Nevin Manimala

J Perinat Med. 2022 Dec 28. doi: 10.1515/jpm-2022-0478. Online ahead of print.

ABSTRACT

OBJECTIVES: Fetal blood circulation may be modified in congenital heart disease (CHD). This retrospective analysis was performed to study whether the type of CHD is associated with specific placental pathology.

METHODS: 3 types of CHD based on presumed proportion of placental and systemic blood distribution in fetal circulation were analyzed: Group 1: 89 cases with low placental blood content (hypoplastic left heart syndrome, transposition of great arteries, coarctation of aorta), Group 2: 71 placentas with intermediate placental and systemic blood content due to increased intracardiac blood mixing (tetralogy of Fallot, truncus arteriosus, double inlet/outlet ventricle), and Group 3: 24 placentas with high placental blood content (tricuspid or pulmonary atresia, Ebstein anomaly). Frequencies of 27 independent clinical and 47 placental phenotypes of 184 placentas in those three groups were statistically compared.

RESULTS: The most advanced gestational age at delivery, and large vessel (global) fetal vascular malperfusion (FVM) were most common in Group 1, while macerated stillbirths, neonatal mortality, abnormal amniotic fluid volume (oligohydramnios or polyhydramnios), other congenital anomalies, distal villous lesions of FVM, placental edema and amnion nodosum were most common in Groups 2 and 3, although the frequencies of placental lesions were statistically not significant.

CONCLUSIONS: Left heart obstructive lesions potentially associated with brain maldevelopment show increase in lesions of global FVM (in aggregate and individually fetal vascular ectasia, stem vessel obliteration and intramural fibrin deposition) as may be seen in umbilical cord compromise. CHD with increased intracardiac blood mixing or with right heart defects is associated with average preterm gestational age at delivery and placental lesions of distal villous FVM, villous edema and amnion nodosum.

PMID:36573345 | DOI:10.1515/jpm-2022-0478

J Comput Assist Tomogr. 2022 Dec 27. doi: 10.1097/RCT.0000000000001403. Online ahead of print.

ABSTRACT

OBJECTIVE: Compression of the left renal vein by the superior mesenteric artery, known as nutcracker phenomenon (NCP), can cause retrograde flow and congestion in communicating venous systems. It has recently been speculated that NCP can result in retrograde flow and congestion of the lumbar veins and epidural venous plexus (EVP), thereby affecting the central nervous system. This study describes the novel use of time-resolved magnetic resonance angiography (trMRA) to evaluate for retrograde left second lumbar vein (L2LV) flow and early EVP enhancement in patients with chronic daily headache (CDH) with and without NCP.

METHODS: A retrospective analysis was performed of 31 patients with CDH (27 females and 4 males; median age, 38 years [range, 18-63 years]) who underwent trMRA centered over the L2LV to evaluate the direction of blood flow and presence of early EVP enhancement from May 2020 to March 2022. Descriptive statistics were performed, and anatomic associations were analyzed in patients with and without retrograde L2LV flow and early EVP enhancement. The accuracy of magnetic resonance imaging findings in detecting these flow patterns was also assessed.

RESULTS: Patients with NCP who demonstrated narrowing of the left renal vein, a positive beak sign (P = 0.052), decreased aortomesenteric distance (P = 0.038), and decreased SMA angle demonstrated increased rates of retrograde L2LV flow and early EVP enhancement. A positive beak sign was 83% specific, and an aortomesenteric distance of ≤6.5 mm was 61% sensitive and 83% specific for identifying retrograde L2LV flow with early regional EVP enhancement in patients with CDH.

CONCLUSIONS: Retrograde L2LV flow with early EVP enhancement in CDH patients can be effectively evaluated using trMRA and was seen with greater propensity in those patients with NCP.

PMID:36573322 | DOI:10.1097/RCT.0000000000001403

Int J Neuropsychopharmacol. 2022 Dec 27:pyac084. doi: 10.1093/ijnp/pyac084. Online ahead of print.

ABSTRACT

BACKGROUND: The serotonin system has been implicated in several psychiatric disorders. All major psychiatric disorders are associated with cognitive impairment, but treatment improving cognitive deficits is lacking partly due to limited understanding of the neurobiology of cognitive functioning. Several markers for the serotonin system have been associated with cognitive functions. Our research group has previously reported a positive correlation between serotonin 5-HT1B receptor availability in the dorsal brainstem and visuospatial memory in a pilot study of healthy subjects. Here, we aim to replicate our previous finding in a larger group of healthy volunteers as well as to investigate putative associations between 5-HT1B receptor availability and other cognitive domains.

METHODS: Forty-three healthy subjects were examined with positron emission tomography using the 5-HT1B receptor radioligand [ 11C]AZ10419369 and a visuospatial memory test to replicate our previous finding, as well as tests of verbal fluency, cognitive flexibility, reaction time and planning ability to explore other domains potentially associated with the serotonin system.

RESULTS: Replication analysis revealed no statistically significant association between 5-HT1B receptor availability in the dorsal brainstem and visuospatial memory performance. Exploratory analyses showed age-adjusted correlations between 5-HT1B receptor availability in whole brain gray matter and specific brain regions, and number of commission errors, reaction time and planning ability.

CONCLUSIONS: Higher 5-HT1B receptor availability was associated with more false positive responses and faster reaction time, but lower performance in planning and problem-solving. These results corroborate previous research supporting an important role of the serotonin system in impulsive behavior and planning ability.

PMID:36573320 | DOI:10.1093/ijnp/pyac084

Clin Transl Allergy. 2022 Dec;12(12):e12213. doi: 10.1002/clt2.12213.

ABSTRACT

BACKGROUND: Health-related quality of life (HRQoL) is significantly and substantially reduced in individuals with peanut allergy due to many factors associated with unanticipated or potentially fatal reactions. Further insight on the impact of peanut oral immunotherapy in managing peanut allergy on HRQoL is needed. The aim of this analysis was to assess effects of peanut (Arachis hypogaea) allergen powder-dnfp (PTAH), a biologic drug for peanut oral immunotherapy, on HRQoL from three phase 3 and two follow-on trials of PTAH.

METHODS: HRQoL assessments from participants aged 4-17 in the PALISADE (ARC003), ARC004 (PALISADE follow-on), ARTEMIS (ARC010), RAMSES (ARC007), and ARC011 (RAMSES follow-on) trials were included in this analysis. Responses on the Food Allergy Quality of Life Questionnaire (FAQLQ) and Food Allergy Independent Measure (FAIM) were evaluated by age group and respondent (self or caregiver proxy). Data were analyzed with descriptive statistics and Student t tests.

RESULTS: Baseline FAQLQ and FAIM total scores appeared comparable between PTAH- and placebo-treated participants. Self and caregiver proxy-reported total scores on the FAQLQ for PTAH-treated participants generally improved at trial exit versus baseline; FAIM total scores improved throughout all trials. The tendency for improvement in FAQLQ total scores from baseline for PTAH appeared larger in self versus caregiver proxy-reports. Between treatment groups, PTAH was generally favored in the PALISADE and ARTEMIS trials; differences varied in the RAMSES trial based on age and respondent types.

CONCLUSIONS: PTAH for the management of peanut allergy in children appeared to have a beneficial effect on HRQoL in trials. Improvements were seen despite rigors of trial participation.

PMID:36573312 | DOI:10.1002/clt2.12213

Eur J Clin Invest. 2022 Dec 26:e13941. doi: 10.1111/eci.13941. Online ahead of print.

ABSTRACT

BACKGROUND: Heart failure (HF) admission in chronic coronary syndrome (CCS) patients has a prognostic impact. Stratification schemes have been described for predicting this end-point but none of them has been externally validated.

OBJECTIVES: Our aim was to develop point-scores for predicting incident HF admission with data from previous studies, to perform an external validation in an independent prospective cohort, and to compare their discriminative ability for this event.

METHODS: Independent predictive variables of HF admission in CCS patients without baseline HF were selected from four previous prospective studies (CARE, PEACE, CORONOR and CLARIFY), generating scores based on the relative magnitude of the coefficients of Cox of each variable. Finally, the scores were validated and compared in a monocentric prospective cohort.

RESULTS: The validation cohort included 1212 patients followed for up to 17 years, with 171 patients suffering at least one HF admission in follow-up. Discriminative ability for predicting HF admission was statistically significant for all, and paired comparison among them were all non-significant except for CORONOR score were superior to CLARIFY score (C-statistic 0.73, 95%CI 0.69-0.76 vs 0.69, 95%CI 0.65-0.73; p=0.03).

CONCLUSION: All tested scores showed significant discriminative ability for predicting incident HF admission in this independent validation study. Their discriminative ability was similar, with significant differences only between the two scores with higher and lower performance.

PMID:36573310 | DOI:10.1111/eci.13941

J Esthet Restor Dent. 2022 Dec 26. doi: 10.1111/jerd.12999. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to explore the influence of smile esthetics on the quality of life in a Han Chinese population.

METHODS: A total of 110 Han Chinese volunteers (52 males and 58 females, mean age 26.7 years) were recruited, and frontal images of their smiles were collected. A photoediting program was used to evaluate the following components of smile esthetics: the buccal corridor ratios, the angle between the interpupillary and commissural lines, the number of visible teeth, and width-to-length ratios of the maxillary central incisors. Oral health-related quality of life (OHRQoL) in these volunteers was evaluated using the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) and Oral Health Impact Profile-14 (OHIP-14). Statistical analyses were performed by using Pearson’s correlations and multiple linear regression (α = 0.05).

RESULTS: Compared to males, females scored higher on psychological impact (p = 0.017). Moreover, the number of visible teeth had a significant effect on social impact, psychological impact and esthetic concern (all p < 0.05). However, the buccal corridor ratios, the angle between the interpupillary and commissural lines, and the width-to-length ratios of the maxillary central incisor did not correlate with the OHRQoL (all p > 0.05).

CONCLUSIONS: The number of visible teeth significantly influenced the quality of life in a Han Chinese population. Smile esthetics had a significantly greater psychological impact on females than males.

CLINICAL SIGNIFICANCE: This study highlights the effects of smile esthetics on the quality of life in a Han Chinese population. Female patients may raise more esthetic concerns in clinical practice.

PMID:36573304 | DOI:10.1111/jerd.12999

Orthop Surg. 2022 Dec 26. doi: 10.1111/os.13619. Online ahead of print.

ABSTRACT

OBJECTIVE: Fluid extravasation is a potentially dangerous complication associated with shoulder arthroscopy. Most relevant studies have involved respiratory system, while the primary purpose was to reveal the effects of the fluid extravasation on cardiovascular system and postoperative function.

METHODS: The clinical data of 92 patients was retrospective analyzed, in which 84 cases with rotator cuff injury, three cases with shoulder instability, three cases with fractures of the greater tuberosity of the humerus, and two cases with frozen shoulder. All the patients were undergoing shoulder arthroscopy. The relationship between the basic information of the patients and cardiac index (CI) or pulse pressure variation (PPV) were evaluated by linear regression analysis. The change of CI or PPV at different states were evaluated by the one-way analysis of variance. The liquid retention (TR) and postoperative clinical outcomes was analyzed using linear regression.

RESULTS: The preoperative CI was affected by anesthesia status and body position, while PPV was not affected. Multivariate mixed-effects model analysis of CI found that there was a statistically significant difference in groups of older than 55 years old and those with obesity (BMI > 24). After the operation, the retention of irrigation fluid significantly influenced the circumference of the deltoid (P < 0.001 (95%CI: [0.30, 1.00])), but not on the circumference of the deltoid, neck, and arm. The multivariate analysis of the American Shoulder and Elbow Surgery (ASES) scores at 3 and 6 months after surgery showed that the fluid retention volume was correlated with the ASES score at 3 months after surgery, especially when the retention volume was greater than 2 L (P = 0.001 (95%). %CI: [-12.49, -3.22]).

CONCLUSION: The retention of irrigation fluid after shoulder arthroscopic surgery causes swelling of local limbs, and has an effect on peripheral blood vessels, which is mainly reflected in its influence on PPV and the postoperative function. Therefore, surgeons need to improve their surgical technique, shorten the operation time and reduce fluid retention.

PMID:36573289 | DOI:10.1111/os.13619

Clin Infect Dis. 2022 Dec 27:ciac447. doi: 10.1093/cid/ciac447. Online ahead of print.

ABSTRACT

BACKGROUND: IFNL4 genetic variants that are strongly associated with clearance of hepatitis C virus have been linked to risk of certain opportunistic infections (OIs) and cancers, including Kaposi sarcoma, cytomegalovirus infection, and herpes simplex virus infection. As the interferon (IFN) λ family plays a role in response to viral, bacterial, and fungal infections, IFNL4 genotype might affect risk for a wide range of OIs/cancers.

METHODS: We examined associations between genotype for the functional IFNL4 rs368234815 polymorphism and incidence of 16 OIs/cancers among 2310 men with human immunodeficiency virus (2038 white; 272 black) enrolled in the Multicenter AIDS Cohort Study during 1984-1990. Our primary analyses used Cox proportional hazards models adjusted for self-reported racial ancestry to estimate hazard ratios with 95% confidence intervals, comparing participants with the genotypes that generate IFN-λ4 and those with the genotype that abrogates IFN-λ4. We censored follow-up at the introduction of highly effective antiretroviral therapies.

RESULTS: We found no statistically significant association between IFNL4 genotype and the incidence of Kaposi sarcoma (hazard ratio, 0.92 [95% confidence interval, .76-1.11]), cytomegalovirus infection (0.94 [.71-1.24]), herpes simplex virus infection (1.37 [.68-2.93]), or any other OI/cancer. We observed consistent results using additive genetic models and after controlling for CD4 cell count through time-dependent adjustment or restriction to participants with a low CD4 cell count.

CONCLUSIONS: The absence of associations between IFNL4 genotype and these OIs/cancers provides evidence that this gene does not affect the risk of disease from opportunistic pathogens.

PMID:36573283 | DOI:10.1093/cid/ciac447

Clin Epigenetics. 2022 Dec 26;14(1):185. doi: 10.1186/s13148-022-01409-1.

ABSTRACT

BACKGROUND: It has been suggested that antenatal exposure to environmental endocrine disruptors is responsible for adverse trends in male reproductive health, including male infertility, impaired semen quality, cryptorchidism and testicular cancer, a condition known as testicular dysgenesis syndrome. Anogenital distance (AGD) is an anthropomorphic measure of antenatal exposure to endocrine disruptors, with higher exposure levels leading to shortened AGD. We hypothesized that exposure to endocrine disruptors could lead to changes in DNA methylation during early embryonic development, which could then persist in the sperm of infertile men with shortened AGD.

RESULTS: Using fluorescence activated cell sorting based on staining with either YO-PRO-1 (YOPRO) or chromomycin-3 (CMA3), we isolated four sperm fractions from eleven infertile men with short AGD and ten healthy semen donors. We examined DNA methylation in these sorted spermatozoa using reduced representation bisulfite sequencing. We found that fractions of spermatozoa from infertile men stained with CMA3 or YOPRO were more likely to contain transposable elements harboring an estrogen receptor response element (ERE). Abnormal sperm (as judged by high CMA3 or YOPRO staining) from infertile men shows substantial hypomethylation in estrogenic Alu sequences. Conversely, normal sperm fractions (as judged by low CMA3 or YO-PRO-1 staining) of either healthy donors or infertile patients were more likely to contain hypermethylated Alu sequences with ERE.

CONCLUSIONS: Shortened AGD, as related to previous exposure to endocrine disruptors, and male infertility are accompanied by increased presence of hormonal response elements in the differentially methylated regulatory sequences of the genome of sperm fractions characterized by chromatin decondensation and apoptosis.

PMID:36572941 | DOI:10.1186/s13148-022-01409-1

Syst Rev. 2022 Dec 26;11(1):281. doi: 10.1186/s13643-021-01867-3.

ABSTRACT

BACKGROUND: Sex-specific analysis and reporting may allow a better understanding of intervention effects and can support the decision-making process. Well-conducted systematic reviews (SRs), like those carried out by the Cochrane Collaboration, provide clinical responses transparently and stress gaps of knowledge. This study aimed to describe the extent to which sex is analysed and reported in a cross-section of Cochrane SRs of interventions, and assess the association with the gender of main authorships.

METHODS: We searched SRs published during 2018 within the Cochrane Database of Systematic Reviews. An investigator appraised the sex-related analysis and reporting across sections of SRs and collected data on gender and country of affiliation of the review first and last authors, and a second checked for accuracy. We conducted descriptive statistics and bivariate logistic regression to explore the association between the gender of the authors and sex-related analysis and reporting.

RESULTS: Six hundred and ten Cochrane SRs were identified. After removing those that met no eligibility criteria, 516 reviews of interventions were included. Fifty-six reviews included sex-related reporting in the abstract, 90 considered sex in their design, 380 provided sex-disaggregated descriptive data, 142 reported main outcomes or performed subgroup analyses by sex, and 76 discussed the potential impact of sex or the lack of such on the interpretations of findings. Women represented 53.1 and 42.2% of first and last authorships, respectively. Women authors (in first and last position) had a higher possibility to report sex in at least one of the review sections (OR 2.05; CI 95% 1.12-3.75, P=0.020) than having none.

CONCLUSIONS: Sex consideration amongst Cochrane SRs was frequently missing. Structured guidance to sex-related analysis and reporting is needed to enhance the external validity of findings. Likewise, including gender diversity within the research workforce and relevant authorship positions may foster equity in the evidence generated.

PMID:36572932 | DOI:10.1186/s13643-021-01867-3