Category: Nevin Manimala

NMR Biomed. 2021 Nov 5:e4638. doi: 10.1002/nbm.4638. Online ahead of print.

ABSTRACT

Nuclear magnetic resonance (NMR) spectroscopy allows for simultaneous detection of a wide range of metabolites and lipids. As metabolites act together in complex metabolic networks, they are often highly correlated, and optimal biological insight is achieved when using methods that take the correlation into account. For this reason, latent-variable-based methods, such as principal component analysis and partial least-squares discriminant analysis, are widely used in metabolomic studies. However, with increasing availability of larger population cohorts, and a shift from analysis of spectral data to using quantified metabolite levels, both more traditional statistical approaches and alternative machine learning methods have become more widely used. This review aims at providing an overview of the current state-of-the-art multivariate methods for the analysis of NMR-based metabolomic data as well as alternative methods, highlighting their strengths and limitations.

PMID:34738674 | DOI:10.1002/nbm.4638

Eur J Neurosci. 2021 Nov 5. doi: 10.1111/ejn.15512. Online ahead of print.

ABSTRACT

Lesch-Nyhan disease is a rare, sex-linked, genetic neurodevelopmental disorder that is characterized by hyperuricemia, dystonia, cognitive impairment, and recurrent self-injury. We previously found reduced brain white matter volume in patients with Lesch-Nyhan disease compared to healthy adults using voxel-based morphometry. Here we address the structural integrity of white matter via diffusion tensor imaging. We hypothesized that white matter integrity would be decreased in men with Lesch-Nyhan disease and to a lesser extent in men with a milder variant of the disease (Lesch-Nyhan variant) relative to healthy men. After acquiring diffusion-weighted brain images from Lesch-Nyhan disease (n = 5), Lesch-Nyhan variant (n = 6), and healthy participants (n = 10), we used both Tract-Based Spatial Statistics and a regions of interest approach to analyze between-group fractional anisotropy differences. We first replicated earlier findings of reduced intracranial, gray matter, and white matter volumes in patients. We then discovered marked reductions of fractional anisotropy relative to the healthy control group. The Lesch-Nyhan disease group showed more pronounced reductions in white matter integrity than the Lesch-Nyhan variant group. In addition to whole brain fractional anisotropy group differences, reductions in white matter integrity were observed in the corpus callosum, corona radiata, cingulum, internal capsule, and superior longitudinal fasciculus. Moreover, the variant group had attenuated dystonia severity symptoms and cognitive deficits. These findings highlight the need to better understand the role of white matter in Lesch-Nyhan disease.

PMID:34738666 | DOI:10.1111/ejn.15512

Child Care Health Dev. 2021 Nov 5. doi: 10.1111/cch.12922. Online ahead of print.

ABSTRACT

BACKGROUND: Medical rehabilitation plays an important role in the health care of chronically ill children and adolescents. During medical rehabilitation, supporting illness-related self-regulation is a central goal. Beliefs about illness and beliefs about treatment are core elements of patients’ self-regulation, and there is evidence, that these beliefs are relevant predictors of different health- and treatment-related outcomes such as adherence. However, little is known about adolescents’ beliefs about rehabilitation. This study therefore explores adolescents’ treatment beliefs in the context of inpatient medical rehabilitation.

METHODS: A qualitative study was conducted in a German rehabilitation clinic for children and adolescents. Using a purposive sampling method, thirteen adolescents (12-16 years old) were recruited. Semi-structured, audiotaped interviews were conducted and analysed using content analysis.

RESULTS: Results demonstrate that adolescents have differentiated rehabilitation-related treatment beliefs. Twelve themes, with various subthemes, emerged which include access to and knowledge about rehabilitation, the rehabilitation-related individual position and normative aspects, expectations of oneself, as well as in respect of the social context (fellow patients, contact with family and friends), expectations of the structure, process and outcome of rehabilitation, concerns and barriers, and emotional aspects.

CONCLUSIONS: Our explorative study revealed a broad range of rehabilitation-related treatment beliefs in adolescents, indicating parallels, but also differences, to research results with adults. Treatment beliefs are assumed to be an influencing factor for various health- and treatment-related outcomes. Thus, implications of our findings for clinical practice and further research are discussed.

PMID:34738647 | DOI:10.1111/cch.12922

J Bone Miner Res. 2021 Nov 5. doi: 10.1002/jbmr.4465. Online ahead of print.

ABSTRACT

Romosozumab monoclonal antibody treatment works by binding sclerostin and causing rapid stimulation of bone formation while decreasing bone resorption. The location and local magnitude of vertebral bone accrual by romosozumab and how it compares to teriparatide remains to be investigated. Here we analysed the data from a study collecting lumbar CT spine scans at enrolment and 12 months post-treatment with romosozumab (210 mg SC QM, n = 17), open-label daily teriparatide (20 ug SC, n = 19) or placebo (SC QM, n = 20). For each of the 56 women, cortical thickness (CtTh), endocortical thickness (EcTh), cortical BMD (CtBMD), cancellous BMD (CnBMD) and cortical mass surface density (CMSD) were measured across the first lumbar vertebral surface. In addition, colour maps of the changes in the lumbar vertebrae structure were statistically analysed and then visualised on the bone surface. At 12 months Romosozumab improved all parameters significantly over placebo and resulted in a mean vertebral CtTh increase of 10.3% versus 4.3% for teriparatide, an EcTh increase of 137.6% versus 47.5% for teriparatide, a CtBMD increase of 2.1% versus a – 0.2% decrease for teriparatide, and a CMSD increase of 12.4% versus 3.8% for teriparatide. For all these measurements the differences between romosozumab and teriparatide were statistically significant (p < 0.05). There was no significant difference between the romosozumab-associated CnBMD gains of 22.2% versus 18.1% for teriparatide, but both were significantly greater compared to the change in the placebo group (-4.6%, p < 0.05). Cortical maps showed the topographical locations of the increase in bone in fracture-prone areas of the vertebral shell, walls and endplates. This study confirms widespread vertebral bone accrual with romosozumab or teriparatide treatment, and provides new insights into how the rapid prevention of vertebral fractures is achieved in women with osteoporosis using these anabolic agents. This article is protected by copyright. All rights reserved.

PMID:34738660 | DOI:10.1002/jbmr.4465

Acta Biomed. 2021 Nov 3;92(5):e2021281. doi: 10.23750/abm.v92i5.9601.

ABSTRACT

AIM: To compare the demographical profile, indications, efficacy, and contributors to adverse outcome following administration of 4F-PCC in patients on warfarin with supratherapeutic INR.

METHODOLOGY: Retrospective cross-sectional study was performed in a community based teaching hospital. All patients 18 years and older on warfarin with supratherapeutic INR, who had received 4F-PCC between January 2014 and December 2018 were eligible and included in the study.

RESULTS: 44 patients were included in the analysis. The mean age of the patients was 79.5 years. The male to female ratio was 1:1. Patients were on warfarin for atrial fibrillation, thromboembolism in 79.5% (N-35), and 20.5% (N-9) respectively. Indications for use of 4F-PCC were active bleeding in 93% (N-41) of patients. The common sites of bleeding were gastrointestinal, intracranial, and musculoskeletal which were seen in 54.5% (N-24), 29.5% (N-13) and 6.8% (N-3) respectively. The median number of doses of 4F-PCC administered was 1 per patient. The mean dose administered was 2,883u. Clinical improvement was documented in 84% (N-37) of patients. Mortality was seen in 16% (N-7) of patients. BMI greater than 30, anemia, hypotension, presence of intracranial bleed, the requirement of blood products, and mechanical ventilation were associated with higher odds for mortality. Hypotension and requirement of mechanical ventilation were statistically significant.

CONCLUSION: 4F-PCC continues to be an effective agent in the rapid reversal of warfarin therapy in patients with supratherapeutic INR presenting with major bleeding events. Most patients have clinical improvement with a single, weight-adjusted dose.

PMID:34738603 | DOI:10.23750/abm.v92i5.9601

J Med Virol. 2021 Nov 5. doi: 10.1002/jmv.27433. Online ahead of print.

ABSTRACT

BACKGROUND: Despite extensive vaccination, the quantity of patients infected with the SARS-CoV-2 virus and its variants continues to grow worldwide. Treating patients with a severe course of COVID-19 is a difficult challenge. One of the generally accepted and specific therapy methods is the use of plasma rich in anti-SARS-CoV-2 antibodies. On the other hand, assessing the antibodies level depending on the time after infection allows for vaccine-decision.

METHODS: the study marked the level of anti-SARS-CoV-2 IgG antibodies in 351 COVID-19 convalescent residents of one geographical region in Poland. The study group included blood donors. The studies were cross-sectional and extended to a questionnaire to determine infection severity. The data was compiled statistically. The study considered epidemiological factors, the time from the end of the infection, and infection severity.

FINDINGS: The fastest increase of the antibodies level was observed up to 59 days after COVID-19, and it was statistically significantly higher among men. Higher levels of antibodies were found among people above the average age in both men and women. It was an increase in the level of antibodies since the onset of the disease in men, while in women, it decreased. The antibodies level was also found to depend on the severity of the course of COVID-19 infection.

CONCLUSIONS: The optimal group of plasma donors in the studied geographical region is men and women above 39 y.o. after more severe infection. The titer of antibodies increases with time from the disease. This article is protected by copyright. All rights reserved.

PMID:34738646 | DOI:10.1002/jmv.27433

Acta Biomed. 2021 Nov 3;92(5):e2021292. doi: 10.23750/abm.v92i5.9925.

ABSTRACT

BACKGROUND AND AIM OF THE WORK: The aim of this study was to evaluate the vaginal microbiota of women admitted to the hospital for premature labour and to compare the flora of those who responded to the tocolytic treatment with the flora of those who did not respond to the treatment and delivered prematurely Materials: the hospital records of 245 women admitted to the division of Obstetrics and Gynaecology of ‘Guglielmo da Saliceto’ Hospital in Piacenza for premature labour, between 24 completed weeks and 36 weeks plus 6 days of pregnancy, were reviewed and the results of vaginal swabs collected on admission were evaluated.

RESULTS: a vaginal dysbiosis, with reduction or absence of lactobacilli and presence of pathogenic microbial species, was found in all women admitted to the hospital for premature labour. Among them, 200 women (81,63%) responded to the tocolytic treatment while 45 women (18,36%) did not respond and delivered before 37 completed weeks. The four microbial species most prevalent in the vaginal flora were :Ureaplasma urealyticum, Streptococcus agalactiae, Candida albicans and Gardnerella vaginalis. When the characteristics of the vaginal flora of the two groups were compared, a more severe dysbiosis, with absence of lactobacilli and evidence of more than one pathogenic species, was found in 18% of women who responded to the tocolysis and in 71,4% of women who did not respond. The difference was statistically significant (p< 0,05, two-tailed test).

CONCLUSIONS: vaginal dysbiosis was diagnosed in all women admitted to the hospital for premature labour . A more severe dysbiosis, with complete absence of lactobacilli and presence of two or more pathogenic microbial species, was in the majority of women who showed no response to the tocolytic treatment compared to women with minor degrees of alteration of the vaginal flora.

PMID:34738595 | DOI:10.23750/abm.v92i5.9925

Acta Biomed. 2021 Nov 3;92(5):e2021284. doi: 10.23750/abm.v92i5.9682.

ABSTRACT

AIM: Evaluate impact of lymph node ratio as prognostic factor in gastric cancer.

METHODS: We studied 463 patients with gastric cancer who underwent curative gastric surgery with D1 or D2 lymphadenectomy, Data were collected from May 1996 through December 2010 at Department of General Surgery of Parma University Hospital. We divided patients in two groups according to number of nodes removed Results: The results of the present nonrandomized retrospective single centre study confirm the promising role of the LNR as an independent prognostic factor. Overall survival between LNR categories are statistically significant different between LNR0 and LNR1.

CONCLUSION: The ratio between the number of metastatic and analysed lymph nodes in patients with gastric cancer can discriminate patients better than the AJCC/UICC staging system: it seems to be related to a more sensitive in the evaluation of overall survival.

PMID:34738601 | DOI:10.23750/abm.v92i5.9682

Acta Biomed. 2021 Nov 3;92(5):e2021302. doi: 10.23750/abm.v92i5.10209.

ABSTRACT

BACKGROUND: Potentially inappropriate brain CT scan requesting in the emergency department imposes extra charges to the healthcare system and patients. Besides, the unnecessary radiation exposure may cause irreparable damage to the patient. In this study we investigated the percentage of potentially inappropriately conducted brain CT scan for different chief complaints in non-traumatic patients presented to our emergency department. Material and methods: 160 patients aged over 18 years old with chief complaints other than trauma, referred to the emergency department of Imam Hossein Hospital (Tehran, Iran), were enrolled in this study. Data were collected from medical records; the inclusion criteria was patients older than 18 years with chief complaint other than trauma. Results: 160 people aged 18 to 100 years old enrolled in this study, 83 (51.87%) were male and 77 (48.13%) were female. There was no statistically significant difference in terms of potentially inappropriate brain CT between different age groups. Percentage of potentially inappropriate CT according to chief complaints were as follows: 4.8% for dysarthria, 0% for right and left hemiplegia, 9.1% for decreased level of consciousness, 30% for nausea and vomiting, 41.7% for generalized weaknesses, 0% for seizures, 55.6% for vertigo, 25% for headache, and 57.7% for other complaints. There was a statistically significant association between chief complaints and potentially inappropriate brain CT scan requests (p-value = 0.001).

CONCLUSION: Considering the significant percentage of potentially inappropriate brain CT scan requests for non-traumatic patients in the setting of emergency department, it is critical for healthcare policymakers to propose practical guidelines and supervise their application.

PMID:34738589 | DOI:10.23750/abm.v92i5.10209

Acta Biomed. 2021 Nov 5;92(5):e2021325. doi: 10.23750/abm.v92i5.10678.

ABSTRACT

BACKGROUND: the optimal treatment of acute type III-V acromioclavicular (A-C) Rockwood dislocations is still a matter of discussion in orthopaedic surgery.

AIM OF THE WORK: retrospective and comparative evaluation of the clinical and radiographic results of three different surgical techniques for stabilization of A-C joint using tension band wiring, hook plate and TightRope.

METHODS: a consecutive series of patients, treated from January 2014 and November 2019, were divided into three groups according to the surgical method used. They were clinically and radiographically assessed and the results were compared with those present in the literature.

RESULTS: 66 patients, with a mean age of 44.7 years, were enrolled with a mean follow-up of 37.7 months (range 6-58 months). All patients, regardless of the group, had satisfactory outcome. According to the DASH score, statistically significant difference favours the TightRope Group (TRG) fixation (p<0.005). The TRG showed the highest mean Constant score (96,1); there are no significative differences between the clinical scores of Hook Plate Group (HPG) and Tension Band Wiring Group (TBWG). However, these two methods showed numerous complications, especially metal-work mobilization and stiffness respectively.

CONCLUSIONS: good results can be overall achieved with primary fixation by the three different surgical methods under investigation. The TightRope system exhibited some advantages such as higher clinical scores, early recovery of range of movements, longitudinal surgical incision with non-keloid scar, no need for a second surgery and lower rate of complications.

PMID:34738583 | DOI:10.23750/abm.v92i5.10678