Tag: nevin manimala

Int Urogynecol J. 2023 Apr 14. doi: 10.1007/s00192-023-05498-1. Online ahead of print.

ABSTRACT

INTRODUCTION AND HYPOTHESIS: The puborectal muscle (PRM), one of the female pelvic floor (PF) muscles, can get damaged during vaginal delivery, leading to disorders such as pelvic organ prolapse. Current diagnosis involves ultrasound (US) imaging of the female PF muscles, but functional information is limited. Previously, we developed a method for strain imaging of the PRM from US images in order to obtain functional information. In this article, we hypothesize that strain in the PRM would differ from intact to the avulsed end.

METHODS: We calculated strain in PRMs at maximum contraction, along their muscle fiber direction, from US images of two groups of women, which consisted of women with intact (n₁ = 8) and avulsed PRMs (unilateral) (n₂ = 10). Normalized strain ratios between both ends of the PRM (avulsed or intact) and the mid region were calculated. Subsequently, the difference in ratio between the avulsed and intact PRMs was determined.

RESULTS: We observe from the obtained results that the contraction/strain pattern of intact and undamaged PRMs is different from PRMs with unilateral avulsion. Normalized strain ratios between avulsed and intact PRMs were statistically significant (p = 0.04).

CONCLUSION: In this pilot study, we were able to show that US strain imaging of PRMs can show differences between intact PRMs and PRMs with unilateral avulsion.

PMID:37058159 | DOI:10.1007/s00192-023-05498-1

Inn Med (Heidelb). 2023 Apr 14. doi: 10.1007/s00108-023-01510-4. Online ahead of print.

ABSTRACT

BACKGROUND: The metabolic syndrome is a decisive risk factor for the manifestation of cardiovascular and metabolic diseases. Metabolic syndrome is the term used to describe the joint presence of specific diseases (obesity, hypertension, type 2 diabetes mellitus, disorders of fat metabolism). A classification is made more difficult by inconsistent definition criteria and a missing International Statistical Classification of Diseases and Related Health Problems (ICD) code. There are no known prevalence studies for Germany based on routine data of the statutory health insurance (GKV).

OBJECTIVE: The main aim of the present study was to classify the metabolic syndrome based on routine data of the GKV and to estimate the frequency of diagnosis. In addition, the influence of social factors (school and educational qualifications) was examined for the subgroup of employees with social insurance.

MATERIAL AND METHODS: A retrospective routine data analysis was carried out based on routine administrative data from the AOK Lower Saxony (AOKN). In contrast to the established definitions, which use medical parameters, the risk factors are taken into account via four coded diagnoses according to the ICD-10 classification: 1) obesity (E66.0, E66.8, E66.9), 2) type 2 diabetes mellitus (E11), 3) hypertension (I10) and 4) metabolic disorders (E78). A metabolic syndrome is present if at least two of the four diagnoses are present.

RESULTS: The prevalence of metabolic syndrome in the population of the AOKN in 2019 was 25.7%. The standardized comparison according to the census population of 2011 showed an increase in the frequency of diagnosis (2009: 21.5% and 2019: 24%). The frequency of diagnosis differed according to school and educational qualifications.

CONCLUSION: A classification and analysis of the frequency of the metabolic syndrome based on routine data of the GKV is possible. Between 2009 and 2019 there was a clear increase in the frequency of diagnoses.

PMID:37058154 | DOI:10.1007/s00108-023-01510-4

Ann Hematol. 2023 Apr 14. doi: 10.1007/s00277-023-05200-x. Online ahead of print.

ABSTRACT

This prospective study aimed to investigate the prognostic effect of sarcopenia, geriatric, and nutritional status in older patients with diffuse large B-cell lymphoma (DLBCL). Ninety-five patients with DLBCL older than 70 years who were treated with immunochemotherapy were included. The lumbar L3 skeletal muscle index (L3-SMI) was measured by computed tomography at baseline, and sarcopenia was defined as low L3-SMI. Geriatric assessment included G8 score, CIRS-G scale, Timed Up and Go test, and instrumental activity of daily living. Nutritional status was assessed using the Mini Nutritional Assessment and the body mass index, and several scores used in the literature incorporating nutritional and inflammatory biomarkers, namely the Nutritional and inflammatory status (NIS), Geriatric Nutritional Risk Index, Prognostic Nutritional Index, and Glasgow Prognostic Score.Fifty-three patients were considered sarcopenic. Sarcopenic patients displayed higher levels of inflammation markers and lower levels of prealbumin than non-sarcopenic patients. Sarcopenia was associated with NIS, but was not associated with severe adverse events and treatment disruptions. They were, however, more frequent among patients with elevated NIS. Sarcopenia did not appear in this study as a prognostic factor for progression-free survival (PFS) or overall survival (OS). However, NIS emerged as predictive of the outcome with a 2-year PFS rate of 88% in the NIS ≤ 1 group and 49% in the NIS > 1 group and a significant effect in a multivariate analysis for both PFS (p = 0.049) and OS (HR = 9.61, CI 95% = [1.03-89.66], p = 0.04). Sarcopenia was not associated with adverse outcomes, but was related to NIS, which appeared to be an independent prognostic factor.

PMID:37058153 | DOI:10.1007/s00277-023-05200-x

Eur J Pediatr. 2023 Apr 14. doi: 10.1007/s00431-023-04948-8. Online ahead of print.

ABSTRACT

Physical activity (PA) is recognized as a marker of health. The aim was to investigate PA differences from adolescence to young adulthood. European adolescents included in the HELENA study were invited to participate in a follow-up study, 10 years later. The present study included 141 adults (25.0 ± 1.4 years) for whom valid accelerometer data were available in adolescence and adulthood. Changes in PA by sex, weight and maternal education level were explored with interactions. Time spent in sedentary activity, light PA (LPA) and moderate PA (MPA) increased by 39.1, 59.6 and 6.6 min/day, respectively, whereas the time spent in vigorous PA (VPA) decreased by 11.3 min/day compared with adolescent VPA (p < 0.05). Increases in MPA were greater on weekends compared with weekdays, but we found a greater decrease in VPA on weekdays compared with weekends. Moderate-to-vigorous PA (MVPA) decreased significantly on weekdays (-9.6 min/day; 95%CI, -15.9 to -3.4), while it increased on weekends (8.4 min/day; 95%CI, 1.9 to 14.8). Significant heterogeneity was found across sexes for VPA and MVPA, with a stronger decrease in VPA in males compared with females and a significant decrease in MVPA (-12.5 min/day; 95%CI, -20.4 to -4.5) in males but not in females (1.9 min/day; 95%CI, -5.5 to 9.2). No significant heterogeneity was found to be linked to maternal education level or weight, irrespective of PA level. Conclusion: Our data suggest that the transition from adolescence to young adulthood is a critical period for lifestyle PA habits. A decline in VPA and an increasingly sedentary time were observed. The observed changes are worrying and may increase the risk of developing adverse health consequences later in life. What is Known: • The transition from adolescence to adulthood is marked by many life changes affecting lifestyle habits. Most studies tracking physical activity from adolescence to adulthood were done using PA questionnaires, which is a subjective method. What is New: • Our study bring first data on objective changes in PA patterns between adolescence and young adulthood, taking account of BMI, sex and maternal educational level. Our results suggest that the transition from adolescence to young adulthood is a critical period for lifestyle PA habits, especially for time spent on sedentary activities.

PMID:37058152 | DOI:10.1007/s00431-023-04948-8

Transl Vis Sci Technol. 2023 Apr 3;12(4):17. doi: 10.1167/tvst.12.4.17.

ABSTRACT

PURPOSE: The purpose of this study was to evaluate rod-mediated function with two-color dark-adapted perimetry (2cDAP) in patients with RPE65-related retinopathy treated with voretigene neparvovec-rzyl.

METHODS: Following dilation and dark adaptation, 2cDAP and FST were performed. The 2cDAP was measured on an Octopus 900 perimeter (Haag-Streit) with cyan (500 nm wavelength) and red (650 nm wavelength) stimuli. Hill of vision (HOV) analysis was performed on 2cDAP perimetry with Visual Field Modeling and Analysis (VFMA). Full field threshold stimulus testing (FST) was also measured as a secondary measure of rod-mediated function, and assessed on a Diagnosys Espion with the ColorDome stimulator (Diagnosys LLC).

RESULTS: Eight eyes from 4 patients who were treated with voretigene bilaterally had rod function assessed by 2cDAP testing at least 1 year after treatment. There was statistically significant improvement in 2cDAP following gene augmentation therapy. HOV VFMA analysis showed widespread improvements that extended beyond the treatment bleb and statistically significant improvement in HOV analysis volumetric measurements post-treatment to cyan and red stimuli. FST testing performed in six eyes from three patients demonstrated statistically significant improvement to all chromatic stimuli following treatment.

CONCLUSIONS: These findings demonstrated statistically significant improvement in 2cDAP and FST following treatment with voretigene.

TRANSLATIONAL RELEVANCE: These findings provide a sensitive method of assessing rod-mediated function in a topographic manner that may be useful in future clinical trials for inherited retinal dystrophies.

PMID:37058101 | DOI:10.1167/tvst.12.4.17

Food Addit Contam Part A Chem Anal Control Expo Risk Assess. 2023 Apr 14:1-16. doi: 10.1080/19440049.2023.2195955. Online ahead of print.

ABSTRACT

Polycyclic aromatics hydrocarbons (PAHs) are ubiquitous in foods and environment and possess carcinogenic and mutagenic potential. Foods are the main source of exposure to PAHs in the general population. In this study, we determined the concentrations of 16 European Union priority PAHs in 1,564 foodstuffs acquired from nine provinces and commonly consumed by the Chinese population. The most predominant PAH was chrysene (16.7%), followed by benz[a]anthracene (12.4%) and benzo[b]fluoranthene (11.7%). Edible vegetable oils (17.89 μg/kg) and fruits (1.97 μg/kg) had the highest and lowest concentrations of total PAHs, respectively. Suitable indicators of PAH contamination in foods were assessed based on the occurrence of other PAHs in samples negative for benzo[a]pyrene and the correlation for the PAHs and their combinations. According to our results, PAH4 was a suitable indicator, better than PAH8 and benzo[a]pyrene alone. PAH exposure in the Chinese population was estimated by combining contamination data with national individual food consumption data, based on the middle bound approach. The overall average dietary exposures for BaP and PAH4 were 3.08 and 17.61 ng/kg bw/day, respectively. The major contributors to the total dietary exposure of PAHs were cereals (39%), edible vegetable oils (28%), and vegetables (20%). We used the margin of exposure (MOE) approach to assess health risk for consumers. MOEs of the mean estimated dietary exposures were >10,000, indicating a low concern for the health of the general population and of consumers of smoked, grilled, or barbecued foods. For high consumers and children, the MOEs were <10,000, indicating potential concerns.

PMID:37058093 | DOI:10.1080/19440049.2023.2195955

Int Wound J. 2023 Apr 14. doi: 10.1111/iwj.14193. Online ahead of print.

ABSTRACT

Prolonged use of personal protective equipment can cause pressure injuries on the skin. The current study was conducted with the aim of investigating the effect of ChitoHeal gel on the nasal site on the prevention of N 95 masks that caused pressure injuries in nurses working in intensive care units. This is a randomised controlled clinical trial that was conducted in 2022. The study sample consisted of 92 nurses working in the intensive care units. A randomised block method was used to allocate the nurses to two equal groups of intervention and control. However, in the intervention group, ChitoHeal gel was applied on nurses’ nose bridge. To perform this, the researcher referred to the department during the morning and evening shifts and applied the gel on nurses’ nose bridge at the beginning of each shift. Then, the N95 mask was installed on the face by the nurse. Before and at the end of each work shift, the skin in both groups was assessed for any signs of pressure injuries. No significant differences were observed between the two intervention and control groups in terms of demographic variables. The frequency distribution of mask-caused pressure injuries on nurses’ nose bridge in the two groups was analysed using the Chi-square test (Fisher’s exact test). The results showed that after the intervention, it was 0 in the intervention group. However, 4 nurses (8.6%) in the control group developed pressure injuries, and this difference between the two groups was statistically significant (P > .05). The result of the current study showed that the use of ChitoHeal gel is effective in preventing N95 mask-related pressure injuries. Considering the cheapness and rational global availability of this gel, it seems that its use is an effective strategy in order to prevent N95 mask-related pressure injuries. Given the lack of studies in this regard, similar studies are strongly recommended to be conducted.

PMID:37057654 | DOI:10.1111/iwj.14193

Transfusion. 2023 Apr 14. doi: 10.1111/trf.17358. Online ahead of print.

ABSTRACT

BACKGROUND: Previous mixed findings on the associations between whole blood (WB) donation and risk of cardiovascular diseases (CVD) may in part reflect inadequate adjustment for the “healthy donor effect” (HDE).

METHODS: We used the Sax Institute’s 45 and Up Study linked with blood donation history and other health-related databases to examine the association between regular, high-frequency WB donation and the risk of CVD. To mitigate the impact of HDE, we used a “5-years qualification period,” in which donors must donate at least 1 WB donation in the 1st and 5th year of “qualification period.” We then compared the risk of CVD in the years following the “qualification period” between the regular high-frequency WB donors (≥2 WB donation in each qualification year) and others using Cox proportional-hazards models. Analyses were adjusted for potential confounders, such as sociodemographic, lifestyle, and health-related variables, and results are reported separately for male and female donors.

RESULTS: A total of 2736 male and 2917 female donors were included in the analyses. The median years of follow-up per donor was 5.84 years (Q1-Q3, 5.47-6.23). The rate of CVD hospitalization was 11.20 and 4.50 per 1000 person-years for males and females, respectively. In fully adjusted models, the risk (hazard ratio) of CVD in regular high-frequency donors compared to other donors was 0.93 (95% Confidence Interval (CI), 0.68-1.29) for males and 0.79 (95% CI, 0.49-1.28) for females.

CONCLUSIONS: We did not observe a statistically significant reduction of CVD risk in regular, high-frequency WB donors when adjusted for potential confounders.

PMID:37057641 | DOI:10.1111/trf.17358

J Forensic Sci. 2023 Apr 14. doi: 10.1111/1556-4029.15237. Online ahead of print.

ABSTRACT

Forensic fractographic features of bone reliably establish crack propagation in perimortem injuries. We investigated if similar fracture surface features characterize postmortem fractures. Experimentally induced peri- and postmortem fractures were used to assess if fractographic features vary as bone elasticity decreases during the postmortem interval (PMI). Thirty-seven unembalmed, defleshed human femoral shafts from males and females aged 33-81 years were fractured at varying PMIs with a drop test frame using a three-point bending setup and recorded with a high-speed camera. Vital statistics, cause of death, PMI length, temperature, humidity, collagen percentage, water loss, fracture energy, and fractography scores were recorded for each sample. Results showed that fractographic features associated with perimortem fractures were expressed in PMIs up to 40,600 accumulated degree hours (ADH), or 60 warm weather days. Hackle was the most consistently expressed feature, occurring in all fractures regardless of ADH. The most variable characteristics were wake features (78.4%) and arrest ridges (70.3%). Collagen percentage did not correlate strongly with ADH (r = -0.04, p = 0.81); however, there was a strong significant correlation between ADH and water loss (r = 0.74, p < 0.001). Multinomial logistic regression showed no association between fractographic feature expression and ADH or collagen percentage. In conclusion, forensic fractographic features reliably determine initiation and directionality of crack propagation in experimentally induced PMIs up to 40,600 ADH, demonstrating the utility of this method into the recent postmortem interval. This expression of reliable fractographic features throughout the early PMI intimates these characteristics may not be useful standalone features for discerning peri- versus postmortem fractures.

PMID:37057637 | DOI:10.1111/1556-4029.15237

Ann Surg. 2023 Apr 14. doi: 10.1097/SLA.0000000000005876. Online ahead of print.

ABSTRACT

OBJECTIVE: To compare endovascular aortic aneurysm repair (EVAR) versus open aortic repair (OAR) on mortality and reintervention after ruptured infrarenal abdominal aortic aneurysm (rAAA) repair in the Vascular Quality Initiative (VQI).

BACKGROUND: The optimal treatment modality for rAAA remains debated with little data on long-term comparisons.

METHODS: VQI rAAA repairs (2004-2018) were matched with Medicare claims (VQI-VISION). Primary outcomes were in-hospital and long-term mortality. Secondary outcome was reintervention. Inverse probability weighting (IPW) was used to adjust for treatment selection and Cox Proportional Hazards models, and negative binomial regressions were used for analysis. Landmark analysis was performed among patients surviving hospital discharge.

RESULTS: Among 1,885 VQI/Medicare rAAA patients, 790 underwent OAR and 1,095 underwent EVAR. Median age 76 years; 73% were male. IPW produced comparable groups. In-hospital mortality was lower after EVAR versus OAR (21% vs. 37%, OR 0.52, 95%CI 0.4-0.7). One-year mortality rates were lower for EVAR versus OAR (HR 0.74, 95%CI 0.6-0.9), but not statistically different after one year (HR 0.95, 95%CI 0.8-1.2). This implies additional benefit to EVAR in the short term. Reintervention rates were higher after EVAR than OAR at 2 and 5-years (RR 1.79 95%CI 1.2-2.7 and RR 2.03 95%CI 1.4-3.0), but not within the first year. Reintervention was associated with higher mortality risk for both OAR (HR 1.66 95%CI 1.1-2.5) and EVAR (HR 2.14 95%CI 1.6-2.9). Long-term mortality was similar between repair types (HR 0.99, 95%CI 0.8-1.2).

CONCLUSIONS: Within VQI/Medicare patients undergoing rAAA repair, the perioperative mortality rate favors EVAR but equalizes after one year. Reinterventions were more common following EVAR and were associated with higher mortality regardless of treatment.

PMID:37057613 | DOI:10.1097/SLA.0000000000005876