bluuebunny/crossref_metadata_2025 huggingface dataset:
Bioactive Potential of Some Bacillus thuringiensis Strains from Macapá, Amazon, Brazil, Against the Housefly Musca domestica (Diptera: Muscidae) Under Laboratory Conditions
Authors: Nascimento Tatiane Aparecida , Paes Maria José , Valicente Fernando Hercos , Queiroz Margareth Maria de Carvalho
Published: December 2024

The high pathogenic activity of Bacillus thuringiensis (Bt) strains against various insect orders has positioned it as the most effective, environmentally safe, and sustainable approach to integrated insect management. We aimed to identify Bt strains capable of effectively controlling the housefly Musca domestica, a species of significant medical, veterinary, and public health concern. Twelve Bt strains from Macapá, Brazil, were tested against housefly larvae. PCR was employed to detect genes encoding Cry and Cyt proteins and Vips. Six strains exhibited 70 to 100% larval mortality, with five containing cry genes, none harboring cyt genes, and four carrying vip genes. Scanning electron microscopy revealed the production of crystal inclusions with distinct morphologies: spherical (TR4J, SOL5DM, SOL6RN), cuboidal and bipyramidal (TRO1TN and TRO2MQ), and spherical and bipyramidal (UNI2MA). The potential presence of genes from the cry1, cry2, vip1, and vip3 families suggests that these strains also exhibit bioinsecticidal activity against other muscoid flies and insect pests across various orders. This study underscores the bioactive potential of these Brazilian Bt strains for developing new bioinsecticides.
Volatiles of the Predator Xylocoris flavipes Recognized by Its Prey Tribolium castaneum (Herbst) and Oryzaephilus surinamensis (Linne) as Escape Signals
Authors: Lu Shaohua , Yang Li , Wu Zonglin , Chen Mingshun , Lu Yujie
Published: December 2024

The olfactory sensory system plays vital roles in daily activities, such as locating mate partners, foraging, and risk avoidance. Natural enemies can locate their prey through characteristic volatiles. However, little is known about whether prey can recognize the volatiles of their predators and if this recognition can increase the efficiency of prey escaping from predators. Xylocoris flavipes is a predator of Tribolium castaneum (Herbst) and Oryzaephilus surinamensis (Linne) that has been widely used in stored pest control. Herein, we analyze the volatile components of Xylocoris flavipes and their impacts on the olfactory behavior of T. castaneum and O. surinamensis. We found that T. castaneum and O. surinamensis preferred blank air rather than odors of X. flavipes and X. flavipes emissions, which significantly decreased the orientation preference of T. castaneum and O. surinamensis to wheat. X. flavipes emits three major volatiles, including linalool, α-terpineol, and geraniol. Y-tube bioassays showed that T. castaneum and O. surinamensis can recognize linalool and geraniol at certain concentrations, especially at 200 μg/mL. EAG recordings verified that linalool and geraniol elicit higher olfactory responses in the two pests, but very small EAG responses were observed in the insects to α-terpineol. A further repellency evaluation also proved that linalool and geraniol are repellent to the two pests, and this repellency can be slightly enhanced by mixing them together. T. castaneum and O. surinamensis can recognize the predator X. flavipes by perceiving its volatiles and using them as signals for escaping. The two most potent volatiles, linalool and geraniol, may have potential values as repellents in controlling pests in these two stored products.
Evaluation of Yellow Fever Virus Infection in Aedes aegypti Mosquitoes from Pakistan with Distinct Knockdown Resistance Genotypes
Authors: dos Santos Carlucio Rocha , Santos Caleb Guedes Miranda dos , Couto-Lima Dinair , Souza Bárbara Silva , Rahman Rafi Ur , Dornelas Ribeiro Marcos , Lima José Bento Pereira , Martins Ademir Jesus
Published: December 2024

Background: Yellow fever (YF) is an acute hemorrhagic disease endemic to Africa and Latin America; however, no cases have been reported in Asian regions with high Aedes aegypti infestation. Factors such as environmental conditions and genetic variations in the yellow fever virus (YFV) strains and mosquito populations may explain this absence. Mosquito populations have undergone strong selective pressure owing to the excessive use of insecticides. This pressure has led to the spread of alterations, such as knockdown-resistant mutations (kdr), which, while conferring resistance to pyrethroids, also induce various physiological side effects in the insect. Therefore, it is important to investigate whether the presence of kdr mutations influences the infectivity of YFV mosquitoes. This study evaluated the susceptibility of Ae. aegypti from Pakistan with distinct kdr genotypes to different YFV strains under laboratory conditions. Methods: Ae. aegypti from a Pakistani colony were exposed to YFV strains (PR4408/2008 and ES504/2017) along with the Rockefeller strain. After 14 days, RNA and DNA were extracted for viral RNA detection (qPCR) and kdr genotyping (TaqMan qPCR and HRM for T1520I and F1534C SNPs). Results: Pakistani Ae. aegypti were orally susceptible to YFV, with infection rates of 83.7% (PR4408/2008) and 61.3% (ES504), respectively, similar to Rockefeller. Two kdr genotypes (II + CC and TI + FC) were identified, with no significant differences in viral infection or dissemination rates. Conclusions: The Ae. aegypti population from Asia is capable of YFV infection and dissemination, regardless of kdr genotype.
Raphe-Type Bicuspid Aortic Valve as a Risk Factor for Transcatheter Aortic Valve Replacement Failure: Improving Outcomes Using the LIRA Method and the Medtronic FX Prosthesis
Authors: Napoli Francesca , Bellini Barbara , Romano Vittorio , Zanda Greca , Vella Ciro , Russo Filippo , Ferri Luca Angelo , Ancona Marco Bruno , Bonfanti Paolo , Agricola Eustachio , Esposito Antonio , Montorfano Matteo
Published: December 2024

Transcatheter aortic valve replacement (TAVR) in patients with severe aortic stenosis and raphe-type bicuspid aortic valve (BAV) is still associated with poor outcomes in terms of increased risk of paravalvular regurgitation, stroke, and permanent pacemaker implantation. There is no definitive consensus on the optimal sizing method for prosthesis selection in this setting. The LIRA method is a supra-annular tailored sizing method specifically designed for bicuspid anatomy that might increase accuracy of prosthesis choice in BAV patients and improve TAVR outcomes. This is the first report of the combination of the novel LIRA method for prosthesis sizing together with the adoption of the technological improvements introduced by the Evolut FX prosthesis as a useful tool for improving outcomes in this high risk subgroup of patients.
Clinical and CT Features, Clinical Management, and Decision on Sport Eligibility of Professional Athletes with Congenital Coronary Anomalies: A Case Series Study
Authors: Guarnieri Gianluca , Conte Edoardo , Marchetti Davide , Schillaci Matteo , Melotti Eleonora , Provera Andrea , Doldi Marco , Squeo Maria Rosaria , Pelliccia Antonio , Maestrini Viviana , Andreini Daniele
Published: December 2024

Background: Congenital coronary artery anomalies (CAAs) are a significant cause of sudden cardiac death and a key factor in determining athletes’ eligibility for competitive sports. Their prevalence varies with diagnostic modalities and may present as asymptomatic or with life-threatening ischemic or arrhythmic events. This case series highlights the diverse manifestations of CAAs and the clinical approaches used to determine sports eligibility. Cases description: Five competitive athletes with different CAAs are presented. These cases include anomalous coronary origins, intramyocardial bridges, and coronary fistulas. Diagnostic tools, including coronary CT angiography (CCTA), cardiac magnetic resonance imaging (CMR), and stress tests, were essential in evaluating these anomalies and determining treatment strategies. In some cases, such as intramyocardial bridges, surgical intervention was necessary, while others required conservative management or exclusion from competitive sports. Conclusions: CAAs require individualized care based on risk stratification through advanced imaging techniques and functional assessment. Surgical interventions are reserved for high-risk anomalies, while others may be managed conservatively. Early detection and tailored management are crucial for ensuring athletes’ safety, and ongoing research is needed to optimize long-term outcomes.
Papillary Muscles of the Left Ventricle: Integrating Electrical and Mechanical Dynamics
Authors: Eötvös Csilla Andrea , Avram Teodora , Lazar Roxana Daiana , Zehan Iulia Georgiana , Moldovan Madalina Patricia , Schiop-Tentea Patricia , Coseriu Giorgia , Sarb Adriana , Gusetu Gabriel , Buzdugan Elena , Chiorescu Roxana , Mocan-Hognogi Diana , Pop Sorin , Heist E. Kevin , Blendea Dan
Published: December 2024

Background: Papillary muscles are structures integrated into the mitral valve apparatus, having both electrical and mechanical roles. The importance of the papillary muscles (PM) is mainly related to cardiac arrhythmias and mitral regurgitation. The aim of this review is to offer an overview of the anatomy and physiology of the papillary muscles, along with their involvement in cardiovascular pathologies, including arrhythmia development in various conditions and their contribution to secondary mitral regurgitation. Methods: A literature search was performed on PubMed using the following relevant keywords: papillary muscles, mitral valve, arrhythmia, anatomy, and physiology. Results: During the cardiac cycle, papillary muscles have continuous dimensional and pressure changes. On one hand, their synchrony or dyssynchrony impacts the process of mitral valve opening and closure, and on the other hand, the pressure changes can trigger electrical instability. There is increased awareness of papillary muscles as an arrhythmic source. Arrhythmias arising from PM were found in patients with or without structural heart disease, via Purkinje fibres, due to increased automaticity or triggered activity. Conclusions: Despite the interest in mitral valve physiology, there are still many unknowns in relation to the papillary muscles, especially with regard to their role in arrhythmogenesis and the pathogenesis of mitral regurgitation.
Does Radioactive Iodine Treatment Affect Thyroid Size and Tracheal Diameter?
Authors: Yazici Demir Kadriye , Kaya Zulkuf , Dayanan Ramazan , Mercantepe Tolga , Mercantepe Filiz
Published: December 2024

Background/Objectives: There exist three principal treatment modalities employed in the management of hyperthyroidism attributable to excessive hormone secretion by the thyroid gland: antithyroid pharmacotherapy, surgical intervention, and radioactive iodine (RAI) therapy. Surgical intervention is typically indicated for markedly enlarged thyroid glands that exert pressure on the trachea. The objective of this investigation was to ascertain the influence of RAI on thyroid volume and tracheal diameter. Methods: This study included 20 patients, six females and 14 males, who received 20 mCi radioactive iodine treatment for toxic nodular goiter at a tertiary university hospital between March 2019 and February 2020. Pre-treatment and six-month post-treatment neck MRI scans were conducted on the cohort. Thyroid and tracheal volumes were quantified using the Cavalieri method based on MRI sections, and comparisons were conducted pre-and post-treatment. Statistical analysis of the comparative values was performed using the dependent samples t-test. Results: A statistically significant reduction in thyroid volume was observed among the 20 patients, averaging a decrease of 36.06% following RAI treatment compared to baseline measurements (p < 0.001). Additionally, an average increase of 12.76% in tracheal volume was noted post-treatment in comparison to initial measurements, which was also statistically significant (p < 0.05). None of the patients exhibited respiratory distress in the immediate postoperative period. Conclusions: The findings indicate that RAI therapy leads to a reduction in thyroid size, accompanied by an increase in tracheal diameters subsequent to treatment. Given the potential complications and risks associated with surgical intervention, it may be prudent to consider large thyroids for RAI therapy as an alternative to surgery.
The Role of Rapid Maxillary Expansion in the Management of Obstructive Sleep Apnoea: Monitoring Respiratory Parameters—A Systematic Review and Meta-Analysis
Authors: Hariharan Aniruddh , Muwaquet Rodriguez Susana , Hijazi Alsadi Tawfiq
Published: December 2024

Background/Objectives: Obstructive sleep apnoea (OSA) is a sleep-related breathing condition that involves the presence of episodic disruptions to the sleeping pattern due to partial or complete airway obstruction. There are a range of treatment options that exist to alleviate the symptoms of this condition including CPAP, mandibular advancement, and maxillary expansion techniques. This systematic review and meta-analysis of published articles aims to determine if rapid maxillary expansion (“RME”) is an effective treatment option in the management of OSA, using quantitative parameters of AHI and SpO2. Methods: An exhaustive review of the literature was conducted on EBSCO, PubMed, and Scopus databases. The PICO question for the systematic review was “Can rapid maxillary expansion be used as a viable treatment option using comparative AHI and SpO2 parameters in the management of obstructive sleep apnoea?” A meta-analysis was also performed and the software used to carry out the meta-analysis was R 4.3.2 (R Core Team (2013)). Results: From the initial search, 62 articles were found and a further 4 articles were obtained from manual findings. Nine articles were included in the final systematic review and meta-analysis. Eight of the studies concluded that RME was successful to varying degrees in the management of OSA across both outcome variables assessed. The meta-analysis indicated that RME is an effective treatment option in the management of adult and paediatric OSA with the improvement of both parameters. The paediatric OSA sample with specific pre-treatment anatomical presentation (clear maxillary deficiency, narrow hard palate with crossbite) showed a noted resolution of OSA following RME at a pre-pubertal age, indicating that RME can be employed as a genuine treatment option for paediatric OSA as suggested by theory. Conclusions: The systematic review and meta-analysis provided sufficient significant data in favour of the alternative hypothesis to indicate that RME is an effective treatment option in the management of obstructive sleep apnoea, in terms of the AHI reduction and SpO2 increase.
Systemic Lupus Erythematosus (SLE) Induced by ASIA Syndrome After the Aesthetic Medicine Procedures—A Case Report
Authors: Knapik Michalina , Owczarczyk-Saczonek Agnieszka , Jaśkiewicz Łukasz , Kuna Jakub , Chmielewski Grzegorz , Krajewska-Włodarczyk Magdalena
Published: December 2024

Introduction: The autoimmune/inflammatory syndrome induced by adjuvants (ASIA) is a rare condition caused by an immune response associated with over-reactivity of the immune system, triggered by adjuvants. The most common adjuvants are aluminium salts but can also be bioimplants or infectious agents. It may lead to the development of various autoimmunologic diseases. Case Report: In the following article, we present the case of a 26-year-old woman who developed SLE likely induced by ASIA syndrome after the aesthetic medicine procedures. The patient was admitted because of arthralgia and fever. She also presented with a butterfly-shaped erythema on her face and erythematous and infiltrative skin lesions on the posterior surface of the thighs and buttocks. We performed numerous diagnostic tests, including laboratory tests, immunological tests, imaging diagnostics such as chest X-ray and USG of the abdomen and joints, and the biopsy of the skin lesion on the left thigh. The results of the diagnostic process led us to diagnose SLE. The patient fulfilled the ACR/EULAR 2019 classification criteria of the SLE. Laboratory results also led to the diagnosis of autoimmune haemolytic anaemia. Due to exposure to numerous adjuvants like tattoo ink, hyaluronic acid, and piercing and the development of the delayed inflammatory reaction (DIR) to hyaluronic acid (HAF), the patient also fulfilled the criteria of ASIA. In the treatment process we applied antibiotics, non-steroidal anti-inflammatory drugs (NSAIDs), steroids, hydroxychloroquine, and cyclosporine. The treatment resulted in an improvement in the general condition, resolution of swelling and joint pain, and improvement in skin lesions. Conclusions: ASIA syndrome after bioimplantation is still underdiagnosed, probably due to ignorance or diagnostic difficulties, as symptoms are uncharacteristic and there is no immunological marker for this syndrome. In addition, as in the presented case, it can develop several years after the procedure, and it is difficult for both patient and physician to become aware of the connection. Early diagnosis requires a multidisciplinary approach and may require immunosuppressive treatment in specific cases.
Relationship Between Inflammatory Readings and the Degree of Coronary Atherosclerosis (Pilot Study)
Authors: Liuizė (Abramavičiūtė) Agnė , Mongirdienė Aušra , Laukaitienė Jolanta
Published: December 2024

Background/Objectives: Some calculated total blood count readings are investigated as novel additional readings to help with evaluation of personalized CAD patients’ clinical management and prognosis. We aimed to investigate the association between readings such as NLR, MLR, PLR, NMR, LMR, MHR, SII, and SIRI and the severity of CAD in patients with SAP. Methods: This retrospective pilot study included 166 patients. All patients underwent CA or CCTA, or both, to assess severity of CAD. Patients were divided three ways: (1) according to presence (n = 146) or absence (n = 20) of CAD; (2) according to Gensini score; (3) according to the CAD-RADS score. Results: Patients with CAD had lower LMR, higher NLR, SIRI, MLR, and SII compared to patients without CAD (p < 0.001 and p = 0.018, respectively for SII). According to the CAD severity by Gensini score, the NLR, MLR, SII, and SIRI values increase and LMR decreases gradually with severity of CAD (p < 0.001). A moderate correlation was found between SII (r = 0.511, p < 0.001), NLR (r = 0.567, p < 0.001), and SIRI (r = 0.474, p < 0.001) and severity of CAD according to Gensini score. MLR and LMR had a low corelation with severity of CAD according to Gensini score (r = 0.356, p < 0.001; r = −0.355, p < 0.001, respectively). The CAD-RADS score weakly correlated with NLR and MHR (r = 0.365, p < 0.001; r = 0.346, p < 0.001, respectively), and moderately with LMR, MLR, and SIRI (r = −0.454, p < 0.001; r = 0.455, p < 0.001; r = 0.522, p < 0.001, respectively). Conclusions: NLR, LMR, and SIRI appear to be potential predictors of chronic inflammation, and SIRI is the best predictor of the degree of atherosclerosis of all the other assessed blood parameters.
Severe Microbial Keratitis in Virgin and Transplanted Cornea—Probability of Visual Acuity Improvement
Authors: Przybek-Skrzypecka Joanna , Ryk-Adamska Małgorzata , Szewczuk Alina , Skrzypecki Janusz , Izdebska Justyna , Udziela Monika , Rypniewska Anna , Suh Leejee H. , Szaflik Jacek P.
Published: December 2024

Purpose: To evaluate visual acuity improvement and identify contributing factors in patients with severe keratitis affecting both virgin and transplanted corneas, treated at a hospital. Methods: A retrospective analysis was conducted on 497 patients with unilateral corneal ulcers treated at a tertiary referral center between 2008 and 2023. Data included distance (BCVA) and near best-corrected visual acuity at initial presentation and at discharge, treatments before hospital admission, demographic details, risk factors, clinical signs and symptoms, ancillary test results, and management strategies. Patients were categorized into two groups: Group A (naïve corneal ulcers, 379 patients) and Group B (post-keratoplasty infectious keratitis, 118 patients). Additional analysis focused on patients with presenting visual acuity of at least 1.0 logMAR (≤5/50 Snellen charts = legal blindness) to predict final visual outcomes. Results: The median BCVA at presentation for the entire cohort was 1.9 logMAR, advancing to 1.5 logMAR at discharge (p < 0.001). At least one line improvement in BCVA was observed in 47% of patients (52% of naïve cornea and 33% of transplanted cornea patients). Significantly worse results were observed in Group B were observed for BCVA at presentation, BCVA improvement, and distance and near vision improvement. Among patients with legal blindness at presentation, vision status improved for 52/379 (14%) in Group A and 6/118 (5%) in Group B during hospital admission (p < 0.001), while 67% of the cohort was discharged with VA equal or worse than 5/50. The average hospital stay was 9 days. Near visual acuity got better in 23% of patients (27% in Group A vs. 9% in Group B). A multivariate regression model showed that older age and worse distance BCVA on admission were independent negative predictors of improvement (p < 0.001, p < 0.001, respectively) while midperiphery ulcers were associated with better visual outcomes. Conclusions: Hospital admission leads to BCVA improvement in 47% of the patients with severe corneal ulcer, though the prognosis is significantly worse for those with post-keratoplasty microbial keratitis. At discharge, 67% of patients remained at the legal blindness level. Older age and lower BCVA at first presentation are associated with worse prognosis, while ulcers located in the corneal midperiphery are linked to better visual outcomes.
Demographic Characteristics and Treatment Outcomes of Intracranial Atherosclerosis Stenting: A Retrospective Case-Series of 216 Consecutive Patients
Authors: Sarshayev Marat , Turdaliyeva Botagoz , Tanbayeva Gulnur , Makhanbetkhan Shayakhmet , Mussabekov Maxat , Davletov Dimash , Maidan Aiman , Berdikhojayev Mynzhylky
Published: December 2024

Background/Objectives: Intracranial atherosclerosis (ICAS) is a major cause of ischemic stroke, disproportionately affecting populations with significant vascular risk factors. Although ICAS imposes a considerable health burden, research on this condition in Central Asia remains scarce, especially among the Kazakh population. This study analyzes demographic characteristics, treatment outcomes, and procedural challenges associated with ICAS in 216 patients treated at a single institution. Methods: This retrospective study included patients with ≥70% intracranial artery stenosis confirmed by imaging and presenting with ischemic symptoms. All patients underwent angioplasty and stenting with dual antiplatelet therapy (DAPT). Data collected included demographics, comorbidities, stenosis characteristics, procedural details, and outcomes assessed by the modified Rankin Scale (mRS). Results: The median age was 63.5 years (IQR: 57–68.6), and 73.7% were male. Hypertension was the most common comorbidity (98%), followed by ischemic heart disease (58%) and diabetes mellitus (40.9%). Multi-location ICAS was significantly associated with patients over 75 years of age (p = 0.025). Additionally, obesity and stenosis severity greater than 70% showed trends toward significance, with p-values of 0.064 and 0.079, respectively. Stenosis predominantly affected the internal carotid artery (54.5%) and vertebrobasilar system (31.6%). The average hospital stay was longer for posterior circulation stenosis (7.1 days) compared to anterior circulation (4.7 days). The periprocedural complication rate was 0.7%, with two deaths attributed to ischemic complications. At follow-up, four patients experienced worsening mRS scores (>2), particularly those with severe stenosis in the basilar artery and M1 segment. Conclusions: ICAS in the Kazakh population is strongly associated with hypertension and aging, with posterior circulation stenosis contributing disproportionately to worse outcomes. The low complication rates highlight the safety of modern endovascular techniques. However, further research is needed to optimize treatment strategies for severe and multi-location ICAS, particularly in Central Asian populations.
Efficacy and Safety of Three Cycles of TIP and Sequential High Dose Chemotherapy in Patients with Testicular Non-Seminomatous Germ Cell Tumors
Authors: Aykan Musa Baris , Yildiran Keskin Gulsema , Erturk İsmail , Acar Ramazan , Kose Ahmet Fatih , Karadurmus Nuri
Published: December 2024

Background: Salvage treatment options have not been validated in relapsed or refractory germ cell tumors. Moreover, the study populations including these patients have different heterogeneities. This study aimed to evaluate the efficacy and safety of three cycles of TIP sequential high-dose chemotherapy in patients with testicular non-seminomatous germ cell tumors who relapsed or had a refractory course after first-line platinum-based chemotherapy. Methods: Data of 141 patients who underwent three cycles of TIP followed by HDCT due to relapsed/refractory gonadal NSGCTs after first-line cisplatin-based chemotherapy (BEP/EP) at Gulhane School of Medicine Hospital Medical Oncology Department between January 2017 and May 2024 were evaluated retrospectively. Patients underwent a treatment regimen consisting of two phases. Initially, they received three cycles of induction therapy using a combination known as TIP, which includes paclitaxel, ifosfomide, and cisplatin. Following this, they were given a single cycle of high-dose chemotherapy. Demographic and clinicopathological features of patients and treatment-related complications and survival outcomes were recorded. Results: Median follow-up for all patients was 35.2 (95% CI, 29.45 to 41.07) months. Complete Response (CR) or marker negative Partial Response (PR) after HDCT was achieved in 84 (59.6%) patients. Median time for PFS not reached (NR) (95% CI, NR) in the entire group. The 2-year PFS rate was 51.8%. Median time for OS not reached (95% CI, NR) and the 2-year OS rate was 72.3%. The most common myelotoxicity observed after HDCT until engraftment was grade 4 neutropenia (100%) and grade 4 thrombocytopenia (96.5%). Transplantation-related mortality occurred in 7.1% of patients. Variables that remained statistically significant in multivariable analysis and were associated with poor prognosis for overall survival were platinum refractory disease and AFP and/or beta HCG elevation. Conclusions: Significant survival can be achieved after three cycles of TIP consecutive HDCT, while treatment-related mortality was found to be low.
Contemporary Management of the Aortic Valve—Narrative Review of an Evolving Landscape
Authors: Lella Srihari K. , Ferrell Brandon E. , Sugiura Tadahisa
Published: December 2024

Background: Aortic valve replacement has undergone novel changes in recent decades, providing not only a multitude of procedural options but expanding the treatable patient population. Specifically, a number of minimally invasive and interventional treatment options have allowed for the treatment of high and prohibitive risk surgical patients. Further, technology is allowing for the development of innovative surgical and transcatheter valve models, which will advance the treatment of aortic valve disease in the future. Objective: Here, we choose to describe the modern aortic valve replacement techniques and the available valves and designs.
Determinants of Sexual Dysfunction in Parkinson’s Disease Patients: A Secondary Analysis of a Multicenter Cross-Sectional Study
Authors: Manuli Alfredo , Maggio Maria Grazia , De Pasquale Paolo , Raciti Loredana , Filoni Serena , Portaro Simona , Pucciarelli Gianluca , Calabrò Rocco Salvatore
Published: December 2024

Background: Sexual dysfunction (SD) in Parkinson’s Disease (PD) patients is a common and distressing concern, although it remains an underdiagnosed and undertreated condition. Indeed, the prevalence of SD in PD ranges from 42.6% to 79% in men and from 36% to 87.5% in women. PD-related SD etiology is multifactorial and includes biological, psychological, and socio-relational factors. In a previous multicenter study on 203 PD patients, we found that there was no gender difference in dysfunction severity, although men were significantly more affected by SD than women. Methods: This paper is a secondary analysis of this previous multicenter study, and aims to investigate the potential risk factors that contribute to SD. The relationship between dysfunction and the experimental factors was assessed using Generalized Linear Mixed-Effects (GLME) model. Results: The final analysis was conducted on a sample of 177 patients (76 women), after excluding individuals with incomplete data, non-compliance with inclusion criteria, or delays in assessment tool administration. The analysis, performed using the GLME model (R2 = 0.68), revealed that gender (p = 0.01), age (p = 0.02), and depression status (HAMD) (p = 0.01) were significant predictors of SD. In contrast, other factors considered in the model, such as diabetes, and autonomic symptoms, did not significantly influence SD. Conclusions: This study demonstrates that age, gender, and depression are important predictors of SD in patients with PD. Although SD is a common NMS in PD patients, it is often neglected in clinical practice and the research on this hot topic is still poor. Then, a multidisciplinary approach, including nursing and coaching, is mandatory in order to improve sexual health in this patient population.
The Impact of Autonomic Nervous System Modulation on Heart Rate Variability and Musculoskeletal Manifestations in Chronic Neck Pain: A Double-Blind Randomized Clinical Trial
Authors: Alkhawajah Hani A. , Alshami Ali M. Y. , Albarrati Ali M.
Published: December 2024

Background: The role of autonomic nervous system (ANS) modulation in chronic neck pain remains elusive. Transcutaneous vagus nerve stimulation (t-VNS) provides a novel, non-invasive means of potentially mitigating chronic neck pain. This study aimed to assess the effects of ANS modulation on heart rate variability (HRV), pain perception, and neck disability. Methods: In this double-blind randomized clinical trial, 102 participants with chronic neck pain were randomly allocated to one of three groups: t-VNS plus standard-care physiotherapy (SC-PT), heart rate variability biofeedback (HRV-BF) with SC-PT, or SC-PT alone. Interventions were administered three times weekly for 6 weeks. The following outcome measures were assessed at baseline and after 6 weeks: HRV, the visual analog scale (VAS), the pressure pain threshold (PPT), and the neck disability index (NDI). Results: The t-VNS group exhibited significant improvements compared to the HRV-BF and SC-PT groups. Specifically, t-VNS increased the RR interval (mean difference [MD] = 35.0 ms; p = 0.037) and decreased the average heart rate (MD = −5.4 bpm; p = 0.039). Additionally, t-VNS reduced the VAS scores (versus HRV-BF: MD = −0.8 cm, p = 0.044; SC-PT: MD = −0.9 cm, p = 0.018), increased the PPT (versus HRV-BF: MD = 94.4 kPa, p < 0.001; SC-PT (MD = 56.2 kPa, p = 0.001)), and lowered the NDI scores (versus HRV-BF: MD = −4.0, p = 0.015; SC-PT: MD = −5.9, p < 0.001). Conclusions: t-VNS demonstrated superior effectiveness compared to HRV-BF and SC-PT in regulating HRV, alleviating pain, and enhancing functional capabilities in individuals with chronic neck pain.
Renal T1 Times on Cardiac Magnetic Resonance Reflect Renal Dysfunction and Are Associated with Adverse Outcomes: Insights from an All-Comer Cohort
Authors: Lunzer Laura , Donà Carolina , Mascherbauer Katharina , Kronberger Christina , Nitsche Christian , Koschutnik Matthias , Poledniczek Michael , Harbich Paul Felix , Kaufmann Christoph , Pogran Edita , Kvakan Heda , Beitzke Dietrich , Loewe Christian , Geppert Alexander , Hengstenberg Christian , Kammerlander Andreas Anselm
Published: December 2024

Background: Renal disease is common in patients with cardiovascular disease (CVD) and is associated with adverse outcomes. Cardiac magnetic resonance (CMR) with advanced mapping techniques is the gold standard for characterizing myocardial tissue, and renal tissue is often visualized on these maps. However, it remains unclear whether renal T1 times accurately reflect renal dysfunction or predict adverse outcomes. Aim: To analyze the relationship between renal T1 times, renal dysfunction, and adverse outcomes. Adverse outcomes were defined as all-cause and cardiovascular death. Methods: Renal T1 times were measured in the native short-axis view in an all-comers cohort undergoing CMR. Renal function parameters were assessed at the time of CMR. Results: A total of 506 patients (mean age 60 ± 15 years, 53% male) were included in the analysis. A significant correlation was observed between log10 renal cortical T1 times and eGFR (r = −0.701, p < 0.001) and creatinine (r = 0.615, p < 0.001). Kaplan–Meier analysis showed an increased risk of all-cause (p < 0.001 by log-rank test) and cardiovascular mortality (p = 0.004 by log-rank test) in patients with renal cortical T1 times above the median. In the univariable Cox regression analysis, there was a significant association between renal cortical T1 times and increased risk of all-cause (HR = 1.73 [95% CI, 1.42–2.11] per every 100 ms increase p < 0.001) and cardiovascular mortality (HR = 1.41 [95% CI, 1.05–1.90] per every 100 ms increase, p = 0.021). This association remained statistically significant after adjustment for prespecified clinical factors (adjusted HR for all-cause death = 1.49 [95% CI, 1.10–2.02] per every 100 ms increase, p = 0.01; adjusted HR for cardiovascular death = 1.42 [95% CI, 1.05–1.90] per every 100 ms increase, p = 0.021). Conclusions: Our results indicate that there is a significant association between increased renal cortical T1 times and impaired renal function, as well as an increased risk of all-cause and cardiovascular mortality, although it should be noted that our results are preliminary and need to be validated in external cohorts performing renal biopsies.
Effectiveness of a Multicomponent Program for Fibromyalgia Patients in a Primary Care Setting (FIBROCARE Program): A Pragmatic Randomized Controlled Trial
Authors: Caballol Angelats Rosa , Gonçalves Alessandra Queiroga , Abellana Rosa , Carrasco-Querol Noèlia , Pàmies Corts Anna , González Serra Gemma , Gràcia Benaiges Dolors , Sancho Sol Maria Cinta , Fusté Anguera Immaculada , Chavarria Jordana Susana , Cuevas Baticón Blanca , Batlle Escolies Gemma , Fibla Reverté Maria , Espuny Vallés Noemí , Buera Pitarque Núria , Martí Cavallé Montserrat , Suazo Nuria Piñana , Estivill Bargalló Joan , López Guerrero Maria Àngels , López Guerrero Carolina , Pérez Acín Pilar , Matamoros Callarisa Immaculada , Baucells Jordi , Suazo Ciurana Adrià , Fernández-Sáez José , Dalmau Llorca M. Rosa , Berenguera Anna , Aguilar Martín Carina
Published: December 2024

Background/Objectives: Multicomponent, non-pharmacological therapies are the preferred first-line treatments for fibromyalgia (FM), but little is known about them in primary care settings. Our study assessed the effectiveness of the FIBROCARE Program in improving the quality of life, functional impact, mood, and pain of people with FM. Methods: We conducted a pragmatic, randomized controlled trial that was not blinded for both patients and the professionals delivering the treatments in the study groups. We compared a group receiving non-pharmacological multicomponent group therapy (MT) based on health education, physical exercise, and cognitive–behavioral therapy with another group receiving the usual clinical care. The MT group was treated in the primary care context in Catalonia (Spain) through 12 consecutive weekly sessions. Both groups were followed up with at the end of the MT group sessions and 6 and 12 months after the group sessions with the Short-Form 36 (SF-36) v2 Health Survey questionnaire, the Hospital Anxiety and Depression Scale (HADS-A and HADS-D), the Visual Analog Scale, and the Revised Fibromyalgia Impact Questionnaire (ClinicalTrials.gov: NCT04049006). Results: Improvements in pain intensity, functional impact, physical health, fatigue, and emotional problems that affect daily activities in the MT group lasted up to 12 months. Benefits measured by the SF-36 Mental Health dimension and the HADS-A subscale were lost after 6 months. Effects on the SF-36 Social Functioning dimension and HADS-D present at 6 months persisted for up to 12 months. Generally, the longer the time since the FM diagnosis, the better was a patient’s mood. Conclusions: The FIBROCARE Program effectively improves all the studied health outcomes except patient mood, since anxiety symptoms persist. The program should reinforce patient psychological support overall, focusing particularly on the years initially after diagnosis.
5-Year Mortality After Complex Displaced Proximal Humerus Fractures in Elderly Patients: Conservative Versus Reverse Total Shoulder Arthroplasty
Authors: Maman Gal , Chechik Ofir , Kazum Efi , Bivas Assaf , Maman Eran , Rotman Dani
Published: December 2024

Background: The mortality rate following proximal humerus fractures (PHFs) in elderly patients is increased, but currently, there are no medium-term studies comparing mortality following treatment with Reverse Total Shoulder Arthroplasty (RTSA) to non-surgical treatment. Methods: This retrospective study compares two groups of elderly patients (aged 75 to 95 at the time of injury) who were diagnosed with PHFs. A total of 79 patients (mean age: 83.1 ± 4.6) were treated conservatively between 2008 and 2010, a time when RTSA was not yet considered a treatment option, and 81 patients (mean age: 82.4 ± 4.4) underwent RTSA between 2012 and 2017. Also, 1-month, 1-year, and 5-year mortality rates were recorded. Results: The 1-month, 1-year, and 5-year mortality rates were 1.2%, 7.4%, and 33.3% in the RTSA group and 2.5%, 11.4%, and 38.0% in the non-surgical treatment group (p = 0.98, p = 0.55, p = 0.65). A subgroup analysis revealed that the mild difference between groups can be attributed to male patients only. Conclusions: This study explored the impact of RTSA versus non-surgical treatment on mortality in elderly patients with PHFs and found similar mortality rates over five years. Better segmentation of the patient population may reveal subgroups with different mortality patterns.
Ultrasonographic Evaluation of Solid Organ Sizes in Children with Primary Malnutrition: A Preliminary Study
Authors: Doğan Kamil , Güngör Şükrü , Doğan Adil , Karaküçük Seda Nida
Published: December 2024

Objectives: Malnutrition is a common health problem affecting overall body functions, growth, and development. The aim of the present study was to explore any potential changes in solid organ sizes due to malnutrition and, if so, their correlation with the degree of malnutrition. Materials and Methods: Solid organ sizes (liver, spleen, and kidneys) in patients with primary malnutrition were measured prospectively using ultrasonography. Results: A correlation was observed between changes in liver, spleen, and kidney sizes and left kidney parenchymal thickness and the degree of malnutrition in patients. Conclusions: The presence and degree of malnutrition were directly proportional to significant decreases in organ sizes. The present study is the first to reveal a positive correlation between anthropometric measurement Z scores and organ sizes.
Validation of an Eye–Foot Coordination Assessment Tool for Children in Dual-Task Condition
Authors: Andrade-Lara Karina Elizabeth , Serrano Huete Víctor , Atero Mata Eva , Párraga Montilla Juan Antonio , Herrador Sánchez Julio , Moreno Marín Asensio , Martínez Redondo Melchor , Pozas Daniel Manjón , Salas Sánchez Jesús , Lucena Zurita Manuel , Cabrera Linares José Carlos , Latorre Román Pedro Ángel
Published: December 2024

Background/Objectives: Eye–foot coordination is essential in sports and daily life, enabling the synchronization of vision and movement for tasks like ball control or crossing obstacles. This study aimed to examine both the validity and reliability of an innovative eye–foot coordination (EFC) test in a dual-task paradigm in children aged 6–11 years and the capacity of this test to discriminate between sex and age. Methods: A total of 440 schoolchildren aged 6–11 years participated in this cross-sectional study. A ball control test, involving kicking and catching, was used to assess EFC. The assessment included three conditions: without interference (WI), with auditory interference (AI), and with visual interference (VI). Results: The ICCs per the EFC test scores were 0.975 for foot successes (95% CI = 0.961–0.983; p < 0.001) and 0.747 for foot mistakes (95% CI = 0.611–0.835; p < 0.001). The SEM for the standing successes was 3.082 (10.81%), and the MDC was 4.860 (17.05%). For the standing mistakes, the SEM was 1.551 (19.33%) and the MDC was 3.452 (43.04%). Moreover, boys had a significantly higher number of successes in the WI, AI, and VI conditions (p < 0.001, respectively) than girls, although girls had more mistakes than boys only in the VI condition (p = 0.025). Conclusions: The EFC test showed adequate reliability and validity. Also, the EFC test showed that performance worsened with interference regardless of sex and age, especially in girls in the VI condition.
The Role of Modern Radiological Procedures in Diagnosing Blunt Liver Injuries Manifested by Upper Gastrointestinal Bleeding
Authors: Arkuszewski Piotr Tomasz , Rybicki Maciej Adam , Białas Bartłomiej , Szymczyk Konrad
Published: December 2024

Objectives: Posttraumatic upper gastrointestinal bleeding (UGIB) is a very rare consequence of blunt liver trauma. It can be quite a diagnostic challenge for clinicians, as it can clinically manifest many weeks after the trauma or be scantily symptomatic. Methods: The following article would like to provide an analysis of clinical cases of 13 patients following blunt liver injuries, the main symptoms of which was bleeding into the gastrointestinal tract through the biliary tree. The article is research of the published literature concentrating on the influence of modern diagnostic methods (scintigraphy, USG and CT) on the diagnosis and long-term survival of patients with haemobilia caused by blunt liver trauma. In each patient, the condition was presented with UGIB symptoms following blunt trauma, before initiation of operative treatment or before death. The cases were divided into 2 groups: prior to and after introduction of modern diagnostic procedures, and then compared together. Results: The study indicates that liver damage can cause symptoms of UGIB, even after minor abdominal trauma and with delayed and uncharacteristic symptoms. Conclusions: Modern diagnostic methods, such as ultrasound, scintigraphy and CT, make it easier to identify these injuries and choose appropriate treatment, reducing the risk of death.
Surgical Treatment of Early-Onset Scoliosis: Traditional Growing Rod vs. Magnetically Controlled Growing Rod vs. Vertical Expandable Prosthesis Titanium Ribs
Authors: Maccaferri Bruna , Vommaro Francesco , Cini Chiara , Filardo Giuseppe , Boriani Luca , Gasbarrini Alessandro
Published: December 2024

Objectives: Severe early-onset scoliosis (EOS) can be addressed by different growth-friendly approaches, although the indications of each technique remain controversial. The aim of this study was to compare, in a large series of patients, the potential and limitations of the different distraction-based surgical techniques to establish the most suitable surgical approach to treat EOS. Methods: We conducted a retrospective observational cohort study evaluating 62 EOS cases treated between January 2002 and December 2021 with a traditional growing rod (TGR), a magnetically controlled growing rod (MCGR) and vertical expandable prosthesis titanium ribs (VEPTR) at IRCSS Istituto Ortopedico Rizzoli, Bologna, Italy. The patients included had a mean age of 7 years and a mean follow-up of 36 months. The COBB angle was measured on x-rays at preoperative, early postoperative, and end of follow-up, and complications were recorded. Results: in our cohort, VEPTR was mainly used in congenital scoliosis (50% vs. a mean value of 25.8%) and syndromic scoliosis (42.9% vs. a mean value of 25.8%). MCGR was mainly used in idiopathic scoliosis (73.9% vs. an average value of 41.9%). TGR was mostly used in muscular neurology EOS (16% vs. an average value of 6.5%). The collected data show a similar deformity correction rate in growing-rod implants in VEPTR, TGR, and MCGR. The mean curve reduction was 25.8 95% CI (21.8–29.8) (p < 0.0005). Compared with preoperative measurements, significant differences in curve magnitude correction between subgroups occurred at the final treatment measurements, when patients with MCGR had a significantly larger correction (53.2° ± 20.84 in %33.9 con DS ± 14.27) than VEPTR (27.12°± 19.13 in %19.7° ± 13.7). Conclusions: Different growing-rod techniques are applied based on EOS etiology. While all EOS etiologies benefited from this surgical approach, congenital EOS had poorer results. Overall, MCGR has been the preferred option for idiopathic EOS and appears to be the most effective in correcting the primary curve.
Gross Motor Development by Age and Functional Level in Children with Cerebral Palsy from 6 Months to 17 Years—A Norwegian Population-Based Registry Study
Authors: Jahnsen Reidun Birgitta , Weedon-Fekjar Harald , Myklebust Gerd , Storvold Gunfrid Vinje
Published: December 2024

Background: Cerebral palsy is a complex lifespan disability caused by a lesion to the immature brain. Evaluation of interventions for children with cerebral palsy requires valid and reliable outcome measures. Motor development curves and reference percentiles for The Gross Motor Function Measure (GMFM-66) are valuable tools for following, predicting, comparing, and evaluating changes in gross motor skills. The aims of this study were to create motor development curves with reference percentiles based on Norwegian data and compare them with published counterparts for Canadian children aged 2–21 years. Method: Prospective population-based cohort data from the Norwegian Quality and Surveillance Registry for Cerebral Palsy (NorCP) for 1206 children with 3612 GMFM-66 tests between 0.5 and 17.3 years of age. Median development by Gross Motor Function Classification System (GMFCS) levels was estimated using a generalized additive regression model with smoothed parameters for location, scale, and shape (based on the R GAMLSS library). To adjust for repeated individual measurements, we report the median curve of 100 random samples with only one observation per observed child. Results: The Norwegian motor development curves for GMFCS levels I–IV increase up to 7 years of age before flattening off, while GMFCS level V curves are relatively flat. Overall, both motor development curves and GMFM-66 percentiles are very similar to Canadian counterparts. Conclusions: The existing Canadian reference curves are valid also for Norway, working well for both clinical and research applications. However, Norwegian percentiles can be used from an earlier age.