Tag: pubmed

JAMA Netw Open. 2024 Oct 1;7(10):e2440301. doi: 10.1001/jamanetworkopen.2024.40301.

ABSTRACT

IMPORTANCE: Despite an increase in maternal prenatal cannabis use and associations with adverse neonatal outcomes, research on child neurodevelopmental outcomes is limited.

OBJECTIVE: To evaluate the association between maternal cannabis use in early pregnancy and child autism spectrum disorder (ASD).

DESIGN, SETTING, AND PARTICIPANTS: This population-based retrospective birth cohort study included children born between 2011 and 2019 to pregnant Kaiser Permanente Northern California members screened for prenatal cannabis use during pregnancy. Statistical analysis was conducted February 2023 to March 2024.

EXPOSURES: Maternal prenatal cannabis use was assessed at entrance to prenatal care (approximately 8- to 10-weeks’ gestation) via self-report and/or positive urine toxicology test. Use frequency was assessed.

MAIN OUTCOMES AND MEASURES: Child ASD was defined by International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) diagnosis codes ascertained from the electronic health record. Associations between maternal prenatal cannabis use and child ASD were modeled using Cox proportional hazards regression adjusted for maternal sociodemographic, other substance use and disorders, prenatal care initiation, comorbidities, and clustering among maternal siblings.

RESULTS: The study cohort included 178 948 singleton pregnancies among 146 296 unique pregnant individuals, including 48 880 (27.3%) Asian or Pacific Islander, 42 799 (23.9%) Hispanic, 9742 (5.4%) non-Hispanic Black, and 70 733 (39.5%) non-Hispanic White pregnancies. The median (IQR) maternal age at pregnancy onset was 31 (6) years; 8486 (4.7%) screened positive for cannabis use, 7054 (3.9%) via urine toxicology testing and 3662 (2.0%) by self-report. In the total study population, the frequency of self-reported use was monthly or less for 2003 pregnancies (1.1%), weekly for 918 pregnancies (0.5%), daily for 741 pregnancies (0.4%), and unknown for 4824 pregnancies (2.7%). ASD was diagnosed in 3.6% of children. After adjustment for maternal characteristics, maternal prenatal cannabis use was not associated with child ASD (hazard ratio [HR], 1.05; 95% CI, 0.84-1.32). When self-reported frequency of use was assessed, no statistically significant associations were observed after confounder adjustment. No sex-specific associations were documented (males: HR, 1.01; 95% CI, 0.77-1.32; and females: HR, 1.19; 95% CI, 0.77-1.85).

CONCLUSIONS AND RELEVANCE: In this cohort study, maternal cannabis use assessed in early pregnancy was not associated with child ASD. Additional studies are needed to evaluate different patterns of use throughout pregnancy. Given the known adverse neonatal health effects of maternal prenatal cannabis use, clinicians should follow national guidelines and advise against use.

PMID:39422906 | DOI:10.1001/jamanetworkopen.2024.40301

Transl Vis Sci Technol. 2024 Oct 1;13(10):28. doi: 10.1167/tvst.13.10.28.

ABSTRACT

PURPOSE: In the past few decades, the prevalence of myopia, where the eye grows too long, has increased dramatically. The visual environment appears to be critical to regulating the eye growth. Thus, it is very important to determine the properties of the environment that put children at risk for myopia. Researchers have suggested that the intensity of illumination and range of distances to which a child’s eyes are exposed are important, but this has not been confirmed.

METHODS: We designed, built, and tested an inexpensive, child-friendly, head-mounted device that can measure the intensity and spectral content of illumination approaching the eyes and can also measure the distances to which the central visual field of the eyes are exposed. The device is mounted on a child’s bicycle helmet. It includes a camera that measures distances over a substantial range and a six-channel spectral sensor. The sensors are hosted by a light-weight, battery-powered microcomputer. We acquired pilot data from children while they were engaged in various indoor and outdoor activities.

RESULTS: The device proved to be comfortable, easy, and safe to wear, and able to collect very useful data on the statistics of illumination and distances.

CONCLUSIONS: The designed device is an ideal tool to be used in a population of young children, some of whom will later develop myopia and some of whom will not.

TRANSLATIONAL RELEVANCE: Such data would be critical for determining the properties of the visual environment that put children at risk for becoming myopic.

PMID:39422897 | DOI:10.1167/tvst.13.10.28

Ophthalmol Ther. 2024 Oct 18. doi: 10.1007/s40123-024-01051-5. Online ahead of print.

ABSTRACT

INTRODUCTION: Our aim in this work was to investigate the macular choroidal thickness (ChT) changes in 6-12-year-old Danish children with myopia during 2 years of low-dose atropine treatment and 1-year wash-out vs. placebo in an investigator-initiated, placebo-controlled, double-blind randomized clinical trial.

METHODS: Ninety-seven participants were randomized to either 0.01% for 2 years, 0.1% loading dose for 6 months followed by 0.01% for 18 months, or placebo, then a 1-year wash-out. The primary outcome was ChT in the sub-foveal and inner and outer superior, nasal, inferior, and temporal sectors. The secondary outcome was axial length (AL). Outcomes were measured at baseline and 6, 12, 24, and 36 months. One-way analysis of variance was used to detect baseline ChT differences between AL-stratified groups (< 24 mm, 24-25 mm, or > 25 mm). To determine the longitudinal changes in ChT and its effect on AL, all eyes were included in linear mixed modeling with individual eyes nested in the study ID as a random effect.

RESULTS: Longer eyes had significantly thinner ChT in all choroidal sectors (adj-P < 0.01) at baseline. There was no statistically significant change in any ChT sector after 3 years in the placebo group. Sub-foveal and nasal ChT in the 0.1% loading dose and 0.01% group were not significantly different from placebo after 2-year treatment. In the placebo group, a 1-mm increase in AL was significantly associated with a 47-µm thinner nasal ChT after 3 years (95% confidence interval (CI): – 55; – 38, adj-P < 0.001). A 10-µm thicker nasal choroid at baseline was associated with 0.13 mm (95% CI: 0.009; 0.017, adj-P < 0.001) less 3-year axial elongation.

CONCLUSIONS: The ChT in Danish children with myopia remained stable over the 3-year follow-up. A thinner choroid at myopia onset might predispose to increased axial elongation. Treatment with 0.01% atropine did not change the ChT. We speculate that low-dose atropine does not primarily reduce myopia progression via a choroidal mechanism.

TRIAL REGISTRATION: ClinicalTrials.gov identifier, NCT03911271.

PMID:39422837 | DOI:10.1007/s40123-024-01051-5

Int Urol Nephrol. 2024 Oct 18. doi: 10.1007/s11255-024-04240-0. Online ahead of print.

ABSTRACT

OBJECTIVE: To explore the clinical characteristics of the current diagnostic and therapeutic approaches for renal tuberculosis.

METHODS: Clinical diagnosis and treatment data from 765 patients definitively diagnosed with renal tuberculosis between January 2013 and December 2022 were retrospectively analyzed to identify optimal diagnostic and treatment modalities guiding clinical practice.

RESULTS: The number of patients with clinically atypical renal tuberculosis has fluctuated in the last decade, but the changes are not statistically different. T-SPOT, CT, and endoscopy are still commonly used tests with high diagnostic value in clinical practice. The efficacy of anti-tuberculosis drugs was suboptimal, resulting in a cure rate of only 15.43% and a progression rate of only 68.55%. Ureteral stent placement, although effective in relieving hydronephrosis, does not reverse renal impairment and has a 21.43% cure rate and a 57.14% progression rate. Surgical resection was necessary for the majority of patients, with a nephrectomy rate of 76.34% and a cure rate of 81.12%.

CONCLUSION: The prognosis for renal tuberculosis is generally poor, particularly in cases of bilateral involvement. Accurate diagnosis and surgical resection of the tuberculous kidney are essential for preventing complications associated with advanced renal tuberculosis.

PMID:39422827 | DOI:10.1007/s11255-024-04240-0

J Cancer Surviv. 2024 Oct 18. doi: 10.1007/s11764-024-01694-0. Online ahead of print.

ABSTRACT

PURPOSE: Studies looking into the concordance between late effects reported by physicians vs. those reported by Hodgkin lymphoma (HL) survivors are missing.

METHODS: A Life Situation Questionnaire focusing on late effects collected data from 1230 HL survivors (median follow-up 14.3 years). Twenty-six disease- and treatment-related late effects from various organ systems were matched with physician-recorded data. The concordance between physicians and survivors was systematically evaluated using percentage agreement and kappa statistics. Potential non-responder biases and associations with patient and disease characteristics were also investigated.

RESULTS: Agreement levels (indicated by kappa statistics) varied from none to moderate agreement, with the highest Kappa values observed for myocardial infarction (kappa = 0.55, 95% CI 0.43-0.66) and pulmonary embolism (kappa = 0.55, 95% CI 0.35-0.75). HL survivors consistently reported a higher prevalence of late effects compared with physicians. Notably, the prevalence of subjective symptoms such as persistent fatigue and xerostomia was repeatedly underreported by physicians. A trend towards higher concordance was observed in survivors with higher clinical stage, higher education level, and treatment initiated at younger ages. Additionally, findings indicated that survivors who did not respond to the questionnaire experienced fewer late effects compared to those who did respond.

CONCLUSIONS: Substantial discrepancies were noted in the reported prevalence of late effects between survivors and physicians, especially for outcomes which are not easily quantified.

IMPLICATIONS FOR CANCER SURVIVORS: It is therefore essential to integrate outcomes reported by both physicians and survivors to achieve a comprehensive assessment of the long-term consequences of HL treatment.

PMID:39422824 | DOI:10.1007/s11764-024-01694-0

Environ Monit Assess. 2024 Oct 18;196(11):1072. doi: 10.1007/s10661-024-13216-7.

ABSTRACT

Monitoring soil quality index (SQI) and soil organic carbon (SOC) stock status of the Western Ghats (WG) forests in India is crucial for providing vital ecosystem services alongside sustainable forest management practices. However, comprehensive profile data on SQI and SOC stock across different forest types under WG forests are limited. The study evaluated SQI and SOC stock under three forest types, i.e. tropical wet evergreen (TWE), tropical semi-evergreen (TSE), and tropical moist deciduous (TMD) across WG in Karnataka. SQI was assessed using principal component analysis with two indexing approaches and scoring methodologies, with weightage indexing through nonlinear scoring functions (NLSF) showing superiority over other methodologies. TMD forests exhibited the highest SQI, followed by TWE and TSE, while the lowest was observed in Rippon Pet RF (0.36 surface, 0.28 control section), primarily due to limitations in organic carbon and clay content. SOC stock mirrored SQI trends (TMD > TWE > TSE), with the highest values in Kollegal RF (339.3 MG ha^-1) and lowest in Rippon Pet RF (102.5 MG ha^-1). Although SOC and SQI were established to be ideal indicators for dynamic ecosystem services (ESs), high OC content in surface soils of Poomale NF induces pedogenic acidification and Al toxicities, indicating potential forest soil degradation. Significant correlation with control section SQI and SOC (p < 0.05) emphasises monitoring subsurface soil status to identify soil degradation, sustainable forestry practices, and complex ESs in forest systems.

PMID:39422796 | DOI:10.1007/s10661-024-13216-7

Acta Neurochir (Wien). 2024 Oct 18;166(1):415. doi: 10.1007/s00701-024-06313-6.

ABSTRACT

BACKGROUND: Glossopharyngeal neuralgia (GN) is a rare pain syndrome often underdiagnosed. This study aimed to assess the challenges in diagnosing GN and identify patients at risk of misdiagnosis.

METHODS: Between 2010 and 2019, nine patients underwent microvascular decompression (MVD) of the glossopharyngeal nerve at two tertiary care hospitals. A retrospective analysis examined symptom characteristics, time to correct diagnosis, operative technique, and clinical outcomes. Barrow Neurological Institute (BNI) pain scores were assessed before surgery and on follow-up.

RESULTS: Six women and three men, aged 55 ± 14.3 years, with unilateral GN were included. Pain was predominantly in the ear (otalgic type) in four patients (44.4%), the pharynx or base of the tongue (pharyngeal type) in four (44.4%), and mixed in one (11.1%). Five patients reported pain radiating to the mandible, all initially misdiagnosed with trigeminal neuralgia (TN) and treated for 2.4(± 3.1) years before presenting to our institution. One case resulted in MVD of the trigeminal nerve and subsequent thermocoagulation of the Gasserian ganglion due to persistent pain. The correct diagnosis of GN was established later in patients with otalgic or mixed pain (3.8 ± 3.4 years) compared to those with pharyngeal pain (0.5 ± 1.0 years), showing a trend (U = 17.0, p = 0.07). There was a significant association between pain radiation to the mandible and misdiagnosis (x² = 9.00, p = 0.003). Endoscopically assisted MVD via the median suboccipital subtonsillary approach was performed, resolving neurovascular conflicts with the PICA (9/9) and vertebral artery (3/9). Follow-up after 15.7(± 18.2) months showed significant pain reduction according to the BNI (preoperative BNI = 5.0 ± 0.0, postoperative BNI = 1.7 ± 1.0,t (8) = 10,CI [1.6-5.1], p < 0.001). No permanent surgery-related deficits occurred.

CONCLUSION: Patients with GN, especially those with predominant otalgic pain and pain radiating to the mandible, are at higher risk of misdiagnosis due to similarities with TN. Despite the rarity of GN, increased awareness of its various pain manifestations may lead to earlier correct diagnoses, which is crucial for surgical treatment.

PMID:39422793 | DOI:10.1007/s00701-024-06313-6

J Robot Surg. 2024 Oct 18;18(1):373. doi: 10.1007/s11701-024-02129-9.

ABSTRACT

Benign prostatic hyperplasia (BPH) affects up to 80% of men by age 80, with large-gland BPH often treated by simple prostatectomy (SP). This technique significantly improves symptoms but is associated with high rates of complications such as transfusions and infections. Minimally invasive techniques, including robotic-assisted laparoscopic simple suprapubic prostatectomy (RALSP), have emerged as alternatives. This study reports on 162 patients who underwent RALSP from May 2018 to June 2023. The mean age of the patients was 69 years, mean prostate volume 144.8 cm³, mean robot time 78.7 min, and mean blood loss 183.1 mL. Results demonstrated significant improvements in the results: prostate volume (mean decrease from 144.8 to 26.6 cm³), mean PSA level decreased from 7.8 to 0.8 (p < 0.0001), mean IPSS decreased from 23.0 to 4.4 (p < 0.0001), and mean uroflowmetry increased from 6.3 to 22.6 ml/s (p < 0.0001). No patient experienced worsening erectile function after surgery. All patients showed absence of stress urinary incontinence within 3 months. Catheterization time decreased from 4.2 to 2.6 days over the study period. The postoperative complication rate was 2.29%, with no need for surgical reintervention for complications. While RALSP showed promising results, further prospective studies are needed to compare it with other techniques. This study highlights RALSP as a viable minimally invasive option for treating large-volume BPH, offering reduced recovery times and fewer complications.

PMID:39422782 | DOI:10.1007/s11701-024-02129-9

Parasitol Res. 2024 Oct 18;123(10):355. doi: 10.1007/s00436-024-08370-3.

ABSTRACT

Recent work has demonstrated that exposure to artificial light at night (ALAN) may alter mosquito feeding behavior and so must be considered a moderator of vector-borne disease transfer. Anopheles funestus mosquitoes are a primary malaria vector in sub-Saharan Africa, but no study to date has tested the impact of ALAN on their feeding behavior. Here we test if the exposure to commonly used household lights (compact fluorescent lights, light-emitting diodes, and incandescent lights) alters Anopheles funestus feeding. Mated, unfed female mosquitoes were exposed to a light treatment, at the onset of darkness, followed by a blood-feeding assay. The light treatments consisted of a 30-min light pulse of one of the three household lights, each in individual experimental containers, versus controls. All three household lights resulted in a reduction in the percentage of females taking a blood meal, but only mosquitoes exposed to incandescent light showed a statistically significant reduction in feeding of 19.6% relative to controls which showed a 42.8% feeding rate. Our results suggest that exposure to some household lights during the night may have an immediate inhibitory effect on Anopheles funestus feeding. By helping identify which light types lead to a suppression of feeding, the findings of this study could provide insight necessary to design household lights that can help minimize mosquito feeding on humans.

PMID:39422781 | DOI:10.1007/s00436-024-08370-3

Wien Klin Wochenschr. 2024 Oct 18. doi: 10.1007/s00508-024-02456-9. Online ahead of print.

NO ABSTRACT

PMID:39422753 | DOI:10.1007/s00508-024-02456-9