Tag: nevin manimala

Ann Plast Surg. 2022 Apr 23. doi: 10.1097/SAP.0000000000003219. Online ahead of print.

ABSTRACT

INTRODUCTION: The transverse upper gracilis (TUG) flap is a reliable alternative to abdominally based breast reconstruction because of its advantageous anatomy. However, the limited tissue volume prevents reconstruction of large breasts. The bilateral TUG flaps for unilateral breast reconstruction can overcome this problem.

METHODS: A retrospective analysis was performed regarding unilateral breast reconstruction with bilateral TUGs at the Queen Victoria Hospital from 2015 to 2019. Associations between categorical variables were examined with Fisher exact test, and any differences in continuous variables by complication status were evaluated with Mann-Whitney-Wilcoxon test for independent samples. A relevant systematic review was conducted with a meta-analysis of proportions using the Freeman-Tukey arcsine transformation for the estimation of the overall survival rates.

RESULTS: Ten cases were identified with 6 having a delayed reconstruction. Median age and body mass index were 50.8 years and 23.9 kg/m2, respectively, and average flap weight was 268.3 g. One flap was placed superiorly with its pedicle anastomosed to the retrograde internal mammary vessels, except of half of the cases where a second anterograde vein was used. The mean follow-up was 21.4 months, and all flaps survived. Two patients returned to theater, and 4 experienced donor-site problems. The presence of complications was not associated with age, ever smoking, body mass index, TUG weight, or anastomosis to retrograde internal mammary vein. The systematic review resulted in 8 eligible articles with a total sample of 156 flaps. The overall survival rate was 96.8%. In 6 cases, the indication was Poland syndrome (7.7%), and in 48.7%, axillary vessels were also used as recipient vessels. The estimated overall flap survival rate was 100% (95% confidence interval, 99%-100%), and no significant heterogeneity was noted (I2 = 0%, P = 0.71).

CONCLUSIONS: The “2-in-1” technique can lead to symmetrical aesthetically pleasant results for both recipient and donor sites. Our case series and the conducted systematic review reiterate the reliability of this approach.

PMID:35502959 | DOI:10.1097/SAP.0000000000003219

Ann Plast Surg. 2022 Apr 23. doi: 10.1097/SAP.0000000000003165. Online ahead of print.

ABSTRACT

BACKGROUND: We sought to compare the safety profile of prepectoral breast reconstruction with total submuscular tissue expander reconstruction, previously our standard. Primary outcomes of interest in this retrospective cohort study were incidence of infection, hematoma, seroma, mastectomy flap necrosis, and reconstruction loss.

METHODS: Total submuscular and prepectoral with acellular dermal matrix reconstructions consecutively performed by a single surgeon (P.D.S.) between January 1, 2016, and December 31, 2019, were compared. Demographic and clinical characteristics, as well as complications and complication types, were extracted for all patients. A t test was used to assess differences in continuous variables. Multivariate logistics regression was used to assess the association between type of reconstruction and complication rate. The statistical significance was set at 0.05 for all comparisons.

RESULTS: A total of 133 patients (234 breasts) were included. There was a significantly greater incidence of infection (16.5% vs 5.5%, P < 0.01) in the prepectoral/acellular dermal matrix cohort. However, reconstructive loss was low in both cohorts (2.5% and 3.0%, P = 0.83). Adjusted odds ratio for complications in the prepectoral cohort was 2.26, but this was not statistically significant (adjusted P = 0.24).

CONCLUSIONS: Prepectoral breast reconstruction shares an overall complication profile that is not greater than that of total submuscular reconstruction. It is associated with a greater risk of infection; however, the ability to salvage the reconstruction with early, aggressive intervention results in low rates of reconstructive loss, comparable with those of total submuscular reconstruction.

PMID:35502960 | DOI:10.1097/SAP.0000000000003165

Acta Crystallogr A Found Adv. 2022 May 1;78(Pt 3):172-199. doi: 10.1107/S2053273322000845. Epub 2022 Apr 28.

ABSTRACT

Statistically sound crystallographic symmetry classifications are obtained with information-theory-based methods in the presence of approximately Gaussian distributed noise. A set of three synthetic patterns with strong Fedorov-type pseudosymmetries and varying amounts of noise serve as examples. Contrary to traditional crystallographic symmetry classifications with an image processing program such as CRISP, the classification process does not need to be supervised by a human being and is free of any subjectively set thresholds in the geometric model selection process. This enables crystallographic symmetry classification of digital images that are more or less periodic in two dimensions (2D), also known as crystal patterns, as recorded with sufficient structural resolution from a wide range of crystalline samples with different types of scanning probe and transmission electron microscopes. Correct symmetry classifications enable the optimal crystallographic processing of such images. That processing consists of the averaging over all asymmetric units in all unit cells in the selected image area and significantly enhances both the signal-to-noise ratio and the structural resolution of a microscopic study of a crystal. For sufficiently complex crystal patterns, the information-theoretic symmetry classification methods are more accurate than both visual classifications by human experts and the recommendations of one of the popular crystallographic image processing programs of electron crystallography.

PMID:35502711 | DOI:10.1107/S2053273322000845

Hypertension. 2022 May 3:101161HYPERTENSIONAHA12219185. doi: 10.1161/HYPERTENSIONAHA.122.19185. Online ahead of print.

ABSTRACT

BACKGROUND: This study aimed to evaluate the association of hypertension with incident infective endocarditis (IE) by investigating the incidence of IE according to blood pressure levels using the National Health Insurance Service database.

METHODS: The data of 4 080 331 individuals linked to the health screening database in 2009 were retrieved (males, 55.08%; mean age, 47.12±14.13 years). From 2009 to 2018, the risk factors for the first episode of IE were investigated. Hypertension was categorized into normotension, prehypertension, hypertension, and hypertension with medication. The Cox proportional hazard model assessed the effect of blood pressure level during the health screening exam on incident IE.

RESULTS: During the 9-year follow-up, 812 (0.02%) participants were diagnosed with IE. The incidence rates of IE in the normotension, prehypertension, hypertension, and hypertension with medication groups were 0.9, 1.4, 2.6, and 6.0 per 100 000 person-years, respectively. Those with prehypertension, hypertension, and hypertension with medication were correlated with an increased risk of IE in a dose-response manner compared with the normotension group (hazard ratio, 1.33 [95% CI, 1.06-1.68]; hazard ratio, 1.98 [1.48-2.66]; hazard ratio, 2.56 [2.02-3.24], respectively, all P<0.001).

CONCLUSIONS: In a large national cohort study with an average follow-up of 9 years, increased blood pressure was identified as a risk factor for incident IE in a dose-dependent manner. Hypertension increases the public health care burden by acting as a risk factor for rare infective heart diseases.

PMID:35502658 | DOI:10.1161/HYPERTENSIONAHA.122.19185

Int Endod J. 2022 May 3. doi: 10.1111/iej.13760. Online ahead of print.

ABSTRACT

AIM: PTEN-induced putative kinase 1 (PINK1) and Parkin E3 ubiquitin-protein ligase (Parkin) are critical for immune and inflammatory regulation in health and disease. PINK1 and Parkin have been confirmed to be involved in the progression of apical periodontitis by affecting mitophagy-related osteoblast apoptosis; however, the expression of PINK1 and Parkin in macrophages, one of the most important cells in apical periodontitis, remains unknown. This study aimed to investigate the expression of PINK1 and Parkin in human apical periodontitis lesions, as well as their possible localization in macrophages.

METHODOLOGY: Thirty-seven human periapical tissues, including periapical granulomas (PGs, n=12), radicular cysts (RCs, n=11), and healthy gingival tissues (n=14) were examined. The inflammatory infiltrates of lesions were evaluated by haemotoxylin staining, and the expression of PINK1 and Parkin was detected by immunohistochemistry. Double immunofluorescence was used to explore the colocalization of microtubule-associated protein 1 light chain 3 (LC3) and TOMM20, as well as the localization of PINK1 and Parkin, in macrophages of human apical periodontitis lesions. The ultrastructural morphology of mitochondria in human apical periodontitis lesions was visualized by transmission electron microscopy (TEM). Data were analyzed by one-way ANOVA with Student-Newman-Keul’s test and Mann-Whitney test. P < 0.05 was considered statistically significant.

RESULTS: Immunohistochemistry demonstrated a significantly higher expression of PINK1 and Parkin proteins in human apical periodontitis lesions than in healthy gingival tissues (P < 0.0001), but no significant difference was demonstrated between PGs and RCs (P > 0.05). The higher expression of LC3 and the presence of more LC3-TOMM20 double-positive cells were also observed in human apical periodontitis. Double-labeling analysis of PINK1, Parkin, and LC3 with CD68 indicated that macrophage mitophagy might be present in the progression of human apical periodontitis. Finally, the results of TEM morphological analysis revealed the appearance of double-membraned mitophagosomes and vacuolated mitochondria in macrophage-like cells of apical periodontitis lesions.

CONCLUSIONS: Our findings indicated that PINK1 and Parkin proteins were highly expressed in clinical apical periodontitis lesions.

PMID:35502680 | DOI:10.1111/iej.13760

ALTEX. 2022 Apr 14. doi: 10.14573/altex.2111301. Online ahead of print.

ABSTRACT

Pharmaceutical products intended for parenteral use must be free from pyrogenic (fever-inducing) contamination. Pyrogens comprise endotoxin from Gram-negative bacteria and non-endotoxin pyrogens (NEP) from Gram-positive bacteria, viruses and fungi. The longstanding compendial test for pyrogens is the rabbit pyrogen test (RPT) but in 2010 the monocyte activation test (MAT) for pyrogenic and pro-inflammatory contaminants was introduced into the European Pharmacopoeia (Ph. Eur.) as a ‘non-animal’ replacement for the RPT. The present study describes the first product-specific GMP validation of Ph. Eur. MAT, Quantitative test, Method A, for the testing of three therapeutic monoclonal antibodies (mAbs). The MAT uses cryo-preserved PBMC with interleukin-6 (IL-6) as the readout. Much of the data presented here for one of the antibodies was included in a successful product licence application to the EMA.

PMID:35502618 | DOI:10.14573/altex.2111301

Pediatrics. 2022 May 3:e2021054201. doi: 10.1542/peds.2021-054201. Online ahead of print.

ABSTRACT

BACKGROUND: Development of cardiovascular disease in adults has been directly linked to an adverse metabolic phenotype. While there is evidence that development of these risk factors in childhood persists into adulthood and the development of cardiovascular disease, less is known about whether these risk factors are associated with target organ damage during adolescence.

METHODS: We collected data from 379 adolescents (mean age 15.5, 60% male) with blood pressure between the 75th and 95th percentile to determine if there is a metabolic phenotype that predicts cardiovascular changes (left ventricular mass, systolic and diastolic function, pulse wave velocity, and renal function). We determined the number of risk factors for cardiovascular disease (hypertension, dyslipidemia, obesity, and insulin resistance) present in each participant. Generalized linear models were constructed to determine if the number of cardiovascular risk factors (CVRFs) were associated with measures of target organ damage.

RESULTS: The number of CVRFs present were associated with statistically significant differences in increased left ventricular mass index, increased pulse wave velocity, decreased peak longitudinal strain, urine albumin to creatine ratio and echocardiographic parameters of diastolic dysfunction. Generalized linear models showed that dyslipidemia and insulin resistance were independently associated with markers of diastolic dysfunction (P ≤ .05) while increased blood pressure was associated with all makers of target organ damage (P ≤ .03).

CONCLUSIONS: These data suggest the of the number of CVRFs present is independently associated with early changes in markers of target organ damage during adolescence.

PMID:35502610 | DOI:10.1542/peds.2021-054201

J Environ Sci Health A Tox Hazard Subst Environ Eng. 2022 May 3:1-10. doi: 10.1080/10934529.2022.2069977. Online ahead of print.

ABSTRACT

The objective of this study was to assess annual, seasonal and spatial trends in copper sediment concentrations in an agricultural California stream (Cache Slough) based on sampling 12 sites over two seasons (spring and fall) in 2012, 2013 and 2014. The relationship between copper sediment concentrations and precipitation was also evaluated. The results from this study showed that copper sediment concentrations from Cache Slough ranging from 19 to 63 ug/g dw were similar to concentrations reported in European agricultural streams. Copper sediment concentrations were not reported to increase over time in this agricultural waterbody where copper was used as a fungicide. However, spatial differences in copper sediment concentrations were reported among sites with the highest concentrations in the middle waterbody section. Seasonal analysis showed no significant difference in copper sediment concentrations for both spring and fall for 2012 and 2013 but 2014 spring concentrations were statistically higher than fall concentrations when precipitation was lower than the two previous years. There were no statistically significant relationships between copper sediment concentrations and precipitation for the three-year period based on an analysis by year and season.

PMID:35502608 | DOI:10.1080/10934529.2022.2069977

Dermatol Ther. 2022 May 3:e15549. doi: 10.1111/dth.15549. Online ahead of print.

ABSTRACT

The use of antioxidants in atopic dermatitis (AD) is controversial. We conducted a systematic review and meta-analysis to evaluate the efficacy and safety of antioxidants therapy in AD. Randomised clinical trials were identified from Medline, Embase and Cochrane library. Changes from baseline in severity and itch score were extracted from individual studies and pooled using random-effects. Eighteen trials including 763 AD patients were eligible. Overall, antioxidants were associated with statistically significant reductions in diseases severity (p < 0.0001), but not with itch score (p = 0.59). No serious adverse events were recorded. Subgroup analyses revealed that antioxidants were associated with a significant reduction in severity score regardless of disease severity at baseline and treatment duration (p < 0.05). However, antioxidants had additional benefit only in children (p = 0.02) but not in adults (p = 0.30). Oral supplementation with vitamin D, combined vitamins D and E, combined vitamins A, D and E and topical vitamin B₁₂ was associated with significantly lower severity score (p < 0.05). There was significant heterogeneity between studies (I² = 50%; p = 0.003). The effect estimates did not change statistically after excluding sources of study heterogeneity. This meta-analysis suggests that antioxidants may be a safe and effective treatment for AD patients, especially when supplemented with oral vitamin D and topical vitamin B₁₂ , as well as in pediatric patients. This article is protected by copyright. All rights reserved.

PMID:35502578 | DOI:10.1111/dth.15549

Gut Liver. 2022 May 3. doi: 10.5009/gnl210009. Online ahead of print.

ABSTRACT

BACKGROUND/AIMS: Contradictory findings on the association between cholecystectomy and cancer have been reported. We aimed to investigate the risk of all types of cancers or site-specific cancers in patients who underwent cholecystectomy using a nationwide dataset.

METHODS: Subjects who underwent cholecystectomy from January 1, 2007, to December 31, 2014, who were older than 20 years and who underwent an initial baseline health check-up within 2 years were enrolled. Those who were diagnosed with any type of cancer before the enrollment or within 1 year after enrollment were excluded. Ultimately, patients (n=123,295) who underwent cholecystectomy and age/sex matched population (n=123,295) were identified from the database of the Korean National Health Insurance Service. The hazard ratio (HR) and 95% confidence interval (CI) for cancer were estimated, and Cox regression analysis was performed.

RESULTS: The incidence of cancer in the cholecystectomy group was 9.56 per 1,000 personyears and that in the control group was 7.95 per 1,000 person-years. Patients who underwent cholecystectomy showed an increased risk of total cancer (adjusted HR, 1.19; 95% CI, 1.15 to 1.24; p<0.001), particularly leukemia and malignancies of the colon, liver, pancreas, biliary tract, thyroid, pharynx, and oral cavity. In the subgroup analysis according to sex, the risk of developing cancers in the pancreas, biliary tract, thyroid, lungs and stomach was higher in men than in women.

CONCLUSIONS: Physicians should pay more attention to the possibility of the occurrence of secondary cancers among patients who undergo cholecystectomy.

PMID:35502586 | DOI:10.5009/gnl210009