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Preprint ARTICLE | doi:10.20944/preprints202004.0345.v1

Incidence of Venous Thromboembolism in Hospitalized Patients with COVID-19

Saskia Middeldorp, Michiel Coppens, Thijs F. van Haaps, Merijn Foppen, Alexander P. Vlaar, Marcella C.A. Muller, Catherine C.S. Bouman, Ludo F.M. Beenen, Ruud S. Kootte, Jarom Heijmans, Loek P. Smits, Peter I. Bonta, Nick van Es

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: COVID-19; venous thrombosis; pulmonary embolism; venous thromboembolism; anticoagulants; mortality

Online: 19 April 2020 (13:08:16 CEST)

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Preprint CASE REPORT | doi:10.20944/preprints202006.0269.v1

A Case of HIV and Clinical Confirmed COVID-19

Cansu Ozgen, Ulku Arslan, Simay Serin, Hulya Sungurtekin

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: HIV; COVID-19

Online: 21 June 2020 (11:59:21 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202003.0065.v1

Short-Term Moderate-Dose Corticosteroid Plus Immunoglobulin Effectively Reverses COVID-19 Patients Who Have Failed Low-Dose Therapy

Zhi-Guo Zhou, Shu-Min Xie, Jing Zhang, Fang Zheng, Di-Xuan Jiang, Ke-Yu Li, Qi Zuo, Yu-Sheng Yan, Ji-Yang Liu, Yuan-Lin Xie, Hong Peng, Lei Zhang

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: humans; infection control; therapy; coronavirus; immunoglobulins; drug therapy; therapeutic use; corticosteroid

Online: 4 March 2020 (11:08:19 CET)

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Background: The coronavirus disease-19 (COVID-19) has spread globally with more than 80,000 people infected, and nearly 3000 patients died. Currently, we are in an urgent need for effective treatment strategy to control the clinical deterioration of COVID-19 patients. Methods: The clinical data of 10 COVID-19 patients receiving short-term moderate-dose corticosteroid (160mg/d) plus immunoglobulin (20g/d) were studied in the North Yard of The First Hospital of Changsha, Hunan from January 17^th to February 27^th, 2020. Epidemiological, clinical, laboratory, radiological findings were analyzed. Results: After treatment with combination of low-dose corticosteroid (40-80mg/d) and immunoglobulin (10g/d), patients’ lymphocyte count (0.88±0.34 vs 0.59±0.18, P<0.05), oxygenation index including SPO₂ (94.90±2.51 vs 90.50±5.91, P<0.05) and PaO₂/FiO₂ (321.36±136.91 vs 129.30±64.97, P<0.05) were significantly lower than pre-treatment, and CT showed that the pulmonary lesion deteriorated in all patients. While after treatment of short-term moderate-dose corticosteroid plus immunoglobulin, patients’ APACHE Ⅱ score (9.10±6.15 vs 5.50±9.01, P<0.05), body temperature (37.59±1.16 vs 36.46±0.25, P<0.05), lymphocyte count (0.59±0.18 vs 1.36±0.51, P<0.05), Lactate dehydrogenase (419.24±251.31 vs 257.40±177.88, P<0.05), and C-reactive protein (49.94±26.21 vs 14.58±15.25, P<0.05) significantly improved compared with post-treatment with low-dose therapy. In addition, oxygenation index including SPO₂ (90.50±5.91 vs 97.50±1.18, P<0.05), PaO₂ (60.47±14.53 vs 99.07±34.31, P<0.05), and PaO₂/FiO₂ (129.30±64.97 vs 340.86±146.72, P<0.05) significant improved. Furthermore, CT showed that pulmonary lesions obviously improved in 7 patients. After systematic therapy, 4 out of 10 COVID-19 patients recovered and discharged. Conclusions: Short-term moderate-dose corticosteroid plus immunoglobulin is effective for reversing the continued deterioration of COVID-19 patients who failed to respond to the low-dose therapy. Funding: This work was supported by the Innovative Major Emergency Project Funding against the New Coronavirus Pneumonia in Hunan Province (Dr. Ji-Yang Liu, number 2020SK3014; Dr. Yuan-Lin Xie, number 2020SK3013).

Preprint BRIEF REPORT | doi:10.20944/preprints202008.0519.v1

Brief Report: Rapid Clinical Recovery from Severe COVID-19 with High Dose Famotidine and High Dose Celecoxib Adjuvant Therapy

kevin tomera, joseph kittah

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: SARS-CoV-2, COVID-19, Acute Respiratory Distress Syndrome, ARDS, Famotidine, Celecoxib

Online: 24 August 2020 (09:46:15 CEST)

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Working Paper ARTICLE

Short-Term Moderate-Dose Corticosteroid Plus Immunoglobulin Effectively Reverses COVID-19 Patients Who Have Failed Low-Dose Therapy

Zhi-Guo Zhou, Shu-Min Xie, Jing Zhang, Fang Zheng, Di-Xuan Jiang, Ke-Yu Li, Qi Zuo, Yu-Sheng Yan, Ji-Yang Liu, Yuan-Lin Xie, Hong Peng, Lei Zhang

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: humans; infection control; therapy; coronavirus; immunoglobulins; drug therapy; therapeutic use; corticosteroid

Online: 8 March 2020 (17:04:19 CET)

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Background: The coronavirus disease-19 (COVID-19) has spread globally with more than 80,000 people infected, and nearly 3000 patients died. Currently, we are in an urgent need for effective treatment strategy to control the clinical deterioration of COVID-19 patients. Methods: The clinical data of 10 COVID-19 patients receiving short-term moderate-dose corticosteroid (160mg/d) plus immunoglobulin (20g/d) were studied in the North Yard of The First Hospital of Changsha, Hunan from January 17^th to February 27^th, 2020. Epidemiological, clinical, laboratory, radiological findings were analyzed. Results: After treatment with combination of low-dose corticosteroid (40-80mg/d) and immunoglobulin (10g/d), patients’ lymphocyte count (0.88±0.34 vs 0.59±0.18, P<0.05), oxygenation index including SPO₂ (94.90±2.51 vs 90.50±5.91, P<0.05) and PaO₂/FiO₂ (321.36±136.91 vs 129.30±64.97, P<0.05) were significantly lower than pre-treatment, and CT showed that the pulmonary lesion deteriorated in all patients. While after treatment of short-term moderate-dose corticosteroid plus immunoglobulin, patients’ APACHE Ⅱ score (9.10±6.15 vs 5.50±9.01, P<0.05), body temperature (37.59±1.16 vs 36.46±0.25, P<0.05), lymphocyte count (0.59±0.18 vs 1.36±0.51, P<0.05), Lactate dehydrogenase (419.24±251.31 vs 257.40±177.88, P<0.05), and C-reactive protein (49.94±26.21 vs 14.58±15.25, P<0.05) significantly improved compared with post-treatment with low-dose therapy. In addition, oxygenation index including SPO₂ (90.50±5.91 vs 97.50±1.18, P<0.05), PaO₂ (60.47±14.53 vs 99.07±34.31, P<0.05), and PaO₂/FiO₂ (129.30±64.97 vs 340.86±146.72, P<0.05) significant improved. Furthermore, CT showed that pulmonary lesions obviously improved in 7 patients. After systematic therapy, 4 out of 10 COVID-19 patients recovered and discharged. Conclusions: Short-term moderate-dose corticosteroid plus immunoglobulin is effective for reversing the continued deterioration of COVID-19 patients who failed to respond to the low-dose therapy. Funding: This work was supported by the Innovative Major Emergency Project Funding against the New Coronavirus Pneumonia in Hunan Province (Dr. Ji-Yang Liu, number 2020SK3014; Dr. Yuan-Lin Xie, number 2020SK3013).

Preprint REVIEW | doi:10.20944/preprints202310.0637.v1

A Systematic Analysis of the Effectiveness of Mitochondrial-Based Therapies for the Management of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)

Leif Gerrit Keferstein

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: Myalgic Encephalomyelitis; chronic fatigue syndrome; therapeutic strategies; personalized treatment; pathophysiology; pharmacological treatments; nutritional supplements; dietary changes; physical therapies; lifestyle modifications

Online: 10 October 2023 (11:23:01 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202001.0209.v1

More than a Box to Check: Research Sponsor and Clinical Investigator Perspectives on Making GCP Training Relevant

Teresa Swezey, F. Hunter McGuire, Patricia Hurley, Janette Panhuis, Kathy Goldstein, Tina Chuck, Carrie Dombeck, Brian Perry, Christina Brennan, Natasha Phrsai, Amy Corneli

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: good clinical practice; clinical trials; quality; investigator training; clinical investigator

Online: 19 January 2020 (04:46:48 CET)

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Preprint ARTICLE | doi:10.20944/preprints201901.0162.v2

Ankylosing Spondylitis Is Associated with Risk of New Onset Obstructive Sleep Apnea: A Nationwide Population-Based Cohort Study

Tsao Chien-Han, Jing-Yang Huang, Hsin-Hsin Huang, Yao-Min Hung, James Cheng-Chung Wei, Hung Yin Tsan

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: ankylosing spondylitis; obstructive sleep apnea; population-based cohort study

Online: 17 January 2019 (04:52:29 CET)

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Preprint ARTICLE | doi:10.20944/preprints201904.0200.v1

Fundamentals of Stem Cells: Why and How Patients' Own Adult Stem Cells Are the Next Generation of Medicine

Eckhard U. Alt, Christoph Schmitz, Xiaowen Bai

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: adipose-derived; bone regeneration; cartilage regeneration; clinical application; clinical studies; differentiation; hair loss; induced pluripotent stem cells; maxillary sinus augmentation; osteoarthritis; pluripotency; regenerative

Online: 17 April 2019 (11:25:14 CEST)

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Preprint REVIEW | doi:10.20944/preprints201804.0086.v1

Clinical Applications of Low-Level Laser Therapy in Reproductive Medicine; A Literature Review

Soheila Borhani, Reza Salman Yazdi

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: low-level laser therapy (LLLT); photobiomodulation; male infertility; sperm motility; assisted reproductive technology (ART)

Online: 8 April 2018 (08:35:22 CEST)

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Preprint REVIEW | doi:10.20944/preprints202203.0105.v1

Tadalafil and Steroid Hormones Interactions in Adipose, Bone and Prostate Tissues: Focus on Translational Perspectives

Emanuela Alessandra Greco, Cristina Antinozzi, Luigi Di Luigi, Antonio Aversa, Paolo Sgrò

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: Tadalafil; prostate cancer; aromatase; adipocytes; bone; androgen receptors; obesity; osteoporosis

Online: 7 March 2022 (14:53:13 CET)

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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 ARTICLE | doi:10.20944/preprints201805.0471.v1

Harmonizing Outcomes for Genomic Medicine: Comparison of eMERGE Outcomes to ClinGen Outcome/Intervention Pairs

Janet L. Williams, Wendy K. Chung, Alex Fedotov, Krzysztof Kiryluk, Chunhua Weng, John J. Connolly, Margaret Harr, Hakon Hakonarson, Kathleen A. Leppig, Eric B. Larson, Gail P. Jarvik, David L. Veenstra, Christin Hoell, Maureen E. Smith, Ingrid A. Holm, Josh F. Peterson, Marc S. Williams

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: genomics; genomic medicine; health outcomes; evidence; standards; eMERGE; ClinGen; precision public health

Online: 31 May 2018 (11:27:23 CEST)

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Preprint ARTICLE | doi:10.20944/preprints201908.0303.v1

Analysis of the Dimensions of Physiotherapy Index of Ventilatory Workload in People with Chronic Obstructive Pulmonary Disease During Stability and Exacerbation in An Outpatient Setting

Rodrigo Muñoz Cofré, Mariano del Sol, Paul Medina González, Jorge Valenzuela Vásquez, Gerardo Molina Vergara, Ramón Pinochet Urzúa, Pablo A. Lizana, Máximo Escobar Cabello

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: ventilatory assessment; physiotherapy; chronic obstructive pulmonary disease

Online: 29 August 2019 (04:52:15 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202205.0202.v2

Safety of Handover: A Global Online Survey of Clinical Practitioners and Leaders Regarding Patient Safety during Transitions of Care

D.J. Hamblin-Brown, Julia Craggs, David Wright, Judi Ingram, Johann Grundlingh, Nhlanhla Ndlovu

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: Clinical handover; Patient Handoff; Patient transfer; Referral and Consultation; Medical Records Systems; Computerized; Patient Safety; Risk Management; Attitude; Institutional Practice

Online: 31 May 2022 (07:14:42 CEST)

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Background: Handover is a critical process for ensuring quality and safety in healthcare. Considerable research suggests that poor handover results in significant morbidity, mortality, dissatisfaction, and excess financial costs. Despite this, little formal attention, education, and evaluation has been given to handover. There is also paucity of data on the opinions of practitioners on the safety of handover.Objectives: The aim of this study was to measure the perceived risk, degree of patient harm and the systems used to support handover, and to understand how this varied by care setting, type of clinical practice, location, or level of experience. Methods: An open, anonymous and confidential online questionnaire covering: (a) respondent characteristics; (b) peer-to-peer handover; (c) internal referrals; (d) discharges and transfers between organisations; and (e) leading and improving handover was conducted with healthcare practitioners and managers from various settings. Results: We gathered a total of 432 completed responses from 26 countries. The average reported performance of handover was rated as 3.9 out of 5.For each type of handover, 12 - 14% reported errors occurring more than weekly. Of those that knew the outcome of such errors, between 29% and 34% reported that they had witnessed moderate or severe harm. 12% and 17% of respondents believed that handover was high or very high risk (See table 4). These respondents were more likely to have witnessed moderate or severe harm, or to be more senior.A wide combination of handover systems was utilised by respondents. 28% - 32% relied exclusively on EPRs (with or without face-to-face contact). 21% used Office documents such as Word and Excel for peer-to-peer handover, and over 30% used hand-written or manual systems. Conclusions: This study suggests the need to do more — and go further — to improve communication and reduce risk during all types of handovers. Clinical leaders should find ways to train and support handover with effective systems, with less experienced staff being the primary focus. More research is needed to demonstrate the interventions that improve the safety of handover.

Preprint ARTICLE | doi:10.20944/preprints202003.0361.v1

Strategy for Disease Diagnosis, Progression Prediction, Risk Group Stratification and Treatment – Case of COVID-19

Mauno Vihinen

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: COVID-19; SARS-CoV-2; pathogenicity model; diagnosis; progression prediction; poikilosis

Online: 24 March 2020 (14:43:24 CET)

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Preprint ARTICLE | doi:10.20944/preprints202108.0343.v1

Direct Use of Clinical Tolerance Limits for Assessing Agreement: A Robust Nonparametric Approach

Abhaya Indrayan

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: Agreement analysis; Bland-Altman method; Clinical tolerance limits; Limits of agreement; Nonparametric approach; Robust method

Online: 16 August 2021 (13:53:22 CEST)

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Preprint ARTICLE | doi:10.20944/preprints201801.0100.v1

Pressure Distribution during Negative Pressure Wound Therapy of Experimental Abdominal Compartment Syndrome in a Porcine Model

Adrienn Csiszkó, Klaudia Balog, Zoltán Attila Godó, Gyula Juhász, Katalin Pető, Ádám Deák, Mariann Berhés, Norbert Németh, Zsolt Bodnár, Zsolt Szentkereszty

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: intra-abdominal pressure; abdominal compartment syndrome; pressure sensor; negative pressure wound therapy; open abdomen;

Online: 11 January 2018 (09:17:10 CET)

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Preprint CASE REPORT | doi:10.20944/preprints202012.0597.v1

Peri-Implantitis - Decontaminating and Regenerative Treatment Protocol

Fernando Duarte, Leonel De Oliveira

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: Peri-implantitis; Implacure® Protocol; Platelet-rich Fibrin

Online: 23 December 2020 (16:12:26 CET)

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Preprint ARTICLE | doi:10.20944/preprints201906.0183.v1

Risk and Prognostic Factors in Very Old Patients with Sepsis Secondary to Community-Acquired pneumonia

Catia Cilloniz, Cristina Dominedò, Antonella Ielpo, Miquel Ferrer, Albert Gabarrus, Denise Battaglini, Jesus Bermejo-Martin, Andrea Meli, Carolina Garcia-Vidal, Adamanthia Liapikou, Mervyn Singer, Antoni Torres

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: sepsis; community-acquired pneumonia; very old, pneumonia

Online: 19 June 2019 (10:00:15 CEST)

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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 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/preprints202211.0273.v1

Pantothenate and L-carnitine Supplementation Corrects Pathological Alterations in Cellular Models of KAT6A Syndrome

Manuel Munuera-Cabeza, Mónica Álvarez-Córdoba, Juan M. Suárez-Rivero, Suleva Povea-Cabello, Irene Villalón-García, Marta Talaverón-Rey, Alejandra Suárez-Carrillo, Diana Reche-López, Paula Cilleros-Holgado, Rocío Piñero-Pérez, José A. Sánchez-Alcázar

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: intellectual disability; KAT6A syndrome; Lysine acetyltransferase 6 A; pantothenate; L-carnitine; histone acetylation

Online: 15 November 2022 (04:14:12 CET)

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Preprint ARTICLE | doi:10.20944/preprints201810.0220.v1

Constitutional Mosaicism in RASA1-Related Capillary Malformation-Arteriovenous Malformation (CM-AVM)

Gema Gordo, Lara Rodriguez-Laguna, Noelia Agra, Pilar Mendez, Marta Feito, Pablo Lapunzina, Juan C. Lopez-Gutierrez, Victor Martinez-Glez

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: RASA1; CM-AVM; capillary malformation-arteriovenous malformation; constitutional mosaicism

Online: 10 October 2018 (12:31:54 CEST)

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Preprint REVIEW | doi:10.20944/preprints202307.0352.v1

Immune Resilience to SARS-CoV-2 Infection by Shifting Risk Within Normal and Disease Populations

Robert Llewellyn Clancy

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: Mucosa; Immunity; Vaccines; Common Mucosal System; Immunobiotics

Online: 5 July 2023 (16:00:08 CEST)

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Preprint CASE REPORT | doi:10.20944/preprints202009.0009.v1

Efficacy of Double Dose Dapsone Combination Therapy in the Treatment of Chronic Lyme Disease/Post-Treatment Lyme Disease Syndrome (PTLDS) and Associated Co-infections: A Report of Three Cases

Richard Horowitz, Phyllis R. Freeman

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: Lyme disease; Post-Treatment Lyme Disease Syndrome (PTLDS); dapsone combination therapy (DDS CT); double dose dapsone combination therapy (DDD CT); babesiosis; persistent infection

Online: 1 September 2020 (11:30:52 CEST)

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Working Paper ARTICLE

Improving the Quality Conduct and Efficiency of Clinical Trials with Training: Recommendations for Qualification of Investigators and Delegates

Jimmy Bechtel, TIna Chuck, Annemarie Forrest, Christine Hildebrand, Janette Panhuis, Suzanne R. Pattee, Sabrina Comic-Savic, Teresa Swezey

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: clinical trials; investigator qualification; good clinical practice; investigator training

Online: 8 October 2019 (05:18:34 CEST)

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Preprint ARTICLE | doi:10.20944/preprints201805.0174.v1

Mismatch between Student and Tutor Evaluation of Training Needs: An Exploratory Study of Traumatology Rotations

Fernando Santonja-Medina, María Paz García-Sanz, Sara Santonja-Renedo, Joaquín García-Estañ

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: e-portfolio; clinical skills; competences; medicine

Online: 11 May 2018 (04:45:11 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202205.0202.v1

Safety of Handover: A Global Online Survey of Clinical Practitioners and Leaders Regarding Patient Safety during Transitions of Care

D.J. Hamblin-Brown, Julia Craggs, David Wright, Johann Grundlingh, Judi Ingram

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: Clinical handover; Patient Handoff; Patient transfer; Referral and Consultation; Medical Records Systems, Computerized; Patient Safety; Risk Management; Attitude; Institutional Practice

Online: 16 May 2022 (09:30:01 CEST)

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Background: Handover is a critical process for ensuring quality and safety in healthcare. Considerable research suggests that poor handover results in significant morbidity, mortality, dissatisfaction, and excess financial costs. Despite this, little formal attention, education, and evaluation has been given to handover. There is also paucity of data on the opinions of practitioners on the safety of handover.Objectives: The aim of this study was to measure the perceived risk, degree of patient harm and the systems used to support handover, and to understand how this varied by care setting, type of clinical practice, location, or level of experience. Methods: An open, anonymous and confidential online questionnaire covering: (a) respondent characteristics; (b) peer-to-peer handover; (c) internal referrals; (d) discharges and transfers between organisations; and (e) leading and improving handover was conducted with healthcare practitioners and managers from various settings. Results: We gathered a total of 432 completed responses from 26 countries. The average reported performance of handover was rated as 3.9 out of 5.For each type of handover, 12 - 14% reported errors occurring more than weekly. Of those that knew the outcome of such errors, between 29% and 34% reported that they had witnessed moderate or severe harm. 12% and 17% of respondents believed that handover was high or very high risk (See table 4). These respondents were more likely to have witnessed moderate or severe harm, or to be more senior.A wide combination of handover systems was utilised by respondents. 28% - 32% relied exclusively on EPRs (with or without face-to-face contact). 21% used Office documents such as Word and Excel for peer-to-peer handover, and over 30% used hand-written or manual systems. Conclusions: This study suggests the need to do more — and go further — to improve communication and reduce risk during all types of handovers. Clinical leaders should find ways to train and support handover with effective systems, with less experienced staff being the primary focus. More research is needed to demonstrate the interventions that improve the safety of handover.

Working Paper REVIEW

Creatine as a Candidate to Prevent Statin Myopathy

Maurizio Balestrino, Enrico Adriano

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: creatine; statin; myopathy; muscle; myalgia; prevention; treatment; pathogenesis; pathophysiology; mitochondria

Online: 11 September 2019 (04:43:37 CEST)

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Preprint ARTICLE | doi:10.20944/preprints201906.0048.v1

Clinical Risk Factors that Predict Functional Recovery in Ischemic Stroke Patients with Pre-Stroke Depression

Leah Wormack, Brice Blum, Benjamin Bailes, Thomas Nathaniel

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: Ambulation, Ischemic stroke, pre-stroke depression, recombinant tissue plasminogen activator (rtPA)

Online: 6 June 2019 (10:37:13 CEST)

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Preprint ARTICLE | doi:10.20944/preprints201808.0056.v1

Evaluation of Novel Classification of Heat-Related Illnesses: A Multicentre Observational Study (Heat Stroke Study 2012)

Takahiro Yamamoto, Motoki Fujita, Yasutaka Oda, Masaki Todani, Toru Hifumi, Yutaka Kondo, Junya Shimazaki, Shinichiro Shiraishi, Kei Hayashida, Shoji Yokobori, Shuhei Takauji, Masahiro Wakasugi, Shunsuke Nakamura, Jun Kanda, Masaharu Yagi, Takashi Moriya, Takashi Kawahara, Michihiko Tonouchi, Hiroyuki Yokota, Yasufumi Miyake, Keiki Shimizu, Ryosuke Tsuruta

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: heat-related illness; international classification; heat cramp; syncope; heat exhaustion; heat stroke; novel classification

Online: 3 August 2018 (03:51:27 CEST)

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Preprint ARTICLE | doi:10.20944/preprints201807.0540.v1

Statins Improve the Long-term Survival in the Survived Sepsis Patients, a Nationwide Cohort Study in Taiwan

Ming-Shun Hsieh, Shu-Hui Liao, Vivian Chia-Rong Hsieh, Chorng-Kuang How, Jen-Huai Chiang, Sung-Yuan Hu, Yi-Tzu Lee, Chen-June Seak, Pau-Chung Chen

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: 3-hydroxy-3-methylglutaryl-coenzyme-A inhibitors; Sepsis

Online: 27 July 2018 (13:07:17 CEST)

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Background: Most sepsis patients died during their first episode and the long-term survival post discharge was low. Major adverse cardiovascular events and repeated infections were regarded as the major causes in such conditions. No definite medications were proven to effectively improve the long-term outcome. We aimed to examine the benefit of statins on the long-term outcome of survived sepsis patients. Methods: Between 1999 and 2013, a total of 220,082 patients with the first episode of sepsis hospitalization were included and 134,448 ones (61.09%) survived to discharge. The survived patients who subsequently had statins use of >30 cumulative defined daily doses (cDDDs) post discharge were defined as the statin users. After propensity score matching of 1:5, a total of 7,356 and 36,780 survived patients were retrieved as the study (statin-users) and comparison cohort (non-statin users), respectively. The main outcome was the long term survival post discharge. HR with 95% CI was calculated using the Cox regression model to evaluate the effectiveness of statins with further stratification analyses according to cDDDs. Results: The study cohort, that is, the statin users had an adjusted HR of 0.29 (95% CI, 0.27-0.31) in long term mortality rate compared with the comparison cohort. For statin users with the cDDDs of 30–180, 180–365, and >365, the adjusted HRs were 0.32, 0.22, and 0.16, respectively, (95% CI, 0.30-0.34, 0.19-0.26, and 0.12-0.23, respectively) compared with the non-statin users (defined as statins use <30 cDDDs post discharge), and the P for trend <.0001. In the sensitivity analysis, after excluding the survived patients who died within three and six months post discharge, the adjusted HR of statins use remained significant (0.35, 95% CI 0.32-0.37 and 0.42, 95% CI 0.39-0.45, respectively). Conclusions: Statins decreased the long-term mortality post sepsis. Further randomized control trial deserved to be conducted to confirm this observation.

Preprint REVIEW | doi:10.20944/preprints202010.0234.v1

The Failed Clinical Story of Myostatin Inhibitors Against Duchenne Muscular Dystrophy: Exploring the Biology Behind the Battle

Emma Rybalka, Cara Timpani, Danielle Debruin, Ryan Bagaric, Dean Campelj, Alan Hayes

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: myostatin inhibition; Duchenne Muscular Dystrophy; skeletal muscle; muscle development; clinical trials; translation

Online: 12 October 2020 (12:07:43 CEST)

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Preprint ARTICLE | doi:10.20944/preprints201806.0216.v1

SpainUDP: The Spanish Undiagnosed Rare Diseases Program

Estrella López Martín, Beatriz Martínez-Delgado, Eva Bermejo-Sánchez, Alonso Javier, Manuel Posada

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: Diagnosis delay; rare diseases; undiagnosed programs; standardized phenotype; phenotype ontologies; whole exome analysis; international data sharing

Online: 13 June 2018 (15:41:21 CEST)

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Preprint ARTICLE | doi:10.20944/preprints201811.0170.v1

Competing-Risk Analysis of Death and ESKD by Hyperkalemia Status in Non-Dialysis CKD Patients Receiving Stable Nephrology Care

Michele Provenzano, Roberto Minutolo, Paolo Chiodini, Vincenzo Bellizzi, Felice Nappi, Domenico Russo, Silvio Borrelli, Carlo Garofalo, Carmela Iodice, Toni De Stefano, Giuseppe Conte, Hiddo Heerspink, Luca De Nicola

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: CKD, ESKD, Death, anti-RAS, hyperkalemia, competing risk

Online: 7 November 2018 (14:48:30 CET)

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Preprint REVIEW | doi:10.20944/preprints202002.0427.v1

A Comprehensive Understanding of UA-ADRCs (Uncultured, Autologous, Fresh, Unmodified, Adipose Derived Regenerative Cells, Isolated at Point of Care) in Regenerative Medicine

Eckhard Alt, Glenn Winnier, Alexander Haenel, Ralf Rothoerl, Oender Solakoglu, Christopher Alt, Christoph Schmitz

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: adipose derived regenerative cells; ADRCs, efficacy; point of care treatment; randomized controlled trials; safety; stem cells; stromal vascular fraction

Online: 28 February 2020 (12:12:23 CET)

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Preprint HYPOTHESIS | doi:10.20944/preprints202009.0346.v1

The Status of An Inversely Coupled Oxic/Sulphidic Oscillator (OSO) in the Whole Body Chemocline Will Determine Clinical Unfolding in Systemic Inflammatory Response Syndrome (SIRS)* of Any Aetiology

Paul Thangaraj

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: Sepsis; SIRS; oxic sulphidic oscillator; risk prediction; multiorgan failure; chemocline

Online: 16 September 2020 (04:07:17 CEST)

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Preprint REVIEW | doi:10.20944/preprints201910.0135.v1

An Overview of Systematic Reviews and Meta Analyses on Acupuncture for Post-Acute Stroke Dysphagia

Zi-Yu Tian, Xing Liao, Ying Gao, Shi-Bing Liang, Chong-Yang Zhang, De-Hao Xu, Jian-Ping Liu, Nicola Robinson

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: acupuncture; dysphagia; post-acute stroke; overview; systematic reviews; meta-analyses; rehabilitation

Online: 12 October 2019 (03:31:46 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202108.0527.v1

Finite Mixture Models Based on Pain Intensity, Functional Disability and Psychological Distress Composite Assessment Allow to Identify Two Distinct Classes of Persistent Spinal Pain Syndrome after Surgery Patients Related to Their Quality of Life

Amine Ounajim, Maxime Billot, Pierre-Yves Louis, Yousri Slaoui, Denis Frasca, Lisa Goudman, Manuel Roulaud, Nicolas Naiditch, Bertille Lorgeoux, Sandrine Baron, Kevin Nivole, Mathilde Many, Nihel Adjali, Philippe Page, Bénédicte Bouche, Elodie Charrier, Laure Poupin, Delphine Rannou, Géraldine Brumauld de Montgazon, Brigitte Roy-Moreau, Chantal H. Wood, Raphael Rigoard, Romain David, Maarten Moens, Philippe Rigoard

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: PSPS; FBSS; chronic pain; health-related quality of life; mixture models analysis; personalized pain management; chronic pain after spinal surgery

Online: 27 August 2021 (15:23:27 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202109.0031.v1

The Added Value of Subcutaneous Peripheral Nerve Field Stimulation Combined with SCS, as Salvage Therapy, for Refractory Low Back Pain Component in Persistent Spinal Pain Syndrome Implanted Patients: A Randomized Controlled Study (CUMPNS Study) Based on 3D-Mapping Composite Pain Assessment

Philippe Rigoard, Amine Ounajim, Lisa Goudman, Benedicte Bouche, Manuel Roulaud, Philippe Page, Bertille Lorgeoux, Sandrine Baron, Kevin Nivole, Mathilde Many, Nihel Adjali, Elodie Charrier, Delphine Rannou, Laure Poupin, Chantal Wood, Romain David, Dylan Héraud, Maarten Moens, Maxime Billot

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: spinal cord stimulation (SCS); peripheral nerve field stimulation (PNfS); SubQ-stimulation; hybrid stimulation; multidimensional pain assessment; pain mapping; pain software; persistent spinal pain syndrome - T2 (PSPS-T2); failed back surgery syndrome; failed spinal cord stimulation syndrome (FSCSS); salvage therapy; salvage algorithm

Online: 1 September 2021 (18:16:10 CEST)

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Preprint HYPOTHESIS | doi:10.20944/preprints202304.0796.v1

Thiamine and High Dose Insulin Treatment for Sepsis

Patrick bradley

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: Sepsis Treatment; Mitochondria; Adenosine Triphosphate (ATP); Pyruvate dehydrogenase complex and thiamine; Glycolysis; Glucose and insulin.

Online: 23 April 2023 (08:39:15 CEST)

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Sepsis is a major health problem and accounts for 20 per cent of deaths worldwide. It is the most expensive condition treated in United States hospitals at $27 billion per year or about $20,000 per patient. Treatment consisting largely of fluid resuscitation and antibiotics has only marginal impact. Mortality is about 27 per cent for hospitalized patients and about 42 per cent for patients in intensive care.There are two phases of sepsis – a hyper inflammatory phase and a subsequent hypo inflammatory phase.During the hyper inflammatory phase the metabolic rate increases associated with an increase in body temperature and a rapid escalation of immune system functioning including increased numbers of leucocytes and migration of those leucocytes to infected and damaged tissues and an increased supply and consumption of glucose to fuel this immune system.During the subsequent hypo inflammatory phase the metabolic rate declines and this is associated with a decrease in body temperature and a generalized decrease in the physiological activity of many organs including the immune system akin to hibernation. The activated immune system has priority for the available glucose over most other organs and physiological functions during such potentially life threatening circumstances. Thus adenosine triphosphate (ATP) production by mitochondria (the source of energy at the cellular level for the organism as a whole) also has a lower priority for the available glucose relative to the activated immune system. If glucose availability is threatened then mitochondrial production of ATP is partially or substantially suppressed in favor of glycolysis because glycolysis can rapidly produce large quantities of ATP that are necessary for immune cell function in infected, anaerobic, ischemic, or damaged tissues.However, glycolysis is only a temporary fix as it cannot produce the quantities of ATP necessary on an ongoing basis for the normal functioning of the healthy animal. Mitochondrial production of ATP must be recommenced for full recovery.It appears that the partial or substantial suppression of mitochondrial production of ATP by activation of the immune response becomes relatively fixated in some patients leading to a substantial ATP deficit. This is the fundamental issue of sepsis.This paper reviews the metabolism of glucose and insulin during sepsis and concludes that high dose insulin with mild hyper glycaemia in conjunction with the intravenous administration of thiamine, an inhibitor of the pyruvate dehydrogenase kinase enzymes, to re-establish physiological ATP production by mitochondria, administered early in the hypo metabolic (hypo inflammatory) phase of sepsis should significantly improve survival.

Preprint REVIEW | doi:10.20944/preprints202305.1487.v1

Laboratory Findings and Biomarkers in Long COVID: What Do We Know So Far? Insights Into Epidemiology, Pathogenesis, Therapeutic Perspectives and Challenges

Dimitrios Tsilingiris, Natalia G. Vallianou, Irene Karampela, Gerasimos Socrates Christodoulatos, Georgios Papavasileiou, Dimitra Petropoulou, Faidon Magkos, Maria Dalamaga

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: biomarkers; COVID-19; epidemiology; laboratory; long COVID; pathogenesis; post-acute sequelae of SARS-CoV-19 infection (PASC); post COVID; post-COVID syndrome (PCS)

Online: 22 May 2023 (09:41:11 CEST)

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Long COVID (LC) encompasses a constellation of long-term symptoms experienced by at least 10% of people after the initial SARS-CoV-2 infection, and so far has affected about 65 million people. The etiology of LC remains unclear; however, many pathophysiological pathways may be involved, including viral persistence; chronic, low grade inflammatory response; immune dysregulation and defective immune response; reactivation of latent viruses; autoimmunity; persistent endothelial dysfunction and coagulopathy; gut dysbiosis; hormonal dysregulation, mitochondrial dysfunction; and autonomic nervous system dysfunction. There are no specific tests for the diagnosis of LC, and clinical features including laboratory findings and biomarkers may not specifically relate to LC. Therefore, it is of paramount importance to develop and validate biomarkers that can be employed for the prediction, diagnosis and prognosis of LC and its therapeutic response. Promising candidate biomarkers that are found in some patients are markers of systemic inflammation including acute phase proteins, cytokines and chemokines; biomarkers reflecting SARS-CoV-2 persistence, reactivation of herpesviruses and immune dysregulation; biomarkers of endotheliopathy, coagulation and fibrinolysis; microbiota alterations; diverse proteins and metabolites; hormonal and metabolic biomarkers; as well as cerebrospinal fluid biomarkers. At present, there are only two reviews summarizing relevant biomarkers; however, they do not cover the entire umbrella of current biomarkers or their link to etiopathogenetic mechanisms, and the diagnostic work-up in a comprehensive manner. Herein, we aim to appraise and synopsize the available evidence on the typical laboratory manifestations and candidate biomarkers of LC, their classification based on main LC symptomatology in the frame of the epidemiological and pathogenetic aspects of the syndrome, and furthermore assess limitations and challenges as well as potential implications in candidate therapeutic interventions.

Preprint ARTICLE | doi:10.20944/preprints202107.0042.v1

Decoding Oxidative Stress and Antioxidative Parameters in Patients with Spinal Cord Injury

Ghizal Fatima, Jan Fedacko, Ammar Mehdi Raza, Najah R. Hadi

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: Spinal Cord Injury; Oxidative stress; Antioxidants, Pain

Online: 2 July 2021 (09:05:08 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202201.0378.v1

The Use of Clinical Prediction Rules without Echocardiographic Evaluation in Staphylococcus aureus bacteraemia may not be Enough to Exclude Infective Endocarditis and be Associated with Increased Mortality

Jorge Calderón-Parra, Itziar Diego-Yagüe, Beatriz Santamarina-Alcantud, Alberto Mora-Vargas, Jose Manuel Vazquez-Comendador, Ana Fernandez-Cruz, Elena Muñez-Rubio, Andrea Gutierrez-Villanueva, Isabel Sanchez-Romero, Antonio Ramos-Martínez

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: staphylococcus aureus; infective endocarditis; clinical prediction rules; echocardiography

Online: 25 January 2022 (10:41:47 CET)

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Preprint ARTICLE | doi:10.20944/preprints202108.0398.v1

Direct Oral Anticoagulants in Patients with Nonvalvular Atrial Fibrillation: A Real-World Experience from a Single Spanish Regional Hospital

Enrique Rodilla, Maria Isabel Orts-Martinez, Miguel Angel Sanz-Caballer, María Teresa Gimeno-Brosel, Maria Jesús Arilla-Morel, Isabel Navarro-Gonzalo, Inmaculada Castillo-Valero, Inmaculada Salvador-Mercader, Ana Carral-Tatay

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: Direct oral anticoagulants (DOACs); Nonvalvular atrial fibrillation (NVAF); Real-world experience

Online: 19 August 2021 (10:32:56 CEST)

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The aim is to evaluate a program for direct oral anticoagulants (DOACs) management in nonvalvular atrial fibrillation (NVAF) patients, according to patient profiles, appropriateness of dosing, patterns of crossover, effectiveness and safety. This is an observational and longitudinal retrospective study in a cohort of patients attended in daily clinical practice in a single regional hospital in Spain with a systematic follow-up plan for up to 3 years for patients initiating dabigatran, rivaroxaban or apixaban between JAN/2012-DEC/2016. We analyzed 490 episodes of treatment (apixaban 2.5 mg: 9.4%, apixaban 5 mg: 21.4%, dabigatran 75 mg: 0.6%, dabigatran 110 mg: 12,4%, dabigatran 150 mg: 19.8%, rivaroxaban 15 mg: 17.8% and rivaroxaban 20 mg: 18.6%) in 445 patients. 13.6% of patients on dabigatran, 9.7% on rivaroxaban, and 3.9% on apixaban, switched to other DOACs or changed dosing. Apixaban was the most frequent DOAC switched to. The most frequent reasons for switching were toxicity (23.8%), bleeding (21.4%) and renal deterioration (16.7%). Inappropriateness of dose was found in 23.8% of episodes. Patients taking apixaban 2.5 mg were older, had higher CHA2DS2VASc score and lower creatinine clearance. Patients taking dabigatran 150 mg and rivaroxaban 20 mg were younger, had lower CHA2DS2VASc and higher creatinine clearance. Rates of stroke/transient ischemic attack (TIA) were 1.64/0.54 events/100 patients-years, while rates of major, clinically relevant non-major (CRNM) bleeding and intracranial bleeding where 2.4, 5, and 0.5 events/100 patients-years. Gastrointestinal and genitourinary bleeding were the most common type of bleeding events (BE). On multivariable analysis, prior stroke (RR: 4.2; CI: 1.5-11.8; p=0.006) and age (RR: 1.2; CI: 1.1-1.4; p=0.006) were independent predictors of stroke/TIA. Concurrent platelet inhibitors (RR: 7.1; CI: 2.3-21.8; p=0.001), male gender (RR: 2.1; CI: 1.2-3.7; p=0.0012) and age (RR: 1.1; CI: 1.02-1.13; p=0.005) were independent predictors of BE. This study complements the scant data available on the use of DOACs in NVAF patients in Spain, confirming a good safety and effectiveness profile

Preprint REVIEW | doi:10.20944/preprints202001.0277.v2

Statins, Bone Biology and Revision Arthroplasty: Review of Clinical and Experimental Evidence

Antony K. Sorial, Sami A. Anjum, Michael J. Cook, Tim N. Board, Terence W. O'Neill

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: statin; arthroplasty; revision; failure; osseointegration; osteolysis; loosening

Online: 20 August 2020 (09:32:07 CEST)

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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 REVIEW | doi:10.20944/preprints201908.0148.v1

Creatine for Prevention of Statin Myopathy

Maurizio Balestrino, Enrico Adriano

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: creatine; statin; myopathy; muscle; myalgia; prevention; treatment; pathogenesis; pathophysiology; mitochondria

Online: 13 August 2019 (04:25:33 CEST)

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Preprint REVIEW | doi:10.20944/preprints201911.0013.v1

Optimizing Nutrition Assessment to Create Better Outcomes in Lung Transplant Recipients: A Review of Current Practices

Mara Weber Gulling, Monica Schaefer, Laura Bishop-Simo, Brian C. Keller

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: lung transplantation; body mass index; nutrition; body composition; lean body mass; muscle mass; leptin; sarcopenia; creatinine-height index

Online: 1 November 2019 (13:02:51 CET)

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Preprint ARTICLE | doi:10.20944/preprints202108.0395.v1

Comparison of Clinical Features and Prognosis in Patients With Cryptogenic and Secondary Organizing Pneumonia

Keum-Ju Choi, Eun-Hyung Yoo, Kyung Chan Kim, Eun Jin Kim

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: Organizing pneumonia; Cryptogenic organizing pneumonia; Secondary organizing pneumonia

Online: 19 August 2021 (10:22:38 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202203.0219.v1

Linear Support Vector Machines and Head Pitch Angular Velocity Are the Best Performers to Distinguish (Sub-)Acute Neck Pain Patients and Controls Assessed with the DidRen Laser Test

Renaud Hage, Fabien Buisseret, Martin Houry, Frédéric Dierick

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: Artificial intelligence; Supervised Machine Learning; Kinematics; Head rotation test; Neck pain

Online: 15 March 2022 (14:30:51 CET)

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Preprint ARTICLE | doi:10.20944/preprints202306.0339.v1

The Language of Pain in the Hypermobile Ehlers-Danlos Syndrome: Metaphors as a Key to Understand the Experience of Pain and a Rehabilitation Tool

Filippo Camerota, Rachele Mariani, Giulia Cordiano, Michela Di Trani, Valentina Lodato, Alessandro Ferraris, Massimo Pasquini, Claudia Celletti

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: Chronic Pain; Hypermobile Ehlers–Danlos syndrome; Linguistic content analysis; Metaphors; Pain; Symbolizing process

Online: 5 June 2023 (14:36:19 CEST)

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Preprint REVIEW | doi:10.20944/preprints202002.0451.v1

Identifying Tools That Assess Factors That May Lead to Adverse Effects in Australian Aged-Care Facilities: A Scoping Review

Haider Saddam Qasim, Maree Simpson, Yann Guisard, Barbora de Courten

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: systematic review; ADR assessment; elderly; aged-care facilities; medications monitoring; nursing home; drug review

Online: 29 February 2020 (03:41:22 CET)

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Preprint ARTICLE | doi:10.20944/preprints202009.0532.v1

Human Tendon Repair Following Injection of Autologous, Unmodified Stem Cells: A Comprehensive Immunohistochemical Evaluation

Eckhard Alt, Ralf Rothoerl, Matthias Hoppert, Hans-Georg Frank, Christopher Alt, Christoph Schmitz

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: adipose derived regenerative cells; ADRCs; efficacy; point of care treatment; stem cells; stromal vascular fraction; tendon healing without scar formation; tendon regeneration

Online: 23 September 2020 (03:49:36 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202209.0289.v1

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome and Post-COVID Syndrome: A Common Neuroimmune Ground?

Varvara A. Ryabkova, Natalia Y Gavrilova, Tamara V Fedotkina, Leonid P Churilov, Yehuda Shoenfeld

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: chronic fatigue syndrome; post-COVID syndrome; postural orthostatic tachycardia; microcirculation; immune system

Online: 20 September 2022 (03:37:00 CEST)

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A Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a debilitating chronic disease of unknown aetiology under growing interest now in view of the increasingly recognized post-COVID syndrome as a new entity with similar clinical presentation. We performed the first cross-sectional study of ME/CFS in community population in Russia and then described and compared some clinical and pathophysiological characteristics of ME/CFS and post-COVID syndrome as neuroimmune disorders. Of the cohort of 76 individuals who suggested themselves suffering from ME/CFS 56 subsequently were confirmed as having CFS/ME according to ≥1 of the 4 most commonly used case definition. Of the cohort of 14 individuals with post-COVID-19 syndrome 14 met diagnostic criteria for ME/CFS. The prevalence of clinically expressed and subclinical anxiety and depression in ME / CFS and post-COVID ME/CFS did not differ significantly from that in healthy individuals. Severity of anxiety / depressive symptoms did not correlate with the severity of fatigue neigther in ME / CFS nor in post-COVID ME/CFS, but the positive correlation was found between the severity of fatigue and 20 other symptoms of ME / CFS related to the domains of “post-exertional exhaustion”, “immune dysfunction”, “sleep disturbances”, "dysfunction of the autonomic nervous system", "neurological sensory / motor disorders" and "pain syndromes". Immunological abnormalities were identified in 12/12 patients with ME / CFS according to the results of laboratory testing. The prevalence of postural orthostatic tachycardia assessed by the active standing test was 37.5% in ME / CFS and 75.0% in post-COVID ME/CFS (the latter was higher than in healthy controls, p = 0.02) There was a more pronounced increase in heart rate starting from the 6th minute of the test in post-COVID ME/CFS compared with the control group. Assessment of the functional characteristics of microcirculation by laser doppler flowmetry revealed obvious and very similar changes in ME/CFS and post-COVID ME/CFS compared to the healthy controls. The identified pattern corresponded to the hyperemic form of microcirculation disorders, usually observed in acute inflammatory processes or in deficiency of systemic vasoconstriction influences.

Preprint ARTICLE | doi:10.20944/preprints202007.0327.v1

Analysis of Metabolites Changes on Obstructive Sleep Apnea Patients After Multilevel Sleep Surgery

Abdulmohsen Alterki, Shibu Joseph, Thangavel Alphonse Thanaraj, Irina Al-Khairi, Preethi Cherian, Arshad Channanath, Devarajan Sriraman, Mahmoud Ebrahim, Alaaeldin Ibrahim, Ali Tiss, Fahd Al-Mulla, Jehad Abubaker, Mohamed Abu-Farha

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: Obstructive sleep apnea; Metabolomics; Triglycerides; Phosphocholines; Ceramides; Apnea Hypopnea Index; Polysomnography; Lipid metabolism; Multilevel Sleep Surgery

Online: 15 July 2020 (09:19:05 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202203.0078.v1

High Aspartate Aminotransferase/Alanine Aminotransferase Ratio is the Conventional Biochemical Biomarker that is Most Closely Associated with All-Cause Mortality in Older People

Kei Nakajima, Mariko Yuno, Kazumi Tanaka, Teiji Nakamura

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: alanine aminotransferase; aspartate aminotransferase; AST/ALT ratio; mortality; artificial intelligence; older people

Online: 4 March 2022 (11:17:44 CET)

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Preprint ARTICLE | doi:10.20944/preprints201810.0392.v1

Diagnostic Performance of Initial Serum Albumin Level for Predicting in-Hospital Mortality Among Necrotizing Fasciitis Patients

Chia-Peng Chang, Wen-Chih Fann, Shu-Ruei Wu, Chun-Nan Lin, I-Chuan Chen, Cheng-Ting Hsiao

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: albumin; mortality; necrotizing fasciitis

Online: 17 October 2018 (17:18:59 CEST)

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Background: Hypoalbuminemia is known to be associated with adverse outcome in critical illness. In this study, we attempted to identify if hypoalbuminemia on emergency department (ED) arrival a reliable predictor for in-hospital mortality in necrotizing fasciitis (NF). patients. Method: A retrospective cohort study of hospitalized patients with NF was conducted in a tertiary teaching hospital in Taiwan between March 2010 and March 2018. Blood samples were collected in the ED upon arrival, and serum albumin levels were determined. we evaluated the predictive value of serum albumin level at ED presentation for in-hospital mortality. All collected data were statistically analyzed. Result: Of the 707 NF patients, 40 (5.66%) died in the hospital. The mean serum albumin level was 3.1 ± 0.9 g/dL and serum albumin levels were significantly lower in the non-survivor group than in the survivor group (2.8± 0.7 g/dL vs. 3.5 ± 0.8 g/dL). In the multivariable logistic regression model, albumin was associated with in-hospital mortality significantly (odds ratio[OR] 0.92, 95% confidential interval (CI) 0.88–0.96, P <0.001). The area under-the-receiver-operating-characteristic curve (AUC) for in-hospital survival was 0.77 (95% CI 0.72–0.82) and corresponding sensitivity, specificity, positive predictive value, negative predictive value, positive and negative likelihood ratio were 66%, 74%, 33%, 88%, 2.25 and 0.48, respectively. High sensitivity (96%) was shown at albumin level of 4.0 g/dL and high specificity (91%) was shown at level of 2.5 g/dL. Conclusion: Initial serum albumin levels were independently associated with in-hospital mortality among adult patients with necrotizing fasciitis and demonstrated fair discriminative performance in the prediction of in-hospital mortality. NF patients with hypoalbuminemia on ED arrival should be closely monitored for signs of deterioration and consider early and aggressive intervention to prevent mortality.

Working Paper REVIEW

Transanal Repair of Rectocele and Rectal Mucosectomy with a Single Circular Stapler (TRREMS) - Why is it Worth Rehearse?

Inese Fišere, Andris Gardovskis, Māris Pavārs, Jānis Gardovskis

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: constipation; obstructed defecation syndrome; rectocele; defecography; rectal mucosal prolapse; transanal repair; TRREMS

Online: 10 July 2019 (08:12:26 CEST)

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Preprint ARTICLE | doi:10.20944/preprints201809.0357.v1

Exploring the Aortic Root Diameter and left Ventricle Size Among Lithuanian Athletes

Renata Žumbakytė-Šermukšnienė, Agnė Slapšinskaitė, Miglė Baranauskaitė, Julija Borkytė, Rasa Sederevičiūtė, Kristina Berškienė

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: Performance, Sports, Aortic Valve, Sinus of Valsalva, Echocardiography, Sudden cardiac death

Online: 18 September 2018 (14:40:43 CEST)

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Aortic rupture is known as one of the potential causes of sudden cardiac death in athletes. Nevertheless, adaptation strategies for aortic root dilation in athletes vary. The purpose of this study was to investigate aortic root adaptation to physical workload and to determine if aortic root’s and left ventricle sizes are contingent upon the physical workload. Echocardiography was applied to 151 subjects to measure the aortic root at aortic valve annulus (AA) and at sinus of Valsalva (VS). 122 were athletes (41 females and 81 males) and 29 were non-athletes (14 females and 15 males). Of the 41 female athletes, 32 were endurance athletes, and 9 strength athletes. From 81 male athletes, 56 were endurance athletes, and 25 were strength athletes. AA and VS mean values for the body surface area were presented as rAA and rVS. Left ventricle (LV) meaures incuded LV end-diastolic diameter (LVEDD), interventricular septum thickness in diastole (IVSTd), LV posterior wall thickness in diastole (LVPWTd), LV mass (LVM), LV mass index, LV end-diastolic diameter index (LVEDDI). Results indicated that VS was higher in female athletes (28.9±2.36mm) than in non-athletes (27.19±2.87mm, p=0.03). On the other hand, rAA was higher in strength athletes (12.19±1.48mm/m2) than in endurance athletes (11.12±0.99mm/m2, p=0.04). Additionally, rVS and rAA were higher in female strength athletes (17.19±1.78mm/m2, 12.19±1.48mm/m2) than female basketball players (15.49±1.08mm/m2, p=0.03, 10.75±1.06 mm/m2, p=0.02). Statistically significant positive moderate correlations were found between VS and LVEDD, LVM, IVSTd, LVPWTd, rVS and LVEDDI parameters in all athletes. The diameter of Valsalva sinus was greater in female athletes compared to non-athletes. The rAA mean value for body surface area was greater in female athletes practising strength sports as compared to their counterparts who were practising endurance sports. The diameter of the aortic root at sinuses positively correlated with the LV size in all athletes. Trial was registered at ClinicalTrials.gov Identifier: NCT03656861, September 3, 2018 (retrospectively registered).

Preprint ARTICLE | doi:10.20944/preprints201901.0162.v1

Ankylosing Spondylitis Is Associated with Risk of New Onset Obstructive Sleep Apnea: A Nationwide Population-Based Cohort Study

Chien-Han Tsao, Jing-Yang Huang, Hsin-Hsin Huang, Yao-Min Hung, James Cheng-Chung Wei

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: ankylosing spondylitis; obstructive sleep apnea; population-based cohort study

Online: 16 January 2019 (09:58:49 CET)

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Preprint ARTICLE | doi:10.20944/preprints202206.0101.v1

Clinical Research in Ayurveda - Can Statistics as A Scientific Discipline Help the Cause?

Vinay Mahajan, Vivek Sanker MK, Aswhini Mathur

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: Ayurveda research; good research; hypothesis generation; hypothesis testing; managing bias and sample size

Online: 7 June 2022 (09:45:11 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202110.0235.v1

The Challenge of Converting “Failed Spinal Cord Stimulation Syndrome” Back to Clinical Success, Using SCS Reprogramming as Salvage Therapy, Through Neurostimulation Adapters Combined with 3D-Computerized Pain Mapping Assessment. A Real-Life Retrospective Cohort Analysis

Philippe Rigoard, Amine Ounajim, Lisa Goudman, Tania Banor, France Héroux, Manuel Roulaud, Etienne Babin, Bénédicte Bouche, Philippe Page, Bertille Lorgeoux, Sandrine Baron, Nihel Adjali, Kevin Nivole, Mathilde Many, Elodie Charrier, Delphine Rannou, Laure Poupin, Chantal Wood, Romain David, Maarten Moens, Maxime Billot

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: Spinal Cord Stimulation; rescue therapy; salvage therapy; new waveforms; paresthesia-free waveforms; High-Frequency stimulation; Burst stimulation; spatial neural targeting; temporal neural targeting; SCS programming; adapter; mapping software; paresthesia coverage; patient outcome; salvage algorithm

Online: 18 October 2021 (10:04:52 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202207.0295.v1

Frequency of Spontaneous Hemothorax, Chylothorax, Pleural, and Pericardial Effusion in Patients Who Had Thorax Tomography during Prepandemic and Pandemic Period

Figen Tunalı Türkdoğan, Abuzer Coskun, Kenan Ahmet Türkdoğan

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: COVID-19; pleural effusion; hemothorax; chylothorax; pericardial effusion

Online: 20 July 2022 (05:57:21 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202203.0055.v1

Endoglin and Other Angiogenesis Markers on Recurrent Varicose Veins

Francisco S. Lozano Sánchez, José A. Carnicero Martínez, Lucía Méndez García, M. Begoña García Cenador, Miguel Pericacho Bustos

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: Varicose veins; Recurrent varicose veins; Angiogenesis; Endoglin

Online: 3 March 2022 (07:47:09 CET)

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Preprint REVIEW | doi:10.20944/preprints202011.0193.v1

Current Status of Cell-Based Therapy in Patients with Critical Limb Ischemia

Frantisek Jaluvka, Peter Ihnat, Juraj Madaric, Vaclav Prochazka

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: Cell therapy, Peripheral arterial disease, Bone marrow, Adipose tissue, Mesenchymal stem cells, Exosome, Critical limb ischemia.

Online: 4 November 2020 (12:37:47 CET)

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Preprint ARTICLE | doi:10.20944/preprints202205.0213.v1

The Big Picture

Beth Alderman

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: Toxicity; Diagnosis; Personal care; Patient encounter; Patient-based medicine

Online: 16 May 2022 (14:06:25 CEST)

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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 ARTICLE | doi:10.20944/preprints202110.0115.v1

A Novel Noninvasive Technique for Intracranial Pressure Waveform Monitoring in Critical Care

Sérgio Brasil, Davi Solla, Ricardo de Carvalho Nogueira, Manoel Jacobsen Teixeira, Luiz Marcelo Sá Malbouisson, Wellingson Paiva Silva

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: intracranial compliance; intracranial pressure; intracranial hypertension; acute brain injury

Online: 7 October 2021 (10:54:26 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202110.0294.v1

Increasing Incidence of Mucormycosis in Spanish inpatients from 1997-2018

Raúl Parra Fariñas, Montserrat Alonso Sardón, Virginia Velasco Tirado, Inmaculada Galindo Pérez, Cristina Carbonell, Elisa Álvarez Artero, Ángela Romero-Alegría, Javier Pardo-Lledías, Moncef Belhassen García

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: Mucormycosis; Zygomycosis; Epidemiology; Incidence; Clinical; Spain.

Online: 20 October 2021 (15:48:58 CEST)

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Working Paper ARTICLE

Time for a Change: Considering Regimen Changes in Analyses of Observational MDR/RR-TB Treatment Cohort Data

Molly Franke, Carole Mitnick

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: tuberculosis; epidemiology; drug-treatment; resistance; analysis

Online: 13 September 2020 (11:20:13 CEST)

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Preprint COMMUNICATION | doi:10.20944/preprints201912.0203.v1

Learning from Patient and Site Perspectives to Develop Better Mobile Clinical Trials: Recommendations from the Clinical Trials Transformation Initiative

Cindy Geoghegan, Virginia Nido, Angie Botto-Ven Bemden, Zachary Hallinan, Les Jordan, Lindsay Kehoe, Steve Morin, Amanda Niskar, Petros Okubagzi, William Wood

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: mobile technology; patient engagement; mobile clinical trials; virtual trials; digital trials; hybrid trials; site engagement; site support; mobile devices

Online: 16 December 2019 (02:44:52 CET)

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Preprint REVIEW | doi:10.20944/preprints202205.0294.v2

The Impact of General Anesthesia on Redox Stability and Epigenetic Inflammation Pathways. Crosstalk on Perioperative Antioxidant Therapy

Stelian Adrian Ritiu, Alexandru Florin Rogobete, Dorel Sandesc, Ovidiu Horea Bedreag, Marius Papurica, Sonia Elena Popovici, Daiana Toma, Robert Iulian Ivascu, Raluca Ramona Velovan, Dragos Nicolae Garofil, Dan Corneci, Melania Lavinia Bratu, Elena Mihaela Pahontu, Adriana Pistol

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: general anesthesia; redox; inflammation; antioxidants; hypermetabolism; microRNAs; biomarkers; oxidative stress; Vitamin C

Online: 6 June 2022 (05:09:14 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202205.0350.v3

When the Patient Is Making the (Wrong?) Diagnosis: A Biographical Approach to Patients Consulting for Presumed Lyme Disease

Lutaud Romain, Pierre Verger, Patrick Peretti-Watel, Carole Eldin

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: lyme disease; clinical decision-making; medical history taking; physician-patient relation; primary health care; qualitative research

Online: 31 May 2022 (09:14:56 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202009.0104.v1

Clinical Leadership and Management Perceptions of Inpatients with Obesity: An Interpretative Phenomenological Analysis

Danielle Hitch, Fiona Pazsa, Alison Qvist

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: attitudes; clinicians; hospital; in-patient; obesity; perceptions

Online: 4 September 2020 (12:27:25 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/preprints202301.0202.v1

Behavioural and Neurophysiological Assessment of Hearing Aid Benefits in an Adult Population with and without Hearing Loss

Shivali Appaiah-Konganda, Mridula Sharma, Ronny Ibrahim, Jessica J. M. Monaghan, John Newall, Joaquin Tomas Valderrama Valenzuela

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: Alpha synchronisation; Working memory; Auditory processing; Modulation detection threshold

Online: 12 January 2023 (01:48:00 CET)

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Background: Despite hearing aids adequately compensate for hearing loss, a substantial proportion of the population leave their hearing difficulties untreated. Even though this is a well-known clinical issue, the optimal approach to address this issue during the hearing rehabilitation process is still unclear. Purpose: The present study aims to characterise behavioural and neurophysiological auditory and cognitive processing skills in experienced hearing aid users versus those with normal hearing, aimed at providing clinicians with the evidence required to adequately manage the expectations of their clients, thus indirectly reinforcing hearing-aid adoption within the adult population with hearing loss. Research design: Behavioural tests included auditory, cognitive, and speech-in-noise tasks; and neurophysiological testing included cortical auditory evoked potentials evoked by a /da/ stimulus presented at 65 dB SPL. The tests were selected based on previous literature supporting specific speech-understanding skills. Study sample: Ten participants (7 female, 21—68 years) with bilateral, mild-moderate to moderately-severe sensorineural hearing loss (HL), and 10 with clinically normal hearing (NH, 8 female, 19—62 years) participated in the study. Data collection and analysis: Behavioural data was analysed using multivariate analysis of variance (MANOVA) and neurophysiological analysis used measurements such as independent t-test, time-frequency analysis and inter-trial phase coherence. Results: The NH and HL groups presented similar scores in all the behavioural tasks. Time-frequency analysis revealed a statistically significantly reduction in alpha (8–12 Hz) synchronisation at the centro-frontal electrodes in the HL group – a brain activity pattern that has been associated with listening effort, inhibition and selective attention. Conclusions and significance: Results support the conclusion that hearing aids are effective in compensating for the audibility of their users, enabling them to perform at similar levels than their normal-hearing peers. However, the reduced alpha synchronisation observed in the HL population indicates that adequate audibility does not extend to improved neural responses. Future studies need to investigate the induced activity in speech understanding paradigms to explore the auditory processing differences at cortical level. The results are only from a small sample size but the findings have the potential to support clinicians in managing adequately the expectations of their clients in regards the benefits of hearing aid technologies.

Preprint ARTICLE | doi:10.20944/preprints202007.0444.v1

Estimation of Stroke Outcomes Based on Time to Thrombolysis and Thrombectomy

Michael Allen, Kerry Pearn, Ken Stein, Martin James

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: stroke; thrombolysis; thrombectomy

Online: 19 July 2020 (20:57:58 CEST)

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Preprint REVIEW | doi:10.20944/preprints202208.0316.v1

Type of ANCA may be Superior to Clinical Phenotype in Distinguishing Different Clinical Entities in ANCA-associated Vasculitis

Afroditi Maria Konstantouli, Georgios Lioulios, Asimina Fylaktou, Maria Stangou

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: ANCA-associated vasculitis; Proteinase 3; Myeloperoxidase; Clinical Phenotype; Outcome

Online: 17 August 2022 (09:58:51 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202305.1738.v1

Fecal Microbiota and Associated Volatile Organic Compounds Distinguishing No Adenoma From High-Risk Colon Adenoma Adults

Kyriaki Katsaounou, Danae Yiannakou, Elpiniki Nikolaou, Cameron Brown, Paris Vogazianos, Aristos Aristodimou, Jianxiang Chi, Paul Costeas, Agapios Agapiou, Elisavet Frangou, George Tsiaoussis, George Potamitis, Athos Antoniades, Christos Shammas, Yiorgos Apidianakis

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: Dysbacteriosis; pathobionts; nutrients; metabolites

Online: 25 May 2023 (05:15:50 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202309.1037.v1

Evaluation of Standard M10 Assay for Rapid Molecular Diagnosis of SARS-CoV-2, Influenza A/B virus and Respiratory Syncytial Virus (RSV)

Azwani Abdullah, I-Ching Sam, Yin Jie Ong, Chun Hao Theo, Muhammad Harith Pukhari, Yoke Fun Chan

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: respiratory syncytial virus; influenza A virus; influenza B virus; SARS-CoV-2; rapid RT-PCR; diagnostic accuracy; point-of-care testing

Online: 15 September 2023 (05:38:13 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202211.0079.v1

Common Prognostic Biomarkers and Outcomes in Patients with COVID-19 Infection

Mashael Abujabal, Mohamed A Shalaby, Layla Abdullah, Amr S Albanna, Mohamed Elzoghby, Sidharth Kumar Sethi, Mohamad-Hani Temsah, Fadi Aljamaan, Khalid Alhasan, Jameela A. Kari

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: Biomarkers; COVID-19; Common Prognostic Biomarkers

Online: 3 November 2022 (12:08:08 CET)

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Preprint REVIEW | doi:10.20944/preprints202205.0294.v1

The Impact of General Anesthesia on Redox Stability and Epigenetic Inflammation Pathways. Crosstalk on Perioperative Antioxidant Therapy

Stelian Adrian Ritiu, Alexandru Florin Rogobete, Dorel Sandesc, Ovidiu Horea Bedreag, Marius Papurica, Sonia Elena Popovici, Daiana Toma, Robert Iulian Ivascu, Raluca Ramona Velovan, Dragos Nicolae Garofil, Dan Corneci, Melania Lavinia Bratu, Elena Mihaela Pahontu, Adriana Pistol

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: general anesthesia; redox; inflammation; antioxidants; hypermetabolism; microRNAs; biomarkers; oxidative stress; Vitamin C

Online: 23 May 2022 (10:28:05 CEST)

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Preprint HYPOTHESIS | doi:10.20944/preprints202304.1068.v1

The Importance of Arterial Blood Gas Analysis as a Systemic Diagnosis Approach in Assessing and Preventing Chronic Diseases, From Emergency Medicine to the Daily Practice

Mario Giosue' Balzanelli, PIETRO DISTRATIS, RITA LAZZARO, Van Hung Pham, Raffaele Del Prete, Gianna Dipalma, Francesco Inchingolo, Sergey Khachatur Aityan, Linh thuy Hoang, Kieu Cao Diem Nguyen, Ciro Isacco gargiulo

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: Key words: arterial blood gas analysis (ABG); partial pressure of oxygen (PaO2); partial pressure PaCO2 (PaCO2); serum bicarbonate (HCO3); Hasselbach; acid/base

Online: 27 April 2023 (10:04:38 CEST)

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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/preprints202307.1470.v1

Post COVID-19 Syndromes -Some New Data on the Changes of Phosphocalcium Metabolism

Lucretia Anghel, Corina Manole, Aurel Nechita, Alin Laurențiu Tatu, Bogdan Ioan Stefanescu, Luiza Camelia Nechita, Camelia Busila, Zainea Pușica, Carmina Liana Musat, Liliana Baroiu

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: COVID-19; phospho-calcium; parathyroid hormone, post-COVID complications, hypocalcemia, hypophosphatemia.

Online: 21 July 2023 (09:23:41 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202309.1272.v1

Evaluating ChatGPT Efficacy in Navigating the Spanish Medical Residency Entrance Examination (MIR): A New Horizon for AI in Clinical Medicine

Francisco Guillen-Grima, Sara Guillen-Aguinaga, Laura Guillen-Aguinaga, Rosa Alas-Brun, Luc Onambele, Wilfrido Ortega, Rocio Montejo, Enrique Aguinaga-Ontoso, Paul Barach, Ines Aguinaga-Ontoso

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: Machine learning; Artificial inteligence; ChatGPT; GPT 3.5; GPT-4; Medical education; quality of care

Online: 19 September 2023 (08:34:31 CEST)

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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 ARTICLE | doi:10.20944/preprints202205.0350.v2

When the Patient Is Making the (Wrong) Diagnosis: A Biographical Approach to Patients Consulting for Presumed Lyme Disease

Lutaud Romain, Pierre Verger, Patrick Peretti-Watel, Carole Eldin

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: lyme disease; clinical decision-making; medical history taking; physician-patient relation; primary health care; qualitative research

Online: 27 May 2022 (08:48:07 CEST)

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Preprint REVIEW | doi:10.20944/preprints202305.0910.v1

Peripapillary Intrachoroidal Cavitation

Adèle Ehongo, Noélie Bacq

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: Myopia; peripapillary intrachoroidal cavitation; Peripapillary staphyloma; gamma peripapillary atrophy; border tissue; optic nerve sheaths; biomechanics

Online: 12 May 2023 (09:00:13 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202301.0296.v1

Effectiveness, Retrievability and Safety of Celect vs ALN Inferior Vena Cava Filters: Randomized Controlled Study

Miguel Angel De Gregorio, Juan Jose Ciampi-Dopazo, Jose Urbano, Roman Bernal, Carolina Serrano- Casorran, Cristina Bonastre, Jose Maria Abadal, Santiago Mendez, Arturo Fredes, Jose Benito Rodriguez, Sergio Rodriguez, Jose Andres Guirola

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: inferior vena cava filter; randomized study

Online: 17 January 2023 (06:36:43 CET)

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Preprint ARTICLE | doi:10.20944/preprints202308.1662.v1

A Systematic Review and Meta-Epidemiology study on Multimorbidity

Gayathri Delanerolle, Yassine Bouchareb, Priyanka Jagadeesan, Guanpeng Li, Xiaojie Yang, Heitor Cavalini, Shaheen Kazali, Alain Zemokoho, David Benfield, Ashish Shetty, Peter Phiri, Jian qing Shi

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: Multimorbidity; Chronic condition; Health Inequalities; Global health; Epidemiology

Online: 23 August 2023 (11:25:08 CEST)

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With enhanced life expectancy and ageing global populations, the prevalence of multimorbidity continues to increase. However, there is a dearth of evidence linked to multimorbidity diagnoses, treatments and health outcomes which remains a concern for future proofing optimal healthcare services. Generating evidence is critical to managing multimorbidity, promoting public health and minimizing health inequalities via effective healthcare policies that improve quality of life for vulnerable populations. This study assessed meta-epidemiology of multimorbidity to report the gaps in scientific knowledge and clinical practice. A systematic methodology was designed and published in PROSPERO (CRD42022347308) to report meta-epidemiology analyses using databases including PubMed, Web of Science, ScienceDirect, EMBASE, The Cochrane Gynaecology and Fertility Group Specialised Register of Controlled Trials and MEDLINE for studies published between the 1^st of January 1980 - 31^st December 2022. A random-effects model was used to estimate the pooled proportion of multimorbidity in adults. Forest plots, pooled odds ratios and statistical heterogeneity metrics were used to assess the association between multimorbidity and investigated factors. Funnel plots and Egger’s regression were used to detect and correct for publication bias. Our findings identified women to be 0.32 times more likely to have multimorbidity in comparison to males. In regard to ethnicity, white people were 0.47 times less likely to develop comorbidities than black people. People who identified as a drinker or unmarried were more likely to develop comorbidities than those who are non-drinkers or married, respectively. Regardless of smoking status, people were equally likely to have comorbidity. In terms of environmental influences, people in rural areas were found to be 0.2 times less likely to have comorbidity in comparison to those living in urban areas. Interestingly, people with a higher education level were 0.57 times more likely to develop comorbidities than those with only a high school education. It is evident that multimorbidity has a significant burden globally and impacts the provision of care necessitated across populations given its association with several social determinants of health. Robust research and healthcare policies are required to better manage multimorbidity in patients. An example of such intervention includes employing prevention programs to reduce risk and incidence of multimorbidity within at-risk populations.

Preprint ARTICLE | doi:10.20944/preprints202306.0264.v1

The Coagulation Profile Monitoring of COVID-19 Patients with Standard and Viscoelastic Point of Care Hemostasis Tests

Milan Lazarević, Natalija Vuković, Dragan Milic, Aleksandar Kamenov, Velimir Peric, Mladan Golubovic, Dimitrije Spasic, Vladimir Stojiljkovic, Marija Stosic, Dragana Stokanovic

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: COVID 19; coagulation; viscoelastic tests; thrombosis; mortality

Online: 5 June 2023 (08:15:17 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202306.0348.v1

Core Needle Biopsy Guidance Based on Tissue Morphology Assessment With AI-OCT Imaging

Gopi Maguluri, John Grimble, Aliana Caron, Ge Zhu, Savitri Krishnamurthy, Amanda McWatters, Gillian Beamer, Seung-Yi Lee, Nicusor Iftimia

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: Tissue biopsy guidance; Optical coherence tomography imaging; Artificial intelligence

Online: 5 June 2023 (16:17:17 CEST)

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Preprint REVIEW | doi:10.20944/preprints202210.0218.v1

Antibiotics Modulate Variable Immunological Responses in Sepsis- A Narrative Review

Naveed Saleem

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: Bactericidal; Bacteriostatic; Antibiotic(s); Antimicrobial Therapy; Narrative review

Online: 17 October 2022 (02:05:28 CEST)

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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 REVIEW | doi:10.20944/preprints202308.0453.v1

In Vivo Gene Editing: A Healthcare Revolution in the Making

Sarfaraz K. Niazi

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: gene editing 1; CRISPR 2; gRNA 3; autoimmune disorders 4; nuclease 5; hereditary disorders 6

Online: 4 August 2023 (19:15:10 CEST)

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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 REVIEW | doi:10.20944/preprints202307.0005.v2

The Potential Role of Hypothalamic Phospholipid Liposomes in the Supportive Therapy of Some Manifestations of Post COVID-19 Condition: Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and Brain Fog

Francesco Menichetti

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: Covid-19; post-COVID syndrome; neuroendocrine disorders; chronic fatigue; brain fog; phospholipids; phospholipid liposome; phosphatidylserine

Online: 15 August 2023 (05:03:11 CEST)

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Medicine and Pharmacology