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Diagnostics (Basel, Switzerland) Oct 2023Mild traumatic brain injury (TBI) and concussion can have serious consequences that develop over time with unpredictable levels of recovery. Millions of concussions... (Review)
Review
Mild traumatic brain injury (TBI) and concussion can have serious consequences that develop over time with unpredictable levels of recovery. Millions of concussions occur yearly, and a substantial number result in lingering symptoms, loss of productivity, and lower quality of life. The diagnosis may not be made for multiple reasons, including due to patient hesitancy to undergo neuroimaging and inability of imaging to detect minimal damage. Biomarkers could fill this gap, but the time needed to send blood to a laboratory for analysis made this impractical until point-of-care measurement became available. A handheld blood test is now on the market for diagnosis of concussion based on the specific blood biomarkers glial fibrillary acidic protein (GFAP) and ubiquitin carboxyl terminal hydrolase L1 (UCH-L1). This paper discusses rapid blood biomarker assessment for mild TBI and its implications in improving prediction of TBI course, avoiding repeated head trauma, and its potential role in assessing new therapeutic options. Although we focus on the Abbott i-STAT TBI plasma test because it is the first to be FDA-cleared, our discussion applies to any comparable test systems that may become available in the future. The difficulties in changing emergency department protocols to include new technology are addressed.
PubMed: 37958226
DOI: 10.3390/diagnostics13213330 -
Journal of Asthma and Allergy 2023A significant link between T allele of the (C590T) gene and developing asthma in some populations was reported. However, no study discussed the link between (C590T)...
BACKGROUND
A significant link between T allele of the (C590T) gene and developing asthma in some populations was reported. However, no study discussed the link between (C590T) gene polymorphism and asthma severity groups (mild and severe). This study investigated the link between gene variation and asthma severity.
METHODS
The study included 215 asthmatic patients, of which 102 had mild asthma, and 126 participants were healthy controls. A previously published polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method was used to identify various (C590T) gene polymorphism genotypes.
RESULTS
The T allele frequency was higher in mild asthma (p=0.002) but not in severe asthma (p=0.12) compared to controls. In mild asthma, the CT genotype and (CT+TT versus CC) increased the likelihood of asthma threefold (p<0.001, 0.001). However, no significant association with severe asthma was found in either genetic model. Stratification analysis showed that the C allele and CC genotype increased the risk of severe asthma (p=0.01). The recessive genetic model indicated a decrease in the risk of severe asthma (OR=0.5, p=0.01) in the non-adjusted regression analysis. Adjusting for age, sex, and other risk factors revealed that the gene polymorphism did not influence the risk of severe asthma (OR=0.92, p=0.80); however, being an elderly female with a history of childhood-onset disease and associated nasal polyp (NP) increased the likelihood of severe asthma, OR=1.08, 2.01, 2.36, 8.42; p<0.001, 0.05, 0.05, <0.001, respectively.
CONCLUSION
The T allele and CT genotype in the co-dominant genetic model and the (CT+TT) genotype in the recessive model were found to have a higher likelihood of developing mild asthma but not severe asthma; severe asthma was found to be higher in elderly females with a history of childhood-onset disease and associated nasal polyps.
PubMed: 38022750
DOI: 10.2147/JAA.S429981 -
Journal of Nanobiotechnology Sep 2023Cancer therapeutic vaccine can induce antigen-specific immune response, which has shown great potential in cancer immunotherapy. As the key factor of vaccine, antigen...
Cancer therapeutic vaccine can induce antigen-specific immune response, which has shown great potential in cancer immunotherapy. As the key factor of vaccine, antigen plays a central role in eliciting antitumor immunity. However, the insufficient antigen delivery and low efficiency of antigen presentation by dendritic cells (DCs) have greatly restricted the therapeutic efficiency of vaccine. Here we developed a kind of DC hybrid zinc phosphate nanoparticles to co-deliver antigenic peptide and photosensitive melanin. Owing to the chelating ability of Zn, the nanoparticles can co-encapsulate antigenic peptide and melanin with high efficiency. The nanovaccine showed good physiological stability with the hydration particle size was approximately 30 nm, and zeta potential was around - 10 mV. The nanovaccine showed homologous targeting effect to DCs in vivo and in vitro, efficiently delivering antigen to DCs. Meanwhile, the nanovaccine could effectively reflux to the tumor-draining lymph nodes. When combined with near-infrared irradiation, the nanovaccine induced effective mild heat in vitro and in vivo to promote antigen presentation. After administrating to MC38 tumor-bearing mice, the hybrid nanovaccine effectively promoted the maturation of DCs, the expansion of cytotoxic T lymphocytes and helper T cells, and the secretion of immunostimulatory cytokines, thereby significantly inhibiting tumor growth.
Topics: Animals; Mice; Hot Temperature; Melanins; Immunotherapy; Immunization; Cancer Vaccines; Dendritic Cells; Neoplasms
PubMed: 37752555
DOI: 10.1186/s12951-023-02106-8 -
Irish Journal of Medical Science Aug 2023Molnupiravir is an oral antiviral drug that received Emergency Use Authorization in three countries for the treatment of mild COVID-19. The aim of this systematic review... (Review)
Review
BACKGROUND
Molnupiravir is an oral antiviral drug that received Emergency Use Authorization in three countries for the treatment of mild COVID-19. The aim of this systematic review was to find out the safety and efficacy of Molnupiravir in SARS-COV-2 infections.
METHODS
The electronic databases such as PubMed, MedRxiv, BioRxiv, FDA, ClinicalTrials.Gov, ctri.nic.in and Google Scholar were searched for articles from January 2021 to March 2022 using the keywords such as "Molnupiravir", "COVID-19", "Oral antiviral pill", "MK-4482", "EIDD-280", "Efficacy" and "Safety". Details of published, unpublished with interim reports and ongoing studies of Molnupiravir in COVID-19 were retrieved, and a systematic review was performed.
RESULTS
A total of 6 articles and 18 ongoing trials data were collected. Out of these, data from 4 published and 2 unpublished with interim reports were extracted. After review of these studies, it was observed that the daily dose of 1600 mg Molnupiravir for 5 days was safe and tolerable with nausea, diarrhea and headache as the common adverse effects. The results also showed significant decrease in time to viral clearance with 800 mg twice daily in mild patients and reduction in the risk of hospitalization or death by 50% in non-hospitalized COVID-19 patients.
CONCLUSION
Evidence from clinical studies showed that Molnupiravir caused significant reduction in the risk of hospitalization or death in high-risk mild COVID-19 patients. Molnupiravir was also found to be well tolerated and safe without any major adverse events on short-term use. For confirmative use of this drug in mild-to-moderate COVID-19 disease, further studies are required in vaccinated COVID-19 patients and against emerging variants.
Topics: Humans; COVID-19; SARS-CoV-2; Databases, Factual; Drug-Related Side Effects and Adverse Reactions
PubMed: 36087236
DOI: 10.1007/s11845-022-03139-y -
Investigative Ophthalmology & Visual... Jul 2023Information on the relationship between meibum lipid composition and severity of meibomian gland dysfunction (MGD) is limited. The purpose of this study was to analyze...
PURPOSE
Information on the relationship between meibum lipid composition and severity of meibomian gland dysfunction (MGD) is limited. The purpose of this study was to analyze the molecular components of meibum collected from individuals with no MGD, mild-to-moderate MGD, and severe MGD.
METHODS
Adults with and without MGD were enrolled in a prospective, multicenter, exploratory clinical trial (ClinicalTrials.gov Identifier: NCT01979887). Molar ratios of cholesteryl ester to wax ester (RCE/WE) and aldehyde to wax ester (Rald/WE) in meibum samples were measured with 1H-NMR spectroscopy. Results were evaluated for participants grouped by MGD disease status and severity (non-MGD, mild-to-moderate MGD, and severe MGD), as defined by maximum meibum quality scores, Schirmer test results, and Subject Ocular Symptom Questionnaire responses.
RESULTS
Sixty-nine meibum samples from 69 individuals were included in the analysis: 24 non-MGD, 24 mild-to-moderate MGD, and 21 severe MGD. Mean RCE/WE was 0.29 in non-MGD, 0.14 in mild-to-moderate MGD (P = 0.038 vs. non-MGD, 51% lower), and 0.07 in severe MGD (P = 0.16 vs. mild-to-moderate MGD, 52% lower; P = 0.002 vs. non-MGD, 76% lower). Mean Rald/WE was 0.00022 in non-MGD, 0.00083 in mild-to-moderate MGD (P = 0.07 vs. non-MGD, 277% higher), and 0.0024 in severe MGD (P = 0.003 vs. mild-to-moderate MGD, 190% higher; P < 0.001 vs. non-MGD, 992% higher).
CONCLUSIONS
RCE/WE was lowest and Rald/WE was highest in the severe MGD cohort, suggesting that these meibum constituent molar ratios may result from the pathophysiology associated with MGD and can impact ocular surface lipid and tear film homeostasis. These findings may potentially help identify targets for MGD treatment.
Topics: Adult; Humans; Meibomian Gland Dysfunction; Tears; Prospective Studies; Meibomian Glands; Eyelid Diseases; Cholesterol Esters
PubMed: 37466951
DOI: 10.1167/iovs.64.10.22 -
Clinical, Cosmetic and Investigational... 2023Atopic dermatitis (AD) is a chronic relapsing disease with a pathophysiology including skin barrier damage, microbiome disbalance and inflammation. Classically,...
INTRODUCTION
Atopic dermatitis (AD) is a chronic relapsing disease with a pathophysiology including skin barrier damage, microbiome disbalance and inflammation. Classically, emollients maintaining a healthy microbiome are recommended as the basis of any AD severity management.
OBJECTIVE
To assess the benefit of a light balm containing vitamin E, tocopherol and glycerine and enriched with and microresyl (Emollient+) in subjects with mild AD over a period of 168 days.
MATERIALS AND METHODS
For this open-label study, subjects above 3 years of age with mild and stable AD for at least 6 months before inclusion and with a SCORAD score of <25 were eligible. Assessments took place at baseline, D14, D28, D84 and D168, and included SCORAD, flare frequency, severity of clinical signs and symptoms, skin hydration status using a Corneometer and local tolerance. QoL was assessed using the DLQI or CDLQI questionnaire. Subjects used Emollient+ at least once daily.
RESULTS
Overall, 56 subjects were included in this study. The mean age was 25.0±20.0 years (45% children); 69.6% were females. Except for erythema in the paediatric population, all clinical parameters had significantly (all p < 0.05) improved at D28. At D168, SCORAD, signs and symptoms had significantly (all p < 0.05) improved in the global, adult and paediatric population at D168 compared to baseline. So did flares, skin hydration and QoL. The regimen was very well tolerated.
CONCLUSION
Emollient+ is highly beneficial and well tolerated in mild AD with early benefits in improving AD signs and symptoms and skin hydration as well as the QoL of subjects as soon as D28.
CLINICALTRIALSGOV IDENTIFIER
NCT05783453.
PubMed: 37575149
DOI: 10.2147/CCID.S417622 -
Health Care Resource Use and Social Costs in Mild Cognitive Impairment and Mild Alzheimer's Disease.Journal of Alzheimer's Disease Reports 2023As the number of patients with dementia increases, so do the social costs. In recent years, attempts have been made to reduce risk to be dementia and treat it from the...
BACKGROUND
As the number of patients with dementia increases, so do the social costs. In recent years, attempts have been made to reduce risk to be dementia and treat it from the early stages of the disease, making it important to estimate the costs of the early stages.
OBJECTIVE
To estimate the medical and social costs of the early stages of Alzheimer's disease (AD), which include mild cognitive impairment (MCI) due to AD and mild AD.
METHODS
Questionnaires were used to obtain basic information (e.g., age, cognitive function) and medical costs, social care costs, family caregiver medical costs, and family caregiver informal care costs from patients with MCI due to AD or mild AD who were attending a memory clinic. A comparison was then conducted between these two groups.
RESULTS
Patients with mild AD had higher total costs, patient medical costs, patient social care costs, and family caregiver informal care costs than did patients with MCI; however, only patient medical costs were significantly different ( = 0.022). A detailed analysis of patient medical costs revealed that anti-dementia drug treatment costs were significantly higher in patients with mild AD ( < 0.001).
CONCLUSION
Compared with patients with mild AD, those with MCI may have lower patient and family caregiver costs. As it is important to reduce social costs through risk reduction and therapeutic interventions from the early stages of AD, the present findings could help estimate the social costs and verify the cost-effectiveness of early interventions for AD.
PubMed: 37483328
DOI: 10.3233/ADR-230032 -
Medicina (Kaunas, Lithuania) Feb 2024Mild Traumatic Brain Injury (mTBI) has been increasingly recognized as a public health concern due to its prevalence and potential to induce long-term cognitive... (Review)
Review
Mild Traumatic Brain Injury (mTBI) has been increasingly recognized as a public health concern due to its prevalence and potential to induce long-term cognitive impairment. We aimed to consolidate this observation by focusing on findings of neuropsychological assessments, neuroimaging, risk factors, and potential strategies for intervention to prevent and treat mTBI-associated cognitive impairments. A thorough search of PubMed, PsycINFO, and Embase databases was performed for studies published until 2024. Studies focusing on cognitive impairment after mTBI, with neurocognitive assessment as a primary outcome, were included. We found consistent evidence of cognitive deficits, such as memory and attention impairments, and affected executive functions following mTBI. Neuroimaging studies corroborate these findings, highlighting structural and functional changes in the brain. Several risk factors for developing cognitive impairment post-mTBI were identified, including age, gender, genetics, and pre-existing mental health conditions. The efficacy of interventions, including cognitive rehabilitation and pharmaceutical treatment, varied across studies. Mild TBI can lead to significant long-term cognitive impairments, impacting an individual's quality of life. Further research is necessary to validate and standardize cognitive assessment tools post-mTBI, to elucidate the underlying neural mechanisms, and to optimize therapeutic interventions.
Topics: Humans; Brain Concussion; Quality of Life; Cognitive Dysfunction; Brain; Cognition Disorders
PubMed: 38541106
DOI: 10.3390/medicina60030380 -
Medicina (Kaunas, Lithuania) Nov 2023The role of the skin-gut axis in atopic dermatitis (AD) remains a subject of debate, limiting non-pharmacological interventions such as probiotics and prebiotics. To... (Observational Study)
Observational Study
The role of the skin-gut axis in atopic dermatitis (AD) remains a subject of debate, limiting non-pharmacological interventions such as probiotics and prebiotics. To improve understanding of their potential as a monotherapy for stable mild cases, we conducted a real-life, multicenter, retrospective observational study in Italy. We administered three selected bacteria ( BS01, LP14, and LR05) orally to patients with mild atopic dermatitis without a placebo control group, following up for 12 weeks. Clinical assessments using the Scoring Atopic Dermatitis (SCORAD), Eczema Area and Severity Index (EASI), and Three-Item Severity (TIS) score were conducted on 144 enrolled patients (average age: 25.1 ± 17.6 years). Notably, both pruritus and AD-related lesions (erythema, edema/papules, excoriation) exhibited significant clinical and statistical improvement ( < 0.001) after 12 weeks of exclusive probiotic and prebiotic use. These preliminary results suggest a potential link between the skin-gut microbiome and support the rationale for using specific probiotics and prebiotics in mild AD, even for maintenance, to reduce flares and dysbiosis.
Topics: Humans; Child; Adolescent; Young Adult; Adult; Prebiotics; Dermatitis, Atopic; Retrospective Studies; Probiotics; Lacticaseibacillus rhamnosus; Severity of Illness Index
PubMed: 38138183
DOI: 10.3390/medicina59122080 -
Dementia and Neurocognitive Disorders Oct 2023Facial emotion recognition deficits impact the daily life, particularly of Alzheimer's disease patients. We aimed to assess these deficits in the following three groups:...
BACKGROUND AND PURPOSE
Facial emotion recognition deficits impact the daily life, particularly of Alzheimer's disease patients. We aimed to assess these deficits in the following three groups: subjective cognitive decline (SCD), mild cognitive impairment (MCI), and mild Alzheimer's dementia (AD). Additionally, we explored the associations between facial emotion recognition and cognitive performance.
METHODS
We used the Korean version of the Florida Facial Affect Battery (K-FAB) in 72 SCD, 76 MCI, and 76 mild AD subjects. The comparison was conducted using the analysis of covariance (ANCOVA), with adjustments being made for age and sex. The Mini-Mental State Examination (MMSE) was utilized to gauge the overall cognitive status, while the Seoul Neuropsychological Screening Battery (SNSB) was employed to evaluate the performance in the following five cognitive domains: attention, language, visuospatial abilities, memory, and frontal executive functions.
RESULTS
The ANCOVA results showed significant differences in K-FAB subtests 3, 4, and 5 (=0.001, =0.003, and =0.004, respectively), especially for anger and fearful emotions. Recognition of 'anger' in the FAB subtest 5 declined from SCD to MCI to mild AD. Correlations were observed with age and education, and after controlling for these factors, MMSE and frontal executive function were associated with FAB tests, particularly in the FAB subtest 5 (=0.507, <0.001 and =-0.288, =0.026, respectively).
CONCLUSIONS
Emotion recognition deficits worsened from SCD to MCI to mild AD, especially for negative emotions. Complex tasks, such as matching, selection, and naming, showed greater deficits, with a connection to cognitive impairment, especially frontal executive dysfunction.
PubMed: 38025409
DOI: 10.12779/dnd.2023.22.4.158