Annals of medicine
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Osteoarthritis (OA) is the most common condition affecting human joints. Along with mechanical and genetic factors, low-grade inflammation is increasingly supported as a causal factor in the development of OA. Gut microbiota and intestinal permeability, via the disruption of tight junction competency, are proposed to explain a gut-joint axis through the interaction with the host immune system. ⋯ KEY MESSAGESPrevious studies and methods have underestimated the impact of the gut-joint axis in osteoarthritis and have focussed on the characterisation of microbiota phenotypes rather than clear molecular mediators of disease. Gut dysbiosis is related to higher levels of bacterial toxins that elicit cartilage and synovium inflammatory pathways. Future research may benefit from focussing on both tight junctions and bacterially-produced products.
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Ursolic acid (UA) is a potent plant-based hepatoprotective agent having poor bioavailability, which hampers its therapeutic efficacy. The present study tries to overcome this limitation by combining it with piperine (PIP), a proven bioenhancer and hepatoprotective agent. ⋯ The findings indicated that the combination of PIP and UA is an effective strategy in enhancing the bioavailability and hepatoprotective potential of UA.KEY MESSAGESUrsolic acid in a combination with piperine provides a synergistic hepatoprotective effect in carbon tetrachloride induced liver damage in rats.Piperine improves the pharmacokinetic properties of ursolic acid when given in combination.Piperine improves the relative oral bioavailability of ursolic acid by tenfold when combined together.
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This study was designed to explore the expression and the diagnostic value of vascular endothelial growth factor (VEGF) and soluble fms-like tyrosine kinase-1 (sFlt-1) in pernicious placenta previa (PPP) combined placental accreta/increta. A total of 140 PPP patients were enrolled and divided into two groups: 56 patients with placenta accreta/increta (PA group), and 84 patients without placenta accreta/increta (non-PA group). In the same period, 46 pregnant women without PPP who had undergone caesarean section were selected as controls. ⋯ KEY POINTSThe levels of VEGF and sFlt-1 could be used to distinguish placenta accreta from placenta increta. VEGF is negatively correlated with sFlt-1 in PPP patients. The levels of VEGF and sFlt-1 could be used as auxiliary indicators to diagnose PPP and distinguish between placenta accreta and increta.
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An unexpected high prevalence of enterococcal bloodstream infection (BSI) has been observed in critically ill patients with COVID-19 in the intensive care unit (ICU). ⋯ The cumulative incidence of enterococcal BSI is high in critically ill patients with COVID-19. Our results suggest a crucial role of the severity of the acute clinical conditions, to which both the underlying viral pneumonia and the enterococcal BSI may contribute, in majorly influencing the outcome.KEY MESSAGESThe cumulative incidence of enterococcal BSI is high in critically ill patients with COVID-19.The crude 30-day mortality of enterococcal BSI in critically ill patients with COVID-19 may be higher than 40%.There could be a crucial role of the severity of the acute clinical conditions, to which both the underlying viral pneumonia and the enterococcal BSI may contribute, in majorly influencing the outcome.
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This paper uses a SEIR(D) model to analyse the time-varying transmission dynamics of the COVID-19 epidemic in Korea throughout its multiple stages of development. This multi-stage estimation of the model parameters offers a better model fit compared to the whole period analysis and shows how the COVID-19's infection patterns change over time, primarily depending on the effectiveness of the public health authority's non-pharmaceutical interventions (NPIs). ⋯ The original SIR compartment model may produce a poor and even misleading estimation result if it is used to cover the entire period of the epidemic. However, if we use the model carefully in distinctive stages of the COVID-19 epidemic, we can find useful insights into the nature of the transmission of the novel coronavirus and the relative effectiveness of the government's non-pharmaceutical interventions over time.Key messagesIdentifies three distinctive waves of the COVID-19 epidemic in Korea.Conducts multi-stage estimations of the COVID-19 transmission dynamics using SEIR(D) epidemic models.The transmission dynamics of the COVID-19 vary over time, primarily depending on the relative effectiveness of the government's non-pharmaceutical interventions (NPIs).The SEIR(D) epidemic model is useful and informative, but only when it is used carefully to account for the presence of multiple waves and context-dependent infection patterns in each wave.