Biomedicine hub最新文献

{"title":"Anti-Inflammatory and Neuroprotective Effects of a Novel Water-Soluble Formulation of Coenzyme-Q10 and Ashwagandha Root Extract in a Paraquat-Induced Rat Model of Parkinson's Disease.","authors":"Caleb Vegh, Gabrielle Walach, Keanna Dube, Natasha Jaleh Malakoti-Negad, Darcy Wear, Hasana Jayawardena, Mansi Patel, Alexa Polsinelli, Sezen Eren, Jerome Cohen, Siyaram Pandey","doi":"10.1159/000550968","DOIUrl":"10.1159/000550968","url":null,"abstract":"<p><strong>Introduction: </strong>Parkinson's disease (PD) is characterized by progressive loss of dopaminergic neurons in the substantia nigra resulting in impaired movement coordination. There is no cure, and current therapies only provide symptomatic relief and have adverse side effects over long-term use. There are several biochemical mechanisms implicated in PD, which include oxidative stress, inflammation, and impaired autophagy. Previous studies have shown that a combination of two nutraceuticals, Ubisol-Q10 and ethanolic Ashwagandha root extract was more effective than each used alone at reducing neurodegeneration in a paraquat-induced rat model of PD by targeting the biochemical mechanisms all at once. In previous research, the oral doses of Ubisol-Q10 were low; however, the doses of ethanolic Ashwagandha used were unrealistically high because the extract's hydrophobicity causes poor bioavailability. The current study aims to determine the neuroprotective effects of Ubisol-Q10 and a novel water-soluble formulation of Ashwagandha extract (WS-ASH) on a Paraquat-injected rat model of PD.</p><p><strong>Methods: </strong>WS-ASH was prepared using a methodology analogous to that used for creating Ubisol-Q10. To test the efficacy of Ubisol-Q10, WS-ASH, and a combination Tonic solution, premortem gross- and fine-motor tests were conducted on a PD rat model, followed by immunofluorescent staining of biomarkers for inflammation, neurotrophic factors, oxidative stress, senescence, autophagy, and synaptic health.</p><p><strong>Results: </strong>This WS-ASH had significant neuroprotective effects at lower doses. The combination of WS-ASH and Ubisol-Q10 (Tonic) provided a better neuroprotective effect. Importantly, Tonic treatment improved gross- and fine-motor skills of a paraquat-injected rat model of PD compared to the untreated group. Furthermore, the combined treatment led to decreased oxidative stress, decreased inflammation, resumption of autophagy, induced the production of pro-survival neurotrophic factors, and increased synapse-specific protein.</p><p><strong>Conclusion: </strong>The results indicate that this combined formulation has potential for an effective therapy for PD patients.</p>","PeriodicalId":101351,"journal":{"name":"Biomedicine hub","volume":"11 1","pages":"61-94"},"PeriodicalIF":0.0,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Testicular Puncture and Aspiration as an Intraoperative Adjunct in Pediatric Testicular Torsion: A Case Report with Long-Term Follow-Up.","authors":"Kazuyoshi Johnin, Ryuta Itoh, Yuri Mori, Kenichi Kobayashi, Tetsuya Yoshida, Susumu Kageyama","doi":"10.1159/000551032","DOIUrl":"10.1159/000551032","url":null,"abstract":"<p><strong>Introduction: </strong>Assessing testicular viability during surgical exploration of an acute scrotum is challenging, especially when the testis appears discolored. The decision between orchiectomy and orchiopexy often relies on subjective intraoperative judgment. We report a case in which testicular puncture and aspiration were used as a therapeutic adjunct to reduce intratesticular pressure during surgery for testicular torsion.</p><p><strong>Case presentation: </strong>A 3-year-old boy presented with right inguinal pain and nausea. After delayed recognition of acute scrotum, he was referred 10 h later with right scrotal discoloration. Ultrasound showed absent Doppler flow and homogeneous echogenicity. Surgical exploration revealed 180° intravaginal torsion and a black, firm testis. Bilateral bell clapper deformity was noted. The affected testis was punctured and aspirated using a 27-gauge needle, resulting in decompression and softening of the testis and avoidance of orchiectomy. Follow-up imaging over 7 years showed stable right-sided atrophy but preserved echogenicity and comparable MRI signal and apparent diffusion coefficient values. At age 15, the patient reached Tanner stage 4, indicating normal pubertal progression.</p><p><strong>Conclusion: </strong>Testicular puncture and aspiration may offer a simple, minimally invasive therapeutic adjunct in the management of torsed testes. Although atrophy developed, structural preservation was suggested by imaging, and the patient experienced normal pubertal progression. Further studies are needed to clarify long-term functional and fertility outcomes.</p>","PeriodicalId":101351,"journal":{"name":"Biomedicine hub","volume":"11 1","pages":"48-52"},"PeriodicalIF":0.0,"publicationDate":"2026-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13068388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147680142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the Reliability of Lung Ultrasound in Neonatal Acute Care Setting: A Systematic Review Protocol.","authors":"Yusuf Syaeful Nawawi, Muchtar Hanafi, Zaka Jauhar Firdaus, Anistyaning Wahyu Adhie","doi":"10.1159/000550915","DOIUrl":"10.1159/000550915","url":null,"abstract":"<p><strong>Introduction: </strong>Choosing appropriate diagnostic imaging modalities in neonates is often challenging. Lung ultrasound (LUS) has been increasingly adopted in the diagnosis and monitoring of respiratory diseases in this population. However, since LUS interpretation relies heavily on operator skills and recognition of artefact patterns, concerns persist regarding its reliability. While numerous studies have explored the clinical utility of LUS, the study of its reliability - particularly inter-rater and intra-rater - remains substantially underrepresented. This systematic review aims to assess the reliability of LUS within neonatal acute care settings and explore associated influencing factors in this context.</p><p><strong>Methods: </strong>We will include studies of LUS examinations performed on neonatal patients (aged <28 days) presenting with respiratory signs, symptoms, or conditions and treated in acute care settings. The systematic review will follow the COSMIN guidelines. The search strategy will include searches of MEDLINE, Embase, Web of Science, Scopus, CINAHL, theses and dissertation repositories, and other gray literature sources. Studies will be assessed by two independent reviewers against the inclusion criteria. We will consider studies published from the 1990s to the present, in any language and of any methodological quality. The COSMIN Risk of Bias checklist will be used. We will extract inter-rater and intra-rater reliability metrics and synthesize the findings narratively and, if appropriate, with meta-analyses. Assessment of certainty of evidence will follow the modified GRADE approach.</p><p><strong>Conclusion: </strong>The findings of this study will address the gap in LUS evaluation on its reliability in neonatal care to guide safe and reproducible clinical practices.</p>","PeriodicalId":101351,"journal":{"name":"Biomedicine hub","volume":"11 1","pages":"38-47"},"PeriodicalIF":0.0,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13030903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147577426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burning Mouth Syndrome and the Oral Microbiome: Unveiling Potential Links.","authors":"Zahra Khorshidi Asl, Farnaz Jafari, Fahimeh Rezazadeh, Homa Kamyabi","doi":"10.1159/000550143","DOIUrl":"10.1159/000550143","url":null,"abstract":"<p><strong>Background: </strong>Burning mouth syndrome (BMS) is a chronic neuropathic orofacial pain condition that remains challenging to manage due to its unclear etiology and limited treatment options. While multiple systemic factors have been proposed, emerging evidence suggests that oral microbial dysbiosis may contribute to neuroinflammatory and pain-related mechanisms. However, the role of the oral microbiota in BMS remains insufficiently understood.</p><p><strong>Summary: </strong>This review examines current evidence regarding the potential association between oral microbiota and BMS, with emphasis on hormonal regulation, immune function, and micronutrient balance. A comprehensive literature search identified studies reporting systemic alterations in patients with BMS. Available evidence suggests that BMS may be associated with changes in sex hormones, thyroid hormones, and neuroendocrine stress responses, potentially influenced by oral microbial composition. Alterations in immune mediators, particularly interleukin-6, and micronutrient imbalances such as vitamin B12 deficiency have also been reported in a subset of patients. These interconnected pathways may contribute to peripheral and central neuropathic pain mechanisms underlying BMS symptoms.</p><p><strong>Key messages: </strong>(i) Oral microbiota may interact with hormonal, immune, and micronutrient pathways relevant to BMS. (ii) The relationship between oral dysbiosis and BMS appears complex and potentially bidirectional. (iii) Further clinical and mechanistic studies are needed to clarify these interactions and inform targeted therapies.</p>","PeriodicalId":101351,"journal":{"name":"Biomedicine hub","volume":"11 1","pages":"23-37"},"PeriodicalIF":0.0,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12999194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147489039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anti-Glomerular Basement Membrane Disease without Linear IgG Deposits in an Elderly Patient with Metastatic Rectal Cancer: A Case Report.","authors":"Louaa Chebbo, Mohammad Ali Yazbek, Youssef Kteich, Rayan Hafez, Hala Kfoury, Ghenwa Dakdouki","doi":"10.1159/000549688","DOIUrl":"10.1159/000549688","url":null,"abstract":"<p><strong>Introduction: </strong>Anti-glomerular basement membrane (anti-GBM) disease is classically diagnosed based on presence of rapidly progressive glomerulonephritis, circulating anti-GBM antibodies, and the hallmark finding of linear IgG deposition along the glomerular basement membrane on kidney biopsy. These deposits are considered a defining feature of the disease, aiding in its differentiation from other pauci-immune glomerulonephritis. However, rare cases lacking IgG deposits on kidney biopsies challenge this paradigm, complicating both diagnosis and management.</p><p><strong>Case presentation: </strong>We report the case of an 80-year-old male with metastatic rectal cancer, who presented with acute kidney injury, hematuria, and proteinuria. Serological testing confirmed elevated anti-GBM antibody levels. Surprisingly, renal biopsy revealed crescentic glomerulonephritis without characteristic linear IgG deposition, which raised diagnostic uncertainty. Despite the absence of this classic finding, the patient's clinical course was consistent with anti-GBM disease. Given his malignancy, treatment was tailored to balance immunosuppression with oncologic and infectious considerations. The patient received a modified immunosuppressive regimen, including plasma exchange and corticosteroids, but IV cyclophosphamide was withheld due to recurrent infections. Initially, from a nephrology standpoint, his clinical course was notable for partial renal recovery, resolution of hematuria, and improvement in both creatinine and proteinuria levels. However, he ultimately passed away due to severe infectious complications.</p><p><strong>Conclusion: </strong>This case underscores the diagnostic challenges and therapeutic decision-making in patients who present with features suggestive of anti-GBM disease, characterized by positive anti-GBM antibodies but absent immune deposits, especially when accompanied by malignancy, prior exposure to immunosuppressive therapy, and concurrent infections.</p>","PeriodicalId":101351,"journal":{"name":"Biomedicine hub","volume":"11 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12726859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145829448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Protocol for the TMaC Study: A Patient-Blinded, Randomised, Sham-Controlled, Parallel-Group Study Evaluating Effects of Repetitive Transcranial Magnetic Stimulation on Chronic Chemotherapy-Induced Pain in Bowel Cancer Patients.","authors":"Eva K Moore, Cassandra Gordon, Brad Gauvin, Timothy J Price, Mark Slee, Hannah R Wardill, Simranjit K Sidhu, Joanne M Bowen","doi":"10.1159/000549605","DOIUrl":"10.1159/000549605","url":null,"abstract":"<p><strong>Introduction: </strong>Chemotherapy-induced peripheral neuropathy (CIPN) is a common and debilitating consequence for people undergoing treatment for cancer, especially bowel cancer. Painful CIPN contributes to psychological distress, functional decline and reduced quality of life. Additionally, it is a dose-limiting factor for anticancer agents, compromising chemotherapy effectiveness and patient survival. To date, no effective long-term management options exist for painful CIPN. Whilst evidence suggests analgesic effects of repetitive transcranial magnetic stimulation (rTMS), little is known regarding its effectiveness specifically for CIPN-associated pain. The proposed study aims to evaluate the analgesic potential of rTMS in bowel cancer survivors, quantify the duration of symptom alleviation, and explore patient perspectives on using rTMS for CIPN management.</p><p><strong>Methods: </strong>Participants will be randomised into two parallel groups (allocation ratio 1:1) to receive rTMS or sham stimulation over four sessions, with each session separated by a minimum of 7 days. Pain scores will be obtained immediately before and after each treatment session, as well as at 8-week and 6-month follow-up sessions using the Visual Analogue Scale for Pain (P-VAS) as the primary outcome. P-VAS scores, along with secondary outcome measures of pain and dysaesthesia, will be compared within and between groups across time to assess short-term and long-term effectiveness of rTMS. An interview will be conducted upon completion of all treatment sessions at the 8-week follow-up for qualitative analysis of patients' acceptance of routine rTMS for pain management.</p><p><strong>Conclusion: </strong>Findings may provide a promising long-term solution to alleviate symptoms of CIPN and enhance quality of life in bowel cancer survivors.</p>","PeriodicalId":101351,"journal":{"name":"Biomedicine hub","volume":"10 1","pages":"219-229"},"PeriodicalIF":0.0,"publicationDate":"2025-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12695115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145746378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Negative Results in Neonatal Trials: Clinical Lessons and Future Directions - A Narrative Review.","authors":"Ashraf Gad, Ammar Yasser Nofal, Leena Khalid Al-Qassem, Loay Alkamel","doi":"10.1159/000549325","DOIUrl":"10.1159/000549325","url":null,"abstract":"<p><strong>Background: </strong>Clinical research involving neonates often presents unique ethical and practical challenges. These difficulties may lead to the early termination of clinical trials, particularly when negative or inconclusive results occur, contributing to publication bias. Failure to report such outcomes ultimately slows the advancement of knowledge and the development of evidence-based care in neonatology.</p><p><strong>Summary: </strong>This review examines the significance of negative trial results in neonatal clinical research, with particular emphasis on interventional studies, and addresses their reliability, challenges in interpretation, and implications for clinical practice. Insights from selected negative neonatal trials were used to assess the impact of unfavorable outcomes on neonatal care. Non-interventional studies were excluded from this review to maintain a focus on controlled clinical trials.</p><p><strong>Key messages: </strong>Properly interpreted negative trials hold significant value in neonatal research. These studies help avoid unnecessary interventions, ensuring more efficient use of resources, and guide future research directions. Despite often being undervalued or overlooked, they remain fundamental to advancing evidence-based neonatal care. Enhanced reporting and interpretation of these findings could greatly benefit both clinical practice and research development in the neonatal population.</p>","PeriodicalId":101351,"journal":{"name":"Biomedicine hub","volume":"11 1","pages":"7-22"},"PeriodicalIF":0.0,"publicationDate":"2025-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12788839/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145954809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of LESTARI (Longitudinal Education and Skills Training in DementiA: Research and Implementation for Informal Caregivers) - A Protocol for Pilot Experimental Study.","authors":"Nicholas Hardi, Kevin Kristian, Yvonne Suzy Handajani, Ika Suswanti, Gennesia Vebriana, Fernandus William, Natalia Natalia, Mikhael Aditya, Nadia Novita Wijaya, Yuda Turana","doi":"10.1159/000548978","DOIUrl":"10.1159/000548978","url":null,"abstract":"<p><strong>Introduction: </strong>Caregivers are essential for people with dementia (PwD). In Indonesia, families often take on this role due to limited professionals, leading to high stress and burden. This study will evaluate the effectiveness of LESTARI project, a caregiver training program adapted from the WHO iSupport framework, aiming to reduce caregiver stress, reduce BPSD, and increase knowledge about delivering care to PwD. Moreover, caregiver satisfaction with the training program will also be assessed.</p><p><strong>Methods: </strong>A non-randomized controlled pilot study will involve primary caregivers of PwD, who will be equally assigned to intervention and control groups. The intervention group will participate in the LESTARI project, which comprises seven training sessions based on the Indonesian WHO's iSupport module. Accordingly, three sessions will be conducted face to face along with four online sessions, all comprising lectures, group discussions, relaxation, and self-reflection activities. The primary outcomes include reducing caregivers' stress and improving QoL, BPSD, and caregiving knowledge in the treatment group versus control. Secondary outcomes assess program acceptability, including session content, process, and hybrid delivery.</p><p><strong>Conclusion: </strong>This study expects the LESTARI training program to reduce caregiver stress, improve quality of life, BPSD, and caregiving knowledge. Secondary outcomes will include caregiver feedback and post-test improvements, supporting feasibility of a hybrid training model as an effective, culturally adapted approach for dementia caregiver support in Indonesia.</p>","PeriodicalId":101351,"journal":{"name":"Biomedicine hub","volume":"10 1","pages":"208-218"},"PeriodicalIF":0.0,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12661140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145650746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Splash Zone: Efficacy of Ureteroscopic Adapters in Containing Hazardous Leak.","authors":"Sami A Mostafa, Hailey Frye, Vishnuvardhan Ganesan, William P Fuell, Emily Turnquist, Deepak K Agarwal, Michael S Borofsky","doi":"10.1159/000546455","DOIUrl":"10.1159/000546455","url":null,"abstract":"<p><strong>Introduction: </strong>Ureteroscopic procedures pose a splash hazard to urologists from irrigant contaminated with urine, blood, or caustic substances, risking health and vision. While ureteroscopic adapters aim to minimize fluid leakage, their efficacy remains unstandardized, with high-pressure irrigation potentially generating hazardous spray. This study aimed to evaluate the potential for hazardous leak of various ureteroscopic adapters.</p><p><strong>Methods: </strong>Six different ureteroscopic adapters were assessed while performing ureteroscopy through a tissue-realistic kidney and ureter model at various levels of pressurized saline generated via a pressure bag and a single-action pumping system (SAPS) with and without a stone basket in the working channel. Leaking was classified as a drip (non-projectile leakage), a spray (small-volume projectile leak), or a splash (large-volume projectile leak). Hazardous spray was defined as any projectile leakage. Ultraviolet fluorescent stain was instilled in the irrigation and utilized to measure the maximal spray distance from the surgeon.</p><p><strong>Results: </strong>The Gyrus Adjustable Biopsy Port Seal had the highest potential for splash, including at gravity. Other adapters that exhibited hazardous leakage include the Gyrus Blue Silicone Seal with a basket in place and the Merit Hemostasis Valve while under high pressure using SAPS. Only one valve demonstrated no leak under any simulated circumstances (the Medtronic Piton). The Cook Check-Flo Adapter and Boston Scientific Urolok II demonstrated nonhazardous leakage. In the second arm of the experiment, maximal spray distance using the Gyrus Adjustable Biopsy Port Seal was 14.4 feet.</p><p><strong>Conclusion: </strong>Ureteroscopic adapter leakage can be variable among adapters, and surgeons should be aware of the hazardous potential for exposure.</p>","PeriodicalId":101351,"journal":{"name":"Biomedicine hub","volume":"10 1","pages":"203-207"},"PeriodicalIF":0.0,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12659600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145650777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Infection-Related Glomerulonephritis Revealed as Shunt Nephritis: A Case Report.","authors":"Nathalie Hammer, Antonio Rodriguez-Calero, Philipp Zens, Uyen Huynh-Do, Ayuna Asoyan","doi":"10.1159/000548443","DOIUrl":"10.1159/000548443","url":null,"abstract":"<p><strong>Introduction: </strong>Shunt nephritis is a rare immune complex-mediated glomerulonephritis associated with an infected ventriculoatrial shunt (VAS) or ventriculoperitoneal shunt (VPS). Its incidence has declined to 0.7-2% due to improved infection management. Low-grade bacteremia, particularly from VAS, often involves pathogens such as <i>Cutibacterium acnes</i>, <i>Staphylococcus epidermidis</i>, and <i>Streptococcus</i> species. Immune complex deposition in the kidneys leads to glomerulonephritis and nephrotic syndrome. Early diagnosis and shunt removal, alongside antibiotics, are crucial for renal recovery.</p><p><strong>Case presentation: </strong>A 35-year-old male with a history of traumatic brain injury and VAS placement presented with generalized edema, hypertension, fatigue, and neurological decline. The patient exhibited nephrotic syndrome with low complement levels. Renal biopsy revealed diffuse membranoproliferative glomerulonephritis with subendothelial deposits. Cerebrospinal fluid (CSF) analysis showed pleocytosis and an elevated albumin ratio, with <i>C. acnes</i> confirmed via blood and CSF cultures. Targeted antibiotic therapy, with first externalization and then removal of the VAS, was followed by a VPS re-implantation after infection resolution. The complement levels normalized, albuminuria decreased, and renal function stabilized.</p><p><strong>Discussion: </strong>This case highlights the diagnostic challenges associated with shunt nephritis, particularly in the absence of overt infection. Early recognition, targeted antibiotics, and shunt removal are essential for preventing progressive kidney damage and resolving nephrotic syndrome. This case highlights the need for multidisciplinary management in such a complex presentation.</p>","PeriodicalId":101351,"journal":{"name":"Biomedicine hub","volume":"10 1","pages":"197-202"},"PeriodicalIF":0.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12659596/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145650797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}