Tag: pubmed

J Periodontal Res. 2023 Dec 21. doi: 10.1111/jre.13223. Online ahead of print.

ABSTRACT

OBJECTIVE: The purpose of the present research is to evaluate the salivary levels of leucine-rich alpha-2 glycoprotein (LRG) and C-reactive protein (CRP) in periodontal health and disease (gingivitis and stage III periodontitis) and also to compare the discriminative efficiencies of both biomarkers in periodontal disease.

BACKGROUND: LRG is a new acute-phase protein whose functions are still being investigated. LRG and CRP are both biomarkers that are increased by inflammation. No clinical study has yet investigated the comparison of the level of LRG and CRP in periodontal health, gingivitis and periodontitis in saliva samples.

METHODS: A total of 60 individuals, including 20 periodontally healthy (control group/group C), 20 with gingivitis (group G), and 20 with Stage III periodontitis (group P), who were systemically healthy and non-smokers, participated in this study. Periodontal charts were used for recording clinical periodontal parameters and saliva LRG and CRP levels were measured by ELISA. Analyzing the area under the curve (AUC) was performed by the receiver-operating characteristics curve.

RESULTS: Salivary levels of LRG and CRP were significantly higher in disease groups than in group C (p < .05). Positive statistically significant correlations were observed between both biomarkers and clinical parameters (p < .05). There was also a strong positive correlation between two biomarkers (p < .05). In distinguishing periodontal disease from periodontal health, LRG (AUC = 0.833) and CRP (AUC = 0.826) were found to have similar accuracy (p = .923).

CONCLUSION: LRG and CRP may be useful and similarly effective biomarkers in the diagnosis of periodontal diseases based on the findings of this study.

PMID:38126217 | DOI:10.1111/jre.13223

Clin Nephrol. 2023 Dec 21. doi: 10.5414/CN110970. Online ahead of print.

ABSTRACT

BACKGROUND: Systemic inflammatory indicators are important in the prognoses of various diseases. Such indicators, including the neutrophil-to-lymphocyte ratio (NLR), can be meaningful in predicting the clinical outcome in patients diagnosed with idiopathic membranous nephropathy (IMN).

MATERIALS AND METHODS: 112 IMN patients diagnosed by renal biopsy were recruited retrospectively. The endpoint was defined as a combination of partial and complete remission. Statistical analysis determined the independent factors associated with clinical remission and the predictive utility of NLR.

RESULTS: Within the 12-month follow-up period, 72 patients achieved clinical remission after treatment. Univariate analysis identified significant differences in serum albumin, estimated glomerular filtration rate (eGFR), proteinuria, neutrophil count, and NLR between the remission group and the non-remission group (all p < 0.05). Cox proportional hazards indicated that elevated eGFR (HR 1.022, 95% CI (1.009 – 1.035), p = 0.001), lower NLR (HR 0.345, 95% CI (0.237 – 0.501), p = 0.0001), and decreased proteinuria (HR 0.826, 95% CI (0.693 – 0.984), p = 0.032) were protective elements for remission. With an optimal cut-off value of 2.61, the pre-treatment NLR had an excellent ability to identify the remission (area under the curve (AUC), 0.785). Participants were separated into low- and high-NLR groups by using 2.61. Kaplan-Meier survival curves revealed significantly higher remission rates in the lower group (p < 0.0001).

CONCLUSION: The NLR is an effective indicator for predicting clinical remission in patients with IMN.

PMID:38126194 | DOI:10.5414/CN110970

Harefuah. 2023 Dec;162(10):656-659.

ABSTRACT

INTRODUCTION: Obstructed Defecation Syndrome (ODS) is a complex surgical condition which involves structural and functional problems which significantly affects quality of life. There is limited information about the Da-Vinci Robotic System use in the treatment of this condition. This study examines the outcomes of robotic-assisted rectopexy. The primary outcome is recovery from surgery, with secondary outcomes including post-surgical complications, length of hospital stay, rehospitalization rate and recurrence after surgery.

METHODS: A retrospective analysis was conducted of prospectively collected data for patients who underwent robotic assisted surgery for ODS between 2011-2022. A colorectal surgeon performed all surgeries at the Sheba Medical Center using the Da Vinci™ robotic system. This analysis uses descriptive statistics and presents the results as medians and ranges.

RESULTS: Out of 33 patients included, 26 (84.9%) were female. Median age was 67 years (Range:19-85 years). Median American Society of Anesthesiology (ASA) score was 2 (1-3). Median Charlson’s comorbidity score was 3 (0-4). Median patients’ Body Mass Index (BMI) was 23.2 (15.6-33.4) kg/m2. Eight patients (24.4%) underwent previous procedure for ODS. Most (23) patients included (69.7%) underwent robotic assisted ventral rectopexy. Other interventions included combined anterior and posterior rectopexy (9.1%), combined ventral rectopexy and sacrocolpopexy (12.1%) and posterior rectopexy (9.1%). No cases of conversion to laparoscopic /open techniques were recorded. Median operation time was 135 minutes (70-270). One intra-operative complication recorded was an injury to the rectum during anterior dissection (3%). No significant blood loss was recorded. A total of 27 patients (81.8%) were operated using the Da Vinci Si system, and the rest (6) using the 6 Da Vinci Xi system. Two patients had post-operative complications. Median length of stay (LOS) was 4 days (2-6 days). Readmission rate within 30 days was 9.1%. Two patients (6.1%) had recurrence of rectal prolapse. Median follow-up was 60 (4-116) months.

CONCLUSIONS: Robotic-assisted surgery for obstructed defecation syndrome is safe, with fast recovery of the patient and it is efficient during long-term follow-up.

PMID:38126149

Harefuah. 2023 Dec;162(10):644-649.

ABSTRACT

INTRODUCTION: The subarachnoid space (SAS) is a potential space surrounding the brain where the cerebrospinal fluid (CSF) flows. Previous work demonstrated how the SAS width changes during pregnancy and measured the normal values per gestational week.

OBJECTIVES: Studying the ratio between the fetal brain volume (STV) and the SAS width (SS ratio), as measured via fetal magnetic resonance imaging (MRI) in different fetal pathologies – macrocephaly and microcephaly, and studying the correlation between this ratio and the gestational week.

METHODS: A retrospective study was conducted on 77 fetuses that underwent fetal MRI scans during gestational weeks 29-37, in three groups: 23 normocephaly, 27 macrocephaly, and 27 microcephaly. SAS width was measured in 10 points via fetal MRI scans, and a ratio was calculated between the width and STV.

RESULTS: The SS ratio is largest in microcephaly group and smallest in normocephaly group, with the macrocephaly group between them. All comparisons were statistically significant except between the macrocephaly and normocephaly groups. There was a strong positive correlation between SS ratio and week of gestation.

CONCLUSIONS: The SS ratio is statistically different between normocephalic fetuses and fetuses with macrocephaly or microcephaly. From week 29 this ratio enlarges with gestational age.

DISCUSSION: The SAS affects the fetal head circumference, an important parameter of fetal growth, thus we decided to study the SS ratio in pathologies of the head circumference. Previous work demonstrated how the STV and the SAS width expand starting at a specific gestational age, thus the gestational week also affects the SS ratio. Summary: The SS ratio is affected by pathologies of the fetal head circumference and by gestational age.

PMID:38126147

Acta Ophthalmol. 2023 Dec 21. doi: 10.1111/aos.16619. Online ahead of print.

ABSTRACT

PURPOSE: To compare detection rates of microaneurysms (MAs) on high-speed megahertz optical coherence tomography angiography (MHz-OCTA), fluorescein angiography (FA) and colour fundus photography (CF) in patients with diabetic retinopathy (DR).

METHODS: For this exploratory cross-sectional study, MHz-OCTA data were acquired with a swept-source OCT prototype (A-scan rate: 1.7 MHz), and FA and CF imaging was performed using Optos® California. MA count was manually evaluated on en face MHz-OCTA/FA/CF images within an extended ETDRS grid. Detectability of MAs visible on FA images was evaluated on corresponding MHz-OCTA and CF images. MA distribution and leakage were correlated with detectability on OCTA and CF imaging.

RESULTS: 47 eyes with severe DR (n = 12) and proliferative DR (n = 35) were included. MHz-OCTA and CF imaging detected on average 56% and 36% of MAs, respectively. MHz-OCTA detection rate was significantly higher than CF (p < 0.01). The combination of MHz-OCTA and CF leads to an increased detection rate of 70%. There was no statistically significant association between leakage and MA detectability on OCTA (p = 0.13). For CF, the odds of detecting leaking MAs were significantly lower than non-leaking MAs (p = 0.012). Using MHz-OCTA, detection of MAs outside the ETDRS grid was less likely than MAs located within the ETDRS grid (outer ring, p < 0.01; inner ring, p = 0.028). No statistically significant difference between rings was observed for CF measurements.

CONCLUSIONS: More MAs were detected on MHz-OCTA than on CF imaging. Detection rate was lower for MAs located outside the macular region with MHz-OCTA and for leaking MAs with CF imaging. Combining both non-invasive modalities can improve MA detection.

PMID:38126128 | DOI:10.1111/aos.16619

J Appl Physiol (1985). 2023 Dec 21. doi: 10.1152/japplphysiol.00622.2023. Online ahead of print.

ABSTRACT

Potential health benefits of an acute fast include reductions in blood pressure and increases in vagal cardiac control. These purported health benefits could put fasted humans at risk for cardiovascular collapse when exposed to central hypovolemia. The purpose of this study was to test the hypothesis that an acute 24-hour fast (vs 3-hours postprandial) would reduce tolerance to central hypovolemia induced via lower body negative pressure (LBNP). We measured blood ketones (β-OHB) to confirm a successful fast (N=18). We recorded the ECG, beat-to-beat arterial pressure, muscle sympathetic nerve activity (MSNA; N=7), middle cerebral artery blood velocity (MCAv), and forearm blood flow. Following a 5-min baseline, LBNP was increased by 15 mmHg until -60 mmHg and then increased by 10 mmHg every 5-min in a stepwise manner until onset of presyncope. Data are expressed as means ± SE. P-values ≤ 0.05 were considered statistically significant. β-OHB increased (β-OHB; 0.12±.04 fed vs. 0.47±.11, p<0.01 mmol/L fast). Tolerance to central hypovolemia was decreased by ~10% in the fasted condition measured via total duration of negative pressure (1370 89 fed vs. 1229±94 s fast, p=0.04), and was negatively associated with fasting blood ketones (R =-0.542, P = 0.02). During LBNP, heart rate and MSNA increased similarly, but in the fasted condition forearm vascular resistance was significantly reduced. Our results suggest that acute fasting reduces tolerance to central hypovolemia by blunting increases in peripheral resistance, indicating that prolonged fasting may hinder an individual’s ability to compensate to a loss of blood volume.

PMID:38126086 | DOI:10.1152/japplphysiol.00622.2023

Aust N Z J Psychiatry. 2023 Dec 21:48674231218623. doi: 10.1177/00048674231218623. Online ahead of print.

ABSTRACT

OBJECTIVE: We evaluated the presence and impact of unblinding during the influential Treatment for Adolescents with Depression Study (ClinicalTrials.gov Identifier: NCT00006286).

METHOD: Our analysis was part of a Restoring Invisible and Abandoned Trials reanalysis. Treatment for Adolescents with Depression Study trialled fluoxetine, placebo, cognitive behaviour therapy or their combination, in treating adolescents with major depressive disorder. We analysed the accuracy of guesses of fluoxetine or placebo allocation, and their effects on change in Children’s Depression Rating Scale-Revised at 12 weeks.

RESULTS: Of 221 participants allocated to fluoxetine or placebo, 151 adolescents (68%) had their guess about pill-treatment-arm allocation recorded at week 6, and guesses were recorded for 154 independent evaluators, 159 parents and 164 pharmacotherapists. All of these groups guessed treatment allocation more accurately than would be expected by chance (60-66% accuracy; all p-values ⩽ 0.004). Guesses did not become more accurate between 6 and 12 weeks and were not predicted by adverse events, though event documentation was poor. Treatment guess had a substantial and statistically significant effect on outcome (Children’s Depression Rating Scale-Revised change mean difference 9.12 [4.69; 13.55], β = 0.334, p < 0.001), but actual treatment arm did not (1.53 [-2.83; 5.89], β = 0.056, p = 0.489). Removing guess from the analysis increased the apparent effect of treatment arm, making it almost statistically significant at the conventional alpha-level of 0.05 (p = 0.06).

CONCLUSIONS: For Treatment for Adolescents with Depression Study, treatment guesses strongly predicted outcomes and may have led to the exaggeration of drug effectiveness in the absence of actual effects. The integrity of double-blinding in trials should be routinely assessed and reported.

PMID:38126083 | DOI:10.1177/00048674231218623

Front Med (Lausanne). 2023 Dec 6;10:1296751. doi: 10.3389/fmed.2023.1296751. eCollection 2023.

ABSTRACT

INTRODUCTION: The purpose of this study is to systematically evaluate the efficacy and safety of acupuncture combined with pelvic floor rehabilitation training in the treatment of postpartum stress urinary incontinence, and to promote the further promotion and application of acupuncture in the field of rehabilitation.

METHODS AND ANALYSIS: Randomized controlled trials (RCTs) of acupuncture combined with pelvic floor rehabilitation in the treatment of postpartum stress urinary incontinence will be searched in PubMed, Web of Science (WOS), Cochrane Library, EMBASE, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (CBM), Wanfang (WF), and VIP databases. The clinical trial Registry (ClinicalTrials.gov and Chinese clinical trial Registry) will also be searched. The search period is limited to July 1, 2023, and the language limit of this systematic review is Chinese and English. The primary outcome is clinical effective rate. International Consultation on Incontinence Questionnaire-Short Form (ICI-Q-SF), 1-h pad test, pelvic floor muscle potential value, incidence of adverse events are secondary outcomes. A meta-analysis will be performed using RevMan 5.4 statistical software. If feasible, subgroup analysis and sensitivity analysis will be performed to address potential causes of inconsistency and heterogeneity. The risk of bias will be assessed using the approach recommended by Cochrane Handbook for Systematic Reviews of Interventions, and the quality of evidence will be assessed using GRADE. This Protocol has been developed in accordance with the guideline of Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) 2015.

DISCUSSION: Acupuncture combined with pelvic floor rehabilitation training can effectively promote the rehabilitation of postpartum stress urinary incontinence patients, and provide a reference for the clinical application of integrated Chinese and Western medicine treatment in the field of rehabilitation.

SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42023455801.

PMID:38126072 | PMC:PMC10730657 | DOI:10.3389/fmed.2023.1296751

Front Med (Lausanne). 2023 Dec 6;10:1268846. doi: 10.3389/fmed.2023.1268846. eCollection 2023.

ABSTRACT

BACKGROUND: The progression of early stage non-small cell lung cancer (NSCLC) is closely related to epidermal growth factor receptor (EGFR) mutation status. The purpose of this study was to systematically investigate the relationship between EGFR mutation status and demographic, imaging, and ultimately pathologic features in patients with NSCLC.

METHODS: A complete literature search was conducted using the PubMed, Web of Science, EMBASE, and Cochrane Library databases to discover articles published by May 15, 2023 that were eligible. The relationship between EGFR mutation status and specific demographic, imaging, and ultimately pathologic features in patients with NSCLC was evaluated using pooled odds ratios (ORs) and their 95% confidence intervals (CIs). The standardized mean difference (SMD) with 95% CIs was the appropriate statistic to summarize standard deviations (SDs) means for continuous variables.

RESULTS: A total of 9 studies with 1789 patients were included in this analysis. The final findings suggested that patients with a greater age, female gender, and non-smoking status would have a relatively higher incidence of EGFR mutations. Additionally, the risk of EGFR mutations increased with larger tumor diameter, tumor imaging presentation of mixed ground glass opacity (mGGO), and tumor pathological findings of minimally invasive adenocarcinoma (MIA) or invasive adenocarcinoma (IAC). Significantly, malignancies presenting as MIA are more likely to contain L858R point mutations (OR = 1.80; 95% CI: 1.04-3.13; p = 0.04) rather than exon 19 deletions (OR = 1.81; 95% CI: 0.95-3.44; p = 0.07).

CONCLUSION: This meta-analysis showed that imaging parameters and histological classifications of pulmonary nodules may be able to predict stage IA NSCLC genetic changes.

PMID:38126071 | PMC:PMC10731050 | DOI:10.3389/fmed.2023.1268846

R Soc Open Sci. 2023 Dec 20;10(12):230621. doi: 10.1098/rsos.230621. eCollection 2023 Dec.

ABSTRACT

Disease spread can be affected by pharmaceutical interventions (such as vaccination) and non-pharmaceutical interventions (such as physical distancing, mask-wearing and contact tracing). Understanding the relationship between disease dynamics and human behaviour is a significant factor to controlling infections. In this work, we propose a compartmental epidemiological model for studying how the infection dynamics of COVID-19 evolves for people with different levels of social distancing, natural immunity and vaccine-induced immunity. Our model recreates the transmission dynamics of COVID-19 in Ontario up to December 2021. Our results indicate that people change their behaviour based on the disease dynamics and mitigation measures. Specifically, they adopt more protective behaviour when mandated social distancing measures are in effect, typically concurrent with a high number of infections. They reduce protective behaviour when vaccination coverage is high or when mandated contact reduction measures are relaxed, typically concurrent with a reduction of infections. We demonstrate that waning of infection and vaccine-induced immunity are important for reproducing disease transmission in autumn 2021.

PMID:38126062 | PMC:PMC10731327 | DOI:10.1098/rsos.230621