Medicina-Lithuania最新文献

{"title":"Association Between <i>Chlamydia trachomatis</i> and <i>Helicobacter pylori</i> with Inflammation in Polycystic Ovary Syndrome: A Cross-Sectional Study.","authors":"Yeşim Alpay Çağlar, Mine Islimye Taşkin","doi":"10.3390/medicina60122102","DOIUrl":"https://doi.org/10.3390/medicina60122102","url":null,"abstract":"<p><p><i>Objective</i>: Chronic low-grade inflammation occurs in polycystic ovary syndrome (PCOS), and there are many contributing factors. In this study, we aimed to investigate <i>Helicobacter pylori</i> and <i>Chlamydia trachomatis</i> infections in patients with PCOS and to evaluate the association between these microorganisms and the inflammatory process in the etiology of the disease. <i>Materials and Methods</i>: This comparative cross-sectional clinical study was conducted at Balıkesir University Hospital and included 40 female patients diagnosed with PCOS in the gynecology outpatients clinic and 40 healthy female controls. Demographic data were recorded. Blood hormone profiles and biochemical parameters were analyzed. An enzyme-linked immunosorbent assay test kit was used to measure <i>H. pylori</i> IgG and <i>C. trachomatis</i> IgG. <i>Results</i>: According to the analysis of the study data, there was no significant association between the PCOS and non-PCOS groups with regard to the presence of <i>Helicobacter pylori</i> IgG (<i>p</i> = 0.1) and <i>Chlamydia trachomatis</i> IgG (<i>p</i> = 0.338). CRP levels were significantly higher in the PCOS group (<i>p</i> = 0.001). In the subgroup analyses, the CRP levels were not significantly different between the <i>H. pylori</i> and <i>C. trachomatis</i> antibody-positive and -negative groups. Diabetes mellitus was significantly associated with PCOS (<i>p</i> = 0.005). The smoking rate was significantly higher in the control group than in the PCOS group (<i>p</i> = 0.036). Compared to the control group, the BMI, LH, HOMA-IR, TSH, and TG levels were significantly higher in participants with PCOS (<i>p</i> = 0.000; <i>p</i> = 0.004; <i>p</i> = 0.001; <i>p</i> = 0.001; <i>p</i> = 0.043; <i>p</i> = 0.000). FSH was lower in PCOS patients compared to controls (<i>p</i> = 001). In the subgroup analyses, no significant differences were found between the <i>H. pylori</i> and <i>C. trachomatis</i> antibody-positive and -negative groups. <i>Conclusions</i>: PCOS is characterized by chronic nonspecific low-grade inflammation. The etiopathogenesis of PCOS involves comorbidities that cause a chronic inflammatory process. However, the possible infective causes still seem to be open to investigation. In particular, studies on microbiota and periodontal diseases in PCOS may provide important contributions.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"60 12","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11679581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Craniocervical Posture and Malocclusion: A Comprehensive Literature Review of Interdisciplinary Insights and Implications.","authors":"Andreea Kui, Alexandru Bereanu, Ana-Maria Condor, Dalia Pop, Smaranda Buduru, Anca Labunet, Sebastian Șoicu, Rareș Buduru, Andrea Chisnoiu","doi":"10.3390/medicina60122106","DOIUrl":"10.3390/medicina60122106","url":null,"abstract":"<p><p><i>Background and Objectives</i>: The impact of craniocervical posture on malocclusion has long intrigued researchers in dentistry, orthodontics, and physical therapy. This research aims to elucidate the relationship between craniocervical posture and both dental and skeletal malocclusions and to explore the potential for integrated multidisciplinary therapeutic approaches. <i>Materials and Methods</i>: We analyzed peer-reviewed articles published between 2013 and 2023 from PubMed/Medline, Web of Science, EMBASE, and Scopus. The search strategy included terms related to craniocervical posture and malocclusion, focusing on studies that evaluated the relationship between these conditions before and after various orthodontic or surgical treatments. <i>Results</i>: A total of 20 studies met the inclusion criteria, providing nuanced insights into the interplay between malocclusion types and craniocervical alignment. Findings suggest that altered craniocervical posture is more prevalent in individuals with skeletal malocclusions. In particular, orthodontic treatment and orthognathic surgery appear to influence craniocervical posture, suggesting a bidirectional relationship between craniofacial structure and neck alignment. <i>Conclusions</i>: Our literature review confirms a significant association between craniocervical posture and malocclusion, emphasizing the need for an integrative approach to the diagnosis and treatment of craniofacial anomalies. Future research should aim to quantify these relationships further through longitudinal studies, thereby increasing the understanding necessary to develop comprehensive treatment protocols.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"60 12","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11676848/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Role of Neutrophil Percentage-to-Albumin Ratio in Patients with Non-ST-Elevation Myocardial Infarction.","authors":"Mehmet Karaca, Ayca Gumusdag","doi":"10.3390/medicina60122101","DOIUrl":"https://doi.org/10.3390/medicina60122101","url":null,"abstract":"<p><p><i>Background and Objectives</i>: This study aimed to investigate whether neutrophil percentage-to-albumin ratio (NPAR) levels on admission have prognostic significance regarding one-year major adverse cardiovascular and cerebrovascular events (MACCEs) in non-ST-elevation myocardial infarction (NSTEMI) patients. <i>Materials and Methods</i>: A total of 464 patients aged 59.2 ± 11.6 years constituted the cohort of this retrospectively designed study. Considering a 1-year follow-up period, the patients were divided into two groups: those with MACCEs and those without. The complete blood count, serum C-reactive protein and serum albumin levels were measured at admission. The NPAR, C-reactive protein/albumin ratio (CAR) and systemic immune-inflammation (SII) index were calculated for all patients, and the associations of these inflammatory-based biomarkers with 1-year MACCEs were evaluated. <i>Results</i>: During the 12-month follow-up period, MACCEs were observed in 75 (16.2%) patients, of which 35 (7.5%) patients died. The patients with MACCEs had higher CRP (<i>p</i> < 0.001), a higher percentage of neutrophils (<i>p</i> < 0.001), lower albumin levels (<i>p</i> < 0.001), a higher CAR (<i>p</i> < 0.001), a higher SII index (<i>p</i> = 0.008) and a higher NPAR (<i>p</i> < 0.001). A high anatomical SxSI score, a high low-density lipoprotein cholesterol level, hypoalbuminemia, high neutrophil counts, a high NPAR level and a high CAR level were independent predictors for one-year MACCEs (all <i>p</i> < 0.05). The NPAR (area under the curve [AUC] = 0.775, <i>p</i> < 0.001) and albumin level (AUC = 0.708, <i>p</i> < 0.001) had better and sufficient discriminatory power and predictive accuracy in determining one-year MACCEs, when compared to the neutrophil (AUC = 0.693, <i>p</i> < 0.001), CAR (AUC = 0.639, <i>p</i> < 0.001) and SII index (AUC = 0.660, <i>p</i> < 0.001), in terms of the receiver operating characteristic curve. The DeLong test revealed that the predictive performance of the NPAR was superior to that of the other inflammatory parameters. In particular, individuals with an NPAR value greater than 17.6 were at greater risk of developing MACCEs (<i>p</i> < 0.001). <i>Conclusions</i>: The NPAR can be used as a newly identified promising inflammatory biomarker to predict one-year MACCEs in NSTEMI patients undergoing revascularization therapy.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"60 12","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11677659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Sodium-Glucose Cotransporter-2 Inhibitors on Body Composition and Fluid Status in Cardiovascular Rehabilitation Patients with Coronary Artery Disease and Heart Failure.","authors":"José C De La Flor, Blanca Coto Morales, Elena Basabe, María Rey Hernandez, Rocío Zamora González-Mariño, Celia Rodríguez Tudero, Irwing Benites Flores, Carlos Espinoza, Michael Cieza Terrones, Secundino Cigarrán Guldris, Jesús Hernández Vaquero","doi":"10.3390/medicina60122096","DOIUrl":"https://doi.org/10.3390/medicina60122096","url":null,"abstract":"<p><p><i>Background and Objectives</i>: Sodium glucose cotransporter-2 (SGLT-2) inhibitors have emerged as integral therapeutic tools in the management of patients with cardiovascular-kidney-metabolic (CKM) syndrome. In addition to their well-documented effects on lowering glucose levels and cardiovascular- and reno-protective actions, SGLT-2 inhibitors, through a reduction in body weight (BW), generate changes in the body composition and volume status that have not been clearly studied. <i>Materials and Methods</i>: This retrospective, observational longitudinal cohort, single-center study analyzed and compared body composition and fluid status measured by bioelectrical impedance analysis (BIA) from weeks 0 to 12 after the initiation of the cardiac rehabilitation (CR) program for coronary artery disease and heart failure in 59 patients who started treatment with SGLT-2 inhibitors (SGLT-2iG) and 112 patients without SGLT-2 inhibitors (non-SGLT-2iG). <i>Results:</i> Changes between the baseline and week 12 in the SGLT-2iG and non-SGLT-2iG were -0.3 L (<i>p</i> = 0.003) and -0.03 L (<i>p</i> = 0.82) in extracellular water (ECW) (<i>p</i> = 0.05), -0.39 L (<i>p</i> < 0.001) and -0.14 L (<i>p</i> = 0.33) in intracellular water (ICW) (<i>p</i> = 0.12), -0.69 (<i>p</i> < 0.001) and -0.16 (<i>p</i> = 0.52) in total body water (TBW) (<i>p</i> = 0.08), and -0.01 (<i>p</i> = 0.37) and -0.001 (<i>p</i> = 0.25) in the ECW/TBW ratio, respectively. After 3 months of exercise therapy in the CR program, patients in the SGLT-2iG showed a greater decrease than the non-SGLT-2iG in weight (-1.34 kg, <i>p</i> < 0.001 vs. -0.99, <i>p</i> = 0.02), body mass index (BMI) (-0.45 kg/m², <i>p</i> < 0.001 vs. -0.38, <i>p</i> = 0.004), arm circumference (-0.57 cm, <i>p</i> = 0.008 vs. -0.12 cm, <i>p</i> = 0.21), waist circumference (-1.5 cm, <i>p</i> = 0.04 vs. -0.11 cm, <i>p</i> = 0.83), systolic blood pressure (SBP) (-8.9 mmHg, <i>p</i> = 0.049 vs. -4.19, <i>p</i> = 0.08), and diastolic blood pressure (DBP) (-5.15, <i>p</i> = 0.03 vs. -2.85, <i>p</i> = 0.01). The bioelectrical impedance analysis (BIA) revealed a significant decrease in body fat mass (BFM) and visceral fat area, without a loss of lean body mass (LBM) or skeletal muscle mass in the SGLT-2iG. <i>Conclusions</i>: SGLT-2 inhibitors exert beneficial effects on body compartments and volume status. Although they induce modest weight loss, this appears to be mainly directed at ECW, BFM, and visceral fat, without a loss of LBM nor skeletal muscle mass, which could contribute to the observed CKM benefits.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"60 12","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11677857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolic Dysfunction-Associated Steatotic Liver Disease in Type 2 Diabetes Patients-The Relationship with Platelets Indicators.","authors":"Danusia Onișor, Andrada Larisa Roiban, Simona Cernea","doi":"10.3390/medicina60122091","DOIUrl":"https://doi.org/10.3390/medicina60122091","url":null,"abstract":"<p><p><i>Background and Objectives</i>: Metabolic dysfunction-associated steatotic liver disease (MASLD) is an important chronic liver disease with major health risks, especially in the presence of T2DM, but the pathophysiology of this condition is not fully understood. This study aimed to investigate the platelet hematometric indices in patients with T2DM and MASLD. <i>Materials and Methods</i>: Demographic and medical (including anthropometric) data were collected from 271 participants, from whom blood samples were also drawn in fasting conditions for complete blood count, liver and metabolic panel, ferritin, haptoglobin, creatinine, and fibrosis markers. The correlations of main platelet parameters with clinical and laboratory data were investigated by bivariate and multiple regression analyses. <i>Results</i>: The median platelets number was 235·10³/μL, and thus, the study population was divided into two subgroups: with higher and lower numbers (group 1 (mean): 286.38 ± 43.29·10³/μL and group 2 (mean): 188.12 ± 39.77·10³/μL). Despite similar BMIs, group 2 had higher fatty liver index (FLI) (84.44 ± 18.04 vs. 79.85 ± 17.98; <i>p</i> = 0.0088) and insulin resistance (HOMA-IR: 3.16 ± 1.50 vs. 2.63 ± 1.31; 0.0008), higher direct bilirubin, transaminases, uric acid, and ferritin concentrations. Higher percentages of males and subjects with HOMA-IR values >2.5 were accounted for in this group. In the multiple regression analyses, the platelet count and plateletcrit (PTC) correlated independently with sex, leucocyte count, HOMA-IR, and bilirubin concentrations (<i>p</i> < 0.0001). The platelet distribution width (PDW) was positively correlated with insulin resistance in two separate analyses (β = 0.060; <i>p</i> = 0.0004, and β = 0.052; <i>p</i> = 0.0025), and with GGT, while the mean platelet volume presented a weak but significant positive association with FLI. Patients with higher HOMA-IR had higher PDW and a lower platelet count and PTC. <i>Conclusions</i>: Male patients with T2DM and MASLD had lower platelet count and PTC and larger PDW. Higher insulin resistance was associated with lower platelet count and PTC and higher PDW.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"60 12","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11676065/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interaction Effects Between COVID-19 Outbreak and Fever on Mortality Among OHCA Patients Visiting Emergency Departments.","authors":"Dahae Lee, Jung Ho Lee, Eujene Jung, Yong Soo Cho, Hyun Ho Ryu","doi":"10.3390/medicina60122095","DOIUrl":"10.3390/medicina60122095","url":null,"abstract":"<p><p><i>Background and Objectives</i>: Fever in patients who have suffered an out-of-hospital cardiac arrest (OHCA) has been linked to poor clinical outcomes, as a fever can exacerbate neurological damage, increase metabolic demands, and trigger inflammatory responses. This study evaluates the impact of the COVID-19 outbreak and associated fevers on OHCA outcomes and examines how they can worsen patient prognosis. <i>Materials and Methods</i>: Our retrospective observational analysis used data from the National Emergency Department Information System (NEDIS), comprising adult OHCA patients at 402 EDs in Korea between 27 January and 31 December 2020 (COVID-19 pandemic period) and the corresponding period in 2019 (pre-COVID-19). The primary outcome was in-hospital mortality, with the COVID-19 outbreak as the main exposure variable and fever as an important interaction variable. We employed multilevel multivariate logistic regression with an interaction term (year of visit × fever) to examine the effects of COVID-19 and fever on mortality. Risk-adjusted mortality rates were calculated, and a difference-in-difference analysis evaluated the impact of COVID-19 on excess mortality by fever status. <i>Results</i>: During COVID-19, in-hospital mortality was higher among OHCA patients compared to the pre-pandemic period (adjusted OR 1.22, 95% CI 1.11-1.34), particularly among febrile patients (adjusted OR 1.40, 95% CI 1.24-1.59). Interaction analysis revealed that COVID-19 disproportionately increased mortality in febrile OHCA patients compared with non-febrile patients (difference-in-difference: 0.8%, 95% CI 0.2-1.5). <i>Conclusions</i>: Our study found that the COVID-19 pandemic significantly increased mortality among OHCA patients, with febrile patients experiencing disproportionately worse outcomes due to systemic delays and pandemic-related disruptions.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"60 12","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11679358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the Effects of Perineural and Intraperitoneal Ozone Therapy on Nerve Healing in an Experimental Sciatic Nerve Injury Model.","authors":"Burcu Ayık, Abdullah Ortadeveci, Fulya Bakılan, Dilek Burukoğlu Dönmez, Semih Öz, Cengiz Bal, Hilmi Özden, Onur Armağan","doi":"10.3390/medicina60122097","DOIUrl":"https://doi.org/10.3390/medicina60122097","url":null,"abstract":"<p><p><i>Background and Objectives:</i> The aim was to evaluate nerve healing using immunohistochemical, histological, and functional techniques and to compare the effects of two different therapeutic ozone application methods by perineural and intraperitoneal ozone treatment in rats with a crush injury model of sciatic nerve. <i>Materials and Methods:</i> Forty male Sprague Dawley rats were divided into four subgroups of ten rats each: (1) Control group: The left sciatic nerve incised and closed without crush injury, no treatment; (2) Paralyzed group: Crush injury to the left sciatic nerve, no treatment; (3) Perineural ozone group: Crush injury to the left sciatic nerve, treated with perineural ozone therapy; (4) Intraperitoneal ozone group: Crush injury to the left sciatic nerve, treated with intraperitoneal ozone therapy. The treatments were administered for a 14-day period. Hematoxylin and eosin (H&E) and toluidine blue staining were used for histological examination; TUNEL staining was used for immunohistochemical examination. Pinch test and rotarod performance assessment were utilized for functional evaluation. <i>Results:</i> The pinch test scores showed significant improvement in perineural and intraperitoneal ozone treatment groups after treatment (<i>p</i> < 0.001 and <i>p</i> = 0.003, respectively). The scores of myelin degeneration, vascular congestion, vascular wall thickness, inflammation, and toluidine blue and TUNEL staining were significantly lower in both ozone treatment groups compared to the paralyzed group (<i>p</i> < 0.001). Vascular wall thickness scores were significantly higher in the perineural ozone group compared to the control and intraperitoneal ozone groups (<i>p</i> = 0.004 and <i>p</i> = 0.013, respectively). The Schwann cell proliferation scores were significantly higher in the perineural ozone group compared to the control group and intraperitoneal ozone groups (<i>p</i> < 0.001). <i>Conclusions:</i> Both applications of ozone therapy accelerated the healing of nerve regeneration, reduced inflammation and apoptosis based on histopathological results, and enhanced nerve function in rats with sciatic nerve injury. Perineural ozone therapy has been demonstrated to be an efficacious alternative to systemic ozone treatments in the management of sciatic nerve injury. Further studies are needed to determine optimal ozone dosage and administration protocols for the treatment of nerve injury.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"60 12","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11679872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Ventilator-Associated Pneumonia Caused by <i>Pseudomonas</i> and <i>Acinetobacter</i> Organisms in a Pediatric Center: A Randomized Controlled Study.","authors":"Mona Moheyeldin AbdelHalim, Seham Awad El Sherbini, El Shimaa Salah Ahmed, Heba Abdullah Abdalbaset Gharib, Marwa O Elgendy, Ahmed R N Ibrahim, Heba Sherif Abdel Aziz","doi":"10.3390/medicina60122098","DOIUrl":"https://doi.org/10.3390/medicina60122098","url":null,"abstract":"<p><p>A dangerous infection contracted in hospitals, ventilator-associated pneumonia is frequently caused by bacteria that are resistant to several drugs. It is one of the main reasons why patients in intensive care units become ill or die. This research aimed to determine the most effective empirical therapy of antibiotics for better ventilator-associated pneumonia control and to improve patient outcomes by using the minimal inhibitory concentration method and the Ameri-Ziaei double antibiotic synergism test and by observing the clinical responses to both single and combination therapies. Patients between the ages of one month and twelve who had been diagnosed with ventilator-associated pneumonia and had been on mechanical ventilation for more than 48 h were included in the study, which was carried out in the Pediatric Intensive Care Unit at Cairo University's Hospital. When ventilator-associated pneumonia is suspected, it is critical to start appropriate antibiotic therapy as soon as possible. This is especially important in cases where multidrug-resistant Gram-negative infections may develop. Although using Polymyxins alone or in combination is effective, it is important to closely monitor their administration to prevent resistance from increasing. The combination therapy that showed the greatest improvement was a mix of aminoglycosides, quinolones, and β-lactams. A combination of aminoglycosides and dual β-lactams came next. Although the optimal duration of antibiotic treatment for ventilator-associated pneumonia is still unknown, treatments longer than seven days are usually required to eradicate MDR <i>P. aeruginosa</i> or <i>A. baumannii</i> completely.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"60 12","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11676743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel Molecular Classification of Breast Cancer with PET Imaging.","authors":"Ngô Minh Toàn","doi":"10.3390/medicina60122099","DOIUrl":"https://doi.org/10.3390/medicina60122099","url":null,"abstract":"<p><p>Breast cancer is a heterogeneous disease characterized by a wide range of biomarker expressions, resulting in varied progression, behavior, and prognosis. While traditional biopsy-based molecular classification is the gold standard, it is invasive and limited in capturing tumor heterogeneity, especially in deep or metastatic lesions. Molecular imaging, particularly positron emission tomography (PET) imaging, offering a non-invasive alternative, potentially plays a crucial role in the classification and management of breast cancer by providing detailed information about tumor location, heterogeneity, and progression. This narrative review, which focuses on both clinical patients and preclinical studies, explores the latest advancements in PET imaging for breast cancer, emphasizing the development of new tracers targeting hormone receptors such as the estrogen alpha receptor, progesterone receptor, androgen receptor, estrogen beta receptor, as well as the ErbB family of receptors, VEGF/VEGFR, PARP1, PD-L1, and markers for indirectly assessing Ki-67. These innovative radiopharmaceuticals have the potential to guide personalized treatment approaches based on the unique tumor profiles of individual patients. Additionally, they may improve the assessment of treatment efficacy, ultimately leading to better outcomes for those diagnosed with breast cancer.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"60 12","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11678748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Standard and Point-of-Care CD4+ T Lymphocyte Measurement Methods in HIV-1 Infected Turkish Patients.","authors":"Müge Toygar Deniz, Sıla Akhan, Murat Sayan, Sibel Balcı","doi":"10.3390/medicina60122094","DOIUrl":"https://doi.org/10.3390/medicina60122094","url":null,"abstract":"<p><p><i>Background and Objectives</i>: CD4+ T lymphocytes are the primary targets of HIV infection. CD4+ T lymphocyte count is an indicator of immune competence. In this study, we aimed to compare standard flow cytometry and point-of-care (POC) CD4+ T lymphocyte in terms of cost, effectiveness, reliability, time, and the use of this method for disease. <i>Materials and Methods</i>: This study includes 113 patients. CD4+ T lymphocyte count and percentage were evaluated by flow cytometry and POC. Also, hemoglobin (Hb) level was studied. The data obtained by two methods are compared. <i>Results</i>: When the two methods were compared, intraclass coefficients demonstrated a good consistency for Hb (ICC = 0.849) and CD4+ T lymphocyte percentage (ICC = 0.803). For CD4+ T lymphocyte count, consistency was moderate, ICC = 0.651, but still statistically significant (<i>p</i> < 0.001). <i>Conclusions</i>: In resource-limited countries, virological monitoring with HIV RNA cannot be performed at any time because it is expensive. However, CD4+ T lymphocyte count and percentage monitoring is important in predicting treatment success. POC results are in good consistency with the standard method, and it is also a test that can be used due to being cheap, easy, and quick.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"60 12","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11676371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}