Medicine
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Comparative Study Observational Study
Neonatal outcomes among twins born through assisted reproduction, compared to those born naturally.
The growing prevalence of assisted reproductive technology (ART) is leading to a continuous rise in twin pregnancies. This study assessed the influence of ART on neonatal outcomes of twin pregnancies. Clinical records of twin deliveries at Fujian Maternity and Child Health Hospital between 2019 and 2021 were retrospectively selected and grouped based on the method of conception: ART-conceived and naturally conceived. ⋯ Twins born through ART had reduced odds of LBW, prematurity, and IUGR, with no impact on other neonatal outcomes. These findings suggest that ART may have a protective effect on twin fetal growth, although the risks associated with multiple gestations remain. Further studies should explore the mechanisms and long-term effects of these outcomes.
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Review Case Reports
Oral vancomycin induced flushing syndrome in a multiple myeloma patient: A case report and review of the literature.
Patients with hematological malignancies are at high-risk of Clostridium difficile infection (CDI). Oral vancomycin is a first-line treatment for CDI. Vancomycin has been widely reported to induce flushing syndrome (also known as Red man syndrome), a well-known hypersensitivity reaction mostly occurs after intravenous administration. However, a few cases of flushing syndrome due to oral vancomycin have been reported. ⋯ Oral vancomycin-induced flushing syndrome is a rare complication that can occur in patients with CDI despite the absence of obvious risk factors. The underlying mechanism of oral vacomycin-induced flushing syndrome may be direct activation of mast cells following mast cell degranulation and histamine release via the MRGPRX2 receptor. However, this is just speculation and there are insufficient data, particularly in vivo data, to draw any conclusions. For patients with risk factors such as gastrointestinal pathology and renal insufficiency, monitoring of vancomycin serum concentration, mast cell degranulation, histamine release, and MRGPRX2 levels is recommended to avoid vancomycin flushing Syndrome, and vancomycin can still be used under supervision.
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Observational Study
Evaluating the prognostic impact of hypoperfusion intensity ratio in acute ischemic stroke patients undergoing early-phase endovascular thrombectomy.
This research aimed to assess the prognostic relevance of the hypoperfusion intensity ratio (HIR) concerning 90-day outcomes in patients with acute ischemic stroke (AIS) managed within the early intervention window. A retrospective review was conducted on AIS patients who received pretreatment computed tomography perfusion imaging and endovascular thrombectomy due to large vessel occlusions in the anterior circulation between January 2020 and September 2022. Clinical data, including the Alberta Stroke Program Early Computed Tomography Score (ASPECTS) from non-contrast CT, along with perfusion metrics such as ischemic core, hypoperfusion extent, core-penumbra mismatch, and HIR, were analyzed. ⋯ Univariate analysis showed significant associations between functional outcomes and variables like age, National Institutes of Health Stroke Scale score at admission, ASPECTS, HIR, ischemic core volume, and hypoperfusion volume (P < .05). Multivariate analysis revealed that younger age (odds ratio [OR] 1.064; 95% confidence interval [CI] 1.025-1.106, P = .001), lower National Institutes of Health Stroke Scale score at admission (OR 1.116; 95% CI 1.038-1.199, P = .003), smaller ischemic core volume (OR 1.017; 95% CI 1.002-1.033, P = .029), higher ASPECTS (OR 0.800; 95% CI 0.662-0.967, P = .021), and reduced HIR (OR 1.516; 95% CI 1.230-1.869, P = .001) independently predicted favorable outcomes at 90 days. Lower HIR was independently linked to improved functional outcomes in AIS patients receiving endovascular thrombectomy within the early intervention timeframe.
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This study employs Mendelian randomization (MR) approach to investigate the potential causal association between genetic variants associated with gut microbiota, inflammatory factors, and the risk of uterine fibroids development. We extracted data on 211 types of gut microbiota, 91 inflammatory factors, and uterine fibroids occurrence from genome-wide association studies and applied the inverse-variance weighted (IVW) method for analysis. To further assess the robustness of our MR analysis, we conducted sensitivity tests including Cochrane's Q test, the MR-Egger intercept test, the MR-PRESSO global test, and a leave-one-out analysis. ⋯ When using 91 inflammation-related proteins as the outcome variable, 13 proteins demonstrated a potential causal association with uterine fibroids risk (IVW, all P < .05). Additionally, the MR-Egger intercept and MR-PRESSO global tests indicated no evidence of horizontal pleiotropy (P > .05), and the leave-one-out analysis confirmed the robustness of the results. This MR approach suggests that specific gut microbiota and inflammatory factors may have a causal association with the development of uterine fibroids, shedding light on the pathogenesis of uterine fibroids and potentially identifying targets for future therapeutic interventions.
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Existing literature offers some insights into the prevalence of anxiety and depression in children with chronic spontaneous urticaria (CSU). However, the literature on anxiety sensitivity (AS) and quality of life (QoL) in these children remains poorly understood. This study aimed to evaluate psychiatric diagnoses, anxiety and depression levels, AS, and QoL in children with CSU compared to healthy controls. ⋯ This study indicated that children with CSU exhibited a higher prevalence of psychiatric diagnoses than controls. Additionally, children with psychopathology in the CSU group demonstrated higher AS and greater impairment of QoL than those without psychiatric diagnoses. Furthermore, the most significant predictor of a decline in QoL was the presence of a psychiatric diagnosis.