Irish Journal of Medical Science最新文献

{"title":"MiR-144-3p participates in the regulation of gestational diabetes mellitus by targeting FOXO1.","authors":"Meiyi Chen, Shaomeng Sun, Lei Ma, Li Bian, Biao Zhao, Haiyong Zeng","doi":"10.1007/s11845-025-03894-8","DOIUrl":"https://doi.org/10.1007/s11845-025-03894-8","url":null,"abstract":"<p><strong>Background: </strong>The pivotal role of microRNAs (miRNAs) in the pathogenesis of gestational diabetes mellitus (GDM) have been increasingly highlighted in recent studies.</p><p><strong>Aims: </strong>To investigate miR-144-3p expression in patients with GDM and its potential mechanisms in GDM.</p><p><strong>Methods: </strong>According to the inclusion criteria, 98 pregnant women with GDM and 98 normal pregnant women were statistically selected. The levels of miR-144-3p were determined by RT-qPCR. The ROC curve was used to evaluate the diagnostic value of miR-144-3p for GDM. Pearson analysis was used to analyze the correlation. HRT-8/SVneo cells were induced by high glucose in vitro to mimic the high glucose environment of GDM. On this basis, the cell models of miR-144-3p overexpression and knockdown were established to investigate the potential mechanism of miR-144-3p in GDM.</p><p><strong>Results: </strong>The level of miR-144-3p in GDM group was markedly higher than that in normal pregnant women. In terms of predicting GDM, miR-144-3p demonstrated high accuracy. MiR-144-3p was positively linked to blood glucose markers in GDM. Further investigation has confirmed that miR-144-3p harbors a binding site for FOXO1 and can directly modulate its expression. Moreover, miR-144-3p targeted FOXO1 to affect the proliferation of trophoblast cells.</p><p><strong>Conclusion: </strong>The expression of miR-144-3p is elevated in pregnant women with GDM. MiR-144-3p may be involved in the regulation of GDM by targeting FOXO1.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143408055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetic screening in cohort of Egyptian patients with pulmonary arterial hypertension disease.","authors":"Samar I E Ayyad, Miral M Refeat, Engy A Ashaat, Abdel-Rahman B Abdel-Ghaffar, Germine M Hamdy","doi":"10.1007/s11845-025-03889-5","DOIUrl":"https://doi.org/10.1007/s11845-025-03889-5","url":null,"abstract":"<p><strong>Background: </strong>Variants in the bone morphogenetic protein 2 receptor gene (BMPR2) are the most frequent genetic cause of pulmonary arterial hypertension (PAH). However, correlation of BMPR2 variants and PAH clinical phenotype remains to be elucidated.</p><p><strong>Methods and results: </strong>The goal of the present study is to investigate variants of the causative gene (BMPR2) in 25 Egyptian patients clinically pre-diagnosed with PAH symptoms and 10 healthy candidates using Sanger sequencing technique. Three pathogenic heterozygous missense variants have been illustrated in BMPR2 gene, two novel variants (V387E, E481K) in exon 9 and 11 respectively and one previously reported missense variant (C496G) in exon 11. The remaining 22 patients as well as the 10 healthy individuals showed no pathogenic variants.</p><p><strong>Conclusion: </strong>Further studies on larger number of participants, using advanced NGS technique, should be performed to enrich information about genotype/phenotype correlations and incidence of PAH disease among Egyptian population; thus, it would provide families of PAH patients with accurate genetic counseling in order to prevent disease recurrence.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143390796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improved performance of cementless total knee arthroplasty (TKA)across international registries: a comparative review.","authors":"Meadhbh Ni Mhiochain de Grae, Armon Nasehi, David F Dalury, Bas A Masri, Gerard A Sheridan","doi":"10.1007/s11845-025-03888-6","DOIUrl":"https://doi.org/10.1007/s11845-025-03888-6","url":null,"abstract":"<p><strong>Background: </strong>Cementless fixation in total knee arthroplasty (TKA) has been associated with higher revision rates in the past. However, due to advancements in design, as well as surgical techniques, cementless TKA performance has significantly improved. The advantages of cementless fixation include reduced cement-related complications, shorter operating times, and the potential benefits of osseointegration. We aim to assess the improvement in revision rates for cementless TKA over the last 9 years based on international registry reports.</p><p><strong>Methods: </strong>A comprehensive retrospective review was conducted of six major English-speaking knee arthroplasty registries across the world including the National Joint Registry of England and Wales, Northern Islan Isle of Man and Guernsey (herby referred to as British), Swedish, Canadian, American, Australian, and New Zealand National Joint Registry. Data was collected from the year 2014 along with the most recent annual report published: 2022 or 2023. Data points collected included usage rates of cemented and cementless prostheses for primary TKA, their respective revision rates, and indications for revision.</p><p><strong>Results: </strong>Across four databases, there was an average 8.3% increase in the utilization of cementless fixation for primary TKA over the past decade. Three registries reported a reduction in revision rates for cementless fixation. Lower revision rates for cementless compared to cemented TKA were observed in the most recent American (3.2% cemented vs. 2.8% cementless) and New Zealand annual reports (11.8% cemented vs. 4.5% cementless). In 2022, the British registry reported lower rates of revision for infection with cementless fixation (0.56 vs. 0.89).</p><p><strong>Conclusion: </strong>International registries demonstrate increased utilization of cementless TKA. Cementless TKA was reported to have lower revision rates in the most recent US and New Zealand annual reports when compared to cemented TKA.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical, biochemical profile and atherosclerotic cardiovascular risk score (ASCVD) in patients with high HDL cholesterol.","authors":"Raksha Udupi Mallya, Sudha Vidyasagar, Varashree Bs, Cynthia Amrutha Sukumar","doi":"10.1007/s11845-025-03878-8","DOIUrl":"https://doi.org/10.1007/s11845-025-03878-8","url":null,"abstract":"<p><strong>Background: </strong>It was observed that many people in the western coastal belt were found to have a high HDL cholesterol, the cause of which was not known. This study was done to learn about the factors contributing to the high HDL cholesterol in these patients and its effect on ASCVD risk.</p><p><strong>Methods: </strong>In this prospective, case control study, 150 patients were recruited, of which 63 were cases (patients with high HDL cholesterol), and 87 were controls (patients with normal HDL cholesterol). Details regarding their diet, sea-food consumption, habits, comorbidities, daily activity (using GPAQ questionnaire), and blood reports were collected. ASCVD risk score was calculated using an online ASCVD risk estimator. Blood samples of 96 patients (cases 40, controls 56) was tested for cholesterol esterase transfer protein (CETP) levels using ELISA, and the results were compared.</p><p><strong>Results: </strong>Patients with high HDL cholesterol were found to be physically more active and had median metabolic equivalent (METs) of 4680 (1200, 8580) compared with controls with median METs of 1680 (720, 5580), P-0.013. Cases had a lower mean BMI 23.09(SD-3.69), than in patients with normal HDL cholesterol with a mean of 24.41(SD-4.01), P-0.04. Cases also had a lower triglyceride level (91(69,118) in cases vs 121 (80,151) in controls, P-0.002. Alcohol and sea food consumption had no role on HDL levels in this study. The median CETP level was lower in patients with high HDL levels, 0.336(0.08, 0.336) versus 1.435(0.061, 2.893) in the control group although not statistically significant. Patients with high HDL cholesterol were found to have a significantly lower median 10-year ASCVD risk score 3.05 (0.6, 8.95), compared with patients with normal HDL 6.45 (2.7,14.2).</p><p><strong>Conclusion: </strong>Patients with high HDL cholesterol were found to be physically more active, had a lower BMI, a lower triglyceride level, and a lower ASCVD risk compared with controls. They also had a lower CETP level. Further research will be required to determine the normal CETP level in Indian population, their genetic makeup, and whether it has a role in cardiovascular protection.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143370506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The patients' perspective of bedside teaching in the post-Covid era.","authors":"Angela Kearns, James Lennon, Lucy Hurley","doi":"10.1007/s11845-025-03900-z","DOIUrl":"https://doi.org/10.1007/s11845-025-03900-z","url":null,"abstract":"<p><strong>Background: </strong>Bedside teaching with real patients is vital to the education of medical students. With the onset of the Covid-19 pandemic in 2020, all student-patient interactions were suspended in order to prevent the spread of the virus. Research has previously focussed on the medical professional and medical student views concerning bedside teaching, with less of a focus on patient insights.</p><p><strong>Aims: </strong>The purpose and aims of this study were to explore the patient's perspectives of encountering medical students and contributing to their learning in the clinical setting, beyond the Covid restrictions.</p><p><strong>Methods: </strong>Qualitative semi-structured interviews were carried out with a cohort of Mayo University hospital inpatients, who had participated in a bedside teaching session. An interview guide was employed to facilitate consistent and analogous data. An interpretative phenomenological approach was used for data analysis yielding a number of themes.</p><p><strong>Results: </strong>Participants recognised the value of their involvement in the clinical education of future doctors, in addition to the positive impacts of such contributions for their own future healthcare. Participants had no concerns about partaking in bedside teaching sessions relating to Covid infection.</p><p><strong>Conclusions: </strong>This study assessed the opinions of hospital inpatients with regards to participating in clinical teaching sessions and found that they do not perceive their role as passive.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143370507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Virtual recovery: efficacy of telerehabilitation on dyspnea, pain, and functional capacity in post-COVID-19 syndrome.","authors":"Zeynal Yasacı, Rustem Mustafaoglu, Ozlem Ozgur, Berna Kuveloglu, Yasemin Esen, Ozge Ozmen, Ebru Yılmaz Yalcinkaya","doi":"10.1007/s11845-025-03899-3","DOIUrl":"https://doi.org/10.1007/s11845-025-03899-3","url":null,"abstract":"<p><strong>Background: </strong>Post-COVID-19 syndrome (PCS) causes persistent symptoms that impair quality of life, and telerehabilitation (TR) provides an effective remote alternative for addressing these challenges.</p><p><strong>Aim: </strong>This study aimed to evaluate the effects of a TR-based exercise program on dyspnea, pain intensity, and functional capacity in individuals with PCS.</p><p><strong>Design: </strong>Sixty PCS patients were randomized into a telerehabilitation group (TG, n = 32) or a control group (CG, n = 28). The TG received supervised TR sessions twice a week for 6 weeks, while the CG performed unsupervised home exercises. Assessments were conducted at the baseline and the end of 6 weeks.</p><p><strong>Results: </strong>TG showed significantly greater improvements compared to CG. mMRC decreased by 1.16 (95% CI, 0.93-1.38) vs. 0.36 (95% CI, 0.17-0.55), NPRS by 1.44 (95% CI, 0.95-1.92) vs. 0.6 (95% CI, 0.28-0.93), and 5-TST improved by 6.8 s (95% CI, 5.59-8.01) vs. 2.12 s (95% CI, 1.08-3.17). Significant differences were also observed for PSQI (p = 0.018) and HADS-anxiety (p = 0.001).</p><p><strong>Conclusions: </strong>A TR-based exercise program significantly reduced dyspnea and pain intensity while improving functional capacity in PCS patients, making it an effective alternative to unsupervised exercise regimens.</p><p><strong>Trial registration: </strong>This study is prospectively registered at NCT05381675 ( clinicaltrials.gov ).</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143370509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Synergistic effects of zP-1 phage and ampicillin against methicillin-resistant Staphylococcus aureus isolated from hospital staff.","authors":"Zain Mehmood, Rabia Kanwar, Kaleem Ullah, Saqib Ali, Muhammad Aamir Aslam, Abdul Qadeer, Haiwad Gul, Mohamed Hassanein Mahmoud","doi":"10.1007/s11845-025-03898-4","DOIUrl":"https://doi.org/10.1007/s11845-025-03898-4","url":null,"abstract":"<p><strong>Background: </strong>Methicillin-resistant Staphylococcus aureus (MRSA) strains are a major cause of hospital-acquired infections, exacerbated by increasing antibiotic resistance.</p><p><strong>Aim: </strong>This study aimed to isolate bacteriophages targeting MRSA and evaluate their antimicrobial activity in combination with antibiotics.</p><p><strong>Methods: </strong>Nasal samples from hospital staff (n = 50) were used to isolate MRSA strains, and sewage samples were processed for phage isolation using the double agar overlay technique. The microtitration plate method evaluated the synergistic effects of isolated phages and antibiotics.</p><p><strong>Results: </strong>Out of 50 samples, 11 MRSA strains were positive, showing high resistance to multiple antibiotics, including oxacillin (95%), and vancomycin (85%). Phage zP-1, belonging to the Myoviridae family, exhibited > 90% lytic activity, stable across temperatures (20-50 °C) and pH (6-8). A statistically significant synergistic effect was observed at a MIC of 0.137 μg/ml for gentamicin (p-value 0.02).</p><p><strong>Conclusion: </strong>These findings suggest that phage-antibiotic synergy may offer a promising strategy to combat MRSA infections, warranting further in vivo studies to assess its clinical potential.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burnout, wearing thin, and the courage to walk away.","authors":"Frank Houghton","doi":"10.1007/s11845-025-03901-y","DOIUrl":"https://doi.org/10.1007/s11845-025-03901-y","url":null,"abstract":"","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143254697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost analysis of limb salvage: comparing limb revascularisation and amputation in patients with Chronic Limb-Threatening Ischaemia (CLTI) at University Hospital Limerick.","authors":"Anne Marie Toomey, Fiona Leahy, Helen Purtill, Norma O'Brien, Emer O'Donovan, Zeeshan Ahmed, Mekki Medani, Tony Moloney, Eamon G Kavanagh","doi":"10.1007/s11845-025-03885-9","DOIUrl":"https://doi.org/10.1007/s11845-025-03885-9","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of peripheral arterial disease (PAD) is increasing globally. An increase in PAD in an ageing population inevitably results in an increase in incidence of Chronic Limb Threatening Ischemia (CLTI). Loss of a limb is a life-changing event with immeasurable cost to the individual, while the potential financial benefit of saving a limb is not well documented.</p><p><strong>Aims: </strong>The focus of this study was to estimate the cost associated with surgical interventions used in the treatment of CLTI compared with amputation.</p><p><strong>Methods: </strong>The cost to treat a CLTI diagnosis in 124 patients was analysed in an acute tertiary referral hospital over a 13-month study period. The analysis included staffing, medical devices used, number of blood components used and the length of stay. Statistical methods included descriptive statistical data and the Mann-Whitney U test.</p><p><strong>Results: </strong>The median cost, associated with length of stay, post-amputation and post-revascularisation (hybrid) was €61,313 [IQR = €44,417, €83,331] and €46,573 [IQR = €25,687, €58,554] respectively, p < 0.001. The total median cost for length of stay for amputees in an acute hospital, rehabilitation and a prosthetic limb was €88,820 [IQR = €74,486, €110,248]. The median surgical cost of an amputation was €2,064 [IQR = €1,342, €2,866], whilst the median surgical cost of a revascularisation procedure (hybrid) was €5,966 [IQR = €4,380, €7,723], p < 0.001, inclusive of total blood components transfused.</p><p><strong>Conclusion: </strong>Revascularisation surgical interventions are more expensive than amputation, however, the length of stay, rehabilitation and prosthetic limb costs, for a patient undergoing a major limb amputation, is significantly more costly.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143254935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of shearing wave elastography in detecting early diabetic nephropathy.","authors":"Amr M Shaker, Shaza Y Sleem, Mayssa I Aly, Asmaa H Habib, Mona G Hassan","doi":"10.1007/s11845-025-03897-5","DOIUrl":"https://doi.org/10.1007/s11845-025-03897-5","url":null,"abstract":"<p><strong>Background: </strong>Diabetes mellitus is one of the systemic diseases affecting the kidneys that eventually develop end-stage kidney disease. Shear wave elastography (SWE) is a reliable and non-invasive ultrasonography test used to determine tissue elasticity. The aim of this study is to detect early diabetic nephropathy by measuring renal stiffness using shear wave elastography (SWE), renal resistivity indices, and laboratory findings in DN patients.</p><p><strong>Methods: </strong>Shear wave elastography and color duplex sonography assessments were performed in 60 diabetic nephropathy patients (divided according to eGFR into 3 stages: stage I-II-III diabetic nephropathy with equal groups of 20 patients in each stage) and 20 healthy age-matched control subjects. The SWE-derived mean value of the tissue stiffness, given in kilopascals (kPa), was correlated to patients' clinico-laboratory data (serum creatinine and eGFR) and resistive index.</p><p><strong>Results: </strong>There is a statistically significant increase in SWE and RI in the diabetic group than control group and a statistically significant increase in SWE (mean) in CKD stage II and III when compared with CKD stage I, SWE can be used to discriminate between diabetic groups and control group at a cutoff level of > 10.5 (kPa), and also, SWE (mean) can be used to discriminate between CKD stage II and III patients at a cutoff level of > 41 (kPa), with 66.7% sensitivity and 64.9% specificity.</p><p><strong>Conclusion: </strong>Shear wave elastography is a sensitive, non-invasive, and specific diagnostic tool for the detection of diabetic nephropathy and differentiation between different stages of DN.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}