Category: Nevin Manimala

J Gastrointest Cancer. 2022 Apr 29. doi: 10.1007/s12029-022-00828-w. Online ahead of print.

ABSTRACT

PURPOSE: The present study aimed to investigate the clinical implications of apical lymph node metastasis (ALNM) after curative resection of stage III colorectal cancer.

METHODS: A retrospective study was conducted of 1403 consecutive colorectal cancer patients who underwent surgical resection at a single institution between April 2008 and January 2020. The characteristics of ALNM, the recurrence status and the relapse-free survival (RFS) were examined.

RESULTS: The numbers of patients with stage ≤ I, II, III, and IV disease were 350, 437, 476, and 140 patients, respectively. Among these patients with stage III disease, ALNM was seen in 21 patients (4.4% of stage III patients). Among them, curative resection was performed in 19 patients. Recurrence was observed in 68% (13/19) of the patients with ALNM who received curative resection. The first sites of recurrence included the lymph nodes 53.8% (7/13), liver 30.8% (4/13), lung 15.4% (2/13), brain 7.7% (1/13), bone 7.7% (1/13), and peritoneum 7.7% (1/13). There was no significant difference in the RFS of patients with ALNM who were managed with or without adjuvant chemotherapy (P = 0.207). Furthermore, the RFS of the group managed without adjuvant chemotherapy and the group that received adjuvant chemotherapy with/without oxaliplatin did not differ to a statistically significant extent (P = 0.318). In stage III colorectal cancer patients with ALNM, recurrence was observed significantly more frequently in comparison to stage III colorectal cancer patients without ALNM (P = 0.007). The first site of recurrence in patients with ALNM was most frequently seen in the distant lymph nodes (P = 0.004).

CONCLUSION: Our findings suggest that ALNM is strongly associated with recurrence in the distant lymph nodes and that it may lead to the development of systemic disease. The current regimen for stage III colorectal cancer may therefore not be sufficient for patients with stage III ALNM.

PMID:35486262 | DOI:10.1007/s12029-022-00828-w

Bull Math Biol. 2022 Apr 29;84(6):61. doi: 10.1007/s11538-022-01019-1.

ABSTRACT

Although great progress has been made in the prevention and mitigation of TB in the past 20 years, China is still the third largest contributor to the global burden of new TB cases, accounting for 833,000 new cases in 2019. Improved mitigation strategies, such as vaccines, diagnostics, and treatment, are needed to meet goals of WHO. Given the huge variability in the prevalence of TB across age-groups in China, the vaccination, diagnostic techniques, and treatment for different age-groups may have different effects. Moreover, the statistics data of TB cases show significant seasonal fluctuations in China. In view of the above facts, we propose a non-autonomous differential equation model with age structure and seasonal transmission rate. We derive the basic reproduction number, [Formula: see text], and prove that the unique disease-free periodic solution, [Formula: see text] is globally asymptotically stable when [Formula: see text], while the disease is uniformly persistent and at least one positive periodic solution exists when [Formula: see text]. We estimate that the basic reproduction number [Formula: see text] ([Formula: see text]), which means that TB is uniformly persistent. Our results demonstrate that vaccinating susceptible individuals whose ages are over 65 and between 20 and 24 is much more effective in reducing the prevalence of TB, and each of the improved vaccination strategy, diagnostic strategy, and treatment strategy leads to substantial reductions in the prevalence of TB per 100,000 individuals compared with current approaches, and the combination of the three strategies is more effective. Scenario A (i.e., coverage rate [Formula: see text], diagnosis rate [Formula: see text], relapse rate [Formula: see text]) is the best and can reduce the prevalence of TB per 100,000 individuals by [Formula: see text] and [Formula: see text] in 2035 and 2050, respectively. Although the improved strategies will significantly reduce the incidence rate of TB, it is challenging to achieve the goal of WHO in 2050. Our findings can provide guidance for public health authorities in projecting effective mitigation strategies of TB.

PMID:35486232 | DOI:10.1007/s11538-022-01019-1

Eur J Orthop Surg Traumatol. 2022 Apr 29. doi: 10.1007/s00590-022-03258-3. Online ahead of print.

ABSTRACT

INTRODUCTION: Civilian gun violence is a public health crisis in the USA that will be an economic burden reported to be as high as $17.7 billion with over half coming from US taxpayers dollars through Medicaid-related costs. The purpose of this study is to review the epidemiology of upper extremity firearm injuries in the USA and the associated injury burden.

METHODS: The Inter-university Consortium for Political and Social Research’s Firearm Injury Surveillance Study database, collected from the National Electronic Injury Surveillance System, was queried from 1993 to 2015. The following variables were reviewed: patient demographics, date of injury, diagnosis, injury location, firearm type (if provided), incident classification, and a descriptive narrative of the incident. We performed chi-square testing and complex descriptive statistics, and binomial logistic regression model to predict factors associated with hospital admission.

RESULTS: From 1993 to 2015, an estimated 314,369 (95% CI: 291,528-337,750; 16,883 unweighted) nonfatal firearm upper extremity injuries with an average incidence rate of 4.76 per 100,000 persons (SD: 0.9; 03.77-7.49) occurred. The demographics most afflicted with nonfatal gunshot wound injuries were black adolescent and young adult males (ages 15-24 years). Young adults aged 25-34 were the second largest estimate of injuries by age group. Hands were the most commonly injured upper extremity, (55,014; 95% CI: 75,973-89,667) followed by the shoulder, forearm, and upper arm. Patients who underwent amputation (OR: 28.65; 95% CI: 24.85-33.03) or with fractures (OR: 26.20; 95% CI: 23.27-29.50) experienced an increased likelihood for hospitalization. Patients with a shoulder injury were 5.5× more likely to be hospitalized than those with a finger injury (OR:5.57; 95% CI:5.35-5.80). The incidence of upper extremity firearm injuries has remained steady over the last decade ranging between 4 and 5 injuries per 100,000 persons. Patients with proximal injuries or injuries involving the bone were more likely to require hospital admission. This study should bring new information to the forefront for policy makers regarding gun violence.

PMID:35486233 | DOI:10.1007/s00590-022-03258-3

Pol Przegl Chir. 2021 Nov 8;94(2):19-26. doi: 10.5604/01.3001.0015.4874.

ABSTRACT

<b>Introduction:</b> Adenomatous polyps are pivotal to the development of colorectal cancer. The risk of colorectal carcinogenesis can be reduced through polypectomy and close surveillance of the disease. Early-stage polyps can be detected and removed endoscopically, therefore, reducing the incidence of carcinoma. The identification of CSC in colon polyps allows for assessment of their potential malignancy. Therefore, it is very relevant to study the prognostic significance of the prevalence of stem cells in colorectal polyps in early detection and prevention of cancer. </br></br> <b> Method:</b> Previously pathologically evaluated adenomatous tumors (60M, 40F) at Azerbaijan Medical University were reevaluated in Meram Medical Faculty Pathology Department. Hematoxylin-Eosin-stained slides were examined and cases with and without dysplasia were determined. New sections were taken from paraffin blocs. Prominin-1 staining was performed immunohistochemically on these sections. Stained slides were examined by an image analysis system. Prominin-1-positive cells were automatically counted with the same image analysis system. The cases that developed malignancy after polypectomy were determined. The relationship between CD133 expression of dysplasia and malignancy was statistically analyzed. </br></br> <b> Results:</b> Statistically significant prominin-1 expression was detected in cases with dysplasia and malignancy. </br></br> <b> Conclusion:</b> The investigation of prominin-1 expression in colorectal polyps may be important to determine malignancy development.

PMID:35485315 | DOI:10.5604/01.3001.0015.4874

Anat Histol Embryol. 2022 Apr 29. doi: 10.1111/ahe.12805. Online ahead of print.

ABSTRACT

In this study, atomic force microscopy (AFM), microtomography (MCT-2D and MCT-3D) and energy-dispersive X-ray fluorescence spectrometry (EDXRF) were used to generate parameters of the microstructure of the hoof capsule of pigmented and partial albino buffaloes. Seventy-two digits of adult pigmented buffaloes and 16 of partial albino buffaloes were used and equally divided into thoracic and pelvic limbs and medial and lateral claws. Fragments of 10 mm × 10 mm of the dorsal wall, abaxial wall and pre-bulbar sole were collected. The parametric assumptions were tested using a Shapiro-Wilk test (normality). The independent t-test was used to compare the means at a 5% significance level. AFM demonstrated that the hoof surface of pigmented buffaloes presented with higher average surface roughness (Ra) and root mean square roughness (Rms) (p < 0.05) than the hoof surface of partial albino buffaloes. MCT-2D revealed that pigmented buffaloes had extra tubular keratin with a higher density than intratubular keratin. No pores were observed in the hoof capsule of the buffalo digits. MCT-3D demonstrated that pigmented buffaloes have a higher percentage of large and intermediate horn tubules than partial albino buffaloes. However, this difference was not statistically significant. Partial albino buffaloes showed a statistically higher number of horn tubules/mm² than pigmented buffaloes (p < 0.05). EDXRF revealed a higher amount of sulphur (S) in the hoof capsule of pigmented buffaloes, and the partial albino buffaloes presented a higher number of minerals such as calcium (Ca), potassium (K), zinc (Zn) and copper (Cu).

PMID:35485276 | DOI:10.1111/ahe.12805

Mol Med Rep. 2022 Jun;25(6):206. doi: 10.3892/mmr.2022.12722. Epub 2022 Apr 29.

ABSTRACT

As the understanding of cancer grows, new therapies have been proposed to improve the well-known limitations of current therapies, whose efficiency relies mostly on early detection, surgery and chemotherapy. Mesenchymal stem cells (MSCs) have been introduced as a promissory and effective therapy. This fact is due to several useful features of MSCs, such as their accessibility and easy culture and expansion in vitro, and their remarkable ability for ‘homing’ towards tumors, allowing MSCs to exert their anticancer effects directly into tumors. Additionally, MSCs offer the practicability of being genetically engineered to carry anticancer genes, increasing their specificity and efficacy for fighting tumors. In the present study, the antitumoral efficacy and post-implant survival of mice bearing lymphomas implanted intratumorally were determined using mouse bone marrow-derived (BM)-MSCs transduced with soluble TRAIL (sTRAIL), full length TRAIL (flTRAIL), or interferon β (IFNβ), naïve BM-MSCs, or combinations of these. The percentage of surviving mice was determined once all not-implanted mice succumbed. It was found that the percentage of surviving mice implanted with the combination of MSCs-sTRAIL and MSCs-IFN-β was 62.5%. Lymphoma model achieved 100% fatality in the non-treated group by day 41. On the other hand, the percentage of surviving mice implanted with MSCs-sTRAIL was 50% and with MSCs-INFβ 25%. All the aforementioned differences were statistically significant (P<0.05). In conclusion, all implants exhibited tumor size reduction, growth delay, or apparent tumor clearance. MSCs proved to be effective anti-lymphoma agents; additionally, the combination of soluble TRAIL and IFN-β resulted in the most effective antitumor and life enlarging treatment, showing an additive antitumoral effect compared with individual treatments.

PMID:35485288 | DOI:10.3892/mmr.2022.12722

BJU Int. 2022 Apr 29. doi: 10.1111/bju.15766. Online ahead of print.

ABSTRACT

OBJECTIVES: Upper tract obstructive uropathy (UTOU) is a complication of advanced prostate cancer (PCa) that may require urinary tract decompression. There are no population-based studies on the incidence, treatment, and outcomes of this complication. We developed and validated a coding framework to identify procedures for UTOU in men with locally advanced and metastatic PCa using administrative hospital data to assess clinical outcomes.

PATIENTS AND METHODS: Patients newly diagnosed with PCa between April 2014 and March 2019 were identified in the English cancer registry. A coding framework based on procedure (OPCS-4) and diagnostic (ICD-10) codes was developed and validated. Subsequent clinical outcomes were determined using Hospital Episodes Statistics (HES) to determine the utility of the intervention.

RESULTS: A total of 77,010 patients newly diagnosed with locally advanced, and 30,083 patients with metastatic PCa were identified. Of these, 1,951 (1.8%) patients underwent an intervention for UTOU according to our coding framework: 830 (42.5%) had locally advanced disease and 1,121 (57.5%) had metastatic disease. 844 (43.3%) had a percutaneous nephrostomy (PCN), 473 (24.2%) had a PCN with antegrade stent and 634 (32.5%) had a retrograde stent. Mean follow-up time was 43.2 months. The cumulative incidence of the use of these interventions at one, three, and five years was 2.5%, 3.6% and 4.2% in men with metastases compared to 0.5%, 0.9% and 1.4% in men with locally advanced disease.

CONCLUSION: A new coding framework, developed to identify procedures for UTOU. was applied in the largest study to date of UTOU in men with primary locally advanced and metastatic PCa. Results demonstrated that 2% of men with locally advanced PCa and 4% of men with metastatic PCa require an intervention to resolve UTOU within 5 years of their PCa diagnosis.

PMID:35485254 | DOI:10.1111/bju.15766

Andrology. 2022 Apr 29. doi: 10.1111/andr.13194. Online ahead of print.

ABSTRACT

BACKGROUND: Nowadays pathogenesis of preeclampsia is still unknown. Among the different etiological hypotheses, some authors proposed that it might be due to an abnormal immunologic response to foreign fetal antigen derived from the father’s sperm. Indeed, the fetus is considered a semi allograft, being one half paternally derived in its antigenicity, and the first pathogenic insult of preeclampsia may be an abnormal maternal immune response towards this semi-allogenic implant. In the context of Artificial Reproductive Techniques, it has been shown that the use of donor and surgically retrieved spermatozoa (e.g. Testicular Sperm Extraction) increases the risk of preeclampsia, confirming the protective effect of sperm exposure on maternal complications.

OBJECTIVE: Determining whether the lack of exposure to sperm antigens is associated with worse maternal and neonatal outcomes in pregnancies obtained through intracytoplasmic sperm injection after testicular sperm extraction for obstructive azoospermia.

MATERIAL AND METHODS: This is a single-center case-control retrospective study, focusing on all first pregnancies obtained through intracytoplasmic sperm injection after testicular sperm extraction for obstructive azoospermia at Humanitas Fertility Center between January 1st, 2010 and December 31st, 2019. Controls included patients that achieved their first pregnancy with intracytoplasmic sperm injection and ejaculated sperm, for a diagnosis other than azoospermia, in the same time period. Cases were matched with controls in a 1:2 ratio, considering female age, female BMI and year of controlled ovarian stimulation. The primary outcome measure was the delivery rate, defined as the number of deliveries divided by the total number of clinical pregnancies. Secondary outcome measures focused on maternal and neonatal complications, such as miscarriage rate, rate of main obstetric complications, prematurity rate and rate of congenital malformations.

RESULTS: By analyzing overall 113 pregnancies among cases and 214 pregnancies among controls, this study showed that the delivery rate was higher in controls with respect to cases (92.06% vs 84.07%, p = 0.026); among deliveries, live births were respectively 98.95% and 100%, while only one stillbirth occurred in cases. The first trimester miscarriage rate was higher in the cases than controls (13.27% vs 6.07%, p = 0.027), while no difference was found among rate of second trimester miscarriages, therapeutic abortions and ectopic pregnancies. There was no difference regarding the rate of maternal complications, including gestational hypertension, preeclampsia, HELLP syndrome, gestational diabetes, placenta previa, placental abruption and premature rupture of the membranes. Considering neonatal complications, it was shown that twins belonging to controls had a higher prematurity rate with respect to cases (65.79% vs 50.00%) but without a statistical relevance. Lastly, the rate of congenital malformations did not differ among the two groups.

DISCUSSION: This study showed that, once couples diagnosed with obstructive azoospermia achieve a pregnancy, they have a much higher risk of miscarriage in the first trimester in respect to non-azoospermic patients. Moreover, controls had a higher delivery rate in respect to cases; however, when the fetal status at birth was compared, no difference was found between live births and stillbirths.

CONCLUSIONS: Differently from the findings in the literature, no association with preeclampsia was found. This might be related to a collider bias/left truncation bias: since azoospermic patients are at higher risk of early termination of pregnancy, it results that they do not have the possibility to develop preeclampsia and other adverse outcomes. This article is protected by copyright. All rights reserved.

PMID:35485252 | DOI:10.1111/andr.13194

Nurs Open. 2022 Apr 29. doi: 10.1002/nop2.1222. Online ahead of print.

ABSTRACT

AIM: To evaluate the effects of a person-centred and thriving-promoting intervention on nursing home residents´ experiences of thriving and person-centredness of the environment, and to evaluate if the effects varied between female and male residents.

DESIGN: A multi-centre, non-equivalent controlled group before-after intervention design.

METHODS: Six nursing homes in Australia, Norway and Sweden were allocated to either intervention or control group. The intervention comprised a staff educational programme. A survey using proxy-ratings by staff was administered before (T0), immediately after (T1) and six months after (T2) the intervention. The sample varied between 205 and 292 residents. Linear regression models were used to explore effects.

RESULTS: Statistically significant effects were found on experiences of thriving and person-centredness of the environment. These effects were significant for male residents but not for female residents. The results emphasize the importance of individually tailored social and recreational activities.

PMID:35485234 | DOI:10.1002/nop2.1222

Int J Dent Hyg. 2022 Apr 29. doi: 10.1111/idh.12594. Online ahead of print.

ABSTRACT

BACKGROUND: Nicotine replacement therapy is the first choice pharmacotherapy for smoking cessation. Oral side effects caused due to NRT lead to discontinuation of treatment. The objective of this meta-analysis is to look for the certainty of evidence on the number of patients that reported oral side effects due to the use of NRT.

METHOD: Eligible studies were selected and data extraction was carried out independently into a pre-tested data extraction form. Risk of Bias was assessed using Cochrane Tool. The heterogeneity between the studies was assessed using Chi-square and I2 tests. Mean difference and Odds ratio at 95% confidence interval were the effect estimates. GRADE working group approach was used to assess the quality of evidence.

RESULTS: 28 studies were included with moderate to low risk of Bias. The pooled estimates revealed a statistically significant number of patients developed mouth or throat irritation (2.54[1.23,5.25]), or oral soreness (2.22[1.40,3.55]) or gastric reflux or vomiting (1.97[1.34,2.90]) due to NRT.

CONCLUSION: It is important to understand that significant implications are caused due to NRT, on oral health. All patients on NRT must adhere to their regular dentist visits and must check their oral mucosa before initiating NRT.

PMID:35485245 | DOI:10.1111/idh.12594