Category: Nevin Manimala

Cancer Med. 2023 May 6. doi: 10.1002/cam4.6009. Online ahead of print.

ABSTRACT

BACKGROUND: Mantle cell lymphoma (MCL) is an uncommon heterogeneous subtype of B cell non-Hodgkin lymphoma, and clinical features in MCL appear regional characteristics. MCL treatment opinions are not uniform between countries or regions within Asia and China, and Asian patient-specific data for MCL treatment are fewer. The study aims to explore the clinical characteristics, treatment patterns and prognosis of MCL patients in China.

METHODS: A total of 805 patients diagnosed with MCL between April 1999 and December 2019 at 19 comprehensive hospitals in China were included in this retrospective analysis. Kaplan-Meier method coupled with the log-rank test was used for univariate analysis, and COX proportional hazards model was used for multivariate analysis (MVA). p < 0.05 was consided statistically significant. All outputs were produced using R version 4.1.0.

RESULTS: The median age of the cohort was 60.0 years with a male-to-female ratio of 3.36:1. Five-year progression-free survival (PFS) and overall survival (OS) rates were 30.9% and 65.0%, respectively. High-intermediate/high-risk group according to MIPI-c, without high-dose cytarabine, lack of Auto-SCT as consolidation and maintenance treatment and SD/PD in initial treatment remained statistically relevant to poor PFS on MVA, and ki67 ≥50%, B symptoms, high-intermediate/high risk group according to MIPI-c, without high-dose cytarabine, lack of maintenance treatment, SD/PD in initial treatment and relapse/refractory state were independently associated with poorer OS on MVA.

CONCLUSIONS: First-line high dose cytarabine exposure, auto-SCT as consolidation therapy obtained survival benefits in Chinese population. Our study further confirmed the value of maintenance treatment and explored the application of new drug treatment and bendamustine in R/R MCL patients.

PMID:37148540 | DOI:10.1002/cam4.6009

Cancer Med. 2023 May 6. doi: 10.1002/cam4.5974. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: Leisure sedentary behavior (LSB) is associated with the risk of cancer, but the causal relationship between them has not been clarified. The aim of this study was to assess the potential causal association between LSB and risk of 15 site-specific cancers.

METHODS: The causal association between LSB and cancer were assessed with univariate Mendelian randomization (UVMR) and multivariate Mendelian randomization (MVMR). 194 SNPs associated with LSB (from the UK Biobank 408,815 individuals) were adopted as the instrument variables. Sensitivity analyses were performed to ensure the robustness of the results.

RESULTS: UVMR analysis revealed that television watching significantly increased the risk of endometrial cancer (OR = 1.29, 95% CI = 1.02-1.64, p = 0.04) (mainly the endometrioid histology [OR = 1.28, 95% CI = 1.02-1.60, p = 0.031])，breast cancer (OR = 1.16, 95% CI = 1.04-1.30, p = 0.007) (both ER+ breast cancer [OR = 1.17, 95% CI = 1.03-1.33, p = 0.015], and ER- breast cancer [OR = 1.55, 95% CI = 1.26-1.89, p = 2.23 × 10^-5 ]). Although causal association was not found between television watching and ovarian cancer, it was seen in low grade and low malignant potential serous ovarian cancer (OR = 1.49, 95% CI = 1.07-2.08, p = 0.018). However, significant results were not obtained in the UVMR analysis between driving, computer use and the 15 types of cancer. Further MVMR analysis indicated that the above results are independent from most metabolic factors and dietary habits, but mediated by educational attainment.

CONCLUSION: LSB in form of television watching has independent causal association with the risk of endometrial cancer, breast cancer, and ovarian cancer.

PMID:37148539 | DOI:10.1002/cam4.5974

Environ Sci Pollut Res Int. 2023 May 6. doi: 10.1007/s11356-023-27242-4. Online ahead of print.

ABSTRACT

Twenty-nine sediment samples were collected from the Hurghada Bay, a heavily polluted bay on the Red Sea of Egypt, to inspect the environmental quality status and anthropogenic consequences on benthic foraminifera. Some foraminiferal species showed deformations in their apertures and coiling directions as a response to environmental stresses. In addition, the FoRAM index, an index used for evaluating the growth of coral reefs, indicated a hazard in the proximity of nearshore stations. To elucidate the relationships between the biological response and chemistry of sediments, eight heavy metals concentrations (Cu, Cd, Zn, Pb, As, Cr, Ni, and Mn) were analyzed using inductively coupled plasma-atomic emission spectrometers (ICP-AES). Interestingly, two groups of benthic foraminiferal associations were illustrated using multivariate statistical analyses. Group I have extremely high heavy metal concentrations, an enriched total organic matter (TOM)%, high deformation percentages, and mud content. Moreover, it is dominated by Ammonia tepida which is regarded as an opportunistic species. Group II includes low to moderately polluted stations, highly enriched living foraminiferal assemblages, and is dominated by the sensitive rotaliids Neorotalia calcar and Amphistegina lobifera. Alternatively, four geochemical indices, EF, CF, I_geo, and PLI, are used to assess the contamination level that shown ominous spots for the nearshore stations of the Hurghada Bay. The pollution indices (HQ and HI) were also conducted to evaluate the risks of carcinogenic heavy metals on human health. Our findings demonstrated that ingestion and dermal exposure have greater carcinogenic hazards for adults and children than inhalation. The lifetime carcinogenic risk (LCR) is significantly higher than the permissible limit and follows this order: Pb > As > Cr > Cd > Ni. To that end, developing strategies to lessen the negative impact of pollution on human health and/or the Red Sea’s biodiversity is an inevitable issue in the present day and future.

PMID:37148519 | DOI:10.1007/s11356-023-27242-4

Environ Sci Pollut Res Int. 2023 May 6. doi: 10.1007/s11356-023-27434-y. Online ahead of print.

ABSTRACT

In this paper, we empirically study the spatial association network of PM_2.5 and the factors influencing those correlations using the gravity model, social network analysis (SNA), and the quadratic assignment procedure (QAP) based on data from the Beijing-Tianjin-Hebei urban agglomeration (BTHUA) in China from 2005 to 2018. We draw the following conclusions. First, the spatial association network of PM_2.5 exhibits relatively typical network structure characteristics: the network density and network correlations are highly sensitive to efforts to control air pollution, and there are obvious spatial correlations within the network. Second, cities in the center of the BTHUA have large network centrality values, while cities in the peripheral region have small centrality values. Tianjin is a core city in the network, and the spillover effect of PM_2.5 pollution in Shijiazhuang and Hengshui is the most noticeable. Third, the 14 cities can be divided into four plates, with each plate having obvious geographical location characteristics and linkage effects. The cities in the association network are divided into three tiers. Beijing, Tianjin, and Shijiazhuang are located in the first tier, and a considerable number of PM_2.5 connections are completed through these cities. Fourth, differences in geographical distance and urbanization are the main drivers of the spatial correlations of PM_2.5. The greater the urbanization differences, the more likely the generation of PM_2.5 links is, while the opposite is true for differences in geographical distance.

PMID:37148508 | DOI:10.1007/s11356-023-27434-y

Environ Sci Pollut Res Int. 2023 May 6. doi: 10.1007/s11356-023-27389-0. Online ahead of print.

ABSTRACT

Phthalates are widely used as plasticizer or fragrance ingredients in various consumer products worldwide. However, evidence for the overall effects of mixed exposure to phthalate on kidney function has not been widely investigated. The purpose of this article was to assess the association of urine phthalate metabolite levels and kidney injury parameters in adolescents. We used data from the combined 2007-2016 National Health and Nutrition Examination Survey (NHANES). We fitted weighted linear regressions and Bayesian kernel machine regressions (BKMR) models to explore the association of urinary phthalate metabolites with four parameters of kidney function after adjusting for covariates. Weighted linear regression models showed that MiBP (β = 8.057; P_FDR = 0.016) was significantly positively associated with eGFR and MEP (β = -0.799; P_FDR < 0.001) was significantly negatively correlated with BUN. BKMR analysis showed that the higher the concentration of phthalate metabolite mixture, the higher eGFR in adolescents. Based on the results of these two models, our findings revealed that mixed exposure to phthalates was associated with elevated eGFR in adolescents. However, as the study is cross-sectional, reverse causality is possible, and altered kidney function may impact the concentration of phthalate metabolites in urine.

PMID:37148507 | DOI:10.1007/s11356-023-27389-0

Neurourol Urodyn. 2023 May 6. doi: 10.1002/nau.25190. Online ahead of print.

ABSTRACT

AIMS: To use machine learning algorithms to develop a model to accurately predict treatment responses to mirabegron or antimuscarinic agents in patients with overactive bladder (OAB), using real-world data from the FAITH registry (NCT03572231).

METHODS: The FAITH registry data included patients who had been diagnosed with OAB symptoms for at least 3 months and were due to initiate monotherapy with mirabegron or any antimuscarinic. For the development of the machine learning model, data from patients were included if they had completed the 183-day study period, had data for all timepoints and had completed the overactive bladder symptom scores (OABSS) at baseline and end of study. The primary outcome of the study was a composite outcome combining efficacy, persistence, and safety outcomes. Treatment was deemed “more effective” if the composite outcome criteria for “successful,” “no treatment change,” and “safe” were met, otherwise treatment was deemed “less effective.” To explore the composite algorithm, a total of 14 clinical risk factors were included in the initial data set and a 10-fold cross-validation procedure was performed. A range of machine learning models were evaluated to determine the most effective algorithm.

RESULTS: In total, data from 396 patients were included (266 [67.2%] treated with mirabegron and 130 [32.8%] treated with an antimuscarinic). Of these, 138 (34.8%) were in the “more effective” group and 258 (65.2%) were in the “less effective” group. The groups were comparable in terms of their characteristic distributions across patient age, sex, body mass index, and Charlson Comorbidity Index. Of the six models initially selected and tested, the decision tree (C5.0) model was chosen for further optimization, and the receiver operating characteristic of the final optimized model had an area under the curve result of 0.70 (95% confidence interval: 0.54-0.85) when 15 was used for the min n parameter.

CONCLUSIONS: This study successfully created a simple, rapid, and easy-to-use interface that could be further refined to produce a valuable educational or clinical decision-making aid.

PMID:37148497 | DOI:10.1002/nau.25190

Endocrine. 2023 May 6. doi: 10.1007/s12020-023-03386-8. Online ahead of print.

ABSTRACT

PURPOSE: This study aimed to investigate the diagnostic value of dual-phase enhanced computed tomography (CT) in the cervical lymph node metastasis (LNM) of papillary thyroid carcinoma (PTC) by analyzing the dual-phase enhanced Hounsfield units (HUs) of lymph node and sternocleidomastoid muscle, and the ratio and difference.

METHODS: The CT arterial-phase and venous-phase imaging data of 143 metastasis-positive lymph nodes (MPLNs) in 88 cases and 172 metastasis-negative lymph nodes (MNLNs) in 128 cases with PTC were retrospectively analyzed. All lymph nodes were confirmed by surgical pathology. The arterial-phase HU of lymph nodes (AN_HU), venous-phase HU of lymph nodes (VN_HU), arterial-phase HU of the sternocleidomastoid muscle (AM_HU) and venous-phase HU of the sternocleidomastoid muscle (VM_HU) were measured, and their difference and ratio (AN_HU-AM_HU, AN_HU/AM_HU, VN_HU-VM_HU, VN_HU/VM_HU) were calculated. The cutoff values and corresponding diagnostic efficacy for diagnosing LNM in PTC were sought by performing the receiver operating characteristic curves. The maximum pathological diameter (MPD) measured on pathological sections of lymph nodes was compared with the maximum transverse diameter (MTD) and maximum sagittal diameter (MSD) and their average values on CT images.

RESULTS: The AN_HU, and VN_HU of MPLNs and MNLNs were 111.89 ± 33.26 and 66.12 (56.81-76.86) (P < 0.001), and 99.07 ± 23.27 and 75.47 ± 13.95 (P < 0.001), respectively. The area under the curve, sensitivity, and specificity of the arterial-phase three parameters (AN_HU, AN_HU-AM_HU, AN_HU/AM_HU) for diagnosing LNM were (0.877-0.880), (0.755-0.769), and (0.901-0.913), respectively, and the venous-phase three parameters (VN_HU, VN_HU-VM_HU, VN_HU/VM_HU) were (0.801-0.817), (0.650-0.678), and (0.826-0.901), respectively. Compared with MPD, MTD (Z = -2.686, P = 0.007) and MSD (Z = -3.539, P < 0.001) were significantly different, while (MTD + MSD)/2 was not statistically different (Z = -0.038b, P = 0.969).

CONCLUSION: In the differential diagnosis of cervical LNM of PTC by dual-phase enhanced CT angiography, the arterial phase had higher diagnostic efficacy.

PMID:37148418 | DOI:10.1007/s12020-023-03386-8

Endocrine. 2023 May 6. doi: 10.1007/s12020-023-03387-7. Online ahead of print.

ABSTRACT

PURPOSE: Thyroid dysfunction in patients with Klinefelter syndrome (KS) remains an unresolved issue. Although low free thyroxine (FT4) levels within the normal range and normal thyroid stimulating hormone (TSH) levels have been reported, there is currently no data on nodular thyroid disease in this population. This study aims to evaluate the results of thyroid ultrasound (US) examinations in KS patients compared with healthy controls.

METHODS: A cohort of 122 KS and 85 age-matched healthy male controls underwent thyroid US screening and thyroid hormone analysis. According to US risk-stratification systems, nodules ≥1 cm were examined by fine needle aspiration (FNA).

RESULTS: Thyroid US detected nodular thyroid disease in 31% of KS compared to 13% of controls. No statistical differences in the maximum diameter of the largest nodules and in moderate and highly suspicious nodules were found between patients and the control group. Six KS patients and two controls with nodules underwent FNA and were confirmed as cytologically benign. In line with published data, FT4 levels were found significantly near the lower limit of the normal range compared to controls, with no differences in TSH values between the two groups. Hashimoto’s thyroiditis was diagnosed in 9% of patients with KS.

CONCLUSIONS: We observed a significantly higher prevalence of nodular thyroid disease in KS compared to the control group. The increase in nodular thyroid disease is likely linked to low levels of FT4, inappropriate TSH secretion, and/or genetic instability.

PMID:37148417 | DOI:10.1007/s12020-023-03387-7

Ir J Med Sci. 2023 May 6. doi: 10.1007/s11845-023-03388-5. Online ahead of print.

ABSTRACT

OBJECTIVE: Polycystic Ovary Syndrome is the most prevalent hormonal disorder in females. Over the years, metformin (MET) has become the first-line choice of treatment; however, due to its gastrointestinal side effects, a more recent drug, myo-inositol (MI), has been introduced. We aim to conduct a systematic review and meta-analysis to compare the effects of MET and MI on hormonal and metabolic parameters.

MATERIALS AND METHODS: Authors extensively searched PubMed, Scopus, Cochrane Library, Google Scholar, and Web of Science for randomized clinical trials (RCTs) until August 2021. Eight (n = 8) articles were included, with a total sample size of 1088, of which 460 patients received MET, 436 received MI, and 192 received a combination of both. Standard mean differences (SMDs) and Confidence Intervals (CIs) were used for data synthesis, and forest plots were made using Review Manager 5.4 for Statistical Analysis using the random-effect model.

RESULTS: The meta-analysis indicates that there is no significant difference between MET and MI in terms of their effects on BMI (SMD = 0.16, 95% CI: – 0.11 to 0.43, p = 0.24), fasting insulin (SMD = 0.00, 95% CI: – 0.26 to 0.27, p = 0.97), fasting blood sugar (SMD = 0.11, 95% CI: – 0.31to 0.53, p = 0.60), HOMA index (SMD = 0.09, 95% CI: – 0.20 to 0.39, p = 0.50), and LH/FSH (SMD = 0.20, 95% CI: – 0.24 to 0.64, p = 0.37). BMI, fasting blood sugar, and LH/FSH ratio reported moderate heterogeneity because of the varying number of study participants.

CONCLUSION: Our meta-analysis comparing hormonal and metabolic parameters between MET and MI did not show much significant difference, indicating both drugs are equally beneficial in improving metabolic and hormonal parameters in patients with PCOS.

PMID:37148410 | DOI:10.1007/s11845-023-03388-5

J Cancer Surviv. 2023 May 6. doi: 10.1007/s11764-023-01388-z. Online ahead of print.

ABSTRACT

PURPOSE: To examine the effects of Hodgkin’s lymphoma and its treatment on reproductive health in female adolescent and young adults (AYA).

METHODS: We conducted a retrospective, population-based, matched-cohort study of female patients with Hodgkin’s lymphoma diagnosed at 15-39 years of age from 1995 to 2014 in Ontario, Canada. Three female individuals with no history of cancer (unexposed) were matched by birth year and census subdivision to each patient with cancer (exposed). In a subset of the cohort (2005 onwards), the Hodgkin’s lymphoma patients were further classified into two groups for analysis based on treatment exposure: (1) chemotherapy alone or (2) combined chemotherapy and radiation. Reproductive health outcomes were infertility, childbirth, and premature ovarian insufficiency (POI). Relative risks (RR) were calculated using modified Poisson regression adjusted for income quintile, immigration status, and parity.

RESULTS: A total of 1443 exposed and 4329 unexposed individuals formed our cohort. Hodgkin’s lymphoma patients were at an increased risk of infertility (aRR 1.86; 95% CI 1.57 to 2.20) and POI (aRR 2.81; 95% CI 2.16 to 3.65). While the risk of infertility persisted in both treatment groups (chemotherapy alone, combined chemotherapy plus radiotherapy), the increased risk of POI was only statistically significant in the chemotherapy plus radiotherapy group. No differences in childbirth rates were observed, overall or by treatment exposure compared with unexposed individuals.

CONCLUSIONS: Female AYA survivors of Hodgkin’s lymphoma face an increased risk of infertility, independent of exposure to chemotherapy alone, or chemotherapy plus radiotherapy. The risk of POI is higher in those requiring radiotherapy vs. chemotherapy alone.

IMPLICATIONS FOR CANCER SURVIVORS: These results emphasize the importance of pre-treatment fertility counseling and reproductive health surveillance for AYAs diagnosed with Hodgkin’s lymphoma.

PMID:37148406 | DOI:10.1007/s11764-023-01388-z