Tag: nevin manimala

Cancer Epidemiol Biomarkers Prev. 2023 Jul 25:EPI-23-0340. doi: 10.1158/1055-9965.EPI-23-0340. Online ahead of print.

ABSTRACT

BACKGROUND: Antibiotics use is associated with higher colorectal cancer risk, but little is known regarding any potential effects on survival.

METHODS: We conducted a nationwide cohort study, using complete-population data from Swedish national registers between 2005 and 2020, to investigate prediagnostic prescription antibiotics use in relation to survival in colorectal cancer patients.

RESULTS: We identified 36 061 stage I-III and 11 242 stage IV colorectal cancer cases diagnosed between 2010 and 2019. For stage I-III, any antibiotics use (binary yes/no variable) was not associated with overall or cancer-specific survival. Compared to no use, moderate antibiotics use (total 11-60 days) was associated with slightly better cancer-specific survival (adjusted hazard ratio (aHR) = 0.93, 95% confidence interval (CI) 0.86-0.99), whereas very high use (>180 days) was associated with worse survival (overall survival aHR = 1.42, 95% CI 1.26-1.60, cancer-specific survival aHR =1.31, 95% CI 1.10-1.55). In analyses by different antibiotic types, although not statistically significant, worse survival outcomes were generally observed across several antibiotics, particularly macrolides and/or lincosamides. In stage IV colorectal cancer, inverse relationships between antibiotics use and survival were noted.

CONCLUSIONS: Overall, our findings do not support any substantial detrimental effects of prediagnostic prescription antibiotics use on cancer-specific survival after colorectal cancer diagnosis, with the possible exception of very high use in stage I-III colorectal cancer. Further investigation is warranted to confirm and understand these results.

IMPACT: Although the study findings require confirmation, physicians probably do not need to factor in prediagnostic prescription antibiotics use in prognosticating colorectal cancer patients.

PMID:37490284 | DOI:10.1158/1055-9965.EPI-23-0340

J Nephrol. 2023 Jul 25. doi: 10.1007/s40620-023-01708-7. Online ahead of print.

ABSTRACT

BACKGROUND: The aim of this study was to evaluate the efficacy and safety of COVID-19 vaccines in patients undergoing haemodialysis in Italy compared to the general population.

METHODS: In this cohort study, 118 dialysis centres from 18 Italian Regions participated. Individuals older than 16 years on dialysis treatment for at least 3 months, who provided informed consent were included. We collected demographic and clinical information, as well as data on vaccination status, hospitalisations, access to intensive care units and adverse events. We calculated the incidence, hospitalisation, mortality, and fatality rates in the vaccinated dialysis cohort, adjusted for several covariates. The incidence rates of infection in the dialysis cohort and the general population were compared through Standardised Incidence Rate Ratio.

RESULTS: The study included 6555 patients vaccinated against SARS-CoV-2 infection according to the schedule recommended in Italy. Between March 2021 and May 2022, there were 1096 cases of SARS-CoV-2 infection, with an incidence rate after completion of the three-dose vaccination cycle of 37.7 cases per 100 person-years. Compared to the general population, we observed a 14% reduction in the risk of infection for patients who received three vaccine doses (Standardised Incidence Rate Ratio: 0.86; 95% Confidence Interval: 0.81-0.91), whereas no statistically significant differences were found for COVID-19-related hospitalisations, intensive care unit admissions or death. No safety signals emerged from the reported adverse events.

CONCLUSIONS: The vaccination program against SARS-CoV-2 in the haemodialysis population showed an effectiveness and safety profile comparable to that seen in the general population.

PMID:37490271 | DOI:10.1007/s40620-023-01708-7

Endocrine. 2023 Jul 25. doi: 10.1007/s12020-023-03455-y. Online ahead of print.

ABSTRACT

BACKGROUND: Familial papillary thyroid microcarcinoma (FPTMC) appears to be more aggressive than sporadic papillary thyroid microcarcinoma (SPTMC). However, there are authors who indicate that unicentric FPTMC has a similar prognosis to SPTMC. The objective is to analyze whether unicentric FPTMC has a better prognosis than multicentric FPTMC.

DESIGN AND METHODS: Type of study: National multicenter longitudinal analytical observational study.

STUDY POPULATION: Patients with FPTMC.

STUDY GROUPS: Two groups were compared: Group A (unicentric FPTMC) vs. Group B (multicentric FPTMC).

STUDY VARIABLES: It is analyzed whether between the groups there are: a) differentiating characteristics; and b) prognostic differences.

STATISTICAL ANALYSIS: Cox regression analysis and survival analysis.

RESULTS: Ninety-four patients were included, 44% (n = 41) with unicentric FPTMC and 56% (n = 53) with multicentric FPTMC. No differences were observed between the groups according to socio-familial, clinical or histological variables. In the group B a more aggressive treatment was performed, with higher frequency of total thyroidectomy (99 vs. 78%; p = 0.003), lymph node dissection (41 vs. 15%; p = 0.005) and therapy with radioactive iodine (96 vs. 73%; p = 0.002). Tumor stage was similar in both groups (p = 0.237), with a higher number of T3 cases in the group B (24 vs. 5%; p = 0.009). After a mean follow-up of 90 ± 68.95 months, the oncological results were similar, with a similar disease persistence rate (9 vs. 5%; p = 0.337), disease recurrence rate (21 vs. 8%; p = 0.159) and disease-free survival (p = 0.075).

CONCLUSIONS: Unicentric FPTMC should not be considered as a SPTMC due to its prognosis is similar to multicentric FPTMC.

PMID:37490266 | DOI:10.1007/s12020-023-03455-y

Psychiatr Q. 2023 Jul 25. doi: 10.1007/s11126-023-10044-9. Online ahead of print.

ABSTRACT

Major depression is a frequent condition which variably responds to treatment. In view of its high prevalence, the presence of treatment resistance in major depression significantly impacts on quality of life. Tailoring pharmacological treatment based on genetic polymorphisms is a current trend to personalizing pharmacological treatment in patients with major depressive disorders. Current guidelines for the use of genetic tests in major depression issued by the Clinical Pharmacogenomics Implementation Consortium (CPIC) are based on CYP2D6 and CYP2C19 polymorphisms which constitute the strongest evidence for pharmacogenomic guided treatment. There is evidence of increased clinical response to pharmacological treatment in major depression although largely in non-treatment resistant patients from Western countries. In this study, well characterised participants (N = 15) with complex, largely treatment resistant unipolar major depression were investigated, and clinical improvement was measured at baseline and at week-8 after the pharmacogenomics-guided treatment with the Montgomery Åsberg Depression Rating Scale (MÅDRS). Results suggested a statistically significant improvement (p = 0.01) of 16% at endpoint in the whole group and a larger effect in case of changes in medication regime (28%, p = 0.004). This small but appreciable effect can be understood in the context of the level of treatment resistance in the group. To our knowledge, this is the first study from the Middle East demonstrating the feasibility of this approach in the treatment of complex major depressive disorders.

PMID:37490261 | DOI:10.1007/s11126-023-10044-9

Mycopathologia. 2023 Jul 25. doi: 10.1007/s11046-023-00770-w. Online ahead of print.

ABSTRACT

BACKGROUND: Sudden upsurge in cases of COVID-19 Associated Mucormycosis (CAM) following the second wave of the COVID-19 pandemic was recorded in India. This study describes the clinical characteristics, management and outcomes of CAM cases, and factors associated with mortality.

METHODS: Microbiologically confirmed CAM cases were enrolled from April 2021 to September 2021 from ten diverse geographical locations in India. Data were collected using a structured questionnaire and entered into a web portal designed specifically for this investigation. Bivariate analyses and logistic regression were conducted using R version 4.0.2.

RESULTS: A total of 336 CAM patients were enrolled; the majority were male (n = 232, 69.1%), literate (n = 261, 77.7%), and employed (n = 224, 66.7%). The commonest presenting symptoms in our cohort of patients were oro-facial and ophthalmological in nature. The median (Interquartile Range; IQR) interval between COVID diagnosis and admission due to mucormycosis was 31 (18, 47) days, whereas the median duration of symptoms of CAM before hospitalization was 10 (5, 20) days. All CAM cases received antifungal treatment, and debridement (either surgical or endoscopic or both) was carried out in the majority of them (326, 97.02%). Twenty-three (6.9%) of the enrolled CAM cases expired. The odds of death in CAM patients increased with an increase in HbA1c level (aOR: 1.34, 95%CI: 1.05, 1.72) following adjustment for age, gender, education and employment status.

CONCLUSION: A longer vigil of around 4-6 weeks post-COVID-19 diagnosis is suggested for earlier diagnosis of CAM. Better glycemic control may avert mortality in admitted CAM cases.

PMID:37490256 | DOI:10.1007/s11046-023-00770-w

Environ Sci Pollut Res Int. 2023 Jul 25. doi: 10.1007/s11356-023-28877-z. Online ahead of print.

ABSTRACT

The development of industry has led to serious air pollution problems. It is very important to establish high-precision and high-performance air quality prediction models and take corresponding control measures. In this paper, based on 4 years of air quality and meteorological data from Tianjin, China, the relationships between various meteorological factors and air pollutant concentrations are analyzed. A hybrid deep learning model consisting of a convolutional neural network (CNN) and bidirectional long short-term memory (BiLSTM) is proposed to predict pollutant concentrations. In addition, a Bayesian optimization algorithm is applied to obtain the optimal combination of hyperparameters for the proposed deep learning model, which enhances the generalization ability of the model. Furthermore, based on air quality data from multiple stations in the region, a multistation collaborative prediction method is designed, and the concept of a strongly correlated station (SCS) is defined. The predictive model is modified using the idea of SCS and is used to predict the pollutant concentration in Tianjin. The coefficient of determination R² of PM_2.5, PM₁₀, SO₂, NO₂, CO, and O₃ are 0.89, 0.84, 0.69, 0.83, 0.92, and 0.84, respectively. The results show that our model is capable of dealing with air pollutant prediction with satisfactory accuracy.

PMID:37490250 | DOI:10.1007/s11356-023-28877-z

Clin Rev Allergy Immunol. 2023 Jul 25. doi: 10.1007/s12016-023-08964-2. Online ahead of print.

ABSTRACT

Many potential environmental risk factors, protective factors, and biomarkers of AR have been published, but so far, the strength and consistency of their evidence are unclear. We conducted a comprehensive review of environmental risk, protective factors, and biomarkers for AR to establish the evidence hierarchy. We systematically searched Embase, PubMed, Cochrane Library, and Web of Science electronic database from inception to December 31, 2022. We calculated summary effect estimate (odds ratio (OR), relative risk (RR), hazard ratio (HR), and standardized mean difference (SMD)), 95% confidence interval, random effects p value, I² statistic, 95% prediction interval, small study effects, and excess significance biases, and stratification of the level of evidence. Methodological quality was assessed by AMSTAR 2 (A Measurement Tool to Assess Systematic Reviews 2). We retrieved 4478 articles, of which 43 met the inclusion criteria. The 43 eligible articles identified 31 potential environmental risk factors (10,806,206 total population, two study not reported), 11 potential environmental protective factors (823,883 total population), and 34 potential biomarkers (158,716 total population) for meta-analyses. The credibility of evidence was convincing (class I) for tic disorders (OR = 2.89, 95% CI 2.11-3.95); and highly suggestive (class II) for early-life antibiotic use (OR = 3.73, 95% CI 3.06-4.55), exposure to indoor dampness (OR = 1.49, 95% CI 1.27-1.75), acetaminophen exposure (OR = 1.54, 95% CI 1.41-1.69), childhood acid suppressant use (OR = 1.40, 95% CI 1.23-1.59), exposure to indoor mold (OR = 1.66, 95% CI 1.26-2.18), coronavirus disease 2019 (OR = 0.11, 95% CI 0.06-0.22), and prolonged breastfeeding (OR = 0.72, 95% CI 0.65-0.79). This study is registered in PROSPERO (CRD42022384320).

PMID:37490237 | DOI:10.1007/s12016-023-08964-2

Pharmacoeconomics. 2023 Jul 25. doi: 10.1007/s40273-023-01297-0. Online ahead of print.

ABSTRACT

BACKGROUND: Missing data in costs and/or health outcomes and in confounding variables can create bias in the inference of health economics and outcomes research studies, which in turn can lead to inappropriate policies. Most of the literature focuses on handling missing data in randomized controlled trials, which are not necessarily always the data used in health economics and outcomes research.

OBJECTIVES: We aimed to provide an overview on missing data issues and how to address incomplete data and report the findings of a systematic literature review of methods used to deal with missing data in health economics and outcomes research studies that focused on cost, utility, and patient-reported outcomes.

METHODS: A systematic search of papers published in English language until the end of the year 2020 was carried out in PubMed. Studies using statistical methods to handle missing data for analyses of cost, utility, or patient-reported outcome data were included, as were reviews and guidance papers on handling missing data for those outcomes. The data extraction was conducted with a focus on the context of the study, the type of missing data, and the methods used to tackle missing data.

RESULTS: From 1433 identified records, 40 papers were included. Thirteen studies were economic evaluations. Thirty studies used multiple imputation with 17 studies using multiple imputation by chained equation, while 15 studies used a complete-case analysis. Seventeen studies addressed missing cost data and 23 studies dealt with missing outcome data. Eleven studies reported a single method while 20 studies used multiple methods to address missing data.

CONCLUSIONS: Several health economics and outcomes research studies did not offer a justification of their approach of handling missing data and some used only a single method without a sensitivity analysis. This systematic literature review highlights the importance of considering the missingness mechanism and including sensitivity analyses when planning, analyzing, and reporting health economics and outcomes research studies.

PMID:37490207 | DOI:10.1007/s40273-023-01297-0

Environ Monit Assess. 2023 Jul 25;195(8):988. doi: 10.1007/s10661-023-11594-y.

ABSTRACT

Pesticide use has increased in the Lake Tana sub-basin due to increased agricultural activity, potentially endangering nontargeted organisms. To assess its potential impact on fish health and fish-consuming human populations, pesticide concentrations in the fillet and liver tissue of three fish species, namely Labeobarbus megastoma, Labeobarbus tsanensis, and Oreochromis niloticus, were investigated in Lake Tana. Fish samples were taken from the lake near the rivers of Ribb and Gumara, which flow through agricultural areas where considerable amounts of pesticides have been applied. A total of 96 fish samples were collected. Liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS) revealed the presence of ten pesticides. Pyrimethanil was frequently detected in 96% of liver and 65% of fillet samples at a median concentration of 33.9 µg kg^-1 and 19.7 µg kg^-1, respectively. The highest concentration of pyrimethanil was found in L. megastoma (1850.0 µg kg^-1). Labeobarbus megastoma also had the highest concentration of oxamyl (507.0 µg kg^-1) and flazasulfuron (60.1 µg kg^-1) detected in the liver tissue. The highest concentration of carbaryl (56.5 µg kg^-1) was found in the liver tissue of O. niloticus. Fish tissue samples from the two study sites contained pyrimethanil, oxamyl, carbaryl, and flazasulfuron. Only pyrimethanil showed a statistically significant difference between the two sites and the species L. megastoma and L. tsanensis. The amounts of pesticides found in the fish species pose no direct risk to the health of fish consumer human population. However, the results show that the lake ecosystem needs immediate attention and regular monitoring of the rising pesticide usage in the lake watershed.

PMID:37490187 | DOI:10.1007/s10661-023-11594-y

Ann Biomed Eng. 2023 Jul 25. doi: 10.1007/s10439-023-03318-7. Online ahead of print.

ABSTRACT

PURPOSE: The study aims to assess ChatGPT performance on the Residency Admission National Exam to evaluate ChatGPT’s level of medical knowledge compared to graduate medical doctors in Italy.

METHODS: ChatGPT3 was used in June 2023 to undertake the 2022 Italian Residency Admission National Exam-a 140 multiple choice questions computer-based exam taken by all Italian medical graduates yearly, used to assess basic science and applied medical knowledge. The exam was scored using the same criteria defined by the national educational governing body. The performance of ChatGPT was compared to the performance of the 15,869 medical graduates who took the exam in July 2022. Lastly, the integrity and quality of ChatGPT’s responses were evaluated.

RESULTS: ChatGPT answered correctly 122 out of 140 questions. The score ranked in the top 98.8^th percentile among 15,869 medical graduates. Among the 18 incorrect answers, 10 were evaluating direct questions on basic science medical knowledge, while 8 were evaluating candidates’ applied clinical knowledge and reasoning under the form of case presentation. Errors were logical (2 incorrect answers) and informational in nature (16 incorrect answers). Explanations to the correct answers were all evaluated as “appropriate.” Comparison to national statistics related to the minimal score needed to match into each specialty, demonstrated that the performance of ChatGPT would have granted the candidate a match into any specialty.

CONCLUSION: ChatGPT proved to be proficient in basic science medical knowledge and applied clinical knowledge. Future research should assess the impact and reliability of ChatGPT in clinical practice.

PMID:37490183 | DOI:10.1007/s10439-023-03318-7