Nevin Manimala

Brain Behav. 2022 Aug 26:e2719. doi: 10.1002/brb3.2719. Online ahead of print.

ABSTRACT

BACKGROUND: The aim of this study was to determine the prevalence of fatigue and cognitive impairment in patients with neuroborreliosis (NB) posttreatment and to determine whether delayed treatment initiation led to higher levels of fatigue and cognitive impairment.

METHODS: The study population consisted of 88 patients with NB included between October 10, 2014, and August 21, 2020, at the Clinical Center for Emerging and Vector-borne Infections at Odense University Hospital, Denmark. The Symbol Digit Modalities Test (SDMT) was used as a cognitive screening test, and the Modified Fatigue Impact Scale (MFIS) was used to assess the patients’ level of fatigue over the course of a year.

RESULTS: Overall, 14.3% of patients had an SDMT score indicative of cognitive impairment, and 38.8% of patients reported experiencing fatigue 12 months posttreatment. We found no statistically significant differences in fatigue or cognitive impairment when comparing the patients who had a treatment delay of ≤14 days and those with a treatment delay of >14 days (p > .05) 12 months posttreatment. A random effects regression model showed a significant positive correlation between longer treatment delay and higher MFIS scores, indicating higher levels of fatigue.

CONCLUSIONS: The results of this study show that both the early and late treatment groups improved significantly over a 12-month period in terms of both cognitive symptoms and fatigue. However, it also showed that a substantial subgroup of patients with NB still suffer from fatigue and cognitive impairment 12 months posttreatment.

PMID:36017773 | DOI:10.1002/brb3.2719

Orthop Surg. 2022 Aug 26. doi: 10.1111/os.13417. Online ahead of print.

ABSTRACT

OBJECTIVE: To explore the mortality of patients with fragile hip fractures and assess the death-associated risk factors.

METHODS: A total of 690 patients with osteoporotic hip fractures (age, 50-103 years) that were treated from January 2010 to December 2015 were enrolled and followed-up in this study and the clinical data were retrospectively collected. Three months, 1 year, and the total mortality were measured. Mortality-related risk factors were assessed including age, gender, surgery, the duration from injury to operation, pulmonary infection, and the number and type of complications. The mortality of each group was compared by chi-square test or corrected chi-square test for univariate analysis, and the factors with statistically significant mortality difference confirmed by univariate analysis were analyzed by binary logistic multivariate analysis.

RESULTS: The 3-month mortality was 7.69%, the 1-year mortality was 15.60%, and the total mortality of the follow-up time was 24.06%. The 1-year and total mortality during the follow-up of the patients were higher in the >75-year-old group than those in the ≤75-year-old group (p = 0.000, respectively); were higher in the male patients than that in the female patients (p = 0.042; p = 0.017, respectively); were significantly lower in the operation group than that in the non-operation group (p = 0.000, respectively); were significantly lower in the patients that underwent the operation in ≤5 days than the patients that underwent the operation within >5 days (p = 0.008; p = 0.000, respectively); were significantly lower in patients with >2 kinds of combined medical diseases than those with ≥2 kinds of chronic diseases (p = 0.000, respectively); were significantly lower in patients receiving anti-osteoporosis treatment than in patients not receiving anti-osteoporosis treatment (p = 0.000, p = 0.002, respectively). Binary logistic regression analysis showed that the independent risk factors affecting mortality included advanced age >75-years-old (OR = 5.653, p = 0.000), male (OR = 1.998, p = 0.001), non-surgical treatment (OR = 9.909, p = 0.000), the number of combined medical diseases ≥2 (OR = 1.522, p = 0.042), and non-anti-osteoporosis treatment (OR = 1.796, p = 0.002).

CONCLUSION: Age, whether or not surgical treatment was performed, the number of medical diseases, and whether or not anti-osteoporosis treatment was performed were independent risk factors for 3-month and 1-year mortality in patients with fragile hip fractures.

PMID:36017769 | DOI:10.1111/os.13417

Orthop Surg. 2022 Aug 26. doi: 10.1111/os.13471. Online ahead of print.

ABSTRACT

OBJECTIVE: Reconstruction of acetabular defects has been extremely challenging in both primary and revision total hip arthroplasty (THA). Impaction bone grafting (IBG) can restore the acetabulum bone mass and anatomically reconstruct the acetabulum. Our study aimed to report the short and medium-term clinical and radiographic outcomes of IBG for acetabular reconstruction in the cemented THA in the Chinese population.

METHODS: This was a single-center retrospective review enrolling 57 patients between May 2013 and July 2019. The patients with acetabular defects were treated with IBG, using low dose irradiated freeze-dried allograft bone with or without autograft bone, in the cemented THA performed by one senior surgeon. Harris hip score (HHS), standard pelvis anterior-posterior radiograph and lateral hip radiograph were obtained before operation and at 1 week, 3 months, 12 months, and yearly. Graft osteointegration was evaluated by Oswestry’s criteria, and complication was documented at the last follow-up. Independent sample ANOVA test and Pearson chi-square tests are used for statistical analysis.

RESULTS: There were 61 hips in 57 patients. The average follow-up time was 35.59 months (5-77 months). According to AAOS classification, a total of 18 hips were identified as segmental bone deficiency (type I), with 21 and 22 hips for cavitary bone deficiency (type II) and the combined bone deficiency (type III), respectively. The average HHS was improved from 44.49 (range: 32-58) preoperatively to 86.98 (range: 78-93) postoperatively. Graft osteointegration was satisfactory (Oswestry score ≥2) in all patients. No dislocation occurred in the 57 patients (61 hips) during follow-up. Although one cup migrated, no revision, re-revision, radiographic loosening, graft bone lysis, or postoperative complications were detected at the final follow-up.

CONCLUSIONS: IBG with low-dose irradiated freeze-dried allograft bone in acetabular bone defect reconstruction is a reliable technique for restoring acetabular bone defects in THA.

PMID:36017764 | DOI:10.1111/os.13471

Clin Exp Dent Res. 2022 Aug 26. doi: 10.1002/cre2.642. Online ahead of print.

ABSTRACT

OBJECTIVE: Operating time is one of the main advantages attributed from the literature to the use of self-ligating brackets (SLB). The aim of this study is to investigate the time needed for a complete archwire change procedure with conventional brackets (CB) and SLBs in a standardized in vitro research setting, comparing operators with different expertise.

MATERIALS AND METHODS: Thirty-three participants were divided into three equal groups: undergraduate students, postgraduate students, and orthodontists. Three sets of typodonts bonded with three types of brackets, including passive SLBs, active SLBs, and CBs using both steel and elastic ligatures were investigated. Operators had to insert, ligate, deligate, and remove wires in sets of typodonts representing an actual dentition before and after orthodontic treatment, mounted in phantoms. Archwire change procedure times were compared between the different bracket/ligation systems, between the before- and after-treatment typodonts, and between operators.

RESULTS: There were significant differences between SLBs and CBs, the greatest difference being 11 min 16 s between passive SLBs and CBs ligated with metallic ligatures at T0, for the total archwire change procedure by the operators overall. For all the operators, there was a statistically significant difference in total archwire change procedure time between the systems. The undergraduate students were the slowest when using CBs, but they showed no significant difference compared to the other users when using SLBs.

CONCLUSION: SLBs can offer a significant operating time reduction compared to CBs, and time saving is not dependent on the operator’s experience and training.

PMID:36017763 | DOI:10.1002/cre2.642

Reprod Domest Anim. 2022 Aug 26. doi: 10.1111/rda.14238. Online ahead of print.

ABSTRACT

The study aimed to validate the double versus single freezing protocol for Beetal buck (Capra hircus) spermatozoa in tris-citric acid (TCA) based extender both in terms of quality and fertilization potential. Computer-assisted sperm motion and kinematic (CASA) variables i.e., total (%), and progressive motilities (TM and PM, %), and rapid velocity (RV, %), average path (VAP, μm/s), straight line (VSL, μm/s), and curved line velocities (VCL, μm/s), straightness, (VSL/VAP, %), and linearity, (VSL/VCL, %) as well as supra-vital plasma membrane integrity (SV-PMI, %), mitochondrial membrane potential (MMP, %), viable / intact acrosome (V-IACR, %) and DNA integrity (DNA-I, %) had significantly greater values (P<0.05) during single freeze-thawing as compared to the double freeze-thawing at 0, 30, 90, 150 and 210 days, respectively. All CASA and other assays alone did not show significant differences (P>0.05) between both freeze-thaw cycles at all treatment durations, respectively. No statistical significance (P>0.05) was observed for the in vivo fertility between single (n = 84/141 = 59.72%) and double freeze-thawing (n =72/136 = 52.90%) cycles, respectively. In conclusion, sperm motion, kinematics, plasma membrane, acrosome, mitochondria and DNA integrities and in vivo fertility are acceptable after the double freezing protocol despite being lower than after one freeze cycle in Beetal buck (Capra hircus).

PMID:36017761 | DOI:10.1111/rda.14238

Chem Biodivers. 2022 Aug 26. doi: 10.1002/cbdv.202200361. Online ahead of print.

ABSTRACT

Background Curcumae Radix (CW) is traditionally used to treat dysmenorrhea caused by uterine spasm. However, the changes of its composition and anti-uterine spasms during vinegar processing and the mechanism in treating dysmenorrhea are not clear. Objective To elucidate the changes of anti-uterine spasm and its substance basis, and the mechanism of treating dysmenorrhea before and after vinegar processing. Methods The uterine spasm contraction model was established, and the uterine activity and its inhibition rate were calculated to evaluate the differences. The main chemical constituents of CW were quickly analyzed by UPLC-Q-TOF-MS/MS technology, and the differences between them were explored by multivariate statistical analysis. Then, the regulatory network of “active ingredients-core targets-signal pathways” related to dysmenorrhea was constructed by using network pharmacology, and the combination between differential active components and targets was verified by molecular docking. Results CW extract relaxed the isolated uterine by reducing the contractile tension, amplitude, and frequency. Compared with CW, the inhibitory effect of vinegar products was stronger, and the inhibition rate was 70.08%. 39 compounds were identified from CW and 13 differential components were screened out ( p <0.05). Network pharmacology screened 11 active components and 32 potential targets, involving 10 key pathways related to dysmenorrhea. The results of molecular docking showed that these differentially active components had good binding activity to target. Conclusion It was preliminarily revealed that CW could treat dysmenorrhea mainly through the regulation of inflammatory reaction, relaxing smooth muscle and endocrine by curcumenone, 13-hydroxygermacrone, (+)-cuparene, caryophyllene oxide, zederone, and isocurcumenol.

PMID:36017755 | DOI:10.1002/cbdv.202200361

J Cosmet Dermatol. 2022 Aug 26. doi: 10.1111/jocd.15332. Online ahead of print.

ABSTRACT

BACKGROUND: Primary cutaneous amyloidosis (PCA) and post-inflammatory hyperpigmentation (PIH) are common causes of cutaneous hyperpigmentation that are usually diagnosed clinically. However, their presentations are sometimes atypical, and their differentiation is difficult. Dermoscopy is a valuable diagnostic tool for pigmented diseases that might aid in their diagnosis.

OBJECTIVE: To describe the characteristic dermoscopic features of PCA and PIH together with histopathological correlation, and to differentiate between these conditions in a non-invasive way.

METHODS: Fifty-two patients with PCA (n=26) and PIH (n=26) were enrolled. A detailed history, skin examination, dermoscopic examination using handheld and video dermoscopy, and histopathological evaluation were performed.

RESULTS: A statistically significant difference could be detected between PCA and PIH in terms of the duration of the disease (p = 0.027), symmetry (p = 0.044), rippling (p <0.001) and back affection (p = 0.048). On dermoscopic examination, central hubs were seen more in the PCA group (p<0.001) with different patterns of peripheral pigmentation. Histopathologically, the number of melanophages per high-power field was significantly higher in the PCA group (p = 0.013).

CONCLUSION: The results of this study shed the light on the potential of dermoscopy as a non-invasive diagnostic tool in differentiating between doubtful cases of PCA and PIH.

PMID:36017750 | DOI:10.1111/jocd.15332

Liver Int. 2022 Aug 26. doi: 10.1111/liv.15413. Online ahead of print.

ABSTRACT

BACKGROUND AND AIM: There is limited data on natural course and interventions in stage-3 acute kidney injury (AKI-3) in patients with acute-on-chronic liver failure (ACLF). We studied the factors of AKI-3 reversal and outcomes on dialysis in ACLF patients.

METHODS: Consecutive patients with ACLF were prospectively enrolled (n=1022) and variables determining AKI and its outcomes were analyzed.

RESULTS: At one-month, 337(33%) patients had AKI-3, of which, 131 had AKI-3 at enrolment, 206 developed AKI-3 during hospital stay. Of patients with AKI-3 at enrolment, 18% showed terlipressin response, 21% had AKI resolution and 59% required dialysis. High MELD (≥35) (model 1), serum bilirubin (≥ 23 mg/dl) (model 2) and AARC score (≥11) (model 3) were independent risk factors for dialysis. Dialysis was associated with worse survival in all AKI patients but improved outcomes in patients with AKI-3 [p=0.022, HR 0.69(0.50-0.95). Post-mortem kidney biopsies (n= 61) revealed cholemic nephropathy (CN) in 54%, acute tubular necrosis (ATN) in 31%, and a combination (CN and ATN) in 15%. Serum bilirubin was significantly higher in patients with CN, CN and ATN compared with ATN respectively [(30.8 ± 12.2) vs. (26.7 ± 12.0) vs. (18.5 ± 9.8); p=0.002].

CONCLUSION: AKI-3 rapidly increases from 13% to 33% within 30 days in ACLF patients. Histopathological data suggested cholemic nephropathy as the predominant cause which correlated with high bilirubin levels. AKI-3 resolves in only one in five patients. Patients with AARC grade 3 and MELD >35 demand need for early dialysis in AKI-3 for improved outcomes.

PMID:36017749 | DOI:10.1111/liv.15413

Eur Heart J. 2022 Aug 26:ehac495. doi: 10.1093/eurheartj/ehac495. Online ahead of print.

ABSTRACT

BACKGROUND: Sodium glucose co-transporter 2 (SGLT2) inhibitors improve cardiovascular outcomes in diverse patient populations, but their mechanism of action requires further study.

AIMS: To explore the effect of empagliflozin on circulating levels of intracellular proteins in patients with heart failure, using large-scale proteomics.

METHODS: Over 1250 circulating proteins were measured at baseline, week 12 and week 52 in 1134 patients from EMPEROR-Reduced and EMPEROR-Preserved, using the Olink® Explore 1536 platform. Statistical and bioinformatical analyses identified differentially expressed proteins (empagliflozin vs placebo), which were then linked to demonstrated biological actions in the heart and kidneys.

RESULTS: At week 12, 32 of 1283 proteins fulfilled our threshold for being differentially expressed, i.e., their levels were changed by ≥10% with a false discovery rate < 1% (empagliflozin vs placebo). Among these, nine proteins demonstrated the largest treatment effect of empagliflozin: insulin-like growth factor-binding protein 1, transferrin receptor protein 1, carbonic anhydrase 2, erythropoietin, protein-glutamine gamma-glutamyltransferase 2, thymosin beta-10, U-type mitochondrial creatine kinase, insulin-like growth factor-binding protein 4, and adipocyte fatty acid-binding protein 4. The changes of the proteins from baseline to week 52 were generally concordant with the changes from baseline to week 12, except empagliflozin reduced levels of kidney injury molecule-1 by ≥10% at week 52, but not at week 12. The most common biological action of differentially-expressed proteins appeared to be the promotion of autophagic flux in the heart, kidney or endothelium, a feature of 6 proteins. Other effects of differentially-expressed proteins on the heart included the reduction of oxidative stress, inhibition of inflammation and fibrosis, and the enhancement of mitochondrial health and energy, repair and regenerative capacity. The actions of differentially expressed proteins in the kidney involved promotion of autophagy, integrity and regeneration, suppression of renal inflammation and fibrosis, and modulation of renal tubular sodium reabsorption.

CONCLUSIONS: Changes in circulating protein levels in patients with heart failure are consistent with the findings of experimental studies that have shown that the effects of SGLT2 inhibitors are likely related to actions on the heart and kidney to promote autophagic flux, nutrient deprivation signaling and transmembrane sodium transport.

PMID:36017745 | DOI:10.1093/eurheartj/ehac495

Swiss Dent J. 2022 Aug 26;132(10). Online ahead of print.

ABSTRACT

In this retrospective study, it was investigated whether the use of a fifth-generation rotary system (ProTaper Next) resulted in improved radiological root filling quality compared to a first-generation counterpart (ProFile) in a controlled student course setting. Cases treated by fourth-year dental students in the 2020/21 academic year were collected and compared to those treated in 2019/20. Root canals in the former group were all instrumented using the ProTaper Next system, and the latter using the ProFile system. All other clinical parameters were similar between the two academic years, including the time of pre-clinical teaching, hands-on course hours, endodontic auxiliaries, and chemicals used for treatment. After excluding patients who were not available or refused to give their informed consent to this study (n = 20), and excluding teeth with missing or poor radiographs (n = 16), the fillings in 178 roots could be assessed by two calibrated observers blinded to the system that was used. The primary outcome was the radiographic quality of the root fillings according to the five-scale modified MOLANDER score. The secondary outcome was the number of separated rotary instruments by group. Both instrumenting systems resulted in a similar number of “excellent” root fillings (score I), 59 % in the ProTaper Next group and 60% in the ProFile group, with no statistically significant difference in outcome scores between groups (Probability > ChiSquare = 0.70). Furthermore, there was merely one separated instrument in the ProTaper Next group, and none in the ProFile group (Fisher’s exact test, p = 1.00).

PMID:36017710