Higher serum levels of periostin and the risk of exacerbations in moderate asthmatics

BACKGROUND: In asthma, exacerbations and poor disease control are linked to airway allergic inflammation. Serum periostin has been proposed as a systemic biomarker of eosinophilic inflammation. This pilot study aims at evaluating whether in patients with moderate asthma, higher baseline levels of serum periostin are associated with a greater risk of exacerbation. METHODS: Fifteen outpatients with moderate allergic asthma were recruited. Serum concentrations of periostin were assessed (ELISA) at baseline, and the frequency of asthma exacerbations was recorded during a one-year follow-up. RESULTS: Patients (M/F: 10/5, mean age of 47.6\u2009\ub1\u200911.0 years) had mean ACQ score of 5.5\u2009\ub1\u20094.2 and FEV1%pred of 81.9\u2009\ub1\u200921.7 %. Baseline serum levels of periostin did not correlate with lung function parameters, nor with the ACQ score (p 650.05 for all analyses). Five subjects (33 % of the study group) reported one or more exacerbations during the following year. Baseline serum levels of periostin were significantly higher in subjects who experienced one or more exacerbations during the one year period of follow-up, compared with subjects with no exacerbations: median serum periostin level was 4047 ng/ml (range: 2231 to 4889 ng/ml) and 222 ng/ml (range 28.2 to 1631 ng/ml) respectively; p\u2009=\u20090.001. CONCLUSION: The findings of the present pilot study could form the basis for the design of larger studies aiming at developing strategies to identify asthmatic patients at risk for exacerbations

Establishing Trust in ChatGPT BioMedical Generated Text: An Ontology-Based Knowledge Graph to Validate Disease-Symptom Links

Methods: Through an innovative approach, we construct ontology-based knowledge graphs from authentic medical literature and AI-generated content. Our goal is to distinguish factual information from unverified data. We compiled two datasets: one from biomedical literature using a "human disease and symptoms" query, and another generated by ChatGPT, simulating articles. With these datasets (PubMed and ChatGPT), we curated 10 sets of 250 abstracts each, selected randomly with a specific seed. Our method focuses on utilizing disease ontology (DOID) and symptom ontology (SYMP) to build knowledge graphs, robust mathematical models that facilitate unbiased comparisons. By employing our fact-checking algorithms and network centrality metrics, we conducted GPT disease-symptoms link analysis to quantify the accuracy of factual knowledge amid noise, hypotheses, and significant findings. Results: The findings obtained from the comparison of diverse ChatGPT knowledge graphs with their PubMed counterparts revealed some interesting observations. While PubMed knowledge graphs exhibit a wealth of disease-symptom terms, it is surprising to observe that some ChatGPT graphs surpass them in the number of connections. Furthermore, some GPT graphs are demonstrating supremacy of the centrality scores, especially for the overlapping nodes. This striking contrast indicates the untapped potential of knowledge that can be derived from AI-generated content, awaiting verification. Out of all the graphs, the factual link ratio between any two graphs reached its peak at 60%. Conclusions: An intriguing insight from our findings was the striking number of links among terms in the knowledge graph generated from ChatGPT datasets, surpassing some of those in its PubMed counterpart. This early discovery has prompted further investigation using universal network metrics to unveil the new knowledge the links may hold.Comment: 7 Pages, 3 algorithms, 4 tables, and 7 figure

The clinical significance of delirium in the intensive care unit

Delirium is prevalent among intensive care unit patients. It prolongs length of stay, increases costs, and is independently associated with higher mortality rates. While its specific biological pathways are largely unknown, environmental and iatrogenic determinants have been repeatedly recognized. Removal of the known triggers and pharmacologic intervention constitute available therapies. This review focuses on the clinical significance of delirium in critically ill patients, from its prevalence to its long- term impact, the ways that we have to diagnose it, and the available therapeutic options

Experiences of patients with Poland syndrome of diagnosis and care in Italy: A pilot survey

Background: Poland Syndrome (PS) is a rare congenital malformation involving functional and aesthetic impairments. Early diagnosis and timely therapeutic approaches play an important role in improving the quality of life of patients and kindred. This study aims to explore healthcare experiences of the diagnosis of patients affected by PS and to investigate the factors associated with diagnostic delay in Italy. Results: Seventy-two patients affected by PS were asked to fill in a self-administered questionnaire on: a) diagnostic path; b) perceived quality of care received after diagnosis; c) knowledge of the rights and the socio-economic hardships related to their disease; d) evaluation of the integration of various professional skills involved in the diagnostic and therapeutic approach; e) perception of the social support provided by the Italian Association of Poland Syndrome (AISP). The average age at diagnosis was around 14 years; diagnosis was made at birth in only 31.58% of cases. Although typical symptomatology had appeared on average at an early age (4 months), only 23 patients (40.35%) received an early diagnosis (within the first year of life). Just over half of the patients (n = 30) were diagnosed in their region of origin, while 27 were diagnosed elsewhere. Furthermore, 12.28% were self-diagnoses. Among the patients who were diagnosed outside their region, 15 (88.24%) stated they had foregone some visits or treatments owing to costs and/or organizational issues. Conclusions: An analysis of the patients' experiences highlights several gaps and a lack of homogeneity in the diagnostic and therapeutic follow-up of PS patients in Italy. A specific national diagnostic and therapeutic path is essential to guarantee patients complete and appropriate health services, compliant with the ethical principles of non-discrimination, justice and empathy. Implementation of an effective information and research network and empowerment of patients' associations are necessary conditions to encourage clinical collaboration and improve the quality of life of people living with rare diseases

Surgical complications after pancreatic transplantation: A computed tomography imaging pictorial review

pancreatic transplantation should start with the evaluation of the arterial Y-graft, the venous anastomosis and the duodenojejunostomy. With regard to complications, CT allows for the identification of vascular complications, such as thrombosis or stenosis of blood vessels supplying the graft, the detection of pancreatic fluid collections, including pseudocysts, abscesses, or leaks, the assessment of bowel complications (anastomotic leaks, ileus or obstruction), and the identification of bleeding. The aim of this pictorial review is to illustrate CT findings of surgical-related complications after pancreatic transplantation. The knowledge of surgical techniques is of key importance to understand postoperative anatomic changes and imaging evaluation. Therefore, we first provide a short summary of the main techniques of pancreatic transplantation. Then, we provide a practical imaging approach to pancreatic transplantation and its complications providing tips and tricks for the prompt imaging diagnosis on CT.Pancreatic transplantation is considered by the American Diabetes Association and the European Association for the Study of Diabetes an acceptable surgical procedure in patients with type 1 diabetes also undergoing kidney transplantation in pre-final or end-stage renal disease if no contraindications are present. Pancreatic transplantation, however, is a complex surgical procedure and may lead to a range of postoperative complications that can significantly impact graft function and patient outcomes. Postoperative computed tomography (CT) is often adopted to evaluate perfusion of the transplanted pancreas, identify complications and as a guide for interventional radiology procedures. CT assessment afte

Determinants of tracheostomy decannulation: an international survey

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PLANT EXTRACTS AS GREEN POTENTIAL STRATEGIES TO CONTROL THE BIODETERIORATION OF CULTURAL HERITAGE

The biodeterioration of historic-artistic manufacts is related to several biological systems, including fungi and bacteria, whose metabolic activities and vegetative development have a direct consequence on the conservation of cultural assets. Generally, different chemical compounds are utilized as biocides in order to control biodeteriogens growth, but recently the attention has been focused on potential risks of their use towards human health (operators, visitors) and the environment. In order to develop alternative methods, various natural products have been tested, particularly to control the colonization by fungi and bacteria. In this study, antimicrobial activity of three different plant products, Tea tree essential oil, Calamintha nepeta and Allium sativum L. extracts, has been evaluated against Bacillus subtilis, Micrococcus luteus, Penicillium chrysogenum and Aspergillus spp. (previously isolated from colonized artworks) through three different in vitro antimicrobial assays (micro-dilution in microtiter plates, well plates diffusion and agar disc diffusion method). The bioassays show a different microbial susceptibility to plant extracts, establishing for each bacteria and fungi the Minimum Inhibitory Concentration (MIC) and defining the diameter of the growth inhibition area. This result supports the data reported in literature and shows an important potential suggestion for the possible use in the control of biodeterioration of cultural heritage, safe both for human health and environment