Medicine and Pharmacology

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Review
Medicine and Pharmacology
Dermatology

Marina Corral-Forteza,

Noelia Pérez-Muñoz,

Maria-Teresa Fernández-Figueras

Abstract: The development of cutaneous lesions in areas of the skin previously affected by a healed, unrelated disease is known as the Wolf isotopic response (WIR). The most common scenario of WIR is reactions following herpes zoster, although it has been reported in many other settings. These affected areas are though to suffer from immune system dysregulation, lymphatic vessel dysfunction, and altered neuromediator activity, leading to increased susceptibility to inflammatory, neoplastic, and infectious pathologies. This phenomenon falls under the broader concept of the “immunocompromised district”, which also includes the Koebner phenomenon and its reverse. We report the case of a 96-year-old woman who developed multiple cysts and comedones at the site of a healed herpes zoster. Persistent and intractable inflammation prompted curettage of the lesions, and histopathological examination revealed an angiosarcoma with a pseudolymphomatous reaction interspersed among the cysts. The coexistence of multiple types of WIR is rare but not exceptional, underscoring the need for awareness of the wide spectrum of pathologies that can arise in such settings. In this review, we provide an updated explanation of current pathogenic theories and a practical compilation of postherpetic reactions reported to date.
Review
Medicine and Pharmacology
Endocrinology and Metabolism

Yongsoo Park,

Kyung Soo Ko,

Byung Doo Rhee

Abstract: Non-alcoholic fatty liver disease (NAFLD) has frequently been associated with obesity, type 2 diabetes (T2D) and dyslipidemia, all of which are shared by increased insulin resistance. It has become the most common liver disorder in Korea as well as in developed countries and, therefore, is associated with increased health burden of morbidity and mortality. It has an association with T2D, and T2D increases the risk of cirrhosis and related complications. NAFLD encompasses a disease continuum from simple steatosis to non-alcoholic steatohepatitis which is characterized by faster fibrosis progression. Although its liver-related complication is estimated to be, at most, 10%, it will be a leading cause of cirrhosis and hepatocellular carcinoma soon in Korea. Although the main causes of death in people with NAFLD are cardiovascular disease and extra-hepatic malignancy, advanced liver fibrosis is a key prognostic marker for liver-related outcomes, and can be assessed with combinations of non-invasive tests in the community. Numbers of components of metabolic syndrome involved could be another important prognostic information of NAFLD assessed easily in the routine care of the community. There is a few approved therapy for NAFLD, although several drugs including antioxidants attracts practitioners’ attention. Because of the modest effect of the present therapeutics, let alone complex pathophysiology and substantial heterogeneity of disease phenotypes, combination treatment is a viable option for many patients with NAFLD in the Korean community. Comprehensive approach taking healthy lifestyle and weight reduction into account remain a mainstay to the prevention and treatment of NAFLD.
Article
Medicine and Pharmacology
Oncology and Oncogenics

Reema Alzeer,

Najla Al-Harbi,

Maha Al-Ghamdi,

Sara Bin Judia,

Basem Alotaibi,

Abdullah Alsuliman,

Khaled Al-Hadyan,

Rafa Almeer,

Ghazi Alsbeih

Abstract: The search for NF-κB blockers to optimize antioxidants and counteract inflammation and carcinogenesis has identified several promising natural compounds, encompassing curcumin. Nonetheless, despite the pleiotropic health attributes of curcumin and established safety, its in vivo efficacy is limited by its poor pharmacokinetic properties, primarily due to its low bioavailability because of its low free serum concentrations and short half-life. To overcome these restrictions, we investigated the efficacy of the synthetic curcumin analog PAC in breast cancer cells. Additionally, MCF-7 and MDA-MB-231 cell lines were employed to explore the anticancer effects of PAC by assessing cell viability, apoptosis, clonogenic survival, and the expression of NF-κB, p53, Bcl-2, and Bax. Our results validate that PAC effectively inhibits cell proliferation and induces apoptosis in a dose-dependent manner. PAC also significantly enhances the radiosensitivity of breast cancer cells, indicating a potential synergistic effect with radiation therapy. Mechanistically, PAC exerts anticancer effects by inhibiting NF-κB signaling and modulating apoptotic genes like p53, Bax, and Bcl-2. These findings highlight its potential as a breast cancer therapeutic, enhancing existing treatments.
Review
Medicine and Pharmacology
Dermatology

Homer S. Black

Abstract: Globally, skin cancer accounts for more than all other malignancies combined. Skin cancer imposes a significant financial and societal burden. UVR exposure is responsible for 90% of skin cancer and is a major source of exogenous free radicals. The free radical theory of aging and cancer led to the investigation of polyunsaturated lipids, antioxidants (including synthetic phenols, polyphenols, flavonoids) and ß-carotene as potential modulators of UVR-carcinogenesis. Experimentally, both dietary lipids and antioxidants modified the tumor latent period and multiplicity. Increasing levels of omega-6 fatty acids exacerbated UVR-carcinogenesis in a near linear fashion. However, omega-3 fatty acid inhibited UVR-carcinogenesis. Both types of lipids exhibit the same level of saturation. Thus, the inhibition of UVR-carcinogenesis by omega-3 fatty acid must rest with differential metabolic intermediates that each generate, both tumor-promoting and immune-modulating. Clinically, a low-fat dietary intervention trial has shown that reduced fat intake significantly reduces the occurrence of nonmelanoma skin cancer. Dietary supplementation of antioxidants and ß-carotene into the complex milieu of the cell with its own intricate and complex free radical defense system has resulted in detrimental responses and antioxidant dietary supplements, as well as ß-carotene, are no longer recommended for the public as a mean to prevent cancer.
Article
Medicine and Pharmacology
Urology and Nephrology

Caterina Carollo,

Luigi Peritore,

Alessandra Sorce,

Emanuele Cirafici,

Miriam Bennici,

Luca Tortorici,

Riccardo Polosa,

Giuseppe Mulè,

Giulio Geraci

Abstract: Objective: The objective was to assess the differences about the prevalence of high blood pressure values in adolescents by applying the 2016 ESH and the 2017 AAP hypertension guidelines and analyze the relationship of pressure increases with lifestyles and potentially risky behaviors, which in Italy are little investigated. Design and method: Blood pressure levels of 1301 students aged between 13 and 20 were recorded. Two questionnaires were administered, one related to anamnestic data and anthropometric parameters and a second one, combined with the measurement of blood pressure, investigated the prevalence of hypertension and its relationship with lifestyle. Three blood pressure and heart rate measurements were taken and the average of these measurements was calculated. For the diagnosis of increased blood pressure both ESH and AAP criteria were considered. For the definition of the height centiles as well as for the BMI, reference was made to the tables produced by WHO 2007. Results: The main result concern the greater prevalence of high blood pressure values by applying new AAP criteria (14,8%) than ESH guidelines (7,5%). In our study we found significant correlation of systolic values and anthropometrics variables: weight (r = 0,342) height (r = 0,321) and BMI (r = 0,318) in the entire population. The condition of overweight in hypertensive subjects in comparison to normotensive was evident, while the prevalence of obesity despite being tendentially greater in hypertensives was not significantly higher. Higher SBP (systolic blood pressure) and DBP (diastolic blood pressure) values are associated with a higher mean heart rate (88 ± 18 bpm). No significant correlations was found with smoking, height and sex. Conclusions: At the best of our knowledge, this study is the first in our country, which investigates the prevalence of hypertension in adolescents, after the publication of 2017 AAP guidelines. Results shows how hypertension is not a rare phenomenon in this age group and confirm that it deserves more attention and following studies.
Article
Medicine and Pharmacology
Dietetics and Nutrition

Lindsay M Reynolds,

Timothy D Howard,

Carl D Langefeld,

Mara Z Vitolins

Abstract:

Tree nut and extra virgin olive oil (EVOO) supplementation can improve cardiometabolic health. However, the effects of tree nut and EVOO consumption on aging biology is unknown. We carried out an exploratory four-week tree nut and EVOO supplementation intervention in 33 adults 48 – 81 years of age (mean age: 68 ± 9 years) with metabolic syndrome to generate preliminary data on a measure of biological aging – epigenetic aging, and qualitatively explored participants’ interest in knowing their epigenetic aging measures. Epigenetic aging was measured in all participants at baseline and after the 4-week intervention (DunedinPACE and GrimAge). At baseline, participants had advanced epigenetic aging measured by the DunedinPACE biomarker but not the GrimAge biomarker, with 100% of participants having DunedinPACE>1 (Wilcoxon test, p=3.73E-9), and 38% of participants having AgeAccelGrim>0 (Wilcoxon test, p=0.48). 84% of participants reported they thought they could participate in a similar 3-4 year study. The majority (77%) of participants educated about epigenetic aging reported they very much wanted to know their epigenetic age (77%), and that they would be somewhat likely (29%) or very likely (57%) to eat tree nuts and EVOO daily if it slowed biological aging. There was not a significant (p<0.05) change in epigenetic aging measures from baseline to after the 4-week intervention. This study further substantiates advanced epigenetic aging in individuals with metabolic syndrome. This pilot study also demonstrates participant interest in learning about biological age and supports the potential for biological aging measures to motivate behavior change.

Article
Medicine and Pharmacology
Hematology

Soslan Shakhidzhanov,

Anna Filippova,

Elizaveta Bovt,

Andrew Gubkin,

Gennady Sukhikh,

Sergey Tsarenko,

Ilya Spiridonov,

Denis Protsenko,

Dmitriy Zateyshchikov,

Elena Vasilieva

+11 authors
Abstract: Introduction: Critically ill COVID-19 patients receiving prophylactic-dose antico-agulation exhibit high rates of thrombosis and mortality. Escalation of anticoagu-lation also does not reduce mortality and has an uncertain impact on the throm-bosis rates. The reasons why escalated doses fail to outperform prophylactic doses in reducing risks of thrombosis and death in critically ill COVID-19 patients remain unclear. We hypothesized that escalated anticoagulation would not ef-fectively prevent plasma hypercoagulability and, consequently, would not reduce the risk of thrombosis and death in some patients. Methods: We conducted a prospective multicenter study that enrolled 3860 COVID-19 patients, including 1654 critically ill. They received different doses of low-molecular-weight or unfractionated heparin, and their plasma coagulability was monitored with activated partial thromboplastin time, D-dimer, and Throm-bodynamics. A primary outcome was plasma hypercoagulability detected by Thrombodynamics. Blood samples were collected at the trough level of antico-agulation. Results: We found that escalated anticoagulation did not prevent hypercoagula-bility in 28.3% of critically ill patients at the trough level of the pharmacological activity. Critically ill patients with hypercoagulability not suppressed by anticoag-ulants had higher levels of inflammation markers and better creatinine clearance compared to critically ill patients without such hypercoagulability. Hypercoagu-lability detected by Thrombodynamics was associated with a 1.75-fold higher hazard rate for death and a 3.19-fold higher hazard rate for thrombosis. Elevated D-dimer levels were also associated with higher hazard rates for thrombosis and death, while shortened APTT were not. Simultaneous use of Thrombodynamics and D-dimer data enhanced the accuracy for predicting thrombotic events and fatal outcomes in critically ill patients. Conclusions: Thrombodynamics reliably detected hypercoagulability in COVID-19 patients and can be used in conjunction with D-dimer to assess the risk of thrombosis and death in critically ill patients. Pharmacological effect of LMWH at the trough level might be too low to prevent thrombosis in some critically ill pa-tients with severe inflammation and better creatinine clearance even if escalated doses are used.
Review
Medicine and Pharmacology
Ophthalmology

Shiva Ram Male,

Sushma Nandyala

Abstract: Background: In recent years, there has been a surge in the popularity of Blepharopigmentation, which is also referred to as permanent eyeliner or eye tattooing, as a cosmetic surgery. Aim: This review article examines the impact and consequences of eyeliner tattooing and embroidery in the context of Blepharopigmentation. Methods: A narrative literature review study design was used to delve into the historical background of these methods, elucidate their methodologies, explore their prospective advantages, and examine the pertinent safety aspects. Furthermore, the eyeliner analysis critically evaluates the diverse range of pigments used, the potential for adverse responses, and the determinants impacting the durability of the outcomes. Results: A total of 15 articles' results were described and emphasised. After incorporating the findings, the study's objectives were considered to conclude the major findings and relevance of blepharopigmentation and its effects on the human cornea. Conclusion: It is critical for eye care professionals in the field and anyone considering using these cosmetic procedures to understand the tremendous effects they may have on many elements affecting blepharopigmentation, and a recommended grading process has emerged from the present review study.
Review
Medicine and Pharmacology
Orthopedics and Sports Medicine

Kenichiro Nakajima

Abstract: In 1927, Cochrane noted that the elastic resistance in hallux dorsiflexion remained after cheilectomy or dorsiflexion osteotomy of the metatarsal head. This hallux rigidus was attributed to the shortening and tightness of the soft tissues below the first metatarsophalangeal joint. A novel surgery was devised, wherein the plantar tissues were divided through a plantar approach, resulting in favorable outcomes in 12 patients. This revolutionary surgical technique directly addressed the cause of hallux rigidus, but this is not done by the current surgeries. This paper offers a critical review of the current surgeries for hallux rigidus. First, we reviewed the literature on the etiologies of hallux rigidus, dorsal impingement, functional hallux rigidus, hallux primus elevatus, and long metatarsal, then reviewed studies on metatarsal decompression osteotomy, metatarsal dorsiflexion osteotomy, and cheilectomy. Finally, we reviewed the studies on arthroscopic cheilectomy and explored the feasibility of arthroscopic surgery, including the arthroscopic Cochrane procedure, for hallux rigidus.
Review
Medicine and Pharmacology
Anesthesiology and Pain Medicine

Émile Breault,

Rebecca L. Brouillette,

Terence E. Hébert,

Philippe Sarret,

Élie Besserer-Offroy

Abstract:

Opioid analgesics have been used for more than 5,000 years and remain the main pain medications prescribed today. Although morphine is considered the gold standard of pain relief, this selective µ-opioid receptor (MOP) agonist provides only moderate relief for many chronic pain conditions, and produces a number of unwanted effects that can affect the patient’s quality-of-life, prevent adherence to treatment or lead to addiction. In addition to the lack of progress in developing better analgesics, there have been no significant breakthroughs to date in combating the above-mentioned side effects. Fortunately, a better understanding of opioid pharmacology has given renewed hope for the development of better and safer pain medications. In this review, we describe how clinically approved opioids were initially characterized as biased ligands and what impact this approach might have on clinical practice. We also looked at the preclinical and clinical development of biased MOP agonists, focusing on the history of oliceridine, the first specifically designed biased analgesic. In addition, we explore the discrepancies between ligands with low intrinsic efficacy and those with biased properties. Finally, we examine the rationale behind the development of biased ligands during the opioid crisis.

Article
Medicine and Pharmacology
Other

Manosha Perera,

Irosh Perera

Abstract: Fibroepithelial polyps are inflammatory hyperplastic lesions characterized by para-keratinized stratified squamous epithelium. They develop in response to chronic irritation and display arcading patterns with a mixed infiltrate of inflammatory cells, predominantly lymphocytes, along with plasma cells. 12 species of Candida were identified in the FEP tissues of a group of Sri Lankan male patients with oral risk habits. Among these, C. albicans was the most prevalent, with an average relative abundance of 29.56%. The other species detected included Candida tropicalis (2.59%), Candida parapsilosis (1.56%), Candida niveriensis (0.91%), Candida salmanticensis (0.74%), Candida blattae (0.13%), Candida doubliniensis (0.10%), Candida etchellsii (0.12%), Candida metapsilosis (0.10%), Candida vanderwaltii (0.34%), Candida santamariae (0.11%), and Candida albicans_nov_92.15% (0.002%) as shown
Review
Medicine and Pharmacology
Gastroenterology and Hepatology

Tancredi Vincenzo Li Cavoli,

Armando Curto,

Erica Nicola Lynch,

Andrea Galli

Abstract: Liver transplantation (LT) has deeply transformed the treatment of end-stage liver disease and hepatocellular carcinoma, offering the most effective therapy for many liver conditions. However, LT carries inherent risks, including the develop-ment of cancers, which can arise from the transmission of neoplastic cells from the donor, the recurrence of pre-existing cancers, or as a long-term effect of the transplant originating from the recipient's own cells. The development of cancer in LT recipients is influenced by a variety of factors, such as age, gender, race, the underlying cause of liver disease, lifestyle factors (like alcohol use and smoking), and the use of immunosuppressive therapy. These combined factors increase the susceptibility of LT recipients to several types of cancer, including skin cancers, gastrointestinal malignancies, and lym-phoproliferative disorders. While long-term survival after LT has significantly improved, there has been a notable increase in the incidence of de novo malignancies, which underscores the importance of diligent cancer screening and monitoring in transplant recipients, especially as they age. To manage this increased risk, various screening programs are recommended, including annual skin exams, colonoscopies for patients with primary sclerosing cholangitis (PSC) or inflammatory bowel disease (IBD), and lung cancer screening with low-dose CT for former smokers. When cancer is detected in LT recipients, reducing immunosuppression is a crucial strategy. Decreasing calcineurin in-hibitors (CNIs) and integrating mTOR inhibitors (mTORi) provide promising avenues for balancing immunological con-trol with oncological risk. Understanding these risk factors and adjusting immunosuppression appropriately is vital for improving cancer outcomes in LT recipients. Although evidence from LT-specific studies remains limited, insights from other solid organ transplant (SOT) settings, especially kidney transplants, offer valuable guidance in managing cancer risks in LT recipients. This narrative review focuses on prevention and management of de novo and donor-transmitted malignancies.
Article
Medicine and Pharmacology
Oncology and Oncogenics

Ebru Karcı,

Ahmet Bilici,

Ferhat Özden,

Elif Kuzucular,

Harun Muğlu,

Ömer Fatih Ölmez,

Özgür Açıkgöz,

Özcan Yıldız

Abstract: Pancreatic ductal adenocarcinoma (PDAC) is a highly aggressive malignancy with limited treatment options. Identifying reliable prognostic biomarkers is crucial for risk stratification and therapeutic decision-making. This study investigates the prognostic significance of Claudin 18.2 (CLDN18.2), isocitrate dehydrogenase-1 (IDH1) expression, and the neutrophil-to-lymphocyte ratio (NLR) in patients with unresectable PDAC receiving first-line chemotherapy. This retrospective, single-center study included 72 patients with histologically confirmed unresectable PDAC treated with either FOLFIRINOX (59.7%) or gemcitabine plus nab-paclitaxel (40.3%). Immunohistochemistry was performed to assess CLDN18.2 and IDH1 expression, while NLR was calculated from pre-treatment blood counts. Univariable and multivariable analyses were conducted to evaluate predictors of progression-free survival (PFS) and overall survival (OS). CLDN18.2 and IDH1 were positively expressed in 18.1% and 2.8% of patients, respectively, while 56.9% had elevated NLR (>3.22). The median PFS was 7.1 months (95% CI: 4.2–9.9), and the median OS was 9.7 months (95% CI: 8.5–10.8). Multivariable analysis identified negative CLDN18.2 expression (HR = 0.38, 95% CI: 0.18–0.81, p = 0.013), positive IDH1 expression (HR = 0.68, 95% CI: 0.19–0.72, p = 0.039), and high NLR (HR = 1.92, 95% CI: 1.03–3.56, p = 0.038) as independent predictors of poorer OS. No independent predictors of PFS were identified. CLDN18.2 and IDH1 expression, along with NLR, are independent prognostic markers for OS in patients with unresectable PDAC undergoing first-line chemotherapy. These biomarkers may facilitate risk stratification and guide personalized treatment strategies. Further prospective validation is warranted to confirm their clinical utility.
Article
Medicine and Pharmacology
Clinical Medicine

Esli Camila Sanchez Moreno,

Andrea Carolina Machado Sulbaran,

Lizbeth Riera Leal,

Yveth Marlene Ortiz Garcia,

Luis Roberto Olivas Roman,

Annie Riera Leal

Abstract:

Background/Objectives: Skin cancer is increasingly prevalent. Non-melanoma skin cancers pose a challenge, as most lesions are diagnosed at later stages and often lead to complications. Although dermatoscopy has emerged as a valuable tool that enhances the confidence of dermatologists, specific patterns for accurately identifying various subtypes of non-melanoma skin cancer have yet to be detailed. This study aimed to investigate dermatoscopic clues that facilitate accurate diagnosis of non-melanoma skin cancer among dark-skinned Mexican individuals. There is insufficient acknowledgment of high skin cancer rates among non-Whites. Methods: The study included fifty-three patients diagnosed with non-melanoma skin cancer, aged 39 to 89, who visited an academic dermatology department for skin examinations. Two certified dermatologists evaluated at least three dermatoscopy images for each lesion. A biopsy was taken to confirm the preliminary diagnosis. Statistical analysis was performed using GraphPad Prism v8.0, considering a probability (p) value of less than 0.05 as significant. Results: Most patients were classified as phototype III. Patients with phototype IV were younger at the time of diagnosis. Basal cell carcinomas were the most common cancer subtype. Nodular and ulcerated tumors were the most prevalent morphology. The dermatoscopic examination revealed that 60% of the lesions were pigmented, with a predominance of polymorphic vascular patterns. Squamous cell carcinomas exhibited monomorphic vascular structures. Both groups' blood vessel arrangements and specific patterns were primarily radial. Conclusions: This study did not demonstrate the effectiveness of the non-melanoma skin cancer dermatoscopy criteria in distinguishing basal cell carcinomas from squamous cell carcinomas. However, certain factors, such as pigmentation and linear vessels, seem to occur more frequently in nodular basal cell carcinomas.

Article
Medicine and Pharmacology
Cardiac and Cardiovascular Systems

Eugenio Capparelli,

Eleonora Zaccara,

Ilaria Suardi,

Antonella Laria,

Laura Castelnovo,

Eleonora Mauric,

Daniela Bompane,

Antonio Tamburello,

Maria Iacovantuono,

Maria Sole Chimenti

+2 authors
Abstract: Background: The 2011 Very Early Diagnosis of Systemic Sclerosis (VEDOSS) criteria include patients at risk of progression and those with mild non-progressive forms of SSc. Early diastolic and systolic dysfunction can indicate myocardial fibrosis in SSc patients, yet data on myocardial impairment in the VEDOSS population are limited. Objectives: This study aimed to identify subclinical echocardiographic changes and predictive markers of cardiac dysfunction in both very early and mild-longstanding forms of VEDOSS. Methods: We conducted a cross-sectional observational study involving 61 patients meeting VEDOSS criteria followed up regularly within our Scleroderma referral center. Patients were categorized as early VEDOSS (e-VEDOSS) or mild-longstanding VEDOSS (ml-VEDOSS) based on disease duration (10 years). We analyzed clinical and demographic data, focusing on echocardiographic parameters such as the E/A ratio and left ventricular (LV) thickness. Statistical analyses included Chi-square, Fischer exact, and Student's T tests, with a significance threshold of p<0.05. Results: ml-VEDOSS patients were older and reported a higher burden of comorbidities. Autoantibody-positive patients exhibited lower E/A ratios and increased left atrial size. Late nailfold videocapillaroscopic pattern patients exhibited increased PWED thickening and aortic valve insufficiency. Notably, patients undergoing vasodilators experienced larger right atrial volume, while patient receiving Renin-Angiotensin-Aldosterone System (RAAS) inhibitors reported reduced E/A ratio. Multivariable analysis confirmed DLCO% as the sole predictor of both diastolic and systolic impairment in VEDOSS population. Conclusion: Careful monitoring of cardiac function in VEDOSS patients is crucial as subclinical alterations may occur even in the absence of symptoms. DLCO% emerged as an important predictor of LV diastolic dysfunction.
Article
Medicine and Pharmacology
Epidemiology and Infectious Diseases

Ana C. Cuéllar,

Roberto D. Coello Peralta,

Davis Calle Atariguana,

Martha Palacios Macias,

Paul L. Duque,

Liliana M. Galindo,

Mario O. Zaidenberg,

María J. Dantur Juri

Abstract: The early warning systems based on statistical prediction models; indicators of environmental risks and remote sensing constitute an essential source of environmental information for the development of these warning systems. The present work is focused on the use of remote sensing for the estimation of the risk of transmission and the prediction of malaria cases in the northwest of Argentina. The study was carried out in the city of San Ramón de la Nueva Orán, where cases of the disease have been reported from 1986 to 2005. The existent relationship between reported malaria cases and climatic/environmental variables (Normalized Difference Vegetation Index (NDVI), Normalized Difference Water Index (NDWI) and Land Surface Temperature (LST)), obtained from Landsat 5 and 7 satellite images, was analyzed through multilevel Poisson regression analyses. A higher abundance of reported cases of malaria in summer was observed. A model of ARIMA (Autoregressive Integrated Moving Average) temporal series, which included the environmental variables, was generated to forecast malaria cases in the year 2000. In turn, the relationship between malaria cases and environmental/climatic factors showed that malaria cases were associated with an increase in LST and mean temperature and a decrease in NDVI. Early warning systems provide information about spatial and temporal predictions of epidemics might help control and prevent malaria outbreaks. Based on the results, this study is expected to be used for the development of future prevention and control actions by the health officials.
Case Report
Medicine and Pharmacology
Neuroscience and Neurology

Kalvis Verzemnieks,

Roberts Tumelkans,

Sintija Strautmane,

Verners Roberts Kalejs,

Julija Dolgopolova,

Egils Valeinis,

Tatjana Tone,

Arturs Balodis

Abstract:

Background. Intracranial dermoid cysts (IDC) are rare benign congenital intracranial lesions. In the case of IDC rupture, these lesions may manifest clinically. Cysts may be visualized on non-enhanced computed tomography (NECT) and magnetic resonance imaging (MRI), facilitating discussions between clinicians and radiologists to determine cyst content and potential dissemination in cases of rupture. This case report describes an IDC rupture presenting as fat-containing lesions in the subarachnoid space and ventricular system, resembling a subarachnoid hemorrhage on MRI. Case report. A thirty-two-year-old Caucasian male patient was admitted to the hospital due to recurrent headache and visual impairment that began at the age of thirty-one. MRI revealed a lesion radiologically consistent with a ruptured dermoid or epidermoid cyst in the anterior fossa with a mass effect on the optic nerve intracranial segments, the chiasma opticum, and proximal optic tracts. The patient underwent a successful neurosurgical resection of the lesion, and histopathological analysis confirmed the diagnosis of a dermoid cyst. The postoperative period was uneventful. MRI follow-up revealed residual tissue of the IDC without any volume increase. Multiple punctate fat-containing lesions were noted, similar to previous MRI. The patient reported no complaints at discharge. Follow-up MRI imaging demonstrated no recurrence or progression of the dermoid cyst at 4 months, 1 year, and 2 years. Conclusion. IDC rupture is a rare event that may present clinically and appear as a blooming artifact on MRI, mimicking subarachnoid hemorrhage. Fat-containing lesions in the subarachnoid space and ventricular system can demonstrate findings indicative of an IDC rupture. MRI diffusion-weighted imaging (DWI) and decreased apparent diffusion coefficient (ADC) values may mimic an epidermoid cyst, a phenomenon rarely described in the literature, further complicating the diagnostic process.

Review
Medicine and Pharmacology
Hematology

Piotr Strzałka,

Kinga Krawiec,

Aneta Wiśnik,

Dariusz Jarych,

Magdalena Czemerska,

Izabela Zawlik,

Agnieszka Pluta,

Agnieszka Wierzbowska

Abstract: Acute myeloid leukemia (AML) corresponds to a heterogeneous group of clonal hematopoietic diseases, which are characterized by uncontrolled proliferation of malignant transformed myeloid precursors and their inability to differentiate into mature blood cells. The prognosis of AML depends on many variables, including the genetic features of the disease. Treatment outcomes, despite the introduction of new targeted therapies, are still unsatisfactory. Recently, there have been an increasing number of reports on enzymatic proteins of the sirtuin family and their potential importance in cancer in general. Sirtuins are a group of 7 (SIRT1-7) NAD+-dependent histone deacetylases with pleiotropic effects on metabolism, aging processes, and cell survival. They are not only responsible for post-translational modification of histones but also play various biochemical functions and interact with other proteins regulating cell survival, such as p53. Thus, their role in key mechanisms of tumorigenesis makes them a worthwhile topic in AML. Different sirtuins have been shown to act oppositely depending on the biological context, the mechanism of which requires further exploration. This review provides a comprehensive description of the significance and role of sirtuins in AML in the light of the current state of knowledge. It focuses in particular on molecular mechanisms regulated by sirtuins and signaling pathways involved in leukemogenesis, as well as clinical aspects and potential therapeutic targets in AML.
Article
Medicine and Pharmacology
Complementary and Alternative Medicine

Shefali Thanawala,

Rajat Shah,

Kiran Bhupathiraju,

Krishnaraju Venkata Alluri,

Prabakaran Desomayanandanam,

Arun Bhuvenendran

Abstract: Background/Objectives: The adaptogenic effects of Ashwagandha root extract are evident. An earlier study showed the therapeutic effects of a once-daily sustained-release (SR) formulation (300 mg) of Ashwagandha root extract over an extended period. This study aimed to evaluate the efficacy and safety of Ashwagandha root extract SR (AshwaSR) 150 mg and 300 mg capsules in reducing stress in healthy adult, stressed subjects. Methods: In this double-blind, randomized, placebo-controlled trial, healthy subjects with Perceived Stress Scale (PSS) score 14-26 were randomized (1:1:1) to AshwaSR 150 mg (group A) or 300 mg (group B) or placebo (group C). Change from baseline to day 60 was evaluated for stress levels, sleep quality, happiness level, eating behavior, and serum cortisol levels in all groups. Results: Of 135 subjects randomized, 126 completed the trial (mean age, 34.79±8.16 years). Mean PSS scores significantly reduced from baseline to day 60 in group A and B (mean change, 38.6% and 41.6% respectively; p<0.0001). Sleep quality, happiness level, and eating behavior significantly improved from baseline to day 60 in groups A and B (p<0.0001). Serum cortisol level in group B was significantly reduced at day 60 (p<0.05). Both group A and B showed significant improvement in stress levels, sleep quality, happiness level, and eating behavior at day 60 (p<0.05) compared to group C. No safety concerns were reported. Conclusions: AshwaSR 150 mg and 300 mg capsules reduced perceived stress and improved sleep quality, eating behavior, and happiness levels and were safe in healthy adult, stressed subjects over 60 days of administration.
Review
Medicine and Pharmacology
Veterinary Medicine

Aftab Siddique,

Niki Whitley,

Oreta Marie Samples,

Joan M Burke,

Thomas H Terrill,

James E Miller,

Tyler Connell

Abstract:

Nematophagous fungi, particularly Duddingtonia flagrans, provide a sustainable and environmentally friendly alternative to chemical anthelmintics for controlling gastrointestinal nematodes (GIN) in livestock. With the increasing prevalence of GIN resistance to anthelmintic drugs, alternative control strategies are essential for maintaining livestock health and productivity. Duddingtonia flagrans has demonstrated efficacy in reducing pasture contamination by trapping and eliminating nematode larvae in feces, thereby interrupting the reinfection cycle. This systematic review consolidates existing research on the biological control potential of D. flagrans, evaluating its efficacy across various livestock species, administration methods, and environmental conditions. While research highlights its ability to reduce nematode burdens, challenges persist in optimizing fungal formulation, improving field efficacy, and assessing economic feasibility. The review identifies critical research gaps, including the need for long-term field trials across diverse climatic conditions, development of bio-encapsulated formulations to enhance spore persistence, and economic assessments comparing the cost-effectiveness of D. flagrans to conventional dewormers. Additionally, integration with sustainable livestock management practices such as rotational grazing and selective breeding requires further exploration. Addressing these challenges through multi-disciplinary research will be crucial in scaling up the application of D. flagrans as a practical and farmer-friendly solution to GIN control. By synthesizing current literature using the Kitchenham framework, this study aims to inform best practices for integrating D. flagrans into sustainable parasite management programs, ensuring its long-term viability as a tool for livestock producers worldwide.

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