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Mortality Prediction of ICU Cardiovascular Patient: Time-Series Analysis
Get PDFIt is estimated that millions of deaths occur annually, which can be prevented when early diagnosis and correct treatment are provided in the intensive care unit (ICU). In addition to monitoring and treating patients, the physician of the ICU has the task of predicting the outcome of patients and identifying them. They are also responsible for the separation of patients who use special ICUs. Because not necessarily all patients hospitalized in ICU benefit from this unit, and hospitalization in a few cases will only lead to an easier death. Therefore, developing an intelligent method that can help doctors predict the condition of patients in the ICU is very useful. This paper aims to predict the mortality of cardiovascular patients hospitalized in the ICU using cardiac signals. In the proposed method, the condition of patients is predicted 30 minutes before death using various features extracted from the electrocardiogram (ECG) and heart rate variability (HRV) signals and intelligent methods. The paper's results showed that combining morphological, linear, and nonlinear features can predict the mortality of patients with accuracy and sensitivity of 96.7±6.7% and 94.1±5.8%, respectively. As a result, accurate classification of diseases and correct prediction of patients by reducing unnecessary monitoring can help optimize ICU beds' use. According to new and advanced techniques and technologies, it is possible to predict and treat many diseases in ICU, leading to longer patient survival
Is Glycemic Control the Primary Goal in Diabetes Treatment?
Get PDFThe prevalence of Diabetes is steadily increasing, raising public health concerns. Hyperglycemia leads to microvascular and macrovascular diseases through several metabolic and biochemical pathways. Previous clinical trials and observational studies have demonstrated that tight glycemic control can reduce the incidence of diabetic complications, with the greatest benefit shown in younger patients with diabetes of shorter duration and those who have no prior history of cardiovascular disease. Moreover, previous studies highlight the concept of metabolic memory and legacy effect, since controlling diabetes early can have an impact on long-term prognosis of the disease. As to whether it is time to consider shifting the treatment focus for patients with type 2 diabetes from a glucose-centric to a weight-centric or a cardio-centric approach, the dilemma remains theoretical; glucose control, weight loss and effective treatment of metabolic and cardio-vascular co-morbidities are interrelated components of an integrated plan of care that should be addressed simultaneously and effectively
A Review on Epigenome Editing using CRISPR-based Tools to Rejuvenate Skin Tissues
Get PDFGenomic activity is controlled by a sophisticated series of cell functions known as the epigenome. The creation of tools capable of directly altering various processes is required to unravel this intricacy. Additionally, by employing tailored DNA-binding platforms connected with effector domains to serve as targeted transcription factors or epigenetic modifiers, it is possible to control the chemical modifiers that regulate the genome's activity. Neoplastic disorders have received the most attention in the study of epigenetics, though the epigenome's significance in a variety of disease processes is now well acknowledged. Researchers are inspired to investigate novel approaches to revert these pathogenic alterations to their normal patterns by considering the fact that the epigenome profile of individuals with aging skin cells or other skin disorders, including atopic dermatitis, differs from that of healthy individuals. Here in this review, we discuss the use of CRISPR/dCas9 as a cutting-edge and flexible tool for fundamental studies on chromatin structure, transcription regulation, and epigenetic landscapes, as well as the potential of this method in these fields. Furthermore, we review on common and recently invented methods to make epigenetic alterations possible in daughter cells after any mitotic differentiations. In the very near future, CRISPR-based epigenomic editing will become a potent tool for comprehending and regulating biological functions
Rare Cadaveric Finding of a Horseshoe Kidney in the Presence of an Abdominal Aortic Aneurysm: A Case Report
Get PDFHorseshoe kidney is a congenital malformation that occurs during gestational development as a result of the fusion of the parenchyma of both kidneys at their lower poles. This leads to the malrotation of the urinary tract and abnormal renal vasculature. The co-existence of horseshoe kidney and abdominal aortic aneurysm is rare; it is found in approximately 1 in 700 autopsied cases and only 0.12% of patients undergo surgical repair of the abdominal aortic aneurysm. Both horseshoe kidney and abdominal aortic aneurysm usually present asymptomatically, and diagnosis may be made by physical examination, incidental findings on imaging, or during post-mortem examination. Furthermore, physicians face a great challenge in the medical and surgical management of these conditions due to the lack of standard guidance. In this article, we present a cadaveric case of a horseshoe kidney accompanied by an abdominal aortic aneurysm. The case report will demonstrate and categorize the horseshoe kidney with the Eisendrath system as type II and III classification, as well as discuss anatomical variations and medical management of the co-existence of a horseshoe kidney and abdominal aortic aneurysm
Semaglutide as Treatment for Obesity in Adolescents
Get PDFBackground: Semaglutide was recently approved to treat obesity in adolescents.
Main objective: To provide a critical appraisal of semaglutide as anti-obesity agent in adolescents.
Methods: Pubmed search up to May 19, 2023. Search terms were obesity, semaglutide, safety, phentermine/topiramate, liraglutide, dulaglutide, exenatide. Clinical trials, prospective and observational studies were included.
Results: The STEP TEENS was a double-blind, randomized trial that evaluated semaglutide 2.4 mg/week in addition to lifestyle changes in 201 adolescents (62% women) with obesity with mean body mass index (BMI) 37.0 kg/m2. After 68 weeks, difference between semaglutide and placebo in reduction of BMI (the primary outcome) was -16.7% (95% CI, -20.3 to -13.2). Corresponding difference in weight loss was -17.7 kg (95% CI, -21.8 to -13.7). Proportions of subjects who had ≥5% weight loss at 68 weeks were 73% and 18% with semaglutide and placebo groups, respectively. In the semaglutide group, reduction in BMI was evident (>5%) after 3 months, reached a nadir in 52-58 weeks then plateaued. Overall, the safety profile of semaglutide in adolescents mimics that in adults, except for higher incidence of gall bladder disease, and allergic reactions (rash and urticaria) in adolescents. Premature discontinuation of treatment due to adverse effects occurred in 5% of semaglutide-treated patients compared with 4% of placebo-treated subjects.
Conclusions: Semaglutide is a promising addition to pharmacological therapy of obesity in adolescents. Further studies are needed to demonstrate its long-term efficacy and safety, particularly in various ethnic minorities and in patients with concomitant type 2 diabetes
Bifurcation of the Brachial Artery into Brachioradial and Brachioulnar Arteries in the Proximal Arm: Case Report and Clinical Significance
Get PDFDuring anatomical dissection of fifty donors in the 2020 undergraduate first-year anatomy course at the Uniformed Services University of the Health Sciences, a high origin of the radial and ulnar arteries, also known as a brachioradial artery and a brachioulnar artery, was observed on the left arm of a 90 year-old White female donor. The bifurcation of the brachial artery occurred in the proximal third of the arm. Both the left brachioradial and left brachioulnar arteries ran superficial and medial to the biceps brachii muscle. The brachioulnar artery continues as the UA in the forearm, ran superficial and lateral to the flexor carpi ulnaris muscle, traversed the flexor retinaculum, and continued to form the superficial arterial palmar arch. The brachioradial artery ran deep to the pronator teres muscle and continued as the RA in the forearm. It presented with an atypical branching pattern and was tortuous until it reached the hand. On the dorsum of the hand, the radial artery runs superficial to the first dorsal interosseous muscle, parallel to the first metacarpal bone. It also reached the palmar side of the hand in an unusual manner. Medical professionals, especially radiologists, orthopedic and vascular surgeons, need to be aware of these variations to avoid iatrogenic injuries during normal procedures, such as venipuncture and intravenous injections. Knowledge of these variations is also important during invasive procedures, such as elbow reconstructive surgery, percutaneous brachial catheterization, and when creating an arteriovenous fistula using the radial artery. When such variations are suspected, Doppler and angiogram studies are necessary
Anatomical Variations of Human Pulmonary Fissures: A Cadaveric Study Conducted in Western Kenya
Get PDFAim and Objective: This cadaveric study was done to describe the variations in the pattern of pulmonary fissures in Western Kenyan population. Data were sourced from 68 lungs fixed in formalin in gross anatomy laboratory of the Department of Human Anatomy, Uzima University. The fissures were studied and the results compared with the previous studies.
Results: In this study 83.82% of lungs had a classical appearance a “textbook” lung: three major fissures that were complete without any accessory fissure. Out of the 31 right lungs examined, the horizontal fissure was absent in 0% lungs, incomplete in 6 lungs (16.13%), and complete in 25 lungs (80.64%). Out of the 37 left lungs, the oblique fissure was incomplete in 4 lungs (10.70%) and complete in 29 lungs (86.30%). The fissure was absent in one of the lungs (2.70%). Four right lung accessory fissures were observed (12.90%). Six left lungs (16.67%) had accessory fissures.
Conclusion: Incidence of complete of oblique fissure was greater in our present work when compared our results with other authors. The incomplete oblique fissure and incomplete horizontal fissure in our study varied compared with other studies. Our study recorded a prevalence of absent oblique fissure in the left lung that was greater in relation to absent horizontal fissure. The superior accessory fissure was higher in our study compared to other studies as well as compared the inferior accessory fissure in our study. The left minor fissure was the most frequently appearing accessory fissure in our study. Anatomists should note that lung fissure anatomy is more variable than orthodoxly presented. Clinicians must be warranted towards the depth and occurrence of these variations. Considering these variants we recommend more explorative research should be done on this topic to cast more light on this
A Communicating Branch Between the Musculocutaneous Nerve and the Median Nerve: A Case Report
Get PDFAnatomical variations of peripheral nerves are commonly reported in the literature. While typically benign, they are of clinical importance as they can contribute to atypical clinical presentations, cause difficulty with imaging and nerve conduction studies, and lead to surgical challenges for surgeons. We report here a communicating branch between the musculocutaneous nerve and median nerve found during cadaveric dissection in a Doctor of Nursing Practice course in the Department of Nurse Anesthesia at Samford University. Although the case described here is among the most common anatomical variations of the peripheral nerves, there are classification systems for this variation that need to be recognized and applied by anatomists, clinicians, and surgeons
Analysis for Molecular Distinction in the Chloroplast DNA Sequences of Gymnospora montana (Celastraceae) and Belanites aegyptiaca (Balanitaceae) from Semi-arid Area
Get PDFGymnospora montana (Celastraceae) and Belanites aegyptiaca (Balanitaceae) showed marked similarity in their cpDNA sequences. Therefore, its detail analysis of cpDNA sequences is performed for codon use bias and its index, relative synonymous codon use value (RSCU), effective number of codons (ENC), GC content of the gene and frequencies of the nucleotides G+C at various positions in synonymous codon were calculated and compared it with Tribulus terresties. Length of the gene and ENC showed close relationship which suggest that longer genes has less codon bias. The codons for leucine, isoleucine and serine were most abundant in the studied plant species. The correlation analysis suggested that codon usage patterns in both cp genomes appear due to the different forces; natural selection, mutation pressure, GC content of gene and protein length. Their role in gene evolution process is discussed
Identification of Unique Water Molecules in Human GRK2 Protein with Bound and Unbound GβGγ Subunit: A Study by Structural Bioinformatics Method
Get PDFThe human G-protein coupled receptor kinase 2 (hGRK2) regulates the desensitization of beta-adrenergic receptors (β-AR), and its overexpression has been implicated in heart failure. The hGRK2 is a serine/ threonine kinase and is one of the members of the AGC family, and it contains the four domains (i) RGS or RH domain (regulator of G-protein signaling res. id. 54-175), (ii) protein kinase or CAT domain (res. id. 191-453), (iii) AGC Kinase domain (res. Id 454-521), and (iv) PH domain (Pleckstrin homology, res. Id. 558-652). Present computational investigations on multiple analyses of X-ray structures (bound and unbound conformation of GβGγ) highlight the presence of seventeen unique water molecules (W1 to W17) that are only available either in hGRK2 with GβGγ or without GβGγ. These water molecules are subdivided into category-I (W1 to W8), which is observed with unbound GβGγ conformation, and category-II (W9 to W17) in hGRK2 with bound GβGγ conformation. The MD simulation results suggest the non-crystal and crystal water molecules are inaccessible to reaching W3, W10, and W12 water sites because they are deeply buried and shielded by neighboring residues, whereas W9, W11, and W13 are accessible by crystal water in MD simulation but not allow entering non-crystal or MD water molecules. During the structural transition of hGRK2 from unbound to bound hGβGγ state, water molecules of category-I (W1 to W8) departed from their respective domains, and water molecules of Category-II (W9 to W17) were reached simultaneously during unbound to bound GβGγ conformation. In this context, the present work identifies new biochemical insights to highlight some rationale clues for heart disease