Category: Nevin Manimala

Obes Surg. 2023 May 4. doi: 10.1007/s11695-023-06625-z. Online ahead of print.

ABSTRACT

PURPOSE: Laparoscopy is advised under the lowest possible intra-peritoneal pressure. The aim of this study is to analyze the safety/feasibility of low pneumoperitoneum pressure (LPP) during laparoscopic sleeve gastrectomy (LSG).

MATERIALS AND METHODS: All primary LSGs who completed a 3-month follow-up were included. Re-do operations and LSGs performed with concomitant procedures were excluded. All LSGs were performed by the senior author. Upon trocar insertions, pressure was set to 10 mmHg, and the procedure was started. The pressure was increased step-wise, according to the senior author’s assessment of the quality of exposure. Doing so, three pressure groups were formed: groups 1 (10 mmHg), 2 (11-13 mmHg), and 3 (14 mmHg). All data was retrieved from our database. Statistical analysis was performed using one-way ANOVA/Tukey’s HSD test/Chi-square test. P values < 0.05 were regarded as significant.

RESULTS: Between February 2018 and October 2022, 708 consecutive/primary LSGs were studied. No mortality/conversion/thromboembolic event was observed. Groups 1, 2, and 3 comprised 376 (53.1%), 243 (34.3%), and 89 (12.6%) patients, respectively. Demographics, initial weight, duration of surgery, history for abdominoplasty, drain output, length of stay, and %total weight loss were evenly distributed among groups. Among 16 bleeding episodes, 14 occurred in the LPP group (p = 0.019). Including the only leak and stenosis, 8/9 of Clavien-Dindo 3b + 4 complications were observed in the LPP group (p = 0.092).

CONCLUSIONS: LSG with LPP is feasible in about half of the patients. However, almost all potentially life-threatening complications occurred in the LPP group where a significantly higher rate of bleeding was observed. Our findings suggest caution for routinely using LPP during LSG.

PMID:37140721 | DOI:10.1007/s11695-023-06625-z

Adv Ther. 2023 May 4. doi: 10.1007/s12325-023-02500-6. Online ahead of print.

ABSTRACT

INTRODUCTION: This ongoing post-marketing surveillance monitors the long-term safety and effectiveness of vedolizumab in routine clinical practice in patients with moderate-to-severe ulcerative colitis (UC) in Japan. This interim analysis assessed induction-phase data, covering the initial three doses of vedolizumab.

METHODS: Patients were enrolled via a web-based electronic data capture system from approximately 250 institutions. Incidence of adverse events and treatment responses were assessed by the physicians after the patient had received three doses of vedolizumab or when the drug was discontinued, whichever occurred first. Therapeutic response was defined as any treatment response, including remission or improvement of complete or partial Mayo score, and was assessed in the total and stratified patient populations according to prior tumor necrosis factor alpha (TNFα) inhibitor treatments and/or baseline partial Mayo score.

RESULTS: The total incidence of adverse drug reactions (ADRs) was 4.10% (11/268). Common ADRs were dizziness, nausea, and arthralgia, each reported in 0.75% of patients (2/268). Serious ADRs were herpes zoster oticus and UC, each reported in 0.37% of patients (1/268). Therapeutic response was reported in 84.5% (218/258) of all patients, 85.8% (127/148) of TNFα inhibitor-naïve patients, and 82.7% (91/110) of TNFα inhibitor-experienced patients. Among patients with partial Mayo score of ≥ 4 at baseline, partial Mayo score remission in patients without or with prior TNFα inhibitor treatment was 62.5% (60/96) and 45.6% (36/79), respectively.

CONCLUSION: The results confirm a safety and effectiveness profile of vedolizumab consistent with that observed in previous trials.

CLINICAL TRIAL REGISTRATION: JapicCTI-194603, NCT03824561.

PMID:37140705 | DOI:10.1007/s12325-023-02500-6

J Comput Neurosci. 2023 May 4. doi: 10.1007/s10827-023-00847-x. Online ahead of print.

ABSTRACT

To understand single neuron computation, it is necessary to know how specific physiological parameters affect neural spiking patterns that emerge in response to specific stimuli. Here we present a computational pipeline combining biophysical and statistical models that provides a link between variation in functional ion channel expression and changes in single neuron stimulus encoding. More specifically, we create a mapping from biophysical model parameters to stimulus encoding statistical model parameters. Biophysical models provide mechanistic insight, whereas statistical models can identify associations between spiking patterns and the stimuli they encode. We used public biophysical models of two morphologically and functionally distinct projection neuron cell types: mitral cells (MCs) of the main olfactory bulb, and layer V cortical pyramidal cells (PCs). We first simulated sequences of action potentials according to certain stimuli while scaling individual ion channel conductances. We then fitted point process generalized linear models (PP-GLMs), and we constructed a mapping between the parameters in the two types of models. This framework lets us detect effects on stimulus encoding of changing an ion channel conductance. The computational pipeline combines models across scales and can be applied as a screen of channels, in any cell type of interest, to identify ways that channel properties influence single neuron computation.

PMID:37140691 | DOI:10.1007/s10827-023-00847-x

Neurosurg Rev. 2023 May 4;46(1):103. doi: 10.1007/s10143-023-02013-4.

ABSTRACT

OBJECTIVE: This study aimed to compare the clinical features, treatment, and clinical outcome of patients with tandem occlusion and isolated intracranial occlusion through endovascular treatment (EVT).

METHODS: Patients with acute cerebral infarction who received EVT in two stroke centers were retrospectively included. According to MRI or CTA results, the patients were divided into tandem occlusion group or isolated intracranial occlusion group. The baseline data, etiological classification, treatment, post-stroke complications, image features, and clinical outcome were compared. Multivariate logistic regression analysis was used to evaluate the related factors affecting the prognosis of patients with EVT.

RESULTS: Among 161 patients with acute cerebral infarction, there were 33 cases (20.5%) in the tandem occlusion group and 128 cases (79.5%) in the isolated intracranial occlusion group. Compared with isolated intracranial occlusion, the patients with tandem occlusion had higher rates of large artery atherosclerosis (P = 0.028), symptomatic intracerebral hemorrhage (sICH) (P = 0.023), bilateral infarction (P = 0.042), and longer time for endovascular procedure (P = 0.026). There was no significant statistical difference in 90-day mRS score between the two groups (P = 0.060). Multivariate logistic regression identified the following independent predictors of poor functional outcome: older age, high fasting blood glucose, infarction area > 1/3, and hemorrhagic transformation.

CONCLUSIONS: Compared with isolated intracranial occlusion, there was not a worse prognosis among patients with tandem occlusion who received EVT.

PMID:37140688 | DOI:10.1007/s10143-023-02013-4

J Cancer Surviv. 2023 May 4. doi: 10.1007/s11764-023-01379-0. Online ahead of print.

ABSTRACT

BACKGROUND: Cancer survivors may have elevated atherosclerotic cardiovascular disease (ASCVD) risk. Therefore, we tested how accurately the American College of Cardiology/American Heart Association 2013 pooled cohort equations (PCEs) predict 10-year ASCVD risk in cancer survivors.

OBJECTIVES: To estimate the calibration and discrimination of the PCEs in cancer survivors compared to non-cancer participants in the Atherosclerosis Risk in Communities (ARIC) study.

METHODS: We evaluated the PCEs’ performance among 1244 cancer survivors and 3849 cancer-free participants who were free of ASCVD at the start of follow-up. Each cancer survivor was incidence-density matched with up to five controls by age, race, sex, and study center. Follow-up began at the first study visit at least 1 year after the diagnosis date of the cancer survivor and finished at the ASCVD event, death, or end of follow-up. Calibration and discrimination were assessed and compared between cancer survivors and cancer-free participants.

RESULTS: Cancer survivors had higher PCE-predicted risk, at 26.1%, compared with 23.1% for cancer-free participants. There were 110 ASCVD events in cancer survivors and 332 ASCVD events in cancer-free participants. The PCEs overestimated ASCVD risk in cancer survivors and cancer-free participants by 45.6% and 47.4%, respectively, with poor discrimination in both groups (C-statistic for cancer survivors = 0.623; for cancer-free participants, C = 0.671).

CONCLUSIONS: The PCEs overestimated ASCVD risk in all participants. The performance of the PCEs was similar in cancer survivors and cancer-free participants.

IMPLICATIONS FOR CANCER SURVIVORS: Our findings suggest that ASCVD risk prediction tools tailored to survivors of adult cancers may not be needed.

PMID:37140677 | DOI:10.1007/s11764-023-01379-0

Eur J Orthop Surg Traumatol. 2023 May 4. doi: 10.1007/s00590-023-03567-1. Online ahead of print.

ABSTRACT

BACKGROUND: The addition of junctions in modular stems implies a greater susceptibility to corrosion.

PURPOSE: The aim of this study is to compare serum chromium and cobalt levels after using a bimodular stem and its monoblock counterpart in primary total hip arthroplasty. Postoperative clinical scores were also compared.

PATIENTS AND METHODS: A prospective cohort study between 2012 and 2015 was designed. One arm of the cohort included patients with the cementless modular neck stem H-Max M® and the other with the cementless monoblock stem counterpart H-Max S®.

RESULTS: No statistically significant difference was found in chromium value between groups (p = 0.621) at two years postoperative. Cobalt value was higher in the modular group (p = < 0.001). No statistically significant difference was found in clinical postoperative scores except for the Harris Hip Score, with better results at six months in modular group (p = 0.007).

CONCLUSIONS: Higher serum cobalt level in the modular group has limited the use of modular stems in our daily practice. Advantages of modular stem were not found.

LEVEL OF EVIDENCE: II.

PMID:37140672 | DOI:10.1007/s00590-023-03567-1

Nutr Cancer. 2023;75(4):1123-1131. doi: 10.1080/01635581.2023.2178908. Epub 2023 Feb 21.

ABSTRACT

The first epidemiologic study was conducted to prospectively examine the association between Food Environment Index (FEI) and gastric cancer (GC) risk in the US. Surveillance, Epidemiology, and End Results provided information on GC incident cases diagnosed between 2000 and 2015 from 16 population-based cancer registries across the US. The county-level food environment was assessed using the FEI, an indicator of access to healthy foods (0 is worst, 10 is best). Poisson regression was used to calculate incidence rate ratios (IRRs) and 95% confidence intervals (CIs) for the association between FEI and GC risk adjusting for individual-level and county-level covariates. Higher levels of FEI were associated with a statistically significant reduced risk for GC (n = 87,288 cases; adjusted IRR for every score increase = 0.50, 95% CI 0.35, 0.70; P < 0.001; adjusted IRR for the medium vs. low category = 0.87, 95% CI 0.81, 0.94; and adjusted IRR for the high vs. low category = 0.89, 95% CI 0.82, 0.95). These results suggest that a healthy food environment, as measured by FEI, may be a protective factor for GC in the US. To reduce the GC incidence, further strategies to improve food environment at the county level are warranted.

PMID:37139870 | DOI:10.1080/01635581.2023.2178908

Hum Fertil (Camb). 2023 May 4:1-8. doi: 10.1080/14647273.2023.2200979. Online ahead of print.

ABSTRACT

To investigate the potential effect of endometriosis on embryo development and clinical outcomes, a retrospective analysis of 716 women undergoing their first standard in vitro fertilization (sIVF) cycles (205 endometriosis and 511 with tubal factor infertility) was performed. The endometriosis group included women with an ultrasonographic or surgical diagnosis. Control subjects were women diagnosed with tubal factor infertility by laparoscopy or hysterosalpingogram. The primary outcome of the study was live birth. Cumulative live birth was also assessed in a subgroups analysis. After adjusting for confounders we found no significant difference in fertilization rate, blastulation, top-quality blastocyst, live birth, cumulative live birth (subgroups analysis) and miscarriage rate. In the endometriosis group, the number of retrieved oocytes was smaller (6.94 ± 4.06 Vs 7.50 ± 4.6, adjusted p < 0.05). We observed a statistically significant difference in the percentage of day-3 embryos with ≥8 blastomeres (33.12 ± 22.72 endometriosis vs, 40.77 ± 27.62 tubal factor, adjusted p < 0.01) and a negative correlation between the presence of endometriomas and a number of retrieved oocytes [B coefficient =-1.41, 95%CI (-2.31-0.51), adjusted p = 0.002]. Our results suggest that endometriosis affects the number of retrieved oocytes but not embryo development and live birth.

PMID:37139851 | DOI:10.1080/14647273.2023.2200979

Cult Health Sex. 2023 May 4:1-19. doi: 10.1080/13691058.2023.2201356. Online ahead of print.

ABSTRACT

Pacific young people living in Aotearoa New Zealand experience disparities in their sexual and reproductive health outcomes, thought to stem from cultural differences and educational inequities. Although these barriers have been characterised in literature, their influence on Pacific youth’s understandings of sexual and reproductive health have been relatively unexplored. This study investigated the sexual and reproductive health knowledge of Pacific students enrolled at a university in Aotearoa New Zealand in 2020 and where they gained this knowledge. The study used the theoretical framework of the (revitalised) Fonofale health model and was guided by the Kakala research methodology. Data were collected by means of an online survey comprised of open-ended questions and Likert scales, completed by eighty-one eligible students. Open-ended questions were analysed for general themes and responses to Likert scale items are reported using descriptive statistical analysis. The study found that Pacific youth have strong foundations of health knowledge that is heavily influenced by Polynesian cultural beliefs. Both formal and non-formal learning environments were important in developing participants’ health knowledge of these topics and for encouraging independent help-seeking behaviours. This is the first reported study to investigate the sexual and reproductive health knowledges of a pan-Pacific tertiary cohort of young people.

PMID:37139841 | DOI:10.1080/13691058.2023.2201356

J Orthod. 2023 May 4:14653125231172211. doi: 10.1177/14653125231172211. Online ahead of print.

ABSTRACT

INTRODUCTION: Orthodontic discrepancies are a common finding in patients with supernumerary teeth (ST). The presence of a ST can cause a number of orthodontic discrepancies, such as delayed eruption or retention of adjacent teeth, crowding, spacing, abnormal root formation and so on. The aim of the present study was to assess the effect of extraction of an anterior supernumerary tooth on the underlying orthodontic discrepancies without additional treatment for a 6-month period.

METHODS: This was a prospective, longitudinal, observational, study. It included 40 individuals with orthodontic malocclusions due to maxillary anterior supernumeraries. We examined the changes in the crowding and excessive space in the anterior and posterior segments on cast models.

RESULTS: In the group that presented with crowding, a statistically significant decrease of 0.95 ± 0.17 mm (P < 0.001) was found between T0 and T1. Of the participants, three exhibited full self-correction. The excessive space at T0 (3.06 mm) decreased by 1.78 ± 0.19 mm to T1 (1.28 mm) in the anterior segment. Seven patients showed full self-correction of the diastemas after the 6-month observation period.

CONCLUSION: The results imply that orthodontic treatment can be postponed for at least 6 months after the extraction of the supernumerary tooth as potential self-correction can be expected. This natural alleviation of the malocclusions may make the orthodontic treatment simpler, shorten the treatment time and decrease overall appliance wear time.

PMID:37139825 | DOI:10.1177/14653125231172211