Medical Principles and Practice最新文献

{"title":"Outcomes of Intermittent Hemodialysis versus Continuous Kidney Replacement Therapy in Hemodynamically Stable Patients with Acute Kidney Injury: A Prospective, Observational, Multicenter Study.","authors":"Ali AlSahow, Omar Alkandari, Yousif Bahbahani, Anas AlYousef, Bassam AlHelal, Heba AlRajab, Ahmed AlQallaf, Monther AlSharekh, Abdulrahman AlKandari, Gamal Nessim, Bassem Mashal, Ahmad Mazroue, Alaa Abdelmoteleb, Mohamed ElAbbadi, Ali Abdelzaher, Emad Abdallah, Mohamed Abdellatif, Ziad ElHusseini, Ahmed Abdelrady","doi":"10.1159/000543882","DOIUrl":"10.1159/000543882","url":null,"abstract":"<p><strong>Introduction: </strong>Continuous dialysis in hemodynamically stable patients with acute kidney injury (AKI) may impact outcomes differently than intermittent dialysis. We evaluated differences in patient and kidney outcomes between the two modalities.</p><p><strong>Methods: </strong>Clinical and 30-day outcome data for inpatients with AKI who were hemodynamically stable and not on ventilation and who received intermittent hemodialysis (IHD) or continuous kidney replacement therapy (CKRT) in public hospitals in Kuwait from January 1 to December 31, 2021, were prospectively collected.</p><p><strong>Results: </strong>We recruited 229 patients (age: 59.9 years; males, 60.3%; baseline estimated baseline glomerular filtration [eGFR], 56 mL/min). CKRT accounted for 72.9% of cases due to lack of access to water treatment. No statistically significant differences were observed between groups in terms of age, baseline eGFR, sex, comorbidities, cause of AKI, or fluid administration. The intensive care unit contributed 21% of cases, with no significant difference between groups. More IHD patients received diuretics (62.9% vs. 43.1% for CKRT, p = 0.008). At 30 days, 21.8% of patients had died. There was no statistically significant difference in mortality between groups (16.1% for IHD vs. 24% for CKRT, p = 0.2). Final eGFR was 53.2 mL/min, with no difference between groups. Complete kidney recovery was greater with CKRT (33.1% vs. 13.5%, p = 0.009). Baseline eGFR < 60 mL/min did not influence mortality or kidney recovery.</p><p><strong>Conclusion: </strong>Compared with IHD, CKRT did not lower mortality at 30 days, which is similar to that of randomized trials; however, it was associated with better complete kidney recovery, which was reported in observational studies.</p>","PeriodicalId":18455,"journal":{"name":"Medical Principles and Practice","volume":" ","pages":"262-270"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12133130/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189723","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":"FORTA Score and Negative Outcomes in Older Adults: Insights from Italian Internal Medicine Wards.","authors":"Marina Azab, Alessio Novella, Luca Pasina","doi":"10.1159/000542109","DOIUrl":"10.1159/000542109","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;The study aimed to assess the relationship between the Fit fOR The Aged (FORTA) score - a classification system designed to evaluate medication appropriateness in older adults - and several negative outcomes, including impaired cognitive performance, functional status, adverse clinical events, and all-cause mortality at 3, 6, and 12 months after hospital discharge.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This retrospective study utilized data from the ELICADHE cohort, a cluster-randomized trial conducted across 20 Italian internal medicine and geriatric wards. The study included patients aged 75 and older with complete FORTA score assessments. Demographics, medication history, and comorbidities were collected. The FORTA classification system assessed medication appropriateness. FORTA scores were calculated and FORTA score cut-offs (3 and 5) were applied. Statistical analyses included descriptive statistics, survival analysis with Cox regression, logistic regression, and negative-binomial regression using SAS 9.4 and RStudio 12.1. Ethical approval was obtained.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of the 506 patients included, 171 (33.8%) were fully assessable with complete FORTA scores. The study found no significant association between higher FORTA scores and impaired cognitive performance, functional status, or mortality. Additionally, no clear relationship was observed between FORTA scores and adverse clinical events or mortality. The analysis indicated that age was a significant factor associated with mortality and adverse clinical events.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The study did not find a significant relationship between the FORTA score and negative outcomes in older patients discharged from internal medicine and geriatric wards. Further research is needed to define specific FORTA score cut-off values and expand the criteria to improve medication assessment in this population.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;The study aimed to assess the relationship between the Fit fOR The Aged (FORTA) score - a classification system designed to evaluate medication appropriateness in older adults - and several negative outcomes, including impaired cognitive performance, functional status, adverse clinical events, and all-cause mortality at 3, 6, and 12 months after hospital discharge.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This retrospective study utilized data from the ELICADHE cohort, a cluster-randomized trial conducted across 20 Italian internal medicine and geriatric wards. The study included patients aged 75 and older with complete FORTA score assessments. Demographics, medication history, and comorbidities were collected. The FORTA classification system assessed medication appropriateness. FORTA scores were calculated and FORTA score cut-offs (3 and 5) were applied. Statistical analyses included descriptive statistics, survival analysis with Cox regression, logistic regression, and negative-binomial regression using SAS 9.4 an","PeriodicalId":18455,"journal":{"name":"Medical Principles and Practice","volume":" ","pages":"57-65"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11805544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142469624","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":"Response to the Letter on \"Risks of New-Onset Atrial Fibrillation after Coronary Artery Bypass Grafting\".","authors":"Sameh Alagha, Serkan Mola, Mehmet Çeber, Alp Yıldırım","doi":"10.1159/000545222","DOIUrl":"10.1159/000545222","url":null,"abstract":"","PeriodicalId":18455,"journal":{"name":"Medical Principles and Practice","volume":" ","pages":"402-403"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12052358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143616272","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":"Global and Regional Burden of Vaccine-Associated Erythema Multiforme and Their Related Vaccines, 1967-2023: An In-Depth Analysis of the World Health Organization Pharmacovigilance Database.","authors":"Seoyeon Kyung, Masoud Rahmati, Jiseung Kang, Kyeogmin Lee, Hayeon Lee, Dong Keon Yon","doi":"10.1159/000541797","DOIUrl":"10.1159/000541797","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Vaccine-associated erythema multiforme (EM) remains under-researched, impacting global vaccine safety evaluations. This study examines the global and regional burden of EM and its association with specific vaccines to optimize vaccination strategies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Subject and methods: &lt;/strong&gt;We analyzed data from the WHO pharmacovigilance database on vaccine-associated EM from 1967 to 2023 (n = 131,255,418 reports). Reporting frequencies, reported odds ratios (RORs), and information components (IC) were calculated for 16 vaccines across 170 countries.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;We identified 6,355 cases (males, n = 3,182 [50.07%]) of vaccine-associated EM from a total of 46,378 reports of all-cause EM. While vaccine-associated EM has been consistently reported, there has been a notable increase in reported incidence particularly in 2010 and 2020. Measles, mumps, and rubella vaccines had the highest association with vaccine-associated EM reports (ROR: 8.75 [95% confidence interval, 8.11-9.44]; IC, 3.10 [IC0.25, 2.97]), followed by hepatitis B (8.54 [7.66-9.51]; 3.06 [2.88]), hepatitis A (8.11 [7.01-9.39]; 2.98 [2.74]), typhoid (6.50 [4.75-8.90]; 2.60 [2.07]), encephalitis (5.86 [4.35-7.91]; 2.47 [1.96]), diphtheria, tetanus toxoids, pertussis, polio, and Hemophilus influenza type b (5.70 [5.42-5.99]; 2.46 [2.38]), pneumococcal (5.56 [5.11-6.06]; 2.45 [2.31]), rotavirus (4.96 [4.21-5.84]; 2.29 [2.01]), varicella-zoster (4.44 [3.99-4.95]; 2.13 [1.95]). Vaccine-associated EM reports were more strongly correlated with younger age groups and males. The overall fatality rate of vaccine-associated EM was 0.04%.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The rise in vaccine-associated EM across multiple vaccines, especially in younger populations, highlights the need for closer monitoring and more informed vaccination practices to mitigate adverse reactions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Vaccine-associated erythema multiforme (EM) remains under-researched, impacting global vaccine safety evaluations. This study examines the global and regional burden of EM and its association with specific vaccines to optimize vaccination strategies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Subject and methods: &lt;/strong&gt;We analyzed data from the WHO pharmacovigilance database on vaccine-associated EM from 1967 to 2023 (n = 131,255,418 reports). Reporting frequencies, reported odds ratios (RORs), and information components (IC) were calculated for 16 vaccines across 170 countries.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;We identified 6,355 cases (males, n = 3,182 [50.07%]) of vaccine-associated EM from a total of 46,378 reports of all-cause EM. While vaccine-associated EM has been consistently reported, there has been a notable increase in reported incidence particularly in 2010 and 2020. Measles, mumps, and rubella vaccines had the highest association with vaccine-associated EM reports (ROR: 8.75 [95% confidence interval, 8.11-9.44]; IC, 3.10 [IC0.25, 2.97]), followed by ","PeriodicalId":18455,"journal":{"name":"Medical Principles and Practice","volume":" ","pages":"25-38"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11805550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142381258","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":"Vitamin D Supplementation Mediates a Shift toward Anti-Inflammatory Cytokine Response in Multiple Sclerosis.","authors":"Suhail Al-Shammri, Arpita Chattopadhyay, Raj Raghupathy","doi":"10.1159/000544106","DOIUrl":"10.1159/000544106","url":null,"abstract":"<p><strong>Objective: </strong>In this study, we assessed the impact of vitamin D (Vit-D) supplementation on cytokine profile in newly diagnosed drug-naïve multiple sclerosis (MS) patients.</p><p><strong>Methods: </strong>We recruited 16 patients with incident MS; those were followed up for 12 months. Serum levels of 25-hydroxy-Vit-D were measured at recruitment and follow-up. Peripheral blood mononuclear cells were isolated from blood samples and stimulated with a mitogen in tissue culture to elicit cytokine production. Culture supernatants were tested after 4 days post-culture for levels of pro-inflammatory (TNF-α, interferon [IFN]-gamma, interleukin [IL]-6, IL-12) and anti-inflammatory cytokines (IL-4, IL-5, IL-10).</p><p><strong>Results: </strong>Baseline blood sample analysis revealed that patients had low Vit-D levels (16.8 [12.41-31.4] nmol/L). Thirteen patients expressed a normal intact parathyroid hormone (iPTH) (5.5 [4.2-6.9]) and were given Caltrate D twice a day; 3 patients having elevated iPTH (mean ± SD: 12.8 ± 1.5) were prescribed 50,000 IU Vit-D once weekly and Caltrate D twice daily. IFN-β1α was prescribed after a confirmed diagnosis of relapsing-remitting MS in 13 patients; 3 patients declined immunotherapy. Irrespective of immunotherapy, we observed a gradual and significant decrease in pro-inflammatory cytokine levels and a steady significant decline in ratios of several pro-inflammatory to anti-inflammatory cytokines. The patients with higher pro-inflammatory to anti-inflammatory cytokine ratios were more prone to having relapses.</p><p><strong>Conclusions: </strong>Low Vit-D levels and elevated pro-inflammatory cytokines in drug-naïve MS patients suggest a potential immune-pathogenic role for hypovitaminosis D in MS development. Vit-D supplementation may exert protective effects by modulating the immune-inflammatory response, emphasizing its therapeutic importance in MS management.</p>","PeriodicalId":18455,"journal":{"name":"Medical Principles and Practice","volume":" ","pages":"360-368"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12324787/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143408962","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":"Histamine Promotes Pseudomonas aeruginosa Biofilm Formation and Renders P. aeruginosa Biofilms More Resistant to Gentamicin and Azithromycin.","authors":"Karim Dib","doi":"10.1159/000544111","DOIUrl":"10.1159/000544111","url":null,"abstract":"<p><strong>Introduction: </strong>Pseudomonas aeruginosa biofilms contribute to the persistent presence of this bacterium in the cystic fibrosis airways. P. aeruginosa produces histamine in vitro and expresses histamine receptors. We investigated whether histamine regulated P. aeruginosa biofilm formation in vitro and contributed to bacterial virulence in Galleria mellonella.</p><p><strong>Methods: </strong>P. aeruginosa biofilms were measured by staining bacteria adhered on polystyrene with crystal violet. Histamine concentrations were measured by ELISA. G. mellonella survival upon inoculation with P. aeruginosa was measured in the absence or presence of histamine.</p><p><strong>Results: </strong>The concentration of histamine in the BHI broth was 140 ng/mL (1.3 μ<sc>m</sc>). Addition to the broth of diamine oxidase (DAO), an enzyme that catabolizes histamine, reduced by ∼3-fold the concentration of histamine and by 2-fold PAO1 strain biofilms. Addition of histamine (10-9<sc>m</sc>-10-4<sc>m</sc>) to the LB medium augmented P. aeruginosa biofilms. Maximum effects were observed with concentrations of 10-5<sc>m</sc> and 10-8<sc>m</sc> for the mucoid NH57388A strain and the PAO1 strain, respectively. DAO reduced mucoid NH57388A biofilms induced by histamine (10-4<sc>m</sc>) added to the LB medium. Addition of histamine to 48 h formed biofilms reduced anti-biofilm activities of gentamicin and azithromycin. Inoculation of G. mellonella with the PAO1 strain led to augmented histamine concentration in the haemolymph. Inoculation of histamine (10-8<sc>m</sc>) reduced the survival rate of G. mellonella infected with the PAO1 strain.</p><p><strong>Conclusion: </strong>Histamine produced during periods of infection may augment P. aeruginosa virulence by promoting the biofilm mode of life of this bacterium.</p>","PeriodicalId":18455,"journal":{"name":"Medical Principles and Practice","volume":" ","pages":"238-249"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12133133/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143408716","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":"Retraction Statement.","authors":"","doi":"10.1159/000545239","DOIUrl":"10.1159/000545239","url":null,"abstract":"","PeriodicalId":18455,"journal":{"name":"Medical Principles and Practice","volume":" ","pages":"404"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12065416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144032264","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":"Relative Importance of Defined Mycobacterium tuberculosis Antigens in the T-Cell Recognition Repertoire of Latently Infected Individuals Not Progressing to Active Disease.","authors":"Fredrik Oftung, Abu Salim Mustafa","doi":"10.1159/000542324","DOIUrl":"10.1159/000542324","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;In this study, we have mapped the relative importance of well-defined recombinantly expressed Mycobacterium tuberculosis antigens in the T-cell recognition repertoire of latently infected individuals not progressing to active disease.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;Peripheral blood mononuclear cells from healthy latently infected long-term non-progressors were screened for antigen-induced proliferation and Th1 cytokine interferon-γ (IFN-γ) responses.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The panel of antigens tested showed a clear spectrum of responsiveness and lead to the identification of a subgroup of frequently recognized antigens (MPT59, CFP7, CFP10, CFP21, TB37.6/PPE68, ESAT-6, MPT51, and DnaK) with a high cellular response level as measured in both proliferation and IFN-γ assays. Among a subgroup of antigens also screened for responses in tuberculosis patients, CFP21 was identified as differentially recognized in non-progressors. For both cellular assays, we found a positive correlation between responder frequency and magnitude of response. A significant correlation between the level of antigen-specific proliferation and INF-γ secretion was also observed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;We have identified a defined set of M. tuberculosis antigens frequently recognized by T cells at a high response level from latently infected long-term non-progressors which warrant further investigation for a potential role in immune regulation and protection against progression to active disease.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;In this study, we have mapped the relative importance of well-defined recombinantly expressed Mycobacterium tuberculosis antigens in the T-cell recognition repertoire of latently infected individuals not progressing to active disease.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;Peripheral blood mononuclear cells from healthy latently infected long-term non-progressors were screened for antigen-induced proliferation and Th1 cytokine interferon-γ (IFN-γ) responses.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The panel of antigens tested showed a clear spectrum of responsiveness and lead to the identification of a subgroup of frequently recognized antigens (MPT59, CFP7, CFP10, CFP21, TB37.6/PPE68, ESAT-6, MPT51, and DnaK) with a high cellular response level as measured in both proliferation and IFN-γ assays. Among a subgroup of antigens also screened for responses in tuberculosis patients, CFP21 was identified as differentially recognized in non-progressors. For both cellular assays, we found a positive correlation between responder frequency and magnitude of response. A significant correlation between the level of antigen-specific proliferation and INF-γ secretion was also observed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;We have identified a defined set of M. tuberculosis antigens frequently recognized by T cells at a high response level from latently infected long-term non-progressors which warrant fur","PeriodicalId":18455,"journal":{"name":"Medical Principles and Practice","volume":" ","pages":"66-74"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11805546/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142546241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Advanced Glycation End Products in Saphenous Vein Graft Failure.","authors":"Alkame Akgümüş, Bedrettin Boyraz, Ahmet Balun","doi":"10.1159/000541879","DOIUrl":"10.1159/000541879","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to investigate the relationship between advanced glycation end product (AGE) levels in patients with saphenous vein graft (SVG) failure and in patients without SVG failure.</p><p><strong>Subjects and methods: </strong>In our study, 55 patients with a history of previous coronary artery bypass grafting (CABG) surgery, who subsequently underwent coronary angiography for any reason and were found to have either SVG occlusion or significant lesions, were included as study patients. Additionally, 55 patients who have had CABG surgery without SVG failure for at least 1 year served as the control group. AGE values of the patients were measured using the skin autofluorescence method.</p><p><strong>Results: </strong>In our study results, we observed a significant difference in AGE levels between the two groups of patients with similar demographic characteristics (SVG failure groups AGE 3.2 [2.8-3.6] vs. control groups AGE 2.4 [2.1-2.7] p < 0.001). In the receiver operating characteristic curve analysis, we determined the ability of AGE levels to detect SVG failure with an area under the curve of 0.869. We found that in patients with AGE >3, it could detect SVG failure with a sensitivity of 70.9% and a specificity of 87.3%.</p><p><strong>Conclusions: </strong>Our results demonstrate that AGE levels can predict SVG failure risk inexpensively, easily, and quickly.</p><p><strong>Objective: </strong>We aimed to investigate the relationship between advanced glycation end product (AGE) levels in patients with saphenous vein graft (SVG) failure and in patients without SVG failure.</p><p><strong>Subjects and methods: </strong>In our study, 55 patients with a history of previous coronary artery bypass grafting (CABG) surgery, who subsequently underwent coronary angiography for any reason and were found to have either SVG occlusion or significant lesions, were included as study patients. Additionally, 55 patients who have had CABG surgery without SVG failure for at least 1 year served as the control group. AGE values of the patients were measured using the skin autofluorescence method.</p><p><strong>Results: </strong>In our study results, we observed a significant difference in AGE levels between the two groups of patients with similar demographic characteristics (SVG failure groups AGE 3.2 [2.8-3.6] vs. control groups AGE 2.4 [2.1-2.7] p < 0.001). In the receiver operating characteristic curve analysis, we determined the ability of AGE levels to detect SVG failure with an area under the curve of 0.869. We found that in patients with AGE >3, it could detect SVG failure with a sensitivity of 70.9% and a specificity of 87.3%.</p><p><strong>Conclusions: </strong>Our results demonstrate that AGE levels can predict SVG failure risk inexpensively, easily, and quickly.</p>","PeriodicalId":18455,"journal":{"name":"Medical Principles and Practice","volume":" ","pages":"87-95"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11805552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142391700","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":"Takotsubo Syndrome Recurrence: A Trigger for Increased 30-Day Cardiovascular Mortality.","authors":"Albert Topf, Moritz Mirna, Uta C Hoppe, Michael Lichtenauer, Lukas Motloch, Ravi Vazirani, Sabine Horn, Iván J Núñez-Gil","doi":"10.1159/000545544","DOIUrl":"10.1159/000545544","url":null,"abstract":"<p><strong>Objectives: </strong>Recurrence of Takotsubo syndrome (TTS) has been reported with a rate up to 4%. The effect of TTS recurrence on clinical outcomes has not been in the focus of studies so far.</p><p><strong>Methods: </strong>In our study, we enrolled 435 patients with TTS, of whom 14 patients had a recurrence. The inclusion interval for the index event was from 2015 to 2022, and patients were followed to categorize them in the group of TTS with or without the recurrence. TTS recurrences were registered until June 2024. Blood samples, data on clinical presentation, precipitating factors, cardiovascular risk factors, medications, demographics, echocardiographic and electrocardiographic parameters were obtained. The 30-day cardiovascular mortality (CV), the 30-day mortality, and arrhythmia during hospitalization were evaluated.</p><p><strong>Results: </strong>Comorbidities, ECG changes, premedication, and symptoms were not significantly different between TTS patients with and without recurrence. Only the index left ventricular ejection fraction (LVEF) of TTS patients with recurrence was significantly decreased (p = 0.046). In the case of outcome parameters, TTS patients with recurrence had a significantly, higher 30-day CV mortality compared to those without recurrence (21.4% vs. 3.8%, p = 0.001) with a 5.9-fold higher 30-day CV mortality (B(SE) = 1.94 (0.70), p = 0.001).</p><p><strong>Conclusion: </strong>In our study, the TTS recurrence was associated with 5.9-fold higher 30-day CV mortality. Therefore, a more precise monitoring is necessary in this high-risk group. Whether only the reduced LVEF is responsible for the increased 30-day CV mortality is an open issue and more factors can be assumed to play a role.</p>","PeriodicalId":18455,"journal":{"name":"Medical Principles and Practice","volume":" ","pages":"391-399"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12097407/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764412","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}