Category: Nevin Manimala

Endokrynol Pol. 2023 Jan 27. doi: 10.5603/EP.a2023.0002. Online ahead of print.

ABSTRACT

INTRODUCTION: The effect of vitamin D status on steatosis has not been fully elucidated. In this study, we planned to investigate this interaction using a large-scale population-based cohort.

MATERIAL AND METHODS: Patients diagnosed with simple steatosis (K76.0) and non-alcoholic steatohepatitis (NASH) (K75.8) by using the International Classification of Diseases 10th Revision (ICD-10) coding system, and who had 25-hydroxyvitamin D (25OHD) measurements at the diagnosis, were included in the study. Control group comprised subjects without liver diseases. Age, gender, alanine aminotransferase (ALT) and 25OHD levels, and the date of the measurements were recorded.

RESULTS: We compared ALT and 25OHD measurements between the patient and control groups, and between the simple steatosis and NASH subgroups. 25OHD levels were lower and ALT levels were higher in the patient group (p < 0.001, effect size = 0.028, and p < 0.001, effect size = 0.442, respectively). Logistic regression analysis showed that when 25OHD levels decrease by 1 ng/dL, it increases the risk of being in the patient group by 3.7%.

CONCLUSION: Our results suggest that vitamin D status may be related to the development of non-alcoholic fatty liver disease (NAFLD). Although this relationship is weak, it may be important in the pathogenesis of steatosis.

PMID:36704977 | DOI:10.5603/EP.a2023.0002

Clin Chem Lab Med. 2023 Jan 27. doi: 10.1515/cclm-2023-0008. Online ahead of print.

ABSTRACT

OBJECTIVES: Clinical practice guidelines endorse the stratification of prostate cancer (PCa) risk according to individual total prostate-specific antigen (tPSA) values and age to enhance the individual risk-benefit ratio. We defined two nomograms to predict the individual risk of high and low grade PCa by combining the assay of tPSA and %free/tPSA (%f/tPSA) in patients with a pre-biopsy tPSA between 2 and 10 μg/L.

METHODS: The study cohort consisted of 662 patients that had fPSA, tPSA, and a biopsy performed (41.3% with a final diagnosis of PCa). Logistic regression including age, tPSA and %f/tPSA was used to model the probability of having high or low grade cancer by defining 3 outcome levels: no PCa, low grade (International Society of Urological Pathology grade, ISUP<3) and high grade PCa (ISUP≥3).

RESULTS: The nomogram identifying patients with: (a) high vs. those with low grade PCa and without the disease showed a good discriminating capability (∼80%), but the calibration showed a risk of underestimation for predictive probabilities >30% (a considerable critical threshold of risk), (b) ISUP<3 vs. those without the disease showed a discriminating capability of 63% and overestimates predictive probabilities >50%. In ISUP 5 a possible loss of PSA immunoreactivity has been observed.

CONCLUSIONS: The estimated risk of high or low grade PCa by the nomograms may be of aid in the decision-making process, in particular in the case of critical comorbidities and when the digital rectal examinations are inconclusive. The improved characterization of the risk of ISUP≥3 might enhance the use for magnetic resonance imaging in this setting.

PMID:36704961 | DOI:10.1515/cclm-2023-0008

Ultrasound Obstet Gynecol. 2023 Jan 27. doi: 10.1002/uog.26165. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the outcomes of monochorionic diamniotic (MCDA) twins complicated by selective fetal growth restriction (sFGR) Type II who underwent laser photocoagulation and to validate the subclassification previously proposed by Chmait et al. (Type IIA with normal Doppler assessment of the ductus venosus (DV) and middle cerebral artery (MCA) of the growth-restricted fetuses and Type IIB with DV absent or reversed flow during atrial contractions and/or MCA peak systolic velocity equal or greater than 1.5 Multiple of Median [MoM]) in a larger multicenter cohort.

METHODS: This retrospective multicenter study included all MCDA twins complicated by Type II sFGR who underwent laser photocoagulation of placental anastomoses at four large tertiary fetal care centers between 2006 and 2020. Cases were then subclassified into Type IIA or IIB based of Doppler evaluation of fetal DV and MCA-PSV as previously mentioned. Demographic characteristics and pregnancy outcomes were compared between groups. Data was presented as mean ± standard deviation or numbers and percentages as appropriate. P-value ˃0.05 is considered statistically significant.

RESULTS: A total of 98 patients with MCDA twins met our inclusion criteria, with 56 sub-classified as Type IIA and 42 as Type IIB. Demographic characteristics were similar between the groups; however, Type IIB cases tended to have an earlier gestational age at diagnosis and at laser surgery as well as larger intertwin estimated fetal weight discordance, which may be a reflection of disease severity. Postnatal survival of the growth-restricted fetus was significantly lower in Type IIB compared to Type IIA cases (23.8% vs 46.4%, P = 0.034) CONCLUSIONS: In MCDA twins complicated by sFGR Type II and treated with laser photocoagulation of placental anastomoses, preoperative Doppler assessment of the ductus venosus and middle cerebral artery help to identify subset of patients at increased risk of demise of the growth-restricted fetuses following intervention. Our study provides valuable information for guiding the surgical management options and patient counseling. This article is protected by copyright. All rights reserved.

PMID:36704956 | DOI:10.1002/uog.26165

J Periodontol. 2023 Jan 27. doi: 10.1002/JPER.22-0693. Online ahead of print.

ABSTRACT

BACKGROUND: Ozone is a molecule that plays an important role in dentistry, specially for wound healing. The aim of the present study was to clinically and immunologically evaluate the effect of ozonated oil on the healing of palatal wounds.

METHODS: This is a prospective, longitudinal, triple-blind, randomized, placebo-controlled clinical trial. The groups were divided as follows: Test group (n = 14): after removal of the free gingival graft (FGG), the palatal wound was treated with ozonated sunflower oil with a peroxide index between 510 – 625 meq O₂ /kg; Control group (n = 14): after removal of the FGG, the palatal wound was treated with non-ozonated sunflower oil (placebo). The treatments were applied three times a day, for seven days.

RESULTS: There were no significant differences in the measurements of wound area (mm² ) between the test and control groups in the different periods evaluated (0, 3, 7, and 14 days; P>0.05). The intra-group analysis showed a significant decrease in wound size over the course of days (0, 3, 7, and 14 days; P<0.05). Vascular endothelial growth factor (VEGF; μg/mL) presented a significant reduction at 7 days (p<0.05) compared to day 3 in the test group (p<0.05). There was a statistical difference for malondialdehyde (MDA; μg/mL) in the test group between 3 and 7 days post-treatment (p<0.05) and between test and control groups on the 7th day (p<0.05).

CONCLUSIONS: The application of highly ozonated sunflower oil did not improve the remaining scar area of the palate, decreasing the VEGF and increasing the oxidative stress marker MDA. This article is protected by copyright. All rights reserved.

PMID:36704931 | DOI:10.1002/JPER.22-0693

Clin Chem Lab Med. 2023 Jan 27. doi: 10.1515/cclm-2022-1053. Online ahead of print.

ABSTRACT

OBJECTIVES: The determination of assay-dependent upper and lower reference limits (URL, LRL) of free triiodothyronine (FT3), free thyroxine (FT4), and thyroid stimulating hormone (TSH) during childhood and adolescence, is challenging.

METHODS: Thyroid hormones were measured via the Abbott Alinity system in 502 euthyroid children partitioned in the following age groups: ≤2, 2.1-10, and 10.1-18 years. The 97.5th and 2.5th percentiles (URL and LRL) were derived according to CLSI EP28- A3c guidelines. Quantile regression models were used to assess: (a) 90% confidence intervals of the URL and LRL, (b) the effect of age on URL and LRL within each age class and on overall age range, (c) the difference between the URLs and LRLs estimated for each age partition with an estimate of the confidence interval divided by the reference interval being derived (CI/RI).

RESULTS: The CI/RI for the LRLs are smaller as compared to the URLs, except for FT4 for the 2.1-10 years age group. Considering the CI/RI and the overlap between CIs across the three age groups, one single LRL might be considered for TSH, FT3 and FT4 between 0 and 18 years. However, for the URL, there was a noticeable decrease in the URL over the 3 age groups for all three biomarkers, with there being no overlap in CIs for the URL between the ≤2 vs. the 10.1-19 years age groups.

CONCLUSIONS: A common LRL for TSH, FT4 and FT3 for patients aged ≤18 years may be utilized when these biomarkers are measured with the Alinity system. For the URLs the use of age-specific URLs for these biomarkers is recommended.

PMID:36704909 | DOI:10.1515/cclm-2022-1053

Eur J Neurol. 2023 Jan 27. doi: 10.1111/ene.15699. Online ahead of print.

ABSTRACT

BACKGROUND: To evaluate the temporal trends, characteristics and in-hospital outcomes of patients hospitalized with acute ischemic stroke (AIS) between those with and without current or historical malignancies.

METHODS: Adult hospitalizations with a primary diagnosis of AIS were identified from the National inpatient sample 2007-2017. Logistic regression was used to compare the differences in the utilization of AIS interventions and in-hospital outcomes. For further analysis, subgroup analyses were performed stratified by cancer subtypes.

RESULTS: There were 892,862 hospitalizations due to AIS, of these, 108,357 (12.14%) had a concurrent diagnosis of current cancer (3.41%) or historical cancer (8.72%). After adjustment for confounders, patients with current malignancy were more likely to have worse clinical outcomes. The presence of historical cancers was not associated with an increase in poor clinical outcomes. Additionally, AIS patients with current malignancy were less likely to receive intravenous thrombolysis (IVT) [(aOR): 0.66, 95% CI: 0.63-0.71]. Among the subgroups of AIS patients treated with IVT or mechanical thrombectomy (MT), outcomes varied by cancer types. Notably, despite these acute stroke interventions, outcome remains poor in AIS patients with lung cancer.

CONCLUSIONS: Although AIS patients with malignancy generally have worse in-hospital outcomes versus those without, there were considerable variations in these outcomes according to different cancer types and the use of AIS interventions. Finally, treatment of these AIS patients with a current or historical cancer diagnosis should be individualized.

PMID:36704907 | DOI:10.1111/ene.15699

Conserv Biol. 2023 Jan 27. doi: 10.1111/cobi.14062. Online ahead of print.

ABSTRACT

Fire has shaped ecological communities worldwide for millennia but impacts of fire on individual species are often poorly understood. We performed a meta-analysis to predict which traits, habitat or study variables, and fire characteristics influence how mammal species respond to fire. We modelled effect sizes of measures of population abundance or occupancy as a function of various combinations of these traits and variables using phylogenetic least squares regression. Only nine of 115 modelled species (7.83%) returned statistically significant effect sizes, suggesting most mammals are resilient to fire. The top-ranked model predicted a negative impact of fire on species with lower reproductive rates, regardless of fire type, a positive impact of burrowing in prescribed fires but not wildfires, and a positive impact of average fire return interval for wildfires but not prescribed fires. If a species’ International Union for Conservation of Nature (IUCN) Red List assessment includes fire as a known or possible threat, the species is predicted to respond negatively to wildfire relative to prescribed fire. These findings provide confidence around experts’ abilities to predict whether fire is a threat to a mammal species, and the ability of managers to meet the needs of fire-threatened species through prescribed fire. We provide a basis to predict mammal responses to fire, to guide conservation actions or interventions in species or communities where empirical data are lacking. This article is protected by copyright. All rights reserved.

PMID:36704894 | DOI:10.1111/cobi.14062

Skin Res Technol. 2023 Jan;29(1):e13269. doi: 10.1111/srt.13269.

ABSTRACT

BACKGROUND: Acne is the eighth-most prevalent inflammatory skin disease with no optimal treatment. Photodynamic therapy (PDT) is an effective treatment for severe acne.

AIMS: The effect of PDT on the composition and diversity of skin microflora in severe acne patients was studied.

MATERIALS AND METHODS: A total of 18 patients with severe acne and 8 healthy individuals were selected for this study. Patients were treated with 5-aminolevulinic acid-mediated PDT once a week three times in total; the skin microbiome was measured by 16S ribosomal RNA gene sequencing before and after treatment (1 week after each PDT).

RESULTS: The microflora composition was different between healthy controls and patients, and between patients before and after treatment. Alpha diversity indices were lower in patients than those in control. There were 15 bacterial genera with high relative abundance that had noticeable changes during treatment. At the genus level,particularly Cutibacterium acnes (C. acnes formerly Propionibacterium acnes), there was no statistically significant difference among different group. The abundances of Staphylococcus epidermidis and Staphylococcus aureus were low.

DISCUSSION: The microbial composition is different between severe acne patients acne patients and healthy individuals. The therapeutic efficacy of severe acne treated with PDT is associated with the composition and diversity of skin microbiota.

CONCLUSION: The skin microbial composition changes after PDT treatment. PDT is an effective method for the treatment of severe acne.

PMID:36704881 | DOI:10.1111/srt.13269

Skin Res Technol. 2023 Jan;29(1):e13260. doi: 10.1111/srt.13260.

ABSTRACT

BACKGROUND: Atopic dermatitis (AD) is a chronic inflammatory disease. Monoclonal antibody dupilumab was approved to treat moderate-to-severe AD in recent years. An objective assessment of treatment response by skin imaging modality is adjuvant for clinical evaluations. This study aimed to explore the value of dermoscopy and high-frequency ultrasound (HFUS) imaging characteristics in treatment evaluation for moderate-to-severe AD patients treated with dupilumab.

METHODS: Moderate-to-severe AD patients refractory to conventional therapy were enrolled in the study. All patients went through at least a 16-week standardized treatment of dupilumab. Clinical scores (eczema area scoring index [EASI], SCOARD, numerical rating scale of pruritus, dermatology life quality index), dermoscopy, and HFUS examinations were conducted at 0, 2, 4, 8, 12, and 16 weeks of treatment. Erythema, scales, erosion, and pigmentation under dermoscopy were scored, and subepidermal low-echogenic band (SLEB) thickness under HFUS was measured as quantitative indexes. Descriptive analysis and mixed effect linear regression models were used for statistical analysis.

RESULTS: Sixteen patients were enrolled in the study and their average age was 45.63 ± 18.18 years. All clinical scores decreased with significant difference after 16-week treatment compared with baseline. All patients achieved EASI 50 (EASI score decreased by 50% or more), and 9/16 patients reached EASI 75 after 16-week treatment. Dermoscopy evaluation of erythema, scales and erosion scores were decreased, and the sign of pigmentation score was increased after treatment. For HFUS, the mean SLEB value was 0.51 ± 0.29 mm and decreased to 0.27 ± 0.15 mm after 16-week treatment (p < 0.01). SLEB value decreased linearly with treatment time and correlated with clinical scores. However, SLEB values of two patients were 0.57 and 0.68 mm at week 16, respectively, which were higher than the average, and one of the patients showed EASI 75.

CONCLUSION: Dermoscopy and HFUS were able to reveal deeper inflammation response than clinical scores in AD and can be an effective method to evaluate and monitor clinical improvement during dupilumab treatment for AD patients. The preliminary value of imaging methods for predicting the treatment endpoint of dupilumab remains to be verified.

PMID:36704877 | DOI:10.1111/srt.13260

Int J Paediatr Dent. 2023 Jan 26. doi: 10.1111/ipd.13053. Online ahead of print.

ABSTRACT

The aim of the present cross-sectional study was to investigate whether family income modifies associations between dental caries and sex, age, mother’s education, type of preschool, sugar intake and tooth brushing. A randomly selected sample of 308 Brazilian preschool children aged one to three years underwent a clinical oral examination for the assessment of moderate/extensive dental caries using codes 3 to 6 of the International Caries Detection and Assessment System. Mothers were asked to fill out a form addressing the child’s demographic and socioeconomic characteristics as well as the frequency of sugar intake. Statistical analysis involved descriptive statistics, the chi-squared test and Poisson regression models. The prevalence of moderate/extensive dental caries was 42.5%. The adjusted model revealed that within low-income families (<2 times the monthly minimum wage), the prevalence of dental caries was higher among children with a high frequency of sugar intake (≥ twice per day) than in those with a low frequency of sugar intake (< twice a day) (RR=1.79; CI: 1.38-2.33). However, in families with higher income (≥2 times the monthly wage), no significant association between sugar intake and dental caries was found. In conclusion, monthly family income can modify the association between the high frequency of sugar intake and dental caries.

PMID:36704857 | DOI:10.1111/ipd.13053