Tag: nevin manimala

Neurol Neurochir Pol. 2023 Sep 5. doi: 10.5603/pjnns.95117. Online ahead of print.

ABSTRACT

INTRODUCTION: The phenomenon known as periodic limb movements in sleep (PLMS) has been linked to a change in autonomic nervous system (ANS) activity and its effect on circulatory regulation. Autonomic dysfunction or dysregulation in patients with PLMS has been described in some domains; however, any relationship between heart rate variability (HRV) and PLMS has not been clearly established. HRV analysis is a recognised, non-invasive research method that describes the influence of the ANS on heart rate (HR). The aim of our study was to further investigate the dysregulation of autonomic HR control in patients with PLMS.

MATERIAL AND METHODS: We undertook a retrospective analysis of the polysomnographic (PSG), demographic and medical data of five patients with a total number of 1,348 PLMS. We analysed HR, HRV HF, systolic blood pressure (SBP), and diastolic blood pressure (DBP) for 10 heartbeats before the series of PLMS and 10 consecutive heartbeats as beat-to-beat measurements. The presented method of using successive, short, 10 RR interval segments refers to the time-frequency measurement, which is very clear and useful for presenting changes in the calculated parameters over time and thereby illustrating their dynamics. This method allowed us to assess dynamic changes in HRV HF during successive PLMS series. Statistical analysis was performed using IBM SPSS Statistics (v. 28.0.0.0). The Kruskal-Wallis test was performed to find statistically significant changes from baseline.

RESULTS: No statistically significant changes in HR, SBP, or DBP were found in our group, although an increase in the value of the HRV HF was noted, suggesting an increase in intracardiac parasympathetic activity during the subsequent series of PLMS.

CONCLUSIONS: Our study indicates an increase in parasympathetic activity during the appearance of successive PLMS, which, with the simultaneous lack of changes in HR, may suggest an increase in sympathetic activity, and therefore the appearance of so-called ‘autonomic co-activation’ resulting in the possibility of life-threatening cardiac events.

CLINICAL IMPLICATIONS: Our findings add to the literature information regarding HRV in PLMS, and highlight the need for further studies to elucidate the effects of these conditions on the ANS, and on cardiovascular health.

PMID:37668022 | DOI:10.5603/pjnns.95117

J Med Virol. 2023 Sep;95(9):e29079. doi: 10.1002/jmv.29079.

NO ABSTRACT

PMID:37668018 | DOI:10.1002/jmv.29079

Proc Inst Mech Eng H. 2023 Sep 5:9544119231196285. doi: 10.1177/09544119231196285. Online ahead of print.

ABSTRACT

This study proposes an intelligent health prediction and fault prognosis of the endodontic file during the root canal treatment. Root canal treatment is the procedure of disinfecting the infected pulp through the canal with the help of an endodontic instrument. Force signals are acquired with the help of a dynamometer during the canal preparation, and statistical features are extracted. The extracted features are selected through the window-wise feature extraction process. Characteristic features for endodontic file prognostics include time-domain features of the signals are evaluated. The extracted feature has inappropriate information, that is, noise between the signals; hence the smoothing of the feature is required at this stage to observe a trend in the signals. Based on the smoothing feature and post-processing of the feature, defined the health index to calculate the health condition of the endodontic instruments. A machine learning algorithm and exponential degradation model are used to predict the health of the endodontic instrument during the root canal treatment. This model is used to forecast the degradation of the endodontic file so that actions can be taken before actual failures happen. The proposed methodology can analyze the failures and micro-crack initiation of the endodontic instruments. Endodontics practitioners can use the machine learning models as well as an exponential model for estimating the health condition of the endodontic instrument. This study may help the clinician to progress the efficiency of the root canal treatment and the competence of the endodontic instruments.

PMID:37668014 | DOI:10.1177/09544119231196285

Cancer Med. 2023 Sep 5. doi: 10.1002/cam4.6476. Online ahead of print.

ABSTRACT

BACKGROUND: The latest fifth edition of the World Health Organization (WHO) classification of the central nervous system (CNS) tumors (WHO CNS 5 classification) released in 2021 defined astrocytoma, IDH-mutant, Grade 4. However, the understanding of this subtype is still limited. We conducted this study to describe the features of astrocytoma, IDH-mutant, Grade 4 and explored the similarities and differences between histological and molecular subtypes.

METHODS: Patients who underwent surgery from January 2011 to January 2022, classified as astrocytoma, IDH-mutant, Grade 4 were included in this study. Clinical, radiological, histopathological, molecular pathological, and survival data were collected for analysis.

RESULTS: Altogether 33 patients with astrocytoma, IDH-mutant, Grade 4 were selected, including 20 with histological and 13 with molecular WHO Grade 4 astrocytoma. Tumor enhancement, intratumoral-necrosis like presentation, larger peritumoral edema, and more explicit tumor margins were frequently observed in histological WHO Grade 4 astrocytoma. Additionally, molecular WHO Grade 4 astrocytoma showed a tendency for relatively longer overall survival, while a statistical significance was not reached (47 vs. 25 months, p = 0.22). TP53, CDK6, and PIK3CA alteration was commonly observed, while PIK3R1 (p = 0.033), Notch1 (p = 0.027), and Mycn (p = 0.027) alterations may affect the overall survival of molecular WHO Grade 4 astrocytomas.

CONCLUSIONS: Our study scrutinized IDH-mutant, Grade 4 astrocytoma. Therefore, further classification should be considered as the prognosis varied between histological and molecular WHO Grade 4 astrocytomas. Notably, therapies aiming at PIK3R1, Notch 1, and Mycn may be beneficial.

PMID:37667984 | DOI:10.1002/cam4.6476

Int J Nurs Pract. 2023 Sep 5:e13199. doi: 10.1111/ijn.13199. Online ahead of print.

ABSTRACT

AIMS: The study aimed to develop and evaluate the effects of a self-determination theory-based, nurse-led, physical activity programme for postmenopausal women with rheumatoid arthritis.

METHODS: Between December 2019 and April 2020, this randomized controlled trial recruited 62 postmenopausal women with rheumatoid arthritis from a university-affiliated hospital in South Korea. The intervention group participated in a self-determination theory-based, nurse-led, physical activity programme that consisted of Tai Chi-based physical activity, a supportive psychosocial strategy, and interactive counselling for 16 weeks, and the control group continued to undergo their usual care.

RESULTS: There were statistically significant group-by-time interactions in physical activity and perceived sarcopenia, which favoured the intervention group. Additionally, the intervention group showed significant improvements in the perceived therapeutic efficacy of physical activity, grip strength, walking speed, disease activity score, and health-related quality of life.

CONCLUSIONS: The programme developed in this study can be an effective and feasible approach for postmenopausal women with rheumatoid arthritis in improving physical activity, selected osteosarcopenic outcomes, and health-related quality of life. Further research is required to investigate the long-term effects of this theory-based programme for postmenopausal women in diverse settings.

PMID:37667974 | DOI:10.1111/ijn.13199

Cardiovasc J Afr. 2023 Aug 31;34:1-6. doi: 10.5830/CVJA-2023-039. Online ahead of print.

ABSTRACT

BACKGROUND: Cardiovascular disease is the leading cause of mortality worldwide, with dyslipidaemia being one of the major risk factors. Point-of-care testing (POCT) allows for the rapid measurement of serum lipids. The aim of this study was to assess the accuracy of serum lipid measurement by the Fujifilm^™ NX700 POCT compared to a gold-standard clinical laboratory method (Medpace, Leuven, Belgium).

METHODS: This was a prospective, observational study conducted at the Lipid Clinic at Charlotte Maxeke Johannesburg Academic Hospital from July to September 2022. Participants were known to have a lipid disorder, most commonly, familial hypercholesterolaemia. Samples sent for lipid measurement by standard laboratory methods were simultaneously measured by the Fujifilm^™ NX700 POCT.

RESULTS: Lipograms evaluating total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C) and calculated low-density lipoprotein cholesterol (LDL-C) were obtained from 115 participants. No statistically significant difference was noted between the parameters tested on the different platforms. The Fujifilm^™ NX700 POCT correctly identified > 91% of serum lipid results as normal or abnormal, as defined by NCEP-ATP III criteria, and exhibited good sensitivity and specificity for each parameter. Lin’s concordance correlation coefficient demonstrated a strong correlation for all parameters; TC (ρ_c = 0.9861), HDL-C (ρ_c = 0.95919), LDL-C (ρ_c = 0.98134) and TG (ρ_c = 0.92775). Bland-Altman plots identified low bias and a good level of agreement between the two test methods.

CONCLUSION: The Fujifilm^™ NX700 POCT compared favourably with gold-standard laboratory methods in the determination of serum lipid measurements, allowing for rapid screening at the primary healthcare level.

PMID:37667971 | DOI:10.5830/CVJA-2023-039

Eur Rev Med Pharmacol Sci. 2023 Aug;27(16):7861-7867. doi: 10.26355/eurrev_202308_33441.

ABSTRACT

OBJECTIVE: SARS-CoV-2 causes acute respiratory disease, interstitial and alveolar pneumonia, and involves numerous organs and systems such as the kidney, heart, digestive tract, blood, and nervous system. We aimed to evaluate the incidence of renal manifestations in patients diagnosed with COVID-19 infection.

PATIENTS AND METHODS: We performed a monocentric, cross-sectional, observational study, conducted on 114 patients with SARS-CoV-2. Clinical and laboratory parameters [renal function, serum electrolytes, inflammatory state, blood gas analysis, Interleukin 6 (IL-6) and urinalysis] were evaluated. The same values were checked out after two months (T1), however after negativization.

RESULTS: We enrolled 114 patients (59 males) with a mean age of 63.8 ± 13.9 years. We found hematuria in 48 patients (55.8%), proteinuria in 33 patients (38.4%), leukocyturia in 61 patients (70.9%), acute kidney injury (AKI) in 28 patients (24.6%), AKI in chronic kidney disease (CKD) in 24 patients (21.1%). Moreover, we found a significant increase of inflammatory indexes as C Reactive Protein (CRP), lactic dehydrogenase (LDH), alpha 1 and alpha 2 globulins with a subsequent reduction at T1 (p = 0.016, p < 0.001, p = 0.005, p = 0.007; respectively). Hemoglobin and erythrocyte values significantly decreased (p < 0.001, p = 0.003, respectively), and we found lymphopenia (p < 0.001). Also, we found elevated levels of the D-Dimer (p < 0.001) and a significant increase in the International Normalized Ratio (INR) (p = 0.038). We also showed a significant improvement after negativization in oxygen partial pressure (p = 0.001) and oxygen saturation (p < 0.001) and a significant increase in pH (p = 0.018) and bicarbonate concentration (p = 0.042). Moreover, we found a significant increase in IL-6 (p = 0.004). Also, we reported mild hyponatremia and hypokalemia with subsequent significant recovery (p < 0.001, p < 0.001, respectively) and mild hypochloremia with a recovery to the limits of statistical significance (p = 0.053). At the entrance, we found an increase in serum glucose with a significant reduction during recovery (p < 0.001).

CONCLUSIONS: The prevalence of AKI and/or CKD and/or abnormal urinalysis in patients diagnosed with COVID-19 on admission seems to be high and appears as a negative prognostic factor. Urinalysis appears to be very useful in unveiling the potential kidney impairment of COVID-19 patients; therefore, urinalysis could be used to reflect and predict the disease severity. We also recommend a careful evaluation of metabolic alterations, inflammatory states, and electrolytic disorders in COVID-19 patients.

PMID:37667963 | DOI:10.26355/eurrev_202308_33441

Eur Rev Med Pharmacol Sci. 2023 Aug;27(16):7823-7830. doi: 10.26355/eurrev_202308_33437.

ABSTRACT

OBJECTIVE: COVID-19 is a febrile infectious disease caused by severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2). This virus affects several organs, including the skin. Acute telogen effluvium (TE) is a non-scarring hair loss characterized by diffuse hair shedding that begins three months after a stressful event and can last up to six months. COVID-19 infection is one of these potential stressors. Recently, there has been a reported link between increased scalp hair shedding and post-infection patients during the COVID-19 outbreak. The present work aimed to study the possible effects of COVID-19 on hair and the relationship between COVID-19 and TE and to assess the level of awareness about TE in the Asir region of Saudi Arabia.

SUBJECTS AND METHODS: A questionnaire-based cross-sectional study was conducted using a pre-validated questionnaire. The study involved 561 participants from the Asir region of Saudi Arabia. Eligible participants were individuals from the Asir region who were 20 years of age or older, had previously contracted COVID-19 and had no history of TE before infection. All statistical methods used were two-tailed with an alpha level of 0.05, considering significance if the p-value was lower than or equal to 0.05.

RESULTS: A total of 1,000 eligible participants completed the study questionnaire. The mean age was 32.5 ± 13.9 years, and 494 (88.1%) participants were females. In addition, 558 (99.5%) of the study participants had received the COVID-19 vaccine. A total of 411 (73.3%) participants experienced an increase in hair loss after COVID-19 infection, and 171 (30.5%) began suffering from pain when combing their hair. In addition, 182 participants (32.4%) had a family history of TE. Only 109 (10.9%) participants had a good awareness level about TE, while 452 (80.6%) had an overall poor awareness level. There was a significant relationship between the level of awareness and age, where 23.9% of the participants aged 20-29 years had a good level of awareness vs. 16.1% of others aged 40 years or older (p = 0.041). Moreover, 26.9% of participants with a family history of TE had a good awareness of TE, vs. 15.8% of those with no family history of TE (p = 0.002). In addition, significant correlations were found between increased hair loss post-COVID-19 infection and female gender (77.3% vs. 43.3%; p = 0.001) as well as suffering from pain when combing hair (86.5% vs. 65.5%; p = 0.001).

CONCLUSIONS: In our study, the incidence of TE was highly related to COVID-19 infections among both sexes. However, the incidence was greater among the female population. The awareness level toward post-COVID-19 TE was poor among most of the participants in our study.

PMID:37667959 | DOI:10.26355/eurrev_202308_33437

Eur Rev Med Pharmacol Sci. 2023 Aug;27(16):7781-7792. doi: 10.26355/eurrev_202308_33433.

ABSTRACT

OBJECTIVE: Renal cell carcinoma (RCC) has gradually increased in recent years. There have been significant developments in metastatic RCC in recent years with the introduction of immune control point inhibitors. Glucocorticoid-induced tumor necrosis factor (TNF) receptor-related protein (GITR) is a co-stimulatory molecule and is seen in the highest amounts in activated CD4+ T lymphocytes and CD8+ T lymphocytes, forkhead box protein 3 (FOXP3) positive regulatory T cells (Treg). GITR leads to an increase in interleukin (IL)-2 and CD25 and Interferon Gamma. It shows an anti-tumoural effect by inhibiting the suppressive functions of FOXP3+ regulatory cells (Treg). Therefore, we aimed to evaluate the prognostic and predictive effect of GITR, tumor-infiltrating lymphocytes (CD4+CD8) (TIL), and FOXP3 in patients with metastatic RCC.

PATIENTS AND METHODS: Patients diagnosed with pathologically confirmed metastatic renal cancer between 2016 and 2021 were included in our study. Clinicopathological features and some laboratory tests were recorded. GITR, CD4, CD8, and FOXP3 were evaluated by immunohistochemistry (IHC) from biopsies or nephrectomy material and recorded.

RESULTS: The study included 41 patients. The median progression-free survival (PFS) was 10.5 months, and the median overall survival (OS) was 13.9 months. Median PFS was 7.9 months for the GITR-low group and 18.9 months for the GITR-high group. Median PFS was statistically significant and longer for the GITR-high group than the GITR-low group (p=0.003). When patients who received nivolumab in the 2nd line were evaluated, median PFS was found to be 5.7 months in the GITR-low group and 15.7 months in the GITR-high group. Median PFS was statistically significantly higher in the GITR-high group than in the GITR-low group (p=0.026).

CONCLUSIONS: In patients with metastatic RCC, higher GITR was associated with better PFS. At the same time, in patients using nivolumab, better PFS was seen in the GITR high group. If supported by prospective studies, GITR can be used as both a prognostic and predictive marker.

PMID:37667956 | DOI:10.26355/eurrev_202308_33433

Eur Rev Med Pharmacol Sci. 2023 Aug;27(16):7768-7780. doi: 10.26355/eurrev_202308_33431.

ABSTRACT

OBJECTIVE: The aim of this study was to systematically assess the effects of different targeted therapies associated with adjuvant chemotherapy on clinical remission, survival and safety of patients with triple-negative breast cancer (TNBC).

MATERIALS AND METHODS: This study searched for case-control trials of TNBC patients from January 2010 to May 2022. Two researchers independently extracted data. RevMan 5.3 statistical software was used for analysis.

RESULTS: This study included a total of 7 clinical controlled studies, containing 620 samples. The results showed that compared with the control group, the study group showed significant differences in objective response rate [OR = 2.44, 95% CI (1.69, 3.5), p < 0.00001], 1-year survival rate [OR = 3.59, 95% CI (2.01, 6.39), p < 0.0001], progression-free survival (PFS) [MD = 2.04, 95% CI (1.68, 2.41), p < 0.00001], with statistical significance (p < 0.05), while there are no significant differences in overall survival [MD = 6.33, 95% CI (-1.65, 14.30), p = 0.12] and incidence of adverse events [OR = 0.73, 95% CI (0.52, 1.02), p = 0.006] (p > 0.05).

CONCLUSIONS: Targeted therapy associated with adjuvant chemotherapy can remarkably enhance the outcome of patients with advanced TNBC, prolonging their progression-free survival (PFS) and overall survival (OS) without increasing adverse effects. The validity of this research, however, will require higher quality studies and longer follow-ups.

PMID:37667955 | DOI:10.26355/eurrev_202308_33431