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BACKGROUND: Abdominal aortic aneurysm (AAA) poses a considerable global health challenge; however, population-based studies on AAA are scarce. The current study determined the hospitalization rates, surgical trends, mortality, and reintervention rates for ruptured (r-AAA) and nonruptured (nr-AAA) AAA by using a national health insurance database. METHODS: We conducted a population-based retrospective cohort study by analyzing data from 2007 to 2018 from the Taiwanese National Health Insurance Research Database. Individuals over 20 years of age with a new diagnosis of AAA were included in this study. RESULTS: A total of 70 457 patients were given a diagnosis of aortic aneurysm or dissection over the study period; 22 538 (32%) adult patients (≥20 years) had AAA. The annual incidence of AAA was approximately 7.7 to 10.3 per 100 000 (r-AAA: 0.8-1.3 per 100 000 versus nr-AAA: 6.8-9.0 per 100 000). Most of the patients with AAA were older adults (85%); 15 392 (68%) patients had a documented hospitalization, and 4885 (32%) underwent surgery within 14 days of diagnosis. The percentage of patients receiving endovascular aneurysm repair (EVAR) increased from 28% to 96% over the study period. The long-term survival rates were higher among the patients who underwent open surgical repair (OSR) compared with those of the patients who received EVAR or conservative treatment, regardless of whether they had r-AAA or nr-AAA. CONCLUSION: AAA is more common among older individuals, and the annual standardized incidence indicates a downward trend. Since the introduction of EVAR, the proportion of patients undergoing EVAR has continually increased, whereas that of those undergoing OSR have decreased. Although EVAR and OSR were both associated with lower mortality rates among patients with r-AAA, OSR resulted in better long-term survival outcomes.
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Electric cell-substrate impedance sensing has been used to measure transepithelial and transendothelial impedances of cultured cell layers and extract cell parameters such as junctional resistance, cell-substrate separation, and membrane capacitance. Previously, a three-path cell-electrode model comprising two transcellular pathways and one paracellular pathway was developed for the impedance analysis of MDCK cells. By ignoring the resistances of the lateral intercellular spaces, we develop a simplified three-path model for the impedance analysis of epithelial cells and solve the model equations in a closed form. The calculated impedance values obtained from this simplified cell-electrode model at frequencies ranging from 31.25 Hz to 100 kHz agree well with the experimental data obtained from MDCK and OVCA429 cells. We also describe how the change in each model-fitting parameter influences the electrical impedance spectra of MDCK cell layers. By assuming that the junctional resistance is much smaller than the specific impedance through the lateral cell membrane, the simplified three-path model reduces to a two-path model, which can be used for the impedance analysis of endothelial cells and other disk-shaped cells with low junctional resistances. The measured impedance spectra of HUVEC and HaCaT cell monolayers nearly coincide with the impedance data calculated from the two-path model.
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Impedância Elétrica , Células Endoteliais , Células Epiteliais , Microeletrodos , Cães , Animais , Humanos , Células Madin Darby de Rim Canino , Células Epiteliais/citologia , Células Epiteliais/fisiologia , Células Endoteliais/citologia , Células Endoteliais/fisiologia , Células Endoteliais da Veia Umbilical Humana , Linhagem Celular , Modelos BiológicosRESUMO
Hyaluronic acid/silk fibroin (HA/SF or HS) hydrogels with remarkable mechanical characteristics have been reported as tissue engineering biomaterials. Herein, the addition of dopamine/polydopamine (DA/PDA) to HS hydrogels to develop multifunctional HA/PDA/SF (or HDS) hydrogels for the delivery of drugs such as N-acetyl-L-cysteine (NAC) from nasal to brain tissue is examined. Herein, DA-dependent functions of HDS hydrogels with highly adhesive forces, photothermal response (PTR) effects generated by near infrared (NIR) irradiation, and anti-oxidative effects were demonstrated. An in-vitro study shows that the HDS/NAC hydrogels could open tight junctions in the RPMI 2650 cell line, a model cell of the nasal mucosa, as demonstrated by the decreased values of transepithelial electrical resistance (TEER) and more discrete ZO-1 staining than those for the control group. This effect was markedly enhanced by NIR irradiation of the HDS/NAC-NIR hydrogels. Compared to the results obtained using NAC solution, an in-vivo imaging study (IVIS) in rats showed an approximately nine-fold increase in the quantity of NAC delivered from the nasal cavity to the brain tissue in the span of 2 h through the PTR effect generated by the NIR irradiation of the nasal tissue and administration of the HDS/NAC hydrogels. Herein, dopamine-dependent multifunctional HDS hydrogels were studied, and the nasal administration of HDS/NAC-NIR hydrogels with PTR effects generated by NIR irradiation was found to have significantly enhanced NAC delivery to brain tissues.
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Fibroínas , Ratos , Animais , Acetilcisteína/farmacologia , Ácido Hialurônico/farmacologia , Dopamina/farmacologia , Hidrogéis/farmacologia , Cavidade Nasal , EncéfaloRESUMO
Background: Although the pathology and bacterial status of the "normal" bone stump after operation of diabetic foot osteomyelitis (DFO) are of great significance for the prognosis of foot wounds, there are only a few studies on this topic; hence, it is clinically relevant and urgent to study this topic. Methods: The data of 57 inpatients with DFO from June 2021 to April 2022 were collected, all of whom had DFO in the forefoot and underwent conservative surgery. After the surgical removal of necrotic bone, bone biopsies were taken from the necrotic phalangeal bone and the reserved "normal" metatarsal stump. They were cultured, after which antibiotic susceptibility test and pathological screening were carried out. According to clinical judgment, inpatients' wounds were divided into metatarsal affected group and metatarsal unaffected group. We then compared and analyzed the pathological and bacterial characteristics of preserved "normal" bone stump and its effect on wound healing and prognosis. Results: The poor concordance rate between deep soft tissue culture and infected phalange culture was only 19.3%. The deep soft tissue (72.6%), infected phalange (70.7%), and metatarsal stump (71.4%) were mainly infected with gram-negative Bacillus. The proportion of Enterococcus spp. increased significantly in bone tissue. Acinetobacter baumannii had the highest drug resistance (88%, 22/25). There was no significant difference in several clinical characteristics and wound healing regardless of whether their metatarsal stumps were affected. Most reserved "normal" metatarsal stumps (84.2%, 48/57) were positive by pathological diagnosis and bacterial culture testing; only 15.7% (9/57) samples were truly sterile. Only 8.3% (4/48) of the former patients healed within 6 months; whereas, all the latter (9/9) patients healed within 6 months. However, the majority (89.6%, 43/48) could heal. There was no difference in operations, skin grafting, negative pressure wound therapy, and mortality between the two groups. Conclusion: The most reserved "normal" metatarsal stumps have been invaded by bacteria. However, the majority stumps can be preserved, and the wound will eventually be healed according to the pathological and bacterial culture results.
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Diabetes Mellitus , Pé Diabético , Ossos do Metatarso , Osteomielite , Humanos , Pé Diabético/cirurgia , Ossos do Metatarso/cirurgia , Osteomielite/complicações , Osteomielite/cirurgia , Pé , CicatrizaçãoRESUMO
Sentinel lymph node (SLN) biopsy plays a critical role in axillary staging of breast cancer. However, traditional SLN mapping does not accurately discern the presence or absence of metastatic disease. Detection of SLN metastasis largely hinges on examination of frozen sections or paraffin-embedded tissues post-SLN biopsy. To improve detection of SLN metastasis, we developed a second near-infrared (NIR-II) in vivo fluorescence imaging system, pairing erbium-based rare-earth nanoparticles (ErNP) with bright down-conversion fluorescence at 1,556 nm. To visualize SLNs bearing breast cancer, ErNPs were modified by balixafortide (ErNPs@POL6326), a peptide antagonist of the chemokine receptor CXCR4. The ErNPs@POL6326 probes readily drained into SLNs when delivered subcutaneously, entering metastatic breast tumor cells specifically via CXCR4-mediated endocytosis. NIR fluorescence signals increased significantly in tumor-positive versus tumor-negative SLNs, enabling accurate determination of SLN breast cancer metastasis. In a syngeneic mouse mammary tumor model and a human breast cancer xenograft model, sensitivity for SLN metastasis detection was 92.86% and 93.33%, respectively, and specificity was 96.15% and 96.08%, respectively. Of note, the probes accurately detected both macrometastases and micrometastases in SLNs. These results overall underscore the potential of ErNPs@POL6326 for real-time visualization of SLNs and in vivo screening for SLN metastasis. SIGNIFICANCE: NIR-IIb imaging of a rare-earth nanoprobe that is specifically taken up by breast cancer cells can accurately detect breast cancer macrometastases and micrometastases in sentinel lymph nodes.
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Neoplasias da Mama , Linfonodo Sentinela , Animais , Camundongos , Humanos , Feminino , Metástase Linfática/diagnóstico por imagem , Metástase Linfática/patologia , Linfonodo Sentinela/diagnóstico por imagem , Linfonodo Sentinela/patologia , Neoplasias da Mama/patologia , Linfonodos/diagnóstico por imagem , Linfonodos/patologia , Micrometástase de Neoplasia/patologia , Biópsia de Linfonodo Sentinela/métodos , Estadiamento de Neoplasias , Axila/patologiaRESUMO
BACKGROUND: Sunlight contains ultraviolet B (UVB) radiation that triggers the production of vitamin D by skin. Vitamin D has widespread effects on brain function in both developing and adult brains. However, many people live at latitudes (about > 40 N or S) that do not receive enough UVB in winter to produce vitamin D. This exploratory study investigated the association between the age of onset of bipolar I disorder and the threshold for UVB sufficient for vitamin D production in a large global sample. METHODS: Data for 6972 patients with bipolar I disorder were obtained at 75 collection sites in 41 countries in both hemispheres. The best model to assess the relation between the threshold for UVB sufficient for vitamin D production and age of onset included 1 or more months below the threshold, family history of mood disorders, and birth cohort. All coefficients estimated at P ≤ 0.001. RESULTS: The 6972 patients had an onset in 582 locations in 70 countries, with a mean age of onset of 25.6 years. Of the onset locations, 34.0% had at least 1 month below the threshold for UVB sufficient for vitamin D production. The age of onset at locations with 1 or more months of less than or equal to the threshold for UVB was 1.66 years younger. CONCLUSION: UVB and vitamin D may have an important influence on the development of bipolar disorder. Study limitations included a lack of data on patient vitamin D levels, lifestyles, or supplement use. More study of the impacts of UVB and vitamin D in bipolar disorder is needed to evaluate this supposition.
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With the extensive application of halogenated aromatic compounds, including 2,4,6-Trichlorophenol (2,4,6-TCP), improper treatment or discharge contribute to persistently harmful effects on humans and the ecosystem, rendering the identification and monitoring of 2,4,6-TCP in the aquatic environment urgently required. In this study, a highly sensitive electrochemical platform was developed using active-edge-S and high-valence-Mo rich MoS2/polypyrrole composites. MoS2/PPy illustrates superior electrochemical performance and catalytic activity and has not been explored for detecting chlorinated phenols previously. The local environment of polypyrrole induces the richness of active edge S and a high oxidation state of Mo species in the composites, both of which endorse a sensitive anodic current response due to the favored oxidation of 2,4,6-TCP through nucleophilic substitution. Also, the higher complementarity between pyrrole and 2,4,6-TCP with respective electron-rich and electron-poor features through π-π stacking interactions enhances the specific detection capability of 2,4,6-TCP by the MoS2/polypyrrole-modified electrode. The MoS2/polypyrrole-modified electrode achieved a linear range of 0.1-260 µM with an ultralow limit of detection of 0.009 µM. Additionally, the structural stability boosted by the linkage of polypyrrole and MoS2 results in good resistance and satisfactory recovery in real water samples. The compiled results demonstrate that the proposed MoS2/polypyrrole composite opens up a new potential to advance a sensitive, selective, facile fabrication, and low-cost platform for the on-site determination of 2,4,6-TCP in aquatic systems. The sensing of 2,4,6-TCP is important to monitor its occurrence and transport, and can also serve to track the effectiveness and adjust subsequent remediation treatments applied to contaminated sites.
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Polímeros , Pirróis , Humanos , Polímeros/química , Pirróis/química , Molibdênio/química , Ecossistema , Eletrodos , Técnicas Eletroquímicas/métodosRESUMO
With the advent of precision medicine, next-generation sequencing (NGS) is playing an increasingly important role in clinical oncology diagnosis and treatment with its advantages of high sensitivity, high accuracy, high efficiency and operability. NGS reveals the genetic characteristics of acute leukemia(AL) patients by screening for specific disease-causing genes to identify occult as well as complex genetic mutations in patients with AL, leading to early diagnosis and targeted drug therapy for AL patients, as well as to predict disease recurrence by detecting mnimal residual disease (MRD) and analyzing mutated genes to determine patient prognosis. NGS plays an increasingly important role in the diagnosis, treatment and prognosis assessment in AL, providing a direction for the pursuit of precision medicine. This paper reviews the research progress of NGS in AL.
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Sequenciamento de Nucleotídeos em Larga Escala , Leucemia Mieloide Aguda , Humanos , Leucemia Mieloide Aguda/genética , Doença Aguda , Mutação , Recidiva , Neoplasia Residual/diagnóstico , Neoplasia Residual/genéticaRESUMO
Breast-conserving surgery (BCS) is the predominant treatment approach for initial breast cancer. However, due to a lack of effective methods evaluating BCS margins, local recurrence caused by positive margins remains an issue. Accordingly, radiation therapy (RT) is a common modality in patients with advanced breast cancer. However, while RT also protects normal tissue and enhances tumor bed doses to improve therapeutic effects, current radiosensitizers cannot meet these urgent clinical needs. To address this, a novel self-assembled multifunctional nanoprobe (NP) gadolinium (Gd)-diethylenetriaminepentaacetic acid-human serum albumin (HSA)@indocyanine green-Bevacizumab (NPs-Bev) is synthesized to improve the efficacy of fluorescence-image-guided BCS and RT. Fluorescence image guidance of the second near infrared NP improves complete resection in tumor-bearing mice and accurately discriminates between benign and malignant mammary tissue in transgenic mice. Moreover, targeting tumors with NPs induces more reactive oxygen species under X-ray radiation therapy, which not only increases RT sensitivity, but also reduces tumor progression in mice. Interestingly, self-assembled NPs-Bev using HSA, the magnetic resonance contrast agent and Bevacizumab-targeting vascular growth factor A, which are clinically safe reagents, are safe in vitro and in vivo. Therefore, the novel self-assembled NPs provide a solid precision therapy platform to treat breast cancer.
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Neoplasias da Mama , Humanos , Camundongos , Animais , Feminino , Neoplasias da Mama/radioterapia , Neoplasias da Mama/cirurgia , Bevacizumab/uso terapêutico , Verde de Indocianina/uso terapêutico , Imageamento por Ressonância Magnética/métodos , Espectroscopia de Ressonância MagnéticaRESUMO
As a critical transformational process in the attributes of epithelial cells, epithelial-to-mesenchymal transition (EMT) is involved in tumor invasion, metastasis, and resistance to treatment, which contributes to the ultimate death of some patients with breast cancer. Glycogen synthase kinase-3-beta (GSK3ß) is thought to be an EMT suppressor that down-regulates the protein, snail, a zinc finger transcription inhibitor, and regulates E-cadherin expression and the Wnt signaling pathway. Our previous studies have shown that Notch3 also inhibits EMT in breast cancer. In mammary gland cells, GSK3ß physically bound and phosphorylated the intracellular domain of two Notch paralogs: N1ICD was positively regulated, but N2ICD was negatively regulated; however, the relationship between Notch3, GSK3ß, and EMT in breast cancer is still unclear and crosstalk between Notch3 and GSK3ß has not been widely investigated. In this study, we revealed that Notch3 was an essential antagonist of EMT in breast cancer cells by transcriptionally upregulating GSK3ß. In breast cancer, MCF-7 and MDA-MB-231 cell lines, the silencing of Notch3 reduced GSK3ß expression, which is sufficient to induce EMT. Conversely, ectopic Notch3 expression re-activated GSK3ß and E-cadherin. Mechanistically, Notch3 can bind to the GSK3ß promoter directly and activate GSK3ß transcription. In human breast cancer samples, Notch3 expression is positively associated with GSK3ß (r = 0.416, p = 0.001); moreover, high expressions of Notch3 and GSK3ß mRNA are correlated to better relapse-free survival in all breast cancer patients via analysis in "the Kaplan-Meier plotter" database. In summary, our preliminary results suggested that Notch3 might inhibit EMT by trans-activating GSK3ß in breast cancer cells. The suppression of Notch3 expression may contribute to EMT by transcriptionally downregulating GSK3ß in breast cancer.
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Neoplasias da Mama , Transição Epitelial-Mesenquimal , Glicogênio Sintase Quinase 3 beta , Receptor Notch3 , Neoplasias da Mama/patologia , Caderinas/genética , Caderinas/metabolismo , Linhagem Celular Tumoral , Transição Epitelial-Mesenquimal/genética , Feminino , Glicogênio Sintase Quinase 3 beta/metabolismo , Humanos , Recidiva Local de Neoplasia , RNA Mensageiro , Receptor Notch3/genética , Via de Sinalização WntRESUMO
Background: The Quality of Life (QOL) in Life-threatening Illness-Family Carer Version (QOLLTI-F) has been proven to be a brief, reliable, and valid instrument for measuring the caregivers' QOL in western cultures. However, whether it is suitable to be used in Chinese culture is unclear. This study aimed to test the reliability and validity of the Chinese version of (QOLLTI-F-CV). Materials and methods: A total of 202 family caregivers (FCs) of advanced cancer patients from Fujian Provincial hospice care center were investigated using the Chinese version of QOLLTI-F-CV from September 2019 to August 2020. The questionnaire was evaluated using an exploratory structural equation model. Its psychometric properties were examined in terms of factor structure, convergent validity, discriminant validity, internal consistency, and test-retest reliability. Results: Differently from the seven-domain original QOLLTI-F, its Chinese version had only three domains including caregiver's self-feelings, caregiver's stress, and caregiver's outlooks. The total variance explanation rate for the domains was 55.4%. The Chinese version fitted well with the structure model (χ2 = 153.932, df = 75, P < 0.001); its comparative fit index (CFI) was 0.971; Tucker-Lewis index was 0.954; and the root mean square error of approximation (RMSEA) was 0.072. The success rate of its convergent and discriminant validity calibration test was 100%. Its Cronbach's alpha coefficient of the whole questionnaire and three domains was from 0.650 to 0.874, and test-retest reliability was 0.836. Conclusion: The 3-domain QOLLTI-F-CV is a valid and reliable instrument for identifying QOL concerns of FCs of advanced cancer patients in China. The refactoring structure optimally matches Chinese culture and value system well.
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This study investigated the effects of naringin on soybean and mung bean sprouts postharvest quality. It was found that naringin could maintain the appearance and quality of soybean sprouts and mung bean sprouts during a 6-day storage period as well as delay the occurrence of browning in mung bean sprouts and soybean sprouts. The optimal application rate of naringin was 50-100 µg/mL, which could effectively inhibit the activity of polyphenol oxidase (PPO) and peroxidase (POD) in bean sprouts and increase the ascorbic acid content, where this inhibition response to the browning of mung bean sprouts and soybean sprouts was significantly reduced. Naringin treatment increased gallic acid and p-coumaric acid content in mung bean sprouts as well as the daidzin and rutin content in soybean sprouts, which was also reflected in the improvement of antioxidant activity. The binding of naringin with PPO and POD was analyzed with molecular docking, naringin, and PPO had a lower binding energy (-1.09 Kcal/mol). In conclusion, naringin application in postharvest preservation of mung bean sprouts and soybean sprouts can maintain favorable consumer quality.
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Objective: Endometrial cancer is the most common malignancy of the female genital tract worldwide, and the associated relationship between endometrial cancer formation and various antipsychotics need to be confirmed. Methods: We conducted a case-control study by using data from Taiwan National Health Insurance Research Database to compare individual antipsychotic exposure between females with and without endometrial cancer. Among 14,079,089 females in the 12-year population-based national dataset, 9,502 females with endometrial cancer were identified. Their medical records of exposure to antipsychotics, including quetiapine, haloperidol, risperidone, olanzapine, amisulpride, clozapine, and aripiprazole, for up to 3 years before endometrial cancer diagnosis were reviewed. Daily dosage and cumulative exposure days were analyzed in the risky antipsychotic users. Additionally, the subsequent 5-year mortality rate of endometrial cancer among users of the risky antipsychotic were also analyzed. Results: Among endometrial cancer patients, the proportion of those who have used haloperidol before being diagnosed with endometrial cancer is significantly higher than other antipsychotic users. The significant odds ratio (OR) and a 95% confidence interval of 1.75 (1.31-2.34) were noted. Furthermore, haloperidol users were associated with a significantly higher 5-year mortality rate after getting endometrial cancer than non-users. Conclusion: There is a high correlation between the use of haloperidol and endometrial cancer formation. However, the underlying pathological biomechanisms require additional investigations.
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Recently, immune checkpoint therapy (ICT) represented by programmed cell death1 (PD-1) and its major ligands, programmed death ligand 1 (PD-L1), has achieved significant success. Detection of PD-L1 by immunohistochemistry (IHC) is a classic method to guide the treatment of ICT patients. However, PD-L1 expression in the tumor microenvironment is highly complex. Thus, PD-L1 IHC is inadequate to fully understand the relevance of PD-L1 levels in the whole body and their dynamics to improve therapeutic outcomes. Intriguingly, numerous studies have revealed that molecular imaging technologies could potentially meet this need. Therefore, the purpose of this narrative review is to summarize the preclinical and clinical application of ICT guided by molecular imaging technology, and to explore the future opportunities and practical difficulties of these innovations.
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Antígeno B7-H1 , Microambiente Tumoral , Humanos , Imuno-Histoquímica , Imagem Molecular , PrognósticoRESUMO
Magnetic resonance imaging-guided high-intensity focused ultrasound (MRI-guided HIFU) is a non-invasive strategy of diagnosis and treatment that is applicable in tumor ablation. Here, we prepared a multifunctional nanotheranostic agent (SSPN) by loading perfluorohexane (PFH) and superparamagnetic iron oxides (SPIOs) in silica lipid for MRI-guided HIFU ablation of tumors. PFH was introduced to improve the ablation effect of HIFU and the ultrasound (US) contrast performance. Due to its liquid-to-gas transition characteristic, it is sensitive to temperature. SPIOs were used as an MRI contrast agent. Silica lipid was selected because it is a more stable carrier material compared with normal lipid. Previous studies have shown that SSPNs have good biocompatibility, stability, imaging, and therapeutic effects. Therefore, this system is expected to develop an important therapeutic agent for MRI-guided HIFU therapy against tumors.
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Background: In the latest rankings, breast cancer ranks first in incidence and fifth in mortality among female malignancies worldwide. Early diagnosis and treatment can improve the prognosis and prolong the survival of breast cancer (BC) patients. The NIMA-related kinase (NEK), a group of serine/threonine kinase, is a large and conserved gene family that includes NEK1-NEK11. The NEK plays a pivotal role in the cell cycle and microtubule formation. However, an integrative analysis of the effect and prognosis value of NEK family members on BC patients is still lacking. Methods: In this study, the expression profiles of NEK family members in BC and its subgroups were analyzed using UALCAN, GEPIA2, and Human Protein Atlas datasets. The prognostic values of NEK family members in BC were evaluated using the Kaplan-Meier plotter. Co-expression profiles and genetic alterations of NEK family members were analyzed using the cBioPortal database. The function and pathway enrichment analysis of the NEK family were performed using the WebGestalt database. The correlation analysis of the NEK family and immune cell infiltration in BC was conducted using the TIMER 2.0 database. Results: In this study, we compared and analyzed the prognosis values of the NEKs. We found that NEK9 was highly expressed in normal breast tissues than BC, and NEK2, NEK6, and NEK11 were significantly highly expressed in BC than adjacent normal tissues. Interestingly, the expression levels of NEK2, NEK6, and NEK10 were not only remarkably correlated with the tumor stage but also with the molecular subtype. Through multilevel research, we found that high expression levels of NEK1, NEK3, NEK8, NEK9, NEK10, and NEK11 suggested a better prognosis value in BC, while high expression levels of NEK2 and NEK6 suggested a poor prognosis value in BC. Conclusion: Our studies show the prognosis values of the NEKs in BC. Thus, we suggest that NEKs may be regarded as novel biomarkers for predicting potential prognosis values and potential therapeutic targets of BC patients.
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Aneurisma da Aorta Torácica , Dissecção Aórtica , Implante de Prótese Vascular , Procedimentos Endovasculares , Dissecção Aórtica/diagnóstico por imagem , Dissecção Aórtica/cirurgia , Aneurisma da Aorta Torácica/diagnóstico por imagem , Aneurisma da Aorta Torácica/cirurgia , Humanos , Impressão Tridimensional , Estudos Retrospectivos , Stents , Resultado do TratamentoRESUMO
BACKGROUND: This study examined whether the hemoglobin concentration is correlated with the hippocampal volume using voxel-based morphometry (VBM). METHODS: This cross-sectional study included 1923 community dwellers, aged 40â89 years, from the sixth wave of the National Institute for Longevity Sciences, Longitudinal Study of Aging. The hemoglobin levels were determined through blood examination. The regional cortical volumes were evaluated using three-dimensional T1-weighted magnetic resonance images. Following preprocessing with a statistical parametric mapping software, a VBM analysis of covariance design was implemented to identify the regional gray matter volumes related to hemoglobin concentration, while adjusting for age, sex, education, body mass index, depressive symptoms, alcohol consumption status, smoking status, medical history, and the estimated glomerular filtration rate. RESULTS: VBM analysis revealed a significantly positive correlation between the hemoglobin concentration and gray matter volume in the bilateral anterior hippocampus and the amygdala clusters as well as in the cingulate and middle temporal gyri, cerebellum, and superior sagittal and transverse sinuses. CONCLUSIONS: The hemoglobin concentration could be positively associated with the hippocampal volume among community-dwelling middle-aged and older adults, which highlights the importance of monitoring the hemoglobin concentration in older adults to decrease the possibility of neurodegeneration.
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Vida Independente , Imageamento por Ressonância Magnética , Idoso , Encéfalo , Estudos Transversais , Hemoglobinas , Hipocampo/diagnóstico por imagem , Humanos , Estudos Longitudinais , Imageamento por Ressonância Magnética/métodos , Pessoa de Meia-IdadeRESUMO
BACKGROUND: Naja atra bites cause wound necrosis, secondary infection, and necrotizing soft tissue infection (NSTI) requiring repetitive surgeries. Little information is known about the predictors for surgery after these bites. MATERIALS AND METHODS: We retrospectively evaluated 161 patients envenomed by N. atra, 80 of whom underwent surgery because of wound necrosis and infection. We compared the patients' variables between surgical and non-surgical groups. To construct a surgical risk score, we converted the regression coefficients of the significant factors in the multivariate logistic regression into integers. We also examined the deep tissue cultures and pathological findings of the debrided tissue. RESULTS: A lower limb as the bite site, a ≥3 swelling grade, bullae or blister formation, gastrointestinal (GI) effects, and fever were significantly associated with surgery in the multivariate logistic regression analysis. The surgical risk scores for these variables were 1, 1, 2, 1, and 2, respectively. At a ≥3-point cutoff value, the model has 71.8% sensitivity and 88.5% specificity for predicting surgery, with an area under the receiver operating characteristic curve of 0.88. The histopathological examinations of the debrided tissues supported the diagnosis of snakebite-induced NSTI. Twelve bacterial species were isolated during the initial surgery and eleven during subsequent surgeries. DISCUSSION AND CONCLUSIONS: From the clinical perspective, swelling, bullae or blister formation, GI effects, and fever appeared quickly after the bite and before surgery. The predictive value of these factors for surgery was acceptable, with a ≥3-point risk score. The common laboratory parameters did not always predict the outcomes of N. atra bites without proper wound examination. Our study supported the diagnosis of NSTI and demonstrated the changes in bacteriology during the surgeries, which can have therapeutic implications for N. atra bites.