Category: Nevin Manimala

Neurol Ther. 2023 Apr;12(Suppl 1):5-12. doi: 10.1007/s40120-023-00469-6. Epub 2023 Apr 28.

ABSTRACT

The prevalence of major depressive disorder (MDD) has been increasing, and MDD is now a leading cause of global disability. Depression often coexists with anxiety, and the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) introduced the ‘anxious distress’ specifier to identify those patients within the MDD category who have anxiety as well. The prevalence of anxious depression is high, with studies suggesting that 50-75% of patients with MDD meet the DSM-5 criteria for anxious depression. However, it can be difficult to discern whether a patient has MDD with anxiety or an anxiety disorder that has triggered an episode of depression. In fact, approximately 60-70% of patients with comorbid anxiety and depression experience anxiety first, but it is often depression that leads the patient to seek treatment. Patients with MDD who also have anxiety have significantly worse psychosocial functioning and poorer quality of life compared with patients with MDD without anxiety. In addition, patients with MDD and anxiety take significantly longer to achieve remission, and are less likely to achieve remission, than patients with MDD without anxiety. Therefore, it is essential that physicians have a high index of suspicion for comorbid anxiety in patients with depression, and that anxiety symptoms in patients with MDD are effectively treated. This commentary is based on a virtual symposium presented at the 33rd International College of Neuropsychopharmacology (CINP) World Congress, Taipei, Taiwan, in June 2022.

PMID:37115459 | DOI:10.1007/s40120-023-00469-6

Int Urol Nephrol. 2023 Apr 28. doi: 10.1007/s11255-023-03613-1. Online ahead of print.

ABSTRACT

AIM: To determine the effect of heparin administered during the early post urethral trauma period on inflammation and spongiofibrosis in rats.

MATERIALS AND METHODS: The study included 24 male rats that were randomized into 3 groups of 8 each. The urethra was traumatized using a 24-G needle sheath in all rats. Group 1 (control group) received intraurethral saline 0.9% injected b.i.d. for 27 days, group 2 received intraurethral Na-heparin (liquemine-Roche) 1500 IU kg^-1 injected b.i.d. for 27 days, and group 3 received intraurethral Na-heparin 1500 IU kg^-1 injected b.i.d and saline 0.9% s.i.d. for 27 days. On day 28 the rats’ penises were degloved and penectomy was performed. Inflammation, spongiofibrosis, and congestion in the urethra were investigated in each group.

RESULTS: A statistically significant difference was found between the three groups (control, heparin, and heparin + saline) in the histopathological status of spongiofibrosis, inflammation, and congestion, respectively (P = 0.0001, P = 0.002, P = 0.0001). Severe spongiofibrosis was observed in six (75%) of the rats in group 1 (control group), whereas severe spongiofibrosis was not observed in group 2 (heparin) or group 3 (heparin + saline).

CONCLUSION: We observed that intraurethral Na-heparin 1500 IU kg^-1 injectioned during the early posturethral trauma period in rats significantly decreased inflammation, spongiofibrosis, and congestion.

PMID:37115457 | DOI:10.1007/s11255-023-03613-1

Int J Clin Oncol. 2023 Apr 28. doi: 10.1007/s10147-023-02339-5. Online ahead of print.

ABSTRACT

The definition of the anal canal was revised in the TNM classification (8th edition). The Japanese Society for Cancer of the Colon and Rectum (JSCCR) conducted a retrospective multi-institutional study to clarify the characteristics of anal canal cancer (ACC) in Japan. The diagnoses of 1781 patients treated for ACC were squamous cell carcimoma (SCC; n = 428; 24.0%), adenosquamous cell carcinoma (n = 7; 0.4%), and adenocarcinoma (n = 1260; 70.7%). Anal carcinoma is associated with human papillomavirus (HPV) infection and is risk factor for anal SCC. Among 40 cases analyzed at Takano Hospital and 47 cases analyzed at National Cancer Center Hospital, 34 cases (85.0%) and 40 cases (85.1%), respectively were infected with HPV; HPV-16 was the most common genotype (79.4% and 82.5%). In the JSCCR retrospective multi-institutional study, the prognosis analysis by stage was performed for anal SCC cases (202 cases treated by CRT and 91 cases treated by surgery). The 5-year overall survival (OS) rates by stage did not differ between the two treatment groups to a statistically significant extent. Regarding the results of cancer treatment of patients who underwent HPV infection tests, although the 5-year OS rates by stage did not differ to a statistically significant extent due to the small number of cases, HPV-positive patients had better survival. While an HPV vaccine for anal canal SCC has already been approved internationally, HPV vaccination has already been implemented in Japan as a national immunization program for young women but not for men at present. An HPV vaccination for men is urgently needed.

PMID:37115427 | DOI:10.1007/s10147-023-02339-5

Int J Clin Oncol. 2023 Apr 28. doi: 10.1007/s10147-023-02320-2. Online ahead of print.

ABSTRACT

BACKGROUND: This study assesses the feasibility of minimally invasive surgery (MIS) for well-selected epithelial ovarian cancer (EOC) patients.

METHODS: We performed a review of data prospectively collected from a single center from 2017 to 2022. Only patients with histologically confirmed EOC, with a tumor diameter of less than 10 cm, were eligible. We also performed a meta-analysis of similar studies comparing the outcomes of laparoscopy and laparotomy. We used MINORS (Methodological Index for Non-Randomized Studies) to assess the risk of bias and calculated the odds ratio or mean difference.

RESULTS: Eighteen patients were included; 13 in re-staging group, four in PDS group, and one in IDS group. All achieved complete cytoreduction. One case was converted to laparotomy. The median number of removed pelvic lymph nodes was 25 (range 16-34), and 32 (range 19-44) for para-aortic nodes. There were two (15.4%) intraoperative urinary tract injuries. The median follow-up was 35 months (range 1-53). Recurrence was observed in one case (7.7%). Thirteen articles for early-stage ovarian cancer were included in our meta-analysis. Analysis of the pooled results found that MIS had a higher frequency of spillage (OR, 2.15; 95% CI 1.27-3.64). No differences were observed in recurrence, complications, or up-staging.

CONCLUSIONS: Our experience supports the possibility of conducting MIS for EOC in well-selected patients. Except for spillage, our meta-analysis findings are consistent with previous reports, the majority of which were also retrospective. Ultimately, randomized clinical trials will be needed to authenticate the safety.

PMID:37115425 | DOI:10.1007/s10147-023-02320-2

Radiol Med. 2023 Apr 28. doi: 10.1007/s11547-023-01636-3. Online ahead of print.

ABSTRACT

PURPOSE: To determine whether the presence of calcifications in specimens collected during stereotactic-guided vacuum-assisted breast biopsies (VABB) is sufficient to ascertain their adequacy for final diagnosis at pathology.

MATERIALS AND METHODS: Digital breast tomosynthesis (DBT)-guided VABBs were performed on 74 patients with calcifications as target. Each biopsy consisted of the collection of 12 samplings with a 9-gauge needle. This technique was integrated with a real-time radiography system (IRRS) which allowed the operator to determine whether calcifications were included in the specimens at the end of each of the 12 tissue collections through the acquisition of a radiograph of every sampling. Calcified and non-calcified specimens were separately sent to pathology and evaluated.

RESULTS: A total of 888 specimens were retrieved, 471 containing calcifications and 417 without. In 105 (22.2%) samples out of 471 with calcifications cancer was detected, while the remaining 366 (77.7%) were non-cancerous. Out of 417 specimens without calcifications 56 (13.4%) were cancerous, whereas 361 (86.5%) were non-cancerous. Seven hundred and twenty-seven specimens out of all 888 were cancer-free (81.8%, 95%CI 79-84%).

CONCLUSION: Although there is a statistical significative difference between calcified and non-calcified samples and the detection of cancer (p < 0.001), our study shows that the sole presence of calcifications in the specimens is not sufficient to determine their adequacy for final diagnosis at pathology because non-calcified samples can be cancerous and vice-versa. Ending biopsies when calcifications are first detected through IRRS could lead to false negative results.

PMID:37115391 | DOI:10.1007/s11547-023-01636-3

Sleep Breath. 2023 Apr 28. doi: 10.1007/s11325-023-02821-4. Online ahead of print.

ABSTRACT

PURPOSE: To explore the association between rapid eye movement-related obstructive sleep apnea (REM-OSA) and common cardiometabolic diseases (CMDs) in patients with mild OSA.

METHODS: This retrospective study was conducted by reviewing the medical records and polysomnograms (PSGs) of patients at Siriraj Hospital. The PSGs of patients diagnosed with mild OSA who had ≥ 15 min of REM sleep were included. REM-OSA was defined if the apnea-hypopnea index (AHI) in REM was ≥ 2 times that of non-REM. Common CMDs included coronary artery disease, stroke, heart failure, diabetes mellitus, and hypertension.

RESULTS: The data of 518 patients with a mean age of 48.3 years, 198 males, and mean AHI of 9.8 events/h were analyzed in this study. When compared with the control group, the REM-OSA group (308 patients) were predominantly female (72%), overweight (62%), and had more severe oxygen desaturation, p-value < 0.001. CMDs were significantly more common in the REM-OSA group than in the controls [odds ratio (OR) 1.52, 95% confidence interval 1.04-2.21, p-value = 0.029]. Patients with a REM AHI of ≥ 20 events/h were significantly associated with hypertension compared to those with a REM AHI of < 20 events/h, p-value = 0.001. However, these associations were found not to be statistically significant after controlling for age, sex, BMI, and prevalent coexisting CMD (OR = 1.13, 95% CI: 0.72-1.76, p-value = 0.605).

CONCLUSION: Common CMDs, particularly HT, tend to show an association with REM-OSA in patients with mild OSA, but this association did not reach statistically significant levels.

PMID:37115354 | DOI:10.1007/s11325-023-02821-4

Support Care Cancer. 2023 Apr 28;31(5):309. doi: 10.1007/s00520-023-07778-4.

ABSTRACT

PURPOSE: Most previous reports on dysphagia in cancer have focused on specific cancer types, particularly head and neck cancer. Therefore, we aimed to investigate the incidence of dysphagia in patients with various cancers using a nationwide database in South Korea.

METHODS: This was a retrospective cohort study using the National Health Insurance Service database. Claim codes were used for the selection criteria and operational definitions. The total population data from 2010 to 2015 were extracted. The crude incidence of dysphagia was calculated per 1,000 person-years. The multivariate adjusted Cox proportional hazards regression was used to determine the effects of different cancers on the incidence of dysphagia.

RESULTS: People with cancer had a lower income and suffered from a higher risk of comorbidities compared to people without cancer. The risk of dysphagia increased in all types of cancers, particularly in the oral cavity and pharynx (hazard ratio [HR]: 20.65, 95% confidence interval [CI]: 17.73-24.06), esophagus (HR: 18.25, 95% CI: 15.66-21.26), larynx (HR: 12.87, 95% CI: 10.33-16.02), and central nervous system (HR: 12.42, 95% CI: 10.33-14.94).

CONCLUSIONS: The risk of dysphagia was significantly higher in the cancer group than in the non-cancer group. As the survival of cancer patients is improving with the development of new treatments, more attention should be paid to dysphagia in the management of cancer. Prompt and appropriate multidisciplinary interventions for dysphagia are necessary to improve the recovery and quality of life in cancer patients.

PMID:37115351 | DOI:10.1007/s00520-023-07778-4

Wien Klin Wochenschr. 2023 Apr 28. doi: 10.1007/s00508-023-02204-5. Online ahead of print.

ABSTRACT

OBJECTIVE: Coronavirus disease 2019 (COVID-19) causes permanent problems, even mild severity. The long-term consequences of COVID-19 are still unknown. This study aimed to investigate physical activity levels, respiratory and peripheral muscle strength, and pulmonary function in the long term in young adult COVID-19 patients who recovered from mild disease.

METHODS: This cross-sectional study was carried out at least 6 months after the COVID-19 diagnosis, 54 patients with COVID-19 (median age: 20 years) and 46 controls (median age: 21 years) were compared. Functional status (post-COVID-19 functional status scale), respiratory (maximum inspiratory and expiratory pressures (MIP, MEP)) and peripheral muscle strength (dynamometer), pulmonary function (Spirometry), dyspnea and fatigue (modified Borg scale), and physical activity levels (International Physical Activity Questionnaire) were evaluated.

CLINICALTRIAL NUMBER: NCT05381714.

RESULTS: Patients with COVID-19 measured and percent predicted MIP and MEP were statistically decreased compared with the controls (p < 0.05). Shoulder abductors muscle strength (p < 0.001) and the number of individuals with low physical activity levels were significantly higher in patients compared with controls (p = 0.048). Pulmonary function, quadriceps muscle strength, exertional dyspnea, and fatigue scores were similar in groups (p > 0.05).

CONCLUSION: Respiratory and peripheral muscle strength and physical activity levels are adversely affected in patients with COVID-19, even though the patients were mildly affected in the long term. Also, symptoms such as dyspnea and fatigue may persist. Therefore, these parameters should be evaluated in the long term, even in young adults who are mildly affected by COVID-19.

PMID:37115337 | DOI:10.1007/s00508-023-02204-5

J Orofac Orthop. 2023 Apr 28. doi: 10.1007/s00056-023-00467-1. Online ahead of print.

ABSTRACT

PURPOSE: The aim of this retrospective cohort study was to evaluate the long-term effects of interceptive orthodontic treatment with a removable expansion plate, based on transversal, sagittal, and vertical parameters.

METHODS: A total of 90 patients needing interceptive treatment due to a crossbite or space deficiency were included. Records consisting of clinical photos, radiographs, and digital dental casts were collected for evaluation at two time points: the start of interceptive treatment (T0) and the start of comprehensive treatment (T1). Molar occlusion, overjet, overbite, presence and type of crossbite, mandibular shift, and transversal measurements were recorded for comparison.

RESULTS: After expansion with removable appliances, a significant increase in intermolar width was achieved and could be maintained over the observation period (p < 0.001). However, no significant changes regarding overjet, overbite, or molar sagittal occlusion were observed. Crossbite correction was successful in 86.9% of patients with unilateral crossbite and in 75.0% of patients with bilateral crossbite (p < 0.001).

CONCLUSION: Early expansion with a removable expansion plate is a successful method to correct crossbites and increase intermolar width in the early mixed dentition phase. Results remain stable until the start of comprehensive treatment in the permanent dentition.

PMID:37115290 | DOI:10.1007/s00056-023-00467-1

World J Microbiol Biotechnol. 2023 Apr 28;39(7):177. doi: 10.1007/s11274-023-03630-3.

ABSTRACT

Benzopyrene is a high-molecular-weight polycyclic aromatic hydrocarbon that is highly recalcitrant and induces carcinogenic effects. CsrA is a conserved regulatory protein that controls the translation and stability of its target transcripts, having negative or positive effects depending on the target mRNAs. It is known that Bacillus licheniformis M2-7 has the ability to grow and survive in certain concentrations of hydrocarbons such as benzopyrene, prompted in part by CsrA, as is present in gasoline. However, there are a few studies that reveal the genes involved in that process. To identify the genes involved in the Bacillus licheniformis M2-7 degradation pathway, the plasmid pCAT-sp containing a mutation in the catE gene was constructed and used to transform B. licheniformis M2-7 and generate a CAT1 strain. We determined the capacity of the mutant B. licheniformis (CAT1) to grow in the presence of glucose or benzopyrene as a carbon source. We observed that the CAT1 strain presented increased growth in the presence of glucose but a statistically considerable decrease in the presence of benzopyrene compared with the wild-type parental strain. Additionally, we demonstrated that the Csr system positively regulates its expression since it was observed that the expression of the gene in the mutant strain LYA12 (M2-7 csrA:: Sp, SpR) was considerably lower than that in the wild-type strain. We were thus able to propose a putative regulation model for catE gene in B. licheniformis M2-7 strain by CsrA regulator in the presence of benzopyrene.

PMID:37115273 | DOI:10.1007/s11274-023-03630-3