Nevin Manimala

Zhonghua Xue Ye Xue Za Zhi. 2024 Dec 14;45(12):1085-1090. doi: 10.3760/cma.j.cn121090-20240613-00222.

ABSTRACT

Objective: This study aimed to summarize the clinical characteristics and prognosis of patients with bone marrow invasive follicular lymphoma (FL) and discuss the treatment modalities. Methods: This study included 183 consecutive patients with FL accompanied by bone marrow invasion and receiving regular treatment at the Hospital of Hematology, Chinese Academy of Medical Sciences, from January 2013 to December 2022. Clinical data were retrospectively collected and analyzed, and single and multifactorial analyses of survival prognosis were conducted with the Kaplan-Meier method and Cox regression model. Results: The median age was 48 (range: 19 – 78) years, and the male-to-female ratio was 0.9∶1. All of the patients had bone marrow invasion, 27.8% had increased lactate dehydrogenase levels, 42.1% had lymphocyte counts of >5×10(9)/L, 18.4% had abnormal chromosomal karyotypes, and 48.6% had Ki-67 index of ≥30% in lymphoid tissue. Comparison of different subgroups: lymphocyte counts of >5×10(9)/L, number of lymph nodes of ≥5 involved, and proportion of bone marrow chromosomal abnormalities occurring were higher in the anthracycline-intensive treatment group than in the rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) protocol and the nucleoside analog (including CD20 monoclonal antibody in combination with fludarabine and bendamustine) groups (all P<0.05). The complete remission rate was 39.1% in the conventional R-CHOP group, which was lower and statistically significant than that in the intensive treatment group (55.1%) and the nucleoside analog group (62.5%) (P=0.042). The multivariate analysis for survival analysis revealed high risk of FLIPI (HR= 1.910, 95% CI 1.036 – 3.522, P=0.036), chromosomal abnormalities karyotype (HR=2.666, 95% CI 1.333-5.331, P=0.006), and conventional R-CHOP treatment (HR=2.287, 95% CI 1.140-4.591, P=0.020) were the independent adverse prognostic factors affecting progression-free survival (PFS), whereas POD24 was the only independent adverse prognostic factor affecting overall survival (OS) adverse prognostic factor (HR=9.581, 95% CI 3.000 – 30.593, P<0.001) . Conclusions: The clinical presentations of patients with bone marrow invasive FL were easy to combine the clinical features, including increased lymphocyte count, chromosomal abnormalities, and Ki-67 index in lymphoid tissues. The FLIPI score, chromosomal abnormal karyotype, and high-lymphoid-tissue Ki-67 index were the poor prognostic factors influencing PFS. R-CHOP therapy demonstrated a poor prognosis in this group of patients.

PMID:39765348 | DOI:10.3760/cma.j.cn121090-20240613-00222

Zhonghua Xue Ye Xue Za Zhi. 2024 Dec 14;45(12):1078-1084. doi: 10.3760/cma.j.cn121090-20240701-00240.

ABSTRACT

Objective: This study aimed to investigate the clinical characteristics of oral mucositis (OM) in patients with hematological diseases who received secondary allogeneic hematopoietic stem cell transplantation (allo-HSCT) . Methods: This study retrospectively analyzed data on 58 patients with hematological diseases who underwent secondary allo-HSCT at the Peking University People’s Hospital from January 2018 to December 2023. The control group included 116 randomized patients after primary allo-HSCT during this period (1:2 ratio) with matched gender, age, and diagnosis. The incidence of OM and overall survival (OS) were compared between the two groups. Results: The secondary allo-HSCT and control groups reported 17 (29.31%) and 16 (13.79%) cases that developed OM (P=0.014), whereas 10 (17.24%) and 7 (6.03%) developed grade ≥3 OM (P=0.019). The median time for OM to occur was 4 days (1-9 days) and 5 days (1-10 days) posttransplantation in the secondary allo-HSCT and control groups, respectively. The multivariate analysis revealed that the use of whole-body radiation therapy as the main pretreatment regimen was an independent risk factor for OM occurrence (P=0.019). Among patients with OM, an age of <55 years is a risk factor for developing grade 3-4 OM (P=0.028). All patients who underwent the secondary allo-HSCT received granulocyte implantation. The median time of granulocyte implantation in 17 patients with OM was 14 days posttransplantation, whereas the median time of granulocyte implantation in patients without OM was 12 days posttransplantation. The difference was not statistically significant (P=0.721). The presence of OM did not affect the occurrence of acute graft-versus-host disease (P=0.938). No statistically significant difference was observed in the 2-year OS rate between patients with and without OM during the secondary allo-HSCT (51.9% vs 50.4%, P=0.943). No statistically significant difference was observed in the 2-year OS rate between patients with OM undergoing the secondary allo-HSCT and those undergoing the primary allo-HSCT (51.9% vs 81.3%, P=0.185) . Conclusions: The proportion of patients with concurrent OM was significantly increased in the secondary allo-HSCT, and the severity was more severe. Whether or not to merge OM does not affect granulocyte implantation, acute graft-versus-host disease incidence, and 2-year OS rate.

PMID:39765347 | DOI:10.3760/cma.j.cn121090-20240701-00240

Int Neurourol J. 2024 Dec;28(4):294-301. doi: 10.5213/inj.2448372.186. Epub 2024 Dec 31.

ABSTRACT

PURPOSE: While pump manipulation is rarely problematic in male patients with artificial urinary sphincters (AUSs), the situation may differ in female patients due to anatomical or cultural factors. This study aimed to evaluate the prevalence of difficulties in pump manipulation among female AUS patients, identify associated risk factors, and explore management strategies for this challenging issue.

METHODS: Data were collected from all female patients who underwent a robotic AUS implantation at a single academic center between 2014 and 2022. The primary endpoint was temporary difficulties, defined by at least one other short hospitalization to learn pump manipulation.

RESULTS: Out of the 88 female AUS patients included in the study, 20 experienced initial difficulties manipulating the pump, accounting for 22.7% of the group. Temporary difficulties were reported by 16 patients (18.2%), while 4 patients (4.5%) had their devices permanently deactivated. Surgical reoperations to reposition the pump were necessary for 5 patients, representing 5.6% of the sample. The only variables significantly associated with temporary difficulties were longer operative time (183.4 minutes vs. 159.1 minutes, P=0.04) and the overall experience of the center (32 vs. 50, P=0.04). The sole variable significantly linked to serious difficulties was the overall experience of the center (11 vs. 47, P=0.004). Although the median age and body mass index were higher in the group with temporary difficulties, these differences were not statistically significant.

CONCLUSION: Difficulties in manipulating the pump are relatively common among female AUS patients. Most of these difficulties can be resolved through repeated patient education and careful follow-up. However, some may lead to serious complications. Raising awareness of this issue, along with ongoing patient education and meticulous follow-up, may help to minimize these consequences.

PMID:39765342 | DOI:10.5213/inj.2448372.186

Int Neurourol J. 2024 Dec;28(4):270-277. doi: 10.5213/inj.2448348.174. Epub 2024 Dec 31.

ABSTRACT

PURPOSE: This study aimed to compare and analyze the feasibility and long-term efficacy of prostatic capsule-sparing (PCS) and nerve-sparing (NS) radical cystectomy in the treatment of bladder cancer.

METHODS: From June 2004 to December 2021, our institution treated and followed 145 patients who underwent radical cystectomy with neobladder reconstruction for over a year. These patients were divided into 2 groups: PCS (n=74) and NS (n=71). To minimize potential biases, 1:1 propensity score matching was utilized to compare oncological outcomes, functional outcomes, and complications between the groups. Additionally, Kaplan-Meier analysis and the log-rank test were used to evaluate survival differences between the PCS and NS groups.

RESULTS: The median follow-up durations for PCS and NS were 155 and 122 months, respectively. After adjusting for propensity scores, a total of 96 patients (48 in each group) were included for further analysis. Kaplan-Meier curves showed no statistically significant differences in metastasis-free probability (P=0.206), cancer-specific survival (P=0.091), and overall survival (P=0.208). The daytime urinary control (UC) rate at 3, 6, and 12 months postoperatively was 72.9%, 91.7%, and 97.9% in the PCS group and 47.9%, 79.2%, and 91.7% in the NS group, respectively (P=0.012, P=0.083, and P=0.362). The nocturnal UC rate was 54.2%, 85.4%, and 95.8% in the PCS group, and 31.3%, 60.4%, and 83.3% in the NS group, respectively (P=0.023, P=0.006, and P=0.091). Regarding erectile function recovery, 62.5% of patients in the PCS group and 22.9% in the NS group returned to preoperative levels (P<0.001).

CONCLUSION: PCS outperformed NS in restoring UC and sexual function and did not affect oncological outcomes. However, PCS was associated with a higher risk of complications linked to bladder-neck obstruction.

PMID:39765339 | DOI:10.5213/inj.2448348.174

Fitoterapia. 2025 Jan 5:106378. doi: 10.1016/j.fitote.2025.106378. Online ahead of print.

ABSTRACT

Genus Acacia comprises around 1500 species. They are widely used to treat inflammation as well as bacterial and fungal infections as they are enriched in phytochemicals, especially phenolics. The aim of this study was to evaluate the antibacterial activity of leaves’ methanolic extracts of twelve Acacia species growing in Egypt against Vibrio parahaemolyticus, Salmonella enterica, Listeria monocytogens, Klebsiella pnemoniae, Bacillus aquimaris, Bacillus subtilis, and Escherichia coli. These species are Acacia nilotica (wild and cultivated), Acacia seyal, Acacia auriculiformis, Acacia saligna, Acacia xanthophloea, Acacia tortilis subsp. raddiana (Gabal Elba and Aswan), Acacia tortilis, Acacia laeta (wild and cultivated), and Acacia albida. Furthermore, to study the metabolomic composition and variation among these species using ultra-high-performance liquid chromatography-electrospray ionization quadrupole time of flight mass spectrometry (UHPLC-q-tof-ESI-MS) coupled with multivariate statistical analysis and correlate it to the antibacterial potential. Results showed that Acacia nilotica (AN) has superior antibacterial activity over the other species. In addition, it exhibited a distinct segregation in Principal component analysis (PCA) and partial least square discriminant analysis (PLS-DA). Full profiling of AN using UHPLC-ESI-q-tof-MS revealed 42 phenolics mainly catechins. It was further subjected to bio-guided fractionation and revealed the presence of methyl gallic acid, gallic acid, catechin gallate, and digallate isomers in its most bioactive fraction. These compounds were identical to the compounds annotated as VIPs and were responsible for the segregation of AN in both PCA and PLS-DA analyses. Hence, this study sheds light on the use of chemometrics as an early tool for the detection of bioactive compounds.

PMID:39765316 | DOI:10.1016/j.fitote.2025.106378

Exp Cell Res. 2025 Jan 5:114408. doi: 10.1016/j.yexcr.2025.114408. Online ahead of print.

ABSTRACT

Fibroblast-like synoviocytes (FLS) are key cells promoting cartilage damage and bone loss in rheumatoid arthritis (RA). They are activated to assume an invasive and migratory phenotype. While mechanisms of FLS activation are unknown, evidence suggests that pre-damaged extracellular matrix (ECM) of the cartilage can trigger FLS activation. Integrin α11β1 might be involved in the activation, as it is increased in RA patients and hTNFtg mice, an RA mouse model. We treated murine chondrocytes with TNFα to produce a damaged, RA-like matrix. Comparison to healthy chondrocyte matrix revealed decreased ECM proteins, e.g. collagens and proteoglycans, increased matrix-degrading proteins and elevated levels of inflammatory cytokines. FLS responded to the damaged chondrocyte matrix with a matrix-remodeling and pro-inflammatory phenotype characterized by a gene signature involved in matrix degradation and increased production of CLL11 and CCL19. Damaged chondrocyte matrix stimulated increased Itga11 expression in FLS, correlating with the increased α11β1 amounts in RA patients. FLS deficient in integrin α11β1 released lower amounts of inflammation-associated cytokines. Our results demonstrate differences in healthy and RA-like chondrocyte ECM and distinctly different responses of wt FLS to damaged versus healthy ECM.

PMID:39765309 | DOI:10.1016/j.yexcr.2025.114408

Clin Biochem. 2025 Jan 5:110871. doi: 10.1016/j.clinbiochem.2024.110871. Online ahead of print.

ABSTRACT

INTRODUCTION: Dyslipidemia is characterized by changes in lipid and lipoprotein levels in the blood where phospholipid transfer protein (PLTP) helps to regulate and modulate the size of high-density lipoproteins (HDL), working on the reverse transport of cholesterol. ApoA-1 is the primary protein component of HDL, and certain genetic variants like rs5072, have been associated with hypertriglyceridemia in children. This study aimed to explore the association between PLTP concentrations and the effect of the genetic variant APOA1 rs5072 on hypertriglyceridemia and atherogenic dyslipidemia (AD) in the pediatric population of Southeastern Mexico.

MATERIALS AND METHODS: A cross-sectional study was carried out with a case-control design for 364 pediatric patients between 2 and 17 years old in Chiapas and Tabasco, Mexico. Serum samples were used to evaluate PLTP concentrations using ELISA kits, and DNA from peripheral blood samples was used to study genetic variation using q-PCR with TaqMan® probes. For statistical analysis, Student t-test for media comparison, Chi-square for frequency and Pearson analysis for correlation was performed. The software SNPStats was used for inheritance models.

RESULTS: Children with hypertriglyceridemia had higher levels of PLTP (8.3 ± 6.5 ng/ml) than the control group (6.4 ± 4.5 ng/ml). Similarly, the pediatric patients with AD had higher PLTP levels of 8.0 ± 6 ng/ml, mainly in children with high triglycerides who were between 10 and 17 years old (9.7 ± 8.0 ng/ml). Also, it was found that the genetic variant rs5072 had a protective effect against hypertriglyceridemia (OR = 0.61, p = 0.024) in the over-dominant inheritance model.

CONCLUSION: PLTP levels increase in pediatric patients aged 10 to 17 years with a diagnosis of hypertriglyceridemia and AD. The genetic variant rs5072 has a protective effect in hypertriglyceridemia.

PMID:39765303 | DOI:10.1016/j.clinbiochem.2024.110871

Neurospine. 2024 Dec;21(4):1210-1218. doi: 10.14245/ns.2448634.317. Epub 2024 Dec 31.

ABSTRACT

OBJECTIVE: Lumbar disc herniation (LDH) represents an increasingly encountered condition in patients with rheumatoid arthritis (RA). The aim of the present study is to assess the progress of health-related quality of life following transforaminal endoscopic lumbar discectomy (TELD) for LDH in patients suffering from RA.

METHODS: Seventy-four patients, scheduled to undergo elective TELD for LDH, were prospectively enrolled in the study. Group A included 36 otherwise healthy individuals and group B 38 patients complementarily diagnosed with RA according to the 2010 ACR/EULAR (American College of Rheumatology/European League Against Rheumatism) criteria. The Medical Outcomes Study 36-item Short Form health survey (SF-36) was selected for the outcome assessment at baseline and postoperatively, at selected intervals at 6 weeks, 3, 6, and 12 months postoperatively.

RESULTS: Group A presented statistically significantly higher scores in all SF-36 domains and all selected intervals (p<0.001), except for mental health parameter. All aspects of SF-36 questionnaire significantly improved postoperatively (p<0.001) and in each group independently. Nevertheless, the absolute improvement between consecutive time intervals did not differ significantly between the 2 groups.

CONCLUSION: Patients diagnosed with RA who undergo TELD for LDH demonstrate statistically significant improvement in their health status, as measured by SF-36 questionnaire, one year after the procedure. This improvement is comparable with normal individuals.

PMID:39765266 | DOI:10.14245/ns.2448634.317

Neurospine. 2024 Dec;21(4):1190-1198. doi: 10.14245/ns.2448718.359. Epub 2024 Dec 31.

ABSTRACT

OBJECTIVE: To compare the safety profiles of biportal endoscopic spinal surgery (BESS) and microscopic spinal surgery (MSS) for lumbar disc herniation and spinal stenosis by analyzing the associated adverse events.

METHODS: We pooled data from 2 prospective randomized controlled trials involving 220 patients (110 in each group) who underwent single-level lumbar surgery. Participants aged 20-80 years with radiating pain due to lumbar disc herniation or spinal stenosis were included in this study. Adverse events were recorded and analyzed over a 12-month follow-up period.

RESULTS: The overall adverse event rates were 9.1% (10 of 110) in the BESS group and 17.3% (19 of 110) in the MSS group, which were not statistically significantly different (p=0.133). Notably, wound dehiscence occurred in 8.2% of MSS cases but in none of the BESS cases. Both groups showed similarly low rates of complications, such as dural tears, epidural hematoma, and nerve root injury. The most common adverse event in the BESS group was recurrent disc herniation (2.7%), whereas that in the MSS group was wound dehiscence (8.2%).

CONCLUSION: BESS demonstrated a safety profile comparable to that of MSS for the treatment of lumbar disc herniation and spinal stenosis, with a trend towards fewer overall complications. BESS offers particular advantages in terms of reducing wound-related complications. These findings suggest that BESS is a safe alternative to conventional MSS and potentially offers the benefits of a minimally invasive approach without compromising patient safety.

PMID:39765264 | DOI:10.14245/ns.2448718.359

Afr J Reprod Health. 2024 Dec 31;28(12):88-96. doi: 10.29063/ajrh2024/v28i12.10.

ABSTRACT

This study assesses gender inequality in education and employment in BRICS (Brazil, Russia, India, China, and South Africa) countries between the 2000 and 2021, using data from the World Bank database. A descriptive data analysis was carried out as well as graphical representations to compare among countries. The results showed that that female education achieved significant success, especially at secondary and tertiary levels, through specific policies including financial support and affirmative actions. Brazil and Russia maintained an increasingly higher enrollment at the secondary level of education. In contrast, China recorded very rapid growth in tertiary enrollments, reaching over 92% enrolment of females. History, poverty, and social pressures were identified as systemic barriers in the enrollment of girls to school in India and South Africa. This study indicate that even when gains are achieved on the educational front, translating them into gains in terms of equality in employment proves difficult. Secondly, the unemployment rates among females in countries such as Brazil and South Africa are higher, reflecting more significant socio-economic problems. This calls for more vigorous policy responses toward gender inequality within the labour market through labour reforms, job creation policies, and specific support to women’s employment in the informal sector in the BRICS countries.

PMID:39764841 | DOI:10.29063/ajrh2024/v28i12.10