Category: Nevin Manimala

Urol Oncol. 2023 Mar 12:S1078-1439(23)00006-6. doi: 10.1016/j.urolonc.2023.01.005. Online ahead of print.

ABSTRACT

BACKGROUND: Patients with high-risk (HR) prostate cancer (PCa) represent a heterogeneous group, however, current treatment guidelines do not consider their specific features. The objective of this study was to evaluate treatment trends and outcomes in HR patients defined by PSA alone and otherwise low-risk features.

METHODS: Using the National Cancer Database, we identified patients diagnosed with HR PCa between 2010 and 2016. A study group of patients defined by PSA >20 ng/ml alone and otherwise low-risk features, was compared to a group of HR patients defined by Gleason score or stage. We compared treatment rates over time, the use of concomitant androgen deprivation therapy (ADT), and overall survival (OS). Examination of treatment trends was done using a Z-test analysis. A Kaplan-Meier survival analysis was used to determine 5-year OS with the Log-rank test for comparison. Statistical analyses were completed using R Version 3.5.2.

RESULTS: We identified 5,652 patients in the study group and 71,922 in the comparison group. Only 6.8% of the study group had disease ≥cT2, compared to 43.7% in the comparison group. In the study group, 12.5% (709), underwent active surveillance (AS), 36.4% (2,055) radiation therapy (EBRT) and 51.1% (2,888) radical prostatectomy (RP), while the rate of AS, EBRT, and RP in the comparison group were 0.3% (191), 43.0% (30,928), and 56.7% (40,803), respectively. Over the study period, adoption of AS increased from 6.2% in 2010 to 25.0% in 2016 in the study group (P< 0.001), but not in the comparison group. In patients undergoing EBRT, ADT treatment increased from 2010 to 2016 in both groups, though by 2016 only 45.3% of patients in the study group and 86.3% in the comparison group received ADT. The 5-year OS was 93.7% (95% CI 92.8-94.6) in the study group and 89.7% (95% CI 89.2-90.1) in the comparison group (P< 0.001).

CONCLUSIONS: Men with HR PCa defined by PSA with otherwise low risk features present at an earlier stage and receive less aggressive therapy than other HR patients. Despite increased rates of AS and decreased use of ADT, these patients appear to have improved survival when compared to other HR patients. These findings suggest that not all HR patients will benefit from aggressive definitive treatment.

PMID:36918337 | DOI:10.1016/j.urolonc.2023.01.005

Burns. 2023 Feb 22:S0305-4179(23)00026-8. doi: 10.1016/j.burns.2023.02.008. Online ahead of print.

ABSTRACT

OBJECTIVES: To describe the epidemiological and clinical features of paediatric scar inpatients and then to facilitate therapeutic schedule for children with scars.

METHODS: In this cross-sectional study, data of patients admitted for scar treatment in 1064 tertiary hospitals from 2013 to 2018 were extracted through the Hospital Quality Monitoring System (HQMS) database. Demographic and clinical features of children with scars were analysed statistically and highlighted compared with those of adults and the elderly scar cases.

RESULTS: In this study, 53,741 paediatric scar cases, accounting for 30.29% of all hospitalized for scar, were analysed. Compared to adults and the elderly, children with scars were mainly males (62.27% vs 50.98% vs 49.85%, P < 0.001) and were vulnerable to scalds (37.10%) and operative intervention (34.11%). Although the scalp/face/neck was the most common affected location, the proportion of scars involving upper limbs (27.88% vs 21.69% vs 7.28%, P < 0.001), lower limbs (15.14% vs 10.28% vs 6.56%, P < 0.001) and perineum (4.59% vs 3.13% vs 2.65%, P < 0.001) was higher in children than that in other two groups. Scar contracture was the most common complications in children (45.27%). Nearly 66% of paediatric scar cases received surgical treatment during hospitalization, among whom release of lesion was the most frequent operation (56.35%). The proportion of keloids was relatively lower in child cases than in other two groups (6.20% vs 14.48% vs 18.15%, P < 0.001). Additionally, the median LOS in child cases was 9 (5-15) days, slightly exceeding that in adult/elderly cases.

CONCLUSIONS: Scars were common inducing factors of hospitalization and contributed greatly to the disease burden of children. More attention should be paid to those who are males, burn survivors, or skin-injured at extremities and perineum to improve therapeutic strategies and prognoses for paediatric scar patients.

PMID:36918334 | DOI:10.1016/j.burns.2023.02.008

Dent Mater. 2023 Mar 12:S0109-5641(23)00067-2. doi: 10.1016/j.dental.2023.03.016. Online ahead of print.

ABSTRACT

OBJECTIVE: The purpose was to compare the degree of conversion (DC), monomer elution (ME), polymerization shrinkage (PS) and porosity of two addition-fragmentation chain transfer (AFCT) modified resin-based composites (RBC) light-cured with rapid- (RP), turbo- (TP) or conventional polymerization (CP) settings.

METHODS: Cylindrical samples (6-mm wide, 4-mm thick) were prepared from Tetric PowerFill (TPF) and Filtek One Bulk (FOB). Four groups were established according to the polymerization settings: 3s-RP, 5s-TP, 10s-CP and 20s-CP. Samples in 1 mm thickness with 20s-CP settings served as controls. The DC at the top and bottom surfaces was measured with micro-Raman spectroscopy. ME was detected with high-performance liquid chromatography. PS and porosity were analyzed by micro-computed tomography. ANOVA and Tukey’s post-hoc test, multivariate analysis and partial eta-squared statistics were used to analyze the data (p < 0.05).

RESULTS: FOB showed higher DC values (61.5-77.5 %) at the top compared to TPF (43.5-67.8 %). At the bottom TPF samples achieved higher DCs (39.9-58.5 %) than FOB (18.21-66.18 %). Extending the curing time increased DC (except the top of FOB) and decreased ME. BisGMA release was the highest among the detected monomers from both RBCs. The amount was three-fold more from TPF. The factor Material and Exposure significantly influenced DC and ME. PS (1.8-2.5 %) did not differ among the groups and RBCs except for the lowest value of TPF cured with the 3s_RP setting (p = 0.03). FOB showed 4.5-fold lower porosity (p < 0.001). Significantly higher pore volume was detected after polymerization in 3s_RP (p < 0.001).

SIGNIFICANCE: High-irradiance rapid 3-s curing of AFCT modified RBCs resulted in inferior results for some important material properties. A longer exposure time is recommended in a clinical situation.

PMID:36918332 | DOI:10.1016/j.dental.2023.03.016

Clin Oncol (R Coll Radiol). 2023 Feb 9:S0936-6555(23)00049-3. doi: 10.1016/j.clon.2023.02.003. Online ahead of print.

ABSTRACT

AIMS: To evaluate whether there is sufficient correlation between patient-reported outcomes (PROs) and clinician-reported outcomes (CROs) in bladder cancer follow-up post-radiotherapy to streamline data collection and to reduce trial follow-up burden on patients, clinicians and trial programmes.

MATERIALS AND METHODS: PROs data were collected within the BC2001 trial using the Functional Assessment of Cancer Therapy specific to bladder cancer (FACT-BL) questionnaire. CROs data were collected by clinicians using Late Effects in Normal Tissues Subjective, Objective and Management (LENT/SOM). Data were collected at baseline, post-treatment, at 6 and 12 months post-randomisation and then annually to 5 years. The percentage agreement between CROs and PROs measures was evaluated at 2 and 5 years post-randomisation. Concordance was tested using the weighted Kappa statistic with 95% confidence intervals.

RESULTS: Correlation was evaluated between six categories of the FACT-BL and LENT/SOM scores. At 2 years the percentage agreement across these domains ranged from 45 to 78%, with the weighted Kappa statistic between 0.07 and 0.35. Results were similar in year 5 with 48-83% agreement and kappa statistics between -0.02 and 0.21.

CONCLUSION: The correlation between CROs and PROs in patients treated with radiotherapy for bladder cancer were generally poor. PROs appear to be more sensitive, with higher grade events reported. Further work is needed to evaluate whether PROs alone can be used to evaluate toxicity-related outcomes in randomised controlled trials.

PMID:36918330 | DOI:10.1016/j.clon.2023.02.003

Am J Prev Med. 2023 Mar 12:S0749-3797(23)00074-0. doi: 10.1016/j.amepre.2023.02.011. Online ahead of print.

ABSTRACT

INTRODUCTION: It is unknown whether and to what extent the duration of smoking abstinence may modify the association between receiving cigarette coupons and smoking relapse in the U.S. This study aims to fill this gap.

METHODS: Data were from the Population Assessment of Tobacco and Health study Wave 4 (December 2016-January 2018, baseline) and Wave 5 (December 2018-November 2019, follow-up) surveys. Analysis was conducted in May 2022. The study sample was participants who formerly smoked cigarettes at baseline (N=5,186). The exposure was past 12-month receipt of cigarette coupons (yes/no) at baseline, and the outcome was cigarette smoking relapse (yes/no) at follow-up. A potential modifier was the duration of smoking abstinence (within/>1 year) at baseline. Baseline single-wave weights were applied, and a multivariable logistic regression model was used to estimate the adjusted association. Interaction between cigarette coupon receipt and duration of smoking abstinence was examined to explore potential modification effects.

RESULTS: Participants who received cigarette coupons at baseline were more likely to relapse at follow-up (AOR=1.63, 95% CI=1.15, 2.32). This association was significantly stronger among participants who quit within 1 year than among participants who quit >1 year at baseline (AOR for the interaction term=2.77, 95% CI=1.22, 6.25). Subgroup analysis shows that receipt of cigarette coupons was significantly associated with smoking relapse among participants who quit within 1 year (AOR=2.10, 95% CI=1.39, 3.17), and this association was not statistically significant among participants who quit >1 year (AOR=0.76, 95% CI=0.36, 1.63).

CONCLUSIONS: Policies restricting cigarette coupons may help adults who recently quit sustain abstinence.

PMID:36918321 | DOI:10.1016/j.amepre.2023.02.011

J Hand Ther. 2023 Mar 12:S0894-1130(22)00088-6. doi: 10.1016/j.jht.2022.09.002. Online ahead of print.

ABSTRACT

STUDY DESIGN: Randomized controlled study.

PURPOSE OF THE STUDY: To evaluate the effect of Kinesio Tape (KT) applied differently in patients diagnosed with Subacromial Impingement Syndrome (SIS) on acromiohumeral distance (AHD) and supraspinatus tendon (SsT) thickness using ultrasound (US) and its effect on pain, upper limb functional status and hand grip muscle strength in the short and mid-term.

METHODS: The 90 patients diagnosed with unilateral SIS by clinical examination were randomized into 3 groups. In addition to exercise therapy, the deltoid in group 1 and the supraspinatus muscle in group 2 were taped from insertion to origin. Group 3, which was the control group, was applied 9 sessions of sham taping for 3 weeks. Cases were evaluated for AHD and SsT thickness, pain was evaluated with the Visual Analog Scale (VAS), function with the Disabilities of the arm, shoulder and hand (DASH) and the Western Ontario Rotator Cuff Index (WORC), and hand grip strength (HGS) using a dynamometer before, and 3rd week and 3rd month after the KT application.

RESULTS: There was a significant improvement in all parameters in the short and mid-term intra group comparisons in Group 1 and 2 after taping (P < .05). In intergroup comparisons, significant improvement was achieved in all parameters in Group 1 and Group 2 in the mid and short term compared to the control group (P < .05). In comparison of Group 1 and Group 2, HGS in the short term (p: 0.07) and the SsT thickness in the short and mid-term (p: 0.36, p: 0.85) did not exhibit any difference. The improvement in all other parameters in group 1 was statistically significant.

CONCLUSION: The findings of our study provide definitive evidence for the effectiveness of KT treatment depending on the method of tape application employed.

PMID:36918309 | DOI:10.1016/j.jht.2022.09.002

Clin Lymphoma Myeloma Leuk. 2023 Feb 21:S2152-2650(23)00062-9. doi: 10.1016/j.clml.2023.02.007. Online ahead of print.

ABSTRACT

BACKGROUND: Natural killer (NK) cells are known to have cytotoxic effects mediated through killer immunoglobulin-like receptors (KIRs) and their cognate ligands. Role of KIRs in myeloma is yet unresolved.

PATIENTS AND METHODS: KIR genotypes and ligands of 204 newly diagnosed MM patients are compared with 424 healthy subjects. Statistical analysis included t-test, chi-square and binary logistic regression.

RESULTS: KIR ligands were significantly more (C2C2: 27.5% vs 15.1%; OR 2.128; 95% CI, 1.417-3.196; P < .001) or less (C1C2: 40.2% vs 51.9%; OR 0.623; 95% CI, 0.444-0.874; P = .006) frequent among MM. Co-occurrence of genotype AA with C2C2 was also higher in frequency among MM (OR 2.509; 95% CI, 1.171-5.378; P = .015) likewise cAB1 with C1C2 was less frequent (OR 0.553; 95% CI, 0.333-0.919; P = .021). Genotypes AA with C1C1, cAB1 with C1C2 or C1C2 alone were associated with a delay (median age: 61 [48-73]; P = .044; 62 [31-81]; P = .030 or 59 [31-85]; P = .028), but AA with C2C2 with an earlier age of onset (48 [29-77]; P = .042). In multivariate analysis including R-ISS, light chain, KIR genotype/ligands; ligand C1C2 (P = .02) and genotype AA-C1C1 (P = .037) were independently associated with age of onset ≥60.

CONCLUSION: C1C2 and C2C2 alone or in combination with KIR genotype (cAB1 and AA, respectively), is observed in less or higher frequency among MM cases and associated with delayed/earlier age of onset, respectively. Genotype AA-C1C1 although in similar frequency between patients and healthy subjects, is also associated with delay. To our knowledge, this is the first study demonstrating an association between KIR and MM onset age, independent from R-ISS or light chain type.

PMID:36918304 | DOI:10.1016/j.clml.2023.02.007

J Prosthodont. 2023 Mar 14. doi: 10.1111/jopr.13672. Online ahead of print.

ABSTRACT

PURPOSE: To assess the changes in intrapulpal temperature between electric high-speed handpieces of different coolant functions (‘Water Jet’ and ‘Water Spray’), coolant port designs (1- and 4-port), suction use and bur and tooth types using an experimental in vitro set-up.

MATERIALS AND METHODS: Forty-four extracted anterior and posterior teeth were collected. A total of 18 groove cuts (n = 18/coolant port spray design, bur and tooth type group) and 12 groove cuts (n = 12/ tooth type and suction use) was completed, with a total of 264 groove cuts. Real-time temperature and duration was recorded at 1 s intervals throughout the preparation process using a thermocouple and digital data logger set-up (GFX Data Logger Series and EL USB-TC; Lascar Electronics Inc, USA), and the data retrieved using EasyLog Software (EasyLog USB; Lascar Electronics Inc, USA). Statistical analysis was performed (SPSS V.27) for the change in temperature using the ANOVA and post-hoc analysis.

RESULTS: The majority of the specimen cuts, regardless of tooth (anterior or posterior) and bur (diamond or carbide) type, handpiece coolant port design and suction use showed an overall decreasing trend in intrapulpal temperature. No cuts caused a mean temperature change that reached the critical temperature of 42.5°C, or resulted in an overall increase in intrapulpal temperature when the 60 s duration was completed.

CONCLUSIONS: The tested electric handpieces efficiently reduced intrapulpal temperature, with the majority displaying a decreasing trend. A greater decrease in intrapulpal temperature was observed in canines compared to premolars; carbide burs compared to diamond; and with no suction preparations compared to when suction was used. This article is protected by copyright. All rights reserved.

PMID:36918297 | DOI:10.1111/jopr.13672

Rapid Commun Mass Spectrom. 2023 Mar 14:e9504. doi: 10.1002/rcm.9504. Online ahead of print.

ABSTRACT

RATIONAL: Cardiac surgery-associated acute kidney injury (CSA-AKI) is a prevalent complication of cardiac surgery, which may be associated with a great risk of developing chronic kidney disease and mortality. This study aimed to investigate the possible links between gut microbiota metabolism and CSA-AKI.

METHODS: A prospective cohort of patients who underwent cardiac surgery was continuously recruited, who were further divided into CSA-AKI group and Non-AKI group based on the clinical outcomes. Their faecal and plasma samples were collected before the surgery and were separately analysed by non-targeted and targeted metabolomics. The differential metabolites related to CSA-AKI were screened out using statistical methods, and altered metabolic pathways were determined by examining the Kyoto Encyclopedia of Genes and Genomes database.

RESULTS: Nearly 1000 faecal metabolites were detected through high-resolution mass spectrometry (MS) and bioinformatics at high and mid confidence levels, and 49 differential metabolites at high confidence level may perform essential biological functions and provide potential diagnostic indicators. Compared with the Non-AKI group, the patients in the CSA-AKI group displayed dramatic changes in gut microbiota metabolism, including amino acid metabolism, nicotinate and nicotinamide metabolism, purine metabolism, and ABC transporters. Meanwhile, 188 plasma metabolites were identified and quantified by tandem MS, and 34 differential plasma metabolites were screened out between the two groups using univariate statistical analysis. These differential plasma metabolites were primarily enriched in the following metabolic pathways: sulphur metabolism, amino acid biosynthesis, tryptophan metabolism, and ABC transporters. Furthermore, the content of indole metabolites in the faecal and plasma samples of the CSA-AKI group was higher than that of the Non-AKI group.

CONCLUSIONS: Patients with CSA-AKI may have dysbiosis of their intestinal microbiota and metabolic abnormalities in their gut system before cardiac surgery. Thus, some metabolites and related metabolic pathways may be potential biomarkers and new therapeutic targets for the disease.

PMID:36918294 | DOI:10.1002/rcm.9504

J Dr Nurs Pract. 2023 Mar 1;16(1):54-61. doi: 10.1891/JDNP-2022-0003.

ABSTRACT

Background: COVID-19 hand hygiene recommendation had resulted in a hand eczema -exacerbation. The guidelines of care for the management of hand eczema recommend the use of educational interventions for patients. Objective: An educational intervention was designed to increase the patient’s knowledge of appropriate hand hygiene and improve the patient’s symptoms. Methods: The validated self-assessment patient-oriented eczema measure tool and pre- and post-tests were used to measure outcomes prior to educational intervention and again in 1-2 months postintervention. Of the 26 participants enrolled, 21 completed the study. The study included newly diagnosed or established patients with eczema, and the education material was available for all patients. Results: The difference between the average pretest and initial posttest was statistically significant (df = 20, P (T ≤ t) = 0.000663535, p < .05). Similarly, the difference between the average pretest and follow-up posttest was also statistically significant (df = 20, P (T ≤ t) < 0.001, p < .05). Participants also had a 2.04 mean point decrease in symptoms severity. Conclusions: The results demonstrated an improvement in patient’s knowledge and reduction in symptoms. Implications for Nursing: The program can serve as a new guideline for managing hand eczema symptoms due to COVID-19 in the adult population in the private office setting.

PMID:36918285 | DOI:10.1891/JDNP-2022-0003