Category: Nevin Manimala

Ann Chir Plast Esthet. 2024 Oct 23:S0294-1260(24)00172-9. doi: 10.1016/j.anplas.2024.09.008. Online ahead of print.

ABSTRACT

Autologous breast reconstruction, especially using the deep inferior epigastric artery perforator (DIEP) flap, is increasingly seen as a reliable, safe, and long-term alternative to implant-based reconstruction. Despite the recognized advantages of the DIEP flap for breast reconstruction, successful realization demands excellent anatomical knowledge, a thorough understanding of autologous breast reconstruction concepts and advanced microsurgical skills. Given that the porcine model is widely employed in microsurgical training, our study aims to assess this model using validated outcomes, with the objective of evaluating the enhancement in a surgeon’s learning curve following training with this model. Forty DIEP flaps were harvested on 20 swines by a single surgeon in “Pius Branzeu Center” (Timisoara, RO) and “Drazan Institute” (University of veterinary of Brno, CZ) laboratories for microsurgical training in 6months (January 2015-June 2015). Then we analyzed data from 40 DIEP flaps harvested by the same surgeon on first 20 consecutive patients undergoing DIEP flap breast reconstruction. Perforator dissection time, surgeon-determined dissection difficulty score (DDS) and venous congestion rate were collected for each flap in porcine model and in patients, then compared and analyzed. The mean of DDS score analysis in first and second swines group dissection resulted as statistically significant (P-value 0.0001), while it was not statistically significant between those analyzed in the second group of swines dissected and patients (P-value 0.8037). Reduction in perforator dissection time between the two swines’ groups and in venous congestion rates from the first swines groups to the second to the human group resulted statistically significant too (P-value respectively 0.0001 and 0.0079). The porcine model has been used for a long time together with other animal models for microsurgical training. Our study confirms and objective by validated scores that it is a valid and reliable model, comparable to the human one and which mimics the dissection of human perforating vessels.

PMID:39448343 | DOI:10.1016/j.anplas.2024.09.008

Nutr Metab Cardiovasc Dis. 2024 Sep 19:S0939-4753(24)00352-1. doi: 10.1016/j.numecd.2024.09.003. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: Hypertension depends on renin-angiotensin system dysfunction; however, little is known about its implications in the outcomes of neurogenic hypertension induced by peri-pubertal insults. This study aimed to evaluate whether hypertension induced by a peri-pubertal low-protein diet is related to renin-angiotensin system dysfunction in adult male Wistar rats.

METHODS AND RESULTS: Thirty-day-old male Wistar rats were fed a low-protein diet (4 % casein) for 30 days and subsequently fed a 20.5 % normal protein diet for a 60-day dietary recovery (LP group). Control animals (NP group) were fed a 20.5 % protein diet throughout their lives. Cardiovascular and renin-angiotensin system functions were evaluated on postnatal day 120 (6-24 animals per group). Statistical analyses were performed using the Student’s t-test. Animals with LP show increased arterial blood pressure. The angiotensin 2 dose-response curve of LP animals showed an increase in the pressor response at a lower dose (50 ng/kg) and a reduction in the pressor response at a higher dose (400 ng/kg) compared with NP animals. Angiotensin 2 type 1 receptor mRNA levels were increased in the hearts of LP animals; however, angiotensin 2 type 2 receptor and MAS receptor mRNA levels were reduced. In the aorta, AT1 and AT2 mRNA levels were increased in LP animals, whereas MAS receptor mRNA levels were decreased in comparison to NP animals.

CONCLUSION: The renin-angiotensin system is disrupted in hypertension induced by protein restriction exposure during peri-pubertal life.

PMID:39448316 | DOI:10.1016/j.numecd.2024.09.003

Urol Oncol. 2024 Oct 23:S1078-1439(24)00688-4. doi: 10.1016/j.urolonc.2024.10.007. Online ahead of print.

ABSTRACT

BACKGROUND: Numerous studies indicate that the gut microbiome is closely associated with prostate cancer (PCa), however, owing to various confounding factors, the causal relationship between gut microbiota and PCa remains unclear.

METHODS: A 2-sample Mendelian randomization (MR) analysis utilized genome-wide association study (GWAS) data on the gut microbiota of 18,340 participants and GWAS summary statistics on PCa involving 46,3010 participants. Inverse variance weighted (IVW) served as the primary method, complemented by the MR-Egger method, weighted median method (WME), simple mode method (SM), and weighted mode method (WM). Finally, to confirm the robustness of the results, heterogeneity test, pleiotropy test, and leave-one-out sensitivity test were conducted.

RESULTS: IVW analysis revealed that 12 specific gut microbial taxa were potentially causally associated with PCa; the genera Victivallis, Akkermansia, Odoribacter, Butyrivibrio, and the families Enterobacteriaceae, Verrucomicrobiaceae, as well as the orders Verrucomicrobiales, Enterobacteriales and the class Verrucomicrobiae, were found to be positively associated with PCa risk. Conversely, the genera Eubacterium ruminantium group, Candidatus Soleaferrea, and RuminococcaceaeUCG003 were negatively associated with PCa risk.

CONCLUSIONS: Our MR study’s results support a genetically predicted causal relationship between the gut microbiota and PCa, and we identified 12 specific gut microbial taxa. These findings could offer new targets for PCa screening and treatment.

PMID:39448300 | DOI:10.1016/j.urolonc.2024.10.007

Oral Surg Oral Med Oral Pathol Oral Radiol. 2024 Aug 5:S2212-4403(24)00403-6. doi: 10.1016/j.oooo.2024.07.013. Online ahead of print.

ABSTRACT

PURPOSE: The aim of this study was to investigate the characteristics of illicit cocaine and opioid drug-related facial trauma and determine whether the presence of cocaine or opioid drug use in facial trauma patients influenced the cause of injury, morbidity, or management.

METHODS: A retrospective observational cohort study was performed using records from a state-wide database of all patients who presented to a Victorian hospital with a facial fracture between 2004 and 2014. Data collected included demographics, concomitant opioid and cocaine use, mechanism of injury, facial injuries, and management. Statistical analysis was done using chi-square test, Student’s t tests, binary logistic regression analysis, and multivariable linear regression analysis. Results were considered statistically significant if P < .05.

RESULTS: A total of 54,613 patient presentations for facial trauma were analyzed with 363 patients in the cocaine and opioid-related group, and 54,250 patients in the nondrug-related group. Patients with illicit drug use were more likely to have facial fractures caused by interpersonal violence when compared with nondrug users (47.9% vs 23.5%, OR = 2.23, P < .001). Opioid and cocaine users had 0.3 more total fractures per presentation, which included more midface and skull fractures, and more facial lacerations (P < .001). There was no statistically significant difference in the need for surgical management between the two groups. Opioid and cocaine affected patients also on average had a longer hospital stay of 3.4 days and required 0.9 more allied health inputs during their admission when compared with nondrug users (P < .05). This effect was similarly reflected when controlling for confounding variables (P < .001).

CONCLUSIONS: Concomitant cocaine or opioid use in facial trauma patients leads to more violence-related injuries with higher morbidity and healthcare costs.

PMID:39448294 | DOI:10.1016/j.oooo.2024.07.013

Int J Oral Maxillofac Surg. 2024 Oct 23:S0901-5027(24)00405-3. doi: 10.1016/j.ijom.2024.10.008. Online ahead of print.

ABSTRACT

This retrospective study examined factors influencing labial bone resorption in the anterior maxilla 6 months after implant insertion with simultaneous guided bone regeneration. Involving 79 patients (118 implants), the study measured labial horizontal bone width and vertical dimensions using cone beam computed tomography scans taken immediately after surgery and at 6 months. A generalized linear mixed model analyzed potential influencing factors: age, sex, implant site, timing of placement, buccal bone width at the implant platform level post-surgery, implant connection, and bone defect morphology. Significant bone resorption was noted at 6 months. The statistical analysis revealed that buccal bone width at the implant platform, implant connection, and bone defect morphology significantly impacted labial bone resorption, while patient age, sex, timing of placement, and implant site did not. Implants with a buccal bone width ≥2 mm showed significantly less labial horizontal and vertical bone resorption (horizontal P < 0.001, vertical P = 0.001), and healing abutments reduced resorption compared to cover screws (horizontal P = 0.002, vertical P = 0.034). More significant vertical resorption occurred in non-contained bone defects after guided bone regeneration (P = 0.040).

PMID:39448289 | DOI:10.1016/j.ijom.2024.10.008

J Voice. 2024 Oct 23:S0892-1997(24)00305-9. doi: 10.1016/j.jvoice.2024.09.014. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aims to evaluate Turkish patient-reported outcome measures (PROM) used in voice disorders using different readability formulas and to examine the relationship between text-based features and readability values.

STUDY DESIGN: A search was conducted to identify published Turkish PRO questionnaires related to dysphonia that are completed by patients.

METHODS: A search was conducted to identify published PROM related to dysphonia that are completed by patients in a self-administered format. Reading grade levels were analyzed for voice-related PROM using the Ateşman readability and the Bezirci-Yılmaz new readability formulas as computed by a readability calculations software package. Text-based quantitative features are obtained. Descriptive statistics were also computed across the questionnaires.

RESULTS: A total of 14 PROMs were found. In the analysis, the mean of the Ateşman readability values of the PROM was calculated as 70.66 (±5.55). This value is defined as “easy,” according to the Ateşman readability measures. The average Bezirci-Yılmaz new readability value is 6.03 (±1.07). This value corresponds to the sixth-grade reading level in the Turkish education system.

CONCLUSIONS: Results show that more than half of the PROMs in the Turkish language have the recommended reading level. PROMs allow health care professionals to objectively understand the patient’s symptoms, both qualitatively and quantitatively. Therefore, it is critical that patients accurately understand and respond to these outcome measures. This is why developers should consider reading as a testable structure. Speech and language therapists should consider the reading level required to understand a specific PROM to obtain the most useful information for treatment planning and outcome assessments.

PMID:39448277 | DOI:10.1016/j.jvoice.2024.09.014

Conscious Cogn. 2024 Oct 23;125:103768. doi: 10.1016/j.concog.2024.103768. Online ahead of print.

ABSTRACT

Does the likelihood of us experiencing inattentional blindness depend on whether the scenes are statistically regular (e.g., probable) or not? Previous studies have shown that observers find it harder to perceive real-world statistical irregularities, such as improbable (statistically irregular) scenes (e.g., scenes unlikely to take place in the real world) as opposed to probable (statistically regular) scenes. Moreover, high inattentional blindness rates have been observed for improbable stimuli (e.g., a gorilla on a college campus). However, no one has directly compared noticing rates for probable and improbable scenes. Here we ask if people are more likely to experience inattentional blindness for improbable than probable scenes. In two large-scale experiments in which one group of participants is presented, on the critical trial, with a probable scene and the other group with an improbable scene, we observed higher rates of inattention blindness for participants receiving improbable scenes than those receiving probable scenes.

PMID:39447236 | DOI:10.1016/j.concog.2024.103768

Clin Neurol Neurosurg. 2024 Oct 19;246:108606. doi: 10.1016/j.clineuro.2024.108606. Online ahead of print.

ABSTRACT

PURPOSE: Anatomic variations of the thenar motor branch of the median nerve (TMB) that place the nerve more ulnarly in the palm can increase the risk for iatrogenic injury to the nerve during carpal tunnel release. This study examines the prevalence of an origin of the TMB that is more ulnar than its typical branching from the radial aspect of the median nerve and explores whether the appearance of the palmar intrinsic muscles at surgery can predict an unusual TMB origin prior to visualizing the TMB itself.

METHODS: A prospective study of patients undergoing carpal tunnel release surgery was undertaken to document the take-off point of the TMB along the circumference of the median nerve and the presence or absence of intrinsic muscle obscuring the distal transverse carpal ligament.

RESULTS: Forty-one hands were evaluated. Eleven (26.8 %) demonstrated transverse carpal muscle. The most common origin of the TMB was from the radial aspect of the median nerve (56.1 %). In approximately 20 % of nerves, the TMB originated near its anterior midline. There was a statistically significant relationship between the TMB originating more ulnarly and the presence of transverse carpal muscle.

CONCLUSIONS: This study introduces a new classification system for further defining anatomic variations of the TMB. When transverse carpal muscle is absent, the TMB is highly likely to arise from the radial aspect of the median nerve. In the presence of transverse carpal muscle, the origin of the TMB is unpredictable and is significantly more likely to arise from the median nerve more ulnarly than is typically seen. Under these circumstances, attempts should be made to identify the TMB prior to completing ligament division.

PMID:39447224 | DOI:10.1016/j.clineuro.2024.108606

Plant Genome. 2024 Oct 24:e20519. doi: 10.1002/tpg2.20519. Online ahead of print.

ABSTRACT

Climate change represents a significant challenge to global food security by altering environmental conditions critical to crop growth. Plant breeders can play a key role in mitigating these challenges by developing more resilient crop varieties; however, these efforts require significant investments in resources and time. In response, it is imperative to use current technologies that assimilate large biological and environmental datasets into predictive models to accelerate the research, development, and release of new improved varieties that can be more resilient to the increasingly variable climatic conditions. Leveraging large and diverse datasets can improve the characterization of phenotypic responses due to environmental stimuli and genomic pulses. A better characterization of these signals holds the potential to enhance our ability to predict trait performance under changes in weather and/or soil conditions with high precision. This paper introduces characterization and integration of driven omics (CHiDO), an easy-to-use, no-code platform designed to integrate diverse omics datasets and effectively model their interactions. With its flexibility to integrate and process datasets, CHiDO’s intuitive interface allows users to explore historical data, formulate hypotheses, and optimize data collection strategies for future scenarios. The platform’s mission emphasizes global accessibility, democratizing statistical solutions for situations where professional ability in data processing and data analysis is not available.

PMID:39447214 | DOI:10.1002/tpg2.20519

J Vet Intern Med. 2024 Oct 24. doi: 10.1111/jvim.17200. Online ahead of print.

ABSTRACT

BACKGROUND: Enteral nutrition (EN) is essential for management of hepatic lipidosis (HL) in cats.

OBJECTIVES: To determine if time to start of EN and other clinicopathologic variables are associated with outcome in cats with HL.

ANIMALS: Forty-eight cats with HL.

METHODS: Retrospective study. Information retrieved from medical records and client communications included clinicopathologic findings, time to start of EN, initial % of resting energy requirements provided, type of feeding tube, duration of hospitalization, and 3-month survival. Variables were compared between surviving and nonsurviving cats and between cats fed ≤12 hours and >12 hours after hospital admission. Multivariable statistical testing was performed to further investigate variables of interest.

RESULTS: Seventeen of 25 (68%) cats fed ≤12 hours and 13 of 23 (57%) of cats fed >12 hours after hospital admission survived (P = .55). Only increasing age (odds ratio [OR], 1.313; 95% confidence interval [CI], 1.032-1.671; P = .03) and the presence of ascites (OR, 6.415; 95% CI, 1.354-30.395; P = .02) were associated with death in multivariable analysis. Hospitalization duration (median, interquartile range [IQR]) was shorter in cats fed >12 hours (2.8 days; IQR, 2.1-3.8 days) as compared with cats fed ≤12 hours (4.8 days; IQR, 3.6-6.2 days) after hospital admission (P < .001).

CONCLUSIONS AND CLINICAL IMPORTANCE: An initial stabilization period before EN introduction does not decrease survival or increase duration of hospitalization in cats with HL.

PMID:39447212 | DOI:10.1111/jvim.17200