Tag: pubmed

Urology. 2023 Sep 11:S0090-4295(23)00783-5. doi: 10.1016/j.urology.2023.08.033. Online ahead of print.

ABSTRACT

OBJECTIVE: To study whether varicocele repair would improve sperm capacitation and probability of generating a pregnancy.

METHODS: Data were collected prospectively of 40 consecutive adult men who presented with infertility confirmed by semen analysis and found to have a varicocele on exam or ultrasound who underwent unilateral or bilateral subinguinal microscopic varicocelectomy. We recorded pre and post-operative SA, Cap-Score, and PGP with a 3-month follow up. Values were compared using paired t-test and Wilcox rank-sum test.

RESULTS: Results showed a 17.4% relative increase in Cap-Score (23% to 27% capacitation), 25% relative increase in probability of generating a pregnancy (PGP) (24% to 30%), as well as statistically significant improvements in sperm concentration, motility, and total sperm count postoperatively.

CONCLUSION: This study confirms that microsurgical varicocelectomy significantly improves sperm capacitation ability and improves the expected probability of generating a pregnancy within three rounds of intrauterine insemination (IUI). The improvement in sperm capacitation ability may help explain how varicocele repair may improve the chance of pregnancy, regardless of standard semen parameter improvements.

PMID:37704009 | DOI:10.1016/j.urology.2023.08.033

Ann Thorac Surg. 2023 Sep 11:S0003-4975(23)00934-7. doi: 10.1016/j.athoracsur.2023.09.002. Online ahead of print.

ABSTRACT

BACKGROUND: Active primary lung malignancy remains a strong contraindication to lung transplantation (LTx). However, outcomes are unclear for patients with early-stage non-small cell lung cancer (NSCLC) who undergo LTx. We hypothesize that patients with early stage NSCLC incidentally discovered in the explanted lungs have comparable survival to LTx recipients without incidental cancer identified.

METHODS: We performed a single-center retrospective analysis of all LTx recipients from May 2007 to September 2021 with incidental cancer identified in the explanted lungs by pathologist report. Survival statistics were estimated using Kaplan-Meier analysis.

RESULTS: Of the 1,586 LTx performed, 23 (1.5%) patients were found to have incidental lung cancer in the explanted lungs. The most common indications for LTx were interstitial lung disease (n=13) and chronic obstructive pulmonary disease (n=7), and the most common histological diagnosis was adenocarcinoma (n=14). In the cohort with Stage I disease (n=9), the 1-year and 5-year unadjusted KM survival rates were 88.9% and 51.9%, respectively. The 1-year and 5-year survival rates for transplants without incidental cancer findings at LTx during this period were 86.7% and 59.4%, respectively, and did not differ significantly between the two strata (p=0.96).

CONCLUSIONS: One- and 5-year survival rates were comparable between LTx recipients with incidentally noted pathological Stage I NSCLC and contemporary recipients without cancer. All cancer-related mortality occurred in recipients with incidentally noted advanced NSCLC. These results suggest that patients with pathological Stage I lung cancer at the time of transplant have outcomes comparable to those without cancer findings at the time of transplant.

PMID:37704001 | DOI:10.1016/j.athoracsur.2023.09.002

J Thorac Oncol. 2023 Sep 11:S1556-0864(23)00806-7. doi: 10.1016/j.jtho.2023.09.004. Online ahead of print.

ABSTRACT

INTRODUCTION: The study aimed to prospectively investigate the bidirectional association between cardiovascular disease (CVD) and lung cancer, and whether this association differs across genetic risk levels.

METHODS: This study prospectively followed 455,804 participants from the UK Biobank cohort who were free of lung cancer at baseline. Cox proportional hazards models were used to estimate hazard ratio (HR) for incident lung cancer according to CVD status. In parallel, similar approaches were used to assess the risk of incident CVD according to lung cancer status among 478,756 participants free of CVD at baseline. The bidirectional causal relations between these conditions were assessed using Mendelian randomization (MR) analysis. Besides, polygenic risk scores were estimated by integrating genome-wide association studies identified risk variants.

RESULTS: During 4,007,477 person-years of follow-up, 2,006 incident lung cancer cases were documented. Compared with participants without CVD, those with CVD had HRs [95% confidence interval (CI)] of 1.49 (1.30-1.71) for non-small cell lung cancer (NSCLC), 1.80 (1.39-2.34) for lung squamous cell carcinoma (LUSC), and 1.25 (1.01-1.56) for lung adenocarcinoma (LUAD). After stratified by smoking status, significant associations of CVD with lung cancer risk were observed in former smokers (HR: 1.44, 95% CI: 1.20-1.74) and current smokers (HR: 1.38, 95% CI: 1.13-1.69), but not in never smokers (HR: 0.98, 95% CI: 0.60-1.61). Additionally, CVD was associated with lung cancer risk across each genetic risk level (P_{heterogeneity} = 0.336). In the second analysis, 32,974 incident CVD cases were recorded. Compared with those without lung cancer, the HRs (95% CI) for CVD were 2.33 (1.29-4.21) in NSCLC, 3.66 (1.65-8.14) in LUAD, and 1.98 (0.64-6.14) in LUSC. In particular, participants with lung cancer had a high risk of incident CVD in high genetic risk level (HR: 3.79, 95% CI: 1.57-9.13). No causal relations between these conditions were observed in MR analysis.

CONCLUSIONS: CVD is associated with an increased risk of NSCLC including LUSC and LUAD. NSCLC, particularly LUAD, is associated with a higher CVD risk. Awareness of this bidirectional association may improve prevention and treatment strategies for both diseases. Future clinical demands will require a greater focus on cardiac oncology.

PMID:37703998 | DOI:10.1016/j.jtho.2023.09.004

Transplant Cell Ther. 2023 Sep 11:S2666-6367(23)01515-4. doi: 10.1016/j.jtct.2023.09.001. Online ahead of print.

ABSTRACT

INTRODUCTION: Extracorporeal photopheresis (ECP) has shown efficacy in graft-versus-host disease (GVHD). We aim to summarize eight years of real-world experience with off-line ECP in our institution, in order to validate this treatment schedule and analyze predictive factors.

MATERIALS AND METHODS: All consecutive adult patients with steroid-dependent or steroidrefractory GVHD receiving off-line ECP were included in this single center, retrospective study. ECP was performed with Spectra Optia®, processing one total blood volume, with a frequency of twice a week for acute GVHD and once a week for chronic GVHD, and tapered individually according to clinical response. Cumulative incidence of response, including complete responses (CR) and partial responses (PR), were compared among patients grouped by different baseline, apheresis and disease characteristics.

RESULTS: Between January 2015 and May 2022, 1382 ECP procedures were proposed for 82 patients. No incidents were reported in 97% of sessions. GVHD responded in 78% of patients (acute GVHD 57% CR and 4% PR, chronic GVHD 39% CR and 48% PR). Overall survival was statistically longer for acute GVHD patients responding to ECP than for those who did not (67.5% vs. 26% at one year, respectively; P = 0.037). Severity was an independent predictor of response in acute GVHD whereas the absence of mouth involvement and lower lymphocyte counts in the apheresis product correlated with a higher response in chronic GVHD.

DISCUSSION: This treatment schedule is effective for GVHD. Further investigation is required to identify ECP-specific predictive factors, as findings are not homogeneous among different studies.

PMID:37703997 | DOI:10.1016/j.jtct.2023.09.001

Gene. 2023 Sep 11:147794. doi: 10.1016/j.gene.2023.147794. Online ahead of print.

ABSTRACT

BACKGROUND: A few studies have reported that allergic rhinitis (AR) pathogenesis is related to genetic factors. And the most important genetic factor is single nucleotide polymorphism (SNP). The study aimed to investigate the effects of LINC00299 SNPs (rs891058, rs13395467 and rs13398375) on AR risk in the Chinese Han population.

METHODS: Independent sample t-test was carried out for statistical analyses of the distribution of age and BMI in AR cases and healthy controls, and χ² test was used for statistical analyses of gender and different regions. The Agena MassARRAY platform was applied for LINC00299 SNP genotyping. Further, the association between SNPs and AR risk was evaluated by odds ratios (ORs) as well as 95% confidence intervals (CIs).

RESULTS: Our study found that LINC00299 rs891058, rs13395467, and rs13398375 were associated with a decreased risk of AR in the Chinese Han population. More precisely, rs891058 and rs13398375 were associated with a reduced risk of AR in subjects aged ≤ 43 years. In males, subjects with BMI ≤ 24 kg/m², and from loess hills region, rs891058, rs13395467, and rs13398375 played a protective role against AR. The study on SNP-SNP interactions suggested that rs891058, rs13395467 and rs13398375 were related.

CONCLUSIONS: LINC00299 polymorphisms rs891058, rs13395467, and rs13398375 are associated with a reduced risk of AR in the Chinese Han population, and these SNPs can be used as potential targets to assess AR risk.

PMID:37703954 | DOI:10.1016/j.gene.2023.147794

Neuroimage Clin. 2023 Sep 9;40:103507. doi: 10.1016/j.nicl.2023.103507. Online ahead of print.

ABSTRACT

Brain imaging research studies increasingly use “de-facing” software to remove or replace facial imagery before public data sharing. Several works have studied the effects of de-facing software on brain imaging biomarkers by directly comparing automated measurements from unmodified vs de-faced images, but most research brain images are used in analyses of correlations with cognitive measurements or clinical statuses, and the effects of de-facing on these types of imaging-to-cognition correlations has not been measured. In this work, we focused on brain imaging measures of amyloid (A), tau (T), neurodegeneration (N), and vascular (V) measures used in Alzheimer’s Disease (AD) research. We created a retrospective sample of participants from three age- and sex-matched clinical groups (cognitively unimpaired, mild cognitive impairment, and AD dementia, and we performed region- and voxel-wise analyses of: hippocampal volume (N), white matter hyperintensity volume (V), amyloid PET (A), and tau PET (T) measures, each from multiple software pipelines, on their ability to separate cognitively defined groups and their degrees of correlation with age and Clinical Dementia Rating (CDR)-Sum of Boxes (CDR-SB). We performed each of these analyses twice: once with unmodified images and once with images de-faced with leading de-facing software mri_reface, and we directly compared the findings and their statistical strengths between the original vs. the de-faced images. Analyses with original and with de-faced images had very high agreement. There were no significant differences between any voxel-wise comparisons. Among region-wise comparisons, only three out of 55 correlations were significantly different between original and de-faced images, and these were not significant after correction for multiple comparisons. Overall, the statistical power of the imaging data for AD biomarkers was almost identical between unmodified and de-faced images, and their analyses results were extremely consistent.

PMID:37703605 | DOI:10.1016/j.nicl.2023.103507

Knee. 2023 Sep 11;44:253-261. doi: 10.1016/j.knee.2023.08.018. Online ahead of print.

ABSTRACT

BACKGROUND: Patient satisfaction following primary total knee arthroplasty (TKA) is a crucial part to evaluate the success of the procedure. The purpose of this study was to develop to predict patient satisfaction following TKA.

METHODS: Satisfaction outcome data after 435 consecutive conventional TKAs performed between August 2020 and December 2021 were retrospectively collected. The total 26 input data were collected. The most favorable algorithm was first found using logistic regression (LR) and machine learning (ML) algorithms. To evaluate the predictive performance of the models, both area under curve (AUC) and F1-score were used as the primary metrics. The shapley additive explanations (SHAP) feature explanation in XGBoost and LR analysis were performed to interpret the model.

RESULTS: The performance of extreme gradient boosting classifier (XGBoost) was only higher than that of conventional LR in AUC (0.782 vs. 0.689). Comparing the F-1 score, only XGBoost showed better performance than LR (0.857 vs. 0.800). The most predictive feature in XGBoost was Short Form-36 physical and mental component summary scores (SF-36 MCS), followed by Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain, Bone mineral density (BMD). In the LR analysis, lumbar spine disease, WOMAC pain, and BMD were statistically significant.

CONCLUSION: XGboost showed the best performance and was superior to conventional LR in the prediction of patient satisfaction after TKA. The SF-36 MCS was the most important feature in the ML model. WOMAC pain and BMD were meaningful variables and demonstrated a linear relationship with satisfaction in both the LR and ML models.

LEVEL OF EVIDENCE: Retrospective cohort study; Level of evidence 3.

PMID:37703604 | DOI:10.1016/j.knee.2023.08.018

J Plast Reconstr Aesthet Surg. 2023 Aug 19;86:58-64. doi: 10.1016/j.bjps.2023.08.011. Online ahead of print.

ABSTRACT

BACKGROUND: To enhance the success rate of alveolar bone grafting, it is crucial to identify the factors that may influence the postoperative bone formation. This study aimed to investigate the impact of various osseous structure characteristics of alveolar clefts on the survival ratio of autogenous cancellous bone particle grafts.

METHODS: A retrospective study was conducted on 60 patients who underwent surgery performed by the same surgeon between 2016 and 2022. Two researchers measured and recorded the bone defect volume (DV), postoperative bone formation volume at 1 year, contact area between the graft and the bone surface within the cleft (S), cleft width (CW), osseous occlusion relationships, and presence of a cleft palate and initial bone bridge within the cleft for each patient. Pearson correlation analysis, Spearman’s correlation analysis, and multiple linear regression analysis were performed.

RESULTS: The analysis results revealed statistical correlations between DV, CW, ratio of S to DV, cleft palate, initial bone bridge presence, and occlusion relationships with the survival rate. Multiple linear regression analysis showed that initial bone bridge and occlusion relationships affected the graft survival rate.

CONCLUSIONS: Based on the presence of initial bone bridges and occlusions, we can make a rough estimate of the postoperative bone formation outcome in patients. However, the underlying mechanisms by which these two factors influence the bone formation require further investigation. In addition, preoperative orthodontic treatment to improve occlusal relationships may improve the postoperative bone formation outcomes in alveolar bone grafting.

PMID:37703598 | DOI:10.1016/j.bjps.2023.08.011

J Stroke Cerebrovasc Dis. 2023 Sep 11;32(10):107302. doi: 10.1016/j.jstrokecerebrovasdis.2023.107302. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aimed to analyze the factors affecting the long-term quality of life of patients with mild stroke and evaluate the differences according to age and sex.

MATERIALS AND METHODS: The Korean Stroke Cohort for functioning and rehabilitation data was used, and patients with mild stroke with a National Institute of Health Stroke Scale score of < 5 were included. Quality of life after 6 months was analyzed using EuroQol-5 dimensions. Demographic and clinical characteristics were evaluated, and factors affecting the quality of life at 6 months were analyzed.

RESULTS: Age, current drinking, marital status, length of stay, and modified Rankin Scale, Fugl-Meyer assessment, Functional Independence Measure, and Geriatric Depression Scale scores affected the quality of life at 6 months in patients with mild stroke. Fugl-Meyer assessment score was a predictor for those aged < 65 years, while the functional ambulatory category was a predictor for those aged ≥ 65 years. Predictors of quality of life, excluding alcohol consumption, were comparable between male and female.

CONCLUSIONS: Among patients aged <65 years, individuals who consumed alcohol, and those who showed better motor function and fewer comorbidities had a higher quality of life. Among patients aged ≥65 years, quality of life was higher in males, younger age, married individuals, those with diabetes, and those with a better walking ability. Among male, individuals who consumed alcohol had a higher quality of life. Rehabilitation treatment should prioritize improving modifiable factors to enhance the quality of life in patients with mild stroke.

PMID:37703592 | DOI:10.1016/j.jstrokecerebrovasdis.2023.107302

Bol Med Hosp Infant Mex. 2023;80(4):242-246. doi: 10.24875/BMHIM.23000032.

ABSTRACT

BACKGROUND: Arterial oxygen saturation (S_aO₂) values are used to make clinical decisions that might change a patient’s prognosis, and it has been proposed as the fifth vital sign. This study aimed to determine the variation of S_aO₂ at different altitudes above sea level (ASL) in healthy Mexican full-term newborns.

METHODS: From July 2018 to June 2019, a cross-over study was conducted in six hospitals at different altitudes ASL in Mexico. S_aO₂ was measured in 4015 newborns after the first 24 h of birth and before leaving the hospital using pulse oximetry. We analyzed three groups: < 250 m ASL (group 1), 1500 m ASL (group 2), and 2250 m ASL (group 3).

RESULTS: The mean S_aO₂ was 97.6 ± 1.8%. For group 1, mean oxygen saturation was 98.2 ± 1.9%; for group 2, 96.7 ± 1.9%, and for group 3, 96.0 ± 2.1%. A statistically significant difference was observed among the groups (p < 0.001), and this difference was higher between groups 1 and 2 (1.5%, p < 0.001). Linear regression analysis showed a decrease in oxygen saturation of 1.01% for every 1000 m ASL.

CONCLUSIONS: We demonstrated a statistically significant reduction in S_aO₂ levels at higher altitudes. This observation can be relevant for clinical decision-making based on pulse oximetry such as critical congenital heart disease screening in Mexico, where more than half of the population lives above 1500 m ASL.

PMID:37703553 | DOI:10.24875/BMHIM.23000032