Tag: pubmed

Pediatr Res. 2024 Nov 24. doi: 10.1038/s41390-024-03759-3. Online ahead of print.

ABSTRACT

BACKGROUND: Clinical effects of subclinical hypothyroidism are not clearly understood. This study aims to investigate the effects of subclinical hypothyroidism (SH) on cardiac autonomic and conduction systems in children.

METHODS: Forty-seven cases (25 female, 22 male) with SH aged between 3 and 17 years and 46 controls that were age, body mass index and sex matched, were included in the study. Heart rate variability (HRV) was used to evaluate cardiac autonomic function while QT dispersion, P dispersion and Tp-e measurements from ECGs to evaluate susceptibility to arrhythmia.

RESULTS: Standard deviation of the average of Normal-Normal intervals in 5-minute measurements was lower in the SH group compared to controls. No statistically significant differences were found in other time or frequency domain parameters. Maximum and minimum corrected QT intervals were longer in the SH group (p = 0.047 and p = 0.012, respectively); there were no significant differences in other ECG parameters.

CONCLUSION: Our study demonstrates that cardiac autonomic dysfunction and arrhyhtmogenesis shown as susceptibility to ventricular arrhythmia and longer intraatrial conduction times, appear in children with SH.

IMPACT: To our knowledge, this is the first study to show changes in cardiac autonomic function using heart rate variability in children with subclinical hypothyroidism (SH). We suppose that the fact that ventricular repolarization is longer in children with SH regardless of heart rate shows a predisposition to ventricular arrhythmia. Our study demonstrates that cardiac autonomic dysfunction and arrhythmogenesis shown as susceptibility to ventricular arrhythmia and longer intraatrial conduction times, appear in children with SH. We suggest that an evaluation regarding arrhythymia together with endocrinological follow-up is warranted when children are diagnosed with SH.

PMID:39582062 | DOI:10.1038/s41390-024-03759-3

Pediatr Res. 2024 Nov 24. doi: 10.1038/s41390-024-03623-4. Online ahead of print.

ABSTRACT

BACKGROUND: Very preterm birth (<32 weeks gestation, VP), immigrant background, and language barriers are all independently associated with a high risk for mental health problems in childhood, but research has neglected the long-term development of immigrant children born VP. We assessed whether behavioural and socio-emotional problems of 5-year-old children born VP growing up across different language contexts in the European Union are associated with an immigrant background and linguistic distance of families’ mother tongue (L1) to the host countries’ official languages.

METHODS: Data are from a population-based cohort including all VP births in 2011/12 in 11 European countries; a total of 3,067 children were followed up at 2 and 5 years of age. Behavioural and socio-emotional difficulties were assessed using the parent-reported Strengths and Difficulties Questionnaire (SDQ).

RESULTS: Mixed-effects models showed that a larger linguistic distance of children’s L1 to the host countries’ official language was associated with higher SDQ total scores (0.02 [0.01, 0.03]), after adjusting for a wide range of social risks, biological, and perinatal clinical factors.

CONCLUSION: Language barriers in the form of linguistic distance between VP children’s L1 and countries’ official languages play a critically important role for the behavioural and socio-emotional development of immigrant children born VP.

IMPACT: Immigrant children born very preterm across Europe face systemic inequalities such as language barriers. Language barriers can be operationalised as a continuous linguistic distance score between children’s mother tongues and countries’ official languages. Linguistic distance plays an important role for the behavioural and socio-emotional development of immigrant children born VP. Research, policy, and practice need to better account for language barriers to increase equity in health and education.

PMID:39582061 | DOI:10.1038/s41390-024-03623-4

BDJ Open. 2024 Nov 24;10(1):86. doi: 10.1038/s41405-024-00271-y.

ABSTRACT

CONTEXT: Mineral Trioxide Aggregate (MTA) is a calcium silicate-based cement that potentially exhibits improved washout resistance when carboxymethyl chitosan or gelatin is incorporated. Gel-form MTA is a novel mineral trioxide aggregate formulated using construction industry-based technology. The present study was conducted to comparatively evaluate the sealing ability and adaptation to dentinal walls of gel-form MTA.

MATERIALS AND METHODS: This in-vitro study consisted of two groups: gel-form MTA and the conventional powder-liquid MTA. 10 samples per group were used for each of the tested parameters. Adaptation of the MTA to the dentinal walls was tested under the light microscope and measured using Image J software. Sealing ability was evaluated using a single aerobic bacterial leakage model. Appropriate statistical analysis was done for the obtained data. Adaptation of the MTA was analyzed using independent t-test and Friedman test, whereas the bacterial leakage was analyzed using chi-square test.

RESULTS: On comparison of the adaptation property at coronal and apical thirds, there was no statistically significant difference between the groups (p = 0.071 and p = 0.638, respectively). However, while comparing the same in the middle one-third of the root, lesser gaps were identified in the gel-form MTA group (p = 0.013). One sample belonging to the conventional powder-liquid MTA group showed significant turbidity during bacteria leakage evaluation (p = 0.001) with the presence of E. faecalis in the count of 10³ colony forming units/milliliter.

CONCLUSION: The gel-form MTA shows a better adaptation to the dentinal walls at the middle third of the root and exhibits better sealing ability against bacterial leakage when tested for E. faecalis. The adaptation of gel-form MTA at coronal and apical third of the root was comparable to the conventional powder-liquid MTA.

PMID:39582050 | DOI:10.1038/s41405-024-00271-y

Sci Rep. 2024 Nov 24;14(1):29112. doi: 10.1038/s41598-024-80313-5.

ABSTRACT

In determining the culprit vessel responsible for inferior ST-segment elevation myocardial infarction (STEMI) as either the right coronary artery (RCA) or left circumflex (LCX), the electrocardiographic value has been validated. However, its ability to predict whether inferior STEMI is complicated by left anterior descending artery (LAD) chronic total occlusion remains uncertain. Based on the involvement of arteries other than the culprit vessels, 189 patients with inferior STEMI from our chest pain center were categorized into four groups: LAD occlusion group (n = 20), LAD stenosis > 50% group (n = 116), normal LAD group (n = 27), and other vessel stenosis > 50% group (n = 26). All groups underwent coronary angiography within 24 h of admission, and electrocardiogram (ECG) and clinical data were retrospectively analyzed. In the LAD occlusion group, hypertension was significantly more prevalent (P = 0.015). Although there was a trend toward higher previous cerebral infarction and lower diabetes prevalence in the Normal LAD group, neither was statistically significant (P = 0.070 and P = 0.088). The LAD occlusion group demonstrated the highest serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels and the most reduced LVEF, with a higher susceptibility to cardiogenic shock (P < 0.01). This group also had a higher use of intra-aortic balloon pump (IABP) and a greater occurrence of ventricular fibrillation or tachycardia compared to the other groups (P < 0.05). The QRS duration in lead V4 (QRS _V4) was 99.4 ± 19.1 ms in the LAD occlusion group, 87.5 ± 14.9 ms in the LAD stenosis group, 89.6 ± 11.4 ms in the normal LAD group, and 87.7 ± 11.7 ms in the other vessel stenosis group (P = 0.010). The difference between ST-segment depression in V4 and ST-segment elevation in lead III (ST _V4↓- ST _III↑) in the LAD occlusion group was the largest at -0.06 (-1.19, 1.05) mm (P = 0.029). ROC curve analysis revealed that the sensitivity of QRS _V4 > 97.7ms and ST _V4↓- ST _III↑> 0 mm diagnosing inferior STEMI complicated with LAD occlusion was 54.5% and 50%, with a specificity of 75.1% and 78.0%, respectively. Multivariate logistic regression analysis indicated that QRS _V4 (OR = 1.062, P = 0.003), ST _V4↓- ST _III↑ (OR = 1.641, P = 0.050), and Killip classification (OR = 2.115, P = 0.004) were all independent risk factors for LAD occlusion. In patients with inferior STEMI complicated by LAD occlusion without anterior myocardial infarction, cardiac function is poorer. The ST-segment deviation between the leads V4 and III, and the duration of QRS in the lead V4, can aid in diagnosis.

PMID:39582040 | DOI:10.1038/s41598-024-80313-5

Diabetol Metab Syndr. 2024 Nov 24;16(1):282. doi: 10.1186/s13098-024-01536-0.

ABSTRACT

BACKGROUND: This study investigated the correlation between the systemic immune-inflammation index (SII) and the systemic inflammation response index (SIRI) and all-cause, cardiovascular, and kidney disease mortality in patients with diabetic nephropathy (DN). It aimed to provide a new predictive assessment tool for the clinic and a scientific basis for managing inflammation in DN.

METHODS: The data utilized in this study were obtained from the National Health and Nutrition Examination Survey (NHANES) database, spanning 1999 to 2018. A total of 2641 patients diagnosed with DN were included in the analysis. The association between SII and SIRI levels and mortality in patients with DN was investigated using multivariate Cox proportional risk regression models. These relationships were further validated by Kaplan-Meier survival curves and restricted cubic spline (RCS) modeling, and subgroup analyses were performed to explore the heterogeneity among different characteristic subgroups.

RESULTS: The multivariate Cox regression analysis indicated that SII and SIRI levels were independently associated with all-cause mortality and cardiovascular mortality in patients with DN. SIRI levels were found to be an independently associated factor with kidney disease mortality in patients with DN. Patients in the highest quartile of SII and SIRI exhibited a 1.49-fold and 1.62-fold increased risk of all-cause mortality, respectively, compared to patients in the lowest quartile. The risk of cardiovascular mortality was 1.31 and 1.73 times higher than that in patients in the lowest quartile, respectively. The risk of kidney disease mortality in patients in the highest quartile of SIRI was 2.74 times higher than that in patients in the lowest quartile. Kaplan-Meier survival curve and RCS analyses further confirmed the positive association between SII and SIRI and mortality and a significant nonlinear relationship between SII and all-cause mortality. The SII and SIRI indices offer incremental value in model predictive power for mortality in patients with DN. Subgroup analyses demonstrated that the correlation between SII and SIRI and mortality risk was stable but heterogeneous across different subgroups.

CONCLUSION: SII and SIRI can be utilized as biomarkers for forecasting the likelihood of all-cause and cardiovascular mortality in patients with DN.

PMID:39582034 | DOI:10.1186/s13098-024-01536-0

Pneumonia (Nathan). 2024 Nov 25;16(1):31. doi: 10.1186/s41479-024-00143-x.

ABSTRACT

BACKGROUND: Most Canadians receive their care in community hospitals, yet most clinical research is conducted in academic hospitals. This study aims to compare patients with community acquired pneumonia (CAP) treated in academic and community hospitals with respect to their demographics, clinical characteristics, treatments and outcomes.

METHODS: This nested observational cohort substudy of the Community Acquired Pneumonia: Toward InnoVAtive Treatment (CAPTIVATE) trial included 1,329 hospitalized adults with CAP recruited between March 1st, 2018 and September 31st, 2023 from 15 Canadian hospitals. Unadjusted and adjusted analyses for age, sex and co-morbidities using logistic, Cox and censored quantile regressions were conducted.

RESULTS: Patients in community hospitals were older (mean [SD] 75.0 [15.7] years vs. 68.3 [16.2] years; p < 0.001), were more likely to be female (49.7% vs. 41.0%, p = 0.002), and had more comorbidities (75.9% vs. 64.8%, p < 0.001). More patients in community hospitals received corticosteroids (49.2% vs. 37.4%, p < 0.001). Community hospital patients had a higher likelihood of developing acute respiratory distress syndrome (OR 3.13, 95% CI: 1.87, 5.24, p = < 0.001), and acute cardiac injury (OR 2.53, 95% CI: 1.33, 4.83, p = 0.005). In unadjusted and adjusted analyses, 28-day mortality difference did not meet statistical significance (OR 1.43, 95% CI: 0.98, 20.7, p = 0.062 and OR 1.23, 95% CI: 0.81, 1.87, p = 0.332, respective).

CONCLUSION: Patients with CAP in Canadian community and academic hospitals differed with respect to their age, clinical characteristics, treatments and outcomes, emphasizing the importance of including more community hospitals in clinical research studies to ensure the generalizability of results.

PMID:39582027 | DOI:10.1186/s41479-024-00143-x

Eur J Med Res. 2024 Nov 24;29(1):559. doi: 10.1186/s40001-024-02164-0.

ABSTRACT

OBJECTIVES: In adult hypertensive patients, blood pressure variability is considered a risk factor for heart failure. The relationship between pulse pressure variability and the risk of heart failure remains unclear. This study aims to explore the impact of pulse pressure variability (PPV) on heart failure through a secondary analysis of the SPRINT randomized controlled trial.

METHODS: The data were derived from the SPRINT (Systolic Blood Pressure Intervention Trial) study. The trial recruited participants 50 years or older, with SBP ≥ 130 mm Hg and at least one additional CVD risk factor. We calculated pulse pressure based on the systolic and diastolic blood pressure obtained during follow-up, and used the coefficient of variation to represent pulse pressure variability (PPV) for statistical analysis. We considered the incidence of acute decompensated heart failure as the outcome measure. We employed multivariable Cox regression analysis to examine the relationship between PPV and the risk of heart failure occurrence. Additionally, we used a restricted cubic spline model to analyze the dose-response relationship between PPV and the risk of heart failure occurrence.

RESULTS: In this study, a total of 9429 participants were included. During a median follow-up time of 3.87 years, 188 new cases of heart failure were observed. The mean age of the study population was 67.9 ± 9.4 years and 3382 participants (35.5%) were females. The average PPCV was 13.85 ± 5.37%. The results from the multivariable Cox regression analysis indicated that the risk of heart failure increased by 3% for every 1% increase in PPCV (HR = 1.030 [95% CI 1.016-1.044]; P < 0.001).

CONCLUSIONS: The study found that PPV is an independent risk factor for the occurrence of heart failure. This underscores the importance of maintaining long-term stability in pulse pressure, in preventing the development of heart failure.

PMID:39582008 | DOI:10.1186/s40001-024-02164-0

Microb Cell Fact. 2024 Nov 25;23(1):318. doi: 10.1186/s12934-024-02587-8.

ABSTRACT

BACKGROUND: To discover effective drugs for treating Influenza (a disease with high annual mortality), large amounts of recombinant neuraminidase (NA) with suitable catalytic activity are needed. However, the functional activity of the full-length form of this enzyme in the bacterial host (as producing cells with a low cost) in a soluble form is limited. Thus, in the present study, a truncated form of the neuraminidase (derived from California H1N1 influenza strain) was designed, then biosynthesized in Escherichia coli BL21 (DE3), Shuffle T7, and SILEX systems. E. coli BL21 (DE3) was selected as a best host for statistical optimization. Using central composite design methodology, neuraminidase expression level was measured at 20 different runs considering most effective factors including; concentration of isopropyl-β-D-thiogalactopyranoside (IPTG), temperature, and induction time.

RESULT: The recombinant neuraminidase was purified using Ni-affinity chromatography in soluble form. The neuraminidase expression was confirmed by western blot technique with a molecular mass of 48 kDa. The optimum expression condition was at temperature (30°C), induction time (3 h), and concentration of IPTG (0.6 mM) resulting in maximum neuraminidase expression (7.6 µg/mL) with P < 0.05. The analysis of variance with the significant value of R² (0.97) indicated that the quadratic model utilized for this prediction was highly significant (p < 0.0001). Applying the optimized condition led to a ~ 2.2-fold increase in NA expression level (from 3.4 to 7.6 µg/ml). The kinetic parameters were also confirmed by fluorescent signals (by 2′-(4-Methylumbelliferyl)-α-D-N acetyl neuraminic acid substrate) with specific activity; ~3.5 IU/mg and Km: 86.49 ± 0.1 µ, close to the Vibrio Cholera neuraminidase with specific activity; 4 IU/mg. The neuraminidase inhibition test confirmed the inhibition of the neuraminidase activity by the drug inhibitor (Oseltamivir) compared to the control sample.

CONCLUSION: The high quality and proper functional activity of the truncated neuraminidase described in this research show that E. coli can be a suitable host for a wide range of applications with less cost and risk compared to eukaryotic expression systems.

PMID:39582000 | DOI:10.1186/s12934-024-02587-8

BMC Oral Health. 2024 Nov 24;24(1):1432. doi: 10.1186/s12903-024-05190-w.

ABSTRACT

OBJECTIVES: This study aimed to investigate the association between sleep disorders and the prevalence of taste dysfunction and the mediation effect of oral microbe in adults over 40 years.

MATERIALS AND METHODS: Cross-sectional data were utilized from the National Health and Nutrition Examination Survey (2011-2014). Regression models were employed, adjusting for demographic variables and covariates. Subgroup analyses were conducted based on age, sex, ethnicity, and education level. Multiplicative interactions were assessed through likelihood ratio tests. Additionally, the impact of sleep disturbance on the alpha diversity of the oral microbiome was examined using the rank-sum test (significance threshold: p < 0.05). Mediation analysis based on oral microbiota was conducted.

RESULTS: The analysis included 4869 participants. After adjusting for adjusting for demographic variables and covariates, individuals with sleep disorders exhibited a 36% increased risk of taste dysfunctions compared to those without sleep disorders (OR: 1.36, 95% CI: 1.00-1.84, p = 0.05). Interaction analyses indicated no significant differences between sleep disorders and taste dysfunctions concerning sex, educational level, and age across various models (Crude Model, Model 1, Model 2, and Model 3; p for interaction > 0.05). Furthermore, compared with the non-sleep disorder group, patients with sleep disorders demonstrated decreased numbers of OTUs, Shannon-Wiener indices, and Faith’s phylogenetic diversity indices in the oral microbiota (p < 0.05). However, the mediation analysis failed to reveal an indirect effect of oral microbiome on taste dysfunction (p > 0.05.) CONCLUSION: Sleep disorders independently correlate with a higher risk of taste dysfunctions, potentially associated with alterations in oral flora.

PMID:39581997 | DOI:10.1186/s12903-024-05190-w

Ren Fail. 2024 Dec;46(2):2427178. doi: 10.1080/0886022X.2024.2427178. Epub 2024 Nov 24.

ABSTRACT

BACKGROUND: The relationships of serum neurofilament light chain (NfL) levels with chronic kidney disease (CKD) and renal function indicators remain controversial, and comprehensive studies with large sample sizes are lacking.

METHODS: In total, 2,051 participants aged 20 to 75 years were identified from the National Health and Nutrition Examination Survey (2013-2014 cycle). Logistic regression models were used to assess the associations between serum NfL levels and CKD, whereas multivariate linear models were used to investigate the relationships between serum NfL levels and two kidney function indicators, namely, estimated glomerular filtration rate (eGFR) and urinary albumin-creatinine ratio (UACR). Adjustments were made to account for potential confounding variables in the analysis. Subgroup analyses stratified by age and sex were conducted. When sNfL is incorporated into the model as continuous variables, a log transformation is applied.

RESULTS: The present study included a cohort of 2,051 individuals ranging in age from 20 to 75 years. After covariate adjustment, multivariable logistic regression revealed a significant association between high serum NfL levels and an increased prevalence of CKD (OR 1.60; 95% CI 1.40-1.82; p < 0.0001), which remained significant when analyzed by quartiles (p for trend <0.0001). There was a statistically significant inverse correlation between the serum NfL level and the eGFR (β=-6.34; 95% CI -8.32 to -4.37; p < 0.0001), as well as a positive correlation between the serum NfL level and the UACR (β = 84.67; 95% CI 19.52-149.83; p < 0.0001). Furthermore, when stratified by age, there were significant interactions of serum NfL levels with CKD, the eGFR, and the UACR (p for interaction = 0.008, 0.016, and 0.020, respectively).

CONCLUSION: Serum NfL levels are positively associated with the prevalence of CKD and the UACR but negatively correlated with the eGFR, particularly in older patients.

PMID:39581996 | DOI:10.1080/0886022X.2024.2427178