Advances in Clinical and Experimental Medicine最新文献

{"title":"Laboratory synthesis and preparation of thermo-responsive polymeric micelle and hydrogel for resveratrol delivery and release.","authors":"Zhuojie Zhao, Liang Xi, Wei Liang","doi":"10.17219/acem/190546","DOIUrl":"https://doi.org/10.17219/acem/190546","url":null,"abstract":"<p><strong>Background: </strong>Resveratrol (RSV) exhibits anti-inflammatory, antioxidative, antiaging, and cardioprotective properties. However, due to its hydrophobic nature, it is prone to instability and oxidation, which significantly limit its biomedical applications.</p><p><strong>Objectives: </strong>The aims of this study were: 1) To prepare and characterize hydrogels and micelles by mixing the synthesized PNIPAM-b-PEO-b-PNIPAM copolymer and RSV in an aqueous environment; 2) To investigate the molecular interactions between the polymer and RSV; 3) To evaluate various properties of the polymeric micelles and hydrogels; 4) To determine the efficiency of RSV release from the polymeric micelles.</p><p><strong>Material and methods: </strong>A well-defined PNIPAM-b-PEO-b-PNIPAM block copolymer was synthesized and purified. Gel permeation chromatography and 1H NMR were used to characterize the chemical composition and molecular weight of each copolymer. The encapsulation of RSV and its interaction with PNIPAM-b-PEO-b-PNIPAM were confirmed using 2D nuclear Overhauser effect spectroscopy (NOESY). The lower critical solution temperature (LCST), critical micelle concentration (CMC) and structure of the polymeric micelle were characterized using surface tension measurements, a viscometer, scanning electron microscopy (SEM), and transmission electron microscopy (TEM). The rheological behavior of the RSV-loaded hydrogels was also investigated.</p><p><strong>Results: </strong>The results showed that the RSV-loaded micelles were successfully prepared. The LCST and CMC of PNIPAM-b-PEO-b-PNIPAM polymeric micelles were determined to be 35°C and 0.005 g/L, respectively. The micelles have a spherical profile with a particle size of 100 nm and a narrow size distribution.</p><p><strong>Conclusions: </strong>Resveratrol can be encapsulated within polymeric micelles formed by PNIPAM-b-PEO-b-PNIPAM block copolymer below the LCST. Its molecules are incorporated into the hydrophobic domains of poly(N-isopropyl acrylamide) (PNIPAM), forming a molecular complex. The point of molecular interaction is primarily at the phenolic region of RSV. Below LCST, PNIPAM-b-PEO-b-PNIPAM behaves as a polymeric surfactant at low concentrations and as an associating polymer at high concentrations. At high polymer concentrations, PNIPAM-b-PEO-b-PNIPAM formed a hydrogel. Above LCST, it was released from the polymeric micelles.</p>","PeriodicalId":7306,"journal":{"name":"Advances in Clinical and Experimental Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142646806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research status and controversy on non-small cell lung cancer stem cells.","authors":"Jin Wang, Yunqing Chen, Chengqin Wang, Keyu Ren","doi":"10.17219/acem/187053","DOIUrl":"10.17219/acem/187053","url":null,"abstract":"<p><p>Lung cancer is a major cause of cancer-related deaths worldwide. It can be divided into 2 main types, namely non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). Most patients with NSCLC are diagnosed at an advanced stage, and current treatments have limited success. Moreover, relapsing tumors that often appear after surgical or drug treatment are particularly difficult to treat. The existence of cancer stem cells (CSCs) has been proposed as a key factor contributing to the development of resistance to therapy, recurrence and metastasis. Targeting CSCs is a potential strategy for eradicating tumors. However, due to the tumor-type specificity and cellular plasticity, the real clinical application of lung cancer stem cells (LCSCs) has not been realized. This review details the existing phenotypic markers of LCSCs and the limitations of their identification and summarizes the roles of the tumor microenvironment (TME) and epithelial-mesenchymal transition (EMT) in the existence and maintenance of LCSCs, as well as the contribution and controversy of cellular plasticity theory on LCSCs. It is expected that future research on LCSCs can solve the present problems, and approaches targeting LCSCs may be applied in the clinic as soon as possible.</p>","PeriodicalId":7306,"journal":{"name":"Advances in Clinical and Experimental Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142646809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of the antibody-dependent cellular phagocytosis-based signature: A prognostic risk model of gastric cancer.","authors":"Qing Zheng, Zhenqi Gong, Baizhi Li, Huaiming Wang, Shaoxiong Lin","doi":"10.17219/acem/189914","DOIUrl":"10.17219/acem/189914","url":null,"abstract":"<p><strong>Background: </strong>Accumulating evidence has supported the effect of antibody-dependent cellular phagocytosis (ADCP) on the tumor microenvironment (TME) and cancer therapy. However, an ADCP-based signature to predict the prognosis of gastric cancer (GC) has not been established.</p><p><strong>Objectives: </strong>We aimed to develop an ADCP-based signature to improve the prognosis prediction of GC.</p><p><strong>Material and methods: </strong>Antibody-dependent cellular phagocytosis genes that exhibited a differential expression were characterized, followed by the construction and validation of the ADCP-based signature. The potential association between the ADCP-based signature and TME was explored, and the features of the signature genes were investigated. Finally, a predictive nomogram was established based on the ADCP-based signature.</p><p><strong>Results: </strong>Four ADCP-related genes, MKNK2, VCAN, LRAT, and GNGB, were identified to construct the ADCP-based signature, and a high ADCP score predicted an unfavorable prognosis in GC patients (p < 0.05). The ADCP-based signature was significantly associated with immune cells, immune checkpoints and immune signaling pathways (p < 0.05). Gastric cancer patients with high ADCP scores benefited less from immunotherapy compared to those with low ADCP scores. A nomogram including age, stage and risk score of the ADCP-based signature was constructed to predict the 1-, 3- and 5-year survival probabilities, with an area under the curve (AUC) of 0.669, 0.675 and 0.685, respectively.</p><p><strong>Conclusions: </strong>The ADCP-based signature may serve as a new option for prognosis prediction and the personalized treatment of GC patients.</p>","PeriodicalId":7306,"journal":{"name":"Advances in Clinical and Experimental Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142646804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic value of inflammation-related model in hepatitis B acute-on-chronic liver failure.","authors":"Huaqian Xu, Xue Li, Yue Zhuo, Chunyan Li, Chengzhi Bai, Jie Chen, Shanhong Tang","doi":"10.17219/acem/192624","DOIUrl":"10.17219/acem/192624","url":null,"abstract":"<p><strong>Background: </strong>Acute-on-chronic liver failure (ACLF) is characterized by rapid onset, rapid development and a high short-term mortality rate. Systemic inflammation exerts an effect on the disease progression of ACLF.</p><p><strong>Objectives: </strong>The purposes of this study were to explore the clinical significance that the inflammatory response has on the disease process of hepatitis B virus acute-on-chronic liver failure (HBV-ACLF) patients, to further compare the values of different inflammation-related biomarkers in the prognosis evaluation of HBV-ACLF patients, and to combine inflammatory-related markers to establish a new prediction model.</p><p><strong>Material and methods: </strong>Baseline admission data and 90-day outcomes were collected from 247 patients who met the inclusion criteria. According to the 90-day survival situation, they were divided into a survival group and a death group. The differences in baseline data and inflammation levels between the 2 groups were compared. A regression model was used to analyze the risk factors for 90-day mortality and establish a new model.</p><p><strong>Results: </strong>The study found that the differences between the survival group and the death group were statistically significant in terms of age, total bilirubin (Tbil), prothrombin time (PT), international standardized ratio (INR), inflammation level, and model for end-stage liver disease (MELD) series scores (p < 0.05). The monocyte-to-lymphocyte ratio (MLR)-integrated iMELD model (MLR-iMELD) can effectively predict the 90-day survival rate of HBV-ACLF patients. The area under the receiver operating characteristic (ROC) curve (AUROC) of the new model was 0.792, and the best cutoff for predicting the prognosis of 90 days for patients was -0.33 (sensitivity 0.577 and specificity 0.898).</p><p><strong>Conclusions: </strong>The higher the level of inflammation in patients with HBV-ACLF, the greater the risk of 90-day death. Compared with other inflammation-related markers, the MLR-iMELD model can better predict the 90-day survival rate of HBV-ACLF patients.</p>","PeriodicalId":7306,"journal":{"name":"Advances in Clinical and Experimental Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142646808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Otolaryngological manifestations in patients with obstructive sleep apnea and continuous positive airway pressure users: A systematic review.","authors":"Jacek M Czubak, Karolina Stolarczyk, Marcin Frączek, Michał Fułek, Krzysztof Morawski, Helena Martynowicz","doi":"10.17219/acem/195243","DOIUrl":"10.17219/acem/195243","url":null,"abstract":"<p><p>Sleep disorders have emerged as a significant public health issue, adversely affecting quality of life and precipitating severe complications. The association between obstructive sleep apnea syndrome (OSAS) and otolaryngological manifestations appears to be underrecognized. This study posits that manifestations in the ear, nose and throat (ENT) among patients with OSAS and users of continuous positive airway pressure (CPAP) therapy are relatively common. Utilizing the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement, this systematic review, registered at PROSPERO (No. CRD42023452473), involved a comprehensive search of the MEDLINE databases. We included studies published in English from 1979 to March 2021 that explored the linkages between OSAS, CPAP and otolaryngological manifestations. A total of 29 articles were reviewed, with findings indicating 12 studies on ear dysfunctions, 11 on nose dysfunctions and 6 on pharynx dysfunctions. Reported symptoms included hearing dysfunction, vestibular function disorders, cerebrospinal fluid leak, Eustachian tube (ET) dysfunction, rhinosinusitis, olfaction and taste disorders, dysphagia, dry mouth, and gastroesophageal reflux. The etiology of these ailments varies, yet an understanding of these symptoms can improve the diagnosis to confirm or rule out OSAS. Early identification of ENT symptoms related to OSAS may facilitate prompt diagnosis and mitigate serious complications.</p>","PeriodicalId":7306,"journal":{"name":"Advances in Clinical and Experimental Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142646807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of gedunin on cell proliferation and apoptosis in skin melanoma cells A431 via the PI3K/JNK signaling pathway.","authors":"Wenming Xiao, Zhujing Li, Shiqing Li, Zhiyang Xia, Jianwu Zhang, Hongyan Liu, Wei Chen","doi":"10.17219/acem/189729","DOIUrl":"https://doi.org/10.17219/acem/189729","url":null,"abstract":"<p><strong>Background: </strong>Melanoma is an aggressive skin malignancy with rapid metastasis and high morbidity. Gedunin (GN) is a tetranortriterpenoid belonging to the Meliaceae family, described for its anticancer, antiproliferative and apoptotic properties.</p><p><strong>Objectives: </strong>In the present study, we investigated the effect of GN on A431 melanoma cell proliferation and apoptosis. The inflammatory proteins (tumor necrosis factor alpha (TNF-α), nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB), cycloxygenase 2 (COX-2), inducible nitric oxide synthase (iNOS), and interleukin 6 (IL-6)) apoptosis-related proteins, such as Bax, Bcl-2 and caspase-3, and alterations in the PI3K/JNK and p38 pathways in A431 cells after GN treatment were examined.</p><p><strong>Material and methods: </strong>The cytotoxicity assay and cell apoptosis of GN activity on A431 cells were assessed using MTT assay, acridine orange/ethidium bromide (AO/EB), DAPI (4',6-diamidino-2-phenylindole), propidium iodide (PI), enzyme-linked immunosorbent assay (ELISA), reverse transcription polymerase chain reaction (RT-PCR) and western blot analyses.</p><p><strong>Results: </strong>The findings demonstrated that GN (10 and 15 μM/mL) inhibits the growth of melanoma cells, triggers apoptosis by enhancing Bax and caspase, and reduces Bcl-2, cyclin-D1, c-myc, and survivin in a concentration-reliant manner. Additionally, GN attenuated the protein expression of inflammatory proteins (TNF-α, NF-κB, COX-2, iNOS, and IL-6) and the cell proliferative PI3K/JNK/p38 signaling pathway. Due to the imbalance in the Bax/Bcl-2 ratio, apoptosis is promoted, and the caspase cascade and Cyt-c are activated. This led us to conclude that GN treatment inhibited Bcl-2, cyclin-D1, c-myc, and survivin activity through the TNF-α/NF-κB and PI3K/JNK/p38 signaling pathways, further preventing the proliferation and stimulation of apoptosis, which contributes to growth arrest in melanoma cells.</p><p><strong>Conclusions: </strong>Gedunin has been shown to promote melanoma cell death in vitro, suggesting that it could be used as a future treatment for malignant melanoma. Our findings suggested that GN might be applied as a preventative measure in the management of skin melanoma cells.</p>","PeriodicalId":7306,"journal":{"name":"Advances in Clinical and Experimental Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142612357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Which risk factors are involved in a distal biceps tendon injury? A systematic review.","authors":"Markus Jaschke, Łukasz Kołodziej, Aleksandra Wilk, Marek Droździk","doi":"10.17219/acem/187891","DOIUrl":"https://doi.org/10.17219/acem/187891","url":null,"abstract":"<p><p>Distal biceps tendon rupture is a rare injury predominately occurring in middle-aged men. This study aimed to collect relevant risk factors associated with distal biceps tendon rupture from the published literature. This systematic review aimed to collect and tabulate the risk factors for distal biceps tendon rupture. Studies published in English were searched concerning risk factors for distal biceps tendon ruptures until July 2022; cohort studies, case series and randomized controlled trials were subjected to analysis. Case studies, cadaveric studies and reviews in any form were excluded. The studies were quantitatively and qualitatively reviewed. One hundred twenty-one articles presenting risk factors for distal biceps tendon ruptures were identified, recruiting a total of 7,484-7,576 patients. The average age of the individuals was 46.8 years, with 96.7% being males and 94.7% having affinity for sports activities. In 56.7% of the cases, the dominant arm was involved, and in 54.6%, the right arm was affected. The use of tobacco was found in 20.8% of cases and of anabolic steroids in 2.5% of cases. On average, 55.8% of distal biceps tendon rupture patients had a physical occupation and the most common mechanism of the injury was related to heavy weight lifting observed in 53.2% of subjects. The most common and outstanding reported risk factors for distal biceps tendon ruptures were age, sex and sports activity, i.e., middle-aged males being still physically active and practicing sports. Steroid usage does not seem to increase significantly the risk of the distal biceps tendon rupture.</p>","PeriodicalId":7306,"journal":{"name":"Advances in Clinical and Experimental Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142612361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancement of human native skin fibroblast proliferation in natural salso-bromo-iodic mineral water added to in vitro culture.","authors":"Marco Saler, Ottavia Ferraro, Angela Faga, Debora Sansotta, Simona Villani, Giovanni Nicoletti","doi":"10.17219/acem/192227","DOIUrl":"https://doi.org/10.17219/acem/192227","url":null,"abstract":"<p><strong>Background: </strong>The favorable regenerative effects of some mineral waters on wound healing have long been empirically demonstrated.</p><p><strong>Objectives: </strong>The aim of this experimental study is to investigate the effects of an Italian salso-bromo-iodic mineral water (Rivanazzano, Italy) on an in vitro human native fibroblast culture model to identify any potential regenerative actions.</p><p><strong>Material and methods: </strong>Human native fibroblasts were cultured under different experimental conditions: - Dulbecco's modified Eagle's medium (DMEM) reconstituted with distilled water (control); - DMEM reconstituted with filtered mineral water collected from the spring; - DMEM reconstituted with filtered mineral water collected at the balneotherapy facility; - DMEM reconstituted with filtered, heated mineral water collected at the balneotherapy facility; - DMEM partially replaced with filtered mineral water collected from the spring at different concentrations (10%, 20%, 30%, 40%, 50%); - DMEM partially replaced with filtered, heated mineral water collected at the balneotherapy facility at different concentrations (10%, 20%, 30%, 40%, 50%); - DMEM partially replaced with filtered mineral water collected at the balneotherapy facility at different concentrations (10%, 20%, 30%, 40%, 50%). Cell proliferation and viability were evaluated using spectrophotometric analysis following staining with the XTT Microculture Tetrazolium Assay. Statistical analyses were performed for each experimental condition at 24, 48 and 72 h.</p><p><strong>Results: </strong>The best outcomes were observed in fibroblasts cultured with DMEM partially replaced with filtered mineral water collected from the spring, within the range of 20-50%.</p><p><strong>Conclusions: </strong>Our research results showed that Rivanazzano salso-bromo-iodic mineral water has a stimulating effect on in vitro human native fibroblast cultures. This activity was most pronounced with water collected from the spring, and it decreased with water collected at the balneotherapy facilities. These findings could form the basis for clinical applications in wound healing and balneotherapy.</p>","PeriodicalId":7306,"journal":{"name":"Advances in Clinical and Experimental Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142612359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do sociodemographic and health predictors affect the non-insulin-based insulin resistance index? A cross-sectional study.","authors":"Maciej Polak, Grzegorz J Nowicki, Maja Chrzanowska-Wąsik, Barbara J Ślusarska","doi":"10.17219/acem/191200","DOIUrl":"https://doi.org/10.17219/acem/191200","url":null,"abstract":"<p><strong>Background: </strong>Insulin resistance (IR) is considered a risk factor for cardiovascular diseases (CVD). Therefore, early diagnosis of IR is clinically significant for primary and secondary CVD prevention initiatives. In addition, non-insulin metabolic indices may be useful for diagnosing IR.</p><p><strong>Objectives: </strong>The first objective was to estimate the triglyceride and glucose (TyG) index and the metabolic score for insulin resistance (METS-IR) index values in a local community with high social deprivation and increased cardiovascular risk according to the Systematic Coronary Risk Evaluation scale. The second objective was to identify significant sociodemographic and health predictors for the TyG index and METS-IR index.</p><p><strong>Material and methods: </strong>This cross-sectional study was conducted in the local community of Janów district in eastern Poland and consisted of 2 stages. The 1st stage involved basic research (n = 4,040), while the 2nd stage involved enhanced diagnostics (n = 2,657). Data from the 2nd stage was used for the analyses. Anthropometric and physiological measurements were taken, blood was drawn for laboratory tests, selected sociodemographic and health variables were evaluated, and the TyG index and METS-IR index were calculated.</p><p><strong>Results: </strong>The mean TyG index score in the study group was 8.65 (±0.58), and the mean METS-IR index score was 41.45 (±9.02). Both indices were significantly associated with age, male sex, smoking, and systolic blood pressure (SBP) in a multivariable model. In addition, alcohol consumption and body mass index (BMI) were significantly correlated with the TyG index, whereas education was significantly associated with the METS-IR index.</p><p><strong>Conclusions: </strong>Our results show the association between IR and sociodemographic and health variables in a group with a high social deprivation rate and increased cardiovascular risk. Early detection of cardiometabolic risk is important for both primary and secondary CVD prevention. In primary healthcare, this can be accomplished through surrogate markers of IR.</p>","PeriodicalId":7306,"journal":{"name":"Advances in Clinical and Experimental Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142612355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex-related differences in the association of obesity described by emergency medical teams on outcomes in out-of-hospital cardiac arrest patients.","authors":"Vicente Doménech Briz, Raúl Juárez-Vela, Łukasz Lewandowski, Grzegorz Kubielas, Jacek Smereka, Vicente Gea-Caballero, Antonio Martínez-Sabater, Michał Czapla","doi":"10.17219/acem/193367","DOIUrl":"https://doi.org/10.17219/acem/193367","url":null,"abstract":"<p><strong>Background: </strong>Out-of-hospital cardiac arrests (OHCA) are a major global health concern, occurring frequently worldwide. Obesity may impact outcomes in OHCA patients.</p><p><strong>Objectives: </strong>This study aimed to assess the impact of obesity on the return of spontaneous circulation (ROSC) in OHCA patients, considering sex differences.</p><p><strong>Material and methods: </strong>A retrospective cohort study was conducted, analyzing medical records of patients assisted by the Emergency Medical System (EMS) in Poland from January 2021 to June 2022. The study included 33,636 patients with OHCA. Obesity status was determined using ICD-10 codes (E66) and descriptive diagnoses recorded by EMS teams.</p><p><strong>Results: </strong>Univariate analysis indicated that obesity decreased the odds of ROSC by 25.47% (odds ratio (OR) = 0.75, 95% confidence interval (95% CI): 0.61-0.92) in women and by 19.76% (OR = 0.80, 95% CI: 0.66-0.97) in men. However, multivariate analysis, adjusting for confounding variables, did not confirm a statistically significant impact of obesity on ROSC outcomes. The likelihood of ROSC was significantly higher in individuals with an initial ventricular fibrillation (VF) or pulseless ventricular tachycardia (pVT) rhythm compared to Asystole/pulseless electrical activity (PEA), being 4.204 times higher in women (95% CI: 3.525-5.014) and 3.655 times in men (95% CI: 3.320-4.023). Out-of-hospital cardiac arrest in a public place increased the odds of ROSC more than twofold for both sexes (women: OR = 2.20, 95% CI: 2.00-2.43; men: OR = 2.13, 95% CI: 1.98-2.29). Among women without obesity, hypertension decreased the odds of ROSC by 11.11% (OR = 0.89, 95% CI: 0.81-0.99).</p><p><strong>Conclusions: </strong>Our study demonstrated that obesity was not an independent predictor of ROSC in OHCA patients. Different predictors of ROSC were identified for men and women. Initial VF/pVT rhythm, location of OHCA and age were the significant factors influencing ROSC.</p>","PeriodicalId":7306,"journal":{"name":"Advances in Clinical and Experimental Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142589667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}