Category: Nevin Manimala

Int J Dermatol. 2021 Aug 7. doi: 10.1111/ijd.15672. Online ahead of print.

ABSTRACT

BACKGROUND: Cutaneous myiasis in patients with malignant wounds or skin cancer is a rare and undesirable event with limited epidemiological data. A subregister of reports, lack of education in the population, inadequate empirical treatments, and medical underestimation are components of a public health problem that threatens patients’ lives.

METHODS: We conducted a systematic review of the literature of cutaneous myiasis associated with malignant wounds and skin cancer, characterizing sociodemographic variables, risk factors, clinical and histological features, and treatment. Additionally, we present a demonstrative case with the adequate taxonomic evaluation.

DISCUSSION: Cutaneous myiasis is an underestimated and poorly managed infestation, which can generate severe complications in oncological patients. This is the first systematic review in the literature about this clinical scenario, which provides information to the physician and clinical researcher about the epidemiological gaps and what has been published so far.

CONCLUSIONS: Findings from the current review have helped to display the sociodemographic, epidemiological, and clinical behavior of myiasis in skin cancer and malignant wounds. Its contribution to the greater tumor tissue destruction is clear; however, more studies are required. The therapeutic management in these patients is equally clarified.

PMID:34363696 | DOI:10.1111/ijd.15672

Aust Endod J. 2021 Aug 7. doi: 10.1111/aej.12554. Online ahead of print.

ABSTRACT

This study aimed to evaluate the prevalence of oval-shaped root canals at the apical, medial and coronal cross sections of all tooth groups using CBCT and image analysis software. Based on the diameter values, the long/short diameter ratio was calculated and each root canal was classified regarding its shape. Oval-shaped canals were present in 45% at the apical, 50% at the medial and 56% at the coronal level of all teeth. The mandibular central incisors presented oval canals in 24%, long oval in 28% and flat in 2% at the apical level. Mandibular molars showed a statistically significant difference (P < 0.05) in the distribution of oval-shaped canals between cross-sectional levels. Analysis of CBCT scans with an image analysis software could be a reliable and reproducible method and a valuable tool for objective determination of root canal shape in further research.

PMID:34363716 | DOI:10.1111/aej.12554

J Burn Care Res. 2021 Aug 7:irab141. doi: 10.1093/jbcr/irab141. Online ahead of print.

ABSTRACT

BACKGROUND: Topical silver sulfadiazine (SSD) is an effective antimicrobial therapy used to prevent burn wound infection and promote healing, but the frequency of application has not been previously examined. This study compares once versus twice daily dressing changes with SSD, focusing on development of wound infections, incidence of hospital acquired complications, patient pain scores, and length of stay.

OBJECTIVE: To evaluate whether a once-daily or twice-daily application of SSD impacts burn wound healing outcomes.

METHODS: Our institution maintained a twice-daily dressing change standard of care until 01/01/2019. Patients admitted after that date had their dressing changed once-daily. We performed a non-inferiority analysis which indicated that a sample size of 75 per group would be sufficient to detect a significant difference with a power of 0.80. Our goal is to review outcomes for 75 patients before the change-of-practice and 75 patients after. Our main outcomes recorded are wound infection, average pain scores, average daily narcotic requirements, and length-of-stay.

RESULTS: Results from 75 pre-change-of-practice and 75 post-change-of-practice patients showed slightly better outcomes in the post-change-of-practice group. The wound-infection rates were the same for both groups (pre=5.33%, post=5.33%), average daily pain-levels for the pre-change group were slightly higher but the difference was negligible and not statistically significant (pre=5.27, post=5.25), hospital-related complication rates (unrelated to wound care) were higher pre-change (pre=10.67%, post=6.67%), and length-of-stay, was longer in the pre-change group (pre=11.97, post=10.31). The amount average amount of SSD (g/day) used per patient per hospital stay was higher as well (pre=320.14, post=202.12). Further statistical analysis of the results, particularly in the distribution of burn type, age, and burn depth showed no discrepancy and a generalized decreased length-of-stay with once-daily SSD dressing change.

CONCLUSION: Our results show that once-daily dressing changes of SSD in burn wounds have no negative impact on wound outcomes. However, it is associated with a decreased length-of-stay, decreased pain levels, and less hospital-acquired complications. A decreased length-of-stay means reduced medical expenses for the patient and the hospital. In addition, less hospital-acquired complications result in better patient recovery. Since the difference in wound outcomes is negligible and statistically insignificant, changing the standard-of-care to once-daily could prove beneficial.

PMID:34363678 | DOI:10.1093/jbcr/irab141

J Neuropathol Exp Neurol. 2021 Aug 7:nlab075. doi: 10.1093/jnen/nlab075. Online ahead of print.

ABSTRACT

Polymorphous low-grade neuroepithelial tumor of the young (PLNTY) is a recently described epileptogenic tumor characterized by oligodendroglioma-like components, aberrant CD34 expression, and frequent mitogen-activated protein kinase (MAPK) pathway activation. We molecularly profiled 13 cases with diagnostic histopathological features of PLNTY (10 female; median age, 16 years; range, 5-52). Patients frequently presented with seizures (9 of 12 with available history) and temporal lobe tumors (9 of 13). MAPK pathway activating alterations were identified in all 13 cases. Fusions were present in the 7 youngest patients: FGFR2-CTNNA3 (n = 2), FGFR2-KIAA1598 (FGFR2-SHTN1) (n = 1), FGFR2-INA (n = 1), FGFR2-MPRIP (n = 1), QKI-NTRK2 (n = 1), and KIAA1549-BRAF (n = 1). BRAF V600E mutation was present in 6 patients (17 years or older). Two fusion-positive cases additionally harbored TP53/RB1 abnormalities suggesting biallelic inactivation. Copy number changes predominantly involving whole chromosomes were observed in all 10 evaluated cases, with losses of chromosome 10q occurring with FGFR2-KIAA1598 (SHTN1)/CTNNA3 fusions. The KIAA1549-BRAF and QKI-NTRK2 fusions were associated respectively with a 7q34 deletion and 9q21 duplication. This study shows that despite its name, PLNTY also occurs in older adults, who frequently show BRAF V600E mutation. It also expands the spectrum of the MAPK pathway activating alterations associated with PLNTY and demonstrates recurrent chromosomal copy number changes consistent with chromosomal instability.

PMID:34363682 | DOI:10.1093/jnen/nlab075

Eur J Cardiothorac Surg. 2021 Aug 7:ezab359. doi: 10.1093/ejcts/ezab359. Online ahead of print.

ABSTRACT

OBJECTIVES: Commissural orientation <160° is a recognized risk factor for bicuspid aortic valve repair failure. Based on this observation, repairing this subtype of aortic valve by reorienting the 2 commissures at 180° has recently been proposed.

METHODS: Nine porcine hearts with aortic annulus diameters of 25 mm were selected. A pathological model of a Sievers 1 bicuspid aortic valve was obtained by suturing the coaptation line between the left and right leaflets. Each heart underwent reimplantation procedures both in the native (120°) and the reoriented (180°) configuration. After the operation, each sample was tested on a pulse duplicator at rest (heart rate 60 beats per min) and with mild exercise (heart rate 90 beats per min) conditions.

RESULTS: No statistically significant difference was noted in mean and peak transvalvular aortic gradients between the 2 configurations at rest (18.6 ± 5 vs 17.5 ± 4 for the mean aortic gradient; 42.8 ± 12.7 vs 36.3 ± 5.8 for the peak aortic gradient) but the group with the 120°-oriented commissures had significantly higher mean transaortic gradients compared to the group with the 180°-oriented commissures at initial exercise stress conditions (30.1 ± 9.1 vs 24.9 ± 3.8; p value 0.002).

CONCLUSIONS: The 180° commissural reorientation of the asymmetrical bicuspid aortic valve does not improve the transvalvular aortic gradient in an acute model at rest conditions, but it could do so under stress situations. Even if it is surgically more complex and time-consuming, this approach could be a good strategy to improve long-term results, particularly in young patients.

PMID:34363669 | DOI:10.1093/ejcts/ezab359

J Neuropathol Exp Neurol. 2021 Aug 7:nlab074. doi: 10.1093/jnen/nlab074. Online ahead of print.

ABSTRACT

The unintended neurologic sequelae of chemotherapy contribute to significant patient morbidity. Chemotherapy-related cognitive impairment (CRCI) is observed in up to 80% of cancer patients treated with chemotherapy and involves multiple cognitive domains including executive functioning. The pathophysiology underlying CRCI and the neurotoxicity of chemotherapy is incompletely understood, but oxidative stress and DNA damage are highly plausible mechanisms based on preclinical data. Unfortunately, validating pathways relevant to CRCI in humans is limited by an absence of relevant neuropathologic studies of patient brain tissue. In the present study, we stained sections of frontal lobe autopsy tissue from cancer patients treated with chemotherapy (n = 15), cancer patients not treated with chemotherapy (n = 10), and patients without history of cancer (n = 10) for markers of oxidative stress (nitrotyrosine, 4-hydroxynonenal) and DNA damage (pH2AX, pATM). Cancer patients treated with chemotherapy had increased staining for markers of oxidative stress and DNA damage in frontal lobe cortical neurons compared to controls. We detected no statistically significant difference in oxidative stress and DNA damage by the duration between last administration of chemotherapy and death. The study highlights the potential relevance of oxidative stress and DNA damage in the pathophysiology of CRCI and the neurotoxicity of chemotherapy.

PMID:34363676 | DOI:10.1093/jnen/nlab074

J Nephrol. 2021 Aug 7. doi: 10.1007/s40620-021-01124-9. Online ahead of print.

ABSTRACT

BACKGROUND: Contrast-induced nephropathy (CIN) is a major adverse event in patients undergoing coronary angiography. The Mehran risk model is the gold-standard for CIN risk prediction. However, its performance in comparison to more contemporary National Cardiovascular Data Registry-Acute Kidney Injury (NCDR-AKI) risk models remains unknown. We aimed to compare both in this study.

METHODS AND RESULTS: Predictions of Mehran and NCDR-AKI risk models and clinical events of CIN and need for dialysis were assessed in a total of 2067 patients undergoing coronary angiography with or without percutaneous coronary intervention. Risk models were compared regarding discrimination (receiver operating characteristic analysis), net reclassification improvement (NRI) and calibration (graphical and statistical analysis). The NCDR risk model showed superior risk discrimination for predicting CIN (NCDR c-index 0.75, 95% CI 0.72-0.78; vs. Mehran c-index 0.69, 95% CI 0.66-0.72, p < 0.01), and continuous NRI (0.22; 95% CI 0.12-0.32; p < 0.01) compared to the Mehran model. The NCDR risk model tended to underestimate the risk of CIN, while the Mehran model was more evenly calibrated. For the prediction of need for dialysis, NCDR-AKI-D also discriminated risk better (c-index 0.85, 95% CI 0.79-0.91; vs. Mehran c-index 0.75, 95% CI 0.66-0.84; p_NCDRvsMehran < 0.01), but continuous NRI showed no benefit and calibration analysis revealed an underestimation of dialysis risk.

CONCLUSION: In German patients undergoing coronary angiography, the modern NCDR risk model for predicting contrast-induced nephropathy showed superior discrimination compared to the GRACE model while showing less accurate calibration. Results for the outcome ‘need for dialysis’ were equivocal.

PMID:34363595 | DOI:10.1007/s40620-021-01124-9

J Adv Nurs. 2021 Aug 7. doi: 10.1111/jan.15004. Online ahead of print.

ABSTRACT

AIMS: To examine patient-caregiver concordances about psychological distress among Chinese patients with breast cancer undergoing chemotherapy and identify factors related to concordance among patients and family caregivers.

DESIGN: Cross-sectional study.

METHODS: From October 2019 to June 2020, 137 patient-caregiver dyads were enrolled. Sociodemographic information, the distress thermometer (including the problem list), the Distress Disclosure Index and the Family Adaptability and Cohesion Evaluation Scale were used to collect data. Data were analysed using intraclass correlation coefficients (ICC), kappa statistics, two related samples test, chi-square tests and/or Fisher’s exact tests and binary logistic regression.

RESULTS: Overall, fair agreement was identified between patients’ and caregivers’ reports (intraclass correlation coefficients [ICC] = .528). Patients reported significantly higher psychological distress scores than paired caregiver reports. Lower psychological distress concordance was found among patients with comorbidities (odds ratio [OR], 0.352; 95% confidence interval [CI], 0.155-0.798) and lower levels of self-disclosure (OR, 0.402; 95% CI, 0.186-0.868).

CONCLUSION: There was relatively low concordance between patients’ reports and caregivers’ perceptions of psychological distress. Family caregivers tended to underestimate patients’ psychological distress. A comorbid condition and lower levels of self-disclosure contributed to this bias.

IMPACT: Having an awareness of the incongruence between patient and caregiver may help healthcare providers better interpret caregiver assessments. Healthcare providers should reinforce patient-caregiver dyadic psychosocial education to improve concordance. More psychological care and substantial emotional support should be provided for Chinese breast cancer patients undergoing chemotherapy by family caregivers and healthcare providers.

PMID:34363625 | DOI:10.1111/jan.15004

Amino Acids. 2021 Aug 7. doi: 10.1007/s00726-021-03058-9. Online ahead of print.

ABSTRACT

Mounting studies have demonstrated that RAB3GAP1 expression is modified in brain diseases with multiple neurobiological functions and processes and acts as a potentially significant target. However, the cellular and molecular events arising from RAB3GAP1 dysexpression are still incompletely understood. In this work, underexpression and overexpression of RAB3GAP1 were first induced into cultured mouse cortical neurons by transfection with lentivirus plasmids. Then we globally explored the effects of RAB3GAP1 dysexpression on the proteome of the neurons through the use of isobaric tag for relative and absolute quantitation (iTRAQ)-based quantitative proteomics with bioinformatics. A total of 364 proteins in the RAB3GAP1-underexpression group and 314 proteins in the RAB3GAP1-overexpression group were identified to be differentially expressed. Subsequent bioinformatics analysis indicated that the proteome functional expression profiles induced by RAB3GAP1 underexpression and overexpression were different, suggesting the potential differences in biological processes and cellular effects. Subsequent intergroup cross-comparison revealed some candidate target proteins regulated directly by RAB3GAP1. Further parallel reaction monitoring (PRM) analysis illustrated that Sub1, Ssrp1, and Top1 proteins might serve as new potentially important linkers in the RAB3GAP1-mediated autophagy pathway in the cortical neurons. Collectively, the current proteomics data furnished new valuable insights to better understand the regulatory molecular mechanism of neuronal RAB3GAP1.

PMID:34363538 | DOI:10.1007/s00726-021-03058-9

Environ Sci Pollut Res Int. 2021 Aug 7. doi: 10.1007/s11356-021-15654-z. Online ahead of print.

ABSTRACT

The present research aims to investigate the impact of air pollution on the number of mortalities caused by COVID-19 per Pakistani province. To do so, for each independent area of Pakistan, the observed mortality due to COVID-19 has been standardized over the entire population using standard age groups ranging from 0 to 4, 5 to 9, 10 to 14,…, 65, and above years, supported by the 2017 state people census. The impact of air pollution and COVID-19 transience among Pakistani areas, Islamabad Capital Territory (ICT), and the Federally Administered Tribal Region (FATA) was analyzed by a multiple-linear regression model, while the broad collection of attributes was observed by the resources of local spatial autocorrelation indicators, including the spatial portion of COVID-19 association. The result indicates that the observed mortality rate is much higher than predicted in certain provinces, namely, the Khyber Pakhtunkhwa and Punjab provinces, and the prevalence of PM₁₀ was independently linked to mortality due to the corona virus. Additionally, the results of the local spatial autocorrelation indicators on the standardized mortality rate and PM₁₀ define a collection of very higher ideologies in the broad range of KPK and the southern part of Punjab province, respectively, with a definite degree of connection between the two distributions in the Khyber Pakhtunkhwa region. In brief, this research seems to find a justification for confirming the existence of a correlation between the possibility of COVID-19 mortality and air pollution, more precisely considering air pollutants (i.e., particulate (PM₁₀) and land take-over. To this end, the need to mediate in favor of measures aimed at eliminating emissions in the environment will be reiterated by speeding up current proposals and policies aimed at all causes of atmospheric pollution: urbanization, water and manufacturing, home heating, and transportation.

PMID:34363580 | DOI:10.1007/s11356-021-15654-z