Hasil untuk "Internal medicine"

M. Jacob, A. Lopata, M. Dasouki et al.

Muthmainnah Muthmainnah, Galuh Mega Kurnia, Avinka Nugrahani

Introduction With Indonesia ranking top in the Association of Southeast Asian Nations for the number of smokers aged 13–15 years, this study aims to analyze the factors associated with smoking prevention behavior among students of senior high school. Methods This cross-sectional pilot study, conducted in 2022 with 90 samples of grade 10–11 students at SMA Negeri 1 Taman Sidoarjo East Java Indonesia, examined variables such as perceived vulnerability (the belief about the risk of experiencing a health issue), severity (the belief about the seriousness of the health issue), benefits (the belief in the benefit of taking preventive actions), barriers (the perceived obstacles to performing preventive behaviors), self-efficacy (the confidence in one's ability to perform preventive behaviors successfully), and cues to action (factors that trigger the decision to engage) in relation to health behaviors. Data were analyzed using the chi-squared test. Results The chi-squared analysis showed significant associations between several factors and smoking prevention behavior. For perceived susceptibility, 34.4% with high susceptibility had good behavior, and 13.3% had not good behavior (p=0.000). For perceived severity, 33.3% with high severity exhibited good behavior, and 21% had not good behavior (p=0.002). Regarding perceived benefits, 28.9% with high benefits showed good behavior, while 22.6% had not good behavior (p=0.018). Self-efficacy indicated 36.7% with high self-efficacy demonstrated good behavior versus 25.8% with not good behavior (p=0.001). Cues to action revealed that 28.9% with high cues had good behavior, and 18.9% did not have good behavior (p=0.003). No association was found for perceived barriers (p=0.386). Conclusions The level of smoking prevention behavior is influenced by perceived susceptibility, severity, benefits, self-efficacy, and cues to action. Therefore, more intensive and targeted efforts are needed to promote awareness of the dangers of smoking and to enhance adolescents' self-efficacy in preventing smoking.

Ho Cheol Kim, Sydney Guthrie, Christopher S. King et al.

Abstract Idiopathic pulmonary fibrosis (IPF) is a progressive interstitial lung disease with a highly variable clinical course. Forced vital capacity (FVC) is widely used as a marker of disease severity and progression, yet its variability and dependence on patient effort raise concerns regarding its reliability. Given these limitations, we investigated the clinical significance of slow vital capacity (SVC) as a potential alternative measure of lung function in IPF. In a retrospective cohort of 89 IPF patients who underwent pulmonary function testing with concomitant SVC measurements, we observed a strong correlation between FVC and SVC (r = 0.973 at baseline, r = 0.978 at follow-up). However, in 99% of cases, SVC values were equal to or exceeded FVC, and follow-up assessments revealed that FVC exhibited greater variability than SVC. Notably, patients with a decrease in SVC demonstrated worse survival outcomes, whereas FVC decline did not show the same prognostic significance. These findings suggest that SVC may provide a more stable and clinically meaningful measure of disease progression in IPF. Moreover, its less effort-dependent nature could improve reproducibility, particularly in patients with advanced diseases. Our study highlights the potential role of SVC as a valuable metric in clinical practice and as an endpoint in future IPF trials. Prospective validation of these findings could further establish SVC as a superior tool for disease monitoring and therapeutic assessment.

Hengjin Ke, Cang Cai, Jia Wu et al.

Chuan Wang, Qian Wang, Guangming Xu et al.

Prolonged or repeated exposure to stress elevates the risk of various psychological diseases, many of which are characterized by central nervous system dysfunction. Recent studies have demonstrated that circular RNAs (circRNAs) are highly abundant in the mammalian brain. Although their precise expression and function remain unknown, they have been hypothesized to regulate transcriptional and post-transcriptional gene expression. In this investigation, we comprehensively analyzed whether restraint stress for 2 days altered the circRNA expression profile in the amygdala of male rats. The impact of restraint stress on behavior was evaluated using an elevated plus maze and open field test. Serum corticosterone levels were measured using an enzyme-linked immunosorbent assay. A total of 10,670 circRNAs were identified using RNA sequencing. Ten circRNAs were validated by reverse transcription and quantitative polymerase chain reaction analysis. Gene ontology and Kyoto encyclopedia of genes and genomes pathway analyzes supported the notion that genes associated with differentially expressed circRNAs are primarily implicated in neuronal activity and neurotransmitter transport. Moreover, the three differentially expressed circRNAs showed high specificity in the amygdala. Overall, these findings indicate that differentially expressed circRNAs are highly enriched in the amygdala and offer a potential direction for further research on restraint stress.

Izabela Hądzlik, Klaudia Wojtyła, Marta Barg

Behavioural addictions, also known as non-substance-related addictions, encompass a range of compulsive behaviours that closely mirror substance use disorders in their effects on the brain's reward system and the individual's daily life. These addictions include, but are not limited to, gambling disorder, internet gaming disorder, compulsive shopping, and the focus of this review - exercise addiction. Exercise addiction is characterized by an intense, uncontrollable urge to engage in physical activity, despite potential negative consequences. Unlike substance use disorders, exercise addiction often remains underrecognized, overshadowed by the widespread promotion of regular physical activity as a healthy lifestyle choice. This review aims to offer a comprehensive overview of exercise addiction, covering its psychological origin and characteristics, diagnostic criteria, co-occurrence with other psychiatric disorders, epidemiology among athletes and management strategies.

Shuai Zhang, Yan Liu, Fangfang Liu et al.

Abstract Background Left ventricular global longitudinal strain (GLS) holds greater diagnostic and prognostic value than left ventricular ejection fraction (LVEF) in the heart failure (HF) patients. The triglyceride-glucose (TyG) index serves as a reliable surrogate for insulin resistance (IR) and is strongly associated with several adverse cardiovascular events. However, there remains a research gap concerning the correlation between the TyG index and GLS among patients with chronic heart failure (CHF). Method 427 CHF patients were included in the final analysis. Patient demographic information, along with laboratory tests such as blood glucose, lipids profiles, and echocardiographic data were collected. The TyG index was calculated as Ln [fasting triglyceride (TG) (mg/dL) × fasting plasma glucose (FPG) (mg/dL)/2]. Results Among CHF patients, GLS was notably lower in the higher TyG index group compared to the lower TyG index group. Following adjustment for confounding factors, GLS demonstrated gradual decrease with increasing TyG index, regardless of the LVEF level and CHF classification. Conclusion Elevated TyG index may be independently associated with more severe clinical left ventricular dysfunction in patients with CHF.

Francesca Mancuso, Iva Arato, Catia Bellucci et al.

IntroductionAmong substances released into the environment by anthropogenic activities, the heavy metal cadmium (Cd) is known to induce severe testicular injury causing male subfertility/infertility. Zinc (Zn) is another heavy metal that, unlike Cd, is physiologically present in the testis, being essential for spermatogenesis. We aimed to examine the possibility that 50 µM ZnCl2 could counteract the toxic effects induced by Cd in an in vitro model of porcine prepubertal Sertoli cells (SCs) exposed to both subtoxic (5 μM) and toxic (10 μM) concentrations of CdCl2 for 48 h.Materials and MethodsApoptosis, cell cycle, and cell functionality were assessed. The gene expression of Nrf2 and its downstream antioxidant enzymes, ERK1/2, and AKT kinase signaling pathways were evaluated.Materials and ResultsWe found that Zn, in co-treatment with subtoxic and toxic Cd concentration, increased the number of metabolically active SCs compared to Cd exposure alone but restored SC functionality only in co-treatment with subtoxic Cd concentration with respect to subtoxic Cd alone. Exposure of Cd disrupted cell cycle in SCs, and Zn co-treatment was not able to counteract this effect. Cd alone induced SC death through apoptosis and necrosis in a dose-dependent manner, and co-treatment with Zn increased the pro-apoptotic effect of Cd. Subtoxic and toxic Cd exposures activated the Nrf2 signaling pathway by increasing gene expression of Nrf2 and its downstream genes (SOD, HO-1, and GSHPx). Zn co-treatment with subtoxic Cd attenuated upregulation on the Nrf2 system, while with toxic Cd, the effect was more erratic. Studying ERK1/2 and AKT pathways as a target, we found that the phosphorylation ratio of p-ERK1/2 and p-AKT was upregulated by both subtoxic and toxic Cd exposure alone and in co-treatment with Zn.DiscussionOur results suggest that Zn could counteract Cd effects by increasing the number of metabolically active SCs, fully or partially restoring their functionality by modulating Nrf2, ERK1/2, and AKT pathways. Our SC model could be useful to study the effects of early Cd exposure on immature testis, evaluating the possible protective effects of Zn.

Christie A. Befort, Kathryn M. Ross, David M. Janicke et al.

Abstract Objective The transition to parenthood is associated with worsening health behaviors, yet the impact of parental status on successful weight loss has rarely been examined. The purpose of this study was to examine the effect of parental status of minor children on weight loss and behavioral adherence in a rural community‐based weight loss intervention. Methods Five hundred and twenty‐eight adults (age 21–75 years, body mass index [BMI] 30–45 kg/m2) were enrolled in a group‐based weight loss intervention consisting of 16 weekly sessions delivered in face‐to‐face group sessions at Cooperative Extension Service (CES) offices. Participants who were parents with at least one minor child (≤18 years old) in the home were compared to participants with no minor children in the home. Measures included percent weight loss, session attendance, adherence to self‐monitoring, and achieving calorie and physical activity goals. Results Compared to participants without minor children, parents with minor children lost significantly less weight (7.5% vs. 6.2%, respectively; p = 0.01), and were less likely to lose ≥5% of baseline weight (59.2% vs. 70.2%, respectively; p = 0.02). In addition, parents with minor children attended significantly fewer sessions, had lower adherence to self‐monitoring, and met calorie and step goals less often (all ps < 0.001). The association between parental status and percent weight loss was not significantly moderated by gender of the parent. Conclusions Parents of minor children had greater difficulty adhering to intervention goals and lost less weight than participants without minor children. Future research should investigate whether tailoring intervention to meet the unique needs of parents can enhance outcomes, especially given the large segment of the population represented by this group.

G. Alekhya, Prajna Paramita Giri, Arjun M.C. et al.

Vaccination is a critical tool in protecting against COVID-19. It is essential to know the time for each activity in a COVID-19 vaccination process for better management, especially during a pandemic. Thus, we conducted a time-motion study to identify activities that led to delayed/increased waiting time in an urban primary health center in Bhubaneswar, India. We observed 196 COVID-19 vaccine beneficiaries over one month (June 2021) from when they arrived at the vaccination center until they left the center. A data collection form and a Stopwatch were used to estimate the time taken for various activities involved in COVID-19 vaccine delivery. The time taken was expressed in mean and median. We also compared the time taken during the first and second doses using the Mann-Whitney U test. The total mean time spent at the vaccination center was 40:56 ± 20:52 minutes. The activity that took the longest was ‘waiting time in queue before vaccination’, which was 34:22 ± 20:56 min constituting 82% of the total time. The activity that took longer for the second dose than the first was the beneficiary verification in the Co-WIN portal with a median of 27 seconds and 36 seconds, respectively (p < .001). This study will help program managers formulate better strategies to improve the vaccination process making it more efficient.

Ridhima Kapoor, Manisha Sabharwal, Suparna Ghosh-Jerath

In India, indigenous communities are nutritionally vulnerable, with indigenous women suffering the greater burden. Studies and surveys have reported poor nutritional outcomes among indigenous women in India, yet systematic documentation of community-specific nutrition data is lacking. We conducted a narrative review of 42 studies to summarise the nutritional profile of indigenous women of India, with details on their food and nutrient intakes, dietary diversity, traditional food consumption and anthropometric status. Percentage deficits were observed in intake of pulses, green leafy vegetables, fruits, vegetables, flesh foods and dairy products when compared with recommended dietary intakes for moderately active Indian women. Indices of diet quality in indigenous women were documented in limited studies, which revealed poor dietary diversity as well as low consumption of diverse traditional foods. A high risk of nutritional inadequacy was reported in all communities, especially for iron, calcium, and vitamin A. Prevalence of chronic energy deficiency was high in most communities, with dual burden of malnutrition in indigenous women of north-eastern region. Findings from this review can thus help guide future research and provide valuable insights for policymakers and program implementers on potential interventions for addressing specific nutritional issues among indigenous women of India.

Qinyang Yu, Qinyang Yu, Wangyang Liu et al.

Stroke is one of the leading causes of death and disability worldwide. However, there is a lack of effective medications to speed up the recovery process. Ischemic stroke, as the result of cerebral infarction or cerebral artery narrowing, is accompanied by hemiplegia or impaired consciousness. There are many transcription factors involved in the development of this condition, whose alterations can influence or signal the prognostic outcomes of ischemic stroke. Among them, the augmented expression of specificity protein 1 (SP1) can participate in the progression of the disease by binding DNA to regulate the transcriptions of many genes. Different studies have provided different answers as to whether SP1 plays a positive or a negative role in ischemic stroke. On the one hand, SP1 can play a cytoprotective role as both an antioxidant and anti-apoptotic agent for neurons and glial cells. On the other hand, it can also damage neuronal cells by promoting inflammation and exacerbating brain edema. In this review, we highlight the roles of SP1 in ischemic stroke and shed light on the underlying mechanism.

Abdulmecit Yildiz, Suat Akgür, Alparslan Ersoy et al.

Herpes zoster causes an acute dermatomal infection with vesicular rash associated with reactivation of the Varicella zoster virus. The infection usually involves the thoracic, cervical, ophthalmic and lumbosacral regions. Herpes zoster infection is common after solid organ transplantation. Herpes zoster ophthalmicus is a rare form of Herpes zoster infection and involves the ophthalmic branch of the trigeminal nerve along the V1-V2 dermatomes. Herein, we reported a kidney recipient who developed Herpes zoster ophthalmicus infection after transplantation.

Wei Zhao, Jinping Zhang, Yun Song et al.

Abstract Background Contrast-induced encephalopathy (CIE) is a well-known complication of iodinated contrast agents during angiography and vascular interventions. It can manifest as hemiparesis, cortical blindness, speech changes, Parkinsonism, confusion, seizure, and coma. Most of the reported CIE cases have been transient and reversible. Irreversible fatal CIE cases have been rarely reported. All the fatal CIE cases reported involved the use of ionic high osmolar contrast agents. Here, we document a heretofore unreported fatal CIE after digital subtraction angiography (DSA) using iopamidol, which is a type of non-ionic monomer low osmolar contrast agent. Case presentation A 71-year-old woman was admitted to our Department of Neurology for tinnitus in the head. The cerebral magnetic resonance angiography (MRA) detected atherosclerotic cerebral arteries and bilateral stenosis of the middle cerebral arteries. The patient underwent DSA for further diagnostic work-up. The total amount of iopamidol used during the procedure was 110 ml. The patient experienced headache during the procedure, followed by dizziness with nausea and vomiting. Despite treatment with anti-oedema medications, her clinical status was gradually deteriorating and ended up with deep coma due to irreversible cerebral oedema which was confirmed by cerebral computed tomography (CT). Finally, the patient died 56 days after the procedure due to irreversible fatal cerebral oedema. Conclusions This report documents that iopamidol-induced encephalopathy may not always have a benign outcome and can result in irreversible fatal cerebral oedema.

Maedeh Zebardast, Maryam Danaye Tous

Background: Various factors influence the natural processing of words. The present study sought to investigate the effect of the regularity variable on the reading of words. Objectives: The participants in the study were 50 normal and 5 aphasic people (of Broca, transcortical motor and conduction aphasia types) who were selected through convenience sampling method. Materials & Methods: It was a quantitative study with quasi-experimental design. In this research, reading aloud subtest of the test 53 of the Psycholinguistic Assessment of Language Processing in Aphasia (PALPA) battery of tests was nativized and used. First, the mean and standard deviation was computed for the test scores of the two groups of participants (i.e. normal and aphasics). Regarding the aphasics’ data, after verifying their normality of distribution by Kolmogorov-Smirnov Test, paired samples t-test was used to compare the mean scores on the results of the test on regular and exception words. Results: Since normal subjects scored a perfect grade (SD=0), it was found that the regularity variable had no effect on the reading process in these individuals. Based on the results of paired samples t-test in the aphasic subjects (P=0.25), it was found that the regularity variable in these individuals has no effect on their reading process, too. Conclusion: The evidence from the present study shows that the word regularity has no impact on the reading of words in both normal and aphasic adults. The theoretical and clinical implications of the findings would be discussed.

Majd AlGhatrif, Ariel Zane, Matt Oberdier et al.

BackgroundLower muscle mitochondrial energy production may contribute to impaired walking endurance in patients with peripheral arterial disease. A borderline ankle‐brachial index (ABI) of 0.91 to 1.10 is associated with poorer walking endurance compared with higher ABI. We hypothesized that in the absence of peripheral arterial disease, lower ABI is associated with lower mitochondrial energy production. Methods and ResultsWe examined 363 men and women participating in the Baltimore Longitudinal Study of Aging with an ABI between 0.90 and 1.40. Muscle mitochondrial energy production was assessed by post‐exercise phosphocreatine recovery rate constant (kPCr) measured by phosphorus magnetic resonance spectroscopy of the left thigh. A lower post‐exercise phosphocreatine recovery rate constant reflects decreased mitochondria energy production.The mean age of the participants was 71±12 years. A total of 18.4% had diabetes mellitus and 4% were current and 40% were former smokers. Compared with participants with an ABI of 1.11 to 1.40, those with an ABI of 0.90 to 1.10 had significantly lower post‐exercise phosphocreatine recovery rate constant (19.3 versus 20.8 ms−1, P=0.015). This difference remained significant after adjusting for age, sex, race, smoking status, diabetes mellitus, body mass index, and cholesterol levels (P=0.028). Similarly, post‐exercise phosphocreatine recovery rate constant was linearly associated with ABI as a continuous variable, both in the ABI ranges of 0.90 to 1.40 (standardized coefficient=0.15, P=0.003) and 1.1 to 1.4 (standardized coefficient=0.12, P=0.0405). ConclusionsAn ABI of 0.90 to 1.10 is associated with lower mitochondrial energy production compared with an ABI of 1.11 to 1.40. These data demonstrate adverse associations of lower ABI values with impaired mitochondrial activity even within the range of a clinically accepted definition of a normal ABI. Further study is needed to determine whether interventions in persons with ABIs of 0.90 to 1.10 can prevent subsequent functional decline.