Category: Nevin Manimala

J Obstet Gynaecol Res. 2023 Jun 1. doi: 10.1111/jog.15699. Online ahead of print.

ABSTRACT

AIM: To explore left ventricular structural/functional abnormalities in preeclampsia patients by using multimodal echocardiography and to analyze the cardiac impact in preeclampsia subtypes.

METHODS: A total of 103 individuals, including 64 preeclampsia patients and 39 healthy pregnant women were recruited for this study from 2019 to 2021. There were 34 patients with preeclampsia with severe features (SPE) patients and 30 with preeclampsia with nonsevere features (NSPE), including 9 with early-onset NSPE (EO-NSPE) patients, 27 early-onset SPE (EO-SPE) patients, 21 later-onset NSPE (LO-NSPE), and 7 with later-onset SPE (LO-SPE). All patients underwent multimodal echocardiography before treatment, including two-dimensional, Doppler, and speckle-tracking echocardiography, to evaluate left ventricular structure/function. Analysis of variance was used to determine statistical significance across groups.

RESULTS: EO-SPE patients showed decreased left ventricular ejection fractions, peak longitudinal systolic strain at apical four-chambers, peak circumferential, and radial systolic strain at the apical and mitral annular plane systolic excursion (MAPSE), and increased mitral regurgitation compared to other preeclampsia patients. Compared to LO-NSPE and EO-SPE patients, LO-SPE patients showed increased left ventricular mass indexed to height^2.7 and early diastolic left ventricular diastolic filling/mitral annular velocity, and decreased MAPSE and early/late diastolic mitral annular velocity.

CONCLUSION: EO-SPE patients were characterized by left ventricular injury and systolic function reduced. LO-SPE patients were characterized by left ventricular hypertrophy and reduced diastolic function. Multimodal echocardiography can detect myocardial injury in PE patients at an early stage.

PMID:37259850 | DOI:10.1111/jog.15699

Future Oncol. 2023 Jun 1. doi: 10.2217/fon-2023-0165. Online ahead of print.

ABSTRACT

Purpose: To evaluate the risk factors for young-onset advanced colorectal neoplasia. Methods: We performed a meta-analysis of 30 potential exposure risk factors from 28 original studies. Results: Several risk factors showed statistical significance, including male sex (odds ratio [OR]: 1.28; 95% CI: 1.12-1.47), metabolic syndrome (OR: 1.34; 95% CI: 1.25-1.44), hypertension (OR: 1.22; 95% CI: 1.17-1.28), diabetes (OR: 1.23; 95% CI: 1.15-1.32), inflammatory bowel disease (OR: 4.62; 95% CI: 1.12-17.54), obesity (OR: 1.23; 95% CI: 1.06-1.43), sedentary behavior (OR: 1.25; 95% CI: 1.06-1.48), smoking (OR: 1.19; 95% CI: 1.05-1.36), high alcohol consumption (OR: 1.37; 95% CI: 1.10-1.71), high intake of sugar (OR: 2.58; 95% CI: 1.61-4.13) and red meat (OR: 1.10; 95% CI: 1.04-1.16), and family history of colorectal cancer (OR: 3.14; 95% CI: 1.29-7.64). Conclusion: Our study identified potential risk factors for young-onset advanced colorectal neoplasms to help develop targeted primary prevention strategies.

PMID:37259811 | DOI:10.2217/fon-2023-0165

Stat Med. 2023 Jun 30;42(14):2311-2340. doi: 10.1002/sim.9725. Epub 2023 Apr 22.

ABSTRACT

We propose a permutation-based method for testing a large collection of hypotheses simultaneously. Our method provides lower bounds for the number of true discoveries in any selected subset of hypotheses. These bounds are simultaneously valid with high confidence. The methodology is particularly useful in functional Magnetic Resonance Imaging cluster analysis, where it provides a confidence statement on the percentage of truly activated voxels within clusters of voxels, avoiding the well-known spatial specificity paradox. We offer a user-friendly tool to estimate the percentage of true discoveries for each cluster while controlling the family-wise error rate for multiple testing and taking into account that the cluster was chosen in a data-driven way. The method adapts to the spatial correlation structure that characterizes functional Magnetic Resonance Imaging data, gaining power over parametric approaches.

PMID:37259808 | DOI:10.1002/sim.9725

Cancer Prev Res (Phila). 2023 Jun 1;16(6):333-341. doi: 10.1158/1940-6207.CAPR-22-0388.

ABSTRACT

NeuVax is a vaccine comprised of the HER2-derived MHC class I peptide E75 (nelipepimut-S, NPS) combined with GM-CSF. We completed a randomized trial of preoperative vaccination with NeuVax versus GM-CSF alone in patients with ductal carcinoma in situ (DCIS). The primary objective was to evaluate for NPS-specific cytotoxic T lymphocyte (CTL) responses. Patients with human leukocyte antigen (HLA)-A2-positive DCIS were enrolled and randomized 2:1 to NeuVax versus GM-CSF alone and received two inoculations prior to surgery. The number of NPS-specific CTL was measured pre-vaccination, at surgery, and 1 and 3 to 6 months post-operation by dextramer assay. Differences in CTL responses between groups and between pre-vaccination and 1-month post-operation were analyzed using a two-sample t test or Wilcoxon rank sum test. The incidence and severity of adverse events were compared between groups. Overall, 45 patients were registered; 20 patients were HLA-A2 negative, 7 declined participation, 1 withdrew, and 4 failed screening for other reasons. The remaining 13 were randomized to NeuVax (n = 9) or GM-CSF alone (n = 4). Vaccination was well-tolerated with similar treatment-related toxicity between groups with the majority (>89%) of adverse events being grade 1. The percentage of NPS-specific CTLs increased in both arms between baseline (pre-vaccination) and 1-month post-operation. The increase was numerically greater in the NPS+GM-CSF arm, but the difference was not statistically significant. NPS+GM-CSF is safe and well-tolerated when given preoperatively to patients with DCIS. In patients with HLA-A2-positive DCIS, two inoculations with NPS+GM-CSF can induce in vivo immunity and a continued antigen-specific T-cell response 1-month postsurgery.

PREVENTION RELEVANCE: This trial showed that vaccination of patients with HLA-A2-positive DCIS with NeuVax in the preoperative setting can induce a sustained antigen-specific T-cell response. This provides proof of principle that vaccination in the preoperative or adjuvant setting may stimulate an adaptive immune response that could potentially prevent disease recurrence.

PMID:37259799 | DOI:10.1158/1940-6207.CAPR-22-0388

Clin Implant Dent Relat Res. 2023 Jun 1. doi: 10.1111/cid.13230. Online ahead of print.

ABSTRACT

OBJECTIVE: The objective of this study was to evaluate the peri-implant soft tissue and marginal bone loss (MBL) around implants with platform-switching and internal conical connection placed at crestal and subcrestal levels in posterior areas.

MATERIALS AND METHODS: Nineteen partially edentulous patients with at least two adjacent missing teeth in posterior areas unilaterally or bilaterally were included. Forty-two implants were placed randomly at the crestal or subcrestal (1 mm) level in a split-mouth design. Implant-supported fixed dental prostheses with screw retention were delivered after 4 months of healing. Clinical and radiological measurements were performed at implant placement (T0), restoration delivery (T1), and 1-year follow-up after loading (T2). MBL was calculated as the change in distance from the implant-abutment interface to the first radiographically visible bone-implant contact. A repeated-measures mixed ANOVA followed by a paired Student’s t-test with the Bonferroni correction was used for statistical analysis. p < 0.05 was considered statistically significant.

RESULTS: Eighteen patients with thirty-eight implants completed the study at T2. The MBL was lower in the subcrestal group than in the crestal group (0.04 ± 0.08 vs. 0.17 ± 0.17 mm, p = 0.004). The peri-implant probing depth (PD) was 2.31 ± 0.48 mm in the subcrestal group and 1.92 ± 0.43 mm in the crestal group; this difference was statistically significant (p = 0.002). Intragroup comparison showed no significant differences in MBL, or PD around the crestal group and subcrestal group from T1 to T2.

CONCLUSION: After 1 year of functional loading, subcrestal placement of implants with platform-switching and internal conical connection showed lower MBL and was associated with greater PD and peri-implant soft tissue height than implants placed at the crestal level.

PMID:37259774 | DOI:10.1111/cid.13230

Eur Rev Med Pharmacol Sci. 2023 May;27(10):4801-4811. doi: 10.26355/eurrev_202305_32491.

ABSTRACT

OBJECTIVE: There is a paucity of information on the COVID-19 pandemic’s impact on young volunteers. Therefore, the aim of this survey was to examine the QoL and mental health of young volunteers of the Novi Sad Voluntary Service during the COVID-19 pandemic.

PATIENTS AND METHODS: This cross-sectional prospective study included 255 members of the Novi Sad Voluntary Service, Serbia. The survey instrument probed into the respondents’ demographic characteristics and was followed by the anonymous WHOQOL-BREF questionnaire that measured their quality of life during the COVID-19 pandemic and DASS-21 scale. All statistical analyses were carried out using IBM SPSS Statistics for Windows, vers. 24.0.

RESULTS: The study sample consisted of 255 young volunteers (71.4% females, 28.6% males), 62.0% of whom were aged 18-25 years, and 52.2% were students. Lower Physical Capacity scores could be predicted by female gender (p < 0.01) and COVID-19 infection among friends (p < 0.05). Male gender (p < 0.05) and being employed (p < 0.05) predicted greater QoL in the Psychological domain. The only predictor of a lower QoL in the Social Relationships domain was the internet as the main COVID-19-related information source (p < 0.05). On the other hand, being female (p < 0.05) and having COVID-19-positive household members (p = 0.01) predicted lower environment domain scores. For the lower overall DASS-21 score, having COVID-19-positive household members was the only significant predictor (p < 0.01).

CONCLUSIONS: Mental health support should pursue strategies to improve all domains of QoL, especially for vulnerable sub-groups of the population, such as young females and the unemployed. Bearing in mind the importance of public engagement and community support in pandemic circumstances, as well as generally in public health, these results are relevant for interventions far beyond the current pandemic.

PMID:37259763 | DOI:10.26355/eurrev_202305_32491

Eur Rev Med Pharmacol Sci. 2023 May;27(10):4792-4800. doi: 10.26355/eurrev_202305_32490.

ABSTRACT

OBJECTIVE: Even before the outbreak of the COVID-19 pandemic, concerns regarding college students’ mental health were on the rise due to the increasing number of students afflicted with mental health issues. Exposure to numerous pandemic-related measures exacerbated existing issues with anxiety, depression, and stress. This study aimed to assess depression, anxiety, and stress levels among university students in the Aseer region in Saudi Arabia.

SUBJECTS AND METHODS: Data were collected from eligible individuals using a web-based, self-administered DASS-21 questionnaire. This questionnaire consists of 21 questions with a rating scale of 0-3. Each of the psychological factors of depression, anxiety, and stress was categorized as normal, mild, moderate, severe, and extremely severe. Results were expressed using descriptive statistics as proportions, and the Mann-Whitney/Kruskal-Wallis’ test was used to evaluate the presence of a significant difference between each of the socio-demographic factors of the respondents and the psychological outcomes.

RESULTS: Respondents aged between 18-24 years reported higher rates of extremely severe depression than other age groups. Females had higher rates of depression, especially severe and extremely severe forms. Extremely severe anxiety had a relatively high prevalence across all age groups. Extremely severe stress was more common among respondents aged between 18-24 years, while respondents older than 34 years reported the highest prevalence of severe stress. The Mann-Whitney/Kruskal-Wallis’ tests showed statistically significant differences between participants in the different groups.

CONCLUSIONS: The COVID-19 pandemic had a high psychological impact on university students, which indicates that a psychological support program should be implemented to reduce this impact.

PMID:37259762 | DOI:10.26355/eurrev_202305_32490

Eur Rev Med Pharmacol Sci. 2023 May;27(10):4772-4781. doi: 10.26355/eurrev_202305_32488.

ABSTRACT

OBJECTIVE: Pregnant women infected with SARS-CoV-2 are more likely to have obstetric complications, particularly preterm births, increasing the likelihood of maternal and neonatal morbidity and mortality. We tested the hypothesis by using a multivariable logistic regression analysis to take into account the effects of known confounding variables.

PATIENTS AND METHODS: A retrospective cohort study targeted a random sample of 89 preterm deliveries at the Obstetrics and Gynecology Department, Zagazig University Hospital, from January 2022 to April 2022, who fulfilled the selection criteria using a pretested, well-structured questionnaire that was composed of three main parts. The collected data were coded and analyzed using appropriate statistical methods.

RESULTS: This retrospective cohort study included 89 participants with a mean age of 26.6 years, 44.9% were middle-educated, 73% were not working, and the majority were not smoking or abusing substances. Regarding the frequency of COVID-19, dividing the studied participants into two groups, 22.5% had been infected, and there was no statistically significant difference between the two groups as regards the demographic characteristics, but smoking statistically increased the smoking (p-value = 0.034). Regarding the relationship between the history of COVID-19 and the past and present obstetric histories, there was no statistically significant difference between them. Even though the SARS-CoV-2 infection is significant (p-value = 0.037), pregnant women who are COVID-19 positive are more likely to have a cesarean section (16/80) than pregnant women who test positive.

CONCLUSIONS: Pregnant and preterm women were more likely to get SARS-CoV-2 if they smoked, had comorbidities, or were overweight or obese. Among COVID-19 preterm pregnancies, substance misuse and comorbidity were risk factors for a poor neonatal outcome, while women who had a previous history of PPH, were smokers, or had comorbid illnesses had a significantly increased risk of having a poor maternal outcome.

PMID:37259760 | DOI:10.26355/eurrev_202305_32488

Eur Rev Med Pharmacol Sci. 2023 May;27(10):4688-4692. doi: 10.26355/eurrev_202305_32480.

ABSTRACT

OBJECTIVE: Melatonin regulates the mammalian circadian rhythm and plays metabolic functions such as glucose homeostasis. Both melatonin receptors (MTNR1A and MTNR1B, encoded by the MTNR1A and MTNR1B genes, respectively) are expressed in pancreatic beta cells and mediate the glucometabolic roles of melatonin as well as insulin secretion. The MTNR1B gene is a well-known genetic risk factor in type 2 diabetes (T2D); however, little is known about the involvement of the MTNR1A gene in here T2D. We aimed to investigate whether MTNR1A is linked to and/or associated with familial T2D.

SUBJECTS AND METHODS: We genotyped 14 single nucleotide polymorphisms within the MTNR1A gene in 212 peninsular Italian families with T2D. We performed parametric linkage and linkage disequilibrium analyses to investigate the role of MTNR1A variants in conferring T2D risk. We considered variants statistically significant if conferring linkage or linkage disequilibrium with p < 0.05.

RESULTS: We found 3 novel variants (rs62350392, rs2119883, and rs13147179) significantly linked to and/or associated with T2D in multigenerational Italian families.

CONCLUSIONS: This is the first study to report MTNR1A as a novel risk gene in T2D. Functional studies are needed to confirm these results.

PMID:37259752 | DOI:10.26355/eurrev_202305_32480

Eur Rev Med Pharmacol Sci. 2023 May;27(10):4626-4632. doi: 10.26355/eurrev_202305_32472.

ABSTRACT

OBJECTIVE: The diabetes epidemic is increasing at an alarming rate in Saudi Arabia. Diabetes and dementia share some pathogeneses, including inflammatory markers, oxidative stress, and insulin resistance. Dementia may substantially influence diabetes self-care activities (DCSAs), thereby initiating a vicious cycle of complications. Therefore, this study aims to assess the effects of mild cognitive impairment (MCI) on DSCA.

PATIENTS AND METHODS: This cross-sectional study was conducted among 206 consecutive patients attending the diabetes center in Tabuk City, Saudi Arabia, during the period from December 2021 to November 2022. A structured questionnaire was administered face-to-face, including sociodemographic data, the Diabetes Self-care Questionnaire, the Mini Cognitive Assessment Tool, and the Hospital Anxiety and Depression Questionnaire. All the participants signed a written informed consent form, and both the Ethical Committees of the University of Tabuk and the Directorate General of Health Affairs, Tabuk, approved the research.

RESULTS: There were 206 patients with diabetes (63.1% women). Dyslipidemia, hypertension, and depression were reported in 59.8%, 55.9%, and 24.3% of patients, respectively, while MCI was reported in 51.5% of patients. MCI was positively correlated with age. MCI also had negative effects on diabetes self-care activities and HbA1c, but these effects were not statistically significant (odds ratio, 0.750, 95% CI, 0.56-1.00, p-value, 0.055, and odds ratio, 1.21, 95% CI, 0.99-1.08, p-value, 0.081, respectively). No significant relationship was found regarding the duration of diabetes, depression, and dyslipidemia (95% CI, 0.95-1.09, 0.32-4.57, and 0.76-8.30, respectively).

CONCLUSIONS: MCI and associated comorbidities were common among patients with diabetes in Tabuk, Saudi Arabia. No association was found between MCI and DSCA, dyslipidemia, hypertension, or duration of diabetes.

PMID:37259746 | DOI:10.26355/eurrev_202305_32472