Frontiers in Medicine最新文献

{"title":"Perspectives of old-age and dementia researchers on communication with policymakers and public research funding decision-makers: an international cross-sectional survey.","authors":"Peter Fusdahl, Miguel Germán Borda, Jonathan Patricio Baldera, Dag Aarsland, Ara Khachaturian, Geir Sverre Braut","doi":"10.3389/fmed.2024.1472479","DOIUrl":"https://doi.org/10.3389/fmed.2024.1472479","url":null,"abstract":"<p><strong>Introduction: </strong>Society commonly believes that research knowledge is complementary to public decision-making. This study aimed to understand the perspectives and implications of dementia researchers communicating with policymakers and public research decision-makers (public officials).</p><p><strong>Methods: </strong>This study uses 24 questions from an anonymous, online survey, which was received by 392 members of nine European, Latin American, and United States medical researcher associations/networks in the fields of age-related neurological degeneration and dementia medicine. The data were analyzed via crosstab analysis, two group comparison analyses, and a logistic regression model.</p><p><strong>Results: </strong>In total, 91 (23.2%) respondents completed the questionnaire. Eight independent variables were related to researchers' research discipline, research remuneration, experience, authorship, H-index, and research grants. The statistically significant variables determining whether the respondents had contact with public officials were \"Years of research experience\" (<i>p</i> = 0.004), \"Number of articles first-authored in the last 5 years\" (<i>p</i> = 0.007), and \"Average H-index in the last 5 years\" (<i>p</i> = 0.048) [median (IQR)]; 47% of the surveyed researchers had been in contact with public officials in the last 12 months. The most frequently communicated topics were the importance of their own research to society (61%) and their own funding (60%); 87% (<i>n</i> = 79) of the researchers did not believe that public officials had a very good understanding of their dementia research.</p><p><strong>Conclusion: </strong>Less than half (47%) of dementia researchers communicate with public officials, and they communicate mostly about the importance of their own research and funding their own research. Nine of 10 researchers do not believe that public officials understand their research well.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1472479"},"PeriodicalIF":3.1,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11695358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The clinical efficacy of a novel smartphone-based salivary self-test for the prediction of pre-eclampsia, pregnancy-induced hypertension and intrauterine growth restriction: a prospective cohort study.","authors":"Ida Catharina Püschl, Lisbeth Bonde, Thomas Alexander Gerds, Mia Sato Tackney, James Quest, Bjarke Lund Sorensen, Nicholas Stephen Macklon","doi":"10.3389/fmed.2024.1385299","DOIUrl":"https://doi.org/10.3389/fmed.2024.1385299","url":null,"abstract":"<p><strong>Introduction: </strong>This study investigated the efficacy of a digital health solution utilizing smartphone images of colorimetric test-strips for home-based salivary uric acid (sUA) measurement to predict pre-eclampsia (PE), pregnancy-induced hypertension (PIH), and intrauterine growth restriction (IUGR).</p><p><strong>Methods: </strong>495 pregnant women were included prospectively at Zealand University Hospital, Denmark. They performed weekly self-tests from mid-pregnancy until delivery and referred these for analysis by a smartphone-app. Baseline characteristics were obtained at recruitment and pregnancy outcomes from the journals. The mean compliance rate of self-testing was assessed. For the statistical analyses, standard color analyses deduced the images into the red-green-blue (RGB) color model value, to observe the individual, longitudinal pattern throughout the pregnancy for each outcome. Extended color analyses were applied, deducing the images into 72 individual color variables that reflected the four dominant color models. The individual discriminatory ability was assessed by calculating the area under the curve for the outcome of PE, and the outcome of hypertensive pregnancy disorders solely or combined with IUGR at 25 weeks of gestation and for the weekly color change between 20 and 25 weeks of gestation.</p><p><strong>Results: </strong>Thirty-four women (6.9%) developed PE, 17 (3.4%) PIH, and 10 (2.0%) IUGR. The overall mean compliance rate was 67%, increasing to 77% after updating the smartphone-app halfway through the study. The longitudinal pattern of the RGB value showed a wide within-person variability, and discrimination was not achieved. However, it was noted that all women with IUGR repeatedly had RGB values below 110, contrasting women with non-IUGR. Significant discriminatory ability was achieved for 8.2% of the analyses of individual color variables, of which 27.4% summarized the Hue color variable. However, the analyses lacked consistency regarding outcome group and gestational age.</p><p><strong>Conclusion: </strong>This study is the first proof-of-concept that digital self-tests utilizing colorimetric sUA measurement for the prediction of PE, PIH, and IUGR is acceptable to pregnant women. The discriminatory ability was not found be sufficient to have clinical value. However, being the first study that compares individual color variables of the four dominant color models, this study adds important methodological insights into the expanding field of smartphone-assisted colorimetric test-strips.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1385299"},"PeriodicalIF":3.1,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11697148/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Very low doses of rituximab in autoimmune hemolytic anemia-an open-label, phase II pilot trial.","authors":"Miriam M Moser, Renate Thalhammer, Christian Sillaber, Ulla Derhaschnig, Christa Firbas, Ulrich Jäger, Bernd Jilma, Christian Schoergenhofer","doi":"10.3389/fmed.2024.1481333","DOIUrl":"https://doi.org/10.3389/fmed.2024.1481333","url":null,"abstract":"<p><strong>Introduction: </strong>Although rituximab is approved for several autoimmune diseases, no formal dose finding studies have been conducted. The amount of CD20+ cells differs significantly between autoimmune diseases and B-cell malignancies. Hence, dose requirements of anti-CD20 therapies may differ accordingly.</p><p><strong>Methods: </strong>We conducted a phase II pilot trial investigating the effects and safety of very low doses of rituximab, i.e., 5 mg/m² every 3 weeks, 20 mg every 4 weeks, 50 mg every 3 months (<i>n</i> = 3 each) and 100 mg every 3 months (<i>n</i> = 1) in patients with autoimmune hemolytic anemia (AIHA) to effectively suppress CD20⁺ cell counts. Doses were increased if circulating CD20⁺ cell depletion was insufficient (i.e., <95% reduction from baseline) in a dose group. Plasma rituximab concentrations were quantified by enzyme-linked immunosorbent assay, CD20⁺ cell counts were determined by flow cytometry.</p><p><strong>Results: </strong>Ten patients were included in the final analysis (7 with cold agglutinin disease, 2 with warm AIHA, 1 with mixed-type AIHA). The first infusion depleted ≥95% of CD20⁺ cells in all but one of the included patients. However, the dosing regimens were found ineffective, because a sustained CD20⁺ cell depletion was not achieved, and CD20⁺ cells recovered with a high interindividual variability. CD20⁺ lymphocytes were below the detection limit if rituximab plasma concentrations exceeded 0.4 μg/mL. One endokarditis occured.</p><p><strong>Conclusion: </strong>Rituximab doses as low as 5 mg/m² transiently depleted CD20⁺ cells in almost all patients, but the tested low-dose regimens failed to permanently suppress CD20⁺ cells. The empirically identified EC95% of 0.4 μg/mL rituximab may guide future studies using low-doses of rituximab.</p><p><strong>Clinical trial registration: </strong>https://clinicaltrials.gov/, identifier [EudraCT 2016-002478-11].</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1481333"},"PeriodicalIF":3.1,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11695359/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of sepsis in trauma patients: a National Trauma Data Bank analysis.","authors":"Ralphe Bou Chebl, Joudie Sahar Alwan, Mounay Bakkar, Saadeddine Haidar, Rana Bachir, Mazen El Sayed, Gilbert Abou Dagher","doi":"10.3389/fmed.2024.1500201","DOIUrl":"https://doi.org/10.3389/fmed.2024.1500201","url":null,"abstract":"<p><strong>Background: </strong>Trauma remains a global health issue being one of the leading causes of death worldwide. Sepsis and infections are common complications contributing to mortality, emphasizing the need to understand factors leading to such complications following trauma.</p><p><strong>Aim: </strong>This study aimed to identify risk factors associated with post-trauma sepsis using data from the National Trauma Data Bank (NTDB).</p><p><strong>Methods: </strong>Using the 2017 National Trauma Data Bank (NTDB), this is a retrospective case-control study that looked at pre-hospital and in-hospital patient data. Trauma patients aged over 15 years presenting to the emergency department (ED) and admitted to a tertiary care center were included. The primary outcome assessed was the development of sepsis post-trauma. Logistic regression analysis was used to identify risk factors, considering patient demographics, injury characteristics, and clinical variables.</p><p><strong>Results: </strong>Among 997,970 trauma patients in the 2017 NTDB, 296,974 were excluded, leaving 700,996 patients for analysis, with 2,297 developing sepsis. Patients who developed sepsis were older than those who did not develop sepsis (mean age 57.57 vs. 53.42 years, <i>p</i>-value<0.001) and predominantly white males. Risk factors associated with sepsis development included: respiratory intubation with mechanical ventilation (OR = 11.99; 95% CI = 10.66-13.48), blood transfusion administration (OR = 2.03; 95% CI = 1.83-2.25), Injury Severity Score (ISS) ≥ 16 (OR = 1.69; 95% CI = 1.51-1.89), chronic obstructive pulmonary disease (COPD) (OR = 1.65; 95% CI = 1.44-1.89), diabetes mellitus (DM) (OR = 1.41; 95% CI = 1.26-1.58), male sex (OR = 1.42; 95% CI = 1.28-1.57), hypertension (HTN) (OR = 1.30; 95% CI = 1.16-1.45), anticoagulation therapy (OR = 1.21; 95% CI = 1.05-1.39), older age (OR = 1.02; 95% CI = 1.01-1.02), and current smoking status (OR = 1.18; 95% CI = 1.06-1.32).</p><p><strong>Conclusion: </strong>This study identified key risk factors for post-trauma sepsis. Recognition of preexisting conditions and injury severity is crucial in trauma patient management to mitigate septic complications. Early identification of at-risk patients could facilitate timely interventions and potentially reduce mortality rates in trauma care settings.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1500201"},"PeriodicalIF":3.1,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11697700/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disease burden and trends of lung cancer attributable to nickel among Chinese and global population: a cross-sectional study.","authors":"Huaye Lu, Lei Han, Peihong Wu, Xin Liu, Qingtao Jiang","doi":"10.3389/fmed.2024.1497597","DOIUrl":"https://doi.org/10.3389/fmed.2024.1497597","url":null,"abstract":"<p><strong>Background: </strong>Nickel is a well-established carcinogen, and China stands as a significant producer of nickel compounds. Nickel-associated lung cancer is increasingly acknowledged as a pressing public health concern. This study presents a comprehensive analysis at temporal, spatial, and population levels utilizing the most recent data from GBD 2019 to estimate the disease burden of nickel-associated lung cancer from 1990 to 2019, and make predictions to 2035.</p><p><strong>Methods: </strong>We delineated data on nickel-associated lung cancer concerning mortality, disability-adjusted life years (DALY), and age-standardized rates (ASRs) over a 30-year period based on the global burden of disease (GBD) 2019. Joinpoint regression analysis was utilized to identify temporal changes and to estimate the annual percentage change (APC) as well as the average annual percentage change (AAPC) for each trend segment. The Nordpred model was employed to elaborate on ASRs trends from 1990 to 2019, along with projections for the subsequent 15 years.</p><p><strong>Results: </strong>In both China and globally, the mortality rate from nickel-associated lung cancer and the associated DALYs have increased by 145.8, 77.8, 120.2, and 64.6%, respectively. ASRs within Chinese and global populations exhibit a pattern characterized by an initial increase followed by a decrease as age progresses, with males higher than females. The trend for DALY indicates an initial rise followed by a decline, peaking in the year 2027.</p><p><strong>Conclusion: </strong>The age structure of nickel-associated lung cancer patients shows an aging trend, and the ASDR in the Chinese population indicates a potential upward trend when projecting the disease burden of nickel-associated lung cancer over the next 15 years. We should place greater emphasis on the implementation of preventive strategies and the enhancement of the quality of life for current sufferers.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1497597"},"PeriodicalIF":3.1,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11695296/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification and treatment of <i>Enterococcus avium</i>-induced diabetic foot ulcer: a case report and microbiome analysis.","authors":"Yuanling Jin, Tao Zhu, Xiao Cai, Zheng Fu, QiangLong Pan, HaiXia Tu, ShouXing Wang, Yan Li","doi":"10.3389/fmed.2024.1502337","DOIUrl":"https://doi.org/10.3389/fmed.2024.1502337","url":null,"abstract":"<p><strong>Abstract: </strong>Diabetic foot ulcer (DFU) is a severe complication of diabetes. Due to conservative or delayed treatment, the majority of DFU patients frequently miss the optimal treatment window, thereby leading to amputation. Despite being a rare pathogen with low virulence, <i>Enterococcus avium</i> (<i>E. avium</i>) exhibits some antibiotic resistance and can be fatal for immunocompromised patients. This report describes a DFU case, caused by <i>E. avium</i> infection due to exposure to poultry. Wound microbiota was dynamically monitored using bacterial culture followed by 16S rRNA gene sequencing throughout the illness. Combination of antibiotics was administered to control the secondary infection.</p><p><strong>Case report: </strong>A 56-year-old man presented with a two-week history of redness, swelling, heat, pain, and pus discharge from a ruptured wound on his left heel. The patient was diagnosed with osteomyelitis and a Wagner grade 3 diabetic foot ulcer infection, complicated by the soft tissue infection in the left heel. Strain identification and antibiotic susceptibility tests were immediately performed after admission. The patient underwent three debridement procedures at the DFU site. However, we observed recurrent bacterial infections, based on the clinical progression. Second-generation sequencing detected various pathogens. After targeted treatment with Vacuum sealing drainage (VSD) combined with antibiotic bone cement, the patient's condition stabilised. A skin graft was subsequently performed. Antibiotics were used to control the infection and blood glucose level was controlled throughout the treatment.</p><p><strong>Conclusion: </strong>Thus, this report provides a comprehensive description of a DFU case, caused by <i>E. avium.</i> Antibiotics and surgical measures should be adjusted according to the pathogens responsible for wound infections in DFU patients. It is important to reduce the mortality and prevent irreversible amputations.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1502337"},"PeriodicalIF":3.1,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11695312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Phage therapy for extensively drug resistant <i>Acinetobacter baumannii</i> infection: case report and <i>in vivo</i> evaluation of the distribution of phage and the impact on gut microbiome.","authors":"Jiayao Qu, Jin Zou, Jiancong Zhang, Jiuxin Qu, Hongzhou Lu","doi":"10.3389/fmed.2024.1432703","DOIUrl":"https://doi.org/10.3389/fmed.2024.1432703","url":null,"abstract":"<p><p>Numerous studies have documented successful instances of bacteriophage therapy in treating infections caused by extensively drug-resistant <i>Acinetobacter baumannii</i> (XDRAB). However, the safety profile of phage therapy and its effects on the human gut microbiota remain areas of concern. In this study, we collected blood, sputum, and fecal samples from an elderly female patient during two phases of inhaled bacteriophage therapy targeting extensively drug-resistant <i>Acinetobacter baumannii</i> (XDRAB). We investigated the <i>in vivo</i> distribution of bacteriophages and their impact on the gut microbiome. Bacteriophage DNA was detected in blood samples exclusively during the first 4 days of the second phase of phage therapy, with Ct values ranging from 32.6 to 35.3. In sputum samples, the Ct values of phages demonstrated a decreasing trend from 45 to 14.7 during the first phase of phage therapy, subsequently stabilizing between 28.5 and 26.8 in the second phase. In fecal samples, a significant reduction in the Ct value of phages was observed following both phases of bacteriophage treatment, with values decreasing from 35.5 to 22.5 and from 32.6 to 22.7, respectively. The composition of the gut microbiota was analyzed using Illumina-based 16S rRNA sequencing from fecal samples. Sequencing analysis revealed significant alterations in the microbiota composition at both the phylum and genus levels during phage therapy. These findings suggest that inhaled phages are detectable in human blood and tend to accumulate in the intestines. Furthermore, notable changes in the gut microbiota were observed throughout the duration of the phage treatment.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1432703"},"PeriodicalIF":3.1,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11695418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case report: Cilioretinal artery occlusion combined with central retinal vein occlusion as the initial presentation of pulmonary arterial hypertension.","authors":"Yane Gao, Xiaofeng Xie, Jiao Li, Qingshuai Mu, Xingrong Wang, Shuya Wang","doi":"10.3389/fmed.2024.1493834","DOIUrl":"https://doi.org/10.3389/fmed.2024.1493834","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary arterial hypertension (PAH) is characterized by elevated pulmonary artery pressure and vascular resistance, leading to systemic venous hypertension and potential right heart failure. These elevated pressures can extend to ocular veins, resulting in complications such as central retinal vein occlusion (CRVO). This case report highlights a rare instance of CRVO combined with cilioretinal artery occlusion (CilRAO), an uncommon ocular manifestation associated with PAH.</p><p><strong>Case presentation: </strong>A 13-year-old girl with a history of surgically repaired ventricular septal defect presented with sudden vision loss and a central visual field defect. Investigation confirmed CRVO and an unusual concurrent CilRAO. Although laboratory tests were inconclusive, the echocardiographic examination suggested severe pulmonary arterial hypertension (PAH). The patient received treatment with Bosentan and traditional Chinese medicine, which improved her vision to 20/20, though a paracentral scotoma remained.</p><p><strong>Conclusion: </strong>This case underscores the critical link between systemic cardiovascular abnormalities and ocular health in PAH, where elevated venous pressure can result in severe and distinctive ocular manifestations. The co-occurrence of CRVO and CilRAO in this patient highlights the susceptibility of cilioretinal arteries to hemodynamic changes, as these arteries lack autoregulatory capacity. Additionally, this case demonstrates the potential for positive outcomes in ocular lesions with targeted PAH therapy. Importantly, it emphasizes the need for vigilance when managing complex cases where conclusions cannot be drawn solely from ocular findings. A multidisciplinary approach and comprehensive diagnostics are essential for identifying underlying causes, ensuring active treatment, and preventing permanent vision loss and serious systemic complications.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1493834"},"PeriodicalIF":3.1,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11695289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Renoprotective effects of remote ischemic preconditioning on acute kidney injury induced by repeated tourniquet application in patients undergoing extremity surgery.","authors":"Ziying Tao, Yang Zhang, Erliang Kong, Haili Wei, Mingyue Li, Shuhui Sun, Liwei Liu, Daqing Yin, Xudong Feng","doi":"10.3389/fmed.2024.1477099","DOIUrl":"https://doi.org/10.3389/fmed.2024.1477099","url":null,"abstract":"<p><strong>Objective: </strong>Limb ischemia-reperfusion injury caused by repeated tourniquet application usually leads to acute kidney injury, adversely affecting patient prognosis. This study aimed to investigate the renoprotective effect of remote ischemic preconditioning (RIPC) in patients undergoing extremity surgery with repeated tourniquet application.</p><p><strong>Methods: </strong>64 patients were enrolled and randomly divided into an RIPC group and a control group, with 32 patients in each. Pretreatment was administered before surgery, and baseline characteristics were collected. Perioperative surgical characteristics, renal biomarkers, oxidative stress markers, inflammatory factors, and postoperative conditions were recorded.</p><p><strong>Results: </strong>2 participant were excluded from each group, leaving 30 patients per group. There were no significant differences between the two groups regarding baseline characteristics and perioperative surgical characteristics (<i>p</i> > 0.05). Compared to the control group, the RIPC group showed a significant decrease in BUN and SCr at 48 h postoperatively (<i>p</i> < 0.05). Levels of Cys-C, [TIMP-2] × [IGFBP-7], KIM-1, IL-18, and NGAL were significantly reduced at the first and second tourniquet releases and at 24 h postoperatively in the RIPC group (<i>p</i> < 0.05). From the first tourniquet release to 48 h postoperatively, MDA levels were significantly lower (<i>p</i> < 0.05) and SOD levels were significantly higher (<i>p</i> < 0.05) in the RIPC group compared to the control group. Postoperative conditions did not differ significantly between the groups.</p><p><strong>Conclusion: </strong>RIPC effectively mitigated acute kidney injury caused by repeated tourniquet application, offering a robust method for perioperative renal protection in patients undergoing extremity surgery. Future studies should explore the underlying mechanisms and long-term clinical outcomes of RIPC in broader patient populations.</p><p><strong>Clinical trial registration: </strong>https://www.chictr.org.cn/showproj.html?proj=231266.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1477099"},"PeriodicalIF":3.1,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11695378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Compartmental analysis of retinal vascular parameters and thickness in myopic eyes using SS-OCTA.","authors":"Chen Zeng, Chong Tang, Yixin Tan, Juxian Liu, Kai Shi, Qi Li","doi":"10.3389/fmed.2024.1521710","DOIUrl":"https://doi.org/10.3389/fmed.2024.1521710","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to comprehensively explore the thickness and topographic distributions of retinal vessel alterations of different myopic eyes by using swept-source OCT angiography (SS-OCTA).</p><p><strong>Methods: </strong>One hundred myopes were included in this observational cross-sectional study. All participants underwent a series of ocular examinations of biometrical parameters, including spherical equivalent refraction (SER), axial length (AL), intraocular pressure (IOP), curvature radius (CR), and others. Retinal parameters like vessel density (VD) of different compartments of papillary and peripapillary sectors were measured by SS-OCTA, respectively. Two sample-independent T-test was applied to identify intraocular differences in retinal biometrical indicators between groups, and correlation analysis was used to explore potential relationships between AL/CR ratio and some ocular variables.</p><p><strong>Results: </strong>For high myopic participants, they exhibited a lower vessel density, a lower small vessel density, and a lower flow area, especially in the superficial layer and the nerve fiber layer (RNFL), along with a thinner superficial layer, RNFL and retina. More alterations were proved in nasal peripapillary sectors in high myopes. We also explored their hidden relationship with AL/CR ratio. We found that in non-high myopes, the thickness of the whole retina, RNFL and the superficial layer were all negatively correlated with AL/CR ratio in the papillary and peripapillary zone. In contrast, the vessel density and flow area of several vessel layers were positively correlated. However, there wasn't so much significance found in high myopic eyes.</p><p><strong>Conclusion: </strong>Retinal vessel microstructure was more easily affected in highly myopic eyes, especially in superficial blood vessels, and compartmental analysis showed that alterations in nasal peripapillary sectors were more evident. Additionally, we highlighted hidden correlations between AL/CR ratio and blood flow characteristics of specific vascular layers, which could serve as sensitive biometrical indicators of early retinal damages.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1521710"},"PeriodicalIF":3.1,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11695306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}