Tag: pubmed

Hormones (Athens). 2024 Nov 22. doi: 10.1007/s42000-024-00617-z. Online ahead of print.

ABSTRACT

AIM: Neuropathy, a common complication of diabetes associated with metabolic issues, lacks clarity regarding its prevalence in metabolically healthy obese versus non-obese individuals. Our study aims to compare neuropathy rates between those with and those without obesity and who are metabolically healthy.

METHODS: We included individuals aged 20-50, one group with a body mass index (BMI) ≥ 30 kg/m² (metabolically healthy and obese) and another with a BMI < 30 kg/m² (metabolically healthy and non-obese). Exclusion criteria encompassed diabetes, hypertension, chronic renal disease, vitamin B12 deficiency, anemia, primary amyloidosis, immune system disorders, malignancy, active infection, and paraneoplastic syndromes. Patients underwent assessments using the Neuropathy Symptom Score (NSS) and modified Neuropathy Disability Score (mNDS).

RESULTS: The median scores for NSS and mNDS were higher among metabolically healthy obese individuals than non-obese participants (2 (1-4) vs. 0 (0-1) for NSS; p < 0.001 and 4 (2-5) vs. 2 (1-4) for mNDS; p < 0.001). Individuals with obesity had a 110.09 times higher likelihood of experiencing neuropathy compared to those without obesity. The severity of neuropathy was significantly greater in the metabolically healthy group with obesity. There were no statistically significant differences in anthropometric and laboratory values between participants with and without neuropathy, except for triglyceride levels. Patients with neuropathy exhibited higher triglyceride levels compared to those without neuropathy.

CONCLUSION: Our study demonstrated a higher prevalence of neuropathy among metabolically healthy obese individuals in comparison to those who were metabolically healthy and non-obese.

PMID:39576448 | DOI:10.1007/s42000-024-00617-z

Clin Rheumatol. 2024 Nov 22. doi: 10.1007/s10067-024-07241-7. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to assess the potential impact of primary Sjögren’s syndrome (pSS) on fertility and ovarian reserve by evaluating the number of antral ovarian follicles (AFC) through ultrasound and analysing serum levels of anti-müllerian hormone (AMH) and follicle-stimulating hormone (FSH), which are currently the most reliable indicators of fertility potential.

METHOD: A total of 52 premenopausal women were recruited from the Maternal, Infantile, and Urological Sciences Department at Umberto I Hospital, Sapienza University of Rome. Among them, 26 had pSS, and 26 served as healthy controls. All participants underwent a gynaecological examination, a transvaginal ultrasound, and serum testing for AMH and FSH levels.

RESULTS: The study found that serum AMH levels were significantly lower (p = 0.002) in pSS patients compared to the controls, indicating a potential reduction in ovarian reserve in these patients. However, no statistically significant differences were observed in FSH levels between the two groups.

CONCLUSIONS: The findings suggest that pSS may have a negative impact on ovarian reserve, as evidenced by lower AMH levels in comparison to age-matched controls. AFC and FSH levels, however, were similar to those of healthy women. These results provide new insights that could be beneficial for this patient population, though further, larger-scale studies are necessary to more comprehensively understand the relationship between pSS and female fertility. Key Points • The study assesses the possible impact of pSS on fertility and ovarian reserve by evaluation of AMH, FSH, and AFC. • Family planning and fertility are important issues for patients with rheumatic disorders and must be considered and discussed with the patient already at the time of diagnosis, and appropriate counselling must be performed.

PMID:39576415 | DOI:10.1007/s10067-024-07241-7

Insights Imaging. 2024 Nov 22;15(1):283. doi: 10.1186/s13244-024-01857-8.

ABSTRACT

OBJECTIVES: To explore the impact of hepatic steatosis measured by MRI-proton density fat fraction (MRI-PDFF) on liver stiffness measurement (LSM) value and its diagnostic performance for staging liver fibrosis in patients with chronic hepatitis B (CHB).

METHODS: A total of 914 patients with CHB who underwent liver biopsy and MRI-PDFF were retrospectively reviewed. The influence of MRI-PDFF on LSM value was assessed using univariate and multivariate linear analyses. To assess the influence of liver steatosis on the diagnostic performance of LSM, a series of ROC analyses were performed and compared by stratifying patients into non-steatosis (PDFF < 5%) and steatosis (PDFF ≥ 5%) groups according to MRI-PDFF values. The effects of different LSM cut-off values on the false-positive rate in the steatosis cohort were compared using McNemar’s test.

RESULTS: LSM values were significantly affected by MRI-PDFF in the entire cohort (B-coefficient: 0.003, p < 0.001), F1 cohort (B-coefficient: 0.005, p < 0.001), and F2 cohort (B-coefficient: 0.003, p = 0.002). Hepatic steatosis was not observed to have a significant influence on the ROC curve of LSM for staging liver fibrosis. Compared with using the cut-off values for the CHB cohort, using relatively higher cut-off values for hepatic steatosis significantly improved the false-positive rate of LSM in the steatosis cohort.

CONCLUSION: Steatosis significantly influenced LSM, with a higher value in the early stage of liver fibrosis but did not affect the diagnostic efficiency of LSM for staging liver fibrosis. Moreover, using relatively high cut-off values significantly improved the false-positive rate of LSM in CHB patients with steatosis.

CLINICAL RELEVANCE STATEMENT: The identified correlation between MRI-PDFF and VCTE-measured LSM is not clinically relevant since the diagnostic performance of LSM in staging liver fibrosis is not affected by steatosis. A higher cut-off should be applied in CHB patients with steatosis to improve the false-positive rate.

KEY POINTS: Steatosis can affect liver stiff measurement (LSM) values in the early stage of liver fibrosis. The diagnostic performance of LSM in staging liver fibrosis is not affected by steatosis. LSM’s cutoffs should be increased in patients with steatosis to improve the false-positive rate.

PMID:39576387 | DOI:10.1186/s13244-024-01857-8

Ann Clin Transl Neurol. 2024 Nov 22. doi: 10.1002/acn3.52238. Online ahead of print.

ABSTRACT

OBJECTIVE: Poststroke aphasia (PSA) has a high prevalence and requires a long recovery period, severely impairing life and work. Its existing behavioral interventions, principally speech and language therapy, are limited by numerous factors. The aims of this study are to evaluate the efficacy and safety of DL-3-N-butylphthalein (NBP) and explore its mechanism in the treatment of ischemic PSA.

METHODS: Patients hospitalized in the Second Hospital of Hebei Medical University in China were randomly administered NBP soft capsules or placebo orally for 6 months from July 1, 2021, to February 25, 2023. Language skills were assessed using the Western Aphasia Battery-Aphasia Quotient (WAB-AQ). We collected plasma samples and detected neurotransmitters by liquid chromatography-mass spectrometry.

RESULTS: In total, 118 out of 124 patients were included in the outcome analysis. Compared with the control group, AQ values in the NBP group significantly improved at 6 months (U = 1187.5, p = 0.003). After eliminating baseline interference, NBP treatment was independently associated with the 6-month AQ improvement [mean difference (MD) 0.106, 95% confidence interval (CI) 0.018, 0.195, p = 0.019]. We observed no statistically significant difference between the groups in abnormal liver function at 1 month [relative risk (RR) 1.07, 95% CI 0.89, 1.28] and 6 months [RR 0.99, 95% CI 0.86, 1.42]. Statistically significant differences were observed in tyrosine (p = 0.043) and 5-hydroxytryptophan (p = 0.041) between the two groups.

INTERPRETATION: NBP treatment might promote the recovery of WAB-AQ in patients with ischemic PSA by increasing levels of monoamine neurotransmitters.

PMID:39575649 | DOI:10.1002/acn3.52238

Biometrics. 2024 Oct 3;80(4):ujae129. doi: 10.1093/biomtc/ujae129.

ABSTRACT

We consider estimation of measures of model performance in a target population when covariate and outcome data are available from a source population and covariate data, but not outcome data, are available from the target population. In this setting, identification of measures of model performance is possible under an untestable assumption that the outcome and population (source or target) are independent conditional on covariates. In practice, this assumption is uncertain and, in some cases, controversial. Therefore, sensitivity analysis may be useful for examining the impact of assumption violations on inferences about model performance. Here, we propose an exponential tilt sensitivity analysis model and develop statistical methods to determine how measures of model performance are affected by violations of the assumption of conditional independence between outcome and population. We provide identification results and estimators for the risk in the target population under the sensitivity analysis model, examine the large-sample properties of the estimators, and apply them to data on lung cancer screening.

PMID:39575627 | DOI:10.1093/biomtc/ujae129

Nucl Med Commun. 2024 Nov 21. doi: 10.1097/MNM.0000000000001933. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to assess the usefulness of thyroglobulin (Tg) after radioiodine (RAI) therapy in predicting excellent response (ER) to therapy in postoperative differentiated thyroid cancer (DTC).

METHODS: A retrospective observational study was conducted on postoperative DTC patients who underwent RAI from August 2018 to December 2022. Various factors were analyzed to predict ER to treatment. This involved Tg under stimulation (sTg) before RAI, Tg immediately (imTg) 112 h post-RAI and imTg/sTg(rTg). Based on the efficacy of RAI, patients were categorized into two groups: ER and non-ER (NER). Univariate logistic analysis was utilized to compare parameters between the two groups, followed by binary logistic regression analysis on factors associated with ER. Receiver operating characteristic (ROC) curves were employed to evaluate the sensitivity, specificity, and optimal diagnostic cutoff points for parameters affecting ER.

RESULTS: The analysis included 45 ER patients and 56 NER patients. Statistical significance was found in the binary logistic regression analysis for the number of lymph nodes in the lateral cervical region (P = 0.016), sTg (P = 0.021), and rTg (P ≤ 0.001) concerning ER. ROC curve analysis revealed that the rTg area under the curve was 0.845, with an optimal cutoff value of 11.78, sensitivity of 82.6%, and specificity of 74.5%.

CONCLUSION: Post-RAI therapy, significant value is demonstrated by rTg with high sensitivity and specificity. This provides a foundation for the evaluation and decisions about DTC treatment in advance.

PMID:39575624 | DOI:10.1097/MNM.0000000000001933

Obstet Gynecol. 2024 Nov 21. doi: 10.1097/AOG.0000000000005727. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate whether transcutaneous electric nerve stimulation (TENS) decreases pain at the time of outpatient endometrial biopsy.

METHODS: We conducted a randomized, double-blind trial of active TENS compared with placebo TENS at the time of endometrial biopsy. The primary outcome was pain measured on a 0- to 100-mm visual analog scale immediately after biopsy, with secondary outcomes including satisfaction and tolerability of TENS and pain scores at other procedural time points. To detect a 15-mm reduction in pain with a 30-mm SD, 80.0% power, and a significance level of 0.05, 64 participants were required in each arm.

RESULTS: From December 2022 to December 2023, 135 participants were randomized with 67 in the placebo TENS arm and 68 in the active TENS arm. Baseline demographic and clinical characteristics were similar between groups. The median (interquartile range) pain score immediately after biopsy was 50 mm (20-80 mm) in the active TENS group and 60 mm (40-100 mm) in the placebo TENS group (P=.039). Pain scores at other time intervals were not statistically significantly different. In a subset analysis, participants with higher-than-median baseline anxiety had postprocedural pain scores (interquartile range) of 50 mm (40-80 mm) in the active TENS group compared with 80 mm (50-100 mm) in the placebo TENS group. Overall satisfaction (interquartile range) with pain control (with 100 mm representing completely satisfied) was 87.5 mm (60-100 mm) for active TENS and 70 mm (41-100 mm) for placebo TENS; 85.3% of active TENS participants would use TENS in a future endometrial biopsy. Minimal side effects were associated with TENS, with one participant reporting itching at the pad sites.

CONCLUSION: Despite a statistical difference in pain scores, a clinical difference was not seen between active and placebo TENS for pain during endometrial biopsy. Satisfaction was higher in the active TENS group, and there were overall minimal side effects associated with TENS.

CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, NCT05472740.

PMID:39575620 | DOI:10.1097/AOG.0000000000005727

J Glob Health. 2024 Nov 22;14:05040. doi: 10.7189/jogh.14.05040.

ABSTRACT

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic had substantially disrupted maternal health care provision and utilisation in Bangladesh. However, the extent of geographical disparities in service utilisation and how the health system withstood these challenges have not been studied. This study explores the divisional disparities in trends and disruptions in maternal health service utilisation caused by the COVID-19 pandemic.

METHODS: Data was extracted from the District Health Information Software of Bangladesh from January 2017 to December 2021. We assessed the trend of first antenatal care visit, institutional delivery and number of caesarean sections over these years. We explored both the yearly and monthly trends to see the variations in the number of utilisations. Segmented regression with Poisson distribution was used to assess changes in service utilisation during the COVID-19 period. We reported incidence rate ratio (IRR) of service utilisation with a 95% confidence interval (CI) in different divisions during COVID-19 (2020-2021) compared to the reference period (2017-2019).

RESULTS: Initially, a notable decline in maternal health care utilisation was observed in 2020 compared to the pre-pandemic period of 2017-2019. Divisional disparities were observed in this trend. Overall, compared to the pre-pandemic period, we observed around 30% decline in all three selected indicators of maternal health care. The lowest value was observed in Chattogram in 2020 (IRR = 0.66; 95% CI = 0.55-0.79) and Rajshahi in 2021 (IRR = 0.71; 95% CI = 0.60-0.82). For institutional delivery, Barishal division had the lowest IRR (0.64; 95% CI = 0.60-0.68) in 2020 and, in 2021 Rajshahi had the lowest IRR (0.71; 95% CI = 0.60-0.82). For caesarean section, the lowest value was observed in Barishal division (IRR = 0.48; 95% CI = 0.44-0.53) in 2020 and in Mymensingh (IRR = 0.37; 95% CI = 0.32-0.43) in 2021. By 2021, the three maternal health care utilisation indicators demonstrated recovery.

CONCLUSIONS: The effect of the pandemic, including lockdown, on the selected maternal service utilisation was observed in Bangladesh though there were substantial geographic disparities. These disruptions slightly recovered after the initial shock. These results will support the government in preparing the national and regional health systems for future epidemics in Bangladesh.

PMID:39575613 | DOI:10.7189/jogh.14.05040

Nutr Hosp. 2024 Nov 12. doi: 10.20960/nh.05421. Online ahead of print.

ABSTRACT

INTRODUCTION: patients with congenital heart disease are considered to be at high nutritional risk due to alterations in the metabolism of the underlying pathology and extracardiac factors. The STAMP (Screening Tool for the Assessment of Malnutrition in Paediatrics) is the only tool validated in our country in a pediatric population for nutritional screening.

OBJECTIVE: to evaluate nutritional risk by STAMP screening in pediatric patients according to type of congenital heart disease.

MATERIAL AND METHODS: an analytical cross-sectional study in 2023 in a pediatric reference hospital. Nutritional status was determined by Z scores based on WHO 2006/CDC 2000 child growth standards. The STAMP questionnaire was administered to establish nutritional risk. Inferential statistics with the Chi-squared and Mann-Whitney U-test were used. Spearman’s correlation coefficient was used. Analyses were carried out using the SPSS V25 statistical package.

RESULTS: 113 patients were included, male (n = 57, 50.4 %) and female (n = 56, 49.6 %). The most common age group was that of infants (n = 47, 45 %). Acute or chronic nutritional status impairment affected n = 50 (44.3 %) subjects. Cyanogenous congenital heart diseases had a greater impact on weight, height, average arm circumference and height/age, WBC/age indices. Two nutritional risk groups were established by STAMP: intermediate risk, n = 74 (65.5 %), and high risk, n = 39 (34.5 %). The greatest impact on anthropometric parameters was associated with elevated risk by STAMP, p = 0.000. The type of congenital heart disease was not associated with a greater increase in nutritional risk by STAMP (p = 0.76). There was no correlation of STAMP score with biochemical parameters.

CONCLUSION: patients with congenital heart disease will have an intermediate risk per STAMP. The type of congenital heart disease is not related to a greater increase in nutritional risk due to STAMP.

PMID:39575608 | DOI:10.20960/nh.05421

Psychol Med. 2024 Nov 22:1-11. doi: 10.1017/S0033291724001715. Online ahead of print.

ABSTRACT

BACKGROUND: Cannabis use and familial vulnerability to psychosis have been associated with social cognition deficits. This study examined the potential relationship between cannabis use and cognitive biases underlying social cognition and functioning in patients with first episode psychosis (FEP), their siblings, and controls.

METHODS: We analyzed a sample of 543 participants with FEP, 203 siblings, and 1168 controls from the EU-GEI study using a correlational design. We used logistic regression analyses to examine the influence of clinical group, lifetime cannabis use frequency, and potency of cannabis use on cognitive biases, accounting for demographic and cognitive variables.

RESULTS: FEP patients showed increased odds of facial recognition processing (FRP) deficits (OR = 1.642, CI 1.123-2.402) relative to controls but not of speech illusions (SI) or jumping to conclusions (JTC) bias, with no statistically significant differences relative to siblings. Daily and occasional lifetime cannabis use were associated with decreased odds of SI (OR = 0.605, CI 0.368-0.997 and OR = 0.646, CI 0.457-0.913 respectively) and JTC bias (OR = 0.625, CI 0.422-0.925 and OR = 0.602, CI 0.460-0.787 respectively) compared with lifetime abstinence, but not with FRP deficits, in the whole sample. Within the cannabis user group, low-potency cannabis use was associated with increased odds of SI (OR = 1.829, CI 1.297-2.578, FRP deficits (OR = 1.393, CI 1.031-1.882, and JTC (OR = 1.661, CI 1.271-2.171) relative to high-potency cannabis use, with comparable effects in the three clinical groups.

CONCLUSIONS: Our findings suggest increased odds of cognitive biases in FEP patients who have never used cannabis and in low-potency users. Future studies should elucidate this association and its potential implications.

PMID:39575607 | DOI:10.1017/S0033291724001715