Category: Nevin Manimala

Epilepsy Behav. 2022 Mar 5;129:108636. doi: 10.1016/j.yebeh.2022.108636. Online ahead of print.

ABSTRACT

OBJECTIVE: The effect of the frontal lobe on cognitive functions is a subject that has been studied frequently. However, cognitive impairments that can be seen in frontal lobe epilepsy are less addressed. In previous studies on decision-making disorders in patients with epilepsy, patients with temporal lobe epilepsy (TLE) were frequently studied, and it was reported that decision-making disorders could be encountered in this patient group. In this study, we aimed to compare the decision-making performance of patients with cryptogenic frontal lobe epilepsy (FLE) and TLE in ambiguous situations.

METHODS: Twenty patients with TLE (mean age: 34.10 ± 11.71 years) and 20 patients with FLE (mean age: 32.25 ± 11.92 years) were enrolled in the study and their cognitive performance was compared with 20 healthy controls (mean age: 33.15 ± 13.66 years). Neuropsychological tests were performed on the participants for sleep, depression, anxiety, impulsivity, intelligence, attention, language functions, memory and learning, and frontal axis functions. Decision-making performance in ambiguous situations was studied using the Iowa Gambling Task (IGT).

RESULTS: Iowa Gambling Task performances of patients with FLE and TLE were found to be worse than in healthy controls (p = 0.049). Although there was no statistically significant difference when the decision-making of patients with TLE and FLE was compared, it was observed that patients with FLE chose higher risk cards compared with those with TLE. The performances of the neuropsychological subgroup tests of patients with TLE and FLE in attention, language functions, memory and learning, and frontal axis functions were found to be significantly worse than in healthy subjects.

CONCLUSION: Decision-making in patients with TLE and FLE in ambiguous situations is similarly impaired compared with healthy controls.

PMID:35259626 | DOI:10.1016/j.yebeh.2022.108636

J Psychosom Res. 2022 Mar 1;156:110775. doi: 10.1016/j.jpsychores.2022.110775. Online ahead of print.

ABSTRACT

OBJECTIVE: To obtain more insight into the patterns of co-occurring symptoms, biomarkers and predictors in Somatic Symptom Disorders and Related Disorders (SSRD) and to identify subgroups with profiles that might allow for personalised treatment.

METHODS: Cross-sectional study design with Latent class analysis (LCA) to determine different subgroups in a cohort of 239 outpatients with SSRD in 3 steps: 1) building a latent class model; 2) assigning subjects to the latent classes that suited them best based on their posterior probability; 3) investigating the associations between these classes and personal characteristics such as age, gender, somatic comorbidity and general health perception.

RESULTS: Four classes with clinically relevant profiles were found. One with trauma plus elevated inflammation biomarkers, high somatic symptom levels, pain and comorbid depression and anxiety. One with pain plus elevated biomarkers, depression and anxiety. One with low IL-6 and hsCRP, mostly linked to Illness Anxiety. And one with high pain and high elevated biomarkers, but less probability of other factors, that occurred mostly in men. General health perception was lower in classes with elevated inflammation biomarkers.

CONCLUSIONS: The findings of this first study exploring latent classes in an SSRD sample corroborate the current DSM-5 SSD subclassification for pain and Illness Anxiety Disorder. There is scope to extend the current DSM-5 classification with a subclassification of SSD with trauma, and a subclassification with elevated IL6 or hsCRP, as relevant for developing new personalised treatments addressing trauma or SLI in SSRD. Further research is needed to explore this.

PMID:35259552 | DOI:10.1016/j.jpsychores.2022.110775

J Neurol Sci. 2022 Feb 24;436:120205. doi: 10.1016/j.jns.2022.120205. Online ahead of print.

ABSTRACT

INTRODUCTION: Despite differences in the pathogenesis and treatment of multiple sclerosis (MS) and neuromyelitis optica spectrum disorders (NMOSD), it remains difficult to distinguish them. In this study, we aimed to discriminate between MS and NMOSD using diffusion tensor imaging (DTI), free water (FW) imaging, and neurite orientation dispersion and density imaging (NODDI).

METHODS: Thirty patients with relapsing-remitting (RR) MS, 18 NMOSD patients with positive anti-aquaporin-4 immunoglobulin G seroreactivity, and 20 age- and sex- matched currently healthy subjects underwent MRI. The differences in the DTI (fractional anisotropy [FA], axial diffusivity [AD], mean diffusivity [MD], and radial diffusivity [RD]), FW and FW-corrected DTI, and NODDI indices between the three groups were evaluated using tract-based spatial statistics (TBSS) and region-of-interest (ROI) analyses.

RESULTS: The ROI analysis of lesions indicated that the RRMS group had significantly higher AD, MD, RD, ISO and FW-corrected AD, and MD; and lower intracellular volume fraction (ICVF) than the NMOSD group. TBSS analysis showed increased water content in RRMS patients compared to NMOSD patients. Compared with healthy controls (HCs) using TBSS and ROI analysis, the changes in FW imaging indices were more limited than those of in DTI in RRMS patients.

CONCLUSION: FW imaging and NODDI were useful for identifying the etiology of neurodegeneration- and neuroinflammation-related microstructural changes in RRMS and NMOSD patients.

PMID:35259556 | DOI:10.1016/j.jns.2022.120205

Acad Pediatr. 2022 Mar 5:S1876-2859(22)00090-0. doi: 10.1016/j.acap.2022.02.020. Online ahead of print.

NO ABSTRACT

PMID:35259547 | DOI:10.1016/j.acap.2022.02.020

Transl Res. 2022 Mar 5:S1931-5244(22)00043-3. doi: 10.1016/j.trsl.2022.02.009. Online ahead of print.

ABSTRACT

Whether hepatitis C virus (HCV) infection is associated with breast cancer risk remains elusive, and we aimed to elucidate it. A nationwide population-based cohort study of the Taiwan National Health Insurance Research Database (TNHIRD) was conducted. Additionally, breast cancer risk factors and HCV core expression were surveyed in breast cancer patients of a tertiary care center. Three TNHIRD cohorts (1:4:4, propensity score-matched, 2003-2012), including HCV-treated (3,646 HCV-infected females with interferon-based therapy ≥ 6 months), HCV-untreated (n=14,584) and HCV-uninfected (n=14,584) cohorts, were enrolled. The HCV-untreated cohort had the highest 9-year breast cancer cumulative incidence [2.017%; 95% confidence interval (CI): 1.382-2.846%], while the HCV-treated (1.073%; 0.414-2.356%) and HCV-uninfected (1.453%; 0.785-2.486%) cohorts showed no difference. Untreated HCV infection [hazard ratio (HR): 1.701; 95% CI: 1.205-2.400], urban residency (1.658, 1.183-2.323) and baseline cardiovascular events (1.920; 1.005-3.668) were associated with incident breast cancers. The interaction analysis showed that particularly among patients <49 years, HCV infection was associated with breast cancer development (2.193; 1.097-4.384). Of 12,170 hospitalized breast cancer patients, 4.90% were HCV Ab-positive. HCV Ab-positive patients were older (60.92+/-10.82 vs. 53.91+/-11.38 years, p<0.0001) and had a higher body mass index (25.39+/-5.1 vs. 24.5+/-4.3 kg/m², p=0.007), rates of diabetes (30.60 vs. 19.98%, p<0.0001), hypertension (46.9 vs. 30.39%, p<0.0001), dyslipidemia (25.52 vs. 20.28%, p=0.031) and hyperuricemia (11.38 vs. 5.52%, p<0.0001) than their counterparts. No HCV core-positive cells were demonstrated in breast cancer tissues. Conclusions: Untreated HCV infection, urbanization, and cardiovascular events were potential risk factors for breast cancer. The HCV-associated risk was most prominent among patients < 49 years, might not be associated with in situ HCV core-related oncogenesis but with metabolic alterations and was reversed by anti-HCV therapy.

PMID:35259528 | DOI:10.1016/j.trsl.2022.02.009

J Vasc Surg Venous Lymphat Disord. 2022 Mar 5:S2213-333X(22)00096-8. doi: 10.1016/j.jvsv.2022.01.012. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the utility of a published clinical decision support tool to predict the likelihood of a retrievable inferior vena cava (IVC) filter being maintained as a permanent device.

METHODS: This multicenter retrospective cohort study included 1,498 consecutive patients (852 men,646 women; median age 60 years (range 18-98 years) who underwent retrievable IVC filter insertion between 1/2012-12/2019. Indication for IVC filtration, baseline neurologic disease, history of venous thromboembolism(VTE), and underlying malignancy were recorded. Accuracy, sensitivity, and specificity of a published clinical support tool were calculated to determine the utility of the tool.

RESULTS: The majority (1,271/1,498;85%) of filters were placed for VTE with a contraindication to anticoagulation. A history of VTE was present in 811/1,498(54%) patients; underlying malignancy in 531/1,498(35%) patients, and neurological disease in 258/1,498(17%) patients. Of 1,498 filters, 456(30%) were retrieved, 276(18%) filters were maintained as permanent devices on follow-up, and 766 (51%) filters were not retrieved. Accuracy of the clinical prediction model was 61%, sensitivity was 60%, and specificity was 62%.

CONCLUSION: A previously published clinical decision support tool to predict permanence of IVC filters had modest utility in the examined population; this should be taken into account when utilizing this clinical decision support tool outside of the original study population. Future studies are required to refine the predictive capability of IVC filter decision support tools for broader use across different patient populations.

PMID:35259532 | DOI:10.1016/j.jvsv.2022.01.012

World Neurosurg. 2022 Mar 5:S1878-8750(22)00286-8. doi: 10.1016/j.wneu.2022.03.005. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aimed to clarify functional outcomes of facet joint distraction (FJD) and identify specific risk factors for excessive FJD during single-level anterior cervical discectomy and fusion (ACDF) for cervical spondylotic myelopathy (CSM).

METHODS: This study retrospectively analyzed 100 patients who underwent single-level ACDF for CSM from January 2016 to May 2020. Anteroposterior and lateral radiographs were obtained before surgery and 12 months after surgery. Radiographic parameters, including anterior intervertebral height (AIH), posterior intervertebral height, facet joint gap, cage posterior depth (CPD), upper vertebral length, cervical segmental cobb angle (CSCA), C2-C7 cobb angle and C2-C7 sagittal vertical axis were analyzed. Functional outcomes were evaluated using the modified Japanese Orthopedic Association Score (mJOA), Visual Analog Scale (VAS) and Neck Disability Index (NDI).

RESULTS: Comparison between the appropriate facet joint distraction and excessive facet joint distraction groups showed statistically significant differences in the NDI, VAS, CPD and ΔAIH (P<0.05). Multivariate logistic regression analysis showed independent factors associated with excessive FJD were: a ΔAIH>2.28mm (OR=6.792, 95%CI=1.885-24.470, P=0.003), CPD>12.45mm (OR=5.876, 95%CI=1.828-18.895, P=0.003) and post-CSCA<0° (OR=6.251, 95%CI=1.275-30.633, P=0.024). Furthermore, ROC curve analysis for the multi-level logistic regression model produced an area under the curve of 0.783 (P<0.001).

CONCLUSION: Patients with an FJD>0.905 mm had worse NDI and VAS pain scores, but not a poorer mJOA recovery rate. Our findings suggested that a ΔAIH>2.28 mm, CPD>12.45 mm and post-CSCA<0° were independent risk factors for excessive FJD after single-level ACDF for CSM.

PMID:35259505 | DOI:10.1016/j.wneu.2022.03.005

World Neurosurg. 2022 Mar 5:S1878-8750(22)00273-X. doi: 10.1016/j.wneu.2022.02.126. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the accuracy of using patient-specific drill guides to place bilateral laminar screws in C1 and C2.

METHODS: Nine cervical specimens (8 male; mean age: 66.6 (56-73)) with the occiput attached (C0-C3) were used in this study. Pre-operative CT scans were used to create digital anatomic models for templating and guide creation. A total of 36 screws were placed with the aid of 3D printed patient-specific guides (2 screws at C1 and C2). Post-operative CT scans were performed following screw insertion. The planned and actual trajectories were compared using pre- and post-operative imaging based on the angular and entry point deviation. After screw placement and post-operative imaging, each specimen was dissected and performed a visual inspection for breaches.

RESULTS: No breaches or violations were observed on post-procedure CT and visual inspection. The average variation of the entry point in the X, Y, and Z-axis was 0.3±0.28, 0.41±0.38, and 0.29±0.24, respectively. No statistically significant difference (p>0.05) was observed between the planned and obtained entry points. There was no significant difference (p>0.05) in the deviation analysis between the planned and obtained angles in the axial and coronal planes.

CONCLUSION: The study demonstrates that patient-specific drill guides allow for accurate C1 and C2 bilateral laminar screw placement, with a low risk of cortical breach.

PMID:35259502 | DOI:10.1016/j.wneu.2022.02.126

Clin Cancer Res. 2022 Mar 8:clincanres.4462.2021. doi: 10.1158/1078-0432.CCR-21-4462. Online ahead of print.

ABSTRACT

On August 25, 2021, the FDA approved ivosidenib for the treatment of adult patients with unresectable locally advanced or metastatic hepatocellular isocitrate-dehydrogenase-1 (IDH1) mutated cholangiocarcinoma (CCA) as detected by an FDA-approved test with disease progression after 1-2 prior lines of systemic therapy for advanced disease. The approval was based on data from Study AG120-C-005 (ClarIDHy), a double-blind placebo-controlled trial which randomly allocated (2:1) patients to receive either ivosidenib or placebo. Independently-assessed progression free survival (PFS) was the primary endpoint. With a median follow up of 6.9 months, the hazard ratio for PFS was 0.37 (95% confidence interval 0.25, 0.54, p&lt; 0.0001). Overall survival (OS) was the key secondary endpoint. At the final analysis of OS, with 70.5% patients in the placebo arm receiving ivosidenib post disease progression, a non-statistically significant improvement in the ivosidenib arm with a HR = 0.79 (95% CI: 0.56, 1.12) and median OS of 10.3 months (95% CI 7.8, 12.4) and 7.5 months (95% CI 4.8, 11.1) in the ivosidenib and placebo arms respectively were reported. Adverse reactions occurring in &gt;20% of patients receiving ivosidenib were fatigue/asthenia, nausea, diarrhea, abdominal pain, ascites, vomiting, cough, and decreased appetite. Adverse reactions occurring in &gt;20% of patients receiving placebo were fatigue/asthenia, nausea, abdominal pain, and vomiting. This is the first approval for the subset of patients with CCA harboring an IDH1 mutation.

PMID:35259259 | DOI:10.1158/1078-0432.CCR-21-4462

PLoS One. 2022 Mar 8;17(3):e0265034. doi: 10.1371/journal.pone.0265034. eCollection 2022.

ABSTRACT

We analyzed data from a cohort of Black and Latino men who have sex with men (MSM) in order to identify correlates of prevalent and incident incarceration, including potential predictors related to their status as sexual and gender minorities (SGMs). Baseline and follow-up self-administered survey data were examined from Los Angeles County participants’ ages 18-45 years at enrollment who were either HIV negative or living with HIV, but recruited to over represent men who used drugs and men with unsuppressed HIV infection. Multivariable logistic regression models were developed to identify predictors of baseline incarceration history and of incident incarceration over study follow-up among 440 and 338 participants, respectively. Older age, Black race, low socioeconomic status, homelessness, stimulant use, and depression symptoms were associated with baseline incarceration history. The only SGM-related factor associated with baseline incarceration history was having experienced violence based on sexual orientation identity. Just one statistically significant, independent positive predictor of incident incarceration was identified: prior incarceration, whereas having four or more friends that could lend money was a statistically significant protective factor against incident incarceration. Fundamental Cause Theory provides a useful framework to explain identified predictors of incarceration. Addressing poverty, housing instability, inadequate access to health care, and their root causes is critical to reducing incarceration rates in this population, as is expanded access to both diversion and anti-recidivism programs and to evidence-based treatment for stimulant use disorders.

PMID:35259198 | DOI:10.1371/journal.pone.0265034