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Exploring skin disorders in palliative care: a systematic review
Get PDFIntroduction: Skin disorders present significant challenges in palliative care settings, often complicating symptom management and diminishing the quality of life for patients facing life-limiting illnesses. Despite their prevalence and impact, there remains a dearth of comprehensive research synthesizing the landscape of skin disorders within palliative care.
Methods: This systematic review aims to elucidate the spectrum of skin disorders manifested in individuals receiving palliative care, providing a comprehensive understanding essential for effective clinical management and improved patient outcomes. A thorough literature search was conducted across b-on, PubMed, Web of Science, and Scopus, focusing on studies involving human participants aged 18 years or over in palliative care settings. Inclusion criteria encompassed randomized controlled trials, observational studies, and quantitative studies published in peer-reviewed journals, specifically addressing skin disorders as a primary focus or significant aspect of palliative care.
Results: From an initial 347 articles, 17 studies met the inclusion criteria. The most common skin disorders identified include pruritus, pressure ulcers, and dermatitis, significantly impacting patients’ physical comfort, emotional well-being, and social interactions. The findings highlight the intricate nature of managing skin disorders in palliative care, necessitating interdisciplinary collaboration and tailored interventions to address the multifaceted needs of this population.
Conclusions: This review underscores the importance of recognizing, assessing, and managing skin disorders to enhance the quality of life of palliative care patients. Future research should focus on developing and implementing targeted strategies to alleviate the burden of skin disorders in this vulnerable group, ultimately improving patient care and outcomes
Anti-oxidant, anti-apoptotic and anti-inflammatory effects of geraniin in spinal cord injury in rats: role of COX-2
Get PDFBackground: Spinal cord injury (SCI) has a devastating effect on degeneration of the spinal column, and vascular problems. However, the currently available therapeutic interventions are insufficient to address these effects, which lead to significant impacts on the morbidity and mortality of patients. In this study, we aimed to investigate the pharmacological effect of geraniin (GER) on SCI in Sprague–Dawley (SD) rats.
Materials and methods: SCIs in rats were induced by the conventional weightdrop method and treated with geraniin (GER) (at 2.5, 5, and 10 mg/kg). Subsequently, the locomotor activity of rats with SCI was assessed using Basso, Beattie, and Bresnahan (BBB) scores, while oxidative stress indicators and inflammatory variables were analysed using commercially available kits. Additionally, neuronal death was quantified using TUNEL labelling. The enzymatic activityof caspase-3, -8, and -9 was also assessed. Furthermore, the expression levels of Bcl2, Bax, and COX-2 in rat spinal cords after SCI were analysed by RT-PCR analysis.
Results: We found that therapy with GER could enhance functional recovery in a dosage-dependent manner, as well as reduce the occurrence of apoptosis, and mitigate the inflammatory and oxidative response in rats with SCI. Furthermore, we observed that GER increased the expression of Bcl2 and decreased the expression of Bax and COX-2. The concentrations of caspase-3, -8, and -9 was observed to be decreased in SCI rats treated with GER.
Conclusions: GER might protect the spinal cord from SCI by reducing apoptosis, oxidative stress, and inflammatory response through the inhibition of COX-2
Digital image analysis of vertebral body L4 and its ossification centre in the human foetus
Get PDFUsing a Siemens-Biograph 128 mCT camera, morphometric analysis of the L4 vertebral body and its ossification centre was done in 55 human foetuses aged 17 to 30 weeks. No sex differences were found. The mean height, and transverse and sagittal diameters of L4 vertebral body followed the logarithmic functions: y = –11.797+ 5.208 × ln(age) ± 0.372, y = –23.462 + 9.428 × ln(age) ± 0.702, and y = 2.770 + 13.521 × ln(age) ± 1.722, respectively. The mean cross-sectional area of the L4 vertebral body followed the linear function: y = –30.683 + 1.976 × age ± 2.701. The mean volume of the L4 vertebral body followed the second-degree polynomial function: y = –93.983+ 0.385 × (age)2 ± 23.707. The mean transverse and sagittal diameters of the ossification centre of the L4 vertebral body followed the natural logarithmic functions: y = –27.106 + 10.178 × ln(age) ± 0.769 and y = –13.345 + 5.458 × ln(age) ± 0.424, respectively. The mean cross-sectional area and the volume of the ossification centre of L4 vertebral body followed the linear functions: y = –30.683 + 1.976 × age ± 2.701 and y = –43.214 + 2.760 × age ± 4.085, respectively
Poliumoside inhibits apoptosis, oxidative stress and neuro-inflammation to prevent intracerebroventricular streptozotocin-induced cognitive dysfunction in Sprague–Dawley rats: an in vivo, in vitro and in silico study
Get PDFBackground: Alzheimer’s disease (AD) is a severe neurological illness that causes cognitive decline and death if not treated early. The current therapeutic modalities are inefficient in managing the cognitive dysfunction of AD. Therefore, in this study, we aimed to investigate the pharmacological benefit of poliumoside (PMD) in streptozotocin-induced cognitive dysfunction in Sprague–Dawley (SD) rats.
Materials and methods: Initially, cognitive dysfunction in rats was induced by the intracerebroventricular administration of streptozotocin. Then rats received PMD at 5 mg and 10 mg/kg body weight. Various behavioural analyses, such as the Morris water maze (MWM) and the object recognition test (ORT), and locomotor analysis was conducted in the PMD-treated group. Biochemical analysis was conducted to analyse the effect of PMD on hippocampus oxidative-nitrosative stress and pro-inflammatory cytokines. MTT assay and annexin V/PI staining were performed to analyse the effect of PMD on the cell viability and neuronal toxicity of PC12 cells, respectively. Molecular docking analysis was also conducted with crystal structure of human AChE.
Results: PMD treatment improved cognitive capacity in rats in MWM and ORT. Compared to STZ rats, PMD-treated rats had significantly higher locomotor activity and lower AChE activity. PMD also restored dopamine, 5-HT, and NE levels and reduced their metabolic deactivation, as evidenced by increased levels of DOPAC, HVA, and 5-HIAA. Nitrite, MDA, SOD, CAT, and GSH levels were restored to near normal in PMD-treated rats, reducing hippocampus oxidative-nitrosative stress. Pro-inflammatory cytokines were similarly lowered in PMD-treated rats. In in vitro studies, PMD did not affect PC12 cell survival at the maximal dose of 10 μM. In addition, PMD concentration-dependently prevented H2O2-induced neuronal death in PC12 cells. In silico docking analysis showed that PMD fitted snugly into the active site of human AChE by engaging with the anionic domain and the catalytic triad of Trp86, Tyr337, Phe338, and Gly121 residues.
Conclusions: This study has demonstrated that PMD has a significant impact on AD by inhibiting ACheE and restoring neurotransmitter levels, which enhances Ach levels in rats, and improves cognitive impairment in STZ rats
Evaluating the effect of coronary atherosclerosis on the occurrence of atrial fibrillation through coronary computed tomography angiography
No full textBackground: The direct impact of atherosclerotic lesions in coronary vessels on the occurrence of atrial fibrillation (AF) in patients without a history of acute myocardial ischemia, myocardial infarction, or revascularization procedures remains largely unknown.Aims: We aimed to assess the risk and predictors of new-onset AF in patients with coronary atherosclerosis confirmed by coronary computed tomography angiography (CCTA).Methods: We included consecutive patients referred for CCTA who had been observed and diagnosed with new-onset AF over 10 years.Results: Of the 549 patients enrolled in the study, 208 (37.9%) were diagnosed with atherosclerotic lesions in the coronary vessels, and 63 (11.5%) developed AF during the 10 years of follow-up. AF patients were older (61.8 [10.4] years vs. 58.3 [9.2] years; P = 0.005), had enlarged left atrium in the anteroposterior dimension (38.2 [7.2] mm vs. 34.4 [5.4] mm; P <0.001), and had thickened interventricular septum (12.3 [2.0] mm vs. 11.0 [2.1] mm; P <0.001). We also found a significant correlation between the occurrence of AF in patients with coronary atherosclerotic lesions and with increased thickness of the interventricular septum relative to the posterior wall of the left ventricle (P = 0.017).Conclusions: Our data indicate an association between coronary atherosclerosis and greater AF risk in patients with increased thickness of the interventricular septum relative to the posterior wall of the left ventricle. This finding suggests that by using CCTA, we can predict which patients are at higher risk of developing AF
The performance of the NAPLES prognostic score in predicting one-year mortality and major adverse cardiovascular events after transcatheter aortic valve implantation in patients with severe aortic stenosis
No full textBackground: Existing risk scores for transcatheter aortic valve implantation (TAVI) may not fully capture patient complexity. Combining nutritional and inflammatory markers, the NPS (the NAPLES prognostic score) might improve outcome prediction.Aims: This study investigated the associations of the NPS with one-year mortality and major adverse cardiovascular events (MACEs) in TAVI patients.Material and methods: This retrospective analysis included 222 patients with severe aortic stenosis who underwent TAVI. The NPS was calculated based on the serum albümin concentration, cholesterol concentration, lymphocyte/monocyte ratio, and neutrophil/lymphocyte ratio. The patients were subsequently categorized into two groups: the low-NPS group (NPS 0–2) and the high-NPS group (NPS 3–4).Results: A high NPS was significantly associated with increased one-year mortality (4.8% vs. 23.7%; P <0.001) and MACE rates (7.2% vs. 35.9%; P <0.001). Cox regression analysis demonstrated that a high NPS was an independent predictor of both mortality (HR, 5.94; 95% CI, 2.03–17.37; P = 0.001) and MACEs (HR, 5.09; 95% CI, 2.15–12.02; P <0.001).Conclusions: The NPS emerged as a potential predictor of long-term mortality and MACEs in TAVI patients. Further validation through larger, multicenter, studies is warranted. This research contributes valuable data on the role of the NPS in TAVI risk stratification
Endovascular treatment of superior vena cava thrombosis: A challenging case and an alternative technique
No full textUltra-long-term histopathological workup of Amplatzer muscular septal defect occluders after surgical removal of the heart due to heart transplantation
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The effect of an antibacterial envelope on cardiac implantable device-related infection — A real-world analysis from a tertiary center
Get PDFBackground: Infections related to cardiac implantable electronic devices (CIED) are associated with significant morbidity and mortality. Antibiotic-eluting envelopes have been introduced as a technology to prevent CIED infections. The aim of this study was to evaluate the effectiveness of the antibacterial envelope in the real-world population of a tertiary center.
Methods: This cohort study includes consecutively enrolled patients undergoing a device procedure from 01/2014 to 12/2020 at the University Hospital in Zurich. During period A (01/2014-12/2019) antibacterial envelopes were not used, whereas during period B (01/2020-12/2020) antibacterial envelopes were used in all device interventions. Follow-up was conducted by assessing all available patient records from patient visits and hospitalization.
Results: 1757 patients (male 70.5%, mean age 67.1 ± 16 years), were analyzed during a follow-up of 24 months. In 302 patients (17.2%) an antibacterial envelope was used. The overall occurrence of a device infection was low (n = 15, 0.85%). Factors that were associated with the incidence of an infection were not undergoing a primary implantation procedure (p = 0.024) and a CRT-P/D intervention (p = 0.022). There was no difference in the rate of infection between patients in whom a bacterial envelope was implanted vs. those in whom it was not used (0.6 vs. 0.9%, p = 0.693).
Conclusion: In a contemporary cohort of consecutive, unselected patients undergoing a device intervention at a large tertiary care center, the rate of device infection was low and not significantly different with vs. without the use of an antibacterial envelope. The data have important practical as well as economic implications for physicians performing such procedures