Medical Principles and Practice最新文献

{"title":"Emergency Department and COVID-19 Pandemic Stress Test: A Comparison between Two European Settings.","authors":"Laura Tomaino, Ilaria Roncarati, Silvia Rodríguez-Mireles, Eva Rivas-Wagner, Beatriz González López-Valcárcel, Carlo La Vecchia, Eva Negri, Valerio Di Maio, Susanna Contucci, Lorenzo Falsetti, Gianluca Moroncini, Lluís Serra-Majem","doi":"10.1159/000546166","DOIUrl":"10.1159/000546166","url":null,"abstract":"<p><strong>Objective: </strong>The aim of the study was to analyze the changes in the emergency department (ED) activity of two hospitals during the 2020 lockdown and corresponding timeframes in 2019 and 2021 to assess whether a more structured primary healthcare service could have influenced the COVID-19 pressure on the ED.</p><p><strong>Subject and methods: </strong>This is a multicenter, retrospective study on adult subjects registered to the selected ED during the timeframes considered. Patients <16 years old and women with obstetric or gynecological complaints were excluded. Study period was from 9 March to 3 May for the Italian ED (55 days) and March 14 to May 10 for the Spanish ED (57 days) in 2019, 2020, and 2021. Primary outcome includes difference in the number of ED admissions. Secondary outcomes consist of differences in hospital admission rates, priority code at triage, and disease group.</p><p><strong>Results: </strong>Overall, a greater number of patients flowed through the Spanish ED (14,034 vs. 8,569 in 2019, 7,208 vs. 3,101 in 2020, and 13,214 vs. 5,555 in 2021), with smaller proportional declines and lower admission rates (13% vs. 16.9% in 2019, 19.6% vs. 34.3% in 2020, and 14.3% vs. 26.3% in 2021) observed. Most referrals were for nonemergency conditions, followed by trauma and intoxications.</p><p><strong>Conclusions: </strong>In comparison with the Italian setting, the Spanish ED showed increased activity alongside lower hospitalization rates. Further investigation is required to evaluate the potential role of more structured primary healthcare assistance in enhancing the discharge rate to homecare or primary healthcare facilities during the specified timeframes.</p>","PeriodicalId":18455,"journal":{"name":"Medical Principles and Practice","volume":" ","pages":"1-10"},"PeriodicalIF":2.9,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12245181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144011959","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":"Hypertension in Czech Adults Aged 25-64: Prevalence, Awareness, Control, and Risk Factors in 2019 - A Cross-Sectional Study.","authors":"Arian Taniwall, Michala Lustigová, Jan Brož, Pavlína Krollová, Juraj Michalec, Kristýna Žejglicová, Jana Malinovská, Lucia Bučková, Juan P González-Rivas, Geraldo A Maranhao Neto, Iuliia Pavlovska, Martina Tuháčková, Lukáš Rozsíval, Jana Urbanová","doi":"10.1159/000545945","DOIUrl":"10.1159/000545945","url":null,"abstract":"<p><strong>Objective: </strong>This study analysed the prevalence of hypertension and its associated risk factors in Czech adults aged 25-64 using data from the 2019 European Health Examination Survey (EHES). Given the limited number of large-scale studies in Central Europe, this study provides crucial evidence to inform public health strategies. Examining gender differences and applying updated control thresholds, it provides valuable insights into hypertension management in Czechia.</p><p><strong>Subject and methods: </strong>We conducted a cross-sectional analysis using EHES 2019 data. Participants underwent a medical examination assessing cardiovascular health, including blood pressure and blood tests. A total of 1,056 participants were included, aged 25-64 years (mean age of 44.4 ± 0.73) years and with a mean BMI of 27.6 ± 0.35 kg/m2. Hypertension was defined as systolic blood pressure and/or diastolic blood pressure (mean of the second and the third measurements, 1 min apart) ≥140/90 mm Hg and/or current antihypertensive treatment. Awareness was determined by self-reporting prior diagnosis. Control was assessed as blood pressure <130/80 mm Hg (control 1) or <140/90 mm Hg (control 2).</p><p><strong>Results: </strong>Hypertension prevalence was 36.3%, with higher rates in males (46.0%) than in females (26.3%, p < 0.001). Awareness was 64.8% greater in females (72.0% vs. 60.9%, p = 0.027). Treatment was received by 47.6% of hypertensives, more by women (57.7% vs. 42.0%, p < 0.001). Control rates were 10.4% (control 1) and 49.4% (control 2).</p><p><strong>Conclusion: </strong>Hypertension is common in Czech adults, with gender differences in prevalence, awareness, and treatment. Despite high awareness, treatment and control remain suboptimal, indicating the need for targeted interventions.</p>","PeriodicalId":18455,"journal":{"name":"Medical Principles and Practice","volume":" ","pages":"1-11"},"PeriodicalIF":2.9,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12148334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143978395","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":"Prevalence of Urinary Tract Infections and Antibiotic Susceptibility Patterns of Uropathogens among Neonates in Maternity Hospital, Kuwait: A Six-Year Retrospective Study.","authors":"Ola H Moghnia, Hessah S Al Otaibi, Aisha M Al Haqqan, Elie S Sokhn, Seema S Pathan, Nawar E Abdulaziz, Habiba Y Mohammed, Noura A Al-Sweih","doi":"10.1159/000543368","DOIUrl":"10.1159/000543368","url":null,"abstract":"<p><strong>Objective: </strong>Urinary tract infections (UTIs) are common in neonates. Understanding the changes in the prevalence of common uropathogens is essential for early diagnosis and effective treatment of UTIs. This study aimed to identify etiological agents and determine the local antibiotic susceptibility patterns of uropathogens causing UTIs.</p><p><strong>Subjects and methods: </strong>A retrospective cross-sectional descriptive study from January 2017 to December 2022 was conducted on hospitalized neonates at Maternity Hospital, Kuwait. Urine samples from neonates were analyzed to identify isolates, and antimicrobial susceptibility testing was determined using the VITEK® 2 system.</p><p><strong>Results: </strong>Out of 3,996 urine samples processed, 282 (7%) samples yielded significant bacteriuria, mostly from male 185 (65.6%). Gram-negative isolates were the most common 141 (50%), followed by yeasts 84 (29.8%) and Gram-positive isolates 57 (20.2%). The common uropathogens were Klebsiella pneumoniae 50 (17.7%), followed by Escherichia coli 47 (16.8%), Candida albicans 39 (13.8%), Enterococcus faecalis 34 (12%), and Staphylococcus epidermidis 17 (6%). High resistance rates were observed among Enterobacterales against ampicillin, cephalothin, cefuroxime, cefotaxime, nitrofurantoin, amoxicillin-clavulanic acid, ceftazidime, and trimethoprim-sulfamethoxazole. A total of 28 (56%) K. pneumoniae and 18 (38.3%) E. coli were extended-spectrum beta-lactamase producers.</p><p><strong>Conclusion: </strong>Gram-negative isolates are considered the predominant causative agents of UTIs in neonates at Maternity Hospital. Reduced antibiotic susceptibility to commonly used antibiotics poses a notable challenge in the clinical management of neonates with UTIs. This study underscores the importance of proactive surveillance in monitoring causative organisms and antibiotic susceptibility in neonates.</p>","PeriodicalId":18455,"journal":{"name":"Medical Principles and Practice","volume":" ","pages":"250-261"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12133137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142922047","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":"Effectiveness of Hormonal Therapy for Post-Menopausal Women with Hormone Receptor-Positive Advanced Breast Cancer: A Systematic Review and Meta-Analysis of Clinical Trials.","authors":"Vitalis C Okwor, Juliet C Okwor, Maryjane K Ukwuoma, Sara B Mitha, Martins C Nweke","doi":"10.1159/000545264","DOIUrl":"10.1159/000545264","url":null,"abstract":"<p><strong>Objective: </strong>Breast cancer (BC) cells exhibit mutations over time, conferring resistance to therapeutic approaches. We attempted to ascertain the efficacy of selected hormonal therapy for advanced BC.</p><p><strong>Methods: </strong>This is a systematic review and meta-analysis of clinical trials. We searched Medline, PubMed, Cochrane Library, Web of Science, and others. Studies that investigated the effectiveness of hormonal therapy for HR positive (HR+) advanced BC were included. The outcomes were progression-free survival (PFS), overall survival (OS), and objective response rate (ORR). A random-effect meta-analysis model was employed. The study protocol was registered with the International Prospective Register of Systematic Reviews: CRD42023431939.</p><p><strong>Results: </strong>Twenty-one studies were included in the meta-analysis with an overall sample size of 8,482. ORR and PFS between aromatase inhibitors (AIs) and other hormonal therapies: selective oestrogen receptor degrader, selective oestrogen modulator (SERM) and androgen inhibitors showed no significant difference (OR = 1.122 [0.917-1.374], p = 0.263; OR = 0.010 [0.000-1.292], p = 0.063), respectively. Subgroup analysis showed a statistically significant difference in ORR in favour of patients who received SERM compared to AI (OR = 1.362 [1.033-1.795], p = 0.028). For OS, no significant difference was observed among anastrozole, letrozole, and exemestane recepients (OR = 1.718 [0.021-139.128], p = 0.809).</p><p><strong>Conclusion: </strong>Given the above findings, clinical decisions could be based on factors such as the line of cancer treatment, adverse events, drug dosing, and individual drug benefits. Although newer combination therapies are being adopted, the agents explored in this review are still widely used in clinical practice for HR+ BC.</p>","PeriodicalId":18455,"journal":{"name":"Medical Principles and Practice","volume":" ","pages":"338-359"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12092009/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649365","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":"Not Indolamine 2,3-Dioxygenase Polymorphisms, but Low Levels of Indoleamine 2,3-Dioxygenase and IDO2 Are Associated with Behçet's Syndrome.","authors":"Haluk Barbaros Oral, Ülkü Uçar, Yağmur Aydın Atalay, Güven Özkaya, Haluk Barbaros Oral","doi":"10.1159/000545581","DOIUrl":"10.1159/000545581","url":null,"abstract":"<p><p><p>Objective: Behçet's syndrome (BS) is a multisystemic disorder with a complex genetic background. Indoleamine 2,3-dioxygenase (IDO) and IDO2, key enzymes in tryptophan metabolism, have immunomodulatory effects. Specific IDO and IDO2 polymorphisms may influence enzymatic activity. This study aimed to explore the association between IDO/IDO2 gene polymorphisms and BS susceptibility, and assess serum levels of IDO and IDO2 in relation to BS.</p><p><strong>Subjects and methods: </strong>Ninety patients with BS and 52 healthy controls were enrolled in this study. Predetermined single-nucleotide polymorphisms (SNPs) were studied at specific gene loci for IDO and IDO2. Serum IDO and IDO2 levels were determined using ELISA.</p><p><strong>Results: </strong>No statistically significant differences were observed in the genotype and allele frequencies of IDO (rs7820268 and rs10108662) and IDO2 (rs4503083) between patients with BS and controls. Furthermore, no significant association was found between clinical findings and SNPs, except that the IDO rs7820268 CT genotype was significantly lower in patients with neurological involvement (0% vs. 42%, p = 0.026, OR = 0.147, 95% CI = 0.18-1.231). Serum levels of IDO and IDO2 were significantly lower in BS patients compared to controls (p < 0.0000 and p < 0.0001, respectively).</p><p><strong>Conclusion: </strong>Our research revealed that the serum IDO/IDO2 levels of BS were substantially lower than those in the control group. This finding has the potential to impact IDO activity and reduce immune tolerance. No correlation was observed between IDO/IDO2 polymorphisms and most clinical findings of BS. However, the IDO rs7820268 CT genotype was significantly reduced in neuro-BS, suggesting a protective effect. Larger prospective trials are needed to further explore these findings. </p>.</p>","PeriodicalId":18455,"journal":{"name":"Medical Principles and Practice","volume":" ","pages":"464-473"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12074646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753358","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":"Coronary Implications of COVID-19.","authors":"Andreas S Triantafyllis, Danai Sfantou, Eleni Karapedi, Katerina Peteinaki, Sotirios C Kotoulas, Richard Saad, Petros N Fountoulakis, Konstantinos Tsamakis, Dimitrios Tsiptsios, Loukianos Rallidis, James N Tsoporis, Dimitrios Varvarousis, Eftychia Hamodraka, Andreas Giannakopoulos, Leonidas E Poulimenos, Ignatios Ikonomidis","doi":"10.1159/000541553","DOIUrl":"10.1159/000541553","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Patients with SARS-CoV-2 infection carry an increased risk of cardiovascular disease encompassing various implications, including acute myocardial injury or infarction, myocarditis, heart failure, and arrhythmias. A growing volume of evidence correlates SARS-CoV-2 infection with myocardial injury, exposing patients to higher mortality risk. SARS-CoV-2 attacks the coronary arterial bed with various mechanisms including thrombosis/rupture of preexisting atherosclerotic plaque, de novo coronary thrombosis, endotheliitis, microvascular dysfunction, vasculitis, vasospasm, and ectasia/aneurysm formation. The angiotensin-converting enzyme 2 receptor plays pivotal role on the cardiovascular homeostasis and the unfolding of COVID-19. The activation of immune system, mediated by proinflammatory cytokines along with the dysregulation of the coagulation system, can pose an insult on the coronary artery, which usually manifests as an acute coronary syndrome (ACS). Electrocardiogram, echocardiography, cardiac biomarkers, and coronary angiography are essential tools to set the diagnosis. Revascularization is the first-line treatment in all patients with ACS and obstructed coronary arteries, whereas in type 2 myocardial infarction treatment of hypoxia, anemia and systemic inflammation are indicated. In patients presenting with coronary vasospasm, nitrates and calcium channel blockers are preferred, while treatment of coronary ectasia/aneurysm mandates the use of antiplatelets/anticoagulants, corticosteroids, immunoglobulin, and biologic agents. It is crucial to untangle the exact mechanisms of coronary involvement in COVID-19 in order to ensure timely diagnosis and appropriate treatment. We have reviewed the current literature and provide a detailed overview of the pathophysiology and clinical spectrum associated with coronary implications of SARS-COV-2 infection. Patients with SARS-CoV-2 infection carry an increased risk of cardiovascular disease encompassing various implications, including acute myocardial injury or infarction, myocarditis, heart failure, and arrhythmias. A growing volume of evidence correlates SARS-CoV-2 infection with myocardial injury, exposing patients to higher mortality risk. SARS-CoV-2 attacks the coronary arterial bed with various mechanisms including thrombosis/rupture of preexisting atherosclerotic plaque, de novo coronary thrombosis, endotheliitis, microvascular dysfunction, vasculitis, vasospasm, and ectasia/aneurysm formation. The angiotensin-converting enzyme 2 receptor plays pivotal role on the cardiovascular homeostasis and the unfolding of COVID-19. The activation of immune system, mediated by proinflammatory cytokines along with the dysregulation of the coagulation system, can pose an insult on the coronary artery, which usually manifests as an acute coronary syndrome (ACS). Electrocardiogram, echocardiography, cardiac biomarkers, and coronary angiography are essential tools to set the diagnosis. Revascularization is th","PeriodicalId":18455,"journal":{"name":"Medical Principles and Practice","volume":" ","pages":"1-12"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11805551/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142290814","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":"Unlocking Nitrofurantoin: Understanding Molecular Mechanisms of Action and Resistance in Enterobacterales.","authors":"Balaram Khamari, Eswarappa Pradeep Bulagonda","doi":"10.1159/000542330","DOIUrl":"10.1159/000542330","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Antimicrobial resistance (AMR) is a global health crisis that has already claimed millions of lives and is projected to affect millions more unless urgent action is taken. Effective control of AMR requires the correct choice and dosage of antibiotics, as well as robust surveillance and research. Understanding the mechanisms of antibiotic action and the emergence of resistance phenotypes along with their genotypes is essential. This knowledge, combined with insights into resistance prevalence and spread, empowers clinicians to propose alternative therapies. Nitrofurantoin, a 70-year-old antibiotic, remains effective for the treatment of uncomplicated lower UTIs. Preventing emergence and spread of nitrofurantoin-resistant superbugs would preserve the efficacy of this antibiotic which is crucial for ongoing and future AMR efforts. Nitrofurantoin resistance evolves slowly, leading to low prevalence compared to other antibiotics. However, it is often linked with extensive drug resistance, complicating treatment outcomes. Even a minor percentage of nitrofurantoin-resistant bacteria can cause significant clinical challenges due to irreversible evolution. While detailed study of these mechanisms can guide the development of strategies to combat nitrofurantoin resistance, early detection of resistant infections is critical for saving lives. The current review aimed to provide a comprehensive analysis of nitrofurantoin's mechanisms of action, resistance evolution, prevalence, and resistance prediction. Our goal is to offer valuable insights for researchers and clinicians to enhance nitrofurantoin use and address the challenges posed by AMR. Antimicrobial resistance (AMR) is a global health crisis that has already claimed millions of lives and is projected to affect millions more unless urgent action is taken. Effective control of AMR requires the correct choice and dosage of antibiotics, as well as robust surveillance and research. Understanding the mechanisms of antibiotic action and the emergence of resistance phenotypes along with their genotypes is essential. This knowledge, combined with insights into resistance prevalence and spread, empowers clinicians to propose alternative therapies. Nitrofurantoin, a 70-year-old antibiotic, remains effective for the treatment of uncomplicated lower UTIs. Preventing emergence and spread of nitrofurantoin-resistant superbugs would preserve the efficacy of this antibiotic which is crucial for ongoing and future AMR efforts. Nitrofurantoin resistance evolves slowly, leading to low prevalence compared to other antibiotics. However, it is often linked with extensive drug resistance, complicating treatment outcomes. Even a minor percentage of nitrofurantoin-resistant bacteria can cause significant clinical challenges due to irreversible evolution. While detailed study of these mechanisms can guide the development of strategies to combat nitrofurantoin resistance, early detection of resistant infections is critical","PeriodicalId":18455,"journal":{"name":"Medical Principles and Practice","volume":" ","pages":"121-137"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11936445/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142546242","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":"Whole-Genome Sequencing of Brucella melitensis Isolates from Kuwait for the Identification of Biovars, Variants, and Relationship within a Biovar.","authors":"Abu Salim Mustafa, Mohd Wasif Khan, Nazima Habibi, Wadha Alfouzan","doi":"10.1159/000542867","DOIUrl":"10.1159/000542867","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The identification of Brucella genotypes is essential for epidemiological studies. The whole-genome sequencing is emerging as a novel tool for genetic characterization of infectious microbes. The aim of this study was to genotype Brucella melitensis isolates from Kuwait using whole-genome sequencing and variant analysis of the sequence data.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;DNA was purified from 15 heat-inactivated B. melitensis isolates and used to prepare sequencing libraries employing Nextera XT DNA Sample Preparation Kit (Illumina San Diego, CA, USA) and sequenced on a MiSeq (Illumina). The sequence files were aligned to three biovars of B. melitensis, i.e., biovar 1 str. 16M, biovar 2 str. 63/9, and biovar 3 str. Ether. The alignment and variant calling were performed using \"bwa-mem\" and SAMtools/VCFtools, respectively.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The genome size of all the isolates was around 3.3 mega base pairs and resembled B. melitensis biovar 2. Single-nucleotide polymorphisms (SNPs), insertions, and deletions (indels) were spread all over the genome; but 138 SNPs were common among the 14 isolates, supporting the same ancestral origin. A neighbor-joining tree analysis identified isolate 2 as an outlier. In addition, SNPs (2-478) specific to each isolate were also identified, which divided the B. melitensis biovar 2 into two major groups/genotypes. A further analysis showed that the Kuwaiti isolates of the present study shared phylogeny mainly with strains from the Middle Eastern countries.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Among the 15 studied isolates from Kuwait, biovar 2 is the most prevalent biovar of B. melitensis. Furthermore, isolate-specific genetic variations were identified, which may be useful in epidemiological investigations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The identification of Brucella genotypes is essential for epidemiological studies. The whole-genome sequencing is emerging as a novel tool for genetic characterization of infectious microbes. The aim of this study was to genotype Brucella melitensis isolates from Kuwait using whole-genome sequencing and variant analysis of the sequence data.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;DNA was purified from 15 heat-inactivated B. melitensis isolates and used to prepare sequencing libraries employing Nextera XT DNA Sample Preparation Kit (Illumina San Diego, CA, USA) and sequenced on a MiSeq (Illumina). The sequence files were aligned to three biovars of B. melitensis, i.e., biovar 1 str. 16M, biovar 2 str. 63/9, and biovar 3 str. Ether. The alignment and variant calling were performed using \"bwa-mem\" and SAMtools/VCFtools, respectively.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The genome size of all the isolates was around 3.3 mega base pairs and resembled B. melitensis biovar 2. Single-nucleotide polymorphisms (SNPs), insertions, and deletions (indels) were spread all over the genome; but 138 SNPs were common among the 14 isolates, supporting the same an","PeriodicalId":18455,"journal":{"name":"Medical Principles and Practice","volume":" ","pages":"152-161"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11936451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142770356","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":"Systemic Statin Use and Pulp Chamber Calcification: A Pilot Retrospective Case-Control Study Using Cone-Beam Computed Tomography.","authors":"Selen Nihal Sisli, Birgul Ozasir, Tufan Ozasir, Derin Bugu Yuzer, Kamran Gulsahi","doi":"10.1159/000542398","DOIUrl":"10.1159/000542398","url":null,"abstract":"<p><strong>Objectives: </strong>This pilot retrospective case-control study questioned whether systemic statin use causes pulp calcification using cone-beam computed tomography (CBCT) images from the patients prescribed oral statins and comparing those of healthy individuals.</p><p><strong>Subjects and methods: </strong>CBCT scans of 54 patients, including 27 age- and sex-matched patients for the study and control groups, were analysed using Mimics Innovation Suite software. The study included patients using statins regularly for at least 1 year. Only intact teeth with opposing teeth were selected for the study group and matched with the control group. Dental crown and pulp chamber volumes were calculated and proportioned. The data were analysed with chi-square and Shapiro-Wilk tests to assess normal distribution, followed by Mann-Whitney U test if necessary.</p><p><strong>Results: </strong>Statistical analysis showed no difference between the study and control groups (p = 0.505). Statin use duration did not cause statistically significant difference in terms of the reduction of pulp chamber volume (p = 0.141).</p><p><strong>Conclusion: </strong>Within the limitations of the study, systemic statin use did not cause dental pulp calcification. The results suggest, oral administration of the statin drugs is not an unfavourable condition for dental practice. Further studies with larger numbers of patients are needed to support this conclusion.</p>","PeriodicalId":18455,"journal":{"name":"Medical Principles and Practice","volume":" ","pages":"291-300"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12133124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142591154","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":"Clinical Features, Diagnostic Implications, and Outcomes of Amyotrophic Lateral Sclerosis and Myasthenia Gravis Overlap Syndrome: A Systematic Review.","authors":"Abdulqadir Jeprel Nashwan, Yousef Hawas, Abdullah Ashraf Hamad, Mostafa Meshref, Mohamed Elbehary, Rashad G Mohamed, Ahmed Elshahat, Manar Alaa Mabrouk, Abdulqadir J Nashwan, Basem Hamdy Fouda","doi":"10.1159/000545806","DOIUrl":"10.1159/000545806","url":null,"abstract":"<p><p><p>Objective: This review aimed to summarize the current evidence of reported myasthenia gravis (MG) and amyotrophic lateral sclerosis (ALS) overlap syndrome regarding clinical and laboratory features, diagnostic implications, management, outcomes, and comorbid conditions to raise awareness among healthcare providers and aid in proper care provision.</p><p><strong>Methods: </strong>Recently, a few cases of an unusual association between both diseases have been reported. PubMed, Scopus, and Web of Science were searched from inception until May 2024 to identify eligible studies. After the screening and data extraction, 20 studies with 42 cases suffering from ALS and MG were included.</p><p><strong>Results: </strong>Forty-two cases were categorized into four groups as follows: the first group had 26 cases with MG onset (age range 26-82 years) preceding ALS (age range 46-83 years). The second group had 9 cases with ALS onset (age range 34-89 years) preceding MG (age range 40-89 years). The third group comprised 5 cases of ALS with positive acetylcholine receptor antibodies but without clinical manifestations of MG. The fourth group involved 2 cases of ALS with initial ocular symptoms that were unresponsive to MG treatments.</p><p><strong>Conclusion: </strong>The onset of new ptosis or diplopia in ALS patients should prompt clinicians to consider the possibility of a coexisting condition or alternative diagnosis. Additionally, positive acetylcholine receptor antibodies alone are insufficient to diagnose MG if ALS coexists. In patients with ALS, repetitive nerve stimulation tests may be less sensitive for detecting MG. Thus, diagnosing MG in ALS patients should rely on clinical presentation and response to empirical treatment. </p>.</p>","PeriodicalId":18455,"journal":{"name":"Medical Principles and Practice","volume":" ","pages":"432-442"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12113421/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016086","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}