Journal of Clinical and Translational Research最新文献

{"title":"Quality of life assessment in the first episode of acute coronary syndrome.","authors":"Smitha Pernaje Seetharam,&nbsp;Vinutha Shankar,&nbsp;Kaviraja Udupa,&nbsp;Raveesha Anjanappa,&nbsp;Niranjan Reddy","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Assessment of health-related quality of life (HRQoL) is an important measure of a patient's recovery after an illness. However, HRQoL among acute coronary syndrome (ACS) survivors has not been extensively studied following cardiac management.</p><p><strong>Aim: </strong>The purpose of this study was to assess the quality of life (QoL) among ACS patients who have undergone percutaneous coronary intervention (PCI).</p><p><strong>Methods: </strong>This cohort study included 145 consecutive male ACS patients between March 2021 and May 2022. Of these patients, 138 (mean age 54.3 ± 10.7 years) completed the QoL assessment using the short form-12 (SF-12) health survey questionnaire. Seventy (51%) of them presented with ST-segment elevation myocardial infarction (STEMI), 18 (13%) had non-STEMI, 39 (28%) had evolved MI, and 11 (8%) had unstable angina. Recruited patients' QoL data were assessed at various time points post-PCI.</p><p><strong>Results: </strong>At the end of the 12 months of follow-up, major clinical events (MCE) defined as death, sudden death, or re-acute myocardial infarction occurred in 54.9% of patients. Out of 7 MCE, four deaths and three re-AMIs had occurred. SF-12 physical component score was found to be significantly improved when compared to the mental component score, which seems to improve without reaching statistical significance over time. Among event-free ACS patients, we found a significant positive correlation between left ventricular ejection fraction and HRQoL.</p><p><strong>Conclusion: </strong>Improvement in HRQoL (physical component) was seen among ACS patients post-PCI.</p><p><strong>Relevance for patients: </strong>QoL assessment outcomes should be considered in clinical settings, practice guidelines, and treatment modality post-PCI to improve QoL in post-ACS survivors.</p>","PeriodicalId":15482,"journal":{"name":"Journal of Clinical and Translational Research","volume":"9 4","pages":"265-271"},"PeriodicalIF":0.0,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f8/8e/jclintranslres-2023-9-4-265.PMC10431193.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10104032","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":"Association between carotid and coronary atherosclerotic plaque morphology: a virtual histology intravascular ultrasound study.","authors":"Dace Sondore,&nbsp;Kārlis Trušinskis,&nbsp;Matīss Linde,&nbsp;Ieva Briede,&nbsp;Inga Narbute,&nbsp;Sanda Jēgere,&nbsp;Kārlis Griķis,&nbsp;Kārlis Štrenge,&nbsp;Andrejs Ērglis","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background and aim: </strong>Atherosclerosis is considered to be a systemic disease; however, evidence exists on the heterogeneous nature of atherosclerotic disease. To date, continuous research seeks to determine the morphological differences between carotid and coronary artery disease. This study aimed to evaluate the relationship of morphological characteristics assessed by virtual histology intravascular ultrasound (VH-IVUS) between carotid and coronary plaque composition among patients with and without a history of cerebrovascular events.</p><p><strong>Methods: </strong>This study was a single-center prospective study (<i>n</i> = 100; age 69.6 ± 8.4). All patients were scheduled for carotid or coronary artery stenting and underwent VH-IVUS examination of the carotid and coronary arteries before intervention.</p><p><strong>Results: </strong>There was a modest, but statistically significant correlation between the carotid and coronary necrotic core ([NC] r = 0.46, <i>P</i> < 0.01), fibrofatty ([FF] r = 0.38, <i>P</i> < 0.01), dense calcium (r = 0.56, <i>P</i> < 0.01), and fibrous (r = 0.42, <i>P</i> < 0.01) plaque composition. The high amount of NC was detected in both arteries of the carotid artery stenting (CAS) group with higher proportion in the coronary artery (20.2% ± 9.4 % vs. 22.7% ± 6.8%, <i>P</i> = 0.02). More fibrolipid content was observed in carotid plaque compared to coronary (19.6% ± 9.9% vs. 12.2% ± 8.1%, <i>P</i> < 0.01). Patients with a history of cerebrovascular events had a numerically greater proportion of necrotic tissue in the carotid artery compared to asymptomatic and symptomatic CAS group patients (23.5% ± 10.7% vs. 18.9% ± 8.2% and 18.7% ± 9.5%, <i>P</i> = 0.11).</p><p><strong>Conclusion: </strong>The percentage of all analyzed plaque components was moderately correlated between coronary and carotid artery plaques. Nevertheless, the proportion of NC plaque tissue was greater in the coronary arteries, while the carotid arteries showed more %FF atherosclerotic lesions. CAS group patients with a history of cerebrovascular events had a tendency of greater proportion of necrotic tissue in analyzed carotid plaques compared to others in the CAS group.</p><p><strong>Relevance for patients: </strong>In this study, we found that patients with a history of cerebrovascular event had a tendency of increased NC content in culprit lesion of carotid artery. Complementary use of non-invasive and invasive imaging modalities allows to detect high-risk atherosclerotic plaques and adjust treatment strategy.</p>","PeriodicalId":15482,"journal":{"name":"Journal of Clinical and Translational Research","volume":"9 4","pages":"253-260"},"PeriodicalIF":0.0,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/56/5a/jclintranslres-2023-9-4-253.PMC10431194.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10403531","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":"Safety and efficacy of intranasal insulin in patients with Alzheimer's disease: a systematic review and meta-analysis.","authors":"Yosra Hussein AboEl-Azm,&nbsp;Mohamed El-Samahy,&nbsp;Nada Ibrahim Hendi,&nbsp;Amina Arar,&nbsp;Noha Samy Yasen,&nbsp;Shrouk Ramadan,&nbsp;Esraa M Zedan,&nbsp;Nada Mostafa Al-Dardery,&nbsp;Abdulrhman Khaity","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background and aim: </strong>We performed this meta-analysis to evaluate the safety and efficacy of intranasal insulin in Alzheimer's disease (AD) patients.</p><p><strong>Methods: </strong>A literature search was conducted for PubMed, Scopus, and Web of Science from inception until August 2022. Documents were screened for qualified articles, and all concerned outcomes were pooled as risk ratios or mean difference (MD) in the meta-analysis models using Review Manager (RevMan version 5.4).</p><p><strong>Results: </strong>Our results from 12 studies favored intranasal insulin over placebo in terms of Alzheimer Disease's Assessment Scale-cognitive subscale (ADAS-cog) 20 IU, (MD = -0.13, 95% CI [-0.22, -0.05], <i>P</i> = 0.003). The overall effect did not favor either of the two groups for ADAS-cog 40 IU, memory composite 20 IU and 40 IU, and adverse events (MD = -0.08, 95% CI [-0.16, 0.01], <i>P</i> = 0.08), (MD = 0.65, 95% CI [-0.08, 1.39], <i>P</i> = 0.08), (MD = 0.25, 95% CI [-0.09, 0.6], <i>P</i> = 0.15), and (MD = 1.28, 95% CI [0.75, 2.21], <i>P</i> = 0.36), respectively.</p><p><strong>Conclusion: </strong>Ultimately, this meta-analysis showed that intranasal insulin in small doses (20 IU) significantly affects patients with AD. Further studies are recommended on reliable insulin delivery devices to increase insulin in the central nervous system.</p><p><strong>Relevance for patients: </strong>Intranasal insulin has shown promising results in treating patients with AD. The lower doses (20 IU) can play a positive role in improving the disease. As research continues, it is likely that this treatment will become more widely accepted and utilized in clinical practice.</p>","PeriodicalId":15482,"journal":{"name":"Journal of Clinical and Translational Research","volume":"9 4","pages":"222-235"},"PeriodicalIF":0.0,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e5/12/jclintranslres-2023-9-4-222.PMC10411979.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10032574","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":"A rare case of asymptomatic Paget's disease of the skull in a 60-year-old Asian female.","authors":"Muhammad Ali,&nbsp;Omama Farooq,&nbsp;Zahra Rafique,&nbsp;Hajrah Farooq,&nbsp;Fazeelat Iftikhar,&nbsp;Muqadsa Malik","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background and aim: </strong>Paget's disease of the bone refers to a chronic cumulative disorder characterized by enhanced osteoclastic function followed by a secondary surge in osteoblastic activity. The condition can manifest as a polyostotic or monostotic bone disease with most patients having an asymptomatic presentation, although some may complain of pain localized to the affected bone while others express symptoms of nerve compression. A pagetic bone is predisposed to develop pathological fractures, bony deformities, and a rare yet detrimental transformation into osteosarcoma. Detection is often accidental when performing radiographic tests for other indications or when elevated blood levels of alkaline phosphatase (ALP) are detected. Treatment with third-generation bisphosphonates is helpful in preventing further bone resorption and, additionally, reduces bony pains that are believed to be caused by excessive metabolic activity. Here, we present a case of a middle-aged asymptomatic female with elevated serum ALP levels up to 1537 IU/L (reference range 40-150 U/L) during her pre-operative evaluation for elective cholecystectomy.^99m Tc-methylene diphosphonate bone scintigraphy revealed diffuse uptake in the skull and, hence, was diagnosed as a case of isolated Paget's disease of the skull.</p><p><strong>Relevance for patients: </strong>The rarity of this disease in Southeast-Asians, its uncontrived detection, and the isolated skull involvement, imparts high clinical relevance on this case. Early detection and management of this disease can help prevent the development of life-threatening complications in affected patients, hence decreasing the morbidity.</p>","PeriodicalId":15482,"journal":{"name":"Journal of Clinical and Translational Research","volume":"9 4","pages":"261-264"},"PeriodicalIF":0.0,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b9/42/jclintranslres-2023-9-4-261.PMC10431192.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10421867","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":"Meta-analysis of clinical trials in the 2020s and beyond: a paradigm shift needed.","authors":"Jonathan J Shuster","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>A peer-reviewed meta-analysis methods article mathematically proved that mainstream random-effects methods, \"weights inversely proportional to the estimated variance,\" are flawed and can lead to faulty public health recommendations. Because the arguments causing this off-label (unproven) use of mainstream practices were subtle, changing these practices will require much clearer explanations that can be grasped by clinical and translational scientists. There are five assumptions underlying the mainstream's derivation of its statistical properties. This paper will demonstrate that if the first is true, it follows that the last two are false. Ratio estimation, borrowed from classical survey sampling, provides a rigorous alternative. Papers reporting results rarely fully disclose these assumptions. This is analogous to watching TV ads with the sound muted. You see high quality of life and do not hear about the complications. This article is a poster child for translational science, as it takes a theoretical discovery from the biostatistical world, translates it into language clinical scientists can understand, and thereby can change their research practice.</p><p><strong>Aim: </strong>This article is aimed at future applications of meta-analysis of complete collections of randomized clinical trials. It leaves it to past authors as to whether to reanalyze their data. No blame for past use is assessed.</p><p><strong>Methods: </strong>By treating the individual completed studies in the meta-analysis as a random sample from a conceptual universe of completed studies, we use ratio estimation to obtain estimates of relative risk (ratio of failure rates treatment: control) and mean differences, projecting our sample value to estimate the universe's value.</p><p><strong>Results: </strong>Two examples demonstrate that the mainstream methods likely adversely impacted major treatment options. A third example shows that the key mainstream presumption of independence between the study weights and study estimates cannot be supported.</p><p><strong>Conclusion: </strong>There is no rationale for ever using the mainstream for meta-analysis of randomized clinical trials.</p><p><strong>Relevance for patients: </strong>Future meta-analysis of clinical trials should never employ mainstream methods. Doing so could lead to potentially harmful public health policy recommendations. Clinical researchers need to play a primary role to assure good research practices in meta-analysis.</p>","PeriodicalId":15482,"journal":{"name":"Journal of Clinical and Translational Research","volume":"9 4","pages":"246-252"},"PeriodicalIF":0.0,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8c/bf/jclintranslres-2023-9-4-246.PMC10411977.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10331671","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":"PD-L1 expression and prognosis in definitive radiotherapy patients with neuroendocrine cervical carcinoma","authors":"Huiling Li, Xiuhua Li, Meichun Yang, Huiyan Su, Jianqiu Zhang, Chunmiao Hu, Yingming Sun, D. Hu, Li Chen","doi":"10.18053/jctres.09.202304.23-00067","DOIUrl":"https://doi.org/10.18053/jctres.09.202304.23-00067","url":null,"abstract":"Background: Neuroendocrine carcinoma of the cervix (NECC) is more prone to lymphatic infiltration, lymph node involvement, local recurrence, and distant metastasis. Using concurrent chemoradiotherapy (CCRT) with or without adjuvant chemotherapy as the standard treatment for locally advanced NECCs and CCRT for patients with early lesions confined to the cervix. However, the prognosis of NECC patients treated with definitive radiotherapy (RT) is unknown. Immune checkpoint inhibitors are a promising therapeutic strategy for locally advanced cervical cancer. Some reports suggest that the expression of PD-L1 in solid tumors correlates with prognosis. Aim: This study investigates prognostic factors for survival in patients with neuroendocrine cervical carcinoma (NECC) treated with definitive RT and the relationship between PD-L1 expression and prognosis in these patients. Methods: This retrospective study included 66 patients with histologically confirmed NECC who received RT with or without chemotherapy. From January 2015 to December 2020, patients received routine extended-field irradiation (EFI), and PD-L1 expression was assessed by immunohistochemistry. The most commonly used chemotherapy agents were etoposide-platinum and paclitaxel-platinum. Results: PD-L1 expression was positive in 17 of 45 (37.8%) patients. There were 52 cases of pure NECC and 14 cases of mixed carcinoma. Sixty stage IB-III patients received definitive RT. The 3- and 5-year progression-free survival (PFS) was 39.8% and 34.1%, and 3- and 5-year overall survival (OS) was 48.0% and 40.2%, respectively. There was no significant difference in 3 and 5-year PFS and 3 and 5-year OS between patients with pure and mixed carcinoma. Positive PD-L1 expression was associated with higher 3-year PFS in patients with mixed histology. Univariate analysis showed that lymph node metastasis (LNM) and the International Federation of Gynecology and Obstetrics stages predicted 3- and 5-year PFS in patients who received definitive RT. The median OS in patients receiving less than four cycles and at least four cycles of chemotherapy (CT) was 26.0 and 44.0 months, respectively (P = 0.038); moreover, 3- and 5-year PFS was 34.1% and 25.7% in the former and 46.4% and 40.4% in the latter. There were no significant differences in OS and PFS between pelvic irradiation and prophylactic EFI in patients treated with definitive RT. There were no significant differences in para-aortic failure rate after concurrent chemoradiotherapy between patients who underwent pelvic irradiation or prophylactic EFI (P = 0.147). Conclusion: In patients with mixed NECC, positive PD-L1 expression is correlated with higher 3-year PFS. Chemoradiotherapy was effective for NECCs. The LNM and stage predicted PFS. Four or more cycles of chemotherapy improve prognosis. Prophylactic EFI did not significantly improve PFS and OS. Relevance for Patients: This study is relevant to patients as it confirms that chemoradiotherapy is effective for ","PeriodicalId":15482,"journal":{"name":"Journal of Clinical and Translational Research","volume":"22 1","pages":"272 - 281"},"PeriodicalIF":0.0,"publicationDate":"2023-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85036549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality of life assessment in the first episode of acute coronary syndrome","authors":"S. Seetharam, V. Shankar, Kaviraja Udupa, Raveesha Anjanappa, N. Reddy","doi":"10.18053/jctres.09.202304.23-00049","DOIUrl":"https://doi.org/10.18053/jctres.09.202304.23-00049","url":null,"abstract":"Background: Assessment of health-related quality of life (HRQoL) is an important measure of a patient’s recovery after an illness. However, HRQoL among acute coronary syndrome (ACS) survivors has not been extensively studied following cardiac management. Aim: The purpose of this study was to assess the quality of life (QoL) among ACS patients who have undergone percutaneous coronary intervention (PCI). Methods: This cohort study included 145 consecutive male ACS patients between March 2021 and May 2022. Of these patients, 138 (mean age 54.3 ± 10.7 years) completed the QoL assessment using the short form-12 (SF-12) health survey questionnaire. Seventy (51%) of them presented with ST-segment elevation myocardial infarction (STEMI), 18 (13%) had non-STEMI, 39 (28%) had evolved MI, and 11 (8%) had unstable angina. Recruited patients’ QoL data were assessed at various time points post-PCI. Results: At the end of the 12 months of follow-up, major clinical events (MCE) defined as death, sudden death, or re-acute myocardial infarction occurred in 54.9% of patients. Out of 7 MCE, four deaths and three re-AMIs had occurred. SF-12 physical component score was found to be significantly improved when compared to the mental component score, which seems to improve without reaching statistical significance over time. Among event-free ACS patients, we found a significant positive correlation between left ventricular ejection fraction and HRQoL. Conclusion: Improvement in HRQoL (physical component) was seen among ACS patients post-PCI. Relevance for Patients: QoL assessment outcomes should be considered in clinical settings, practice guidelines, and treatment modality post-PCI to improve QoL in post-ACS survivors.","PeriodicalId":15482,"journal":{"name":"Journal of Clinical and Translational Research","volume":"13 12","pages":"265 - 271"},"PeriodicalIF":0.0,"publicationDate":"2023-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91483449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A rare case of asymptomatic Paget’s disease of the skull in a 60-year-old Asian female","authors":"M. Ali, Omama Farooq, Zahra Rafique, Hajrah Farooq, Fazeelat Iftikhar, Muqadsa Malik","doi":"10.18053/jctres.09.202304.22-00186","DOIUrl":"https://doi.org/10.18053/jctres.09.202304.22-00186","url":null,"abstract":"Background and Aim: Paget’s disease of the bone refers to a chronic cumulative disorder characterized by enhanced osteoclastic function followed by a secondary surge in osteoblastic activity. The condition can manifest as a polyostotic or monostotic bone disease with most patients having an asymptomatic presentation, although some may complain of pain localized to the affected bone while others express symptoms of nerve compression. A pagetic bone is predisposed to develop pathological fractures, bony deformities, and a rare yet detrimental transformation into osteosarcoma. Detection is often accidental when performing radiographic tests for other indications or when elevated blood levels of alkaline phosphatase (ALP) are detected. Treatment with third-generation bisphosphonates is helpful in preventing further bone resorption and, additionally, reduces bony pains that are believed to be caused by excessive metabolic activity. Here, we present a case of a middle-aged asymptomatic female with elevated serum ALP levels up to 1537 IU/L (reference range 40–150 U/L) during her pre-operative evaluation for elective cholecystectomy.99m Tc-methylene diphosphonate bone scintigraphy revealed diffuse uptake in the skull and, hence, was diagnosed as a case of isolated Paget’s disease of the skull. Relevance for Patients: The rarity of this disease in Southeast-Asians, its uncontrived detection, and the isolated skull involvement, imparts high clinical relevance on this case. Early detection and management of this disease can help prevent the development of life-threatening complications in affected patients, hence decreasing the morbidity.","PeriodicalId":15482,"journal":{"name":"Journal of Clinical and Translational Research","volume":"40 1","pages":"261 - 264"},"PeriodicalIF":0.0,"publicationDate":"2023-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86431385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of a 20% intravenous fat emulsion therapy on pregnancy outcomes in women with RPL or RIF undergoing IVF/ICSI: a systematic review and meta-analysis.","authors":"Greg J Marchand, Ahmed Taher Masoud, Hollie Ulibarri, Amanda Arroyo, Catherine Coriell, Sydnee Goetz, Carmen Moir, Atley Moberly, Daniela Gonzalez, Madison Blanco, Harry Randall Craig","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background and aim: </strong>The aim of this study was to evaluate the efficacy a 20% intravenous fat emulsion therapy in women suffering from recurrent pregnancy loss or recurrent implantation failure (RPL/RIF) who are undergoing <i>in vitro</i> fertilization (IVF) or intracytoplasmic sperm injection (ICSI).</p><p><strong>Materials and methods: </strong>We searched Cochrane Library, ISI Web of Science, MEDLINE, ClinicalTrials.gov, PubMed, and Scopus using relevant keywords during February 2020 for randomized controlled trials (RCTs) comparing the therapy versus placebo or no intervention in women suffering from RPL/RIF and undergoing IVF/ICSI.</p><p><strong>Results: </strong>We included five RCTs with 840 patients. The intravenous fat emulsion therapy was significantly effective in increasing clinical pregnancy rates compared to the control group (risk ratios [RR] = 1.48, 95% confidence intervals [CI] [1.23, 1.79], <i>P <</i> 0.001). Furthermore, ongoing pregnancy and live birth rates were significantly higher with 20% intravenous fat emulsion therapy RR = 1.71, 95% CI [1.27, 2.32], <i>P</i> = 0.005 and RR = 1.85, 95% CI [1.44, 2.38], <i>P</i> < 0.001. Despite the statistically significant differences, the quality of evidence was only considered moderate, and this was primarily due to high risk of bias in the included RCTs.</p><p><strong>Conclusion: </strong>Our review provides a moderate level of evidence that intravenous fat emulsion therapy is effective in improving reproductive outcomes among women with RPL/RIF performing IVF/ICSI techniques. Further, investigation is required to ascertain optimal dosage and timing of administration.</p><p><strong>Relevance for patients: </strong>Women suffering from RPL or RIF may wish to consider discussing with their reproductive endocrinologist the addition of a 20% fat emulsion therapy to planned IVF or ICSI cycles, which may improve outcomes.</p>","PeriodicalId":15482,"journal":{"name":"Journal of Clinical and Translational Research","volume":"9 4","pages":"236-245"},"PeriodicalIF":0.0,"publicationDate":"2023-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c3/5f/jclintranslres-2023-9-4-236.PMC10411978.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10032575","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":"Association between carotid and coronary atherosclerotic plaque morphology: a virtual histology intravascular ultrasound study","authors":"D. Sondore, K. Trušinskis, Matīss Linde, I. Briede, I. Narbute, S. Jēgere, Kārlis Griķis, K. Strenge, A. Erglis","doi":"10.18053/jctres.09.202304.23-00030","DOIUrl":"https://doi.org/10.18053/jctres.09.202304.23-00030","url":null,"abstract":"Background and Aim: Atherosclerosis is considered to be a systemic disease; however, evidence exists on the heterogeneous nature of atherosclerotic disease. To date, continuous research seeks to determine the morphological differences between carotid and coronary artery disease. This study aimed to evaluate the relationship of morphological characteristics assessed by virtual histology intravascular ultrasound (VH-IVUS) between carotid and coronary plaque composition among patients with and without a history of cerebrovascular events. Methods: This study was a single-center prospective study (n = 100; age 69.6 ± 8.4). All patients were scheduled for carotid or coronary artery stenting and underwent VH-IVUS examination of the carotid and coronary arteries before intervention. Results: There was a modest, but statistically significant correlation between the carotid and coronary necrotic core ([NC] r = 0.46, P < 0.01), fibrofatty ([FF] r = 0.38, P < 0.01), dense calcium (r = 0.56, P < 0.01), and fibrous (r = 0.42, P < 0.01) plaque composition. The high amount of NC was detected in both arteries of the carotid artery stenting (CAS) group with higher proportion in the coronary artery (20.2% ± 9.4 % vs. 22.7% ± 6.8%, P = 0.02). More fibrolipid content was observed in carotid plaque compared to coronary (19.6% ± 9.9% vs. 12.2% ± 8.1%, P < 0.01). Patients with a history of cerebrovascular events had a numerically greater proportion of necrotic tissue in the carotid artery compared to asymptomatic and symptomatic CAS group patients (23.5% ± 10.7% vs. 18.9% ± 8.2% and 18.7% ± 9.5%, P = 0.11). Conclusion: The percentage of all analyzed plaque components was moderately correlated between coronary and carotid artery plaques. Nevertheless, the proportion of NC plaque tissue was greater in the coronary arteries, while the carotid arteries showed more %FF atherosclerotic lesions. CAS group patients with a history of cerebrovascular events had a tendency of greater proportion of necrotic tissue in analyzed carotid plaques compared to others in the CAS group. Relevance for Patients: In this study, we found that patients with a history of cerebrovascular event had a tendency of increased NC content in culprit lesion of carotid artery. Complementary use of non-invasive and invasive imaging modalities allows to detect high-risk atherosclerotic plaques and adjust treatment strategy.","PeriodicalId":15482,"journal":{"name":"Journal of Clinical and Translational Research","volume":"104 1","pages":"253 - 260"},"PeriodicalIF":0.0,"publicationDate":"2023-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82768876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}