Tag: nevin manimala

J Am Vet Med Assoc. 2023 Jul 31:1-8. doi: 10.2460/javma.23.05.0288. Online ahead of print.

ABSTRACT

OBJECTIVE: To describe radiotherapy outcomes for canine infiltrative lipomas and provide detailed radiotherapy planning data.

ANIMALS: 24 dogs from 2000 to 2020.

METHODS: In this retrospective study, dogs received 1 to 3 surgeries prior to conventionally fractionated radiotherapy for gross (18) or microscopic (8) infiltrative lipomas. Dogs received 45 to 51 Gray (Gy) in 15 to 20 daily fractions, with 71% of dogs receiving 48 Gy in daily 3-Gy fractions.

RESULTS: Masses were regionally located as follows: limbs (7), trunk (13), head/neck (4). At analysis, 16/24 dogs were deceased, 5/24 were alive (median follow-up for alive dogs: 1,216 days [range, 741 to 1,870 days]), and 3/24 were lost to follow-up. One living dog had progressive disease 923 days after completing conventionally fractionated radiotherapy and received another surgery. The estimated median overall survival (OS) after completing radiotherapy was 4.8 years (1,760 days; 95% CI, 1,215 to 2,777 days; range, 23 to 3,499 days) for any cause of death, and no patients were reported to have been euthanized or died from their tumor. No statistically significant difference was found for dogs based on gross versus microscopic disease (gross OS, 4.8 years vs microscopic OS, 3.6 years; P = .45). Furthermore, the number of surgeries before radiotherapy did not impact survival (P = .96). The survival difference between females (median OS, 7.6 years; 95% CI, 963 days to not reached) versus males (median OS, 4.6 years; 95% CI, 335 to 2,245 days; P = .05) was statistically significant, although 4/5 living dogs were female.

CLINICAL RELEVANCE: This study demonstrates lengthy survivals with radiotherapy, even with gross disease, for dogs with infiltrative lipomas.

PMID:37524353 | DOI:10.2460/javma.23.05.0288

Bone Joint J. 2023 Aug 1;105-B(8):920-927. doi: 10.1302/0301-620X.105B8.BJJ-2022-1104.R2.

ABSTRACT

AIMS: Traumatic central cord syndrome (CCS) typically follows a hyperextension injury and results in motor impairment affecting the upper limbs more than the lower, with occasional sensory impairment and urinary retention. Current evidence on mortality and long-term outcomes is limited. The primary aim of this study was to assess the five-year mortality of CCS, and to determine any difference in mortality between management groups or age.

METHODS: Patients aged ≥ 18 years with a traumatic CCS between January 2012 and December 2017 in Wales were identified. Patient demographics and data about injury, management, and outcome were collected. Statistical analysis was performed to assess mortality and between-group differences.

RESULTS: A total of 65 patients were identified (66.2% male (n = 43), mean age 63.9 years (SD 15.9)). At a minimum of five years’ follow-up, 32.3% of CCS patients (n = 21) had died, of whom six (9.2%) had died within 31 days of their injury. Overall, 69.2% of patients (n = 45) had been managed conservatively. There was no significant difference in age between conservatively and surgically managed patients (p = 0.062). Kaplan-Meier analysis revealed no significant difference in mortality between patients managed conservatively and those managed surgically (p = 0.819). However, there was a significant difference in mortality between the different age groups (< 50 years vs 50 to 70 years vs > 70 years; p = 0.001). At five years’ follow-up, 55.6% of the patient group aged > 70 years at time of injury had died (n = 15). Respiratory failure was the most common cause of death (n = 9; 42.9%).

CONCLUSION: Almost one-third of patients with a traumatic CCS in Wales had died within five years of their injury. The type of management did not significantly affect mortality but their age at the time of injury did. Further work to assess the long-term functional outcomes of surviving patients is needed to generate more reliable prognostic information.

PMID:37524347 | DOI:10.1302/0301-620X.105B8.BJJ-2022-1104.R2

Neuro Endocrinol Lett. 2023 Jul 28;44(5):283-289. Online ahead of print.

ABSTRACT

BACKGROUND: Cognitive impairment (CI) may be present in people with multiple sclerosis (PwMS) in different stages of the disease, as well as in PwMS with various degrees of disability. This study aimed to investigate cognitive decline over a period of 12 months and to examine an association between cognition and the disability in PwMS, also over a period of 12 months.

METHODS: The Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) battery was used, containing the Symbol Digit Modalities Test (SDMT), the Categorical Verbal Learning Test (CVLT), and the Brief Visuospatial Memory Test-Revised (BVMT-R). The Expanded Disability Status Scale (EDSS), Timed 25-Foot Walk (T25FW), and 9-Hole Peg Test (9-HPT) were used to assess the degree of disability. For the analysis of cognitive decline over the period of 12 months, Wilcoxon signed-rank test (paired sample t-test) was used. For the correlation between cognition and disability, Spearman’s correlation test was used.

RESULTS: We observed statistically meaningful difference only in one measure of cognition (CVLT), not the other two (SDMT and BVMT-R). SDMT significantly correlated with methods assessing the degree of disability in both time points. In the second examination, we observed a correlation between BICAMS and 9-HPT. Similarly, SDMT and BVMT-R also correlated with EDSS.

CONCLUSION: To investigate the cognitive decline in PwMS, a longer period of time probably should have been chosen. EDSS is commonly used to monitor disease progression, but it does not include the evaluation of various parameters, such as cognition or upper limb function. Its use with the 9-HPT and cognitive tests may represent a more reliable and comprehensive assessment of a patient’s clinical condition.

PMID:37524317

Gynecol Endocrinol. 2023 Dec;39(1):2239934. doi: 10.1080/09513590.2023.2239934.

ABSTRACT

OBJECTIVE: Though recent studies have pointed out different manifestations between obese and nonobese patients with polycystic ovarian syndrome (PCOS), there is no clear evidence to confirm this viewpoint. Therefore, the metabolic characteristics of obese and nonobese patients with PCOS were systematically compared through meta-analysis in this study.

METHODS: Data were searched from PubMed, Web of Science, Embase, Cochrane Library, CNKI, and Wanfang databases. Articles on obese and nonobese patients with PCOS published from database inception to January 2022 were included. Meta-analysis was performed using Stata 16.0 statistical software.

RESULTS: A total of 739 articles were initially retrieved, and ultimately 14 studies were involved in the meta-analysis. Specifically, there were 801 patients in the observation group (obese patients with PCOS) and 925 patients in the control group (nonobese patients with PCOS). Compared with the control group, the observation group had significantly lower levels of sex hormone-binding globulin (SHBG), high-density lipoprotein (HDL), luteinizing hormone (LH), follicle-stimulating hormone (FSH), and higher levels of total cholesterol (TC), triglyceride (TG), and low-density lipoprotein (LDL). Nevertheless, there were no significant differences between the two groups in systolic blood pressure (SBP), diastolic blood pressure (DBP), glucose, and testosterone.

CONCLUSION: Compared with nonobese patients with PCOS, obese patients with PCOS have worse blood lipid parameters and lower levels of LH and FSH. Also, there are significant differences in metabolic characteristics between the two groups of patients. Most importantly, our findings provide guidance for the clinical diagnosis and treatment of PCOS.

PMID:37524309 | DOI:10.1080/09513590.2023.2239934

Clin Microbiol Infect. 2023 Jul 29:S1198-743X(23)00342-7. doi: 10.1016/j.cmi.2023.07.016. Online ahead of print.

ABSTRACT

OBJECTIVE: We aimed to identify predictors of confirmed mpox among people with mpox-like illness and to develop a multivariable model for confirmed mpox.

METHODS: We performed a retrospective study using national epidemiologic surveillance data in Mexico from May to November 2022. People with mpox-like illness were reported to the Mexican Ministry of Health (MMH) and real-time polymerase chain reaction was performed in clinical samples to confirm mpox. Sociodemographic and clinical data were collected with a case-report form. We performed univariable logistic regressions to estimate predictive capability of individual characteristics, reported with odds ratios and 95% confidence intervals (OR, 95%CI). Variables of interest were included in multivariable logistic regression models and Akaike information criterion was used to retain variables for the final model. Discrimination and calibration of the model were estimated in bootstrap resamples.

RESULTS: 5,078 people were reported with mpox-like illness. 3,291/5,078 (64.8%) had confirmed mpox. The strongest clinical predictors of confirmed mpox in univariable models were proctitis (OR 6.54, 5.93-7.21), inguinal adenopathy (OR 5.91, 5.36-6.52), and anogenital lesions (OR 5.45, 4.94-6.02). The final model included being a man who has sex with men(MSM) (8.75, 7.37-10.38), HIV diagnosis (3.04, 2.51-3.69), inguinal adenopathy (2.24, 1.81-2.77), anogenital lesions (2.32, 1.97-2.74), and pustules (1.55, 1.32-1.81). Discrimination capability was excellent (c statistic 0.88, 95%CI 0.87-0.89) and it was well calibrated (calibration slope 1, 95%CI 0.95-1.05).

CONCLUSION: A third of people with mpox-like illness do not have mpox. Being MSM, HIV diagnosis, inguinal adenopathy, pustules, and anogenital lesions are strongly associated with confirmed mpox.

PMID:37524303 | DOI:10.1016/j.cmi.2023.07.016

Ocul Surf. 2023 Jul 29:S1542-0124(23)00096-4. doi: 10.1016/j.jtos.2023.07.010. Online ahead of print.

ABSTRACT

BACKGROUND: Meibomian gland dysfunction (MGD) is one of the most common conditions in ophthalmic practice and the most frequent cause of evaporative dry eye disease (DED). However, the immune mechanisms leading to this pathology are not fully understood and the diagnostic tests available are limited. Here, we used the nCounter technology to analyze immune gene expression in DED-MGD that can be used for developing diagnostic signatures for DED.

METHODS: Conjunctival cell samples were obtained by aspiration from patients with DED-MGD (n = 27) and asymptomatic controls (n = 22). RNA was purified, converted to cDNA, preamplified and analyzed using the Gene Expression Human Immune V2 panel (NanoString), which includes 579 target and 15 housekeeping genes. A machine learning (ML) algorithm was applied to design a signature associated with DED-MGD.

RESULTS: Forty-five immune genes were found upregulated in DED-MGD vs. controls, involved in eight signaling pathways, IFN I/II, MHC class I/II, immunometabolism, B cell receptor, T Cell receptor, and T helper-17 (Th-17) differentiation. Additionally, statistically significant correlations were found between 31 genes and clinical characteristics of the disease such as lid margin or tear osmolarity (Pearson’s r < 0.05). ML analysis using a recursive feature elimination (RFE) algorithm selected a 4-gene mRNA signature that discriminated DED-MGD from control samples with an area under the ROC curve (AUC ROC) of 0.86 and an accuracy of 77.5%.

CONCLUSIONS: Multiplexed mRNA analysis of conjunctival cells can be used to analyze immune gene expression patterns in patients with DED-MGD and to generate diagnostic signatures.

PMID:37524297 | DOI:10.1016/j.jtos.2023.07.010

Int J Infect Dis. 2023 Jul 29:S1201-9712(23)00681-1. doi: 10.1016/j.ijid.2023.07.031. Online ahead of print.

ABSTRACT

BACKGROUND: A previous review demonstrated that the majority of NTM infections in the Northern Territory (NT) are pulmonary in nature,[1] however skin and soft tissue (SST) are likely the next most common sites of disease. The current epidemiology of NTM SST infections across the NT is not known. We aimed to establish the current and historical incidence rates, and the organisms involved.

METHODS: All NTM cases reported to the Centre for Disease Control in Darwin from 1989-2021 were retrospectively reviewed.

RESULTS: 226 NTM notifications were reviewed. 73 (32%) cases were SST infections. The incidence of SST cases increased over the study period. Female cases were more common (p=0·002). Disease occurred across a wide age range (1-85 years). Only 16% of cases occurred in Aboriginal individuals. Many cases had no clear provocation, but localised trauma was the most common risk factor. The most common organism identified was M. fortuitum (41%). Diagnosis was often delayed, with a median time to diagnosis of 69 days (IQR=31-149). Most cases (60%) underwent surgical intervention with adjunctive anti-mycobacterial medical therapy.

CONCLUSION: NTM SST incidence rates increased over the study period. NTM SST infections are a rare but important differential diagnosis for non-healing cutaneous wounds.

PMID:37524256 | DOI:10.1016/j.ijid.2023.07.031

J Foot Ankle Surg. 2023 Jul 29:S1067-2516(23)00174-6. doi: 10.1053/j.jfas.2023.07.007. Online ahead of print.

ABSTRACT

Charcot neuroarthropathy (CNA) is a progressive disease that affects the bones and joints of the foot. To prevent collapse and loss of stability within the pedal architecture, CNA should be diagnosed and managed early. The objective of this retrospective study was to review patients who underwent midfoot CNA reconstructive surgery and evaluate subsequent rates of minor and major amputations. Secondary objectives include identifying patients that underwent midfoot CAN with and without a subtalar joint arthrodesis. Out of the 72 patients, 4 (5.6%) underwent minor (digital, ray) amputation, 2 (2.8%) underwent proximal amputations (either below or above the knee), and none underwent midfoot amputation (transmetatarsal, Lisfranc, Chopart). A Fisher’s exact test was employed to compare the outcomes of minor and major amputation rates in our CNA cohort with those who underwent midfoot CNA reconstruction with STJ arthrodesis and found no statistical significance (P = 0.15). Overall, a total progression to amputation was 8.4 % following midfoot CNA reconstruction, with 2.8 % of patients undergoing major amputation (below knee or above knee). Despite no statistical significance, we recommend surgeons to consider including an STJ arthrodesis in addition to midfoot CNA reconstruction to establish a stable and plantigrade foot. LEVEL OF CLINICAL EVIDENCE: 3.

PMID:37524241 | DOI:10.1053/j.jfas.2023.07.007

Mol Phylogenet Evol. 2023 Jul 29:107892. doi: 10.1016/j.ympev.2023.107892. Online ahead of print.

ABSTRACT

As genomic data proliferates, the prevalence of post-speciation gene flow is making species boundaries and relationships increasingly ambiguous. Although current approaches inferring fully bifurcating phylogenies based on concatenated datasets provide simple and robust answers to many species relationships, they may be inaccurate because the models ignore inter-specific gene flow and incomplete lineage sorting. To examine the potential error resulting from ignoring gene flow, we generated both a RAD-seq and a 500 protein-coding loci highly multiplexed amplicon (HiMAP) dataset for a monophyletic group of 12 species defined as the Bactrocera dorsalis sensu lato clade. With some of the world’s worst agricultural pests, the taxonomy of the B. dorsalis s.l. clade is important for trade and quarantines. However, taxonomic confusion confounds resolution due to intra- and interspecific phenotypic variation and convergence, mitochondrial introgression across half of the species, and viable hybrids. We compared the topological convergence of our datasets using concatenated phylogenetic and various multispecies coalescent approaches, some of which account for gene flow. All analyses agreed on species delimitation, but there was incongruence between species relationships. Under concatenation, both datasets suggest identical species relationships with mostly high statistical support. However, multispecies coalescent and multispecies network approaches suggest markedly different hypotheses and detected significant gene flow. We suggest that the network approaches are likely more accurate because gene flow violates the assumptions of the concatenated phylogenetic analyses, but the data-reductive requirements of network approaches resulted in reduced statistical support and could not unambiguously resolve gene flow directions. Our study highlights the importance of testing for gene flow, particularly with phylogenomic datasets, even when concatenated approaches receive high statistical support.

PMID:37524217 | DOI:10.1016/j.ympev.2023.107892

Rev Esp Med Nucl Imagen Mol (Engl Ed). 2023 Jul 29:S2253-8089(23)00069-1. doi: 10.1016/j.remnie.2023.07.006. Online ahead of print.

ABSTRACT

INTRODUCTION AND OBJECTIVES: 18F-FDG PET with the Deauville score (DS) is a unique semiquantitative method for lymphoma. However, type of standard uptake values (max, mean, and peak) reconstruction algorithms could affect DS. We compared the Bayesian Penalized Likelihood reconstruction algorithm (BPL) with Ordered Subsets Expectation Maximization (OSEM) on quantitative parameters and DS in lymphoma. We investigated the effect of the size of the lymph node on quantitative variation.

PATIENTS AND METHODS: Raw PET data of 255 lymphoma patients were reconstructed separately with Q.Clear (GE Healthcare), a BPL, and SharpIR (GE Healthcare), an OSEM algorithm. In both images, each patient’s liver, mediastinal blood pool, and SUVs (SUVmax, SUVmean, and SUVpeak) of a total of 487 lesions selected from the patients were performed. DSmax, DSmean, and DSpeak were compared.

RESULTS: In our study, DS increased significantly with BPL (p < 0.001), and the DS increased to 4-5 in thirty patients evaluated as 1-2-3 with OSEM. It was found that the quantitative values of the lymph nodes increased statistically with BPL (p < 0.001), and the liver from the reference regions were significantly decreased (p < 0.001). In addition, difference in lymph node was independently associated with size of lesion and was significantly more pronounced in small lesions (p < 0.001). The effects of BPL algorithm were more pronounced in SUVmax than in SUVmean and SUVpeak. DS-mean and DS-peak scores were less changed by BPL than DS-max.

CONCLUSION: Different reconstruction algorithms in FDG PET/CT affect the quantitative evaluation. That variation may affect the change in DS in lymphoma patients, thus affecting patient management.

PMID:37524200 | DOI:10.1016/j.remnie.2023.07.006