BackgroundIt is unclear whether an implantable cardioverter-defibrillator (ICD) is generally beneficial in survivors of out-of-hospital cardiac arrest (OHCA).ObjectiveWe studied the association ...between ICD implantation prior to discharge and survival in patients with cardiac aetiology or initial shockable rhythm in OHCA.DesignWe conducted a retrospective cohort study in the Swedish Registry for Cardiopulmonary Resuscitation. Treatment associations were estimated using propensity scores. We used gradient boosting, Bayesian additive regression trees, neural networks, extreme gradient boosting and logistic regression to generate multiple propensity scores. We selected the model yielding maximum covariate balance to obtain weights, which were used in a Cox regression to calculate HRs for death or recurrent cardiac arrest.ParticipantsAll cases discharged alive during 2010 to 2020 with a cardiac aetiology or initial shockable rhythm were included. A total of 959 individuals were discharged with an ICD, and 2046 were discharged without one.ResultsAmong those experiencing events, 25% did so within 90 days in the ICD group, compared with 52% in the other group. All HRs favoured ICD implantation. The overall HR (95% CI) for ICD versus no ICD was 0.38 (0.26 to 0.56). The HR was 0.42 (0.28 to 0.63) in cases with initial shockable rhythm; 0.18 (0.06 to 0.58) in non-shockable rhythm; 0.32 (0.20 to 0.53) in cases with a history of coronary artery disease; 0.36 (0.22 to 0.61) in heart failure and 0.30 (0.13 to 0.69) in those with diabetes. Similar associations were noted in all subgroups.ConclusionAmong survivors of OHCA, those discharged with an ICD had approximately 60% lower risk of death or recurrent cardiac arrest. A randomised trial is warranted to study this further.
Background and purpose: Duchenne muscular dystrophy (DMD), a lethal X-linked recessive muscle dystrophy, is resulted in by different mutations including mostly frame-shifting gross deletions and ...duplications and rarely point mutations in DMD gene. Increasing weakness, progressive loss of skeletal muscle mass, and later-onset cardiomyopathy are serious clinical symptoms which ultimately lead to cardiac and respiratory failure, and premature death in DMD patients by age of 30. DMD is a prevalent genetic disorder and considers as an interesting target for gene therapy approaches. Massive gene size and existence of enormous number of muscle tissues are terrific hindrance against DMD treatments, nevertheless enormous efforts have been executed in the fields of gene replacement therapy, gene editing strategies, cell-based treatments, and small drug medications. Hot spot exons skipping and suppression of premature stop codons are the most interesting treatments for restoring functional DMD product, dystrophin protein. Clustered regularly interspaced short palindromic repeats (CRISPR)-CRISPR-associated protein (Cas) systems are the most interesting genome editing platforms that are able to restore open reading frame of DMD gene. CRISPR-Cas9 and CRISPR-Cpf1 are two main genome editing sub-types that successfully used in mdx mice.
Conclusions: This review aims to present recent progresses and future prospects over three main DMD therapeutic subgroups including gene therapy, cell therapy, and pharmacological therapy.
Background: Multiple sclerosis (MS), as an inflammatory autoimmune disease and chronic degenerative central nervous system degeneration, often occurs in early adulthood. One of the common and ...debilitating symptoms of this disease is fatigue, which can affect up to 80% of patients with MS. This study aimed to evaluate the effectiveness of magnetic field therapy on fatigue in patients with MS. Methods: Present study is a single-blind randomized clinical trial (RCT) that Was conducted on patients with multiple sclerosis from March 2019 to September 2021. In this study, 46 patients who met our inclusion criteria were divided into two groups randomly: magnetotherapy intervention and control group. The intervention was performed in the form of a pulsed magnetic field with a frequency of 15 Hz and an intensity of 4.5 Millie Tesla. In order to blind patients, they were unaware of the intervention or control group, and the technician in charge of the treatment and the statistician knew about it. Data were then collected and recorded using the Fatigue Severity Scale, the Patient Health Questionnaire, and the Epworth Sleepiness Scale Questionnaire. Results: Of the 46 patients studied, 22 (48%) were male and the rest of them were female 24 cases (52%). The mean age of men and women was 34.4±7.3 and 33.5±1.7 years, respectively. Among the intervention and control groups, 8 people took amantadine equally in each group. In the magneto-therapy intervention group, the mean severity of fatigue reduced from 4.91±0.86 to 4.27±1.10, which was significant (p=0.024). In our control group, the mean intensity of fatigue reduced from 4.83±0.83 to 4.37±0.81, which was significant statistically (p=0.028). Although, the difference between the response of the two groups to treatment was not significant (p=0.382). Conclusion: Due to the lack of significant differences in the reduction of fatigue severity, this treatment is not recommended for the treatment and management of fatigue in patients with MS.
A mild, efficient, green, and selective oxidation method of sulfides to sulfoxides or sulfones using H
2
O
2
in the presence of catalytic amounts of sulfamic acid has been developed. Various ...substituted sulfides having functional groups such as alcohol, ester, and aldehyde are successfully and selectively oxidized without affecting the sensitive functionalities in good to excellent yields at room temperature.
