Nevin Manimala

J Sex Med. 2021 Jul 16:S1743-6095(21)00529-4. doi: 10.1016/j.jsxm.2021.06.004. Online ahead of print.

ABSTRACT

BACKGROUND: Chemotherapeutics, one of the standard treatment options for cancer worldwide, have various adverse effects, including erectile dysfunction (ED).

AIM: To investigate erectile function in an animal model after administration of the anticancer agent oxaliplatin (L-OHP).

METHODS: Male Wistar/ST rats were divided into 2 groups: L-OHP rats (n = 21), which were intravenously administered L-OHP (4 mg/kg; twice a week for 4 weeks), and Control rats (n = 21), which were injected with the same volume of 5% glucose solution, using the same dosing schedule. At the end of the study period, erectile function was evaluated by measuring intracavernous pressure (ICP) and mean arterial pressure (MAP) after cavernous nerve stimulation (n = 9-10). Endothelial function was evaluated with an isometric tension study using corpus cavernosum strips (n = 11). Western blot analysis was used to assess neuronal nitric oxide (nNOS) and endothelial NO synthase (eNOS) protein levels (n = 7). Real-time quantitative polymerase chain reaction (qRT-PCR) was used to assess the expression of inflammation- and oxidative stress-related markers (nicotinamide adenine dinucleotide phosphate oxidase-1, p22^phox, interleukin [IL]-6, and nuclear factor-kappa B) (n = 6). Statistical significance was determined using the Student’s t-test.

OUTCOMES: The L-OHP group had a significantly lower ICP:MAP ratio than the control group (P < .05). Compared to the Control group, the L-OHP group exhibited significantly lower responses to ACh and eNOS protein levels and significantly higher inflammatory biomarker levels.

CLINICAL TRANSLATION: The results based on this animal model indicate that use of the anticancer agent L-OHP should be considered as a risk factor for ED occurring via reduction of NO bioavailability in humans; our results provide possible treatment strategies for maintaining the erectile function of cancer survivors.

STRENGTHS AND LIMITATIONS: Our study showed that the anticancer agent L-OHP has the propensity to cause ED in rats. A major limitation of this study is the lack of an established cure for ED associated with L-OHP and the lack of clinical evidence.

CONCLUSIONS: L-OHP causes ED in rats via reduction of NO bioavailability caused by endothelial dysfunction. Kataoka T, Mori T, Suzuki J, et al. Oxaliplatin, an Anticancer Agent, Causes Erectile Dysfunction in Rats due to Endothelial Dysfunction. J Sex Med 2021;XX:XXX-XXX.

PMID:34281797 | DOI:10.1016/j.jsxm.2021.06.004

Int Orthod. 2021 Jul 16:S1761-7227(21)00082-6. doi: 10.1016/j.ortho.2021.06.003. Online ahead of print.

ABSTRACT

BACKGROUND: Micro-osteoperforation (MOP), a minimally invasive technique for accelerating the rate of orthodontic tooth movement has been research extensively, but with varied clinical results.

OBJECTIVE: To compare the efficacy of one-time versus two-time micro-osteoperforation on the rate of maxillary canine retraction, its influence on anchorage loss, canine angulation and the levels of interleukin (IL-1β) in gingival crevicular fluid (GCF).

MATERIALS AND METHODS: The split-mouth study included 16 patients in which the left and right sides were randomly allocated to the control side (one-time MOP) and experimental side (two-time MOP). MOP was performed on both sides distal to the maxillary canines and canine retraction was carried out using NiTi closed coil springs (150gm) and direct anchorage with miniscrew implants. The second MOP was performed on experimental side one month after the first MOP. The rate of canine movement was assessed using 3D model superimposition over a period of six months. The type of tooth movement, anchorage loss and levels of IL-1β were also evaluated.

RESULTS: Sixteen patients (mean age, 17.87±3.34 years) were analysed for a rate of canine retraction, anchorage loss, and type of tooth movement, while 15 patients were analysed for IL-1β. The rate was significantly higher on two-time MOP side after two months (P<0.001). No statistical difference was found in anchorage loss and controlled tipping of canines was observed. The IL-1β levels immediately after 2^nd MOP were significantly higher than 1^st MOP (P<0.001).

CONCLUSION: The two-time intervention of MOP is more efficacious than one-time MOP in accelerating tooth movement.

PMID:34281788 | DOI:10.1016/j.ortho.2021.06.003

Chin J Traumatol. 2021 May 21:S1008-1275(21)00086-9. doi: 10.1016/j.cjtee.2021.05.002. Online ahead of print.

ABSTRACT

PURPOSE: The use of tourniquet in orthopedic surgeries facilitates operations by establishing a bloodless surgical field. However, many complications following the use of tourniquets have been reported. Tourniquet pain is the most common complication. This study aimed to find the actual incidence of pain associated with tourniquet use in orthopedic surgery and the various factors.

METHODS: It is a prospective observational study conducted on 132 consecutive cases. Patients aged between 18 and 70 years with musculoskeletal problems of the forearm and leg requiring surgery were included in the study. Patients with open injuries or contraindications such as diabetes mellitus, compromised circulatory states, neurological deficit, compartment syndrome and unable to give informed consent were excluded. The parameters assessed included duration of tourniquet use, tourniquet pressure, type of anesthesia, any interval release of the tourniquet and reapplication after a reperfusion period, whether upper or lower limb surgery, severity of tourniquet pain, timing of tourniquet release and complications. Chi-square and non-parametric Mann-Whitney U test were used for data analysis.

RESULTS: In upper limb surgeries, if duration of surgery was less than 60 min, 14 (51.8%) cases experienced tourniquet pain and 13 (48.1%) had no pain, and if duration of surgery was more than 60 min, 24 (60.0%) had pain and 16 (40.0%) experienced no pain. In lower limb surgeries if duration of surgery was less than 60 min, 2 (7.7%) experienced pain and 24 (92.3%) had no pain, and if duration of surgery was more than 60 min, 14 (35.8%) experienced pain and 25 (64.8%) had no pain. Degree of tourniquet pain increases with increase in the duration of surgery. Statistically there was significant association between tourniquet inflation time and tourniquet pain in both upper and lower limbs (p = 0.034 and 0.024, respectively) CONCLUSION: Incidence of tourniquet pain was in direct proportion to the duration of tourniquet use and was higher in cases with regional anesthesia. Other risk factors assessed including tourniquet pressure, upper or lower limb surgery, tourniquet release time and interval had no significant contribution to the incidence or severity of tourniquet pain.

PMID:34281783 | DOI:10.1016/j.cjtee.2021.05.002

Clin Lung Cancer. 2021 Jun 24:S1525-7304(21)00158-3. doi: 10.1016/j.cllc.2021.06.007. Online ahead of print.

ABSTRACT

BACKGROUND: Video-assisted thoracic surgery (VATS) has been widely used in the surgical treatment of thoracic diseases, and it suggested surgical and oncological advantages compared with open surgery. However, reports on the application of VATS in surgery of small cell lung cancer (SCLC) are scarce. This study aimed to explore the advantages and disadvantages of different surgical approaches in the treatment of pathological stage T1(pT1) SCLC in terms of safety, clinical outcomes, and lymph node dissection.

PATIENTS AND METHODS: Patients who underwent lobectomy for pT1 SCLC between January 2014 and September 2017 were identified from the National Collaborative Lung Cancer Database (LinkDoc Database). The patients were stratified based on the surgery approach (VATS or open lobectomy). Perioperative outcomes and long-term survival were analyzed using SPSS software.

RESULTS: A total of 169 patients with pT1 SCLC met the criteria and were enrolled for this study, including 110 cases of VATS lobectomies and 59 cases of open lobectomies. VATS lobectomy was associated with less blood loss than open surgery (168.1 ± 237.4 vs. 340.0 ± 509.8 mL, P = .002). Open lobectomy harvested more N2 LNs (11.8 ± 8.2 vs. 8.4 ± 5.8, P = .048) and identified more metastasis positive LNs (3.1 ± 6.0 vs. 1.4 ± 3.0, P = .050). Open lobectomy associated with longer overall survival (OS) but has no statistical difference (23.4 ± 13.2 vs. 20.2 ± 10.9, P = .070).

CONCLUSION: Open lobectomy had better lymph node dissection results, and comparable postoperative complications, postoperative hospital stay, and OS to VATS lobectomy. Further studies may still be needed to confirm the recommendation of thoracoscopic approach as a routine surgical procedure for operable SCLC, and until then, open surgery should still be considered.

PMID:34281774 | DOI:10.1016/j.cllc.2021.06.007

J Fr Ophtalmol. 2021 Jul 16:S0181-5512(21)00329-6. doi: 10.1016/j.jfo.2021.01.025. Online ahead of print.

ABSTRACT

INTRODUCTION: The goal of our study was to create a cross-cultural adaptation of the questionnaire « National Eye Institute Visual Function Questionnaire » (NEI-VFQ-25) for the Tunisian population (Tu-VFQ-25) and to test its psychometric properties in a group of patients with chronic uveitis.

PATIENTS AND METHODS: The study consisted of two steps. The first was translation of the NEI-VFQ-25 and its cross-cultural adaptation to the Tunisian dialect (Tu-VFQ-25) according to the guidelines of Beaton et al. The second step consisted of studying the psychometric properties of the Tu-VFQ-25. Enrolled patients, diagnosed with chronic uveitis, were interviewed face-to-face by two different investigators, followed by a telephone interview by the first investigator 48hours later. Feasibility, internal consistency and reproducibility of the Tu-VFQ-25 were then tested using statistical methods.

RESULTS: The mean time taken to administrate the questionnaire to each of the 45 patients was 11min 40 s (± 2min 24 s). Internal consistency was acceptable, with Cronbach’s alpha coefficients above 0.7 except the “Ocular Pain” and “Driving” subscales (0.645 and 0.559 respectively). Inter-observer reliability was excellent, with intra-class correlation coefficients (ICC) ranging from 0.857 to 0.985 for all subscales. Test-retest reliability, assessed for 43 patients, was good to excellent, with ICC above 0.80 for all subscales except “General Vision,” which had a value of 0.786.

CONCLUSION: As with previous versions, the Tu-VFQ-25 is an easy and reliable tool for assessing vision-related quality of life of Tunisian patients with chronic uveitis.

PMID:34281759 | DOI:10.1016/j.jfo.2021.01.025

J Voice. 2021 Jul 16:S0892-1997(21)00197-1. doi: 10.1016/j.jvoice.2021.06.010. Online ahead of print.

ABSTRACT

OBJECTIVE: To analyze and compare cepstral measurements in singing and non-singing men and women to understand if vocal adaptations of singers reflect greater cepstral measurement results.

METHOD: The study included 91 vocally healthy individuals, consisting of 60 erudite or popular singers (30 males, 30 females) and 31 non-singers (16 males, 15 females). The Cepstral Peak Prominence (CPP) and Cepstral Peak Prominence-Smoothed (CPPS) measures were carried out using the sustained /a/ vowel recorded with a unidirectional condenser microphone associated with a sound card on the computer. The Praat software (version 6.1.16) was used to extract the CPP and CPPS measurements. The intra and intergroup values obtained for each sex were compared using the t-test with a 5% significance level.

RESULTS: There was a CPP (P = 0,000) and CPPS (P = 0,000 and P = 0,001) value difference between the sexes in both groups. Cepstral measurements showed no statistically significant difference between singing and non-singing participants (male: P = 0,778 and P = 0,622; female: P = 0,622 and P = 0,460).

CONCLUSION: Men presented higher CPP and CPPS values than women, which may be related to the presence of the physiological posterior glottic cleft in women. The knowledge of the cepstral values of singers shows that singing specificities may not reflect in all vocal evaluations.

PMID:34281752 | DOI:10.1016/j.jvoice.2021.06.010

J Voice. 2021 Jul 16:S0892-1997(21)00190-9. doi: 10.1016/j.jvoice.2021.05.019. Online ahead of print.

ABSTRACT

OBJECTIVES/HYPOTHESIS: The objectives of this study were to (1) identify optimal clusters of 15 standard acoustic and aerodynamic voice metrics recommended by the American Speech-Language-Hearing Association (ASHA) to improve characterization of patients with primary muscle tension dysphonia (pMTD) and (2) identify combinations of these 15 metrics that could differentiate pMTD from other types of voice disorders.

STUDY DESIGN: Retrospective multiparametric METHODS: Random forest modeling, independent t-tests, logistic regression, and affinity propagation clustering were implemented on a retrospective dataset of 15 acoustic and aerodynamic metrics.

RESULTS: Ten percent of patients seen at the New York University (NYU) Voice Center over two years met the study criteria for pMTD (92 out of 983 patients), with 65 patients with pMTD and 701 of non-pMTD patients with complete data across all 15 acoustic and aerodynamic voice metrics. PCA plots and affinity propagation clustering demonstrated substantial overlap between the two groups on these parameters. The highest ranked parameters by level of importance with random forest models-(1) mean airflow during voicing (L/sec), (2) mean SPL during voicing (dB), (3) mean peak air pressure (cmH2O), (4) highest F0 (Hz), and (5) CPP mean vowel (dB)-accounted for only 65% of variance. T-tests showed three of these parameters-(1) CPP mean vowel (dB), (2) highest F0 (Hz), and (3) mean peak air pressure (cmH2O)-were statistically significant; however, the log2-fold change for each parameter was minimal.

CONCLUSION: Computational models and multivariate statistical testing on 15 acoustic and aerodynamic voice metrics were unable to adequately characterize pMTD and determine differences between the two groups (pMTD and non-pMTD). Further validation of these metrics is needed with voice elicitation tasks that target physiological challenges to the vocal system from baseline vocal acoustic and aerodynamic ouput. Future work should also place greater focus on validating metrics of physiological correlates (eg, neuromuscular processes, laryngeal-respiratory kinematics) across the vocal subsystems over traditional vocal output measures (eg, acoustics, aerodynamics) for patients with pMTD.

LEVEL OF EVIDENCE: II.

PMID:34281751 | DOI:10.1016/j.jvoice.2021.05.019

J Formos Med Assoc. 2021 Jul 16:S0929-6646(21)00311-9. doi: 10.1016/j.jfma.2021.06.030. Online ahead of print.

ABSTRACT

BACKGROUND/PURPOSE: In this study we aimed to investigate the prevalence of abnormal nasality in patients with unilateral rhinosinusitis and their nasality outcomes following functional endoscopic sinus surgery (FESS).

METHODS: A total of 42 patients with unilateral chronic rhinosinusitis who underwent unilateral FESS between April 2016 and November 2017 were enrolled. Questionnaires on sinonasal symptoms and nasality were recorded. The change in the nasalance score of vowels [a], [i] [u], nasal consonant [m], 2 nasal syllable repetitions, and 2 Chinese sentences were measured. The patients were evaluated preoperatively, 6 months, and 12 months after the operation. The patients were divided into two groups, wide opening surgery and limited surgery, according to the severity of the disease.

RESULTS: Among 42 patients, the subjective reports showed that one-third of unilateral chronic rhinosinusitis (CRS) patients had abnormal nasality preoperatively and significant improvement following FESS. The Lund-Mackay score was significantly negatively correlated with preoperative nasalance of [i] and positively correlated with change of nasalance of [i]. The increase in the value of [i] is statistically significant (p = 0.01) following FESS. In the further subgroup analysis, the change in nasalance was significant in the wide opening surgery group, but not in the limited surgery group.

CONCLUSION: Although only one side of the nasal airway was involved, one-third of the patients reported abnormal nasality. In patients with more disease severity who underwent wide opening surgery, the nasalance significantly increased 1 year after FESS. The increase in the objective nasalance score was corresponded to a significant improvement of subjective self-reported nasality assessment postoperatively.

PMID:34281727 | DOI:10.1016/j.jfma.2021.06.030

Cont Lens Anterior Eye. 2021 Jul 16:101489. doi: 10.1016/j.clae.2021.101489. Online ahead of print.

ABSTRACT

PURPOSE: To investigate the ocular subclinical inflammatory response in two soft contact lens materials when used in combination with two different care systems (‘solutions’).

METHODS: Fifteen established soft contact lens wearers wore each of two lenses: Acuvue® 2 (CH) and Acuvue® Oasys® (SiH) or no lenses in random sequence for one week. Two care systems were used: a peroxide system: Oxysept 1 Step® (P) for the right lens and Opti-Free® Replenish® (MPS) for the left lens. After one week of lens/no lens wear, in vivo confocal microscopy (IVCM) of corneal and conjunctival regions was carried out. Density of presumed dendritic cells (DC) and ‘white spots’ (WS) were quantified. Impression cytology of the bulbar and upper eyelid margin conjunctivae was carried out and samples were analysed for CD45+, CD3+ and CD11c+ cells.

RESULTS: The SiH + MPS combination showed a greater inflammatory response compared to SiH + P in seven out of 12 parameters investigated (p < 0.05). The remaining five were not statistically different between the two solutions. The converse was found for the CH lens, with four of the 12 parameters showing a greater response with the P solution compared to the MPS (p < 0.05).

CONCLUSION: This study suggests that the SiH lens investigated demonstrated an upregulated response when used with a MPS compared to a P solution whereas the converse is true for the CH lens which showed a reduced response when used with a MPS compared to a P solution. This finding aids in the understanding of the biological underpinnings of manifest corneal inflammatory events during contact lens wear.

PMID:34281726 | DOI:10.1016/j.clae.2021.101489

Clin Oncol (R Coll Radiol). 2021 Jul 16:S0936-6555(21)00262-4. doi: 10.1016/j.clon.2021.07.003. Online ahead of print.

ABSTRACT

Modern multimodality cancer treatment has led to a rise in cancer survivors, and by 2030 the survival rate is estimated to increase by 31.4%. This is an impressive survival statistic on which clinicians and services continue to build. One of the less well-acknowledged consequences of survivorship among health professionals and patients alike is female sexual dysfunction, despite it occurring in more than 60% of women diagnosed with cancer. The systematic assessment and management of late effects from cancer lack integration within current models of oncology follow-up. Although highly prevalent, issues linked to sexual health are often not addressed among survivors. This overview aims to focus on the sexual impact of gynaecological cancer treatment. Clinicians should raise the topic of the sexual consequences of cancer treatment as a legitimate aspect of survivorship and service provision. Increased focus on the sexual consequences of treatment and cancer survivorship may in time lead to greater clinical recognition, service development and, most importantly, increase research focused on the effective management of what remains a neglected aspect of cancer care.

PMID:34281725 | DOI:10.1016/j.clon.2021.07.003