Aim: Multiple sclerosis (MS) is a chronic inflammatory pathology affecting the central nervous system. Many therapeutic options have been approved against MS until today. In this study, it was aimed ...to investigate the effect of fingolimod treatment (FT) on the liver enzyme levels of relapsing-remitting multiple sclerosis (RRMS) patients.
Material and Methods: Body mass index, FT (0.5 mg/day) duration, and liver enzyme (alanine aminotransferase, ALT; gamma glutamyl transferase, GGT) levels of 102 RRMS patients (66 female, 36 male, mean age was 40.9±10.9 years) were gathered from polyclinic records retrospectively.
Results: The FT duration of MS patients was between 0.5 and 6 years. Increased ALT and GGT levels were detected in RRMS patients after >3 month-long FT. After FT, ALT and GGT levels elevated in males almost 2 times higher than in females. It was observed that ALT and GGT levels increased by 1.3 and 1.5 times in females, while 1.6 and 1.9 times in males, respectively. Of the MS patients with increased transaminases post-FT, 7 (23.3%) males and 8 (17.4%) females were at upper limit of normal for ALT whereas 9 (34.6%) males and 14 (32.6%) females as for GGT. Age and FT duration did not affect ALT and GGT levels.
Conclusion: Overall, FT elevated ALT and GGT levels of RRMS patients. Thus, it is of high importance to monitor MS patients throughout FT. So that, we suggest tracking ALT and GGT levels during and after FT to prevent possible liver damage or the occurrence of other systemic diseases.
Amaç: Multipl skleroz (MS) merkezi sinir sistemini etkileyen kronik inflamatuvar bir patolojidir. Günümüze kadar MS’e karşı birçok tedavi seçeneği onaylanmıştır. Bu çalışmada, fingolimod tedavisinin (FT) relapsing-remitting multipl skleroz (RRMS) hastalarının karaciğer enzim düzeylerine etkisinin araştırılması amaçlanmıştır.
Gereç ve Yöntemler: Yüz iki RRMS hastasının (66 kadın, 36 erkek, ortalama yaş 40,9±10,9 yıl) vücut kitle indeksi, FT (0,5 mg/gün) süreleri ve karaciğer enzim (alanin aminotransferaz, ALT; gama glutamil transferaz, GGT) seviyeleri poliklinik kayıtlarından geriye dönük olarak incelendi.
Bulgular: MS hastalarının FT süresi 0,5 ile 6 yıl arasındaydı. Üç ay ve daha fazla FT süresi olan RRMS hastalarında ALT ve GGT seviyelerinin arttığı tespit edildi. FT sonrası, ALT ve GGT seviyeleri erkeklerde kadınlara kıyasla yaklaşık olarak 2 kat daha yüksekti. Kadınlarda ALT ve GGT seviyelerinin sırasıyla 1,3 ve 1,5 kat, erkeklerde ise bu seviyelerin 1,6 ve 1,9 kat arttığı görüldü. FT sonrası transaminaz seviyesi artan MS hastalarından 9 (%34,6) erkek ve 14 (%32,6) kadın GGT için normalin üst seviyesindeyken, 7 (%23,3) erkek ve 8 (%17,4) kadın ALT için normalin üst seviyesindeydi. Yaş ve FT süresi, ALT ve GGT seviyelerini etkilemiyordu.
Sonuç: Sonuç olarak, FT RRMS hastalarının ALT ve GGT seviyelerini yükseltmiştir. Bundan dolayı, MS hastalarının FT süresince takibi oldukça önemlidir. Bu yüzden, MS hastalarında olası karaciğer hasarı ya da diğer sistemik hastalıkların önlenmesi için FT sırasında ve sonrasında ALT ve GGT seviyelerinin takip edilmesini öneriyoruz.
The pedicled anterolateral thigh (PALT) flap is an underutilized flap for locoregional reconstruction largely because methods to maximize its reach are neither universally implemented nor fully ...understood. In addition, most of the available literature has focused on the utility of the free anterolateral thigh flap with less emphasis on the PALT flap. Moreover, flap design concepts to maximize its utility and reach and optimize outcomes have not been comprehensively described. In an effort to address this knowledge gap, the authors sought to review their institution's experience with the PALT flap for locoregional reconstruction.
Numerous HBeAg-positive chronic hepatitis B (CHB) patients with persistently normal ALT have significant liver histopathology. It is imperative to identify true "immune tolerant" patients. We aimed ...to evaluate the liver histopathology features of HBeAg-positive CHB patients with normal ALT and the incidence of liver cirrhosis and HCC in CHB patients during follow-up. 179 HBeAg-positive CHB patients with normal ALT who performed liver biopsy from 2009 to 2018 were retrospectively analyzed. Liver necroinflammation greater than or equal to G2 and/or liver fibrosis greater than or equal to S2 was defined as significant liver histopathological change. 57.5% patients were in the indeterminate phase with significant liver histological changes. The proportion of the patients with evident liver necroinflammation was higher in the high-normal ALT group (21-40U/L) when compared with the low-normal ALT group (less than or equal to 20 U/L) (51.3% vs. 30.0%, p < 0.05), and patients aged greater than or equal to 40 years had a higher proportion of significant fibrosis than those aged < 40 years (64.5% vs. 39.9%, p < 0.05). The percentages of patients with greater than or equal to S2 and greater than or equal to G2/S2 in the HBV DNA < 10.sup.7 IU/mL group were higher than those in the HBV DNA greater than or equal to 10.sup.7 IU/mL group (72.7% vs. 40.1%, p < 0.01; 81.8% vs. 54.1%, p < 0.05). During follow-up, two of immune tolerant patients and four of indeterminate patients developed into cirrhosis, and one of immune tolerant patients and one of indeterminate patients developed into HCC, respectively. HBeAg-positive CHB patients with high-normal ALT or HBV DNA < 10.sup.7 IU/mL were tend to be indeterminate. Liver biopsy or noninvasive approaches are recommended to evaluate liver histopathology, and antiviral therapy is recommended for patients with significant liver histopathology.
In the modern financial system, the ability to create money is in the hands of a few central institutions. Blockchain networks, and by extension cryptocurrencies, were created with the promise of ...giving that power to users. The most well-known example of a blockchain technology achieving such decentralization is Bitcoin, but its popularity has arguably been matched by an alternative-currency named Dogecoin. Unlike other cryptocurrencies, which have marketed themselves on differentiating technical features, Dogecoin’s allure likely stems from its cultural roots as a meme. Where cryptocurrency is typically regarded as a difficult topic to grasp, the introduction of Doge’s (2013) most popular meme, into the crypto-space increased crypto’s accessibility to new participants. Consequently, Dogecoin exists in two economies: the financial economy and the cultural meme economy, with the latter having unprecedented tangible impacts on the former. Dogecoin’s unique cultural significance provides an example of how blockchain can succeed in promoting alternative money systems. At its peak in 2021, Dogecoin achieved a market capitalization of $88 billion. Where analysis of the Dogecoin phenomenon is lacking in the current literature, we will fill that gap with a case study of Dogecoin. By studying Dogecoin as a combination of money and meme, we can further our understanding of how to better promote social finance initiatives through the virality of memes.
In this work, poly (methyl vinyl ether-alt-maleic anhydride) abbreviated as P(MVE-MA) is employed as an ecofriendly electrolyte additive for stabilizing the interface of high-voltage layered Li-rich ...oxides (LLROs) without sacrificing performance. By the addition of 1 wt.% P(MVE-MA), the capacity retention of the Li-rich oxides at 250 mA g−1 for 300 cycles in the voltage range of 2.5–4.6 V is significantly improved from 38.6% to 77.2%, and the retained specific discharge capacity is as high as 159 mAh g−1. It is also found that the voltage decay and resistance increase during cycling are both suppressed noticeably because that the addition of P(MVE-MA) suppresses electrolyte degradation. Based on various characterizations, P(MVE-MA) mainly has two functions: one is to decrease the H2O and HF contents in the electrolyte due to the hygroscopic property of anhydride; and the other is to form thin and stable polymer cathode electrolyte interphase (CEI) on LLROs because of its strong adhesive ability to the cathode. Therefore, the side reactions and structural degradation of LLROs are mitigated distinctly, improving the electrochemical performance of LLROs. Considering its effective and ecofriendly performance for high-voltage LLROs, P(MVE-MA) is believed to be positive for other high-voltage cathode materials.
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The purpose of the study is to study the influence of different vitamin-mineral supplement “Tekro” doses on biochemical parameters in blood plasma and liver of rabbits of New Zealand breed. The ...research methodology is based on research according to generally accepted research methods. Biochemical parameters were studied in rabbits’ organisms at 45, 60, 75 and 90 days of rearing with feeding of different doses of vitamin-mineral supplement “Tekro”, namely 3 %, 3.5 %, 4 %. The academic novelty is that nowadays the problem of the effect of different vitamin-mineral supplement “Tekro” doses on biochemical parameters in the blood and liver of rabbits has not been studied. Analyzing the indicators of the total protein content in the blood plasma of rabbits of the experimental groups and the control one for 90 days, it was noted that there was no significant difference in the indicators. In the liver of rabbits of the age from 45 to 90 days there was a tendency to increase the protein content due to the effects on the body of various doses of vitamin and mineral supplement “Tekro”. It has been established the positive effect of vitamin-mineral supplement “Tekro” on ALT activity of rabbits in experimental groups. At the age of 75 days, significantly higher ALT activity was recorded in rabbits of the 3rd experimental group by 35.8 % compared to animals in the control group.
Although media images typically present the alt right as a "manosphere," white women continue to participate actively in white supremacist movements. Alt right women's presence as "shield maidens," ..."fashy femmes," and "trad wives" serves to soften and normalize white supremacy, often in ironic and insidious ways. In this essay, I examine the continued investment of white women in these traditional sex/gender roles espoused by the alt right. While feminism has done much to liberate women, I conclude that the images of women as Moms circulating in mainstream politics today suggest that white supremacy and white women's complicity in it has yet to be overcome.
Objective
To evaluate the associations of preoperative De Ritis ratio (aspartate transaminase AST/alanine transaminase ALT) with postoperative clinical outcomes after surgical treatment of localized ...RCC.
Materials and Methods
We retrospectively reviewed data from 2 965 patients surgically treated for non‐metastatic RCC. Propensity scores for high AST/ALT ratio were calculated and 430 patients with a high AST/ALT ratio were matched to 1 117 patients with a low AST/ALT ratio. The association between AST/ALT ratio and postoperative outcomes was tested. Multivariate Cox analyses were performed to identify the independent predictors of progression‐free (PFS), overall (OS) and cancer‐specific survival (CSS).
Results
According to the receiver‐operating curve of AST/ALT for cancer‐specific mortality, we stratified the patients into two groups using a threshold of 1.5. Before matching, patients with a high AST/ALT ratio had worse PFS, OS and CSS (all P < 0.001). In the propensity score‐matched cohort with 1 547 patients, patients with a high AST/ALT ratio had inferior PFS, OS and CSS outcomes (all P < 0.001). Multivariate analysis showed that a high AST/ALT ratio was an independent predictor of disease progression (hazard ratio HR 1.372, 95% CI 1.003–1.882; P = 0.048), overall mortality (HR 1.559, 95% CI 1.069–2.272; P = 0.021), and cancer‐specific mortality (HR 1.974, 95% CI 1.250–3.118; P = 0.004). In a subgroup analysis according to tumour histology, high AST/ALT had a significant association with postoperative survival in clear‐cell renal cell carcinoma (RCC), but not in non‐clear‐cell RCC.
Conclusion
An elevated AST/ALT ratio was significantly associated with worse postoperative survival in patients surgically treated for localized clear‐cell RCC. Further prospective studies are needed to understand the prognostic value of preoperative AST/ALT ratio.
Exenatide, an incretin mimetic for adjunctive treatment of type 2 diabetes (T2DM), reduced hemoglobin A(1c) (A1C) and weight in clinical trials. The objective of this study was to evaluate the ...effects of > or = 3 years exenatide therapy on glycemic control, body weight, cardiometabolic markers, and safety.
Patients from three placebo-controlled trials and their open-label extensions were enrolled into one open-ended, open-label clinical trial. Patients were randomized to twice daily (BID) placebo, 5 mug exenatide, or 10 mug exenatide for 30 weeks, followed by 5 mug exenatide BID for 4 weeks, then 10 mug exenatide BID for > or = 3 years of exenatide exposure. Patients continued metformin and/or sulfonylureas.
217 patients (64% male, age 58 +/- 10 years, weight 99 +/- 18 kg, BMI 34 +/- 5 kg/m(2), A1C 8.2 +/- 1.0% mean +/- SD) completed 3 years of exenatide exposure. Reductions in A1C from baseline to week 12 (-1.1 +/- 0.1% mean +/- SEM) were sustained to 3 years (-1.0 +/- 0.1%; p < 0.0001), with 46% achieving A1C < or = 7%. Exenatide progressively reduced body weight from baseline (-5.3 +/- 0.4 kg at 3 years; p < 0.0001). Patients with elevated serum alanine aminotransferase (ALT) at baseline (n = 116) had reduced ALT (-10.4 +/- 1.5 IU/L; p < 0.0001) and 41% achieved normal ALT. Patients with elevated ALT at baseline tended to lose more weight than patients with normal ALT at baseline (-6.1 +/- 0.6 kg vs. -4.4 +/- 0.5 kg; p = 0.03), however weight change was minimally correlated with baseline ALT (r = -0.01) or ALT change (r = 0.31). Homeostasis Model Assessment B (HOMA-B), blood pressure, and aspartate aminotransferase (AST) all improved. A subset achieved 3.5 years of exenatide exposure and had serum lipids available for analysis (n = 151). Triglycerides decreased 12% (p = 0.0003), total cholesterol decreased 5% (p = 0.0007), LDL-C decreased 6% (p < 0.0001), and HDL-C increased 24% (p < 0.0001). Exenatide was generally well tolerated. The most frequent adverse event was mild-to-moderate nausea. The main limitation of this study is the open-label, uncontrolled nature of the study design which does not provide a placebo group for comparison.
Adjunctive exenatide treatment for > or = 3 years in T2DM patients resulted in sustained improvements in glycemic control, cardiovascular risk factors, and hepatic biomarkers, coupled with progressive weight reduction.
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