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Πέμπτη 16 Φεβρουαρίου 2023

Onychomycosis associated with diabetic foot syndrome: a systematic review

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Abstract

Background

A systematic review was conducted to investigate the prevalence of onychomycosis in patients with diabetes. The association of onychomycosis with risk factors in patients with diabetic foot syndrome was also examined.

Methods

The recommendations in the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist were applied, and the included studies were assessed using the Strengthening the Reporting of Observational studies in Epidemiology (STROBE) method. Searches were conducted in October 2022 using PubMed (Medline) and Scopus for clinical studies, clinical trials, comparative studies, observational studies, and randomised clinical trials or controlled clinical trials addressing the prevalence and consequences of onychomycosis in patients with diabetes, diagnoses, or treatments. Two authors performed the study selection and data extraction, and any discrepancies between the two reviewers were resolved through discussion with a third reviewer.

Results

The systematic review included nine studies that met the inclusion criteria, and these studies enrolled 5426 patients with diabetes. Among these patients, 28.55% had onychomycosis that was mainly caused by Trichophyton rubrum. A significant association was found between the occurrence of onychomycosis and the presence of diabetic neuropathy (p=0.012) and elevated glycosylated haemoglobin values (p=0.039). There was no significant association between onychomycosis and ulceration (p=0.185). Eight studies had a grade 4 level of evidence and a grade C recommendation, and one study had a grade 1b level of evidence and a grade A recommendation.

Conclusion

The information described in the literature is insufficient and heterogeneous regarding the association of risk factors and ulceration in patients with diabetic foot compared with developing onychomycosis. There is also a need to implement onychomycosis diagnostic testing instead of relying only on a clinical diagnosis. Additional prospective, randomised, comparative studies are needed to increase the quality of studies in the literature.
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PPAR-γ activation promotes xenogenic bioroot regeneration by attenuating the xenograft induced-oxidative stress

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International Journal of Oral Science, Published online: 16 February 2023; doi:10.1038/s41368-023-00217-4

PPAR-γ activation promotes xenogenic bioroot regeneration by attenuating the xenograft induced-oxidative stress
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In vivo PIWI slicing in mouse testes deviates from rules established in vitro [LETTER TO THE EDITOR]

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Argonautes are small RNA-binding proteins, with some having small RNA-guided endonuclease (slicer) activity that cleaves target nucleic acids. One cardinal rule that is structurally defined is the inability of slicers to cleave target RNAs when nucleotide mismatches exist between the paired small RNA and the target at the cleavage site. Animal-specific PIWI clade Argonautes associate with PIWI-interacting RNAs (piRNAs) to silence transposable elements in the gonads, and this is essential for fertility. We previously demonstrated that purified endogenous mouse MIWI fails to cleave mismatched targets in vitro. Surprisingly, here we find using knock-in mouse models that target sites with cleavage-site mismatches at the 10th and 11th piRNA nucleotides are precisely sliced in vivo. This is identical to the slicing outcome in knock-in mice where targets are base-paired perfectly with the piRNA. Additionally, we find that pachytene piRNA-guided slicing in both these situations failed to initiate phased piRNA production from the specific target mRNA we studied. Instead, the two slicer cleavage fragments were retained in PIWI proteins as pre-piRNA and 17–19 nt by-product fragments. Our results indicate that PIWI slicing rules established in vitro are not respected in vivo, and that all targets of PIWI slicing are not substrates for piRNA biogenesis.
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Designing a Prolonged Method of Therapeutic Delivery to Support Rehabilitation From Ototoxic Damage in a Schwann Cell Model

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imageHypothesis The ototoxicity of gentamicin and cisplatin can be evaluated with a Schwann cell model to screen for otoprotective agents that can be encapsulated into poly (lactic-co-glycolic acid) (PLGA) microparticles for drug delivery to the inner ear. Background Aminoglycosides and cisplatin are widely prescribed but known to cause ototoxicity. There is strong evidence that compromise to Schwann cells ensheathing inner ear afferent neurons results in inner ear dysfunction mimicking drug-induced ototoxicity. There is a need for a model for ototoxic demyelination to screen medications for protective potential and to subsequently target and tune the delivery of any promising agents. Methods RT4-D6P2T rat schwannoma cells were used as a Schwann cell model to assess gentamicin and cisplatin toxicity and to screen for protective agents. Cell viability was evaluated with the MTT cell proliferation assay. N-acetylcysteine (NAC) was encapsulated into a PLGA microparticle, and its elution profile was determined. Results The estimated 50% lethal concentration dose for gentamicin was 805.6 μM, which was 46-fold higher than that for cisplatin (17.5 μM). In several trials, cells dosed with NAC and cisplatin demonstrated a 22.6% (p
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Motor Imagery EEG Decoding Based on Multi-Scale Hybrid Networks and Feature Enhancement

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Motor Imagery (MI) based on Electroencephalography (EEG), a typical Brain-Computer Interface (BCI) paradigm, can communicate with external devices according to the brain's intentions. Convolutional Neural Networks (CNN) are gradually used for EEG classification tasks and have achieved satisfactory performance. However, most CNN-based methods employ a single convolution mode and a convolution kernel size, which cannot extract multi-scale advanced temporal and spatial features efficiently. What's more, they hinder the further improvement of the classification accuracy of MI-EEG signals. This paper proposes a novel Multi-Scale Hybrid Convolutional Neural Network (MSHCNN) for MI-EEG signal decoding to improve classification performance. The two-dimensional convolution is used to extract temporal and spatial features of EEG signals and the one-dimensional convolution is used to extract advanced temporal features of EEG signals. In addition, a channel coding method is proposed to improve the expression capacity of the spatiotemporal characteristics of EEG signals. We evaluate the performance of the proposed method on the dataset collected in the laboratory and BCI competition IV 2b, 2a, and the average accuracy is at 96.87%, 85.25%, and 84.86%, respectively. Compared with other advanced methods, our proposed method achieves higher classification accuracy. Then we use the proposed method for an online experiment and design an intelligent artificial limb control system. The proposed method effectively extracts EEG signals' advanced temporal and spatial features. Additionally, we design an online recognition system, which contributes to the further development of the BCI system.
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Surface Electromyography-Based Analysis of the Lower Limb Muscle Network and Muscle Synergies at Various Gait Speeds

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Gait movement is an important activity in daily human life. The coordination of gait movement is directly affected by the cooperation and functional connectivity between muscles. However, the mechanisms of muscle operation at different gait speeds remain unclear. Therefore, this study addressed the gait speed effect on the changes in co operative modules and functional connectivity between muscles. To this end, surface electromyography (sEMG) signals were collected from eight key lower extremity muscles of twelve healthy subjects walking on a treadmill at high, middle, and low motion speeds. Nonnegative matrix factorization (NNMF) was applied to the sEMG envelope and intermuscular coherence matrix, yielding five muscle synergies. Muscle functional networks were constructed by decomposing the intermuscular coherence matrix, revealing different layers of functional muscle networks across frequencies. In addition, the coupling strength between cooperative muscles grew with gait speed. Different coordination patterns among muscles with changes in gait speed related to the neuromuscular system regulation were identified.
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Fasting Plasma Glucose Increase and Neutrophil-to-Lymphocyte Ratio as Risk Predictors of Clinical Outcome of COVID-19 Pneumonia in Type 2 Diabetes Mellitus

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Exp Clin Endocrinol Diabetes
DOI: 10.1055/a-2009-6937

Aim of the study To evaluate fasting plasma glucose (FPG) increase and neutrophil-to-lymphocyte ratio (NLR) as risk predictors of severe clinical outcome of COVID-19 pneumonia in type 2 diabetes mellitus (T2DM) hospitalised patients. Patients and methods Type 2 diabetes mellitus (T2DM) patients hospitalised between March 2020 and February 2021 were studied retrospectively. The NLR ratio at admission and FPG increase (day 7, day with maximal FPG) were evaluated in association with the clinical progression of SARS-CoV-2 infection. Results Three hundred patients (165 men, 135 women) were included in the study. The mean age was 67.17±8.65 years. Severe COVID-19 pneumonia was diagnosed in 170 patients (56.7%). Fifty-four patients (18%) were intubated and 49 (16.3%) died. Greater increase in FPG (79.5 vs. 44.5 mg/dL for day 1–7, p<0.001; and 113.5 vs. 75 mg/dL for day 1-day with maximum glucose value, p<0.001) and higher NLR at admission (10.65 vs. 6.85) were seen in patients with need of high-flow oxygen compared to those without need, and they were associated with a higher probability of intubation and death. Conclusion FPG increase and NLR could be significant risk predictors of severe COVID-19 pneumonia in T2DM hospitalised patients.
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Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany

Article in Thieme eJournals:
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Analysis of Imaging Results for Semisitting Compared with Supine Positioning in the Retrosigmoid Approach for Resection of Cerebellopontine Angle Vestibular Schwannomas

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imageObjective To compare the completeness of resection of vestibular schwannomas using three-dimensional segmented volumetric analysis of pre- and postoperative magnetic resonance imaging (MRI) of patients undergoing supine and semisitting positioning for the retrosigmoid approach. Study Design Retrospective chart review. Setting Tertiary medical center. Patients Patients with vestibular schwannomas undergoing surgical resection via the retrosigmoid approach. Intervention(s) Tumor resection via the retrosigmoid approach with different patient positioning: standard supine versus semisitting. Main Outcome Measure(s) Preoperative versus postoperative three-dimensional segmented volumetric MRI analysis of vestibular schwannomas. Results A total of 43 patients (15 supine and 28 semisitting) underwent retrosigmoid craniotomy for resection of vestibular schwannomas. For the conventional supine and semisitting positioning, mean preoperative tumor volumes were 12.65 and 8.73 cm3 (p = 0.15), respectively. Postoperative mean tumor volumes for the supine and semisitting positions were 2.09 and 0.48 cm3 (p = 0.13), respectively. There were 11 cases of postoperative sigmoid sinus thrombosis, 3 in the conventional supine group and 8 in the semisitting groups, and there were 6 cases of postoperative cerebrospinal fluid leaks, all in the semisitting group. The mean House–Brackmann scores for the supine and semisitting groups were 2.9 and 2.3, respectively. There was no statistically significant difference between groups in the rates of these or any other postoperative complications. Conclusions The semisitting position for the suboccipital retrosigmoid approach for vestibular schwannoma resection does not compromise the ability to adequately resect the tumor as seen by volumetric MRI results. Further studies are needed to establish the safety of this position compared with the traditional supine approach.
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