Nevin Manimala

Inquiry. 2022 Jan-Dec;59:469580221098754. doi: 10.1177/00469580221098754.

ABSTRACT

The Youth and Young Adults Cancer Knowledge Attitudes and Practices (C-KAP) exploratory study in 2 rural underserved areas in a border community. C-KAP is an interdisciplinary research pilot project led by university scholars in psychology and social work in partnership with community partners. The exploratory cross-sectional mix-method study recruited 141 (n=141) youth and young adults (ages 18-39). This study was informed on empirical research and a bilingual online questionnaire was field-tested, and data was collected via QuestionPro Software. Quantitative analysis was conducted using SPSS version 27. Descriptive statistics and frequency analysis were used for demographics and basic statistics. Chi square tests and Fisher’s exact tests between variables were ran to find statistically significant associations. For the qualitative data, independent coders conducted recurrent content analysis to identify themes. Salient themes include knowledge about cancer types; access to health care; prevention; and the perceived impact of COVID-19 pandemic. Findings highlight a lack of knowledge and orientation on cancer in youth and young adults suggesting the need for community tailored education and screening interventions. Other findings reflect gender differences in knowledge and practices, which indicates that a gender-specific lens is needed when delivering education.

PMID:35502985 | DOI:10.1177/00469580221098754

Retina. 2022 Mar 30. doi: 10.1097/IAE.0000000000003497. Online ahead of print.

ABSTRACT

PURPOSE: Evaluating the impact of delayed care, secondary to COVID-19 pandemic lockdowns, on visual acuity in previously treated neovascular AMD (nAMD) patients.

METHODS: A multi-center, retrospective, study of nAMD patients previously treated with anti-VEGF injections who were followed-up during 2019 (pre COVID-19) and compared to nAMD patients during 2020 (COVID-19).

RESULTS: A total of 1,192 nAMD patients with a mean age of 81.5 years met the inclusion criteria. Of these, 850 patients were assessed in 2019 (pre COVID-19) and 630 patients assessed in 2020 (COVID-19). 308 patients were assessed through both 2019-2020 and thus were included in both cohorts. There was no significant difference between the years 2020 and 2019 in terms of baseline and change in BCVA (p=0.342, p=0.911 respectively). Mean number of anti-VEGF injections was significantly lower (5.55 Vs 6.13, p<0.01), with constant lower ratio of injections per patient in the COVID-19 period. Baseline BCVA (0.859, p<0.01), number of injections (-0.006, p=0.01) and age (0.003, p<0.01) were predictors of final BCVA.

CONCLUSIONS: In nAMD patients, delayed care secondary to COVID-19 pandemic lockdowns has no statistically significant impact on BCVA. Baseline BCVA, older age and lower number of yearly anti VEGF injections are predictors for decrease BCVA.

PMID:35502974 | DOI:10.1097/IAE.0000000000003497

J Ultrasound Med. 2022 May 3. doi: 10.1002/jum.16001. Online ahead of print.

ABSTRACT

OBJECTIVES: To describe the comparative incidence, detection of small-for-gestational age (SGA), and composite perinatal morbidity (CPM) associated with diagnostic criteria of fetal growth restriction (FGR) by estimated fetal weight (EFW) <10% with those with isolated abdominal circumference (AC) measurements <10%.

METHODS: We performed a retrospective cohort study of 1587 patients receiving prenatal care and delivery at our institution. We included all patients with ultrasounds and delivery outcomes available, and excluded terminations, second trimester losses, and pregnancies without ultrasounds. EFW was calculated from Hadlock and use of the Duryea centiles, and AC from Hadlock’s reference curves. We determined SGA at birth and defined CPM as birthweight less than 3% or birthweight less than 10% with neonatal morbidity.

RESULTS: Of 1587 patients, 28 (1.8%) were classified as FGR by EFW <10%. Three of 12 patients with isolated AC <10% developed EFW <10% later in pregnancy (25%). The performance of each diagnostic criteria were comparable for the outcomes of SGA and CPM, with similar sensitivities, but with decreased specificity for SGA outcome, and an increased false positive rate for patients classified as FGR by isolated AC <10, with a tradeoff of decreased false negatives.

CONCLUSIONS: Broadening the diagnosis of FGR to include patients with isolated AC <10 did not significantly increase the detection of pregnancies at risk for SGA or CPM. Our conclusions may be limited by a lack of statistical power given a low frequency of SGA and CPM.

PMID:35502972 | DOI:10.1002/jum.16001

Ann Plast Surg. 2022 Apr 23. doi: 10.1097/SAP.0000000000003165. Online ahead of print.

ABSTRACT

BACKGROUND: We sought to compare the safety profile of prepectoral breast reconstruction with total submuscular tissue expander reconstruction, previously our standard. Primary outcomes of interest in this retrospective cohort study were incidence of infection, hematoma, seroma, mastectomy flap necrosis, and reconstruction loss.

METHODS: Total submuscular and prepectoral with acellular dermal matrix reconstructions consecutively performed by a single surgeon (P.D.S.) between January 1, 2016, and December 31, 2019, were compared. Demographic and clinical characteristics, as well as complications and complication types, were extracted for all patients. A t test was used to assess differences in continuous variables. Multivariate logistics regression was used to assess the association between type of reconstruction and complication rate. The statistical significance was set at 0.05 for all comparisons.

RESULTS: A total of 133 patients (234 breasts) were included. There was a significantly greater incidence of infection (16.5% vs 5.5%, P < 0.01) in the prepectoral/acellular dermal matrix cohort. However, reconstructive loss was low in both cohorts (2.5% and 3.0%, P = 0.83). Adjusted odds ratio for complications in the prepectoral cohort was 2.26, but this was not statistically significant (adjusted P = 0.24).

CONCLUSIONS: Prepectoral breast reconstruction shares an overall complication profile that is not greater than that of total submuscular reconstruction. It is associated with a greater risk of infection; however, the ability to salvage the reconstruction with early, aggressive intervention results in low rates of reconstructive loss, comparable with those of total submuscular reconstruction.

PMID:35502960 | DOI:10.1097/SAP.0000000000003165

Ann Plast Surg. 2022 Apr 23. doi: 10.1097/SAP.0000000000003219. Online ahead of print.

ABSTRACT

INTRODUCTION: The transverse upper gracilis (TUG) flap is a reliable alternative to abdominally based breast reconstruction because of its advantageous anatomy. However, the limited tissue volume prevents reconstruction of large breasts. The bilateral TUG flaps for unilateral breast reconstruction can overcome this problem.

METHODS: A retrospective analysis was performed regarding unilateral breast reconstruction with bilateral TUGs at the Queen Victoria Hospital from 2015 to 2019. Associations between categorical variables were examined with Fisher exact test, and any differences in continuous variables by complication status were evaluated with Mann-Whitney-Wilcoxon test for independent samples. A relevant systematic review was conducted with a meta-analysis of proportions using the Freeman-Tukey arcsine transformation for the estimation of the overall survival rates.

RESULTS: Ten cases were identified with 6 having a delayed reconstruction. Median age and body mass index were 50.8 years and 23.9 kg/m2, respectively, and average flap weight was 268.3 g. One flap was placed superiorly with its pedicle anastomosed to the retrograde internal mammary vessels, except of half of the cases where a second anterograde vein was used. The mean follow-up was 21.4 months, and all flaps survived. Two patients returned to theater, and 4 experienced donor-site problems. The presence of complications was not associated with age, ever smoking, body mass index, TUG weight, or anastomosis to retrograde internal mammary vein. The systematic review resulted in 8 eligible articles with a total sample of 156 flaps. The overall survival rate was 96.8%. In 6 cases, the indication was Poland syndrome (7.7%), and in 48.7%, axillary vessels were also used as recipient vessels. The estimated overall flap survival rate was 100% (95% confidence interval, 99%-100%), and no significant heterogeneity was noted (I2 = 0%, P = 0.71).

CONCLUSIONS: The “2-in-1” technique can lead to symmetrical aesthetically pleasant results for both recipient and donor sites. Our case series and the conducted systematic review reiterate the reliability of this approach.

PMID:35502959 | DOI:10.1097/SAP.0000000000003219

Acta Crystallogr A Found Adv. 2022 May 1;78(Pt 3):172-199. doi: 10.1107/S2053273322000845. Epub 2022 Apr 28.

ABSTRACT

Statistically sound crystallographic symmetry classifications are obtained with information-theory-based methods in the presence of approximately Gaussian distributed noise. A set of three synthetic patterns with strong Fedorov-type pseudosymmetries and varying amounts of noise serve as examples. Contrary to traditional crystallographic symmetry classifications with an image processing program such as CRISP, the classification process does not need to be supervised by a human being and is free of any subjectively set thresholds in the geometric model selection process. This enables crystallographic symmetry classification of digital images that are more or less periodic in two dimensions (2D), also known as crystal patterns, as recorded with sufficient structural resolution from a wide range of crystalline samples with different types of scanning probe and transmission electron microscopes. Correct symmetry classifications enable the optimal crystallographic processing of such images. That processing consists of the averaging over all asymmetric units in all unit cells in the selected image area and significantly enhances both the signal-to-noise ratio and the structural resolution of a microscopic study of a crystal. For sufficiently complex crystal patterns, the information-theoretic symmetry classification methods are more accurate than both visual classifications by human experts and the recommendations of one of the popular crystallographic image processing programs of electron crystallography.

PMID:35502711 | DOI:10.1107/S2053273322000845

Int Endod J. 2022 May 3. doi: 10.1111/iej.13760. Online ahead of print.

ABSTRACT

AIM: PTEN-induced putative kinase 1 (PINK1) and Parkin E3 ubiquitin-protein ligase (Parkin) are critical for immune and inflammatory regulation in health and disease. PINK1 and Parkin have been confirmed to be involved in the progression of apical periodontitis by affecting mitophagy-related osteoblast apoptosis; however, the expression of PINK1 and Parkin in macrophages, one of the most important cells in apical periodontitis, remains unknown. This study aimed to investigate the expression of PINK1 and Parkin in human apical periodontitis lesions, as well as their possible localization in macrophages.

METHODOLOGY: Thirty-seven human periapical tissues, including periapical granulomas (PGs, n=12), radicular cysts (RCs, n=11), and healthy gingival tissues (n=14) were examined. The inflammatory infiltrates of lesions were evaluated by haemotoxylin staining, and the expression of PINK1 and Parkin was detected by immunohistochemistry. Double immunofluorescence was used to explore the colocalization of microtubule-associated protein 1 light chain 3 (LC3) and TOMM20, as well as the localization of PINK1 and Parkin, in macrophages of human apical periodontitis lesions. The ultrastructural morphology of mitochondria in human apical periodontitis lesions was visualized by transmission electron microscopy (TEM). Data were analyzed by one-way ANOVA with Student-Newman-Keul’s test and Mann-Whitney test. P < 0.05 was considered statistically significant.

RESULTS: Immunohistochemistry demonstrated a significantly higher expression of PINK1 and Parkin proteins in human apical periodontitis lesions than in healthy gingival tissues (P < 0.0001), but no significant difference was demonstrated between PGs and RCs (P > 0.05). The higher expression of LC3 and the presence of more LC3-TOMM20 double-positive cells were also observed in human apical periodontitis. Double-labeling analysis of PINK1, Parkin, and LC3 with CD68 indicated that macrophage mitophagy might be present in the progression of human apical periodontitis. Finally, the results of TEM morphological analysis revealed the appearance of double-membraned mitophagosomes and vacuolated mitochondria in macrophage-like cells of apical periodontitis lesions.

CONCLUSIONS: Our findings indicated that PINK1 and Parkin proteins were highly expressed in clinical apical periodontitis lesions.

PMID:35502680 | DOI:10.1111/iej.13760

Hypertension. 2022 May 3:101161HYPERTENSIONAHA12219185. doi: 10.1161/HYPERTENSIONAHA.122.19185. Online ahead of print.

ABSTRACT

BACKGROUND: This study aimed to evaluate the association of hypertension with incident infective endocarditis (IE) by investigating the incidence of IE according to blood pressure levels using the National Health Insurance Service database.

METHODS: The data of 4 080 331 individuals linked to the health screening database in 2009 were retrieved (males, 55.08%; mean age, 47.12±14.13 years). From 2009 to 2018, the risk factors for the first episode of IE were investigated. Hypertension was categorized into normotension, prehypertension, hypertension, and hypertension with medication. The Cox proportional hazard model assessed the effect of blood pressure level during the health screening exam on incident IE.

RESULTS: During the 9-year follow-up, 812 (0.02%) participants were diagnosed with IE. The incidence rates of IE in the normotension, prehypertension, hypertension, and hypertension with medication groups were 0.9, 1.4, 2.6, and 6.0 per 100 000 person-years, respectively. Those with prehypertension, hypertension, and hypertension with medication were correlated with an increased risk of IE in a dose-response manner compared with the normotension group (hazard ratio, 1.33 [95% CI, 1.06-1.68]; hazard ratio, 1.98 [1.48-2.66]; hazard ratio, 2.56 [2.02-3.24], respectively, all P<0.001).

CONCLUSIONS: In a large national cohort study with an average follow-up of 9 years, increased blood pressure was identified as a risk factor for incident IE in a dose-dependent manner. Hypertension increases the public health care burden by acting as a risk factor for rare infective heart diseases.

PMID:35502658 | DOI:10.1161/HYPERTENSIONAHA.122.19185

ALTEX. 2022 Apr 14. doi: 10.14573/altex.2111301. Online ahead of print.

ABSTRACT

Pharmaceutical products intended for parenteral use must be free from pyrogenic (fever-inducing) contamination. Pyrogens comprise endotoxin from Gram-negative bacteria and non-endotoxin pyrogens (NEP) from Gram-positive bacteria, viruses and fungi. The longstanding compendial test for pyrogens is the rabbit pyrogen test (RPT) but in 2010 the monocyte activation test (MAT) for pyrogenic and pro-inflammatory contaminants was introduced into the European Pharmacopoeia (Ph. Eur.) as a ‘non-animal’ replacement for the RPT. The present study describes the first product-specific GMP validation of Ph. Eur. MAT, Quantitative test, Method A, for the testing of three therapeutic monoclonal antibodies (mAbs). The MAT uses cryo-preserved PBMC with interleukin-6 (IL-6) as the readout. Much of the data presented here for one of the antibodies was included in a successful product licence application to the EMA.

PMID:35502618 | DOI:10.14573/altex.2111301

Pediatrics. 2022 May 3:e2021054201. doi: 10.1542/peds.2021-054201. Online ahead of print.

ABSTRACT

BACKGROUND: Development of cardiovascular disease in adults has been directly linked to an adverse metabolic phenotype. While there is evidence that development of these risk factors in childhood persists into adulthood and the development of cardiovascular disease, less is known about whether these risk factors are associated with target organ damage during adolescence.

METHODS: We collected data from 379 adolescents (mean age 15.5, 60% male) with blood pressure between the 75th and 95th percentile to determine if there is a metabolic phenotype that predicts cardiovascular changes (left ventricular mass, systolic and diastolic function, pulse wave velocity, and renal function). We determined the number of risk factors for cardiovascular disease (hypertension, dyslipidemia, obesity, and insulin resistance) present in each participant. Generalized linear models were constructed to determine if the number of cardiovascular risk factors (CVRFs) were associated with measures of target organ damage.

RESULTS: The number of CVRFs present were associated with statistically significant differences in increased left ventricular mass index, increased pulse wave velocity, decreased peak longitudinal strain, urine albumin to creatine ratio and echocardiographic parameters of diastolic dysfunction. Generalized linear models showed that dyslipidemia and insulin resistance were independently associated with markers of diastolic dysfunction (P ≤ .05) while increased blood pressure was associated with all makers of target organ damage (P ≤ .03).

CONCLUSIONS: These data suggest the of the number of CVRFs present is independently associated with early changes in markers of target organ damage during adolescence.

PMID:35502610 | DOI:10.1542/peds.2021-054201