BACKGROUND AND OBJECTIVES

A mounting evidence links dysregulated immune response to cases of fatal pneumonia seen in COVID-19 infection. We aimed to validate the COVID-19-associated Hyperinflammatory Syndrome (cHIS) score, a novel clinical tool devised to identify those at risk for adverse outcomes, in a local population and investigate the relationship of cHIS score taken at admission and the risk of mortality and the need of mechanical ventilation.

METHODS

This retrospective cohort study analyzed the sociodemographic, clinical, and laboratory data of 1,881 COVID-19 patients admitted at a tertiary hospital in Davao City, Philippines from January to December 2021. We calculated the cHIS score, composed of six clinical and laboratory criteria from admission, and used multivariate logistic regression to determine the risk of mortality and need of mechanical ventilation.

RESULTS

The cHIS score taken at admission, regardless of cut-off value, was a significant predictor of mortality (OR 0.979 [99% CI 0.894-1.064]) and need of mechanical ventilation (OR 0.586 [99% CI 0.4975-0.6745]). Using the Youden Index, a cut-off cHIS score of 3 or more was a better predictor of mortality (sensitivity, 88.59%; specificity, 71.72%), and a cut-off score of 2 or more was a better predictor of need of mechanical ventilation (sensitivity, 84.02%; specificity, 70.82%) than other cutoff cHIS scores.

CONCLUSION

Among COVID-19 patients, the cHIS score at admission correlated with the risk of mortality and the need of mechanical ventilation. Cutoff scores of 3 and 2 had the optimal sensitivities and specificities to predict the risk of mortality and the need of mechanical ventilation, respectively.

Human ; Covid-19 ; Inflammation ; Mortality ; Mechanical Ventilation ; Respiration, Artificial ; Cytokine Storm ; Cytokine Release Syndrome

Cardioembolic stroke is a special type of ischemic stroke caused by cardiac diseases， and its development is closely associated with the structural and functional abnormalities of the heart. The pathophysiological mechanisms of this type of stroke are complex. It is often induced by thrombosis due to cardiac diseases， followed by thrombus detachment and entry into cerebral vessels， leading to ischemic injury and subsequent cascade reactions. Inflammatory response plays a crucial role in the development and progression of cardioembolic stroke， being involved in processes ranging from thrombosis to acute-phase brain injury after embolism， short-term neurological recovery， and long-term prognosis prediction， and can also be used as a biomarker and diagnostic factor. This article summarizes the mechanism by which inflammation contributes to the development and progression of cardioembolic stroke， as well as the current research advances in the etiology of cardioembolic stroke， the recovery of neurological function after stroke， and personalized treatment strategies.
Inflammation

INTRODUCTION

Neonatal sepsis is a significant cause of morbidity and mortality, particularly among preterm infants, and remains a pressing global health concern. Early-onset neonatal sepsis is particularly challenging to diagnose due to its nonspecific clinical presentation, necessitating effective and timely diagnostic tools to reduce adverse outcomes. Traditional methods, such as microbial cultures, are slow and often unavailable in resource-limited settings. This study aimed to develop a robust multivariable risk prediction model tailored to improve early detection of Early Onset Sepsis (EOS) among preterm infants in the Philippines.

METHODS

We conducted a retrospective analysis at a tertiary hospital in the Philippines using data from 1,354 preterm infants admitted between January 2019 and June 2024. Logistic regression models were employed, and predictors were selected through reverse stepwise elimination. Two scoring methods were developed: one based on beta coefficients divided by standard errors and another standardized to a total score of 100. The models were validated using Receiver Operator Characteristic curve analysis.

RESULTS

Version 1 of the scoring model demonstrated an Area Under the Curve (AUC) of 0.991, with a sensitivity of 90.91% and a specificity of 98.10%. Version 2 achieved an AUC of 0.999, with a sensitivity of 96.4% and a specificity of 92.44%.

CONCLUSIONS

The developed models provide a reliable, region specific tool for early detection of neonatal sepsis. Further validation across diverse populations and the integration of emerging diagnostic technologies, such as biomarkers and artificial intelligence, are warranted to enhance their applicability and accuracy.

Human ; Bacteria ; Infant: 1-23 Months ; Neonatal Sepsis ; Logistic Models ; Infant, Premature ; Philippines

Depression is an affective disorder caused by multiple factors,and its pathogenesis is still unclear.However,in recent years,studies have found an association between neuroinflammation and depression,which is mainly reflected in the interaction of their pathogeneses,such as abnormalities of monoamine neurotransmitters in the brain,dysregulation of the hypothalamic-pituitary-adrenal axis,and dysfunction of neurogenesis.Currently,exercise as a therapy for depression has attracted widespread attention.By reviewing relevant research reports,this article summarizes that exercise alleviates neuroinflammation by playing an anti-inflammatory role,thus improving the mood-related pathway to treat depression.Furthermore,this article explores the effects of different exercise prescriptions on the anti-inflammatory role of exercise,aiming to provide new scientific ideas for the treatment of depression associated with neuroinflammation.
Humans ; Depression/therapy* ; Neuroinflammatory Diseases/therapy* ; Exercise ; Inflammation ; Exercise Therapy ; Animals

Objective To investigate the correlations of circulating miRNA-205 expression with systemic immune-inflammation index(SII)and systemic inflammation response index(SIRI)in patients with severe obstructive sleep apnea(OSA). Methods The patients who attended the Hypertension Center of the People's Hospital of Xinjiang Uygur Autonomous Region from January to June 2023 and underwent complete overnight polysomnography were consecutively included in this study.Among them,30 patients had severe OSA,and 32 patients did not have OSA.Blood routine tests(white blood cells,neutrophils,monocytes,platelets,etc.)were performed and the expression of miRNA-205 was determined by quantitative reverse transcription PCR.Simple regression was adopted to analyze the correlations among miRNA-205,SII,SIRI,and OSA parameters.The potential regulatory effects of miRNA-205 on OSA and inflammation indices were further evaluated. Results The patients with severe OSA showed lower expression of circulating miRNA-205[1.910(1.240,2.403)vs.3.650(2.148,5.109),z=-3.874,P<0.001]and higher SIRI[1.090(0.775,1.573)vs.0.870(0.650,1.240),z=-2.031,P=0.041]and SII[555.200(451.780,936.350)vs.448.685(380.823,646.073),z=-2.029,P=0.042]than non-OSA patients.In the whole population,apnea-hypopnea index(AHI)showed a negative correlation with circulating miRNA-205(r=-0.391,P=0.002).Among severe OSA patients,each 1-unit increase in AHI was associated with a reduction of 0.030 in miRNA-205 and increases of 10.046 and 0.037 in SII and SIRI,respectively(SII:P=0.003;SIRI:P=0.037).Conversely,each 1-unit rise in miRNA-205 predicted a decrease of 121.093 in SII(β=-0.40,P=0.046).The low expression of miRNA-205 might have a negative moderating effect on elevated SII(β=-0.40,P=0.004). Conclusions Compared with the patients without OSA,those with severe OSA showed elevated SII and SIRI and down-regulated expression of miRNA-205.The low expression of miRNA-205 might have a negative moderating effect on the systemic inflammatory state associated with severe OSA.
Humans ; Sleep Apnea, Obstructive/blood* ; MicroRNAs/blood* ; Inflammation/blood* ; Male ; Polysomnography ; Middle Aged ; Female ; Adult

Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection,with a high mortality rate.Sirtuin 3,a deacetylase within mitochondria,plays an important regulatory role in cellular metabolism,oxidative stress,and inflammatory responses.In recent years,significant progress has been made in the study of the function and regulatory role of sirtuin 3 in sepsis-related diseases.Research has shown that sirtuin 3 can alleviate organ damage caused by sepsis by regulating mitochondrial function,reducing oxidative stress,and inhibiting inflammatory responses.The specific mechanisms include the regulation of mitochondrial bioenergetics,activation of antioxidant enzyme systems,and inhibition of inflammatory mediator expression.In addition,sirtuin 3 plays a protective role in the pathological process of sepsis by interacting with multiple signaling pathways.This article summarizes the functions and regulatory mechanisms of sirtuin 3 in various sepsis-related diseases,aiming to provide new targets and strategies for the prevention and treatment of sepsis in the future.
Sepsis/metabolism* ; Sirtuin 3/physiology* ; Humans ; Animals ; Oxidative Stress ; Mitochondria/metabolism* ; Signal Transduction

Lichen planus (LP) is a chronic, immune-mediated dermatosis, clinically characterized by the classic “5 P’s”: pruritic, purplish, polygonal, planar papules, and plaques. While typically LP is idiopathic, the Koebner phenomenon may trigger LP by trauma, infections, medications, or foreign substances such as, in this case, tattoo pigments. A 27-year-old Filipino male presented with a 10-month history of intensely pruritic papules and plaques involving both tattooed and adjacent nontattooed regions of the forearms. Lesions initially appeared as papules along the tattoo margins approximately 1 year after tattoo placement and subsequently, spreading to form confluent plaques. Despite multiple courses of high-potency topical corticosteroids, symptoms persisted with progressive lesion thickening. Dermoscopy was performed, but the findings did not conclusively indicate LP; therefore, a biopsy was done to confirm LP. Owing to the extent of involvement and lack of steroid response, the therapy was transitioned to tacrolimus 0.1% ointment applied twice daily. The patient experienced a marked reduction in pruritus, flattening of papules, residual postinflammatory erythema, and no reported adverse effects within 2 weeks. This case highlights the therapeutic potential of topical calcineurin inhibitors in managing LP, particularly in cases where there is resistance to corticosteroids. Tacrolimus 0.1% ointment may present a safe and effective alternative for disseminated or steroid-refractory LP, warranting consideration in clinical practice.

Human ; Male ; Adult: 25-44 Yrs Old ; Adrenal Cortex Hormones ; Inflammation ; Lichen Planus ; Tacrolimus ; Treatment ; Tattoo

OBJECTIVES

Gestational diabetes mellitus (GDM), a pregnancy-induced hyperglycemia, affects approximately 17% of pregnancies globally. Its pathophysiology remains unclear, with inflammation and vascular remodeling playing key roles. CD248, a glycoprotein linked to inflammation and vascular remodeling, has been implicated in various conditions, but its role in GDM is uncertain.

METHODOLOGY

A prospective case-control study was conducted with 169 pregnant women aged 18 to 49 at a tertiary hospital. Serum CD248 levels were assessed at 24 to 28 weeks of gestation prior to the oral glucose tolerance test (OGTT). Statistical analyses evaluated the association between CD248 levels, BMI and GDM status.

RESULTS

Of the participants, 32 (18.9%) were diagnosed with GDM. CD248 levels were lower in GDM patients (8.15 ± 10.16 ng/mL) than in controls (11.42 ± 15.44 ng/mL), but the difference was not statistically significant (p = 0.084). Although CD248 levels did not correlate with OGTT values, it was positively associated with BMI (pCONCLUSION

Unlike earlier findings associating elevated CD248 levels with early pregnancy GDM risk, this study found no significant relationship during later gestational stages. These results highlight a potentially complex and context-dependent role for CD248 in GDM pathophysiology.

Human ; Diabetes, Gestational ; Inflammation ; Glucose Tolerance Test

BACKGROUND

Endometriosis is an inflammation-dependent condition characterized by the uncontrolled development of lesions resembling the endometrium. For the host tissue to maintain homeostasis throughout the active process of inflammation resolution, endogenous factors must be activated.

OBJECTIVE

To determine if using specialized pro-resolving mediators (SPM) to treat endometriosis patients’ persistent pelvic pain is safe and effective.

METHODS

A systematic review was performed to determine studies that determined the effect of Specialized Pro-resolving Mediators (SPM) on endometriosis control. A descriptive narrative approach was applied to synthesize the findings of this systematic review.

RESULTS

Three prospective case-control studies and three in vitro studies were included. All studies involved Lipoxin A4 as the specialized pro-resolving mediator assessed for benefit on endometriosis control. All studies consistently reported that SPM can be potentially effective in treating endometriosis. The search terms used were: “Specialized Pro-resolving Mediators,” “SPM,” “Chronic inflammatory agent,” pelvic pain, and endometriosis.

CONCLUSION

Despite the lack of trials on the use of Specialized Pro-resolving Mediators to manage chronic pelvic pain, case-control and in vitro studies are consistent in detailing the potential benefits of SPM for endometriosis control. Given the concrete pathophysiologic basis for the mechanism of action for SPM, it is highly recommended that future trials be made to determine its efficacy and safety.

Human ; Endometriosis ; Inflammation ; Specialized Pro-resolving Mediators

Aims or objective: To determine the prevalence of neurodevelopmental disorder (NDD) comorbidities and their association with the clinical profile of children with focal epilepsy treated at the Philippine Children’s Medical Center from 2023 to 2024.

Materials and Method: This cross-sectional analytical study was conducted from June 10, 2023 to June 1, 2024 at the Philippine Children's Medical Center. Detailed information was obtained for each case according to protocol. A complete history was taken from the accompanying caretakers. Children aged 0 to 7 years and 11 months, recently diagnosed with focal epilepsy, were evaluated using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5-TR) criteria. The level of early child development was determined based on the total Battelle Developmental Inventory-2 developmental quotient score.

Results: The study examined 246 children with focal epilepsy. Significant findings included those children with NDD had a higher median age (4.67 years) compared to those without NDD (3.37 years) (p < .001). A higher proportion of non-NDD children were under one year old. Children without NDD had mothers with higher educational attainment (p = .015) and came from families with higher incomes (p = .003). Neonatal complications such as hypoxic-ischemic encephalopathy (HIE) and sepsis were more common in children with NDD (p = .005 and p = .006). Phenobarbital use was more frequent in children with NDD (p = .001), who also had more abnormal EEG and neuroimaging findings (p < .001). Neurodevelopmental evaluations were conducted later for children with NDD (p < .001). A significant number (75.20%) of children exhibited neurodevelopmental problems, with global developmental delay being most prevalent. Crude analysis showed associations between age, number of antiseizure medications, and delays in evaluation with increased odds of NDD.

Conclusion: The study offers insights into children with focal epilepsy at a tertiary hospital in the Philippines, emphasizing the impact of low socioeconomic status, age, birth complications and multiple anti-seizure medications. These findings are vital for clinicians to modify care plans through a multidisciplinary approach to enhance outcomes and improve quality of life in this high-risk population.

Human ; Male ; Female ; Infant Newborn: First 28 Days After Birth ; Infant: 1-23 Months ; Child Preschool: 2-5 Yrs Old ; Child: 6-12 Yrs Old ; Neurodevelopmental Disorders ; Sepsis ; Hypoxia-ischemia, Brain ; Epilepsies, Partial ; Educational Status ; Diagnostic And Statistical Manual Of Mental Disorders ; Child Development