Category: Nevin Manimala

Mol Ther. 2022 Mar 9:S1525-0016(22)00158-7. doi: 10.1016/j.ymthe.2022.03.002. Online ahead of print.

ABSTRACT

As mediators of intercellular communication, extracellular vesicles containing molecular cargo such as microRNAs, are secreted by cells and taken up by recipient cells to influence their cellular phenotype and function. Here, we report that cardiac stress-induced differential microRNA content, with miR-200c-3p being one of the most enriched, in cardiomyocyte-derived extracellular vesicles mediates functional crosstalk with endothelial cells. Silencing of miR-200c-3p in mice subjected to chronic increased cardiac pressure overload resulted in attenuated hypertrophy, smaller fibrotic areas, higher capillary density and preserved cardiac ejection fraction. Interestingly, we were able to maximal rescue microvascular and cardiac function with very low doses of antagomir, which specifically silences miR-200c-3p expression in the non-myocyte cells. Our results reveal vesicle transfer of miR-200c-3p from cardiomyocytes to cardiac endothelial cells, underlining the importance of cardiac intercellular communication in the pathophysiology of heart failure.

PMID:35278675 | DOI:10.1016/j.ymthe.2022.03.002

J Shoulder Elbow Surg. 2022 Mar 9:S1058-2746(22)00269-5. doi: 10.1016/j.jse.2022.01.151. Online ahead of print.

ABSTRACT

BACKGROUND: The development of radioulnar synostosis secondary to posttraumatic injuries to the elbow or forearm can lead to debilitating outcomes. Several treatment options are available to hinder the progression and prevent reoccurrence. The authors used a combination of these treatments on a series of patients and observed the outcomes.

METHODS: A retrospective study was conducted on 10 patients with posttraumatic radioulnar synostosis (9 males and 1 female) that required surgical intervention in a tertiary orthopedic center. All of these patients were subjected to the same treatment combination (preoperative radiotherapy, tissue interposition post heterotopic ossification resection and adjuvant indomethacin Postoperatively). Improvement in range of motion (flexion, extension, and rotation) and Mayo score was performed and compared pre- and postoperatively via statistical analysis.

RESULTS: In comparison to their preoperative state that ranged from fair to poor, all 10 patients reported excellent Mayo score results post intervention with triple therapy combination with a mean of 36 ± 10.2 points. Flexion, extension, and rotation scores improved with means of 55.2° ± 38.7, 50.2° ± 34.0, and 47.9° ± 40.0, respectively. We had one complication that has subsided on follow-up.

CONCLUSION: The triple therapy combination has been noted to provide good functional and prophylactic results preventing recurrence.

PMID:35278681 | DOI:10.1016/j.jse.2022.01.151

J Vasc Surg. 2022 Mar 9:S0741-5214(22)00421-9. doi: 10.1016/j.jvs.2022.02.053. Online ahead of print.

ABSTRACT

OBJECTIVE: The Gore Excluder iliac branch endoprosthesis (IBE; W.L. Gore & Associates, Flagstaff, AZ) is the only iliac branch device approved in the United States to preserve blood flow to the external and internal iliac arteries (IIAs). Some surgeons have used the Gore Viabahn VBX balloon expandable endoprosthesis (VBX; W.L. Gore & Associates) in the IIA rather than the self-expanding endograft designed for the IBE, the internal iliac component (IIC). The objective of the present study was to examine outcomes in patients treated for aortoiliac artery aneurysms with the IBE using either the IIC or VBX stent.

METHODS: We performed a retrospective, single-center review of patients treated for aortoiliac artery aneurysms using the Gore IBE device, with either the IIC or VBX stent into the internal iliac artery from February 2016 to March 2021. Patient demographics, procedure details, 30-day morbidity and mortality, and 6-month and 1-year outcomes and mortality were analyzed. The categorical factors were summarized using frequencies and percentages. Continuous measures were summarized using mean ± standard deviation. A significance level of P = .05 was assumed for all test results. The analyses were performed using SAS software, version 9.4 (SAS Institute, Cary, NC).

RESULTS: Sixty-four patients underwent elective aortoiliac artery aneurysm repair with IBE. IIC was used exclusively in 35 patients (55%) and VBX in 29 (45%). Patients receiving VBX had higher American Society of Anesthesiologists class (P = .006). Upper extremity access was used for VBX delivery in 24.1% of the procedures. No return to the operating room was required in either group. No differences were found in technical success (97.1% IIC vs 93.1% VBX; P = .59), presence of endoleak upon completion (20.0% vs 6.9%; P = .17), readmission (97.1% vs 93.1%; P = .59), or mortality (1.6% vs 0%; P = .45) at 30 days. No differences were found in the requirement for any IBE reintervention after 30 days. No type Ia, Ib, or III endoleaks occurred in either group at any follow-up point. There was no significant difference in internal iliac limb primary patency (IIC 100% vs VBX 96.3%) between groups. A non-statistically significant trend was found toward fewer trunk-ipsilateral leg type II endoleaks in the VBX group during post-procedure follow-up.

CONCLUSIONS: These data suggest that VBX is a reasonable substitute for IIC and has a comparable safety and efficacy profile. Given its inherent conformability, greater range of diameters, and longer working length, VBX offers expanded internal iliac artery branch options with IBE.

PMID:35278651 | DOI:10.1016/j.jvs.2022.02.053

Environ Pollut. 2022 Mar 8:119118. doi: 10.1016/j.envpol.2022.119118. Online ahead of print.

ABSTRACT

Sediment denitrification plays an important role in nitrogen removal in aquatic systems. However, the importance in nitrogen removal in reservoirs, with a focus on seasonal differences of conditions such as macrophyte beds and environmental factors, is less well understood. This study examined sediment denitrification rate (D_n), and their potential controlling factors were determined in both macrophyte beds and deeper waters in the subtropical reservoir. The mean D_n in the reservoir annually was 18.0 ± 6.3 (mean ± S.E.) mmol N m^-2 d^-1, with significant seasonal variation (p < 0.01), i.e. 43.2 ± 12.8, 6.7 ± 6.3, and 4.0 ± 2.2 mmol N m^-2 d^-1 in winter, spring and summer respectively. There were no statistical differences in D_n between shallow waters with macrophyte beds and deeper waters without macrophyte beds, although macrophyte beds had higher denitrification rates in summer. The D_n rates were significantly correlated with temperature, conductivity, dissolved oxygen, pH, nitrate-nitrogen concentration (NO₃^–-N) (p < 0.01) and turbidity (p < 0.05). Linear regression models demonstrated environmental variables explained between 36% and 76% of the variation in D_n. The correlation with NO₃^–-N concentrations suggests that it may be a limited factor for D_n. Annual nitrogen removal of the reservoir by a combination of sediment and water denitrification was totally estimated to be 370 t N with an annual removal efficiency of approximately 11%. Nitrogen removal was much higher in winter than other seasons, with about 305 t N removed, accounting for 12% of the total nitrogen inputs. Therefore, denitrification appears to play a minor role throughout much of the year, but in winter months when nitrate accumulates, it may play a more major role.

PMID:35278586 | DOI:10.1016/j.envpol.2022.119118

Ann Rehabil Med. 2022 Feb;46(1):45-52. doi: 10.5535/arm.21148. Epub 2022 Feb 28.

ABSTRACT

OBJECTIVE: To analyze how Pilates exercises affect standing, walking, and balance in children with diplegic cerebral palsy throughout a 10-week program.

METHODS: We included 40 children aged 7-9 years with diplegic cerebral palsy, and randomly allocated them into two groups of the same size: conventional therapy group (group A) and conventional therapy+Pilates group (group B). We administered the same conventional physical therapy program to both groups for 45 minutes, with group B receiving additional Pilates exercises for 45 minutes. Both groups attended the intervention program three times/week for 10 weeks. We used the Growth Motor Function Measure Scale (GMFM-88) to evaluate standing and walking (Dimensions D and E), and the Pediatric Balance Scale to evaluate balance function before and after treatment.

RESULTS: Comparison of the average values of all measured variables before and after therapy showed a statistically significant difference (p<0.05) between the two groups. All measured variables showed a significant difference between groups A and B, in favor of group B (p<0.05).

CONCLUSION: Pilates exercise in addition to conventional therapy is more effective in improving balance and gross motor function in children with diplegic cerebral palsy than the conventional therapy alone.

PMID:35272439 | DOI:10.5535/arm.21148

Zhonghua Wai Ke Za Zhi. 2022 Apr 1;60(4):379-387. doi: 10.3760/cma.j.cn112139-20211210-00592. Online ahead of print.

ABSTRACT

Objective: To investigate the association between prealbumin and the long-term prognosis of patients with hilar cholangiocarcinoma(HCCA) following radical surgery. Methods: The clinical data of 262 HCCA patients who underwent radical surgery admitted from January 2010 to January 2017 at the First Affiliated Hospital of Army Medical University were collected,retrospectively. There were 158 males and 104 females; aged (57.6±9.9)years old(range:32 to 78 years). According to the preoperative serum prealbumin level(170 mg/L),the patients were divided into low prealbumin group(n=143) and normal prealbumin group(n=119). Follow-up until September 2020,the main research indicator was overall survival(OS), and the secondary research indicator was recurrence-free survival(RFS). The measurement data conforming to the normal distribution adopted the t test,the measurement data not conforming to the normal distribution adopted the Mann-Whitney U test,and the count data adopted the χ² test. The Kaplan-Meier method was used to calculate the cumulative survival rate. The Log-rank test was used for univariate analysis of the cumulative survival rate. Variables with P<0.10 in univariate analysis were included in the Cox proportional hazards model for multivariate analysis. Results: The 1-, 3-, and 5-year OS rate of the 262 patients was 73.4%, 32.1%, and 24.0%, respectively, and the 1-, 3-, and 5-year RFS rate was 54.6%, 25.2%, and 16.2%, respectively. Median OS and RFS were 21 months and 12 months for patients with low prealbumin and 25 months and 19 months for patients with normal prealbumin. The OS rate and RFS rate of patients in the low prealbumin group were lower than those in the normal prealbumin group, and the difference was statistically significant (both P<0.05). The results of univariate analysis indicated that low prealbumin, CA19-9>150 U/L, tumor infiltration length>3 cm, preoperative jaundice, macrovascular invasion, microvascular invasion, lymph node metastasis, and poor differentiation maybe the risk factors of OS,and low prealbumin,tumor invasion length>3 cm,macrovascular invasion, microvascular invasion,lymph node metastasis,and poor differentiation maybe the risk factors of RFS for postoperative for radical resection in patients with HCCA (all P<0.10). Multivariate results suggested that low prealbumin,tumor invasion length>3 cm,microvascular invasion,lymph node metastasis,and poor differentiation were independent risk factors affecting OS and RFS in patients with HCCA after radical operation all (P<0.05). Conclusion: Preoperative prealbumin level can predict the long-term prognosis of patients with hilar cholangiocarcinoma following radical surgery.

PMID:35272430 | DOI:10.3760/cma.j.cn112139-20211210-00592

Ann Rehabil Med. 2022 Feb;46(1):1-8. doi: 10.5535/arm.22001. Epub 2022 Feb 28.

ABSTRACT

With rapid aging, the number of stroke survivors with disabilities in Korea is increasing even if mortality is declining. Despite coordinated efforts for quality improvement of stroke rehabilitation in Korea, the statistics of stroke rehabilitation were not well reported. This review aimed to provide contemporary and comprehensive statistics and recent changes in stroke rehabilitation in Korea. The Clinical Practice Guideline for Stroke Rehabilitation in Korea was developed in 2009 and updated in 2012 and 2016. Additionally, the representative databases for stroke rehabilitation include the Korean Brain Rehabilitation Database and the Korean Stroke Cohort for functioning and rehabilitation. These nationwide databases provided current information on stroke rehabilitation. Among Korean stroke survivors, one in three had motor impairment, one in four had cognitive impairment, one in three had speech impairment, one in four was dependent in ambulation, one in six had swallowing difficulty, and one in four was dependent in activities in daily living at 5 years after stroke. Comprehensive inpatient rehabilitation following transfer to the department of rehabilitation medicine significantly decreased stroke-related mortality and long-term disability. This review provides an improved understanding of stroke rehabilitation and guidance to implement timely, coordinated, evidence-based stroke rehabilitation services to relieve the socioeconomic burden of stroke.

PMID:35272435 | DOI:10.5535/arm.22001

Zhongguo Zhen Jiu. 2022 Mar 12;42(3):271-6. doi: 10.13703/j.0255-2930.20210429-k0004.

ABSTRACT

OBJECTIVE: To compare the efficacy of different acupuncture frequencies in tobacco-dependent patients and explore the impact of nicotine metabolite rate (NMR) on smoking cessation in the intervention with acupuncture.

METHODS: A total of 120 cases of tobacco-dependent patients were randomly divided into a high-frequency group (60 cases, 12 cases dropped off) and a low-frequency group (60 cases, 6 cases dropped off). In the two groups, smoking cessation counseling was provided prior to acupuncture. Acupuncture was applied to Baihui (GV 20), Lieque (LU 7), Zusanli (ST 36), etc. Additionally, electric stimulation was added at Lieque (LU 7) and Zusanli (ST 36), with continuous wave, 15 Hz in frequency. The duration of treatment was 8 weeks in either group. In the high-frequency group, the treatment was given 5 times weekly from week 1 to week 4, and was 3 times weekly from week 5 to week 8. In the low-frequency group, the treatment was given 3 times weekly from week 1 to week 4, and was twice a week from week 5 to week 8. The immediate withdrawal rate, persistent withdrawal rate, the score of Fagerstrőm test for nicotine dependence (FTND) before and after treatment, as well as the score of Minnesota nicotine withdrawal scale (MNWS) in 1 and 8 weeks of treatment were compared among the patients with high and low NMR between the two groups separately. The Logistic regression analysis was used to screen the influencing factors of smoking cessation in the intervention with acupuncture.

RESULTS: After treatment, there was no statistical significance of the differences in the immediate withdrawal rate (35.4% [17/48] vs 29.6% [16/54]) and the persistent withdrawal rate (33.3% [16/48] vs 25.9% [14/54]) between the high-frequency group and the low-frequency group (P>0.05). The difference in withdrawal rate had no statistical significance between high and low NMR patients (P>0.05). FTND scores after treatment were lower than those before treatment (P<0.01) and MNWS scores were lower than those in 1 week of treatment (P<0.01) in the two groups. However, the differences had no statistical significance between the two groups and between the patients with high NMR and low NMR (P>0.05). Age, education level and NMR were the influencing factors of smoking cessation in the intervention with acupuncture (P<0.05).

CONCLUSION: Acupuncture with different frequencies has no obvious impact on the efficacy in tobacco-dependent patients. The lower nicotine metabolite rate in individuals, the better efficacy of acupuncture. The smokers with high nicotine metabolite rate may obtain a better effect of cessation in the high-frequency intervention with acupuncture.

PMID:35272403 | DOI:10.13703/j.0255-2930.20210429-k0004

Z Orthop Unfall. 2022 Mar 10. doi: 10.1055/a-1737-4541. Online ahead of print.

ABSTRACT

BACKGROUND: Initial results after autologous fat transfer for treatment of thumb carpometacarpal joint osteoarthritis have been promising. But long-term results have not yet been available.

METHODS: In a prospective study, 42 patients with thumb carpometacarpal joint osteoarthritis were observed for a mean time of 5 years after autologous fat transfer. Manual liposuction and centrifugation were performed. Pain rating according to numerous analogue pain scale; objective force of pinch grip and fist closure; and Disabilities of the Arm, Shoulder, and Hand questionnaire score (DASH score) before and after treatment were analysed.

RESULTS: The average pain preoperatively was 8.0 ± 1.6 and 4.0 ± 3.0 after 5 years overall. Force and pinch force of the treated hand improved from 71% and 60% preoperative in comparison to the non-treated hand to 100% and 96%, respectively, 5 years after fat transplantation. There were similar improvements for the parameters strength and DASH score. All improvements were statistically significant. No serious adverse events were observed.

CONCLUSIONS: Autologous fat transplantation is a real alternative to trapeziectomy even in the long term in basal joint osteoarthritis of the thumb. The low invasiveness of the procedure and early recovery of patients compared with classical procedures such as trapeziectomy, and the superior long-term results compared with classical injection therapy, make this approach feasible as a first-line therapy in basal joint osteoarthritis of the thumb as it offers stable results and warrants a high patient satisfaction rate.

PMID:35272382 | DOI:10.1055/a-1737-4541

Rofo. 2022 Mar 10. doi: 10.1055/a-1735-3615. Online ahead of print.

ABSTRACT

PURPOSE: In addition to direct oncologic therapy, interventional radiology plays an important supportive role in oncologic therapy primarily guided by other disciplines. These supporting measures include diagnostic punctures, drainages, biliary interventions, central venous access including port implantations, osteoplasties, pain therapies etc.). This study investigated the extent to which these radiologically guided supportive measures are available in Germany.

MATERIAL AND METHODS: All interventional procedures documented in the DeGIR-registry (excluding transhepatic portosystemic shunts) of the years 2018 and 2019 were recorded (DeGIR-module C). A breakdown of the documented interventions was performed based on federal states as well as 40 individual regions (administrative districts and former administrative districts).

RESULTS: A total of 136,328 procedures were recorded at 216 centers in DeGIR Module C in 2018 and 2019. On average, 389 cases were documented per hospital in 2018 and 394 cases in 2019; the increase per hospital from 2019 is not statistically significant but is relevant in the aggregate when new participating centers are included, with an overall increase of 10 % (6,554 more cases than the previous year). Normalized to one million inhabitants, an average of 781 procedures took place across Germany in 2018 and 860 in 2019. Districts with no registered procedures are not found for Module C.Indications for Module C interventions were mostly interdisciplinary in 2018 and 2019. In this context, the quality of outcome was very high; for the procedures drain placement, marking and biopsy the technical success was 99 %, while the complication rate was lower than 1 %.

CONCLUSION: The structural analysis of this work concludes that in Germany there is good nationwide availability of radiologically guided supportive measures in oncological therapy. Accordingly, the training situation for prospective interventional radiologists is good, as the distribution to centers with high experience is excellent. In addition, the overall outcome quality of radiology-guided interventions is very high.

KEY POINTS: · In Germany, there is good nationwide coverage of radiologically guided supportive interventions in oncological therapy.. · The training situation for prospective interventional radiologists is good, as the distribution to centers with high experience is excellent.. · The overall outcome quality of radiology-guided interventions is very high..

CITATION FORMAT: · Nadjiri J, Schachtner B, Bücker A et al. Nationwide Provision of Radiologically-guided Interventional Measures for the Supportive Treatment of Tumor Diseases in Germany – An Analysis of the DeGIR Registry Data. Fortschr Röntgenstr 2022; DOI: 10.1055/a-1735-3615.

PMID:35272356 | DOI:10.1055/a-1735-3615