Category: Nevin Manimala

Oral Oncol. 2022 Feb 2;126:105750. doi: 10.1016/j.oraloncology.2022.105750. Online ahead of print.

ABSTRACT

OBJECTIVES: While the NCCN guidelines maintain that T4b oral cavity squamous cell carcinoma (OCSCC) should undergo either non-surgical treatments or clinical trials, promising outcomes of T4b OCSCC having surgical excision have been reported. We analyzed and compared the clinical outcomes of Taiwanese patients with pT4a and pT4b OCSCC who had undergone surgical treatment.

METHODS: From 2011 to 2017, a total of 4031 and 355 patients with first primary pT4a and pT4b OCSCC were identified. A propensity score (PS)-matched analysis of patients (n = 351 each) for pT4a and pT4b tumors was also performed.

RESULTS: The 5-year disease-specific and overall survival (DSS/OS) rates were more favorable in patients with pT4a than in those with pT4b OCSCC (64%/55%, p < 0.0001; 55%/43%, p < 0.0001, respectively). Compared with pT4a, those with pT4b tumors had a higher burden of the following risk factors: buccal/retromolar/hard palate subsite, male sex, depth ≥ 10 mm, and positive margins. Before PS matching, multivariable analyses revealed that pT4b tumors (versus pT4a) were an adverse prognosticator for both 5-year DSS and OS (hazard ratios: 1.32 and 1.39, respectively). However, in the PS-matched cohort, no significant differences in 5-year DSS and OS rates were observed between pT4a and pT4b OCSCC (57%/56%, p = 0.4024; 48%/44%, p = 0.1807, respectively) CONCLUSIONS: No significant outcome differences were evident between pT4b and pT4a OCSCC after PS matching. The most plausible hypothesis for the observed survival difference between T4a and T4b tumors is that it was driven by positive margins. We suggest that T4b OCSCC should undergo initial surgical excision if adequate resection is possible.

PMID:35123256 | DOI:10.1016/j.oraloncology.2022.105750

Seizure. 2022 Jan 29;96:46-58. doi: 10.1016/j.seizure.2022.01.014. Online ahead of print.

ABSTRACT

BACKGROUND: Compared to healthy controls, adults with epilepsy have a disrupted sleep architecture. Changes in sleep macrostructure may be associated with the refractoriness of epilepsy. However, there is no consensus regarding the changes in sleep architecture in patients with epilepsy. This meta-analysis aimed to elucidate the differences in sleep architecture between patients with epilepsy and healthy controls.

METHODS: This study followed the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines. The PubMed, Embase, and Cochrane Central databases were searched (until May 2021) for studies comparing polysomnographic sleep macrostructures between patients with epilepsy and healthy controls. A meta-analysis was performed using a random-effects model. The percentage of rapid eye movement (REM) sleep, slow-wave sleep (SWS), and sleep efficiency (SE) were compared between patients with epilepsy and healthy controls.

RESULTS: Overall, 24 studies involving 789 patients with epilepsy and 599 healthy controls fulfilled the eligibility criteria. Compared to healthy controls, patients with focal epilepsy had decreased REM sleep and SE. Patients with generalised epilepsy had increased SWS and decreased SE. Subgroup analyses focussed on the potential effect of seizure control on sleep architecture. The results revealed that both antiseizure medication (ASM)-untreated and treated patients had decreased SE. ASM treatment may restore REM sleep in patients with generalised epilepsy but not in patients with focal epilepsy.

CONCLUSIONS: This meta-analysis revealed statistically significant differences in the sleep macrostructure between patients with epilepsy and healthy controls. There were significant differences in the sleep macrostructure between ASM-untreated patients and healthy controls, which may be an intrinsic change attributable to epilepsy.

PMID:35123233 | DOI:10.1016/j.seizure.2022.01.014

Vet Med Sci. 2022 Feb 5. doi: 10.1002/vms3.752. Online ahead of print.

ABSTRACT

OBJECTIVE: Gross, histopathological, and immunohistochemical characteristics of uveal melanocytic neoplasms in dogs and cats were investigated.

SAMPLES: Thirty-two enucleated globes with uveal melanocytic neoplasms, 27 from dogs and 5 from cats, were examined.

PROCEDURES: Morphological characteristics of uveal melanocytic neoplasms in dogs and cats were evaluated with anti-PNL2, anti-Melan-A, anti-Ki-67, anti-caspase-3, and anti-BAP1 immunomarkers. Statistical analysis was performed to compare canine melanocytomas and melanomas.

RESULTS: The 32 uveal neoplasms were classified as melanocytomas (19/27 in dogs) or melanomas (8/27 in dogs, 5/5 in cats). Most tumours (84%) were located in the anterior uvea. Neoplastic cells were classified as epithelioid, spindle-shaped, mixed, or special type (balloon and signet ring cells). The percentage of cells with melanin, melanin concentration within cells, anisocytosis and anisokaryosis, mitotic count, lymphocytic inflammation, necrosis, vascular invasion, and glaucoma were also characterized. Anisocytosis, percentage of neoplastic cells with melanin, mitotic count, and indices (proliferation and apoptotic) varied significantly between canine uveal melanomas and melanocytomas; in general, melanomas had greater cell variability, were less pigmented, and had a higher mitotic count. The melanocytic origin of the neoplasms was confirmed by positive anti-PNL2 immunolabelling (29/32) and positive anti-Melan-A immunolabelling (3/32). In canine uveal melanomas, anisocytosis and anisokaryosis correlated with less pigmentation and minimal pigmentation correlated with a high percentage of immunolabelling for caspase-3.

CONCLUSIONS: Uveal melanocytomas were more common in dogs, and uveal melanomas were more frequent in cats. Anisocytosis, percentage of neoplastic cells with melanin, and mitotic count are important histologic characteristics of malignancy to evaluate in uveal melanocytic neoplasms. The proliferation and apoptotic indices are relevant when comparing malignant tumours with benign tumours.

PMID:35122675 | DOI:10.1002/vms3.752

Environ Sci Pollut Res Int. 2022 Feb 5. doi: 10.1007/s11356-022-18829-4. Online ahead of print.

ABSTRACT

Global emission statistics show that Africa is among the least carbon-emitting continents. However, the rising drive for economic growth amid urbanization and globalization in recent years has continued to attract the attention of policymakers to the attendant potential environmental risks. Hence, using robust empirical techniques, this study examines the impacts of increasing urbanization alongside its interactions with energy portfolios on environmental prospects of 15 selected African countries including the most urbanized and leading oil producers in the continent of Africa. The results of the analysis produced insightful implications for achieving both environmental and economic sustainability for the understudied countries. Firstly, the trio of urbanization, economic globalization, and income levels aggravate environmental degradation among these countries as they were found to be essential drivers of carbon emission levels over the understudied period (1990-2015). Secondly, while urbanization significantly poses threat to environmental sustainability, the evidence obtained regarding its interaction with energy portfolios of the understudied countries differs. The significant detrimental environmental impacts of the interaction between urbanization and energy portfolios were only confirmed in the context of fossil energy consumption among the countries, while renewables exist as a significant decarbonization channel within the framework of the increasing level of urbanization among the countries. Thirdly, the study upholds the EKC conjecture. Hence, policymakers and authorities in Africa should capitalize on maximizing the benefits of the huge renewable resource potentials on the continent through adequate investments in green energy technologies for urban infrastructures toward the realization of sustainable development goals (SDGs 11 and 13).

PMID:35122645 | DOI:10.1007/s11356-022-18829-4

J Am Geriatr Soc. 2022 Feb 5. doi: 10.1111/jgs.17682. Online ahead of print.

ABSTRACT

BACKGROUND: Potentially disruptive medical, surgical, and social events-such as pneumonia, hip fracture, and widowhood-may accelerate the trajectory of decline and impact caregiving needs in older adults, especially among people with dementia (PWD). Prior research has focused primarily on nursing home residents with dementia. We sought to assess the incidence of potentially disruptive events in community-dwelling people with and without dementia.

METHODS: Retrospective cohort study of participants aged 65+ enrolled in the Health and Retirement Study between 2010 and 2018 (n = 9346), including a subset who were married-partnered at baseline (n = 5105). Dementia was defined with a previously validated algorithm. We calculated age-adjusted and gender-stratified incidence per 1000 person-years and incidence rate ratios of: 1) hospitalization for pneumonia, 2) hip fracture, and 3) widowhood in people with and without dementia.

RESULTS: PWD (n = 596) were older (mean age 84 vs. 75) and a higher proportion were female (67% vs. 57%) than people without dementia (PWoD) (n = 8750). Age-adjusted incidence rates (per 1000 person-years) of pneumonia were higher in PWD (113.1; 95% CI 94.3, 131.9) compared to PWoD (62.1; 95% CI 54.7, 69.5), as were hip fractures (12.3; 95% CI 9.1, 15.6 for PWD compared to 8.1; 95% CI 6.9, 9.2 in PWoD). Point estimates of widowhood incidence were slightly higher for PWD (25.3; 95% CI 20.1, 30.5) compared to PWoD (21.9; 95% CI 20.3, 23.5), but differences were not statistically significant. The association of dementia with hip fracture-but not pneumonia or widowhood-was modified by gender (male incidence rate ratio [IRR] 2.24, 95% CI 1.34, 3.75 versus female IRR 1.31 95% CI 0.92,1.86); interaction term p = 0.02).

CONCLUSIONS: Compared to PWoD, community-dwelling PWD had higher rates of pneumonia and hip fracture, but not widowhood. Knowing how often PWD experience these events can aid in anticipatory guidance and care planning for this growing population.

PMID:35122662 | DOI:10.1111/jgs.17682

Drugs. 2022 Feb 5. doi: 10.1007/s40265-021-01668-x. Online ahead of print.

ABSTRACT

BACKGROUND: Gliomas represent most common primary brain tumors. Glioblastoma (GBM) is the most common subtype and carries a poor prognosis. There is growing interest in the anti-glioma properties of statins. The aim of this study was to conduct a systematic review of the preclinical literature and to meta-analyze existing clinical studies to determine what benefit, if any, statins may confer in the context of glioma.

METHODS: The PubMed, Embase, Cochrane, and Web of Science libraries were queried in May 2021. Preclinical studies were included if they investigated the anti-cancer effects of statins in glioma in vitro and in vivo. Clinical studies were included if they reported incidence rates of glioma by statin use, or mortality outcomes among GBM patients by statin use. Pooled point estimates were calculated using a random-effects model.

RESULTS: In total, 64 publications, 51 preclinical and 13 clinical, were included. Preclinical studies indicated that statins inhibited glioma cell proliferation, migration, and invasion. These effects were time- and concentration-dependent. Synergistic anti-glioma effects were observed when statins were combined with other anti-cancer therapies. Clinical observational studies showed an inverse, albeit non-statistically significant, association between statin use and incidence rate of glioma (HR = 0.84, 95% CI 0.62-1.13, I² = 72%, p-heterogeneity = 0.003, 6 studies). Statin use was not associated with better overall survival following GBM surgery (HR = 1.05, 95% CI 0.85-1.30, I² = 30%, p-heterogeneity = 0.23, 4 studies).

CONCLUSION: Statins were potent anti-cancer drugs that suppressed glioma growth through various mechanisms in vitro; these effects have translated into the clinical realm, clinically but not statistically, in terms of glioma incidence but not GBM survival.

PMID:35122635 | DOI:10.1007/s40265-021-01668-x

Oral Radiol. 2022 Feb 5. doi: 10.1007/s11282-022-00586-2. Online ahead of print.

NO ABSTRACT

PMID:35122625 | DOI:10.1007/s11282-022-00586-2

Endocrine. 2022 Feb 5. doi: 10.1007/s12020-022-03001-2. Online ahead of print.

ABSTRACT

PURPOSE: Osteoporosis (OP) is a common disease among adults aged >50 years. At present, the main approach to screen or to diagnosis OP is mainly via bone mineral density (BMD) testing, which might not be optimal for OP screening. This study aimed to develop and validate a convenient and effective prediction model for screening OP based on the demographic information, medical history, and lifestyle habits in the elderly in the United States.

METHODS: All data were collected from the National Health and Nutrition Survey database. Participants aged ≥50 years with complete BMD data were included in this study. Twelve candidate predictors were initially selected to develop the prediction model. Final predictors screening and model development were based on multivariate logistic regression. Model discrimination (C statistic) and calibration (Brier scores) were calculated to evaluate the performance of the model. Internal validation was performed using the bootstrap resampling technique, and external validation was based on the validation cohort.

RESULTS: The screening tool was developed with individual patient data from 1941 patients and validated with data from 1947 patients after the development of the model. Seven predictors (patient age, sex, race, body mass index, physical activity, sleep duration, and history of fracture) were included in the final prediction model, and the final model had a C statistic of 0.849 [95% confidence interval (CI): 0.820-0.878] and Brier scores of 0.062 [95% CI: 0.054-0.070] on the development cohort. For the validation of the developed model, the results showed a C statistic >0.800 and Brier scores <0.070, irrespective of internal validation or external validation.

CONCLUSIONS: A novel screening tool for OP in the elderly, which has excellent discrimination and useful calibration, has been developed and externally validated. Considering its simplicity, generalizability, and accuracy, this tool has the potential to become a practical mean for the elderly to screen OP.

PMID:35122626 | DOI:10.1007/s12020-022-03001-2

Dermatol Ther (Heidelb). 2022 Feb 5. doi: 10.1007/s13555-022-00681-6. Online ahead of print.

ABSTRACT

INTRODUCTION: Treatment of early-stage mycosis fungoides (MF) requires safe, skin-directed therapies. Medication side effects can lead to underutilization of effective therapies. The objective of this study was to assess the use of topical triamcinolone 0.1% ointment as a means of reducing contact dermatitis associated with topical mechlorethamine/chlormethine gel for the treatment of MF.

METHODS: This prospective, randomized, open-label study evaluated 28 adults with mycosis fungoides who were eligible for treatment with topical mechlorethamine/chlormethine gel from December 17, 2017 to December 23, 2020. Patients were treated for 4 months with clinical follow-up through 12 months. Patients had half of their lesions also treated with topical triamcinolone 0.1% ointment (while the other half were treated with mechlorethamine/chlormethine alone). The study was self-controlled with separate lesions in the same patient receiving each treatment arm. Treatment arms were determined by the flip of a coin.

RESULTS: Twenty-eight patients enrolled (17 men (61%) and 11 women (39%)). Demographics included 25 White, 2 African Americans, and 1 Asian patient. Twenty-five completed the 12-month follow-up. Triamcinolone 0.1% ointment led to increased tolerability of mechlorethamine/chlormethine gel but did not change the efficacy of mechlorethamine/chlormethine. There was a statistically significant 50% decrease in dermatitis (SCORD score) at month 2 in the triamcinolone-treated arm.

CONCLUSIONS: Topical triamcinolone ointment is a helpful adjuvant therapy when treating patients with topical mechlorethamine/chlormethine gel. It diminishes inflammation and does not reduce efficacy. The peak incidence of dermatitis in the study occurred in the second and third months.

TRIAL REGISTRATION: ClinicalTrials.gov identifier, NCT03380026.

PMID:35122614 | DOI:10.1007/s13555-022-00681-6

J Psycholinguist Res. 2022 Feb 5. doi: 10.1007/s10936-022-09841-3. Online ahead of print.

ABSTRACT

The present study investigated the effect of emotional valence on auditory word recognition memory in English as a foreign language. Participants included 48 native Spanish speakers whose foreign language was English. They viewed four emotionally negative, four positive, and four neutral videos that, in total, contained 48 emotionally valenced target words. After watching the videos, participants completed an auditory word recognition memory task where target words, and the same number of fillers, were presented. The results showed a statistically significant main effect of valence on both reaction times and accuracy. Positive words were recognised more accurately and faster than neutral and negative words, but no difference between neutral and negative stimuli was found. These findings fit in well within the gradient model of automatic vigilance, which implies that emotional valence has a monotonic effect on processing latencies during auditory recognition memory in a foreign language.

PMID:35122567 | DOI:10.1007/s10936-022-09841-3