Nevin Manimala

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

Handchir Mikrochir Plast Chir. 2022 Apr;54(2):106-111. doi: 10.1055/a-1720-1681. Epub 2022 Apr 13.

ABSTRACT

INTRODUCTION: The improvement of health-related quality of life (HRQoL) via post-bariatric tightening operations and their effects on long term weight stability is considered to be ensured. This study investigates the relevancy of influencing factors.

PATIENTS, MATERIAL AND METHODS: For the data analysis, the HRQoL was ascertained before and after the abdominoplasty using the 36-Item Short-Form Health Survey questionnaire. In addition, the occurrence frequency of bloating-symptoms was recorded. It was checked whether this occurrence was related to a rectus plication simultaneously performed with the abdominoplasty. Inclusion criterion was obesity ≥ I° prior to the weight loss. Exclusion criteria were a postoperative, newly manifested and serious disease, as well as a pregnancy during the observation period. The results were compared to the German population (standard).

RESULTS: The postoperative HRQoL was significantly improved as far as the physical healthscale (KSK) is concerned (preOP: 40,19 ± 12,27; postOP: 47,72 ± 9,89; p < 0,001). Preoperatively, the KSK and the PSK (psychological health scale) were statistically significant below the value of the normal population (KSK: p < 0,001; PSK: p < 0,01). There were no significant differences postoperatively (KSK: p = 0,051; PSK: p = 0,118). Patients on which an additional rectus plication was performed (n = 9) suffered significantly more often from bloating-symptoms than patients without this surgical step (n = 21) (p < 0,05). Patients with bloating-symptoms < 4/W (vs > 4/W) had a significantly better vitality (< 4/W: 61,09 ± 24,95; > 4/W: 34,29 ± 21,49; p < 0,05) and a better general health (< 4/W: 68,04 ± 23,23; > 4/W: 44,71 ± 27,8; p < 0,05). Compared to the standard, patients with bloating-symptoms > 4/W had a poorer vitality (p < 0,05).

CONCLUSION: Based on the analysis, a postoperative improvement of the HRQoL in the formerly obese can be assumed. It can also be predicated that there is a postoperative adjustment of the HRQoL compared to that of the German population. Furthermore, a rectus plication that is performed in addition to the abdominoplasty more frequently leads to bloating-symptoms, which, in turn, worsen the HRQoL. The diagnosis of a depressive disorder is a good predictor for a worse HRQoL outcome.

PMID:35419780 | DOI:10.1055/a-1720-1681

Horm Metab Res. 2022 Apr 13. doi: 10.1055/a-1825-0316. Online ahead of print.

ABSTRACT

Polycystic ovary syndrome (PCOS) is an endocrine disorder that frequently affects women of reproductive age. In PCOS, the incidence of thyroid diseases has increased in addition to reproductive and metabolic problems. To compare thyroid nodule, volume, autoimmunity, and thyroid function tests of euthyroid PCOS and its phenotypes. The files of 178 patients with PCOS aged 18-45 years and 92 patients with no disease who were matched for body mass index were retrospectively scanned. Women with PCOS were divided into four phenotypes, ABCD, according to the Rotterdam guideline, as determined using thyroid ultrasonography (USG) of all participants, and PCOS phenotypes, as well as thyroid-stimulating hormone (TSH), fT4, fT3 thyroid peroxidase (anti-TPO), and thyroglobulin (anti-Tg) thyroid volume, nodule number, and nodule diameter were noted. Anti-TPO titer and prevalence, fT3, and thyroid volume were higher in the PCOS group compared with the control group (p=0.004, p=0.023, p=0.001, and p=0.001, respectively) in terms of anti-Tg levels, presence of nodules, and the number of nodules. There was no statistical difference between the PCOS group and the healthy controls. The number of nodules of 1 cm and above was found to be higher only in patients with PCOS compared with the control group (p=0.018). When the phenotypes were examined, thyroid dysfunction features were found in phenotype A, which was the most prominent. Thyroid autoimmunity, thyroid volume, and the number of nodules larger than 1 cm increased in patients with PCOS compared with controls. This situation is thought to be caused by the reproductive and metabolic properties of PCOS because thyroid dysfunction was detected more in phenotype A, which is called the full phenotype. Therefore, all patients with PCOS, especially phenotype A, should be evaluated for the presence of nodules with autoimmunity using USG, even if there are no symptoms, and thyroid functions.

PMID:35419775 | DOI:10.1055/a-1825-0316

J Gen Intern Med. 2022 Apr 13. doi: 10.1007/s11606-022-07494-5. Online ahead of print.

ABSTRACT

BACKGROUND: As health profession schools implement addiction curricula, they need survey instruments to evaluate the impact of the educational interventions. However, existing measures do not use current non-stigmatizing language and fail to capture core concepts.

OBJECTIVE: To develop a brief measure of health profession student readiness to work with people who use drugs (PWUDs) and establish its content validity.

METHODS: We conducted a literature review of existing instruments and desired clinical competencies related to providing care to PWUD and used results and expert feedback to create and revise a pool of 72 items. We conducted cognitive interviews with ten pre-clinical health profession students from various US schools of nursing, pharmacy, and medicine to ensure the items were easy to understand. Finally, we used a modified Delphi process with twenty-four health professions educators and addiction experts (eight each from nursing, pharmacy, and medicine) to select items for inclusion in the final scale. We analyzed expert ratings of individual items and interdisciplinary agreement on ratings to decide how to prioritize items. We ultimately selected 12 attitudes and 12 confidence items to include in the REadiness to Discuss Use, Common Effects, and HArm Reduction Measure (REDUCE-HARM). Experts rated their overall assessment of the final scale.

RESULTS: Twenty-two of twenty-four experts agreed or strongly agreed that the attitudes scale measures student attitudes that impact readiness to work with PWUDs. Twenty-three of twenty-four experts agreed or strongly agreed that the confidence scale measures student self-efficacy in competencies that impact readiness to work with PWUDs. Seven of 72 initial items and none of the 24 selected items had statistically significant differences between disciplines.

CONCLUSIONS: The REDUCE-HARM instrument has strong content validity and may serve as a useful tool in evaluating addiction education. Additional research is needed to establish its reliability, construct validity, and responsiveness to change.

PMID:35419741 | DOI:10.1007/s11606-022-07494-5

Support Care Cancer. 2022 Apr 13. doi: 10.1007/s00520-022-07051-0. Online ahead of print.

ABSTRACT

PURPOSE: The aim of this study was to determine the quality of life and its related factors in the caregivers of children with cancer.

METHODS: This cross-sectional study assessed the quality of life of 270 caregivers of children with cancer in Iran. Data collection tools were a personal information form and the Caregiver Quality of Life Index-Cancer. Data were analyzed by SPSS-18 software using descriptive and inferential statistics (independent t-test, analysis of variance, and linear regression model).

RESULTS: The mean score of quality of life was 78.3 ± 1.6 out of 140. Variables that were significantly associated with quality of life included age (p = .031), gender (p = .021), education (p = .048), occupation (p = .011), economic status (p = .038), average caring time (p = .021), and age of the child (p = .011).

CONCLUSION: The caregivers of children with cancer did not have a good quality of life. Healthcare providers need to provide comprehensive educational, emotional, social, and economic support to the caregivers of patients with cancer.

PMID:35419732 | DOI:10.1007/s00520-022-07051-0

J Cancer Res Clin Oncol. 2022 Apr 13. doi: 10.1007/s00432-022-04002-4. Online ahead of print.

ABSTRACT

PURPOSE: To investigate the protein expression of DNA mismatch repair (MMR) proteins in patients with cutaneous melanoma (CM) under immune checkpoint inhibitor (ICI) therapy.

METHODS: Immunohistochemistry was performed on tumor tissue for MMR proteins MLH1, MSH2, MSH6, and PMS2 in 50 metastatic CM patients treated with ICI (ipilimumab, nivolumab, pembrolizumab).

RESULTS: Best overall response (BOR) rate was 48% (24/50). Reduced MMR protein expression (nuclear expression in < 80% of tumor cells) was observed in 8 patients (16%). Compared to other clinical parameters, baseline neutrophil/lymphocyte ratio and reduced intratumoral MMR protein expression (P = 0.0033) were determined as the only parameters significantly associated with favorable BOR. However, in this small study population, reduced MMR protein expression did not reach statistical significance in multivariate analysis.

CONCLUSION: Reduced MMR protein expression is observed in CM and might predict favorable BOR in patients treated with ICI, as was observed for other entities. However, these findings need to be substantiated in larger patient cohorts.

PMID:35419731 | DOI:10.1007/s00432-022-04002-4

Diagnosis (Berl). 2022 Apr 14. doi: 10.1515/dx-2022-0010. Online ahead of print.

ABSTRACT

BACKGROUND: Diagnostic errors are frequently the product of cognitive biases that arise when heuristic-based approaches fail. The efficiency-thoroughness tradeoff (ETTO) principle states sacrificing thoroughness for efficiency is normal and occurs frequently in medicine. The goal of a diagnostic timeout was to provide an actionable template for when providers transition to an analytical mindset and to help incorporate the ETTO principle during the diagnostic process.

METHODS: A diagnostic time-out was adapted for use in pediatric hospital medicine (PHM). In this prospective study, a group of eight PHM providers piloted the time-out in the hospitalized setting. Data was collected over 12 months and descriptive statistics were used for analysis.

RESULTS: Cases were most frequently chosen for time-out use due to clinician intuition. In more than half the cases the time-out didn’t confirm the initial diagnosis and alternate diagnoses for the wrong diagnosis were pursued. There was only one case of the time-out being burdensome from a time perspective. Learners participated in all cases. As a result of the diagnostic time-out, new actions were taken in all cases.

CONCLUSIONS: Implementation of a diagnostic time out provides an actionable template for providers to actively change their mindset to an analytical thinking process to counteract cognitive biases and potentially reduce diagnostic errors in the pediatric inpatient setting.

PMID:35417931 | DOI:10.1515/dx-2022-0010

J Phys Condens Matter. 2022 Apr 13. doi: 10.1088/1361-648X/ac671c. Online ahead of print.

ABSTRACT

As a fundamental type of topological spin textures in two-dimensional (2D) magnets, a magnetic meron carries half-integer topological charge and forms a pair with its antithesis to keep the stability in materials. However, it is challenging to quantitatively calculate merons and their dynamics by using the widely used continuum model because of the characteristic highly inhomogeneous spin textures. In this work, we develop a discrete method to address the concentrated spin structures around the core of merons. We reveal a logarithmic-scale interaction between merons when their distance is larger than twice their core size and obtain subsequent statistics of meron gas. The model also predicts how these properties of single and paired merons evolve with magnetic exchange interactions, and the results are in excellent agreement with the Monte Carlo simulations using the parameters of real 2D van der Waals magnetic materials. This discrete approach not only shows equilibrium static statistics of meron systems but also is useful to further explore the dynamic properties of merons through the quantified pairing interactions.

PMID:35417893 | DOI:10.1088/1361-648X/ac671c

Georgian Med News. 2022 Mar;(324):170-175.

ABSTRACT

The purpose of the work was to analyze the pro-inflammatory reaction caused by different duration of ischemic-reperfusion of intestinal damage in occlusion of anterior mesenteric artery in the experiment. Ischemic reperfusion damage of the intestinal wall was simulated using reversible occlusion of the anterior mesenteric artery with 30 rats. Two types of operations were carried out: operation 1 – the duration of ischemia 20 minutes, reperfusion – 40 minutes, operation 2 – 30 and 30 minutes, respectively. Four groups were formed by simple sampling: the first – false-operated animals (n=5), the second – model-operation 1 (n=8), the third – model-operation 2 (n=6), the 4th – control group (n=7). Lactate level was determined by BM-Lactat test strips and the number of blood leukocytes was calculated before and after the surgery. During the postoperative period, interleukin-1β (IL-1β), tumor necrosis factor α (TNF-α), monocytic chemotoxic factor-1 (MCF-1) in serum were determined. In groups 2 and 3 it was established: a decrease in leukocytes in peripheral blood by 15-20% and an increase in lactate level by 20-120% during the postoperative period with the establishment of direct statistically significant connections between the number of leukocytes in the blood and lactate content (r=+0.83, p=0.01); between the number of leukocytes in the blood and IL-1β blood level (r=+0.96; p=0,00002); reduction of IL-1β level in blood with the animals of group 3 as compared with false-operated and MCF-1 level with the animals of group 2 as compared with false-operated, which may be related to the influence of corrective action of anti-inflammatory response. The increase of TNF-a level with the animals of the second group by 1.5-2 times and in the third group by 3 times compared to false-operated animals, which is the most significant manifestation of pro-inflammatory response to ischemia/reperfusion, depends on the degree of the damage due to the duration of ischemic period. The development of systemic pro-inflammatory reactions in the simulation of reversible occlusion of anterior mesenteric artery is the basis for the rehabilitation of patients after various surgical interventions in the intestine in order to prevent abdominal postoperative complications.

PMID:35417880