Nevin Manimala

Burns Trauma. 2023 Dec 18;11:tkad031. doi: 10.1093/burnst/tkad031. eCollection 2023.

ABSTRACT

BACKGROUND: Sepsis is a potentially life-threatening condition that occurs when the body’s response to infection leads to widespread inflammation and tissue damage. Negative cultures can make it difficult for clinicians to make a diagnosis and may raise questions about the validity of the definition of sepsis. In addition, the clinical distinctions between burn patients with blood culture-positive and -negative sepsis are also poorly understood. Therefore, this study aimed to examine the clinical differences between blood culture-positive and -negative sepsis in burn patients in order to improve the understanding of the pathophysiology and epidemiology of sepsis in this population.

METHODS: This study had a retrospective design, and the participants were adults aged ≥18 years. Patients diagnosed with sepsis were divided into two groups based on their blood culture results within 1 week of sepsis diagnosis.

RESULTS: We enrolled 1643 patients admitted to our institution’s burn intensive care unit between January 2010 and December 2021. pH, platelet count, bicarbonate and haematocrit were significant in both the positive and negative groups. However, lymphocyte, red cell distribution width and blood urea nitrogen were significant only in the positive group, whereas lactate dehydrogenase was significant only in the negative group. Acinetobacter baumannii, Pseudomonas aeruginosa, and Klebsiella pneumonia are common gram-negative bacterial species, and Staphylococcus aureus and Staphylococcus epidermidis are common gram-positive bacterial species seen in burn patients with positive blood cultures. Carbapenem resistance was found to be associated with an unfavourable prognosis in gram-negative bacteria, with the exception of P. aeruginosa.

CONCLUSIONS: pH, platelet count, bicarbonate and haematocrit were routine biomarkers that demonstrated statistical significance in both groups. Lactate dehydrogenase was significant in the blood-negative group, while red cell distribution width, blood urea nitrogen and lymphocyte count were significant in the positive group. Furthermore, the most common causes of sepsis are gram-negative bacteria, including A. baumannii, K. pneumoniae and P. aeruginosa. Additionally, resistance to carbapenems is associated with unfavourable outcomes.

PMID:38116468 | PMC:PMC10729782 | DOI:10.1093/burnst/tkad031

Obstet Gynecol Int. 2023 Dec 11;2023:9970818. doi: 10.1155/2023/9970818. eCollection 2023.

ABSTRACT

BACKGROUND: Endometriosis is a benign disorder that is generally defined as the presence of endometrial glands and stroma outside their normal location. TGF-β1 is found in stromal cells and its expression is increased in epithelial cells of endometriotic cysts. Endometriosis diagnostics take a long time, so new markers are needed to diagnose endometriosis. This study aims to determine the diagnostic value of TGF-β1 in menstrual blood in diagnosing endometriosis.

METHOD: Diagnostic tests to compare eutopic endometrial TGF-β1 levels from menstrual blood of patients with suspected endometriosis were undertaken in the Obstetrics and Gynecology Department of Dr. Mohammad Hoesin General Hospital, Faculty of Medicine, Sriwijaya University, Palembang, from July 2019 to November 2020. 50 patients who were suspected with endometriosis met the inclusion criteria. Comparison of TGF-β1 levels between endometriosis and nonendometriosis patients was analyzed using the Mann-Whitney test. The cutoff point of the TGF-β1 level towards the histopathological outcome was obtained using the ROC curve. Data analysis was performed by using SPSS version 22.0.

RESULTS: In this study, endometriosis patients were 31.6 ± 6.55 years of age with a range of 20 to 46 years. In statistical analysis, there was no difference in BMI (p = 0.181) and BMI classification (p = 0.207), the history of contraception (p = 0.097), infertility (p = 1.000), and dysmenorrhoea (p = 1.000) between endometriosis and nonendometriosis patients. In the study, there were differences in TGF-β1 between endometriosis and nonendometriosis patients (p ≤ 0.001). By using the ROC curve, the cutoff point for TGF-β1 levels has the best sensitivity and specificity, which is 515 ng/ml. The TGF-β1 level has a sensitivity of 80%, a specificity of 90%, a positive predictive value (PPV) of 0.969, a negative predictive value (NPV) of 0.529, a positive likelihood ratio of 8, a negative likelihood ratio of 0.222, and an accuracy of 0.820 to the endometriosis outcome.

CONCLUSION: It can be concluded that the TGF-β1 level has a very good diagnostic value in establishing endometriosis diagnostics. This trial is registered with ISRCTN72218532.

PMID:38116460 | PMC:PMC10728358 | DOI:10.1155/2023/9970818

One Health. 2023 Nov 26;17:100657. doi: 10.1016/j.onehlt.2023.100657. eCollection 2023 Dec.

ABSTRACT

Recent outbreaks of Avian Influenza across Europe have highlighted the potential for syndromic surveillance systems that consider other modes of data, namely social media. This study investigates the feasibility of using social media, primarily Twitter, to monitor illness outbreaks such as avian flu. Using temporal, geographical, and correlation analyses, we investigated the association between avian influenza tweets and officially verified cases in the United Kingdom in 2021 and 2022. Pearson correlation coefficient, bivariate Moran’s I analysis and time series analysis, were among the methodologies used. The findings show a weak, statistically insignificant relationship between the number of tweets and confirmed cases in a temporal context, implying that relying simply on social media data for surveillance may be insufficient. The spatial analysis provided insights into the overlaps between confirmed cases and tweet locations, shedding light on regionally targeted interventions during outbreaks. Although social media can be useful for understanding public sentiment and concerns during outbreaks, it must be combined with traditional surveillance methods and official data sources for a more accurate and comprehensive approach. Improved data mining techniques and real-time analysis can improve outbreak detection and response even further. This study underscores the need of having a strong surveillance system in place to properly monitor and manage disease outbreaks and protect public health.

PMID:38116453 | PMC:PMC10728316 | DOI:10.1016/j.onehlt.2023.100657

One Health. 2023 Nov 10;17:100651. doi: 10.1016/j.onehlt.2023.100651. eCollection 2023 Dec.

ABSTRACT

Giardia duodenalis is one of the major causes of diarrhea among humans, especially in young children. Statistical analysis revealed that the pooled prevalence of G. duodenalis in humans, dogs, and cats was 9.72% (10,921/112383), 15.60% (7510/48140), and 14.53% (1125/7740), respectively. Unquestionably, the canine-specific assemblages C and D and the feline-specific assemblage F were the dominant genotypes in dogs and cats, respectively. Additionally, the prevalence of zoonotic G. duodenalis assemblages (A and B) in dogs and cats was 23.07% (875/3792) and 41.42% (169/408), respectively, implying that the potential transmission of G. duodenalis from dogs and cats to human infection cannot be ignored. The highest frequency of potentially zoonotic assemblages was found among working dogs (3.55%, 25/705) and the 1-5 age group (22.92%, 11/48). In summary, dogs and cats have a significant role in the zoonotic transmission of G. duodenalis due to their close contact with humans and the higher frequency presence of zoonotic assemblages. Further studies are necessary to explore the presence of G. duodenalis among humans and animals and in environmental samples. Researchers should adopt a one-health approach to gain a deeper understanding of G. duodenalis in dogs and cats and potential transmission routes to humans.

PMID:38116451 | PMC:PMC10728314 | DOI:10.1016/j.onehlt.2023.100651

ACS Med Chem Lett. 2023 Nov 14;14(12):1656-1663. doi: 10.1021/acsmedchemlett.3c00264. eCollection 2023 Dec 14.

ABSTRACT

This work describes the synthesis and pharmacological and toxicological evaluation of melanostatin (MIF-1) bioconjugates with amantadine (Am) via a peptide linkage. The data from the functional assays at human dopamine D₂ receptors (hD₂R) showed that bioconjugates 1 (EC₅₀ = 26.39 ± 3.37 nM) and 2 (EC₅₀ = 17.82 ± 4.24 nM) promote a 3.3- and 4.9-fold increase of dopamine potency, respectively, at 0.01 nM, with no effect on the efficacy (E_max = 100%). In this assay, MIF-1 was only active at the highest concentration tested (EC₅₀ = 23.64 ± 6.73 nM, at 1 nM). Cytotoxicity assays in differentiated SH-SY5Y cells showed that both MIF-1 (94.09 ± 5.75%, p < 0.05) and carbamate derivative 2 (89.73 ± 4.95%, p < 0.0001) exhibited mild but statistical significant toxicity (assessed through the MTT reduction assay) at 200 μM, while conjugate 1 was found nontoxic at this concentration.

PMID:38116429 | PMC:PMC10726482 | DOI:10.1021/acsmedchemlett.3c00264

Cureus. 2023 Nov 19;15(11):e49047. doi: 10.7759/cureus.49047. eCollection 2023 Nov.

ABSTRACT

BACKGROUND: Alzheimer’s disease is a neurodegenerative disease that slowly deteriorates cognitive function over time. This condition disables the geriatric population worldwide. Knowing its symptoms and presentation could help the general population seek medical attention early.

OBJECTIVE: This study aims to assess the level of awareness, knowledge, and attitude towards Alzheimer’s disease among the general population in Makkah City.

METHODS: This cross-sectional study employed an online questionnaire distributed randomly in Makkah, Saudi Arabia. A sociodemographic and attitude panel is included under each section of the questionnaire, as well as a knowledge panel based on the Alzheimer’s Disease Knowledge Scale (ADKS). The knowledge and awareness level regarding Alzheimer’s disease was determined by adding up discrete scores for each correct knowledge item. A participant’s awareness level was categorized as poor if their score was less than 60%. Participants whose scores were 60% or higher were considered to have a high level of awareness Results: A total of 545 participants were investigated; 316 (58%) were females. A range of ages was represented among the participants, from 18 to over 60. Of the study respondents, 68 (12.5%) had an overall good awareness and knowledge of Alzheimer’s disease and its management while 477 (87.5%) had a poor knowledge level. Among divorced/widowed participants, 16.2% had an overall good knowledge level of the disease compared to 8.3% of married respondents with recorded statistical significance (P=.049). Also, 20.4% of those with relatives diagnosed with Alzheimer’s disease had good knowledge of the disease versus 10.7% of others without (P=.009).

CONCLUSION: According to the results, there is a lack of awareness and knowledge of Alzheimer’s disease. This study suggests increasing public awareness and knowledge of Alzheimer’s disease through campaigns and public education so that the disease is detected earlier.

PMID:38116357 | PMC:PMC10728572 | DOI:10.7759/cureus.49047

Cureus. 2023 Nov 19;15(11):e49043. doi: 10.7759/cureus.49043. eCollection 2023 Nov.

ABSTRACT

OBJECTIVES: This study aimed to examine the impact of demographic variables on mandibular condyle morphology, a critical factor in orthodontic treatment and maxillofacial surgery. The investigation focuses on the relationship between gender, age, and skeletal class with the morphological dimensions of the condyle, utilizing panoramic radiography as a diagnostic tool.

METHODOLOGY: A retrospective analysis was conducted on 150 panoramic radiographs from individuals stratified into six groups according to gender and skeletal class. Skeletal classes were determined using Steiner and McNamara cephalometry. The Kodak Carestream software (Rochester, NY: Carestream Health) was employed to measure condylar height, width, and morphology. Statistical evaluations included ANOVA, correlation assessments, and multivariate binary logistic regression to discern the differences and associations among the variables studied.

RESULTS: The findings revealed notable differences in condylar dimensions between genders across different skeletal classes, with males typically presenting larger condylar dimensions than females. The data also showed a moderate positive correlation between condyle height and width. Round-shaped condyles were the most common form found, with significant gender differences observed in certain skeletal classes. Additionally, logistic regression analysis identified significant associations between gender, age, and condylar width and shape.

CONCLUSIONS: The study concludes that demographic factors, such as gender and age, significantly affect mandibular condyle morphology. These factors should be carefully considered in clinical evaluations using panoramic radiography to enhance the precision of diagnoses and the effectiveness of subsequent orthodontic and maxillofacial treatments. The results provide valuable insights for healthcare professionals in regions where more advanced imaging techniques may not be readily available.

PMID:38116346 | PMC:PMC10729778 | DOI:10.7759/cureus.49043

NMR Biomed. 2023 Dec 19:e5080. doi: 10.1002/nbm.5080. Online ahead of print.

ABSTRACT

For liver intravoxel incoherent motion (IVIM) data acquisition, respiratory-triggering (RT) MRI is commonly used, and there are strong motivations to shorten the scan duration. For the same scan duration, more b values or higher numbers of excitations can be allowed for free-breathing (FB) imaging than for RT. We studied whether FB can be used to replace RT when careful IVIM image acquisition and image processing are conducted. MRI data of 22 healthy participants were acquired using a 3.0 T scanner. Diffusion imaging was based on a single-shot spin-echo-type echo-planar sequence and 16 b values of 0, 2, 4, 7, 10, 15, 20, 30, 46, 60, 72, 100, 150, 200, 400, and 600 s/mm² . Each subject attended two scan sessions with an interval of 10-20 days. For each scan session, a subject was scanned twice, first with RT and then with FB. The mean image acquisition time was 5.4 min for FB and 10.8 min for RT. IVIM parameters were calculated with bi-exponential model segmented fitting with a threshold b value of 60 s/mm² , and fitting started from b = 2 s/mm² . There was no statistically significant difference between IVIM parameters measured with FB imaging or RT imaging. Perfusion fraction ICC (intraclass correlation coefficient) for FB imaging and RT imaging in the same scan session was 0.824. For perfusion fraction, wSD (within-subject standard deviation), BA (Bland-Altman) difference, BA 95% limit, and ICC were 0.022, 0.0001, -0.0635~0.0637, and 0.687 for FB and 0.031, 0.0122, -0.0723~0.0967, and 0.611 for RT. For D_slow (×10^-3 s/mm² ), wSD, BA difference, BA 95% limit, and ICC were 0.057, 0.0268, -0.1258~0.1793, and 0.471 for FB and 0.073, -0.0078, -0.2170-0.2014, and <0.4 for RT. The D_fast coefficient of variation was 0.20 for FB imaging and 0.28 for RT imaging. All reproducibility indicators slightly favored FB imaging.

PMID:38113878 | DOI:10.1002/nbm.5080

Chemotherapy. 2023 Dec 19. doi: 10.1159/000535755. Online ahead of print.

ABSTRACT

INTRODUCTION: The aim of this study was to compare the disease-free survival (DFS) and overall survival (OS) of patients who underwent interval cytoreductive surgery after 3-4 cycles or 6 cycles of neoadjuvant chemotherapy (NACT) in advanced epithelial ovarian cancer patients.

METHODS: Out of 219 patients with advanced epithelial ovarian cancer,123 patients received 3-4 cycles and 96 patients received 6 cycles of platinum-based NACT. Afterwards, laparotomy was performed for interval cytoreductive surgery.

RESULTS: No statistically significant difference was found for DFS and OS of the patients who received 3-4 cycles and those who received 6 cycles of NACT (HR:1.047,95.0%CI [0.779-1.407]; p:0.746 for DFS, and HR:1.181,95.0% CI [0.818-1.707]; p:0.368 for OS). Evaluating 123 patients who received 3-4 cycles of NACT;87 patients (70.7%) without macroscopic residual tumor after interval cytoreductive surgery had significantly longer DFS and OS compared to 36 patients(29.3%) with any residual tumor (HR:1.830,95.0% CI [1.194-2.806]; p:0.003 for DFS, and HR:1.946,95.0% CI [1.166-3.250]; p:0.009 for OS).96 patients who received 6 courses of NACT were evaluated;63 patients (65.6%) without macroscopic residual tumor after interval cytoreductive surgery had significantly longer DFS and OS than 33 patients (34.4%) with any residual tumor (HR:1.716,95.0% CI [1.092-2.697];p:0.010 for DFS, and HR:1.921,95.0%CI [1.125-3.282]; p:0.013 for OS).

CONCLUSION: In patients with advanced ovarian cancer,there is no significant difference in DFS and OS between 3-4 cycles or 6 cycles of NACT.The most important factor determining survival is whether macroscopic residual tumor tissue remains after interval cytoreductive surgery following NACT.

PMID:38113873 | DOI:10.1159/000535755

Cerebrovasc Dis. 2023 Dec 19. doi: 10.1159/000535286. Online ahead of print.

ABSTRACT

Background The relationship between ischemic stroke (IS) and lipoprotein-associated phospholipase A2 (Lp-PLA2) activity is still unclear, and there is a dearth of stratified research on the relationship between Lp-PLA2 activity and different IS subtypes. Therefore, Mendelian randomization was used in this study to examine the relationship between genetically proxied Lp-PLA2 activity and the risks of IS and its subtypes. Methods Based on information from a meta-analysis of GWAS, which included 13,664 European people, five single-nucleotide polymorphisms related to Lp-PLA2 activity were chosen as instrumental variables. Summary statistics information about MEGESTROKE consortium with the European group (40,585 cases and 406,111 controls) include any ischemic stroke (AIS) (n = 34,217); large-artery stroke (LAS, n=4,373), cardioembolic stroke (CES, n=7,193) and small vessel stroke (SVS, n=5,386). In order to determine the causal relationships between Lp-PLA2 activity and IS as well as its subtypes, the inverse variance weighted (IVW) approach was chosen as the primary analysis. Significant estimates were then tested by sensitivity analysis to rule out heterogeneity and pleiotropy. Results IVW showed Lp-PLA2 activity was causally associated with LAS (OR=3.25, 95% CI=1.65-6.41, p=0.0007), but not with other subtypes of stroke. Sensitivity analysis for causal estimates between Lp-PLA2 activity and LAS showed no significant heterogeneity or pleiotropy. Conclusions These MR analyses support a causal effect of Lp-PLA2 activity on LAS but not on AIS, CES or SVS, which suggests that serum Lp-PLA2 activity might be a biomarker for prediction of LAS.

PMID:38113871 | DOI:10.1159/000535286