Pharmaco-Invasive Strategy Vs Primary Percutaneous Coronary Intervention for ST-Segment Elevation Myocardial Infarction in Latin America: A Meta-Analysis.

Background: Primary percutaneous coronary intervention (PCI) is the established treatment for ST-segment elevation myocardial infarction (STEMI), but often it is not readily available in low-resource settings. We assessed the safety and efficacy of the pharmaco-invasive strategy compared to primary PCI for STEMI in Latin America.

Methods: MEDLINE, Embase, and Latin American and Caribbean Health Sciences Literature (LILACS) were searched for the period from their inception to September 2023, for studies that compared a pharmaco-invasive strategy vs primary PCI in Latin America.

Community-based model for management and follow-up by non-physician healthcare workers to improve awareness, treatment, and control of hypertension: The COTRACO study protocol.

Introduction: Cardiovascular diseases are the leading cause of death and morbidity worldwide, with a significantly higher burden in low- and middle-income countries. Hypertension, a major risk factor for cardiovascular morbidity and mortality, remains under-diagnosed and poorly controlled, especially in regions such as Latin America. The HOPE-4 study demonstrated that the involvement of non-physician health workers (NPHWs), the use of standardized treatment algorithms, the provision of free antihypertensive drugs and home follow-up can significantly improve hypertension control and reduce cardiovascular risk, as demonstrated in Colombia and Malaysia.

Blood levels of cytokines highlight the role of inflammation in Alzheimer's disease.

Inflammation and angiogenesis have been defined as potential mechanisms associated with clinical progression from a cognitively normal state to Alzheimer's disease (AD). In this observational case-control study, we aimed to determine plasma levels of cytokines as indicators of inflammation involved in cognitive decline. We measured 30 plasma proteins in 49 controls (CTL), 36 individuals with mild cognitive impairment (MCI) and 52 patients diagnosed with probable AD.

Identifying silver ore sources for the earliest coins of Athens.

Unlabelled: This study addresses longstanding questions concerning the ore sources used in the first series of coins of ancient Athens known as the (c.540-c.500 BCE) by combining comprehensive numismatic data on 22 coins (16 new and 6 legacy analyses) with lead isotope and surface elemental measurements (MC-ICP-MS and XRF).

Occluding mucous airway plugs in patients with obstructive lung diseases: a new treatable trait?

https://bit.ly/4gyJHFW.

Long-term outcomes in five patients with autoimmune pulmonary alveolar proteinosis treated with molgramostim inhalation solution.

Autoimmune pulmonary alveolar proteinosis (aPAP), which accounts for >90% of all cases of PAP, is a rare lung disease mediated by granulocyte-macrophage colony-stimulating factor (GM-CSF) autoantibodies that block GM-CSF signalling, leading to reduced surfactant clearance causing abnormal accumulation of alveolar surfactant and impaired gas exchange [1-3]. The current standard of care for aPAP is whole-lung lavage (WLL), which is invasive, resource intensive, carries procedural risk, does not address the underlying cause of disease and often must be repeated regularly [4]. Hence, there is a therapeutical need to address the underlying pathophysiology of the disease.

Developing a Prototype Machine Learning Model to Predict Quality of Life Measures in People Living With HIV.

Background: In the realm of Evidence-Based Medicine, introduced by Gordon Guyatt in the early 1990s, the integration of machine learning technologies marks a significant advancement towards more objective, evidence-driven healthcare. Evidence-Based Medicine principles focus on using the best available scientific evidence for clinical decision-making, enhancing healthcare quality and consistency by integrating this evidence with clinician expertise and patient values. Patient-Reported Outcome Measures (PROMs) and Patient-Reported Experience Measures (PREMs) have become essential in evaluating the broader impacts of treatments, especially for chronic conditions like HIV, reflecting patient health and well-being comprehensively.

Refractive Accuracy of a Novel Swept-Source OCT in Patients With Short and Long Eyes.

To analyze the refractive accuracy of a novel swept-source optical coherence biometer (SS-OCT), that uses individual refractive indices to measure axial length, in short and long eyes implanted with monofocal intraocular lenses (IOLs). This retrospective comparative study considered eyes with short axial length (AL) (< 22.5 mm) or long AL (> 26 mm) bilaterally implanted with the Acrysof IQ monofocal IOL.

A multi-country cohort database study to assess pregnancy and infant outcomes after potential maternal or paternal exposure to cladribine tablets in the treatment of multiple sclerosis: the CLEAR study methods and status update.

Background: Cladribine tablets are contraindicated during pregnancy; therefore, safety data on pregnancies exposed to this treatment are limited. CLEAR collects and describes pregnancy outcomes in this understudied population.

Objectives: To describe the main features of the CLEAR study design, including the data sources and the methodological approach, and provide a status update.

A gut instinct for childhood leukemia prevention: microbiome-targeting recommendations aimed at parents and caregivers.

Childhood leukemia accounts for 30% of all pediatric cancer cases with acute lymphoblastic leukemia (ALL) being the most common subtype. Involvement of the gut microbiome in ALL development has recently garnered interest due to an increasing recognition of the key contribution the microbiome plays in maintaining the immune system's homeostatic balance. Commensal gut microbiota provide a first line of defense against different pathogens and gut microbiome immaturity has been implicated in ALL pathogenesis.

Microfluidic model of the alternative vasculature in neuroblastoma.

Unlabelled: Neuroblastoma (NB) is a highly vascularized pediatric tumor arising from undifferentiated neural crest cells early in life, exhibiting both traditional endothelial-cell-driven vasculature and an intriguing alternative vasculature. The alternative vasculature can arise from cancer cells undergoing transdifferentiation into tumor-derived endothelial cells (TEC), a trait associated with drug resistance and tumor relapse. The lack of effective treatments targeting NB vasculature primarily arises from the challenge of establishing predictive in vitro models that faithfully replicate the alternative vasculature phenomenon.

The influence of physical activity levels on lactate production during squat training using a functional electromechanical dynamometer.

Objective: This study aimed to determine the association between changes in lactate production and levels of physical activity in a group of healthy young adults in response to two squat training protocols.

Material And Methods: Twenty-nine students majoring in Sports Science willingly participated in this study. Participants visited the lab four times within a two-week period, ensuring at least 48 h between visits.

Assessing and comparing compassionate communities benefits across cities in diverse cultural contexts: a step toward the identification of the most important ones.

Background: As Compassionate Communities (CCs) are developing worldwide, there is a growing need to systematically assess if they are having the expected effects on the community. Although having a single strategy would be ideal in terms of standardization and comparison, due to the inherent heterogeneity of CCs, it is not known how feasible this would be.

Objectives: To assess the feasibility of creating a general strategy, based on the results of a series of focus groups conducted across three diverse CCs, to guide the evaluation of already existing programs and the development of new ones.

Experiences and overall impact reported by people living with obesity: results from a multinational study.

Objectives: To explore the impact of obesity on clinical outcomes, health-related quality of life, emotional well-being, and work productivity in people/patients with obesity across six countries by body mass index and the presence of complications.

Methods: Adelphi Real World Obesity Disease Specific Programme™ captured data related to physicians and their consulting people/patients with obesity on a weight management program or anti-obesity medication in Brazil, Canada, China, Japan, Kingdom of Saudi Arabia, and the United Arab Emirates from April to December 2022. Physicians reported data for up to eight qualifying people/patients with obesity.

Severe ARDS due to disseminated toxoplasmosis in a person with HIV successfully treated with ECMO: a case report.

Disseminated toxoplasmosis (DT) is an uncommon but severe complication associated with acquired immunodeficiency syndrome (AIDS). This case report describes the successful treatment of a 28-year-old male individual with AIDS who developed severe and life-threatening acute respiratory distress syndrome (ARDS) resulting from DT, in which extracorporeal membrane oxygenation (ECMO) was employed effectively.

High-refractive-index 2D photonic structures for robust low-threshold multiband lasing.

High-refractive-index (HRI) dielectrics are gaining increasing attention as building blocks for compact lasers. Their ability to simultaneously support both electric and magnetic modes provides greater versatility as compared to plasmonic platforms. Moreover, their reduced absorption loss minimizes heat generation, further enhancing their performance.

The impact of pre-treatment aneurysm angulation. What happens with WEB devices at follow-up?

Background: WEB shape modification has been analyzed in relation to the aneurysm occlusion outcome and techniques have been presented with one-dimensional measurements of the device to quantify the change after implantation. In this work, we present an analysis of pre-treatment vascular morphology and hemodynamics of cases treated with WEB devices, which were three-dimensionally quantified in morphology and position to detect modifications.

Methods: Seventeen WEB-treated aneurysms with pre-treatment, post-treatment and follow-up 3D flat-panel CT were included.

Rethinking Optimal Immunogens to Face SARS-CoV-2 Evolution Through Vaccination.

SARS-CoV-2, which originated in China in late 2019, quickly fueled the global COVID-19 pandemic, profoundly impacting health and the economy worldwide. A series of vaccines, mostly based on the full SARS-CoV-2 Spike protein, were rapidly developed, showing excellent humoral and cellular responses and high efficacy against both symptomatic infection and severe disease. However, viral evolution and the waning humoral neutralizing responses strongly challenged vaccine long term effectiveness, mainly against symptomatic infection, making necessary a strategy of repeated and updated booster shots.

A review of clinical applications of pharmacokinetic simulations for a 2-month long-acting injectable formulation of aripiprazole.

Aripiprazole 2-month ready-to-use (Ari 2MRTU) is a long-acting injectable antipsychotic that was approved for use in Europe in March 2024, for the maintenance treatment of schizophrenia in adult patients stabilized with aripiprazole; it is administered via gluteal intramuscular injection once every two months. This review examines population pharmacokinetic model-based simulations relevant to the use of Ari 2MRTU in Europe, accompanied by expert commentary that contextualizes the simulations and highlights the potential implications of the availability of Ari 2MRTU for patients, caregivers, and clinicians. Various simulations conducted across 8 weeks (representing the first dosing interval), or 32 weeks (representing maintenance dosing) demonstrated an aripiprazole exposure profile for Ari 2MRTU that was similar to aripiprazole once-monthly (AOM), but with an extended dosing interval.

The ITP diagnostic challenge.

Despite numerous advances, the diagnosis of immune thrombocytopenia (ITP) remains a diagnosis of exclusion. This commentary analyses and contextualizes the recent report from Garabet et al. that MicroRNA-199a-5p could be used as a diagnostic marker for ITP.

Aortic valve repair in adults: long-term clinical outcomes and echocardiographic evolution in different valve repair techniques.

Objective: Aortic valve repair/sparing have been established as effective treatments for aortic regurgitation and/or aortic aneurysms. However, concerns remain regarding long-term durability, reproducibility, and patient selection. This study aims to asses long-term clinical and echocardiographic outcomes, with a focus on aortic regurgitation grade and left ventricular ejection fraction evolution, in adults undergoing these procedures.

New insights into the long-term adverse effects of antimalarials in patients with systemic lupus erythematosus.

Background: Hydroxychloroquine is recommended for all patients with systemic lupus erythematosus (SLE) because of its efficacy and safety. Previous studies of antimalarial toxicity under non-experimental conditions have often grouped hydroxychloroquine and chloroquine. This study focuses on the long-term toxicity of antimalarial drugs in SLE patients at a single reference centre.

Death before birth: An encounter between Prenatal Pedagogy and the Pedagogy of Death.

Prenatal death is shrouded in silences. One such silence is in education. The main objective of this essay is to approach the study of prenatal death from the point of view that pedagogy can and should contribute to the family, educational, health, and social spheres.