Nevin Manimala

J Minim Access Surg. 2023 Feb 3. doi: 10.4103/jmas.jmas_281_22. Online ahead of print.

ABSTRACT

INTRODUCTION: One-anastomosis gastric bypass (OAGB) presents a satisfactory long-term outcome in terms of weight loss, amelioration of comorbidities and low morbidity. However, some patients may present insufficient weight loss or weight regain. In this study, we tackle a case series evaluating the efficiency of the combined laparoscopic pouch and loop resizing (LPLR) as a revisional procedure for insufficient weight loss or weight regain after primary laparoscopic OAGB.

MATERIALS AND METHODS: We included eight patients with a body mass index (BMI) ≥30 kg/m² with a history of weight regain or insufficient weight loss after laparoscopic OAGB, who underwent revisional laparoscopic intervention by LPLR between January 2018 and October 2020 at our institution. We conducted a 2 years’ follow-up. Statistics were performed using International Business Machines Corporation^® SPSS^® software for Windows version 21.

RESULTS: The majority of the eight patients were males (62.5%), with a mean age of 35.25 at the time of the primary OAGB. The average length of the biliopancreatic limb created during the OAGB and LPLR were 168 ± 27 and 267 ± 27 cm, respectively. The mean weight and BMI were 150.25 ± 40.73 kg and 48.68 ± 11.74 kg/m² at the time of OAGB. After OAGB, patients were able to reach an average lowest weight, BMI and per cent of excess weight loss (%EWL) of 89.5 ± 28.85 kg, 28.78 ± 7.47 kg/m² and 75.07 ± 21.62%, respectively. At the time of LPLR, patients had a mean weight, BMI and %EWL of 116.12 ± 29.03 kg, 37.63 ± 8.27 kg/m² and 41.57 ± 12.99%, respectively. Two years after the revisional intervention, the mean weight, BMI and %EWL were 88.25 ± 21.89 kg, 28.44 ± 4.82 kg/m² and 74.51 ± 16.54%, respectively.

CONCLUSION: Combined pouch and loop resizing is a valid option for revisional surgery following weight regain after primary OAGB, leading to adequate weight loss through enhancement of the restrictive and malabsorptive effect of OAGB.

PMID:36861534 | DOI:10.4103/jmas.jmas_281_22

Indian J Cancer. 2022 Oct-Dec;59(4):457-461. doi: 10.4103/ijc.IJC_22_21.

ABSTRACT

In the Cox proportional hazards regression model, which is the most commonly used model in survival analysis, the effects of independent variables on survival may not be constant over time and proportionality cannot be achieved, especially when long-term follow-up is required. When this occurs, it would be better to use alternative methods that are more powerful for the evaluation of various effective independent variables, such as milestone survival analysis, restricted mean survival time analysis (RMST), area under the survival curve (AUSC) method, parametric accelerated failure time (AFT), machine learning, nomograms, and offset variable in logistic regression. The aim was to discuss the pros and cons of these methods, especially with respect to long-term follow-up survival studies.

PMID:36861518 | DOI:10.4103/ijc.IJC_22_21

Endosc Ultrasound. 2023 Jan-Feb;12(1):120-127. doi: 10.4103/EUS-D-21-00221.

ABSTRACT

BACKGROUND AND OBJECTIVES: EUS-guided choledochoduodenostomy (EUS-CDS) is commonly employed to address malignant biliary obstruction (MBO) after a failed ERCP. In this context, both self-expandable metallic stents (SEMSs) and double-pigtail stents (DPSs) are suitable devices. However, few data comparing the outcomes of SEMS and DPS exist. Therefore, we aimed to compare the efficacy and safety of SEMS and DPS at performing EUS-CDS.

METHODS: We conducted a multicenter retrospective cohort study between March 2014 and March 2019. Patients diagnosed with MBO were considered eligible after at least one failed ERCP attempt. Clinical success was defined as a drop of direct bilirubin levels ≥ 50% at 7 and 30 postprocedural days. Adverse events (AEs) were categorized as early (≤7 days) or late (>7 days). The severity of AEs was graded as mild, moderate, or severe.

RESULTS: Forty patients were included, 24 in the SEMS group and 16 in the DPS group. Demographic data were similar between the groups. Technical success rates and clinical success rates at 7 and 30 days were similar between the groups. Similarly, we found no statistical difference in the incidence of early or late AEs. However, there were two severe AEs (intracavitary migration) in the DPS group and none in the SEMS cohort. Finally, there was no difference in median survival (DPS 117 days vs. SEMS 217 days; P = 0.99).

CONCLUSION: EUS-guided CDS is an excellent alternative to achieve biliary drainage after a failed ERCP for MBO. There is no significant difference regarding the effectiveness and safety of SEMS and DPS in this context.

PMID:36861511 | DOI:10.4103/EUS-D-21-00221

Asian J Androl. 2023 Feb 24. doi: 10.4103/aja2022120. Online ahead of print.

ABSTRACT

The penis is a vital organ of perception that transmits perceived signals to ejaculation-related centers. The penis consists of the glans penis and penile shaft, which differ considerably in both histology and innervation. This paper aims to investigate whether the glans penis or the penile shaft is the main source of sensory signals from the penis and whether penile hypersensitivity affects the whole organ or only part of it. The thresholds, latencies, and amplitudes of somatosensory evoked potentials (SSEPs) were recorded in 290 individuals with primary premature ejaculation using the glans penis and penile shaft as the sensory areas. The thresholds, latencies, and amplitudes of SSEPs from the glans penis and penile shaft in patients were significantly different (all P < 0.0001). The latency of the glans penis or penile shaft was shorter than average (indicating hypersensitivity) in 141 (48.6%) cases, of which 50 (35.5%) cases were sensitive in both the glans penis and penile shaft, 14 (9.9%) cases were sensitive in the glans penis only, and 77 (54.6%) cases were sensitive in the penile shaft only (P < 0.0001). There are statistical differences in the signals perceived through the glans penis and the penile shaft. Penile hypersensitivity does not necessarily mean that the whole penis is hypersensitive. We classify penile hypersensitivity into three categories, namely, glans penis, penile shaft, and whole-penis hypersensitivity, and we propose the new concept of penile hypersensitive zone.

PMID:36861504 | DOI:10.4103/aja2022120

Aging Clin Exp Res. 2023 Mar 1. doi: 10.1007/s40520-023-02369-z. Online ahead of print.

ABSTRACT

BACKGROUND: As a result of falls, older patients experience injury and loss of function, and their length of hospital stay and care costs increase.

AIM: This study was conducted to determine fall risks and compare the sensitivity and specificity of three fall risk assessment tools.

METHODS: Older patients’ fall risk levels were determined according to the Itaki, Hendrich-II, and Morse tools within 2 h following their admission to the wards. A methodological design was used in the study, which included 388 hospitalized elderly patients. The mean age of the patients was 72.29 ± 5.6 years, and 57.7% were female.

RESULTS: According to the ROC curve values of Sensitivity and 1-Specificity, the cut-off points for the Hendrich-II, Itaki, and Morse fall tools were accepted as 27.5, 8.5, and 6.5, respectively. According to the analysis results, the ratios of the areas under the ROC curve for the Itaki, Morse, and Hendrich-II fall tools were 0.794, 0.773, and 0.724, respectively, which were found to be statistically significant for all three tools (p ≤ 0.001).

CONCLUSIONS: The Itaki Fall Risk Tool was found to be the most sensitive one among the three instruments in assessing the fall risk of older hospitalized patients. The Itaki Fall Risk Tool was followed by the Morse and Hendrich-II tools, respectively, in terms of sensitivity.

PMID:36859749 | DOI:10.1007/s40520-023-02369-z

Nat Genet. 2023 Mar 1. doi: 10.1038/s41588-023-01350-w. Online ahead of print.

NO ABSTRACT

PMID:36859734 | DOI:10.1038/s41588-023-01350-w

Arch Osteoporos. 2023 Mar 2;18(1):39. doi: 10.1007/s11657-023-01226-w.

ABSTRACT

Endothelial dysfunction underlies the development of atherosclerotic vascular disease, which in turn is associated with osteoporotic fractures. Here, we examined the association of two markers of endothelial dysfunction with incident hip fracture risk in older adults but found no statistically significant associations between them.

PURPOSE/INTRODUCTION: Endothelial dysfunction underlies the development of atherosclerotic vascular disease. Vascular disease, in turn, is associated with the risk of osteoporotic fractures, such as hip fractures. Here, we examine whether two measures of endothelial dysfunction are related to hip fracture risk.

METHODS: Participants for this study were 2792 individuals (mean age 78.6 years) who had flow-mediated dilation (FMD) measured after ischemia in the forearm and 2255 adults (mean age 73.3 years) with measured soluble intercellular adhesion molecule (siCAM) levels, a constitutive endothelial cell membrane protein associated with the initiation of atherosclerosis. Mean follow-up was 9.7 and 11.7 years, respectively. There were 375 and 265 incident hip fractures, respectively, in each group.

RESULTS: In Cox proportional hazards models, there was no significant association between FMD response and incident hip fracture (HR per 1% higher FMD was 0.98 [0.93, 1.04]; p = 0.44). In exploratory analyses, when data were examined dichotomously, participants in the lowest 80% of FMD (≤ 4.5%) had an adjusted 1.29 (0.98, 1.68; p = 0.067) higher hazard of hip fracture compared to participants in the upper 20% of FMD change. There were no significant associations between siCAM and incident hip fracture whether examined as a continuous or dichotomized variable.

CONCLUSIONS: Among older adults, two measures of endothelial dysfunction were not significantly associated with hip fracture risk. There was a trend for higher fracture risk with lower FMD.

PMID:36859726 | DOI:10.1007/s11657-023-01226-w

Commun Biol. 2023 Mar 1;6(1):229. doi: 10.1038/s42003-023-04587-7.

ABSTRACT

The Western honey bee Apis mellifera, which provides about 90% of commercial pollination, is under threat from diverse abiotic and biotic factors. The ectoparasitic mite Varroa destructor vectoring deformed wing virus (DWV) has been identified as the main biotic contributor to honey bee colony losses worldwide, while the role of the microsporidium Nosema ceranae is still controversially discussed. In an attempt to solve this controversy, we statistically analyzed a unique data set on honey bee colony health collected from a cohort of honey bee colonies over 15 years and comprising more than 3000 data sets on mite infestation levels, Nosema spp. infections, and winter losses. Multivariate statistical analysis confirms that V. destructor is the major cause of colony winter losses. Although N. ceranae infections are also statistically significantly correlated with colony losses, determination of the effect size reveals that N. ceranae infections are of no or low biological relevance.

PMID:36859713 | DOI:10.1038/s42003-023-04587-7

Sci Rep. 2023 Mar 1;13(1):3479. doi: 10.1038/s41598-023-30643-7.

ABSTRACT

The aim of the present study was to investigate the effect of linagliptin on microalbuminuria in patients with diabetic nephropathy (DN). The present double-blind randomized placebo-controlled clinical trial was performed on 92 patients with DN who were divided into two groups. The intervention and control groups received linagliptin 5 mg and placebo for 24 weeks, respectively. Blood pressure, lipid profile, liver enzymes, fasting plasma glucose (FPG), and urine albumin-creatinine ratio (UACR) were assessed and recorded before, 12 weeks, and 24 weeks after the beginning of the intervention. The mean value of UACR decrease was significant over time in both groups, with higher decrease in linagliptin group, however, the differences between two groups were not, statistically significant (P > 0.05). However, the percentage of improvement in microalbuminuria (UACR < 30 mg/g) in the linagliptin group was significantly higher than that of the control group during 24 weeks of intervention (68.3% vs. 25%; P-value < 0.001). There was no statistically significant difference in the mean value of the UACR and other parameters between linagliptin treated and placebo treated patients with diabetic nephropathy. Further studies, with longer periods of follow-up are suggested to examine these patients’ renal outcomes.

PMID:36859710 | DOI:10.1038/s41598-023-30643-7

Anal Sci. 2023 Mar 1. doi: 10.1007/s44211-023-00289-6. Online ahead of print.

ABSTRACT

Loss of biodiversity is a serious concern, and amphibians are particularly threatened. Most small salamanders in Japan are endangered. Distributional information is fundamental to the conservation of these rare species; however, small salamanders are generally difficult to locate or catch. Environmental DNA analysis is an effective survey method for monitoring such rare species. The conventional polymerase chain reaction (PCR) method, which combines PCR amplification with subsequent electrophoresis, and the real-time PCR method, which uses fluorescent material, are commonly used for this purpose. In this study, a comparison of these two detection methods was conducted using a rare salamander species, Hynobius boulengeri, as a model case. We compared three points: (i) detection sensitivity, (ii) influence of environmental factors related to detection, and (iii) time and financial costs of the two methods. To perform this comparison, we developed a real-time PCR detection assay, conducted field surveys, and compared the time and financial costs of conventional and real-time PCR methods. The comparison showed no statistical difference in the detection sensitivity from field samples, and the effects of environmental factors tended to be similar. In addition, the financial cost was lower for the conventional PCR method while the time cost was lower for the real-time PCR method. Therefore, selecting eDNA detection methods based on objectives, time, and financial costs will promote efficient monitoring and contribute to the conservation of rare species.

PMID:36859696 | DOI:10.1007/s44211-023-00289-6