Nevin Manimala

Eur J Clin Invest. 2022 Jul 31:e13852. doi: 10.1111/eci.13852. Online ahead of print.

ABSTRACT

BACKGROUND: Snoring and impaired glucose metabolism are common clinical manifestations and associated. The purpose of our study is to estimate the causal associations between snoring and glycemic traits.

METHODS: We compared the weighted mean differences (WMD) for fasting insulin (FINS), glycosylated hemoglobin (HbA1c), fasting blood glucose (FBG) and 2h-glucose post-challenge (2hGlu) levels between snorers and non-snorers by meta-analysis. Then, we obtained summary statistics from published GWAS of snoring and glycemic traits to perform bidirectional two-sample MR. Inverse variance weighting (IVW) method was applied as major estimate while MR Egger, Weighted median and MR-Robust Adjusted Profile Score (RAPS) played a subsidiary role.

RESULTS: Snoring participants had higher FBG (WMD=0.14mmol/L, 95%CI=[0.10,0.19]), HbA1c (WMD=0.10%, 95%CI=[0.07,0.13]), FINS (WMD=0.92μIU/mL, 95%CI=[0.59,1.26]) and 2hGlu (WMD=0.30mmol/L, 95%CI=[0.06,0.55]) levels than non-snorers. Further, elevated FINS levels shown robust causal effect on snoring (IVW: OR=1.07, 95%CI=[1.02,1.12], p=2.2×10^-3 ), which was consistent by complementary methods of MR Egger (OR=1.14, 95%CI=[1.01-1.30], p=4.72×10^-2 ), Weighted median (OR=1.11, 95%CI=[1.07,1.15], p=1.53×10^-7 ) and MR RAPS (OR=1.07, 95% CI=[1.05,1.10], p=2.81×10^-9 ). Such causal situation was stable after identifying and removing the outliers in sensitivity analysis. However, there was no causality of snoring on increasing FINS levels. Additionally, there were no causal associations between snoring and other three traits of FBG, HbA1c and 2hGlu levels from either direction.

CONCLUSIONS: Snorers are subjected to higher FBG, HbA1c, FINS and 2hGlu levels, and elevated FINS levels further provides robust causality on snoring, suggesting that behind common snoring may lie hyperinsulinemia or insulin resistance.

PMID:35908195 | DOI:10.1111/eci.13852

Anat Histol Embryol. 2022 Jul 30. doi: 10.1111/ahe.12840. Online ahead of print.

ABSTRACT

The caudal colliculus serves as an integrative station and switchboard, controlling nucleus of lower auditory pathway and motor-auditory reflex production. The rostral colliculus coordinates reflexive movement of the head, neck, eye and focus the lens for visual tracking of objects. There is no information comparing mesencephalic tectum among neonates, juveniles and adults of African giant rat (AGR). Hence, this study aimed to compare the gross features and morphometric parameters of mesencephalic tectum postnatally in AGR. The following were found and reported: (a) Paired dorsal tips of caudal colliculi were observed through transverse fissure of the intact brain and so, corpora quadrigemina were partly occluded by cerebral cortex in neonates and juveniles. (b) The lateral and medial geniculate bodies were visible, though the lateral was grossly bigger than the medial in adults and juveniles but, only the lateral was distinguishable in neonates. (c) Live body weight, absolute brain weight, caudal colliculus width, nose-rump and tail lengths increased as AGRs developed with age; mean values of rostral colliculus weight, caudal colliculus height and weight of caudal colliculus in neonates and juveniles were statistically same; while midbrain weight and rostral colliculus height tends to decrease as rats aged. (d) The mean weight of caudal colliculi and width of rostral colliculi were not affected by age. (e) Caudal colliculi were grossly wider than rostral in juveniles and adults, but not neonates. Established regression formulae are necessary to avoid future sacrifice of this rodent.

PMID:35908185 | DOI:10.1111/ahe.12840

Aesthet Surg J. 2022 Jul 31:sjac211. doi: 10.1093/asj/sjac211. Online ahead of print.

ABSTRACT

BACKGROUND: Supratip depression is a common complication after preservation rhinoplasty.

OBJECTIVES: This paper presents a simple surgical maneuver to prevent supratip depression.

METHODS: Thirty-six patients who underwent closed-approach low-septal-resection dorsal preservation rhinoplasty between January and June 2021 were included in this retrospective study. Depending on the operation performed on Pitanguy’s midline ligament, the patients were divided into two main groups as follows: (1) a group in which Pitanguy’s midline ligament was transected (the transection group), and (2) a group in which Pitanguy’s midline ligament was preserved (the preservation group). Standardized postoperative 6-month lateral-view photographs were scanned for the presence of supratip depression or pollybeak deformity. The Rhinoplasty Outcome Evaluation (ROE) scale was applied at 6 months.

RESULTS: Supratip depression was observed in four patients in the preservation group (n = 16), and it was not observed in any of the patients in the transection group (n = 20; p < 0.05). There was no pollybeak deformity in either group. For the ROE scores and number of satisfied patients, no statistically significant difference was found between the groups with Pitanguy’s midline ligament transected versus preserved (p > 0.05).

CONCLUSIONS: Transecting Pitanguy’s midline ligament reduces the likelihood of supratip depression and does not affect the likelihood of pollybeak deformity in closed-approach low-septal-resection dorsal preservation rhinoplasty.

PMID:35908175 | DOI:10.1093/asj/sjac211

Acta Anaesthesiol Scand. 2022 Jul 30. doi: 10.1111/aas.14118. Online ahead of print.

ABSTRACT

BACKGROUND: The effects of glucocorticoids may include both genomic and rapid nongenomic effects. The potential rapid analgesic effect during surgery has not previously been investigated. We aimed to explore the effect of dexamethasone on intraoperative infusion rate of remifentanil in patients undergoing total knee arthroplasty surgery under general anaesthesia.

METHODS: In this post-hoc subgroup analysis we included patients randomized in the DEX-2-TKA trial, who were operated under total intravenous anaesthesia with remifentanil and propofol. Trial medication, intravenous dexamethasone 24 mg or placebo, was administered immediately after anaesthesia onset. The primary outcome was the median weight-corrected infusion rate of remifentanil during surgery. Secondary outcomes included median weight-corrected infusion rate of propofol, median intraoperative bispectral index, and time spent in the post anaesthesia care unit.

RESULTS: Eighty-seven patients were included in the analysis of the primary outcome. A significantly higher remifentanil infusion rate was observed in the dexamethasone group compared with the placebo group, p=0.02. None of the secondary outcomes resulted in statistically significant differences between groups.

CONCLUSION: This explorative post-hoc analysis of the randomized DEX-2-TKA trail showed that patients undergoing total knee arthroplasty surgery under general anaesthesia and who received dexamethasone, seemed to have a higher remifentanil infusion rate compared with patients who received placebo. The clinical implications of the potentially increased remifentanil infusion rate need to be validated and explored further. This article is protected by copyright. All rights reserved.

PMID:35908167 | DOI:10.1111/aas.14118

Drug Saf. 2022 Jul 30. doi: 10.1007/s40264-022-01213-z. Online ahead of print.

ABSTRACT

INTRODUCTION: The recurrence rates of immediate adverse drug reactions (ADRs) to the alternative radiocontrast media (RCM) are not well known. Previous studies suggest selection of alternative RCM considering carbamoyl side chains; however, its usefulness for preventing the recurrence of ADRs has not been clearly verified.

OBJECTIVE: The aim of this study was to verify the recurrence rate of immediate ADRs according to the alternative RCM.

METHOD: This retrospective study analyzed 6420 contrast-enhanced computed tomography (CT) cases of 2009 patients registered in the ADR system from 861,664 CT cases in a single tertiary hospital between 2015 and 2020. Iohexol, iopromide, iobitridol, and iopamidol were used for CT. According to the carbamoyl side chains present, iohexol belongs to group 1, iopromide belongs to groups 1 and 2, iobitridol belongs to group 2, and iopamidol belongs to group 3.

RESULTS: Replacing iobitridol with iopamidol (odds ratio [OR] 2.595, 95% confidence interval [CI] 1.48-4.550) or iopromide (OR 3.354, 95% CI 1.420-7.926) as the subsequent RCM was associated with increased recurrence, while replacing iopamidol with iobitridol (OR 0.506, 95% CI 0.282-0.908) and iopromide with iohexol (OR 0.355, 95% CI 0.177-0.711) was associated with decreased recurrence. Other changes did not influence the recurrence of ADRs.

CONCLUSIONS: The recurrence of immediate ADRs increased in certain RCM combinations of preceding and subsequent CT scans, and the RCMs did not show cross-reactivity. Therefore, the clinical benefit of the alternative RCM considering cross-reactivity is limited. This result suggests that the side chains of RCM do not have an important role in the recurrence of immediate ADRs.

PMID:35908149 | DOI:10.1007/s40264-022-01213-z

Spine Deform. 2022 Jul 30. doi: 10.1007/s43390-022-00547-z. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate clinical and radiographic outcomes after surgical scoliosis correction and posterior instrumented fusion in SMF patients.

METHODS: A single-center medical database was reviewed to identify MF patients who presented with scoliosis from 2000 to 2015. Patients who underwent spinal fusion surgery were included. Demographic, operative and clinical data were reviewed, and the preoperative, postoperative, and latest follow-up radiographic parameters were compared.

RESULTS: Twelve patients were identified (2 males, 10 females) with an average age at surgery of 14.4 ± 2.6 years. Comorbidities were found in 84.6%. Most patients (90.9%) presented with a right thoracic curve. The average preoperative Cobb angle was 75.6 ± 15.5 degrees. Posterior instrumented spinal fusion was performed in all patients (1 hook/pedicular screw and 11 pedicle screws only). The average follow-up period was 6.8 ± 3.1 years. The mean postoperative Cobb angle after surgery and at the final follow-up was 33.4 ± 18.0 degrees and 35.5 ± 18.4 degrees, respectively. There was a statistically significant difference among the preoperative and postoperative Cobb angles (p < 0.001), but no significant difference among the sagittal angles. Two perioperative complications including superficial wound infection and broken rods were observed.

CONCLUSIONS: Posterior scoliosis correction and instrumented spinal fusion resulted in a satisfactory outcome in MF patients. Perioperative complications are not uncommon; however, no neurological complication or spinal decompensation was observed in this study.

LEVEL OF EVIDENCE: IV.

PMID:35908146 | DOI:10.1007/s43390-022-00547-z

J Mol Model. 2022 Jul 30;28(8):239. doi: 10.1007/s00894-022-05234-4.

ABSTRACT

Plants from the Garcinia genus have been used worldwide due to their therapeutic properties. Among the various metabolites isolated from this genus, 7-epi-clusianone, a tetraprenylated benzophenone, stands out for its wide range of identified biological activities. This benzophenone can exist in five tautomeric forms, although the benzene-d₆ and chloroform-d₃ solution nuclear magnetic resonance (NMR) spectra revealed only two tautomeric forms (B and C) in equilibrium, with concentration ratio depending on the solvent in which the spectrum was obtained. Calculated energy values suggested that tautomeric forms B and E would be prevalent in benzene-d₆ solution, in contrast to the experimental data. Considering this conflicting result, we employed the statistical DP4 + method based on ¹³C and ¹H NMR chemical shift calculations, in the gas phase and in benzene-d₆ solution, to confirm that the B and C tautomeric forms of 7-epi-clusianone are the most prevalent in the experimental conditions.

PMID:35908141 | DOI:10.1007/s00894-022-05234-4

Support Care Cancer. 2022 Jul 30. doi: 10.1007/s00520-022-07289-8. Online ahead of print.

ABSTRACT

BACKGROUND: Breast cancer (BC) patients face various physical and psychological challenges. The mutual impacts of patients and caregivers on each other show the need for further supportive care from the community and family. This study aimed to identify the predictors of the direct and indirect relationships of the duration of cancer (CANCERT) and care time (CARET) with the supportive care needs (SCN) of the patients and the quality of life (QOL) of their family caregivers.

METHODS: This descriptive study included 150 patients and their caregivers in Iran. Data were collected using the Supportive Care Needs Survey-Short Form (SCNS-SF34), the Caregiver Quality of Life Index-Cancer (CQOLC) scale, and a socio-demographic checklist. The data were then analyzed in SPSS-24 and Lisrel-8.8 software using descriptive statistics and path analysis.

RESULTS: The mean age of the patients and caregivers was 45.76 ± 10.44 and 43.46 ± 9.5, respectively. The majority of patients (96%) were in stages II and III of the disease. There was no statistically significant relationship between cancer stages with SCN of the patients and also caregivers’ QOL (P > 0.05). Based on the test results, the CANCERT was positively correlated with the patients’ care and support needs (SN) in total effect (β = 0.24). The patients’ sexuality needs had the highest negative correlation with their CANCERT in the direct path (β = – 0.27) and had the highest negative correlation with psychological needs in the indirect path (β = – 0.174). The CARET (hours per day) had positive correlation with health systems and information needs in both the direct (β = 0.26) and indirect paths (β = 0.15). The highest positive correlation with physical needs was in the direct path (β = 0.34). The caregivers’ QOL had a negative and direct relationship with the CANCERT (β = – 0.19), and there was a positive and direct relationship between CARET and the caregivers’ QOL (β = 0.18).

CONCLUSIONS: The correlations obtained from this study are not necessarily strong, yet they are important and should be noticed and tested in the future studies. The present findings reveal the need to provide comprehensive care, planning to provide supportive care, and counseling to both BC patients and their family caregivers, especially when the duration of the disease is prolonged.

PMID:35908140 | DOI:10.1007/s00520-022-07289-8

Prog Orthod. 2022 Jul 31;23(1):25. doi: 10.1186/s40510-022-00420-9.

ABSTRACT

BACKGROUND: Estimating skeletal maturation and growth potential is essential for developing adolescents’ best orthodontic treatment plan. The purpose of this study was to compare the duration of adolescent growth peak in subjects of skeletal classes I and III using the cervical vertebral maturation (CVM) method.

METHODS: This retrospective cross-sectional study included 116 Iranian subjects (skeletal class I = 68, skeletal class III = 48) aged 8-16 years old and without previous orthodontic treatments. Using Steiner and Wits analyses, two independent examiners traced pre-treatment lateral cephalograms to determine the subjects’ skeletal relationship. The skeletal maturation was then assessed using Baccetti’s CVM method. The onset and duration of adolescent growth peak (interval of CS3-CS4) were compared between two skeletal classes and two genders using independent samples t test.

RESULTS: In skeletal class I and III subjects, the adolescent peak had a mean duration of 1.62 (± 1.33) and 2.00 (± 1.27) years, respectively. The average difference of 0.38 years (4.6 months) between the two groups was statistically significant (p < 0.001). Furthermore, the onset age of adolescent growth peak was 11.91 (± 1.32) and 12.08 (± 1.31) years old in class I and III subjects, respectively. This age difference was not statistically significant (p = 0.630). Males’ adolescent growth peak occurred 1.44 years later (p < 0.001) and lasted 0.20 years less (p < 0.001).

CONCLUSIONS: The adolescent growth peak started at a similar age in class I and III subjects, but the latter experienced the peak for 4.6 months longer. Moreover, females had an earlier and more extended adolescent growth peak.

PMID:35908119 | DOI:10.1186/s40510-022-00420-9

Knee Surg Sports Traumatol Arthrosc. 2022 Jul 30. doi: 10.1007/s00167-022-07052-w. Online ahead of print.

ABSTRACT

PURPOSE: The recovery of strength is a key element in successfully returning to sports after ACL reconstruction. The type of anaesthesia has been suspected an influential factor in the post-operative recovery of muscle function.

METHODS: In this retrospective analysis, n = 442 consecutive patients undergoing primary isolated ACL reconstruction using a hamstring autograft were analysed by pre- and post-operative isokinetic tests in a single orthopaedic centre. These were subdivided into four cohorts: (1) general anaesthesia (n = 47), (2) general anaesthesia with prolonged (48 h) on-demand femoral nerve block (n = 37), (3) spinal anaesthesia (n = 169) and (4) spinal anaesthesia with prolonged (48 h) on-demand femoral nerve block (n = 185). Primary outcome was the change from pre- to post-operative isokinetic strength during knee extension and flexion.

RESULTS: Using one-way ANOVA, there was no significant influence of the type of anaesthesia. The main effect of anaesthesia on change in extension forces was not significant, and effect sizes were very small (n.s.). Similarly, the main effect of anaesthesia on change in flexion forces was statistically not significant (n.s.).

CONCLUSIONS: The findings of this study support the interpretation that the type of anaesthesia has no significant effect on the ability to recover thigh muscle strength 6 months after isolated hamstring ACL reconstruction. With regard to the recovery of athletic performance and return-to-sports testing criteria, there is no reason to avoid regional anaesthesia.

LEVEL OF EVIDENCE: III.

PMID:35908113 | DOI:10.1007/s00167-022-07052-w