Tag: nevin manimala

J Thorac Cardiovasc Surg. 2022 Mar 12:S0022-5223(22)00272-0. doi: 10.1016/j.jtcvs.2021.11.102. Online ahead of print.

ABSTRACT

OBJECTIVE: Isolated tricuspid valve surgery is perceived as high-risk. This perception is nurtured by patients who often present with substantial liver dysfunction, which is inappropriately reflected in current surgical risk scores (eg, the Society of Thoracic Surgeons [STS] score has no specific tricuspid model). The Model for End-Stage Liver Disease (MELD) has was developed as a measure for the severity of liver dysfunction. We report scores and outcomes for our patient population.

METHODS: We calculated STS, European System for Cardiac Operative Risk Evaluation (EuroSCORE) II (ESII), and MELD scores for all of our patients who received isolated tricuspid valve surgery between 2011 and 2020 (n = 157). We determined the MELD score, stratified patients into 3 groups (MELD <10: low, n = 53; 10 to <20: intermediate, n = 78; ≥20: high, n = 26) and describe associated outcomes.

RESULTS: Patients were 72 ± 10 years old and 43% were male. Mean STS score was 4.9 ± 3.5% and ESII was 7.2 ± 6.6%. Mortality was 8.9% at 30 days and 65% at latest follow-up (95% CI, 51%-76%). Median follow-up was 4.4 years (range, 0-9.7 years). Although ESII and STS score accurately predicted 30-day mortality at low MELD scores (observed to expected [O/E] for ESII score = 0.8 and O/E for STS score = 1.0) and intermediate MELD (O/E for ESII score = 0.7, O/E for STS score = 1.0), mortality was underestimated at high MELD (O/E for ESII score = 3.0, O/E for STS score = 4.7). This subgroup also had higher incidence of new-onset hemodialysis. Besides MELD category, recent congestive heart failure, endocarditis, and hemodialysis were also associated with 30-day mortality.

CONCLUSIONS: For isolated tricuspid valve regurgitation, classic surgical risk stratification with STS or ESII scores failed to predict perioperative mortality if there was evidence of severe liver dysfunction. Preoperative MELD assessment might be useful to assist in proper risk assessment for isolated tricuspid valve surgery.

PMID:35431033 | DOI:10.1016/j.jtcvs.2021.11.102

J Card Surg. 2022 Apr 17. doi: 10.1111/jocs.16511. Online ahead of print.

ABSTRACT

OBJECTIVES: To compare outcomes of complete transcatheter (TAVI plus PCI) versus complete surgical (SAVR plus CABG) approach to treat patients with aortic stenosis (AS) and concomitant coronary artery disease (CAD).

METHODS: Study-level meta-analysis with reconstructed time-to-event data including studies published by November 2021. The primary endpoints were 30-day mortality, overall survival, and major adverse cardiovascular and cerebrovascular events (MACCE). The secondary endpoints were 30-day stroke, myocardial infarction, and permanent pacemaker implantation (PPI); in-hospital major vascular events and acute kidney injury (AKI).

RESULTS: Eight studies met our eligibility criteria, including a total of 33,286 patients (3448 for TAVI plus PCI and 29,838 for SAVR plus CABG). The pooled risk of 30-day mortality was lower for TAVI plus PCI (OR 0.63; 95% CI 0.51-0.80; p < .001). Patients undergoing TAVI plus PCI had lower risk of in-hospital AKI (OR 0.49; 95% CI 0.28-0.85; p = .01), however, higher risk of major vascular events (OR 7.33; 95% CI 1.80-29.85; p = .005) and higher risk of PPI (OR 2.96; 95% CI 1.80-4.85; p < .001). No statistically significant difference was observed for myocardial infarction and stroke between the groups. In the follow-up analyses, we observed a higher risk of mortality (HR 1.64, 95% CI 1.36-1.96, p < .001) and MACCE with TAVI plus PCI (HR 1.35 (95% CI 1.08-1.69, p = .009).

CONCLUSION: Patients who undergo TAVI plus PCI (in comparison with SAVR plus CABG) initially experience lower rates of in-hospital death and AKI; however, they experience significantly lower survival rates and more MACCE at 5-year follow up. Structural heart surgeons and interventional cardiologists should consider these aspects when referring patients for one approach or the other.

PMID:35430755 | DOI:10.1111/jocs.16511

Compr Rev Food Sci Food Saf. 2022 Apr 17. doi: 10.1111/1541-4337.12943. Online ahead of print.

ABSTRACT

Camel milk consists of an essential macro/micronutrient for human nutrition in the arid and urban regions. This review study aimed to use meta-analysis statistical techniques for assessment and correction of publication bias, exploration of heterogeneity between studies, and detailed assessment of the effect of a comprehensive set of moderators including breed, season, country, year of publication, and the interaction between composition elements. This could provide a single synthesis of the camel milk composition to warrant strong generalizability of results, examine variability between available studies, and analyze differences in camel milk composition among different exposures. Such a finding will aid future researchers and health professionals in acquiring a more precise understanding of camel milk composition and drawing more clinical implications. Six searching databases and bibliographic were used including PubMed/MEDLINE, ScienceDirect, Springer, EBSCOhost, Scopus, and Web of Science from January 1980 to December 2021. The DerSimonian-Laird estimator was used to create the current random-effects meta-analysis. This systematic review and meta-analysis included a total of 7298 camel milk samples from 23 countries. This review comprises 79 studies published in the English language on or after 1980, including a subgroup of 117 analyses consisting of seasons, sub-breeds, and countries. The contents of macro/micronutrients in camel milk were identified as follows: protein, 3.17%; fat, 3.47%; lactose, 4.28%; ash, 0.78%; and total solids, 11.31%; calcium, 112.93 mg/100 g; iron, 0.45 mg/100 g; potassium, 116.13 mg/100 g; magnesium, 9.65 mg/100 g; sodium, 53.10 mg/100 g; zinc, 1.68 mg/100 g; vitamin C, 5.38 mg/100 g; vitamin A, 0.36 mg/100 g; vitamin B₁ ,0.05 mg/100 g; vitamin B₂ , 0.13 mg/100 g; vitamin B₃ , 0.51 mg/100 g; vitamin B₆ , 0.09 mg/100 g; and vitamin B₁₂ , 0.0039 mg/100 g. Our meta-regression analysis found that fat and total solids were statistically significant moderators of protein; moreover, total solids content is a statistically significant moderator of fat. Discrepancies observed in camel milk profiles are dependent upon several factors, including number of included studies, number of samples, different analytical techniques, feeding patterns, camel’s breeds, geographical locations, and seasonal variations.

PMID:35430763 | DOI:10.1111/1541-4337.12943

Dermatol Ther (Heidelb). 2022 Apr 17. doi: 10.1007/s13555-022-00720-2. Online ahead of print.

ABSTRACT

INTRODUCTION: Atopic dermatitis (AD) is one of the most common skin diseases, and it may be associated with skin cancer risk. However, there is a controversy pertaining to whether it implies a greater or decreased risk of skin cancers. We aimed to study the relationship between AD and skin cancer risk.

METHODS: PubMed and Embase databases from their inception to 4 August 2021 were systematically searched.

RESULTS: We evaluated 16 studies involving a total of 9,638,093 participants examining the contribution of AD to skin cancers. Random-effects model was applied to estimate the overall effect sizes. The pooled analysis of 16 studies indicated that AD was significantly associated with an overall increased risk of skin cancer. Subgroup pooled analyses showed that AD was statistically associated with an increased risk of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). With regard to cohort study, AD was statistically associated with an increased risk of nonmelanoma skin cancer (NMSC), BCC, and SCC, but not melanoma risk. Sensitivity analysis revealed that excluding each study in turn did not alter the overall combined results. No publication bias existed among the studies.

CONCLUSION: It can be concluded that AD is associated with risk of skin cancers; however, this association still needs to be verified in well-designed, worldwide trials (especially prospective, non-Western studies). The mechanism of AD leading to skin cancer is not clear, and further research is needed to explore the possibility of a potential pathogenesis.

PMID:35430723 | DOI:10.1007/s13555-022-00720-2

Ann Surg Oncol. 2022 Apr 16. doi: 10.1245/s10434-022-11744-5. Online ahead of print.

NO ABSTRACT

PMID:35430657 | DOI:10.1245/s10434-022-11744-5

World J Surg. 2022 Apr 16. doi: 10.1007/s00268-022-06558-1. Online ahead of print.

ABSTRACT

BACKGROUND: This study aimed to investigate the consequences of repairing versus not repairing diaphragmatic injury caused by penetrating left thoracoabdominal stab wounds.

METHODS: Diagnostic laparoscopy was performed to evaluate the left diaphragm in patients with penetrating left thoracoabdominal stab wounds who did not have an indication for emergency laparotomy. Patients who did not consent to laparoscopy were discharged without undergoing surgery. Post-discharge radiological images of patients who underwent diaphragmatic repair and radiological images of patients who could not undergo laparoscopy, both during hospitalization and after discharge, were evaluated and compared.

RESULTS: Diagnostic laparoscopy was performed on 109 patients. Diaphragmatic injuries were detected and repaired in 32 (29.36%) of these patients. Seventeen patients were lost to follow-up. After a mean follow-up of 57.67 months, none of the remaining 15 patients developed a diaphragmatic hernia. On the other hand, 43 patients refused to undergo diagnostic laparoscopy. Twenty of them were lost from follow-up. The diaphragmatic injury was detected in seven of the remaining 23 patients (30.44%) during initial computed tomography (CT) examinations. In this group, the mean follow-up time was 42.57 months, and delayed diaphragmatic hernia developed in one patient (14.30%). Patients who underwent diaphragmatic repair were compared to patients who did not undergo diagnostic laparoscopy but had diaphragmatic injuries detected on their CT. No statistical differences were detected.

CONCLUSIONS: Diaphragmatic injuries caused by penetrating stab wounds can sometimes heal spontaneously. However, diagnostic laparoscopy is still relevant for revealing and repairing possible diaphragmatic injuries.

PMID:35430645 | DOI:10.1007/s00268-022-06558-1

Ann Surg Oncol. 2022 Apr 16. doi: 10.1245/s10434-022-11637-7. Online ahead of print.

NO ABSTRACT

PMID:35430654 | DOI:10.1245/s10434-022-11637-7

Jpn J Ophthalmol. 2022 Apr 17. doi: 10.1007/s10384-022-00918-z. Online ahead of print.

ABSTRACT

PURPOSE: To assess the risk factors for intraocular pressure (IOP) elevation during the early period post cataract surgery.

STUDY DESIGN: Retrospective study.

METHODS: This study involved 1587 eyes that underwent cataract surgery at the Baptist Eye Institute, Kyoto, Japan between April 2020 and May 2021. In all subjects, risk factors for early postoperative IOP elevation (i.e., an increase of IOP of 10 mmHg or more at 1-day postoperative compared with that at baseline, or a postoperative IOP of 28 mmHg or more) were analyzed by multivariate logistic regression analysis.

RESULTS: Of the 1587 treated eyes in this study, 100 (6.3%) experienced early-postoperative IOP elevation. Of those 100 eyes, 78.0% were men, 27.0% had an axial length (AL) of ≥ 26.5 mm, 23.0% had a history of glaucoma treatment, 11.0% had poor mydriasis and 10.0% had intraoperative floppy iris syndrome (IFIS). Multivariate analysis findings revealed that male [odds ratio (OR) 4.36; 95% confidence interval (CI) 2.63-7.23; P < 0.001], AL of ≥ 26.5 mm (3.11; 1.83-5.30; P < 0.001), a history of glaucoma treatment (2.83; 1.63-4.91; P < 0.001), poorly mydriasis (2.63; 1.16-6.01; P = 0.02), IFIS (4.37; 1.78-10.74; P = 0.001) and baseline high IOP (1.09; 1.01-1.18; P = 0.03) were associated with increased IOP during the early period post cataract surgery.

CONCLUSIONS: The findings in this study reveal that male sex, high myopia, a history of glaucoma treatment, poor mydriasis, IFIS and baseline high IOP are risk factors for IOP elevation during the early period post cataract surgery.

PMID:35430642 | DOI:10.1007/s10384-022-00918-z

Mycopathologia. 2022 Apr 16. doi: 10.1007/s11046-022-00631-y. Online ahead of print.

ABSTRACT

BACKGROUND: Whether cystic fibrosis transmembrane conductance regulator (CFTR) gene mutations contribute to the high prevalence of allergic bronchopulmonary aspergillosis (ABPA) in India remains unknown. We aimed to evaluate the occurrence of CFTR mutations in subjects with ABPA complicating asthma.

METHODS: We sequenced the CFTR gene using genomic DNA from blood on the Illumina NextSeq500 platform. Before undertaking zygosity analysis by genome analysis toolkit, the known or novel single nucleotide polymorphisms (SNPs) and indels were called. For rigorous analysis, we included only high-quality SNPs (scores > 500) and coverage ranging from 30 × 150x.

RESULTS: We included 18, 12, and eight adult participants of ABPA, asthma, and healthy controls, respectively. The frequency of SNPs was higher in asthmatic subjects than ABPA or healthy controls, albeit not statistically significant (9/12 [75%] vs. 11/18 [61.1%] vs. 3/8 [37.5%], p = 0.24). Of the 38 subjects, 23 yielded 50 variants (healthy controls [n = 5], ABPA [n = 22], asthma [n = 23]) corresponding to six SNPs not previously linked with ABPA. Of these, four SNPs (rs213950, rs200735475, rs1800113, and rs1800136) were catalogued in the NCBI database. We identified two novel SNPs (chr7:117250703, chr7:117282655) in four (ABPA [n = 1], asthma [n = 3]) subjects without corresponding reference SNP. Most SNPs (85.5%) were heterozygous. The frequency of SNPs was higher in ABPA subjects with high-attenuation mucus (52.2%) and bronchiectasis (39.1%) than serological ABPA (8.7%).

CONCLUSIONS: Our study suggests the role of CFTR mutations in the pathogenesis of ABPA. The SNPs in the CFTR gene may contribute to disease severity in ABPA. Larger studies are required to confirm our findings.

PMID:35430640 | DOI:10.1007/s11046-022-00631-y

Nicotine Tob Res. 2022 Apr 17:ntac107. doi: 10.1093/ntr/ntac107. Online ahead of print.

ABSTRACT

INTRODUCTION: Bans of menthol characterizing flavor in tobacco products have been proposed, however there is limited data regarding the impact on current menthol cigarette smokers of including e-cigarettes in such bans.

METHODS: In this six-week pilot study, menthol smokers were randomized to receive all tobacco products from an experimental marketplace simulating either no menthol ban, a menthol ban for cigarettes but not e-cigarettes or a ban for both (“total menthol ban”).

RESULTS: At the first experimental marketplace visit, all but one participant selected cigarettes with e-cigarettes selected by 38%, 69% and 40% of participants in the no ban, menthol cigarette ban and total menthol ban groups, respectively. Over the study period, the total menthol ban group smoked more than the menthol cigarette ban group (estimated mean ratio [EMR] in cigarettes per day = 1.38; 95% CI: 1.1, 1.75; p=0.006). Compared to the no ban condition, the menthol cigarette ban group smoked slightly fewer (EMR = 0.87; 95% CI: 0.68, 1.11) and the total menthol ban group smoked slightly more (EMR = 1.20; 95% CI: 1.00, 1.45) although neither difference reached statistical significance. In both menthol ban conditions, ratings were lower (vs. no ban) on several measures of craving and of cigarette effects and liking.

CONCLUSIONS: Menthol bans that include e-cigarettes may result in different patterns of tobacco use than if only combustible cigarettes are included, although e-cigarettes were not extensively used in any group. Larger studies are needed to determine which policies most likely provide the largest public health benefit.

IMPLICATIONS: Bans of menthol characterizing flavor have been proposed, however the effects on menthol cigarette smokers of including e-cigarettes in such bans are not clear. This study found that smokers randomized to a simulated ban on menthol in both cigarettes and e-cigarettes smoked more cigarettes per day over the 6-week study period than those randomized to a simulated ban on menthol in only cigarettes suggesting that smoking patterns among current menthol smokers differ depending on which products are included in a menthol ban. Larger studies are needed to determine policies most likely to provide the largest public health benefit.

PMID:35430631 | DOI:10.1093/ntr/ntac107