Search Results (227,319)

Background: Crystal arthritides represent the most common inflammatory rheumatologic condition. While the prevalence of gouty arthritis by monosodium urate (MSU) is well established, the prevalences of calciumpyrophosphat (CPP) and basic calcium pyrophosphate (ARP) arthritis are less clear. We herein sought to assess the prevalence and inflammatory characteristics of crystal arthritides at our institution, the biggest tertiary center in Switzerland. Methods: A total of 5036 synovial fluid (SF) samples were analyzed with regard to crystal positivity as well as joint, age, and sex distribution in affected patients. We furthermore compared inflammatory and non-inflammatory SF samples for yields of their Polymorphonuclear (PMN) fractions. Results: About half of all samples were derived from knee joints, a male/female ratio up to 10.1:1 among the MSU-positive, and a clear shift towards elder patients with CPP–arthritis was seen. These findings were in line with previous studies and suggest good comparability of our cohort. Of note, 21.9% of all samples were CPP positive, whereas 15.3% and 9.5% were positive for MSU and ARP/alizarin-red positive, respectively. Importantly, CPP crystals were predominant in inflammatory (58.9%) and non-inflammatory (65.7%) samples. By contrast, MSU crystals were significantly more often associated with synovitis (p < 0.001). Interestingly, higher PMN fractions were found in non-inflammatory MSU-positive samples (p < 0.01), whereas a similar trend was seen in CPP-positive samples. Conclusions: CPP arthritis represented the most frequent crystal arthritis form at our center. Higher PMN fractions in non-inflammatory samples with CPP and MSU crystals suggest subclinical inflammation and provide further arguments for earlier anti-inflammatory and uric acid-lowering therapies in patients with crystal deposits. Full article

Background/Objectives: Li-Fraumeni syndrome (LFS) is a disease caused by a germline mutation of the tp53 gene that predisposes the individual to various malignancies, including breast cancer. Its impact on treatment modalities in oncology remains poorly studied. In this critical review, we aimed to retrieve and analyze available data concerning adjuvant radiotherapy in early breast cancer for LFS patients, as well as the current guidelines. Methods: We reviewed articles with LFS patient cohorts that reported secondary malignancy rates after breast adjuvant radiotherapy. Rates of recurrence, when available, were also included. Furthermore, we discussed contemporary radiobiological evidence and guidelines on the subject. Results: Six retrospective studies were reviewed. Five reported much higher rates of secondary malignancies compared to the general population. Additionally, there was no clear trend toward increased locoregional control after adjuvant radiotherapy. Radiobiological data suggest increased radioresistance and radiosensitivity within p53-mutated cells. Guidelines recommend avoiding radiotherapy in LFS patients when possible. Conclusions: Currently, there is no standard treatment or cure for LFS or a germline variant of the TP53 gene. With few exceptions, cancers in people with LFS are treated the same way as cancers in other patients, but research continues into the best way to manage cancers involved in LFS. Full article

Objectives: This study aimed to evaluate the incidence of adverse reactions to the COVID-19 vaccine among pregnant and breastfeeding women and identify associated demographic and clinical factors. Methods: A cross-sectional study was conducted at a hospital in Hanoi, Vietnam, from November 2021 to March 2022. A total of 1204 participants, including 991 pregnant women beyond 13 weeks of gestation and 213 breastfeeding women, were recruited through convenience sampling. Data were collected using a self-administered questionnaire designed to capture demographic information and adverse reactions occurring within seven to 28 days post-vaccination. Statistical analyses, including chi-square tests, Fisher’s exact tests, and logistic regression, were performed using Stata 16.0, with the significance set at p < 0.05. Results: The most common adverse reactions were localized pain at the injection site (26.2%), dizziness and fatigue (19.2%), and fever below 39 °C (29.1%). Severe adverse reactions, such as a tight throat, coma, and premature birth, were rare. A multivariate analysis identified the significant factors associated with the adverse reactions, including age (aOR = 2.04 for participants aged 36–40 years), occupation (lower odds for farmers and business professionals), urban residency (aOR = 0.64), and a history of allergies (aOR = 1.59). Education level, number of children, and gestational age were not significantly associated with adverse events. Conclusions: The findings support the safety of the COVID-19 vaccine in pregnant and breastfeeding women, with most of the adverse reactions being mild and self-limiting. Full article

Background/Objectives: Remifentanil-based anesthesia is linked to opioid-induced hyperalgesia (OIH), increasing postoperative pain and analgesic requirements. Magnesium, an N-methyl-D-aspartate (NMDA) receptor antagonist, might alleviate OIH. We aimed to assess whether intravenous magnesium reduces postoperative pain, analgesic requirements, and hyperalgesia in adults receiving remifentanil-based anesthesia. Methods: We searched PubMed, Embase, the Cochrane Library, and Web of Science (1 December 2024) for randomized controlled trials (RCTs) comparing intravenous magnesium vs. placebo. Risk of bias was evaluated with the Cochrane RoB 2 tool, and random-effects meta-analyses were conducted. GRADE was used to assess evidence quality. Primary outcomes were postoperative analgesic requirements and pain scores; secondary outcomes included intraoperative remifentanil consumption, shivering, postoperative nausea/vomiting (PONV), extubation time, hypotension, and bradycardia. PROSPERO registration: CRD42024609911. Results: Twenty-two RCTs (n = 1362) met eligibility. Magnesium significantly decreased 24 h analgesic requirements (standardized mean difference [SMD] −1.51; 95% confidence interval [CI] −2.15 to −0.87; p < 0.0001) and pain scores (SMD −0.61; 95% CI −0.90 to −0.32; p < 0.0001), with benefits persisting up to 48 h. It also reduced intraoperative remifentanil use (SMD −0.52), shivering (odds ratio [OR] 0.25), and PONV (OR 0.66), without prolonging extubation or increasing hypotension/bradycardia risk. High heterogeneity, potential publication bias, and moderate-to-very-low evidence certainty warrant caution. Conclusions: Intravenous magnesium appears beneficial in remifentanil-based anesthesia, but further large-scale, methodologically robust trials are needed to confirm optimal and clarify safety profiles across diverse surgical populations. Full article

Analysis of the (i) charge balance function and (ii) fluctuations of the net electric charge of hadrons in $Pb$+$Pb$ collisions at center-of-mass energy 2.76 TeV per nucleon pair was performed within a two-component hydjet++ model. It is shown that neither the widths of the balance function nor the strongly intensive quantities, D and $\Sigma$, used to describe the net-charge fluctuations, can be reproduced within the model based on a grand canonical ensemble approach for generating multiparticle production. To solve this problem, it is necessary to take into account exact charge conservation in an event-by-event basis. The corresponding procedure was developed and implemented in the modified hydjet++ model. It provides a fair description of the experimental data. Full article

Objective: To characterize facial fracture patterns and understand predictors of surgical repair and LOS with the objective of assisting providers in managing and understanding these complex injuries. Study Design: This is a retrospective cohort chart review study. Methods: A retrospective review was conducted for patients admitted with gunshot wounds (GSWs) to the head, neck, or face between January 2013 and March 2020 at a level one trauma tertiary care hospital. Univariate and multivariate analysis were performed to identify associations with surgical repair and LOS. Results: Of the 578 patients with head, neck, or facial GSWs, 204 survived and sustained facial fractures. The maxilla (n = 127, 62%), orbit (n = 114, 55%), and mandible (n = 104, 51%) were the most fractured. Operative rates differed by location (p < 0.001) with highest rates for fractures involving the mandible (76%). In univariate analysis, overall facial fracture surgery was associated with transfacial injuries; mandible, palate and nasal fractures; tracheostomy; gastrostomy tube placement; ICU admission; and a longer-than-24 h ICU stay (all p < 0.05). In multivariate analysis, predictors of surgical repair included a length of stay greater than 3 days (OR 2.9), transfascial injury (OR 3.7) and tracheostomy placement (OR 5.1; all p-values < 0.05), while nasal and mandible fractures were also associated with overall operative repair (OR 2.5 and 9.3, respectively; p-value < 0.05 for both). Univariate analysis showed that among patients with GSW injuries who underwent facial plastic reconstructive surgery (FPRS) with comorbid serious polytrauma, the inpatient LOS was predicted solely by the presence of subarachnoid, subdural and intracranial hemorrhage (p-value < 0.005). Subsequent multivariate analysis found that the only predictor for greater hospital LOS for patients who underwent surgical repair was earlier timing to FPRS of less than five days (OR 0.17) and placement of a gastrostomy tube (OR 7.85). Conclusions: Managing facial fractures in GSW patients requires complex medical decision making with a consideration of functional and esthetic outcomes in the context of concomitant injuries and overall prognosis. Certain characteristics such as ICU admission, longer hospital stay, trajectory of GSW, tracheostomy placement, and specific operative locations are associated with higher rates of operative repair. Inpatient hospitalization LOS for patients who underwent FPRS was predicted by timing from admission to surgical repair. Full article

Background: The complete loss of S-methyl-5′-thioadenosine phosphorylase (MTAP) expression, often due to homozygous 9p21 deletion, creates a druggable vulnerability in cancer cells. Methods: A total of 769 primary pancreatic ductal adenocarcinomas were analyzed on tissue microarrays with MTAP immunohistochemistry (IHC) and 9p21 fluorescence in situ hybridization (FISH). Intratumoral heterogeneity was assessed on a “heterogeneity” TMA containing up to nine samples from different areas of 236 primary tumor and nodal metastases, and whole sections of all tumor blocks from 19 cancers. Results: MTAP expression loss was found in 181 (37.9%) of 478 interpretable primary tumors and was unrelated to pT, pN, grade, and tumor size. MTAP expression loss was homogenous in 37.6% and heterogeneous in 1.1% of the 181 tumors, with at least three evaluable samples on the heterogeneity TMA. On whole sections, 1 of 19 tumors showed heterogeneous MTAP loss. The correlation between IHC and FISH was nearly perfect, with 98.8% of MTAP-deficient samples showing a 9p21 deletion. Conclusions: MTAP expression loss is frequent, caused by homozygous deletion, and mostly homogeneous in pancreatic ductal adenocarcinomas. Considering also their aggressive clinical behavior, pancreatic adenocarcinomas may represent an ideal cancer type for studying new drugs targeting MTAP-deficient cancer cells in clinical trials. Full article

Introduction: Achieving long-term impacts from cognitive remediation (CR) interventions is a key goal in rehabilitative care. Integrating virtual reality (VR) with psychoeducational approaches within CR programs has shown promise in enhancing user engagement and addressing the complex needs of individuals with bipolar disorder (BD). A previous randomized controlled crossover feasibility trial demonstrated the viability of a fully immersive VR-CR intervention for BD, reporting low dropout rates, high acceptability, and significant cognitive improvements. This secondary analysis aimed to evaluate the stability of these outcomes over time. Methods: This paper presents a 6- to 12-month follow-up of the initial trial. Secondary cognitive outcomes were assessed, including visuospatial abilities, memory, attention, verbal fluency, and executive function, using validated assessment tools. Statistical analyses were conducted using Friedman’s test. Results: A total of 36 participants completed the 6- to 12-month follow-up. Overall, cognitive functions showed a trend toward stability or improvement over time, except for visuospatial and executive functions, which demonstrated inconsistent trajectories. Significant improvements were observed in language (p = 0.02). Conclusion: This study highlights the overall stability of cognitive functions 12 months after a fully immersive VR-CR program for individuals with BD. To sustain long-term clinical benefits, an integrated approach, such as incorporating psychoeducational strategies within cognitive remediation interventions, may be essential. Further follow-up studies with control groups and larger sample sizes are needed to validate these findings. Full article

Inorganic polyphosphate (PolyP) is a high-molecular-weight polymer that plays multiple roles in regulating immune responses. However, the specific anti-inflammatory mechanisms of bacteria-derived PolyP are unclear. In the present study, PolyP was extracted from Lactobacillus plantarum (L. plantarum), and the chain length was estimated to be approximately 250 Pi residues. The immune regulatory functions of PolyP were investigated using a lipopolysaccharide (LPS)-induced RAW264.7 cell oxidative stress model, and dexamethasone was used as a positive control. The result revealed that both dexamethasone and PolyP were protective against oxidative stress by inhibiting macrophage M1 polarization and the production of several markers, such as nitric oxide (NO), reactive oxygen species (ROS), inducible nitric oxide synthase (iNOS), and cyclooxygenase (COX)-2. In addition, PolyP suppressed inflammation progression by regulating the production of several cytokines, such as interleukin (IL)-1β, interferon (INF)-γ, tumor necrosis factor (TNF)-α, and IL-6, and inhibited the expressions of inhibitory κB kinase (IKK) α, IKKβ, and extracellular regulated protein kinases 2 (ERK2). Conclusively, PolyP derived from L. plantarum has the ability to protect cells from oxidative stress damage by inhibiting M1 polarization in macrophages. These findings provide insights into the function of PolyP and offer support for the potential application of PolyP in immune-related diseases. Full article

Static magnetic field (SMF) treatment is a new type of physical preservation method. In this study, SMF treatment was applied to fresh-cut lotus root to investigate its effects and possible mechanisms in terms of preserving color and maintaining freshness, with the goal of developing a preservation method for fresh-cut lotus root. Fresh-cut lotus root was treated with a magnetic field strength of 3 mt and stored for 14 days under cold conditions (temperature 4 °C, humidity 70%, wind speed 0.1–0.3 m/s, and no light). The control group received no SMF treatments. The effects of the SMF on the color, hardness, browning, weight loss, soluble solids content, vitamin C (Vit. C) content, and polyphenol content, as well as the activities of MDA, POD, PPO, and PAL and the contents of flavor substances of the fresh-cut lotus root were monitored every 2 days throughout the storage period. The results showed that the SMF treatment significantly slowed the decline in the sensory quality of fresh-cut lotus root (p < 0.05). After 6 days of storage, the degree of browning in the control group was 1.96 times that in the SMF group. The SMF treatment also significantly delayed reductions in the Vit. C and polyphenol contents in fresh-cut lotus root (p < 0.05). After 8 days of storage, the polyphenol content in the SMF group was 1.54 times that in the control group. After 12 days of storage, the Vit. C content of the SMF group was 1.45 times that of the control group. When the storage time reached 12 days, the L* and ΔE values of the control group were 1.89 times and 1.44 times those of the SMF group, respectively. The SMF treatment significantly reduced the activities of PPO and POD oxidases, as well as the MDA content (p < 0.05). After 12 days of storage, the activities of PPO and POD and the MDA content in the control group were 2.04 times, 1.42 times, and 1.71 times higher than those in the SMF group, respectively. After 14 days of storage, the weight loss rate in the control group was 1.65 times that in the SMF group, while the hardness of the SMF group was 1.23 times that of the control group. The SMF treatment increased the contents of esters, aldehydes, and ketones in fresh-cut lotus root compared with the control group. The contents of esters, aldehydes, and ketones in the SMF group were 1.04 times, 1.41 times, and 1.49 times higher than those in the control group, respectively. Moreover, using SMF treatment as a new preservation method for fresh-cut lotus root provides a promising strategy for preserving other fresh-cut fruits and vegetables. Full article

Blood pressure (BP), interarm differences (IAD) in BP, and arterial stiffness (AS) are related to cardiovascular disease risk and are attenuated by exercise training. While active, tennis players (TP) experience bilateral differences in shear stress, and thus vascular function due to the unilateral nature of the sport. However, it is unknown if this translates into attenuated bilateral differences in peripheral blood pressure (pBP), estimated central blood pressure (cBP), and AS, which could provide insight into the local versus systemic effects of exercise training on BP in women. Purpose: to evaluate bilateral differences in pBP, cBP, and AS in Division III female college TP and healthy recreationally active (RA) age- and sex-matched controls. Methods: In a parallel design, TP (n = 10) and RA controls (n = 10) were assessed for anthropometrics, body composition, and bilateral BP measurements using oscillometric cuff technique. Results: TP and RA were well-matched for body weight, body fat percentage, and BMI (all, p > 0.69). Interaction of arm and group, and effects of arm, or group were insignificant for pSBP and pDBP (all, p > 0.137). IAD in pSBP tended lower in TP (p = 0.096, d = 0.8), but IAD in cSBP was lower (p = 0.040, d = 0.8). Augmentation pressure and index were different between arms (p = 0.02), but no interactions (group by arm) were observed (p > 0.05). Conclusions: In groups well-matched for age and body composition, TP tended to have lower BP and IAD in pSBP, but cSBP revealed ~50% lower IAD in TP. Thus, measurement site and exercise training matter when assessing arterial stiffness and interarm differences in BP. Full article

Background: Cerebral vasospasm after craniotomy tumor (CVACT) is a rare complication that can occur following tumor craniotomy and significantly affects the outcome of patients. Unfortunately, it is not well understood, leading to delayed and ineffective management. This study aims to investigate CVACT by examining the factors contributing to its occurrence, its underlying mechanisms, diagnostic approaches, management strategies, and outcomes. The goal is to identify the characteristics and risk factors associated with CVACT, its clinical symptoms, diagnostic methods, management options, and potential outcomes. Methods: A systematic search used relevant keywords to identify cases of “cerebral vasospasm” after tumor resection in PubMed and Science Direct databases. Relevant cross-references were added by manually searching the references of all retrieved articles. Result: We included 60 inclusion patients from 14 case reports and 13 case series with 33 (55%) females and 27 (45%) males with a mean age of 44.05 ± 16.8 years. The most common tumors were pituitary adenomas, which were found in 22 (36.66%), the most common tumor location was the middle cranial fossa (75%), and the most common surgery technique used was transsphenoidal surgery (50%). Most of those who experience vasospasm have a craniotomy with the TSS technique (50%) with complications of intraoperative bleeding. The range of onset of VS symptoms postoperatively was 0–30 days (mean 6.59 d). The symptoms included asymptomatic, headache, loss of vision, hemiparesis, diplopia, etc. The vascular involvement was mainly anterior circulation (78.33%). The diagnostic tools most commonly used were angiography and transcranial doppler (TCD). The most common management of VS from the included studies was pharmacology. The survival rate was 61.66%. We found the tumor location and vascular-affected vasospasm were significantly correlated with mortality rates: p = 0.015 and p = 0.02. Conclusions: Cerebral vasospasm after craniotomy tumor removal (CVACT) frequently arises in tumors situated in the medial cranial fossa, predominantly pituitary adenomas and meningiomas. The minimally invasive surgical approach of TSS may contribute to the mechanism of CVACT incidence. The existence of preoperative vascular pathology, as encasement or narrowing, appears to be a predictor alongside the incidence of intra- or postoperative hemorrhage. The vascular structures most susceptible to vasospasm are located in the anterior circulation of the Willis circle, which appears to correlate with the vascular problems that typically undergo preoperative encasement of the internal carotid artery (ICA). The most reliable and real time diagnostic instrument employed is TCD, while imaging continues to be the gold standard. Nimodipine treatment continues to be a viable therapeutic option that can enhance patient outcomes. Full article

Given the high postural control demands of sport Jiu-Jitsu, prolonged training in this discipline may result in sport-specific adaptations, particularly in positions closely related to combat scenarios. This study aimed to evaluate the differences in reaction time and postural control between elite Jiu-Jitsu athletes and untrained individuals, highlighting the potential influence of specialized training on these critical performance attributes. This study was conducted on thirty-one young participants (fifteen Brazilian Jiu-Jitsu athletes and sixteen non-athletes). Reaction time was measured using the Fit Light Trainer system in two positions. Postural control was assessed during 30 s bipedal and single-leg standing, both with and without a dual task involving tracking a randomly moving point on a screen. Results indicated that athletes demonstrated significantly faster reaction times (p = 0.0242) and greater complexity in postural control mechanisms, as evidenced by higher fractal dimension values during single-leg standing with dual tasks in the anterior–posterior direction (p = 0.0011). These findings suggest that Brazilian Jiu-Jitsu athletes possess enhanced neuromuscular and cognitive–motor integration, crucial for managing the complex demands of martial arts. This study highlights the importance of incorporating dual-task scenarios in training to optimize athletic performance and postural control in high-demand sport contexts. Full article

Nitrate pollution in drinking water is a major environmental and health issue. High levels of nitrates in water sources present serious risks to both the environment and public health, highlighting the need for immediate research and management efforts to reduce pollution sources and safeguard water resources for sustainable growth. This study investigates the elemental associations with nitrate concentrations in groundwater across the northeastern region of Saudi Arabia, employing diverse analytical techniques to assess water quality and develop sustainable management strategies. Spatial variations in nitrate levels were observed in both deep and shallow wells using GIS-based interpolation, revealing distinct patterns influenced by geological, hydrological, and anthropogenic factors. A strong linear correlation with a high coefficient of determination (R² of 0.99) between electrical conductivity and dilution factor suggests the potential interchangeability of ion-selective electrode methods and conductivity meters for EC determination. The study identified a positive correlation between nitrate concentration and electrical conductivity in groundwater samples (R² of 0.70), indicating that conductivity measurements could potentially serve as a proxy for estimating nitrate levels. However, a very weak negative correlation between nitrate and pH suggests other factors may have a more significant impact on groundwater pH. The research also highlights the strong positive correlation between nitrate and nitrate-nitrogen concentrations, reflecting their close chemical association in water. These findings contribute to the understanding of nitrate dynamics in groundwater and emphasize the importance of comprehensive water quality assessments. Future research should focus on elucidating factors influencing nitrate distribution in groundwater systems and developing more robust predictive models based on readily measurable water quality parameters. Full article

Equine herpesvirus 1-induced myeloencephalopathy has a significant impact on the equine industry. Nevertheless, the clinical variables that may affect the severity of the disease are still under investigation. The objective of this research is studying the relationship between the level of lymphopenia and vaccination status with the severity of the disease in horses at an event, considering whether they had been correctly vaccinated or not prior to exposure to EHV-1. Ten horses were admitted to a veterinary teaching hospital following an equine herpesvirus myeloencephalopathy outbreak during an international show jumping competition in Spain. Data were collected from passport vaccination records, daily analyses, and the clinical histories of the affected horses. Correctly vaccinated horses had a significantly longer hospitalization duration (6/10, 15.5 ± 1.2 days) compared to incorrectly vaccinated horses (4/10, 12.5 ± 1.2 days; p = 0.01). Lymphopenia (<1.6 × 10³ lymphocytes/µL) was the most common leukogram abnormality. Correctly vaccinated horses demonstrated a higher lymphocyte count compared to incorrectly vaccinated horses within 24 h of admission (p < 0.01). This difference remained significant from days 1 to 4 and on day 6 post-admission (p =0.03). This study found that lymphopenia is a common leukogram alteration in equine herpesvirus 1-infected horses, and horses correctly vaccinated prior to an equine herpesvirus myeloencephalopathy outbreak tend to have a longer hospitalization time. Correctly vaccinated horses exhibited higher lymphocyte counts during the first 24 h and throughout hospitalization compared to incorrectly vaccinated horses. The immune system could play a relevant role in influencing the severity of equine herpesvirus myeloencephalopathy outbreaks, highlighting the need for further studies in this area. Full article