Category: Nevin Manimala

J Gastrointest Cancer. 2023 Nov 21. doi: 10.1007/s12029-023-00989-2. Online ahead of print.

ABSTRACT

PURPOSE: Recent studies suggested a protective role of metformin in the development of colorectal cancer (CRC) and its precursors. We aimed to investigate if metformin was associated with a lower prevalence and number of colorectal polyps in diabetic patients and also adenomas, high-risk adenomas, and CRC.

METHODS: Retrospective study on adult patients with diabetes mellitus followed in our hospital with a total colonoscopy between 2015 and 2019, treated with either metformin for > 5 years or other antidiabetic agent (control group). We assessed the number, size, and histopathology examination of proliferative lesions detected on colonoscopy.

RESULTS: We included 401 patients aged 69 ± 9 years, 57% males, divided into two groups: treated with metformin (n = 260) and without (n = 141). The number of polyps detected was significantly lower in patients under metformin (p = 0.014). There was a nonsignificant trend towards lower polyp detection rates in the metformin compared to the control group both in unadjusted analysis (50% vs 60%, p = 0.058) and multivariable adjusted analysis (odds ratio [OR] 0.68, 95% confidence interval [CI] 0.43-1.09, p = 0.111). In the latter, we identified male gender (OR 2.24, 95%CI 1.44-3.49, p < 0.001), age (OR 1.35 for every 10 years, 95%CI 1.07-1.71, p = 0.012), glycated hemoglobin value (OR 1.20 for every 1% increase, 95%CI 1.06-1.37, p = 0.005), and hypertension (OR 1.76, 95%CI 1.01-3.08, p = 0.046) as factors associated with a higher prevalence of polyps. We saw no statistically significant differences regarding adenoma (p = 0.231), high-risk adenoma (p = 0.810), and CRC (p = 0.705) diagnoses between groups.

CONCLUSION: In our study, metformin was associated with less colorectal polyps in diabetic patients compared to other treatment modalities. We observed a nonsignificant trend towards lower polyp detection rates in the metformin group both in unadjusted and adjusted analyses.

PMID:37987968 | DOI:10.1007/s12029-023-00989-2

Biometals. 2023 Nov 21. doi: 10.1007/s10534-023-00560-3. Online ahead of print.

ABSTRACT

Environmental mercury exposure possesses a significant risk to many human populations. At present there are no effective treatments for acute mercury toxicity. A new compound, N,N’bis-(2-mercaptoethyl) isophthalamide (NBMI), a lipophilic chelating agent was created to tightly/irreversibly bind mercury. A post hoc dose-dependent analysis of NBMI therapy was undertaken on data from a randomized controlled NBMI human treatment trial on 36 Ecuadorian gold miners with elevated urinary mercury concentrations. Study subjects were randomly assigned to receive 100 milligram (mg) NBMI/day, 300 mg NBMI/day, or placebo for 14 days. For each study subject daily mg NBMI dose/Kilogram (Kg) bodyweight were determined and plasma and urine mercury concentrations (micrograms (µg)/Liter (L)) on study day 1 (pre-NBMI treatment), 15 (after 14 days of NBMI treatment) and 45 (30 days after NBMI treatment) were correlated with NBMI dosing using the linear regression statistic in SAS. Regression revealed significant inverse correlations between increasing per mg NBMI/Kg bodyweight/day and reduced concentrations of urinary and plasma mercury on study day 15 (reduced by in urine = 18-20 µg/L and plasma = 2 µg/L) and study day 30 (reduced by in urine = 15-20 µg/L and plasma = 4 µg/L) and significant correlations between reductions in mercury concentrations in urine and plasma. Significant 30% reductions in urinary mercury concentrations per mg NBMI/Kg bodyweight/day administered for 14 days were observed. This study supports the dose-dependent ability of NBMI therapy to significantly reduce mercury concentrations, particularly in the urine, in an acutely mercury exposed human population. NBMI therapy should be evaluated in other mercury exposed populations.

PMID:37987955 | DOI:10.1007/s10534-023-00560-3

Int Urol Nephrol. 2023 Nov 21. doi: 10.1007/s11255-023-03872-y. Online ahead of print.

ABSTRACT

PURPOSE: In this study, the feasibility of tubeless percutaneous nephrolithotomy (PCNL) for the treatment of upper urinary tract stones was investigated.

METHODS: From January 2021 to December 2022, the clinical data of 273 patients who received tubeless PCNL (Group A) were studied. The control group includes clinical data from 302 patients (from January 2019 to October 2022) who received standard PCNL (Group B). The baseline characteristics were consistent between the two groups after using the propensity score matching (PSM) method. Compare the preoperative clinical characteristics, postoperative complications, residual stones, catheterization time, and hospital stay between the two groups.

RESULTS: 146 pairs of patients were successfully paired through PSM. There was no statistically significant difference in operative time, blood leukocyte counts, haemoglobin decrease, fever, urinary extravasation, sepsis, bleeding, blood transfusion rates, embolism, and residual stones after surgery between the two groups; Postoperative day 1 and discharge day, the VAS pain score in Group A was significantly lower than that in Group B. The catheterization time and hospitalization time of patients in Group A were significantly lower than those in Group B.

CONCLUSION: According to the inclusion and exclusion criteria, selecting suitable patients for tubeless PCNL is safe and effective, while significantly alleviating pain and reducing catheterization time and hospital stay.

PMID:37987954 | DOI:10.1007/s11255-023-03872-y

Environ Monit Assess. 2023 Nov 21;195(12):1502. doi: 10.1007/s10661-023-12001-2.

ABSTRACT

Environmental contamination especially air pollution is an exponentially growing menace requiring immediate attention, as it lingers on with the associated risks of health, economic and ecological crisis. The special focus of this study is on the advances in Air Quality (AQ) monitoring using modern sensors, integrated monitoring systems, remote sensing and the usage of Machine Learning (ML), Deep Learning (DL) algorithms, artificial neural networks, recent computational techniques, hybridizing techniques and different platforms available for AQ modelling. The modern world is data-driven, where critical decisions are taken based on the available and accessible data. Today’s data analytics is a consequence of the information explosion we have reached. The current research also tends to re-evaluate its scope with data analytics. The emergence of artificial intelligence and machine learning in the research scenario has radically changed the methodologies and approaches of modern research. The aim of this review is to assess the impact of data analytics such as ML/DL frameworks, data integration techniques, advanced statistical modelling, cloud computing platforms and constantly improving optimization algorithms on AQ research. The usage of remote sensing in AQ monitoring along with providing enormous datasets is constantly filling the spatial gaps of ground stations, as the long-term air pollutant dynamics is best captured by the panoramic view of satellites. Remote sensing coupled with the techniques of ML/DL has the most impact in shaping the modern trends in AQ research. Current standing of research in this field, emerging trends and future scope are also discussed.

PMID:37987882 | DOI:10.1007/s10661-023-12001-2

J Plast Reconstr Aesthet Surg. 2023 Oct 15;88:182-192. doi: 10.1016/j.bjps.2023.10.060. Online ahead of print.

ABSTRACT

BACKGROUND: Alopecia is a common and distressing medical condition that has been related to psychiatric disorders. Stem cell-derived conditioned medium (CM), a novel therapy for hair regeneration, has shown effectiveness in several trials.

METHODS: This meta-analysis aims to explore the effectiveness of stem cell-derived CM in improving hair growth for patients of alopecia. We prospectively registered this systematic review and meta-analysis in PROSPERO (CRD42023410249). Clinical trials that the enrolled participants suffering from alopecia applied stem cell-derived CM were included. We calculated the mean and standard deviation for the hair density and thickness.

RESULTS: Ten clinical trials were included in our analysis. On the basis of eight clinical trials (n = 221), our pooled results indicate that stem cell-derived CM is effective in increasing hair density (mean difference [MD]: 14.93, confidence interval [95% CI]: 10.20-19.67, p < 0.0001) and thickness (MD: 18.67, 95% CI: 2.75-34.59, p < 0.0001) (μm) in patients with alopecia. Moreover, our findings suggest that longer treatment duration is associated with significantly greater improvement than shorter treatment duration (p = 0.02). Three of the included studies were randomized controlled trials (RCTs), and when we specifically analyzed these RCTs; statistical significance could also be observed in terms of hair density (MD: 9.23, 95% CI: 1.79-16.68, p < 0.00001).

KEY MESSAGES: Stem cell-derived conditioned medium can effectively increase hair density and thickness for alopecia, and there is no difference between each method (topical application, microneedling, or injection).

PMID:37983981 | DOI:10.1016/j.bjps.2023.10.060

Clin Pharmacol Ther. 2023 Nov 20. doi: 10.1002/cpt.3110. Online ahead of print.

ABSTRACT

First-in-class (FIC) designation became a hallmark of innovation, however, even at the marketing authorisation stage, little is known about the clinical benefits these products deliver. We identified the provenance of the FIC drugs that entered the French market from 2008 to 2018 and matched these medicines to the clinical benefit grading by Haute Autorité de Santé (HAS) and Prescrire. Analyses were performed using descriptive statistics to present our findings by drug origin and therapeutic area and to establish the degree of concordance between HAS and Prescrire. Of the 135 FIC drugs identified, 71.1 % (n=96) originated from the industry, 16.3% (n=22) from academia and 12.6% (n=17) from joint partnerships. Three therapeutic areas accounted for most FIC medications: antineoplastic (25.9%, N=35), anti-infective (14.1%, N=19), and metabolic (11.1%, N=15) agents. HAS and Prescrire agreed on 60.74% of clinical benefit gradings. According to HAS, only 5% of all FIC drugs had substantial added benefit, and only 3%, according to Prescrire. HAS and Prescrire graded 45.9% and 68.2%, respectively, of FIC drugs as no clinical benefit and 48.9% and 28.9%, respectively, as some clinical benefit. FIC-designated drugs are primarily of industry (>70%) rather than academic origin. We found that 55% of FIC medicines that entered the French market over the 10-year period deliver no additional clinical benefit. Whilst FIC medicines may represent important scientific advancements in drug development, in >50% of cases, the new mode of action does not translate into additional clinical benefits for patients.

PMID:37983965 | DOI:10.1002/cpt.3110

Helicobacter. 2023 Nov 20:e13038. doi: 10.1111/hel.13038. Online ahead of print.

ABSTRACT

BACKGROUND: To investigate the antibiotic resistance of Helicobacter pylori (H. pylori) strains to clarithromycin, metronidazole, amoxicillin, levofloxacin, furazolidone, and tetracycline in Chinese children.

MATERIALS AND METHODS: This multicenter, retrospective study was conducted from January 2016 through May 2023. Gastric mucosa biopsies were obtained from pediatric participants who underwent upper gastrointestinal endoscopy at 96 hospitals in northern, southwestern, and southeastern China. The susceptibility of H. pylori to six commonly used antibiotics was determined by agar dilution method.

RESULTS: Among the 3074 H. pylori isolates, 36.7% were resistant to clarithromycin, 77.3% to metronidazole, 16.6% to levofloxacin, and 0.3% to amoxicillin. No strains were detected to be resistant to furazolidone or tetracycline. During the 8-year study period, resistance to clarithromycin and metronidazole showed a significant upward trend, while the resistance pattern of the other antibiotics demonstrated a slight but nonsignificant fluctuation. Significant regional differences were found in the distribution of clarithromycin resistance among the northern (66.0%), southwestern (48.2%), and southeastern (34.6%) regions. The metronidazole resistance rate was significantly lower in the southeastern coastal region (76.3%) than in the other two regions (88.2% in the north and 87.7% in the southwest). Multi-drug resistance for two or more antibiotics was detected in 36.3% of the H. pylori strains, and the predominant multi-resistance pattern was the dual resistance to clarithromycin and metronidazole.

CONCLUSIONS: The prevalence of H. pylori resistance to clarithromycin and metronidazole is rather high in Chinese children and has been increasing over time. A relatively high resistance rate to levofloxacin was also noticed in children, while almost all strains were susceptible to amoxicillin, furazolidone, and tetracycline. It will be of great clinical significance to continuously monitor the antibiotic-resistance patterns of H. pylori in the pediatric population.

PMID:37983899 | DOI:10.1111/hel.13038

J Oral Rehabil. 2023 Nov 20. doi: 10.1111/joor.13622. Online ahead of print.

ABSTRACT

BACKGROUND: Temporomandibular disorders are the most common condition affecting the orofacial region, resulting in pain and dysfunction.

OBJECTIVE: This study aimed to elucidate the ambiguous association between cervical features and temporomandibular disorders by measuring the rotations between the skull-atlas, atlas-axis and mandible-atlas and examining the relationship between these rotations and temporomandibular disorders.

METHODS: Cone-beam computed tomography (CBCT) images from 176 patients, 97 females and 79 males with an average age of 25.7 years were used in this study. The patients were divided into two groups: those with joint dysfunction (n = 88) and those without (n = 88). The study employed various methods to determine rotations in the skull-atlas, atlas-axis and mandible atlas based on anatomical landmarks and measurements. These methods include the use of specific planes, angles and distances to identify and measure rotation. Data analysis was performed using the TURCOSA statistical software (Turcosa Analytics Ltd Co, Turkey, www.turcosa.com.tr).

RESULTS: The results showed that the degree of rotation between the skull and the atlas was higher in the TMD group than in the control group (p < .001). Similarly, Atlas-axis rotation was significantly higher in the TMD group (p < .001). However, no significant difference was found between mandible atlas rotations in the two groups (p = .546). The study also found a significant difference between the direction of rotation between the atlas and axis and the direction of mandible atlas rotation (p < .001) as well as between skull and atlas rotations and mandible-atlas rotations (p < .001).

CONCLUSION: Overall, the study suggests that there is a relationship between the skeletal structures of the cranio-cervico-mandibular system and TMD. Skull-atlas and atlas-axis rotations may play an important role in the aetiology of TMD in individuals with TMD. Therefore, it is important to evaluate rotations in the skull-atlas-axis region for the treatment of TMD.

PMID:37983893 | DOI:10.1111/joor.13622

Acta Ophthalmol. 2023 Nov 20. doi: 10.1111/aos.15811. Online ahead of print.

ABSTRACT

PURPOSE: The role of the choroid in Leber hereditary optic neuropathy (LHON) remains unclear. The literature is scarce, with conflicting results and lacks axial length measurements. Therefore, we aimed to analyse the choriocapillaris (CC) vessel density (VD) and choroidal thickness (ChT) in all stages of LHON using swept source (SS) technology and considering the possible influence of axial length on choroidal parameters.

METHODS: This was a prospective cross-sectional observational study. A total of 119 eyes of 60 patients with molecularly confirmed LHON across all stages and 120 eyes of 60 control participants were included. We obtained the CC VD using optical coherence tomography angiography maps centred on the fovea. ChT was measured from the Bruch’s membrane to the choroid-sclera interface in the macular and peripapillary regions.

RESULTS: The CC VD was not significantly affected in any sector or average, except for a slight change in the superior region of chronic eyes (52.08 ± 1.62% vs. 53.50 ± 2.29%, p = 0.002). ChT demonstrated a trend towards decreased values in asymptomatic eyes and increased values in the symptomatic stages that failed to reach statistical significance in sectors corresponding to the papillomacular bundle except for the macular nasal inner sector of chronic eyes (281.10 ± 67.12 μm vs. 252.08 ± 70.55 μm, p = 0.045). No significant correlations were observed between visual acuity and CC VD or ChT.

CONCLUSION: The CC VD remained stable across the LHON stages. Choroidal vasculature does not appear to play a role in LHON pathophysiology. Further research is needed on ChT as a potential biomarker of LHON.

PMID:37983892 | DOI:10.1111/aos.15811

Plast Reconstr Surg. 2023 Nov 14. doi: 10.1097/PRS.0000000000011198. Online ahead of print.

ABSTRACT

INTRODUCTION: Carbon-assisted Q-switched Nd:Yag laser treatment consists in applying a topical carbon suspension all over the face followed by irradiation with a Q-switched 1064 Nd:YAG laser. The delivery of multiple microdroplets of dilute Onabotulinum Toxin-A into the dermis, has been investigated as a tool for facial rejuvenation. The aim of this study is to assess the effectiveness of the combined treatment with botulinum toxin and carbon peel laser (performed with a standardized technique) in patients with seborrhea, dilated pores and wrinkles, and to demonstrate its benefits in improving the overall skin aspect.

MATERIAL AND METHODS: Patients enrolled in this prospective pilot study were subjected to 3 sessions of the combined treatment carried out 3 months apart. To evaluate the improvement of skin texture, wrinkles, dilated pores and acne lesions, several scales have been used, namely Fitzpatrick Wrinkle Assessment Scale (FWAS), the Physician Global Aesthetic Improvement Scale (GAIS), a photographic scale for the pore assessment and the Investigator Global Assessment of Acne (IGA). Face Q was also administered to assess patients’ satisfaction. The scores obtained were compared using a paired T-test.

RESULTS: Twenty patients were recruited. Difference of pre and post-treatment scores of the FWAS, GAIS, IGA, Face Q and the photographic scale for the pore assessment were statistically significant (p < 0,05).

CONCLUSIONS: This combined protocol could be considered as an useful tool to treat skin flaws affecting texture, microroughness and seborrhea and to reduce enlarged pore size and its versatility allows customized treatment with minimum discomfort in patients.

PMID:37983881 | DOI:10.1097/PRS.0000000000011198