Tag: nevin manimala

WMJ. 2021 Mar;120(S1):S6-S9.

ABSTRACT

IMPORTANCE: Wisconsin has the second-highest Black homicide rate in the country, reporting a rate of 37.57 deaths per 100,000 Black non-Hispanic Wisconsinites. Meanwhile, White non-Hispanics experience a homicide rate of 2.0 deaths per 100,000.

OBJECTIVE: This data identifies a public health disparity that deserves further investigation. This study seeks to detail the mortality rate of all-cause homicide, firearm-related homicide, non-firearm-related homicide, and legal intervention firearm-related homicide; leading causes of death; average age of death; and years of potential life lost (YPLL) between White non-Hispanics and Black non-Hispanics in Wisconsin during 2000-2017.

DESIGN: Wisconsin homicide rates, ranked leading causes of death, and average age of death were obtained through the Wisconsin Department of Health Services via the Wisconsin Interactive Statistics on Health (WISH) Query System. National data were obtained through the Centers for Disease Control and Prevention’s Web-based Injury Statistics Query and Reporting System (WISQARS). Homicide rates, ranked leading causes of death, average age of death, and YPLL were compared by mechanism of injury, county of residence, and race and ethnicity.

PARTICIPANTS AND EXPOSURES: The entire population of Black non-Hispanic Americans and White non-Hispanic Americans during 2000-2017 was included. For comparison, this was narrowed to the population of Black non-Hispanic Wisconsinites and White non-Hispanic Wisconsinites during 2000-2017. Exposure groups include all homicide victims during 2000-2017.

MAIN OUTCOMES AND MEASURES: We hypothesized that Black non-Hispanic Wisconsinites would have a significantly worse burden of disease compared to White non-Hispanic Wisconsinites, as well as Black non-Hispanic Americans.

RESULTS: This study found that firearm-related homicide rates for Black non-Hispanics compared to White non-Hispanics were 14.6 times greater in Milwaukee, 29.9 times greater in Wisconsin, and 13.0 times greater in urban counties of the United States. Firearm-related homicide is the second-leading cause of death for Black non-Hispanics in Milwaukee and the fourth-leading cause of death in Wisconsin. YPLL per person for Black non-Hispanic victims of firearm-related homicide are 36.83 years in Milwaukee and 37.04 years in Wisconsin.

CONCLUSION AND RELEVANCE: Our findings strongly suggest that Black non-Hispanic Wisconsinites endure a significantly worse burden of firearm-related homicide compared to White non-Hispanic Wisconsinites and Black non-Hispanic Americans. This study demonstrates a significant disparity in firearm-related homicide that should inspire policy discussion.

PMID:33819395

J Pediatr Endocrinol Metab. 2021 Apr 6. doi: 10.1515/jpem-2020-0512. Online ahead of print.

ABSTRACT

OBJECTIVES: Given their established role in hepatic function and insulin resistance for adults, early screening of type 2 diabetes mellitus (T2DM) in the pediatric population may potentially be improved by the assessment of elevated liver enzymes.

METHODS: Our study enrolled 151 nondiabetic children aged 10-14 years. Patients were assessed for demographics and five risk factors for T2DM. The levels of γ-glutamyl transpeptidase (GGT), alanine aminotransferase (ALT), and alkaline phosphatase (ALP) levels were determined in serum samples. The effects of demographics and risk factors on abnormal liver enzyme levels were assessed with univariate chi-square analyses and also with multivariate logistic regression analyses, which were controlled for gender.

RESULTS: Frequencies for abnormal liver enzyme values were as follows: 13 (9%) for GGT, 5 (3%) for ALT, and 20 (13%) for ALP. Across analyses, two results were consistently statistically significant. Females were more likely to have abnormal ALP levels, and patients with BMI percentile ≥95% and with acanthosis nigricans were more likely to have abnormal GGT levels.

CONCLUSIONS: Our study suggests GGT as potential marker for T2DM discovery in children. Subsequent long-term longitudinal studies would help to more clearly delineate GGT’s association with T2DM. Additionally, future studies that elucidate the molecular contribution of GGT elevation to T2DM pathogenesis are needed.

PMID:33819416 | DOI:10.1515/jpem-2020-0512

Pathol Int. 2021 Apr 5. doi: 10.1111/pin.13098. Online ahead of print.

ABSTRACT

Colorectal cancer (CRC) is the second leading cause of cancer-related mortality worldwide. Kinesin Family Member C1 (KIFC1) has been proposed as a promising therapeutic target due to its pivotal role in centrosome clustering to mediate cancer cell progression. This study aimed to analyze the expression and biological function of KIFC1 in CRC. Immunohistochemically, 67 (52%) of 129 CRC cases were positive for KIFC1 and statistically associated with poorer overall survival. KIFC1 small interfering RNA (siRNA)-transfected cells demonstrated lower cell proliferation as compared to the negative control cells. A specific KIFC1 inhibitor, kolavenic acid analog (KAA) drastically inhibited CRC cell proliferation. Microarray analysis revealed that KAA-treated CRC cells presented reduced ZW10 interacting kinetochore protein (ZWINT) expression as compared to control cells. Immunohistochemical analysis demonstrated that 61 (47%) of 129 CRC cases were positive for ZWINT and ZWINT expression was significantly correlated with KIFC1 expression. ZWINT-positive cases exhibited significantly worse overall survival. KIFC1 siRNA-transfected cells showed reduced ZWINT expression while ZWINT siRNA-transfected cells decreased cell proliferation. Both KIFC1 and ZWINT knockdown cells attenuated spheroid formation ability. This study provides new insights into KIFC1 regulating ZWINT in CRC progression and its potential as a therapeutic target.

PMID:33819373 | DOI:10.1111/pin.13098

Asia Pac J Clin Oncol. 2021 Apr 5. doi: 10.1111/ajco.13570. Online ahead of print.

ABSTRACT

BACKGROUND: The COVID-19 pandemic has forced rapid system-wide changes to be implemented within cancer care at an alarming pace. Clinical trials are a key element of comprehensive cancer care. Ensuring the continuing safe conduct of cancer clinical trials in the context of a pandemic is challenging.

METHODS: We aimed to describe the COVID-19 pandemic response of a Cancer Care Clinical Research Unit (CRU) of a tertiary hospital in Queensland, Australia. We used a mixed methods approach for this case study. Emailed directives from CRU managers to all CRU staff sharing were qualitatively analysed and mapped against our unit activities over longitudinal time points. Data from patient recruitment and protocol deviations were analysed using descriptive statistics.

RESULTS: Mapping activity from 11 March to 30 September 2020 revealed rapid change during the first 2 weeks. Four key strategies to accommodate change were identified: supporting patients and families, introduction of telehealth, accessing investigational product, and social distancing. Early in the pandemic we recognised that our core key stakeholders were integral to our response. When compared to the previous 12 months, our recruitment numbers dropped markedly in early phases of the response but recovered over time, as we accommodated internal and external impacts.

CONCLUSION: Our experience of agility as a necessity, adapting to support patients, and managing both clinical research activity and sponsors during the height of the pandemic response is presented here in order to inform future disaster response planning by clinical trial organisations.

PMID:33819387 | DOI:10.1111/ajco.13570

Ann Clin Transl Neurol. 2021 Apr 5. doi: 10.1002/acn3.51358. Online ahead of print.

ABSTRACT

OBJECTIVE: Despite the need for diagnostics and research, data on fluid biomarkers in hereditary spastic paraplegia (HSP) are scarce. We, therefore, explore Neurofilament light chain (NfL) levels in cerebrospinal fluid (CSF) of patients with hereditary spastic paraplegia and provide information on the influence of demographic factors.

METHODS: The study recruited 59 HSP cases (33 genetically confirmed) and 59 controls matched in age and sex. Neurofilament light chain levels were assessed by enzyme-linked immunosorbent assay. The statistical analysis included the effects of age, sex, and genetic status (confirmed vs. not confirmed).

RESULTS: Levels of CSF NfL were significantly increased in patients with hereditary spastic paraplegia compared to controls (median 741 pg/mL vs. 387 pg/mL, p < 0.001). Age (1.4% annual increase) and male sex (81% increase) impacted CSF NfL levels in patients. The age-dependent increase of CSF NfL levels was steeper in controls (2.6% annual increase). Thus, the CSF NfL ratio of patients and matched controls-expressing patients’ fold increases in CSF NfL-declined considerably with age.

INTERPRETATION: CSF NfL is a reliable cross-sectional biomarker in hereditary spastic paraplegia. Sex is a relevant factor to consider, as male patients have remarkably higher CSF NfL levels. While levels also increase with age, the gap between patients and controls is narrowing in older subjects. This indicates distinct temporal dynamics of CSF NfL in patients with hereditary spastic paraplegia, with a rise around phenotypic conversion and comparatively static levels afterward.

PMID:33819388 | DOI:10.1002/acn3.51358

Int J Periodontics Restorative Dent. 2021 Mar-Apr;41(2):269-275. doi: 10.11607/prd.4444.

ABSTRACT

The efficacy of the socket preservation procedure using deproteinized bovine bone mineral, bioabsorbable collagen membrane, and collagen sponge on molar extraction sites with severe periodontitis was assessed at 6 postoperative months, before implant placement. Results revealed excellent soft tissue healing without loss of keratinized tissue and no statistically significant differences in socket marginal bone changes in 20 molar extraction sockets. High levels of primary implant stability were recorded. Socket preservation using a minimally invasive surgical technique provides good soft and hard tissue healing as well as anticipated stability of implant placement at sites of extracted molars with severe periodontitis.

PMID:33819334 | DOI:10.11607/prd.4444

Int J Periodontics Restorative Dent. 2021 Mar-Apr;41(2):285-293. doi: 10.11607/prd.4653.

ABSTRACT

This randomized split-mouth preliminary clinical trial aimed to evaluate periodontal parameters and gingival blood flowmetry, comparing sites that received subepithelial connective tissue graft from the palate after deepithelialization (DE) or obtained with parallel incision (PI). Periodontal parameters were evaluated at baseline and 6 months postoperative. Gingival blood flows were analyzed by laser Doppler flowmetry (LDF) at baseline and 2, 7, and 14 days postoperative. Statistical and LDF analyses were performed with R version 3.5.1 and MATLAB software, and clinical parameters through ANOVA and Wilcoxon signed-rank tests. LDF showed superior decrease in power spectral density (PSD) for DE after 2 days. After 7 days, PSD returned to initial values only for PI, and DE had not returned to the initial values by day 14. Despite major initial revascularization challenges for DE sites, both grafts promoted satisfactory root coverage in the treatment of multiple gingival recessions.

PMID:33819336 | DOI:10.11607/prd.4653

J Magn Reson Imaging. 2021 Apr 5. doi: 10.1002/jmri.27626. Online ahead of print.

ABSTRACT

BACKGROUND: Early detection and grading of pancreatic fibrosis (PF) are important and challenging clinical goals.

PURPOSE: To determine main pancreatic duct (MPD) diameter, pancreatic thickness, and grades of PF via magnetic resonance elastography (MRE), T1 mapping, and intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI), assessing respective diagnostic performances.

STUDY TYPE: Prospective.

SUBJECTS: Histopathologic and imaging records (MRE, T1 mapping, and IVIM-DWI) generated by 144 patients between December 2018 and May 2020 were collected for analysis. Grades of PF were distributed as follows: F0, 82; F1, 22; F2, 22; and F3, 18.

FIELD STRENGTH/SEQUENCE: 3 T pancreatic MRI, encompassing MRE, T1 mapping, and IVIM-DWI.

ASSESSMENT: In all patients, T1 relaxation times, pancreatic stiffness values, IVIM-DWI parameters, MPD diameter, and pancreatic thickness were measured.

STATISTICAL TESTS: Receiver operating characteristic (ROC) analysis served to assess imaging parameters useful in diagnosing PF. To identify relations between specific parameters and grades of PF, logistic regression analysis was invoked.

RESULTS: Both pancreatic stiffness (r = 0.754; P < 0.001) and T1 relaxation time (r = 0.433; P < 0.001) correlated significantly with PF (%). To determine PF grades ≥F1, a combined model (area under the curve [AUC] = 0.906) performed significantly better than pancreatic stiffness (AUC = 0.855; P < 0.001) or T1 relaxation time (AUC = 0.754; P < 0.001) alone. For PF grades ≥F2 or grade F3, both the combined model (≥F2: AUC = 0.910; F3: AUC = 0.939) and pancreatic stiffness (≥F2: AUC = 0.906; F3: AUC = 0.929) outperformed T1 relaxation time (≥F2: AUC = 0.768 [P = 0.005 and P = 0.004, respectively]; F3: AUC = 0.816 [both P < 0.005]). All IVIM-DWI parameters generated AUC values <0.700.

DATA CONCLUSION: A combination of MRE and T1 mapping seems promising in diagnosing various grades of PF, particularly at an early stage.

LEVEL OF EVIDENCE: 1 TECHNICAL EFFICACY: Stage 2.

PMID:33819364 | DOI:10.1002/jmri.27626

Int J Clin Pract. 2021 Apr 5:e14212. doi: 10.1111/ijcp.14212. Online ahead of print.

ABSTRACT

AIMS: To investigate the effect of ideal period (Δ-day), which is a period between the sterile urine culture and initiation of flexible ureteroscopy (f-URS), on postoperative urinary tract infections (UTI) in our tertiary referral center.

METHODS: After obtaining the approval of the local ethics committee, retrospective data was collected for all f-URS procedures performed between January 2017 and March 2019. Patients that developed UTI were matched in 1:1 proportion with patients that didn’t develop UTI based on their demographic and stone characteristics. The group of patients with postoperative UTI was compared with the control group.

RESULTS: A total of 916 f-URS cases that had all required data were analyzed. Sixty-eight patients with postoperative UTI were determined and a total of 136 patients were included in the study after match-pair. We found that if the Δ-day is longer than 2 weeks, the possibility of postoperative urinary infection rates increase with statistical significance (p=0.006). According to our subgroup analysis, postoperative UTI was more common if the Δ-day >14 days. ROC curve analysis provided a 14.5-day period as a cut-off value of Δ-day for postoperative UTI.

CONCLUSIONS: The present study is the first to examine the impact of the Δ-day for f-URS on postoperative UTIs. In brief, prolonging the Δ-day, especially if Δ-day >14 days, leads to increase in the rates of postoperative UTI. We conclude that it is preferred to either perform the f-URS in the early period after the urine culture analysis or doing the urine culture analysis shortly before the surgery.

PMID:33819371 | DOI:10.1111/ijcp.14212

Int J Periodontics Restorative Dent. 2021 Mar-Apr;41(2):187-192. doi: 10.11607/prd.4071.

ABSTRACT

This paper reports on a study undertaken to ascertain the efficacy of the erbium:YAG laser (EYL) for peri-implantitis treatment. A total of 12 patients with bone loss resulting from peri-implantitis were involved in this study. The treatment protocol consisted of using the EYL for implant surface debridement and deproteinized bovine bone mineral (DBBM) for bone grafting. The following parameters were analyzed: probing pocket depth (PPD), clinical attachment level (CAL), bleeding on probing (BOP), bone levels (BLs), and the lipopolysaccharide levels before and after debridement with the EYL. This study found a statistically significant improvement in PPD, CAL, BOP, and BL at 3 and 12 months postoperative. Furthermore, a statistically significant decrease in implant-surface LPS levels was observed following debridement with the EYL. These findings show that using the EYL for debridement in peri-implantitis cases is effective in decreasing LPS levels. Moreover, after partial reconstruction with DBBM grafting, BLs were restored for at least 12 months. It was shown in one case that BLs had remained stable over 6 years, which also attests to the efficacy of this treatment. The combined use of EYL and DBBM could be effective for regenerative surgical peri-implantitis treatment.

PMID:33819321 | DOI:10.11607/prd.4071