Category: Nevin Manimala

J Neurol. 2024 Jun 3. doi: 10.1007/s00415-024-12437-7. Online ahead of print.

ABSTRACT

BACKGROUND: In Amyotrophic Lateral Sclerosis (ALS) patients with SOD1 mutation the intrathecal administration of tofersen slowed down the progression of disease in a controlled clinical study, but results were not statistically significant.

METHODS: In this multicentre, observational study, we evaluated a cohort of 27 ALS-SOD1 patients who were treated with tofersen, focussing on 17 patients who were followed for at least 48 weeks (median period of 84 weeks, range 48-108). We compared the clinical slopes, as measured by ALSFRS-R, MRC scale and Forced Vital Capacity, during tofersen treatment with retrospective data at 1 year prior to therapy. Cerebrospinal fluid (CSF) and serum neurofilament light chains (NFL) were measured in all patients.

RESULTS: Cumulative evaluation of the ALSFRS-R and MRC progression rates showed a statistically significant change during treatment with respect to the period prior to therapy (p = 0.023 and p = 0.007, respectively). The analysis of individual patients showed that nine of the seventeen patients substantially stabilized or slightly improved. Four patients deteriorated during treatment, while in the remaining patients the very slow course did not allow to identify significant changes. CSF and serum NFL concentration markedly decreased in the near totality of patients. Increased levels of white blood cells and proteins in the CSF were found in 60% of patients. Such alterations were clinically asymptomatic in all but two patients who showed an acute pure motor radiculitis, which responded to steroid therapy.

CONCLUSIONS: Clinical findings and NFL analysis strongly suggest that tofersen may have a disease-modifying effect in a subset of SOD1-ALS patients.

PMID:38829431 | DOI:10.1007/s00415-024-12437-7

J Dev Orig Health Dis. 2024 Jun 3;15:e12. doi: 10.1017/S2040174424000114.

ABSTRACT

Obesity is associated with osteoarthritis (OA), but few studies have used fetal origin to explore the association. Our study aims to disentangle the causality between birth weight, childhood obesity, and adult OA using Mendelian randomization (MR). We identified single nucleotide polymorphisms (SNPs) related to birth weight (n = 298,142) and childhood obesity (n = 24,160) from two genome-wide association studies contributed by the Early Growth Genetics Consortium. Summary statistics of OA and its phenotypes (knee, hip, spine, hand, thumb, and finger OA) from the Genetics of Osteoarthritis Consortium (n = 826,690) were used to estimate the effects of SNPs on OA. Multivariable MR (MVMR) was conducted to investigate the independent effects of exposures. It turned out that genetically predicted standard deviation increase in birth weight was not associated with OA. In contrast, there was a marginally positive effect of childhood obesity on total [odds ratio (OR) = 1.07, 95% confidence interval (CI) = 1.00, 1.15 using IVW], knee (OR = 1.13, 95% CI = 1.05, 1.22 using weighted median), hip (OR = 1.13, 95% CI = 1.04, 1.24 using IVW), and spine OA (OR = 1.12, 95% CI = 1.03, 1.22 using IVW), but not hand, thumb, or finger OA. MVMR indicated a potential adulthood body mass index-dependent causal pathway between childhood obesity and OA. In conclusion, no association of birth weight with OA was suggested. Childhood obesity, however, showed a causality with OA in weight-bearing joints, which seems to be a general association of obesity with OA.

PMID:38828686 | DOI:10.1017/S2040174424000114

Ultrastruct Pathol. 2024 Jun 3:1-7. doi: 10.1080/01913123.2024.2362758. Online ahead of print.

ABSTRACT

OBJECTIVE: Thyroid carcinoma ranks as the 9th most prevalent global cancer, accounting for 586,202 cases and 43,636 deaths in 2020. Computerized image analysis, utilizing artificial intelligence algorithms, emerges as a potential tool for tumor evaluation.

AIM: This study aims to assess and compare chromatin textural characteristics and nuclear dimensions in follicular neoplasms through gray-level co-occurrence matrix (GLCM), fractal, and morphometric analysis.

METHOD: A retrospective cross-sectional study involving 115 thyroid malignancies, specifically 49 papillary thyroid carcinomas with follicular morphology, was conducted from July 2021 to July 2023. Ethical approval was obtained, and histopathological examination, along with image analysis, was performed using ImageJ software.

RESULTS: A statistically significant difference was observed in contrast (2.426 (1.774-3.412) vs 2.664 (1.963-3.610), p = .002), correlation (1.202 (1.071-1.298) vs 0.892 (0.833-0.946), p = .01), and ASM (0.071 (0.090-0.131) vs 0.044 (0.019-0.102), p = .036) between NIFTP and IFVPTC. However, morphometric parameters did not yield statistically significant differences among histological variants.

CONCLUSION: Computerized image analysis, though promising in subtype discrimination, requires further refinement and integration with traditional diagnostic parameters. The study suggests potential applications in scenarios where conventional histopathological assessment faces limitations due to limited tissue availability. Despite limitations such as a small sample size and a retrospective design, the findings contribute to understanding thyroid carcinoma characteristics and underscore the need for comprehensive evaluations integrating various diagnostic modalities.

PMID:38828684 | DOI:10.1080/01913123.2024.2362758

Laryngoscope. 2024 Jun 3. doi: 10.1002/lary.31558. Online ahead of print.

ABSTRACT

OBJECTIVES: Vestibular disorders can impact cognitive domains, including spatial orientation and memory, which are also affected in Alzheimer’s disease. This study aimed to examine the association between Alzheimer’s disease and a prior diagnosis of peripheral vestibular disorders in the elderly Taiwanese population.

METHODS: The case-control study sample was retrieved from Taiwan’s Longitudinal Health Insurance Database 2010. We included 3138 cases with Alzheimer’s disease and 9414 propensity-matched controls. We conducted multivariable logistic regression modeling to investigate the association between Alzheimer’s disease and a prior diagnosis of peripheral vestibular disorders after accounting for sociodemographic characteristics and medical comorbidities including diabetes, coronary heart disease, hypertension, hyperlipidemia, and hearing loss.

RESULTS: The results revealed a statistically significant difference in the prevalence of prior peripheral vestibular disorders between patients with Alzheimer’s disease and controls; 20.6% among patients with Alzheimer’s disease and 11.4% among controls (p < 0.001). Multivariable logistic regression analysis found that patients with Alzheimer’s disease were twice as likely as controls to have had a prior diagnosis of peripheral vestibular disorders, adjusted odds ratio 2.040 (95% confidence interval: 1.829-2.274).

CONCLUSIONS: The findings suggest the possibility of shared or related pathophysiological pathways in Alzheimer’s disease and vestibular dysfunction disorders.

LEVEL OF EVIDENCE: 3 Laryngoscope, 2024.

PMID:38828678 | DOI:10.1002/lary.31558

Cogn Behav Ther. 2024 Jun 3:1-19. doi: 10.1080/16506073.2024.2360054. Online ahead of print.

ABSTRACT

There is widespread empirical evidence that the COVID-19 pandemic contributed to elevated risk of mental and physical health symptoms and decreased quality of life. The present investigation sought to examine if individual differences in anxiety sensitivity was associated with mental health, psychosomatic, and well-being among a sample of US adults during a 6-month period early in the COVID-19 pandemic. Employing longitudinal research methodology, we tested the hypothesis that the anxiety sensitivity global factor would be related to increased risk of anxiety, depression, fatigue, and lower well-being. Secondary analyses evaluated the lower order anxiety sensitivity factors for the same criterion variables. The sample consisted of 778 participants with an average age of 37.96 (SD = 11.81; range 18-73). Results indicated that, as hypothesized, anxiety sensitivity was associated with increased risk for more severe anxiety, depression, fatigue, and lesser well-being; the observed effects of anxiety sensitivity were relatively robust and evident in adjusted models that controlled for numerous theoretically and clinically relevant factors (e.g. perceived health status). Overall, these results suggest that pandemic functioning could likely be improved via interventions that target elevated anxiety sensitivity as a vulnerability factor for a broad range of aversive psychosomatic symptoms and personal well-being.

PMID:38828649 | DOI:10.1080/16506073.2024.2360054

Curr Opin Neurol. 2024 Jun 4. doi: 10.1097/WCO.0000000000001278. Online ahead of print.

ABSTRACT

PURPOSE OF REVIEW: The primary aim of this review is to describe and update the pathophysiological and relevant therapeutic strategies for freezing of gait (FoG) in patients with Parkinson’s disease (PD).

RECENT FINDINGS: FoG presumably involves dysfunction of multiple cortical and subcortical components, including dopaminergic and nondopaminergic circuits. In this regard, levodopa and physical therapy represent the first-choice therapeutic options for PD patients with FoG. However, the relationship between FoG and levodopa is not fully predictable. For those patients with levodopa-resistant FoG, there is promising but still controversial data on the benefits of bilateral high-frequency transcranial magnetic stimulation and deep brain stimulation on the subthalamic nuclei, substantia nigra pars reticulata, pedunculopontine nucleus, and the Fields of Forel. On the other hand, general exercise, gait training with a treadmill, focus attention on gait training, and conventional physiotherapy have demonstrated moderate to large benefits in FoG.

SUMMARY: FOG requires different treatment strategies. The inclusion of adequate detection and prediction of FoG combined with double-blind, and statistically powered protocols are needed to improve patients’ quality of life, the motor and nonmotor symptoms and societal burden associated with FoG.

PMID:38828625 | DOI:10.1097/WCO.0000000000001278

J Health Care Poor Underserved. 2024;35(2):731-742.

ABSTRACT

Despite facing many social and structural challenges inside and outside of health systems, transgender and gender diverse (TGD) Brazilian immigrants in the U.S. are understudied, and their barriers to care are largely unnamed. In this commentary, we build on existing literature and our experiences at a safety-net community health system that sees a high volume of Brazilian patients to discuss challenges facing TGD Brazilian immigrant populations. We highlight that while Brazilian TGD populations face discrimination in Brazil, major challenges persist upon immigrating to the U.S., and include: difficulty updating identity documents and changing immigration status, barriers seeking general and specialized health care (including finding bilingual and bicultural providers), challenges navigating complex health and insurance systems, and a lack of community supports. We end by recommending more coordinated efforts between health care and community organizations to help ensure the health and wellness of TGD Brazilian immigrants in the United States.

PMID:38828592

J Health Care Poor Underserved. 2024;35(2):707-725.

ABSTRACT

Using a social-ecological model (SEM), this qualitative study explored the facilitators of access to primary health care (PHC) among Ethiopian immigrant women in the U.S. Data were collected through in-depth interviews (N=21, ≥18 years) and analyzed thematically using Nvivo12. At the individual level, stable employment, insurance, immigration status, proactivity, education, communication skills, and internet usage were identified as facilitators of PHC access. Interpersonal support from family and friends was highlighted as a key facilitator. Institutional facilitators included interpretation services and the sociocultural background of health care providers. On the community level, support from community organizations and residing in certain locations were recognized as facilitators of PHC access. No policy-level facilitators were identified. The findings underscore the importance of strengthening individual and interpersonal capacities, including job opportunities, social support, legal assistance for immigration status, and education and communication skills. Further research is needed to analyze policy gaps and suggest viable solutions.

PMID:38828590

J Health Care Poor Underserved. 2024;35(2):692-706.

ABSTRACT

This study examined the e-cigarette and vaping resistance strategies used by Native Hawaiian and Pacific Islander (NHPI) youths in rural Hawai’i. Focus groups (N = 17) were conducted in eight geographically dispersed elementary, middle/intermediate, and multilevel schools in low-income communities on Hawai’i Island. Sixty-nine youths (67% NHPI, Mage = 12.5 years) participated in this study. The resistance strategies discussed across the greatest number of groups were “refuse” (saying no), “explain” (providing reasons for vaping refusal), “avoid” (avoiding people or places where e-cigarettes were used), and “leave” (walking away from a situation where e-cigarettes were being used). Participants described the challenges in using these strategies within contexts characterized by widespread peer and family vaping and strong social demands to use e-cigarettes. The findings suggest the need for multi-level interventions based on youths’ resistance strategies to meaningfully reduce youth vaping use in rural and/or NHPI communities.

PMID:38828589

J Health Care Poor Underserved. 2024;35(2):672-691.

ABSTRACT

This study explores the association between health system changes over the last decade and women’s preventive care utilization in Illinois. A cross-sectional analysis using Illinois Behavioral Risk Factor Surveillance System (BRFSS) data from 2012-2020 among women aged 21-75 (n=21,258) examined well-woman visit (WWV) receipt and breast and cervical cancer screening overall and over several time periods. There was an increase in the prevalence of receiving a WWV for Illinois women overall from 2012-2020. However, the overall adjusted prevalence difference was only significant for the 2020 versus 2015-2019 comparison and not for 2015-2019 versus 2012-2014. The COVID-19 pandemic was not associated with a decrease in the prevalence of mammogram use but was manifest for cervical cancer screening, particularly for Black women. Finally, those reporting having a WWV in the past year had a significantly higher prevalence of being up to date with screening compared with those not reporting a WWV.

PMID:38828588