Nevin Manimala

J Neurovirol. 2022 Mar 25. doi: 10.1007/s13365-022-01064-5. Online ahead of print.

ABSTRACT

The objective of this study is to investigate the risk factors of oral or facial herpes simplex virus (HSV-1) infection after primary trigeminal neuralgia (PTN). The clinical data of 33 PTN patients admitted by the same surgeon in the neurosurgery were retrospectively analyzed. Among the 33 patients, 26 patients underwent microvascular decompression (MVD), 6 patients who have not been found the clear offending vessels during the operation underwent partial sensory rhizotomy (PSR), and only one underwent adhesive band separation. Thirteen patients with postoperative oral and facial HSV-1 infection were selected as the herpes group, and the remaining 20 patients without postoperative oral and facial HSV-1 infection were selected as the non-herpes group. The differences between the two groups were compared by statistical analysis of factors such as gender, age, operation mode, operation time, and serum HSV-1 antibody titer value before surgery. Compared with the non-herpes group, there were no statistically significant differences in sex ratio (P = 0.930), age composition (P = 0.261), or disease profile (P = 0.226). Twenty-six patients underwent MVD operation, eight of whom were infected, and the difference between the two groups was statistically significant (P = 0.029). The operation time of the herpes group was 10-30 min, which was significantly longer than that of the non-herpes group. The difference in operation time between the two groups was statistically significant (P = 0.023). Serum HSV-1-IgM was negative (< 0.9 COI) in all patients before surgery, but the positive rate of HSV-1-IgG (≥ 1.1 COI) was 97%, and the titer was greater than four times in 97% (32/33) of patients. The titer of IgG antibody in the herpes group was significantly lower than that in the non-herpes group, and the difference between the two groups was statistically significant (P = 0.017). The serum HSV-1-IgG in most of the PTN patients was positive. Latent HSV-1 in the trigeminal ganglion may be reactivate after PTN surgery to produce ipsilateral oral and facial herpes infection. The infection of HSV-1 reactivation after PTN surgery was positively correlated with the operation time but negatively correlated with the titer of HSV-1-IgG antibody before PTN surgery. The incidence of HSV-1 infection after PTN operation is related to different surgical procedures.

PMID:35334082 | DOI:10.1007/s13365-022-01064-5

Cancer Causes Control. 2022 Mar 25. doi: 10.1007/s10552-022-01573-y. Online ahead of print.

ABSTRACT

PURPOSE: Underserved Black and Hispanic/Latinx women show low rates of follow-up care after an abnormal Pap test, despite the fact that cervical cancer is one of the few preventable cancers if detected early. However, extant literature falls short on efficacious interventions to increase follow-up for this population. A concurrent mixed methods study was completed to evaluate the acceptability of a text message-based intervention and identify perceived barriers and facilitators to follow-up after an abnormal Pap test among underserved predominantly Black and Hispanic/Latinx women.

METHODS: Patients who completed follow-up for an abnormal Pap test were recruited to complete a cross-sectional survey, qualitative interview assessing barriers and facilitators to follow-up, and text message content evaluation (N = 28). Descriptive statistics were performed to describe background variables and to evaluate the acceptability of text messages. A directed content analysis was completed for the qualitative interviews.

RESULTS: Participants expressed interest in a text message-based intervention to increase abnormal Pap test follow-up. In the qualitative interviews, low knowledge about cervical risk and negative affect toward colposcopy/test results were identified as barriers to follow-up. Facilitators of follow-up included feeling relieved after the colposcopy and adequate social support. Participants rated the text messages as understandable, personally relevant, and culturally appropriate.

CONCLUSION: The findings suggest that underserved Black and Hispanic/Latinx women experience cognitive and emotional barriers that undermine their ability to obtain follow-up care and a text message-based intervention may help women overcome these barriers. Future research should develop and evaluate text message-based interventions to enhance follow-up after an abnormal Pap test.

PMID:35334016 | DOI:10.1007/s10552-022-01573-y

Biomech Model Mechanobiol. 2022 Mar 25. doi: 10.1007/s10237-022-01564-7. Online ahead of print.

ABSTRACT

On the basis of a tensor representation of protein shape, obtained by an affine decomposition of residue velocity, we show how to identify actions at continuum scale for both single proteins and their complexes in terms of power equivalence. The approach constructs and justifies a continuum modeling of protein complexes, which avoids a direct, atomistic-based, simulation of the whole complex, rather it focuses (in a statistical sense) on a single protein and its interactions with the neighbors. In the resulting setting we also prove the existence of equilibrium configurations (native states) under large strains.

PMID:35334002 | DOI:10.1007/s10237-022-01564-7

Langenbecks Arch Surg. 2022 Mar 25. doi: 10.1007/s00423-022-02498-5. Online ahead of print.

ABSTRACT

PURPOSE: Presentation of results of non-stenting treatment versus endoscopic stenting placement in gastric staple leaks after laparoscopic sleeve gastrectomy (LSG).

METHODS: Between January 2007 and August 2020, 1371 eligible patients underwent LSG. After gastric leak detection, patients were classified into treatment groups A (endoscopic stent placement) and B (non-stenting management). Overall hospital stay, the time to complete gastric leak resolution and the incidence of further operative management constituted the main outcome measures. Statistical analysis included descriptive statistics and linear regression tests as needed.

RESULTS: A total of 27 patients (19 F/8 M, median age: 44.8 years (range: 36-58) with median preoperative BMI: 43.5 kg/m² (range: 37.0-48.7)) presented with gastric staple line leak (1.9%) – mean detection day 5.8 postop (range: 1-12). Eight patients enrolled in group A and 19 patients in group B. The mean hospital stay for group A was 41.2 days (range: 24-60) versus 15 days (range: 12-18) for group B (p < 0.001). Complete leakage resolution was observed at mean 42.4 days (range 25-60) for group A and 34.5 days (range: 28-40) for group B patients, (p = 0.025). Only 2 group A patients accomplished complete leak resolution without additional intervention. Five group A patients (62.5%) versus 4 group B patients (21.1%) needed operative intervention during the treatment course (p = 0.037).

CONCLUSIONS: Conservative, non-stenting treatment of staple line leaks after LSG is feasible and is associated with superior results in terms of hospital say and leak resolution in comparison to endoscopic stenting.

PMID:35333965 | DOI:10.1007/s00423-022-02498-5

Eur Arch Otorhinolaryngol. 2022 Mar 25. doi: 10.1007/s00405-022-07325-7. Online ahead of print.

ABSTRACT

PURPOSE: The preoperative diagnosis of noninvasive fungal rhinosinusitis (NIFRS) is inaccurate, and biomarkers to assist the diagnosis are urgently needed. We aimed to evaluate the relationship between albumin levels and NIFRS to assist in early diagnosis.

METHODS: Patients with NIFRS and chronic sinusitis were enrolled in this study. Appropriate statistical methods were used to determine whether there was a statistical difference between the groups. Subgroup analysis was performed to investigate the relationship between albumin levels and NIFRS, and a generalised additive model (GAM) was used to perform nonlinear relationships.

RESULTS: A total of 620 patients were included, including 240 patients with NIFRS. A close relationship was found between albumin levels and NIFRS (P < 0.0001), and the low albumin group was associated with a higher incidence of NIFRS, which was reduced by 60 and 70% in the middle and high albumin groups, respectively. The subgroup analysis also demonstrated an association between albumin levels and NIFRS, except in patients with an alcohol history (P = 0.0665). Interestingly, a nonlinear relationship is observed according to the adjusted GAM. The inflection point was set at 37.0 g/L. A negative correlation was observed among patients with albumin > 37.0 g/L. When the albumin count was <37.0 g/L, the Y value obviously increased and was saturated at 70%, with no further significant increase.

CONCLUSION: Albumin levels were significantly negatively correlated with the incidence of NIFRS, and the incidence increased markedly among patients with albumin < 37.0 g/L.

PMID:35333963 | DOI:10.1007/s00405-022-07325-7

Eur Arch Otorhinolaryngol. 2022 Mar 25. doi: 10.1007/s00405-022-07349-z. Online ahead of print.

ABSTRACT

BACKGROUND: Surgical site infection (SSI) in open surgical tracheostomy (ST) occurs in up to 33% of the cases. SSI can be reduced by a postoperative antibiotic prophylaxis (POAP). The effect of Clindamycin on SSIs in head and neck surgery (HNS) is discussed controversially in the literature.

METHODS: An 8 year single-center retrospective comparative analysis of 441 STs (Visor-ST and Bjoerk-flap technique) performed within major HNS was evaluated due to the event of a SSI within 7 days and analyzed descriptively. Logistic regression model evaluated the impact of POAP with Clindamycin on SSIs.

RESULTS: The use of Clindamycin showed twice the rate of ST-SSI as all patients that did not receive Clindamycin, treated with other perioperative antibiotics. (Fisher’s p = 0.008) The logistic regression model could not prove a statistically significant impact. (OR = 2.91, p = 0.04).

CONCLUSION: We recommend that Clindamycin should be reconsidered as a POAP regimen in ST. Further studies should evaluate alternatives for Penicillin-allergic patients.

LEVEL OF EVIDENCE III: Comparative retrospective monocentric study.

PMID:35333962 | DOI:10.1007/s00405-022-07349-z

Eur Spine J. 2022 Mar 25. doi: 10.1007/s00586-022-07184-0. Online ahead of print.

ABSTRACT

PURPOSE: In this prospective observational cohort study, the development of lumbar intervertebral discs (LIVD) on magnetic resonance imaging (MRI) was investigated from childhood to adulthood with emphasis on the possible association of disc degeneration (DD) to low back pain (LBP).

METHODS: In 2021, 89 subjects who were enrolled in 1994 in a longitudinal study with lumbar spine MRI at ages 8, 11 and 18 were invited to participate in a long-term follow-up comprising a clinical examination, selected patient-reported outcome measures and a lumbar spine MRI. We assessed all MRIs (three lowest LIVDs) with the Pfirrmann summary score, and the ratio of signal intensity of nucleus pulposus to signal intensity of cerebrospinal fluid (SINDL). We further analyzed whether disc changes at any age were associated with self-reported LBP at age 34.

RESULTS: Of the 48 subjects in the follow-up, 35 reported LBP at age 34. The Pfirrmann summary score significantly increased with age (p < 0.001). Subjects reporting LBP at age 34 demonstrated statistically significantly higher summary scores at age 18 and 34 compared to asymptomatic subjects (p = 0.004 at age 18, and p = 0.039 at age 34). SINDL significantly decreased with age (p < 0.001 for all levels separately), but no significant differences between subjects with or without LBP at age 34 were noticed.

CONCLUSION: Subjects with LBP at age 34 had more widespread or severe DD already at age 18 compared to those without LBP.

PMID:35333957 | DOI:10.1007/s00586-022-07184-0

Soc Psychiatry Psychiatr Epidemiol. 2022 Mar 25. doi: 10.1007/s00127-022-02274-2. Online ahead of print.

ABSTRACT

PURPOSE: The purpose of the study was to investigate the changes in psychosocial and psychiatric services in the German city of Leipzig during the COVID-19-pandemic.

METHODS: A participatory, mixed-methods study was used involving a quantitative online survey and qualitative semi-structured interviews with professionals. Quantitative findings were reported with descriptive statistics, and thematic analysis was conducted for qualitative data.

RESULTS: Fifty professionals from various mental health services participated in the survey and eleven professionals were interviewed. Quantitative findings showed that some services were closed intermittently and that there was a stiff increase in use of digital/telephonic service and a decrease in face-to-face services. Staff or funding did not change considerably during the pandemic. Psychosocial groups were suspended or reduced, while access to services became more difficult and professional training for staff was stopped. Thematic analysis of the interviews showed that professionals experienced different phases and levels of change during the pandemic, including changes on a structural level, on the users’ level, and on the staff’ level. Professionals particularly criticised the equivocality of COVID-19 regulations, a defective flow of information and lack of attention for mental healthcare in public policies. They also saw positive aspects, such as the capacity of users and the outpatient care system to adapt to the new situation.

CONCLUSION: This study suggests directions for policy and service development, such as communicating clearly in infection-control measures, fostering outpatient care and networks between services.

PMID:35333930 | DOI:10.1007/s00127-022-02274-2

Am J Hypertens. 2022 Mar 25:hpac042. doi: 10.1093/ajh/hpac042. Online ahead of print.

ABSTRACT

OBJECTIVE: To compare prevalence of hypertension and stage II hypertension assessed by two blood pressure observation protocols.

METHODS: Participants aged 18 years and older (n = 4,689) in the National Health and Nutrition Examination Survey (NHANES 2017-2018) had their blood pressure (BP) measured following two protocols: the legacy auscultation protocol [AP] and oscillometric protocol [OP]. The order of protocols was randomly assigned. Prevalence estimates for hypertension (BP ≥130/80 mm Hg or use of medication for hypertension) and stage II hypertension (BP ≥140/90 mm Hg) were determined overall, by demographics, and by risk factors for each protocol. Ratios (OP% ÷ AP%) and Kappa statistics were calculated.

RESULTS: Age-adjusted hypertension prevalence was 44.5% (95% CI: 41.1%-48.0%) using OP and 45.1% (95%CI: 41.5%-48.7%) using AP, prevalence ratio=0.99, (95% CI=0.94-1.04)). Age-adjusted Stage II hypertension prevalence was 15.8% (95% CI: 13.6%-18.2%) using AP and 17.1% (95% CI: 14.7%-19.7%) using OP, prevalence ratio=0.92, (95% CI=0.81-1.04)). For both hypertension and Stage II hypertension, the prevalence ratios by demographics and by risk factors all included unity in their 95% CI, except for Stage II hypertension in adults 60+ years (ratio: 0.88 (95% CI: 0.78-0.98)). Kappa for agreement between protocols for hypertension and stage II hypertension were 0.75 (95% CI=0.71-0.79) and 0.67 (95% CI=0.61-0.72), respectively.

CONCLUSIONS: In adults and for nearly all subcategories there were no significant differences in prevalence of hypertension and stage II hypertension between protocols, indicating that protocol change may not affect the national prevalence estimates of hypertension and stage II hypertension.

PMID:35333925 | DOI:10.1093/ajh/hpac042

Cancer Epidemiol Biomarkers Prev. 2022 Mar 25:cebp.1318.2021. doi: 10.1158/1055-9965.EPI-21-1318. Online ahead of print.

ABSTRACT

BACKGROUND: Results of previous observational studies examining the risk of cancer among chronic kidney disease (CKD) patients are conflicting. We here explore the causal relationship between estimated glomerular filtration rate (eGFR) and albuminuria, two principal measurements of CKD, and 19 site-specific cancers using Mendelian randomization (MR) analysis.

METHODS: Single nucleotide polymorphisms reported to be strongly correlated with eGFR and albuminuria in recent large genome-wide association studies were used as instrumental variables to investigate the causal relationship with cancer using summary-level statistics from several cancer-specific consortia, as well as data of 347,408 participants in the UK Biobank and 260,405 participants in the FinnGen.

RESULTS: Our data showed that impaired kidney function was associated with higher odds of leukemia (odds ratio [OR] 1.23, 95% confidence interval [CI] 1.06-1.43, P = 0.007), cervical cancer (OR 1.22, 95% CI 1.04-1.43, P = 0.017) and female renal cell carcinoma (OR 1.4, 95% CI 1.12-1.77, P = 0.004), per 10% decrease in eGFR. The odds ratios were 1.21 (95% CI 1.07-1.36, P = 0.002) for colorectal cancer and 0.76 (95% CI 0.62-0.92, P = 0.006) for non-Hodgkin lymphoma, per doubling odds of albuminuria. In multivariable MR, effect sizes of eGFR-cervical cancer remained strong after adjusting for confounders.

CONCLUSIONS: The current study indicates that progression of CKD contributes to carcinogenesis of renal cell carcinoma, leukemia, cervical and colorectal cancer.

IMPACT: The potential association of kidney function and albuminuria with certain cancers warrants further investigation in order to provide appropriate recommendations regarding cancer screening among patients with CKD.

PMID:35333923 | DOI:10.1158/1055-9965.EPI-21-1318