Nevin Manimala

Wiad Lek. 2021;74(9 cz 1):2082-2086.

ABSTRACT

OBJECTIVE: The aim: On the basis of radiological data to evaluate the effectiveness of our developed treatment complex of patients with temporomandibular joint dysfunction after mandibular fractures.

PATIENTS AND METHODS: Materials and methods: To achieve this goal, 92 patients hospitalized in the department of surgical dentistry of the Chernivtsi Regional Clinical Hospital were examined for traumatic fractures of the mandible with functional disorders of the TMJ. 46 patients (main group) were treated according to the treatment method developed by us, and 46 patients (control group) were treated with the traditional method. Patients underwent orthopanthography and radiography of the temporomandibular joint according to Schuller. Statistical processing of research results was carried out using commonly used methods of variation statistics.

RESULTS: Results: After 12 months of studies in patients of the main group, unilateral narrowing of the joint space was determined in 6,52 ± 1,83% of persons p, p1 0.05.The number of persons with unilateral expansion of the joint space according to Rtg, in the main group decreased by 2,3 times relative to the data before treatment.

CONCLUSION: Conclusions: Timely treatment of musculoskeletal disorders with the help of pharmacological and physiotherapeutic methods proposed by us, allowed, to a large extent, to eliminate clinical, radiological and ultrasound symptoms of temporomandibular joint dysfunction in patients with post-traumatic lesions of mandibule. This was confirmed by the improvement of the data of the conducted functional researches.

PMID:34725280

Wiad Lek. 2021;74(9 cz 1):2076-2081.

ABSTRACT

OBJECTIVE: The aim: To study and analyze the dynamics of women’s reproductive health in Ukraine as a factor in population reproduction and to study the features of menstrual disorders in Ukraine in 2010-2019. In women of reproductive age with hyperproliferative pathology of the endometrium without atypia.

PATIENTS AND METHODS: Materials and methods: A descriptive epidemiological study was conducted using data from the departmental statistical reporting of the Ministry of Health of Ukraine on the number of cases of gynecological pathology for 2010-2019. The peculiarities of menstrual function in patients of reproductive age with atypical hyperproliferative pathology of the endometrium were studied. We examined 84 patients of the gynecological department of the Sumy Regional Clinical Perinatal Center with a diagnosis of hyperproliferative pathology of the endometrium without atypia, who sought medical help during 2017-2020 for hyperplastic processes of the endometrium in reproductive age (18 to 49 years). All patients were divided into three groups, up to group I women with endometrial hyperplasia without atypia (HGE) (n = 30); Group II – patients diagnosed with endometrialpolyps (n = 30); group III included patients with combined hyperproliferative pathology (uterine body polyps and endometrial hyperplasia without atypia) (n = 24).

RESULTS: Results: As a result of the conducted systematic analysis it was established: the higher the prevalence of PMC, the higher the frequency of diseases of the genitourinary system and some gynecological diseases. This is confirmed by the calculated coefficients of correlation of the prevalence of PMC with the frequency of diseases of the genitourinary system (r = 0.75, p<0.001), salpingitis (r = 0.63, p<0.001) and endometriosis (r = 0.42, p<0, 05). The assessment of the relative risk of gynecological diseases has shown that the greatest attention needs to be paid to improving the diagnosis of infertility and endometriosis, as well as the prevention and treatment of salpingitis and uterine cancer. When women with menstrual disorders go to the gynecologist, it is necessary to pay attention to the presence of hyperproliferative pathology, and if women have other chronic diseases, offer rehabilitation of these foci, which can further have a positive effect on reproductive health.

CONCLUSION: Conclusions: The highest rates of menstrual irregularities were found in women with endometrial hyperplasia without atypia and a combination diffuse hyperplasia with endometrial polyps in contrast to patients with only endometrial polyps. Menstrual irregularities can be considered as a marker and indicator of dysfunction of the genitourinary system and the presence of a hyperproliferative process at the prehospital stage.

PMID:34725279

Postgrad Med J. 2021 Nov 1:postgradmedj-2021-141186. doi: 10.1136/postgradmedj-2021-141186. Online ahead of print.

ABSTRACT

INTRODUCTION: Pulmonary cancer is a kind of deeply invasive tumour which is difficult to treat, and its mortality rate is high. Previous research has shown that activation of complement could contribute to the progression of non-small-cell lung cancer (SCLC). However, little research has been done on SCLC.

METHODS: Complement factor H (CFH), complements C3 as well as C4 were measured in patients, and the prognostic impact of different parameters was assessed by log-rank function analysis and Cox multifactor models. Besides, we constructed a predictive model based on complement fractions and validated the accuracy of the model.

RESULTS: Among these 242 patients, 200 (82.6%) died. The median survival time was 18.3 months. We found by multifactorial analysis that high levels of CFH decreased the risk of death (HR 0.23, 95% CI 0.10 to 0.57, p<0.001), while elevated complement C4 displayed poor prognosis (HR 2.28, 95% CI 1.66 to 3.13, p<0.001). We screened variables by Cox models and constructed CFH-based prediction models to plot a nomogram by internal validation. The nomogram showed excellent accuracy in assessing the probability of death, yielding an adjusted C-statistics of 0.905.

CONCLUSIONS: CFH can be recognised as a biomarker to predict the risk of death in SCLC. The prediction model established based on CFH, C3 and C4 levels has good accuracy in patients’ prognostic assessment.

PMID:34725230 | DOI:10.1136/postgradmedj-2021-141186

Hosp Pediatr. 2021 Nov 1:hpeds.2021-005903. doi: 10.1542/hpeds.2021-005903. Online ahead of print.

ABSTRACT

BACKGROUND: Social determinants of health (SDOH) contribute to racial disparities in asthma outcomes. Community health worker (CHW) programs represent a promising way to screen for SDOH and connect patients to resources, but the impact of CHW programs in the inpatient pediatric setting has been examined in few studies. In this study, we aimed to evaluate a CHW program for children hospitalized with asthma in a predominantly Hispanic community by examining rates of SDOH and social resource navigation.

METHODS: This pilot study involved a CHW intervention to improve pediatric asthma care. Patients were included if they were hospitalized with asthma over an 18-month period and enrolled in the CHW program during their hospitalization. In an intake interview, CHWs screened caregivers for SDOH and provided tailored social resource navigation. Descriptive statistics were used to assess rates of social risk factors and social resource navigation.

RESULTS: Eighty patients underwent SDOH screening. The majority of patients were Hispanic (81.3%, n = 65). Half of caregivers reported food or housing insecurity over the past 12 months (50.0%, n = 40), and most reported inadequate housing conditions (63.8%, n = 51). CHWs coordinated social resources for the majority of families (98.8%, n = 79), with the most common being food resources (42.5%, n = 34), housing resources (82.5%, n = 66), and appointment navigation (41.3%, n = 33).

CONCLUSIONS: CHWs identified a high burden of unmet social needs and provided associated social resource navigation in a largely Hispanic pediatric population hospitalized for asthma. CHW programs have potential to improve asthma outcomes by linking high-risk patients with social resources.

PMID:34725201 | DOI:10.1542/hpeds.2021-005903

Proc Natl Acad Sci U S A. 2021 Nov 9;118(45):e2113527118. doi: 10.1073/pnas.2113527118.

ABSTRACT

Here, we study the dynamical expression of endogenously labeled Hes1, a transcriptional repressor implicated in controlling cell proliferation, to understand how cell-cycle length heterogeneity is generated in estrogen receptor (ER)⁺ breast cancer cells. We find that Hes1 shows oscillatory expression with ∼25 h periodicity and during each cell cycle has a variable peak in G1, a trough around G1-S transition, and a less variable second peak in G2/M. Compared to other subpopulations, the cell cycle in CD44^HighCD24^Low cancer stem cells is longest and most variable. Most cells divide around the peak of the Hes1 expression wave, but preceding mitoses in slow dividing CD44^HighCD24^Low cells appear phase-shifted, resulting in a late-onset Hes1 peak in G1. The position, duration, and shape of this peak, rather than the Hes1 expression levels, are good predictors of cell-cycle length. Diminishing Hes1 oscillations by enforcing sustained expression slows down the cell cycle, impairs proliferation, abolishes the dynamic expression of p21, and increases the percentage of CD44^HighCD24^Low cells. Reciprocally, blocking the cell cycle causes an elongation of Hes1 periodicity, suggesting a bidirectional interaction of the Hes1 oscillator and the cell cycle. We propose that Hes1 oscillations are functionally important for the efficient progression of the cell cycle and that the position of mitosis in relation to the Hes1 wave underlies cell-cycle length heterogeneity in cancer cell subpopulations.

PMID:34725165 | DOI:10.1073/pnas.2113527118

Proc Natl Acad Sci U S A. 2021 Nov 9;118(45):e2111863118. doi: 10.1073/pnas.2111863118.

ABSTRACT

Although amyloid plaques composed of fibrillar amyloid-β (Aβ) assemblies are a diagnostic hallmark of Alzheimer’s disease (AD), quantities of amyloid similar to those in AD patients are observed in brain tissue of some nondemented elderly individuals. The relationship between amyloid deposition and neurodegeneration in AD has, therefore, been unclear. Here, we use solid-state NMR to investigate whether molecular structures of Aβ fibrils from brain tissue of nondemented elderly individuals with high amyloid loads differ from structures of Aβ fibrils from AD tissue. Two-dimensional solid-state NMR spectra of isotopically labeled Aβ fibrils, prepared by seeded growth from frontal lobe tissue extracts, are similar in the two cases but with statistically significant differences in intensity distributions of cross-peak signals. Differences in solid-state NMR data are greater for 42-residue amyloid-β (Aβ42) fibrils than for 40-residue amyloid-β (Aβ40) fibrils. These data suggest that similar sets of fibril polymorphs develop in nondemented elderly individuals and AD patients but with different relative populations on average.

PMID:34725161 | DOI:10.1073/pnas.2111863118

Proc Natl Acad Sci U S A. 2021 Nov 9;118(45):e2108551118. doi: 10.1073/pnas.2108551118.

ABSTRACT

Fluids in natural systems, like the cytoplasm of a cell, often contain thousands of molecular species that are organized into multiple coexisting phases that enable diverse and specific functions. How interactions between numerous molecular species encode for various emergent phases is not well understood. Here, we leverage approaches from random-matrix theory and statistical physics to describe the emergent phase behavior of fluid mixtures with many species whose interactions are drawn randomly from an underlying distribution. Through numerical simulation and stability analyses, we show that these mixtures exhibit staged phase-separation kinetics and are characterized by multiple coexisting phases at steady state with distinct compositions. Random-matrix theory predicts the number of coexisting phases, validated by simulations with diverse component numbers and interaction parameters. Surprisingly, this model predicts an upper bound on the number of phases, derived from dynamical considerations, that is much lower than the limit from the Gibbs phase rule, which is obtained from equilibrium thermodynamic constraints. We design ensembles that encode either linear or nonmonotonic scaling relationships between the number of components and coexisting phases, which we validate through simulation and theory. Finally, inspired by parallels in biological systems, we show that including nonequilibrium turnover of components through chemical reactions can tunably modulate the number of coexisting phases at steady state without changing overall fluid composition. Together, our study provides a model framework that describes the emergent dynamical and steady-state phase behavior of liquid-like mixtures with many interacting constituents.

PMID:34725154 | DOI:10.1073/pnas.2108551118

BMJ Open. 2021 Nov 1;11(11):e054777. doi: 10.1136/bmjopen-2021-054777.

ABSTRACT

INTRODUCTION: Major depressive disorder (MDD or depression) is prevalent among adults aged 65 years and older. The effectiveness and safety of interventions used to treat depression is often assessed through randomised controlled trials (RCTs). However, heterogeneity in the selection, measurement and reporting of outcomes in RCTs renders comparisons between trial results, interpretability and generalisability of findings challenging. There is presently no core outcome set (COS) for use in RCTs that assess interventions for older adults with MDD. We will conduct a methodological review of the literature for outcomes reported in trials for adults 65 years and older with depression to assess the heterogeneity of outcome measures.

METHODS AND ANALYSIS: RCTs evaluating pharmacotherapy, psychotherapy, or any other treatment intervention for older adults with MDD published in the last 10 years will be located using electronic database searches (MEDLINE, Embase, PsycINFO and the Cochrane Central Register of Controlled Trials). Reviewers will conduct title and abstract screening, full-text screening and data extraction of trials eligible for inclusion independently and in duplicate. Outcomes will be synthesised and mapped to core outcome-domain frameworks. We will summarise characteristics associated with trials and outcomes.

ETHICS AND DISSEMINATION: We hope that findings from our methodological review will reduce variability in outcome selection, measurement and reporting and facilitate the development of a COS for older adults with MDD. Our review will also inform evidence synthesis efforts in identifying the best treatment practices for this clinical population. Ethics approval is not required, as this study is a literature review.

PROSPERO REGISTRATION NUMBER: CRD42021244753.

PMID:34725082 | DOI:10.1136/bmjopen-2021-054777

BMJ Open. 2021 Nov 1;11(11):e049884. doi: 10.1136/bmjopen-2021-049884.

ABSTRACT

INTRODUCTION: Activity-based therapy (ABT) is an important aspect of rehabilitation following traumatic spinal cord injury (SCI). Unfortunately, it has never been adapted to acute care despite compelling preclinical evidence showing that it is safe and effective for promoting neurological recovery when started within days after SCI. This article provides the protocol for a study that will determine the feasibility and explore potential benefits of early ABT in the form of in-bed leg cycling initiated within 48 hours after the end of spinal surgery for SCI.

METHODS AND ANALYSIS: PROMPT-SCI (protocol for rapid onset of mobilisation in patients with traumatic SCI) is a single-site single-arm proof-of-concept trial. Forty-five patients aged 18 years or older with a severe traumatic SCI (American Spinal Injury Association Impairment Scale grade A, B or C) from C0 to L2 undergoing spinal surgery within 48 hours of the injury will be included. Participants will receive daily 30 min continuous sessions of in-bed leg cycling for 14 consecutive days, initiated within 48 hours of the end of spinal surgery. The feasibility outcomes are: (1) absence of serious adverse events associated with cycling, (2) completion of 1 full session within 48 hours of spinal surgery for 90% of participants and (3) completion of 11 sessions for 80% of participants. Patient outcomes 6 weeks and 6 months after the injury will be measured using neurofunctional assessments, quality of life questionnaires and inpatient length of stay. Feasibility and patient outcomes will be analysed with descriptive statistics. Patient outcomes will also be compared with a matched historical cohort that has not undergone in-bed cycling using McNemar and Student’s t-tests for binary and continuous outcomes, respectively.

ETHICS AND DISSEMINATION: PROMPT-SCI is approved by the Research Ethics Board of the CIUSSS NIM. Recruitment began in April 2021. Dissemination strategies include publications in scientific journals and presentations at conferences.

TRIAL REGISTRATION NUMBER: NCT04699474.

PMID:34725077 | DOI:10.1136/bmjopen-2021-049884

AJNR Am J Neuroradiol. 2021 Nov 1. doi: 10.3174/ajnr.A7324. Online ahead of print.

ABSTRACT

BACKGROUND AND PURPOSE: Compared with BRAF p. V600E wild-type pleomorphic xanthoastrocytoma, BRAF p. V600E-mutant pleomorphic xanthoastrocytoma showed a higher survival rate. In this study, we focused on finding preoperative MR imaging differences between BRAF p. V600E mutant and wild-type in pleomorphic xanthoastrocytoma and anaplastic pleomorphic xanthoastrocytoma.

MATERIALS AND METHODS: Twenty-three patients with pathologically confirmed pleomorphic xanthoastrocytoma or anaplastic pleomorphic xanthoastrocytoma in our hospital were retrospectively analyzed from January 2015 to December 2020. They were divided into a BRAF p. V600E-mutant group (including 6 pleomorphic xanthoastrocytomas and 5 anaplastic pleomorphic xanthoastrocytomas) and a wild-type group (including 8 pleomorphic xanthoastrocytomas and 4 anaplastic pleomorphic xanthoastrocytomas). The preoperative MR imaging characteristics of these groups were statistically compared.

RESULTS: The wild-type pleomorphic xanthoastrocytoma group presented with more aggressive conventional and advanced MR imaging features than the mutant pleomorphic xanthoastrocytoma group, including greater mean maximum tumor diameter (3.1 [SD, 0.9] cm versus 1.7 [SD, 0.4 ] cm, P < .05), more frequent heterogeneous contrast enhancement of solid portions (100% versus 0%, P < .001), more obvious peritumoral edema (mean, [2.1 SD, 0.7] cm versus 0.6 [SD, 0.2] cm, P < .01), and lower mean minimum relative ADC (896 [SD, 86] versus 988 [SD, 73], P < .05) and mean relative ADC (1060 [SD, 159] versus 1248 [SD, 116], P < .05) on DWI. However, there was no significant difference in either conventional or advanced MR imaging features between the wild-type anaplastic pleomorphic xanthoastrocytoma group and the mutant anaplastic pleomorphic xanthoastrocytoma group.

CONCLUSIONS: Neurosurgeons should carefully interpret MR images before an operation and select appropriate surgical strategies according to genotype prediction.

PMID:34725042 | DOI:10.3174/ajnr.A7324