Tag: pubmed

J Acad Nutr Diet. 2023 Aug 22:S2212-2672(23)01490-9. doi: 10.1016/j.jand.2023.08.127. Online ahead of print.

ABSTRACT

BACKGROUND: Inflammatory and prothrombotic responses are hallmark to the progression of cardiovascular disease (CVD) and may be influenced by the type of dietary fat. Cottonseed oil (CSO) is rich in omega-6 polyunsaturated fats (n-6 PUFA) and improves traditional CVD risk factors such as cholesterol profiles. However, some clinicians are still hesitant to promote n-6 PUFA consumption despite growing evidence suggesting they may not be independently pro-inflammatory.

OBJECTIVE: To investigate the inflammatory and coagulation marker responses to an 8-week diet intervention rich in either CSO or olive oil (OO; monounsaturated fat rich) in adults with untreated hypercholesterolemia.

DESIGN: This was a secondary analysis of a parallel-arm randomized clinical trial with the main outcome of cholesterol measures.

PARTICIPANTS: /setting: Participants included in this analysis were 42 sedentary adults age 30-75 (62% female) in the Athens, GA area, between May 2018 and June 2021, with untreated hypercholesterolemia or elevated blood lipids and BMIs >18.5. Hypercholesterolemia was defined as at least two blood lipids in a “borderline undesirable/at risk” range (total cholesterol (TC) ≥ 180 mg/dL, Low-density lipoprotein cholesterol (LDL-c) ≥ 110 mg/dl, high-density lipoprotein cholesterol (HDL-c) < 50 mg/dL, or triglycerides (TG) ≥ 130), or at least one in an “undesirable” range (TC ≥ 240 mg/dL, LDL-c ≥ 160 mg/dl, HDL-c< 40 mg/dL, or TG ≥ 200).

INTERVENTION: Participants were randomly assigned to either the CSO or OO group in a partial outpatient feeding trial. Meals from the study provided approximately 60% of their energy needs with 30% of energy needs from either CSO or OO for eight weeks. Participants fulfilled their remaining energy needs with meals of their choosing.

MAIN OUTCOME MEASURES: Fasting plasma concentrations of inflammatory markers including C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and interleukin-1β (IL-1β) were measured at baseline and 8-weeks. Markers of coagulation potential including plasminogen activator inhibitor-1 (PAI-1), and tissue factor (TF) were measured at the same time points.

STATISTICAL ANALYSES PERFORMED: Repeated measures linear mixed models were used with treatment and visit in the model for analyses of all biochemical markers.

RESULTS: There were no significant differences in fasting CRP (p=0.70), TNF-α (p=0.98), IL-6 (p=0.21), IL-1β (p=0.13), PAI-1 (p=0.29), or TF (p=0.29) between groups across the intervention.

CONCLUSION: Inflammation and coagulation marker responses to diets rich in CSO vs. OO were not significantly different between groups, and neither group showed changes in these markers in adults with untreated hypercholesterolemia. This provides additional evidence suggesting that dietary n-6 PUFAs may not promote inflammation compared to MUFAs, even in adults at increased risk for CVD.

PMID:37619782 | DOI:10.1016/j.jand.2023.08.127

Complement Ther Med. 2023 Aug 22:102975. doi: 10.1016/j.ctim.2023.102975. Online ahead of print.

ABSTRACT

BACKGROUND: Post-stroke depression (PSD) is a common complication following a stroke, significantly impacting patients’ quality of life and mental well-being. Currently, two primary approaches are employed to treat PSD: drug therapy and non-drug therapy. Among these, acupuncture, specifically scalp acupuncture (SA), has gained attention due to its cost-effectiveness and broad social benefits. SA is a precise and direct form of acupuncture that has been utilized in the treatment of PSD. Although several randomized controlled trials (RCTs) have demonstrated the efficacy of SA in treating PSD, there is a lack of comprehensive systematic reviews. Given the limitations of existing evidence, we conducted a systematic evaluation to assess the effectiveness of SA in combination with conventional therapy (CT) for intervening in PSD.

METHODS: We systematically searched five databases for articles published up until May 31, 2023, pertaining to SA treatment of PSD. A team of researchers meticulously screened and assessed these articles to identify the final included studies. After extracting relevant information and outcome indicators from the selected articles, we employed RevMan5.3 software to evaluate their quality and perform statistical analysis. Throughout our research, we strictly adhered to the PRISMA 2020 guidelines.

RESULTS: A total of 11 articles were included, and a meta-analysis was conducted to evaluate the effectiveness of SA combined with CT for treating PSD. The results revealed that SA combined with CT can effectively improve the treatment’s success rate for PSD and reduce the severity of depressive symptoms measured by the Self-Rating Depression Scale. However, SA combined with CT did not show significant reductions in depressive symptoms assessed by the Hamilton Rating Scale for Depression, which may be related to the inclusion of high heterogeneity articles. Importantly, the combination treatment did not lead to an increase in adverse reactions among PSD patients.

CONCLUSION: While the effectiveness of SA combined with CT in treating PSD still requires further validation through rigorous randomized double-blind trials, this study provides a comprehensive collection of studies that meet the criteria for SA combined with CT in PSD treatment. It objectively and systematically evaluated the impact of SA combined with CT on PSD. Consequently, the findings of this study hold certain clinical significance.

PMID:37619716 | DOI:10.1016/j.ctim.2023.102975

Complement Ther Med. 2023 Aug 22:102974. doi: 10.1016/j.ctim.2023.102974. Online ahead of print.

ABSTRACT

BACKGROUND: Royal jelly (RJ) may contribute to glycemic control and liver function through various mechanisms. The present study aimed to quantify the effect of RJ supplementation on these outcomes.

METHODS: A literature search of Web of Science, Scopus, and PubMed/Medline, was conducted for RCTs investigating the efficacy of RJ on plasma liver enzymes and glycemic indices. Weighted mean differences (WMDs) and 95% confidence intervals (CIs) were calculated for net changes using a random-effects model.

RESULTS: Ten RCTs were selected for inclusion in this meta-analysis. Combined estimate of effect sizes for the impact of RJ on neither the plasma liver enzymes nor the glycemic indices were statistically significant. Subgroup analysis showed a significant reduction of serum FPG in trials with intervention duration ≥8 weeks (WMD: -4.28mg/dl, 95% CI -7.41 to -1.14mg/dl, p =0.007), and those conducted in non-healthy populations (WMD: -4.28mg/dl, 95% CI -7.41 to -1.14, p = 0.007).

CONCLUSION: RJ does not significantly affect liver function and glycemic profile of adult population. In trials with longer intervention and those conducted in non-healthy populations a significant reduction of serum FBG was observed. This meta-analysis should be repeated in the future, with more primary articles included, in order to provide conclusive results.

PMID:37619715 | DOI:10.1016/j.ctim.2023.102974

J Vasc Surg Venous Lymphat Disord. 2023 Aug 22:S2213-333X(23)00318-9. doi: 10.1016/j.jvsv.2023.08.007. Online ahead of print.

ABSTRACT

BACKGROUND: Venous thromboembolism (VTE) has both environmental and genetic risk factors. It is regulated by polygenes and multi-sites. Polygenic risk score (PRS) has been widely used because any single genetic biomarker failed to accurately predict the genetic risk of VTE. However, no polygenic risk model has been proposed for VTE in the Chinese population.

OBJECTIVE: We aimed to construct a PRS model for the first episode of VTE in the Chinese population.

METHODS: (A) Single nucleotide polymorphisms (SNPs) associated with VTE in genome-wide association studies (GWAS), meta-analyses, and candidate gene studies were screened as variables in PRS. The logarithm of the odds ratio (OR) was used as the weight of the variables. (B) A training set with simulated data from 1,000 cases of VTE and 1,000 controls was created with different genotypes and frequencies. (C) We calculated the area under the receiver operating characteristic (ROC) curve (AUC) for evaluating the discriminatory ability of the PRS model.

RESULTS: We screened 53 SNPs potentially associated with the first episode of VTE in the Chinese population. The AUC value of the PRS-53 model was 0.748 [95% confidence level (CI), 0.727-0.770] in the training set. From the largest weight to the smallest weight, SNPs were incrementally added to the model to calculate the AUC value for model optimization. The AUC value of the PRS-10 model containing 10 SNPs was 0.718 (95% CI, 0.696-0.740), with no statistical difference from the AUC value of the PRS-53 model containing 53 SNPs.

CONCLUSION: The PRS-10 and PRS-53 model showed similar prediction abilities and satisfactory discriminatory power, which can be used to predict the genetic risk of the first episode of VTE in the Chinese population. The simplified PRS-10 model is more efficient in clinical practice.

PMID:37619711 | DOI:10.1016/j.jvsv.2023.08.007

J Stomatol Oral Maxillofac Surg. 2023 Aug 22:101609. doi: 10.1016/j.jormas.2023.101609. Online ahead of print.

ABSTRACT

OBJECTIVE: Role of neutrophils in shaping the tumor microenvironment is well known in oral squamous cell carcinoma (OSCC). However, neutrophil microabscess (NM) formation within the tumor islands is distinctive phenomenon and has never been investigated in the literature. This pilot observational study identifies the incidence of NM in OSCC and its clinicopathologic correlation as a platform for the future studies.

METHODOLOGY: A retrospective study was carried out on archival specimens of 121 cases of surgically excised OSCC specimens for identification of NM formations within the tumour islands using compound microscope. Mean NM density was calculated based on the quantification done at five randomly selected hotspots.

RESULTS: Out of total 121 cases of OSCC, thirteen (10.74%) cases showed a frank evidence of NM within tumor islands. The hotspot analysis showed that the NM density ranges from 2 to 7 with mean of 3.76 ± 1.39 per high power field. NM density was higher in moderately differentiated OSCC (3.76 ± 1.93) than well differentiated (3.76 ± 1.93) however the differences were not statistically significant (p = 0.165). Similarly, higher NM density was reported in advanced T stage, lymph node involvement, advanced TNM stage and lymphovascular invasion, however, the results were statistically insignificant.

CONCLUSION: There is evidence of NM formation in the tumour islands of OSCC, however their exact role as a prognosticator needs further exploration with large sample size and follow-up data.

PMID:37619671 | DOI:10.1016/j.jormas.2023.101609

Radiother Oncol. 2023 Aug 22:109863. doi: 10.1016/j.radonc.2023.109863. Online ahead of print.

ABSTRACT

When radiotherapy is used in the treatment of head and neck cancers, the brain commonly receives incidental doses of radiotherapy with potential for neurocognitive changes and subsequent impact on quality of life. This has not been widely investigated to date. A systematic search of MEDLINE, EMBASE, Psycinfo Info and the Cochrane Central Register of Controlled Trials (CENTRAL) electronic databases was conducted. Of 2077 records screened, 20 were eligible comprising 1308 patients. There were no randomised studies and 73.3% of included patients were from single center studies. IMRT was delivered in 72.6% of patients, and chemotherapy used in 61%. There was considerable heterogeneity in methods. Narrative synthesis was therefore carried out. Most studies demonstrated inferior neurocognitive outcomes when compared to control groups at 12 months and beyond radiotherapy. Commonly affected neurocognitive domains were memory and language which appeared related to radiation dose to hippocampus, temporal lobe, and cerebellum. Magnetic Resonance Imaging could be valuable in the detection of early microstructural and functional changes, which could be indicative of future neurocognitive changes. In studies investigating quality of life, the presence of neurocognitive impairment was associated with inferior quality of life outcomes. (Chemo)radiotherapy for head and neck cancer appears to be associated with a risk of long-term neurocognitive impairment. Few studies were identified, with substantial variation in methodology, thus limiting conclusions. High quality large prospective head and neck cancer studies using standardised, sensitive, and reliable neurocognitive tests are needed.

PMID:37619657 | DOI:10.1016/j.radonc.2023.109863

Inflamm Bowel Dis. 2023 Aug 24:izad184. doi: 10.1093/ibd/izad184. Online ahead of print.

ABSTRACT

BACKGROUND: Although increasing studies have reported that dose escalation can improve treatment response to ustekinumab in patients with Crohn’s disease (CD), their strategies mainly focus on maintenance regimen. Evidence of ustekinumab dose escalation in induction regimen, particularly in severe CD, remains limited. This study evaluated the efficacy and safety of intravenous ustekinumab with 2 initial doses in patients with severely active CD.

METHODS: A retrospective observational study of 99 adult patients with severe CD treated with ustekinumab from 3 IBD centers included 48 patients with standard and 51 with optimized induction treatment. Clinical outcomes, inflammatory biomarkers including fecal calprotectin (FC) normalization, and endoscopic outcomes were evaluated at weeks 16 and 48. Adverse events and treatment decisions after initial induction were also collected.

RESULTS: Compared with the standard group, 2 initial intravenous injections of ustekinumab achieved higher clinical response (92.2%, 47 of 51, P = .656), clinical remission (88.2%, 45 of 51, P = .221), endoscopic response (75.8%, 25 of 33, P = .125), and FC normalization (70.6%, 36 of 51, P = .138) at week 16. The mucosal healing rate at week 16 (63.6%, P = .022) was statistically higher in the optimization group. At week 48, patients with optimized treatment achieved higher clinical response (80.4%, 41 of 51, P = .003), clinical remission (70.6%, 36 of 51, P = .007), FC normalization (66.7%, 34 of 51, P = .031), endoscopic response (72.7%, 24 of 33, P = .006), and mucosal healing (57.6%, 19 of 33, P = .004). At the last follow-up, 82.4% of optimally treated patients adhered to continued treatment with ustekinumab (P < .001).

CONCLUSIONS: Optimization of ustekinumab by 2 initial intravenous inductions is more effective than standard therapy for adult patients with severe CD.

PMID:37619248 | DOI:10.1093/ibd/izad184

N Z Med J. 2023 Aug 25;136(1581):28-43.

ABSTRACT

AIMS: This study aimed to estimate the prevalence of vicarious racism experienced by children (0-14 years) in Aotearoa New Zealand and investigate the association between vicarious racism and diagnosed child mental health conditions.

METHODS: Adult and child 2016/2017 New Zealand Health Survey data were merged to create child-caregiver dyads. Multivariable logistic regression models were used to investigate the association between the caregiver experiences of racism (exposure) and diagnosed child mental health conditions (outcome), adjusting for confounders and exploring potential pathway variables.

RESULTS: Looking at 2,989 dyads, the prevalence of “any” vicarious racism was higher for Māori (28.1%; 95% CI 24.2-31.9), Pacific (23.2%; 95% CI 17.9-28.5) and Asian (29%; 95% CI 23.6-34.5) children compared to European/Other children (12.5%; 95% CI 10.2-14.8). A statistically significant association was identified between >2 reports of vicarious racism and the outcome (OR= 2.53, 95% 1.18-5.43). Adding caregiver psychological distress reduced this association (OR= 1.92, 95% 0.91-4.08).

CONCLUSIONS: Children in Māori, Pacific and Asian ethnicity groupings experience higher exposure to vicarious racism than those in the European/Other grouping. Multiple experiences of vicarious racism are associated with increased odds of diagnosed child mental health conditions in a dose-response distribution.

PMID:37619225

Inflamm Bowel Dis. 2023 Aug 24:izad167. doi: 10.1093/ibd/izad167. Online ahead of print.

ABSTRACT

BACKGROUND: Exclusive enteral nutrition (EEN) is the recommended first-line induction treatment in pediatric patients with active luminal Crohn’s disease (CD). We aimed to provide a nationwide overview of evolving EEN practices during an era of increasing biologic use.

METHODS: We analyzed a prospectively identified nationwide cohort of newly diagnosed pediatric patients with CD in Scotland between January 1, 2015, and June 30, 2022. Patients who received EEN for any indication were divided into 6-monthly epochs and examined over time. Differences during the COVID-19 pandemic (March 16, 2020, to July 19, 2021) were examined. Data were retrospectively collected from electronic medical records: demographics, anthropometrics, concomitant treatments, aspects of EEN administration, and remission/response rates. Descriptive statistics and linear regression were used for analyses.

RESULTS: A total of 649 patients with CD were identified (63% male; median age 12.6 [interquartile range, 10.8-14.8] years); 497 (77%) of 649 received EEN as postdiagnosis induction therapy with a median course length of 7.7 (interquartile range, 5.9-8.0) weeks. Including repeat courses, 547 EEN courses were examined. An increasing incidence of CD was observed over time with no significant changes in EEN usage, remission or response rates, nasogastric tube usage, or course completion (all P > .05). Increasing use of EEN combined with biologics (combination induction) as first-line induction was observed over time (P < .001). Considering COVID-19, lower rates of EEN usage were observed (P = .008) with no differences in remission, oral administration, and course completion rates (all P > .05).

CONCLUSIONS: Over the past 7.5 years, except during the COVID-19 pandemic, EEN usage rates have not changed despite an increase in biologic use, although combination induction is an emerging trend.

PMID:37619221 | DOI:10.1093/ibd/izad167

Chic Med J Exam. 1878 Jun;36(6):613-618.

NO ABSTRACT

PMID:37617384 | PMC:PMC9839178