Environmental Modeling for Radiation Safety
Published on: 28th August, 2023
The newly launched IAEA project MEREIA (MEthods for Radiological and Environmental Impact Assessment; 2021- 2025), MEREIA continues some activities of previous IAEA exercises in the field of radioecological modelling and focuses on areas where the probabilistic approach determines the predictive capability of environmental models. The program offered the opportunity to set up well-designed and verified scenarios to collect and compare exposures predicted by particular models based on this scenario and then perform a validation study of contributing models. It consists of the comparison of model prediction with observed data or in the case where there is a lack of measurement data to perform a comparison within model prognoses. The previous international works have brought significant improvement in environmental modeling in terms of better understanding and mathematical description of complex physical and chemical phenomena that occur in various environmental media and also have promoted new areas for experimental investigations. The new experimental results yielded updated handbooks of a large number of environmental parameters for less-known elements. Moreover, the principal objective of the activities in environmental modelling was an integrated risk assessment of the reference group of population and biota associated with radionuclides releases from various kinds of nuclear facilities as from different types and power nuclear reactors, radioactive waste disposal and more complex nuclear research facility. This reflects recent international recommendations to extend protection against radiation hazards of humans to wildlife flora and fauna. However, the statistics supported knowledge on some essential environmental parameters still remain small. Therefore, one could be aware of some limitations of the probabilistic approach that required advanced methods of probabilistic prognosis Monte Carlo.
Faecal Transplant Therapy: A Promising Treatment Modality for Cardiovascular Diseases
Published on: 28th August, 2023
Cardiovascular diseases (CVD) are considered as “lifestyle” diseases and so far “No unified procedure” or medicines are effective in the management of this group of diseases. Researchers and clinicians have indicated that no safe therapeutic window is available in therapeutics at present. Recent research showed that gut microbiota are effective in managing lifestyle diseases therefore we introduced the influence of gut microbiota in the prognosis of the CVDs. Faecal transplant therapy(FMT) has been anticipated to treat many diseases similar to recurrent bacterial Clostridioides difficile infection which has been used worldwide. Recently, FMT was tried on an animal model to treat CVDs, and recent human trials that were tried to manage CVDs in humans by FMT showed encouraging results. The mechanism of action of transplanted bacteria to manage CVDs in the human population is also discussed. In-depth knowledge on the pros and cons of FMT will pave the way to standardize the procedure once the lacuna existing at present in treating CVDs, is paved, this technology will be useful for the masses.
Causal Link between Human Blood Metabolites and Asthma: An Investigation Using Mendelian Randomization
Published on: 29th August, 2023
Background: Asthma, a chronic inflammatory respiratory ailment, is characterized by variable airflow obstruction and heightened bronchial reactivity. Despite therapeutic advancements, a comprehensive comprehension of its underlying metabolic mechanisms remains elusive. Metabolomics has emerged as a powerful approach to investigating the complex connections between serum metabolites and disease pathogenesis. However, exploring the causal relationship between serum metabolites and asthma susceptibility demands meticulous examination to unveil potential therapeutic targets.Methods: Mendelian randomization (MR) approach was explored to investigate the potential causal associations between serum metabolites and asthma risk. The main analysis employed the inverse variance weighted method, supported by supplementary approaches such as MR-Egger, weighted median, weighted mode, and sample mode. To enhance the strength and credibility of our results, we conducted sensitivity analyses encompassing heterogeneity testing, assessment of horizontal pleiotropy, and leave-one-out analysis. Additionally, pathway enrichment analysis was performed to further elucidate the results.Results: We identified 18 known and 12 unknown metabolites with potential associations with asthma risk. Among known metabolites, seven exhibited protective effects (e.g., 4-acetamidobutanoate, allantoin, kynurenine, oxidized bilirubin*), while eleven were considered risk factors (e.g., ornithine, N-acetylornithine, alanine). Through the integration of four additional MR models and sensitivity analyses, we revealed a connection between 4-acetamidobutanoate and approximately 6% lower asthma risk (OR = 0.94, 95% CI: 0.90–0.98).Conclusions: Our MR analysis uncovered protective and risk-associated metabolites, alongside 12 unknown metabolites linked to asthma. Notably, 4-acetamidobutanoate demonstrated a nominal 6% reduction in asthma risk, highlighting its potential significance.
THz Analysis in the Depth of a Sunflower Leaf
Published on: 1st September, 2023
The internal structure of a sunflower leaf could be reconstructed by applying RET reverse engineering techniques on measurements from terahertz time-domain probing (Time Domain Spectroscopy TDS). This new and non-destructive method allows us to follow the evolution of this structure in time during a process of dehydration. This paper is a synthesis of our previous work.
Utilization of Molecular Simulation Applications for Stability Testing of Anthocyanin Compounds in Black Elderberry
Published on: 1st September, 2023
Recently, many studies on the molecular activity of compounds have been carried out using simulations through computer programs or in silico simulations. Anthocyanins are one of the compounds that are often used as food coloring agents and can function as antioxidants to prevent blockage of blood vessels, as an anti-cancer that can prevent the development of cancer cells and tumors and have anti-inflammatory effects. The purpose of the research is to determine the stability of anthocyanins using molecular simulations and determine the best mixing sequence of ingredients to produce the most stable anthocyanin mixture. Based on the results of the simulations carried out, it can be proven that the final 3 sets (the modeled compound belonging to namely AP and AZ followed by a number based on the simulation order) selected are AP17, AP18, and AZ17. The AP17 set had the lowest potential energy at the end of molecular dynamics simulations, but molecular visualization showed structural instability indicated by the formation of gaps in the molecular conformation. The AP18 set had the second lowest potential energy at the end of molecular dynamics simulations and molecular visualization showed molecular conformation that tended to be stable during molecular simulations with no change in structure. The AZ17 set had the highest potential energy of the final 3 sets selected and molecular visualization showed a gap in the conformation at the beginning of the simulation, but over time the gap became denser, indicating that the molecule became more stable over time. Based on the research results, the AP18 set was chosen because it has relatively low potential energy and it can be proven that the structure visualization of this set tends to be more stable over time during molecular dynamics simulations.
CT-guided Retrograde Urography as a Diagnostic Tool for Post-kidney Transplantation Evaluation: A Case Report
Published on: 4th September, 2023
The vast majority of urological complications occur at the ureterovesical junction and usually occur early after transplantation. The aim of this study is to enhance the quality of medical care provided to patients who undergo kidney transplantation. Cystography was conducted on renal transplant recipients utilizing computed tomography. The utilization of changes in the patient’s position and reconstructed images of the bladder can serve as a diagnostic tool to assess the normal functioning of the urinary tract system subsequent to kidney transplantation. To ensure adequate filling of the bladder and ureter, it is necessary to introduce varying amounts of contrast medium through the urinary catheter into these structures. This diagnostic procedure aims to verify the existence of stenosis or leakage occurring at the vesicoureteral junction. The evaluation and diagnosis of urinary tract problems subsequent to kidney transplantation can be effectively conducted. Furthermore, it has the potential to mitigate the adverse effects and alleviate the strain on the renal system resulting from the administration of contrast agents in computed tomography urography. CT-guided cystography can enhance the medical quality and comfort of Kidney transplantation patients.
Microbial Conversion and Utilization of CO2
Published on: 4th September, 2023
Rising greenhouse gas emissions have contributed to unprecedented levels of climate change, while microbial conversion and utilization of CO2 is a practical way to reduce emissions and promote green manufacturing. This article mainly summarizes several natural CO2 pathways that have been discovered, including the Calvin cycle, the reduced tricarboxylic acid (rTCA) cycle, the Wood–Ljungdahl (WL) pathway, the 3-hydroxypropionate/4-hydroxybutyrate (HP/HB) cycle, the dicarboxylate/4-hydroxybutyrate (DC/HB) cycle, the 3-hydroxypropionate (3HP) cycle, the reductive glycine (rGly) pathway, and artificially designed carbon fixation pathways includes the CETCH cycle, the MOG pathway, the acetyl-CoA bicycle, and the POAP cycle. We also discussed applications of different carbon fixation enzymes, notably ribulose-1, 5-diphosphate carboxylase/oxygenase, pyruvate carboxylase, carbonic anhydrase, as well as formate dehydrogenase. This paper further addressed the development of photosynthetic autotrophs, chemergic autotrophs and model bacteria Escherichia coli or yeast produced main products for CO2 fixation through metabolic engineering, such as alcohols, organic acids, fatty acids and lipids, bioplastics, terpenoids, hydrocarbons, and biomass. Future studies on CO2 microbial conversion should focus on improving the efficiency of carbon fixation enzymes, metabolic modules of the carbon sequestration pathway, and intracellular energy utilization. Coupled microbial and electrochemical methods for CO2 fixation, in addition to biological fixation, show considerable promise.
Comparison of Patient Satisfaction and Quality of Life Among Post-elbow Fracture Stiffness Patients Undergoing Proprioceptive Neuromuscular Facilitation Stretching vs. Passive Stretching
Published on: 5th September, 2023
Background: Post-fracture prolonged immobilization or post-operative elbow stiffness is relatively common and markedly interferes with normal upper extremity function. This study aims to evaluate and compare the levels of patient satisfaction and quality of life in individuals with post-elbow fracture stiffness who undergo Proprioceptive Neuromuscular Facilitation (PNF) stretching versus those who receive passive stretching.Methodology: This (six months) analytical comparative cross-sectional study was conducted at various healthcare institutions. The sample consisted of 377 patients using non-probability convenient sampling. Inclusion criteria included specific types of elbow fractures, a minimum immobilization period of three weeks, and limited range of motion (ROM). Exclusion criteria covered various medical and psychological conditions. Standardized questionnaires Short Form 36 Health Survey Questionnaire (SF-36) and Patient Satisfaction Questionnaire (PSQ-18) were used for measuring Quality of life and patient satisfaction. Data analysis was done using SPSS version 22.Results: Short Form 36 Health Survey Questionnaire scores were significantly higher in the PNF Stretching group (mean 82.34 ± 6.63) compared to the Passive Stretching group (mean 63.98 ± 14.42), with a p - value of 0.000. Similarly, Patient satisfaction questionnaire scores were significantly higher in the PNF Stretching group (mean 77.61 ± 4.43) compared to the Passive Stretching group (mean 70.93 ± 8.49), with a p - value of 0.000. These findings indicate that there is a statistically significant difference observed between the two groups.Conclusion: There is a statistically significant difference observed between both groups as the patients undergoing PNF stretching have higher satisfaction and better quality of life, in comparison to the passive stretching group.
Hypersexual Disorder: A Comprehensive Review of Conceptualization, Etiology, Assessment and Treatment
Published on: 6th September, 2023
Hypersexual disorder, also known as compulsive sexual behavior or sex addiction, is a complex and clinically significant condition characterized by intense and recurrent sexual fantasies, urges, or behaviors that significantly disrupt an individual’s daily life and overall well-being. Despite its importance, hypersexual disorder remains a controversial and debated topic, lacking standardized diagnostic criteria in major classification systems.This review paper provides a comprehensive examination of hypersexual disorder, encompassing its definition, conceptualization, etiology, co-occurring conditions, effects on mental and physical health, assessment, treatment approaches, cultural and ethical considerations, and future research directions. By synthesizing information from existing literature and research, this review aims to deepen our understanding of hypersexual disorder and contribute to the development of evidence-based interventions.The review begins by exploring the evolution of the term “hypersexual disorder” and its current status in diagnostic classifications. It then delves into the potential etiological factors contributing to the development of hypersexual behaviors, including neurobiological, genetic, and psychosocial factors.Furthermore, the review discusses the common comorbidities associated with hypersexual disorder, emphasizing the importance of addressing co-occurring mental health conditions in treatment planning. The psychological and physiological effects of hypersexual behaviors on affected individuals are examined, underscoring the urgency of early intervention and comprehensive treatment.The assessment and diagnosis of hypersexual disorder are thoroughly examined, considering the challenges and methodologies involved in identifying and evaluating affected individuals. Cultural and ethical considerations are highlighted, stressing the significance of providing culturally sensitive and ethical care to diverse populations.In the context of treatment, the review discusses various therapeutic approaches, including psychotherapy, medication, support groups, and harm-reduction strategies. The need for evidence-based treatments tailored to hypersexual disorder is underscored while recognizing the challenges of developing standardized protocols in this evolving field.Finally, future research directions are outlined, focusing on the standardization of diagnostic criteria, prevalence studies, neurobiological investigations, and the integration of cultural competency in treatment approaches.In conclusion, this review paper aims to contribute to a comprehensive understanding of hypersexual disorder and its implications for affected individuals and society. By exploring the multifaceted aspects of the condition, this review seeks to provide insights into effective treatment approaches and inspire further research in the study of hypersexual disorder.
Potential Use of Essential Oils and Their Individual Components in Cosmeceuticals: A Review
Published on: 7th September, 2023
The cosmetic industry is searching for new active ingredients from renewable natural sources to make more environmentally friendly and safe products. Botanical extract is a nearly limitless source of these new actives due to the current consumer demands as well as international regulations. Due to both their fragrant nature for the creation of fragrances and perfumes and the numerous advantageous properties of their individual components (EOCs), such as anti-inflammatory, antimicrobial, and antioxidant properties, essential oils (EOs) emerge as a very common natural ingredient in cosmetics and toiletries. Additionally, nowadays, the cosmetic industry includes EOs or different mixtures of their individual components (EOCs), either as active ingredients or as preservatives, in various product ranges (e.g., moisturizers, lotions, and cleansers in skin care cosmetics; conditioners, masks or anti-dandruff products in hair care products; lipsticks, or fragrances in perfumery). However, because each essential oil’s distinct chemical profile is linked to a different set of advantages, it is challenging to generalize about how they might be used in cosmetics and toiletries. Formulators frequently spend time looking for appropriate combinations of EOs or EOCs to achieve particular advantages in the finished products. The literature on the most recent developments in the use of EOs and EOCs in the production of cosmetic products is updated in this work’s review of the literature. Additionally, certain particular issues pertaining to the security of EOs and EOCs in cosmetics will be covered. It is expected that the information contained in this comprehensive review can be exploited by formulators in the design and optimization of cosmetic formulations containing EOs.
Hazardous Effects of Malaria for Patients Residing in Low-probability Malaria Areas: A Case Report and Critiques of the Literature for Cerebral Malaria
Published on: 13th September, 2023
Despite decades of global and country commitments towards eradicating malaria, malaria remains the most hazardous parasitic disease and the most common cause of fever for humans, especially in tropical countries. Plasmodium falciparum causes 90% of malaria cases. Coma [Cerebral Malaria (CM)], acidosis, hypoglycemia, severe anemia, renal dysfunction, and pulmonary edema are the most common complications of malaria caused by Plasmodium falciparum and the most common cause of death related to malaria. People from less prevalent malaria areas are at high risk of developing these complications. A 16-year-old male from a low malaria transmission area was diagnosed with CM. Prior to developing CM, he was treated with Coartem. CM is a medical emergency and one of the forms of severe malaria. CM has high mortality and morbidity rates. Yet, international health-related agencies, funders, and policy-makers are unfamiliar with it. The continuous occurrence of CM validates the considerable need for global investment in malaria control and elimination programs. Early administration of Artesunate to all patients suspected of having severe malaria would reduce global malaria-related mortality and morbidity. Simple tests, such as the determination of malaria parasitic density either with thin or thick blood smears, may influence the proper management of all severe malaria cases. However, in clinical practice, the determination of malaria parasitic density is not routinely done. Further commitments are needed to ensure routine determination of malaria parasitic density for all suspected severe malaria cases. Moreover, further commitments are needed to guarantee the proper management of CM because it is a major cause of reversible encephalopathy in tropical countries.
Hydrogel-Based Formulations for Drug Delivery to the Posterior Segment of the Eye
Published on: 12th September, 2023
Hydrogel-based formulations hold significant promise for treating ocular diseases that impact the posterior segment of the eye. These formulations exhibit the ability to surmount ocular barriers and offer sustained drug release, rendering them efficacious drug delivery systems. This article addresses the challenges linked to treating disorders affecting the posterior eye segment and underscores the imperative for less invasive drug delivery methodologies. We further delve into diverse contemporary ocular dosage forms, encompassing gels, nanostructures, and implants, with a specific emphasis on hydrogels. Hydrogels offer several merits, including precise targeting, sustained release, enhanced bioavailability, and non-invasiveness. Moreover, they curtail the risk of adverse effects and foster patient adherence. An enthralling advancement is the amalgamation of hybrid drug delivery systems, integrating nanoparticles, liposomes, dendrimers, and stimuli-activated nano-systems, with hydrogels for posterior eye ailment treatment. These hybrid nano-systems exhibit promise in enhancing drug stability, prolonging drug release, and pinpointing specific tissues within the posterior segment. We also provide an overview of ongoing clinical trials and approved hydrogel-based drug delivery systems, like Retisert and Ozurdex. These systems have demonstrated efficacy in managing chronic non-infectious uveitis, Age-related Macular Degeneration (AMD), and diabetic macular edema. Nevertheless, challenges persist, including optimizing bioavailability, maintaining drug stability, and implementing personalized treatment approaches. The incessant evolution of gel-based drug delivery systems stands to substantially enhance patients’ quality of life and establish new benchmarks in treating posterior eye diseases. The future of ophthalmology brims with excitement, as gel-based drug delivery systems hold the potential to revolutionize ocular therapies, providing effective remedies for an array of vision-related afflictions.
Intersecting Pathways: Examining Hildegard Peplau's and Rosemarie Parse's Nursing Theories through a Comparative Lens
Published on: 12th September, 2023
Background: Nursing theories are organized bodies of knowledge providing a way to define nursing as a unique discipline that is separate from other disciplines. As a profession, nursing is committed to recognizing its own unparalleled body of knowledge vital to nursing practice and science. Nursing is a science based on the theory of what nursing is, what nurses do, and why.Aim: This paper aims to elucidate the practical application of Hildegard Peplau's and Rosemarie Parse's nursing theories, individually and in synthesis, in modern nursing practice. Key points: These include a) Hildegard Peplau's Theory of Interpersonal Relations emphasizes the nurse-patient relationship, therapeutic communication, and the continuous search for improvement in patients, even those facing mental health challenges. b) Rosemarie Parse's Theory of Human Becoming underscores the uniqueness of each patient's lived experiences, the significance of "meaning" in health experiences, "rhythmicity" in patterns, and the potential for "transcendence" and growth. c) Integrating Peplau's and Parse's theories promotes holistic patient-centered care, compassionate and empathetic nursing, enhanced communication skills, patient autonomy, cultural competence, continuity of care, and a deep respect for human dignity. d) By embracing both theories, nurses can provide comprehensive, compassionate, and patient-centered care that respects each patient's individuality and capacity for growth.Conclusion: The synthesis of Hildegard Peplau's and Rosemarie Parse's nursing theories offers nurses a comprehensive framework for modern nursing practice. It guides nurses in providing high-quality, patient-centered care that preserves human dignity and recognizes the uniqueness of each patient. Drawing from multiple theoretical perspectives enhances nursing practice and ensures the well-being of patients in today's evolving healthcare landscape.
Analysis of Microbial Diversity and Community Structure in the Rhizosphere of Cigar Tobacco in Different Agroecological Zones
Published on: 13th September, 2023
To reveal the influence of ecological zones on the structure of microbial communities in cigar rhizosphere soils, Yunnan's cigar tobacco production region was first divided into three ecological zones. Soil samples were collected at maturity and the community structure of fungi and bacteria in the rhizosphere soil was analyzed using 18S rRNA and 16S rRNA high-throughput sequencing techniques. The results showed that the dominant fungi were Ascomycota, Mortrellomycota, and Basidiomycota, and the dominant bacteria were Ascomycota and Proteobacteria. The dominant genera and relative abundances of fungi and bacteria differ at the genus level. Ecoregions may affect the community structure and distribution of fungal and bacterial diversity in the rhizospheric soil of cigars at maturity, which may provide a theoretical basis for the selection of high-quality cigar-producing regions in the future.
Relationship between the Level of Spirituality and Blood Pressure Control among Adult Hypertensive Patients in a Southwestern Community in Nigeria
Published on: 19th September, 2023
Background: Spirituality has been strongly associated with good blood pressure control as it forms a strong coping mechanism in hypertensive patients. This hospital-based cross-sectional study was done to determine the relationship between spirituality and blood pressure control among adult hypertensive patients in rural Southwestern Nigeria to achieve good blood pressure control.Method: The selection was done by systematic random sampling technique. Socio-demographic and clinical information were obtained through semi-structured interviewer-administered questionnaires. The level of spirituality was assessed using the Spiritual Perspective Scale. Data were analysed using the Statistical Package for Social Sciences version 20.0. Statistical significance was set at p ≤ 0.05.Results: The mean age of the respondents was 61.1 ± 11.1 years. More than half (52.6%) had a high level of spirituality and more than two-thirds (67.1%) of respondents had controlled blood pressure. Respondents with a high level of spirituality were 4.76 times more likely to have good blood pressure control {p < 0.001, 95% CI (1.05-14.99)} than those with a low level of spirituality. Conclusion: Proper understanding and effective utilization of this relationship will assist health professionals and researchers in the appropriate integration of this concept into patients’ holistic care with the aim of achieving better blood pressure control among hypertensive patients.
A Rare Case of an Acquired Isolated Factor VII Deficiency was Discovered in a 23-Year-Old Female Patient
Published on: 20th September, 2023
Introduction: Factor VII (FVII) deficiency, a rare bleeding disorder, can manifest as an autosomal recessive congenital or an acquired coagulopathy. Acquired FVII deficiency, although infrequently reported, presents unique challenges in understanding its mechanisms and identifying underlying causes. Case presentation: We present a case of acquired FVII deficiency discovered in a 23-year-old female patient with no apparent underlying disease. The patient exhibited spontaneous ecchymosis and gingival hemorrhage, along with low FVII activity and isolated prolongation of prothrombin time. Extensive laboratory investigations excluded liver dysfunction, familial deficiency, vitamin K deficiency, and inhibitory antibodies. Prompt treatment with Fresh Frozen Plasma (FFP) and bypassing agents resulted in a favorable response and resolution of hematomas. Conclusion: Acquired FVII deficiency was identified with bleeding symptoms in association with prolonged prothrombin time and a low level of FVII activity. In literature, this deficiency has been associated with various conditions such as sepsis, aplastic anemia, stem cell transplantation, and neoplasms, although approximately 14% of cases remain idiopathic. Clinical outcomes remain generally poor, with limited complete remissions reported.
Clinical Approach to Immunotherapy-induced Type 1 Diabetes Mellitus: A Case of Pembrolizumab Associated Insulin-dependent Diabetes in a Patient with NSCLC
Published on: 25th September, 2023
As the introduction of immune checkpoint inhibitors in the treatment of various cancers is now proven to be already acquired knowledge, so does a new challenge arise for clinicians; the understanding, diagnosis, and management of the rarest adverse effects of immunotherapy. We present a case of type-1 diabetes Mellitus (T1DM) in a patient with non-small cell lung carcinoma (NSCLC) treated with pembrolizumab. Following ten cycles of treatment, our patient was diagnosed with T1DM after being admitted for diabetic ketoacidosis and stayed hospitalized in the ICU. Later, they continued treatment with insulin, having shown disease response to pembrolizumab, and resumed immunotherapy while on insulin. Immunotherapy-induced T1DM can sometimes occur with PD1/PD-L1 blockage therapies. It has a rapid onset, is characterized by insulin deficiency due to the autoimmune destruction of beta-cells, and usually presents itself with diabetic ketoacidosis. Unlike most of the other adverse effects of immunotherapy, glucocorticoids don’t seem to be of therapeutic value, and insulin substitution is required. Regular glucose monitoring can be key to early diagnosis and prevention of hospitalization.
A Case of Catastrophic Atypical Hemolytic Uremic Syndrome Unresponsive to Eculizumab and the use of Ravulizumab Off-label
Published on: 5th October, 2023
“A 40-year-old woman with melanoma, under treatment with Dabrafenib and Trametinib, was evaluated in our hospital for rapidly progressive deterioration of renal function”. 8 months before the current admission, the patient had been diagnosed with melanoma, and underwent radical surgery and subsequent therapy with Dabrafenib and Trametinib.After 5 months of therapy, the patient was brought to this hospital for precordial pain, with a diagnosis of myopericarditis, therapy was started for heart failure with a good response. However, the patient developed a progressive impairment of renal function, associated with hemolytic anemia and thrombocytopenia. The peripheral smear showed the presence of schistocytes.The suspicion of atypical Hemolytic Uremic Syndrome (aHUS) was confirmed by the assay of C5B-9 induced by serum on endothelial cells, which showed a deposition of 331%, treatment with Eculizumab was initiated.After 3 administrations the patient did not improve, with further worsening of the hemolytic condition, and progression of renal damage.Due to the failure of Eculizumab, we considered the use of Ravulizumab. However, in Italy only can be administered to patients in Eculizumab stable treatment for at least three months. Nevertheless, faced with the catastrophic condition, it was decided to shift the therapy and use off-label Ravulizumab. After 10 days of the first administration, the laboratory tests showed a continuous rise in the values of haptoglobin, platelets, and hemoglobin, and a decrease in LDH. The renal function failed to return to normal values but after 20 days of therapy with Ravulizumab, there was complete resolution of the hemolytic condition.
Correlation between the Values of Immature Platelet Fraction and Mean Platelet Volume with the Extent of Coronary Artery Disease in Patients with Non-ST-Segment Elevation Myocardial Infarction
Published on: 26th September, 2023
Introduction: The identification of new markers of thrombotic risk and early diagnosis of Non-ST-segment Elevation Myocardial Infarction (NSTEMI) could allow the optimization of the therapy and predict short and long-term prognosis. Aims and objective: We aimed to assess the impact of Immature Platelet Fraction (IPF) and Mean Platelet Volume (MPV) levels on the extent of Coronary Artery Disease (CAD) in patients with NSTEMI undergoing coronary angiography. Methods: This is a prospective observational study in which 100 subjects of Non-ST Elevation Myocardial Infarction were recruited. For the measurement of platelet count, IPF and MPV samples were analyzed by an automated hematology analyzer (Sysmex XN 1000). Patients were subjected to coronary angiography as per institutional protocol and the extent of coronary artery lesion was noted. Result: A cutoff of MPV (fL) ≥ 10.6 can predict the involvement of the left anterior descending artery (LAD) with a sensitivity of 84%, and a specificity of 50%. With the cutoff of IPF (%) ≥ 2.4, it can even predict the type of disease i.e., Double Vessel Disease (DVD), or Triple Vessel Disease (TVD) with a sensitivity of 97%, and a specificity of 19%. Mean IPF values and MPV levels were significantly higher in patients with LAD involvement i.e., 4.40 ± 1.72% (p = 0.003) and 12.45 ± 1.88 (p = 0.030) respectively than in patients without involvement of LAD i.e., 2.78 ± 1.50% and 11.08 ± 2.19 respectively. Conclusion: Immature platelet fraction and mean platelet volume were significantly associated with the involvement of the left anterior descending artery which was the most commonly involved vessel in patients with NSTEMI. Mean platelet volume was also associated with TVD which was statistically significant. MPV and IPF can be useful early independent hematologic markers to identify patients with a higher risk for significant CAD as they are readily available and inexpensive.
Laser Doppler Flowmeter as a Periodontal Evaluation Method: A Clinical Pilot Study
Published on: 9th October, 2023
Background and objectives: Periodontal disease, as an inflammatory pathology, induces hemodynamic changes that can be evaluated by different unbiased methods such as laser Doppler flowmetry. This clinical investigation assesses laser Doppler as a non-invasive procedure to monitor gingival vascularization and its potential relationship with the response to treatment of periodontal disease.Materials & methods: 45 sites of white Spanish patients with active periodontitis undertake a complete periodontal analysis. This included periodontal pathogens identification along with the monitoring of the gingival margin microvascularization using a Doppler laser at the points exhibiting the most periodontal damage. All assessments were performed before and after periodontal combined treatment PCT (scaling, root planing, and antibiotic therapy prescription) (n = 45 sites).Results: Parameters of periodontal disease showed a positive correlation with pathogen levels. Blood flow readings decreased significantly after PCT (p < 0,05), although this parameter was not statistically correlated with periodontal nor microbial assessments in a significant range.Conclusion: Laser Doppler is a complementary method of monitoring periodontal inflammation to traditional techniques of clinical periodontal evaluation. Further studies are necessary to determine its usefulness as a predictive method of periodontal disease evolution.
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