Tag: nevin manimala

CMAJ Open. 2023 Jun 6;11(3):E475-E484. doi: 10.9778/cmajo.20220092. Print 2023 May-Jun.

ABSTRACT

BACKGROUND: The COVID-19 pandemic has created major disruptions in cancer care, with reductions in diagnostic tests and treatments. We evaluated the impact of these health care-related changes on cancer staging by comparing cancers staged before and during the pandemic.

METHODS: We performed a retrospective cohort study at London Health Sciences Centre and St. Joseph’s Health Care London, London, Ontario, Canada. We evaluated all pathologically staged breast, colorectal, prostate, endometrial and lung cancers (the 5 most common cancers by site, excluding nonmelanoma skin cancer) over a 3-year period (Mar. 15, 2018-Mar. 14, 2021). The pre-COVID-19 group included procedures performed between Mar. 15, 2018, and Mar. 14, 2020, and the COVID-19 group included procedures performed between Mar. 15, 2020, and Mar. 14, 2021. The primary outcome was cancer stage group, based on the pathologic tumour, lymph node, metastasis system. We performed univariate analyses to compare demographic characteristics, pathologic features and cancer stage between the 2 groups. We performed multivariable ordinal regression analyses using the proportional odds model to evaluate the association between stage and timing of staging (before v. during the pandemic).

RESULTS: There were 4055 cases across the 5 cancer sites. The average number of breast cancer staging procedures per 30 days increased during the pandemic compared to the yearly average in the pre-COVID-19 period (41.3 v. 39.6), whereas decreases were observed for endometrial cancer (15.9 v. 16.4), colorectal cancer (21.8 v. 24.3), prostate cancer (13.6 v. 18.5) and lung cancer (11.5 v. 15.9). For all cancer sites, there were no statistically significant differences in demographic characteristics, pathologic features or cancer stage between the 2 groups (p > 0.05). In multivariable regression analysis, for all cancer sites, cases staged during the pandemic were not associated with higher stage (breast: odds ratio [OR] 1.071, 95% confidence interval [CI] 0.826-1.388; colorectal: OR 1.201, 95% CI 0.869-1.661; endometrium: OR 0.792, 95% CI 0.495-1.252; prostate: OR 1.171, 95% CI 0.765-1.794; and lung: OR 0.826, 95% CI 0.535-1.262).

INTERPRETATION: Cancer cases staged during the first year of the COVID-19 pandemic were not associated with higher stage; this likely reflects the prioritization of cancer procedures during times of reduced capacity. The impact of the pandemic period on staging procedures varied between cancer sites, which may reflect differences in clinical presentation, detection and treatment.

PMID:37279981 | DOI:10.9778/cmajo.20220092

J Sex Med. 2023 Jun 6:qdad066. doi: 10.1093/jsxmed/qdad066. Online ahead of print.

ABSTRACT

BACKGROUND: Limitation to the capacity to love is often a feature of a suffering personality.

AIM: We aimed to investigate the role of the capacity to love in hypersexual behavior, considering both distress and defense mechanisms as possible psychological mediators.

METHODS: Through an online platform, we recruited a convenience sample of 521 subjects (390 [74.9%] females and 131 [25.1%] males; mean [SD] age, 26.46 [5.89] years).

OUTCOMES: Recruited subjects completed a psychometric protocol that included completion of the following measurement tools: (1) the Capacity to Love Inventory (CTL-I), (2) the Hypersexual Behavior Inventory (HBI), (3) the 30-item self-report Defense Mechanisms Rating Scale, and (4) the Brief Symptom Inventory. We then performed correlation and regression analyses and used a mediation model for data analysis.

RESULTS: A significant negative relationship between the capacity to love and hypersexual behavior was found. Furthermore, indirect effects were also statistically significant, supporting the hypothesis that limitation to the capacity to love is related to hypersexuality through the paths of psychological distress and immature defense mechanisms. Finally, compared to the other subjects, those with pathological scores for the HBI showed significantly lower scores on the CTL-I, which suggested limitations to the capacity to love.

CLINICAL IMPLICATIONS: The relationship between limitation to the capacity to love and hypersexuality is fundamental to the diagnostic process in persons with problematic sexuality and psychopathological distress.

STRENGTHS AND LIMITATIONS: This study is the first, to our knowledge, to highlight the role of the capacity to love in sexual behavior, although future studies in specific clinical sample groups would be suitable for further investigation of the relationships among the considered variables.

CONCLUSION: The etiology of limitation in the capacity to love is related to dysfunctional aspects of psychological functioning, such as psychological distress and immature defense mechanisms, and these factors together generate problematic sexuality such as hypersexual behavior. Our results highlight the central role in mental and sexual health of the capacity to love. Based on these findings, clinicians should take these aspects into consideration for diagnosis and treatment of patients presenting with problematic sexuality.

PMID:37279963 | DOI:10.1093/jsxmed/qdad066

J Clin Endocrinol Metab. 2023 Jun 6:dgad339. doi: 10.1210/clinem/dgad339. Online ahead of print.

ABSTRACT

BACKGROUND: Few studies have examined the relationship between vitamin D and the risk of recurrent cardiovascular events in people with coronary heart disease (CHD).

AIM: This study aimed to investigate the associations of serum 25-hydroxyvitamin D [25(OH)D] concentration and the vitamin D receptor (VDR) polymorphisms with the risk of recurrent cardiovascular events in individuals with established CHD.

METHODS: A total of 22,571 participants with CHD were included from the UK Biobank. Recurrent cardiovascular events, including myocardial infarction (MI), heart failure (HF), stroke, and CVD mortality, were identified from electronic health records. Cox proportional hazard models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs).

RESULTS: The median (interquartile range) of serum 25(OH)D concentration was 44.8 (30.3, 61.4) nmol/L, and 58.6% of participants had 25(OH)D below 50 nmol/L. During a median follow-up of 11.2 years, a total of 3,998 recurrent cardiovascular events were documented. After multivariable adjustment, there was a non-linear inverse relationship between serum 25(OH)D and recurrent cardiovascular events (P non-linearity <0.01), and the decreasing risk gradually leveled off at around 50 nmol/L. Compared with participants with serum 25(OH)D <25.0 nmol/L, the HRs (95% CIs) for participants with serum 25(OH)D of 50.0-74.9 nmol/L were 0.64 (0.58, 0.71) for recurrent cardiovascular events, 0.78 (0.65, 0.94) for MI, 0.66 (0.57, 0.76) for HF, and 0.66 (0.52, 0.84) for stroke. In addition, these associations were not modified by genetic variants in the VDR.

INTERPRETATION: In people with established CHD, higher serum 25(OH)D concentrations were non-linearly associated with a lower risk of recurrent cardiovascular events, with a potential threshold around 50 nmol/L. These findings highlight the importance of maintaining adequate vitamin D status in the prevention of recurrent cardiovascular events among individuals with CHD.

PMID:37279959 | DOI:10.1210/clinem/dgad339

Oncologist. 2023 Jun 6:oyad159. doi: 10.1093/oncolo/oyad159. Online ahead of print.

ABSTRACT

BACKGROUND: In recent years, breast cancer has become the most common cancer in the world, increasing women’s health risks. Approximately 60% of breast cancers are categorized as human epidermal growth factor receptor 2 (HER2)-low tumors. Recently, antibody-drug conjugates have been found to have positive anticancer efficacy in patients with HER2-low breast cancer, but more studies are required to comprehend their clinical and molecular characteristics.

METHODS: In this study, we retrospectively analyzed the data of 165 early breast cancer patients with pT1-2N1M0 who had undergone the RecurIndex testing. To better understand HER2-low tumors, we investigated the RecurIndex genomic profiles, clinicopathologic features, and survival outcomes of breast cancers according to HER2 status.

RESULTS: First, there were significantly more hormone receptor (HR)-positive tumors, luminal-type tumors, and low Ki67 levels in the HER2-low than in the HER2-zero. Second, RI-LR (P = .0294) and RI-DR (P = .001) scores for HER2-low and HER2-zero were statistically significant. Third, within HER2-negative disease, HR-positive/HER2-low tumors showed highest ESR1, NFATC2IP, PTI1, ERBB2, and OBSL1 expressions. Fourth, results of the survival analysis showed that lower expression of HER2 was associated with improved relapse-free survival for HR-positive tumors, but not for HR-negative tumors.

CONCLUSIONS: The present study highlights the unique features of HER2-low tumors in terms of their clinical characteristics as well as their gene expression profiles. HR status may influence the prognosis of patients with HER2-low expression, and patients with HR-positive/HER2-low expression may have a favorable outcome.

PMID:37279952 | DOI:10.1093/oncolo/oyad159

Synapse. 2023 Jun 6:e22277. doi: 10.1002/syn.22277. Online ahead of print.

ABSTRACT

Addiction is a global concern with a high relapse rate and without effective therapeutic options. Developing new effective therapeutic strategies is impossible without discovering the disease’s neurobiological basis. The present systematic review aimed to comprehensively recognize and discuss the role of local field potentials from brain areas essential in forming and storing context-drug/food associations following the conditioned place preference (CPP) paradigm as a popular animal model of reward and addiction. Qualified studies were incorporated by a broad search of four databases, including Web of Science, Medline/PubMed, Embase, and ScienceDirect, in July 2022, and they were evaluated via appropriate methodological quality assessment tools. The current study found that drug-seeking behavior in different stages of the CPP paradigm is accompanied by alterations in neural oscillatory activity and adaptations in connectivity among various areas such as the hippocampus, nucleus accumbens, basolateral amygdala, and prelimbic area, intensely engaged in reward-related behaviors. These findings need to be extended by more future advanced studies to finally recognize the altered oscillatory activity patterns of large groups of cells in regions involved in reward-context associations to improve clinical strategies such as neuromodulation approaches to modify the abnormal electrical activity of these critical brain regions and their connections for treating addiction and preventing drug/food relapse in abstinent patients. DEFINITIONS: Power is the amount of energy in a frequency band and is the squared amplitude of the oscillation. Cross-frequency coupling refers to a statistical relationship between activities in two different frequency bands. Phase-amplitude coupling is perhaps the most commonly used method of computing cross-frequency coupling. Phase-amplitude coupling involves testing for a relationship between the phase of one frequency band and the power of another, typically relatively higher, frequency band. Thus, within phase-amplitude coupling, you refer to the “frequency for phase” and the “frequency for power.” Spectral coherence has been frequently used to detect and quantify coupling between oscillatory signals of two or more brain areas. Spectral coherence estimates the linear phase-consistency between two frequency-decomposed signals over time windows (or trials).

PMID:37279942 | DOI:10.1002/syn.22277

Global Spine J. 2023 Jun 6:21925682231181884. doi: 10.1177/21925682231181884. Online ahead of print.

ABSTRACT

STUDY DESIGN: Retrospective comparative study.

OBJECTIVE: To compare the accuracy of intra-operative navigation-assisted percutaneous pedicle screw insertion between bone fixed and skin fixed dynamic reference frame (DRF) in Minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF).

METHODS: Between October 2018 and September 2022, patients who underwent MIS-TLIF were included in this study with DRF fixed either on bone (group B) or skin (group S). Pedicle screws were inserted under the guidance of intra-operative Cone bean Computed tomography (cbCT) based navigation. Accuracy of pedicle screw placement was immediately checked by a final intra-operative cbCT Spin.

RESULTS: Among 170 patients, group B included 91 patients and group S included 79 patients. Out of total 680 screws, 364 screws (group B) and 316 screws (group S) were placed. Patient’s demographic data and distribution of screws showed no statistically significant difference. The accuracy showed no significant difference between both the groups (94.5% in group B and 94.3% in group S).

CONCLUSION: Skin fixed DRF can serve as an alternate way for placement and avoids extra incision with similar accuracy in pedicle screw insertions with bone fixed DRF using intra-operative CT guided navigation in MIS TLIF.

PMID:37279918 | DOI:10.1177/21925682231181884

J Appl Microbiol. 2023 Jun 5:lxad117. doi: 10.1093/jambio/lxad117. Online ahead of print.

ABSTRACT

AIMS: The aim of this study was to determine the biofilm-forming ability of a strain belonging to Ps. fluorescens group isolated from the dairy environment under food-relevant conditions. Moreover, the effects of commercial sanitizers against preformed biofilms were assessed both in terms of viability and structure.

METHODS AND RESULTS: The biofilms were formed on polystyrene, stainless steel (SS), and polytetrafluoroethylene (PTFE) in a wide range of temperatures (4-25°C) and were subjected to the action of ten different sanitizers. The strain under study showed to be a strong biofilm-former regardless of temperature, particularly on polystyrene. The biofilms were mostly sensitive to chlorine and peracetic acid-based sanitizers. For some sanitizers (e.g. amphoteric), a relationship was observed between the material and the tolerance, while the temperature was not statistically significant. The formation of long-term biofilms on SS was also structurally affected by the temperature, showing microcolonies more irregular in shape and with lower cellularity at 4°C compared to 15°C, where the biofilm was more compact and with a high presence of EPS.

CONCLUSIONS: The strain belonging to Ps. fluorescens group was shown to quickly adhere and form mature biofilm at temperatures and on materials relevant to the food sector, however, biofilms formed under different conditions were differently tolerant to disinfectants.

PMID:37279902 | DOI:10.1093/jambio/lxad117

Exp Clin Endocrinol Diabetes. 2023 Jun 6. doi: 10.1055/a-2106-4732. Online ahead of print.

ABSTRACT

BACKGROUND: One of the goals of the St. Vincent Declaration was to reduce serious complications of diabetes, including strokes. However, it remains uncertain whether this goal has been achieved.

STUDY AIM: The aim of our review was to evaluate the incidence of stroke in the diabetic population and its differences regarding sex, ethnicities, age and regions, to compare the incidence rate (IR) in people with and without diabetes, and to investigate time trends.

MATERIALS AND METHODS: A systematic review was conducted according to the guidelines for meta-analysis of observational studies in epidemiology (the MOOSE group) and to the PRISMA group guidelines.

RESULTS: Nineteen of the 6.470 studies retrieved were included in the analysis. The incidence of stroke in the population with diabetes ranged from 238 per 100,000 person-years (PYs) in Germany in 2014 to 1191 during the 1990s in the United Kingdom. The RR comparing people with diabetes to those without diabetes varied between 1.0 and 2.84 for total stroke, 1.0 and 3.7 for ischemic stroke, and 0.68 and 1.6 for hemorrhagic stroke. Significant differences were found between fatal and non-fatal stroke depending on the time period and the population. We found decreasing time trends in people with diabetes and stable incidence rates of stroke over time in people without diabetes.

CONCLUSION: The considerable differences between results can partly be explained by differences in study designs, statistical methods, definitions of stroke, and methods used to identify patients with diabetes. The lack of evidence arising from these differences ought to be rectified by new studies.

PMID:37279879 | DOI:10.1055/a-2106-4732

J Arthroplasty. 2023 Jun 4:S0883-5403(23)00603-4. doi: 10.1016/j.arth.2023.05.061. Online ahead of print.

ABSTRACT

BACKGROUND: Antibiotic-loaded bone cement (ALBC) is commonly used in the treatment of periprosthetic joint infections (PJI) to increase the local concentration of antibiotic at the site of infection. The use of ALBC has been associated with rare instances of acute kidney injury (AKI) despite low systemic absorption of the nephrotoxic antibiotics; however, the incidence of AKI is unknown. The purpose of this study was to determine the incidence of and risk factors for AKI associated with ALBC.

METHODS: This single-site, retrospective cohort study compared 162 PJI patients who underwent a Stage 1 revision to a spacer with ALBC to 115 PJI patients who underwent a debridement and implant retention (DAIR) without the use of ALBC. Both groups received similar systemic antibiotics post-operatively. Descriptive statistics and multivariable logistic regressions were used to analyze risk factors for AKI.

RESULTS: There was no statistically significant difference in the rate of AKI: 29 patients (17.9%) in the ALBC group and 17 (14.7%) in DAIR group developed AKI (Odds Ratio 1.43; 95% Confidence Interval 0.70-2.93). There was a trend toward increased severity of AKI in the ALBC group. Chronic kidney disease, systemic vancomycin, and diuretic use were independent factors associated with the risk of AKI.

CONCLUSION: An AKI occurred in 17% of PJI patients receiving either a spacer with ALBC or a DAIR. The use of ALBC was not associated with a significant increased risk of AKI. However, the use of systemic vancomycin and diuretic use were independent predictors of AKI in this patient population.

PMID:37279850 | DOI:10.1016/j.arth.2023.05.061

J Environ Manage. 2023 Jun 4;342:118289. doi: 10.1016/j.jenvman.2023.118289. Online ahead of print.

ABSTRACT

This study examines the health consequences of prenatal exposure to air pollution by combining child health data from an original survey with the Air Pollution Index (API) from official Chinese statistics. Our results show that exposure to air pollution in late trimester (four-week windows before delivery) is negatively associated with health outcomes in children in the short and long terms. One standard deviation increase in the API in the final 28 days before delivery decreased birth weight and length by 0.388 and 0.458, respectively, in z-scores and lowered the weight-for-age and height-for-age by 0.370 and 0.441, respectively, in z-scores at 13-15 years post-exposure. Although the timing of exposure and its consequences have been the subject of debate in existing literature, our results focus on four-week windows and demonstrate that exposure during the late pregnancy period may have adverse health effects on children. We conducted analyses that accounted for potential covariates and omitted variables, and our results remain robust and statistically significant. We also found gender heterogeneous effects that girls are more vulnerable to fetal air pollution exposure than boys. Our findings uncover fetal and child health risks regarding air pollution and reinforce the importance of policies for mitigating air pollution in developing countries.

PMID:37279606 | DOI:10.1016/j.jenvman.2023.118289