Journal of Clinical Research

Introduction: Glioblastoma (GBM) is characterized by recurrence (rGBM), resistance to chemotherapy and low life expectancy. The methyl grouping pathway plays a crucial role in macromolecule synthesis, gene expression control and maintenance of cellular redox balance. Under physiological conditions, the clearance pathways of homocysteine (Hcys) do not exist in the brain. This work aimed to determine circulating homocysteine levels according to the location of the tumor lesion (lobar or deep).

Material and methods: Hcys was dosed by enzymatic method in the serum of 61 patients at the time of inclusion in the Phase I/II study protocol (CONEP 9681 no: 25000.009627/2004-25). Medians were compared between the groups according to tumor location and statistical significance by effect size. Moreover, statistical significance by effect size between survival and homocysteine level and significance by effect size between survival and tumor location were calculated.

Results: Cohort included 65.6% men and 34.4% women (age 19-81 years). The mean value of Hcys was 63 times higher than the physiological maximum limit and 8 times higher than in severe hyperhomocysteinemia. Patients with tumor with deep localization had higher Hcys than rGB with lobar tumor. Patients with ≤ 585 μM survived longer than ≥ 585 μM. Patients with right hemisphere tumor localization survived longer than left hemisphere tumor localization.

Conclusions: The results confirm that Hcys may be an indicator of the highly proliferative characteristic and heterogeneity of the methyl group pathway in the different brain microenvironments in rGBM related to distinct microenvironments with marked metabolic demand.

MDR-TB is a type of tuberculosis that is resistant to at least two of the most effective first-line anti-TB medications: rifampicin and isoniazid. It occurs when the TB-causing bacteria acquire mutations that render them drug-resistant. Because it is more challenging to treat and control than drug-susceptible TB, MDR-TB is a serious global health issue. Effective patient management, the introduction of appropriate treatment, and the prevention of further transmission all depend on a diagnosis of MDR-TB that is both prompt and accurate. To identify MDR-TB strains, various diagnostic methods have been developed and implemented over time. The various diagnostic methods used to detect MDR-TB are discussed in detail in this article, along with their advantages, disadvantages, and advancements.

Sepsis is still a serious medical condition that has a big impact on healthcare systems all over the world. When the body's response to an infection spirals out of control, leading to organ dysfunction, it is a life-threatening condition. In order to receive prompt and specialized care, patients with severe sepsis must be admitted to the Intensive Care Unit (ICU). In order to improve patient outcomes and optimize treatment strategies, it is essential to comprehend the clinical manifestations and outcomes of sepsis patients in the intensive care unit. It's a medical emergency that needs to be attended to right away. Everyone from young children to older adults can get sepsis. The immune system responds in an abnormally fast and irregular manner. The body experiences widespread inflammation as a result of this overactive immune response, which can damage organs and tissues. If not treated, the inflammation can cause organ failure, septic shock, and death. It can also disrupt normal organ function.

One of the most devastating challenges facing global health today is HIV/AIDS. However, significant advancements have been made in recent years, particularly in the areas of prompt treatment and early diagnosis. It is impossible to overstate the significance of these interventions, which have the ability to significantly alter HIV patients' prospects. The life-altering advantages of early diagnosis and timely treatment for HIV-positive patients are examined in this article, which sheds light on their impact on prognosis. It is impossible to overstate the transformative power of timely diagnosis and treatment on HIV-positive patients' prognoses. These interventions have the potential to end the transmission cycle, improve quality of life, and extend life expectancy.

The world has been grappling with the COVID-19 pandemic for over two years, and the development of effective vaccines has been a crucial step towards controlling the spread of the virus. Among the many vaccines developed, a novel COVID-19 vaccine has emerged as a potential gamechanger in the fight against the virus. In this article, we delve into the findings from a Phase III clinical trial that evaluated the immunogenicity and safety of this groundbreaking vaccine. The Phase III clinical trial aimed to assess the effectiveness, immunogenicity, and safety profile of the novel COVID-19 vaccine in a large-scale population. The trial enrolled a diverse group of participants across different age groups, demographics and geographical locations to ensure a representative sample.