Biomedicine (Journal)
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Age-Specific Percentile-based Prostate-Specific Antigen Cutoff Values Predict the Risk of Prostate Cancer: a single hospital observation
No full textBackground Testing for prostate-specific antigen (PSA) is often recommended for men with a potential risk of prostate cancer (PCa) before requiring advanced examination. However, the best PSA cutoff value remains controversial. Object We compared the predictive performance of age-specific percentile-based PSA thresholds with a conventional cutoff of \u3e4 ng/mL for the risk of PCa. Methods We included men who received PSA measurements between 2003 and 2017 in a medical center in Taiwan. Logistic regression modeling was used to assess the association between age-specific percentile-based PSA thresholds and PCa risk in age subgroups. We further applied C-statistic and decision curve analysis to compare the predictive performance of age-specific percentile-based PSA with that of a conventional cutoff PSA. Results We identified 626 patients with PCa and 40836 patients without PCa. The slope of PSA in patients \u3e 60-year-old was almost 3 times that of those70-year-old: 5.84 ng/mL) were comparable to those observed based on the conventional cutoff in all age groups. However, the discrimination performance of the 75th percentile PSA cutoff was better than that of the conventional cutoff among patients age
Red cell distribution width, neutrophil lymphocyte ratio and interleukin 10 are good prognostic markers in multiple myeloma
No full textMultiple myeloma (MM) is still an incurable disease so we need to continue developing new diagnostic and prognostic options for its management. There are multiple prognostic factors for MM, but most of them are costly and time consuming. Hence comes the urge to identify bed side and low cost prognostic tools. That is why this study was aiming to identify in Egyptian MM patients. Materials and methods: The study was carried on 60 newly diagnosed multiple myeloma patients and 20 age and sex matched healthy individuals as controls. Studied subjects were subdivided into two groups: Group I: 60 multiple myeloma patients which were subdivided into three subgroups: Stage I: 10 patients, Stage II: 17 patients, Stage III: 33 patients, Group II: 20 healthy controls. Results: A progressive significant increase in IL-10, RDW, NLR, and beta2 microglobulin (β2M) with disease progression from stage I towards stage III as compared to the control group However, IL-10, RDW, and NLR have the best prognostic efficiency value regarding to sensitivity, specificity and positive predictive value when compared with β2M. Conclusions: IL-10, RDW, and NLR are simple, easy and bedside tests (in the case of RDW, and NLR). They have high sensitivity and specificity when compared to β2M, which is a well-established prognostic factor that highlights the valuable role they play as prognostic markers in MM
Evaluation of SARS-CoV-2 infection risks after primary vaccination with BNT162b2, BBIBP-CorV, or ChAdOx1-nCOV-19 and after homologous and heterologous booster vaccinations with these vaccines and evaluation of SARS-CoV-2 reinfection profiles
No full textBackground: The emergence of SARS-CoV-2 variants has significantly increased the number of cases of COVID-19 among vaccinated individuals, raising concerns about the effectiveness of current vaccines. The aim of this study was to analyze the SARS-CoV-2 infection risks after primary vaccination with BNT162b2, BBIBP-CorV, or ChAdOx1-nCOV-19 and after homologues and heterologous booster vaccinations with these vaccines, as well as the profiles of reinfected patients. Methods: We analyzed retrospectively 1082 patients vaccinated or unvaccinated with BNT162b2, BBIBP-CorV, and/or ChAdOx1nCoV-19 vaccines to determine their SARS-CoV2 infection statuses using the reverse transcription-polymerase chain reaction (RT-PCR) in addition to their clinical features. The infection risks of patients receiving the different vaccine regimens were compared using multivariate logistic regression analysis, comparing the adjusted OR of a positive COVID-19 test result. Results: Among 596 vaccinated patients, 53%(n=286) tested positive for SARS-CoV-2 and 57%(n=310) tested negative. Among positive cases, 10 were reinfection cases. The risk of SARS-CoV-2 infection was 1.6 (adj. OR) for patients who received one dose compared with those who received two doses (95% CI=1.3-1.8;
Combination treatment of pembrolizumab with DC-CIK cell therapy for Advanced hepatocellular carcinoma: a case report
No full textBackground: Recently, immunotherapy has emerged as a promising method for advanced HCC treatment. There are several clinical trials and meta-analyses of immune checkpoint inhibitors and immune cell therapy, but clinical evidence on the combination of these two therapies is lacking. Case description: A 66-year-old man with chronic hepatitis B-related cirrhosis complained of acute abdominal pain in an emergency department of a hospital. On exams, there was a palpable mass in the right upper quadrant of his abdomen. Contrast-enhanced abdominal computed tomography showed a large tumor in the right lobe, 13 cm x 17cm in size, and right portal vein thrombosis. The alpha-fetoprotein(AFP) level was 30905 mg/dL. Therefore this patient was diagnosed with BCLC stage C hepatocellular carcinoma(HCC). He underwent trans-arterial chemo-embolization(TACE), abdominal radiotherapy, nivolumab, and lenvatinib. His disease had been under control until two years later, the disease progressed with multiple lung metastases, and his AFP level rose from around 1000 to 17000 ng/ml. At this stage, he underwent new combination immunotherapy in January 2022. He used pembrolizumab(100mg) first, and the AFP level decreased by 600ng/ml daily. Then he received DC-CIK cell therapy two weeks after using pembrolizumab, and the AFP level declined to 900ng/ml a day. Unfortunately, severe pneumonitis and tension pneumothorax developed after therapy. The patient denied undergoing further treatment and expired peacefully. Conclusion: The previous in-vivo study found that combination immunotherapy can improve tumor control in the mice model. Besides, in previous clinical studies, the level of AFP may be a surrogate marker of tumor response. Therefore we thought the more rapidly declined level of AFP was the clinical evidence of the synergistic effect of checkpoint inhibitors combined with cell therapy in HCC treatment
Continuous Intrathecal Saline Infusion for Treating Refractory Spontaneous Intracranial Hypotension: A Case Report
No full textSpontaneous intracranial hypotension (SIH) is a poorly understood condition that presents with a wide variety of symptoms, ranging from mild headaches to coma. It is typically caused by continuous spontaneous leakage of spinal cerebrospinal fluid (CSF), resulting in orthostatic headaches. However, the appropriate management of refractory SIH remains unclear. A 50-year-old man presented with orthostatic headache followed by a rapid decline in mental status. The imaging findings were consistent with the diagnosis of SIH, with bilateral cerebral subdural hematomas and abnormal fluid collection in the posterior epidural space from the T2 to T12 levels. Computed tomography myelography of the whole spine revealed multiple high-flow CSF leakages at the T6 to T8 levels. Despite treatment with bilateral burr hole drainage for subdural hematomas and repeated lumbar epidural blood patch (EBP) three times, the patient\u27s condition worsened and he developed stupor. A lumbar intrathecal saline bolus (90 ml) was administered to restore CSF depletion. The patient\u27s verbal function improved immediately, and continuous intrathecal saline infusion was administered at a rate of 10 ml/hour for two days. The patient\u27s stupor gradually resolved, and after his symptoms improved, the EBP injection was repeated at the T8 level. The patient recovered completely, and during the six-year follow-up, there were no signs of recurrence. SIH may cause a refractory decline in mental status, and lumbar intrathecal saline infusion may help arrest or reverse an impending central (transtentorial) herniation. This case demonstrates an appropriate bolus and continuous infusion of normal saline, and documents the resolution of SIH. This maneuver may change the CSF flow pattern and aims to seal the CSF fistula. Further studies are needed to better understand the mechanism of intrathecal saline infusion and establish effective treatment strategies for refractory cases of SIH
Jugular Foramen versus Hypoglossal Canal in Axial CT scan
No full textBackground: Differentiating jugular foramen from hypoglossal canal in computed tomography (CT) scan is vital for correct diagnosis of posterior fossa pathologies; however, it has been shown that the ability for differentiating these skull base elements is limited. The purpose of this study was to produce a simple algorithm for differentiating the jugular foramen from the hypoglossal canal in axial CT scan on two levels (top level where bony carotid canal is evident and lower level where bony carotid canal is not evident). Methods: Data derived from axial CT scan of 250 patients (500 sides) were used for producing algorithm. At top level petro-occipital fissure utilized for recognizing occipital condyle in which hypoglossal canal is located; and, at lower level the distance between the posterior border of the anatomic element (jugular foramen or hypoglossal canal) and the tangent to the anterior bony part is used for producing algorithm. Results: The mean age of patients was 38.1 ± 19 years. The petro-occipital fissure can be used in all patients for differentiating hypoglossal canal. At lower level the distance between the anterior tangent and the posterior border of the element was significantly lower for hypoglossal canal (P value \u3c 0.001). The distance more than 3.5 millimeters with sensitivity 83.8% and specificity 97.1% differentiate jugular foramen from hypoglossal canal. Conclusion: Simple algorithms based on quantitative morphologic features of the jugular foramen and hypoglossal canal can be used with high sensitivity and specificity to distinguish these elements
Toxicological Evaluation of a Polyherbal Formulation on Testicular Function and Gonadal Histomorphology in Exposed Wistar Rats
No full textIntroduction: Dr Iguedo Goko Cleanser® is a herbal formulation (HF) widely marketed in southern Nigeria and purported to be very efficacious for the management of various diseases including giardiasis, toilet infections, hypertension, diabetes, ulcer, impotence, low libido, low sperm count amongst others. Medicinal plants reportedly produce an array of adverse reactions capable of inducing harmful conditions, including death. Aim: This study evaluated the subchronic toxicity concern of HF on testicular function and gonadal histoarchitecture in Wistar rats. Methods: Thirty Wistar rats of both sexes were randomly divided into six groups (5/group) and were orally administered HF for 60 days. The control groups received 5 mL/kg of distilled water; the treatment groups were administered 476.24 and 158.75 mg/kg body weight of HF each for both male and female rats. Using standard procedures, semen analysis was done for all male rats. Animals were anaesthetised and sacrificed on the 62nd day; the gonads were eviscerated, weighed and fixed in 10% buffered formalin for histopathological examinations. Results: Significant (
Hipoxia modulates the secretion of growth factors in of human umbilical cord-derived mesenchymal stem cells
No full textBackground: Mesenchymal stem cell (MSC) has great potential as therapies due its ability to regenerate tissue damage and promote tissue homeostasis. Preconditioning of MSC in low oxygen concentration has been shown to affect the therapeutic potential of these cells. This study aimed to compare the characteristic and secretion of trophic factors of MSCs cultured under hypoxia and normoxia. Methods: MSCs were isolated from Wharton\u27s jelly of human umbilical cord (UC) tissue by explant method and characterized by flow cytometry. Following 24 hours of CoCl2induced hypoxic culture, the viability and metabolic activity of MSC were analyzed by trypan blue exclusion test and methyl thiazolyl tetrazolium (MTT) assay, respectively. The secretion of hepatocyte growth factor (HGF) and vascular endothelial growth factor (VEGF) was assessed in conditioned medium using enzyme-linked immunosorbent assay (ELISA) method. Results: Flow cytometry analysis showed \u3e99% of the population of MSCs cells were positive for CD73 and CD90 and \u3e62% were positive for CD105. While the cell viability of MSC was not affected by hypoxic cultured condition, the metabolic activity rate of these cells was decreased under hypoxic conditioning. In line with reduced metabolic activity, hypoxic human UC-derived MSC produced less HGF than normoxic counterpart. Compared to normoxic MSC, hypoxic preconditioned MSC secreted higher level of VEGF in the conditioned medium (
Comparative Analysis of the Nutritional, Biochemical and Hematological Parameters of Pregnant Women Attending the University of Abuja Teaching Hospital, Nigeria
No full textBackground: Despite the efforts to encourage the intake of nutritional supplements during antenatal periods, there are still many cases of anemia and protein-energy malnutrition during pregnancy. Hence, this study determined the incidence of anemia, protein-energy malnutrition, and associated risk factors among pregnant women in Abuja, Nigeria.
Materials and Methods: This hospital-based, case-control study involved randomly selected 176 pregnant and non-pregnant women attending the University of Abuja Teaching Hospital (UATH), Gwagwalada, Nigeria. Hemoglobin and hematocrit measurements were used to determine anemia incidence, while plasma protein, zinc levels and body mass index (BMI) were used to determine energy index status. Complete blood counts were analyzed using 5 parts-automatic hemo-analyzer, while plasma protein and zinc were analyzed using calorimetric method. Anemia and protein-energy malnutrition were defined using the World Health Organization (WHO) cut-off values.
Results: The mean age of participants was 28.75 ± 5.22 years. Out of 176 participants, 7 (4%) were malnourished while 25% of the participants were anemic. Anemia was significantly associated with participants’ occupation (p=0.002), parity (p˂0.001) and gestational age (p˂0.001). Most hematological indices, plasma globulin, albumin, protein, and zinc levels were significantly different (p˂0.001) among non-pregnant and pregnant women of the first, second and third trimesters.
Conclusion: The incidence of anemia and malnutrition was high among study participants. There is a need for improved nutritional intervention, increased awareness and strengthening of health systems in the area of maternal health in Nigeria