Nevin Manimala

J Matern Fetal Neonatal Med. 2022 Feb 20:1-8. doi: 10.1080/14767058.2022.2040475. Online ahead of print.

ABSTRACT

PURPOSE: Vitamin D deficiency is common during pregnancy and may cause complications such as preterm labor (PTL). This study was aimed to investigate the effect of the vitamin D-binding protein (VDBP) rs7041 genotype, which has a significant effect on vitamin D metabolism and PTL.

METHODS: This cross-sectional study was conducted with 32 pregnant women who had spontaneous PTL and 54 pregnant women who had no specific findings as a control group. Serum total vitamin D 25-hydroxy vitamin D (25(OH)D) levels were measured using the Elecsys Vitamin D Total Kit. VDBP was measured using a VDBP Quantikine ELISA Kit. The levels of bioavailable 25(OH)D were calculated based on the total 25(OH)D and VDBP concentrations. DNA was extracted using the DNeasy Blood and Tissue Kit. Single nucleotide polymorphisms (rs7041) in GC were analyzed using a TaqMan SNP Genotyping Assay Kit. The unpaired t-test, Chi-squared, and ANCOVA tests were performed. Firth’s penalized logistic regression was applied. The area under the curve (AUC) was calculated and the cutoff value was determined. All statistical analyses were performed using R version 4.0.3 (R Foundation for Statistical Computing, Vienna, Austria).

RESULTS: Total 25(OH)D levels were not significantly different between the two groups. Bioavailable 25(OH)D was significantly decreased in PTL women (p= .011), and VDBP was significantly increased in PTL women (p= .004) compared to the controls. Bioavailable 25(OH)D was lower in women with GT/TG and TT rs7041 genotypes than in those with GG, with statistical significance in women with the TT allele (p= .048). VDBP was higher in women with GT/TG and TT than those with GG, but there was no statistical significance. In PTL prevalence, bioavailable 25(OH)D and VDBP, the odds ratio increased by 1.463 times in GT/TG (p= .728) and increased by 1.675 times in TT compared to the GG allele (p= .640). In receiver operating characteristic (ROC) analysis for bioavailable 25(OH)D and VDBP, the AUC was 0.665 and 0685, respectively. The optimum cutoff of bioavailable 25(OH)D and VDBP levels for the diagnosis of PTL was calculated as 0.6 ng/mL and 523 µg/mL, respectively.

CONCLUSIONS: Pregnant women with the VDBP rs7041(c.1296 T > G) T allele genotype had reduced serum levels of bioavailable 25(OH)D and were more likely to develop PTL. Therefore, if the T allele is found in the VDBP rs7041 SNP genotyping test before or during pregnancy, more careful prenatal care may be required because of the increased risk of PTL.

PMID:35188037 | DOI:10.1080/14767058.2022.2040475

Nutr Cancer. 2022 Feb 21:1-14. doi: 10.1080/01635581.2021.2019284. Online ahead of print.

ABSTRACT

The aim of this systematic review and meta-analysis was to investigate the effects of resistant starch (RS) on inflammation and oxidative stress related indicators. PubMed, Embase and The Cochrane library were systematically searched to find randomized controlled trials (RCTs) of RS intervention up to February 2020. We used from the effect size, as estimated by the standardized mean difference (SMD) with 95% confidence intervals (95%CI) to perform the random method meta-analysis, with P value ≦0.05 as statistically significant. The 16 included trials with 17 effect sizes included a total of 739 participants in this paper. The intervention duration was from 2 weeks to 3 months. The analysis indicated that RS decreases the levels of tumor necrosis factor-α (TNF-α) (SMD = -0.711; 95%CI: -1.227, -0.194; P = 0.007) and interleukin 6 (IL-6) (SMD = -0.609; 95%CI: -0.924, -0.294; P < 0.001), increases total antioxidant capacity (TAC) (SMD = 2.543, 95% CI: 0.069: 5.017, P = 0.044). No significant effects on C-reactive protein (CRP) (SMD = -0.583; 95%CI: -1.270, 0.104; P = 0.096), superoxide dismutase (SOD) (SMD = 0.091; 95%CI: -0.156, 0.338; P = 0.471), and malondialdehyde (MDA) (SMD = -0.320; 95%CI: -0.907, 0.266; P = 0.285). Subgroup analysis shown that CRP level significant reduced in subjects from the east (SMD = -1.501; 95%CI: -2.662, -0.340; P = 0.011) or suffering from diseases (SMD: -1.057; 95%CI: -1.999, -0.115; P = 0.028).Supplemental data for this article is available online at https://doi.org/10.1080/01635581.2021.2019284.

PMID:35188032 | DOI:10.1080/01635581.2021.2019284

Urologia. 2022 Feb 21:3915603221078263. doi: 10.1177/03915603221078263. Online ahead of print.

ABSTRACT

PURPOSE: To investigate the prevalence of overactive bladder (OAB) in patients with obstructive sleep apnea syndrome (OSAS) and the factors affecting it.

MATERIALS AND METHODS: A total of 255 patients were included in this prospectively designed study. Among all patients, 166 were male, 89 were female; 213 patients were married and 42 were single. All patients underwent polysomnography. All patients completed the OAB-V8 form. OSAS was diagnosed via polysomnography. OAB was diagnosed via OABV8. The participants were evaluated as patients with and without OAB and those with and without OSAS. SPSS for Windows version 18.0 software was used for the statistical analysis and the level of significance was set at α = 0.05.

RESULTS: The prevalence of OAB was high among the OSAS patients (66.3%, n = 136). Age, body mass index, waist circumference, marital status, oxygen desaturation index (ODI4) ⩾4%, apneahypopnea index (AHI), the number and duration of decreases in O₂ saturation below 90%, wake after sleep onset (WASO) duration, and groups, and OSAS severity were different in the OAB group (p < 0.05). Duration and number of O₂ saturation <90%, and ODI4 are higher in the OSAS group and OAB group (p < 0.05). In multivariate logistic regression analysis, AHI, WASO, age, and marital status were the factors influencing OAB.

CONCLUSION: OAB is seen at a high rate in OSAS patients. Hypoxia is the main basis for both diseases and probably it is the common pathway. AHI, WASO, age, and marital status can provide valuable information to physicians for predicting OAB.

PMID:35188003 | DOI:10.1177/03915603221078263

Ear Nose Throat J. 2022 Feb 21:1455613221076786. doi: 10.1177/01455613221076786. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aims to explore the effects of laryngopharyngeal reflux disease (LPRD) and proton pump inhibitor (PPI) treatment on Eustachian tube function in patients with obstructive sleep apnea (OSA).

METHODS: The Eustachian tube score-7 (ETS-7) was observed before and after PPI treatment in the control group, OSA only group, and OSA + LPRD group.

RESULTS: Age, sex, smoking history, and drinking history showed no differences among 3 groups (P > .05). The body mass index (BMI) in the control group was lower than that in other groups (P < .017). Before PPI treatment, the abnormality rate of ETS-7 in the OSA + LPRD group statistically differed from that in the control group and the OSA only group (P < .017). After PPI treatment, the abnormality rate of ETS-7 in the OSA + LPRD group exhibited no significant differences compared with that in the control group and the OSA only group (P > .017), and it declined remarkably compared with that before PPI treatment (75% vs 35%, χ² = 13.334, P = .001). Moreover, the multivariate analysis revealed that only LPRD had an independent correlation with the abnormality of ETS-7 (OR = 1.245, 95% CI: 1.759-6.861, P = .000).

CONCLUSION: In view of its high incidence in OSA patients, LPRD may be a considerable factor for the high incidence of abnormality rate of ETS-7 in OSA patients, and PPI therapy is of significant value in improving Eustachian tube function in OSA patients with LPRD.

PMID:35187968 | DOI:10.1177/01455613221076786

Eur J Ophthalmol. 2022 Feb 21:11206721221080818. doi: 10.1177/11206721221080818. Online ahead of print.

ABSTRACT

BACKGROUND: To assess the benefit of macular spectral-domain optical coherence tomography (SD-OCT) as a part of the routinary preoperative study of patients undergoing cataract surgery.

METHODS: A prospective single-center study study was performed. Consecutive patients with normal biomicroscopic funduscopy, moderate cataract and no history of ophthalmological pathologies were enrolled. All patients underwent macular SD-OCT. The obtained images were analysed by a general ophthalmologist and two retina specialists. Incidence of macular pathology and its relation to age and comorbidities were assessed.

RESULTS: Eight-hundred and thirty-six eyes of 419 patients were enrolled in this study. All images were analysed telematically by a general ophthalmologist. Forty-nine eyes were excluded due to insufficient quality of the obtained images. Abnormal images were observed in 156 eyes (18.6%), including age-related macular degeneration in 68 (8.2%), epiretinal membrane (ERM) in 67 (8.0%), cystoid macular edema in 3 eyes (0.4%), among others. Diagnostics with severe impact on patient visual prognosis were observed in 16 eyes (3.82%) from 12 patients. The relationship between incidence of macular pathologies and age or comorbidities was not statistically significant. To assess accuracy of the first observer, images were subsequently analysed by two retinologists. The kappa index of concordance was 0.80 and 0.85.

CONCLUSIONS: Implementing a systematic macular SD-OCT as a preoperative test prior to cataract surgery would improve quality of postoperative visual prognosis information. A general ophthalmologist would be suitable to screen for pathology through macular OCT images.

PMID:35187961 | DOI:10.1177/11206721221080818

Orthop J Sports Med. 2022 Feb 14;10(2):23259671221076877. doi: 10.1177/23259671221076877. eCollection 2022 Feb.

ABSTRACT

BACKGROUND: When performing a medial patellofemoral ligament (MPFL) reconstruction, surgeons may place the MPFL graft under higher than anatomic tension to minimize the chance of recurrent instability.

PURPOSE: To investigate whether a lateral retinacular release (LRR) significantly decreases patellofemoral contact pressures after an overtensioned (OT) MPFL reconstruction.

STUDY DESIGN: Controlled laboratory study.

METHODS: Mean and peak pressure across the patellofemoral joint at 30°, 45°, and 60° of flexion was assessed in 14 cadaveric knee specimens with intact MPFL, transected MPFL, reconstructed MPFL with graft OT, and OT MPFL with LRR. The Wilcoxon signed rank test was used to determine differences across states, with W and C values calculated when possible.

RESULTS: Mean pressure decreased significantly after MPFL transection compared with intact at 30° (456.9 ± 116.8 vs 410.9 ± 109.4 N, P = .006, W < 7) and 45° (404.9 ± 91.7 vs 369.4 ± 85.3 N, P = .005, W < 5) and increased significantly from intact to OT graft at 30° (456.9 ± 116.8 vs 563.0 ± 11.2 N, P = .003, W < 7), 45° (404.9 ± 91.7 vs 481.4 ± 14.8 N, P = .005, W < 5), and 60° (272.9 ± 139.0 vs 367.0 ± 53.7 N, P = .007, W < 3). Peak pressure increased significantly between intact and OT graft at 30° (1364.0 ± 478.2 vs 2094.4 ± 619.8 N, P = .002, W < 9), 45° (1224.7 ± 491.5 vs 1676.7 ± 779.1 N, P = .005, W < 5), and 60° (1117.7 ± 566.8 vs 1604.2 ± 772.9 N, W < 3). In knees with significantly increased mean pressure after overtensioning, mean pressure increased by 23.3% (11/14 knees) at 30°, 18.3% (10/14 knees) at 45°, and 35.0% (10/14 knees) at 60°. Peak pressure increased significantly by 35.3% (30°), 25.2% (45°), and 29.3% (60°). A significant decrease in mean pressure, toward but not to baseline, was observed between the OT and LRR states at 30° (563.0 ± 11.2 vs 501.5 ± 9.3 N, W < 7) and 60° (367.0 ± 53.7 vs 302.0 ± 13.8 N, W < 5) and a decrease in peak pressure at 30° (2094.4 ± 619.8 vs 1886.5 ± 655.3 N; W < 9).

CONCLUSION: LRR led to a statistically significant decrease in pressure across the patellofemoral joint in knees that demonstrated increased contact pressures after an OT MPFL graft.

CLINICAL RELEVANCE: LRR after an MPFL reconstruction in which the MPFL graft has been OT may help reduce patellofemoral contact pressures at the time of surgery.

PMID:35187185 | PMC:PMC8848066 | DOI:10.1177/23259671221076877

Orthop J Sports Med. 2022 Feb 14;10(2):23259671211062225. doi: 10.1177/23259671211062225. eCollection 2022 Feb.

ABSTRACT

BACKGROUND: Equipment used to guide surgical incisions has been shown to be a source of bacterial contamination during surgery.

PURPOSE/HYPOTHESIS: To compare the culture-positive rates of sterile marking pens used before and after skin preparation for shoulder surgery. It was hypothesized that there will be no difference in culture-positive rates from marking pens used after skin preparation compared with before skin preparation.

STUDY DESIGN: Controlled laboratory study.

METHODS: Overall, 43 consecutive patients undergoing elective shoulder surgery were enrolled prospectively into this study. Each patient provided 2 samples: study pens (from marking the surgical site incision after skin preparation) and positive control pens (from marking the surgical site incision before skin preparation). In addition, there were 43 negative control pens evaluated (straight from the packaging without any patient contact). Cultures were evaluated at 4 and 21 days, and all positive cultures were further evaluated for speciation, if able. Standard descriptive summaries and Fisher exact tests were used to compare the study samples.

RESULTS: The average age of the 43 patients was 54 years (range, 18-76 years). There were 29 (67%) female patients, and 30 (70%) procedures were on the right shoulder. Of the 43 procedures performed, 29 (67.4%) were arthroscopic, 12 (27.9%) were open, and 2 (4.7%) were closed. Of the 43 study pens, 1 culture was positive for Propionibacterium acnes (2.3%). Of the 43 positive control pens, 2 cultures were positive for bacterial growth (4.7%): P. acnes and Gram-positive bacilli (no speciation could be obtained). Of the 43 negative control pens, none of the cultures were positive for bacterial growth (0%). There was no statistical difference in the culture-positive rate between the study pens and the positive or negative control pens (P ≥ .999).

CONCLUSION: Study results indicated that sterile surgical marking pens used to plan incisions and to outline anatomic landmarks did not have a higher culture-positive rate compared with pens used on unprepared skin or pens straight from the packaging.

CLINICAL RELEVANCE: As a precaution, sterile surgical marking pens should be discarded after use on the skin surface and not placed on the sterile field.

PMID:35187182 | PMC:PMC8848060 | DOI:10.1177/23259671211062225

Biomed Res Int. 2022 Feb 9;2022:4946848. doi: 10.1155/2022/4946848. eCollection 2022.

ABSTRACT

BACKGROUND: Many complications occur after surgery in patients with spinal tuberculosis (STB); however, the severity varies in different patients. The complications’ severity is evaluated from grades I to V by the Clavien-Dindo classification (CDC), and grade V is the most severe. Most complications are mild, and only severe complications are life threatening, and thus, it is important to identify severe complications in patients with STB. The purpose of this study was to identify the risk factors of postoperative complication severity in patients with STB.

METHODS: Between January 2012 and May 2021, a retrospective study included 188 patients that underwent STB debridement surgery. The patients were divided into three groups based on postoperative complication severity. Clinical characteristics measured included age, sex, body mass index (BMI), comorbidities of diabetes mellitus and pulmonary tuberculosis, alcohol use and smoking history, course of disease, preoperative hemoglobin, preoperative serum albumin, preoperative lymphocytes, preoperative erythrocyte sedimentation rate (ESR), preoperative C-reactive protein (CRP), surgical approach, operating time, blood loss during surgery, postoperative hemoglobin, and postoperative serum albumin. The clinical characteristics of patients with STB who developed postoperative complications were evaluated using logistic regression analysis.

RESULTS: 188 patients suffered at least one postoperative complication; 77, 91, and 20 patients experienced grade I, II, and III-IV complications, respectively. In the univariate analysis, sex, diabetes mellitus, postoperative hemoglobin, and postoperative albumin are statistically significant. In the multivariable analysis, postoperative albumin (adjusted odds ratio (OR) = 0.861, P < 0.001) was an independent risk factor of the postoperative complication severity in patients with STB. Receiver operating characteristic (ROC) analysis showed that the optimal cutoff values for postoperative albumin were 32 g/L (sensitivity: 0.571, specificity: 0.714, area under the ROC curve: 0.680) and 30 g/L (sensitivity: 0.649, specificity: 0.800, area under the ROC curve: 0.697) for grade II and grade III-IV complications, respectively.

CONCLUSIONS: Postoperative albumin is an independent risk factor for postoperative complication severity in patients with STB. The improvement of postoperative albumin levels may reduce the risk of severe complications in patients with STB.

PMID:35187165 | PMC:PMC8850042 | DOI:10.1155/2022/4946848

Biomed Res Int. 2022 Feb 10;2022:2204745. doi: 10.1155/2022/2204745. eCollection 2022.

ABSTRACT

INTRODUCTION: The concept of selective neck dissection (SND) in locally advanced oral cancers is emerging. Contemporary studies support the feasibility of SND in selected node-positive oral cancers with early primaries. Nevertheless, the suitability of SND in clinically node-positive (cN+) oral cancers with advanced primaries (T3/T4) is unknown.

AIM: This study explores if patients with cN+ advanced primaries were suitable candidates for SND by spotting the involved lymph node distribution in various stations of the neck. Secondary objectives were to check if predictive clinicopathological factors for metastases to the neck in general also apply for lymph node metastases to levels IV and V.

METHODS: The present retrospective study analysed the distribution of pathologically involved lymph nodes in 134 patients and explored the interrelation of various predictive factors and cervical metastases overall and those specific to levels IV and V.

RESULTS: Level V was involved in 6.7% (6/83) of T4 and none of the T3 primaries. Depth of invasion (DOI), perineural invasion (PNI), and skin invasion were statistically significant predictors for nodal metastases in general on multivariate analysis.

CONCLUSION: Our analysis supports the option of considering SND, sparing level V in patients with cN+ oral cancers in a subset with T3 primary and nodal stage N2 and below.

PMID:35187160 | PMC:PMC8853780 | DOI:10.1155/2022/2204745

Biomed Res Int. 2022 Feb 9;2022:1703869. doi: 10.1155/2022/1703869. eCollection 2022.

ABSTRACT

PURPOSE: To determine the hardness and Young’s moduli of both commercial and experimental vinyl poly siloxane (VPS).

METHODS: The purpose of this study was to develop a medium-bodied experimental (Exp-I, II, III, IV, and V) VPS impression materials and to analyse their effects on hardness and Young’s modulus and compare them with three commercial VPS materials (Aquasil, Elite, and Extrude) using Shore A hardness tester. Measurements were recorded after 1, 24, 72, and 168 hours of mixing. The results were analysed with one-way ANOVA and post hoc Tukey’s test using the SPSS PASW statistical 22 software.

RESULTS: Commercial and experimental vinyl polysiloxane exhibited higher Shore A hardness values with time (i.e., 1 hour after mixing, 24 hours after mixing, 72 hours after mixing, and 1 week after mixing). All Comml and Exp VPS demonstrated a significant increase (ANOVA, p < 0.05) in hardness at increasing time points. Generally, all commercial VPS exhibited significantly higher values for Shore A hardness compared to all Exp formulations. For commercial products, Elt M presented significantly highest values at all-time points followed by Aq M then Extr M. Exp-I was significantly harder than all other Exp VPS at all-time points. Young’s modulus values were directly related to Shore A hardness; materials with higher Shore A hardness values had higher Young’s moduli.

CONCLUSION: Continued polymerisation of elastomeric impression materials results in increased hardness over time. Hardness, Young’s moduli, and rigidity of the set commercial and experimental VPS materials were within the required limits. Shore A hardness and Young’s moduli were directly proportional to each other, and commercial and experimental materials had enough rigidity to contain the stone during pouring.

PMID:35187157 | PMC:PMC8849984 | DOI:10.1155/2022/1703869