A Review and Bibliometric Analysis of Studies on Advances in Peripheral Nerve Regeneration.

Peripheral nerve injuries (PNIs) pose significant clinical challenges due to their complex healing processes and the often incomplete functional recovery. This review and bibliometric analysis aimed to provide a comprehensive overview of advancements in peripheral nerve regeneration research, focusing on trends, influential studies, and emerging areas. By analyzing 2921 publications from the Web of Science Core Collection, key themes such as nerve regeneration, repair, and the critical role of Schwann cells were identified. The study highlights a notable increase in research output since the early 2000s, with China and the United States leading in publication volume and citations. The analysis also underscores the importance of collaborative networks, which are driving innovation in this field. Despite significant progress, the challenge of achieving complete functional recovery from PNIs persists, emphasizing the need for continued research into novel therapeutic strategies. This review synthesizes current knowledge on the mechanisms of nerve regeneration, including the roles of cellular and molecular processes, neurotrophic factors, and emerging therapeutic approaches such as gene therapy and stem cell applications. Additionally, the study revealed the use of nanotechnology, biomaterials, and advanced imaging techniques, which hold promise for improving the outcomes of nerve repair. This bibliometric analysis not only maps the landscape of peripheral nerve regeneration research but also identifies opportunities for future investigation. This study has some limitations, including reliance on the Web of Science Core Collection, which may exclude relevant research from other databases. The analysis is predominantly English-based, potentially overlooking significant non-English studies. Citation trends might be influenced by shifting research priorities and accessibility issues, affecting the visibility of older work. Additionally, geographical disparities and limited collaboration networks may restrict the global applicability and knowledge exchange in this field.

Parkinson's Disease Treatment: A Bibliometric Analysis.

Parkinson's disease (PD) is a progressive neurodegenerative disorder marked by motor symptoms like bradykinesia, tremor, rigidity, and postural instability. Patients also experience non-motor symptoms that greatly affect their quality of life. The global prevalence of PD is increasing, especially among the elderly, necessitating effective treatment strategies. This review provides an overview of the current treatment modalities for PD, including pharmacological and surgical interventions, and employs a bibliometric analysis to evaluate the trends and impact of scientific research in this field. A comprehensive search of the Web of Science Core Collection (WoSCC) database was conducted on July 12, 2024, yielding 3,724 publications related to PD treatment. Bibliometric analysis was performed using Biblioshiny and VOSviewer to assess publication trends, impact, and collaborative networks. Metrics such as the number of publications, citations, h-index, and country/institutional contributions were analyzed to identify key areas of focus and influential research in PD treatment. The analysis revealed a significant increase in PD research output from 2000 onwards, peaking between 2011 and 2016. The United States led in research production, followed by China, Canada, and the United Kingdom. Key researchers included Lang AE, Okun MS, and Lozano AM, with the University of Toronto, University of California System, and Harvard University being the top contributing institutions. The study identified major trends in pharmacological treatments, such as dopamine replacement therapy and deep brain stimulation (DBS) as the most common surgical intervention. Bibliometric analysis highlighted significant international collaborations and identified influential studies shaping the current understanding and treatment of PD. This bibliometric analysis elucidated the trends and impacts of scientific contributions, emphasizing the prolific output from leading countries and institutions in relation to the treatment of Parkinson's disease. Take-home messages for the conclusion of our study are as follows: (1) this study found a substantial increase in Parkinson's disease (PD) research output from 2000 onwards, peaking around 2017-2018, (2) noted a decline in publication output post-2020, (3) the United States had the highest research output, followed by significant contributions from countries like China, Canada, and the United Kingdom, (4) international collaborations played a vital role in advancing PD research, (5) key researchers in the field were Lang AE, Okun MS, and Lozano AM, (6) and established institutions like the University of Toronto, Johns Hopkins University and Harvard University made substantial contributions to the field, emphasizing the role of leading academic centers in driving PD research.

[The association of job satisfaction with self-reported burnout among urologists with migration background working at German hospitals : Results of the EUTAKD study]. / Die Assoziation von beruflicher Zufriedenheit mit selbstberichtetem Burnout bei Urologen und Urologinnen mit Migrationshintergrund tätig an deutschen Kliniken : Ergebnisse der EUTAKD-Studie.

INTRODUCTION: Urologists with a migration background currently provide patient care in German hospitals. Study results on job satisfaction and burnout of this important professional group have not been available so far. MATERIALS AND METHODS: Between August and October 2020, a questionnaire (SurveyMonkey® with 101 items) was conducted among urologists with migration background working in German hospitals regarding professional satisfaction and a validated survey of burnout (Maslach Burnout Inventory), among others. The subject of this work was the association of job satisfaction with the critical thresholds of burnout in the domains of emotional exhaustion (EE), depersonalization (DP), and low personal accomplishment (PA). RESULTS: For this work, 68 questionnaires could be completely analyzed. Study participants were dominantly male (90%), between 30 and 39 years of age (69%), married (72%), and working full-time (94%). Above critical thresholds of high burnout in the EE, DP, and PA domains were 27.9% (n = 19), 35.3% (n = 24), and 73.5% (n = 50) of study participants. A sum score was formed from five of a total of 39 satisfaction items, which independently predicted the EE and DP endpoints and a combined EE and DP endpoint in well-adjusted regression models. For each individual score of the sum score (range 5-25 points), the probability of a critical burnout is reduced by a relative 57% (EE), 25% (DP), and 34% (combined endpoint). In contrast, permanent employment contract, the clinic position as senior physician or chief physician, working full-time, and a married marital status significantly reduced the critical PA domain. CONCLUSION: Several dimensions of professional satisfaction were identified, the improvement of which could contribute to a decrease in burnout among urologists with a migrant background. Future intervention studies aimed at improving job satisfaction must follow.

Psychosocial stressors and low birthweight in an urban population.

INTRODUCTION: Low birthweight is a major determinant of infant mortality, as well as a contributor to infant and childhood morbidity. A key issue is how to reduce the incidence of low birthweight in the United States. One emerging factor is exposure to psychosocial stressors. In this research, we evaluated the association between exposure to psychosocial stressors and low birthweight in a population of urban, low-income pregnant women. METHODS: Over 2,000 pregnant women 18 years of age and older were enrolled in this prospective study and recruited at their first prenatal care visit. We obtained information on maternal exposure to stressors. After the pregnancy, we abstracted clinical records of each woman enrolled in the study. Logistic regression was used to estimate the adjusted odds ratio for the association between stressor group membership and low birthweight, controlling for the effects of confounding factors. RESULTS: In logistic regression analyses stratified by race, for African-American women, the following variables were significantly associated with low birthweight: smoking, hypertension, low prepregnancy weight, hospitalization during pregnancy, previous preterm birth, and exposure to stressors. For Caucasian women, significant predictors were: smoking, drug use, hospitalization during pregnancy, hypertension, and previous preterm birth. Exposure to stressors was also significantly associated with many clinical and behavioral risks for low birthweight. CONCLUSION: Our results suggest two potential mechanisms for an association between stressors and low birthweight. Exposure to stressors may be indirectly associated with low birthweight through a relationship with clinical and behavioral risks for low birthweight. Exposure to psychosocial stressors may also be directly associated with risk of low birthweight among African-American women.

Behavior of serum interleukin 12 in human acute pancreatitis.

We evaluated the behavior of sera interleukin p70 (IL-12p70) and IL-12p40 in patients with acute pancreatitis. Twenty-three acute pancreatitis patients were studied (12 had severe pancreatitis and 11 had mild pancreatitis). Twenty healthy subjects were studied as controls. Serum concentrations of total IL-12, IL-12p70, IL-12p40, and IL-6 were determined in all subjects on admission to the hospital; in patients with acute pancreatitis, the serum levels of these molecules also were determined for the 5 days after admission. Acute pancreatitis patients had serum concentrations of total IL-12, IL-12p40, and IL-6 significantly higher (p < 0.05) than those of the healthy subjects from the first to the sixth day of the study; serum concentrations of IL-12p70 were significantly higher in acute pancreatitis patients (p < 0.02) than in the healthy subjects on the first of the disease and significantly lower (p < 0.05) on the second, third, and fourth days of illness. Reduction of IL-12p70 in acute pancreatitis patients was not due to a failure of the monocytes because the production of IL-6 was increased. Increased amounts of IL-12p40 in acute pancreatitis patients may be responsible for their increased susceptibility to infection.

Effects of early ductal decompression in human biliary acute pancreatitis.

It was recently demonstrated in experimental models that, after pancreatic outflow obstruction, serum amylase levels first increase and then progressively decline regardless of whether the obstruction was maintained or relieved. Furthermore, early decompression of the ductal biliary system may prevent the progression of the disease. This finding prompted us to look for a similar pattern in patients with obstructive acute pancreatitis due to biliary stones. Forty-two patients with biliary acute pancreatitis were prospectively studied. Twenty-one patients underwent urgent endoscopic sphincterotomy (ES), and 21 received conservative medical treatment (CMT). The two groups were comparable for sex, age, onset of pain, and severity. Serum amylase and lipase were determined in all patients on admission and 24 h later. The percentage variation of serum amylase and lipase was calculated considering, for each patient, the concentrations of the two enzymes assayed on admission and 24 h later. On admission, all patients had elevated serum concentrations of amylase (mean +/- SEM: ES, 2,560+/-473 U/L; CMT, 1,783+/-481 U/L) and lipase (ES, 3,037+/-574 U/L; CMT, 3,179+/-724 U/L). The serum amylase variation (mean +/- SEM) was -65.6+/-5.5% in the ES and -47.2.1+/-8.1% in the CMT patients. The serum lipase variation was -59.1+/-7.7 and -33.1+/-18% in the same groups, respectively. These differences were not statistically significant. Acute pancreatitis worsened in one patient in the ES group and in seven in the CMT group; this difference was statistically significant (p < 0.02). The mean length of hospitalization was 8.9 days in the ES group and 19.7 days in the CMT group (p < 0.001). Serum pancreatic enzymes determination is not useful to evaluate the results of the early decompression of biliary duct in human acute pancreatitis. Indeed, early endoscopic sphincterotomy may result in a substantial improvement in the outcome of biliary acute pancreatitis.

Time-course and clinical value of the urine trypsinogen-2 dipstick test in acute pancreatitis.

OBJECTIVE: Urine trypsinogen-2 has been suggested as a marker of damage due to acute pancreatitis. Our aim was to assess the time-course and the clinical value of this test in acute pancreatitis. METHODS: A urine trypsinogen-2 dipstick test was performed on 30 patients with acute pancreatitis upon admission to the emergency room, as well as on 30 patients with non-pancreatic acute abdominal pain, and in 30 healthy subjects. RESULTS: In 53.3% of the patients with acute pancreatitis the dipstick test showed abnormal urine trypsinogen-2 whereas this test gave negative results in all patients with non-pancreatic acute abdomen and in all healthy subjects. Patients with severe acute pancreatitis had a frequency of abnormal results of urine trypsinogen-2 (8/9, 88.9%; 95% CI, 51.8-99.7%) significantly higher (P = 0.031) than those with the mild disease (8/21, 38.1%; 95% CI, 18.1 -61.6%), while no significant differences were found in the urine trypsinogen-2 results between patients with biliary acute pancreatitis and those with non-biliary acute pancreatitis. Regarding the time-course of urine trypsinogen-2, there were no significant differences during the three days of the study. CONCLUSIONS: The specificity of urine trypsinogen-2 in the diagnosis of acute pancreatitis is good however its sensitivity is low.

Relapses of biliary acute pancreatitis in patients with previous attack of biliary pancreatitis and gallbladder in situ.

AIM: To evaluate relapse of acute pancreatitis in patients with biliary pancreatitis in whom coexisting diseases or patient refusal have excluded cholecystectomy. PATIENTS AND METHODS: Forty-seven patients presenting a first episode of biliary acute pancreatitis underwent urgent endoscopic retrograde cholangiopancreatography (ERCP) with endoscopic sphincterotomy (ES). RESULTS: ERCP with ES was successful in all but one patient (97.8%) who was then cholecystectomised. Complications related to the endoscopic procedure were reported in five patients (10.6%). During the follow-up period (median time 12 months; range 1-84 months), 10 patients (21%) suffered from biliary complications. Three patients (6.4%), all with lithiasis of the gallbladder, had relapses of acute pancreatitis, two of them within 2 months of the previous episode, and one about a year later after ingestion of a rich meal and alcoholic beverages. The first two were cholecystectomised. Two patients died during the follow-up period from unrelated diseases. CONCLUSIONS: In subjects who are at high risk for anaesthesia, endoscopic procedures may be utilised.

Silent myocardial ischemia induced by hypoglycemia.

Hypoglycemia is known to produce various EKG changes, including arrhythmias. Although these changes have been rarely documented, their presence may pose diagnostic and therapeutic problems in an emergency situation. We report the case of a 81-year-old man with insulin-dependent diabetes mellitus who showed electrocardiographic features of acute myocardial ischemia during an episode of hypoglycemia; these alterations disappeared after glucose administration.

The use of the peripheral leukocyte count and chest X-rays in early assessment of the severity of acute pancreatitis in comparison with the Ranson score system.

BACKGROUND: To evaluate the efficacy of the peripheral leukocyte count and chest X-rays as an index which could be used in the early assessment of the severity of acute pancreatitis in an Emergency Room. METHODS: We prospectively evaluated the peripheral leukocyte count and the findings of chest X-rays in 181 consecutive patients (102 males, 79 females, mean age 61 years, range 16-97) who were admitted to our Emergency Department with acute pancreatitis. One hundred twenty six patients had mild pancreatitis and 55 had severe pancreatitis. The peripheral leukocyte count and the chest X-rays were evaluated in all patients upon admission. The Ranson criteria were also assessed. RESULTS: Using a cut off value of 13,000/mm3, 45% of the patients with severe pancreatitis and 17% of those with mild acute pancreatitis had a peripheral leukocyte count greater than 13,000/mm3. Pleural or pulmonary alterations observed on chest X-ray were found in 66% of patients with severe pancreatitis and in 2% of those with mild acute pancreatitis. A peripheral leukocyte count greater than 13,000/mm3 and/or pleural or pulmonary alterations present on chest X-ray were found in 78% of the patients with severe pancreatitis and in 19% of those with mild pancreatitis. The Ranson criteria greater than or equal to three were found in 45% of the patients with severe acute pancreatitis and in 16% of those with the mild form of the disease. The positive predictive value was 92% for the presence of alterations on the chest X-rays, 64% for the alteration of at least one of the abnormal findings on the chest X-ray and a peripheral leukocyte count greater than 13,000/mm3, 56% for a peripheral leukocyte count greater than 13,000/mm3, and 54% for the presence of Ranson criteria greater than or equal to three. The negative predictive values were similar. CONCLUSIONS: The presence of pleural or pulmonary alterations on chest X-rays may be useful in the Emergency Room for the early identification of patients with severe acute pancreatitis.

Conserving fertility with early management of cervical pregnancy. A case report.

BACKGROUND: Cervical pregnancy can be a life-threatening entity, with the diagnosis often made on the hysterectomy specimen. A case of distal ectopic pregnancy involved the endocervical canal, and prompt diagnosis and treatment allowed the preservation of fertility. CASE: The patient presented at six weeks' gestation with vaginal bleeding. Serial ultrasound examinations revealed a viable pregnancy and ultimately suggested placental implantation within the endocervical canal. Curettage was performed using cervical stay sutures at the three and nine o'clock positions, with minimal bleeding and no postoperative morbidity. One year after the procedure the patient had a spontaneous delivery of a full-term male following an unremarkable prenatal course. CONCLUSION: Improvements in sonography and serum testing have allowed earlier diagnosis and hence greater success with conservative management of cervical pregnancy.

Electrocardiographic abnormalities in acute pancreatitis.

It has been reported that electrocardiographic abnormalities may be associated with acute pancreatitis. However, the data are lacking or sketchy. The aim of this study was to assess the frequency and type of electrocardiographic abnormalities present in patients with acute pancreatitis. Fifty-six consecutive patients with acute pancreatitis and without previous history of heart disease were studied. Eleven patients had arterial hypertension. Forty-one patients had mild pancreatitis and 15 had the severe form of the disease. On admission, all patients underwent a standard 12-leads electrocardiogram and a serum electrolyte determination. Nineteen healthy subjects were also studied as controls. Twenty-seven patients (48.2%) (10 with severe pancreatitis and 17 with mild pancreatitis) had a normal electrocardiogram. In the remaining 29 patients (51.8%), one patient with severe pancreatitis had atrial extrasystoles and eight had bradycardia (less than 60 beats/minute) (two with severe pancreatitis and six with mild pancreatitis); 14 patients had changes of the T-wave and/or the ST-segment (two with severe pancreatitis and 12 with mild pancreatitis); seven patients showed disturbances of the intraventricular conduction (one with severe pancreatitis and six with mild pancreatitis): four had left anterior hemiblock, two had complete left bundle branch block and one had left anterior hemiblock and incomplete right bundle branch block; one patient with mild pancreatitis had atrioventricular block (first degree). No differences in heart rate, RR interval, PR interval and QT interval were found when patients with acute pancreatitis were compared with healthy subjects, nor when patients with severe pancreatitis were compared with those having the mild form of the disease. Seventeen of the 29 patients with electrocardiographic abnormalities (52.6%) also had serum electrolyte alterations. More than 50% of the patients with acute pancreatitis had electrocardiographic abnormalities and electrolyte alterations were also present in about one-half of these.

[Rhabdomyolysis during acute poisoning with drugs and narcotics. Experience with 7 clinical cases]. / Rabdomiolisi in corso di intossicazione acuta da farmaci e sostanze stupefacenti. Esperienza su 7 casi clinici.

Numerous and extremely varied conditions (intense muscular activity, ischemia, metabolic and genetic disorders, infections, immunological diseases and toxic causes) may play a role in the genesis of non-traumatic rhabdomyolysis. Over the past years there has been an increased number of reports of forms due to drug or narcotic intoxication. Seven cases of rhabdomyolysis are reported in patients admitted to emergency wards in a state of coma due to heroin overdose (4 cases), cocaine overdose (1 case), carbamazepin (1 case), and tricyclic anti-depressives (1 case). In all cases it was possible to hypothesise a multifactorial pathogenesis of the disease in which other factors, such as acidosis, hypoxia, hypothermia and compression of the muscle mass during coma, were associated with the direct toxic damage caused by the drug. The most frequent complication was acute renal failure. One case of myocardial involvement with non-Q infarction characteristics was also observed.

Selective regulation of p38ß protein and signaling by integrin-linked kinase mediates bladder cancer cell migration.

Integrin-linked kinase (ILK) and p38(MAPK) are protein kinases that transduce extracellular signals regulating cell migration and actin cytoskeletal organization. ILK-dependent regulation of p38(MAPK) is critical for mammalian kidney development and in smooth muscle cell migration, however, specific p38 isoforms has not been previously examined in ILK-regulated responses. Signaling by ILK and p38(MAPK) is often dysregulated in bladder cancer, and here we report a strong positive correlation between protein levels of ILK and p38ß, which is the predominant isoform found in bladder cancer cells, as well as in patient-matched normal bladder and tumor samples. Knockdown by RNA interference of either p38ß or ILK disrupts serum-induced, Rac1-dependent migration and actin cytoskeletal organization in bladder cancer cells. Surprisingly, ILK knockdown causes the selective reduction in p38ß cellular protein level, without inhibiting p38ß messenger RNA (mRNA) expression. The loss of p38ß protein in ILK-depleted cells is partially rescued by the 26S proteasomal inhibitor MG132. Using co-precipitation and bimolecular fluorescent complementation assays, we find that ILK selectively forms cytoplasmic complexes with p38ß. In situ proximity ligation assays further demonstrate that serum-stimulated assembly of endogenous ILK-p38ß complexes is sensitive to QLT-0267, a small molecule ILK kinase inhibitor. Finally, inhibition of ILK reduces the amplitude and period of serum-induced activation of heat shock protein 27 (Hsp27), a target of p38ß implicated in actin cytoskeletal reorganization. Our work identifies Hsp27 as a novel target of ILK-p38ß signaling complexes, playing a key role in bladder cancer cell migration.

Activins and inhibins in mammalian testis development: new models, new insights.

The discovery of activin and inhibins as modulators of the hypothalamic-pituitary-gonadal axis has set the foundation for understanding their central importance to many facets of development and disease. This review contains an overview of the processes and cell types that are central to testis development and spermatogenesis and then provides an update focussed on information gathered over the past five years to address new concepts about how these proteins function to control testis development in fetal and juvenile life. Current knowledge about the interactive nature of the transforming growth factor-ß (TGFß) superfamily signalling network is applied to recent findings about activins and inhibins in the testis. Information about the regulated synthesis of signalling components and signalling regulators in the testis is integrated with new concepts that demonstrate their functional significance. The importance of activin bioactivity levels or dosage in controlling balanced growth of spermatogonial cells and their niche at different stages of testis development is highlighted.

Abdominal pain and ECG alteration: a simple diagnosis?

Acute pancreatitis is a disease initially located into the pancreas that may become a systemic disease involving organs distant from the pancreas. All organs may be involved during an acute attack of pancreatitis: lungs, kidney, heart, liver, brain. The differential is sometime difficult because acute pancreatitis may sometimes mimic an acute coronary syndrome. We report a case of a 36-year-old man who was admitted to Emergency Room for persistent epigastric pain. Serial electrocardiograms (ECG) showed signs of acute myocardial infarction. However, a coronary angiogram demonstrated no coronary artery disease, and serum troponin was undetectable. Later, serum pancreatic enzyme levels were elevated and an ultrasonography scan of the abdomen was consistent with pancreatitis. Physicians should keep in mind the possibility of an attack of pancreatitis in a patient with abdominal pain and ECG modifications who is a heavy drinker.