Nevin Manimala

Pain. 2024 Jul 26. doi: 10.1097/j.pain.0000000000003333. Online ahead of print.

ABSTRACT

Female sex is a prominent risk factor for chronic pain, although the underlying mechanisms are not fully understood. This cross-sectional study aimed to investigate the relationship between age at menopause, reproductive lifespan, and chronic pain in a sample of postmenopausal women aged 40 to 93 years. Data were collected from the Tromsø study conducted in Norway between 2015 and 2016 (Tromsø7). Chronic pain was assessed using a single question, which formed a sample size of 5741 participants. Chronic widespread pain was evaluated using the more comprehensive Graphical Index of Pain, resulting in a sample size of 5920 women. Premenopausal women and those who experienced menstrual cessation due to chemotherapy/radiation or hormonal intrauterine devices were excluded from the analysis. Adjusted relative risk ratios with 95% confidence intervals were calculated to determine associations. The results showed that early menopause was associated with a 1% increase in the prevalence of chronic pain for each year of earlier onset at menopause (0.992, CI 95% 0.985-0.998). This association was also observed in women who experienced natural menopause only. However, the association between menopause and chronic widespread pain did not reach statistical significance in the fully adjusted analysis (0.996, CI 95% 0.975-1.017). There were no significant associations found between reproductive lifespan and either outcome. In conclusion, the findings suggest that early menopause in postmenopausal women is linked to a higher prevalence of chronic pain. However, reproductive lifespan does not appear to have a significant impact on chronic pain or chronic widespread pain.

PMID:39058956 | DOI:10.1097/j.pain.0000000000003333

Blood Adv. 2024 Jul 26:bloodadvances.2024013623. doi: 10.1182/bloodadvances.2024013623. Online ahead of print.

ABSTRACT

Optimal therapy for the growing number of patients with lenalidomide (LEN)-refractory multiple myeloma (MM) in first relapse remains poorly defined. We therefore undertook a randomized phase II study evaluating the efficacy and safety of combining the oral proteasome inhibitor ixazomib (IXA) with pomalidomide (POM) and dexamethasone (DEX) for this patient population. The overall response rate (ORR) for POM-DEX was 43.6% and 63.2% for IXA-POM-DEX. Depth of response, as measured by attainment of a very good partial response or better favored the triplet over the doublet, 28.9% vs 5.1%, respectively (p = 0.0063). A pre-planned interim analysis after 75% of the progression events had occurred demonstrated a progression-free survival (PFS) advantage favoring IXA-POM-DEX that crossed the predefined boundary of superiority, leading to release of the study results. With additional follow-up, the median PFS for POM-DEX was 7.5 months (95% confidence interval [CI] 4.8 – 13.6 months) vs 20.3 months for IXA-POM-DEX (95% CI 7.7 – 26.0 months, hazard ratio 0.437 [upper 90% bound = 0.657]). ORR and median PFS for the 26 of 30 eligible patients who crossed over from the doublet to the triplet at progression was 23.1% and 5.6 months, respectively. Overall survival was similar between the two groups. More hematologic toxicities were seen with the triplet, but non-hematologic adverse events were similar between the two arms. Our data support further testing of this all-oral triplet vs current standard triplet therapy in the context of phase III studies for patients with LEN-refractory disease in first relapse. This trial is registered at www.clinicaltrials.gov as NCT02004275.

PMID:39058954 | DOI:10.1182/bloodadvances.2024013623

Am J Audiol. 2024 Jul 26:1-10. doi: 10.1044/2024_AJA-24-00009. Online ahead of print.

ABSTRACT

PURPOSE: Spatial hearing is necessary for adequate sound awareness and speech perception abilities; however, research indicates that children have difficulties on these spatial hearing tasks that affect functioning in their daily environment. The purpose of this study was to validate a pediatric version of the Spatial Hearing Questionnaire (P-SHQ) for determining binaural hearing benefits and spatial hearing ability in children.

METHOD: We recruited parents and guardians of 68 children ages kindergarten through eighth grade to participate. Parents completed the P-SHQ, the Speech, Spatial and Qualities of Hearing Scale-Parent version, and a demographic questionnaire. To determine the factor structure of the P-SHQ, we conducted an exploratory factor analysis and reliability was assessed by calculating correlation coefficients.

RESULTS: Three factors emerged during factor analysis: Factor 1 = sound localization, Factor 2 = speech-in-noise perception, and Factor 3 = speech perception in quiet. The P-SHQ has good internal consistency reliability (α = .97), and high item-total correlations were found. The correlation between scores from the P-SHQ questionnaire and the SSQ-Spatial subscale questionnaire provides evidence for the construct validity of the P-SHQ.

CONCLUSIONS: The P-SHQ is a reliable and valid questionnaire to assess spatial hearing ability in children. This quick-to-administer tool can be incorporated into audiological care to determine the spatial hearing skills of a child and assist in counseling, making it a valuable assessment for hearing health care professionals.

PMID:39058953 | DOI:10.1044/2024_AJA-24-00009

Int J Periodontics Restorative Dent. 2024 Jul 26;0(0):1-27. doi: 10.11607/prd.5078. Online ahead of print.

ABSTRACT

BACKGROUND: Dental autotransplantation (ATT) of mature teeth in adult patients has recently been supported by a growing body of evidence. Thus, ATT can be considered as an alternative to single implants for the replacement of a compromised tooth. This case series study aims to provide an initial comparison between ATT (test group) and immediate implant treatment (IIT standard group), in terms of volumetric changes and patient-related outcome measures (PROMs).

MATERIALS AND METHODS: Thirty-one interventions (29 patients) were grouped into two similar cohorts. Measurements were made on the superimposed STL files before and at least six months after treatment, and PROMs were obtained from a questionnaire in two follow-up checks. Data were analyzed using descriptive and inferential statistics. Adverse events and complications were also recorded.

RESULTS: Volume reduction was 3 to 4 times less in the ATT group than in the ITT group (p<0.05). Patients in the ATT group reported higher levels of perceived inflammation than the IIT group (p&#61;0.015), although patients rated satisfaction similarly between the two treatments, above 9 on a scale of 1-10.

CONCLUSIONS: Although this research should be considered an initial step requiring larger samples and follow-up, it supports the trend of including ATT as an alternative option to IIT in molar replacement.

PMID:39058939 | DOI:10.11607/prd.5078

J Speech Lang Hear Res. 2024 Jul 26:1-15. doi: 10.1044/2024_JSLHR-24-00107. Online ahead of print.

ABSTRACT

PURPOSE: We investigated speech and nonspeech auditory processing of temporal and spectral cues in people who do and do not stutter. We also asked whether self-reported stuttering severity was predicted by performance on the auditory processing measures.

METHOD: People who stutter (n = 23) and people who do not stutter (n = 28) completed a series of four auditory processing tasks online. These tasks consisted of speech and nonspeech stimuli differing in spectral or temporal cues. We then used independent-samples t-tests to assess differences in phonetic categorization slopes between groups and linear mixed-effects models to test differences in nonspeech auditory processing between stuttering and nonstuttering groups, and stuttering severity as a function of performance on all auditory processing tasks.

RESULTS: We found statistically significant differences between people who do and do not stutter in phonetic categorization of a continuum differing in a temporal cue and in discrimination of nonspeech stimuli differing in a spectral cue. A significant proportion of variance in self-reported stuttering severity was predicted by performance on the auditory processing measures.

CONCLUSIONS: Taken together, these results suggest that people who stutter process both speech and nonspeech auditory information differently than people who do not stutter and may point to subtle differences in auditory processing that could contribute to stuttering. We also note that these patterns could be the consequence of listening to one’s own speech, rather than the cause of production differences.

PMID:39058919 | DOI:10.1044/2024_JSLHR-24-00107

Age Ageing. 2024 Jul 2;53(7):afae162. doi: 10.1093/ageing/afae162.

ABSTRACT

BACKGROUND: Intrinsic capacity refers to a broad range of health traits, including the physiological and psychological changes brought on by aging. Previous research has shown that intrinsic capacity, as an independent emerging construct, is a highly effective predictor of several health outcomes.

OBJECTIVE: We aimed to summarise the predictive effect of intrinsic capacity at baseline on health outcomes among middle-aged and older adults.

DESIGN: A systematic review and meta-analysis.

PARTICIPANTS: Middle-aged and older adults.

METHODS: We systematically searched up to 3 April 2024 in 10 electronic databases. Studies investigating the predictive effect of baseline composite intrinsic capacity and health outcomes were included. Publications that had reported hazard ratios (HRs) or odd ratios (ORs) and 95% confidence intervals (CIs) as effect size were considered.

RESULTS: A total of 23 publications were included. The sample size ranged from 100 to 17 031. The results of the meta-analysis showed statistically significant prediction of adverse health outcomes such as disability (OR = 1.84, 95% CI: 1.68-2.03, I2 = 41%, Pheterogeneity=.10), falls (OR = 1.38, 95% CI: 1.19-1.60, I2 = 45%, Pheterogeneity=.11), hospitalisation (OR = 2.25, 95% CI: 1.17-4.3, I2 = 68%, Pheterogeneity=.08), mortality (OR = 1.72, 95% CI: 1.54-1.91, I2 = 32%, Pheterogeneity=.12) and frailty (OR = 1.57, 95% CI: 1.45-1.70, I2 = 2%, Pheterogeneity=.31) by the baseline composite intrinsic capacity.

CONCLUSIONS: Declined intrinsic capacity has potential predictive value for adverse health outcomes, further high-quality study is needed to validate these findings and strengthen their cumulative impact. Attention to health outcomes should also focus on both breadth and category precision.

PMID:39058916 | DOI:10.1093/ageing/afae162

Medicine (Baltimore). 2024 Jul 26;103(30):e38996. doi: 10.1097/MD.0000000000038996.

ABSTRACT

In patients with coronavirus disease (COVID-19), a massive inflammatory response is a significant cause of morbidity and mortality. Inflammatory markers are prognostic indicators of disease severity and the ultimate clinical outcome. Several studies have demonstrated a correlation between serum levels of neopterin, which can be an immune system marker, disease severity, and poor outcomes in COVID-19 patients. Our study aimed to determine the diagnostic significance of neopterin in conjunction with routinely measured inflammatory markers in patients with severe COVID-19. Serum neopterin, C-reactive protein (CRP), albumin levels, and complete blood count were determined in 39 patients with severe COVID-19 and 30 healthy individuals. Demographic characteristics, serum neopterin levels, and other laboratory data were compared between patients and healthy volunteers and statistically analyzed. High neopterin levels were observed in patients with severe COVID-19 compared to healthy volunteers. Furthermore, albumin levels were decreased, while CRP levels were increased in patients, statistically significantly. Also, positive correlations were shown between serum neopterin levels and serum CRP levels, while negative correlations were shown between serum neopterin levels and serum albumin levels. Systemic inflammation markers, CRP/albumin ratio, neutrophil/lymphocyte ratio, and platelet/lymphocyte ratio were significantly higher, while lymphocyte/monocyte ratio was also significantly lower in patients with severe COVID-19 than in healthy volunteers. However, serum neopterin levels were not linked to the CRP/albumin ratio, the neutrophil/lymphocyte ratio, or the platelet/lymphocyte ratio. On the other hand, they were linked negatively to the lymphocyte/monocyte ratio. Our findings highlight the association between high neopterin levels and patients with severe COVID-19. Neopterin is correlated with traditional inflammatory biomarkers and may indicate general immune and inflammatory activation in patients with severe COVID-19.

PMID:39058886 | DOI:10.1097/MD.0000000000038996

Medicine (Baltimore). 2024 Jul 26;103(30):e39067. doi: 10.1097/MD.0000000000039067.

ABSTRACT

An increasing body of evidence supports the involvement of inflammation and immune responses in the occurrence and development of keratoconus (KC). However, the causal relationship between inflammatory factors and KC remains unclear. We employed a 2-way Mendelian randomization (MR) approach to investigate the interaction between KC and inflammatory factors. Instrumental variables for 41 circulating inflammatory regulators and 12 matrix metalloproteinases (MMPs) were selected from genome-wide association studies of European ancestry. Summary statistics for KC were obtained from a genome-wide association study comprising 2116 cases and 24,626 controls of European ancestry. The primary analytical method for assessing causality was the inverse-variance weighted method. Two additional MR methods (MR-Egger and weighted median) were employed to complement the inverse-variance weighted results. In addition, several sensitivity analyses were conducted to evaluate heterogeneity, horizontal pleiotropy, and stability. Our findings indicated that genetically predicted higher levels of macrophage inflammatory protein-1β (odds ratio = 1.126, 95% confidence interval: 1.029-1.232, P = .01) and MMP-13 (odds ratio = 1.211, 95% confidence interval: 1.070-1.371, P = .003) were positively associated with an elevated risk of KC. Conversely, genetically predicted KC was associated with increased levels of interferon-gamma, interleukin-4, and MMP-1. Our current study provided suggestive evidence supporting causal associations of macrophage inflammatory protein-1β and MMP-13 with the risk of KC. In addition, KC appeared to affect the expression of interferon-gamma, interleukin-4, and MMP-1.

PMID:39058875 | DOI:10.1097/MD.0000000000039067

Medicine (Baltimore). 2024 Jul 26;103(30):e39054. doi: 10.1097/MD.0000000000039054.

ABSTRACT

BACKGROUND: Our aim was to observe the effects of local infiltration analgesia (LIA) or erector spinae plane block (ESPB) methods, which we applied preemptively in patients who were scheduled for surgery with a lumbotomy surgical incision and on intraoperative remifentanil consumption, and to compare the postoperative numerical rating scale (NRS), morphine demand, consumption, and pain degrees.

METHODS: Sixty American Society of Anesthesiologists I to III patients aged 18 to 75 years who were due to be operated on with a lumbotomy surgical incision were included in the study. The present study was conducted via prospective, randomized controlled, double-blind trials. After the induction of standard anesthesia, LIA was applied to 30 patients and ESPB was applied to 30 patients preemptively. The dose of remifentanil consumed in the intraoperative period was measured, and the hemodynamic parameters were measured every 5 minutes. Morphine bolus treatment with the postoperative patient-controlled analgesia and rescue analgesia with paracetamol were planned for the patients. Postoperative morphine and additional analgesia consumption, NRS, hemodynamic parameters, and complications were recorded for 48 hours.

RESULTS: There was no difference between the groups in terms of demographic and hemodynamic data. The mean consumption of remifentanil was measured as 455 ± 165.23 µg in the intraoperative ESPB group and 296.67 ± 110.59 µg in the LIA group, and a statistical difference was observed (P = .001). In the postoperative follow-ups, the ESPB group drug consumption and NRS score averages were significantly lower at all times (P = .01; patient-controlled analgesia-morphine, 41.93 ± 14.47 mg vs 57.23 ± 15.5 mg and additional analgesic-paracetamol: 2.1 ± 1.06 vs 4.27 ± 1.14 g). The mean duration of additional analgesic intake of the groups was 10.6 ± 8.1 in the LIA group, while it was 19.33 ± 8.87 in the ESPB group, a significant difference. The patient satisfaction questionnaire was also significantly in favor of ESPB (P = .05).

CONCLUSIONS: In conclusion, it has been shown that the intraoperative LIA method is more effective in terms of remifentanil consumption and in controlling pain in operations performed with a flank incision, but the ESPB method provides longer and more effective pain control in postoperative follow-ups.

PMID:39058874 | DOI:10.1097/MD.0000000000039054

Medicine (Baltimore). 2024 Jul 26;103(30):e39059. doi: 10.1097/MD.0000000000039059.

ABSTRACT

OBJECTIVE: The objective of this meta-analysis was to compare the efficacy and safety between glucocorticoids combined with mycophenolate mofetil (MMF) versus glucocorticoids combined with cyclophosphamide (CTX) for henoch schonlein purpura nephritis (HSPN) in children.

METHODS: Databases including PubMed, EMbase, the Cochrane Library, China National Knowledge Infrastructure, and Wanfang database were searched from the inception to April 5th, 2024. Eligible studies comparing glucocorticoids combined with MMF versus glucocorticoids combined with CTX for HSPN in children were included. Data were analyzed using Review Manager Version 5.3.

RESULTS: Ten studies were included in the meta-analysis. Six randomized controlled trials (RCTs) and 4 non-randomized studies involving 675 patients were identified. Compared with CTX therapeutic schedule, MMF therapeutic schedule had a higher complete remission (CR) within the 6 months (OR 1.61, 95%CI 1.16-2.22, P = .004) and CR within the 12 months (OR 1.73, 95%CI 1.00-2.97, P = .05). However, there was no significant difference between MMF and CTX therapeutic schedule concerning total remission (TR) within the 6 months (OR 1.54, 95%CI 0.82-2.92, P = .18) and TR within the 12 months (OR 2.08, 95%CI 0.86-5.01, P = .10). In addition, incidences of gastrointestinal discomfort (OR 0.33, 95%CI 0.19-0.56, P < .0001), liver function injury (OR 0.28, 95%CI 0.09-0.87, P = .03), myelosuppression (OR 0.15, 95%CI 0.06-0.41, P = .0001), alopecia (OR 0.25, 95%CI 0.07-0.91, P = .03) in MMF therapeutic schedule were all lower than CTX therapeutic schedule. There was no statistically significant difference between the 2 therapeutic schedules concerning infection (OR 0.90, 95%CI 0.50-1.61, P = .72), rash (OR 0.38, 95%CI 0.07-2.04, P = .26).

CONCLUSION: Glucocorticoids combined with MMF had a higher CR and lower incidence of adverse effects compared with glucocorticoids combined with CTX in the treatment of HSPN in children.

PMID:39058868 | DOI:10.1097/MD.0000000000039059