Medicina
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Background and objectives: Slit1 is a secreted protein that is closely related to cell movement and adhesion. Few studies related to fibrosis exist, and the preponderance of current research is confined to the proliferation and differentiation of neural systems. Hypertrophic scars (HTSs) are delineated by an overproduction of the extracellular matrix (ECM) by activated fibroblasts, leading to anomalous fibrosis, which is a severe sequela of burns. ⋯ The treatment of rSlit1 in HNFs facilitated cell migration, concurrent with enhanced levels of N-cadherin and vimentin, and a diminished expression of E-cadherin. Treatment with rSlit1 resulted in the phosphorylation of SMAD pathway proteins, including SMAD2, SMAD3, and SMAD1/5/8, and non-SMAD pathway proteins, including TAK1, JNK1, ERK1/2, and p38, in HNFs. Conclusions: Exogenous Slit1 potentiates the epithelial-mesenchymal transition and upregulates SMAD and non-SMAD signaling pathways in HNFs, leading to the development of HTS, suggesting that Slit1 is a promising new target for the treatment of post-burn HTS.
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Background and Objectives: Most orthodontic forces are absorbed-dissipated before reaching the dental pulp and its neuro-vascular bundle (NVB); however, no data are available about their amounts. The objective of this study was to assess the amount of orthodontic force that reaches the dental pulp and its NVB during orthodontic movements in a healthy periodontium. Materials and Methods: This study involved the second lower premolars of nine patients and 180 numerical simulations. ⋯ Only about 2.85% of the initial orthodontic load of 40 KPa/4 N applied at the bracket level induced stresses in the NVB, while the dental pulp was reached by 0.5% of the applied force. A similar distribution was seen at 5 KPa/0.5 N. Conclusions: The absorption-dissipation ability of the dental tissue varies between 97.15 and 99.98%.
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Review Meta Analysis
Prevalence of Vitamin D Deficiency Among Adults in Kazakhstan: A Systematic Review and Meta-Analysis.
Background and Objectives: Despite frequent references to the high prevalence of vitamin D deficiency in Kazakhstan, a comprehensive synthesis of existing research on this issue among adults is lacking. This systematic review and meta-analysis aim to address this gap by determining the mean prevalence of vitamin D deficiency among adults in Kazakhstan. A secondary objective is to evaluate whether the prevalence differs between healthy adults and those with chronic conditions. ⋯ Overall, the pooled mean prevalence of vitamin D deficiency in the adult population was 57% (95% CI, 45-69%). Conclusions: This analysis indicates a high prevalence of vitamin D deficiency among adults in Kazakhstan, with 57% of the population affected. Addressing this issue requires a multifaceted approach, including policy reforms that consider the impact of time zone changes on sunlight exposure and the active involvement of nurse practitioners in preventive strategies.
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Background and Objectives: Recent advances in intraoperative navigation systems have improved the accuracy of pedicle screw placement in spine surgery. However, many hospitals have limited access to these advanced technologies due to resource constraints. In such settings, postoperative computed tomography (CT) evaluation remains crucial for assessing screw placement and related potential complications. ⋯ In clinical validation, the software showed superior intraobserver (0.83 vs. 0.74) and interobserver reliability (0.855 vs. 0.513) compared to picture archiving and communication system (PACS) workstation evaluation. Conclusions: The developed software provides improved accuracy and reliability in pedicle screw position evaluation through distinct screw outline visualization and metal artifact reduction. Its equipment-independent nature and cost-effectiveness make it particularly valuable for clinical implementation.
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Background and Objectives: In patients with acute coronary syndrome, electrocardiographic parameters, including ST elevation in lead aVR (aVR-STE), ST depression (aVR-STD), and QTc prolongation, are crucial. This study aims to show the predictive value of a longer QTc in emergency department patients with acute coronary syndrome and ≥1 mm ST elevation or depression in the aVR lead in electrocardiography. Materials and Methods: A retrospective analysis was conducted on 1273 patients admitted to the emergency department with a preliminary diagnosis of acute coronary syndrome between 2020 and 2023. ⋯ In the uni-multivariable regression analysis performed for both change in aVR derivation and mortality, it was determined that prolonging QTc could be a predictive value for acute coronary syndrome (p < 0.001). We found sensitivity at 99.7% and specificity at 99.2% in predicting mortality in patients with prolonged QTc (AUC: 0.983, 95% CI: 0.974-0.993, p < 0.001). Conclusions: In patients with acute coronary syndrome, a prolonged QTc is an independent predictor of short- and long-term mortality in alterations in aVR derivation.