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Med. Sci., Volume 8, Issue 2 (June 2020) – 6 articles

Cover Story (view full-size image): Cardiac remodeling requires the ability of cardiomyocytes to adapt to an alterations in three-dimensional structure of the heart. This complex scenario can be studied ex vivo by challenging isolated ventricular cardiomyocytes to adapt to a two-dimensional cell culture dish. Using this approach, it was shown that growth factors can induce the expression of proteasome subunit low molecular weight protein (LMP)-2 . Obviously, this accelerates proteasomal degradation of sarcomere proteins, allowing the cells to rearrange their sarcomeres as required for adaptation to altered environments. Without this induction, cells are unable to de-arrange their existing sarcomeres and subsequently unable to rebuild new sarcomeres as required for successful survival.

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9 pages, 753 KiB

Open AccessArticle

Osteopathic Manipulative Treatment in Neonatal Intensive Care Units

by Luca Cicchitti, Alessandra Di Lelio, Gina Barlafante, Vincenzo Cozzolino, Susanna Di Valerio, Paola Fusilli, Giuseppe Lucisano, Cinzia Renzetti, Marco Verzella and Maria Chiara Rossi

Med. Sci. 2020, 8(2), 24; https://doi.org/10.3390/medsci8020024 - 24 Jun 2020

Cited by 5 | Viewed by 8441

Abstract

The aim of this study was to assess the impact of osteopathic manipulative treatment (OMT) on newborn babies admitted at a neonatal intensive care unit (NICU). This was an observational, longitudinal, retrospective study. All consecutive admitted babies were analyzed by treatment (OMT vs. usual care). Treatment group was randomly assigned. Between-group differences in weekly weight change and length of stay (LOS) were evaluated in the overall and preterm populations. Among 1249 babies (48.9% preterm) recorded, 652 received usual care and 597 received OMT. Weight increase was more marked in the OMT group than in the control group (weekly change: +83 g vs. +35 g; p < 0.001). Similar trends were found in the subgroup of preterm babies. A shorter LOS was found in the OMT group vs. the usual care group both in overall population (average mean difference: −7.9 days, p = 0.15) and in preterm babies (−12.3 days; p = 0.04). In severe preterm babies, mean LOS was more than halved as compared to the control group. OMT was associated with a more marked weekly weight increase and, especially in preterm babies, to a relevant LOS reduction: OMT may represent an efficient support to usual care in newborn babies admitted at a NICU. Full article

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10 pages, 239 KiB

Open AccessArticle

An Exploratory Study of Quality of Life and Its Relationship with Academic Performance among Students in Medical and other Health Professions

by Vijay Kumar Chattu, Pradeep Kumar Sahu, Neela Seedial, Gerlisa Seecharan, Amanda Seepersad, Melina Seunarine, Shivanna Sieunarine, Kahamaron Seymour, Samantha Simboo and Arissa Singh

Med. Sci. 2020, 8(2), 23; https://doi.org/10.3390/medsci8020023 - 9 Jun 2020

Cited by 16 | Viewed by 4745

Abstract

Quality of life (QOL) is a broader concept which represents experiences, states, appraisals, behaviors, capacities and emotional reactions to circumstances. The study aimed to evaluate the differences in various domains of QOL among the students of five schools (medicine, dentistry, veterinary medicine, pharmacy and nursing) and an optometry unit in the Faculty of Medical Sciences, Trinidad and Tobago. Further, the study evaluated the factors (sociodemographic variables and academic performance) predictive of physical, psychological, social and environment domains of quality of life. The research tool consisted of a validated questionnaire which had two sections; (1) sociodemographics inclusive of students’ cumulative grade point average and (2) the shorter version of WHO quality of life (WHOQOL-BREF). The data were transformed into a linear scale and exported into the IBM SPSS version 24 where t-tests, one-way ANOVA and stepwise regression were performed. Of the total 535 participants, most 383 (71.6%) were females. While comparing the differences in the domains of QOL that existed based on the schools (professions) they were enrolled, significant differences were recorded for physical (p < 0.05), psychological (p < 0.05) social (p < 0.05) and environmental domains (p < 0.05). Though the domains of physical health, psychological health and environment showed a significant association with the academic performance of students, the social domain had no such relationship. The overall quality of life has a positive connection with the academic performance of students in medical and health professions. Therefore, universities and all stakeholders involved in health professions need to play a critical role to ensure the students in health professions maintain a high QOL. At the same time, there is a great need for extra attention for students who showed poor academic performance in the previous semester to bring them on track. Full article

9 pages, 1157 KiB

Open AccessArticle

Serum Chloride Levels at Hospital Discharge and One-Year Mortality among Hospitalized Patients

by Tananchai Petnak, Charat Thongprayoon, Wisit Cheungpasitporn, Tarun Bathini, Saraschandra Vallabhajosyula, Api Chewcharat and Kianoush Kashani

Med. Sci. 2020, 8(2), 22; https://doi.org/10.3390/medsci8020022 - 19 May 2020

Cited by 7 | Viewed by 3593

Abstract

This study aimed to assess the one-year mortality risk based on discharge serum chloride among the hospital survivors. We analyzed a cohort of adult hospital survivors at a tertiary referral hospital from 2011 through 2013. We categorized discharge serum chloride; ≤96, 97–99, 100–102, 103–105, 106–108, and ≥109 mmoL/L. We performed Cox proportional hazard analysis to assess the association of discharge serum chloride with one-year mortality after hospital discharge, using discharge serum chloride of 103–105 mmoL/L as the reference group. Of 56,907 eligible patients, 9%, 14%, 26%, 28%, 16%, and 7% of patients had discharge serum chloride of ≤96, 97–99, 100–102, 103–105, 106–108, and ≥109 mmoL/L, respectively. We observed a U-shaped association of discharge serum chloride with one-year mortality, with nadir mortality associated with discharge serum chloride of 103–105 mmoL/L. When adjusting for potential confounders, including discharge serum sodium, discharge serum bicarbonate, and admission serum chloride, one-year mortality was significantly higher in both discharge serum chloride ≤99 hazard ratio (HR): 1.45 and 1.94 for discharge serum chloride of 97–99 and ≤96 mmoL/L, respectively; p < 0.001) and ≥109 mmoL/L (HR: 1.41; p < 0.001), compared with discharge serum chloride of 103–105 mmoL/L. The mortality risk did not differ when discharge serum chloride ranged from 100 to 108 mmoL/L. Of note, there was a significant interaction between admission and discharge serum chloride on one-year mortality. Serum chloride at hospital discharge in the optimal range of 100–108 mmoL/L predicted the favorable survival outcome. Both hypochloremia and hyperchloremia at discharge were associated with increased risk of one-year mortality, independent of admission serum chloride, discharge serum sodium, and serum bicarbonate. Full article

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15 pages, 1715 KiB

Open AccessArticle

Induction of Proteasome Subunit Low Molecular Weight Protein (LMP)-2 Is Required to Induce Active Remodeling in Adult Rat Ventricular Cardiomyocytes

by Antonia Petersen, Hanna Sarah Kutsche, Franziska Nippert, Rolf Schreckenberg, Rainer Schulz and Klaus-Dieter Schlüter

Med. Sci. 2020, 8(2), 21; https://doi.org/10.3390/medsci8020021 - 1 May 2020

Cited by 4 | Viewed by 2790

Abstract

Isolated adult rat ventricular cardiomyocytes (ARVC) adapt to the two-dimensional surface of culture dishes once they are isolated from the three-dimensional heart tissue. This process mimics aspects of cardiac adaptation to pressure overload and requires an initial breakdown of sarcomeric structures. The present study therefore aimed to identify key steps in this remodeling process. ARVC were cultured under serum-free or serum-supplemented conditions and their sizes and shapes were analyzed as well as apoptosis and the ability to disintegrate their sarcomeres. ARVC require serum-factors in order to adapt to cell culture conditions. More ARVC survived if they were able to breakdown their sarcomeres and mononucleated ARVC, which were smaller than binucleated ARVC, had a better chance to adapt. During the early phase of adaptation, proteasome subunit low molecular weight protein (LMP)-2 was induced. Inhibition of LMP-2 up-regulation by siRNA attenuated the process of successful adaptation. In vivo, LMP-2 was induced in the left ventricle of spontaneously hypertensive rats during the early phase of adaptation to pressure overload. In conclusion, the data suggest that breakdown of pre-existing sarcomeres is optimized by induction of LMP-2 and that it is required for cardiac remodeling processes, for example, occurring during pressure overload. Full article

(This article belongs to the Special Issue Feature Papers in Medical Sciences)

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9 pages, 729 KiB

Open AccessArticle

Advances and Challenges in European Paediatric Palliative Care

by Lorna K Fraser, Myra Bluebond-Langner and Julie Ling

Med. Sci. 2020, 8(2), 20; https://doi.org/10.3390/medsci8020020 - 17 Apr 2020

Cited by 27 | Viewed by 5388

Abstract

Advances in both public health and medical interventions have resulted in a reduction in childhood mortality worldwide over the last few decades; however, children still have life-threatening conditions that require palliative care. Children’s palliative care is a specialty that differs from palliative care for adults in many ways. This paper discusses some of the challenges, and some of the recent advances in paediatric palliative care. Developing responsive services requires good epidemiological data, as well as a clarity on services currently available and a robust definition of the group of children who would benefit from palliative care. Once a child is diagnosed with a life-limiting condition or life-limiting illness, parents face a number of complex and difficult decisions; not only about care and treatment, but also about the place of care and ultimately, place of death. The best way to address the needs of children requiring palliative care and their families is complex and requires further research and the routine collection of high-quality data. Although research in children’s palliative care has dramatically increased, there is still a dearth of evidence on key components of palliative care notably decision making, communication and pain and symptom management specifically as it relates to children. This evidence is required in order to ensure that the care that these children and their families require is delivered. Full article

(This article belongs to the Special Issue Current Advances in Palliative and Hospice Care)

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8 pages, 1480 KiB

Open AccessArticle

Atmospheric Pollution and Thyroid Function of Pregnant Women in Athens, Greece: A Pilot Study

by Ioannis Ilias, Ioannis Kakoulidis, Stefanos Togias, Stefanos Stergiotis, Aikaterini Michou, Anastasia Lekkou, Vasiliki Mastrodimou, Athina Pappa, Evangelia Venaki and Eftychia Koukkou

Med. Sci. 2020, 8(2), 19; https://doi.org/10.3390/medsci8020019 - 4 Apr 2020

Cited by 13 | Viewed by 3126

Abstract

Exposure to air pollution and, in particular, to nitrogen dioxide (NO₂) or particulate pollutants less than 2.5 μm (PM2.5) or 10 μm (PM10) in diameter has been linked to thyroid (dys)function in pregnant women. We hypothesized that there may be a dose—effect relationship between air pollutants and thyroid function parameters. We retrospectively evaluated thyrotropin (TSH) in 293 women, NO₂, PM2.5 and PM10 levels in Athens. All the women were diagnosed with hypothyroidism for the first time during their pregnancy. Exposure to air pollution for each woman was considered according to her place of residence. Statistical analysis of age, pregnancy weight change, and air pollutants versus TSH was performed with ordinary least squares regression (OLS-R) and quantile regression (Q-R). A positive correlation for logTSH and PM2.5(r = +0.13, p = 0.02) was found, using OLS-R. Further analysis with Q-R showed that each incremental unit increase (for the 10th to the 90th response quantile) in PM2.5 increased logTSH(±SE) between +0.029 (0.001) to +0.025 (0.001) mIU/L (p < 0.01). The other parameters and pollutants (PM10 and NO₂) had no significant effect on TSH. Our results indeed show a dose—response relationship between PM2.5 and TSH. The mechanisms involved in the pathophysiological effects of atmospheric pollutants, in particular PM2.5, are being investigated. Full article

(This article belongs to the Section Endocrinology and Metabolic Diseases)

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