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Nevin Manimala Statistics

Occurrence of adverse events after magnetic resonance-guided high-intensity focused ultrasound (MR-HIFU) therapy in symptomatic uterine fibroids-a retrospective case-control study

Int J Hyperthermia. 2023;40(1):2219436. doi: 10.1080/02656736.2023.2219436.

ABSTRACT

OBJECTIVES: Our study aims at the comprehensive analysis of adverse events (AEs) in patients with symptomatic uterine fibroids (UFs) who underwent magnetic resonance-guided high-intensity focused ultrasound (MR-HIFU) in the last 6 years in one of the major Polish centers performing this type of therapy.

METHODS: The presented retrospective case-control study was conducted in the Department of Obstetrics and Gynecology, Pro-Familia Hospital, Rzeszów in cooperation with the Second Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education, Warsaw. The study enrolled 372 women with symptomatic UFs who underwent MR-HIFU and reported AEs during or after the procedure. The occurrence of particular AEs was analyzed. Statistical comparison of two cohorts (patients with and without AEs) was conducted based on epidemiological factors, UF characteristics, fat layer thickness, the presence of abdominal scars and technical parameters of the procedure.

RESULTS: The overall mean occurrence rate of AEs was 8.9% (n = 33). No major AEs were reported. The only statistically significant risk factor of AEs was the treatment of type II UFs according to Funaki (OR 2.12, CI 95%, p = 0.043). Other investigated factors did not have a statistically significant influence on AE occurrence. Abdominal pain was the most common AE.

CONCLUSION: Our data showed that MR-HIFU seemed to be a safe procedure. The AE rate after the treatment is relatively low. According to the obtained data it seems that the occurrence of AEs does not depend on the technical parameters of the procedure and the volume, position and location of UFs. Further prospective, randomized studies and with long follow-up are necessary to confirm the final conclusions.

PMID:37277102 | DOI:10.1080/02656736.2023.2219436

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Comparative Efficacy of Granisetron and Droperidol After Orthognathic Surgery for Prophylaxis of Postoperative Nausea and Vomiting: A Retrospective Study

J Oral Maxillofac Surg. 2023 May 26:S0278-2391(23)00471-8. doi: 10.1016/j.joms.2023.05.010. Online ahead of print.

ABSTRACT

BACKGROUND: In the fall of 2021, granisetron was approved for postoperative nausea and vomiting (PONV) management in Japan. However, the comparative efficacy of droperidol and granisetron in the field of orthognathic surgery has not been determined.

PURPOSE: We compare the efficacy of droperidol and granisetron for PONV prophylaxis following orthognathic surgery.

STUDY DESIGN, SETTING, SAMPLE: We performed a retrospective cohort study of patients who underwent orthognathic surgery at a single institution from September 2020 to December 2022. Patients who had undergone Le Fort I osteotomy with sagittal split ramus osteotomy or isolated sagittal split ramus osteotomy were included. Patients were divided into three groups; the isolated droperidol (D), isolated granisetron (G), and droperidol with granisetron (DG) groups. General anesthesia was performed using total intravenous anesthesia for all patients; however, droperidol and granisetron were administered at the anesthesiologist’s discretion.

PREDICTOR VARIABLE: PONV prophylactic therapy included isolated droperidol, isolated granisetron, and droperidol with granisetron administration.

OUTCOME VARIABLES: Postoperative nausea (PON) and postoperative vomiting (POV) were determined through medical examination within 48 hours following surgery. Secondary outcomes included complications due to droperidol and/or granisetron administration.

COVARIATES: Age, sex, body mass index, Apfel’s score, duration of surgery, duration of anesthesia, intraoperative blood loss, and type of surgery.

ANALYSES: Statistical analysis was conducted using Fisher exact test, Mann-Whitney U test with Bonferroni correction for univariate comparison, and modified Poisson regression for comparison of PON and POV efficacy for multivariate analyses. P values <.05 were considered statistically significant.

RESULTS: Our study included 218 participants. There were no significant differences in covariates between groups D (n = 111), G (n = 52), and DG (n = 55). No significant difference in PON incidence was observed between groups. However, POV incidence was significantly lower in group DG than group D (relative risk, 0.21; 95% confidence interval, 0.05 to 0.86; P = .03). No significant difference in complication incidence was observed between groups.

CONCLUSIONS AND RELEVANCE: Granisetron was as effective as droperidol for PONV management, while droperidol combined with granisetron was more effective than isolated droperidol for POV management. As compared to the use of each drug separately, their combination was considered safe, with no increase in complication rates.

PMID:37277099 | DOI:10.1016/j.joms.2023.05.010

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Nevin Manimala Statistics

Neonatal Head Circumference as a Risk Factor for Obstetric Anal Sphincter Injuries: A Systematic Review and Meta-Analysis

Am J Obstet Gynecol MFM. 2023 Jun 3:101047. doi: 10.1016/j.ajogmf.2023.101047. Online ahead of print.

ABSTRACT

Between 53-79% of women will sustain some degree of perineal lacerations during vaginal delivery. Third and fourth degree perineal lacerations are known as obstetric anal sphincter injuries. Timely diagnosis and prompt treatment of obstetric anal sphincter injuries can help to prevent the development of severe consequences like fecal incontinence, urinary incontinence and rectovaginal fistula. Neonatal head circumference is routinely measured postpartum, but is often not mentioned as a risk factor among clinical guidelines. Thus far, no review article on risk factors for obstetric anal sphincter injuries has discussed the role of neonatal head circumference.

OBJECTIVE: This review aimed to review and analyze the relationship between head circumference and the occurrence of obstetric anal sphincter injuries among previous studies to conclude whether HC should be recognized as an important risk factor.

DATA SOURCES: Through study screening on Google Scholar, PubMed, Scopus and Science Direct for articles published between 2013 to 2023, followed by assessment of eligibility – this study ended up reviewing 25 studies, 17 of which were included in meta-analysis.

STUDY ELIGIBILITY CRITERIA: Only studies which measured both neonatal head circumference and the occurrence of obstetric anal sphincter injuries were included in this review.

STUDY APPRAISAL: Included studies were appraised using the Dartmouth Library risk of bias assessment checklist.

SYNTHESIS METHODS: Qualitative synthesis was based on the study population, findings, adjusted confounding factors and suggested causative links in each study. Quantitative synthesis was based on calculation and pooling of odds ratio and inverse variance using Review Manager 5.4.1.

RESULTS: A statistically significant association between head circumference and obstetric anal sphincter injuries was reported in 21 out of the 25 studies; four studies reported head circumference as a true independent risk factor. Meta-analysis among studies which measured neonatal HC as a dichotomous categorical variable with a cut-off point at 35±1cm yielded statistically significant pooled results (OR=1.92, 95% CI=1.80-2.04).

CONCLUSION: The risk for obstetric anal sphincter injuries increases as neonatal head circumference increases – this should be considered in decision-making during labour and postpartum management to attain the best outcome.

PMID:37277090 | DOI:10.1016/j.ajogmf.2023.101047

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Consumption of commercially sold dried fish snack “Charales” contaminated with microplastics in Mexico

Environ Pollut. 2023 Jun 3:121961. doi: 10.1016/j.envpol.2023.121961. Online ahead of print.

ABSTRACT

Inadvertent human exposure to microplastics by the ingestion of microplastic-contaminated processed foods poses health risks and new preventative issues; nevertheless, investigations analyzing microplastic occurrences in commercially dried fish for direct human consumption are scarce. This study assessed the abundance and characteristics of microplastics in 25 commercially sold dried fish products (4 supermarkets, 3 street vendors, and 18 traditional agri-product farmers’ markets) from two widely consumed and commercially important Chirostoma species (C. jordani and C. patzcuaro) in Mexico. Microplastics were detected in all the samples examined, with abundances ranging from 4.00 ± 0.94 to 55.33 ± 9.43 items g-1. C. jordani dried fish samples had higher mean microplastic abundance (15.17 ± 5.90 items g-1) than the C. patzcuaro dried fish samples (7.82 ± 2.90 items g-1); nevertheless, there was no statistically significant difference in microplastic concentrations between the samples. The most prevalent type of microplastic was fiber (67.55%), followed by fragment (29.18%), film (3.00%), and sphere (0.27%). Non-colored microplastics (67.35%) predominated, while microplastic sizes varied from 24 to 1670 μm, with sizes less than 500 μm (84%) being the most common. ATR-FTIR analysis revealed polyester, acrylonitrile butadiene styrene, polyvinyl alcohol, ethylene-propylene copolymer, nylon-6 (3), cellophane, and viscose in the dried fish samples. Overall, this study’s findings are the first in Latin America to demonstrate microplastic contamination in dried fish for human consumption, underscoring the need for developing countermeasures to prevent plastic pollution in fish-caught regions and reduce the risks of human exposure to these micropollutants.

PMID:37277071 | DOI:10.1016/j.envpol.2023.121961

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Heparanase-mediated histone 3 acetylation regulates VEGF gene transcription in the hyperglycemia and hypoxia human retinal endothelial cells

Exp Eye Res. 2023 Jun 3:109519. doi: 10.1016/j.exer.2023.109519. Online ahead of print.

ABSTRACT

Heparanase (HPA) is believed that might mediate histone 3 lysine 9 acetylation (H3K9ac) to regulate vascular endothelial growth factor (VEGF) gene expressions in the hyperglycemia and hypoxia human retinal endothelial cells (HRECs). Cultured human retinal endothelial cells (HRECs) in hyperglycemia, hypoxia, siRNA, and normal medium, respectively. Distributions of H3K9ac and HPA in HRECs were analyzed by immunofluorescence. Western blot and real-time PCR were respectively used to evaluate the expression of HPA, H3K9ac, and VEGF. The differences in occupancies of H3K9ac and RNA polymerase II at VEGF gene promoter among three groups were studied by Chromatin immunoprecipitation (ChIP) combined with real-time PCR. Co-immunoprecipitation (Co-IP) was used to measure the status of HPA and H3K9ac. Re-ChIP was used to verify whether HPA and H3K9ac associate to the transcription of VEGF gene. HPA was consistent with that of H3K9ac in the hyperglycemia and hypoxia groups. And the fluorescent lights of H3K9ac and HPA in siRNA groups were similar to the control group, fainter than that of hyperglycemia, hypoxia, and non-silencing groups. Western blot results showed that the expressions of HPA, H3K9ac, and VEGF in hyperglycemia and hypoxia HRECs were statistically higher than that of the control. HPA, H3K9ac, and VEGF expressions in siRNA groups were statistically lower than hyperglycemia and hypoxia HRECs. The same trends also were found in real-time PCR. ChIP exhibited the occupancies of H3K9ac and RNA Pol II at VEGF gene promoter in hyperglycemia and hypoxia groups were significantly more increased than in the control group. Co-IP revealed that HPA combined with H3K9ac in hyperglycemia and hypoxia groups; while it was not discovered in the control group. Re-ChIP showed that HPA combined with H3K9ac at VEGF gene promoter in the hyperglycemia and hypoxia HRECs nuclear. In our study HPA can influence expressions of H3K9ac and VEGF in the hyperglycemia and hypoxia HRECs. HPA can probably combine with H3K9ac and regulate the transcription of the VEGF gene in the hyperglycemia and hypoxia HRECs.

PMID:37277067 | DOI:10.1016/j.exer.2023.109519

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Nevin Manimala Statistics

Long-term data show alarming decline of majority of fish species in a Lower Mekong basin fishery

Sci Total Environ. 2023 Jun 3:164624. doi: 10.1016/j.scitotenv.2023.164624. Online ahead of print.

ABSTRACT

Overexploitation, habitat fragmentation, and flow alteration are major threats to freshwater biodiversity that can lead to fisheries collapse and species extinction. These threats are particularly alarming in poorly monitored ecosystems where resource use supports the livelihoods of numerous people. The Tonle Sap Lake in Cambodia is such an ecosystem, supporting one of the world’s largest freshwater fisheries. Tonle Sap Lake fishes are the focus of indiscriminate harvest affecting species stocks, community composition and food-web structure. Changes in the magnitude and timing of the seasonal flood pulse have also been linked to declines in fish stocks. Yet, changes in fish abundance and species-specific temporal trends remain poorly documented. Analyzing 17 years’ time series of fish catch data for 110 species, we show that fish populations have declined by 87.7 %, owing to a statistically significant decline for >74 % species, particularly the largest ones. Despite large variations in species-specific trends – going from locally extinct to >1000 % increase – declines were found across most migratory behaviors, trophic positions or IUCN threat categories, though uncertainty regarding the magnitude of effect precluded us drawing conclusions in some cases. These results, reminiscent of alarming declines in fish stocks in many marine fisheries, provide unequivocal evidence that Tonle Sap fish stocks are increasingly depleted. The consequences of this depletion on ecosystem function are unknown but will undoubtedly affect the livelihoods of millions of people, stressing the need to set-up management strategies aimed to protect both the fishery and its associated diversity. Flow alteration, habitat degradation / fragmentation – especially deforestation of seasonally inundated areas and overharvest – have been reported as major drivers in population dynamics and community structure, highlighting the need for management efforts aimed at preserving the natural flood pulse, protecting flooded forest habitats, and reducing overfishing.

PMID:37277043 | DOI:10.1016/j.scitotenv.2023.164624

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Significance of cell adhesion molecules profile during pregnancy in gestational diabetes mellitus. A systematic review and meta-analysis

Diabetes Res Clin Pract. 2023 Jun 3:110740. doi: 10.1016/j.diabres.2023.110740. Online ahead of print.

ABSTRACT

Endothelial dysfunction has been considered as a key etiological factor contributed to the development of vascular disease in diabetes mellitus. Serum level of endothelial cell adhesion molecules (AMs) were reported to be increased in GDM and pregnant women with normal glucose tolerance when compared with nonpregnant women. The literature provides limited evidence of endothelial dysfunction in GDM with heterogeneous and contradictory results respect to their possible involvement in maternal, perinatal and future complications. Our objective is to evaluate current evidence on the role of AMs in maternal and perinatal complications in women with GDM. PubMed, Embase, Web of Science, and Scopus databases were searched. We evaluated the studies’ quality using the Newcastle-Ottawa scale. Meta-analyses were conducted, and heterogeneity and publication bias were examined. Nineteen relevant studies were finally included, recruiting 765 GDM and 2368 control pregnant women. AMs levels were generally higher in GDM participants showing statistical significance maternal ICAM-1 levels (SMD=0.58, 95% CI= 0.25 to 0.91; p=0.001). Our meta-analysis did not detect significant differences in subgroups or in meta-regression analyses. Future studies are needed to establish the potential role of these biomarkers in GDM and its complications.

PMID:37276983 | DOI:10.1016/j.diabres.2023.110740

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Nevin Manimala Statistics

Real-life 24-week changes in glycemic parameters among European users of flash glucose monitoring with type 1 and 2 diabetes and different levels of glycemic control

Diabetes Res Clin Pract. 2023 Jun 3:110735. doi: 10.1016/j.diabres.2023.110735. Online ahead of print.

ABSTRACT

AIM: To evaluate real-life changes of glycemic parameters among flash glucose monitoring (FLASH) users who do not meet glycemic targets.

METHODS: De-identified data were obtained between 2014 and 2021 from patients using FLASH uninterrupted for a 24-week period. Glycemic parameters during first and last sensor use were examined in four identifiable groups: type 1 diabetes mellitus (T1DM), type 2 diabetes mellitus (T2DM) on basal-bolus insulin, T2DM on basal insulin, and T2DM without insulin treatment. Within each group, subgroup analyses were performed in persons with initial suboptimal glycemic regulation (time in range (TIR; 3.9-10 mmol/L) <70%, time above range (TAR; >10 mmol/L) >25%, or time below range (TBR; <3.9 mmol/L) >4%).

RESULTS: Data were obtained from 1,909 persons with T1DM and 1,813 persons with T2DM (1,499 basal-bolus insulin, 189 basal insulin, and 125 non-insulin users). In most of the performed analyses, both overall and in the various subgroups, significant improvements were observed in virtually all predefined primary (TIR) and secondary endpoints (eHbA1c, TAR, TBR and glucose variability).

CONCLUSIONS: 24-weeks FLASH use in real life by persons with T1DM and T2DM with suboptimal glycemic regulation is associated with improvement of glycemic parameters, irrespective of pre-use regulation or treatment modality.

PMID:37276981 | DOI:10.1016/j.diabres.2023.110735

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Nevin Manimala Statistics

Longer breastfeeding duration is associated with lower consumption of ultra-processed foods in a sample of Spanish preschoolers: The SENDO project

J Acad Nutr Diet. 2023 Jun 3:S2212-2672(23)00288-5. doi: 10.1016/j.jand.2023.05.028. Online ahead of print.

ABSTRACT

BACKGROUND: Breastfeeding has been linked to a higher consumption of fruit and vegetables at 4 to 5 years of age. More recently, it has been suggested that it may also be associated with lower ultra-processed food (UPF) consumption in childhood.

OBJECTIVE: The aim of this study was to assess whether breastfeeding duration was associated with consumption of UPF in a sample of Mediterranean preschoolers.

DESIGN: This study involved a cross-sectional analysis of baseline information of children in the SENDO cohort. Children were enrolled at 4 to 5 years of age and information was gathered through an online questionnaire completed by parents. Dietary information was collected with a previously validated semi-quantitative food frequency questionnaire (FFQ) and foods were classified based on the degree of processing according to the NOVA classification.

PARTICIPANTS/SETTING: This study used baseline information for 806 participants enrolled in the SENDO cohort between January 2015 and June 2021 in Spain.

MAIN OUTCOMES MEASURES: Main study outcome measures were 1) Difference in g/day and in the percentage of total energy intake (TEI) from UPF consumption related to breastfeeding duration, and 2) Odds ratio (OR) that UPF represents a high percentage of TEI.

STATISTICAL ANALYSES: Crude and multivariable adjusted estimates were calculated with generalized estimating equations to account for intra-cluster correlation between siblings.

RESULTS: The prevalence of breastfeeding in the sample was 84%. After adjusting for potential confounders, children who were breastfed for some time reported significantly lower consumption of UPF than children who were not breastfed at all. The mean differences were -19.2 g. (95% CI: -44.2, 10.8) for children who were breastfed for <6 months, -42.5 g. (95% CI: -77.2, -7.80) for those who were breastfed for 6-12 months, and -43.6 g. (95% CI: -79.8, -7.48) for those who were breastfed for 12 months or more (p for trend=0.01). After adjusting for potential confounders, compared with children who were not breastfed, those who were breastfed for ≥12 months had consistently lower odds of UPF representing more than 25%, 30%, 35% and 40% of TEI.

CONCLUSION: Breastfeeding is associated with lower consumption of UPF in Spanish preschoolers.

PMID:37276962 | DOI:10.1016/j.jand.2023.05.028

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Benefits of music intervention on anxiety, pain, and physiologic response in adults undergoing surgery: a systematic review and meta-analysis

Asian Nurs Res (Korean Soc Nurs Sci). 2023 Jun 3:S1976-1317(23)00031-2. doi: 10.1016/j.anr.2023.05.002. Online ahead of print.

ABSTRACT

PURPOSE: Evidence on factors influencing the variations of music effect on anxiety and pain in surgical patients is unclear. We aimed to elucidate the effects of music intervention on anxiety and pain by study characteristics.

METHODS: We conducted a search on the PubMed, CINAHL, Embase, Cochrane, and Web of Science databases from March 7 to April 21, 2022, for randomized controlled trials (RCTs) for the effect of music intervention on anxiety, pain, and physiological responses in surgical patients. We included studies published within the last 10 years. We assessed the risk of bias in study using the Cochrane risk of bias tool for randomized trials and performed meta-analyses using random-effects model for all outcomes. We used change-from-baseline scores as summary statistics and computed bias-corrected standardized mean difference (Hedges’g) for anxiety and pain outcomes and mean differences (MD) for blood pressure and heart rate.

RESULTS: Of the 454 records retrieved, 30 RCTs involving 2280 participants were found to be eligible. Music intervention was found to be superior to standard care in reducing anxiety (Hedges’g = -1.48, 95% confidence interval: -1.97 to -0.98), pain (Hedges’g = -0.67, -1.11 to -0.23), systolic blood pressure (MD = -4.62, -7.38 to -1.86), and heart rate (MD = -3.37, -6.65 to -0.10) in surgical patients. The impact of music on anxiety and pain relief varied significantly depending on the duration of the intervention. The largest effect was observed in interventions lasting between 30 to 60 minutes, with a decrease in anxiety and pain.

CONCLUSION: Music intervention is an effective way to reduce anxiety, pain, and physiological response in surgical patients. Future reviews examining the influence of different types of surgery on the effects of music would add to the body of knowledge in this field. This study has been registered on PROSPERO under the number CRD42022340203, with a registration date of July 4, 2022.

PMID:37276961 | DOI:10.1016/j.anr.2023.05.002