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Dosage and utilization of dexamethasone in the management of COVID-19: A critical review

World Journal of Virology 2024年第3期13卷 107-114页

作者： Imran Sethi Asim Shaikh Musa Sethi Hira Khalid Chohan Sheraz Younus Syed A Khan Salim Surani department of Critical care Medicine Marion General HospitalMarionIN 46952United States department of Medicine Aga Khan UniversityKarachi 74200SindhPakistan department of Medicine Eman SchoolFishersIN 46038United States department of Internal Medicine Dow University of Health ScienceKarachi 74200SindhPakistan department of Hospital Medicine Franciscan HealthIndianapolisIN 46237United States department of Critical care Medicine Mayo Clinic Health SystemMankatoMN 56001United States department of Medicine and Pharmacology Texas A and M UniversityCollege StationTX 77843United States

BACKGROUND The severe respiratory manifestations observed in severe coronavirus disease 2019(COVID-19)cases are often associated with an excessive inflammatory ***,a synthetic glucocorticoid,exerts its anti-inflammatory effects by inhibiting the transcription of pro-inflammatory genes and suppressing the activity of various immune *** mechanism has implications for mitigating the cytokine storm observed in severe COVID-19 *** on in the pandemic,the Recovery Collaborative working group showed a mortality benefit of using dexamethasone in decreasing mortality in patients with COVID-19 requiring respiratory ***,the optimal dosage of corticosteroids remains *** studies that compare different doses of dexamethasone in COVID-19 exist,but the results are *** To review the latest evidence regarding dosage,safety,and efficacy of dexamethasone in severe *** We followed preferred reporting items for systematic reviews and meta-analysis guidelines.A detailed literature search was conducted across PubMed,Google Scholar,and Medline to include publications up to March *** keywords included“COVID-19”“SARS-CoV-2”“dexamethasone”“corticosteroid”“steroid”and“glucocorticoid”-along with their *** employed the Cochrane Risk of Bias Tool and the Newcastle-Ottawa scale to evaluate the integrity and potential of bias in the included studies.A meta-analysis was conducted using a random-effects model,assessing pooled odds ratios and mean differences,with heterogeneity gauged by the I2 statistic and theχ^(2) *** No statistical differences were found in 28-day all-cause mortality[pooled odds ratio(OR)=1.109,95%CI:0.918-1.340],60-day all-cause mortality(OR=0.873,95%CI:0.744-1.024;I2=47.29%),mean length of hospital stay(mean difference=-0.08 days,95%CI:-0.001 to 0.161)and adverse events(OR=0.877,95%CI:0.707-1.087).CONCLUSION Differing doses of corticosteroids have no clinical implication

关键词： COVID-19 Steroids Corticosteroids Steroid dosage Critical care Corona virus

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Natural history of asymptomatic gallbladder stones in clinic without beds:A long-term prognosis over 10 years

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World Journal of clinical Cases 2024年第1期12卷 42-50页

作者： Yuji Sakai Toshio Tsuyuguchi Hiroshi Ohyama Junichiro Kumagai Takashi Kaiho Masayuki Ohtsuka Naoya Kato Tadao Sakai department of Gastroenterology Sakai ClinicKimistu 299-1162Japan department of Gastroenterology Graduate School of MedicineChiba UniversityChiba 260-8677Japan department of Gastroenterology Chiba Prefectural Sawara HospitalChiba Prefectural Sawara HospitalSawara 287-0003Japan department of Gastroenterology Kimitsu Central HospitalKisarazu 292-8535Japan department of Surgery Kimitsu Central HospitalKisarazu 292-8535Japan department of General Surgery Graduate School of MedicineChiba UniversityChiba 260-8677Japan

BACKGROUND Several studies have explored the long-term prognosis of patients with asymp-tomatic gallbladder *** reports were primarily conducted in facilities equipped with beds for addressing symptomatic *** To report the long-term prognosis of patients with asymptomatic gallbladder stones in clinics without bed *** We investigated the prognoses of 237 patients diagnosed with asymptomatic gallbladder stones in clinics without beds between March 2010 and October *** symptoms developed,patients were transferred to hospitals where appropriate treatment was *** investigated the asymptomatic and survival periods during the *** Among the 237 patients,214(90.3%)remained asymptomatic,with a mean asymptomatic period of 3898.9279±46.871 d(50-4111 d,10.7 years on average).Biliary complications developed in 23 patients(9.7%),with a mean survival period of 4010.0285±31.2788 d(53-4112 d,10.9 years on average).No patient died of biliary *** The long-term prognosis of asymptomatic gallbladder stones in clinics without beds was *** the condition became symptomatic,the patients were transferred to hospitals with beds that could address it;thus,no deaths related to biliary complications were *** finding suggests that follow-up care in clinics without beds is possible.

关键词： Gallbladder stone Acute cholangitis Acute cholecystitis Asymptomatic gallbladder stone Symptomatic gallbladder stone

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Multi-aspect analysis of ureteral access sheath usage in retrograde intrarenal surgery: A RIRSearch group study

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Asian Journal of Urology 2024年第1期11卷 80-85页

作者： Oktay Özman Hacı M.Akgül Cem Başataç Önder Çınar Eyüp B.Sancak Cenk M.Yazıcı Bülent Önal Haluk Akpınar Gaziosmanpasa Training and Research Hospital Urology ClinicİstanbulTurkey TekirdağNamık Kemal University School of MedicineDepartment of UrologyTekirdağTurkey Group Florence Nightingale Hospitals Department of UrologyİstanbulTurkey Zonguldak Bulent Ecevit University School of MedicineDepartment of UrologyZonguldakTurkey Çanakkale Onsekiz Mart University School of MedicineDepartment of UrologyÇanakkaleTurkey İstanbul University-Cerrahpaşa Cerrahpaşa Medical FacultyDepartment of UrologyİstanbulTurkey

Objective:To evaluate the effect of ureteral access sheath(UAS)use and calibration change on stone-free rate and complications of retrograde intrarenal surgery(RIRS).Methods:Data from 568 patients undergoing RIRS for kidney or upper ureteral stones were retrospectively ***,patients were compared after 1:1 propensity score matching,according to UAS usage during RIRS(UAS used[+]87 and UAS non-used[−]87 patients).Then all UAS+patients(n=481)were subdivided according to UAS calibration:9.5-11.5 Fr,10-12 Fr,11-13 Fr,and 13-15 *** outcomes of the study were the success and complications of ***:Stone-free rate of UAS+patients(86.2%)was significantly higher than UAS−patients(70.1%)after propensity score matching(p=0.01).Stone-free rate increased with higher caliber UAS(9.5-11.5 Fr:66.7%;10-12 Fr:87.0%;11-13 Fr:90.6%;13-15 Fr:100%;p<0.001).Postoperative complications of UAS+patients(11.5%)were significantly lower than UAS−patients(27.6%)(p=0.01).Complications(8.7%)with 9.5-11.5 Fr UAS was lower than thicker UAS(17.2%)but was not statistically significant(p=0.09).UAS usage was an independent factor predicting stone-free status or peri-and post-operative complications(odds ratio[OR]3.654,95%confidence interval[CI]1.314-10.162;OR 4.443,95%CI 1.350-14.552;OR 4.107,95%CI 1.366-12.344,respectively).Conclusion:Use of UAS in RIRS may increase stone-free rates,which also increase with higher caliber *** usage may reduce complications;however,complications seemingly increase with higher UAS calibration.

关键词： Stone Retrograde intrarenal surgery Ureteral access sheath Urolithiasis Kidney

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Regulation of AMPK activation by extracellular matrix stiffness in pancreatic cancer

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Genes & Diseases 2024年第3期11卷 338-350页

作者： Xin Xu Yuan Fang Somaira Nowsheen Ye-Xiong Li Zhenkun Lou Min Deng State Key Laboratory of Molecular Oncology and department of Radiation Oncology National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021China department of General Surgery Shanghai General HospitalShanghai Jiaotong University School of MedicineShanghai 200080China department of General Surgery Zhongshan HospitalFudan UniversityShanghai 200032China department of Dermatology University of California San DiegoSan DiegoCA 92093USA department of Oncology Mayo ClinicRochesterMN 55905USA

The adenosine monophosphate(AMP)-activated protein kinase(AMPK)sits at a cen-tral node in the regulation of energy metabolism and tumor *** is best known to sense high cellular ADP or AMP levels,which indicate the depletion of energy *** studies have shown that the low expression of phosphorylated AMPK is associated with a poor prognosis of pancreatic *** this study,we report that AMPK is also highly sensitive to extracellular matrix(ECM)*** found that AMPK is activated in cells when cultured under low ECM stiffness conditions and is functionally required for the metabolic switch induced by ECM *** regulation of AMPK requires the Hippo kinases but not LKB1/*** kinases directly phosphorylate AMPKa at Thr172 to activate AMPK at low ECM ***,we found AMPK activity is inhibited in patients with pancreatic ductal adenocarcinoma(PDAC)with high ECM stiffness and is associated with a poor survival *** activation of Hippo kinases by ROCK inhibitor Y-27632 in combination with the mitochondrial inhibitor metformin synergistically activates AMPK and dramatically inhibits PDAC ***,these findings establish a novel model for AMPK regulation by the mechanical properties of ECMs and provide a rationale for simultaneously targeting the ECM stiffness-Hippo kinases-AMPK signaling and low glucose-LKB1-AMPK signaling pathways as an effective therapeutic strategy against PDAC.

关键词： AMPKactivity Cellularmetabolic switch ECM stiffness Hippokinase signaling Pancreaticductal adenocarcinoma

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Enhancing transjugular intrahepatic portosystemic shunt procedure efficiency with digital subtraction angiography image overlay technology in esophagogastric variceal bleeding

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World Journal of Gastrointestinal Surgery 2024年第9期16卷 2870-2877页

作者： Xiao-Yan Li Yao Li Wen-Qiang Li Shuai Ju Zhi-Hui Dong Jian-Jun Luo Vascular and wound Center Jinshan HospitalFudan UniversityShanghai 201508China department of Vascular Surgery Institute of Vascular SurgeryZhongshan Hospital Fudan UniversityShanghai 200032China department of Interventional Radiology Zhongshan Hospital Fudan UniversityShanghai 20032China

BACKGROUND Transjugular intrahepatic portosystemic shunt(TIPS)is a pivotal intervention for managing esophagogastric variceal bleeding in patients with chronic hepatic *** To evaluate the efficacy of digital subtraction angiography image overlay tech-nology(DIT)in guiding the TIPS *** We conducted a retrospective analysis of patients who underwent TIPS at our hospital,comparing outcomes between an ultrasound-guided group and a DIT-guided *** analysis focused on the duration of the portosystemic shunt puncture,the number of punctures needed,the total surgical time,and various clinical indicators related to the *** The study included 52 patients with esophagogastric varices due to chronic hepatic *** demonstrated that the DIT-guided group expe-rienced significantly shorter puncture times(P<0.001)and surgical durations(P=0.022)compared to the ultrasound-guided ***,postoperative assessments showed significant reductions in aspartate aminotransferase,B-type natriuretic peptide,and portal vein pressure in both ***,the DIT-guided group also showed significant reductions in total bilirubin(P=0.001)and alanine aminotransferase(P=0.023).CONCLUSION The use of DIT for guiding TIPS procedures highlights its potential to enhance procedural efficiency and reduce surgical times in the treatment of esophagogastric variceal bleeding in patients with chronic hepatic schistoso-miasis.

关键词： Portal hypertension Digital subtraction angiography Image overlay technology Hepatic artery labeling Transjugular intrahepatic portosystemic shunt

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Music as medicine for traumatic brain injury:a perspective on future research directions

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Neural Regeneration Research 2024年第10期19卷 2105-2106页

作者： Anthony E.Kline Eleni H.Moschonas Corina O.Bondi department of Physical Medicine&Rehabilitation University of PittsburghPittsburghPAUSA Safar Center for Resuscitation Research University of PittsburghPittsburghPAUSA Center for Neuroscience University of PittsburghPittsburghPAUSA department of Critical care Medicine University of PittsburghPittsburghPAUSA Center for the Neural Basis of Cognition University of PittsburghPittsburghPAUSA department of Psychology University of PittsburghPittsburghPAUSA department of Neurobiology University of PittsburghPittsburghPAUSA

Traumatic brain injury(TBI) impacts 69 million individuals globally each year and is a leading cause of death and disability(Dewan et al.,2019).The majority of moderate-to-severe TBI survivors endure long-lasting disturbances in motor,cognitive,and affect that negatively impacts their *** a plethora of research on pharmacological interventions for TBI has been conducted,none has translated to the clinic,thus advocating for the evaluation of nonpharmacological therapeutic approaches that may increase translational success.

关键词： injury traumatic

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Degradation Rate Assessment of Biodegradable Magnesium Alloys

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Materials Sciences and Applications 2024年第8期15卷 245-252页

作者： Bianmei Cao Limei Cao David F. Kallmes department of Radiology Mayo Clinic Rochester MN USA National Institutes for Food and Drug Control Beijing China

Biodegradable magnesium alloys have been widely used in medical implants. But safety concerns were put forward for the high degradation rate of biodegradable magnesium alloy. The optimal biodegradable magnesium alloys that give rise to the desired degradation rate hasn’t yet to be defined. Assessing the degradation rate of biodegradable magnesium alloys involves in vitro testing, in vivo testing, numerical modeling, understanding the factors influencing their degradation in physiological environments, biocompatibility testing, and clinical studies. It is important to standardize analytical tools aimed at assessing the degradation rate of biodegradable magnesium alloys. It is advisable to identify the threshold for safe degradation rate of biodegradable magnesium alloys in biomedical applications.

关键词： Magnesium Alloys Biomedical Application Biodegradation Degradation Rate Biocompatibility

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In-Hospital Outcomes in Minimally Invasive Mitral Valve Surgery: First Results in a Brazilian Single Center

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Open Journal of Thoracic Surgery 2024年第1期14卷 17-28页

作者： Daniel de Magalhães Freitas João Alberto Pansani Max Weyler Nery Stanlley de Oliveira Loyola Maurício Lopes Prudente Giulliano Gardenghi Artur Henrique de Souza department of Cardiovascular Surgery Encore Hospital Aparecida de Goiania Brazil Anesthesia clinic (Clianest) Goiania Brazil

Introduction: Treatments for cardiovascular diseases have increasingly evolved with the tendency to offer minimally invasive or transcatheter procedures instead of conventional sternotomy surgery. In this context, we highlight minimally invasive mitral valve surgery (MIMVS), which has been shown to be an increasingly solid option with some superior results when compared to the conventional technique: better pain control, shorter hospital stays, shorter recovery time, shorter readmission rate in the first postoperative year, better aesthetic results, and lower overall cost. Aim: This study aims to evaluate the stages of MIMVS, by primary mitral valve consultation, in our service and compare these results with data from the literature. Methods: All electronic medical records of patients who underwent MIMVS for primary mitral valve injury in the Encore Hospital from January 2020 to February 2023 were analyzed. Tabulation and statistical analysis were performed using the Microsoft Excel® program. Quantitative variables were presented as means, standard deviations. Results: 46 patients were enrolled in our study (Age: 59.1 ± 12.4 years old;60.8% Female, BMI: 26 ± 4.4 Kg/m2, Low risk STS score: 82.6%). The observed 30-day mortality was 2.1%, plastic rate of 23.9%, blood transfusion rate of 41.3%, length of stay in an intensive care bed (ICB) of 3.3 ± 3.3 days and hospital stay of 6.4 ± 5.1 days. Conclusions: We noticed that the MIMVS results carried out in our service agree with data from national and international literature with approximately 1.3 days more hospitalization in ICB.

关键词： Minimally Invasive Surgical Procedures Mitral Valve Outcome Assessment Health care

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The genomic and immunogenomic landscape of mechanics pathway informs clinical prognosis and response to mechanotherapy

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Science China(Life Sciences) 2024年第8期67卷 1549-1562页

作者： Peidong Zhang Peiwei Li Muya Tang Ryan CGimple Liang Huang Jing Yue Qiuhong Shen Yiwei Du Qian Zhang Zhengnan Yang Haihuai He Kailin Yang Linjie Zhao Shengtao Zhou department of Obstetrics and Gynecology Key Laboratory of Birth Defects and Related Diseases of Women and Children of MOEState Key Laboratory of BiotherapyWest China Second HospitalSichuan University and Collaborative Innovation CenterChengdu 610041China Physician Scientist Training Program Department of MedicineWashington University School of MedicineSt.Louis 63110USA department of Neurosurgery State Key Laboratory of BiotherapyWest China HospitalSichuan University and Collaborative Innovation CenterChengdu 610041China department of Radiation Oncology Taussig Cancer CenterCleveland ClinicCleveland 44106USA

Mechanics shape cell and tissue plasticity and maintain their *** cancers,mechanical signals regulate cancer hallmarks via mechanotransduction pathways,such as proliferation,metastasis and metabolic ***,comprehensive characterization of mechanotransduction pathway genes and their clinical relevance across different cancer types remains ***,we systematically portrayed the alterations of mechanotransduction pathway genes across 31 cancer types using The Cancer Genome Atlas(TCGA)*** the cancer types could be categorized into 6 subtypes based upon the transcriptional pattern of mechanics pathway *** subtype has its own unique molecular expression pattern,mutation landscapes,immune infiltrates,and patient clinical *** further found that the responses of two subtypes of cancers,one with the optimal outcome and the other with the worst prognosis,to a classical mechanotherapeutic agent(Fasudil,RhoA/ROCK inhibitor)were totally different,indicating that our cancer stratification system based upon mechanotransduction pathway genes could inform clinical responses of patients to mechanotherapeutic ***,our study provides a novel pan-cancer landscape of the mechanotransduction pathways and underscores its potential clinical significance in the prediction of clinical prognosis and therapeutic responses to mechanotherapy among cancer patients.

关键词： pan-cancer cancer mechanics multi-omics immunology

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Delphi study for developing a checklist of adverse events associated with acupotomy

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Journal of Integrative Medicine 2024年第5期22卷 579-587页

作者： Hyungsun Jun Haebeom Lee Sang-Hoon Yoon Chan-Young Kwon Damin Jeon Jun-Hwan Lee Jungtae Leem department of Diagnostics College of Korean Medicine Wonkwang University 7Days Inc. Chung-Yeon Korean Medicine clinic department of Oriental Neuropsychiatry Dong-Eui University College of Korean Medicine Chonnam National University Hwasun Hospital KM Science Research Division Korea Institute of Oriental Medicine department of Korean Convergence Medical Science KIOM School University of Science & Technology (UST) department of Physical Medicine and Rehabilitation Spaulding Rehabilitation Hospital Harvard Medical School Research Center of Traditional Korean Medicine College of Korean Medicine Wonkwang University

Background: Acupotomy, a more invasive procedure than acupuncture, involves the use of a thicker needle with an integrated knife at the tip, necessitating safety research. We aimed to define relevant adverse events(AEs) and create a standardized form of the ACUPOtomy-related AEs CHECKlist(ACUPOCHECK).Methods: Before conducting the Delphi process, a systematic review and pilot prospective study were conducted to gather information on previously reported AEs. Using these data, pilot versions of the ACUPOCHECK and Delphi questionnaires were developed. The Delphi questionnaire involved selecting types of AE for inclusion, establishing separate criteria for acupotomy-related AEs, and achieving a consensus on AE assessment. Thirteen Korean doctors with experience in acupotomy or AE research were recruited to participate in each Delphi round. Consensus was considered to have been reached if the critical value for the content validity ratio met or exceeded ***: The final ACUPOCHECK was developed using four rounds of the Delphi method and one face-toface consensus meeting. It included 12 local AEs(pain, hemorrhage, bruise, hematoma, edema, pruritus,rash, infection, nerve damage, dysesthesia, movement impairment, and pneumothorax) and 14 systemic AEs(disease aggravation, needle fatigue, sleepiness, procedural nausea, procedural vomiting, procedural headache, procedural dizziness, sweating, procedural shock, syncope, dyspnea, procedural pain, sleep disorder, and postprocedural infection). Separate criteria were established for pain, hemorrhage and bruising: pain was defined as pain that occurrs during daily activities and persists for longer than 72 h,hemorrhage as bleeding that continues for ≥ 3 min despite pressure application, and bruising as having a bruise with a diameter of ≥ 3 cm. Open-ended descriptions were allowed for AEs not covered by the checklist, and severity and causality were assessed using the Common Terminology Criteria for Adverse Events and modif

关键词： Acupotomy Delphi technique Patient safety Safety management Adverse event

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