Nevin Manimala

J Occup Environ Med. 2021 Jul 27. doi: 10.1097/JOM.0000000000002336. Online ahead of print.

ABSTRACT

OBJECTIVE: To investigate whether health care workers’ (HCWs) return to work (RTW) after coronavirus disease 2019 (COVID-19) was associated with time to a negative viral detection test.

METHODS: To evaluate the association of return to work (RTW) with an undetectable RT-PCR adjusting for different factors.

RESULTS: 375 HCWs who required medical leave for COVID-19 at a hospital in Madrid. Multivariable analyses confirmed the association of delayed RTW with interval to negative PCR (ORadj 1.12, 95% CI 1.08, 1.17) as well as age, sex, and nursing staff and clinical support services compared to physicians. A predictive model based on those variables is proposed, which had an area under the receiver operating curve of 0.82.

CONCLUSIONS: Delayed RTW was associated with longer interval to a negative RT-PCR after symptom onset, adjusting for occupational category, age, and sex.

PMID:34325436 | DOI:10.1097/JOM.0000000000002336

ORL J Otorhinolaryngol Relat Spec. 2021 Jul 29:1-8. doi: 10.1159/000516592. Online ahead of print.

ABSTRACT

INTRODUCTION: Thyroglossal duct cysts (TGDCs) are the most common form of congenital neck cysts. They may become infected causing dysphagia or respiratory distress. Accordingly, the treatment is always surgical removal.

OBJECTIVES: The objectives of this article were to examine complications following TGDC excision by surgical specialty, demographics, and comorbid conditions.

METHODS: A retrospective review of the National Surgical Quality Improvement Program database was performed. Pediatric cases from January 1, 2014 to November 1, 2015 with a current procedure terminology code of 60,280 (excision of TGDC or sinus) were included. Statistical analysis was performed to assess associations between complications and surgical specialty, demographics, and comorbidities.

RESULTS: Of the 867 cases that met inclusion criteria, the median age was 4 years. There were 448 males (52.3%) and 408 females (47.7%). Thirty-six patients (4.2%) experienced at least one 30-day complication. The most predominant complications were reoperation (19 patients, 2.2%), readmission (18 patients, 2.1%), and surgical site infection (16 patients, 1.9%). There was no statistically significant difference between complications and surgical specialty. In those experiencing a complication, there was a statistically significant difference between males (86.1%) and females (13.9%). Of patients with at least one comorbidity, 36.67% had a complication, while 17.22% did not have a complication. There was also a statistically significant difference in the percentage of patients with a past medical history of asthma between those with at least one complication (16.67%) compared to those without any complications (4.76%).

CONCLUSIONS: excision is a generally safe procedure across surgical specialties. There is a higher complication rate in males compared to females as well as those with a history of at least one medical comorbidity and those with asthma. The most common 30-day complications are reoperation, readmission, and surgical site infection.

PMID:34325433 | DOI:10.1159/000516592

Eur Neurol. 2021 Jul 29:1-10. doi: 10.1159/000517584. Online ahead of print.

ABSTRACT

BACKGROUND: Previous studies have shown inconsistent results for associations between vitamin D and risk of stroke. We gathered the existing published articles and conducted this meta-analysis with the aim to explore the association between vitamin D and risk of stroke.

METHODS: We searched for articles exploring the association between vitamin D and risk of stroke and published before April 2021 in the following databases: PubMed, Web of Science, MEDLINE, EMBASE, and Google Scholar. All statistical analyses were made using STATA 12.0 software. Q test and I2 were applied to examine heterogeneities between studies.

RESULTS: For the association between serum levels of 25(OH) vitamin D and risks of stroke, the present analysis included 20 cohort studies (including 213,276 participants) and a case-control analysis (including 13,642 participants). Additionally, the analysis included 15 studies (including 41,146 participants given vitamin D supplementation and 41,163 participants given placebo) to evaluate the influence of vitamin D supplementation on risk of stroke. Higher circulating levels of 25(OH) vitamin D were associated with a reduced risk of stroke (odds ratio/relative risk = 0.78, 95% confidence interval [CI]: 0.70-0.86, I2 = 41.5%, p = 0.025). However, the present analysis showed that vitamin D supplementation did not influence the risk of stroke (hazard ratio = 1.05, 95% CI: 0.96-1.14, I2 = 2.3%, p = 0.425).

CONCLUSIONS: Our analysis indicated that lower circulating level of vitamin D was associated with an elevated risk of stroke, but extra supplement of vitamin D failed to show benefit in decreasing the risk of stroke. Further research and study are also needed to show the role of vitamin D in relation to stroke.

PMID:34325429 | DOI:10.1159/000517584

Gerontology. 2021 Jul 29:1-8. doi: 10.1159/000514678. Online ahead of print.

ABSTRACT

INTRODUCTION: Anemia is a common condition encountered in acute ischemic stroke, and only a few pieces of evidence has been produced suggesting its possible association with short-term mortality have been produced. The study sought to assess whether admission anemia status had any impact on short-term clinical outcome among oldest-old patients with acute ischemic stroke.

MATERIALS AND METHODS: A retrospective review of Electronic Medical Recording System was performed in 2 tertiary hospitals. Data, from the oldest-old patients aged > = 80 years consecutively admitted with a diagnosis of acute ischemic stroke between January 1, 2015, and December 31, 2019, were analyzed. Admission hemoglobin was used as indicator for anemia and severity. Univariate and multivariate regression analyses were used to compare in-hospital mortality and length of in-hospital stay in different anemia statuses and normal hemoglobin patients.

RESULTS: A total of 705 acute ischemic stroke patients were admitted, and 572 were included in the final analysis. Of included patients, 240 of them were anemic and 332 nonanemic patients. A statistical difference between the 2 groups was found in in-hospital mortality (p < 0.001). After adjustment for baseline characteristics, the odds ratio value of anemia for mortality were 3.91 (95% confidence intervals (CI) 1.60-9.61, p = 0.003) and 7.15 (95% CI: 1.46-34.90, p = 0.015) in moderate and severely anemic patients, respectively. Similarly, length of in-hospital stay was longer in anemic patients (21.64 ± 6.17 days) than in nonanemic patients (19.08 ± 5.48 days, p < 0.001).

CONCLUSIONS: Increased severity of anemia may be an independent risk factor for increased in-hospital mortality and longer length of stay in oldest-old patients with acute ischemic stroke.

PMID:34325428 | DOI:10.1159/000514678

Parkinsonism Relat Disord. 2021 Jul 24;90:8-14. doi: 10.1016/j.parkreldis.2021.07.021. Online ahead of print.

ABSTRACT

INTRODUCTION: Levodopa-induced dyskinesia is a complication of levodopa therapy and negatively impacts the quality of life of patients. We aimed to elucidate white matter alterations in Parkinson’s disease with levodopa-induced dyskinesia using advanced diffusion magnetic resonance imaging techniques.

METHODS: The enrolled subjects included 26 clinically confirmed Parkinson’s disease patients without levodopa-induced dyskinesia, 25 Parkinson’s disease patients with levodopa-induced dyskinesia, and 23 healthy controls. Subjects were imaged using a 3-T magnetic resonance scanner. Diffusion tensor imaging, diffusion kurtosis imaging, and neurite orientation dispersion and density imaging findings were compared between groups with a group-wise whole brain approach and a region-of-interest analysis for each white matter tract. Additionally, logistic regression analysis was used to calculate odds ratios for levodopa-induced dyskinesia.

RESULTS: Group-wise tract-based spatial statistical analysis revealed significant white matter differences in isotropic diffusion, complexity, or heterogeneity, and neurite density between healthy controls and Parkinson’s disease patients without levodopa-induced dyskinesia and between patients with and without levodopa-induced dyskinesia. Region-of-interest analysis revealed similar alterations using a group-wise whole-brain approach in the external capsule, inferior fronto-occipital fasciculus, inferior longitudinal fasciculus, and uncinate fasciculus. These tracts had an odds ratio of approximately 2.3 for the presence of levodopa-induced dyskinesia.

CONCLUSIONS: Our findings suggest that Parkinson’s disease with levodopa-induced dyskinesia produces less white matter microstructural disruption, especially in temporal lobe fibers, than Parkinson’s disease without levodopa-induced dyskinesia. These fibers has a more than 2-fold odds ratio for the presence of levodopa-induced dyskinesia and might be associated with the pathogenesis of the sequela.

PMID:34325387 | DOI:10.1016/j.parkreldis.2021.07.021

Curr Opin Pharmacol. 2021 Jul 26;60:34-39. doi: 10.1016/j.coph.2021.06.006. Online ahead of print.

ABSTRACT

Biophysically realistic computer modeling of neuronal microcircuitry has served as a testing ground for hypotheses related to the structure and function of different brain microcircuits. Recent advances in single-cell transcriptomics provide snapshots of a neuron’s molecular state and have demonstrated that cell-specific genetic markers engineer the electrophysiological properties of a neuron. Integrating these molecular details with biophysical modeling can allow unprecedented mechanistic insights. In this opinion review, we consider systems biology-based strategies involving statistical deconvolution and gene ontology to integrate the two approaches. We foresee that this integration will infer the nonlinear interactions between the transcriptomically detailed neurons in different brain states. For an initial assessment of these integrative strategies, we recommend testing them on a penetrant phenotype such as epilepsy or a basic organism model such as Caenorhabditis elegans.

PMID:34325379 | DOI:10.1016/j.coph.2021.06.006

Clin Neurol Neurosurg. 2021 Jul 10;208:106818. doi: 10.1016/j.clineuro.2021.106818. Online ahead of print.

ABSTRACT

OBJECTIVE: The aim of the study is to compare the efficacy and safety of angioplasty alone with acute stenting for acute tandem occlusions (TO) due to internal carotid artery atherosclerotic.

METHODS: We identified 112 patients who underwent an endovascular treatment (EVT) for acute tandem internal carotid artery occlusions from the prospectively maintained registries 5 comprehensive stroke centers. The study cohort included 75 patients with underlying atherosclerotic lesion of the extracranial internal carotid artery, forty-five in the balloon angioplasty (BA) alone group and 30 in the acute stenting (AS) group. Using propensity score matching analysis, forty-four patients were matched. Clinical characteristics and outcome data were compared between two groups.

RESULTS: The successful reperfusion immediately post procedure [72.7% (16/22) vs. 77.3% (17/22), P = 1.0] and 90-days good functional outcome [54.5% (12/22) vs. 59.1% (13/22), P = 0.761] were not significantly different between the BA group and AS group. There was also no significant difference in the rate of symptomatic intracranial hemorrhage [13.6% (3/22) vs. 9.1% (2/22), P = 1.00] and restenosis of ICA (>50%)[27.3% (6/22) vs. 22.7% (5/22), P = 0.728] between 2 groups. Patients in the BA group appear to have a numerically lower rate of asymptomatic intracranial hemorrhage [40.9% (9/22) vs. 50% (11/22), P = 0.545] and mortality [0 vs. 9.1% (2/22), P = 0.488] than in the AS group, although there were not statistically significant.

CONCLUSION: Among TO patients with etiology of large vessel atherosclerosis, no statistical differences in outcome are identified between balloon angioplasty alone versus acute stenting. Future randomized controlled trials are warranted.

PMID:34325333 | DOI:10.1016/j.clineuro.2021.106818

Lung Cancer. 2021 Jul 17;159:111-116. doi: 10.1016/j.lungcan.2021.07.003. Online ahead of print.

ABSTRACT

OBJECTIVE: The association between the morphological characteristics and survival outcome of lung cancer associated with cystic airspaces (LCCAs) is unclear due to rarity of this disease. The current study attempted to compare the survival outcome between LCCAs and non-LCCAs and investigate the correlation between imaging features and prognosis of LCCA.

METHOD: Of 10,835 patients diagnosed with non-small cell lung carcinoma (NSCLC) between January 2015 and December 2016, 123 patients with LCCA were included. The non-LCCA group comprised 3136 patients with primary solitary adenocarcinoma or squamous cell lung cancer. Propensity score matching (PSM) was performed for age, sex, tumor size, tumor stage, and lymph node involvement in a 1:1 ratio between the LCCAs and non-LCCAs, and the correlation between radiological features and recurrence-free survival (RFS) was analyzed.

RESULT: The computed tomography (CT) lesion size was found to be higher in all LCCA subtypes, particularly in Type III (a cystic airspace with a mural nodule) and Type IV (mixed) LCCAs (3.09 and 3.65 cm, respectively), than in non-LCCAs (2 cm) after PSM. Three-year RFS in the LCCA group was higher than in the non-LCCA group (Type I- IV LCCAs: 100%, 84%, 77% and 83%, respectively vs. non-LCCAs: 77%). However, statistically significant difference was only found in comparison between LCCA Type I (thin-walled) and non-LCCA groups (P = 0.026). Type III lung cancer exhibited the worst survival among all four LCCA subtypes.

CONCLUSIONS: The CT lesion size and pathologic tumor size varied significantly across LCCAs. Type I LCCAs exhibited better survival than non-LCCAs, whereas Type III LCCAs exhibited the worst survival rate among the four LCCA subtypes.

PMID:34325317 | DOI:10.1016/j.lungcan.2021.07.003

J Chromatogr B Analyt Technol Biomed Life Sci. 2021 Jul 3;1179:122820. doi: 10.1016/j.jchromb.2021.122820. Online ahead of print.

ABSTRACT

Untargeted metabolomics approach based on ultra high performance liquid chromatography coupled with high resolution mass spectrometry (UHPLC-HRMS) was used to investigate the differences in cage duck eggs and sea duck eggs that from different poultry breeding system, which could help to combat fraud within the egg industry. High dimensions and complex data collected by UHPLC-HRMS were analyzed by multivariate statistical analysis. Identification model of sea duck eggs based on was established. After matching with the chemical databases, four potential markers were putatively matched. Further analysis showed that three of them were confirmed by reference standards. All these three markers (n-behenoyl-d-erythro-sphingosine, 1,2-dipalmitoyl-sn-glycero-3-phosphocholine and n-nervonoyl-d-erythro-sphingosine) have higher content in sea duck eggs. The quantitative analysis showed that the content difference of three markers in farm samples were in highly consistent with the concentration changes measured in experimental samples, which indicate that these three markers are reliable.

PMID:34325310 | DOI:10.1016/j.jchromb.2021.122820

J Mech Behav Biomed Mater. 2021 Jun 26;122:104654. doi: 10.1016/j.jmbbm.2021.104654. Online ahead of print.

ABSTRACT

AIM: The aim of this study was to evaluate the fracture resistance of cervical lesion centered access cavity restored with short glass fibre reinforced resin materials in human mandibular premolars.

MATERIALS AND METHODS: Sixty freshly extracted human mandibular premolars were collected and assigned to positive control group (G1- Intact teeth) and other experimental groups (G2, G3. G4, G5, G6), Traditional Access Cavity(TAC) and Cervical Lesion Centered Access Cavity(CLCAC). Following endodontic therapy, samples were grouped accordingly, G2-CLCAC without restoration (Negative Control), G3-CLCAC restored with conventional nano-hybrid composite (Tetric-N-Ceram), G4-TAC restored with short glass fibre reinforced resin composite (Ever-X Posterior), G5-CLCAC restored with short glass fibre reinforced resin composite (Ever-X Posterior), G6- CLCAC restored with individually formed unidirectional fibre-reinforced post (Everstick post) and short glass fibre-reinforced resin composite (Ever-X Posterior). The samples were thermocycled (35 °C/28s, 15 °C/2s, 35 °C/28s, 45 °C/2s/10,000 cycles) and cyclically fatigued(2,50,000 cycles/15-30N/2 Hz) and then subsequently loaded to failure. The mean load to fracture (Newtons) were statistically analyzed using one-way ANOVA and Tukey’s post HOC test and failure mode analysis was also done.

RESULTS: The mean fracture resistance of the CLCAC design restored with fibre reinforced materials was higher when compared to the TAC design but the difference was not statistically significant. The negative control group (CLCAC without restoration) showed significantly the least fracture resistance (P < 0.05) when compared to all the other groups except for group 3 (CLCAC restored with conventional composites).

CONCLUSIONS: Within the limitations of the study, it can be concluded that short glass fibre reinforced resin composites improved the fracture resistance of endodontically treated mandibular premolars irrespective of the type of access cavity designs. Favourable fractures were seen more in cervical lesion centered access cavity restored with short glass fibre reinforced composite materials. Nevertheless, the applicability of this design in multirooted teeth, canal cleanliness efficacy, and long term clinical performance are yet to be explored to complement this new access design.

PMID:34325237 | DOI:10.1016/j.jmbbm.2021.104654