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Elevated IL-37 Serum Lvels in Patients with Transitional Cell Carcinoma of Bladder

Iran J Immunol. 2021 Dec;18(4):8. doi: 10.22034/IJI.2021.92669.2167.

ABSTRACT

BACKGROUND: Interleukin-37 (IL-37) is a recently described cytokine that emerges as a natural inhibitor of inflammatory and immune responses. However, IL-37 has not yet been investigated in bladder cancer, and its biological role is unknown.

OBJECTIVE: The purpose of this study was to investigate IL-37 serum levels in patients with bladder cancer and determine whether they were linked to the patients’ pathological characteristics.

METHODS: IL-37 serum levels were measured using a commercial ELISA kit in 60 patients with transitional cell carcinoma (TCC) of the bladder (mean age: 64.55±12.93) and 50 healthy controls (mean age: 62.94±12.69). Non-parametric tests were used for statistical comparisons, and the Cohen’s d effect size was calculated to evaluate the practical and clinical significance of the results.

RESULTS: Our findings indicated an increasing trend in IL-37 serum levels in patients with TCC (42.77±3.36 pg/ml) in comparison with controls (40.51±3.88 pg/ml, p=0.09). However, IL-37 serum levels were found to be significantly higher in male patients (44.72±3.81 pg/ml) and patients aged ≥70 (46.92±6.77 pg/ml) in comparison with male controls (29.96±3.30 pg/ml, p=0.026) and controls aged ≥70 (23.62±4.34 pg/ml, p=0.009). In comparison to similar controls, Cohen’s d effect size for patients aged ≥70 years was found to be 0.90.

CONCLUSION: The findings reveal a higher serum level of IL-37 in patients with TCC, which might be clinically associated with immunosuppression and tumor growth. However, this is a preliminary study, and more research on the biological role of IL-37 and its potential therapeutic effects in bladder cancer is required.

PMID:34931620 | DOI:10.22034/IJI.2021.92669.2167

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Efficacy and Safety of Shengmai Preparation Combined with Western Medicine for Coronary Heart Disease: A Systematic Review and Meta-Analysis

Am J Chin Med. 2021 Dec 20:1-27. doi: 10.1142/S0192415X22500057. Online ahead of print.

ABSTRACT

The efficacy and safety of Shengmai preparation combined with Western medicine (SMP-WM) to treat coronary heart disease (CHD) were reviewed. Twenty-five randomized controlled trials of SMP-WM treatment for CHD were retrieved from seven databases and other trial sources between their inception and April 10, 2021. The risk of bias domains was accessed by Cochrane Collaboration’s tool, and the data were statistically analyzed using RevMan 5.3 and Stata 12.0 software. The majority of included studies had a low or unclear risk of overall bias. Total mortality was not reduced (RR = 0.39, 95% CI: 0.13-1.19, [Formula: see text] = 0.10), but the cardiovascular events (RR = 0.35, 95% CI: 0.22-0.54, [Formula: see text] < 0.01), weekly frequency (SMD = -2.38, 95% CI: -2.89 – -1.88, [Formula: see text] < 0.01), and duration (SMD = -3.24, 95% CI: -3.76 – -2.71, [Formula: see text] < 0.01) of angina pectoris attacks were significantly decreased by SMP-WM. The SMP-WM combination exerted antiplatelet activity by reducing platelet adhesion (SMD = -0.97, 95% CI: -1.49 – -0.45, [Formula: see text] = 0.0003) and the platelet reactivity index (SMD = -1.75, 95% CI: -2.04 – -1.46, [Formula: see text] < 0.01). SMP-WM could protect endothelial function by increasing nitric oxide (SMD = 1.28, 95% CI: 0.54-2.02, [Formula: see text] < 0.01) and decreasing endothelin (SMD = -1.26, 95% CI: -1.85 – -0.66, [Formula: see text] < 0.01). The combination also improved hemorheology by reducing whole blood viscosity (SMD = -1.59, 95% CI: -2.32 – -0.85, [Formula: see text] < 0.01), plasma viscosity (SMD = -0.65, 95% CI: -0.86 – -0.45, [Formula: see text] < 0.01), and fibrinogen (SMD = -4.21, 95% CI: -4.58 – -3.83, [Formula: see text] < 0.01). The SMP-WM combination favorably impacts cardiovascular events, angina symptoms, endothelial function, platelet aggregation, and blood viscosity, with comparable safety to that of routine Western medicine. Further investigation is required to enhance the strength of the evidence.

PMID:34931586 | DOI:10.1142/S0192415X22500057

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Comparative efficacy of ravulizumab and eculizumab in the treatment of atypical hemolytic uremic syndrome: An indirect comparison using clinical trial data


Clin Nephrol. 2021 Dec 21. doi: 10.5414/CN110516. Online ahead of print.

ABSTRACT

Ravulizumab and eculizumab are approved terminal complement inhibitor treatments for atypical hemolytic uremic syndrome (aHUS). Ravulizumab was engineered from eculizumab to have an increased half-life allowing for reduced dosing frequency (8-weekly vs. 2-weekly). To account for differences in respective clinical trials, a validated balancing technique was used to enable an indirect comparison of ravulizumab and eculizumab treatment efficacy in aHUS. Patient-level data from four eculizumab clinical trials were available for pooling and comparison with data from two ravulizumab trials. In the primary analysis, adult native kidney data were compared. Propensity scores were calculated from baseline characteristics (dialysis status, estimated glomerular filtration rate, platelet count, serum lactate dehydrogenase). Stabilized inverse probability weighting was used to balance groups. Changes in outcomes from baseline to 26 weeks were compared between treatment groups. Sensitivity and subgroup analyses were conducted to assess the robustness of findings. Overall, 85 patients (46 ravulizumab, 39 eculizumab) were included in the primary analysis. Demographic and clinical characteristics were well balanced after weighting at baseline. At 26 weeks, clinical outcomes (including renal function, hematological markers, and dialysis prevalence), and fatigue and quality of life measures were improved with eculizumab and ravulizumab treatment. No differences between treatment groups reached statistical significance, although confidence intervals were wide. Sensitivity and subgroup analysis results were consistent with those of the primary analysis. Using appropriate methodology for indirect comparison of studies, no differences in outcomes were seen between ravulizumab and eculizumab, although, owing to small sample sizes, confidence intervals were wide. .

PMID:34931610 | DOI:10.5414/CN110516

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Relationships Between University Students’ Gender and Physical Activity (PA) and Their Exercise Self-Schemas, Processing of PA-Related Information, and PA Decision-Making

Percept Mot Skills. 2021 Dec 21:315125211060187. doi: 10.1177/00315125211060187. Online ahead of print.

ABSTRACT

In the current study, we investigated the effects of gender and regular physical activity (PA) on PA decision-making and speed of information processing. We enrolled 110 university students (Mage = 20.91, SD =2.28 years) in an experiment involving two tasks and a questionnaire. One of the two tasks assessed how much participants agreed with presented PA words and phrases and the other task predicted behavior and responses to future situations. We collected and measured the participants’ choices and the time they took to make them. The questionnaire, the International Physical Activity Questionnaire (IPAQ), consisted of exercise self-schema and PA questions. We conducted a 2 (gender: male or female) ×2 (regular PA or not) multivariate analysis of variance (MANOVA) and found statistically significant differences between variables as a function of participants’ gender (λ = .66, p < .001) and regular PA engagement (λ = .51, p < .001). In a regression analysis, we also found gender differences [males showed relationships between agreement with PA information and information processing speed for decisions on future behavior (R2 = .31, F = 12.50); females showed relationships between their exercise self-schema (R2 = .26, F = 18.18) and regular PA such that, in the non-regular PA group, exercise self-schema was related to reaction time in making decisions on future behavior (R2 = .29, F = 11.23), and in the regular PA group, agreement with PA information was related to reaction time for PA-related words, and agreement with non-PA information (R2 = .29, F = 8.91)]. These results highlight the need to consider participant characteristics when designing exercise interventions, and we present supplementary data regarding exercise self-schemas, decision-making, and the speed of processing PA information.

PMID:34931560 | DOI:10.1177/00315125211060187

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A Programmatic Evaluation of School Preparedness for Latinx Children and Families: A Partnership Program

Hisp Health Care Int. 2021 Dec 21:15404153211063639. doi: 10.1177/15404153211063639. Online ahead of print.

ABSTRACT

Introduction: Latinx children are the fastest-growing ethnic minority of children under the age of 5 years in a tri-county area in the Southeastern United States (US Census, 2018). There are limited culturally and linguistically appropriate school preparedness initiatives in this geographic region. Methods: A cultural and linguistic appropriate program was developed in coordination with the state’s largest Latinx advocacy organization and two patient-centered pediatric medical homes (PCPMHs) after securing extramural grant funding for an evidenced-based home visitation program using skilled community health workers (CHWs) aimed at Latinx children at the age of 0-5 years and their caregivers. The program includes developmental screenings using the Ages & Stages Questionnaires®, Third Edition (ASQ®-3), CHW role modeling of developmentally appropriate play, early literacy, connection to resources, oral health, nutrition, and physical activity. Results: Of the 103 unique children represented in this programmatic evaluation that received an initial and follow-up ASQ®-3 developmental screening, paired t-tests indicate statistically significant improvement in mean scores from the first to second ASQ®-3 in all five major developmental domains with the largest gains represented in the communication and fine motor skill domains. Conclusion: This evaluation suggests that low-frequency home visits from skilled CHWs can have a beneficial effect on development in early childhood. PPCMHs can serve as a hub for these community-based programs.

PMID:34931566 | DOI:10.1177/15404153211063639

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Analgesic efficacy of single-shot adductor canal block versus adductor canal block combined with intra-articular ropivacaine infusion after total knee arthroplasty

Bone Jt Open. 2021 Dec;2(12):1082-1088. doi: 10.1302/2633-1462.212.BJO-2021-0119.R1.

ABSTRACT

AIMS: Single-shot adductor canal block (ACB) after total knee arthroplasty (TKA) for postoperative analgesia is a common modality. Patients can experience breakthrough pain when the effect of ACB wears off. Local anaesthetic infusion through an intra-articular catheter (IAC) can help manage breakthrough pain after TKA. We hypothesized that combined ACB with ropivacaine infusion through IAC is associated with better pain relief compared to ACB used alone.

METHODS: This study was a prospective double-blinded placebo-controlled randomized controlled trial to compare the efficacy of combined ACB+ IAC-ropivacaine infusion (study group, n = 68) versus single-shot ACB+ intra-articular normal saline placebo (control group, n = 66) after primary TKA. The primary outcome was assessment of pain, using the visual analogue scale (VAS) recorded at 6, 12, 24, and 48 hours after surgery. Secondary outcomes included active knee ROM 48 hours after surgery and additional requirement of analgesia for breakthrough pain.

RESULTS: The study group (mean visual analogue scale (VAS) pain score of 5.5 (SD 0.889)) experienced significant reduction in pain 12 hours after surgery compared to the control group (mean VAS 6.62 (SD 1.356); mean difference = 1.12, 95% confidence interval (CI) -1.46 to 0.67; p < 0.001), and pain scores on postoperative day (POD) 1 and POD-2 were lower in the study group compared to the control group (mean difference in VAS pain = 1.04 (-1.39 to -0.68, 95% CI, p < 0.001). Fewer patients in the study group (0 vs 3 in the control group) required additional analgesia for breakthrough pain, but this was not statistically significant. The study group had significantly increased active knee flexion (mean flexion 86.4° (SD 7.22°)), compared to the control group (mean 73.86° (SD 7.88°), mean difference = 12.54, 95% CI 9.97 to 15.1; p < 0.014).

CONCLUSION: Combined ACB+ ropivacaine infusion via IAC is a safe, reproducible analgesic modality after primary TKA, with superior analgesia compared to ACB alone. Further large volume trials are warranted to generate evidence on clinical significance on analgesia after TKA. Cite this article: Bone Jt Open 2021;2(12):1082-1088.

PMID:34931538 | DOI:10.1302/2633-1462.212.BJO-2021-0119.R1

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Photobiomodulation of inflamed dental pulp stem cells under different nutritional conditions

Regen Med. 2021 Dec 21. doi: 10.2217/rme-2021-0056. Online ahead of print.

ABSTRACT

Aim: The present study aimed to investigate photobiomodulation’s (PBM) effect on inflamed dental pulp stem cells (IDPSCs) under different nutritional conditions. Methods: Cell proliferation and odontogenic differentiation were evaluated using the MTT assay and real-time quantitative reverse transcription PCR, respectively after laser PBM of cells in 5 or 10% fetal bovine serum (FBS) culture conditions. Results: A significant positive effect of laser irradiation on cell proliferation under both nutritional conditions after 24 and 48 h was observed. DMP-1 gene expression increased in the groups with laser irradiation and 5% FBS. Comparison of gene expression levels in the four groups revealed no statistically significant stimulatory effect. The highest gene expression was observed in the non-laser group with 5% FBS. Conclusion: Further studies are required to obtain an irradiation setup to ideally improve inflamed dental pulp stem cells’ proliferation and differentiation.

PMID:34931540 | DOI:10.2217/rme-2021-0056

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Low-intensity shockwave treatment (liswt) improves penile rigidity in eugonadal subjects with erectile dysfunction: a pilot study

Minerva Endocrinol (Torino). 2021 Dec 21. doi: 10.23736/S2724-6507.21.03686-1. Online ahead of print.

ABSTRACT

BACKGROUND: Since low-intensity shockwave treatment (LISWT) has putative effects on penile hemodynamics remodeling, the aim of this study was to evaluate any improvement of penile vascular flows after LISWT treatment in patients with erectile dysfunction (ED) and poor response to PDE5i.

METHODS: Twenty-one eugonadal patients with different ED severity underwent six weekly LISWT sessions (1500-4000 pulses) after 2 weeks withdrawal from PDE5i assumption. Once daily Tadalafil (2.5 mg daily) was reintroduced 4 weeks apart from LISWT termination and patients were evaluated at 1, 2 and 6 months follow-up (T1, T2, T6) by the International Index of Erectile Function-15 items questionnaire (IIEF-15) erectile function (EF) domain, Erection Hardness Score (EHS) and Global Assessment Questionnaires (GAQ). Basal Penile Color-Doppler Ultrasound parameters in the flaccid state (B-PCDU) were evaluated before, during and after interventional protocol.

RESULTS: Mean EHS score improved in 35% of patients at T1, and in up to 50 % of patients at T2 and T6 follow-up visits (p<0.05). We found 25% improvement of EF scores at T1 session, 43.75% at T2 and 62.5% at T6, respectively (p<0.05). No statistically significant differences in flow parameters, EF-domain and testosterone levels were found when baseline and last observation carried forward (LOCF) parameters were compared. The GAQ questionnaire scored higher satisfaction rates either at the end of the treatment (100%), or at LOCF (92.5%).

CONCLUSIONS: Despite the study limitations with respect to B-PCDU in this setting, our results confirm a trend toward improvement of erectile questionnaire scores after LISWT with higher overall satisfaction rates among patients with ED. We conclude that LISWT may be an effective option in some difficult-to-treat patients with ED by improving the erectile response to PDE5i.

PMID:34931511 | DOI:10.23736/S2724-6507.21.03686-1

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Adverse Perinatal Outcomes Before and After Diagnosis with Systemic Lupus Erythematosus Among African American Women

Arthritis Care Res (Hoboken). 2021 Dec 20. doi: 10.1002/acr.24848. Online ahead of print.

ABSTRACT

OBJECTIVE: Women with systemic lupus erythematosus (SLE) may experience adverse perinatal outcomes in the years before an SLE diagnosis. Overall, there is limited research on perinatal outcomes among African American women with SLE.

METHODS: Women with SLE identified from the Georgia Lupus Registry and the Georgians Organized Against Lupus Cohort were linked with birth certificates by the Georgia Department of Public Health. Births were categorized into occurring more than 3 years before SLE diagnosis, 0-3 years before SLE diagnosis, 0-3 years after SLE diagnosis or more than 3 years after SLE diagnosis. Comparison births certificates to African American women in the same geographic area were obtained from the National Center for Health Statistics. We used log-risk models to compare the risk of preterm birth or small-for-gestational age among SLE births in each diagnosis timing category to the general population, adjusting for maternal age and education and parity.

RESULTS: Births to women with SLE were more likely to occur preterm 0-3 years before SLE diagnosis (risk ratio [RR]: 1.71, 95% confidence interval [CI]: 1.24, 2.35), 0-3 years after SLE diagnosis (RR: 2.29, 95% CI: 1.70, 3.09) and 3 or more years after diagnosis (RR: 2.83, 95% CI: 2.36, 3.38), but not 3 or more years before SLE diagnosis compared to the general population (RR: 1.03, 95% CI: 0.77, 1.38). Similar results were observed for small-for-gestational age births.

CONCLUSION: Our analysis, conducted among African American women, demonstrates an increased risk of adverse perinatal outcomes even before a clinical diagnosis of SLE.

PMID:34931482 | DOI:10.1002/acr.24848

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The Impact of the COVID-19 Pandemic in Adolescents with Asthma

J Korean Med Sci. 2021 Dec 20;36(49):e339. doi: 10.3346/jkms.2021.36.e339.

ABSTRACT

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic is affecting people at any age and there is limited information about the effect of the COVID-19 pandemic on quality of life (QoL) in adolescents with asthma. In the present study, it was aimed to assess the attitudes of adolescents with asthma toward the COVID-19 pandemic and determine the effects of the pandemic on their QoL.

METHODS: In total, 125 adolescents with asthma and 98 healthy adolescents participated in the present study. The questionnaire form consisted of three parts. In the first part, all the participants were asked whether they complied with the protective measures against COVID-19. The second part included questions for measuring the participants’ level of concern about COVID-19, while the third part consisted of EUROHIS-QOL 8.

RESULTS: The patient and control groups were similar in terms of the female/male ratio (55/70 and 48/50, respectively) and mean participant age (14.6 ± 2 and 15.1 ± 1.65 years, respectively) (P = 0.459 and P = 0.062, respectively). The prevalence of COVID-19 in the patients (n = 2, 1.6%) was lower than that in the controls (n = 6, 6.1%); however, the difference was not statistically significant (P = 0.142). The total EUROHIS-QOL score was significantly lower in the patients (31.2 ± 6.7) than in the controls (33.7 ± 4.4) (P < 0.001). The total QoL scores of asthmatic adolescents without other allergic disease (31.4 ± 6.7) was also lower than those of the controls (33.7 ± 4.4) (P = 0.009). Treatment disruption was significantly more common in patients who received subcutaneous immunotherapy (n = 20, 48.8%) than in those who did not (n = 8, 9.5%) (P < 0.001). Moreover, the patients had lower EUROHIS-QOL scores in the overall QoL, general health, finance, and home domains.

CONCLUSION: Our results indicate that the mean QoL score of asthmatic adolescents during COVID-19 pandemic is lower than in the healthy population. Disruption in their treatment was most common in patients with asthma who were receiving subcutaneous immunotherapy.

PMID:34931499 | DOI:10.3346/jkms.2021.36.e339