METHODS: Databases of MEDLINE, EMBASE, and CENTRAL were searched from their inception date until October 2023. Randomized Clinical Trials (RCT) comparing methylene blue and placebo in adults with septic shock were included.
RESULTS: Our systematic review included 5 studies (n = 257) for data analysis. As compared to the placebo, our pooled analysis showed that methylene blue significantly increased mean arterial pressure (MD: 1.34 mmHg, 95% CI 0.15 to 2.53, p = 0.03, level of evidence: very low). Patients who were given methylene blue were associated with statistically lower mortality rate (OR = 0.49, 95% CI 0.27 to 0.88, p = 0.02, level of evidence: low), reduced serum lactate levels (MD: -0.76 mmoL.L-1, 95% CI -1.22 to -0.31, p = 0.0009, level of evidence: low), reduced length of hospital stay (MD: -1.94 days, 95% CI -3.79 to -0.08, p = 0.04, level of evidence: low), and increased PaO2/FiO2 (MD: 34.78, 95% CI 8.94 to 60.61, p = 0.008, level of evidence: low).
CONCLUSIONS: This meta-analysis demonstrated that methylene blue administration was associated with an increased in mean arterial pressure and PaO2/FiO2 ratio, along with a reduction in mortality rates, serum lactate levels, and length of hospital stay. However, substantial degree of heterogeneity and inadequate number of studies with low level of evidence warrant future adequately powered RCTs to affirm our results.
METHODS: Five databases were searched. Studies with patients of any age with acute asthma exacerbations and at least one clinical outcome measure were included. Studies on intubated patients and outpatients were excluded. Two independent reviewers screened abstracts and then full texts for eligibility.
RESULTS: 1242 records were identified and 11 studies were included in the review. Three out of five studies found significant differences in capnography measures between patients eventually admitted and those discharged from the emergency department. Patients with lower initial EtCO2 were more likely to require hospital admission. Other components of the capnography waveform were associated with disposition, including a larger alpha angle and a lower ratio between phase III duration and respiratory rate being associated with hospital admission. Seven studies examined correlations between capnography measures and other markers of airway obstruction and weak or absent correlations were generally found. Three studies reported significant change in capnography measures after treatment.
CONCLUSION: Lower EtCO2 may predict poorer outcome in acute asthma exacerbations. Other measures taken from the capnography waveform appear to be useful indicators of severity. Addressing patient selection issues and conducting prognostic accuracy studies of EtCO2 with clinical endpoints may provide meaningful evidence for clinical practice.
METHOD AND CONCLUSION: In this brief report, we will first discuss the concepts of malformations and neoplasia and then focusing on their relevance to odontogenic tumors, which impacts their classification and treatment, particularly mixed odontogenic lesions.
MATERIALS AND METHODS: A cross-sectional study was conducted from September to November 2023, utilizing a validated questionnaire to assess 461 randomly selected participants from four communities (Azuba, Bukan Sidi, Danka Sarki, and Doka), representing diverse sociodemographic profiles and varying degrees of exposure to risk factors associated with HBV infection. Data were analyzed using chi-square (χ2) tests with IBM SPSS statistical software version 28.0 at a significance level of p < 0.05.
RESULTS: The findings showed that the overall prevalence of HBV infection was 7.8%. A significant association was observed between the prevalence of HBV infection and monthly income (p < 0.01). However, no associations were found with age, gender, educational level, marital status, occupation, or religion. Regarding risk factors, a significant association was found between HBV infection and awareness of one's HBV status (p < 0.03).
CONCLUSION: These findings highlight the need for targeted public health interventions and policies aimed at reducing HBV transmission among high-risk sociodemographic groups in Lafia Metropolis. This approach could potentially reduce the burden of HBV and improve health outcomes in affected communities.
METHODS: Derived from the randomized SPIRR-CAD trial, plasma leptin were measured by the Human Leptin DuoSet ELISA at baseline in 539 patients (including 115 (21.3 %) women and 424 (78.7 %) men) and in 373 participants after 18-months follow up (T3). RDM was based on the clinical course from baseline to follow-up assessed by the Hamilton Depression Rating Scale (HAMD). Multivariate binary logistic regression models identified predictors for heightened leptin at T3.
RESULTS: At baseline, highest leptin level (3rd tertile) was associated with type 2 diabetes (p = 0.009), heart failure symptoms (NYHA III) (p
AIM OF THE STUDY: To investigate the antinociceptive, anti-neuropathic, and anti-migraine activities of Fritillaria imperialis bulbs essential oil (FIEO) as well as to uncover the potential mechanisms of action involved.
MATERIALS AND METHODS: The antinociceptive activity of FIEO and its main constituent, Verticinone (Vt), was assessed using the formalin-induced paw licking assay. The potential mechanisms of antinociception were investigated through various antagonists. Additionally, their antineuropathic activity was examined using the cervical spinal cord contusion (CCS) technique and the possible role of Stat3 was evaluated using Western blot analysis. The nitroglycerin-induced model (NTG) was also employed for the evaluation of migraine.
RESULTS: FIEO demonstrated significant antinociceptive activity in both phases of the formalin-induced test. However, the FIEO activity was more pronounced effect observed in the second phase. Modulators of the NO-cGMP-K+ channel pathway significantly reversed the antinociceptive activity of FIEO (P
METHODS: BMP10 levels were quantified in 2085 chronic HF patients from the European BIOlogy Study to TAilored Treatment in Chronic Heart Failure (BIOSTAT-CHF) cohort and in 1487 patients from the Scottish validation cohort. Multivariable linear regression identified independent associates of BMP10. Proteomic analysis of 6369 proteins with subsequent gene set enrichment analysis was used to explore biological pathways associated with elevated BMP10. Cox proportional hazards models adjusting for established risk factors were used to associate BMP10 levels with clinical outcomes, including all-cause mortality and HF hospitalisation.
RESULTS: In a multivariable model including clinical and echocardiographic parameters, log-transformed and standardised BMP10 levels were significantly associated with a history of atrial fibrillation (Sβ=0.419; p<0.001), and with echocardiographic features reflecting atrial stress, such as increased left atrial diameter (Sβ=0.075; p=0.048). By contrast, these were not among the strongest associates of NT-proBNP levels. Gene set enrichment analysis showed significant overrepresentation in pathways of muscle contraction and extracellular matrix organisation. Higher log-transformed and standardised BMP10 levels predicted a combined outcome of 2-year all-cause mortality and HF rehospitalisation (HR=1.10, 95% CI=1.02-1.19), with the validation cohort yielding comparable results.
CONCLUSION: BMP10 emerges as a novel biomarker reflecting atrial stress and remodelling in chronic HF patients. Its additional predictive value for adverse outcomes underscores its potential utility in enhancing risk stratification and guiding therapeutic interventions in HF management.
RECENT FINDINGS: Asia is the epicenter of diabetes. There have been marked advances with genotyping and phenotyping of the Asian patient with T2D, particularly with young onset diabetes where early beta cell failure and rapid progression of complications are more frequent. As Asians have lower muscle mass and higher adiposity, sarcopenia is increasingly associated with diabetes. Response to lifestyle and pharmacotherapy are generally similar, but unique features exist with different populations. Across Asia, use of guideline directed medical therapy for cardio-renal protection are recommended, but uptake of these newer agents are suboptimal and barriers exist with regards to standardized care.
SUMMARY: Although many similarities have been observed across Asia, due to the heterogeneity of populations within Asia, further research is required to streamline and pave the way towards precision medicine. There is an urgent need for region wide consensus to minimize barriers to diabetes care and stigma in diabetes terminology across Asia.