Tag: nevin manimala

Eur J Prev Cardiol. 2023 Jun 2:zwad187. doi: 10.1093/eurjpc/zwad187. Online ahead of print.

ABSTRACT

BACKGROUND: In clinical practice, factors associated with cardiovascular disease (CVD) like albuminuria, education level, or coronary artery calcium are often known, but not incorporated in cardiovascular risk prediction models. The aims of the current study were to evaluate a methodology for the flexible addition of risk modifying characteristics on top of SCORE2 and to quantify the added value of several clinically relevant risk modifying characteristics.

METHODS AND RESULTS: Individuals without previous CVD or DM were included from the UK Biobank, ARIC, MESA, EPIC-NL and HNR studies (n=409,757) in whom 16,166 CVD events and 19,149 non-cardiovascular deaths were observed over exactly 10.0 years of follow-up. The effect of each possible risk modifying characteristic was derived using competing risk-adjusted Fine and Gray models. The risk modifying characteristics were applied to individual predictions with a flexible method using the population prevalence and the subdistribution hazard ratio (SHR) of the relevant. Risk modifying characteristics that increased discrimination most were CAC percentile with 0.0198 (95%CI 0.0115; 0.0281) and hs-Troponin-T with 0.0100 (95%CI 0.0063; 0.0137). External validation was performed in the CPRD cohort (UK, n = 518,015, 12,675 CVD events). Adjustment of SCORE2 predicted risks with both single and multiple risk modifiers did not negatively affect calibration and led to a modest increase in discrimination (0.740 (95%CI 0.736-0.745) versus unimproved SCORE2 risk C-index 0.737 [95%CI 0.732-0.741]).

CONCLUSIONS: The current paper presents a method on how to integrate possible risk modifying characteristics that are not included in existing CVD risk models for the prediction of CVD event risk in apparently healthy people. This flexible methodology improves the accuracy of predicted risks and increases applicability of prediction models for individuals with additional risk known modifiers.

PMID:37264679 | DOI:10.1093/eurjpc/zwad187

Technol Cancer Res Treat. 2023 Jan-Dec;22:15330338231171470. doi: 10.1177/15330338231171470.

ABSTRACT

PURPOSE: Compared and analyzed the MRI imaging features of brain invasion otherwise benign (BIOB) meningiomas and WHO grade 1, grade 2 meningiomas, discussed the WHO grading of BIOB from the perspective of imaging.

MATERIALS AND METHODS: A retrospective analysis was performed on 675 meningiomas patients who carried on MRI examination from January 2006 to February 2022. Setting the 2022 Central nervous system (CNS) WHO Guidelines as the gold standard for pathological diagnosis. Statistical analysis of age, gender, and MRI features of meningiomas in relation to WHO grade and brain invasion.

RESULTS: Among 675 cases meningiomas, 543 (80.4%) were WHO grade 1, 123 (18.2%) were WHO grade 2, and 9 (1.3%) were WHO grade 3. There were 108 cases meningiomas with brain invasion (BI) (16.0%) and 567 cases without BI (84.0%). Among BI cases, 67 cases were BIOB. Compared the MRI features between BIOB and WHO grade 1 meningiomas, multivariate analysis demonstrated that the most strongly factors associated with distinguish them were enhancement degree, peritumoral edema, tumor-brain interface, fingerlike protrusion, mushroom sign, and bone invasion (AUC: 0.925 (0.901∼0.945), sensitivity: 0.925, specificity: 0.801). Compared the MRI features between BIOB and WHO grade 2 meningiomas, multivariate analysis demonstrated that the most strongly factors associated with distinguish them were enhancement degree and the tumor-brain interface (AUC: 0.779 (0.686∼0.841), sensitivity: 0.746, specificity: 0.732), their efficacy was slightly weaker.

CONCLUSIONS: BIOB is more similar to WHO grade 2 meningiomas in clinical and imaging features than WHO grade 1, so we think that it may be reasonable to classify BIOB as WHO Grade 2 meningiomas in the guidelines.

PMID:37264676 | DOI:10.1177/15330338231171470

Scand J Surg. 2023 Jun 1:14574969231176111. doi: 10.1177/14574969231176111. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVE: The aim of gender affirmation surgery is to ease gender dysphoria. In transgender men, chest wall masculinization is the most common gender affirmation surgery. The BODY-Q Chest module is currently the only instrument developed to measure health-related quality of life (HRQL) in men undergoing chest wall surgery. Linguistic validation and cultural adaption to Finnish were performed previously. The study aims to validate the BODY-Q Chest module in transgender men who have undergone surgical chest wall masculinization.

METHODS: All transgender patients who underwent chest wall masculinization at Helsinki University Hospital between 2005 and 2018 were invited to the study. The BODY-Q Chest module comprises two scales-chest and nipple. Data were obtained using the BODY-Q Chest module, the 15D questionnaire, and specifically targeted items designed by the authors. The statistical analyses were conducted to exclude selection bias, evaluate validity of the instrument, and compare it to other instruments.

RESULTS: Of the 220 patients invited, 123 participated in the survey (response rate 56%). Ceiling effects were observed with 18.9% and 20.5% scoring maximum points. Cronbach’s alpha was 0.92 and 0.88 for the chest and nipple scales, respectively. In exploratory factor analysis, both scales loaded to one factor confirming unidimensionality. Correlation with the generic 15D questionnaire was low.

CONCLUSIONS: The BODY-Q Chest module provides valid scores with sufficient consistency and reliability when measuring HRQL in transgender men undergoing chest wall masculinization. Moreover, it offers specificity that existing or generic instruments cannot provide. Ceiling effect was expected due to the postoperative status of participants.

PMID:37264645 | DOI:10.1177/14574969231176111

J Intensive Care Med. 2023 Jun 2:8850666231177602. doi: 10.1177/08850666231177602. Online ahead of print.

ABSTRACT

Background and Objectives: In lactic acidosis, lactate can only explain 30% of the variance in the anion gap (AG), and the elevated AG not explained by lactate is due to unmeasured organic anions (UOAs). Some studies using less precise surrogates for UOA have suggested that UOA may predict clinical outcomes better than lactate. The aim of this study was to determine whether UOA predicts clinical outcomes better than lactate levels. Design, Setting, Participants, & Measurements: This was a retrospective cohort study of adult ICU patients with sepsis. Baseline AG and albumin measurements were obtained. An albumin-corrected delta AG was calculated. UOAs were estimated using the formula: Delta AG – serum lactate. A multivariate logistic regression model with its respective ROC curve was constructed to explore the relationship between in-hospital mortality, UOA, and lactate. Results: 526 patients were included. In the combined model examining both lactate and UOA, the odds ratio (OR) [95% CI] for predicting ICU length of stay (LOS) was 1.050 [1.029-1.072] and 1.022 [1.009-1.035], respectively; the OR [95% CI] for predicting in-hospital mortality was 1.224 [1.104-1.358] and 0.997 [0.943-1.054], respectively. The ROC curve for in-hospital mortality demonstrated that the Area Under the Curve (AUC) for lactate, UOA, and combined lactate and UOA was 0.7726, 0.7486, and 0.7732, respectively. The AUC for combined lactate and UOA were not statistically significantly higher than the AUC for lactate alone (P .9193). Conclusions: As expected, serum lactate predicted both ICU LOS and in-hospital mortality. UOA did predict ICU LOS, although the reason for this association is not known. UOA did not predict in-hospital mortality based on the OR and the ROC curve’s AUC, contrary to some previous studies. However, our study used a more precise quantitative estimate of UOA, including the use of baseline albumin-corrected AG. Prior studies attempting to identify UOA have identified Krebs cycle intermediates including citrate and isocitrate, suggesting that in our study these anions associated with the Krebs cycle contributed to the UOA.

PMID:37264611 | DOI:10.1177/08850666231177602

Food Sci Technol Int. 2023 Jun 1:10820132231179492. doi: 10.1177/10820132231179492. Online ahead of print.

ABSTRACT

Cassava starch-based edible food wraps were prepared by incorporating leaf powder from Indian curry leaf and Malabar bay leaf, reinforced with different (0.2, 0.4, 0.6, 0.8) wt.% of chitosan. Eleven combinations of films were prepared and their sensory acceptability, physical properties, Fourier-transform infrared spectroscopic (FTIR) spectrum, and scanning electron microscopy (SEM) image, were evaluated. The thickness of the films ranged from 0.198 ± 0.12 to 0.372 ± 0.27 mm. Tensile strength was reported to be the highest (40.71 ± 1.21 MPa) in the curry leaf powder incorporated sample. Maximum elongation at break was reported by bay leaf powder incorporated (5.8 ± 1.59%) sample. The Young’s modulus values were observed to be increasing along with the concentration of chitosan. Maximum seal strength values were reported by curry leaf powder incorporated film with 0.8% chitosan (2.93 ± 0.22 N/mm). The leaf powder incorporated samples reported a higher flavonoid content compared to the control. The color analysis (L*, a*, b*) of the films was identical to the natural leaf color. The SEM images indicated a rough texture for the leaf powder incorporated films. The FTIR evaluation confirmed the presence of the respective functional groups. The statistical evaluation done by statistical package for social sciences software showed that all the data were significantly different (P ≤ 0.05.). The study demonstrated the potential of incorporation of leaf powder and chitosan to enhance the properties of starch-based edible packaging.

PMID:37264607 | DOI:10.1177/10820132231179492

BMJ Support Palliat Care. 2023 Jun 1:spcare-2022-004034. doi: 10.1136/spcare-2022-004034. Online ahead of print.

ABSTRACT

PURPOSE: The objective of this study was to summarise the literature on current interventions available for carers of men with prostate cancer and analyse the outcomes of these interventions in supporting carers’ needs.

METHODS: A systematic review was conducted, searching databases MEDLINE, PsycINFO, CINAHL, Scopus and Cochrane, using terms related to prostate cancer, carers and interventions. Randomised controlled trials and non-randomised controlled trials of interventions for informal carers with or without patients were included. Data were analysed using descriptive and frequency statistics; interventions and their impact on carers’ outcomes were reported on narratively. The SwiM guidelines were applied to guide data synthesis.

RESULTS: Overall, 24 articles were included in the review. On average, participants were spouses (92%) and women (97%). Interventions largely rwere delivered face-to-face (42%) or used a combination of face to face and online modalities (38%). Two-thirds (63%) showed a significant improvement in carer’s outcomes including psychological, sexual, physical and relationship/marital. The majority of studies (79%) tailored contents to carers’ circumstances, most within a couples counselling format. Over one-third (42%) of studies focused on a range of supportive care needs, most commonly were psychological (58%), sexual (42%) and informational (25%).

CONCLUSIONS: Interventions for carers of men with prostate cancer were largely face to face, patient-spouse focused and two-thirds had some measurable impact on carer’s outcomes. Research continues to underserve other patient-carer roles, including non-spousal carers. Interventions delivered solely for carers are required to meet gaps in care, and determine the impact on carer outcomes. Further research and more targeted interventions are needed.

PROSPERO REGISTRATION NUMBER: CRD42021249870.

PMID:37263759 | DOI:10.1136/spcare-2022-004034

Ann Rheum Dis. 2023 Jun 1:ard-2023-224032. doi: 10.1136/ard-2023-224032. Online ahead of print.

ABSTRACT

INTRODUCTION: Current scientific evidence guiding the decision whether men with an active desire to become a father should be treated with methotrexate (MTX) remains controversial. We aimed to prospectively evaluate the testicular toxicity profile of MTX focusing on several markers of male fertility, including semen parameters and sperm DNA fragmentation index (sDFI). As a secondary outcome, we aimed to evaluate whether MTX-polyglutamates can be detected in spermatozoa and seminal plasma and to evaluate the enzymatic activity in spermatozoa of folylpolyglutamate synthetase (FPGS).

METHODS: In a prospective cohort study, men ≥18 years who started therapy with MTX were invited to participate (MTX-starters). Participants were instructed to produce two semen samples (a pre-exposure and a post-exposure sample after 13 weeks). Healthy men ≥18 years were invited to participate as controls. Conventional semen analyses, male reproductive endocrine axis and sDFI were compared between groups. FPGS enzymatic activity and MTX-PG1-5 concentrations were determined by mass spectrometry analytical methods.

RESULTS: In total, 20 MTX-starters and 25 controls were included. The pre-exposure and postexposure semen parameters of MTX-starters were not statistically significant different. Compared with healthy controls, the conventional semen parameters and the sDFI of MTX-starters were not statistically significant different. These data were corroborated by the marginal accumulation of MTX-PGs in spermatozoa, consistent with the very low FPGS enzymatic activity associated with the expression of an alternative FPGS splice-variant.

DISCUSSION: Treatment with MTX is not associated with testicular toxicity, consistent with the very low concentration of intracellular MTX-PG. Therefore, therapy with MTX can be safely started or continued in men and with a wish to become a father.

PMID:37263756 | DOI:10.1136/ard-2023-224032

Clin Exp Optom. 2023 Jun 1:1-8. doi: 10.1080/08164622.2023.2216840. Online ahead of print.

ABSTRACT

CLINICAL RELEVANCE: Online family health education may be effective for myopia prevention in children, and the effects may be different between children with myopic and non-myopic parents.

BACKGROUND: Myopia is a common cause of vision loss. The aims of this study were to evaluate the effects of online family health education on preventing the development of myopia in children, and to estimate whether the effects vary according to parental myopia.

METHODS: A cluster randomised trial including grade 1 and grade 2 children from 12 primary schools was conducted in Guangzhou, China. Weekly online family health education messages were sent to parents in the intervention group. Data collection included eye examinations of children and questionnaires completed by parents.

RESULTS: Among the 3123 children included at baseline (1703 boys [54.5%]; mean [SD] age, 6.83 [0.73] years), 2376 completed the follow-up after 3 years. The differences in the incidence of myopia and myopic shift between the study groups were not significant in total. However, the 3-year cumulative incidence rate of myopia in the intervention group (125 of 445 [28.1%]) was significantly lower than that in the control group (225 of 603 [37.3%]; difference, 9.2% [95% CI, -14.9% to -3.5%]; P = 0.001) among children with non-myopic parents. In parallel, among children with non-myopic parents, the mean myopic change in SER was less for the intervention group than for the control group (-1.10 D vs. -1.24 D; difference, 0.13 D [95% CI, 0.03 to 0.23 D]; P = 0.01).

CONCLUSIONS: Compared with children with myopic parents, online family health education was more effective in children with non-myopic parents. The incidence of myopia and myopic shift in refraction have been reduced in children with non-myopic parents. Further studies are needed to assess these differences by parental myopia.

PMID:37263755 | DOI:10.1080/08164622.2023.2216840

BMJ Open. 2023 Jun 1;13(6):e071023. doi: 10.1136/bmjopen-2022-071023.

ABSTRACT

INTRODUCTION: Globally, no person has been untouched by the COVID-19 pandemic. Yet, little attention has been given to children and adolescents in policy, provision and services. Moreover, there is a dearth of knowledge regarding the impact of COVID-19-associated orphanhood and caregiver loss on children. This study aims to provide early insights into the mental health and well-being of children and adolescents experiencing orphanhood or caregiver loss in South Africa.

METHODS AND ANALYSIS: Data will be drawn from a quantitative longitudinal study in Cape Town, South Africa. A sample of children and adolescents between the ages of 9 and 18 years, experiencing parental or caregiver loss from COVID-19, will be recruited together with a comparison group of children in similar environments who did not experience loss. The study aims to recruit 500 children in both groups. Mental health and well-being among children will be explored through the use of validated and study-specific measures. Participants will be interviewed at two time points, with follow-up data being collected 12-18 months after baseline. A combination of analytical techniques (including descriptive statistics, regression modelling and structural equation modelling) will be used to understand the experience and inform future policy and service provision.

ETHICS AND DISSEMINATION: This study received ethical approval from the Health Research Ethics Committee at Stellenbosch University (N 22/04/040). Results will be disseminated via academic and policy publications, as well as national and international presentations including high-level meetings with technical experts. Findings will also be disseminated at a community level via various platforms.

PMID:37263702 | DOI:10.1136/bmjopen-2022-071023

BMJ Open. 2023 Jun 1;13(6):e069712. doi: 10.1136/bmjopen-2022-069712.

ABSTRACT

INTRODUCTION: Chronic kidney disease (CKD) is associated with significant morbidity, mortality, healthcare cost and reduced health-related quality of life (HRQoL). This study aimed to assess HRQoL and associated factors among patients with CKD at both Zewditu Memorial and Tikur Anbessa Specialised Hospitals, Ethiopia.

METHOD: A cross-sectional study design was performed. All patients who visited the renal clinics in both hospitals from March to July 2019 were targeted, and data were collected using interviews and medical records. HRQoL was assessed using the Kidney Disease and Quality of Life-36 tool. Normality assessment was done for HRQoL subscales. Descriptive statistics, logistic regression, t-test and one-way analysis of variance were performed.

RESULT: A total of 300 patients with CKD were included. Around 62% of them were in either stage 3 or 4 CKD. The mean domain scores of physical component summary (PCS), mental component summary (MCS), burden of kidney disease, effect of kidney disease and symptoms and problems of kidney disease (SPKD) subscales were 50.4, 59.5, 63.1, 74.6 and 80.4, respectively. The lowest HRQoL was seen in the PCS scale, while the highest was in SPKD. In addition, the study revealed that a lower level of education, elevated serum creatinine and a history of smoking were significantly associated with poor PCS score. Further, the presence of three or more comorbidities, CKD-related complications and a lower haemoglobin level were significantly associated with poor MCS.

CONCLUSION: The overall mean scores of PCS and MCS were low, below the standard level. Level of education, serum creatinine and smoking history were significantly associated with PCS, while the presence of comorbidity, complications and haemoglobin level were significantly associated with MCS. Stakeholders working on CKD management should design a relevant strategy targeting patients, patients’ care providers and healthcare professionals to improve HRQoL of patients.

PMID:37263701 | DOI:10.1136/bmjopen-2022-069712