Journal of Clinical and Translational Research最新文献

{"title":"Safety and efficacy of intranasal insulin in patients with Alzheimer’s disease: a systematic review and meta-analysis","authors":"Y. AboEl-Azm, Mohamed A. El-Samahy, N. I. Hendi, Amina Arar, Noha Yasen, Shrouk Ramadan, Esraa M Zedan, N. M. Al-Dardery, A. Khaity","doi":"10.18053/jctres.09.202304.23-00013","DOIUrl":"https://doi.org/10.18053/jctres.09.202304.23-00013","url":null,"abstract":"Background and Aim: We performed this meta-analysis to evaluate the safety and efficacy of intranasal insulin in Alzheimer’s disease (AD) patients. Methods: 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). Results: 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], P = 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], P = 0.08), (MD = 0.65, 95% CI [−0.08, 1.39], P = 0.08), (MD = 0.25, 95% CI [−0.09, 0.6], P = 0.15), and (MD = 1.28, 95% CI [0.75, 2.21], P = 0.36), respectively. Conclusion: 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. Relevance for Patients: 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.","PeriodicalId":15482,"journal":{"name":"Journal of Clinical and Translational Research","volume":"1 1","pages":"222 - 235"},"PeriodicalIF":0.0,"publicationDate":"2023-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89697316","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":"Meta-analysis of clinical trials in the 2020s and beyond: a paradigm shift needed","authors":"J. Shuster","doi":"10.18053/jctres.09.202304.22-00019","DOIUrl":"https://doi.org/10.18053/jctres.09.202304.22-00019","url":null,"abstract":"Background: 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. Aim: 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. Methods: 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. Results: 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. Conclusion: There is no rationale for ever using the mainstream for meta-analysis of randomized clinical trials. Relevance for Patients: 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.","PeriodicalId":15482,"journal":{"name":"Journal of Clinical and Translational Research","volume":"5 1","pages":"246 - 252"},"PeriodicalIF":0.0,"publicationDate":"2023-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75516498","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, A. Masoud, H. Ulibarri, A. Arroyo, C. Coriell, S. Goetz, C. Moir, A. Moberly, Daniela González, Madison Blanco, Harry Randall Craig","doi":"10.18053/jctres.09.202304.23-00060","DOIUrl":"https://doi.org/10.18053/jctres.09.202304.23-00060","url":null,"abstract":"Background and Aim: 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 in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI). Materials and Methods: 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. Results: 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], P < 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], P = 0.005 and RR = 1.85, 95% CI [1.44, 2.38], P < 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. Conclusion: 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. Relevance for Patients: 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.","PeriodicalId":15482,"journal":{"name":"Journal of Clinical and Translational Research","volume":"30 1","pages":"236 - 245"},"PeriodicalIF":0.0,"publicationDate":"2023-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82306136","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 network pharmacology and bioinformatics exploration of the possible molecular mechanisms of Fuzheng Xiaoliu Granule for the treatment of hepatocellular carcinoma.","authors":"Tianyu Fan,&nbsp;Xi Chen,&nbsp;Fangming Yang,&nbsp;Yanjie Li,&nbsp;Qi Gao,&nbsp;Shanyi Li,&nbsp;Xinju Chen,&nbsp;Xiaoqi Chen","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background and aim: </strong>Hepatocellular carcinoma (HCC) is one of the ten most common malignant tumors in the world, and it is a major problem in the world. Traditional Chinese medicine (TCM) has many advantages in the prevention and treatment of HCC, but its complicated mechanism of action is difficult to clarify, which limits its research and development. The continuous development of bioinformation technology provides new methods and opportunities for the research of TCM. This study used modern network pharmacology and bioinformatic methods to explore the possible molecular mechanism of the Chinese herbal compound Fuzheng Xiaoliu Granule (FZXLG) to treat HCC, to provide a theoretical basis for their clinical application and basic research, to promote the modernization of TCM, and to promote its worldwide application.</p><p><strong>Methods: </strong>The active ingredients of FZXLG were collected and screened through TCMSP, BATMAN-TCM, and other databases. The targets of FZXLG were predicted by PubChem and SwissTargetPrediction; HCC disease-related targets were obtained by GeneCards, OMIM, and other disease databases, and the potential gene targets of FZXLG for HCC treatment were screened. The \"Prescription-TCMs-Ingredients-Targets\" network of FZXLG for the treatment of HCC was constructed, along with the screening of core effective components. The differentially expressed genes (DEGs) of HCC tumor and non-tumor adjacent tissues combined with clinical data in the TCGA database were analyzed to obtain the prognostic genes of HCC. Then, FZXLG genes affecting HCC prognosis were screened and further screening the core target genes. The correlation between core gene expression with prognosis, immune cell infiltration, and immunohistochemical changes in HCC patients was studied. Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis and Gene Ontology enrichment analysis of the FZXLG genes affecting HCC prognosis were performed using DAVID database. AutoDockTools software was then used for molecular docking verification.</p><p><strong>Results: </strong>The ten core effective ingredients of FZXLG for HCC treatment included multiple flavonoids ingredients such as quercetin, luteolin, and formononetin. 11 core targets of FZXLG affecting the prognosis of HCC were screened, among which estrogen receptor 1 (ESR1) and catalase (CAT) were favorable prognostic factors, while EGF, MMP9, CCNA2, CCNB1, CDK1, CHEK1, and E2F1 were adverse prognostic factors. MMP9 and EGF were positively correlated with six TIIC subsets. The different expression levels of CAT, PLG, AR, MMP9, CCNA2, CCNB1, CDK1, and E2F1 were correlated with the immunohistochemical staining changes in normal liver and liver cancer. KEGG pathway enrichment analysis yielded 33 pathways including cell cycle, p53, hepatitis B, and other signaling pathways. Molecular docking verified that the main core components had good binding to the protective prognostic core targets ESR1 and","PeriodicalId":15482,"journal":{"name":"Journal of Clinical and Translational Research","volume":"9 3","pages":"182-194"},"PeriodicalIF":0.0,"publicationDate":"2023-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6c/ae/jclintranslres-2023-9-3-182.PMC10238106.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9584084","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":"Therapeutic outcomes of early and delayed endoscopic retrograde cholangiopancreatography and percutaneous transhepatic cholangial drainage in patients with obstructive severe acute biliary pancreatitis.","authors":"Xue Ling Zhang,&nbsp;Jia Huan Sun,&nbsp;Yue Wu,&nbsp;Min Xie,&nbsp;Cong Cong Li,&nbsp;Dong Lv,&nbsp;Wei Yu,&nbsp;Pei Lin Cui","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Obstructive severe acute biliary pancreatitis (SABP) is a clinical emergency with a high rate of mortality that can be alleviated by endoscopic retrograde cholangiopancreatography (ERCP) and percutaneous transhepatic cholangial drainage (PTCD) selectively. However, the optimal timing of ERCP and PTCD requires elucidation.</p><p><strong>Aim: </strong>The aim of this study was to evaluate outcome parameters in patients with SABP subjected to ERCP and PTCD compared to SABP patients who were not subjected to any form of invasive intervention.</p><p><strong>Methods: </strong>A total of 62 patients with obstructive SABP who had been treated from July 2013 to July 2019 were included in this retrospective case-control study and stratified into a PTCD group (N = 22), ERCP group (N = 24), and conservative treatment group (N = 16, control). Patients in the PTCD and ERCP groups were substratified into early (≤72 h) and delayed (>72 h) treatment groups based on the timing of the intervention after diagnosis. Clinical chemistry, hospitalization days, liver function, abdominal pain, and complications were determined to assess the treatment efficacy and safety of each modality and to establish the optimal timing for PTCD and ERCP.</p><p><strong>Results: </strong>The average hospitalization time, time to abdominal pain relief, and time to normalization of hematological and clinical chemistry parameters (leukocyte count, amylase, alanine transaminase [ALT], and total bilirubin [TBiL]) were shorter in the PTCD and ERCP groups compared to the conservative treatment group (<i>p</i> < 0.05). The average hospitalization time in the ERCP group (16.7 ± 4.0 d) was shorter compared to the PTCD group (19.6 ± 4.3 d) (<i>p</i> < 0.05). Compared to the conservative treatment group (62.5%), there were more complications in patients treated with ERCP and PTCD (<i>p</i> < 0.05). In the early ERCP group, the average hospitalization time (13.9 ± 3.3 d) and the time to normalization of leukocyte count (6.3 ± 0.9 d) and TBiL (9.1 ± 2.0 d) were lower than in the delayed ERCP group (18.6 ± 4.1 d, 9.9 ± 2.4 d, 11.8 ± 2.9 d, respectively) and early PTCD group (16.4 ± 3.7 d, 8.5 ± 2.1 d, 10.9 ± 3.1 d, respectively) (<i>p</i> < 0.05). In the delayed ERCP group, the average hospitalization time (18.6 ± 4.1 d) and ALT recovery time (12.2 ± 2.6 d) were lower than in the delayed PTCD group (21.9 ± 4.3 d and 14.9 ± 3.9 d, respectively) (<i>p</i> < 0.05).</p><p><strong>Conclusions: </strong>ERCP and PTCD effectively relieve SABP-associated biliary obstruction with comparable overall incidence of complications. It is recommended that ERCP is performed within 72 h after diagnosis; and PTCD drainage may be considered an alternative approach in cases where patients are unable or unwilling to undergo ERCP, or when ERCP is unsuccessful.</p><p><strong>Relevance for patients: </strong>ERCP and PTCD in patients with obstructive SABP can resolve biliary obstruction and dela","PeriodicalId":15482,"journal":{"name":"Journal of Clinical and Translational Research","volume":"9 3","pages":"160-167"},"PeriodicalIF":0.0,"publicationDate":"2023-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/60/f1/jclintranslres-2023-9-3-160.PMC10339408.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10202763","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":"Noninvasive central hemodynamic monitoring in the primary care setting: improving prevention and management of cardiovascular diseases.","authors":"Troy Grogan,&nbsp;Marcos A Sanchez-Gonzalez,&nbsp;Miklós Illyés,&nbsp;Syed A A Rizvi","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Although cardiovascular disease (CVD) has markedly declined since the early 1960s due to medical advances and better management, this condition persists as the most critical and preventable cause of death in the US. For that reason, the identification and application of more sensitive, specific, validated, and noninvasive biomarkers of cardiovascular functioning in the primary care setting for the early identification of CVD risk at the subclinical level are warranted.</p><p><strong>Aim: </strong>The goal of the present review is twofold: first, to familiarize the primary care practitioner with noninvasive aortic hemodynamic parameters, including how these could be integrated into primary care services and patient management, and second, to propose a model for earlier detection of CVD based on the noninvasive hemodynamic parameters in the primary care setting.</p><p><strong>Relevance for patients: </strong>Implementation of noninvasive hemodynamic monitoring in a primary care setting could help in the identification of heart disease risk at the early onset thus preventing the need for expensive treatment or death at later stages.</p>","PeriodicalId":15482,"journal":{"name":"Journal of Clinical and Translational Research","volume":"9 3","pages":"175-181"},"PeriodicalIF":0.0,"publicationDate":"2023-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/fa/40/jclintranslres-2023-9-3-175.PMC10238103.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9575863","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 dietary supplement Cyplexinol^® alleviates joint pain in men and women.","authors":"Jacquelyn Pence,&nbsp;Michelle Stockton,&nbsp;Richard J Bloomer","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background and aim: </strong>Joint pain afflicts millions of adults worldwide. The effect of a bone morphogenetic protein complex on joint pain is assessed in this study.</p><p><strong>Methods: </strong>We compared the impact of a dietary supplement protein complex (Cyplexinol^®) and placebo in 18 men and women (aged 43 ± 10 years) with self-reported joint pain. Subjects were randomly assigned to each condition, consumed twice daily for 14 days (900 mg/day). Subjects completed questionnaires (e.g., Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and subjective pain using a visual analog scale [VAS]) at the start and end of each treatment phase. Blood samples were analyzed for bone morphogenic protein (BMP), alkaline phosphatase, and cytokines (tumor necrosis factor [TNF]-α, interleukin [IL]-6, IL-10, IL-1β, and TGF-β). Blood was also collected on days 1 and 15 to determine the acute impact of treatment on these measures.</p><p><strong>Results: </strong>Pain and discomfort scores improved (<i>P</i> ≤ 0.05) for subjects following use of Cyplexinol^® but not placebo. Improvements were noted for WOMAC pain (<i>P</i> = 0.05), stiffness (<i>P</i> = 0.039), and total pain (<i>P</i> = 0.026), as well as VAS pain (<i>P</i> = 0.015), recreational activity interference (<i>P</i> = 0.023), mood interference (<i>P</i> = 0.012), and total pain (<i>P</i> = 0.024). A trend was noted for WOMAC physical function (<i>P</i> = 0.052). An approximate 50% increase in BMP5 was noted following Cyplexinol^® (<i>P</i> = 0.01), with a similar increase noted for placebo (<i>P</i> = 0.022). A near doubling in TGF-β (<i>P</i> = 0.001) was noted for Cyplexinol^®. No other changes of significance were noted across time, nor were any differences noted in cytokines following acute intake of the conditions (<i>P</i> > 0.05).</p><p><strong>Conclusions: </strong>Cyplexinol^® can alleviate joint pain in middle-aged men and women, while elevating BMP5 and TGF-β. Cyplexinol^® does not influence cytokines, at least within a short 2-week supplementation period or within the 2-h post-ingestion period.</p><p><strong>Relevance for patients: </strong>Individuals suffering with joint pain in the knee and/or hip may benefit from daily use of Cyplexinol^®, as we observed decreased pain and stiffness following treatment.</p>","PeriodicalId":15482,"journal":{"name":"Journal of Clinical and Translational Research","volume":"9 3","pages":"212-221"},"PeriodicalIF":0.0,"publicationDate":"2023-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7f/2f/jclintranslres-2023-9-3-212.PMC10339409.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10202761","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":"Best management of patients with malignant pericardial effusion: A comparative study between imaging-guided pericardiocentesis and surgical pericardial window.","authors":"Abdul Baqi,&nbsp;Intisar Ahmed,&nbsp;Pirbhat Shams","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>The clinical course of malignancies is frequently complicated by third spacing in body cavities, including pericardial effusion. What remains the optimal management for malignant pericardial effusion is a dilemma.</p><p><strong>Aim: </strong>We aimed to compare 30-day outcomes of imaging-guided pericardiocentesis and surgical pericardial window in patients with malignant pericardial effusion.</p><p><strong>Methods: </strong>A retrospective observational study was done at a tertiary care hospital. We reviewed hospital record files of 91 consecutive patients admitted with malignant pericardial effusion from January 2010 to December 2019 and requiring imaging-guided pericardiocentesis or pericardial window.</p><p><strong>Results: </strong>A total of 71 patients were included in the final analysis. Most patients were male (68%). The mean age was 45 years. Hypertension was the most common comorbid condition. Lymphoma or leukemia (39%) was the most common cause of malignant pericardial effusion followed by lung cancer (28%). About 57.7% of patients underwent pericardiocentesis, and the remainder underwent surgical pericardial window (42.3%). The overall procedural success was 97.2%, and the overall mortality was 5.6%. The success rate was similar when pericardiocentesis was compared with the surgical pericardial window (<i>p</i> = 0.22). The length of hospital stay was higher in patients undergoing pericardial window (<i>p</i> = 0.007), whereas the re-accumulation rate was higher in the pericardiocentesis group (0% versus 34%, <i>p</i> < 0.001). Patients undergoing pericardial window had higher odds of major bleeding requiring transfusions.</p><p><strong>Conclusion: </strong>There is a higher rate of recurrence following isolated pericardiocentesis but a comparable mortality difference between the two procedures. Complication rates can be reduced by improving surgical technique and peri-operative management. Meticulous surgical care, infection precautions, and good glycemic control in this immunocompromised subset can preserve the pericardial window as a better management option.</p><p><strong>Relevance to patients: </strong>Pericardial window is a promising and effective management option for patients with recurrent malignant pericardial effusion, but it comes at the cost of bleeding and infection. More extensive trials are needed to understand better the long-term outcomes of pericardial window or pericardiocentesis in patients with malignant effusion.</p>","PeriodicalId":15482,"journal":{"name":"Journal of Clinical and Translational Research","volume":"9 3","pages":"206-211"},"PeriodicalIF":0.0,"publicationDate":"2023-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/53/7f/jclintranslres-2023-9-3-206.PMC10339407.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10202754","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":"Best management of patients with malignant pericardial effusion: A comparative study between imaging-guided pericardiocentesis and surgical pericardial window","authors":"Abdul Baqi, I. Ahmed, Pirbhat Shams","doi":"10.18053/jctres.09.202303.010","DOIUrl":"https://doi.org/10.18053/jctres.09.202303.010","url":null,"abstract":"Background: The clinical course of malignancies is frequently complicated by third spacing in body cavities, including pericardial effusion. What remains the optimal management for malignant pericardial effusion is a dilemma. Aim: We aimed to compare 30-day outcomes of imaging-guided pericardiocentesis and surgical pericardial window in patients with malignant pericardial effusion. Methods: A retrospective observational study was done at a tertiary care hospital. We reviewed hospital record files of 91 consecutive patients admitted with malignant pericardial effusion from January 2010 to December 2019 and requiring imaging-guided pericardiocentesis or pericardial window. Results: A total of 71 patients were included in the final analysis. Most patients were male (68%). The mean age was 45 years. Hypertension was the most common comorbid condition. Lymphoma or leukemia (39%) was the most common cause of malignant pericardial effusion followed by lung cancer (28%). About 57.7% of patients underwent pericardiocentesis, and the remainder underwent surgical pericardial window (42.3%). The overall procedural success was 97.2%, and the overall mortality was 5.6%. The success rate was similar when pericardiocentesis was compared with the surgical pericardial window (p = 0.22). The length of hospital stay was higher in patients undergoing pericardial window (p = 0.007), whereas the re-accumulation rate was higher in the pericardiocentesis group (0% versus 34%, p < 0.001). Patients undergoing pericardial window had higher odds of major bleeding requiring transfusions. Conclusion: There is a higher rate of recurrence following isolated pericardiocentesis but a comparable mortality difference between the two procedures. Complication rates can be reduced by improving surgical technique and peri-operative management. Meticulous surgical care, infection precautions, and good glycemic control in this immunocompromised subset can preserve the pericardial window as a better management option. Relevance to Patients: Pericardial window is a promising and effective management option for patients with recurrent malignant pericardial effusion, but it comes at the cost of bleeding and infection. More extensive trials are needed to understand better the long-term outcomes of pericardial window or pericardiocentesis in patients with malignant effusion.","PeriodicalId":15482,"journal":{"name":"Journal of Clinical and Translational Research","volume":"26 1","pages":"206 - 211"},"PeriodicalIF":0.0,"publicationDate":"2023-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74704405","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":"Acute ischemic colitis associated with oral decongestant use: a systematic review.","authors":"Muhammad Hassan Naeem Goraya, Faisal Inayat, Sobaan Taj, Junaid Rasul Awan, Adil Mohyudin, Syed Hasan Ali, Arslan Afzal, Muhammad Junaid Ashraf, Muhammad Adnan Zaman, Zahra Akhtar, Gul Nawaz, Zahid Ijaz Tarar","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background and aim: </strong>Acute ischemic colitis (IC) has been linked with the use of oral decongestants. However, clinical evidence on this association remains limited. We aim to evaluate the occurrence and clinical outcomes of acute IC following over-the-counter (OTC) use of pseudoephedrine and phenylephrine.</p><p><strong>Methods: </strong>We conducted a systematic review of the MEDLINE, Google Scholar, Scopus, and Embase databases between inception and July 20, 2022. Specific search terms were used. The inclusion criteria consisted of English-language articles describing acute IC secondary to pseudoephedrine or phenylephrine.</p><p><strong>Results: </strong>A total of 18 case reports (level of clinical evidence: IV) fulfilled our inclusion criteria. The mean age of patients was 51.6 ± 15.3 years, with 14 (77.8%) cases reported in women. The clinical presentation was mainly related to abdominal pain 16 (88.9%), hematochezia 15 (83.3%), and/or abdominal tenderness 10 (55.6%). The medical background showed that 5 (27.8%) patients were previously healthy. In the 13 (72.2%) patients with comorbidities, hypertension 6 (46.2%), a history of tobacco use 5 (38.5%), and psychiatric illnesses 4 (30.8%) were commonly reported. Leukocytosis was encountered in 13 (72.2%) patients. Diagnostic investigations included a combination of computed tomography scan and colonoscopy in 10 (55.6%), colonoscopy alone in 6 (33.3%), and flexible sigmoidoscopy in 1 (5.6%) patient. Colonoscopic biopsy was the mainstay of diagnosis in 15 (83.3%) patients. Treatment was based on supportive care in 18 (100%), concurrent antibiotic use in 2 (11.1%), and surgical intervention in 1 (5.6%) patient. Recurrent episodes of IC occurred in 4 (22.2%) patients.</p><p><strong>Conclusions: </strong>Acute IC secondary to oral decongestants remains a rare but important clinical phenomenon. Clinical suspicion and imaging findings are important for the early diagnosis.</p><p><strong>Relevance to patients: </strong>In unexplained cases of IC, clinicians should specifically inquire about oral decongestants since they are OTC and patients commonly fail to reveal their usage. These drugs should be avoided for transient cold symptoms, especially in women.</p>","PeriodicalId":15482,"journal":{"name":"Journal of Clinical and Translational Research","volume":"9 3","pages":"195-205"},"PeriodicalIF":0.0,"publicationDate":"2023-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9c/cf/jclintranslres-2023-9-3-195.PMC10238105.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9584088","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}