Tag: nevin manimala

Photodiagnosis Photodyn Ther. 2023 May 5:103598. doi: 10.1016/j.pdpdt.2023.103598. Online ahead of print.

ABSTRACT

PURPOSE: This study aimed to evaluate the adhesive bond strength and antibacterial efficacy of methylene blue (MB)-mediated antimicrobial photodynamic therapy (aPDT) and curcumin (CUR)-mediated aPDT versus the conventional disinfectants, such as chlorhexidine gluconate (CHX) gel and sodium hypochlorite (NaOCl), for indirect pulp capping (IPC) treatment of permanent molars.

METHODS: One Hundred grossly carious human permanent molars were collected through non-traumatic extraction. All specimens were embedded in polyvinyl cross-sections to the cemento-enamel junction. The cavity preparation was conducted by grinding the samples using silicon carbide discs. After culturing Streptococcus mutans (S. mutans), a 10 µL of S. mutans suspension (10⁶ colony forming units/mL) was transferred in each tooth cavity and anaerobically incubated for 48 hours at 37°C. All specimens were randomly divided into 5 groups: Group-I: samples treated IPC; Group-II: samples treated with 2% CHX gel; Group-III: samples treated with 6% NaOCl; Group-IV: irradiation of prepared cavity with MB-mediated aPDT; and Group-V: irradiation of prepared cavity with CUR-mediated aPDT. After disinfection methods, the universal adhesive was used, and all specimens were restored using giomer. Eventually, confocal laser scanning microscopy, shear bond strength (SBS), micro-tensile bond strength (μTBS), four-point bending strength (4P-BS) analyses were performed, and the data were analyzed statistically.

RESULTS: At baseline, the highest SBS (48.8 ± 6.5 MPa), μTBS (54.3 ± 3.9 MPa), and 4P-BS (123 ± 32 MPa) scores were demonstrated by the samples treated with MB-mediated aPDT. However, after 12 months of storage, the highest SBS (42.3 ± 3.9 MPa) and μTBS (45.2 ± 6.6 MPa) scores were shown by samples treated with MB-mediated aPDT, while CUR-mediated aPDT treated samples demonstrated the highest 4P-BS scores (70 ± 18 MPa). Moreover, the highest antibacterial activity against S. mutans was shown by the samples treated with MB-mediated aPDT.

CONCLUSIONS: The application of aPDT, especially MB-mediated, demonstrated superior SBS, μTBS, and 4P-BS values as well as antibacterial activity against S. mutans as compared to 2% CHX gel and 6% NaOCl as cavity disinfectants for IPC treatment of permanent molars.

PMID:37150490 | DOI:10.1016/j.pdpdt.2023.103598

J Heart Lung Transplant. 2023 May 5:S1053-2498(23)01851-X. doi: 10.1016/j.healun.2023.05.001. Online ahead of print.

ABSTRACT

BACKGROUND: The risk and benefit of desensitization therapy (DST) in highly sensitized mechanical circulatory support (MCS) patients are not well known. We investigated three year post-transplant outcome of desensitized durable MCS patients.

METHODS: Among 689 consecutively enrolled HTx recipients between 2010 and 2016, we categorized them into Group A (desensitized MCS patients, n = 21), Group B (desensitized non-MCS patients, n = 28) and Group C (all non-desensitized patients, n = 640). Post-transplant outcomes included the incidence of primary graft dysfunction (PGD), 3-year survival, freedom from cardiac allograft vasculopathy (CAV), non-fatal major adverse cardiac events (NF-MACE), any treated rejection (ATR), acute cellular rejection (ACR), antibody mediated rejection (AMR) and infectious complications.

RESULTS: The types of DST in Groups A and B were similar and included combinations of rituximab/IVIG and plasmapheresis/bortezomib. Group A, compared with Group B, showed significantly higher pre-DST PRA (92.2 ± 9.8 vs. 83.3 ± 15.6, P = 0.007) and higher PRA reduction after DST (-22.2 ± 26.9 vs. -6.3 ± 7.5, P = 0.015). Groups A and C showed comparable PGD, 3-year survival, freedom from CAV, NF-MACE, ATR, ACR and AMR. Although statistically not significant, Group A showed a numerically higher 3-year freedom from AMR than Group B. Infectious complications were similar in both Groups A and B.

CONCLUSIONS: DST for MCS patients showed significant PRA reduction, resulting in an expansion of the donor pool. Post-transplant outcome of desensitized MCS patients showed comparable clinical outcome to non-desensitized control patients in the same study period, revealing the safety and efficacy of DST.

PMID:37150473 | DOI:10.1016/j.healun.2023.05.001

Sci Total Environ. 2023 May 5:163980. doi: 10.1016/j.scitotenv.2023.163980. Online ahead of print.

ABSTRACT

BACKGROUND: Sex difference in the association between ambient air pollution and cognitive aging remained unclear. This current study aimed to assess the impacts of long-term exposure to major air pollutants on cognitive performance among Chinese middle-aged and older adults, and explore whether these associations could be modified by sex.

METHODS: By deriving longitudinal data from four waves of the China Health and Retirement Longitudinal Study, we included 13,507 participants aged 45+ years who had at least two cognitive tests recorded from 2011 to 2018. We used a standardized questionnaire consisting of five domain-specific functions to measure global cognitive score. Based on well-validated spatiotemporal datasets, annual average concentrations of ambient fine particulate matter (PM_2.5), nitrogen dioxide (NO₂), and ozone (O₃) were assigned to each enrollee at prefectural city level and at the simulated residential addresses through Monte Carlo simulation approach. Linear mixed-effects models were applied to assess the impacts of major air pollutants on cognitive function with multiple adjustments. Sex-stratified analyses were performed to examine the potential effect modification on these associations. To enhance the interpretability of our results, we also compared the estimated effects of air pollutants with the effect of aging on cognitive function.

RESULTS: We evaluated 38,950 records of cognitive function tests, of which 44.0 % were from women. An increase of 10-μg/m³ in PM_2.5, NO₂ and O₃ exposure were associated with 0.36 (95 % confidence interval: -0.40, -0.31), 0.51 (-0.60, -0.43) and 0.26 (-0.47, -0.06) points decline in global cognitive score, respectively, equivalent to the effect of aging by 2.8-5.0 years. Sex-stratified analyses suggested significantly greater cognitive impairment associated with air pollutants in women than men. We found reversely J-shaped concentration-response relationships between ambient air pollutants and cognitive decline in both sexes. Main findings on sex-specific associations were robust to the adjustments for covariates, inclusion criteria, and co-pollutant analyses, as well as sensitivity analyses based on simulation-based exposure for PM_2.5 and NO₂.

CONCLUSIONS: Later-life exposure to ambient air pollution may accelerate cognitive aging of middle-aged and older adults, suggesting significant sex disparity with higher vulnerability in women.

PMID:37150467 | DOI:10.1016/j.scitotenv.2023.163980

Radiother Oncol. 2023 May 5:109694. doi: 10.1016/j.radonc.2023.109694. Online ahead of print.

ABSTRACT

BACKGROUND AND PURPOSE: Outcome prediction of patients with glioma early after the completion of radiotherapy represents a major clinical challenge. Previously, the prognostic value of chemical exchange saturation transfer (CEST) imaging has been demonstrated in patients with newly diagnosed glioma. The objective of this study was to assess the potential of amide proton transfer (APT)-, relayed nuclear Overhauser effect (rNOE)- and semi-solid magnetization transfer (ssMT)-imaging according to Zhou et al. (APTw_asym), Goerke et al. (MTR_RexAPT, MTR_RexNOE and MTR_RexMT) and Mehrabian et al. (PeakAreaAPT, PeakAreaNOE and MT_const) for the prognostication of the overall survival (OS) of patients with glioma at the first follow-up after the completion of radiotherapy.

MATERIALS AND METHODS: 49 of 72 participants with diffuse glioma, who underwent CEST MRI at 3T between July 2018 and December 2021 4 to 6 weeks after the completion of radiotherapy, were analyzed. Contrast-enhancing tumor (CE) and whole tumor (WT) volumes were segmented on T2w-FLAIR and contrast-enhanced T1w images. Kaplan-Meier analysis and logrank-test were used for statistical analyses.

RESULTS: APTw imaging demonstrated the strongest association with OS (HR=4.66, p<0.001). The MT_const (HR=2.54, p=0.044) was associated with the OS of participants with residual contrast-enhancing glioma tissue, whilst the MTR_RexAPT (HR=2.44, p=0.056) showed a trend in this sub-cohort. The MTR_RexNOE, MTR_RexMT and PeakAreaNOE were not associated with survival.

CONCLUSION: Imaging of the APT and ssMT at the first follow-up 4 to 6 weeks after the completion of radiotherapy at 3T were associated with the overall survival of patients with glioma.

PMID:37150450 | DOI:10.1016/j.radonc.2023.109694

Rev Esp Anestesiol Reanim (Engl Ed). 2023 May 5:S2341-1929(23)00091-4. doi: 10.1016/j.redare.2023.05.002. Online ahead of print.

ABSTRACT

OBJECTIVES: Identifying independent predictor factors of failure of ultra-fast track (UFT) extubation and to compare in-hospital outcomes with UFT extubation versus fast track (FT) extubation after cardiovascular surgery in adults.

MATERIAL AND METHODS: Retrospective analysis of 1,498 consecutive patients aged over 18 years-old undergoing cardiovascular surgery at a single institution. Between December 2014 and December 2016, FT extubation was used (N = 713) while, between December 2016 and December 2018, all patients were preoperatively considered suitable for UFT extubation (N = 785). In this instance, a standardized anaesthetic protocol was applied in all cases. The decision to not extubate in the operating room (OR) was based on intraoperative haemodynamic and ventilation.

RESULTS: Extubation in the OR was possible in 699 (89%) patients. Significant independent predictors factors of UFT extubation failure were: preoperative NYHA class III-IV, myocardial infarction within two days prior to surgery, preoperative intra-aortic balloon counterpulsation, urgent/emergent surgery, intraoperative transfusion of platelets and intraoperative inotropic and vasopressor support. UFT extubation was associated with lower rates of cardiovascular complications such as congestive cardiac insufficiency (OR: 1,57; 95% CI: 1,13-2,19; P = 0,008) and new-onset postoperatory atrial fibrillation (OR: 1,40; 95% CI: 1,06-1,86; P = 0,020). Patient extubated in the OR presented lower risk of overall complications, shorter intensive care unit stay and higher short-term survival, although, no statistically significance was found when performing the multivariate adjustment.

CONCLUSIONS: A routine immediate extubation in the OR following adult cardiovascular surgery is a feasible and safe practice, associated with low cardiovascular morbidity.

PMID:37150440 | DOI:10.1016/j.redare.2023.05.002

J AAPOS. 2023 May 5:S1091-8531(23)00081-2. doi: 10.1016/j.jaapos.2023.02.005. Online ahead of print.

ABSTRACT

PURPOSE: To analyze rates of follow-up eye care for students that failed school vision screenings over a 7-year period in 238 Arkansas school districts.

METHODS: In this cross-sectional study, vision screening, demographic, socioeconomic, academic, and eye care provider data were collected. The main outcomes were referral rates, rates of follow-up eye care for students with failed vision screenings, and estimated associations between the rate of follow-up and school district and county-level characteristics, such as race, poverty, insurance coverage, academic achievement, and the number of eye care providers.

RESULTS: A total of 1,744,805 vision screenings over 7 academic years (2013-2020) were included. The average screening rate was 35.4% across the study years. The screening failure rate ranged from 8.0% to 9.4%. Two-thirds of districts had a follow-up rate between 20% and 50%. 91% had follow-up rates of <60%. School districts with higher concentrations of White students (P < 0.001), higher graduation rates (P = 0.024), higher percentages of students on government-assisted insurance (P = 0.035), and higher standardized scores (P < 0.001) had higher rates of follow-up. There were no statistically significant relationships between the rate of follow-up eye care and the number of school nurses per school district or the number of ophthalmologists or optometrists per county.

CONCLUSIONS: Arkansas children in our study cohort that failed vision screenings had inadequate follow-up eye care. Follow-up rates were associated with several key indicators of socioeconomic status.

PMID:37150435 | DOI:10.1016/j.jaapos.2023.02.005

J Minim Invasive Gynecol. 2023 May 5:S1553-4650(23)00170-X. doi: 10.1016/j.jmig.2023.05.001. Online ahead of print.

ABSTRACT

OBJECTIVE: To assess the efficacy and safety of mechanical bowel preparation before benign laparoscopic or vaginal gynecologic surgeries.

DATA SOURCES: Database searches of MEDLINE (PubMed), EMBASE (OVID), Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Sciences as well as citations and reference lists published up to December 2021.

METHODS OF STUDY SELECTION: Randomized clinical trials in any language comparing mechanical bowel preparation with no preparation were included. Two reviewers independently screened 925 records and extracted data from 12 selected articles and assessed the risk of bias with the Rob2 tool. A random-effects model was used for the analysis. Surgeon findings (surgical field view, quality of bowel handling and bowel preparation), operative outcomes (blood loss, operative time, length of stay, surgical site infection) and patient’s pre-operative symptoms and satisfaction were collected.

TABULATION, INTEGRATION AND RESULTS: Thirteen studies (1715 patients) assessing oral and rectal preparations before laparoscopic and vaginal gynecologic surgeries were included. No significant differences were observed with or without mechanical bowel preparation on surgical field view (primary outcome, risk ratio (RR) = 1.01, 95%CI 0.97 to 1.05, p=0.66, I²=0%); bowel handling (RR = 1.01, 95%CI 0.95 to 1.08, p=0.78, I²=67%) or bowel preparation. In addition, there were no statistically significant differences in peri-operative findings. Mechanical bowel preparation was associated with increased pain (mean difference (MD) 11.62[2.80 to 20.44], I²=76, p=0.01); weakness (MD 10.73[0.60 to 20.87], I²=94, p=0.04); hunger (MD 17.52[8.04 to 27.00], I²=83, p=0.0003); insomnia (MD 10.13[0.57 to 19.68], I²=82, p=0.04); and lower satisfaction (RR = 0.68 95%CI 0.53 to 0.87, I²=76%, p=0.002), compared with controls.

CONCLUSIONS: Mechanical bowel preparation has not been associated with improved surgical field view, bowel handling or operative outcome. However, in view of the adverse effects induced, its routine use prior to benign gynecological surgeries should be abandoned. PROSPERO Registration: CRD42022296724.

PMID:37150431 | DOI:10.1016/j.jmig.2023.05.001

Arch Phys Med Rehabil. 2023 May 5:S0003-9993(23)00284-8. doi: 10.1016/j.apmr.2023.04.016. Online ahead of print.

ABSTRACT

OBJECTIVE: This study describes the creation and examination of the internal consistency, content validity, construct-structural validity, and criterion-concurrent validity of the Select Medical Patient Reported Experience Measure (SM-PREM ©).

DESIGN: Observational study design.

SETTING: 1,054 outpatient physical and occupational therapy locations in North America.

PARTICIPANTS: The study included 89,205 patients with various musculoskeletal disorders.

INTERVENTION: Not applicable.

MAIN OUTCOME MEASURES: Content validity was described, and internal consistency, construct-structural validity (factor analysis), and criterion-concurrent validity were analyzed, with concurrent validity compared against patient reported outcomes (PROM), the Net Promoter Scale (NPS), and the Orebro Musculoskeletal Screening Questionnaire-12 (OMSQ-12).

RESULTS: Exploratory and confirmatory factor analysis of the SM-PREM yielded three dimensions, each with a very strong internal consistency (>.850). The SM-PREM yielded statistically significant results in all areas, with values that reflected minimal to fair association with PROMs.

CONCLUSION: The SM-PREM appears to capture a unique construct compared to PROMs. The 11-item tool has three definitive dimensions and exhibits strong internal consistency. The tool may be useful in examining patient experience in patients with musculoskeletal injuries seen by physical and occupational therapists.

PMID:37150428 | DOI:10.1016/j.apmr.2023.04.016

J Ethnopharmacol. 2023 May 5:116609. doi: 10.1016/j.jep.2023.116609. Online ahead of print.

ABSTRACT

ETHNOPHARMACOLOGICAL RELEVANCE: The traditional Chinese medicine formula Danggui-Shaoyao-San (DSS) has been reported to have estrogen-like effects and therapeutic effects on the symptoms of Alzheimer’s disease (AD).

AIM OF THE STUDY: To explore whether the central oxytocin and neuroendocrine system is involved in the modulating effects of DSS on the cognition and neuropsychiatric hebaviors in female AD rats, and to investigate the pharmacokinetics of paeoniflorin and ferulic acid in female AD rats with DSS treatment.

MATERIAL AND METHODS: DSS (1.2, 3.2, 8.6g/kg/day) was orally administered to ovariectomized (OVX) rats, and saline was orally administered to sham operation rats as control group. The Morris water maze test, novel object recognition test, and passive avoidance test were conducted for evaluation of learning and memory abilities, while elevated plus maze test and forced swim test were performed to assess anxiety- and depressive-like behaviors. ELISA kits were used to detect the levels of estrogen (E), estrogen receptor α (ERα), oxytocin (OT), oxytocin receptor (OTR), acetylcholine (Ach), acetylcholin esterase (AchE), and choline acetyl transferase (ChAT) in the cortex. The concentrations of Ach, glutamate (Glu), γ-aminobutyric acid (GABA), 5-hydroxytryptamine (5-HT), norepinephrine (NE) and dopamine (DA) in the hippocampus were assessed by HPLC-MS. The changes of neuronal morphology in the hippocampus were observed by Nissl staining. The pharmacokinetics of paeoniflorin and ferulic acid in OVX rats with DSS treatment were studied by HPLC.

RESULTS: In the Morris water maze test, novel object recognition test, and passive avoidance test, OVX rats showed cognitive impairment. In the elevated plus maze test and forced swim test, the anxiety- and depressive-like behaviors of OVX rats were significant as compared to the control group. Treatment of DSS significantly imporved the cognitive deficits, and ameliorated anxiety- and depressive-like behaviors of OVX rats. The expression of E, ERα, OT, OTR, AchE and ChAT in the cortex of model group were significantly decreased, and DSS significantly reversed these changes. The concentrations of Ach, Glu, GABA, 5-HT and NE in the hippocampus of OVX rats were significantly decreased, whereas DSS significantly increased the levels of Ach, Glu, GABA, 5-HT and NE. There was no significant difference in the concentration of DA in the hippocampus among groups. Degenerating neurons in the hippocampal CA3 region were observed in OVX rats, and the number of neurons was decreased. DSS treatment reduced the degenerating neurons, and incresed the number of neurons. The MRT (0 – ∞), AUC (0 – ∞), Cmax and t1/2z values of paeoniflorin, and the AUC _0-∞ and C_max value of ferulic acid were higher in DSS-treated OVX rats than those in the DSS-treated control rats.

CONCLUSIONS: DSS improves the learning and memory ability, and attenuates anxiety- and depressive-like behaviors of OVX rats. The mechanism may be through increasing estrogen, reducing cholinergic damage, and modulating neurotransmitters. The increase in absorption and elimination time of paeoniflorin and ferulic acid in OVX rats may enhance the efficacy of DSS.

PMID:37150422 | DOI:10.1016/j.jep.2023.116609

Gastrointest Endosc. 2023 May 5:S0016-5107(23)02505-1. doi: 10.1016/j.gie.2023.04.2091. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: Endoscopic ultrasound (EUS)-guided interventions currently serve as first-line treatment for symptomatic pancreatic fluid collections (PFCs) but require high-level expertise and multidisciplinary care. Hospital caseload has not been fully examined in relation to clinical outcomes of patients with endoscopically managed PFCs.

METHODS: Using the Diagnosis Procedure Combination database, a Japanese nationwide inpatient database, we identified 4,053 patients receiving EUS-guided treatment of PFCs at 486 hospitals in 2010-2020 and examined an association of hospital volume (average annual number of cases at a hospital) with in-hospital mortality. Associations with bleeding, length of stay, and total costs were examined as secondary analyses. Multivariable logistic regression analysis was conducted with adjustment for potential confounders.

RESULTS: The hospital volume was inversely associated with the risk of in-hospital mortality (P_trend < .001). The adjusted odds ratio for in-hospital mortality comparing the extreme quintiles of hospital volume was 0.17 (95% confidence interval, 0.09-0.33). A restricted cubic spline analysis yielded no statistically significant evidence on the nonlinear relationship (P_nonlinearity = .19). The types of stents (plastic vs. lumen-apposing metal stent) appeared to have no effect modification on the volume-mortality relationship (P_interaction = .58). Higher hospital volume was also associated with lower risk of bleeding, shorter length of stay, and lower medical costs of inpatient care.

CONCLUSIONS: Higher hospital volume was associated with a lower risk of in-hospital mortality of patients receiving EUS-guided treatment of PFCs. A further investigation is warranted to justify the volume-based selective referral of the patients.

PMID:37150410 | DOI:10.1016/j.gie.2023.04.2091