Medical principles and practice : international journal of the Kuwait University, Health Science Centre最新文献

{"title":"Reply to Letter \"Immune Polarization in Coexisting Rheumatoid Arthritis and Asthma: Insights into Th2 Dominance and Unresolved Confounding\".","authors":"Sana S Almutairi, Fawaz Y Azizieh, Adeeba A Al-Herz, Tahany E Al-Shemary, Ahmed R Alsaber, Raj Raghupathy","doi":"10.1159/000553011","DOIUrl":"10.1159/000553011","url":null,"abstract":"","PeriodicalId":520708,"journal":{"name":"Medical principles and practice : international journal of the Kuwait University, Health Science Centre","volume":" ","pages":"1-2"},"PeriodicalIF":2.2,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13436971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148230551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantitative Imaging of the Mandibular Condyle: Radiomics and Microarchitectural Biomarkers.","authors":"Daniel Negrete, Ana Cristina Borges-Oliveira, Marcos Murilo Alves Santos, Sérgio Lucio Pereira de Castro Lopes, Andre Luiz Ferreira Costa","doi":"10.1159/000552871","DOIUrl":"10.1159/000552871","url":null,"abstract":"<p><p>Radiomics makes it possible to extract quantitative data from medical images, revealing details about tissue heterogeneity that are not apparent from visual evaluation alone. Conventional evaluation of temporomandibular joint (TMJ) imaging still primarily relies on qualitative morphological criteria that primarily detect late-stage structural alterations. This narrative review summarizes current evidence on quantitative imaging of the mandibular condyle and subchondral bone within the TMJ, with emphasis on radiomics applications using computed tomography (CT), cone-beam CT (CBCT), and magnetic resonance imaging (MRI). Studies have shown that texture and morphometric features derived from CT and CBCT can reflect trabecular organization and subchondral remodeling, with some parameters validated against micro-CT in experimental settings. MRI-based approaches are particularly sensitive to changes in subchondral bone marrow, especially in inflammatory and degenerative conditions, even when morphological alterations are subtle or absent. Radiomic features can detect patterns associated with joint degeneration and adaptation across imaging modalities. However, variability in acquisition protocols, segmentation methods, and limited longitudinal data still restrict their clinical application. At present, quantitative imaging should be considered a research tool that may support the development of imaging biomarkers and contribute to a better understanding of TMJ disease.</p>","PeriodicalId":520708,"journal":{"name":"Medical principles and practice : international journal of the Kuwait University, Health Science Centre","volume":" ","pages":"1-14"},"PeriodicalIF":2.2,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13395468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148207584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differential Therapeutic Modulations of Adiponectin: Beneficial, Adverse, and Context-Dependent Effects in Chronic Coronary Syndromes.","authors":"Sanja Stojanović, Vladimir Petrović, Jasmina Jocić, Dejan Petrović, Miljana Šarac, Nemanja Nikolić, Dejan Simonović, Marija Marinković","doi":"10.1159/000552748","DOIUrl":"10.1159/000552748","url":null,"abstract":"<p><p>Different degrees of chronic metabolic inflammation and adiponectin resistance significantly contribute to the development of cardiovascular diseases and metabolic syndrome. Adiponectin is a unique pleiotropic adipokine with anti-inflammatory, antiatherogenic, and antidiabetic effects. In early metabolic dysfunction, adiponectin levels increase as a compensatory response, whereas in advanced coronary disease, hypoadiponectinemia develops due to adiponectin resistance. The aim of this review was to highlight how contemporary cardiovascular therapies alter adiponectin levels and why this is clinically important for reducing low-grade systemic and vascular inflammation in chronic coronary syndromes. Evidence suggests that drug classes such as peroxisome proliferator-activated receptor agonists, sodium-glucose transport proteins inhibitors, glucagon-like peptide-1 receptor agonists, renin-angiotensin-aldosterone system blockers, metformin, certain statins, and fibrates may increase adiponectin levels, although effects vary by drug class and disease stage. Although adiponectin represents a promising therapeutic target for the treatment of coronary syndromes, further experimental and pharmacological research is necessary to develop drugs based on its mechanism of action.</p>","PeriodicalId":520708,"journal":{"name":"Medical principles and practice : international journal of the Kuwait University, Health Science Centre","volume":" ","pages":"1-13"},"PeriodicalIF":2.2,"publicationDate":"2026-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13412414/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148059144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<italic>Kluyvera</italic> Infections in Humans: A Systematic Review.","authors":"Sofia Maraki, Viktoria Eirini Mavromanolaki, Evangelia Iliaki-Giannakoudaki, Anna Kasimati","doi":"10.1159/000552538","DOIUrl":"10.1159/000552538","url":null,"abstract":"<p><strong>Objective: </strong>Kluyvera species are Gram-negative rods, catalase-positive, oxidase-negative, and glucose-fermenting members of the Enterobacteriaceae family. Although often considered saprophytic, Kluyvera can cause opportunistic infections, particularly in immunocompromised individuals, with severe underlying medical conditions. The objective of this study was to identify and evaluate all published cases of human infections by Kluyvera spp., through a systematic literature review.</p><p><strong>Methods: </strong>We searched PubMed and Scopus databases for articles providing data related to the epidemiology, clinical features, and microbiology of Kluyvera human infections.</p><p><strong>Results: </strong>In total, 73 studies provided information on 97 patients with Kluyvera infections. The mean age of the patients was 39.5 years and most (53.6%) were females. The most frequently reported types of infection were bacteremia, urinary tract infections, intra-abdominal infections, and soft tissue infections, and more than half of them were community-acquired. Comorbidities were common in majority of the patients, and almost half of these were immunosuppressed. K. ascorbata was the most commonly identified species (59.8%), followed by Kluyvera cryocrescens (23.7%), Kluyvera intermedia (3.1%), and Kluyvera georgiana (1.0%). High rates of resistance were recorded for ampicillin (78.1%), 1st-generation cephalosporins (52.1%), and 2nd-generation cephalosporins (43.8%). Third-generation cephalosporins were the most commonly used antibiotics, followed by aminoglycosides. The outcome was favorable for the majority of the patients (89.2%). The mortality rate attributed to the infection was 4.3%.</p><p><strong>Conclusion: </strong>Early detection of Kluyvera species is critical for effective infection control and antimicrobial stewardship, as these opportunistic pathogens are known to act as reservoirs for antibiotic resistance genes.</p>","PeriodicalId":520708,"journal":{"name":"Medical principles and practice : international journal of the Kuwait University, Health Science Centre","volume":" ","pages":"1-21"},"PeriodicalIF":2.2,"publicationDate":"2026-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13391090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148059118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epigenetic Reactivation of <italic>SOCS-3</italic> and Inhibition of ERK1/2 Underlie Thymoquinone-Induced Apoptosis in a Chronic Myeloid Leukemia Xenograft Model.","authors":"Futoon Abedrabbu Al-Rawashde, Moath Alqaraleh, Diya Hasan, Abdullrahman Elsayed, Nur Anis Ashiela Mohd Amiludin, Fouad Saleih Resq Al-Suede, Hamid Ali Nagi Al-Jamal","doi":"10.1159/000552709","DOIUrl":"10.1159/000552709","url":null,"abstract":"<p><strong>Objective: </strong>This research aimed to assess thymoquinone (TQ)'s potential to demethylate and re-express the suppressor of cytokine signaling-3 (SOCS-3) in the chronic myeloid leukemia (CML) mice model.</p><p><strong>Subject and methods: </strong>A nude mouse model of CML was established, and the apoptotic influence of TQ was identified. TQ's impact on the target gene expressions was examined using real-time quantitative PCR (RT-qPCR), and SOCS-3 methylation was assessed by pyrosequencing. TQ's effects on the extracellular signal-regulated kinase 1 (ERK1) and ERK2 phosphorylation were assessed using Jess Simple Western analysis. Molecular docking of TQ's interaction with the anti-apoptotic proteins was assessed.</p><p><strong>Results: </strong>TQ exerted a marked hypomethylating influence on SOCS-3 and reduced ERK1/2 phosphorylation level in K562-xenograft tumors. TQ also significantly upregulated the apoptosis-related cysteine peptidase (Caspase-3), BCL-2-interacting mediator of cell death (Bim), p53-upregulated modulator of apoptosis (PUMA), and other apoptotic genes and downregulated B-cell lymphoma 2 (BCL-2), BCL2-like 2 (BCL-w), survivin, and X-linked inhibitor of apoptosis (XIAP) in K562 cells. TQ also exhibited marked inhibitory properties on BCL-2-related gene expressed in fetal liver (BFL-1), B-cell lymphoma-extra large (BCL-xL), myeloid cell leukemia-1 (MCL-1), and BCL-2 proteins. This led to growth inhibition and apoptosis of the K562-tumour xenograft.</p><p><strong>Conclusion: </strong>These results indicate that TQ enhances CML cells' apoptosis by hypomethylating and re-expressing SOCS-3, inhibiting ERK1/2, and modulating the apoptosis-regulator gene expression and by showing consistent interaction with most of the anti-apoptotic proteins, highlighting its potential as a scaffold for designing novel inhibitors to combat CML cells.</p>","PeriodicalId":520708,"journal":{"name":"Medical principles and practice : international journal of the Kuwait University, Health Science Centre","volume":" ","pages":"1-18"},"PeriodicalIF":2.2,"publicationDate":"2026-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399987/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148008086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Convolutional Neural Networks in Radiology: Principles, Clinical Applications, and a Practical Framework for Radiologists.","authors":"Ben Thompson, Jonathan Gibson, Shashank Chapala, Ali Shah, Rajesh Botchu","doi":"10.1159/000552704","DOIUrl":"10.1159/000552704","url":null,"abstract":"<p><p>Artificial intelligence is increasingly embedded within radiology workflows. In radiology, large language models may support reporting and communication tasks, while machine learning and deep learning models are increasingly used for image classification, segmentation, and quantitative analysis. This article is an educational review and practical guide rather than an experimental study. It summarizes how convolutional neural networks work, outlines the key stages of model development and validation, and discusses how modern language models may assist with code prototyping and troubleshooting. Although these tools may reduce technical barriers, clinically useful models still require appropriate datasets, external validation, transparent reporting, governance, and human oversight. This review aimed to help radiologists understand the principles, potential, and limitations of convolutional neural networks in contemporary practice.</p>","PeriodicalId":520708,"journal":{"name":"Medical principles and practice : international journal of the Kuwait University, Health Science Centre","volume":" ","pages":"1-12"},"PeriodicalIF":2.2,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13395463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148007913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Histopathological Analysis of Adipose-Derived Mesenchymal Stem Cells and Their Osteogenic Derivatives in Promoting Bone Regeneration in a Model of Fracture Nonunion.","authors":"Serhii Maslennikov, Maksym Danukalo, Mariia Isachenko, Yuliya Avramenko, Maksym Holovakha, Yurii Kolesnyk","doi":"10.1159/000552577","DOIUrl":"10.1159/000552577","url":null,"abstract":"<p><strong>Objective: </strong>To perform a histopathological analysis of the effects of mesenchymal stem cells (MSCs) and their osteogenically differentiated derivatives (Dif-MSCs) on reparative processes in bone tissue using an experimental model of fracture nonunion.</p><p><strong>Subjects and methods: </strong>Fifteen male rabbits aged 3 months were randomly assigned to three groups: control with induced femoral nonunion (n = 5), nonunion treated with adipose-derived MSCs (n = 5), and nonunion treated with Dif-MSCs (n = 5). MSCs were isolated from lipoaspirate, cultured to passage 3, and differentiated osteogenically for 4 weeks. A 5-mm bone defect was created surgically, and cells were injected into the defect zone on day 7. Animals were euthanized at 6 weeks postinjection. Bone specimens underwent fixation, decalcification, histological staining (hematoxylin-eosin and Van Gieson), and quantitative analysis of osteoblasts and osteocytes using ImageJ. Statistical analysis included one-way ANOVA and Welch's t test.</p><p><strong>Results: </strong>Macroscopic and histological evaluation revealed a gradation in regeneration: control group showed predominant fibrous tissue with immature bone and inflammation; MSCs group exhibited fibrocartilaginous callus with immature bone, bone marrow formation, and increased osteoblasts (52.0 ± 16.2 per 10 HPF vs. control 28.6 ± 7.0, p = 0.032); Dif-MSCs group demonstrated mature lamellar bone, organized osteons, mature bone marrow, and higher osteocytes (vs. MSCs, p = 0.006). ANOVA indicated trends in osteoblast increases (p = 0.092) and significant osteocyte variability (p = 0.014).</p><p><strong>Conclusion: </strong>Undifferentiated MSCs enhance early osteogenesis via endochondral ossification, while Dif-MSCs promote advanced maturation through mixed intramembranous and endochondral pathways, suggesting superior efficacy for treating fracture nonunion.</p>","PeriodicalId":520708,"journal":{"name":"Medical principles and practice : international journal of the Kuwait University, Health Science Centre","volume":" ","pages":"1-12"},"PeriodicalIF":2.2,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13372317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148008271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuropsychiatric Adverse Effects Associated with the Use of Levetiracetam in Adults: A Systematic Review and Meta-Analysis.","authors":"Sofía Ramírez-Guerrero, Mariana Gaviria-Carrillo, Jonathan Suarez-Rubiano, Mauricio O Nava-Mesa, Paola Mendivelso-Juya, Maria Daniela Olaya-Galindo, Carlos Elías Pardo, Oscar Vargas-Cifuentes, Maria Alejandra Bohorquez-Sanchez, Valentina Mansilla-Santamaría, Alberto Velez-van-Meerbeke","doi":"10.1159/000552515","DOIUrl":"10.1159/000552515","url":null,"abstract":"<p><strong>Objective: </strong>Levetiracetam is a broad-spectrum anti-seizure medication (ASM) with a good safety profile; however, the occurrence of neuropsychiatric manifestations has been described in relation to its use. The aim of this study was to provide an updated assessment of the neuropsychiatric adverse effects related to levetiracetam in patients aged 16 and older with epilepsy, without psychiatric comorbidity, and perform a meta-analysis comparing the occurrence of neuropsychiatric adverse effects between levetiracetam, placebo, and other ASMs.</p><p><strong>Methods: </strong>A systematic literature search was conducted in PubMed, Embase, and Web of Science. Studies published until March 14th, 2024, were included. Out of the 33 studies, 7 were randomized clinical trials comparing levetiracetam to placebo and 4 comparing levetiracetam to other ASM, all of which were selected for further quantitative analysis.</p><p><strong>Results: </strong>Somnolence was the most frequently reported NPAE (15 articles), followed by depression (11 articles). Fatigue, aggression/agitation, cognitive and memory impairment, irritability, anxiety, and behavioral changes were also commonly described. Across pooled analyses, levetiracetam-treated patients demonstrated a significantly higher risk of somnolence/drowsiness (OR 1.61, 95% CI: 1.20-2.17) and asthenia/fatigue (OR 1.48, 95% CI: 1.04-2.11) compared with placebo. In contrast, a separate meta-analysis comparing levetiracetam to other ASMs showed no significant difference for depression (OR 1.41, 95% CI: 0.80-2.51).</p><p><strong>Conclusion: </strong>Patients treated with levetiracetam have a greater risk of developing neuropsychiatric effects, such as somnolence and fatigue, compared to placebo.</p>","PeriodicalId":520708,"journal":{"name":"Medical principles and practice : international journal of the Kuwait University, Health Science Centre","volume":" ","pages":"1-22"},"PeriodicalIF":2.2,"publicationDate":"2026-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13372319/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147978327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retracted Paper: Comparing Spinal and General Anesthesia for Prone Percutaneous Nephrolithotomy: A Propensity Score-Matched Study.","authors":"Lingjun Chen, Dian Xu, Lulu Hou","doi":"10.1159/000552326","DOIUrl":"10.1159/000552326","url":null,"abstract":"","PeriodicalId":520708,"journal":{"name":"Medical principles and practice : international journal of the Kuwait University, Health Science Centre","volume":" ","pages":"1"},"PeriodicalIF":2.2,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147849230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Outcomes of Low-Dose Intranasal Midazolam for Severe Gag Reflex in Endodontic Patients: A Retrospective Case Series Study.","authors":"Hilal Erdogan, Seza Apiliogullari, Funda Kont Cobankara","doi":"10.1159/000552355","DOIUrl":"10.1159/000552355","url":null,"abstract":"<p><strong>Objective: </strong>The severe gag reflex (SGR) is an involuntary protective response to foreign substances. SGR presents a significant obstacle to the provision of standard dental care. This retrospective case series study evaluates the clinical outcomes and the feasibility of low-dose (2.5 mg) intranasal midazolam administration on SGR control in uncooperative patients with Gagging Severity Index 5.</p><p><strong>Material and methods: </strong>This retrospective study includes patients who could not receive endodontic treatment due to the SGR and were referred for general anesthesia. Data from 13 adult patients, one of whom had an intellectual disability, were used. A fixed low-dose (2.5 mg) of intranasal midazolam was administered under the control of an anesthesiologist. Clinical monitoring (vital signs) focused on respiratory effort, skin color, and the maintenance of verbal commands. Endodontic treatment was started with local anesthesia approximately 10 min after 2.5 mg midazolam administration, averaging 40 min per session.</p><p><strong>Results: </strong>All patients remained conscious, responsive to verbal commands, and cooperative during treatment. One patient received intranasal saline as an ad hoc clinical observation, but midazolam was later administered due to persistent gagging. SGR was effectively managed in all patients during initial and ongoing sessions of endodontic treatment without side effects. All necessary dental procedures, including root canal treatment and restorations, were performed comfortably.</p><p><strong>Conclusion: </strong>A conservative 2.5 mg dose of intranasal midazolam can safely control SGR in adult patients during long and complex dental procedures, such as endodontic treatment. Also, it is a practical, less invasive alternative to general anesthesia.</p>","PeriodicalId":520708,"journal":{"name":"Medical principles and practice : international journal of the Kuwait University, Health Science Centre","volume":" ","pages":"1-7"},"PeriodicalIF":2.2,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13336803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147826182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}