Nevin Manimala

Int J Paleopathol. 2021 May 4;33:170-181. doi: 10.1016/j.ijpp.2021.04.007. Online ahead of print.

ABSTRACT

OBJECTIVE: To estimate the prevalence rate of gout and to explore the social factors that contributed to its development in the various sub-populations in medieval Cambridge.

MATERIALS: 177 adult individuals from four medieval cemeteries located in and around Cambridge, UK.

METHODS: Lesions were assessed macroscopically and radiographically. Elements with lytic lesions were described and imaged using micro-computed tomography (μCT) to determine their morphology.

RESULTS: Gout was identified in 3 % of the population. Individuals buried in the friary had highest prevalence (14 %), with low prevalence rates in the Hospital (3 %) and town parish cemetery (2 %), with no cases in the rural parish cemetery. Gout was more prevalent during the 14th-15th centuries than the 10th-13th centuries.

CONCLUSION: The high prevalence rate of gout in the friary is at least partly explained by the consumption of alcohol and purine-rich diets by the friars and the wealthy townsfolk. Medieval medical texts from Cambridge show that gout (known as podagra) was sometimes treated with medications made from the root of the autumn crocus. This root contains colchicine, which is a medicine that is still used to treat gout today.

SIGNIFICANCE: This is one of the first studies to assess the epidemiology of gout in medieval England and suggests that gout varied with social status.

LIMITATIONS: Our sample size precludes statistical analysis.

SUGGESTIONS FOR FURTHER RESEARCH: Additional studies that assess the epidemiology of gout in medieval Europe is needed in order to be able to fully contextualize these findings.

PMID:33962231 | DOI:10.1016/j.ijpp.2021.04.007

Clin Imaging. 2021 Mar 31;78:187-193. doi: 10.1016/j.clinimag.2021.03.027. Online ahead of print.

ABSTRACT

OBJECTIVE: A recent study described the relationship between cerebral venous diameter and white matter hyperintensity (WMH) volume. However, the adults were not further grouped; therefore, we aimed to compare across age groups and use susceptibility-weighted imaging (SWI) to explore whether there is also a relationship between a larger cerebral draining venous diameter and age, which could provide evidence of a temporal relationship.

METHODS: We retrospectively analysed data collected from 405 subjects (90 youths, 166 middle-aged participants, and 149 elderly subjects) and respectively used T2-weighted fluid-attenuated inversion recovery (FLAIR) and SWI to assess WMHs and venous diameter.

RESULTS: An increased internal cerebral vein (ICV) diameter was associated with age in different WMH groups (F = 3.453, 10.437, 11.746, and 21.723, respectively, all p < 0.001; multiple comparisons all p < 0.05), whereas the effect of the anterior septal vein (ASV) was opposite (F = 1.046, 1.210, 0.530, and 0.078, respectively, p > 0.05). There was a positive correlation between the ICV diameter and age with increasing WMH severity (R = 0.727, 0.709, 0.754, and 0.830, respectively, all p < 0.001). A statistically significant relationship between the thalamostriate vein (TSV) diameter and age was observed only in the moderate and severe WMH groups (F = 4.070 and 3.427, respectively, all p < 0.05; multiple comparisons all p < 0.05).

CONCLUSIONS: Our study demonstrates that increased TSV and ICV diameters are associated with age with increasing WMH severity, especially the ICV diameter using SWI.

PMID:33962184 | DOI:10.1016/j.clinimag.2021.03.027

Clin Neurol Neurosurg. 2021 Apr 20;205:106644. doi: 10.1016/j.clineuro.2021.106644. Online ahead of print.

ABSTRACT

BACKGROUND: The efficacy of laser interstitial thermal therapy (LITT) in mesial temporal lobe epilepsy (MTLE) has not been clearly established yet.

OBJECTIVE: We conducted a meta-analysis to estimate the efficacy of LITT for TLE (Q1). We also examined the effect of the patient’s age (Q2), the total ablation volume (TAV) (Q3), the strength of the MRI unit (Q4), the type of the utilized stereotactic platform (Q5), and the follow up period (Q6) on the patient’s outcome.

METHODS: Fixed- and random-effects model meta-analysis was conducted to assess the proportion estimate for each parameter individually. Kaplan-Meier survival-analysis was performed on the available individual patient time-to-first seizure data.

RESULTS: Sixteen studies with 575 patients fulfilled our eligibility criteria. The efficacy of LITT was 0.547 (95%CI: 0.506-0.588). Our statistical analysis had robust results after stratification according to the study population (Q2; p = 0.3418), and the type of the utilized stereotactic platform (Q5; p = 0.286), whereas the role of the TAV (Q3; p = 0.058) and strength of the magnetic field (Q4; p = 0.062) in seizure control remained unclear. The median seizure-free period (Q6) was 0.643 (0.569-0.726) and 0.467 (0.385-0.566) for the one- and the two-year follow up.

CONCLUSIONS: LITT seems to offer a viable alternative to resective surgery, with a moderate efficacy and enduring results. Higher ablation volumes may be associated with improved seizure control, although our current study provided no statistically significant data. More high-quality studies are required to highlight the role of LITT in epilepsy surgery, particularly in the pediatric population.

PMID:33962146 | DOI:10.1016/j.clineuro.2021.106644

J Anxiety Disord. 2021 May 3;81:102415. doi: 10.1016/j.janxdis.2021.102415. Online ahead of print.

ABSTRACT

Since the outbreak of the coronavirus disease (COVID-19), several reports have shown that fear relating to COVID-19 has sharply increased. To measure fear of COVID-19, various questionnaires have been developed in parallel. However, fear concerning COVID-19 is not necessarily a uniform construct and the different questionnaires may cover diverse aspects. To examine the underlying structure of fear of COVID-19, we conducted structural equation modelling and network analyses on four scales in an online convenience sample (N = 829). Particularly, the Fear of COVID-19 Scale (Ahorsu et al., 2020), the Fear of the Coronavirus Questionnaire (Mertens et al., 2020), and the COVID Stress Scales (Taylor, Landry, Paluszek, Fergus et al., 2020, Taylor, Landry, Paluszek, Rachor et al., 2020) were included in our study, along with a new scale that also assessed socio-economic worries relating to COVID-19. We found that fear of COVID-19 was best classified into four clusters: Fear of health-related consequences, fear of supplies shortages and xenophobia, fear about socio-economic consequences, and symptoms of fear (e.g., compulsions, nightmares). We also find that a central cluster of items centered on fear of health, which likely represents the core of fear of COVID-19. These results help to characterize fear due to COVID-19 and inform future research.

PMID:33962142 | DOI:10.1016/j.janxdis.2021.102415

Intern Med J. 2021 May 7. doi: 10.1111/imj.15340. Online ahead of print.

ABSTRACT

BACKGROUND: Due to the COVID-19 pandemic, telephone clinics have been utilised to reduce the risk of transmission. Evidence supporting its quality and safety is required.

AIMS: Assess the efficacy and safety of telephone clinics in delivering care to established oncology patients and assess patient and health professionals’ preference (telephone vs face-to-face clinics).

METHODS: Retrospective chart audit in the month preceding and month following introduction of telephone clinics at the Gold Coast University hospital and a patient and health professional questionnaire.

RESULTS: In total, 1212 clinical encounters occurred in the month post the introduction of telephone clinics (vs 1208 encounters prior). There were no statistically significant differences in 24-h (18 vs 22, p = 0.531) or 7-day admissions (50 vs 46, p = 0.665) comparing encounters in the month prior to the introduction of telephone clinics vs the month post, but there was a statistically significant difference in 30-day mortality post systemic therapy in favour of the post-telephone clinic period (7 vs 0 patients, p = 0.008). Of the 222 patients who undertook the questionnaire, 42.3% preferred telephone clinics (95% CI 35.97-48.97), 25.2% preferred face-to-face clinics (95% CI 19.92-31.39) and 32.4% did not prefer one method over another. Of the 24 health professionals who undertook the questionnaire, 70.8% felt patients preferred phone clinics.

CONCLUSIONS: Generally, patients and clinicians viewed telephone clinics favourably. Nevertheless, a large portion of patients still prefer face-to-face clinics. Services should be tailored to individual preferences. Although there were no ‘red flags’ in terms of mortality or admission rates, further longitudinal research is required. This article is protected by copyright. All rights reserved.

PMID:33961726 | DOI:10.1111/imj.15340

Int J Cancer. 2021 May 7. doi: 10.1002/ijc.33674. Online ahead of print.

ABSTRACT

Ewing Sarcoma (ES) is the second most common primary bone tumor in children and adolescents. There are few known epidemiological or genetic risk factors for ES. Numerous reports describe incidence rates and trends within the United States, but international comparisons are sparse. We used the Cancer Incidence in Five Continents (CI5) data to estimate age standardized incidence rates (ASRs; cases per million) and 95% confidence intervals (95% CI), male-to-female incidence rate ratios (IRR; 95% CI), and the average annual percent change in incidence (AAPC; 95% CI) for ES by geographic region for children and adults aged 0-49 years. We also estimated the ASR for each country or country subpopulation among the 10-19-year-old age range; capturing the peak incidence of ES. In total, 15 874 ES cases ages 0-49 were reported in the CI5 series between 1988 and 2012. AAPC estimates varied by age group and geographic region. Most of the statistically significant AAPCs showed an increased incidence over time; the only statistically significant decreases in incidence were observed among 20-29-year-olds and 30-39-year-olds in Southern Asia at -1.93 and – 1.67%. When categorized by predominant ancestry, we observed countries and subpopulations with predominately African, East Asian, and South-east Asian ancestry had the lowest incidence rates, whereas Pacific Islanders and populations with predominantly European and North African/Middle Eastern ancestry had the highest. An excess incidence in males was observed in most regions. Our results highlight substantial variation in ES incidence across geographic populations, reflecting potential ancestral influence on disease risk.

PMID:33961701 | DOI:10.1002/ijc.33674

J Surg Oncol. 2021 May 7. doi: 10.1002/jso.26520. Online ahead of print.

ABSTRACT

BACKGROUND: In the management of peritoneal metastases from colon and rectal cancer, the most favorable results are reported with an aggressive combined treatment on patients who have a small extent of the disease. A test to detect occult peritoneal metastases would greatly facilitate the management of this component of colorectal dissemination.

METHODS: Currently, the standard test by which to confirm the diagnosis of the peritoneal spread of colorectal cancer is peritoneal cytology. To study the utility of this test, we gathered information from patients with biopsy-proven peritoneal metastases. The clinical, histologic, and treatment-related features of these patients at the time of a cytoreductive surgery were statistically correlated with the results of the peritoneal cytology test.

RESULTS: Forty-nine patients with colorectal cancer peritoneal metastases and a peritoneal cytology determination at the time of a cytoreductive surgery were available for analysis. Twenty-eight patients (55.1%) had a positive test. Patients with a high peritoneal cancer index and mucinous histology were most likely to have positive peritoneal cytology.

CONCLUSION: Peritoneal cytology identified patients with mucinous histology and a large extent of disease but was consistently negative in patients who had a small extent of disease compatible with a favorable response to treatment.

PMID:33961696 | DOI:10.1002/jso.26520

PLoS One. 2021 May 7;16(5):e0251260. doi: 10.1371/journal.pone.0251260. eCollection 2021.

ABSTRACT

INTRODUCTION: Work-life conflicts (WLC) may impact health, but few studies prospectively consider the impact of WLC on objective outcomes such as cardiovascular disease. Using data from the Gutenberg Health Study (GHS), we examined if WLC at baseline was associated with an increased five-year incidence of cardiovascular events (myocardial infarct, stroke, atrial fibrillation, peripheral artery disease, coronary artery disease, chronic heart failure, sudden cardiac death). We also considered if WLC was associated with incident hypertension and arterial stiffness and if the effects of WLC on cardiovascular health differ for men and women.

METHODS: A working subsample of the 15,010 GHS cohort participants completed the Copenhagen Psychosocial Questionnaire, which included five “work-privacy conflict” questions at baseline and at the five-year follow-up. Relative risks for incident hypertension due to increased WLC at baseline (WLC scores exceeding 60 out of 100) were estimated with Poisson regression in the subgroup of participants without hypertension at baseline (n = 2426). Categories of WLC at baseline and follow-up were also used to examine the risk of hypertension due to chronic/recurrent WLC. In this subgroup, we also examined the association between WLC as a continuous score ranging from 0 to 100 with change to arterial stiffness after five years using linear regression. Hazard ratios were estimated for incident cardiovascular events in a larger subsample of participants without prevalent cardiovascular disease at baseline (n = 3698) using Cox regression. We used various multivariable regression models to adjust for sex, age, socioeconomic status, occupational, household, and cardiovascular risk factors.

RESULTS: We found no association between WLC and incident hypertension or increased arterial stiffness. The fully-adjusted relative risk for WLC >60 at baseline and hypertension was 0.93 (95% 0.74-1.17). The risk of hypertension due to chronic/recurrent WLC >60 was increased but not statistically significant (RR = 1.13, 95% CI 0.83-1.54). Overall, hazard ratios for incident cardiovascular events were also not increased. However, stratifying the results by sex resulted in a hazard ratio of 1.47 (95% CI 0.54-3.98) for incident cardiovascular disease among women in the fully adjusted model.

CONCLUSIONS: Although our results were not statistically significant, they indicate that WLC is negatively impacting the cardiovascular health of women. While these results need to be confirmed with additional research and a longer follow-up, interventions to prevent WLC will promote health and could be especially beneficial for women.

PMID:33961688 | DOI:10.1371/journal.pone.0251260

PLoS One. 2021 May 7;16(5):e0251360. doi: 10.1371/journal.pone.0251360. eCollection 2021.

ABSTRACT

Changes in phenological events have been vastly documented in face of recent global climate change. These studies are concentrated on temperate plants, and the responses of tropical species are still little understood, likely due to the lack of long-term phenological records in the tropics. In this case, the use of herbarium specimens to gather phenological data over long periods and wide geographic areas has emerged as a powerful tool. Here, we used four Melastomataceae species endemic to the Brazilian Atlantic Forest to evaluate phenological patterns and alterations as responses to recent climate changes. Phenological data were gathered from Reflora Virtual Herbarium specimens collected between 1920 and 2018, and analyzed with circular statistics applied to the intervals 1920-1979, 1980-1999, and 2000-2018. The effects of temperature range, average temperature, precipitation, and photoperiod on flowering and fruiting of each species were tested using multiple linear regressions. Through circular statistics, we detected changes, mostly delays, in the flowering of Miconia quinquedentata, Pleroma clavatum and P. trichopodum, and in the fruiting of M. acutiflora, P. clavatum and P. trichopodum. We also found that flowering and fruiting occurrence were related to local climatic conditions from months prior to the collections. We found marked phenological variations over the decades and also that these variations are associated to global climate change, adding up to the large body of evidence from higher latitudes. Our results also support herbarium collections as an important source for long-term tropical phenological studies. The lack of consistent patterns of responses among the four species (e.g. fruiting delayed two months in P. clavatum and advanced one month in M. acutiflora) suggests that climate change has unequal effects across tropical forests. This highlights the urgent need for further research to understand and forecast the ecological implications of these changes in global ecosystems processes.

PMID:33961684 | DOI:10.1371/journal.pone.0251360