Category: Nevin Manimala

Ann Dermatol. 2023 Feb;35(1):38-45. doi: 10.5021/ad.22.118.

ABSTRACT

BACKGROUND: Atopic dermatitis (AD) patients usually wonder if their condition will worsen after vaccination or if they should continue with the treatment they are receiving. Considering that many patients treated with dupilumab had previously experienced severe AD symptoms and flares, the concerns are more understandable.

OBJECTIVE: This study aimed to investigate the safety of the coronavirus disease 2019 (COVID-19) vaccination in patients with AD treated with dupilumab.

METHODS: We enrolled 133 patients (101 dupilumab-treated and 32 systemic oral agents-treated as control group) with AD from six hospitals. Patients were asked about worsening pruritus and AD (5-point Likert scale) after vaccination. AD variables (eczema area and severity index [EASI], investigator’s global assessment [IGA], itch numerical rating scale [NRS], sleep NRS, and patient-oriented eczema measure [POEM]) were compared pre- and post-vaccination. Adverse reactions to the COVID-19 vaccination were observed.

RESULTS: The incidence of adverse reactions to COVID-19 vaccines and worsening AD symptoms in dupilumab-treated patients were not significantly different compared with that in the control group. The itch NRS score increased significantly after vaccination (p<0.001). However, there were no statistically significant differences between the pre-and post-EASI, IGA, and POEM scores. Eight patients (7.9%) had worse EASI scores and required rescue therapy; however, most were easily managed with low-dose steroids or topical agents. None of the patients discontinued dupilumab treatment.

CONCLUSION: No serious adverse reactions were observed in patients with AD after COVID-19 vaccination. Exacerbation of pruritus and AD symptoms was observed but was mostly mild and transient.

PMID:36750457 | DOI:10.5021/ad.22.118

Clin Spine Surg. 2023 Feb 3. doi: 10.1097/BSD.0000000000001436. Online ahead of print.

ABSTRACT

STUDY DESIGN: Retrospective cohort study.

OBJECTIVE: We aim to investigate the relationship between the intraoperative motor evoked potential (MEP) signal changes during surgical treatment of cervical myelopathy with postoperative functional outcomes and determine what factors correlate with MEP signal changes.

SUMMARY OF BACKGROUND DATA: Intraoperative neurophysiologic monitoring with MEP for cervical cord decompression can potentially predict postoperative neurological complications.

MATERIALS AND METHODS: We prospectively collected data from 114 consecutive cervical compressive myelopathy patients who underwent decompressive cervical spine surgery. Functional outcomes were measured preoperatively and postoperatively at the 6-month mark, using the modified Japanese Orthopedic Association score.

RESULTS: Among the 114 patients, 87 patients showed significant MEP improvement, 1 patient with MEP degeneration, 3 patients with no change in MEP, and 23 patients with MEP change, but which eventually returned to baseline. Univariate analysis showed that patients with MEP improvement had similar 6-month functional and Japanese Orthopedic Association scores compared with patients who did not have MEP improvement. Critically, a longer duration of symptoms was shown to have a statistically significant relationship with patients who did not have MEP improvement on univariate analysis (49.2 wk in patients with no MEP improvement compared with 34.59 wk in patients with MEP improvement, P = 0.03) but this did not translate to differences in functional outcomes. There was also no statistically significant association between the functional outcome scores and demographics, surgical, or radiologic factors.

CONCLUSIONS: Our study shows that the duration of symptoms is not attributed to lower functional outcomes but is associated with a lack of MEP improvement.

LEVEL OF EVIDENCE: Level III.

PMID:36750440 | DOI:10.1097/BSD.0000000000001436

J Hand Surg Am. 2023 Feb 5:S0363-5023(22)00722-5. doi: 10.1016/j.jhsa.2022.11.020. Online ahead of print.

ABSTRACT

PURPOSE: Although carpal tunnel syndrome (CTS) can be diagnosed clinically with the Carpal Tunnel Syndrome 6 (CTS-6) evaluation tool, the relationship between disease severity and CTS-6 score has not been elucidated. The purpose of our study was to determine the correlation of the CTS-6 score and other physical examination maneuvers with the carpal tunnel severity grade by electrodiagnostic testing (EDT). We hypothesized that the CTS-6 score, Durkan test, and Semmes Weinstein Monofilament Testing (SWMT) positively correlate with EDT severity.

METHODS: We prospectively enrolled 105 consecutive patients who presented to the office with suspected CTS, excluding those with previous surgery, previous EDT from an outside facility, or concomitant neuropathy. Four fellowship-trained hand surgeons obtained the CTS-6 score, time to obtain a positive Durkan compression test, and SWMT of the thumb, index, and middle fingers. All patients were sent for EDT. Hand surgeons were blinded to the results of the EDT, and the electrodiagnosticians were blinded to the clinical data. We used the Bland criteria (0-6) to grade CTS severity on EDT. This grade was compared with the CTS-6 score, Durkan time, and SWMT results.

RESULTS: Using Spearman correlation coefficients, we found a weakly positive correlation between a higher CTS-6 score and a higher severity grade on EDT. The mean CTS-6 score based on EDT grading were the following: (1) 14.8 (grade 0), (2) 16.0 (grade 1), (3) 14.8 (grade 2), (4) 16.7 (grade 3), (5) 18.7 (grade 4), (6) 18.3 (grade 5), and (7) 22.4 (grade 6). We also found a statistically significant association between the SWMT and a higher CTS-6 score as well as a higher severity grade on EDT. Durkan compression test did not appear to correlate with the EDT grade.

CONCLUSIONS: The CTS-6 and SWMT show a positive correlation with EDT severity in CTS on the basis of the Bland criteria. The time to a positive Durkan test did not show any correlation.

TYPE OF STUDY/LEVEL OF EVIDENCE/LEVEL OF EVIDENCE: Diagnostic II.

PMID:36750395 | DOI:10.1016/j.jhsa.2022.11.020

Med Dosim. 2023 Feb 6:S0958-3947(23)00013-4. doi: 10.1016/j.meddos.2023.01.003. Online ahead of print.

ABSTRACT

To evaluate the effects of arc geometry on lung stereotactic body radiation therapy (SBRT) plan quality, using collision check software to select safe beam angles. Thirty lung SBRT cases were replanned 10Gy x 5 using 4 volumetric modulated arc therapy (VMAT) geometries: coplanar lateral (cpLAT), coplanar oblique (cpOBL), noncoplanar lateral (ncpLAT) and noncoplanar oblique (ncpOBL). Lateral arcs spanned 180° on the affected side whereas the 180° oblique arcs crossed midline to spare healthy tissues. Couch angles were separated by 30° on noncoplanar plans. Clearance was verified with Radformation CollisionCheck software. Optimization objectives were the same across the four plans for each case. Planning target volume (PTV) coverage was set to 95% and then plans were evaluated for dose conformity, healthy tissue doses, and monitor units. Clinically treated plans were used to benchmark the results. The volumes of the 25%, 50% and 75% isodoses were smaller with noncoplanar than coplanar arcs. The volume of the 50% isodose line relative to the PTV (CI50%) was as follows: clinical 3.75±0.72, cpLAT 3.39 ± 0.37, cpOBL 3.36 ± 0.34, ncpLAT 3.02 ± 0.21 and ncpOBL 3.02 ± 0.22. The Wilcoxon signed rank test with Bonferroni correction showed p < 0.005 in all CI50% comparisons except between the cpLat and cpObl arcs and between the ncpLat and ncpObl arcs. The best lung sparing was achieved using ncpObl arcs, which was statistically significant (p < 0.001) compared with the other four plans at V12.5Gy, V13.5Gy and V20Gy. Chest wall V30Gy was significantly better using noncoplanar arcs in comparison to the other plan types (p < 0.001). The best heart sparing at V10Gy from the ncpOBL arcs was significant compared with the clinical and cpLat plans (p < 0.005). Arc geometry has a substantial effect on lung SBRT plan quality. Noncoplanar arcs were superior to coplanar arcs at compacting the dose distribution at the 25%, 50% and 75% isodose levels, thereby reducing the dose to healthy tissues. Further healthy tissue sparing was achieved using oblique arcs that minimize the pathlength through healthy tissues and avoid organs at risk. The dosimetric advantages of the noncoplanar and oblique arcs require careful beam angle selection during treatment planning to avoid collisions during treatment, which may be facilitated by commercial software.

PMID:36750392 | DOI:10.1016/j.meddos.2023.01.003

Phytother Res. 2023 Feb 7. doi: 10.1002/ptr.7753. Online ahead of print.

ABSTRACT

One of the complications of menopause is sleep disorders, which affect women’s health. Ocimum basilicum contains compounds that may affect sleep. The aim of this study was to determine the effect of an oral capsule of O. basilicum leaf extract on sleep quality and the severity of insomnia in menopausal women. This triple-blind, randomized clinical trial study was performed on 60 Iranian menopausal women aged 40 to 65 years. Subjects were randomly assigned into two groups of intervention (each capsule containing 250 mg of O. basilicum extract and 250 mg Avicel) per day for 1 month and placebo. The Pittsburgh Sleep Quality and Insomnia Intensity Index were used to assess sleep quality and severity of insomnia before, 2 weeks after and 1 month after the intervention. There was no statistically significant difference in the baseline variables between the intervention and placebo groups (p > .05). The total sleep quality scores in the two groups of intervention and placebo were 6.2 ± 0.3 versus 9.3 ± 0.3 (p < .001) and 3.7 ± 0.3 versus 9.1 ± 0.3 (p = .015) 2 weeks and 1 month after the intervention, respectively. The total insomnia severity scores in the two groups of intervention and placebo were 9.0 ± 0.3 versus 12.1 ± 0.3 (p < .001) and 5.6 ± 0.5 versus 11.0 ± 0.5 (p < .001) 2 weeks and 1 month after the intervention, respectively. Consumption of O. basilicum capsules improved sleep quality and insomnia in menopausal women. This study was approved (code IR.MUMS.NURSE.REC.1398.070) by the Ethic committee of Mashhad University of Medical Sciences and registered at the Iranian Registry of Clinical Trials, with the No. IRCT20200104046001N1 in January 2020.

PMID:36750371 | DOI:10.1002/ptr.7753

Wei Sheng Yan Jiu. 2023 Jan;52(1):33-39. doi: 10.19813/j.cnki.weishengyanjiu.2023.01.006.

ABSTRACT

OBJECTIVE: To investigate the dietary fiber intake status and analyze the relationship between dietary fiber and glucose metabolic disorder of the elderly in China.

METHODS: Data were collected from the participants of Chinese adult chronic diseases and nutrition surveillance in 2015. General information were collected by standardized questionnaires, anthropometric index and blood pressure of respondents were measured according to standard method. Food intake was collected by three consecutive day 24 h dietary recalls, dietary fiber was calculated through China food composition. Fasting venous blood were collected to measure glucose, HbA1C, and other related biochemical index. Subjects were divided into three groups: normal glucose(NG, normal glucose), pre-diabetes(Pre-DM, pre-diabetes mellitus) and diabetes(T2DM, type 2 diabetes mellitus). Multiple logistic regression model was used to analyze the relationship between dietary fiber intake and Pre-DM as well as T2DM.

RESULTS: A total of 20 996 elderly people aged 60 years and above were included. There 10 773 cases were males(51.3%) and 10 223 cases were females(48.7%), the age of both gender were(68.21±6.26) years and(67.67±6.26) years. A total of 6526 cases of pre-diabetes were detected in 20 996 elderly participants with detection rate of 31.1%. There 3274 cases were male and 3252 cases were female, the detection rates of both genders were 30.4% and 31.8%, respectively. While 1572 participants were detected as T2DM(784 of males and 788 of females), the detection rate of T2DM was 7.5%, 7.3% for males and 7.7% for females. There were significant differences in mean age, BMI, waist circumference, systolic blood pressure, diastolic blood pressure, TC, TG, HDL-C, LDL-C, HbA1c level among different dietary intake groups(P&lt;0.005). With the increase of dietary fiber intake, the proportion of overweight and obesity, central obesity and dyslipidemia showed an increasing trend(P&lt;0.05), and the proportion of hypertension showed a decreasing trend(P&lt;0.000 1). After adjusting for potential confounding factors, compared to participants with lowest fiber intake, participants in subgroups of lower, minor lower, and higher fiber intake were associated with decreased risk of pre-diabetes, the OR and 95%CI were(OR=0.911, 95%CI 0.835-0.993), (OR= 0.861, 95%CI 0.790-0.938) and(OR= 0.913, 95%CI 0.838-0.994), respectively. However, there was only a statistically significant negative association between the higher intake of dietary fiber and T2DM(OR = 0.848, 95%CI 0.726-0.991).

CONCLUSION: Dietary fiber intake was negatively related with diabetes and pre-diabetes mellitus. The risk of glucose metabolic disorder was decreased with the increase of dietary fiber intake.

PMID:36750345 | DOI:10.19813/j.cnki.weishengyanjiu.2023.01.006

Wei Sheng Yan Jiu. 2023 Jan;52(1):20-26. doi: 10.19813/j.cnki.weishengyanjiu.2023.01.004.

ABSTRACT

OBJECTIVE: To analyze the current situation and long term trends in minerals intakes from 1989 to 2018 in adults aged 18 to 35 years in 15 provinces(autonomous regions, municipalities) of China.

METHODS: Based on the data of China Health and Nutrition Survey from 1989 to 2018. Adults aged 18 to 35 were selected as study subjects. According to the dietary survey result of 3-day 24-hour dietary review method and weighing accounting method, the mineral intake was calculated and analyzed. Nonparametric statistical method was used to analyze the trend of dietary minerals intake with years. Comparing the dietary minerals intake with the dietary reference intakes, the trend of the proportion of people at risk of insufficient dietary minerals intake was analyzed by Cochran-Armitage trend test. According to the different demographic characteristics in 2018, the minerals intake status and the proportion of people with insufficient dietary minerals intake were analyzed.

RESULTS: In 2018, the median intakes of dietary minerals of adults were 302.96 mg/d of calcium, 887.91 mg/d of phosphorus, 1451.69 mg/d of potassium, 3760.09 mg/d of sodium, 238.50 mg/d of magnesium, 19.40 mg/d of iron, 9.91 mg/d of zinc, 43.54 μg/d of selenium, 1.41 mg/d of copper and 4.59 mg/d of manganese, respectively, with significant gender differences(P&lt;0.05). The intakes of dietary calcium, phosphorus, magnesium, potassium, selenium and copper in urban areas were significantly higher than those in rural areas(Z values were 3.00, 2.04 and 3.10, respectively, P&lt;0.05). The dietary intakes of calcium, phosphorus, magnesium, potassium, selenium and copper showed significant differences among regions, education levels and income levels. From 1989 to 2018, the dietary mineral intake of calcium, phosphorus, potassium, sodium, magnesium, iron, zinc, copper and manganese of adults aged 18-35 in 15 provinces(autonomous regions and municipalities) of China showed a downward trend, only selenium intake showed an upward trend, and the intake of men was higher than that of women. The proportion of people at risk of inadequate intake of dietary phosphorus, magnesium, iron, zinc and copper showed an increasing trend year by year. In each survey year, the proportion of people at risk of insufficient calcium intake was more than 90%.

CONCLUSION: From 1989 to 2018, there was a risk of insufficient intake of minerals in adults aged 18-35 in 15 provinces(autonomous regions, municipalities) in China, and the problem of inadequate calcium intake was serious.

PMID:36750344 | DOI:10.19813/j.cnki.weishengyanjiu.2023.01.004

Wei Sheng Yan Jiu. 2023 Jan;52(1):142-147.

ABSTRACT

OBJECTIVE: To study the effect of reactive oxygen species(ROS) in cadmium chloride-induced apoptosis of mouse Leydig cells(TM3 cells) and explore the underlying molecular mechanisms.

METHODS: TM3 cells were used as an in vitro model for studying reproductive toxicity induced by cadmium exposure. The cells were treated with different concentrations of CdCl_2(0, 5 and 10 μmol/L) for 24 h. CCK-8 assay was used to detect the effect of CdCl_2 on TM3 cell activity. Hoechst33342 staining was performed to explore the formation of apoptotic bodies. DCFH-DA probe was used to detect the level of ROS in the cells. TM3 cells were pretreated with 1 mmol/L NAC for 1 h and then treated with 10 μmol/L CdCl_2 for 24 h. The protein expression levels of pro-apoptotic proteins Caspase-9 and cleaved Caspase-3 were detected by Western blot; RT-qPCR was used to measure the expression of anti-apoptotic gene Bcl-2 and pro-apoptotic genes Caspase-9 and Caspase-3.

RESULTS: After exposure to CdCl_2 for 24 h, viability of TM3 cells decreased and the number of apoptotic bodies increased. Western blot result showed that the protein level of Caspase-9 in the 10 μmol/L CdCl_2 treatment group was increased to 0.86±0.10(P&lt;0.05) compared with the control group(0.56±0.07). Compared with the control group(0.37±0.11), the protein level of cleaved Caspase-3 in the 5 and 10 μmol/L CdCl_2 treatment groups were increased to 0.65±0.03 and 1.05±0.13(P&lt;0.05). Compared with the control group(46.80±1.24), the intracellular ROS content in the 5 and 10 μmol/L treatment groups increased to 60.47±1.39 and 80.63±1.34(P&lt;0.05). Compared with the cadmium-treated group, NAC inhibited Caspase-9(CdCl_2 group: 0.89±0.07; CdCl_2+NAC group: 0.28±0.02)and cleaved Caspase-3(CdCl_2 group: 1.53±0.21; CdCl_2+NAC group: 0.66 ±0.07), the difference was statistically significant(P&lt;0.05). At the same time, NAC decreased the ROS level(62.64±0.93) in the CdCl_2 exposure group(80.13±0.94)(P&lt;0.05). In addition, RT-qPCR result showed that the Caspase-9 mRNA levels in the 5 and 10 μmol/L CdCl_2 treatment groups were 1.40±0.14 and 1.90±0.12(P&lt;0.05), compared with the control group(0.97±0.10). Compared with the control group(0.88±0.08), the cleaved Caspase-3 mRNA levels in the 5 and 10 μmol/L CdCl_2 treatment groups were increased to 1.42±0.11 and 1.59±0.12(P&lt;0.05). While in the 5 and 10 μmol/L CdCl_2-treated group, compared with the control group(0.94±0.02), the Bcl-2 mRNA level were decreased to 0.60±0.02 and 0.50±0.09(P&lt;0.05). Compared with the cadmium treatment group(0.57±0.06), NAC could significantly improve the cadmium-induced Bcl-2 mRNA expression level(0.92±0.03), and Caspase-9(CdCl_2 group: 1.96±0.07; CdCl_2+NAC group: 1.04±0.02) and Caspase-3(CdCl_2 group: 1.65±0.02; CdCl_2+NAC group: 0.66±0.04) were decreased(P&lt;0.05).

CONCLUSION: The Caspase cascade in mouse Leydig cells can be activated by excessive ROS induced by CdCl_2, and inhibition of ROS production can significantly reduce the CdCl_2-induced apoptosis of TM3 cells.

PMID:36750343

Wounds. 2023 Jan;35(1):E35-E38.

ABSTRACT

INTRODUCTION: A novel BCMH sheet has been shown to achieve improved wound closure rates in chronic and acute wounds when compared with SOC.

OBJECTIVE: This retrospective evaluation assessed chronic wound closure rates with SOC or treatment with the BCMH sheet in an urban hospital wound clinic.

METHODS: Forty-seven chronic wounds were treated with SOC or the BCMH sheet. The primary endpoint was time to closure. For wounds that did not close, investigations were conducted to determine the reason.

RESULTS: Twenty wounds were treated with SOC, which varied in usage of multiple products and/or therapies, and 27 wounds were treated with the BCMH sheet. The average initial wound size was not statistically different between the groups. In both groups, most wounds that were treated did not close. For wounds that did close, the average time to closure was 2x faster in the BCMH group compared with the SOC group (7.4 weeks and 14.8 weeks, respectively; P < .05).

CONCLUSIONS: This retrospective evaluation showed average time to wound closure to be significantly faster with BCMH compared with SOC in patients who maintained adherence with regular visits.

PMID:36749996

J Breath Res. 2023 Feb 7. doi: 10.1088/1752-7163/acb9b2. Online ahead of print.

ABSTRACT

Early, rapid and non-invasive diagnosis of Severe Acute Respiratory Syndrome CoronaVirus 2 (SARS-CoV-2) infection is needed for the prevention and control of coronavirus disease 2019 (COVID-19). COVID-19 mainly affects the respiratory tract and lungs. Therefore, analysis of exhaled breath could be an alternative scalable method for reliable SARS-CoV-2 screening. In the current study, an experimental protocol using an electronic-nose (“e-nose”) for attempting to identify a specific respiratory imprint in COVID-19 patients was optimized. Thus the analytical performances of the Cyranose®, a commercial e-nose device, were characterized under various controlled conditions. In addition, the effect of various experimental conditions on its sensor array response was assessed, including relative humidity, sampling time and flow rate, aiming to select the optimal parameters. A statistical data analysis was applied to e-nose sensor response using common statistical analysis algorithms in an attempt to demonstrate the possibility to detect the presence of low concentrations of spiked acetone and nonanal in the breath samples of a healthy volunteer. Cyranose® reveals a possible detection of low concentrations of these two compounds, in particular of 25 ppm nonanal, a possible marker of SARS-CoV-2 in the breath.

PMID:36749983 | DOI:10.1088/1752-7163/acb9b2