Thursday, March 4, 2021

A multidisciplinary approach to the management of liver disease and alcohol disorders in psychiatric settings (Review)

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Exp Ther Med. 2021 Mar;21(3):271. doi: 10.3892/etm.2021.9702. Epub 2021 Jan 25.

ABSTRACT

Society is burdened with the uncontrolled use of alcohol, an ongoing issue, with a substantial associated morbidity and a pressing economical reverberation. It is inevitable that a series of psychiatric patients who display alcohol disorders will be admitted to hospital while also suffering from health conditions, such as liver disease, due to the consumption of alcohol. Managing comorbid patients in a psychiatric facility is a delicate matter that requires a collaborative team. The aim of this systematic paper is to highlight the following: The possibility of treating alcohol use disorder (AUD) and alcohol withdrawal syndrome (AWS) overlapping alcohol liver disease (ALD) within a psychiatric institution, and the importance of a collaborative multidisciplinary team; correctly dosing psychoactive medication when metabolism is affected by ALD; decidi ng when is it necessary to seek a transfer to a general hospital. Prescribing medication in patients suffering from ALD is still a not a fully documented territory. Protein binding, metabolism, bioavailability, extraction ratios, excretion route, and half-life must be taken into consideration as well as frequently repeating liver panels. Studies suggest that short-acting benzodiazepines are preferred over their alternatives when treating AWS in ALD. All anticonvulsants can be used in patients with decompensated liver disease with caution, although newer generation antiepileptic agents should be first line. Propofol is favored to benzodiazepines or opioids in the case of decompensated cirrhosis. Patients with ALD are likely to be further compromised by the potential hepatocytotoxicity of some pharmacological agents. On that account, having an integrated perspective of the medical case while taking into consideration the underlying illness as well as possible drug interaction is cruci al in treating AUD or AWS in a psychiatric institution.

PMID:33603878 | PMC:PMC7851668 | DOI:10.3892/etm.2021.9702

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HSP70 expression before and after treatment and its clinical value in patients with acute angle-closure glaucoma

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Exp Ther Med. 2021 Mar;21(3):253. doi: 10.3892/etm.2021.9683. Epub 2021 Jan 25.

ABSTRACT

The present study aimed to explore the clinical role of heat shock protein 70 (HSP70) in patients with acute angle-closure glaucoma (AACG). Seventy-four AACG patients who were admitted to our hospital from April 2017 to April 2019 were enrolled as a study group (SG). A further 70 healthy people undergoing physical examinations during the same period were enrolled as a control group (CG). HSP70 concentration was compared between the two groups, and the clinical value of this protein in AACG was analyzed. HSP70 concentration in SG was significantly lower than that in CG (P<0.050). The sensitivity and specificity of HSP70 for diagnosing AACG were 79.73 and 74.29%, respectively (P<0.001). HSP70 concentration was positively correlated with central anterior chamber depth and peripheral anterior chamber depth, but negatively correlated with anterior angle and intraocular pressure (P<0.001). HSP70 had a relatively satisfactory predictive value for adverse reactions during the treatment (P<0.001). HSP70 concentration was markedly reduced in AACG patients, and its detection had a relatively satisfactory predictive value for AACG. Thus, HSP70 may be a potential and notable indicator for diagnosing and treating glaucoma in the future.

PMID:33603860 | PMC:PMC7851605 | DOI:10.3892/etm.2021.9683

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Neurobiology of sleep (Review)

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Exp Ther Med. 2021 Mar;21(3):272. doi: 10.3892/etm.2021.9703. Epub 2021 Jan 25.

ABSTRACT

Sleep is a physiological global state composed of two different phases: Non-rapid eye movement (NREM) and rapid eye movement (REM) sleep. The control mechanisms of sleep manifest at the level of genetic, biological and cellular organization. Several brain areas, including the basal forebrain, thalamus, and hypothalamus, take part in regulating the activity of this status of life. The signals between different brain regions and those from cortical areas to periphery are conducted through various neuromediators, which are known to either promote wakefulness or sleep. Among others, serotonin, norepinephrine, histamine, hypocretin (orexin), acetylcholine, dopamine, glutamate, and gamma-aminobutyric acid are known to orchestrate the intrinsic mechanisms of sleep neurobiology. Several models that explain the transition and the continuity between wakefuln ess, NREM sleep and REM sleep have been proposed. All of these models include neurotransmitters as ligands in a complex reciprocal connectivity across the key-centers taking part in the regulation of sleep. Moreover, various environmental cues are integrated by a central pacemaker-located in the suprachiasmatic nucleus-which is able to connect with cortical regions and with peripheral tissues in order to promote the sleep-wake pattern.

PMID:33603879 | PMC:PMC7851648 | DOI:10.3892/etm.2021.9703

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MicroRNA-34b-5p inhibits proliferation, stemness, migration and invasion of retinoblastoma cells via Notch signaling

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Exp Ther Med. 2021 Mar;21(3):255. doi: 10.3892/etm.2021.9686. Epub 2021 Jan 25.

ABSTRACT

Retinoblastoma (RB) is one of the most common forms of childhood intraocular cancer. While the occurrence of RB is traditionally associated with dysregulation of the RB1 gene, efforts have been made to assess the role of several other pathways that may result in RB. The Notch signaling pathway has been identified as one of the sentinel pathways in retinal development and has been indicated to serve as a tumor suppressor. However, epigenetic modifications of the Notch signaling pathway, and their consequences on tumor establishment and progression, have received little attention. The present study attempted to elucidate the microRNA (miR)-mediated dysregulation of the Notch signaling pathway and its implications on tumor initiation. Upon recruitment of patients with RB (age, 4-25 months), the levels of miR-34b-5p were determined in tumor and adjacent healthy tissues. Simultaneously, the serum levels of miR-34b-5p were measured in tumor and healthy samples using reverse transcriptase-quantitative PCR (RT-qPCR). Binding of miR-34b-5p to Notch1 and Notch2 were confirmed bioinformatically. In vitro studies were performed in Y79 and Weri-Rb-1 RB cell lines. The cell lines were transfected with miR-34b-5p constructs and miR-34b-5p overexpression was confirmed using RT-qPCR. The impact of miR-34b-5p overexpression on cell growth and cancer stemness markers (Sox-2, Nanog, and CD133) was examined. The expression levels of Notch1 and Notch2 were evaluated in the presence of miR-34b-5p. The rescue of cell growth and cancer stemness phenotypes was evaluated by co-transfection of miR-34b-5p with Notch1 or Notch2. The results of the present study indicated that the expression levels of miR-34b-5p were reduced in patient tissues and serum samples compared with those in healthy tissues and samples. Notch1 and Notch2 expression l evel was negatively correlated with the expression level of miR-34b-5p. Overexpression of miR-34b-5p resulted in reduced cell proliferation, migration, invasion and cancer stemness compared with the control group. Further in vivo experiments confirmed the inhibitory effects of miR-34b-5p on RB cell proliferation. Upon co-transfection of miR-34b-5p with Notch1 or Notch2, these phenotypes were rescued with reversal of cell growth and tumor sphere formation. Collectively, the results indicated that miR-34b-5p functions as a tumor suppressor in RB via regulating the Notch signaling pathway. Therefore, miR-34b-5p may be explored for its utility as a therapeutic target in RB.

PMID:33603862 | PMC:PMC7851672 | DOI:10.3892/etm.2021.9686

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Ultrasonography of the larynx: Novel use during the SARS-CoV-2 pandemic (Review)

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Exp Ther Med. 2021 Mar;21(3):273. doi: 10.3892/etm.2021.9704. Epub 2021 Jan 25.

ABSTRACT

Few articles have been published on the subject of laryngeal ultrasonography. However, considering the increased power and accuracy of ultrasound technology, this imaging modality should be reevaluated. The present review aimed to increase the awareness of fellow specialists regarding the use of this imaging tool in healthcare units that do not benefit from onsite ear, nose and throat (ENT) service. We illustrate the ultrasonographic examination protocol for the larynx along with the relevant anatomic landmarks. We review cases with laryngeal tumoral pathology that underwent ultrasonographic examination for improved management. All findings were confirmed through computerized tomography (CT) and endoscopy performed by the ENT specialist. The ultrasound of the larynx has potential utility in diagnosis (e.g., laryngeal abnormalities, speech and swall owing abnormalities, identification of endotracheal tube placement), treatment (e.g., guidance of percutaneous tracheostomy and cricothyrotomy) and prognosis (e.g., prediction of postextubation stridor and difficult intubation). This imaging modality could be useful in the current SARS-CoV-2 pandemics in reducing the exposure to invasive maneuvers producing aerosol, such as endoscopy.

PMID:33603880 | PMC:PMC7851652 | DOI:10.3892/etm.2021.9704

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MicroRNA-129-5p promotes proliferation and metastasis of hepatocellular carcinoma by regulating the BMP2 gene

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Exp Ther Med. 2021 Mar;21(3):257. doi: 10.3892/etm.2021.9688. Epub 2021 Jan 25.

ABSTRACT

Hepatocellular carcinoma (HCC) is a malignant tumor that poses a serious threat to human health. Due to its occult onset and rapid development, HCC is a challenge to diagnose early and effectively treat, and thus patients with HCC often have an unfavorable prognosis. MicroRNA (miR)-129 and its target gene play an important role in the regulation of various diseases. Therefore, the aim of the present study was to investigate the role and mechanism of action for miR-129-5p in the development of HCC. Quantitative results of clinical samples analyzed using reverse transcription-quantitative PCR suggested that miR-129-5p had a significantly lower expression level in tumoral tissues compared with corresponding peritumoral tissues. Overexpression of miR-129-5p in HCC cells was performed using a transfection technique, followed by MTT, Transwell, invasion and wound healing assays to detect the effect of miR-129-5p on the cell cytotoxicity and metastasis of liver cancer in vitro. The downstream target gene of miR-129-5p, bone morphogenetic protein 2 (BMP2), was determined using a luciferase reporter assay. Overexpression of miR-129-5p played a vital role in decreasing cytotoxicity and promoting metastasis of HCC, which may be attributed to its inhibitory effect on the expression of its target gene, BMP2. In clinical samples, miR-129-5p expression levels were found to be negatively correlated with BMP2 and closely associated with HCC metastasis and infiltration. Collectively, the results suggested that miR-129-5p may contribute to proliferation and metastasis of HCC through its target gene, BMP2, and thus may be a potential novel therapeutic target for the treatment of HCC.

PMID:33603864 | PMC:PMC7851647 | DOI:10.3892/etm.2021.9688

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Enterically transmitted hepatitis in the third millennium in northeastern Romania

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Exp Ther Med. 2021 Mar;21(3):274. doi: 10.3892/etm.2021.9705. Epub 2021 Jan 25.

ABSTRACT

While the incidence of hepatitis A virus (HAV) infections has decreased in the last few years, the incidence of hepatitis E virus (HEV) is increasing in developed countries. Both infections remain a worldwide reality, strongly related to socio-economic conditions. We retrospectively analyzed the medical files of patients with viral hepatitis hospitalized in the Infectious Disease Hospital Iasi, Romania between 2018 and 2019. The serological confirmed cases of HAV and HEV infections were included in the analysis; included in our analysis were 269 HAV-infected patients. The most affected were males (53.9% cases) aged between 8 and 15 years (53.6% cases). Severe infections were recorded at admission in 2.24% cases and evolution was favorable under supportive and symptomatic treatment. Only three adult males, with no recent history of travel, were conf irmed with HEV infection. Even though we have identified a small number of cases, recent studies performed in our region found a seroprevalence of 32.5% in the general population, possibly related to zoonotic transmission. While outbreaks of HAV infection are still noted in our region, a lack of hospitalized HEV-infected patients suggest that most cases are asymptomatic or underdiagnosed. HEV infection remains an underreported disease, possibly due to misdiagnosis, subclinical or dual hepatitis infection, but with a significant risk in vulnerable categories, such as pregnant women or immunosuppressed patients.

PMID:33603881 | PMC:PMC7851663 | DOI:10.3892/etm.2021.9705

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Basic biochemical and hematological parameters in perinatal asphyxia and their correlation with hypoxic ischemic encephalopathy

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Exp Ther Med. 2021 Mar;21(3):259. doi: 10.3892/etm.2021.9690. Epub 2021 Jan 25.

ABSTRACT

Perinatal hypoxic-ischemic encephalopathy (HIE) represents a major cause of neonatal death or long-term disability. Inflammation plays an important role in mediating brain damage induced by neonatal hypoxic-ischemic encephalopathy. The mechanisms underlying the inflammatory response in hypoxia and ischemia are complex and are still being extensively researched. The objective of this study was to determine the predictive value of peak lactate dehydrogenase (LDH), C-reactive protein (CRP), procalcitonin (PCT) and of the evolution of leukocytes, neutrophils and lymphocytes in the first 96 h after birth for the grade of encephalopathy and neurodevelopmental outcome in newborns with HIE. In order to reveal this relationship we used comparisons between the above mention parameters. The observed hematological changes were nonspecific. The vast majority of the 78 newborns included in the study had PCT values above normal in the first 24 h, contrasting with CRP values that were positive in only 15.8% of the patients. A total of 76.9% of the patients had LDH values higher than the upper limit of normal values. The mean LDH values in patients with an unfavorable prognosis were 1,235 U/l. We can conclude that LDH is a good predictor of HIE in the first 12/24 h after birth.

PMID:33603866 | PMC:PMC7851675 | DOI:10.3892/etm.2021.9690

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Urban allergy review: Allergic rhinitis and asthma with plane tree sensitization (Review)

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Exp Ther Med. 2021 Mar;21(3):275. doi: 10.3892/etm.2021.9706. Epub 2021 Jan 25.

ABSTRACT

Respiratory allergies represent a major public health issue in the modern world. Pollens are among the most significant causes of seasonal allergic rhinitis, with pollens of wind-pollinated trees representing an important cause. Members of the Platanaceae family (Platanus acerifolia, Platanus orientalis) are well-recognized sources of allergenic pollens worldwide, due to their high capacity of sensitization and widespread usage as ornamental urban trees. Air pollution, characteristic to all important urban conglomerates in the world and provoked by diesel exhaust gases, industrial and domestic fumes, and biogenic volatile organic compounds represents another major public health issue. Plane trees, along with other species of trees, are one of the main sources of volatile compounds. Recent studies have demonstrated a strong correlation between air pollution and respiratory allergies, with airway chemical compounds intensifying the capacity of sensitization to allergenic pollens. This study presents an overview of the known negative elements on public health of the Platanus family.

PMID:33603882 | PMC:PMC7851681 | DOI:10.3892/etm.2021.9706

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Inherited thrombophilia is significantly associated with severe preeclampsia

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Exp Ther Med. 2021 Mar;21(3):261. doi: 10.3892/etm.2021.9691. Epub 2021 Jan 25.

ABSTRACT

Methods to prevent the development of pathologies due to placental dysfunctions, such as gestational hypertension and preeclampsia, are the main approaches for obtaining the best maternal and fetal antepartum and postpartum prognosis. During 5 years of study (January, 2015 to December, 2019), the cases of pregnancy and puerperium complicated with pathology due to placental dysfunction were analyzed. The main objective was to determine the magnitude of the impact of thrombophilia on the development of an entity of gestational hypertension disorder. We compared the impact of thrombophilia and its associated complications in patients with gestational hypertension with moderate and severe preeclampsia. Thus, we found obesity, thrombophilia, and underlying cardiac pathology to be significant risk factors for severe preeclampsia. Regarding the comparativ e analysis of the risk factors and complications associated with patients with mild preeclampsia compared with those with severe preeclampsia, the presence in severe preeclampsia of thrombophilia, endocrine, liver, and cardiac pathology was higher and, a higher rate of complications was observed; complications included fetal death, intrauterine growth restriction (IUGR), prematurity, fetal arrhythmia with acute fetal distress, HELLP syndrome, and placental abruption. Thrombophilia has a significant effect on the development of severe preeclampsia, and oligohydramnios as specific complication of mild preeclampsia. Factors indicating an increased risk of progression from mild preeclampsia to severe preeclampsia are in addition to inherited thrombophilia the underlying pathologies, namely cardiac, hepatic, and endocrine factors.

PMID:33603868 | PMC:PMC7851666 | DOI:10.3892/etm.2021.9691

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