Tag: pubmed

Cancer Causes Control. 2024 Dec 24. doi: 10.1007/s10552-024-01933-w. Online ahead of print.

ABSTRACT

INTRODUCTION: The prevalence of smokeless tobacco consumption remains high despite policies on reduction interventions. This study aims to quantify the associations between smokeless tobacco use with cancer incidence and mortality globally.

METHODS: We conducted a systematic review and meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and PROSPERO protocol (ID: CRD42023390468). A comprehensive literature search was performed using PubMed, Web of Science, and Scopus databases, covering the period from January 1, 2000, to February 28, 2023. We included peer-reviewed observational studies, specifically case-control and cohort studies, where smokeless tobacco use was the primary exposure and cancer incidence, or mortality were the main outcomes. Three independent reviewers screened titles, abstracts, and full texts, and extracted data from the included studies. Risk of bias was assessed by the same three reviewers. Any disagreements were resolved through discussion with a fourth reviewer. We performed random-effects meta-analyses and assessed heterogeneity and publication bias to ensure the robustness of our findings.

RESULTS: Of the 3,611 articles identified, 80 were included in the final analysis. Increased risks were observed for cancer mortality [Risk Ratio (RR) 1.38, 95% Confidence Interval (CI) 1.22-1.56] and incidence [RR 1.17, 95% CI 1.08-1.27]. The specific cancer sites with increased mortality risk included head and neck cancers, as well as stomach cancer. For cancer incidence, associations were observed with head and neck, oral, esophageal, stomach, and pancreatic cancers. Significant heterogeneity (I² statistic 65% to 90%) was observed among most cancer outcomes.

CONCLUSION: Our study found significant associations between smokeless tobacco use and cancer incidence and mortality. Targeted policy interventions, such as stricter regulations on smokeless tobacco use, are recommended to reduce its consumption and mitigate the associated cancer risks.

PMID:39718727 | DOI:10.1007/s10552-024-01933-w

Eur J Orthop Surg Traumatol. 2024 Dec 24;35(1):47. doi: 10.1007/s00590-024-04144-w.

ABSTRACT

PURPOSE: To assess the rate of heterotopic ossification (HO) following acetabular surgery with a standardized protocol via the Kocher-Langenbeck. Secondarily, to evaluate patient characteristics, injury variables, and perioperative data among patients with HO and no HO.

METHODS: This was a retrospective case series from an academic Level I trauma center. Included patients had displaced acetabular fractures treated via Kocher-Langenbeck approach with debridement of (1) gluteus minimus muscle (GMM) from the posterior wall and column up to the superior gluteal neurovascular bundle, (2) unhealthy appearing piriformis muscle without fascial disruption, and (3) superior and inferior gemelli in the location of implant placement. Those with posterior hip dislocations and gluteus medius injury received prophylactic indomethacin.

RESULTS: Fifty-seven patients met inclusion criteria. Thirteen patients (22.8%) developed HO, and 44 patients (77.2%) had no evidence of HO. Ten (17%) patients developed mild HO (Brooker classification (BC) I/II), 3 (5%) developed moderate HO (BC III), and no patients developed severe HO (BC IV). There were no differences in the prevalence of elementary versus associated acetabular fracture patterns or individual fracture patterns among cohorts. Patients with HO had longer times to surgical intervention (5.3 ± 5.1 days vs. 2.4 ± 1.6 days, p = 0.002) and length of intensive care unit (ICU) stay (6.7 ± 12.2 days vs. 1.5 ± 3.3 days, p = 0.013) compared with the no HO cohort. There was no difference in rates of HO prophylaxis use and subsequent HO among cohorts.

CONCLUSION: This study describes a standardized protocol developed by the senior author that resulted in low rates of HO following acetabular fixation via the Kocher-Langenbeck approach. Patients with HO had a significantly longer time to surgical intervention and length of ICU level of care.

LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors of a complete description of levels of evidence.

PMID:39718662 | DOI:10.1007/s00590-024-04144-w

Environ Geochem Health. 2024 Dec 24;47(2):31. doi: 10.1007/s10653-024-02327-2.

ABSTRACT

This study investigates the quantities of Rare Earth Elements (REEs) and Potentially Toxic Elements (PTEs) in Dong Nai Province’s surface soils. Atomic Absorption Spectrometry (AAS) and Instrumental Neutron Activation Analysis (INAA) were used to determine element concentrations. To validate the concentration results, established reference materials (NIST 2711 and IAEA Soil-7) were used. Element concentrations followed a certain order, with Mn, Cr, V, and Zn dominating, except for Al, which were used to determine the enrichment factor. Arsenic (As) concentrations ranged from 0.8 to 37.5 mg/kg, exceeding global averages but below Vietnam quality standards. Cadmium (Cd) concentrations ranged from 0.03 to 0.16 mg/kg, below global averages and quality standards. Cobalt (Co) and chromium (Cr) concentrations ranged from 0.5 to 135.1 mg/kg and 18 to 844 mg/kg, respectively, with notable percentages of samples exceeding global averages. Copper (Cu) and lead (Pb) exhibited elevated concentrations, with varying proportions exceeding quality standards. Manganese (Mn) and antimony (Sb) exceeded global averages in a significant percentage of samples. Vanadium (V) concentrations surpassed the crustal average by over half of the sites. Zinc (Zn) concentrations were below reference values. REEs showed significantly higher concentrations than global soil averages, with a substantial proportion of samples exceeding reference values. Geo Accumulation Index (Igeo), Enrichment Factor (EF), and Pollution Load Index (PLI) analyses provided a detailed numerical assessment of contamination and soil quality. Statistical analysis showed correlations and clusters of toxic elements and highlighted the spatial distribution of samples based on elemental compositions.

PMID:39718640 | DOI:10.1007/s10653-024-02327-2

Heart Vessels. 2024 Dec 24. doi: 10.1007/s00380-024-02510-6. Online ahead of print.

ABSTRACT

The optimal procedural protocol for coronary stent deployment remains undetermined. Post-dilation with a high-pressure balloon is often performed to optimize the stent expansion. However, high-pressure dilation also carries the potential risk of coronary artery injury. A previous in vitro study reported that multiple-times balloon inflation at the same pressure resulted in better stent expansion compared to one-time balloon inflation. In our facility, we frequently perform the repeated 3-time-balloon-inflation method, wherein the stent delivery balloon was inflated 3 times at nominal pressure to deploy the stent, to improve stent expansion without high-pressure balloon inflation. Although this method seems effective in avoiding excessive high-pressure dilation, its clinical data are insufficient. In this study, we investigated the clinical outcomes of the repeated 3-time-balloon-inflation method. This retrospective study included 370 patients with 467 stented coronary lesions. These subjects were divided into two groups: one with standard balloon inflation and the other with repeated 3-time balloon inflation, and treatment outcomes were compared. The repeated 3-time-balloon-inflation group had 254 lesions, and the standard-balloon-inflation group had 213 lesions. Stent edge dissection occurred in 6 lesions (2.8%) in the standard-balloon-inflation group, whereas did not occur in the repeated 3-time-balloon-inflation group. A statistically significant difference remained even after propensity score matching (p = 0.040). The final minimum stent area and long-term clinical outcomes were not significantly different between the two groups. The repeated 3-time-balloon-inflation method may reduce stent edge dissection while demonstrating comparable minimal stent area and long-term outcomes to the standard-balloon-inflation method.

PMID:39718636 | DOI:10.1007/s00380-024-02510-6

Abdom Radiol (NY). 2024 Dec 24. doi: 10.1007/s00261-024-04765-z. Online ahead of print.

ABSTRACT

OBJECTIVES: Implementation of diffusion-weighted imaging (DWI) for abdominal imaging in children has challenges due to motion artifacts exacerbated by long acquisition times. We aimed to compare acquisition time and image quality between conventional DWI and multi-band (MB) DWI of the liver in children and young adults.

METHODS: Clinical MRI exams from May 2023 to January 2024 were reviewed, including four DWI sequences: respiratory-triggered (RTr, clinical standard), free-breathing (FB), MB-DWI with shift factor 1 (MBsf1), and MB-DWI with shift factor 2 (MBsf2). Acquisition times were recorded, and signal intensity and apparent signal-to-noise ratio (aSNR) were calculated for the liver and spleen. Six blinded pediatric radiologists independently assessed image quality, artifacts, and lesion visualization on a 5-point Likert scale and identified their preferred sequence. Statistical comparisons were made using Kruskal-Wallis and ANOVA tests.

RESULTS: Median acquisition times were significantly reduced with MB-DWI (43 s for MBsf1/MBsf2) compared to FB (84 s) and RTr (240 s). Image quality and artifact scores were highest for RTr and FB sequences (p < 0.0001). Mean image quality scores were 3.7 (RTr, FB), 3.4 (MBsf1), and 3.5 (MBsf2), while artifact scores followed a similar trend (higher score = fewer artifacts). Lesion visualization scores were comparable across sequences (p = 0.11), and reviewers expressed no preference in 47% of cases. Apparent diffusion coefficient (ADC) values were consistent across all sequences (p > 0.05).

CONCLUSION: MB-DWI significantly reduces acquisition time while maintaining acceptable image quality and lesion visualization, making it a valuable option for pediatric abdominal MRI.

PMID:39718630 | DOI:10.1007/s00261-024-04765-z

Aesthetic Plast Surg. 2024 Dec 24. doi: 10.1007/s00266-024-04638-2. Online ahead of print.

ABSTRACT

BACKGROUND: Oncoplastic surgery for breast cancer patients poses the challenge of achieving optimal aesthetic outcomes without increasing the risk of complications. Omental flap has emerged as n reconstructive option in breast surgery, yet the efficacy and safety of large omental flaps remain uncertain. This study aims to conduct a systematic review and single-arm meta-analysis to comprehensively evaluate the effectiveness, safety, and cosmetic outcomes of large omental flap breast reconstruction, providing updated evidence for clinical practice.

METHODS: We systematically searched Embase, PubMed, Cochrane Library, and CNKI databases until August 2023. Studies were screened using inclusion and exclusion criteria. The quality of each study was evaluated with the Newcastle-Ottawa Scale. Meta-analysis was performed using R version 4.2.0.

RESULTS: A total of 22 studies with 1031 patients were reviewed and analyzed. Meta-analysis results showed that hematoma and seroma rate were 4.1% (95%CI 0.8-8.8, P < 0.01). The pooled cosmetic outcomes demonstrated excellent rate 56.7% (95%CI 46.4-69.3, P < 0.01), good rate 7.9% (95%CI 3.9-11.9, P < 0.01), fair rate 28.7% (95%CI 19.9-37.5, P < 0.01). The pooled blood loss was 110.74 ml (95%CI: 72.33-149.14, P = 0), hospital stays was 7.27 (95%CI 5.65-8.89, P < 0.01), the time of omental flap harvest was 65.63 min (95%CI 59.95-71.32, P < 0.01), the time for surgery was 240.87 min (95%CI 5.65- 8.89, P = 0).

CONCLUSIONS: This meta-analysis indicates that the omental flap in breast reconstruction is safe and effective with good cosmetic outcomes and a low incidence of complications. The study highlights the benefits of comprehensive assessment, warranting further investigation through high-quality studies and long-term follow-up.

LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

PMID:39718627 | DOI:10.1007/s00266-024-04638-2

Eur J Nutr. 2024 Dec 24;64(1):55. doi: 10.1007/s00394-024-03551-3.

ABSTRACT

PURPOSE: Although total dietary protein intake has been associated with bladder cancer (BC) risk, the effect of the origin (plant or animal) and the substitutions remain to be understood. This study aimed to investigate the effect of total dietary protein, animal-based protein, plant-based protein, and their substitutions with each other on the risk of BC using a pooled analysis of 10 cohort studies.

METHODS: The study was conducted within the “BLadder cancer Epidemiology and Nutritional Determinants” (BLEND) study, including 10 prospective cohort studies from several European countries, the United Kingdom, and the United States. Individual data from 10 prospective cohorts containing 434,412 participants (overall male/female ratio was almost 3:1) with a total of 4,224,643.8 person-years of follow-up was analyzed. Hazard ratios (HRs) and 95% confidence intervals (CIs) for BC risk for animal and plant-based protein substitutions of 30gram (g) per day (g/day) were estimated by multivariable adjusted HRs using Cox proportional hazards models.

RESULTS: During 11.4 years of follow-up, among 434,412 participants (73.28% female), 1,440 new cases of BC were identified. After multivariable adjustment, no association was observed between the intake of total, animal-based protein, and plant-based protein and BC risk. Replacement of every 30 g/day of animal-based protein intake by the same amount of plant-based protein intake or vice versa was not associated with the risk of BC.

CONCLUSION: In conclusion, our study found no association between protein intake-whether from animal or plant sources-and the risk of BC. Substituting animal-based protein with plant-based protein, or the reverse, did not influence BC risk. Future studies are required to provide information on the link between animal- and plant-based proteins and BC risk.

PMID:39718625 | DOI:10.1007/s00394-024-03551-3

Naunyn Schmiedebergs Arch Pharmacol. 2024 Dec 24. doi: 10.1007/s00210-024-03745-w. Online ahead of print.

ABSTRACT

The research investigated the capacity of myo-inositol (MI) in order that it improves biochemical markers in serum and follicular fluid and, ultimately, intracytoplasmic sperm injection (ICSI) outcomes of women with PCOS. Sixty infertile patients with PCOS, who were undergoing ovulation induction for ICSI, were randomly divided to two groups. The MI group received 2000 mg myo-inositol + 1 mg folic acid twice a day for 6 weeks with starting the ICSI cycle. For the same period, the control group received a placebo containing only folic acid (1 mg). Levels of hormonal profiles in serum and follicular fluid, as well as oxidative stress markers (MDA, TAC, GPx, and SOD), were estimated using an ELISA assay. Primary end points were ICSI cycle outcomes. Compared to the placebo group, the MI group demonstrated significant reduction in serum and follicular fluid levels of LH, LH/FSH ratio, total testosterone, AMH, and androstenedione. Furthermore, the MI group exhibited meaningful increases in TAC, GPx, and SOD, but MDA significantly decreased. While the number of retrieved and mature oocytes is not statistically similar among the groups, the MI group showed significant improvements in the percentage of immature oocytes, cleavage rate, and good embryo quality. A meaningful correlation was checked between follicular fluid AMH level and LH, FSH, total testosterone, androstenedione, insulin, MDA, the number of retrieved oocytes, and immature oocytes. Our outcomes indicate that myo-inositol administration in women with PCOS undergoing ART helps to improve their hormonal profiles, and the quality of oocytes and embryos. Registration details: Date: 2022.10.19, Registry: https://irct.behdasht.gov.ir/trial/66005 , and Trial registration: IRCT202220921056008N1.

PMID:39718613 | DOI:10.1007/s00210-024-03745-w

Naunyn Schmiedebergs Arch Pharmacol. 2024 Dec 24. doi: 10.1007/s00210-024-03733-0. Online ahead of print.

ABSTRACT

This study evaluates the protective effects of sinapic acid (SA), a polyphenolic compound with diverse biological activities, against ethanol-induced gastric ulcers in rats. A gastric ulcer model was established using ethanol (ETH), and the experimental groups received either omeprazole (OMEP, 20 mg/kg) or SA at doses of 20 mg/kg and 40 mg/kg via oral gavage for 14 days. Biochemical markers, including total antioxidant status (TAS), total oxidant status (TOS), oxidative stress index (OSI), malondialdehyde (MDA), and myeloperoxidase (MPO) activity, were assessed alongside proinflammatory cytokines (tumor necrosis factor-alpha (TNF-α), interleukin-1 beta (IL-1β), and IL-6) using ELISA. Histopathological and immunohistochemical analyses were conducted to evaluate tissue integrity and apoptosis. Statistical analysis was performed using one-way ANOVA, followed by Tukey’s HSD test for post hoc comparisons. For non-parametric data, the Kruskal-Wallis test and Mann-Whitney U test were used. A p-value < 0.05 was considered statistically significant. Results revealed that SA significantly enhanced antioxidant defenses, as evidenced by elevated TAS levels and reductions in TOS, OSI, MPO activity, and MDA levels (p < 0.05). Additionally, SA treatment mitigated inflammation and apoptosis by decreasing TNF-α, IL-1β, IL-6, and Bax expression (p < 0.05). These effects were comparable to those observed with OMEP, a widely used clinical agent. Notably, the findings underscore SA’s potential as a novel therapeutic agent for managing ethanol-induced gastric ulcers. By targeting oxidative stress and inflammatory pathways, SA could complement or serve as an alternative to current treatment strategies. Future research should focus on exploring SA’s molecular mechanisms, dose optimization, and long-term efficacy in clinical settings, paving the way for its integration into therapeutic regimens for gastric mucosal injuries.

PMID:39718611 | DOI:10.1007/s00210-024-03733-0

Eur J Orthop Surg Traumatol. 2024 Dec 24;35(1):46. doi: 10.1007/s00590-024-04149-5.

ABSTRACT

BACKGROUND: Due to the specific anatomical features of the tibia (limited soft tissue coverage), more than a quarter of its fractures are classified as open, representing the most common open long-bone injuries. Open tibial fractures frequently cause significant bone comminution, periosteal stripping, soft tissue loss, contamination and are prone to bacterial entry with biofilm formation, which increases the risk of deep bone infection. The main objective of this study was to determine prevalence of infection and its associated factors in surgically treated open tibial fracture, at Addis Ababa Burn Emergency and Trauma (AaBET) hospital.

METHOD: A facility-based retrospective cross-sectional study was conducted among patient treated for open tibial fracture at AaBET hospital from September 2018 to September 2021. The data were collected from patient’s chart using a structured data collection form and entered and analyzed using SPSS version 26. Binary logistic regression was fitted to determine risk factors associated with surgically treated open tibial fracture. Multicollinearity was checked using variance inflation factor and tolerance. Model adequacy was tested using the Hosmer-Lemeshow goodness-of-fitness test, and adjusted odds ratio (AOR) with a 95% CI at p value < 0.05 was reported statistically significant.

RESULT: From a total of 235 patients enrolled in the study, 33.9% of the patients developed infection. Initial IV antibiotic time (AOR = 2.924, 95% CI 1.160-7.370) and time of wound closure from injury (AOR = 3.524, 95% CI 1.798-6.908), injury to admission time (AOR = 2.895, 95% CI 1.402-5.977) and definitive fixation method (AOR = 0.244, 95% CI 0.113-0.4508) were the factors found to had significantly increased the risk of the occurrence of infection.

CONCLUSION: The high rate of infection in open tibial fractures indicates that there is a need to improve the management of open tibial fractures treated at AaBET hospital. Significant delay of patient with open tibial fracture was found from in injury time to presentation to trauma center since majority of the cases were from peripheral health facility without getting prophylactic antibiotics.

PMID:39718604 | DOI:10.1007/s00590-024-04149-5