Nevin Manimala

Int J Hematol. 2024 Feb 26. doi: 10.1007/s12185-024-03727-x. Online ahead of print.

ABSTRACT

The number of umbilical cord blood transplantation (U-CBT) procedures has been growing annually, but little research has been done on long-term immune recovery after U-CBT. Infection risk is high in U-CBT recipients, and this can be partially attributed to immature immunocompetent cells in umbilical cord blood. In this study, we analyzed lymphocyte subset (LST) number to determine the long-term recovery timeline. We included 36 U-CBT and 10 unrelated bone marrow transplantation (U-BMT) recipients who survived more than 2 years after transplantation, and followed them for up to 10 years post-transplant. Recovery kinetics in the early phase post-transplant was different for each LST. Recovery of CD19⁺ B cells was faster after U-CBT than after U-BMT in the first 5 years after transplantation. Although CD4⁺ T cells increased in the first several months after U-CBT, long-term cell count recovery was impaired in approximately 20% of patients. Thus, although the LST recovery pattern after U-CBT was unique, LST number recovery was statistically comparable between U-CBT and U-BMT past 5 years post-transplantation.

PMID:38407785 | DOI:10.1007/s12185-024-03727-x

Adv Mater. 2024 Feb 26:e2314337. doi: 10.1002/adma.202314337. Online ahead of print.

ABSTRACT

The unique properties of conjugated polymers (CPs) in various optoelectronic applications are mainly attributed to their different self-assembly processes and superstructures. Various methods have been utilized to tune and control CP structure and properties with less attention paid to the use of chirality. CPs with main chain chirality are rare and their microscopic and macroscopic properties are still unknown. In this work, we provide the first experimental results along these lines by synthesizing a series of racemic and enantiopure CPs containing statistical and alternating carbo[6]helicene and indacenodithiophene moieties and evaluating their microscopic (optical, energy levels) and macroscopic properties (hole mobilities, photovoltaic performance). We demonstrate that a small statistical insertion of either the racemic or enantiopure helicene into the polymer backbone finely tunes the microscopic and macroscopic properties as a function of the statistical content. The microscopic properties of the enantiopure versus the racemic polymers with the same helicene loading remain similar. On the contrary, the macroscopic properties, and more interestingly those between the two enantiomeric forms, are altered as a function of the statistical content. Once incorporated into a solar cell device, these chiral CPs display better performance in their enantiopure versus racemic forms. This article is protected by copyright. All rights reserved.

PMID:38406997 | DOI:10.1002/adma.202314337

J Surg Oncol. 2024 Feb 26. doi: 10.1002/jso.27605. Online ahead of print.

ABSTRACT

BACKGROUND: Differentiating clinical near-complete and complete responses (cCR) after neoadjuvant therapy (NT) is challenging in rectal cancer patients. We hypothesized that magnetic resonance imaging staging limitations for low rectal cancers may increase the proportion of abdominoperineal resection (APR) with permanent colostomy for those without a cCR.

METHODS: Single institution retrospective analysis of rectal cancer cases before and after adoption of nonoperative “watch and wait” (W&W) pathway. APR as a percentage of rectal resections was the primary outcome.

RESULTS: There were 76 total mesorectal excisions (TME) in the pre-W&W group and 98 in the post-W&W group. NT was significantly more common in the post-W&W group. There was no significant difference in the APR primary outcome (pre-W&W APR 33.3% vs. post-W&W APR 26.5%, p = 0.482). APR patients had fewer complete TME grades (69.2% vs. 46.2%) and more pathologic complete responses (0% vs. 26.9%) in the post-W&W period. The cCR rate for patients with nonoperative management was 51.4% (n = 37) and 13.5% (n = 5) had regrowths, all of whom underwent salvage surgery.

CONCLUSION: APR for those without a cCR to NT has not increased in the nonoperative management era. Balancing the pathologic complete response rate may require restaging some patients with clinical near-complete responses.

PMID:38406980 | DOI:10.1002/jso.27605

Curr Protoc. 2024 Feb;4(2):e1002. doi: 10.1002/cpz1.1002.

ABSTRACT

The widespread application of high-throughput sequencing technology has generated massive sequences of B-cell receptor (BCR) immune repertoires. Computational analysis of these data has gained significant attention due to the increasing importance of immunotherapy and precision medicine. It not only reveals the diversity and dynamic changes in immune responses, contributing to the study of associated diseases, but also provides valuable information for immunodiagnostics and drug development. Recently, we introduced a BCR-specific multiple sequence alignment (MSA) method along with a comprehensive platform software called Abalign, which stands out as an excellent choice for analyzing BCR immune repertoires due to its unique high-throughput processing capability. It offers ultra-fast MSA functionality and a wide range of analytical features, including BCR/antibody extraction, clonal grouping, lineage tree construction, mutation profiling, diversity statistics, VJ gene assignment, antibody humanization, and more. Importantly, users can perform these analyses using the graphical user interface without any programming skills or scripts. In this article, we present a series of protocols that integrate Abalign’s analysis modules into a cohesive workflow. This step-by-step workflow provides detailed instructions for software installation, data preparation, and comprehensive analysis of BCR immune repertoires. This workflow facilitates the efficient acquisition of comprehensive results in profiling BCR immune repertoires, offering insights into the impacts of infectious diseases, allergies, autoimmune disorders, tumor immunology, and antibody drugs. Abalign is freely available at http://cao.labshare.cn/abalign/. © 2024 Wiley Periodicals LLC. Basic Protocol 1: Resource preparation Basic Protocol 2: Analyzing BCR immune repertoires Support Protocol 1: Aiding antibody humanization Support Protocol 2: Constructing B-cell lineage trees Alternate Protocol: Running with Linux command line Basic Protocol 3: Comparing BCR immune repertoires.

PMID:38406972 | DOI:10.1002/cpz1.1002

Hand (N Y). 2024 Feb 26:15589447241233707. doi: 10.1177/15589447241233707. Online ahead of print.

ABSTRACT

BACKGROUND: To determine the amount of micromotion during forearm rotation after diaphyseal ulnar shaft fracture or osteotomy.

METHODS: This was a biomechanical study using 7 paired-matched cadavers. The upper extremity was mounted in a custom rig and the forearm brought through full pronation and supination. A Hall effect sensor was placed at the fracture ends to measure micromotion for all tested conditions. There were 4 conditions tested: (1) intact ulnar shaft with plate to act as a control; (2) transverse fracture/osteotomy without stabilization; (3) fracture/osteotomy with cortical apposition stabilized with plate fixation; and (4) 50% comminuted fracture stabilized with plate.

RESULTS: There was a significantly greater amount of fracture site motion in the fracture/osteotomy model without stabilization compared with all other tested conditions (P < .001, .0001, .0003, respectively). The fracture/osteotomy site with cortical apposition and the comminuted fracture models showed no statistically significant differences in the amount of micromotion compared with each another (P = .952) or compared with the intact ulnar shaft (P = .997, .889, respectively).

CONCLUSIONS: There was no significant difference in the amount of motion between an intact ulnar shaft, an ulnar shaft fracture with cortical apposition stabilized with a plate, and a plated comminuted fracture. These findings may help surgeons decide on their type of postoperative immobilization in the setting of isolated ulnar shaft fractures or ulnar shaft osteotomies stabilized with plate fixation.

PMID:38406971 | DOI:10.1177/15589447241233707

Geriatr Gerontol Int. 2024 Feb 26. doi: 10.1111/ggi.14843. Online ahead of print.

ABSTRACT

AIM: This study was conducted to determine the relationship between sociodemographic characteristics, prolonged grief, meaning reconstruction, and posttraumatic growth of elderly individuals who have lost loved ones.

METHODS: A total of 122 elderly individuals who had lost loved ones were included in the research conducted in a nursing home.

RESULTS: The levels of Prolonged Grief Inventory (PG-13), Grief and Meaning Reconstruction Inventory (GMRI), and Posttraumatic Growth (PTG) scale were found to be high among the individuals in the study. While the PG-13 scores of single individuals who have lost their spouses are statistically significantly higher compared to married individuals, the scores for GMRI are higher for elderly individuals with chronic illness and expected death compared to those who have experienced sudden loss. A significant negative correlation was also determined between PG-13, GMRI, and PTG scores.

CONCLUSION: Counseling to reconstruct grief and meaning is recommended for at-risk groups. Geriatr Gerontol Int 2024; ••: ••-••.

PMID:38406968 | DOI:10.1111/ggi.14843

J Ayub Med Coll Abbottabad. 2023 Oct-Dec;35(4):645-649. doi: 10.55519/JAMC-04-12318.

ABSTRACT

BACKGROUND: Split-thickness skin grafting (STSG) is a widely employed technique for repairing wounds, such as ulcers, trauma, or in reconstructive surgeries. The objective was to compare the efficacy of different dressing materials for healing donor-site wounds after split-thickness skin grafting.

METHODS: A single center, randomized controlled trial was conducted at the Department of Plastic Surgery, Civil Hospital Karachi, Pakistan, over a period of six months. The study included patients aged 18 years and above, of both genders, who underwent single donor-site wounds after split-skin grafting with a surface area larger than 10 cm². The eligible patients were randomly divided into six groups: Film, Alginate, Gauze, Hydrofiber, Hydrocolloid, and Silicone. Pain, itching, scarring, complications, and patient satisfaction were evaluated after 12 weeks using standardized assessment scales.

RESULTS: The median time to complete wound healing and re-epithelialization varied among the different dressing groups, with hydrofiber and silicone dressings demonstrating the shortest healing time. Statistical analysis revealed a significant difference in the median time to complete wound healing among the dressing groups (p-value=0.019). However, no significant differences were observed in pain, itching, scarring (POSAS observer and patient), or patient satisfaction among the different dressings (p-value>0.05).

CONCLUSIONS: Although the dressing type did not significantly affect pain, itching, scarring, or patient satisfaction, variations were observed in the time to complete wound healing. These findings contribute to the selection of appropriate donor site dressings for optimizing outcomes in split-skin grafting procedures.

PMID:38406953 | DOI:10.55519/JAMC-04-12318

J Ayub Med Coll Abbottabad. 2023 Oct-Dec;35(4):640-644. doi: 10.55519/JAMC-04-12361.

ABSTRACT

BACKGROUND: Several previous studies have suggested a positive association between Alopecia Areata and thyroid disorders. However, there is a paucity of such studies in our country. Our study aimed to know the frequency of thyroid dysfunction and thyroid autoimmunity in patients reporting to Dermatology Outdoors with Alopecia Areata (AA) and to compare it with normal controls.

METHODS: This was a Case-Control study conducted at the Dermatology outpatient of a tertiary care hospital in Pakistan. 102 patients with AA and 102 age and sex-matched controls were enrolled. The age of onset of the disease, the involved sites and the presence of other associated diseases were noted. Venous blood samples were taken from patients and controls for Thyroid function tests and Anti- Thyroid peroxidase antibodies (Anti-TPO Ab). The data was analyzed using Statistical Package for Social Sciences (SPSS) version 23.

RESULTS: The mean age of onset of the disease was 30.37±12.53. 91.2% of patients had the classic patch type of AA. The most commonly involved site was Scalp. Associated diseases were found in eight (7.8%) patients. Thyroid dysfunction was found in two patients and none of the Controls. Both the patients had Subclinical thyroid disease. The p-value was 0.157, which was not statistically significant. Thyroid autoimmunity (raised Anti-TPO Ab titre) was detected in five (4.90%) patients and none of the Controls. The p-value was 0.024, which was statistically significant.

CONCLUSIONS: AA is significantly associated with Thyroid autoimmunity but there is no significant association between AA and clinical or subclinical thyroid disease.

PMID:38406952 | DOI:10.55519/JAMC-04-12361

J Ayub Med Coll Abbottabad. 2023 Oct-Dec;35(4):623-628. doi: 10.55519/JAMC-04-12276.

ABSTRACT

BACKGROUND: Preventing tooth loss is of utmost importance in maintaining optimal mastication, phonation, and aesthetics. Most commonly, pulpitis occurs as a result of caries, while trauma less frequently causes it. In both cases, it can lead to unbearable pain. To alleviate this pain and preserve the tooth without resorting to extraction, root canal treatment is indicated. To compare the radiographic quality of root canal filling sealing achieved with the Obtura II system and the cold lateral condensation technique.

METHODS: This randomized clinical trial was conducted at the School of Dentistry with a total of 260 participants. The study focused on single-rooted teeth that required endodontic treatment. Group A was assigned the cold lateral condensation, while Group B received obturation using the Obtura II system. A radiographic assessment was performed to evaluate the presence of voids and the extent of extension at the apex in both groups. The chi-square test was utilized to compare the occurrence of voids and the extent of extension between the two groups.

RESULTS: In the Cold Lateral Compaction cold lateral condensation group, 113 cases (86.92%) achieved optimum extension, while in the Obtura II group, 114 cases (87.69%) achieved the same. A statistically significant difference was observed between the groups in terms of extension (p=0.033). Although the difference in extension quality was not statistically significant, it is worth noting that the Obtura II group had a higher incidence of overextension. The cold lateral condensation group had 104 cases (80.00%) with no voids, whereas the Obtura II group had 121 cases (93.08%) without voids. A statistically significant difference was observed between the groups regarding the presence of voids (p=0.004).

CONCLUSIONS: Obtura II exhibits a denser sealing and fewer voids compared to the cold lateral condensation technique. However, Obtura II showed a slightly higher tendency to extend beyond the apex compared to the CLC technique.

PMID:38406949 | DOI:10.55519/JAMC-04-12276

J Ayub Med Coll Abbottabad. 2023 Oct-Dec;35(4):612-615. doi: 10.55519/JAMC-04-12285.

ABSTRACT

BACKGROUND: One of the major causes of cardiovascular morbidity and mortality is heart failure. The study aims to assess the effect of heart rate on the incidence of rehospitalization in patients with heart failure and reduced ejection fraction.

METHODS: It is a cross-sectional, analytical research conducted over six months, from June to December 2022, at the cardiology department of a tertiary care hospital. Patients who satisfied the modified Framingham heart failure criteria at admission and were discharged with an initial diagnosis of heart failure and those readmitted within 6 months or less of their discharge were included in the study. Pregnant women, patients diagnosed with cognitive impairment, and patients who had contraindications for taking any of the beta-blockers, angiotensin-converting enzyme inhibitor/angiotensin receptor blocker /angiotensin receptor -neprilysin inhibitor, Sodium-Glucose co-transport inhibitor, and mineralocorticoid inhibitors were excluded from the study.

RESULTS: A total of 77 patients were included in the study. At discharge, approximately 71 patients had a heart rate of less than 70 beats/min and had no readmissions whereas, 6 patients had a heart rate of greater than 70 beats/min with 5 patients requiring readmission in the following 6 months. This relationship was statistically significant with a p-value of 0.000.

CONCLUSIONS: According to the study, heart rate is a significant factor in the rehospitalization of individuals with heart failure and a low ejection fraction. At discharge, if the heart rate is not optimized then the rate of readmissions is increased.

PMID:38406946 | DOI:10.55519/JAMC-04-12285