Maria Elena

Department of Anesthesia and Intensive Care, “Cuza Vodă” Hospital, 700038 Iasi, Romania

Background: Delirium or an acute confusional state (ACS) is characterised as being a frequent and complex hospital complication in older adult patients, which can affect their level of independence and increase patient morbidity and mortality. Critically ill patients in the intensive care unit (ICU) frequently develop ICU delirium, leading to longer hospital and ICU stays, increased mortality and long-term impairment. Objectives: This review aims to assess existing evidence of interventions that can be considered effective for the management and prevention of delirium in ICUs, reducing short-term morbidity and mortality, ICU and hospital admission times and the occurrence of other long-term complications. Methodology: For this systematic review, we searched Medline, PubMed, Cochrane Library, CINHAL, LILACS, SciELO and Dialnet from January 2018 to August 2024, in English, Spanish and French. MeSH descriptors were adjusted to search the different databases. We also checked Prospero for ongoing systematic reviews. Main results: The electronic search yielded a total of 2656 studies, of which 14 trials met the eligibility criteria, with a total of 14,711 participants. We included eight randomised clinical trial (RCTs), four cohort analyses, one systematic review and one observational trial, including participants over 65 years admitted to the ICU. Ten of these studies were based on pharmacological interventions, three of them examined non-pharmacological interventions and the remaining study examined mixed (pharmacological and non-pharmacological) interventions. Six placebo RCTs were included, plus four reported comparisons between different drugs. Regarding non-pharmacological interventions, nursing programmes focused on optimising modifiable risk factors or the use of therapies such as bright light are emerging. Regarding mixed interventions, we found the combination of invasive techniques and with sedoanalgesia. Conclusions: Due to its satisfactory level of sedation, dexmedetomidine is presented as a viable option because, although olanzapine offers safer results, postoperative administration angiotensin inhibitor systems significantly reduced the incidence of delirium. As for propofol, no significant differences were found. Among the non-pharmacological and mixed therapies, bright light therapy was able to reduce the incidence of delirium, and the combination of epidural/general anaesthesia was effective in all subtypes of delirium. Concerning the remaining interventions, the scientific evidence is still insufficient to provide a definitive recommendation.

Background: Fibromyalgia (FM) is characterized by chronic pain and a complex array of symptoms, with neuroinflammation implicated in its pathophysiology. Methods: This study aimed to explore the association between neuroinflammation, measured through interleukin levels (IL-1, IL-6, IL-8), and clinical outcomes in FM patients. Using a cross-sectional study design, blood levels of these interleukins were correlated with pain severity and disability, assessed via the Fibromyalgia Impact Questionnaire (FIQ) and pain measures. Results: Results indicated that IL-6 and IL-8 may particularly serve as biomarkers for pain severity and disability in FM patients, showing significant associations with worse clinical outcomes. Elevated IL-8 levels, for instance, correlated strongly with increased pain perception and higher disability scores. Conclusions: These findings suggest that specific interleukins are not only elevated in FM but are actively involved in the modulation of pain and disability, underscoring the role of systemic neuroinflammation in the clinical severity of FM. This study contributes to a deeper understanding of the inflammatory mechanisms in FM and underscores the potential of targeting interleukins in therapeutic strategies.

We want elected leaders who care about us, who hear our concerns. The two-party system leads many voters to feel disenfranchised, but here is another option for Nutmeggers looking for a political home: the Working Families Party.

PIK3CA-related overgrowth spectrum (PROS) disorders are caused by somatic mosaic variants that result in constitutive activation of the phosphatidylinositol-3-kinase/AKT/mTOR pathway. Promising responses to molecularly targeted therapy have been reported, although identification of an appropriate agent can be hampered by the mosaic nature and corresponding low variant allele frequency of the causal variant. Moreover, our understanding of the molecular consequences of these variants—for example how they affect gene expression profiles—remains limited. Here we describe in vitro expansion of a human capillary malformation followed by molecular characterization using exome sequencing, single cell gene expression, and targeted long-read single cell RNA-sequencing in a patient with clinical features consistent with Megalencephaly-Capillary Malformation Syndrome (MCAP, a PROS condition). These approaches identified a targetable PIK3CA variant with expression restricted to PAX3+ fibroblast and undifferentiated keratinocyte populations. This study highlights the innovative combination of next-generation single cell sequencing methods to better understand unique transcriptomic profiles and cell types associated with MCAP, revealing molecular intricacies of this genetic syndrome.

Separation techniques are employed to treat and preconcentrate samples. Preconcentration commonly employs adsorption due to the wide range of sorbents available. The biosorbent composite has emerged as a highly effective alternative, primarily due to its selectivity for active sites and its impressive adsorption capability. This study aimed to assess and create a spherical biosorbent composite using cellulose acetate and avocado seed. The purpose of this work was to use a biosorbent composite for copper adsorption by flame atomic absorption spectrometry. The copper adsorption follows the Langmuir isotherm, which indicates that it occurs in a monolayer and is homogeneous. Additionally, the adsorption nature is favorable according to the RL factor. The highest capacity for copper adsorption is 0.121 mg g−1. The report describes the methodology and validation process for quantifying copper. The findings demonstrate that the composite biosorbent enables accurate preconcentration and quantification of copper found in decongestants.

The achievement of complete remission (CR) is crucial for acute myeloid leukemia (AML) patients undertaking curative therapy, but relapse often occurs within months, highlighting the need for strategies to prolong disease-free survival (DFS). Our phase III study compared the efficacy and safety of azacitidine (AZA) to best supportive care (BSC) in elderly AML patients who achieved CR following intensive induction and consolidation therapy. This ancillary study (QOL-ONE Trans-2) evaluated biological changes in bone marrow using Next-Generation Sequencing (NGS). We analyzed baseline, randomization, and 6-month post-remission samples from 24 patients (median age of 71 and 12 males). High-throughput NGS targeted 350 myeloid malignancy-related genes, considering variants with a variant allele frequency ≥ 4%. At diagnosis, all patients had 5 to 17 (median = 10) mutations, with DNMT3A (42%), NPM1 (33%), and TET2 (33%) being most frequent. FANCA mutations in four patients were linked to a higher relapse risk (HR = 4.96,

Background/Objectives: Plant-based diets (PBDs) are dietary patterns characterized by a certain degree of animal-derived food exclusion. PBDs can be divided into different dietary patterns, from vegetarian to vegan, depending on the degree and the extent of animal-derived food avoidance. PBDs are becoming epidemically popular among the general population, including adult subjects as well as children and adolescents, who often follow the dietary pattern chosen by their families. Methods: Our narrative review aims to analyze the most frequently adopted plant-based dietary patterns in children and adolescents and to evaluate their feasibility, advantages, and risks in terms of health promotion and disease prevention in the developmental age. The MEDLINE–PubMed database was searched to collect and select publications from 1980 to 2024. Results: Subjects following these dietary patterns, especially vegan diets, must be under strict nutritional control and receive adequate micronutrients and vitamin supplementation. Conclusions: Nutrition-skilled professionals should be adequately updated and informed about the feasibility and the risks of these different patterns' adoption at different ages, as they should guide and accompany children and adolescents and their families in their nutritional choices without prejudices, granting adequate macronutrient and micronutrient intake, adequate growth and neurodevelopment.

The screening of plant-derived compounds with anti-cancer properties is a promising strategy to meet the growing need for new, safe and effective anti-cancer drugs. Justicidin B is a plants secondary metabolite that displays anti-cancer properties in several tumor cells. Therefore, it represents a good candidate. We used the 3R-compliant organism Caenorhabditis elegans to evaluate the safety of justicidin B produced by in vitro-grown adventitious roots of Linum lewisii. We showed that a dose of 100 µg/mL justicidin B does not affect worm vitality in either short-term or chronic administration; in contrast, the 200 µg/mL dose induces a lifespan reduction, but only in short-term daily treatment. We attributed this effect to its accumulation in lipofuscin granules in the pharynx as observed through confocal analysis. HPLC analysis confirmed the higher accumulation justicidin B with a 200 µg/mL dose but also revealed the presence of metabolic derivatives that could be responsible for the toxicity. We also demonstrated that the 100 µg/mL dose does not affect worm fertility or development. Our results highlight the safety of justicidin B, supporting its employment in cancer therapy, and encourage the use of a C. elegans model as an appropriate tool to assess compounds’ toxicity before moving to more complex organisms.

The juniper (Taxodium mucronatum Ten. of the Cupressaceae family) is a long-lived species that forms gallery forests. Dozens of dead junipers > 100 years old have been identified in the San Pedro Mezquital watershed in Durango, Mexico. This work determines the causes of death of these specimens. The work was carried out in the field and in the laboratory, where in the former the surface of the damaged trees was identified, together with the changes observed in the watercourses. In the latter, sabino seedlings were transported to the work center and exposed for 7 days in containers with gravel to five types of wastewater generated in the region. With the above, the conditions experienced by the adult trees in the field were studied, as well as the sensitivity of the young specimens to the types of water quality, and the differences were validated with ANOVA tests. Five sites with dead junipers were found, ranging in size from 0.5 to 4 ha, with ages between 200 and 400 years. It was found that during the dry season, water is diverted to irrigated areas, leaving some areas without water for several months. The shoots survived in most of the water qualities, except the one with high salinity (3.34 mS/cm). It is concluded that the lack of water in the rivers had a stronger influence than the water quality and is the probable cause of the death of the sabino.