Category: Nevin Manimala

J Appl Lab Med. 2022 Aug 13:jfac063. doi: 10.1093/jalm/jfac063. Online ahead of print.

ABSTRACT

BACKGROUND: 5-alpha reductase (5-AR) enzyme is responsible for conversion of testosterone to dihydrotestosterone (DHT) in humans, which subserves various functions. The aim of the study was to establish a normal reference interval (RI) for blood levels of the enzyme 5-AR.

METHODS: We conducted a prospective study on 150 boys, 75 of whom underwent circumcision for various benign conditions or for religious reasons (Group A/controls) and 75 suffering from hypospadias of variable severity (Group B/cases). The plasma levels of 5-AR were measured by enzyme-linked immunosorbent assay (ELISA) in all 150 boys and correlated with the severity of hypospadias.

RESULTS: The 5-AR levels in Group A ranged from 14.6 to 17.3 ng/mL. The enzyme levels decreased in value with increasing severity of hypospadias in Group B (P-value <0.01 – statistically significant). The levels of the enzyme in this group ranged from 0.6 ng/mL (in the most severe variety of hypospadias) to 11.5 ng/mL (mild variety of hypospadias).

CONCLUSIONS: There is no record of RI values of 5-AR in the literature. The RI of 5-AR needs to be determined by conducting more studies globally. Its levels falls considerably with clinical severity of hypospadias, reinforcing the importance of the enzyme in the development of male external genitalia.

PMID:35962645 | DOI:10.1093/jalm/jfac063

Iran J Kidney Dis. 2022 Jul;16(4):259-265.

ABSTRACT

INTRODUCTION: SARS-CoV-2 infection have been reported to have a greater mortality rate in adults receiving dialysis, as compared to general population. Hence, vaccination is very important in this vulnerable population group, in order to achieve an acceptable level of immunity. The aim of this study was to compare the level of anti-SARS-CoV-2 anti-spike protein receptor-binding domain IgG neutralizing antibody before and after vaccination with two doses of Sinopharm® vaccine, in patients undergoing hemodialysis.

METHODS: Ninety patients on maintenance in-center hemodialysis received two doses of Sinopharm® COVID-19 vaccine with an interval of about 28 days. Anti-SARS-CoV-2 anti-spike protein receptor-binding domain IgG (Anti-RBD) neutralizing antibody was measured with an ELISA kit. All statistical analyses were performed by SPSS-26 software.

RESULTS: The absolute mean (± SE) change in antibody titer following full-scheduled vaccination was 8.98 ± 1.49 µg/mL. The rate of seroconversion was 31.1% after two doses of vaccine. In addition, the rate of seroconversion was higher in those with a history of COVID-19 than in those without a history of COVID-19.

CONCLUSION: The administration of booster doses, doubling of the dose in each episode of vaccination schedule as well as combination of different vaccine platforms are recommended to increase COVID-19 vaccine efficacy in hemodialysis patients. DOI: 10.52547/ijkd.7024.

PMID:35962641

Iran J Kidney Dis. 2022 Jul;16(4):246-251.

ABSTRACT

INTRODUCTION: Kidney biopsy is a procedure of choice for the diagnosis of many kidney diseases. In children it is performed with the use of sedatives. The aim of this study was to compare the combination of propofol/fentanyl with midazolam/ketamine for sedation in pediatric patients undergoing kidney biopsy.

METHODS: In this double-blinded clinical trial, seventeen children, candidate of kidney biopsy were included and randomized into two groups. One group received Midazolam/Ketamine with doses of 30 to 50 μg/kg and 0.25 to 1 mg/kg, and the other group were sedated with propofol/fentanyl combination in doses of 0.5 to 1 mg/kg and 0.5 to 1 mg/kg, respectively. Administration time, medication doses, total procedure time, need for analgesic use after the procedure, and patient relaxation, with no agitation during and after the biopsy were recorded.

RESULTS: Nine patients received midazolam/ketamine and eight received propofol/fentanyl. None of them experienced vomiting or itching after sedation. There were no meaningful differences in qualitative variables of the need for pain relief between two groups. Regarding the distribution of pain at the time of sedation, and 1, 3, 6, and 24 hours after sedation, there was no significant statistical difference between the two groups. There was also no significant statistical difference between the two groups, regarding patients’ relaxation during, and 1, 3, 6, and 24 hours after biopsy.

CONCLUSION: There was no statistically significant difference between the degree of sedation and the analgesic effect of the two regimens in the two groups. DOI: 10.52547/ijkd.6982.

PMID:35962639

Iran J Kidney Dis. 2022 Jul;16(4):252-258.

ABSTRACT

INTRODUCTION: The aim of this study was to investigate the expression of aquaporin 1 (AQP-1), AQP-3 and vascular endothelial growth factor A (VEGF-A) in peritoneal tissues of patients without kidney disease, chronic kidney disease at stages 5 (CKD 5) and patients on prolonged peritoneal dialysis with ultrafiltration failure (PDUFF), and elucidate the possible mechanism of peritoneal dialysis ultrafiltration failure.

METHODS: Peritoneal specimens were collected from the following patient groups at Xianju People’s hospital: CKD 5, PD-UFF and normal control groups. Routine staining and immunohistochemical analyses were performed on samples obtained from the three groups.

RESULTS: The expression of AQP-1 and AQP-3 on peritoneal mesothelial cells, peritoneal vessels and in the interstitium was significantly lower in the PD-UFF group than the CKD 5 and control groups (P < .01), while no statistically significant difference was found between the CKD 5 and control groups (P > .05). In contrast, VEGF-A expression was significantly higher in peritoneal mesothelial cells, peritoneal vessels and the interstitium in the PD-UFF group than the CKD 5 and control groups (P < .01). No statistically significant difference was found between the CKD 5 and control groups (P > .05).

CONCLUSION: AQP-1 and AQP-3 expression levels decrease in peritoneal mesothelial cells and the vascular interstitium of patients with a prolonged peritoneal dialysis course, while VEGF-A expression gradually increases. The formation of peritoneal neovascularization and the decrease in AQP expression may be primarily associated with peritoneal dialysis ultrafiltration failure. DOI: 10.52547/ijkd.6928.

PMID:35962640

J Sch Health. 2022 Aug 13. doi: 10.1111/josh.13228. Online ahead of print.

ABSTRACT

BACKGROUND: In South Carolina (SC), 42% of youth are overweight or obese. Two sets of modifiable behaviors contributing to obesity are physical activity (PA) and dietary habits. School-based interventions have successfully improved these behaviors. The purpose of this study was to identify SC public school personnel perspectives on the most common barriers and facilitators to regular PA and healthy eating behaviors in schools.

METHODS: A needs assessment survey was conducted with school personnel statewide. There were 17 questions on the survey that addressed: (1) demographic information about participants’ educational backgrounds, (2) barriers to regular PA and healthy eating behaviors in schools, and (3) facilitators to regular PA and healthy eating behaviors in schools. Univariate and bivariate descriptive statistical analyses were performed using IBM SPSS Statistics 27.

RESULTS: Participants (N = 1311) indicated insufficient time for regular PA (n = 514, 39.2%) and limited access to healthy foods for healthy eating (n = 271, 20.7%) as main barriers. The primary facilitators were support from administrators for regular PA (n = 264, 20.1%) and support from cafeteria staff for healthy eating (n = 234, 17.8%). Further analyses explored how factors compared based on roles in schools, academic levels, and school district classifications.

CONCLUSIONS: Results suggest that overarching barriers and facilitators to school-based interventions addressing childhood obesity exist, so common strategies to mitigate challenges and maximize supports can be used in schools. Future studies are needed to examine how decreasing barriers and enhancing facilitators affect the implementation and outcomes of these school-based interventions.

PMID:35962619 | DOI:10.1111/josh.13228

BJU Int. 2022 Aug 13. doi: 10.1111/bju.15870. Online ahead of print.

ABSTRACT

OBJECTIVES: To investigate the timing of the clinical presentation of various types of bacille Calmette-Guérin (BCG) infections in a Finnish population of patients with bladder cancer treated with BCG instillation therapy.

MATERIALS AND METHODS: We identified patients with a history of post-instillation BCG infection from 1996-2016 using the Finnish Cancer Registry and the Finnish National Infectious Diseases Registry. We categorised infections as systemic if the infection was found in the non-urogenital system and genitourinary if the infection affected the urogenital tract. We calculated the time interval between the last BCG instillation and the presentation of the infection. The infection was considered late if the time interval was one year or more.

RESULTS: A total of 100 patients with BCG infection were identified during the study period. Thirty-nine (39%) infections presented as systemic and 61 (61%) were in the genitourinary tract. The majority of the systemic infections presented rapidly after the last instillation, while five (13%) presented after a latency of one year or more. The presentation of genitourinary infections was more heterogeneous, with 12 (20%) presenting as late infections.

CONCLUSION: This study confirms the concept of early and late infection types, especially among systemic infections. However, late infections appeared to be rarer than previously described. Urologists should be aware of the possibility of late BCG infection if patients develop symptoms even several years after the BCG regimen.

PMID:35962611 | DOI:10.1111/bju.15870

Physiother Res Int. 2022 Aug 12:e1970. doi: 10.1002/pri.1970. Online ahead of print.

ABSTRACT

INTRODUCTION: Stroke patients have problems with voluntary movement and trunk control. Moreover, the respiratory function in stroke patients is affected by neurological impairment, which increases the incidence of respiratory complications.

OBJECTIVES: To determine the correlation between trunk rotation range of motion (TRROM) and trunk lateral flexion range of motion (TLFROM), peak cough flow (PCF), and chest expansion in stroke patients.

METHODS: This was an observational study involving 21 patients with a clinical diagnosis of stroke from October 2021 to January 2022. TRROM and TLFROM were assessed using smartphone applications (Compass and Clinometer), respectively, PCF was assessed using a peak flow meter, and chest expansion was assessed using a tape measure. Pearson’s correlation was used to analyze the relationships between the variables.

RESULTS: Statistically significant correlations were found between TRROM and TLFROM (r = 0.91, p < 0.01) and between upper chest expansion and PCF (r = 0.59, p < 0.01). There were significant correlations between lower chest expansion and TRROM (r = 0.50, p < 0.05) and between lower chest expansion and TLFROM (r = 0.51, p < 0.05).

CONCLUSION: This study demonstrates the relationship between upper chest expansion and PCF. Upper chest expansion exercises should be considered to improve the PCF in stroke patients. In addition, a very strong positive correlation between TRROM and TLFROM was demonstrated. TRROM and TLFROM exercises should be considered to improve the lower chest expansion in stroke patients.

PMID:35962597 | DOI:10.1002/pri.1970

J Thromb Haemost. 2022 Aug 12. doi: 10.1111/jth.15847. Online ahead of print.

ABSTRACT

BACKGROUND: Developmental ontogeny of neonatal thrombopoiesis retains characteristics that are distinct from adult although molecular mechanisms remain unestablished METHODS: We applied multiparameter quantitative platelet responses with integrated ribosome profiling/transcriptomic studies to better define gene/pathway perturbations regulating the neonatal-to-adult transition. A bioinformatics pipeline was developed to identify stable, neonatal-restricted platelet biomarkers for clinical application RESULTS: Cord blood (CB) platelets retained the capacity for linear agonist-receptor coupling linked to phosphatidylserine exposure (PS) and α-granule release, although a restricted block in cross-agonist activation pathways was evident. Functional immaturity of synergistic signaling pathways was due to younger ontogenetic age and singular underdevelopment of the protein secretory gene network, with reciprocal expansion of developmental pathways (E2F, G2M checkpoint, c-Myc) important for megakaryocytopoiesis. Genetic perturbations regulating vesicle transport and fusion (TOM1L1, VAMP3, SNAP23, and DNM1L) and PS exposure and procoagulant activity (CLCN3) were the most significant, providing a molecular explanation for globally-attenuated responses. Integrated transcriptomic and ribosomal footprints identified highly-abundant (ribosome-protected) DEFA3 (encoding human defensin neutrophil peptide 3) and HBG1 as stable biomarkers of neonatal thrombopoiesis. Studies comparing CB- or adult-derived megakaryocytopoiesis confirmed inducible and abundant DEFA3 antigenic expression in CB megakaryocytes, ~3.5-fold greater than in leukocytes (the most abundant source in humans). An initial feasibility cohort of at-risk pregnancies manifest by maternal/fetal hemorrhage (chimerism) were applied for detection and validation of platelet HBG1 and DEFA3 as neonatal thrombopoiesis markers, most consistent for HBG1 which displayed gestational age-dependent expression.

CONCLUSIONS: These studies establish an ontogenetically-divergent stage of neonatal thrombopoiesis, and provide initial feasibility studies to track disordered fetal-to-adult megakaryocytopoiesis in vivo.

PMID:35962592 | DOI:10.1111/jth.15847

Am J Mens Health. 2022 Jul-Aug;16(4):15579883221108895. doi: 10.1177/15579883221108895.

ABSTRACT

There is a continuous worldwide increase in incidences of metabolic syndrome (MetS) reaching about a quarter of the world’s population. Thus, studies that allow for a robust diagnosis of MetS are of paramount importance from an economic and medical point of view. This study was carried out in a group of men diagnosed with MetS using consensus definition criteria that included the definitions of the International Diabetes Foundation and Diabetes Federation and the American Heart Association/National Heart, Lung, and Blood Institute. The control group consisted of men for whom the parameters that define the MetS were in the norm. This study analyzed statistical differences between MetS and healthy men and the correlations between the set of 14 potential markers of MetS, that is, between body mass index, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein, triglycerides, cortisol, adiponectin, monocyte chemotactic protein-1 (MCP-1), C-reactive protein (CRP), adipsin, leptin, resistin, and plasminogen activator inhibitor-1 (PAI)-1. This report revealed a significant difference between MetS and healthy men in most of the parameters studied. Furthermore, a strong positive correlation between cortisol levels and body mass index was demonstrated. Furthermore, MCP-1 levels in men with MetS were significantly higher than their levels in healthy men. Finally, a strong positive correlation was also observed between adiponectin and adipsin in Mets men. Thus, this study reveals the potential usefulness of adiponectin, MCP-1, adipsin, leptin, resistin, and PAI-1 as markers of MetS in adult men.

PMID:35962582 | DOI:10.1177/15579883221108895

Ann Otol Rhinol Laryngol. 2022 Aug 12:34894221118769. doi: 10.1177/00034894221118769. Online ahead of print.

ABSTRACT

OBJECTIVE: To determine what prospective residency applicants look for on otolaryngology residency program websites.

STUDY DESIGN: Survey.

SETTING: The survey was distributed in a virtual format through Google Forms. A link to the survey was given at the University at Buffalo Otolaryngology Chautauqua, sent to Otolaryngology program directors with requests to forward to PGY1 residents and Otolaryngology interest groups, sent to medical school Otolaryngology interest group leaders, posted on Twitter through several accounts, and on otomatch.com.

METHODS: A 45 item survey was given to fourth year medical students applying to otolaryngology, re-applicants applying to otolaryngology, and first year otolaryngology residents who had recently matched. Data collected included participant’s age, sex, race and ethnicity, current status in school/residency program, and their type of medical degree (MD or DO). Participants were then asked to mark the components listed that they wished to see. Components were separated into 5 categories: Application/Selection Criteria, Employment Aspects, Program Features, Social/Community, and Faculty/Contact Information. Data was analyzed using Mann-Whitney and Kruskal Wallis tests when appropriate. P value <.05 was considered statistically significant.

RESULTS: One hundred one surveys were collected. Sixty-four (63.4%) participants were fourth-year medical students, 32 (31.7%) were first-year residents, and 5 (5.0%) were re-applicants. Thirteen of the items on the survey were sought by 80% or more of respondents. Ninety-nine (98.0%) of the participants wanted to see a current resident list with photos and 97 (96.0%) wanted to see the intern year schedule online. Eighty-five percent agreed that salary and benefits information would be valuable on residency websites. Women expressed significantly more interest in salary (P = .034), benefits (P = .026), and parking information (P = .048).

CONCLUSION: Our study provides insight on key items to include on residency program websites. Websites that contain information that applicants want to use can be helpful for application decisions in the future.

PMID:35962584 | DOI:10.1177/00034894221118769