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Turkish Journal of Medical Sciences 2024The treatment for multiple sclerosis (MS) does not cure the disease, but it is intended to reduce the intensity, duration, and frequency of symptoms. Rehabilitation... (Observational Study)
Observational Study
BACKGROUND/AIM
The treatment for multiple sclerosis (MS) does not cure the disease, but it is intended to reduce the intensity, duration, and frequency of symptoms. Rehabilitation therapy (RT), including an individualized physical therapy program (PTP) and adapted occupational therapy (OT), has benefits in terms of aerobic capacity, muscle strength, coordination, and ability to perform activities of daily living (ADL). The primary objective of this study was to examine the efficacy of RT comprising PTP, OT, and drug treatment (DT) versus DT alone in patients with MS. Another objective was to highlight the importance of continuing the PT and OT at home, in the long term, practically for their entire life.
MATERIALS AND METHODS
Between 2020 and 2022, a follow-up observational study was conducted that included 77 patients diagnosed with MS, independent in terms of ability to perform ADL, divided into two groups: group A (39 patients who complied with the RT) and group B (38 patients who did not comply). At the beginning and end of the study, the following parameters were assessed: timed walk for 25 feet [Timed 25-Foot Walk test (T25FW test)], dexterity of the upper limbs [9-Hole Peg Test (9HPT)], and cognitive function [Paced Auditory Serial Addition Test (PASAT)].
RESULTS
Significant improvement in the experimental group was observed regarding the mobility and the performance of leg function (T25FW, p < 0.05) and finger dexterity (9HPT, p < 0.05) for the dominant hand.
CONCLUSION
The current study proves the importance of combining DT with RT in MS therapy with clear benefits in regaining muscle strength in the lower limbs, thus improving coordination and balance while walking and improving dexterity in the dominant hand.
Topics: Humans; Female; Male; Multiple Sclerosis; Adult; Middle Aged; Activities of Daily Living; Physical Therapy Modalities; Occupational Therapy; Follow-Up Studies; Treatment Outcome
PubMed: 38812628
DOI: 10.55730/1300-0144.5776 -
Turkish Journal of Medical Sciences 2024Trunk control, which plays a key role in balance and mobility, decreases in patients with multiple sclerosis (PwMS) and many parameters such as sensory, motor, and...
BACKGROUND/AIM
Trunk control, which plays a key role in balance and mobility, decreases in patients with multiple sclerosis (PwMS) and many parameters such as sensory, motor, and musculoskeletal systems affect trunk control. The aim of this study was to compare trunk control, spinal mobility, and spinal posture in PwMS with healthy controls and investigate the relationship between trunk control with spinal posture and spinal mobility in PwMS.
MATERIALS AND METHODS
The study was completed with 38 PwMS and 38 healthy controls with matched age and sex. Trunk control was evaluated with the Trunk Impairment Scale (TIS). Spinal posture and mobility were evaluated in sagittal and frontal planes using an IDIAG M360 Spinal Mouse. Spinal posture was evaluated in upright, maximum flexion, extension, left and right lateral flexion positions, and spinal mobility was evaluated from upright to flexion, extension, right and left flexion positions in sagittal and frontal planes.
RESULTS
TIS scores, thoracic mobility angles (from upright to flexion and left lateral flexion), lumbar mobility angles (from upright to extension and right lateral flexion) and lumbar posture angle (maximum right lateral flexion) were lower, and thoracic posture angles (upright and maximum extension) were higher in PwMS than healthy controls (p < 0.05). No significant difference was found between other spinal postures and mobility values. In addition, there was only a negative relationship between thoracic spinal mobility from upright to extension and trunk control in PwMS (r = -0.349; p = 0.032).
CONCLUSION
These findings indicate the importance of early detection of trunk disturbances in PwMS. Thus, even in the early stages of multiple sclerosis, detailed trunk assessment will guide the implementation of comprehensive exercise programs.
Topics: Humans; Cross-Sectional Studies; Multiple Sclerosis; Female; Male; Posture; Adult; Torso; Range of Motion, Articular; Middle Aged; Spine; Postural Balance; Case-Control Studies
PubMed: 38812624
DOI: 10.55730/1300-0144.5778 -
Central-European Journal of Immunology 2024The low-grade inflammation occurring in obese individuals leads to many diseases, including cardiovascular disease (CVD). Dietary patterns, food groups or nutrients in a...
INTRODUCTION
The low-grade inflammation occurring in obese individuals leads to many diseases, including cardiovascular disease (CVD). Dietary patterns, food groups or nutrients in a well-balanced diet may reduce the level of pro-inflammatory markers and the risk of obesity-related morbidities. Our study aims to describe three cytokines in obese patients in relation to dietary habits, lifestyle and body composition.
MATERIAL AND METHODS
Serum samples were collected from 84 obese adult volunteer subjects [body mass index (BMI) ≥ 30 kg/m] to analyze the concentrations of interleukin 6 (IL-6), tumor necrosis factor α (TNF-α) and interferon γ (IFN-γ). The subjects were tested by bioelectrical impedance analysis (BIA) and completed a three-day food diary and original questionnaire with the FFQ-6 food consumption frequency questionnaire.
RESULTS AND CONCLUSIONS
Higher serum levels of IL-6 and IFN-γ were found in patients with atherosclerosis, but the group was too small for a reliable correlation. Subcutaneous but not visceral adipose tissue correlated positively with IL-6 levels. Dietary factors such as amount of sugars, including galactose and sucrose, in the diet and the frequency of consumption of sweet flavored dairy products correlated positively with the levels of IL-6 and TNF-α, while the frequency of alcohol consumption negatively correlated with the level of IL-6. The greater the frequency of sports, the higher was the level of IL-6. In obese individuals, the level of pro-inflammatory cytokines could predispose to atherosclerosis and is associated with dietary factors and lifestyle.
PubMed: 38812610
DOI: 10.5114/ceji.2024.138748 -
IScience Jun 2024The sun and outer space are two crucial renewable thermodynamic resources that work together to maintain the delicate energy balance of our planet. The challenge lies in...
The sun and outer space are two crucial renewable thermodynamic resources that work together to maintain the delicate energy balance of our planet. The challenge lies in harvesting both resources synergistically and converting them into high-quality electricity. Here, we introduce a photovoltaic thermoelectric radiative cooling (PV-TE-RC) system. This system uses the full spectrum of the sun and the atmospheric window to generate electricity and achieve high-quality collaborative utilization of solar energy and space energy. Outdoor experiments have demonstrated the system's capacity to operate efficiently around the clock. Notably, during the peak solar concentration, the thermoelectric generator (TEG) and the system achieved power outputs of 870 mW/m and 85.87 W/m, respectively. We have further developed a three-dimensional transient coupled simulation model, which can accurately predict its operational limits. Therefore, this study provides practical insights and recommendations for large-scale and efficient collaborative power generation using these two thermodynamic resources.
PubMed: 38812537
DOI: 10.1016/j.isci.2024.109952 -
Integrative Cancer Therapies 2024Many patients diagnosed with cancer use complementary and integrative healthcare (CIH) approaches to manage their cancer- and treatment-related symptoms and improve...
BACKGROUND
Many patients diagnosed with cancer use complementary and integrative healthcare (CIH) approaches to manage their cancer- and treatment-related symptoms and improve their well-being. Evidence suggests that counseling on CIH can improve health outcomes and decrease healthcare costs by increasing patient activation. This qualitative study explores the experiences of cancer patients who underwent interprofessional counseling on CIH to gain insights into how these patients were able to integrate recommended CIH measures into their daily lives while undergoing conventional cancer treatment.
METHODS
Forty semi-structured interviews were conducted with cancer patients participating in the CCC-Integrativ study and its process evaluation. The interviews were audio-recorded, transcribed verbatim, and analyzed using content analysis following Kuckartz and Rädiker. A purposeful sampling strategy was used to achieve a balanced sample regarding gender, age, cancer diagnosis, and treatment approach.
RESULTS
Most patients with cancer reported largely implementing the CIH recommendations. Participants acknowledged the efficacy of CIH recommendations in managing their symptoms. They felt strengthened and empowered to actively take part in their healthcare decisions. However, the patients encountered obstacles in incorporating the recommended CIH applications into their daily routines. These challenges encompassed the effort required for treatment application (e.g., baths, compresses), limitations imposed by the cancer disease (e.g., fatigue, pain), difficulties acquiring necessary materials, associated costs, and lack of infrastructure for CIH. Facilitators of CIH implementation included the availability of easily manageable CIH measures (e.g., herbal teas), informative materials on their application, distribution of samples, family support, and a high level of self-efficacy. The patient-centered approach and strong patient-provider partnership within the counseling context were perceived as empowering. Participants expressed a desire for a consistent point of contact to address their CIH concerns.
CONCLUSIONS
The findings underscore the benefits of CIH counseling for cancer patients' symptom management and overall well-being. Healthcare professionals providing CIH counseling to patients with cancer may recognize the barriers identified to better support their patients in the regular use of CIH.
Topics: Humans; Neoplasms; Male; Female; Complementary Therapies; Middle Aged; Qualitative Research; Integrative Medicine; Aged; Adult; Counseling
PubMed: 38812440
DOI: 10.1177/15347354241252195 -
Journal of Translational Medicine May 2024The aging process of the kidneys is accompanied with several structural diseases. Abnormal fiber formation disrupts the balance of kidney structure and function, causing...
The aging process of the kidneys is accompanied with several structural diseases. Abnormal fiber formation disrupts the balance of kidney structure and function, causing to end-stage renal disease and subsequent renal failure. Despite this, the precise mechanism underlying renal damage in aging remains elusive. In this study, ABI3BP gene knockout mice were used to investigate the role of ABI3BP in renal aging induced by irradiation. The results revealed a significant increase in ABI3BP expression in HK2 cells and kidney tissue of aging mice, with ABI3BP gene knockout demonstrating a mitigating effect on radiation-induced cell aging. Furthermore, the study observed a marked decrease in Klotho levels and an increase in ferroptosis in renal tissue and HK2 cells following irradiation. Notably, ABI3BP gene knockout not only elevated Klotho expression but also reduced ferroptosis levels. A significant negative correlation between ABI3BP and Klotho was established. Further experiments demonstrated that Klotho knockdown alleviated the aging inhibition caused by ABI3BP downregulation. This study identifies the upregulation of ABI3BP in aged renal tubular epithelial cells, indicating a role in promoting ferroptosis and inducing renal aging by inhibiting Klotho expression.
Topics: Klotho Proteins; Animals; Ferroptosis; Aging; Kidney; Mice, Knockout; Humans; Cell Line; Glucuronidase; Mice, Inbred C57BL; Mice; Carrier Proteins; Male
PubMed: 38812032
DOI: 10.1186/s12967-024-05300-w -
BMC Palliative Care May 2024In the context of pediatric palliative care, where the quality of life of children with life-limiting or life-threatening conditions is of utmost importance, the...
BACKGROUND
In the context of pediatric palliative care, where the quality of life of children with life-limiting or life-threatening conditions is of utmost importance, the integration of health technology must support the provision of care. Research has highlighted the role of healthcare personnel when utilizing health technology in home-based pediatric palliative care, but specific knowledge of healthcare personnel's views on the technological relevance remains limited. Therefore, our study has explored potentials and limitations of health technology in home-based pediatric palliative care from the perspectives of healthcare personnel.
METHODS
Our study utilized a qualitative, descriptive, and exploratory design, including five focus groups with a total of 22 healthcare personnel. The participants were selected from various health regions in Norway and were experienced in providing home-based pediatric palliative care. Using reflexive thematic analysis, we interpreted data obtained from focus groups, identified patterns, and developed themes.
RESULTS
The analysis resulted in the development of three intersecting themes: balancing in-person interaction and time in home-based pediatric palliative care; exchange of information can improve timely and appropriate care; and the power of visual documentation in pediatric palliative care. The healthcare personnel acknowledged difficulties in fully replacing in-person interaction with health technology. However, they also emphasized potentials of health technology to facilitate information sharing and the ability to access a child's health record within interdisciplinary teams.
CONCLUSION
The results underscored that technology can support pediatric palliative care but must be thoughtfully integrated to ensure an individualized patient-centered approach. To maximize the benefits of health technology in enhancing home-based pediatric palliative care, future research should address the limitations of current health technology and consider the opinions for information sharing between relevant healthcare team members, the child, and their family.
Topics: Humans; Palliative Care; Qualitative Research; Norway; Focus Groups; Home Care Services; Health Personnel; Female; Male; Pediatrics; Adult; Biomedical Technology; Attitude of Health Personnel; Middle Aged
PubMed: 38811957
DOI: 10.1186/s12904-024-01464-w -
BMC Cardiovascular Disorders May 2024Myocardial ischemia-reperfusion injury (I/RI) is a major cause of perioperative cardiac-related adverse events and death. Studies have shown that sevoflurane...
BACKGROUND
Myocardial ischemia-reperfusion injury (I/RI) is a major cause of perioperative cardiac-related adverse events and death. Studies have shown that sevoflurane postconditioning (SpostC), which attenuates I/R injury and exerts cardioprotective effects, regulates mitochondrial dynamic balance via HIF-1α, but the exact mechanism is unknown. This study investigates whether the PI3K/AKT pathway in SpostC regulates mitochondrial dynamic balance by mediating HIF-1α, thereby exerting myocardial protective effects.
METHODS
The H9C2 cardiomyocytes were cultured to establish the hypoxia-reoxygenation (H/R) model and randomly divided into 4 groups: Control group, H/R group, sevoflurane postconditioning (H/R + SpostC) group and PI3K/AKT blocker (H/R + SpostC + LY) group. Cell survival rate was determined by CCK-8; Apoptosis rate was determined by flow cytometry; mitochondrial membrane potential was evaluated by Mito Tracker™ Red; mRNA expression levels of AKT, HIF-1α, Opa1and Drp1 were detected by quantitative real-time polymerase chain reaction (qRT-PCR); Western Blot assay was used to detect the protein expression levels of AKT, phosphorylated AKT (p-AKT), HIF-1α, Opa1 and Drp1.
RESULTS
Compared with the H/R group, the survival rate of cardiomyocytes in the H/R + SpostC group increased, the apoptosis rate decreased and the mitochondrial membrane potential increased. qRT-PCR showed that the mRNA expression of HIF-1α and Opa1 were higher in the H/R + SpostC group compared with the H/R group, whereas the transcription level of Drp1 was lower in the H/R + SpostC group. In the H/R + SpostC + LY group, the mRNA expression of HIF-1α was lower than the H/R + SpostC group. There was no difference in the expression of Opa1 mRNA between the H/R group and the H/R + SpostC + LY group. WB assay results showed that compared with the H/R group, the protein expression levels of HIF-1α, Opa1, P-AKT were increased and Drp1 protein expression levels were decreased in the H/R + SpostC group. HIF-1α, P-AKT protein expression levels were decreased in the H/R + SpostC + LY group compared to the H/R + SpostC group.
CONCLUSION
SpostC mediates HIF-1α-regulated mitochondrial fission and fusion-related protein expression to maintain mitochondrial dynamic balance by activating the PI3K/AKT pathway and increasing AKT phosphorylation, thereby attenuating myocardial I/R injury.
Topics: Hypoxia-Inducible Factor 1, alpha Subunit; Proto-Oncogene Proteins c-akt; Animals; Myocytes, Cardiac; Sevoflurane; Signal Transduction; Myocardial Reperfusion Injury; Mitochondrial Dynamics; Cell Line; Rats; Apoptosis; Phosphatidylinositol 3-Kinase; Mitochondria, Heart; Membrane Potential, Mitochondrial; Cell Hypoxia; Dynamins; GTP Phosphohydrolases; Phosphoinositide-3 Kinase Inhibitors; Cytoprotection; Ischemic Postconditioning; Phosphorylation
PubMed: 38811893
DOI: 10.1186/s12872-024-03868-1 -
BMC Nephrology May 2024Pathological changes were observed in the diaphragm due to abnormal renal function in chronic kidney disease (CKD). Inspiratory muscle training (IMT) has been suggested... (Randomized Controlled Trial)
Randomized Controlled Trial
Effects of different inspiratory muscle training protocols on functional exercise capacity and respiratory and peripheral muscle strength in patients with chronic kidney disease: a randomized study.
BACKGROUND
Pathological changes were observed in the diaphragm due to abnormal renal function in chronic kidney disease (CKD). Inspiratory muscle training (IMT) has been suggested for patients with CKD; however, the most appropriate intensity for IMT has not been determined. Therefore, this study aimed to investigate the effects of different IMT protocols on respiratory muscle strength, quadriceps femoris muscle strength (QMS), handgrip muscle strength (HGS), functional exercise capacity, quality of life (QoL), pulmonary function, dyspnoea, fatigue, balance, and physical activity (PA) levels in patients with CKD.
METHODS
This randomized, controlled, single-blind study included 47 patients and they were divided into three groups: Group 1 (n = 15, IMT with 10% maximal inspiratory pressure (MIP)), Group 2 (n = 16, IMT with 30% MIP), and Group 3(n = 16; IMT with 60% MIP). MIP, maximal expiratory pressure (MEP), 6-min walking test (6-MWT), QMS, HGS, QoL, pulmonary function, dyspnoea, fatigue, balance, and PA levels were assessed before and after eight weeks of IMT.
RESULTS
Increases in MIP, %MIP, 6-MWT distance, and %6-MWT were significantly higher in Groups 2 and 3 than in Group 1 after IMT (p < 0.05). MEP, %MEP, FEF QMS, HGS, and QoL significantly increased; dyspnoea and fatigue decreased in all groups (p < 0.05). FVC, PEF, and PA improved only in Group 2, and balance improved in Groups 1 and 2 (p < 0.05).
CONCLUSIONS
IMT with 30% and 60% MIP similarly improves inspiratory muscle strength and functional exercise capacity. IMT with 30% is more effective in increasing PA. IMT is a beneficial method to enhance peripheral and expiratory muscle strength, respiratory function, QoL and balance, and reduce dyspnoea and fatigue. IMT with %30 could be an option for patients with CKD who do not tolerate higher intensities.
TRIAL REGISTRATION
This study was retrospectively registered (NCT06401135, 06/05/2024).
Topics: Humans; Male; Female; Muscle Strength; Renal Insufficiency, Chronic; Exercise Tolerance; Middle Aged; Single-Blind Method; Respiratory Muscles; Breathing Exercises; Quality of Life; Adult; Hand Strength; Dyspnea; Aged
PubMed: 38811888
DOI: 10.1186/s12882-024-03610-1 -
BMC Genomics May 2024The colonization of land and the diversification of terrestrial plants is intimately linked to the evolutionary history of their symbiotic fungal partners. Extant...
BACKGROUND
The colonization of land and the diversification of terrestrial plants is intimately linked to the evolutionary history of their symbiotic fungal partners. Extant representatives of these fungal lineages include mutualistic plant symbionts, the arbuscular mycorrhizal (AM) fungi in Glomeromycota and fine root endophytes in Endogonales (Mucoromycota), as well as fungi with saprotrophic, pathogenic and endophytic lifestyles. These fungal groups separate into three monophyletic lineages but their evolutionary relationships remain enigmatic confounding ancestral reconstructions. Their taxonomic ranks are currently fluid.
RESULTS
In this study, we recognize these three monophyletic linages as phyla, and use a balanced taxon sampling and broad taxonomic representation for phylogenomic analysis that rejects a hard polytomy and resolves Glomeromycota as sister to a clade composed of Mucoromycota and Mortierellomycota. Low copy numbers of genes associated with plant cell wall degradation could not be assigned to the transition to a plant symbiotic lifestyle but appears to be an ancestral phylogenetic signal. Both plant symbiotic lineages, Glomeromycota and Endogonales, lack numerous thiamine metabolism genes but the lack of fatty acid synthesis genes is specific to AM fungi. Many genes previously thought to be missing specifically in Glomeromycota are either missing in all analyzed phyla, or in some cases, are actually present in some of the analyzed AM fungal lineages, e.g. the high affinity phosphorus transporter Pho89.
CONCLUSION
Based on a broad taxon sampling of fungal genomes we present a well-supported phylogeny for AM fungi and their sister lineages. We show that among these lineages, two independent evolutionary transitions to mutualistic plant symbiosis happened in a genomic background profoundly different from that known from the emergence of ectomycorrhizal fungi in Dikarya. These results call for further reevaluation of genomic signatures associated with plant symbiosis.
Topics: Mycorrhizae; Symbiosis; Phylogeny; Genomics; Evolution, Molecular; Genome, Fungal; Glomeromycota; Plants
PubMed: 38811885
DOI: 10.1186/s12864-024-10391-2