Category: Nevin Manimala

Acta Ophthalmol. 2024 Nov 24. doi: 10.1111/aos.16785. Online ahead of print.

ABSTRACT

PURPOSE: To compare patient-reported visual function outcomes of immediate sequential bilateral cataract surgery (ISBCS) and delayed sequential bilateral cataract surgery (DSBCS).

METHODS: Single-center, randomised controlled trial of patients eligible for bilateral cataract surgery allocated to ISBCS or DSBCS. Patients filled out the Catquest-7SF questionnaire before surgery, 1 week after surgery, and 3 months after surgery.

RESULTS: Ninety-eight patients were included for analysis (ISBCS = 51; DSBCS = 47). In both groups, there was a statistically significant improvement in Catquest-7SF patient-reported outcomes after surgery (p < 0.001), and no difference between the ISBCS and DSBCS groups (p ≥ 0.424). At both 1 week and 3 months post-surgery, a statistically significantly higher proportion of patients were “very satisfied” with the surgical approach in the ISBCS group (94.1% at both 1 week and 3 months) compared to the DSBCS group (55.3% at 1 week and 63.8% at 3 months), both p < 0.001.

CONCLUSIONS: Both ISBCS and DSBCS are effective options to treat bilateral cataracts with no statistically significant difference in patient-reported vision outcomes. However, we found postoperative satisfaction with the surgical approach to be higher among ISBCS patients, which suggests that ISBCS-related benefits, such as fewer health care visits and shorter vision rehabilitation, are compelling to patients.

PMID:39582084 | DOI:10.1111/aos.16785

Sci Rep. 2024 Nov 24;14(1):29099. doi: 10.1038/s41598-024-80705-7.

ABSTRACT

Until recently, the main diagnostic methods for bladder cancer (BC) are still voided urine cytology and cystoscopy, and many drawbacks persist. In this retrospective study, we evaluated the sensitivity and specificity of the CellDetect assay in the detection of BC with comparison to standard diagnostic methods. Between August 2020 and July 2022, B-ultrasonography or computed tomography (CT) scan was performed for patients with hematuria or irritative voiding symptoms. If no bladder mass was detected, the patient was excluded. A total of 148 patients with bladder mass formed the final study cohort. The patients’ urine samples were measured with CellDetect assay, followed by cystoscopy or diagnostic transurethral resection of bladder tumor. The patients were divided into two groups based on previous history of BC: group P and group R. The analysis included descriptive statistics and percentages. Finally, 115 cases had a positive CellDetect result, with 68 cases in group P and 47 in group R, respectively. And 134 cases revealed malignant tumor pathologically. The overall sensitivity and specificity for all patients were 82.1% and 64.2%, respectively. Concerning the subgroups, the respective sensitivity and specificity were: in group P- 81.0% and 50.0%; and in group R- 85.2% and 83.3%, respectively. In conclusion, CellDetect assay demonstrated significant performance for diagnosis of BC: it can identify BC patients at early stage with significant diagnostic performance and good reliability. This assay might develop novel methods and ideas for future clinical practice.

PMID:39582079 | DOI:10.1038/s41598-024-80705-7

Npj Ment Health Res. 2024 Nov 24;3(1):57. doi: 10.1038/s44184-024-00101-x.

ABSTRACT

This study examines how pandemic-related worries affected mental health in India’s adults from 2020 to 2022. Using data from the Global COVID-19 Trends and Impact Survey (N = 2,576,174), it explores the associations between worry variables (financial stress, food insecurity, and COVID-19-related health worries) and self-reported symptoms of depression and anxiety. Our analysis, based on complete cases (N = 747,996), used survey-weighted models, adjusting for demographics and calendar time. The study finds significant associations between these worries and mental health outcomes, with financial stress being the most significant factor affecting both depression (adjusted odds ratio, aOR: 2.36; 95% confidence interval, CI: [2.27, 2.46]) and anxiety (aOR: 1.91; 95% CI: [1.81, 2.01])). Models with interaction terms revealed gender, residential status, and calendar time as effect modifiers. This study demonstrates that social media platforms like Facebook can effectively gather large-scale survey data to track mental health trends during public health crises.

PMID:39582077 | DOI:10.1038/s44184-024-00101-x

Sci Rep. 2024 Nov 24;14(1):29118. doi: 10.1038/s41598-024-80697-4.

ABSTRACT

Spinal stenosis is a commonly chronic spinal degenerative disease, which is a major cause of pain and dysfunction in the elderly. Mendelian randomization (MR) has been widely applied to repurpose licensed drugs and identify novel therapeutic targets. Consequently, we intended to identify new therapeutic targets for spinal stenosis and to analyze their possible mechanisms and potential side effects.We conducted the Mendelian randomization analysis to identify potential drug targets for the management of spinal stenosis. Cis-expressed quantitative trait loci (cis-eQTL) data as genetic instrumental variables were acquired from the eQTLGen consortium. The summary statistics for single nucleotide polymorphism (SNP) associations of spinal stenosis were obtained from the FinnGen study(20,807 cases and 294,770 controls). Co-localization analysis was performed to determine whether there was shared causal variation between the SNPs associated with spinal stenosis as well as the eQTL. Multiple external validations were performed to reinforce the reliability and stability of the findings utilizing the cis-eQTL from the GTEx portal, the Ferkingstad et al. pQTL dataset, and the Sun et al. pQTL dataset. The viability of the identified drug targets for future clinical applications was elucidated through the phenome-wide association study and drug candidate prediction. Three drug targets (BMP6, DLK1, and GFPT1) exhibited significant causal associations with spinal stenosis in the eQTLGen cohort by MR analysis, which was strongly supported by the results of the co-localization analysis. The causal association of DLK1 and GFPT1 with spinal stenosis remained remarkable with multiple external validations. Multivariate MR and phenome-wide association study analysis indicated that both targets were not associated with other traits. In addition, phenome-wide association study analysis and drug prediction analysis demonstrated the potential of these two targets for future clinical applications. In this study, DLK1 and GFPT1 were identified as promising novel therapeutic targets for spinal stenosis, providing initial genetic insights for drug development in spinal stenosis.

PMID:39582071 | DOI:10.1038/s41598-024-80697-4

Pediatr Res. 2024 Nov 24. doi: 10.1038/s41390-024-03759-3. Online ahead of print.

ABSTRACT

BACKGROUND: Clinical effects of subclinical hypothyroidism are not clearly understood. This study aims to investigate the effects of subclinical hypothyroidism (SH) on cardiac autonomic and conduction systems in children.

METHODS: Forty-seven cases (25 female, 22 male) with SH aged between 3 and 17 years and 46 controls that were age, body mass index and sex matched, were included in the study. Heart rate variability (HRV) was used to evaluate cardiac autonomic function while QT dispersion, P dispersion and Tp-e measurements from ECGs to evaluate susceptibility to arrhythmia.

RESULTS: Standard deviation of the average of Normal-Normal intervals in 5-minute measurements was lower in the SH group compared to controls. No statistically significant differences were found in other time or frequency domain parameters. Maximum and minimum corrected QT intervals were longer in the SH group (p = 0.047 and p = 0.012, respectively); there were no significant differences in other ECG parameters.

CONCLUSION: Our study demonstrates that cardiac autonomic dysfunction and arrhyhtmogenesis shown as susceptibility to ventricular arrhythmia and longer intraatrial conduction times, appear in children with SH.

IMPACT: To our knowledge, this is the first study to show changes in cardiac autonomic function using heart rate variability in children with subclinical hypothyroidism (SH). We suppose that the fact that ventricular repolarization is longer in children with SH regardless of heart rate shows a predisposition to ventricular arrhythmia. Our study demonstrates that cardiac autonomic dysfunction and arrhythmogenesis shown as susceptibility to ventricular arrhythmia and longer intraatrial conduction times, appear in children with SH. We suggest that an evaluation regarding arrhythymia together with endocrinological follow-up is warranted when children are diagnosed with SH.

PMID:39582062 | DOI:10.1038/s41390-024-03759-3

Pediatr Res. 2024 Nov 24. doi: 10.1038/s41390-024-03623-4. Online ahead of print.

ABSTRACT

BACKGROUND: Very preterm birth (<32 weeks gestation, VP), immigrant background, and language barriers are all independently associated with a high risk for mental health problems in childhood, but research has neglected the long-term development of immigrant children born VP. We assessed whether behavioural and socio-emotional problems of 5-year-old children born VP growing up across different language contexts in the European Union are associated with an immigrant background and linguistic distance of families’ mother tongue (L1) to the host countries’ official languages.

METHODS: Data are from a population-based cohort including all VP births in 2011/12 in 11 European countries; a total of 3,067 children were followed up at 2 and 5 years of age. Behavioural and socio-emotional difficulties were assessed using the parent-reported Strengths and Difficulties Questionnaire (SDQ).

RESULTS: Mixed-effects models showed that a larger linguistic distance of children’s L1 to the host countries’ official language was associated with higher SDQ total scores (0.02 [0.01, 0.03]), after adjusting for a wide range of social risks, biological, and perinatal clinical factors.

CONCLUSION: Language barriers in the form of linguistic distance between VP children’s L1 and countries’ official languages play a critically important role for the behavioural and socio-emotional development of immigrant children born VP.

IMPACT: Immigrant children born very preterm across Europe face systemic inequalities such as language barriers. Language barriers can be operationalised as a continuous linguistic distance score between children’s mother tongues and countries’ official languages. Linguistic distance plays an important role for the behavioural and socio-emotional development of immigrant children born VP. Research, policy, and practice need to better account for language barriers to increase equity in health and education.

PMID:39582061 | DOI:10.1038/s41390-024-03623-4

BDJ Open. 2024 Nov 24;10(1):86. doi: 10.1038/s41405-024-00271-y.

ABSTRACT

CONTEXT: Mineral Trioxide Aggregate (MTA) is a calcium silicate-based cement that potentially exhibits improved washout resistance when carboxymethyl chitosan or gelatin is incorporated. Gel-form MTA is a novel mineral trioxide aggregate formulated using construction industry-based technology. The present study was conducted to comparatively evaluate the sealing ability and adaptation to dentinal walls of gel-form MTA.

MATERIALS AND METHODS: This in-vitro study consisted of two groups: gel-form MTA and the conventional powder-liquid MTA. 10 samples per group were used for each of the tested parameters. Adaptation of the MTA to the dentinal walls was tested under the light microscope and measured using Image J software. Sealing ability was evaluated using a single aerobic bacterial leakage model. Appropriate statistical analysis was done for the obtained data. Adaptation of the MTA was analyzed using independent t-test and Friedman test, whereas the bacterial leakage was analyzed using chi-square test.

RESULTS: On comparison of the adaptation property at coronal and apical thirds, there was no statistically significant difference between the groups (p = 0.071 and p = 0.638, respectively). However, while comparing the same in the middle one-third of the root, lesser gaps were identified in the gel-form MTA group (p = 0.013). One sample belonging to the conventional powder-liquid MTA group showed significant turbidity during bacteria leakage evaluation (p = 0.001) with the presence of E. faecalis in the count of 10³ colony forming units/milliliter.

CONCLUSION: The gel-form MTA shows a better adaptation to the dentinal walls at the middle third of the root and exhibits better sealing ability against bacterial leakage when tested for E. faecalis. The adaptation of gel-form MTA at coronal and apical third of the root was comparable to the conventional powder-liquid MTA.

PMID:39582050 | DOI:10.1038/s41405-024-00271-y

Sci Rep. 2024 Nov 24;14(1):29112. doi: 10.1038/s41598-024-80313-5.

ABSTRACT

In determining the culprit vessel responsible for inferior ST-segment elevation myocardial infarction (STEMI) as either the right coronary artery (RCA) or left circumflex (LCX), the electrocardiographic value has been validated. However, its ability to predict whether inferior STEMI is complicated by left anterior descending artery (LAD) chronic total occlusion remains uncertain. Based on the involvement of arteries other than the culprit vessels, 189 patients with inferior STEMI from our chest pain center were categorized into four groups: LAD occlusion group (n = 20), LAD stenosis > 50% group (n = 116), normal LAD group (n = 27), and other vessel stenosis > 50% group (n = 26). All groups underwent coronary angiography within 24 h of admission, and electrocardiogram (ECG) and clinical data were retrospectively analyzed. In the LAD occlusion group, hypertension was significantly more prevalent (P = 0.015). Although there was a trend toward higher previous cerebral infarction and lower diabetes prevalence in the Normal LAD group, neither was statistically significant (P = 0.070 and P = 0.088). The LAD occlusion group demonstrated the highest serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels and the most reduced LVEF, with a higher susceptibility to cardiogenic shock (P < 0.01). This group also had a higher use of intra-aortic balloon pump (IABP) and a greater occurrence of ventricular fibrillation or tachycardia compared to the other groups (P < 0.05). The QRS duration in lead V4 (QRS _V4) was 99.4 ± 19.1 ms in the LAD occlusion group, 87.5 ± 14.9 ms in the LAD stenosis group, 89.6 ± 11.4 ms in the normal LAD group, and 87.7 ± 11.7 ms in the other vessel stenosis group (P = 0.010). The difference between ST-segment depression in V4 and ST-segment elevation in lead III (ST _V4↓- ST _III↑) in the LAD occlusion group was the largest at -0.06 (-1.19, 1.05) mm (P = 0.029). ROC curve analysis revealed that the sensitivity of QRS _V4 > 97.7ms and ST _V4↓- ST _III↑> 0 mm diagnosing inferior STEMI complicated with LAD occlusion was 54.5% and 50%, with a specificity of 75.1% and 78.0%, respectively. Multivariate logistic regression analysis indicated that QRS _V4 (OR = 1.062, P = 0.003), ST _V4↓- ST _III↑ (OR = 1.641, P = 0.050), and Killip classification (OR = 2.115, P = 0.004) were all independent risk factors for LAD occlusion. In patients with inferior STEMI complicated by LAD occlusion without anterior myocardial infarction, cardiac function is poorer. The ST-segment deviation between the leads V4 and III, and the duration of QRS in the lead V4, can aid in diagnosis.

PMID:39582040 | DOI:10.1038/s41598-024-80313-5

Diabetol Metab Syndr. 2024 Nov 24;16(1):282. doi: 10.1186/s13098-024-01536-0.

ABSTRACT

BACKGROUND: This study investigated the correlation between the systemic immune-inflammation index (SII) and the systemic inflammation response index (SIRI) and all-cause, cardiovascular, and kidney disease mortality in patients with diabetic nephropathy (DN). It aimed to provide a new predictive assessment tool for the clinic and a scientific basis for managing inflammation in DN.

METHODS: The data utilized in this study were obtained from the National Health and Nutrition Examination Survey (NHANES) database, spanning 1999 to 2018. A total of 2641 patients diagnosed with DN were included in the analysis. The association between SII and SIRI levels and mortality in patients with DN was investigated using multivariate Cox proportional risk regression models. These relationships were further validated by Kaplan-Meier survival curves and restricted cubic spline (RCS) modeling, and subgroup analyses were performed to explore the heterogeneity among different characteristic subgroups.

RESULTS: The multivariate Cox regression analysis indicated that SII and SIRI levels were independently associated with all-cause mortality and cardiovascular mortality in patients with DN. SIRI levels were found to be an independently associated factor with kidney disease mortality in patients with DN. Patients in the highest quartile of SII and SIRI exhibited a 1.49-fold and 1.62-fold increased risk of all-cause mortality, respectively, compared to patients in the lowest quartile. The risk of cardiovascular mortality was 1.31 and 1.73 times higher than that in patients in the lowest quartile, respectively. The risk of kidney disease mortality in patients in the highest quartile of SIRI was 2.74 times higher than that in patients in the lowest quartile. Kaplan-Meier survival curve and RCS analyses further confirmed the positive association between SII and SIRI and mortality and a significant nonlinear relationship between SII and all-cause mortality. The SII and SIRI indices offer incremental value in model predictive power for mortality in patients with DN. Subgroup analyses demonstrated that the correlation between SII and SIRI and mortality risk was stable but heterogeneous across different subgroups.

CONCLUSION: SII and SIRI can be utilized as biomarkers for forecasting the likelihood of all-cause and cardiovascular mortality in patients with DN.

PMID:39582034 | DOI:10.1186/s13098-024-01536-0

Pneumonia (Nathan). 2024 Nov 25;16(1):31. doi: 10.1186/s41479-024-00143-x.

ABSTRACT

BACKGROUND: Most Canadians receive their care in community hospitals, yet most clinical research is conducted in academic hospitals. This study aims to compare patients with community acquired pneumonia (CAP) treated in academic and community hospitals with respect to their demographics, clinical characteristics, treatments and outcomes.

METHODS: This nested observational cohort substudy of the Community Acquired Pneumonia: Toward InnoVAtive Treatment (CAPTIVATE) trial included 1,329 hospitalized adults with CAP recruited between March 1st, 2018 and September 31st, 2023 from 15 Canadian hospitals. Unadjusted and adjusted analyses for age, sex and co-morbidities using logistic, Cox and censored quantile regressions were conducted.

RESULTS: Patients in community hospitals were older (mean [SD] 75.0 [15.7] years vs. 68.3 [16.2] years; p < 0.001), were more likely to be female (49.7% vs. 41.0%, p = 0.002), and had more comorbidities (75.9% vs. 64.8%, p < 0.001). More patients in community hospitals received corticosteroids (49.2% vs. 37.4%, p < 0.001). Community hospital patients had a higher likelihood of developing acute respiratory distress syndrome (OR 3.13, 95% CI: 1.87, 5.24, p = < 0.001), and acute cardiac injury (OR 2.53, 95% CI: 1.33, 4.83, p = 0.005). In unadjusted and adjusted analyses, 28-day mortality difference did not meet statistical significance (OR 1.43, 95% CI: 0.98, 20.7, p = 0.062 and OR 1.23, 95% CI: 0.81, 1.87, p = 0.332, respective).

CONCLUSION: Patients with CAP in Canadian community and academic hospitals differed with respect to their age, clinical characteristics, treatments and outcomes, emphasizing the importance of including more community hospitals in clinical research studies to ensure the generalizability of results.

PMID:39582027 | DOI:10.1186/s41479-024-00143-x