Nevin Manimala

J Athl Train. 2021 Jun 29. doi: 10.4085/1062-6050-0026.21. Online ahead of print.

ABSTRACT

CONTEXT: Symptomatic Femoroacetabular Impingement Syndrome (FAIS) is a painful condition that leads to decreased function. It is currently unknown how walking gait changes over time following surgery for FAIS earlier than one year, or how these changes present in females.

OBJECTIVE: The purpose was to determine biomechanical gait differences between females with FAIS/labral tears and controls pre-operatively, and three- and six-months post-operatively.

DESIGN: Case-Control Study.

SETTING: Gait laboratory.

PARTICIPANTS: The study included 18 female participants (n=9 FAIS patients, n=9 controls).

MAIN OUTCOME MEASURES: Between-group comparisons of the Hip Outcome Score activity of daily living subscale (HOSadl) and gait biomechanics were evaluated at pre-operative and three- and six-months post-operative sessions. Statistical parametric mapping was conducted on normalized time-series data.

RESULTS: Pre-operatively, the FAIS group had poor HOSadl scores [Pre-operative: 64.1 (15.4), Controls 100.0 (0), p<0.001;], walked 15% slower, and had several gait differences compared to controls. Three months post-operatively, the FAIS group had greater vGRF (p=0.013), ankle dorsiflexion angles (p=0.021), and external dorsiflexion moment (p=0.012) in midstance, as well as greater knee flexion through the second half of stance (p<0.001). The FAIS group also demonstrated less hip extension (p=0.024) and hip abduction (p=0.010) through the second half of stance, which transitioned into less hip extension (p=0.040) and hip abduction (p=0.025) during the subsequent swing phase. The FAIS improved their HOSadl to 87.6 (7.6) by 6-months post-operatively and had greater dorsiflexion moment (p=0.003) and ankle external rotation during stance (p=0.033). The FAIS patients also showed greater external hip ER moment in late stance (p<0.001).

CONCLUSIONS: The most biomechanical differences between groups occurred 3-months post-operatively, suggesting that female FAIS patients have more post-operative gait compensations in the short term after surgery. By six-month post-operatively, the patient reported outcomes greatly improved and there were few gait differences compared to the control group.

PMID:34185835 | DOI:10.4085/1062-6050-0026.21

J Clin Endocrinol Metab. 2021 Jun 29:dgab468. doi: 10.1210/clinem/dgab468. Online ahead of print.

ABSTRACT

CONTEXT: While adrenal adenomas have been linked with cardiovascular morbidity in convenience samples of patients from specialized referral centers, large-scale population-based data is lacking.

OBJECTIVE: To determine the prevalence and incidence of cardiometabolic disease and assess mortality in a population-based cohort of patients with adrenal adenomas.

DESIGN: Population-based cohort study.

SETTING: Olmsted County, Minnesota.

PATIENTS: Patients diagnosed with adrenal adenomas without overt hormone excess and age- and sex-matched referent subjects without adrenal adenomas.

MAIN OUTCOME MEASURE: Prevalence, incidence of cardiometabolic outcomes, mortality.

RESULTS: Adrenal adenomas were diagnosed in 1,004 patients (58% women, median age 63 years). At baseline, patients with adrenal adenomas were more likely to have hypertension (aOR 1.96, 95% CI 1.58-2.44), dysglycemia (aOR 1.63, 95% CI 1.33-2.00), peripheral vascular disease (aOR 1.59, 95% CI 1.32-2.06), heart failure (aOR 1.64, 95% CI 1.15-2.33), and myocardial infarction (aOR 1.50, 95% CI 1.02-2.22) compared to referent subjects. During median follow-up of 6.8 years, patients with adrenal adenomas were more likely than referent subjects to develop de novo chronic kidney disease(aHR 1.46, 95% CI 1.14-1.86), cardiac arrhythmia(aHR 1.31, 95% CI 1.08-1.58), peripheral vascular disease (aHR 1.28, 95% CI 1.05-1.55), cardiovascular events (aHR 1.33, 95% CI 1.01-1.73), and venous thromboembolic events (aHR 2.15, 95% CI 1.48-3.13). Adjusted mortality was similar between the two groups.

CONCLUSION: Adrenal adenomas are associated with an increased prevalence and incidence of adverse cardiometabolic outcomes in a population-based cohort.

PMID:34185830 | DOI:10.1210/clinem/dgab468

Age Ageing. 2021 Jun 26:afab126. doi: 10.1093/ageing/afab126. Online ahead of print.

ABSTRACT

BACKGROUND: The Hospital Frailty Risk Score (HFRS) has made it possible internationally to identify subgroups of patients with characteristics of frailty from routinely collected hospital data.

OBJECTIVE: To externally validate the HFRS in France.

DESIGN: A retrospective analysis of the French medical information database.

SETTING: 743 hospitals in Metropolitan France.

SUBJECTS: All patients aged 75 years or older hospitalised as an emergency in 2017 (n = 1,042,234).

METHODS: The HFRS was calculated for each patient based on the index stay and hospitalisations over the preceding 2 years. Main outcome measures were 30-day in-patient mortality, length of stay (LOS) >10 days and 30-day readmissions. Mixed logistic regression models were used to investigate the association between outcomes and HFRS score.

RESULTS: Patients with high HFRS risk were associated with increased risk of mortality and prolonged LOS (adjusted odds ratio [aOR] = 1.38 [1.35-1.42] and 3.27 [3.22-3.32], c-statistics = 0.676 and 0.684, respectively), while it appeared less predictive of readmissions (aOR = 1.00 [0.98-1.02], c-statistic = 0.600). Model calibration was excellent. Restricting the score to data prior to index admission reduced discrimination of HFRS substantially.

CONCLUSIONS: HFRS can be used in France to determine risks of 30-day in-patient mortality and prolonged LOS, but not 30-day readmissions. Trial registration: Reference ID on clinicaltrials.gov: ID: NCT03905629.

PMID:34185827 | DOI:10.1093/ageing/afab126

PLoS One. 2021 Jun 29;16(6):e0253606. doi: 10.1371/journal.pone.0253606. eCollection 2021.

ABSTRACT

INTRODUCTION: Impaired lung function is independently associated with higher rates of disability, however, few studies have examined the association between lung function and functional limitation. This study aimed to assess this association and dose-response relationship in older adults.

METHODS: Data from the National Health and Nutrition Examination Survey (2007-2012) was used as a cross-sectional study. Lung function was determined by Forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC). Functional limitation in older adults was identified by six self-reported questions on physical function. 3070 adults aged 60 and over were enrolled in our study. Logistic regression models and restricted cubic spline models were applied to examine the association between lung function and the risk of functional limitation.

RESULTS: FEV1 and FVC were inversely associated with the risk of functional limitation. In the full adjusted model, compared with the lowest tertile of FEV1, the odds ratios (95% confidence intervals) of functional limitation for tertile 2 and tertile 3 were 0.5422 (0.3848-0.7639) and 0.4403 (0.2685-0.7220), and the odds ratios (95% confidence intervals) of functional limitation for tertile 2 and tertile 3 of FVC were 0.5243 (0.3503-0.7848) and 0.3726 (0.2072-0.6698). Furthermore, an inverse association persisted after stratified analysis by gender and sensitivity analysis. Dose-response analyses showed that the odds of functional limitation declined with increase in FEV1 and FVC in a nonlinear manner.

CONCLUSIONS: Lung function was inversely associated with functional limitation among older adults.

PMID:34185814 | DOI:10.1371/journal.pone.0253606

PLoS One. 2021 Jun 29;16(6):e0253889. doi: 10.1371/journal.pone.0253889. eCollection 2021.

ABSTRACT

BACKGROUND: The clinical significance of the quantitative value of antibodies in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection remains mostly unidentified. We investigated the dynamics and clinical implications of the SARS-CoV-2 antibody over time using three automated chemiluminescence immunoassays targeting either nucleocapsids or spikes.

METHODS: A total of 126 specimens were collected from 23 patients with confirmed and indeterminate COVID-19 identified by molecular tests. SARS-CoV-2 antibody index was measured using SARS-CoV2 IgG reagent from Alinity (Abbott) and Access (Beckman Coulter) and SARS-CoV2 Total (IgG + IgM) from Atellica (Siemens).

RESULTS: Three immunoassays showed strong correlations with each other (range of Pearson’ s correlation coefficient (r) = 0.700-0.854, P < 0.001). Eleven (8.7%) specimens showed inconsistencies. SARS-CoV-2 IgG showed a statistically significantly higher value in patients with severe disease than that in non-severe disease patients (P < 0.001) and was significantly associated with clinical markers of disease severity.

CONCLUSION: The quantitative value of the SARS-CoV-2 IgG antibody measured using automated immunoassays is a significant indicator of clinical severity in patients with COVID-19.

PMID:34185813 | DOI:10.1371/journal.pone.0253889

PLoS One. 2021 Jun 29;16(6):e0253920. doi: 10.1371/journal.pone.0253920. eCollection 2021.

ABSTRACT

To better understand age-related disparities in US maternal mortality, we analyzed 2016-2017 vital statistics mortality data with cause-of-death literal text (actual words written on the death certificate) added. We created a subset of confirmed maternal deaths which had pregnancy mentions in the cause-of-death literals. Primary cause of death was identified and recoded using cause-of-death literals. Age-related disparities were examined both overall and by primary cause. Compared to women <35, the 2016-2017 US maternal mortality rate was twice as high for women aged 35-39, four times higher for women aged 40-44, and 11 times higher for women aged 45-54 years. Obstetric hemorrhage was the leading cause of death for women aged 35+ with rates 4 times higher than for women <35, followed by postpartum cardiomyopathy with a 3-fold greater risk. Obstetric embolism, eclampsia/preeclampsia, and Other complications of obstetric surgery and procedures each had a two-fold greater risk of death for women aged 35+. Together these 5 causes of death accounted for 70.9% of the elevated maternal mortality risk for women aged 35+. The excess maternal mortality risk for women aged 35+ was focused among a few causes of death and much of this excess mortality is preventable. Early detection and treatment, as well as continued care during the postpartum year is critical to preventing these deaths. The Alliance for Innovation on Maternal Health has promulgated patient safety bundles with specific interventions that health care systems can adopt in an effort to prevent these deaths.

PMID:34185810 | DOI:10.1371/journal.pone.0253920

PLoS One. 2021 Jun 29;16(6):e0253581. doi: 10.1371/journal.pone.0253581. eCollection 2021.

ABSTRACT

PURPOSE: Associations between rheumatic heart disease (RHD) in pregnancy and fetal outcomes are relatively unknown. This study aimed to review rates and predictors of major adverse fetal outcomes of RHD in pregnancy.

METHODS: Medline (Ovid), Pubmed, EMcare, Scopus, CINAHL, Informit, and WHOICTRP databases were searched for studies that reported rates of adverse perinatal events in women with RHD during pregnancy. Outcomes included preterm birth, intra-uterine growth restriction (IUGR), low-birth weight (LBW), perinatal death and percutaneous balloon mitral valvuloplasty intervention. Meta-analysis of fetal events by the New-York Heart Association (NYHA) heart failure classification, and the Mitral-valve Area (MVA) severity score was performed with unadjusted random effects models and heterogeneity of risk ratios (RR) was assessed with the I2 statistic. Quality of evidence was evaluated using the GRADE approach. The study was registered in PROSPERO (CRD42020161529).

FINDINGS: The search identified 5949 non-duplicate records of which 136 full-text articles were assessed for eligibility and 22 studies included, 11 studies were eligible for meta-analyses. In 3928 pregnancies, high rates of preterm birth (9.35%-42.97%), LBW (12.98%-39.70%), IUGR (6.76%-22.40%) and perinatal death (0.00%-9.41%) were reported. NYHA III/IV pre-pregnancy was associated with higher rates of preterm birth (5 studies, RR 2.86, 95%CI 1.54-5.33), and perinatal death (6 studies, RR 3.23, 1.92-5.44). Moderate /severe mitral stenosis (MS) was associated with higher rates of preterm birth (3 studies, RR 2.05, 95%CI 1.02-4.11) and IUGR (3 studies, RR 2.46, 95%CI 1.02-5.95).

INTERPRETATION: RHD during pregnancy is associated with adverse fetal outcomes. Maternal NYHA III/IV and moderate/severe MS in particular may predict poor prognosis.

PMID:34185797 | DOI:10.1371/journal.pone.0253581

PLoS One. 2021 Jun 29;16(6):e0253458. doi: 10.1371/journal.pone.0253458. eCollection 2021.

ABSTRACT

L-Dopa decarboxylase (DDC) is the most significantly co-expressed gene with ACE2, which encodes for the SARS-CoV-2 receptor angiotensin-converting enzyme 2 and the interferon-inducible truncated isoform dACE2. Our group previously showed the importance of DDC in viral infections. We hereby aimed to investigate DDC expression in COVID-19 patients and cultured SARS-CoV-2-infected cells, also in association with ACE2 and dACE2. We concurrently evaluated the expression of the viral infection- and interferon-stimulated gene ISG56 and the immune-modulatory, hypoxia-regulated gene EPO. Viral load and mRNA levels of DDC, ACE2, dACE2, ISG56 and EPO were quantified by RT-qPCR in nasopharyngeal swab samples from COVID-19 patients, showing no or mild symptoms, and from non-infected individuals. Samples from influenza-infected patients were analyzed in comparison. SARS-CoV-2-mediated effects in host gene expression were validated in cultured virus-permissive epithelial cells. We found substantially higher gene expression of DDC in COVID-19 patients (7.6-fold; p = 1.2e-13) but not in influenza-infected ones, compared to non-infected subjects. dACE2 was more elevated (2.9-fold; p = 1.02e-16) than ACE2 (1.7-fold; p = 0.0005) in SARS-CoV-2-infected individuals. ISG56 (2.5-fold; p = 3.01e-6) and EPO (2.6-fold; p = 2.1e-13) were also increased. Detected differences were not attributed to enrichment of specific cell populations in nasopharyngeal tissue. While SARS-CoV-2 virus load was positively associated with ACE2 expression (r≥0.8, p<0.001), it negatively correlated with DDC, dACE2 (r≤-0.7, p<0.001) and EPO (r≤-0.5, p<0.05). Moreover, a statistically significant correlation between DDC and dACE2 expression was observed in nasopharyngeal swab and whole blood samples of both COVID-19 and non-infected individuals (r≥0.7). In VeroE6 cells, SARS-CoV-2 negatively affected DDC, ACE2, dACE2 and EPO mRNA levels, and induced cell death, while ISG56 was enhanced at early hours post-infection. Thus, the regulation of DDC, dACE2 and EPO expression in the SARS-CoV-2-infected nasopharyngeal tissue is possibly related with an orchestrated antiviral response of the infected host as the virus suppresses these genes to favor its propagation.

PMID:34185793 | DOI:10.1371/journal.pone.0253458

PLoS One. 2021 Jun 29;16(6):e0253270. doi: 10.1371/journal.pone.0253270. eCollection 2021.

ABSTRACT

BACKGROUND: Endometriosis is associated with increased risk of clear cell ovarian cancer and has even suggested being an etiological factor for this cancer. Association between endometriosis and extraovarian clear cell cancers is unclear. This study aimed to assess the association between surgically diagnosed endometriosis and risk of extraovarian clear cell cancers according to the type of endometriosis (i.e., ovarian, peritoneal, and other endometriosis) and the site of clear cell cancer.

METHODS: In this register-based historic cohort study we identified all women with surgically diagnosed endometriosis from the Finnish Hospital Discharge Registry 1987-2012. Data on extraovarian clear cell cancers of these women were obtained from the Finnish Cancer Registry. The follow-up started January 1st, 2007 or at endometriosis diagnosis (if later), and ended at emigration, death or on the December 31st, 2014. Standardized incidence ratios were calculated for each site of clear cell carcinoma (intestine, kidney, urinary tract, gynecological organs other than ovary), using the Finnish female population as reference.

RESULTS: The endometriosis cohort consisted of 48,996 women, including 22,745 women with ovarian and 19,809 women with peritoneal endometriosis. Altogether 23 extraovarian clear cell cancers were observed during 367,386 person-years of follow-up. The risk of extraovarian clear cell cancer was not increased among all women with surgically diagnosed endometriosis (standardized incidence ratio 0.89, 95% confidence interval 0.56-1.33) nor in different types of endometriosis. The incidence of clear cell cancer in any specific site was not increased either.

CONCLUSIONS: The risk of extraovarian clear cell cancers in women with surgically diagnosed endometriosis is similar to that in the general population in Finland.

PMID:34185779 | DOI:10.1371/journal.pone.0253270

Psychiatr Danub. 2021 Summer;33(2):240-247. doi: 10.24869/psyd.2021.240.

ABSTRACT

OBJECTIVE: The COVID-19 pandemic process caused many physiological and psychological effects on individuals. This study aims to examine the ruminative thinking and alexithymia levels of people in the COVID-19 pandemic process.

METHODS: The descriptive, cross-sectional, and the correlational designed study was conducted with 852 people in ?stanbulTurkey during the COVID-19 pandemic process between March and May 2020. The data of the research was collected with the Sociodemographic Form Toronto Alexithymia Scale and Ruminative Thought Style Questionnaire.

RESULTS: It was found that the average of ruminative thought score of the people was 92.49±19.89 and the alexithymia score average was 71.76±13.70. A positive and significant relationship was found between the Ruminative Thought Style Questionnaire and the Toronto Alexithymia Scale and subscale scores (p<0.05). According to the results, ruminative thinking levels were affected by 12% alexithymia level and 9% time spent on conversation. A statistically significant relationship was found between rumination, alexithymia, and its sub-dimensions and the number of times people spend for conversation during the day and the number of people they live with (p<0.05). It was determined that those living with family/friends were lower than those who were alone, and those with good communication in relationships had lower rumination and alexithymia (p<0.05).

CONCLUSION: Care should be taken against alexithymia and rumination during the COVID-19 pandemic process, and attention should be given to interpersonal relationships, conversation, and communication in the quarantine process.

PMID:34185756 | DOI:10.24869/psyd.2021.240