Nevin Manimala

J Am Geriatr Soc. 2022 Feb 5. doi: 10.1111/jgs.17682. Online ahead of print.

ABSTRACT

BACKGROUND: Potentially disruptive medical, surgical, and social events-such as pneumonia, hip fracture, and widowhood-may accelerate the trajectory of decline and impact caregiving needs in older adults, especially among people with dementia (PWD). Prior research has focused primarily on nursing home residents with dementia. We sought to assess the incidence of potentially disruptive events in community-dwelling people with and without dementia.

METHODS: Retrospective cohort study of participants aged 65+ enrolled in the Health and Retirement Study between 2010 and 2018 (n = 9346), including a subset who were married-partnered at baseline (n = 5105). Dementia was defined with a previously validated algorithm. We calculated age-adjusted and gender-stratified incidence per 1000 person-years and incidence rate ratios of: 1) hospitalization for pneumonia, 2) hip fracture, and 3) widowhood in people with and without dementia.

RESULTS: PWD (n = 596) were older (mean age 84 vs. 75) and a higher proportion were female (67% vs. 57%) than people without dementia (PWoD) (n = 8750). Age-adjusted incidence rates (per 1000 person-years) of pneumonia were higher in PWD (113.1; 95% CI 94.3, 131.9) compared to PWoD (62.1; 95% CI 54.7, 69.5), as were hip fractures (12.3; 95% CI 9.1, 15.6 for PWD compared to 8.1; 95% CI 6.9, 9.2 in PWoD). Point estimates of widowhood incidence were slightly higher for PWD (25.3; 95% CI 20.1, 30.5) compared to PWoD (21.9; 95% CI 20.3, 23.5), but differences were not statistically significant. The association of dementia with hip fracture-but not pneumonia or widowhood-was modified by gender (male incidence rate ratio [IRR] 2.24, 95% CI 1.34, 3.75 versus female IRR 1.31 95% CI 0.92,1.86); interaction term p = 0.02).

CONCLUSIONS: Compared to PWoD, community-dwelling PWD had higher rates of pneumonia and hip fracture, but not widowhood. Knowing how often PWD experience these events can aid in anticipatory guidance and care planning for this growing population.

PMID:35122662 | DOI:10.1111/jgs.17682

Environ Sci Pollut Res Int. 2022 Feb 5. doi: 10.1007/s11356-022-18829-4. Online ahead of print.

ABSTRACT

Global emission statistics show that Africa is among the least carbon-emitting continents. However, the rising drive for economic growth amid urbanization and globalization in recent years has continued to attract the attention of policymakers to the attendant potential environmental risks. Hence, using robust empirical techniques, this study examines the impacts of increasing urbanization alongside its interactions with energy portfolios on environmental prospects of 15 selected African countries including the most urbanized and leading oil producers in the continent of Africa. The results of the analysis produced insightful implications for achieving both environmental and economic sustainability for the understudied countries. Firstly, the trio of urbanization, economic globalization, and income levels aggravate environmental degradation among these countries as they were found to be essential drivers of carbon emission levels over the understudied period (1990-2015). Secondly, while urbanization significantly poses threat to environmental sustainability, the evidence obtained regarding its interaction with energy portfolios of the understudied countries differs. The significant detrimental environmental impacts of the interaction between urbanization and energy portfolios were only confirmed in the context of fossil energy consumption among the countries, while renewables exist as a significant decarbonization channel within the framework of the increasing level of urbanization among the countries. Thirdly, the study upholds the EKC conjecture. Hence, policymakers and authorities in Africa should capitalize on maximizing the benefits of the huge renewable resource potentials on the continent through adequate investments in green energy technologies for urban infrastructures toward the realization of sustainable development goals (SDGs 11 and 13).

PMID:35122645 | DOI:10.1007/s11356-022-18829-4

Drugs. 2022 Feb 5. doi: 10.1007/s40265-021-01668-x. Online ahead of print.

ABSTRACT

BACKGROUND: Gliomas represent most common primary brain tumors. Glioblastoma (GBM) is the most common subtype and carries a poor prognosis. There is growing interest in the anti-glioma properties of statins. The aim of this study was to conduct a systematic review of the preclinical literature and to meta-analyze existing clinical studies to determine what benefit, if any, statins may confer in the context of glioma.

METHODS: The PubMed, Embase, Cochrane, and Web of Science libraries were queried in May 2021. Preclinical studies were included if they investigated the anti-cancer effects of statins in glioma in vitro and in vivo. Clinical studies were included if they reported incidence rates of glioma by statin use, or mortality outcomes among GBM patients by statin use. Pooled point estimates were calculated using a random-effects model.

RESULTS: In total, 64 publications, 51 preclinical and 13 clinical, were included. Preclinical studies indicated that statins inhibited glioma cell proliferation, migration, and invasion. These effects were time- and concentration-dependent. Synergistic anti-glioma effects were observed when statins were combined with other anti-cancer therapies. Clinical observational studies showed an inverse, albeit non-statistically significant, association between statin use and incidence rate of glioma (HR = 0.84, 95% CI 0.62-1.13, I² = 72%, p-heterogeneity = 0.003, 6 studies). Statin use was not associated with better overall survival following GBM surgery (HR = 1.05, 95% CI 0.85-1.30, I² = 30%, p-heterogeneity = 0.23, 4 studies).

CONCLUSION: Statins were potent anti-cancer drugs that suppressed glioma growth through various mechanisms in vitro; these effects have translated into the clinical realm, clinically but not statistically, in terms of glioma incidence but not GBM survival.

PMID:35122635 | DOI:10.1007/s40265-021-01668-x

Endocrine. 2022 Feb 5. doi: 10.1007/s12020-022-03001-2. Online ahead of print.

ABSTRACT

PURPOSE: Osteoporosis (OP) is a common disease among adults aged >50 years. At present, the main approach to screen or to diagnosis OP is mainly via bone mineral density (BMD) testing, which might not be optimal for OP screening. This study aimed to develop and validate a convenient and effective prediction model for screening OP based on the demographic information, medical history, and lifestyle habits in the elderly in the United States.

METHODS: All data were collected from the National Health and Nutrition Survey database. Participants aged ≥50 years with complete BMD data were included in this study. Twelve candidate predictors were initially selected to develop the prediction model. Final predictors screening and model development were based on multivariate logistic regression. Model discrimination (C statistic) and calibration (Brier scores) were calculated to evaluate the performance of the model. Internal validation was performed using the bootstrap resampling technique, and external validation was based on the validation cohort.

RESULTS: The screening tool was developed with individual patient data from 1941 patients and validated with data from 1947 patients after the development of the model. Seven predictors (patient age, sex, race, body mass index, physical activity, sleep duration, and history of fracture) were included in the final prediction model, and the final model had a C statistic of 0.849 [95% confidence interval (CI): 0.820-0.878] and Brier scores of 0.062 [95% CI: 0.054-0.070] on the development cohort. For the validation of the developed model, the results showed a C statistic >0.800 and Brier scores <0.070, irrespective of internal validation or external validation.

CONCLUSIONS: A novel screening tool for OP in the elderly, which has excellent discrimination and useful calibration, has been developed and externally validated. Considering its simplicity, generalizability, and accuracy, this tool has the potential to become a practical mean for the elderly to screen OP.

PMID:35122626 | DOI:10.1007/s12020-022-03001-2

Oral Radiol. 2022 Feb 5. doi: 10.1007/s11282-022-00586-2. Online ahead of print.

NO ABSTRACT

PMID:35122625 | DOI:10.1007/s11282-022-00586-2

Dermatol Ther (Heidelb). 2022 Feb 5. doi: 10.1007/s13555-022-00681-6. Online ahead of print.

ABSTRACT

INTRODUCTION: Treatment of early-stage mycosis fungoides (MF) requires safe, skin-directed therapies. Medication side effects can lead to underutilization of effective therapies. The objective of this study was to assess the use of topical triamcinolone 0.1% ointment as a means of reducing contact dermatitis associated with topical mechlorethamine/chlormethine gel for the treatment of MF.

METHODS: This prospective, randomized, open-label study evaluated 28 adults with mycosis fungoides who were eligible for treatment with topical mechlorethamine/chlormethine gel from December 17, 2017 to December 23, 2020. Patients were treated for 4 months with clinical follow-up through 12 months. Patients had half of their lesions also treated with topical triamcinolone 0.1% ointment (while the other half were treated with mechlorethamine/chlormethine alone). The study was self-controlled with separate lesions in the same patient receiving each treatment arm. Treatment arms were determined by the flip of a coin.

RESULTS: Twenty-eight patients enrolled (17 men (61%) and 11 women (39%)). Demographics included 25 White, 2 African Americans, and 1 Asian patient. Twenty-five completed the 12-month follow-up. Triamcinolone 0.1% ointment led to increased tolerability of mechlorethamine/chlormethine gel but did not change the efficacy of mechlorethamine/chlormethine. There was a statistically significant 50% decrease in dermatitis (SCORD score) at month 2 in the triamcinolone-treated arm.

CONCLUSIONS: Topical triamcinolone ointment is a helpful adjuvant therapy when treating patients with topical mechlorethamine/chlormethine gel. It diminishes inflammation and does not reduce efficacy. The peak incidence of dermatitis in the study occurred in the second and third months.

TRIAL REGISTRATION: ClinicalTrials.gov identifier, NCT03380026.

PMID:35122614 | DOI:10.1007/s13555-022-00681-6

Curr Med Sci. 2022 Feb 5. doi: 10.1007/s11596-022-2538-z. Online ahead of print.

ABSTRACT

OBJECTIVE: To investigate the value of routine intraoperative ultrasound (IU) and intraoperative contrast-enhanced ultrasound (ICEUS) in the surgical treatment of brain tumors, and to explore the utilization of ICEUS for the removal of the remnants surrounding the resection cavity.

METHODS: In total, 51 patients who underwent operations from 2012 to 2018 due to different tumors in the brain were included in this study. The clinical data were evaluated retrospectively. IU was performed in all patients, among which 28 patients underwent ICEUS. The effects of IU and ICEUS on tumor resection and recurrence were evaluated. Semiquantitative analysis was performed to compare ICEUS parameters of the brain tumor with those of the surrounding tissue.

RESULTS: In total, 36 male and 15 female patients were included in this study. The average age was 43 years (range: 14-68 years). The follow-up period was from 7 to 74 months (mean follow-up 32 months). IU was used in all patients, and no lesion was missed. Among them, 28 patients underwent ICEUS. The rate of total removal of the ICEUS group (23/28, 82%) was significantly higher than that of the IU group (11/23, 48%) (P<0.05). The recurrence rate of ICEUS and IU was 18% (5/23), and 22% (5/28), respectively, and the difference did not reach statistical significance (P>0.05). The semiquantitative analysis showed that the intensity and the transit time of microbubbles reaching the lesions were significantly different from the intensity and the transit time of microbubbles reaching the surrounding tissue (P<0.05) and reflected indirectly the volume and the speed of blood perfusion in the lesions was higher than those in the surrounding tissue.

CONCLUSION: ICEUS is a useful tool in localizing and outlining brain lesions, especially for the resection of the hypervascular lesions in the brain. ICEUS could be more beneficial for identifying the remnants and improving the rate of total removal of these lesions than routine intraoperative ultrasound.

PMID:35122612 | DOI:10.1007/s11596-022-2538-z

J Psycholinguist Res. 2022 Feb 5. doi: 10.1007/s10936-022-09841-3. Online ahead of print.

ABSTRACT

The present study investigated the effect of emotional valence on auditory word recognition memory in English as a foreign language. Participants included 48 native Spanish speakers whose foreign language was English. They viewed four emotionally negative, four positive, and four neutral videos that, in total, contained 48 emotionally valenced target words. After watching the videos, participants completed an auditory word recognition memory task where target words, and the same number of fillers, were presented. The results showed a statistically significant main effect of valence on both reaction times and accuracy. Positive words were recognised more accurately and faster than neutral and negative words, but no difference between neutral and negative stimuli was found. These findings fit in well within the gradient model of automatic vigilance, which implies that emotional valence has a monotonic effect on processing latencies during auditory recognition memory in a foreign language.

PMID:35122567 | DOI:10.1007/s10936-022-09841-3

Egypt Heart J. 2022 Feb 5;74(1):8. doi: 10.1186/s43044-022-00243-3.

ABSTRACT

BACKGROUND: Transradial access (TRA), which has a minimal risk of problems such as radial artery occlusion (RAO), hemorrhage, spasm, and so on, is now considered the standard procedure for cardiac catheterization. The aim of the study is to present the distal transradial access (d-TRA) as a possible promising novel technique in the field of cardiac coronary interventions comparing it to the standard conventional TRA using primary and secondary endpoints, exploring its benefits and drawbacks as a new experience in Alexandria University. One hundred cases with variable indications for coronary interventions were randomized to two arms using systematic random sampling method, coronary interventions in the first one were done via d-TRA (50 patients) and in the second arm via conventional TRA group (50 patients).

RESULTS: Technically, there were highly statistically significant differences between the two arms in favor of TRA regarding procedural success, number of punctures taken, Access time, Total procedural time, vasodilator used, and crossover to another access site; meanwhile safety profile parameters have showed statistically significant differences in favor of d-TRA regarding post-operative hematoma, AV fistula, post-operative pain and compression time, and there were no statistically significant differences regarding RAO although it occurred more in TRA group.

CONCLUSIONS: In the realm of cardiac intervention, the distal radial approach is a promising technique. When compared to TRA, we found it to be a viable and safe method for coronary angiography and interventions and it could be a real option for the interventionists in the near future, with a lower risk of radial artery blockage and no significant differences in wrist hematoma and radial artery spasm. The success rate of d-TRA is proportional to the steepness of the operator’s learning curve and the quality of the examples chosen.

PMID:35122566 | DOI:10.1186/s43044-022-00243-3

Clin Oral Investig. 2022 Feb 5. doi: 10.1007/s00784-022-04392-2. Online ahead of print.

ABSTRACT

OBJECTIVES: The purpose of this study was to evaluate the clinical and microbiological impact of adjunctive metronidazole to periodontal surgery.

MATERIALS AND METHODS: Systemically healthy patients, with stages III-IV, grades B-C periodontitis, were randomly assigned to receive metronidazole or placebo adjunctive to periodontal surgery, after subgingival instrumentation. Clinical variables were recorded at the initial visit, 6 weeks after subgingival instrumentation, and 3, 6, and 12 months after surgery. Microbiological samples were taken at initial and final visits and analyzed by quantitative polymerase chain reaction.

RESULTS: Our results showed no statistically significant differences in the reduction of probing depth between the initial and final (1 year) visits in the two treatment groups. Additionally, no statistically significant differences were observed between study groups when comparing the post-subgingival instrumentation and final visits. However, 3 months after surgery, probing depth (mean difference, MD = 0.31 mm, 95% confidence interval, CI [0.13; 0.49]; p = 0.001) and clinical attachment level (MD = 0.64 mm, 95% CI [0.02; 1.27]; p = 0.044) were significantly lower in the test group.

CONCLUSIONS: The adjunctive use of systemic metronidazole to periodontal surgery has a limited clinical and microbiological impact in the present study, and therefore, its use is not recommended.

CLINICAL RELEVANCE: There are no studies that have evaluated the clinical and microbiological impact of the adjunctive use of systemic metronidazole to periodontal surgery (step 3 of periodontal therapy). The results of the present study do not support the adjunctive use of systemic metronidazole to periodontal surgery.

PMID:35122549 | DOI:10.1007/s00784-022-04392-2