Nevin Manimala

Indian J Gastroenterol. 2021 Nov 16. doi: 10.1007/s12664-021-01200-9. Online ahead of print.

ABSTRACT

BACKGROUND/AIM: The aim of this study was to find out the clinical spectrum of acute viral hepatitis A (AVH-A) infection in children, the relationship between atypical manifestations and laboratory findings and the outcome of patients with typical and atypical hepatitis A virus (HAV) manifestations.

METHODS: From January 2018 to September 2019, consecutive children (<18 years of age) with features suggestive of AVH with positive IgM anti-HAV both from inpatient and outpatient services were included in this study. Detailed history, physical findings, and investigations were recorded in the study questionnaire. Patients were followed up weekly until complete recovery. The Statistical Package for the Social Sciences (SPSS) version 22 was used for statistical analysis.

RESULT: The mean age of 200 children who were finally included in the study was 8.3±3.5 years with male to female ratio of 134:66. Atypical features were present in 30 (15%) children; prolonged cholestasis (17, 8.5%), ascites (12, 6%), pleural effusion (4, 2%), thrombocytopenia (2, 1%), and hemolysis (1, 0.5%) were observed. Pruritus (p=0.005), higher serum total and direct bilirubin (p=0.00 and 0.001 respectively), and lower serum albumin (p=0.01) levels were statistically significant in children with atypical manifestations. Moreover, this group had prolonged mean duration of jaundice and hospital course (p=0.00 and 0.083 respectively).

CONCLUSION: Atypical manifestations such as prolonged cholestasis and ascites are not uncommon in children with AVH-A in developing countries and seen in almost one-sixth of patients.

PMID:34783989 | DOI:10.1007/s12664-021-01200-9

Genes Genomics. 2021 Nov 16. doi: 10.1007/s13258-021-01190-0. Online ahead of print.

ABSTRACT

BACKGROUND: Early detection is essential to improve the survival of lung cancer (LC). The quantitative measurement of specific DNA methylation changes in the peripheral blood could provide an efficient strategy for the detection of early cancer.

OBJECTIVE: We applied a candidate approach and assess the association between blood-based SH3BP5 methylation and the risk of lung adenocarcinoma (LUAD) in a case-control cohort.

METHODS: The methylation level of four CpG sites in the promoter of SH3BP5 gene was quantitatively determined by mass spectrometry in 171 very early-stage LUAD patients (93.6% LUAD at stage I) and 190 age and gender-matched controls. The logistic regression and non-parametric tests were used for the statistical analyses.

RESULTS: We observed a significant association between decreased methylation of SH3BP5_CpG_4 in the peripheral blood and increased risk of LUAD (odds ratio (OR) per-10% methylation = 1.51, P = 0.006, FDR = 0.024), and even for the LUAD at stage I (OR per-10% methylation = 1.53, P = 0.006, FDR = 0.024). Moreover, the lower quartile of SH3BP5_CpG_4 methylation was correlated with increased risk for LUAD with a P trend of 0.011. Further investigation disclosed that the hypomethylation of SH3BP5_CpG_4 was mostly associated with LUAD in younger subjects (OR per-10% methylation = 2.02, P = 0.010, age < 55 years old) and probably could be enhanced by advance stage.

CONCLUSION: Our study revealed an association between blood-based SH3BP5 hypomethylation and very early-stage LUAD, which provides a novel support for the blood-based methylation signatures as a potential marker for the evaluation of cancer risk.

PMID:34783986 | DOI:10.1007/s13258-021-01190-0

Int Urol Nephrol. 2021 Nov 16. doi: 10.1007/s11255-021-03055-7. Online ahead of print.

ABSTRACT

PURPOSE: To test for differences in cancer-specific mortality (CSM) rates in Hispanic/Latino prostate cancer patients according to treatment type, radical prostatectomy (RP) vs external beam radiotherapy (EBRT).

METHODS: Within the Surveillance, Epidemiology, and End Results database (2010-2016), we identified 2290 NCCN (National Comprehensive Cancer Network) high-risk (HR) Hispanic/Latino prostate cancer patients. Of those, 893 (39.0%) were treated with RP vs 1397 (61.0%) with EBRT. First, cumulative incidence plots and competing risks regression models tested for CSM differences after adjustment for other cause mortality (OCM). Second, cumulative incidence plots and competing risks regression models were refitted after 1:1 propensity score matching (according to age, PSA, biopsy Gleason score, cT-stage, cN-stage).

RESULTS: In NCCN HR patients, 5-year CSM rates for RP vs EBRT were 2.4 vs 4.7%, yielding a multivariable hazard ratio of 0.37 (95% CI 0.19-0.73, p = 0.004) favoring RP. However, after propensity score matching, the hazard ratio of 0.54 was no longer statistically significant (95% CI 0.21-1.39, p = 0.2).

CONCLUSION: Without the use of strictest adjustment for population differences, NCCN high-risk Hispanic/Latino prostate cancer patients appear to benefit more of RP than EBRT. However, after strictest adjustment for baseline patient and tumor characteristics between RP and EBRT cohorts, the apparent CSM benefit of RP is no longer statistically significant. In consequence, in Hispanic/Latino NCCN high-risk patients, either treatment modality results in similar CSM outcome.

PMID:34783982 | DOI:10.1007/s11255-021-03055-7

Qual Life Res. 2021 Nov 16. doi: 10.1007/s11136-021-03034-6. Online ahead of print.

ABSTRACT

PURPOSE: To investigate patient-reported outcome (PRO) measures in patients with relapsing-remitting multiple sclerosis (RRMS) who transition to secondary progressive multiple sclerosis (SPMS).

METHODS: Subjects enrolled in the Comprehensive Longitudinal Investigation of Multiple Sclerosis at Brigham and Women’s Hospital (CLIMB) who completed PRO measures in the RRMS and SPMS phases were identified (n = 52). The PRO measures were Medical Outcomes Study Short-Form 36 Health Survey (SF-36), the Modified Fatigue Impact Scale (MFIS), and the Center for Epidemiologic Studies Depression Scale (CESD). Two control groups of RRMS CLIMB patients who did not progress to SPMS were identified based on different matching criteria related to age, sex, disease duration and Expanded Disability Status Scale (EDSS). Summary statistics for each PRO were calculated at the last RRMS measurement and first SPMS measurement, and the change over this transition was calculated using a paired t-test. Patients who transitioned were compared to the control groups using linear regression to adjust for age, disease duration and EDSS and a mixed model to further account for the matching with a random effect for matched group.

RESULTS: Patients who transitioned from RRMS to SPMS had noticeable deficits in terms of Quality of Life (QOL) and fatigue at the visit prior to the transition. Patients worsened in terms of SF-36 Role Physical (- 3.6 [- 6.6, – 0.7]), Social Functioning (- 3.7 [- 6.4, – 1.0]), and Physical Component Summary (- 2.3 [- 4.5, – 0.1]) during the transition from RRMS to SPMS. When patients who transitioned were compared to the matched subjects, they had worse scores on several outcomes, including Physical Functioning (adjusted mean difference = – 10.8 [- 14.1, – 7.5]), Physical Component Summary (- 5.2 [- 9.3, – 1.0]), fatigue (8.9 [1.7, 16.1]), and depression (3.1 [0.3, 5.9]).

CONCLUSIONS: Patients in the period closely preceding transition from RRMS to SPMS have worse physical QOL and fatigue compared to subjects who remain RRMS.

PMID:34783972 | DOI:10.1007/s11136-021-03034-6

Obes Surg. 2021 Nov 16. doi: 10.1007/s11695-021-05790-3. Online ahead of print.

ABSTRACT

Bariatric endoscopy (BE) is an emerging treatment option for people with obesity. Spin (i.e., the practice of frequent misrepresentation or overinterpretation of study findings) may lead to imbalanced and unjustified optimism in the interpretation of the results. The aim of this systematic review was to determine the frequency and type of spin in randomized controlled trials (RCTs) of endoscopic primary weight loss techniques with statistically significant and nonsignificant primary outcomes. In conclusion, spin is observed in the abstract and main text of BE reports and can lead to misinterpretation or overinterpretation of the results. Since BE challenges the available non-endoscopic treatments for obesity, further research is needed to better qualify these techniques, as being effective and safe, as well as predefined hypotheses and analyses.

PMID:34783961 | DOI:10.1007/s11695-021-05790-3

Obes Surg. 2021 Nov 16. doi: 10.1007/s11695-021-05758-3. Online ahead of print.

ABSTRACT

BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) is a standard procedure due to its low complication rates and favorable outcomes. However, limited data are available regarding the optimal size of linear staplers in relation to gastric wall thickness (GWT).

METHODS: Between August 2016 and December 2020, we performed LSG in 70 patients with an average age, body weight, and body mass index of 42 years, 107 kg, and 40 kg/m², respectively. We measured the GWT at the antrum, body, and fundus using resected specimens. We used an endo-linear stapler, and the closed staple height (CSH) was 1.75 mm.

RESULTS: We found that the average GWT at the antrum was significantly thicker than the GWT at the body and fundus. There was a statistically significant relationship between body weight and the GWT at the antrum and body and obstructive sleep apnea and the GWT at the body. The average CSH/GWT ratios were 0.55, 0.62, and 0.90 at the antrum, body, and fundus, respectively. However, in 20 patients (29%), the CSH/GWT ratio at the fundus area was ≥ 1.0, and only preoperative body weight was a significant predictor for a CSH/GWT ratio of ≥ 1.0.

CONCLUSION: A light body weight may be related to a CSH/GWT ratio of ≥ 1.0 at the fundus.

PMID:34783958 | DOI:10.1007/s11695-021-05758-3

Cancer Causes Control. 2021 Nov 16. doi: 10.1007/s10552-021-01515-0. Online ahead of print.

ABSTRACT

PURPOSE: African men are disproportionately affected by prostate cancer (PCa). Given the increasing prevalence of obesity in Africa, and its association with aggressive PCa in other populations, we examined the relationship of overall and central obesity with risks of total and aggressive PCa among African men.

METHODS: Between 2016 and 2020, we recruited 2,200 PCa cases and 1,985 age-matched controls into a multi-center, hospital-based case-control study in Senegal, Ghana, Nigeria, and South Africa. Participants completed an epidemiologic questionnaire, and anthropometric factors were measured at clinic visit. Multivariable logistic regression was used to examine associations of overall and central obesity with PCa risk, measured by body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR), respectively.

RESULTS: Among controls 16.4% were obese (BMI ≥ 30 kg/m²), 26% and 90% had WC > 97 cm and WHR > 0.9, respectively. Cases with aggressive PCa had lower BMI/obesity in comparison to both controls and cases with less aggressive PCa, suggesting weight loss related to cancer. Overall obesity (odds ratio: OR = 1.38, 95% CI 0.99-1.93), and central obesity (WC > 97 cm: OR = 1.60, 95% CI 1.10-2.33; and WHtR > 0.59: OR = 1.68, 95% CI 1.24-2.29) were positively associated with D’Amico intermediate-risk PCa, but not with risks of total or high-risk PCa. Associations were more pronounced in West versus South Africa, but these differences were not statistically significant.

DISCUSSION: The high prevalence of overall and central obesity in African men and their association with intermediate-risk PCa represent an emerging public health concern in Africa. Large cohort studies are needed to better clarify the role of obesity and PCa in various African populations.

PMID:34783926 | DOI:10.1007/s10552-021-01515-0

Cancer Causes Control. 2021 Nov 16. doi: 10.1007/s10552-021-01520-3. Online ahead of print.

ABSTRACT

PURPOSE: Surgery is an important part of early stage breast cancer treatment that affects overall survival. Many studies of surgical treatment of breast cancer rely on data sources that condition on continuous insurance coverage or treatment at specified facilities and thus under-sample populations especially affected by cancer care inequities including the uninsured and rural populations. Statewide cancer registries contain data on first course of cancer treatment for all patients diagnosed with cancer but the accuracy of these data are uncertain.

METHODS: Patients diagnosed with stage I-III breast cancer between 2003 and 2016 were identified using the North Carolina Central Cancer Registry and linked to Medicaid, Medicare, and private insurance claims. We calculated the sensitivity, specificity, positive predictive value, negative predictive value, and Kappa statistics for receipt of surgery and type of surgery (breast conserving surgery or mastectomy) using the insurance claims as the presumed gold standard. Analyses were stratified by race, insurance type, and rurality.

RESULTS: Of 26,819 patients who met eligibility criteria, 23,125 were identified as having surgery in both the claims and registry for a sensitivity of 97.9% (95% CI 97.8%, 98.1%). There was also strong agreement for surgery type between the cancer registry and the insurance claims (Kappa: 0.91). Registry treatment data validity was lower for Medicaid insured patients than for Medicare and commercially insured patients.

CONCLUSIONS: Cancer registry treatment data reliably identified receipt and type of breast cancer surgery. Cancer registries are an important source of data for understanding cancer care in underrepresented populations.

PMID:34783925 | DOI:10.1007/s10552-021-01520-3

Psicol Reflex Crit. 2021 Nov 16;34(1):35. doi: 10.1186/s41155-021-00200-0.

ABSTRACT

Short-term memory is a dynamic psychological process that operates within a network in which non-verbal intelligence and attentional domains are connected. However, no consensus has been reached about which process has the greatest effect on this memory ability, which was the main objective of the present study. A sample of 1448 Brazilian participants (mean age = 26.62 years, standard deviation = 9.97 years; 53.9% females) were collectively tested on pen-and-paper standardized and validated measures of selective (ROTAS-C), alternating (ROTAS-A), and divided (ROTAS-D) attention. They also performed the R1 Non-verbal Intelligence Test and a visual short-term memory test (Memória Visual de Curto Prazo [MEMORE] test). The statistical analyses consisted of a data mining procedure, in which exhaustive automatic selection screening was performed. The results were compared with Corrected Akaike Information Criteria. The linear model met the classic assumptions of ordinary least squares and only included main effects of selective attention (standardized β = 0.39) and non-verbal intelligence (standardized β = 0.37) as main predictors (F_2,39 = 7.01, p < 0.01, adjusted R² = 24%). The results are discussed within a cognitive psychology framework.

PMID:34783917 | DOI:10.1186/s41155-021-00200-0

Clin Oral Investig. 2021 Nov 16. doi: 10.1007/s00784-021-04258-z. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aimed to investigate the detection of Epstein-Barr virus (EBV) in oral squamous cell carcinoma (OSCC) and to verify the concordance of EBV-DNA frequency in subgingival sites and in the OSCC.

METHODS: A cross-sectional study with 30 OSCC patients, aged from 44 to 88 years old, was conducted. Samples were collected in subgingival sites and at the OSCC, then submitted to DNA isolation, qPCR, and genotyping. Descriptive statistic was performed to report the frequency of EBV-DNA in all samples, and McNemar test was applied to verify the concordance among the EBV-DNA frequency in both sites.

RESULTS: The individuals presented 62 years old in average, and the majority were male (66.6%). EBV-DNA was detected in 56.7% OSCC lesions. Among the subgroup of 19 dentate individuals, high concordance (73.7%) in both EBV-DNA detection and the absence in subgingival sites and OSCC was observed, and it was statistically significant (p < 0.05).

CONCLUSIONS: We report the notable occurrence of EBV-DNA in OSCC; also, the presence of EBV in periodontal sites may contribute to find it in OSCC, although the possible contribution of EBV in the OSCC remains to be investigated.

CLINICAL RELEVANCE: The identification of this easily accessible site of EBV latent infection may help to improve the patient’s quality of life by maintenance of oral/periodontal health condition and preventing further possible disorders related to the virus, and also encourages new approaches for investigating EBV, periodontitis, and OSCC.

PMID:34783915 | DOI:10.1007/s00784-021-04258-z