Tag: nevin manimala

Am J Obstet Gynecol. 2022 Mar 6:S0002-9378(22)00170-3. doi: 10.1016/j.ajog.2022.02.042. Online ahead of print.

ABSTRACT

OBJECTIVES: This study investigated the efficacy and safety of pharmacological interventions to prevent vertical transmission of hepatitis B virus.

DATA SOURCE: Medline, Cochrane and Scopus databases were searched up to 28^th October 2020.

STUDY ELIGIBILITY CRITERIA: All randomized controlled trials reporting vertical hepatitis B virus transmission with pharmacological intervention were included.

STUDY APPRAISAL AND SYNTHESIS METHODS: Risk of bias was assessed using the Cochrane Risk-of-Bias tool Version 2. Treatment efficacy was estimated using stratified network meta-analysis based on maternal hepatitis B envelope antigen status.

RESULTS: Nineteen studies were included for mothers positive for hepatitis B surface and envelope antigens. Pooling indicated a combination of hepatitis B vaccine and hepatitis B immunoglobulin in infants significantly reduced transmission risk compared to vaccine alone with a risk ratio of 0.52 (95% confidence interval 0.30, 0.91). Only the addition of maternal tenofovir disoproxil fumarate, but not telbivudine, lamivudine, or maternal hepatitis B immunoglobulin further reduced transmission risk compared to a combination of hepatitis B vaccine and hepatitis B immunoglobulin in infants, with a pooled risk ratio of 0.10 (0.03, 0.35). Twelve studies conducted in mothers with hepatitis B surface antigen positivity and mixed, unknown or negative hepatitis B envelope antigen status, provided limited evidence to suggest that maternal hepatitis B immunoglobulin combined with hepatitis B vaccine and immunoglobulin in infants was the likely best treatment, but this failed to reach statistical significance compared to a combination of hepatitis B vaccine and immunoglobulin in infants. Similarly, infant hepatitis B immunoglobulin, added to vaccination, likely provides additional benefit but again failed to reach statistical significance.

CONCLUSION: A combination of hepatitis B vaccine and immunoglobulin in infants is the cornerstone for prevention of vertical transmission for mothers double positive for both hepatitis B surface and envelope antigens. The addition of maternal tenofovir in this infant combination regimen was considered the likely most effective treatment. For infants of mothers with hepatitis B surface antigen positivity and mixed, unknown or negative hepatitis B envelop antigen status, no additional agents provided further benefit beyond hepatitis B vaccine alone.

PMID:35263648 | DOI:10.1016/j.ajog.2022.02.042

Am J Hum Genet. 2022 Mar 3:S0002-9297(22)00064-7. doi: 10.1016/j.ajhg.2022.02.013. Online ahead of print.

ABSTRACT

One mechanism by which genetic factors influence complex traits and diseases is altering gene expression. Direct measurement of gene expression in relevant tissues is rarely tenable; however, genetically regulated gene expression (GReX) can be estimated using prediction models derived from large multi-omic datasets. These approaches have led to the discovery of many gene-trait associations, but whether models derived from predominantly European ancestry (EA) reference panels can map novel associations in ancestrally diverse populations remains unclear. We applied PrediXcan to impute GReX in 51,520 ancestrally diverse Population Architecture using Genomics and Epidemiology (PAGE) participants (35% African American, 45% Hispanic/Latino, 10% Asian, and 7% Hawaiian) across 25 key cardiometabolic traits and relevant tissues to identify 102 novel associations. We then compared associations in PAGE to those in a random subset of 50,000 White British participants from UK Biobank (UKBB_50k) for height and body mass index (BMI). We identified 517 associations across 47 tissues in PAGE but not UKBB_50k, demonstrating the importance of diverse samples in identifying trait-associated GReX. We observed that variants used in PrediXcan models were either more or less differentiated across continental-level populations than matched-control variants depending on the specific population reflecting sampling bias. Additionally, variants from identified genes specific to either PAGE or UKBB_50k analyses were more ancestrally differentiated than those in genes detected in both analyses, underlining the value of population-specific discoveries. This suggests that while EA-derived transcriptome imputation models can identify new associations in non-EA populations, models derived from closely matched reference panels may yield further insights. Our findings call for more diversity in reference datasets of tissue-specific gene expression.

PMID:35263625 | DOI:10.1016/j.ajhg.2022.02.013

Clin Exp Optom. 2022 Mar 9:1-6. doi: 10.1080/08164622.2022.2048174. Online ahead of print.

ABSTRACT

CLINICAL RELEVANCE: Practitioners can be reassured that this antihistamine-releasing contact lens has no additional effect on corneal epithelial integrity.

BACKGROUND: To evaluate the effect of an antihistamine-releasing soft contact lens on corneal epithelium integrity when worn on a daily disposable modality for 12 weeks.

METHODS: Two clinical trials using the same randomised, double-masked, placebo-controlled, parallel-group design enrolled healthy contact lens wearers. Participants wore either etafilcon A with 0.019 mg ketotifen (test; n = 374) or etafilcon A with no added drug (placebo; n = 186). Assessments were conducted at baseline, 1 week and 4, 8, and 12 weeks. Slit-lamp evaluations of corneal staining (using sodium fluorescein) in all regions of the corneas of both eyes were graded on a 0-4 scale. Data from all randomised participants were analysed.

RESULTS: Corneal staining was infrequent and, where present, was mild (Grade 2) or trace (Grade 1). There were no Grade 3 or 4 findings of corneal staining. The overall proportion of findings of Grade 0 corneal staining was 95.86% with the test lens and 95.88% with the placebo lens. The odds of no staining were not statistically different between the test and placebo lenses (Odds Ratio: 0.96, 95% Confidence Intervals: 0.76 to 1.20). There were no serious ocular adverse events or signs of ocular surface medicamentosa.

CONCLUSION: Both test and placebo lenses were well tolerated by subjects during the 3 months of wear. The antihistamine-releasing contact lens does not significantly impact corneal epithelial integrity.

PMID:35263558 | DOI:10.1080/08164622.2022.2048174

J Invest Surg. 2022 Mar 9:1-11. doi: 10.1080/08941939.2022.2046215. Online ahead of print.

ABSTRACT

OBJECTIVE: The hypothesis of this parallel group randomized trial testifies if TissuGlu is a safe and an effective alternative to the conventional drainage placement in regard to post-operative fluid management in the abdominal donor site for autologous (DIEP flap) breast reconstruction with a higher postoperative patient quality of life.

PATIENTS AND METHODS: Data was collected for 58 women who required to be at min.18 years old with a BMI < 30 and not taking any SSRIs (Selective Serotonin Reuptake Inhibitors).Exclusion criteria: Discharge with indwelling suction drains at the abdominal site or signs of wound infection during hospital stay.The patients were randomized into a study group (donor site closure with application of surgical adhesive without drains) and a control group (donor site closure with drains) using a randomly sorted sealed envelope system.Th e primary outcome was defined as the number of post-operative seroma formations.The secondary endpoint was the evaluation of patient satisfaction with both methods.

RESULTS: 58 patients underwent a DIEP reconstruction (29 in the control- and 29 in the study group).Both groups were homogenous. Rate of seroma was 17%(5/29) in the study group and 10%(3/29) in the control group which showed no statistical significance (p-value = 0.71).Smoking and previous abdominal surgery turned out to be a risk factor for seroma formation in the study group.Overall satisfaction was evaluated with a questionnaire and was higher in the study group.

CONCLUSION: The abdominal closure with the surgical adhesive seems to be a safe procedure that contributes to patient satisfaction and increases the independence upon discharge in patients with adequate inclusion criteria.

PMID:35263551 | DOI:10.1080/08941939.2022.2046215

J Recept Signal Transduct Res. 2022 Mar 9:1-9. doi: 10.1080/10799893.2022.2044860. Online ahead of print.

ABSTRACT

Mycobacterium tuberculosis (Mtb) is the causative agent of infectious diseases worldwide. Oxadiazole derivatives have many biological activities and can be a good alternative to antimicrobial drugs. In this study, the quantitative structure-activity relationship (QSAR) of fifty-one novel oxadiazoles derivatives has been studied using the density functional theory (DFT) and statistical methods. Becke’s three-parameter hybrid method and the Lee-Yang-Parr B3LYP functional employing 6-31++G (d) basis set are used to calculated quantum chemical descriptors using Gaussian09 software. The other descriptors including Lipinski, physicochemistry, topological, etc. were calculated using Chembio3d software. Statistically, the best correlation between the independent variables and the PMIC as the dependent variable was a 6-variable equation for which the correlation coefficient were as follows R² = 0.86 and R = 0.93. Also, the values of MAE = 0.003 and Q²_CV = 0.9 confirm the acceptability of the obtained model. The obtained equation shows that NRB, energy gap (ΔE), Henry’s law constant, O-C, and C-N bonds length, and the Free Gibbs energy have the highest correlation with the anti-Tb activity.

PMID:35263550 | DOI:10.1080/10799893.2022.2044860

Environ Sci Technol. 2022 Mar 9. doi: 10.1021/acs.est.2c01177. Online ahead of print.

NO ABSTRACT

PMID:35263543 | DOI:10.1021/acs.est.2c01177

N Engl J Med. 2022 Mar 9. doi: 10.1056/NEJMoa2200797. Online ahead of print.

ABSTRACT

BACKGROUND: Waning of vaccine protection against coronavirus disease 2019 (Covid-19) and the emergence of the omicron (or B.1.1.529) variant of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have led to expedited efforts to scale up booster vaccination. Protection conferred by booster doses of the BNT162b2 (Pfizer-BioNTech) and mRNA-1273 (Moderna) vaccines in Qatar, as compared with protection conferred by the two-dose primary series, is unclear.

METHODS: We conducted two matched retrospective cohort studies to assess the effectiveness of booster vaccination, as compared with that of a two-dose primary series alone, against symptomatic SARS-CoV-2 infection and Covid-19-related hospitalization and death during a large wave of omicron infections from December 19, 2021, through January 26, 2022. The association of booster status with infection was estimated with the use of Cox proportional-hazards regression models.

RESULTS: In a population of 2,239,193 persons who had received at least two doses of BNT162b2 (Pfizer-BioNTech) or mRNA-1273 (Moderna) vaccine, those who had also received a booster were matched with persons who had not received a booster. Among the BNT162b2-vaccinated persons, the cumulative incidence of symptomatic omicron infection was 2.4% (95% confidence interval [CI], 2.3 to 2.5) in the booster cohort and 4.5% (95% CI, 4.3 to 4.6) in the nonbooster cohort after 35 days of follow-up. Booster effectiveness against symptomatic omicron infection, as compared with that of the primary series, was 49.4% (95% CI, 47.1 to 51.6). Booster effectiveness against Covid-19-related hospitalization and death due to omicron infection, as compared with the primary series, was 76.5% (95% CI, 55.9 to 87.5). BNT162b2 booster effectiveness against symptomatic infection with the delta (or B.1.617.2) variant, as compared with the primary series, was 86.1% (95% CI, 67.3 to 94.1). Among the mRNA-1273-vaccinated persons, the cumulative incidence of symptomatic omicron infection was 1.0% (95% CI, 0.9 to 1.2) in the booster cohort and 1.9% (95% CI, 1.8 to 2.1) in the nonbooster cohort after 35 days; booster effectiveness against symptomatic omicron infection, as compared with the primary series, was 47.3% (95% CI, 40.7 to 53.3). Few severe Covid-19 cases were noted in the mRNA-1273-vaccinated cohorts.

CONCLUSIONS: The messenger RNA (mRNA) boosters were highly effective against symptomatic delta infection, but they were less effective against symptomatic omicron infection. However, with both variants, mRNA boosters led to strong protection against Covid-19-related hospitalization and death. (Funded by Weill Cornell Medicine-Qatar and others.).

PMID:35263534 | DOI:10.1056/NEJMoa2200797

J Diabetes Investig. 2022 Mar 9. doi: 10.1111/jdi.13786. Online ahead of print.

ABSTRACT

To estimate the trends in the prevalence of severe hypoglycemia (SH) in patients with type 2 diabetes (T2D) in Korea, we investigated the total number of SH episodes among T2D patients aged ≥30 years who visited the emergency department between 2002 and 2019, using the Korean National Health Insurance Service database. The prevalence of SH events increased from 2002 to 2012; however, it has decreased gradually since 2012. In 2019, the prevalence of SH was 0.6%, with an incidence rate of 4.43 per 1,000 person-years. Approximately 23,000 SH events occur every year in Korea. Although the incidence is steadily decreasing, there are a considerable number of SH events in T2D patients. The decline in the incidence of SH seems to most likely be due to the increased prescription rate of hypoglycemic agents without hypoglycemia risk, less strict treatment goals, and the individualization of therapy.

PMID:35263509 | DOI:10.1111/jdi.13786

Pediatr Transplant. 2022 Mar 9:e14265. doi: 10.1111/petr.14265. Online ahead of print.

ABSTRACT

BACKGROUND: Asymptomatic hyperuricemia is frequently observed in pediatric kidney transplant recipients; symptomatic hyperuricemia, however, is a rare complication. Only few data are available in this patient population. We, therefore, investigated the prevalence of hyperuricemia and its association with kidney transplant function and blood pressure in a multicenter cohort of pediatric kidney transplant recipients.

METHODS: This is a retrospective, observational multicenter registry study. All pediatric kidney transplant recipients in the CERTAIN database with at least one documented serum uric acid level and a follow-up of 5 years posttransplant were eligible. We identified 151 patients with 395 measurements of serum uric acid. We calculated the prevalence of hyperuricemia, analyzed potential risk factors and clinical consequences such as elevated blood pressure and reduced estimated glomerular filtration rate (eGFR). Statistical analysis was performed using IBM SPSS Statistics 26.

RESULTS: One hundred and ten of 395 (27.8%) serum uric acid levels were above 416 µmol/L (7.0 mg/dL), defined as the upper limit of normal. Univariate analysis showed a significant (p = .026) inverse association of serum uric acid with eGFR overtime. There was no significant association of serum uric acid concentrations with body mass index (z-score), blood pressure (z-score), or sex. No episodes of gout were documented.

CONCLUSION: This study shows that hyperuricemia is present in a considerable number of patients sometime after pediatric kidney transplantation and is associated with lower eGFR. Whether hyperuricemia contributes to faster decline of graft function or to the overall cardiovascular risk of these patients remains to be elucidated.

PMID:35263498 | DOI:10.1111/petr.14265