Tag: nevin manimala

Eur J Cancer Prev. 2023 Apr 10. doi: 10.1097/CEJ.0000000000000778. Online ahead of print.

ABSTRACT

BACKGROUND: In Brazil, there is lack of studies on the incidence and mortality of this malignancy. The aim of this study was to describe the profile of HL in Brazil for incidence, mortality and trends.

METHODS: Data on incidence in Brazil were collected from Population-Based Cancer Registries (1988-2017) and mortality for 1979-2019. Age-standardized incidence and mortality rates were calculated. Average annual percent change was estimated and analyzed in two calendar periods for mortality (1979-1999 and 2000-2019).

RESULTS: Trends in the incidence of HL for males in Brazil declined in two state capitals – Belo Horizonte, -3.7% (95% CI, -7.1 to -0.3); and Salvador, -8.5% (95% CI, -13.0 to -3.8) – and remained stable in other cities. For females, two capitals showed a decrease in incidence: Salvador, -9.5% (95% CI, -15.3 to -3.2) and Porto Alegre, -3.9% (95% CI, -7.0 to -0.8). Mortality rates in males were higher than those in females. However, the decrease in mortality was greater in males, -2.2% (95% CI, -2.5 to -1.8). Age incidence distribution across Brazilian capitals showed a higher incidence among younger (15-30 years) individuals yet no clear incidence among older adults (>60 years).

CONCLUSION: The incidence trend of HL in Brazil has remained stable. While the mortality has decreased for both sex. Age distribution for mortality in young age and older ages follows the bimodal pattern for Brazil as a whole. Finally, further studies are necessary to understand age incidence distribution of HL in Brazil.

PMID:37038979 | DOI:10.1097/CEJ.0000000000000778

Arthritis Care Res (Hoboken). 2023 Apr 11. doi: 10.1002/acr.25128. Online ahead of print.

ABSTRACT

OBJECTIVE: In this study we obtained descriptive data on the beliefs, behaviors, and openness regarding dietary changes for rheumatic diseases (RMDs) in an urban U.S. Hispanic RMD patient population, as foundational data for future intervention design.

METHODS: We distributed a voluntary survey to our primarily Hispanic population at an outpatient rheumatology clinic for 19 weeks. This survey queried individuals’ behaviors as it related to dietary intake used for RMD treatment, perceptions of the effect of food groups on RMD activity, barriers to physician-recommended diets, and willingness to try future interventions. We used descriptive statistics and Pearson’s chi-square test to evaluate associations.

RESULTS: Over 40% of survey respondents from our primarily (88%) Hispanic population noted a link between what they ate and their underlying RMD activity. Over a third of patients had, at some point, modified dietary intake to affect their RMD. Vegetables, fruit, and white meats were commonly reported to improve disease, while red meat and processed foods were reported to worsen disease. Barriers to following a pre-specified diet included cost and lack of knowledge. Over 70% of respondents indicated willingness to attempt certain eating patterns should it help their underlying RMD.

CONCLUSION: In this primarily Hispanic RMD patient population, many have not only noted a correlation between dietary intake and RMD activity, but are also open to future nutrition-related interventions. As this population experiences poor RMD outcomes and a high rate of lifestyle-related comorbidities, an intervention to optimize healthy eating patterns would likely be beneficial as well as acceptable.

PMID:37038969 | DOI:10.1002/acr.25128

Arthritis Care Res (Hoboken). 2023 Apr 11. doi: 10.1002/acr.25127. Online ahead of print.

ABSTRACT

OBJECTIVE: To investigate the relationship between sleep disturbance, catastrophizing, and knee pain in middle-aged and older persons.

DESIGN: Data from the Osteoarthritis Initiative (OAI) cohort from months 48 to 96 were used, where month 48 was treated as baseline. Knee pain (the Western Ontario and McMaster Osteoarthritis Index [WOMAC] pain scale ≥5, 0-20), catastrophizing (extracted from the Coping Strategies Questionnaire [CSQ] ≥3, 0-6), and sleep quality (extracted from the Center for Epidemiologic Studies Depression Scale [CES-D], 1-4) were assessed annually. We described the association of sleep disturbance with the presence and risk of knee pain and catastrophizing. The mediation effect of knee pain and catastrophizing on sleep-catastrophizing and sleep-pain association was evaluated, respectively.

RESULT: Catastrophizing and knee pain were reported in 346 (10%) and 917 (24%) of the 3813 participants (mean 64.9 years, 58% female) at baseline. Participants with worse sleep disturbance were more likely to have knee pain (prevalence ratios [PR]1.4-2.0, Ptrend <0.001) and catastrophizing (PR 1.4-3.1, Ptrend <0.001). Sleep disturbance at baseline predicted the risk of knee pain (risk ratios [RR] 1.1, Ptrend <0.001) and catastrophizing (RR 1.2-1.7, Ptrend <0.001) during the follow-up. No statistically significant interactions between sleep disturbance and knee pain or catastrophizing were observed. Knee pain and catastrophizing mediated the sleep-catastrophizing and sleep-pain association respectively at baseline, and knee pain negatively mediated the sleep-catastrophizing association longitudinally.

CONCLUSION: Sleep disturbance was associated with the presence and risk of catastrophizing and knee pain. Sleep interventions may have a universal and independent effect in preventing incident knee pain.

PMID:37038964 | DOI:10.1002/acr.25127

Nucl Med Commun. 2023 Apr 10. doi: 10.1097/MNM.0000000000001695. Online ahead of print.

ABSTRACT

AIM OF WORK: To determine the predictive value of initial [18F]FDG PET/computed tomography (CT) volumetric and radiomics-derived analyses in patients with head and neck squamous cell carcinoma (HNSCC).

METHODS: Forty-six adult patients had pathologically proven HNSCC and underwent pretherapy [18F]FDG PET/CT were enrolled. Semi-quantitative PET-derived volumetric [(maximum standardized uptake value (SUVmax) and mean SUV (SUVmean), total lesion glycolysis (TLG) and metabolic tumor volume (MTV)] and radiomics analyses using LIFEx 6.73.3 software were performed.

RESULTS: In the current study group, the receiver operating characteristic curve marked a cutoff point of 21.105 for primary MTV with area under the curve (AUC) of 0.727, sensitivity of 62.5%, and specificity of 86.8% (P value 0.041) to distinguish responders from non-responders, while no statistically significant primary SUVmean or max or primary TLG cut off points could be determined. It also marked the cutoff point for survival prediction of 10.845 for primary MTV with AUC 0.728, sensitivity of 80%, and specificity of 77.8% (P value 0.026). A test of the synergistic performance of PET-derived volumetric and textural features significant parameters was conducted in an attempt to develop the most accurate and stable prediction model. Therefore, multivariate logistic regression analysis was performed to detect independent predictors of mortality. With a high specificity of 97.1% and an overall accuracy of 89.1%, the combination of primary tumor MTV and the textural feature gray-level co-occurrence matrix correlation provided the most accurate prediction of mortality (P value < 0.001).

CONCLUSION: Textural feature indices are a noninvasive method for capturing intra-tumoral heterogeneity. In our study, a PET-derived prediction model was successfully generated with high specificity and accuracy.

PMID:37038954 | DOI:10.1097/MNM.0000000000001695

Nucl Med Commun. 2023 Apr 10. doi: 10.1097/MNM.0000000000001693. Online ahead of print.

ABSTRACT

OBJECTIVE: The aim of this study is to evaluate the prognostic role of Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 and quantitative 68Ga-DOTATATE PET/computed tomography parameters such as maximum standardized uptake value (SUVmax), mean SUV (SUVmean), DOTATATE tumor volume (DTV), total lesion DOTATATE (TLD) in patients with gastroenteropancreatic neuroendocrine tumors (GEP-NETs) treated with 177Lu-DOTATATE.

MATERIAL AND METHOD: Our retrospective study included 21 patients with GEP-NETs treated with 177Lu-DOTATATE between January 2017 and January 2022. SUVmax, SUVmean, SUVmax/spleenSUVmax (SUVmax/Sx), DTV, TLD, SUVmean/spleenSUVmean (SUVmean/Sm), TLD/Sm values were calculated and recorded for all patients before and after 177Lu-DOTATATE treatment.

RESULTS: A total of 319 metastases were detected in the patients included in the study, and a total of 68 target lesions were selected. In univariant Cox regression analysis, TLD/Sm percent change (∆TLD/Sm) was found to be statistically significant on overall survival (OS) (P = 0.044). The 3-year survival in nonresponders was 50% (P = 0.034) based on ∆SUVmax/Sx values, 50% (P = 0.002) based on RECIST values, 50% based on ∆TDTV + new lesion values (P = 0.033), and according to ∆TTLD + new lesion values, it was 66% (P = 0.030).

CONCLUSION: In our study, we showed that SUVmax/Sx, RECIST, ∆TDTV + new lesion, and ∆TTLD + new lesion parameters can predict OS in the evaluation of response to treatment.

PMID:37038931 | DOI:10.1097/MNM.0000000000001693

Crit Rev Clin Lab Sci. 2023 Apr 11:1-15. doi: 10.1080/10408363.2023.2195496. Online ahead of print.

ABSTRACT

Reference intervals (RIs) are the cornerstone for evaluation of test results in clinical practice and are invaluable in judging patient health and making clinical decisions. Establishing RIs based on clinical laboratory data is a branch of real-world data mining research. Compared to the traditional direct method, this indirect approach is highly practical, widely applicable, and low-cost. Improving the accuracy of RIs requires not only the collection of sufficient data and the use of correct statistical methods, but also proper stratification of heterogeneous subpopulations. This includes the establishment of age-specific RIs and taking into account other characteristics of reference individuals. Although there are many studies on establishing RIs by indirect methods, it is still very difficult for laboratories to select appropriate statistical methods due to the lack of formal guidelines. This review describes the application of real-world data and an approach for establishing indirect reference intervals (iRIs). We summarize the processes for establishing iRIs using real-world data and analyze the principle and applicable scope of the indirect method model in detail. Moreover, we compare different methods for constructing growth curves to establish age-specific RIs, in hopes of providing laboratories with a reference for establishing specific iRIs and giving new insight into clinical laboratory RI research. (201 words).

PMID:37038925 | DOI:10.1080/10408363.2023.2195496

J Int Med Res. 2023 Apr;51(4):3000605231166222. doi: 10.1177/03000605231166222.

ABSTRACT

OBJECTIVE: There is a lack of established biological, psychological, social, and digital markers for the prediction, identification, and stratification of patients with major depressive disorder (MDD). We therefore aimed to evaluate serum nerve growth factor (NGF) in MDD patients.

METHODS: In this case-control study, we recruited MDD patients and age- and sex-matched healthy controls (HCs). A qualified psychiatrist evaluated study participants according to the Diagnostic and Statistical Manual of Mental Disorders, fifth edition. Serum NGF levels were analyzed using a commercially available enzyme-linked immunosorbent assay kit.

RESULTS: We analyzed data from 106 MDD patients and 88 HCs. Mean serum NGF concentrations were significantly higher in MDD patients (104.70 ± 6.43 pg/mL) than in HCs (72.09 ± 7.69 pg/mL). Receiver operating characteristic curve analysis revealed the good diagnostic performance of serum NGF in MDD.

CONCLUSIONS: Higher serum NGF levels might be involved in MDD pathophysiology, and altered NGF levels may be an early warning sign of depression. The present findings will aid in the development of new and improved therapies for depressive patients. Further interventional studies are recommended to explore the underlying mechanisms, risk factors, disease course, and treatment responses of NGF in MDD.

PMID:37038918 | DOI:10.1177/03000605231166222

Pediatrics. 2023 Apr 11:e2022059839. doi: 10.1542/peds.2022-059839. Online ahead of print.

ABSTRACT

BACKGROUNDS: This study aimed to determine the best educational application of a respiratory function monitor and a video laryngoscope.

METHODS: This study was a randomized controlled simulation-based trial, including 167 medical students. Participants had to execute ventilation and intubation maneuvers on a newborn manikin. Participants were randomized into 3 groups. In group A (no-access), the feedback devices were not visible but recording. In group B (supervisor-access), the feedback devices were visible to the supervisor only. In group C (full-access), both the participant and the supervisor had visual access.

RESULTS: The two main outcome variables were the percentage of ventilations within the tidal volume target range (4-8mL/kg) and the number of intubation attempts. Group C achieved the highest percentage of ventilations within the tidal volume target range (full-access 63.6%, supervisor-access 51.0%, no-access 31.1%, P < .001) and the lowest mask leakage (full-access 34.9%, supervisor-access 46.6%, no-access 61.6%; A to B: P < .001, A to C: P < .001, B to C: P = .003). Overall, group C achieved superior ventilation quality regarding primary and secondary outcome measures. The number of intubation attempts until success was lowest in the full-access group (full-access: 1.29, supervisor-access: 1.77, no-access: 2.43; A to B: P = .001, A to C: P < .001, B to C: P = .015).

CONCLUSIONS: Our findings confirm that direct visual access to feedback devices for supervisor and trainees alike considerably benefits outcomes and can contribute to the future of clinical education.

PMID:37038898 | DOI:10.1542/peds.2022-059839

Tuberc Respir Dis (Seoul). 2023 Apr 11. doi: 10.4046/trd.2022.0048. Online ahead of print.

ABSTRACT

BACKGROUND: : Surgical resection is the standard treatment for early-stage lung cancer. Since postoperative lung function is related to mortality, predicted postoperative lung function is used to determine the treatment modality. The aim of this study was to evaluate the predictive performance of linear regression and machine learning models.

METHODS: We extracted data from the Clinical Data Warehouse (CDW) and developed 3 sets: set Ⅰ, the linear regression model; set Ⅱ, machine learning models omitting the missing data: and set Ⅲ, machine learning models imputing the missing data. Six machine learning models, the least absolute shrinkage and selection operator (LASSO), ridge regression, ElasticNet, Random Forest, eXtreme gradient boosting (XGBoost), and the light gradient boosting machine (LightGBM) were implemented. The forced expiratory volume in one second (FEV1) measured 6 months after surgery was defined as the outcome. Five-fold cross-validation was performed for hyperparameter tuning of the machine learning models. The dataset was split into training and test datasets at a 70:30 ratio. Implementation was done after dataset splitting in set Ⅲ. Predictive performance was evaluated by R2 and mean squared error (MSE) in the 3 sets.

RESULTS: A total of 1,487 patients were included in sets Ⅰ and Ⅲ and 896 patients were included in set Ⅱ. In set Ⅰ, the R2 value was 0.27 and in set Ⅱ, LightGBM was the best model with the highest R2 value of 0.5 and the lowest MSE of 154.95. In set Ⅲ, LightGBM was the best model with the highest R2 value of 0.56 and the lowest MSE of 174.07.

CONCLUSION: The LightGBM model showed the best performance in predicting postoperative lung function.

PMID:37038881 | DOI:10.4046/trd.2022.0048

JACC Cardiovasc Imaging. 2023 Feb 7:S1936-878X(23)00032-3. doi: 10.1016/j.jcmg.2022.12.027. Online ahead of print.

ABSTRACT

BACKGROUND: Left ventricular (LV) diastolic function is primarily assessed by means of echocardiography, which has limited utility in detecting fibrosis. Cardiac magnetic resonance (CMR) readily detects and quantifies fibrosis.

OBJECTIVES: In this study, the authors sought to determine the association of LV diastolic function by to echocardiography with CMR-determined global fibrosis burden and the incremental value of fibrosis with diastolic function grade in prediction of total mortality and heart failure hospitalizations.

METHODS: A total of 549 patients underwent comprehensive echocardiography and CMR within 30 days. Echocardiography was used to assess LV diastolic function, and CMR was used to determine LV volumes, mass, ejection fraction, replacement fibrosis, and percentage extracellular volume fraction (ECV).

RESULTS: Normal diastolic function was present in 142 patients; the rest had diastolic dysfunction grades I to III, except for 18 (3.3%) with indeterminate results. The event rate was higher in patients with diastolic dysfunction compared with patients with normal diastolic function (33.4% vs 15.5; P < 0.001). The model including LV diastolic function grades II and III predicted composite outcome (C-statistic: 0.71; 95% CI: 0.67-0.76), which increased by adding global fibrosis burden (C-statistic: 0.74, 95% CI: 0.70-0.78; P = 0.02). For heart failure hospitalizations, the competing risk model with LV diastolic function grades II and III was good (C-statistic: 0.78; 95% CI: 0.74-0.83) and increased significantly with the addition of global fibrosis burden (C-statistic: 0.80; 95% CI: 0.76-0.85; P = 0.03).

CONCLUSIONS: Higher grades of diastolic dysfunction are seen in patients with replacement fibrosis and increased ECV. Fibrosis burden as determined with the use of CMR provides incremental prognostic information to echocardiographic evaluation of LV diastolic function.

PMID:37038874 | DOI:10.1016/j.jcmg.2022.12.027