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Phase I NT-501 Ciliary Neurotrophic Factor Implant Trial for Primary Open-Angle Glaucoma: Safety, Neuroprotection, and Neuroenhancement

Ophthalmol Sci. 2023 Mar 11;3(3):100298. doi: 10.1016/j.xops.2023.100298. eCollection 2023 Sep.

ABSTRACT

PURPOSE: To assess the safety and efficacy of a ciliary neurotrophic factor (CNTF) intraocular implant on neuroprotection and neuroenhancement in glaucoma.

DESIGN: Open-label, prospective, phase I clinical trial.

PARTICIPANTS: A total of 11 participants were diagnosed with primary open-angle glaucoma (POAG). One eye of each patient was assigned as the study (implant) eye.

METHODS: The study eye was implanted with a high-dose CNTF-secreting NT-501 implant, whereas the other eye served as a control. All patients were followed up for 18 months. Analysis was limited to descriptive statistics.

MAIN OUTCOME MEASURES: Primary outcome was safety through 18 months after implantation assessed by serial eye examinations, structural and functional testing, and adverse events (AEs) recording. Parameters measured included visual acuity (VA), Humphrey visual field (HVF), pattern electroretinogram, scanning laser polarimetry with variable corneal compensation (GDx VCC), and OCT. These parameters were also used for secondary analysis of efficacy outcome.

RESULTS: All NT-501 implants were well tolerated with no serious AEs associated with the implant. The majority of AEs were related to the implant placement procedure and were resolved by 12 weeks after surgery. Foreign-body sensation was the most commonly reported AE and was self-limited to the postoperative period. The most common implant-related AE was pupil miosis; no patients underwent explant. Visual acuity and contrast sensitivity decreased more in fellow eyes than in study eyes (VA, -5.82 vs. -0.82 letters; and contrast sensitivity, -1.82 vs. -0.37 letters, for fellow vs. study eyes, respectively). The median HVF visual field index and mean deviation measurements worsened (decreased) in fellow eyes (-13.0%, -3.9 dB) and improved (increased) in study eyes (2.7%, 1.2 dB). Implanted eyes showed an increase in retinal nerve fiber layer thickness measured by OCT and by GDx VCC (OCT, 2.66 μm vs. 10.16 μm; and GDx VCC, 1.58 μm vs. 8.36 μm in fellow vs. study eyes, respectively).

CONCLUSIONS: The NT-501 CNTF implant was safe and well tolerated in eyes with POAG. Eyes with the implant demonstrated both structural and functional improvements suggesting biological activity, supporting the premise for a randomized phase II clinical trial of single and dual NT-501 CNTF implants in patients with POAG, which is now underway.

FINANCIAL DISCLOSURES: Proprietary or commercial disclosure may be found after the references.

PMID:37197702 | PMC:PMC10183667 | DOI:10.1016/j.xops.2023.100298

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Adverse Pregnancy Outcomes Associated with Endometriosis and Its Influencing Factors

Evid Based Complement Alternat Med. 2023 May 8;2023:7486220. doi: 10.1155/2023/7486220. eCollection 2023.

ABSTRACT

AIM: To investigate the adverse pregnancy outcomes associated with endometriosis and its influencing factors.

METHODS: A total of 188 endometriosis patients who gave birth at our hospital between June 2018 and January 2021 were screened for eligibility and included in the research group, while a control group of 188 nonendometriosis women who delivered at our hospital during the same period were also included as healthy controls. Pregnancy outcomes were the key outcome measure, and the relationship between endometriosis and unfavorable pregnancy outcomes, as well as the influencing factors, were explored.

RESULTS: There was no significant difference in the risk of adverse pregnancy events such as miscarriage, ectopic pregnancy, termination of pregnancy, and fetal death between the two groups (P > 0.05). The differences in hypertensive disorder in pregnancy, gestational diabetes, placental abruption, fetal growth restriction, and luteal support between the two groups also failed to reach the statistical standard (P > 0.05). The two groups significantly differed in terms of cesarean delivery, preterm delivery, and placenta previa (1.92 (95% CI 1.33-2.85), 2.43 (95% CI 1.05-5.58), and 4.51 (95% CI 1.23-16.50)) (P < 0.05).

CONCLUSION: Endometriosis is an influential factor in adverse pregnancy outcomes and results in a high risk of preterm delivery, placenta previa, and cesarean delivery in patients. Mutual interactions exist among adverse pregnancy outcomes and thus require appropriate management.

PMID:37197694 | PMC:PMC10185417 | DOI:10.1155/2023/7486220

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Injury Types and Training Habits among Soccer (Football) Athletes

Orthop Rev (Pavia). 2023 May 13;15:74883. eCollection 2023.

ABSTRACT

BACKGROUND: For soccer athletes, injuries are frequent and pose a considerable health and financial burden for individuals and families. While studies have previously assessed the incidence of soccer injuries and preventive strategies male athletes use to reduce these occurrences, few have included women and players of varying skill levels.

OBJECTIVE: To report the frequency of injuries in a cohort of male and female soccer athletes and describe the training habits that have helped prevent injury.

METHODS: Two hundred (n=200) United States participants completed a questionnaire on soccer practicing frequency, habits, injuries, and treatments. A screening question ensured all respondents had played soccer for at least one year and determined eligibility for the study. Participant information related to age, sex, education, income, and race was also collected. JMP statistical software was used to analyze collected data and build multivariate regressions, mosaic plots, and histograms.

RESULTS: The mean number of practice sessions per week was 3.60 +/- 1.64, and the median experience playing soccer was 2-4 years. Older participants were more likely to practice once (p = 0.0001) or twice (p= 0.0008) per week. Women were less likely to include warmups before playing soccer (p = 0.022). This was problematic as participants who did not include a proper warmup routine were more likely to have been absent from play for longer amounts of time following injury (p = 0.032). The four most common injury sites were knees (n = 35, 17.5%), ankles (n = 31, 15.5%), shoulders (n = 25, 12.5%), and head/neck (n = 24, 12%). 140 (47.62%) patients used pain medication as their main remedy, 128 (43.54%) went to physical therapy, and 26 (10.78%) underwent surgery.

CONCLUSION: In any sample of soccer athletes involving variations in sex, race, and competitive play, injuries are highly common. Few studies before this one have included female athletes, and our findings highlight an important discrepancy in training habits between sexes. Women are less likely to follow a warmup regimen and are thus injured for longer. Incorporating dynamic stretching and plyometrics are particularly helpful to stay healthy.

PMID:37197671 | PMC:PMC10184884

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Identification of multiple novel susceptibility genes associated with autoimmune thyroid disease

Front Immunol. 2023 May 1;14:1161311. doi: 10.3389/fimmu.2023.1161311. eCollection 2023.

ABSTRACT

BACKGROUND: Autoimmune thyroid disease (AITD) is induced by various factors, including inheritability, which regulates gene expression. Multiple loci correlated with AITD have been discovered utilizing genome-wide association studies (GWASs). Nevertheless, demonstrating the biological relevance and function of these genetic loci is difficult.

METHODS: The FUSION software was utilized to define genes that were expressed differentially in AITD using a transcriptome-wide association study (TWAS) method in accordance with GWAS summary statistics from the largest genome-wide association study of 755,406 AITD individuals (30,234 cases and 725,172 controls) and levels of gene expression from two tissue datasets (blood and thyroid). Further analyses were performed such as colocalization, conditional, and fine-mapping analyses to extensively characterize the identified associations, using functional mapping and annotation (FUMA) to conduct functional annotation of the summary statistics of 23329 significant risk SNPs (P < 5 × 10-8) recognized by GWAS, together with summary-data-based mendelian randomization (SMR) for identifying functionally related genes at the loci in GWAS.

RESULTS: There were 330 genes with transcriptome-wide significant differences between cases and controls, and the majority of these genes were new. 9 of the 94 unique significant genes had strong, colocalized, and potentially causal correlations with AITD. Such strong associations included CD247, TPO, KIAA1524, PDE8B, BACH2, FYN, FOXK1, NKX2-3, and SPATA13. Subsequently, applying the FUMA approach, novel putative AITD susceptibility genes and involved gene sets were detected. Furthermore, we detected 95 probes that showed strong pleiotropic association with AITD through SMR analysis, such as CYP21A2, TPO, BRD7, and FCRL3. Lastly, we selected 26 genes by integrating the result of TWAS, FUMA, and SMR analysis. A phenome-wide association study (pheWAS) was then carried out to determine the risk of other related or co-morbid phenotypes for AITD-related genes.

CONCLUSIONS: The current work provides further insight into widespread changes in AITD at the transcriptomic level, as well as characterized the genetic component of gene expression in AITD by validating identified genes, establishing new correlations, and uncovering novel susceptibility genes. Our findings indicate that the genetic component of gene expression plays a significant part in AITD.

PMID:37197658 | PMC:PMC10183592 | DOI:10.3389/fimmu.2023.1161311

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Decreased vector magnitudes may help identify events in patients with Long QT syndrome

J Electrocardiol. 2023 May 3;80:51-55. doi: 10.1016/j.jelectrocard.2023.04.008. Online ahead of print.

ABSTRACT

INTRODUCTION: All Long QT syndrome (LQTS) patients are at elevated risk for channelopathy-induced delayed myocardial repolarization and consequently potentially life-threatening cardiac events with 90% of initial cardiac events occurring between preteen and 40 years old. Utilizing ECG and derived vectorcardiographic parameters, including T wave Vector Magnitude (TwVM) measurement data, this study attempts to determine whether TwVM from baseline ECGs is effectively predictive of future cardiac events for genotype-positive LQTS patients.

METHODS: Verified carriers of established LQTS disease-causing genotypes were selected from University of Minnesota patient encounters between 2010 and 2020 for inclusion in this retrospective study. Baseline and predictive ECG and derived vectorcardiographic parameter evaluation, clinical data, and statistical analysis were compared between patients with and patients without cardiac events. First recorded ECG was at presentation to our hospital and final ECG is defined as ECG just prior to cardiac event (event defined below in Methods) or the most final documented ECG before cut-off year of 2020 for the event-free group.

RESULTS: Of 41 participants, 15 experienced cardiac events and 26 did not. While many baseline electrocardiographic parameter measurements did not show significant differences between patient groups, vectorcardiographic parameters at baseline, specifically the QRS vector magnitude (QRSVM) and azimuth of the spatial ventricular gradient, showed significance. Additionally, final vectorcardiographic parameters, particularly the QRSVM, TwVM, and azimuth of the spatial ventricular gradient showed significant differences between patient groups. Final T-wave frontal axis was significantly larger in those without cardiac events. Significant Kaplan-Meier curve separation between patient groups was noted based on a QRSVM of 1.43 mV or lower, with additional consideration to patient age, genotype, and beta blocker use.

CONCLUSION: This study shows evidence of ECG and derived vectorcardiographic parameters, including TwVM, being effective in early prediction of cardiac events in genotype-positive LQTS patients.

PMID:37196379 | DOI:10.1016/j.jelectrocard.2023.04.008

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Vincristine-associated total antioxidant and oxidant status of ovaries and in vitro nuclear oocyte maturation in dogs with canine transmissible venereal tumor

Anim Reprod Sci. 2023 May 15;253:107260. doi: 10.1016/j.anireprosci.2023.107260. Online ahead of print.

ABSTRACT

The aim of this study is to evaluate the effects of scheduled vincristine sulfate therapy on canine oocyte quality and nuclear oocyte maturation, associated with total antioxidant and oxidant status of ovaries and Anti-Müllerian Hormone (AMH) concentrations in dogs with Canine Transmissible Venereal Tumor (CTVT). Six bitches suffering from CTVT and six healthy bitches were included in the study. Hemogram was carried out weekly. AMH measurements and ovariohysterectomy operations were performed after the termination of vincristine sulfate therapies. Tissue samples from ovaries were utilized for Malondialdehyde (MDA), reduced Glutathione (GSH), Superoxide Dismutase (SOD), Total Anti-oxidative Status (TAS), Total Oxidative Status (TOS) measurements, and Oxidative Stress Index (OSI) was calculated. Collected oocytes were evaluated for meiotic competence, after In Vitro Maturation (IVM) and parthenogenetic activation. No difference between the two groups was observed in hematologic parameters (P > 0.05). Meiotic stages of Germinal Vesicle Break Down (GVBD), Metaphase I (MI), and Metaphase II (MII) were significantly different between groups (P < 0.05). The number of oocytes reaching MII and meiotic resumption was lower in the CTVT group. Furthermore, AMH concentrations, oxidant parameters (OSI, TOS, and MDA), and antioxidant parameters (GSH, SOD, and TAS) were also statistically different between groups (P < 0.05). The results of this study show that vincristine sulfate application in the treatment of CTVT could alter oxidant/antioxidant status in ovaries. Apart from these, oocyte quality and IVM rates seem to decline related to gonadotoxicity. Moreover, AMH could be an important marker in the evaluation of oocyte qualities in bitches, as it is in women.

PMID:37196377 | DOI:10.1016/j.anireprosci.2023.107260

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Clinical features, diagnosis, and treatment of different types of congenital preauricular fistulas in pediatric patients

Int J Pediatr Otorhinolaryngol. 2023 May 9;170:111599. doi: 10.1016/j.ijporl.2023.111599. Online ahead of print.

ABSTRACT

OBJECTIVE: The aim of this study was to summarize the clinical features of congenital preauricular fistula (CPF) in pediatric patients to improve the levels of diagnosis and treatment, reduce the rates of missed diagnosis and recurrence, and shorten the total diagnosis and treatment time.

METHODS: A total of 353 patients with CPF who were admitted to the Department of Otolaryngology in The Children’s Hospital, Zhejiang University School of Medicine between January 2019 and December 2021 was enrolled in this retrospective observational study. Follow ups for 12-42 months were performed to investigate the classification, surgical methods, and postoperative conditions of CPF and to compare the recurrence rate, complication rate, and total diagnosis and treatment time between the active infection CPF group (AICPFG) and infection-controlled/non-infected CPF group (IC/NICPFG).

RESULTS: In 316 cases (89.5%) out of the 353 patients, the natural fistula orifice was located in front of the crus helicis; in 33 cases (9.4%), the natura fistula orifice was located at the crus helicis; and in 4 cases (1.1%), the natura fistula orifice was located in the external acoustic meatus. The AICPFG had 52 cases (14.7%), including 1 case (0.28%) of recurrence and 2 cases (0.56%) of infection at the incision site. The IC/NICPFG had 301 cases (85.3%), including 4 cases (1.13%) of recurrence, 6 cases (1.7%) of infection at the incision site, and 1 case (0.28%) of scar formation at the incision site. There were no significant differences in the recurrence rates and postoperative complications between the AICPFG and IC/NICPFG (p > 0.05). There was a statistically significant difference in the total diagnosis and treatment time between the AICPFG and IC/NICPFG (p < 0.05).

CONCLUSION: A reasonable classification of CPF, use of appropriate surgical methods, and belonging to the AICPFG do not increase the recurrence and complication rates of children but shorten the total treatment course, relieve patients’ suffering, reduce treatment costs, and achieve a better clinical prognosis.

PMID:37196371 | DOI:10.1016/j.ijporl.2023.111599

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Major Gaps in Understanding Dietary Supplement Use in Health and Disease

Annu Rev Nutr. 2023 May 17. doi: 10.1146/annurev-nutr-011923-020327. Online ahead of print.

ABSTRACT

Precise dietary assessment is critical for accurate exposure classification in nutritional research, typically aimed at understanding how diet relates to health. Dietary supplement (DS) use is widespread and represents a considerable source of nutrients. However, few studies have compared the best methods to measure DSs. Our literature review on the relative validity and reproducibility of DS instruments in the United States [e.g., product inventories, questionnaires, and 24-h dietary recalls (24HR)] identified five studies that examined validity (n = 5) and/or reproducibility (n = 4). No gold standard reference method exists for validating DS use; thus, each study’s investigators chose the reference instrument used to measure validity. Self-administered questionnaires agreed well with 24HR and inventory methods when comparing the prevalence of commonly used DSs. The inventory method captured nutrient amounts more accurately than the other methods. Reproducibility (over 3 months to 2.4 years) of prevalence of use estimates on the questionnaires was acceptable for common DSs. Given the limited body of research on measurement error in DS assessment, only tentative conclusions on these DS instruments can be drawn at present. Further research is critical to advancing knowledge in DS assessment for research and monitoring purposes. Expected final online publication date for the Annual Review of Nutrition, Volume 43 is August 2023. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

PMID:37196365 | DOI:10.1146/annurev-nutr-011923-020327

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Increased Burden of Second Bladder Cancer and Rectal Cancer in Prostate Cancer Treated With Radiotherapy: Results From Surveillance, Epidemiology, and End Results

Cancer Control. 2023 Jan-Dec;30:10732748231177544. doi: 10.1177/10732748231177544.

ABSTRACT

BACKGROUND: Previous studies have confirmed the higher risk of bladder cancer (BC) and rectal cancer (RC) development among prostate cancer (PCa) patients receiving radiotherapy. In this study, we intend to explore the long-term trend in second BC and RC incidence among PCa patients undergoing radiotherapy.

METHOD: We identified first primary PCa patients diagnosed between 1975 and 2014 from the Surveillance, Epidemiology, and End Results (SEER)-9 cancer registries. Standardized incidence ratios (SIRs) were calculated by calendar year of diagnosis among PCa patients receiving radiotherapy and not. P trends were evaluated using Poisson regression. 10-year cumulative incidence of BC and RC was calculated utilizing competing risk regression model.

RESULT: Of PCa patients treated with radiotherapy, SIRs of BC increased from .82 (95% CI: .35- 1.61) in 1980-1984 to 1.58 (95% CI: 1.48-1.68) in 2010-2014 (Ptrend=.003). SIRs of RC increased from 1.01 (95% CI: .27-2.58) in 1980-1984 to 1.54 (95% CI: 1.31-1.81) in 2010-2014 (Ptrend=.025). No statistically significant change in both BC and RC incidence was observed. The 10-year cumulative incidence of BC increased from 1975-1984 (.04%) to 2005-2014 (.15%) among PCa treated with radiotherapy. Simultaneously, the 10-year cumulative incidence of RC was demonstrated to range from 1975-1984 (.02%) to 2005-2014 (.11%).

CONCLUSION: we have observed an increasing trend in second BC and RC incidence in PCa patients receiving radiotherapy. There was no significant change in the incidence of second BC and RC in PCa without radiotherapy. These results reflect the increasing clinical burden of second malignant tumors in PCa patients undergoing radiotherapy.

PMID:37196346 | DOI:10.1177/10732748231177544

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Correction: WeChat-Based HIV e-Report, a New Approach for HIV Serostatus Requests and Disclosures Among Men Who Have Sex With Men: Prospective Subgroup Analysis of a Randomized Controlled Trial

JMIR Mhealth Uhealth. 2023 May 17;11:e48961. doi: 10.2196/48961.

ABSTRACT

[This corrects the article DOI: 10.2196/44513.].

PMID:37196344 | DOI:10.2196/48961