Nevin Manimala

Radiol Oncol. 2023 Jul 26. doi: 10.2478/raon-2023-0032. Online ahead of print.

ABSTRACT

BACKGROUND: Stereotactic body radiation therapy (SBRT) precisely and non-invasively delivers ablative radiation dose to tumors in early-stage lung cancer patients who are not candidates for surgery or refuse it. The aim of research was to evaluate local control, overall survival (OS), local progression free survival (LPFS), distant metastases free survival (DMFS), disease free survival (DFS) and toxicity in early-stage lung cancer patients treated with SBRT in a single tertiary cancer centre.

PATIENTS AND METHODS: We retrospectively evaluated medical records and radiation treatment plan parameters of 228 tumors irradiated in 206 early-stage lung cancer patients between 2016 and 2021 at the Institute of Oncology Ljubljana.

RESULTS: After 25 months of median follow up, 68 of 206 (33%) patients died. Median OS was 46 months (CI 36-56), 1-year, 2-year and 3-year OS were 87%, 74% and 62% and 5-year OS was 31%. A total of 45 disease progressions have been identified in 41 patients. Local progress only was noticed in 5 (2%) patients, systemic progress in 32 (16%) and combined systemic and local in 4 (2%) patients. Local control rate (LCR) at 1 year was 98%, at 2 and 3 years 96% and 95% at 5 years. The 1-, 2- and 3-year LPFS were 98%, 96% and 94%, respectively and 5-year LPFS was 82%. One, 2-, 3- and 5-year DFS were 89%, 81%, 72% and 49%, respectively. Among 28 toxicities recorded only one was Grade 4 (pneumonitis), all others were Grade 1 or 2. No differences in LCR, LPFS, DFS were found in univariate analysis comparing patient, tumor, and treatment characteristics. For OS the only statistically significant difference was found in patients with more than 3 comorbidities compared to those with less comorbidities.

CONCLUSIONS: Early lung cancer treated with SBRT at single tertiary cancer centre showed that LCR, LPFS, DFS, DMFS and OS were comparable to published studies. Patients with many comorbidities had significantly worse overall survival compared to those with less comorbidities. No other significant differences by patient, tumor, or treatment characteristics were found for DMFS, LPFS, and DFS. Toxicity data confirmed that treatment was well tolerated.

PMID:37494591 | DOI:10.2478/raon-2023-0032

Rev Bras Ginecol Obstet. 2023 Jun;45(6):303-311. doi: 10.1055/s-0043-1770087. Epub 2023 Jul 21.

ABSTRACT

OBJECTIVE: The lack of data on the impact of hyperglycemia and obesity on the prevalence of pregnancy-specific urinary incontinence (PSUI) led us to conduct a cross-sectional study on the prevalence and characteristics of PSUI using validated questionnaires and clinical data.

METHODS: This cross-sectional study included 539 women with a gestational age of 34 weeks who visited a tertiary university hospital between 2015 and 2018. The main outcome measures were the prevalence of PSUI, the International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF), and the Incontinence Severity Index (ISI) questionnaires. The women were classified into four groups: normoglycemic lean, normoglycemic obese, hyperglycemic lean, and hyperglycemic obese. The differences between groups were tested using descriptive statistics. Associations were estimated using logistic regression analysis and presented as unadjusted and adjusted odds ratios.

RESULTS: Prevalence rates of PSUI were no different between groups. However, significant difference in hyperglycemic groups worse scores for severe and very severe PSUI. When adjusted data for confound factors was compared with normoglycemic lean group, the hyperglycemic obese group had significantly higher odds for severe and very severe forms of UI using ICIQ-SF (aOR 3.157; 95% CI 1.308 to 7.263) and ISI (aOR 20.324; 95% CI 2.265 to 182.329) questionnaires and highest perceived impact of PSUI (aOR 4.449; 95% CI 1.591 to 12.442).

CONCLUSION: Our data indicate that obesity and hyperglycemia during pregnancy significantly increase the odds of severe forms and perceived impact of PSUI. Therefore, further effective preventive and curative treatments are greatly needed.

PMID:37494572 | DOI:10.1055/s-0043-1770087

Environ Sci Technol. 2023 Jul 26. doi: 10.1021/acs.est.3c02073. Online ahead of print.

ABSTRACT

Evaluating the volatility of organic compounds based solely on their molecular formulas would avoid tough demands in deriving molecular structures. Here, we deployed an iodide-adduct Long Time-of-Flight Chemical Ionization Mass Spectrometry (LToF-CIMS) combined with a Filter Inlet for Gases and AEROsols (FIGAERO) to investigate molecular formulas and thermograms of organic compounds on ambient particulate samples collected in the summer of 2021 in a suburban site of Shanghai and to estimate saturation vapor pressures of low- and semivolatile components of ambient organic aerosols. Then, a hierarchical cluster analysis and a subsequent classification of obtained clusters by similarity calculation were applied to the measured data set of molecular formulas and saturation vapor pressures of organic aerosols with at least a 2/3 appearance frequency, together with a similar data set collected at a rural site in the Beijing-Tianjin-Hebei region during the winter of 2018 (Ren et al., 2018), to classify all compounds into multiple groups. For each group of compounds, parametrizations between volatility and elemental composition were derived, and then relationships between each group of parameters and the mean O:C were established to achieve a volatility-molecular formula parametrization with the O:C as a key input. Statistical comparison of estimated volatilities of low-volatile organic compounds shows a much better performance of our parametrization than previous molecular formula-based ones.

PMID:37494566 | DOI:10.1021/acs.est.3c02073

J Pediatr Gastroenterol Nutr. 2023 Jul 26. doi: 10.1097/MPG.0000000000003905. Online ahead of print.

ABSTRACT

OBJECTIVES: Fatigue is a common symptom in children with inflammatory bowel disease (IBD). Diagnostic tests to evaluate biological causes of fatigue commonly include markers of inflammation and haemoglobin (Hb), yet functional parameters have been inadequately studied in paediatric IBD. In this study we compared fatigued and non-fatigued children with IBD from both a biological and functional point of view.

METHODS: A cross-sectional study of 104 paediatric IBD patients with mild to moderately active IBD was conducted. Fatigued children were defined as those with a Pediatric Quality of Life Inventory (PedsQL TM) Multidimensional Fatigue Scale Z-score <-2.0. Non-fatigued children had a Z-score ≥ -2.0. Disease-specific quality of life (measured with IMPACT-III score), C-reactive protein (CRP), faecal calprotectin (FC), haemoglobin Z-score (Hb Z-score) and physical activity tests including 6-minute walking distance Z-score (6MWD Z-score) and triaxial accelerometry (TA) were evaluated.

RESULTS: Fatigued children (n=24) had a significant lower IMPACT-III score than non-fatigued children (n=80). Hb Z-scores, CRP, FC and 6 MWD Z-scores were not significantly different between groups. TA was performed in 71 patients. Wear time validation requirements were met in only 31 patients. Fatigued patients spent significant shorter median time in moderate-to-vigorous activity than non-fatigued patients (18.3 versus 37.3 minutes per day, P=0.008).

CONCLUSION: Biological parameters did not discriminate fatigued from non-fatigued patients. TA possibly distinguishes fatigued from non-fatigued patients; the potential association may provide a target for interventions to combat fatigue and improve quality of life.

PMID:37494540 | DOI:10.1097/MPG.0000000000003905

Am J Perinatol. 2023 Jul 20. doi: 10.1055/s-0043-1771051. Online ahead of print.

ABSTRACT

OBJECTIVE: Neonatal catheters and tubes are commonly used for monitoring and support for intensive care and must be correctly positioned to avoid complications. Position assessment is routinely done by radiography. The objective of this study is to characterize neonatal catheter and tube placement in terms of the proportion of those devices that are malpositioned.

STUDY DESIGN: Using an institutional dataset of 723 chest/abdominal radiographs of neonatal intensive care unit (ICU) patients (all within 60 days of birth), we assessed the proportion of catheters that are malpositioned. Many radiographs contained multiple catheter types. Umbilical venous catheters (UVCs; 448 radiographs), umbilical arterial catheters (UACs; 259 radiographs), endotracheal tubes (ETTs; 451 radiographs), and nasogastric tubes (NGTs; 603 radiographs) were included in our analysis.

RESULTS: UVCs were malpositioned in 90% of radiographs, while UACs were malpositioned in 36%, ETTs in 30%, and NGTs in just 5%. The most common locations in which UVCs were malpositioned were in the right atrium (31%) and umbilical vein (21%), and for UACs the most common malpositioned tip location was the aortic arch (8%). For the remaining tubes, 5% of ETTs were found to be in the right main bronchus and 4% of NGTs were found in the esophagus.

CONCLUSION: A substantial proportion of catheters and tubes are malpositioned, suggesting that optimizing methods of catheter placement and assessment ought to be areas of focus for future work.

KEY POINTS: · Neonatal catheters are frequently malpositioned.. · Most umbilical venous catheters need readjustment.. · X-ray and ultrasound are important for assessment.. · Catheter tips should be assessed in all X-rays..

PMID:37494483 | DOI:10.1055/s-0043-1771051

Am J Perinatol. 2023 Jul 20. doi: 10.1055/s-0043-1771050. Online ahead of print.

ABSTRACT

OBJECTIVE: Sickle cell disease is associated with adverse perinatal outcomes. Aspects of sickle cell disease in pregnancy, such as health care utilization and neonatal abstinence syndrome, are understudied. We aimed to describe contemporary sickle cell disease outcomes in a U.S. hospital system to improve perinatal counseling.

STUDY DESIGN: We conducted a retrospective cohort study of patients with sickle cell disease who delivered at >20 weeks’ gestation at two sites within the University of Pennsylvania Health System from May 1, 2017 to August 30, 2020. Descriptive statistics were utilized.

RESULTS: Over the study period, 48 patients with sickle cell disease had 52 deliveries of 53 neonates. Sickle cell disease-related morbidity was prevalent prior to pregnancy; 27% had a history of avascular necrosis, and 58% had experienced acute chest syndrome. In the year prior to pregnancy, 52% used daily opioids. During pregnancy, more than half of patients were admitted at least once for sickle cell disease-related complications, spending a median 3 days admitted interquartile range (0-23); >10% spent >70 days of pregnancy admitted. New daily opioids were prescribed during pregnancy for 10% to manage pain crises. Acute chest syndrome was experienced by 23% of patients during pregnancy, and 8% required placement of long-term intravenous access. Preterm delivery <37 weeks occurred in 48%. The primary cesarean rate in nulliparas was 43%. Additionally, 50% experienced a hypertensive disorder of pregnancy, 35% underwent transfusion during delivery admission, and 10% had a perinatal venous thromboembolism. Finally, 53% of neonates were admitted to the intensive care unit. Low birth weight was noted in 34%, severe respiratory distress in 15% of infants, and neonatal abstinence syndrome in 21%.

CONCLUSION: Sickle cell disease remains associated with significant perinatal morbidity and need for hospitalization. These data provide contemporary outcomes to target improvements in the care of patients with sickle cell disease.

KEY POINTS: · SCD was associated with significant perinatal morbidity and healthcare utilization.. · Most patients with SCD required hospitalization during pregnancy.. · Neonates of patients with SCD experienced preterm birth, NICU admission, and neonatal abstinence syndrome..

PMID:37494482 | DOI:10.1055/s-0043-1771050

J AOAC Int. 2023 Jul 26:qsad087. doi: 10.1093/jaoacint/qsad087. Online ahead of print.

ABSTRACT

BACKGROUND: Drug impurities are now seen as a major threat to the production of pharmaceuticals around the world and a major part of the global contamination problem, especially when it comes to carcinogenic impurities.

OBJECTIVE: we present the first spectrophotometric strategy based on a combination of univariate and multivariate methods as impurity profiling methods for the estimation of lignocaine (LIG) and fluorescein (FLS) with their carcinogenic impurities: 2,6-xylidine (XYL) and benzene-1,3-diol (BZD).

METHODS: The data processing strategy depends on overcoming unresolved bands by employing five affordable, accurate, selective, and sensitive methods. The methods applied were a direct UV univariate spectrophotometric analysis (D0) and four multivariate chemometric methods including, classical least squares (CLS), Principal component regression (PCR), Partial least squares (PLS), and genetic algorithm (GA-PLS). FLS analysis (1-16 μg/mL) was performed using the D0 method at 478 nm; then, the application of the ratio subtraction method (RSM) allowed the removal of interference caused by the FLS spectrum. From the resulting ratio spectra, LIG, XYL, and BZD can be efficiently determined by chemometrics. The calibration set was carefully selected at 5 concentration levels utilizing a partial factorial training design, resulting in 25 mixtures with central levels of 160, 40, and 3 μg/mL for LIG, XYL, and BZD, respectively. Another 13 samples were applied to validate the predictive ability.

RESULTS: The statistical parameters demonstrated exceptional recoveries and smaller prediction errors, confirming the experimental model’s predictive power.

CONCLUSION: The proposed approach was effectively tested using newly FDA-approved LIG and FLS pharmaceutical preparation and aqueous humour. Additionally, it was effectively assessed for whiteness, greenness, and sustainability using five assessment tools.

HIGHLIGHTS: With its remarkable analytical performance, sustainability, affordability, simplicity, and cost-efficiency, the proposed strategy is an indispensable tool for quality control and in-situ analysis in little-equipped labs, increasing the proposed approach’s surveillance ability.

PMID:37494481 | DOI:10.1093/jaoacint/qsad087

Am J Occup Ther. 2023 Jul 1;77(Supplement_2):7711500001p1. doi: 10.5014/ajot.2023.77S2-RP1.

ABSTRACT

Date Presented 04/20/2023 The concurrent and construct validity of the Sensory Profile Interoception (SPI) was supported by statistically significant relationships with the Adolescent/Adult Sensory Profile and other measures associated with interoception. With the more precise information the SPI provides, professionals can design tailored interventions to support everyday life goals, and researchers can study interoception in authentic activities. Primary Author and Speaker: Winnie Dunn Additional Authors and Speakers: Catana Brown.

PMID:37494480 | DOI:10.5014/ajot.2023.77S2-RP1

Ann Work Expo Health. 2023 Jul 26:wxad042. doi: 10.1093/annweh/wxad042. Online ahead of print.

NO ABSTRACT

PMID:37494458 | DOI:10.1093/annweh/wxad042

Ann Med. 2023 Dec;55(1):2236013. doi: 10.1080/07853890.2023.2236013.

ABSTRACT

BACKGROUND AND AIMS: Hepatic encephalopathy (HE) implies high morbidity and mortality. The assessment of covert HE (CHE) [i.e. minimal HE (MHE) plus grade 1 HE] is often neglected in Taiwan. Therefore, the aim was to investigate the potential of the animal naming test (ANT₁ and simplified ANT₁ (S-ANT₁₎) for assessing CHE in Chinese-speaking regions, specifically Taiwan.

METHODS: A prospective cohort study was conducted, comprising 65 cirrhotic patients and 29 healthy controls (relatives of the patients). Patients were followed up every three months and censored after two years or until death. Hospitalization for overt HE (OHE) and mortality were considered. All subjects underwent ANT₁, psychometric HE score (PHES), and mini-mental state examination (MMSE). The patients underwent an electroencephalogram (EEG) to detect slowing indicative of MHE. Cut-off values for ANT₁ and S-ANT₁ were assessed by ROC analysis and Youden’s index, considering CHE as a reference. The prognostic values for OHE and OHE-free survival were assessed.

RESULTS: Preliminary analysis confirmed that PHES ≤-4 is a good discriminant point for abnormal results. CHE was found in 29 patients: 9 had MHE (PHES ≤ -4 or altered EEG) and 20 had grade 1 HE. ANT₁ and S-ANT₁ were found to have diagnostic values for CHE: AUC = 0.807, 0.786; cut off: 18 and 19, respectively. ANT₁ and S-ANT₁ were found to have prognostic value for OHE, number of hospitalization episodes for OHE, and OHE recurrence-free survival.

CONCLUSIONS: ANT₁ shows promise as a tool for CHE detection, quantification, and follow-up in Taiwan and other Chinese-speaking regions.Key messagesThe animal naming test (ANT₁) is a simple and valid semantic fluency test that can be easily performed in outpatient or bedside settings in one minute and can also be used as a tool for covert hepatic encephalopathy (CHE) detection, quantification, and follow-up in Taiwan, other Chinese-speaking regions, and many other countries.The diagnostic value of ANT₁ and S-ANT₁ for CHE were found to be significant, with area under the receiver operating characteristic curve (AUROC) values of 0.807 and 0.786 respectively, and cut-off scores of 18 and 19.ANT₁ and S-ANT₁ have prognostic value for the first breakthrough of overt hepatic encephalopathy (OHE), number of hospitalization episodes for OHE, and OHE recurrence-free survival, independent of the MELD score.

PMID:37494454 | DOI:10.1080/07853890.2023.2236013