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Preprint ARTICLE | doi:10.20944/preprints202404.1242.v1

Acute Exercise for the Hypertensive Elderly Affects the Whole-Body Capillary: A Single- Center Pilot Trial

MISA Miura, Masahiro Kohzuki, Chie Saito, Satoshi Sakai, Hisashi Sugaya, Shingo Koyama, Yasushi Matsui, Tohru Sakuma, Osamu Ito, Kunihiro Yamagata

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: ; nailfold capillary; acute exercise; hypertensive elderly; health related parameters ;

Online: 18 April 2024 (10:38:35 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202404.1176.v1

Invasive Procedures Used in Tuberculosis With Questionable Indications: Report From Russia

Sergei Jargin

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: tuberculosis; surgery; bronchoscopy; surfactant; alcoholism; Russia

Online: 17 April 2024 (17:01:42 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202404.1040.v1

Effectiveness of a Dual-Task Intervention Involving Exercise and Vocalized Cognitive Tasks

Masahiro Abo, Toyohiro Hamaguchi

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: cross-step training; dual task; MoCA-J; CS-30

Online: 16 April 2024 (13:59:34 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202404.0994.v1

The Curious Role of PAI‐1 in Severe OSA

Tea Friščić, Edvard Galić, Domagoj Vidović, Petrana Brečić, Igor Alfirević

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: plasminogen activator inhibitor-1; obstructive sleep apnea; continuous positive airway pressure; atherogenesis; fibrinolytic capacity

Online: 16 April 2024 (07:41:29 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202404.1003.v1

Ending an Odyssey? The Psychosocial Experiences of Parents after the Genetic Diagnosis of a Mitochondrial Disease in Children

Oliver Heath, Emma Hammerl, Anna Spitzinger, Saskia B. Wortmann

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: Mitochondrial diseases; genetic diagnosis; value of a diagnosis; diagnostic odyssey; parental attitudes

Online: 16 April 2024 (03:41:30 CEST)

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Preprint CASE REPORT | doi:10.20944/preprints202404.0887.v1

Saving High-Risk Patients from COVID-19 Severity and Death Mainly with Plant-Based Diets and Supplements

Dasaad Mulijono

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: plant-based diet; supplement; COVID-19; inflammation; cardiometabolic; antioxidant; anti-viral; anti-thrombotic

Online: 15 April 2024 (09:33:38 CEST)

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Preprint REVIEW | doi:10.20944/preprints202403.0100.v2

Plant-Based Diet and Supplements Reduced COVID-19 Severity and Mortality in Elderly Patients with Multiple Comorbidities (Part 2: Exploring the Underlying Mechanisms of Successful Intervention)

Dasaad Mulijono, Albert Manggading Hutapea, I Nyoman Ehrich Lister, Mondastri Khorib Sudaryo, Helwiah Umniyati

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: Plant-based; COVID-19; Inflammation; Supplements

Online: 9 April 2024 (10:00:02 CEST)

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Preprint REVIEW | doi:10.20944/preprints202404.0627.v1

Diagnostic Modalities in the Detection of Cardiac Amyloidosis

Syed Bukhari, Zubair Bashir

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: Cardiac amyloidosis; transthyretin; echocardiography; cardiac magnetic resonance; Tc-pyrophosphate scintigraphy

Online: 9 April 2024 (09:32:10 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202404.0602.v1

Enhancing EQ-5D-5L sensitivity in capturing the most common symptoms in post COVID-19 patients: an exploratory cross-sectional study with focus on fatigue, memory/concentration problems and dyspnea dimensions

Helena Janols, Carl Wadsten, Christoffer Forssell, Elena Raffeti, Christer Janson, Xingwu Zhou, Marta A. Kisiel

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: EQ-5D-5L, fatigue, memory/concentration problems, dyspnea, EQ-VAS, COVID-19

Online: 9 April 2024 (09:01:21 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202404.0492.v1

Clinical Evaluation of VITEK MS PRIME with PICKME Pen for Bacteria and Yeasts, and RUO database for Filamentous Fungi

Hyeyoung Lee, Jehyun Koo, Junsang Oh, Sung-Il Cho, Hyunjoo Lee, Hyun Ji Lee, Gi-Ho Sung, Jayoung Kim

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: MALDI-TOF mass spectrometry; VITEK MS PRIME; PICKME; filamentous fungi; yeast; bacteria

Online: 8 April 2024 (08:19:41 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202404.0273.v1

Carotid Plaques and Hypertension on the Risk of Cardiovascular Disease and All-Cause Mortality

Vilma Dzenkeviciute, Tadas Adomavicius, Gabriele Tarulyte, Egidija Rinkuniene, Vytautas Kasiulevicius, Jolita Badariene

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: all-cause mortality; cardiovascular disease; carotid plaque; hypertension

Online: 5 April 2024 (03:57:02 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202404.0308.v1

Quality of life of colorectal cancer survivors: Mapping the key indicators by expert consensus and measures for their assessment

Urška Smrke, Sara Abalde-Cela, Catherine Loly, Jean-Paul Calbimonte, Liliana R. Pires, Simon Lin, Alberto Sánchez, Sara Tement, Izidor Mlakar

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: quality of life; surveys and questionnaires; adult oncology; colorectal cancer survivors; Delphi study; scoping review; expert consensus

Online: 3 April 2024 (15:36:33 CEST)

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Preprint REVIEW | doi:10.20944/preprints202404.0280.v1

Cerebral Malaria: Clinicians, Extracellular Vesicles, and Therapeutically-Rational Exchange (T-REX)

Ryan Philip Jajosky, Audrey Nadine Jajosky, Philip Jajosky

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: cerebral malaria; therapeutically-rational exchange transfusion (T-REX); extracellular vesicles; decoy ligands; competitive binding; coma-recovery time; CD36; PfEMP1

Online: 3 April 2024 (10:31:22 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202404.0100.v1

Plant-Based Diets and Supplements Reduced COVID-19 Severity and Achieved Zero Mortality in Elderly Patients with Multiple Comorbidities

Dasaad Mulijono, Albert M Hutapea, I Nyoman E Lister, Mondastri K Sudaryo, Helwiah Umniyati

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: Plant-based; Supplement; COVID-19; Inflammation

Online: 2 April 2024 (03:08:16 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202404.0030.v1

Evaluation of Biochemical and Oxidative Stress Markers in the Early Stages of Rheumatoid Arthritis in a Comparative Study of Two Different Therapeutic Approaches

Stavroula Ioannidou, Athanasia Tsiakalidou, Konstantina Kazeli, Argyrios Ginoudis, Ariadne Fouza, Maria Daoudaki, Evgenia Lymperaki

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: Rheumatoid arthritis; oxidative stress markers; antioxidant markers; biochemical markers; Methotrexate; DMARD; biological agents

Online: 1 April 2024 (11:12:48 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202404.0001.v1

Dysregulation of Glypicans and Notum in Osteoarthritis: Plasma Levels, Bone Marrow Mesenchymal Stromal Cells and Osteoblasts.

IRENE GONZALEZ-GUEDE, Maria Lopez-Ramos, Luis Rodríguez-Rodriguez, Lydia Abasolo, Arkaitz Mucientes, Benjamín Fernández-Gutiérrez

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: Osteoarthritis; Bone Marrow Mesenchymal Stem Cells; Osteoblast; Glypican; NOTUM

Online: 1 April 2024 (09:47:08 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202403.1761.v1

Comparative Impact of Supine versus Prone Positioning on Segmental Lumbar Lordosis in Patients Undergoing ALIF followed by PSF

Sina Sadeghzadeh, Kelly Yoo, Ivan Lopez, Thomas Johnstone, Ethan Schonfeld, Ghani Haider, Neelan J Marianayagam, Martin N. Stienen, Anand Veeravagu

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: spine surgery; spinal instrumentation; ALIF; PSF; segmental lumbar lordosis

Online: 28 March 2024 (12:14:35 CET)

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Preprint ARTICLE | doi:10.20944/preprints202403.1649.v1

Relationship between Glucose 6-Phosphate Dehydrogenase and Pyruvate Kinase Deficiency with New Generation Inflammation Biomarkers of in Term Newborns with Prolonged Neonatal Jaundice

Omer Okuyan, Yusuf Elgormus, Seyma Dumur, Hafize Uzun

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: Prolonged jaundice, breast milk, glucose 6 phosphate dehydrogenase, pyruvate kinase, systemic-immune-inflammation index, neutrophil-to-lymphocyte ratio

Online: 27 March 2024 (08:12:05 CET)

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Preprint ARTICLE | doi:10.20944/preprints202403.1575.v1

Edge AI Model Deployed for Real-time Detection of Atrial Fibrillation Risk during Sinus Rhythm

Hongmin Wu, Takumi Sawada, Takafumi Goto, Tatsuya Yoneyama, Tetsuo Sasano, Ken Asada

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: atrial fibrillation; sinus rhythm; standard 12-lead ECGs; deep learning-based; edge AI deployment.

Online: 26 March 2024 (09:17:27 CET)

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Preprint ARTICLE | doi:10.20944/preprints202403.0261.v2

Being Physically Active for a Long-Standing Mitigates Inflammaging Progression in Older Adults during the COVID-19 Pandemic

Carlos André Freitas Dos Santos, Ariane Nardy, Renato Jimenez Gomes, Brenda Rodrigues Silva, Fernanda Rodrigues Monteiro, Marcelo Rossi, Jônatas Bussador do Amaral, Vitória Paixão, Mauro Vaisberg, Gislene Rocha Amirato, Rodolfo de Paula Vieira, Juliana de Melo Batista Dos Santos, Guilherme Eustáquio Furtado, Ana Paula Ribeiro, Patrícia de Souza Colombo, Alessandro Ferrari Jacinto, André Luis Lacerda Bachi

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: aging; older people; citokines; gait speed; TUGT; handgrip

Online: 14 March 2024 (15:05:33 CET)

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Preprint REVIEW | doi:10.20944/preprints202403.0306.v1

Putting Functional Gastrointestinal Disorders within the Spectrum of Inflammatory Disorders Can Improve Classification and Diagnostics of These Disorders

Šojat Dunja, Volarić Mile, Tanja Keškić, Nikola Volarić, Venija Cerovečki, Ljiljana Majnarić Trtica

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: gastrointestinal diseases; chronic diseases; cytokines; gastrointestinal microbiome; inflammation

Online: 6 March 2024 (10:57:20 CET)

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Preprint ARTICLE | doi:10.20944/preprints202403.0261.v1

Being Physically Active for a Long-Standing Mitigates Inflammaging Progression in Older Adults during the COVID-19 Pandemic

Carlos André Freitas Dos Santos, Ariane Nardy, Renato Jimenez Gomes, Brenda Rodrigues Silva, Fernanda Rodrigues Monteiro, Marcelo Rossi, Jônatas Bussador do Amaral, Vitória Paixão, Mauro Vaisberg, Gislene Rocha Amirato, Rodolfo de Paula Vieira, Juliana de Melo Batista Dos Santos, Guilherme Eustáquio Furtado, Ana Paula Ribeiro, Patrícia de Souza Colombo, Alessandro Ferrari Jacinto, André Luis Lacerda Bachi

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: aging; older people; citokines; gait speed; TUGT; handgrip

Online: 5 March 2024 (13:00:16 CET)

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Preprint ARTICLE | doi:10.20944/preprints202403.0227.v1

Prescribing Competence of Canadian Medical Graduates: National Survey of Medical School Leaders

Anne Holbrook, Simran Lohit, Oswin Chang, Jiawen Deng, Dan Perri, Gousia Dhhar, Mitch Levine, Jill Rudkowski, Heather McLeod, Kaitlynn Rigg, Victoria Telford, Anthony Levinson

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: prescribing competency; medical education; survey; Canada; medication safety

Online: 5 March 2024 (06:40:31 CET)

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Preprint ARTICLE | doi:10.20944/preprints202403.0239.v1

JAKinhibs in Psoriatic Disease: Analysis of the Efficacy/Safety Profile in Daily Clinical Practice

Francesco Bizzarri, Ricardo Ruiz-Villaverde, Pilar Morales-Garrido, Jose Carlos Ruiz Carrascosa, Marta Cebolla-Verdugo, Alvaro Prados-Carmona, Mar Rodriguez-Troncoso, Enrique Raya-Alvarez

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: JAK inhibitors; Psoriasis; Psoriatic arthitis

Online: 5 March 2024 (06:02:35 CET)

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Introduction. Psoriatic disease (PsD), encompassing psoriasis, psoriatic arthritis, inflammatory bowel disease, and uveitis, presents a significant burden due to its chronic and diverse inflammatory nature, affecting various clinical domains including skin, joints, and internal organs. Psoriasis, affecting up to 3% of the global population, not only poses physical challenges but also profoundly impacts patients' psychological well-being, ranking among the most debilitating chronic conditions. Furthermore, PsD exhibits a spectrum of manifestations ranging from skin lesions like plaque psoriasis to systemic complications such as cardiovascular comorbidities, necessitating comprehensive assessment and management strategies. The increasing understanding of the aetiopathogenic mechanisms of these immune-mediated diseases and of the proinflammatory intracellular signalling pathways involved in Psoriatic disease (PsD) has facilitated the identification and development of new small molecules capable of inhibiting JAK proteins, emerging as effective treatment options for rheumatic and dermatological manifestations JAK inhibitors act rapidly, within a few days, with a striking beneficial class effect on pain. The oral formulation they share makes them a well-tolerated class of drugs, with a clear advantage over FAME in terms of convenience of administration, improving therapeutic compliance. Material and method. This observational, retrospective study conducted in a single-centre dermatology-rheumatology consultation of a second-level hospital in Granada, Spain, focused on patients diagnosed with Psoriatic Arthritis (PsA) over the last two years, who initiated treatment with Tofacitinib or Upadacitinib due to DMARD failure, excluding those with major contraindications to JAK inhibitors. Results: This study analyzed data from 32 patients diagnosed with Psoriatic Arthritis (PsA), focusing on their demographics, disease characteristics, and treatment history. The majority of patients (75%) initiated treatment with Tofacitinib, while the remainder started with Upadacitinib. The mean age of the patients differed between the two treatment groups. All patients met the CASPAR criteria for PsA diagnosis, with predominantly peripheral joint involvement. The average time from PsA diagnosis to initiation of JAKinhib treatment was 6.5 years, slightly longer for Upadacitinib users. Most patients presented with cutaneous psoriasis, and a minority exhibited radiographic erosions. Before JAKinhib therapy, all patients had previously received DMARDs. A subset of patients received concomitant DMARD therapy, predominantly methotrexate. Additionally, a proportion of patients were on low-dose corticosteroids. Baseline CRP and ESR levels were indicative of systemic inflammation. Disease activity measures at baseline indicated moderate disease activity, with a substantial proportion of patients having mild psoriasis involvement. Upadacitinib recipients with psoriasis primarily exhibited mild involvement. This study provides valuable insights into the characteristics and treatment patterns of PsA patients initiating JAKinhib therapy. Discusion. In this study, the efficacy, safety, and real-world outcomes of Janus kinase inhibitors (JAKinhibs) in the treatment of Psoriatic Arthritis (PsA) were assessed and compared with findings from pivotal randomized controlled trials (RCTs). Both Tofacitinib and Upadacitinib demonstrated significant efficacy in PsA patients refractory to DMARDs and TNF inhibitors, with rapid improvement in joint and skin activity indices. Although patients in this cohort exhibited younger age, higher female prevalence, and shorter disease duration compared to those in RCTs, treatment responses were comparable or even superior. Notably, despite fewer concurrent DMARDs and a higher proportion of patients receiving monotherapy, JAKinhibs maintained a favorable safety profile, with a low frequency of mild adverse events leading to treatment discontinuation. These findings emphasize the robust efficacy and tolerability of JAKinhibs in real-world clinical settings, supporting their role as effective therapeutic options for PsA patients.

Preprint REVIEW | doi:10.20944/preprints202403.0100.v1

Plant-Based Diet and Supplements Reduced COVID-19 Severity and Mortality in Elderly Patients with Multiple Comorbidities (Part 2: Exploring the Underlying Mechanisms of Successful Intervention)

Dasaad Mulijono, Albert Manggading Hutapea, I Nyoman Ehrich Lister, Mondastri Khorib Sudaryo, Helwiah Umniyati

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: Plant-based; COVID-19; Inflammation; Supplements

Online: 4 March 2024 (10:00:10 CET)

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Preprint REVIEW | doi:10.20944/preprints202403.0061.v1

Unraveling the Complexity: From Molecular Subtypes to Therapeutic Strategies in Heart Failure with Preserved Ejection Fraction and Atrial Fibrillation

Behzad Fahimi, Somayeh Beikmohammadi, Parsa Rostami

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: Atrial Fibrillation; Heart Failure with Preserved Ejection Fraction (HFpEF); Cardiac Amyloidosis; Molecular Imaging; Catheter Ablation; SGLT2 Inhibitors

Online: 1 March 2024 (14:46:58 CET)

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fibrillation (AF) and heart failure with preserved ejection fraction (HFpEF). Join us on a journey that unravels the mysteries of molecular intricacies, delves into advanced imaging techniques, and sheds light on therapeutic pathways. Unveiling the role of cardiac amyloidosis, particularly sub-clinical isolated cardiac amyloidosis (ICA), the narrative unfolds the heightened risk of AF in the elderly. State-of-the-art imaging techniques like cardiac magnetic resonance (CMR) and molecular imaging step into the spotlight, unraveling diagnostic and prognostic nuances of AF and HFpEF. Embarking on the molecular voyage, the article navigates through next-generation sequencing and comprehensive genomic profiling, shedding light on genetic alterations shaping the AF-HFpEF landscape. This molecular compass lays the groundwork for personalized medicine, illuminating pathways to identify therapeutic bullseyes and biomarkers. In the realm of medical strategies, the discussion homes in on the promising notes struck by SGLT2 inhibitors, particularly dapagliflozin, orchestrating a reduction in AF burden. Characters like spironolactone and dronedarone make appearances, each weaving a distinct tale, revealing their potential roles in steering the ship for AF- HFpEF patients. The subplot involving obesity in HFpEF unfolds, with the LEGACY study portraying the benefits of weight reduction. The pivotal intervention of catheter ablation emerges as the hero, boasting positive outcomes in reducing hospitalization rates and overall mortality for AF-HFpEF patients. However, cautionary tales echo about its impact on left atrial function, adding layers of complexity that beckon careful consideration and monitoring. Amidst the narrative, critical discussions unfold about the limitations of current research, echoing the need to define acute heart failure, refine imaging techniques, and tailor management strategies. The narrative passionately advocates for a personalized touch in addressing AF-HFpEF, recognizing the unique blend of clinical and molecular personas. In essence, this review paints a vivid mural of AF-HFpEF, skillfully bridging the realms of molecular intricacies and the artistry of clinical management.

Preprint REVIEW | doi:10.20944/preprints202402.1673.v1

Neurofilament Light Chain in Systemic Amyloidosis: A Systematic Review

Milou Berends, Hans Nienhuis, David Adams, Chafic Karam, Marco Luigetti, Michael Polydefkis, Mary Reilly, Yoshiki Sekijima, Bouke Pier Hazenberg

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: systemic amyloidosis; hereditary transthyretin amyloid; immunoglobulin light chain amyloid; transthyretin gene variant carrier; biomarker; neurofilament light chain; polyneuropathy; small fiber neuropathy; autonomic neuropathy

Online: 29 February 2024 (10:42:35 CET)

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Preprint ARTICLE | doi:10.20944/preprints202402.1531.v1

The Clinical Outcome Features for Non-HIV Kaposi’s Sarcoma and the Role for Surgical Wide Excision on Survival: A Retrospective Cohort Study

Chia-Kai Hsu, Fang-Yu Hsu, Hung-Chi Chen, Chang-Cheng Chang

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: Kaposi’s sarcoma; non-HIV; surgery; non-surgical procedures

Online: 27 February 2024 (12:23:02 CET)

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Preprint ARTICLE | doi:10.20944/preprints202402.1352.v1

Personalized Assessment of Mortality Risk and Hospital Stay Duration in Hospitalized Patients with COVID-19 Treated with Remdesivir: A Machine Learning Approach

Antonio Ramón, Andrés Bas Castillo, Santiago Herrero González, Pilar Blasco, Miguel Suárez, Jorge Mateo

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: COVID-19; hospital stay; machine learning; mortality; SARS-CoV-2; remdesivir; XGB

Online: 24 February 2024 (08:57:01 CET)

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Preprint CASE REPORT | doi:10.20944/preprints202402.1240.v1

Staphylococcal Enterocolitis: An Atypical Clinical Presentation of a Neglected Disease

Rodrigo Cuiabano Paes Leme, Felipe Ramos Pinheiro, Renta Freire Alves Pereira, Fábio Aguiar Alves

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: immunosuppression; Staphylococcus aureus; gastrointestinal disease.

Online: 21 February 2024 (15:52:16 CET)

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Preprint ARTICLE | doi:10.20944/preprints202402.1223.v1

Comparative Targeted Metabolomics in Ischemic Stroke Patients: Profiling Thrombi and Serums Samples for Identification of Stroke-related Metabolites

Ivana Karmelić, Ivana Rubić, Katarina Starčević, David Ozretić, Zdravka Poljaković, Mia Jurilj Sajko, Vladimir Kalousek, Rafaela Kalanj, Dina Rešetar-Maslov, Josipa Kuleš, Marina Roje Bedeković, Tomislav Sajko, Krešimir Rotim, Vladimir Mrljak, Dragana Fabris

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: ischemic stroke; stroke thrombi; targeted metabolomics; metabolic biomarkers

Online: 21 February 2024 (11:16:54 CET)

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Preprint ARTICLE | doi:10.20944/preprints202402.1184.v1

Histopathological Diagnosis of Primary Central Nervous System Lymphoma After Preoperative Corticosteroid Therapy

Julia Feldheim, Marvin Darkwah Oppong, Jonas Alexander Feldheim, Ramazan Jabbarli, Philipp Dammann, Anne-Kathrin Uerschels, Oliver Gembruch, Yahya Ahmadipour, Cornelius Deuschl, Andreas Junker, Ulrich Sure, Karsten Henning Wrede

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: primary central nervous system lymphoma; stereotactic biopsy; corticosteroid; histopathology; brain tumor

Online: 21 February 2024 (04:02:28 CET)

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Preprint ARTICLE | doi:10.20944/preprints202402.1018.v1

Management of Short Bowel Syndrome/Chronic Intestinal Failure – the Experience of a Single Portuguese Center

Marisa Domingues Santos, Vânia Magalhães, Luís Loureiro, Pedro Pina, Ana Castro, Paulina Aguiar, Ana Gomes, Diana Soares, Anabela Rocha

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: Keywords; Short bowel Syndrome; Chronic Intestinal failure; Home Parenteral Nutrition; Teduglutide; Complications of Parenteral Support

Online: 19 February 2024 (16:24:26 CET)

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Preprint REVIEW | doi:10.20944/preprints202402.0938.v1

Biomarkers of Brain Dysfunction in Perinatal Iron Deficiency

Raghavendra B Rao

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: biomarker; brain; ferritin; hemoglobin; iron; iron deficiency; neurodevelopment; perinatal; reticulocyte hemoglobin; zinc protoporphyrin-to-heme ratio

Online: 19 February 2024 (10:28:17 CET)

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Preprint COMMUNICATION | doi:10.20944/preprints202401.0639.v3

Rikkosan’s Short-term Analgesic Effect of Burning Mouth Syndrome: A single-arm cohort study

Tatsuki Itagaki, Keisuke Nakamura, Tougo Tanabe, Takumi Shimura, Yu Nakai, Ken-ichiro Sakata, Jun Sato, Yoshimasa Kitagawa

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: Burning mouth syndrome; Nociplastic pain; Pharmacotherapy; Kampo medicine

Online: 14 February 2024 (11:31:21 CET)

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Preprint ARTICLE | doi:10.20944/preprints202402.0736.v1

The Human Phospholipase B-II Precursor (HPLBII-P) in Urine as a Novel Biomarker of Glomerular Activity in COVID-19 and Diabetes Mellitus

Shengyuan Xu, Michael Hultström, Anders Larsson, Miklos Lipcsey, Cecilia Lindskog, Sara Bülow, Robert Frithiof, Per Venge

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: Kidney; Diabetes; COVID-19; Urine Biomarkers

Online: 13 February 2024 (11:45:22 CET)

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Preprint REVIEW | doi:10.20944/preprints202402.0646.v1

Advancing the Clinical and Molecular Understanding of Cornelia De Lange Syndrome: A Multidisciplinary Pediatrics Case Series and Review of Literature

Karolina Gruca-Stryjak, Emilia Doda-Nowak, Julia Dzierla, Karolina Wrobel, Marta Szymankiewicz-Breborowicz, Jan Mazela

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: Cornelia de Lange syndrome; pediatric genetics; phenotypic variability; cohesinopathies; rare diseases

Online: 13 February 2024 (08:04:32 CET)

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Preprint ARTICLE | doi:10.20944/preprints202402.0719.v1

Calcineurin inhibitor combined with Rituximab is superior to combined with glucocorticoids or RTX alone in the treatment of IMN：A retrospective study

Xiang long Sun, Jian ying Wang, Kai li Fan, Fang Yin, Li li Qin, Li jie Su, Jing shu Sun, Yue Xu, Kun ying Zhang

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: membranous nephropathy；; rituximab；; calcineurin inhibitor

Online: 13 February 2024 (05:16:02 CET)

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BACKGROUND Studies demonstrate that T cells secrete interleukin and other cytokines to promote the growth and activation of B cells, and B lymphocytes release antibodies that attach to the PLA2R and THSD7A surface antigens on podocytes to create immunological complexes that are deposited beneath the glomerular epithelium, which damage the filtration barrier and trigger proteinuria.The combination regimen of Calcineurin inhibitors（CNIs）and rituximab(RTX) could simultaneously inhibit the proliferation of T and B lymphocytes and reduced the production of immune complexes.This kind of therapeutic method for idiopathic membranous nephropathy may achieve better clinical results and less complications. METHODS Fifty-eight patients who were diagnosed as idiopathic membranous nephropathy（IMN）through a biopsy suffering from nephrotic syndrome (NS) were recruited, and were divided into RTX treatment group(RTX group), CNIs combined with RTX treatment group(CNIs+RTX group) and CNIs combined with glucocorticoids(GC) treatment group(CNIs+CG group) according to their treatment background. All patients in 3 groups were followed up for at least 12 months. Clinical composite remission(including complete or partial remission) at 12 months was the main result; safety and the incidence of adverse events were the secondary outcomes. RESULTS The PLA2R antibody level of RTX+CNIs group at the baseline much higher than RTX and CNIs+GC groups (240.30(84.56,386.99)RU/ml vs. 44.94(11.48,143.94)RU/ml, 7.72(2.00,102.68) RU/ml, respectively, p=0.006). The PLA2R antibody concentrations among the three groups become comparable at the end of 3 months(36.80(2.10,88.05) RU/ml vs.14.32(2.00,47.98)RU/ml, 2.60(2.00,24.50) RU/ml, respectively, p>0.05). At 12 months, all patients in the CNIs+GC group achieved immune remission, and the PLA2R-ab concentration was less than 14RU/ml. At 3 months, 33of 58 patients(56.90%) had a composite remission(complete or partial remission), including 4 of 14 patients (27.85%) in the RTX group, 11 of 17 patients(64.71%) in the CNIs+RTX group and 18 of 27 patients (66.67%) in the CNIs+GC group (p=0.048). At 12 months, 51 of 58 patients(87.93%) had a composite remission, including 12 of 14 patients (85.71%) in the RTX group, 15 of 17 patients(88.24%) in the CNIs+RTX group and 24 of 27 patients (88.89%) in the CNIs+GC group (p=0.957). During the 12-month study, 7 patients did not response for the treatment. 1 patient relapsed during the 12-month treatment with a re-elevation of antibodies. Adverse events occurred in 18(31.03%)patients in the whole study, including 3 patients(5.17%) in the RTX group, 2 patients(3.45%) in the CNIs+RTX and 13patients(22.41%) in the CNIs+GC group(p< 0.05). CONCLUSIONS The combination of CNIs and RTX can effectively alleviate idiopathic membranous nephropathy with nephrotic syndrome in the first 3 months，as well as the combination of CNIs and GC, and the efficacy of both treatment methods for IMN was superior to that of RTX alone at the first 3 months. Furthermore, the RTX+CNIs group had less side effects compared with GC+CNIs group. So CNIs combined with RTX could be recommended as a superior therapeutic method for IMN treatment to shorten remission durion with less complications.

Preprint REVIEW | doi:10.20944/preprints202402.0634.v1

A Review of High Intensity Focused Ultrasound

Benjamin Turner, David Cranston

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: High Intensity Focused Ultrasound: HIFU: Non invasive surgery: Targeted Drug Delivery.

Online: 12 February 2024 (07:44:23 CET)

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Preprint ARTICLE | doi:10.20944/preprints202402.0500.v1

Clinical and Structural Biological Studies of Central Nervous System Inflammatory Demyelinating Diseases Related to COVID-19 Vaccines

Mei-Yun Cheng, Hsuan-Chen Ho, Jung-Lung Hsu, Yi Wang, Lin-Yi Chen, Ming-Feng Liao, Long-Sun Ro

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: Acute disseminated encephalomyelitis; Central nervous system inflammatory demyelinating diseases; COVID-19 vaccines; Myelin oligodendrocyte glycoprotein antibody-associated disease; Neuromyelitis optica spectrum disorders; Transverse myelitis

Online: 8 February 2024 (08:43:50 CET)

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Preprint ARTICLE | doi:10.20944/preprints202402.0420.v1

Divergences in Antiviral Therapy for Diabetic Patients with COVID-19

Andreea Fitero, Nicoleta Negrut, Carmen Delia Nistor-Cseppento, Delia Mirela Tit, Paul Andrei Negru, Cristian Bustea, Andrei-Flavius Radu, Simona Gabriela Bungau

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: SARS-CoV-2; favipiravir; molnupiravir; diabetes mellitus; COVID-19

Online: 7 February 2024 (07:57:47 CET)

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Preprint ARTICLE | doi:10.20944/preprints202402.0161.v1

Variations in Heart Rate Variability Subsequent to Auriculotherapy Among Individuals Afflicted by Significant Burn Scars

CHACHUN CHEN, Chung-Hua Hsu, SANPEI CHEN

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: auriculotherapy; HRV; TBSA; PBS syndrome

Online: 2 February 2024 (11:45:25 CET)

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Preprint ARTICLE | doi:10.20944/preprints202401.2069.v1

The Redox Homeostasis Alteration Is Restored by Melatonin Treatment in COVID-19 Patients

María Elena Soto, Israel Pérez-Torres, Linaloe Manzano-Pech, Adrían Palaciós-Chavarría, Rafael Ricardo Valdez-Vázquez, Verónica Guarner-Lans, Elizabeth Soria-Castro, Eulises Díaz-Díaz, Vicente Castrejón-Tellez

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: Melatonin; SARS-CoV-2; oxidative stress; COVID-19; redox homeostasis; antioxidant enzymes

Online: 31 January 2024 (01:47:29 CET)

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Preprint ARTICLE | doi:10.20944/preprints202401.2012.v1

Further Delineation of Clinical Phenotype of ZMYND11 Variants in Patients with Neurodevelopmental Dysmorphic Syndrome and Hyperinsulinemic Hypoglycemia

Aleksandra Maria Bodetko, Joanna Chrzanowska, Malgorzata Rydzanicz, Agnieszka Borys-Iwanicka, Pawel Karpinski, Joanna Bladowska, Rafal Ploski, Robert Smigiel

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: ZMYND11; neurodevelopmental dysmorphic syndrome; hyperinsulinemic hypoglycaemia; diazoxide

Online: 29 January 2024 (13:05:26 CET)

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Preprint ARTICLE | doi:10.20944/preprints202401.1988.v1

The Effect of Seven-Strain Probiotic Supplementation on Th17 and Treg in Patients with Severe Traumatic Brain Injury Admitted to ICU: A Randomized Controlled Clinical Trial

Seyed Hamze Abbaszadeh, Mehdi Yousefi, Seyed Rafie Arefhosseini, Ata Mahmoodpoor, Mehrangiz Ebrahimi-Mameghani

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: severe traumatic brain injury; regulatory T cell; forkhead box protein 3; T helper 17; retinoic acid receptor-related orphan receptor gamma t; gut microbiome; probiotic

Online: 29 January 2024 (08:51:54 CET)

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Preprint REVIEW | doi:10.20944/preprints202401.1812.v1

Isolated Terminal Ileitis- Crohn’s Disease or Something Else?

Harleen Chela, Fazia Mir, Asli Tahan, Benjamin Schmidt, Hamza Ertugrul, Albulmajeed Albarrak, Mohamad H Yousef, Saeed Kamran Shaffi, Ebubekir Daglilar, Veysel Tahan

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: Terminal ileitis; Endoscopy; crohns disease; IBD

Online: 25 January 2024 (08:40:03 CET)

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Introduction: Isolated terminal ileitis (ITI) is commonly found associated with Crohn’s disease but it has other etiologies too. Other common causes of ITI include nonsteroidal anti-inflammatory drug (NSAID) use, tuberculosis and other bacterial/parasitic infections, neoplasia, radiation or other autoimmune disorders. Methods: After obtaining IRB approval, a retrospective chart review was conducted on patients with biopsy proven ITI from May 2011 to May 2016 at our academic medical Centre. Data was collected pertaining to demographics, body mass index (BMI), associated Crohn’s disease or ulcerative colitis, treatment received and other causes of ileitis noted. Data was analyzed using SPSS software with chi square used to analyze categorical variables. P<0.05 was considered statistically significant. Results: A total of 229 patients with clinical symptoms and ITI on biopsy were reviewed. The mean age of our patients was 43.7 years old. Of the patient group, 49% (n=113/229) were males and the rest were females. Only 42% of patients with ITI were eventually diagnosed with Crohn's disease. Stool cultures were performed in 37% (n=86/229) of patients with positive results in 0.04% (n=4/86) of the patients. Most patients were treated with antibiotics after diagnosis of ileitis without determination of the exact etiology of the condition. Amongst those evaluated, one had tuberculosis, one had ischemic ileitis and one had Meckel’s diverticulum. NSAID use accounted for 26% (n=59/229) of ITI cases. Treatment generally involved antibiotics, initiation of biologics or use of 5-aminosalicylic acid products. The mean length of hospitalization was 1.25 days. Mean BMI of our patients was 25 kg/m2 and there was no statistically significant association noted between ITI and BMI. Presence of Crohn’s disease with ITI had a statistically significant association with positive clostridium difficile infection and subsequent need for treatment with biologics for isolated disease (p<0.001). Conclusions: Isolated terminal ileitis is commonly associated with Crohn’s disease but there are other conditions that should be suspected and can mimic Crohn’s disease histologically and endoscopically in the Ileum. NSAIDS are an important cause of ITI and need to be specifically inquired from the patient. If not considered it can result in misdiagnosis of Crohn’s disease and inappropriate treatment. Hence being aware of the wide range of differential diagnoses that can present with inflammation of the terminal ileum is important to avoid this inadvertent mislabeling. This retrospective study highlights the importance of other differentials when considering the management of a patient with ITI and not just focusing on only Crohn’s disease as the possible etiology.

Preprint COMMUNICATION | doi:10.20944/preprints202401.0639.v2

Rikkosan’s Short-term Analgesic Effect of Burning Mouth Syndrome: A single-arm cohort study

Tatsuki Itagaki, Keisuke Nakamura, Tougo Tanabe, Takumi Shimura, Yu Nakai, Ken-ichiro Sakata, Jun Sato, Yoshimasa Kitagawa

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: Burning mouth syndrome; Nociplastic pain; Pharmacotherapy; Kampo medicine

Online: 24 January 2024 (09:47:20 CET)

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Preprint REVIEW | doi:10.20944/preprints202401.1684.v1

False Liver Metastasis by PET/CT Scan After Chemoradiotherapy for Esophageal Cancer- A Potential Overstaged Pitfalls of Treatment

Sen-Ei Shai, Yi-Ling Lai, Chen-I Chang, Chi-Wei Hsieh

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: False Liver Metastasis; neoadjuvant chemoradiotherapy (nCRT); F-18-fluorodeoxyglucose (18F-FDG); positron emission tomography computed tomography (PET-CT); radiation-induced liver injury (RILI); radiation-induced liver disease (RILD)

Online: 23 January 2024 (09:23:05 CET)

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Preprint REVIEW | doi:10.20944/preprints202401.1521.v1

Cardiovascular Benefits of High-Intensity Interval Training in Patients with Hypertension: A Systematic Review

Priyanka Yelavarthy, Binay Panjiyar, Pragathi Yelavarthy, Sriharsha Lankala

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: hypertension; cardiac complications; high-intensity interval training in hypertension; high blood pressure; hypertension; cardiovascular diseases

Online: 19 January 2024 (16:02:16 CET)

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Preprint BRIEF REPORT | doi:10.20944/preprints202311.1197.v2

Wharton’s Jelly Tissue Allograft for Connective Tissue Defects Surrounding Nerves in the Tarsal Tunnel: A Retrospective Case Series

Ronald Bruton, Tracie Gilliland, John Shou, Naomi Lambert, Crislyn Woods, Tyler Barrett

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: tarsal tunnel; nerve damage; neuropathy; wharton’ s jelly; regenerative medicine

Online: 19 January 2024 (07:54:24 CET)

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Preprint COMMUNICATION | doi:10.20944/preprints202401.1387.v1

Novel Knowledge of Macrolide Resistance in Mycoplasma pneumoniae by Azithromycin Exposure

Tomohiro Oishi, Nemu Hattori, Daisuke Yoshioka

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: Mycoplasma pneumoniae; macrolide; mutation; azithromycin

Online: 18 January 2024 (13:59:07 CET)

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Preprint REVIEW | doi:10.20944/preprints202401.1425.v1

SWOT and Root Cause Analysis of Antimicrobial Resistance to Oral Antimicrobial Treatment of Cystitis

Pradeep Tyagi, Shachi Tyagi, Laurence Stewart, Scott Glickman

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: UTI, AMR, oral treatment and intravesical treatment

Online: 18 January 2024 (13:03:03 CET)

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Preprint REVIEW | doi:10.20944/preprints202401.1316.v1

Arrhythmias and Device Therapies in Cardiac Amyloidosis

Syed Bukhari, Syed Zamrak Khan, Mohamed Ghoweba, Bilal Khan, Zubair Bashir

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: Cardiac amyloidosis; arrhythmia; left atrial appendage closure device; pacemaker; implantable cardioverter-defibrillator

Online: 17 January 2024 (15:50:03 CET)

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Preprint REVIEW | doi:10.20944/preprints202401.1295.v1

Autonomic Function in Obese Children and Adolescents: Systematic Review and Meta-Analysis

Georgios E. Papadopoulos, Foteini Balomenou, Xenofon M Sakellariou, Christos Tassopoulos, Dimitrios N Nikas, Vasileios Giapros, Theofilos M Kolettis

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: obesity; heart rate variability; autonomic nervous system; sympathetic activity; vagal activity; children; adolescents

Online: 17 January 2024 (10:16:30 CET)

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Preprint ARTICLE | doi:10.20944/preprints202401.1123.v1

The Complexity of Skeletal Transverse Dimension: From Diagnosis, Management, and Treatment Strategies to the Application of Collaborative Cross (CC) Mouse Model

Nezar Watted, Iqbal M Lone, Kareem Midlej, Osayd Zohud, Obaida Awadi, Samir Masarwa, Ali Watted, Eva Paddenberg, Sebastian Krohn, Christian Kirschneck, Peter Proff, Fuad A. Iraqi

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: Skeletal Transverse Dimension; Diagnosis; management; treatment strategies; Collaborative Cross (CC) mouse model

Online: 15 January 2024 (10:58:39 CET)

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Static and functional occlusal relationships are the well-defined objectives of orthodontic therapy. To accomplish it, the jaws must be positioned in centric relation (CR)/ Central occlusion (CO) and appropriately proportioned in three space planes. Orthodontists have well-established techniques when analyzing the skeletal connection between the maxilla and mandible in both sagittal and vertical planes. Although there exist multiple analyses for the skeletal transverse dimension (STD), their inclusion in conventional orthodontic diagnosis is not widely acknowledged. Transverse tooth compensations have been visually represented in prosthodontic literature using a crosshatch arch that passes through the buccal and palatal cusps of maxillary molars, known as the Wilson curve. An inflated Wilson curve has long been seen as a prosthetic maxim, increasing the possibility of working and non-working side interferences. Research has indicated a connection between higher masticatory muscle activity and posterior occlusal contacts or interferences. When skeletal transverse issues are concealed by dental expansion, there is an elevated susceptibility to gingival recession in orthodontic patients who have a small Maxilla or constricted upper jaw. The temporomandibular joints, muscles, periodontal tissue, and airway might all suffer in a susceptible patient with a transverse insufficiency brought on by a narrow maxilla. As for orthodontists, the objective is to create skeletal connections and functional occlusion that are as near ideal as feasible. This will reduce the likelihood of occlusion-related inconsistencies exacerbating the negative consequences on the dentition, periodontium, or joints. An accurate skeletal and dental diagnostic in all three space planes is required. Our goal is to explain all approaches to enable readers to use a transverse skeletal diagnostic in their practice regardless of the technological level at their disposal. The initial step is to ascertain the kind and presence of deficiencies in the maxilla. Since fewer soft tissue alterations are caused by maxilla hypoplasia in the transverse direction, skeletal transverse dimension (STD) assessment is a more significant challenge than vertical or sagittal discrepancy assessment. Model analysis, clinical assessments, radiographic measurements, and occlusograms have all proven successful in producing accurate assessments. Most of the time, surgically assisted maxillary expansion (SARME) is reported to have higher stability than orthopedic maxillary expansion (OME). We examine and discourse on possible research opportunities using the Collaborative Cross (CC) mouse model as a substitute research model.

Preprint CASE REPORT | doi:10.20944/preprints202401.1009.v1

First Case Report of Sunvozertinib for the Treatment of Her2 Exon 20 Insertion in Lung Adenocarcinoma

Tao Luan, Xin Qing Lin, Xiao Hong Xie, Shuai Yin Wang, Heng Lu, Lian sheng Liu, Gang Yang, Yun Hui Zhang, Cheng Zhi Zhou

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: case report; targeted therapy; gene mutation; novel therapy

Online: 12 January 2024 (09:49:20 CET)

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Preprint ARTICLE | doi:10.20944/preprints202401.0862.v1

Nutrient Intake and its Association with Appendicular Total Lean Mass, Function and Strength in Older Adults: A Population-Based Study

Miguel Germán Borda, Jessica Samuelsson, Tommy Cederholm, Jonathan Patricio Baldera, Mario Ulises Perez-Zepeda, George E. Barreto, Anna Zettergren, Silke Kern, Rydén Lina, Mariana Gonzalez-Lara, Salomón Salazar-Londoño, Gustavo Duque, Ingmar Skoog, Dag Aarsland

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: Sarcopenia; Body Composition; Aging; Diet; Walking Speed; Muscle Strength

Online: 11 January 2024 (10:21:38 CET)

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Preprint COMMUNICATION | doi:10.20944/preprints202401.0639.v1

Rikkosan’s Short-term Analgesic Effect of Burning Mouth Syndrome: A single-arm cohort study

Tatsuki Itagaki, Keisuke Nakamura, Tougo Tanabe, Takumi Shimura, Yu Nakai, Ken-ichiro Sakata, Jun Sato, Yoshimasa Kitagawa

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: Burning mouth syndrome; Nociplastic pain; Pharmacotherapy; Kampo medicine

Online: 8 January 2024 (16:57:52 CET)

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Preprint REVIEW | doi:10.20944/preprints202401.0594.v1

Exploring the potential impact of non-invasive modifications of the Gut Microbiome on Cancer Immunotherapy – a narrative review

Adi David, Shaked Lev-Ari

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: ICB; irAE; CTCAE; microbiome; biomarkers; Diet; metabolism

Online: 8 January 2024 (11:27:56 CET)

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Preprint ARTICLE | doi:10.20944/preprints202401.0491.v1

Perspectives of Medical Imaging Professionals about the Impact of AI on Swiss Radiographers

Mélanie Champendal, Stephanie De Labouchère, Switinder Singh Ghotra, Isabelle Gremion, Zhonghua Sun, Sofia Torre, Ricardo Khine, Laurent Marmy, Christina Malamateniou, Claudia Sa Dos Reis

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: Artificial intelligence; radiography; radiology; practice; impact; knowledge; profession

Online: 5 January 2024 (12:49:21 CET)

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Preprint REVIEW | doi:10.20944/preprints202401.0259.v1

Advantages of the Utilization of Wide-Field OCT and Wide-Field OCT Angiography in Clinical Practice

Maciej Gawęcki, Krzysztof Kiciński

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: wide-field fluorescein angiography; wide-field optical coherence tomography; wide-field OCT angiography; diabetic retinopathy; retinal vein occlusion; peripheral retinal degeneration

Online: 3 January 2024 (15:08:56 CET)

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Preprint ARTICLE | doi:10.20944/preprints202401.0148.v1

Doxcycline post-exposure prophylaxis: are we using the correct method to assess for effect on antimicrobial resistance?

Thibaut Vanbaelen, Zina Gestels, Said Abdellati, Irith De Baetselier, Sheeba Manoharan-Basil, Chris Kenyon

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: AMR; MIC; proportion resistant; doxycycline PEP

Online: 3 January 2024 (10:56:36 CET)

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Preprint REVIEW | doi:10.20944/preprints202312.2324.v1

A Contemporary Review of the Use of Extracorporeal CytoSorb® Hemoadsorption Therapy in Patients with Infective Endocarditis

Anan Gong, Yupei Li, Mei Yang, Shujing Wang, Baihai Su

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: hemoadsorption; infective endocarditis; Cytosorb®; cardiopulmonary bypass; cardiac surgery; mortality

Online: 29 December 2023 (15:27:52 CET)

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Preprint CASE REPORT | doi:10.20944/preprints202312.2024.v1

Tirzepatide and Glycemic Control Metrics Using Continuous Glucose Monitoring in Older Patients with Type 2 Diabetes Mellitus: An Observational Pilot Study

Takuya Omura, Akemi Inami, Taiki Sugimoto, Shuji Kawashima, Takashi Sakurai, Haruhiko Tokuda

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: Tirzepatide; time in range; continuous glucose monitoring; elderly

Online: 27 December 2023 (07:49:36 CET)

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Preprint ARTICLE | doi:10.20944/preprints202312.1949.v1

Elderly Patients with Idiopathic Pulmonary Hypertension: Clinical Characteristics, Survival and Risk-Stratification in a Single-Center Prospective Registry

Natalia S. Goncharova, Kirill B. Lapshin, Aelita V. Berezina, Maria A. Simakova, Alexander O. Marichev, Irina S. Zlobina, Narek V. Marukyan, Kirill N. Malikov, Alexandra S. Aseeva, Vadim V. Zaitsev, Olga M. Moiseeva

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: idiopathic pulmonary arterial hypertension; comorbidities; survival; risk stratification

Online: 26 December 2023 (06:57:04 CET)

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Introduction: The predictive value of the risk stratification scales in elderly patients with IPAH might differ from that in younger. It is unknown whether young and older IPAH patients have the same survival dependence on PAH-specific therapy numbers. The aim of the study was to evaluate the prognostic relevance of risk stratification scales and PAH medication numbers in elderly in comparison with young IPAH patients. Material and methods: 119 patients from a prospective single-center PAH registry were divided on to group I <60 years old (n=89) and group II ≥60 years old (n=30). ESC/ERS, REVEAL, and REVEAL 2.0 risk stratification scores were assessed at baseline, as well as H2FpEF- score and survival at follow-up. Results: During a mean follow-up period of 2.9 years (1.63; 6.0) 42 (35.3%) patients died; at 1, 2, 3, 5, 7, and 10 years survival was 95%, 88.6%, 78.5%, 61.7%, 48.5% and 33.7%, respectively. No survival difference was observed between the two groups despite the use of monotherapy in elderly patients. The best predictive value exhibited the REVEAL in group II (IPAH patients ≥60 years) - AUC 0.73 (0.56-0.91), p = 0.03; and in patients with LHD comorbidities in the entire cohort - AUC 0.73 (0.59-0.87), p<0.009. Factors independently associated with death in the entire cohort were CKD (p=0.01, HR 0.2), the right-to-left ventricle dimension ratio (p=0.0047, HR 5.97), and NT-proBNP >1400 pg/ml (p=0.008, HR 3.18). Conclusion: Risk stratification in elderly IPAH patients requires a fundamentally different approach than that of younger patients, taking into account the initial limitations in physical performance and comorbidities that interfere with current assessment scores. The REVEAL score reliably stratifies patients at any age and LHD comorbidities. The initial monotherapy seems to be reasonable in patients over 60 years. Selection tools for initial combination PAH therapy in older IPAH patients with comorbidities need to be validated in prospective observational studies.

Preprint CASE REPORT | doi:10.20944/preprints202312.1839.v1

Unveiling Extramedullary Hematopoiesis: A Case Report Highlighting the Causes, Symptoms, and Management Strategies

Konstantinos Manganas, Aikaterini Xydaki, Angeliki Kotsiafti, Olympia Papakonstantinou, Sophia Delicou

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: extramedullary hematopoiesis; chronic hemolytic anemia; thalassemia; blood transfusions; radiation therapy; surgical decompression; hydroxyurea therapy

Online: 25 December 2023 (08:15:21 CET)

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Preprint ARTICLE | doi:10.20944/preprints202312.1731.v1

Circuit training improves the levels of Aβ and BDNF related to cognitive impairment risk factors in obese elderly Korean women

Duwang Kang, Suhan Koh, Taekyu Kim, Eadric Bressel, Do-yeon Kim

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: circuit training; β-amyloid; BDNF; cognitive function; obese elderly women

Online: 22 December 2023 (10:20:35 CET)

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Preprint ARTICLE | doi:10.20944/preprints202306.0574.v2

Strategies of Screening and Treating Post-extubation Dysphagia: An Overview of the Situation in Greek-Cypriot ICUs

Meropi Mpouzika, Stelios Iordanou, Maria Kyranou, Katerina Iliopoulou, Stelios Parissopoulos, Maria Kalafati, Maria Karanikola, Elizabeth Papathanassoglou

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: assessment; awareness; diagnosis; dysphagia; intensive care; management; screening; treatment; practices

Online: 21 December 2023 (09:11:40 CET)

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Preprint ARTICLE | doi:10.20944/preprints202312.1476.v1

Antibodies against Small Ubiquitin-Like Modifier Activating Enzyme Might Be A Protective Factor from Rapid Progressive Interstitial Lung Disease in Patients Bearing Antibodies against Melanoma Differentiation Associated Gene 5

Hung-Cheng Tsai, Wei-Sheng Chen, Yi-Syuan Sun, Chien-Chih Lai, Ying-Ying Yang, Wen-Ru Chou, Hsien-Tzung Liao, Chang-Youh Tsai, Chung-Tei Chou

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: anti-MDA5 antibodies; dermatomyositis (DM); anti-SAE antibodies; rapidly progressive interstitial lung disease (RPILD)

Online: 20 December 2023 (09:53:05 CET)

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： Anti-MDA5 antibody bearing (anti-MDA5+)-dermatomyositis (DM) or polymyositis (PM) is notorious for causing rapidly progressive interstitial lung disease (RPILD) &/or cancers with high mortality rate. However, anti-MDA5 antibodies (Abs) are also found in other connective tissue diseases and their link with RPILD especially with regards to the mortality rate are unknown. We retrospectively recruited 71 patients bearing anti-MDA5-Abs in serum, stratified them in terms of a presence or absence of RPILD, and evaluated their clinical features, laboratory findings, associated myositis antibodies, concurrent connective tissue disease (CTD) as well as newly developed malignancies. Thirty-nine (55%) patients presented with DM/PM but 32 (45%) didn’t. Twenty-two of the former and 11 of the latter developed RPILD eventually, accounting for a total of 46% of all MDA5 bearing patients. On the other hand, 15 of all 71 (21.1%) patients had cancers. Among 32 patients who didn’t have DM/PM, 27 (38.0% of all 71) had other CTDs, indicating that only 5 (7.0% of 71) patients did not have CTDs. Senility (odds ratio [OR]=1.816, P=0.032), presence of anti-Ro-52 antibody (OR=1.676, P=0.018), elevated C-reactive protein (CRP, OR= 4.354, P<0.001) and carcinoembryonic antigen (CEA, OR=2.625, P=0.005) posed risks for RPILD. High lactose dehydrogenase (LDH, p=0.009), CRP (p=0.001), CEA (p=0.001), ferritin (p ≤ 0.001) and low albumin (p ≤ 0.001) were significantly associated with mortality. Anti-SAE antibodies were negatively correlated with RPILD as analyzed by univariate (OR=0.245, P=0.017) and multivariate (OR= 0.058, P=0.036) regressions, indicating that they may be a protective factor from RPILD (OR= 0.543, P=0.008) or fatality (OR= 0.707, P=0.012), which was also demonstrated in subgroup analyses. In contrast to various risk factors for RPILD or mortality, anti-SAE antibodies might be conversely a protective factor in anti-MDA5+ patients.

Preprint REVIEW | doi:10.20944/preprints202312.0983.v1

Conservative Management of Acute Sports-Related Concussions: A Narrative Review

Sohaib Kureshi, Maria Mendizabal, John Francis, Hamid R. Djalilian

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: concussion; mild traumatic brain injury (mTBI); central sensitization; sports-related concussion; peripheral sensitization; glymphatic system; neuroinflammation; pain catastrophizing.

Online: 13 December 2023 (11:33:11 CET)

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Preprint INTERESTING IMAGES | doi:10.20944/preprints202312.0985.v1

Aggressive Аngiomyxoma of the Female External Genitalia - A Rare Clinical Case

Dobrinka Hristova Gincheva, Grigor Angelov Gorchev, Aleksandar Vanov Vanov, Veronika Hristova Gincheva

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: aggressive angiomyxoma; soft tissue tumors

Online: 13 December 2023 (11:29:13 CET)

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Preprint ARTICLE | doi:10.20944/preprints202312.0817.v1

The Paleolithic Ketogenic Diet (PKD) Is Associated with Low C-peptide Levels in Non-T1DM Patients and Healthy Subjects

Zsófia Clemens, Andrea Dabóczi, Enikő Andrásofszky, Mária Schimmer, Natalie Daniels, Orsolya Szathmári, Erika Fésüs, Réka Horváth

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: C-peptide; paleolithic ketogenic diet; diabetes; T1DM; low-carbohydrate diet; insulin

Online: 12 December 2023 (11:15:21 CET)

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Preprint CASE REPORT | doi:10.20944/preprints202312.0541.v1

Cytomegalovirus Pneumonia in Down Syndrome

Francesco Perrotta, Donato Piscopiello, Daniela Rizzo, Gaetano Iosa, Giorgio Garzya, Piero Calò, Daniele Gemma

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: Down Syndrome; Pneumonia; Cytomegalovirus

Online: 9 December 2023 (09:18:49 CET)

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Preprint REVIEW | doi:10.20944/preprints202312.0631.v1

An Overview of Parenteral Nutrition from Birth to Adolescence, Based on a Composite Fish Oil Containing Lipid Emulsion and a Pediatric Amino Acid Solution

Olivier GOULET

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: intestinal failure, parenteral nutrition, home parenteral nutrition, fish oil based intravenous lipid emulsion, crystalline amino acids solution, multi-chamber bags

Online: 8 December 2023 (15:19:06 CET)

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Preprint ARTICLE | doi:10.20944/preprints202312.0466.v1

Pre-analytical Considerations for Clinical Assays of Circulating Human miRNA-451a for Diagnostic Purposes.

M. Rohan Fernando, Dinesh S Chandel, Wesley Tom, Chao Jiang, Gary Krzyzanowski, Nirmalee Fernando

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: Preanalytical factors; Blood processing; Circulating miRNA-451; Blood storage; Hemolysis; clinical assays; diagnosis

Online: 7 December 2023 (08:18:30 CET)

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Preprint CASE REPORT | doi:10.20944/preprints202312.0402.v2

Late presentation of Ebstein Anomaly: An Unique Case at 67yrs

Ishita Roy, Nilanjan Roy

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: RBBB; Ebstein anomaly; TGA; tricuspid valve

Online: 7 December 2023 (07:05:48 CET)

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Preprint CASE REPORT | doi:10.20944/preprints202312.0402.v1

Late presentation of Ebstein Anomaly: A Unique Case at 67yrs

Ishita Roy, Nilanjan Roy

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: RBBB; Ebstein anomaly; TGA; tricuspid valve

Online: 6 December 2023 (10:26:25 CET)

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Preprint ARTICLE | doi:10.20944/preprints202312.0372.v1

Electric Scooter and Bicycle-Related Trauma in a Hungarian Level-1 Trauma Center – a Prospective 1-Year Study

Dávid Süvegh, Ádám Juhász, Mohammad Walid Al-Smadi, Dániel Sándor Veres, Árpád Viola

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: electric scooter; emergency care; trauma care; injury; scooter; bicycle; intoxication; traffic accident; injury patterns; craniofacial injury

Online: 6 December 2023 (10:21:19 CET)

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Preprint CASE REPORT | doi:10.20944/preprints202312.0325.v1

A Case of Severe Acute Renal Failure Due to Oxalate Crystal Deposition Induced Severe Interstitial Nephritis: A Case Report and Literature Review.

Praveen Errabelli, Maulik Lathiya, Sasmit Roy, Neeharik Mareedu

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: oxalate crystal nephrpathy; acute renal failure

Online: 6 December 2023 (10:15:11 CET)

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Preprint ARTICLE | doi:10.20944/preprints202312.0342.v1

Effect of Nursing Intervention Combined with Voice Training on Voice Recovery in Patients with Unilateral Vocal Cord Paralysis after Thyroid Surgery

Jie OUYANG, WANG Xiaoqin

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: Nursing; Voice Training; Post-Thyroid Surgery; Vocal Cord Paralysis

Online: 6 December 2023 (08:50:34 CET)

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Preprint ARTICLE | doi:10.20944/preprints202312.0316.v1

Temporal Trend of the SARS-CoV-2 Omicron Variant and Res-Piratory Syncytial Virus in the Nasal Cavity and Accuracy of the Newly Developed Antigen-Detecting Rapid Diagnostic Test

Daisuke Tamura, Yuji Morisawa, Takashi Mato, Shin Nunomiya, Masaki Yoshihiro, Yuta Maehara, Shizuka Ito, Yasushi Ochiai, Hirokazu Yamagishi, Toshihiro Tajima, Takanori Yamagata, Hitoshi Osaka

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: Omicron; rapid diagnostic test; RT-PCR; RSV; SARS-CoV-2; viral antigens

Online: 6 December 2023 (07:38:00 CET)

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Preprint ARTICLE | doi:10.20944/preprints202312.0334.v1

Enhancing Osteoporotic Vertebral Fracture Diagnosis and Treatment Planning: Comparing CT and STIR Sequence MRI

Reka Viola, Siran Aslan, Mohammad Walid Al-Smadi, Árpad Viola

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: STIR MRI; CT; Osteoporotic fracture; Spine fracture; Treatment planning; Diagnosis protocol; Surgical intervention; Radiological Assessment; Osteoporosis.

Online: 6 December 2023 (07:14:12 CET)

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Preprint ARTICLE | doi:10.20944/preprints202312.0308.v1

The Prevalence of the Frailty Syndrome in a Hospital Setting – Is Its Diagnosis a Challenge?

Agnieszka Kasiukiewicz, Zyta Beata Wojszel

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: older patients; hospital acute care units; sub-intensive care units; clinical challenges; medical complexity; frailty syndrome; frailty diagnosis

Online: 6 December 2023 (04:33:50 CET)

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Preprint ARTICLE | doi:10.20944/preprints202312.0136.v1

Impact of CytoSorb Hemoadsorption Therapy on Fluid Balance in Patients with Septic Shock

Klaus Kogelmann, Tobias Huebner, Matthias Drüner, Dominik Jarczak

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: Inflammation; septic shock; CytoSorb; hemoadsorption; fluid balance; vasopressors; vascular barrier function; endothelial integrity

Online: 5 December 2023 (06:12:45 CET)

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Preprint ARTICLE | doi:10.20944/preprints202312.0167.v1

Urinalysis Results and Resistance to Hospital Treatment with Injectable Antimalarials in Angola

Euclides Nenga Manuel Sacomboio, Telma Patrícia Pereira Paulo, Edson Kuatelela Cassinela, Cruz dos Santos Sebastião

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: ; Urinalysis; resistance treatment; injectable antimalarials; sociodemographic; clinical

Online: 4 December 2023 (11:27:16 CET)

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Preprint REVIEW | doi:10.20944/preprints202311.1719.v1

Clinical and Genetic Features of Dravet Syndrome: A Prime Example of the Role of Precision Medicine in Genetic Epilepsy

Hueng-Chuen Fan, Ming-Tao Yang, Lung-Chang Lin, Kuo-Liang Chiang, Chuan-Mu Chen

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: Dravet Syndrome; developmental epileptic encephalopathy; genetics; targeted therapy; epilepsy syndrome

Online: 28 November 2023 (08:12:09 CET)

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Preprint CASE REPORT | doi:10.20944/preprints202311.1726.v1

Atypical Milroy's Disease with Predominant Unilateral İnvolvement: A Case Report

Songül Keskin kavak

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: Hereditary lymphedema type I,; inherited primary lymphedema,; Milroy's Disease; Complete Decongestive Therapy,

Online: 27 November 2023 (16:51:24 CET)

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Preprint ARTICLE | doi:10.20944/preprints202311.1689.v1

No Association between Antimicrobial Consumption and Antimicrobial Resistance in a PrEP Population: A Cross Sectional Study

Thibaut Vanbaelen, Jolein Laumen, Christophe Van Dijck, Tessa De Block, Sheeba Manoharan-Basil, Chris Kenyon

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: Antimicrobial resistance; PrEP; saturation; Neisseria gonorrhoeae; gonorrhoea; stewardship

Online: 27 November 2023 (11:48:53 CET)

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Preprint ARTICLE | doi:10.20944/preprints202311.1568.v1

Red Blood Cell Distribution Width, Erythrocyte Indices and Elongation Index, at Baseline, in a Group of Trained Subjects

Gregorio Caimi, Melania Carlisi, Rosalia Lo Presti

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: regular exercise; red blood cell distribution width; erythrocyte indices; erythrocyte deformability; trained subjects.

Online: 26 November 2023 (05:59:31 CET)

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Preprint ARTICLE | doi:10.20944/preprints202311.1387.v1

Artificial Intelligence-Assisted Detection of Osteoporotic Vertebral Fractures on Lateral Chest Radiographs in Post-menopausal Women

Jenna Silberstein, Cleo Wee, Ashu Gupta, Hannah Seymour, Switinder Singh Ghotra, Claudia Sa Dos Reis, Zhonghua Sun

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: AI; spine fractures; diagnosis; thoracic X-ray; medical imaging; accuracy

Online: 22 November 2023 (08:46:51 CET)

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Post-menopausal women are at risk of osteoporotic vertebral fractures (OVFs), which if undetected and untreated, can lead to significant pain and morbidity. However, OVFs are often not reported by radiologists on routine chest radiographs. Artificial Intelligence (AI) is increasingly used in medical applications with improvements in detection and diagnosis. This study aims to investigate the clinical value of a newly developed AI tool, Ofeye 1.0 for automated detection of OVFs on lateral chest radiographs in post-menopausal women (>60 years) who were referred to undergo chest x-rays for other reasons. A total of 510 de-identified lateral chest radiographs from three clinical sites were retrieved and analysed by Ofeye1.0 tool. These images were then reviewed by a consultant radiologist to decide whether there is any fracture present or not with findings served as the reference standard for determining the diagnostic performance of the AI tool. The percentage of radiologist reports which included the OVF was analysed by comparing diagnostic reports with AI findings, while the accuracy, sensitivity, specificity, positive predictive value (PPV) and negative predictive values (NPV) of the AI tool were calculated. Out of all the original radiologist reports, missed OVFs were found in 14% images but were detected by the AI tool. The AI tool demonstrated a relatively high specificity 92.8% (95% CI: 89.6, 95.2%), moderate accuracy 80.3% (95% CI: 76,3, 80.4%), PPV 73.7% (95% CI: 65.2, 80.8%) and NPV 81.5% (95%CI: 79, 83.8%), but low sensitivity 49% (95%CI: 40.7, 57.3%). The high false negative results were mainly due to mild OVFs with <20% vertebral height loss. The new AI software tool has high specificity with a low false positive rate of 5.1%, showing that it can be used as a complimentary tool to the routine diagnostic reports for reduction of missed OVF in elderly women. The low sensitivity with high false negative rates indicate the necessity of radiologist’s in identifying and reporting early OVFs.

Preprint REVIEW | doi:10.20944/preprints202311.1296.v1

Hyperhomocysteinemia in Adult Patients: A Treatable Metabolic Condition

Domingo González-Lamuño, Francisco Jesus Arrieta Blanco, Elena Dios Fuentes, María Forga, Montserrat Morales-Conejo, Luis Peña-Quintana, Isidro Vitoria-Miñana

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: homocystein; hyperhomocysteinemia; homocystinuria; inborn metabolic diseases; transsulfuration; remethylation; thromobotic events; marfanoid habitus; ectopia lentis; betaine

Online: 21 November 2023 (10:01:21 CET)

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Preprint ARTICLE | doi:10.20944/preprints202311.1224.v1

Association of WBC Levels With All-Cause Mortality in ICU Patients Receiving CRRT: A Retrospective Cohort Study

Haowen Huang, Feng Huang, Jie Zhou, Zhiqin Zhang, Yuan Ren, Sansi Chang, Jun Xue

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: acute kidney injury; continuous renal replacement therapy; intensive care unit; cox regression; prediction model

Online: 20 November 2023 (07:53:38 CET)

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Preprint ARTICLE | doi:10.20944/preprints202311.1228.v1

Varvara Aleksandrovna Ryabkova, Artemiy Vladimirovich Rubinskiy, Valeriy Nikolaevich Marchenko, Vasiliy Ivanovich Trofimov, Leonid Pavlovich Churilov

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: chronic fatigue syndrome; COVID-19; Post-COVID; heart rate variability; autonomic dysfunction

Online: 20 November 2023 (07:51:21 CET)

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Background There is a considerable overlap between clinical presentation of post-COVID-19 condition (PCC) and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) . Many of their common symptoms can be linked to dysregulation of the autonomic nervous system (dysautonomia). This study aimed to objectively assess autonomic function in patients with PCC and in patients with ME/CFS whose disease was not related to COVID-19. Methods Synchronous recordings of an electrocardiogram, continuous dynamics of blood pressure in the digital artery using the Penaz method and ultrasound pneumotachography with the spirography function were obtained with spiroarteriocardiorhythmography method in 34 patients diagnosed with ME/CFS, in whom the onset of the disease was not associated with COVID-19, 29 patients meeting PCC definition and 32 healthy controls. Heart rate variability (HRV), systolic and diastolic blood pressure variability (RV), respiration variability were assessed at rest and in tests with fixed respiratory rates. At rest, indicators of baroreflex regulation were additionally determined (baroreflex effectiveness index and baroreflex sensitivity). Results The total power, power of very low frequency, low-frequency and high-frequency of RR interval variability at rest as well as baroreflex effectiveness index in up-ramps of arterial blood pressure and baroreflex sensitivity were significantly lower both in PCC and ME/CFS patients compared to HC. Several diagnostic prediction models for ME/CFS were developed based on HRV parameters. During slow breathing HRV parameters return to normal in PCC, but not in ME/CFS. Correlation analysis revealed a close relationship of HRV, RV parameters and baroreflex sensitivity with fatigue, but not with HADS depressive/anxiety symptoms in ME/CFS and PCC. Conclusion A similar pattern of HRV and baroreflex failure with signs of a pathological acceleration of age-dependant dysautonomia was identified in ME/CFS and PCC. The clinical, diagnostic and therapeutic implications of these findings are discussed, in light of previously described relationship between inflammation, vascular pathology, atherosclerotic cardiovascular disease and autonomic dysfunction.

Preprint BRIEF REPORT | doi:10.20944/preprints202311.1197.v1

Wharton’s Jelly Tissue Allograft for Connective Tissue Defects Surrounding Nerves in the Tarsal Tunnel: A Retrospective Case Series

Ronald Bruton, Tracie Gilliland, John Shou, Naomi Lambert, Crislyn Woods, Tyler Barrett

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: tarsal tunnel; nerve damage; neuropathy; wharton’ s jelly; regenerative medicine

Online: 20 November 2023 (03:36:52 CET)

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Background Caused by age or trauma, collapsed connective tissue can cause nerve entrapment and damage within the tarsal tunnel. With an unknown incidence rate, tarsal tunnel syndrome is relatively underdiagnosed, and current literature is inconclusive on best practices for patient care. While most standard treatments involve symptom management, this retrospective case series highlights a novel approach, targeting the damaged tissues surrounding the nerves and replacing the structural cushioning with a Wharton’s jelly tissue allograft. Methods This cohort was selected from the retrospective repository at Regenativelabs. The eight selected patients had tarsal tunnel-related defects from four clinical sites. Patient outcomes were tracked on a 90-day calendar utilizing the Numeric Pain Rating Scale (NPRS) and the Western Ontario and McMaster University Arthritis Index (WOMAC). All patients had failed standard care practices for at least six weeks. Each patient received one 2mL application of 150mg minimally manipulated Wharton’s jelly tissue allograft to strategic sites around the affected tarsal tunnel. No patients experienced adverse reactions. Red light and laser therapies were recommended post-application. Results The percent change of improvement in patient pain scales was calculated with the cohort averages at initial application, 30-day follow-up, and 90-day follow-up appointments. All patients reported decreased pain on both scales. Percent change calculated from the initial application to the 90-day follow-up showed an improvement of 59.43% in NPRS and a 37.58% improvement in WOMAC. Conclusions Given the reported pain improvements on various pain rating scales, this study provides evidence that WJ allograft applications are safe, minimally invasive, and efficacious for patients who have failed standard care treatments for connective tissue defects associated with Tarsal Tunnel syndrome. The results of this study warrant further research to confirm the efficacy of Wharton's jelly added to conservative care protocols to clarify WJ allograft application's optimal dose, protocol, and durability.

Preprint ARTICLE | doi:10.20944/preprints202311.0894.v1

The IFSD Score － A Practical Prognostic Model for Invasive Fungal Spondylodiscitis

Chao-Chun Yang, Ming-Hsueh Lee, Chia-Yen Liu, Meng-Hung Lin, Yao-Hsu Yang, Kuo-Tai Chen, Tsung-Yu Huang

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: invasive fungal infection; fungus; candida; aspergillus; spondylodiscitis; osteomyelitis; mortality; chang gung research database

Online: 14 November 2023 (10:24:43 CET)

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Preprint ARTICLE | doi:10.20944/preprints202311.0855.v1

Expanding the Clinical Spectrum of Coffin-Siris Syndrome with Anorectal Malformations: Case Report and Review of the Literature

Ralah Alharbi, Anna Suchet-Dechaud, Renaud Touraine, Inès Harzallah, Francis Ramond

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: Coffin-Siris syndrome; ARID1A; anorectal malformation; anal atresia; anteriorly placed anus; imperforate anus

Online: 14 November 2023 (09:06:54 CET)

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Preprint ARTICLE | doi:10.20944/preprints202307.0141.v3

Diagnostic Accuracy of a Portable Electromyography and Electrocardiography Device to Measure Sleep Bruxism in a Sleep Apnea Population: A Comparative Study

Rosana Cid-Verdejo, Adelaida A. Domínguez Gordillo, Eleuterio A. Sánchez Romero, Ignacio Ardizone García, Francisco J. Martínez Orozco

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: bruxism; electromyography; sleep apnea; polysomnography; sleep bruxism; sleep wake disorders

Online: 14 November 2023 (07:55:30 CET)

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Background: The gold standard for the diagnosis of sleep bruxism (SB) and obstructive sleep apnea (OSA) is Polysmnography (PSG). At the end of the apnea episodes there is frequently a final hy-permotor muscle activity that could act as a confusion factor in the diagnosis of SB with the elec-tromyography portable devices. The aim of this study was to compare the concordance on the number of episodes of SB in a population with OSA, between the diagnosis obtained by PSG, an-alyzed manually by a neurophysiologist and that obtained manually and automatically by a portable electromyography (EMG) and electrocardiography (EKG) device. Methods: Twenty-three subjects underwent one night of polysomnographic study with simulta-neous recording with the EMG-EKG device. The variables referring to the number of episodes and the SB index measured with both tools and analyzed in the manual and automatic modes were compared. Masticatory muscle activity was scored according to published criteria. The sample was segmented by severity of OSA according to AASM criteria. ANOVA, correlations, and the Bland–Altman plot were used to quantify the agreement between both methods. The concordance was calculated through the ICC. Results: The total events of SB per night in the PSG study were on average (8.17), lower than the one obtained with EMG-EKG manual analysis (14.13) and automatic (29.26). Both the SB PSG and Manual EMG-EKG episodes decrease from non-OSA (PSG = 16 ± 13,55, EMG-EKG = 16,83 ±11,58) to severe OSA (PSG = 3,14 ± 4,26, EMG-EKG = 9,86 ± 8,09). However, in the case of automatic EMG-EKG mode: the number of SB episodes in severe OSA doubled (41,23 ± 12,50) with respect to non OSA (24,50 ± 12,19). On average: the EMG-EKG device Automatic analysis measures 21.08 units more than PSG. The results with the manual EMG-EKG analysis improved. Conclusion: There is no concordance between the results obtained in the PSG neurophysiologic analysis and those obtained by means of the EMG-EKG device automatic and manual analysis for the diagnosis of SB in a population mostly with OSA. The OSA could act as a confusion factor in the diagnosis of SB with the electromyography portable devices, but further study is needed.

Preprint ARTICLE | doi:10.20944/preprints202311.0620.v1

Self-efficacy, Vulnerability to Stress and Anxiety, Psychological Factors Involved in Arterial Hypertension

Lucia BUBULAC, Maria-Cristina BURUNTIA

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: self-efficacy; stress-vulnerability; perceived stress; anxiety; hypertension

Online: 9 November 2023 (11:17:51 CET)

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Preprint REVIEW | doi:10.20944/preprints202311.0539.v1

Why Citicoline (A Medical Food) Should Not Be Prescribed to Treat People with Acute Ischemic Stroke: The Certainty of the Evidence

Arturo J Martí-Carvajal

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: Citicoline; Medical Food; Acute Ischemic Stroke; Evidence-based Medicine; Philosophy of Science

Online: 8 November 2023 (13:49:03 CET)

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Background: Citicoline, a medical food, lacks proven efficacy for ischemic stroke and has uncertainties around its harms. The continued prescription should be reevaluated given the more robust, high-quality Evidence against that medical food. This essay is based on a recent Cochrane review and uses only one all-cause mortality as the primary outcome. Therefore, the essay should be considered as something other than an updated Cochrane review but like a reflection based on Evidence-based Medicine and Philosophy of Science analysis. Question Research: Why citicoline (a medical food) should not be prescribed to treat people with acute ischemic stroke: The certainty of the Evidence.? Objective: Demonstrate from evidence-based medicine and philosophy of science perspective that citicoline should not be prescribed for acute ischemic stroke due to lack of efficacy and harm uncertainties. Search publications: We searched in PubMed and Cochrane Library from 2020 until 30 October 2023. We, furthermore, used engineering machines Bing and Google Scholar to detect additional papers. Additionally, we also reviewed reference lists of the retrieved publications and review articles and searched the websites of the U.S. Food and Drug Administration (FDA) and European Medicines Agency (EMA). Selection criteria: We included systematic reviews, meta-analyses, randomized clinical trials, clinical guidelines focused on acute ischemic stroke and comparing citicoline versus placebo or no intervention. We excluded narrative reviews, observational studies and ongoing trials. Data collection and analysis: We identified only new randomized clinical trials and assessed the risk of bias in seven domains. The other eight trials were already included in the mentioned Cochrane review. The systematic reviews with or without meta-analyses were assessed using McMaster University guidelines. We estimated risk ratios (RRs) for that outcome. We measured statistical heterogeneity using the I² statistic. We conducted our analyses using the fixed effect model. We did not use the GRADE approach due to what is shown in a Cochrane review published in 2020 by Martí-Carvajal et al. We used the RevMan 5.4 software from Cochrane Collaboration to conduct the forest plot. We used a Trial Sequential Analysis with Copenhagen Trial Unit Software. We estimated a Bayes factor from the relative risk and 95% confidence interval. Results: We identified only one new RCT (N = 99) reported mortality data and three clinical guidelines. We conducted a new meta-analysis with nine trials (N = 4461) having a high risk of bias and showing little to no difference in mortality between citicoline and placebo (17.1% vs 18.4%; RR 0.94, 95% CI 0.82 to 1.06; I2 = 0%). The Bayes factor was 0.7, indicating weak Evidence for the null over the alternative hypothesis. Trial sequential analysis suggested sufficiency of Evidence for mortality. No guidelines recommend citicoline. Conclusions: This essay reassessed citicoline for acute ischemic stroke after the 2020 Cochrane review. Adding a new RCT further supported the lack of mortality benefit with citicoline. The overall evidence quality could be better. Analyses using evidence-based medicine and philosophy of science approaches do not support prescribing citicoline due to a lack of efficacy substantiation and potential harms.

Preprint BRIEF REPORT | doi:10.20944/preprints202311.0471.v1

Tacrolimus as a Promising Drug for Epistaxis and Gastro Intestinal Bleeding in HHT

Paloma Alvárez-Hernández, José Luis Patier, Sol Marcos, Vicente Gómez del Olmo, Laura Lorente-Herraiz, Lucía Recio-Poveda, Luisa María Botella, Adrián Viteri-Noël, Virginia Albiñana

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: HHT; bleeding; epistaxis; GI bleeding; tacrolimus; ESS; Hemoglobin

Online: 8 November 2023 (01:35:55 CET)

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Medicine and Pharmacology