Nevin Manimala

Orv Hetil. 2024 May 12;165(19):742-746. doi: 10.1556/650.2024.33056. Print 2024 May 12.

ABSTRACT

Bevezetés: A felnőtt-, illetve a gyermekkori appendicitis kezelése kapcsán számos irodalmi adat áll rendelkezésre mind a nyitott, mind a laparoszkópos appendectomia előnyeiről és hátrányairól. Célkitűzés: Egy országos centrumban kívántuk vizsgálni a gyermekkorban végzett laparoszkópos és nyitott appendectomiák eredményeit. Módszer: Retrospektív, megfigyelésen alapuló kohorszvizsgálatot végeztünk a 2011 és 2020 között nyitott vagy laparoszkópos appendectomián átesett 0–18 éves gyermekek körében. A társbetegséggel bíró betegeket kizártuk a vizsgálatból. A betegeket nyitott (idesoroltuk a konvertált műtéteket is) és laparoszkópos appendectomia szerint csoportosítottuk, illetve a szövettani eredményeik alapján „nem komplikált” (negatív, simplex, catarrhalis, phlegmonosus, gangraenás) és „komplikált” (perforált) appendicitis-alcsoportokat állítottunk fel. A posztoperatív szövődményeket (sebgyógyulási zavar, ileus, intraabdominalis abscessus) és a kórházi ápolási időt vizsgáltuk. A statisztikai analízisekhez Fisher -féle egzakt, khi2- (chi2 test for trend) és Mann–Whitney-féle U-tesztet használtunk. Eredmények: A vizsgálatba 1444 beteget vontunk be (nyitott: 842, laparoszkópos: 602), a mediánéletkor 10,93 (SD 3,49) év volt. Szövődményeket számottevően inkább nyitott műtétek után (83/842, 9,86%), kevésbé a laparoszkópos megoldás után (45/602, 7,48%) észleltünk (p = 0,1163). A kórházi tartózkodás mediánértéke nyitott műtétek után 3 (2,4) nap, laparoszkópia esetén 4 (3,5) nap volt (p<0,0001). A nem komplikált eseteknél a medián ápolási idő laparoszkópia után rövidebb: 3 (2,3) nap, míg nyitott műtétet követően hosszabb: 3 (3,5) nap volt (p<0,0001). Komplikált esetek mellett a kórházi tartózkodás mediánideje laparoszkópia után 8 (6, 10), nyitott műtét után 8 (7, 10) napnak adódott (p = 0,0202). Megbeszélés: A laparoszkópia eleinte a nőgyógyászatban, majd a sebészetben és csak ezek után a gyermeksebészetben is a napi rutin része lett. Következtetés: Mind a nyitott, mind a laparoszkópos appendectomia biztonságos beavatkozás gyermekkorban. A két módszer között nem észleltünk különbséget a szövődmények tekintetében, de laparoszkópos beavatkozás után szignifikánsan rövidebbnek találtuk a kórházi ápolási időt. A gyermekkori nem komplikált (korai stádiumban felismert) appendicitisek műtéti kezelésében a rövidebb kórházi tartózkodás miatt a laparoszkópos appendectomia a választandó módszer. Orv Hetil. 2024; 165(19): 742–746.

PMID:38735030 | DOI:10.1556/650.2024.33056

Surg Radiol Anat. 2024 May 12. doi: 10.1007/s00276-024-03345-6. Online ahead of print.

ABSTRACT

BACKGROUND: No studies have been conducted to define the lengths of the upper airway’s different segments in normal healthy adults.

AIMS/OBJECTIVES: This study aimed to determine the length of the subglottis and extrathoracic trachea and the factors affecting it.

MATERIAL AND METHODS: This was an observational retrospective review study. Included 102 adult patients who underwent CT scan during the quiet inspiration phase of the upper airway.

RESULTS: The results revealed significant positive linear relationships between height and both anterior and posterior subglottic measurements (p < 0.001). Additionally, a statistically significant, moderately strong negative correlation between age and extrathoracic tracheal measurements (p > 0.001) was observed. Men exhibited longer anterior (p < 0.001) and posterior (p > 0.001) subglottic measurements. In both sexes, the average length of the anterior subglottis was 14.16 (standard deviation [SD]: 2.72) mm, posterior subglottis was 14.51 (SD: 2.85) mm and extrathoracic trachea was 66.37 (SD: 13.71) mm.

CONCLUSION AND SIGNIFICANCE: We concluded that a normal healthy adult’s anterior subglottis length is 6.3-19.3 mm (mean: 14.16 [SD: 2.72] mm), posterior subglottis length is 6.1-20.0 mm (mean: 14.51 [SD: 2.85] mm) and extrathoracic trachea length is 25.2-98.5 mm (mean: 66.37 [SD: 13.71] mm). Age, height and sex affected the upper airway length.

PMID:38735016 | DOI:10.1007/s00276-024-03345-6

Discov Oncol. 2024 May 12;15(1):159. doi: 10.1007/s12672-024-01019-8.

ABSTRACT

BACKGROUND AND AIMS: Chemotherapy resistance in colorectal cancer have been faced with significant challenges in recent years. Particular interest is directed to tumor microenvironment function. Recent work has, identified a small molecule named Divertin that prevents myosin light chain kinase 1(MLCK1) recruitment to the perijunctional actomyosin ring(PAMR), restores barrier function after tumor necrosis factor(TNF)-induced barrier loss and prevents disease progression in experimental inflammatory bowel disease. Studies have shown that MLCK is a potential target for affecting intestinal barrier function, as well as for tumor therapy. However, the relative contributions of MLCK expression and chemotherapy resistance in colorectal cancers have not been defined.

METHODS: Statistical analysis of MYLK gene expression differences in colorectal cancer patients and normal population and prognosis results from The Cancer Genome Atlas(TCGA) data. Cell activity was detected by Cell counting Kit-8. Cell proliferation was detected by monoclonal plate. The apoptosis was detected by flow cytometry and western blot. Determine the role of MLCK1 in inducing 5-Fluorouracil(5-Fu) resistance in colorectal cancer cells was detected by overexpression of MLCK1 and knock-down expression of MLCK1.

RESULTS: MLCK1 is expressed at different levels in different colorectal cancer cells, high MLCK1 expressing cell lines are less sensitive to 5-Fu, and low MLCK1 expressing cell lines are more sensitive to 5-Fu. MLCK1 high expression enhances resistance to 5-Fu in colorectal cancer cells and the sensitivity to 5-Fu was increased after knocking down the expression of MLCK1, that might be closely correlated to TNFR2/NF-κB pathway.

CONCLUSIONS: MLCK1 high expression can enhance resistance to 5-Fu in colorectal cancer cells and the sensitivity to 5-Fu was increased after knocking down the expression of MLCK1, that might be closely correlated to TNFR2/NF-κB pathway, which will provide a new method for the treatment of colorectal cancer patients who are resistant to 5-Fu chemotherapy.

PMID:38735014 | DOI:10.1007/s12672-024-01019-8

Arch Gynecol Obstet. 2024 May 12. doi: 10.1007/s00404-024-07547-6. Online ahead of print.

ABSTRACT

PURPOSE: This study aimed to determine the association of first-trimester maternal serum biomarkers with preterm birth (PTB), fetal growth restriction (FGR) and hypertensive disorders of pregnancy (HDP) in twin pregnancies.

METHODS: This is a retrospective cohort study of twin pregnancies followed at Maternidade Dr. Alfredo da Costa, Lisbon, Portugal, between January 2010 and December 2022. We included women who completed first-trimester screening in our unit and had ongoing pregnancies with two live fetuses, and delivered after 24 weeks. Maternal characteristics, pregnancy-associated plasma protein-A (PAPP-A) and β-human chorionic gonadotropin (β-hCG) levels were analyzed for different outcomes: small for gestational age (SGA), gestational hypertension (GH), early and late-onset pre-eclampsia (PE), as well as the composite outcome of PTB associated with FGR and/or HDP. Univariable, multivariable logistic regression analyses and receiver-operating characteristic curve were used.

RESULTS: 466 twin pregnancies met the inclusion criteria. Overall, 185 (39.7%) pregnancies were affected by SGA < 5th percentile and/or HDP. PAPP-A demonstrated a linear association with gestational age at birth and mean birth weight. PAPP-A proved to be an independent risk factor for SGA and PTB (< 34 and < 36 weeks) related to FGR and/or HDP. None of the women with PAPP-A MoM > 90th percentile developed early-onset PE or PTB < 34 weeks.

CONCLUSION: A high serum PAPP-A (> 90th percentile) ruled out early-onset PE and PTB < 34 weeks. Unless other major risk factors for hypertensive disorders are present, these women should not be considered candidates for aspirin prophylaxis. Nevertheless, close monitoring of all TwP for adverse obstetric outcomes is still recommended.

PMID:38734998 | DOI:10.1007/s00404-024-07547-6

Electromagn Biol Med. 2024 May 12:1-8. doi: 10.1080/15368378.2024.2352429. Online ahead of print.

ABSTRACT

Biological effects of radio frequency electromagnetic radiation (RF-EMR) in the range of 900-1800 MHz emerging from the mobile phone were investigated and were found to influence the locomotor pattern when exposure was initiated from 1 hour post fertilization (hpf) in zebrafish embryos (ZE), Danio rerio. Mobile phones and other wireless devices offer tremendous advantages. However, on the flipside they are leading to an increased electromagnetic energy in the environment, an excess of which could be termed as electromagnetic pollution. Herein, we tried to understand the effects of RF-EMR emerging from the mobile phone, on the development and behavior of ZE, exposed to RF-EMR (specific absorption rate of 1.13 W/kg and 1800 MHz frequency) 1 hr daily, for 5 days. To understand if there could be any developmental stage-specific vulnerability to RF-EMR, the exposure was initiated at three different time points: 1hpf, 6hpf and 24hpf of ZE development. Observations revealed no significant changes in the survival rate, morphology, oxidative stress or cortisol levels. However, statistically significant variations were observed in the batch where exposure started at 1hpf, with respect to locomotion patterns (distance travelled: 659.1 ± 173.1 mm Vs 963.5 ± 200.4 mm), which could be correlated to anxiety-like behavior; along with a corresponding increase in yolk consumption (yolk sac area: 0.251 ± 0.019 mm² Vs 0.225 ± 0.018 mm²). Therefore, we conclude that RF-EMR exposure influences the organism maximally during the earliest stage of development, and we also believe that an increase in the time of exposure (corresponding to the patterns of current usage of mobile phones) might reveal added afflictions.

PMID:38734994 | DOI:10.1080/15368378.2024.2352429

Med Phys. 2024 May 12. doi: 10.1002/mp.17132. Online ahead of print.

ABSTRACT

BACKGROUND: In recent years, genetic algorithms have been applied in the field of nuclear technology design, producing superior optimization results compared to traditional methods. They can be employed in the design and optimization of beam shaping assemblies (BSA) BSA to obtain the desired neutron beams. But it should be noted that the direct combination of Monte Carlo methods with genetic algorithms requires a significant amount of computational resources and time.

PURPOSE: Design and optimize BSA more efficiently to achieve neutron beams that meet specified recommendations.

METHODS: We propose an approach of NSGA II with crucial variables which are identified by multivariate statistical techniques. This approach significantly reduces the problem sizes, thus reducing the time required for optimization. We illustrate this methodology using the example of BSA design for AB-BNCT.

RESULTS: The computational efficiency has tripled with crucial variables. By using NSGA II, we obtained optimized models conforming to both the new and old version IAEA BNCT guidelines through a single optimization process and subjected them to phantom analysis. The results demonstrate that models obtained through this method can meet the IAEA recommendations with deep advantage depth (AD) and high absorbed ratio (AR).

CONCLUSION: The genetic algorithm with crucial variables displays tremendous potential in addressing BSA optimization challenges.

PMID:38734991 | DOI:10.1002/mp.17132

Clin Infect Dis. 2024 May 12:ciae260. doi: 10.1093/cid/ciae260. Online ahead of print.

ABSTRACT

BACKGROUND: Congenital syphilis disproportionately affects individuals impacted by adverse social determinants of health. Understanding these determinants may help facilitate holistic care.

METHODS: We performed a retrospective review of mother-infant dyads with potential congenital syphilis in a Missouri hospital system. Cases were classified per Centers for Disease Control and Prevention clinical scenarios. Information was collected regarding demographics, prenatal care, substance use, and other social factors. Dyads with confirmed/highly probable or possible congenital syphilis (“congenital syphilis outcomes”) were compared to those with less likely/unlikely congenital syphilis (“non-congenital syphilis outcomes”) using descriptive statistics.

RESULTS: We identified 131 dyads with infant dates of birth from 12/2015-6/2022: 74 (56%) with congenital syphilis outcomes and 56 (43%) with non-congenital syphilis outcomes. Most mothers were Black/African American (n = 84, 65%) and lived in areas with high Social Vulnerability Indices. Many had inadequate prenatal care (n = 61, 47%) and/or substance use histories (n = 55, 42%). Significant associations with congenital syphilis outcomes included limited prenatal care (OR 3.01, 95% CI 1.38-6.56), no prenatal care (OR 16.08, 95% CI 1.96-132.11), substance use (OR 3.42, 95% CI 1.61-7.25), housing instability (OR 3.42, 95% CI 1.39-8.38), and justice system interactions (OR 2.29, 95% CI 1.00-5.24). Substance use correlated with prenatal care adequacy (p < 0.001). 30% of infants with congenital syphilis outcomes were taken into protective custody.

CONCLUSIONS: Adverse social determinants of health are common in dyads impacted by congenital syphilis. Health systems should consider interdisciplinary programming to improve testing and linkage to care. Future studies should evaluate social support for congenital syphilis prevention and management.

PMID:38734971 | DOI:10.1093/cid/ciae260

Urol J. 2024 May 12. doi: 10.22037/uj.v21i.7943. Online ahead of print.

ABSTRACT

OBJECTIVE: to review the literature regarding the relationship between pre- and post-transplant hypo-Albuminemia with various renal transplant-related infections.

MATERIALS AND METHODS: In a systematic review, we included the following keyword in the search: (Albumin*) AND (infection*) AND (“renal transplant” OR “renal transplantation” OR “renal transplants”) OR (“kidney transplant” OR “kidney transplantation” OR “kidney transplants”) OR “kidney grafting”) with investigating databases including ProQuest, PubMed, Scopus, and Web of Science to May 2023. All adult patients who had renal transplantation were included. Albumin levels of infected (bacterial, fungal, or viral) patients and the type of infection should be reported in the included studies. The search strategy used in this review was reported by Preferred Reporting Items for Systematic Reviews and Meta-Analyses literature search extension (PRISMA-S). To conduct Meta-analyses, Stata version 17 was used. Also, DerSimonian-Laird random-effects models were used for this study. In our study, heterogeneity was quantified with I2 and τ2 statistics. inconsistency across studies is quantified by I2 statistics, and the impact of heterogeneity on the meta-analysis is assessed by this quantification.

RESULTS: Overall, 18 studies were found to be reporting measures of association including risk ratio, odds ratio, and, hazard ratio. Among them, 10 and 8 studies were reporting bacterial and viral types of infection. The combined risk ratios were not statistically significant, in either type of infection. The mean (SD) of ages for bacterial and viral infections were found to be 45.3 (6.4) and 50.5 (7.6) years old, respectively.

CONCLUSION: Hypoalbuminemia is not related to post-transplantation infections, and it seems that with adherence to proper pretransplant screening of recipients, vaccination, and post-transplant surveillance and prophylaxis, the impact of infections may be reduced.

PMID:38734965 | DOI:10.22037/uj.v21i.7943

J Prosthodont. 2024 May 12. doi: 10.1111/jopr.13866. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the effect of different printing orientations and post-polymerization time with thermal cycling on the translucency of 3D-printed denture base resins.

METHODS: Heat-polymerized (HP) acrylic resin specimens were fabricated and 3D-printed denture base materials (NextDent, ASIGA, FormLabs) were printed with different printing orientations (0, 45, 90 degrees) and subjected to different post-polymerization times (15-, 30-, 60-, and 90-min). All specimens were polished and immersed in distilled water for 1 day at 37°C. CIEDE2000 was used to measure the translucency parameters (TP₀₀) before and after thermal cycling (5000 cycles) recording the color parameters (L^*, a^*, b^*) against a black and white background using a spectrophotometer. k-factors ANOVA followed by post hoc Tukey’s test (α = .05) was performed for statistical analysis.

RESULTS: The k-factors ANOVA test showed a significant effect of resin material, post-polymerization time, and printing orientation on translucency (p < 0.001). In comparison to HP, all 3D-printed resins showed lower translucency with all post-polymerization times and printing orientation (p < 0.001) except FormLabs resin (p > 0.05). For all 3D-printed resins, the translucency increased, with increasing the post-polymerization time (p < 0.001) and 60- and 90-min showed the highest translucency. For printing orientation, 90 and 45 degrees significantly showed high translucency in comparison to 0 degrees (p < 0.001). FormLabs showed significantly higher translucency when compared with NextDent and ASIGA per respective printing orientation and post-polymerization time. The translucency significantly decreased after thermal cycling for all tested resins (p < 0.001).

CONCLUSION: The findings of this study demonstrated that the translucency of 3D-printed resins is influenced by the printing orientation, post-polymerization time, and resin type. As a result, choosing a resin type, and printing orientation, with a longer post-polymerization time should be considered since it may improve the esthetic appearance of the 3D-printed resins.

PMID:38734933 | DOI:10.1111/jopr.13866

J Prosthodont. 2024 May 12. doi: 10.1111/jopr.13865. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the fracture resistance of zirconia overlays, considering various preparation designs and the presence of endodontic access.

MATERIALS AND METHODS: Ninety translucent zirconia (5Y-PSZ) overlay restorations were divided into six groups (n = 15/group) based on different preparation designs, with and without endodontic access: chamfer margin 4 mm above the gingival level without (group 1) and with endodontic access (group 2); margin 2 mm above the gingival level without (group 3) and with endodontic access (group 4); overlay with no chamfer margin without (group 5) and with endodontic access (group 6). Restorations were bonded to mandibular first molar resin dies, and the groups with endodontic access were sealed with flowable resin composite. All restorations underwent 100,000 cycles of thermal cycling between 5°C and 55°C, followed by loading until fracture. Maximum load and fracture resistance were recorded. ANOVA with Tukey post-hoc tests were used for statistical comparison (α < 0.05).

RESULTS: Fracture resistance significantly varied among overlay designs with and without endodontic access (p < 0.001), except for the no-margin overlays (groups 5 and 6). Overlays with a 2 mm margin above the gingival margin with endodontic access (group 4) exhibited significantly higher fracture resistance compared to both the 4-mm supragingival (group 2) and no-margin (group 6) designs, even when compared to their respective intact groups (groups 1 and 5). There were no significant differences between the no-margin and 4-mm supragingival overlays.

CONCLUSION: The more extensive zirconia overlay for mandibular molars is the first choice since the 2 mm margin above the gingival level design withstood considerable loads even after undergoing endodontic access. A no-margin overlay is preferred over the 4-mm supragingival design as it preserves more tooth structure and there was no outcome difference, irrespective of endodontic access. Caution is warranted in interpreting these findings due to the in vitro nature of the study.

PMID:38734932 | DOI:10.1111/jopr.13865