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Background In the available literature, levels of BDNF and CRP have been reported to correlate with suicide in depressive patients but there are inconsistencies in the results. We aimed to evaluate and compare BDNF and CRP concentrations in MDD patients with(MDD + SA) and without suicide attempts (MDD-SA) and healthy controls. Methods 30 (MDD + SA) patients, 30 (MDD-SA) patients, and 26 healthy controls were enrolled in the study. Age, sex, and BMI of patients were recorded. Blood sample was obtained for measurement of BDNF and CRP. Smoking and drug history, family history of suicide, and history of self-harm were also documented. Data were analyzed with SPSS version 22 and R version 4.1.1. Results 86 patients in three groups were evaluated (mean age: 28.45 ± 9.27 years, 56.71% female). Baseline and demographic parameters except for self-harm (40%, 3.3%, and 0% for MDD + SA, MDD-SA, and healthy controls, respectively, p = 0.001) did not differ between groups. CRP level was not significantly different between groups. BDNF showed a significant difference between groups (17.35, 16.45, and 19.43 for three groups, respectively, p < 0.001). An increase in BDNF decreased the odds of both depression and suicide. Roc curve showed excellent power for BDNF in discriminating MDD groups With healthy group.Roc can notdicrimiate MDD + SA and MDD-SA. Conclusion In our study, the concentration of BDNF differed significantly between depressed patients with/without suicide attempts and healthy controls which shows the association of BDNF with depression development and not suicide attempts. We could not find any association between CRP level and suicide attempt but still larger cohorts are needed for a definite conclusion.

Background A 13-year-old boy with well-controlled asthma presented with acute respiratory distress, generalized urticaria, and cyanosis after playing soccer, raising concerns for food-dependent exercise-induced anaphylaxis (FDEIA) or exercise-induced anaphylaxis (EIA). The patient initially underwent evaluation at a nearby clinic and was later admitted to the hospital where the initial management involved intubation and intensive resuscitation after a preliminary diagnosis of anaphylaxis. Case presentation At the presentation in the hospital, the patient had severe neurological impairment with a Glasgow Coma Scale of 3/15. On physical examination, abnormalities included hypotension, tachycardia, fever, and severe hypoxemia, with a SpO2 of 99%. The neurological examination was positive for dilated pupils and absent deep tendon reflexes. Laboratory results showed significant metabolic derangements, elevated liver enzymes, and markedly elevated lactate levels. The patient received fluid resuscitation, neuroprotection, broad-spectrum antibiotics, and antiepileptic treatment. CT scan was positive for cerebral edema and diffuse hypoxia. Despite maximum medical therapy, including sedation and inotropic support, the patient eventually progressed to evidence of brain death three days after admission. Conclusion The case illustrates the difficulty of managing severe anaphylactic reactions in an asthmatic patient after playing soccer, resulting in neurological sequelae. It emphasizes the necessity of further research on prevention measures and guidelines for managing such a case.

Background Tissue engineering has become increasingly applied for tissue repair purposes. Scaffolds, one of the main components of tissue engineering, provide a supportive framework for cell culture and growth. The objective of the present study was to investigate the odontogenic/osteogenic differentiation of dental pulp stem cells, cultured on a polycaprolactone (PCL)-based nanofibrous scaffold, coated with Biodentine. This study evaluated the use of Biodentine as a coating on nanofiber scaffolds and investigated the biological effects of this material on the differentiation of dental pulp stem cells, which hold promising applications in dental and bone tissue engineering. Methods This study is a basic research investigation. Initially, PCL nanofibrous scaffolds were produced through electrospinning, followed by a post-fabrication surface modification step. The morphology and properties of the scaffolds were examined using scanning electron microscopy (SEM). In the surface treatment step, two different concentrations of Biodentine (0.05% and 0.01%) were applied on the mats. The biocompatibility of the scaffolds was assessed using an MTT assay on days 1, 3, and 5. Additionally, the odontogenic/osteogenic differentiation potency of fabricated scaffolds was evaluated by alkaline phosphatase (ALP) activity and deposited calcium of the cells on days 7, 14, and 21. Results SEM analysis revealed that Biodentine coating increased surface roughness, particularly at the 0.05% concentration, where excessive particle aggregation was observed. In contrast, the control PCL scaffold exhibited a well-organized fibrous structure with a smooth surface, whereas the 0.01% Biodentine-coated scaffold displayed a moderately roughened surface with uniformly distributed mineralized deposits. Cell viability was higher in the 0.01% Biodentine group, while the 0.05% concentration showed reduced proliferation. ALP activity peaked on day 14, and the highest level of calcium deposition was observed in the 0.01% Biodentine group on day 21, indicating enhanced biomineralization. Conclusion Biodentine/PCL scaffolds demonstrated notable and suitable physical and chemical properties. Furthermore, they enhanced odontogenic/osteogenic differentiation and mineralization compared to the control group. These findings support the potential of fabricated scaffolds for odontogenic/osteogenic differentiation applications.

Background Physiological thoracic kyphosis (TK) allows sagittal balance of human body. Unlike lumbar lordosis (LL), TK has been relatively neglected in the literature. EOS is an imaging technique employing high-sensitivity xenon particles, featured by low-dose exposure combined with high accuracy compared to conventional radiography. The aim of this study was to investigate predictors of TK in patients with phyiological spine morphology using EOS imaging. Methods EOS images of 455 patients without spinal anomalies were retrospectively assessed for TK (T1- T12), upper thoracic kyphosis (UTK, T1-T5), lower thoracic kyphosis (LTK, T5-T12), LL (L1-S1) and pelvic incidence (PI). The latter curves were measured by two researchers separately and the average of the two measurements was used for further analysis. Spearman non-parametric correlation was estimated for age, PI, LL, LTK, UTK and TK. Multiple robust linear regression analysis was employed to estimate TK, controlling for the effect of age, sex, LL and LTK. Results The mean age of patients was 28.3 ± 19.2 years and 302 (66.4%) of them were females. The mean TK, UTK and LTK was 45.5° ± 9.3, 16 ± 7.4° and 29.7° ± 8.9, respectively. The mean UTK in people under 40 years of age was 17.0° ± 7.2, whereas for patients 40+ years old it was 13.6° ± 7.4. At univariable analysis TK positively correlated with UTK (p<0.001), LTK (p<0.001) an LL (p<0.001). At multivariable linear regression TK increased with LTK (RC = 0.67; 95%CI: 0.59; 0.75) or LL (RC = 0.12; 95%CI: 0.06; 0.18), whereas it decreased with age (RC = -0.06; 95%CI: -0.09;—0.02). Conclusion If EOS technology is available, the above linear regression model could be used to estimate TK based upon information on age, sex, LL and LTK. Alternatively, TK could be estimated by adding to LTK 17.0° ± 7.4 for patients < 40 years of age, or 13.6° ± 7.4 in patients 40 + years old. The evidence from the present study may be used as reference for research purposes and clinical practice, including spine examination of particular occupational categories or athletes.

Background Autoimmune liver diseases (AILD) are increasing and common forms of chronic liver disease (CLD) with different clinical responses and characteristics which can result in cirrhosis. This study aimed to investigate the natural history and characteristics of AILD in an Iranian population. Methods Patients with AILD [Autoimmune Hepatitis (AIH), Primary Biliary Cholangitis (PBC), Primary Sclerosing Cholangitis (PSC) and Overlap Syndrome (OS)] referred to Middle East Liver Diseases (MELD) center, Tehran, Iran, between January 2002 and December 2022 were included in this retrospective cohort study. The main features of natural history (the trends of liver functional tests (LFT), Auto-Antibodies, response to treatment and cirrhotic status) along with demographic data were studied. Results Two hundred sixty-five patients (160 (60.4%) AIH, 37 (14.0%) PBC, 20 (7.5%) PSC, 48 (18.1%) overlap syndrome) with a median follow-up time of 5 years (IQR 4 to 8 years) were included. Baseline laboratory tests revealed that patients with AIH exhibit elevated transaminase levels. However, patients suffering from PBC and PSC displayed increased alkaline phosphatase levels. Conversely, in overlap syndrome patients, both transaminases and alkaline phosphatase were observed at high levels. Autoantibodies represented themselves as important diagnostic markers for the AIH and PBC but not for PSC. The complete response occurred in 112 (70%) of and 28 (58.4%) patients with AIH and overlap syndrome respectively and 21 patients 11 (6.9%) of AIH and 10 (20.8%) of overlap syndrome) were non-responders. Other patients in these two categories were considered as insufficient responders. On the other side, 32 (91.9%) and 8 (40%) of patients with PBC and PSC biochemically responded to Ursodeoxycholic Acid (UDCA). Unpredictably, cirrhosis regression was observed in some AIH and PBC patients. Conclusion Appropriate medication management for AILD patients may leads to regression from cirrhosis and improvement of manifestations; while discontinuation of medication may cause relapses. However, patient suffering from PSC showed limited response to treatment.

Background Episodes of recurrent or severe hypoglycemia can occur in patients with diabetes mellitus, insulinoma, neonatal hypoglycemia, and medication errors. However, little is known about the short-term and long-term effects of repeated episodes of acute severe hypoglycemia on the brain, particularly in relation to hippocampal damage and cognitive dysfunction. Methods Thirty-six wistar rats were randomly assigned to either the experimental or control group. The rats were exposed to severe hypoglycemia, and assessments were conducted to evaluate oxidative stress in brain tissue, cognitive function using the Morris water maze test, as well as histopathology and immunohistochemistry studies. The clinical and histopathological evaluations were conducted in the short-term and long-term. Results The mortality rate attributed to hypoglycemia was 34%, occurring either during hypoglycemia or within 24 h after induction. Out of the 14 rats monitored for 7 to 90 days following severe/recurrent hypoglycemia, all exhibited clinical symptoms, which mostly resolved within three days after the last hypoglycemic episode, except for three rats. Despite the decrease in catalase activity in the brain, the total antioxidant capacity following severe insulin-induced hypoglycemia increased. The histopathology findings revealed that the severity of the hippocampal damage was higher compared to the brain cortex 90 days after hypoglycemia. Memory impairments with neuron loss particularly pronounced in the dentate gyrus region of the hippocampus were observed in the rats with severe hypoglycemia. Additionally, there was an increase in reactive astrocytes indicated by GFAP immunoreactivity in the brain cortex and hippocampus. Conclusion Recurrent episodes of severe hypoglycemia can lead to high mortality rates, memory impairments, and severe histopathological changes in the brain. While many histopathological and clinical changes improved after three months, it seems that the vulnerability of the hippocampus and the development of sustained changes in the hippocampus were greater and more severe compared to the brain cortex following severe and recurrent hypoglycemia. Furthermore, it does not appear that oxidative stress plays a central role in neuronal damage following severe insulin-induced hypoglycemia. Further research is necessary to assess the consequences of repeated hypoglycemic episodes on sustained damage across various brain regions.

We performed a review study according to recent COVID-19 vaccines’ real-world data to provide comparisons between COVID-19 vaccines regarding their relative efficacy. Although most vaccine platforms showed comparable effectiveness and efficacy, we highlight critical points and recent developments generated in studies that might affect vaccine efficacy including population-dependent effects of the vaccine (transplantation, adiposity, and specific comorbidities, as well as older age, male sex, ethnicity, and prior infection), vaccine type, variants of concern (VOC), and an extended vaccine schedule. Owing to these factors, community-based trials can be of great importance in determining vaccine effectiveness in a systematic manner; thus, uncertainty remains regarding vaccine efficacy. Long immune protection of vaccination with BNT162b2 or ChAdOx1 nCoV-19 has been demonstrated to be up to 61 months and 5–12 months after the previous infection, and boosting infection-acquired immunity for both the first and second doses of the BNT162b2 and ChAdOx1 nCoV-19 vaccines was correlated with high and durable protection. However, large cohort and longitudinal studies are required for the evaluation of immunity dynamics and longevity in unvaccinated, vaccinated, and infected individuals, as well as vaccinated convalescent individuals in real-world settings. Regarding the likelihood of vaccine escape variants evolving, an ongoing examination of the protection conferred against an evolving virus (new variant) by an extended schedule can be crucial.

The role of post‐mastectomy screening in female to male transsexual patients remains uncertain; however, breast cancers may appear more invasively after sex reassignment surgery. Female‐to‐male transsexuals should undergo regular breast screening examinations, and any mastectomy specimen should be sent for full histopathological examination.

ABSTRACT Accurate geometrical representation of stenosis is essential for stent design, surgical planning, and computational fluid dynamics (CFD) simulations, as even minor shape variations significantly alter hemodynamic predictions. This review systematically compiles and classifies the diverse stenosis geometries proposed in prior studies, creating a foundational reference for researchers. We catalog models ranging from idealized analytical shapes (e.g., axisymmetric cosine, Gaussian, and asymmetric profiles), patient‐specific reconstructions to parametric frameworks, highlighting their mathematical formulations, hemodynamic implications, and clinical applications. By consolidating these geometries, this article enables researchers to: (1) identify the most suitable existing model for their specific study, (2) understand inconsistencies in results across studies due to geometrical differences, and (3) develop new models informed by prior morphological variations. Crucially, we emphasize how stenosis geometry governs key hemodynamic parameters such as wall shear stress and pressure gradients and influences stent performance, underscoring why shape selection cannot be overlooked. This structured classification is intended to guide model selection and study design by aligning geometric fidelity with specific research objectives and practical constraints, rather than to imply predictive accuracy or clinical superiority.

Recent studies on the pathophysiology of COVID-19 are indicating that the Angiotensin convertase enzyme 2 (ACE-2) and transmembrane serine protease 2 (TMPRSS2) can act as a major component in the fusion of SARS-Cov-2 with target cells. It has also been observed that the expression of ACE-2 and TMPRSS2 can be altered in malignancies. Shedding light on this matter could be crucial since the COVID-19 pandemic interfered with many gastrointestinal cancer screening programs. Herein we discuss the possibility of severe forms of COVID-19 in patients with gastrointestinal cancers due to the gastrointestinal entry route of SARS-CoV-2 into the human body. The disruption of cancer screening programs caused by the current COVID-19 pandemic could therefore have massive negative health impact on patients affected by gastrointestinal malignancies.