Medical Principles and Practice最新文献

{"title":"The Anti-Elixir Triad: Non-Synced Circadian Rhythm, Gut Dysbiosis, and Telomeric Damage.","authors":"Anup Kumar Mani, Venkatachalam Deepa Parvathi, Sumitha Ravindran","doi":"10.1159/000542557","DOIUrl":"10.1159/000542557","url":null,"abstract":"<p><p>Aging is an inevitable life process which is accelerated by lifestyle and environmental factors. It is an irreversible accretion of molecular and cellular damage associated with changes in the body composition and deterioration in physiological functions. Each cell (other than stem cells) reaches the limit of its ability to replicate, known as cellular or replicative senescence, and consequently, the organs lose their physiological functions, resulting in overall impairment. Other factors that promote aging include smoking, alcohol, UV rays, sleep habits, food, stress, sedentary lifestyle, and genetic abnormalities. These stress factors can alter our endogenous clock (the circadian rhythm) and the microbial commensals. As a result of the effect of these stressors, the microorganisms that generally support human physiological processes become baleful. The disturbance of natural physiology instigates many age-related pathologies, such as cardiovascular diseases, chronic obstructive pulmonary disorder, cerebrovascular diseases, opportunistic infections, high blood pressure, cancer, diabetes, kidney diseases, dementia, and Alzheimer's disease. The present review covers the three most essential processes of the circadian clock; the circadian gene mechanism and regulation, the mitotic clock (which plays a vital role in the telomere's attrition) and the gut microbiota and their metabolome that drive aging and lead to age-related pathologies. In conclusion, maintaining a synchronized circadian rhythm, a healthy gut microbiome, and telomere integrity is essential for mitigating the effects of aging and promoting longevity. The interplay among these factors underscores the importance of lifestyle choices in enhancing overall health and lifespan.</p>","PeriodicalId":18455,"journal":{"name":"Medical Principles and Practice","volume":" ","pages":"212-225"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12133136/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142623803","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":"Racial Discrimination and Multiple Health Outcomes: An Umbrella Review of Systematic Reviews and Meta-Analyses.","authors":"Jun Hyuk Lee, Hyeri Lee, Yejun Son, Hyeon Jin Kim, Jaeyu Park, Hayeon Lee, Guillaume Fond, Laurent Boyer, Lee Smith, Masoud Rahmati, Damiano Pizzol, Jiseung Kang, Dong Keon Yon, Hans Oh","doi":"10.1159/000542988","DOIUrl":"10.1159/000542988","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;We aimed to systematically investigate the associations between racial discrimination and various health outcomes and to evaluate the certainty of evidence from existing meta-analyses of observational studies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Method: &lt;/strong&gt;We systemically searched the associations between racial discrimination and health outcomes for PubMed/MEDLINE, Embase, WoS, and Google Scholar up until January 31, 2024. Notably, the included studies were predominantly conducted in the USA and Europe, limiting the generalizability of our findings to a global context.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Eight meta-analyses of observational studies involving over 1 million individuals were included, describing 15 potential health outcomes related to racial discrimination. The quality assessment revealed that most included meta-analyses were of low quality. For oncological health outcomes, significant associations were found with the mortality of hepatocellular carcinoma (HCC); black patients had a higher risk, while Asian patients had a lower risk when compared to white patients. In addition, black patients with disparities on the cancer care continuum are a protective factor for early-stage HCC diagnosis. For gastroenterological health outcomes, Hispanic patients with nonalcoholic fatty liver disease and black patients with socioeconomic status/differential access to health care, compared to white patients (reference), showed significant associations. For mental health outcomes, racial discriminations were significantly associated with increased odds of psychotic experiences, suicidal ideation, and suicidal attempts. Numerous significant associations were from weak to suggestive evidence levels, indicating variability in the evidence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Despite the complexity of measuring its impact, racial discrimination shows a profound influence across clinical areas, including an unexpected protective association in early-stage HCC diagnosis among black patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;We aimed to systematically investigate the associations between racial discrimination and various health outcomes and to evaluate the certainty of evidence from existing meta-analyses of observational studies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Method: &lt;/strong&gt;We systemically searched the associations between racial discrimination and health outcomes for PubMed/MEDLINE, Embase, WoS, and Google Scholar up until January 31, 2024. Notably, the included studies were predominantly conducted in the USA and Europe, limiting the generalizability of our findings to a global context.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Eight meta-analyses of observational studies involving over 1 million individuals were included, describing 15 potential health outcomes related to racial discrimination. The quality assessment revealed that most included meta-analyses were of low quality. For oncological health outcomes, significant associations were found with the mortali","PeriodicalId":18455,"journal":{"name":"Medical Principles and Practice","volume":" ","pages":"138-151"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11936452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142785459","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 and Medical Economic Value of Screening Colonoscopy before Laparoscopic Cholecystectomy.","authors":"Tsuyoshi Igami, Masanao Nakamura, Takuya Ishikawa, Takeshi Yamamura, Kentaro Yamao, Keiko Maeda, Yasuyuki Mizutani, Tsunaki Sawada, Yukihiro Yokoyama, Takashi Mizuno, Junpei Yamaguchi, Shunsuke Onoe, Masaki Sunagawa, Nobuyuki Watanabe, Taisuke Baba, Shoji Kawakatsu, Hiroki Kawashima, Tomoki Ebata","doi":"10.1159/000545322","DOIUrl":"10.1159/000545322","url":null,"abstract":"<p><strong>Objective: </strong>Clinical value of screening colonoscopy (SC) has been widely accepted; however, its clinical utility remains controversial in patients who undergo laparoscopic cholecystectomy (LC). The aim of this study was to evaluate the clinical value of medical care costs for SC before LC.</p><p><strong>Subject and methods: </strong>Of the 509 patients who underwent LC, 335 underwent preoperative SC before LC. The electronic medical records were retrospectively reviewed, and the technical fees of SC and endoscopic and/or surgical resection for colorectal neoplasia (CRN) were analyzed.</p><p><strong>Results: </strong>In the 335 patients with SC before LC, the rate of CRN requiring resection, including advanced adenoma and adenocarcinoma, was 13.1%. The detected rate of CRN requiring resection in the age-groups of <45, 44-55, 55-65, 65-75, ≥75 years was 5.3%, 3.8%, 9.8%, 17.4%, and 22.9%, respectively. Of the 174 patients without SC before LC, 4 patients were diagnosed with resectable colorectal carcinomas after LC. The total technical fees of SC and/or treatment of CRNs among the 335 patients with SC before LC and surgical procedures among the 4 patients with resectable colorectal carcinoma were United States dollar (USD) 84,700 and USD 32,000 USD, respectively. Regarding the technical fee per person, the former group (USD 250) had much economic advantage compared to the latter group (USD 8,000).</p><p><strong>Conclusion: </strong>Scheduling LC is recognized as an important chance to undergo SC. For the patients aged ≥55 years, colonoscopy is no longer a screening option but a clinical necessity due to the high detected rates of CRN requiring resection.</p>","PeriodicalId":18455,"journal":{"name":"Medical Principles and Practice","volume":" ","pages":"369-378"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12052350/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657530","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":"Plasma Sodium and Laboratory Parameters in Determining Complicated Appendicitis in Children.","authors":"Ramazan Amanvermez, Hızır Ufuk Akdemir","doi":"10.1159/000541748","DOIUrl":"10.1159/000541748","url":null,"abstract":"","PeriodicalId":18455,"journal":{"name":"Medical Principles and Practice","volume":" ","pages":"96-97"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11805540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142381259","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":"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":2.9,"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":"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":2.9,"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":"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":2.9,"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":"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":"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}