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Use of a Flexible Ruler in Measuring the Length of Artificial Stapes During Stapedotomy Under Otoendoscopy

Med Sci Monit. 2023 Jul 22;29:e940337. doi: 10.12659/MSM.940337.

ABSTRACT

BACKGROUND We explored a new method for measuring the length of artificial stapes during stapedotomy in otoendoscopic middle-ear surgery using a flexible ruler. MATERIAL AND METHODS A retrospective analysis was conducted on 56 cases of otosclerosis, comprising 56 ears with a follow-up of over 6 months and complete data. Patients were admitted to the Department of Otology, Huazhong University of Science and Technology Union Shenzhen Hospital from July 2020 to June 2022. SPSS statistical software was used for efficacy analysis. The results of different measurement methods on the implantation time of the prosthesis and postoperative hearing follow-up were compared. RESULTS The 56 patients were randomly divided into 2 groups. In 1 case measured by the metal measuring stick, the prosthesis was too short and was replaced during the operation; 2 patients experienced transient dizziness postoperatively, and the other patients had no surgical complications. All 56 patients had varying degrees of hearing improvement after surgery, and no dislocation of the ossicular chain was observed during the follow-up. There was a statistically significant difference in the implantation time of the prosthesis between the different measurement methods (P<0.05). The improvement in hearing in the flexible ruler group was statistically significant (P<0.05). CONCLUSIONS The selection of the length of the ossicular prosthesis is a crucial step in the operation and can directly affect hearing outcomes. The use of a flexible ruler to measure prosthesis length can significantly shorten operation time and improve hearing, and the ruler is easily obtainable. It is worth promoting its application in ear endoscopic stapedotomy.

PMID:37480226 | DOI:10.12659/MSM.940337

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The causal relationship of depression, anxiety, and neuroticism with main indicators of sarcopenia: A Mendelian randomization study

Int J Geriatr Psychiatry. 2023 Jul;38(7):e5980. doi: 10.1002/gps.5980.

ABSTRACT

BACKGROUND: Observational studies have shown the relationship between sarcopenia and psychiatric disorders. However, due to the limitations of traditional research methods, the causal relationship between them has not been accurately concluded. At the same time, considering that sarcopenia is mainly manifested by low muscle strength and low muscle mass, we used Mendelian randomization (MR) analysis in this study to explore the causal relationship of anxiety, depression, and neuroticism with muscle strength and muscle mass, respectively.

METHODS: Genetic variants associated with depression were obtained from FinnGen Biobank (Ncase = 33,812, Ncontrol = 271,380), those associated with anxiety were from FinnGen Biobank (Ncase = 21,519, Ncontrol = 307,558), and those associated with neuroticism, including 12 items, were from a large-scale genome-wide association study (N range: 366,301-375,913). Muscle strength was represented by the hand grip strength (HGS), and muscle mass was represented by the appendicular lean mass (ALM) and the body fat percentage. The inverse-variance weighted (IVW) method was used as the primary analysis method, and the Mendelian Randomization Egger (MR-Egger) and the weighted median were used as supplementary methods to test whether the three psychological factors were causally related to these two main indicators of sarcopenia severity.

RESULTS: Depression and neuroticism had different degrees of causal influence on muscle mass and strength, which was statistically significant. Specifically, the depression predicted by genes was significantly associated with ALM (beta = -0.043, p = 0.027), low hand grip strength (LHGS, measured for people of 60 years and older) (odds ratio (OR) = 1.129 (1.019-1.251), p = 0.019), right HGS (beta = -0.050, p = 0.001), left HGS (beta = -0.06, p = 0.001), and body fat percentage (beta = 0.035, p = 0.0138). The neuroticism predicted by genes was significantly associated with ALM (beta = -0.073, p = 0.034), LHGS (OR = 1.222 (1.085-1.377), p = 0.001), right HGS (beta = -0.058, p = 0.000), left HGS (beta = -0.080, p < 0.000), and body fat percentage (beta = 0.063, p = 0.008). However, anxiety was only significantly associated with LHGS (OR = 1.215 (1.008-1.465), p = 0.041) but not significantly associated with ALM (beta = 0.033, p = 0.313), right HGS (beta = -0.008, p = 0.678), left HGS (beta = 0.007, p = 0.712), or body fat percentage (beta = 0.022, p = 0.559).

CONCLUSION: This study supported the causal association of depression and neuroticism with muscle strength and mass, which are the two main indicators of sarcopenia. At the same time, there was no sufficient evidence for the causal relationship between anxiety and muscle strength or mass. The results of this study pointed to the need to intervene in the mental health of the elderly to prevent sarcopenia or reduce its severity.

PMID:37480221 | DOI:10.1002/gps.5980

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Association of salivary levels of DNA sensing inflammasomes AIM2, IFI16 and cytokine IL 18 with periodontitis and diabetes

J Periodontol. 2023 Jul 21. doi: 10.1002/JPER.23-0184. Online ahead of print.

ABSTRACT

BACKGROUND: Aberrant deoxyribonucleic acid (DNA) contributes to inflammasome orchestrated progression of chronic inflammatory diseases like diabetes and periodontitis. The purpose of the present study was to estimate salivary levels of DNA sensing inflammasomes; absent in melanoma 2 (AIM2), interferon γ inducible protein (IFI16) and cytokine interleukin 18 (IL18) in individuals with periodontitis, diabetes and healthy controls and interpret its association with periodontal and diabetic parameters.

METHODS: Salivary levels of AIM2, IFI16 and IL18 was estimated by enzyme linked immunosorbent assay (ELISA) in a total of 120 individuals (n = 30 in each group), namely healthy (Group 1), periodontitis (Group 2), diabetes (Group 3) and diabetes with periodontitis (Group 4). Correlations of inflammasome levels and periodontal clinical parameters – plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing pocket depth (PPD), clinical attachment level (CAL) and periodontal inflamed surface area (PISA)was performed. Multiple regression was carried out to predict AIM2 and IFI16 with various independent variables.

RESULTS: The mean salivary levels of AIM2, IFI16 and IL18 were highest in diabetes with periodontitis (Group 4) and least in healthy (Group 1) and statistically significant between the groups (p = 0.000). Significant positive correlation between clinical periodontal parameters and AIM2, IFI16 and IL8 was present (p≤0.05). Multiple regression showed HbA1C (p = 0.002), GI (p = 0.016), PISA (p = 0.002) and CAL (p = 0.004) were significant predictors of AIM2, while HbA1C (p = 0.012), PISA (P = 0.003) and CAL (p = 0.007) predicted IFI16.

CONCLUSION: The results of the present study showed higher levels of AIM2, IFI16 and IL18 in saliva of individuals with diabetes and periodontitis. HbA1C, PISA and CAL were significant independent predictors of salivary AIM2 and IFI16 levels. This article is protected by copyright. All rights reserved.

PMID:37480196 | DOI:10.1002/JPER.23-0184

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Prolyl 4-hydroxylase subunit beta (P4HB) could serve as a prognostic and radiosensitivity biomarker for prostate cancer patients

Eur J Med Res. 2023 Jul 22;28(1):245. doi: 10.1186/s40001-023-01215-2.

ABSTRACT

BACKGROUND: Prolyl 4-hydroxylase subunit beta (P4HB) has been reported as a suppressor in ferroptosis. However, no known empirical research has focused on exploring relationships between P4HB and prostate cancer (PCa). In this research, we initially examine the function of P4HB in PCa by thorough analysis of numerous databases and proliferation experiment.

METHODS: We analyzed the correlations of P4HB expression with prognosis, clinical features, mutation genes, tumor heterogeneity, stemness, tumor immune microenvironment and PCa cells using multiple databases and in vitro experiment with R 3.6.3 software and its suitable packages.

RESULTS: P4HB was significantly upregulated in tumor tissues compared to normal tissues and was closely related to biochemical recurrence-free survival. In terms of clinical correlations, we found that higher P4HB expression was significantly related to older age, higher Gleason score, advanced T stage and residual tumor. Surprisingly, P4HB had highly diagnostic accuracy of radiotherapy resistance (AUC 0.938). TGF beta signaling pathway and dorso ventral axis formation were upregulated in the group of low-expression P4HB. For tumor stemness, P4HB expression was positively related to EREG.EXPss and RNAss, but was negatively associated with ENHss and DNAss with statistical significance. For tumor heterogeneity, P4HB expression was positively related to MATH, but was negatively associated with tumor ploidy and microsatellite instability. For the overall assessment of TME, we observed that P4HB expression was negatively associated with all parameters, including B cells, CD4+ T cells, CD8+ T cells, neutrophils, macrophages, dendritic cells, stromal score, immune score and ESTIMATE score. Spearman analysis showed that P4HB expression was negatively related to TIDE score with statistical significance. In vitro experiment, RT-qPCR and western blot showed that three siRNAs of P4HB were effective on the knockdown of P4HB expression. Furthermore, we observed that the downregulation of P4HB had significant influence on the cell proliferation of six PCa cell lines, including LNCap, C4-2, C4-2B, PC3, DU145 and 22RV1 cells.

CONCLUSIONS: In this study, we found that P4HB might serve as a prognostic biomarker and predict radiotherapy resistance for PCa patients. Downregulation of P4HB expression could inhibit the cell proliferation of PCa cells.

PMID:37480146 | DOI:10.1186/s40001-023-01215-2

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Prevalence of hepatitis C virus among patients with arthralgia: is it logic for screening?

Virol J. 2023 Jul 21;20(1):162. doi: 10.1186/s12985-023-02124-w.

ABSTRACT

BACKGROUND: Hepatitis C virus (HCV) is well-known to be associated with multiple extrahepatic manifestations such as arthralgia, myalgia, arthritis, and vasculitis. Many studies reported frequent rheumatologic manifestations among patients infected by HCV. The purpose of this study was to determine the prevalence of HCV among chronic unexplained arthralgia patients in order to aid in the early detection and treatment of silent HCV infection.

METHODS: This study was a cross-sectional observational study conducted from July 2020 to May 2022. It included 145 individuals suffering from chronic unexplained arthralgia, with vast majority having oligoarticular joint pain (110, 75.9%). They were 103 (71%) females and 42 (29%) males. Serum samples from all patients were examined for the presence of anti-HCV antibodies using a rapid immunochromatographic assay. Seropositive samples were further examined using polymerase chain reaction (PCR) for detection of HCV RNA to confirm HCV infection.

RESULTS: Out of 145 patients who complained of arthralgia, seven patients tested positive for anti-HCV with a seroprevalence of 4.8% while five patients tested positive for HCV-RNA with a molecular prevalence of 3.4%. All positive patients were males (11.9%) with high statistical significance (χ2 = 12.7 and p = 0.002). No association was found between HCV infection and age, blood transfusion, surgery, using personal shaving tools, or being a health-care worker.

CONCLUSIONS: The prevalence of HCV was high among males who complained of arthralgia. Patients with arthralgia, especially male patients, are recommended to perform HCV screening test.

PMID:37480120 | DOI:10.1186/s12985-023-02124-w

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Comparison of mini-open reduction and autologous bone grafting with closed reduction and intramedullary device insertion for tibial shaft fractures: a retrospective study

J Orthop Surg Res. 2023 Jul 22;18(1):519. doi: 10.1186/s13018-023-04024-9.

ABSTRACT

BACKGROUND: We compared the clinical efficacy of mini-open reduction and autologous bone grafting (GM) and closed reduction (GC) using intramedullary nailing for the treatment of tibial shaft fractures.

METHODS: This retrospective study included 70 tibial shaft fractures treated with GM or GC between January 2018 and December 2021. The demographic characteristics and clinical outcomes were compared between the two treatment methods.

RESULTS: This study included 70 patients who were followed-up for 12.4 months. In total, 31 and 39 patients were treated with GM and GC, respectively. The operative duration was significantly shorter for GM (95.2 ± 19.3 min) than for GC (105.5 ± 22.2 min, p = 0.0454). The number of radiation times was significantly lower for GM (14.7 ± 6.3) than for GC (22.2 ± 9.2, p < 0.005). There were no statistically significant differences between the groups in terms of the wound complication or infection rates. The malunion and nonunion rates were high after GC than after GM, but there are no significant differences between the groups.

CONCLUSIONS: Closed reduction and intramedullary nailing remains the first choice for tibial shaft fractures. GM is a safe and effective treatment worth considering. Future prospective randomized controlled trials are warranted.

PMID:37480093 | DOI:10.1186/s13018-023-04024-9

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Colorectal adenocarcinoma in Uganda: are right-sided and left-sided colon cancers two distinct disease entities?

World J Surg Oncol. 2023 Jul 22;21(1):215. doi: 10.1186/s12957-023-03094-7.

ABSTRACT

INTRODUCTION: In Western countries, right-sided colon cancers (RSCC) present at an older age and advanced stage. Researchers believe that there is a difference between left-sided colon cancer (LSCC) and RSCC. In Uganda, however, it is unknown whether differences exist in the pathological profile between RSCC and LSCC. The aim of this study was to determine the differences in clinicopathological characteristics between RSCC and LSCC in Ugandan patients.

METHODOLOGY: A cross-sectional study was conducted in which colorectal adenocarcinoma formalin-fixed paraffin-embedded tissue (FFPE) blocks were obtained from 2008 to 2021. Colorectal specimens were obtained from prospectively recruited patients. In the retrospective study arm, FFPE blocks and data were obtained from the archives of pathology laboratory repositories. Parameters studied included age, sex, location of the tumour, grade, stage, lymphovascular (LVI) status, and histopathological subtype between LSCC and RSCC.

RESULTS: Patients with RSCC were not older than those with LSCC (mean age, 56.3 years vs 53.5 years; p = 0.170). There was no difference in the stage between RSCC and LSCC. Poorly differentiated tumours were more commonly found in RSCC than in LSCC (18.7% vs 10.1%; p = 0.038). Moderately and poorly differentiated colonic tumours were more common with RSCC (89.3%) than with LSCC (75.1%) (p = 0.007). Younger patients had more poorly differentiated tumours than older patients (19.6% versus 8.6%; p = 0.002). LVI was more common with RSCC than with LSCC (96.8% vs 85.3%; p = 0.014). Mucinous adenocarcinoma (MAC) was more common with RSCC (15.8%) compared with LSCC (8.5%) (p = 0.056) although statistical significance was borderline.

CONCLUSIONS: Clinicopathological features of RSCCs tend to be different from those of LSCCs. RSCCs tend to be associated with MAC, a higher grade and LVI status compared to LSCC. LSCC and RSCC present predominantly with an advanced stage; therefore, national screening programmes for the early detection of CRC are necessary to reduce mortality in our Ugandan population.

PMID:37480083 | DOI:10.1186/s12957-023-03094-7

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Does it fit in your pocket? economic burden of PD-1 inhibitors’ toxicity in the supplementary health system: evidence from Brazil

BMC Health Serv Res. 2023 Jul 21;23(1):781. doi: 10.1186/s12913-023-09736-6.

ABSTRACT

BACKGROUND: A full understanding of the economic burden associated with treatment-related adverse events (AEs) can aid estimates of the incremental costs associated with incorporating new technologies and support cost-effective economic modeling in Brazil. In this context, the main objective of this work was to evaluate in a real-life database: (i) the direct medical cost of monitoring the occurrence of AEs (CMO); (ii) the direct medical cost of managing an identified AE (CMN); and (iii) the total direct medical cost of monitoring and managing AEs (TMC), in quarterly periods from 0 to 24 months of the monitoring of cancer patients who used a PD-1 inhibitor from the perspective of the supplementary health system in Brazil.

METHODS: This study was conducted from the supplementary health system (SSS) perspective and followed the methodological guidelines related to cost-of-illness studies. A bottom-up (person-based) approach was used to assess the use of health resources to monitor and manage AEs during the use of PD-1 inhibitors, which made it possible to capture differences in the mean frequency of the use of health services with stratification results for different subgroups. As the Brazilian SSS is complex, asymmetric, and fragmented, this study used information from different sources. The methodology was divided into three parts: (i) Data Source: clinical management of AEs; (ii) Microcosting: management of the economic burden of AEs; (iii) Statistical analysis: stratification of results for different subgroups.

RESULTS: Analysis of the economic burden of toxicity showed higher CMO costs than CMN in all the periods analyzed. In general, for every BRL 100 on average invested in the TMC of AEs, BRL 95 are used to monitor the occurrence of the AE and only BRL 5 to manage an identified AE. This work also showed that the sociodemographic characteristics of patients, the journey of oncological treatment, and the toxicity profile affect the economic burden related to AE.

CONCLUSION: This study provided real-world evidence of the economic burden of AEs associated with the use of PD-1 inhibitors in Brazil. This work also made methodological contributions by evaluating the economic burden of AE of PD-1 inhibitors considering the kinetics of toxicity occurrence and categorizing the costs in terms of CMO, CMN and TMC.

PMID:37480058 | DOI:10.1186/s12913-023-09736-6

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Causal discovery approach with reinforcement learning for risk factors of type II diabetes mellitus

BMC Bioinformatics. 2023 Jul 21;24(1):296. doi: 10.1186/s12859-023-05405-x.

ABSTRACT

BACKGROUND: Statistical correlation analysis is currently the most typically used approach for investigating the risk factors of type 2 diabetes mellitus (T2DM). However, this approach does not readily reveal the causal relationships between risk factors and rarely describes the causal relationships visually.

RESULTS: Considering the superiority of reinforcement learning in prediction, a causal discovery approach with reinforcement learning for T2DM risk factors is proposed herein. First, a reinforcement learning model is constructed for T2DM risk factors. Second, the process involved in the causal discovery method for T2DM risk factors is detailed. Finally, several experiments are designed based on diabetes datasets and used to verify the proposed approach.

CONCLUSIONS: The experimental results show that the proposed approach improves the accuracy of causality mining between T2DM risk factors and provides new evidence to researchers engaged in T2DM prevention and treatment research.

PMID:37480046 | DOI:10.1186/s12859-023-05405-x

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Early discontinuation of long-acting reversible contraceptives at four government hospitals, Addis Ababa, Ethiopia

Contracept Reprod Med. 2023 Jul 21;8(1):38. doi: 10.1186/s40834-023-00238-8.

ABSTRACT

OBJECTIVE: Given high unmet need for contraception in Ethiopia, this study aimed to determine prevalence and factors associated with early discontinuation of long-acting reversible contraceptives (LARC).

METHODS: This institution-based cross-sectional study was conducted with 389 participants using exit interviews with clients presenting for removal of LARC at the family planning clinic of four government hospitals in Addis Ababa. SPSS version 26 was used for analysis. Descriptive statistics, bivariate, and multivariate logistic regression were computed.

RESULT: Among the 389 clients, 236 (60.7%) discontinued early. In multivariate regression, lack of pre-insertion counseling on side effects (AOR = 3.5, p = 0. 000; 95% C.I = 1.8-6.8), presence of side effects (AOR = 1.9, p = 0. 017; 95% C.I = 1. 1- 3.4), history of abortion (AOR = 3.5, p = 0. 001; 95% C.I = 1. 6- 7.4); and no prior contraception use (AOR = 2.9, p = 0. 000; 95% C.I = 1. 6- 5.3) were positively associated with early discontinuation. Whereas insertion outside of Saint Paul’s Hospital Millennium Medical College (AOR = 0.4, p = 0. 000; 95% C.I = 0. 2- 0.6), and influence on choice of contraceptives by others (AOR = 0.2, p = 0. 000; 95% C.I = 0. 2- 0.4) were negatively associated with early discontinuation.

CONCLUSION: Early discontinuation of LARC was high among study participants. Counseling about possible side effects and giving women the opportunity to decide their own choice of contraception might help in reducing early discontinuation.

PMID:37480045 | DOI:10.1186/s40834-023-00238-8