Exploring Blood Cell Count-Derived Ratios as Practical Diagnostic Tools for Scabies in Vulnerable Populations.

Scabies is a neglected tropical disease and represents a considerable global burden. Although consensus diagnostic criteria for scabies have been recently published, diagnosing scabies infestation remains challenging in clinical practice. We investigated the diagnostic utility of complete blood cell count (CBC) and CBC-derived ratios obtained at diagnosis in a set of 167 patients who are Vietnamese with confirmed scabies. These parameters were compared with those of patients with dermatophytosis (N = 800) and urticaria (N = 2023), two diseases frequent in Vietnam, which can present with similar skin manifestations to scabies and tend to pose a diagnostic challenge in vulnerable populations. Our analysis revealed that white blood cell, monocyte, and eosinophil counts were significantly higher among patients with scabies than the other two diseases. Similarly, the monocyte-to-lymphocyte ratio (MLR) and eosinophil-to-lymphocyte ratio (ELR) were significantly higher among patients with scabies. The optimal cut-off values to distinguish scabies from dermatophytosis and urticaria were 0.094 for ELR (sensitivity: 74.85%, specificity: 70.7%) and 0.295 for MLR (sensitivity: 52.69%, specificity: 73.54%). CBC, ELR, and MLR are low-cost and easily calculated parameters that may be helpful for the diagnosis of scabies.

The Kuchi-kara Taberu index as a predictive marker of oral intake recovery in patients with aspiration pneumonia.

AIM: In recent years, the Kuchi-kara Taberu (KT) index has been used as a new tool for the evaluation of dysphagia; however, its predictive ability remains unknown. This study was conducted to examine the validity of oral intake recovery prediction using the KT index in patients with aspiration pneumonia. METHODS: The subjects were older inpatients admitted to an acute-care hospital for the treatment of aspiration pneumonia. A logistic regression analysis was conducted to clarify factors significantly associated with oral intake recovery. In addition, cut-off values of the predictors were calculated using a receiver operating characteristic curve analysis with the area under the curve (P < 0.05). RESULTS: A total of 124 patients (mean age 84.3 ± 7.9 years old, 70 males, 54 females) were enrolled in this study and divided into two groups at discharge: the oral intake group (62.1%) and the non-oral intake group (37.9%). The significant predictors of the recovery of oral intake were the pre-treatment period, treatment period, and the total score of the KT index; the respective odds ratios were 1.082 (95% confidence interval [CI] 1.013-1.156), 1.018 (1.003-1.033) and 0.850 (0.780-0.927), and the respective areas under the curve were 0.407 (95% CI 0.300-0.515), 0.304 (0.208-0.399), and 0.732 (0.640-0.824). The cut-off value of the total score of the KT index was 30. The model showed 85.7% sensitivity and 57.4% specificity. CONCLUSION: The KT index is suggested to be a valid variable for predicting whether or not a patient with aspiration pneumonia can recover their oral intake ability during acute-care hospitalization. Geriatr Gerontol Int 2023; 23: 221-226.

The effects of the pressure on the coccygeal skin on the perception of backward-leaning sitting positions in stroke patients.

The present study investigated the effects of an additional pressure stimulus on coccygeal skin using an original tool to evaluate the perceptibility of sitting while leaning backward in 13 chronic stroke patients who were able to walk independently and 12 age-matched healthy subjects. Each participant's perception of the trunk reference angle at which they felt the highest-pressure stimulation of the coccygeal skin while leaning backward from a quiet sitting position was evaluated based on the accuracy of each reproduction under both normal and additional pressure conditions. The absolute error under the pressure condition was significantly smaller than that under the normal condition in the control group, while no marked difference between conditions was found in the stroke group. The relationship between the absolute error under the normal condition and the pressure effect index showed a significant negative correlation in the stroke group. In stroke patients with a high trunk position perceptibility under the normal condition, the additional pressure information may have functioned as a disturbance and reduced the position perceptibility. In contrast, stroke patients with a low perceptibility in the normal condition may have been able to re-weight and prioritize the additional pressure information in the reference frame. In the control group, the added pressure information may have been re-weighted as prior position information in the reference frame.

The role of the pressure information from the heel on the perception of the backward-leaning standing position.

The purpose of this study was to clarify the functional role of the heel pressure information for perceiving a backward-leaning position through a decrease in sensory information using local cooling on the heel in healthy participants (n = 11). The position of the center of pressure in the anteroposterior direction (CoPy position) while standing was represented as the percentage distance (%FL) from the hindmost point of the heel (0 %FL) in relation to the foot length. The most backward-leaning position was measured under cool-heel condition and normal-heel condition. The perceptibility of six reference positions (45 %FL, 40 %FL, 35 %FL, 30 %FL, 25 %FL, and 20 %FL) was evaluated with regard to the reproducibility of these positions under both heel conditions. The most backward-leaning position under cool-heel condition was located significantly further backward than that under normal-heel condition. The absolute error at 25 %FL under cool-heel condition was significantly larger than that under normal-heel condition. The sensory information from the heels may have a decisive meaning in the perception of the most backward-leaning position. At 25 %FL, there may be no other sources of sensory information for sensory reweighting aside from the heel pressure for position perception under cooled condition.

Host-microbe interactions in the pathogenesis and clinical course of sarcoidosis.

Sarcoidosis is a rare inflammatory disease characterized by the development of granulomas in various organs, especially in the lungs and lymph nodes. Clinics of the disease largely depends on the organ involved and may range from mild symptoms to life threatening manifestations. Over the last two decades, significant advances in the diagnosis, clinical assessment and treatment of sarcoidosis have been achieved, however, the precise etiology of this disease remains unknown. Current evidence suggests that, in genetically predisposed individuals, an excessive immune response to unknown antigen/s is crucial for the development of sarcoidosis. Epidemiological and microbiological studies suggest that, at least in a fraction of patients, microbes or their products may trigger the immune response leading to sarcoid granuloma formation. In this article, we discuss the scientific evidence on the interaction of microbes with immune cells that may be implicated in the immunopathogenesis of sarcoidosis, and highlight recent studies exploring potential implications of human microbiota in the pathogenesis and the clinical course of sarcoidosis.

Gnetin-C and other resveratrol oligomers with cancer chemopreventive potential.

Resveratrol has been extensively studied to investigate its biological effects, including its chemopreventive potential against cancer. Over the past decade, various resveratrol oligomers, both naturally occurring and synthetic, have been described. These resveratrol oligomers result from the polymerization of two or more resveratrol units to form dimers, trimers, tetramers, or even more complex derivatives. Some oligomers appear to have antitumor activities that are similar or superior to monomeric resveratrol. In this review, we discuss resveratrol oligomers with anticancer potential, with emphasis on well-characterized compounds, such as the dimer gnetin-C and other oligomers from Gnetum gnemon, whose safety, pharmacokinetic, and biological activities have been studied in humans.

The Repeated Administration of Resveratrol Has Measurable Effects on Circulating T-Cell Subsets in Humans.

Preclinical studies have shown that resveratrol exerts immunomodulatory effects with potential clinical value in the amelioration of autoimmune disorders and cancer prevention; however, little is known about the in vivo effects of this naturally occurring polyphenol on human immune cells. We assessed the effects of repeated doses of resveratrol (1000 mg/day for 28 days) on circulating immune cells in healthy Japanese individuals. Resveratrol was safe and well tolerated and was associated with significant increases in the numbers of circulating γδ T cells and regulatory T cells and resulted in small, yet significant, decreases in the plasma levels of the proinflammatory cytokines TNF-α and MCP-1 and a significant increase in the plasma antioxidant activity compared with the corresponding antioxidant baseline activity and with that in four control individuals. In in vitro studies, resveratrol significantly improved the growth of γδ T cells and regulatory T cells. These findings demonstrate that resveratrol has some clear biological effects on human circulating immune cells. Further studies are necessary to interpret the long-term immunological changes associated with resveratrol treatment.