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Medicina (Kaunas, Lithuania) Jun 2024: Remimazolam, a novel benzodiazepine, is used for procedural sedation and general anesthesia due to its rapid onset and short duration of action. However,... (Review)
Review
: Remimazolam, a novel benzodiazepine, is used for procedural sedation and general anesthesia due to its rapid onset and short duration of action. However, remimazolam-induced anaphylaxis (RIA) is a rare but severe complication. This study aimed to analyze RIA characteristics, focusing on cardiovascular collapse, and provide guidelines for safe remimazolam use. : This study conducted a systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. Research articles retrieved from PubMed on 26 May 2023, using the keywords 'remimazolam AND anaphylaxis' were evaluated based on the inclusion criteria of being written in English and aligning with the World Allergy Organization criteria for anaphylaxis, while studies not meeting these criteria were excluded. All published articles up to the search date were included without any date restrictions. The review analyzed factors such as age, sex, type of anesthesia, remimazolam dose (bolus/continuous), allergic symptoms and sign, epinephrine use, serum tryptase levels, and skin prick tests. : Among eleven cases, the mean age was 55.6 ± 19.6 years, with 81.8% male. Hypotension (81.8%) was the most common symptom, followed by bradycardia (54.5%) and desaturation (36.4%). Two patients experienced cardiac arrest. Serum tryptase levels confirmed anaphylaxis in ten cases. Epinephrine was the primary treatment, with intravenous doses ranging from 0.1 mg to 0.3 mg. : Vigilance is crucial when administering remimazolam, adhering to recommended dosages, and promptly treating RIA with epinephrine. Further research is needed to understand the risk factors and refine the management strategies. Guidelines for safe remimazolam use are proposed.
Topics: Humans; Anaphylaxis; Male; Benzodiazepines; Female; Middle Aged; Hypnotics and Sedatives; Adult; Aged
PubMed: 38929588
DOI: 10.3390/medicina60060971 -
International Journal of Environmental... Jun 2024This study aimed to systematically review current research on the application of existing social support scales in research with refugees in resettlement, assess their... (Review)
Review
This study aimed to systematically review current research on the application of existing social support scales in research with refugees in resettlement, assess their quality, and identify gaps in measurement to enhance research and practice. A scoping review was conducted on the extant literature published until March 2023. A team of researchers conducted search, sorting, and data extraction processes following best practices for scale development and validation. Of the 1185 studies collected from the search process, 41 articles were retained in the final analysis, from which 17 distinct social support instruments used in research with resettled refugees were identified. An assessment of all 17 instruments showed the presence of one or more limitations associated with construct, criterion, convergent, and/or discriminant validity. Test of reliability was assessed in all studies, with a range of 0.80 to 0.90. Our findings show that most of the research evaluating social support among resettled refugees is conducted without measurement instruments adequately validated in the resettlement context. This analysis highlights the need for rigorously developed social support scales that reflect the lived experiences, needs, and priorities of resettled refugees.
Topics: Refugees; Social Support; Humans; Reproducibility of Results; Surveys and Questionnaires
PubMed: 38929051
DOI: 10.3390/ijerph21060805 -
International Journal of Environmental... Jun 2024The suicide rates in Guyana, Suriname and Trinidad and Tobago are among the highest in the Americas, containing significant Indo-Caribbean populations that are suggested... (Review)
Review
The suicide rates in Guyana, Suriname and Trinidad and Tobago are among the highest in the Americas, containing significant Indo-Caribbean populations that are suggested to be most vulnerable to suicide. This systematic review analyzes the existing literature and identifies knowledge gaps in risk and protective factors against suicide in these countries. The literature search conducted followed PRISMA guidelines using the PubMed and APA PsycInfo databases. The PRISMA flow diagram illustrated that eight scholarly papers were eligible for inclusion. Included literature examined stratified data focused on the aforementioned countries, as well as their Indo-Caribbean adolescent populations. Excluded literature did not mention suicidality, adolescents, Indo-Caribbeans, or the focal countries or was focused on the Jonestown mass murder-suicide event. The studies encompassed 6581 individuals. Identified risk factors include social stigma regarding suicide, mental health resource scarcity, and difficult socioeconomic conditions. The identified protective factors for youth include religious/spiritual practices and group activities. Limitations include database quantity, risk of publication bias, and the small sample for each study. A prevailing social stigma regarding suicide was identified. Greater research is needed relating to effects of suicide legislation, bereavement experiences, sociocultural contexts, geography, migration patterns, and culturally compatible interventions to aid future suicide prevention efforts. The protocol was registered with PROSPERO (CRD42023417494).
Topics: Humans; Adolescent; Suicide; Risk Factors; Suicidal Ideation
PubMed: 38929047
DOI: 10.3390/ijerph21060801 -
International Journal of Environmental... Jun 2024Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder that is typically managed with pharmacological and psychotherapeutic... (Review)
Review
Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder that is typically managed with pharmacological and psychotherapeutic interventions. In the general population, exposure to nature has been found to have robust beneficial effects on cognitive performance, including attention. With inattention being a factor of the symptomatology of individuals with ADHD, this provides a rationale to investigate the potential benefits of exposure to nature for this population. Four electronic databases (PubMED, PsycINFO, Embase, and Web of Science) were searched for empirical studies investigating the effects of nature on ADHD prevalence and/or symptom severity in populations of school-aged children. Key characteristics, methodologies, and outcomes of included studies were extracted and evaluated. Out of the 458 studies identified, 7 met the inclusion criteria. Despite the large heterogeneity in methodological approaches, the included articles consistently reported that exposure to nature is associated with reduced ADHD diagnoses and symptom severity. Furthermore, when several covariates, such as age, gender, annual household income, parental income, and education level, as well as several pre-natal factors, were controlled for, the relationship between nature and ADHD remained significant. The reviewed literature provides strong support for the benefits of exposure to nature on ADHD in school-aged children.
Topics: Attention Deficit Disorder with Hyperactivity; Humans; Child
PubMed: 38928982
DOI: 10.3390/ijerph21060736 -
International Journal of Environmental... May 2024The National Disability Insurance Scheme (NDIS) ushered in a transformative era in disability services in Australia, requiring new workforce models to meet evolving... (Review)
Review
The National Disability Insurance Scheme (NDIS) ushered in a transformative era in disability services in Australia, requiring new workforce models to meet evolving participant needs. Therapy Assistants are utilised to increase the capacity of therapy services in areas of workforce shortage. The governance arrangements required to support this emergent workforce have received limited attention in the literature. This review examined the key components and contextual factors of governance in rural settings, specifically focusing on therapy support workers under the guidance of allied health professionals in rural and remote areas. Guided by the social model of disability and the International Classification of Functioning, Disability and Health, a realist perspective was used to analyse 26 papers (after deduplication), mostly Australian and qualitative, with an emphasis on staff capabilities, training, and credentialling. Success measures were often vaguely defined, with most papers focusing on staff improvement and few focusing on client or organisational improvement. Consistent staffing, role clarity, community collaboration, and supportive leadership were identified as enabling contexts for successful governance of disability therapy support workers in rural areas. Investment in capability (soft skills) development, tailored training, competency assessment, credentialling, and supervision were identified as key activities that, when coupled with the identified enabling contexts, were likely to influence staff, client and organisational outcomes. Further research is warranted to explore long-term impacts of governance arrangements, educational program accountability, and activities targeted at enhancing staff capabilities.
Topics: Humans; Disabled Persons; Australia; Rural Health Services; Rural Population; Allied Health Personnel
PubMed: 38928939
DOI: 10.3390/ijerph21060693 -
Diagnostics (Basel, Switzerland) Jun 2024This systematic review investigates the diagnostic, prognostic, and therapeutic implications of immunohistochemical markers in dentigerous cysts (DCs) and odontogenic... (Review)
Review
OBJECTIVE
This systematic review investigates the diagnostic, prognostic, and therapeutic implications of immunohistochemical markers in dentigerous cysts (DCs) and odontogenic keratocysts (OKCs) associated with impacted third molars.
MATERIALS AND METHODS
A comprehensive search strategy was employed across major databases including MEDLINE/PubMed, EMBASE, and Web of Science, from the inception of the databases to March 2024. Keywords and Medical Subject Heading (MeSH) terms such as "dentigerous cysts", "odontogenic keratocysts", "immunohistochemistry", "Ki-67", and "p53" were used. The PRISMA 2020 guidelines were followed to ensure methodological rigor. Inclusion criteria encompassed studies on humans and animals providing definitive diagnoses or specific signs and symptoms related to DCs and OKCs, with results on protein expression derived from immunohistochemistry, immune antibody, proteomics, or protein expression methods.
RESULTS
Of the 159 studies initially identified, 138 met the inclusion criteria. Our analysis highlighted significantly higher expressions of Ki-67 (22.1% ± 4.7 vs. 10.5% ± 3.2, < 0.001), p53 (15.3% ± 3.6 vs. 5.2% ± 1.9, < 0.001), and Bcl-2 (18.4% ± 3.2 vs. 8.7% ± 2.4, < 0.001) in OKCs compared to DCs, indicating a higher proliferative index, increased cellular stress, and enhanced anti-apoptotic mechanisms in OKCs. Additionally, PCNA levels were higher in OKCs (25.6% ± 4.5 vs. 12.3% ± 3.1, < 0.001). Genetic mutations, particularly in the PTCH1 gene, were frequently observed in OKCs, underscoring their aggressive behavior and potential malignancy.
CONCLUSIONS
The findings emphasize the significant role of immunohistochemical markers in distinguishing between DCs and OKCs, with elevated levels of Ki-67, p53, Bcl-2, and PCNA in OKCs suggesting a higher potential for growth and recurrence. Genetic insights, including PTCH1 mutations, further support the need for personalized treatment approaches. These markers enhance diagnostic accuracy and inform targeted therapeutic strategies, potentially transforming patient management in oral and maxillofacial surgery.
PubMed: 38928661
DOI: 10.3390/diagnostics14121246 -
International Journal of Molecular... Jun 2024The process of identification and management of neurological disorder conditions faces challenges, prompting the investigation of novel methods in order to improve... (Review)
Review
The process of identification and management of neurological disorder conditions faces challenges, prompting the investigation of novel methods in order to improve diagnostic accuracy. In this study, we conducted a systematic literature review to identify the significance of genetics- and molecular-pathway-based machine learning (ML) models in treating neurological disorder conditions. According to the study's objectives, search strategies were developed to extract the research studies using digital libraries. We followed rigorous study selection criteria. A total of 24 studies met the inclusion criteria and were included in the review. We classified the studies based on neurological disorders. The included studies highlighted multiple methodologies and exceptional results in treating neurological disorders. The study findings underscore the potential of the existing models, presenting personalized interventions based on the individual's conditions. The findings offer better-performing approaches that handle genetics and molecular data to generate effective outcomes. Moreover, we discuss the future research directions and challenges, emphasizing the demand for generalizing existing models in real-world clinical settings. This study contributes to advancing knowledge in the field of diagnosis and management of neurological disorders.
Topics: Humans; Machine Learning; Nervous System Diseases
PubMed: 38928128
DOI: 10.3390/ijms25126422 -
Genes Jun 2024The ring finger protein 213 gene (RNF213) is involved in several vascular diseases, both intracranial and systemic ones. Some variants are common in the Asian population...
The ring finger protein 213 gene (RNF213) is involved in several vascular diseases, both intracranial and systemic ones. Some variants are common in the Asian population and are reported as a risk factor for moyamoya disease, intracranial stenosis and intracranial aneurysms. Among intracranial vascular diseases, both moyamoya disease and intracranial artery dissection are more prevalent in the Asian population. We performed a systematic review of the literature, aiming to assess the rate of RNF213 variants in patients with spontaneous intracranial dissections. Four papers were identified, providing data on 53 patients with intracranial artery dissection. The rate of RNF213 variants is 10/53 (18.9%) and it increases to 10/29 (34.5%), excluding patients with vertebral artery dissection. All patients had the RNF213 p.Arg4810Lys variant. RNF213 variants seems to be involved in intracranial dissections in Asian cohorts. The small number of patients, the inclusion of only patients of Asian descent and the small but non-negligible coexistence with moyamoya disease familiarity might be limiting factors, requiring further studies to confirm these preliminary findings and the embryological interpretation.
Topics: Humans; Adenosine Triphosphatases; Aortic Dissection; Asian People; Genetic Predisposition to Disease; Intracranial Aneurysm; Moyamoya Disease; Polymorphism, Single Nucleotide; Ubiquitin-Protein Ligases
PubMed: 38927660
DOI: 10.3390/genes15060725 -
Genes May 2024Deficits in theory of mind (ToM), known as the ability to understand the other's mind, have been associated with several psychopathological outcomes. The present... (Review)
Review
Deficits in theory of mind (ToM), known as the ability to understand the other's mind, have been associated with several psychopathological outcomes. The present systematic review aims to summarize the results of genetic studies that investigated gene polymorphisms associated with mentalization performance tasks in children and adults. The systematic review was carried out following PRISMA guidelines, and the literature search was conducted in PubMed and EBSCOhost using the following keywords: 'theory of mind, mentalizing, mindreading' and 'gene, genetic basis'. Nineteen studies met the eligibility criteria for inclusion. Most of the literature focused on the role of , , , , , , , , , , , and the family of genes in influencing ToM. However, controversial results emerged in sustaining the link between specific genetic polymorphisms and mentalization abilities in children and adults. Available data show heterogeneous outcomes, with studies reporting an association between the same family genes in subjects of the same age and other studies reporting no correlation. This does not allow us to draw any solid conclusions but paves the way for exploring genes involved in ToM tasks.
Topics: Humans; Theory of Mind; Polymorphism, Genetic; Child; Adult; Mentalization
PubMed: 38927653
DOI: 10.3390/genes15060717 -
Biomolecules Jun 2024Dilated cardiomyopathy (DCM) is a common cause of heart failure (HF) and heart transplantation (HTx), with genetic factors playing a significant role. In recent years,... (Review)
Review
Dilated cardiomyopathy (DCM) is a common cause of heart failure (HF) and heart transplantation (HTx), with genetic factors playing a significant role. In recent years, the RNA-binding protein motif 20 (), which affects the gene splicing of various proteins with different cellular functions, was identified as the first DCM gene with regulatory properties. Variants of have been associated with severe forms of DCM. The aim of this critical systematic review was to analyse cardiomyopathy clinical features and outcomes. According to PRISMA guidelines, a search was run in the PubMed, Scopus and Web of Science electronic databases using the following keywords: ""; "cardiomyopathy"; "arrhythmias"; "heart failure". A total of 181 records were screened, of which 27 studies were potentially relevant to the topic. Through the application of inclusion and exclusion criteria, eight papers reporting 398 patients with pathogenic variants were analysed. The mean age at presentation was 41 years. Familiarity with cardiomyopathy was available in 59% of cases, with 55% of probands reporting a positive family history. Imaging data indicated a mild reduction of left ventricular ejection fraction (mean LVEF 40%), while tissue characterization was reported in 24.3% of cases, showing late gadolinium enhancement in 33% of patients. Composite outcomes of sustained monomorphic ventricular tachycardia or ventricular fibrillation occurred in 19.4% of patients, with 12% undergoing HTx. There were no gender differences in arrhythmic outcomes, while 96.4% of patients who underwent HTx were male. In conclusion, cardiomyopathy exhibits a severe phenotypic expression, both in terms of arrhythmic burden and HF progression.
Topics: Humans; RNA-Binding Proteins; Cardiomyopathy, Dilated; Male; Female; Adult
PubMed: 38927106
DOI: 10.3390/biom14060702