Search

Purpose: Quetiapine is a drug used to treat schizophrenia, bipolar disorder, and major depressive disorder. However, it can cause mild or severe hepatic adverse events and rarely fatal liver damage. This study was aimed at investigating hepatic toxicity caused by quetiapine use by analyzing the information captured from hospital electronic health records by using the Observational Medical Outcomes Partnership common data model (CDM)., Methods: This was a retrospective observational study involving a nested case-control method. A CDM based on an electronic health record database from five hospitals between January 2009 and May 2020 was used. We analyzed the status of quetiapine use, adverse events, and hepatic impairment., Results: The numbers of patients with non-serious and severe hepatic adverse reactions were 2566 (5.05%) and 835 (1.64%) out of 50 766 patients, respectively. After adjusting for covariates, the odds ratio of hepatic adverse events was 2.35 (95% CI: 2.03-2.72), and the odds ratio of severe hepatic adverse events was 1.76 (95% CI: 1.16-2.66)., Conclusion: Our findings suggest that quetiapine should be cautiously used, and hepatic function should be monitored in patients using quetiapine because it can cause mild or severe hepatic adverse events, complications, and in rare cases, fatal liver damage., (© 2023 John Wiley & Sons Ltd.)

Aim: This study aimed to assess the effects of daily sedation interruption on the mechanical ventilation duration and relevant outcomes in mechanically ventilated patients in the intensive care unit (ICU)., Background: Previously, three meta-analyses on the association of daily sedation interruption with the mechanical ventilation duration have reported conflicting findings, and these did not support current guideline recommendations that daily sedation interruption can be routinely used in mechanically ventilated adult ICU patients., Design: This was a systematic review and meta-analysis of randomized controlled studies., Data Sources: Data were from PubMed, Embase, Cochrane Library, CINAHL, ProQuest dissertation and theses, Airiti Library, China National Knowledge Infrastructure, Wanfang Data Chinese, Science Direct and PsycINFO databases., Review Methods: Two reviewers independently assessed, extracted and appraised the included studies. Then, pooled estimates were calculated using a random-effects model., Results: In total, 45 studies involving 5493 participants were included. Compared with controls, daily sedation interruption significantly reduced the mechanical ventilation duration, ICU stay length, sedation duration, and tracheostomy and ventilator-associated pneumonia risks (all p ≤ 0.001). Moreover, the Acute Physiology and Chronic Health Evaluation II score and study quality were significant moderators., Conclusion: Daily sedation interruption could substantially reduce the duration of mechanical ventilation, particularly when it was applied to patients with high disease severity., (© 2021 John Wiley & Sons Australia, Ltd.)

Purpose: To determine whether microfracture with bone marrow aspirate concentrate (BMAC) improves functional outcome and cartilage regeneration better than microfracture alone in patients undergoing high tibial osteotomy (HTO) for medial unicompartmental osteoarthritis (OA)., Methods: Among 436 patients treated with HTO for medial unicompartmental OA with varus deformity between 2010 and 2016, clinical outcomes were retrospectively compared between the microfracture alone group (group I, 43 cases) and microfracture with BMAC augmentation group (group II, 48 cases). Of these, 64 patients underwent a second-look arthroscopic assessment. Clinical outcomes were compared based on the Knee Society Score (KSS), International Knee Documentation Committee (IKDC) subjective score, and Western Ontario and McMaster Universities Arthritis Index (WOMAC). Cartilage regeneration was assessed according to Koshino's staging system and the International Cartilage Repair Society (ICRS) Cartilage Repair Assessment (CRA) grading system., Results: At the last follow-up, there were no significant intergroup differences in terms of KSS for pain and function (p > 0.05). Moreover, WOMAC scores were similar between the two groups (p > 0.05). Regarding second-look arthroscopy findings, according to Koshino's staging system, there was no significant intergroup difference in terms of defect coverage (p = 0.187). However, group II showed a significantly better mean CRA score than group I (p = 0.035)., Conclusion: There were no significant differences in clinical outcomes and cartilage regeneration between the groups. However, the CRA score was significantly higher with BMAC augmentation and microfracture than microfracture alone. Therefore, BMAC augmentation had a synergistic effect for a better cartilage regeneration, although studies with a longer follow-up might help to confirm whether microfracture with BMAC augmentation would ensure better clinical outcomes than microfracture alone for the treatment of knee OA.

Purpose: To investigate the relationship between macular thickness and axial length (AL) in myopic eyes., Methods: We included 441 myopic eyes in this study and measured macular thickness at the fovea and in other macular regions, using optical coherence tomography. We got thickness difference indices (TDIs) which by definition are the values of thickness difference obtained by subtracting the foveal thickness from that of each macula sector to evaluate macular contour. We then analyzed the relationships between AL and foveal thickness and AL and the TDIs of each macular sector., Results: In polynomial regression analyses, foveal thickness slope was relatively flat up to an AL of 25.5 mm and began to rise from 25.5-26.0 mm. The TDIs were also relatively flat up to AL of 25.5mm and started to show steepened negative slopes from around AL of 25.5 mm. When grouping myopia participants as high myopia or non-high myopia based on AL of 25.5mm, all macular indices of the high myopia group showed significant correlation with AL (all p values <0.01). But all indices of non-high myopia group had no significant correlation with AL., Conclusions: Average macular thickness profiles showed that appreciable changes started at an AL of 25.5mm., Competing Interests: The authors declare that they have no conflicts of interest.

Diabetes and obesity represent the major health problems and the most age-related metabolic diseases. Protein-tyrosine phosphatase 1B (PTP1B) has emerged as an important regulator of insulin signal transduction and is regarded as a pharmaceutical target for metabolic disorders. To find novel natural materials presenting therapeutic activities against diabetes and obesity, we screened various herb extracts using a chip screening allowing the determination of PTP1B inhibitory effects of the tested compounds using insulin receptor (IR) as the substrate. Cudrania tricuspidata leaves (CTe) had a strong inhibitory effect on PTP1B activity and substantially inhibited fat accumulation in 3T3-L1 cells. CTe was orally administrated to diet-induced obesity (DIO) mice once daily for 3 weeks after which changes in glucose, insulin metabolism, and fat accumulation were examined. Hepatic enzyme markers (aspartate aminotransferase, AST, and alanine aminotransferase, ALT) and total fat mass and triglyceride levels decreased in CTe-treated mice, whereas body weight and total cholesterol concentration slightly decreased. CTe increased the phosphorylation of IRS-1 and Akt in liver tissue. Furthermore, CTe treatment significantly lowered blood glucose levels and improved insulin secretion in DIO mice. Our results strongly suggest that CTe may represent a promising therapeutic substance against diabetes and obesity.

In delay tolerant network (DTN), an end-to-end path is not guaranteed and packets are delivered from a source node to a destination node via store-carry-forward based routing. In DTN, a source node or an intermediate node stores packets in buffer and carries them while it moves around. These packets are forwarded to other nodes based on predefined criteria and finally are delivered to a destination node via multiple hops. In this paper, we improve the dissemination speed of PRoPHET (probability routing protocol using history of encounters and transitivity) protocol by employing epidemic protocol for disseminating message m, if forwarding counter and hop counter values are smaller than or equal to the threshold values. The performance of the proposed protocol was analyzed from the aspect of delivery probability, average delay, and overhead ratio. Numerical results show that the proposed protocol can improve the delivery probability, average delay, and overhead ratio of PRoPHET protocol by appropriately selecting the threshold forwarding counter and threshold hop counter values.

One of the key technologies to support mobility of mobile station (MS) in mobile communication systems is location management which consists of location update and paging. In this paper, an improved movement-based location management scheme with two movement thresholds is proposed, considering bursty data traffic characteristics of packet-switched (PS) services. The analytical modeling for location update and paging signaling loads of the proposed scheme is developed thoroughly and the performance of the proposed scheme is compared with that of the conventional scheme. We show that the proposed scheme outperforms the conventional scheme in terms of total signaling load with an appropriate selection of movement thresholds.

Objective: To analyse factors associated with endocervical cone margin involvement and suggest appropriate cone depth for the conization procedure., Design: Retrospective cohort study., Setting: Gynecological oncology center., Population: One thousand two hundred and twenty women undergoing conization for cervical intraepithelial neoplasia (CIN) II or III or stage IA1 microinvasive cervical carcinoma., Methods: The following factors were analysed: age, parity, gravida, conization type, margin status, disease severity and specimen depth. Receiver operating characteristic curve analyses were used to determine the best cut-off points to define appropriate cone depth., Main Outcome Measures: Cone depth to avoid endecervical margin involvement., Results: Ninety-one women had endocervical margin involvement (7.5%). This was positively associated with disease severity and age and inversely related to cone depth. In women under 50 years of age, the cut-off value was achieved at 1.8 cm cone depth, with high sensitivity and relatively low specificity [area under the curve (AUC) 0.64, sensitivity 0.86, specificity 0.27, p= 0.005]. For a subset of CIN II patients aged ≤50 years, the cut-off value was 1.2 cm (AUC 0.75, sensitivity 0.90, specificity 0.47, p= 0.008). In women <40 years of age, the cut-off value was 1.8 cm (AUC 0.60, sensitivity 0.88, specificity 0.25, p= 0.036). In a subset of CIN II, the cut-off value was 0.9 cm (AUC 0.87, sensitivity 0.83, specificity 0.69, p= 0.002)., Conclusions: Age, disease severity and cone depth are predictive factors for endocervical margin involvement. In women of reproductive age, the appropriate cone depth to avoid endocervical margin involvement can be changed depending on age and disease severity., (© 2012 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2012 Nordic Federation of Societies of Obstetrics and Gynecology.)

Progesterone and progesterone receptors (PGR) are known to play important roles in the pathophysiology of pelvic organ prolapse (POP). We investigated whether the PGR gene polymorphisms were associated with POP by conducting a case-control association study in 87 women with POP and 150 women without POP. Genotypes of the PGR gene polymorphisms (rs500760 and rs484389) were determined by polymerase chain reaction, followed by restriction fragment length polymorphism analysis. There was significant difference between women with and those without POP in the distribution of the PGR rs484389 genotypes evaluated. Using multivariable logistic regression, older age, increased body mass index, menopausal status, and PGR rs484389 genotype CT were significantly associated with POP. The present study shows that PGR genotype may be associated with POP.

Objective: To investigate whether pelvic organ prolapse (POP) is associated with collagen 3 alpha 1 (COL3A1) polymorphisms and other factors., Methods: A case-control association study was conducted with 84 women affected with POP and 147 controls. The genotypes of nucleotides COL3A1 rs1800255 and COL3A1 rs1801184 polymorphisms were ascertained by polymerase chain reaction and restriction fragment length polymorphism analysis., Results: The distribution of the COL3A1 rs1800255 genotypes was significantly different among affected women and controls. Older age and incidence of COL3A1 rs1800255 genotype AA were significantly associated with risk of POP., Conclusion: There may be an association between COL3A1 genotype and risk of POP.