Category: Nevin Manimala

J Child Psychol Psychiatry. 2021 Aug 10. doi: 10.1111/jcpp.13498. Online ahead of print.

ABSTRACT

BACKGROUND: Parental criticism is correlated with internalising symptoms in adolescent offspring. This correlation could in part reflect their genetic relatedness, if the same genes influence behaviours in both parents and offspring. We use a Children-of-Twins design to assess whether parent-reported criticism and offspring internalising symptoms remain associated after controlling for shared genes. To aid interpretation of our results and those of previous Children-of-Twins studies, we examine statistical power for the detection of genetic effects and explore the direction of possible causal effects between generations.

METHODS: Data were drawn from two Swedish twin samples, comprising 876 adult twin pairs with adolescent offspring and 1,030 adolescent twin pairs with parents. Parent reports of criticism towards their offspring were collected concurrently with parent and offspring reports of adolescent internalising symptoms. Children-of-Twins structural equation models were used to control for genetic influence on the intergenerational association between parental criticism and adolescent internalising.

RESULTS: Parental criticism was associated with adolescent internalising symptoms after controlling for genetic influence. No significant role was found for shared genes influencing phenotypes in both generations, although power analyses suggested that some genetic effects may have gone undetected. Models could not distinguish directionality for nongenetic, causal effects between generations.

CONCLUSIONS: Parental criticism may be involved in psychosocial family processes in the context of adolescent internalising. Future studies should seek to identify these processes and provide clarity on the direction of potential causal effects.

PMID:34374994 | DOI:10.1111/jcpp.13498

Turk Neurosurg. 2021 Jun 19. doi: 10.5137/1019-5149.JTN.34412-21.3. Online ahead of print.

ABSTRACT

AIM: We aimed to determine whether using gabapentin (GBP), especially in the first maternal trimester, would affect the neural tube development of embryos in an early stage chick embryo (ESCE) model.

MATERIAL AND METHODS: One hundred fertile specific pathogen-free (SPF) chick eggs were used to investigate neurulation; they were divided into four groups of 25 eggs (Groups A, B, C, and D including control, subtherapeutic, therapeutic, and supratherapeutic dose subjects, respectively). After 30 h of incubation, all eggs reached the ninth stage of embryonic development, as defined by Hamburger and Hamilton. GBP was administered through the subblastoderm, and the eggs were incubated for 72h. The embryos were macroscopically and histopathologically investigated with hematoxylin eosin following incubation and extraction.

RESULTS: In the 72nd hour of the study, a total of 6 eggs showed no embryo development. In groups A, B, C, and D, 1 (4.34%), 13 (59.09%), 15 (65.21%), and 18 (81.81%) neural tube defective embryos, respectively, were detected. Statistically, the difference between the groups was significant, especially in the comparisons of all GBP groups to the control group (p˂0.001) (SPSS for Windows v 23.0). However, there was no significant difference between groups B, C, and D. Additionally, we suggest that at all doses, GBP could cause neural tube defects in the ESCE.

CONCLUSION: Based on these results, we concluded that GBP use at any dose led to midline closure defects in ESCEs. This is the first report in the literature on GBP using an ESCE model. However, further investigations with a larger sample size are required to assess its effect at lower doses and to determine the mechanisms of embryonic damage.

PMID:34374986 | DOI:10.5137/1019-5149.JTN.34412-21.3

Turk Neurosurg. 2021 Jan 5. doi: 10.5137/1019-5149.JTN.32533-20.3. Online ahead of print.

ABSTRACT

AIM: Introduction: Intra-procedural rupture (IPR) of cerebral aneurysms is a serious complication of endovascular treatment (EVT) that is associated with high rate of mortality and poor outcomes. Therefore, it is important to identify the risk factors for aneurysmal IPR to improve patient outcomes. We evaluated the possible risk factors for aneurysmal IPR and discussed its management and outcomes for patients.

MATERIAL AND METHODS: Methods: A total of 106 patients with cerebral aneurysm who have undergone EVT were included in this study, with a mean follow-up period of 17.2 months. Risk factors for IPR, such as the aneurysm’s location, size and morphology, etc. were evaluated, and the chi-squared test was used for statistical analysis. Clinical outcomes were assessed using the modified Rankin scale (mRS) at 15 months.

RESULTS: Results: Among all 106 patients who have undergone EVT, five (4.7%) had aneurysmal IPR as well as ruptured aneurysms with subarachnoid haemorrhage (SAH). Among those five patients, primary coiling was performed in three cases and balloon/stent-assisted coiling was performed in two cases, with complete occlusion of the aneurysmal sac achieved in four (4/5) patients. Clinical follow-up with the mRS scores of the patients revealed mortality in one patient (20%), favourable outcomes in three patients (60%) and unfavourable outcomes in one patient (20%).

CONCLUSION: Conclusion: Aneurysmal IPR is considered a rare but important complication of endovascular coiling that is associated with poor clinical outcomes. Several risk factors are significantly associated with IPR, such as small-sized aneurysm ( 3.5 mm), presence of bleb and parent vessel tortuosity. Acom location, irregular shape and past episode of SAH also increase the risk of IPR, but such association was found to be statistically insignificant in our study. Although IPR is considered a devastating complication, good clinical outcomes can be achieved with early detection and proper management using rapid aneurysmal coil packing and occlusion.

PMID:34374972 | DOI:10.5137/1019-5149.JTN.32533-20.3

Turk Neurosurg. 2021 Feb 9. doi: 10.5137/1019-5149.JTN.33017-20.2. Online ahead of print.

ABSTRACT

AIM: To compare the effect of ultrasound-guided modified thoracolumbar interfascial plane (TLIP) block versus local anesthetic infiltration on the wound site for post-op analgesia in patients undergoing lumbar disk surgery with spinal anesthesia.

MATERIAL AND METHODS: This prospective and observationally planned study included 42 patients from the ages of 18 to 75 years, American Society of Anesthesiologists classes I-III, who underwent lumbar disk surgery. In Group L, bupivacaine infiltration was performed on the surgical incision line. In Group T, TLIP block was performed with ultrasound. In the postoperative period, Visual Analogue Scale (VAS) values were also investigated and recorded on the 10th day after discharge. Nausea, vomiting, and sedation score values and analgesic doses used by all patients in the postoperative period were recorded.

RESULTS: During any of the postoperative follow-up hours, the VAS score was ≤ 3 (mild pain), and those who did not need tramadol were 80.9% (n = 17) in Group T and 71.4% (n = 15) in Group L. VAS scores at the 1st, 4th, and 8th hours were statistically lower in Group L than those in Group T (p values: 0.011, 0.028, and 0.029). The average amounts of tramadol consumption per patient were determined as 19.04 mg ± 40.23 in Group T and 27.38 ± 44.65 mg in Group L in the first 24 hours postoperatively. There was no statistically significant difference between groups (p = 0.519).

CONCLUSION: In our study, we determined that the modified In this study, it was determined that the modified TLIP block application performed for the purpose of post-op analgesia in lumbar disk surgery was not superior to local anesthetic infiltration in terms of postoperative opioid consumption and VAS scores.

PMID:34374980 | DOI:10.5137/1019-5149.JTN.33017-20.2

Turk Neurosurg. 2021 May 21. doi: 10.5137/1019-5149.JTN.34653-21.2. Online ahead of print.

ABSTRACT

AIM: The aim of this study is to compare biomechanical results between different polymethylmethacrylate (PMMA) augmentation methods on failed lumbar pedicle screw models of animal vertebrae Material and Methods: Thirty lumbar vertebrae were harvested from six calves, and their bone mineral density was measured. 60 Polyaxial pedicle screws were inserted to all vertebrae. Pull-out tests were performed to all specimens on an Instron machine. The specimens were randomly divided into four groups. The same screws used in primary screwing process were labeled and used in revision. Screws in the first group were augmented by injecting PMMA into the failed screw hole with a syringe; screws in the second group by inserting bone graft and roll-shaped PMMA, screws in the third group by inserting bone graft and injecting PMMA with a syringe; and the fourth group by inserting bone graft and injecting PMMA through a fenestrated pedicle screw. The pull-out strength (POS) results of all specimens were recorded and compared with statistical analyses.

RESULTS: The mean BMD of the vertebrae was 1.31 ± 0.225 g/cm2 and no significant difference was found between the groups (p 0.05). The mean POS of the primary screws in the first, second, third, and fourth groups were 2166,5 N/m2, 2183,5 N/m2, 2508,5 N/m2, and 2005c N/m2 respectively. After the augmentation, the mean POS in the first, second, third and fourth groups were 3839 N/m2, 2874 N/m2, 2929 N/m2 and 3826 N/m2 respectively. No statistical difference was found between the groups in post-revision POS values (p 0.05).

CONCLUSION: There was no significant statistical difference in POS between the augmentation methods.

PMID:34374983 | DOI:10.5137/1019-5149.JTN.34653-21.2

Oncol Ther. 2021 Aug 10. doi: 10.1007/s40487-021-00163-3. Online ahead of print.

ABSTRACT

The concept of cure from cancer is important to patients, but can be difficult to communicate in terms that are meaningful. This is because there are a number of definitions of cure that are applied by clinicians, patients and the public, and by policymakers that have a different meaning and significance. In this article, we provide a narrative review of the evidence concerning cure in lung cancer and show how the different definitions may apply in different settings. A better understanding of the various concepts of cure will improve communication with patients on this important topic. This article is based on previously conducted studies and does not contain any new studies with human participants or animals performed by any of the authors.

PMID:34374957 | DOI:10.1007/s40487-021-00163-3

Drug Saf. 2021 Aug 10. doi: 10.1007/s40264-021-01091-x. Online ahead of print.

ABSTRACT

INTRODUCTION: The safety profile of remdesivir, conditionally approved for COVID-19, was limited at its 2020 introduction. Adverse drug reactions (ADRs) for medicines are collected in VigiBase, the WHO Global Database of Individual Case Safety Reports (ICSRs).

OBJECTIVE: This study aimed to provide a descriptive analysis of COVID-19 ICSR data focusing on remdesivir, including a disproportionality analysis (DA) of ADRs.

METHODS: A dedicated algorithm enabled retrieval of all COVID-19 treatment-specific ICSRs. A severity algorithm based on co-reported medicines and symptoms enabled selection of tocilizumab with its well established safety profile as comparator for remdesivir. Descriptive statistics were used for general ICSR demographics for all COVID-19-specific medicines, remdesivir and tocilizumab individually and furthermore to present treatment patterns of medicines co-reported with remdesivir. A COVID-19 indication-focused DA was deployed to minimize confounding from underlying polysymptomatic disease.

RESULTS: 14,574 COVID-19-related ICSRs were entered into VigiBase during 2020. Remdesivir was the most common medicine reported. Of 4944 remdesivir ICSRs, where tocilizumab was not co-reported, 93% described remdesivir as the sole suspect medicine. Sixty percent of ICSRs concerned males, median age was 63 years and the majority originated from the Americas (72%). In 1089 (21%) of remdesivir ICSRs, data indicated severe/critical disease. Co-reported medicines peaked during the first 3 days of remdesivir treatment. The DA for the established tocilizumab and the new remdesivir were mainly in line with the safety profiles for both medicines but suggested new safety concerns. The most reported ADRs for remdesivir represented liver dysfunction, kidney injury, death and bradycardia.

CONCLUSION: Global COVID-19-related ADR reporting proved useful in providing information on ADRs as well as on treatment patterns in this patient group. Indication-focused disproportionality analysis, together with the use of a comparator with a known safety profile, proved effective in identifying known safety information and suggested new safety concerns for remdesivir.

PMID:34374967 | DOI:10.1007/s40264-021-01091-x

J Assist Reprod Genet. 2021 Aug 10. doi: 10.1007/s10815-021-02260-8. Online ahead of print.

ABSTRACT

PURPOSE: To examine associations between objectively measured sleep duration and sleep timing with odds of completion of an in vitro fertilization (IVF) cycle.

METHODS: This prospective cohort study enrolled 48 women undergoing IVF at a large tertiary medical center between 2015 and 2017. Sleep was assessed by wrist-worn actigraphy, 1-2 weeks prior to initiation of the IVF cycle. Reproductive and IVF cycle data and demographic and health information were obtained from medical charts. Sleep duration, midpoint, and bedtime were examined in relation to IVF cycle completion using logistic regression models, adjusted for age and anti-Müllerian hormone levels. A sub-analysis excluded women who worked non-day shifts to control for circadian misalignment.

RESULTS: The median age of all participants was 33 years, with 29% of women >35 years. Ten women had an IVF cycle cancelation prior to embryo transfer. These women had shorter sleep duration, more nocturnal awakenings, lower sleep efficiency, and later sleep timing relative to those who completed their cycle. Longer sleep duration was associated with lower odds of uncompleted IVF cycle (OR = 0.88; 95%CI 0.78, 1.00, per 20-min increment of increased sleep duration). Women with later sleep midpoint and later bedtime had higher odds of uncompleted cycle relative to those with earlier midpoint and earlier bedtime; OR = 1.24; 95%CI 1.09, 1.40 and OR = 1.33; 95%CI 1.17, 1.53 respectively, for 20-min increments. These results were independent of age, anti-Müllerian hormone levels, or sleep duration, and remained significant after exclusion of shift-working women.

CONCLUSIONS: Shorter sleep duration and later sleep timing increase the odds of uncompleted cycles prior to embryo transfer.

PMID:34374922 | DOI:10.1007/s10815-021-02260-8

Infect Dis Ther. 2021 Aug 10. doi: 10.1007/s40121-021-00516-5. Online ahead of print.

ABSTRACT

INTRODUCTION: Tigecycline is a potential alternative to trimethoprim-sulfamethoxazole in treating Stenotrophomonas maltophilia infections due to its potent in vitro antimicrobial activity. Clinical evidence regarding the use of tigecycline in the treatment of S. maltophilia infections is scarce. In this study, we assessed the efficacy of tigecycline treating ventilator-associated pneumonia (VAP) due to S. maltophilia in comparison with fluoroquinolones.

METHODS: This is a multicenter retrospective cohort study of patients admitted between January 2017 and December 2020 with the diagnosis of VAP caused by S. maltophilia receiving either tigecycline or fluoroquinolones as the definitive therapy ≥ 48 h. Clinical outcomes including 28-day mortality, clinical cure and microbiological cure were analyzed.

RESULTS: Of 82 patients with S. maltophilia VAP included, 46 received tigecycline, and 36 received fluoroquinolones; 70.7% of patients had polymicrobial pneumonia, and the appropriate empiric therapy was applied to only 14.6% of patients. The overall 28-day mortality was 39%. Compared with patients receiving fluoroquinolones, tigecycline therapy resulted in worse clinical cure (32.6% vs. 63.9%, p = 0.009) and microbiological cure (28.6% vs. 59.1%, p = 0.045), while there was no statistical difference between 28-day mortality (47.8% vs. 27.8%, p = 0.105) in the two groups. Similar results were also shown in the inverse probability of treatment weighted univariable regression model and multivariable regression model.

CONCLUSIONS: The standard dose of tigecycline therapy was associated with a lower clinical and microbiological cure rate but not associated with an increased 28-day mortality in patients with S. maltophilia VAP compared with fluoroquinolones. Considering the unfavorable clinical outcomes, we therefore recommend against using the standard dose of tigecycline in treating S. maltophilia VAP unless new clinical evidence emerges.

PMID:34374953 | DOI:10.1007/s40121-021-00516-5

Lasers Med Sci. 2021 Aug 10. doi: 10.1007/s10103-021-03395-x. Online ahead of print.

ABSTRACT

The purpose of this study is to analyze the influence of InGaAlP diode laser (660 nm) with or without an odontogenic medium (OM) in the functional activity of OD-21 cells. Undifferentiated OD-21 pulp cells were cultivated with or without OM and divided into four groups (n = 5): nonirradiated control (C -), nonirradiated + OM (C +), irradiated (L -), and irradiated + OM (L +). Laser application was performed in two sessions of a 24-h interval with an irradiance of 11.3 mW/cm2, energy density of 1 J/cm², and total cumulative energy/well of 4.6 J. Cell proliferation, VEGF-164 expression, mineralization, and expression of Alp, Runx2, and Dmp1 genes, as well as immunolocalization of RUNX2 and MEPE proteins, were evaluated. Data were analyzed by statistical tests (α = 0.05). All studied groups showed a similar increase in cell proliferation with or without OM. After 7 and 10 days, a significatively higher concentration of VEGF-164 in L – group when compared to C – group was observed. A significant increase in mineralized nodules in the L + was noted when compared to C + in the same conditions. Photobiomodulation upregulated significantly Runx2 and Dmp1 expression after 10 days in L – and after 7 days in L + , with downregulation of Dmp1 after 10 days in L + group. Immunolocalization of RUNX2 and MEPE was expressive after 7 days of culture in the cytoplasm adjacent to the nucleus with a decrease after 10 days, regardless of the presence of OM. Photobiomodulation enhances metabolism associated with angiogenesis, gene expression, and mineralization regardless of the odontogenic medium in OD-21 cells.

PMID:34374881 | DOI:10.1007/s10103-021-03395-x