Category: Nevin Manimala

Nutr Cancer. 2023 Jan 24:1-14. doi: 10.1080/01635581.2023.2170431. Online ahead of print.

ABSTRACT

More information is needed about the impact of outpatient nutrition care from a registered dietitian nutritionist (RDN) on patient outcomes. This study aimed to assess the feasibility of a cohort study design to evaluate impact of RDN nutrition care on patient outcomes, describe clinic malnutrition screening practices, and estimate statistical parameters for a larger study. Seventy-seven patients with lung, esophageal, colon, rectal, or pancreatic cancer from six facilities were included (41 received RDN care and 36 did not). RDN nutrition care was prospectively documented for six months and documented emergency room visits, unplanned hospitalizations and treatment changes were retrospectively abstracted from medical records. Most facilities used the Malnutrition Screening Tool (MST) to determine malnutrition risk. Patients receiving RDN care had, on average, five, half hour visits and had more severe disease and higher initial malnutrition risk, although this varied across sites. Documented medical and treatment outcomes were relatively rare and similar between groups. Estimated sample size requirements varied from 113 to 5856, depending on tumor type and outcome, and intracluster correlation coefficients (ICCs) ranged from 0 to 0.47. Overall, the methods used in this study are feasible but an interventional or implementation design might be advantageous for a larger study.

PMID:36691979 | DOI:10.1080/01635581.2023.2170431

Hepatol Commun. 2023 Jan 18;7(2):e0011. doi: 10.1097/HC9.0000000000000011. eCollection 2023 Feb 1.

ABSTRACT

BACKGROUND: Antiviral therapy is not indicated for patients with chronic hepatitis B (CHB) in the immune-tolerant (IT) phase. We compared the outcomes between the untreated IT phase and the treated immune-active (IA) phase in noncirrhotic HBeAg-positive CHB patients.

METHODS: We systematically searched 4 databases, including PubMed, Medline, Embase, and Cochrane, until August 2021. The pooled incidence rates of HCC and mortality in the IT and IA cohorts and phase change in the IT cohort were investigated. Studies that included patients with liver cirrhosis were excluded.

RESULTS: Thirteen studies involving 11,903 patients were included. The overall median of the median follow-up period was 62.4 months. The pooled 5-year and 10-year incidence rates of HCC were statistically similar between the IT and IA cohorts (1.1%, 95% CI: 0.4%-2.8% vs. 1.1%, 95% CI: 0.5%-2.3%, and 2.7%, 95% CI: 1.0%-7.3% vs. 3.6%, 95% CI: 2.4%-5.5%, respectively, all p>0.05). The pooled 5-year odds ratio of HCC between IT and IA cohorts was 1.05 (95% CI: 0.32-3.45; p=0.941). The pooled 5-year incidence rate of mortality was statistically similar between the IT and IA cohorts (1.9%, 95% CI: 1.1%-3.4% vs. 1.0%, 95% CI: 0.3%-2.9%, p=0.285). Finally, the pooled 5-year incidence rate of phase change in the IT cohort was 36.1% (95% CI: 29.5%-43.2%).

CONCLUSION: The pooled incidence rates of HCC and mortality were comparable between the untreated IT and the treated IA phases in noncirrhotic HBeAg-positive CHB patients.

PMID:36691962 | DOI:10.1097/HC9.0000000000000011

Eur Heart J. 2023 Jan 24:ehac825. doi: 10.1093/eurheartj/ehac825. Online ahead of print.

ABSTRACT

AIMS: Chronic kidney disease (CKD) increases risk of cardiovascular disease (CVD). Less is known about how CVD associates with future risk of kidney failure with replacement therapy (KFRT).

METHODS AND RESULTS: The study included 25 903 761 individuals from the CKD Prognosis Consortium with known baseline estimated glomerular filtration rate (eGFR) and evaluated the impact of prevalent and incident coronary heart disease (CHD), stroke, heart failure (HF), and atrial fibrillation (AF) events as time-varying exposures on KFRT outcomes. Mean age was 53 (standard deviation 17) years and mean eGFR was 89 mL/min/1.73 m2, 15% had diabetes and 8.4% had urinary albumin-to-creatinine ratio (ACR) available (median 13 mg/g); 9.5% had prevalent CHD, 3.2% prior stroke, 3.3% HF, and 4.4% prior AF. During follow-up, there were 269 142 CHD, 311 021 stroke, 712 556 HF, and 605 596 AF incident events and 101 044 (0.4%) patients experienced KFRT. Both prevalent and incident CVD were associated with subsequent KFRT with adjusted hazard ratios (HRs) of 3.1 [95% confidence interval (CI): 2.9-3.3], 2.0 (1.9-2.1), 4.5 (4.2-4.9), 2.8 (2.7-3.1) after incident CHD, stroke, HF and AF, respectively. HRs were highest in first 3 months post-CVD incidence declining to baseline after 3 years. Incident HF hospitalizations showed the strongest association with KFRT [HR 46 (95% CI: 43-50) within 3 months] after adjustment for other CVD subtype incidence.

CONCLUSION: Incident CVD events strongly and independently associate with future KFRT risk, most notably after HF, then CHD, stroke, and AF. Optimal strategies for addressing the dramatic risk of KFRT following CVD events are needed.

PMID:36691956 | DOI:10.1093/eurheartj/ehac825

Nucleosides Nucleotides Nucleic Acids. 2023 Jan 24:1-8. doi: 10.1080/15257770.2023.2169934. Online ahead of print.

ABSTRACT

CDKN1A gene is implicated in cell differentiation, development process, repair, apoptosis, senescence, migration, and tumorigenesis. Somatic alterations and polymorphisms may interfere in the function of CDKN1A, and this could affect the individual susceptibility to colorectal cancer (CRC). Here in, we evaluated the importance of single nucleotide polymorphic variants in codon 31 of CDKN1A (rs1801270: C > A) for the development of colorectal cancer in an Iranian population. A total of 150 CRC patients and 150 healthy controls were enrolled in this study. Genomic DNA was extracted from peripheral blood specimens. Genotypes were determined using Polymerase Chain Reaction-Restriction Fragment Length Polymorphism (PCR-RFLP) assay. In CRC patients, the genotype frequencies detected were 90%, 8.0% and 2.0%2 for CC, AC and AA genotypes while the genotype frequencies in control group were 78%, 20.7% and 1.35% 1.35% for CC, AC and AA genotype, respectively. There were statistically significant differences in the distribution of CDKN1A rs1801270 genotypes and allele frequencies between colorectal cancer patients and healthy controls (p value = 0.021). Also, results indicated a significant negative association between AC genotype and risk of colorectal cancer occurrence. (Odds ratio (OR)=0.357; 95% confidence interval (CI)=0.168-0.760, p = 0.007). Our data suggest that the AC genotype may have a protective role in the development of CRC in an Iranian population.

PMID:36691945 | DOI:10.1080/15257770.2023.2169934

Int J Vitam Nutr Res. 2023 Jan 24. doi: 10.1024/0300-9831/a000775. Online ahead of print.

ABSTRACT

Background: The effect of serum lycopene on the progression of cardiovascular diseases (CVDs) and their longevity remains a controversial topic. The purpose of this study was to evaluate the associations of different isomeric forms of serum lycopene with CVD and all-cause mortality in the American population. Methods: The National Health and Nutrition Examination Survey (NHANES) is a large population survey to investigate public health in the US. We analyzed data from 2003-2006 linked with mortality data obtained in 2015. Cox proportional hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated to assess the risk of CVD and all-cause mortality caused by serum lycopene. Results: Among 7452 participants (aged 20-85 years, 46.7% male), 298 died from CVDs among the total 1213 deaths during a median follow-up of 10.7 years. Serum lycopene is a protective factor for all-cause and CVD mortality. In multivariable-adjusted models, the hazard ratio (with 95% confidence intervals) associated with Q4 compared to Q1 of serum total-lycopene, trans-lycopene and cis-lycopene was 0.49 (0.38,0.63), 0.49 (0.39,0.63) and 0.55 (0.43,0.70) for all-cause mortality (P_trend<0.05), and was 0.53 (0.32,0.96), 0.48 (0.32,0.72) and 0.63 (0.41,0.97) for CVD mortality (P_trend<0.05). The subgroup analyses showed that different isomeric forms of lycopene showed varied associations with CVD and all-cause mortality based on age, drinking status, history of hypertension and diabetes. Conclusions: Serum lycopene concentration was significantly associated with the risk of CVD and all-cause mortality. Cis-lycopene had a U-shaped relationship with mortality, while trans-lycopene had an inverse relationship with it.

PMID:36691936 | DOI:10.1024/0300-9831/a000775

J Anal Toxicol. 2023 Jan 24:bkad003. doi: 10.1093/jat/bkad003. Online ahead of print.

ABSTRACT

The present work describes a practical application of Green Analytical Toxicology (GAT) during the development of an eco-friendly dispersive liquid-liquid microextraction (DLLME) avoiding the use of highly toxic chlorinated solvents that are commonly used in this type of technique. The purpose was to further consolidate GAT guidelines during method development. Thus, a full method optimization using a multivariate statistical approach and validation were performed. To that end, synthetic cathinones (SC), one of the major classes of new psychoactive substances, were the target analytes due to their relevance and chemical diversity. Furthermore, whole blood and urine samples were the matrices of choice due to their clinical relevance. The sample preparation step prior to DLLME consisted of protein precipitation of whole blood samples, while urine specimens were centrifuged and diluted with ultrapure water. Then, borate buffer, NaCl, and ethyl acetate:acetonitrile were added and vortexed. Finally, vials were centrifuged and the organic layer was transferred to autosampler vials, evaporated to dryness and resuspended with mobile phase prior to injection into the ultra-high performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS) system. Once optimized, the proposed DLLME was fully validated: 0.2 and 1 ng/mL as LOD; and 1 and 10 ng/mL as LOQ for urine and blood samples, respectively. Linear range was established as 1-100 and 10-1000 ng/mL for urine and blood samples, respectively (r2 > 0.99), while bias and precision were within acceptable limits (≥ 80%). The matrix effect was of 1.9-260.2% and -12.3-139.6%; while recovery was of 27.4-60.0% and 13.0-55.2%; and process efficiency ranged from 45.0% to 192.0% and 17.9% to 58.4% for whole blood and urine, respectively. Finally, the method was applied to real case samples as proof of applicability. Thus, a simple, cheap, and fast eco-friendly technique to analyze SC in two biological specimens was described.

PMID:36691915 | DOI:10.1093/jat/bkad003

Gerodontology. 2023 Jan 24. doi: 10.1111/ger.12673. Online ahead of print.

NO ABSTRACT

PMID:36691885 | DOI:10.1111/ger.12673

J Gerontol B Psychol Sci Soc Sci. 2023 Jan 24:gbad010. doi: 10.1093/geronb/gbad010. Online ahead of print.

ABSTRACT

OBJECTIVE: Both loneliness and use of psychotropic drugs are common in later life. While loneliness has been found to be associated with psychotropic drugs use, most studies have been cross-sectional, and we know less about their longitudinal associations.

METHODS: Drawing on five waves of data from Health and Retirement Study and two statistical approaches (fixed-effects and cross-lagged panel models), we examine longitudinal associations between loneliness and use of prescription pain and depression/anxiety medications.

RESULTS: Across 57,654 observations among 20,589 respondents, 22.8% reported regular use of pain prescription medications, 17.8% regular use of depression/anxiety prescription medication, and 15.6% feeling lonely in the past week. Loneliness and use of depression/anxiety medications were associated according to both modelling approaches, net of covariates. In years when a respondent reported feeling lonely, odds of regular use of depression/anxiety medications were 1.42 times higher (p<.001) than years when they did not feel lonely. Regarding reciprocation, odds of regular depression/anxiety medication use in a given wave range from 1.3 to 1.5 times higher if loneliness was reported in prior wave. Likewise, the odds of reporting loneliness in a given wave range from 1.5 to 1.8 times higher if regular depression/anxiety medication was reported in prior wave.

DISCUSSION: Prior loneliness predicts contemporaneous regular use of depression/anxiety prescription medications. While this confirms the directional association found in prior studies, we found prior use of depression/anxiety medications is also associated with increased odds of loneliness, suggesting further research is needed to understand mechanisms that explain their associations and potential interventions.

PMID:36691876 | DOI:10.1093/geronb/gbad010

Vet Rec. 2023 Jan 24:e2582. doi: 10.1002/vetr.2582. Online ahead of print.

ABSTRACT

BACKGROUND: The need for proper age determination in puppies has increased enormously due to the growing illegal trade in puppies that are too young to be removed from the litter or too young to have been properly vaccinated against rabies.

METHODS: Dorsopalmar and mediolateral radiographs of the (meta)carpal region, either taken from puppy cadavers or from the Faculty’s patient database, were studied in a cross-sectional study of 252 puppies of various sizes, aged 6-212 days. The appearance and development of ossification centres as a function of age in five regions of interest in the (meta)carpal region were scored using a two- to six-step scoring system based on shape and delineation.

RESULTS: A positive correlation with age was found for all investigated regions. Intra- and interrater agreement between two observers was excellent, except for the distal epiphyses of the metacarpal bones. Postnatal ossification started after the second week of life with the carpal bones, closely followed by the radial trochlea. All ossification centres were present in all puppies from 84 days, except for the sesamoid bone in the tendon of the long abductor muscle of the first digit. Timing of appearance differed significantly between different sized breeds. There were no significant differences between the sexes.

LIMITATIONS: Age distribution was not balanced for all breed size classes.

CONCLUSIONS: The radiographic timing of the appearance and development of ossification centres in the carpal region is a promising method for age estimation in puppies.

PMID:36691858 | DOI:10.1002/vetr.2582

J Osteopath Med. 2023 Jan 25. doi: 10.1515/jom-2022-0177. Online ahead of print.

ABSTRACT

CONTEXT: Rheumatoid arthritis (RA) is a systemic autoimmune disease that commonly affects joints. Although many treatment options exist, the most common, s (DMARDs), have been associated with pulmonary infections. These types of infections (specifically pneumonia) can be detrimental to RA patients. This leads providers to utilize other treatment modalities such as glucocorticoids (GCs). GCs are commonly utilized to treat RA; however, the role of GCs in the onset of pneumonia in RA patients is not fully understood.

OBJECTIVES: The goal of this study was to systematically review and statistically analyze pooled data documenting pneumonia as an adverse event in RA patients on DMARDs as a monotherapy vs RA patients on DMARDs and GCs as combination therapy utilizing the Population, Intervention, Comparison, and Outcomes (PICO) framework.

METHODS: On August 1, 2021, a search was conducted and completed on six databases: Embase, MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, International Pharmaceutical Abstracts (IPA), and ClinicalTrials.gov. A total of 12 researchers were involved with the search and screening of articles (K.E., P.R.; V.A., D.P.C.; C.B., D.C.; T.A., E.S.; S.H., L.B.; K.S., C.S.). Search terms were identified utilizing Medical Subject Headings (MeSH) and Emtree and included “glucocorticoids,” “rheumatoid arthritis,” “pneumonia,” and “respiratory tract infections,” Inclusion criteria included human subjects over the age of 18 with seropositive RA, on a combination of GC (prednisone, methylprednisolone, or prednisolone) with DMARD (methotrexate [MTX], hydroxychloroquine [HCQ], or sulfasalazine [SSZ]) and developed pneumonia of bacterial, viral, or fungal origin. The control groups were on a DMARD monotherapy regimen. Articles were excluded if they were not in English, had less than 20 participants, were case reports or literature reviews, included animal subjects, and did not adhere to the established PICO framework. Five teams of two researchers individually sorted through abstracts of articles based on the inclusion and exclusion criteria. The same teams individually sorted through full-text articles of selected abstracts based on the same criteria. Conflicts between each team were resolved by a separate researcher. Odds ratios were utilized to quantify the effect sizes of combined studies from a random effects model. Chi-square tests and I2 statistics were utilized to analyze heterogeneity.

RESULTS: A total of 3360 articles were identified from all databases, and 416 duplicate articles were removed. Thus, a total of 2944 articles abstracts were screened, of which 2819 articles either did not meet the inclusion criteria or did meet the exclusion criteria. A total of 125 articles were retrieved and assessed for full-text eligibility, of which only three observational articles were included for meta-analysis. Statistical results revealed that patients treated with DMARDs monotherapy are 95% (95% CI: 0.65-0.99) less likely to develop pneumonia compared to patients treated with a DMARD and GCs (p=0.002).

CONCLUSIONS: Our data suggest that RA patients have a higher probability of developing pneumonia on combination therapy with GCs, compared to monotherapy with DMARDs. To our knowledge, our findings are the first to systematically review and statistically evaluate the relationship between the use of GCs and show an increased chance of developing pneumonia.

PMID:36691851 | DOI:10.1515/jom-2022-0177