positive, to treat the patient with an appropriate antibiotic.
{"title":"Infections May Cause Arterial Inflammation, Atherosclerosis, Myocarditis and Cardiovascular Disease","authors":"U. Ravnskov, A. Alabdulgader, K. Mccully","doi":"10.18103/mra.v11i5.3866","DOIUrl":"https://doi.org/10.18103/mra.v11i5.3866","url":null,"abstract":"Effective prevention and treatment of atherosclerosis and cardiovascular disease (CVD), the commonest cause of death in most countries, is still lacking. For many years we have studied the cholesterol hypothesis and found that there are many contradictions to this hypothesis. For instance, no trial has shown exposure response; the lipid values are not associated with degree of atherosclerosis, and people with high LDL-C live just as long or longer than people with low LDL-C. These facts together with the observation that inflammation is a common finding in atherosclerotic arteries have probably contributed to the hypothesis that CVD may be caused by inflammation. However, several trials with anti-inflammatory drugs have shown that such treatment increases the risk of CVD. Therefore, a relevant hypothesis is whether it is infections which cause the inflammation and whether CVD may be caused by infections because many human observations and animal experiments are in accordance with this idea. As cholesterol-lowering treatment is ineffective and may cause serious side effects, we believe that future research should elucidate the importance of infections in the etiology of CVD. A relevant method would be to perform a blood culture on all patients with an acute AMI and if it is positive, to treat the patient with an appropriate antibiotic.","PeriodicalId":94137,"journal":{"name":"Medical research archives","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74169690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.18103/mra.v11i7.2.4169
J. Guerrero, Joaquín Fernández de la, Concha Castañeda, A. Piñero, F. Javier, G. Md, N. Castellano, J. Ferrer, I. Lozano, Javier Moreno, A. Madrid
Background. Chronic heart failure is a very important public health problem, and brain natriuretic peptide monitoring may help in its management but faces important logistical problems. A readily available surrogate of brain natriuretic peptide would be of value in this field. We hypothesized that SonR measurements might be this brain natriuretic peptide surrogate. Methods. Patients with chronic heart failure, left ventricular ejection fraction ≤ 30% and implanted with a cardiac resynchronization therapy defibrillator able to provide SonR values underwent monthly assessment of brain natriuretic peptide levels for 1 year. The relationship between brain natriuretic peptide levels and paired SonR values was evaluated. Results. An inverse and highly significant relationship between brain natriuretic peptide levels and paired SonR values was obtained. Conclusions. We found an inverse and significant relationship between SonR values and brain natriuretic peptide levels. This finding might lead to the use of SonR values to monitor treatment and preclude hospital admissions in patients with chronic heart failure.
{"title":"Avcs-Sonr Pilot Study: N-Terminal Pro-Brain Natriuretic Peptide Inversely Correlates with Sonr Signal in Patients with Dilated Cardiomyopathy and Reduced Left Ventricular Ejection Fraction","authors":"J. Guerrero, Joaquín Fernández de la, Concha Castañeda, A. Piñero, F. Javier, G. Md, N. Castellano, J. Ferrer, I. Lozano, Javier Moreno, A. Madrid","doi":"10.18103/mra.v11i7.2.4169","DOIUrl":"https://doi.org/10.18103/mra.v11i7.2.4169","url":null,"abstract":"Background. Chronic heart failure is a very important public health problem, and brain natriuretic peptide monitoring may help in its management but faces important logistical problems. A readily available surrogate of brain natriuretic peptide would be of value in this field. We hypothesized that SonR measurements might be this brain natriuretic peptide surrogate. Methods. Patients with chronic heart failure, left ventricular ejection fraction ≤ 30% and implanted with a cardiac resynchronization therapy defibrillator able to provide SonR values underwent monthly assessment of brain natriuretic peptide levels for 1 year. The relationship between brain natriuretic peptide levels and paired SonR values was evaluated. Results. An inverse and highly significant relationship between brain natriuretic peptide levels and paired SonR values was obtained. Conclusions. We found an inverse and significant relationship between SonR values and brain natriuretic peptide levels. This finding might lead to the use of SonR values to monitor treatment and preclude hospital admissions in patients with chronic heart failure.","PeriodicalId":94137,"journal":{"name":"Medical research archives","volume":"71 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75665630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The genetic code encoding amino acid sequences in ribosomal translation consists of an alphabet of 61 triplet codons for 20 amino acids and three chain termination signals. Basically the same universal code is employed by all organisms from the Last Universal Common Ancestor (LUCA)-proximal Methanobacter kandleri (Mka) to humans. This universal code, which has remained invariant for all living species, enables the transplantation of protein-coding genes between different species without loss of function, and constrains the chemical diversity of the encoded amino acids. Over the initial decades following the discovery of the code, its invariance coupled with the lack of any information regarding its origin have led to the view that the code might represent an inexplicable ‘frozen accident’ in the history of life. However, with the formulation of the coevolution theory of the genetic code and its multifaceted supporting evidence, this view has become untenable. Instead, the encoded amino acids are known to comprise two different classes: ten Class 1 amino acids available on prebiotic Earth were incorporated into the protocells as they evolved into life forms, while the ten Class 2 amino acids were produced by early life through biosynthesis. Thus, the later entry of the Class 2 amino acids identified them as end products of cellular evolution, which suggests the plausibility of continuing alterations of the encoded amino acids after an eons-long pause. Accordingly, attempts were made by our group to replace Trp by 4-fluroTrp (4FTrp) from the proteome of Bacillus subtilis. The targeted replacement obtained proved the inherent mutability of the code, and this has stimulated the development of a wide range of mutated codes through a variety of approaches. Hundreds of genetic code mutants have now been successfully isolated from microbes to animals, transforming the code from an immutable construct to a highly malleable molecular device. The effects of such new codes on medicine and health range from treatments for a variety of diseases to the alleviation of food crisis arising from the degradation of the environment and devastation due to natural disasters.
{"title":"Potential Impact of Genetic-Code Mutations on Medicine and Health","authors":"T. Wong, Hong Xue","doi":"10.18103/mra.v11i8.4331","DOIUrl":"https://doi.org/10.18103/mra.v11i8.4331","url":null,"abstract":"The genetic code encoding amino acid sequences in ribosomal translation consists of an alphabet of 61 triplet codons for 20 amino acids and three chain termination signals. Basically the same universal code is employed by all organisms from the Last Universal Common Ancestor (LUCA)-proximal Methanobacter kandleri (Mka) to humans. This universal code, which has remained invariant for all living species, enables the transplantation of protein-coding genes between different species without loss of function, and constrains the chemical diversity of the encoded amino acids. Over the initial decades following the discovery of the code, its invariance coupled with the lack of any information regarding its origin have led to the view that the code might represent an inexplicable ‘frozen accident’ in the history of life. However, with the formulation of the coevolution theory of the genetic code and its multifaceted supporting evidence, this view has become untenable. Instead, the encoded amino acids are known to comprise two different classes: ten Class 1 amino acids available on prebiotic Earth were incorporated into the protocells as they evolved into life forms, while the ten Class 2 amino acids were produced by early life through biosynthesis. Thus, the later entry of the Class 2 amino acids identified them as end products of cellular evolution, which suggests the plausibility of continuing alterations of the encoded amino acids after an eons-long pause. Accordingly, attempts were made by our group to replace Trp by 4-fluroTrp (4FTrp) from the proteome of Bacillus subtilis. The targeted replacement obtained proved the inherent mutability of the code, and this has stimulated the development of a wide range of mutated codes through a variety of approaches. Hundreds of genetic code mutants have now been successfully isolated from microbes to animals, transforming the code from an immutable construct to a highly malleable molecular device. The effects of such new codes on medicine and health range from treatments for a variety of diseases to the alleviation of food crisis arising from the degradation of the environment and devastation due to natural disasters.","PeriodicalId":94137,"journal":{"name":"Medical research archives","volume":"61 2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73262792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.18103/mra.v11i7.1.4107
K. Zeng, B. Chou, A. Sadun
Background: Patients with Leber hereditary optic neuropathy, a genetic cause of severe optic atrophy and blindness, demonstrate characteristic structural changes measurable through optical coherence tomography, including initial swelling of the retinal nerve fiber layer and progressive thinning of the ganglion cell layer. After symptomatic conversion, patients experience progressive vision loss, often with dense central scotomas. Aims: This study aims to explore the predictive potential of ocular structural measurements to visual function in patients with Leber hereditary optic neuropathy. Methods: Medical records were reviewed retrospectively for patients with Leber hereditary optic neuropathy clinical testing. Structural measurements, including the average thickness of the ganglion cell layer, the retinal nerve fiber layer, and minimum thickness of the ganglion cell layer, measured through optical coherence tomography were obtained along with measures of visual function such as visual acuity and mean deviation of visual field testing. Simple and multivariable linear regressions were performed to determine correlations between structural measurements and visual functions. Analyses were conducted for all patients, and subgroup of symptomatic patients. Results: Overall, 92 eyes were included with 78 symptomatic eyes. Across all patients, the minimum ganglion cell layer thickness had the highest correlation coefficient with visual acuity (Beta -0.632, adjusted R2 0.396) and with visual field function (Beta 0.572, adj. R2 0.320) compared to the average thickness of the ganglion cell layer (Beta 0.474, adj. R2 0.216) and retinal nerve fiber layer (Beta 0.481, adj. R2 0.223). In multivariate analysis, the minimum ganglion cell layer thickness was the only significant measurement that correlated with visual acuity across all eyes (Beta -0.527, P<0.001) and symptomatic eyes (Beta -0.479, P<0.001). The minimum ganglion cell layer thickness (Beta 0.440, P<0.001) and retinal nerve fiber layer average thickness (0.258, P=0.023) were significant structural measurements correlating to visual field function. Conclusion: The minimum ganglion cell layer thickness is the best structural measure predictor for visual field and visual acuity compared to other common structural measurements in patients with Leber hereditary optic neuropathy. It is a good predictor even when evaluating only symptomatic eyes. Additional attention toward the minimum ganglion cell layer thickness may offer further insight into a patient’s visual potential and the natural history of this disease.
{"title":"Minimum Ganglion Cell Layer Thickness is the Best Structural Predictor of Visual Function in Leber Hereditary Optic Neuropathy","authors":"K. Zeng, B. Chou, A. Sadun","doi":"10.18103/mra.v11i7.1.4107","DOIUrl":"https://doi.org/10.18103/mra.v11i7.1.4107","url":null,"abstract":"Background: Patients with Leber hereditary optic neuropathy, a genetic cause of severe optic atrophy and blindness, demonstrate characteristic structural changes measurable through optical coherence tomography, including initial swelling of the retinal nerve fiber layer and progressive thinning of the ganglion cell layer. After symptomatic conversion, patients experience progressive vision loss, often with dense central scotomas. Aims: This study aims to explore the predictive potential of ocular structural measurements to visual function in patients with Leber hereditary optic neuropathy. Methods: Medical records were reviewed retrospectively for patients with Leber hereditary optic neuropathy clinical testing. Structural measurements, including the average thickness of the ganglion cell layer, the retinal nerve fiber layer, and minimum thickness of the ganglion cell layer, measured through optical coherence tomography were obtained along with measures of visual function such as visual acuity and mean deviation of visual field testing. Simple and multivariable linear regressions were performed to determine correlations between structural measurements and visual functions. Analyses were conducted for all patients, and subgroup of symptomatic patients. Results: Overall, 92 eyes were included with 78 symptomatic eyes. Across all patients, the minimum ganglion cell layer thickness had the highest correlation coefficient with visual acuity (Beta -0.632, adjusted R2 0.396) and with visual field function (Beta 0.572, adj. R2 0.320) compared to the average thickness of the ganglion cell layer (Beta 0.474, adj. R2 0.216) and retinal nerve fiber layer (Beta 0.481, adj. R2 0.223). In multivariate analysis, the minimum ganglion cell layer thickness was the only significant measurement that correlated with visual acuity across all eyes (Beta -0.527, P<0.001) and symptomatic eyes (Beta -0.479, P<0.001). The minimum ganglion cell layer thickness (Beta 0.440, P<0.001) and retinal nerve fiber layer average thickness (0.258, P=0.023) were significant structural measurements correlating to visual field function. Conclusion: The minimum ganglion cell layer thickness is the best structural measure predictor for visual field and visual acuity compared to other common structural measurements in patients with Leber hereditary optic neuropathy. It is a good predictor even when evaluating only symptomatic eyes. Additional attention toward the minimum ganglion cell layer thickness may offer further insight into a patient’s visual potential and the natural history of this disease.","PeriodicalId":94137,"journal":{"name":"Medical research archives","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75387083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Direct oral anticoagulants are recommended as first line therapy for patients with atrial fibrillation and venous thromboembolic disease. Measurement of drug levels or pharmacodynamic effect is not recommended during treatment. Dose adjustments are based on age, weight, kidney function and drug-drug interactions. These adjustments are generally based on an estimate of their effect on drug concentration. DOAC dosing recommendations differ across the world. These differences in prescribing recommendations result in different levels of DOAC exposure in patients with identical clinical characteristics. Additionally, data from clinical trials has shown that drug levels may vary significantly in individual patients with identical clinical characteristics despite taking the same prescribed dose. More concerning is that current prescribing recommendations provide cut points for dose adjustments, as an example age 80 or greater in the case of apixaban in atrial fibrillation, which may result in dramatically higher drug concentrations in patients with significantly higher bleeding risk. Data from outcome trials in both atrial fibrillation and venous thromboembolism have provided mean-median drug concentrations for each of the DOACs. These trial results appear to demonstrate that once a threshold DOAC plasma concentration is reached, higher concentrations fail to provide significant added ischemic stroke reduction while at the same time add an increased risk of bleeding. Bleeding remains a significant problem with DOACs and is associated with an increase in short and long-term mortality, ischemic stroke, myocardial infarction, cost, and drug interruption and discontinuation. Over the past years, our clinic has been assessing DOAC concentration in patients at risk for under or over exposure. Based on our experience, clinical characteristics alone appear to be insufficient, as a significant number of patients with characteristics suggesting high exposure would be under-dosed using a purely clinical approach and an even greater number, who are at elevated risk of bleeding would have had excessive levels, if prescribing were based strictly on the established dose reduction criteria. We propose, and provide our supporting clinical experience, that measuring DOAC levels in select patients will increase the margin of safety of these medications without compromising efficacy.
{"title":"Is there a Role for Measuring Direct Oral Anticoagulant Levels in Select Patients?","authors":"L. Baruch, K. Bhatia, P. Lopez, O. Sherman","doi":"10.18103/mra.v11i1.3527","DOIUrl":"https://doi.org/10.18103/mra.v11i1.3527","url":null,"abstract":"Direct oral anticoagulants are recommended as first line therapy for patients with atrial fibrillation and venous thromboembolic disease. Measurement of drug levels or pharmacodynamic effect is not recommended during treatment. Dose adjustments are based on age, weight, kidney function and drug-drug interactions. These adjustments are generally based on an estimate of their effect on drug concentration. DOAC dosing recommendations differ across the world. These differences in prescribing recommendations result in different levels of DOAC exposure in patients with identical clinical characteristics. Additionally, data from clinical trials has shown that drug levels may vary significantly in individual patients with identical clinical characteristics despite taking the same prescribed dose. More concerning is that current prescribing recommendations provide cut points for dose adjustments, as an example age 80 or greater in the case of apixaban in atrial fibrillation, which may result in dramatically higher drug concentrations in patients with significantly higher bleeding risk. Data from outcome trials in both atrial fibrillation and venous thromboembolism have provided mean-median drug concentrations for each of the DOACs. These trial results appear to demonstrate that once a threshold DOAC plasma concentration is reached, higher concentrations fail to provide significant added ischemic stroke reduction while at the same time add an increased risk of bleeding. Bleeding remains a significant problem with DOACs and is associated with an increase in short and long-term mortality, ischemic stroke, myocardial infarction, cost, and drug interruption and discontinuation. Over the past years, our clinic has been assessing DOAC concentration in patients at risk for under or over exposure. Based on our experience, clinical characteristics alone appear to be insufficient, as a significant number of patients with characteristics suggesting high exposure would be under-dosed using a purely clinical approach and an even greater number, who are at elevated risk of bleeding would have had excessive levels, if prescribing were based strictly on the established dose reduction criteria. We propose, and provide our supporting clinical experience, that measuring DOAC levels in select patients will increase the margin of safety of these medications without compromising efficacy.","PeriodicalId":94137,"journal":{"name":"Medical research archives","volume":"66 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75531583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Digitalization of the education system in Indonesia became an important topic in the country’s ministry of Education, Culture, Research, and Technology during the period of COVID as all the schools in the country were closed indefinitely. Online classrooms were adopted nationally to ensure that learning persisted despite the shutdown, with teachers and students communicating digitally on instruction, assessment, reporting, and conversations. After the pandemic, the country has not dropped the technology but rather, has taken several steps towards completely digitizing the education system. A literature review was conducted in this paper to understand how COVID pandemic has been instrumental in bringing digital transformations in Indonesia’s education system. It was found that the country has carried forward, as well as introducing further actions in the efforts to digitize the country’s education system. Intriguingly, Indonesia highlights some of the ways that covid-19 has revitalized the tradition of gotong royong (mutual cooperation) within the current setting, in addition to the influence of digitalization on life. Gotong royong is a technique that is frequently employed to raise public awareness of the harm that results from breaking through social barriers, even in the name of getting back together with families to observe a religious holiday. The idea has given rise to a new view of collectivism that does not require physical proximity for us to keep each other safe in this situation.
{"title":"Influence of COVID in Digitizing and Collective Endeavor in Indonesia","authors":"P. Rimbawati","doi":"10.18103/mra.v11i6.3861","DOIUrl":"https://doi.org/10.18103/mra.v11i6.3861","url":null,"abstract":"Digitalization of the education system in Indonesia became an important topic in the country’s ministry of Education, Culture, Research, and Technology during the period of COVID as all the schools in the country were closed indefinitely. Online classrooms were adopted nationally to ensure that learning persisted despite the shutdown, with teachers and students communicating digitally on instruction, assessment, reporting, and conversations. After the pandemic, the country has not dropped the technology but rather, has taken several steps towards completely digitizing the education system. A literature review was conducted in this paper to understand how COVID pandemic has been instrumental in bringing digital transformations in Indonesia’s education system. It was found that the country has carried forward, as well as introducing further actions in the efforts to digitize the country’s education system. Intriguingly, Indonesia highlights some of the ways that covid-19 has revitalized the tradition of gotong royong (mutual cooperation) within the current setting, in addition to the influence of digitalization on life. Gotong royong is a technique that is frequently employed to raise public awareness of the harm that results from breaking through social barriers, even in the name of getting back together with families to observe a religious holiday. The idea has given rise to a new view of collectivism that does not require physical proximity for us to keep each other safe in this situation.","PeriodicalId":94137,"journal":{"name":"Medical research archives","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74553662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.18103/mra.v11i7.2.4091
A. Valle, Aloíso Carvalho, Samir Rahme, A. Araújo, P. Malard, H. Brunel
Homeopathy has become increasingly known and used in various treatments, showing excellent clinical results. One of its most common indications is to help treat chronic diseases, directly improving patients' quality of life, especially those with cancer. Hepatocellular carcinoma is a disease that depends on different factors for its development and the success of its treatment. In this context, searching for new therapeutic tools is essential, and homeopathy seems promising. Therefore, Anonna muricata (soursop/graviola) and Handroanthus impetiginosus (purple ipe) have been studied due to their action potential against tumor cells. This study aimed to evaluate the effect of these medicines combined in 1.1mL ampoules, in homeopathic dilutions, on HepG2 (hepatocellular carcinoma) cells through in vitro tests. Cells were cultivated in 75 cm² culture bottles in an oven with controlled temperature and CO2 quantity (37 ºC, 5% CO2). Then, cells were plated in 96-well plates where treatment was performed using the products at different concentrations. After 48 hours of treatment, cell viability analyses were performed by MTT and quantification of the nitric oxide released using the Griess reaction. Treatment with the Anonna muricata D5 (1x10-5) + Handroanthus impetiginosus D5 (1x10-5) formulation resulted in decreased cell viability and increased nitric oxide production by these cells. These findings indicate that this medicine showed an antitumor effect and can be an ally in treating this type of pathology.
{"title":"Evaluation of cell viability and nitric oxide release after treatment of human hepatocellular carcinoma cells with a homeopathic compound of Graviola (Anonna muricata) and Purple Ipe (Handroanthus impetiginosus)","authors":"A. Valle, Aloíso Carvalho, Samir Rahme, A. Araújo, P. Malard, H. Brunel","doi":"10.18103/mra.v11i7.2.4091","DOIUrl":"https://doi.org/10.18103/mra.v11i7.2.4091","url":null,"abstract":"Homeopathy has become increasingly known and used in various treatments, showing excellent clinical results. One of its most common indications is to help treat chronic diseases, directly improving patients' quality of life, especially those with cancer. Hepatocellular carcinoma is a disease that depends on different factors for its development and the success of its treatment. In this context, searching for new therapeutic tools is essential, and homeopathy seems promising. Therefore, Anonna muricata (soursop/graviola) and Handroanthus impetiginosus (purple ipe) have been studied due to their action potential against tumor cells. This study aimed to evaluate the effect of these medicines combined in 1.1mL ampoules, in homeopathic dilutions, on HepG2 (hepatocellular carcinoma) cells through in vitro tests. Cells were cultivated in 75 cm² culture bottles in an oven with controlled temperature and CO2 quantity (37 ºC, 5% CO2). Then, cells were plated in 96-well plates where treatment was performed using the products at different concentrations. After 48 hours of treatment, cell viability analyses were performed by MTT and quantification of the nitric oxide released using the Griess reaction. Treatment with the Anonna muricata D5 (1x10-5) + Handroanthus impetiginosus D5 (1x10-5) formulation resulted in decreased cell viability and increased nitric oxide production by these cells. These findings indicate that this medicine showed an antitumor effect and can be an ally in treating this type of pathology.","PeriodicalId":94137,"journal":{"name":"Medical research archives","volume":"26 7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74593678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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