Nevin Manimala

Epidemiol Health. 2021 Feb 28:e2021017. doi: 10.4178/epih.e2021017. Online ahead of print.

ABSTRACT

OBJECTIVES: The effect of age, gender and other demographic factors on relationship between smoking and dry mouth remained unknown. The aim of this study was to measure the relationship between dry mouth and smoking specifically by considering demographic characteristics.

METHODS: In this case-control study, 5640 subjects who were randomly selected from 10000 participants of the second phase of Kerman coronary artery disease risk factors study (KERCADRS) during 2014-2018, were included. Demographic characteristics and smoking frequency in the participants were recorded by a checklist. Six-item Fox questionnaire was filled out by the participants to determine dry mouth as a dependent variable. The interaction terms of daily cigarette smoking with sex, age, educational level, and marital status were entered to the model and non-significant terms were removed by the hierarchical model selection.

RESULTS: It was revealed that 3429 (60.8%) of controls had not dry mouth and 2211 (39.2%) of cases had xerostomia. Statistical analysis revealed that smokers are more likely to have dry mouth in all ages and both sexes (p<0.001). As men get older, the chance of having dry mouth increases more rapidly among them than female smokers (p<0.001). In addition, female smokers have more chance to have dry mouth compared to male smokers (p<0.001).

CONCLUSION: Age, sex, and daily cigarette smoking affect the prevalence of dry mouth in the very complex way. Cigarette smoking was associated with more chance of having dry mouth especially in female smokers.

PMID:33677858 | DOI:10.4178/epih.e2021017

Breast J. 2021 Mar 6. doi: 10.1111/tbj.14216. Online ahead of print.

ABSTRACT

In the last few years, ultrasound-guided vacuum-assisted breast biopsy (US-VABB) has replaced surgical biopsy due to higher diagnostic accuracy and lower patient discomfort, and, at present, an even greater possibility is represented by the new wireless ultrasound-guided VAB device (Wi-UVAB). The purpose of our study is to determine the diagnostic accuracy of this new device in a sizeable representative number of patients. From January 2014 to June 2018, 168 biopsies were performed in our institution using the new Wi-UVAB device. We analyzed sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of biopsies obtained with the new device using surgical results as reference point, following patients for at least one year. In our cohort, we obtained a complete sensitivity of 97.5%, an absolute sensitivity of 94.3%, a complete specificity of 98%, and an absolute specificity of 98%. The positive predictive value of the procedure was 97.5% while the negative predictive value was 98%. The diagnostic accuracy was 98%. The Wi-UVAB is a safe procedure with high diagnostic accuracy, comparable to that of the traditional vacuum-assisted breast biopsy and even higher than that of core needle biopsy (CNB). Moreover, the Wi-UVAB is easy to use and shows low costs as core needle biopsy (CNB).

PMID:33677844 | DOI:10.1111/tbj.14216

Hepatol Res. 2021 Mar 6. doi: 10.1111/hepr.13627. Online ahead of print.

ABSTRACT

AIM: Patients who undergo the Fontan procedure for complex congenital heart disease are prone to liver cirrhosis. Liver stiffness (LS) reflects liver fibrosis stage in patients with chronic viral hepatitis; however, its accuracy in predicting liver fibrosis stage in Fontan patients is controversial. We aimed to clarify the correlation between LS and liver fibrosis stage in Fontan patients.

METHODS: Fifty-eight Fontan patients were prospectively measured for LS with transient elastography. We undertook liver biopsy, cardiac catheterization, and laboratory tests in 22 of these patients (median age, 14.7 years; range, 9.9-32.1 years) with LS > 11.0 kPa (median, 19.2 kPa; range, 12.2-39.8 kPa); these elevated LS values suggest liver cirrhosis.

RESULTS: Histologically, all patients showed mild-to-severe portal and sinusoidal fibrosis but no cirrhosis. Statistically, LS did not predict histological liver fibrosis scores (p = 0.175). Liver stiffness was not correlated with central venous pressure (p = 0.456) or with the hepatic venous pressure gradient (HVPG; p = 0.062), although the p value for HVPG was only slightly above the threshold for significance.

CONCLUSIONS: Fontan patients are prone to developing both portal and sinusoidal fibrosis. Liver stiffness could be influenced by HVPG, and using the conventional cut-off values for LS overestimates and overtreats liver fibrosis in these patients.

PMID:33677839 | DOI:10.1111/hepr.13627

Breast Cancer Res Treat. 2021 Mar 6. doi: 10.1007/s10549-021-06151-5. Online ahead of print.

ABSTRACT

PURPOSE: Our study examined whether common variants of obesity-associated genes FTO, MC4R, BDNF, and CREB1 moderated the effects of a lifestyle intervention on weight change among breast cancer survivors.

METHODS: 151 breast cancer survivors with a body mass index ≥ 25 kg/m² were randomly assigned to a 6-month weight loss intervention or usual care group. Genotyping of FTO rs9939609, MC4R rs6567160, BDNF rs11030104, CREB1 rs17203016 was performed. Linear mixed models were used including the main effects of genotype (assuming a dominant genetic model), treatment arm on weight and percent body fat changes, and genotype by treatment interaction variable. All statistical tests were evaluated against a Bonferroni-corrected alpha of 0.0125.

RESULTS: Women in the intervention group achieved significantly greater weight loss than the usual care group (5.9% vs 0.4%, p < 0.001), regardless of genotype. Changes in weight and percent body fat did not differ significantly between carriers of the FTO rs9939609, MC4R rs6567160, BDNF rs11030104, and CREB1 rs17203016 risk alleles compared to non-carriers (p-interaction > 0.0125 for each single-nucleotide polymorphisms).

CONCLUSIONS: Women who are genetically predisposed to obesity and recently diagnosed with breast cancer may achieve significant and clinically meaningful weight loss through healthy eating and exercise.

CLINICAL TRIAL REGISTRATION: NCT02863887 (Date of Registration: August 11, 2016); NCT02110641 (Date of Registration: April 10, 2014).

PMID:33677781 | DOI:10.1007/s10549-021-06151-5

Hepatol Int. 2021 Mar 7. doi: 10.1007/s12072-021-10162-1. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: Antiviral treatment with necleos(t)ide analogues contributes to histological improvement and virologic response in chronic hepatitis B (CHB) patients. However, whether adding pegylated interferon alpha2a (Peg-IFN-α-2a) can help additional clinical benefit, particularly on fibrosis regression was still unknown.

METHODS: Chronic hepatitis B patients with pre-treatment biopsy-proven Ishak fibrosis score 2, 3 or 4 were randomly assigned to entecavir (ETV) alone or ETV plus Peg-IFN-α-2a (Peg-IFN-α-2a add-on) group (1:2 ratio). Post-treatment liver biopsy was performed at week 78. Fibrosis regression was defined as decrease in Ishak fibrosis score by ≥ 1 stage or predominantly regressive categorized by P-I-R score. Serum HBV DNA levels were assessed at baseline and every 26 weeks, while HBsAg and HBeAg were evaluated at baseline and every 52 weeks.

RESULTS: A total of 218 treatment-naive CHB patients were randomly assigned to ETV alone or Peg-IFN-α-2a add-on group. Totals of 155 patients (ETV alone: Peg-IFN-α-2a add-on, 47:108) were included in statistical analysis. Fibrosis regression rates were 68% (32/47) in the ETV alone and 56% (60/108) in Peg-IFN-α-2a add-on group (p = 0.144). Both groups showed a similar trend of virological suppression during the process of 104-week antiviral therapy (p = 0.132). HBeAg or HBsAg loss or seroconversion rates in the ETV alone group were lower than Peg-IFN-α-2a add-on group though without statistical significance.

CONCLUSIONS: Peg-IFN-α-2a add-on therapy did not yield additional fibrosis regression and virologic response than ETV alone therapy.

PMID:33677771 | DOI:10.1007/s12072-021-10162-1

Int J Colorectal Dis. 2021 Mar 7. doi: 10.1007/s00384-021-03899-6. Online ahead of print.

ABSTRACT

BACKGROUND: The aim of this study was to assess failure rates following nonoperative management of acute diverticulitis complicated by abscess and trends thereof.

METHOD: Pubmed, MEDLINE, EMBASE, CINAHL, Cochrane Library, and Web of Science were systematically searched. Nonoperative management was defined as a combination of nil per os, IV fluids, IV antibiotics, CT scan-guided percutaneous drainage, and total parenteral nutrition. The primary endpoint was failure of nonoperative management defined as persistent or worsening abscess and/or sepsis, development of new complications, such as peritonitis, ileus, or colocutaneous fistula, and urgent surgery within 30-90 days of index admission. Data were stratified by three arbitrary time intervals: 1986-2000, 2000-2010, and after 2010. The primary outcome was calculated for those groups and compared.

RESULTS: Thirty-eight of forty-four eligible studies published between 1986 and 2019 were included in the quantitative synthesis of data (n = 2598). The pooled rate of failed nonoperative management was 16.4% (12.6%, 20.2%) at 90 days. In studies published in 2000-2010 (n = 405), the pooled failure rate was 18.6% (10.5%, 26.7%). After 2000 (n = 2140), the pooled failure rate was 15.3% (10.7%, 20%). The difference was not statistically significant (p = 0.725). After controlling for heterogeneity in the definition of failure of nonoperative management, subgroup analysis yielded the pooled rate of failure of 21.8% (16.1%, 27.4%).

CONCLUSION: This meta-analysis found that failure rates following nonoperative management of acute diverticulitis complicated by abscess did not significantly decrease over the past three decades. The general quality of published data and the level and certainty of evidence produced were low.

PMID:33677750 | DOI:10.1007/s00384-021-03899-6

J Assist Reprod Genet. 2021 Mar 6. doi: 10.1007/s10815-021-02127-y. Online ahead of print.

ABSTRACT

PURPOSE: The purpose of this study is to explore the reproductive outcomes of women with Turner syndrome (TS) in preimplantation genetic testing (PGT) cycles.

METHODS: A retrospective study of 100 controlled ovarian stimulating cycles, 68 TS (sixty-four mosaic Turner syndrome (MTS) and four pure Turner syndrome (PTS)) women underwent PGT was conducted from 2013 to 2018.

RESULTS: Embryo X chromosome abnormal rates of TS women were significantly higher than women with normal karyotype (7.04 vs 1.61%, P<0.01). Cumulative live birth rates (CLBR) after PGT-NGS treatment were lower in TS than control (31.15 vs 45.59%, P<0.05). Clinical pregnancy rates per transfer (CPR), miscarriage rates (MR) and live birth rates per transfer (LBR) remained comparable between TS and control group. Reproductive outcomes (X chromosome abnormal rates, CPR, MR, LBR and CLBR) among low (<10%), medium (10-50%) and high (>50%) level 45,X mosaicism groups were not statistically different.

CONCLUSIONS: To avoid high risk of embryo X chromosome abnormalities, prenatal or preimplantation genetic testing should be recommended to mosaic or pure TS patients.

PMID:33677746 | DOI:10.1007/s10815-021-02127-y

Int J Cardiovasc Imaging. 2021 Mar 7. doi: 10.1007/s10554-021-02191-6. Online ahead of print.

ABSTRACT

Advances in virtual reality have made it possible for clinicians and trainees to interact with 3D renderings of hearts with congenital heart disease in 3D stereoscopic vision. No study to date has assessed whether this technology improved instruction compared to standard 2D interfaces. The purpose of this study was to assess whether stereoscopic virtual reality improves congenital heart disease anatomy education. Subjects in a prospective, blinded, randomized trial completed a pre-test assessing factual and visuospatial knowledge of common atrioventricular canal and were randomized to an intervention or control group based on their score. The intervention group used a 3D virtual reality (VR) headset to visualize a lecture with 3D heart models while the control group used a desktop (DT) computer interface with the same models. Subjects took a post-test and provided subjective feedback. 51 subjects were enrolled, 24 in the VR group & 27 in the DT group. The median score difference for VR subjects was 12 (IQR 9-13.3), compared to 10 (IQR 7.5-12) in the DT group. No difference in score improvement was found (p = 0.11). VR subjects’ impression of the ease of use of their interface was higher than DT subjects (median 8 vs 7, respectively, p = 0.01). VR subjects’ impression of their understanding of the subject matter was higher than desktop subjects (median 7 vs 5, respectively, p = 0.01). There was no statistically significant difference in the knowledge acquisition observed between the stereoscopic virtual reality group and the monoscopic desktop-based group. Participants in virtual reality reported a better learning experience and self-assessment suggesting virtual reality may increase learner engagement in understanding congenital heart disease.

PMID:33677745 | DOI:10.1007/s10554-021-02191-6

Support Care Cancer. 2021 Mar 6. doi: 10.1007/s00520-021-06103-1. Online ahead of print.

ABSTRACT

PURPOSE: Central sensitization (CS)-related symptoms and pain catastrophizing contribute to persistent post-mastectomy pain (PPMP). Pain neuroscience education (PNE) is effective in reducing CS-related symptoms and pain catastrophizing in patients with chronic pain. However, to date, no intervention study of PNE has been conducted to patients with PPMP. This study was aimed to examine whether PNE is more effective than biomedical education (BME) for PPMP.

METHODS: In this retrospective case-control study, 118 patients were included. We intervened different patients at different times as follows: (1) a BME group (n = 58) of patients who received BME combined with physiotherapy and (2) a PNE group (n = 60) of patients who received PNE combined with physiotherapy. One year after surgery, we assessed pain intensity and interference (brief pain inventory [BPI]), CS-related symptoms (central sensitization inventory [CSI]), and pain catastrophizing (pain catastrophizing scale [PCS]). Propensity score matching was used to reduce or minimize selection bias and confounding biases and to make the number of cases in both groups match 1:1.

RESULTS: Propensity score matching generated the BME group (n = 51) and the PNE group (n = 51). The BPI score, CSI score, and PCS score were statistically significantly lower in the PNE group than in the BME group (all, p < 0.05). The effect sizes for the BPI intensity (r = 0.31) were moderate.

CONCLUSIONS: PNE resulted in a better outcome of pain management with less functional disability and CS-related symptoms compared to BME after breast surgery.

PMID:33677717 | DOI:10.1007/s00520-021-06103-1

Trop Anim Health Prod. 2021 Mar 6;53(2):197. doi: 10.1007/s11250-021-02632-3.

ABSTRACT

In the present study, an attempt was made to elucidate the genetic parameters for body weight traits of lambs from Corriedale sheep population at different ages. Data were collected from 6874 lambs born over a span of 49 years from 1969 to 2017. The traits under study included body weight at birth (BW), weaning (WW), 6 months of age (6MW), 9 months of age (9MW) and yearling stage (YW). Data were statistically analyzed using restricted maximum likelihood (REML) algorithm in WOMBAT program. A multi-variate animal model was fitted to the data incorporating season and period of lambing, sex of lamb and litter size as fixed effects. Variance and covariance components were estimated using the animal model after incorporating direct additive genetic effect of animal as random factor. Genetic and phenotypic correlations with corresponding standard errors were also estimated. The heritability estimates for BW, WW, 6MW, 9MW and YW were 0.130 ± 0.023, 0.300 ± 0.029, 0.292 ± 0.030, 0.191 ± 0.025 and 0.169 ± 0.024, respectively. The genetic correlation between different traits under study was high, except between BW and 9MW for which the estimate was moderate. Phenotypic correlation ranged from low to high for different trait combinations. Among different traits under study, only two traits showed moderate heritability i.e. WW and 6MW while heritability of other traits was low. Both these traits showed high correlation with all subsequent traits. Selection programme for Corriedale sheep should be based on WW which is expressed early in life and shall lead to moderate genetic response to selection.

PMID:33677706 | DOI:10.1007/s11250-021-02632-3