Tag: nevin manimala

PLoS One. 2021 Aug 9;16(8):e0255293. doi: 10.1371/journal.pone.0255293. eCollection 2021.

ABSTRACT

Uveal melanoma (UVM), the most common primary intraocular malignancy, has a high mortality because of a high propensity to metastasize. Our study analyzed prognostic value and immune-related characteristics of CARD11 in UVM, hoping to provide a potential management and research direction. The RNA-sequence data of 80 UVM patients were downloaded from The Cancer Genome Atlas database and divided them into high- and low-expression groups. We analyzed the differentially expressed genes, enrichment analyses and the infiltration of immune cells using the R package and Gene-Set Enrichment Analysis. A clinical prediction nomogram and protein-protein interaction network were constructed and the first 8 genes were considered as the hub-genes. Finally, we constructed a competing endogenous RNA (ceRNA) network by Cytoscape and analyzed the statistical data via the R software. Here we found that CARD11 expression had notable correlation with UVM clinicopathological features, which was also an independent predictor for overall survival (OS). Intriguingly, CARD11 had a positively correlation to autophagy, cellular senescence and apoptosis. Infiltration of monocytes was significantly higher in low CARD11 expression group, and infiltration of T cells regulatory was lower in the same group. Functional enrichment analyses revealed that CARD11 was positively related to T cell activation pathways and cell adhesion molecules. The expressions of hub-genes were all increased in the high CARD11 expression group and the ceRNA network showed the interaction among mRNA, miRNA and lncRNA. These findings show that high CARD11 expression in UVM is associated with poor OS, indicating that CARD11 may serve as a potential biomarker for the diagnosis and prognosis of the UVM.

PMID:34370778 | DOI:10.1371/journal.pone.0255293

PLoS One. 2021 Aug 9;16(8):e0255279. doi: 10.1371/journal.pone.0255279. eCollection 2021.

ABSTRACT

BACKGROUND: The purpose of this study is to investigate and analyze the prevalence and influencing factors of stroke in hypertensive patients aged 60 and above in Jiading District, Shanghai.

METHODS: The population-based study included 18,724 screened people with hypertension (age ≥ 60 years, 48.7% women). From 2016 to 2019, data on demographics, potential influencing factors and health status were collected through face-to-face interviews, physical examinations, and laboratory tests. Logistic multivariate logistic regression model was used to analyze the influencing factors associated with stroke.

RESULTS: Among the object of study from 2016 to 2019, 2,025 patients were screened for stroke, with the overall prevalence rate of 10.82% (10.41%-11.23%). Multivariate adjusted model analysis showed that dyslipidemia (OR:1.31,95%CI:1.19-1.45), lack of exercise (OR:1.91,95%CI:1.32-2.76), atrial fibrillation [OR:1.49,95%CI:1.35-1.65), family history of stroke (OR:2.18,95%CI:1.6-2.88) were the significant independent influencing factors of stroke in hypertensive patients over 60 years old. When these four factors were combined, compared with participants without any of these factors, the multi-adjusted odds ratios (95% confidence interval) of risk of stroke for persons concurrently having one, two and three or more of these factors were 1.89 (1.67-2.13), 2.15 (1.86-2.47) and 6.84 (4.90-9.55), respectively (linear trend P < 0.001); after multivariate adjustment, the family history of stroke had additive interaction with lack of exercise [RERI = 1.08(0.22-1.94), AP = 0.19(0.04-0.35), S = 1.31(1.02-1.69)], dyslipidemia [RERI = 0.87(0.41-1.33), AP = 0.23(0.08-0.38), S = 1.46(1.04-2.05)].

CONCLUSION: The prevalence of stroke was high in hypertensive patients aged 60 and above in Jiading District, Shanghai. Dyslipidemia, lack of exercise, atrial fibrillation and family history of stroke were significantly associated with stroke in hypertensive population. Stroke risk can be increased especially when multiple factors coexisting, and family history of stroke combined with a lack of exercise or dyslipidemia.

PMID:34370757 | DOI:10.1371/journal.pone.0255279

PLoS One. 2021 Aug 9;16(8):e0255912. doi: 10.1371/journal.pone.0255912. eCollection 2021.

ABSTRACT

BACKGROUND: In Ethiopia, nearly one-third of people living with human immunodeficiency viruses do not adhere to antiretroviral therapy. Moreover, information regarding non-adherence and its associated factors among adults on first-line antiretroviral therapy in Northeast Ethiopia is limited. Therefore, this study aimed to assess the level of non-adherence and its associated factors among adults on first-line antiretroviral therapy in North Shewa Zone, Amhara Regional State, Ethiopia.

METHODS: A facility-based cross-sectional study was conducted on 326 participants selected by systematic random sampling technique from the five randomly selected public health facilities. Data were collected using the questionnaire adapted from the studies conducted previously and the collected data were entered into Epi data version 3.1 and exported to Stata version 14 for further analysis. Multivariable logistic regression analysis was done and an adjusted odds ratio with its corresponding 95% confidence interval was used to declare a statistical significance.

RESULTS: The overall prevalence of non-adherence was 17.4% [95% CI: (12.8%, 21.2%)]. Patients with no formal education [AOR (95% CI) = 5.57 (1.97, 15.88)], those who did not use memory aids to take their medications [AOR (95% CI) = 3.01 (1.27, 7.11)], travel more than 10 kilometers to visit the nearby antiretroviral therapy clinics [AOR (95% CI) = 2.42 (1.22, 25.86)], those who used substance [AOR (95% CI) = 3.57 (1.86, 28.69)], and patients whose medication time interfered with their daily routine activities [AOR (95% CI) = 15.46 (4.41, 54.28) had higher odds of having non-adherence to first-line antiretroviral therapy compared to their counter groups.

CONCLUSION: The level of non-adherence to first-line antiretroviral therapy was 17.4%, higher compared to WHO’s recommendation. Hence, patients counseling focused on avoiding substance use, use memory aids, and adjusting working time with medication schedule are very crucial. Furthermore, the ministry of health and the regional health bureau with other stakeholders should expand antiretroviral therapy service delivery at health facilities that are close to the community to address distance barriers.

PMID:34370762 | DOI:10.1371/journal.pone.0255912

J Long Term Eff Med Implants. 2021;31(3):83-89. doi: 10.1615/JLongTermEffMedImplants.2021038612.

ABSTRACT

Our goal was to evaluate the association between gingival biotype and flap design consideration at the time of stage two uncovery. A retrospective study was done in which 528 implants were placed from June 1, 2019, to March 1, 2020, were included. Data was reviewed from patient records, and the data of 86,000 patients that were documented in a private institution between June 2019 and March 2020 was analyzed. Statistical analysis was performed to assess the association between gingival biotype and flap design consideration at the time of stage two uncovery. We found that gingival biotype had no significant difference when compared between males and females and among different age groups. Flap design consideration had no significant difference when compared between males and females, but the difference was statistically significant when different age groups were compared. There was a statistically significant association between gingival biotype and flap design consideration at the time of stage two uncovery (p < 0.05). We conclude that there is significant association between gingival biotype and flap design consideration at the time of stage two uncovery. Therefore, it should be one of the factors considered during planning of implant placement in a particular case for successful implant treatment.

PMID:34369727 | DOI:10.1615/JLongTermEffMedImplants.2021038612

J Long Term Eff Med Implants. 2021;31(3):51-56. doi: 10.1615/JLongTermEffMedImplants.2021038608.

ABSTRACT

Implant systems today have come a long way to provide comfort and long-term success rate in patients requiring implant supported prosthesis as part of their oral rehabilitation. It is currently overtaking the other prosthetic treatment especially in the case of replacing anterior teeth. The aim of this study was to evaluate the association of age, gender, bone density and implant brands with respect to implants placed in the maxillary anterior region in a private hospital setup. It is a retrospective university setting study performed by evaluating the case histories of patients placed with implants in the anterior region. The data was extracted and subjected to statistical analyses using SPSS software. In this study, D2 bone was most commonly seen in the anterior region followed by D3 and D1. D1 and D3 bone were prevalent in patients in the age group of 41 to 60 years and D2 bone was prevalent in the group of 26-40 years. Males showed greater bone density than females. Implant brand Straumann Roxolid SLActive was mostly used in the anterior region and most of the implants are placed equicrestal in position. As a practitioner, one should have clear knowledge on implant brand, bone densities, crestal relation and age association in order to exert a successful treatment response in the future.

PMID:34369722 | DOI:10.1615/JLongTermEffMedImplants.2021038608

J Long Term Eff Med Implants. 2021;31(3):15-26. doi: 10.1615/JLongTermEffMedImplants.2021038016.

ABSTRACT

A combination treatment using a retrograde intramedullary (IM) nail and a lateral locking plate has scarcely been described in distal femur fracture treatment. In this retrospective inquiry, we review 97 patients who were treated for distal femur fracture by one of five fellowship-trained orthopedic trauma surgeons at an urban level-1 trauma center. Of the 97 patients enrolled in this investigation, eight were treated with a combined nail-plate hybrid construct. The remaining 89 patients were treated with either traditional IM nailing (22 patients) or locking plate fixation (67 patients) alone. Patient demographics, fracture and injury characteristics, operative variables, radiographic information, and postoperative outcome measurements were recorded for each patient in the study. All eight patients who were treated with the combined nail-plate construct proceeded to fracture union (100% vs. 69% in the control group; p = 0.33). Both procedure duration (p = 0.006) and total fluoroscopy time (p = 0.004) were significantly higher in the nail-plate construct group. No statistically significant difference was found between the two groups regarding complication rate. A combined nail-plate construct is a successful treatment alternative for acute management of distal femur fractures. This technique may be most beneficial for patients at higher risk for nonunion (i.e., those with open, comminuted metaphysis fractures) or those with a need for an additional load-sharing construct (i.e, osteopenic or noncompliant patients).

PMID:34369718 | DOI:10.1615/JLongTermEffMedImplants.2021038016

J Long Term Eff Med Implants. 2021;31(3):27-32. doi: 10.1615/JLongTermEffMedImplants.2021036412.

ABSTRACT

AIM: The aim of the current study is to assess and evaluate the effectiveness of concentrated growth factors on wound healing after implant placement procedures.

METHODOLOGY: Twenty-four patients who underwent implant placement were included in the study and were divided into two groups (group 1 = non-CGF group; group 2 = CGF group). Conventional implant placement was done in both the groups followed by placement of CGF membrane and closure using 3-0 silk in the CGF group and only closure using 3-0 silk sutures in the control group. The patients were asked to report on the 3rd and 7th day respectively and the wound healing was assessed using an early wound healing index given by Lorenzo Marini.

STATISTICAL ANALYSIS: Shapiro-Wilk test was used to test the normality of the test, which was found to deviate from normal distribution and hence Mann-Whitney U test was employed to evaluate the statistical significance of the two independent samples.

RESULTS: The mean ± SD was found to be 6.17 ± 2.04 for the control (group 1) and 5.67 ± 0.51 for CGF group (group 2) on the 3rd day. The mean and SD of control group and test group on the 7th day was 7 ± 1.55 and 9.33 ± 1.63, respectively. The difference between the groups on the 7th day was found to be statistically significant (P value < 0.05).

CONCLUSION: Concentrated growth factor application had positive effects on surgical wound healing after implant placement.

PMID:34369719 | DOI:10.1615/JLongTermEffMedImplants.2021036412

J Magn Reson Imaging. 2021 Aug 9. doi: 10.1002/jmri.27877. Online ahead of print.

ABSTRACT

BACKGROUND: Knee assessment with and without load using magnetic resonance imaging (MRI) can provide information on knee joint dynamics and improve the diagnosis of knee joint diseases. Performing such studies on a routine MRI-scanner require a load-exerting device during scanning. There is a need for more studies on developing loading devices and evaluating their clinical potential.

PURPOSE: Design and develop a portable and easy-to-use axial loading device to evaluate the knee joint dynamics during the MRI study.

STUDY TYPE: Prospective study.

SUBJECTS: Nine healthy subjects.

FIELD STRENGTH/SEQUENCE: A 0.25 T standing-open MRI and 3.0 T MRI. PD-T₂ -weighted FSE, 3D-fast-spoiled-gradient-echo, FS-PD, and CartiGram sequences.

ASSESSMENT: Design and development of loading device, calibration of loads, MR safety assessment (using projectile angular displacement, torque, and temperature tests). Scoring system for ease of doing. Qualitative (by radiologist) and quantitative (using structural similarity index measure [SSIM]) image-artifact assessment. Evaluation of repeatability, comparison with various standing stances load, and loading effect on knee MR parameters (tibiofemoral bone gap [TFBG], femoral cartilage thickness [FCT], tibial cartilage thickness [TCT], femoral cartilage T₂ -value [FCT2], and tibia cartilage T₂ -value [TCT2]). The relative percentage change (RPC) in parameters due to the device load was computed.

STATISTICAL TEST: Pearson’s correlation coefficient (r).

RESULTS: The developed device is conditional-MR safe (details in the manuscript and supplementary materials), 15 × 15 × 45 cm³ dimension, and <3 kg. The ease of using the device was 4.9/5. The device introduced no visible image artifacts, and SSIM of 0.9889 ± 0.0153 was observed. The TFBG intraobserver variability (absolute difference) was <0.1 mm. Interobserver variability of all regions of interest was <0.1 mm. The load exerted by the device was close to the load during standing on both legs in 0.25 T scanner with r > 0.9. Loading resulted in RPC of 1.5%-11.0%, 7.9%-8.5%, and -1.5% to 13.0% in the TFBG, FCT, and TCT, respectively. FCT2 and TCT2 were reduced in range of 1.5-2.7 msec and 0.5-2.3 msec due to load.

DATA CONCLUSION: The proposed device is conditionally MR safe, low cost (material cost < INR 6000), portable, and effective in loading the knee joint with up to 50% of body weight.

EVIDENCE LEVEL: 1 TECHNICAL EFFICACY: Stage 1.

PMID:34369633 | DOI:10.1002/jmri.27877

Zhen Ci Yan Jiu. 2021 Jul 25;46(7):586-91. doi: 10.13702/j.1000-0607.200616.

ABSTRACT

OBJECTIVE: To evaluate the therapeutic effect and safety of transcutaneous electrical acupoint stimulation (TEAS) on epidural-related maternal fever in parturients undergoing epidural labor analgesia.

METHODS: A total of 198 primiparas with single birth, full-term pregnancy and head position were recruited and randomized into a TEAS group (98 cases) and a control group (100 cases). In the TEAS group, after epidural labor analgesia, TEAS was applied to bilateral Hegu (LI4) and Quchi (LI11), once an hour, for 30 min each time, till the end of childbirth. In the control group, after epidural labor analgesia, TEAS electrodes were attached to the same acupoints, but without electric stimulation. Maternal tympanic temperature and the score of Visual Analogue Score (VAS) were measured before analgesia, at 1, 2, 3, 4 and 5 h after analgesia and during labor respectively and maternal fever rate was evaluated in the parturients of two groups. Separately, before analgesia, 2 h after analgesia and during labor, the levels of serum interleukin (IL-6) and IL-1β were determined in the parturients of two groups. The duration of labor, the mode of labor, oxytocin dosage, postpartum hemorrhage, neonatal Apgar scores, time of labor analgesia, labor analgesic consumption and adverse effects were recorded in the parturients of two groups.

RESULTS: Maternal tympanic temperature increased progressively in two groups as analgesic time prolonged. Tympanic temperature at 3, 4 and 5 h after analgesia and du-ring labor, and maternal fever rate during labor in the TEAS group were all lower than those in the control group respectively (P<0.05). The levels of serum IL-6 and IL-1β increased after analgesia in the parturients of two groups. The serum IL-6 level during labor and the level of IL-1β at 2 h after analgesia and during labor in the parturients of the TEAS group were lower than those in the control group (P<0.05). The analgesic consumption in the TEAS group was less than that in the control group (P<0.05). The incidence of chills in the TEAS group was lower than that in the control group (P<0.05). The differences were not statistical in VAS score, duration of labor, mode of labor, oxytocin dosage, postpartum hemorrhage, time of labor analgesia and neonatal Apgar score, as well as the incidence of urine retention, nausea and vomiting and urinary retention between two groups (P>0.05).

CONCLUSION: Transcutaneous electrical acupoint stimulation at LI11 and LI4 is conductive to relieving epidural-rela-ted maternal fever and reducing serum levels of IL-6 and IL-1β in the parturients undergoing epidural labor analgesia. It is safe and effective in clinical application.

PMID:34369679 | DOI:10.13702/j.1000-0607.200616

Med Phys. 2021 Aug 9. doi: 10.1002/mp.15149. Online ahead of print.

ABSTRACT

PURPOSE: PET attenuation correction (AC) in PET/MR scanners constitutes a critical and barely explored issue in spinal cord investigation, mainly due to the limitations in accounting for highly attenuating bone structures which surround the spinal canal. Our study aims at evaluating the clinical suitability of MR-driven AC (MRAC) for ¹⁸ F-FDG-PET in spinal cord.

METHODS: Thirty-six patients, undergoing PET/CT and PET/MR in the same session for oncological examination, were retrospectively analyzed. For each patient, raw PET data from PET/MR scanner were reconstructed with 4- and 5-class MRAC maps, generated by hybrid PET/MR system (PET_MRAC4 and PET_MRAC5, respectively), and an AC map derived from CT data after a custom co-registration pipeline (PET_rCTAC), which served as reference. Mean PET standardized uptake values (SUV_m ) were extracted from the three reconstructed PET images by regions of interest (ROIs) identified on T2-weighted MRI, in the spinal cord, lumbar cerebrospinal fluid (CSF), and vertebral marrow at 5 levels (C2, C5, T6, T12, and L3). SUV_m values from PET_MRAC4 and PET_MRAC5 were compared with each other and with the reference by means of paired t-test, and correlated using Pearson’s correlation (r) to assess their consistency. Cohen’s d was calculated to assess the magnitude of differences between PET images.

RESULTS: SUV_m values from PET_MRAC4 were lower than those from PET_MRAC5 in almost all analyzed ROIs, with a mean difference ranging from 0.03 to 0.26 (statistically significant in the vertebral marrow at C2 and C5, spinal cord at T6 and T2, and CSF at L3). This was also confirmed by the effect size, with highest values at low spinal levels (d = 0.45 at T12 in spinal cord, d = 0.95 at L3 in CSF). SUV_m values from PET_MRAC4 and PET_MRAC5 showed a very good correlation (0.81 < r < 0.97, p < 0.05) in all spinal ROIs. Underestimation of SUV_m between PET_MRAC4 and PET_rCTAC was observed at each level, with a mean difference ranging from 0.02 to 0.32 (statistically significant in the vertebral marrow at C2 and T6, and CSF at L3). Although also PET_MRAC5 underestimates PET_rCTAC (mean difference ranging from 0.02 to 0.3), an overall decrease in effect size could be observed for PET_MRAC5, mainly at lower spinal levels (T12, L3). SUV_m from both PET_MRAC4 and PET_MRAC5 methods showed r value from good to very good with respect to PET_rCTAC (0.67 < r < 0.9 and 0.73 < r < 0.94, p < 0.05, respectively).

CONCLUSIONS: Our results showed that neglecting bones in AC can underestimate the FDG uptake measurement of the spinal cord. The inclusion of bones in MRAC is far from negligible and improves the AC in spinal cord, mainly at low spinal levels. Therefore, care must be taken in the spinal canal region and the use of AC map reconstruction methods accounting for bone structures could be beneficial. This article is protected by copyright. All rights reserved.

PMID:34369590 | DOI:10.1002/mp.15149