Nevin Manimala

J Stomatol Oral Maxillofac Surg. 2021 Jun 19:S2468-7855(21)00131-2. doi: 10.1016/j.jormas.2021.04.014. Online ahead of print.

ABSTRACT

PURPOSE: The aim of this study was to evaluate effects of extended maxillary advancement osteotomy on pharyngeal airway space (PAS) in mid-facial deficient cleft lip and palate (CLP) patients and mid-facial deficient non-CLP patients.

METHODS: Pharyngeal airway space (PAS) of 10 CLP and 10 non-CLP patients with the mean age of 19 years 10 months was measured on digitized lateral cephalograms taken shortly before maxillary advancement operation with Quadrangular Le Fort I osteotomy (QLF-I) (T0), early post-operative, (T1) and long term post-operative (T2). Two way repeated analysis of variance, independent samples t-test and correlations tests were used for statistical analysis of airway and skeletal changes.

RESULTS: Total PAS depth and area was significantly increased after the advancement and was stable in long term post-operative period for CLP and non-CLP patients. Nasopharyngeal and velopharyngeal airway space depth and area was statistically increased at T1 and T2 for both groups. Oropharyngeal airway depth and area showed no significant statistical difference at any of the time points. The effect of QLF-I osteotomy on (PAS) was similar in both CLP and non-CLP patients CONCLUSIONS: Nasopharyngeal, velopharyngeal, and total pharyngeal airway space depth and area increased after maxillary advancement with the QLF-I osteotomy; this increase was stable in long term follow up. Maxillary advancement with the QLF-I technique had no significant effect on oropharyngeal airway space depth and area in both CLP and non-cleft patients.

PMID:34157445 | DOI:10.1016/j.jormas.2021.04.014

J Proteomics. 2021 Jun 19:104306. doi: 10.1016/j.jprot.2021.104306. Online ahead of print.

ABSTRACT

In cyanobacteria, it is known that the excitation ratios of photosystem (PS) I and PSII changes with the wavelength of irradiated light due to mobile phycobilisome (PBS) and spillover, affecting the photosynthetic ATP/NADPH synthesis ratio and metabolic flux state. However, the mechanisms by which these changes are controlled have not been well studied. In this study, we performed a targeted proteomic analysis of Synechocystis sp. PCC 6803 under different spectral light conditions to clarify the regulation mechanisms of mobile PBS, spillover and metabolisms under different light qualities at the protein level. The results showed an increase in the amount of proteins mainly involved in CO₂ fixation under Red1 light conditions with a high specific growth rate, suggesting that the rate of intracellular metabolism is controlled by the rate of carbon uptake, not by changes in the amount of each enzyme. Correlation analysis between protein levels and PSI/PSII excitation ratios revealed that PsbQUY showed high correlations and significantly increased under Blue and Red2 light conditions, where the PSI/PSII excitation ratio was higher due to spillover. In the strains lacking the genes encoding these proteins, a decrease in the PSI/PSII excitation ratio was observed, suggesting that PsbQUY contribute to spillover occurrence. SIGNIFICANCE: In cyanobacteria, the photosynthetic apparatus’s responses, such as state transition [mobile PBS and spillover], occur due to the intensity and wavelength of irradiated light, resulting in changes in photosynthetic electron transport and metabolic flux states. Previous studies have analyzed the response of Synechocystis sp. PCC 6803 to light intensity from various directions, but only spectroscopic analysis of the photosynthetic apparatus has been done on the response to changes in the wavelength of irradiated light. This study analyzed the response mechanisms of mobile PBS, spillover, photosynthetic, and metabolic systems in Synechocystis sp. PCC 6803 under six different spectral light conditions by a targeted proteomic analysis. As a result, many proteins were successfully quantified, and the metabolic enzymes and photosynthetic apparatus were analyzed using an integrated approach. Principal component and correlation analyses and volcano plots revealed that the PSII subunits PsbQ, PsbU, and PsbY have a strong correlation with the PSI/PSII excitation ratio and contribute to spillover occurrence. Thus, statistical analysis based on proteome data revealed that PsbQ, PsbU, and PsbY are involved in spillover, as revealed by spectroscopic analysis.

PMID:34157441 | DOI:10.1016/j.jprot.2021.104306

Colorectal Dis. 2021 Jun 22. doi: 10.1111/codi.15776. Online ahead of print.

ABSTRACT

AIM: Robotic surgery for colorectal cancer has been slower to become established than in other specialties. This study outlines the outcomes from laparoscopic and robotic surgery performed by a subspecialist rectal cancer team in a District General Hospital.

METHODS: Outcomes from consecutive patients undergoing minimal access rectal cancer surgery between July 2008 and January 2020 were analysed. Comparisons were made between short-term outcomes including conversion rates, anastomotic leaks and pathological outcomes, as well as long-term survival and cancer recurrence.

RESULTS: 337 patients were included for analysis, 204 (60.5%) underwent robotic surgery. Demographic characteristics and use of neo-adjuvant chemoradiotherapy were similar between groups. However, patients having robotic surgery had significantly lower tumours than in the laparoscopic group (7.6cm versus 9.8cm, p=0.003). Conversion to open surgery in the robotic group was significantly less likely (9.8% versus 22.6%, p=0.001). Operative mortality, clinical leakage, and major complications were similar between groups. While asymptomatic ‘radiological’ leaks were significantly more common following robotic surgery (13.7% versus 5.3%, p=0.017) this did not affect the long-term stoma-closure rate. Pathological outcomes were similar with the exception of shorter mean distal resection margins (25.9mm versus 32.8mm, p=0.001) for the robotic group of patients. There was no statistical difference in 5 year survival between groups (78.7% robotic versus 85.4% laparoscopic, p=0.263) nor local recurrence (2.0% robotic versus 3.8% laparoscopic, p=0.253).

CONCLUSIONS: These results illustrate how the selective use of robotic surgery by a dedicated rectal cancer team can achieve low rates of cancer recurrence and low permanent stoma rates.

PMID:34157214 | DOI:10.1111/codi.15776

Int J Clin Pract. 2021 Jun 22:e14559. doi: 10.1111/ijcp.14559. Online ahead of print.

ABSTRACT

BACKGROUND: In the past two decades, there has been a profound increase in the incidence of metabolic disorders among the general population, and psychotropics are also said to play a major role in the development of metabolic syndrome.

AIM: Determining the prevalence of Metabolic Syndrome (MetS) and sexual dysfunction (SD) and their correlation in psychiatric patients treated with psychotropics in a tertiary care hospital in Salem region, Tamilnadu, India.

MATERIALS AND METHODS: A cross-sectional study was conducted in the psychiatric department of Vinayaka Mission’s Medical College and Hospitals, Salem on patients (n=108) treated with psychotropics. The sociodemographic information, anthropometric measurements, and laboratory tests for metabolic functions were collected and assessed to determine the presence of Metabolic Syndrome (As per NCEP ATP III Criteria). All the results were statistically analyzed and P-Value <0.05 was considered to be statistically significant.

RESULTS: The overall prevalence of MetS in the study population was 25.93 %. The study found significant relationships between using olanzapine, risperidone, buspirone, and the presence of MetS. Depression was also found to be associated with the development of MetS.

CONCLUSION: From this current study, it may be concluded that the psychiatric population is at risk for developing MetS, and the use of Atypical antipsychotics (olanzapine, risperidone), anti-anxiety agent (Buspirone), and clinical depression is significantly associated with Metabolic Syndrome. Hence the metabolic function of psychiatric patients must be regularly assessed for early detection and management of any metabolic abnormalities. The study did not find a significant correlation between SD and MetS in psychiatric patients.

PMID:34157190 | DOI:10.1111/ijcp.14559

Int J Clin Pract. 2021 Jun 22:e14557. doi: 10.1111/ijcp.14557. Online ahead of print.

ABSTRACT

AIM: An urgent need to define clinical and laboratory parameters to predict progression to the severe and lethal forms of Coronavirus Disease 2019 (COVID 19). To investigate the direct/total bilirubin ratio (D/TBil), as a novel parameter, to predict the poor survival of COVID-19 Pneumonia.

METHODS: The clinical characteristics and laboratory parameters of hospitalized COVID-19 pneumonia patients were analyzed from 20 March to 1 August 2020, in a tertiary hospital, retrospectively. All remarkable variables were selected for a forward stepwise binary logistic regression analysis to define the independent risk factors for mortality.

RESULTS: Among 537 (248 women and 289 men) patients were separated into two groups for analysis; survivors vs deceased’s. The mean age of the deceased group was statistically significantly higher than the survivor group 72 (30-92) years vs 50 (18-97) years, (p< 0.001). D/TBil, age, gender, hypertension, and neutrophil-to-lymphocyte ratio (NLR) variables contributed significantly to the binary logistic regression model. The mortality risk increased 14.6 times in patients with D/TBil > 0.5, and 2.4 times in patients with NLR > 4.

CONCLUSION: D/TBil > 0.5 was associated with as a novel parameter to poor survival of COVID-19 on admission. Also, the combination of age, gender, the presence of hypertension, D/TBil, and NLR contributed significantly to predicting the poor survival of COVID-19.

PMID:34157182 | DOI:10.1111/ijcp.14557

Psychooncology. 2021 Jun 22. doi: 10.1002/pon.5754. Online ahead of print.

ABSTRACT

OBJECTIVE: End-of-life care for patients with cancer is often overly burdensome, and palliative and hospice care are underutilized. The objective of this study was to evaluate whether the mental health diagnoses of anxiety and depression were associated with variation in end-of-life care in metastatic cancer.

METHODS: This study used electronic health data from 1,333 adults with metastatic cancer who received care at two academic health centers in Louisiana, USA, and died between 1/1/2011-12/31/2017. The study used descriptive statistics to characterize the sample and logistic regression to examine whether anxiety and depression diagnoses in the six months before death were associated with utilization outcomes (chemotherapy, intensive care unit [ICU] visits, emergency department visits, mechanical ventilation, inpatient hospitalization, palliative care encounters, and hospice utilization), while controlling for key demographic and health covariates.

RESULTS: Patients (56.1% male; 65.6% White, 31.1% Black) commonly experienced depression (23.9%) and anxiety (27.2%) disorders within six months of death. Anxiety was associated with an increased likelihood of chemotherapy (odds ratio [OR]=1.42, p=.016), ICU visits (OR=1.40, p=.013), and inpatient hospitalizations (OR=1.85, p<.001) in the 30 days before death. Anxiety (OR=1.95, p<.001) and depression (OR=1.34, p=.038) were associated with a greater likelihood of a palliative encounter.

CONCLUSIONS: Patients with metastatic cancer who had an anxiety disorder were more likely to have burdensome end-of-life care, including chemotherapy, ICU visits, and inpatient hospitalizations in the 30 days before death. Depression and anxiety both increased the odds of palliative encounters. These results emphasize the importance of mental health considerations in end-of-life care. This article is protected by copyright. All rights reserved.

PMID:34157174 | DOI:10.1002/pon.5754

Photodermatol Photoimmunol Photomed. 2021 Jun 22. doi: 10.1111/phpp.12710. Online ahead of print.

ABSTRACT

BACKGROUND: Currently, sunscreens’ sun protection factor (SPF) and ultraviolet (UV) A protection are tested separately under indoor conditions, without considering external conditions that may affect performance. Studies are often conducted in Caucasian individuals; other racial groups may respond differently.

METHODS: An outdoor, double-blind, intra-individual study was performed in 63 healthy Chinese and Caucasian volunteers in Singapore. Subjects underwent one outdoor sun exposure lasting 2-3 hours. ISO reference products P3 (SPF 15), P5 (SPF 30) and P8 (SPF 50+) applied at 2 mg/cm² were compared against each other and against an untreated exposed area (positive control) and an unexposed area (negative control). Endpoints were investigator global assessment (IGA) of erythema at 24 hours, IGA of pigmentation at 1 week, and colorimetry (a*, L* and ITA) at 24 hours and 1 week.

RESULTS: Clinical erythema and pigmentation scores were statistically significantly different among the three sunscreens, with the highest SPF product providing the highest protection, confirming the discriminatory capacity of the model used. Colorimetric assessment correlated well with clinical evaluation.

CONCLUSION: This study confirmed the feasibility of ranking sunscreens (at 2 mg/cm² ) based on clinical effects of high-intensity outdoor solar radiation. Larger studies are needed to look at differences in erythema and pigmentation reactions between Chinese and Caucasian individuals, which could be relevant for photoprotection.

PMID:34157168 | DOI:10.1111/phpp.12710

Photodermatol Photoimmunol Photomed. 2021 Jun 22. doi: 10.1111/phpp.12709. Online ahead of print.

ABSTRACT

BACKGROUND: Photodynamic therapy for hidradenitis suppurativa (HS) is a therapeutic alternative with a good safety profile, but its effectiveness has yet to be demonstrated.

OBJECTIVES: To demonstrate the effectiveness of PDT with intralesional methylene blue in HS lesions.

METHODS: A retrospective cross-sectional study was performed. Forty-one patients were treated with intralesional methylene blue and a diode lamp. Follow-up was carried out at 1 and 6 months after therapy. Efficacy was determined by the diameter reduction of the lesion measured by high-frequency ultrasound.

RESULTS: A reduction of ≥75% in the maximum diameter was recorded in 58.5% of the lesions, while 22% showed a reduction between 50 and 75%, and 19.5% showed a reduction of <50 %. Recurrence rate was 12,5%. The lesions treated in patients with typical forms of HS (Canoui-Poitrine phenotype I) had a better therapeutic response. No statistically significant differences were found in terms of lesion location or concomitant treatment.

CONCLUSION: This therapy may potentially be a cost-effective and well-tolerated local therapy for Hurley I-II patients with superficial abscesses and fistulas.

PMID:34157160 | DOI:10.1111/phpp.12709

J Clin Endocrinol Metab. 2021 Jun 22:dgab459. doi: 10.1210/clinem/dgab459. Online ahead of print.

ABSTRACT

PURPOSE: Dehydroepiandrosterone sulfate (DHEAS) from the adrenal cortex substantially decreases with age, which may accelerate osteoporosis. However, the association of DHEAS with bone mineral density (BMD) and fracture is inconclusive. We conducted a Mendelian randomization (MR) analysis to investigate the role of DHEAS in age-related changes in BMD and fracture risk.

METHODS: Single nucleotide polymorphisms (SNPs) associated with serum DHEAS concentrations were used as instrumental variables (4 SNPs for main analysis; 4 SNPs for men and 5 SNPs for women in sex-related analysis). Summary statistics were obtained from relevant genome-wide association studies.

RESULTS: A log-transformed unit (μmol/L) increase in serum DHEAS concentrations was associated with SD increase in estimated BMD at the heel (estimate, 0.120; 95% confidence interval [CI], 0.081-0.158; P = 9 × 10 -10), and decreased fracture (odds ratio [OR], 0.989; 95%CI, 0.981-0.996; P = 0.005), consistent with dual-energy X-ray absorptiometry-derived BMD at the femoral neck and lumbar spine. Their associations remained even after adjusting for height, body mass index, testosterone, estradiol, sex hormone-binding globulin, and IGF-1. The association of DHEAS with fracture remained after adjusting for falls, grip strength, and physical activity but was attenuated after adjusting for BMD. The MR-Baysian model averaging analysis showed BMD was the top mediating factor for association of DHEAS with fracture. The association between DHEAS and BMD was observed in men but not in women.

CONCLUSION: DHEAS was associated with increased BMD and decreased fracture. DHEAS may play a protective role in decreasing fracture risk, mainly by increasing bone mass.

PMID:34157116 | DOI:10.1210/clinem/dgab459

Nutr Rev. 2021 Jun 22:nuab028. doi: 10.1093/nutrit/nuab028. Online ahead of print.

ABSTRACT

CONTEXT: There are only a few systematic reviews on the association of obesity with risk of inflammatory bowel disease (IBD) to date.

OBJECTIVE: The current study was undertaken to systematically review prospective cohort studies on the association between body mass index (BMI) and risk of IBD. It was carried out according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines.

DATA SOURCES: Relevant prospective cohort studies published from 1969 to July 2020 were searched through PubMed, MEDLINE, SCOPUS, EMBASE, and Google Scholar, using suitable keywords.

DATA EXTRACTION: Hazard ratios (HRs) or relative risks (RRs) and 95% confidence intervals (CIs) for IBD or its subtypes across categories of BMI were extracted.

DATA ANALYSIS: The log HRs/RRs, including standard errors, were calculated based on reported HRs or RRs and their 95% CIs, and overall effect size was calculated using a fixed-effects model. All statistical analyses were done using STATA version 14.0 (Stata Corp LP, College Station, TX, USA).

CONCLUSION: Overall, 9 studies were included. Combining findings from 5 studies, a statistically significant 21% lower risk of ulcerative colitis incidence was found in patients with obesity than in those with normal weight (RR, 0.79; 95% CI, 0.68-0.92; I2= 0.0%), but not with risk of ulcerative colitis exacerbation, as found by meta-analysis of 3 studies. Pooling data from 5 studies, no significant differences were seen in the risk of Crohn’s disease incidence between patients in the highest range of BMI and those in the normal range. In addition, no significant nonlinear association was found between BMI and risk of Crohn’s disease (P=0.94). A significant inverse association was found between obesity and total IBD incidence (RR, 0.76; 95% CI, 0.66-0.88; I2=93.2%), but not between increasing BMI and IBD exacerbation, or between increasing BMI and IBD incidence.

PMID:34157115 | DOI:10.1093/nutrit/nuab028