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Autologous cord blood vs individualized supplements in autistic spectrum disorder:CORDUS study results

World Journal of Clinical Pediatrics 2025年第1期14卷 101-112页

作者： Felician A Stancioiu Raluca Bogdan Bogdan Ivanescu Radu Dumitrescu department of Clinical Research Bio-Forum FoundationBucharest 040245BucurestiRomania department of Pediatrics Medicover Hospital BucharestBucharest 013982BucurestiRomania Doctor MiT Clinic Bucharest 013929BucurestiRomania department of Anesthesiology and intensive therapy Medicover HospitalBucharest 013982BucurestiRomania

BACKGROUND Cellular therapies have started an important new therapeutic direction in autistic spectrum disorder(ASD),and the ample diversity of ASD pathophysiology and the different types of cell therapies prompt an equally ample effort to employ clinical studies for studying the ASD causes and cell *** cells have yielded so far mixed results in clinical trials,and at patient level the results varied from impressive to no *** this context we have administered autologous cord blood(ACB)and a non-placebo,material intervention repre-sented by an individualized combination of supplements(ICS)to ASD *** CORDUS clinical study is a crossover study in which both oral ICS and intravenous ACB were sequentially administered to 56 children;ACB was infused as an inpatient *** efficacy was evaluated pre-treatment and post-treatment at 6 months by an independent psychotherapist with Autism Treatment Evaluation Checklist,Quantitative Checklist for Autism in Toddlers and a 16-item comparative table score,after interviewing the children’s parents and *** and after each intervention participants had a set of blood tests including inflammatory,metabolic and oxidative markers,and the neuronal specific *** No serious adverse reactions were noted during and after cord blood or supplement *** improved evaluation scores in 78%of children with age 3–7-years(n=28),but was much less effective in kids older than 8 years or with body weight of more than 35 kg(n=28;only 11%of children improved scores).ICS yielded better results than ACB in 5 cases out of 28,while in 23 kids ACB brought more improvement than ICS(P<0.05);high initial levels of inflammation and ferritin were associated with no *** individual differences were noted in children's progress,and statistically significant improvements were seen after ACB on areas such as verbalization and social interaction,but not on irritability or

关键词： Autistic spectrum disorder Cord blood Stem cells Neuroinflammation Autologous stem cell treatment Neuronal specific enolase

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Effect of dietary fibre on the gastrointestinal microbiota during critical illness:A scoping review

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World Journal of Critical Care Medicine 2025年第1期14卷 49-59页

作者： Angajendra N Ghosh Calum J Walsh Matthew J Maiden Tim P Stinear Adam M Deane department of intensive Care The Northern HospitalEpping 3076VictoriaAustralia department of Microbiology and Immunology The Peter Doherty Institute for Infection and ImmunityMelbourne 3052VictoriaAustralia department of intensive Care The Royal Melbourne HospitalThe University of MelbourneParkville 3050VictoriaAustralia department of intensive Care Medicine The Royal Melbourne HospitalParkville 3050VictoriaAustralia

The systemic effects of gastrointestinal(GI)microbiota in health and during chronic diseases is increasingly *** strategies to modulate the GI microbiota during chronic diseases have demonstrated *** changes in dietary intake can rapidly change the GI microbiota,the impact of dietary changes during acute critical illness on the microbiota remain *** fibre is metabolised by carbohydrate-active enzymes and,in health,can alter GI *** aim of this scoping review was to describe the effects of dietary fibre supplementation in health and disease states,specifically during critical *** controlled trials and prospective cohort studies that include adults(>18 years age)and reported changes to GI microbiota as one of the study outcomes using non-culture methods,were *** show dietary fibres have an impact on faecal microbiota in health and *** fibre,inulin,has a marked and specific effect on increasing the abundance of faecal *** chain fatty acids produced by Bifidobacteria have been shown to be beneficial in other patient *** few trials have evaluated the effect of dietary fibre on the GI microbiota during critical *** research is necessary to establish optimal fibre type,doses,duration of intervention in critical illness.

关键词： Gastrointestinal microbiota Dietary fibre Health Critical illness Short chain fatty acids

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Advances and challenges in diagnosing and managing adult autoimmune enteropathy

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World Journal of Gastroenterology 2025年第2期31卷 128-131页

作者： Grigorios Christodoulidis Sara E Agko Marina N Kouliou Konstantinos E Koumarelas Dimitris Zacharoulis department of General Surgery University Hospital of LarissaLarissa 41110Greece department of intensive Care Unit Asklepios Paulinen Clinic WiesbadenWiesbaden 65197Germany department of Emergency Medicine General Hospital of LarissaLarissa 41221Greece department of Surgery University Hospital of LarissaLarissa 41334Greece

Autoimmune enteropathy(AIE)is a rare immune mediated disorder primarily affecting children,characterized by chronic diarrhea,malabsorption,vomiting,weight loss and villous *** has also been observed in adults presenting diagnostic and treatment challenges due to its overlap with other gastrointestinal disorders such as celiac *** diagnostic criteria for AIE include small bowel villous atrophy,lack of response to dietary restrictions,presence of anti-enterocyte antibodies,and predisposition to autoimmunity without severe *** criteria emphasize characteristic histological findings and exclusion of other causes of villous *** is associated with various autoimmune disorders and can present with overlapping features with Celiac disease,including villous atrophy but without significant intraepithelial *** primarily involves immunosuppression using corticosteroids,calcineurin inhibitors,and anti-tumor necrosis factor therapy,alongside nutri-tional *** the challenges,understanding AIE’s diverse manifest-ations and improving diagnostic criteria are essential for effective management and improved patient *** research is needed to elucidate the pathogenesis,disease progression and long-term outcomes of AIE.

关键词： Autoimmune enteropathy Diagnosis Prognosis Adult autoimmune enter-opathy and challenges Autoimmune enteropathy and treatment Autoimmune enteropathy and diagnostic criteria Pathophysiology of autoimmune enteropathy

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Transient extreme insulin resistance in a critically ill patient:A case report

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World Journal of Clinical Cases 2025年第8期13卷 35-40页

作者： Xiu-Yu Wei Hsiu-Nien Shen department of Internal Medicine Taichung Veterans General HospitalTaichung 407TaiwanChina department of intensive Care Medicine Chi Mei Medical CenterTainan 710TaiwanChina

BACKGROUND Acute hyperglycemia due to insulin resistance is common in critically ill patients,typically managed with insulin ***,the occurrence of transient extreme insulin resistance(EIR)requiring exceptional high-dose insulin is *** SUMMARY We present the case of a 68-year-old woman with pneumonia who suffered an out-of-hospital cardiac arrest,subsequently developing transient EIR following a new episode of ***,insulin resistance rapidly reversed when the insulin infusion rate peaked at 960 units/hour(a total of 18224 units on that day),and it was promptly titrated down to zero upon achieving the target glucose *** Exceptional high-dose insulin infusion may be required in critically ill patients with stress-related EIR,which is typically *** should be aware of the phenomenon and cautious to avoid hypoglycemia and fluid overload during the steep titration of high-dose insulin infusion.

关键词： Hyperglycemia Insulin Insulin resistance Sepsis Critical illness Case report

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Comparison of the prognostic value of frailty assessment tools in patients aged≥65 years hospitalized in a cardiac care unit with acute coronary syndrome

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Journal of Geriatric Cardiology 2022年第5期19卷 343-353页

作者： Wojciech Nowak Ilona Kowalik Małgorzata Kuzin Agnieszka Krauze Anna Mierzyńska Ewa Sadowy Kamil Marcinkiewicz Janina Stępińska department of intensive cardiac therapy National Institute of CardiologyWarsawPoland Clinical Research Support Center National Institute of CardiologyWarsawPoland department of Coronary Artery Disease and cardiac Rehabilitation National Institute of CardiologyWarsawPoland

BACKGROUND Frailty is associated with adverse events in elderly patients with acute coronary syndrome(ACS).Our aim was to compare the prognostic value of four frailty scales in patients aged≥65 years hospitalized with ACS in a cardiac care unit(CCU).METHODS Patients aged≥65 years with ACS were *** was assessed using the Fried frailty scale(reference standard),the Edmonton Frail Scale(EFS),the FRAIL scale,and the Clinical frailty scale(CFS).The primary end point was all-cause mortality and the secondary end point was unscheduled *** One hundred and seventy four patients aged≥65 years with ACS were *** median follow-up was 637.5 *** was identified in 41.4%,40.2%,39.1%and 36.3%patients by the Fried frailty scale,EFS,FRAIL scale and CFS,*** agreement coefficients were 0.88,0.86,and 0.79 for the FRAIL scale,EFS and CFS,*** the Cox regres-sion model,frailty was associated with all-cause mortality regardless of the scale used(univariate:hazard ratio[HR]95%CI=10.5,2.4-46.8 Fried frailty scale;12.0,2.7-53.4 FRAIL scale;7.1,2.0-25.2 EFS;8.3,2.4-29.6 ***:HR=5.1,1.1-23.8 Fried frailty scale;5.7,1.2-26.8 FRAIL scale;3.7,1.0-14.0 EFS;4.2,1.1-15.9 CFS).The FRAIL scale had the highest *** the uni-variate analysis,frailty was associated with unscheduled rehospitalization(HR=3.2,1.7-6.0 Fried frailty scale;3.4,1.8-6.3 FRAIL scale;3.5,1.8-6.6 EFS;3.1,1.7-5.8 CFS).In the multivariate analysis,only the EFS independently predicted unscheduled rehospit-alization(HR=2.2,1.1-4.63).CONCLUSIONS Frailty assessed by the Fried frailty scale,FRAIL scale,EFS and CFS is associated with all-cause mortality and unscheduled rehospitalization in elderly patients hospitalized in a CCU with *** adjusted HR of the FRAIL scale for all-cause mortality was the highest among the scales compared,whereas the EFS was an independent predictor of unscheduled *** data should be taken into consider

关键词： patients mortality coronary

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The impact of frailty on in-hospital complications in elderly patients with acute coronary syndrome

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Journal of Geriatric Cardiology 2023年第3期20卷 174-184页

作者： Wojciech Nowak Ilona Kowalik Michał Nowicki Tomasz Cichocki Janina Stępińska department of intensive cardiac therapy National Institute of CardiologyWarsawPoland Clinical Research Support Center National Institute of CardiologyWarsawPoland department of Coronary Artery Disease and cardiac Rehabilitation National Institute of CardiologyWarsawPoland

BACKGROUND Acute coronary syndrome(ACS)is linked to a range of in-hospital complications,and age is recognized as risk factor for adverse *** between physiological and chronological age are explained by ***,the relationship between frailty and in-hospital complications is not *** Assessment of frailty in patients was carried out using the FRAIL ***-hospital complications assessed included,bleeding,infection,arrhythmia,acute kidney injury(AKI),delirium,stroke/transient ischemic attack(TIA),liver injury,hypoglycemia,length of stay in the cardiac care unit(CCU).RESULTS Of the 174 patients,frailty was identified in 39.1%and pre-frailty in 29.9%.Frailty was associated with a higher incidence of all types of bleeding(frail ***:45.5%vs.16.7%,Ptherapy(52.9%vs.13.0%,Ptherapy during hospitalization,the incidence of AF and liver injury were more often in patients with pre-frailty compared to the robust *** adjustment for potential confounders,frailty remained independently associated with an increased risk of infection(OR:3.3[1.6-7.0]),including pneumonia/LRTI(OR:2.5[1.1-5.8])and UTI(OR:4.8[1.8-12.5]).Frail individuals had an increased requirement for antibiotic therapy(OR:3.9[1.9-8.1]),and greater risk of AF(OR:3.5[1.3-9.3]),AKI(OR:2.6[1.2-5.3])delirium(OR:11.7[4.8-28.7]),as well as having to stay longer in the CCU(>3 days)(OR:3.7[1.9-7.3]).CONCLUSIONS Frailty was associated with an increased risk of numerous in-hospital complications in elderly patients who had been

关键词： patients complications coronary

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Hypoxia-preconditioned bone marrow-derived mesenchymal stem cells protect neurons from cardiac arrest-induced pyroptosis

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Neural Regeneration Research 2025年第4期20卷 1103-1123页

作者： Xiahong Tang Nan Zheng Qingming Lin Yan You Zheng Gong Yangping Zhuang Jiali Wu Yu Wang Hanlin Huang Jun Ke Feng Chen Shengli Clinical Medical College of Fujian Medical University Fujian Medical UniversityFuzhouFujian ProvinceChina department of Emergency Fujian Provincial HospitalFuzhouFujian ProvinceChina Fujian Provincial Key Laboratory of Emergency Medicine FuzhouFujian ProvinceChina The Second department of intensive Care Unit Fujian Provincial Hospital South BranchFuzhouFujian ProvinceChina

cardiac arrest can lead to severe neurological impairment as a result of inflammation,mitochondrial dysfunction,and post-cardiopulmonary resuscitation neurological *** preconditioning has been shown to improve migration and survival of bone marrow–derived mesenchymal stem cells and reduce pyroptosis after cardiac arrest,but the specific mechanisms by which hypoxia-preconditioned bone marrow–derived mesenchymal stem cells protect against brain injury after cardiac arrest are *** this end,we established an in vitro co-culture model of bone marrow–derived mesenchymal stem cells and oxygen–glucose deprived primary neurons and found that hypoxic preconditioning enhanced the protective effect of bone marrow stromal stem cells against neuronal pyroptosis,possibly through inhibition of the MAPK and nuclear factor κB ***,we transplanted hypoxia-preconditioned bone marrow–derived mesenchymal stem cells into the lateral ventricle after the return of spontaneous circulation in an 8-minute cardiac arrest rat model induced by *** results showed that hypoxia-preconditioned bone marrow–derived mesenchymal stem cells significantly reduced cardiac arrest–induced neuronal pyroptosis,oxidative stress,and mitochondrial damage,whereas knockdown of the liver isoform of phosphofructokinase in bone marrow–derived mesenchymal stem cells inhibited these *** conclude,hypoxia-preconditioned bone marrow–derived mesenchymal stem cells offer a promising therapeutic approach for neuronal injury following cardiac arrest,and their beneficial effects are potentially associated with increased expression of the liver isoform of phosphofructokinase following hypoxic preconditioning.

关键词： bone marrow–derived mesenchymal stem cells cardiac arrest cardiac resuscitation hypoxic preconditioning liver isoform of phosphofructokinase mitochondria neuroinflammation oxidative stress pyroptosis reactive oxygen species

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Forging an easier path through graduation:Improving the patient transition from paediatric to adult critical care

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World Journal of Critical Care Medicine 2025年第1期14卷 82-90页

作者： Stephen Warrillow Ben Gelbart Jess Stevens Gordon Baikie Mark E Howard department of intensive Care Austin HealthHeidelberg 3084VictoriaAustralia department of Critical Care The University of MelbourneParkville 3010VictoriaAustralia department of intensive Care Royal Children’s HospitalParkville 3010VictoriaAustralia Living with Disability Research Centre La Trobe UniversityBundoora 3086VictoriaAustralia department of Neurodevelopment&Disability Royal Children’s HospitalParkville 3010VictoriaAustralia department of Paediatrics The University of MelbourneParkville 3010VictoriaAustralia department of Respiratory and Sleep Medicine Austin HealthHeidelberg 3084VictoriaAustralia department of Medicine Austin HealthThe University of MelbourneHeidelberg 3084VictoriaAustralia

Adolescence and the journey to adulthood involves exciting opportunities as well as psychosocial stress for young people growing *** normal experiences are potentially magnified for teenagers living with chronic illness or disability and their *** in care have improved survival for children with a variety of serious chronic medical conditions such that many who may once have died in childhood now survive well into adulthood with ongoing *** those with highly complex needs,care is often provided at major paediatric hospitals with expertise,specially trained personnel,and resources to support young people and their families for the first decades of *** the end of adolescence,however,it is generally appropriate and necessary for young adults and their caregivers to transition to the care of clinicians trained in the care of adults at general *** there are some well-managed models to support this journey of transition,these are often specific to certain conditions and usually do not involve intensive *** patients may encounter considerable challenges during this *** may include the loss of established therapeutic relationships,a perception of austerity and reduced amenity in facilities oriented to caring for adult patients,and care by clinicians with less experience with more common paediatric *** addition,there is a risk of potential conflict between clinicians and families regarding goals of care in the event of a critical illness when it occurs in a young adult with major disability and long-term health *** challenges present genuine opportunities to better understand the transition from paediatric to adult-based care and to improve processes that assist clinicians who support patients and families as they shift between healthcare settings.

关键词： Paediatric intensive care Disability Adult intensive care Transition Critical care

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Proton pump inhibitors and all-cause mortality risk among cancer patients

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World Journal of Clinical Oncology 2025年第1期16卷 34-42页

作者： Arunkumar Krishnan Carolin Victoria Schneider Declan Walsh department of Supportive Oncology Atrium Health Levine CancerCharlotteNC 28204United States department of Medicine Section of Hematology and OncologyWake Forest University School of MedicineWinston-SalemNC 27101United States department of Medicine Ⅲ GastroenterologyMetabolic Diseasesand Intensive CareUniversity Hospital RWTH AachenAachen 52074Germany

BACKGROUND Proton pump inhibitors(PPIs)are widely used,including among cancer patients,to manage gastroesophageal reflux and other gastric acid-related *** evidence suggests associations between long-term PPI use and higher risks for various adverse health outcomes,including greater *** To investigate the association between PPI use and all-cause mortality among cancer patients by a comprehensive analysis after adjustment for various confounders and a robust methodological approach to minimize *** This retrospective cohort study used data from the TriNetX research network,with electronic health records from multiple healthcare *** study employed a new-user,active comparator design,which compared newly treated PPI users with non-users and newly treated histamine2 receptor antagonists(H2RA)users among adult cancer *** prescribed PPIs(esomeprazole,lansoprazole,omeprazole,pantoprazole,or rabeprazole)users were compared to non-users or newly prescribed H2RAs(cimetidine,famotidine,nizatidine,or ranitidine)*** primary outcome was all-cause *** patient in the main group was matched to a patient in the control group using 1:1 propensity score matching to reduce confounding *** Cox regression models were used to estimate hazard ratios(HRs)and 95% confidence interval(CI).RESULTS During the follow-up period(median 5.4±1.8 years for PPI users and 6.5±1.0 years for non-users),PPI users demonstrated a higher all-cause mortality rate than non-users after 1 year,2 years,and at the end of follow up(HRs:2.34-2.72).Compared with H2RA users,PPI users demonstrated a higher rate of all-cause mortality HR:1.51(95%CI:1.41-1.69).Similar results were observed across sensitivity analyses by excluding deaths from the first 9 months and 1-year post-exposure,confirming the robustness of these *** a sensitivity analysis,we analyzed all-cause mortality outcomes between former PPI users and individual

关键词： All-cause mortality Cancer Histamine-2 receptor antagonists Mortality Malignancy Proton pump inhibitors Carcinoma Outcome

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Prognostic impact of hypernatremia for septic shock patients in the intensive care unit

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World Journal of Clinical Cases 2025年第7期13卷 28-38页

作者： Mai-Qing Shi Jun Chen Fu-Hai Ji Hao Zhou Ke Peng Jun Wang Chun-Lei Fan Xu Wang Yang Wang department of Anesthesiology The First Affiliated Hospital of Soochow UniversitySuzhou 215006Jiangsu ProvinceChina department of General Surgery The First Affiliated Hospital of Soochow UniversitySuzhou 215006Jiangsu ProvinceChina intensive Care Medicine The First Affiliated Hospital of Soochow UniversitySuzhou 215006Jiangsu ProvinceChina

BACKGROUND Hypernatremia represents a significant electrolyte imbalance associated with numerous adverse outcomes,particularly in cases of intensive care unit(ICU)-acquired hypernatremia(IAH).Nevertheless,its relevance in patients with septic shock remains *** To identify independent risk factors and their predictive efficacy for IAH to improve outcomes in patients with septic *** In the present retrospective single-center study,a cohort of 157 septic shock patients with concurrent hypernatremia in the ICU at The First Affiliated Hospital of Soochow University,between August 1,2018,and May 31,2023,were *** were categorized based on the timing of hypernatremia occurrence into the IAH group(n=62),the non-IAH group(n=41),and the normonatremia group(n=54).RESULTS In the present study,there was a significant association between the high serum sodium concentrations,excessive persistent inflammation,immunosuppression and catabolism syndrome and chronic critical illness,while rapid recovery had an apparent association with ***,multivariable analyses revealed the following independent risk factors for IAH:Total urinary output over the preceding three days[odds ratio(OR)=1.09;95%CI:1.02–1.17;P=0.014],enteral nutrition(EN)sodium content of 500 mg(OR=2.93;95%CI:1.13–7.60;P=0.027),and EN sodium content of 670 mg(OR=6.19;95%CI:1.75–21.98;P=0.005)were positively correlated with the development of ***,the area under the curve for total urinary output over the preceding three days was 0.800(95%CI:0.678–0.922,P=0.001).Furthermore,maximum serum sodium levels,the duration of hypernatremia,and varying sodium correction rates were significantly associated with 28-day in-hospital mortality in septic shock patients(P<0.05).CONCLUSION The present findings illustrate that elevated serum sodium level was significantly associated with a poor prognosis in septic shock patients in the *** is highly recommended that hypernatremia be

关键词： Hypernatremia Hypernatremia acquired in the intensive care unit Septic shock Persistent inflammation Immunosuppression Catabolism syndrome Chronic critical illness Prognosis

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