Category: Nevin Manimala

Vet J. 2021 Jun;272:105664. doi: 10.1016/j.tvjl.2021.105664. Epub 2021 Mar 26.

ABSTRACT

Tuberculin skin tests remain widely used in the control of bovine tuberculosis (bTB) in cattle. Little is known about the rate of regression of tuberculin reactions after the comparative intradermal cervical test (CICT) in cattle. This study aimed to collect data to describe tuberculin regression in reactors following the CICT at 72 ± 4 h post injection. Reactors were also tested using the interferon gamma (IFN-γ) assay to establish if any pattern existed between these results and the CICT reaction regression. The data were derived from 108 herds, 112 herd-level CICTs and 1008 animals. A multivariable linear mixed model was built to explore the regression of the bovine tuberculin reaction over time and the influence of potential predictors. The results confirmed a proportional decline in the bovine tuberculin reaction occurred over time. The predictors in the final model demonstrated that regression of the tuberculin reaction differed between reactors according to their IFN-γ test results and whether visible lesions were present at slaughter. Follow-up measurement of tuberculin reactions and the serial use of the IFN-γ assay in large breakdowns has the potential to provide both a mechanism for quality assurance of the current CICT bTB surveillance and the identification of atypical breakdowns or reactors requiring further investigation.

PMID:33941331 | DOI:10.1016/j.tvjl.2021.105664

Pract Radiat Oncol. 2021 May-Jun;11(3):202-211. doi: 10.1016/j.prro.2020.11.006.

ABSTRACT

PURPOSE: To assess the intermodality and intertracer variability of gallium-68 (⁶⁸Ga)- or fluorine-18 (¹⁸F)-labeled prostate-specific membrane antigen (PSMA) positron emission tomography (PET) and biparametric magnetic resonance imaging (bpMRI)-based gross tumor volume (GTV) delineation for focal boosting in primary prostate cancer.

METHODS: Nineteen prospectively enrolled patients with prostate cancer underwent a PSMA PET/MRI scan, divided into a 1:1 ratio between ⁶⁸Ga-PSMA-11 and ¹⁸F-PSMA-1007, before radical prostatectomy (IWT140193). Four delineation teams performed manual contouring of the GTV based on bpMRI and PSMA PET imaging, separately. Index lesion coverage (overlap%) and interobserver variability were assessed. Furthermore, the distribution of the voxelwise normalized standardized uptake values (SUV%) was determined for the majority-voted (>50%) GTV (GTV^majority) and whole prostate gland to investigate intertracer variability. The median patientwise SUV% contrast ratio (SUV%-CR, calculated as median GTV^majority SUV% / median prostate gland without GTV^majority SUV%) was calculated according to the tracer used.

RESULTS: A significant difference in overlap% favoring PSMA PET compared with bpMRI was found in the ¹⁸F subgroup (median, 63.0% vs 53.1%; P = .004) but was not present in the ⁶⁸Ga subgroup (32.5% vs 50.6%; P = .100). Regarding interobserver variability, measured Sørensen-Dice coefficients (0.58 vs 0.72) and calculated mean distances to agreement (2.44 mm vs 1.22 mm) were statistically significantly lower and higher, respectively, for the ¹⁸F cohort compared with the ⁶⁸Ga cohort. For the bpMRI-based delineations, the median Sørensen-Dice coefficient and mean distance to agreement were 0.63 and 1.76 mm, respectively. Median patientwise SUV%-CRs of 1.8 (interquartile range [IQR], 1.6-2.7) for ¹⁸F-PSMA and 3.3 (IQR, 2.7-5.9) for ⁶⁸Ga-PSMA PET images were found.

CONCLUSIONS: Both MRI and PSMA PET provided consistent intraprostatic GTV lesion detection. However, the PSMA tracer seems to have a major influence on the contour characteristics, owing to an apparent difference in SUV% distribution in the prostate gland.

PMID:33941347 | DOI:10.1016/j.prro.2020.11.006

Perioper Med (Lond). 2021 May 4;10(1):14. doi: 10.1186/s13741-021-00183-7.

ABSTRACT

BACKGROUND: Inadequate neuromuscular recovery might impair pulmonary function among adult patients who undergo general anaesthesia and might thus contribute to critical respiratory events in the post-anaesthesia care unit (PACU). The pilot study aims to understand the baseline incidence of residual neuromuscular blockade (RNMB) and postoperative critical respiratory events (CREs), which are described in a modified Murphy’s criteria in the PACU.

METHOD: This is a prospective cohort study from January to March 2017 from a tertiary hospital in Saudi Arabia with thirty adult patients over 18 years old scheduled for elective surgery under general anaesthesia with neuromuscular blocking drugs (NMBDs) who were enrolled in the study. The Mann-Whitney U tests, chi-square tests and independent-samples T tests were used. The train-of-four (TOF) ratios were measured upon arrival in the PACU by using acceleromyography with TOF-Scan. Subjects’ demographics, perioperative data and the occurrence of postoperative CREs in the PACU were recorded.

RESULTS: Twenty-six (86.7%) patients out of thirty in the study have received rocuronium as NMBDs whilst neostigmine as a reversal drug with only 23 (76.7%). The incidence of RNMB (TOF ratio < 0.9) was in 16 patients (53.3%). The incidence of RNMB was significantly higher in female patients (p = 0.033), in patients who had not undergone quantitative neuromuscular monitoring before extubation (p = 0.046) and in patients with a shorter duration of surgery (p = 0.001). Postoperative CREs occurred in twenty patients (66.7%), and there were significantly more of these CREs among patients with RNMB (p = 0.001). In addition, a statistically significant difference was observed in the occurrence of CREs according to body mass index (p = 0.047).

CONCLUSION: This research showed that RNMB is a significant contributing factor to the development of critical respiratory events during PACU stay. Therefore, routine quantitative neuromuscular monitoring is recommended to reduce the incidence of RNMB.

PMID:33941287 | DOI:10.1186/s13741-021-00183-7

J Health Popul Nutr. 2021 May 3;40(1):21. doi: 10.1186/s41043-021-00247-w.

ABSTRACT

OBJECTIVE: This study aims to explain the correlation among non-alcoholic fatty liver disease (NAFLD), hyperuricemia, and thyroid function and to find independent risk factors for each other.

METHODS: Data were obtained from subjects who underwent health examination in the Health Promotion Centre of Sir Run Run Shaw Hospital of Zhejiang University from January 2017 to February 2019. The diagnosis of NAFLD was according to the clinical diagnosis of the guidelines. Serum uric acid (SUA) > 360 μmol/L (female) and SUA > 420 μmol/L (male) were enrolled in the hyperuricemia group. R software was used for statistical analysis.

RESULTS: 55,449 subjects were included in the analysis. 34.27% of patients were classified as NAFLD group (N=19004), and 65.73% of patients were classified as non-NAFLD group (N=36445). The levels of gender ratio, age, BMI, waist circumference, systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FBG), HbA1c, triglyceride (TG), high-density lipoprotein (HDLC), alanine aminotransferase (ALT), aspartate aminotransferase (AST), urea nitrogen (BUN), creatinine (CR), FT3, FT4, and TSH were significantly different between the non-NAFLD group and NAFLD group. Age, BMI, waist circumference, DBP, fFBG, HbA1c, total cholesterol (TC), low-density lipoprotein (LDLC), AST, and UA were all independent risk factors for NAFLD. In the normal uric acid group, variables other than SBP and TSH were independent factors of NAFLD. In the hyperuricemia group, all variables except SBP, FT4, and TSH were independent factors of NAFLD.

CONCLUSION: The level of uric acid is related to the occurrence of NAFLD. Hyperuricemia is one of the independent risk factors of NAFLD. TSH level is not related to the occurrence of NAFLD, while FT3 and FT4 may be related to NAFLD.

PMID:33941292 | DOI:10.1186/s41043-021-00247-w

Cardiol Young. 2021 May 4:1-6. doi: 10.1017/S1047951121001633. Online ahead of print.

ABSTRACT

OBJECTIVE: There are a few number of case reports and small-scale case series reporting dilated cardiomyopathy due to vitamin D-deficient rickets. The present study evaluates the clinical, biochemical, and echocardiographic features of neonates with vitamin D deficiency.

PATIENTS AND METHODS: In this prospective single-arm observational study, echocardiographic evaluation was performed on all patients before vitamin D3 and calcium replacement. Following remission of biochemical features of vitamin D deficiency, control echocardiography was performed. Biochemical and echocardiographic characteristics of the present cohort were compared with those of 27 previously published cases with dilated cardiomyopathy due to vitamin D deficiency.

RESULTS: The study included 148 cases (95 males). In the echocardiographic evaluation, none of the patients had dilated cardiomyopathy. All of the mothers were also vitamin D deficient and treated accordingly. Comparison of patients with normocalcaemia and hypocalcaemia at presentation revealed no statistically significant difference between the ejection fraction and shortening fraction, while left ventricle end-diastolic diameter and left ventricle end-systolic diameter were higher in patients with hypocalcaemia. Previously published historical cases were older and had more severe biochemical features of vitamin D deficiency.

CONCLUSION: To the best of our knowledge, in this first and largest cohort of neonates with vitamin D deficiency, we did not detect dilated cardiomyopathy. Early recognition and detection before developing actual rickets and preventing prolonged hypocalcaemia are critically important to alleviate cardiac complications.

PMID:33941295 | DOI:10.1017/S1047951121001633

Borderline Personal Disord Emot Dysregul. 2021 May 4;8(1):14. doi: 10.1186/s40479-021-00154-w.

ABSTRACT

BACKGROUND: Emotion Dysregulation (ED), childhood trauma and personality are linked to the occurrence of maladaptive behaviours in adolescence which, in turn, may be related to increased risk for psychopathology in the life course. We sought to explore the relationship among the occurrence of different clusters of maladaptive behaviours and ED, clinical features (i.e. impulsivity, childhood maltreatment, anxiety, depressive symptoms) and personality traits that have been found to be associated to Borderline Personality Disorder (BPD), in a sample of 179 adolescent students.

METHODS: Multiple Correspondence Analysis (MCA) was applied to detect clustered types of maladaptive behaviours and groups of students were defined as individuals engaging in these clustered behaviours (non-suicidal self-injury-NSSI, binge eating, binge drinking, cannabis use, and sexual risk behaviours). Logistic models were used to evaluate the association among clinical scales, and student groups. Mediation analysis was used to evaluate whether clinical features affected the association between personality traits and student groups.

RESULTS: MCA analysis allowed to identify three student groups: NSSI/binge eating (NSSI-BE) behaviours, other maladaptive behaviours and “none”. Higher scores in ED, impulsivity, childhood maltreatment, anxiety and depressive symptoms increased the risk of belonging to the cluster of NSSI-BE behaviours compared to the other two groups. ED, depression and anxiety symptoms were found to be mediators of the relationship between specific personality traits, mainly pertaining to the negative affectivity construct, and NSSI/BE.

CONCLUSIONS: Individuals engaging in NSSI-BE behaviours represent a vulnerable adolescent population. ED, depression and anxiety were mediators of the relationship between a variety of personality traits related to BPD and NSSI and binge eating behaviours. Findings have important clinical implications in terms of prevention and interventions among adolescents engaging in self-damaging behaviours.

PMID:33941285 | DOI:10.1186/s40479-021-00154-w

Am J Dent. 2021 Apr;34(2):101-104.

ABSTRACT

PURPOSE: To evaluate and describe the most frequent TMJ degenerative bone alterations on MRI and CT and to determine the accuracy, sensitivity, and specificity of MRI.

METHODS: Images of 80 subjects were selected and evaluated from a database and 57 were selected. The subjects were submitted to CT and MRI exams (each subject on the same day). The joints were evaluated in the sagittal and coronal planes under closed mouth position. Each individual parameter was scored as absent or present. Absolute and relative frequencies were obtained and the Kappa concordance index test and equality of two proportions were used. To correlate the presence of bone alterations, the Chi-Square test was performed. A significance level of 0.05 (5%) was defined, with 95% of statistical confidence interval.

RESULTS: Of the 57 subjects, (47 female, 10 male), the ages ranged from 18-83 years (mean 43 years). The intra and inter-rater agreement tests demonstrated reliability among the examiners for all variables analyzed on MRI and CT.

CLINICAL SIGNIFICANCE: MRI is a reliable and valid method for observing bone changes in the TMJ, with the advantage of non-exposure to radiation and cost-effectiveness due to the use of only one exam.

PMID:33940668

Tuberc Respir Dis (Seoul). 2021 Mar 24. doi: 10.4046/trd.2021.0016. Online ahead of print.

ABSTRACT

BACKGROUND: The Korea National Health and Nutrition Examination Survey (KNHANES) is a well-designed survey to collect national data, which many researchers have used for their studies. In KNHANES, although portable spirometry was used, its reliability has not been verified.

METHODS: We prospectively enrolled 58 participants from four Korean institutions. The participants were classified into normal pattern, obstructive pattern, and restrictive pattern groups according to their previous spirometry results. Lung function was estimated by conventional spirometry and portable spirometry, and the results were compared.

RESULTS: The intraclass correlation coefficients of forced vital capacity (FVC) (coefficient, 9.993; 95% confidence interval [CI], 0.988-0.996), forced expiratory volume in 1 second (FEV1) (coefficient, 0.997; 95% CI, 0.995-0.998), FEV1/FVC ratio (coefficient, 0.995; 95% CI, 0.992-0.997), and forced expiratory flow at 25-75% (FEF25-75%; coefficient, 0.991; 95% CI, 0.984-0.994) were excellent (all p<0.001). In the subgroup analysis, the results of the three parameters were similar in all groups. In the overall and subgroup analyses, Pearson’s correlation of all the parameters was also excellent in the total (coefficient, 0.986-0.994; p<0.001) and subgroup analyses (coefficient, 0.915-0.995; p<0.001). In the paired t-test, FVC, FEV1/FVC, and FEF25-75% estimated by the two instruments were statistically different. However, FEV1 was not significantly different.

CONCLUSION: Lung function estimated by portable spirometry was well-correlated with that estimated by conventional spirometry. Although the values had minimal differences between them, we suggest that the spirometry results from the KNHANES are reliable.

PMID:33940672 | DOI:10.4046/trd.2021.0016

Am J Dent. 2021 Apr;34(2):91-96.

ABSTRACT

PURPOSE: To evaluate and compare the flexural strength of three CAD-CAM glass-ceramic materials and to investigate the effect of various surface treatments on their flexural strength.

METHODS: 120 rectangular specimens were fabricated from three different types of CAD-CAM ceramic blocks and were divided into three groups: zirconia-reinforced lithium silicate (Celtra Duo, Group 1), leucite-reinforced glass-ceramic (IPS Empress CAD, Group 2), and lithium disilicate ceramic (IPS e.max CAD, Group 3). Dimensions of the specimens were standardized to 14.5×12.5 mm and 1.5 mm thickness. Specimens in each group were randomized into four subgroups. The first subgroup (NS) did not undergo any surface treatment; the second subgroup (P) underwent polishing only; the third subgroup (G) underwent glazing only; and the fourth subgroup (PG) underwent both polishing and glazing surface treatments. Biaxial flexural strength (FS) testing was performed until fracture occurred; FS was calculated in MPa. All analyses were performed using SPSS version 24.

RESULTS: Group NS2 showed the lowest FS (89.34 ± 25.30 MPa). Group PG3 showed a significantly higher FS (365.38 ± 52.52 MPa) than Group P3 (268.15 ± 48.34). There was a statistically significant difference among the material groups for each surface treatment: IPS e.max CAD showed the highest FS, which was significantly greater than that of both Celtra Duo and IPS Empress CAD. The combination of polishing and glazing surface treatment resulted in significantly higher flexural strength than polishing alone for all three materials tested. For each material, no significant difference was found between the following surface treatments: control and polishing-only surface treatments; glazing-alone and the combination of polishing and glazing surface treatments. For each surface treatment, Celtra Duo showed significantly lower flexural strength than IPS e.max CAD. However, it displayed higher flexural strength than IPS Empress CAD, although the difference was only significant for glazing and the combination of polishing and glazing.

CLINICAL SIGNIFICANCE: This study provides the clinician with an estimate of the flexural strength of glass-ceramic materials and shows how various surface treatments affect their strength.

PMID:33940666

Am J Perinatol. 2021 May 3. doi: 10.1055/s-0041-1728826. Online ahead of print.

ABSTRACT

OBJECTIVE: Postpartum hypertension (PP-HTN), defined as systolic/diastolic blood pressure (SBP/DBP) ≥140/90, on two occasions at least 4 hours apart after delivery occurs in up to 50% of preeclamptic pregnancies, and is associated with adverse maternal outcomes. Excessive production of antiangiogenic factors (i.e., soluble fms-like tyrosine kinase 1 [sFLT1]) and reduced levels of proangiogenic factors (i.e., placental growth factor [PlGF]) are associated with preeclamptic pregnancies. The aim of this study was to identify clinical risk factors and/or serum biomarkers associated with PP-HTN in preeclampsia.

STUDY DESIGN: Preeclamptic women (n = 82, aged ≥18 years) were prospectively enrolled in an observational study. Serial blood pressures were obtained through the labor course and until 48 hours postpartum, and serum was obtained within 24 hours postpartum. Statistical analysis was performed by using Student’s two-tailed t-test and Fisher’s exact test.

RESULTS: Baseline comorbidities and antihypertensive use were similar among those who developed PP-HTN and those who did not. Among preeclamptic patients, 33% developed PP-HTN; these had significantly more severe preeclampsia features versus no PP-HTN (96 vs. 78%, p = 0.05). PP-HTN was associated with higher re-hospitalization rates (26 vs. 6%, p = 0.01). Among those taking low-dose aspirin (ASA) for preeclampsia prophylaxis (n = 12), PP-HTN was significantly less frequent versus those not taking low-dose ASA (0 vs. 22%, p = 0.007). Low-dose ASA use was associated with significantly lower peripartum sFLT1 levels (4,650 ± 2,335 vs. 7,870 ± 6,282 pg/mL, p = 0.03) and sFLT1/PlGF ratio (397 ± 196 vs. 1,527 ± 2,668, p = 0.03).

CONCLUSION: One-third of women with preeclampsia develop PP-HTN; these patients have more severe preeclampsia and have higher re-hospitalization rates. Prenatal low-dose ASA use was associated with significantly lower incidence of PP-HTN, reduced levels of antiangiogenic factors, and lower 6-week re-hospitalization rates. These findings, if replicated, may have clinical implications on the use of low-dose ASA during pregnancy to reduce incidence of postpartum HTN.

KEY POINTS: · Postpartum hypertension is common in preeclampsia.. · Prenatal aspirin may reduce postpartum hypertension.. · Prenatal aspirin may reduce sFLT1 levels..

PMID:33940641 | DOI:10.1055/s-0041-1728826