Archives of Medical Research最新文献

{"title":"Apparent Diffusion Coefficient Measurements. A Reliable Tool for the Diagnosis of Creutzfeldt-Jakob Disease","authors":"Marie Catherine Boll ,&nbsp;Ignacio Muñoz-López ,&nbsp;Graciela Cárdenas ,&nbsp;Miguel Ángel Ramírez-García ,&nbsp;María Guadalupe Nava-Galán ,&nbsp;Petra Yescas-Gómez","doi":"10.1016/j.arcmed.2024.103104","DOIUrl":"10.1016/j.arcmed.2024.103104","url":null,"abstract":"<div><h3>Background and Purpose</h3><div>Creutzfeldt-Jakob disease (CJD) is a rare, rapidly fatal neurodegenerative disorder. The gold standard test for a positive diagnosis of definite CJD is histopathological confirmation, usually post-mortem; however, an autopsy study is not always feasible in all health settings.</div></div><div><h3>Materials and Methods</h3><div>We performed a cross-sectional analysis of a retrospectively enrolled cohort of patients with suspected prion disease between 2008 and 2019. Only patients with complete medical histories who fulfilled a diagnostic checklist were enrolled. The magnetic resonance imaging (MRI) sequences (T2-FLAIR and DWI) were analyzed, and the apparent diffusion coefficients (ADCs) were calculated for five regions of interest (ROIs) in each cerebral hemisphere.</div></div><div><h3>Results</h3><div>In total, 72 MRI scans were post-processed. The series included 47 cases of CJD, including 25 genetic and 22 sporadic cases, in addition to 25 age-paired controls with non-prion encephalopathies. The neostriatum showed the most significant difference in ADC values (×10^–3 mm²/s) at 0.5946 in the left anterior putamen vs. 0.8644 in the control encephalopathies (<em>p</em> &lt; 0.001; 95% confidence interval: 0.5751–0.6142 vs. 0.7812–0.9476), while the other ROIs also showed significant differences. The best cut-off value to differentiate CJD from other encephalopathies was identified as 0.65×10^–3 mm²/s, with no significant differences in this coefficient between sporadic and genetic cases.</div></div><div><h3>Conclusions</h3><div>Quantitative ADC measurements made in the basal ganglia seem to be the most useful ante-mortem diagnostic tool for differentiating CJD from non-prion encephalopathies when cerebrospinal fluid real-time quaking-induced conversion or other specific misfolded protein detection tests are inaccessible.</div></div>","PeriodicalId":8318,"journal":{"name":"Archives of Medical Research","volume":"56 2","pages":"Article 103104"},"PeriodicalIF":4.7,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"GNLY as a novel cis-eQTL and cis-pQTL mediated susceptibility gene in suppressing prostatitis. Mendelian randomization study","authors":"Yi Wang ,&nbsp;Hao Ji ,&nbsp;Guihua Chen ,&nbsp;Jianhua Zhou ,&nbsp;Dongliang Zhang ,&nbsp;Xiang Wang","doi":"10.1016/j.arcmed.2024.103098","DOIUrl":"10.1016/j.arcmed.2024.103098","url":null,"abstract":"<div><h3>Background</h3><div>Prostatitis is characterized by high prevalence, low cure rates, and frequent recurrences, and remains one of the most clinically challenging problems. Hence, in this article, we first integrated Mendelian randomization (MR) with expression quantitative trait loci (eQTL) and protein quantitative trait loci (pQTL) data to identify novel therapeutic targets and their potential metabolic mechanisms for prostatitis.</div></div><div><h3>Methods</h3><div>Prostatitis-related genetic data, eQTLs, pQTLs, and 1400 metabolites were downloaded from online databases. MR, or summary data-based MR (SMR) analyses were applied to assess the potential causal relationships between exposures and predicted outcomes. Sensitivity analysis was conducted using pleiotropy, heterogeneity, and leave-one-out analysis to evaluate the robustness of our results.</div></div><div><h3>Results</h3><div>Based on our results, we first identified and validated GNLY as a novel cis-eQTL and cis-pQTL-mediated susceptibility gene for reducing prostatitis risk in five independent datasets (one discovery dataset and four validation datasets) (all <em>p</em> &lt;0.05). Meanwhile, we also found that the GNLY eQTL could increase the metabolite of sphingomyelin level (d18:0/20:0, d16:0/22:0) risks (<em>p</em> &lt;0.05), and the metabolite of sphingomyelin level (d18:0/20:0, d16:0/22:0) could reduce the risk of prostatitis (<em>p</em> &lt;0.05). According to the above-mentioned relationships, we finally revealed the potential metabolic mechanism of GNLY eQTL in suppressing prostatitis via regulating the metabolite of sphingomyelin level (d18:0/20:0, d16:0/22:0).</div></div><div><h3>Conclusions</h3><div>We successfully identified GNLY as a novel cis-eQTL and cis-pQTL-mediated susceptibility gene in suppressing prostatitis and its potential metabolic mechanism via regulating sphingomyelin (d18:0/20:0, d16:0/22:0) levels, providing a novel therapeutic target and paving the way for future GNLY-related studies in prostatitis.</div></div>","PeriodicalId":8318,"journal":{"name":"Archives of Medical Research","volume":"56 2","pages":"Article 103098"},"PeriodicalIF":4.7,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Suicides in Czech Republic, Slovakia, Hungary, and Poland in 1990–2019: Epidemiological patterns and trends in European and Global context","authors":"Alena Lochmannová ,&nbsp;Marek Majdan ,&nbsp;Miroslav Šafr","doi":"10.1016/j.arcmed.2024.103100","DOIUrl":"10.1016/j.arcmed.2024.103100","url":null,"abstract":"<div><h3>Background</h3><div>Suicides are a major public health problem with serious consequences for societies.</div></div><div><h3>Aim</h3><div>To compare epidemiological patterns and trends of suicides in the Czech Republic, Slovakia, Hungary, and Poland in 1990–2019, and analyze them in the European and global context.</div></div><div><h3>Methods</h3><div>A trend analysis was conducted in Czech Republic, Slovakia, Hungary, Poland, in Western Europe and on global level for 1990–2019. All data were obtained from the Global Burden of Diseases study 2019. Numbers and age-standardized rates of deaths and Years of Life Lost (YLL) due to suicides were analyzed, stratified by sex and age (0–14 years old, 15–49 years old, 50–69 years old, 70+ years).</div></div><div><h3>Results</h3><div>In 2019, 759,028 suicides occurred globally, 17,408 (2.3%) in Central Europe. The proportion of males was substantially larger, compared to the global and Western European levels (E.g., 82 vs. 69% and 75%, respectively). The highest rates of suicide were in Hungary (19.7 per 100,000), lowest in Slovakia (12.8); the rate in Central Europe was higher than the global rate (15.2 vs. 9.8), and the rate in Western Europe (11.4). A steady decline of rates was observed in all countries, particularly in Hungary. In Czech Republic we found an increasing relative importance of suicides among people 70 years and older.</div></div><div><h3>Conclusions</h3><div>Death rates due to suicides have been declining in the analyzed countries, but some characteristics and trends when compared to global and regional estimates, such as substantially higher proportion of male suicides or high death rates among the elderly warrant specifically tailored preventative action coordinated by governments with community involvement.</div></div>","PeriodicalId":8318,"journal":{"name":"Archives of Medical Research","volume":"56 2","pages":"Article 103100"},"PeriodicalIF":4.7,"publicationDate":"2024-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142482845","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":"Improving Efficiency in Healthcare: Lessons from Successful Health Policies in Chile","authors":"Manuel A. Espinoza ,&nbsp;Paula Zamorano ,&nbsp;Carlos Zuñiga-San Martin ,&nbsp;Carla Taramasco ,&nbsp;Felipe Martinez ,&nbsp;Sergio Becerra ,&nbsp;Maria Jose Letelier ,&nbsp;Nicolas Armijo","doi":"10.1016/j.arcmed.2024.103105","DOIUrl":"10.1016/j.arcmed.2024.103105","url":null,"abstract":"<div><h3>Background</h3><div>Chile has made significant progress in recent decades in implementing policies to improve the efficiency of its health system with an impact on population health.</div></div><div><h3>Aim</h3><div>To present five case studies of successful policies whose impact has been documented.</div></div><div><h3>Methods</h3><div>Case study report.</div></div><div><h3>Results</h3><div>First, we present a summary of the evidence supporting the policy that is changing the Chilean care model from a problem-based to a patient-centered care model. Second, we show how tele-nephrology and advanced renal care units have demonstrated significant impact on chronic kidney disease in Chile. This internationally recognized successful Chilean policy is contributing to address one of the conditions that explains the highest financial burden on the health system. Third, we present recent evidence on the effectiveness of teleoncology care in Chile. Fourth, we highlight the most recent system of epidemiological surveillance implemented in Chile, the EPIVIGILA system, which was essential to support decisions throughout the pandemic. Finally, we underline the health benefit plans implemented in recent decades to improve access to services and financial protection.</div></div><div><h3>Conclusions</h3><div>Chile has successfully implemented policies in its health system that have an impact on efficiency and population health. These experiences can be replicated in countries facing similar challenges, using the Chilean experience as a benchmark.</div></div>","PeriodicalId":8318,"journal":{"name":"Archives of Medical Research","volume":"56 1","pages":"Article 103105"},"PeriodicalIF":4.7,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142445450","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":"Low muscle mass in the internal medicine ward: Prevalence and survival implications","authors":"Luis Andrés González-Torres ,&nbsp;Víctor Daniel Acuña-Rocha ,&nbsp;Mario Herrera-Nuñez ,&nbsp;Juan Manuel Millán-Alanís ,&nbsp;Carlos de la Cruz-de la Cruz ,&nbsp;Ricardo Humberto Z’ Cruz-López ,&nbsp;Joel Isaí Alcalá-González ,&nbsp;Juan Francisco Moreno-Hoyos-Abril ,&nbsp;Julio Edgardo González-Aguirre","doi":"10.1016/j.arcmed.2024.103103","DOIUrl":"10.1016/j.arcmed.2024.103103","url":null,"abstract":"<div><h3>Background</h3><div>Low muscle mass is common in hospitalized patients. It is associated with adverse clinical outcomes. Reported prevalence varies widely due to non-universally accepted diagnostic criteria and the heterogeneity of the populations studied. Non-surgical ill patients are underrepresented in the literature.</div></div><div><h3>Aims</h3><div>To estimate the prevalence of low muscle index and its impact on survival in patients admitted to an internal medicine unit.</div></div><div><h3>Methods</h3><div>We prospectively enrolled patients with abdominal CT scans on admission to the Internal Medicine ward. We assessed muscle mass index (L3MI) at the level of the L3 lumbar vertebra. The primary outcome was to estimate the prevalence of low muscle mass on admission. Secondary outcomes were to determine the relationship of low L3MI with hospital mortality, length of stay, nosocomial infections, and hospital readmission.</div></div><div><h3>Results</h3><div>One hundred and seven patients were included. The prevalence of low L3MI was 46.7%. An L3MI of 46.3 cm²/m² in men and 40.9 cm²/m² in women predicted death at one year with a sensitivity of 66% and a specificity of 78% (AUC = 0.62 [95% CI 0.38–0.86]) and 69 and 66% (AUC of 0.63 [95% IC 0.47–0.78]), respectively. In-hospital mortality, death at 60, 90, and 360 d, and hospital readmission were significantly higher in patients with low L3MI.</div></div><div><h3>Conclusion</h3><div>Almost half of the patients admitted to an internal medicine ward have low muscle mass index. The cutoff point of 40.9 cm²/m² in females and 46.3 cm²/m² in males predicts relevant clinical variables. We established the better L3MI cutoff value to predict 12-month mortality.</div></div>","PeriodicalId":8318,"journal":{"name":"Archives of Medical Research","volume":"56 2","pages":"Article 103103"},"PeriodicalIF":4.7,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142432020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 policy response: Perspectives of key stakeholders in Mexico's health system and implications for resilience","authors":"Lina Díaz-Castro ,&nbsp;Christian Díaz de León-Castañeda ,&nbsp;Galileo Pérez-Hernández ,&nbsp;José Carlos Suárez-Herrera","doi":"10.1016/j.arcmed.2024.103097","DOIUrl":"10.1016/j.arcmed.2024.103097","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aims to analyze the perspectives of key stakeholders within Mexico's health system regarding the policy response to COVID-19 in 2020 to inform future policy formulation.</div></div><div><h3>Methods</h3><div>This qualitative study is based on a secondary data analysis (SDA) derived from a broader primary research on governance in Mexico during the COVID-19 pandemic. The analysis adopted a grounded theory approach to examine 15 semi-structured interviews with prominent figures in the health system between June and November 2020. The interviews were audio-recorded and analyzed through the lens of the Health Policy Triangle which includes context, key actors, and the Mexican health policy process. Moreover, the analysis was enriched by incorporating the framework outlined in the World Health Organization's COVID-19 Strategic Preparedness and Response Plan (SPRP).</div></div><div><h3>Results</h3><div>The findings indicate that key stakeholders perceived a centralized approach to policymaking with a strong emphasis on cross-sector communication, expert panels, equity-focused measures, accessibility to healthcare services (promoting portability), and improvements in the health information system.</div></div><div><h3>Conclusion</h3><div>Key stakeholders recognized the response to COVID-19 was complex, involving multiple dimensions and levels of action. The importance of preparedness and response in building health system resilience is emphasized. Recommendations include explicitly integrating resilience into national and local policy agendas, addressing systemic structural deficiencies, promoting equity in the pandemic response, improving risk governance, strengthening coordination mechanisms, ensuring supply chain resilience, improving personnel training, and enhancing local diagnostic capacity to better prepare for future public health emergencies.</div></div>","PeriodicalId":8318,"journal":{"name":"Archives of Medical Research","volume":"56 2","pages":"Article 103097"},"PeriodicalIF":4.7,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142432021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post COVID-19: Advancing medical laboratory service integration in nigeria and progress towards establishing integration guideline","authors":"Augustine Onyeaghala ,&nbsp;Nkechi Nwoke ,&nbsp;Kingsley Odiabara ,&nbsp;Ughweroghene Kingston Omo-Emmanuel ,&nbsp;Jibrin Kama ,&nbsp;Bashir Mahmud ,&nbsp;Charles Michael Etoroma ,&nbsp;Gaius Mathew","doi":"10.1016/j.arcmed.2024.103094","DOIUrl":"10.1016/j.arcmed.2024.103094","url":null,"abstract":"<div><h3>Background</h3><div>The Nigerian healthcare system, including medical laboratories, operates in a three-tiered structure across public and private sectors. Lessons from COVID-19 show the urgent need for a guideline to drive medical laboratory service integration.</div></div><div><h3>Problem</h3><div>Lack of operational guideline to drive the integration of laboratory services has resulted in siloed operations across different medical laboratories causing duplication of resources, coordination issues, and inefficiencies.</div></div><div><h3>Aim</h3><div>To highlight the development processes of medical laboratory service integration guideline and discuss its key provisions.</div></div><div><h3>Method</h3><div>The Medical Laboratory Services Division (MLSD), Federal Ministry of Health (FMoH) initiated the development of a national guideline for integrating medical laboratory services. Partnering with stakeholders and engaging two consultants, a technical workshop was facilitated in January 2024. The Consultants garnered the initial inputs stakeholders made at the five-day meeting. The inputs were collated and organized to produce the guideline. The guideline was circulated to participants and other stakeholders for review and feedback received was used to finalize the document. The MLSD with support from partners further held a three-day stakeholders’ meeting in May 2024 to validate the document before submitting it to the Health Minister for endorsement.</div></div><div><h3>Result</h3><div>The guideline sets standards for achieving medical laboratory services and systems integration across different medical laboratories. The contents of the guideline are enumerated and respective recommendations made under each element are highlighted.</div></div><div><h3>Conclusion</h3><div>The implementation of the guideline will help harmonize services, improve access to diagnostics, streamline processes, reduce redundancies, optimize resource utilization, enhance communication, data sharing, and pandemic preparedness.</div></div>","PeriodicalId":8318,"journal":{"name":"Archives of Medical Research","volume":"56 1","pages":"Article 103094"},"PeriodicalIF":4.7,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142433341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Masseter Muscle Volume and Its Association with Sarcopenia and Muscle Determinants in Older Japanese Adults: the Bunkyo Health Study","authors":"Abulaiti Abudurezake ,&nbsp;Saori Kakehi ,&nbsp;Futaba Umemura ,&nbsp;Hideyoshi Kaga ,&nbsp;Yuki Someya ,&nbsp;Hiroki Tabata ,&nbsp;Yasuyo Yoshizawa ,&nbsp;Hitoshi Naito ,&nbsp;Tsubasa Tajima ,&nbsp;Naoaki Ito ,&nbsp;Hikaru Otsuka ,&nbsp;Huicong Shi ,&nbsp;Mari Sugimoto ,&nbsp;Shota Sakamoto ,&nbsp;Yukiko Muroga ,&nbsp;Hidetaka Wakabayashi ,&nbsp;Ryuzo Kawamori ,&nbsp;Hirotaka Watada ,&nbsp;Yoshifumi Tamura","doi":"10.1016/j.arcmed.2024.103095","DOIUrl":"10.1016/j.arcmed.2024.103095","url":null,"abstract":"<div><h3>Aim</h3><div>Sarcopenia has been with a decrease in masseter muscle (MM) thickness in high-risk older populations. However, the relationship between sarcopenia and determinants of MM volume (MMV) in the general elderly population remains unclear.</div></div><div><h3>Method</h3><div>In a cross-sectional study of 1,484 older adults in Tokyo, we evaluated MMV using 3D MRI scanning, appendicular skeletal muscle mass (ASMM), handgrip strength, dietary intake, smoking, insulin-like growth factor 1 (IGF-1) levels, and the ACTN3 R577X polymorphism. Participants were divided into quintiles based on MMV (<em>Q1</em>–5).</div></div><div><h3>Results</h3><div>Participants in our study had a mean age of 73.0 ± 5.3 years and their MMV (Men: 35.3 ± 7.8 mL, Women: 25.0 ± 5.1 mL) was significantly higher in men than in women. A significant association between MMV and sarcopenia was observed, with the lowest quintile (<em>Q1</em>) showing a higher risk compared to the highest quintile (<em>Q5</em>) in both sexes. Body mass index (BMI) and age were independent determinants of ASMM in both sexes, whereas BMI, but interestingly not age, was a determinant of MMV. Moreover, IGF-1 was positively correlated with MMV in both sexes; smoking was negatively correlated with MMV in women. The ACTN3 577XX genotype was only associated with smaller MMV in men.</div></div><div><h3>Conclusion</h3><div>Low MMV increased the risk of sarcopenia, particularly in men. BMI and age strongly influenced ASMM, while MMV was only weakly associated with BMI and not with age. Notably, IGF-1 level was positively associated with MMV only, and ACTN3 genotype was associated to reduced MMV only in men.</div></div>","PeriodicalId":8318,"journal":{"name":"Archives of Medical Research","volume":"56 1","pages":"Article 103095"},"PeriodicalIF":4.7,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142432866","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":"Kidney growth progression patterns in autosomal dominant polycystic kidney disease","authors":"Aaron Pérez-Segovia ,&nbsp;Gabriel Cojuc-Konigsberg ,&nbsp;Estefania Reul-Linares ,&nbsp;Elisa Naomi Hernández-Paredes ,&nbsp;Mónica Chapa-Ibargüengoitia ,&nbsp;Juan C. Ramírez-Sandoval","doi":"10.1016/j.arcmed.2024.103099","DOIUrl":"10.1016/j.arcmed.2024.103099","url":null,"abstract":"<div><h3>Background</h3><div>Prognosis for autosomal dominant polycystic kidney disease (ADPKD), the main inherited cause of kidney failure, relies on estimating cystic growth using linear formulas derived from height-adjusted total kidney volume (Ht-TKV). However, nonlinear renal growth patterns may occur in typical ADPKD.</div></div><div><h3>Aims</h3><div>To determine kidney outcomes of subjects diagnosed with typical ADPKD exhibiting nonlinear, and unpredictable cystic growth during follow-up.</div></div><div><h3>Methods</h3><div>Retrospective cohort study. We categorized TKV changes in individuals with typical ADPKD according to observed kidney growth trajectories. Ht-TKV was calculated from consecutive CT or MRI using the ellipsoid method. We compared estimated glomerular filtration rate (eGFR) trajectories with linear mixed models.</div></div><div><h3>Results</h3><div>We included 83 individuals with ADPKD (67% women; age 47 ± 12 years; follow-up 5.2 years [IQR 2.8–9.0]). Three kidney growth patterns were observed: slow progression (24%, &lt;3%/year linear increase), fast progression (39%, ≥3%/year linear increase), and atypical progression (37%, nonlinear growth). Adjusted ht-TKV change in mL/m/year was +1.4 (IQR –4.5 to +10.0), +40.3 (+16.9 to +89.3), and +32.8 (+15.9 to +85.9) for slow, fast, and atypical progressors, respectively (<em>p</em> &lt; 0.001). Atypical progressors exhibited a significantly greater decline in eGFR in mL/min/m²/year (–7.9, 95% CI –6.5, –3.9) compared to slow (–0.5, 95% CI –3.1 to +0.5) and fast progressors (–3.4, 95% CI –7.9, –2.0; between-group <em>p</em> &lt; 0.001). Atypical progressors had a higher proportion of acute complications, including hemorrhages, infections, and urolithiasis (84%), compared to slow (20%) and fast progressors (31%) (<em>p</em> &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>In typical ADPKD, nonlinear, abrupt, and unpredictable cyst growth occurs frequently, leading to a higher risk of acute complications and kidney function decline.</div></div>","PeriodicalId":8318,"journal":{"name":"Archives of Medical Research","volume":"56 2","pages":"Article 103099"},"PeriodicalIF":4.7,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142407337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Theranostics advances in the treatment and diagnosis of neurological and neurosurgical diseases","authors":"Wireko Andrew Awuah ,&nbsp;Arjun Ahluwalia ,&nbsp;Joecelyn Kirani Tan ,&nbsp;Vivek Sanker ,&nbsp;Sakshi Roy ,&nbsp;Adam Ben-Jaafar ,&nbsp;Devansh Mitesh Shah ,&nbsp;Pearl Ohenewaa Tenkorang ,&nbsp;Nicholas Aderinto ,&nbsp;Toufik Abdul-Rahman ,&nbsp;Oday Atallah ,&nbsp;Athanasios Alexiou","doi":"10.1016/j.arcmed.2024.103085","DOIUrl":"10.1016/j.arcmed.2024.103085","url":null,"abstract":"<div><div>Theranostics represents a significant advance in the fields of neurology and neurosurgery, offering innovative approaches that combine the diagnosis and treatment of various neurological disorders. This innovation serves as a cornerstone of personalized medicine, where therapeutic strategies are closely integrated with diagnostic tools to enable precise and targeted interventions. Primary research results emphasize the profound impact of theranostics in Neuro Oncol. In this context, it has provided valuable insights into the complexity of the tumor microenvironment and mechanisms of resistance. In addition, in the field of neurodegenerative diseases (NDs), theranostics has facilitated the identification of distinct disease subtypes and novel therapeutic targets. It has also unravelled the intricate pathophysiology underlying conditions such as cerebrovascular disease (CVD) and epilepsy, setting the stage for more refined treatment approaches. As theranostics continues to evolve through ongoing research and refinement, its goals include further advancing the field of precision medicine, developing practical biomarkers for clinical use, and opening doors to new therapeutic opportunities. Nevertheless, the integration of these approaches into clinical settings presents challenges, including ethical considerations, the need for advanced data interpretation, standardization of procedures, and ensuring cost-effectiveness. Despite these obstacles, the promise of theranostics to significantly improve patient outcomes in the fields of neurology and neurosurgery remains a source of optimism for the future of healthcare.</div></div>","PeriodicalId":8318,"journal":{"name":"Archives of Medical Research","volume":"56 1","pages":"Article 103085"},"PeriodicalIF":4.7,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142382743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}