Tag: nevin manimala

Breast Cancer Res Treat. 2022 Aug 26. doi: 10.1007/s10549-022-06694-1. Online ahead of print.

ABSTRACT

AIM OF THE STUDY: The study aims to evaluate the performance of selected, high-volume, highly specialized, Italian Breast Centers at the time of COVID-19 pandemic (year 2020), compared to pre-pandemic time (year 2019), highlighting differences in terms of clinical presentation of breast cancer (BC) and therapeutic strategies.

METHODS: Patients’ data were provided by the Senonetwork data warehouse Senonet. In order to examine changes in the surgical and oncological management of BC patients during different phases of COVID-19 pandemic, we took advantage of a selection quality indicators (QIs). We performed the analyses in two time-frames, from July to September (Jul-Sep) (2019 versus 2020) and from October to December (Oct-Dec) (2019 versus 2020).

RESULTS: Our analysis did not show any statistically significant difference in terms of diagnosis, surgical, oncological and radiation therapy procedures between the two trimesters 2019 and 2020. Nevertheless, we observed statistically significant differences, favoring 2020, when analyzing time-to surgery and time-to radiotherapy. On the other hand, we observed a significant reduction of neoadjuvant chemotherapy and we did not recollect any data on a major use of neoadjuvant endocrine therapy.

CONCLUSIONS: In Italian Breast Centers, partners of Senonetwork, we could not observe any treatment delay or change in standard clinical practice for BC care during the 2020 pandemic year, compared to 2019 pre-pandemic year. This finding is in contrast with the globally reported decrease in the performance of the Italian Breast Centers due to the COVID-19 pandemic, and has to be linked to the sharp selection of Senonetwork Breast Centers.

PMID:36018455 | DOI:10.1007/s10549-022-06694-1

Prog Orthod. 2022 Aug 26;23(1):40. doi: 10.1186/s40510-022-00424-5.

ABSTRACT

OBJECTIVES: To compare the clinical effectiveness of Hawley retainers (HRs) and modified vacuum-formed retainers (mVFRs) with palatal coverage in maintaining transverse expansion throughout a 24-month retention period and to assess the subjects’ perception toward the retainers.

MATERIALS AND METHODS: The trial accomplished blinding only by the outcome assessor and data analyst. Data were collected from post-orthodontic treatment patients who met the inclusion criteria. Thirty-five subjects were randomly allocated using a centralized randomization technique into either mVFR (n = 18) or HR group (n = 17). Dental casts of subjects were evaluated at debond (T0), 3-month (T1), 6-month (T2), 12-month (T3), and 24-month retention (T4). The intercanine width (ICW), interpremolar width (IPMW), interfirst molar mesiobuccal cusp width (IFMW1), and interfirst molar distobuccal cusp width (IFMW2) were compared between groups over time using Mixed ANOVA. A pilot-tested and validated questionnaire consisting of six items were given at T4. Subjects were instructed to rate their retainer in terms of fitting, speech, appearance, oral hygiene, durability, and comfort on a 100-mm Visual Analogue Scale (VAS).

RESULTS: No statistically significant differences in arch width were found between the two groups at ICW (P = .83), IPMW (P = 0.63), IFMW1 (P = .22), and IFMW2 (P = .46) during the 24-month retention period. Also, no statistically significant differences were found between perception of both retainers in terms of fitting, speech, oral hygiene, durability, and comfort (P > .05) after 24-month wear. The appearance of mVFRs was rated significantly higher compared to HRs (P < .05).

CONCLUSIONS: HR and mVFR have similar clinical effectiveness for retention of transverse expansion cases in a 24-month retention period. Both retainers were perceived to be equal in terms of fitting, speech, oral hygiene, durability, and comfort. Subjects in the mVFRs group found their retainers to be significantly more esthetic than those in HRs group.

PMID:36018418 | DOI:10.1186/s40510-022-00424-5

J Feline Med Surg. 2022 Aug 26:1098612X221115674. doi: 10.1177/1098612X221115674. Online ahead of print.

ABSTRACT

OBJECTIVES: The aims of this study were to describe the clinical features of cats presented for trauma in a first-opinion and referral teaching hospital in New Zealand, and to determine the relationship between those features and outcome.

METHODS: The electronic medical records of cats presented for trauma to the Massey University Pet Emergency Centre between September 2013 and January 2019 were examined, from which the signalment, clinical parameters and patient outcomes were extracted. Cases were assigned an Animal Trauma Triage (ATT) score and Modified Glasgow Coma Scale (MGCS) score. Variables were selected for inclusion in a logistic regression model to predict survival, and backward elimination was used to find the minimal significant model.

RESULTS: In total, 530 cats met the inclusion criteria. The cause of injury was not known in the majority of cases (38.0%). The most common location of injury was the hindlimbs/pelvis/tail (n = 247; 41%), and skin lacerations/abrasions were the most common specific injury. Multivariate analysis revealed altered mentation (odds ratio [OR] 0.31, P = 0.029), hypothermia (rectal temperature <37.8°C [<100.04°F]; OR 0.45, P = 0.015) and an ATT score ⩾5 (OR 0.13, P <0.001) to be statistically significantly associated with mortality.

CONCLUSIONS AND RELEVANCE: Altered mentation and hypothermia are easily measurable perfusion parameter abnormalities associated with mortality in cats presenting with trauma. The ATT score appears to be an accurate prognostic indicator in cats presenting with trauma in New Zealand. These results highlight the importance of incorporating a hands-on triage examination in each cat that presents as an emergency after trauma.

PMID:36018375 | DOI:10.1177/1098612X221115674

Anxiety Stress Coping. 2022 Aug 26:1-17. doi: 10.1080/10615806.2022.2110588. Online ahead of print.

ABSTRACT

BACKGROUND: People of lower social status tend to have greater emotional responses to stress. The present study assessed whether lower social status was related to greater emotional responses in anticipation of a naturalistic stressor: academic exams among college students.

METHODS: College students in an introductory statistics class (N = 252; 75.81% female; 18.41% Latino, 25.10% White, 43.93% Asian, 12.56% different racial backgrounds) completed two course exams as part of this naturalistic prepost-experimental design. They provided four reports of positive, depressive, and anxious emotion – one the day before and one immediately after each exam.

RESULTS: As hypothesized, multilevel models (ratings nested within participants) predicting emotion indicated that students with lower mother’s education had less positive emotion, more depressive emotion, and more anxious emotion the day prior to academic exams than students with higher mother’s education (proportional reductions in variance [PRV] = .013-.020). Specifically, lower mother’s education was associated with poorer well-being before but not after the exam. Exploratory models revealed that differences in emotion by mother’s education were strongest for students with lower exam scores (PRV = .030-.040).

CONCLUSIONS: Socioeconomic status may influence college students’ anticipatory distress prior to academic exams, which may impact health and academic performance.

PMID:36018365 | DOI:10.1080/10615806.2022.2110588

Eur J Nucl Med Mol Imaging. 2022 Aug 26. doi: 10.1007/s00259-022-05949-9. Online ahead of print.

ABSTRACT

PURPOSE: Sparse inverse covariance estimation (SICE) is increasingly utilized to estimate inter-subject covariance of FDG uptake (FDG_cov) as proxy of metabolic brain connectivity. However, this statistical method suffers from the lack of robustness in the connectivity estimation. Patterns of FDG_cov were observed to be spatially similar with patterns of structural connectivity as obtained from DTI imaging. Based on this similarity, we propose to regularize the sparse estimation of FDG_cov using the structural connectivity.

METHODS: We retrospectively analyzed the FDG-PET and DTI data of 26 healthy controls, 41 patients with Alzheimer’s disease (AD), and 30 patients with frontotemporal lobar degeneration (FTLD). Structural connectivity matrix derived from DTI data was introduced as a regularization parameter to assign individual penalties to each potential metabolic connectivity. Leave-one-out cross validation experiments were performed to assess the differential diagnosis ability of structure weighted SICE approach. A few approaches of structure weighted were compared with the standard SICE.

RESULTS: Compared to the standard SICE, structural weighting has shown more stable performance in the supervised classification, especially in the differentiation AD vs. FTLD (accuracy of 89-90%, while unweighted SICE only 85%). There was a significant positive relationship between the minimum number of metabolic connection and the robustness of the classification accuracy (r = 0.57, P < 0.001). Shuffling experiments showed significant differences between classification score derived with true structural weighting and those obtained by randomized structure (P < 0.05).

CONCLUSION: The structure-weighted sparse estimation can enhance the robustness of metabolic connectivity, which may consequently improve the differentiation of pathological phenotypes.

PMID:36018359 | DOI:10.1007/s00259-022-05949-9

Biomater Sci. 2022 Aug 26. doi: 10.1039/d2bm00828a. Online ahead of print.

ABSTRACT

The pulmonary fibrotic microenvironment is characterized by increased stiffness of lung tissue and enhanced secretion of profibrotic soluble cues contributing to a feedback loop that leads to dysregulated wound healing and lung failure. Pinpointing the individual and tandem effects of profibrotic stimuli in impairing immune cell response remains difficult and is needed for improved therapeutic strategies. We utilized a statistical design of experiment (DOE) to investigate how microenvironment stiffness and interleukin 13 (IL13), a profibrotic soluble factor linked with disease severity, contribute to the impaired macrophage response commonly observed in pulmonary fibrosis. We used engineered bioinspired hydrogels of different stiffness, ranging from healthy to fibrotic lung tissue, and cultured murine alveolar macrophages (MH-S cells) with or without IL13 to quantify cell response and analyze independent and synergistic effects. We found that, while both stiffness and IL13 independently influence macrophage morphology, phenotype, phagocytosis and efferocytosis, these factors work synergistically to exacerbate impaired macrophage phenotype and efferocytosis. These unique findings provide insights into how macrophages in fibrotic conditions are not as effective in clearing debris, contributing to fibrosis initiation/progression, and more broadly inform how underlying drivers of fibrosis modulate immune cell response to facilitate therapeutic strategies.

PMID:36018297 | DOI:10.1039/d2bm00828a

Eur Arch Otorhinolaryngol. 2022 Aug 26. doi: 10.1007/s00405-022-07611-4. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aims to evaluate Eustachian tube (ET) function tests and their impact on outcomes of tympanoplasty in patients with inactive chronic suppurative otitis media.

MATERIALS AND METHODS: A prospective study was conducted involving patients diagnosed with chronic suppurative otitis media (CSOM) and having a central dry perforation. Assessment of the ET function was done for all included cases by three tests; pressure swallow equalization test, saccharine test and methylene blue test. The primary outcome is the graft success rate defined as intact graft without any residual perforation at 6 months postoperatively. Secondary outcomes include hearing assessment and possible associated complications.

RESULTS: 64 patients were included in the study with an average age of 36.59 ± 11.96 years. All patients underwent assessment of the ET function by saccharine test, methylene blue test and pressure equalization test (PET) followed by microscopic post-auricular tympanoplasty. Successful tympanoplasty is achieved in 93.75% of cases with residual perforation in four patients. Mean air-bone gap is significantly improved from 23.73 ± 2.80 preoperatively to 10.93 ± 5.46 postoperatively. Results of Methylene blue test has no statistical impact on graft take rate (p value = 0.379), while saccharine test and pressure equalization test results have statistically significant correlation with graft success (p value ≤ 0.001).

CONCLUSIONS: Saccharine and Pressure equalization tests have a good positive correlation with the graft healing in tympanoplasty, while methylene blue test was found to have no correlation with the success rate.

PMID:36018358 | DOI:10.1007/s00405-022-07611-4

Shock. 2022 Aug 16. doi: 10.1097/SHK.0000000000001978. Online ahead of print.

ABSTRACT

PURPOSE: To determine if initiating vasopressin earlier in septic shock reduces organ dysfunction and in-hospital all-cause mortality.

METHODS: This multicenter, retrospective, cohort study evaluated patients admitted to the medical intensive care unit (ICU) between October 2011 and August 2018 with septic shock who received vasopressin within 48 hours of shock onset. The primary composite outcome was the proportion of patients with a change in the sequential organ failure assessment (SOFA) score of >3 from baseline to 72 hours after initiation of vasopressin and/or in-hospital all-cause mortality. Secondary outcomes included time to hemodynamic stability, acute kidney injury, and ICU length of stay.

RESULTS: A total of 385 patients included in the final evaluation with a mean APACHE II score of 31 and a mean baseline SOFA score of 13. Median time to initiation of vasopressin after norepinephrine was 7.3 hours. The primary composite outcome was significantly reduced in patients who had vasopressin initiated earlier in septic shock (OR = 1.08; 95% CI 1.03-1.13; p < 0.001). After controlling for baseline data in a multivariable regression model the primary outcome remained statistically significant (OR = 1.04; 95% CI 1.02-1.07, p = 0.001).

CONCLUSION: Early initiation of vasopressin in septic shock may reduce the risk of in-hospital all-cause mortality and/or organ dysfunction.

PMID:36018257 | DOI:10.1097/SHK.0000000000001978

J Hypertens. 2022 Aug 23. doi: 10.1097/HJH.0000000000003280. Online ahead of print.

ABSTRACT

OBJECTIVE: Multiple trials on sodium-glucose cotransporter (SGLT) inhibitors have been performed recently demonstrating blood pressure (BP) reduction benefits in both diabetic and nondiabetic patients. Hence, we conducted a systematic review and meta-analysis to determine the effect of different SGLT inhibitors on BP in both patients with and without diabetes mellitus.

METHODS: Four electronic databases (PubMed, Embase, Cochrane, and SCOPUS) were searched on 4 November 2021 for articles published from 1 January 2000 up to 21 November 2021, for studies evaluating the BP effects of SGLT inhibitors. Pair-wise meta-analysis and random effects metaregression models were utilized.

RESULTS: In total, 111 studies examining SBP (108 studies, 104 304 patients) and/or DBP (82 studies, 74 719 patients) were included. In patients with diabetes, the random effects model demonstrated SGLT inhibitor produced a mean reduction in SBPs of -3.46 mmHg (95% confidence interval: -3.83, -3.09) compared with placebo. There were no statistically significant changes in BP among patients without diabetes. Drug response relationship was not observed in SGLT inhibitors and BP, except for Canagliflozin and DBP.

CONCLUSION: Sodium-glucose cotransporter 2 inhibitors and combined sodium-glucose cotransporter 1/2 inhibitors produced small reductions in BP in patients with diabetes.

PMID:36018229 | DOI:10.1097/HJH.0000000000003280

Afr J Paediatr Surg. 2022 Oct-Dec;19(4):203-208. doi: 10.4103/ajps.ajps_109_21.

ABSTRACT

BACKGROUND: In managing paediatric spinal deformities, the currently-in-use growth maturity assessment parameters (clinical or radiological) are based mostly on Caucasian populations. They may be adequate for general treatment planning but may not accurately predict the remaining growth potential. Some therapies (e.g. growing rod distractions or growth modulation surgeries) require more accurate predictions of remaining growth potential and race-specific values. Lumbar lordosis (LL) development ceases at spinal bone maturity. The age-of-cessation seems a more accurate predictor of remaining spinal bone growth potential, compared to currently-in-use growth maturity assessment parameters, but is rarely included in the growth maturity assessment parameters.

AIMS AND OBJECTIVES: As a predictor of remaining spinal growth potential, age-of-cessation of LL development (Race-specific of Black populations) was quantified.

MATERIALS AND METHODS: In archival normal lateral lumbosacral radiographs of patients of a tertiary hospital in South-East Nigeria, LL development across five age groups (Birth- 9, 10-15, 16-20, 21-25 and 26-30 years) was quantified with lumbosacral joint angle (LSJA) in 215 (110 males, 105 females), and lumbosacral angle (LSA) in 238 (119 males, 119 females). Data were analysed with IBM SPSS Statistics 23.0 (NY, USA). P ≤ 0.05 was considered statistically significant.

RESULTS: Both LSJA and LSA age groups’ mean values progressively increased with age, and plateaued at 21-25 years range, with LSJA mean of 23.4 ± 1.3 years, and LSA mean 23.5 ± 1.3 years; the means difference was insignificant (P = 0.680).

CONCLUSION: With ageing, there is progressive increment, and later, cessation of LL. Age-of-cessation indirectly infers spinal-maturity-age, and could indirectly be an assessment parameter of spinal-maturity-status.

PMID:36018198 | DOI:10.4103/ajps.ajps_109_21