Nevin Manimala

Int J Dermatol. 2021 May 20. doi: 10.1111/ijd.15628. Online ahead of print.

ABSTRACT

BACKGROUND: Drug survival is useful to evaluate long-term drug performance in daily practice. The aim of this study was to evaluate drug survival for methotrexate (MTX) monotherapy in patients with plaque-type psoriasis.

METHODS: We reviewed 3,512 follow-up charts of patients with psoriasis at five tertiary referral centers between January 2012 and January 2020. We analyzed baseline data and treatment outcomes of patients under MTX monotherapy. Drug survival was analyzed using Kaplan-Meier and Cox regression analyses.

RESULTS: Patients with psoriasis who were treated with MTX monotherapy were enrolled (N = 649). The median duration of drug survival was 15 months (95% CI: 13.2-16.8). The overall drug survival rate was 54.7%, 17.4%, and 8% after 1, 3, and 5 years, respectively. The main reasons for discontinuation were adverse effects (n = 209, 32.2%) and inefficacy (n = 105, 15.6%). Based on multivariate Cox regression analysis, the presence of nausea/vomiting (HR: 2.01, 95% CI: 1.49-2.71; P < 0.001) was observed as a statistically significant risk factor for drug discontinuation. Age over 50 years (HR: 0.68, 95% CI: 0.48-0.97; P = 0.03) and using MTX dose ≥15 mg/weekly were positive predictors for drug survival (HR: 0.72, 95% CI: 0.54-0.95; P = 0.02).

CONCLUSIONS: The average drug survival of MTX was 15 months. MTX is still the first-line treatment of moderate-to-severe plaque psoriasis, as highlighted in guidelines. To prevent premature discontinuation, physicians need to look at the response time of at least 16-24 weeks, especially when a stepwise dose increment is used. The presence of nausea/vomiting seemed to be associated with an approximately twofold risk of discontinuation.

PMID:34013975 | DOI:10.1111/ijd.15628

J Pediatric Infect Dis Soc. 2021 May 20:piab010. doi: 10.1093/jpids/piab010. Online ahead of print.

ABSTRACT

BACKGROUND: The Zika virus (ZIKV) epidemic had devastating consequences in Brazil. We investigated whether a radiologic finding (ie, infratentorial abnormalities) was associated with sight-threatening defects in children born with congenital Zika syndrome (CZS). We also investigated whether ophthalmic abnormalities correlated with head circumference (HC) and gestational age of infection.

METHODS: Cross-sectional evaluation based upon a previous cohort from March 2016 to December 2018, in Paraíba, Brazil. The study population was comprised of children born to mothers with laboratory-confirmed ZIKV infection during pregnancy (ZIKV reverse transcriptase polymerase chain reaction [RT-PCR]+) and children born with clinical and radiologic features of CZS.

RESULTS: A total of 75 infants had complete data. All 75 had brain calcifications. Microcephaly was present in 53 (71%) of them. Infratentorial abnormalities were present in 17 infants (22.7%). Ophthalmic abnormalities were seen in 16 of the 17 children (94%) with infratentorial abnormalities, while 28% of children without infratentorial abnormalities had ophthalmic findings (odds ratio [OR]: 42.0; 95% confidence interval [CI]: 5.1-342.9). Similar associations were observed when macular chorioretinal atrophy and optic nerve abnormalities were analyzed individually (OR: 23.7; 95% CI: 6.0-93.3 and OR: 11.5; 95% CI: 3.3-40.0, respectively). Infratentorial abnormalities were more frequently associated with ophthalmic abnormalities (94%) than microcephaly (43.4%) (P < .001). Mean HC was statistically different between groups with and without ophthalmic abnormalities (P = .01). A statistically significant difference in gestational age between both groups was not noted (P = .12).

CONCLUSIONS: In children with CZS, the presence of infratentorial abnormalities is a significant predictor of ophthalmic abnormalities. All neonates whose mothers had ZIKV exposure during pregnancy should have an ophthalmologic examination.

PMID:34013960 | DOI:10.1093/jpids/piab010

Leuk Lymphoma. 2021 May 20:1-7. doi: 10.1080/10428194.2021.1929962. Online ahead of print.

ABSTRACT

There are only a few predictive markers that can truly aid therapy decisions in patients with acute myeloid leukemia (AML). The current study aimed to examine the impact of easily available common laboratory parameters on the course and prognosis of patients with AML. Gender, initial bone marrow blast percentage, mean platelet volume (MPV), lymphocyte-to-monocyte ratio, treatment regimen, and complete remission (CR1) were found to have a statistically significant effect on both OS and PFS (p < 0.05). Only MPV, LDH, and initial treatment regimen were found to have a significant effect on CR1 achievement (p < 0.05). According to the current study, besides the induction regimen, only MPV was seen to affect short and long-term outcomes including both CR achievement, OS and PFS. MPV can be considered as a predictive or prognostic marker in patients with AML. Patients with higher MPV at the time of diagnosis should be evaluated carefully.

PMID:34013848 | DOI:10.1080/10428194.2021.1929962

Int J Hyperthermia. 2021;38(1):781-785. doi: 10.1080/02656736.2021.1926561.

ABSTRACT

OBJECTIVE: To compare the efficacy and safety of the treatment of vulvar lichen simplex chronicus (VLSC) using high-intensity focused ultrasound (HIFU) at different powers.

METHODS: This retrospective study included 152 patients with VLSC. Among these patients, 70 were treated with HIFU at low power (level 2), and 82 were treated at normal power (level 3). The treatment responses, recurrence rates and intra- and postoperative complications were all compared.

RESULTS: No statistically significant differences were found between the two groups in age, disease course, menopause status, lesion size and severity of symptoms. All patients received one session of HIFU therapy, and the treatment process was successful. No difference was found in the total response rate between the two groups at 1 (85.7% versus 87.8%, p = .35), 6 (80% versus 80.5%, p = .65) and 12 (80% versus 80.5%, p = .73) months after HIFU therapy. No significant difference was observed in the recurrence rate between the two groups at 6 (5.7% versus 9.8%, p = .36) and 12 (22.9% versus 26.8%, p = .57) months after HIFU treatment. Patients in the low-power group had a lower incidence of blisters (10% versus 23.3%, p = .04).

CONCLUSION: Based on our results, low-power HIFU treatment can achieve a therapeutic effect similar to normal power HFU treatment for VLSC, but its incidence of side effects is lower.

PMID:34013843 | DOI:10.1080/02656736.2021.1926561

Lupus. 2021 May 20:9612033211016074. doi: 10.1177/09612033211016074. Online ahead of print.

ABSTRACT

BACKGROUND: Systemic lupus erythematosus (SLE) increases the incidence of adverse pregnancy outcomes (APOs). Nevertheless, most of the data on SLE pregnancies were derived from database studies in which details of the pregnancies were unavailable, and no consensus exists on the risk of APO in patients with prior severe organ manifestations.

METHODS: SLE patients followed by rheumatologists and gynecologists throughout pregnancy at our institute were retrospectively identified, and their data between April 2003 and December 2020 were reviewed from electronic records. We assigned patients based on the presence of prior severe organ manifestation (renal/neurological manifestation, prior treatment with methylprednisolone pulse therapy/prednisolone 1 mg/kg/day/biological or cytotoxic therapy) and compared the incidence of overall and serious APO (maternal death, pregnancy loss, preterm birth <32 weeks, birthweight <1500 g, Apgar score <7 at 5 min and birth defect).

RESULTS: This study included 34 pregnancies in 32 patients; 23 pregnancies in 22 patients were classified as SLE with prior severe organ manifestation. There was no statistical difference in the incidence of overall APO between the two groups (52.2% vs 45.5%, P = 1). Among patients with prior severe organ manifestation, 17.4% had serious APO. A detailed electronic health record search revealed specific causes of APO in all pregnancies with serious APO, except the presence of prior severe organ manifestation.

CONCLUSION: The incidence of overall APO in SLE patients was not affected by prior severe organ manifestation. Although the incidence of serious APOs increased in patients with previous severe organ manifestation, there were other risk factors for poor pregnancy outcomes besides prior lupus severity. Therefore, proper management by rheumatologists and gynecologists may enable patients with prior severe organ manifestation to safely deliver healthy babies.

PMID:34013819 | DOI:10.1177/09612033211016074

J Feline Med Surg. 2021 May 20:1098612X211013745. doi: 10.1177/1098612X211013745. Online ahead of print.

ABSTRACT

OBJECTIVES: Bisphenol A (BPA) is one of the most widely used synthetic compounds on the planet. It is used in the synthesis of polycarbonate plastics, epoxy resins and other polymer materials. Owing to its excellent chemical and physical properties, it is used to produce food and beverage containers or the linings for metal products. BPA has been mentioned as a possible cause of feline hyperthyroidism. Cat food is considered one of the main sources of BPA intake. The purpose of this study was to evaluate BPA concentration in various types of commercial cat food available in the Czech Republic.

METHODS: In total, 172 samples prepared from 86 different types of commercial cat food were assessed. The concentration of BPA was measured using liquid chromatography-tandem mass spectrometry.

RESULTS: Measurable concentration of BPA was found in all samples (range 0.065-131 ng/g), with the highest concentration (mean ± SD) of BPA in canned food (24.6 ± 34.8 ng/g). When comparing BPA concentration in food trays (1.58 ± 0.974 ng/g), pouches (0.591 ± 0.592 ng/g) and dry food (1.18 ± 0.518 ng/g), concentrations of BPA in food trays and dry food were significantly higher (P <0.01) compared with pouches. Comparing BPA concentrations in canned food of different manufacturers, statistically significant differences were found as well.

CONCLUSIONS AND RELEVANCE: The highest concentrations of BPA were found in cans. Thus, cans represent the highest possibility of exposure to BPA in comparison with other types of commercial feline food.

PMID:34013813 | DOI:10.1177/1098612X211013745

Curr Eye Res. 2021 May 20. doi: 10.1080/02713683.2021.1933056. Online ahead of print.

ABSTRACT

PURPOSE: To analyze the accuracy of 18 intraocular lens (IOL) power calculation formulas in eyes with axial length (AL) ≤ 22 mm.

METHODS: We analyzed 241 eyes of 241 patients. Eighteen formulas were evaluated: Barrett Universal II (BUII), EVO 2.0, Haigis, Hoffer Q, Holladay 1 and 2, Cooke K6, Kane, LadasSuperFormula AI, Naeser 2, Olsen, Panacea, Pearl-DGS, RBF 2.0, SRK/T, T2, VRF and VRF-G. Optical biometry was performed with an IOLMaster 700 (Carl Zeiss Meditec, Jena, Germany). With lens constants optimized for the whole range of AL, the mean prediction error (PE) and its standard deviation (SD), the median absolute error (MedAE), the mean absolute error (MAE) and the percentage of eyes with PEs within ±0.25 D, ±0.50 D and <±1.00 D were calculated.

RESULTS: Post-hoc analysis of the absolute PE revealed statistically significant differences (P < 0.05) between some of the newer formulas (K6, Kane, Naeser 2, Olsen and VRF-G), which obtained the lowest MedAE (respectively 0.308, 0.300, 0.277, 0.310 and 0.276 D) and the remaining ones. These formulas yielded also the highest percentage of eyes with a PE within ±0.50 D (70.54%, 72.20%, 71.37%, 70.95% and 73.03%, respectively), whereas Panacea and SRK/T yielded the lowest percentage (62.24%), with a stastically significant difference (P < 0.05) with respect to most formulas.

CONCLUSION: In eyes with AL ≤22.0 mm, new formulas (K6, Kane, Naeser 2, Olsen and VRF-G) offer the most accurate predictions of postoperative refraction.

PMID:34013799 | DOI:10.1080/02713683.2021.1933056

Am J Mens Health. 2021 May-Jun;15(3):15579883211007277. doi: 10.1177/15579883211007277.

ABSTRACT

The objective of this study is to investigate the association between periodontitis (PD) and erectile dysfunction (ED).A systematic review and meta-analysis on data was extracted and conducted according to PRISMA. Relevant articles were selected from a literature search using MEDLINE, EMBASE, Scopus, Web of Science and CENTRAL from inception until August 2, 2020. Both randomized and nonrandomized controlled studies were included. Case reports, case series, nonsystematic reviews and trials published as abstract were excluded. Odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were used to estimate the association between PD and the risk of ED. The meta-analysis was conducted with RevMan 5.3. Methodological quality assessment was carried out using the Newcastle-Ottawa Quality Assessment Scale and the quality of evidence was assessed using the GRADE approach.Six articles (215008 subjects) were included for analysis. Of the participants, 38,675 cases were compared to 1,76,333 healthy controls. Based on the random effects model, periodontitis was associated with an increased risk of ED (OR = 2.56, 95% CI: 1.70-3.85) as compared with the non-periodontitis individuals. The findings were statistically significant with a p < .0001. The statistical heterogeneity was high across all studies (I² = 98%, p < .00001). Estimates of total effects were generally consistent with the sensitivity and subgroup analyses.Within the limits of the available evidence, our review and meta-analysis showed that a significant association exists between the PD and ED. The results should be interpreted with caution due to high degree of inconsistency across all the studies.

PMID:34013796 | DOI:10.1177/15579883211007277

J Hand Surg Eur Vol. 2021 May 20:17531934211016668. doi: 10.1177/17531934211016668. Online ahead of print.

ABSTRACT

The incidence of distal radioulnar joint instability following a distal radius fracture is estimated around one in three based upon clinical examination. Using a validated rig, we objectively measured distal radioulnar joint translation in vivo following distal radius fracture. Dorsopalmar translation of the distal radioulnar joint was measured in 50 adults with previous distal radius fractures. Measurements were compared with the uninjured wrist and against a database of previous measurements within healthy and clinically lax populations. Translation at the distal radioulnar joint was greater in injured wrists at 12.2 mm (range 10-15, SD 1.2) than the uninjured wrists at 6.4 (range 4-9, SD 0.8) (p < 0.001) and was always outside the established normal range. There was no statistically significant link between translation and the severity of the injury. Instability appears almost inevitable following a distal radius (wrist) fracture, albeit subclinical in the vast majority.

PMID:34013791 | DOI:10.1177/17531934211016668

Asia Pac J Public Health. 2021 May 20:10105395211014642. doi: 10.1177/10105395211014642. Online ahead of print.

ABSTRACT

This review aimed to investigate national estimates of sugar-sweetened beverage (SSB) consumption in children and adolescents aged 2 to 18 years, from countries in regions particularly burdened by dietary-related chronic illnesses. The most recent studies or reports from included countries (n = 73) with national-level consumption data of SSBs in children and adolescents, collected between January 2010 and October 2019, were considered for inclusion. A random effects meta-analysis was used to calculate pooled estimates of the mean consumption of SSB in millimeters per day. Heterogeneity between national estimates was assessed using the I² statistic and explored via subgroup analyses by the World Health Organization region, age groups, and country-level income. Forty-eight studies were included in the review reporting national estimates of consumption for 51 countries. The highest estimate of daily consumption was in China at 710.0 mL (95% confidence interval [CI] = 698.8-721.2), while the lowest was in Australia at 115.1 mL (95% CI = 111.2-119.1). Pooled synthesis of daily SSB consumption of the 51 countries was 326.0 mL (95% CI = 288.3-363.8), although heterogeneity was high, and was not explained by subgroup analyses. While there is considerable variability between countries, intake of SSB remains high among children and adolescents internationally underscoring the need for public health efforts to reduce SSBs consumption.

PMID:34013784 | DOI:10.1177/10105395211014642