Nevin Manimala

J Endocrinol Invest. 2023 Aug 6. doi: 10.1007/s40618-023-02159-4. Online ahead of print.

ABSTRACT

PURPOSE: The risk of cardiovascular diseases’ death (CVD) in patients with differentiated thyroid cancer (DTC) treated with radioactive iodine (RAI) after surgery has not been adequately studied.

METHODS: Data of DTC patients who received RAI after surgery were retrieved from the Surveillance, Epidemiology, and End Result (SEER) database (2004-2015). Standardized mortality rate (SMR) analysis was used to evaluate the CVD risk in patients with RAI vs general population. A 1:1 propensity score matching (PSM) was applied to balance inter-group bias, and Pearson’s correlation coefficient was used to detect collinearity between variables. The Cox proportional hazard model and multivariate competing risk model were utilized to evaluate the impact of RAI on CVD. At last, we curved forest plots to compare differences in factors significantly associated with CVD or cancer-related deaths.

RESULTS: DTC patients with RAI treatment showed lower SMR for CVD than general population (RAI: SMR = 0.66, 95% CI 0.62-0.71, P < 0.05). After PSM, Cox proportional hazard regression demonstrated a decreased risk of CVD among patients with RAI compared to patients without (HR = 0.76, 95% CI 0.6-0.97, P = 0.029). However, in competing risk regression analysis, there was no significant difference (adjusted HR = 0.82, 95% CI 0.66-1.01, P = 0.11). The independent risk factors associated with CVD were different from those associated with cancer-related deaths.

CONCLUSION: The CVD risk between DTC patients treated with RAI and those who did not was no statistical difference. Noteworthy, they had decreased CVD risk compared with the general population.

PMID:37543985 | DOI:10.1007/s40618-023-02159-4

Arch Iran Med. 2023 Jan 1;26(1):8-15. doi: 10.34172/aim.2023.02.

ABSTRACT

BACKGROUND: The co-existence of chronic diseases (CDs), a condition defined as multimorbidity (MM), is becoming a major public health issue. Therefore, we aimed to determine the patterns and predictors of MM in the Azar Cohort.

METHODS: We evaluated the prevalence of MM in 15,006 (35-70-year old) subjects of the Azar Cohort Study. MM was defined as the co-existence of two or more CDs. Data on the subjects’ socioeconomic status, demographics, sleeping habits, and physical activity were collected using questionnaires.

RESULTS: The overall prevalence of MM was 28.1%. The most prevalent CDs, in decreasing order, were obesity, hypertension, depression, and diabetes. Obesity, depression, and diabetes were the most co-occurring CDs. The MM risk increased significantly with age, illiteracy, and in females. Also, the subjects within the lowest tertile of physical activity level (OR=1.89; 95% CI: 1.75-2.05) showed higher MM risk than those with the highest level of physical activity. Findings regarding current smoking status indicated that being an ex-smoker or smoker of other types of tobacco significantly increased the risk of MM.

CONCLUSION: The reduction of MM is possible by promoting public health from an early age among people of various socioeconomic conditions. It is vital to offer the necessary health support to the aging population of Iran.

PMID:37543916 | DOI:10.34172/aim.2023.02

Arch Iran Med. 2022 Nov 1;25(11):737-741. doi: 10.34172/aim.2022.116.

ABSTRACT

BACKGROUND: In December 2019, a cluster of viral pneumonia cases, later identified as coronavirus disease 2019 (COVID-19), was first reported in Wuhan, China, and then continued to spread to other parts of the world. COVID-19 is thought to be more prevalent in adults than children; therefore, information about COVID-19 burden and characteristics in children is lacking.

METHODS: We gathered data on the profile and transmission in children with COVID-19 from data collected by the North Sumatera Provincial Health Office team. Data were presented as mean±SD and percentage. Statistical analysis was performed using STATA version 15.0.

RESULTS: From April to October 2020, there were 1125 confirmed COVID-19 cases in children in North Sumatera, representing approximately 8.9% of all cases. Death occurred in 0.62% of the patients, and the children who died had underlying diseases. Four major clusters of COVID-19 infection in children were found in three Islamic boarding schools and one refugee shelter.

CONCLUSION: A high number of children in North Sumatera were affected by COVID-19, and mortality was found to be higher in children with underlying diseases. Major clusters were found in places with prolonged and repeated activities in close contact, such as boarding schools and a refugee shelter.

PMID:37543898 | DOI:10.34172/aim.2022.116

Arch Iran Med. 2022 Sep 1;25(9):617-623. doi: 10.34172/aim.2022.97.

ABSTRACT

BACKGROUND: Organ preservation solutions are not easily accessible in Iran, similar to many resource-limited countries. We aimed to evaluate the efficacy of a locally-produced HTK solution among adult liver transplantation candidates in a pilot clinical trial study.

METHODS: Adult patients undergoing liver transplantation were randomly allocated into two groups. One received the HTK solution (PharMedCina Inc., Shiraz, Iran), and the second received the commercially available HTK solution (Custodiol ^®).

RESULTS: Overall, 28 individuals entered the study, including 11 and 9 males (78.6% and 64.3%) in the Custodiol^® and local HTK groups, respectively. Clinical characteristics, including postoperative biliary complications, reperfusion syndrome, infection and primary non-function (PNF) rates, amount of intraoperative bleeding, length of hospital and ICU stay, peak aspartate aminotransferase (AST) and alanine aminotransferase (ALT), and duration of follow-up were similar between the two groups (P>0.05). One patient died in the locally-produced HTK group. The patient underwent re-transplantation 20 days after his first liver transplantation due to PNF. Two patients died in the Custodiol group, both due to PNF of the liver, which occurred five and three days after transplantation. The two groups did not show any difference regarding serum levels of AST, ALT, alkaline phosphatase (ALP), bilirubin, platelet count, prothrombin time and international normalized ratio, white blood cell count, blood urea nitrogen, and creatinine on the first postoperative day and on the day of discharge (P>0.05).

CONCLUSION: Based on the findings of this pilot study with the current sample size, no statistically significant difference was found between our locally-produced HTK solution and Custodiol^® regarding clinical outcomes.

PMID:37543887 | DOI:10.34172/aim.2022.97

Arch Iran Med. 2022 Aug 1;25(8):552-556. doi: 10.34172/aim.2022.88.

ABSTRACT

BACKGROUND: The accuracy and reliability of noninvasive methods of neonatal jaundice assessment are not completely obvious, including which area of the body is more suitable to estimate actual bilirubin with transcutaneous bilirubinometry (TCB).

METHODS: This cross-sectional study compares the accuracy of three noninvasive methods for neonatal jaundice estimation included visual estimation, TCB on the forehead, and TCB on the sternum. The mean and standard deviation describe quantitative variables. In addition to analytical analysis, we used the linear regression test to evaluate the association of different variables with the accuracy of TCB as well as paired t test for comparing the TCB results on the sternum with the forehead before and after phototherapy. For all statistical tests, a P value less than 0.05 was considered as significant.

RESULTS: We enrolled 100 neonates with a mean age (±SD, standard deviation) of 6.5±1.9 days (range 2-11 days) in our study. The mean gestational age (GA) of the participants was 38.94 weeks±1.00 w SD, and their mean (±SD) weight was 3302 g (±315.60). The mean (mg/dL)±SD for bilirubin level by clinical estimation of jaundice, TCB on the forehead and TCB on the sternum were 17.35±2.88, 17.23±1.63, and 17.77±1.58, respectively. Also, comparing mean differences before and after phototherapy showed that TCB on the sternum is a good predictor for neonatal jaundice before phototherapy (0.539 vs. 0.348).

CONCLUSION: TCB on the sternum is more predictive than the forehead, especially before phototherapy, to assess the need for treatment in outpatient settings.

PMID:37543878 | DOI:10.34172/aim.2022.88

Lab Med. 2023 Aug 6:lmad070. doi: 10.1093/labmed/lmad070. Online ahead of print.

ABSTRACT

OBJECTIVE: With the recent reports of additional alleles of the CYP2C19 gene with decreased or no function, the clinical utility of real-time polymerase chain reaction (PCR)-based testing that detects only a small number of variant targets needs to be evaluated.

METHOD: We retrospectively reviewed 7-year data for real-time PCR test records from a single hospital and analyzed CYP2C19 genotypes from publicly available whole-genome or whole-exome data from a healthy Korean population.

RESULTS: Of the 2327 test results in this hospital, the *1 allele was most common (60.5%), followed by *2 (28.0%), *3 (10.1%), and *17 (1.4%). Among 5305 healthy Korean individuals, the frequencies of the *2, *3, and *17 alleles were 28.6%, 9.9%, and 1.0%, respectively, which were not statistically different from those of the hospital data (P = .4439, P = .6025, and P = .1142, respectively). Interestingly, the total frequency of additional nonfunctional alleles (*4, *6, *22, and *24) that could not be detected using real-time PCR was only 0.1%, with a total allele count of 8.

CONCLUSION: Our study shows that the clinical utility of real-time PCR for CYP2C19 genotyping remains satisfactory. However, caution should be exercised because the test can miss patients with decreased CYP2C19 function.

PMID:37543868 | DOI:10.1093/labmed/lmad070

Cell J. 2023 Jul 25;25(7):455-460. doi: 10.22074/cellj.2023.1987024.1217.

ABSTRACT

OBJECTIVE: Some reports have indicated that conditioned medium from growing mouse embryonic stem cells (ESCs) provides a supportive condition for small follicles growing, oocyte maturation, and following embryo growth. The aim of this study is assessing in vitro maturation (IVM) and consequent in vitro fertilization (IVF) outcome of immature mouse oocytes using human embryonic stem cells conditioned medium (HESCM).

MATERIALS AND METHODS: In this experimental study, 240 germinal vesicle (GV) oocytes were took from NMRI female mice, aged 4-6 weeks, 48 hours before injection of 5 IU pregnant mare serum gonadotropin (PMSG). 120 GV oocytes without cumulus cells were cultured in each of the groups. 120 GV were cultured in HESCM as test groups and also 120 GV cultured in human embryonic stem cells medium (HESM) as control groups. After evaluating the metaphase II (MII) oocyte maturation rate at 8, 16 and 24 hours, the MII oocytes subsequently were fertilized in vitro and the two-cell embryo development rate was recorded at days 1, 2, and 3. Statistical analysis was performed by using the generalized estimating equations (GEE) method that calculated their rate ratio.

RESULTS: Our data indicated there are significant differences between the maturation rates in HESCM and HESM (P=0.004), also the two-cell embryo development was significant between two culture media (P=0.00).

CONCLUSION: Similar to some other studies, the secretome of the HESCM showed a significant impact on the IVM outcomes in mice.

PMID:37543858 | DOI:10.22074/cellj.2023.1987024.1217

J Inj Violence Res. 2023 Aug 6;15(2). doi: 10.5249/jivr.v15i2.1788. Online ahead of print.

ABSTRACT

BACKGROUND: the present study aimed to investigate gender difference in the perceived cause (intrinsic or extrinsic) of falls leading to fracture (FLF) and its association with selected social, health, and environmental factors.

METHODS: All patients aged 60 years or older who were admitted to two referral hospitals due to FLF from August 1, 2018, to the end of May 2019, were included in the study. An interview-administered questionnaire was used to collect the required data from 300 participants (136 men and 164 women).

RESULTS: When compared to men, women were less physical active, were less smoker, had lower education, had more vision problems, used more sedatives, and were more satisfied with their life (P less than 0.05 for all). No statistical difference was observed between men and women about the perceived cause of Fall.

CONCLUSIONS: Although women and men were the same in the perceived cause of fall, they had considerably riskier lifestyles and lower health status. These factors include education, vision condition, physical activity, occupation, and taking sleeping pills. On the other hand, men were more smoker and alcohol user.

PMID:37543839 | DOI:10.5249/jivr.v15i2.1788

Medicine (Baltimore). 2023 Aug 4;102(31):e34501. doi: 10.1097/MD.0000000000034501.

ABSTRACT

Patients with non-muscle-invasive bladder cancer (NMIBC) who are at high and very high risk of disease progression are recommended for radical cystectomy (RC). However, the impact of neoadjuvant chemotherapy (NAC) on survival outcomes in NMIBC patients undergoing RC remains unclear. Patients diagnosed with T1 high-grade NMIBC who underwent RC were identified from the Surveillance, Epidemiology, and End Results (SEER) database. Overall survival (OS) was assessed using the Kaplan-Meier technique, and multivariable Cox regression analysis was conducted to determine the independent factors of OS. A total of 1268 T1 high-grade NMIBC patients who underwent RC between 2004 and 2015 were included in the study. NAC was administered to 76 (6.0%) patients. At a median follow-up of 75 months, there was no significant difference in the OS between the NAC and non-NAC groups (HR = 0.89, 95% CI 0.61-1.30, P = .539). However, in the multivariate Cox regression model, NAC demonstrated a more pronounced improvement in OS approaching statistical significance (HR = 0.7, 95% CI 0.47-1.05, P = .088). Subgroup analysis revealed a survival benefit of NAC in patients with lymph node metastasis. In summary, the results of this study suggest that NAC has the potential to confer a survival advantage in patients diagnosed with T1 high-grade NMIBC who undergo RC, but additional studies are needed. Nonetheless, the survival benefits of NAC in patients with lymph node involvement are apparent.

PMID:37543821 | DOI:10.1097/MD.0000000000034501

Medicine (Baltimore). 2023 Aug 4;102(31):e34369. doi: 10.1097/MD.0000000000034369.

ABSTRACT

Hospital Cancer Registries serve as a vital source of information for clinical and epidemiological research, allowing the evaluation of patient care outcomes through therapeutic protocol analysis and patient survival assessment. This study aims to assess the trend of incompleteness in the epidemiological variables within the Hospital Cancer Registry of a renowned oncology center in a Brazilian state. An ecological time-series study was conducted using secondary data from the Hospital Santa Rita de Cássia Cancer Registry in Espírito Santo between 2000 and 2016. Data completeness was categorized as follows: excellent (<5%), good (5%-10%), fair (10%-20%), poor (20%-50%), and very poor (>50%), based on the percentage of missing information. Descriptive and bivariate statistical analyses were performed using the free software RStudio (version 2022.07.2) and R (version 4.1.0). The Mann-Kendall test was used to assess temporal trends between the evaluated years, and the Friedman test was employed to evaluate quality scores across the years. Among the variables assessed, birthplace, race/color, education, occupation, origin, marital status, history of alcohol and tobacco consumption, previous diagnosis and treatment, the most important basis for tumor diagnosis, tumor-node-metastasis staging (TNM) staging, and clinical tumor staging by group (TNM) showed the highest levels of incompleteness. Conversely, other epidemiological variables demonstrated excellent completeness, reaching 100% throughout the study period. Significant trends were observed over the years for history of alcohol consumption (P < .001), history of tobacco consumption (P < .001), TNM staging (P = .016), clinical tumor staging by group (TNM) (P = .002), first treatment received at the hospital (P = .012), disease status at the end of the first treatment at the hospital (P < .001), and family history of cancer (P < .001), and tumor laterality (P = .032). While most epidemiological variables within the Hospital Santa Rita de Cássia Cancer Registry exhibited excellent completeness, some important variables, such as TNM staging and clinical staging, showed high levels of incompleteness. Ensuring high-quality data within Cancer Registries is crucial for a comprehensive understanding of the health-disease process.

PMID:37543818 | DOI:10.1097/MD.0000000000034369