Category: Nevin Manimala

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

J Cancer Res Clin Oncol. 2023 Apr 28. doi: 10.1007/s00432-023-04803-1. Online ahead of print.

ABSTRACT

PURPOSE: Immune checkpoint inhibitors (ICIs) have become an indispensable part of clinical practice; however, off-label use of these agents is unknown. We aimed to define the patterns of off-label use of ICIs in a nationwide sample of patients.

METHODS: The online database (Reçetem) was retrospectively searched for off-label use cases related to ICIs approved during a 6-month period. Adult patients with metastatic solid tumors were included. Ethics approval was obtained. Reasons for off-label use were recorded in eight categories and cases were assessed for adherence to current guidelines. Statistical analysis was performed with GNU PSPP version 1.5.3.

RESULTS: Five hundred seventy-seven reasons for use were recorded for 538 cases related to 527 patients (67.5% male). Non-small-cell lung cancer (NSCLC) (35.9%) was the most common cancer type. Nivolumab (49%), pembrolizumab (25.5%), and atezolizumab (25%) were commonly used. The top reason for off-label use was lack of approval for the cancer type (37.1%), followed by use beyond the approved treatment line (21%). Nivolumab was more frequently used than atezolizumab and/or pembrolizumab in patients with malignant melanoma, kidney cancer, head and neck cancer, and hepatocellular carcinoma (Chi-square goodness-of-fit test, p < 0.001). The guideline adherence rate was 60.5%.

CONCLUSION: Off-label use of ICIs was primarily related to (NSCLC), and most patients were treatment-naïve in contrast to the acceptance that off-label use results from exhausted treatment options. Lack of approval is a significant reason for the off-label use of ICIs.

PMID:37115271 | DOI:10.1007/s00432-023-04803-1

J Prosthodont. 2023 Apr 28. doi: 10.1111/jopr.13694. Online ahead of print.

ABSTRACT

PURPOSE: To compare the fracture resistance and failure modes of anterior cantilever resin-bonded fixed partial dentures (RBFPDs) fabricated from high translucency zirconia with different intaglio surface treatments.

MATERIALS AND METHODS: Sound-extracted canines (N = 50) were randomly divided into five groups (n = 10), to be restored with high translucency zirconia RBFBDs of different intaglio surface treatments. The RBFPD was designed using an exocad software and fabricated using a CAM milling machine. The RBFPDs were treated differently. Abrasion with 50μm alumina particles (Group 1); abrasion with 30μm silica-coated alumina particles (Group 2); abrasion with silica-coated alumina particles (30μm) and silane application (Group 3); abrasion with silica coated alumina particles (30μm) and 10-MDP primer application (Group 4); abrasion with silica-coated alumina particles (30μm) and silane, and 10-MDP primer application. All RBFPDs were cemented using dual-cured resin cement. The RBFPDs underwent 6000 thermal cycles with distilled water at 5°C/55°C for 2 minutes per cycle and then mechanical cyclic loading with 1,200,000 cycles of 50 N at a 1.7Hz frequency at an angle of 135° to the abutment’s long axis. Then, RBFPDs were loaded to fracture using a universal testing machine at 1mm/min. Maximum fracture forces and failure modes were recorded. Fractured specimens and uncemented specimens were examined using a scanning electron microscope. Data were analyzed using ANOVA and Games-Howell post hoc tests at P<0.05.

RESULTS: Mean fracture load results showed a statistically significant difference between the research groups (P<0.0001) and it ranged from 69.78-584 N. Group 4 exhibited the highest fracture load mean (P < 0.0001) which was significantly different from all other groups. Group 2 recorded a significantly higher fracture load mean than Group 3 (P = 0.029). Three modes of failure were observed; prosthesis debonding, prosthesis fracture, and abutment fracture.

CONCLUSIONS: Abrasion of zirconia surface with 30μm silica-coated alumina particles and application of 10-MDP primer yielded the highest mean fracture loads of monolithic high translucency zirconia RBFPD. The mode of fracture of the RBFPDs was influenced by the type of surface treatments. This article is protected by copyright. All rights reserved.

PMID:37114526 | DOI:10.1111/jopr.13694

Scand J Clin Lab Invest. 2023 Apr 28:1-7. doi: 10.1080/00365513.2023.2204401. Online ahead of print.

ABSTRACT

Paraproteins are a potential source of error for electrolyte analyses. The exclusion effect itself causes a discrepancy between direct and indirect ion selective electrode assays (dISE and iISE, respectively). We tested the applicability of different pretreatment methods and the difference of dISE and iISE with paraprotein-rich samples. We analysed chloride (Cl-), potassium (K+), and sodium (Na+) on 46 samples with paraproteins up to 73 g/L. We compared pretreatment methods of preheating, precipitation, and filtration to the native sample. All induced a statistically significant difference (p-value <0.05). Clinically significant difference was induced by precipitation for all analytes, and filtration for Cl- and Na+, but for none by preheating. The difference in electrolyte measurements with either dISE or iISE on native samples was explained by total protein concentration (TP). There was a statistically significant difference in all electrolyte measurements. On average, there was a clinically significant difference in Na + but not in Cl- and K + measurements. Paraprotein concentration (PP) or heavy chain class did not induce a statistically significant effect. The regression analysis and comparison to the theoretical exclusion effect supported the conclusion that TP is the only explanatory factor in the difference between dISE and iISE. We conclude that preheating is a suitable pretreatment method for all the studied analytes. Precipitation is not valid for any of them, and filtration can be considered only for K+. Because the difference between dISE and iISE was explained by the exclusion effect caused by TP, dISE is the more suitable method to analyse paraprotein-rich samples.

PMID:37114525 | DOI:10.1080/00365513.2023.2204401

United European Gastroenterol J. 2023 Apr 28. doi: 10.1002/ueg2.12398. Online ahead of print.

ABSTRACT

BACKGROUND: A previous comparative analysis of the time trends of Hodgkin lymphoma (HL), multiple sclerosis (MS), Crohn’s disease (CD), and ulcerative colitis (UC) suggested that the occurrence of all four diseases was precipitated by exposure to similar environmental risk factors during early lifetime. In the present cross-sectional study, it was hypothesized that besides their resembling temporal variations the four diseases would also show similar geographic distributions.

METHODS: Using the vital statistics of 21 countries from 1951 to 2020, overall and age-specific death rates from the four diseases were calculated for each individual country. The death rates of different countries were compared using linear regression analysis.

RESULTS: The data revealed strikingly similar geographic distributions of all four diseases. Their occurrence was common in Europe and relatively uncommon in countries outside Europe. Further stratification by consecutive age groups showed that for each disease analyzed separately, there were significant correlations amongst each two sequential age groups. In HL and UC, the inter-age correlations started at age 5 years or less. In MS and CD, the inter-age correlations only started at age 15 years.

CONCLUSIONS: The similarities in the geographic distributions of death rates from HL, MS, CD, and UC suggest that these four diseases share a set of one or more common environmental risk factors. The data also support the contention that the exposure to such shared risk factors starts during an early period of lifetime.

PMID:37114502 | DOI:10.1002/ueg2.12398

Rev Esp Salud Publica. 2023 Apr 26;97:e202304034.

ABSTRACT

OBJECTIVE: The multiple effects of the COVID-19 pandemic are beginning to be seen from the alteration of vital statistics figures. This is summarized in changes in the usual causes of death and excess attributable mortality, which can finally be seen in structural changes in the populations of the countries. For this reason, this research was created with the objective of determining the impact of the COVID-19 pandemic on maternal, perinatal and neonatal mortality in four locations in Bogotá D.C. (Colombia).

METHODS: A retrospective longitudinal investigation was carried out in which 217,419 mortality data were analyzed in the towns of Kennedy, Fontibón, Bosa and Puente Aranda in the city of Bogotá – Colombia that occurred between the years 2018 to 2021, of which maternal (54), perinatal (1,370) and neonatal (483) deaths in order to identify a history of SARS-CoV-2 infection that could be related to the excess mortality associated with COVID-19. The data were collected from the open records of vital statistics of the National Statistics Department (DANE), where they were analyzed from frequency measures or central tendency and dispersion according to the types of variables. The specific mortality indicators related to maternal, perinatal and neonatal death events were calculated.

RESULTS: A decrease in perinatal and neonatal mortality was evidenced since 2020, which was associated with the progressive decrease in pregnancies in those same years; Additionally, a considerable increase in maternal deaths was observed for 2021 compared to the other years analyzed. The proportion of maternal deaths in 2020 and 2021 by 10% and 17%, respectively, were attributed to COVID-19.

CONCLUSIONS: It is observed that the trend of maternal mortality is related to the increase in mortality from COVID-19, maternal deaths associated with COVID-19 occurred specifically in the zonal planning units that registered more than 160 cases of COVID-19 for the year 2021.

PMID:37114485