Nevin Manimala

Diagn Interv Radiol. 2023 Aug 9. doi: 10.4274/dir.2023.232188. Online ahead of print.

ABSTRACT

PURPOSE: This study aimed to compare the variability of the uterus during the menses phase (MP), follicular phase (FP), and luteal phase (LP) of the menstrual cycle using intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI).

METHODS: This prospective study was conducted at the Guangdong Provincial Hospital of Traditional Chinese Medicine between January 2022 and January 2023. Women of childbearing age (18-45 years) with appropriate progesterone levels were included in this study. Conventional magnetic resonance imaging and IVIM-DWI scans were performed during the MP, FP, and LP. The differences in IVIM-DWI-derived parameters between these phases were then compared, and the overlap was quantitatively described.

RESULTS: The apparent diffusion coefficient (ADC) and pure molecular diffusion coefficient (D) values from the endometrium, uterine junctional zone (UJZ), and myometrium indicated statistical differences between the MP and FP and the MP and LP (ADC: endometrium, both P < 0.001; UJZ, P = 0.008 and P < 0.001, respectively; myometrium, P = 0.033 and P = 0.006, respectively; D: endometrium, both P < 0.001; UJZ, P = 0.008 and P = 0.006, respectively; myometrium, P = 0.041 and P = 0.045, respectively). The perfusion-related diffusion coefficient (D*) values from the myometrium indicated statistical differences between the FP and MP and the FP and LP (D*: myometrium, P = 0.049 and P = 0.009, respectively). The overlapping endometrium ratios between the MP and FP or LP were lower than 50% in the ADC and D values (ADC: overlapping of MP and FP: 33.33%, overlapping of MP and LP: 23.33%; D: overlapping of MP and FP: 40.00%, overlapping of MP and LP: 43.33%).

CONCLUSION: The ADC and IVIM-derived parameters indicated differences in the uterus in diverse phases of the menstrual cycle, especially in the endometrium in relation to ADC and D values.

PMID:37555386 | DOI:10.4274/dir.2023.232188

Int Health. 2023 Aug 9:ihad059. doi: 10.1093/inthealth/ihad059. Online ahead of print.

ABSTRACT

Trichomonas vaginalis is a protozoan parasite and probably one of the main causes of adverse birth outcomes. Still, there is a paucity of information regarding the burden of T. vaginalis infection in Iranian women. To address this gap, we conducted a systematic review and meta-analysis of studies on trichomoniasis among females in Iran from January 2000 to January 2023. We searched multiple electronic databases (PubMed, Science Direct, Scopus, ProQuest, Web of Science, Google Scholar, Scientific Information Database, Iran Medex, Magiran and Iran Doc) and identified 108 articles with a total of 200 728 women. Using a random effects model, we found a pooled prevalence of 4.30% (95% CI 3.23 to 5.52%). Subgroup analysis, also, demonstrated a statistically significant association between the T. vaginalis prevalence in Iranian women, and the age range, city, sample type, being in prison, sex working and symptomatic infections. Our findings provide important information for healthcare authorities and can inform prevention strategies against trichomoniasis in Iran.

PMID:37555353 | DOI:10.1093/inthealth/ihad059

Int J Gynaecol Obstet. 2023 Aug 9. doi: 10.1002/ijgo.15019. Online ahead of print.

ABSTRACT

OBJECTIVE: Surgical management of bowel endometriosis is still controversial. Recently, many authors have pointed out the potential benefits of preserving the superior rectal artery, thus ensuring better perfusion of the anastomosis. The aim of this study was to evaluate the complication rate and functional outcomes of a bowel resection technique for deep endometriosis (DE) involving a nerve- and vascular-sparing approach.

METHODS: A single-center retrospective study was conducted by enrolling patients who underwent segmental resection of the rectus sigmoid for DE in our department between September 2019 and April 2022. Intraoperative and postoperative complications were recorded for each woman, and functional outcomes relating to the pelvic organs were assessed using validated questionnaires (Knowles-Eccersley-Scott-Symptom [KESS] questionnaire and Gastro-Intestinal Quality of Life Index [GIQLI] for bowel function, Bristol Female Lower Urinary Tract Symptoms [BFLUTS] for urinary function, and Female Sexual Function Index [FSFI] for sexual function). These were evaluated preoperatively and postoperatively after 6 months from surgery.

RESULTS: Sixty-one patients were enrolled. No patients had Clavien-Dindo grade 3 or 4 complications, there were no rectovaginal fistulas or ureteral lesions, and in no cases was it necessary to reoperate. Temporary bladder voiding deficits were reported in 8.2% of patients, which were treated with self-catheterizations, always resolving within 45 days of surgery. Gastrointestinal function evaluated by KESS and GIQLI improved significantly after surgery, whereas sexual function appeared to worsen, although without reaching the level of statistically significant validity.

CONCLUSION: Our vascular- and nerve-sparing segmental bowel resection technique for DE had a low intraoperative and postoperative complication rate and produced an improvement in gastrointestinal function after surgery.

PMID:37555349 | DOI:10.1002/ijgo.15019

Allergy. 2023 Aug 9. doi: 10.1111/all.15839. Online ahead of print.

NO ABSTRACT

PMID:37555336 | DOI:10.1111/all.15839

Cephalalgia. 2023 Aug;43(8):3331024231177636. doi: 10.1177/03331024231177636.

ABSTRACT

BACKGROUND: Clinical trials on anti-calcitonin gene-related peptide monoclonal antibodies poorly investigated their impact on migraine accompanying symptoms.

OBJECTIVE: To evaluate the impact of basal accompanying symptoms on anti-CGRP monoclonal antibodies treatment response and their evolution after six months of treatment in migraine patients.

METHODS: Patients with migraine diagnosis seen in the Headache Clinic and treated with erenumab, galcanezumab or fremanezumab were prospectively recruited. They completed a daily eDiary which provided data on headache frequency and the following accompanying symptoms of each day: photophobia, phonophobia, nausea, dizziness, and aura. Patients were classified as responders or non-responders based on 50% or greater reduction in headache days per month at month 6 (≥50% response rate). Accompanying symptoms ratios based on headache days per month were assessed per patient at baseline and after three and six months. Comparisons for basal characteristics, basal accompanying symptoms ratios and their evolution after six months between responders and non-responders were performed.

RESULTS: One hundred and fifty-eight patients were included, 44% (69/158) showed ≥50% response rate after six months. A significant reduction in headache days per month in both groups was found at month 6 (-9.4 days/month in ≥50% response rate group; p < 0.001, -2.2 days/month in <50% response rate group; p = 0.004). Additionally, significant decreases in photophobia (-19.5%, p < 0.001), phonophobia (-12.1%, p = 0.010) and aura ratios (-25.1%, p = 0.008) were found in ≥50% response rate group. No statistically significant reductions were found in nausea and dizziness in any group since their reduction was correlated with the decrease in headache days per month. Higher photophobia ratios at baseline were predictive of an increased response between months 3 and 6 (Incidence Risk Ratio = 0.928, p = 0.040).

CONCLUSIONS: The days per month with photophobia, phonophobia and aura decreased at a higher rate than headache days per month after six months in the ≥50% response group. Higher photophobia ratios were associated with higher response rates between three and six months. It could indicate an involvement of peripheral CGRP in photophobia as well as a central modulation of migraine through these treatments which mainly act on the periphery.

PMID:37555331 | DOI:10.1177/03331024231177636

Tumori. 2023 Aug 9:3008916231186178. doi: 10.1177/03008916231186178. Online ahead of print.

ABSTRACT

OBJECTIVE: The expression and significance of human epidermal growth factor receptor 2 (Her2) in upper tract urothelial carcinoma (UTUC) remains controversial. Thus, we aimed to systemically review the Her2 expression in UTUC patients and its relationship with pathological characters and clinical outcomes with meta-analysis.

MATERIALS AND METHODS: A systematically computerized search in PubMed, Scopus, Embase and Cochrane was conducted. From a total of 454 related articles, 35 articles were finally reviewed and 16 papers were chosen for further analysis. Pathological characters included tumor stage, grade, lymph node metastasis (LNM) and lymphovascular invasion (LVI). The clinical outcomes included overall survival (OS), recurrence-free survival (RFS), cancer specific survival (CSS), metastatic-free survival (MFS) and progression-free survival (PFS). RevMan software was used for meta-analyses.

RESULTS: In total 16 studies from 1994 to 2020 were chosen, 14 studies used immunohistochemistry to assess the expression of Her2 and 5 studies used in situ hybridization, with a positive rate of 0 to 74.0% and 7.2 to 18.1%, respectively. Her2-positive was significantly associated with stage (pooled HR 1.86; 95 % CI 1.43-2.42), grade (pooled HR 2.81; 95 % CI 1.01-7.85) and LNM (pooled HR 1.93; 95 % CI 1.18-3.15). However, there was no statistically relationship between Her2-positive with LVI (pooled HR 1.48; 95 % CI 0.64-3.46) and RFS (pooled HR 1.41; 95 % CI 0.98-1.83).

CONCLUSIONS: This review indicated that UTUC patients with Her2-positive tended to develop higher stage and grade tumors and LNM. The Her2 expression in UTUC patients deserves further investigation in the future.

PMID:37555322 | DOI:10.1177/03008916231186178

Psychol Med. 2023 Aug 9:1-10. doi: 10.1017/S0033291723001812. Online ahead of print.

ABSTRACT

BACKGROUND: Smoking contributes to a variety of neurodegenerative diseases and neurobiological abnormalities, suggesting that smoking is associated with accelerated brain aging. However, the neurobiological mechanisms affected by smoking, and whether they are genetically influenced, remain to be investigated.

METHODS: Using structural magnetic resonance imaging data from the UK Biobank (n = 33 293), a brain age predictor was trained on non-smoking healthy groups and tested on smokers to obtain the BrainAge Gap (BAG). The cumulative effect of multiple common genetic variants associated with smoking was then calculated to acquire a polygenic risk score (PRS). The relationship between PRS, BAG, total gray matter volume (tGMV), and smoking parameters was explored and further genes included in the PRS were annotated to identify potential molecular mechanisms affected by smoking.

RESULTS: The BrainAge in smokers was predicted with very high accuracy (r = 0.725, MAE = 4.16). Smokers had a greater BAG (Cohen’s d = 0.074, p < 0.0001) and higher PRS (Cohen’s d = 0.63, p < 0.0001) than non-smokers. A higher PRS was associated with increased amount of smoking, mediated by BAG and tGMV. Several neurotransmitters and ion channel pathways were enriched in the group of smoking-related genes involved in addiction, brain synaptic plasticity, and some neurological disorders.

CONCLUSION: By using a simplified single indicator of the entire brain (BAG) in combination with the PRS, this study highlights the greater BAG in smokers and its linkage with genes and smoking behavior, providing insight into the neurobiological underpinnings and potential features of smoking-related aging.

PMID:37555321 | DOI:10.1017/S0033291723001812

Health Info Libr J. 2023 Aug 9. doi: 10.1111/hir.12506. Online ahead of print.

ABSTRACT

BACKGROUND: Considering social distancing requirements and isolation during the COVID-19 pandemic and the widespread health mis/disinformation on social media, filling the pandemic-related information gap is critical.

OBJECTIVES: This study explored COVID-19-related question topics, topic correlation, evolving trends, and community interactions by leveraging data from a health question-answering (Q&A) community (public and health professionals) over a 2-year period.

METHODS: A total of 828 questions were collected and manually reviewed from a health Q&A and classified into 2492 codes. Question topic correlations, trends, and community interactions were generated using different statistical techniques.

RESULTS: Thirty-seven topics were identified, and strong topic correlations were observed between the cognitive layer and other layers. These topics changed as the pandemic developed. Community interaction analyses revealed topics that were popular but received comparatively fewer responses.

DISCUSSION: The findings could illuminate the dynamic changes in people’s interests and concerns related to COVID-19 and their experiences of exchanging information in social Q&A communities.

CONCLUSION: This study examined the practical significance of understanding topics of interest during a pandemic. The findings can inform the design of social health Q&A platforms that could reduce the risks of misinformation and disinformation.

PMID:37555296 | DOI:10.1111/hir.12506

Int Wound J. 2023 Aug 9. doi: 10.1111/iwj.14334. Online ahead of print.

ABSTRACT

Optimal management of burns begins with first aid from the first hours of injury. Adequate knowledge of how to perform first aid for burns can reduce the consequences of injury. Therefore, this study aims to determine the knowledge, attitude, and sources of information assessment towards burn First aid among people referred to a burn centre in the north of Iran. A questionnaire-based survey was conducted to assess knowledge, attitude, and sources of information towards burn first aid among people referred to a burn centre in the north of Iran in 2023. In this survey, a convenience sampling method was adopted. The variables consisted of four items on socio-demographic information, 15 items on knowledge, ten items on attitude, and one item on sources of information related to burn First aid. A total of 371 individuals responded to the survey. The mean age of participants was 31.90 ± 8.49 years old. The mean score of the total knowledge of the participants in the research was 6.04 ± 3.05. There was a statistically significant relationship between the variables of age, sex, marital status, place of residence, level of education, and history of receiving first aid training with the participants’ knowledge level. The average score of the total attitude of the participants was 44.08 ± 3.88. Out of 371 participants, 214 people (57.7%) had an average attitude, and 157 people (42.3%) had a good attitude towards burn first aid. There was a statistically significant relationship between place of residence, level of education, and history of receiving first aid training with the participants’ attitudes in the research. In addition, the level of knowledge had a statistically significant relationship with the participants’ attitude level in the research (p-value <0.001). The majority of participants have limited knowledge of burn first aid. This lack of knowledge could lead to severe consequences. Therefore, healthcare organizations should review and promote consistent guidelines for burn first aid to tackle and minimize the effect of this grave injury.

PMID:37555290 | DOI:10.1111/iwj.14334

Environ Sci Process Impacts. 2023 Aug 9. doi: 10.1039/d3em00135k. Online ahead of print.

ABSTRACT

Some studies of endocrine-disrupting polycyclic aromatic hydrocarbon (PAH) exposure and thyroid hormones (THs) are inconclusive. To assess the associations between PAHs and THs, and the influence of the iodine status on PAHs-THs, we employed 648 adolescents (12-19 years old) and 2691 adults from the National Health and Nutrition Examination Survey 2007-2008 and 2011-2012. PAH metabolites [1-hydroxynaphthalene (1-NAP), 2-NAP, 1-hydroxyphenanthrene (1-PHE), 2-PHE, 3-PHE, 2-hydroxyfluorene (2-FLU), 3-FLU, 9-FLU, and 1-hydroxypyrene (1-PYR)], THs [total and free thyroxine (TT4 and FT4), total and free triiodothyronine (TT3 and FT3), thyroid stimulating hormone (TSH), and thyroglobulin (Tg)], peripheral deiodinase activity (G_D) and thyroid’s secretory capacity (G_T) were involved. Multiple linear regression and weighted quantile sum (WQS) regression models were used to assess PAH-TH associations and the interaction between PAHs and the iodine status. Stratification analyses were conducted based on sex, smoking and iodine status. For adolescents, in a multivariable-adjusted regression model (β; 95% CI), 1-PHE (4.08%; 1.01%, and 7.25%), 2-PHE (3.98%; 0.70%, and 7.25%) and 9-FLU (3.77%; 1.10%, 7.47%) were positively correlated with TT3; 3-PHE and 1-PYR interacted with the iodine status (P-int < 0.05); 9-FLU was positively correlated with G_D in both sexes. Combined exposure to PAHs was positively associated with Tg (0.137; 0.030, and 0.243), and negatively correlated with TSH (-0.087; -0.166, and -0.008). For adults, 2-NAP was positively correlated with FT3 (0.90%; 0.20%, and 1.61%), FT4 (1.82%; 0.70%, and 2.94%), TT3 (1.31%; 0.10%, and 2.63%), TT4 (2.12%; 0.90%, and 3.36%) and G_T (2.22%; 1.01%, and 3.46%), but negatively correlated with TSH (-4.97%; -8.33%, and -1.49%); 1-NAP interacted with the iodine status (P-int < 0.05); 1-PHE was inversely correlated with TT3 in males; 2-PHE was positively correlated with TT3 in females. Combined exposure to PAHs was positively associated with FT3 (0.008; 0.001, and 0.014). Combined exposure to PAHs was positively associated with FT3, TT3 and G_D, and negatively correlated with FT4, TT4 and G_T in non-smoking adults; but positively associated with Tg (β = 0.140; 95% CI: 0.042, 0.237) in smoking adults. Our results indicated that combined and individual PAH exposure might be related to THs, and the iodine status had an influence on PAH-TH associations. These associations were not identical between adolescents and adults, and there were sex and smoking status differences.

PMID:37555279 | DOI:10.1039/d3em00135k