Nevin Manimala

Clin Rheumatol. 2023 Dec 5. doi: 10.1007/s10067-023-06830-2. Online ahead of print.

ABSTRACT

OBJECTIVE: To conduct a comparative study of high-frequency ultrasound and magnetic resonance imaging (MRI) combined with serum RANKL and OPG detection, and assess the efficacy of high-frequency ultrasound with RANKL and OPG detection in screening early rheumatoid arthritis (RA).

METHOD: High-frequency ultrasound and MRI were performed on both carpal joints of 60 patients with early RA, and the frequencies of synovitis, joint effusion, tenosynovitis, and bone erosion detected by high-frequency ultrasound and MRI were observed. The serum levels of receptor activator for nuclear factor-κB ligand (RANKL) and osteoclastogenesis inhibitory factor (OPG) were also detected. The serum levels of RANKL and OPG were also detected in 80 normal healthy examinees. The data were recorded and statistically analyzed.

RESULTS: The detection rates of carpal synovitis, joint effusion, tenosynovitis, and bone erosion in RA patients by high-frequency ultrasound were 81.66%, 69.16%, 63.33%, and 1.66%, respectively, while the detection rates by MRI were 80.00%, 71.66%, 65.00%, and 15.00%, respectively. There was no significant difference between high-frequency ultrasound and MRI in the detection rates of carpal synovitis, joint effusion, and tenosynovitis in RA patients (P > 0.05), while the detection rate of bone erosion by high-frequency ultrasound was significantly lower than that by MRI. The serum levels of RANKL and OPG in RA patients were 231.47 and 68.71, respectively, while the serum levels of RANKL and OPG in normal healthy examinees were 123.51 and 385.05, respectively. The serum RANKL levels of RA patients were significantly higher than those of healthy examinees, while the serum OPG levels of RA patients were significantly lower than those of healthy examinees, which were statistically significant (P < 0.01). The AUC values of the ROC curves obtained by high-frequency ultrasound and MRI combined with serum RANKL and OPG detection in Synovitis modeling were 0.955 and 0.954, respectively. The AUC values of the ROC curves obtained from the joint fusion modeling using high-frequency ultrasound and MRI combined with serum RANKL and OPG detection were 0.949 and 0.950, respectively. The AUC values of the ROC curves obtained from modeling Tenosynovitis using high-frequency ultrasound and MRI combined with serum RANKL and OPG detection were 0.941 and 0.949, respectively. The AUC values of ROC curves obtained by combining high-frequency ultrasound and MRI with serum RANKL and OPG detection in Bone erosion modeling were 0.908 and 0.923, respectively.

CONCLUSION: High-frequency ultrasound combined with serum RANKL and OPG detection has comparable effects to MRI on screening early RA, providing a safe, simple, and cost-effective screening method for the early detection of RA patients. Key Points • High-frequency ultrasound and MRI can effectively detect early lesions of the wrist joints in RA patients. • Ultrasound diagnosis has the advantages of being quick, inexpensive, and repeatable, making it the preferred choice of imaging examination for RA patients at an early stage.

PMID:38051416 | DOI:10.1007/s10067-023-06830-2

Int Orthop. 2023 Dec 5. doi: 10.1007/s00264-023-06053-9. Online ahead of print.

ABSTRACT

PURPOSE: Total Hip Arthroplasty (THA) is one of the most commonly performed orthopaedic surgeries, with hip arthritis being the main indication. This procedure is usually performed when other non-surgical methods fail to relieve patients’ hip pain and improve their quality of life. However, limited information exists to identify and compare the demographics and clinical characteristics of patients undergoing this procedure in Jordan. This study aims to identify these demographic and clinical characteristics and compare the findings in terms of gender differences.

METHODOLOGY: This is a retrospective study that analysed the hospital records of 650 patients undergoing THA in tertiary referral hospital in Jordan over a four-year period from January 2019 to December 2022. The collected data were classified into three categories: demographic characteristics, perioperative variables, and patients’ related health profiles. IBM’s Statistical Package for the Social Sciences (SPSS) version 23 software (IBM, USA) and descriptive analysis were used for data analysis.

RESULTS: Two-thirds of the sample studied were female (63.4%). In terms of bleeding profiles, the mean intraoperative blood loss was 542 millilitres. The major indication for THA was degenerative hip arthritis (50.5%), followed by hip dysplasia (40.3%).. Comparing the findings of the two gender groups, females were more likely to have degenerative and dysplastic hip arthritis (221 and 157, p = 0.04 and p = 0.1, respectively) when compared to males. Although males were more likely to lose more blood during the surgery (557 ml vs. 533 ml, p = 0.33, females needed more blood transfusions both during (21 vs. 6 patients, p = 0.12) and after the surgery (57 vs. 16 patients, p = 0.006). Furthermore, females were more likely to have comorbidities such hypertension (293 vs. 179 patients, p = 0.20), and hypothyroidism (313 vs 187, p = 0.36), and diabetes (85 vs. 38 patients, p = 0.15), among many other health conditions. However, in the study sample, male smokers outnumbered female smokers (132 vs. 63).

CONCLUSION: Gender highly impacted the immediate surgical outcomes of patients who underwent THA. Females were more likely to need blood transfusions both during and after the surgery and had lower post-operative haemoglobin readings. In addition, females had more comorbidities and degenerative hip osteoarthritis. We believe that raising awareness about comorbidity management, preoperative smoking cessation, and perioperative blood transfusion management can improve medical and surgical outcomes.

PMID:38051384 | DOI:10.1007/s00264-023-06053-9

Public Health Nutr. 2023 Dec 5:1-28. doi: 10.1017/S1368980023002707. Online ahead of print.

ABSTRACT

OBJECTIVE: Assess whether the MedDiet is associated with lower micronutrients inadequacy in a sample of Spanish preschoolers.

DESIGN: We conducted a cross-sectional study with 4-5-year-old children participating in the SENDO project. Information was gathered through an online questionnaire completed by parents. Dietary information was collected with a previously validated semi-quantitative food frequency questionnaire. The estimated average requirements or adequate intake levels as proposed by the Institute of Medicine were used as cut-off point to define inadequate intake.

STATISTICAL ANALYSES: Crude and multivariable adjusted estimates were calculated with generalized estimated equations to account for intra-cluster correlation between siblings.

PARTICIPANTS: We used baseline information of 1153 participants enrolled in the SENDO project between January 2015 and June 2022.

MAIN OUTCOMES MEASURES: Odds Ratio and 95% Confidence Interval of presenting an inadequate intake of ≥3 micronutrients associated to the MedDiet.

RESULTS: The adjusted proportion of children with inadequate intake of ≥3 micronutrients were 27.2%, 13.5% and 8.1% in the categories of low, medium and high adherence to the MedDiet respectively. After adjusting for all potential confounders, children who had a low adherence to the MedDiet showed a significant lower odds of inadequate intake of ≥3 micronutrients compared to those with a high adherence (OR 9.85; 95% CI 3.33-29.09).

CONCLUSION: Lower adherence to the MedDiet is associated with higher odds of nutritional inadequacy.

PMID:38050795 | DOI:10.1017/S1368980023002707

Dis Model Mech. 2023 Dec 5:dmm.050395. doi: 10.1242/dmm.050395. Online ahead of print.

ABSTRACT

Duchenne muscular dystrophy (DMD), caused by mutations in the dystrophin gene, is associated with fatal muscle degeneration and atrophy. Patients have progressive reductions in skeletal muscle strength and resistance to eccentric muscle stretch. We assessed tibiotarsal joint (TTJ) flexor and extensor force dynamics, and resistance of dystrophic muscle to eccentric stretch in the DE50-MD dog model of DMD. Male DE50-MD and WT dogs were analysed every 3 months until 18 months of age. There was an age-associated decline in eccentric contraction resistance in DE50-MD TTJ flexors that discriminated, with high statistical power, WT from DE50-MD individuals. For isometric contraction, at the majority of timepoints DE50-MD dogs had lower maximum absolute and relative TTJ flexor force, reduced TTJ muscle contraction times and prolonged relaxation compared to WT dogs. Cranial tibial muscles, the primary TTJ flexor, of 18-month-old DE50-MD dogs had significant numbers of regenerating fibres as expected, but also fewer type I fibres and more hybrid fibres than WT dogs. We conclude that these parameters, in particular the eccentric contraction decrement, could be used as objective outcome measures for pre-clinical assessment in DE50-MD dogs.

PMID:38050706 | DOI:10.1242/dmm.050395

Rev Esp Salud Publica. 2023 Dec 15;97:e202312105.

ABSTRACT

OBJECTIVE: Mental health problems are increasing in Spain, and those related to drug use are a preventable aspect of public health. In Spain there are few studies on the incidence and characteristics of acute psychosis due to illegal drug use, especially at national and multicenter level, reason that motivated this paper.

METHODS: A prospective multicentre study was carried out in eleven hospital Emergency Departments in Spain, lasting twenty-four months (REDUrHE Registry). Patients with acute psychosis were compared with those with organic pathology, analysing demographic aspects, drugs involved, associated clinical manifestations and evolution Quantitative variables were compared using Student’s t-test and qualitative variables were compared using the chi-squared test (or Fisher’s exact test as appropriate) and the magnitude of the association with the presence of psychosis using logistic regression. A p-value of less than 0.05 was considered statistically significant or if the 95%CI of the OR excluded the value 1.

RESULTS: Of the 4,487 patients in the registry, 9.5% presented acute psychosis, with a median age of thirty-two years and 79% male. The main clinical features were agitation (53%, p=0.001), hallucinations (43.2%, p=0.001) and anxiety (40%, p=0.00). Psychosis was more frequent with cannabis (57.7%), cocaine (42%) and amphetamines and derivatives (26.4%), although in the analysis adjusted for co-drug use (39.5%), or in association with ethyl alcohol (57.7%), it was only statistically significant for cannabis (p=0.0). Patients with psychosis required more hospital admissions (38.1% vs. 10%, p=0.001), mainly in psychiatric units (34.1% vs. 4.2%, p=0.001), with hardly any intensive care unit admissions (0.4% vs. 2.1%, p=0.01). ED stay was high (29.3±73.8 hours vs 10.5±58.8 hours, p=0.001).

CONCLUSIONS: In Spain, cannabis is the drug most associated with psychosis. This clinical condition produces more hospital admissions, although with a low risk at an organic level.

PMID:38050699

Int Endod J. 2023 Dec 5. doi: 10.1111/iej.14006. Online ahead of print.

ABSTRACT

AIM: Guanylate-binding protein 5 (GBP5) is an interferon (IFN)-inducible GTPase that plays a crucial role in the cell-autonomous immune response against microbial infections. In this study, we investigated the immunoregulatory role of GBP5 in the pathogenesis of dental pulpitis.

METHODOLOGY: Gene-set enrichment analysis (GSEA) was utilized to evaluate the IFN-γ signalling pathway, and the differential expression of GBP mRNA in normal versus inflamed dental pulp tissues was screened, based on Gene Expression Omnibus (GEO) datasets associated with pulpitis. Both normal pulp tissues and inflamed pulp tissues were used for experiments. The expression of IFNs and GBPs was determined by qRT-PCR. Immunoblotting and double immunofluorescence were performed to examine the cellular localization of GBP5 in dental pulp tissues. For the functional studies, IFN-γ priming or lentivirus vector-delivered shRNA was used to, respectively, overexpress or knock down endogenous GBP5 expression in human dental pulp stem cells (HDPSCs). Subsequently, LPS was used to stimulate HDPSCs (overexpressing or with knocked-down GBP5) to establish an in vitro model of inflammation. qRT-PCR and ELISA were employed to examine the expression of proinflammatory cytokines (IL-6, IL-8 and IL-1β) and cyclooxygenase 2 (COX2). Every experiment has three times of biological replicates and three technical replicates, respectively. Statistical analysis was performed using the Student’s t-test and one-way ANOVA, and a p-value of <.05 was considered statistically significant.

RESULTS: GSEA analysis based on the GEO dataset revealed a significant activation of the IFN-γ signalling pathway in the human pulpitis group. Among the human GBPs evaluated, GBP5 was selectively upregulated in inflamed dental pulp tissues and predominantly expressed in dental pulp cells. In vitro experiments demonstrated that IFN-γ robustly induced the expression of GBP5 in HDPSCs. Knockdown of GBP5 expression in HDPSCs significantly amplified the LPS-induced upregulation of inflammatory mediators (IL-6, IL-8, IL-1β and COX2) both with and without IFN-γ priming.

CONCLUSION: Our findings demonstrated that GBP5 partook in the pathogenesis of dental pulpitis. The involvement of GBP5 in pulpitis appeared to coordinate the regulation of inflammatory cytokines. Knockdown of GBP5 contributed to the exacerbation of LPS-mediated inflammation.

PMID:38050666 | DOI:10.1111/iej.14006

Int Wound J. 2023 Dec 5. doi: 10.1111/iwj.14519. Online ahead of print.

ABSTRACT

Ankle Brachial Pressure Index (ABPI) measurement has long been considered the gold standard of vascular assessment for people with lower limb ulceration. Despite this, only around 15% of patients in the United Kingdom who require an ABPI measurement undergo the assessment. The Lanarkshire Oximetry Index (LOI) is a cheaper and arguably more accessible approach to vascular assessment and was initially proposed as an alternative to the ABPI in 2000. No synthesis of evidence related to the LOI has been performed since its introduction into the literature. Primary studies were sought to determine the clinimetric properties of the LOI and its level of agreement with ABPI assessments. Systematic searches of MEDLINE, CINAHL, Cochrane Central Register of Controlled Trials, BNI, ProQuest Health and Medicine, Science Direct, Google Scholar and the British Library (online search) were conducted. Reference lists of identified studies were also reviewed to identify additional studies. Three primary studies met the inclusion criteria, reporting data from 307 patients and 584 limbs assessed using both the LOI and ABPI. All three studies reported fair to moderate kappa values for interrater reliability (κ = 0.290-0.747) and statistically significant positive correlation coefficients (r = 0.37, p < 0.001 in two studies) between the LOI and ABPI. The combined data from the three studies indicated a sensitivity of 52% (41.78-62.1, 95% confidence interval [CI]) and specificity of 96.08% (93.4-97.9, 95% CI) for the LOI using the ABPI as a reference. Additional data are required to indicate the safety of the LOI in practice. Data are also required to determine if the LOI is more acceptable to clinicians compared to the ABPI and whether there are any barriers/enablers to its implementation in practice. Given the relatively low specificity of the LOI, it may be beneficial to combine measurement of the LOI with a subjective clinical risk assessment tool to improve the sensitivity of this alternative approach to vascular assessment.

PMID:38050665 | DOI:10.1111/iwj.14519

Int Wound J. 2023 Dec 5. doi: 10.1111/iwj.14523. Online ahead of print.

ABSTRACT

In a meta-study, we evaluated the effectiveness and security of the combination of topical anaesthetic and dexmedetomidine in the treatment of postoperative pain in patients with lumbar disease. Four databases were systematically searched for possible related articles. Only English-language research was taken into account on the Internet. Furthermore, we only took into account the studies that were published prior to 2023. Only those that fulfilled the eligibility criteria were considered: (1) in adults who were about to undergo spine operation, (2) dexmedetomidine combined with local anaesthesia, (3) Visual Analog Scale scores at 4 and 24 h after the event and (4) this was a randomized or nonrandomized, controlled study. The meta-analysis was carried out with Revman 5.3 software. A ROBINS-I-based instrument was used to evaluate controlled studies. All trials were synthesized by computing the end results with either a fixed or a random effect model, which was dependent on statistical diversity. Five trials showed a marked reduction in wound pain at 4 h after the operation in patients who were treated with dexmedetomidine for lumbar spinal surgery (MD, -0.81; 95% CI, -1.24, -0.35; p = 0.0005). In the case of lumbar spinal operations, the addition of dexmedetomidine to the postoperative treatment resulted in a marked reduction in the pain at 24 h post-operation (MD, -0.64; 95% CI, -0.79, -0.48; p < 0.0001). The quality of the data we evaluated was ‘moderate’ to ‘good’; thus, we have limited confidence in the impact estimation, and the actual impact might be significantly different from what we had expected. Additional studies should concentrate on practices that are well known to cause severe postoperative pain, especially for cases where the improvement of pain management may lead to substantial clinical benefits in terms of reduction of morbidity or cost-effectiveness in terms of quicker healing and release.

PMID:38050653 | DOI:10.1111/iwj.14523

J Aquat Anim Health. 2023 Dec 4. doi: 10.1002/aah.10212. Online ahead of print.

ABSTRACT

Feed additives have attracted increased attention in aquaculture due to their ability to modulate fish gut microbiota, resulting in improved fish growth and immunity. This study assessed two synbiotics’ effects in Japanese eels: Bacillus subtilis with mannooligosaccharide (MOS) and Enterococcus faecium with fructooligosaccharide (FOS). Six diets, including a control (CON), oxytetracycline (OTC), and four synbiotic diets – B.subtilis at 1 × 10⁶ and 10⁷ CFU/g with 5 g/kg MOS (BS6MO and BS7MO) and E. faecium at 1 × 10⁶ and 10⁷ CFU/g with 5 g/kg FOS (EF6FO and EF7FO) – were fed to triplicate groups of 20 fish averaging 6.00 ± 0.07g for eight weeks. Fish fed the BSMOS diets showed significantly higher weight gain (WG), specific growth rate (SGR), and feed efficiency (FE) compared to the CON and OTC diets (P < 0.05), but not significantly different from those fed the EFFOS diets. Weight gain, SGR of fish fed EFFOS were not significantly different from those fed all other diets (P > 0.05). Fish fed the OTC diet showed a higher mean aspartate aminotransferase (AST) level, though the difference was not statistically significant. The myeloperoxidase (MPO) activity of fish fed the BS7MO diet was significantly higher than in all other diets, and the superoxide dismutase (SOD) activity of fish fed the BS7MO diet was also significantly higher than in the EF7FO diet. Overall, the BSMOS synbiotic diets were significantly more effective than the CON diet in enhancing fish survival against Vibrio anguillarum. Our findings suggest that synbiotics can be a preferable alternative to antibiotics in aquaculture.

PMID:38050651 | DOI:10.1002/aah.10212

J Cosmet Dermatol. 2023 Dec 4. doi: 10.1111/jocd.16084. Online ahead of print.

ABSTRACT

BACKGROUND: Hair serum is recommended therapy for the management of hair fall problems. People of all ages suffer from hair fall.

AIM: To evaluate safety and efficacy of hair growth promoting product in healthy adult subjects with hair fall complaints (Alopecia).

METHODS: In this safety and efficacy clinical study, 32 healthy individuals (aged 18-45 years) experiencing hair loss were enrolled. Participants applied 0.5 mL of the product to the affected scalp area daily for 60 days. The study evaluated various factors, including hair growth rate, thickness, density, scalp condition using CASLite-Nova, anagen-to-telogen ratio, hair fall reduction, overall hair and scalp appearance, hair strength, and participants’ subjective perceptions of the product.

RESULTS: Highly statistically significant improvement was observed in hair growth rate, thickness, and density at Day 30 and Day 60. Hair growth rate increased (p-value <0.01) by 10.52% in 30 days and 31.62% in 60 days after test product application. Average hair growth increased by 424.21 μm/day and 487.31 μm/day at Day 30 and 60 respectively. The hair growth improved by up to 1.5 times after 60 days of usage in healthy subjects with hair fall complaints. No adverse events or product-related adverse events were reported.

CONCLUSION: Hair serum containing Redensyl, AnaGain, Procapil, Capilia longa, and 5 kDa hyaluronic acid was efficacious and well tolerable in reducing hair fall (Alopecia). Hair serum significantly improved hair growth, hair density, hair thickness, and hair strength within 60 days of usage, thereby demonstrating it worth as a beneficial inclusion as a daily haircare product.

PMID:38050644 | DOI:10.1111/jocd.16084