Category: Nevin Manimala

Clin Endocrinol (Oxf). 2021 Mar 14. doi: 10.1111/cen.14459. Online ahead of print.

ABSTRACT

OBJECTIVE: Obesity and liver fat are associated with decreased levels of serum sex hormone-binding globulin (SHBG). Laboratory studies suggest that hepatic de novo lipogenesis (DNL) is involved in the downregulation of SHBG synthesis. The aim of the present study was to address the role of DNL on serum SHBG in humans.

DESIGN: A cross-sectional study examining the association between DNL, measured by stable isotopes, and serum SHBG, stratified by sex.

PARTICIPANTS: Healthy men (n=34) and women (n=21) were combined from two cross-sectional studies. Forty-two percent of participants had hepatic steatosis, and the majority were overweight (62%) or obese (27%).

RESULTS: DNL was inversely associated with SHBG in women (β: -0.015, 95%CI: -0.030;0.000), but not in men (β: 0.007, 95%CI: -0.005;0.019) (p for interaction=0.068). Adjustment for study population, age and BMI did not materially change these results, although statistical significance was lost after adjustment for serum insulin.

CONCLUSIONS: An inverse association between DNL and SHBG may explain the decreased SHBG levels that are observed in obesity, at least in women.

PMID:33715205 | DOI:10.1111/cen.14459

Acta Neurol Belg. 2021 Mar 13. doi: 10.1007/s13760-021-01644-y. Online ahead of print.

ABSTRACT

BACKGROUND: Psoriatic arthritis (PsA) is an inflammatory rheumatic disorder associated with cutaneous psoriasis. Neurological manifestations are not uncommon in rheumatic diseases and recent studies point to a possible underestimation of cognitive impairment in this group of diseases. Our aim was to assess the cognitive impairment in patients with PsA.

METHODS: We carried out a cross-sectional case-control study with consecutive patients with PsA. Trained interviewers conducted structured and standardized in-person assessments. At baseline, functional limitations were characterized using the Health Assessment Questionnaire (HAQ). Cognitive function was evaluated with the Montreal Cognitive Assessment (MoCA) and neuropsychiatric symptoms were investigated with the Hospital Anxiety and Depression Scale (HADS). Using a proper statistical analysis, we compared the differences in the neurological outcomes between cases and controls.

RESULTS: A total of 37 patients with PsA and 36 healthy controls were included in our study. Patients with PsA had a worse MoCA score when compared to controls (p = 0.01). The proportion of patients with cognitive impairment according to MoCA between cases and controls was also statistically significant (91.9% vs 58.3%, p = 0.002). Executive skills, naming, language, and abstraction were the most affected domains. There was no statistical difference between the prevalence of neuropsychiatric symptoms between the two groups. Patients with increased functional limitations are associated with poor cognitive performance (p < 0.05).

CONCLUSION: Cognitive impairment might be a neurological manifestation of PsA.

PMID:33715103 | DOI:10.1007/s13760-021-01644-y

Environ Sci Pollut Res Int. 2021 Mar 13. doi: 10.1007/s11356-021-13319-5. Online ahead of print.

ABSTRACT

The impact of high concentrations of air pollution on COVID-19 has been a major air quality and life safety issue in recent studies. This study aimed to assess the contribution of different air pollution indicators in different spaces on the newly confirmed cases of coronavirus. According to causality’s results between air pollution (AP) and COVID-19 infection in 9 countries, first, we examined the non-linear relationship from AP to COVID-19 with PM_2.5 as the rating variable (the cut point is 35 μg/m³) at the national level. It is concluded that the effects of PM_2.5 and PM₁₀ on COVID-19 are more sensitive in Russia, England, Germany, and France, while O₃ and PM_2.5 are more sensitive in America and Canada from 21 Jan to 20 May. Second, we examined the threshold effects from AP to COVID-19 with PM_2.5, PM₁₀, SO₂, CO, NO₂, and O₃ as the threshold variables, respectively, at the municipal level in China during the period 28 Jan to 31 May. It is concluded that except CO, the remaining 5 indicators are very sensitive to the increase of newly confirmed cases, and the spread of COVID-19 can be prevented and controlled by the determination of thresholds. In addition, the 9 countries and 27 provinces show that PM_2.5 in high concentrations is the more sensitive pollutant on the spread of COVID-19 infection.

PMID:33715120 | DOI:10.1007/s11356-021-13319-5

Ir J Med Sci. 2021 Mar 13. doi: 10.1007/s11845-021-02567-6. Online ahead of print.

ABSTRACT

BACKGROUND: Appendicitis is the most common abdominal emergency in England accounting for 40,000 admissions per year. The Good Surgical Practice guideline by Royal College of Surgeons England (RCSEng) defines criteria detailing what constitutes a safe and comprehensive operation note. High-quality operation notes enable continuity of care and safe post-operative management.

AIMS: (1) Assess whether laparoscopic appendicectomy operation notes are adherent to RCSEng criteria. (2) Implement an operation note proforma to improve adherence. (3) Re-audit to assess effectiveness of operation note proforma.

METHODS: A retrospective audit was performed measuring compliance of laparoscopic appendicectomy notes to RCSEng criteria over a 4-month period at a central London tertiary care centre. A laparoscopic appendicectomy operation note proforma was designed and implemented. Compliance to RCSEng criteria was then re-audited against RCSEng criteria, and statistical analysis performed to assess the significance of changes to compliance.

RESULTS: The average compliance with the RCSEng guidelines after the first cycle retrospectively was 56.1%. The average compliance after implementation of the proforma was 98.2%, with above 80% of operation notes satisfying all RSCEng criteria. This was a significant 42.1% (p < 0.0001) increase in average compliance. The implementation of the proforma reduced the amount of hand-written information, saving time and improving legibility of the operation notes.

CONCLUSION: The implementation of an operation note proforma has the ability to significantly improve operation note quality. This simple and effective intervention to improve operation note quality has the potential to improve post-operative safety and continuity of care post laparoscopic appendicectomy.

PMID:33715070 | DOI:10.1007/s11845-021-02567-6

Biol Trace Elem Res. 2021 Mar 14. doi: 10.1007/s12011-021-02626-0. Online ahead of print.

ABSTRACT

Osteoporosis is a systemic metabolic disease defined by a decreased bone mineral density, microarchitectural deterioration, and an increased incidence of fragility fractures that may lead to morbidity and mortality. Boron may stimulate new bone formation and regeneration, when combined with nano-hydroxyapatite. We questioned whether injecting boron-containing nano-hydroxyapatite composites with hyaluronan increased the bone mineral density and new bone formation in osteoporotic rabbit femurs. The regenerative effects of injectable boron-containing nano-hydroxyapatite composites from 6 to 12 weeks, which may prevent osteoporotic femoral fractures, were assessed. Boron-containing (10 μg/ml) nano-hydroxyapatite composites were injected into the intramedullary femoral cavity with hyaluronan. These significantly increased the histomorphometric new bone surface to the total bone surface ratio at 6 and 9 weeks. The micro-tomographic bone volume to the total volume ratio and bone mineral density in osteoporotic rabbit femurs increased when compared to the hyaluronan (p = 0.004, p = 0.004, p = 0.004, p = 0.01, respectively) and the sham-control (p = 0.01, p = 0.004, p = 0.01, p = 0.037, respectively) groups. The boron-containing group had a higher bone mineralization and new bone formation compared to the nano-hydroxyapatite group, although the difference was not statistically significant. These findings reveal that intramedullary injection of boron-containing nano-hydroxyapatite with hyaluronan increases new bone formation and mineralization in ovariectomized rabbit femurs. Boron-containing nano-hydroxyapatite composites are promising tissue engineering biomaterials that may have regenerative potential in preventing primary and/or secondary femoral fractures in osteoporosis patients.

PMID:33715074 | DOI:10.1007/s12011-021-02626-0

Radiol Med. 2021 Mar 14. doi: 10.1007/s11547-021-01341-z. Online ahead of print.

ABSTRACT

OBJECTIVE: Fractional extracellular space has been validated as a marker of hepatic fibrotic in cirrhotic patients at CT-scan as well as on dual-energy CT, which takes advantage from iodine uptake. Since no consensus still exists between equilibrium phases performed at 3 or 10 min, the first aim of this work is to evaluate performances at the two different time points. Moreover, correlation between fractional extracellular space and oesophageal varices, directly related to liver fibrosis, has been assessed.

MATERIALS AND METHODS: Dual-Energy equilibrium phases at 3 and 10 min were performed within a follow-up CT-protocol scan in cirrhotic patients. Oesophageal varices were endoscopically assessed according to their size. At the two different time points, correlation between iodine density of the right and left liver lobes and correlation between the fractional extracellular space values were assessed. Correlation between fractional extracellular space and endoscopic grade of oesophageal varices was calculated.

RESULTS: No statistical differences were found between the iodine density values from the two liver lobes at the two time points (p = 0.8 at 3′; p = 0.5 at 10′). No statistical difference about fractional extracellular space estimation was found between the two time points (p = 0.17). Correlation between fractional extracellular space values and oesophageal varices was moderate (ρ = 0.45, IC 0.08-0.71, p < 0.05).

CONCLUSION: Fractional extracellular space assessed on dual-energy CT at equilibrium phases with different timing was substantially similar. The moderate correlation found between fractional extracellular space and endoscopic grade of oesophageal varices confirms that CT-scan is not currently reliable as endoscopy.

PMID:33715036 | DOI:10.1007/s11547-021-01341-z

Oral Maxillofac Surg. 2021 Mar 13. doi: 10.1007/s10006-021-00940-4. Online ahead of print.

ABSTRACT

PURPOSE: This study aimed to compare the three-dimensional volumetric changes of human maxillary sinuses after reconstruction using 5 different bone grafts.

PATIENTS AND METHODS: Patients underwent unilateral maxillary sinus bone height reconstruction using 5 bone substitutes allocated in different groups as follows: group 1 was grafted with autogenous bone graft alone; group 2 with beta-tricalcium phosphate (β-TCP); group 3 with β-TCP + autogenous bone graft 1:1; group 4 with bioactive glass; and group 5 with bioactive glass + autogenous bone graft 1:1. The patients were submitted to cone beam computed tomography in two periods: 15 days after the surgical procedure (T1) and after 6 months (T2). The results were evaluated as the formula T2-T1 expressing the three-volumetric changes of the biomaterials in elapsed time.

RESULTS: The resorption rate of autogenous bone graft was -630.699 ± 300.9 mm³; in the β-TCP group, it was -315.772 ± 125.6 mm³; in the group with β-TCP + autogenous bone graft 1:1, it was -336.205 ± 195.7 mm³; and in groups with bioactive glass and with the addition of autogenous bone graft 1:1, it was -428.878 ± 311.6 mm³ and -576.917 ± 471.6 mm³, respectively, without statistical difference (p = 0.167). Pearson’s correlated test revealed a strong correlation as well as a progressive resorption of the grafts during bone healing.

CONCLUSION: The similar outcomes for the three-dimensional volumetric changes using the bone substitutes evaluated after 6 months of bone healing suggest that all these grafts can be performed to maxillary sinus reconstruction.

PMID:33715054 | DOI:10.1007/s10006-021-00940-4

Clin Oral Investig. 2021 Mar 14. doi: 10.1007/s00784-020-03713-7. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate pain, disruptive behavior, and anxiety in children undergoing different local dental anesthetic techniques.

METHODS: This randomized/parallel clinical trial analyzed three groups of patients (9-12 years old) (n = 35) who received infiltrative anesthesia using conventional (CA), vibrational (VBA), and computer-controlled techniques (CCLAD). The outcomes were pain self-perception (Wong-Baker Faces Pain Rating Scale (WBF); Numerical Ranting Scale (NRS)), disruptive behavior (Face, Legg, Activity, Crying, Consolability Scale (FLACC)), anxiety (Corah’s Dental Anxiety Scale; modified Venham Picture test (VPTm)), and physiological parameters (systolic (SBP)/diastolic pressure (DBP); heart rate (HR); oxygen saturation (SpO2); respiratory rate (RR)). Statistical analysis was accomplished using Kruskall-Wallis test and ANOVA for repeated measures (α = 0.05).

RESULTS: Dental anxiety levels at the baseline were similar for all patients. CA promoted less pain than VBA in WBF (p = 0.018) and NRS (p = 0.006) and CCLAD in WBF (p = 0.029). There were no differences in disruptive behavior (FLACC p = 0.573), anxiety (VPTm p = 0.474), blood pressure (SBP p = 0.954; DBP p = 0.899), heart rate (p = 0.726), oxygen saturation (p = 0.477), and respiratory rate (p = 0.930) between anesthetic techniques.

CONCLUSION: Conventional technique resulted in less pain perception for dental local anesthesia.

CLINICAL RELEVANCE: Conventional technique reduces the self-reported pain in children 9-12 years old, and therefore, the use of additional devices or different anesthetic techniques is not justified.

PMID:33715064 | DOI:10.1007/s00784-020-03713-7

Mod Pathol. 2021 Mar 13. doi: 10.1038/s41379-021-00777-y. Online ahead of print.

ABSTRACT

Studies validating the prognostic accuracy of the tumor-node-metastases (TNM) classification in patients with lung cancer treated by neoadjuvant therapy are scarce. Tumor regression, particularly major pathological response (MPR), is an acknowledged prognostic factor in this setting. We aimed to validate a novel combined prognostic score. This retrospective single-center study was conducted on 117 consecutive patients with non-small cell lung cancer resected after neoadjuvant treatment at a Swiss University Cancer Center between 2000 and 2016. All cases were clinicopathologically re-evaluated. We assessed the prognostic performance of a novel prognostic score (PRSC) combining T-category, lymph node status, and MPR, in comparison with the eighth edition of the TNM classification (TNM8), the size adapted TNM8 as proposed by the International Association for the Study of Lung Cancer (IASLC) and MPR alone. The isolated ypT-category and the combined TNM8 stages accurately differentiated overall survival (OS, stage p = 0.004) and disease-free survival (DFS, stage p = 0.018). Tumor regression had a prognostic impact. Optimal cut-offs for MPR emerged as 65% for adenocarcinoma and 10% for non-adenocarcinoma and were statistically significant for survival (OS p = 0.006, DFS p < 0.001). The PRSC differentiated between three prognostic groups (OS and DFS p < 0.001), and was superior compared to the stratification using MPR alone or the TNM8 systems, visualized by lower Akaike (AIC) and Bayesian information criterion (BIC) values. In the multivariate analyses, stage III tumors (HR 4.956, p = 0.003), tumors without MPR (HR 2.432, p = 0.015), and PRSC high-risk tumors (HR 5.692, p < 0.001) had significantly increased risks of occurring death. In conclusion, we support 65% as the optimal cut-off for MPR in adenocarcinomas. TNM8 and MPR were comparable regarding their prognostic significance. The novel prognostic score performed distinctly better regarding OS and DFS.

PMID:33714982 | DOI:10.1038/s41379-021-00777-y

J Anim Sci. 2021 Mar 14:skab083. doi: 10.1093/jas/skab083. Online ahead of print.

ABSTRACT

Neonatal calf survival and health is predominantly dependent on sufficient consumption of immunoglobulin G (IgG) and the resulting transfer of passive immunity (TPI). In this study we investigate the potential for continued IgG secretion and temporal kinetics of mammary IgG output in sequential milkings performed at 0, 4, 16, 28, 40 and 52 hours post-calving in Holstein dairy cows. For colostrum (0 hour), we also scrutinize the relationships between IgG concentration, volume, refractometer readings (˚Bx values, Brix ®) and concentration of sugars (lactose and glucose). Mammary transcripts postpartum (0 hour) indicated that active IgG secretion continues beyond the first milking (colostrum; n=4-5). IgG measurements at the different timepoints indicated that colostrum represents only 25.1% of the total IgG produced across the six sequential milking timepoints, with a substantial 48.9% being secreted into transition milk over the next three timepoints (4-, 6- and 28-hour) combined. The differences on the basis of IgG concentrations across 0-, 4- and 16-hour milking timepoints were not statistically significant (p=0.1522; n=9). For colostrum, volume remained highly variable, even with induced let-down prior to milking (n=27). Nonetheless, colostrum IgG secretion was significantly co-regulated with volume (R 2=0.915; p<0.001; n=18), an association that was stronger than that measured for lactose (R 2=0.803; p<0.001; n=18) and glucose (R 2=0.467; p=0.002; n=17). Comparing colostrum ˚Bx values to absolute IgG concentrations showed no correlation (R 2=0.127; p=0.07; n=27); biochemical separation of colostrum components indicated that both proteins and non-protein solutes could affect ˚Bx values (p<0.0001 for both; n=5). This suggests that ˚Bx values do not reasonably indicate IgG concentration to serve as a measure of “colostrum quality.” Additionally, our finding that early transition milk (4-, 6- and 28-hour) can contribute substantially more IgG than colostrum forces a rethink of existing feeding paradigms and means to maximize TPI in calves. Collectively, our results reveal the remarkable value of early transition milk and caveats to colostrum assessments that could advance application in enhancing neonatal calf health.

PMID:33715013 | DOI:10.1093/jas/skab083