Tag: nevin manimala

Int Ophthalmol. 2023 Mar 27. doi: 10.1007/s10792-023-02660-y. Online ahead of print.

ABSTRACT

BACKGROUND: To assess and compare the accuracy of 10 intraocular lens (IOL) power calculation formulas after cataract surgery in eyes with an axial length (AL) shorter than or equal to 22.00 mm.

METHODS: A retrospective case series included 100 eyes with an AL ≤ 22.00 mm that underwent uneventful cataract surgery. The refractive prediction error (PE) was calculated using 10 different IOL power calculation formulas: Barrett Universal II, EVO 2.0, Haigis, Hill RBF 2.0, Hoffer Q, Holladay 1 and 2, Kane, SRK/T and SuperLadas. The median absolute prediction error (MedAE ± SD) and mean absolute prediction error (MAE ± SD) were calculated after adjusting the mean prediction error (ME) to 0.

RESULTS: Hoffer Q obtained the lowest MedAE (0.292 D) after adjusting the ME to 0, followed very closely by EVO 2.0 (0.298 D) and Kane (0.300 D). EVO 2.0 and Kane obtained both the lowest MAE after adjusting the ME to 0 (0.386). Differences in MAE among the different formulas were not statistically significant (p > 0.05).

CONCLUSIONS: Our study reflects a tendency of the EVO 2.0 formula and the Kane formula along with the older Hoffer Q formula, to predict more accurately the refractive outcomes in short eyes that undergo cataract phacoemulsification surgery compared to the other formulas, despite this difference could not be statistically proved.

PMID:36971929 | DOI:10.1007/s10792-023-02660-y

Int Ophthalmol. 2023 Mar 27. doi: 10.1007/s10792-023-02685-3. Online ahead of print.

ABSTRACT

PURPOSE: This study aimed to compare the efficacy of topical bevacizumab and motesanib in an experimental corneal neovascularization model, and find the most effective motesanib dose.

MATERIALS AND METHODS: In experiments, 42 Wistar Albino rats were randomly divided into six groups (n = 7). Corneal cauterization was applied to all groups except the group 1. Group 1 did not receive any treatment. Topical dimethylsulfoxide was applied to sham group three times a day(tid). Topical bevacizumab drops (5 mg/ml) were applied to Group 3 tid. Topical motesanib drops with a dose of 2.5, 5, and 7.5 mg/ml were respectively applied in Groups 4, 5, and 6 tid. On the 8th day, corneal photographs of all rats were taken under general anesthesia, and the percentage of corneal neovascular area was calculated. VEGF-A mRNA, VEGFR-2 mRNA, miRNA-21, miRNA-27a, miRNA-31, miRNA-126, miRNA-184, and miRNA-204 were evaluated by the qRT-PCR method in corneas taken after decapitation.

RESULTS: The percentage of corneal neovascularization areas and VEGF-A mRNA expression levels were decreased in all treatment groups compared to group 2 (p < 0.05). VEGFR-2 mRNA levels were found to be statistically significantly decreased in groups 4 and 6 compared to group 2 (p < 0.05). Statistically significant changes were detected in the expression levels of only miRNA-126 among all miRNAs.

CONCLUSION: Motesanib with a dose of 7.5 mg/ml statistically significantly suppressed the VEGFR-2 mRNA level compared with other treatment doses and may be more effective than bevacizumab. Further, miRNA-126 can be used as a proangiogenic marker.

PMID:36971928 | DOI:10.1007/s10792-023-02685-3

Int J Colorectal Dis. 2023 Mar 27;38(1):82. doi: 10.1007/s00384-023-04378-w.

ABSTRACT

PURPOSE: There is not enough information to position medications for the treatment of Crohn’s disease (CD). Therefore, using a network meta-analysis and systematic review, we evaluated the efficacy and safety of combination therapy and infliximab (IFX) monotherapy in CD patients.

METHODS: We identified randomized controlled trials (RCTs) in CD patients who were given IFX-containing combination therapy versus IFX monotherapy. Induction and maintenance of clinical remission were the efficacy outcomes, while adverse events were the safety outcomes. The surface under cumulative ranking (SUCRA) probabilities was used to assess ranking in the network meta-analysis.

RESULTS: In total, 15 RCTs with 1586 CD patients were included in this study. There was no statistical difference between different combination therapies in induction and maintenance of remission. In terms of inducing clinical remission, IFX + EN (SUCRA: 0.91) ranked highest; in terms of maintaining clinical remission, IFX + AZA (SUCRA: 0.85) ranked highest. There was no treatment that was significantly safer than the others. In terms of any adverse events, serious adverse events, serious infections, and infusion/injection-site reactions, IFX + AZA (SUCRA: 0.36, 0.12, 0.19, and 0.24) was ranked lowest for all risks; while IFX + MTX (SUCRA: 0.34, 0.06, 0.13, 0.08, 0.34, and 0.08) was rated lowest for risk of abdominal pain, arthralgia, headache, nausea, pyrexia, and upper respiratory tract infection.

CONCLUSION: Indirect comparisons suggested that efficacy and safety of different combination treatments are comparable in CD patients. For maintenance therapies, IFX + AZA was ranked highest for clinical remission and lowest for adverse events. Further head-to-head trials are required.

PMID:36971914 | DOI:10.1007/s00384-023-04378-w

Med Oncol. 2023 Mar 27;40(5):131. doi: 10.1007/s12032-023-01999-7.

ABSTRACT

Rutin is one of the flavonoids found in fruits and vegetables. The PI3K/AKT/mTOR signaling pathway is critical for the life cycle at the cellular level. In current study, we purposed to demonstrate the antitumoral effect of rutin at different doses through the mTOR-signaling pathway and argyrophilic nucleolar regulatory region. EAC cells were injected subcutaneously into the experimental groups. 25 and 50 mg/kg Rutin were injected intraperitoneally to the animals with solid tumors for 14 days. Immunohistochemical, Real-time PCR and AgNOR analyzes were actualized on the taken tumors. When the rutin given groups and the tumor group were compared, the tumor size increase was detected to be statistically significant (p < 0.05). In immunohistochemical analysis, a significant decrease was encountered in the AKT, mTOR, PI3K and F8 expressions especially in the groups administered 25 mg Rutin, in comparison with the control group (p < 0.05). AgNOR area/nuclear area (TAA/NA) and average AgNOR number were determineted, and statistically important differences were detected between the groups in terms of TAA/NA ratio (p < 0.05). There were significant statistical differences between the mRNA quantity of the PI3K, AKT1 and mTOR genes (p < 0.05). In the in vitro study, cell apoptosis was evaluated with different doses of annexin V and it was determined that a dose of 10 µg/mL Rutin induced apoptosis (p < 0.05). In our study, it was demonstrated in vivo and in vitro that Rutin has an anti-tumor effect on the development of solid tumors formed by both EAC cells.

PMID:36971893 | DOI:10.1007/s12032-023-01999-7

J Dermatol. 2023 Mar 27. doi: 10.1111/1346-8138.16781. Online ahead of print.

ABSTRACT

Infantile hemangiomas (IH) are benign vascular tumors that are common in infancy. They vary in growth, size, location, and depth, and although most lesions are relatively small, approximately one fifth of patients have multiple lesions. Risk factors for IH include female sex, low birth weight, multiple gestation, preterm birth, progesterone therapy, and family history, but the mechanism that causes multiple lesions is unclear. We hypothesized that blood cytokines are involved as a cause of multiple IHs, and tried to prove this using sera and membrane arrays from patients with single and multiple IHs. Serum samples were obtained from five patients with multiple lesions and four patients with a single lesion, none of which had received any treatment. Serum levels of 20 cytokines were measured using human angiogenesis antibody membrane array. Four of the 20 cytokines (bFGF, IFN-γ, IGF-I, and TGF-β1) were higher in the patients with multiple lesions than in those with single lesion, with statistically significant difference (p < 0.05). Notably, signal for IFN-γ was evident in all cases with multiple IHs, but was absent in cases with single IH. Although not significant, there was mild correlation between IFN-γ and IGF-I (r = 0.64, p = 0.065), and between IGF-I and TGF-β1 (r = 0.63, p = 0.066). bFGF levels were strongly and significantly correlated with the number of lesions (r = 0.88, p = 0.0020). In conclusion, blood cytokines could act as a cause of multiple IHs. This is a pilot study with a small cohort, so further large-scale studies are necessary.

PMID:36971143 | DOI:10.1111/1346-8138.16781

Cancer Biol Med. 2023 Mar 24;20(3):j.issn.2095-3941.2022.0513. doi: 10.20892/j.issn.2095-3941.2022.0513.

ABSTRACT

OBJECTIVE: Neoadjuvant therapy (NAT) has been widely implemented as an essential treatment to improve therapeutic efficacy in patients with locally-advanced cancer to reduce tumor burden and prolong survival, particularly for human epidermal growth receptor 2-positive and triple-negative breast cancer. The role of peripheral immune components in predicting therapeutic responses has received limited attention. Herein we determined the relationship between dynamic changes in peripheral immune indices and therapeutic responses during NAT administration.

METHODS: Peripheral immune index data were collected from 134 patients before and after NAT. Logistic regression and machine learning algorithms were applied to the feature selection and model construction processes, respectively.

RESULTS: Peripheral immune status with a greater number of CD3⁺ T cells before and after NAT, and a greater number of CD8⁺ T cells, fewer CD4⁺ T cells, and fewer NK cells after NAT was significantly related to a pathological complete response (P < 0.05). The post-NAT NK cell-to-pre-NAT NK cell ratio was negatively correlated with the response to NAT (HR = 0.13, P = 0.008). Based on the results of logistic regression, 14 reliable features (P < 0.05) were selected to construct the machine learning model. The random forest model exhibited the best power to predict efficacy of NAT among 10 machine learning model approaches (AUC = 0.733).

CONCLUSIONS: Statistically significant relationships between several specific immune indices and the efficacy of NAT were revealed. A random forest model based on dynamic changes in peripheral immune indices showed robust performance in predicting NAT efficacy.

PMID:36971132 | DOI:10.20892/j.issn.2095-3941.2022.0513

Vet Surg. 2023 Mar 27. doi: 10.1111/vsu.13953. Online ahead of print.

ABSTRACT

OBJECTIVE: To describe and compare the pattern of fluid dispersal and retrieval in a novel instillation therapy system.

STUDY DESIGN: In vitro experimental study.

METHODS: A 10 cm² square model was constructed using plastic sheeting secured to plexiglass, with a wound infusion catheter and Jackson-Pratt (JP) active suction drain positioned in 4 configurations: parallel, perpendicular, diagonal, and opposite. Fluid was instilled using the wound infusion catheter, allowed to dwell for 10 min, and retrieved using the JP drain. Two surface area calculations were made using imaging software: coloration with diluted methylene blue (MB) on photos, and filling with diluted contrast on fluoroscopic images. Fluid retrieval was recorded. Statistical analysis was performed using a mixed-effects linear model (p < .05).

RESULTS: Configuration influenced fluid dispersion within the model (p = .0001); the diagonal configuration had the greatest surface area coverage (mean ± SD; 94.5 ± 2.4%) and the parallel configuration had the lowest surface area coverage (60.2 ± 2.9%). A dwell period increased fluid dispersal by an average of 4.0 ± 0.8% (p < .0001). Fluid retrieval exceeded 16.7 ± 1.5 mL (83.5 ± 7.5% volume instilled) for all configurations and was 0.5 ± 0.1 mL (2.5 ± 0.5% volume instilled) greater for MB than contrast agent (p < .0001).

CONCLUSION: Perpendicular or diagonal configurations and low-viscosity fluid maximized fluid dispersion and retrieval.

CLINICAL SIGNIFICANCE: Wound instillation therapy involves delivering lavage fluid or medications to a closed wound space. This is feasible using a wound-infusion catheter and active suction drain. Configuration should be considered to optimize fluid dispersal and retrieval when planning instillation therapy.

PMID:36971099 | DOI:10.1111/vsu.13953

Sci Diabetes Self Manag Care. 2023 Mar 27:26350106231163516. doi: 10.1177/26350106231163516. Online ahead of print.

ABSTRACT

PURPOSE: The purpose of the study was to examine the relationship between satisfaction of Medicare coverage for out-of-pocket costs and problems paying medical bills among Medicare beneficiaries with type 2 diabetes.

METHODS: The 2019 Medicare Current Beneficiary Survey Public Use File, a nationally representative sample of Medicare beneficiaries aged ≥65 years with type 2 diabetes, was analyzed (n = 2178). A survey-weighted multivariable logit regression model was conducted to examine the association between satisfaction of Medicare coverage for out-of-pocket costs and problems paying medical bills, adjusted for sociodemographics and comorbidities.

RESULTS: Among study beneficiaries, 12.6% reported problems paying medical bills. Among those with and without problems paying medical bills, 59.5% and 12.8%, respectively, were dissatisfied with out-of-pocket costs. In the multivariable analysis, beneficiaries who were dissatisfied with out-of-pocket costs were more likely to report problems paying medical bills than those who were satisfied. Younger beneficiaries, beneficiaries with lower incomes, those with functional limitations, and those with multiple comorbidities were more likely to report problems paying medical bills.

CONCLUSIONS: Despite having health care coverage, more than one-tenth of Medicare beneficiaries with type 2 diabetes reported problems paying medical bills, which raises concerns about delaying or forgoing needed medical care due to unaffordability. Screenings and targeted interventions that identify and reduce financial hardships associated with out-of-pocket costs should be prioritized.

PMID:36971086 | DOI:10.1177/26350106231163516

J Asthma. 2023 Mar 27:1-18. doi: 10.1080/02770903.2023.2196689. Online ahead of print.

ABSTRACT

Objective: The nitric-oxide pathway plays a crucial role in the pathogeneses of asthma and NOS3-encoded endothelial nitric oxide synthase is one of the main components of the pathway. Variants of NOS3 are known to contribute to asthma development and pathophysiology. Methods: We investigated the association of NOS3-c.894G/T (rs1799983) with asthma risk and severity by studying frequencies of its genotypes and alleles in 555 asthmatics (93 intermittent, 240 mild, 158 moderate, and 64 severe asthma cases) and 351 control participants using the PCR-FRLP method, logistic regression analysis and generalized ordered logit estimates. Results: GT genotype (OR_adj:1.39; CI:1.04-1.85; P = 0.026), dominant model GT + TT (OR_adj:1.41; CI:1.07-1.87; P = 0.015), and T allele (OR_adj:1.32; CI:1.05-1.67; P = 0.018) was associated with increased ORs in asthmatics. Also, the frequency of GT + TT (OR_adj:1.55; CI:1.01-2.38; P = 0.044) was significantly higher in males. Furthermore, GT genotype (OR_adj:1.39; CI:1.04-1.85; P = 0.024), GT + TT (OR_adj:1.42; CI:1.07-1.87; P = 0.014), and T allele (OR_adj:1.32; CI:1.05-1.66; P = 0.018) in total population and GT + TT (OR_adj:1.56; CI:1.02-2.37; P = 0.04) in males were significantly associated with increased risk of severe, moderate, mild, intermittent asthma vs. controls. Also, GT genotype (OR_adj:1.39; CI:1.02-1.91; P = 0.039) was significantly more frequent in severe, moderate grades vs. lower severity grades in the total population. Frequencies of GT genotype (OR_adj:1.77; CI:1.05-3.00; P = 0.032) and GT + TT (OR_adj:1.74; CI:1.04-2.90; P = 0.036) in total population and GT genotype (OR_adj:2.40; CI:1.16-4.97; P = 0.018) and GT + TT (OR_adj:2.30; CI:1.12-4.74; P = 0.023) in male subpopulation were significantly higher in severe cases compared to lower grades. Conclusions: NOS3-c.894G/T may be associated with asthma risk and its severer grades, with greater effects in men.

PMID:36971059 | DOI:10.1080/02770903.2023.2196689

Med J Aust. 2023 Mar 27. doi: 10.5694/mja2.51903. Online ahead of print.

ABSTRACT

OBJECTIVE: To simulate the impact on population mental health indicators of allowing people to book some Medicare-subsidised sessions with psychologists and other mental health care professionals without a referral (direct access), and of increasing the annual growth rate in specialist mental health care capacity (consultations).

DESIGN: System dynamics model, calibrated using historical time series data from the Australian Bureau of Statistics, HealthStats NSW, the Australian Institute of Health and Welfare, and the Australian Early Development Census. Parameter values that could not be derived from these sources were estimated by constrained optimisation.

SETTING: New South Wales, 1 September 2021 – 1 September 2028.

MAIN OUTCOME MEASURES: Projected mental health-related emergency department presentations, hospitalisations following self-harm, and deaths by suicide, both overall and for people aged 15-24 years.

RESULTS: Direct access (for 10-50% of people requiring specialist mental health care) would lead to increases in the numbers of mental health-related emergency department presentations (0.33-1.68% of baseline), hospitalisations with self-harm (0.16-0.77%), and deaths by suicide (0.19-0.90%), as waiting times for consultations would increase, leading to disengagement and consequently to increases in adverse outcomes. Increasing the annual rate of growth of mental health service capacity (two- to fivefold) would reduce the frequency of all three outcomes; combining direct access to a proportion of services with increased growth in capacity achieved substantially greater gains than an increase in service capacity alone. A fivefold increase in the annual service growth rate would increase capacity by 71.6% by the end of 2028, compared with current projections; combined with direct access to 50% of mental health consultations, 26 616 emergency department presentations (3.6%), 1199 hospitalisations following self-harm (1.9%), and 158 deaths by suicide (2.1%) could be averted.

CONCLUSION: The optimal combination of increased service capacity growth (fivefold) and direct access (50% of consultations) would have double the impact over seven years of accelerated capacity growth alone. Our model highlights the risks of implementing individual reforms without knowledge of their overall system effect.

PMID:36971040 | DOI:10.5694/mja2.51903