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Progress in Neuro-psychopharmacology &... Jun 2024Biological sex disparities manifest at various stages of drug addiction, including craving, substance abuse, abstinence, and relapse. These discrepancies are underpinned... (Review)
Review
Biological sex disparities manifest at various stages of drug addiction, including craving, substance abuse, abstinence, and relapse. These discrepancies are underpinned by notable distinctions in neurobiological substrates, encompassing brain structures, functions, and neurotransmitter systems implicated in drug addiction. Neuronal biomarkers, such as neurotransmitters, signaling proteins, and genes may be associated with the diagnosis, prognosis, and treatment outcomes in both biological sexes afflicted by drug abuse. Sex differences in the neural reward system, mainly through dopaminergic transmission during drug abuse, can be attributed to modifications in neurotransmitter systems and signaling pathways. This results in distinct patterns of neural activation and responsiveness to addictive substances in males and females. Sex hormones, the estrus/menstrual cycle, and cerebral neurochemistry contribute to the progression of psychological and physiological dependence in both male and female individuals grappling with addiction. Moreover, the alteration of sex hormone balance and neurotransmitter release plays a pivotal role in substance use disorders, subsequently modulating cognitive functions pertinent to reward, including memory formation, decision-making, and locomotor activity. Comparative investigations reveal distinctions in brain region volume, gene expression, neuronal firing, and circuitry in substance use disorders affecting individuals of both biological sexes. This review examines prevalent substance use disorders to elucidate the impact of sex hormones as therapeutic biomarkers on the mesocorticolimbic neurotransmitter systems via diverse mechanisms within the addicted brain. We underscore the imperative necessity of considering these variations to gain a deeper comprehension of addiction mechanisms and potentially discern sex-specific neuronal biomarkers for tailored therapeutic interventions.
PubMed: 38944334
DOI: 10.1016/j.pnpbp.2024.111068 -
The Journal of Allergy and Clinical... Jun 2024This review will summarize new research developments and clinical practice recommendations for the diagnosis and management of anaphylaxis presented in the Joint Task...
This review will summarize new research developments and clinical practice recommendations for the diagnosis and management of anaphylaxis presented in the Joint Task Force on Practice Parameters' 2023 Anaphylaxis Practice Parameter Update. It is intended to serve as a high-level summary of the 2023 practice parameter, which makes clinically impactful recommendations based on new evidence that has emerged since the 2015 practice parameter. We invite clinicians to explore the full 2023 practice parameter to better understand the research methods and underlying evidence that have informed the recommendations summarized here. There are new and evolving diagnostic criteria for anaphylaxis, rules for defining elevated tryptase levels, and recognition of signs and symptoms particular to infants and toddlers. The administration of epinephrine should not be used as a surrogate to diagnose anaphylaxis. Risk factors for anaphylaxis should be assessed on a case-by-case basis. Patient counseling and shared decision making (SDM) are essential for supporting patients' treatment decisions and capacity to manage the risk of anaphylaxis at home and in other community settings. Activation of emergency medical services following home epinephrine administration may not be required in all cases, and patients should be engaged in SDM to determine when home management may be appropriate.
PubMed: 38944199
DOI: 10.1016/j.jaip.2024.06.036 -
Interdisciplinary Cardiovascular and... Jun 2024The healthcare registries in Denmark present a unique opportunity to gain novel insights into the outcomes associated with both transcatheter and surgical approaches to...
Severe aortic stenosis treated with transcatheter aortic valve implantation or surgical aortic valve replacement with perimount in Western Denmark 2016-2022: a nationwide retrospective study.
OBJECTIVES
The healthcare registries in Denmark present a unique opportunity to gain novel insights into the outcomes associated with both transcatheter and surgical approaches to aortic valve replacement. Our objective is to enhance shared decision-making by comparing long-term mortality and clinical outcomes between treatments.
METHODS
This observational study included all patients with severe aortic stenosis undergoing elective isolated transfemoral transcatheter aortic valve implantation (TAVI) or surgical aortic valve replacement (SAVR) in Western Denmark between January 2016 and April 2022. Patient population and clinical data were identified from the Western Danish Heart Registry and the National Danish Patient Registry, respectively. A propensity score-matched population was generated. Outcomes were investigated according to Valve Academic Research Consortium-3.
RESULTS
A total of 2269 TAVI patients and 1094 SAVR patients where identified. The propensity score-matched population consisted of 468 TAVI patients (mean[SD]age, 75.0[5.3] years) and 468 SAVR patients (mean[SD] age, 75.1[4.6]years). The Kaplan-Meier estimate for the 5-year all-cause mortality was 29.8% in the TAVI group and 16.9% for in the SAVR group (p = 0.019). The risk of all stroke or transient ischaemic attack after five year was 15.1% in the TAVI group and 11.0% in the SAVR group (p = 0.047).
CONCLUSIONS
This study underscores the importance of evaluating all patient factors when choosing an aortic valve replacement method. Surgical aortic valve replacement was a viable choice, especially for patients with New-York Heart Association class I/II, ≥75 age, left ventricular ejection fraction ≥50%, or longer life expectancy.
PubMed: 38944031
DOI: 10.1093/icvts/ivae122 -
Food Chemistry Jun 2024This pilot study evaluated the impact of pistachio consumption on cognitive performance and mood in overweight young adults. Pistachios were characterized (chemical and...
This pilot study evaluated the impact of pistachio consumption on cognitive performance and mood in overweight young adults. Pistachios were characterized (chemical and nutraceutical), and a baseline-final, uncontrolled nutritional intervention was performed (28 g of pistachio/28 days). Psychometric tests were applied to estimate cognitive performance and mood; anthropometric evaluation, biochemical analysis, and plasma antioxidant activity were included. The main component of nuts was lipids (48.1%). Pistachios consumption significantly (p ≤ 0.05) reduced waist circumference (-1.47 cm), total cholesterol (-10.21 mg/dL), LDL (-6.57 mg/dL), and triglycerides (-21.07 mg/dL), and increased plasma antioxidant activity. Pistachio supplementation improved risk tolerance (p ≤ 0.006) and decision-making strategy (p ≤ 0.002; BART-task), executive functions (BCST-task; p ≤ 0.006), and selective and sustained attention (Go/No-Go-test; p ≤ 0.016). The mood state was positively modulated (p ≤ 0.05) for anxiety, anger-hostility, and sadness-depression. These results show for the first time the benefits of pistachio consumption on cognitive performance and mood in overweight young adults.
PubMed: 38943918
DOI: 10.1016/j.foodchem.2024.140211 -
Journal of Hazardous Materials Jun 2024Biochar is effective in mitigating heavy metal pollution, and cadmium (Cd) is the primary pollutant in agricultural fields. However, traditional trial-and-error methods...
Biochar is effective in mitigating heavy metal pollution, and cadmium (Cd) is the primary pollutant in agricultural fields. However, traditional trial-and-error methods for determining the optimal biochar remediation efficiency are time-consuming and inefficient because of the varied soil, biochar, and Cd pollution conditions. This study employed the machine learning method to predict the Cd immobilization efficiency of biochar in soil. The predictive accuracy of the random forest (RF) model was superior to that of the other common linear and nonlinear models. Furthermore, to improve the reliability and accuracy of the RF model, it was optimized by employing a root-mean-squared-error-based trial-and-error approach. With the aid of the optimized model, the empirical categories for soil Cd immobilization efficiency were biochar properties (60.96 %) > experimental conditions (19.6 %) ≈ soil properties (19.44 %). Finally, this study identified the optimal biochar properties for enhancing agricultural soil Cd remediation in different regions of China, which was beneficial for decision-making regarding nationwide agricultural soil remediation using biochar. The immobilization effect of alkaline biochar was pronounced in acidic soils with relatively high organic matter. This study provides insights into the immobilization mechanism and an approach for biochar selection for Cd immobilization in agricultural soil.
PubMed: 38943890
DOI: 10.1016/j.jhazmat.2024.135065 -
Reproductive Biomedicine Online Feb 2024In 15-30% of couples with infertility, no abnormalities are found after the initial diagnostic work-up. The aim of this study was to investigate the prevalence of... (Review)
Review
In 15-30% of couples with infertility, no abnormalities are found after the initial diagnostic work-up. The aim of this study was to investigate the prevalence of endometriosis in patients with unexplained infertility undergoing diagnostic laparoscopy in the current era of improved imaging and assisted reproductive technology. A systematic search of PubMed, Embase and Cochrane Central was conducted to identify all studies reporting on pelvic pathologies found by laparoscopy in couples diagnosed with unexplained infertility. Normal ovulatory cycles, normal semen analysis and an infertility period of ≥12 months were the minimum requirements for a study population to be included. The prevalence of endometriosis was 44%, and most lesions were classified as minimal or mild (74%). The prevalence rates of tubal factors and adhesions were 20% and 16%, respectively. The detection rate for pelvic abnormalities was higher in women with prior fertility treatment (75%) compared with women without prior fertility treatment (53%). Despite the significant improvements in imaging for the diagnosis of endometriosis and tubal factors over the last decades, the prevalence rates of endometriosis and tubal abnormalities remain high in patients with unexplained infertility. The high prevalence of endometriosis in this population is important for decision-making in patients who also suffer from pain symptoms suggestive of endometriosis.
PubMed: 38943813
DOI: 10.1016/j.rbmo.2024.103848 -
Neuro-Chirurgie Jun 2024Posterior fossa epidural hematoma (PFEDH) is rare, occurring in less than 3% of head injuries. It can be managed either operatively or non-operatively. Management... (Review)
Review
BACKGROUND
Posterior fossa epidural hematoma (PFEDH) is rare, occurring in less than 3% of head injuries. It can be managed either operatively or non-operatively. Management guidelines date from 2006, without recent updates providing class III evidence.
METHOD
We searched PubMed and other databases for English language observational studies up to 2021 that compared the two treatment approaches for PFEDH and.
RESULTS
Twenty-four of the 350 references, for involving 874 patients, met the study criteria. Conservative management showed higher GOS 5 scores and lower mortality. GCS 13-15 patients were more prevalent in the conservative group. Surgical cases often involved ventriculomegaly/compression, hydrocephalus or contusion.
CONCLUSION
The study shed light on surgical versus conservative PFEDH management, although evidence is sparse. Generally, conservative methods showed better initial outcomes, and should be preferred. However, respect of individual patient traits and Brain Trauma Foundation guidelines is crucial: conservative management may not suit all cases. To enhance the evidence base, RCTs are important for optimal PFEDH management. Bridging this gap can substantially improve patient outcomes and clinical decision-making, emphasizing the need to consider both the available evidence and patient-specific factors for effective guidance.
PubMed: 38943702
DOI: 10.1016/j.neuchi.2024.101578 -
Genetics in Medicine : Official Journal... Jun 2024Germline testing in pediatric cancer presents opportunities and challenges. Understanding family perspectives, experiences, and preferences will optimize integration... (Review)
Review
PURPOSE
Germline testing in pediatric cancer presents opportunities and challenges. Understanding family perspectives, experiences, and preferences will optimize integration into routine care.
METHODS
Following PRISMA guidelines, we searched four databases for studies exploring perspectives, experiences, and preferences of parents/caregivers and/or patients regarding germline testing of children with cancer. Qualitative and quantitative data was extracted, organized, and summarized by research question and themes.
RESULTS
We identified 2286 unique articles, of which 24 were included. Interest in and uptake of testing was high. Families were motivated by altruism and a desire for inheritance/causation information. Testing barriers included psychological concerns, timing of the testing approach if offered at diagnosis or in a high-risk cancer setting and privacy/discrimination. Testing experiences highlighted challenges yet also positive impacts, with results providing psychological relief and informing proactive decision-making. Timing preferences varied, however allowing time to adjust to a new diagnosis was a common theme. Most wanted to receive as many germline sequencing-related results as possible.
CONCLUSION
Findings underscore the importance of integrating germline analyses into pediatric cancer care with flexibility and support for families facing challenges. Where possible, consent should be provided at a time that suits each family's situation with access to information aligning with their needs and preferences.
PROSPERO
CRD42023444890.
PubMed: 38943478
DOI: 10.1016/j.gim.2024.101197 -
Otolaryngology--head and Neck Surgery :... Jun 2024
PubMed: 38943455
DOI: 10.1002/ohn.886 -
Muscle & Nerve Jun 2024Type 1 myotonic dystrophy (DM1) is a neuromuscular disorder of multiple organ systems with important electrophysiologic (EP) manifestations, leading to a cumulative...
INTRODUCTION/AIMS
Type 1 myotonic dystrophy (DM1) is a neuromuscular disorder of multiple organ systems with important electrophysiologic (EP) manifestations, leading to a cumulative incidence of sudden death of 6.6%. Due to genetic anticipation, there is a pediatric subset of this patient population. However, most EP research on DM1 patients has been in adults, making cardiac care for pediatric patients difficult and directed by adult guidelines which often leads to cardiovascular implantable electronic device (CIED) implants. We sought to investigate the prevalence of CIEDs in the pediatric DM1 population.
METHODS
The Vizient® Clinical Data Base was queried from October 2019 to October 2023 for admissions with and without ICD-10 code for myotonic dystrophy (G71.11), with and without codes for presence of a pacemaker or ICD (Z95.0, Z95.810). Patients who were identified were stratified by age: Pediatric (0-21 years) and Adult (22-50 years).
RESULTS
Prevalence of CIED in pediatric DM1 was 2.1% and in adult DM1 was 15.8%. When comparing to pediatric and adult patients with CIED and without DM1, the odds ratio for CIED in pediatric DM1 was 48.8, compared to 23.3 for CIED in adult DM1.
DISCUSSION
There are pediatric DM1 patients who have received CIED despite a lack of data to inform this decision-making. Further research will be important to ensure appropriate use of CIED in this population and to develop appropriate guidelines to direct management.
PubMed: 38943290
DOI: 10.1002/mus.28188