Bosnian Journal of Basic Medical Sciences (BJBMS)
Not a member yet
1863 research outputs found
Sort by
Invasive pulmonary aspergillosis evaluation in hematology patients: Three years results of tertiary hospital
Get PDFInvasive pulmonary aspergillosis (IPA) is the most frequent invasive fungal disease occurring in patients with hematological malignancies. Serum galactomannan (GM) antigen monitoring is thought to be helpful in the diagnosis of IPA. The aim of this study was to determine the role of a GM assay in serum samples for the diagnosis of IPA in patients with hematological disease. The data of 366 immunosuppressed patients that were hospitalized and followed up in the hematology clinic from January 2017 to December 2019 were retrospectively analyzed. The clinical and radiological findings of the patients and the GM results, requested twice a week, were evaluated. In this study, the incidence of probable and possible IPA was determined to be 15.3% (56/366). Of the cases detected, 28 (50.0%) were patients diagnosed with acute myeloid leukemia (AML), and 34 (60.7%) patients who had compatible clinical and examination findings were started on antifungal treatment. Additionally, area under the curve (AUC) values were calculated by receiver operating characteristic (ROC) analysis, and it was determined that the diagnostic efficiency was more predictive when the cut-off was 0.5 in the GM test for IPA disease. The detection of GM antigen in serum is a very useful and rapid method for diagnosing IPA disease in immunosuppressed hematology patients. However, GM results should be evaluated together with clinical and radiological findings for early diagnosis, and the treatment approach should be determined accordingly
Stress-induced hyperglycemia and mortality in patients with traumatic brain injury without preexisting diabetes: A meta-analysis
Get PDFStress-induced hyperglycemia (SIH) is common in patients with traumatic brain injury (TBI) and has been suggested to influence mortality rates. This meta-analysis aims to evaluate the impact of SIH on mortality in TBI patients without preexisting diabetes mellitus (DM). A comprehensive search was performed in Medline, Web of Science, Embase, Wanfang, and China National Knowledge Infrastructure (CNKI) databases up to May 15, 2024, to retrieve relevant studies. Observational studies reporting the incidence of all-cause mortality among TBI patients without preexisting DM, comparing those with and without SIH, were included. The association between SIH and all-cause mortality was analyzed using risk ratios (RR) and 95% confidence intervals (CI) with a random-effects model. Twelve cohort studies comprising 15 datasets with 16,387 TBI patients were included. The pooled analysis showed that SIH was associated with a higher risk of all-cause mortality (RR: 2.00, 95% CI: 1.72–2.33, P < 0.001), with mild heterogeneity (I² = 25%). Sensitivity analysis confirmed the robustness of these findings. Subgroup analyses indicated no significant differences based on study design, patient age, gender proportion, SIH definition, or follow-up duration. However, the association was slightly weaker but still significant in studies using multivariate analyses (RR: 1.76) compared to univariate analyses (RR: 2.69). In conclusion, SIH was associated with a higher risk of all-cause mortality in TBI patients without preexisting DM. Further research should explore the underlying mechanisms and optimal management strategies for SIH in this population
Curcumin ameliorates ischemic stroke injury by downregulating GMFB expression: An in vitro study
Get PDFIschemic stroke (IS) is a cerebrovascular sickness, and cerebral ischemia-reperfusion (I/R) damage often occurs, but there is still a lack of drugs that can significantly alleviate it. Curcumin (Cur) exerts pharmacological effects such as antioxidative stress, anti-inflammation, and the promotion of apoptosis through regulating various pathways, but its efficacy and specific mechanism of action in IS have not been fully clarified. The purpose of this paper is to study the influence of Cur on IS. Brain microvascular endothelial cells (BMECs) were used to create an oxygen-glucose deprivation/reoxygenation (OGD/R) model to simulate I/R damage. The cell viability was assessed using an MTT assay. The LDH level and ROS positive rate were measured using commercial kits. The cell invasion was examined using a transwell assay. The apoptosis was assessed by flow cytometry. The contents of GMFB, Bax, and Bcl2 were measured using western blot. We confirmed that in the OGD/R-induced IS cell model, the abundance of GMFB was enhanced in the OGD/R group versus the control group. GMFB overexpression promoted OGD/R-induced cell viability diminution, increased LDH and ROS levels, lessened cell invasion ability, enhanced cell apoptosis, enhanced Bax levels, and decreased Bcl2 levels. Silencing GMFB ameliorated OGD/R-induced cell damage. Cur ameliorated OGD/R-induced cell damage. Cur curbed OGD/R-induced cell damage by downregulating GMFB expression. In conclusion, Cur cured ischemic stroke-induced cell damage by downregulating GMFB expression
Natural biomaterials in the management of the aortic valve pathology. Biomedical and clinical aspects: A review
Get PDFHeart valve diseases are a prevalent cardiovascular pathology worldwide, affecting nearly 2.5% of the population. Degenerative aortic stenosis is the most common form of heart valve disease. The treatment options include surgical or transcatheter procedures. There are two main categories of valve prostheses available: mechanical heart valves constructed from synthetic materials and bioprosthetic heart valves made from natural biomaterials. The choice of valve type depends on various factors, including the underlying medical condition, suitability for anticoagulation, valve durability, and the patient’s age and preferences. Mechanical heart valves have the advantage of long-term durability. However, patients receiving mechanical implants are subjected to lifelong anticoagulation therapy with an increased risk of thromboembolism and bleeding. Natural biomaterials do not require long-term anticoagulation. However, they experience degenerative changes leading to structural valve deterioration that may require reoperation. The purpose of this article is to review the role of natural biological materials used for aortic valve replacement or repair, assess their biomedical and clinical advantages and limitations, and analyze the direction and perspectives of future development
Epidemiology, prognostic factors, and survival analysis in small cell esophageal carcinoma: A population-based study with external validation
Get PDFSmall cell esophageal carcinoma (SCEC) is a poorly differentiated esophageal neuroendocrine neoplasm with a poor prognosis. This study aimed to explore the factors and treatment approaches influencing the prognosis of SCEC. In this retrospective study, we collected data from the 18 Surveillance, Epidemiology, and End Results (SEER) registries cohort between 2004 and 2019, as well as from a Chinese institutional registry covering the period from 2012 to 2022. We assessed the annual percentage change (APC) in incidence of SCEC. Kaplan-Meier and Cox regression analyses were conducted to evaluate survival outcomes. Additionally, nomograms were developed for overall survival (OS) and cancer-specific survival (CSS) in the SEER cohort for SCEC and validated in an independent Chinese cohort. This analysis included 299 SCEC patients from the SEER cohort and 66 cases from the Chinese cohort. During the period of 2004–2019, the incidence of SCEC reached a plateau, with an APC of -1.40 (95% confidence interval [CI]: -4.3 to 1.40, P > 0.05). Multivariable Cox regression analysis revealed that age, distant metastasis, and chemotherapy were independent factors for OS, while distant metastasis and chemotherapy were independent factors for CSS. The nomograms developed for OS and CSS in SCEC exhibited remarkable accuracy and reliable predictive capacity in estimating 1-year, 3-year, and 5-year OS and CSS. SCEC is a rare malignancy with aggressive behavior. Distant metastasis is significantly associated with worse OS and CSS in patients with SCEC. Currently, chemotherapy remains the primary treatment approach for SCEC
Research and clinical implications of emerging evidence regarding patterns of postoperative opioid-induced respiratory depression
Get PDFThe wider availability of continuous respiratory monitors and advanced data abstraction techniques has led to a substantial increase in understanding of postoperative opioid-induced respiratory depression (OIRD), particularly regarding its incidence, presentation, temporal distribution, and risk factors. Self-limited episodes of OIRD are relatively common, typically presenting as repetitive apneas beginning in the postoperative period and continuing through the first night after surgery. In contrast, life-threatening episodes of OIRD are rare and usually occur on the day of surgery. Traditional monitoring of patient vital signs may be insensitive in detecting OIRD, while healthcare staff may be more adept at recognizing the concurrent development of somnolence. Although obstructive sleep apnea (OSA) is a known risk factor for OIRD, a more comprehensive phenotype is emerging-elderly patients with debility and substantial comorbidity. These advances have significant implications for managing postoperative OIRD. This review will focus on how these new insights into OIRD have highlighted knowledge gaps and created opportunities for future research and practice initiatives
NEWS, SIRS and qSOFA criteria for predicting sepsis and sepsis with high risk of death in emergency room: A comparison study and improved predictive models based on local data from CETAT and MIMIC-IV databases
No full textEarly identification of sepsis in emergency department patients is critical for initiating timely interventions, highlighting the need for effective predictive scoring systems. A retrospective observational study was conducted using data from the CETAT database collected between December 2019 and October 2021. The study evaluated how well the systemic inflammatory response syndrome (SIRS), quick Sepsis-related Organ Failure Assessment (qSOFA), and National Early Warning Score (NEWS) scoring systems, along with logistic regression models, predict sepsis, and high-risk sepsis in emergency department patients. The logistic regression models were further optimized by incorporating additional features based on local data. A total of 12,799 patients were analyzed, including 1360 sepsis cases, of which 373 were classified as high-risk sepsis. The NEWS score demonstrated superior predictive performance compared to qSOFA and SIRS, with an area under the receiver operating characteristic curve (AUC-ROC) of 0.737 (95% confidence interval [CI] 0.72–0.75) for sepsis and 0.653 (95% CI 0.62–0.69) for high risk sepsis . After optimization, the NEWS-based model improved to an AUC-ROC of 0.756 (95% CI 0.74–0.77) for sepsis and 0.718 (95% CI 0.69–0.75) for high-risk sepsis. Further enhancement was observed with the inclusion of additional clinical variables, resulting in AUC-ROC values of 0.834 (95% CI 0.82–0.85) for sepsis and 0.756 (95% CI 0.73–0.78) for high-risk sepsis. Data from the Medical Information Mart for Intensive Care (MIMIC)-IV database, which included sepsis status and relevant variables for SIRS, qSOFA, and NEWS score calculations, confirmed that the optimized NEWS-based model improved the sepsis prediction AUC-ROC from 0.690 (95% CI 0.68–0.70) to 0.708 (95% CI 0.70–0.72), and consistently outperformed qSOFA and SIRS in sepsis prediction
Therapeutic potential of simvastatin in ALS: Enhanced axonal integrity and motor neuron survival through Apoa4 and Alb modulation
Get PDFAmyotrophic lateral sclerosis (ALS) is a neurodegenerative disease characterized by the selective death of motor neurons in the spinal cord, brainstem, and motor cortex. This study investigates the effects of simvastatin on the G93A-copper/zinc superoxide dismutase (G93ASOD1) transgenic mouse model of ALS. The experiment included three groups: C57BL/6 wild-type mice, C57BL/6J SOD1G93A mice treated with PBS (SOD1G93A + PBS), and C57BL/6J SOD1G93A mice treated with simvastatin (SOD1G93A + simvastatin). The primary endpoints were survival rates, body weight changes, performance in pole climbing and suspension tests, and neurological deficit scores. Pathological changes were assessed using hematoxylin and eosin staining, transmission electron microscopy, Nissl staining, and Masson staining. Proteomic and metabolomic analyses were performed to identify differentially expressed proteins (DEPs) and metabolites. Quantitative real-time polymerase chain reaction and western blotting were used to measure gene expression. Although there were no significant differences in survival rates, body weight, pole climbing, and suspension test performance, or neurological deficit scores between the SOD1G93A + simvastatin and SOD1G93A + PBS groups, simvastatin treatment improved axonal organization within the spinal cord, increased the number of neurons, and reduced cytoplasmic swelling and gastrocnemius fibrosis. A total of 47 DEPs and 13 differential metabolites were identified between the SOD1G93A + PBS and SOD1G93A + simvastatin groups. Notably, the expression levels of Apoa4 and Alb were elevated in the SOD1G93A + simvastatin group compared to the SOD1G93A + PBS group. Our results suggest that simvastatin may have potential therapeutic effects in ALS, likely involving the modulation of Apoa4 and Alb expression
Mechanistic insights into Y-Box binding protein-1 mediated regulation of lipid metabolism and oxidative stress in NAFLD via INHBE/TNF-β pathway
Get PDFNonalcoholic fatty liver disease (NAFLD) is a prevalent liver disorder that has emerged as a significant public health concern. This study aimed to investigate the mechanisms by which Y-box binding protein-1 (YB1) knockdown influences lipid metabolism and oxidative stress in palmitic acid (PA)-induced NAFLD LO2 cells. The expression of YB1 was analyzed using the GSE89632 dataset from the Gene Expression Omnibus (GEO) database. RNA sequencing was performed, followed by Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses, and protein-protein interaction (PPI) network analyses to identify differentially expressed genes (DEGs). Quantitative real-time PCR (QRT-PCR), Western blotting, flow cytometry, and various biochemical assays were used to evaluate gene expression, lipid accumulation, and oxidative stress. Our results demonstrated that YB1 is highly expressed in NAFLD. RNA sequencing revealed 798 DEGs between the shCtrl and shYB1 groups, with 190 genes upregulated and 608 genes downregulated. Notably, we observed an increase in Inhibin beta E (INHBE) expression, while EGR1, GDF15, NUPR1, and FOSB were decreased in NAFLD LO2 cells. YB1 knockdown, particularly when combined with INHBE suppression, significantly enhanced cell viability, improved lipid metabolism, and reduced reactive oxygen species (ROS) accumulation and malondialdehyde (MDA) content. The downstream mechanism was primarily associated with TNF-β signaling. Specifically, we observed decreased levels of TGF-β1, p-Smad2, and p-Smad3 following YB1 and INHBE knockdown. Furthermore, INHBE overexpression reversed the beneficial effects induced by YB1 knockdown. In conclusion, YB1 knockdown improves lipid metabolism and reduces oxidative stress in NAFLD LO2 cells, largely through the INHBE/TNF-β signaling pathway. These findings provide valuable insights into novel therapeutic strategies for managing NAFLD
Effect of elevated CEA levels on the outcome of colorectal cancer patients with different histopathologic types:A SEER population-based study
Get PDFLimited and contradictory evidence has been reported regarding the prognostic effects of carcinoembryonic antigen (CEA) on the prognosis and metastasis of classical adenocarcinoma (CA), mucinous adenocarcinoma (MA), and signet-ring cell carcinoma (SRCC) in colorectal cancer (CRC) patients. We investigated the associations between histological subtypes and preoperative serum CEA levels in determining the oncologic outcomes of CRC patients. A total of 47,692 patients with clearly diagnosed CRC were selected from the Surveillance, Epidemiology, and End Results (SEER) database and divided into two cohorts based on serum CEA levels: CEA-normal (C0) and CEA-elevated (C1). Chi-square analysis revealed a correlation between CEA levels and histological classification. We then included a newly defined interaction variable (H&CEA) in the Cox regression analysis, which demonstrated that this variable could serve as an independent prognostic factor (P < 0.001). CA, in the context of elevated serum CEA levels, differed from the other two histopathological types, showing unexpectedly higher risks for both overall survival (OS) (HR = 1.70, 95% CI = 1.65–1.75, P < 0.001) and cancer-specific survival (CSS) (HR = 1.78, 95% CI = 1.72–1.85, P < 0.001). Furthermore, elevated CEA levels significantly increased the proportion of liver metastases in the CA group (25.43% vs 3.95%, P < 0.001). The interaction variable H&CEA can be used as an independent prognostic factor for CRC and should be considered in the diagnosis of CRC and the development of personalized treatment plans. Additionally, in the context of elevated CEA levels, CA is associated with poor prognosis and increased liver metastases. This CRC subgroup warrants special clinical attention from oncologists