Rev Invest Clin
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Observational Study
Assessment of Osteoprotegerin and Receptor Activator of Nf-Κb Ligand in Malaysian Male Patients with Chronic Obstructive Pulmonary Disease: A Cross-Sectional Study.
Background: Limited information exists regarding the pathophysiological interactions between osteoporosis and chronic obstructive pulmonary disease (COPD). Objective: To study the association of Osteoprotegerin (OPG) and receptor activator of nuclear factor kappa-Β ligand (RANKL) in male COPD patients. Methods: An observational clinical study was conducted at Penang General Hospital in Malaysia. ⋯ Furthermore, patients with severe COPD had a 3 times greater risk of developing osteoporosis (OR = 2.997 [95% CI = 2.181, 4.118], p < 0.001), while spirometric parameters had a significant inverse relationship with osteoporosis (FEV1% OR = 0.970, [95% CI = 0.954, 0.986], p = 0.001; FEV1/FVC OR = 0.984, (95% CI = 0.970, 0.999], p = 0.035). Conclusion: The study concluded that COPD patients had lower sOPG levels, leading to decreased OPG/RANKL ratio and faster bone resorption. Low bone mineral density was associated with more severe COPD. (Rev Invest Clin. 2024;76(6):262-73).
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Background: The effective use of combination antiretroviral therapy (ART) has significantly improved the life expectancy of people living with the human immunodeficiency virus (HIV). However, complications have shifted from opportunistic infections to issues such as drug toxicity and resistance, as well as an increase in premature cardiovascular diseases (CVD). These conditions are attributed to chronic immune activation and persistent inflammation caused by HIV, along with lipid abnormalities and insulin resistance. ⋯ In addition, 53.8% of the patients exhibited hypertriglyceridemia, and 54.8% met the diagnostic criteria for metabolic syndrome. The D: A: D reduced and full models identified significant risk factors for individuals over 30 years of age, highlighting notable associations with cholesterol levels, triglyceride levels, and smoking status. In contrast, the Framingham model did not demonstrate significant risk associations. (Rev Invest Clin. 2024;76(6):274-85).
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Artificial intelligence (AI) generative models driven by the integration of AI and natural language processing technologies, such as OpenAI's chatbot generative pre-trained transformer large language model (LLM), are receiving much public attention and have the potential to transform personalized medicine. Dialysis patients are highly dependent on technology and their treatment generates a challenging large volume of data that has to be analyzed for knowledge extraction. We argue that, by integrating the data acquired from hemodialysis treatments with the powerful conversational capabilities of LLMs, nephrologists could personalize treatments adapted to patients' lifestyles and preferences. ⋯ In this paper, we will revise LLMs potential strengths in terms of their contribution to personalized medicine, and, in particular, their potential impact, and limitations in nephrology. Nephrologists' collaboration with AI academia and companies, to develop algorithms and models that are more transparent, understandable, and trustworthy, will be crucial for the next generation of dialysis patients. The combination of technology, patient-specific data, and AI should contribute to create a more personalized and interactive dialysis process, improving patients' quality of life.
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The development of hemodialysis (HD) membranes has substantially advanced in the last decade. This has resulted in the manufacturing of medium cut-off membranes (MCO) whose internal architecture is based on greater pore size and a smaller diameter, thus promoting the clearance of particles of greater size as well as retrofiltration. Multiple studies have proven their efficacy in the clearance of uremic mid-sized molecules such as β2-microglobulin, free light chains, and some interleukins; this clearance is far superior with MCO membranes when compared with high-flux HD, and similar to that obtained with online hemodiafiltration. This review summarizes the results of the most relevant clinical studies of this membrane in terms of uremic toxin clearance, as well as the features of some clinical outcomes such as quality of life and hospitalizations.