Nevin Manimala

Parasitol Res. 2022 Nov 19. doi: 10.1007/s00436-022-07730-1. Online ahead of print.

ABSTRACT

Because the number of wild raccoons in Germany is increasing constantly, it appears to be economic reasonable to use their meat as food. For this purpose, it is essential to generate data regarding the pathogen load of the meat to be consumed and handled. It is known that raccoons, particularly in Germany, show a high seroprevalence of Toxoplasma gondii. Because serological data only indicates contact of a host to a parasite additional direct detection is needed to prove presence of parasitic stages in particular tissues. Therefore, a total of 150 samples from raccoons with known serostatus were tested and quantified using magnetic-capture real-time PCR for Toxoplasma gondii. As it represents potentially consumption-relevant parts of raccoons, meat from forelimb and hindlimb was examined. Samples were stratified into three groups based on the animals’ serostatus (each 50 negative, low positive, and high positive). All samples from seronegative animals were found negative by MC-PCR as well. In a total of 56 meat samples from 100 seropositive animals, T. gondii DNA was detected. Statistically significant more samples were positive by MC-PCR in the high positive than in the low positive serostatus group (38/50 vs. 18/50, p < 0.0001). Furthermore, samples from the former group were also found to have statistically significant higher DNA equivalent values compared to samples from the low positive serostatus group (p < 0.0001). These results suggest that meat from seropositive raccoons may contain considerable numbers of T. gondii presenting a potential public health risk for humans whilst handling and consumption.

PMID:36401669 | DOI:10.1007/s00436-022-07730-1

Eur Spine J. 2022 Nov 19. doi: 10.1007/s00586-022-07466-7. Online ahead of print.

ABSTRACT

PURPOSE: To describe the incidence of complications associated with cervical spine surgery and post-operative physical therapy (PT), and to identify if the timing of initiation of post-operative PT impacts the incidence rates.

METHODS: MOrtho PearlDiver database was queried using billing codes to identify patients who had undergone Anterior Cervical Discectomy and Fusion (ACDF), Posterior Cervical Fusion (PCF), or Cervical Foraminotomy and post-operative PT from 2010-2019. For each surgical procedure, patients were divided into three 12-week increments for post-operative PT (starting at post-operative weeks 2, 8, 12) and then matched based upon age, gender, and Charlson Comorbidity Index score. Each group was queried to determine complication rates and chi-square analysis with adjusted odds ratios, 95% confidence intervals, and p-values were used.

RESULTS: Following matching, 3,609 patients who underwent cervical spine surgery at one or more levels and had post-operative PT (ACDF:1784, PCF:1593, and cervical foraminotomy:232). The most frequent complications were new onset cervicalgia (2-14 weeks, 8-20 weeks, 12-24 weeks): ACDF (15.0%, 14.0%, 13.0%), PCF (18.8%, 18.0%, 19.9%), cervical foraminotomy (16.8%, 16.4%, 19.4%); revision: ADCF (7.9%, 8.2%, 7.4%), PCF (9.3%, 10.6%, 10.2%), cervical foraminotomy (11.6%, 10.8% and 13.4%); wound infection: ACDF (3.3%, 3.4%, 3.1%), PCF (8.3%, 8.0%,7.7%), cervical foraminotomy (5.2%, 6.5%, < 4.7%). None of the comparisons were statistically significant.

CONCLUSION: The most common post-operative complications included new onset cervicalgia, revision and wound infection. Complications rates were not impacted by the timing of initiation of PT whether at 2, 8, or 12 weeks post-operatively.

PMID:36401668 | DOI:10.1007/s00586-022-07466-7

J Hum Lact. 2022 Nov 18:8903344221135793. doi: 10.1177/08903344221135793. Online ahead of print.

ABSTRACT

BACKGROUND: Painful and damaged nipples are frequently associated with breastfeeding cessation in the early postpartum period. The results of researchers’ studies utilizing different treatments have been inconclusive.

RESEARCH AIM: To compare the intensity of nipple pain and the healing of damaged nipples during the first 10 days postpartum using either lanolin or human milk treatments.

METHODS: This single-blind randomized controlled trial included participants (N = 206) who were primiparous with painful and damaged nipples. Participants were recruited from the tertiary teaching hospital within the first 72 hr after delivery and randomized to the intervention group with lanolin (n = 103) and a human milk control group (n = 103). Data were collected in the maternity ward, 3 and 7 days after randomization. The primary outcome was nipple pain intensity and quality measured 3 and 7 days after randomization by the McGill Pain Questionnaire – short form. The nipple damage self-assessment questionnaire was used for the assessment of nipple healing. Breastfeeding self-efficacy, breastfeeding duration, and exclusivity were assessed as secondary outcomes.

RESULTS: Participants in both groups reported a statistically nonsignificant reduction in pain (quality and intensity of pain) as well as improved nipple healing 7 days after randomization. Participants in the lanolin group exclusively breastfed their infants 3 days after randomization-significantly more often than participants in the control group (p = .026). The study did not reveal any statistically significant differences for other secondary outcomes.

CONCLUSION: Both lanolin and human milk are equally effective in treating painful and damaged nipples.Registered with Clinicaltrials.gov (NCT04153513).

PMID:36401521 | DOI:10.1177/08903344221135793

J Endourol. 2022 Nov 18. doi: 10.1089/end.2022.0386. Online ahead of print.

ABSTRACT

PURPOSE: Ureteral stenting following uncomplicated ureteroscopy is common practice. Several studies have proven the safety of omitting routine stent placement following distal ureteral stone treatment. However, there is a paucity of data regarding the utility of stent placement for proximal ureteroscopy. We designed a prospective, randomized controlled trial to evaluate the role of ureteral stent placement following ureteroscopy for proximal ureteral and renal stones.

METHODS: Seventy-two patients with proximal ureteral or renal stones measuring up to 1.5cm were prospectively randomized into stented (37) or unstented (35) groups. The surgeon was blinded to the treatment group until after stone treatment. Patients tracked postoperative pain medications and completed validated pain questionnaires on postoperative days 0, 3, 7 and 28. Stents were removed on postoperative day 7. Postoperative follow up imaging was obtained at four weeks.

RESULTS: No statistical differences between the two groups in terms of demographics or stone characteristics. Operative time was longer in the stented group (p<0.03). Patients in the stented group had more irritative urinary symptoms (p <.0001) and pain (p<.0001), lower quality of life scores (p<0.001) and used more narcotics (p<.0005) during the first week but no differences at 30 days. Emergency room visits and overall complication rates were similar between the two groups. 3 nonstented patients required stent placement. 2 stented patients required early stent removal. Urinary tract infections developed in 3 stented but in no unstented patients. Postoperative imaging did not reveal any hydronephrosis in either group and the total stone free rate (SFR) was 94%.

CONCLUSION: For the majority of uncomplicated ureteroscopic treatment of proximal ureteral and kidney stones, it may be safe to omit ureteral stents in order to potentially decrease urinary symptoms and pain while improving short-term quality of life. Further studies with larger patient cohorts may be warranted to confirm our results.

PMID:36401514 | DOI:10.1089/end.2022.0386

J Endourol. 2022 Nov 18. doi: 10.1089/end.2022.0234. Online ahead of print.

ABSTRACT

AIM: To conduct a comparative, non-randomised study to assess the feasibility of mini-Endoscopic combined Intra Renal Surgery(ECIRS) using supine Mini-Percutaneous nephrolithotomy (PCNL) access (16 Fr) in Galdakao Modified Supine Valdivia(GMSV) position for managing proximal large volume impacted ureteral calculi as ambulatory day-care surgery vis-a-vis standalone ureteroscopy with push-back PCNL, if needed. The primary aim was to study the outcomes and stone-free rates. Secondary aim was to compare the intra-operative and short-term post-operative complications.

MATERIALS AND METHODS: Data of sixty patients undergoing ECIRS(Group 1) from January 2016 to December 2019 were collected prospectively in a non-randomized fashion from a single centre after ethics committee approval. A matched-paired analysis was performed with retrospectively collated data of 60 patients undergoing standard ureteroscopy / pushback PCNL(Group 2) using analysis of variance, Fisher’s exact test, and Chi-square test. P < 0.05 was considered statistically significant.

OUTCOMES AND RESULTS: GROUP 1 patients had a significantly shorter procedure time vs GROUP 2 (42.1 ± 11.2 minutes vs 52.1 ± 13.7 minutes, p <0.001). GROUP 1 (59/60) patients had an overall single-stage (SFR) of 98.3% which was significantly higher than single-stage SFR of 83% in GROUP 2 (50/60) (p<0.002). GROUP 2 patients had a higher incidence of fever (10 vs 4, p=0.01). However, there were no cases of sepsis in either group. Rest of the complications were comparable for both the need for ancillary procedures was significantly higher in GROUP 2 (10% vs 1.7%, p<0.001). Patients were discharged on same day in both groups.

CONCLUSIONS: The findings of our study suggest that, in large and impacted proximal ureteric stones, combined minimally-invasive endoscopic approach offers the best option to render the patient stone-free by a single intervention. With better intra- and post-operative outcomes and safety profile, Mini-ECIRS may be considered as an ambulatory procedure in this setting.

PMID:36401507 | DOI:10.1089/end.2022.0234

AIDS Res Hum Retroviruses. 2022 Nov 18. doi: 10.1089/AID.2022.0086. Online ahead of print.

ABSTRACT

In the era of combination antiretroviral therapy (ART), people living with HIV (PLHIV) still face an increased risk of cardiovascular disease (CVD). Tenofovir alafenamide fumarate (TAF) is superior to its precursor tenofovir disoproxil fumarate (TDF) regarding bone and renal toxicity, but there are concerns about a negative effect on lipid profile. This observational, single-center study investigates the effects on lipid profile and cardiovascular (CVD) risk of the switch from TDF to TAF, in combination with FTC/EVG/c, in patients with no exposure to other antiretrovirals. Routine laboratory measurements, somatometric characteristics and smoking status were analyzed for the assessment of CVD risk changes, using D:A:D and ATP III scores pre- and post-switch. A total of 62 patients with a mean age of 32.9 years were included in this study. 61 (98.4%) were males, 38 (61.3%) late presenters and 39 (62.9%) active smokers. A year after the switch, there was a significant increase in total cholesterol (178±38 to 194±40 mg/dL, p<0.001), HDL (45±12 to 48±13 mg/dL, p=0.001), LDL (117±32 to 137±36 mg/dL, p<0.001). Mean increase of the 10-year D:A:D score was 1.13% (95% CI 1.05-1.22, p=0,002). Changes were more prominent in non-smokers. Body mass index and average weight showed an upward trend. Switching from TDF to TAF caused significant changes in lipid profile at 14 months of follow-up, in young, otherwise healthy PLHIV. CVD risk, as measured by D:A:D, showed a statistically significant increase, but more data are needed to determine clinical significance. These results point towards a patient-centered approach when selecting an ART regimen.

PMID:36401506 | DOI:10.1089/AID.2022.0086

Medicine (Baltimore). 2022 Nov 18;101(46):e31450. doi: 10.1097/MD.0000000000031450.

ABSTRACT

BACKGROUND: Some patients develop long-term symptoms after Corona virus disease 2019 (COVID-19), and chronic fatigue syndrome (CFS) is one of the main symptoms. CFS is characterized by fatigue lasting for more than 6 months accompanied by sleep disorders, anxiety, and depression, which causes a certain degree of harm to both physiological and psychological aspects of the individual. Traditional Chinese exercises (TCEs) are an ancient Chinese therapy and has recently been reported to be effective for CFS. Therefore, we will conduct a systematic review and meta-analysis aiming to accurately evaluate the efficacy of TCEs on post-COVID-19 CFS and provide an alternative treatment for post-COVID-19 CFS.

METHODS: Seven databases (PubMed, Ovid Embase, Cochrane Library, Web of Science, Chinese National Knowledge Infrastructure (CNKI), China Biology Medicine (CBM), and Wanfang) will be searched from establishment to August 2022, and we will only include randomized controlled trials of TCEs for post-COVID-19 CFS. Two reviews will independently include the research according to the inclusion and exclusion criteria. Review Manager 5.2 software will be used to analyze the accepted literature, and the relative risk ratio (RR) and 95% confidence interval (CI) will be used as effect indicators for the outcome indicator dichotomous variables. For continuous variables, weighted mean difference (MD) and 95% CI will be used as effect indicators. The heterogeneity test will be assessed using the I2 statistic and Q statistic. The PEDro scale was used to evaluate the methodological quality of the included studies. Subgroup analysis was performed according to different TCEs, age, gender, and duration of CFS.

RESULTS: This systematic review and meta-analysis will evaluate the efficacy of TCEs in post-COVID-19 CFS.

CONCLUSION: The results of this study will provide reliable evidence for the effects of TCEs for post-COVID-19 CFS on patients’ fatigue, anxiety, depression, sleep, and quality of life.

PMID:36401484 | DOI:10.1097/MD.0000000000031450

Medicine (Baltimore). 2022 Nov 18;101(46):e31406. doi: 10.1097/MD.0000000000031406.

ABSTRACT

Advances in the biology of Ewing sarcoma, which continues to be an important cause of mortality, have caused an increase in information in the literature related to the underlying molecular base of the disease and discussions of new treatment approaches. In this study, we aimed to comprehensively analyze the published scientific articles on Ewing sarcoma. The Web of Science database was used to obtain and statistically analysis articles on Ewing sarcoma that were published between 1980 and 2021. Maps of network visualization were used to reveal trending topics, global collaborations, and the most effective studies. Correlation analysis was performed using Spearman’s correlation coefficient. A total of 3236 articles were analyzed. The first 3 countries that contributed the most to the literature and cooperated most intensively were USA (1194, 36.8%), Germany (293, 9%), Italy (254, 7.8%). Pediatric Blood & Cancer (n = 122), Cancer (87), Journal of Pediatric Hematology Oncology (71) were among the top 3 journals with the most articles. The most active author was Piero Picci (n = 94). High-income countries have a great effect on the literature on this subject. The most studied trend topics in recent years were pediatric oncology, EWS RNA Binding Protein 1 (EWSR1), EWSR1-FL1, epigenetics, bioinformatics, microRNA, gene expression, metastasis, migration, biomarker, immunotherapy, survival, outcomes, surveillance epidemiology and end results (SEER), nomogram, temozolomide, irinotecan, and drug resistance. Genetic studies, metastasis, immunotherapy, life analyses/nomogram based on new data obtained from SEER, and chemotherapy with irinotecan and temozolomide combination, were seen to be the topics researched in recent years.

PMID:36401481 | DOI:10.1097/MD.0000000000031406

Medicine (Baltimore). 2022 Nov 18;101(46):e31218. doi: 10.1097/MD.0000000000031218.

ABSTRACT

INTRODUCTION: Orofacial pain and tensional cephalea were symptoms commonly reported in COVID-19 patients, even after recovery, and were considered chronic pain in these cases. The aim of this research is to evaluate the effect of the application of photobiomodulation with red and infrared lasers applied locally and systemically.

METHODS AND ANALYSIS: For this purpose, individuals who have been diagnosed with COVID-19 and have had a tension headache and/or orofacial pain for more than 3 months will be selected by convenience. The participants will be divided into two different groups: G1-photobiomodulation with red and infrared laser with local application on the pain points (808 nm and 660 nm, 100 mW, 6 J per point) and G2-photobiomodulation with red laser with transcutaneous application on the radial artery (660 nm, 100 mW, 30 minutes). All participants will be treated for a period of 4 weeks, with 8 application sessions. The effects will be measured by means of blood lactate level, Brief Pain Inventory, Visual Analog Scale (VAS), and Cephalea Impact Test. The data will be collected weekly before and after the treatment, and the following tests will be applied: Analysis of variance (ANOVA), Tukey paired t test, Kruskal-Wallis, or Wilcoxon, according to data distribution. α = 0.05 will be considered as the level of statistical significance.

ETHICS AND DISSEMINATION: This study was approved by the Research Projects Committee of the Nove de Julho University (approval number 4.673.963). Results will be disseminated through peer-reviewed journals and events for the scientific and clinical community, and the general public. It is registered in the ClinicalTrials.gov database with the number NCT05430776.

PMID:36401476 | DOI:10.1097/MD.0000000000031218

Medicine (Baltimore). 2022 Nov 18;101(46):e31636. doi: 10.1097/MD.0000000000031636.

ABSTRACT

BACKGROUND: Cough variant asthma (CVA), also called concealed asthma or allergic asthma, is the most common cause of chronic cough in children. The disorder is mainly characterized by a nonproductive dry cough associated with a high recurrence rate that is conventionally treated with antibiotics, anti-inflammatory medications, cough suppressants, or expectorants. For millennia, Chinese herbal medicine (CHM) has been used widely in China to treat pediatric CVA cases, although high-quality evidence of CHM efficacy is lacking. In this study, the effectiveness and safety of Xiehuangjiejing (XHJJ) granule will be evaluated when used alone to treat children with CVA.

METHODS AND ANALYSIS: A randomized, double-blind, parallel, placebo-controlled multicenter trial will be conducted over the course of 2 weeks. A total of 180 CVA patients of ages between 4 and 7 years old will be randomly assigned to the experimental group (XHJJ granules, 4.5 g administered 3 times daily) or control group (matched placebo, 4.5 g administered 3 times daily) in a 2:1 ratio based on subject number per group, respectively. The trial will consist of a 7-day medical interventional stage and a 7-day follow-up stage. On day 7 of the follow-up stage, an evaluation of all subjects will be carried out to assess cough symptom score as the primary outcome and several secondary outcomes, including TCM (traditional Chinese medicine) syndrome score, lung function, and dosage of salbutamol aerosol inhaler therapy. Safety assessments will also be evaluated during the trial.

DISCUSSION: The aim of this study was to examine the effectiveness and safety of Xiehuangjiejing (XHJJ) granule using a trial protocol designed to yield high-quality, statistically robust results for use in evaluating CHM as a treatment for CVA in children.

PMID:36401471 | DOI:10.1097/MD.0000000000031636