Nevin Manimala

J Cosmet Dermatol. 2022 Apr 14. doi: 10.1111/jocd.14987. Online ahead of print.

ABSTRACT

INTRODUCTION: Vitiligo is a skin disease that is associated with impaired skin immune systems and pigment degradation in skin melanocyte cells. Despite the significant impact of the disease on the quality of life of patients, treatment of the disease using effective method such as the transplantation of uncultivated melanocytes was considered by researchers around the world. The goal of this research was to use microneedling to transplant epidermal keratinocyte-melanocyte cells suspension for the treatment of vitiligo patients.

METHODS: In this study, 15 male and female vitiligo in face region patients aged 18 to 45 years were studied. In this study, melanocyte-keratinocyte cells suspension was sprayed. Patients underwent microneedling treatment after spraying the cells. Before and after transplantation, patients were biometrically examined, and the quantity of pigmentation and changes in the transplanted region were documented. Statistical software was used to examine the results.

RESULTS: The color difference between the lesion area and normal skin in one, two, and six months after treatment with cell suspension was significantly reduced compared to before treatment (by 48.95 %). Moreover, the amount of melanin was significantly increased 6 months after treatment compared to before treatment (129.8±4.16 vs. 195.2±3.54, P = 0.000). A significant decrease in skin brightness in the skin of the lesion area was observed compared to normal skin, 6 months after treatment compared to before treatment (43.7±1.44 vs. 27.9±1.24, P = 0.000).

CONCLUSION: Epidermal keratinocyte – melanocyte cells suspension in combination with microneedling could be considered as an effective treatment of vitiligo.

PMID:35419925 | DOI:10.1111/jocd.14987

Dermatol Ther. 2022 Apr 13:e15508. doi: 10.1111/dth.15508. Online ahead of print.

ABSTRACT

BACKGROUND: Polycaprolactone (PCL)-based fillers are widely used for skin rejuvenation and wrinkle reduction.

OBJECTIVE: To compare the efficacy and safety of newly developed PCL-based fillers (SYB filler®; SF-01) and widely used existing PCL-based fillers (Ellansé-M®) for correction of moderate-to-severe nasolabial folds.

METHODS: In a randomized, participant-and evaluator-blinded, matched-pair, prospective study, participants were randomized for injections of SF-01 or Ellansé-M® in both nasolabial folds. Efficacy was evaluated using the Wrinkle Severity Rating Scale (WSRS), Global Esthetic Improvement Scale (GAIS), and a 3-dimensional (3D) scanner. All adverse events (AEs) were examined and reported.

RESULTS: At month 12, both SF-01-and Ellansé-M®-treated groups showed statistically significant improvements in the WSRS, GAIS, and 3D scanner scores compared to baseline. The difference in changes in WSRS scores at month 12 between the two groups was 0.08 ± 0.34 compared to baseline. The upper limit of the 95.0% confidence interval was 0.0031, which was lower than the predefined margin for non-inferiority (0.35). All AEs were injection site-related (swelling, pain, and erythema) and disappeared within 30 min after the procedure.

CONCLUSION: SF-01 was non-inferior to Ellansé-M® and demonstrated favorable efficacy and safety at 12 months after correcting moderate-to-severe nasolabial folds.

PMID:35419911 | DOI:10.1111/dth.15508

Dermatol Ther. 2022 Apr 13:e15510. doi: 10.1111/dth.15510. Online ahead of print.

ABSTRACT

AIMS: To characterize moderate to severe psoriasis (PsO) adult patients treated with secukinumab, estimate drug persistence and assess any reasons for treatment discontinuation.

METHODS: Non-interventional, retrospective, longitudinal record-based study including patients diagnosed with PsO who started secukinumab between January 2018 and January 2020. Baseline characteristics were analysed by descriptive statistics; drug persistence and predictive factors were assessed through Kaplan-Meier curves and univariate and multivariate analysis, respectively.

RESULTS: A total of 302 patients were included in the study: mean age was 48.4 years, 41.7% were female, median time since diagnosis was 12.9 years. 51.3% of patients were bio-naïve while 48.7% had previously been treated with biologics. PsO in difficult-to-treat locations (DTL) was present in 82.1% of patients, with scalp PsO in about half of patients. At 5-years follow-up, 84 patients discontinued secukinumab, 45 of which due to loss of efficacy. At week 104, overall treatment persistence was 71.7%. A higher probability of drug persistence was identified among those patients who initiated secukinumab ≥5 years after diagnosis, were bio-naïve or treated with only one previous biologic, had no PsO on DTL, and had diabetes mellitus. The predictive factors for discontinuation identified in our study were the start of secukinumab <5 years after diagnosis (p=.001), the bio-experimented status with ≥2 biologics (p=.007), and the presence of PsO on DTL (p=.014).

CONCLUSIONS: A time since diagnosis of ≥5 years, naïve status or previous use of only one biologic are predictors for secukinumab persistence, whereas the presence of PsO on DTL predicts drug discontinuation.

PMID:35419886 | DOI:10.1111/dth.15510

Clin Endocrinol (Oxf). 2022 Apr 13. doi: 10.1111/cen.14739. Online ahead of print.

ABSTRACT

Ultrasound (US) is the pivotal procedure during the diagnostic work-up of thyroid nodule and several US-based risk stratification systems (RSSs) have been recently developed. Since the performance of RSSs in detecting medullary thyroid carcinoma (MTC) has been rarely investigated, the present systematic review aimed to achieve high evidence about 1) how MTC is classified according to RSSs; 2) if RSSs correctly classify MTC at high risk/suspicion, and 3) if MTC is classified as suspicious at US when RSSs are not used. The review was performed according to MOOSE. The online search was performed by specific algorithm on January 2022. A random-effects model was used for statistical analysis. Twenty-five papers were initially included and their risk of bias was generally low. According to ATA system, 65% of MTCs was assessed at high suspicion and 25% at intermediate suspicion. Considering all RSSs, a 54.8% of MTCs was put in a high-risk/suspicion category. Pooling data from studies without data of RSS the prevalence of ultrasonographically suspicious MTCs was 60%. As conclusion, MTC presentation according to RSSs is partially known and it is classified in a high-risk/suspicion category of RSSs in just over a half of cases. This advises for further studies, ideally supported by international societies, to better define the US presentation of MTC. This article is protected by copyright. All rights reserved.

PMID:35419855 | DOI:10.1111/cen.14739

J Med Virol. 2022 Apr 13. doi: 10.1002/jmv.27778. Online ahead of print.

ABSTRACT

BACKGROUND: The exposure of healthcare workers (HCWs) to SARS-CoV-2 has been a major concern since the beginning of the COVID-19 pandemic. The study aimed to investigate the relationship between vaccination status and the status of catching COVID-19 in HCWs working in a Training and Research Hospital in Turkey, and the clinical course of the disease in those who were caught.

METHODS: In the current study, the vaccination status of 1279 HCWs working at Siirt Training and Research Hospital during the period when the SARS CoV-2 Delta variant was dominant, their cases of catching COVID-19 during this period, and the clinical course of the disease in patients with COVID-19 were investigated retrospectively.

RESULTS: We found that the rate of COVID-19 transmission was lowest in fully vaccinated HCWs (p<0.05). The rate of COVID-19 transmission in HCWs who received 2 doses of BioNTech vaccine (4.4%) and 2 doses of CoronaVac+1 dose of BioNTech vaccines (2.7%) was considerably lower than those without vaccination (26.2%) (p<0.05). The transmission rate was lowest among those vaccinated with 2 doses of CoronaVac+1 dose of BioNTech. Hospitalization was not required in fully vaccinated HCWs. The lymphocyte count was found to be significantly higher in fully vaccinated patients than incompletely vaccinated and unvaccinated patients. Although CRP, d-dimer, ferritin values were higher in unvaccinated and partially vaccinated patients than in fully vaccinated patients, the differences were not statistically significant.

CONCLUSION: As a result, the transmission rate of COVID-19 was lowest in fully vaccinated HCWs and in those vaccinated with 2 doses of CoronaVac+1 dose of BioNTech. In fully vaccinated HCWs, hospitalization was not needed. This article is protected by copyright. All rights reserved.

PMID:35419851 | DOI:10.1002/jmv.27778

Clin Cardiol. 2022 Apr 14. doi: 10.1002/clc.23831. Online ahead of print.

ABSTRACT

BACKGROUND: Among subjects with exercise intolerance and suspected early-stage pulmonary hypertension (PH), early identification of pulmonary vascular disease (PVD) with noninvasive methods is essential for prompt PH management.

HYPOTHESIS: Rest gas exchange parameters (minute ventilation to carbon dioxide production ratio: V_E /VCO₂ and end-tidal carbon dioxide: ETCO₂ ) can identify PVD in early-stage PH.

METHODS: We conducted a retrospective review of 55 subjects with early-stage PH (per echocardiogram), undergoing invasive exercise hemodynamics with cardiopulmonary exercise test to distinguish exercise intolerance mechanisms. Based on the rest and exercise hemodynamics, three distinct phenotypes were defined: (1) PVD, (2) pulmonary venous hypertension, and (3) noncardiac dyspnea (no rest or exercise PH). For all tests, *p < .05 was considered statistically significant.

RESULTS: The mean age was 63.3 ± 13.4 years (53% female). In the overall cohort, higher rest V_E /VCO₂ and lower rest ETCO₂ (mm Hg) correlated with high rest and exercise pulmonary vascular resistance (PVR) (r ~ 0.5-0.6*). On receiver-operating characteristic analysis to predict PVD (vs. non-PVD) subjects with noninvasive metrics, area under the curve for pulmonary artery systolic pressure (echocardiogram) = 0.53, rest V_E /VCO₂ = 0.70* and ETCO₂ = 0.73*. Based on this, optimal thresholds of rest V_E /VCO₂ > 40 mm Hg and rest ETCO₂ < 30 mm Hg were applied to the overall cohort. Subjects with both abnormal gas exchange parameters (n = 12, vs. both normal parameters, n = 19) had an exercise PVR 5.2 ± 2.6* (vs. 1.9 ± 1.2), mPAP/CO slope with exercise 10.2 ± 6.0* (vs. 2.9 ± 2.0), and none included subjects from the noncardiac dyspnea group.

CONCLUSIONS: In a broad cohort of subjects with suspected early-stage PH, referred for invasive exercise testing to distinguish mechanisms of exercise intolerance, rest gas exchange parameters (V_E /VCO₂ > 40 mm Hg and ETCO₂ < 30 mm Hg) identify PVD.

PMID:35419844 | DOI:10.1002/clc.23831

Scand J Med Sci Sports. 2022 Apr 14. doi: 10.1111/sms.14166. Online ahead of print.

ABSTRACT

Nine months after anterior cruciate ligament (ACL) reconstruction, athletes who undergo surgery using a bone-patellar-tendon-bone (BPTB) autograft demonstrate higher loading asymmetries during vertical jumping than those with a hamstring tendon (HT) autograft. These asymmetries may transfer into sporting movements with a greater ACL injury risk. The aim of this study was to compare between-limb asymmetries in knee mechanics and task performance during an unplanned 90° change-of-direction (CoD) task in male field sport athletes reconstructed with BPTB or HT autografts. Seventy-eight male multidirectional field sport athletes with either a BPTB (n=39) or HT (n=39) autograft completed maximal unplanned CoD trials in a three-dimensional motion capture laboratory at approximately nine months post-surgery. A mixed model 2×2 ANOVA (autograft type x limb) was used to compare variables related to ACL injury risk (e.g. internal knee moments) and performance (e.g. completion time) between autografts and limbs. Statistical parametric mapping was used for a waveform comparison throughout stance, supplemented with a discrete point analyses of peak knee moments and performance variables. Interaction effects were found at the knee joint, with BPTB demonstrating greater asymmetries than HT in knee extension moment (p<0.001); resultant ground reaction force (p<0.001); peak knee external rotation moment (p=0.04); and knee adduction (p=0.05), medial rotation (p<0.001) and flexion (p<0.001) angles. No differences were found between autografts for any performance variable. BPTB demonstrated greater lower-limb biomechanical asymmetries than HT during CoD, which may influence knee loading and longer-term outcomes and should thus be targeted during rehabilitation prior to return to play.

PMID:35419809 | DOI:10.1111/sms.14166

Ginekol Pol. 2022 Apr 14. doi: 10.5603/GP.a2021.0243. Online ahead of print.

ABSTRACT

OBJECTIVES: To reveal the effect of surgeon’s experience on the outcomes of the total laparoscopic hysterectomy (TLH) surgery.

MATERIAL AND METHODS: Design: Retrospective case series.

SETTING: A tertiary care university hospital.

PATIENTS: 1295 cases with an indication for hysterectomy.

INTERVENTIONS: Total laparoscopic hysterectomy.

RESULTS: All cases were grouped according to the surgeon’s experience. For 30 different surgeons, their first 20 operations constituted Group A, 21st-50th operations Group B, 51st-100th operations Group C, and their operations after the 100th surgery Group D. Demographic data and post-operative results were compared between the groups. There were no statistical differences in terms of demographic data and major complications. A statistically significant decrease was observed in the post-operative fall in hemoglobin level and the duration of hospitalization in the groups with increased experience (p = 0.021, p < 0.001, respectively). There wasn’t an increase in uterine specimen weight with increased experience (p = 0.267).

CONCLUSIONS: We obtained that the peak value in the learning curve cannot be evaluated according to the operation time or complication rates. Although the complication rate seems unaffected by surgical experience, concerns about complications may decrease as experience increases. Since the trend of minimally invasive surgery will continue increasingly in the next century because of higher patient comfort, all gynecologists should gain competence in endoscopic surgery.

PMID:35419792 | DOI:10.5603/GP.a2021.0243

Ginekol Pol. 2022 Apr 14. doi: 10.5603/GP.a2021.0102. Online ahead of print.

ABSTRACT

OBJECTIVES: It is believed that there are still unclear areas in the formation mechanism of leiomyomas. In our study, it was aimed to investigate the formation mechanisms of leiomyomas due to local MED 12 gene exon 2 mutation and local microRNA-124 expression in a Turkish population.

MATERIAL AND METHODS: Thirty patients who underwent hysterectomy for leiomyoma uteri at Gaziantep University between January 2013 and January 2016 were included in our study. In the pathology specimens of these patients, the patient’s myometrium tissue and her own leiomyoma tissue were analysed via quantitative Realtime PCR in association with MED 12 exon 2 mutation and microRNA-124 expression.

RESULTS: The average age of the 30 patients included in our study is 46.67 ± 5.42 and 13 patients had single leiomyoma; 17 patients had more than one leiomyoma. There were significantly higher c.130G> T (p.G44C) mutation and c.131G> A (p.G44A) mutation of MED 12 gene exon in leiomyoma tissues than healthy myometrium tissues of same patients. There was a 3.7-fold decrease in the expression of microRNA-124 in leiomyoma tissues compared to intact eutopic myometrium tissues, but this difference was not statistically significant.

CONCLUSIONS: In recent studies, it has been suggested that MED 12 gene may play an active role in the formation of fibroids. MED12 and β-catenin / Wnt pathway were emphasized, and alternative genetic pathways are sought in fibroid formation. Also, tumour suppressor and oncogenesis effects of microRNAs have been demonstrated in many different studies. Since it is involved in the Wnt pathway, microRNA-124 has been blamed by some previous studies for the formation of fibroids. This study demonstrates that MED12 exon 2 mutations and probably microRNA-124 gene expressions might contribute to uterine leiomyoma pathology.

PMID:35419790 | DOI:10.5603/GP.a2021.0102

Handchir Mikrochir Plast Chir. 2022 Apr;54(2):149-154. doi: 10.1055/a-1794-5668. Epub 2022 Apr 13.

ABSTRACT

BACKGROUND: The biological mechanism of Dupuytren’s contracture needs to be further studied in order to minimize postoperative recurrence and provide a pathological basis for the development of new therapeutic targets.

METHODS: HE staining, immunohistochemistry, PCR and western blotting were performed in pathological palmar aponeurosis specimens and normal palmar aponeurosis tissues for comparative study.

RESULTS: (1) TNF-α expression was up-regulated: TNF-α mRNA was more highly expressed in the pathological tissues of DD patients than in the CT group, P < 0.05, and the difference between the two groups was statistically significant; (2) Dkk-1 expression was down-regulated: Dkk-1 mRNA was lower expressed in the pathological tissues of DD patients than in the CT group, P < 0.05, and the difference between the two groups was statistically significant; (3) TGF-β1 expression was up-regulated: TGF-β1 mRNA was higher expressed in the pathological tissues of DD patients than in the CT group, P < 0.05, and the difference between the two groups was statistically significant; (4) Pearson correlation analysis suggested that TNF-α expression was positively correlated with TGF-β1 expression, TNF-α expression was negatively correlated with DKK-1 expression, and TGF-β1 expression was negatively correlated with DKK-1 expression.

CONCLUSION: TNF-α, DKK-1 and TGF-β1 may play a role in the pathogenesis of palmar aponeurosis contracture, and there is a relationship between them. The study of the relationship between the three and their related signaling pathways provides a therapeutic target and a basis for the prevention and early treatment of palmar aponeurotic contracture.

PMID:35419784 | DOI:10.1055/a-1794-5668