Nevin Manimala

Mar Biotechnol (NY). 2022 Sep 14. doi: 10.1007/s10126-022-10164-6. Online ahead of print.

ABSTRACT

Trichomoniasis is the most common non-viral sexually transmitted infection (STI) in the world caused by Trichomonas vaginalis. Failures in the treatment with the 5-nitroimidazole class including parasite resistance to metronidazole elicit new alternatives. Marine natural products are sources of several relevant molecules, presenting a variety of metabolites with numerous biological activities. In this work, we evaluated the anti-T. vaginalis activity of fungi associated with marine invertebrates by mass spectrometry-based metabolomics approaches. After screening of six marine fungi, extract from Penicillium citrinum FMPV 15 has shown to be 100% active against T. vaginalis, and the gel permeation column on Sephadex LH-20® yielded twelve organic fractions which five showed to be active. Metabolomics and statistical analyses were performed with all the samples (extract and fractions), and several compounds were suggested to be related to the activity. These components include citrinin, dicitrinin C, citreoisocoumarin, dihydrocitrinone, decarboxycitrinin, penicitrinone C, and others. The minimum inhibitory concentration (MIC) value of anti-T. vaginalis activity of citrinin was 200 µM. The marine fungi metabolites show potential as new alternatives to overcome drug resistance in T. vaginalis infections.

PMID:36102994 | DOI:10.1007/s10126-022-10164-6

Int Orthop. 2022 Sep 14. doi: 10.1007/s00264-022-05571-2. Online ahead of print.

ABSTRACT

PURPOSE: The purpose is to verify the intra- and inter-operator reliability of an extramedullary (EM) accelerometer-based smart cutting guide for distal femoral resection during primary total knee arthroplasty (TKA). The hypothesis of the present study was that the use of the device would result in a good correlation between different operators with a difference between repeated measurements of less than 1°.

METHODS: Twenty-five not consecutive patients with knee osteoarthritis undergone to primary TKA using an EM inertial-based cutting guide to perform distal femoral resection. In order to assess the agreement in femoral axis definition of the device, two operators performed three time each the manoeuvres necessary to define axis. Inter-rater agreement was evaluated with Bland and Altman agreement test. Intra-rater repeatability was evaluated analysing average results distribution of repeated measurements. Accuracy of the device was evaluated comparing differences between intra-operative device data with final implant alignment measured on post-operative longstanding x-rays using Students’ t test.

RESULTS: Agreement between the two operators was statistically significant (p < 0.05) with a bias of – 0.4° (95% CI – 0.6° to – 0.2°). Average difference between cut orientation measured with device and final implant position, measured on x-rays, was 0.2° (95% CI – 1.5° to 1.7°) with no statistical difference between the two measurements. Final implant alignment, measured on x-ray, was 90.2°, with 95% of cases distributed within range 88.0° to 92.0° for varus-valgus and 2.8° and with 95% of cases distributed within range 2.0° to 4.0° for flexion-extension.

CONCLUSIONS: The EM accelerometer-based smart cutting guide used to perform distal femoral resection during primary TKA demonstrated a good intra- and inter-operator reliability in the present in vivo study.

PMID:36102981 | DOI:10.1007/s00264-022-05571-2

World J Surg. 2022 Sep 14. doi: 10.1007/s00268-022-06715-6. Online ahead of print.

ABSTRACT

BACKGROUND: Fascial dehiscence (FD) and incisional hernia (IH) pose considerable risks to patients who undergo abdominal surgery, and many preventive strategies have been applied to reduce this risk. An accurate predictive model could aid identification of high-risk patients, who could be targeted for particular care. This study aims to systematically review existing FD and IH prediction models.

METHODS: Prediction models were identified using pre-specified search terms on SCOPUS, PubMed, and Web of Science. Eligible studies included those conducted in adult patients who underwent any kind of abdominal surgery, and reported model performance. Data from the eligible studies were extracted, and the risk of bias (RoB) was assessed using the PROBAST tool. Pooling of C-statistics was performed using a random-effect meta-analysis. [Registration: PROSPERO (CRD42021282463)].

RESULTS: Twelve studies were eligible for review; five were FD prediction model studies. Most included studies had high RoB, especially in the analysis domain. The C-statistics of the FD and IH prediction models ranged from 0.69 to 0.92, but most have yet to be externally validated. Pooled C-statistics (95% CI) were 0.80 (0.74, 0.86) and 0.81 (0.75, 0.86) for the FD (external-validation) and IH prediction model, respectively. Some predictive factors such as body mass index, smoking, emergency operation, and surgical site infection were associated with FD or IH occurrence and were included in multiple models.

CONCLUSIONS: Several models have been developed as an aid for FD and IH prediction, mostly with modest performance and lacking independent validation. New models for specific patient groups may offer clinical utility.

PMID:36102959 | DOI:10.1007/s00268-022-06715-6

Orthop Surg. 2022 Sep 14. doi: 10.1111/os.13492. Online ahead of print.

ABSTRACT

OBJECTIVE: A detailed analysis of the morphology of distal humeral articulation can help in the creation of anatomic prostheses of hemiarthroplasty. This study used statistical shape modeling to evaluate the 3D morphology of the distal humerus in healthy Chinese individuals and to investigate the proper articular morphology differences.

METHODS: A statistical shape model (SSM) of the distal humerus was created using CT scans of 106 survey-confirmed nonpathologic elbows. In addition, the articular components of each principal component (PC) were selected and fitted on the mean mode. The Euclidean point-to-mesh distance of articular modes was calculated as a measurement the proper change in the morphology of the articulation.

RESULTS: The first seven PCs jointly accounted for 80.9% of the total variation (44.4%, 12.2%, 7.9%, 5.9%, 4.1%, 3.4% and 3%, respectively). In the mean model, the distance between the medial and lateral epicondyles was 57.4 mm, the width of the articulation was 42.1 mm, and the angle of the transepicondylar line (TEL) and C line was 4.8°. The articular surface differences of the first PC were significant (RMS: 1.43 mm in the -3 SD model and 2.38 mm in the +3 SD model), whereas under other conditions, the differences were not remarkable despite the maximum deformation not exceeding 1 mm.

CONCLUSION: A novel method (SSM) was used to evaluate the 3D morphology of the distal humerus in healthy Chinese individuals and investigate the proper articular shape differences. We found the proper shape of articular surface basically transformed into one variation pattern which was relevant to the bone size, even though the morphology of distal humerus possessed complicated variation modes. The findings of this study can be helpful to design the next generation of elbow hemiarthroplasty in the future.

PMID:36102259 | DOI:10.1111/os.13492

Br J Nutr. 2022 Sep 14:1-27. doi: 10.1017/S0007114522002938. Online ahead of print.

ABSTRACT

The objectives of this study were (1) to systematically review the literature on the association between birth weight in children born in the first and second generation; (2) to quantify this association by performing a meta-analysis. A systematic review was carried in six databases (Pubmed, Science Direct, Web of Science, Embase, Scopus, CINAHL and LILACS), in January 2021, for studies that recorded the birth weight of parents and children. A meta-analysis using random effects to obtain a pooled effect of the difference in birth weight and the association of low birth weight (LBW) between generations was performed. Furthermore, univariable meta-regression was conducted to assess heterogeneity. Egger’s tests were used to possible publication biases. Of the 9878 identified studies, 70 were read in full and 20 were included in the meta-analysis (10 prospective cohorts and 10 retrospective cohorts), 14 studies for difference in means and 11 studies for the association of LBW between generations (23 estimates). Across all studies, there was no statistically significant mean difference (MD) birth weight between first and second-generation (MD 19.26, 95% CI -28.85, 67.36; p= 0.43). Overall, children of LBW parents were 69% more likely to have low birth weight (pooled effect size (ES) 1.69, 95% CI 1.46, 1.95); I ² : 85,8%). No source of heterogeneity was identified among the studies and no publication bias. The average birth weight of parents does not influence the average birth weight of children, however the proportion of LBW among the parents seems to affect the offspring’s birth weight.

PMID:36102244 | DOI:10.1017/S0007114522002938

Ann Noninvasive Electrocardiol. 2022 Sep 14:e13006. doi: 10.1111/anec.13006. Online ahead of print.

ABSTRACT

BACKGROUND: It is difficult to insert cardiac pacing leads in patient with tricuspid valve surgery (TVS). The aim of this study was to evaluate safety and effectiveness of a novel technique applied for bedside temporary pacemaker placement (TPP) in patients with TVS.

METHODS: We investigated patients with TVS who required bedside TPP without X-ray guidance in cardiac intensive care unit between January 2019 and March 2022. They were divided into Novel pre-shaped group (N = 21) and Control group (routine pre-shaped group, N = 26). The ordinary bipolar electrodes were applied in both groups. In Novel pre-shaped group, electrodes were reshaped by a novel technique with three-curve with anterior tip method, while electrodes were shaped by traditional strategy in Control group. We evaluated the operation duration, first-attempt success rate of the lead placement, pacing threshold, success rate of lead placement, the rate of leads displacement, and complications.

RESULTS: Compared with that in Control group, the procedure time was significantly shortened and the first-attempt success rate of lead placement was obviously increased in Novel pre-shaped group (both p < 0.05). Although there was a slight reduction in complications in Novel pre-shaped group when compared with that in Control group. However, there were no statistical significance in pacing threshold, the success rate of lead placement, the rate of leads displacement, and complications when compared between two groups.

CONCLUSIONS: We propose a novel technique, three-curve with anterior tip method, is a feasible and effective bedside method to insert emergency temporary pacing leads in patients with TVS.

PMID:36102234 | DOI:10.1111/anec.13006

Orthop Surg. 2022 Sep 14. doi: 10.1111/os.13479. Online ahead of print.

ABSTRACT

OBJECTIVE: Traditional lateral soft tissue release (LSTR) was conducted by an additional dorsal first web incision, as the malformed thick scar and neuritis were common after surgery. A new method of lateral soft tissue release in a single medial incision via dorsal flap over the first metatarsal (LSTR-SMI-DFFM) should be recommended. The objective is to investigate the clinical effectiveness and safety of scarf + Akin osteotomy (SAO) combined with lateral soft tissue release in a single medial incision via dorsal flap over the first metatarsal (LSTR-SMI-DFFM) for moderate to severe hallux valgus.

METHODS: Patients who were performed surgery for hallux valgus from April 2014 to June 2020 were retrospectively reviewed. The visual analog scale (VAS) was recorded before surgery and during follow-up, as well as the forefoot score of the American Orthopaedic Foot and Ankle Society (AOFAS). Patient satisfaction was evaluated at the follow-up time. The preoperative and follow-up weightbearing X-ray were conducted in all patients. The radiological parameters of hallux valgus angle (HVA), intermetatarsal angle (IMA), and distal metatarsal articular angle (DMAA) were measured. Tibial sesamoid position (TSP) was also recorded according to seven-part grading system. The quantitative data were performed as mean ± standard deviation or median ± interquartile range. Student’s t test was performed in HVA, IMA, and DMAA. The TSP, VAS, and AOFAS were statistical analyzed by Mann-Whitney U test. p value of <0.05 was considered significant.

RESULTS: There were 123 feet conducted surgery in 96 patients. The AOFAS score improved a lot which was preoperative 39 to 100 at the follow-up time and VAS was 4 to 0 (p < 0.001). A total of 63 (51.2%) patients were very satisfied, 47 (38.2%) were satisfied, five (4.1%) were undecided and eight (6.5%) were not satisfied. The HVA, IMA, DMAA, and TSP were all decreased after surgery and were statistically significant (p < 0.001).

CONCLUSION: The SAO combined with a LSTR-SMI-DFFM for moderate to severe hallux valgus is effective and safe with pretty good clinical and radiographic results, as well as minimal complications. The corrections of AOFAS and VAS conformed to the minimum clinically important difference (MCID).

PMID:36102216 | DOI:10.1111/os.13479

Pharmacol Res Perspect. 2022 Oct;10(5):e01007. doi: 10.1002/prp2.1007.

ABSTRACT

Pharmacy services within hospitals are changing, with more taking on medication reconciliation activities. This systematic review was conducted to determine the measured impacts of Pharmacy teams working in an acute or emergency medicine department. The protocol followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was prospectively registered on PROSPERO, National Institute for Health and Care Research, UK registration number: CRD42020187487. The systematic review had two co-primary aims: a reduction in the number of incorrect prescriptions on admission by comparing the medication list from primary care to secondary care, and a reduction in the severity of harm caused by these incorrect prescriptions; chosen to determine the impact of pharmacy-led medication reconciliation services in the emergency and acute medicine setting. Seventeen articles were included. Fifteen were non-randomized controlled trials and two were randomized controlled trials. The number of patients combined for all studies was 7630. No studies included were based within the UK. All studies showed benefits in terms of a reduction in medicine errors and patient harm, compared to control arms. Nine articles were included in a statistical analysis comparing the pharmacy intervention arm with the non-pharmacy control arm, with a Chi² of 101.10 and I² value = 92%. However, studies were heterogenous with different outcome measures and many showed evidence of bias. The included studies consistently indicated that pharmacy services based within acute or emergency medicine departments in hospitals were associated with fewer medication errors. Further studies are needed to understand the health and economic impact of deploying a pharmacy service in acute medical settings including out-of-hours working.

PMID:36102210 | DOI:10.1002/prp2.1007

Clin Transplant. 2022 Sep 14:e14821. doi: 10.1111/ctr.14821. Online ahead of print.

ABSTRACT

Preemptive wait-listing of deceased donor kidney transplant candidates before maintenance dialysis increases the likelihood of transplantation and improves outcomes among transplant patients. Previous studies have identified substantial disparities in rates of preemptive listing, but a gap exists in examining geographic sources of disparities, particularly for sub-regional units. Identifying small area hot spots where delayed listing is particularly prevalent may more effectively inform both health policy and regionally appropriate interventions. We conducted a retrospective cohort study utilizing 2010-2020 Scientific Registry of Transplant Recipients data for all deceased donor kidney transplant candidates to examine overall and race-stratified geospatial hot spots of post-dialysis wait-listing in U.S. zip code tabulation areas. Three geographic clustering methods were utilized to identify robust statistically significant hot spots of post-dialysis wait-listing. Novel sub-regional hot spots were identified in the southeast, southwest, Appalachia, and California, with a majority existing in the southeast. Race-stratified results were more nuanced, but broadly reflected similar patterns. Comparing transplant candidates in hot spots to candidates in non-clusters indicated a strong association between residence in hot spots and high area deprivation (OR: 6.76, 95%CI: 6.52-7.02), indicating that improving access healthcare in these areas may be particularly beneficial. This article is protected by copyright. All rights reserved.

PMID:36102154 | DOI:10.1111/ctr.14821

J Clin Endocrinol Metab. 2022 Sep 14:dgac527. doi: 10.1210/clinem/dgac527. Online ahead of print.

ABSTRACT

OBJECTIVE: A hypothesis-free genetic association analysis has not been reported for patients with primary hyperparathyroidism (PHPT). We aimed to investigate genetic associations with PHPT using both genome-wide association study (GWAS) and candidate gene approaches.

METHODS: A cross-sectional study was done among patients of European Caucasian ethnicity recruited in Tayside (Scotland, UK). Electronic medical records were used to identify PHPT cases and controls, and linked to genetic biobank data. Genetic associations were performed by logistic regression models and Odds Ratios (ORs). The combined effect of the genotypes was researched by genetic risk score (GRS) analysis.

RESULTS: We identified 15,622 individuals for the GWAS that yielded 34 top single-nucleotide polymorphisms, and LPAR3-rs147672681 reached genome-wide statistical significance (P=1.2e-08). Using a more restricted PHPT definition 8,722 individuals with data on the GWAS-identified loci were found. Age-sex adjusted ORs for the effect alleles of SOX9-rs11656269, SLITRK5-rs185436526, and BCDIN3D-AS1-rs2045094 showed significant increased risks (P<1.5e-03). GRS analysis of 5482 individuals showed an OR of 2.51 (P=1.6e-04), 3.78 (P=4.0e-08) and 7.71 (P=5.3e-17) for the second, third and fourth quartiles respectively compared to the first, and there was a significant linear trend across quartiles (P<1.0e-04). Results were similar when stratifying by gender.

CONCLUSIONS: Using genetic loci discovered in a GWAS of PHPT carried out in a Scottish population, this study suggests new evidence for the involvement of genetic variants at SOX9, SLITRK5, LPAR3 and BCDIN3D-AS1. It also suggests that both male and female carriers of greater numbers of PHPT-risk alleles have a significant increased risk of PHPT.

PMID:36102151 | DOI:10.1210/clinem/dgac527