bluuebunny/crossref_metadata_2025 huggingface dataset:
ЕФЕКТИВНІСТЬ ЗАСТОСУВАННЯ ПРОБІОТИКА «ЛАКТІАЛЄ ЖЕРМІНА ФОРТЕ» У КОМПЛЕКСНОМУ ЛІКУВАННІ ХВОРИХ НА COVID-19
Authors: Юрко К. В. , Соломенник Г. О. , Кучерявченко В. В.
Published: October 2023

Мета роботи – проаналізувати частоту виникнення та спектр розладів з боку травного каналу (ТК) у пацієнтів із COVID-19 та оцінити ефективність застосування пробіотика, що містить спори B. clausii UBBC-07.

Матеріали і методи. Обстежено 85 хворих на COVID-19, з яких 59 (69,4 %) осіб мали шлунково-кишкові розлади. Їх було поділено на дві групи: до групи I увійшли 30 (50,9 %) пацієнтів, яким додатково до стандартної терапії призначали пробіотик «Лактіалє Жерміна Форте» по 1 флакону 2 рази на добу протягом 7 діб, до групи II – 29 (49,1 %) хворих, які отримували стандартну етіотропну та патогенетичну терапію.

Результати досліджень. Шлунково-кишкові розлади у хворих на COVID-19 характеризувалися зниженням або відсутністю апетиту, діареєю, гіркотою в роті, болем у животі, нудотою, блюванням. Симптоми ураження ТК на 7-й день від початку лікування зберігалися в 5 (16,7 %) хворих групи I і 20 (69,0 %) осіб із групи II (р˂0,001). У представників I групи вміст інтерлейкіну-1β, інтерлейкіну-2 та інтерлейкіну-8 знижувався в динаміці, порівняно з початковим рівнем (р˂0,01), був нижчим за аналогічний показник у групі порівняння (р˂0,05) після лікування. Також у цих хворих відбулося підвищення вмісту біфідо- та лактобактерій відносно значно зниженого початкового рівня (р˂0,001), пригнічення росту золотистого стафілокока (р˂0,001), грибів роду Candida (р˂0,01), зменшення кількості кишкової палички зі зниженою ферментативною активністю (р˂0,001), ентерококів (р˂0,001), тенденція до зменшення кількості кишкової палички з гемолітичною активністю (р˃0,05).

Висновки. Виникнення розладів з боку ТК є типовим для COVID-19. Застосування в комплексній терапії пацієнтів «Лактіалє Жерміна Форте» сприяє регресії клінічних проявів, нормалізації або наближенню до нормалізації вмісту прозапальних цитокінів у сироватці крові, відновленню стану кишкової мікрофлори, порівняно зі стандартною терапією.
СИНДРОМ ГІПЕРЧУТЛИВОСТІ ДО АНТИКОНВУЛЬСАНТІВ, ПОВ’ЯЗАНИЙ З РЕАКТИВАЦІЄЮ ЕПШТЕЙНА-БАРР-ВІРУСНОЇ ІНФЕКЦІЇ
Authors: Колотило Т. Р. , Москалюк В. Д. , Дучко М. В.
Published: October 2023

Синдром гіперчутливості до антиконвульсантів – небезпечна реакція, спричинена прийомом ароматичних протисудомних засобів, а саме: фенітоїну, карбамазепіну, фенобарбіталу. Клінічні ознаки включають висип, гарячку, лімфаденопатію, ураження внутрішніх органів (гепатит, кардит, внутрішній нефрит або інтерстиційний пневмоніт), а також гематологічні відхилення, такі як лейкоцитоз з еозинофілією чи атиповий лімфоцитоз. Синдром виникає після тривалого впливу антиконвульсантів на організм.

Мета – дослідити закономірність впливу антиконвульсантів на організм пацієнта з латентною інфекцією, спричиненою HHV-4 людини (вірусом Епштейна-Барр – EBV).

Можливою причиною синдрому гіперчутливості до протисудомних препаратів вважають генетичний дефіцит детоксикаційних ферментів, зокрема епоксидгідролази, що призводить до накопичення токсичних метаболітів, або взаємодії між вірусом і ліками, як це спостерігається у випадках вірусу імунодефіциту людини та вірусу герпесу людини. Ароматичні протисудомні засоби метаболізуються цитохромом Р-450 до проміжних метаболітів, таких як оксиди арена. Якщо є дефекти метаболізму, ці токсичні метаболіти можуть спричинити некроз або апоптоз клітин і індукувати вторинну імунну відповідь. Клінічний випадок характеризує симптоматику синдрому, діагностичні критерії та підтверджує доцільність лікування синдрому глюкокортикостероїдами. Доведено, що у пацієнтів із синдромом гіперчутливості до антиконвульсантів генетичний алель HLA-A-3101 асоціюється із шкірними реакціями, спричиненими карбамазепіном.

Висновки. Метаболіти ареноксиду ароматичних протисудомних засобів (фенітоїну, фенобарбіталу та карбамазепіну) можуть брати участь у патогенезі реакцій гіперчутливості та реактивації латентної EBV-інфекції. Перехресна реакція серед основних протисудомних засобів поширена, тож її слід враховувати перед тим, як ухвалювати рішення про альтернативну терапію. Беручи до уваги високий рівень носіїв HLA-A-3101 у всьому світі, підвищення обізнаності медичних працівників із синдромом гіперчутливості до антиконвульсантів має важливе значення для зниження кількості клінічних випадків реактивації латентної EBV-інфекції і запобігання можливим серйозним ускладненням.
АНАЛІЗ ПОКАЗНИКІВ ЕНДОТОКСИКОЗУ У ХВОРИХ НА ЦИРОЗ ПЕЧІНКИ З МЕТАБОЛІЧНИМ СИНДРОМОМ ТА ДИСБІОЗОМ
Authors: Олійник Н. М.
Published: October 2023

РЕЗЮМЕ. У розвитку та прогресуванні ендотоксикозу при цирозі печінки доведена роль метаболічного синдрому та дисбіозу кишечника.
Мета – дослідити окремі показники ендотоксикозу, вираження його дисбалансу у хворих на ЦП з дисбіозом кишечника при наявності метаболічного синдрому.
Матеріал і методи. Було обстежено 101 хворого на ЦП різної етіології. Верифікацію діагнозу проводили на основі анамнестичних, клінічних, лабораторних (біохімічних, серологічних) даних, визначали сироваткові маркери вірусів гепатиту В та С, результатів ультразвукового дослідження печінки за допомогою уніфікованих методик, затверджених МОЗ України.
Результати. Аналіз показників ЕІ у хворих на ЦП різної етіології виявив вірогідне підвищення рівня маркерів у всіх етіологічних групах. У жінок з ЦП алкогольної етіології спостерігали більш виражений рівень ІЕІЕ порівняно із чоловіками. Спостерігалося вірогідне зростання маркерів ендотоксикозу при декомпенсації ЦП.  Аналіз маркерів ендотоксикозу у хворих на ЦП при наявності метаболічного синдрому виявив вірогідне підвищення всіх показників у групі М, порівняно з групою Ц.
Висновки. У хворих на ЦП з дисбіозом спостерігається виражений ендотоксикоз. Рівень ІЕІЕ був вищим за контрольний в 2,3 раза, СМП1 – в 1,7 раза, СМП2 – в 2,0 раза (p<0,05), що є показником виражених проявів ендотоксикозу при ЦП. Рівень маркерів ендотоксикозу виявився достовірно вищим у хворих на ЦП при наявності метаболічного синдрому, що призводить до поглиблення процесів фіброгенезу.
КІЛЬКІСНЕ МОРФОЛОГІЧНЕ ВИВЧЕННЯ ОСОБЛИВОСТЕЙ ПОРУШЕНЬ ВЕНОЗНОГО ДРЕНАЖУ ВІД СІМ’ЯНИКІВ В УМОВАХ ЕТАНОЛОВОЇ ІНТОКСИКАЦІЇ
Authors: Нестерук С. О. , Татарчук Л. В. , Гнатюк М. С. , Монастирська Н. Я.
Published: October 2023

РЕЗЮМЕ. Алкоголізм є поширеною медико-соціальною патологією, при якій уражаються майже всі органи та системи організму. Особливості порушень венозного дренажу від сім’яників в умовах етанолової інтоксикації до кінця не вивчені.
Мета – кількісними морфологічними методами дослідити особливості порушень венозного дренажу від сім’яників в умовах етанолової інтоксикації.
Матеріал і методи. Морфологічно досліджено венозне русло сім’яників 62 лабораторних статевозрілих білих щурів-самців, які були поділені на 2 групи. Перша група нараховувала 30 інтактних контрольних тварин, 2 – 32 щури, яким внутрішньошлунково вводили 30 % розчин етанолу в дозі 2 мл на 100 г маси тіла протягом 28 діб один раз на добу. Евтаназію тварин виконували кровопусканням в умовах тіопенталового наркозу через 30 днів від початку досліду. На гістологічних препаратах сім’яників визначали діаметри закапілярних венул, венул, венозних судин, їх просвіт, товщину стінки, висоту ендотеліоцитів, діаметр їх ядер, ядерно-цитоплазматичні відношення в ендотеліоцитах та відносний об’єм їх уражень. Кількісні показники обробляли статистично.
Результати. Встановлено виражену структурну перебудову венозного русла сім’яників в умовах тривалого етанолового отруєння. Виявлено виражене розширення закапілярних венул та венул сім’яників, збільшення зовнішнього та внутрішнього діаметрів венозних судин, потоншення їх стінки, зростання відносних об’ємів пошкоджених ендотеліоцитів, порушення в них ядерно-цитоплазматичних відношень. Венозна гіперемія ускладнювалася гіпоксією, дистрофією, некробіозом ендотеліоцитів, сперматогенних епітеліоцитів, інтерстиційних ендокриноцитів, інфільтрацією та склерозом. Морфологічні зміни домінували у лівому сім’янику.
Висновки. Тривала інтоксикація організму лабораторних статевозрілих білих щурів-самців етанолом призводить до вираженого ремоделювання венозного русла сім’яників, яке характеризується значним розширенням та повнокров’ям венозних судин, порушенням їх венозної дренажної функції, гіпоксією, дистрофічними, некробіотичними, інфільтративними та склеротичними процесами у досліджуваних органах. Виявлена структурна перебудова венозних судин домінувала у лівому сім’янику.
ПОКАЗНИКИ ЦИТОКІНОВОГО СТАТУСУ (IL-6 ТА IL-10) У ХВОРИХ, ЯКІ ЗАЗНАЛИ ОПЕРАТИВНОГО ВТРУЧАННЯ В УМОВАХ ЗАГАЛЬНОЇ АНЕСТЕЗІЇ
Authors: Салій З. В. , Салій І. І. , Салій М. І.
Published: October 2023

РЕЗЮМЕ. З огляду на поширеність післяопераційної когнітивної дисфункції, актуальним є встановлення факторів ризику її розвитку з метою корекції та профілактики.
Мета – встановити діагностичну цінність визначення вмісту IL-6 та IL-10 для прогнозування розвитку ПОКД.
Матеріал і методи. У 32 хворих, які зазнали оперативного втручання в умовах загальної анестезії, дослідили вміст IL-6 та IL-10 в сироватці крові в перед- та ранньому післяопераційному періоді. Середній вік хворих – (52,28±2,13) років. Середня тривалість оперативного втручання – (78,91±5,04) хвилин. Тривалість дії анестезії – (103,91±6,59) хвилин. Розподіл за видом оперативного втручання: ендопротезування – 17 хворих (53,13 %), металоостеосинтез – 15 хворих (46,87 %). З метою оцінки стану когнітивних функцій використовували Монреальську шкалу оцінки когнітивних функцій (МоСА), для визначення рівня тривожності та депресії – Госпітальну шкалу тривожності і депресії (HADS). До контрольної групи увійшли 22 практично здорові особи, репрезентативні за віком та статтю.
Результати. До оперативного втручання у пацієнтів основної групи, в порівнянні з контрольною, вміст IL-6 був достовірно вищим, що можна розцінювати як реакцію на травму. Оперативне втручання сприяло зростанню рівня прозапального цитокіну IL-6 в 3,57 раза на тлі помірного зростання протизапального – IL-10 (в 1,2 раза).
Післяопераційний вміст IL-6 був достовірно вищим у групі з ендопротезуванням (р=0,04). Встановлено кореляційний зв’язок між рівнем IL-6 і тривалістю операції (r=0,77, р=0,001), рівнем IL-10 і депресією (r=0,64, р=0,013).
Висновок. Оперативне втручання в умовах загальної анестезії сприяло зростанню рівня прозапального цитокіну IL-6 та тлі помірного зростання протизапального – IL-10. Достовірно вищий рівень післяопераційного IL-6 був у пацієнтів з тривалістю анестезії понад 120 хвилин, негативно корелюючи з результатом МоСА-тесту (r=-0,57, р=0,035). Установлено особливості реагування системи цитокінового статусу залежно від характеру патології, з приводу якої виконувалося ортопедичне втручання.
Análise dos estudos brasileiros sobre quadrinhos publicados de 2018 a 2020
Authors: Santos Ana Ligia Feliciano dos , Silva Fábio Mascarenhas e
Published: October 2023

Os quadrinhos são objeto de estudo em pesquisas sob diferentes perspectivas e áreas do conhecimento. Assim, esta pesquisa caracteriza os estudos brasileiros dos quadrinhos, publicados no período de 2018 a 2020. É uma pesquisa descritiva, quanto aos fins, e bibliográfica, quanto aos meios, que analisa a comunicação científica nacional indexada nas bases de dados ScienceOpen e Directory of Open Access Journals (DOAJ), além da publicada no periódico 9ª Arte. Identifica as características intrínsecas aos estudos e traça relações com as categorias, bem como evidencia tendências e direções das pesquisas, por meio da aplicação de técnicas de análise de conteúdo. Conclui que os estudos analisados contribuem para a legitimação dos quadrinhos como produto artístico e cultural e objeto de pesquisa, bem como para o fortalecimento do campo científico.
iCPET Calculator: A Web‐Based Application to Standardize the Calculation of Alpha Distensibility in Patients With Pulmonary Arterial Hypertension
Authors: Elliott Jordan , Menakuru Nainika , Martin Kellan Juliet , Rahaghi Farbod Nicholas , Rischard Franz P. , Vanderpool Rebecca R.
Published: October 2023

Background

Pulmonary vascular distensibility associates with right ventricular function and clinical outcomes in patients with unexplained dyspnea and pulmonary hypertension. Alpha distensibility coefficient is determined from a nonlinear fit to multipoint pressure‐flow plots. Study aims were to (1) create and test a user‐friendly tool to standardize analysis of exercise hemodynamics including distensibility, and (2) investigate changes in distensibility following treatment in patients with pulmonary arterial hypertension.

Methods and Results

Participants with an exercise right heart catherization were retrospectively identified from the University of Arizona Pulmonary Hypertension (UA PH) registry and split into a pulmonary arterial hypertension group, a comparator group, and a control group. Right ventricular function was quantified using the coupling ratio and diastolic stiffness. Prototypes of the invasive cardiopulmonary exercise testing (iCPET) calculator were developed using Matlab, Python, and RShiny to analyze exercise hemodynamics and alpha distensibility coefficient, α (%/mm Hg) from multipoint pressure flow plots. Interclass correlation coefficients were calculated for interplatform and interobserver variability in alpha. No significant bias in the intraplatform (Matlab versus RShiny; intraclass correlation coefficient: 0.996) or interobserver (intraclass correlation coefficient: 0.982) comparison of alpha values. Afterload significantly decreased (
P
<0.05) with no change in alpha distensibility in the pulmonary arterial hypertension group at follow‐up. The comparator group had no change in pressure, resistance or alpha distensibility. There were no significant changes in RV diastolic stiffness at follow‐up.

Conclusions

The interactive user interface in the iCPET calculator allows exploration of alpha distensibility using standardized methods. No significant change in alpha distensibility at follow‐up suggests that alpha may be less modifiable in patients with long‐standing pulmonary arterial hypertension.
Paradoxical Effects of Prolonged Insufficient Sleep on Lipid Profile: A Pooled Analysis of 2 Randomized Trials
Authors: Barragán Rocío , Zuraikat Faris M. , Cheng Bin , Scaccia Samantha E. , Cochran Justin , Aggarwal Brooke , Jelic Sanja , St‐Onge Marie‐Pierre
Published: October 2023

Background

Insufficient sleep is associated with increased cardiovascular disease risk, but causality is unclear. We investigated the impact of prolonged mild sleep restriction (SR) on lipid and inflammatory profiles.

Methods and Results

Seventy‐eight participants (56 women [12 postmenopausal]; age, 34.3±12.5 years; body mass index, 25.8±3.5 kg/m
2
) with habitual sleep duration 7 to 9 h/night (adequate sleep [AS]) underwent two 6‐week conditions in a randomized crossover design: AS versus SR (AS–1.5 h/night). Total cholesterol, low‐density lipoprotein cholesterol (LDL‐C), high‐density lipoprotein cholesterol, triglycerides, and inflammatory markers (CRP [C‐reactive protein], interleukin 6, and tumor necrosis factor‐α) were assessed. Linear models tested effects of SR on outcomes in the full sample and by sex+menopausal status (premenopausal versus postmenopausal women+men). In the full sample, SR increased high‐density lipoprotein cholesterol compared with AS (β=1.2±0.5 mg/dL;
P
=0.03). Sex+menopausal status influenced the effects of SR on change in total cholesterol (
P
‐interaction=0.04), LDL‐C (
P
‐interaction=0.03), and interleukin 6 (
P
‐interaction=0.07). Total cholesterol and LDL‐C decreased in SR versus AS in premenopausal women (total cholesterol: β=−4.2±1.9 mg/dL;
P
=0.03; LDL‐C: β=−6.3±2.0 mg/dL;
P
=0.002). Given paradoxical effects of SR on cholesterol concentrations, we explored associations between changes in inflammation and end point lipids under each condition. Increases in interleukin 6 and tumor necrosis factor‐α during SR tended to relate to lower LDL‐C in premenopausal women (interleukin 6: β=−5.3±2.6 mg/dL;
P
=0.051; tumor necrosis factor‐α: β=−32.8±14.2 mg/dL;
P
=0.027).

Conclusions

Among healthy adults, prolonged insufficient sleep does not increase atherogenic lipids. However, increased inflammation in SR tends to predict lower LDL‐C in premenopausal women, resembling the “lipid paradox” in which low cholesterol associates with increased cardiovascular disease risk in proinflammatory conditions.

Registration

URL:
https://www.clinicaltrials.gov
; Unique identifiers: NCT02835261, NCT02960776.
Haloed Hallucinations
Authors: Eklund Erik
Published: October 2023

Among the most popular hagiographies throughout Eastern and Coptic Christianity, Athanasius’ Life of Antony has exercised profound influence upon Western visual and literary art, not least Vladimir Nabokov’s Bend Sinister. Querying the alleged originality of Nabokov’s “symbol of the Divine power,” this article examines Nabokov’s engagement with the Antonian hagiographic tradition—represented by Athanasius’ Life, Hieronymus Bosch’s Triptych of the Temptation of St. Anthony, and Gustave Flaubert’s Le Tentation de saint Antoine—to reveal the religious ground of protagonist Adam Krug’s saint-like identity and the novel’s metaliterary mysticism in the Lord’s figural descent upon an inclined beam of light at the end of Antony’s temptations. Providing a transgressive theological terroir for Nabokov to probe the porous varieties of the real, the Antonian sources of Krug’s “haloed hallucination” invite further reconsideration of Nabokov’s self-styled “indifference” to the Christian imaginary.
History, the Mother of Truth
Authors: Plot Martín
Published: October 2023

In this paper I offer a new reading of some of the philosophical and political implications of Argentine writer Jorge Luis Borges’ work. The aim of this new reading is to show that Borges exhibited broad ethical sympathies for the pragmatist imagination. The first section offers a genealogy of Borges’ unusual and original first fictional pieces and a reading of “Pierre Menard, Author of the Quixote.” It is in this text that Borges first engaged William James. In the second section, the text presents a broad picture of pragmatism, from its origins in the work of Peirce to its recent revival in Rorty’s tour de force. In the final section I analyze Borges’ essays on James and suggest they are evidence that the former’s interest in James was related to something much more ethical and political than a mere attraction for the latter’s prose or his work’s overall aesthetic value.
Taxonomic diversity of Ochrotrichiinae (Trichoptera: Hydroptilidae) from Peru with the description of ten new species, a new distributional record, and an updated checklist
Authors: ROCHA ISABELA CRISTINA , SANTOS ALLAN PAULO MOREIRA , NESSIMIAN JORGE LUIZ
Published: October 2023

We describe here ten new species of Ochrotrichiinae from southern Peru in genera Metrichia (7 new species), Ochrotrichia (1 new species), and Rhyacopsyche (2 new species). In addition to describing and illustrating male genitalia of the new species, we also highlight diagnostic features from antennae, head setal warts, and wing venation. These structures have received little attention in taxonomic studies of Hydroptilidae, and we think they may be useful in future morphological studies involving the family. We also record O. puyana for the first time from Peru, which was previously known only from Ecuador. Comments on the distribution of the Peruvian Ochrotrichiinae are also provided, along with a distributional map and an updated checklist of the species recorded in the country. This work revealed a total of 56 species of Ochrotrichiinae from Peru.
Ghatiana sanguinolenta, a new species of freshwater crab (Brachyura: Gecarcinucidae) from the Central Western Ghats of India
Authors: PATI SAMEER KUMAR , THACKERAY TEJAS , PAWAR SWAPNIL
Published: October 2023

Ghatiana sanguinolenta sp. nov. is recognized herein as the twelfth species of the gecarcinucid genus Ghatiana Pati & Sharma, 2014, and the fifth species of the genus from the Karnataka state. This new species of freshwater crab is currently known only from the type locality, which is situated in the Central Western Ghats of India. Ghatiana sanguinolenta sp. nov. can be immediately distinguished from congeners by the outwardly curved ultimate article of the male first gonopod and the dark blood-red colour in life.
Associating Internalizing and Externalizing Symptom Features With the Personality Inventory for DSM-5 Brief Form (PID-5-BF) in a Large Community Sample
Authors: Cox Sylvia M. L. , McQuaid Robyn J. , Ogunlana Ayotola , Jaworska Natalia
Published: October 2023

The Personality Inventory for DSM-5-Brief Form (PID-5-BF) is a relatively novel measure assessing maladaptive personality traits. We examined whether PID-5-BF traits are associated with non-personality measures of wellbeing in N = 661 Canadian adults in the community. Depression, anxiety, and perceived stress measures were obtained, as were indices of alcohol and cannabis use. Symptoms of depression and perceived stress were associated with all PID-5-BF dimensions, except for antagonism. Anxiety symptoms were associated with negative affectivity (NA) and, to a lesser extent, psychoticism. A younger age and female sex were related to higher depression and stress scores. In contrast to the models assessing depressive, anxiety and stress symptoms, in which NA was the strongest contributor, no significant contribution of internalizing traits (i.e., PID-5-BF NA) on substance use outcomes was found when externalizing traits were included in the models. Specifically, binge drinking and cannabis use were associated with higher disinhibition scores and lower psychoticism scores. Regression models were substantially weaker for substance use than for the mood and stress symptoms. Younger individuals used more cannabis and males engaged in more binge drinking. These findings largely confirm PID-5-BF’s construct validity, and indicate that various indices of wellbeing (not necessarily personality-associated measures) are associated with personality traits, as measured with the brief from of PID-5-BF.
Classic, Segmented-, or Neo-Assimilation, Which Theory to Use? A Scientific-Method Investigation
Authors: Karimi Aryan , Wilkes Rima
Published: October 2023

Classic, segmented, and neo-assimilation theories delineate immigrants’ assimilation trajectories. Classic assimilation, since the early twentieth century, treats newcomers’ and established groups’ interactions as leading to ethnoracial pluralism within one culture. Segmented-assimilation, since the 1990s, examines non-European immigrants’ experiences, and considers how factors such as ethnic capital, immigration policies, and racial discrimination cause assimilation into upper, middle, and underclasses. Neo-assimilation, since the early 2000s, posits that assimilation compels upward mobility into a diverse mainstream. While the progenitors of each theory have pointed out the other's deficiencies, in this paper we simultaneously compare the three theories in light of the scientific method's criteria of deductive-inductive hypothesizing and falsification. We find that classic theory follows the scientific method and is falsifiable. In comparison, we find that because segmented- and neo-assimilation each depart from the scientific method in three ways they are not readily testable or falsifiable. We discuss the implications for migration and assimilation research.
Safety and efficacy of prostatic artery embolization in patients with hematuria due to benign prostate hyperplasia
Authors: Hijazi Bilal Ahmad , Shi Hai-Bin , Liu Sheng , Wei Tian , Alqurashi Turki Atia , Sabri Zakir Jamal , Singh Vinay , Hamdy Hayam
Published: October 2023

Background

Benign prostate hyperplasia (BPH) commonly affects aging men that can result in hematuria. For patients who are not suitable candidates for surgery, prostatic artery embolization (PAE) has emerged as a minimally invasive alternative. This study aimed to assess the safety and efficacy of PAE specifically for treating hematuria in BPH patients who cannot undergo surgery.

Methods

The study included n = 110 participants. PAE was performed, and outcomes of interest, including resolution of hematuria, improvement in lower urinary tract symptoms (LUTS), prostate volume (PV), and quality of life (QoL), were assessed. Adverse events were also analyzed.

Results

The study demonstrated a 100% clinical success rate in resolving hematuria at 3 months, with no recurrence observed during the 6-month follow-up. Mean hemoglobin levels increased, indicating successful resolution of bleeding. PAE also led to a significant reduction in LUTS severity, as measured by the International Prostate Symptom Score (IPSS). Improvement in the mean maximum urinary flow rate (Qmax) indicated enhanced urinary flow. Additionally, MRI measurements showed a reduction in prostate volume following PAE. These improvements contributed to enhanced QoL for the patients.

Conclusions

Prostatic artery embolization (PAE) was found to be a safe and effective treatment option for hematuria in BPH patients not suitable for surgery. PAE demonstrated a high success rate in resolving hematuria and resulted in significant improvements in LUTS, prostate volume, and QoL outcomes. These findings have important implications for clinical decision-making and improving patient care for BPH patients with hematuria. Further research and long-term follow-up studies are necessary to validate these findings and assess the durability of PAE outcomes in this patient population.
Methodology for the adolopment of recommendations for the treatment of rheumatoid arthritis in the Kingdom of Saudi Arabia
Authors: Khabsa Joanne , Yaacoub Sally , Omair Mohammed A. , Al Rayes Hanan , Akl Elie A. ,   the KSA 2021 ACR RA adolopment working group, Abdulaziz Sultana , Al Janobi Ghada A. , Al Khalaf Abdulaziz , Al Mehmadi Bader , Al Nassar Mahasin , AlBalawi Faisal , AlFurayj Abdullah S. , Al-Jedai Ahmed Hamdan , Almalag Haya Mohammed , Almudaiheem Hajer Yousef , AlRehaily Ali , Attar Mohammed A. , Kibbi Lina El , Fraenkel Liana , Halabi Hussein , Hasan Manal , Singh Jasvinder A.
Published: October 2023

Background

Currently, there are no guidelines for the treatment of rheumatoid arthritis (RA) tailored to the context of the Kingdom of Saudi Arabia (KSA). Adaptation of guidelines accounts for contextual factors and becomes more efficient than de novo guideline development when relevant, good quality, and up-to-date guidelines are available. The objective of this study is to describe the methodology used for the adolopment of the 2021 American College of Rheumatology (ACR) guidelines for the treatment of RA in the KSA.

Methods

We followed the ‘Grading of Recommendations Assessment, Development and Evaluation’ (GRADE)-ADOLOPMENT methodology. The adolopment KSA panel included relevant stakeholders and leading contributors to the original guidelines. We developed a list of five adaptation-relevant prioritization criteria that the panelists applied to the original recommendations. We updated the original evidence profiles with newly published studies identified by the panelists. We constructed Evidence to Decision (EtD) tables including contextual information from the KSA setting. We used the PanelVoice function of GRADEPro Guideline Development Tool (GDT) to obtain the panel’s judgments on the EtD criteria ahead of the panel meeting. Following the meeting, we used the PANELVIEW instrument to obtain the panel’s evaluation of the process.

Results

The KSA panel prioritized five recommendations, for which one evidence profile required updating. Out of five adoloped recommendations, two were modified in terms of direction, and one was modified in terms of certainty of the evidence. Criteria driving the modifications in direction were valuation of outcomes, balance of effects, cost, and acceptability. The mean score on the 7-point scale items of the PANELVIEW instrument had an average of 6.47 (SD = 0.18) across all items.

Conclusion

The GRADE-ADOLOPMENT methodology proved to be efficient. The panel assessed the process and outcome positively. Engagement of stakeholders proved to be important for the success of this project.
Female sex and overweight are associated with a lower quality of life in patients with myasthenia gravis: a single center cohort study
Authors: Wilcke Hannah , Glaubitz Stefanie , Kück Fabian , Anten Christoph , Liebetanz David , Schmidt Jens , Zschüntzsch Jana
Published: October 2023

Background

Myasthenia gravis (MG) affects individuals as a chronic autoimmune disease for many years. Commonly, chronic diseases significantly reduce the patients’ quality of life. Aiming to improve the future quality of life in MG, this study assessed the factors impacting quality of life. As gender-specific medicine is becoming increasingly important, this study also focused on understanding gender differences in the outcome of MG.

Methods

The study is a combined monocentric, retrospective and prospective database analysis of patient records based on 2,370 presentations of 165 patients with clinically, serologically and/or electrophysiologically confirmed MG over an observation period of up to 47 years. The data collection included the following parameters: antibody status, disease severity, age, medication use, gender, and disease duration. In addition, a prospective survey was conducted on the quality of life using the Myasthenia gravis-specific 15-item Quality of Life scale (MG-QoL15) and on the activities of daily living using the MG-specific Activities of Daily Living scale (MG-ADL).

Results

Of the 165 patients, 85 were male (51.5%) and 80 were female (48.5%). The remaining baseline characteristics (e.g. age and antibody status) were consistent with other myasthenia gravis cohorts. A high body mass index (BMI) (p = 0.005) and a high disease severity (p < 0.001) were significantly associated with lower disease-specific quality of life. Additionally, the quality of life in women with MG was significantly reduced compared to male patients (19.7 vs. 13.0 points in the MG-QoL15, p = 0.024). Gender differences were also observable in terms of the period between initial manifestation and initial diagnosis and women were significantly more impaired in their activities of daily living (MG-ADL) than men (4.8 vs. 3.0 points, p = 0.032).

Conclusion

Women with MG had significantly poorer disease specific quality of life compared to men as well as patients with a higher BMI. In order to improve the quality of life, gender-specific medicine and further investigation regarding a modification of the quality of life by lowering the BMI are essential and necessary.

Trial registration

Study approval by the Ethics Committee of the University Medical Center Göttingen was granted (number 6/5/18).
Comparison between continued inpatient treatment versus day patient treatment after short inpatient care in early onset anorexia nervosa (COTIDEA trial): a study protocol for a non-inferiority randomised controlled trial
Authors: Ayrolles A. , Bargiacchi A. , Clarke J. , Michel M. , Baillin F. , Trebossen V. , Kalifa H. Poncet , Guilmin-Crépon S. , Delorme R. , Godart N. , Stordeur C.
Published: October 2023

Background

In children with early-onset anorexia nervosa (first symptoms before 13 years old, EO-AN), experts recommend initial outpatient treatment but in-patient treatment (IP) is frequently indicated due to acute medical instability or for those who have not improved with outpatient treatment. This IP can target either a partial weight restauration or a total weight normalization (return to the previous BMI growth trajectory). There are no evidence in the literature on which is the better therapeutic option in EOAN. But as long length of stay induce social isolation, with elevated costs, we wonder if a stepped-care model of daypatient treatment (DP) after short IP stabilisation may be a treatment option as effective as full-time IP to target weight normalization. We designed a two-arm randomised controlled trial testing the non-inferiority of a stepped-care model of DP after short IP stabilisation versus full-time IP.

Methods

Eighty-eight children aged 8 to 13 years suffering from EOAN with initial severe undernutrition will be randomly allocated to either IP treatment as usual or a stepped care DP model both targeting weight normalization. Assessments will be conducted at inclusion, somatic stabilization, weight normalization, 6 months and 12 months post randomisation. The primary outcome will be BMI at 12 months post-randomisation. Secondaries outcomes will included clinical (tanner stage), biological (prealbumin, leptin, total ghrelin and IGF1) and radiological (bone mineralization and maturation) outcomes, eating symptomatology and psychiatric assessments, motivation to change, treatment acceptability and quality of life assessments, cost-utility and cost-effectiveness analyses.

Discussion

COTIDEA will provide rigorous evaluation of treatment alternative to full-time inpatient treatment to allow a reduction of social iatrogenic link to hospital length of stay and associated costs.

Trial registration

Trial is registered on ClinicalTrials.gov (NCT04479683).
Sex-based influential factors for dental caries in patients with schizophrenia
Authors: Yang Mi , Xu Jingjing , Chen Xiaoqin , Liu Liju , Kong Di , Yang Yan , Chen Wei , Li Zezhi , Zhang Xiangyang
Published: October 2023

Background

Schizophrenia is a common mental disorder that seriously affects patients’ daily lives and brings heavy psychological and economic burdens to their families and society. The oral problems of patients with schizophrenia are gradually gaining attention, among which dental caries are among the most common oral diseases. Sex differences may be related not only to the various clinical symptoms of schizophrenia but also to different oral hygiene statuses; therefore, the main purpose of this paper is to investigate sex differences related to influencing factors for dental caries in patients with schizophrenia.

Method

Inpatients with schizophrenia over 18 years old were included in this study, and multidimensional indicators such as demographics, symptom and cognitive impairment assessments, medications, and the caries index of decayed, missing, and filled teeth (DMFT) were collected. An analysis of sex-based influential factors for dental caries in schizophrenia patients was performed.

Results

Four-hundred and ninety-six patients with schizophrenia were included, with a mean age of 46.73 ± 12.23 years, of which 142 were females and 354 were males. The mean DMFT was significantly higher in males (8.81 ± 8.50) than in females (5.63 ± 6.61, p < 0.001), and the odd ratio of caries in males to females was significantly higher as well (OR = 2.305, p < 0.001). The influential factors of caries in male patients were independently associated with age and smoking status, in which current smokers were at the highest risk for developing caries, and different smoking statuses had various influencing factors for caries. The influencing factors for caries in female patients were independently associated with age, antipsychotic dose, PANSS-positive symptoms, and MMSE levels.

Conclusion

Our findings suggest sex differences exist among influential factors for caries in patients with schizophrenia. These risk factors may even be associated with and affect the treatment and prognosis of psychiatric symptoms in patients. Therefore, oral hygiene management of patients with schizophrenia should be enhanced. These differential factors provide new visions and ideas for formulating individual interventions, treatments, and care priorities.
Evaluating the effect of an adapted mental health literacy intervention on mental health related stigma among secondary students in Germany: results of a pre-post evaluation study
Authors: Kirchhoff Sandra , Fretian Alexandra M. , Okan Orkan , Bauer Ullrich
Published: October 2023

Background

Most mental health problems develop during youth, with about three quarter emerging before age 25. In adolescence, stigmatizing attitudes related to mental illness become more nuanced and consolidate into one’s belief system. As the stigma of mental illness is still one of the leading barriers to help-seeking, intervention measures should explicitly address it before it becomes entrenched over time. Preventive measures, for example, based on promoting mental health literacy (MHL), can be used to address and tackle stigmatizing attitudes. The Canadian MHL-based intervention “the Guide” was translated and adapted for the use in German schools. The present study evaluates the effect of the German version of the Guide on attitudes towards mental illness among students in Germany.

Methods

The first-time application of the Guide (German version) was evaluated with a pre-post-evaluation study with an intervention and a control group. The evaluation data of 188 students (intervention group n = 106, control group n = 82) were statistically analyzed focusing on the outcomes social stigma, social distance, and self-stigma.

Results

The analysis showed that participants do not tend to hold stigmatizing attitudes even before the intervention. Nevertheless, the intervention was effective in reducing social stigma, but not in reducing social distance and self-stigma. Neither gender, pre-existing experience with mental illness, nor the delivery modality of the contact element within the intervention (speaker vs. video) seemed to influence the outcomes.

Conclusions

The German version of the MHL-based intervention, the Guide, seems to be a suitable intervention to improve attitudes towards mental illness among students in Germany. More extensive research is necessary to confirm the findings and further explore factors that influence the program’s effects on attitudes short- and long-term.
Biomechanical improvement of anterior talofibular ligament by augmentation repair of ligament advance reinforcement system: a cadaver study
Authors: Xiang Dulei , Jin Wenming , Li Han , Zhao Gen , Li Bao , Du Shuyuan , Liu Xinwei
Published: October 2023

Background

Ankle sprain are one of the most frequent sports injuries. Some individuals will develop chronic lateral ankle instability (CLAI) after ankle sprain and suffer from recurrent ankle sprain. Current surgical treatment of CAI with anterior talofibular ligament (ATFL) rupture fails to restore the stability of the native ATFL. Ligament Advance Reinforcement System (LARS) augmentation repair of ATFL was developed to improve its primary stability after repaired.

Methods

This study was performed to evaluate whether LARS augmentation repair of ATFL had similar stability as the modified Broström repair and the intact ATFL to maintain ankle construct stability. Standardized surgical techniques were performed on eighteen fresh frozen cadaver ankle specimens. The intact ATFL group has just undergone an ATFL exploratory surgery. The modified Broström procedure is based on anatomical repair of the ATFL with a 2.9 mm suture anchor, and the LARS procedure is an augmentation procedure of the ATFL using LARS ligaments based on the modified Broström procedure. A dynamic tensile test machine was used to assess load-to-failure testing in the three groups. The ultimate failure load and stiffness were calculated and reported from the load-displacement curve. A one-way analysis of variance was used to detect significant differences (p < 0.05) between the LARS augmentation repair, the modified Broström repair and the intact ATFL, followed by least significant difference (LSD) post-hoc tests.

Results

The LARS augmentation repair group showed an increased in ultimate failure to load and stiffness compared to the other two groups. There were no significant differences in ultimate failure to load and stiffness between the modified Broström and the intact ATFL, the LARS ligament for ATFL augmentation allows for improved primary stability after repair and reduced stress on the repaired ATFL, which facilitates healing of the remnant ligament.

Conclusions

The LARS augmentation repair of ATFL represents a stable technique that may allow for the ankle stability to be restored in patients with CAI after surgery.
Conservative management of double teeth in molar teeth with pulp or periapical disease: a report of five cases and literature review
Authors: Chen Mengxi , Bai Xinna , Wang Xiangzhu , Xie Xiaoli , Chen Minmin
Published: October 2023

Background

Double teeth are usually the result of an abnormality in the developing tooth germ. Double teeth can occur in either the primary or permanent dentition, with the majority of cases concerning permanent teeth reported in the anterior teeth and less frequently in the molar teeth.

Case presentation

This report illustrates five cases of double teeth in molars with pulp and periapical disease, including one case of geminated teeth and four cases of fused teeth. Radiographic findings revealed the presence of extra teeth on the buccal aspect of the molar in five cases, with or without communication between the two root canal systems. Root canal treatment was performed by using CBCT and a dental operating microscope. The treatment outcome was good in all five cases.

Conclusion

The diagnosis and treatment of double teeth requires special attention. The root canal system should be carefully explored to obtain a full understanding of the anatomy, allowing it to be fully cleaned and obturated. Proper anatomical structure analysis prior to treatment facilitates the development of an appropriate treatment plan, thereby increasing the likelihood of successful treatment both aesthetically and functionally.
Practice of non-institutional delivery and its associated factors among women who gave birth in Southern Ethiopia, 2022
Authors: Geta Temesgen , Sugebo Fekire , Anjulo Fekadu
Published: October 2023

Background

Non-institutional delivery is one of the major reasons that results in high mortality rates for a mother and her neonate. The World Health Organization estimates that only 43% of mothers have access to skilled delivery services. A recent Ethiopian Mini Demographic Survey indicated that more than half of Ethiopian women have given birth non-institutionally. This shows that maternal health remains a major public health challenge in Ethiopia, irrespective of the government’s measures for institutional delivery. So, the aim of this study was to assess the practice of non-institutional delivery and its associated factors among women who gave birth in the study area.

Methods

A community-based cross-sectional study was carried out on 260 study participants from June 1 to July 1, 2022, in Boloso Bombe Woreda. Data collection was done using a structured questionnaire, and systematic sampling techniques were used to select the study subjects. The data was entered into the EPI data version 3.1 and analyzed using SPSS version 25. The adjusted odds ratio, along with 95% confidence intervals, was used, and the level of statistical significance was declared at a P-value of 0.05.

Result

Out of 260 women interviewed, 252 (97%) pregnant women participated in the interview. The prevalence of non-institutional delivery among study participants was 68.7% (95% CI: 63.1–72.9). Mothers who were a daily laborer [AOR = 6.6;95%CI(3.6(1.2–11.2), last pregnancy planned [AOR = 0.4; 95%CI (0.4(0.2–0.8)), an absence of antenatal care contacting history [AOR = 3.3; 95%CI (1.3–8.6)], respondents’ knowledge on the labor complication [AOR = 3; (95%CI); 3.5(2.2–6.1)], and place of first delivery [AOR = 8.7 95%CI(3.2–23)] were factors that significantly associated with practice of non-institutional delivery.

Conclusion

This study indicated that the majority of study participants practiced non-institutional delivery in this study area. Thus, we strongly recommend that all responsible bodies take immediate action, such as community health education on pregnancy-related complications, encouraging ANC visits, and raising awareness of the advantages of preventing non-institutional delivery in order to reduce non-institutional pregnancy practices and improve the factors identified.
Online education isn’t the best choice: evidence-based medical education in the post-epidemic era—a cross-sectional study
Authors: Zhang Yi , Liu Jiarui , Liang Jun , Lang Jie , Zhang Lijia , Tang Mingwen , Chen Xinyu , Xie Yan , Zhang Jianlin , Su Liyu , Wang Xin
Published: October 2023

Background

The COVID-19 pandemic led many educational institutions to shift to online courses, making blended education a significant trend in teaching. We examined the effectiveness of blended learning in an evidence-based medicine course.

Methods

We compared the examination scores of a blended learning group, an online only group, and a traditional offline group and conducted a questionnaire survey on students’ preferences for different learning modes and the reasons for their preferences. A total of 2100 undergraduate students in clinical medicine were included in this cross-sectional study. Examination results were collected, and questionnaires were administered to the study participants. We compared the mean scores and exam pass rates of the three teaching groups using ANOVA and c2test for multiple comparisons.

Results

The blended group’s exam scores and pass rate were significantly higher than those of the offline and online groups. Furthermore, 71.6% preferred the blended teaching mode. In the survey on " learning effectiveness”, the majority of the students believed that blended education could better enhance the initiative of learning, the interest of the course, the pertinence of the learning content, the comprehension of evidence-based medical thinking, and the basic skills of evidence-based practice. Subsequently, in a questionnaire administered to a blended group of students, their foremost reason for liking online instruction was ‘flexible in time and space’ (99%), followed by ‘can be viewed repeatedly, facilitating a better understanding of knowledge points’ (98%). Their foremost reason for liking offline teaching was ‘helps to create a good learning atmosphere’ (97%), followed by ‘teachers can control students’ learning status in real time’ (89%).

Conclusions

This study explored the effectiveness of learning in evidence-based medicine courses by comparing the learning outcomes and personal perceptions of three different teaching modes. This is the first cross-sectional study in which three different teaching models are compared and discussed in an evidence-based medicine course. We also elaborate on the specific instructional protocols for each model. This study shows that using a blended education approach in evidence-based medicine courses can improve students’ learning motivation, autonomy, and satisfaction. It also enhances instructional efficiency, thereby improving students’ understanding of the course content.