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Nevin Manimala Statistics

Alopecia areata does not increase the risk of venous thromboembolism: an All of Us case-control study

Arch Dermatol Res. 2024 Aug 24;316(8):574. doi: 10.1007/s00403-024-03306-4.

ABSTRACT

Alopecia areata (AA) is an autoimmune disease driven by cytokine dysregulation resulting in hair loss, and recent data suggests inflammation may be occurring systemically. This systemic increase in inflammatory cytokines may increase the incidence of thrombotic events, including deep vein thrombosis, stroke, myocardial infarction, and pulmonary embolism. As the use of JAK inhibitors for AA becomes more common, it is important to further investigate this potential relationship to prevent exacerbation of such events. The purpose of this case-control study was to determine if there is an increased association between thrombotic events and alopecia areata using the All of Us database. We matched 926 patients with AA 4:1 to controls without any alopecia, and we found that there was a statistically significant increase in the incidence of venous thromboembolism (VTE) in patients with AA (p = 0.009). Multivariable conditional logistic regression was then used to estimate the odds of AA in relation to VTE, controlling for common hypercoagulable factors (atrial fibrillation, estrogen replacement, obesity, malignancy, pregnancy, and smoking history). We found that after controlling for these risk factors, there was no significant difference in the incidence in VTE between those with and without AA (OR: 1.549, CR 95% (0.862, 2.783)). While recent reports have suggested alopecia areata to be significantly associated with venous thromboembolisms, we did not observe a significant association after controlling for hypercoagulable factors.

PMID:39180570 | DOI:10.1007/s00403-024-03306-4

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The comparison of 2D and 3D systems in total laparoscopic hysterectomy: a systematic review and meta-analysis

Arch Gynecol Obstet. 2024 Aug 24. doi: 10.1007/s00404-024-07630-y. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the existing evidence regarding the comparison between 2 and 3D systems in Total Laparoscopic Hysterectomy (TLH) in terms of surgical outcomes.

METHODS: A systematic review of electronic databases, including PubMed/MEDLINE and Web of Science, was conducted to identify relevant studies comparing 2D and 3D systems in TLH. The search employed a combination of Medical Subject Headings (MeSH) terms and keywords related to the topic. Studies meeting predefined criteria were included, while case reports and studies not directly comparing 2D and 3D systems were excluded. Two independent reviewers evaluated study eligibility and performed quality assessment. The quantitative synthesis was conducted using meta-analysis techniques.

RESULTS: A statistically significant longer operation time in the 2D group compared to the 3D group (7 studies, mean difference [MD]: 13.67, 95% confidence interval [CI] 9.35-18.00, I2 = 16%). However, no statistically significant differences were found between the groups in terms of vaginal cuff closure time (2 studies, MD: 3.22, CI – 6.58-13.02, I2 = 96%), complication rate (7 studies, odds ratio [OD]: 1.74, CI 0.70-4.30, I2 = 0%), blood loss (3 studies, MD: 2.92, CI – 15.44-21.28, I2 = 0%), and Hb drop (3 studies, MD: 0.17, CI – 0.08-0.42, I2 = 1%).

CONCLUSION: Our results revealed a significant difference favoring 3D systems in operation time, while clinical outcomes between the two systems were found to be comparable in TLH. However, further research, particularly prospective studies with larger cohorts and longer-term follow-up, along with economic analyses, is needed to provide clinicians and healthcare decision-makers with essential guidance for practice and resource allocation.

PMID:39180564 | DOI:10.1007/s00404-024-07630-y

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Clinical efficacy of 595 nm pulsed dye laser in combination with supramolecular salicylic acid in the treatment of rosacea

Arch Dermatol Res. 2024 Aug 24;316(8):579. doi: 10.1007/s00403-024-03290-9.

ABSTRACT

OBJECTIVE: This research was aimed at ascertaining the clinical effects of 595 nm pulsed dye laser (PDL) in combination with supramolecular salicylic acid (SSA) in the treatment of rosacea.

METHODS: Eighty-four patients with rosacea were selected, of which 42 patients treated with PDL alone were considered as the control group, and 42 patients treated with 595 nm PDL in combination with 30% SSA were regarded as the observation group. The treatment continued for 4 months in the two groups. Clinical symptom scores, skin barrier function indicators, serum inflammatory factors, Acne⁃QOL scores and adverse reactions between the two groups were compared.

RESULTS: After treatment, levels of inflammatory factors, clinical symptom scores, transdermal water loss, and oil volume were decreased, and epidermal water content and Acne-QOL scores were increased in both groups (all P < 0.05), and the changes in the observation group were more pronounced versus the control group (all P < 0.05). The difference in the incidence of adverse reactions was not statistically significant between the two groups (P > 0.05).

CONCLUSION: 595 nm PDL in combination with SSA is safe in the treatment of rosacea.

PMID:39180560 | DOI:10.1007/s00403-024-03290-9

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Elongated morphology of osteoid osteoma is associated with radiofrequency ablation failure in children

Skeletal Radiol. 2024 Aug 24. doi: 10.1007/s00256-024-04776-3. Online ahead of print.

ABSTRACT

OBJECTIVE: To compare the frequency of elongated morphology of osteoid osteoma (OO) in children compared to adolescents and to determine if this elongated morphology is associated with radiofrequency ablation treatment failure.

MATERIALS AND METHODS: Retrospective review of first-time CT-guided radiofrequency ablation performed for presumed OO in patients < 21 years old between 1990 and 2023. Children were considered 0 to 10 years old, and adolescents were considered 11 to 20 years old. Treatment failure was considered symptomatic recurrence requiring follow-up intervention. The largest tumor dimensions in three orthogonal planes were measured using multiplanar reformatted technology. Maximum tumor dimension, tumor volume, and eccentricity index were calculated. Elongated morphology criteria were (a) largest dimension > 10 mm and (b) eccentricity index ≥ 3. Lesion locations were recorded. Statistical analyses included the chi-square test, Fisher’s exact test, nonparametric Wilcoxon rank-sum test, receiver operating characteristic analysis, and Spearman’s nonparametric rank correlation.

RESULTS: Of 366 included patients (median 15 years, IQR 11-18 years, 254 male), there were 86 (23.5%) children, 280 (76.5%) adolescents, and 24 (6.6%) cases of treatment failure. Elongated morphology was more common in children (19.7%) than adolescents (8.6%) (p = 0.004) and associated with younger age (p = 0.009). Elongated morphology was associated with treatment failure in children (p = 0.045) but not adolescents (p > .99) or all patients (p = 0.17). Treatment failure was not associated with age, largest dimension, eccentricity index, volume, or location.

CONCLUSION: Elongated morphology of OO is associated with younger age and radiofrequency ablation treatment failure in children. Identifying this morphology may assist with counseling and treatment planning.

PMID:39180558 | DOI:10.1007/s00256-024-04776-3

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A comparison of tinted sunscreen availability in urban versus suburban settings in the Detroit area

Arch Dermatol Res. 2024 Aug 24;316(8):570. doi: 10.1007/s00403-024-03318-0.

NO ABSTRACT

PMID:39180553 | DOI:10.1007/s00403-024-03318-0

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Strategies for improving dermatologist comfort and quality of patient care in inpatient settings: a cross-sectional survey study

Arch Dermatol Res. 2024 Aug 24;316(8):575. doi: 10.1007/s00403-024-03329-x.

NO ABSTRACT

PMID:39180539 | DOI:10.1007/s00403-024-03329-x

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Microbiological profiles in periprosthetic joint infections after total knee arthroplasty: a comparative analysis of diabetic and non-diabetic patients

Int Orthop. 2024 Aug 24. doi: 10.1007/s00264-024-06275-5. Online ahead of print.

ABSTRACT

AIM OF THE STUDY: The purpose of this study is to conduct a comparative analysis of the microbiological profiles in periprosthetic joint infections (PJIs) after total knee arthroplasty (TKA) between diabetic and non-diabetic patients. The study aims to address what are the variations in microbial colonization and infection patterns between diabetic and non-diabetic patients undergoing total knee arthroplasty.

METHODS: A retrospective analysis of 2,569 culture-positive cases of PJIs post-TKA was conducted, comparing outcomes between diabetic (n = 321) and non-diabetic (n = 2,248) patients. Demographic, clinical, and microbiological data were collected and analyzed using descriptive statistics, chi-squared tests, logistic regression, and other statistical tests.

RESULTS: Diabetic patients exhibited distinct microbial colonization patterns, with a higher prevalence of pathogens such as Staphylococcus aureus (p = 0.033), Pseudomonas aeruginosa (p < 0.001), Streptococcus spp. (Streptococcus agalactiae and Streptococcus dysgalactiae; p = 0.010, 0.016 respectively), Candida spp. (p = 0.010), and Corynebacterium spp. (p = 0.024). Additionally, diabetic patients were at increased risk of polymicrobial infections. Comorbidities associated with diabetes, including chronic pulmonary disease, renal insufficiency, and peripheral artery disease, were significantly more prevalent in diabetic patients and further complicated PJI outcomes.

CONCLUSION: This study underscores the importance of tailored perioperative antimicrobial strategies and vigilant infection control measures in diabetic patients undergoing TKA. Understanding the differential microbial profiles and associated comorbidities can inform targeted interventions to mitigate the risk of PJIs and improve outcomes in this high-risk population. Further research is warranted to elucidate the underlying mechanisms and optimize management strategies for diabetic patients undergoing TKA.

PMID:39180538 | DOI:10.1007/s00264-024-06275-5

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Association of serum and synovial adipokines (chemerin and resistin) with inflammatory markers and ultrasonographic evaluation scores in patients with knee joint osteoarthritis- a pilot study

Rheumatol Int. 2024 Aug 24. doi: 10.1007/s00296-024-05672-8. Online ahead of print.

ABSTRACT

Chemerin and resistin are adipokines studied as potential markers for early diagnosis and disease severity in patients with knee osteoarthritis (KOA) Therefore, we aimed to investigate the associations serum and synovial levels of chemerin and resistin with inflammatory parameters and ultrasonographic scores (US) in KOA individuals. Serum was collected from 28 patients with KOA and synovial fluid was obtained from 16 of them. Another 31 age and sex matched cases with no joint disease were included as healthy controls. Concentrations of chemerin, resistin, interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-alpha) were determined with ELISA. Erythrocyte sedimentation rate (ESR), C-reactive protein, serum uric acid (UA) were measured in the patients group. Participants with KOA underwent US assessment using the Outcome Measures in Rheumatology (OMERACT) scores. Patients with KOA had statistically significant higher level of serum resistin than healthy controls [11.05 (3.78-24.13) ng/mL and 7.23 (3.83-12.19) respectively, p < 0.001]. A strong correlation was found between serum chemerin and ESR (r = 0.434, p = 0.021), uric acid (r = 0.573, p = 0.001) as well as the US (r=-0.872, p < 0.001). Serum resistin demonstrated significant association with TNF-alpha (r = 0.398, p = 0.044). In conclusion, both chemerin and resistin might contribute to inflammatory changes associated with KOA. Further studies are needed to elucidate their potential role in the pathogenesis of the disease.

PMID:39180525 | DOI:10.1007/s00296-024-05672-8

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Evaluation of automated photograph-cephalogram image integration using artificial intelligence models

Angle Orthod. 2024 Aug 21. doi: 10.2319/010124-1.1. Online ahead of print.

ABSTRACT

OBJECTIVES: To develop and evaluate an automated method for combining a digital photograph with a lateral cephalogram.

MATERIALS AND METHODS: A total of 985 digital photographs were collected and soft tissue landmarks were manually detected. Then 2500 lateral cephalograms were collected, and corresponding soft tissue landmarks were manually detected. Using the images and landmark identification information, two different artificial intelligence (AI) models-one for detecting soft tissue on photographs and the other for identifying soft tissue on cephalograms-were developed using different deep-learning algorithms. The digital photographs were rotated, scaled, and shifted to minimize the squared sum of distances between the soft tissue landmarks identified by the two different AI models. As a validation process, eight soft tissue landmarks were selected on digital photographs and lateral cephalometric radiographs from 100 additionally collected validation subjects. Paired t-tests were used to compare the accuracy of measures obtained between the automated and manual image integration methods.

RESULTS: The validation results showed statistically significant differences between the automated and manual methods on the upper lip and soft tissue B point. Otherwise, no statistically significant difference was found.

CONCLUSIONS: Automated photograph-cephalogram image integration using AI models seemed to be as reliable as manual superimposition procedures.

PMID:39180503 | DOI:10.2319/010124-1.1

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Inflammation, Physical Activity, and Disease-Free Survival in Stage III Colon Cancer: CALGB/SWOG 80702 (Alliance)

J Natl Cancer Inst. 2024 Aug 24:djae203. doi: 10.1093/jnci/djae203. Online ahead of print.

ABSTRACT

BACKGROUND: Both inflammation and insufficient physical inactivity contribute to individual-level risk of disease recurrence and death in stage III colon cancer. The extent to which increased inflammatory risk can be offset by sufficient physical activity remains unknown.

METHODS: This cohort study was nested within the CALGB/SWOG 80702 (Alliance) randomized trial. Inflammatory burden was quantified by high-sensitivity C-reactive protein, interleukin-6, and soluble tumor necrosis factor-α receptor 2 after recovery from tumor resection. Physical activity was measured during and after postoperative chemotherapy. The primary endpoint was disease-free survival.

RESULTS: The 3-year disease-free survival rate was 88.4% among patients with low inflammation and sufficient physical activity (referent group for all comparisons), 84.9% with low inflammation and insufficient physical activity [absolute risk difference (RD): -3.5%, 95% Confidence Interval (CI): -11.3, 4.3; P = .38], 78.0% with intermediate inflammation and insufficient physical activity (RD: -10.4%, 95% CI: -17.4, -3.3; P = .007), and 79.7% with high inflammation and insufficient physical activity (RD: -8.7%, 95% CI: -15.7, -1.6; P = .022). In contrast, the 3-year disease-free survival rate was 87.3% among patients with intermediate inflammation and sufficient physical activity (RD: -1.1%, 95% CI: -7.5, 5.3; P = .74) and 84.4% with high inflammation and sufficient physical activity (RD: -4.0%, 95% CI: -12.3, 4.3; P = .34).

CONCLUSION: In this observational study of stage III colon cancer patients, physical activity was associated with improved disease-free survival despite high inflammation. Patients with intermediate or high inflammation who were physically active had disease-free survival rates that were not statistically significantly different from those with low inflammation.

PMID:39180477 | DOI:10.1093/jnci/djae203