The inseparable relationship between constipation and blood pressure
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Blood pressure elevations post-lenvatinib treatment in hepatocellular carcinoma: a potential marker for better prognosis
Lenvatinib is a tyrosine kinase inhibitor that effectively inhibits vascular endothelial growth factor signaling and is used for treating hepatocellular carcinoma. However, angiogenesis inhibitors often cause hypertension. Although lenvatinib-induced hypertension has been proposed as a potential surrogate marker for better prognosis, studies on blood pressure elevations and outcomes following lenvatinib initiation are limited. This study included 67 patients who underwent lenvatinib therapy at the Department of Gastroenterology, Kagoshima University Hospital, between May 2018 and December 2023. The median age of the cohort was 71 years, and 82.1% of the patients were male. The median blood pressure at admission was 128/73 mmHg, which significantly increased to 136/76 mmHg the day after lenvatinib administration. Grade 3 hypertension (≥160/100 mmHg) occurred in 37.3% of patients during hospitalization. The median increase in systolic blood pressure from admission to its peak during hospitalization was 26 mmHg. Patients who experienced an increase in blood pressure of ≥26 mmHg were classified into the blood pressure elevation group, which showed a significantly lower mortality rate than that of the blood pressure non-elevation group (35.3% vs. 81.8%, log-rank p = 0.007), even after adjusting for age, sex, disease stage, performance status, and liver reserve function. This study demonstrated that patients who experienced earlier blood pressure elevation after lenvatinib administration had lower overall mortality rates. These findings suggest that blood pressure elevations after lenvatinib initiation may serve as valuable prognostic indicators in patients with cancer undergoing lenvatinib therapy.
Distinct age-related characteristics in patients with irritable bowel syndrome: patient reported outcomes and measures of gut physiology
Irritable bowel syndrome (IBS) is common among all ages, but the associations between symptoms, gut physiology, and ageing are poorly understood. We aimed to characterize patients of different age by comparing symptom reports and gut physiology measures. This retrospective cohort study included IBS patients that completed questionnaires (severity of (non-) gastrointestinal and psychological symptoms, quality of life) and gut physiology testing (transit time, rectal sensitivity, anorectal manometry, small bowel permeability). We included 1677 IBS patients (females 74%, mean age 39 ± 14 years). Younger age was associated with more severe symptoms and worse quality of life. Ageing affects the physiologic state of the gut; older patients have slower gut transit and have an altered anorectal function. Exploratory analyses suggest that age-related changes in gut sensorimotor function could partially explain the severity of specific gastrointestinal symptoms. Our results underline that age should be taken into consideration in the management of IBS.
Bicomponent nano- and microfiber aerogels for effective management of junctional hemorrhage
Managing junctional hemorrhage is challenging due to ineffective existing techniques, with the groin being the most common site, accounting for approximately 19.2% of potentially survivable field deaths. Here, we report a bicomponent nano- and microfiber aerogel (NMA) for injection into deep, narrow junctional wounds to effectively halt bleeding. The aerogel comprises intertwined poly(lactic acid) nanofibers and poly(ε-caprolactone) microfibers, with mechanical properties tunable through crosslinking. Optimized aerogels demonstrate improved resilience, toughness, and elasticity, enabling rapid re-expansion upon blood contact. They demonstrate superior blood absorption and clotting efficacy compared to commercial products (i.e., QuikClot® Combat Gauze and XStat®). Most importantly, in a lethal swine junctional wound model (Yorkshire swine, both male and female, n = 5), aerogel treatment achieved immediate hemostasis, a 100% survival rate, no rebleeding, hemodynamic stability, and stable coagulation, hematologic, and arterial blood gas testing.
Blood pressure management to prevent recurrent stroke: current evidence and perspectives
Hypertension is the leading risk factor for stroke, causing about 60% of cases. Effective blood pressure control is vital for preventing recurrent ischemic strokes, with studies showing mixed results. Intensive control reduces cardiovascular events, as seen in the SPRINT, PROGRESS and STEP studies, while trials like RESPECT show no difference. Technological advances like AI and wearables enhance management, but challenges remain in achieving equitable control, especially for minorities.
Dependence of cyanobacterium growth and Mars-specific photobioreactor mass on total pressure, pN2 and pCO2
In situ resource utilization systems based on cyanobacteria could support the sustainability of crewed missions to Mars. However, their resource-efficiency will depend on the extent to which gases from the Martian atmosphere must be processed to support cyanobacterial growth. The main purpose of the present work is to help assess this extent. We therefore start with investigating the impact of changes in atmospheric conditions on the photoautotrophic, diazotrophic growth of the cyanobacterium Anabaena sp. PCC 7938. We show that lowering atmospheric pressure from 1 bar down to 80 hPa, without changing the partial pressures of metabolizable gases, does not reduce growth rates. We also provide equations, analogous to Monod’s, that describe the dependence of growth rates on the partial pressures of CO2 and N2. We then outline the relationships between atmospheric pressure and composition, the minimal mass of a photobioreactor’s outer walls (which is dependent on the inner-outer pressure difference), and growth rates. Relying on these relationships, we demonstrate that the structural mass of a photobioreactor can be decreased – without affecting cyanobacterial productivity – by reducing the inner gas pressure. We argue, however, that this reduction would be small next to the equivalent system mass of the cultivation system. A greater impact on resource-efficiency could come from the selection of atmospheric conditions which minimize gas processing requirements while adequately supporting cyanobacterial growth. The data and equations we provide can help identify these conditions.
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